HISTORY OF DEVELOPMENT OF NURSING

PROFESSION, CHARACTERISTICS,
CRITERIA, PERSPECTIVE OF NURSING
PROFESSION-NATIONA, GLOBAL.

G. SUSHMA SWATHI

MSC(N) 1ST YEAR.

INTRODUCTION
 INTRODUCTION

NURSING IS THE ONE OF THE OLDEST ARTS AND IS AN ESSENTIAL MODERN OCCUPATION. IT BEGAN
WITH THE NEED TO PROVIDE CARE AND COMFORT TO THOSE SUFFERING FROM ILLNESS AND INJURY.
SURVIVAL OF HUMAN RACE IS AN INTERTWINED WITH THE DEVELOPMENT OF NURSING. KNOWLEDGE OF
GENERAL HISTORY IS NECESSARY AS A BASIS TO UNDERSTAND AND INTERPRET THE CHANGES WHICH HAVE
TAKEN PLACE IN NURSING.

KNOWLEDGE OF THE PROFESSION’S HISTORY INCREASES THE NURSE’S AWARENESS AND PROMOTES
AN UNDERSTANDING OF THE SOCIAL AND INTELLECTUAL ORIGINS OF THE DISCIPLINE. FROM ITS EARLIEST
HISTORY, THE NURSING WAS A FORM OF COMMUNITY SERVICE TO PROTECT AND PRESERVE THE FAMILY.

HISTORICALLY MEN AND WOMEN HELD THE ROLE OF NURSE. IN PREHISTORIC PERIOD, WOMEN WERE
RESPONSIBLE FOR GATHERING HERBS, ROOTS AND PLANTS THAT WERE USED TO HEAL SICK.
TERMINOLOGY

1. Affiliation: Is an official connection to something.

2. Benedictine: A monk or nun of a Christian religion.
3. Credentialing: Is the process of establishing the qualification of licensed medical
professionals and assessing their background and legitimacy.
4. Crusade: A vigorous campaign for political, social, or religious change.
5. Custodial: Relating to or requiring imprisonment.
6. Deacon: A member of the lowest rank of the threefold Christian ministry (below the priest
and bishop) or, in various protestant churches, who shares in the ministry.
7. Deaconess: A women with duties similar to those of deacon.
8. Interpersonal: Relating to relationships or communication between people.
9. Intertwined: Connect or link (two or more things) closely.
10. Myth: A traditional story, especially one concerning the early history of a people or
explaining a natural or social phenomenon, and typically involving supernatural beings or
events.
11. Nurturing: Help or encourage the development.
 

HISTORY OF NURSING

Christianity
The entry of women into nursing can be traced to approximately 300 AD. Christians taught that men and
women are equal before God and appealed to carry on his work on behalf of all who were in distress. The
founding of Benedictine order in sixth century increased the number of men in nursing.

Middle ages
During the middle ages (1100-1200 AD) charitable institutions were started to care to the aged, sick and
poor. Nurses delivered custodial care and depended on physicians or priests for direction. Nurse midwifery
flourished during middle ages.
Fifteenth to nineteenth century

The crusades expanded health care by establishing hospitals and nursing orders for men.
Christianity greatly influenced the development of nursing. One of the earliest records of Christian
nursing was the formation of the order of deaconesses, a group of public health or visiting nurses.
Deaconesses’ appointments by the bishops were highly valued and given only to women of high
social standing. The need for nursing responsibilities were due to the economic growth of eighteenth
century, the smallpox epidemic and the Revolutionary war. The sisters of charity, founded in 1633 by
St.vincent de paul, cared for people in hospitals, asylums and poor houses.
The sisters became widely known as visiting nurse because they cared for sick people in their
homes. The first supervisor of the sisters of charity was Louise de Gras and was later known as Sr. Louise
de Marillac. she established perhaps the first educational program to be associated with a nursing order.
 In 1809 the sisters of charity was introduced in America by mother Elizabeth Senton, later
their name was changed to daughters of charity. In the eighteen century the further growth of
cities brought an increase in the number of hospitals and expanded role of nurses.
Due to smallpox epidemics in the French colonies the Revolutionary war, the English
colonies increased the need of nursing services. Because there was little formal nursing
education, nursing knowledge and skills were generally passed by experienced nurses.
During the nineteenth century protestant churches revived the Deaconess order. The
deaconess institute at kaiserwerth, Germany was established in 1836 by pastor Theodore
Flieder.
 
