International Nursing History Conference 2010

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International Nursing History Conference 2010
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International Perspectives in the History of Nursing
14 – 16 September 2010
Royal Holloway, University of London, Egham, Surrey
CONFERENCE BOOK OF ABSTRACTS
Roundtable Debate
Tuesday 14th September 2010
2:45pm – 4:00pm
Windsor Building Auditorium
‘Was there a Nightingale System of training, and, if so, what influence
did it have on the development of nursing in the late nineteenth century?’
Chair: Anne Marie Rafferty, Professor, CBE, RN, DPhil (Oxon)
Speakers:
Carol Helmstadter, Toronto, Canada: ‘Nightingale‖Training‖in‖Context’
Barbra Mann-Wall,‖The‖University‖of‖Pennsylvania,‖Philadelphia,‖USA:‖‘Nuns,‖Nightingale‖and‖
Nursing’
Judith Godden,‖The‖University‖of‖Sydney,‖Australia:‖‘The‖Power‖of‖the‖Ideal:‖How‖the‖Nightingale‖
System shaped modern nursing’
Lynn McDonald ‘The‖Nightingale‖system‖of‖training‖and‖its‖influence‖worldwide’
Sponsored by Royal College of Nursing
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Concurrent Session 1
Session 1a: Community Nursing
MOVING FORWARD BY LOOKING BACK: AN EXPLORATION OF HISTORY TEACHING IN
NURSING CURRICULA ACROSS AUSTRALIA
Margaret McAllister, Ed D, RN, PhD is Associate Professor, School of Health and Sport Sciences,
Faculty of Science, Health and Education, University of the Sunshine Coast, Queensland, Australia.
61 7 5456 5032
[email protected]
Wendy Madsen, PhD, RN is Senior Lecturer in the Faculty of Science, Engineering and Health at
Central Queensland University, Bundaberg.
Judith Godden, PhD, is Honorary Associate in the Department of History, University of Sydney.
Jennene Greenhill, PhD, RN is Director of Research, Senior Lecturer and Coordinator of the Masters
in Clinical Education program with the Flinders University Rural Clinical School in South Australia.
Aim: This study took place in 2007-8 in order to provide a national perspective on the teaching of
history of nursing within Australia. It aimed to produce information about existing content and
processes of history teaching in undergraduate programmes.
Rationale: While teaching the history of nursing can directly improve students’‖awareness‖of‖nursing‖
and professional identity, it does not enjoy a prominent place within Australian nursing curricula.
Despite‖the‖extant‖body‖of‖literature‖on‖nursing’s‖history,‖for‖example,‖Lewenson‖and‖Herrmann‖
(2008) and Godden and Forsyth (2003), Australian nursing history projects have not been extended to
produce educational outcomes (Nelson, 2002).
Significance: The national picture produced on‖the‖challenges‖of‖teaching‖nursing’s‖history as well as
the creative approaches, enabled critical analysis and a baseline for strategic curriculum
development.
Methodology: All Schools of Nursing in Universities across Australia were invited to participate in a
national survey. Semi structured telephone interviews explored what and how the history of nursing
is taught to undergraduate students within Australian nursing programmes.
Findings: A good response rate was achieved, with 22 of the 36 Universities participating. The study
found that even though participants valued history of nursing teaching, educators have difficulty
finding a place for history in the crowded curriculum, due to an over-emphasis on technical skills.
Consequently, opportunities to be pedagogically creative were minimal.
The study also found that history learning in nursing in Australia occurs in a variety of ways and
some respondents did move beyond teaching basic facts and dates, towards the so called secondorder learning wherein students are learning history, albeit in a brief time, in order to make
judgments about the profession’s‖evolution‖and‖to‖make‖decisions‖about‖the‖significance‖of‖events.‖
However, these various teaching strategies and resources are not evenly available.
Conclusions: The benefits of, and approaches to, history learning need to be more persuasively
disseminated across Australia. Similarly, the risk of an over-focus in the curriculum on technical
competence and vocational preparedness needs to be communicated. In the context of a health-care
world that is changing rapidly the pressure from industry has led to a situation where there is
shrinking space for history learning within this crowded curriculum and thus we are at risk of
producing short term gains of technical proficiency and losing the long term gains of critical,
constructive thinkers.
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SICK NURSES, MONTHLY NURSES AND MIDWIVES:
HOME CARE IN NINETEENTH-CENTURY CANADA
Judith Young
Independent Scholar
Tel: 416 488 0597
Email: [email protected]
This paper focuses on nurses and midwives hired to provide home care in the decades before nurse
training was securely established in Canada. The study builds on my earlier work detailing
nineteenth-century caregivers in Toronto and compares and contrasts those findings with
information on nurses and midwives in the cities of Montreal, Quebec and Halifax, Nova Scotia. The
history of religious nursing orders, particularly in Quebec, is well documented; we know also
something of early Canadian hospital nurses but little, however, of nurses and midwives hired to
care for people in their homes. My study seeks to document the growth of the private health care
market in nineteenth-century Canada.
The major primary sources for this study were public documents such as the census, city directories,
almanacs, and contemporary newspapers. Among the secondary sources, the work of Carol
Helmstadter, Barbara Mortimer, Anne Summers, and Susan Reverby on British and American
nursing was especially valuable. For information on working-class Canadian women I looked
mainly to Bettina Bradbury and Jane Errington and for the history of midwives in Canada to Hélène
Laforce and J.T.H. Connor.
The findings of this study indicate that until the late nineteenth century when trained nurses
appeared on the scene, nurses and midwives hired to provide care in Canadian homes were
overwhelmingly working-class and female, most were literate, and many were widows. The same
was true of Toronto. During this era, it was not possible to clearly separate nurses from midwives;
roles were fluid and, in the course of a career, some women used both titles. I found that the number
of private nurses grew as cities grew and prospered; this was most evident in Toronto and Montreal
but less so in Halifax, a city that experienced less population growth. Much has been written of the
‘disappearance’‖of‖midwives‖in‖Canada.‖‖By‖the‖late‖nineteenth-century, this was very true of
Toronto but not of Montreal and Halifax where a significant number of midwives continued to
practice. It is possible to trace some nurses and midwives through several decades and, in particular,
I highlight the surprising story of midwife Catherine Adams (1834-1908) of Halifax.
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LEADERSHIP STRUCTURES IN GERMAN HOME NURSING FROM
THE SECOND HALF OF THE 19th CENTURY- A CASE STUDY OF THE CITY OF HAMBURG
Mathilde Hackmann, RN, Diplom-Pflegepädagogin (FH), MSc
Hamburger Fern-Hochschule
Alter Teichweg 19 – 23
22081 Hamburg
Germany
++49 (0) 40 72699996
[email protected]
Aim of study
The study will illuminate the development of leadership structures in home nursing in the city of
Hamburg against the political and social background covering the second half of the 19th and the 20th
century. The following questions will be addressed: Who were the leaders? Which qualification and
preparation, if any, did they have? What were typical responsibilities? Is there a progress in an
independent leadership role of nurses?
Rationale and significance
With the introduction of long-term care insurance by the German federal government in 1994 a new
role of nursing manager in home nursing was introduced. It is already known how political decisions
influence home nursing in different countries (Buhler-Wilkinson 2004, Moers 1997). However no
research has been conducted on the development of leadership roles in German home nursing. An
historical analysis into leadership roles might help to understand the situation today and strengthen
nursing services for communities in the future.
Methodology
To answer the research questions a case study approach was used by focussing on the city of
Hamburg. Primary sources include documents from government on the federal and state level, two
of the leading nursing journals, reports from the governing boards of different home nursing
agencies and seven interviews with community nurses from an oral history project. Secondary
sources include journal articles and studies on German home nursing conducted during the last
decades.
Findings
In the second half of the 19th century the protestant church was very active in providing community
nursing in Hamburg with lady managers or deaconesses as leaders. Private-duty nursing was mainly
offered by individual nurses. In their daily work both groups of nurses were very independent with
little changes up to the 1960s. A leadership role of nurses became more necessary with the building
of teams of nurses. In Hamburg social workers were introduced to lead teams of community nurses
in the 1980s.
Conclusions
The development of the independent role of the nurse manager in home nursing was not a
straightforward one. In Hamburg nurses took over the leadership positions only recently.
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Session 1b: Technology and the Patient
FROM TOUCH TO TECHNOLOGY: MASSAGE IN U.S.
NURSE TRAINING-SCHOOL CURRICULA (1861-1945)
Paula Thomas Ruffin, MSN, RN, CMT
PhD Student/Pre-Doctoral Fellow in the Center for the Study of Complementary & Alternative
Therapies
The University of Virginia School of Nursing
434-244-0962
[email protected]
AIM: This paper traces the early roots of massage in the medical literature; the inclusion of massage
in nurse training-school curricula; and examines the historical shift from providing massage as a
basic nursing comfort measure to a specialization of physiotherapy.
RATIONALE: Early nursing care focused on principles of hygiene and basic comfort measures.
Guided‖by‖Florence‖Nightingale,‖the‖founder‖of‖the‖first‖nurse‖training‖school‖at‖St.‖Thomas’‖
Hospital‖in‖1861,‖massage‖techniques‖were‖thought‖to‖have‖been‖included‖as‖part‖of‖nurses’‖
qualifications and nurse training instruction methods and therefore were duplicated in the United
States nurse training curricula. During the 1880s and early 1900s massage was part of nurse training
curricula and instruction was delivered by physicians, nurses, or masseurs for many disease
conditions. By the 1930s and 40s influential nurse authors/educators began to recommend
specialization in physiotherapy for nurses, and as more scientific, and pharmacological solutions for
symptoms of disease became increasingly popular, the practice of basic nursing comfort measures
that incorporated gentle, soothing touch of the body such as massage declined.
METHODOLOGY: Primary sources: Text-books written by physicians, nurses, massage instructors;
medical/ nursing journals; and nursing curriculum guidelines from archival collections of the Center
for Historical Nursing Inquiry and the Special Collections Center at the University of Virginia.
Secondary sources: Published books/articles.
FINDINGS/CONCLUSIONS: Prior to the increase in scientific care, the use of analgesics, and the
specialization of physiotherapy departments the nurse provided basic comfort measures that
included massage to soothe fears and relieve discomfort among patients. Nursing care of the 1800s
included physician ordered massage as treatment for many diseases. Nurse massage instructors
believed massage was one of the most effective means of influencing the functions of the human
body and also held a firm belief that the act of massage was fundamental in the education of any
nurse. Historical research in the use of massage as a basic comfort measure in health care may help
refocus attention on the healing of the mind and body and reinforce the value of compassionate
touch‖and‖balance‖in‖today’s‖expensive, scientifically and technologically based health care setting
that‖often‖alienates,‖frightens,‖and‖may‖even‖do‖our‖patient’s‖harm.‖This‖research‖supports‖the‖
position that more curriculum time could be given to not only teach the benefits of massage, but
incorporate massage into almost all plans of nursing care.
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UK TREATMENT AND NURSING CARE OF TRAUMATIC
BRAIN INJURY IN THE TWENTIETH CENTURY
Christine Eberhardie, MSc, RN, RNT, FHEA, Cert HSM, Adv Dip in Local History
Honorary Principal Lecturer in Nursing,
Faculty of Health and Social Care Sciences,
Kingston‖University‖and‖St‖George’s,‖University‖of‖London
+44 208 641 6033
christine.e[email protected]
Aim of the Study:
To examine the changes in the treatment and nursing care of traumatic brain injury (TBI) in
the UK during the 20th century.
Rationale and Significance:
Modern treatment and care of TBI has developed exponentially during the late 20th century. In
order to understand why a person in their eighties today may have different attitudes and
fears‖of‖treatment‖which‖they‖may‖have‖observed‖or‖experienced‖in‖the‖1930’s,‖it‖is‖essential‖to‖
discover what the treatment was like in the early 20th century too.
Methodology:
To describe the treatment and care of TBI through content analysis of contemporary textbooks
and articles.
Reference will be made to primary documents where they exist.
To compare and contrast the findings with oral history records e.g. Nurses Voices
Findings:
The treatment of TBI in the early 20th century was less physiological than today although the
fundamentals of surgery were similar. Ventilation and sedation were not the first line
treatment of severe TBI.
During and after World War I the treatment and care of TBI was influenced by the work of the
American neurosurgeon Harvey Cushing and involved wide excision of damaged brain
tissue.
Techniques such as hypothermic baths were used up until the Fifties and nurses describe the
difficulties caused to the staff and patients of this treatment.
The Sixties and Seventies brought more advanced diagnostic investigations including the CT
scanner. Intensive care units were introduced with new roles for doctors, nurses and other
health care professionals.
The Eighties and Nineties brought more physiological approaches to neuroprotection. New
clinical nurse specialist roles were developed in neurorehabilitation and neurosurgical units.
Conclusions
Medical and nursing texts give a limited idealized account of the treatment and care of
patients but nevertheless record changes in the techniques available and recommended.
The oral history data gives an insight into what the experience may have been like for the
patients and staff.
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FROM CERTAIN DEATH TO LONGER LIFE:
TECHNOLOGY AND THE IMPACT ON DIABETES IN CHILDREN: 1900 – 1930.
Deborah Gleason-Morgan, RN, MSN, CPNP
PhD Student, University of Virginia, School of Nursing
Charlottesville, Virginia 22903
(804) 938 8630,
Fax: (804) 755 4929
[email protected],
Aim of Study: This paper examines how the care of children with diabetes was positively affected
by‖the‖changes‖in‖medical‖technology‖in‖the‖early‖twentieth‖century.‖‖The‖nurses’‖use‖of‖technology‖
in the care of children with diabetes will be described.
Rationale and Significance: At the turn of the century rapid changes in technology had a significant
impact on the care of children with diabetes. In earlier times doctors were the primary users of
technology. By the early twentieth century, the transfer of the use of some technology from doctors
to nurses began to occur, thus blurring the boundaries of medicine and nursing. Unlike the care
delivered in many other medical conditions, nurses caring for children with diabetes had more
autonomy in the uses of technology. This occurred because nurses were far too often left to care for
patients long after doctors went home, and in many cases had to make emergency decisions without
advice from the doctor. Over time as doctors saw that nurses could (and did!) make appropriate
decisions, (often using technology as back-up),‖doctors‖began‖to‖relinquish‖some‖of‖these‖‚tasks‛‖to‖
nurses. This transfer of the use of technology from doctor to nurse has continued into the Twenty
First Century. Issues of class, race and gender are discussed.
Methodology: The methods of social history were used in this study. Primary sources included the
F.G. Banting, and the Elizabeth Hughes papers of the Thomas Fisher Rare Book Library, University
of Toronto; medical, nursing and dietary books from the early twentieth century, as well as medical
and nursing journal articles of the era. Secondary sources included The Discovery of Insulin, by
Michael Bliss; Bittersweet, by Chris Feudtner; Devices & Desires: Gender, Technology, and American
Nursing, by Margarete Sandelowski; and A Social History of American Technology, by Ruth Schwartz
Cowan.
Findings and Conclusions: Technological changes which occurred during the early twentieth
century are outlined using a case study of a child who experienced, first hand, the impact these
changes‖had‖on‖the‖care‖of‖children‖with‖diabetes‖in‖the‖1920’s‖and‖1930’s.‖‖Responsibility‖for‖the‖use‖
of‖technology‖changed‖over‖time.‖‖Although‖initially,‖the‖nurse’s‖job‖was‖to observe and monitor
patients with their eyes and hands (without the use of technology), this evolved. This evolution of
the transfer of technology from doctor to nurse is discussed. Additionally, how nurses cared for
children with diabetes, using technology is discussed.
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Session 1c: Images of Nurses and Imagining the Nurse
‚HOLLYWOOD NURSES‛ IN WEST-GERMANY – BIOGRAPHIES, SELF-IMAGES, AND
EXPERIENCES OF ACADEMICALLY TRAINED NURSES, 1945–1980
Susanne Kreutzer, PhD,
Department for Humanities/Nursing Science
University of Osnabrück
Albrechtstr. 28, 49076 Osnabrück, Germany
0049 – 30 – 629 08 286 (private)
[email protected]
Aim of study
The paper explores the biographical experiences of nurses who played an important role in the
professionalisation of nursing in West-Germany. It focuses on the 1950s to 1970s when there was a
significant restructuring of the occupational image. In the early 1950s, the catholic and protestant
motherhouse sisterhoods still dominated the vocation. However, this changed essentially in the late
1950s and 1960s when the erstwhile religious calling transformed into a modern day female
profession that was brought in line with scientific standards.
Rationale and significance
Of vital importance in the reform process was the School of Nursing at the University of Heidelberg
which was funded by the Rockerfeller Foundation and started 1953. The school was meant to educate
a new elite of nurses and played a decisive role in the transfer of US-American concepts of
professional nursing into the West German context. The paper concentrates on the biographies, selfimages and experiences of these so-called‖‚Hollywood-Nurses‛.
First, the paper outlines the educational concept of the Heidelberg Nursing School. The focus then
shifts‖to‖the‖‚Hollywood-Nurses‛‖themselves‖– their personal background, their motivations to enter
the new type of Nursing School, their experiences during education and later on in the process of
nursing reform.
Methodology
The considerations are, on one hand, based on interviews with Heidelberg Nursing School alumnae.
On the other hand, published and unpublished sources of the Nursing School are taken into account.
