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Florence Nightingale Medal

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118-679: The Florence Nightingale Medal is an international award presented to those distinguished in nursing and named after British nurse Florence Nightingale . The medal was established in 1912 by the International Committee of the Red Cross (ICRC), following the Eighth International Conference of Red Cross Societies in London in 1907. It is the highest international distinction a nurse can achieve and

236-602: A plurality of seats in parliament, and Milton Margai was re-elected as prime minister. Margai was popular among Sierra Leoneans during his time in power, mostly known for his self-effacement. He was neither corrupt nor did he make a lavish display of his power or status. He based the government on the rule of law and the separation of powers, with multiparty political institutions and fairly viable representative structures. Margai used his conservative ideology to lead Sierra Leone without much strife. He appointed government officials to represent various ethnic groups. Margai employed

354-452: A bed. They often delegate such care to nursing assistants . Medication management and administration are common hospital nursing roles, although prescribing authority varies across jurisdictions. In many areas, RNs administer and manage medications prescribed by others. Nurses are responsible for evaluating patients throughout their care – including before and after medication administration – adjustments to medications are often made through

472-486: A brokerage style of politics, by sharing power among political parties and interest groups; especially the involvement of powerful paramount chiefs in the provinces, most of whom were key allies of his government. Upon Milton Margai's unexpected death in 1964, his younger half-brother , Sir Albert Margai, was appointed as prime minister by parliament. Sir Albert's leadership was briefly challenged by Foreign Minister John Karefa-Smart, who questioned Sir Albert's succession to

590-720: A collaborative effort between the prescriber and the nurse. Regardless of the prescriber, nurses are legally responsible for the drugs they administer. Legal implications may accompany an error in a prescription, and the nurse may be expected to note and report the error. In the United States, nurses have the right to refuse to administer medication that they deem to be potentially harmful. Some nurses take additional training that allows them to prescribe medications within their scope of practice. Effective patient/family education leads to better outcomes. Nurses explain procedure, recovery, and ongoing care, while helping everyone cope with

708-550: A delegate from the British Red Cross. In 2015, the 45th set of medals were awarded to 36 recipients from 18 countries, including one posthumously to a Sierra Leonian nurse, Mr Morison Musa, who had worked in an Ebola treatment centre. In 2017, the 46th set of medals were awarded to 39 recipients from 22 countries, including one to Rear Admiral Sylvia Trent-Adams , the Acting Surgeon General of

826-652: A few hundred municipal hospices to remain in operation in northern Europe. Nuns who had been serving as nurses were given pensions or told to marry and stay home. Nursing care went to the inexperienced as traditional caretakers, rooted in the Roman Catholic Church , were removed from their positions. The nursing profession in Europe was extinguished for approximately 200 years. During the Crimean War , Grand Duchess Elena Pavlovna called for women to join

944-453: A green laurel crown. Recipients are also presented with a parchment diploma of the award and, from 1927, a miniature version of the medal that could be more easily worn. The medal and a diploma are usually presented by the head of state at a ceremony in their own country, which is required to have "a formal character, in keeping with the founders' wishes". In 2007, the 41st set of medals were awarded to 35 recipients from 18 countries. In 2009,

1062-647: A half century, over 5,000 deaconesses had surfaced in Europe. Formal use of nurses in the military began in the latter half of the nineteenth century. Nurses saw active duty in the First Boer War , the Egyptian Campaign (1882), and the Sudan Campaign (1883). In the 19th and early 20th century, nursing was considered a woman's profession, just as doctoring was a profession for men. With increasing expectations of workplace equality during

1180-409: A local African chieftain, but he retaliated, attacking the settlement, which was reduced to a mere 64 settlers comprising 39 black men, 19 black women, and six white women. Black settlers were captured by unscrupulous traders and sold as slaves, and the remaining colonists were forced to arm themselves for their own protection. The 64 remaining colonists established a second Granville Town. Following

1298-634: A move that foreshadowed the women's suffrage movements in Britain, the heads of all households, of which a third were women, were given the right to vote. Black settlers in Sierra Leone enjoyed much more autonomy than their white equivalent in European countries. Black migrants elected different levels of political representatives, 'tithingmen', who represented each dozen settlers and 'hundreders' who represented larger amounts. This sort of representation

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1416-578: A narrower scope of practice. Nursing is a female-dominated profession in many countries; according to the WHO's 2020 State of the World's Nursing, approximately 90% of the nursing workforce is female. For instance, the male-to-female ratio of nurses is approximately 1:19 in Canada and the United States. This ratio is matched in many other countries. Notable exceptions include Francophone Africa , which includes

1534-632: A plan of care, working collaboratively with physicians , therapists , patients, patients' families, and other team members that focuses on treating illness to improve quality of life. In the United Kingdom and the United States, clinical nurse specialists and nurse practitioners diagnose health problems and prescribe medications and other therapies, depending on regulations that vary by state. Nurses may help coordinate care performed by other providers or act independently as nursing professionals. In addition to providing care and support, nurses educate

1652-649: A prominent Temne chief in Kasseh who was fighting against the "hut tax". The war was later known as the Hut Tax War of 1898 . Madam Yoko ( c.  1849 –1906) was a woman of culture and ambition. She employed her capacity for friendly communications to persuade the British to give her control of the Kpaa Mende chiefdom. She used diplomacy to communicate with local chiefs who did not trust her friendship with

1770-581: A protracted civil war broke out between the government and the Revolutionary United Front (RUF) rebel group. The conflict, characterized by multiple coups d'état , persisted for 11 years. Intervention by ECOMOG forces and later by the United Kingdom resulted in the defeat of the RUF in 2002, ushering in a period of relative stability. The two major political parties that remain are the APC and

