Intro Quiz: How did hospitals change over time and improve prevention and treatment of illness and disease?

Video: How did hospitals change over time and improve prevention and treatment of illness and disease?

﻿Hello, and welcome to another lesson about the history of medicine. This time, we'll be looking at how hospitals changed over time for mediaeval times, up to the end of the 19th century in the year 1900. My name is Mr Prudden, and I'll be talking you through all you need to know about the history of hospitals. Please check that you have a pen and paper or something to write on. Also find a nice quiet space to work with no distractions so that you can focus 100%. It would be sensible to keep all your notes for medicine for your time together and add to them with every lesson that you complete. Right, are you ready? Okay, well, let's begin. Can you remember what hospitals were like can mediaeval and renaissance times, which of these sentences relate to mediaeval hospitals and which three sentences relate to renaissance. Remember, when we're talking about mediaeval times, we mean between years, 1250 and 1500. And when we're talking about renascence times, we mean between the years 1500 and 1700. So A says, 30% were owned and run by the church, attached to monasteries, where monks and nuns said prayers for the sick. B, patients who were contagious were treated by specialist hospitals called Pest Hospitals. C, patients could expect a visit from physicians, who observed symptoms and prescribed treatments. Medicines were mixed by an apothecary on site. D, the purpose of a hospital was to care for the sick, not to cure or treat disease. Therefore, there were no physicians or surgeons on site. E, infectious patients were rejected as were pregnant women and the mentally ill. And the hospitals were kept clean. For example, patients bed, linen and clothing were changed regularly. So press pause, you might want to read the statements again, make your decisions, and then press play when you're ready to continue. Well done, A, D and E describe mediaeval hospitals. Remember mediaeval hospitals were places of care rather than treatment. Hence why no physicians or surgeons were on site. B and C, both described renaissance hospitals. whereas contagious patients were rejected from mediaeval hospitals, by the renascence time, there were specially built hospitals to treat patients with contagious diseases like plague and pox. Also note how in the renascence times hospitals start to become places of treatment, not just care as physicians visited and diagnosed the patients. F, can be mediaeval and renaissance. Hospitals were generally clean in both of these time periods. So let's review how hospitals changed between mediaeval and renaissance times. One example of progress was the type of care you likely received. Mediaeval patients were cared for, but not treated. For example, nuns would keep patients clean by washing them and changing their beds or monks would pray for them. Whereas in renaissance times, patients were visited by physicians who would observe their symptoms and prescribe them treatments. Another example of progress was how in renaissance times, infectious patients were now cared for and treated in pest houses. However, slightly worryingly by 1700, there were only five hospitals left in the country, all in London. So overall, I think we can describe the rate of progress or improvement between mediaeval and renaissance hospitals as slight progress. Now, a question for you to think about by yourself, would you expect progress into the next time period? Well, let's find out what happened next. So as already mentioned, by 1700, there were only five hospitals left in the country and they were all in London. However new hospitals did begin to appear in other cities in the 18th century, founded using donations from wealthy people and often members of the middle classes, such as lawyers and businessmen. Hospitals continued to become places where sick people were treated as opposed to places where people could rest and pray. Doctors visited patients regularly. And there was a surgeon as well as apothecary on site, for daily treatments. So now hospitals became places of surgery as well. A small staff of untrained nurses cared for the patients. Nursing was not a respected profession. Nurses were often criticised for being dirty or drunk. In this cartoon, actually called the drunken nurse, you can see a nurse is passed out while attending her patient because she's drunk. The patient is dying. The patient needs her help, but she's too drunk to be able to help. Hospitals were still not places that people often chose to be treated. The rich received medical treatment and even surgery in their own homes, because it was perceived to be much safer. Unfortunately, as more people started to attend, hospitals became less sanitary, less clean, less hygienic. They became less strict about turning away infectious patients. Doctors and nurses went from patient to patient and ward to ward without washing their hands or changing their clothes. Which meant diseases began to spread. Cramped and stuffy wards, which were not cleaned often enough or effective enough, helped infections to spread really quickly. Okay, so let's pause and reflect on what we've just discovered about hospitals in 1700. So can you complete the following sentences? So an example of progress, improvement between renaissance hospitals and hospitals by 1700 is... Two examples of regression are... So regression is the opposite of progression, when things get worse. I think the biggest problem with hospitals by 1700 was... And there's a challenge question for you. Why would you expect hospitals to improve from the 1860s? So press pause. And when you're ready to continue, press play. More great work well done. So examples of progress you could've mentioned, there were now more hospitals, some more places of treatment, surgery was now conducted in hospitals and there was even less reliance on prayer. A positive example of continuity, so a positive example of something that stayed the same. Doctors visits their patients and apothecaries were on site to mix treatments. And then examples of regression things getting worse. So hospitals were less sanitary. Like we said, doctors and nurses didn't clean their hands and wards were cramped and stuffy. Infectious