Nursing history by roheeda riaz khan

HISTORY &
DEVELOPMENT
OF NURSING BY
ROHEEAD RIAZ
KAHN
RN.RM.PRN.MSN
GCON, HMC
PESHAWR

OBJECTIVES
• By the end of presentation learners will be able to:
• Summarize the Ancient Cultures in the field of Nursing.
• Describe site of health care in Ancient Cultures.
• Discuss Islam and Nursing.
• Explain Historical perspective and founder of Nursing.
• Discuss mughal period in Nursing. Define nursing by
WHO and different scholars
• Briefly describe types of Nursing educational programs
• History of Nursing Education in Pakistan

INTRODUCTION
• Treating the sick is nothing new. People have cared
for the sick throughout history, beginning in ancient
times
• However, considering the long history of nursing, it
was not until fairly recently that nurses received a
formal nursing education.
• Over hundreds of years, nursing has undergone an
evolution, eventually transforming itself into the
respected profession we all know of today.

NURSING IN ANCIENT TIMES
In some early cultures, the provision of
nursing care was assigned to females, because
women provided nurturing to their infants
and it was assumed that they could provide
the same type of care to the sick and injured.

In other ancient societies, however, men were
designated to care for the sick, because they
were considered priests, spiritual guides or
“medicine men.”

• There was no formal education available in primitive
societies, so the earliest nurses learned the tricks of
the trade via oral traditions that were passed down
from one generation to the next.
• They also learned how to nurse patients back to
health through trial and error and by observing
others who cared for the sick.

 The earliest nurses used
plants and herbs to heal
and believed that evil
spirits and magic could
affect one’s health.
 Illness was often viewed
as a sign that something
was done to offend the
priests or gods.

• The Egyptian healthcare system was the first to
maintain medical records starting at around
3000 B.C.
• Egyptian society was also the first to classify
medications and develop plans to maintain
people’s health.
• They were the first to use the concepts of
Sutures in repairing wounds
• Egyptian physicians are believed to have
specialized in certain diseases (such as internal
diseases, fractured bones, and wounds).

Greece
From1500 B.C. to 100 B.C., Greek philosophers sought to
understand man and his relationship with Gods ,nature and
other men.
They believed that god and goddesses of Greek mythology,
controlled health and illness. Temples were built to honor
the Asclepius , the god of medicine, and were designated
to care for the sick.
The Greeks believed in Apollo, the Greek god of healing
and prayed to him for magic cures for their illness.

Hippocrates was the first who attributed disease to
natural cause rather than supernatural causes and
curses of gods and 400 B.C. ,the famous Greek
physician Hippocrates believed that disease had
natural, not magical, causes.

INDIA
Dating from 2000 to 1200 B.C., the earliest cultures of
India were Hindu. The sacred books of Hindu, Vedas,
were used to guide healthcare practices.
The Vedas included herbs, spices, displays of magic,
and charms. The Indian documented information
concerning prenatal care and childhood illness.

CHINA
The teaching of Confucius (551-479 B.C.) had a powerful impact
on the customs and practices of people of ancient China. One
tradition that exemplified their belief about health and illness
was the yin and yang philosophy.
The Chinese believed that an imbalance between these two
forces would result in in illness, where as balance between the
yin and yang represent good health. The ancient Chinese used a
variety of treatments believed to promote health and harmony,
including acupuncture to affect the balance of yin and yang.
Hydrotherapy, massage, and exercise were used as preventive
health measures.

ROME
In ancient Rome, during the early Christian era,
deaconesses were selected by the church to provide care
for the sick.
Deaconesses had some education and were selected by the
church’s bishops to visit and care for the sick in their
homes.
The deaconess Phoebe is considered to be the first “visiting
nurse” who provided expert home nursing care.

The Roman Empire (27BC. - 476 A.D.) a military
dictatorship, adopted medical practices from the countries
they conquered and the physicians they enslaved. The first
military hospital in Europe was established in Rome. Both
male and female attendants assisted in the care of sick.
Galen was a famous Greek physician who worked in Rome
and made important contribution to the practice of
medicine by expanding his knowledge in anatomy,
physiology, pathology and medical therapeutics.

The Middle Ages
The Middle ages (476BC. To 1450 A.D.) followed the demise of
Roman Empire. Women used herbs and new methods of
healings whereas man continued to use purging and leeching.
This period also saw the Roman Catholic Church become a
central Figure in the organization and management of health
care.
Most of the changes in health care were based on the Christian
concepts of charity and sanctity of human life.
Wives of emperors and other women considered noble were
become nurses.

