The Evolution of Nursing: Always a Mirror for Cultural Attitudes, But With Some Constants

Of hygiene practices at one public institution, Hobson wrote, “The visitor found a woman with a broken leg twelve days after she had been brought to the hospital in the same miserable garments in which she fell.” In describing an almshouse (poorhouse) hospital, she said, “The condition of the patients was unspeakable; the one

[untrained] nurse slept in the bathroom, and the tub was filled with filthy rubbish.”

. . . On the subject of nutrition, Hobson recounted a Friday meal in the same hospital, wherein “the dinner of salt fish was brought in a bag to the ward and emptied on to the table; the convalescents helped themselves, and carried to the others their portions on a tin plate with a spoon.”

Pediatric NP, circa 1965. Courtesy of Barbara Bates Center for the Study of the History of Nursing, Univ. of Penn. School of Nursing

These are quotes from “Key Ideas in Nursing’s First Century,” an article in the May issue of AJN by historian Ellen Davidson Baer. Baer draws on vivid primary sources  from the 19th century, such as the one quoted above, to depict stages in the evolution of nursing into a respected and regulated profession with standards and essential skills and knowledge.

Though nursing has changed a great deal since its early days, Baer sees theory and compassion as intertwined constants throughout the history of nursing, both of them very much present from the start.

She’s also attuned to ways in which the evolution of nursing reveals a great deal about cultural attitudes toward gender (specifically, the roles of women), class, race, scientific knowledge, and professionalism. As you read, it’s easy to see how far nursing has come—but also how much such matters continue to play a role in the ways nurses see themselves and in how the public views nurses.—Jacob Molyneux, senior editor