Nursing

Nursing is a health care profession that "integrates the art and science of caring and focuses on the protection, promotion, and optimization of health and human functioning; prevention of illness and injury; facilitation of healing; and alleviation of suffering through compassionate presence". Nurses practice in many specialties with varying levels of certification and responsibility. Nurses comprise the largest component of most healthcare environments. There are shortages of qualified nurses in many countries.
Nurses develop a plan of care, working collaboratively with physicians, therapists, patients, patients' families, and other team members that focuses on treating illness to improve quality of life.
In the United Kingdom and the United States, clinical nurse specialists and nurse practitioners diagnose health problems and prescribe medications and other therapies, depending on regulations that vary by state. Nurses may help coordinate care performed by other providers or act independently as nursing professionals. In addition to providing care and support, nurses educate the public and promote health and wellness.
In the U.S., nurse practitioners are nurses with a graduate degree in advanced practice nursing, and are permitted to prescribe medications. They practice independently in a variety of settings in more than half of the United States. In the postwar period, nurse education has diversified, awarding advanced and specialized credentials, and many traditional regulations and roles are changing.

History

Premodern

Nursing historians face challenges of determining whether care provided to the sick or injured in antiquity is called nursing care. In the fifth century BC, for example, the Hippocratic Collection in places described skilled care and observation of patients by male "attendants", who may have provided care now provided by nurses. Around 600 BC in India, it is recorded in Sushruta Samhita, Book 3, Chapter V about the role of the nurse as "the different parts or members of the body as mentioned before including the skin, cannot be correctly described by one who is not well versed in anatomy. Hence, anyone desirous of acquiring a thorough knowledge of anatomy should prepare a dead body and carefully, observe, by dissecting it, and examining its different parts."
In the Middle Ages, members of religious orders such as nuns and monks often provided nursing-like care. Examples exist in Christian, Islamic, Buddhist, and other traditions. The biblical figure of Phoebe is described in many sources as "the first visiting nurse". These traditions were influential in the development of the ethos of modern nursing. Its religious roots remain in evidence in many countries. One example in the United Kingdom is the use of the historical title "sister" to refer to a senior nurse.
During the Reformation, Protestant reformers shut down monasteries and convents, allowing a few hundred municipal hospices to remain in operation in northern Europe. Nuns who had been serving as nurses were given pensions or told to marry and stay home. Nursing care went to the inexperienced as traditional caretakers, rooted in the Roman Catholic Church, were removed from their positions. The nursing profession in Europe was extinguished for approximately 200 years.

19th century

During the Crimean War, Grand Duchess Elena Pavlovna called for women to join the Order of Exaltation of the Cross for a year of service in military hospitals. The first section of twenty-eight "sisters", headed by Aleksandra Petrovna Stakhovich, the Directress of the Order, reached Crimea early in November 1854.
File:Florence Nightingale.jpg|upright|thumb|Florence Nightingale was an influential figure in the development of modern nursing. No uniform had been created when Nightingale was employed during the Crimean War. Often considered the first nurse theorist, Nightingale linked health with five environmental factors: pure or fresh air, pure water, efficient drainage, cleanliness, and light, especially direct sunlight. Deficiencies in these five factors resulted in a lack of health or illness. Both the role of nursing and education were first defined by Nightingale.
Florence Nightingale laid the foundations of professional nursing after the Crimean War, in light of a comprehensive statistical study she made of sanitation in India, leading her to emphasize the importance of sanitation. "After 10 years of sanitary reform, in 1873, Nightingale reported that mortality among the soldiers in India had declined from 69 to 18 per 1,000".
Nightingale believed that nursing was a social freedom and mission for women. She believed that any educated woman could help improve the care of the ill. Her Notes on Nursing was a popular call to action. The Nightingale model of nursing education led to one of the first schools of nursing to be connected to a hospital and medical school. It spread widely in Europe and North America after 1870.
Nightingale included five factors that helped nurses in her time who worked amidst poor sanitation and little education. These factors include fresh air, clean water, a working drainage system, cleanliness, and good light. Nightingale believed that a clean working environment was important in caring for patients. In the 19th century, this theory was ideal for helping patients, providing a guide for nurses to alter the environment around patients for the betterment of their health.
Nightingale's recommendations built upon the successes of Jamaican "doctresses" such as Mary Seacole, who like Nightingale, served in the Crimean War. Seacole practised hygiene and the use of herbs in healing wounded soldiers and those suffering from diseases in the 19th century in the Crimea, Central America, and Jamaica. Her predecessors had great success as healers in the Colony of Jamaica in the 18th century, and they included Seacole's mother, Sarah Adams, Cubah Cornwallis, and Grace Donne, the mistress and doctress to Jamaica's wealthiest planter, Simon Taylor.
Other important nurses in the development of the profession include:

