History of

Nursing

Prepared by:
Susana P. Arellano, RN, MAN, MSN
 In the World……

HISTORICAL EVOLUTION OF NURSING

I. Period of Intuitive Nursing/Medieval Period
 From Prehistoric times up to the early Christian Era
 Nursing was “untaught” and instinctive. It was

performed of compassion for others, out of the wish

to help others.
 Nursing was a function that belonged to women. It

was viewed as a natural nurturing job for women. She

is expected to take good care of the children, the sick
and the aged.
 No care giving training is evident. It was based on

experience and observation.

 Primitive men believed that illness was caused by
the invasion of the victim’s body of evil spirits.
They believed that the medicine man, Shaman or
witch doctor had the power to heal by using white
magic, hypnosis, charms, dances, incantation,
purgatives, massage, fire, water and herbs as a mean
of driving illness from the victim.
 Trephining – drilling a hole in the skull with a rock

or stone without anesthesia was a last resort to drive

evil spirits from the body of the afflicted.
CONTRIBUTIONS to MEDICINE and
NURSING during this time

A. Babylonia
◦ Code of Hammurabi – provided laws
that covered every facet of Babylonian
life including medical practice. The
medical regulations established fees,
discouraged experimentation,
recommended specific doctors for each
disease and gave each patient the right to
choose between the use of charms,
medications, or surgical procedures to
cure the disease. There was no mention
of nurses or nursing.
B. Egypt
◦ Egyptians introduced the art
of embalming, which
enhanced their knowledge of
human anatomy
◦ Left a record of 250
recognized diseases
◦ No mention of nurses,
hospitals or hospital
personnel: slaves and
patient’s families nursed the
sick.
C. Israel
◦ Moses
 Recognized as the “Father of
Sanitation”
 Wrote the five books of the Old
Testament which:
1. Emphasized the practice of
hospitality to strangers and acts of
charity
2. Promulgated laws of control on
the spread of communicable
disease and the ritual of
circumcision of the male child
(Book of Leviticus)
3. Referred to nurses as midwives,
wet nurses or child’s nurses whose
acts were compassionate and
tender (outpouring of maternal
instincts)
D. China
◦ The people strongly believed in spirits and
demons as seen in the practices such as using
girl’s clothes for male babies keep evils away
from them.
◦ They practiced ancestor worship which
prohibited the dissection of dead human body
◦ They gave the world knowledge of materia
medica (pharmacology), which prescribed
methods of treating wounds, infections and
muscular afflictions.
◦ There was no mention of nursing in their
records. It is assumed that the care of the
sick was done by female members of the
household.
E. India
◦ Men of medicine built
hospitals, practiced an intuitive
form of asepsis and were
proficient in the practice of
medicine and surgery.
◦ Sushurutu made a list of
function and qualifications of
nurses. For the first time in
recorded history, there was a
reference to the nurses’ taking
care of patients. These nurses
were prescribed as combination
of physical therapist and
cook.
F. Ancient Greece
◦ Nursing was the task of
untrained slave
◦ Greeks introduced the
caduceus, the insignia of the
medical profession today
• Hippocrates was given the title
“Father of Scientific Medicine.”
He made a major advance in
medicine by rejecting the belief that
diseases had supernatural causes.
He also developed assessment
standards for clients, established
overall medical standards,
recognized a need for nurses.
G. Rome
◦ The transition from pagan to Christian
philosophy took place.
◦ The Romans attempted to maintain
vigorous health, because illness was a
sign of weakness.
◦ Care of the ill was left to the slaves or
Greek physicians. Both groups were
looked upon as inferior by Roman
society
◦ Fabiola was a worldly, beautiful Roman
matron who was converted to
Christianity by her friends Marcella and
Paula. With their help, she made her
home the first hospital in the Christian
world.
II. Period of Apprentice Nursing/Middle Ages

