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The History of Nursing Education in Modern Greece

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Balkan Military Medical Review
Jul - Sep 2013; 16(3): 375 - 381

Review Article

The History of Nursing Education in Modern Greece

Theologia ZIOGOU1, Aliki DIMITRIADOU2, Evangelos FRADELOS3*

Affiliation of authors:
1. Clinical Lecturer, Department of Nursing, Alexander Technological Educational Institute,
Thessaloniki, Greece.
2. Assistant Professor, Department of Nursing, Alexander Technological Educational
Institute, Thessaloniki, Greece
3. Nurse RN, State Mental Hospital of Attica “Daphne”, Athens, Greece

Corresponding Author:
Evangelos FRADELOS
Davaki 20, Glyfada, 16674
Athens,Greece
Tel. +3066946228458
E.mail: evagelosfradelos@hotmail.com
376 Balkan Military Medical Review
Vol. 16, No 3, Jul - Sep 2013

Abstract foundation of the first nursing school at St.


The following historical study presents Thomas Hospital in London in 1860 [3].
the chronicle of the evolution of nursing Greek Nursing was also affected by
education in modern Greece. This study the global growth of Nursing and followed
indicates that although Nursing started an equal path over the years, with
as a bread-winning occupation of low significant growth in the recent years.
educational level, today it is taught in Briefly, this historical study
higher education institutions highlights and projects the important
(Universities and Technological nursing educational work that was
Institutions). It requires specialized organized by the troubled Greek state from
knowledge and techniques within its the time of its foundation until today.
application, which shape the level of In order to conduct this study, the
quality of care in all health services of methodology of historical research was
modern Greek reality. used. Sources of data were the Laws and
decrees of the time, publications such as
Keywords: History, Evolution, Nursing articles, studies, as well as text and
education, Greece, Nursing schools photographs regarding this matter. For
archiving the material a classification
system of data was used, according to the
source and its alphabetical and
Introduction chronological order.

Nursing is a science and an art. It is The Evolution of Nursing in Modern


about servicing the health needs of Greece
individuals, of families and society in
general, with an ultimate goal to maintain After the fall of Constantinople, the
health, prevent disease, as well as Byzantine capital city in 1453, organized
providing treatment that will restore nursing stops its development and is left to
health. the private initiative. During the siege of
The nursing profession seems to Thessaloniki by the Turks women were
have appeared in the history of mankind offering nursing services. Later,
from the time where a fee was a throughout the period of Ottoman rule, the
prerequisite in order for a specialized monasteries were the centers of social
person to provide healthcare to those who welfare and nursing care [4].
needed it[1]. After liberation and creation of the
Within the passage of time, the new Greek state, the health status of the
inevitable changes that occurred in people's country was in bad shape and the
lives reformed the nature of the nursing healthcare problem was huge. There were
from a family affair into a profession [2]. too many disabled, injured and sick.
Leader of this effort was the great Greece, however, had well-trained doctors
British nurse Florence Nightingale, whose at that time. In the Ionian Islands, as early
successful actions in the Crimean War as the 17th century, Medicine was taught
(1854-1856) were succeeded by the in the so-called „Exisfalismenon‟ Acade
my, the Academy of Fertile and the
Academy of the Wanderers [5].
Ziogou Th. et al: The History of Nursing Education in Modern Greece 377

