Running head: HISTORICAL INFLUENCES ON NURSING

Historical Influences on Nursing: Facing Great Change in the Profession

Alexis Hayden
University of Saint Mary

HISTORICAL INFLUENCES ON NURSING

Abstract
The present day view of the nursing profession is one of trust and respect. Nursing has long been
molded by centuries of its existence. Historical time periods and figures have passed along
attributes of nursing that are still seen today. The pathway to present nursing stretches back to
Ancient Greece and works its way forward to the great Florence Nightingale. This paper will
discuss the growth of the nursing world and how patient care has consistently remained the
central theme of the profession.

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Historical Influences on Nursing: Facing Great Change in the Profession

Spanning back to centuries ago there have always been people whose duty it was to treat
and to care for others, this has evolved into what is known today as nursing. It is difficult to
mark the beginning of the nursing profession due to the lack of written records. Going back as
far as there is evidence for nursing, one would be examining Ancient Greece, which occurred
during year 126 Before Christ (Theofanidids & Sapountzi-Krepia, 2015). This beginning period
and the centuries that followed show a general progression on how nursing has produced a great
impact on the world. It is important to look back in history to see how the nursing profession has
changed to make great advancements for patient care, yet to also recognize that in many
foundational ways, it has stayed the same.
Beginning this historical journey in Ancient Greece, one would find actual health care
facilities, in which those who were seeking medical assistance could go. Patient care was given
by women, some of them being slaves. This occupation was regarded as not important in the
medical world or to patients health. Nurses were to provide only basics of comfort and some
mixing of herbs. During this era, herbs were considered to help heal wounds and work as antidepressants. Whenever wars occurred, special military hospitals were set up and nurses would be
present to help the wounded. For comparison of the modern health care world, one can see that
Ancient Greece did have a foundation on many structural parts of health care, specifically
looking as their medical centers and military hospitals. Medicine, being mainly herbs, was being
discovered as something that helped with the recovery of the sick. Regarding the nursing
profession, it was mainly a womans job to provide care to others and the job itself was not
respected by society (Theofanidis & Sapountzi-Krepia, 2015).
Flash forward to the medieval period which took place in the 5th-15th century, the nursing

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profession had a continuation of certain aspects from previous years; however, a different
outlook emerged about the profession. The idea of trial and error was very important for
nurses. There was still no required schooling to be a nurse and those that were masters at nursing
simply relied on their experience while novices just had to be exposed to situations in order to
learn from them. Great development can be seen in which nursing was looked at more of a caring
and trusting occupation by the public. The continuation of women being the only individuals to
perform nursing tasks continued, while men were looked at to be the medicine men. The
foundation of medicine was largely based on magic to rid of the evil within ones body. This time
period reflects the importance that experience has and will always play a vital role in the world
of nursing. Lives were lost through this trial and error stage and it was the nurses duty to
recognize what could have been done differently for the care of the patient in order to make
progress for the future (Chernenko, 2013).
The centuries leading up to the molding of modern nursing (11th-17th), which includes
the imperative Renaissance period, displays a religious time period for the profession. Nuns from
the Catholic faith practiced nursing. Still, no education was received for nursing skills. The
healthcare settings were monasteries where all patients were welcomed. However, these
monasteries were destroyed by King Henry VIII during his reign in the 16th century. Now, many
sick people did not know where to go in order to seek medical treatment. This problem obviously
did not go unnoticed and soon, the public witnessed the erection of the first hospitals. These
hospitals were highly unsanitary and people were more prone to infections by simply being in
the hospital environment. During this time, nursing lost much of the respected progress it had
made. Evidence has been presented that certain religious groups frowned upon nursing,
Nursing, not considered a respectable profession by Protestants, was relegated to women who

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were drunken, illiterate, and often prostitutes (Chernenko, 2013, p. 4). Most of society actually
did have this outlook along with some Protestants. Nursing staff had to complete care and
housekeeping duties in the hospital. Thus, this situation resulted in mediocre care giving due to
the incredibly long list of tasks that had to be completed (Chernenko, 2013).
The 11th-17th centuries represent a time where nursing and religion combined. This is still
seen today with various hospitals having certain faith affiliations. The construction of hospitals,
whose only purpose is to treat the sick, represents some molding of modern health care.
However, the status of the hospitals is not on the same par as one sees today. The nursing
occupation suffered a great loss with having a negative image put upon it from society after the
establishment of these horror hospitals. There is some modernization with the structural
attribute of hospitals, but major setback with the disrespect that nursing received (Chernenko,
2013).
The mid-8th century through the 19th century there was a great breakthrough into the dawn
of modern nursing. This transition period was spearheaded by Florence Nightingale. In 1820,
Nightingale was born in Florence, Italy. Her family was British and one of high class. Due to her
familys wealth, Nightingale received the best education-very much rich in the art of language
and becoming a woman. It was much to the familys dismay when Nightingale announced that
she wanted to become a nurse. For young ladies that were held at high standards amongst
society, did not become nurses. Nightingale was very much expected at this period in her life to
be married and become a mother. Because of this, Nightingales family attempted to veer her
from her dreams, but ultimately at the age of 32, her father gave in and decided that she needed
to leave the house. Nightingale was given 500 pounds and she made her way to France and
Germany to become a nurse (Begley, 2016).