 From the founding of the

Religious orders in the 11th
century up to 1836
 Care was done by crusaders,

prisoners, religious orders

 Nursing care was performed

without any formal education

and by people who were directed
by more experienced nurses (on-
the-job training). This kind of
nursing was developed by
religious orders of the Christian
 Nursing went down to the lowest level (dark period
of Nursing), from 17th to 19th century
◦ Wrath/anger of Protestantism confiscated properties of
hospitals and schools connected with Roman Catholicism.
◦ Nurses fled their lives; soon there was shortage of people to
care for the sick
◦ Hundreds of Hospitals closed, there was no provision for the
sick, no one to care for the sick
◦ Nursing became the work of the least desirable of women –
prostitutes, alcoholics, prisoners
 Pastor Theodore Fliedner and
his wife, Frederika established
the Kaiserswerth Institute for
the training of Deaconesses
(the 1st formal training school
for nurses) in Germany.
◦ This was where Florence
Nightingale received her 3-month
course of study in nursing.
Important personalities in this period:

• St. Clare – gave nursing care

to the sick and the afflicted
• St. Elizabeth of Hungary –
Patroness of nurses
• St. Catherine of Siena – the
“first lady with the lamp”
III. Period of Educated Nursing/Nightingale
Era 19th-20th century
 Began on June 15, 1860 when Florence Nightingale
School of Nursing opened St. Thomas Hospital in
London
 The development of nursing during this period was
strongly influenced by:
a) Trends resulting from wars – Crimean, civil war
b) Arousal of social consciousness
c) Increased educational opportunities offered to women.
 Florence Nightingale was asked by Sir Sidney
Herbert of the British War Department to recruit
female nurses to provide care for the sick and injured
in the Crimean War.
 It was the 1st school of nursing that provided both

theory-based knowledge and clinical skill

building.
 Nursing evolved as an art and science
 Formal nursing education and nursing service

begun
FACTS ABOUT FLORENCE
NIGHTINGALE

 Mother of modern nursing. Lady with

the Lamp because of her achievements
in improving the standards for the care
of war casualties in the Crimean war.
 Born may 12, 1800 in Florence, Italy
 Raised in England in an atmosphere of
culture and affluence
 Not contended with the social custom imposed upon
her as a Victorian Lady, she developed her self-
appointed goal: To change the profile of Nursing
 She compiled notes of her visits to hospitals and her

observations of the sanitary facilities, social problems

of the places she visited.
 Noted the need for preventive medicine and god

nursing
 Advocated for care of those afflicted with diseases

caused by lack of hygienic practices

 At age 31, she entered the
Deaconesses School at Kaiserswerth
inspite of her family’s resistance to
her ambitions. She became a nurse
over the objections of society and
her family.
 Worked as a superintendent for
Gentlewomen Hospital, a charity
hospital for ill governesses.
 Disapproved the restrictions on
admission of patients and considered
this unchristian and incompatible
with health care
 Upgraded the practice of nursing and
made nursing an honourable
profession for women.
 Led nurses that took care of the
wounded during the Crimean war
 Put down her ideas in 2 published
books: Notes on Nursing, What It Is
and What It Is Not and Notes on
Hospitals.
 She revolutionized the public’s
perception of nursing (not the image
of a doctor’s handmaiden) and the
method for educating nurses.
IV. Period of Contemporary Nursing/20th
Century
 Covers the period after the
world war II to the present
 Licensure of nurses started
 Specialization of Hospital and

diagnosis
 Training of Nurses in diploma

program
 Development of baccalaureate

and advance degree programs

 Scientific and technological development as well as
social changes mark this period.
 Health is perceived as a fundamental human right
 Nursing involvement in community health
 Technological advances – disposable supplies and
equipments
 Expanded roles of nurses was developed
 WHO was established by the United Nations
 Aerospace Nursing was developed
 Use of atomic energies for medical diagnosis, treatment
 Computers were utilized – data collection, teaching,
diagnosis, inventory, payrolls, record keeping, billing.
 Use of sophisticated equipment for diagnosis and therapy.
In the Philippines:
Early Beliefs, Practices and Care of the sick
 Early Filipinos subscribed to
superstitious belief and
practices in relation to health
and sickness
 Diseases, their causes and

treatment were associated with

mysticism and superstitions
 Cause of disease was caused

by another person (an enemy

of witch) or evil spirits
 Persons suffering from diseases without any
identified cause were believed bewitched by
“mangkukulam”
 Difficult childbirth were attributed to “nonos”
 Evil spirits could be driven away by persons with

powers to expel demons

 Belief in special Gods of healing: priest-physician

(“word doctors”), herbolarios/herb doctors

The Earliest Hospitals Established were the
following:

