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Nursing Nuns (St. Elizabeth) Cologne Master, late 14th cent.	*Florence Nightingale*

NURSING, as well as the scientific development of medicine, had undergone a “dark ages” from the seventeenth through the early nineteenth centuries. This could not have happened at a worse time, as industrialization and urbanization increased overcrowding, taxed sanitary facilities and promoted infectious diseases

The Lady with the Lamp

Job bathing

Florence Nightingale experienced a conversion a - “call to service” - on Feb. 7 1837, when she was age sixteen.

Not initially permitted to study nursing by her family, she eventually visited hospitals throughout Europe, workhouses in England and Roman Catholic nursing orders on the Continent.

At age thirty-one she was able to spend three months at the Lutheran Deaconess Institution at Kaiserswerth At thirty-three that she was permitted to take a position as a nurse, superintending an institution for ill governesses in Upper Harley St., London.

In 1854-56, at age thirty-four she led the nursing team for the British Army in the Crimean War, and returned a national heroine for saving lives and reforming many practices, against significant opposition from the military physicians.

She then began her perhaps even more influential career as a "nurse and social reformer"

Investigators such as John and Sonya McKinlay and Thomas McKeown have emphasized that the primary determinants of change in mortality rates over the past two centuries included:

c. Impact of the hygiene and public health measures (such as improving water quality and sewage disposal)

e. Changes in the biological organism causing the disease (i.e.: changes in the organisms influence transmission and zero mortality rates)

Nursing Through the Mid-19th Century
ASA Newslatter, October 1996
Volume 60 Number 10
http://www.asahq.org/Newsletters/1996/10_96/Article4.html

Modern nursing care, as the term is known today, can trace its beginnings to Florence Nightingale (1820-1910), whose dedication to helping the sick and injured was the catalyst for nursing having developed into the respectable profession it is today.

During the previous millennia, nursing struggled in its efforts to obtain stature in the art of tender, loving care for the sick. In Greek mythology, two daughters of Asclepius assumed roles in the health of patients, Hygeia as the Goddess of Health and Panacea as the Restorer of Health. In ancient Greece, spas and health resorts were established for the sick and were directed by physicians.

Gradually, hospitals began an association with the care of the injured and sick. In Rome, the first large hospital was established by a Greek Christian woman, Fabiola. In 330 C.E., the Emperor Constantine founded a large hospital in Constantinople, and Saint Basil of Athena erected a large institution. The Roman Catholic Church founded the Hôtel Dieu Hospital in Lyons (592 C.E.) and the Hôtel Dieu Hospital in Paris (650 C.E.). In the eighth to 10th centuries of the common era, hospitals were constructed by the Moslems in Iraq, Syria and Egypt.

The art of nursing in the Middle Ages was relatively simple. It provided for the physiologic needs of patients, administered medications, and dressed wounds and ulcers. Discipline was strict; early nursing was steeped in a tradition of obedience to superiors, dating back to the Middle Ages.

The Augustinian Sisters took charge of the Hôtel Dieu Hospital in Paris. St. Catherine of Siena (1347-1380) established her order (her lamp was the model for Florence Nightingale's lamp in the Crimean War) at the hospital of LaScala, which is still standing as her memorial. St. Hildegarge, a Benedictine abbess in Germany, trained young noblewomen in the care of the sick in her abbey. The Ursuline Sisters, established in the 16th century, emphasized the care of the sick and the injured.

The Third Order of St. Francis of Assisi improved nursing care in the communities in which members of the order lived. The Order of St. Vincent de Paul founded a nursing order with Louise de Gras in Paris called the Sisters of Charity, which trained young women to become nurses. The Beguines were lay nurses organized in 1170 by the priest Lambert de Begue; the order grew to more than 200,000 members who nursed the sick or taught in The Netherlands, France and Germany.

Then came the dark ages of nursing. The Protestant Reformation upset the Catholic organizations that had been established. In England alone, more than 100 hospitals were closed. The aura of the Catholic Church faded into relative obscurity, and nurses were drawn from the lower strata of society. The Protestants were immune to the concept of freedom of action for women; the concept of careerwomen was unthinkable since a woman's place was thought to be in the home. Consequently, nursing as a career lost its organization and social standing. Nursing itself became a blotch in 17th- and 18th-century society. During this relative void came the Industrial Revolution and new thinking in the natural sciences, political philosophy and the wonders of the machine age. With it came hospital reform and construction. As workers concentrated in large cities, large hospitals were founded in London, Grosse Charities in Berlin, Allgemeines Krankenhaus in Vienna and the pavilion system in French hospitals.

However, nursing as an inviting profession lay in the doldrums, although some attempts were made to revive it in the early 19th century. In Ireland, lay nursing institutions were initiated by the Sisters of Charity and the Sisters of Mercy (1812-15). The latter group sent branches to many parts of the world, e.g., Mercy Hospital in Chicago and Pittsburgh. Training schools in nursing were established in 1825, primarily due to the urging of Robert Gooch, M.D. In Germany, the Rev. Theodor Fliedner and his wife set up the Kaisersworth School of Deaconesses near Dusseldorf in 1836 to train nurses to care for sick and convalescent patients. Strictness was observed, uniforms were worn and theoretical institution was given in a three-year course. Similar organizations were formed in London and Boston. The Charity Hospital of New Orleans was begun in 1737, but a teaching school for nurses was not inaugurated until 1894. The Ursuline Sisters came to Canada in 1639, and in 1658, they established a school for nurses at the newly built Hôtel Dieu Hospital in Montreal. In 1830, the Sisters of Charity established the first hospital west of the Mississippi River in St. Louis; it became the present DePaul Hospital.

