Dr. Prabha K.

Dasila, PhD (N), MSc (N)

Historical Evolution of Nursing
 Period of Intuitive Nursing
• Illness earlier was seen as “magic”, “sin”
or “punishment” 

• The Primitive men believed that illness was caused

by the invasion of evil spirits.

• They believed that the medicine man, 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.
 Period of Intuitive Nursing

• 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.
 Period of Intuitive Nursing
• 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.
 Period of Intuitive Nursing
• During 700-600 B.C. Sushruta Samhita was
written by the great surgeon Sushruta, who
said "the physician, the patient, the drugs
and the nurse are four feet of `Padas' of the
medicine, upon which the cure depends".

• The first nursing school started in India in250

B.C. during Charaka's time and only men were
considered pure enough to be nurses.
 Stages of Nursing
• Nursing from Ancient times to the
nineteenth century
Early Civilization
Christianity
Middle Ages
Fifteenth to Nineteenth Century
 Early Civilization
In ancient India, early
hospitals were staffed by
male nurses who were
required to meet four
qualifications:
• Knowledge of the drug
preparation,
• Cleverness,
• Devotedness to the
patient
• Purity of mind and body.
 Early Civilization

• The Greeks believed in God of healing and

prayed to him for magic cures for their
illness.
 Early Civilization

Greek 400 B.C., the famous Greek physician

Hippocrates (Father of Medicine) believed that
disease had natural, not magical, causes. He
developed terms prognosis, diagnosis, cure.
 Early Civilization

Egyptian physicians are believed to have

specialized in certain diseases (such as
internal diseases, fractured bones, and
wounds).
 Early Civilization
• Egyptian physicians They hired women,
to assist with childbirth. later known as
midwives, These women were the first
records nurses.
 Early Civilization

• Roman Empire : 300 B.C., early physicians

built on the groundwork of their Egyptian
and Greek predecessors.
• The Romans are best known for advances in
the health of the public.
 Christianity
• Nursing began to have a formal and
more clearly defined role.
• Led by the belief that love and caring for
others were important, women made
the first visits to sick people, male gave
nursing care and buried the dead.
• Nursing became a respected vocation.
 Christianity

• Women began nursing as an expression of Christianity (acts of

mercy) and recognized as important members of community
• Phoebe Palmer- The first Deaconess and visiting nurse
• Fabiola - A wealthy Christian in Rome and founded the first
public hospital in Rome
• Paula - Friend of Fabiola. She devoted herself for the services
of the sick. She built a hospital for strangers, pilgrims, and
travelers and for the sick and constructed a monastery in
Bethlehem.
 Middle Ages
• Throughout the middle ages, care
was provided primarily by religious orders to
sick and poor.
• The monasteries became the places
of education, medical care and nursing.
• More hospitals were built.
 Middle Ages
• Nurses delivered custodial care and depended
on physicians for direction. Nurse midwifery,
as one of the oldest nursing roles, flourished.
• Much nursing care was provided by monks
and nuns, which was segregated by sex.
 Fifteenth to Nineteenth Century
• The extensive population growth in
cities, lack of hygiene and sanitation
and increasing poverty in urban centers
resulted in serious health problem.

• Society changed from one with a

religious orientation to one that
emphasized on exploration, and
expansion of knowledge.
 Fifteenth to Nineteenth Century
• Many monasteries and convents closed,
leading to a tremendous shortage of
people to care for the sick.
• Women who had committed crimes were
recruited into nursing in lieu of serving
sentences.
• The only acceptable nursing role was
within a religious order where services
were provided as part of Christianity
charity.
• Pastor Theodor Fliedner opened the
Kaiserwerth Deaconess Institute the first REAL
nursing school. Its most famous student;
Florence Nightingale
 (1820-1910)
 Fifteenth to Nineteenth Century

• Period of Nightingale
Her education included
the mastery of several
ancient and modern
language, literature,
philosophy, history,
science, mathematics,
religion, art and music.
 Fifteenth to Nineteenth Century
• Florence Nightingale was
born on may 12, 1820 in
Italy in a wealthy family.
• Went to Kaiserwerth for
3months
• In 1854, left with 38 women
for the Crimean War—
British casualties were high;
within 6 months, death rate
cut in half 
• Made rounds at night with
a lamp “Lady of the Lamp” 
 Fifteenth to Nineteenth Century
Period of Nightingale
• Outbreak of the Crimean War gave Nightingale an
opportunity for achievement
• Nightingale and her nurses transformed the military
hospitals by setting up diet kitchens, a laundry,
recreation centers, and reading rooms, and
organizing classes for orderlies.
 Accomplishments of Florence Nightingale
at Crimean
• Death rate decreased drastically
• Established cleanliness and sanitation rules
• Supplied special diets and plenty of food,
• Improved water supply
• Established a reputation which allowed her to
improve nursing standards at home.
 Fifteenth to Nineteenth Century
Period of Nightingale
• After the war, Florence Nightingale established
the Nightingale Training School for Nursed at St.
Thomas’ hospital in London.

• Served as the founder of modern nursing,

Florence Nightingale established the first nursing
philosophy based on health maintenance and
restoration.

• Died on 13th August 1910

Pioneer of Modern Nursing