A. Hospital Real de Manila (1577)

 Established mainly to care for the Spanish King’s
soldiers, but also admitted Spanish civilians
 Founded by Gov. Francisco de Sande
 San Lazaro Hospital (1578)
 Built exclusively for patients with leprosy.
 Founded by Brother Juan Clemente
 SLH was founded in 1577 as a dispensary clinic in Intramuros
by Spanish Frey Juan Clemente. It became a hospital in 1578
for patient suffering from leprosy and other diseases.
  In 1784, SLH was relocated to Hacienda Mayhaligue, the
present site, through a Royal Decree from the King of Spain.
A chapel was built and its premises enclosed with stone walls
by Frey Felix Huerta in 1859.
 The American run the hospital in 1898 as a contagious disease
hospital, after 320 years of Spanish governance.
 It was only in 1918 that Filipinos started operating the
hospital. From 1930-31, insane patients were transferred to
National Mental Hospital ( National Center for Mental
Health). In 1949, patients with leprosy were located to Tala
Leprosarium, now Jose N. Rodriquez Memorial Hospital.
 SLH is a referral facility for Infectious/
Communicable Diseases. It is one of the retained
special tertiary hospital of the Department of Health
(DOH) which is subsidized by the national
government.
 The hospital has a 500-bed capacity that provides free

health care delivery service  particularly among the

depressed, underserved and underprivileged sectors
of the society.
 Since 1986, cases of HIV/AIDS were admitted to this

hospital.
 Hospital de Indio (1586)
 Established by the Franciscan Order; Service was in general
 Supported by alms and contribution from charitable persons.
 Hospital de Aguas Santas (1590)
 Established in Laguna, near a medicinal spring
 Founded by Brother J. Bautista of the Franciscan Order
 San Juan de Dios Hospital (1596)
 Founded by the Brotherhood de Misericordia and support was
derived from alms and rents.
 Rendered general health service to the public.
 Recognized as the oldest hospital in the Philippines, 
San Juan de Dios Hospital was established upon the
arrival of Franciscan missionaries, among whom was
a lay brother, Fray Juan Clemente, in the islands on
24 June 1578. The friar, having difficulties in
learning the native language, began studying the
tropical plants of the Philippines and their medicinal
values. By the last quarter of 1578, Fray Clemente
built a nipa hut and bamboo hospital with two 300
square meters yard, serving the sick and the poor.
 In 1596, Hermanidad de la Misericordia (Confraternity of
Mercy) took charge of the hospital after serving in the 1594
wars. In 1603 and 1645, the hospital was struck by fire and
earthquake respectively which drained the confraternity of
funds. This made the confraternity to hand over the
management to the Brothers of St. John of God, thus, the
Hospital San Juan de Dios came to be known. When the
religious order was transferred to Cavite, the Council of
Inspectors took over the hospital, and was passed to the
Daughters of Charity of St. Vincent de Paul. San Juan de Dios
Hospital underwent a series of renovation and rehabilitation
every time its structure was put into danger. By the time that
the Americans settled in the country, the then hospital for the
poor now admitted affluent patients.
Nursing During the Philippine Revolution

The prominent
persons involved in
the nursing works
were:
Josephine Bracken

 Wife of Jose Rizal

 Installed a field hospital in an

estate house in Tejeros

 Provided nursing care to the

wounded night and day.

Rosa Sevilla De Alvero

 Converted their house into

quarters for the Filipino
soldier, during the
Philippine-American war
that broke out in1899.
Dona Hilaria de Aguinaldo

 Wife of Emilio Aguinaldo; Organized the Filipino Red

Cross under the inspiration of Apolinario Mabini.
Dona Maria de Aguinaldo

 Second wife of Emilio Aguinaldo. Provided nursing

care for the Filipino soldier during the revolution.
 President of the Filipino Red Cross branch in Batangas.
Melchora Aquino (Tandang Sora)

 Nurse the wounded Filipino

soldiers and gave them shelter
and food.
Capitan Salome

 A revolutionary leader in Nueva Ecija

 Provided nursing care to the wounded when not in

combat
Agueda Kahabagan

 Revolutionary leader in
Laguna, also provided
nursing services to her troop.
Trinidad Tecson

 “Ina ng Biac na Bato”

 Stayed in the hospital at Biac na

Bato to care for the wounded

soldier.
 