RENAISSANCE PERIOD
The Renaissance and Reformation period (1500 to 1700) also
known as the rebirth of Europe, followed the middle ages
period. During the renaissance period, a growing interest in
science and technology led to advances in medicine and
public health.
At the time, the rich paid for their sick to be cared for at
home, while the poor were cared for in hospitals. By the time
many poor people arrived at hospitals, they were already very
ill, so they often died in the hospitals.
Being hospitalized had negative connotations for most people,
as hospitals were considered places where people went to
die. It was also referred as the Dark Ages of Nursing.

• Following the Protestant Reformation, monasteries
and convents were closed, and the lands were
seized. “Common” women who were too old or ill to
find other jobs started caring for the sick.
• Although there were a few hospitals in Protestant
Europe, there were no regular system of nursing.
Female practitioners cared for neighbors and family,
but their work was unpaid and unrecognized.
• In Catholic areas, however, the tradition of nursing
nuns continued uninterrupted.

FOUNDATIONS OF MODERN NURSING
• Modern nursing began in the 19th century in
Germany and Britain.
• The practice had spread worldwide by about
1900. British social reformers advocated for the
formation of groups of religious women to staff
existing hospitals in the first half of the 19th
century.
• Two influential women in the field of nursing
during this time period were Elizabeth Fry and
Florence Nightingale.

THE 19TH AND 20TH CENTURIES
• In the late 19th century, nursing professionalized
rapidly in the United States.
• Women who had served as nurses during the Civil
War realized the importance of a formal nursing
education and played a crucial role in establishing
the first nurse training schools.
• Hospitals began setting up nursing schools that
attracted women from both working-class and
middle-class backgrounds.

The 19th and 20th Centuries
• The first permanent school of nursing founded
in the United States was the nurse training
school at the Women’s Hospital of
Philadelphia, which was established in 1872.
• During the second half of the 20th century,
the number of graduate programs in nursing
grew rapidly.

THE 19TH AND 20TH CENTURIES
• Graduate nursing programs focusing on
clinical specialties laid the basis for the
expansion of advanced practice nursing.
• By the end of the 1960s, there were 1,343
nursing schools with 1,64,545 nursing
students enrolled, according to the National
Student Nurses Association (NSNA)

NURSING IN ISLAM
• Nursing in Islam is a healthcare services related to
caring patient, individual, family, and community
as manifestation of love for Allah and the Prophet
Muhammad(PBUH).
• Nursing as a profession is not new to Islam. In
fact, it is attributive to sympathy and
responsibility towards the concerned in need.
• This undertaking had started during the
development of Islam as a religion, a culture, and
civilization.

NURSING IN ISLAM
1.“ heal the breasts of believers ”
ِ‫ف‬ْ‫ش‬َ‫ي‬ َ‫و‬
ٍ‫م‬ ْ‫و‬َ‫ق‬ َ‫ُور‬‫د‬ُ‫ص‬
َ‫ين‬ِ‫ن‬ِ‫م‬ْ‫ؤ‬ُ‫م‬ (Tuba -14)
2.“ and a healing for the diseases in your hearts ” ٌ‫ء‬‫ا‬َ‫ف‬ِ‫ش‬ َ‫و‬
ِ
‫ُور‬‫د‬ُّ‫ص‬‫ال‬ ‫ي‬ِ‫ف‬ ‫ا‬َ‫م‬ِ‫ل‬ (Yonos – 57)
3.“ we send down stag by stage in the Qur'an and that
which is a healing and a mercy to those who believe”
(Israa – 82 ) َ‫ين‬ِ‫ن‬ِ‫م‬ْ‫ؤ‬ُ‫م‬ْ‫ل‬ِ‫ل‬ ٌ‫ة‬َ‫م‬ْ‫ح‬ َ‫ر‬ َ‫و‬ ٌ‫ء‬‫ا‬َ‫ف‬ِ‫ش‬ َ‫و‬ُ‫ه‬ ‫ا‬َ‫م‬ ِ‫ن‬َ‫آ‬ ْ‫ر‬ُ‫ق‬ْ‫ال‬ َ‫ن‬ِ‫م‬ ُ‫ل‬ ِّ‫َز‬‫ن‬ُ‫ن‬ َ‫و‬ “
4.“and when I am ill, it is He who cures me ” ُ‫ت‬ْ‫ض‬ ِ
‫ر‬َ‫م‬ ‫ا‬َ‫ذ‬ِ‫إ‬ َ‫و‬
ِ‫ين‬ِ‫ف‬ْ‫ش‬َ‫ي‬ َ‫و‬ُ‫ه‬َ‫ف‬ (Shoaara – 80)

NURSING IN ISLAM
• And there are many statements of our
prophet. Muhammad (PBUH) related to this
subject example:
–Our God create treatment for every disease
some people know it and some of them
don’t.
–Seek for treatment and medical help.

