[edit] Early life

Embley Park, now a school, was the family home of Florence Nightingale.
Florence Nightingale was born into a rich, upper-class, well-connected British family at the Villa
Colombaia,[1] near the Porta Romana in Florence, Italy, and was named after the city of her birth.
Florence's older sister Parthenope (pronounced /pɑrˈθi:nəpɪ/) had similarly been named after
her place of birth, a Greek settlement now part of the city of Naples.
Her parents were William Edward Nightingale (1794–1874) and Frances ("Fanny") Nightingale
née Smith (1789–1880). William Nightingale was born William Edward Shore. His mother Mary
née Evans was the niece of one Peter Nightingale, under the terms of whose will William Shore
not only inherited his estate Lea Hurst in Derbyshire, but also assumed the name and arms of
Nightingale. Fanny's father (Florence's maternal grandfather) was the abolitionist William Smith.
Inspired by what she took as a Christian divine calling, which she experienced first in 1837 at
Embley Park and later throughout her life, Florence announced her decision to enter nursing in
1845, despite the intense anger and distress of her family, particularly her mother. In this, she
rebelled against the expected role for a woman of her status, which was to become a wife and
mother. Nightingale worked hard to educate herself in the art and science of nursing, in spite of
opposition from her family and the restrictive societal code for affluent young English women.
She cared for people in poverty. In December 1844, she became the leading advocate for
improved medical care in the infirmaries and immediately engaged the support of Charles
Villiers, then president of the Poor Law Board. This led to her active role in the reform of the
Poor Laws, extending far beyond the provision of medical care. She was later instrumental in
mentoring and then sending Agnes Elizabeth Jones and other Nightingale Probationers to
Liverpool Workhouse Infirmary.
Nightingale was courted by politician and poet Richard Monckton Milnes, 1st Baron Houghton,
but she rejected him, convinced that marriage would interfere with her ability to follow her
calling to nursing. When in Rome in 1847, recovering from a mental breakdown precipitated by
a continuing crisis of her relationship with Milnes, she met Sidney Herbert, a brilliant politician
who had been Secretary at War (1845–1846), a position he would hold again during the Crimean
War. Herbert was already married, but he and Nightingale were immediately attracted to each
other and they became lifelong close friends. Herbert was instrumental in facilitating her
pioneering work in the Crimea and in the field of nursing, and she became a key adviser to him
in his political career. In 1851, she rejected Milne's marriage proposal, against her mother's
wishes.
Nightingale also had strong and intimate relations with Benjamin Jowett, particularly about the
time that she was considering leaving money in her will to establish a chair in applied statistics at
the University of Oxford.[2]
Nightingale continued her travels with Charles and Selina Bracebridge as far as Greece and
Egypt. Though not mentioned by the Oxford Dictionary of National Biography, her writings on
Egypt in particular are testimony to her learning, literary skill and philosophy of life. Sailing up
the Nile as far as Abu Simbel in January 1850, she wrote
"I don't think I ever saw anything which affected me much more than this." And, considering the temple:
"Sublime in the highest style of intellectual beauty, intellect without effort, without suffering... not a
feature is correct – but the whole effect is more expressive of spiritual grandeur than anything I could
have imagined. It makes the impression upon one that thousands of voices do, uniting in one unanimous
simultaneous feeling of enthusiasm or emotion, which is said to overcome the strongest man."
At Thebes she wrote of being "called to God" while a week later near Cairo she wrote in her
diary (as distinct from her far longer letters that her elder sister Parthenope was to print after her
return): "God called me in the morning and asked me would I do good for him alone without
reputation."[3] Later in 1850, she visited the Lutheran religious community at Kaiserswerth-am-
Rhein where she observed Pastor Theodor Fliedner and the deaconesses working for the sick and
the deprived. She regarded the experience as a turning point in her life, and issued her findings
anonymously in 1851; The Institution of Kaiserswerth on the Rhine, for the Practical Training of
Deaconesses, etc was her first published work.[4]
On 22 August 1853, Nightingale took the post of superintendent at the Institute for the Care of
Sick Gentlewomen in Upper Harley Street, London, a position she held until October 1854.[5]
Her father had given her an annual income of £500 (roughly £25,000/US$50,000 in present
terms), which allowed her to live comfortably and to pursue her career. James Joseph Sylvester
is said to have been her mentor.
[edit] Crimean War

