At the end of the class the students will be able: To introduce the History of Development of Nursing Profession. To discuss Pre-historic Nursing. To explain in Early Civilization. To describe Early Christian Era. To describe Medieval Era. To discuss Modern Nursing Era. To discuss History of Nursing in India.

1. SEMINAR
ON
HISTORY OF DEVELOPMENT
OF NURSING PROFESSION
Mr. Shashi Prakash
M.Sc. Nursing II Year
CON, ILBS, New Delhi

2. SPECIFIC OBJECTIVES
At the end of the class the students will be able:
• To introduce the History of Development of
Nursing Profession.
• To discuss Pre-historic Nursing.
• To explain in Early Civilization.
• To describe Early Christian Era.
• To describe Medieval Era.
• To discuss Modern Nursing Era.
• To discuss History of Nursing in India.

3. INTRODUCTION
• Nursing is an oldest art and is an essential
modern occupation.
• It began with need to provide care and
comfort to those suffering from illness and
injury.
• Knowledge of profession’s history increases
the nurse’s awareness and promotes an
understanding of social and intellectual origins
of discipline.

4. Continued....
• From its earliest history nursing was a form of
community service to protect & preserve the
family.
• Historically Men & Women held the role of
nurse.
• In prehistoric period, women were responsible
for gathering herbs, roots and plants that
were used to heal the sick.

5. PRE-HISTORIC NURSING
• Myths, songs and other findings of the
archeologists throw light on pre-historic man’s
care for the sick.
• It was believed that ‘evil spirits cause illness
within the body’. Then body was ill-treated by
starving, beating of drums, magic rites and
ceremonies and by causing sudden fright to
get evil spirit .
• Doctor cum nurses was the magic man.

6. NURSING IN EARLY CIVILIZATIONS
(ANCIENT TIMES)
In Egypt :
• Medicine was thought to be divine in origin.
• Temples took place of hospitals and doctor cum
nurses was the priest.
• High ranking women who became priestesses in
the temples played role of nurses.
• Mothers and daughters nursed sick at home.
• Sacred books were strictly followed by priest
physicians.

7. • Egypt made progress in medicine and nursing.
• Egypt made progress in medicine, surgery and
nursing though it soon declined for no
dissection was permitted.

8. In Greece:
• Medicine was closely connected with religion.
• Apollo ‘The Sun God’ was their god of healing ;
Asclepius, the son of Apollo, was the Greek God
of medicine.
• Hygeia, the daughter of Apollo, for magical cures
for their illness.
• Temples were also places for the treatment of
sick and priest physician was in-charge of them.

9. • Personal cleanliness, exercise and the
diabetics were emphasized.
• Hippocrates , in 100 BC, known as “ father of
scientific medicine” separated medicine from
religion for the first time.

10. In Rome:
• There was proper sanitation, drainage and
sewage system.
• Roman noble women cared for the sick.
• With the invent of Christianity deacons and
deaconess performed duties of nurses.

11. In China:
• There was an advancement in medicine and
surgery.
• They had good knowledge of internal organs
and knew about blood circulation.
• They practiced dissections, vaccination and
physiotherapy.

12. • The sick were prayed for in halls of healing.
• Importance was given to cleanliness and
hygiene.

13. In India:
3000 BC:-
• Ayurvedic system stressed hygiene, sickness
prevention, inoculation against smallpox,
sanitation, good ventilation, and kitchen,
construction of hospitals, medicinal plants
cultivation and suitable building for animals.

14. 700 BC to 600 BC:
• Nurse attended the patient, cool headed and
pleasant in his demeanor, did not speak ill of
anybody , was strong and attentive to
requirements of sick and strictly followed
instructions of physicians.
• According to Charakha Sanhita: there should
be resourcefullness, devotedness, purity of
mind and body.

15. • Attendants of sick should have good behavior and
should be distinguished for purity and cleanliness
of habits.
• Nursing treatments prescribed were baths,
enema, emetics, vaginal and urethral infusions,
venesection, gargles, massages, rubbing or
pressing the limbs, etc….
• Nurses assisted patients to walk or move about to
make clean beds.
• Nurse should be skilled in compounding drugs
and ever willing to do her work.

16. 226 BC to 250 BC:
• King Ashoka built monasteries and hospitals for
both men and animals.
• Doctors and midwives were to be trustworthy
and skillfull. They had to wear clean clothes, cut
short nails.
• Operations preceded by religious ceremonies and
prayers.
• Nurses were usually men or old women.