1888-808: A single political system for both the Colony and the Protectorate. Most proposals came from leaders of the Protectorate, whose population far outnumbered that in the colony. The Krios, led by Isaac Wallace-Johnson , opposed the proposals, as they would have resulted in reducing the political power of the Krios in the Colony. In 1951, Lamina Sankoh ( born :Etheldred Jones) collaborated with educated protectorate leaders from different groups, including Sir Milton Margai , Siaka Stevens , Mohamed Sanusi Mustapha, John Karefa-Smart , Kande Bureh, Sir Albert Margai , Amadu Wurie and Sir Banja Tejan-Sie joined together with

2006-787: A source of free/inexpensive labor. Exploitation of nurses was not uncommon by employers, physicians, and education providers. Many nurses saw active duty in the First World War , but the profession transformed again during the Second World War . British nurses of the Army Nursing Service were part of every overseas campaign. More nurses volunteered for service in the US Army and Navy than any other occupation. The Nazis had their own Brown Nurses, numbering 40,000. Two dozen German Red Cross nurses were awarded

2124-412: A wide range of settings, including hospitals, private homes , schools , and pharmaceutical companies . Nurses work in occupational health settings (also called industrial health settings), free-standing clinics, physician offices, nurse-led clinics , long-term care facilities and camps. They work on cruise ships , military bases , and in combat settings. Nurses act as advisers and consultants to

2242-463: Is awarded to nurses or nursing aides for "exceptional courage and devotion to the wounded, sick or disabled or to civilian victims of a conflict or disaster" or "exemplary services or a creative and pioneering spirit in the areas of public health or nursing education" . The Florence Nightingale Medal Commission comprises several members and staff of the ICRC, several of whom are nursing professionals, and

2360-537: Is defined and governed by law, and entrance to the profession is regulated at the national or state level. The nursing community worldwide aims for professional nurses to ensure quality care, while maintaining their credentials, code of ethics , standards, and competencies, and continuing their education. Multiple educational paths lead to becoming a professional nurse; these vary by jurisdiction; all involve extensive study of nursing theory and practice as well as training in clinical skills. Nurses provide care based on

2478-533: Is described in many sources as "the first visiting nurse". These traditions were influential in the development of the ethos of modern nursing. Its religious roots remain in evidence in many countries. One example in the United Kingdom is the use of the historical title "sister" to refer to a senior nurse. During the Reformation , Protestant reformers shut down monasteries and convents, allowing

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2596-438: Is divided into five administrative regions, which are further subdivided into 16 districts . Sierra Leone is a presidential republic , with a unicameral parliament and a directly elected president . It is a secular state . Its constitution provides for the separation of state and religion and freedom of conscience (which encompasses both freedom of thought and religion ). Muslims constitute three-quarters of

2714-406: Is further complicated by the numerous interpretations of nursing's defining essence. During the 1980s there was an increased focus on research utilization (RU). Nursing research took an interest in clinical issues and US nursing schools began teaching research methods to facilitate interpretation and integration of scientific findings in routine practice. Several RU initiatives were active during

2832-400: Is marked by continuous human habitation for at least 2,500 years, influenced by migrations from across Africa. The adoption of iron technology by the 9th century and establishment of agriculture by 1000 AD along the coast. Climate shifts over centuries altered the ecological zones, influencing migration and conquest dynamics. The region's dense tropical rainforest and swamps, coupled with

2950-468: Is rich with natural resources, notably diamonds, gold, bauxite and aluminium. As of the most recent survey in 2019, 59.2% of the population is affected by multidimensional poverty and an additional 21.3% vulnerable to it. Sierra Leone maintains membership in several international organizations, including the United Nations, African Union, Economic Community of West African States (ECOWAS), and

3068-406: Is selected based on the care setting and the population served. In providing nursing care, the nurse uses both nursing theory and best practice derived from nursing research . Many nursing theories are in use. Like other disciplines, the profession has developed multiple theories derived reflecting varying philosophical beliefs and paradigms or worldviews . In general terms, the nursing process

3186-753: Is the method used to assess and diagnose needs, plan outcomes and interventions, implement interventions, and evaluate outcomes. The nursing process as defined by the American Nurses Association comprises five steps: 1) evaluate, 2) implement, 3) plan, 4) diagnose, and 5) assess. Digital health platforms connect nurses and nurse assistants with job openings in healthcare facilities such as skilled nursing homes, home health agencies, and hospitals. Platforms offer an app to facilitate communication and allow nurses to find work opportunities based on their preferences. Healthcare partners and facilities benefit from access to qualified nurses. In 2017,

3304-408: Is the most diverse of all health care professions . Nurses practice in a wide range of settings, but generally follows the needs of their patients. The major specialties are: Nurses with additional degrees allow for specialization. Nursing professions can be separated into categories by care type, age, gender, certain age group, practice setting, individually or in combination. Nurses practice in

3422-458: The All People's Congress (APC), the country adopted a new constitution, transforming Sierra Leone into a presidential republic, with Stevens as the inaugural president. In 1978, Stevens declared the APC to be the sole legally recognized party . In 1985, he was succeeded by Joseph Saidu Momoh . Momoh's enactment of a new constitution in 1991 reintroduced a multi-party system . That same year,