A tinted lithograph by William Simpson illustrating conditions of the sick and injured in
Balaklava. Published April 1855, digitally restored.
A ward of the hospital at Scutari where Nightingale worked, from an 1856 lithograph.
Florence Nightingale's most famous contribution came during the Crimean War, which became
her central focus when reports began to filter back to Britain about the horrific conditions for the
wounded. On 21 October 1854, she and a staff of 38 women volunteer nurses, trained by
Nightingale and including her aunt Mai Smith,[6] were sent (under the authorization of Sidney
Herbert) to Turkey, about 545 km across the Black Sea from Balaklava in the Crimea, where the
main British camp was based.
Nightingale arrived early in November 1854 at Selimiye Barracks in Scutari (modern-day
Üsküdar in Istanbul). She and her nurses found wounded soldiers being badly cared for by
overworked medical staff in the face of official indifference. Medicines were in short supply,
hygiene was being neglected, and mass infections were common, many of them fatal. There was
no equipment to process food for the patients.
Death rates did not drop; on the contrary, they began to rise. The death count was the highest of
all hospitals in the region. During her first winter at Scutari, 4,077 soldiers died there. Ten times
more soldiers died from illnesses such as typhus, typhoid, cholera and dysentery than from battle
wounds. Conditions at the temporary barracks hospital were so fatal to the patients because of
overcrowding and the hospital's defective sewers and lack of ventilation. A Sanitary Commission
had to be sent out by the British government to Scutari in March 1855, almost six months after
Florence Nightingale had arrived, and effected flushing out the sewers and improvements to
ventilation.[7] Death rates were sharply reduced. Until recently it was commonly asserted that
Nightingale reduced the death rate from 42% to 2% either by making improvements in hygiene
herself or by calling for the Sanitary Commission. For example the 1911 first edition of the
Dictionary of National Biography made this claim, but the second edition in 2001 did not.
During the war she did not recognize hygiene as the predominant cause of death, and she never
claimed credit for helping to reduce the death rate.[8]
Nightingale continued believing the death rates were due to poor nutrition and supplies and
overworking of the soldiers. It was not until after she returned to Britain and began collecting
evidence before the Royal Commission on the Health of the Army that she came to believe that
most of the soldiers at the hospital were killed by poor living conditions. This experience
influenced her later career, when she advocated sanitary living conditions as of great importance.
Consequently, she reduced deaths in the army during peacetime and turned attention to the
sanitary design of hospitals.
[edit] The Lady with the Lamp
During the Crimean campaign, Florence Nightingale gained the nickname "The Lady with the
Lamp", deriving from a phrase in a report in The Times:
She is a ‘ministering angel’ without any exaggeration in these hospitals, and as her slender form glides
quietly along each corridor, every poor fellow's face softens with gratitude at the sight of her. When all
the medical officers have retired for the night and silence and darkness have settled down upon those
miles of prostrate sick, she may be observed alone, with a little lamp in

