The History and Evolution of Nursing

Nursing has changed dramatically over time. It's a profession that's been around for a long
time. Nurses are trusted healthcare professionals who play an important part in the treatment and
medical care of the sick. Nursing comes from the Latin word "nutrire" which meaning to nourish.

Nursing during Ancient Times

Nursing, medicine, and hospitals have their origins in ancient times, dating back to 3000 BCE.
Nursing has a long history that is connected with medicine and health care between 3000 BCE and
CE 1000. Nursing may be traced back over 5000 years to ancient Egypt, Babylon, and Greece.

Ancient Egypt
Physicians and healers were introduced in
ancient Egypt, and they were mainly priests who were
responsible for treating physical and psychological
illnesses. Priests served as a bridge between humans
and the gods. The Egyptian thought that in order to be
healthy and happy, humans had to make the gods
happy.

Injuries were simple to comprehend; sickness,

on the other hand, was more complex. When someone
is injured, there is an obvious cause and effect that
can be treated, but when someone is sick, the cause is
less clear, making diagnosis more difficult. The cause
was usually assumed to be the result of sin, and if that
was not the case, the sufferer was believed to be
under demonic control and was being plagued by an angry ghost or god felt they needed to learn a
lesson.

Since the Egyptians believed disease was caused by an evil force entering the body, the first
'doctor' was a magician. In addition to magical spells, ancient Egyptians use incantations, amulets,
offerings, aromas, tattoos, and statuary to either drive away from the ghost or demon, please
the god or gods who had sent the illness, or request protection from a higher power as a
means of prevention. The spells and incantations were written down on papyrus scrolls which
became the medical text of the day.
 Only a few ancient Egyptian texts have
survived to the present time. It provides a lot of
information about how Egyptians understood
diseases and what they considered can alleviate
the symptoms or lead to a cure. They are named
after the person who originally owned them or the
institution that keeps them. For obvious reasons,
the Egyptians referred science of medicine as a
"necessary art."

Male or female physicians performed in

ancient Egypt. Imhotep, the architect most
known for building the Step Pyramid of Djoser at
Saqqara, was the 'first physician', eventually
deified as a god of health and healing. Although
Merit-Ptah is the first female doctor in recorded
history, evidence suggests that a medical school was managed by a woman whose name is unknown
at the Temple of Neith in Sais, Lower Egypt. Not only did a doctor need to be literate, but he or she
also has to be pure in body and mind. Doctors were known as wabau and were supposed to bathe as
regularly and meticulously as a high priest.

Although there is no record of a school or professional training, the nurse could be female or
male and was a highly respected medical professional. The wet nurse was the most important type
of nurse. "With the people's likelihood of high maternal mortality, wet nurses would have been
extremely critical," Grave-Brown says. Women died often during childbirth, according to legal
documents showing agreements between wet nurses and families to care for the newborn if the
mother died.

Mummification comes from the ancient

Egyptians' process of embalming or restoring the
dead body. The Egyptians used unique techniques
to remove all moisture from the body, leaving only
a dry tissue that would not decay easily. It was
crucial to their beliefs that the deceased body be
preserved as realistic as possible. They were so
successful that we can presently look at an
Egyptian's mummified body and get a good picture
of what he or she seemed like in life, 3,000 years
ago. The earliest prehistoric mummies were most
likely caused by chance. Egyptians began actively
mummifying the deceased around 2600 BCE,
during the Fourth and Fifth Dynasties. The quality
of mummification varies depending on the amount
paid for it at any given time. The best-preserved mummies come from the New Kingdom's
Eighteenth to Twentieth Dynasties and include those of Tutankhamen and other well-known
pharaohs.
Ancient Babylonian
Medicine in ancient Babylonia was mostly based on magic,
with little scientific method other than diagnosis and prognosis, which
were infused with supernaturalism. These Babylonian physicians
wrote down a large number of prescriptions, the majority of which are
now regarded ineffective for the ailment in question. Most of the
materials used were most likely chosen based on a combination of
trial and error and guesswork. In addition to the guesswork, part of
the reason most of these prescriptions weren't of the functions of most
of the body's components was due to the fact that most of these
prescriptions weren't of the functions of most of the body's
components.

The majority of Babylonian medicine aimed to diagnose and cure a wide range of diseases,
including digestive diseases, respiratory problems, urinary troubles, epilepsy, and other mental
disorders. They didn't always attribute afflictions to gods or spirits, instead of depending on astrology
and other superstitions for prognosis and treatment.

