Nursing has been called the oldest of arts and the youngest of professions (Donahue, 1996). In ancient periods because of maternal instinct women were considered born nurses. They cared for their own family and trained their daughters and other women in their community in the procedures in which they specialized. In the 16th century the meanings nursing included “a person, or a woman who waits upon or tends to the sick”. During the 19th century, nursing was considered training of those who tend to the sick and carrying out duties under direction of a physician (Donahue, 1996). Today, nursing has become both an art and a science.
It focuses on health promotion, professionalism, skills, knowledge and education. It is now a career of all genders and races and one of the highest growing professions in the United States. To understand how nursing has arrived we must first review where nursing has come from. In this paper you will learn about nursing before Florence Nightingale, the reforms that Florence made that changed nursing as a profession, and Innovations in nursing as it continue to evolve. Nursing has its origins in Christianity. According to Joyce (2002), some of the earliest nurses and individuals who ran hospitals were Catholic nuns and monks.
Deacons and deaconesses of the church were trained as nurses and went out into the community to provide nursing care. In the 1840s, nursing- sisterhoods were founded to improve standards of nursing in Britain (Joyce, 2002). This organization was of the Catholic nursing order. According to Joyce (2002), St. John’s House was an Anglican Nursing Sisterhood founded in 1848, it provided nurses to care for the sick in their own homes. This is considered one of the first training schools. They trained nurses for private work but they gained experience in hospital wards (Joyce, 2002).
In the 17th and 18th century, the infirmaries were local houses used for providing employment for the destitute. During this time most people who needed nursing were nursed at home. Those who were not nursed at home ended up in workhouses, with primitive wards, for the sick and infirm. Some of the older hospitals were rebuilt often by private benefactors (Grell, 1997). They appointed private contractors who looked after the parish’s poor. The individuals would then be employed and in return would receive board and lodging. The infirmaries were often filled with patients from the hospitals who could not be cured.
They became so bad that only those who had resigned themselves to death would stay. Usually the infirmary was a freezing cold and draughty room. There were iron beds with thin mattresses, the only furniture in the room. The sick were not cared for properly, the volunteer hospitals were unable to cope with the increasing population and there were no facilities for training nurses (French and Wear, 1991). The growth of the 18th century brought overcrowding in the cities which increased the spread of disease. The building of railways in the vicinity led to the admission of many accident cases and often to a rise in the sepsis rate.
Due to the overcrowding in hospitals; bedsores, malnutrition, and infections were everyday occurrences (Grell, 1997). Nurses were seen differently during the eighteenth century. They were not perceived as medical practitioners but as domestic servants. According to Grell (1997), nurses were inferior largely because nursing was historically subservient roles before the 1800’s. The people staffed as nurses were traditionally convicts, widows, and orphans in exchange for food and shelter. Nurses were poorly trained, poorly paid, and the ill were cruelly treated and abused and neglected (Grell, 1997).
Charles Dickens novel, “The Life and Adventures of Marin Chuzzlewit”, tells of Sarah Gamp, a fictional nurse portrayed as an alcoholic who is a nurse midwife and layer out of the dead. She enjoys all of the hospitality given to her with no regard to the individuals to which she is hired to care for. According to the story nurses were ignorant, drunk, and lazy (Dickens, 2011). Although nursing care reform was a concern there were definite issues such as pay, workload, and recruiting quality individuals. The threat of nurse values arose concerning nursing care of the sick, so did the push for change in the quality of nurse selection.
The domestic organization was under the direction of a Matron, recruited from a higher order of society and paid according to the position. Nurses were appointed by matrons who tried to find women of good character. According to French and Wear, in 1845 the matron of the Middlesex told the weekly board how she chose nurses. “They should be between 30 and 45 years of age, strong, healthy, unmarried and unencumbered with children. They should be accustomed to nursing, able to read and write, humane, honest, sober and clean in their work and person (French and Wear, 1991, 268)”.
The nature and duties of patient care also was re-evaluated. The duties concerning patient care were the manual tasks of administering food and medicine, changing linen and emptying bedpans, and they also did the basic hospital cleaning (French and Wear, 1991). Pay being low, recruitment was difficult and many nurses were discharged for taking bribes or rollicking with the patients. The ward sisters, were principal nurses in immediate personal response on patients they played the key role. They were responsible to the matron and the steward for everything within the ward which was not a matter for the medical staff.
They received differential rate of pay as senior nurses or sisters, typically in the range of five to ten pounds per annum 11 (French and Wear, 1991). By day the nurses performed domestic duties and administered to the wants of the patients. At night ‘watchers’ of a yet lower class supervised the wards, calling the sister who slept nearby if there was an important change in the condition of a patient. If watchers lay down or slept they were instantly discharged. The wages were comparable with the wages of a domestic servant and in certain areas lower (French and Wear, 1991).
Reform took its shape in areas of parliament and government concerning wages. According to French and Wear (1991), many nurses required the sick or dying individual to pay them money before they would administer any care. This had become problematic, the Royal Infirmary Governor pushed to raise the wage for nurses. This wage increase would involve the nurse to discontinue this practice and was used to recruit and retain better nurses who took pride in their appearance and character. The change in recruitment strategy was to recruit women from a higher social class (French and Wear, 1991).