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Mary Seacole was a Jamaican nurse who played a vital role in nursing history. She used her own funds to establish a lodging house in Crimea to care for soldiers.

In 1893, Lystra Gretter, principal of Farrand Training School in Detroit, led a committee to modify the Hippocratic Oath, naming it the Nightingale Pledge.

In the 1800s, southern hospitals were largely prejudiced against women, especially as casualties increased in the field during conflicts.

Many soldiers died due to poorly trained medical corps.
Southern women stepped up as volunteers to care for the wounded.
After several months of service, these women received recognition for their efforts.
100 women were selected to a Short training courses were finally offered to them in New York, from health care providers

Dorothea Lynde Dix, a teacher, became superintendent of nurses, tasked with organizing a corps of female nurses under 30. She was a long-time advocate for better conditions for the mentally ill and was the first to establish a hospital dedicated to mental health care.

Clara Barton was a teacher and a key figure in the Civil War, known for gathering army supplies. She rented a warehouse, encouraging friends to donate for soldiers. In 1864, she was appointed superintendent of nurses. Barton played a crucial role in introducing the International Red Cross to America, which was officially established in New York in 1881.

Formal Training: Practical Nursing

In 1893, The Ballard School in Brooklyn started the first 3-month practical nurse program focusing on home health for the chronically ill, children, and the elderly. The curriculum included cooking, nutrition, basic science, and nursing procedures. Graduates became attendant nurses, primarily working in home care, with some serving as midwives for new mothers.

In the late 19th century, practical nursing expanded significantly, moving from home care to public health nursing. Nurses began addressing the needs of clients in slums, schools, and industries, particularly in baby care. This period marked the pioneering of the new public health movement, focusing on broader community health needs.

Lillian Wald, a social worker who graduated in nursing, established the Henry Street Settlement in 1893 in New York. She provided home nursing to immigrants and recognized their significant medical needs, prompting her to start a nursing service. Practical nurses educated families on cleanliness and disease prevention, resulting in an estimated survival rate increase of 1,200 babies. Additionally, Wald developed the Little Mother Leagues, teaching girls over 8 to care for themselves and younger siblings.

1914: Mississippi became the first state to pass a nursing licensing law.
1917: The League of Nursing Education (NLN) established a nationwide system for standardizing practical nursing requirements.
1938: New York was the only state with mandatory nursing licensure.

In 1917, America declared war on Germany, facing a nursing shortage. National leaders M. Adekaide Nutting, Anna Goorich, and Lillian Wald formed the National Emergency Committee on Nursing. They established the Vassar Training Camp, a 3-month intensive program at Walter Reed Hospital. This period highlighted nurses' capabilities, leading to improved training and the movement of nursing education into colleges, raising admission standards and graduate expectations.

In 1917, the Smith Hughes Act aimed to address the severe nursing shortage exacerbated by the 1917 pneumonia outbreak and the deadly 1918 Spanish flu epidemic. Although it provided funds for developing additional nursing schools, the pace was insufficient to meet the urgent demand for nurses due to high death rates during this period.

An acute shortage of nurses in the 1920s happened after the war which many nurses did not come home to help with relief efforts.many hospitals opened schools of nurses to help provide with staffing

By 1952 nearly 60% of the nursing were practical nurses. RNs became bitter because hospitals were hiring LPNs for less salary with a bigger workload beyonf there educational level . Rns also expressed concerns about the public being able to indentify between the two.

In 1956 Public Law 911 provided millions to expand the Practical nursing programs.

by 1975 there were 1337 programs. whcih graudated a toal of 46,080 practical nurses.

During the Vietnam War (1961-1973), nearly 10,000 women served as nurses. They enlisted for various reasons: tuition forgiveness, free medical and dental care, opportunities for travel, and love for their country. All volunteers underwent a 6-week basic training course before being assigned to a year-long stint in Vietnam. Unprepared for the dire conditions, nurses performed tasks that exceeded their training, treating unfamiliar wounds and diseases beyond their scope, including typhoid, malaria, dengue fever, bubonic plague, and viral hepatitis. They faced significant challenges such as skin diseases and diarrheal illnesses. The emotional, physical, and mental demands were overwhelming. Nurses worked grueling 12-hour shifts, 6 days a week, often foregoing their one day off due to the high rates of casualties, reflecting the intense pressure and chaotic environment of war.

Iraq war in 2003 to 2011 and afghan war 2001- 2021

Mildred l. Clark- chief of the army corps from 1963-1967

Ana Mae Hayes- chief of chief of army corps form 1967-1971

On June 11, 1970, Colonel Ana Mae Hayes became the first female nurse in the U.S. military to achieve the rank of brigadier general. Despite this milestone, women were regarded as second-class citizens, and both male and female veterans faced poor treatment from the public after the war.

During the 1990s assitive personnel (AP) were hired to give client care. Drawing major concerns as they were not license working under LPN/LVNs.