The methodology of the paper draws on the experiences of Oral History Studies which reflect the
actual context of the narratives, the problem of commemoration and the relationship between
individual and collective memory. Comparison with written sources allows to verify the statements
of the interviews.
Findings and Conclusions
The‖ ‚Hollywood-Nurses‛‖ came‖ from‖ a‖ well-educated middle-class background. In the precarious
economic situation after the Second World War they had to enter the field of nursing. For these
women the Heidelberg School was highly attractive because it offered them an education according
to their social status.
The‖ group‖ of‖ ‚Hollywood‖ Nurses‛‖ was‖ small‖ in‖ number‖ and‖ met‖ strong‖ resistance in the field of
nursing. Nevertheless they were highly influential and established an important network of mutual
support. Large numbers of women who since the 1980s became the first West German professors for
nursing science had been educated in Heidelberg.
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‚GOD OF MERCY, SEND US HELP‛
FLORENCE NIGHTINGALE, HER PHILOSOPHY AND WORK, ON FILM AND TELEVISION
Lisa F. Stern, RN, MSN
Planned Parenthood Los Angeles
203-747-0763
[email protected]
Aim of Study
In‖a‖1995‖article,‖Patricia‖D’Antonio‖explains‖historians’‖persistent‖desire‖to‖interpret‖the‖legacy‖of‖
Florence Nightingale. A‖‚universal‖symbol,‛‖D’Antonio‖argues,‖Nightingale‖serves‖as‖a‖supple‖
historical figure, through which ideals of medicine, nursing, femininity, nationalism, and religiosity
can be refracted. In‖addition‖to‖scholars’‖interest‖in‖Nightingale,‖films,‖television‖features,‖and other
creative works have repeatedly re-envisioned the nursing leader since her death a century ago.
These‖works‖of‖popular‖fiction‖both‖reflect‖and‖influence‖Nightingale’s‖and‖nurses’‖position‖in‖the‖
public imagination. While previous analyses of Nightingale’s‖image‖on‖film‖(Kalisch‖&‖Kalisch,‖1983;‖
Hudson Jones, 1988) have engaged the broad question of how the protagonist is depicted, this paper
focuses‖specifically‖on‖how‖filmmakers‖capture‖Nightingale’s‖achievements‖as‖a‖nurse‖and‖how‖they‖
understand the philosophies underlying her work. Evaluating the extent to which the movies and
TV programs conform to the historical record, the paper will shed light on the public understanding
of Nightingale as a professional and as a thinker.
Rationale and Significance
Nurses‖and‖historians‖can‖gain‖from‖understanding‖the‖evolution‖of‖Nightingale’s‖professional‖
image over time, particularly in crafting strategies to shape public perceptions of nurses and their
work. The paper traces a concise historical map of imagined ideals of nursing and interrogates the
role of popular works in communicating the history of nursing and medicine.
Methodology
The analysis is founded on a close reading of films and television programs. Movies and TV
programs include The White Angel (Warner Brothers, 1936), The Lady with a Lamp (British Lion Film
Corporation, 1951), The Holy Terror (Hallmark Hall of Fame, 1965), an animated Florence
Nightingale for children (NEST, 2005) and two TV biopics also entitled Florence Nightingale (1985;
2008). An unproduced 1934 Paramount script will also be considered, the paper also incorporates
production documents, correspondence, reviews, and articles. These fictionalized versions of
Nightingale’s‖work‖are‖weighed‖against‖her‖own‖writings‖and‖the scholarship of Charles Rosenberg,
Julia Hallam, Anne Hudson Jones, and others. Contemporary biographies by Mark Bostridge and
Gillian Gill provide additional background. General critiques (Farella, 2001; Gordon, 2006) of images
of nursing in film enrich the analysis, as does work by Naomi Rogers, Nancy Tomes, and others on
nursing, medicine and film.
Findings and Conclusions
While volumes of material and hours of time have been dedicated to popular
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ANALYZING THE IMAGE: THE PHOTOGRAPHIC COLLECTION OF THE
PHILADELPHIA GENERAL HOSPITAL SCHOOL OF NURSING
Jean C. Whelan, PhD, RN, Assistant Adjunct Professor of Nursing
University of Pennsylvania
610-896-0622 (home)
610-5732168 (fax)
[email protected]
Purpose of Study: This study demonstrates the use of historical photographic analysis as a means of
interpreting historical documents such as photos placing them in their historical social, cultural and
economic context.
Rationale and Significance: Archival collections hold an enormous number of photos documenting
the nursing history. Yet, few analyses of historical photographs exist. While photos often accompany
nursing research text, most do so for illustrative rather than analytical purposes. This study utilizes
the historical photograph as a primary document, to which can be applied the same questions asked
of other historical sources. Analyzing historic photos enhances and expands our knowledge of
historical events providing an additional source from which to contextualize and interpret the past.
This study analyzed the photo collection of the Alumnae Association of the Philadelphia General
Hospital (PGH) School of Nursing. Founded in 1885, the PGH School was one of the first schools of
nursing in Philadelphia established on the principles of Florence Nightingale and enjoyed a long and
excellent reputation as a major teaching centers for nurses from the late 19th to mid-20th century.
The PGH photo collection totals approximately 1500 photos featuring images of life in the school and
on the wards and campus of the hospital spanning the years from 1880 to the 1970s. The collection is
in excellent condition and offers exceptional visual images of the activities in which nurses engaged,
the buildings in which delivery of health care took place and the individuals critical to the
maintenance of the school and hospital. The breadth, depth, and scope of this collection make it a
historically important collection in the field of health care and nursing history.
Methodology: Primary sources used were a selection of PGH photos taken during the late 19th to the
20th century. Titles and other identifying information accompanying the photos were verified.
Photos were categorized using predetermined themes. Photographic analysis applied to each photo
generated conclusions. Secondary sources used to contextualize findings included books
documenting the history of PGH and articles found in nursing and health related professional
journals.
Findings and Conclusion: The PGH photographic collection portrays the vast network of activities
that took place within a large hospital; analysis of which demonstrates the use of a unique data
source to expand interpretation of historic events. Although photographic analysis possesses
limitations it also provides a means to investigate the daily workings of hospitals and the power
structures within the hospital hierarchy.
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Session 1d: Perceptions of Midwifery
MEASURING MIDWIVES: MODELS AND (MISS)CONCEPTIONS
Vanessa L. Nelson, Bachelors of Nursing (BN), Bachelor of Arts in International Relations (BA-IR)
University of Calgary, Alberta, Canada
403 629 6372
[email protected]
Aim of study: First, this paper traces the development of midwifery in the province of Alberta from
the 1970s until the present. Second, historical barriers to establishing professional autonomy are
examined and evaluated within a Canadian and international context. Lastly, this paper considers
the‖implications‖of‖the‖government’s‖recently‖proposed‖‚new‖service‖delivery‖models‛‖on‖the‖future‖
of midwifery practice in Alberta.
Rationale and significance: Since April 1, 2009 midwifery has been a publicly funded service in the
provincial‖health‖care‖system.‖The‖Alberta‖government’s‖decision‖to‖publicly‖fund‖was‖long‖awaited‖
and has been regarded, by the midwifery community and their consumer advocates, as one of the
final achievements toward formal inclusion in the provincial health care system. However, after a
decade without funding many midwives have left the province, which has compromised the
midwives ability, as a larger profession, to realize autonomy. Furthermore, this recent inclusion in
the health care system presents a familiar challenge, co-optation,‖ with‖ a‖ new‖ face,‖ the‖ ‚new‖ public‖
management.‛‖ The‖proposed‖development‖of‖‚new‖service‖ delivery‖models‛‖undermines‖mid-wife
led models of care and, similarly, threatens the professional autonomy that midwives have been
struggling for since the 1970s.
Methodology: A‖ gender‖ approach‖ is‖ employed‖ to‖ understand‖ ‘obstructions’‖ to‖ the‖ delivery‖ of‖
midwifery services. The identification of midwifery as‖a‖women’s‖policy,‖within‖the‖larger‖women’s‖
health movement, aids in explaining the barriers to its adoption. Primary sources include
correspondence letters from professional bodies, transcripts of parliamentary debates, local
newspapers, as well as position papers from professional and government bodies. Secondary sources
from variety of disciplines on the subject of midwifery are used, such as those from history, nursing,
medicine, sociology, and law.
Findings: Barriers‖ to‖ midwifery’s‖ development‖ in‖ Alberta include: the social and economic
environment, the ideology of the dominant party, the strength of oppositional stakeholders, and the
controversial nature of the policy.
Conclusions: Midwifery has made relative gains toward professional autonomy since the 1970s. In
the first decade of the 21st century, midwifery in Alberta is exercising more professional autonomy
than it has historically been afforded. However, many of the barriers identified in this study still exist
and, consequently, could limit further realization of professional autonomy. Finally, the recent
inclusion of midwifery into the public health system, paradoxically, undermines midwifery practice
by suggesting the integration of non-midwife led models of care.
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THE MIDWIFE’S REGISTERS: THE DOMICILIARY PRACTICE OF A
NINETEENTH CENTURY COVENTRY MIDWIFE, 1847-1875.
Frances J Badger, RGN, RM, BSc, MSc.
PhD student, History of Medicine Unit, University of Birmingham, UK
0121 458 4576
07753 149111
Aim of the study
The overall study aim is to explore and analyse the history of nineteenth century midwifery in the
English midlands. One of the most significant primary sources identified to date are the registers of a
midwife who practised in Coventry, in the county of Warwick, over a period of 28 years, from 1847
until her death in 1875. Rationale & significance
The registers are unique, and a highly significant source which has not been previously analysed by
academic historians. The registers appear to be one of the most extensive and complete records of
female domiciliary midwifery practice in England in the second half of the nineteenth century.
Survival of such registers from this period are rare and it has been asserted that female midwifery in
the nineteenth century was in the hands of occasional practitioners who were unskilled, dangerous
and‖lacked‖sufficient‖experience‖to‖become‖competent.‖The‖Coventry‖midwife’s‖registers‖are‖
significant because of their survival, and because they indicate a much greater intensity of midwifery
practice than previously reported, demonstrating that the midwife was a trusted professional, a
‘somebody’‖in‖her‖local‖community‖and‖well‖regarded‖by‖poor‖women,‖elite‖subscribers‖and‖medical‖
men alike.
Methodology
The registers had previously been transcribed for use by family historians and the file was arranged
with‖clients’‖names‖in‖alphabetical‖order.‖With‖the‖aid‖of‖a‖macro,‖the‖file‖entries‖were‖returned‖to‖
chronological order and checked against the original registers for accuracy. Three main analyses have
been conducted: 1) A caseload profile. 2) Identification of repeat custom by local women. 3) Analysis
of the links between the midwife, poor women, the lying-in charities and their subscribers and
medical men.
Findings
The registers contain 5,029 entries over 28 years, and possibly represent all the deliveries she
attended. The midwife was regularly delivering over 200 women a year, with a peak of 286
deliveries, over five a week, in 1857, and there is evidence of repeat custom from local woman. The
last entry is dated just six weeks before she died, aged 69.
Conclusions
This rich data source demands that the nature and scope of female midwifery practice in the English
provinces in second half of the nineteenth century is reconsidered to take account of midwives’‖
professional profiles, as revealed in the registers of the Coventry midwife.
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Page 13 of 13
‘THE DOCTOR SWEARS BY HER AND I’M HAVING HER’:
A CASE HISTORY OF MIDWIFERY CARE IN 1930S ENGLAND
Tania McIntosh, MA, PhD, RM.
Lecturer in Midwifery
University of Nottingham
0115 8231924
[email protected]
Aim of Study
To explore the role of the midwife in England in the 1930s through the detailed study of the working
life of one individual, focusing on concepts of professional identity and changing patterns of work.
Rationale and significance
This paper focuses on a seminal period in maternity provision, when the practice of unqualified
midwives was phased out, and a salaried local authority employed midwifery workforce was created
following the 1936 Midwives Act. The golden period of midwifery in England is generally taken as
being the twenty years following the formation of the NHS when historians have perceived
midwives to have autonomy and job satisfaction as well as providing a seamless neighbourhood
based service (Allison, Delivered at Home, London, 1992). However, this paper demonstrates that
midwives were providing care along very similar lines, and with the same ethos, in the 1930s. This
was the decade in which the role of the midwives was externally formalised, and this paper
demonstrates the effect of this process on the work and mindset of an individual midwife.
Methodology
This paper is based on an oral interview conducted by the author with retired midwife Alice Pearson.
This is analysed in conjunction with her case records which give details of all her deliveries. Her
records contained information about factors such as length of labour, and the proportion of that time
spent with the woman by the midwife, allowing for descriptive analysis of her work load and care.
This is further informed by contemporary sources which focused on concern about rates of maternal
mortality and preventative strategies, including formalised antenatal care. The effect of these
national debates at the level of individual practice are explored.
Findings
Alice Pearson articulated and demonstrated a sense of professional identity through her work, as
well as a sense of vocation. Her pattern of care exemplified partnership with women and other
professionals, and put her caring role -rather than quasi-medical surveillance -at the centre of her
work.
Conclusion
The 1930s was a seminal period in the development of maternity care in England. This paper
highlights the central role of the midwife not only in providing care during this period of flux, but in
creating a template of the profession for future generations, through the articulation of a caring and
partnership ethos.
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Page 14 of 14
Session 1e: Nursing Skills and Nursing Labour
THE CLINICAL WORK OF HOSPITAL NURSES BETWEEN 1930 AND 1945
David Justham, MSc, BSc, RN, OHNC, RNT, FHEA
Lecturer, School of Nursing, Midwifery and Physiotherapy
The University of Nottingham
01522 573897 (direct line)
[email protected]
Aim: An exploration of the clinical work of nurses in the period between 1930 and 1945 before the
commercial availability of penicillin in hospitals in England and Wales
Rationale and significance: Medical texts in the 1930s commonly refer to the need for good nursing
care in the management of patients with life-threatening acquired infection. However, good nursing
care is not defined. Nursing manuals published in the same period describe the procedures nurses
should follow for particular tasks. The extent to which this was done can only be recalled from the
nurses themselves. The 1930s was a time of great change in healthcare. The nineteenth century
sanitarian, Florence Nightingale, had developed her ideas about nursing in response to miasma. The
theory of miasma taught that disease was spontaneously generated out of filth and foul air.
Developments in the understanding of specific disease being attributed to specific causative factors,
in particular the understanding of the microbial causes of diseases, from the late nineteenth century
onwards, had led to the demise of miasma as a theory of disease causation. The history of hospital
nurses’‖work‖in‖the‖period‖1930‖to‖1945‖may‖offer‖provide‖insights‖for‖present and future nurses
working with patients with acquired new or antibiotic resistant infections.
Methodology: The study is primarily based on oral histories collected in 2008. Thirteen histories
were‖digitally‖recorded‖in‖the‖respondents’‖homes.‖Oral‖history provides the historian access to the
world of those disenfranchised (typically women and their work) from traditional history
(Thompson 2000). Former nurses were recruited via advertisements in the local press and via the
mailing list of a voluntary hospital’s‖Nurses’‖League.‖
Findings: The discipline and ward routines evident in the accounts of this sample of hospital nurses
illustrate the management of a ward environment and the provision of nursing care explained
through miasma as a cause for disease. The persistence of the notion of miasma may have helped
with patient and visitor management. Evidence is found for a mutual working relationship between
nurses and doctors rather than a master and servant one. Evidence is found of nurses not being
wholly compliant with the expectations of senior nurses for their work.
Conclusions: This study provides valuable insight into the clinical work of nurses caring for patients
with acquired infection before the availability of antibiotics using oral histories as primary source
material.
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Page 15 of 15
MANAGING THE BURDEN:
NURSING OLDER PEOPLE IN BRITAIN : 1955-1980
Jane Brooks, RN, PhD
School of Nursing, Midwifery and Social Work
University of Manchester
0161 306 7636
[email protected]
Aim of study: to explore the work of front line nurses on older adult wards and the training that they
received for this work
Rationale: as a clinical nurse I spent much of my professional life working with older people both in the
community and in hospital. I was aware that many considered this work tedious and overly arduous. As
a nurse historian I therefore decided to research the history of caring for the elderly, but from those on the
front line; ordinary ward nurses.
Significance: as nursing history has developed as a discipline, research is moving away from professional
and educational issues to practice. People over the age of 60 have long composed the largest hospital
population; however they have historically been cared for in the poorest accommodation, were the most
poorly staffed and had only very limited access to equipment. It is hoped that this research will provide
valuable insights the work of these nurses.
Methodology: the paper is based on an oral history project of 20 nurses who had worked in elderly care;
as students and qualified nurses between 1955 and 1980. All the interviews were recorded and
transcribed verbatim.
Findings: the participants were split between those who considered the work too arduous and souldestroying and those who found the work valuable. All the participants described the work as amongst
the hardest that nurses do; with the lowest staffing levels, the poorest equipment and often without
managerial support. Nevertheless, the participants also describe the enjoyment of Christmas and ward
outings and the pleasure of seeing patients with their relatives. Key themes which emerged in the
interviews and to be discussed in the paper include: personal care, mealtimes and leisure, professional
relations and training. Within these themes the difficulties faced by nurses will be explored; lack of
equipment and staff and the status of elderly care.
