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NSG 370 Nursing as a Profession

Nightingale to the 1920’s Loralee Sessanna, DNS, RN, CNS, AHN-BC

Florence Nightingale Founder of Modern Nursing Background:

Born May 12, 1820 to a wealthy, well educated family Wanted to be a nurse since she was a small child Learned Greek, Latin, French, German, & Italian languages Studied history, philosophy, science, math, music, art, classical literature, economics, astronomy; was influenced by the works of Plato Stated that she had been “called by God” 1st calling age 6. Had little patience with organized religion! Determined to do something to “lift the load of suffering from the helpless & the miserable”- this was her calling *

in in a hospital for nursing was strongly opposed by her family-nurses were poor, unskilled, drunken, & immoral; hospitals were filthy/filled with stench & for the poor & destitute.

Dossey, B.M. (2000). Florence Nightingale: Mystic, visionary, healer. Springhouse, PA: Springhouse Corporation.

ining center in Germany & wrote :

; There my heart is, and there I trust one day will be my body…”

mily. Eventually, she was allowed to attend the school for 4 months but the family kept it quiet.

otes about her observations of treatments/responses of the sick. Also recorded in detail the role and work of the Superintendent of the hospital (administrative responsibilities)- which helped her in her first superintendent job.

1

iserwerth arnest in 1851 when she received training in Germany as a Deaconess of Kaiserwerth . While at Kaiserwerth, Nightingale reported having her most important intense and compelling experience of her divine calling.

Nightingale In her early 30’s, Nightingale’s training and experience as a superintendent became useful in her Crimean War work .

At request of British gov’t , she led group of 38 nurses to Scutari Hospital in Turkey to help in the Crimean War 1854-1856. Nightingale:

redesigned wards & the hospital to make them more efficient. kept administrative records /accounting/statistical records. reputation spread throughout medical circles in England & beyond

Scutari Hospital The Old Barrack Hospital During the Crimean War

Crimean War…

Nightingale …1851, before Scutari

… 1856, just five years later

hope my voice may perpetuate the great work of my life. God bless my dear old comrades of Balaclava and bring them safe to shore.” Florence Nightingale, 1890

Florence Nightingale Known as the “Lady with the Lamp” from her work nursing wounded soldiers by candlelight

Accomplishments: created a diet kitchen: previously no provisions for food & water cleaned & scrubbed the hospital got rid of vermin/rat infestations clothes/linens/bandages washed offered words of comfort & care fought for soldier entitlement to sick pay & improved health/living conditions for soldiers reformed hospitals: sanitation /plumbing standards statistical records (army statistics/hospital stats) improved sanitary conditions : introduced a system of recording military hospital sickness and mortality data. This system allowed her to successfully plead her cases for health care reform (evidence – based) wrote numerous books and reports

(1860) Notes on Nursing: What it is and What it is Not

Nightingale is often viewed as nursing’s first theorist

The “lamp” used by Nightingale

htingale’s Accomplishments Con’t health advocate/reformer

shed School of Nursing 1860 gale Training School for Nurses at St. Thomas’ Hospital, London: marked the beginning of professional education in nursing m: bedside nursing, physiology, medical-surgical nursing t associated with hospital; graduates spread knowledge g education emphasized:

ood nurse, one must be an improving woman; for stagnant waters sooner or later, and stagnant air, as we know ourselves, always grow corrupt and unfit for use. Is any one of us a stagnant woman? to the Probationers (students) of the Nightingale Training School at St. Thomas's Hospital London, 1872)

urse researcher (stats, reports): used her statistical data & analysis to improve hospital conditions at Scutari

Nightingale Training School for Nurses at St. Thomas’ Hospital

urning into the war hospitals to find their wounded lovers, and when found, forthwith abandoning their sick-ward for their lover, as might be expected. Yet in the estimation of the authors, these ladies were none the worse for that, but on the contrary, heroines of nursing” (p. 134).

otion as hard a preparation, as any painter's or sculptor's work; with having to do with the living body, the temple of God's spirit? It is one of the fine arts: I had almost said, the finest of Fine Arts.

gale Nurse was to….. no flirtatious, unlady-like, or disrespectful behavior, dress, or activity tolerated ood character. If nurses returned late or drunk, automatically expelled ganization and the skills of observation

rly all nursing duties with tenderness, sympathy, and kindness…qualities “necessary to raise a nurse’s social and moral character” nitation, pharmacy/herbs, diet, disease/pathophysiology, & anatomy. ules for work, classes, sleep, and meals r to pass a required exam needed to be recognized as a professional nurse

le: Mystic, visionary, healer. Springhouse, PA: Springhouse Corporation.