3540-558: The Creole/Krio ethnicity and an English-based creole language ( Krio ), which is the lingua franca and de facto national language used among many of the ethnicities in the country. The colonial era saw Sierra Leone evolving under British rule, with a unique settlement pattern composed of displaced Africans following the abolition of the slave trade . Sierra Leone developed as an educational center in West Africa, with

3658-510: The Iron Cross for heroism under fire. The development of undergraduate and post-graduate nursing degrees came after the war. Nursing research and a desire for association and organization led to the formation of professional organizations and academic journals . Nursing became recognized as a distinct academic discipline, initially tasked to define the theoretical basis for practice. Nurses are perceived to be in short supply around

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3776-495: The Republic of Sierra Leone , is a country on the southwest coast of West Africa . It is bordered to the southeast by Liberia and by Guinea to the north. Its land area is 71,740 km (27,699 sq mi). It has a tropical climate and environments ranging from savannas to rainforests . As of the 2023 census, Sierra Leone has a population of 8,908,040. Freetown is both its capital and its largest city. The country

3894-745: The Sierra Leone Company was established to relocate Black Loyalists who wanted to take their chances in West Africa. In 1792 nearly 1,200 persons from Nova Scotia crossed the Atlantic to build the second (and only permanent) Colony of Sierra Leone and the settlement of Freetown on 11 March 1792. In Sierra Leone they were called the Nova Scotian Settlers , the Nova Scotians , or the Settlers . Clarkson initially banned

4012-418: The first schools of nursing to be connected to a hospital and medical school. It spread widely in Europe and North America after 1870. Nightingale included five factors that helped nurses in her time who worked amidst poor sanitation and little education. These factors included fresh air, clean water, a working drainage system, cleanliness, and good light. Nightingale believed that a clean working environment

4130-490: The paramount chiefs in the face of Krio intransigence. Later, Margai used the same skills to win over opposition leaders and moderate Krio elements to achieve independence from the UK. In November 1951, Margai oversaw the drafting of a new constitution, which united the separate Colonial and Protectorate legislatures and provided a framework for decolonisation . In 1953, Sierra Leone was granted local ministerial powers and Margai

4248-467: The (British) monopoly on Sierra Leone trade. At about the same time (following the Slave Trade Act 1807 which abolished the slave trade), Royal Navy crews delivered thousands of formerly enslaved Africans to Freetown, after liberating them from illegal slave ships. These Liberated Africans or recaptives were sold for $ 20 a head as apprentices to the white settlers, Nova Scotian Settlers, and

4366-558: The 19th century in the Crimea, Central America, and Jamaica. Her predecessors had great success as healers in the Colony of Jamaica in the 18th century, and they included Seacole's mother (Mrs. Grant), Sarah Adams, Cubah Cornwallis , and Grace Donne, the mistress and doctress to Jamaica's wealthiest planter, Simon Taylor . Other important nurses in the development of the profession include: Red Cross chapters, which began appearing after

4484-639: The 42nd set of medals were awarded to 28 recipients from 15 countries, including one for the first time to a nurse in Afghanistan , Sister Anisa In 2011, the 43rd set of medals were awarded to 39 recipients from 19 countries, including for the first time to two Kenyan nurses, as well as to the first recipient from the Central African Republic - Sylvie Ngouadakpa . In 2013, the 44th set of medals were awarded to 32 recipients from 16 countries, including one posthumously to Khalil Dale MBE,

4602-490: The 50th set of medals were awarded to 37 nurses from 22 countries, including three posthumously to: Meggist Menil Abetew, and Amidekrose Aregaw Gebiru, both Ethiopian ambulance drivers who were shot dead in the Tigray region; Margita Kosturikova, a Slovakian nurse. In 2023, Wilbroad William Rwenyagira became the first Tanzanian awardee of this medal. Nursing Nursing is a health care profession that "integrates

4720-849: The American Revolution, Black Loyalists from Nova Scotia , Canada, were relocated to Sierra Leone, founding Freetown and contributing significantly to the Krio people and Krio language that would come to define the region. Following the American Revolution , more than 3,000 Black Loyalists had also been settled in Nova Scotia , where they were finally granted land. They founded Birchtown , but faced harsh winters and racial discrimination from nearby Shelburne . Thomas Peters pressed British authorities for relief and more aid; together with British abolitionist John Clarkson ,

4838-698: The British Crown founded a settlement in Sierra Leone in what was called the " Province of Freedom ". About 400 black and 60 white colonists reached Sierra Leone on 15 May 1787. After they established Granville Town , most of the first group of colonists died, owing to disease and warfare with the indigenous African peoples ( Temne ), who resisted their encroachment. When the ships left them in September, they had been reduced to "276 persons, namely 212 black men, 30 black women, 5 white men and 29 white women". The settlers that remained forcibly captured land from

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4956-502: The British decided they needed to establish more dominion over the inland areas, to satisfy what was described by the European powers as "effective occupation". In 1896 it annexed these areas, declaring them the Sierra Leone Protectorate. With this change, the British began to expand their administration in the region, recruiting British citizens to posts and pushing Krio people out of positions in government and even

5074-652: The British evacuated from the nascent United States and resettled in colonies elsewhere in British North America . Pro-slavery advocates accused the Black Poor of being responsible for a large proportion of crime in 18th century London. While the broader community included some women, the Black Poor seems to have exclusively consisted of men, some of whom developed relationships with local women and often married them. Slave owner Edward Long criticized marriage between black men and white women. However, on

5192-491: The British. Because Madam Yoko supported the British, some sub-chiefs rebelled, causing Yoko to take refuge in the police barracks. For her loyalty, she was awarded a silver medal by Queen Victoria . Until 1906, Madam Yoko ruled as a paramount chief in the new British Protectorate. The British annexation of the Protectorate interfered with the sovereignty of indigenous chiefs. They designated chiefs as units of local government, rather than dealing with them individually as had been