FLORENCE NIGHTINGALE
FLORENCE NIGHTINGALE

The founder of modern nursing, Florence Nightingale, established the first nursing philosophy,
based on health maintenance and restoration in ‘Notes of Nursing’. Her views on nursing were derived from
a spiritual philosophy, developed in her adolescence and adulthood, reflecting the changing needs of
society.

In 1853 nightingale went to Paris to study with the sisters of charity and was appointed as the
superintendent of the English general hospitals in Turkey.

During the Crimean war period she brought about major reforms in hygiene, sanitation and nursing
practice and reduced the mortality rate at the Barracks Hospital, Turkey.
THE CIVIL WAR

• The civil war stimulated the growth of nursing in United states. Clara Barton, founder of American Red Cross, tended
soldiers on the battle field, cleansing their wounds, meeting their basic needs and comforting them in death.
• Dorothea Leynde Dix,Mary Ann Ball and Harriet Tubman also influenced nursing during Civil war. After the Civil war,
nursing schools in the United States and Canada began to pattern their curricula after Nightingale school.
• St.Catherine’s in Ontario, was founded in 1874. The first African-American professional nurse was Mary Mahoney.
• Isabel Hampton Robb, a graduate of St.Catherine’s in Ontario was the first superintendent of Johns Hopkins training
school in Baltimore, Maryland in 1894.
• Nursing in hospitals expanded in the late nineteenth century. However, nursing in the community did not increase
significantly until 1893, when Lillian Wald and Mary Brewster opened the Henry street settlement which focused on
the health needs of poor people who lived in the tenements in New York City.
 
TWENTIETH CENTURY
 
 In the early twentieth century, a movement toward a Scientific, research-based defined body of
nursing knowledge and practice was seen. Nurses began to assume expanded and advance
practice roles.
 
 Mary Adelaide Nutting, a member of the first graduating class at Johns Hopkins Hospital and
successor to Isabel Hampton Robb as superintendent of the Johns Hopkins training school, was
instrumental in the affiliation of nurse’s education with university.
 
 She became the first professor of nursing at Columbia University Teachers College in 1907. In 1923
the Rockfeller foundation funded a survey of nursing education, the Goldmark Report.
 
 The report concluded that the nursing education needed increased financial support and the
nursing education needed increased financial support and suggested that the money be given to
university schools of nursing. As education developed, nursing practice also expanded.in 1901 the
Army Nurse.
 
 Corps was established. By the year 1908 Navy Corps established. By the year 1920s nursing
specialization was developing. Graduate nurse midwifery programs, were initiated and beginning in
1950s specially nursing organizations such as association of Operating room.
 
 Nurses (1949), American Associations of critical care nurses and Oncology Nursing Society were
formed. Today, the profession is faced with multiple challenges. Nurses and Nurse educators are
revising nursing practice and curricula to meet the everchanging needs of society.
 