Nightingale School of Nursing: Monthly State of Personal Character and Acquirements of Nurse During Period of Service (Probationers graded monthly: Excellent, Moderate, or “0”) Personal Characteristics: Punctuality Quietness Trustworthiness Personal Neatness and Cleanliness Acquirements (Skills): Cooking and Preparing Food/Diets Changing Dressings/Cleaning Wounds Applying Leeches/Enemas/Catheters Preparing Medications Rubbing (massage) ng Ward Clean: scrubbing walls, floors, dusting, ventilating Washing: patients, bandages, dishes, linens, and curtains Cleanliness of Utensils Management of Convalescents/Ward Observation of the Sick/Communicating Writing Letters /Reading to the Sick Studying/Work Hours Dossey, B.M. (2000). Florence Nightingale: Mystic, visionary, healer. Springhouse, PA: Springhouse Corporation.

s Notes on Nursing: Nursing ming (fresh air!) (5 essential points) ent (visitors, mail, paint, smells, “charge duties” -carry out proper measures yourself and to see that everyone else does too)

gale: Notes on nursing. New York, NY: Fall River Press.

13 Rules of Nursing Con’t Light Cleanliness of rooms(She did not believe Personal cleanlinessin the Germ theory!) Chattering hopes & advices Observation of sick Are any of these rules pertinent to nursing in the 21st century?

Nightingale, F. (2009). Florence Nightingale: Notes on nursing. New York, NY: Fall River Press.

The Nightingale Pledge instructor of nursing at the old Harper Hospital in Detroit, Michigan, and was first used by its graduating class in the spring of 1893. It is an adaptation of the Hippocratic Oath taken by physicians.

ill do all in my power to maintain and elevate the standard of my profession, and will hold in confidence all personal matters committed to my keeping and all fami

Nightingale: 1820 to 1910 Confined herself to her bedroom for the last 14 years of her life Suffered with “Crimean Fever”/ Brucellosis for many years Died at the age of 90

Nightingale Museum /

America Civil War at the outbreak of the Civil War. There were no trained nurses.

an nurses & opened doors to women entering nursing ( the only nurses were in religious orders such as the Catholic Sisters of Mercy and the Sisters of Charity who were overwhelmed by the large number of war causalities).

Nursing Service in 1861 war. The Service was headed by Dorothea Dix who faced many obstacles, including the prejudice of male surgeons who unwelcomed the nurses.

formal training of nurses

l War Nurses Dix islation & reform to improve mental health and prison care; no nursing preparation! ng the civil war, she was appointed the Union’s Superintendent of Female Army Nurses and was in charge of appointing nurses, assigning duties, and overseeing supplies and distributions to troops. when appointed!

Alcott war volunteer nurse; minister’s daughter; women’s rights advocate; famous author- “Little Women” about civil war nursing in 1863- “Hospital Sketches”

man nteer civil war hospital nurse in Washington, DC to the wounded his nursing experiences in a collection of poems called Drumtaps s, Specimen Days and Collect ove of women nursing in military hospitals (not for proper ladies)

urses eturned more of its patients to ranks than any other medical facility. Officers tried to place their most seriously wounded soldiers in Tompkin’s nt care practices.

se in the Union hospitals, toured Union Army camps, and reviewed troops with her husband. mmission which raised private donations to supplement federal funds for soldier supplies, housing, employment, clothing, and medical care of recently freed slaves.

