Lecture 9: History of Nursing

• THE WIDOWS AND THE VIRGINS

Two other groups—the Order of Widows and the Order of Virgins—shared many common characteristics with the deaconesses and carried out similar responsibilities. Members of the Order of Widows may never have been married. It seems that the title of widow was used to designate respect for age. Those who were married, however, took vows never to remarry if widowed. The Order of Virgins emphasized virginity as essential to purity of life, and virgins were ranked as equals to the clergy. Because these women often visited the sick in their homes, they are often mentioned along with the deaconesses as being the earliest organized group of public health nurses.

First Canadian Nursing School: 1914

U of T committee on nursing education found that continual physical and mental strain on the students was reducing enrolment and effective training

First Canadian Nursing School: 1892

Victoria General Hospital School of Nursing had two male graduates in their first graduating class. At that time, male nursing students were generally given a higher status in the nursing school with special privileges Ontario's second nursing school (Canada's first Catholic nursing school) founded at Toronto's St. Michael's Hospital School by the Sisters of Saint Joseph

Greek Civilization - (460 BCE - 370 BCE)

• Greek • The beginning of the scientific method is attributed to Hippocrates • Known as the Father of medicine • He dismissed the idea that illnesses were caused by demons, evil spirits and magic • Observation and rational thinking physician's best tools • Use senses to assess • Humane care provided by both men and women • Care provided at temples.. More like spas • Emphasis on good nutrition, exercise, relaxation and rest • Hippocrates believed in prevention and therapy

Nursing in Canada

• For over 350 years, nurses have had a profound effect on the quality of Canadian life • Nurses were fundamental to the development of New France....

Florence Nightingale

• Founder of modern nursing • Born May 12, 1820 Died in 1910 • Said she was called to God's service at the age of seventeen, "to do something toward lifting the load of suffering from the helpless and miserable" • https://www.youtube.com/watch?v=Tgxg5_dU8Dc • Florence received an exceptional education o History, philosophy, science, classical literature, mathematics, languages o She traveled broadly o Visited hospitals during travel o She kept notes on management, hygiene, architecture and design of the hospital wards

Health care ... early times

• Later, as larger groups gathered into tribes, people were chosen as spiritual/healing leaders • Shamans • Belief that humans are an integral part of an ordered system and that illness is the consequence of disharmony (Relates to Newman's theory of nursing)

A time of discovery...

• Microscope • Thermometer • Clock • Asepsis - Joseph Lister (1827 - 1912) developed aseptic technique

Industrial Revolution - 1750 - 1830

• New world order • Time of free thought, individualism, and the beginning of capitalism and democratic forms of government

Protestant Reformation - 1500's

• Protestants revolted again Pope • Catholic institutions were abolished • Hospitals closed and replaced by work houses and alms houses for the poor • Nursing shortage! • Did not have the management and organization of the Catholic Church • Care in new institutions provided by prisoners, pardoned criminals, alcoholics and aged prostitutes

High Middle Ages (1000-1475)

• Small states emerged after wars • Catholic Church became dominant • Medicine declined • Monastatic orders began with strict discipline, obedience and devotion • The Crusades began

18th, early 19th centuries

• The sick and poor were in great numbers— • "change" was needed—the stage was set for those with "social" vision

Early Christian Era

• Women began nursing as an expression of Christianity (acts of mercy) • Women were recognized (first recording in history) as important members of community • Phoebe—considered the first Deaconess and visiting nurse • Fabiola—was a wealthy Christian in Rome and founded the first public hospital in Rome • Fabiola (who later became Saint Fabiola) was a Roman matron of rank of the company of noble Roman women who, under the influence of the Church, gave up all earthly pleasures and devoted themselves to the practice of Christian altruism and to charitable work.

