This article is a continuation of a study on nursing at the Santa Creu Hospital in Barcelona; this article is concentrates on the second half of the 19th Century, a period characterized by great development in the medical fields and by important social changes which render obsolete the social-sanitary assistance model in vogue until that time in that hospital. Without noticing any special novelties in regards to nursing care, which continues in the hands of religious communities, the authors observe a growing influence of the medical corps in making decisions which affect both the treatment provided to patients and the internal organization of this hospital. As a consequence of the development of medicine, the role of paramedics also increases as they assume an almost total role of collaboration. The care takers were then generally called "sisters" or "brothers", reserving the term "nurse" for the caretakers designated to nursing departments.