The History of Perioperative Nursing

By: Ruth Crothers, RN BSN CNOR RNFA

Why Care About The History of Nursing?

“You have to know who you are and where you come from.

If you don’t know where you come from, how do you know where you are going?”

F. Fleisher, The Jazz Singer-1980

Leg Surgery Performed in the Kitchen

Hand Washing & Boiling of Instruments Practiced Much Later

Eye Surgery in the City Plaza

Early Neurosurgery 1561

Women Go To War

• Early recognition of the importance of hand washing.

• Gradually, cloths, instruments and dressings were meticulously cleaned.

• The practice of asepsis was advanced.

Due to the Influence of Louis Pasteur, Various Types of Sterilizers Were Developed and Asepsis

Became the Standard

Civil War Nursing

• Anesthetics allowed for more complicated surgeries.

• Fatal infections occurred in more than 30% of patients.

• Draining of incisions began around 1860 to treat infections.

“The Agnew Clinic”1899

In 1891, rubber gloves were introduced and later the face mask was adopted

Spanish-American War 1899

Positioning Patients in the 1800s

OR Table 1850Gyne Chair 1878

OR Nursing Late 1800s

Operating Room Theatre 1898

Operating Theatre 1897

In 1901 the four blood groups were identified for blood transfusions.

OR Nursing in the 1890s

• The student nurse was responsible for sterility of equipment.

• She prepared the room, scrubbed the floor and walls with antiseptics.

• Dressings were boiled, soaked and wrapped in antiseptic towels or large glass jars.

• She prepared everything that was needed including….

Surgical Supplies

• Hot water bottle• Stimulants• Clean towels• Soft rags• Lint• Basins• Pails• Hot and cold water• Bran • Sticking plaster• Carbonized water

• Ice • Pins• Needles• Silk• Petroleum jelly• Soap• Oil silk• Sponges• Rubber blanket• Pillow• Sheet to cover patient

OR Nursing Education

• The nurse was to read no medical books. Nursing texts did not exist.

• “If she wishes to be a physician, she should go to medical school.”

• “Nurses who read medical books are overburdening their brains.”

• “In any case, any information read would not be remembered overnight.”

World War I

OR Nursing France 1918

• Administered Anesthesia

• Sutured and Tied

• Placed Drains

• Removed Dead and Devitalized Tissue

OR & Anesthesia-First Nursing Specialties

Surgery 1918

Surgical Gloves

Choosing gloves for an Appy 1941

Recycling Gloves

Surgery Prep 1940s

X-ray Department 1940s

WWII Nurses

World War II

World War II Nurse POWs

New Professionalism

Instrument Nurses 1950s

Surgical Bunker - Korean War

Korean War OR

M.A.S.H. – Images of Nurses

Margaret “Hotlips” HoolihanA True Perioperative Nurse

Major Hoolihan’s image evolved much like the image of

nursing.

Surgery Team 1960s

Nursing Images of Viet Nam War

Capt Eleanor Grace Alexander, US Army, BSN, RN, Age 27Died in aircraft crash on 11/30/1967, Central Highlands, Republic of VietnamHer remains were guarded by Sgt W. J. Doyle, Jr, USAF, at Dover AFB, DE Mortuary

Operation Desert Storm

Student Nurses in the OR

Most nursing curricula offered 12-16 weeks perioperative

experience

Students were exposed to the practice of

perioperative nursing

1984 Survey of 1400 Schools

• 16.6% offered perioperative nursing in basic curriculum

• 13.3% reported integration of perioperative nursing as elective

• 67% had no perioperative content

• Virtually no perioperative experience offered today.

Welcome To Perioperative Nursing!