Nursing: A History of Making a Difference


Nursing: A History of Making a Difference

The highly-educated professional RN of today would scarcely recognize nurses from a century ago.

By Katy Allgeyer
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This year’s theme for National Nurses’ Week is “Nurses: Making a Difference.” If you’re like all the typical dedicated, hardworking nurses we know, you might follow that theme phrase with a big “Well, DUH!” since you experience the difference you make to your patients and colleagues on a daily basis. Okay, so you’re probably not as sarcastic and cynical as all that (unless you’re coming off the ER night shift!) but you might be jaded enough to take it for granted that you have an amazing impact on so many people’s lives.

Do you remember the last time you reflected on how you actually do make a difference? What a privilege it is to be able to contribute so tangibly to the good of humankind and to do it day in and day out. This is National Nurses’ Week—go ahead and pat yourself on the back for a job well done. You deserve it. And while you’re at it, take a moment to ponder the deep roots of nursing history leading to the development of the modern nursing practice.


Before there were RNs like you, people relied on the mercy of their family members to take care of them if they were ill. Having a large family was not only a necessity to keep the farm running, but also to provide built-in caregivers for the infirm and the elderly. People also often hired “wet nurses” to breastfeed their babies. Nursing is fundamentally linked to nurturing and caring for another human.

Not much in the way of medical care was expected of the family members other than keeping the patient comfortable until they either recovered or passed on. Hospitals were not in abundance and were far beyond the reach of many rural communities, both in distance and in cost. The job almost always fell to the womenfolk.


Beyond the family, there was the church. Nuns and other clergy often provided nursing-like services to the impoverished, the imprisoned, and those wounded in battlefield. When the plague and other deadly epidemics raged through Europe, these women of God sacrificed their own health and risked their lives to tend to the sick. To this day, senior female nurses in England are referred to as “sisters” as a result of these brave women whose compassionate care made a difference.


Some women actually enjoyed the role of caregiver and took it beyond the scope of their own family. One such woman defied her rich, upper-class family’s wishes that she become a society matron and instead chose to raise nursing from a personal sacrifice to a respected, paid profession. That woman was Florence Nightingale.

She cared for the poor and indigent and developed a lot of nursing skills in the process. Florence’s work instituting changes in the medical environment during the Crimean War in 1854-1856 led to the mortality rate dropping from 60 percent to two percent. In 1860, Florence wrote, Nurse Feature ArticleNotes on Nursing, What it is, and What it is Not, thus laying a sizable brick in the foundation of modern nursing as we know it today. Now that’s making a difference!


The American Civil War resulted in more than 618,000 casualties and hundreds of thousands of wounded fathers, brothers, husbands, and sons. The numbers of critically wounded soldiers was staggering and no match for the military or civilian facilities of the day. The women left behind formed local Ladies Aid Societies that supplied rudimentary untrained nursing services—often in people’s homes or barns—rolling bandages, knitting socks, sewing clothing and tending the fallen.

Clara Barton, aka “The Angel of the Battlefield,” was a private citizen who formed one such ladies’ group to distribute supplies to the battlefield because she was appalled by the lack of care for wounded Union soldiers. Clara’s efforts during the Civil War led her to make a huge difference: she went on to form the American Red Cross.

Another early nursing advocate was Dorothea Dix. Dorothea was active in working towards improved medical care at mental institutions and prisons prior to the Civil War. An early formal nurse’s training service, The US Sanitary Commission, was formed during the early part of the Civil War and Dorothea was asked to supervise it. She went on to become the Superintendent of the Union Army Nurses. Dorothea’s pioneering nursing efforts within the military certainly made a difference.


After her husband was wounded in the Civil War, one woman—Linda Richards—tended to him until he died four years later. Linda was interested in medicine and caring for people, and had informally trained under the doctor that took care of her ailing mother. Following her husband’s death, Linda moved to Boston and briefly worked at Boston City Hospital as a nurse. Keep in mind, nurses at that time were little more than maids, however, her interest in healthcare led Linda to answer an ad for nurses’ training at the New England Hospital for Women and Children.

Linda Richards was the first student to enroll and also the first to graduate after a year of formal training. She officially became America’s first trained nurse, paving the way for all the many dedicated nurses who followed in her footsteps. You can see her diploma in the Smithsonian Institute in Washington, DC. In 1879, the same nursing program that graduated Mary Eliza Mahoney, America’s first African-American professional nurse.

While New Zealand was the first country to regulate nurses nationally, in 1903, North Carolina was the first state in America to pass a law requiring nurses to be licensed. Registered Nurses were finally officially recognized for—you guessed it—making a difference.


Not only did nursing play a huge role in liberating women by giving them an alternative to being housewives (there weren’t many other roles open to women prior to World War II), it was the first major professional group to integrate black and white members very early on. America’s history of slavery includes many African-American women and men whose role on the plantation was that of nurse and caregiver to both their own families and the white families that owned them. In 1783, James Derham from New Orleans, an African slave employed as a male nurse, bought his freedom and moved to Philadelphia to practice nursing. He went on to study medicine and became the first African-American physician in the United States, which of course, inspired others and made a huge difference for many.

The Women’s Movement also was directly impacted by the nursing profession. In 1916, Margaret Sanger, a public health nurse, opened the first family planning clinic in the United States in New York City and coined the phrase “birth control.” Coming from a large family (she was one of 11 children), she was conscious of the burdens of unwanted pregnancies among the working poor. As a nurse, Margaret went on to launch the Planned Parenthood Federation in 1952. Hmmmm… it took awhile to make a difference with that concept, as evidenced by the burgeoning Baby Boom years of that time period. However, this pioneering nurse planted the seeds (pardon the pun) to give women more options both at home and in the workplace. And that has also freed up men to pursue a career in nursing as well.

The direct compassionate service nurses provide has made an enormous difference in both individual lives and in the society as a whole. Keep up the good work. From all of us at Working Nurse, happy Nurses’ Week 2008!

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