5310-631: The Commonwealth of Nations, among others. Sierra Leone derives its name from the Lion Mountains near its capital, Freetown. Originally named Serra Leoa ( Portuguese for 'lioness mountains') by Portuguese explorer Pedro de Sintra in 1462, the modern name is derived from the Venetian spelling, which was introduced by Venetian explorer Alvise Cadamosto and subsequently adopted by other European mapmakers . Sierra Leone's history

5428-566: The Creole ethnic group. As a result, Albert Margai became unpopular in the Creole community, many of whom had supported Sir Milton. Margai sought to make the army homogeneously Mende , his own ethnic group, and was accused of favouring members of the Mende for prominent positions. In 1967, riots broke out in Freetown against Margai's policies. In response, he declared a state of emergency across

5546-596: The Gold Coast; his government hanged 96 of the chief's warriors. Bureh was allowed to return in 1905, when he resumed his chieftaincy of Kasseh. The defeat of the Temne and Mende in the Hut Tax War ended mass resistance to the Protectorate and colonial government, but intermittent rioting and labour unrest continued throughout the colonial period. Riots in 1955 and 1956 involved "tens of thousands" of Sierra Leoneans in

5664-646: The Government of Queen Elizabeth II and British Colonial Secretary Iain Macleod in negotiations for independence held in London. On the conclusion of talks in London on 4 May 1960, the United Kingdom agreed to grant Sierra Leone independence on 27 April 1961. On 27 April 1961, Sir Milton Margai led Sierra Leone to independence from Great Britain and became the country's first prime minister. Sierra Leone had its own parliament and its own prime minister, and had

5782-694: The Governor of the Sierra Leone Company and a leading abolitionist, surrendered the company's charter. This ended its 16 years of running the Colony. The British Crown reorganised the Sierra Leone Company as the African Institution ; it was directed to improve the local economy. Its members represented both British who hoped to inspire local entrepreneurs and those with interest in the Macauley & Babington Company, which held

5900-695: The Jamaican Maroons. Many Liberated Africans were treated poorly and even abused because some of the original settlers considered them their property. Cut off from their various homelands and traditions, the Liberated Africans were forced to assimilate to the Western styles of Settlers and Maroons. For example, some of the Liberated Africans were forced to change their name to a more Western sounding one. Though some people happily embraced these changes because they considered it as being part of

6018-617: The Liberated Africans became successful traders and spread Christianity throughout West Africa, they intermarried with the Nova Scotians and Maroons, and the two groups eventually became a fusion of African and Western societies. These Liberated Africans were from many areas of Africa, but principally the west coast. Between the 18th and 19th century, freed African Americans, some Americo Liberian "refugees", and particularly Afro-Caribbeans , mainly Jamaican Maroons, also immigrated and settled in Freetown. Together these peoples formed

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6136-513: The Nursing and Midwifery Council (NMC) are male. The number of male nurses in the United States doubled between 1980 and 2000. On average, male nurses in the US receive more pay than female nurses. Nursing practice is the actual provision of nursing care. In providing care, nurses implement a nursing care plan defined using the nursing process . This is based around a specific nursing theory that

6254-743: The Order of Exaltation of the Cross ( Krestodvizhenskaya Obshchina ) for a year of service in military hospitals. The first section of twenty-eight "sisters", headed by Aleksandra Petrovna Stakhovich, the Directress of the Order, reached Crimea early in November 1854. Florence Nightingale laid the foundations of professional nursing after the Crimean War , in light of a comprehensive statistical study she made of sanitation in India, leading her to emphasize

6372-483: The Protectorate. Domestic slavery , which continued to be practised by local African elites, was abolished in 1928. A notable event in 1935 was the granting of a monopoly on mineral mining to the Sierra Leone Selection Trust , run by De Beers . The monopoly was scheduled to last 98 years. Mining of diamonds in the east and other minerals expanded, drawing labourers there from other parts of

6490-549: The Register of Liberated Africans. Often documentation would be subjective and result in inaccurate entries, making them difficult to track. Differences between the Register of Liberated Africans of 1808 and the List of Captured Negroes of 1812 (which emulated the 1808 document) revealed disparities in the entries, specifically in the names; many recaptives decided to change their given names to anglicised versions which contributed to

6608-462: The SLPP leadership position. Karefa-Smart led a prominent small minority faction within the SLPP party in opposition of Albert Margai as prime minister. However, Karefa-Smart failed to receive broad support within the SLPP in his attempt to oust Albert Margai as both the leader of the SLPP and prime minister. The large majority of SLPP members backed Albert Margai over Karefa-Smart. Soon after Albert Margai

6726-469: The SLPP. Sierra Leone is a culturally diverse country, home to approximately 18 ethnic groups , with the Temne and Mende peoples being predominant. The Creole people , descendants of freed African-American, Afro-Caribbean slaves and liberated Africans, constitute about 1.2% of the population. English is the official language, while Krio is the lingua franca , spoken by 97% of the population. The country

6844-472: The UK's National Health Service began trialing such a platform. Platforms such as United States –based ConnectRN, Nomad Health, Gale Healthcare solutions or Lantum add resources, career development tools, and networking opportunities. Florence Nightingale's seminal epidemiological study examining mortality among British soldiers during the Crimean War was published in 1858. With the exception of her works, nursing practice remained an oral tradition until

