clan nursing bolu

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Continous Learning for Adults

with Needs(CLAN)

Prepared by: Nahide Yaman, Sevilay Yıldız

NURSING AS A JOB

LITERATURE SCAN

NATIONAL PROVINCE DIRECTORATE

BOLU – 2008

CLAN – Continuous Learning for Adults with Needs134649-LLP-1-2007-1-IT-GRUNDTVIG-GMP

Grant Agreement 2007-3569/001-001This project has been funded with support from the European Commission.

This publication reflects the views only of the author, and the Commission cannot be held responsible for any use

which may be made of the information contained therein

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NURSING AS A JOB

Since the very early beginning of the history, health has been on of the most

indispensable aspects of life. According to modern public health

conception, preserving the good health before it gets worse isamong the initial targets. That is why the reforms on health

field and the expectations and complaints of the health

personell are getting more and more importance day by day.

Health, for the individuals, is one of the basic needs which is

compulsory, indispensable and preserving the level of its importance throughout the each

periods of life.

A nurse is a female person who ,after getting certain education, takes care of the

sick, gives health service at the clinics and assists to the doctor. Various definition has

been made throughout the history, for example; in the 19th century Florence Nightingale

defined it as “in order to recover the sick from his illness, the act of bettering and

ordering the environment of the sick”. In he 20 th century, Handerson defined it as “a

dynamic power to achieve the sick’s health and independence” The Union of International

Nurse Community approved this definition. In 1980, The Union of American Nurses

defined the nursing as “a profession that offers help” and the act of nursing as “the

diagnosis and the treatment of man’s reactions against the existing and the potentialhealth problems” (http://www.blogcu.com).

Nursing is tough job which involves hard working conditions and which includes

self-commitment, self-sacrifice, patience and tolerance. Nursing, likewise the other

professions, has arisen from social needs, and is very much related to human life. It

involves good skills on cooperation, manuel aptitude and pace, moreover in its core,

there lies respect and love. A nurse, without having any discrimination such as religion,

language, nationality, tries to do her best in order to make the individual, the family and,

the society recover from their illness’. Because of that it is impossible for a person that

lacks love, compassion, discipline and solemnity, to carry out this job. Because, the nurse

gives service to the people that are destitute of health and needing nelp. Form this point

of view, it is obvious that the nurses should be backed up with psychological, social and

financial aspects(http://www.hemsireler.org).

The nursing which has got deep historical roots, had been carried out in Ancient

Egypt, India, Greece and Rome not as much as it is done today. Florance Nightingale who

is the founder of modern nursing, opened the first nursing school in London in 1962. In

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http://www.blogcu.com/

http://www.hemsireler.org/





Turkey, the first nursing courses go back to an institution named “Hilal-i Ahmer Cemiyeti"

(Kızılay) in 1911. The ones who finished these courses, took care of the wounded of

1912-1914 The Balkan Wars and 1st World War. After the foundation of the modern

Turkish republic, the first nursing school was opened in Istanbul which was followed by

the opening of the nursing school in Ankara in 1939. This schools give education as threeyears with the level of a primary school and four years with the level of a high school.

Nowadays, they are health high schools with four year education. Also two year

occupational high schools are available for high school graduates

(http://www.hemsireler.org).

Presentation of Society Service

Nursing, after the doctors, is the oldest health profession. We could analyze the

functions of nursing under four headings.

1st function; is the method of transporting the protective, developer, recovering or

rehabilitating nursing services to the society.

2nd function; the training of the sick, service receivers and health maintenance

personell.

3

rd

function; working as an effective member of health maintenance outfit.

4th function; developing the nursing applications by way of critical thinking and

research.

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Nursing in Turkey

The nursing in Turkey, despite having a great importance

as one of the outfits giving health services, are not

esteemed enough. A nurse is usually considered as the

assistant to a doctor and despite the fact that it is stressed

that health service is achieved only by a well-organized

cooperation, however in practical that is not the case.