Conclusions: nursing older people remained physically hard work even into the last quarter of the 20th
century. The nurses continued to work in routines, most especially in the areas of hygiene and
mealtimes. These routines did often mean that patients were adequately fed and remained dry.
However, not all units for older people were able to provide even such fundamental care for the patients
and whilst brutality was uncommon, neglect was often a bi-product of poor staffing, low morale and
limited leadership.
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Page 16 of 16
THE USE OF FOREIGN LABOUR WITHIN THE BRITISH NURSING WORKFORCE IN THE
IMMEDIATE POST WORLD WAR 11 PERIOD.
Richard Hatchett, RN, BA (Hons), MSc, PhD, MBA, RNT
Faculty of Health and Social Care, London South Bank University
0207 815 8023
[email protected]
Aim of study
To explore and understand British ministerial workforce policy in regard to nurse recruitment and
foreign labour in the immediate post World War II period.
Rationale and significance
This paper offers an understanding of how three ministries viewed nurse recruitment and worked
together to meet a severe shortage of nursing staff at the inception of the National Health Service (NHS).
It demonstrates the limitations of a reactive workforce policy and one not linked to statistical planning. It
illustrates how wider social issues, such as the decline of Empire and economic downturn in parts of the
world, were used to the benefit of Britain but how potential workforce solutions run close to attitudes to
foreign workers. Such issues remain significant today.
Methodology
Historiography utilising primary ministerial sources from the National Archives, The Royal of College
of Nursing Archives and the Modern Records Centre. Secondary sources primarily focus upon
evaluation of the race issues linked to British workforce policy in nursing and other work areas.
Findings
The paper argues that the government workforce policy and planning for British nursing in the
immediate post World War II period was reactive and essentially ineffective. Its primary aim was to
increase recruitment diversification to staff the new NHS by targeting a number of specific groups,
including the young, part-time nurses and men. Created interest was large, but the ultimate numbers
recruited remained small. Little statistical analysis occurred throughout this period with regard to either
local need or the effects on the occupation of targeting specific groups.
The use of nurses from the colonies and foreign labour, such as European volunteer workers (EVWs),
presented additional target groups within a largely reactive policy. A variety of factors, some fortuitous,
others deliberately manipulated by the ministries, facilitated an active recruitment campaign within
these new groups. The paper offers a progressively racist attitude, both in government departments and
in nursing and is framed against nurse recruitment.
Conclusions
Ministerial workforce policy within nursing in this time period (and indeed beyond) was reactive,
focused on diversification and was poorly linked to any strong statistical analysis. Nursing was
generally welcoming to overseas recruits but this can be framed against an increasing racial tension.
Britain lessened its support of nursing standards in the colonies in favour of British workforce needs.
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Page 17 of 17
Session 1f: Wartime Nursing
‚TURN A BOLD FRONT TO FORTUNE‛:
EMOTIONAL RESILIENCE IN WARTIME NURSES’ NARRATIVES
Jessica Howell, Ph.D.
Centre for the Humanities and Health and Florence Nightingale School of Nursing and Midwifery
King’s‖College,‖London
020 7848 3230
[email protected]
Aim of study: This paper seeks to elucidate the ways in which literature portrays the emotional
resilience‖of‖wartime‖nurses.‖By‖analyzing‖passages‖drawn‖from‖Mary‖Seacole’s‖Wonderful Adventures
of Mary Seacole in Many Lands (1857) and‖Louisa‖M.‖Alcott’s‖Hospital Sketches (1863), I will
demonstrate that these wartime nurses wrote of their experiences in the Crimean and American Civil
wars, respectively, with humor and a sense of adventure. Though not without compassion for the
pain and suffering of those around them, Seacole‖and‖Alcott‖resist‖nervous‖prostration‖or‖‚nursing‖
shell‖shock‛‖as‖a‖way‖to‖maintain‖their‖own‖autonomy‖and‖health.‖
Rationale and significance: Familiar are nineteenth-century stories of female nervous prostration. In
addition, popular novels such as The English Patient (1992) depict nurses who have sustained
emotional trauma from caring for the dying and wounded. However, I argue that there was another
narrative stance adopted by certain nineteenth-century women authors, who also served as wartime
nurses: that of emotional resilience and strength. In fact, both Mary Seacole and Louisa Alcott depict
key moments when they choose to remain strong in the face of the horrors of war, discrimination,
prejudice or seemingly insurmountable barriers. This strength manifests through humor,
indignation, or sometimes even anger.
Methodology: Though‖Alcott‖and‖Seacole’s‖works‖have‖both‖been‖analyzed‖in‖terms‖of‖their‖
sentimental and maternal overtones (see Glenn Hendler and Nicole Fluhr, respectively), their texts
have‖not‖been‖approached‖in‖terms‖of‖what‖they‖teach‖us‖about‖nurses’‖health‖and‖emotional‖
strength. My paper will build upon a tradition of reading both authors transgressing normative roles.
I will closely examine certain passages from both Seacole and Alcott’s‖primary‖texts,‖placing‖them‖in‖
contrast with nineteenth-century discourses of nervous prostration. In addition, I will provide brief
historical and biographical contexts for each author. The presentation will be in the format of a read
paper, supplemented with visuals (excerpted texts and relevant images).
Findings and conclusions: In contrast to Hana in The English Patient, Seacole‖and‖Alcott’s‖emotional‖
stances may partly stem from their own political beliefs and faith in the causes that they support, as
well as from their own determination to stay independent and autonomous women.
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Page 18 of 18
NO SAFE PLACES: THE LIVED EXPERIENCE OF U.S. MILITARY NURSES IN
THE IRAQ AND AFGHANISTAN WARS, 2003-2009
Elizabeth Scannell-Desch, PhD, RN, OCNS
Professor of Nursing
Mount Saint Mary College, Newburgh, New York, USA, 12550
(845) 702-0800
[email protected] [email protected]
Mary Ellen Doherty, PhD, RN, CNM
Professor of Nursing
Western Connecticut State University, Danbury, CT, USA
(978) 807-5320
[email protected] [email protected]
Aim of the Study: To describe the lived experience of U.S. military nurses who served in Iraq or
Afghanistan during the war years 2003-2009, and life after returning from war.
Rationale and Significance: The‖study‖of‖nurses’‖experience‖in‖war‖is‖timely,‖relevant,‖and‖
significant given the realities of armed conflict in our world today. When war breaks out nurses are
called to serve. Matejeski (1979) includes war as a significant factor that has influenced nursing and
society‖for‖decades,‖and‖suggests‖that‖nurses’‖experiences‖in‖war‖be‖investigated.‖‖Following‖the‖
terrorist attacks in the U.S. on September 11, 2001, several coalition countries, including the U.S.,
deployed forces to Afghanistan to engage the Taliban and Al Qaeda. In 2003 the U.S. began
assigning military nurses and other medical personnel to hospitals in Bagram and Kandahar,
Afghanistan. The first contingent of military nurses supporting the U.S. invasion of Iraq was sent to
Kuwait in February 2003. To date, no published studies have explored U.S. military nurses
experience in the Iraq and Afghanistan wars.
Methodology: Colaizzi’s‖(1978)‖phenomenological‖method‖guided‖discovery.‖‖This‖method‖includes‖
elements of both descriptive and interpretive phenomenology. The sample consisted of 37 military
nurses who served in the Army, Navy, or Air Force in the Iraq or Afghanistan wars. Contact
information for all nurses who met these criteria was not centrally available, so a purposive
‘snowball‖sampling’‖(Polit‖&‖Hungler,‖2000)‖and‖calls‖for voluntary participation were used. Four
data-generating questions guided the interview process. Most interviews were face-to-face and
conducted in naturalistic settings chosen by the participants. Several interviews were conducted
telephonically‖due‖to‖geographical‖constraints.‖Data‖analysis‖followed‖Colaizzi’s‖method‖of‖analysis.‖‖
Findings: Seven‖themes‖emerged‖from‖the‖data,‖including:‖‖‘Deploying‖to‖war’;‖‘Remembrance‖of‖
war:‖‖Most‖chaotic‖scene’;‖‘Nurses‖in‖harm’s‖way:‖‖More‖than‖I‖bargained‖for’;‖‘Kinship‖and‖bonding:‖‖
My‖military‖family’;‖‘My‖war‖stress:‖‖I’m‖a‖different‖person‖now’;‖‘Professional‖growth:‖‖Expanding‖
my‖skills’;‖and‖‘Listen‖to‖me:‖‖Advice‖to‖deploying‖nurses.’‖‖Analysis‖continued‖until‖data‖saturation‖
was achieved.
Conclusions: War takes its toll on everyone involved, including caregivers. Nurses returning from
war can provide valuable insights to those who follow. This study gives these nurses a voice in
describing their experience, including their stresses, daily milieu, feelings, and a tapestry of the entire
deployment.
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Page 19 of 19
Plenary Session
The Karen Buhler-Wilkerson Plenary on Community and Public Health Nursing
POLITICS AND PUBLIC HEALTH: COMMUNITY NURSING,
THE COUNTY, AND THE STATE
Rima D. Apple, PhD, Professor Emerita
University of Wisconsin-Madison, United States
Phone: (US) 608-251-3094
email: [email protected]
Aim of study: To analyze the social, political, professional, personal, and local factors that inhibited
and‖promoted‖a‖county’s‖acceptance‖of‖community‖nursing‖in‖order‖to‖disclose‖salient‖issues‖that‖
shape the public health activities.
Rationale and significance: In 1935, Wisconsin, a state in the mid-west United States, introduced an
innovative‖program‖to‖encourage‖the‖state’s‖rural‖counties‖to‖establish‖community‖nursing‖offices.‖‖
Wisconsin offered to fund a 2-year position of County Demonstration Nurse in each willing county, a
role similar to today's Nurse-Family Partnership. The state expected that after two years the
beneficial results of this office would be so obvious that the county would continue the program with
its‖own‖resources.‖‖Many‖of‖Wisconsin’s‖counties‖accepted‖the‖offer‖but‖not‖all‖elected‖to‖extend‖the‖
position with county funds. This study enables us to tease out the crucial issues that affected
different counties' decisions about local public health concerns.
Methodology: Records held by the Wisconsin Historical Society form the bulk of the source material
for this study. They include: official reports of the nurses and the state Department of health, County
Health Board reports, and, most especially, the personal reports of the nurses fighting to solidify
their positions. These are supplemented with local newspaper reports, the minutes of the County
Boards of Supervisors, and correspondence between state officials and county officials. Histories of
public health in Wisconsin and rural public health in other areas of the United States provide a
background for the analysis.
Findings and conclusion: This study highlights the distinctive and unique factors, ranging from
patriotism to personality, that affected the employment of public health nurses. Through a close
reading of the words and activities of the nurses involved and the State Department of Health, and
the reactions of county officials and other community members, this paper unpacks the complicated
and contradictory administrative structures, professional tensions, and local rivalries that determined
a‖county’s‖employment‖of‖public‖health‖nurses‖during‖a‖period‖of‖economic‖stress‖and‖shortage‖of‖
professional personnel, Most significantly, it documents the critical role of nurses in the
establishment and maintenance of public health offices.
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Page 20 of 20
HISTORICAL LINKS TO CONTEMPORARY OCCUPATIONAL HEALTH NURSING.
Jan Maw, RCN Public Health Nurse Advisor
Royal College of Nursing
The paper will explore what impact historical developments have had upon the current clinical
practice of occupational health nursing and their role as public health practitioners.
This paper will consider how the early roots of industrialisation impacted upon the social as well as
the industrial revolution, and how the past has shaped current thinking about the role of public
health practice in workplace health and wellbeing initiatives.
Early industrial health initiatives will be presented, for example, the work of Agricola who in the 16th
century wrote of high rates of mortality and morbidity in mine workers and their recommendations
to wear face veils, and the work of Paracelsus whose study of metals led to the recommendations that
inhalation of metal fumes should be avoided.
Also explored, will be the work of the early 19th century pioneers of industrial and public health
nursing such as Molly Young, who worked in the Lanarkshire Mills, and Phillipa Flowerday, who
worked at Coleman Mustards Factory. Links will be made between the practice of those early
pioneers and the current vision for contemporary workplace health and wellbeing strategies.
The paper will conclude by presenting parallels between the recommended education of industrial
nurses in the early 20th century to current curriculum, and will highlight how policy of the past is still
relevant to the direction of travel for the 21st century vision for improved health and wellbeing in the
workplace.
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Page 21 of 21
‚WHAT’S IN A NAME?‛ : A PUBLIC HEALTH NURSING HISTORY
Sandra B. Lewenson, EdD, RN, FAAN
Lienhard School of Nursing, Pace University
Pleasantville, New York
[email protected]
Aim of the Study:
This study examines the history of public health nursing by exploring the shift in roles as the names
changed throughout the late 19th century until today. It also explores the changes in educational
requirements to meet the expectations of this nursing role.
Rationale and Significance:
In the late 19th century Florence Nightingale‖spoke‖of‖‚health‖nursing,‛‖and‖a‖little‖later‖American‖
nursing‖leader‖Lillian‖Wald‖coined‖the‖term‖‚public‖health‖nurse.‛‖‖What‖the‖nurse‖who‖works‖in‖the‖
community in the United States is called has changed over time and has included terms such as
district nurse, visiting nurse, public health nurse, tuberculosis nurse, community health nurse, and
home health nurse. The change in terms often related to the setting, the location, the clinical focus, or
the level of education. Nursing educators, not always clear on what constitutes a public health
nursing‖experience,‖debate‖what‖is‖the‖‚right‛‖clinical‖experience‖for‖students‖in‖courses‖designated‖
public health/ community health nursing. As the public health nursing role evolved, so did the
nomenclature,‖leading‖some‖to‖question,‖‚what‖is‖a‖public‖health‖nurse?‛‖
Methodology:
A historical review of the published public health nursing literature beginning in the late 19 th
throughout the 20th century was completed. Primary data included early public health nursing
textbooks and published and archival materials from the National Organization of Public Health
Nursing. Secondary sources including public health/home care nursing histories provided contextual
background.
Findings:
The changing name reflects a variety of social, political, and economic factors that influence the
implementation, education, and focus of the role of the public health nurse. Whether public health
nurses cared for the sick poor or for those who could pay, whether they worked involuntary visiting
nurses’‖organizations‖or‖in‖municipal‖health‖departments,‖whether‖they‖were‖educated‖in‖
postgraduate programs or in baccalaureate degree programs, these nurses provided both curative
and preventive services in the community.
Conclusion:
The ability to continue to work in public health, regardless of the term applied to their work, shows
the resiliency of public health nurses. Gaining clarity in the evolving role and identity of the public
health nurse offers greater opportunity to educate leaders in public health nursing. Considering the
many iterations of this role over time helps public health nurses continue to work towards improving
the health status of individuals, families, populations, and communities throughout the world.
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Page 22 of 22
Concurrent Session 2
Session 2a: Issues in Mental Health Nursing
GENDER, WORK, AND IDENTITY IN COMMUNITY MENTAL HEALTH CARE
Geertje Boschma, RN, PhD, Associate Professor
School of Nursing, University of British Columbia
T201 - 2211 Wesbrook Mall, Vancouver BC V6T 2B5 Canada
604 822 7467 (phone), 604 7466 (fax)
[email protected]
Purpose: As controversy over large mental hospitals grew in the latter half of the 20th century a
deinstitutionalization movement reshaped the context mental health care. A new discourse of
community mental health and rehabilitation replaced former discourses of institutional work and
custodial care, constructing new identities of client, consumer, survivor, and peer support worker.
This study analyzes oral histories of men and women living with mental illness in one western
Canadian community, who actively engaged with this complex process of change and negotiated
new cultural identities. With a particular focus on the role and identity of the peer support worker, I
examine how this emerging group negotiated a new professional identity, while navigating the
complex relationships between gender, work, and mental illness.
Rationale & Significance: Peer support workers had a substantial role in the construction of new
rehabilitative practices, peer support, and community mental health services in the post-war era. But
we only have scant knowledge of their work in this transformative process. Their stories provide a
unique lens through which to explore larger social and cultural tensions between work and mental
illness. Examining the multifaceted connections between gender, work, and identity, this micronarrative analysis of a new area of caring work provides insight into the history of community
mental health care in the particular context of western Canada.
Methodology: Using oral history methodology, the paper analyses interviews with consumers and
peer support workers. The concepts of gender and place form central categories of analysis,
highlighting how new community connections and work identities were formed against the
backdrop of a rising and empowering consumer movement.
Primary and secondary sources: Oral histories of consumers and peer support workers, collected
as part of a larger study of the development of community mental health services in New
Westminster, form the primary source material. Oral evidence is augmented with archival records
regarding mental health care held by the Provincial Archives of British Columbia. Other relevant
primary and secondary sources are used as well.
Findings & Conclusions:‖Detailed‖analysis‖of‖consumers‖and‖peer‖support‖workers’‖experiences‖
reveal that the gendered construction of caring work permitted a fluid transition between consumer
and work identities. Gender coded processes of exclusion and inclusion structure an often
fragmented web of community support of subsidized living, volunteer work, support services, and
paid employment. People with mental illness actively take part in the construction of this network,
illustrating how illness, recovery, and community are fluid notions that need to be revisited,
reworked and renegotiated as circumstances change.
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Page 23 of 23
‘THE WEAKEST LINK IN THE CHAIN OF NURSING’?