TWENTY FIRST CENTURY

The role you play in the provision of medical services, as a nurse, has
evolved in the 21st century owing to technological advancement in the health
sector. Nursing has now become a more defined profession because of the
modification of health service polices, the advent of new drugs and treatment
methods, and global shortage of nurses and other medical practitioners such as
Doctors. Certified nurse midwife, nurse educator, nurse advocate and nurse
practitioner are some of the nursing roles evolved in the twenty first century
HISTORY OF NURSING IN INDIA
 1664-Military Nursing was started by East India Company in St.George Military
Hospital in Madras.
 1854-Govt.Sanctioned training school for midwives.
 1861-Public health nursing school was started.
 1867-St.stephens hospital at Delhi was first one to begin training pf Indian girls as
nurses.
 1871-First school of nursing started in Govt. General hospital, Madras with 6 months
Diploma midwives program.
 1890 to 1900-Many schools under mission or govt. were started in various parts of
India.
 1897-Dr BC Roy did great work in raising the standards of nursing and that of male and
female nurses.
 1908-TNAI formed to uphold dignity and honor of nursing profession.
 1918-Training schools were started for health visitors and dais at Delhi and Karachi.
 1926-Madras state formed the first registration council to provide basic standards in
education and training.
 1946-First 4-year basic Bachelor Degree program was established at RAK College of
nursing in Delhi and CMC, Vellore.
 1947-After independence, Community Development program and expansion of hospital service created a large
demand for nurses, ANM, Health visitors, midwives, nursing tutors and nursing administrators.
 1949-INC was constituted.
 Miss Andrenwala was appointed as nursing Advisor to Govt. of India.
 1959-the first master’s program in nursing was started at RAK College of nursing, new Delhi.
 1963-School of nursing in Trivandrum instituted the first 2 years post-certificate Bachelor Degree program.
 1985-IGNOU, established.
 1986-M Phil at RAK College of nursing, New Delhi, was started.
 1991-The first doctoral program in nursing was established in institute of nursing sciences, MV Shetty Memorial
College, Mangalore.
 1992-Postbasic programme started under IGNOU.
 2002 Onwards nursing education flourished in an unprecendented manner throughout India.
 2005 to 2006- INC started PhD Programme (INC consortium) with the collaboration of Rajiv Gandhi University
with 25 seats.
2010-BFUHS, Faridkot, started PhD programme
CHARACTERISTICS OF A PROFESSION
 
Profession: a profession is an occupation with ethical components i.e. devoted to the
promotion of human and social welfare. The services and knowledge by a profession are
based on specialized skills. Professions are those occupations possessing a particular
combination of characteristics.
 
The characteristics of a profession as described by various scholars are as follows:
According to Esther Brown, Profession as following characteristics:
 Has a theoretical body of knowledge leading to defined skills, abilities, and norms.
 Provide scientific service.
 Has Autonomy in decision making and practice.
 Has a whole code of ethical practice.
 Requires an extended education as well as a basic liberal foundation.
According to Friedson,1994; Miller, Adams and Beck,1993;
Profession has the following characteristics:
 Authority to control its own work
 Exclusive body of specialized knowledge
 Extensive period of formal training
 Specialized competence
 Control over work performance
 Service to society
 Self -regulation
 Credentialing system to certify competence
 Legal reinforcement of professional standards
 Ethical practice
 Creation of collegial subculture
 Intrinsic rewards
 Public acceptance.
The characters are further characterized as:
 Intellectual
 Personal and interpersonal
 Reflecting commitment to serve society
 Emphasizing autonomy
 Reflecting shared personal values.
CRITERIA OF PROFESSION
Criteria are the standards of judging something. these are the standards for
what a profession should be. All true professions work towards meeting these
criteria. The criteria for a profession was described as early as 1915 and discussed by
professional sociologist continues today.
 
The following are criteria used:
1. Uses a body of specialized knowledge on the level of higher learning in its
practice.
2. Constantly enlarges its body of knowledge and improves its services through
scientific methods.
3. Educates its practitioners in institution of higher education.
4. Offers vital which are vital to human and social welfare.
5. Makes its own policies and controls its own activities.
6. Attracts those who put service above personal gain and accepts their occupation
as their life work.
7. Stives to provide freedom of action, opportunity for continuous professional
growth and economic security.
The above criteria can be summarized as:
A profession should be:
 Intellectual
 Scientific
 Requires higher knowledge
 Essential
 Self-governing
 Service oriented
 Should try to provide personal development and economic security for its
members.
 