Main Problems of Nursing in Turkey

Getting educations with different levels: In our country, there are five levels of

nursing education. They are 4 year college, 2 yer college, open-university, high-school,

and 18 month course after high-school. This variety affects the profession negatively. The

difference at education level are not reflected at the authorization and responsibility at

the workplace. The health high schools which were closed in 1996, were reopened in

2001. The nurse’s request for university education wasn’t taken into consideration.

However, there is no country that satisfies with high school education nowadays.

The Law of Nursing 6283 numbered and 1954 dated Nursing Law doesn’t reply the

needs of the changing roles and responsibilities of the nurses. While some laws inaccordance with the EU laws are putting into practice, a nursing law isn’t planned and

existing laws doesn’t reply the problems of health sector today.

The Employment of Nurses: Some politics named the conversions at the health sector,

have badly influenced the health personell especially the nurses and are still influencing

badly. These politics that are aiming at getting profit from health sector, are bringing an

umemployment problem for the nurses into the light since they are based upon

recovering health service not upon protecting health service. 90% of the total 80.000nurses of our country are working for recovering health service which indeed is the half

of needed nurse number. For instance, if a hospital of 400 beds, even though it is stated

that 400 nurses are needed, generally you could see 150-170 nurses. Under such hard

conditions, nurses are facing the problem of leaving the care activities to some other

people. This situation affects the quality of the job badly and causes some ideas such as

a nurse is someone who acts accordingly by the orders of the doctor.

Seperating into branches: In our country, except for the scholar life, there cannot beseen separating into branches (such as Operation room nurses, intensive care unit

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nurses, oncology nurses etc.) Some nurses who worked for oncology clinics for years can

be transferred to some other sectors.

Sex: the most important sociological characteristic is the sex. There are very few male

nurses in our country. Since nursing as a job has always been attributed to the femalesex, it affects the development of profession badly. Since in an patriarchial society, a

woman is expected to yield to the man, this situation is truly reflected in health sector.

According to the survey which was carried out by Turkish Nurses Association in 2000

and which consists of the nurses, midwives, and health civil servants; it has been

observed that 41,9% of the nurses are content eith their profession whereas 58,1% of

the nurses are discontent with their profession. Some reaons for this discontent are:

1. Deficiency of money,

2. Uncertainty at duties and responsibilities,

3. Having too much risk,

4. Being appointed to some tasks out of profession,

5. Not being able to make an advancement at the profession,

6. Negative approach of the society to the profession,

7. Intensive working conditions,

8. Being accepted as an assisting person,9. Over-working

10. Not being able to work under the wanted branch.

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When making plans on health sector in our country, nurses’ not being represented

enough is seen as one of the reasons of the profession’s not having autonomy.

Nursing is a professional kinda activity. Even though it has achieved its professional

development in the developed countries, it has not been achieved in Turkey enough

because of the reasons above.( http://gazi27.blogcu.com ).

Ataturk, who thought that a modern society is only

achieved by good education for both men and

women, expressed his idea: “It is compulsory that

both men and women must take proper education

on science.” Women got their almost all the rights

under the light of Ataturk’s these ideas. It hasalways been stated that the women of our country

got their rights without struggle. But, this is not the case in health sector. Unfortunately,

the sexual discrimination is still going on in the health sector. Nowadays, there are still

people who are thinking that higher education is not necessary for the nurses. They

believe that nursing doesn’t demand much information and skill. They think that being

lovely, cheerful and self-committed are enough for being a good nurse. As a matter of

fact, in the higher health convention in 20th of October, 2007, the decision on opening

nursing high-schools shows us that this idea is still on.As of summarizing the development of nursing: the history of nursing starts with

the curing role of woman. But, a modern approach to nursing as a job starts with

Florance Nightingale (1820-1910) who gave health service in Istanbul during the

Crimmean War (1854-56). That is to say, Turkey witnessed the birth of modern nursing.

Turkish Nursed Association organized the room in which Nightingel worked as a museum

in 1954. Florance Nighingale is one of the initiators of Human Rights. According to her,

someone who has got a creative thinking can change the destiny of human being and

shape the future. Dr. Besim Omer Pasa (1962-1940) is founder of modern nursing who

attended the nursing conference in London in 1907 and met Florence Nightingale there.

