Basic Clinical Nursing Skills

Image of Nursing

The Nurse as Mother
The early development of nursing was rarely documented, so we must speculate about its character from what we know of early civilizations. The nurse was generally a member of the family or, if not, then a member of the community who demonstrated a special skill in caring for others. Nursing in this perspective was seen largely as a feminine role an extension of mothering. Indeed, the word nursing itself may have been derived from the same root as the words nourish and nurture. This view of nursing was prevalent in the earliest historical records and is still present in primitive cultures.

The Nurse as God’s Worker
In the Bible, a woman named Phoebe is identified as the first deaconess, a word meaning servant or helper. Deaconess cared for widows, orphans, and the sick. Olympias, a woman of Constantinople, set up a hospital to care for the sick. In Rome, Marcella established a monastery for those in need of care. Fabiola, who was converted to Christianity by Marcella, established hospitals for the sick poor. In the middle Ages, the traditional role of the religious groups in caring for the ill was continued by various orders of monks and nuns. When the crusade attempted to regain Jerusalem from Muslim control, the Knights Hospitalers, and order of religious workers who cared for the injured and fought to protect them, marched with the armies. During this time, unfortunately, the knowledge of hygiene and sanitation gained by Greek, Roman, Egyptian, and other ancient civilizations was forgotten. There was no growth or development in knowledge regarding care of the sick.

Throughout the Middle Ages and into the Reformation, religious orders ran almost all of the hospitals and provided most of the nursing care in Europe. With the advent of the Reformation and the presence of Protestant religious groups, the nature of these orders changed. Women might join for a limited period of time, rather than devoting the entire lifetime to service. They were again referred to as deaconess, the term used in the early church. For example, a church order of deaconesses was organized by Pastor Theodor Fleidner in Kaiserswerth, Germany called the Sisters of Mercy of the Church of England. Another order established St. John’s House, an Anglican Hospital in London. The Protestant Nursing groups were comprised totally of women, and only one nursing order made up of men, the Brothers Hospitalers of St. John, remained in the Catholic Church. The Muslim religion has a similar tradition of service to others in the name of God. Rofiada al Islamiah, one of the wives of Mohammand who cared for the sick and injured, is considered the mother of nursing in the Mideastern Muslim countries (Meleis, 1985).

The Nurse as Servant
The Renaissance saw the decline of monastic orders and the rise in individualism and materialism. There was a radical change from the image of the selfless nurse that had developed in the early Christian period and the Middle Ages. Care of the ill was delegated to servants and those unable to find any other means of support. The hospitals of this time were plagued by pestilence and filled with death; those who worked in them were seen as corrupt and unsavory. 

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