Copyright © Hans Högman 2021-09-10
History of Swedish Hospitals
History of Swedish Hospitals -
Medical Schools and Training
Physicians
Medical education was available early on at the
universities of Uppsala and Lund. The Karolinska
Institute of Medical Surgery in Stockholm was founded
in 1810, but medical education had been carried out
long before that in Stockholm under the Collegium
Medicum, i.e. the Medical Council. One of Karolinska's
founders was Jöns Jacob Berzelius, a professor of
chemistry and pharmacy, who defended the institute
against Uppsala University, which did not want the
competition.
In 1861 Karolinska Institutet (KI) - Karolinska
Institute Medical University - was granted the right to
award degrees (diplomas) and in 1906 the right to
confer doctors of medicine; by then it had achieved
full equality with Uppsala University.
The Medical College was established in Gothenburg
in 1948, but the courses had developed since 1940.
The Medical College became a Faculty of Medicine
within the University of Gothenburg in 1954. Medical
education is now also available at the universities in
Umeå and Linköping.
The Seraphim Hospital also functioned as a teaching
and research hospital, and the chief physicians were
usually professors at Karolinska Institutet (KI).
The image shows a lecture in the operating theater of
the Seraphim Hospital in 1910. Image: Wikipedia.
Pharmacists
At the end of the 18th century, training to become a
pharmacist was done by becoming an apprentice;
in addition to good manners, knowledge of Latin was
required.
The Pharmaceutical Institute was located in
Stockholm between 1837 and 1968 and was run by
the Pharmaceutical Society (Apotekarsocieteten) until
1881 when the school became government-run. From
1895, a high school exam was required to enter the
program. In 1968, the institute was transformed into
the Faculty of Pharmacy at Uppsala University with a
pharmacist and junior pharmacist program.
Nurses
From the late 19th century until the 1960s, nursing
training was conducted in boarding schools with
severe personal restrictions on students. The new
Uppsala University Hospital (Akademiska sjukhuset),
built in 1867, established a nursing school.
In 1884, the private Sophiahemmet Hospital in
Stockholm started an education based on the eighth
grade of girls' school. Three years of training were
given, but then three years of service at
Sophiahemmet, which hired out private nurses, were
required.
The Red Cross Nursing Home opened in 1891 a 2-
year nursing training course, which required the
equivalent of the highest grade in secondary school.
After training, the student was obliged to serve for 1
½ year. In 1903, the Southern Sweden’s Nursing
Home (Södra Sveriges sjuksköterskehem) in Lund
started a two-year training course with a minimum of
sixth-grade secondary school and required one year's
service after training.
Sophiahemmet is a hospital founded in 1889 on
Valhallavägen in Stockholm by Swedish Queen Sophia
of Nassau and her husband King Oscar II.
Sophiahemmet is home to the Sophiahemmet
School of Nursing.
The beginnings of Sophiahemmet's activities date
back to the founding of the "Home for Nurses"
foundation, which was inaugurated by Queen Sophia
on 1 January 1884. This establishment was located at
the present
Upplandsgatan in
Stockholm.
The image to the
right shows the
Sophiahemmet
Hospital in 2006.
Image: Wikipedia.
The aim was to train nurses and for practical training,
they had access to Sabbatsberg Hospital and Serafim
Hospital. However, cooperation with the city's
hospital did not work well and the foundation also
wanted its own hospital. A
donation of SEK 160,000 from King
Oscar II and his consort, Queen
Sophia, made it possible to build a
new hospital named after Queen
Sophia.
The image on the left shows a
Sophia sister (nurse) sometime
between 1889 and 1915. Image:
Wikipedia
The new hospital was inaugurated on 1 October
1889. Sophiahemmet then became Sweden's first
private hospital with a total of 60-70 beds.
The layout is characterized by a system of long
corridors throughout the building, with sickrooms
and a meeting hall to the south. Operating theaters
were located to the north. The nurses' home
contained rooms for 40-50 nurses and students, as
well as reception rooms for visitors, a meeting room,
and accommodation for the matron. In 1907, the
Solhemmet was opened as a retirement home for
retired Sophia nurses.
Full nursing schools started at Sabbatsberg
Hospital in Stockholm in 1911 and Sahlgrenska
Hospital in Gothenburg in 1912, although they had
been training nurses since the 1870s. Prerequisites
were higher girls' school, after 2 years of training an
examination certificate was awarded but there was
no obligation to serve in the hospitals. Other
hospitals also provided training for their own needs,
but there were no set curricula and no certification.