History of nursing
Main article: Timeline of nursing history

See also: Category:Nurses and Category:Nursing museums

Florence Nightingale, "Lady with the Lamp", pioneer of Modern Nursing

Nursing comes in various forms in every culture, although the definition of the term and the
practice of nursing has being known as a wet nurse and the latter being known as a dry nurse.[1]
In the 15th century, this developed into the idea of looking after or advising another, not
necessarily meaning a woman looking after a child.[1] Nursing has continued to develop in this
latter sense, although the idea of nourishing in the broadest sense refers in modern nursing to
promoting quality of life.
Prior to the foundation of modern nursing, nuns and the military often provided nursing-like
services.[2] The religious and military roots of modern nursing remain in evidence today in many
countries, for example in the United Kingdom, senior female nurses are known as ‘‘sisters’’. It
was during time of war that a significant development in nursing history arose when English
nurse Florence Nightingale, working to improve conditions of soldiers in the Crimean War, laid
the foundation stone of professional nursing with the principles summarised in the book Notes
on Nursing. Other important nurses in the development of the profession include: Mary Seacole,
who also worked as a nurse in the Crimea; Agnes Elizabeth Jones and Linda Richards, who
established quality nursing schools in the USA and Japan, and Linda Richards who was officially
America's first trained nurse, graduating in 1873 from the New England Hospital for Women and
Children in Boston.

A U.S. Navy recruiting poster from World War II, showing a Naval nurse with a
hospital ship.

New Zealand was the first country to regulate nurses nationally, with adoption of the Nurses
Registration Act on the 12th of September, 1901. Ellen Dougherty was the first registered nurse.
North Carolina was the first state in the United States to pass a nursing licensure law in 1903.[3]
Nurses have experienced difficulty with the hierarchy in medicine that has resulted in an
impression that nurses primary purpose is to follow the direction of medics.[4] This tendency is
certainly not observed in Nightingale's Notes on Nursing, where the doctors are mentioned
relatively infrequently and often in critical tones, particularly relating to bedside manner.[5]
The modern era has seen the development of nursing degrees and nursing has numerous journals
to broaden the knowledge base of the profession. Nurses are often in key management roles
within health services and hold research posts at universities.

