District nurses are those senior nurses who are involved in managing care in a community by leading teams of both support workers and community nurses. This particular paper talks about the history of district nursing since its emergence in England over one hundred and fifty years ago. It then discusses the progress of district nursing in other countries, in this case, Australia.
Nursing can be defined as a science and an art with an exceptional body of knowledge drawing from behavioral, physical, and social sciences (Funnel et al, 2005, p. ). It is a profession that is unique in its own way because it addresses families and individuals responses to health problems, health maintenance, as well as health promotion. Over one hundred years ago, nursing was defined by Florence Nightingale as the act of making use of a patient’s environment in a bid to helping that particular patient recover. To facilitate for quick recovery, she considered a clean, quiet, and well ventilated environment as very essential.
Nursing helps in facilitation of prescribed therapy, assists patients to be independent of assistance, and also help the patients to function to their maximum potential as soon as possible. Various themes have been associated with the definition of nursing. Some describe nursing as an art, as a science, that nursing is about caring, it is holistic, that it is client oriented, adaptive, and that nursing is generally a helping profession. The historical accounts of the profession clearly bring out the revolving nature of nursing.
The word nurse was derived from a Latin word which means to cherish or nourish. In a human being’s life, birth, death, sickness, and injury are all very common. There has therefore always been that need to take care of others, especially those in need. Funnel et al state that some of the earliest and most organized nursing carried out by men who worked in hospitals which were established by military religious orders at the period the crusades. Some examples included the knights of St. Lazarus, and the Knights of St. John of Jerusalem. Henry VIII, during the sixteenth century, commanded the closure of English monasteries and the confiscation of their wealth as well. What this meant was that all the sick and destitute people had no where to stay and were hence left to die. This then saw the construction of work houses which were used to house the poor and especially the sick. Here they lived in very bad conditions and were at the same time required to work in order to earn their continued stay there.
Conditions in London got to a very desperate state, and after many petitions from the citizens, Henry VIII had no option but to allow for the re-founding of some hospitals like St Mary’s, St Thomas’s, as well as St Bartholomew’s. These hospitals despite their reopening were very poorly staffed and were characterized by untrained workers whose characters were very poor. Patients who were admitted in these hospitals lived under appalling conditions in overcrowded wards Funnel et al add that the early 18th and mid 19th century came to be termed as nursing “Dark Ages” of nursing.
It was an age where caring of the sick and nurses’ status reached to the lowest levels ever imaginable (5). A clergyman named Theodor Fliedner in 1836 founded the institution Kaiserwerth where they trained specially chosen women as deaconesses. The institution was then to be famous for its high standards and levels of training as well as the care given to the sick. The institution then grew very famous and finally became the centre for training nurses and as a result received very many trainees, and from all parts of the world.
Some of these trainees later opened up centers in their respective countries. Modern nursing has hence evolved as a result of the influence Kaiserwerth had on individuals like Florence Nightingle. She had spent two weeks at Kaiserwerth in 1850 and later visited the institution again in 1851 and was named Superintendent for Establishment for Gentlewomen during Illness. She became famous when she took with her a team of thirty nurses to Scutari where they were met with a lot of resistance from medics who refused them to take care of the sick and injured soldiers.
She however did not give up and devoted her time and energy to improving bad conditions in the camps through the introduction of communal as well as personal hygiene, organization of excellent food supply, getting hold of medical supplies, and basic sanitary conditions like washing of hands and also the importance of fresh air. In a span of two to three weeks, the opposition she had earlier faced was no more and the nurses were then called back to come and take care of the sick.
Florence Nightingle was viewed as an idol by the soldiers because she brought hope and comfort to the sick just by the light of the lamp she used t carry at night, hence she was later came to be known as the Lady of the Lamp. In the case of Australia, very little interest was paid for the care of the sick when the original English colony was established at Sydney Cove. In 1811, Sydney hospital was opened and the staff included of female convicts with some male convicts also carrying out nursing duties.
They were however received no wages for the labor they offered although they received their keep. The nurses’ behavior here was wanting and they were known to be of poor character with them being drunk in most cases while on duty. In 1811, Australia opened its first lunatic asylum and it was characterized by untrained mental attendants. As a way of control, huge numbers of disturbed individuals were literally restrained because most of the staff were custodians and there was no emphasis whatsoever on treatment (Funnel et al, 2005, p. 5).
In 1838, the first group of trained nurses arrived in Sydney. They were five in number. The influence of Nightingale was experienced in 1868. The principles of Nightingale were gradually adapted and the physically ill could now be cared for. Nurses were not left behind either. Practical skills were taught to them such as those of leeching, dressing, as well as administering enemas. Emphasis was however put on their punctuality, sexual purity, cleanliness, and most importantly obedience. A huge percentage of nursing comprised of housekeeping, and was dominated by house hold work.
