Nursing in the Middle East
The historical context of nursing in the Middle East predates the era of Florence Nightingale. The first Muslim nurse was Rufaidah Al-Asalmiya, who lived during the time of the Prophet Mohammad (peace be upon him) in the 8th century (CE). Like Nightingale, Rufaidah set up a training school for nurses, developed the first code of conduct and ethics, and was a promoter of community health. She cared for patients in a tent erected outside the Prophets’ (peace be upon him) mosque and led nurses in caring for the wounded during the time of the Holy Wars. The history of Rufaidah and other nurses at this time is recorded in the Sunnah (the record of the traditions, sayings and actions of the Prophet (peace be upon him). The recognition of Rufaidah as the first Muslim nurse and role model is a very recent phenomenon as Saudi nurses looked to their religion and history to place the nursing role within their religious framework (Lovering 1996) and has positively impacted on the acceptance of nursing as a profession for women in the Middle East.
Society views nurses in the Middle East as having a low status and compromised moral standing. Low status relates to low academic achievement, ill-defined roles, mixing of genders in the workplace, the confusion of multiple levels of entry into practice and dominance of the medical profession over nursing education, practice and management.
The Arab Muslim nursing community has expressed concerns that their nursing education and practice derives from the Western nursing perspective, which are not always congruent with the cultural and religious beliefs of Arab Muslim nurses or their patients. There have been recent calls for a nursing model based on Arab cultural values and Islamic health beliefs applicable to Muslim nurses and patients in Arab and Islamic societies to provide direction for nurse education and provision of care to Muslim patients, whether in Arab cultures, Islamic societies or with immigrant Arab Muslim populations. In addition, a nursing model can provide the basis for a nursing identity that is congruent within the Arab Muslim culture and a beginning point for improving the moral status and image of nursing in the Arab world.
The COCM© is based on the values and beliefs of Arab Muslim nurses in caring for their Arab Muslim patients. Dr Sandy Lovering co-created the original ‘model’ diagram with Arab Muslim nurses as representative of their caring model (Lovering, 2008). The COCM© Model Development Group at KFSH&RC (Gen Org) – Jeddah took the original diagram and asked “How do you use this model to guide the care of Arab Muslim patients”, regardless of whether you are Arab Muslim, or of another cultural or religious background. Through this process, the COCM© has become a nursing model for application with Arab Muslim populations in other settings. Through using the model, nurses in the Middle East have found a nursing model that reflects their cultural and spiritual values and ‘fits’ their patient population.