Academic journal article Nursing History Review

Nursing History: An Irrelevance for Nursing Practice?

Academic journal article Nursing History Review

Nursing History: An Irrelevance for Nursing Practice?

Article excerpt

It was a great privilege for me as a non-nurse to be invited to deliver the Monica Baly Lecture for 2006. Though I did not have the pleasure of meeting Monica, we shared a love of Georgian Bath and in the early 1990s corresponded over a short article of mine on corruption at the famous Mineral Water Hospital in the city, which was duly published in the History of Nursing Society Journal. 1 Even in that brief exchange of letters, Monica's commitment to and enthusiasm for historical research were immediately striking. I cannot do full justice to her memory. I want to attempt, however, to spell out the relevance for nursing practice of the approach to nursing history that she pioneered. To do this, I shall be exploring three principal themes: the development of nursing history since 1900; the origins of the medical model that continues to inform the British health care system; and the ways historical scholarship can offset the worst effects of this model by facilitating critical reflection on professional identity, patient perspectives, and evidence-based decision making.

The Development of Nursing History

Like women's history, nursing history had its origins in Victorian biography, which celebrated "women worthies" whose good example was seen as an exemplar for female readers. 2 With this agenda, it is not surprising that the "iconic figure of Florence Nightingale" reigned supreme. 3 Sarah Tooley's Life, for instance, was a romantic tale, written in 1904 to coincide with the 50th anniversary of Florence's departure to the Crimea. A simple chronology, short on insight into her personality and motivation, it emphasized the self-sacrifice to which all women were expected to aspire, along with their duty to supply physical and spiritual sustenance. 4 During the course of the 20th century, the genre of critical biography emerged from this hagiographic approach. 5 Even Sir Edward Cook's official biography of 1913, though eulogistic, flagged less favorable qualities: Florence's domineering personality; the long and bitter struggle with her family; her cavalier treatment of friends; her calculated decision not to marry. Cook even discreetly suggested that the relentless pursuit of public activity was a product of frustrated sexuality! 6 Almost 40 years were to elapse before Cecil Woodham-Smith produced her much-acclaimed biography. Woodham-Smith insisted in her "Note of Acknowledgement" that she was offering "a complete picture of Miss Nightingale"-a recreation of her personality that not only brought out Florence's inner conflict with herself and outer conflict with her family, but also showed how she was able to operate effectively in a world controlled by men.7

Biography has many virtues as a historical tool. First, individuals come alive. Second, criticisms are voiced, despite fears that negative comment may be suppressed. Thus in Eminent Victorians, published in 1918, Lytton Strachey penned a scathing essay on Florence, indulging in wit and mocking sarcasm: "At times Mrs Nightingale almost wept. 'We are ducks,' she said with tears in her eyes, 'who have hatched a wild swan.' But the poor lady was wrong; it was not a swan that they had hatched, it was an eagle." 8 Third, biography is able to challenge biography. Witness how Jane Robinson's recent study has rehabilitated Mary Seacole 9 -quickly forgotten after her death though greeted with "rapturous enthusiasm" at the public banquet held in London to honor Crimean soldiers. Now she has been featured on a postage stamp, issued in July 2006 to commemorate the 150th anniversary of the National Portrait Gallery. 10 Nevertheless, biography does have limitations. In particular, it overlooks "the more ordinary lives" of nurses and patients, and prevents a comprehensive analysis of the economic, social, political, and cultural environments in which they lived. 11 Therefore, a contextual approach is essential to counterbalance these shortcomings.

The first attempt at contextualization came in 1960 with Brian Abel-Smith's History of the Nursing Profession, which looked at the politics of general nursing and assessed the role of structure, recruitment, terms and conditions, professional associations, and trade unions. …

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