240 unit 3 | Professional Issues
Introduction
It is often said that you do not know where you are
going until you know where you have been. Over
30 years ago, Beletz (1974) wrote that most people
thought of nurses in gender-linked, task-oriented
terms: “a female who performs unpleasant techni-
cal jobs and functions as an assistant to the physi-
cian” (p. 432). Although the image of nurses and
nursing has advanced considerably since then, some
still think of nurses as helpers who carry out the
physician’s orders.
In its history, the nursing profession has had
many great leaders. There are several who not only
demonstrate the strengths of nursing’s leaders but
also reflect some of the most important issues that
the profession has faced over the past 150 years.
Each of these leaders initiated change within the
social environment of the time, using the strategies
of change and conflict resolution discussed earlier
in the text.
Nursing Defined
The changes that have occurred in nursing are
reflected in the definitions of nursing that have
developed over time. In 1859, Florence Nightingale
defined the goal of nursing as putting the client “in
the best possible condition for nature to act upon
him” (Nightingale, 1859, p. 79). In 1966, Virginia
Henderson focused her definition on the unique-
ness of nursing:
“The unique function of the nurse is to assist the indi-
vidual, sick or well, in the performance of those activ-
ities contributing to health or its recovery (or to
peaceful death) that he would perform unaided if he
had the necessary strength, will or knowledge. And to
do this in such a way as to help him gain independ-
ence as rapidly as possible” (Henderson, 1966, p. 21).Martha Rogers defined nursing practice as “the
process by which this body of knowledge, nursing
science, is used for the purpose of assisting human
beings to achieve maximum health within the
potential of each person” (Rogers, 1988, p. 100).
Rogers emphasized that nursing is concerned with
all people, only some of whom are ill.
Florence Nightingale is probably the best
known of the historic leaders and is considered the
founder of modern nursing. Nightingale brought
about change in the care of soldiers, the keeping of
hospital records, the status of nurses, and even the
profession itself. Her concepts of nursing care
became the basis of modern theory development in
nursing.
Lillian Wald, founder of the Henry Street
Settlement, is a role model for contemporary com-
munity health nursing. She developed a model for
bringing health care to people.
Margaret Sanger, a political activist like many of
the others, is best known for her courageous fight
to make birth control information available to
everyone who needed or wanted it. Her fight to
make Congress aware of the plight of children in
the labor force is less well known but led to impor-
tant changes in the child labor laws. Sanger may
have been the first nurse lobbyist.
Mary Eliza Mahoney was the first black gradu-
ate nurse in the United States. Her professional
attitude helped to change the status of black nurs-
es in this country.
Mildred Montag proposed having two levels of
nursing. She developed an associate degree nursing
program at Adelphi University.
Virginia Henderson was a 20th century
Florence Nightingale. She wrote the nursing fun-
damentals textbook most commonly used by nurse
educators throughout the country for most of the
last century.
Many of their characteristics—intelligence,
courage, and foresight—are the same ones needed
in today’s nursing leaders.Florence Nightingale
Background
Florence Nightingale, an English noblewoman,
was born in the city for which she was named—
Florence, Italy—on May 12, 1820. Her father was
a well-educated, wealthy man who put considerable
effort into the education of his two daughters
(Donahue, 1985). Florence Nightingale learned
French, German, and Italian. Mr. Nightingale per-
sonally instructed her in mathematics, classical art,
and literature. The family made extended visits to
London every year, which provided opportunities
for contact with people in the highest social circles.
These contacts were very valuable to Nightingale in
later years.
Despite her family’s ability to shelter her from
the meaner side of life, Nightingale always had an
interest in the welfare of those less fortunate than
herself. She was never quite content with herself, as