Part 1: The nurse and the hospital before training

Part 1: The nurse and the hospital before training Chapter 1: “Professed” nursing: from duty to trade Lauren Heeke Cohort 7

Nursing’s original roots • Originally a duty, not a job • “In sickness and in health” • Obligation to family trumped any paid position

What did nursing entail in the 1800’s? • Physical and emotional strength, skill, and patience were required • Food and tonic preparation • Dressing changes • Application of plasters, poultices, leeches • Massages • Emotional comfort and support • By the time of the Civil War, the “professed” nurse became more popular

Culture shift (1840’s) • Expanding industrial economy • Importance of parenting in middle class families • “Duty” took on new meanings • For some, caring as love could be separated from caring as labor, and a woman’s virtues were maintained

What kinds of nurses? • Child nurse/nursemaid • Wet nurse • Midwife • Monthly nurse • Sick nurse • Work varied depending on the patient and family • Nurse had the freedom to diagnose and change doctor’s orders on her own as she gained experience • Reputation varied

ranking • The nurse was not as lowly as a simple domestic, nor as highly ranked as a cook • Wage was between that of a seamstress and a cook • Gratuities became expected • Became mostly work for white, native-born, older, or poor women as domestic duties were performed mostly by slaves • Marital status

The professed nurse • Many women who survived their husbands became “professed nurses” • Home for Aged Women (Boston) was home for “respectable poor” (retired professionals) kept records that give insight to the lives of these women • Most retired nurses who lived here came from families of farmers • Between 1850-80 about half of these women had never married • After this, 60% were widowed, separated, or divorced and 40% had never married

A woman’s fate • Older woman did not often “choose” nursing but were left with few options • Virginia Penny: “To make a kind and sympathizing nurse, one must have waited, in sickness, upon those she loved dearly” • A sympathetic physician or druggist often allowed women to establish themselves as nurses • Nearly 25% of all women in the Home for Aged Woman had been a nurse at some point

Age mattered! • To be accepted as a nurse, a woman needed to have many years’ experience caring for the sick • Younger nurses were allowed to do only some nursing, and needed practice and life experience to develop their “natural-born” tendencies • Due to sexuality and contagion, older women were more suited as nurses

Stepping out of the home • Most sickness, birthing, and dying took place in the home • As notions of middle class working women grew, nursing became less important to concept of “womanhood” • Nursing could easily become a trade to be “professed” in the working world

Nursing becomes a trade • Women were available to perform nursing work for wages, and middle and upper class families were willing to pay • In mid 1800s, physicians began to give advice based on assumptions that families would have a relative or hired labor to deliver the ordered care • 1870: 10,000 women claimed to be nurses • 1940: 100,000 women claimed to be nurses • Remained primarily older women with no formal education

In summary • Nursing evolved from dutiful caretakers to nursing as professionals -although still characterized by older, uneducated women • Paralleled women’s social status in American culture over time • By 1940s, nursing as a profession had gained acceptance

References Reverby, S. M. (1987). “Professed” nursing: from duty to trade. Ordered to Care (11- 16). Cambridge, United Kingdom: Cambridge University Press.

Part 1: The nurse and the hospital before training