The History of Health Care, Essay Example

As I read Whelan’s article and looked at the pictures it contained, it really  struck me how far nursing has come since Florence Nightingale in October of 1854 led some female nurses to deliver nursing care to British soldiers in the Crimea.  It was not surprising to read that Nightingale, upon her return to England, established nursing education programs in some hospitals.  It was a nice refresher to read about the “Nightingale Principles” because while many people know something about Florence Nightingale, they may not know that the term, “Nightingale Principles” came about as a result of  the schools that Nightingale established being organized “around a specific  set of ideas of how nurses should be educated” (ibid.), which were developed by Nightingale.

Virtually everything connected with nursing has progressed.  As I look at the 1929 class of student nurses, I try to imagine how they could move quickly in their long and cumbersome uniforms.  The nurses must also have been very warm in the summer as I do not think that their various places of employment were air conditioned.  I say various because most nurses upon graduation went to work as private duty nurses, usually in private homes because hospitals hired only a few graduate nurses as supervisors and relied upon students for most of the bedside care.

This did, however, not provide regular employment and remuneration. “It was not until the mid-twentieth century that hospitals hired nurses as regular staff on a permanent basis, providing full professional nursing services to all hospitalized patients” (ibid.).  It was of great interest to me to read how quickly the number of nurses grew and how diversified they became.  Due to the opening of settlement houses (the first one in 1893 by Lillian Wald), public health nursing came into being.  Nurses were trained as midwives and to administer anesthesia during surgery.

They also performed extremely well in both World War I and World War II.  However, after World War II, a shortage of nurses occurred because fewer young females (males were usually not admitted) were willing to enter the nursing profession because they viewed it as consisting of hard work, low pay, and poor working conditions.  Interestingly, it is not uncommon today for hospitals to have a shortage of nurses for some of the same reasons.

About this time, there was also a movement to change nursing education from hospital based to educational institutions.  “By 1960, approximately 172 college-based nursing education programs awarded Bachelor of Science in Nursing Degrees” (ibid.).  Also about this time,  two-year community college programs  (also known as Associate Degree Programs) came into being, which seemed to provide a good solution to the debate in that “education took place in institutions of higher education and the demands of patient care did not intrude on the learning process as often occurred in the diploma programs” (ibid.).

The types of nurses and their practice location continue to this day with, perhaps, the latest debate surrounding the avenues of practice that should be accorded to a nurse practitioner.

It was most informative to read that in “the second half of the nineteenth century, the most critical health problems were related to contaminated food and water, inadequate housing and sewage disposal.  A countrywide cholera epidemic and a yellow fever epidemic killed more than 30,000 Americans between 1853 and 1858” (The Health Care System in the United States).  By 1900, infectious disease epidemics had been brought under control, and chronic diseases were now concentrated upon.  Essential hygiene was the most important factor in the decline in mortality followed closely by proper nutrition.  “According to the World Health Organization (WHO), the best vaccine against common diseases is an adequate diet (ibid.).

I am interested in pursuing a career in health care management including occupational therapy because both interest me, and I see a need for both.  Occupational injuries occur in most workplaces at one time or another and unless quick and expert care is given an individual can have an unnecessary impediment for life.  As for health care management, the number of places (in hospitals and clinics and as an educational instructor) I can practice will permit me to do so where I ultimately feel that I am doing the most good and receiving the greatest satisfaction.

The poor, as a general rule, have  had the most negative health outcomes from the days when nurses were hired privately, and they could not afford one to today where funding restrictions for advanced treatments affect the poor greatly.   On a positive note, in 2005, life expectancy was at its highest and the death rates for both the young and the elderly had decreased significantly, the latter being largely due to a “collaboration between medicine and public health in efforts to educate the public, especially about lifestyle changes (ibid.).International travel and immigration by both rich and poor increase the risk of “exposure to infectious diseases such as the Avian Flu and Severe Acute Respiratory Syndrome” (ibid.).

Higher socio-economic people tend to be healthier than lower because they usually have better nutrition, exercise more, have better housing, and can avail themselves of better health care.

There are many resources available for finding more information on the history of health care in the United States.  Using one’s computer search engine, one can come up with a plethora of informative material.  Various government bodies, health education schools and universities, nursing journals, and public health agencies will give you access to such information as well.  Hard cover books in various libraries also contain such information. An old set of encyclopaedias may also contain some surprisingly excellent information.

References

The Health Care System in the United States.  Retrieved on October 14, 2012, from Introduction_to_the_Health_Professions_5e_Ch01(1)pdf(SECURED)_AdobeReader.

Whelan, J. C.  American Nursing:  An introduction to the past.  University of Pennsylvannia School of Nursing.  Retrieved on October 14, 2012, from http://www.nursing.upenn.edu/nhhc/Pages/American.