History of Nursing in the United States

Nursing has been around for centuries, but it was not always considered a profession. Though the women of many households were accustomed to treating ill members of their family, they were not trained in the medical arts, but rather relied on handed down information from their mothers and grandmothers. However, as time passed and the value of women in nursing professions became more apparent, the building blocks of the nursing profession and formal training were laid out.

In 1907, Mary Adelaide Nutting and Lavinia Dock wrote and illustrated A History of Nursing — The Evolution of Nursing in Systems from the Earliest Times to the Foundation of the First English and American Training Schools. Another two volumes were written by Dock herself and were published in 1912 under the subtitle, Earliest Times to the Present Day with Special Reference to the Work of the Past Thirty Years.

Both Dock and Nutting were born in 1858, in the time of Florence Nightingale’s rise to nursing fame. This time saw new interest in nursing as a bonafide profession and as a way to help soldiers who were injured on battlefields. Both women were registered nurses that had a vast amount of experience in nursing when they wrote the volumes.

The history of nursing begins with the formation of the Nurses Associated Alumnae of the United States when it became apparent that training was necessary to protect the sick and injured from nurses that were incompetent and unable to provide adequate care. Meeting in Baltimore, Maryland in 1897, the beginnings of what we now recognize as modern nursing were put into place.

Soon after, the American Society of Superintendents of Training Schools for Nurses was also established. (It was later named National League for Nursing Education). This organization sought to establish rules and regulations for the training of nurses.

In the early 1900s, several states passed nurse licensure laws, including New York, North Carolina, Virginia, and New Jersey. Shorter training hours were established as well as stricter qualifications for getting into nursing school. For instance, one prerequisite was at least one year of high school education. The idea of having students work in a more active role prior to seeing patients was a new idea that was beginning to pay off.

To continue the education and intelligence of nurses, the American Journal of Nursing was established. This journal allowed readers to stay informed of the latest medical advances as well as advances in nursing education and training.

With all of these new frontiers arising, it’s not surprising that the 1910s were a time of nursing education confusion and disarray. Students were expected to work long hours and teachers were not necessarily paid. During World War I, this became an additional stress to the nursing world. By the 1920s, there were so many nursing students that there were not enough jobs to go around. Many hospitals were using student nurses as cheap labor and not hiring them when they graduated.

To help their financial burden, as well as the burden of a nurse that got ill from a patient, the Relief Fund was set up in 1910, though it was not considerably important until a decade later.

With the Great Depression, student nurses were having an even harder time in the late 1920s and 1930s. To redress in this matter, the Works Progress Administration picked up some nurses while the Civil Works Administration helped to employ others. Still, the nursing world was scarce for jobs, especially when student nurses could be utilized for cheaper pay. But as hospitals closed down with financial burdens, more nurses were finally finding permanent positions.

With the onset of World War II, there was a reemergence of nursing needs as well as new programs to entice women into training. They were offered tuition, books, housing, and stipends if they would train as nurses and help with the war efforts. These recruitment efforts were handled by the US Cadet Nurses Corps from 1943 to 1948.

After the war ended, the 1950s ushered in the ‘baby boom’ during which more health care was needed for the ever-growing population. Nurses were in high demand like never before, as more than 75 million infants were born from 1946 to 1964. Complicating the demand surge, some nurses opted to get married and stay home with their new family, leading to a shortage in care.

The 1960s brought Medicare and Medicaid to the country, allowing more people to receive health care. And while the fight for fair wages and hours raged on for nurses, the overall nursing field was still in high demand and growing each year. The 1970s showed an expansion of the nursing fields, allowing for more specialties as well as the need for nurses in Vietnam.

The 1980s also experienced a shortage of nurses as the new need for HIV- and AIDS-related care was brought to light. Further discussions of the worth of nurses in the health care setting were brought to light in the political setting, helping to insure the nurses of the future with stable salaries due to new health care companies.

From the 1990s and into the future, the need for nurses is greater than ever as health care reform continues in Congress and in the lives of the older generations. With the aging of the ‘Baby Boomers’, not only are nurses retiring, but these same retirees are finding that they now need better health care. What will nursing do next? What responsibilities lie ahead? The best guess for anyone is that the need for that special touch and skill set will not be diminished any time soon.

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