History of Nsg

8/8/2019 History of Nsg

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Health and HospitalsHealth and Hospitals Year 11 Year 11HistoryHistory





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With the advent of industry cameWith the advent of industry cameindustrial diseases such as dermatitis,industrial diseases such as dermatitis,

lung disease and phossy jaw. (ugh!)lung disease and phossy jaw. (ugh!)

Those most quickly

affected were theworkers who dipped

sticks into phosphorus

paste.



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With the expansion of the EmpireWith the expansion of the Empirecame contact with diseases such ascame contact with diseases such as

yellow fever.yellow fever.

With urbanisation came public healthWith urbanisation came public health

problems that included 'filth diseases'problems that included 'filth diseases'such as cholera and typhus.such as cholera and typhus.



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By the wayBy the way

The real MedicalThe real MedicalRevolution startedRevolution startedin France.in France.

After the French After the FrenchRevolution theRevolution theright to health wasright to health was

one of the 'rightsone of the 'rightsof man' claimed byof man' claimed byworking people.working people.



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WarWar

Wars were waged on a greater scaleWars were waged on a greater scale(creating mass injuries that were(creating mass injuries that were

hitherto unknown, and required newhitherto unknown, and required newmedical and surgical techniques).medical and surgical techniques).

Who could do the quickest Who could do the quickest amputation without anaesthetic?!amputation without anaesthetic?!



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HospitalsHospitals

With the rapid growth of theWith the rapid growth of thepopulation during the 18th and 19thpopulation during the 18th and 19th

centuries it was obvious that localcenturies it was obvious that localcharities and the workhouse systemcharities and the workhouse systemcould not provide sufficient medicalcould not provide sufficient medicalcare for the poor.care for the poor.



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Westminster HospitalWestminster Hospital

WestminsterWestminsterHospital in London,Hospital in London,constructed inconstructed in1720, was the first 1720, was the first public hospital inpublic hospital in

England.England.

Founded as aFounded as avoluntary hospitalvoluntary hospitalin a small house inin a small house in

Petty France,Petty France,Pimlico, with just Pimlico, with just 10 beds in 1719. It 10 beds in 1719. It occupied otheroccupied other

sites, including onesites, including oneoppositeoppositeWestminster AbbeyWestminster Abbeyand another inand another inPage Street Page Street



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It may seem a strange principle to It may seem a strange principle toenunciate as the very first requirement in aenunciate as the very first requirement in ahospital that it should do the sick no harm.hospital that it should do the sick no harm.It is quite necessary nevertheless to layIt is quite necessary nevertheless to laydown such a principle, because the actualdown such a principle, because the actual

mortality in hospitals, especially those themortality in hospitals, especially those thecrowded cities, is very much higher thancrowded cities, is very much higher than

any calculation founded on the mortality of any calculation founded on the mortality of the same class of patient treated out of the same class of patient treated out of hospital would lead us to expect.'hospital would lead us to expect.' FlorenceFlorence

NightingaleNightingale Notes on HospitalsNotes on Hospitals 18591859



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Nineteenth Century NursingNineteenth Century Nursing



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By 1800, all sizeable British townsBy 1800, all sizeable British townshad a hospital, and London's hospitalshad a hospital, and London's hospitals

admitted over 20,000 patients a year.admitted over 20,000 patients a year.Out Out--patient departments were evenpatient departments were evenbusier. In 1800, St Thomas's Hospitalbusier. In 1800, St Thomas's Hospitalestimated that its out estimated that its out--patient patient

department dealt with 10,000department dealt with 10,000patients. By 1890, the number waspatients. By 1890, the number was100,000.100,000.



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Voluntary hospitals generally admitted the Voluntary hospitals generally admitted thesick poor but not sick paupers. Followingsick poor but not sick paupers. Followingthe Poor Law Act (1834), there wasthe Poor Law Act (1834), there was

increasing realisation that most of thoseincreasing realisation that most of thoseadmitted to workhouses were sick oradmitted to workhouses were sick orelderly, and that sickness was the fastest elderly, and that sickness was the fastest route to pauperism. Workhouse infirmariesroute to pauperism. Workhouse infirmarieswere rapidly filled to capacity, and by thewere rapidly filled to capacity, and by the1860s, hospitals were being erected1860s, hospitals were being erectedalongside workhouses.alongside workhouses.



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During the 18th century, the wealthyDuring the 18th century, the wealthyhad largely been treated at home byhad largely been treated at home byprivate doctors but from the midprivate doctors but from the mid--19th19thcentury, some were choosing hospitalcentury, some were choosing hospitaladmission. This resulted in loss of admission. This resulted in loss of income for a number of doctors soincome for a number of doctors sothat it became advantageous tothat it became advantageous tosecure an honorary consultancy post secure an honorary consultancy post at a local hospital as well asat a local hospital as well asmaintaining a private practice.maintaining a private practice.



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Hospital consultants became the doctors of Hospital consultants became the doctors of choice for rich patients. In addition, bedschoice for rich patients. In addition, bedswere set aside in voluntary hospitals forwere set aside in voluntary hospitals for

paying patients, and a number of small,paying patients, and a number of small,private 'nursing homes' were established.private 'nursing homes' were established.These were effectively private hospitals forThese were effectively private hospitals forthe middle classes. At the same time, somethe middle classes. At the same time, some

general practitioners began to establishgeneral practitioners began to establishtheir own 'cottage' hospitals.their own 'cottage' hospitals.