Nursing Education Canada

•1959- Master's degree programs were established (McMaster) •1962- Canadian Nurses Foundation (CNF) established- students were able to receive financial support for doing master and doctoral degrees •1968- Nursing Papers now known as Canadian Journal of Nursing Research is published •1970-Canadian Association of University Schools of Nursing (CAUSN)(accrediting body for nursing schools)

World War II

•Canada's nursing sisters played a vital role in the care of wounded soldiers during WWII. By the war's end some 3,649 women had served in the Royal Canadian Army Medical Corps (RCAMC), 481 had served in the Royal Canadian Air Force and 343 in the Royal Canadian Navy. Nurses who served in the forces were always referred to as nursing sisters or n/s. All nursing sisters were commissioned officers. This gave them positions of relative authority within the forces. •Nursing sisters taking part in field training in England. After their initial training in Canada, many nurses travelled to England where they worked in hospitals and prepared for duty near the front lines in Europe.

1920s

•Efforts made to take nursing training out of the hospital and place it in a university setting. This was difficult, as strong opposition still existed to women receiving university education in preparation for professional careers •1920 : The Ontario Red Cross Society funded a one-year university program for public health nurses at the University of Toronto •1922 : Nursing was officially recognized as a regulated profession when the provincial government passed a Nurses Registration Act in Ontario •1925 : The Registered Nurses' Association of Ontario (RNAO) is incorporated

Heading out west... 1844

•Four grey nuns took a canoe journey from Montreal to St. Boniface, Manitoba where their mission was to care for the sick •1859 ... more nuns continued further west to Alberta to set up the first mission in Lac Ste Anne •1895 - Edmonton General Hospital formed •In Ontario... In 1883... The Toronto Medical Society set up a Directory for Nurses... listing private nurses available to be hired.. However many or most of these nurses were untrained •1884 - Mary Agnes Snively, the first Ontario nurse educated according to Nightingales' principles assumed superintendent of TGH School of Nursing.. She made a profound difference there... established curriculum and a student residence. Later she co-founded the International Council of Nurses and played a large part in the establishment of the CNA

Canada - Late 1800's - 1940's...

•In 1897- Victoria Order of Nurses (VON) was established by Lady Aberdeen •Fully trained in midwifery and district nursing. Trained to care for those with infectious diseases, dying women in childbirth, infants and young children •These nurses headed up north to take care of Aboriginal communities •VON... and community nursing very strong... personal grooming and strict 'bag' procedures o"the nurse rolls her sleeves above her elbows- opens her bag and removes paper napkin, paper towel and bottle of green soap. The paper napkin is spread on the table which is protected by a newspaper...... "(Bates, 2005) •Private nurses

1950 - 1965

•In the period after the second world war, the shortage of qualified nurses required to staff hospitals, public health units, private organizations and industrial positions had reached severe proportions in Canada. •While Canadian training hospitals and schools worked to supply a growing number of graduate nurses, foreign-born nurses who were educated outside of Canada were recruited by hospitals and health care organizations to provide certified care for a population that was becoming increasingly concerned with issues of health and well-being. •It was not until the 1960s that Canada began to liberalize its immigration laws and policies, and by the end of the decade, substantial numbers of immigrants, especially skilled workers, began arriving from countries like India, Hong Kong, Pakistan and the Philippines. •Nurses and physicians came in large numbers from the Philippines in particular

World War I

•Nurses seen as noble and self sacrificial •Were the envy of all women •Nursing is the most prominent role that Canadian women played at the front in Europe..

1535 - Jacques Cartier arrived in Canada

-Jacques Cartier uses 2 ships to explore the St. Lawrence River. He raised a cross in the Gaspé on 24 July, claiming the land for France and King Francis I..