17. • Nursing of patients seemed to have been
devoted primarily to men, great deal of
unrewarded work.
• Qualities expected of nursing attendants were
good behavior, purity, kindness and skill.
• Ashoka made provision for the education and
training of women for that purpose.

18. EARLY CHRISTIAN ERA (1- 500 AD)
• Religious beliefs played a major role in
building attitude towards the sick and made
for caring for the sick and their sufferings.
• Christianity believed in rendering services of
love to humanity without any reward .
• Women assisted clergy in the work of Church.

19. Deaconess:
• Originated from Greek word “ diakonia” which
means “ to minister” or “to serve” in both the
material and spiritual sense.
• Human who were mature, gave teaching and
cared for the sick in homes.

20. • Marriages was not prohibited, and they could
live at home.
• Duties included clerical work in Church,
teaching, helping women converts, teaching in
missions and visiting the sick. They have been
called first visiting nurses .

21. Widows:
• They assisted the deaconess in home visiting.
• Freedom from responsibilities at home was a
necessity.

22. Virgins:
• They were younger women, assisting in caring
for Church vestments and in giving alms to
poor.
• They lived in there own homes, and received
no pay except when necessary. Order of
virgins was created when Church felt that
virginity was essential to purity of life.

23. Later, Widows and virgins merged into group
of nuns, certain things were common:
a. Wore usual dress of women, later dressed
wore uniformly.
b. Lived in own houses and many received
allotment from Church.
c. All members were enrolled for Church
service.

24.  Phoebe was the first deaconess , intelligent,
educated who could care for the sick in their
homes. She can be compared to a modern
public health nurse.
 Fabiola was the daughter of the great Roman
noble. She converted her palace into hospital ,
first Christian hospital in Rome, collected poor
and sick from streets and cared herself, in her
palace.

25. Paula was the friend of Fabiola, devoted
herself for the services of sick. She build
hospital for strangers, pilgrims and travelers &
for the sick , constructed monastery in
Bethlehem.
Marcella was wealthy women. She was able to
lead a group of high rank women and induced
them in works of Charity.

26. MEDIEVAL ERA (500 AD -1500 AD)
(ALSO CALLED MIDDLE AGES)
• During this period the Roman Empire broke-up.
Seat of the Roman govt. was shifted from Rome
to Constantinople.
• The medical schools appeared in Roman times
disappeared . the practice of medicine reverted
back to primitive medicine dominated by
superstition and dogma.
• Consequently there was no progress in medicine
or surgery. The medieval period is, therefore,
called the “Dark ages of Medicine”.

27. • Altruism taught that the sincere love for god
and a desire to be like him, would be the chief
motive for one’s selfless and sacrificial service
to the mankind without of reward.
• It inspired men and women opened their
homes to the sick who were called
“Diakonia”.

28. 1. Monasticism:
• Monasteries become chief place for
education, medicine, and nursing.
• Monks and nuns worked as doctors and
nurses. They were skilled in the use of home
remedies .
• They got scientific knowledge in care of sick
from books in monasteries.

29. • Monasteries did ground work for the
development of universities , gave medical and
nursing care to travelers , poor and needy.
• Women found freedom to develop ideas and
skills in monasteries.
• They becomes wealthier, gained more freedom
and political power.
• Monateries when criticised , made rules stricter
and many lost interest in the work. Between 9th
and 10th century, monasteries declined.

30. 2. Military nursing orders:
• During the middle ages, a religious movement
known as the Crusades, took place. There was
mass movement of devoted people who left
their homes under the leadership of soldiers,
and knights to Jerusalem to rescue the tomb
of Jesus Christ from the Muslims.

31. • In order to render medical and nursing care to
sick and wounded, two military orders were
formed:
– Order of knights of St. John of Jerusalem.
– Order of knights of St. Lazarus.
• Nursing orders brought discipline and
unquestioned Obedience into nursing. They
rendered excellent nursing services.

32. • In short, nursing was greatly enriched with
and strengthened by these military orders.

33. 3. Medicant and Secular nurses orders:
• Medicants were traveling Monks.
• They gave up their possessions and lived with
poors.
• They earned their livelihood by mannual labor
or begging.
• They were all inspired by religious teaching of
Jesus Christ.