Hospitals and Nursing Schools
Iloilo Mission Hospital School of Nursing
(Iloilo City, 1906)
 It was ran by the Baptist Foreign
Mission Society of America.
 Miss Rose Nicolet, a graduate of
New England Hospital for
woman and children in Boston,
Massachusetts, was the first
superintendent
 Miss Flora Ernst, an American
nurse, took charge of the school
in 1942
 1909 – distinction of graduating the 1st trained nurses
in the Phils. With no standard requirements for
admission of applicants except their “willingness to
work”
 April 1946 – a board exam was held outside of

Manila. It was held in the Iloilo Mission Hospital

thru the request of Ms. Loreto Tupas, principal of the
school.
St. Paul’s Hospital School of Nursing (Manila,
1907)
 The hospital was established
by the Archbishop of Manila,
The Most Reverend Jeremiah
Harty, under the supervision
of the Sisters of St. Paul de
Chartres.
 It was located in Intramuros

and it provided general

hospital services.
Philippine General Hospital School of
Nursing (1907)
 In 1907, with the support of the
Governor General Forbes and the
Director of Health and among others,
she opened classes in nursing under
the auspices of the Bureau of
Education.
 Anastacia Giron-Tupas, was the
first Filipino to occupy the position
of chief nurse and superintendent in
the Philippines, succeeded her.
St. Luke’s Hospital School of Nursing
(Quezon City, 1907)
 The Hospital is an
Episcopalian Institution. It
began as a small dispensary
in 1903. In 1907, the school
opened with three Filipino
girls admitted.
 Mrs. Vitiliana Beltran was

the first Filipino

superintendent of nurses.
Mary Johnston Hospital and School of
Nursing (Manila, 1907)
 It started as a small
dispensary on Calle
Cervantes (now Avenida)
 It was called Bethany

Dispensary and was founded

by the Methodist Mission.
 Miss Librada Javelera was

the first Filipino director of

the school.
Philippine Christian mission Institute School
of Nursing.
 The United Christian Missionary of Indianapolis,
operated Three schools of Nursing:
1. Sallie Long Read Memorial Hospital School of Nursing
(Laoag, Ilocos Norte,1903)
2. Mary Chiles Hospital School of Nursing (Manila, 1911)
3. Frank Dunn Memorial Hospital
San Juan de Dios hospital School of Nursing
(Manila, 1913)
Emmanuel Hospital School of Nursing
(Capiz,1913)
Southern Island Hospital School of Nursing
(Cebu,1918)

 The hospital was established under the Bureau of

Health with Anastacia Giron-Tupas as the organizer.
The First Colleges of Nursing in the
Philippines
1. University of Santo Tomas College of Nursing
(1946)
2. Manila Central University College of Nursing
(1948)
3. University of the Philippines College of Nursing
(1948). Ms.Julita Sotejo was its first Dean
4. Far Eastern University Institute of Nursing (1955)
5. University of the East College of Nursing (1958)
Nursing Leaders in the Philippines
Anastacia Giron-Tupas

 First Filipino nurse to hold

the position of Chief Nurse
Superintendent
 Founder of the Philippine

Nurses Association
Cesaria Tan

 First Filipino nurse to receive a Masters degree in

Nursing abroad
Socorro Sirilan

 Pioneered in Hospital Social Service in San Lazaro

Hospital where she was the Chief Nurse
Rosa Militar

 A pioneer in school health education

Sor Ricarda Mendoza
 A pioneer in nursing education
Socorro Diaz
 First editor of the PNA magazine called “The Message”
Conchita Ruiz
 First full-time editor of the newly named PNA
magazine “The Filipino Nurse”
Loreto Tupaz
 “Dean of the Philippine Nursing”
 Florence Nightingale of Iloilo
History bullets:
 1909 – 3 females graduated as “qualified medical-surgical nurses”
 1920 – 1st board examination for nurses was conducted by the Board of
Examiners, 93 candidates took the exam, 68 passed with the highest rating
of 93.5% - Anna Dahlgren
 1921 – Filipino Nurses Association was established (now PNA) as the
national organization of Filipino nurses
 PNA: 1st President – Rosario Delgado
 1919 – The 1st Nurses Law (Act#2808) was enacted regulating the
practice of the nursing profession in the Philippines Islands. It also
provided the holding of exam for the practice of nursing on the 2 nd
Monday of June and December of each year.
 1953 – Republic Act 877, known as the “Nursing Practice Law” was
approved.