1940's

-Nursing programs began accepting African-Canadian and First nation applicants in response to the lack of nurses partially related to the Second World War -Penicillin required injection every three hours.. Overwhelmed the physicians and turned to nurses who adopted IM's as a standard nursing skill •1946 oThe first training centers for nursing assistants , offering a nine month training program, were opened in Toronto, Kingston and Hamilton o1947 - Ontario hospitals established intravenous and blood transfusions as a nursing skill

The Development of Nursing Education: Nightingales' 7 basic tenets were that

1.The content of nursing education must be defined by nurses 2.Nurse educators are responsible for the nursing care provided by students 3.Educators must be trained nurses themselves 4.Nursing schools should be separate entities, not connected with physicians or hospitals 5.Nurses should be prepared with advanced education and should engage in continuing education throughout their careers 6.Nursing involves both sick nursing and health nursing and includes the environment as well as the patient 7.Nursing must include theory

1639

3 sisters of Order of St. Augustine arrived to establish and staff a medical mission that was then expanded to become the Hotel Dieu Hospital in Quebec

1950's

Auxiliary personnel such as nursing aids and orderlies expanded , along with the active recruitment of men and immigrant nurses to fill vacancies in hospital staff nursing positions.

1963

Certified nursing assistant title change to Registered nursing assistant

1960

College of Nurses of Ontario became the regulatory body for Ontario nurses

The Development of Nursing Education: 1860

Florence Nightingale established a financially independent School of Nursing in London Soon hospital training schools for nurses based on this model were established throughout Europe and North America... some essential parts of Nightingale's education program were missing however... related to finances.. nursing students were 'staffing' the hospitals...

First Canadian Nursing School: 1910

Lina Struthers returns from New York City to become Toronto's first city school nurse

First Canadian Nursing School: 1912

Ontario Hospital Act passes and included the right to use the title Registered Nurse

1608: Champlain

Quebec city Fur trade First colonists provided own health care •The first nurses to tend to the sick in a type of health center were male attendants at a 'sick bay' established at the French garrison in Port Royal in Acadia in 1629 •They had no formal nursing education •Jesuits also provide health care •Small pox and Iroquois war

First Canadian Nursing School: 1881

School of Nurses at the Toronto General Hospital was established under the direction of Mary Agnes Snively(Flow of Canada)

First Canadian Nursing School: 1874

St. Catharine's Training School at the St. Catharine's General and Marine hospital •Admission - plain English education, good character and Christian motives •At this time nursing still considered an undesirable vocation for a refined lady, but the only acceptable profession was teaching •Course of study - chemistry, sanitary science, physiology, anatomy and hygiene •Taught to report 'faithfully' to the attending physicians

• THE DEACONESSES

The deaconesses of the Christian Church represent one group of particular significance to the history of nursing. Required to be unmarried or widowed, these women were often the widows or daughters of Roman officials, and thus had breeding, culture, wealth, and social position

Jeanne Mance

arrived in New France...during foundation of Montreal .... Cared for Iroquois peoples and colonists. Founded Hotel Dieu hospital in Montreal •Studied nursing from Augustine nuns... •Called Canada's first lay nurse (not educated; everybody)

• THE DEACONESS

like the deacon, was ordained, and, as a church official, worked on an equal basis with the deacon. These dedicated young women practiced "works of mercy" that included feeding the hungry, clothing the naked, visiting the imprisoned, sheltering the homeless, caring for the sick, and burying the dead. Often cited as the earliest counterparts to the community health nurses of today, the deaconesses carried a basket (a forerunner of the contemporary visiting nurse's bag) when they entered homes to distribute food and medicine.

World War II: Training

oRecruits had to be British subjects between the ages of 21 and 36, nursing school graduates registered with the professional association within their province, and single women or widows without children. •Post WW II... shortage of nurses.. •Nursing a very attractive profession for young women but other professions opening up... medicine, law.... •Nursing Assistant was born to relieve short term stress on system.....

A time of shame....

