The nursing profession has evolved significantly from its origins of providing domestic care to becoming a formally trained and licensed role. In the 1800s, nursing began as performing domestic duties but hospitals began training their own nurses. Today, nursing education occurs primarily through academic institutions. Advances in medicine and surgery led to nursing evolving into its own specialty, with organizations like AMSN supporting medical-surgical nurses. The development of anesthesia in the 1840s allowed for longer surgeries and new nursing responsibilities in surgical units.