Instruccion de enfermeros (Instructions for nurses): a precursor to modern nursing?

Aims and focus of the research: Instruccion de Enfermeros is a Spanish nursing treatise that was first published in 1617. This treatise was used as an instructional guide for (presumed) novice and trainee nurses and outlined foundational nursing concepts and care. Significantly, the treatise: included rationales which were (then) scientifically-based; was peer-reviewed; and was endorsed by Spanish royalty. Five editions of the treatise were published over a period of 111 years. The aims of this study are: • To describe the bibliographical detail of the five editions of Instruccion de Enfermeros; • To present a brief insight to the context of the text; and, • To provide an overview of the key concepts of nursing care described in Instruccion de Enfermeros. Method: The first stage of the analysis was performed by using historical method to describe the bibliographical details of the five editions of Instruccion de Enfermeros. The second stage of the analysis involved the identification of the key concepts described in Instruccion de Enfermeros. This was accomplished by performing inductive coding on an English translation of the second edition of the text. Sources: Digitised copies of Instruccion de Enfermeros and an English translation of the second edition were used for analysis. Results: Instruccion de Enfermeros had five editions published over more than a century. The main bibliographical details for the five editions of the book are listed in Table 1.The information presented in Instruccion de Enfermeros is similar to the structural organisation of today's fundamental nursing texts. The nursing interventions included in the treatise are organised under six pillars of instruction: medication administration, provision of hygienic cares, assisting with elimination, managing nutrition and fluid status, clinical skills and procedures, and other duties. Each nursing intervention is presented using a logical formula of Who, What, When, Where, How, Why and What if? The rationales for each descriptor of care are underpinned by anatomy and physiology, humoralism and clinical reasoning. Non-technical skills such as clinical judgement, communication, advocacy, prioritisation, problem-solving, reflection and critical thinking are also found in the descriptors