RECRUITMENT AND RETENTION IN MENTAL HEALTH NURSING
IN ENGLAND. 1948-1968.
Claire Chatterton, PhD
Staff Tutor
The Open University in the North West
0161 998 7272
[email protected]
Aim of study- The study had 2 objectives. Firstly it explored the reasons that were given for the
severe shortage of mental health nurses that occurred following the inception of the British National
Health Service and which continued throughout the 1950s and 1960s. Secondly it analysed the
strategies that were adopted to ameliorate the problem.
Rationale and significance - Recruitment and retention in nursing is a topic that has aroused much
attention in the past but also remains a contemporary issue. In areas of nursing that have
traditionally had lower status, such as mental health or psychiatric nursing, this has been particularly
severe.
Peter‖Nolan‖(1992)‖has‖described‖mental‖health‖nurses‖as‖‚orphans‖of history,‛‖
because they have received such little attention from historians. Recruitment and retention in
nursing is also a topic that has received relatively little attention from researchers.
Methodology- primary archival sources were utilised to explore these issues. Records of the
Ministries of Labour and Health, the Central Office of Information and the General Nursing Council
were all examined as was archival material from the Royal College of Psychiatrists, the Royal College
of nursing and the trade union – COHSE. In addition the records of several mental hospitals were
examined in their respective county archives. A journal search during this period of both nursing and
medical journals was also undertaken, as was a search of Hansard – the record of parliamentary
proceedings. In addition, a series of oral history interviews were conducted with retired mental
health nurses, who were trained and had practiced during this period.
Findings – Reasons for difficulties in recruitment and retention were found to be complex. A
dissonance was found between the explanations given by official sources, at government and senior
management level, and those at grass roots level. In addition, the strategies that were adopted were
found to have been largely unsuccessful.
Conclusion – It is argued that this was because of the difference between the image and ideal of what
a mental health nurse should be, promulgated by the Ministry of Health and General Nursing
Council (based on a scientific, sickness model of care), and the reality of mental nursing in the large
institutions of the period, which were much likely to be largely custodial, with only intermittent
applications of new techniques and practices.
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Page 24 of 24
‚SCUFFLES ARE MALPRACTICE.‛ VIOLENCE IN DAILY LIFE OF A
PSYCHIATRIC ASYLUM IN THE 1930s IN SWITZERLAND
Sabine Braunschweig, lic. phil. I (=MA),
Freelance historian with own office
Büro für Sozialgeschichte Basel, Switzerland
Phone 0041 61 331 18 00
[email protected]
Aim of Study, Rationale and Significance
I present findings on history of mental health nursing practice in Switzerland. I analyse the agency of
nurses in a critical situation in daily life of the psychiatric asylum in Basel. Contrary to general
nurses, mental health nurses can get into a predicament where they use power and act violently. This
contradicts the traditional conception of nursing as attending to patients and supporting them. The
aim of the present paper is to shed light on the behaviour of nurses acting and reacting to patients
being upset and agitated. What were their responsibilities in situations where nurses had to force
patients to do something they did not want to do or to bar them from doing something they wanted
to do?
Methodology
This dilemma is illustrated by the example of a patient who was agitated and threatening in a way
that he had to get overwhelmed by several male attendants giving him a sedative injection. Later on
he got problems with his knee. His family filed a suit claiming that the injury of his knee was caused
by that scuffle and demanded financial compensation. The litigation produced piles of documents
that provide useful insight into daily practice of a mental health ward. Analysing the patient
document written by psychiatrists, the nursing reports by the attendants involved and the letters by
the‖patient’s‖family‖pictures‖this‖incidence‖from‖different‖perspectives.‖The‖materials‖illustrate‖how‖
the actors dealt with the incidence. Furthermore, we can compare the actual situation with the
prescription of the textbook at the time. To what extent did the attendants correspond with the
theoretical instructions?
Findings
These primary sources allow historians to analyse the quite unspectacular, yet common incidence in
psychiatry at a time – the 1930s – when chemical drugs were not yet introduced. We learn about the
daily routine of health professionals in a psychiatric asylum, the existing power relations, and the
behaviour patterns of the involved actors.
Conclusions
Mental health nurses are on a balancing act due to the predicament of psychiatric institutions. On the
one hand the order of psychiatry means the support of patients, on the other hand it is a disciplinary
force to reintegrate patients into society. Mental health nurses can get overstrained by this
contradictory exigence. This can lead to burn-out, illness, or aggressive behaviour towards patients –
problems‖that‖are‖still‖observed‖in‖today’s‖psychiatric‖institutions.
24
Page 25 of 25
Session 2b: Nursing and Religious Devotion
‘HOW I SHOULD HAVE FAILED WITHOUT YOUR HELP’,
THE CONTRIBUTION OF THE BERMONDSEY NUNS
TO FLORENCE NIGHTINGALE’S NURSING WORK AT THE CRIMEAN WAR
Therese Connell Meehan, RGN., Ph.D.
School of Nursing, Midwifery and Health Systems
University College Dublin
Belfield, Dublin 4, Ireland
+353 1 219 4846, [email protected]
Aim: To identify and analyse the nursing work and personal relationships with Florence Nightingale
of five nuns; Clare Moore, Gonzaga Barrie, Anastasia Kelly, Mary Stanislaus Jones, and De Chantal
Hudden‖from‖London’s‖Bermondsey‖Convent‖of‖Mercy;‖who‖accompanied‖Nightingale‖as‖nurses‖to‖
the Crimean war of 1854-1856.
Rationale and significance: The nuns worked with Florence Nightingale at the Scutari Barrack and
General hospitals, however the details of their work and their personal relationships with
Nightingale are little known.
Methodology: A social history approach was used to help understand their nursing work and
relationships within the complex social and political circumstances‖of‖Britain’s‖involvement‖in‖the‖
war. Primary sources included letters of the Bermondsey nuns, Florence Nightingale and Mary
Shore Smith; other letters, journals and accounts written by contemporaneous observers; and the 19 th
century annals of the Convent of Mercy, Bermondsey. Secondary sources included publications by
Sullivan on the work of the Bermondsey nuns and by Fletcher and Ishchenko and others on the
circumstances and conditions at the Crimean war.
Findings: The Bermondsey nuns worked closely with Nightingale for fifteen months, mainly at the
Barrack hospital. They had charge of their assigned wards or departments and worked, relatively
autonomously, up to twelve hours a day. They washed, fed and comforted the sick and wounded
soldiers, cleaned and dressed wounds, burnt and bandaged amputated limbs, prepared and
administered‖special‖diets‖and‖medicinal‖spirits,‖wrote‖soldiers’‖letters‖home,‖supervised‖nurses‖and‖
orderlies and assisted doctors. Moore had twenty-two years experience in nursing and management
and worked particularly closely with Nightingale. For some months Barrie led a party of nurses
daily to the General hospital where she had informal charge of nursing. Moore, in some ways similar
to Nightingale in education and social background and Barrie, superior to Nightingale in social
background, had much in common with Nightingale, and all the nuns and Nightingale developed
reciprocal relationships of respectful affection. Nightingale was privately unstinting in her praise
and appreciation for their contribution to her nursing work. However, the long-standing religious
conflict in British society required that the nuns work quietly and be as unobtrusive as possible.
Conclusions: The Bermondsey nuns nursed with skill and self-assurance, developed close
friendships with Nightingale and contributed significantly to her nursing work at the Crimean war.
However, prevailing religious sentiments in British society served to practically eradicate them from
the record of Crimean war nursing.
25
Page 26 of 26
‘ONWARDS, UPWARDS, HEAVENWARDS, HOMEWARDS’:
MISSIONARY NURSES IN PAPUA NEW GUINEA, 1946-1975
Susan Sherson, RN, BA, MRCNA
The Royal Melbourne Hospital, Victoria, Australia
61 3 9342 7148 (W) or 61 3 9380 1500 (H)
[email protected]
Aim of Study:
To explore the comparatively little examined contribution of missionary nurses to the development
of modern nursing in Papua New Guinea (PNG) from post- World War Two until Independence
from Australia was declared in 1975.
Rationale and Significance:
In January 1946 Jean Henderson, a young nurse and Anglican/Episcopalian missionary, arrived in
PNG, barely three months after the final Japanese surrender in the Pacific. The country had been
declared an Australian protectorate but areas like Oro Bay, where Jean and a similarly youthful
missionary teacher were assigned to work, lacked even the most basic infrastructure available on
mainland Australia. The local people and the resident missionaries had suffered grievously under
Japanese occupation and many were in dire need of effective health care. At Oro Bay, there was no
hospital or school. However, the relieving United States Army had erected a number of temporary
buildings. In what was formerly an American bakery, Jean Henderson began her first hospital and
later a School of Nursing for indigenous students.
The development of missionary hospitals, including the establishment of hospital-based Schools of
Nursing and their contribution to the wider development of nursing education in PNG prior to
Independence, is a story not widely told. It documents a little known but important facet of nursing
history, particularly Third World nursing history.
Methodology:
The primary sources applied in this paper are Jean‖Henderson’s‖own‖contemporaneous‖writings‖and‖
later written reminiscences, oral history interviews with the author of this paper, contemporaneous
Anglican Church publications, and local newspapers. Secondary sources are the small number of
books that document nursing events in PNG in the period 1946-1975.
Findings:
Missionary nurses such as Jean Henderson made a significant contribution to the development of
modern nursing in PNG post-World War Two. More than that, missionary nurses were instrumental
in the establishment of ongoing nursing education nationwide. As Jean recalls it, these were
challenging but exciting experiences.
Conclusions:
This perspective of viewing local nursing history through the eyes of one participant gives a unique
insight into the day to day struggles of establishing and maintaining both a hospital and a School of
Nursing in a diverse, underdeveloped country struggling for identity and nationhood. Its ultimate
achievement as part of the wider development of nursing is an inspiration.
26
Page 27 of 27
"LIFE AND WORK OF THE NURSE BERNARDINO DE OBREGÓN (1540-1599).
A REFORMER OF THE SPANISH NURSING‛.
Manuel Jesús, Profesor Asociado en la Escuela Universitaria de Ciencias de la Salud de la
Universidad de Sevilla (Departamento de Enfermería).
(http://www.portalhiades.com)
Antonio Claret García Martínez, Profesor Titular de Paleografía y Diplomática en la Facultad de
Humanidades de la Universidad de Huelva.
(http://www.portalhiades.com)
Teléfono personal: 619 902 546
Lugar de trabajo, Universidad: 954 551 484
[email protected]
Aim of study:
To announce the life and work of a Spanish nurse, Bernardino de Obregón (1540-1599), who reformer
developed an important task in the service of taken care, founding a nurses' congregation (1567) that
lasted up to the last third of the 19th century.
Rationale and significance:
For the knowledge of the evolution of the profession nurse is fundamental to know the major
number of these professionals: his lives and works. Twenty years of research, formed, between other
studies, a Doctoral Thesis, it has allowed us to know the life and work of Bernardino de Obregón,
who occupies one to bequeath head place in the Spanish nursing history.
The congregation for him founded, called "Minimal Congregation of the Brothers Poor Nurses"
(Mínima Congregación de los Hermanos Enfermeros Pobres), expanded to the whole Iberian
Peninsula and its territories of Overseas, and they elaborated a didactic agreement for the training of
the nurses, with five editions, used up to the 19th century.
Methodology:
Systematic work carried out in more than 20 archives of the country and some other libraries,
compiling an abundant manuscript and printed documentation, emphasizing the manuscript that
contains the Process of beatification of Bernardino de Obregón's, dated in 1633. Numerous original
documents have transcribed and studied, some of them dated in the last third of the 16th century,
which a rich information.
Findings:
Our researches have allowed us to know the labor developed by prominent figures as Bernadino de
Obregón and his nurses' congregation, and his contribution to the profession nurse not known in the
history of the nursing only two decades ago.
Conclusions:
Bernardino de Obregón's contribution supposed a new vision in the practical nurse, who transmitted
the members of his Congregation and whom they applied in the hospitals and sanitary Institutions
for them managed. This integral vision was contemplating to the patient since three side: biological,
psicological and social, founding centers for those patients who were lacking means and had to
convalesce of his disease.
His interest in training good nurses is a present way along his life.
27
Page 28 of 28
Session 2c: Borders and Boundaries
CROSSING THE BOUNDARIES’: HOSPITAL AND COMMUNITY NURSING
IN ONE CITY OF THE ENGLISH NHS, 1948-1974.
Judith Redman
Nursing Lecturer
Sheffield Hallam University, Sheffield, UK
+44 (0) 114 225 2522
[email protected]
Aim of the Study
The aim of the study, conducted for a doctoral thesis, was to analyse general hospital nursing in one
industrial city in England during the early years of the NHS, 1948 to 1974, taking into consideration
the relationships between nursing and the socio-political and physical environments within which it
was practised, as well as national and local influences.
Rationale and significance
The National Health Service (NHS) began in the United Kingdom (UK) on 5 July 1948, bringing
together‖ a‖ ‘muddled‖ patchwork’‖ of‖ health‖ provision‖ into‖ a‖ system‖ of‖ tax-funded primary and
secondary health care services for all citizens, free at the point of use. However, the new service came
at a price. The political compromise represented by the tri-partite structure of the NHS meant the
sundering of ties between hospitals and community-based personal health services that had been run
by the municipalities.
Methodology
This paper draws on archival research undertaken in hospital and health service records held in
Sheffield Archives and Local Studies Library (primary sources). Secondary sources include local
(Sheffield) and national (English) newspaper accounts of the inception of the NHS and contemporary
nursing issues, as well as general political, NHS and nursing histories.
Findings
Changes in the relationship between hospital and community in England during the third quarter of
the 20th Century, and the developing notion of continuity of care for patients, implications for nurses,
their work and their training in and beyond the general hospitals of one city are considered. This
leads from an examination of the external relations between hospital and community at
organizational level, across the borders with the outside world traversed by volunteers and visitors,
to the internal world of the ward and relations between hospital and patients and the paths that they
took to return to the community.
Conclusions
The shift in boundaries between public and private in the hospital is exemplified by the gradual
erosion of those boundaries, seen in the growing acceptance of .members of the local community as
visitors and volunteers on the wards and of patients as individuals. The shift in focus that
accompanied these developments required hospital staff to turn their attention from intra-sectoral,
hospital service, concerns to consider the continuity of patients' and relatives' lives outside the
hospitals.
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Page 29 of 29
THE RELATIONSHIP BETWEEN DOCTORS AND NURSES
IN AGNES KARLL‘S LETTERS AROUND 1900
Karen Nolte, PhD, Assistant Professor
Institute for the History of Medicine (Institut fuer Geschichte der Medizin)
Oberer Neubergweg 10 a
97074 Wuerzburg
Germany
0049-(0)931-8888-3094/3093
[email protected]
http://www.medizingeschichte.uni-wuerzburg.de/nolte.html
Problem
Agnes Karll (1867-1927) was a co-founder of the "Professional Organization of Nurses in Germany"
(founded in 1903) and thus contributed significantly to the professionalization of nursing care in
Germany. The paper proposed here is going to analyze the relationship between doctors and nurses
during the everyday nursing care as Agnes Karll described it around 1900. On the one hand, it will
be shown how Karll described her self-conception as a nurse, demarcating herself from the doctors.
On the other hand, I will analyze Karll's desires and projections during the daily interactions with the
physicians that exceed simple dichotomies. In a second step, Karll's dealings with the doctors will
be put within the context of the history of nursing care, i.e., it will be compared to the doctor-nurse
relationship within confessional nursing care.
Sources
The main source for this paper is the correspondence between Agnes Karll and her mother from
1887-1903. Already in 1977, it was edited and partially published by the nursing historian and
Kaiserswerth deaconess Anna Sticker (1902-1995). However, it is essential to use the original letters
since Sticker shortened the letters – at times without marking the cuts. These passages, which are
missing from the published material and have not been marked, often express doubts and crises that
reveal Agnes Karll as a person with weaknesses and emotions. Sticker crucially shaped the image of
Agnes Karll in Germany with this biography that essentially consists of the correspondence between
Karll and her mother and the editor's comments.
Results
Agnes Karll, who would have liked to become a doctor, herself alternates in her description of the
physicians' behavior between criticism and admiration. In contrast to the deaconesses who regarded
the care for the soul as a source of identity that distinguished them from the doctors, this was not the
case for the Red Cross nurse Agnes Karll. Her activities depended on the doctors' orders since she
was now following a concept of nursing care that was influenced by science and medicine. For that
reason her self-conception as a nurse was based on the recognition of her work by the physicians.
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Page 30 of 30
WHAT A NURSE IS AND WHAT SHE IS NOT: STRUGGLES FOR
PROFESSIONAL TERRITORY IN NINETEENTH CENTURY NURSING
Sue Hawkins, PhD
Kingston University London, Department of History
07939025737;
[email protected]
Aim: To analyse the development of the nursing role in the late 19th century in the UK compared to
the US.
Rationale and significance: The emergence in late 19th century England of a new view of nursing as a
‘scientific‖metier’‖has‖been‖linked‖to‖a‖wide‖range‖of‖influences,‖from‖the‖needs‖of‖medical‖
practitioners for better educated nurses to the urgent societal need to find suitable employment for
growing numbers of respectable unmarried women, who sought more challenging alternatives to the
traditional occupations open to them.
