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Roman healthcare, 300 CE -

Healthcare and nursing, in some form or another, have been around since the beginning of civilization. As an institution, however, nursing can trace its roots back to the Roman Empire. Around the 4th century CE, when Christianity was quickly becoming the dominant religion of the empire, hospitals run by priests, monks, and nuns became more and more common across the land.

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A hospital in every town -

A central tenet of early Christianity was something called "practical charity," which primarily involved tending to the sick, elderly, and impoverished. It became a priority of the Christian leadership to establish a hospital in every city, town, and village of Roman Europe.

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Byzantine hypourgoi -

After the split of the Roman Empire, the eastern Byzantine Empire continued to put more and more effort into the development of the nursing profession. Two massive and technologically advanced hospitals were erected in Constantinople during the 4th and 5th centuries, and were operated by nurses known as hypourgoi. These hypourgoi were professional healthcare workers who helped to advance the institution of nursing and garnered considerable respect in Byzantine society.

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Nursing in the Middle Ages -

The spread of Catholicism throughout Europe developed in tandem with the spread of hospitals and nursing. Almost all hospitals were run by monks and nuns, who took healthcare upon themselves as a holy charitable practice. Many hospitals were attached to monasteries, while others functioned independently. The inextricable link between Christianity and nursing is aptly expressed in the old French word for hospital, hôtel-Dieu, or "hostel of God."

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Catholic nuns and nurses -

During the Middle Ages, almost every nurse was a nun, but not all nuns were nurses. Practical charity was still an idea associated exclusively with the Catholic Church. Many of these nun-nurses were canonized as spiritual representations or saviors of healthcare.

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Masona and the advent of universal nursing -

For centuries, the link between Christianity and healthcare meant that only Christians received healthcare. That changed around the 8th century, when a hospital opened in 580 CE, when Masona, the bishop of the Spanish town of Mérida, established a hospital that was built for the express purpose of treating individuals from all walks of life, regardless of social standing, place of origin, or religion. It wasn't long, however, until Europe began to fall on hard times, and many of these hospitals closed, leading many nun-nurses to return to ascetic, withdrawn lifestyles.

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Charlemagne and the revival of nursing -

At the turn of the 9th century, Emperor Charlemagne the Great united Western and Central Europe for the first time since the Fall of Rome. One of his myriad of accomplishments was the restoration of the countless old and derelict hospitals around the continent.

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Charlemagne and the revival of nursing -

Not only did Charlemagne restore preexisting hospitals and breathe new life into the nursing profession, he also called for the building of numerous new hospitals that were better equipped for the needs of the time.

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A hospital for every church -

To make things simpler, Charlemagne ordered that every church, cathedral, and monastery in his domain was to be have a hospital added to it. This led to Europe developing the most comprehensive healthcare system it had ever seen thus far.

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Norman charitable houses -

Europe saw centuries of efficiently operated hospitals that catered to all the needs of the public, from the lowliest peasant to prestigious members of European nobility. Following the Norman Conquest of England in the 11th century, a new form of healthcare centers known as charitable houses quickly popped up all over the newly conquered islands. These charitable houses were extremely well funded by members of the nobility who saw charity as a ticket to heaven after death.

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The honorable medieval nurse -

Women made up the overwhelming majority of nurses in medieval Europe, and were held in considerably high esteem. The life of a nun was eagerly sought out by women of all social classes, and members of the nobility paid exceedingly large dowries to enable their daughters to become women of the cloth. Nuns who practiced nursing were some of the most respected women in all of medieval society, before the role of the European woman was reconsidered and their relative freedom all but disappeared.

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The rise of Protestantism -

Martin Luther's posting of his 95 Theses in 1517 posed a grave and immediate threat to the Catholic Church and the many hospitals that operated under its wings. One of the central arguments of Martin Luther's Protestant beliefs was that of sola fide, or that holy salvation could be achieved only through rigorous faith and worship, not through good deeds of charity. The belief that charity, paying indulgences, and other actions achieved through money could secure one's ticket to heaven was, at the end of the day, a primary driving force behind the success of Catholic hospitals and charitable houses.

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The fall of nursing -

What's more, the rise of Protestantism snatched away the relatively progressive place in society that women held. While women were encouraged to join the clergy, become nuns, and participate in social acts of charity, namely nursing, the virtues of Protestantism resigned them to the household almost overnight. No longer were women given a choice in whether to marry, whether to bear children, or whether to practice a profession. Women were quickly banned from the clergy, and the only acceptable role for a woman in Protestant society was that of wife, mother, and homemaker. Nurses still managed to provide healthcare during this time, but were restricted to only their family and neighbors, forcing huge swaths of the needy populace out to dry.

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Estate nurses -

Some places in Western Europe, such as France and Italy, remained staunchly Catholic during the Protestant Reformation. In these regions, nurses continued to work, but the number of available healthcare professionals dropped drastically. Many nurses who once worked in hospitals became "estate nurses."

