Widely recognized as the founder of modern nursing, Florence Nightingale is best known for her role during the Crimean War (1853–1856) as a manager of volunteer nurses and advocate for improved sanitary conditions in military hospitals to help prevent infection. Her work to help improve sanitation, nutrition, and the overall conditions in which patients were kept helped dramatically reduce death rates during the war and were later implemented in civilian hospitals upon her return to England. Her advocacy for the use of statistics as a tool in decision making helped set a precedent for continued growth and ingenuity in healthcare, while her work in highlighting the importance of sanitary conditions in hospitals has directly impacted the standard of hospital conditions today.

Nurses commonly find themselves challenging controversial practices. Their first-hand knowledge of the patient experience often gives them a more in-depth understanding of patient needs. The importance of perseverance in the face of controversy was exemplified by Australian nurse Elizabeth Kenny in the early 1900s. With no official record of formal training, Kenny is believed to have been self-trained. She began her career as a home nurse providing care to anyone in need and later opened a cottage hospital for patients suffering from polio. Due to her lack of formal education, Kenny faced harsh criticism on her approach to treating polio, which completely defied the standard practice of immobilization. Instead of using casts and splints, her treatment focused on passive movement of affected limbs in combination with hot compresses — a basis of muscle rehabilitation that would later become the foundation for physical therapy as a treatment for various conditions.

Phototherapy, or the use of visible light for the treatment of jaundice in the newborns, is one of the most common nonroutine therapies used in newborn conditions – but this was not always the case. Sister Jean Ward of Rochford General Hospital in Essex, England, became aware of the benefits of phototherapy in 1956 when she would wheel infants afflicted with jaundice outdoors into the hospital courtyard against the doctors’ wishes. The visibly improved state of newborns exposed to sunlight created undeniable reassurance in her belief that sunlight could better treat jaundice in this population; it also provided a much simpler solution than the existing standard practice of transfusing blood over a period of several hours. This new treatment would almost completely eliminate the need for donor blood while achieving the same results. Upon sharing her findings with physicians and scientists at Rochford Hospital, Ward’s observances sparked continued research in this approach and the idea of phototherapy for neonatal jaundice was developed.

At the dawn of the AIDS epidemic, when the disease was spreading faster than information about the disease could be obtained, it was at a great personal risk that nurses stood by patients as they faced painful symptoms and, many times, death. In San Francisco General Hospital, care units Ward 5B and 5A were specifically designed for care addressing AIDS symptoms and were primarily managed by nurses. There nurses defied convention and treated HIV/AIDS patients with compassion, finding innovative ways to improve care. The patient-focused approach implemented by nurses in the unit played a leading role in gathering information to transform the disease from a fatal prognosis into a manageable condition and was essential in providing care for patients in a time where no standard treatment existed. Nurses like Alison Moed Paolercio, Ward 5B’s first nurse manager, were also critical players in developing a new standard of care in the face of limited information, defining a crucial role in the care of patients with AIDS by providing comfort, managing symptoms and often caring for those who were dying.

It is the ability to be resourceful even in the wake of an epidemic that makes student nurse Fatu Kekula an example of nurse innovation inspired by ultimate necessity. When her father became frighteningly ill and hospitals in Liberia were at full capacity, Fatu had no choice but to treat him and eventually the rest of her family, at home with limited resources. Following the guidance of her family doctor who refused to come to her house but would help over the phone, Fatu became the only hope for saving her entire family. Plastic trash bags, a pair of rainboots, a rain jacket and a mask transformed into the daily uniform that kept Fatu safe from contracting what would later be identified as the Ebola virus. Following the meticulous daily process of ensuring her gear was as protective as possible, Fatu saved her family by providing medications obtained at a local clinic and administering fluids through intravenous lines she started herself — before she even finished nursing school.

As advances in technology continue to transform healthcare practices, it is up to leaders in the healthcare community to develop improvements in patient care that speak directly to patient needs — or even better, help patients speak for themselves. This is exactly what nurse Rebecca Koszalinski had in mind when she developed Speak for Myself^®, a mobile app specifically developed to help patients who are unable to communicate, express their needs more quickly and precisely.

Johnson & Johnson is proud to spotlight how nurses like these throughout history and today are bringing innovation to patient care that is profoundly changing human health. Watch an extended cut below of our Nurses Change Lives video for more inspiration from these pioneering nurses who have impacted patient outcomes throughout history.

Nurses change lives. And that changes everything.