Ch. 1: The Evolution of Professional Nursing
Early Civilization: India
3000-1500 BC, earliest cultures were Hindu. The sacred book of Brahmanism (Hinduism) the Vedas was used to guide health care practices. The Vedas considered by some to be the oldest written material, emphasized hygiene and prevention of sickness and described major and minor surgeries. The importance of prenatal care to mother and infant was well understood Public hospital were constructed from 274-236BC and were staffed by male nurses with qualifications and duties to those of a practical nurse.
Mary Seacole
A Jamaican nurse who learned the art of caring and healing from her mother. In her native land of Jamaica, British West Indies, she was nicknamed "Doctress" because of her administration of care to the sick in a lodging house in Kingston. Learned of the Crimean War and wrote to the British government reception to join Nightingale's group of nurses. But was denied, because she was black. Had previously served a nurse in Cuba and Panama during the Yellow Fever and cholera epidemics. She conducted forensic studies on an infant who died of cholera in Panama. She sailed to England at her own expense, provided a letter of introduction to Nightingale, which was blocked bc she was black. Purchased her own supplies and traveled more than 3000miles to the Crimea, built a lodging house. Long after the war, British government honored her with a medal in recognition of her efforts and services he provided.
Early Civilization: Rome
A military dictatorship, adapted medical practices from the countries they conquered and the physicians they enslaved. At the end of the Dark ages, there were a series of holy wars, including the crusades. First military hospital in Europe was established here. Military nursing orders that were made up exclusively of men were developed. Very well organized and dedicated, and wore suits of armor for protection with an emblem of a red cross. Practice advanced hygiene and sanitation and emphasized bathing.
Early Civilization: Egypt
Are noted in their accomplishments in health care at an early period in civilization. Were the first to use the concept of suturing in repairing wounds. Also the first to be recorded as developing community planning that resulted in a decrease in public health problems. One of the main early public health problems was the speed of disease through contaminated water sources. Specific laws on cleanliness, food use, prevention, drinking, exercise, and sexual relations were developed. Health benefits determined preventive measures taken and personal health behaviors practiced. Were usually carried out to accommodate the gods. Some were also practiced expressly to appease the spirits of the dead. Developed the calendar and writing, which initiated recorded history. The oldest record dated back to the 16th century BC in Egypt. A pharmacopoeia that classified more than 7-- drugs was written to assist in the care and management of disease. Shiphrah and puah, the midwife who saved the baby Moses, were used by kings and other aristocrats to deliver babies and care for the younger, older, and those who were sick.
Nursing in the US: World War II (1940 to 1945)
Entered WWII after the bombing of Pearl Harbor in December 1941. At this time nursing divisions of all of the military branches had inadequate numbers of nurses. Congress passed legislation to provide needed funds to expand nursing education. A committee of 6 national nursing organizations called the National Nursing Council received 1mill dollars to accomplish the needed expansion. U.S. Public Health Service became the administrator of the funds, which further strengthened the tie between the US public service and nursing. The war was considered a global conflict, and nursing became an essential part of the military advance. Nurses were required to function under combat conditions and had to adapt nursing care to meet the challenges of different climates, facilities, and supplies. As a result of their service, nurses were finally recognized as an integral part of the military and attained the ranks of officers in the army and navy. Colonel Julie O Flikke was the first army nurse to be promoted to colonel in the U.S. army and served as Superintendent of the Army Nurse Corps from 1937-1942.
The Middle Ages (476BC to 1450 AD)
Followed the demise of the Roman Empire. Women began to using herbs and new methods of healing. Men continued to use purging, leeching, and mercury. This period also saw the Roman Catholic Church become a central figure in the organization and management of health care. Most of the changes in HC were based on the church's emphasis on charity and the sanctity of human life. Wives of emperors and other women considered to be noble became nurses. They devoted themselves to caring for the sick, often carrying a basket of food and medicine as they journeyed from house to house. Widows and unmarried women became nuns and deaconesses. Dorcas and Phoebe mention in the bible for the care they provided to the sick. Physicians spent most of their time translating medical essays, and provided little actual medical care. Poorly trained barbers, who lacked any formal medical education performed surgery and medial treatments that were considered bloody or messy. During the crusades military nursing orders, known as Templars and Hospitalers, were founded. Monks and Christian knight provided nursing care and defended the hospitals during battle, wearing a suit of armor under their religious habits. The habits are distinguished by the Maltese cross to identify the monks and knights as Christian warriors. The same cross was used years later on a badge designated for the first school of nursing and became a forerunner for the design of nursing pins.
