The medical world is in the news quite a bit these days, in part because of the tremendous shortage of medical professionals in the United States. At this very moment, more students are entering medical school, but not enough to fill our ever-increasing need for medical professionals. This doesn’t just include doctors, but nurses as well.
In fact, nurses are increasingly the most important providers of medical services in our hospitals. They are the front lines of medical care, seeing to immediate medical needs and administering the medication and care that doctors recommend based on their diagnosis. Without nurses, what few doctors we have would be stretched far too thin to be effective. Given how important nurses and nursing has become, it is important for us to understand how we got here, if we are to understand how nursing will continue to change and become an even greater part of our lives.
Nursing and Hospitals in the Ancient World
The acceptance of Christianity as the official religion of the Roman Empire led to an expansion of care for the empire’s citizenry. Hospitals were built in every cathedral, with well-maintained libraries and training programs, and doctors compiling and sharing their medical and pharmacological manuscripts. These Christian Byzantine hospitals included a staff of a Chief Physician, professional nurses, and orderlies.
During this time, Saint Fabiola is remarkable for her role as the creator and patron of a Roman hospital, where she tended patients herself. In fact, her lifelong devotion to caring for the underserved influenced generations of sister nuns to come.
Later, hospitals in medieval Europe were similar to the hospitals in the Roman, and later Byzantine, Empire. They were essentially religious communities, where monks and nuns tended to patients.
The Lord Giveth
Protestant reformers largely shut down monasteries and convents, which essentially put an end to the hospitals that were connected to those religious communities and operated by their residents. Those nuns who had been serving as nurses were given pensions, and forced either to become married or to remain homebound. Until 1800, Protestant Europe had few if any hospitals, and no system of nursing. Female practitioners were limited to caring for neighbors and family in an unpaid and unrecognized manner.
In Catholic areas of Europe, nuns continued the tradition of nursing. The Daughters of Charity of Saint Vincent de Paul, founded in 1633, took an especially active role in nursing. Other, new orders of nuns took on a number of activities, ranging from providing care for the sick poor to serving as physicians, surgeons, and apothecaries (pharmacists, in today’s vernacular). Unfortunately, the French Revolution saw many of these organizations shut down. However, public demand for the nursing services these orders provided saw them restored after 1800.
Nursing Yesterday
Modern nursing is characterized in Europe by the presence of diaconates. Theodor Fliedner and his wife Friederike Munster opened their first deaconate motherhouse in Kaiserwerth in Germany in 1836. The hospital was called a deaconate after the first nurse to be mentioned in the New Testament, Phoebe. Women who worked in the diaconate model performed 5 years of service in return for room, board, uniforms, pocket money, and lifelong care. Some deaconates emphasized preparing women for marriage, childcare, social work, and housework through their nursing training.
In France, the government worked to secularize public institutions and reduce the role the Catholic Church played in public life. Lay staff was enlarged, but lay nurses came from peasant or working class backgrounds, and were poorly trained when compared to the experienced Catholic nuns. During World War II, many women went to work in hospitals temporarily, but left when the war ended.
During this time, the nursing service that Florence Nightingale and Mary Seacole provided during the Crimean War – the preamble to many of the major wars of the 19th century – went on to inspire women across Europe and North America to enter into nursing.
The Stars and Stripes
Dorothea Dix is noted for fighting for a woman’s right to work in a military hospital during the Civil War, leading to women’s’ increased visibility as nurses. She went on to establish the first mental health system in the U.S. – a system that would go on to serve battle-scarred war veterans to this day.
Nursing became a “profession” in the late 19th and early 20th century that was especially attractive to ambitious women from a variety of economic backgrounds. Over time, those nursing schools that had been inspired by Florence Nightingale came under the control of hospitals, which favored clinical experience over academic study. Over time, women came to prefer graduate nursing programs and social work programs to nursing schools.
A Legacy Lives On
Nursing has seen a number of changes over the years, but it is notable how the profession has largely sprung from religious communities and the call of war. Without the nuns and other intrepid nurses who saw caring for the sick and injured as their civil, moral, and/or religious calling, nursing might not have survived the resistance it faced again and again down through the centuries. The human impulse to learn, to care, and to heal could not be suppressed, however, and our lives are the richer for that.
