History of Health Care &

Nursing

Rasheed Ahmed Khan

Nursing instructor
ION(DUHS)
 NURSING: DEFINITIONS
Nursing (as an art)
Is the art of caring sick and well individual. It refers to
the dynamic skills and methods in assisting sick and
well individual in their recovery and in the promotion
and maintenance of health. It involves the creative
application of knowledge in the service of people
Nursing (as a science)
It is the “body of abstract knowledge” arrived through
scientific research and logical analysis.
Is the scientific knowledge and skills in assisting
individual to achieve optimal health. It is the diagnosis
and treatment of human responses to actual or potential
problem.
Cont …………
Nursing (as a profession)
Profession- a calling in which its members profess to
have acquired special knowledge by training or
experience, or both so that they may guide, advise or
save others in that special field.
Florence Nightingale
Nursing is the act of utilizing the environment of the
patient to assist him in his recovery.
 Cont ……….
Virginia Henderson
Nursing is the act of assisting the individual, sick or well,
in the performance of those activities contributing to
health or its recovery (or to a peaceful death) that he
would perform independently if he had the necessary
strength, will, or knowledge, and to do this in such a way
as to help him gain independence as rapidly as possible.
Cont ………..
Canadian Nurses Association (CNA)
Nursing is a dynamic, caring, helping relationship in which
the nurse assist the client to achieve and obtain optimal
health. – 1987
Themes that are common to these definition:
• Nursing is caring
• Nursing is an art
• Nursing is a science
• Nursing is client-centered
• Nursing is holistic
• Nursing is concerned with health promotion, health maintenance,
and
health restoration
• Nursing is a helping profession
Cont ……..

American Nurses Association (ANA)

1973
Nursing is direct, goal oriented, and adaptable to the needs
of the individual, the family, and community during health
and illness.
1980
Nursing is the diagnosis and treatment of human responses
to actual or potential health problems.
 Cont ……..
1995
ANA acknowledge four essential features of contemporary
nursing practice:
• Attention to the full range of human experiences and
responses to health and illness.
• Integration of objective data with knowledge gained from
understanding of the client or group’s subjective experience.
• Application of scientific knowledge to the processes of
diagnosis and treatment.
• Provision of caring relationship that facilitates health and
healing.
Nurse: Definition
Nurse
• Comes from a Latin word “to nourish” or “to cherish
• One who cares for the sick, the injured, and the physically,
mentally, and emotionally disabled
• One who advise and instruct individuals, families, groups
and communities in the prevention, treatment of illness and
diseases and in the promotion of health.
• An essential member of a health team who cares for
individuals, families and communities in disease and illness
prevention and in the promotion of health.
 Patient: Definition
Patient
• Comes from a Latin word, “to Suffer” or “to Bear”
• An individual who is in the state of physical, mental, and
emotional imbalance
• An individual who seeks for nursing assistance, medical
assistance, or for surgery due to illness or a disease.
• Is an individual who is waiting or undergoing medical or
surgical care. One who is physically or mentally disabled.
History of Health Care and Nursing
in
Ancient civilizations
Ancient civilizations
 The first nurse – the first mother
 Illness was seen as “magic” “sin” or

“punishment”
 Guidelines of behavior became

rules. rules were to protect people

and guarantee group survival
 Old Testament refers to dietary,

hygiene and health laws for the

Hebrews
 There was no organized nursing

care
Evolution of Nursing
 As an instinctive response to the desire to keep healthy,
the sick
 Responsibility – nurturing children, care of the elderly

and the sick

 Education – Through trial & error and information

sharing, intuition
 Religions – accepting the illness but

 Superstition & magic

Ancient Societies
 Nomadic
 Solidarity for mutual protection

 Belief in the power of Gods

 Black and white magic

 Ingenious techniques of health practices,

 Med & Surg treatments, Massage, fomentation,

trephining, bone setting, amputation, hot and cold baths.

ANCIENT BABYLONIANS
Code Of Hammurabi
1st record on the medical practice

Established the medical fees

Discouraged experimentation

Specific doctor for each disease

Right of patient to choose treatment between the use

of medicine, or surgical procedure

No organized nursing care.
ANCIENT EGYPTIANS
 Art Of Embalming
 By river Nile. Healthiest & most advanced

 Priest physicians - Belief in evil spirits

 Imhotep – A surgeon, architect, priest, magician)

 A system of community planning (hygiene, sanitation,

embalming, dentistry)
 Women assisted ‘priest- physician’ as priestess/ midwives/

wet-nurses
 Dissection – Prohibited. Hence no further progress

 Documentation about 250 diseases and treatments

HEBREW
 Motivated servant of God
‘Mosaic code’- Isolation, hygiene, rest & sleep, hrs of

work, disposal of excreta, disinfection, regulations to

check animals before slaughtering/ eating
 Religion ‘Do not eat meat past the 3 rd day’
 King gave health power to ‘priest physician’
 Priest physician – took the role of health inspector
Basic nursing practices were existed.
 Cont ………
 Purification of man and his food
 The ritual of Circumcision – on the 8th day after birth

 Mosaic Law

 Meant as a survival for health and hygienic reason only

 Use of pharmacologic drugs

ANCIENT CHINA
 By the Yellow river
 Confucius – Patriarchal role

 Importance to rule of etiquette

 Value of family as a unit
 Women inferior to men
‘Yang’ & ‘Yin’ – Active (male) & passive (female) force