6962-611: The United States . Roselyn Nugba-Ballah was the first ever Liberian recipient of the medal, due to her work in the Ebola epidemic. In 2019, the 48th set of medals were awarded to 29 nurses from 19 countries, including one to Captain Felicity Gapes, a New Zealand Red Cross nurse. In 2021, the 49th set of medals were awarded to 25 nurses from 18 countries, including two posthumously to: Bernadette Gleeson, an Australian nurse, and Arasta Bakhishova , an Azerbaijani nurse. In 2023,

7080-545: The West Coast. For more than a century, it was the only European-style university in west Sub-Saharan Africa . Samuel Ajayi Crowther was the first student to be enrolled. Fourah Bay College soon drew Creoles/Krio people and other Africans seeking higher education in British West Africa. These included Nigerians, Ghanaians, Ivorians and others, especially in the fields of theology and education. Freetown

7198-415: The ability to make 100% of its own laws, however, as with countries such as Canada and Australia, Sierra Leone remained a "Dominion" and Queen Elizabeth was Queen of the independent Dominion of Sierra Leone . Thousands of Sierra Leoneans took to the streets in celebration. The Dominion of Sierra Leone retained a parliamentary system of government and was a member of the Commonwealth of Nations. The leader of

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7316-488: The art and science of caring and focuses on the protection, promotion, and optimization of health and human functioning; prevention of illness and injury; facilitation of healing; and alleviation of suffering through compassionate presence". Nurses practice in many specialties with varying levels of certification and responsibility. Nurses comprise the largest component of most healthcare environments. There are shortages of qualified nurses in many countries. Nurses develop

7434-519: The body as mentioned before including the skin, cannot be correctly described by one who is not well versed in anatomy. Hence, anyone desirous of acquiring a thorough knowledge of anatomy should prepare a dead body and carefully, observe, by dissecting it, and examining its different parts." In the Middle Ages , members of religious orders such as nuns and monks often provided nursing-like care. Examples exist in Christian , Islamic , Buddhist , and other traditions. The biblical figure of Phoebe

7552-428: The community, some were not happy with these changes and wanted to keep their own identity. Many Liberated Africans were so unhappy that they risked the possibility of being sold back into slavery by leaving Sierra Leone and going back to their original villages. The Liberated Africans eventually modified their customs to adopt those of the Nova Scotians, Maroons and Europeans, yet kept some of their ethnic traditions. As

7670-422: The conflict somewhat later, for other reasons. For several months, Bureh's fighters had the advantage over the vastly more powerful British forces but both sides suffered hundreds of fatalities. Bureh surrendered on 11 November 1898 to end the destruction of his people's territory and dwellings. Although the British government recommended leniency, Cardew insisted on sending the chief and two allies into exile in

7788-433: The countries of Benin, Burkina Faso, Cameroon, Chad, Congo, Côte d'Ivoire , the Democratic Republic of Congo , Djibouti , Guinea , Gabon , Mali , Mauritania , Niger , Rwanda , Senegal , and Togo , which all have more male than female nurses. In Europe, in countries such as Spain , Portugal , Czech Republic and Italy , over 20% of nurses are male. In the United Kingdom, 11% of nurses and midwives registered with

7906-405: The country. In 1924, the UK government divided the administration of Sierra Leone into Colony and Protectorate, with different political systems for each. The Colony was Freetown and its coastal area; the Protectorate was defined as the hinterland areas dominated by local chiefs. Antagonism between the two entities escalated to a heated debate in 1947, when proposals were introduced to provide for

8024-472: The country. Sir Albert was accused of corruption and of a policy of affirmative action in favour of the Mende ethnic group. He also endeavoured to change Sierra Leone from a democracy to a one-party state . The APC, with its leader Siaka Stevens , narrowly won a small majority of seats in Parliament over the SLPP in a closely contested 1967 general election . Stevens was sworn in as prime minister on 21 March 1967. Within hours after taking office, Stevens

8142-497: The culture, eventually establishing a strong foothold in the north. The conquest by Samory Touré in the northeast solidified Islam among the Yalunka , Kuranko and Limba people. The 15th century marked the beginning of European interaction with Sierra Leone, highlighted by Portuguese explorer Pedro de Sintra mapping the region in 1462 and naming it after the lioness mountains. This naming has been subject to historical reinterpretation, suggesting earlier European knowledge of

8260-403: The desirable residential areas in Freetown. During the British annexation in Sierra Leone, chiefs in the north and south of the country resisted the "hut tax" imposed by the colonial administrators. In the north, there was a Limba chief named Almamy Suluku fighting to protect his territory, while using diplomacy to trick the protectorate administrators, and sending fighters to assist Bai Bureh ,

8378-430: The difficulty in tracking them after they arrived. In the early 19th century, Freetown served as the residence of the British colonial governor of the region, who also administered the Gold Coast (now Ghana ) and the Gambia settlements. Sierra Leone developed as the educational centre of British West Africa . The British established Fourah Bay College in 1827, which became a magnet for English-speaking Africans on

8496-484: The dwellings, and 24 chiefs signed a petition to Cardew, stating how destructive this was; their people could not afford to take time off from their subsistence agriculture. They resisted payment of taxes, tensions over the new colonial requirements and the administration's suspicions towards the chiefs, led to the Hut Tax War. The British fired first; the northern front of mainly Temne people was led by Bai Bureh. The southern front, consisting mostly of Mende people , entered

8614-451: The establishment of Fourah Bay College in 1827, attracting English-speaking Africans from across the region. The settlement of Sierra Leone in the 1800s was unique in that the population was composed of displaced Africans, brought to the colony after the British abolition of the slave trade in 1807. Upon arrival in Sierra Leone, each recaptive was given a registration number, and information on their physical qualities would be entered into