Civil War Nurses Mary Ann Ball Bickerdyke -“Mother Bickerdyke” - fought for better hospital conditions -searched the battlefields at night for wounded soldiers who may have been mistakenly left on the battlefield; soldiers called her “Mother”. -served as a nurse in 19 battles working under fire

Mary Jane Safford helped Bickerdyke search for wounded when the Civil War was over, she studied medicine and became one of the first female surgeons in America

Clara Barton “Angel of the Battlefield" founded the American Red Cross in 1881 gathered baskets of food and supplies from her own household and from the homes of her friends and donated these to the wounded soldiers. brought bandages and dressings to surgeons handed out supplies and carried food and water to wounded men on the battlefield. began a registry for missing soldiers

Visit the Clara Barton House Chapter #1: /

ursing Education Late 19th –Early 20th Century

ellevue Hospital in New York City was the First Nightingale School of Nursing to open in the United States in 1873

Nursing Education Late 19th –Early 20th Century evue Hospital; created a system for charting and maintaining individual medical records for each patient (nurses notes/doctors orders). Instituted the practice of nurses wearing uniforms.

ned black nurse. Did private duty nursing and active at national nurses meetings; one of the first African American women to join the American Nurses Association.

Margaret Sanger: Women’s health. In 1914 she founded the In 1916 , she set up the first birth control clinic in the United States and was sent to the workhouse for "creating a public nuisance." Her many arrests and prosecutions helped lead to changes in birth control rights for women.

Nursing Education Late 19th –Early 20th Century Isabel Hampton Robb graduated from Bellevue in 1883 proposed a three year curriculum that would combine classes and clinical practice daily students should be trained on diversity of patients established the first grading policy in a nursing school -served as President of the American Society of Superintendents of Training Schools for nurses and the Nurses Associated Alumnae of the United States and Canada

Lillian Wald & Mary Brewster (Public Health Nursing) In 1893, founded the Henry Street Visiting Nurse Service which later grew into the Visiting Nursing Service (VNS) of New York City

Wald and Brewster in their Henry Street Office, 1895

Nursing Education Late 19th –Early 20th Century Lavinia Dock : worked with Nutting and Robb to start the first major nursing organization which we know today as the National League for Nurses. advocated women’s suffrage and women’s rights wrote Materia Medica for Nurses, one of the first nursing textbooks

Adelaide Nutting: ntendent at Johns Hopkins Training School for Nurses in 1894, initiated a three year nursing program with eight hour workdays for student nurses believed strongly that nursing should be controlled by nurses and not by doctors or hospital administrators became the first Professor of nursing in the United States

Nursing Education Late 19th –Early 20th Century Clara Louise Maass the first nurse honored on a United States postage stamp the first nurse for whom an American hospital was named the only American and only female to volunteer for the yellow fever inoculation experiment

Civil War Nurse Activists Harriet Tubman “The Moses of Her People” - Black civil war nurse who provided badly needed nursing care to black soldiers and hundreds of newly liberated slaves who crowded Union camps - Freed herself from slavery & led many black slaves to freedom in her underground railroad activities

Please watch:

Sojourner Truth “Traveling Preacher” (Born Isabella Baumfree) Abolitionist (movement to abolish slavery) Speaker/preacher; traveled to speak the truth about women’s rights Activist for women’s rights: famous speech “Ain’t I a Woman?” against those who felt that women & blacks were inferior provided nursing care & collected food and clothing contributions for black regiments

Please watch “Ain’t I a Women”:

arity Hospital 1848-1900 on, first Catholic Bishop of Buffalo harity who called themselves sisters rather than nuns to suggest a worldly mission of service to the needy, especially the sick poor independent of religious affiliation.

eters, electrocardiograms, insulin and 100 percent oxygen. It was the first to use sterile surgical procedures, the first to support cancer research, first to use X-ray machines, blood dialyzers for kidney disease, and the first to use the “patch-graft”

nt in Nursing in the Early 1900s g” (AJN) ed school nurse in North Carolina ablished with 20 Navy nurses 1909: The American Red Cross Nursing Service is organized by Jane Delano 1909: The University of Minnesota develops the first bachelors degree program

resentation Summary

rence Nightingale: The Founder of Modern Nursing & Lady with the Lamp. ought honor and recognition to nursing practice.

ny nurses were actively involved in the political and social issues of their time.

ny famous nursing leaders, activists, and role models contributed to the development of nursing as a profession.

roughout the 1800s and early 1900s, nursing continued to struggle for professional recognition and status.

r influenced the need for nurses and the need for nursing education....