But, as nursing began to incorporate elements of medical knowledge into its training and practice,
sections within the medical profession became increasingly uneasy. The infiltration of medicine by
nursing was in some quarters compared with the subtle infringement of medical boundaries by
apothecaries several centuries earlier. At the close of the nineteenth century, the medical profession
had only recently secured its monopoly over healthcare, with state recognition of that status, and was
anxious to safeguard its professional boundaries from new intruders.
Even doctors who approved of better educated nurses were careful to draw a line under what was
and what was not acceptable in the context of nursing roles; on the one hand encouraging the
transfer of some of the more mundane tasks previously undertake by medical practitioners, while
firmly holding on to others. Dyce Duckworth and Octavius Sturges, both influential medical
members‖of‖the‖council‖of‖the‖Royal‖British‖Nurses’‖Association,‖were‖strong‖advocates‖of‖medical‖
education for nurses, but only under strictly controlled conditions, and wrote often about the need
for nurses‖‘to‖know‖their‖place’.‖
Methodology: Using published material - text books and articles in the medical and nursing press –
this paper will investigate the extent of the limits placed on nurses in the UK and compare this to the
situation of nurses in the USA, in the late nineteenth and early twentieth centuries.
Findings and Conclusions: In the late 19th century‖British‖nurses’‖role‖and‖knowledge‖were‖tightly‖
monitored and constrained by the medical profession, which attempted to draw hard boundaries
between their own practice and that of nursing. In the USA, these boundaries appear to have been
less clear, with nursing apparently taking a different, more liberal path.
30
Page 31 of 31
Session 2d: Politics, Ideology and the Development of Nursing
Dedicated to the memory of Paul Wainwright
THE HISTORICAL DEVELOPMENT OF INTENSIVE CARE NURSING
IN THE UNITED STATES
Christine Cutugno, PhD, RN, CCRN
Hunter College School of Nursing
City University of New York
212-876-6818
[email protected]
Aim of the Study
This study examined the development of intensive care nursing in the United States from the time
immediately after World War II, when the specialty was nonexistent, until 1970 when it was first
acknowledged as a specialty nursing organization. The period between 1945 and 1970 was one of
unparalleled growth of hospitals in general and intensive care units in particular and one in which
intensive care nursing developed and flourished.
Rationale and Significance
An examination of the development of intensive care nursing is vitally important to the
understanding of current health care issues. These same variables of funding, public expectations of
health care and technological developments will continue to influence the larger health care system.
The U.S. is poised to establish care priorities in a system with endless needs. As an acknowledged
trusted member of the health care team and the member with the broadest systems knowledge,
nursing is uniquely positioned to contribute to these priorities being equitable and ethical.
Methodology
The historical methodology was employed in this study. Preliminary topic exploration on the
development of health care services in the United States examined the influence of social milieu on
the post-war expansion of health care services and the subsequent development and proliferation of
intensive care units. Primary and secondary nursing and medical sources clearly revealed postWorld War II origins for ICUs, though evidence of clustering patients for closer observation can be
found as early as in the writings of Florence Nightingale. Primary sources establishing the post-war
status of science, hospitals and nursing included professional literature, federal commission studies,
congressional records, and lay public magazines and newspapers.
Findings
Science was widely seen as winning the war and making rapid advances toward improving health,
resulting in post-war support of funding for scientific and medical research. An expanding economy
and the wider availability of health insurance led to expansion of hospitals. ICUs, first developed to
address severe post-war shortages of personnel and equipment, proliferated as a result of this unique
convergence of economic, political, and social support of science and health care after World War II.
Conclusions
ICU nursing evolved within an environment of economic expansion, proliferation of technological
developments, and public demand for care. The success of the ICUs, largely attributable to nursing,
led to their rapid proliferation and resulted in the development of ICU nursing.
31
Page 32 of 32
‘THE ROLE OF POLITICAL INFLUENCE IN THE
DEVELOPMENT OF NURSING IN WALES 1948-1998’
Andrea Jones, RN
PhD Student
Swansea University, Wales
01437 781120
07866849999
[email protected]
Aim of Study
To consider from a historical perspective changes in the political influence of nurse leaders in Wales
between the creation of the NHS in 1948 and devolution of health services to the Welsh Assembly
Government in 1998.
Rationale and Significance
The use of historical material for nursing research has been neglected by traditionally scientific and
social science approaches. This project places primary material from oral and documentary sources
within historical debates to consider how effectively nurse leaders engaged in political processes that
promoted and shaped the profession in Wales. Conclusions may then be drawn regarding the
evolution of nursing influence and an evaluation of significant themes that drove changes in nursing
politics and policy. This will enhance understanding of the process of change in nursing in Wales,
and if and how this differs from the rest of the United Kingdom.
Methodology
Official documents from government bodies and professional organisations from the United
Kingdom and Wales are the main primary documentary source, with contemporary journal and
newspapers adding dimension and interpretation to events. The unique resource of oral testimony
of retired nurse leaders from management, education and professional representation in Wales
enable the voice of participants and observers in the political process to be discovered, providing
material where documentary evidence has been lost or disregarded.
Findings
The political role of nurse leadership evolved dramatically after 1948. Nurse leaders initially
reflected the matrons who emerged from the London Hospitals in their style and level of influence.
This position became fragmented as a diverse profession fought to maintain a voice in the
bureaucratic environment of the new NHS. By the 1960s, a voice of nurses in Wales began to emerge,
with a Wales board of the RCN and Chief Nursing Officer at the new Welsh Office. Later, the Welsh
National Board‖for‖Nursing‖and‖Midwifery‖and‖‘Strategy‖for‖Nursing‖in‖Wales’‖confirmed‖a‖
significant regional perspective.
Conclusion
The ability of nurse leaders to achieve significant political influence was undoubtedly inhibited by
factors outside the control of the profession. Service needs often superceded the nurses own
objectives and the ability of their leaders to promote their agendas effectively. However, despite this,
a clear voice of nursing in Wales did emerge that was quantifiably different to that of the rest of the
United Kingdom. (396)
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Page 33 of 33
THE ‚HISTORY OF NURSING‛ IN FUNDAMENTAL TEXTBOOKS:
CHALLENGING EMBEDDED IDEOLOGY
Teddie M. Potter, RN, Master of Science
University of Minnesota, USA
PhD candidate, California Institute of Integral Studies, USA
Minneapolis College, Minneapolis, Minnesota USA
W- 612-659-6407
H- 612-822-5669
[email protected] minneapolis.edu
Aim of study
The purpose is to identify ideological messages in nursing fundamental textbooks, which confuse
nursing identity and diminish the healing potential of nurses.
Rationale/significance
Nursing fundamental textbooks initiate socialization and profoundly impact the self-identity and
practice of future nurses. Therefore assumptions and ideologies within the texts must be critically
evaluated. Assumptions and beliefs are most evident in chapters describing the history of nursing.
They transmit powerful images that initiate development of nursing identity. With a more inclusive
history of nursing students can make fully informed decisions about a broader range of options in
nursing care.
Methodology
Chapters containing the history of nursing, in the most current edition of seven nursing
fundamentals textbooks were evaluated using content and narrative analysis. Two editions of the
same text were compared for changes over time.
Findings
Each textbook acknowledged the importance of nursing history while dedicating less than one
percent‖of‖total‖content‖to‖historical‖material.‖‖Sixty‖percent‖of‖the‖texts‖cited‖‚the‖future‖is‖a‖product‖
of‖the‖past‛‖as the primary reason for studying nursing history. Only forty percent suggested history
could be used to inspire and guide nurses. There was lack of consensus regarding definitions of
nursing and professionalism and the meaning of service. These texts generally ignored the profound
historical contributions of nurses throughout the world. Each text differed in the historical content
used to create an image of nursing. Seventy percent of the texts cited the mother/child relationship
as the template for nursing. There is limited coverage of herbalists, midwives, and other
autonomous models of nursing. Data also indicates ambivalence about the connection of nursing
and spirituality. Several texts made assertions about nursing care in the past but these claims were
not based on research. Application of historical research was very limited with an average use of four
references per text.
Conclusions
The history of nursing in nursing textbooks is essentially a subjective story carefully crafted to impart
select values to new nurses. Nursing is defined by the current needs of health care systems. This
decreases meaning and career satisfaction for nurses. A deeper grasp of the history of healing is
needed to create grounded nursing identity. If historical data is threaded through fundamental
textbooks, future nurses will have a broader understanding of the healing traditions and the healing
choices they can make in patient care.
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Page 34 of 34
Session 2e: Epidemics and Disasters
‚WITHOUT ENOUGH NURSES WE ARE HELPLESS‛:
PHILADELPHIA NURSES AND THE INFLUENZA EPIDEMIC, 1918-1919.
Arlene W. Keeling, PhD, RN, FAAN
The University of Virginia School of Nursing
434-924-5906
[email protected]
Aims: The purpose of this paper is to describe and analyze‖the‖nurses’‖role‖in‖responding‖to‖the‖1918‖
influenza epidemic in Philadelphia, the city with the highest flu mortality rate in the United States. It
focuses specifically on the response by hospital nurses and the Visiting Nurse Society during the
months of September to December, 1918, and considers their roles within the social, political, medical
and nursing context of the period.
Rationale and Significance: Since the spring of 2009, the United States, Mexico, and other countries
have been responding to a pandemic of the novel H1N1 influenza virus. Thus, there is renewed
interest among health care leaders, physicians, and nurses in lessons learned from the influenza
pandemic of 1918-1919, one of the largest and deadliest disease outbreaks recorded in history.
Indeed, experiences with pandemics in the past provide historical data on which to base plans for
how we will meet present and future epidemics.
Methods /Sources: Traditional historical methods with a social history framework were used for data
collection, data immersion, the development of a chronology and themes. Critical analysis of social,
political, and economic context, as well as the state of the art of nursing, public health and medicine,
was also done. Primary sources included the American Red Cross reports from the National Archives
Records Administration (RGs 2 and 75), and the Visiting Nurse Society of Philadelphia Collection,
the Brandywine Home Health Agency records and other hospital collections located in the Bates
Center for the Study of the History of Nursing, University of Pennsylvania.
Findings: Philadelphia in 1918 was at the center of the war industry and was teeming with large
ghettos of ethnic minorities. It also was the American city with the highest most rapidly
accumulating‖death‖toll‖during‖the‖epidemic.‖The‖nurses’‖response,‖amid‖a‖major‖nursing‖shortage—
both in hospitals and in the community -- was critical. Themes that have emerged in the analysis are
‚spontaneous‖cooperation,‛‖‚controlling‖contagion,‛‖‚crossing‖social‖boundaries,‛‖and‖‚maintaining‖
racial‖segregation.‛‖
Conclusion: Race, class and gender, as well as the state of the art of medicine and nursing and the
severe nursing shortage caused by the Great War shaped both the nursing response and the patient
experience in Philadelphia during the flu epidemic. In hospitals, segregation of blacks was
maintained despite the crisis, while in the homes, nurses and the upper and middle class women
who volunteered to accompany them, cared for patients regardless of ethnicity or class.
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Page 35 of 35
‚THIS WAS HARD WORK‛: KEZIA PAYNE DEPELCHIN AND THE MEMPHIS YELLOW
FEVER EPIDEMIC OF 1878
Adrian Melissinos, MSN, RN
[email protected]
713-667-3828
Purpose
This study is part of a dissertation that examines nursing during the 1878 yellow fever
epidemic in Memphis. Mrs. DePelchin traveled from Houston to Memphis to provide nursing care
in a city overwhelmed by over 17,000 victims of the epidemic. In almost daily letters written to her
sister, Mrs. DePelchin provided a first-person account of nursing activities during the epidemic. The
purpose of this study was to examine nursing roles and functions during the yellow fever epidemic
within the system of care in the beleaguered city.
Rationale and Significance Although over 500 nurses from areas throughout the United States
responded to the call for help from Memphis, little is understood about specific roles fulfilled by
nurses‖during‖the‖yellow‖fever‖epidemic.‖‖Mrs.‖DePelchin’s‖letters provide valuable insight into the
role of nursing during the public health crisis in Memphis.
Method
Primary‖sources‖include‖but‖are‖not‖limited‖to‖Mrs.‖Depelchin’s‖letters,‖newspapers‖in‖
Houston and Memphis, letters and other documents from the Tennessee State Library and Archive,
the Memphis Shelby County Public Library, and the Houston Metropolitan Research Center, as well
as secondary sources.
Findings
Mrs.‖DePelchin’s‖letters‖provide‖a‖detailed‖view‖into‖the‖life‖and‖responsibilities‖of‖a‖
nurse during the Memphis epidemic. Without a known source or treatment of the disease, nursing
care was essential. The hard work of a nurse included direct patient care, management of auxiliary
personnel, the application of fumigation techniques, and compassionate concern for patients and
family. Nursing care was prolonged and intense. Without professional training but with a reliance
upon her own skill and personal faith, Mrs. DePelchin demonstrated the ability to withstand the
physical and emotional burdens that caring for yellow fever victims engendered. Her detailed
accounts provide insight into the varied and skilled roles in which she engaged.
Discussion and Conclusions
Mrs. DePelchin chronicled her experiences as a Howard
Association nurse and articulated the essential roles that nurses executed. Mrs. DePelchin and other
nurses in Memphis successfully contributed to the response mounted against the Memphis disaster
in the summer and fall of 1878 and assisted in raising public awareness to the need for the
development of the professional nurse.
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CROSSING BORDERS AND BLURRING BOUNDARIES: CANADIAN AND UNITED STATES
NURSES IN THE HALIFAX, NOVA SCOTIA DISASTER OF DECEMBER 6, 1917
Deborah Sampson
Hancock
USA
Aim of Study: I investigate the activities of Canadian and United States nurses who provided
disaster relief after the Halifax, Nova Scotia harbour explosion on December 6, 1917. I explore
concepts of humanitarian intervention, disaster response, international cooperation, and nurses
literally and figuratively crossing geographic and practice boundaries to provide care amid the chaos
of disaster.
Rationale and Significance:‖This‖paper‖addresses‖issues‖of‖nurses’‖volunteerism,‖disaster‖nursing‖
care, and international cooperation. This research enhances understanding of transnational nursing
identity and activities in the context of Canadian/American relations in the early 20 th century and
nurses’‖organizing‖and‖implementing‖emergency‖and‖convalescent‖care‖after‖a‖disaster.‖
Methodology: Social history research methods were used to conduct this research. Archival sources
were used in the United States, specifically in Massachusetts, and in Halifax Nova Scotia. Further, online archival records of census data, national archives, and newspapers in both countries were
accessed. Secondary sources included books and journal articles related to the Halifax disaster and
Canadian‖and‖United‖States‖women’s‖history‖in‖the‖late‖1800s‖and‖1900s.
Findings: Halifax nurses provided initial care for thousands of trauma victims during the first hours
after the explosion. Other relief nurses arrived from other parts of eastern Canada within a few
hours. Trainloads of nurses, a few physicians, and supplies arrived from the United States within 2
days to relieve the exhausted Canadian‖‘first‖responders’,‖many‖of‖whom‖were‖also‖residents‖of‖the‖
city and had worked nonstop for two days amid wreckage, bitter cold and a blizzard to care for
almost 10,000 wounded and homeless people. Nurses provided emergency and ongoing care for
victims of physical and emotional trauma. Initial relief efforts lasted for a month with nurses from
both countries providing the majority of care in hastily-assembled healthcare facilities throughout the
city.
Conclusions: This paper provides insights into the interrelatedness of American and Canadian
history and culture, particularly in terms of the role of nursing in Canadian/American relations in the
early 20th century. Shared identity across national borders as exemplified by the activities of nurses
during a disaster in early 20th century North America is a story of based on strong cultural, familial,
historical, economic, and wartime ties of Eastern Maritime Canada and north-eastern United States.
Moreover, the social, economic, and political aspects of‖nurses’‖work‖and‖lives‖during‖this‖disaster‖
demonstrates the conflicts, cooperation and endurance the Canadian and U.S. nurses.
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Session 2f: Rural and Remote Nursing
‚MUST BE PREPARED TO PERFORM ANY DOMESTIC DUTY NECESSARY‛:
MISS BROADWOOD’S COTTAGE NURSES
Karen J. Egenes, RN, EdD
Loyola University Chicago
(773)508-2885
[email protected]
Aim: In 1883, Miss Bertha Broadwood, a non-nurse aristocrat from Lyne in Surrey, England,
established the Cottage Benefit Nursing Association to provide home care and midwifery services to
impoverished‖residents‖of‖rural‖districts‖who‖could‖not‖afford‖the‖services‖of‖a‖‚fully‖trained‛‖nurse.‖
Although provision of nursing care was envisioned as the primary responsibility of the cottage
nurse, the role also included housekeeping, meal preparation, and care of children and farm animals.
To prepare for this work, cottage nurses received a six month training course which included
instruction in bed-making, bed baths, dressing changes, female catheterization, assessment of
symptoms,‖and‖midwifery‖care.‖However,‖they‖soon‖found‖themselves‖in‖competition‖with‖Queen’s‖
Institute Nurses, founded in 1887, who also provided home care, but who were graduates of hospital
training schools.