 2000 BC – Dissection done, circulation, pulse, elaborate

materia medica, importance to hygiene

 Cont……..
 Rule of physical exam – ‘Look, listen, ask and feel’
 Baths to reduce fever

 1000 BC - Sen Lung (Father of medicine), used veg and

animal drugs, vaccination, physiotherapy, treated syphilis

and gonorrhea
 1200 BC - Liver diet for anemia,

 Hence nursing was impossible

ANCIENT INDIAN
First civilizations were highly developed
1500 BC Ayurveda
Explains hygiene, disease prevention, major/ minor
surgery, children’s disease, inoculation, materia medica,
disease of CNS & GUS
1400 BC- Sushruta
‘Father of Surgery’ in India. Charaka wrote ‘Internal
medicine’
ANCIENT INDIAN
King Ashoka (272 – 236 BC)
Public hospitals with male nurses and some older women,
hospitals for animals. Universities (monasteries) of Taxila
& Nalanda (Bihar)
Nurses should have 3 qualities – high standards, skills and
trustworthiness
1 AD
Superstition & magic replaced by more up-to-date practice.
But medicine remained in the hands of priest physician,
who refused to touch blood and pathological tissue
 ANCIANT INDIAN

1000 AD
Brahmin influences gained strength and re-
established itself. Buddhism declined. Brahmins
were priest physicians
Rigid Hindu caste system. No dissection.
Superstition and magic replaced practice of
medicine
ANCIENT GREEK
 Apollo (son of God) – God of health
 Asculapus (son of Apollo) – God of healing

 Epigone – (Asculapus’ wife) – The soother

 Hygeia – (daughter of Asculapus ) – Goddess of health

 Temples – became social, intellectual and medical centers

 Aristotle – differentiated arteries from vein

 Hippocrates in the 5th century
• Known as “Father of Medicine”
 Hippocratic oath is from him

 Said Illness had specific causes: black bile, yellow

bile and red bile

 Developed terms prognosis, diagnosis, cure

 Diagnosis—identifying disease scientifically

 Prognosis—predicting possible outcome
 Cure— restoration of health
NURSES à function of untrained slaves
ANCIENT ROMANS
 Medical advances borrowed from Greece after they
conquered it
 Clung to superstitions

 Had good hygiene and sanitation

 Made drainage systems, drinking water aqueduct,

public baths, hospitals (for soldiers and slaves)

 Men & women of good character did nursing

 Two classes

 Patricians

 Plebicians
Nursing in Early Christian Era
 Women began nursing as an expression of Christianity
(acts of mercy)
 Women were recognized (first recording in history) as

important members of community

 Phoebe considered the first Deaconess and visiting nurse

 Fabiola started the first public hospital in Rome

Early Middle Ages (AD 476-1000)
“Dark Ages”
Learning stopped and Christianity retreated behind the
walls of monasteries due to the wars occurring in the land
(The Roman Empire collapsed)
Focus was on care and comfort (foundation of nursing)

science declined
Nursing care was controlled by the Catholic Church
High Middle Ages (1000-1475)
Small states emerged after wars
Catholic Church became dominant

Medicine declined

Monastatic orders began with strict discipline, Obedience

and devotion
Monasteries became the place for education of medicine
and nursing. But Too strict > Diminished interest in work
> decline of monasteries between 9th and 10th century.
Cont ……..
 12th – 16th century – Ruled by religious order
 Nursing done by dedicated women, who took vows,
but could not leave or get married.
 Also nursing brothers.
 Age – Between 16 – 24 yrs
The Crusades

• Europe rose to reclaim the Holy Land from the Muslims

• Hospitals developed on the battlefields
• Knight Hospitaliers of St. John’s of Jerusalem cared for the
injured
• Knights organized nursing care
• Had a probationary period before you could wear the
“white” robes of knighthood
• Nursing became acceptable for women and encouraged by
Catholic Church
The Bubonic Plague (1347-1350)
Ended the middle ages
Was very deadly

Germs carried by rats

Killed ¼ of the entire world population

“ring around the rosy”

Renaissance (1400-1600) “Rebirth”
Interest
increased in science and discovery;
medicine increased

Nursing declined
The Reformation

Led by Martin Luther

The birth of protestantism; end of dominance of the

Catholic Church
Women remained subordinate, women did not work

outside the home

“Wayward” women of low status became “nurses”

instead of going to jail

18th, early 19th centuries
The sick and poor were in great numbers ”change” was
needed, the stage was set for those with “social” vision
19th century
Era of social reform for prisons, public health and care of
the poor
Pastor Theodur Fliedner opened the Kaiserwerth

Deaconess Institute—the first REAL nursing school

Its most famous student:
Florence Nightengale (1820-1910)
 Florence Nightingale
Mother of Modern Nursing
Went to Kaiserwerth for 3 months

On Oct. 21, 1854, left with 38 women for the Crimean War,

British casualties were high; within 6 months, death rate cut

in half
Made rounds at night with a lamp “Lady of the Lamp”

Opened the Nightingale School of Nursing in 1860 where

she stressed good food, clean air and sanitation

Wrote textbooks on nursing

Wrote famous “Notes on Nursing” Some of her ideas are

still valid today

Late 19th Century, 20 Century to NOW
Civil War shaped nursing by dramatizing the need for
nursing care
Clara Barton established hospitals for both sides and for all

colors of people; later founded the American Red Cross

Bellevue Hospital 1873 opened the New York Training

School modeled after Nightingale school

Linda Richards first U.S. Trained nurse, 1873

Mary Mahoney first black nurse trained in 1879