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In 1852, Nightingale found herself attending a nursing training program in Kaisersworth,

Germany. Shortly after, the Crimean war broke out, and all the untrained nurses in the German
program became stationed at the Scutari hospital in Turkey. At first, tasks for the nurses revolved
around housekeeping and wound care to those who had been severely injured. Nightingale, who
became the charge nurse for over 30 untrained nurses, was far from impressed with the state of
the hospital. For the next three years, Nightingale devoted her time to the wounded. When the
Crimean War came to an end, Nightingale was in charge of coming up with the statistics of the
hospital-most notable number of deaths. It was to Nightingales great disappointment that more
soldiers died in her hospital rather than the tents. At this point in Nightingales life, she became
closed off to the world around her. With the aid of her mother and sister, Nightingale lived a life
of seclusion for eleven years. Information was then gained that the Scutari hospital was poorly
built on top of a sewage system. This poor infrastructure discovery no doubt had contributed the
deaths of many soldiers in the hospital. The whole experience of Scutari, from the sanitization
and leading untrained nurses paved the way for Nightingale to publish her first book, Notes on
Nursing: What it is and what it is not. This work led the way to changing the field of nursing and
the outlook the world had on the profession (Begley, 2016).
Nightingales work became revolutionary to how hospitals view sanitization, holistic
care, and the training of nurses. For sanitization, Nightingale discusses the importance of
changing sheets in between patients to avoid spreading the previous patients fluids to the next
one. The act of cleanliness geared towards the nurses as well, Nightingale found it imperative
that all nurses need to wash their hands throughout the day. Holistic care was a theme carried
through many chapters in Nightingales book. Giving the patient proper ventilation by opening
windows in the room could make all the difference in the healing process. The act of

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conversation and offering to listen rather to advise makes a whole chapter in the book.
Nightingale discusses why false hope needs to be avoided in patients who are chronically ill. For
the patients themselves know that their situation is one that is dire. The nurse plays the important
role of understanding the patients needs and to be at their bedside when needed for therapeutic
conversation (Nightingale, 1859). Amongst all the important points made, Nightingale was also
notorious for pointing out how nursing malpractice can end up putting the patient at increased
risk and can rapidly decrease their health. It is the nurses job to create a healthy environment
and understand basic knowledge about sanitization to keep his or her patient from further harm.
Nightingale paved the road to present day nursing with her discoveries about the hospital setting
regarding the patients health and is credited with the first nursing theory known as the
Environmental Theory (Potter, Perry, Stocker, & Hall, 2017).
In 1860, Nightingale further sought to make a difference in the nursing world, this time
through education. The Florence Nightingale Faculty of Nursing and Midwifery was established
in London. The school was supported by various donors and students from around the world
attended this school. The school had a rigid curriculum that kept the central focus being the
patients and teaching nurses how to be advocates for their patients. The nurses in training were
exposed to different environments such as military, midwifery, care of the poor, and public health
nursing. This program brought rapid change to not only nursing, but the lives of women. For up
until the school opened, women were always expected to stay inside the house and be mothers,
being at the workplace was not the right environment for them. This school inspired women to
do both, to be exposed to the work environment and also prove to be a great mom at the same
time. However, men were also admitted to Nightingales school, breaking the gender norms of
the profession. Nightingale kept up the school and the curriculum until she passed away

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in 1910, she was 90 years old (Selanders & Crane, 2012).