patients were not turned away and nurses were not trained. For the challenge question. Why would you expect hospitals to improve from the 1860s? Well, there are two possible answers. One is a lady called Florence Nightingale, who we'll be looking at in a moment, you may already have heard of her, but the second is germ theory, which you have heard of before, definitely. So Pasteur published, scientific evidence in 1861, that linked dirt and disease, which Robert Cock went on to develop in the 1870s and 1880s. And like we discussed in our last lesson, faced with scientific proof, the government could no longer ignore the need to fund public health reforms, including in hospitals. So clearly we can see regression between renaissance and industrial hospitals. So in other words, hospitals were getting worse. Hospitals were now unsanitary, full of infection. They were not safe places to visit. Hence why the rich received medical treatment and even surgery in their own homes, because it was safer to stay at home. And nurses were untrained and often incompetent. So let's look at the next chapter of our story. When the Crimean war broke out between Britain, France and Russia in 1854, Florence Nightingale took 38 nurses to Crimea, which lies between Russia and Turkey. Arriving at the army hospital at Scutari, Nightingale and her nurses were appalled by the dirty conditions. Nightingale ordered 300 scrubbing brushes to get rid of any dirt near patients being treated. Nurses were organised to treat nearly 2000 wounded soldiers. Clean bedding and good meals were provided. And here's the thing, in six months, Florence Nightingale slashed the death rate from 40% to 2%. So by the time Nightingale returned to Britain in 1856, she was a national hero. There'd been a great deal of publicity about the conditions in war hospitals and Nightingale was famous for making a big difference. This gave her credibility and helped her to make changes to hospitals in Britain too. So how did Florence Nightingale improve hospitals in Britain? So we can divide her improvements into three. The training of nurses, cleanliness and the design of hospitals. So lets start with training of nurses. Nightingale wrote a book called notes on nursing in 1859. Setting out the key role of a nurse and the importance of thorough training. In 1860, Nightingale set up the Nightingale school for nurses at St. Thomas's Hospital London. Here, nurses were trained mainly on sanitary matters, at cleanliness, importance of hygiene. Nightingale made nursing seem like a respectable occupation. Nightingale nurses were more often middle class women. Previously nurses had been from working class backgrounds and had a reputation for being drunk, flirtatious, and uncaring. But rigorous training turned nursing into a profession, rather than a simple unskilled job and this encouraged more women to sign up. And so the number and skill of nurses grew rapidly. Let's have a look at cleanliness. So Nightingale's recommendations, new hospitals were built out of materials that could be easily cleaned. Nightingale believed dirt spread disease. So tiles on the floors and painted walls and ceilings made it possible to wash all surfaces and get rid of the dirt. Nightingale also pushed for ventilation to make sure patients got fresh, clean air to breathe, as well as clothing and washing facilities for patients. The Nightingale School for Nurses, ensured nurses were trained mainly on sanitary and hygiene. And then hospital design, Nightingale promoted what we call, pavilion style hospitals. Where separate wards were built in hospitals to ensure infectious patients could be kept separate. Okay, so let's pause for a moment and check our Nightingale knowledge. For each of the following. Is it true or is it false. And if it is false, why is it false? And make the correction. So pause the video, make your decisions and press play when you're ready. Well done. So A, is false. It was in six months, not 12, that Nightingale slashed the death rate from 40% to 2%. B is also false, Nightingale wrote notes on nurses in 1859, not hospitals. If you remember, notes on nursing sets out the key role of a nurse and the importance of thorough training. C is true, Nightingale did make nursing seem like a respectable occupation. Remember, before, Nightingale nurses had been from working class backgrounds and had a reputation for being drunk, flirtatious and uncaring. D is also true, but E is false. Nightingale promoted pavilion style hospitals, not Nightingale style. These hospitals had separate wards to ensure infectious patients could be kept separate. So what were hospitals like by the end of the 19th century and by 1900? Well, by the end of the 19th century, progress in hospitals had continued. Many different wards split up infectious patients from those requiring surgery. Operating theatres and specialist departments for new medical equipment provided separate spaces for certain procedures. So hospitals were far more organised. Cleanliness was now at the utmost importance. So antiseptics where you use to clean up germs and prevent them from getting in to begin with. Operating theatres were rigorously cleaned. And from 1887, all medical instruments were steam sterilised. Why? We'll remember, Pasteur's germ theory of 1861 had scientifically linked dirt and disease. As mentioned last lesson, faced with scientific proof, the government could no longer ignore the need to fund public health reforms. And this included hospital conditions. Doctors, junior doctors who were training and trained nurses were a common sight. So I think we can describe the progress from the 1860s as rapid. Why? Well, one key example of rapid progress, was the quality of nurses. By 1700, a small staff of untrained nurses cared for the patients. They were often not respected and regarded as negligent. Whereas by 1900, Nightingale schools for nurses provided nurses with that much needed and thorough training on sanitary matters. And seeing nurses being trained in a hospital was a common sight. Another example of rapid progress was hospital cleanliness. In 1700, hospitals were really unsanitary, weren't they? Not helped by doctors going from patient to patient around the different wards, without washing their hands or changing their clothes. Whereas by 1900, antiseptics were being used to clean up germs and prevent them getting