History Of Nursing – How Has It Evolved?
Nursing is one of the very few professions that has remained consistently at the heart of society since its inception. Whilst the ages of industrialisation and computerisation have transformed – and indeed, removed – various vocations, the history of nursing has seen nurses become only more vital in the fabric of a fully-functioning human civilisation. This makes the history of nursing a fascinating topic to study.
The origins of nursing
Nursing has always been at the centre of humanity, with people tending to others and caring for the sick and vulnerable. However, it wasn’t until the height of the Roman Empire – around 300 A.D. when it was officially recognised as a profession. During this period, imperial forces decided to establish a hospital within every town under its rule, and hired nurses in each of these institutions to support doctors.
This developed throughout the Byzantine era, and nurses became known as ‘hypourgoi’. The hospitals carried out a number of roles, including housing lepers, refugees and injured citizens. Due to the huge demand for services and lack of stratified hierarchies, nurses’ roles were complex, involving a wide range of responsibilities.
500-600 CE: Nursing and the church
Beginning around 500 to 600 CE, medical care in Europe came under the dominion of the Catholic church. Hospitals were instructed to care for the sick, regardless of their nation of origin or religious affinity. This was successful for a few hundred years before the institutions began to decay around 800. In Spain, Emperor Charlemagne decided to restore the hospitals with the latest medical equipment and ordered that each cathedral and monastery in Europe should contain a hospital. This significantly increased the number of nurses across the continent.
This continued throughout the 10th and 11th centuries, with nurses providing patients with any form of care they required or requested – even if it was not necessarily within the bounds of medical services. The model spread throughout Europe and came to be seen as a standard to which nurses should treat their patients. It also became customary during this time for nurses to travel to neighbouring towns to make house calls, in a similar way to how community nurses do today.
Mid-1000s: nursing as public service
The mid-1000’s saw a rise in what were known as ‘charitable houses’. These institutions differed significantly from church and monastery hospitals, largely because they served wealthy patients. The richest of the parents were provided with alms and other medicines, which were used in burial preparations, and became highly sought after. This effectively introduced a new era of nursing.
1800s-1900s: Florence Nightingale
The 1800s saw the age of one of the most influential figures in modern nursing: Florence Nightingale. As most nurses will know, Florence Nightingale began her career as a nurse in the Crimean war, treating soldiers in battle during the 1850s. At this time, nursing was becoming increasingly vital due to the need for treatment for soldiers on the front line.
Then, deaths from injuries gained in warfare were rife because of the low hygiene standards that caused infections. Realising this to be the case, Nightingale requested aid from the British government to create better hygiene standards in the battlefield and the hospital, causing deaths from infections to plummet rapidly. The entirety of Nightingale’s impactful career was spent campaigning for sanitary patient conditions – principles which heavily inform the foundations of modern nursing.
In 1860, Nightingale solidified her legacy by opening the first ever nursing school in London – the Florence Nightingale School for Nurses. For the first time, nurses were able to be trained in standardised care procedures, beginning the process of regulating healthcare around the world.
WWI and the nursing boom
1887 saw the foundation of the British Nurses Association, a union of nurses who sought professional registration. This started a movement in making the nursing profession more officially recognised and regulated. In 1908, the first National Council of Trained Nurses of Great Britain and Ireland was held in London.
The demand for nurses rose yet again during the First World War. At the time it began, the number of nurses in the UK was low, with an estimated 2,200 members enrolled in Queen Alexandra’s Nursing Service. The huge need for medical care created a resurgence in nursing in the mid-1900s, increasing enrolment to well over 10,000 by the conclusion of the war. Later, in 1916, the Royal College of Nursing was founded with an initial 34 members. In 1919, the Nurses’ Act created the first official register through the General Nursing Council.
This pattern was mirrored in the U.S., where the government invested millions of dollars in the healthcare industry.
Late 20th century: expanding roles for nurses
In the late 20th century, a growing number of schools began to offer nurse training courses, allowing individuals to qualify as licensed and registered nurses or progress to Masters and Doctorate nursing degrees from 1950 to 1970. The technological age served as a catalyst for this process, with significant developments in research and capability expanding the role of nurses.
This period was also important for opening up the sector to more demographics, with male nurses being allowed to join the professional register in 1951.
The healthcare industry was changed forever in 1948, when the National Health Service was founded, offering free treatment for all patients in the UK at the point of care.
In 1972, the Briggs Committee suggested that all nurses should be prepared through degree study with research-based practice, forging the path for modern nursing education. This era also saw the American Nurses’ Association publishing the first ever American Journal of Nursing, enabling nurses and other healthcare professionals to stay on the pulse with the latest research in the field. Today, this sector has expanded and diversified, with thousands of nurses checking nursing blogs regularly for the latest news.
In the 20th century, nurse jobs expanded. Various areas were introduced which nurses could specialise in, including paediatrics, mental health nursing and surgical nursing. Nurses also became more independent, so that, rather than merely assisting doctors, they became able to diagnose, treat and, in 2002, prescribe to patients themselves.
In 2004, the Royal College of Nurses voted for degree-only preparation for nurses, and in 2009, all nurses in the UK became degree level certified.
Much has changed over the history of nursing, but one thing has remained certain: this challenging yet rewarding career is one of the most important in the world.
To find out more about the history of nursing, check out the RCN’s History of Nursing guide. Or, to keep up-to-date with the latest developments in the sector, and to continue to make nursing history, download the Nursco App or contact us on 020 3954 1917.