It was however acknowledged that compassion and also dignity were characteristics that were desirable for all those who took care of the sick. The necessity for nurses training in Australia grew as scientific advances continued to be made. By the year 1900, most of the Australian hospitals had a three year training program for student nurses where lectures were delivered by the medical staff. The students could not however maintain their concentration in class as a result of long hours of work.
IN the wake of the twentieth century, conflict would arise whether nursing should be viewed as a vocation, subordinate to medicine, or as a profession which is different but of equal status with medicine. (Funnel et al, 2005, p. 6) add that in the year 1867, an Act of Parliament was passed which stated that all individuals displaying signs of mental impairments should be sent to mental asylums and not prisons. As a result, the developmentally disabled were then able to be separated from the mentally ill.
Nursing in these mental asylums was delivered mostly by male attendants, and even though care remained and continued to be custodial, the medical staff was able to offer some lectures to these attendants. This is the period in which female attendants begun receiving serious considerations. As the increase in training of nurses continued to increase, so was the agitation for nurses’ registration. In 1920, South Australia was the first of the states to pass the relevant legislation followed by Western Australia in 1922 and Victoria and New South Wales in 1924.
Industrial issues emerged as the sense of professionalism emerged among nurses. In 1924, the Australian Nursing Federation was able to hold its first meeting and the meting addressed several issues including the improved working conditions, improved wages, and the need for greater professional acknowledgment. According to the Australian Bureau of Statistics (1986), home nursing in Australia started in 1885 when a group of concerned nationals came together in Victoria and founded the Melbourne District Nursing Service. The main objective of the group was to look after the underprivileged sick people at home.
Since then, nursing services have been seen to spread to every territory and state. Today, there are more than two hundred institutions using modern technology to take care of the sick and at the same time offer both general and specialized nursing services to the citizens of Australia. Australian Bureau of Statistics states that the link with district nurses from England is apparent in the growth of nursing institutes in Australia. In England, nurses begun to be trained for work districts in 1848. One, Mr. William Rathborne, in 1859, saw the need to provide a nurse who was meant to work amongst the poor in Liverpool.
He later founded a training school for district nurses using his own personal finances. These nurses were not only seen as caring but also as social reformers due to their knowledge and also direct contact they established with those they cared for. During Queen Victoria’s Jubilee Year in 1887, some of the funds collected for her gift were given by the queen for the setting up of Queen Victoria’s Jubilee Institute of Nurses. Throughout England for many years, the establishment facilitated both the employment and training of district nurses.
A considerable number of district nurses also came to undertake this particular training program. The relevant information regarding district nursing services was brought to Australia by Dr. Caffyn and Rev. C. Strong who were from England. They were both very instrumental when it came to setting up the first home nursing in Australia which was known as the Melbourne District Nursing Society (204). According to the Australian Bureau of Statistics, the first State to introduce a district nursing service in Australia was that of Victoria in 1885.
It was then followed by South Australia in the year 1894, then came Tasmania in 1896, New South Wales, Queensland, and Western Australia in 1900, 1904, and 1905 respectively. One notable nursing service was the Blue Nursing Service. According to the history of Blue care, Blue care started off being known as the Blue Nursing Services. The service came to be through the vision and urgings of Rev. Arthur Preston, who was the founder. There was a great shortage of hospital beds in Australia and the nursing bodies that were in existence then were not able to cope with the demands of an ever growing population.
This was the reason the founders saw the need to establish a new home nursing service to cater for this rising need. In 1977, together with the Methodist and Presbyterian churches, Blue Nursing was seen as a uniting factor in Australia. It is evident from the history of district nursing that the establishment of all nursing organizations was triggered by identified health care needs present in the society. At fist, focus was mainly at the poor, disadvantaged, and the sick. Services were however later made accessible to everyone in society.
This was attributed to the government started issuing subsidies to most of these organizations. Nursing institutions today operate in very different structures and also under different support like voluntary bodies, local government, and hospitals. At the same time, nurses working in these organizations share one common goal and commitment: that of providing quality care in the society. There has been new demand on those nurses working in the society caused by the increased development of both technological and medical services.
This has its results as people are now being discharged from hospitals earlier and also at a more accurate stage of sickness. Nurses have been forced to further and upgrade their current education so that they can keep up with helping and providing quality care to the community. For Australia, district nursing is a record of success. Realizing their extended roles as nurses which are based on their expertise, experience, as well as knowledge is crucial if at all effectiveness is to be maintained in delivery of their services.
Courtney from Study Moose
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