As compared with Great Britain and the United States in the same period, the degree to which, in the nineteenth and twentieth centuries, Germany's nurses became professionalized was not as marked-in terms of nurse education, nursing research, and the status of nurses in the health system. In the nineteenth century, the period and the course of nurse training were not in general regulated, nor did state recognition yet exist. The education of nurses was left largely to nursing organizations and local communities, with a paucity of teaching hospitals in the latter. Around 1900, the length of training varied significantly, often as much as from three months to one year.1
The introduction of statewide nursing examinations followed upon a decision of the Upper House (Bundesrat) of the Federal Parliament in 1906. Prussia, the most important of the German states, introduced the examination in 1907, while other German states, such as Baden and Bavaria, delayed the introduction of the examination until after the end of World War I. The examination itself represented a compromise between government, medical profession, and denominational interests:2 only one year of vocational training was required. At first, the extent of theoretical education was not fixed, and the educational requirements for the examination (elementary school [Volksschule] or its equivalent) were low. In the examination regulations, which were published following the Upper House decision in 1906, nursing was defined as an occupation ancillary to the needs and concerns of physicians, a definition that featured in subsequent reforms.
Nursing History Research and Historiography
The slower pace of professionalization also had consequences for the development of nursing historiography. In spite of the 1990s development of nurse-oriented academic education, nursing history research per se has not been institutionalized at a university or university of applied sciences. That is to say, an institute for the history of nursing has not yet been established, unlike, for example, the history of medicine. In 2006, the Institute for the History of Medicine of the Robert Bosch Foundation sent out a nursing history questionnaire to nursing departments in forty-four universities and universities of applied sciences. Out of twenty-two responses received, seventeen institutions informed us that they offer education in nursing history on a more or less limited scale.
Some initiatives to institutionalize nursing history have been undertaken. Hilde Steppe (1947-99), herself a nurse, nurse historian, and, from 1998 until her death in 1999, professor of nursing research at the University of Applied Sciences in Frankfurt am Main, founded, in 1995, the Dokumentationsstelle Pflege (Nursing Documentation Center) there. The center has subsequently developed into the Hilde-Steppe-Archiv (www.hilde-steppe-archiv. de). The Sektion Historische Pflegeforschung (Nursing History Research Section; http://www.dg-pflegewissenschaft.de/sektion_Historische.php) was founded in 1991 by nurses who were actively interested in the history of their profession, and constitutes one of several sections of the Deutsche Gesellschaft für Pflegewissenschaften (German Society of Nursing Science), which was founded in 1989.
The slower pace of professionalization, together with the lack of any concerted effort to institutionalize nursing history, has had an impact on nursing historiography. The research field is consequently somewhat fragmented, tending in the past to be dominated by professional viewpoints, with the attendant risk of bias. Christoph Schweikardt, in his detailed 2004 overview of the research on nursing history in Germany, has stated: "Frequently the contributions, diverse as they were, were predominantly the work of physicians and nurses and were strongly shaped by the occupational background of the author and professional political agendas of all kinds." In contrast, he feels that in recent years "valuable scholarly contributions on the history of nursing organizations have appeared. …