Nursing as a profession
The authority for the practice of nursing is based upon a social contract that delineates
professional rights and responsibilities as well as mechanisms for public accountability. In
almost all countries, nursing practice is defined and governed by law, and entrance to the
profession is regulated at national or state level.
The aim of the nursing community worldwide is for its professionals to ensure quality care for
all, while maintaining their credentials, code of ethics, standards, and competencies, and
continuing their education.[6] There are a number of educational paths to becoming a professional
nurse, which vary greatly worldwide, but all involve extensive study of nursing theory and
practice and training in clinical skills.
Nurses care for individuals who are healthy and ill, of all ages and cultural backgrounds, and
who have physical, emotional, psychological, intellectual, social, and spiritual needs. The
profession combines physical science, social science, nursing theory, and technology in caring
for those individuals.
In order to work in the nursing profession, all nurses hold one or more credentials depending on
their scope of practice and education. A Licensed practical nurse (LPN) (also referred to as a
Licensed vocational nurse, Registered practical nurse, Enrolled nurse, and State enrolled nurse)
works under a Registered nurse. A Registered nurse (RN) provides scientific, psychological, and
technological knowledge in the care of patients and families in many health care settings.
Registered nurses may also earn additional credentials or degrees enabling them to work under
different titles.
Nurses may follow their personal and professional interests by working with any group of
people, in any setting, at any time. Some nurses follow the traditional role of working in a
hospital setting.
Main article: Nursing practice
Nursing practice is primarily the caring relationship between the nurse and the person in their
care. In providing nursing care, nurses are implementing the nursing care plan, which is based on
a nursing assessment.
Definition
Although nursing practice varies both through its various specialities and countries, these nursing
organizations offer the following definitions:
Nursing encompasses autonomous and collaborative care of individuals of all ages, families, groups and
communities, sick or well and in all settings. Nursing includes the promotion of health, prevention of
illness, and the care of ill, disabled and dying people. Advocacy, promotion of a safe environment,
research, participation in shaping health policy and in patient and health systems management, and
education are also key nursing roles.
— International Council of Nurses [6]
The use of clinical judgement in the provision of care to enable people to improve, maintain, or recover
health, to cope with health problems, and to achieve the best possible quality of life, whatever their
disease or disability, until death."
—Royal College of Nursing UK [7]
Nursing is the protection, promotion, and optimization of health and abilities; prevention of illness and
injury; alleviation of suffering through the diagnosis and treatment of human responses; and advocacy in
health care for individuals, families, communities, and populations.
—American Nurses Association[8]
The unique function of the nurse is to assist the individual, sick or well, in the performance of those
activities contributing to health or its recovery (or to peaceful death) that he would perform unaided if he
had the necessary strength, will or knowledge.
—Virginia Avenel Henderson[9]
Nursing theory and process
Main articles: Nursing theory and Nursing process
In general terms, the nursing process is the method used to assess and diagnose needs, plan and
implement interventions, and evaluate the outcomes of the care provided. Like other disciplines,
the profession has developed different theories derived from sometimes diverse philosophical
beliefs and paradigms or worldviews to help nurses direct their activities to accomplish specific
goals. Currently, two paradigms exist in nursing, the totality paradigm and the simultaneity
paradigm.
Practice settings
Nurses practice in a wide range of settings, from hospitals to visiting people in their homes and
caring for them in schools to research in pharmaceutical companies. Nurses work in occupational
health settings (also called industrial health settings), free-standing clinics and physician offices,
nurse-run clinics, long-term care facilities and camps. They also work on cruise ships and in
military service. Nurses act as advisers and consultants to the health care and insurance
industries. Some are attorneys and others work with attorneys as legal nurse consultants,
reviewing patient records to assure that adequate care was provided and testifying in court.
Nurses can work on a temporary basis, which involves doing shifts without a contact in a variety
of settings, sometimes known as per die nursing, agency nursing or travel nursing. Nurses work
as researchers in laboratories, universities and research institutions.
Work Environment
Internationally, there is a serious shortage of nurses.[10] One reason for this shortage is due to the
work environment in which nurses practice. In a recent review of the empirical human factors
and ergonomic literature specific to nursing performance, nurses were found to work in generally
poor environmental conditions. DeLucia, Ott, & Palmieri (2009) concluded, "the profession of
nursing as a whole is overloaded because there is a nursing shortage. Individual nurses are
overloaded. They are overloaded by the number of patients they oversee. They are overloaded by
the number of tasks they perform. They work under cognitive overload, engaging in multitasking
and encountering frequent interruptions. They work under perceptual overload due to medical
devices that do not meet perceptual requirements (Morrow et al., 2005), insufficient lighting,
illegible handwriting, and poor labeling designs. They work under physical overload due to long
work hours and patient handling demands which leads to a high incidence of MSDs. In short, the
nursing work system often exceeds the limits and capabilities of human performance. HF/E
research should be conducted to determine how these overloads can be reduced and how the
limits and capabilities of performance can be accommodated. Ironically, the literature shows that
there are studies to determine whether nurses can effectively perform tasks ordinarily performed
by physicians. Results indicate that nurses can perform such tasks effectively. Nevertheless,
already overloaded nurses should not be given more tasks to perform. When reducing the
overload, it should be kept in mind that underloads also can be detrimental to performance
(Mackworth, 1948). Considering both overloads and underloads are important to consider for
improving performance." [11]
Regulation of practice
The practice of nursing is governed by laws that define a scope of practice, generally mandated
by the legislature of the political division within which the nurse practices. Nurses are held
legally responsible and accountable for their practice. The standard of care is that of the "prudent
nurse."

Nursing specialties
Main article: List of nursing specialties
Nursing is the most diverse of all healthcare professions. Nurses practice in a wide range of
settings but generally nursing is divided depending on the needs of the person being nursed.
The major divisions are:-
• the nursing of people with mental health problems - Psychiatric and mental
health nursing
• the nursing of people with learning or developmental disabilities - Learning
disability nursing (UK)
• the nursing of children - Pediatric nursing.
• the nursing of older adults - Geriatric nursing
• the nursing of people in acute care and long term care institutional settings.
• the nursing of people in their own homes - Home health nursing (US), District
nursing and Health visiting (UK). See also Live-in nurse
There are also specialist areas such as cardiac nursing, orthopedic nursing, palliative care,
perioperative nursing and oncology nursing, or the specialization to cancer.

