Nursing has gone through many changes over its long history. We can trace the history of the profession, in some form, back to Roman times. Much of the history of Nursing revolves around the UK, and to one person – Florence Nightingale.
The first written mention of Nursing is found in documents from the Roman Empire, around 300 AD. In these documents we learn that the Empire was trying to build hospitals in every town under its rule – and that these hospitals required nurses to work with their doctors. Spanish hospitals would be built from around the year 600AD onward and were the first institutions to care for anyone – regardless of where they came from. They were staffed with caregivers that we would now see as doctors and nurses. Through the 900s and 1000s AD, hospitals were increasingly built as part of monasteries, and nurses were expected to provide many care services – covering both core health issues and wider wellbeing.
Through the 1600s, as monasteries were closed, nursing became rarer. Over the coming decades, the profession would keep a relatively low profile, without many changes being made. In 1850, Florence Nightingale (a nurse who worked in the Crimean war) campaigned for better hygiene in the caring of injured soldiers, leading to decreased deaths, and the acknowledgement that standards were required for nurses.
In 1860 the first nursing school opened in London, followed by many others over the coming years. Now, nurses would be provided with adequate training.
In 1948, the NHS was created, albeit with a shortage of around 48,000 nurses. Many of these places would be filled by immigrants from the British Empire – notably those of the Windrush generation from Jamaica and the West Indies. These nurses would go on to fill roles in a field that Florence Nightingale had reformed into one of discipline and professionalism. They would be the start of the diverse NHS, which takes much of its strength from that diversity. In the early days of the NHS, nursing was considered as a ‘sacrifice’ of sorts, with nurses expected to work long hours, live in nurses’ accommodation, and attend classes on top of their long shifts. Many nurses were unable even to marry, having to quit the profession if they chose to marry.
Midwives, district nurses and health visitors were initially seen as unimportant in the NHS, being seen as something as a side issue, away from the central roles of doctors and hospital nurses.
In the 1960s, Nursing began to be better established, with a clear hierarchy established of junior nurses attending to routine tasks and senior nurses giving orders. Ward matrons had huge power, and junior nurses would expect little to no interaction with doctors. Home births are unusual in our current era but it was only in the seventies that the hospital delivery became the norm so it was certainly remiss for domiciliary midwifery to be neglected. In 1966, the Salmon Report brought about changed to this hierarchy, removing the power of matrons and giving power over the ward to a grouping of people rather than one matron.
Over the coming decades, Nursing would become a profession accessed through a degree, beginning to remove the barriers between doctors and nurses. Integrated patient care, with interdisciplinary work as key and involving the sharing of information and advice between professionals, would become the norm.
You will not be expected to have an encyclopaedic knowledge of the profession’s history, but an acknowledgement of it will go some way to showing your interest. You should be aware of the NHS’s inception, and how Nursing has changed in the past 50 years.
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