Nursing
is an ancient art and one of the oldest professions that has been around since
the beginning of human life. It started with the need to provide care and
comfort to those who were suffering from illness or injury. Throughout history,
nursing has evolved from being a form of community service to a modern
profession that requires specialized knowledge and training.
The
roots of nursing can be found in mythology, ancient cultures, and religions. In
the Middle Ages, nursing was primarily performed by religious orders, such as
nuns and monks. In the 19th century, nursing began to emerge as a modern
profession, thanks to the work of Florence Nightingale. She emphasized the
importance of hygiene, sanitation, and patient care, which transformed nursing
into a respected profession.
Today,
nursing is a highly respected profession that requires specialized knowledge
and training. Nurses play a critical role in healthcare, providing care and
support to patients in hospitals, clinics, and home care settings. The history
of nursing profession reflects the evolution of healthcare and the important
role that nursing has played in the care of individuals and communities
throughout history.
PRE-HISTORIC
NURSING
Prehistoric
nursing practices were based on myths and superstitions, with the belief that
illnesses were caused by evil spirits. Prehistoric communities would use
various methods to try to rid the body of these spirits, such as starvation,
beating, and administering nauseous substances. They would also use magic rites
and ceremonies to try to cure the sick.
Prehistoric
communities also had individuals who acted as both doctors and nurses. These
individuals were believed to possess special powers that allowed them to
communicate with the spirits and to heal the sick. There practices were based on a combination
of superstition, magic, and herbal remedies. While these methods may not have
been effective in curing illnesses, they did provide some comfort to the sick
and helped to alleviate their suffering.
NURSING
IN EARLY CIVILIZATIONS (ANCIENT TIMES)
Nursing
has been an essential part of healthcare since ancient times. In the early
civilizations, nursing was closely related to religion and spirituality, and
healthcare practices were often based on superstition and belief.
· In ancient Egypt, medicine and nursing
were thought to be of divine origin. Temples served as hospitals, and priest
physicians served as doctors and nurses. High-ranking women who became
priestesses played the role of nurses, and mothers and daughters nursed the
sick at home. Sacred books were strictly followed by priest physicians, and the
society made progress in medicine, surgery, and nursing.
·
In ancient Greece, medicine was closely
connected with religion, and Apollo, the Sun God, was the God of healing.
Temples were also places for the treatment of the sick, and priest physicians
were in charge of them. Personal cleanliness, exercise, and dietetics were
emphasized. Hippocrates separated medicine from religion for the first time.
· In ancient Rome, there was proper
sanitation, drainage, and sewage systems, and Roman noble women cared for the
sick. With the advent of Christianity, deacons and deaconesses performed the
duties of nurses.
· In ancient China, there was an advancement
in medicine and surgery. The society had good knowledge of internal organs and
blood circulation, and they practiced dissections, vaccinations, and
physiotherapy. The sick was prayed for in halls of healing, and importance was
given to cleanliness and hygiene.
· In ancient India, the Ayurvedic system
stressed hygiene, sickness prevention, sanitation, good ventilation, and the cultivation of medicinal plants. Nurses
attended to the patient, and the attendant had to be cool-headed and pleasant
in demeanour. The nursing treatments prescribed included baths, enema, emetics,
vaginal and urethral infusions, venesection, gargles, massages, and rubbing or
pressing limbs, among others. Nursing attendants were expected to have good behaviour,
purity, kindness, and skill. King Ashoka built monasteries and hospitals for
both men and animals and made provision for the education and training of women
for nursing.
Nursing
in early civilizations had a spiritual and religious significance, and nursing
practices were based on belief and superstition. However, advancements were
made in medicine, surgery, and nursing, and nursing played an essential role in
the care of the sick and in preserving life. The evolution of nursing practices
throughout history reflects the advancements in medical knowledge and
technology, and the important role that nurses play in the care of individuals
and communities.
EARLY
CHRISTIAN ERA (1-500 AD)
During
the early Christian era, Religion played a significant role in shaping the attitude
towards the sick and their care. The fundamental belief of Christianity was to
serve humanity with love and without any reward.
· Deaconess, derived from the Greek word
"diakonia," which means to serve or minister, was a group of mature
women who taught and cared for the sick in their homes. Marriage was not
prohibited, and they could live at home while performing their duties. They
were involved in clerical work in the church, teaching, helping women converts,
and visiting the sick. They were the first visiting nurses.
· Widows were another group of women who
assisted deaconesses in home visiting. They were granted freedom from their
responsibilities at home to serve the sick and the church.
· Virgins were younger women who helped in
caring for the church vestments and providing alms to the poor. They lived in
their own homes, and when necessary, received payment. The order of virgins was
created because the church felt that virginity was essential to purity of life.
· Later, widows and virgins were merged into
a group of nuns. They wore the usual dress of women, which was later changed to
a more uniform one. They lived in their own houses, and many received allotment
from the church. All members were enrolled for church service.
· Phoebe was the first deaconess who was
intelligent and educated. She could care for the sick in their homes and can be
compared to a modern public health nurse.