8732-587: The establishment of the International Committee of the Red Cross in 1863, offered employment and professionalization opportunities for nurses (despite Nightingale's initial objections). Catholic orders such as Little Sisters of the Poor , Sisters of Mercy , Sisters of St. Mary , St. Francis Health Services, Inc. and Sisters of Charity built hospitals and provided nursing services during this period. The modern deaconess movement began in Germany in 1836. Within

8850-507: The following definitions: Nursing encompasses autonomous and collaborative care of individuals of all ages, families, groups and communities, sick or well, and in all settings. Nursing includes the promotion of health, prevention of illness, and the care of ill, disabled and dying people. Advocacy, promotion of a safe environment, research, participation in shaping health policy and in patient and health systems management, and education are also key nursing roles. The use of clinical judgment in

8968-567: The founding of the Cochrane Collaboration in 1993. The emerging area of evidence-based medicine also applies to nursing. Common barriers to the study and integration of research findings into clinical decision making include: a lack of opportunity, inexperience, and the rapid pace of evidence accumulation. Nurses manage and coordinate care to support activities of daily living (ADL). This includes assisting in patient mobility, such as moving an activity intolerant patient within

9086-574: The head nurse of the International Federation of Red Cross and Red Crescent Societies . A representative of the International Council of Nurses also participates in the work of the commission. The medal was initially set up to be awarded to six nurses annually, although the first 42 awards were only made in 1920 due to the disruption of the First World War . The first recipients came from Great Britain (including

9204-551: The health care and insurance industries. Many nurses also work in health advocacy and patient advocacy , helping in clinical and administrative domains. Some are attorneys and others work with attorneys as legal nurse consultants , reviewing patient records to assure that adequate care was provided and testifying in court. Sierra Leone Sierra Leone , ( / s i ˌ ɛr ə l i ˈ oʊ n ( i )/ , also UK : / s i ˌ ɛər ə -/ , US : / ˌ s ɪər ə -/ ; Krio : Salone ) officially

9322-466: The importance of sanitation. "After 10 years of sanitary reform, in 1873, Nightingale reported that mortality among the soldiers in India had declined from 69 to 18 per 1,000". Nightingale believed that nursing was a social freedom and mission for women. She believed that any educated woman could help improve the care of the ill. Her Notes on Nursing (1859) was a popular call to action. The Nightingale model of nursing education led to one of

9440-435: The individual's physical, emotional, psychological, intellectual, social, and spiritual needs. The profession combines physical science, social science, nursing theory, and technology. Nurses typically hold one or more formal credentials. Roles and responsibilities follow the level of education. For example, in the United States, Licensed Practical Nurses (LPN) have less education than Registered Nurses (RN) and accordingly,

9558-619: The inland Protectorate was created as a result of the Berlin Conference of 1884–1885 . This led to the formal recognition of the territory as the Sierra Leone Colony and Protectorate . Sierra Leone attained independence from the United Kingdom in 1961 under the leadership of Prime Minister Sir Milton Margai of the Sierra Leone People's Party (SLPP). In 1971, under Prime Minister Siaka Stevens of

9676-509: The king of an area. Local Afro-European merchants often acted as middlemen, the Europeans advancing them goods to trade to indigenous merchants, most often for slaves and ivory. Portuguese traders were particularly drawn to the local craftsmanship in ivory , leading to a notable trade in ivory artifacts such as horns, Sapi Saltceller , and spoons. The Sapi people belonged to a cluster of people who spoke West Atlantic languages , living in

9794-690: The late 18th century, African Americans who had fought for the British Crown during the American Revolutionary War were resettled in Sierra Leone, forming a community named Black Loyalists . This resettlement scheme was partly motivated by social issues in London, with the Sierra Leone Resettlement Scheme offering a new beginning for the Black Poor , though it was fraught with challenges. In

9912-570: The late 18th century, many African Americans claimed the protection of the British Crown. There were thousands of these Black Loyalists, people of African ancestry who joined the British military forces during the American Revolutionary War. Many had been slaves who had escaped to join the British, lured by promises of freedom ( emancipation ). Official documentation known as the Book of Negroes lists thousands of freed slaves whom

10030-464: The late 20th century, but the RU movement was superseded by evidence-based practice in the 1990s. Evidence-based practice (EBP) is about using research, but unlike RU it allows for the integration of research findings with clinical expertise and patient preferences. The EBP movement had originated in the field of medicine with Archie Cochrane publishing Effectiveness and Efficiency in 1972, leading up to

10148-412: The late 20th century, nursing became an officially gender-neutral profession, though in practice the percentage of male nurses remained well below that of female physicians in the 21st century. Hospital-based training became standard in the US in the early 1900s, with an emphasis on practical experience. The Nightingale-style school began to disappear. Hospitals and physicians saw women in nursing as

10266-461: The list. A 2023 American survey found that around 30% were considering leaving patient care. According to the traditional interpretation physicians are concerned with curing or treating medical conditions, while nurses focus on care. In healthcare settings this line is often blurred, complicating the task of distinguishing the professions. Although nursing practice varies both through its various specialties and countries, nursing organizations offer

10384-420: The main opposition All People's Congress (APC), Siaka Stevens, along with Isaac Wallace-Johnson, another outspoken critic of the SLPP government, were arrested and placed under house arrest in Freetown, along with sixteen others charged with disrupting the independence celebration. In May 1962, Sierra Leone held its first general election as an independent state. The Sierra Leone People's Party (SLPP) won

10502-409: The medical situation. Many times, nurses are busy, leaving little time to educate patients. Patients' families needs similar education. Educating both patient and their families increases the chance for a better outcome. Nurses have to communicate in a way that can be understood by patients. Education techniques encompass conversations, visuals, reading materials, and demonstrations. Nursing

10620-424: The mid-20th century. The inaugural issue of Nursing Research , the first scientific journal specialized in nursing, came in in 1952. During the 1960s, interest in attaining PhDs increased among nurses in the US, but nursing remained a fledgling area of research, with few journals until the 1970s. Nursing research is increasingly presented as a valid discipline, although lacking a prevailing definition. The question

10738-432: The nurse is to assist the individual, sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge. The practice of nursing is based upon a social contract that delineates professional rights and responsibilities as well as accountability mechanisms. In almost all countries, nursing practice

10856-412: The population, and there is a significant Christian minority. Notably, religious tolerance is very high: it is both a social norm and part of the nation's cultural identity. Sierra Leone's current territorial configuration was established in two phases: in 1808, the coastal Sierra Leone Colony was founded as a place to resettle returning Africans after the abolition of the slave trade ; then in 1896,

10974-403: The powerful paramount chiefs in the protectorate to form the Sierra Leone People's Party or SLPP as the party of the Protectorate. The SLPP leadership, led by Sir Milton Margai, negotiated with the British and the educated Krio-dominated colony based in Freetown to achieve independence. Owing to the astute politics of Milton Margai, the educated Protectorate elites were able to join forces with

11092-604: The presence of the tsetse fly which carried a disease fatal to horses and the zebu cattle used by the Mandé people , provided natural defenses against invasions by the Mandinka Empire and other African empires, and limited influence by the Mali Empire , preserving its indigenous cultures from external dominions. The introduction of Islam by Susu traders, merchants and migrants in the 18th century further enriched

11210-406: The previous practice. They did not maintain relationships even with longstanding allies, such as Bai Bureh, who was later unfairly portrayed as a prime instigator of the Hut Tax War. Colonel Frederic Cardew , military governor of the Protectorate, in 1898 established a new tax on dwellings and demanded that the chiefs use their people to maintain roads. The taxes were often higher than the value of

11328-515: The provision of care to enable people to improve, maintain, or recover health, to cope with health problems, and to achieve the best possible quality of life, whatever their disease or disability, until death. Nursing is the protection, promotion, and optimization of health and abilities; prevention of illness and injury; alleviation of suffering through the diagnosis and treatment of human responses; and advocacy in health care for individuals, families, communities, and populations. The unique function of

11446-524: The public and promote health and wellness. In the U.S., nurse practitioners are nurses with a graduate degree in advanced practice nursing, and are permitted to prescribe medications. They practice independently in a variety of settings in more than half of the United States. In the postwar period, nurse education has diversified, awarding advanced and specialized credentials , and many traditional regulations and roles are changing. Nursing historians face challenges of determining whether care provided to

11564-637: The region of modern day Sierra Leone. There had already been a carving culture established in the area prior to Portuguese contact and many travelers to Sierra Leone initially impressed with their carving skills took local ivory horns back to Europe. One notable description at the beginning of the 16th century, by Pacheco noted that: in this country [Sierra Leone] they make beautiful mats of palm-leaf and necklaces of ivory [...]: In this land they make ivory necklaces more delicately carved than in any other country, also very fine and beautiful mats of palm-leaf, which are call 'bicas' [which are] very beautiful and good. In

11682-633: The region. Following Sintra, European traders established fortified posts, engaging primarily in the slave trade , which shaped the socio-economic landscape significantly. Traders from Europe, such as the Dutch Republic , England and France started to arrive in Sierra Leone and establish trading stations. These stations quickly began to primarily deal in slaves, who were brought to the coast by indigenous traders from interior areas, undergoing conflicts over territory. The Europeans made payments, called Cole , for rent, tribute, and trading rights, to

11800-636: The running of the new colony. Government officials soon became involved in the scheme as well, although their interest was spurred by the possibility of resettling a large group of poor citizens elsewhere. William Pitt the Younger , prime minister and leader of the Tory party, had an active interest in the Scheme because he saw it as a means to repatriate the Black Poor to Africa, since "it was necessary they should be sent somewhere, and be no longer suffered to infest

11918-548: The settlers revolted. The Crown subdued the revolt by bringing in forces of more than 500  Jamaican Maroons , whom they transported from Cudjoe's Town (Trelawny Town) via Nova Scotia in 1800. Led by Colonel Montague James , the Maroons helped the colonial forces to put down the revolt, and in the process the Jamaican Maroons in Sierra Leone secured the best houses and farms. On 1 January 1808, Thomas Ludlam ,

12036-552: The sick or injured in antiquity is called nursing care. In the fifth century BC, for example, the Hippocratic Collection in places described skilled care and observation of patients by male "attendants," who may have provided care now provided by nurses. Around 600 BC in India, it is recorded in Sushruta Samhita , Book 3, Chapter V about the role of the nurse as "the different parts or members of

12154-582: The streets of London". In January 1787, the Atlantic and the Belisarius set sail for Sierra Leone, but bad weather forced them to divert to Plymouth, during which time about 50 passengers died. Another 24 were discharged, and 23 ran away. Eventually, with more recruitment, 411 passengers sailed to Sierra Leone in April 1787. On the voyage between Plymouth and Sierra Leone, 96 passengers died. In 1787