Two types of practitioners were responsible for Babylonian healthcare: the physician and the
exorcist. These two collaborated to provide medical treatment and also protection from evil spirits
that were thought to be dangerous for health. There were no requirements for accreditation or proof
of knowledge, so anyone might proclaim to be a doctor and practice medicine. Non-superficial
diseases were frequently attributed to the supernatural by Babylonian physicians, and magical
treatments were normally the expertise of the exorcist. Its major function was to remove bad spirits
believed to be responsible for a variety of illnesses, therefore preventing patients from further harm.
However, the exorcist did sometimes act as a physician, providing diagnosis, prognoses, and natural
treatment in tandem with the supernatural.

Ancient Babylonian medicine made extensive use of a variety of materials, mainly plant and
animal life, and also minerals. While magic was often used to treat mental illnesses, physicians
used mostly natural treatments. Both the exorcist and the physician used the supernatural to a
significant extent. Even natural medical treatment would always be followed by a spell or incantation.
Gula, the goddess of healing, is mentioned several times. She is frequently mentioned in magical
incantations performed in ancient Babylonian medicine's spiritual aspects. These spells are more
than just appeals to gods and spirits, they were a form of prose, often using symbolic language and
repeating motifs.

Cuneiform tablets, sometimes known as the oldest

medical manual, contain the oldest scientific literature. It is said
to have been written by an unknown Sumerian physician who
lived near the end of the third century B.C. He kept track of all of
his important medicines. He jotted down over a dozen of his
favorite medicines in cuneiform scripts. This is the world's oldest medical manual, dating back over
4000 years and discovered buried in the Nippur ruins.

Ancient China
The Chinese medical system is thousands of years old and has never been influenced by
outside forces. Huangdi, one of the famous founders of Chinese culture, is said to have written the
Huangdi neijing, a canon of internal medicine, around the 3rd millennium BCE. The Mojing, written
around 300 CE, and the Yuzhuan yizong jinjian, a 1742 compilation of medicinal writings from
the Han dynasty (202 BCE–220 CE), are two more well-known books.

The dualistic cosmological concept of yinyang is fundamental to

traditional Chinese medicine. The heavens represent the yang, the
male principle, which is dynamic and bright. The earth represents
the yin, the female principle, which is quiet and dark. Wood, fire,
earth, metal, and water are the five elements that make up the
human body and matter in general. The preponderance of the yin or
the yang at any one time determines health, character, and the
success of all political and private undertakings, and the major goal
of ancient Chinese medicine is to manage their proportions in the
body.

Religious communities forbid the mutilation of the deceased human body, hence ancient
anatomy had no scientific basis. The cosmic system, which postulates the presence of such
hypothetical structures as the 12 channels and the three so-called burning spaces, supports
traditional Chinese anatomy.

The Chinese materia medica has always been broad, including cures for plants, animals, and
minerals. There were legendary herbals in ancient times, but Li Shijen collected them all in the
compilation of Bencao gangmu in the 16th century CE, which numbered around 1,000. Ginseng is a
very well and pricy Chinese remedy. Reserpine, the active ingredient of the Chinese herb Rauwolfia,
has also been identified and is used to treat high blood pressure as well as some emotional and
mental disorders.

Nursing in Ancient Greece

Apollo, the Sun God, was regarded as the God of Healing, while Asclepius, Apollo's son,
was regarded as the Greek God of Medicine. Hygiea, Apollo's daughter, was the goddess of
health and was associated with miraculous healings. Personal hygiene, exercise, and ortho-
nutrition diets were all heavily promoted during that time.
 The beginnings of Greek Nursing can also be found in ancient Greek sanitariums where
some kind of organized nursing was present. Sanitariums before Asclepieia, which flourished in
ancient Greece and offered more organized healthcare. Nursing care was the duty of housewives,
both free or slaves, in ancient Greece. Historians have determined that nursing was a duty of Greek
women and was considered to be of little interest to the development of medical knowledge at the
time. During the plagues in ancient Athens, patient care was delivered by the women of the  family
members, slaves, and their friends.

The first Spanish hospital was created in Merida, Spain, in the late 500s to early 600s, with
the aim of treating for all sick patients regardless of ethnic origin or religion. Several others were
established in the centuries, but their administration was ignored until Emperor Charlemagne began
to restore and modernize the supplies and equipment in the 800s.

Because of changes in European rulings, the nursing profession expanded throughout the
10th and 11th centuries. Hospitals started to be incorporated into monasteries and other religious
institutions, and nurses provided a wide range of medical care services as needed, even going
beyond traditional healthcare. This all-encompassing model gained popularity and is still in charge of
the extensive range of duties that a nurse is accountable for today.

Nursing as a profession was rare in the beginning of the 17th century for a variety of reasons,
such as the closing of monasteries that housed hospitals. However, in some areas of Europe where
the Catholic Church remained in power, hospitals remained in service, and nurses remained to play a
significant role.