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Estate nurses -

Estate nurses wielded considerably more responsibility than hospital nurses. Estate nurses were frequently the only healthcare providers throughout their patron's estate, and practiced not only nursing but also surgery, apothecary services, and general medical practices traditionally carried out by male doctors and physicians.

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Florence Nightingale -

The modern practice of nursing as we know it today is widely said to have started with one woman: Florence Nightingale. Born in Florence, Italy, and hence her name, to English parents, the family soon moved back to England. Nightingale found herself at the center of the nursing profession serving as a nursing teacher and manager during the 1853-1856 Crimean War between Russia and a coalition of European and Ottoman powers.

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"The Lady with the Lamp" -

Portrayed in contemporary art and media as "the Lady with the Lamp," Nightingale became the face of a new, elevated profession of nursing that stressed the importance of hygiene, bedside care, and the well-being of both nurses and patients.

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The birth of modern nursing -

Also a skilled statistician, Nightingale introduced the practice of record keeping to nursing for the first time, shedding light on the true effectiveness of certain medical practices, and the danger of others. Using this information, Nightingale was able to kickstart the rapid and immensely beneficial evolution of healthcare procedures that had stagnated and failed to develop for generations.

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Advancements in care and hygiene -

During the Crimean War and later the British occupation of India, Nightingale solved the persistent issues of poor ventilation, contaminated water, and the sharing of contagious conditions in overcrowded hospitals. Her advancements in sanitation and hygiene saved countless lives during her day.

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The Florence Nightingale Training School -

Nightingale also furthered the evolution of nursing as a secular and respected profession through the founding of the Florence Nightingale Training School, located at Saint Thomas' Hospital in London, in 1860. It was the first secular nursing school in the world.

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Mortality rates take a turn for the better -

All of a sudden, healthcare and nursing were no longer the crude, hit-or-miss professions they once were. Florence Nightingale and her innovations caused astronomical rises in patient survival rates all across Europe and the still-adolescent United States, and paved the way for the modern heroes of nursing that came to follow.

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Clara Barton -

Clara Barton was born in Massachusetts in 1821. An early champion of civil rights and women's suffrage, Barton served as a hospital nurse during the American Civil War without receiving any formal training, as professional nursing training was still all but unheard of in the United States at the time. Barton was a self-taught nurse who became widely renowned for her excellent quality of care.

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The founding of the American Red Cross -

On May 21, 1881, Clara Burton founded the American Red Cross and served as its first president, after spending some time in Europe working with the International Red Cross. The American Red Cross remains today one of the most prominent and effective providers of emergency healthcare and disaster relief in the nation.

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Linda Richards -

Linda Richards is known today as the first nurse professionally trained in America. Richards was  the first student to enroll in Dr. Susan Dimock's cutting-edge nursing school, the first of its kind, at the New England Hospital for Women and Children. Richards graduated in 1872, and went on to develop novel techniques in keeping track of individual patient records. She is responsible for establishing some of the first widely popular nursing training programs in both the United States and Japan.

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Agnes Elizabeth Jones -

Irish nurse Agnes Elizabeth Jones was deeply impressed and inspired by the work of Florence Nightingale from a young age, and decided to dedicate her life to nursing. Jones enrolled in Nightingale's nursing school in London in 1862; upon graduation, Nightingale praised Jones as her "best and dearest pupil." Later, Jones became the massive Liverpool Workhouse Hospital's first professionally trained Nursing Superintendent.

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The state of nursing today -

Much has changed since the days of Florence Nightingale and Clara Barton. Nurses are still held in high esteem by most members of the public, and there have been incredible advancements in medical technology that should make their work easier on both nurse and patient. Unfortunately, however, as nurses provide progressively more and more effective care, their place in the healthcare institution and their financial compensation has stagnated for a dangerously long time.

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Underpaid and overworked -

Nurses around the world have for decades now complained of deteriorating working conditions, offensively low pay, and frequent mistreatment in the workplace. When the COVID-19 pandemic swept across the globe, the condition of nursing professionals was driven into crisis at blinding speeds.

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The global nursing crisis -

Today, the world finds itself in the midst of a nursing crisis that threatens to persist for years to come. Pitiful offers of hazard pay and offensively low wage increases in the face of a global pandemic, as well as a frightening trend of rapid inflation around the world, has utterly failed in providing nursing professionals with the support, care, compensation, and respect they deserve. Nurses are quitting out of desperation at an alarming rate, while hospitals everywhere continue to experience dramatic instances of overcrowding and bed shortages caused not only by COVID-19, but also due to a generally aging population. With global governments refusing to propose an acceptable solution, this nursing shortage continues with no end in sight.

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How to keep nursing from vanishing -

As we have seen, nurses have acted as the backbone and bedrock of healthcare for time immemorial. While they are held in almost universally high esteem in the opinion of the public, that respect has failed to translate into material action. Supporting our nurses means supporting appropriate wage increases, advocating for safer and healthier working conditions to prevent burnout, overworking, and abuse, and pressuring authorities to show their appreciation through real reform and compensation.

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