Article: Historical Evolution of Nursing

I. Period of Intuitive Nursing/Medieval Period

• Nursing was “untaught” and instinctive. It was performed of compassion for others, out of the wish to help others.
• Nursing was a function that belonged to women. It was viewed as a natural nurturing job for women. She is expected to take good care of the children, the sick and the aged.
• No caregiving training is evident. It was based on experience and observation.
• Primitive men believed that illness was caused by the invasion of the victim’s body of evil spirits. They believed that the medicine man, Shaman or witch doctor had the power to heal by using white magic, hypnosis, charms, dances, incantation, purgatives, massage, fire, water and herbs as a mean of driving illness from the victim.
• Trephining – drilling a hole in the skull with a rock or stone without anesthesia was a last resort to drive evil spirits from the body of the afflicted.

II. Period of Apprentice Nursing/Middle Ages

• Care was done by crusaders, prisoners, religious orders
• Nursing care was performed without any formal education and by people who were directed by more experienced nurses (on the job training).This kind of nursing was developed by religious orders of the Christian Church.
• Nursing went down to the lowest level

1. wrath/anger of Protestantism confiscated properties of hospitals and schools connected with Roman Catholicism
2. Nurses fled their lives; soon there was shortage of people to care for the sick
3. Hundreds of Hospitals closed, there was no provision for the sick, no one to care for the sick
4. Nursing became the work of the least desirable of women – prostitutes, alcoholics, prisoners

• Pastor Theodore Fliedner and his wife, frederika established the Kaiserswerth Institute for the training of Deaconesses (the 1^st formal training school for nurses) in Germany.
• This was where Florence Nightingale received her 3-month course of stude in nursing.

III. Period of Educated Nursing/Nightingale Era 19^th-20^th century

• The development of nursing during this period was strongly influenced by:

1. trends resulting from wars – Crimean, civil war
2. arousal of social consciousness
3. increased educational opportunities offered to women.

• Florence Nightingale was asked by Sir Sidney Herbert of the British War Department to recruit female nurses to provide care for the sick and injured in the Crimean War.
• In 1860, The Nightingale Training School of Nurses opened at St. Thomas Hospital in London.

1. The school served as a model for other training schools. Its graduates traveled to other countries to manage hospitals and institute nurse-training programs.
2. Nightingale focus vision of nursing Nightingale system was more on developing the profession within hospitals. Nurses should be taught in hospitals associated with medical schools and that the curriculum should include both theory and practice.
3. It was the 1^st school of nursing that provided both theory-based knowledge and clinical skill building.

• Nursing evolved as an art and science
• Formal nursing education and nursing service begun

FACTS ABOUT FLORENCE NIGHTINGALE

• Mother of modern nursing. Lady with the Lamp because of her achievements in improving the standards for the care of war casualties in the Crimean war.
• Born may 12, 1800 in Florence, Italy
• Raised in England in an atmosphere of culture and affluence
• Not contended with the social custom imposed upon her as a Victorian Lady, she developed her self-appointed goal: To change the profile of Nursing
• She compiled notes of her visits to hospitals and her observations of the sanitary facilities, social problems of the places she visited.
• Noted the need for preventive medicine and god nursing
• Advocated for care of those afflicted with diseases caused by lack of hygienic practices
• At age 31, she entered the Deaconesses School at Kaiserswerth inspite of her family’s resistance to her ambitions. She became a nurse over the objections of society and her family.
• Worked as a superintendent for Gentlewomen Hospital, a charity hospital for ill governesses.
• Disapproved the restrictions on admission of patients and considered this unchristian and incompatible with health care
• Upgraded the practice of nursing and made nursing an honorable profession for women.
• Led nurses that took care of the wounded during the Crimean war
• Put down her ideas in 2 published books: Notes on Nursing, What It Is ans What It Is Not and Notes on Hospitals.
• She revolutionized the public’s perception of nursing (not the image of a doctor’s handmaiden) and the method for educating nurses.

IV. Period of Contemporary Nursing/20^th Century

• Licensure of nurses started
• Specialization of Hospital and diagnosis
• Training of Nurses in diploma program
• Development of baccalaureate and advance degree programs
• Scientific and technological development as well as social changes mark this period.

1. Health is perceived as a fundamental human right
2. Nursing involvement in community health
3. Techological advances – disposable supplies and equipments
4. Expanded roles of nurses was developed
5. WHO was established by the United Nations
6. Aerospace Nursing was developed
7. Use of atomic energies for medical diagnosis, treatment
8. Computers were utilized-data collection, teaching, diagnosis, inventory, payrolls, record keeping, billing.
9. Use of sophisticated equipment for diagnosis and therapy.