Bixler and Bixler criteria for Profession
Genevieve and Roy Bixler who were against the status of ‘Nursing as a Profession,1945’ appraised
nursing according to their original seven criteria as follows:
1. A profession utilizes in its practice a well-defined and well-organized body of knowledge, which is on the
intellectual level of the higher training.
2. A profession constantly enlarges the body of knowledge, its uses and improves its techniques of education and
service by the use of the scientific method.
3. A profession entrusts the education of its practitioners to institutions of higher education.
4. A profession applies the body of knowledge in practical service, which is vital to human beings and social welfare.
5. A profession functions autonomously in the formulation of professional policy and in control of professional
activities thereby.
6. A profession attracts individuals of intellectual and personal qualities, who exalt service above personal gain and
who can recognize their chosen profession as life-long.
7. A profession strives to compensate its practitioners by providing freedom of actions, opportunity for continuous
professional growth and economic security.
After examining all the criteria of profession and other related concepts and aspects
“World Health Organization” has already recognized ‘Nursing as a Profession’.
Nursing is a dynamic and supportive profession guided by its code of ethics, is rooted in
caring, a concept evident in its four fields of activity:
 Practice
 Education
 Administration
 Research.
 
PERSPECTIVE OF NURSING PROFESSION
AT NATIONAL LEVEL
During the post-independence period, there has been enormous change and development in the field of medicine,
medical technology, healthcare and nursing. Some vital recommendations to the Bohre Committee relevant to nursing
profession are given below:
1. Stipends to the nursing students.
2. Nurses, midwifes and dais.
3. Training of nurses and midwifes.
4. Male nurses.
5. Public health nurses.
6. Midwives.
7. Dais.
8. Nursing staff.
ESTABLISHMENT OF INDIAN NURSING COUNCIL
 
As a result of Bhore committee recommendations, Indian nursing council was established in 1947 to regulate the
standards of nursing. Nursing council made the important decisions:
a. There should be only two standards of training of General Nursing and Midwifery:
 The full course of general nursing to be for three years followed by a minimum of nine months of midwifery.
 A course of Auxiliary nurse midwife for two years.
a. The minimum entrance requirement of General nursing course to be Matriculation and for auxiliary nurse
midwife to be 7th or 8th standard of education.
b. The Auxiliary nurse midwife course to replace various courses like junior grade nursing Certificate and courses
other than for nurses.
 
DEVELOPMENT OF NURSING EDUCATION IN INDIA

The Auxiliary nurse midwife/General nurse Midwife program

The Indian nursing council at its meeting in 1950 came out with some important decisions relating to future
patterns of nursing training in India. One of the important decisions was that there should be two standards of
training of Nursing Midwifery:
 A full course of 3 years in nursing and minimum of 6 months of Midwifery.
 A course of Auxiliary nurse Midwives of 2 years which would replace various courses for junior grade
Certificate.
The first course of ANM was started at St. Mary’s hospital Taran, Punjab in 1951.Initially a very few training
centers undertook to give this course but the financial aid was given by the Govt. of India under the scheme
for preparing personnel for primary health centers gave a great impetus to the training program. the
entrance qualification was raised from seventh class passed to matriculation.
 UNIVERSITY LEVEL PROGRAMES

 BASIC .SC.NURSING
 POST BASIC/POST CERTIFICATE B.SC. NURSING
 POST-GRADUATION EDUCATION
 M.PHIL PROGRAM
 PH.D PROGRAMME
 AT GLOBAL LEVEL

 ASSOCIATE DEGREE EDUCATION

 DIPLOMA EDUCATION
 BACCALAUREATE EDUCATION
 MASTERS DEGREE PREPARATION

 DOCTORAL PREPARATION
 CONTINUING AND IN-SERVICE EDUCATION
 LICENSED PRACTICAL NURSE EDUCATION
CONCLUSION
 
Knowledge of the profession history increases the nurse’s awareness and promotes an
understanding of the social and intellectual origins of the discipline. A nurse is a health care professional
who, in collaboration with other members of a health care team, is responsible for treatment, safety,
and recovery of acutely or chronically -ill individuals, health promotion and maintenance within the
families. Communities and population; and, treatment of life Threatening emergencies in a wide range
of health care setting. Nurses perform a wide range of clinical and non-clinical functions necessary to the
delivery of health care, and may also be involved in medical and nursing research.