Common threads bring us back to the future
AS THE NATION CELEBRATES its 250th anniversary, the story of nursing emerges with lessons and common threads from our past that inform contemporary practice. As the authors of our feature article note, “the story of American nursing is as old as the story of the nation itself.”
Studying the history of nursing to write this piece was awe-inspiring. Our daily busyness prevents us from seeing what matters. The urgent drives out the important.
The history of nursing exposes several themes that continue to shape practice, education, leadership, and professional identity. Although technologies, scientific knowledge, and care settings have evolved, many of the challenges and values that defined nursing in the past remain relevant today.
Commitment to caring and compassion
Perhaps the most consistent thread throughout nursing history is the commitment to caring for individuals during times of illness, injury, suffering, and vulnerability. From informal caregiving in families and religious communities to modern professional nursing practice, compassion remains central. Historical examples: nurses serving soldiers during war and early public health nurses caring for impoverished populations. Contemporary relevance: patient-centered care, compassionate communication, and holistic health and healing.
Patient advocacy
Nurses have long served as advocates for those who lack power and access. Throughout history, nurses have frequently been the first to identify unsafe conditions, inequities, and unmet needs. Historical examples: Florence Nightingale advocating for sanitation reforms during the Crimean War, public health nurses addressing poverty and disease in urban communities, and military nurses improving conditions for the wounded. Contemporary relevance: Nurse-led patient safety initiatives, ethical decision-making, and health equity efforts.
Leadership during times of crisis
Nursing’s history is closely linked with responding to crises—wars, epidemics, natural disasters, public health emergencies. Historical examples: Revolutionary War and Civil War nursing, the 1918 influenza pandemic, and polio outbreaks. Contemporary relevance: COVID-19 pandemic response, disaster preparedness, emergency management, crisis leadership. Nurses frequently serve as the healthcare professionals who remain closest to patients during uncertainty and disruption.
Focus on safety and quality
Long before “quality improvement” and “patient safety” became common terms, nurses observed care processes and determined how to reduce harm. Historical examples: Nightingale’s use of data to reduce mortality, infection prevention efforts before fully understanding germ theory, and hospital reforms focused on sanitation and organization. Contemporary relevance: High-reliability healthcare, human factors engineering, evidence-based practice, quality improvement science, and medication safety. I view modern patient safety efforts as an extension of nursing’s historical commitment to preventing harm.
The history of nursing teaches that although healthcare environments change, the profession’s core values remain remarkably consistent. Caring, advocacy, safety, leadership, observation, education, innovation, social responsibility, professionalism, and courage have connected generations of nurses across more than two centuries. Understanding these historical threads helps nurses appreciate not only where the profession has been but also our responsibility to shape what’s next. Look back, and you will see the future.
Lillee Gelinas, DNP, RN, CPPS, FAAN
Editor-in-Chief
American Nurse Journal. 2026; 21(7). Doi: 10.51256/ANJ072604
