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Both nursing roles and education were first defined by Florence Nightingale, following her experiences caring for the wounded in the Crimean War.[1] Prior to this, nursing was thought to be a trade with few common practices or documented standards. Nightingale's concepts were used as a guide for establishing nursing schools at the beginning of the twentieth century, which were mostly hospital-based training programs emphasizing the development of a set of clinical skills.[1]The profession's early utilization of a general, hospital-based education is sometimes credited for the wide range of roles nurses have assumed within health care, and this is contrasted with present-day nursing education, which is increasingly specialized and typically offered at post-secondary institutions.[2]

Practice as a nurse is often defined by state, provincial or territorial governments. As an example, the province of Ontario classifies nurses into the roles of

Registered Practical Nurse, Registered Nurse (general class), and Registered Nurse (extended class).[3] In this respect, the title "nurse" is protected by lawwithin the province, and regulated by legislative statute.[3] Some regions havelegislated different or expanded roles for nurses, generating many potential nurse careers.

Around the world, nurses have been traditionally female. Despite equal opportunity legislation nursing has continued to be a female dominated profession.[4] Forinstance, in Canada and America the male-to-female ratio of nurses is approxima

tely 1:19.[5][6] This ratio is represented around the world. Notable exceptionsinclude: Francophone Africa, which includes the countries of Benin, Burkino Faso, Cameroon, Chad, Congo, Ivory Coast, the Democratic Republic of Congo, Djibouti, Guinea, Gabon, Mali, Mauritania, Niger, Rwanda, Senegal, and Togo, which all have more male than female nurses.[7] In Europe, in countries such as Spain, Portugal, Czechoslovakia, and Italy, over 20% of nurses are male.[7]

Currently, a nursing shortage exists within the United Kingdom, United States, Canada, and a number of other developed countries.[8] The majority of analysis refers to a shortage of Registered Nurse staff.[8] The Canadian Registered Nurse shortage has been linked to longer wait times for hospital-based procedures, increased adverse events for patients, and more stressful work environments.[9] As the shortage of Registered Nurses increases, it is expected that there will be an

increasing move towards utilizing unregulated healthcare workers to meet demands for basic nursing care within hospitals and the community.[10]

[edit] EducationTypically, nurses are distinguished from one another by the areathey work in (critical care, perioperative, oncology, nephrology, pediatrics, a

dult acute care, geriatrics, psychiatric, community, occupational health, etc.).Bodies such as the American Nurses Association and the Canadian Nurses Associat

ion have both supported a move towards the creation of national specialty certifications, in order to support more specialized nursing roles.[11] As nursing rol

es and specialties are continually changing, the International Council of Nursesstates that nursing education should always include continuing education activities; while educational preparation is expected to vary between countries, all nursing jurisdictions are encouraged to promote continuing education as an important form of professional education.[12]

Nursing education varies widely, and continues to produce an array of options asnursing roles evolve and also expand in scope. Educational preparation as a nur

se may include certificate, diploma, associates, bachelors, masters or doctoralpreparation.

[edit] EtymologyThe English word nurse also refers to the act of breastfeeding.[13] A wet nurse is considered someone who provides her own breast-milk to infant

s. In other languages, the word for nurse comes from the same etymology as the word infirmary, such as in French (infirmier), or Italian (infermiere).