in to begin with. So I think it's really important to emphasise that history is not just a story of continued progress. Remember the quality of hospitals actually regressed got worse between 1700 and the 1860s before the rapid progress took place. Now let's read through the comprehension questions really carefully. So question one, can you describe two problems with hospitals by 1700? Question two, how did Florence Nightingale, improve the cleanliness of hospitals? Question three, what was a pavilion style hospital? Question four, can you describe two big improvements made to hospitals by 1900? And question five is your challenge question. How far do you agree that Florence Nightingale, was mostly responsible for improved hospital conditions in the second half of the 19th century? For this question think, did hospitals improve just because of Nightingale or did something else contribute to progress as well? You may want to use the sentence starters to help you. So now pause the video, read the slides on the resource worksheet and answer the comprehension questions. Then press play. When you're ready to review your answers. Very well done for working hard, answering those comprehension questions. So now let's review our answers. So question one asked, can you describe two problems with hospitals by 1700? So here are a few examples of those problems. Don't panic if you've written something slightly different to me. So I said, hospitals became less sanitary, less hygienic, than they had been previously in the renaissance. One reason was because they became less strict about turning away infectious patients. Remember in the renaissance, there were pest houses where the infectious patients went to. By 1700, the infectious were mixing with the non-infectious, very silly. Doctors and nurses went from patient to patient without washing their hands or changing their clothes, which meant diseases began to spread. We're talking about really unhygienic standards here. Wards were cramped and stuffy and not cleaned often or effectively enough, which again, helped infection to spread. And as we've said before, nurses were often criticised for not doing their job properly, for being dirty, for being drunk. Remember the picture you saw of the nurse being drunk while on duty. Question two, how did Florence Nightingale, improve the cleanliness of hospitals? Well, she encouraged the building of new hospitals out of materials that could be easily cleaned. For example, tiles on the floors and painted walls and ceilings made it possible to spot all the dirt and also to wash over surfaces and get rid of the dirt. She also encouraged good ventilation to make sure patients got fresh, clean air to breathe, as well as clean clothing and washing facilities for patients. And finally the Nightingale School for Nurses ensured that nurses were trained mainly on those hygienic standards in sanitary matters. So the importance of keeping clean became central. Question three. What was a pavilion style hospital? So these were the type of hospitals promoted by Nightingale, where separate wards were built in hospitals to ensure that the infectious patients were kept away, kept separated from the non-infectious patients. Question four, can you describe two big improvements made to hospitals by 1900? So here are some examples, as of question one, don't panic if you've included something different. So I said, would different wards split up the infectious from the non-infectious and from those requiring surgery? So like renaissance times, there was now a clear division between infectious and non-infectious. Operating theatres and specialist departments for new medical equipment provided separate spaces for certain procedures. So like I said earlier, hospitals were far more organised. Antiseptics were being used to clean up germs and prevent them from getting in to begin with. For example, from 1887, all medical instruments were sterilised. So hospitals by 1900 were sanitary and very hygienic. And doctors, junior doctors who training and trained nurses were now a common sight. So there was clear emphasis on the importance of medical training. It's like we said earlier, it became more professional. The whole idea of working in hospital, working as a medic or a nurse, you were trained, you were professional. And your challenge question, how far do you agree that Florence Nightingale was mostly responsible for the improved hospital conditions in the second half of the 19th century? So if we start with evidence to agree, so Nightingale wrote notes on nursing in 1859, setting up the key role of a nurse and the importance of thorough training. This helped make nursing seem like a respectable occupation. The Nightingale School for Nurses ensured nurses were training mainly on sanitary matters. So she helped improve the hygiene in hospitals. And she also promoted pavilion style hospitals, where separate wards were built in hospitals to ensure infectious patients could be kept separate. So she makes nursing more respectable. She makes hospitals cleaner, more sanitary and she also helps redesign hospitals to make them more organised and also more, more clean and hygienic places. And then we've got evidence to disagree. So you could argue that actually, hospital conditions really improved because of germ theory. And this is because Louis Pasteur germ theory of 1861, scientifically linked dirt and disease. And it's because of this, we end up getting antiseptics being used to clean up germs and prevent them from getting in to begin with. So it's the scientific proof that germs spread disease, that pushed the government into funding and improving hospital cleanliness. And this is a theme we're going to tackle next lesson as well. When we look at how surgery improved in the 19th century. Well done, great work this lesson, once again, you've taken on board, lots of new ideas. Next lesson, you will look at how surgery changed over time. And in particular key developments in the 19th century. It'll be a really good idea to summarise hospitals in each of the time periods we've looked at, this lesson. Mediaeval, renaissance, 1700 and by 1900. One sentence for each. And don't forget to see how much you've learned this lesson by taking the exit quiz now. Well, all that's left for me to say is, thank you, take care and enjoy the rest of your learning for today.