The Renaissance and the Reformation Period
Following the Middle Ages. Also known as the rebirth of Europe. Major advancements were made in pharmacology, chemistry, and medical knowledge, including anatomy, physiology, and surgery. During, new emphasis was given to medical education, but nursing education was practically nonexistent. The reformation, began in Germany in 1517, was a religious movement that resulted in a dissention between Roman Catholics and Protestants. Women were encouraged toward toward charitable services, but their main duties included bearing and caring for children in their homes. Hospitals were no longer appealing to women of high economic status, and individuals who worked as nurses in hospital were often female prisoners, prostitutes, and alcoholics. Nursing was no longer the respected profession it had once been. Period is referred to as the "Dark Ages" of NURSING. Out of great concern for social welfare, several nursing groups such as the Order of the Visitation of St. Mary, St. Vincent de Paul, and the Sisters of Charity were organized to give time, service, and money to the poor and sick. The Sisters of Charity recruited intelligent young women for training in nursing, developed educational programs, and cared for abandoned children.
Early Civilization: Palestine
From 1400-1200BC, the Hebrews migrated from the Arabian Desert and gradually settled in Palestine where they became an agricultural society. Under leadership of Moses, Hebrews developed a system of laws called the Mosaic Code, one of the first organized methods of disease control and prevention, contained public health laws that dictated person, family and public hygiene.
Early Civilization: Greece
From 1500-100 BC, Philosophers sought to understand man and his relationship with the gods, nature, and other men. Believed that the gods and goddess of Greek mythology controlled health and illness. Temples built to honor Aesculapius, the god of medicine, were designated to care for the sick. Aesculapius carried a staff that was intertwined with serpents, representing wisdom and immortality. The staff was thought to be the model of today's medical caduceus. Hippocrates considered the "Father of Medicine" paved the way in establishing scientific knowledge in medicine. He was the first attribute disease to natural causes rather than supernatural causes and curses of the gods. His teachings also emphasized the patient-centered approach and use of the scientific method for solving problems.
Nursing in the US: 1900 to World War I
In 1900s states began to require nurses to become registered before entering practice. The army and Navy Nurse Corps was created in 1901 an 1908, an estimated 30,000 nurses served in WWI Lillian Wald- was a pioneer in public health nursing, and best known for the development and establishment of the first viable practice for public health nurses. The main location of this practice was the Henry Street Settlement House in the lower east side of NYC. Its purpose was to provide well-baby care, health education, disease prevention, and treatment of patients with minor illnesses. Nursing practice based her formed the basis of public health nursing for the entire country. Instead of relying o patients visiting the clinic, nurses made their way to the various tenement located around Henry Street. She also developed the first nursing service for occupational health. Believed that prevention of disease among workers would improve productivity and was able to convince the Metropolitan Life Insurance Company that her ideas had merit. As a result, nursing agencies provided skilled nursing services to employees. The sliding fee scale also emerged-patients are billed according to their income or their ability to pay. In 1911, Wald chaired a committee formed by members of the Associated alumnae of training Schools for Nurses now known as the ANA, and the Society of superintendents of Training schools for Nurses, the precursor for the NLN.
