An Historical Overview of Nursing
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55966_CH02_021_040.qxd 2/27/09 1:34 PM Page 21 © Jones and Bartlett Publishers, LLC. NOT FOR SALE OR DISTRIBUTION Chapter 2 An Historical Overview of Nursing Marilyn Klainberg OUTLINE The Impact of Nursing on the Evolution of The 20th and 21st Centuries Health Care Nursing Education in the United States Introduction: Ancient Cultures Before Christ Licensure The Crusades (A.D. 1095–1291) The Great Depression The Renaissance Nurses in Wars Fought by the United The 18th Century States The 19th Century Nursing Leaders of the 20th Century John Snow Today Nursing Leaders of the 19th Century PURPOSE • To familiarize the reader with the impact of historical events on nursing • To present social factors that have influenced the development of nursing • To explore political and economic factors influencing nursing today • To introduce nurses and other leaders in health care who have had an impact on nursing 21 55966_CH02_021_040.qxd 2/27/09 1:34 PM Page 22 © Jones and Bartlett Publishers, LLC. NOT FOR SALE OR DISTRIBUTION 22 Chapter 2: An Historical Overview of Nursing The Impact of Nursing on the at that time was clearly very different because of Evolution of Health Care the needs of and the lifestyles in society and the impact of science and technology. Back then, pal- This chapter provides a brief historical overview liative care was primarily provided for the sick. of health care and identifies nurse leaders who Life in ancient cultures (and in some non- have influenced the events that changed or Western cultures today) was nomadic and was improved the healthcare system within the built around finding food and maintaining framework of specific historical events. Addi- warmth. Health practices were varied and based tional nurse leaders who have more recently upon ingenuity, prior experiences, and the envi- influenced the healthcare system are identified ronment. People used plants and herbs to heal, and presented throughout this book. and they harbored the notion that evil spirits and It is important to be familiar with the efforts magic affected well-being. Early people viewed of those who have gone before us, because they illness and death as part of the natural phenom- have a special meaning to our future. It has been ena of life, and of course there were variations of said that “those who cannot remember the past practices among cultures (Spector, 2004). are condemned to repeat it” (Santayana, 1953). Persons designated to care for the sick—usually Much of the early history of and information men—passed information verbally through the about nursing health care is based on informa- generations. Some of the information we know tion about ancient cultures that has been gath- about these ancient cultures and their forms of ered by anthropologists and documented by health care comes from the work of anthropolo- historians (Spector, 2004). gists, and some comes from information that has been handed down from generation to generation. As people’s lives and environments became Introduction: Ancient Cultures more developed, irrigation and waste were the Before Christ first issues related to treating disease. Priests, Care of the sick is not new. People have cared for spiritual guides, or “medicine men” were the their sick throughout recorded history, and we healthcare providers for their communities. assume, before that. The term to nurse comes During these times, the sick became their re- from the Middle English words nurice and norice, sponsibility (Kalisch & Kalisch, 1978). Sickness which are contractions of nourice, from Old was often attributed to evil spirits or something French that was originally derived from Latin that had been done to offend the priests or gods. nutricia (Klainberg, Holzemer, Leonard, & Health care was often the result of trial and error, Arnold, 1998). This term means “a person who because science and technology as we know them nourishes” and often referred to a wet nurse. (A today were not available. If a person ate some- wet nurse is a woman who breastfeeds infants for thing that made him ill, that person was told not those who are unable to do so.) (Klainberg, et to eat it again; if an herb made someone feel well al., 1998). or seemed to improve health, then that herb Although we often assume that life in ancient would be used for its assumed curative powers. and earlier cultures may have been a basis for As early as 3000 B.C., the Egyptian health- what we consider nursing today, care of the sick care system was the first to maintain medical 55966_CH02_021_040.qxd 2/27/09 1:34 PM Page 23 © Jones and Bartlett Publishers, LLC. NOT FOR SALE OR DISTRIBUTION The Impact of Nursing on the Evolution of Health Care 23 records. The Egyptians were also the first to clas- During the time of the