THE FIRST MUSLIM NURSE
• The first professional nurse in the history of Islam is a
woman named, Rufaidah bento Saad Al Aslamiah, from
the Bani Aslam tribe in Madina Al Monawarah
• She lived at the time of Prophet Muhammad (saw) and
was among the first people in Medina to accept Islam
• Rufaidah received her training and knowledge in
medicine from her father, a physician whom she
assisted regularly

After the Muslim state was established in Medina, she
would treat the ill in her tent set up outside the
mosque
During times of war, she would lead a group of
volunteers to the battlefield and would treat casualties
and injured soldiers.
Rufaidah is described as a woman possessing the
qualities of an ideal nurse: compassionate, empathetic,
good leader and a great teacher, passing on her clinical
knowledge to others she trained.

Furthermore, Rufaidah’s activities as someone greatly
involved in the community, in helping those at the more
disadvantaged portions of society symbolize the ethos of
care identified above.
Anas ibn Mâlik said: “Muhammad (PBUH) used to go out
to the battles taking Umm Sulaym and some other
women of the Ansaar with Him; when He fights in the
battle, they [i.e. the women] would give water to the
soldiers and treat the injured.”

Florence Nightingale
• She was born in 1820 and died in 1910
• Born in Italy to wealthy English parents
• Frustrated by lack of options for women of her
social background
• Challenged parents and society and traveled
to Germany and throughout Europe to train as
a nurse
• Her big opportunity came when the Crimean
war broke out in 1854

FLORENCE NIGHTINGALE
• Secretary of War asked her to go take charge of the
hospital at Scutari in Turkey.
• Nightingale showed up with 38 trained nurses and
faced a death rate of 40%
• Nightingale found that conditions in the military
hospitals were terrible. The absence of sewers and
laundry facilities, the lack of supplies, the poor food,
and the disorganized medical services contributed to
a death rate of more than 50% among the wounded.

Florence Nightingale
• She established cleanliness and sanitation rules
• Patients received special diets and plenty of food
• Improved water supply
• Patients received proper nursing care
• Nightingale established a reputation which
allowed her to improve nursing standards at
home
• Nightingale’s strong statements about the role of
nurses and their need for lifelong education are
still quoted widely today

FLORENCE NIGHTINGALE
• Established nursing school at St. Thomas’
Hospital, London.
• By 1887, had her nurses working in six
countries and U.S.
• She was a nurse, philosopher, statistician,
historian, politician and more
• Today she is considered the founder of
modern nursing

NURSING DEFINITIONS BY SCHOLARS
Nursing definitions by Florence Nightingale
She defined nursing 100 years ago as “ the act
of utilizing the environment of the patient to
assist him in his recovery”
(Nightingale 1860)

Virginia Henderson’s Definition
“The unique function of the nurse is to assist: the
individual, sick or well, in the performance of those
activities contributing to health or its recovery( or to peace
full death)
He / She would perform independently if he, she had the
necessary strength, will, or knowledge and to do this in
such a way as to help him gain independence as rapidly as
possible.”

ANA’s Definition
• In 1980, the ANA (American Nurses Association)
published this definition of nursing “Nursing is
the diagnosis and treatment of human responses
to actual or potential health problems.”
(ANA, 1980, p. 9)

Nursing Definition WHO
Nursing definition WHO
Nursing encompasses autonomous and collaborative
care of individuals of all ages, families, groups and
communities, sick or well and in all settings. It
includes the promotion of health, the prevention of
illness, and the care of ill, disabled and dying people.

