History of Nursing

Trends and Changes

History and Evolution of Nursing

Early HistoryAncient writings in Greece, Rome, Egypt and India refer to persons dedicated to caring for the sick, injured, making herbal remedies, and midwives for new mothers

Nurses are mostly household servants, part of the military or members of religious orders.

12th century the Knights of St. Thomas a group of vowed Englishmen with the purpose of tending to the sick, wounded and burying fallen crusade soldiersPlague DoctorsSeparate occupation from the surgeon-barber and town physician

Hired to care for people inflicted with bubonic plague (black death) and dispose of the bodies

Kept quarantined from the rest of the town and village

Contract for a plague doctor: Pavia, Italy 1479Clause 1. The community of Pavia and its council shall provide the sum of 30 florins per month to Master Giovanni de Ventura.Clause 4. The community of Pavia and its council shall provide Dr. Ventura with an adequate house in an adequate location, completely furnished.Clause 5. The community of Pavia and its council shall continue to pay Master Giovanni Ventura for a period of two months after the termination of his employment.Clause 6. The said Master Giovanni shall not be bound or held under obligation except only in attending the plague patients. Giovanni must treat all patients and visit infected places as it shall be found to be necessary.Clause 9. The said Master Giovanni shall not be able to ask a fee from anyone, unless the plague victim himself or his relatives shall freely offer it.Clause 14. Said Master Giovanni would have and should be obliged to do his best and visit the plague patients twice or three times or more times per day, as it will be found necessary.(http://web.mac.com/mloret/iWeb/apeuro06/Plague%20Doctor.html)The Reformation

Diminished role of nursing care provided by religious orders as convents and monasteries were closed in countries hostile to the Catholic Church (www.angelfire.com/fl/EeirensFaerieTales/NursingDeclineHistory, 2010)

Early application of science in explanation of health and diseaseIllustrations of human anatomy Rudimentary explanations from vivisections

Victorian EraAttending to the ill in poor houses and sanatoriums was done by prostitutes and prisoners

Sairey Gamp (Charles Dickens novel Martin Chuzzlewitt) the unpleasant domestic nurse . (Dickens, 1843)

Mrs. Beeton's Book of Household Management, 1861, places nurses in the chapter domestic servants (www.victorianlondon.org/professionsandtrades, 2010)

Contemporary Events1796: Jenner inoculates people with cow pox to prevent small pox trend towards science of vaccines1858: Publication of Grays Anatomy: Descriptive and Surgical1860s: Louis Pasteur proves broth does not spontaneously spoil without microorganismsBeginning of the germ theory1856-1863: Bro. Gregor Mendel charted genetic patterns in pea plants (work rediscovered in 1930s)1867: Joseph Lister performed surgery using carbolic acid for antiseptic surgery1901: Landsteiner categorized blood types for successful transfusions

Florence NightingaleConsidered the founder of modern nursing, applied statistics, epidemiology, hospital administration and sanitary engineering, plus was a social reformerHighly-educated and from a wealthy familyWent from goodwill hospital visitor to nurseTrained in hospital at Kaiserwerth Germany and with Sisters of Charity in Paris

1860, Opened college level St. Thomas school of nursing in London Wanted nurses to be upper-class and educated women who cared for the sick and wounded for altruistic reasons

(Tomey and Alligood, 2006)

8Nightingales WorkIn 1859, wrote Notes on nursing: What it is and what it is not, the first textbook and nursing theory

A social reformer who petitioned politicians for better conditions for the poor and soldiers, and more career opportunities for women

Organized district nursing in London in partnership with businessman and MP William Rathbone

Nightingale in the Crimean WarWith 38 women volunteers, Nightingale travelled to Turkey in 1854 to help the sick and wounded English soldiers in campsHer statistics proved more soldiers died from preventable infections than from battle injuriesImproved the camps sanitation and lowered the mortality rate from infections 42% to 2%An example of one of her pie charts, she visually depicted more soldiers dying from infections then from battle injuries.

(www.uh.edu/engines/epi1712.htm, 2010)

Her Nursing PracticeThe body heals itself, disease is the bodys way of repairing itself after exposure to poison or decayNurses should be proper women who are single, chaste, and live without alcohol, tobacco and dancingNursing is to create an environment where healing can occurFresh air, clean water, removal of waste, moderate room temperaturesExposure to pollutants perpetuates illnessCreate an atmosphere of rest and protect patient from worry

Her writingsNightingale did not write about human anatomy or microorganisms in her book. She wrote about maintaining a clean and healing environment. The chapters to Notes on Nursing are as follows:

Preface Ventilation and Warming Health of Houses Petty Management Noise Variety Taking Food What Food?

Bed and BeddingLight Cleanliness of Rooms And Walls Personal Cleanliness Chattering Hopes And Advices Observation of the Sick Conclusion Appendix Notes on NursingNotes on Nursing was not a comprehensive guide for trained nurses, but was written to help any women provide better care for sick persons at homeThe following notes are by no means intended as a . . . manual to teach nurses to nurse. They are meant simply to give hints for thought to women who have personal charge of the health of others. Every woman . . . in England has, at one time or another of her life, charge of the personal health of somebody, whether child or invalid,--in other words, every woman is a nurse (Nightingale, Notes on Nursing, Preface, 1859)

Select QuotesAir: The very first canon of nursing, the first and the last thing upon which a nurse's attention must be fixed, the first essential to a patient, without which all the rest you can do for him is as nothing, with which I had almost said you may leave all the rest alone, is this: TO KEEP THE AIR HE BREATHES AS PURE AS THE EXTERNAL AIR, WITHOUT CHILLING HIM.(Nightingale, Notes on Nursing, Ch 1, 1859)Every nurse ought to be careful to wash her hands very frequently during the day. (Nightingale, Notes on Nursing, Ch 11, 1859)

Select Quotes Light: Second only to their need of fresh air is their need of light; that, after a close room, what hurts them most is a dark room. And that it is not only light but direct sun-light they want. (Nightingale, Notes on Nursing, Ch. 9, 1859)

Music: Wind instruments, including the human voice, and stringed instruments, capable of continuous sound, have generally a beneficent effect--while the piano-forte, with such instruments as have no continuity of sound, has just the reverse. The finest piano-forte playing will damage the sick, while an air . . . will sensibly soothe them.(Nightingale, Notes on Nursing, Ch.4, 1859)

Nursing in the Civil War EraNo organized nursing profession prior to the 1860s in the United StatesConfederate and Union armies during the Civil War recruited nurses to treat injured soldiersFirst use of shrapnel to injure multiple people at onceMore people needed to treat the injuredGangrene infectionsCatholic Sisters formed and staffed make-shift tent hospitalsEfficient, clean and devoted to their patientsMen and women volunteersSojourner Truth, Harriet Tubman and Walt WhitmanDorothea Dix (1802-1887)Originally a school teacher who in 1841 became a reformer for treatment of the mentally illWithin 10 years visited >300 jails and >500 almshousesAdvocated for mentally ill persons to be removed from jails/almshouses and be placed in public hospitals

By 1880,