The History of Nursing

Nursing through the years has improved dramatically due to factors such as the way women were perceived and social reforming. With the advancement of medical knowledge the nursing profession has grown from strength to strength with society understanding the need to train, educate and establish sanitary standards. All of which we can be grateful to many pioneers throughout the years such as Florence Nightingale and Ethel Bedford-Fenwick.

In earlier centuries nursing care was usually provided by volunteers who were untrained or those who possessed little training. During the reign of Henry VIII, nurses were seen to be the ‘dregs’ of society and nursing was considered an unsuitable occupation for ‘proper’ women, this was undoubtedly due to the fact that hospitals in those days were dirty pest houses were patients usually died and the people who were ill were seen to have brought it about upon themselves. Although prior to this, nuns and monks nursed the sick in monasteries until their king abolished all of the caring institutions.

(Encarta Encyclopedia, accessed 09 October 2004) Modern nursing improved throughout the nineteenth century, one major development being brought about by pioneer Florence Nightingale who during the Victorian era changed the way that society viewed nurses and gave them the respect and high stature that was deserved.

Nightingales impacts began when she volunteered her services during the Crimean War addressing the needs of wounded soldiers. It was during her time her that she revealed the appalling hygiene conditions in which the soldiers were living and she noticed that death rates were not down to injuries and infections but due to bad sanitary practice. Being a keen statistician and researcher she analysed and documented the data that she discovered producing the ‘polar-area diagram’, this is a statistical model which helps compare data, this showed that nursing care decreased the mortality of soldiers, and with the help of her contact John Delane, the editor of The Times, she published her findings.

Nightingale proposed reformation and was encountered by military officers and doctors objecting, although after she withdrew her services it was recognised that the abominable conditions that she had improved whilst there by cleaning the kitchens, wards and patients, suddenly returned and subsequently she was begged to return and help. (Anglin, L.T. 2000) It was found that due to the sanitary reforming during the Crimean War, mortality rates dropped from 40% down to 2% with thanks going to Nightingale. On her return to Britain she decided to campaign to improve the quality of nursing and in 1856 Nightingale had a long interview with Queen Victoria and Prince Albert, consequently leading to her giving evidence at the 1857 Sanitary Commission.

To get her opinions on reform heard, Nightingale went on to publish two books with the support from her wealthy friends, from this she raised �59,000 and used the money to improve nursing by opening The Nightingale School and Home For Nurses based at St Thomas’s Hospital. The opening of this school marked the beginning of professional education within nursing. Part of the training here included the introduction of the following: the code of practice, supervision, examined practice, regime uniforms. Nightingale was very selective of her nursing students only taking on very few, from this a group of professionally trained nurses were formed. ( accessed on 09 October 2004)

Nightingales contributions to the evolution of nursing as a profession was therefore invaluable, as before she went about reforming, nurses were usually untrained people who saw it to be chore. Through her hard work the stature of nursing was raised to a profession with high standards of education, responsibilities and excellent sanitary practice. Nursing was on the rise when another pioneer came about, Ethel Bedford-Fenwick concentrated on the politics side, not surprising for someone married to a poli cian, though this proved to be advantageous to her as her husband Dr Fenwick, helped to campaign in order to safeguard the title of ‘nurse’ and request that a register be introduced. This idea was to increase the standard of nursing so that the character of women was improved; she also wanted to introduce an entry test and 3 years training.

Many People were opposed to the Fenwick’s new propositions such as Florence Nightingale, all in disagreement about making nursing professional through training. In a passage of (Baly, M.E. 1995, p. 146) it states that in a letter to Mrs Bedford-Fenwick, Nightingale wrote: “Nursing has to do with living spirits and bodies. It cannot be tested by public examination, though it may be tested by current supervision” Ethel Bedford-Fenwick in 1983 acquired the Nursing Record (later became British Nursing Journal) and as editor, used it as the source of her campaign for registration.

The first steps towards the organisation of nursing was when Burdett, the spokesman of the hospitals association, noticed benefits of introducing a register but his ideas differed from those of Mrs Bedford-Fenwick’s, and during a meeting at Burdett’s house, it is believed that Mrs Bedford-Fenwick invited ‘ladies who wished to form a nursing section’ to her home and there the BNA (British Nursing Association) was created. The BNA insisted that 3 years of training was required whereas Burdett and Nightingale thought that 1 years training was sufficient, although Nightingale thought that those who were to teach other should obtain 2 years of training. Together the BNA formed a pressure group for state registration.

At the end of World War I, with the position that women were now in, it was seen that nurses needed their own professional organisation and in 1916 The College of Nursing (Later the RCN) was registered as a limited company and a council was selected. The idea was to promote the register, education, and training. In 1919 ‘The Nurses’ Registration Act’ was passed and nursing became a regulated profession and each country established a GNC (General Nurses Council). They had the duty of setting up the register, Ethel Bedford-Fenwick being the first name on the world’s first nursing register.

Even after the register was introduced Mrs Bedford-Fenwick did not stop there, even at the age of seventy she continued to devote time to organisations such as Royal British Nurses’ Association. Later in 1926 a new organisation called British College of Nurses was formed after a large anonymous donation was received, Dr Fenwick being the treasurer and Mrs Fenwick as president. This was to be the rival of the College of Nursing.

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