He, being aware of the fact that nursing is of great significance, trained the “ladies” of

the important families of Istanbul himself. Only after that was it possible for the Muslim

women to attend the Balkan War (1912) and

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http://gazi27.blogcu.com/




Dardanos War (1915-16) and give health service to the wounded.

(http://www.saglikbilgisi.com).

Legal Regulations

Today, all the legal issues are being considered under the 6283 numbered and1954 dated nursing services law. In this law, nursing is defined as a profession that is

acquired by a high school education, is bound to the responsible doctor, and a female

profession as well. This law is quite out of fashion today. In 1992, The Ministry of Health

launched some reforms on health field and prepared a draft on “Nursing and Turkish

Nursing Association” in which it is stated that nursing is a profession that is acquired by

four year college education and suitable for both sexes. This law draft which took a place

in the agenda of the 55th government (12/01/1999) was neglected because of the fact

that the 55th

government was brought down.

Occupational Organizations

The first nursing organization in Turkey was founded by volunteer nurses in 1933

under the name of “Turkish Sick Carers Association”. This association was reorganized in

1943 and the board was replaced by educated nurses and renamed “Turkish Nursing

Association”

Today, what the nurses demand is that they want equality and cooperation with

other health personell such as doctor, pharmacist, physical-therapist and become anautonomous profession. Several factors had roles in professional enlightenment. Some

social, political and financial developments in Europe in the last 25 years, the efforts of

EU, some developments in science and technology left some problems facing the health

sector. The expenses for health service rose quite high and there happened a need for a

cheaper but more qualified health service. In this new approach, the actual health staff

is expected to play the lead. WHO defined the nurses and midwives as the most

important figure in order to give cheaper but qualified health service. Those recent

developments necessitated a change in nursing. Some organizations such as ICN, WHO,Europe Nursing Office, EU Nursing Perpetual Committee played important roles in legal

changes in nursing profession. With the helps of these organizations, some books and

study materials have been prepared for all the national nurses. One of the most

important activity for strengthening the nursing profession is the European Nursing

Conference held in Vienna in 1988. The decisions took in this conference have been

unanimously accepted by the participants. The main decisions are as follows

(http://www.hemsireler.org):

All the educational programmes must be reorganized.

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Nursing education must be reorganized as being a four year college education.

Only the nurses themselves must be responsible for the education of the nurses.

The laws on nursing must be reorganized as leaving the development and

management of the profession to the nurses themselves.

RELATED RESEARCHES

In this section, there are samples of some researches on nursing in Turkey.

Metin and Ozer (2007) in their work named “The Setting out the Level of Nurses’ Being

Exhausted” have set out the level of nurses’ being exhausted in Denizli SSK Hospital. 87

nurses working at Denizli SSK Hospital made up the universe of the research. The

universe has been directly studied without choosing a sample (n=64). The interviews

have been executed between 8th March and 19th March, 2004. The average age was32.45±6.46.

71,8% of the nurses are graduates of two-year degree.

76,6% of the nurses are married.

85,9% of the nurses are having nuclear family.

71,9% of the married ones are having children.

It has been observed that desensitization point average is higher in the ones that

are having nuclear family or having a kid and the average points of desensitization and

being emotionally exhausted are higher in the ones that are thinking of changing theprofession. It has been also observed that as the years pass the level of being emotionally

exhausted decreases.

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Karadağ and his friends have spotted that the nurses that are having an experience of less

than 10 years have got a higher level of desensitization whereas the ones that are working

for more than ten years are more dwelling upon the individual success (2002).

Güneş (2007) has got a MA named the “The Factors that are Effecting the Nurses

Who are working at the University Hospitals”. This research which was fulfilled on 407nurses who are working at the two university hospitals has stated that the nurses that

are working at the daytime and are having day-offs at the weekend have got a higher

degree of professional satisfaction and efficiency. Gunes, stating that in the past, the

satisfaction of the nurses was effected by the number of the sick, regular turns etc.,

states that nowadays things like commitment to the institution, self-development are on

the ground. Güneş says that 60% of the nurses emphasized the commitment to the

institution. He also says that as the level of being educated rises, the expectations follow

a different path. Among the mostly disturbed factors by the nurses are ambiguity onroles, ambiguity on duties and some conflicts between the outfits.

