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Nurse with stethoscope and patient.

America’s Caregivers: The history and the future of the Nursing Profession

Published on May 10, 2021

There are 4 million registered nurses in the United States who hold one of the most unique places in the health care system. Nurses, more than any other health care services providers, work in diverse settings and fields to provide care to patients at their homes, clinics, hospitals, and residential care settings such as assisted living (ALs) and skilled nursing facilities (SNFs).

After being on the frontline of COVID-19 for more than a year now, the nursing profession is in a state of growth and opportunity. To understand the critical role nurses will play in our future, it is important to understand how the profession has evolved for more than 100 years.

History of Nursing Highlights:
Florence Nightingale is considered the beginning of the nursing profession. The upper-class British woman led a group of nurses to Crimea in 1854 to deliver nursing care to British soldiers. After returning to England, she established nurse education programs in several British hospitals. Her ideas about how nurses should be educated has shaped the future of the nursing profession ever since then. 

It was not until the beginning of the 19th century when industrialization and urbanization spread that hospitals began to be built across the country in large cities. Previously, caring for someone who was sick took place in the home and it was the responsibility of family and friends to provide care except during epidemics or plagues. 

The outbreak of the Civil War created an immediate need for nurses. Close to 20,000 women and men served as nurses for both sides of the conflict. The service they provided in caring for the wounded again highlighted the need for more nurse training programs. One of the first classes graduated in 1869 from the Women’s Hospital of Philadelphia. The class was six months long. 

In 1873, the New York Training School at Bellevue Hospital, the Connecticut Training School, and the Boston Training School at Massachusetts Hospital all began training operations. By 1900, there were more than 400 schools operating across the country. In World War I and II, nurses took important roles in the armed services to ensure the military received proper medical care. About 78,000 nurses served in World War II.  

The profession thrived during the remainder of the 20th century. New types of nurses emerged that could provide care in a variety of settings. Now, nurse practitioners, clinical specialists and other specialty nurses carry out a large portion of the health care services. 

Future of Nursing Profession:
While the profession has grown through many phases and challenges, their greatest hurdles have been being on the frontline of the COVID-19 pandemic and the upcoming health care needs of the “Baby Boomer” generation. 

Baby Boomers are the generation of Americans who were born between 1946 -1964. The period saw a marked rise in the population’s birthrate after the Great Depression and WWII. The U.S. Census Bureau estimates there are 76.4 million Baby Boomers. By 2029, the last of the Baby Boomers will hit retirement age, and the health care needs of these individuals are going to jump dramatically. 

Baby Boomers will enter this new health care market with different medical conditions than previous generations. They may face obesity, diabetes, heart conditions, high-blood pressure, cholesterol levels, cancer and more. 

New opportunities in nursing have emerged since the COVID-19 pandemic began. Infection preventionist (IP) positions are more common. IPs should have clinical expertise and use critical thinking skills to engage in practices of infection risk assessment, surveillance analysis, investigation and control of healthcare acquired infections and outbreaks.

Consistently, the nursing profession has stepped up to the challenges of America’s need for quality care and demonstrated its ability to adapt. As one of the most trusted individuals in the health care system, nurses will continue to be a beacon of hope for millions requiring care each day. 


Author: Brandon S. Totten
Community Relations Manager, AMFM Nursing & Rehabilitation Centers