Joan E. Lynaugh, PhD, RN, FAAN
Institutions created for the purpose of caring for the sick, sheltering children or assisting the elderly or infirm must, first and foremost, find able people to provide the care they promise. In the nineteenth century, as countries in the western world increasingly came to rely on institutions to aid families when care was needed, modern nursing was invented to supply those essential caregivers. The development of hospitals, asylums, homes for the aged, and a wide array of other institutions and the development of nursing were parallel in time and place.
Nineteenth century nurses watched over hospital patients, gave them food, bathed them, kept order in the hospital wards and dispensed medicine. They collaborated with hospital board members to reform the hospital so as to match the idealized middle class home, that is, a place of safety, cleanliness, and respectability where healing would be possible. From the beginning it was clear that nurses had to be educated for the work. For aspiring nurses the only route to recognition as a “trained nurse” was through the hospital owned training school. Not until after World War II would nursing education gradually begin to conform to the rest of our educational system. Now, most nurses are educated in community colleges or universities.
Still, as the papers in this section show, nurses remain tightly linked with institutions, since often that is where the patients they care for are to be found. And, the issues remain much the same as they were when nursing was invented: how much care can be given when people cannot care for themselves; how should that care be paid for; how will the work of care be divided; where will the caregivers come from; and, how much knowledge and skill should caregivers have?