History of Nursing Science: Key Theorists and Theories

Introduction

Nursing has existed in some form for as long as humans have roamed the earth. The modern era of nursing began with the emergence of Florence Nightingale during the Crimean War in the 1850s. The daughter of affluent parents, Nightingale greatly accelerated the development of nursing and is widely acknowledged as the most important person in the history of nursing. Nursing science translates to the profession itself in the form of best practices that have been formulated, debated, reviewed, and analyzed so as to verify the validity of nursing theories before they are put into practice.

Nightingale Emerges

As is the case with many nurses and others who dedicate their lives to the care of others, Nightingale was driven largely by her spirituality and religious convictions. Many people perceive an inherent conflict between religion and science, but Nightingale did not believe this to be the case. Nightingale began to make her impact during the Crimean War in the 1850s, a conflict between Russia and a coalition of European countries that included Britain. Immediately upon her arrival, she instituted a number of changes including improvements in the handling of meals and nursing care for injured soldiers. These changes were based on the importance of order and cleanliness. Mortality rates immediately started to drop upon the implementation of these changes (Parker & Smith, 2010).

Two major schools of thought relating to disease in the mid-1800s were contagionism and anti-contagionism. The former held that diseases were communicable and spread in areas where many people congregated, such as markets. Nightingale was a staunch supporter of anti-contagionism, asserting that filth and dirtiness were the main causes of disease spreading, and that requiring cleanliness while administering care greatly aided in the treatment of disease. Another strong position Nightingale held was an aversion to marriage. She never clearly articulated feminist viewpoints, but many people attribute her belief structure to feminist ideology (Parker & Smith, 2010).

Nightingale's creation of modern nursing science began when she constructed a number of assumptions about nursing — eleven in total (Parker & Smith, 2010). These eleven assumptions included the idea that nursing and medicine are separate disciplines, that nurses should be formally trained, that a nurse should be vigilant and quick to respond, and that the focus should be on the patient at all times (Parker & Smith, 2010). She followed this up with the thirteen canons of nursing and the model of nursing and the environment (Parker & Smith, 2010).

Early 20th Century Nursing Theorists

Nursing science advancements of the twentieth century started with Ernestine Wiedenbach. Born in 1900, she served as a nurse during World War II in the 1940s and subsequently taught about the development of prescriptive theory from her position at Yale University. She continued these teachings even after her retirement in 1966. She insisted that nursing should be considered a professional practice discipline and that nursing practice theory was a concept that should be researched and expanded. She also asserted in 1964 that nursing was patient-centered (McKenna, 1998).

Active around the same time was Virginia Henderson. Henderson questioned the idea of nursing being secondary in nature to medicine rather than an integral part of it. Publishing some of her best work in 1955, she insisted that the functions of nurses be clearly defined and that the meaning of good nursing care be properly articulated (Parker & Smith, 2010).

Lydia Hall, born in 1906 and a 1927 graduate of the York Hospital School of Nursing, further altered the conceptual framework of nursing when she asserted that professional nursing was a key part of the medical care and rehabilitation process (Parker & Smith, 2010). Hall brought these ideas to life when she opened the Loeb Center in 1963. Hall's main theory was the Care, Cure, and Core model, which was refined during the 1950s and 1960s. Hall asserted, among other things, that intimate bodily care — such as bathing and feeding — should be handled by nurses alone. These tasks fall under the care component of Hall's philosophy (Parker & Smith, 2010). The cure component pertains to the nurse assuming medicine administration duties for the patient. The core referred to meeting the emotional and social needs of the patient.

Conclusion

Florence Nightingale started a significant evolution of the practice and science of nursing a century and a half ago. Her impact continues to be felt today. Advancements in nursing science continue to be translated into real-world practice as concepts are developed and integrated into the clinical nursing environment.