In 1835 the Medical Society of body of nurses selected from the finest of
Athens was founded and in 1837 the the enlistment. Approximately 160 years
School of medicine of the University of ago, the very few soldiers who knew
Athens [6, 7]. The first Hospital of Athens reading and writing, were considered well
was the Military Hospital „Makriyannis‟ educated [11, 14].
(1836) and the state Hospital „Elpis‟ Finally, it should be noted that
(1836) [8, 9]. during the „Greek-Turkish war‟ in 1897 the
The successful implementation of nurses - soldiers fulfilled their debt to both
medical services to hospitalized militaries Asclepius and Ares (Mars): “…officer and
and other citizens was provided, in support soldier that showed admittedly his
of the medical work, by the well trained superhuman bravery ... and those of the
and responsible nursing personnel. Healthcare sector, doctors and nurses that
took part and two of them were killed!”.
Stages of Evolution of Nursing [14] Those were Verginis Athanasios from
Education in Greece Kalamitsi of Corfu and Dimitrios Tsamis
from Mandra of Attica [15].
Hospitalization of patients in the The first efforts for professional
first hospitals after the liberation of the education for nurses belong to Queen Olga,
country was exercised by practical nurses. who in 1875 founded the first School of
They were women with low educational Nurses called „Evangelismos‟: it was the
levels who practiced the nursing third in the world [16]. Nine years later, in
occupation to earn their living [2, 4]. The 1884, the hospital „Evangelismos‟ was
first effort for educated and trained nurses founded, one of whose purposes was "... to
that were in fact men, was made by the educate women nurses according to the
Directorate of Health Services of the Greek rules of science". Initially, the attendance
Army, which created the first „School of at this nursing school was for 2 years.
Nursing‟ by a decree "About the Later, in 1930 it was reorganized and
recommendation of school for Nurses" on became a three-year program. The
August 18, 1861 [10]. The establishment educational program of the School had a
of the School occured about the same time significant positive impact on the nursing
with the School of Nursing of Florence services of the hospital and in the patient
Nightigale at Saint Thomas Hospital in treatment provided. Training courses were
London (1860) [11, 12]. organized, as well as seminars and special
It is also mentioned in the great symposiums. Graduates of the school were
Military and Naval Encyclopedia: "The also retrained abroad [17]. They were
school was founded on the 18th of August extremely hard-working with and did so
of 1861, aiming to educate experienced with a lot of heroism during the Balkan
nurses for peace and campaign Services. wars (1912-1913), the flu epidemic
The soldiers that had successfully attended (1918) the dengue fever epidemic (1928)
the school were given the specialty of and during the war of 1940-'41 [1, 4].
nurse and were used as such; this specialty The establishment of the
was also noted on their army certificate" Evangelismos Hospital must be considered
[13]. as a turning point for two reasons: first, the
The choice of soldiers - nurses relatively comfortable surroundings began
from „the excellent or unimpaired of trim‟ to attract people and not frighten them, and
and the notice that they should know secondly it started the systematic
reading and writing indicates the interest of scientific training of women nurses. As it
the army department to be staffed by a was characteristically described in an
378 Balkan Military Medical Review
Vol. 16, No 3, Jul - Sep 2013

article written by Trifon Andrianakos in of them gave their lives for their country
1930 in the journal Greek Medicine “Until [1, 12]. The State acknowledged the
the time of the creation of 'Evangelismos‟ sacrifices of Sisters nurses and in 1946 the
in Greece, and most especially in Athens, Greek Parliament unanimously passed the
the idea of hospitalization was frightening Legislative Decree (LD) 663/46 by which
for the poor and the general population… many matters relating to the Sisters nurses
as for the wealthy and educated people, were settled [23].
they preferred home healthcare and The year 1946 was a milestone in
considered hospitalization of their the evolution of nursing in our Country. By
relatives as inappropriate” [18, 19]. LD 663/1946 the title „graduate nurse‟ was
As time passed and after the Balkan established and the procedure for
wars had ended, in 1914, the Hellenic Red dispensing license to practice was defined;
Cross (HRC) founded a two-year the same law described the duties,
attendance school for the Sisters organized nursing education and
assistants of HRC. Zenovia Bolla, a Greek addressed the careers of the Sisters, the
graduate Sister from the School of Nursing certificate of the old-type of high school
of London Hospital, was asked to be the was considered an essential qualification
director of school. Marianthi Lekatsa, for the introduction of female students at
which had been trained in the school of the schools of nurses. Greece was the first
Boston, also taught there [2, 3]. The Country in Europe that established the
Graduates of the school, given an existing School Certificate as an entry qualification
law that that was published in the Official to nursing schools, followed by Belgium
Gazette in May 1914, were granted by the ten years later in1956 [4, 24, 25].
Greek Government the first official license In May of 1948 the Board of
to practice the nursing profession [1,3,20]. Nursing was established at the Ministry of
Furthermore, in 1924 the HRC Health, which was responsible for Nursing
founded the „Higher School of Nursing of Education, keeping records of the nurses
the Hellenic Red Cross‟, the first in Greece and for all matters that were related to the
with a three-year training program since its practice of the profession [4, 26, 27].
foundation. Until then, the students of Later on, new Schools for Nurses
HRC were trained in the hospital were created and the first was in 1946, the
„Evangelismos‟ [21]. In 1937, with the Military Officers Schools for Nurses in
Law 613/1937, the school of visiting Athens. The Director of this school was
sisters and nurses was founded inside the Cleopatra Avagianou, a graduate of HRC
Health School of Athens in Ambelokipoi, school [28]. In 1954 another State Nurses
and was supervised by Helen School was created in Thessaloniki [29].
Vassilopoulou [22]. That was followed by the
In the war of 1940, Sisters worked establishment and operation of several
exceptionally well under difficult and training schools for Nurses with a three- or
dangerous conditions. The Hellenic Red four-year study, under the auspices of the
Cross mobilized approximately 3,000 Ministry of Health and Welfare [4, 27].
Sisters, of which 300 were graduates and In chronological order according to
2,700 volunteers. All these Sisters covered the year of their foundation these schools
the nursing needs of the Armed Forces of were:
the country. Mountain surgeries, Nursing school of Agia Sophia Hospital,
ambulance stations, military and Floating founding year 1960;
Hospitals. Many of these Sisters were Nursing and Health Visitors School of
injured and some were disabled while 14 PIKPA, founding year 196;
Ziogou Th. et al: The History of Nursing Education in Modern Greece 379

