SIGNIFICANT EVENTS IN THE EVOLUTION OF NURSING INTERNATIONALLY

1600’S-1800’S

• Religious orders and early institutional care

• Monastic and charitable institutions provided organized care in Europe and parts of Asia; nursing roles often gendered and low status compared with physicians.

MEDIEVAL PERIOD 

• Care provided mainly by family members, religious orders and temple attendants; nursing duties were often integrated with religious charity and caregiving rather than a formal profession.

1600’S-1800’S

• Monastic and charitable institutions provided organized care in Europe and parts of Asia; nursing roles often gendered and low status compared with physicians. 

1854-1899

• Florence Nightingale and the professionalizing impulse

• Florence Nightingale’s work in the Crimean War and her founding of the nursing school at St Thomas’ Hospital are widely recognized as foundational in shaping modern, secular nursing education and professional norms.

• The move towards training schools and formalized nursing roles.

• Founding of the international council of nurses in Geneva.

ST. THOMAS’S HOSPITAL

Florence Nightingale’s work in the Crimean War and her founding of the nursing school at St Thomas’ Hospital are widely recognized as foundational in shaping modern, secular nursing education and professional norms.

FLORENCE NIGHTINGALE

THE INTERNATIONAL COUNCIL OF NURSES

1899 — First international coordination: 

International Council of Nurses (ICN) The ICN was founded as the first international organization representing nurses and national nursing associations; it played a long-term role in standard-setting, advocacy, and international cooperation.

1914-1916

• WW1

• WW2

• Regulation and licensure 

• Nurse practitioners 

BOTH WORLD WARS MASSIVELY INCREASED THE SCALE, SCOPE, AND PUBLIC VISIBILITY OF NURSING.

• Both world wars massively increased the scale, scope, and public visibility of nursing. Nurses served in military and civilian roles, which accelerated clinical training, expanded responsibilities, and drove social recognition — but also contributed to post-war workforce shortages and reshaped gender and workforce patterns.

1950’S-60’S

• Regulation

• Licensure

• Nurse practitioners

• Governments and medical authorities introduced formal licensure, registration systems, and national bodies to regulate nursing practice and education. Nurse registration and state regulation became common across many countries during the 20th century. 

• The nurse practitioner (NP) role originated in the mid-1960s, to meet primary care shortages and expanded over following decades into many countries as advanced practice roles. 

1900’S-20TH CENTURY 

• Globalization

• “State of the world’s nursing” by W.H.O

• COVID-19 

• Workforce crisis

• W.H.O. Policy updates

90’S- 2000’S

• International migration of nurses increased leading to policy debates on ethical recruitment, and workforce distribution. Global reports and regulatory atlases began tracking cross-border issues.

2020

• WHO released the first-ever State of the World’s Nursing report in April 2020, calling for investment in nursing education, jobs, and leadership. Almost immediately, COVID-19 placed nurses globally on the front lines — highlighting both the centrality of nursing to health systems and severe workforce stresses the pandemic accelerated public and policy attention to nursing but exposed vulnerabilities.

ONGOING WORKFORCE CRISIS

• WHO continued tracking the global nursing workforce; the 2025 State of the World’s Nursing expanded indicators and reiterated urgent policy priorities to close shortages and strengthen nursing leadership. Reports and national studies since 2020 document large numbers of nurses leaving practice (burnout, retirement), an ethical debate about international recruitment, and the growth of contract/travel nursing during the pandemic. 

SIGNIFICANT EVENTS IN THE EVOLUTION OF NURSING LOCALLY

1837

• The funding of the first hospital, which although temporary, marked the beginning of formal medical care and the introduction of nursing positions.

1860

• Florence Nightingale began influencing nursing in the Caribbean.

 1860-61

• The asylum was established in Belmont for the mentally ill, as well as the San Fernando colonial hospital.

1930-40

·         The Certified Nurses Association of Trinidad and Tobago was founded at the San Fernando Hospital.

·         The nursing council was formed to regulate the nursing practice.

1970-78

• Local Nursing education and policy began to incorporate North America and other themes

• P.A.H.O support in creating the first Nursing General Education Curriculum to start the Nursing Education.                                   Declaration of ALMA  ATA

1980-2000

• Strengthen the scientific and Technological approach to Nursing- Introducing quality assurance and management strategies in Nursing.

• Launch of the Bachelor of Science in Nursing (BScN) at COSTAATT.

2000-25

·         Covid-19 pandemic highlighted the critical role of Nurses, accelerating training in emergency and critical care.

·         Increased emphasis on advance practice Nursing, Nurse practitioners and digital Health Care Integration.

SIGNIFICANT EVENTS IN THE EVOLUTION OF NURSING REGIONALLY.

TRADITIONAL HEALING

Since the 15th century Amerindians practiced healing using traditional methods

however new diseases emerged when Europeans arrived. Early nursing was mainly

administered by untrained women who often worked in colonial hospitals and provided

care in a local capacity.

 HERBAL REMEDIES

The term bush doctor and healer used by African predecessors held true as the remedies provided were herbal in nature however gradual reforms began as neglect of public health care by colonizers caused the general health conditions to worsen.