· Fabiola was the daughter of a great Roman
noble. She converted her palace into the first Christian hospital in Rome and
collected the poor and sick from the streets to care for them in her palace.
· Paula, a friend of Fabiola, devoted
herself to the service of the sick. She built hospitals for strangers,
pilgrims, and travellers, and the sick. She also constructed a monastery in Bethlehem.
· Marcella, a wealthy woman, led a group of
high-ranking women and induced them to work for charity.
Women
played a vital role in caring for the sick. They served as deaconesses, widows,
and virgins who later merged into a group of nuns. These women dedicated their
lives to caring for the sick and the poor and provided a foundation for
modern-day nursing.
MEDIEVAL ERA (500 AD – 1500 AD)
The
Medieval era, spanning from 500 AD to 1500 AD, is often referred to as the “Middle
ages” or "Dark Ages of Medicine". During this time, the Roman Empire
broke apart, resulting in a decline of medical knowledge and a return to
primitive medicine based on superstition and dogma. Despite this setback, the
Middle Ages saw the rise of altruism, which encouraged people to serve others
without any expectation of reward. This spirit of selflessness laid the
foundation for new developments in nursing care.
One
of the most important developments during this time was the emergence of
monasticism. Monasteries became centres of learning, medicine, and nursing.
Monks and nuns worked as doctors and nurses, using their knowledge of home
remedies to care for the sick. They also gained scientific knowledge from books
in monasteries, which contributed to the development of universities.
Monasteries provided medical and nursing care to travellers, the poor, and the
needy, giving women the freedom to develop their skills and ideas. However,
criticism of monasteries led to stricter rules and declining interest in the
work by the 9th and 10th centuries.
During
the Crusades, a religious movement that aimed to rescue the tomb of Jesus
Christ in Jerusalem from the Muslims, two military nursing orders were formed:
the Order of Knights of St. John of Jerusalem and the Order of Knights of St.
Lazarus. These orders provided excellent nursing care to the sick and wounded,
and their traditions continue to live on today in organizations like the St.
John Ambulance Corps. The Order of St. Lazarus specialized in the care of
leprosy patients, which enriched and strengthened nursing care.
The
rise of medicant and secular nursing orders further advanced nursing care
during the Middle Ages. Medicants were traveling monks who gave up their
possessions and lived with the poor, earning their livelihood through manual
labor or begging. Inspired by the religious teachings of Jesus Christ, they
formed various religious and non-religious orders for providing nursing care.
Prominent monks like St. Dominie and St. Francis of Assisi had large numbers of
followers who took vows of chastity and obedience, and who provided nursing
care to the sick.
Despite
the lack of progress in medicine during the Medieval era, nursing care advanced
through the emergence of monasticism, military nursing orders, and medicant and
secular nursing orders. These developments laid the foundation for future
advancements in nursing care and continue to influence nursing practices today.
"DARK AGES IN NURSING (1500 AD – 1850 AD)"
The
period between 1500 AD and 1850 AD is often referred to as the "Dark Ages
in Nursing". It was a time when nursing was considered to be a lowly and
undesirable profession. Nursing was often carried out by women who were poor,
uneducated and had no other means of supporting themselves.
During
this time, nursing was associated with religious institutions and convents. The
nuns who provided nursing care were often untrained and had little knowledge of
medical science. Nursing care was based on religious beliefs and superstitions
rather than scientific knowledge.
It
was not until the 19th century that nursing began to emerge as a profession in
its own right. Florence Nightingale was a pioneer in this regard. She is often
credited with being the founder of modern nursing. She established the first
professional nursing school at St. Thomas' Hospital in London in 1860.
Nightingale
was instrumental in promoting nursing as a profession for women. She believed
that nursing was a noble and important calling and that women were ideally
suited to this role. Nightingale's work during the Crimean War in the 1850s
brought nursing to the attention of the public and helped to raise the profile
of the profession.
In
addition to Nightingale, other notable figures emerged during this time who
made significant contributions to the field of nursing. These include Mary
Seacole, a Jamaican nurse who provided care to soldiers during the Crimean War,
and Dorothea Dix, an American nurse who campaigned for the rights of the
mentally ill.
Despite
the efforts of Nightingale and others, nursing remained a low-paying and
undervalued profession throughout much of the 19th century. Nurses were often
subjected to poor working conditions and long hours. It was not until the early
20th century that nursing began to be recognized as a profession in its own
right, with its own set of standards and qualifications.
In
conclusion, the period between 1500 AD and 1850 AD was a difficult time for
nursing. It was a time when nursing was associated with religious institutions
and was often carried out by untrained and poorly educated women. However, the
work of pioneers like Florence Nightingale helped to transform nursing into the
respected and valued profession that it is today.
MODERN ERA OF NURSING
The
modern era of nursing began in the mid-19th century and is characterized by the
emergence of nursing as a distinct profession with a unique body of knowledge
and skills. This era saw the development of modern healthcare systems,
advancements in medical knowledge and technology, and the growth of nursing
education and research.
