Ordered to care

1. Ordered to care Chapter 6 Nursing as work: divisions in the occupation By Corrina Johnson

2. Diversity continued • Diversity continued after nursing students received their diplomas • Turn of the century • Hospitals grew in number and size • Some graduates were lucky to find work in a nursing school or in a small hospital

3. Diversity Continued • Most graduates found work in a private duty home • It was exhausting work • Work approximately a maximum of 10 years • Nurses didn’t have a monopoly on the private duty. • Chronic patients needed companions- family likely to hire non-trained nurses. • Income of the family determined what type of nurse was hired.

4. Nursing Income • From 1880’s – 1890’s • New Graduates • $15.00-$18.00 in Boston • Per week • By late 1890’s • Nurses commanded • $20.00-$25.00 • Per week

5. Nursing vs. Servants • Clash between nursing and servant-like duties • Always afraid of being asked “to do too much” • Nurses wanted to be treated like ladies • They wanted to be served dinner at the table with the family instead of the kitchen with the servants • Detrimental to their career • Fine line between “knowing the rules” of the family • Nursing – Known as overbearing, or dictatorial • Left families with no choice but to hire either un-trained nurses or obtain an expensive private room in a hospital

6. Difficulties Looking for work • New graduates looked for work • Nurses worked under the physician • Nurses worked in patients homes or small hospitals • Untrained nurses were considered a threat • Required less income • Were not looking for superiority from the servants

7. Private duty vs. Hospital • Private duty • Lack of supervision • Poor technique can be hidden for years • Patient and family is the center of nursing attention • Shifts of 12-24 hours were the norm • 84-164 hours a week • Average case lasted about 4 weeks A nurse leader summarized the effects of the work on the nurse It’s irregularity breaks down her health, its seclusions tend to narrow her interests. She cannot charge in accordance with any particular skill she had acquired; she is unethical if, after ten years of hard work, she charges any more than does the newest graduate in the field. Yet she must be all thinks to all people, she must remain human though she cannot live like most humans.

8. Private duty vs. hospital • Hospital base • Head nurse or supervisor • Experience and skill • Task oriented • Longer life span

9. Nursing presence in Hospital administration • Over the years, the presence of nursing increased • Hospitals <100 beds • By 1927 only about 20 % of US hospitals were nursing administered • By 1933, that number increased to 41 % • Hospital > 100 beds • Continued to be run by Male doctors and other trained men.

10. Life table and Choices • Age affected career opportunities • Average professional nurse was expected to be young • The Physicians journal “American Medicine” editorialized that nursing required “the young and vigorous, who can bend to the strains and not break” • Average age of professional nurse between 1880 and 1914 was 28, with a mode of 25 • Average age of the untrained nurse was an average of 35, with a mode of 40. • Marriage • Marriage meant dropping out of the work force • Most never married • By 1920, increasing number of married women, stayed in nursing or returned to nursing • 1 in 5 working nurses were married.

11. Divided home • As woman’s labor • Nursing demanded self-sacrifice • As an occupational group • Divided into numerous different practice fields • Provided woman with a skill to practice for a lifetime until marriage • Chance to move “up the ladder” • Comfort • Freedom • Sense of independence • Self-worth • These positions and subsequent divisions shaped the politics of nursing reform