MUGHAL PERIOD AND NURSING
Maham Anga, a great lady served as a wet
Nurse of King Akbar in Mughal Empire
She nursed during Wars in India and
Afghanistan

TYPES OF NURSING EDUCATION
PROGRAMMES
• NURSING DIPLOMA
• CERTIFIED NURSING ASSISTANCE (CAN)
• ASSOCIATE OF SCIENCE IN NURSING
• BACHELOR OF SCIENCE IN NURSING (BSN
• RN-TO-BSN (POST RN BSN)
• MASTER OF SCIENCE IN NURSING (MSN)
• DOCTORATE NURSING DEGREE PROGRAMS
• MPH RELATED TO NURSING CARE IN PUBLIC
HEALTH OR PROJECT RESEARCHER
• MSPH

HISTORY OF NURSING EDUCATION IN
PAKISTAN
• Initially, the health-care services in Pakistan were ill-
developed and the rate of employment in health-care
jobs in Pakistan was very low. Since 1951 Pakistani
governments have concentrated on the development
and improvement of health care services and one of
the major steps is increasing the rate of funding to PNC
office. The Nursing council (PNC) has also played a key
role to provide world-class health care and nursing
services to the patients.
• Pakistan had a nurse-to-population ratio of 1:32000 in
1960, improving to 1:5199 by 1997

PAKISTAN
• According to figures cited by the Journal of Pioneering
Medical Sciences in 2013, the existing nurse-patient ratio
in Pakistan is approximately 1:50 whereas the ratio
prescribed by the Pakistan Nursing Council (PNC) is 1:10
in general areas and 2:1 in specialized areas.
• Currently, Pakistan has 162 registered nursing colleges.

PAKISTAN NURSING COUNCIL (PNC)
The PNC is an autonomous, regulatory body
constituted under the Pakistan Nursing Council Act
(1952, 1973) and empowered to register (license)
Nurses, Midwives, Lady Health Visitors (LHVs) and
Nursing Auxiliaries to practice in Pakistan. PNC was
established in 1948.
The PNC has involvement in improving and
standardizing public education and clinical nursing
standards. They also oversee the ethical standards
and general welfare of nurses.

Roles/functions of the PNC?
1. PNC sets the curriculum for the education of
Nurses, Midwives, LHVs and Nursing Auxiliaries.
2. PNC inspects educational institutions for approval
based on established standards
3. PNC provides registration (license) to practice.
4. PNC maintains standards of education and practice.

5. PNC works closely with the four provincial Nursing
Examination Boards (NEBs).
6. PNC plays and advisory role for the overall benefit of
Nurses, Midwives, LHVs and Nursing Auxiliaries in the
country.
7. PNC maintains an advisory role for the Federal and
Provincial Government regarding nursing education and
nursing services.

8. PNC communicates policy decisions regarding nursing education
and the welfare of nurses, taken in Council meetings, to
Governments, Nursing Institutions, NEBs and Armed Forces
Nursing Services for implementation.
9. PNC prescribes penalties for fraudulent registration by intention
of removes persons from the Register for professional misconduct.

PAKISTAN
• 1948: First Nursing School was established in Ganga
Ram small private Hospital Lahore.
• In 1952: first group of 07 girls passed the nursing
course from this school.
• In 1948: Second School of Nursing was opened in
JPMC Karachi.

PAKISTAN
• This development followed by Bahawalpur, Hyderabad and
Multan, Lady Reading Hospital Peshawar, Civil Hospital
Karachi, Mayo Hospital Lahore.
• In 1951: LHV Training extended to 02years, one year
midwifery and second in nursing emphasized on community
nursing.

PAKISTAN
Every year 1800-2000 Registered Nurses, 1200-
1300 Midwives Nurses and 300-400 Lady Health
Visitors are produced in the country.

THE FUTURE OF NURSING
• International Nurses Day is observed on May 12 across
the globe to acknowledge the role that nurses play in the
healthcare system
• Pakistan is running short of nursing staff and currently
nursing education is in transition period and diploma
education has been replaced by university degree 2018

THE FUTURE OF NURSING
 A few universities offer master degree & PhD in
nursing sciences. Recently KMU has started PhD
Nursing ( First ever public sector university of
Pakistan).
 However, there is a lot to be done more as currently
degree program is lacking quality with exception to
some institution, along with surfacing of some ghost
institutions offering degree to remote students even
without attendance, reason behind is the culture of
political nepotism and corruption.

REFERENCES
1. Craven, R. F., & Hirnle, C. J. (2000). Fundamentals
of Nursing: Human Health and Function. (3rd ed.). New
York: Lippincott.
2. Delaune, S. C., & Ladner, P. K. (2002). Fundamentals of
Nursing: Standards and Practice. (2nd ed.) Canada:
Delmar.
3. Erb, G. K., B. (2000). Fundamentals of Nursing:
Concepts, Process and Practice (5th ed.) Addison: Wesley.
4. Potter, P. A & Perry, A. G. (2003). Basic Nursing:
Essentials for Practice (5th ed.) St. Louis: Mosby.

Nursing history by roheeda riaz khan

Nursing history by roheeda riaz khan

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