Dark Age of Nursing

 Nurses ventured into the society throughout the late Middle Ages (1000-1500) due to
overcrowded and poor cleanliness in monasteries. Hospitals were created during this time period,
and the number of medical schools increased. The Renaissance influenced nursing from 1500 to
1860 (A.D.). Nursing lost a lot of its financial and social backing because it wasn't seen as an
intellectual endeavor. The nursing situation was at its worst, and it was dubbed the "black time of
nursing". New hospitals were erected, but they quickly became sites of terror as filthy circumstances
led epidemics and disease to spread

Nursing during Modern Era

Nursing began as a humane profession, frequently performed by nuns and military people
during times of war. Until recently, nursing was thought to be a woman's career. In some locations,
men are still criticized for seeking nursing occupations. Modern nursing, on the other hand, is a
completely different field than it was before the great wars, and even before the Crimean War.
Florence Nightingale was a nurse who treated injured
soldiers during the Crimean War in the 1850s and was successful
in changing the nature of the nursing profession in the 19th century.
Her observations of the situations in military hospitals motivated her
to write the Environment Theory, which addressed patient
sanitation and was described in her book Notes on Nursing. Her
theory became the sanitary conditions resulted in a higher rate of
patient recovery and a decrease in complications. Nightingale also
built the first nursing school, the Nightingale School for Nurses, in
1860, which began to supervise how nurses taught and practiced.
This not only guaranteed that nurses had a good educational
foundation of knowledge and procedures, but it also helped to
assure a high standard of care for patients. Because of Nightingale's accomplishments to modern
nursing, the pledge made by nurses when they graduate is known as the "Nightingale Pledge."

During this time, nurses' roles expanded because of the requirement for their presence on the
front lines of wars, when poor hygienic standards frequently resulted in severe infections in the
injuries. Nightingale advocated for enhanced sanitary standards in the hospitals that cared for injured
soldiers, which resulted in a reduced number of infection-related deaths. With the foundation of the
first nursing school in London in 1860, the profession of nursing grew even further. This was the
beginning of many other schools for new nurses to receive sufficient training and instruction before
entering field practice.

In the modern nursing field, nurses have a higher reputation, as well. They are no longer seen
as simply assistants to physicians who do the things physicians won’t do. Instead, nursing is a strong
field of its own, and nurses have a wide range of duties and responsibilities. Nurses earn respect for
themselves among health care professionals because of the education and experience required to be
a nurse. Nursing is developing at the same level that medicine and health care are. As researchers
develop new technologies, therapies, techniques, and medications to help patients in becoming
healthy, the field of nursing adjusts to the developments to improve patient health care. In nursing
schools, new nurses learn about new techniques and information, while practicing nurses learn about
changes and developments in continuing education courses when they renew their licenses. This
contributes to health care remaining on the cutting edge of medicine.

History of Nursing in the Philippines

Nursing has a deep and mysterious history in the Philippines. It originates from the care
provided by women, priests, and herbalists in the pre-colonial Philippines. Even though women had
few opportunities to be formally educated in schools since only a small number of Filipino women
acquired primary education in charitable institutions founded by Spaniards, this tradition remained
during the Spanish colonial era. During the Philippine revolution, Filipino women became caregivers
for injured revolutionaries. During the American period in the Philippines, Filipino women were
allowed to get an education as nurses, guided by their American nurse and missionary mentors,
until nursing became a full-fledged profession in the Philippines, a career path not only for modern-
day women in the country but also for men.

Superstitions and mysticism, these were the early health and illness beliefs in the
Philippines. The primary cause of a disease was assumed to be on some other person, who was an
enemy, or a witch or demonic forces. For the sake of their health, Filipinos were very cautious not to
upset other people or evil spirits in the early days. Persons with the capability to remove demons may
force these evil spirits away. These wicked spirits could be driven away by persons who have the
power to remove demons, such as priests or herbalists. Filipinos who got ill were generally cared for
at home by female family members or friends.

Many superstitions and traditions were believed to be directly related to health. Herb men were
called "herbichero”. Victims with mysterious diseases were believed to have been cursed by
wizards and witches known as "mangkukulam/mangagaway". The “mabuting hilot” was generally
present during labor. If the birth got too risky, bad omens and evil wizards were accused. Exploding
gunpowder from a bamboo cane near the head of the person whose suffering would generally
remove the bad omen.

During Spanish Era (1565-1898)

During the colonial reign of Spain, the Philippine education system brought different and
unequal chances for Filipinos depending on gender. One example of this is sexism, permitting only a
small number of women to attend primary school in Spanish charitable organizations. Family
members and personal experience with the sick provided the knowledge of caring for others. Nursing
other people was regarded as a task rather than a job or a career. The Spanish were plagued with
strange diseases as they were exposed to the strange environment of the Philippines. To fight this,
they established hospitals dedicated entirely to their health. Spanish friars were in charge of some of
the country's early health establishments.
 The first hospital in the Philippines was Hospital Real, it was built in Cebu in 1565. It was
relocated to Manila to accompany the administration. The hospital's mission was to care for the
Spanish army and navy, as well as individuals suffering from disease and war casualties. Despite
receiving assistance from the Spanish government, Hospital Real needed funds, people, and
supplies. On June 3, 1863, an earthquake devastated Hospital Real.