Nursing by country

History of Nursing Schools in the United States

In the beginnings of formal nursing, most nursing education was done within the hospital
context. Nurses learned from trial and errors on the job, under the supervision of other superior
nurses. However, this lack of formal training led to high mortality rates and nurses with scattered
skill sets. Clearly, there was a need for some sort of nursing school. This became evident in the
early 1900s.
The work of Clara Barton during the Civil War cannot be ignored. While stationed as a patent
clerk, she began to organize ways of getting vital medical supplies to the troops and then headed
into the battlefield herself in order to administer aid. With this fervor, it was clearly seen that
nursing needed to be organized in order to provide the best possible care for all patients.
The movement began with Congress’ authorization of the Army Nurse Corps in 1901. In this
group, nurses would be trained in various life-saving techniques and then be able to help soldiers
heal from their battle wounds. With all of the threats of infection in this time, it was imperative
to have some form of education to prevent the spread of disease. This acknowledgement by the
government allowed the nursing society to become more valid in the eyes of the country and
started a chain of events that would forever change the fate of nursing education in the United
States.
In 1905, Annie Walburton Goodrich became the first women named president of the American
Society of Superintendents of Training Schools for Nurses. She began the revolution of
establishing guidelines for learning and the proper nursing instruction. She held her position as
president until 1906 and served as president of the International Council of Nurses as well as the
American Nurses Association in the following years before becoming an assistant professor at
Columbia University.
It is interesting to note that Columbia University was established in 1892 with Anna Maxwell as
director. However, Columbia isn’t always given the distinction of the first formal school because
Yale was the first autonomous nursing school in 1923. Columbia brought much to the nursing
professional, graduating nearly 9,000 students from its well-planned program.
To this day, Columbia University offers the oldest program in nursing midwifery as well as
being the first to offer a master’s degree in a clinical specialty for nurses (since 1956). Columbia
was the first nursing school to have admitting privileges at a local teaching hospital and requires
that its staff do funded research on cutting edge topics. Columbia was also the first nursing
school to be recognized by the World Health Organization as a Collaborating Center for
international development of nurses in advanced practices.
But that doesn’t mean that Yale hasn’t had its fair measure of success as well. Established in
1923, Yale Nursing School named Annie Walburton Goodrich its first dean of studies and paved
the way for women in nursing. Unlike Yale College, Yale Nursing School did admit women and
requires the same high academic prerequisites. Classes began in 1924.
In 1925, Yale Nursing Schools established its Bachelor of Science in Nursing program and
required that applicants complete two years of general college education prior to applying to the
nursing school. This was the highest academic requirement in that time. By 1934, the
requirements were raised to an undergraduate bachelor’s degree.
Not to be outdone, the University of Michigan also opened its doors to nursing students in the
late 1800s. Though not an autonomous nursing school, six students graduated in 1893. In 1919,
the University of Michigan began offering a five-year program that resulted in a general
Bachelor of Letters degree as well as a nursing diploma. By 1944, the university added a five-
year Bachelor of Science degree that included two years in the college of literature, arts, and
sciences and three years in the nursing program. This allowed the university to be one of the first
institutes to offer concurrent academic and nursing education programs. In 1953, their Bachelor
of Science degree program was founded.
There are hundreds of nursing schools that were established throughout the United States in
order to regulate training in order to help aid patients more effectively. With the institution of
these schools, fewer patients were dying due to poor practices. Furthermore, more advanced
techniques could be taught to more nurses.
In modern times, nursing schools are offering advanced programs that give nurses even more
skills to advance their careers as well as the care of their patients. There are nurse practitioners as
well as certified midwifes that can help patients as well as doctors and obstetricians. Also, more
entry-level nursing programs are available to help students determine if nursing is truly for them.
Schools now offer certified nurse assistant, licensed practical nurse, licensed vocational nurse
and advanced practice nurse programs. There are also programs for becoming a clinical nurse
specialist.
Find a nursing school near you by using our online search tool below: