History of nursing/19. century

The 19th century is characterized by the emergence of professional nursing.

From the 14th century onwards, it became increasingly difficult, if not impossible, for women in Europe to practice medicine or surgery. They were not allowed to study at medical faculties or become members of organizations that issued permits to practice.In the new hospitals of the nineteenth century, women formed a significant part of the nursing staff.

The first sign of reform was the movement of Protestant deaconesses in Northern Europe at the beginning of the nineteenth century. Young women visited the sick and helped them.

Kaiserwerth Lutheran pastor Theodor Fliedner trained deaconesses and became familiar with the work of the Quaker prison reformer Elizabeth Fry. These experiences led him to found a school for deaconesses - nurses. The duration of the training lasted three years. Female graduates could distribute medicines and take care of the sick and convalescents. By 1864, the school had educated 1,600 sisters.

In 1840, Fry visited Kaiserwerth and on her return to London established a nursing home. It was staffed by religious ladies who called themselves the Protestant Sisters of Mercy. Later, however, they changed their name to Nursing Sisters. These nurses did not have a theoretical education and were trained only in home care of the sick. Nursing the sick was also accepted by the Anglican Church and a number of nursing associations were established - e.g. School of St. Jana founded in 1848. Ladies from the English middle classes were systematically trained here. In 1856, the school took over nursing care at a London hospital. A year later, Sister Mary Jones founded a five-year school for nurses.

Nikolai Ivanovich Pirogov
Nikolay Ivanovich Pirogov (13/11/1810 – 15/12/1881) was born in Moscow as the last fourteenth child of a civil servant. Most of his siblings died. Only two brothers and three sisters remained alive. The father died in 1824, and the family was thus left unprovided for. The family doctor, Professor of Anatomy and Physiology at Moscow University Efrem Mukhin (1766–1850), arranged for Pirogov to begin his studies at the Faculty of Medicine in Moscow in 1825. Ivanovič Pirogov At the age of twenty-six, Pirogov accepted the position of surgeon at the German University in Doprat, where he worked from 1836 to 1840. In 1840, Minister Kleinmichel approached Pirogov and offered him the position of chief of surgery in a 1,000-bed hospital - in Military Academy of Army Medicine in St. Petersburg.

In September 1854, Pirogov, a respected Russian physician, wrote to Grand Duchess Yelena Pavlovna (Czar Nicholas's sister-in-law) about his plan to found a society of women to help the sick and wounded, and invited her to select the staff. The Grand Duchess founded from her own resources the Community of Sisters of the Upliftment of St. Crosses to help wounded and sick soldiers. In September 1854, thousands of wounded people died in Sevastopol.

Pirogov asked to be sent to the Crimean War. Thanks to the help of the Grand Duchess, the request was accepted. Accompanied by several other doctors and at the head of a group of Krestovozdvizhenskoi obshchyna sisters of Miloserdija, Pirogov set off for Crimea on November 9, 1854. He worked here for 14 months. At first, Pirogov and the nurses met with great displeasure from the general public. All the time they worked in infirmaries set up in tents (not in buildings) and rescued the wounded even in the field. Although Pirogov was an excellent surgeon, he was not well liked by other doctors. However, despite this, he contributed to the creation of women's nursing and promoted the idea of ​​using women on the battlefield. It must be remembered that at the time it was unthinkable for women to treat patients – let alone in war. Pirogov also introduced surgery on the battlefield under narcosis (anesthesia), fundamentally reducing the number of amputations.

As a writer, he is recognized for, among other things, his important work on war surgery. It was published in German in 1864 in Leipzig (Grundzüge der allgemeinen Kriegschirurgie) and then in Russian in 1865–1866 (Načala obščej voenno polevoj chirurgii; Fundamentals of general war surgery). Pirogov also elaborated on the topic of traumatic shock. Immediately after the end of the Crimean War, Voprosy publishes the Žizni. Dnevnik starogo vrača (Questions of life. Diary of an old doctor, 1856; Czech 1911).

He also devoted himself to education reform. In Russia, he created the foundations of modern pedagogy, promoted education and the dignified position of women in society. He was persecuted by the Russian regime for his progressive views.

