History of Nursing and Florence Nightingale

Nursing History

• Nursing is the art and science of assisting individuals to learn self-care and care for others when they cannot meet their needs.
• It focuses on the patient's response to the illness, as opposed to the illness itself.
• It assists patients to a higher level of wellness.

Pre-Civilization (4000 BC)

• Illness was believed to be caused by sin and displeasure of gods.
• Temples were centers of medical care.
• Priests were physicians.
• Nursing was considered a menial task performed by slaves, carrying out tasks ordered by priests
• Most early nursing occurred in the home by females.
• Many early hospitals were founded by religious orders.

1836

• Deaconess groups originated in the Roman Empire.
• Theodore Fliedner reinstated the Order of Deaconess.
• He opened a small hospital and training school in Kaiserswerth, Germany.
• Florence Nightingale trained at the Kaiserswerth School.

16th Century

• Focus shifted from religion to warfare.
• Exploration and expansion of knowledge.
• Nursing shortage led to the recruitment of criminals.
• Nursing was considered disreputable.

18th-19th Centuries

• Hospital schools were organized.
• First formal training for practical nurses in 1893 by the Brooklyn School.
• First laws passed in 1914 to govern the practice of practical nurses in Mississippi. Mississippi Legislature passed license laws for practical nurses.
• Female nurses were under the control of male hospital administrators and physicians.
• Male dominance in healthcare.
• Nursing gradually became a respected occupation.
• Modern methods in nursing education were founded.

Societal Attitudes (1800)

• Societal attitudes influenced professional nursing significantly.
• Charles Dickens' Martin Chuzzlewit (1896) portrayed a negative image of nurses, neglecting, stealing from, and physically abusing patients,.
• This negative image of nurses persisted into contemporary times.
• Positive image – "Guardian of angel" or "Angel of Mercy" image in the later 19th century largely because of the work of Florence Nightingale during the Crimean War.
• Nightingale brought respectability to the nursing profession.
• Another image– "doctor's handmaiden" prevailed in the 19th century.
• Attitudes toward women and their roles were also key factors.

World War II

• Explosion of knowledge in medicine and technology.
• Efforts to upgrade nursing education.
• Rise in assertiveness and independence of women.

1950s-Present

• Varied healthcare settings developed.
• Nursing broadened in all areas.
• Nursing grew as a profession.

Florence Nightingale (1820-1910)

• Founder of modern nursing.
• Promoted public awareness of the need for educated nurses.
• Developed nursing education, based on experiences training nurses to care for British soldiers.
• Believed nursing was separate and distinct from medicine.
• Recognized the importance of nutrition for health.
• Introduced occupational and recreational therapy for patients..
  • Stressed need for continuing education for nurses.
  • Established nursing education and respected occupation for women.

Nightingale's Concepts

• Systematic assessment methods
• Individualized care based on patient's needs
• Confidentiality
• Environment promoting healing

Environment That Promotes Healing

• "Nature alone cures" and nursing's role is to put patients in the best condition for nature to work.

• Careful observation to discover laws of healing, including nourishment, ventilation, cleanliness, and quiet.

Nursing Pioneers

• Clara Barton (1812-1912): Organized the American Red Cross in 1881.
• Mary Breckenridge: Introduced a system for delivering healthcare to rural America in 1925 (founded Frontier Nursing Service).
• Lavinia Dock: Wrote nursing textbooks and was the first editor of the American Journal of Nursing.
• Lillian Wald: Founder of public health nursing, established Henry Street Settlement and Visiting Nurse Service in 1893.

History of Nursing in Malaya (1800s-1900s)

• Hospitals existed in 1800 in Malaya.
• Penang was ahead of Singapore in establishing medical services.
• The head of the medical department in 1819 was Superintending Surgeon G. Alexander.
• Sub assistant surgeon Thomas Prendergast went to Singapore from Penang. The only medical officer in the General Hospital.
• Known as the Central Pharmacy.
• Only G. Hospital until 1827.
• Attendants and later dressers, no mention of female nurses.
• 1873: Sir Andrew Clarke – period of progress in Malaya history.
• Jose d'Almeida, a Portuguese surgeon, settled in Singapore in 1825 and opened a dispensary.
• 1833-1845: European patients were treated. Hospitals were maintained by the Pork Tax. Military hospitals established at Fort Canning, Sepoy Lines, and Tanglin.
• 1833-1845: Pork tax abolished in 1837; the government had to support the hospital.
• 1833-1845: Lepers and other inmates did the cleaning. Two meals a day (7am and 2pm). Clothing changed on Thursdays and Sundays.
• 1833-1845: The medical staff from the East India Company. Leper asylum at Pulau Jerejak and quarantine facilities for ships were established by Dr. Alexander.
• 1886: First trained nurses arrived from Madras, India. Traveled by sampan and bullock cart to Taiping.
• 1885-1900: Nursing by Catholic nuns in General Hospitals in Singapore & Penang (1887-1903).. 21 nuns altogether – 10 in Penang and 11 in Singapore.
• 1900: English nurses arrived from England.
• Cholera and smallpox epidemics in 1902. Infectious disease hospital built in 1913,
• 1917: Midwives ordinance came into force. Mrs. Blundell, municipal nurse.
• 1900 to present: Nurses received training for practice and theory, staff nurse, senior staff nurse.
• 1946-1947: Preliminary training School in Johore Bahru and Penang's School of Nursing started. 3rd school of Nursing opened in Kuala Lumpur. 16 nurses selected for the first Preliminary Training School.
• 1950: Nurses Board & Federation of Malaya established. Registration of all nurses came into force.
• 1955: Procedure Manual book published. Nurses to Australia under Colombo Plan to complete training (2 years training).
• 20th Century (90s): Nursing education reached tertiary level, involving higher education. First Private Nursing school (1961) Tun Tan Cheng Lock, Hospital Assunta, Petaling Jaya. Hospital University nursing school in 1968.
• 1980s-1990s: Private health organizations established nursing schools and colleges for the nation (Ex: Nursing College PUSRAWI, K.L. and Nursing college Mahkota).
• 20th Century(1993-2001): University Malaya Degree Program. Diploma & Degree Program in Uni. Sains Malaysia & Uni. Kebangsaan Malaysia

21st Century

• Ongoing development of nursing programs. Further development of education.

Nursing Education Programs

• Hospital-based
• Basic (19 MoH)
• Post basic
• University-based programs (UM, UKM, UNIMAS, USM, UiTM, UPM, UIA, UMS)
• Private Colleges
• Private Universities