In early Melbourne the sick were generally cared for at home by family members or private nurses. Among the nurses working in Melbourne in 1847 were Margaret Bruce, a 'nurse-tender' of Fore Close Street, Collingwood, and Johanna Leary, a nurse at the Colonial Hospital, Collins Street. Although male nurses predominated in hospital settings for the first half of the 19th century, by its end most hospitals had dispensed with male nurses in favour of female nurses. This shift followed the recommendation of a royal commission in 1890, and was in line with international trends that equated modern scientific nurses with the ideals of Florence Nightingale, who decreed that educated ladies made the best nurses.
In 1862 the Melbourne Lying-In Hospital became the first institution in Australia to offer formal training to women employed to nurse. These women were trained at their own expense at a cost of six guineas per month including board. The first training course for non-midwives was at the Melbourne Hospital for Sick Children in 1879. By 1890 training programs were widespread. The development of trained nursing in Melbourne reflected international trends. Miss Haldane Turriff became the first matron at the Alfred Hospital in 1870 and the State's first Nightingale.
Nurses trained at the Alfred under the motto: 'Where there is not a woman, there a sick man groans'. Isabella Rathie of the influential Edinburgh Infirmary was in the second wave of Nightingales, and became matron of the Melbourne Hospital in 1890. Tipperary-born Mother Berchmans Daly founded St Vincent's Hospital in 1893, introducing the Irish Sisters of Charity tradition to the city.
In 1901 the Royal Victorian Trained Nurses' Association (RVTNA) was instituted under the leadership of Dr J.W. Springthorpe and began the work of self-regulating the profession. This was considered a victory for community safety and professional recognition. Henceforth all courses were accredited and only qualified nurses were employed in public hospitals and in private nursing agencies. An early board member of the RVTNA was suffragist and feminist Vida Goldstein who was forced to resign because of her Christian Scientist beliefs. During World War I members of the RVTNA comprised nearly half of all serving nurses nationally. However, despite the patriotic vote of thanks for war nurses, Victoria's nursing registration legislation was not passed until 1923. Nursing politics between the wars was dominated by the figure of Miss Jane Bell, matron of the Royal Melbourne Hospital, influential president of the RVTNA and member of the Nurses' Board. During World War II army nurses were awarded formal ranking and Melbourne nurse Annie Sage became Colonel-in-Chief and, later, matron of the Royal Women's Hospital and foundation president of the Royal College of Nurses Victoria. From the 1950s to the 1970s nurses continued to be trained in hospitals, working as they learned their profession, but shortages of skilled staff and variations in nursing education persisted. It was over the latter part of this period that the profession once more opened to men, although the number of men remained low.
In 1984 the federal government agreed to an in-principle commitment to transfer nursing education to the tertiary sector, transforming nurses from hospital workers to students. Neil Blewett, then Minister for Health, called it 'a victory for women'. In 1985 Victoria witnessed the most extensive nursing strike in the country's history. Nurses struck for 50 days, virtually shutting down Melbourne hospitals. This industrial action won nurses improved conditions and a landmark new career structure. Melbourne continues to be affected by shortages of skilled nurses. Just as it was one hundred years ago, nursing practice at the start of the 21st century is dominated by issues of community safety, professional recognition, and funding for health.