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Tuesday, 11 August 2015

The "Imagine" Reality Check: Health Care Infrastructure, Part 2: Nursing

   The origin of nursing care as we know it began in the early days of Christianity, where males and females offered comfort and practical help to those who were ill.  It modelled itself after the practical care and love Jesus showed to the sick during his ministry.  The progress of this calling, however, was anything but linear.
   Within the monasteries and early hospitals, nurses had an important role.  As things became more formalized with specific “orders” (Hospital Brothers of St. Anthony 1095, Knights Hospitaller 1099 and Franciscans in the 13th century), monks and nuns were trained to the degree that medical knowledge was available.  They were respected for the care they gave to anyone who needed it, free of charge.  Becoming a nun who served the sick was considered an honorable vocation.
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   One of the unfortunate consequences of the Protestant Reformation was that in nations where Roman Catholicism was displaced or outlawed, health care suffered and nurses became devalued.  In Protestant Germany it took 200 years before a revival of nursing took place through the movement of deaconesses.  This movement was based upon a number of models: the deaconess Phoebe mentioned only once in the New Testament book of Romans, the deaconess movement in the Netherlands, the work of the Sisters of Charity affiliated with St. Vincent de Paul and the diaconal movement of Johann Hinrich Wichern within the Lutheran community.  The Deaconess Community established training schools that extended to neighboring countries as well as particular districts within Pennsylvania, Maryland and Nebraska. [1]
   Up until this point in much of Protestant Europe, the position of a nurse was considered one of the lowest possible for any woman.  The pay was meager, and many nurses supplemented their income by acting as prostitutes.  Since the importance of hygiene was not known or recognized, nurses often caught the diseases of those they were treating [2].
   One person whose mission it was to change the face of nursing was a British citizen named Florence Nightingale.  Her family did not support her desire to care for the sick because of the reputation of nurses, but finally in her early 30’s she succeeded in going to Kaiserwerth, Germany to be taught by the Deaconesses.  Using this training and her uncommon insights into effective, compassionate care for the sick, Nightingale became the superintendent of a new London hospital.  Within seven months, she had her sights on becoming Superintendent of Nurses so that systemic changes could be made that centered on training good nurses. In another seven months she was dispatched with a team of 38 nurses to assist the army hospital stationed along the Black Sea in modern-day Turkey.  At this time the Crimean War was taking place, and Nightingale worked tirelessly to minister to the wounded soldiers; she created clean living quarters and the means to provide healthy food so that victims would be able to recover.
   Florence Nightingale was motivated by a sense of calling by God to a life of service, a calling she received when she was just 16 years old [3].  As her life unfolded, the three years between August 1853 and August 1856 proved to be pivotal to the care of the sick starting in Britain and the British military but spreading ever outward to continental Europe and as far away as India.  Nightingale wrote the textbook Notes on Nursing (based largely on exhaustive notes and statistics she had kept while on duty) that was used in her nursing schools.  Even when she was later confined to a small room because of her own health concerns, Florence Nightingale was always active by writing letters, reports, pamphlets and books to improve health care.
   Something essential to a good nurse, according to Nightingale, was good moral character.  Thus, she encouraged nursing students to enjoy poetry and music and to attend church [4]. She saw in the task of nursing a noble vocation, and that vision has led to its present status as a respected profession for both women and men.

[1] For further information, see http://deaconesscommunity.org/our-history/  
[2] Gena K. Gorrell.  Heart and Soul: The Story of Florence Nightingale.  Toronto: Tundra Books (2000), p. 34.
[3] Gorrell, p. 21.

[4] Gorrell, p. 131.

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