FUNDAMENTAL NURSING SKILLS

Its always been inculcated in our mind during our freshman year that fundamentals are very important, and i prove that its true when i graduated and took the board exam, there are so many question in the local board exam that pertains to basic and fundamentals of nursing thats is why i would like to share to you this ebook.

In 1859 Florence Nightingale suggested that ‘The elements of nursing are all but unknown’. It could be argued that this statement remains true today: some groups maintain that nursing is about keeping clients clean and well nourished; others that it is about making clients feel safe; others focus purely on the psychological needs of clients; and yet others think that it is about carrying out physical tasks delegated by, but remaining under the auspices of, doctors (Hilton 1997).

In looking back down the well-trodden path it can be seen that over the past 150 years or so nursing has slowly evolved from something that was considered essentially women’s work, which could be undertaken by any ‘good woman’, was largely concerned with caring for the sick, and with providing the best environment for nature to take its course, to being something that is very complex, skilled and sometimes highly technical, involving health education and promotion as well as meeting a wide variety of illness-related needs of clients. It is now an occupation that attracts both men and women whose pay constitutes more than a bottle of gin(Hilton 1997).

Indeed, many now contend that nursing has reached the epitome, that long-strived-for goal of professional recognition (Clay 1987), as it now has an academic, secular training programme, a Code of Professional Conduct (see Appendix I) and its own regulating body, the Nurses and Midwives Council. It is a profession that is clearly distinct from medicine, where registered
nurses are considered autonomous, accountable practitioners who work from a soundly researched knowledge base and whose practice is for the benefit of others.

The majority of changes that have occurred in nursing and other emergent professions allied to medicine, such as physiotherapy and occupational therapy, have occurred as a result of changing health care needs, technological advances and a plethora of new knowledge as well as changes in societal attitudes, values and beliefs and an increasing cultural milieu. We now live in times of continuing change and advancement.

Consequently health care, and therefore nursing, cannot remain a static entity. It must move, develop and evolve in the light of societal changes along with its other related disciplines.

In order to enable effective response, to provide direction to influence health care policy and legislation, to assist in determining further workforce needs, and to inform resource management the Royal College of Nursing (RCN) has recently undertaken a scoping exercise. It defined nursing as ‘the use of clinical judgement and the provision of care to enable people to promote, improve, maintain or recover health or, when death is inevitable, to die peacefully’ (RCN 2003:1). This has come at a time when the current government is seeking to contain costs, destabilize the professions and merge professional boundaries with the ultimate aim of promoting better interprofessional working and, thus, higher standards and more cost-effective but better-quality health care.

As such, a much greater emphasis is being placed on the promotion and maintenance of health and well-being. However, a word of caution: this definition advanced by the RCN, and the assumptions on which it is based, should not be viewed in isolation. As with many of the previous
definitions of nursing offered and indeed the sometimes radical changes in nursing and health care that have taken place in recent years, to date there has been no client involvement in its conception or development.

However, despite presenting a little background to nursing and health care today, it is not the purpose of this text to dwell on definitions of health and illness or to debate the politics of health care, but to provide practical direction in day-to-day clinical experiences. It would therefore
seem prudent to reflect on current practice, part of which is about assessing client care needs.

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