Nursing school of Aglaia Kyriakou Universities, one in the University of


Hospital, founding year 1964; Athens and the second at the University
Nursing school of Pammakaristos Hospital, of the Peloponnese; there also exist seven
founding year 1965; nursing departments in Technological
Nursing school of 'King Paul' Athens Education institutions [1, 3]. Thereby the
General Hospital, founding year 1969; whole "nursing education" has been
School of deaconesses and nurses transferred from the Ministry of Health
„Olympiada', founding year 1969. (Boarding Schools by bedside of the
In 1973 five nursing schools were patient, according to Florence Nightingale)
founded at the Centers for Higher to the Ministry of Education (according to
Technical Training (Ministry of Education) the American education system) [1,3,29].
in Athens, Thessaloniki, Patras, Larissa Nursing education was extended to
and Iraklion [1, 2]. issues of social sciences, management
In 1979 by Presidential Decree (PD practices and teaching, Legislation, Public
184/79) that was published in the Health, Pediatrics and Psychiatry. By the
"Government Gazette" (GG 5IA/15-3- Law 1579/1985 four nursing specialties
1979) the Department of Nursing was were established: Internal Medicine,
founded at the School of Health Sciences Surgery, Mental Health and Pediatric
of the University of Athens [30, 31]. Nursing. By the same law the term that
Since 1983, the department was used sister-nurse was replaced by Title
operates autonomously. The first Ph.D. Nurse - RN [35]. These programs are
Nursing Diploma from a Greek University operating satisfactorily until now.
was awarded in June 1987 to a graduate of Responsible for implementing them are
the Nursing Department; since 1993 it nurses along with the managers of nursing
started more systematically as a two-year Services. By addressing all the problems
Postgraduate study Program before the that had arisen, they managed to preserve
Ph.D. [1,2]. Furthermore, by the Law the gravity and validity of their programs,
3391/2005/ “GG” 240/4-10-2005 the so for ten years now are steadily sought
Department of Nursing at the University of after by nurses from all over Greece [27].
Peloponnese was founded and began its So Greece became the first
operation in the academic year 2005-2006 European country to apply generalized
[32]. nursing programmes, as America and
The Law 1404/1983 established the Canada did many years ago. It should also
Technological Educational Institute (TEI) be noted that the education that was
under the auspices of the Ministry of provided at the time, was one of the finest
Education as the Centers for Higher in Europe. It was shown after Greece's
Technical Training and the nursing accession to the European Union (EU) in
schools of various hospitals were abolished 1981, that the nursing programmes were
[33]. Thus, Departments of higher nursing fulfilling the EU guidelines dating from
Schools, health Visitors and Nursing, that 1977 [1, 36].
were under the jurisdiction of the Ministry It should also be noted that after
of Health, Welfare and Social Security and 1990 the Vocational Training Institutes
Centers for Higher Technical Training (IEK) were created, which provided
were joined to the technological education specializations in nursing. According to the
[1, 3]. Presidential Decree no. 210/2001 license to
The Law 2916/2001 joined all the practice the profession is granted to those
TEIs in higher education [34]. Today there that have a diploma from the Organisation
are only two departments of Nursing at for Vocational Education and Training to
380 Balkan Military Medical Review
Vol. 16, No 3, Jul - Sep 2013

the level of post-secondary vocational development and social recognition of


training, to specialties such as „Nursing nursing [42].
Traumatology‟, „Nursing for Oncology
Diseases‟, „Operating Room nursing‟,
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