|Some steps in the
development of nursing in Britain as a profession
|1. In the medieval period the
care of the sick was undertaken in monastic houses.
|2. At the Reformation in sixteenth century
Britain, the monasteries were done away with. However three monastic
infirmaries were refounded: St. Bartholomew's (1546), St. Thomas's
(1551) and the Bethlehem Hospital. Otherwise such nursing as there
was, was then normally provided in the home. There was little understanding of
disease, medicine and appropriate nursing care, so that nursing would be as
good - or as bad - in the home as anywhere else.
|3. On the continent, In the
seventeenth century, a French priest, Vincent de Paul, organised regular
visiting of the sick in his parish by women who would see that they were
washed, fed and made comfortable. He then founded the lay Institute of the
Sisters of Mercy, where sick people could be nursed in an organized manner by
people recruited specially for this work.
|4. The eighteenth and nineteenth centuries
saw a growth in the provision of hospitals. In the eighteenth century these
were founded by individual benefactors or, more usually, by a body of
philanthropic subscribers. The first of these was Westminster Infirmary
(1720) followed soon afterwards by Guy's Hospital (1724) and
Edinburgh Infirmary (1729). The founding of voluntary hospitals
continued in the nineteenth century. But now other hospitals were provided by
local authorities in response to society's perceived needs. There were private
asylums for people from wealthy families, and other asylums provided by county
magistrates for those of the poor, who suffered from psychiatric illnesses.
Municipal councils provided isolation hospitals for people with such illnesses
as diptheria or scarlet fever. Boards of Guardians provided infirmaries,
associated with the workhouses, for the poor. Each of these hospitals and
institutions provided some measure of 'on the job' training for their nurses.
|5. Theodor Fliedner, a German
pastor, opened an institute at Kaiserwerth, near Dusseldorf, in 1833 where
deaconesses were given some training in the care of the sick. His movement
spread rapidly and many more houses were opened. He had an influence on
Elizabeth Fry and on Florence Nightingale who undertook a period of training
|6. In 1840 Elizabeth Fry established the
Institution of Nursing Sisters who would learn their work in a general hospital
and then nurse the sick in their own homes.
|7. In 1848 two nursing orders
were founded within the Church of England: the Sisters of Mercy and the
Community of St.John's House.
|8. On 24 June 1860 the first probationers
began their course at the Nightingale Training School at St.Thomas's Hospital,
London. This was, it is often argued, the world's first truly professional
nurse training school, with a regular programme of lectures as well as work in
the hospital wards. It was founded with money raised as a tribute to the work
of Florence Nightingale in the Crimean War. She herself took a close interest
in the nature of the training provided.
|9. William Rathbone, adopting a
suggestion made by Florence Nightingale, provided a school of nursing in
Liverpool where women could be trained for hospital work and as district
|10. The influence of Nightingale -trained
nurses spread to other hospitals and from the 1880s onwards standards or
nursing training improved very substantially.
|11 The Nurses Registration Act
of 1919 gave formal recognition to appropriately trained nurses, who became
SRNs, or State Registered Nurses, registered by the General Nursing Council.
This provided a standard system of accreditation.
|12..Until the end of the first world war
nursing was regarded as a profession primarily for women. There were male
nurses long before this but they were to be found normally either in military
hospitals or asylums for the mentally ill. After the war, during a period of
high unemployment, there was an influx of men into the nursing profession
although even at the end of the twentieth century only some 12% of nurses in
Britain are male and the majority of these are engaged in the care of the
|13. In 1939, in an effort to
secure more nurses, the classification of SEN, or State Enrolled Nurse, was
introduced, requring a lesser achievement that the SRNs.
|14. University degree courses for nurses
were introduced in the 1960s but attracted fewer candidates than had been
|15. In 1979 the Nursing,
Midwifery and Health Visitors Act established the Central Council for Nursing,
Midwifery and Health Visiting (UKCC).
|16. The 1980s saw a major review of nurse
recruitment and training needs, resulting in the Project 2000 approach to nurse
training. This reflects a shift towards a more academic framework with Schools
of Nursing now linked with institutions of higher education. Nurses qualifying
under Project 2000 gain a University Diploma of Higher Education and at the
same time become General Registered Nurses.