Evolution Of Nursing in The Gambia an Address By Mr Thomas A.b King, Registrar Nurses and Midwives Council on The Occasion of The Gambia Nurses And Midwives Association Celebration of International Nurses Day

Historical Overview of the Nursing profession.

From a historical perspective the evolution of Nursing has been one of movement from the dependent, hospital- trained nurse tothe emergence of the independent, college- educated one. In the early Judeo- Christian era, women provided NursingServices in the home as part of their ethical and humanitarianresponsibilities. No formal education or training was expected, but rather the women used her skills as a wife and a mother to care for the ill on a person to person basis.Not until the middleages (5oo-1500A.D.) did nursing become an organized service.

Most nurses were part of religious orders which werefounded for ministeringpurposes. The nurses received training from the order itself, as well as, from their practical experience in caring for the sick.

were better educated than other women since they came from the upper classes, where it was expected that women would devote time outside the home to care for the poor and the sick.

This pattern of nursing carecontinued into the Industrial Revolution (1800s), untilthe time of Florence Nightingale. Miss Nightingale was born into a prominent English family and had the benefits of an execellent education and a knowledge of the social conditions and reforms of the time.

She believed that nursing should be a separate career and not part of religious resonsibilities. In addition, Ms Nightingale advocated the careful selection of educated,competent individuals as nurses, establishment of schools specifically for the education and training of nurses, and general reform of health and sanitary conditions. The (Nightingale Era) was the beginning of nursing as a profession.

Although, FlorenceNightingale set the stage for the evolution of professional nursing, the course has been neither smooth nor rapidNursing has traditionally followed a medical model approach in education, practice, and identification. This has meant that nursing school curricula were disease oriented, based on treating signs and symptoms of pathologic states, with many courses designed, prepared and taught by physicians.

Emphasis was place on the dependent role of the nurse in carrying out the physician,sorders and following established routines and patterns of care. Nursing did not possess its own body of knowledge nor did it generate knowledge through nursing research.

As a result of the scientific and technological changes and advancements coupled with societal trends, nursing had to reassess itself as a profession. An examination of its aims and potentials for meeting the health care needs of individuals has led to a redefinition of nursing as a professionwhich has its own unique contribution, to make to society.

In the past ,nursing ,followed the medical model which is disease oriented ,either in terms of curing or preventing illness. Today, however ,the nurse is concerned not only with disease prevention and treament,but also more importantly with wellness promotion.with this shift of emphasis, nurses now function not only in hospital settings, but also inindependent practices in the community, school clinic or any other setting where they can make a positive difference in the ability of individuals, to meet their health careneeds. The nurse is now required to make decisions, communicate effectively, have a broad- based education, possess leadership abilities, make sound professional judgments , problem solve and be accountable to individual,and hisfamily and /or significant otherssociety, and the profession for the quality and quantity of health care given.