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Paper Presented at the 3rd International Nursing Conference "Empowerment and Health: An Agenda for Nurses in the 21st Century" held in Brunei Darussalam on 1-4 November 1998; by Prof Dr Omar Hasan Kasule, Sr. MB ChB, MPH, DrPH (Harvard), Deputy Dean for Research and Post-graduate Affairs, Faculty of Medicine, International Islamic University, Malaysia. Fax 603 757 7970
Abstract
The paper reviews the historical development of professional nursing from its informal beginnings in the family and community through its acceptance as a supportive profession in the 19th century to its present status of an independent profession that is growing and is developing specializations. The following trends in nursing in the 21st century are extrapolated from the historical review: increasing professionalization and specialization, wider use of technology, relative decline of the nurturing & human touch aspects of early nursing, and equal gender representation in the profession. These trends are discussed in the context of the Muslim world that is undergoing rapid technological change and is experiencing tension between the western-driven development and the Islamic intellectual and cultural heritage developed over the past 14 centuries of Muslim history. Three challenges in nursing that are of interest to Muslims have been identified by the paper: (a) Technology: has given the nurse ability to give comfort and care to patients that was not imaginable a few decades ago. It has however created new problems: the caring and nurturing nurse, who in the beginning was an extension of the family-centered parental (maternal & paternal) loving into medical care, has been turned into a technician using sophisticated equipment. This threatens to marginalize the human aspect of nursing. Islam emphasizes the dignity of the human and puts high value on direct human contact and interaction not mediated through technology. (b) Specialization: Increasing specialization in nursing in tandem with technological development is marginalizing the previous holistic nursing role that looked at the patient as a whole human being with needs, feelings and aspirations and not a case of pathological diagnoses and medical procedures. Very water-tight specialization runs counter to the Islamic teachings of an integrated approach to human problems based on the tauhidi paradigm (c) Gender: nursing has traditionally been a female occupation but need not continue so. There is no evidence that males cannot be good nurses. In the context of the Muslim world, the emphasis on equal gender representation in the nursing profession is a crucial issue. The Muslim society is bisexual and not unisexual. It requires that except in cases of unavoidable necessity, dharurat, intimate matters like medical care and nursing should be segregated by gender. This requires that equal numbers of male and female nurses be trained to fully serve the needs of the Muslim community.