Rationale and Significance: Although studies have focused on the evolution of district nursing in
London, the establishment of Rural District Nursing in Gloucestershire, and the foundation of the
Queen’s‖Nursing‖Institute,‖little‖attention‖has‖been‖given‖to‖cottage‖nurses, other than allusions to the
shortcomings in their educational preparation. Yet cottage nurses played a role in the professional
development of district nursing in the United Kingdom.
Methodology and Sources: Methods of social history were used in this study. Primary source
materials included the diaries of Miss Broadwood, from the Surrey History Centre. Secondary
sources included published histories of district nursing, as well as contemporary journal articles from
the British Medical Journal and the British Journal of Nursing.
Findings and Conclusions: British nursing associations were dismayed that Miss Nightingale's
minimum standard of one year of hospital training had been reduced to only a few months for the
cottage nurses. The professional identity‖of‖the‖Queen’s‖Institute‖Nurses,‖as‖well‖as‖their‖salaries,‖
were threatened by nurses with lesser preparation. In contrast, some prominent physicians spoke in
favor of the expansion of the scheme, citing the willingness of the cottage nurses to work under the
direction of a physician and to follow his directives. With time, a Queen's Institute Nurse was
required to serve as county superintendent, responsible for the supervision of cottage nurses.
However, the role of the cottage nurse may have indirectly influenced the passage legislation that
required higher standards for midwives and the eventual passage of the Registration Bill for nurses.
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EXPERIENCES OF INTERNATIONALLY EDUCATED NURSES (IENs) WHO IMMIGRATED TO
NEWFOUNDLAND AND LABRADOR, CANADA
Marilyn Beaton, MScN, MBA, Professor
Jeanette Walsh, MScN, BN, Assistant Professor (retired)
Memorial University of Newfoundland School of Nursing
300 Prince Philip Drive
St.‖John’s,‖NL,‖Canada
A1B 3V6
Phone: 709 777 7039
Fax: 709 777 7037
Email: [email protected]
Aim of this study:
To capture a piece of the history of nursing in Newfoundland and Labrador (NL) as related through
the stories of nurses who immigrated to practice nursing in a variety of settings throughout the
province and opted to stay. What were the challenges they encountered in their practice? How did
nursing practice in NL compare to their country? How did they adapt?
Rationale and significance:
Recruitment of internationally educated nurses has been used to supplement the nursing workforce in
NL for over a century. Initial recruitment efforts began in1893 for nursing stations in Labrador and
expanded in the 1920s to provide nurses for rural areas of the province. Overseas recruitment
continues today for nurse midwives to practice in northern regions of the province. Many of the
recruits came from large teaching hospitals in the UK only to find themselves as the lone health care
provider in small isolated communities. Overseas recruitment and the contribution of these nurses are
a significant but undocumented part of NL nursing history. This project was intended to record the
experiences of IENs who immigrated to NL, to explore the challenges encountered by these nurses
and the local nursing community, and‖to‖identify‖factors‖influencing‖the‖nurses’‖decision‖to‖come‖and‖
to stay.
Methodology:
This is an oral history study. Forty one nurses who immigrated to Newfoundland and Labrador
between 1949 and 2004 and practiced in all regions of the province and practice settings were
interviewed using a semi structured interview format. The data was analyzed for themes.
Findings:
The data revealed the following themes: deciding to immigrate; arriving in NL; finding differences
and similarities in nursing and health care; being accepted or not; discovering NL culture; doing
what had to be done; and making a home in NL. These themes were further analyzed to identify
factors contributing to each.
Conclusion
This paper focuses on the experiences of a group of IENs who immigrated to NL and opted to stay.
Their‖stories‖reveal‖the‖challenges‖these‖nurses’‖encountered‖adapting‖to‖nursing‖and‖health‖care‖in‖
NL as well as to the local culture. Their stories also reveal the factors which impacted on their
decision to immigrate and their decision to stay.
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THE STORIES OF ABORIGINAL NURSES IN QUEENSLAND AUSTRALIA 1950-2005
Odette Best, Master of Philosophy, Bachelor of Health Science
Certificate of Sexual Health Clinical Provision
Certificate of Cancer Screening and Pap Smear Procedures
Hospital Certificate in General Nursing
Queensland Health
07) 3237 1559
[email protected]
Aim of study
There is a minuscule amount of international research into the history of Indigenous peoples entering
nursing/midwifery. New Zealand, Canada and the USA identify their first Indigenous Registered
Nurse in contrast Australia has done very little. The above mentioned countries have two
commonalities worth noting, firstly, their initial establishment as British colonies and secondly the
development of nursing. Florence Nightingale had exceptional influence over the development of
nursing albeit initially aimed at the training of non-Indigenous women. Within Australia, Aboriginal
nurses‖were‖not‖able‖to‖enter‖the‖nursing‖and‖midwifery‖workforce‖until‖the‖1940’s.‖The‖aim‖of‖this‖
research is to document the experiences of Aboriginal nurses across 7 decades.
Rationale and Significance
There is a dearth of available literature outlining the experiences of Australian Aboriginal nurses and
the important contribution they have played in service provision within the wider non-Indigenous
community and importantly within the Indigenous community. The desire was to discover the
historically excluded knowledge of Aboriginal nurse and midwives and turn their experiences into
narratives.
It is essential to note that presently there is only a small number of written works published that
outline the experiences of Australian Aboriginal Registered Nurses. When drilling down to the
timeframe that is the parameter of this research the amount of literature consists of only two small
research projects and one published book.
Methodology
A qualitative design with thematic analysis and narrative was utilised to achieve the aims of this
research. A narrative methodology was identified most appropriate for this research due to the
traditional oral culture of Aboriginal Australians and its common utilisation within nursing research.
Data was collected via in-depth interviews. The goal was to allow the participants to tell their
experiences as Aboriginal nurses. Furthermore participants undertook an in-depth questionnaire.
Findings
All encountered racism
All have chosen to work within Aboriginal Health services.
All have experienced having to deny their cultural values to work within a non-Indigenous
nursing profession.
All expressed the desire to help their community to attain better health outcomes as a major
motivator for becoming nurses.
Conclusions
1. Aboriginal nurses have a rich and varied work history that needs to be documented. It must
be acknowledged that overwhelmingly Aboriginal nurses work in Indigenous health and
often this is identified as the motivation behind attaining nursing qualifications.
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Concurrent Session 3
Session 3a: Transport and Mobile Nursing in Wartime
ON THE BLOOD-DARK MEDITERRANEAN SEA:
TRANS-NATIONAL MILITARY NURSING AT GALLIPOLI IN 1915
Kirsty Harris, BA (RMIT), MA (Monash University), PhD (The University of Melbourne)
The University of Melbourne,
Victoria, Australia
+61 3 8344 3149
[email protected]
Aim
To provide a social and cultural history of trained nurses from the British, Australian and New
Zealand military forces who nursed in British ships off the coast of the Gallipoli peninsula, Turkey
during World War I.
Rationale and significance
Existing histories have vastly underestimated the number of military nurses deployed at Gallipoli.
As a result, the contribution of this cohort of nurses has not been examined in detail. The research
described in this paper enhances our comprehension of the development of trans-national military
nursing‖work‖and‖women’s behaviour while working under gunfire.
Methodology
Primary‖sources‖include‖military‖personnel‖files,‖nurses’‖diaries,‖autobiographies,‖letters‖and‖official‖
files. Secondary sources include official histories, nursing association journals and published World
War I histories. Descriptive statistics from both primary sources and secondary sources of the three
countries are provided. Statistical analysis is used to determine those women who actually served in
the battle zone at Gallipoli as opposed to those who did not see or hear the conflict but sailed
between Greece, Egypt, Malta and home countries.
Findings
This research reveals that more than 230 British nurses, over 100 Australian nurses, and some 20 New
Zealand nurses served either at or on Gallipoli during 1915. They worked mainly on hospital ships
and transport ships deployed to evacuate the thousands of casualties from the amphibious operation
on the peninsula from April to December 1915. Often they worked under shellfire. An examination of
this war arena reveals the emergence of a trans-national nursing practice due to cultural differences
and the expansion of the nurses’ roles into being first aiders, decision makers and managers of men;
Australian and New Zealand nurses who went to sea found their nursing practice was different from
that of their British counterparts. Findings also reveal‖the‖nurses’‖professionalism, their contrasting
management skills and their initiative in producing effective solutions in the chaos of war. The data
confirms that military nursing at sea is different from nursing on land.
Conclusion
The evolution of a trans-national practice occurred as ‘imperial’ and ‘colonial’ nurses sought to
impress their skills upon each other in nursing the wounded and sick. These findings raise questions
about other arenas where transnational nursing emerged for example, at casualty clearing stations
and forward operating centres where Canadian and US personnel were also involved.
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THE FLYING SISTERS – AUSTRALIA’S FIRST FLIGHT NURSES IN WAR
Maxine Dahl, RN, BAppSC (Nsg Sc), MNSt
PhD candidate
+61 2 6292 1193
[email protected]
Air evacuation of casualties became established by Allied nations during in WWII when patients had
to be moved over longer distances and harsher terrains. The Royal Australian Air Force (RAAF)
developed a medical air evacuation system with trained flight teams in early 1944 but its
development and the role of the nurses who led the flight teams remains largely unexplored and is
the focus of this research.
Aim of Study:
The aim of the full study was two-fold in that it sought to explore factors that influenced the
development of the Royal Australian air Force (RAAF) medical air evacuation system and the
flight nurse role in war between 1943 and1953.
Rationale and Significance:
Development‖of‖the‖RAAF’s‖flight‖nurse’s‖role‖and‖how‖the‖nurses‖lived‖and‖worked‖during‖
war remains largely unexplored and unknown. This study analyses that role within the social
context of the period.
Methodology: (include primary/secondary sources)
This historical research uses both narrative and analytical methodology. Primary source
documents including Defence files and interviews with ex-nurses deployed specifically to
undertake flight nurse duties in war-time enabled exploration of the training, role and
working conditions of these flight nurses.
Findings and Conclusions:
The‖ concept‖ of‖ ‘being‖ a‖ good‖ nurse’,‖ gender‖ and‖ class‖ were‖ shown‖ to‖ influence‖ the‖ flight‖
nurse’s‖role‖within‖the‖social‖structure‖and‖context‖of‖the‖time.‖The‖research‖ also argues that
flight nurses were valuable contributors to the Australian war effort.
This paper will focus on the training, role and working conditions of RAAF nurses who worked
specifically as a flight nurses in WWII only. It will also explore the factors that influenced the
emerging flight nursing role.
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THEATRE NURSING AT THE NORWEGIAN MOBILE ARMY SURGICAL HOSPITAL
DURING THE KOREAN WAR, 1951 – 1954
Jan-Thore Lockertsen, Assistant Professor, RN, Theatre nurse, Master of Health Science
All from The University of Tromso
The University of Tromso and The University Hospital of Northern Norway
+ 47 900 60 669
[email protected] / [email protected]
Aim of study
The aim of this study is to tell the Norwegian nurses story with a special focus on the theatre nursing.
Little, nearly nothing has been written about the Norwegian nurses’ work in Korea yet. Serving in a
tent with lack of many of the facilities they were used to in hospitals arises several questions that
have not been researched yet.
Rational and significance
During The Korean War Norway participated with a full Mobil Army Surgical Hospital, NORMASH.
Thou it was a UN-operation, the Norwegians served equipped with uniforms from the US army and
under the supreme command of the US 8th Army. In this hospital 111 Nurses, mostly theatre nurses,
22 male nurses and 80 doctors, served. Who were the nurses, and why did they go to Korea? What
challenges did the theatre nurses meet serving in a MASH, and how did the nursing develop during
the war? Did participation in the Korean War bring any consequences, if any, for nursing in Norway
after that war?
Methodology
The study will be done qualitative with interviews of retired nurses. Other possible informants are
doctors that served and military that served as guards. Pictures from NORMASH show both daily
life and work in the operation theatre. Articles in magazines such as the Norwegian nurses monthly,
‚Sykepleien‛, gives valuable insight in the trip to Korea, but there is nothing written about the
conflict itself and daily life at NORMASH. The Norwegian Army will give full access to their
archives.
Findings and conclusions
This is a work in progress. During the period 18th July 1951 – 18th October 1954, the hospital treated
more than 90.000 patients, 14.755 were in-patients, and over 9.600 patients received surgical
treatment. This was the first organized international participation in a conflict by Norwegian nurses
without Norway being in war. Many of the nurses that served in Korea came back to Norway and
served as Head Nurses for operation theatres, teachers for nurses, and Matrons at hospitals. They
were highly regarded for their nursing skills and it is widely accepted that experience from Korea
was‖one‖of‖the‖main‖sources‖for‖their‖skills.‖The‖nurses’‖story‖is‖yet‖to‖be‖told.
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Session 3b: Nursing, Power and Politics
NURSING WITH AND WITHOUT A MISSION: NURSING UNDER APARTHEID IN
KWAZULU NATAL, SOUTH AFRICA, 1920-1990
Helen Sweet, PhD
Research Associate at the Wellcome Unit for the History of Medicine at the University of Oxford on a
history of nursing and medicine in KwaZulu Natal, South Africa.
01285 861604, [email protected]
Aim of study: To explore the professional position of the nurses who trained and worked under
apartheid‖South‖Africa‖both‖as‖(‘white’)‖missionary‖nurses‖and‖as‖(‘black’)‖African‖nurses.‖To what
extent did race affect the recruitment, training, pay and conditions of African nurses and what was
the significance of the mission hospital to the development of nursing during the apartheid regime?
Rationale and significance: The relationship between black and white nurses was a complex and
subtly changing one throughout the C20th and perhaps nowhere more so than in the mission
hospitals. The race laws were imposed by the Nationalist Government and enforced by a
complicated system of permits and controls, and by a Department of Justice which implicitly
sanctioned police reprisals including violence and torture against opponents of apartheid - both
black and white – as‖well‖as‖covert‖‘municipal‖policing’.‖
Whilst these laws and the tensions resulting from them, clearly affected the daily routine and
management of the hospitals and their schools of nursing, this paper breaks new ground in asking
how this impacted the nurses working at grass-roots level on a daily basis, and also in considering
the difficulties and dilemmas that faced white missionary nurses working under these restrictions as
the minority group and often as foreign nationals.
Methodology: This paper uses a number of case studies of mission hospitals from varying religious
denominations but mostly based in rural KwaZulu Natal, to examine the change in inter- and intraprofessional relationships over a seventy year period of unofficial and official apartheid. It draws
from oral history as well as hospital newsletters and the more traditional documentary evidence to
what was the real‖relationship‖between‖African‖nurses‖and‖those‖termed‖‘White’‖or‖‘European’.‖
Findings and conclusions: Shula Marks, in her groundbreaking work, Divided Sisterhood stated that
what‖was‖peculiar‖to‖South‖Africa‖was:‖‘the‖way‖in‖which‖professional‖and‖class struggles in nursing
intersected‖with‖issues‖of‖race‖and‖ethnicity’ This paper will demonstrate that whilst the mission
hospitals were no exception, the way in which this was handled was rather different from lay
healthcare outside the world of the mission.
Marks, S., 1994 Divided Sisterhood: Race, Class and Gender in the South African Nursing Profession. Basingstoke, St. Martin's
Press: 5.
1
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RELUCTANT CITIZENS: NURSES AND POLITICS, 1918-1939
Susan McGann, BA Hons., Archivist
Royal College of Nursing of UK
0131 662 8190
[email protected]
Aim
The established image of nurses in Britain in the interwar years is of a conservative workforce which
accepted the traditional domestic role of women in society. This paper will study how nurses
engaged‖with‖political‖issues‖at‖this‖time‖and‖consider‖whether‖nurses’‖behaviour‖was‖any‖different‖
to that of the majority of women.
Rationale
The leaders of the suffrage campaign had argued that women had a unique contribution to make as
women to the political system. Yet after obtaining the vote in 1918/1928 women in Britain showed
little interest in politics and made little impact on the political process in the interwar years. Nurses
formed a distinct sub-group of the female electorate, they were predominantly single and employed
and it might be expected that they would show more enthusiasm for politics than married women
and housewives. A study of the attitudes of the members of the Royal College of Nursing provides
some evidence of how nurses engaged with the political issues of the time.
It was a constant challenge to the organisers of the Royal College of Nursing to get their members to
participate in the democratic structure of the college and to voice their opinions. They had to be
introduced to the ways of democracy, local branch meetings, council elections, public speaking. This
experience is compared to other non-feminist organisations such as the National Federation of
Women’s‖Institutes,‖the‖National‖Union‖of‖Townswomen’s‖Guilds,‖and‖the‖Mothers’‖Union.‖‖These‖
organisations,‖while‖accepting‖that‖the‖‘natural’‖role‖of‖women‖was‖as‖wives‖and‖mothers,‖also‖took‖
up the challenge of educating women in the ways of democracy.
Findings & Conclusion
Although nurses were working women and predominantly unmarried, they shared the same
disinterest in politics as women in general. This suggests that it was not because women were
married, or because they were mothers and housewives, that they were reluctant to engage with the
political process. It suggests that it was a more fundamental problem; possibly that women viewed
the political system as a male construct which did not reflect their world and were not convinced that
they could have any influence on it.
