that is essential in nursing leadership. Additionally, the sheer fascination of reading nurses' notes written long ago or touching worn student nurses' uniforms—with patients' blood and students' sweat still visible on them—may be added to these reasons for studying the history of nursing.
Let's tackle these four reasons one by one, bearing in mind that they can't really be looked at separately. First, how can knowledge of nursing history positively impact patient care? One reason is that the patients' voices we “hear” through historic documents such as nurses' notes, or case studies, or in the meeting minutes of patient care committees, remind us that our patients are the raison d'etre of our work. In today's technological world this is sometimes forgotten. Another reason is that history is the basis for nursing practice research. For example, with current outbreaks of infectious diseases such as measles, nurses want to study ways to increase the percentage of childhood immunization. Yet any research on immunization rates would be flawed if nurses ignored the history of why parents had refused immunization for their children in the past. Historical research, such as that conducted by Lusk, Keeling, and Lewenson (2016), identified the critical interconnected variables of poverty, social class, ignorance, and fear of authority that was demonstrated during the forced smallpox vaccinations at the turn of the last century. Historical research provides the foundation for current nursing investigations
Second, nursing history generates professional identity, that is the public's understanding of what a nurse does, by reflecting the profession's history as well as the profession's current status, and thus career stability. Satisfying careers, whether in the arts or the sciences, usually have a history. Think of some familiar careers. Today's chemists or biologists or mathematicians proudly follow famed predecessors and carry part of their mystique. Likewise, artists of every stripe add to the acknowledged body of art that came before them. Knowing that nurses, too, have a long and rich history provides professional identity and commitment, thus leading to career stability. However, nursing history hasn't been adequately acknowledged, either within or outside the profession. Today's nurses and members of the public are not aware of nursing's rich and important past. That needs to change for everyone's benefit—including the patients. If nurses leave nursing because work that doesn't have a history isn't worth fighting for, then the nursing shortage continues and the patients suffer.
The third claim, that nursing history demands critical thinking, is based on the complexity of nursing's past. The history of nursing is not a linear progression from simple to advanced. For example, Florence Nightingale is revered as being the founder of modern nursing, but she was vehemently against registration for nurses. Taken at face value, that is probably shocking to most nurses today. Yet closer analysis of this issue by nurse historian Carol Helmstadter suggests that Nightingale had good reasons for objecting to nurse registration. Registration, Nightingale thought, would create an elite class of nurses who had the financial means to afford the requisite nursing education. Working‐class nurses, the vast majority of nurses at the time, would be excluded. Further, Nightingale wisely understood that registration would legally place nurses under the authority of physicians, typically male, and thus limit nursing's female empowerment. Lastly, Nightingale found the state registration proposals for credentialing inadequate. She believed that registration, if attempted, should be more rigorous (Helmstadter, 2007). The registration issue, as are most issues, was nuanced, requiring critical thinking. Attempting to understand historical complexities serves as excellent preparation for understanding the intricacies of our patients and their care.
Finally, the last claim, that nursing history supports effective writing that is clear and convincing, was made because history requires reading—history is not a series of numbers or bullet points. With longer reading comes better analysis and writing skills. It is that simple. So that when you need to develop and fight for a plan, or you need to argue that person A is right for a position and person B is not, or when you are on a board promoting a health care initiative, reasoning and writing skills are imperative. Indeed, the need for effective writing is more relevant today, in this electronic age, than ever.
This chapter will give you selected highlights of the history of professional nursing in the United States. Other parts of the world have their own historical stories. Nurses who have excelled in leadership and management covering a range of workplaces will be featured as case studies. Critical thinking boxes will pose overtly nuanced scenarios chosen to illustrate that nursing practice is complex. The chapter will start with a discussion of the founding of nursing in the years before nurses received any kind of specialized training and close with a review of nursing's historic contributions and future nursing challenges. Nursing's history was affected by the role of women and women's place in society, social forces, industrialization, scientific awakening, and discrimination toward race and gender (negatively impacting minorities, women, and men). As former nursing dean Helen Grace wrote: “The struggles reflected in the development of nursing as a profession…mirror the struggles of women through the ages in defining a position of equality and worth” (Grace, 1978, p. 17).
The Founding of Nursing
Women and men practiced nursing whenever human beings gathered. Nurses helped people through illness, childbirth, and death. These nurses were often friends or family members or local women and men who were known for their healing and consoling skills. The past few hundred years have provided more evidence of these nurses' work as they gained in specialized knowledge. Military religious nursing orders, known as Hospitallers, were men who undertook nursing in the Crusades of the Middle Ages (Donahue, 2011). English midwives in the seventeenth century trained in unofficial midwifery apprenticeships and were licensed by the church (Evenden, 2000). Historian Nina Rattner Gelbart (1998) relays the fascinating history of Madame du Coudray who, on the orders of the King, traveled all over France educating midwives in the eighteenth century. For her teaching demonstrations, Du Coudray invented a model doll and pelvis, her “obstetrical machine,” made of wicker, fabric, leather, stuffing, and sponges. From du Coudray's time through to the start of the nineteenth century, when medicine in Europe had become increasingly based on science, more educated nurses were needed (Helmstadter & Godden, 2011).
In the United States (U.S.), Native Americans had a long history of nursing their ill with natural remedies, rituals, and prayer when the European settlers arrived in the seventeenth century (Keeling, Hehman, & Kirchgessner, 2018). Unfortunately for these settlers, they chose to fight the Native Americans rather than learn from them. As the decades progressed and thousands of settlers had died through famine and/or disease, rudimentary order began to surface. The diary of Maine midwife, Martha Ballard, written from 1785 to 1812, offers a detailed and intimate picture of her work as meticulously presented by historian Laurel Thatcher Ulrich (1991). We learn that Ballard was a highly skilled midwife who delivered 816 babies over the 27‐year period of her diary. She was also a wife, the mother of nine, and an accomplished nurse. Ulrich notes that Ballard “knew how to manufacture salves, syrups, pills, teas, and ointments, how to prepare an oil emulsion, how to poultice wounds, dress burns, treat dysentery, sore throat, frostbite, measles, colic, “Whooping Cough,” [sic] “chin cough,” “St. Vitus dance,” “flying pains,” the salt rhume,” and “the itch,” how to cut an infant's tongue, administer a “clyster” (enema), lance an abscessed breast, apply a “blister” or a “back plaster,” induce vomiting, assuage bleeding, reduce swelling, and relieve a toothache, as well as deliver babies (Ulrich, 1991, p. 11).
We have less information about most other nurses' work, but there are some things to be elicited from surviving records. For example, Susanna Emlen's letters describing her breast amputation because of a tumor in 1814, without anesthesia of course, note that a nurse came with the surgeon, as well as his sister and his daughter. Four other doctors also attended. “About one o'clock,” Emlen wrote, “Nurse Hooke came into the chamber I was in to tell me the Doctors waited my coming in my own room. She covered my head with a handkerchief, as she led me in, hoping it might save me the sight of the preparations—I however saw Dr. Dorsey with his sleeves tucked up and his cloaths [sic] covered with a large apron …. My suffering was severe beyond expression” (Garfinkel, 1990, p. 21). We may extrapolate
