Turn of the Century to World War II
From Nursing Career
Nursing from the Turn of the Century to World War II
The journey to respectable and necessary status for nurses in the Protestant countries of the West was a long and slow one. In fact, centuries passed where there was virtually no noticeable progress the nursing profession made in terms of impact on culture. The Crimean War in Europe and the Civil War in the United States would change the place of the nurse within the health care system and society at large forever, however, and by the end of the 19th century there were well-established training schools for nurses in most Western countries. The challenge for the new century was for the profession to be recognized as an entity unto itself, through the establishment of resources, standard curriculums for training programs, and through a recognition of the nurse as a career person.
The very first years of the 20th century would see a substantial growth in the regard with which nurses were held all over the former colonies of the British Empire. New organizations dedicated to the standardization of training and to the dissemination of knowledge unique to the nursing profession would begin to spring up all over the world in the early 1900s.
It should come as no surprise that the army, ever in need of qualified health care providers, was among the first organizations to officially recognize the need for a trained body of professionals. In 1900, the United States Army put forward a motion to establish a permanent nurse corps as part of the division of the medical department. This motion was carried through on February 2, 1901. In the same year, New Zealand became the first country to regulate nurses nationally, as its first registered nurse completed the designated program. The international nursing picture was further enhanced by the creation of the International Council of Nurses, which had been formed in 1900. It was the first international organization for health care professionals in the world.
Also in 1900, the first publication for the dissemination of nursing knowledge was created. The American Journal of Nursing was conceived as any other academic publication; it was a peer reviewed publication dedicated to the furthering of nursing excellence in the United States.
The first two decades of the 20th century would also see the evolution of various organizations from catch-all associations to ones dedicated to the practice of nursing in particular. Included in this group was the American Nurses Association, which grew out of the Alumnae Association in 1911. The Association held a keystone meeting in the summer of that year. The meeting would establish a code of ethics which was to be added to and maintained by the nursing profession at large as expanding medical science made new applications possible. The association also committed itself to elevating the standards of nursing education within the country (right up until after World War II, nurse training schools would largely be tied to major hospitals). Finally, the association declared one of the foundations of existence to be the promotion of the usefulness and honor of the profession, and the protection of financial and other interests of members of the profession.
Another organization which grew out of the pre-War years of the 20th century was the National Organization for Public Health Nursing (1912 in Chicago). This organization sought some sort of standardization in the pay and the work of public health nurses. Up until the creation of the organization, public health nurses were retained by hospitals, who collected a fee for the services that the nurse conducted. When this situation was no longer tenable, public health nurses would use the services of registries which would place them for a commission fee.
The outbreak of World War I meant that the demand for nurses was incredibly high. As a result, educational standards began to fall, and by the end of the War many acknowledged that the profession was in crisis. In order to combat the widespread employment of unqualified individuals, the Rockefeller Foundation began to commission studies to determine the best course of action. The findings of the studies suggested that more attention needed to be paid to the area of nursing, and to public health nursing in particular. The studies would also make important recommendations in terms of nursing schools. Instead of having one nurse as head of both the school of nursing and acting as the head nurse, the studies suggested that the two jobs be filled by separate individuals.
As the post-war years went on, more and more nurses would leave the profession without being replaced. This was first due to the fact that the roaring twenties meant that nurses could choose to stay home with their families rather than go out and work on their own; the Depression of the thirties meant that no one could afford either to train or pay nurses to work.
Despite these setbacks, the various nursing organizations continued to cry for more standardization within the profession. In 1937, the National League for Nursing released the third edition of A Curriculum Guide for Schools of Nursing. This publication was unique in that it was a guide only, and thus set the groundwork for different states to set their own standards as far as the education of nurses. The guide strongly recommended a standardized approach for nursing schools in sours and classwork, as well as suggesting that practical training take place within hospital wards.