From 1920, nursing schools were supervised by an
inspectorate of the then The National Board of Health
(Medicinalstyrelsen). Municipal nursing schools had to
be approved by the government from 1923. The
Stockholm County Council (Landstinget) had a nursing
school between 1940 and 1970 at St Erik's Hospital
and between 1964 and 1970 at St Göran's Hospital.
Stockholm's government-run nursing school started
in 1939, Gothenburg's in 1954, and Norrköping's in
1962. The central agency was the National Board of
Health, which granted licenses to doctors but also to
nurses from 1958 (registered nurses).
In 1916, a study had proposed training of assistant
nurses (undersköterskor), but this did not get
underway until 1946. This training was intended to
provide further training for experienced nursing
auxiliaries (sjukvårdsbiträden) and was carried out in
hospitals. Training for nursing auxiliaries, which had
previously taken place exclusively in the workplace,
was introduced in Gothenburg's vocational schools in
1958.
In 1958, the Association of County Councils sent out a
report on health care training to the county councils,
which then began to organize courses for basic
training of nursing auxiliaries and further training as
assistant nurses. From this developed the county
nursing schools, which in 1971 became upper
secondary schools with two-year nursing courses,
and from 1992 three-year courses. In Gothenburg,
which was outside the county councils, the municipal
vocational school took over the training of assistant
nurses in 1961.
Before the Nurses
Before the advent of nurses in the second half of the
19th century, there was a group of women in
hospitals or similar institutions who assisted in the
care of patients, known as nursing maids (sjukpigor),
night duty maids (nattvakterskor), or orderlies
(sjukvakterskor). They lacked nursing training and
performed only unskilled tasks. The status of the
profession was very low and the nursing maids were
often described as dirty and irresponsible. In the past,
hygiene conditions were, from a modern point of
view, almost a disaster and the death rate of hospital
in-patients was high.
As the importance of hygiene in the care of the sick
became better understood, outcomes in the care of
the sick also improved and the reputation of hospitals
increased.
With the advent of nursing schools in the second
half of the 19th century and a greater degree of
professionalism, the quality and the status of the
profession improved. Nursing was now considered
acceptable even for the daughters of the bourgeoisie.
With education came the status of the profession.
Nurse’s Uniforms
Early on, it was decided that students in nursing
schools would wear special uniforms. These nursing
uniforms were also to be worn after training, i.e.
during further professional practice, i.e. it became a
working uniform. The idea was that the nurse's
uniform should infuse respect and therefore it should
always be kept clean and intact. Furthermore, nurses
were to have a dignified demeanor and language and
show great respect for superiors. Nursing was long
seen as a vocation and nurses were expected to be
unmarried.
The different nursing schools had different looks for
their nurse’s uniforms with different details, color
choices, caps, and aprons. If you look at older
pictures of nurses in a hospital, you can see that the
different nurses wear different types of nurse’s
uniforms, depending on where they received their
nursing training.
The image shows nurses in a hospital in 1945 wearing
different types of nurse’s uniforms. Photographer
Walter Olson, 1945. Kalmar County Museum, ID:
KLMF.KWO25706.
In the beginning, the uniforms had a so-called
standing collar, i.e. a high stiff collar. The nurses had
to have the uniform made up themselves. In their
spare time, nurses had to wear the so-called “fracken”,
a black dress of ankle-length, and nurses were also
expected to behave with dignity and respect in their
spare time.
Nurse’s Brooches
A brooch was also worn with the nurse's uniform and
was proof of completion of training. The brooch was
awarded during the graduation ceremonies. Each
school of nursing had its own design on the
brooch, which means that if you see an older photo
of a nurse in uniform, you can identify which school
the nurse attended. The brooches served as a kind of
early professional sign of certification.
The brooches were often decorated with a St. George
cross with silver or gold details. They could also be
decorated with the school's monogram. In the days
when brooches served as professional identification,
they had to be returned to the school of nursing that
issued them after the nurse's demise.
The nurses with the highest reputation and esteem
were those trained at Sophiahemmet, the Red Cross
and, Ersta Hospital. The nurses trained at these
nursing schools were highly regarded and sought
after in the country's various
hospitals and care institutions.
The image to the right shows a
Sophia nurse from Uppsala in
1958 with a brooch and their
characteristic cap. Photographer
Inga Larsson, 1958. Image:
Uppland Museum, ID: FN02197.
The two nurses in the middle of
the group photo above are Red Cross sisters as you
can see from their brooches. The nurse sitting on the
right may be wearing the Sabbatsberg nurses' brooch
which was shaped like a St George's cross.
Examples of Nurse’s Brooches:
