Fundamentals Lecture 1: Development of Nursing

Nursing, like every discipline, evolved from its primitive form to a developing branch of professional discipline. In this Fundamentals of Nursing Lecture, we will tackle on key happenings that led to the evolution of nursing as a science and an art. 

This lecture note is in an outline form to compliment your classroom discussion. This are compiled notes of the author. Care is taken in synthesizing the compiled notes.

Early times

Nursing was untaught and instinctive

Performed out of compassion for others and desire to help others

Beliefs and Practices of Prehistoric Man

Nursing was a function that belonged to women taking care of the children, the sick and the aged.

Believed that illness causes the invasion of evil spirit through the use of black magic or voodoo.

Believed that medicine man was called shaman or witch doctor having the power to heal using white magic.

They also practiced “trephining” or drilling a hole in the skull with a rock or stone without anesthesia as a last resort to drive evil spirits from the body.

Contributions to Medicine and Nursing

Babylonia

o Code of Hammurabi  provided laws that covered every facet of Babylonian life including medical practice and recommended specific doctors for each disease and gave each patient the right to choose between the use of charms, medications or surgical procedures.

Egypt

o Introduced the art of embalming

o Developed the ability to make keen observation and left a record of 250 recognized diseases

o Slaves and patient’s families nursed the sick

Israel

o Moses was recognized as the “Father of Sanitation” and wrote in Old Testament which:

Emphasized the practice of hospitality to strangers and acts of charity

o Promulgated laws of control on the spread of communicable disease and the ritual of circumcision of the male child

 o Referred to nurses as midwives, wet nurses or child’s nurses whose acts were compassionate and tender

China

o Believed that in using girl’s clothes for male babies keep evils away from them

o Prohibited the dissection of dead human body as a worship to ancestors

o They gave the world knowledge of material medica (pharmacology)

India

o Men of medicine built hospitals, practiced an intuitive form of asepsis and were proficient in the practice of medicine and surgery

o Sushurutu made a list of function and qualifications of nurses. This was the first reference to nurse’s taking care of the patient’s.

Ancient Greece

o Nursing was the task of untrained slave

o Introduced caduceus, the insignia of medical profession today

o Hippocrates was given the title of “Father of Scientific Medicine”. He made major advances in medicine by rejecting the belief that diseases had supernatural causes. He also developed assessment standards for clients, established overall medical standards, recognized a need for nurses.

Rome

o The Romans attempted to maintain vigorous health, because illness was a sign of weakness

o Care of the ill was left to the slaves or Greek physicians. Both groups were looked upon as inferior by Roman society.

o Fabiola made her home the first hospital in the Christian world through the help of Marcella and Paula

Period of Apprentice Nursing

• Also called the period of “on the job” training.
• Nursing care was performed without any formal education and by people who were directed by more experienced nurses
• Religious orders of the Christian church were responsible for the development of this kind of nursing.
• Founding of religious nursing orders to 1836 when Kaiserwerth Institute for the training of Deaconesses in Germany was established

Crusades

• Military religious orders established hospitals staffed with men
• Knights of Lazarus was founded and primarily for the nursing care of lepers in Jerusalem after the Christians had conquered the city.

Rise of Secular Orders

• Religious taboos and social restrictions influenced nursing at the time of the Religious Nursing orders
• Hospitals were poorly ventilated and the beds were filthy
• There was overcrowding of patients: 3 or 4 patients regardless of diagnosis or whether dead or alive, may have shared one bed. 
• Practice of environmental sanitation and asepsis were non-existent
• Older nuns prayed with and took good care of the sick, while younger nuns washed soiled linens, usually in the rivers.
• St. Catherine of Siena. The first “Lady with a Lamp”. She was a hospital nurse, prophetess, researcher and a reformer of society and the church.
• In 16th century, hospitals were established for the care of the sick where hospitals were gloomy, cheerless, airless and unsanitary. People entered hospitals only under compulsion or as a last resort.

Dark Period of Nursing

(17th to 19th century)

• There were no provisions for the sick, no one to care for the sick
• Nursing became the work of the least desirable of women---women who took bribes from patients, who stole the patient’s food and who used alcohol as a tranquilizer.
• They worked seven days a week slept in cubbyhole near the hospital ward or patient and ate scraps of food when they could find them.

Period of Educated Nursing

(From June 15, 1869 when Florence Nightingale School of Nursing was opened until World War II)

• The development of nursing during this period was strongly influenced by trends resulting from wars, from an arousal of social consciousness, from the emancipation of women and from the increased educational opportunities offered to women
• Popularization of the philosophy of the Nightingale System

o Importance of nursing education

o Hospital affiliation

o Nurses teaching students

o Health teaching as critical responsibility

o Enforced written physician orders

o Expansion in no. of schools to North America

o Specialization developed

Period of Contemporary Nursing

(Period after World War II up to present)

• Scientific and technological developments as well as social changes mark this period
• Establishment of WHO
• Use of atomic/nuclear energy for medical diagnosis and treatment
• Utilization of computers
• Use of sophisticated equipment for diagnosis and therapy
• Health is perceived as a fundamental human rightNursing involvement in community health is greatly intensified
• Development of the expanded role of nurses
• Professionalization of nursing