The Evolution of Nursing: Past, Present, and Future Challenges

The history of nursing is a tale of transformation and resilience. From ancient civilizations where nurses were esteemed as experts and authority figures, through later periods of intense adversity, to present-day successes and struggles, the journey of nurses has been fascinating.

In this article we explore the historical significance of nursing, the field’s current challenges, and the state of nursing employment today.

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Nursing Through the Ages

In ancient times, nurses were revered for their knowledge and skills. Centuries ago, nurses were central to healthcare systems, with their significance dating back to ancient India and the Islamic world.

Ancient medical texts such as the Charaka-Samhita, written 2,000 years ago, emphasized the importance of nurses. In the early days of Islam, figures such as Rufaida-Al-Aslamiya exemplified the role of nurses, who cared for wounded soldiers and provided health education.

Notably, historical nursing roles were not limited to women, with both men and women serving as practitioners. But with the opening of new medical schools in Europe during the Middle Ages, women in healthcare began to be marginalized, paving the way for their exclusion in certain functions in healthcare.

Florence Nightingale: An Impact Both Positive and Negative

Florence Nightingale, renowned for her role in reviving the importance of nurses, paradoxically also had a negative impact on the profession

During the Crimean War in the 1850’s, Nightingale’s intervention was sought to address the high mortality rates due to infections. While her contributions brought nurses back into the healthcare system, she envisioned nursing as a female profession subordinate to physicians. 

This notion perpetuated the idea of nurses as mere assistants.

Nightingale’s adherence to a strict hierarchical structure stifled the autonomy of nurses, leading to conflicts and constraints. This inflexibility frustrated nurses who felt unable to fulfill their calling and provide the level of comfort they felt that patients required.

Changes and Evolution: Top Issues Facing Today’s Nurses

Modern nurses face challenges both multifaceted and daunting. A recent survey by AMN Healthcare indicated that nearly 1/3 of nurses nationwide are contemplating leaving the profession. 

This level marks an increase of at least 7 points since 2021 and is a concerning trend for the profession. This trend is probably due to the impact of the COVID-19 pandemic.

The ongoing shortage of nurses remains a pressing issue. Note:

  • 94% of nurses in the survey reported a severe or moderate shortage in their areas
  • Approximately 89% of registered nurses (RNs) perceived the nursing shortage as more severe than it was 5 years ago 
  • Nurses are not optimistic about the future, with 80% of those surveyed expecting the situation to worsen in another 5 years

On the other hand, National Nurses United says that there isn’t a nurse shortage at all. The problem, they say, is merely a shortage of nurses who want to work under current conditions.

What Nurses are Seeking Today

Many nurses are fighting for better working conditions, as low staffing levels have had detrimental effects on their workload, stress levels, and patient care quality. 

It’s worth noting that the nursing shortage crisis existed before the pandemic, with some healthcare organizations highly focused on prioritizing profits exacerbating the problem. 

Many of today’s nurses report not having enough time for basic needs such as lunch or bathroom breaks during their shifts. These conditions can contribute to high levels of stress, burnout, and emotional exhaustion.

Nurses Remain Viewed as Ethical and Trusted

Yet despite the challenges and adversities, the ethical standing of nurses remains high. 

Recent polling from Gallup indicates that nurses continue to be viewed as highly ethical professionals.

  • A remarkable 79% of U.S. adults perceive nurses as having “high” or “very high” standards of honesty and ethics
  • Although that figure decreased from its peak during the first year of the COVID-19 pandemic, nurses maintain a significantly higher ethical reputation compared to other professions
  • Medical doctors and pharmacists, for example, also hold favorable ethical standings, with 62% and 58% of U.S. adults, respectively, considering them to have high ethical standards

The Nurses’ Journey Continues

The history of nursing reveals a remarkable journey of transformation and resilience. Today’s nurses confront many challenges. Yet their work ethic remains unwavering, with nurses continuing to be highly regarded. 

As nurses persist in their dedication to patient care, their enduring legacy of compassion and ethics shines through into the present day.

Written by Warren Goldie

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