One
of the most influential figures in the modern era of nursing was Florence
Nightingale. During the Crimean War, Nightingale led a team of nurses to care
for wounded soldiers. She transformed nursing by introducing principles of
sanitation, hygiene, and patient-cantered care. Her efforts reduced the
mortality rate among soldiers and set a new standard for nursing care.
In
the United States, the modern era of nursing was influenced by the work of
Clara Barton, who founded the American Red Cross in 1881. The organization
provided nursing care during wartime and disaster relief efforts, and Barton
advocated for the professionalization of nursing.
The
20th century brought significant changes to nursing practice, including the
development of nursing specialties such as paediatrics, psychiatry, and
critical care. Nurses began to play a more active role in patient care
decision-making, and nursing education expanded to include advanced degrees and
research opportunities.
The
establishment of professional organizations, such as the American Nurses
Association (ANA) and the International Council of Nurses (ICN), helped to
promote nursing as a distinct profession and advocate for the rights of nurses
and patients.
Advancements
in medical technology, such as antibiotics, diagnostic imaging, and life
support systems, also changed the way nurses provide care. Nurses are now able
to provide more complex and specialized care and have a greater understanding
of the pathophysiology and treatment of disease.
The
modern era of nursing has also been marked by a focus on cultural competency
and diversity in nursing practice. Nurses are trained to provide care that is
sensitive to patients' cultural backgrounds and beliefs, and to advocate for
social justice and health equity.
Today,
nursing continues to evolve with the changing healthcare landscape. Nurses are
at the forefront of healthcare delivery, providing critical care and promoting
health and wellness. The profession remains committed to advancing nursing
science, education, and practice to improve patient outcomes and meet the
healthcare needs of diverse populations.
HISTORY OF NURSING IN INDIA
The
history of the professional nursing in India dates back to the 17th century
when the East India Company started Military Nursing in St George Military
Hospital in Madras in 1664. Since then, nursing has come a long way and has
become an integral part of the healthcare system in India. Here is a brief
overview of the history of nursing in India:
In
1854, the government sanctioned the first training school for midwives, and in
1861, the first public health nursing school was started. In 1867, St. Stephens
Hospital in Delhi became the first hospital to begin training Indian girls as
nurses. In 1871, the first school of nursing was established in Govt. General
Hospital, Madras with a 6-month diploma midwives’ program.
Between
1890 and 1900, many schools under mission or government were started in various
parts of India. In 1897, Dr BC Roy played a significant role in raising the
standards of nursing and that of male and female nurses. In 1908, the Trained
Nurses Association of India (TNAI) was formed to uphold the dignity and honour
of the nursing profession.
In
1918, training schools were started for health visitors and dais at Delhi and
Karachi. In 1926, Madras state formed the first registration council to provide
basic standards in education and training.
In
1946, the first 4-year basic bachelor’s degree program was established at RAK
College of Nursing in Delhi and CMC, Vellore. After independence in 1947, the
Community Development Programme and the expansion of hospital services created
a large demand for nurses, ANMs, health visitors, midwives, nursing tutors, and
nursing administrators. The Indian Nursing Council (INC) was constituted in
1949, and Miss Andrenwala was appointed as Nursing Advisor to the Government of
India.
In
1959, the first master’s program in nursing was started at RAK College of
Nursing, New Delhi. In 1963, the School of Nursing in Trivandrum instituted the
first 2 years post-certificate bachelor’s degree program. In 1985, the Indira
Gandhi National Open University (IGNOU) was established.
In
1986, the M. Phil program at RAK College of Nursing, New Delhi, was started. In
1991, the first doctoral program in nursing was established at the Institute of
Nursing Sciences, MV Shetty Memorial College, Mangalore. In 1992, the
post-basic program was started under IGNOU.
From
2002 onwards, nursing education flourished in an unprecedented manner
throughout India. In 2005-06, the INC started the PhD program (INC consortium)
with the collaboration of Rajiv Gandhi University with 25 seats.
Today,
nursing is a respected profession in India, and nurses play a crucial role in
providing quality healthcare services to people. Nursing education has also
undergone significant changes, and many specialized courses and programs are
now available to aspiring nurses.
CONCLUSION
Nursing
has come a long way to evolve as a respected and essential profession in the
healthcare industry. Globally, the development of nursing can be traced back to
Florence Nightingale, who pioneered the transformation of nursing into a
skilled and specialized profession. In India, nursing began with the East India
Company's Military Nursing in 1664 and has since grown significantly. With the
establishment of nursing schools, the formation of professional associations,
and the introduction of degree and doctoral programs, the nursing profession
has witnessed remarkable progress in India. The profession's evolution has been
marked by the incorporation of technological advances, the development of
specialized fields, and the emphasis on evidence-based practice. The continuous
growth and expansion of nursing as a profession in India and globally are
essential for improving healthcare outcomes and addressing the healthcare needs
of individuals and communities. The future of nursing appears bright, with
increasing emphasis on professionalism, education, and research.
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