34. • St. Dominie and St. Francis of Assisi were well
known monks, and each had large no. of
followers.
• The followers of these monks took vows of
Charity and obedience.
• One of the activities was nursing care to sick.
• They formed various religious and non-
religious orders for providing nursing care.

35. MODERN ERA (1500-1850 AD)
(DARK AGES IN NURSING)
Renaissance (14th -16th Century):
• New ideas in art, architecture and literature
developed.
• Reformation (1517) :Revolt against feudalism
and power of Church over non- church
matters.

36. Industrial Revolution:
• Change in manufacture of goods from
production in homes to factories. Many left
country to settle near factories. Children used
to go to work long hours to help family in
earning livelihood.

37. Unhealthy Living conditions:
• People lived in crowded, unhygienic/
unsanitary conditions. There were illness ,
poverty and suffering.

38. Hospitals:
• Hospitals were needed more than ever.
• These were influenced by politics.
• Lay people who lacked religious motive, were
hired to care for the patients.
• There was no isolation of patients.
• Doctors did most nursing duties like changing
sheets, doing dressing and giving medicines.
Servants did bathing care of excreta.

39. • Nursing:
• It included mostly cleaning and scrubbing.
• Nurses were poorly fed, over worked and
treated badly.
• Nurses lacked in skills and morals.
• Women of refinement and intelligence did not
take up nursing.

40. Renowned nursing personalities of the time
were:
1. St. Vincet De Paul (1576- 1660 AD):
• Born in little villege of Pony, France, went to
Rome.
• He educated poor boys, brought food to
hungry peasants and attended the sick,
founded confraternity of Charity of women
(1617): visiting nurse association.

41. • He exhorted wealthy women to seek god
through works of charity, comfort of food and
caring sickness to prisoners.
• He founded night shelters and workshops for
idle beggars.
• Purposes were to reform the clergy, conduct
missions among the poor people, body relief
to poor and sick while a providing spiritual
welfare.

42. • He was the founder of “Daughters of Charity”
(1633 AD): first organized group to make practice
of nursing sick in their homes. Now it is called
“Sisters of Charity”.
• Training period was six months to one year and
consist of:
– Exercise of prayer and spiritual life in order to teach
poor.
– To attend the needs during illness.
– Dressing of sores of poor.
– Moral training for themselves.

43. 2. Elizabeth Fry (1780-1845 AD):
• Famous for work among prisoners.
• Founder of institute of nursing sisters in 1840.
• Worked for sick poor.
• Became interested and terrible conditions-
both physical and moral-that existed in
prisons.

44. 3. Florence Nightingale (1820-1910 AD):
• The era of modern nursing commences with
the work of Florence Nightingale in the
Crimean war.
• She was born 12th May 1820.
• She belonged to a well- to- do family.
• She felt that God had called her to a mission
of Mercy and nursing appeared suitable for
her calling.

45. • In 1851 she went to Kaiserwerth, Germany, for
her early nursing training.
• After leaving Kaiserwerth, she continued to
examine the facilities at hospital, reformatories
and Charitable institutions.
• In 1853, she became superintendent of the
hospital for invalid Gentlewomen in London.
• During the Crimean war , Nightingale volunteered
to go to Suctari, Turkey, where she organized a
nursing deppt. And devoted her efforts to
eliminating sanitation problems in wards.

46. • Nightingale’s work make her popular with the
men.
• They called her “Lady with the Lamp”, in
recognition of her turkish candle lantern, which
she carried through the corridors packed with
wounded soldiers.
• After returning back to England after war, she
established a teaching institutions for nurses at
St. Thomas hospital and at King’s College hospital
in London.

47. • Within a few years after its foundation, the
Nightingale school began receiving requests
for nurses to found new schools and hospitals
world wide and nightingale’s reputation as the
founder of modern nursing was assured.
• During her career, Nightingale concentrated
on Army sanitation reform, Army hospitals
and sanitation in India and among the poorer
classed in England.

48. • For her efforts, Nightingale received numerous
honors, including the Order of Merit from king
Edward 7th , Germany’s Cross of Merit and
France’s Secours Aux Blesses Militaries.
• She wrote between 15,000 and 20,000 letters to
friends and distinguished acquaintances.
• Nightingale was regarded as Pioneer in the
graphic display of statistics and was elected as
the fellow of the Royal statistical society in 1858.