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During the first half of the century,During the first half of the century,nursing the sick was generally not nursing the sick was generally not

believed to require any specialbelieved to require any specialtraining or experience. In thetraining or experience. In thevoluntary hospitals, convalescent voluntary hospitals, convalescent patients were often called upon topatients were often called upon to

help with acutely ill patients. In thehelp with acutely ill patients. In theworkhouse infirmaries, ableworkhouse infirmaries, able--bodiedbodiedpaupers nursed the sick.paupers nursed the sick.



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In 1866, there were only 111 paidIn 1866, there were only 111 paidnurses in all the London workhousesnurses in all the London workhouses

and they earned £12and they earned £12--£30 a year. Mrs£30 a year. MrsIsabella Beeton (1836Isabella Beeton (1836--1865), who1865), whowrote her famous book of cookerywrote her famous book of cookeryand household management betweenand household management between

18591859--1861, had been the head nurse1861, had been the head nurseat the Strand workhouse.at the Strand workhouse.



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Ward sisters wereWard sisters wereoften recruited fromoften recruited fromhead servants inhead servants in

'gentlemen's''gentlemen's'households or werehouseholds or were'respectable' widows.'respectable' widows.Matrons, whose dutiesMatrons, whose dutieswere largelywere largely

administrative, wereadministrative, weregenerally from middlegenerally from middle--class backgrounds.class backgrounds.



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http://www.thegarret.org.uk/tour.htmhttp://www.thegarret.org.uk/tour.htm

Click for virtual tour of a VictorianClick for virtual tour of a Victorianhospital.hospital.

Also provides useful links! Also provides useful links!



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Florence NightingaleFlorence Nightingale

Nursing was first popularized byNursing was first popularized byFlorence Nightingale; she portrayed it Florence Nightingale; she portrayed it

as a dignified and glamorousas a dignified and glamorousprofession. Nightingale led the first profession. Nightingale led the first women nurses, ten of them, into thewomen nurses, ten of them, into theCrimea, and afterwards, BritishCrimea, and afterwards, British

society awarder her with enoughsociety awarder her with enoughfunding to found a nursing school.funding to found a nursing school.



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The traditionalThe traditional NightingaleNightingale ward of ward of long straight corridors with wardslong straight corridors with wards

radiating off at right angles andradiating off at right angles andclustered around courtyards, was aclustered around courtyards, was alegacy of the disastrous healthcarelegacy of the disastrous healthcareexperience of British troops in theexperience of British troops in the

Crimea.Crimea.



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NightingaleNightingale had observed howhad observed howsoldiers who were taken into hospitalsoldiers who were taken into hospital

invariably died, while those who wereinvariably died, while those who werenot treated there often survived.not treated there often survived.Crucially, she realised that many of Crucially, she realised that many of the causes of death for recuperatingthe causes of death for recuperating

soldiers could be designed out.soldiers could be designed out.



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What she did wasWhat she did wasto lay down a set to lay down a set of dimensions toof dimensions to

provide a safeprovide a safeplace for patients,place for patients,most importantlymost importantlyfresh air, warmfresh air, warmfood and anfood and anenvironment that environment that was free of droplet was free of droplet infection.infection.





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Crimean WarCrimean War

In March 1854 the Crimean War broke out In March 1854 the Crimean War broke out and the reports of the sufferings of the sickand the reports of the sufferings of the sickand wounded in the English camps createdand wounded in the English camps createdanger in Britain. William Russell,anger in Britain. William Russell, TheTheTimesTimes' correspondent, described the' correspondent, described theterrible neglect of the wounded, andterrible neglect of the wounded, andpointed to the differences between thepointed to the differences between thefacilities provided for British and Frenchfacilities provided for British and Frenchsoldiers. He asked: Are there no devotedsoldiers. He asked: Are there no devotedwomen among us, able and willing to gowomen among us, able and willing to goforth to minister to the sick and sufferingforth to minister to the sick and sufferingsoldiers of the East in the hospitals of soldiers of the East in the hospitals of Scutari?Scutari?



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ConditionsConditions

Descriptions from Nightingale and herDescriptions from Nightingale and hernurses give some idea of the conditionsnurses give some idea of the conditionsthere:there:

There were no vessels for water or utensilsThere were no vessels for water or utensilsof any kind; no soap, towels, or clothes, noof any kind; no soap, towels, or clothes, nohospital clothes; the men lying in theirhospital clothes; the men lying in theiruniforms, stiff with gore and covered withuniforms, stiff with gore and covered withfilth to a degree and of a kind no one couldfilth to a degree and of a kind no one couldwrite about; their persons covered withwrite about; their persons covered withvermin...vermin...



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We have not seen a drop of milk, andWe have not seen a drop of milk, andthe bread is extremely sour. Thethe bread is extremely sour. The

butter is most filthy; it isIrish butterbutter is most filthy; it isIrish butterin a state of decomposition; and thein a state of decomposition; and the

meat is more like moist leather thanmeat is more like moist leather thanfood. Potatoes we are waiting for,food. Potatoes we are waiting for,

until they arrive from France...until they arrive from France...



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rateful soldiersGrateful soldiersdubbed her 'Thedubbed her 'TheLady With TheLady With The

Lamp' because of Lamp' because of her nightly roundsher nightly roundsof the wards.of the wards.



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HomeworkHomework

Research:Research:

See what you can find out about See what you can find out about

Mary Seacole.Mary Seacole.



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