• Exploitation of workers • Child labour and sweatshops... disease and accidents were the norm • Hospitals were places where the poor went to die

Early Middle Ages (CE 476-1000)

• "Dark Ages" • Learning stopped and Christianity retreated behind the walls of monasteries due to the wars occurring in the land (The Roman Empire collapsed) • Focus was on care and comfort (foundation of nursing); science declined • Nursing care was controlled by the Catholic Church

First Doctoral Program

• 1991- PHD program established in Canada at the University of Alberta • Trivia- first person admitted to program? • 2005: As of January 1, 2005 the requirement for RPN entry to practice was increased from a certificate to a diploma from a College of Applied Arts and Technology • 2005 : As of January 1, 2005 the minimum requirement for RN entry to practice was increased from a diploma from a College of Applied Arts and Technology to a four-year baccalaureate degree in nursing or equivalent • 2001 - 2004 : Emergence of Collaborative Nursing programs (university and college together)( Queen's U - SLC program) • 2005 LU-SLC Collaborative program begins • 2006 : The Ontario Government launches the Health Force Ontario (ForceSantéOntario) strategy to create new and innovative health care roles and to recruit and retain the best and brightest health care workers, ensuring Ontario has the right supply and mix of health care professionals when and where they are needed

Early Civilization

• At some unknown prehistoric time, humans evolved into social beings concerned with the care of others in their family or group • Evil spirits were thought to be the cause of illness

Early Christian Civilization

• Churches established • Groups organized as orders (religious) to provide care • Christ taught men= women • The role of deaconesses, virgins and widows in nursing was prominent at the time and several of them became saints. • THE DEACONESSES • THE DEACONESS • THE WIDOWS AND THE VIRGINS

The Bubonic Plague (1347-1350)

• Ended the middle ages • was very deadly - 'bubo'- swelling of lymph glands • Germs carried by rats (actually the fleas) • Killed ¼ of the entire world population • "ring around the rosy" o Ring a-ring o' roses, A pocketful of posies. a-tishoo!, a-tishoo!. We all fall down.

Nightingale and the Crimean War

• England, France and Turkey were allied against Russia in the Crimean War • War correspondents at the battle sites used the telegraph and sent home daily reports on the progress of the battles • Scutari... where the wounded were kept... conditions terrible • Nightingale became aware of this situation and asked to lead a group of nurses to care for the soldiers there • Within 6 months of being at Scutari, the death rate had been reduced from 60% to 2% • Set up kitchens, laundry and sanitation facilities • Remodeled military hospitals and barracks • Kept statistics • Because she made rounds of the soldiers long after everyone else was asleep, the correspondents referred to her as "the lady with the lamp" • Established first independent School of Nursing in 1860 • Contracted Crimean fever • ? Post traumatic syndrome • Wrote books.. "Notes on Nursing" 1859 • Black stripe on nursing caps signified mourning for her death

19th century

• Era of social reform for prisons, public health and care of the poor • Pastor Fliedner opened the Kaiserwerth Deaconess Institute—the first REAL nursing school • Its most famous student: » Florence Nightingale (1820-1910)

The Crusades

• Europe rose to reclaim the Holy Land from the Muslims • Hospitals developed on the battlefields • Knight Hospitaliers of St. John's of Jerusalem cared for the injured—their symbol: a bright, Red Cross • Knights organized nursing care • Had a probationary period before you could wear the "white" robes of knighthood • These knights found they preferred the role of nurse and nursing became their profession • The knight's shields ... represented by the nursing pins worn by many nurses

Arrival of the Grey Nuns

•One year after the hospital was built, Montreal became a target of the Iroquois. •With a war going on, a request was made for additional help from France. •Grey Nuns arrived •1738 - Grey nuns or Sisters of Charity of Montreal cared for sick •Formed by Marguerite d'Youville •Focus on --Health --Well being --Religious life • They visit the sick in their homes • 1760 - 1870 • More hospitals built • Epidemics from overcrowding (measles, flu, smallpox) • Many untrained nurses • Pre Industrial Ontario... o A 'nurse' was a woman who gave care in the home, usually to members of her own family who were ill or giving birth o Kingston's Female Benevolent Society provided the only hospital care available to the sick poor