Saturday, 21 May 2016 23:04

The Fascinating History of Nursing

Written by Written by Lorne VanSinclair, originally published in the Orillia Packet & Times

There is a whole area of collecting that revolves around professions. The medical profession has been an area of intense interest, doctors’ bags, instruments and old medicine bottles have been hotly collected but lately there has also been more interest in the nursing profession.

Nurses didn’t have a whole arsenal of medical instruments associated with their profession, there’s not a lot of stuff to collect but if you do a quick search on eBay for nursing collectibles you’ll find a very active market in graduation pins (which are often made of silver or gold) and nurses’ caps, which are hard to find because it was feared they carried diseases so they were thrown out.

151 cap contentThey’ve largely disappeared from everyday use but up until a few decades ago that white, starched, crescent-shaped cap was a universal symbol of nursing. They weren’t all the same; each nursing school had its own version, with different sets of stripes and markings denoting rank or level of achievement. The Canadian Museum of History has a whole exhibition devoted solely to nurses’ caps and Canada has a very remarkable and proud history in nursing.

We recently commemorated Nurses’ Week, an annual celebration that started as Nurses’ Day, held on May 12th, the birth date of Florence Nightingale.  

Nightingale is credited with founding modern nursing, which she did, but the history of nursing, and the origin of the cap, goes back well before her time.

There were nurses in ancient times; the word itself is said to derive from the Latin word “nutrire” which meant to suckle, as in wet-nurse, naturally a job for women.

From its earliest days, Christianity was all about helping the sick, something that won them a lot of sympathy in Europe where the Pagans had no thought of such things. Priests were often physicians and nuns acted as care-givers. Care was given to anyone, of any (or no) faith, and at no cost. After Christianity became the official religion of the Roman Empire in 325 AD, the practice of care-giving spread throughout the Byzantine Empire and eventually into Europe.  While there was no science involved they did keep manuscripts, and had training programs so this period is considered the beginning of modern medicine.

Care-giving was further spread in the 7th century by Islam, in which caring for the sick and weak was seen as an expression of love of Allah.

Throughout the middle ages the Catholic Church established dozens of convents all over Europe, each having a care-giving facility staffed by nuns. They were usually funded by wealthy families who gave money (and their daughters) because they were told doing good works was a pathway to salvation. The poor, they believed, could gain salvation from their suffering, so all is good. When the Normans conquered Britain in 1066 they established a similar system there.

The Protestant Reformation in the 16th Century changed all that. Led by Martin Luther, the Protestants rejected the self-serving doctrine that rich people could buy their way to heaven by giving money to the church. As the reformation spread, the Protestants closed most of the convents in Germany, the Netherlands and Scandinavia and told the nuns to go home and get married. Similarly in Britain the Anglicans closed convents but allowed two care-giving facilities to remain open, under state control.

In 1836 Theodor Fliedner and his wife Friederike Münster, seeing a need, set up a replacement system by reviving the ancient role of deaconess, a non-ordained ministry for women, to provide care. They opened what was called a diaconate at Kaiserwerth on the Rhine. This Lutheran model was soon adapted all over Protestant Europe and the Americas, giving rise to the religion-based hospitals we still have today.

In 1850, Florence Nightingale visited Kaiserwerth and was so moved she decided to make nursing her life’s work. This was not a casual decision; Nightingale was born into wealth and aristocracy at a time when that really mattered. What’s more, nursing in Britain had fallen into disrepute. With the nuns gone nursing care, such as it was, had largely fallen to untrained women who were often characterized in popular fiction (even by Charles Dickens) as slovenly and alcoholic. Despite her family’s strenuous objections she persevered because she said she had been called by God to a higher purpose.

She had the means to pursue her passion, was well educated, well-travelled, well-connected and utterly oblivious to what anybody else thought of her. She not only trained herself but trained others in the art of nursing but did it quietly, learning her chops. She got a chance to demonstrate her effectiveness in the Crimean War in 1853.

In our long history of stupid, brutal wars, the Crimean War was particularly stupid and brutal. The Industrial Revolution was well underway and humans were finding new, inventive ways to maim and kill each other. Communications were also improving so reports of the horrific conditions were getting back to the homeland, and being published in newspapers. These reports prompted Nightingale gather up 38 of her volunteer trainees with some Catholic nuns and, using her connections, had them all sent to the British camp in Istanbul, just across the Black Sea from Crimea where an alliance of British, French and Ottomans were battling the Russians.

This is where she got the now-famous “Lady with the lamp” designation but it wasn’t her compassion that won over those in power. Nightingale quickly ascertained that the vast majority of soldiers were not dying from their wounds but from the deplorable conditions in the hospital itself. It lacked basics like sanitation, medicine and food. She convinced the British Army to send over a whole new, prefabricated hospital then got the sewers cleaned up and introduced practices like hand-washing and proper nutrition. Under Nightingale’s supervision the death rate at the camp plunged from 42% to 2%.

Although she claimed no credit for the improvement she became a national hero, she convinced the government to start the first secular training school for nursing and, through her writing and training started what became a world-wide movement of professional nursing.

Training was paramount. Although she was profoundly religious, Nightingale insisted the profession should be secular; nurses were trained in science, not theology. Her schools introduced nurses’ uniforms, and caps, to differentiate their graduates from the untrained care-givers of earlier years. In a nod to the professions’ Roman Catholic origins, the caps were modeled after a nun’s coif.

Canada, being both French and English, benefited from the early and later systems of nursing. Augustine nuns set up the first mission and training facility in Quebec in 1639, fully two centuries before nursing started anywhere else on the continent. Catholic orders worked at spreading the movement across Canada but it really got going late in the 19th century when English Canada adopted the Nightingale model.

But there were other, uniquely Canadian concerns.

Most facilities were in cities so in 1897 the wife of the Governor General, Lady Aberdeen (whose real name was Ishbel Maria Hamilton-Gordon) founded the Victorian Order of Nurses for the purpose of providing care to those in remote areas. VON nurses served with distinction in the Yukon during the Gold Rush. Canadian nurses had already proved their worth to the military in the Metis Rebellion of 1870 so with the onset of World War I, the Canadian Army was the first in the world to make all their nurses officers, with the rank of lieutenant.

This was a big deal; at home, nurses made suggestions, in the Army, they gave orders, and the enlisted men had no choice but to obey.

I bet many nurses are wishing for that status now. The profession is under siege from cost cuts and the demands of an aging population; nurses are under paid and over worked. The cap is gone, a relic of a bygone era, but we still respect nurses and we should let them know that, every chance we get.