On Independence Day, 242 years ago, our Founding Fathers signed the Declaration of Independence, moving the original thirteen colonies towards a future in which they were not bogged down by the rule of a tyrannous, greedy king. That was July 4th of 1776, but today is July 4th of 2019. This year, we’re sure that many of you are not working, though a good number of nurses may still be carrying out their shifts in the hospital. Barbecues, fireworks, and family — these are some of the things that make Independence Day such a great for Americans. Between these celebrations, we’re to remember what made this country what it is and what values we should still be upholding. That’s plenty of thought to American history, but do you know what else is a part of American history that is not taught in detail ever? The history of nurses! This year, NursingCE wants to help you understand where nursing came from and how it’s changed throughout the years, like when did states begin requiring CEs to be completed every two to three years?
For a very long time, healthcare was inefficient and sparse. Because of the nature of society back then in America, women played the essential role of care-taking and “keepers” of medical information. During the Revolutionary War, there was an estimated 200 doctors with educational degrees offering medical care to those in need. At this time, nursing was not an official profession; it was not until the middle of the 1800s during which there were formal programs for nurses to learn and become what they wanted to be. However, in July 1775, which is a year before the Declaration of Independence was signed, George Washington, the American leader at the time, recognized that the soldiers fighting the war needed better care than they had. Thus, he approved medical support for a Continental Army of 20,000 men. One nurse helped care for every ten patients, and in that decree that Washington himself put out, he states, “a matron [must] be allotted to every hundred sick or wounded, who shall take care that provisions are properly prepared; that the wards, beds, and utensils be kept in neat order…” Very clearly, nursing has changed and become much more encompassing since then.
While on the job, nurses learned a lot. The experience they gained from being near battlegrounds was immense, though there was yet to be a formal training program to help them with their education. This professionalization happened over time. In the latter half of the 1700s, medical schools and structured medical training for doctors began to develop. Though cities were expanding in size and population, hospitals were a rare commodity before the 1860s. There were many efforts, though, to try and build professional knowledge in medical care; for example, in 1839, Dr. Joseph Warrington founded the Nurses Society in Philadelphia in an attempt to better the care of mothers and their infants, even publishing The Nurse’s Guide to set nursing standards for improving the profession. In 1861, Elizabeth Blackwell, the first woman to graduate from medical school in the United States, created a course to help train women serving as nurses for the Union Army. Throughout the Civil War, there were many more opportunities for women to join the growing profession of nursing; thousands of women joined the cause, many of whom started the war with very little training but learned along the way.
(Additionally, Florence Nightingale reformed nursing and laid many foundations for modern nursing as a profession. She assisted heavily in Britain during 1854’s Crimean War, tailoring her medical care to the belief that dirt was causing death and misery, not microscopic pathogens. She caused the mortality rate to drop significantly. She’s from Britain, though, so this is not included in great detail. This is the American history of nurses, after all!)
Catholic nuns also played an important role in advancing nursing in the United States; after the civil war, they were pivotal in the opening of nearly 500 hospitals. They also assisted in opening nursing schools to standardize and professionalize nursing in the United States.
After the Civil War, attitudes about women working outside of teaching began to change. During the 18th and 19th centuries, many found it unbelievable that women were working outside of the home; but attitudes changed slightly. Different reform movements and suffrage movements began to impact how society perceived women’s roles.
During the 1860s, healthcare began to move from the home into hospitals. There were more skilled staff members who knew how to care for and treat disease and illness. Nursing also grew, and two leaders in professionalizing medicine were Dr. Ann Preston and Dr. Maria Zakrzwska. They were both female physicians, which was rather rare at the time, and they founded women’s hospitals run by and for women that also trained female doctors and nurses.
In 1872, the first permanent school of nursing in America was opened; it was the nurse training school of the Women’s Hospital of Philadelphia. It followed Nightingale’s model of caring about sanitation and had a set nursing study curriculum, paid nursing instructors, and equipment to practice skills and procedures.
Racial prejudice and segregation during the 19th and 20th centuries unfairly kept most African Americans from becoming nurses. In fact, up until 1879, racial prejudice kept them from being trained formally in totality, but that year, Dr. Zakrzwska’s nursing school gave a degree to Mary Eliza Mahoney, the first African American professional nurse in the United States.
In 1883, the number of nursing schools in the United States had grown to 35. In 1896, the Nurses’ Associated Alumnae of the United States and Canada was founded; this organization is now known as the American Nurses Association (ANA).
By 1900, 432 nursing schools had been opened across the United States. The U.S. even began to pass legislation and make laws that regulated the practice of nursing. World War I and World War II pushed the nursing profession into a place where Americans thought they were incredibly respectable and trustworthy. In 1903 specifically, North Carolina passed the FIRST EVER BILL that allowed nurses to register with the state after receiving an education from an approved institution. Thus began the age of registration, licensure, and re-licensure for nurses.
In this day and age, medicine and treatment have been so radically reformed by technology. In the last century, there have been so many advances that have changed the world: sanitation in hospitals, clean water supplies, vaccines, antibiotics, radiology, anesthetics, and so on. Now, nurses can focus their training to specialize in different fields of medical care, such as general practice, pediatrics, neurology, cardiology, and orthopedics, just to name a few.
So today, when you’re sitting on blankets spread across lawns waiting for night to fall, when you’re watching bright colors explode all across the sky, even when some of you are in your workspace taking care of patients, take a moment to recall the history of what has made America, and now, another moment to recall the history of what it took to make nursing a profession in America. Without the brave, courageous, and intelligent women (and men) who paved the way for nursing, set down foundations despite gender barriers, and helped continuously reform nursing to be the best it can be, nursing would not exist as you know it today.
It is now up to you, then, to continue making better what has been passed on down to you. Remember history, and be a part of it. Continue to advance nursing in a positive way while keeping in line with the present and future so that medical care and all others can be as well-off as possible, too.
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