Agnes Hunt from Shropshire was the first orthopedic nurse and was pivotal in the emergence of the orthopedic hospital, the Robert Jones & Agnes Hunt Hospital in Oswestry, Shropshire.
Valérie de Gasparin opened, with her husband Agénor de Gasparin, the world's first nursing school:, in Lausanne, Switzerland.
Agnes Jones established a nurse training regime at Brownlow Hill infirmary, Liverpool, in 1865.
Linda Richards established nursing schools in the United States and Japan, and was officially the first professionally trained nurse in the US, graduating in 1873 from the New England Hospital for Women and Children in Boston.
Clarissa Harlowe "Clara" Barton was a pioneer American teacher, patent clerk, nurse, and humanitarian, and the founder of the American Red Cross.
Saint Marianne Cope was a Sister of St. Francis who opened and operated some of the first general hospitals in the United States, instituting cleanliness standards that influenced the development of America's hospital system.

Red Cross chapters, which began appearing after the establishment of the International Committee of the Red Cross in 1863, offered employment and professionalization opportunities for nurses. Catholic orders such as Little Sisters of the Poor, Sisters of Mercy, Sisters of St. Mary, St. Francis Health Services, Inc. and Sisters of Charity built hospitals and provided nursing services during this period. The modern deaconess movement began in Germany in 1836. Within a half century, over 5,000 deaconesses had surfaced in Europe.
Formal use of nurses in the military began in the latter half of the nineteenth century. Nurses saw active duty in the First Boer War, the Egyptian Campaign, and the Sudan Campaign.

20th century

In the 19th and early 20th century, nursing was considered a woman's profession, just as doctoring was a profession for men. With increasing expectations of workplace equality during the late 20th century, nursing became an officially gender-neutral profession, though in practice the percentage of male nurses remained well below that of female physicians in the 21st century.
Hospital-based training became standard in the US in the early 1900s, with an emphasis on practical experience. The Nightingale-style school began to disappear. Hospitals and physicians saw women in nursing as a source of free/inexpensive labor. Exploitation of nurses was not uncommon by employers, physicians, and education providers.
Many nurses saw active duty in the First World War, but the profession transformed again during the Second World War. British nurses of the Army Nursing Service were part of every overseas campaign. More nurses volunteered for service in the US Army and Navy than any other occupation. The Nazis had their own Brown Nurses, numbering 40,000. Two dozen German Red Cross nurses were awarded the Iron Cross for heroism under fire.
The development of undergraduate and post-graduate nursing degrees came after the war. Nursing research and a desire for association and organization led to the formation of professional organizations and academic journals. Nursing became recognized as a distinct academic discipline, initially tasked to define the theoretical basis for practice.

Shortages

Nurses are perceived to be in short supply around the world, particularly in South East Asia and Africa. A global survey by McKinsey & Company in 2022 found that between 28% and 38% of nurse respondents in the United States, the United Kingdom, Singapore, Japan, and France said they were likely to leave their role in direct patient care in the next year. The top five factors which they said would make them stay were:

Safe working environment
Work-life balance
Caring and trusting team-mates
Meaningful work
Flexible work schedule

Pay ranked eighth on the list. A 2023 American survey found that around 30% were considering leaving patient care.