Methodology
Sources consulted: Primary - Royal College of Nursing archives, news cuttings, nursing journals,
oral history interviews. Secondary sources – unpublished Ph.D theses, books and journal articles on
women’s‖organisations‖in‖the‖interwar‖years.‖
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NURSES FOR A NEW FATHERLAND. GENDER AND IDEOLOGY IN THE HEALTH POLICIES
OF THE EARLY FRANCO REGIME IN SPAIN (1938-1942)
Eugenia Galiana-Sánchez, Tenured Lecturer (Community Nursing); Josep Bernabeu-Mestre:
Professor of History of Science; Pilar García Paramio: Associate Lectured (Nursing).
Community Nursing, Preventative Medicine & Public Health and History of Science Department.
University of Alicante. Campus de San Vicente del Raspeig. Ap. 99. E- 03080, Alicante.
965903919/965909853/669551416
[email protected]
Josep Bernabeu-Mestre,
Pilar García Paramio
RATIONALE AND SIGNIFICANCE: During the initial years of Francoism, the process of
institutionalising nursing in Spain suffered an important setback and was affected by the various
political and sociocultural factors that defined the new regime. Two core categories – gender and
ideology – determined how the professional evolved: with regard to gender, professional nursing
during this period cannot be separated from the legal, ideological and educational setbacks suffered
by general population, but which specifically affected females. In terms of ideology, the political and
religious institutions exerted an ideological control over both the public and private lives of the
population, which had its own repercussions in the nursing profession. Religion combined with the
Francoist‖concepts‖of‖fatherland‖and‖nation‖formed‖part‖of‖the‖philosophy‖that‖was‖present‖in‖nurses’‖
training and practical experience.
AIM: This paper analyses the influence of gender and ideology on shaping the new role of nursing,
and particularly childcare, during the early years of the Franco regime.
METHODOLOGY: Our main source of study was the text Formación de Enfermeras Sociales de Falange
Española Tradicionalista y de las JONS (‚Training‖ Social‖ Nurses‖ of‖ the‖ political‖ movement‖ Falange‖
Española‖ Tradicionalista‖ y‖ de‖ las‖ JONS‛),‖ published‖ in‖ 1938.‖ The‖ manual‖ includes‖ the‖ initiative‖ of‖
organising a course for nurses from the Technical Section of the Falange (the fascist party that
supported‖the‖1936‖coup‖d’état),‖which‖was‖aimed‖at‖providing‖scientific‖training‖for‖visiting‖nurses‖
in the field of childcare. Other training texts were also consulted, such as Estudios Sociales y de
Puericultura para Visitadoras y Enfermeras (‚Social‖ and‖ Childcare‖ Studies‖ for‖ Visitors‖ and‖ Nurses‛),‖
published‖ by‖ Joaquín‖ Valenzuela‖ in‖ 1942,‖ as‖ well‖ as‖ other‖ sources‖ relating‖ to‖ the‖ Falange’s‖ health‖
policy criteria.
FINDINGS / CONCLUSIONS: Femininity, understood solely in the terms considered acceptable by
the regime, was a requirement and to an extent a guarantee for nurses to carry out their work
correctly. The work of social nurses went beyond individual or collective healthcare. Through
intervention in child healthcare, they were given the task of restoring morale and helping to renovate
society. This meant adhering to feminine and Christian virtues, which in the eyes of health officials
were indispensable for nursing work, by sustaining the fascist idea of empire and ensuring the
creation of a new fatherland.
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Session 3c: Fighting for Professionalization
FIGHTING FOR THE NURSING PROFESSION IN PORTUGAL (1930-1960)
Helena da Silva, Licenciatura in History
PhD student in History
Ecole des Hautes Etudes en Sciences Sociales (Paris, France) and Universidade do Minho (Braga, Portugal)
0033688810432
[email protected]
Aim of the study: Analysing and understanding who were the persons fighting to develop the
nursing profession and what their demands were. At the beginning of the 1930s several nursing
schools existed in Portugal. Each school used to decide how to train its students and to deliver its
own diploma since there were no unified standards at a national level. Different nursing trade
unions, associations and professional nurses (male and female) fought to have a common training
programme and a national diploma. However, many people carried on practicing nursing without
such diploma.
Rationale and significance: To acknowledge how different nursing associations and trade unions
tried to improve the nursing profession during a dictatorship. Despite the censorship all along this
period (1930-1960), nursing professionals (male and female) took part in the development of nursing
as a professional group. Methodology: A critical analysis of the different revues published during
this period (1930-1960) by nursing associations and trade unions will allow understanding who was
interfering in this process, how it was being done and what their demands were. A series of
interviews to male and female nurses will also be taken into account to give a clear portrait of the
situation at this period of time.
Findings: The first striking remark is the reduced presence of female nurses that were actively
fighting to create a national diploma. This situation is different than in other European countries,
where female nurses played a key role in this profession. In the case of Portugal, male nurses were
the ones demanding the unification of nurses training and struggling with those that practiced
without any diploma. Among these last ones there were numerous religious women working in local
hospitals.
Conclusions: This study revealed the late unification of nurses training and the late creation of a
national diploma in Portugal. Consequently, in the 1950s there were still people working as nurses
without any training or diploma. The different nursing associations and trade unions fought actively
against these people. By doing so they were trying to improve the quality of nursing and to protect
the professional nurses. This fight contributed to unite the nursing professionals as a group, playing
a‖crucial‖role‖in‖the‖Portuguese‖society.‖Male‖nurses’‖actions‖were‖more‖visible‖than‖women’s.‖
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THE TROUBLED PROFESSIONALIZATION PROCESS OF ITALIAN NURSES: SOME
PARALLELS BETWEEN THE BEGINNING OF THE 20TH AND THE 21ST CENTURY.
Cecilia Sironi, MSc, BNS, RN, Pre-registration nursing degree Supervisor
Università degli‖Studi‖dell’Insubria‖and‖Azienda‖‚Ospedale‖di‖Circolo‖e‖F.‖Macchi‛‖di‖Varese
Corso di laurea in Infermieristica, Padiglione Antonini
Via O. Rossi, 9
21100 Varese (ITALY)
0039 0332 217940 (office);
0039 0332 320808 (home);
0039 3484977576 (mobile)
[email protected]
Aim of study The aim of the study was to look for common issues into the professionalization
process of Italian nurses in the early 20th and 21st century in order to compare situations and learn
lessons for the future.
Rationale and significance In the last 15 years Italian nurses have witnessed major changes,
especially in education. However, what could be seen as steps toward an increase in professional
attributions might also be warning bells against de-professionalizing attitudes.
Methodology Sources from the few Italian nursing historians dealing with the crucial transition
period between the 19th and the 20th century have been analysed, as well as the professional attributes
developed‖with‖the‖spread‖of‖Nightingale’s‖education model (Nightingale, 1860; Celli, 1908; Pittini,
1948; Smith, 1954; Palazzo, 1957; Calamandrei, 1983; Vicinus, Nergaard, 1989; Sironi, 1991, 1996, 2002;
Dimonte, 1995; Fiumi, 1999). These issues have been compared with 21st century developments. For
the most recent history, the author has availed herself of her thirty years of professional life and her
extensive reading of national journals.
Findings The‖transferral‖of‖Nightingale’s‖education‖model‖to‖Italy‖was‖critical,‖due‖to‖the‖different‖
power balance between doctors and nurses. In the early 20th century knowledge was mainly
transmitted by doctors holding both positions of Hospital Director and Head of Nursing School.
Nurses (nuns and unmarried ladies) taught ethics, and practice skills aimed at caring the sick.
However, most of these women were not Hospital Matrons. Nursing programmes and nursing
practice were strongly value-driven, and a clear identity was formed. Before a National Nurses Board
was constituted, many nurses belonged to lay and religious professional associations. A dominant
theme in early 20th century‖literature‖was‖the‖shortage‖of‖nurses.‖Unqualified‖and‖‚low‖personnel‛‖
fought against upper-class registered nurses.
Conclusions The main change in 21st century nursing has been the transferral of nursing education
to Universities. In Medicine Faculties medical professors are course leaders while nurses are Clinical
Placements Coordinators. Nursing programmes are medically driven and a clear nursing identity is
hard to form and depends on local characteristics. Every nurse in Italy must be registered with the
National Nurses Board in order to practice, though, only few are active members. A permanent
problem in Italy is the shortage of nurses, supplemented with a growing intake from abroad.
Unqualified personnel and caregivers are eroding traditional nursing roles. Some lessons can be
learned from the past in order to avoid de-professionalization in nursing.
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NURSING TRANSITIONS IN PORTUGAL – SECOND HALF OF 20TH CENTURY
José Amendoeira, PhD, MsD, RN.
Director of the Health Higher School of Santarém (PORTUGAL).
Lecturer in Master and Doctoral programmes in Nursing Science
968582604
[email protected]
Aim of the Study: to contextualize nursing transitions in the second half of the 20th century, in the dimensions:
context, curricula and actors.
Purpose: As far as nursing education is concerned, in the Portuguese case for many years we can not talk about
the existence of a discipline of nursing.
The construction of the discipline seems to have happened‖ between‖ the‖ process‖ of‖ the‖ nurses’‖
professionalization‖and‖the‖social‖construction‖of‖the‖curriculum,‖essentially‖since‖the‖50’s‖of‖the‖20th century.
Methodology:
The historic method allowed formulating connections between ideas, events, institutions and people in the past
enlightening the socio-historic discourse throughout this period. The stories of life assumed a particular effect,
connecting them to the formation of trajectories to understand the mechanisms and processes used by
participants in managing the situations they were in, with the resource of the ethno-biographic interview. The
Unique Case Study, with qualitative characteristics, allowed us to know individual, organizational, social and
political phenomena.
Findings:
We have analyzed the data under three dimensions - Contexts, Curricula and Actors – along the decades from
year‖50’‖to‖the‖beginning‖of‖XXI‖Century.
About Contexts , until 1965 the School for Nurses was within the hospital, and without autonomy. After the
national evaluation of the state of the schools of nursing about their pedagogic conditions to teach,
recommended by OMS in 1963, the Schools started , in 1965, a process of autonomy with the creation of the first
Nursing School (1967), independent of hospitals – School of Education and Management in Nursing. One of the
most important fact occurred in 1988 with the Integration of Nursing in Higher Education, and the conversion
of the schools in Higher Nursing Schools, in 1989.
From Curricula, as a dimension we can emphasize that in 1947 were established two levels of nursing
education.‖The‖Introduction‖of‖the‖contents‖‚medical‖nursing‖techniques‛‖and‖‚chirurgic‖nursing‖techniques‛‖
in 1952, can be considered as the emergence of nursing as a discipline, because of the official participation of
nurses in the education of pairs, and the beginning of conceptualization of nursing care. Because of this in 1964,
occurred a Curricula reformation. Discipline of Nursing (with biomedical orientation) structuring the
education, biomedical disciplines and inclusion of social and human sciences. In the year of 1967 we assist to the
beginning of the education on Investigation. After the carnation revolution, many things have changed and we
have assisted one of the most important transitions, the unification of pre-graduate education (1975). The
integration in higher education with bachelor degree (1988) and with Degree in 1999, are also considered two
important transitions.
Considering the Actors in this transitional analysis, in 1947 the State has begun the control of the legal exercise
of nursing and with the conditions promoted by the transitions in contexts and curricula. After 1965 we assisted
to a very important evolution and social recognition, with responsibility of education and the Direction of the
Schools by nurses and the promotion of similar access conditions as required for other courses in higher
education. Since 1975 we have in Portugal a unique Professional – Nurse, transition that contributed to the
Regulation of the Professional Exercise of Nursing, in 1996. In 1998, the Portuguese State has regulated the
possibility to the establishment of the Nurses Order.
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Conclusions:
Contexts - Nursing Higher Schools are autonomous organizations, in different scenarios of the higher
education network: Schools integrated in Polytechnics Institutes, Not integrated Schools and schools integrated
in Universities, but all of them within a polytechnic system.
Curricula - From the unique curriculum to curricular diversity, the conception and curricular development
occurs from Nursing, discipline and profession, along the three cycles of Bologna studies.
Actors - The qualifications for the skills that enhance to deal with the complexity in health suggest the debate on
nursing education about professionalism and multidisciplinary. The professionalization process is going on, but
we assist still to a lack of social and professional identity.
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Session 3d: Northern Nursing
ETTA SCHUREMAN JONES –
ALASKA NURSE TEACHER PIONEER AND PRISONER OF WAR
Thelma M. Robinson, MS., RN
303-442-8536
[email protected]
www.cadetnurse.com
Aim of Study: The purpose of this study was to document the mission of Etta Schureman Jones, a
nurse teacher Alaska pioneer and to record her experience of being taken prisoner of war when the
Japanese invaded the island of Attu during World War II.
Rationale and Significance: Well qualified as a teacher, nurse, and community worker, Etta
Schureman Jones with her husband, Foster, served Indians, Eskimos, and Aleuts in five native
villages in Alaska for two decades. On their last assignment on Attu, the Japanese invaded the
island. Etta was captured and Foster was killed. Etta was the only white woman to be taken prisoner
of war on American soil during World War II. She was held captive for more than three years.
Methodology: Historical method was used to examine and interpret primary and secondary
sources. Primary sources draw from family letters and records collected by a grand-niece and from
the Bureau of Indian Affairs and the National Archives Records. A relevant secondary source
included‖a‖book,‖‚Not‖Now‖Tomorrow‛‖written‖by‖Alice‖M.‖Bowman,‖an‖Australian‖nurse,‖who‖was‖
a prisoner of war with Etta Jones in Japan.
Findings and Conclusions: After graduation from High School in 1898, Etta Schureman attended
Connecticut State Normal College and taught school for five years. She then enrolled in the
Pennsylvania Hospital Training School for nurses and received a diploma. She served as a nurse in
hospitals in Philadelphia and Pittsburgh from 1913 to 1922.
In August 1922, Etta, 43, and her sister, Marie, 39, embarked on an adventure to serve the native
people in Alaska. After a year Marie returned to the East Coast, but Etta had fallen in love and
married Foster Jones. The husband and wife team happily served Native Americans from 1923 to
1942. Although both 61 years of age, September 1941, the Jones accepted the challenge of serving on
an extremely isolated island at the tip of the Aleutian chain.
On June 7, 1942, Japanese invaders separated Mr. & Mrs. Jones, and Mrs. Jones did not see her
husband after the second day. Etta Jones was transported to Japan and became a prisoner of war
along with 18 Australian nurses who had been captured in New Guinea. Until August 1945, the fate
of the Jones couple and the 45 natives living on Attu was unknown.
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BORDERLAND NURSING FROM A NORTHERN PERSPECTIVE
Ingrid Immonen, Cand. San., Associate Professor
Høgskolen i Finnmark
Avdeling for Helsefag
Finnmark University College
Faculty of Nursing
N-9613 Hammerfest, Norway
+47-784 27 845
ingrid.immonen(at)hifm(dot)no
Aim of study
This study is a part of a project within Nursing History that sets light on nursing and health care
during‖World‖War‖II‖in‖Northern‖Norway.‖‖The‖study‖‚Borderland Nursing from a Northern
Perspective‛‖aims‖to‖focus‖on‖challenges‖in‖nursing‖care‖that‖arise‖in‖situations‖where‖ordinary‖
health care organisation in the community is broken down. That is, in a situation where the picture of
enemy and friend changes, borders are adjusted, there are war activities, supplies are scarce and
communities are inhabited by enemy troops, up to ten times their own population. In the final stage
of the war there was deportation of the population and strategy of scorched earth was used by the
withdrawing troops.
Rationale and significance
Today questions about cooperation across borders and the significance of neighbours changing status
between friend and enemy, has influenced on the health situation and development of local nursing
care, as well as interaction between nurses across borders in spite of largely diverging health care
systems. The Arctic Area is highlighted in politics in Norway, and the outcome of the project will
contribute to the platform of understanding both attitudes among the population towards nursing
and health care systems as well as understanding differences in defining health.
Methodology
Written material: Because of war activities, deportation and burning of the county, archives are
fragmentary. Central archives can contribute with annual reports from health authorities in all
communities. Local archives are fragmentary and not easy to find. There are a number of reports
written soon after the war, as well as a number of biographical booklets of newer date. There might
still be diaries and photographs as well as unpublished records from voluntary organisations.
Interviews: There are a number of recorded interviews. There are as well still living persons who
were young adults during the war.
The challenge is to find these unpublished sources, as they will be found scattered all over the
country.
Findings and Conclusions
The main focus in this paper will be data mainly based on reports and letters from nurses during war
years, as well as interviews with nurses that served in Northern Norway during war. Their stories
tell about coping as nurses in a society that has broken down and to keep up nursing standards for
people living in the area.
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WARTIME AND THE CARE FOR THE MENTALLY ILL:
WHAT CONSEQUENCES OCCURRED WHEN PUBLIC CARE AND NURSING WAS
ELIMINATED DURING WWII IN NORTHERN NORWAY?
Åshild Fause, RN, Phd, Associate Professor
Department of Health and Care Sciences
Faculty of Health and Care Sciences
University of Tromsø
Norway
Aim of study
The presentation deals with what consequences occurred when the publicly supported care and
nursing of mentally ill to a large extent was eliminated in wartime Northern Norway. The study is
part of a project within history of nursing that sheds light on nursing and health care in Northern
Norway during World War II.