Worksheet: How did hospitals change over time and improve prevention and treatment of illness and disease?

Exit Quiz: How did hospitals change over time and improve prevention and treatment of illness and disease?

Completed: How did hospitals change over time and improve prevention and treatment of illness and disease?

In this lesson you will consider the rate of progress in hospital care and treatment from medieval times to the year 1900. In particular, you will look at the state of hospitals by 1700, the significance of Florence Nightingale, and why hospitals had changed so much by 1900.

History

Y10 History

Key Stage 4

Year 10

How did hospitals change over time and improve prevention and treatment of illness and disease?

Medicine through time, c.1250-present day

UNIT

How much medical progress did ancient Greece and Rome make?

What did people think about where disease came from in medieval Britain?

How did people in medieval times try to prevent and cure diseases?

Who did people go to for medical help in medieval times?

What can the Black Death tell us about medieval medicine?

How much medical progress was made during medieval Britain?

Why was there greater medical progress between 1500-1700?

Why did ideas about causes of disease change between 1500-1700?

How did individuals change medical understanding between 1500-1700?

How did ideas about the cause of disease change between 1700-1900?

Why did ideas about the cause of disease change between 1700-1900?

How did ideas about causes of disease change after 1900?

How quickly did ideas about causes of disease change and why did ideas change over time?

Did ideas about prevention and treatment change between 1500-1700?

How did approaches differ in dealing with the Great Plague compared to the Black Death?

When did vaccination really start to make a difference to health in Britain?

How far did John Snow change ideas about the prevention of disease?

How and why did ideas about responsibility for public health change?

Why were there improvements in surgery?

Did the NHS transform medicine in Britain?

How far did treatment advance in the 20th century?

How important was the role of chance in the discovery and development of penicillin?

How has the use of science and technology changed ideas around the treatment and prevention of lung cancer?

How quickly did ideas about prevention and treatment of disease change and why did ideas change over time?

How were trenches designed and why did battles on the Western Front lead to medical advancement?

What medical conditions were there on the Western Front?

How far did war on the Western Front give rise to new techniques in medical treatment?

How were wounded soldiers helped on the Western Front?

How far did WW1 accelerate medicine and treatment in the 20th century?

History

How did hospitals change over time and improve prevention and treatment of illness and disease?

Introductory Quiz

Video

Worksheet

Final Quiz

Lesson Complete