Nightingale Schools: Moving Nursing Outside the HospitalIn September, we discussed how nursing education evolved from practical training in hospitals to diploma schools. Practical training in hospitals was difficult work, and while it prepared nurses for palliative and post-procedural care, it wasn’t the most thorough training. Many student nurses were left to learn on their own.

Practical training then moved toward diploma schools, where nurses earned more formal recognition of their training: a diploma calling them a qualified nurse. Yet this training wasn’t thorough enough for many of the greatest nurses of the time, many of whom were trained deaconesses or held their own diplomas.

The greatest reformer of nursing education is also one of the most well-known nurses in history: Florence Nightingale. Influenced by her own education and her experiences in the Crimean War, Nightingale became an advocate for more enhanced nursing training. She was able to see the fruits of her reform: academic nursing schools established in her name.

St. Thomas’ Hospital: The First Nightingale School

Today, the Nightingale Faculty of Nursing and Midwifery is part of King’s College, London, but its origins are with St. Thomas’ Hospital, one of the oldest hospitals in the United Kingdom.  It established its medical school in 1550 and continues to provide care and training today.

Nightingale established her school of nursing at St. Thomas’ in 1860. The Crimean War played a role in Nightingale’s training and her attitude toward health care and its reform. Nightingale’s effect on the war was a direct reaction to reports of the conditions in the field hospitals.

Asked by the British Minister of War, an acquaintance, to establish the presence of female nurses in the battlefield hospitals, Nightingale and 38 nurses traveled to Scutari in November of 1854. Working in these hospitals showed Nightingale, and others, that nursing training still needed more formalization.

Because of the pioneering work she did in the Crimea, members of the public established the Nightingale Fund. This early form of crowdfunding raised nearly £45,000, equivalent to £2,000,000 today. Nightingale used the fund to set up the training school at St. Thomas’, and the first class began training on July 9, 1860.

The Birth of Nursing Certifications

Nightingale’s training school established two tracks for trainee nurses: one for upper class women and one for the country's others classes. Traditionally separated, these two tracks received the same education and training while at the school but different compensation at the end.

A graduate of the common classification, as it was called, received a small stipend and a placement, in either a home or another institution. The upper class graduates, who were still expected to marry and produce children, were given their educations and a chance to assist in the school if they wished.

Students would study for a year, and if their training and character met standards, they were certified to nurse patients.  Upon graduation, they would get the opportunity to meet Nightingale herself.  The great healthcare reformer had retreated from the public eye by the time students began graduating from her school.

The original Nightingale school, still going strong today, is the first nursing school to be connected for its entire history to a working hospital and medical school. This connection to both a medical school and a serving hospital serves as the model for much of today’s nursing training.

Just as it evolved from one style of nursing education, it also continued to evolve over the years.  Its main areas of modern specialization are child and adolescent nursing; midwifery and women's health; adult nursing; mental health nursing; and postgraduate research.

Specializations such as these serve as the next step in the evolution of nursing education: diploma nursing, which is unique to last month’s discussion of diploma schools. Come back to next month to learn about the difference.


Biography of Florence Nightingale.  Retrieved from

Crimean War.  Retrieved from

Florence Nightingale Faculty of Nursing and Midwifery.  Retrieved from

History’s Favorite Nurses.  Retrieved from

"The very first requirement in a hospital is that it should do the sick no harm."
~Florence Nightingale