The history of travel nursing is as old as modern nursing itself. While these first travel nurses were not under contract, they were in fact nurses traveling to fill crisis needs. So a piece on the History of Travel Nursing wouldn’t be complete without them.
Florence Nightingale
With England & France backing the Ottoman Empire in their border war with the Russian Empire. While the war was initially expected to conclude quickly, it dragged for years longer than expected. A year into the war, reports of horrendous conditions for the sick and wounded started to come back to the UK. On October 21st, 1854 Florence Nightingale and 38 female volunteer nurses traveled from the United Kingdom to the Ottoman Empire in modern history’s first example of travel nurses filling crisis needs.
Nightingale’s journey from London to the Ottoman Hospital in Scutari took a grand total of 13 days. They first traveled by boat to a fishing village in Northern France named Boulogne-sur-Mer. They then traveled by land through Paris to Marseilles where they boarded a steamboat, The Vectis. They arrived by early November at the Scutari barracks in the suburbs of the capital Constantinople, Turkey.
What Florence Nightingale and her team of volunteer nurses found was horrifying. The wounded were sleeping in overcrowded & filthy quarters without any blankets. Hygiene was being completely neglected resulting in mass infections. Ten times more men were dying from diseases such as typhus, typhoid, cholera & dysentery than from injuries incurred from battle. While the doctors were understaffed, overworked and lacking sufficient medical supplies and they still didn’t want the nurses’ help. But after major battles they came to understand that they needed Florence Nightingale and her team of volunteer nurses.
Upon witnessing the horrendous conditions first hand, Florence Nightingale sent a plea toThe Times, one of London’s most prominent news publications. Her plea was a public outcry for a government solution to enhance the conditions of the medical facilities. Upon her request, the British Government commissioned engineers to build a prefabricated hospital in London to ship to the Ottoman Empire. The result was a new hospital, The Renkioi Hospital, which had a death rate of less than 1/10th that of the Scutari Hospital.
In the prestigious Dictionary of National Biography, Stephen Paget claimed that Nightingale reduced the death rate from 42% to 2% by either making improvements to sanitation herself or by mandating the Sanitary Commission. An example of a sanitation practice Nightingale is credited for was as basic as handwashing.
During her first Winter in Scutari, 4,077 soldiers died in the hospital mostly because of poor living conditions. Only 6 months after Nightingale’s arrival, the British Government sent the Sanitary Commission to improve on the stale air & defective sewers Nightingale observed and wrote home about. The Commission flushed out the sewers and improved the ventilation which resulted in the massive drop in the death rate.
During her time in the Ottoman Empire, the soldiers referred to Nightingale as “The Lady with the Lamp” because after all other medical workers would go to sleep she would stroll through the corridors with a lamp checking on all those who needed medical assistance throughout the night. Nightingale became one of the most prominent Victorian Icons of the 19th century. An excerpt of The Times wrote of Nightingale as
“A ‘ministering angel’ without any exaggeration in these hospitals and as her slender form glides quietly along each corridor, every poor fellow’s face softens with gratitude at the sight of her. When all the medical officers have retired for the night and silence and darkness have settled down upon those miles of prostrate sick, she may be observed alone, with a little lamp in her hand, making her solitary rounds.”
Her prominence was recognized by foreign governments which consulted with her as the expert in hospital administration and sanitation. Upon her return to London, she established the first secular nursing school in the world, St. Thomas’ Hospital which today is a part of King’s College in London where she established the fabled Nightingale Pledge. The Florence Nightingale medal is the most prestigious international award in nursing.
Nightingale was not only a pioneer in healthcare but for women and in the workforce in Victorian England. She wrote and published works to spread medical knowledge in simple English so that the undereducated could read and understand the knowledge. In an incredibly hierarchical Victorian England that was revolutionary at the time.
Clara Barton
Six and a half years after Florence Nightingale and her team of volunteer nurses traversed Europe to become history’s first travel nurses, Clara Barton, a school teacher and law clerk, rushed to a Washington DC train station to nurse 40 men of the Massachusetts regiment after the Baltimore Riot, or the Civil War’s first instance of bloodshed.
She continued to help the men of the 6th Massachusetts Militia who were temporarily housed in DC’s unfinished Capitol Building. Barton, with the help of other volunteer women, provided clothing, food & medical supplies to the wounded. She also offered emotional support to the soldiers by reading to them and writing letters to their families for those who were too injured to write. Even before officially being a member of the Union Army, Barton used her own home as a storeroom for medical supplies that she distributed regularly with the help of her friends despite the opposition of the War Department and Army Surgeons.
After the First Battle of Bull Run in July, 1861, Barton put an advertisement in a Massachusetts newspaper soliciting medical supplies and the public responded enthusiastically. Upon her father’s death in late 1861, Barton left her hometown to become America’s first travel nurse amongst the soldiers.
Almost a year after the First Bull Run, Barton finally gained permission from Quartermaster Daniel Rucker to work on the front lines in August of 1862. From that point forward, Barton rode her medical wagons alongside Union soldiers to distribute medical supplies, clean field hospitals, and supply food to the wounded Union soldiers and Confederate prisoners. It’s said that sometimes Barton’s Medical Wagons even rode ahead of the Union Wagons at times.
Bartons work in the battles such as Cedar Mountain, The Second Bull Run & Fredricksberg was crucial to the livelihood of countless Americans on both sides of the war. In the battle of Antietam, Barton ran out of bandages and resourcefully used corn-husks to dress the injuries of the wounded.
Following the war, there was an influx of letters written to the army by concerned family members of the soldiers. Barton led the Office of Missing Soldiers in finding and identifying soldiers killed in battle or missing in action. Barton and her assistants replied to over 40,000 concerned family members and located, identified & buried over 22,000 men.
Barton’s legacy in the history of travel nursing is cemented by her founding of the American Red Cross, an offshoot of the original Red Cross of Switzerland. Barton was the founder and president of the inaugural American Red Cross which held their first meeting in her Washington DC apartment.
The History of Travel Nursing Under Contract
The first incident of an American hospital contracting temporary workers to fill a crisis need was in the late 70s in New Orleans during Mardi Gras. With an incredibly large number of patients to deal with, the hospitals turned to bring in travel nurses to fill their needs. Travel Nursing continued to be a growing trend throughout the 80s and 90s in response to a growing nursing shortage.
In the late 90s the digital world would change the history of travel nursing forever. VMSs and MSPs would completely revolutionize the history of travel nursing as you can read about here