49. • In 1874, an honorary membership in the
American statistical association was bestowed on
her.
• Her writings, notes on matters affecting the
health, efficiency and hospital administration of
the British Army (1858), notes on hospitals
(1858), notes on nursing (1859), notes on
sanitary states of the army in India (1871), and
death in India (1874), reflect her continuing
concerns about these issues.

50. • She worked into her eighties gathering data
about nursing and health care.
• She died in her sleep at age of ninety on
August 13, 1910 in London.

51. HISTORY OF NURSING IN INDIA
• 1664: Military nursing was started by East
India Company in St. George Military hospital
in Madras.
• 1854: Government Sanctioned training school
for Midwives.
• 1861: Public Health nursing school was
started.
• 1867: St. Stephens hospital Delhi was first one
to begin training of Indian girls as nurses.

52. • 1871: First school of Nursing started in govt.
General hospital, Madras with six months
diploma midwives program.
• 1890- 1900: Many schools under mission or govt.
were started in various parts of India.
• 1897: Doctor BC Roy did great work in raising the
standard of nursing and that of male and female
nurses.
• 1908: TNAI formed to uphold dignity and honor
of nursing profession.

53. • 1918: Training schools were started for health
visitors and Dais at Delhi & Karachi.
• 1926: Madras state formed the first
registration council to provide basic standards
in education and training.
• 1946: First four year basic Bachelor degree
programme was established at RAK College of
Nursing Delhi. And CMC Vellore.

54. • 1947: After independence, community
development programme and expansion of
hospital service created a large demand for
nurses, ANM, Health visitor, Midwives,
Nursing tutors and nursing administrators.
• 1949: INC were constituted.
• 1956: Miss. Andrenwala was appointed as
nursing advisor to govt. of India.

55. • 1959: The first Master’s programme in nursing
was started at RAK college of nursing , New
Delhi.
• 1963: School of nursing in Trivendrum
instituted the first two years post certificates
bachelor degree programme.
• 1985: IGNOU established .
• 1986: M. Phil. At RAK college of nursing New
Delhi started.

56. • 1991: The first Doctoral programme in nursing
was established in institute of nursing science,
MV Shetty Memorial college Mangalore.
• 1992: Post basic programme was started under
IGNOU.
• 2002 onwards: Nursing education flourished in
an unprecedented manner throughout in India.
• 2005-2006: INC started Ph D. Programme (INC
consortium) with the collaboration of Rajiv
Gandhi University with 25 seats.

57. • 2010: BFUHS, Faridkot started Ph D.
Programme.

58. CONCLUSION

59. SUMMARY
In this teaching I included sub-topics :
• Introduction of History of Development of Nursing
Profession.
• Pre-historic Nursing.
• Early Civilization.
• Early Christian Era.
• Medieval Era.
• Modern Nursing Era.
• History of Nursing in India.

60. EVALUATION
Q1- What was the name of the king who built
monasteries for both man and animals (in
226 BC – 250 BC) ?
Ans- King Ashoka.
Q2- What is the means of word ‘Deaconess’
(Greek word) ?
Ans- Originated from Greek word ‘diakonia’,
which means ’to minister’ or ‘to serve’ in
both the material & spiritual sense.

61. Q3- Name all three Renowned nursing
personalities of the modern era time
(1500- 1850) ?
Ans- The three personalities were:
- St. Vincet De Paul (1576- 1660 AD).
- Elizabeth Fry (1780- 1845 AD).
- Florence Nightingale (1820- 1910 AD).

62. Q4- Who was the first appointed nursing
advisor to govt. of India ?
Ans- Miss. Andernwala (1956).
Q5- The first Post basic programme started
under IGNOU in the year?
Ans- 1992.

63. RESEARCH INPUT
Rediscovering a history of nursing management;
From Nightingale to Modern Matron.
Wildman S. and Hewison A.
The study concluded that the history of nursing
management has been “lost in celebrating and
uncritical accounts of nursing as a whole. The
important influence of key figures other than
Nightingale has been overlooked and it emerges that
nursing management has a longer and more complex
history than is generally accepted.

64. BIBLIOGRAPHY
• Brar K.N., Rawat C.H. A Textbook of Advanced
Nursing Practice, First Edition, 2015, Published by
Jaypee Brothers Medical Publishers (P) Ltd. Page 3-7.
• Kaur L., Kaur M. A Textbook of Nursing Foundation,
Second Edition, Published by S. Vikas & Company.
Page 51.
• Research Source:
http://www.journalofnursingstudies.com/article/S00

65. Thankyou