The Evolution of Nursing

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Today’s professional nurses are the backbone of the medical field.

The field of nursing has evolved significantly over the past 150 years, especially since Florence Nightingale began revolutionizing modern health care in the1800s.

Gone are the days when all nurses were female and wore stark-white dresses and heeled shoes, took temperatures with mercury-glass thermometers and hand wrote all of their notes and orders on paper charts.

Instead, today’s nurses — male and female — don multicolored scrubs and supportive, comfortable shoes, use temporal thermometers that only require a quick swipe across a patient’s forehead, and log medical records electronically.

They’ve gone from switchboards to smartphones and diplomas to degrees.

Over the decades, nurses have become highly specialized and integrated members of the healthcare community. They are the true backbone of the medical field.

Settings and Culture

The typical setting of early healthcare practices was in homes — or on the battlefield — where resources and tools were limited.

Nurses who did work in hospitals had access to healthcare’s early machines and tools, such as the iron lung and the first sphygmomanometer.

The iron lung was an enormous external negative-pressure ventilator that helped patients breathe and was initially developed to treat people who were poisoned by coal gas. The first sphygmomanometer (blood-pressure monitor) consisted of an inflatable cuff attached to a mercury-filled glass tube.

Nurses who work in hospitals today can take advantage of modern technology that helps improve their accuracy and efficiency while caring for patients. Mobile apps put pertinent medical information right at their fingertips, implantable devices can administer medications to patients and special beds alleviate heavy lifting.

Patients can now be intubated with an internal device that breathes for them, and blood pressure can be taken automatically with the simple push of a button.

Job Responsibilities

Nursing duties used to read like a household chore list, but the scope of the work has expanded over the years, allowing nurses to engage in more critical responsibilities.

“The change in responsibilities for nurses stems from a few changes in the field, including more comprehensive training, changing views of women and the need for medical professionals growing quickly,” according to the article “How Nursing Has Changed Over Time” on

“The setting for nurses really started to change with the added training … that made them more respected medical personnel and not just women who focused on assisting doctors and giving sponge baths.”

While nursing was once viewed as an extension of a woman’s caretaking role at home, modern nurses take on more responsibilities than ever before. In fact, many states have granted full-practice authority to nurse practitioners, allowing them the autonomy to act as primary-care providers and prescribe medications without physician oversight.

Today’s nurses are not seen as just doctors’ assistants, but as highly trained professionals in their own right with the medical knowledge and education to back it up.

Career Training

“Reports on nursing throughout the past 120 years have recommended higher education and greater responsibilities for nurses, but progress often was impeded by gender and class barriers, and by short-term economic demands of the healthcare industry,” according to “History lesson: Nursing education has evolved over the decades” on

The Nightingale School of Nursing, founded by Florence Nightingale in 1860, is considered the catalyst for many early nursing diploma programs. At the time, curriculum was not standardized, and instead of classroom experience, nursing students often performed 12 to 18 hours of free labor a day at hospitals, where they learned hands-on.

By the late 1900s, diploma programs evolved into courses that required more time to complete — most of them took three years.

Diploma programs provided the majority of RN graduates until the 1960s. Early graduates wrote nursing textbooks, which shifted nursing education from apprentice-style learning to more classroom-based instruction at the college or university level.

Fewer than 100 diploma programs still exist in the U.S. — located mostly in the East and Midwest — with a curriculum similar to that of an Associate Degree in Nursing (ADN) program.

Modern nursing education gives students an opportunity to earn anything from a two-year associate degree up to a Doctor of Nursing Practice (DNP) or Doctor of Philosophy (PhD) in nursing. These programs offer a science- and skill-based education in a variety of specialties, such as forensic nursing. Many schools even have high-tech simulation labs with lifelike patient mannequins on which students can practice real-life situations.

The range of today’s advanced nursing degrees and certifications give graduates more career options and advancement opportunities in the field. Plus, nurses can now work in myriad settings beyond hospitals, including research labs, schools, correctional facilities, federal agencies and private-practice offices.

Nurses will continue to be in high demand into the foreseeable future. Job growth for RNs is expected to increase 15 percent from 2016 to 2026, according to the U.S. Bureau of Labor Statistics. In addition, four of the highest-paying nursing jobs require a BSN: nurse practitioner, clinical nurse specialist, nurse midwife and nurse anesthetist.

About Duquesne University’s Bachelor of Science in Nursing

Students in Duquesne’s RN-BSN online degree program can take advantage of its flexible format while continuing to work as a registered nurse. Coursework includes information technology, practice issues, population-based health and nursing ethics. RN-BSN students may also take up to three graduate-level (MSN) courses to get a head start on the next step in their academic journey.

The benefits of having a BSN are abundant. A bachelor’s degree makes nurses more competitive in their field, opening the door to a variety of job opportunities and higher salaries. In addition, a BSN allows nurses to grow as leaders, providing them with stronger influence over patient care. BSN graduates may work as clinical research nurses, RN case managers, travel nurses and more.



Nursing Is In Transformation, And That’s Good For Nurses —

How Nursing Has Changed Over Time —

Vintage Medical Equipment Nurses Used in the Past —

History lesson: Nursing education has evolved over the decades —

Nursing Diploma Programs —

Occupational Outlook: Registered Nurses —