12272-554: The survivors of Granville Town from joining the new settlement, blaming them for the demise of Granville Town. The Settlers built Freetown in the styles they knew from their lives in the American South ; they also continued American fashion and American manners. In addition, many continued to practise Methodism in Freetown. In the 1790s, the Settlers, including adult women, voted for the first time in elections. In 1792, in

12390-610: The then British Empire ), Austria , Belgium Czechoslovakia , Denmark , France , Greece , Hungary , Italy , Japan , Romania and the United States . Included in the nine nurses from Great Britain and the then British Empire were: Beatrice Isabel Jones , Margaret MacDonald , and Hester Maclean . The six American nurses were: Florence Merriam Johnson , Helen Scott Hay , Linda K. Meirs , Martha M. Russell , Mary E. Gladwin , and Alma E. Foerster , and three German nurses including Elsbeth von Keudell . Ida F. Butler

12508-458: The voyage between Plymouth, England and Sierra Leone, 70 European girlfriends and wives accompanied the Black Poor settlers . Many in London thought moving them to Sierra Leone would lift them out of poverty. The Sierra Leone Resettlement Scheme was proposed by entomologist Henry Smeathman and drew interest from humanitarians like Granville Sharp , who saw it as a means of showing the pro-slavery lobby that black people could contribute towards

12626-404: The words "Ad memoriam Florence Nightingale 1820–1910". On the reverse, the name of the recipient and the date of the award is engraved, surrounded by the inscription "Pro vera misericordia et cara humanitate perennis décor universalis" ("true and loving humanitarianism – a lasting general propriety"). The medal is attached to a white and red ribbon by a clasp featuring a red enamel cross encircled by

12744-466: The world, particularly in South East Asia and Africa. A global survey by McKinsey & Company in 2022 found that between 28% and 38% of nurse respondents in the United States, the United Kingdom, Singapore, Japan, and France said they were likely to leave their role in direct patient care in the next year. The top five factors which they said would make them stay were: Pay ranked eighth on

12862-548: Was elected Chief Minister of Sierra Leone. The new constitution ensured Sierra Leone had a parliamentary system within the Commonwealth of Nations . In May 1957, Sierra Leone held its first parliamentary election. The SLPP, which was then the most popular political party in the colony of Sierra Leone as well as being supported by the powerful paramount chiefs in the provinces, won the most seats in Parliament and Margai

12980-536: Was important in caring for patients. In the 19th century, this theory was ideal for helping patients, providing a guide for nurses to alter the environment around patients for the betterment of their health. Nightingale's recommendations built upon the successes of Jamaican "doctresses" such as Mary Seacole , who like Nightingale, served in the Crimean War. Seacole practised hygiene and the use of herbs in healing wounded soldiers and those suffering from diseases in

13098-467: Was known as the " Athens of Africa" due to the number of excellent schools in Freetown and surrounding areas. The British interacted mostly with the Krio people in Freetown, who did most of the trading with the indigenous peoples of the interior. Educated Krio people held numerous positions in the colonial government, giving them status and well-paying positions. Following the Berlin Conference of 1884–85,

13216-614: Was later freed and fled the country, going into exile in neighbouring Guinea. However, on 23 March 1967, a group of military officers in the Sierra Leone Army led by Brigadier General Andrew Juxon-Smith , staged a counter-coup against Commander Lansana. They seized control of the government, arrested Lansana, and suspended the constitution. The group set up the National Reformation Council (NRC), with Andrew Juxon-Smith as its chairman and Head of State of

13334-471: Was not available in Nova Scotia. The initial process of society-building in Freetown was a harsh struggle. The Crown did not supply enough basic supplies and provisions and the Settlers were continually threatened by illegal slave trading and the risk of re-enslavement. The Sierra Leone Company, controlled by London investors, refused to allow the settlers to take freehold of the land. In 1799 some of

13452-499: Was opposed to the colonial legacy of allowing executive powers to the Paramount Chiefs, many of whom had been allies of his late brother Sir Milton. Accordingly, they began to consider Sir Albert a threat to the ruling houses across the country. Margai appointed many non-Creoles to the country's civil service in Freetown, in an overall diversification of the civil service in the capital, which had been dominated by members of

13570-603: Was ousted in a bloodless military coup led by Brigadier General David Lansana , the commander of the Sierra Leone Armed Forces . He was a close ally of Albert Margai, who had appointed him to the position in 1964. Lansana placed Stevens under house arrest in Freetown and insisted that the determination of the Prime Minister should await the election of the tribal representatives to the House. Steven

13688-453: Was re-elected as Chief Minister by a landslide. Sierra Leone was granted independence by the United Kingdom in 1961, transitioning to a state with its own governance structures, though it faced significant political instability post-independence, including the establishment of a one-party state and periods of civil unrest. On 20 April 1960, Milton Margai led a 24-member Sierra Leonean delegation at constitutional conferences that were held with

13806-430: Was sworn in as prime minister, he fired several senior government officials who had served in his elder brother Sir Milton's government, viewing them as a threat to his administration, including Karefa-Smart. Sir Albert resorted to increasingly authoritarian actions in response to protests and enacted several laws against the opposition All People's Congress, while attempting to establish a one-party state . Sir Albert

13924-410: Was the fifteenth American recipient of the award in 1937. The medal was restricted to female nurses until regulation changes in 1991. Under the new regulations, it is open to both women and men and is awarded every two years to a maximum number of fifty recipients worldwide. The vesica piscis -shaped medal is composed of gold and silver-gilt and bears a portrait of Florence Nightingale surrounded by

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