Nursing in the US: The Civil War Period (1861-1865)
Numerous epidemics plagued the country, including syphilis, gonorrhea, malaria, smallpox, and typhoid. Initiated the attack on Fort Sumter, SC April 7, 1861. men and women volunteered to care for the wounded. Hospitals were set up in the field, and transports were put in place to carry the wounded to hospitals. Secretary of War Simon Cameron appointed a school teacher named Dorothea Dix to organize military hospitals and provide medical supplies to the Union Army Soldiers. Women providing nursing care during, worked under very primitive conditions. Maintaining sanitary conditions was an overwhelming challenge and often not possible. Greater than 6million patients were admitted to hospitals. 3 black nurses made particularly important contributions to nursing efforts during: Harriet Tubman, cared for the sick as a nurse in the Sea Islands off the coast of SC and later underground railroad. She was first woman to lead American troops into battle. Sojourner Truth known for her abolitionist and nursing efforts was an advocate of clean and sanitary conditions. Susie King Taylor hired to work in the laundry, served as a nurse bc of the growing number of wounded who needed care. Learned to read and write, she taught many of her comrades in Company E to as well. Others were: Clara Barton- served o the front line during the Civil War, operated a war relief program to provide supplies to the battlefields and hospitals. Also set up a postwar service to find missing soldiers and is credited with founding the American Red Cross. Louisa May Alcott-Served as a nurse for 6 weeks until stopped by ill health authored detailed accounts of the experiences encountered by nurses during the war for a newspaper publication titled Hospital Sketches. The war had proven the need for more nurses to be formerly trained, the number of training schools increased. These early nursing programs offered little or no classroom education, and on-the-job training occurred in the hospital wards. John D Rockefeller funded the establishment of the first school of nursing for black women at the Atlanta Baptist Seminary-now known as Spelman College.
Nursing in the US: The Great Depression (1930-1940)
Stock market crash in October 1929. During the Depression, many nurses found themselves unemployed because most families could no longer afford private duty nurses. Franklin D. Roosevelt, elected president in 1932. Responded with several innovative and necessary inventions, ushered in the first major social legislation titled the "New Deal"-had several social components that affected the provision of medical care and other services for indigent people across the country. Social Security Act of 1935- set the precedent for the passage of Medicare and Medicaid in 1965. SSA main purpose were to provide: 1. A national old age insurance system 2. federal grants to states for maternal and child welfare services. 3. Vocational rehabilitation services for the handicapped 4. Medical care for crippled children and blind people 5. A plan to strengthen public health services 6. A federal-state unemployment system. Passing of the SSA provided avenues for nursing care, and jobs were created. Public health nursing became the major source of health care for dependent mothers and children, the blind, and crippled. Hospital job opportunities also were created, and the hospital became the usual employment setting for RNs.
Early Civilization: China
Teachings of scholar Confucius had a powerful effect on the customs and practices of the people. He taught a moral philosophy that addressed one's obligation to society. Several hundred years after his philosophy became the basis for their education and government. Central to his teachings were service to the community and the value of the family as a unit. However women were considered inferior to men. Believed that health and illness was based on the yin and yang philosophy. Yin-feminine forces, negative and passive. Yang- Masculine forces, positive and active. Believed that an imbalance between these two forces would result in illness. Acupuncture Hydrotherapy, massage, and exerciser were used as preventive health measures.
The Colonial American Period
The first hospital and the first medical school in North American were founded in Mexico. The hospital of the Immaculate conception in Mexico City an the medical school at the University of Mexico. During this time American colonies, individuals with infectious diseases were isolated in almshouses or "penthouses." Procedures such as purgatives and bleeding, were widely used, leading to shortened life expectancy. Plagues such as scarlet fever, dysentery, an smallpox caused thousands of deaths. Benjamin Franklin, who was outspoken regarding the care of the sick, insisted that a hospital be built in the colonies. Through his efforts, the fist hospital called Pennsylvania Hospital, was built in the US in Philadelphia in 1751.
Nursing in the US: World War I and the 1920's
The primary site for medical care moved from the home to the hospital, and surgical diagnostic techniques were improved. Pneumonia management was the focus of scientific study. Insulin was discovered in 1922. Alexander Fleming discovered the precursor of penicillin which would eventually be used to successfully treat patients with pneumonia and other infections. With the outbreak of WWI, nurses needed to are for the soldiers who were injured or suffered from many illness that were a result of trench warfare. The war offered nurses a chance to advance into new fields of specialization. Ex: Anesthesiologists first appeared as a part of the surgical teams at the front lines.
