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History of Nursing 1700s to the 1970s
Posted: 4/5/2016 8:59 AM by
As caretakers of children, family and community, it was natural that women were the nurses, the caregivers, as human society evolved.
The home, in fact, was the center of health care, and for the first two centuries after European exploration of North America, all nursing was home nursing. Even when the nation’s first hospital began in Philadelphia in 1751, it was thought of primarily as an asylum or poorhouse; another century or more would pass before the public viewed hospitals as reputable and safe.
Before the foundation of modern nursing, nuns and the military often provided nursing-like services.
The religious and military roots of modern nursing remain in evidence today in many countries, for example in the United Kingdom, senior female nurses are known as sisters. Nurses execute the "Orders" of other health care professionals in addition to being responsible for their own practice.
The Crimean War was a significant development in nursing history when English nurse Florence Nightingale laid the foundations of professional nursing with the principles summarized in her book
Notes on Nursing
Nightingale's revelation of the abysmal nursing care afforded soldiers in the Crimean War energized reformers. Queen Victoria in 1860 ordered a hospital to be built to train Army nurses and surgeons, the Royal Victoria Hospital.
Modern nursing began in the 19th century in Germany and Britain, and spread worldwide by 1900.
In the mid-19th century nursing was transformed from a domestic duty of caring for members of one’s extended family, to a regular job performed for a cash wage. Nurses were now hired by strangers to care for sick family members at home. These changes were made possible by the realization that expertise mattered more than kinship, as physicians recommended nurses they trusted. By the 1880s home care nursing was the usual career path after graduation from the hospital-based nursing school.
Professionalization was a dominant theme during the Progressive Era, because it valued expertise and hierarchy over volunteering in the name of civic duty. Congress consequently established the Army Nurse Corps in 1901 and the Navy Nurse Corps in 1908. The Red Cross became a quasi-official federal agency in 1905 and its American Red Cross Nursing Service took upon itself primary responsibility for recruiting and assigning nurses.
In World War I Army Nurse Corps personnel received officer-equivalent ranks and wore Army rank insignia on their uniforms. However, they did not receive equivalent pay and were not considered part of the US Army.
The nursing profession was transformed by World War Two. Army and Navy nursing was highly attractive and 30% volunteered for duty—a larger proportion than any other occupation in American society. As the nurses rose in rank they took more control and by 1944 were autonomous of the Red Cross.
The public image of nurses was highly favorable during the war, as represented in Hollywood films such as "Cry 'Havoc'" which made the selfless nurses heroes under enemy fire.
Some nurses were captured by the Japanese, but in practice they were kept out of harm's way, with the great majority stationed on the home front.
President Franklin D. Roosevelt hailed the service of nurses in the war effort in his final "Fireside Chat" of January 6, 1945. Expecting heavy casualties in the invasion of Japan, he called for a compulsory draft of nurses. The casualties never happened and there was never a draft of American nurses.
War continued to impact the profession, with 10,000 nurses volunteering for duty in Vietnam. The Vietnam War witnessed an evolution in trauma and combat casualty care. Progress in medical evacuation made intensive care nursing the standard rather than the exception. Trauma care specialization as well as shock/trauma units developed from this experience. Nurses gained respect not only for their technical skills but also for their independent clinical judgements.
The nursing profession has continued to evolve as technology and changes to the business of healthcare impact patient care. See part 2 for continuation of Nursing history.
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