Nursing in America
From Nursing Career
Nursing in America To the 20th Century
When looking at the history of nursing in the United States of America, it is important to remember that the New World was “discovered” in pieces by several different cultures. The history of nursing within the nation, therefore, reflects the combination of races which contributed to the development of the nation as a whole. To be sure, there are differing degrees of impact. The biggest influence in the development of the profession was Britain, both before and after the War of Independence. The French and Spanish also made their contribution through their holdings in North America, although these Catholic influences were highly mitigated when the colonies came to be included in the United States after wars or negotiations such as the Louisiana Purchase.
The earliest settlements in the United States, of course, were not European at all but were those sites occupied by the various native tribes indigenous to the continent. These tribes had their own systems of caring for the sick or infirm that, like most others, revolved around the family unit or designated individuals.
To both the south and north of the British colonial holdings were areas settled by the French and Spanish. Both of these nations were Catholic, and thus the standards of nursing received within these colonies was substantially higher than that of the Protestant holdings. Both the Jesuit and the Franciscan orders played a vital role in the health care not only of the settlers but often also for the indigenous cultures as well, as the population began to succumb to the diseases carried over from Europe. The first hospital established in what would eventually be America was the Charity Hospital in New Orleans in 1737 (it remains a training center for health care professionals to this day). Other important people who played a vital role in the formalization of nursing were the Ursuline sisters, who came over from France in 1727 and spent much of their lives tending to the sick throughout the continent.
The Protestant settlements continued to reflect the poor regard in which nurses were held in Britain, with few exceptions. There were some attempts to organize hospitals and include a designated staff of care givers, such as the Pennsylvania Hospital which was established in 1756. Benjamin Franklin was among the first administrators of this hospital, and all evidence points to his excellent leadership in the area. As far as influence throughout the colonies, however, the innovation had little impact.
After the War of Independence, there was a general disposition among the new nation to reject all things British, a state of mind that remained prominent for a few decades after. With a nation that was quickly growing, the new government realized that health care among the citizens was suffering, and sought to recruit professional nurses for the care of the population. Due in part to the continuing acrimony between the nations, and the fact that most Protestant nations still had no real claim to a health care system anyway, it was Catholic orders that answered the call. Among the most important volunteers were Mother Elizabeth Bayley Seton, a New York Catholic who organized the Sisters of Charity in 1809 and cared for the sick in Maryland.
There were also early attempts to form training schools for nurses in the United States. The very first was in 1839, a year before Florence Nightingale was to undergo a similar endeavor in England. This school was set up by Dr. Joseph Warrington in Philadelphia in 1839, and offered a certificate of approbation after three months of training. The school was not destined to last, however, as the nursing profession was still not taken seriously enough by the population at large, and especially by those who held power.
What was to change the way in which nursing’s importance was regarded in the United States was parallel to the events in England. As far as health care, the Civil War was analogous to the British experience in Turkey. More soldiers died due to poor conditions than did from wounds inflicted in battle. In response, and to accommodate the number of women who wished to help in the war effort, the United States Sanitary Commission was created. It was originally overseen by Dorothea Lynde Dix, but her leadership style was soon seen to be more by example than through effective organization.
After the Civil War, the need for formally trained nurses was recognized both through the American experience and the contributions of Florence Nightingale in England. A series of training schools for nurses were established in the years after the war. These hospitals (the New England Hospital in 1872, the Massachusetts General Hospital in 1873, and the Bellevue School in 1873) all followed systems which mirrored the one Nightingale had established in Britain. Nurses were trained at these facilities for a period of one year.
