The nursing profession has been around since the beginning of time, although it has evolved over the history. Today nurses are one of the most important professions within the health care industry.

It is believed that the first recorded nursing as a profession was during the Roman empire, around 300 A.D. The Empire tried to place a hospital within every town under its rule. As a result there were many “nurses” during that time that assisted in in-patient medical care alongside doctors. However, nursing became much more popularized in Europe during the middle ages, due to its spread by the Catholic church.

During this period of time, nursing was still largely based on religion, with the majority of nurses consisting of nuns and even monks. Hospitals functioned in various, housing lepers and refugees among the typical sick and injured patients. It might be due to this that a nurse’s role within the hospital involved a wider range of duties than may be seen today.

Around the late 500’s to early 600’s, the first Spanish hospital was created in Merida, Spain, with many of its nurses being supplied by the Catholic church. They were explicitly told to care for all of the sick, no matter their nation of origin or the religion they belonged to. The Spanish Emperor also demanded that hospitals should be attached to every cathedral and monastery within Europe.

During the10th and 11th centuries nursing began to expand when monasteries started housing hospitals inside their premises. Within these monasteries, nurses were made to provide patients with any type of service that they asked for, even outside of general health care services. This model of nursing became popular and provided the general outline for how nurses are expected to treat their patients today. Nurses were often asked to provide assistance and care by travelling to neighbouring areas in order to make house calls.

Unfortunately, at the beginning of the 17th century most monasteries were shut down during the Protestant reformation, as well as the hospitals within them. The nuns that had been working as nurses were made leave the profession and stay at home. It was due to this that nursing largely stagnated between the 17th and 18th centuries in Europe. Nurses at that time were often required to perform the duties provided by apothecaries, physicians and surgeons. Nurses remained in demand and often provided health care services to patients.

The roots of modern nursing began to shape in the 18th and 19th centuries. During these years, Britain and North America were at the forefront of innovation within the industry.

At that time the nursing profession expanded to include care of soldiers during many wars. In 1853, Florence Nightingale served as a nurse during the Crimean War, during which she not only cared for the injured, but set standards of cleanliness in the areas where she worked; her sanitary reforms reduced the overall incidence of infection where they were implemented. Nightingale moved on to write a book called Notes on Nursing, which was written as a set of guidelines for other nurses. She eventually opened one of the first nursing schools, the Florence Nightingale School for Nurses in London in 1860.

At the end of the 19th century, more nurses began to work toward education in nursing schools, recognizing their role as more than that of a bedside caregiver. During the 20th century, nursing continued to evolve, with the addition of new programs and professional organizations designed to specifically address some of the challenges of the nursing profession. Nursing programs changed to offer students new courses to become licensed practical nurses and to require certification and testing to become registered nurses. Nursing schools began to evolve from traditional hospital-based programs to university-level curricula. Nurses began to gain further education in the form of advanced degrees.

Nursing skills developed during the 20th century as nurses have greater roles with more critical functions. Nurses began to work in more specialized care settings and studied care of patients in their respective fields. Nursing schools taught skills in areas such as orthopaedics, paediatrics, critical care, trauma and flight nursing, neonatal nursing, and psychiatric nursing.

Nurses also moved beyond the role of being the doctor’s assistant. They now perform many procedures and lifesaving measures that used to be restricted only to the practice of medical doctors. Nursing diagnoses guide the care of patients depending on their needs during hospitalization or supervision. The role of the nurse practitioner allows prescribing medication, performing procedures, and following the clinical patient care. Nurses play an essential role in not just the physical or emotional care of patients, but in the management of social issues, prevention of disease, and monitoring of trends. Nursing continues to expand into a distinct element of the health care team, providing caring and service to those in need worldwide.

Florence was born in 1820. She lived through the reign of Queen Victoria.

Florence Nightingale made hospitals cleaner places. She showed that trained nurses and clean hospitals helped sick people get better. She was the founder of modern nursing.

Florence's father was William Nightingale, a rich banker. William and his wife Fanny went to Italy after they married in 1818. Florence was born in Italy on 12th May. She was named after the city of Florence. Florence had an older sister, Frances Parthenope (known as 'Pop'). Pop was born in Italy too. The girls had lessons from their father. Florence was clever, and liked history and maths.

Florence was very religious. From the age of 16 she believed God wanted her to do important work. When she was 22, a young writer asked her to marry him. After seven years making up her mind, Florence said no. She did not want a life of leisure. She wanted to be a nurse.

When Florence told her parents, they were shocked. Hospitals at this time were dirty and horrible. Doctors did operations with no anaesthetic. Most people who went into hospital died. Nurses were also not respectable or trained.

