NURSING. The evolution of the sick-nurse is mainly due to three very diverse influences—religion, war and science—to name them in chronological order. It was religion which first induced ladies, in the earlier centuries of Christianity, to take up the care of the sick as a charitable duty. The names of the oldest foundations which still survive, such as the Hotel Dieu in Paris, St. Thomas's and St. Bartholomew's in London, the order of St. Augustine, the order of St. Vincent de Paul, and (in the form of a modern revival) that of St. John of Jerusalem, sufficiently in dicate the original religious The training of nurses, which was inaugurated in Germany in 1836 on a semi-religious basis, received great impetus from the Crimean War, which was further emphasized by the Civil War in America and the subsequent great conflicts in Europe. The despatch of Florence Nightingale with a staff of trained nurses, to superintend the administration of the military hospitals was the direct result of the publicity given to the details of the Crimean War by The Times newspaper. The work undertaken and accomplished by this lady was far more important than the mere nursing of sick and wounded soldiers. She had grasped the principles of hygiene, which were then beginning to be under stood, and she applied them to the reform of the hospital admin istration. In civil life it had a marked effect in stimulating the training movement and raising the status of the nurse. It re mained for the third influence to develop systematic nursing to its present dimensions. Since 1880 advances in medical knowl edge, particularly in respect of bacteriology, antisepsis and asepsis, have revolutionized nursing in the home, the hospital and the Poor Law infirmary. The nurse is now looked upon as following a great vocation for which she has to be qualified by years of training.
Training of Nurses.—In Great Britain the training of the nurse is regulated by the state through the Nurses' Registration Act of 1919. This act was only carried into law after years of
controversy, ending with the War. There is a general nursing council for England and Wales and another for Scotland, and 16 of the 25 members of the English council must be registered nurses elected by persons registered under the act.
In addition to the ordinary registration of nurses with a general training (which occupies three or four years) there are five supple mentary registers for male, mental, fever, mental defectives' and sick children's nurses. Nurses usually begin their general training in recognized training schools at an age not less than 2 1 , though for certain kinds of training (such as those for nurses of fever or sick children) probationers are taken earlier. The nurses usually live in the hospital or in hostels near it ; and as a rule, those who remain in hospital retire about the age of so or 55, when a pension is frequently provided with or without contribution. Post-graduate teaching is developed in the best schools, as is the system of pro viding tutor-nurses. There is not as yet much connection with the universities though the University of Leeds grants a diploma in nursing. The matron of a great hospital holds a very important position as regards her staff, which is divided into sisters, staff nurses and probationers. There are specialists in electric and other technical work, but these have usually first completed their gen eral training. Strenuous efforts have been made to reduce the hours of service and to increase the salaries, which for many years have been extremely low.
In 1916 a college of nursing was established and in 1925 it had a membership of 24,000 with 42 branches and sub-branches throughout the United Kingdom. Connected with it are a student nurses' association for nurses in training, a section for sister tutors and a section for public health workers. It is recognized by the Ministry of Health as an approved centre for the training of health visitors.