Traditional female roles of wife, mother, daughter, and sister are considered as nurturing and caring roles. Most nursing historian agree that nursing or the care of sick and injured has been performed by those nurturing roles and it has been there since the dawn of human life. As Zerwekh and Claborn (2006) stated that, “Nursing came from Latin word nutricitus, meaning nourishing” (p.122). The ancient time also depict nursing role as slavery because nursing role was performed by female slaves. As they were slaves, the noble work of caring for sic was never acknowledged and documented (Kozier and Blais, 2006). There is no doubt that ancient time began with nursing as an occupation and not as a profession. At that time, nursing as an occupation was more dependent and catered the physical and comfort needs of the sick. On the contrary, today nursing is a profession which is not only articulates the holistic needs of the sick but also perform many roles as educator, advocate, and manager.
Image of nursing in 1800-1900 centuries In nineteenth century, women were seen as a primary care taker of home and family. They were not supposed to work outside their homes thus, financially dependent on husband’s salary. Care of the sick and injured was actually performed by women prisoners and prostitutes who had no education or training in nursing. This is where the notion of profession started as a non-noble occupation (Kozier & Blais). Nevertheless, the only acknowledged role of nursing was in religions order where services were provided to sick with little or no cost. At that time, there was a light of hope came as an emergence of Deaconesses institute at Kaiserwerth Germany. This institute was affiliated with religious organization. They actually recognize the need for nursing and started a training school for nurses. Florence Nightingale the legend also went through a nursing training program at Kaiserwerth. 1861-1873 The American Civil war: A driving force for trained nursing Florence Nightingale as a head of a group of nurses developed a plan of action. At that time no professional nurse available to provide care for wounded and dying man. Appeal for nurses were made gathered these religious sisters; they were highly disciplined, organized, and efficient and supported the war effort. Thus the civil war for its destruction and horror, helped to advance the cause of professional nursing. From there, the legend grew (Kozier and Blais, 2006). 1869-1900 Commence of school for nurses Nightingale great success prompted schools of nursing based on knowledge what was effective nursing. After NightIngale’s famous school at St Thomas hospital in London opened in 1873, other training schools opened in USA. After the war, nursing education and practice expanded, as nursing schools provided classroom instruction as well as clinical practices (Wolfe, 1997).
In 1900 scholarly articles has enhanced the notion of nursing education. Several nursing leaders’ printed papers on the need of proper nursing curriculum. This was supported by Florence Nightingale who read a paper on the need for scientific transition of nurses (Chitty and Black, 2007). Several milestones happened one of them was the American society of superintendents of training schools for nurses, which was formed to address issues in nursing education and in 1952 the National League for nursing (NLN) formulated. In1946 the American nurses association established. The mission was to enhance collaboration among practicing nurses and educators. American journal of nursing introduced in 1900. As nursing continued to search for its identity, it focused on the scientific bases for nursing practice. Clinical nursing research began in earnest and journey of nursing research was first published. Today this nursing research has taken another turn in a form of evidence based nursing.
Rise of hospital In 1946 the Hill Burton Act was implemented, which provide funds to construct hospitals to combat the shortage of nursing (Chitty and Black, 2007). Professional regulations and economic securities In 1935 National Labor Act, known as the Wagner Act introduced. It was also diagnosed that the low salary and long hours restricted social opportunities for nurses. Preventing nurses from securing education and experiences needed for personal and professional growth. The International council of nurses passed a resolution asking each country and state to provide for licensure of their nurses (Wolfe, 1997). In 1950 NLN presumed responsibility for administering the first nation wide state board exam. In 1955 study showed a market analysis of nurse’s wages with other workers. Nurse’s salaries were below than accountant, teachers, social welfare, and recreation workers. According to Wolfe (1997), in 1969 a survey showed that nurses earned $ 141 weekly.
Furthermore, to combat the shortage of nursing several strategies were introduced, team nursing was one of the strategies. Team nursing involved the provision of care to a group of patients by a team of care providers. Another response to shortage was the institution of the Associate degree program. Collective bargaining has helped improve nursing salaries. Nursing wages dramatically increased during the 1980s as a direct result of the publicized shortage of nurses.
According to Chitty & Black (2007), when nursing as a profession began in the mid 1800s the most common roles assumed by woman were within their families and involved for caring others, maintaining a house hold, and pleasing their husbands. Respectable women didn’t work outside the home for money, but rather relied on their husbands or families for support. Stereotyping of women also included the notion that women were intellectually inferior to men and hence women were not called upon to make decision or think. As Nursing education moved into the academic settings, these trends, and stereotypes were slowly faded away.
In terms of roles, nurses wear many hats. The nurse as a teacher is often referred to when discussing patient care or nursing education. Nurses also worked as an advocate for the patients while giving care. Nurses as clinicians protect patients from harm. In addition, nurses are also manger even Florence NightIngale recognized the needs for nurses to be manger. She insisted that nurses needed to organize the care of the patients so that other nurses could carry on when they were not present. The concept of round the care was emerged. Another interesting role for the nurse is that colleague . The role of colleague is vital one for any profession. The status of colleague within the health care generates pictures of nurses, doctors, pharmacists, and health team at large (Zerwekh and Claborn, 2006).
Influx of technology : It is the major event in health care. Electronic medical records with computers at the bedside. Patient, Doctors, nurses and pharmacy work collaboratively to achieve the optimal level of health (Chitty and Black, 2007). Diverse population : We also recognize the need for culturally sensitive care. Immigrant population keeps on rising. As a result, diversity training becomes a must for the nursing workforce to ensure that nurses provide culturally competent and meaningful care. Working with colleagues from diverse background is in itself a challenge (Chitty and Black, 2007). Promoting evidence based practice : According to Zerwekh & Claborn, “Evidence based practice is the conscientious use of current best evidence in making decision about patient care” (p.342). It is a systemic reflection based scientific approach to ensure the best practice we give to our patients. This practice was started with the scholarly articles of Florence Nightingale and many other nursing leaders in the nineteenth century. 21st century had brought it on a turning point with the incorporation of technology. Henceforth, promote competence, and excellence.
Nurses are taking more responsibilities in delivering and promoting health care (Wolfe, 1997). Nurses have become the main providers of home health care where not only patients and their families are highly dependent but it has reached its highest corporate level. Nurses are also advancing their career in health risk management, health promotion, home health, case management to name it a few. This has helped significantly in lowering the mortality and morbidity rates especially for population who don’t have an easy access to health care.
With the overview of historical time frame and its impact on nursing has helped to understand the rise of professional identity. We can infer now that how an occupation has changed into a profession. Knowledge of reviewing history and time line of nursing has given an insight to acknowledge the hard work done by nursing leaders and has given a perspective to pursue the challenges of 21st century health care