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This chapter has skimmed over some of the key events in nursing's history. It has told some stories in depth, for example, that of nursing student Isabella Lauver's early experiences at Cook County Hospital in the 1880s and Madame du Coudray's work in France in the 1700s. The point is to alert you to the complexity of history. There was no golden age of nursing when nurses were always wise and had plenty of time for hands‐on patient care. That is a product of wishful thinking on the part of today's public and public policy makers. Likewise, nursing education didn't start with Florence Nightingale, as demonstrated by Madame du Coudray and her “obstetrical machine” of the century before Nightingale. The past was both worse and better than we might imagine and it cannot be judged with today's lens. Furthermore, we cannot consider nursing's past in isolation from its contextual issues of gender, society, science, and place. Society in the nineteenth and early twentieth centuries lacked today's social safety nets, such as Medicaid, Medicare, and Social Security, but medical science was advancing rapidly. Nurses thus witnessed extraordinary patient need alongside the new realities of, for example, effective drugs and newly developed vaccines. The concept of place in nursing's past means that nurses' education and practice was affected by the geographical setting—urban or rural, southern state or northern state, general hospital or tuberculosis hospital.

The rise of public health nursing came from late nineteenth, early twentieth century concerns about great income disparities and lack of health care for immigrants and the poor. Some nurses addressed these concerns at the policy level, while thousands of public health nurses went from door to door doing the actual work of nursing. The work of these public health nurses of the past has influenced health care administration today with the current shift to outpatient care wherever possible (McDermott, Elixhauser, & Sun, 2017). Additionally, nursing has a history of giving care to the poor, who in these days are the uninsured. Witness the work of Rose Hawthorne discussed in Case Study 3.4.

The checkered story of formal education in nursing, briefly covered in this chapter, must be placed in the context of society in the nineteenth century, particularly the role of women at that time. In the nineteenth century and the early decades of the twentieth century, women's education was not a priority. Women were expected to become mothers and housewives. But the scientific advances of the nineteenth and twentieth centuries required that nurses, even though they were predominantly women, become appropriately educated. The importance of professional organizations over the decades, and their leadership, cannot be overemphasized in the history of nursing. From the NLN's early nursing curricula, starting in 1917, to the Advanced Practice Nurse organizations' recent moves in clarifying and publicizing the advanced practice roles, professional organizations have led the way forward.

Appreciation of nurses' current ethical responsibilities must be guided by awareness of nursing's complex past, as described in Dunphy's (2001) story of the iron lung nurses in the 1950s and 1960s. History has shown us that nursing is not exempt from ethical wrongdoing; to state that nurses are always ethical is naïve. Critical thinking, strengthened by historical analysis, will support nurses' understanding of complex issues and ethical questions. Table 3.3 summarizes key events in the history of nursing in order to expose you to thought‐provoking elements of your profession and pique your interest for further study.

Table 3.3 Historically Significant Events in the History of Nursing Compiled by B. Lusk

1846	First public use of anesthesia during surgery: allowed more complex surgeries and thus required more skilled nursing.
1851–1854	Crimean War: English aware of poor nursing care for troops. Nightingale and 38 volunteer nurses sent to English army hospitals in Turkey, near the Crimean peninsula.
1860	Nightingale establishes first training school for nurses in London, England
1863	International Red Cross established in Geneva, Switzerland.
1873	First “Nightingale Type” Nurse Training Schools opened in the U.S.
1880s	Germ theory of disease developed
1899	International Council of Nurses founded.
1893	National League for Nursing (NLN) founded. Lillian Wald founds the Visiting Nurse Service of New York.
1896	American Nurses Association (ANA) founded.
1902	Lina Rogers Struthers hired, in New York, as the first U.S. school nurse.
1908	National Association of Colored Graduate Nurses founded; merged with the ANA in 1951.
1909	First university‐based school of nursing opened at the University of Minnesota.
1912	Public Health Nurses Association founded; merged with the NLN in 1951.
1917	Standardized curriculum for nursing developed by NLN.
1920	Women gained the vote.
1922	Sigma Theta Tau founded at Indiana University.
1923	Goldmark Report on Nursing Education. Mary Breckenridge founds the Frontier Nursing Service.
1924	First doctoral program for nurses, in education, opened at Teacher's College, Columbia University, New York.
1930s	Great Depression: Graduate nurses began staffing hospitals; closure of some hospital‐based training schools; start of hospital insurance programs.
1934	Grading Committee Report on Nursing Education.
1942	Penicillin (discovered in 1928) starts to be used to treat infections.
1945	Cadet Corps nursing program initiated.
1946	Hill‐Burton Act. Infusion of money into hospital construction.
1948	Brown Report on Nursing Education.
1950s	Beginning of associate degree education for nurses, closure of some hospital diploma training schools.
1953	National Student Nurses Association founded.
1960s	Development of specialized hospital patient units for coronary and critical care. Growth of nursing specialization.
1964	Nurse Training Act. Infuses Federal money into nursing and nursing education.
1965	First Nurse Practitioner program established at University of Colorado; Development of Medicaid and Medicare programs—expands insured health care.
1970s	Clinical Nurse Specialist role developed.
1971	American Assembly for Men in Nursing founded.
1974	Florence Wald founds first U.S. Hospice in Connecticut.
1986	National Center for Nursing Research founded.
1993	National Institute of Nursing Research, one of the National Institutes of Health, founded.
2004	Doctorate in Nursing Practice endorsed by member schools of the American Association of Colleges of Nursing.
2008	Consensus model for Advance Practice Registered Nurses developed by the National Council of State Boards of Nursing and the APN Consensus Work Group. The roles are: Certified Nurse Midwife, Certified Registered Nurse Anesthetist, Clinical Nurse Specialist, and Certified Nurse Practitioner.
2010	Affordable Care Act—expands health insurance.