She wanted to reduce the infection where she worked. Nightingale wrote as set of guidelines that nurses have to follow in order to maintain that cleanliness. Florence Nightingale opened the first nursing school in London in 1860. There was a lot of nurses that worked during the Civil War. In 1881 Clara Barton started a Humanitarian program to meet needs of those affected by the disaster. She had worked during the war and understood the necessities such water, food, and shelter. The Organization is know as the Red Cross. Burton worked as a leader for 20 years. Toward the end of the 19th century nurses began to work toward changing policies in leadership and education in nursing schools. By bringing change many nurses went to educate in leadership about the necessity of prevention. In 1893 Lillian Wald promoted nurses going and helping people outside of the hospital. In 1925 Mary Breckenridge begun the Frontier Nursing Service to help people living in rural parts of America. In the 20th century the Nursing Profession Continue to advance. New Programs and new Organizations to address the challenges that come along with the Profession. The