In 1845, hospitals generally were recognized as places of wretchedness, degradation and squalor, with a lack of sanitation. Fifty to 60 beds, less than 2 feet apart, were crammed into wards. Nursing care, such as it was, was in the hands of uneducated, "immoral" women who considered patients as necessary evils with whom to contend. As one physician stated, "Drink was the curse of the hospital nurse: the nurses are drunkards." Visiting friends and family were the only reliable help to patients.

Into this vacuum came Florence Nightingale. Born into the family of an English country gentleman, she received the proper education and training to be a lady. She then traveled extensively in Europe, ending in Geneva. On returning home, she became a part of English society, attending balls and the busy society of the age. However, she was of a rebellious nature and began to realize her "calling" in life was to nurse the sick, which required a special type of training. However, these ideas aroused great antagonism in her family. Was this ambition of hers the reason she had been educated as a promising young lady of society?

Nevertheless, Nightingale persisted in her quest, and in 1851, at 31 years of age, she went to the Institute of Protestant Deaconesses in Kaisersworth, Germany, under the direction of the Rev. Fliedner for three months. She wrote: "We get up at 5:00, breakfast at 5:45, etc. Several evenings in the week we collect in the Great Hall for bible lessons. Now I know what it is to live and love life." In 1852, she was appointed Superintendent of the Institution for the Care of Sick Gentlewomen in Distressed Circumstances in London, created by Lady Canning. Nightingale realized that what she needed for the institute were superior types of nurses, who were at that time nonexistent, so she planned to create a school to train respectable, reliable, qualified and educated nurses.

However, the Crimean War then burst upon Britain, with many casualties and none to care for them. In 1854, Sir Sidney Herbert, Secretary of War, obtained approval to appoint Nightingale the "Superintendent of the Female Nursing Establishment in Turkey," and later that year, 38 nurses, 24 being professed nuns or Anglican sisters and 14 being "professionals," left London for the Barracks Hospital in Scutari. Nightingale and the group were not welcomed by the British medical authorities, but they obtained a foothold by improving the meals provided to the injured and by caring for the sheer mass of casualties arriving (there were approximately 12,000 in the hospital). The Nightingale group gradually won the respect of everyone. The patients adored them, the purveyors grew to rely on Nightingale, and the doctors came to recognize the value of the nursing abilities provided.

Meanwhile back in England, Nightingale became a heroine. A "Nightingale Fund" was established, and more than 9,000 pounds was contributed, which she used to improve the lot of the British soldier. After the war, two figures emerged as being heroic -- the soldier and the nurse.

Nightingale, however, became seriously ill and depressed and accepted no public engagements for a time. Recently, Canadian commentator James LeFanu, M.D., conjectured that Nightingale was suffering from brucellosis contracted during the Crimean War.

In 1860, Nightingale founded the Nightingale School for nurses, based out of St. Thomas' Hospital in London, with Mrs. Wardrope as its matron. She believed that training and education had two basic aims -- acquisition of knowledge and development of character. It was a standard to which nurses had never been exposed. Strict behavior was mandatory; they attended classes regularly, acted as assistants on wards and received practical instruction from physicians.

In 1897, at Queen Victoria's Diamond Jubilee celebrations, Nightingale's fame was embellished with the public acknowledgement of her influence in the progress of nursing as a distinct profession. There is no doubt that Florence Nightingale should be revered as the founder of modern nursing.

The founding of the Nightingale School coincided with the onset of the Civil War in the United States in 1860. But the American forces were no more equipped for the mass casualties in the Civil War than was the British Army in Crimea. Early on in the conflict, nurses were recruited primarily from Catholic orders: the Sisters of Mercy, Sisters of Charity, Sisters of St. Vincent de Paul and Holy Cross Sisters. An Anglican order also supplied some nurses.

In 1861, the Secretary of War appointed a Sanitary Commission, and the Army Nursing Service was placed in the control of Dorothea Dix, who was not a nurse but the former head of an insane asylum. Eventually, some 2,000 women were recruited; not only was this an inadequate number, but many of those who enlisted had no formal nursing training. However, many provided much needed tender, loving care to the soldiers, established adequate standards of cleanliness and sanitation in the hospitals, and provided improvements in available meals.

Numerous books have been written that detail the work that women and nurses provided for the injured. For example, Mary A. Brody, an Irish immigrant and wife of a lawyer, organized an association of women who visited base hospitals to supply food, established a depot of sanitary supplies, restored morale and often changed dressings. "Mother" Byckerdyke of Illinois not only performed great work in the field, but exercised common sense and instilled the concept that the soldier was always right. She set up washing machines in all Memphis army hospitals for the first time, thereby promoting harmony between her and the physicians. General Ulysses S. Grant gave her permission to go anywhere. Anna Etheridge, or "Gentle Anna," combined true heroism with quiet bearing, deferential manners and unobtrusive worth; "she deserved a gold medal," so the soldiers said. The Sisters of the Holy Cross in Mound City acted as efficient nurses in the hospital and by their skill, quietness, gentleness and tenderness, were invaluable. Mary Safford nursed in one of the Cairo hospitals and overcame the opposition of doctors by her sweet manner, bringing order out of chaos. She was loved by the soldiers. After the war, she became a physician and professor at the Boston University School of Medicine.

Following the Civil War, a number of nursing schools were established in the United States, all being patterned according to the principles established by Florence Nightingale. The Bellevue Hospital School of Nursing in New York City was established in 1873; the New England Hospital Nursing School in Boston, 1872; the Massachusetts General Hospital School of Nursing, 1873, with six pupils; and the New Haven Hospital School of Nursing, 1873.

This Webpage was created for a workshop held at Saint Andrew's Abbey, Valyermo, California in 1990....x.... ’ “”.