THE ROLE OF THE MONASTIC ORDERS

The monastic orders also developed during this period, including the order of Benedictines, which still exists. The monasteries played a large role in the preservation of culture and learning, as well as in offering refuge to the persecuted, care to the sick, and education to the uneducated. By joining a monastic order, young men and women were able to follow the career of their choice while living a Christian life. The learning of the classical period would have been lost when the Roman Empire fell were it not for the monks and monasteries. One of the earliest organizations for men in nursing, the Parabolani brotherhood, was established at this time. Responding to the needs created by the Black Plague, this group reportedly organized a hospital and traveled throughout Rome caring for the sick. At the same time, monastic nurses such as the famous St. Brigid (an abbess in Ireland known for her healing of the lepers), St. Scholastica (a twin sister of St. Benedict), and St. Hilda, founded schools, tended to the sick, and gave to the poor (Donahue, 1996). During this period (approximately 50 A.D. to 800 A.D.), the first hospitals were established, usually as a part of a nearby monastery that included grain fields, gardens, orchards, farm buildings, and eventually schools, in addition to the church. Many of these hospitals are still standing. There were more than 700 hospitals in England by the middle of the 16th century. The Hôtel Dieu in Lyons was established in 542 and the Hôtel Dieu in Paris around 652. The Hôtel Dieu in Paris was staffed by the first order specifically devoted to nursing, the Augustinian Sisters (Kalisch & Kalisch, 1995). The Santo Spirito Hospital in Rome, the largest medieval hospital, was established by papal order in 717 (Donahue, 1999).
The Crusades, which swept from northern Europe to the Mideast in response to the advance of the Ottoman Empire into Spain, France, and Eastern Europe, lasted for almost 200 years (1096–1291). Military nursing orders, such as the Knights Hospitallers of St. John, evolved as a result of the Crusades. The Knights was organized to staff two hospitals located in Jerusalem, and had as its grand master a monk named Gerard. He drew up codes and introduced the black robe with a white Maltese cross that became the uniform for the brethren (Kalisch & Kalisch, 1995). The same cross was later used on a badge designed for the Nightingale School; this badge was the forerunner of the nursing pin as we know it today. (The symbolism of the pin is discussed later in this chapter.) The Knights, organized as a nursing order, soon became famous for their hospitality and care and their numbers, possessions, and wealth increased. At times they were required to defend the hospital and its patients. In Germany, a women’s order called “consorores” was founded specifically to perform hospital work. Although they took vows, the women were not granted the same status as the Knights, and they lived outside the monastic precincts. Two other monastic orders were founded during this period: the Knights Templars in 1118 and the Knights of the Teutonic Order in 1190. The Hospitallers and the Templars played significant roles during the Crusades. Secular orders of nurses also came into existence at this time. Operating much like the monastic orders, members of these groups could terminate their vocations at any time and were not bound to the vows of monastic life. Examples of the secular orders include the Order of Antonines (1095); the Beguines of Flanders, Belgium (1184); the Misericordia (1244); and the Alexian Brothers, founded during the bubonic plague epidemic of 1348. The only nursing education offered to these dedicated people was in the form of an apprenticeship during which a newcomer would be assigned to a more experienced person for instruction. The inquiring student is encouraged to seek greater depth of knowledge about the nursing orders, their purposes and goals, and the lives of those who devoted their energies to the care of the sick and the poor by consulting the nursing references given at the end of this chapter.