Crusades, monks sify drugs and develop a planned system to main- often tended to the sick. It was during this time tain the health of their society. Rules regarding that the Church established military nursing food safety and cleanliness were first attributed to orders, such as the Knights Hospitalers (the the Egyptians and are still maintained today by Knights of Saint John of Jerusalem), made up many of the Muslim and Jewish faiths. exclusively of men who provided care for pil- Babylonia was the second oldest society to grims and travelers who were in need of care maintain medical records (Donahue, 1996). (Beyond the French Riviera, 2007). Their fame During this time, the Persians, Italians, Chinese, was widespread, and it even influenced some and Indians also developed rudimentary and crusaders to lay down their weapons and join the early attempts at the provision of health care. Knights of St. John in their work to provide for Greek society put an emphasis on personal the poor, the pilgrims, and travelers (Nutting & health more than community health and be- Dock, 1935). lieved that personal health was influenced by the environment. The Romans recognized the im- The Renaissance portance of the regulation of medical practice Throughout the Renaissance period, from 1500 and created punishment for medical negligence. to 1700, growing interest in science and tech- During the Middle Ages, A.D. 500 to 1500, nology led to some advances in medicine and Christianity attempted to bring forth the notion public health. In 1601, the Church of England of personal responsibility for self, as well as for mandated the Elizabethan Poor Law, which cre- others, and this was reflected in the care of the ated overseers for the poor, blind, orphans, and sick. Religious communities established care for lame (Bloy, 2002). Poverty was considered a way the sick poor in hospes, places that could offer of life for some. The rich paid for nurses to take nurturance and palliative care and from which care of their sick at home. The Poor Law was the terms hospital and hospice derive (Nutting & intended to provide a place where the poor sick Dock, 1935). and orphaned would be cared for. From A.D. 50 to 800, these hospes, or hospi- It was under this law that provisions for the tals, were usually near a church or a monastery. poor to receive care in either hospitals or alms- Men were the caregivers during this time, and houses became available. Because many of the women were permitted to be midwives or wet poor were very ill when they arrived at hospitals, nurses and were considered witches if they and little more than palliative care could be pro- attempted to usurp the role of the male health- vided for them, they often died in the hospitals. care provider (Ehrenreich & English, 1973). Therefore, to most people the idea of being hos- pitalized had negative connotations, and hospi- The Crusades (A.D. 1095–1291) tals were considered places where people were War has always had an impact on the health care sent to die. of society and on nursing. Woven throughout Those who were sick but rich continued to be the history of humans and throughout this cared for at home by private duty nurses, who chapter are the impact and legacy of war upon were privately reimbursed. Often nurses who health. took care of the sick in their homes were also 55966_CH02_021_040.qxd 2/27/09 1:34 PM Page 24 © Jones and Bartlett Publishers, LLC. NOT FOR SALE OR DISTRIBUTION 24 Chapter 2: An Historical Overview of Nursing expected to do other jobs within the household, In 1776, the United States declared indepen- including housekeeping, cleaning, and cooking. dence from Britain, and in 1789 the French Revolution began. The 18th century was also a time of scientific innovation. Benjamin Franklin The 18th Century invented eyeglasses that addressed both near- and farsightedness, Leeuwenhoek improved the The industrial revolution began in the late 18th microscope invented earlier by Galileo so that century in England (1760) and continued into body cells and bacteria could be identified, and the early 19th century. It was a time of techno- the functioning of the heart was described. logical advancement throughout the world. Early These changes began to influence how people technology influenced the economy. Because of lived. It was during this time that the role of the the evolution of technology, factories emerged nurse began to be acknowledged and schools of that had the ability to manufacture and produce nursing were established. specific products in volume rather than goods acquired from farming, manual labor, or crafts- persons. The use of machinery and the develop- The 19th Century ment of factories quickly spread throughout the world. Change is often a result of challenges in the com- As factories evolved, people left rural and munity and the world.