Ten years after the Crimean War, international humanitarian laws (the so-called laws of war) and the Geneva Conventions were formulated. In 1864, the Swiss Henri Dunant (winner of the first ever Nobel Peace Prize from 1901) founded the international Red Cross organization. The Russian Red Cross was founded by Jelena Pavlovna and Pirogov was its representative.

Florence Nightingale
Florence Nightingale (12/5/1820 – 13/8/1910) came from a noble family. She was born during her parents' trip to Florence, which is why she was given the Christian name Florence.

Together with her sister Parthenope (to whom she had a very close relationship), she received her education from home teachers and from her father, a graduate of the universities of Cambridge and Edinburgh. Florence liked mathematics and statistics, was spiritually oriented and thoughtful. During the trips, her parents allowed her to visit hospitals, which she looked at and took notes on. She also met Sydney Herbert (later Secretary of War), who influenced her decision to work as a nurse. When she announced her desire to be a nurse to her parents, a conflict arose between them. Her parents did not approve of her enthusiasm. At that time, the work of nurses was not considered acceptable for women (the sick were treated by men), let alone for such an educated woman from a high social class. Her parents also most likely envisioned Florence marrying and starting a family.

In 1851 (she was 31 years old), she passed the nursing exam with Theodor Fliedner at the hospital in Kaiserswerth (in Germany), where she completed a three-month nursing course.

VIn the years 1853-1856, the Crimean War took place. Florence Nightingalová left for the Crimea in 1854 with carefully selected and trained nurses. At her own request and at the request of Sydney Herbert, she was officially seconded by the War Department. On September 4, 1854, she arrived in Scutari with 38 sisters that she personally chose - ten Roman Catholic nuns, eight Anglican nuns, six members of the Order of St. John’s House and fourteen non-denominational sisters. They started working in a war zone. In a "military hospital" set up from barracks, 2,300 patients were housed in filthy rooms infested with rats and fleas. In the run-down barracks, wounded and sick soldiers lay naked on the bare, dirty floor, lacking basic necessities such as regular food, warmth, a clean bed, toilets and other sanitary facilities. They received one meal a day, ate it with their hands, and some days they were even hungry. They suffered from typhus, cholera and diarrhea more frequent and dangerous than the injuries themselves.

Upon arrival, Nightingale received no support from either the doctors or the members of the administrative committee. It was only when she personally visited Queen Victoria and Prince Albert and suggested they form a commission on military health reforms that things moved forward. Florence continued to collect data, trained the members of the new commission, and in the winter of 1854 submitted an eighty-page (!) shocking report to the government. She began by ordering three hundred coarse brushes, organized nursing services, set up a laundry, diet kitchen, sanitary facilities, took care of food supplies, linens for staff and soldiers, and laboratory equipment. She established hygiene rules. She fed three times a day. In six months, in addition to having to overcome the resistance of military officials, she was able to reduce the death rate from 42% to 60% to an incredible 2%, and even to 1% by the end of the war.

The Lady-in-Chief, as the Nightingales called her, also looked after the mental needs of the soldiers. She made it possible for them to write home, introduced a system thanks to which they could send money regularly to their families, set up a reading room, a library, a cafe for convalescents and arranged for lectures. For the first time in history, patients received sickness benefits.

After a day's work, she would walk around the hospital checking that everything was okay (earning her another nickname, The Lady with Lamp). In return, she gained the respect and admiration of the British soldiers. "What a relief it was to see her pass. . . . We lay there in hundreds, but we could kiss her shadow as it fell on the pillow and left our heads at ease again," writes a soldier of the Nightingale home. Another soldier writes: “He is an angel of mercy in these hospitals, without exaggeration. … When all the doctors had gone to sleep and darkness had fallen over the miles of exhausted sick, you could see her with a lamp in her hand on her lonely errands.” After the Scutari Hospital was opened, Florence Nightingale founded two more hospitals in the Crimea.

As a token of the nation's thanks and appreciation for the hard work of F. Nightingale and the nurses, a public fundraiser was organized in 1855, which enabled her to continue the reform of civilian health care in Britain. She was also awarded by Queen Victoria. She donated the money to build a hospital.

After returning, she gradually fell ill with cholera, dysentery and rheumatism. She lived in seclusion but still worked. She wrote the world-famous publication Notes on Nursing (1860; Notes on Nursing, Czech 1874: Miss Florence Nightingale's Book on Nursing), in which she captured completely new and modern views on nursing. She also paid attention to the work of a nurse in field care and in households. She is the founder of Community Care and Health Statistics. She consistently believed in the strength and power of facts and therefore called statistics the most important science in the world. Among other things, she is also the author of so-called pie charts.