CRIMEMAN WAR 1853-56

The Crimean War was fought between the Russian Empire and an alliance of the Ottoman Empire, the Second French Empire, the United Kingdom of Great Britain and Ireland, and the Kingdom of Sardinia-Piedmont from October 1853 to February 1856.

Mary Jane Seacole was a Jamaican nurse and businesswoman. She was famous for her nursing work during the Crimean War and for publishing the first autobiography written by a Black woman in Britain. She used her knowledge of traditional Jamaican medicine and herbal remedies to treat patients, and her efforts saved many lives. During the Crimean War, she established the British Hotel to provide care and shelter for soldiers who were suffering from cholera and dysentery.

 REGIONAL NURSING BODY FORMED

During the 1950s Nita barrow and Ena Walters advocated for professional standardization and leadership including standardized training certification and registration amongst the nursing body.

Nita Barrow                                                     Ena Walters

COLONIAL HYGIENE

The term colonial hygiene stems from the encouragement of segregation between colonizer and colonized from as far back as the early 1800’s. As a racist objective, to prioritize the health of the colonizers and plantation labourers. This was enabled by the provision of trained nurses to Britain’s empire in 1895 as the colonial nursing association was formed.

COLONIAL AUTHORITY ENDED

In the early 1970’s, official colonial authority ended, and the Caribbean Nurses Organization was founded and coordinated regional initiatives to raise training, practice, and regulatory standards. Groups of locally trained nurses who were sent to Britain for training and experience during the colonial rule, returned with innovation to be applied to their new leadership roles in the medical field.

BERENICE DOLLY

1917 – 2002

ACHIEVEMENTS

• Co-founded and president the Trinidad and Tobago registered Nurses Association.

• Received the order of the British empire

• Acknowledged by Trinidad and Tobago government for volunteerism

• Rallied for legal registration and regulation in nursing.

1930

Berenice Dolly was the co-founder and the president on the Trinidad and Tobago Nursing Association which is now known as the Trinidad and Tobago Registered Nurses Association.

 1962

• Ms. Dolly was honored by the British empire (OBE) as an officer of the order for her contributions to nursing in the country.

·         The government of Trinidad and Tobago also recognized Ms. Dolly for her volunteerism and community service and in the same year and they awarded her the Gold Medal of Merit Order of the Trinity.

IMPACT ON NURSING - LOCALLY

·         Because of her dedication and dynamic attitude towards nursing Ms. Dolly pushed for the nursing industry to be legally registered and regulated

·         In 1950 The Nurses’ Registration Ordinance No.38 prevailed due to Ms. Dolly’s persistence.

DAME RUTH NITA BARROW

1916-1995

EDUCATIONAL TIMELINE OVERVIEW

• 1935: Started as a nurse at Barbados General Hospital.

• 1940: Began midwifery training at the Port-of-Spain General Hospital.

• 1941: Continued her studies at the University of Toronto on a Rockefeller Fellowship.

• 1949: Instrumental in the founding of the general trained Nurse’s Association in Jamaica. Currently known as the Nurse’s association of Jamaica.

• 1951 Her advocacy led to the implementation of the nurse’s registration bill in Jamaica.

• 1952: Pursued specialist studies at the Royal College of Nursing at the University of Edinburgh.

• 1955: Earned her Bachelor of Science in nursing from Columbia University

 CAREER TIMELINE

• Governor-General of Barba1995): As the first female Governor-General, she served as the symbolic head of state for Barbados.

• Ambassador and Permanent Representative to the UN (1986–1990): In this capacity, she represented Barbados at the United Nations.

• Director of the Christian Medical Commission (World Council of Churches): In this role, she promoted primary healthcare and supported the integration of traditional medicine. (1975 -1980)

• 1964: Appointed as Nursing Adviser for the World Health Organization (WHO) and the Pan American Health Organization (PAHO): She advised these organizations on health care and public health matters.

• President of the world Y.W.C.A (young women’s Christian association) 1975-1983

• First Caribbean woman to receive the order of the Caribbean people award: 1994

 1935- THE JOURNEY BEGINS

Nita Barrow began her nursing studies by enrolling as a student nurse at the Barbados General Hospital in 1935. She later completed her midwifery training at the Port-of-Spain General Hospital in Trinidad and Tobago.

1949: THE NURSE’S ASSOCIATION OF JAMAICA

She was the driving force behind the formation of the Jamaica General Trained Nurses’ Association, now the Nurses’ Association of Jamaica. Her advocacy led to the historic passage of a nurses’ registration bill in Jamaica in 1951, a major step forward for professional recognition.

1963: REGIONAL HEALTH SURVEY

: Her expertise was recognized globally through her work as a public health adviser and consultant for the World Health Organization (WHO) and the Pan-American Health Organization (PAHO).

1975/80

Advocated for women’s rights: Barrow was a leading voice for women’s empowerment and leadership. She served as president of the World YWCA (1975–1983) and convened the Non-Governmental Organization (NGO) Forum for the UN Decade for Women in Nairobi, Kenya, which was the largest gathering of women in the history of the United Nations.

1975-83

1986/90

Ambassador to the United Nations: She served as Barbados’ Ambassador and Permanent Representative to the UN from 1986 to 1990, bringing international attention to issues of development and the environment.

1990/95

• From 1990 until her death in 1995, she was Barbados’ first and only female Governor- General, a position in which she was beloved as “the people’s Governor-General”.