Florence's parents sent her to Italy, to forget about nursing. She met a young Englishman, Sidney Herbert, and he told her rich people should help the poor. Florence came home determined to be a nurse. In 1851, Florence went to Germany, to a Christian nursing school for women. She learned nursing for three months. It was hard work, but she loved it.

In 1853 a rich friend asked Florence to run a London hospital for 'Invalid Gentlewomen'. There was no pay, but Mr Nightingale gave her money. She made lots of useful changes in the hospital. At home, when her father and sister became ill, Florence nursed them.

In 1854 the Crimean War began. Britain, France and Turkey were fighting Russia. The Crimea was part of Russia. British soldiers went to the war in ships. These soldiers were dying there of hunger and cold. Many of them were sick and there was no proper medical care.

Things got worse after battles. Army hospitals were filled with wounded men. But without nurses, more soldiers were dying from diseases than in battles.

Sidney Herbert was now Minister for War. He asked Florence to lead a team of nurses to the Crimea. This was her chance to do something important!

Florence and 38 nurses arrived in Turkey in November 1854. At first the Army doctors wanted nothing to do with her. Florence would not go away. So the doctors let the nurses into the Army hospital at Scutari. The hospital was overcrowded and filthy. There were not enough beds, so men lay on the floor. They were not washed. There were no proper toilets. Drains were blocked. Rats ran everywhere. The smell was terrible.

The patients ate bread that was mouldy-green, and meat 'more like leather', Florence said. Without good food, sick men could not get better. Without clean bandages, clean beds and clean water, many died from diseases.

Florence worked 20 hours a day. She went to the town to buy fresh food. She started clean kitchens, and a French chef named Alexis Soyer came to cook better meals. She paid workmen to clear the drains. Soon the hospital was cleaner, and fewer men were dying.

At night Florence walked around the wards, to make sure the men were comfortable. She sat with dying soldiers. She wrote letters home for men who could not write. She carried a lantern, so the soldiers called her 'The Lady with the Lamp'.

People in Britain gave money to a fund to help the 'Nightingale Nurses'. When Florence came home in 1856, people called her a heroine. The Sultan of Turkey sent her a diamond bracelet! Queen Victoria wrote a letter of thanks.

Florence went home to Derbyshire by train. She called herself 'Miss Smith' so people would not know who she was. Later Florence met Queen Victoria. She told the Queen what was wrong with Army hospitals. Florence went on visiting Army camps and hospitals. She wrote letters to important people. The Army started training doctors. Hospitals got cleaner. Soldiers got better clothes and food.

In 1860 the Nightingale Training School for nurses was opened at St Thomas's Hospital in London. Florence's book Notes for Nursing helped many student nurses.

Florence worked so hard she became ill. For the last 40 years of her life she stayed in bed most of the time. But she went on writing letters, collecting facts and figures. In 1907 she was awarded the Order of Merit. She was the first woman to receive this honour.

Florence Nightingale died on 13th August 1910.

Nursing within the United States took a different path than in European countries. Due to the absence of strong Catholicism within America, the nursing profession was not provided by nuns. Nursing officially began in the early 1700’s when the first almshouse was opened in Philadelphia. However, many of the hospitals that were created in the United States throughout the next centuries because of the fear of diseases spreading to the more wealthy population.

The only roles for a nurse during this period of time revolved primarily around tending to the elderly and those with sicknesses, such as the flu and the common cold. These almshouses were rarely equipped to deal with any actual illnesses that needed to be treated immediately. However, most nurses spent their time tending to soldiers wounds within the Civil War, as well as joining the American Red Cross soon after the war. It wasn’t until the 20th century that actual progress and modernization of nursing began to take place.

Many of the modern advancements in nursing took place after WWI and into WWII, when technology was starting to take a bigger role in the world. The nursing profession within the United States became as popular as it is today due primarily to its huge focus within WWII. Many women from around the nation were desperate to give care to the soldiers that were fighting across the seas. As such, the entire prospect became an attractive one, as nurses were being called heroes more than ever during this period. This led to thousands of women volunteering for the cause. Despite the fact that many nurses went in untrained, they received a wealth of specialty training while overseas by dealing firsthand with the atrocities they were presented with on the front. As such, they brought home a large tool-set of skills after the war that were valuable within the medical profession.

The 20th century also paved the way for a larger and more expanded role for nurses, introducing a number of areas in which nurses could specialize in, including such specialty care as orthopedics, trauma, critical care, pediatrics and neonatal nursing.

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