During Philippine Revolution

During the Philippine Revolution, several women converted their homes
into hospitals for Filipino soldiers and revolutionaries. Melchora Aquino,
commonly called the "mother of the Philippine Revolution", was one
of these women. Aquino, who was around 80 years old at the time, was
a supporter of the revolution, providing shelter and food to
revolutionaries. She cared for those who got sick or hurt. However, just a
few days after the revolution began, she was imprisoned by the
Spaniards for providing medical attention to the revolutionaries. Aquino
was deported to Guam in the Marianas after refusing to provide any
information to the Spanish regarding the location of the rebel leader. She
was able to return to the Philippines after six years of exile in 1903, when the Philippines finally
achieved independence from the Americans. During the revolution, Aquino's devotion in helping the
sick and injured has drawn similarities to the British Florence Nightingale. Both of these women
provided nursing care to soldiers during the war and laid the way for nursing practice.

During American Colonial Rule

Despite the Philippines' independence from Spain, the United States began to exert its
authority over the islands, causing a fight between the Filipinos and the Americans. This marked the
start of the Philippine–American War. The arrival of Americans had a significant influence on the
growth of nursing as a profession. Nurses and missionaries
from the United States traveled to the Philippines to work as
nurse mentors to the Filipina women. Teaching and missionary
work in the Philippines, as well as nursing education, giving
white American women a sense of meaning in the country.

Dr. and Mrs. Joseph A. Hall, Presbyterian Foreign

Mission Board missionaries from the United States,
established a temporary bamboo clinic on Calle Amparo in
Iloilo City in 1901 to serve as a location for the administration
of medical services to the very poor.

During Post-Colonial Philippines

 The end of colonialism between the United States and the Philippines was officially declared
on July 4, 1946, when Manuel Roxas won the presidency of the Republic of the Philippines. The
islands of the Philippines were in ruins, and Roxas was determined to recover his homeland. The first
steps Roxas took is to balance the Philippines' budget were to collect overdue taxes, reduce
spending, and promote overseas trade, which included the exporting of Filipino nurses. Filipino
nurses, who had already been trained by Americans, were ideal candidates to help the United States
and other countries suffering from post-World War II shortages.

By the mid-1960s, thousands of Filipino nurses had arrived in the United States. The
advantage for the traveling nurses was that they could earn approximately 20 times more than they
did at home. A portion of this money would be remitted to their families, strengthening the Philippine
economy. The nurses' high exportation rate had the unintended consequence of increasing their own
country's shortage of nurses.

During Early 1900’s

Nurse licensure reforms have been passed in some states across the United States. Shorter
training requirements were implemented, as well as stricter admissions requirements for nursing
schools. Before meeting patients, the idea of having students work in a more active position was a
radical idea that was beginning to pay off. It was also in the early 1900s in the Philippines that the first
nursing school was formed. The study plan remained broken and ambiguous. Only a few students
were engaged in this type of study on a part-time basis. The "First True Nursing Regulation" was
established in 1919 as a result of the need for legislation or law at the time. On September 2,
1922, the Philippine Nurses Association was established.
References:
http://internationaljournalofcaringsciences.org/docs/31_Theofanidis_special_8_3.pdf. (2015). Retrieved from
31_Theofanidis_special_8_3.pdf:
http://internationaljournalofcaringsciences.org/docs/31_Theofanidis_special_8_3.pdf

https://healthandfitnesshistory.com/ancient-medicine/babylonian-medicine/. (2020). Retrieved from Health and Fitness

History: https://healthandfitnesshistory.com/ancient-medicine/babylonian-medicine/

Peteprin, A. (2020). https://nursing-theory.org/articles/modern-nursing.php. Retrieved from NURSING THEORY:

https://nursing-theory.org/articles/modern-nursing.php

Smith, Y. (n.d.). https://www.news-medical.net/health/History-of-Nursing.aspx. Retrieved from NEWS MEDICAL LIFE

SCIENCES: https://www.news-medical.net/health/History-of-Nursing.aspx

Smithsonian. (n.d.). Retrieved from Ancient Egypt. Egyptian Mummies:

https://www.si.edu/spotlight/ancient-egypt/mummies

history of medicine-China. (n.d.). Retrieved from Britanicca:

https://www.britannica.com/science/history-of-medicine/China

(https://en.wikipedia.org/wiki/Nursing_in_the_Philippines, 2021)
(https://healthandfitnesshistory.com/ancient-medicine/babylonian-medicine/, 2020)
(bartleby research, 1992)

(https://ispub.com/, 2013)