A Brief History of Nursing

2020 has been declared the International Year of the Nurse and Midwife by the World Health Organization (WHO). It will be the first such celebration of the profession. It aims to commemorate the birth of Florence Nightingale 200 years ago, highlight the enormous sacrifices and contributions of the two professions and acknowledge the central role played by nurses and midwives in the health of people everywhere.1

However, even before we get to the New Year, there’s another milestone event to look forward to this month. 100 years ago, on 23 December 1919, the Nurses Registration Act became law. For the first time, and against a lot of opposition, the Act required nurses to register and train to a professional standard. The pressure to move in this direction came from several sources at the time, including the recently formed (1916) College of Nursing Limited, which started out with just 34 members.2 To mark the centenary, the Royal College of Nursing (RCN) has launched a major exhibition, Wake Up Slackers! The Great Nursing Registration Controversy. This runs until March 2020 at the RCN Library and Heritage Centre.3 Catch it if you can.

It may seem bizarre, but along with many doctors and hospital leaders, one of the voices against nurse registration all those years ago was Florence Nightingale. Her view was that nursing was a vocation – a calling rather than a science – and certification would not guarantee the quality of patient care.

Florence was joined in opposition to registration by Eva Luckes. Eva Luckes was Matron of the London Hospital in the East End of London from 1880-1919 – yes, that’s right, 39 years!  For good reasons, she was known as the ‘matron of matrons’; nevertheless, she too was opposed to registration. Florence and Eva became great friends. She was clearly an inspirational character and a stickler – for Eva ‘second-best would never do’.4

One other character who figured prominently in this debate was Ethel Gordon Fenwick (1857-1947). Without her tenacity, we might not be where we are today. A real pioneer, she founded the Royal British Nurses Association in 1887 and the International Council of Nurses a year later. In 1903, she became editor of the British Journal of Nursing which, of course, also become part of her campaign to see nurses join doctors on a register of trained professionals.

Ethel Fenwick devoted 32 years of her life to campaigning for registration and the removal of ‘bad nurses’. Her long, hard-fought campaign concluded when the Act was passed in 1919 and, in 1921, she became ‘State Registered Nurse Number 1’. From then on, all nurses had to register to practise.

Back then, registration required nurses to prove they were at least 21 years old, of good character, with one year’s training and two years of practical experience. By setting out these standards, the Act cleared the way for the profession to grow and develop, and to become the truly amazing and worthwhile career it is today. We all owe a huge debt of gratitude to Ethel. Expect to see her named-checked in the months ahead.

1. International Council of Nurses and Nursing

2. Royal College of Nursing

3. Royal College of Nursing

4. The Hospital. Miss Eva Luckes – a Great Woman

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