Nursing in the US: Post-World War II Period (1945-1950)
Was a time of prosperity for the average American. GI bill enabled returning veterans to complete their interrupted education. The unemployment rate dropped to an all-time low in the US. In an effort to provide more areas o employment for the returning men, the federal gov. mounted a massive campaign to encourage women to return to the more traditional roles of wife and mother. After WWII, the Soviet Union began invading and taking over Eastern European countries. With the support from China, the North Koreans made a grab for South Korea, resulting in the Korean War. Again nurses volunteered for the armed services to provide care to patients near the battlefields in Korea. This time they worked in mobile army surgical hospitals better known as MASH units, where medical and surgical techniques were further refined. Two decades after WWII, saw the emergence of nursing as a true profession. National standards for nursing education were established by the National Accrediting Service. By 1950, all state boards were participating in the test pool. Associate degree programs in community or junior colleges emerged. The end of WWII & early 1950s marked the beginning of significant federal intervention in health care. The Nurse Training Act of 1943 was the first instance of federal funding being used to support nurse training. The passage of the Hill-Burton Act or the Hospital Survey and Construction Act of 1946 marked the largest commitment of federal dollars to health care in the country's history. Purpose as to provide funding to construct hospitals and assist states i planning for other health care facilities based on the needs of the community. Nearly 40% of the hospital constructed in the late 40s, and early 50s, built with the Hill-Burton funds. This boom led to an increased demand for professional nurses. Also in 50's the National Association of Colored Graduate Nurses went out of existence.
Florence Nightingale
Was born in Florene, Italy on may 12, 1820. At 25, she became interested in training as a nurse. in 1851, her family permitted hr to pursue training as a nurse. At 31, she attended a 3-month nursing program at the Institution of Deaconesses at Kaiserswerth, Germany. In 1854, she began training nurses at the Harley Street Nursing Home and served as superintendent of nurses at King's College Hospital in London. The outbreak of the Crimean War marked a turning point in her career. In October 1854 Sidney Herbert, British Secretary of War, wrote to Nightingale asking her to lead a group of nurses to the Crimea to work at one of the military hospitals. Accepted, and assembled 38 nurses who were sisters and nuns from various Catholic and Anglican orders. They were assigned to the Barracks Hospital at Scutari. 3000-4000 sick and wounded packed into hospital. No beds, blankets, food, or medicine. Many soldiers had been placed on the floor where lice, maggots, vermin, rodents, and blood covered their bodies. Within a week faced scurvy, starvation, dysentery, and the eruption of more fighting. Nightingale used her own money and Relief Fund, bought supplies; Within 10days, she set up a kitchen for special diets and had rented a house to do laundry. Wives of the soldiers were hired to manage and operate laundry service. Assigned soldiers to make repairs and clean up the buildings. She introduced a system for transcribing physicians' orders, and a procedure to maintain patient records. Is credited with using public health principles and statistical methods to advocate for improved health conditions for British soldiers. Among her most popular books is Notes on Nursing published in 1859. In 1860, she established the first nursing school in England, St. Thomas's Hospital of London. Graduates migrated to US where became supervisors in the first of the hospital based nursing schools: Massachusetts General Hospital in Boston, Bellevue Hospital in New York, and the New Haven Hospital in Connecticut. She is honored as the founder of professional nursing.
Prehistoric Period
was delineated by health practices that were strongly guided by belies of magic, religion, and superstition. individuals who were ill were considered to be cursed by evil spirits and evil gods that entered the human body and caused suffering and death if not cast out. Members of tribes participated in rituals, wore masks, and engaged in demonstrative dances to rid the sick of demonic possession of the body. Sacrifices and offerings, sometimes including human sacrifices, were made to rid the body of evil gods, demons, and spirits. Many tribes used special herbs, roots, vegetables to cast out the "curse" of illness.