In 1860, she founded a nursing school at the St. Thomas in London. Sarah Wardroper, matron of the hospital, became headmaster of the school. Future nurses studied for one year, which included theory and practice in a hospital setting. They were then enrolled as nurses on probation for a period of three years. They received a suit and were in the service of the school, although for a small salary. Only then were they real nurses.

Mary Seacole
Mary Seacole, whose real name was Jane Grant, was born to a Creole mother and a Scottish father in Jamaica in 1805. She was raised by a governess at an early age. From the age of 12, she helped treat British soldiers and used the experience gained in South America and Crimea. In 1836 she married Edwin Horatio Hamilton Seacole and they set up shop. In 1844 her husband died. 200px|preview|Marry Seacole In 1850 cholera broke out in Jamaica. Maryla to the sick in the fight against this disease. After the epidemic ended, she went to visit her brother in Panama, where the epidemic also appeared. People called Seacola the yellow doctores – the Creole doctor. Although she herself fell ill with a mild form of cholera, she recovered. She prepared medicines for the sick - ground mustard dissolved in water (for vomiting), application of mustard poultices applied to the whole body (the poultice also contained flour, bread, bran and linseed) or mercuric chloride as a laxative, which was mixed with water.

She gained further practical experience in Jamaica, where yellow fever began to rage in 1853. The epidemic was strong. However, even this time Mary was not afraid of infection and went among the sick and treated them. Here she was caught up with reports about the war in the Crimea published by The Times war correspondent W. H. Russell, who described the terrible conditions in military hospitals and the shortcomings in the treatment of soldiers. Mary Seacol went to London to the recruitment office and offered her services in the treatment of the wounded in the Crimea - she applied for a position as a nurse. British and French troops were just marching on Sevastopol, and Mary wanted to join the regiments of "boys" from Jamaica. However, the office was not interested in her services (Mary was a businesswoman, not a nurse). Therefore, she decided to go to Crimea at her own expense as a food supplier. On the way, she sought out Florence Nightingale at the hospital in Scutari. However, she did not directly express the wish that she would like to work with her, but she probably hoped so. She handed her a letter of recommendation. Nightingale read it and asked gently but matter-of-factly, “What do you wish, Mrs. Seacol—is there anything we can do for you? If it is in my power, I shall be very happy." "So I told her of my apprehensions about the night journey by rowing boat," reports Seacol, "and that I should not probably find the Hollander (propeller steamer) in the dark; it was with some mistrust that I entrusted myself to Scuttari's hospitality, offering to nurse the sick for the night.” It seems that Mary Seacol did not really tell Florence Nightingale directly that she was interested in staying and nursing the sick. She slept in the laundry room and in the morning set off on another journey to Balaklava (see Mašková below). However, Florence wouldn't be able to accept her anyway. As an envoy of the Ministry of War of England, she was responsible for the nurses selected and trained in England and for the activities of the entire team.

Mary Seacol arrived at Balaklava. Two miles away, together with Thomas Day, a distant cousin, they built the "British Hotel" at their own expense. She named the place "Spring Hill". In the hotel, she built dining areas and accommodation for sick and wounded soldiers (she called them her sons - "my sons"). She provided them with food and medicine. There was a restaurant and bar on the lower floor, and the upper one was modified in the manner of a hospital. Mary was a shrewd business woman. On the one hand, she abounded in generosity, but on the other, she required payment for hotel services, as the hotel financially provided nursing care. Although the hotel was only partially built, it was always in order and thus gained a reputation. The buildings and garden were spread over 4,000m2 of land and cost £800. Mary's supplies were said to have everything from an anchor to a needle at "Mother's". For transportation, Mary Seacol and Thomas Day used two-wheeled carriages drawn by horses and mules, but they were often stolen. Thieves (humans and rats destroying supplies) were hard to deal with.

Mary treated the wounded even on the battlefield. When Sevastopol fell on September 8, 1855, she was given permission to enter the city to treat the wounded. The soldiers started calling her "black Nightingale". W. H. Russel wrote about her that she was the first to clear the concept of market woman from the suspicion of uselessness, commercial meanness and profiteering. "I trust that England will not forget the woman who nursed the sick, sought out the wounded, aided and consoled them, and who gave them the last aid in death." The peace treaty was signed on 3/15/1856.

