Before training schools, hospitals and families hired untrained women — often elderly, often desperate for work — to sit with, feed and lay out the sick. Charles Dickens's gin-drinking Sairey Gamp in Martin Chuzzlewit (1843–44) fixed the type in the public mind and became a recruiting argument for reform; training schools and Britain's 1919 Nurses Registration Act finally priced the watcher out of existence.
Hired watcher ('Gamp' nurse) no longer exists as a living trade. Here is what erased it, and which profession took on the work.
1550 – 1854
The long decline and the hired watcher
The Reformation dissolved the monasteries and convents that had staffed northern Europe's hospitals, and no trained substitute appeared for three centuries. Nursing in Protestant countries sank to poorly paid, untrained hired watchers — immortalized by Charles Dickens as the drunken, negligent Sairey Gamp in 1844 — while Catholic orders like the Daughters of Charity preserved standards elsewhere. The contrast between the two systems became a standing argument for reform.
What else was happening then
1836
Kaiserswerth trains the first deaconess nurses
Pastor Theodor Fliedner and his wife Friederike open the Deaconess Institute at Kaiserswerth on the Rhine, giving respectable Protestant women systematic training in bedside care, pharmacy and ethics. Its alumnae seeded hospitals across Europe and the Middle East, and a 31-year-old Florence Nightingale spent three formative months training there in 1851.
1854
Nightingale at Scutari
Nightingale arrives at the Barrack Hospital at Scutari, near Constantinople, with 38 nurses during the Crimean War. Hospital mortality, which peaked above 40 percent in February 1855, fell to a few percent within months after a Sanitary Commission flushed the sewers and Nightingale imposed order on supplies, food and wards — a collapse in death rates she later analyzed statistically for the rest of her life.
1860
The Nightingale Training School opens
Funded by roughly £45,000 in public donations to the Nightingale Fund, the first secular nurse training school opens at St Thomas' Hospital, London, with 15 probationers. Its graduates — 'Nightingales' — exported the model to hospitals across Britain, its empire and the United States, and Nightingale's 1859 'Notes on Nursing' became the profession's founding text.
1899
The International Council of Nurses
British nurse Ethel Gordon Fenwick founds the International Council of Nurses in London — the world's first international organization for health professionals, and among the first for professional women of any kind. The ICN campaigned country by country for state registration of nurses, the reform Fenwick had fought for in Britain for decades.
Where that work lives now
Healthcare's largest profession: from Scutari's lamp to the ICU monitor, the person who is still at the bedside when everyone else has gone home.
💉 Nurse →