If the historical perspectives of children’s nursing are explored in conjunction with the society of the day, it will allow some insight as to why some initiatives were successful while others clearly failed. Although contemporary society has changed, some of the issues have similarities with the past. Jolley (2011) has undertaken research into the history of children’s nursing giving valuable insight into the origins of children’s nursing, frequently explaining how external influences have helped to shape children’s nursing. Ramsay (2008) points out that children’s nursing is a comparatively recent specialism, traceable only to the 18th and 19th century yet Jolley (2011) identifies that all healthcare professions have existed for substantial periods of time. According to Lumsden (2010) professions have developed in ‘silos’ rather than in an integrated way. This means that each of the healthcare professions has established its ‘professional identity’, which shapes and influences service development and service issues (Figure 1.1). It may have been due to prevailing issues in society and political drivers at the time, as to whether children required a child-focused nurse to provide care. Jolley (2011) highlights that in order to understand what shapes the standards of care and the standards of the professional children’s nurse in contemporary nursing it is essential to consider the historical perspectives. Lumsden (2010) reports that during the 19th century the professionals had expertise in a specific area and were autonomous practitioners, but were both predominantly male and also unregulated, and compares this to a contemporary professional who works for an organisation in which there is professional regulation and should no longer be predominately led by males or upper classes. There is a tendency in contemporary children’s nursing for a predominantly female workforce.