There is no doubt that nursing is one of the most challenging yet rewarding career choices there is. Nurses are incredible human beings who care for people at their greatest time of need; providing medical, physical, and emotional support when people are at their most vulnerable. A great nurse can truly make all the difference to a person’s recovery after illness or injury, but the path to modern nursing has not been smooth, and it has taken a lot of hard work, innovation, and some amazing people throughout history to get this worthy role to the standard it is now at.
Although modern nursing is generally agreed to have begun between 150 and 170 years ago, records show that the Roman Empire did have ‘nurses’ who worked with doctors in the hospitals they opened in each of its towns. Later on, The Byzantine Empire created two hospitals in Constantinople, where male and female nurses known as ‘hypourgoi’ worked.
Although not generally thought of as a time for good hygiene practices, let alone medical advances, the Middle Ages saw the roles of nurses expand. During this time, it was predominantly nuns and monks who were charged with looking after patients, due to hospitals being run by the church. These hospitals began taking in a wider range of people, not just limited to the sick or injured, but also people such as refugees, which meant that the nurses who worked in them developed an ever-increasing range of skills.
The first hospital in Spain was built in the late 1500s in Merida and was, again, mostly run by Catholic nurses, although they were charged with the care of all who needed it, regardless of religion or nationality. Emperor Charlemagne decided that all hospitals in Europe should be attached to a cathedral and monastery, and went about restoring decrepit hospitals, ensuring they were equipped with the most up-to-date equipment.
During the Protestant reformation in Europe, many hospitals were lost due to the monasteries being closed, and nuns being released as nurses. Those that did remain, where Catholicism still existed however, began to take on more tasks which were usually only performed by physicians and surgeons.
The 1800s saw a great amount of progression in the field of nursing across the globe, as you can see on this site. At the start of the century, low-status women were trained by physicians to help them with tasks they found below them. In 1854 however, nursing changed dramatically thanks to two women who reformed the way patients were treated. In 1854, during the Crimean War, Florence Nightingale made dramatic changes to nursing practices while caring for wounded soldiers. The biggest change she made was to drastically improve hygiene, after seeing that the filthy conditions in which the soldiers were housed was the leading cause of death, due to infection. Even after the war, Nightingale continued to advocate for sanitary conditions in hospitals and education of nurses, publishing ‘Notes on Nursing’ in 1859. In 1860, The Nightingale Training School for nurses opened, and nursing became a respected profession. Mary Seacole was also a nurse during this time, developing her own treatment for cholera in 1850, before joining the care for soldiers in the Crimean War, setting up the ‘British Hotel’ to house them, as well as famously riding out to treat soldiers on the battlefield.
In 1863, the Bellevue Hospital opened in New York, and was the first in the USA to base its treatments on Florence Nightingale’s teachings. This paved the way for more hospitals across the US to follow suit and by 1900, there were over 400 hospital-based nursing schools, providing high quality training for nurses.
After the Civil War, in 1865, the American Red Cross was founded by Clara Barton after spending the war both treating the injured, and helping to identify those who were missing or had died. Her work led the way for future disaster relief efforts.
In the 1900s, nursing schools began to be run by hospitals, which allowed those training to take a more hands-on approach. In 1909, The University of Minnesota School for Nurses became the first to award degrees in nursing, requiring high standards of both education and training.
During WW1, both trained and untrained nurses were put to work during the war and were often given the opportunity to progress through the ranks as a reward for their effort. On returning from the war, they were regarded as heroes, and brought back many skills learned in action, leading to more money being put into the healthcare industry.
In 1923, Mary Breckenridge set up the Frontier Nursing Service to provide healthcare services to those who lived in poor, rural areas. At the same time, the Goldman Report was published, stating that nursing should be subject to academic standards, and set in universities – a report which was backed up in 1948 by the Brown Report, although hospital-based training has continued to reign.
In 1950, Texas Women’s University became the first in its state to open a nationally accredited nursing program. In 1952, an associate degree program was introduced by Columbia University, with training split between classes and clinical experience.
In the 1960s and 70s, the number of nursing programs declined and were replaced with degrees. Although the Associate Degree in Nursing was the most popular degree among nurses, in 1982, the National League in Nursing, followed by other organizations, declared that the Bachelor of Science in Nursing (BSN) should be the minimum requirement.
By the end of the 1990s, there had been great leaps made in the education of nurses, areas in which they could specialize in, and journals to help them keep up to date with latest research and treatments.
More emphasis was put on nurses to continue education after numerous studies showed that patient outcomes were considerably better where higher numbers of staff nurses were educated to BSN level. Nursing shortages have so far stopped the BSN from becoming a minimum requirement nationally, although many nursing positions state a preference for this.
In 2020, the WHO and other organizations recognized the work done by nurses around the globe in what was named the ‘Year of the Nurse’ in celebration of Florence Nightingale’s 200th birthday. Hopefully, this gesture made everyone appreciate just how talented and dedicated our nurses are, and how hard they work.