RUNNING HEAD: Evolution of Nursing

Evolution of Nursing
Amber McElroy
Gurnick Academy of Medical Arts
Instructor: Debi Marks, R.N.
January 20, 2015

Evolution of Nursing

Evolution of Nursing

Little did Florence Nightingale know, when she opened her first nursing school in the
mid 1800s, that she would be paving the way for the nurses of today. Nightingale had studied in
Germany and, after returning to England, managed a charity hospital and trained other women to
care for the sick and wounded during the Crimean War. With infections, war wounded and death
rates high, Nightingale realized that without necessary changes things could only get worse. She
believed proper training of nurses and the creation of a clean, safe environment focused on the
patients physical and emotional needs would be most beneficial to the sick. These two priorities,
refined into modern nursing schools and PPEs, are still valued in nursing today. (deWitt, O'Neill,
2014)
One of Florence Nightingales ideals, the importance of providing quality training for
nurses, has been a driving force behind change in the field over the centuries. Linda Richards
and Agnes Elizabeth Jones helped to create a number of nursing schools throughout the United
States and Japan during the mid to late 1800s. These women worked tirelessly to provide high
quality health care to anyone that needed it, providing the model for nursing that still exists
today. (The History of Nursing, 2014) Richards and Jones, like Nightingale, saw the importance
of proper training as a critical area of need, and they worked to ensure that those entering the
field were provided that training. Their work and their desire to equip nurses with the skills
necessary to provide patient-focused care is also what has guided the idea of modern day
umbrella acceptance in Emergency Rooms, where a person in need of immediate medical
attention receives it regardless of funds or insurance.
In America the nursing field took a very different approach than in Europe. It was not
grounded in the church and run by nuns, but in hospitals by every day women. Nursing education
evolved from training by more advanced nurses with books to a hospital based instruction. World
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War II brought a new need for nurses on the frontlines. During this conflict, women often went
in with little training, but through experience, gained a wealth of knowledge. The government
realized that creating a new program that accepted both women and men would be beneficial to
both them and the students. It was also realized that healthcare was an expanding job field and
the government began to place funding into courses that would educate more people who were
interested in becoming nurses and physicians.
The dawn of the Twentieth Century brought with it advances in medical science and
technology. Armed with these advances, nurses were able to begin training in more specialized
areas such as dialysis, critical care and many more. The arena of nursing education began to
expand into the wide variety of highly specialized vocations that we now find in the field.
Nursing education now is available in a wide variety of formats; including institutions like
Gurnick Academy of Medical Arts. These institutions have taken up the mantle of Nightingale,
Richards, and Jones. New nurses are led into the field by a team of highly trained nurses with a
combination of lecture, books and hands on experience.
Another idea brought forth by those early pioneers in nursing that has been expanded and
modernized is the belief that a clean, safe environment is critical to proper patient care and to
reducing the possibilities of infection and other medical complications. Perhaps the greatest
change in this area is the development of Personal Protective Equipment. Personal Protective
Equipment (PPE) is defined by Mosbys Medical Dictionary as a part of Standard Precautions for
all health care workers to prevent skin and mucous membrane exposure when in contact with
blood and body fluid of any patient. (Mosby's Medical-Dictionary, 2009) The evolution of
gloves, masks, and aprons are just a few of the changes made to better healthcare. Sanitation in
nursings past was not what we think of it today. With little knowledge of how viruses and
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bacteria spread and cause infection, the likelihood that healthcare facilities were completely
sanitary was low. Hospitals were regarded as houses of death which patients tried to avoid, if
possible, because of rampant infection. (Lathan, 2010) It was Dr. William Halsted, the first
Surgeon in Chief at Johns Hopkins Hospital, who contracted Charles Goodyear, the mind behind
the first patented Vulcanized rubber in the 1840s, to manufacture gloves for his scrub nurses
hands. Many of these nurses could not tolerate the disinfectants mercuric chloride and carbolic
acid (Lathan, 2010) and thus began the use of gloves in the surgical area.
The first disposable latex gloves, with and without powder, came into nursing in the
1960s. This was another advancement in clean, safe care, but although this was seen as a boon
to the field of nursing, it also came with its own set of new issues, and once again PPEs had to
change. According to the OSHA Latex Allergy page, Workers exposed to latex gloves and other
products containing natural rubber latex may develop allergic reactions such as skin rashes;
hives; nasal, eye, or sinus symptoms; asthma; and (rarely) shock. (Labor, n.d.) It is also
estimated by OSHA that 8-12 percent of health care workers are latex sensitive with reactions
ranging from irritant contact dermatitis and allergic contact sensitivity, to immediate, possibly
life-threatening, sensitivity. (Labor, n.d.) Due to the rising number of people affected by a latex
allergy working in the medical field, new materials such as vinyl, nitrile rubber and neoprene
have become more widely used.

These two areas, the advancement of training for nurses and the continuing modification
and modernization of Personal Protective Equipment, have changed the face of nursing as we
know it. As nursing continues to evolve in the Twenty-First Century, we must continue to keep
our focus, as Florence Nightingale did, on advancing our training of nursing professionals and
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the safety of the medical environment to ensure that we are able to provide the highest level of
care to our patients.

References
deWitt, O'Neill. (2014). FUNDAMENTAL CONCEPTS AND SKILLS FOR NURSING (4th
ed.). St. Louis: ELSEVIER.
Labor, U. S. (n.d.). OSHA. Retrieved January 17, 2015, from OSHA:
https://www.osha.gov/SLTC/etools/hospital/hazards/latex/latex.html
Lathan, S. R. (2010, October 23). Caroline Hampton Halsted: the first to use rubber
gloves in the operating room. Retrieved January 17, 2015, from NCBI:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2943454/

Evolution of Nursing
Mosby's Medical-Dictionary. (2009). Retrieved January 17, 2015, from PPE:
http://medical-dictionary.thefreedictionary.com/PPE
Rubber Gloves: "Born" - and Now Banished - At Johns Hopkins. (2008, January 14).
Retrieved January 17, 2015, from John Hopkins Medicine:
http://www.hopkinsmedicine.org/news/media/releases/rubber_gloves_born___
and_now_banished___at_johns_hopkins
The History of Nursing. (2014, September 11). Nursing School Hub. Retrieved
January 17, 2015, from NURSINGSCHOOLHUB.COM/HISTORY-NURSING/