The accomplishments of Florence Nightingale extend to the 21st century. The momentous
opportunities found in nursing today can be credited back to Nightingale with her publishings
and school. The information found in Nightingales book is looked at today as something that is
rather obvious. However, it is important to remember, for the 1800s, this information was
revolutionary. All were truly unaware of how vital it is to keep a clean environment in order to
help with sickness. This is far from the only contribution Nightingale made to the present.
Looking back through the various time periods discussed, nursing gained two important
attributes through Nightingale, trust and respect. Nurses are now known as the patients
advocate, due to how much time nurses spend in contact with the patient versus other healthcare
professionals. Nurses are now put in the stance of leadership in the workplace. This kind of
placement could not have been attained without proper education. Nightingales school of
nursing soon caused a wave effect of other colleges and universities opening up their own
nursing schools. The curriculum was also passed down, consisting of lecture, lab, and clinical.
Today, nurses can now go on to achieve higher education to delve into specialties. Nurses can no
longer see the end to the opportunities at hand. Nightingales legacy lives on in these amazing
present day opportunities (Selanders & Crane, 2012).
In conclusion, the nursing profession roots can be found at the dawn of organized
civilization. With the skills of caring and the respect of none, mother figures, the uneducated and
the overlooked dominated the field. For great periods of time, growth of the profession
plateaued. Great change for the profession occurred with the presence of Florence Nightingale.
Nightingale went against the tides of her high society life and went off to become a nurse. She
led untrained nurses to care for the wounded during the Crimean War. She published works

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containing revolutionary information regarding holistic health and the environment contribution
to the patients health. And finally, she established the curriculum for the first nursing school,
which would ultimately become the foundation of many nursing schools. Nursing is now viewed
as a trusting profession, it has truly come a long way, yet has never lost the sight of caring for
those in need.

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References
Begley, D. (2016). Florence Nightingale. Nevada Rnformation, 25(2), 10-11.
http://www.nursingald.com/articles/15555-florence
nightingale?query=Florence%20Nightingale&s=84
Chernenko, S. (2013). GUEST EDITORIAL. Nursing in the 21st century -- how have we
changed?. Transplant Journal Of Australasia, 22(1), 4-6. Retrieved from
http://www.cambridgepublishing.com.au/publications/transplant-journal-ofaustralasia.aspx
Nightingale, F. (1859). Notes on nursing: What it is, and what it is not. Philadelphia, PA:
Edward Stern and Company. 113, 135
Potter, P. A., Perry, A. G., Hall, A., & Stockert, P. A. (2017). Fundamentals of nursing (9th ed.).
St. Louis, MO: Mosby Elsevier. 45
Selanders, L., Crane, P., (2012) "The Voice of Florence Nightingale on Advocacy" OJIN: The
Online Journal of Issues in Nursing Vol. 17, No. 1, Manuscript 1
doi: 10.3912/OJIN.Vol17No01Man0
Theofanidis, D., & Sapountzi-Krepia, D. (2015). Nursing and caring: An historical overview
from ancient Greek tradition to modern times. International Journal Of Caring
Sciences, 8(3), 791-800. Retrieved from
http://www.internationaljournalofcaringsciences.org/

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Appendix
I.
II.

III.

IV.

V.

VI.

Introduction
Ancient Greek Nursing
A.
Who were nurses
B.
Societal views on nurses
C.
Advancement of medicine
1.
Use of herbs
2.
Structure of health care centers and hospitals
D.
Compare each point to modern day nursing
Medieval Nursing
A.
Who were nurses
B.
Skills
1.
Trial and error
2.
Experience
C.
Societal views on nurses
D.
Compare to modern day nursing
Renaissance Nursing
A.
Who were nurses
1.
Religion
2.
Nuns and Monks
B.
Societal views on nurses
1.
Catholic vs Protestant
2.
Negative outlook
C.
Advancements of medicine
1.
Monasteries offering health care
2.
Construction of hospitals
a. Infection control
b. Nurses role
D.
Compare to modern day nursing
Florence Nightingale-Birth Of Modern Nursing
A.
Early life
1.
What part of society she grew up in
2.
Mother and Father role
B.
Becoming a nurse
1.
Why?
2.
How she studied to become a nurse
C.
Crimean War
1.
Brief background on war
2.
Work ethics
a. Leadership among nurses at the hospital
b. Hospital conditions
Florence Nightingale- Environmental Theory
A.
Discovery of theory
1.
Amount of deaths in hospital
2.
Sanitization
B.
Development of theory

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VII.

VIII.

IX.

1.
How cleanliness helps patients
2.
Infection control
C.
Notes on nursing: what it is and what it is not
1.
When she wrote the book
2.
What the book entails
a. Bedding
b. Cleanliness
c. Food
d. Observation
3.
Impact of the book
Florence Nightingale Faculty Of Nursing And Midwifery
A.
Establishment of first nursing school
1.
First Class of nursing school
2.
Requirements of nursing school
a. The importance of character
b. Clinical at St. Thomas Hospital
c. Classroom work
B.
Impact of nursing school
1. Preparedness
2. Notable graduates
Florence Legacy For The Modern World
A.
Structure of nursing school
1.
Benefits
2.
Advancements made since
B.
Environmental Theory
C.
Caring/Character aspect of nursing
1.
The factor that has been since the beginning of nursing
Conclusion

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