History of Nursing and The
Development of the Profession
Nursing over the years has greatly
evolved from caring for the sick in
homes, churches into hospitals with
these changes women have went from
uneducated, nonvalued caregivers to
educated and valued professionals.
Nursing before the 1800’s was not
valued in society. Caring for the sick
was mainly supported by religious
monks, nuns or religious community
who wanted to do work for God.
Nursing and caring for the ill changes
during the Crimean War by one
women.
In 1837 Florence Nightingale felt called
to the profession of nursing to after
doing charitable deeds within the
community.
Coming from wealthy statue her
parents put hault to her choices of the
nursing occupation saying it was
inappropriate to women of her class.
Being raised in a wealthy family in
England her parents had expectations
of her to marry and live life as a upper
class citizen and not one of a lower
statue.
In 1844 her parents eventually were
expecting of her calling to nursing and
she began her study at Luthern
hospital, Kaiserwerth, Germany.
In 1850 Florence Nightingale traveled
to Alexandria, Egypt where she
expanded her knowledge at St.
Vincent de Paul Institute.
In 1853 Nightngale returned to
England and became a superintendent
of a hospital for invalid women.
In 1854, after the Cimean War broke
out there were a shortage of medical
facilities for wounded British soldiers.
Sidney Herbert, a war minster, who
knew Nightingale asked her to gather
a team of nurses to oversee the
military hospital in Turkey.
By 1854 her team had greatly
improved the hospital conditions and
decreased the rate of mortality.
Nightingale’s focus was to improve
patient care by recognizing and
cleaning. In this time period
medications were readily available,
hygiene was neglected and mass
infections were common.
She believed that implementing and
improving sanitary conditions would
decrease mortality and infectious
disease.
To prove that her change in sanitary
condition really was effective,
Nightingale used her mathematical
Intelligence to prove the statistical
data.
Nightingale came up with a coxcomb
graph which became an excellent tool
to visually present statistical data.
In 1858, Florence Nightingale
presented the coxcomb graph to Royal
Communission in hopes to improve
sanitation, medical care and public
health within all hospital settings.
In 1860, Florence Nightingale
established a nursing training school at
St. Thomas hospital in London.
In 1873, the Royal Commission
approved her reform to improve
sanitary conditions.
The Royal Commission declared that
all hospitals implement Nightingale’s
protocol on sanitation due to the year
alone the mortality rate in Indian
soldiers went from 69% to 10% per
1,000 soldiers.
In 1874, the first professional
American trained nurse was Linda
Richards who received her degree at
New England Hospital.
In 1877, Richards later advanced her
practiced at Nightingale’s school at St.
Thomas Hospital in London. This is
where she gained knowledge in
charting, pt records, and aseptic
technique.
Later in Richard’s career established
nursing schools using Nightingale’s
model in Japan and United States.
The first nursing school in the USA
was the Nursing training school of
Women’s Hospital of Philadelphia,
established in 1872 which followed
Nightingale’s theory of nursing.
At the age of 38, Nightingale was
bedridden due to contracting Crimean
fever. Pursuiting her dream did not
stop here. Linda Richards a former
student, consulted her for knowledge
on managing care during the Civil War.

Dorothea Dix’s was well known nurse
in the mid 1800’s for her devotion to
mentally ill and aiding the wounded
during the Civil War.
In 1848, Dix’s lobbied at the federal
level for a grant of 12 million acres oof
land as public endowment for the
mentally ill.
Dorothea Dix lobby was approved by
the Congress but later vetoed in 1854
by President Franklin Pierce.
In 1861 after the civil war broke out
Dix’s volunteered her services and
was named the superintendent of
nurses.
Dorothea Dix was responsible for
organizing field hospitals, first aide
stations, recruiting nurses, managing
supplies, and setting up training
camps.
After the war, Dorothea Dix went back
to working with the mentally ill and was
able to establish 32 mental institutions
across the United United states.
In the late 1800’s nursing schools were
economically dependent on hospitals
to the advantage of student labor on
site.
Student nurses were known to be
obedient and compliant. They were
cheap help, delivered efficient patient
care was very cost effective when
being compared to a graduate nurse
that are hired in.
After nursing training was completed,
only a handful graduated nurses would
be able to find work in the hospital
setting due to the majority of care was
provided by the nursing students.
In 1896, the American Nursing
Association was formed to protect the
public from the danger of uneducated
nursing personnel. It was noticed that
only 1/10 of the people practicing
nursing during this time period were
educated. This organization wanted all
graduated nurses to achieve licensure
following graduation prior to taking
care of the ill.
In 1903, North Carolina passed the
first nurse licensure act in the United
States.
By 1921, 48 states followed North
Carolina’s pursuit the practice of
professional nursing licensure.
These laws all changed during the
Great Depression States started to
become more lenient and lacked the
reinforcement of nurse licensure. Many
uneducated nurses were working with
the sick just for pay. This created a
competition for positions within the
work field between the educated and
the uneducated.
By the help of the ANA in 1940, it
became a mandated law that all
nurses must be licensed to practice in
the nursing profession.