Mary Seacol was leaving for England penniless. To get out of existential difficulties, she wrote the autobiography Wonderful Adventures of Mrs. Seacole in Many Lands, published in 1857 and 1858. The English press picked up on her plight and money was raised for Mary during four days of major military celebrations. Sculptor Countess Gleichen, Queen Victoria's niece, created her bust – Mary was considered a close friend by members of the royal family.

She worked and traveled between London and Kingston for the rest of her life. She died on 14/05/1881 in Paddington aged 76. She is buried in the Catholic cemetery of St. Mary in North West London.

During her lifetime, she received the English, French, Russian and Turkish orders of merit from military officials. After her death, gradually, as the witnesses of her merits died, she was forgotten. In the second half of the 20th century attempts are being made to restore Mary Seacol's memory. In 1954, on the centenary of the Crimean War, the General Association of Registered Nurses of Jamaica was renamed the Mary Seacole Centre. On November 20, 1973, a ceremony was held on the occasion of the reconstruction of M. Seacol's tombstone, since May 14, 1981, a commemorative ceremony has been held annually on the anniversary of her death, and in 1984, her book Wonderful Adventures of Mrs. Seacole in Many Lands.

Unlike Florence Nightinagal, Mary Seacol devoted herself to the direct care and healing of the wounded and sick. Her exceptionality lies in the courage to be self-reliant, in the intensity of immediate care, in the work in the field and in the kindness and compassion shown. In Crimea, it created an alternative to lazarets and hospitals. Unfortunately, she did not record her nursing or treatment knowledge. Florence Nightingalová, on the other hand, was an excellent and courageous organizer, formulated nursing principles and procedures that are still valid today, trained the first nurses in England, founded nursing education in Europe, reformed military and civilian nursing and published over 200 professional papers. She did not deal with healing (she left that to the doctors) or direct nursing (that was the concern of the nurses she led).

These two exceptional women are united by purposefulness, courage, dedication, their voluntary departure to the Crimean War and, in the name of humanitarian aid, the courage to sacrifice the certainties (comforts) of life in their native country and, among other things, the strength to assert their own convictions, to fight against prejudices and lack of interest.

Maria Simon
Marja Simonowa (1824–1877), a Lusatian Serb, was a volunteer nurse for the wounded, a pioneer in the education of nurses, and also a pioneer in the work of the Red Cross in Germany. She was born in Dobruš in Upper Lusatia as Marja Janašec. Her second husband F.A. Simon had a white linen and lace shop in Dresden, and Marja helped him until the beginning of the summer of 1866, when she went to the Králové Hradec battlefield to nurse the soldiers. After discovering that there were hundreds of wounded with no one to care for, she brought a load of medical supplies from Dresden. The following year, Princess Carola, the wife of Crown Prince Albert of Saxony, founded the women's nursing association Albertverein, to which she also invited Marja Simonowa to lead. Prince Albert had already accepted the idea of ​​the international Red Cross some time ago, for which Henri Dunant himself had been enthusiastic. The nurses were called Albertines, later Red Cross sisters. During the Franco-Prussian War, Simonowa worked as a nurse; she summarized her experience in the valued publication Erfahrungen auf dem Gebiete der freiwilligen Krankenpflege im deutsch-französischen Kriege 1870-1871: Briefe und Tagebuchblätter (1872) and put it to good use in further practice: in 1872 she founded a sanatorium for invalids near Dresden, where new nurses were trained. She was instrumental in ensuring that women's nursing of the wounded and sick was finally recognized as an independent profession.

Related articles

 * History of nursing
 * DHistory of nursing/Prehistoric times

Used literature

 * MASKOVA, Jana. Nursing during the Crimean War: Master's thesis, 1st Faculty of Medicine of the UK, Institute of Theory and Practice of Nursing. 1st edition. 2007. 107 pp. Thesis supervisor J. Mlynkova.
 * PEARN, John. Doctors and Nurses in the Crimean War: A perspective of Military Medicine with some contributions of Russian and British doctors and nurses to contemporary medicine [online] . 1st edition. 2005. 31 p. Also available from .

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