Yildirim and others made a research in 2007 called “the setting up the level of

nurses’ using cognitive strategies for coping with the stress and effecting factors” 150

nurses who are working at Erzincan State Hospital made up the universe of this research

which was held between 1st February and 14th February 2005. In this research, it was

found the as the years pass the level of learned strength rises; the level of education, the

unit to be worked, and the working style have got nothing to the with learned strength. Itwas also founded that the nurses haven’t got the wanted level of learned strength.

Ozaltin and Nehir (2007) did a study on the stress factors for the nurses of the

intensive care unit of the hospitals in Ankara and the way of their coping with that stress.

In this research, it has been seen that most of the nurses are single, between 20 and 30,

and are graduates of four-year degree and MA degree, are dissatisfied with the payment.

In thi study, it has also been seen that the most important factors of stress are taking

care of the most critic sick persons and their relatives. The ones who are working at the

insurance hospital, over 31, married, reluctantly working at the intensive care units,

lacking the necessary eduction, are having more stress than those ones.

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Moreover, they stated that they look for social back up in order to cope with stress. It is

also recommend that some modifications should be put into practises in order to better

the working conditions for the nurses so that this modifications should help them for

coping with the stress. A cooperation with the psychiatry section is also recommended.

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BİBLİOGRAPHY

Arcak, Rojan ve Evin Kasımoğlu.” Diyarbakır Merkezdeki Hastane ve Sağlık Ocaklarında

Çalışan Hemşirelerin Sağlık Hizmetlerindeki Rolü ve İş Memnuniyetleri” Dicle Tıp

Dergisi, Diyarbakır: 2006 Cilt:33, Sayı:1, (23-30)

Güneş, Nuray. “Üniversite Hastanelerinde Çalışan Hemşireleri Etkileyen Etmenlerin

Belirlenmesi” Yayımlanmamış Yüksek Lisans Tezi. Dokuz Eylül Üniversitesi Genel

Cerrahi Ana Bilim Dalı , İzmir: 2007 (Hürriyet 12 Kasım 2007)

Metin Ögür ve Fadime Gök Özer. “Hemşirelerin Tükenmişlik Düzeyinin Belirlenmesi”

Atatürk Üniversitesi Hemşirelik Yüksekokulu Dergisi, Erzurum:2007; 10: 1

Özaltın, Gülten ve Sevgi Nehir. “Ankara İlindeki Hastanelerin Yoğun Bakım

Ünitelerinde Çalışan Hemşirelerin İş Ortamındaki Stres Etkenleri Ve Kullandıkları

Başetme Yöntemlerinin Belirlenmesi” Atatürk Üniversitesi Hemşirelik

Yüksekokulu Dergisi, Erzurum: 2007; 10: 3

Taş, Fatma ve ümran Çevik.” Konya İlindeki Pediatri Hemşirelerin Şiddete Maruz Kalma

Durumları” “ Atatürk Üniversitesi Hemşirelik Yüksekokulu Dergisi Cilt: 9 Sayı: 3

2006

Uğur, Esra ve Süheyla Aban. “Hemşirelerin Iş Yaşamı Kalitesi Ve Etkileyen Faktörlere

Ilişkin Görüşleri” Tıp Bilimleri Dergisi, Ankara: Yıl: 2008 Cilt: 28 Sayı:3

Yıldırım, Arzu; Hacıhasanoğlu, Rabia ve Papatya Karakur. “Hemşirelerin Stresle BaşaÇıkmada Bilişsel Stratejileri Kullanma Düzeylerinin Ve Etkileyen Faktörlerin

Belirlenmesi” Atatürk Üniversitesi Hemşirelik Yüksekokulu Dergisi,

Erzurum:2007; 10: 4

http://www.blogcu.com

http://www.hemsireler.org

http://gazi27.blogcu.com

http://www.saglikbilgisi.com

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