The Nursing Profession: A Historical Perspective

Nursing today is much different from nursing practices years ago. The nursing profession is expected to continue changing all for the better of nurses and the patients they take care of.

The traditional roles of wife, mother, daughter and sister have always included caring for and nurturing other family members. This has been fact even from the beginning of time as women cared for infants and children. As a result, we can assume that nursing values and characteristics actually began in the home.

Throughout time women have also been called upon to care for others in the community who were ill. The care provided was mostly related to physical maintenance and comfort. This traditional nursing role has always involved humanistic caring, nurturing, comforting, and supporting.

How does religion play into the role of nursing?

It was the Christian value of “love thy neighbor as thyself” and Christ’s parable of the Good Samaritan that had a significant religious impact on the development of Western nursing.

Several wealthy matrons of the Roman Empire converted to Christianity during the third and fourth centuries and used their wealth to provide houses of care and healing (which preceded the hospitals) for the poor, the sick, and the homeless. Women were not the only providers of nursing services even in this very early development of the profession; however, women were probably in the majority.

The Christian Crusades formed several orders of knights that included:

• The Knights of Saint John of Jerusalem (also known as the Knights Hospitalers)
• The Teutonic Knights
• The Knights of Saint Lazarus

These brothers in arms provided nursing care to their sick and injured comrades. They built hospitals in which the organization and management set a standard for the administration of hospitals throughout Europe at that time.

The Knights of Saint Lazarus dedicated themselves to caring for people with:

• Leprosy
• Syphilis
• Chronic skin conditions

In 1836, when Theodore Fliedner reinstituted the Order of Deaconesses, opened a small hospital and training school in Kaiserswerth, Germany where Florence Nightingale received her training in nursing.

Florence Nightingale is considered the founder of modern nursing. She was influential in developing nursing education, practice, and administration. She published “Notes on Nursing: What It Is, and What It Is Not,” first in England 1859 and in the U.S. in 1860. This publication was intended for all women and brought her the recognition of nursing’s first scientist-theorist.

Florence Nightingale foresaw nursing that included public health and health promotion roles for nurses. Her vision was only partially addressed in the early days of nursing. The early focus was more on developing the profession within hospitals.

Ms. Nightingale saw her role in nursing as a spiritual calling from God. She was born into a wealthy family who did not approve of her ambitions of nursing. Her contributions have been well documented. Her greatest achievement was probably in nursing education. She developed the Nightingale Training School for Nurses that opened in 1860 and has served as a model for other training schools. Graduates of these schools traveled to other countries and managed hospitals and institute nurse-training programs.

Religious values have dominated nursing throughout its history. Some of these values include:

• Self-denial
• Spiritual calling
• Devotion to duty
• Hard work

The nurse’s commitment to these values often resulted in exploitation and not much in the way of monetary rewards or professionalism. It was a common belief for many nurses themselves to feel it inappropriate to expect economic gain from their “calling” into the nursing profession.

Days of War for the Nurse

Throughout our history, wars have always created a greater need for nurses. Florence Nightingale addressed a problem of inadequate care given to soldiers during the Crimean War (1854-1856). Nightingale and her nurses transformed the military hospitals by setting up sanitation practices like hand washing and washing clothing regularly. She is also credited for performing miracles. For example, the mortality rate in the Barrack Hospital in Turkey was reduced from 42 to 2 percent.

Other influential female nurses in our history include:

• Harriet Tubman: Known as “The Moses of Her People” for her work with the Underground Railroad during the Civil War
• Sojourner Truth: Abolitionist, Underground Railroad agent, preacher, and women’s rights advocate and a nurse for over 4 years during the Civil War
• Clara Barton: A schoolteacher who volunteered as a nurse during the American Civil War. She organized the nursing services and is noted for her role in establishing the American Red Cross. She persuaded Congress in 1882 to ratify the Treaty of Geneva so that the Red Cross could perform humanitarian efforts in time of peace.
• Lillian Wald: She is considered the founder of public health nursing
• Lavinia L. Dock: She was a feminist, prolific writer, political activist, suffragette and friend of Wald. She participated in protest movements for women’s rights that resulted in the 1920 passage of the 19th Amendment to the U.S. Constitution that granted women the right to vote.
• Margaret Higgins Sanger: She was imprisoned for opening the first birth control information clinic in America and is considered the founder of Planned Parenthood. She had experience with a large number of unwanted pregnancies among the working poor that lead her to be very instrumental in addressing the problem.
• Mary Breckinridge: She established the Frontier Nursing Service (FNS), worked with the American Committee for Devastated France to distribute food, clothing and supplies to rural villages and took care of sick children. When she returned to the United States she and two other nurses began the FNS in Leslie County, Kentucky, and started one of the first midwifery training schools in the U.S.

Source: Fundamentals of Nursing, Concepts, Processes, and Practice, Seventh Edition by Kozier, Erb, Berman, Synder

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© 2007 Connie Limon All Rights Reserved