Modern nursing began in Europe in the early 19th century with the Protestant Deaconess Movement, which was based in motherhouses where the sick and infirm were cared for (Nursing). The first secular nursing school was established in 1836 in Kaiserwerth, Germany, and was visited in 1851 by Florence Nightingale, a woman from a well-to-do British family who decided to devote her life to nursing. In 1854, she volunteered to serve in the Crimean War, where she transformed the poorly ventilated, vermin-infested barracks hospital into a clean, well-managed infirmary, and reduced the death toll from 40 percent to two percent within six months. Nightingale published her Notes on Nursing in 1859, and it became required reading for all nursing students, and she went on to open the Nightingale School for Nurses in London.
At the outbreak of the Civil War, nursing was still in its infancy, and women nurses usually worked in base hospitals, but Clara Barton worked on the battlefield (Nursing). Other notable nurses in the Civil War were author Louisa May Alcott and runaway slave Harriet Tubman. The rapid expansion of nursing in the United States was due in part to the establishment of three national nursing organizations established by the nurses out of their sense of responsibility for the ethics, standards and educational development of their profession (Wald, 1999). The National League was organized in 1893 by 18 women superintendents of hospitals to promote nursing education
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