Nurse education qualification courses have graduate status. Traditionally, from the times prior to Florence Nightingale, nursing was seen as an apprenticeship, often undertaken in religious institutes such as convents by young women, although there has always been a proportion of male nurses, especially in mental health services. In 1860 Nightingale set up the first nurse training school at St Thomas' Hospital, London. Nightingale's curriculum was largely base around nursing practice, with instruction focused upon the need for hygiene and task competence. Her methods are reflected in her "Notes on Nursing", (1898). Some other nurses at that time, notably Ethel Gordon Fenwick, were
Florence Nightingale nurses in the American Civil War. The Union government approached her for advice in organising field medicine. Her ideas inspired the volunteer body of the United States Sanitary Commission. In the 1870s, Nightingale mentored Linda Richards, "America's first trained nurse", and enabled her to return to the United States with adequate training and knowledge to establish high-quality nursing schools. Richards went on to become a nursing pioneer in the US and Japan. By 1882, several Nightingale nurses had become matrons at several leading hospitals, including, in London (St Mary's Hospital, Westminster Hospital, St Marylebone Workhouse Infirmary and the Hospital for