The presentation will give a summary of the mental health care system in the two northernmost
counties in Norway, in Troms and Finnmark, what it was like and how it functioned, by 1940, at the
time when Norway was invaded by German forces. Three main questions will be highlighted. First,
I will focus on the ideological and political underpinnings of decentralized mental health care in
Norway. Second, I will focus on what happened to the care system, the patients and the nurses when
the German occupants requisitioned hospitals and nursing homes in 1942. Third, we will try to
answer what happened to the mentally ill when the Germans by force evacuated the entire
population in Finnmark and the northern part of Troms in November 1944 as a strategy of the
scorched earth.
Rationale and significance
We know little about what happened to mentally ill and the nursing care during World War II in
Norway. No one has ever written about this before.
Methodology
Written materials:
Because of war activities and evacuation and burning of the county, archives are fragmentary. There
are some biographical booklets as well as published records from voluntary organisations and local
history publications.
Journals of psychiatric patients and annual medical reports on the health condition in the district,
both written by districts physicians in Troms and Finnmark during the 1940 – 1945 period.
Annual reports telling the costs and amount of mentally ill in local community and counties.
Despite the burning of all public buildings in Finnmark, some archives have been saved.
Interviews
Interviews with nurses and eyewitnesses more than 60 years later.
Findings and Conclusions
During the wartime psychiatric hospitals and nursing homes in the north of Norway were
requisitioned for military purposes. The patients were either sent home or evacuated to hospitals
southwards. As for the 1944 deportation, medical reports, newspapers, nurses and eyewitnesses tell
different stories about what happened to the mentally ill.
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Session 3e: Children’s Nursing and Child Health
OVERCOMING DEFORMITY: TWO U.S. APPROACHES TO CARE FOR CRIPPLED CHILDREN
Mary E. Gibson, PhD, RN
University of Virginia
Phone: 434-924-0130
Fax: 434-977-070
[email protected]
AIM: The aim of this study is to trace the development of care for children with orthopedic
disabilities during the early 20th century in two rural states in the U.S., Minnesota and Virginia, and
to identify regional differences, nursing roles and glimpse the child experience in these systems of
care.
RATIONALE AND SIGNIFICANCE: Nurses played a pivotal role in care of children with disabilities
despite regional differences in the development of care. By looking at two very different rural states,
some common themes and interesting differences emerged concerning how children were identified
and brought to treatment. Specialized nursing care for these children was considered essential from
discovery of the patient to treatments including long periods of rest and nutritional support, surgical
and mechanical care, and ongoing follow up and rehabilitation. The study of children with
disabilities reveals important observations regarding specialized nursing and medical roles and
development of care strategies as well as the unique approaches of individual states.
METHODOLOGY & SOURCES: This study employed traditional and social history methods.
Sources included archival records from the Gillette State Hospital for Crippled Children, Minnesota
Board of Control reports, Virginia Board of Health, Virginia Health Department reports, Instructive
Visiting‖Nurse‖Association‖and‖Crippled‖Children’s‖Hospital‖archival‖records,‖journal‖articles,‖
newspapers and books of the period, along with secondary sources which provided information
about the Progressive Era.
FINDINGS AND CONCLUSIONS: Minnesota enacted the first publicly funded care for children
with orthopedic disabilities in the United States in 1897. Virginia’s‖legislature‖voted‖to‖fund‖crippled‖
children’s‖care‖in‖1918.‖‖In‖both‖cases,‖private‖dollars‖were‖needed‖to‖supplement‖the‖limited‖public‖
funds and volunteer physicians provided surgical care while well-to-do women supported the
programs with money, their time and expertise. Bony tuberculosis dominated the early cases in
Minnesota, yet 20 years later, in addition to bony tuberculosis, epidemics of infantile paralysis drew
attention to the many children requiring care in Virginia. In Minnesota, an orthopedic surgeon and a
disabled‖young‖woman‖advocated‖for‖the‖earliest‖care,‖while‖it‖was‖Virginia’s‖visiting‖nurses‖who‖
located, coordinated with an orthopedic surgeon and brought children to treatment. Capturing the
child’s‖viewpoint‖is‖elusive,‖yet‖one can glean from records and some written accounts, a glimpse of
the‖children’s‖experiences.
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‚I TOLD THEM, ‚LEAVE IT ALONE: IT’S OUR CENTER‛: MIDWIVES’ COLLABORATIVE
ACTIVISM TOWARDS INFANT MORTALITY IN TWO U.S. CITIES, 1970 –1990
Linda Tina Maldonado, RN, MS, Pre-Doctoral Student, Barbara Bates Center for the Study of the
History of Nursing, University of Pennsylvania, School of Nursing
215-850-8090
[email protected]
Aim: Using Philadelphia and Washington, DC, as case studies, this paper examines the importance
of little-known individuals whose ideas and practices exemplified what is valued in nursing and
midwifery.‖In‖particular,‖it‖explores‖the‖collaborative‖efforts‖of‖women’s‖health‖activists‖committed
to addressing the tragic infant mortality rates in their respective communities during 1970-1990.
Rationale: Infant mortality within the black community has been a persistent phenomenon in the
United States, despite a dependence on advancing medical technologies and medical models of birth.
Longitudinal studies before the mid-1990s historically linked poverty as the dominant factor in infant
mortality affecting black communities. Refusing to accept poverty as a major determinant of infant
mortality within marginalized populations of women, midwives during the 1970s, 1980s, and 1990s
formed collaborative efforts with social workers, community activists, physicians, and public health
workers to assist in the empowerment and education of affected communities. Negotiating with
hospital administrators and powerful physician groups, these activists were able to improve
substandard medical treatment of marginalized pregnant women, resulting in enduring reductions
in infant mortality. This paper explores the means through which the activist midwives collaborated,
negotiated, and sometimes conflicted with numerous stakeholders in their struggle to reduce infant
mortality.
Significance: This study builds upon a growing body of scholarship exploring the contribution of
midwives to positive maternal/fetal outcomes in marginalized populations. Its findings provide
further insight into the relationships between the midwives and the communities they serve.
Methodology: A social historical methodology was employed for the completion of this study. Oral
histories of midwives, Sister Teresita Hinnegan (Philadelphia) and Ruth Watson Lubic (Washington,
DC) were taken. In addition, primary archival resources were reviewed from the University of
Pennsylvania Rare Book and Manuscript Library as well as Columbia University Archives and
Special‖Collections.‖Secondary‖sources‖included‖major‖historical‖work‖on‖women’s‖health‖activism,‖
birth activism, disparities in maternal and child health, and historical accounts of birth during
slavery.
Findings and Conclusions: Collaborations between activist midwives, hospital systems, and
community residents became a defining and enduring solution to infant mortality within those
communities. Midwives and community-centered models of care were central to the
accomplishments of these endeavors, serving as the cornerstones for health promotion, social
support, and activism
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FLORENCE NIGHTINGALE, CHARLES WEST, AND THE
PROBLEM OF CHILDREN'S NURSING.
Andrew Kennedy, MA, RN
Liverpool John Moores University
0151 231 5488
[email protected]
Aim of study
The paper compares two professional and ideological approaches to the nursing care of children. By
examining the consequences of Nightingale's great propaganda victory it renews the case for
children's nursing as a discipline in its own right.
Rationale and significance
Having had to fight for recognition ever since the original debates about registration, the profession
finds itself once again having to justify its nature and relevance (Parish, 2007). At a time of
considerable uncertainty about the continuation of children's nursing as a distinct discipline it is
necessary to demonstrate afresh both its origins and its continuing necessity.
Methodology
The study compares West's humane, child-centred approach with that of Nightingale, which stressed
technique. It examines the protagonists' own published words as well as the arguments of their
contemporaries as expressed in publications such as the Lancet, the Edinburgh Medical Journal, and
contemporary pamphlets. The relative successes of competing visions set out at that time are
evaluated with reference to more recent papers such as Glasper and Charles-Edwards' The Child First
and Always: the registered children's nurse over 150 years (May & June, 2002) and Bradley's Pride or
prejudice – issues in the history of children's nurse education (July, 2003). Nightingale's own motivation
and achievements are scrutinised through the use of secondary sources including Baly's Florence
Nightingale and the Nursing Legacy (2e 1997) and Bostridge's Florence Nightingale (2008).
Findings
Nightingale's primary interest was in efficient administration; the presence of children in hospital
was a problem first and foremost. Her view of children as both vulnerable and disruptive shaped
children's nursing for the following century and is reflected in society's current ambivalence towards
them. West's humane and practical approach is far closer to that which informs the best of current
practice, and yet must be constantly defended against the rationalisers for whom an elegant system is
of more importance than the interests of the people it purports to serve.
Conclusions
Whilst Nightingale is often credited with having had a formative influence on the nursing profession
in the English-speaking world, it was West who first articulated the role of the modern children's
nurse. Only in recent decades has the profession managed to shake off some of Nightingale's less
helpful strictures and to embrace more fully West's vision of how to care for sick children.
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Session 3f: People and Ideas
BRITISH AND AMERICAN NURSING IDEAS IN PALESTINIAN/ISRAELI ATTIRE:
HISTORICAL DOCUMENTATION OF NURSES IN A LEADING MEDICAL ORGANIZATION
(1948–2009)
Nira Bartal, RN, PhD
Lecturer, Henrietta Szold Hadassah-Hebrew University School of Nursing,
Jerusalem, Israel.
Tel: 9722-5342556
[email protected]
Hadassah Medical Organization, American in origin, was one of the founders of health services in
Palestine and of nursing as a profession under the British Mandate (1918–1948),‖as‖N.‖Bartal’s‖book‖
(2005) demonstrates.
Aim of study: to illuminate selected characteristics of nursing at the Hadassah Medical Center in
Jerusalem from 1948 on.
Rationale and significance: investigation of the continuity‖of‖the‖influence‖of‖Hadassah’s‖nurses—
who reflect British and American ideas and serve irrespective of religion, race, and gender—on
nursing in Israel.
The study probes the development of two aspects, firstness and influence, via selected criteria:
(a) initial specializations—midwifery, community nursing, and operating rooms; (b) role models of
clinical experts and area coordinators; (c) Hadassah nurses who played leading roles in Israel;
(d) Hadassah nurses who served amid recurrent waves of mass immigration and wars; (e) nurses
who helped Asian and African countries.
Methodology: the study is based on oral documentation, archive documents, research literature, and
belles lettres. It includes texts of sixty interviews (fifty-eight of which with nurses), most 60–120
minutes long. The texts, reflecting the general population of graduates of Hadassah School of
Nursing‖and‖nurses‖who‖worked‖in‖the‖organization’s‖institutions,‖are‖analyzed‖from‖a‖critical
perspective.
Findings: until‖the‖1980s,‖Hadassah’s‖nurses‖were‖leaders‖in‖nursing‖administration‖and‖education‖in‖
Israel,‖as‖exemplified‖by‖the‖functions‖of‖Chief‖National‖Nurse,‖Secretary‖of‖the‖National‖Nurses’‖
Association, directors of nursing services in large hospitals,‖and‖founders‖of‖the‖country’s‖first‖two‖
university departments of nursing. Since then, more than fourteen pioneering functions developed in
Hadassah, some replicated in other Israeli institutions—e.g., clinical experts and area coordinators in
breast cancer, pain, and quality of care—and, from 1948 on, influential role models in midwifery,
community‖nursing,‖and‖operating‖rooms‖took‖shape.‖The‖study‖depicts‖the‖nurses’‖roles‖in‖two‖
wars (1967, 1973), in the first of which Hadassah Hospital in Jerusalem was shelled, and on behalf of
immigrants and people from African and Asian countries.
Conclusions: Nursing at Hadassah, imbued with ideas culled from British and American nursing,
had a major impact on the Israeli nursing profession. Mindful of its reputation and its leadership
role, the Hadassah nursing administration displayed entrepreneurial qualities and also encouraged
trailblazing nurses to create pioneering role models.
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A CASE STUDY OF THE FIRST NATIVE PRINCIPAL OF NURSING SCHOOL IN
PEKING UNION MEDICAL COLLEGE (PUMC): NIEH YU-CHAN (1903-1998)
Chou Chuan-Chiang Yao, Doctor of Nursing Science,
University of San Diego, USA (1997)
396 Chang Jung Rd., Sec. 1, Kway Jen, Tainan 71101, Taiwan
886-6-2785123 ext 1600
[email protected] ; [email protected]
Aim of study: to understand Nieh Yu-Chan’s‖background, core values supporting her professional
career‖and‖the‖influences‖of‖traditional‖Chinese‖culture‖and‖Christianity‖on‖her‖as‖well‖as‖Nieh’s‖role
in the development of Chinese nursing profession.
Rationale and significance: Nightingale’s‖style‖of‖nursing‖was‖introduced‖by‖Christian‖missionaries‖
to China in the late 19th century. The missionaries established hospital nursing system for the purpose
of‖saving‖people’s‖life‖and‖spirit.‖Nursing‖in‖China‖has‖been‖impacted‖by‖Christianity‖for‖many‖
years. A fresh look at the cross-cultural dynamics in which western missionary and Chinese nurses
were involved during the first half of the 20th century is well worth taking and will be both
interesting and informative. It is expected that the examination of previous historical instances of
cross-cultural experiences in nursing education will facilitate the understanding of the concepts of
multiculturalism, diversity, and globalization.
Methodology: literature review, collection of photographs and review of formal documents were
used. Content analysis was performed on the information collected.
Findings and conclusions: The poverty and weakness of the community made Nieh thought over
what she could do for the country since she was very young. When Nieh knew the serious lack of
high quality nursing leaders, even worse than lack of doctors in China, Nieh made decision to
transfer from medical to nursing school at PUMC. During that time, people did not want to be nurses
except those with religion and willing to devote themselves to the society. Throughout the story of
Nieh, the challenges of a pioneer native nursing leader in China were addressed, including how she
cared people, how she devoted herself to the development of nursing profession, her resilience in the
face of hardship, and her industry during the turning point of the nursing profession in China are
appreciated. This study also addressed the history of western nursing development in China and
used‖case‖study‖to‖describe‖the‖facts‖of‖China’s‖higher‖education‖in‖nursing‖from‖1930‖to‖1949.‖
Finally, from the point of globalization in nursing education, the cross-cultural experiences were also
presented.
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Session 3g: Nursing and Place
LOCAL NURSING ASSOCIATIONS IN AN AGE OF NURSING REFORM: ENGLAND 1862-1900
Stuart Wildman, Lecturer in Nursing
School of Health and Population Sciences
College of Medical and Dental Sciences
52 Pritchatts Road
University of Birmingham, B15 2TT
United Kingdom
0121 414 2667
[email protected]
Aim of study
The concept of time is used in most traditional narratives of professional nursing in England to
demonstrate unrelenting progress, from a dark period inhabited by nurses represented by Sarah
Gamp to an enlightened golden age of nursing. Timing has always been seen as an important
consideration in the historiography of nursing whilst the geography of reform has received scant
attention. In spatial terms reform was assumed to have taken place in the hospital, having originated
in London and then rolled out to the rest of country, the empire and the world. The aim of this study
is to challenge these assumptions by analysing the significance of local associations in the
development of nursing in England.
Rationale and significance
The historical geography of subjects as diverse as science, religion and asylums has been studied in
recent years. An analysis of local nursing associations will help to give a greater understanding of the
geography of nursing reform.
Methodology
This research is based on documentary analysis of the records of nine provincial associations of
which Liverpool, established in 1862, was the first. Sources include minute books, annual reports,
correspondence, newspapers, the decennial census returns and miscellaneous documents. Analysis
of secondary sources has linked the findings from this study to the situation at the national level and
within hospitals.
Findings
A significant, but uncoordinated, movement towards the reform of nursing took place in towns and
cities during the 1860s and early 1870s led by associations that were independent from the hospital.
This reform was an extension of local philanthropic effort and in most cases in advance of hospitals
in the locality. Substantial support from the middle classes resulted in some towns and cities being
able to establish associations and thus improve the quality of nursing available to the rich and poor
in their own homes. This was facilitated by a significant input from women and was based on
sanitary reform and a domestic service paradigm. The prominence of these associations was shortlived and it was the hospitals which became the focus of nursing reform in the latter part of the
century.
Conclusions
This study considers the geography of nursing reform and challenges the idea of an exclusively
London and hospital based movement. It points to a much more complex situation regarding the
reform of nursing in nineteenth-century England.
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THE ATKINSON MORLEY’S HOSPITAL, LONDON:
A CENSUS ANALYSIS 1871-1911
Christine Eberhardie, MSc, RN, RNT, FHEA, Cert HSM, Adv Dip in Local History
Honorary Principal Lecturer in Nursing,
Faculty of Health and Social Care Sciences,
Kingston‖University‖and‖St‖George’s,‖University‖of‖London
+44 208 641 6033
[email protected]
Aim of the Study:
To gain an insight into the staff and patients of the Atkinson‖Morley’s‖Hospital‖during‖the‖period‖
when it was a convalescent hospital (1869-1942) by analyzing available census enumerator books.
Rationale and Significance:
The‖Atkinson‖Morley’s‖Hospital‖opened‖in‖1869‖and‖closed‖in‖2003.‖It‖has‖always‖been‖associated
with‖St‖George’s‖Hospital,‖London‖but‖little‖is‖known‖about‖the‖work‖of‖the‖hospital‖during‖the‖
period when it was a convalescent hospital (1869-1942) apart from the medical staff and Matrons.
Primary‖sources‖such‖as‖the‖St‖George’s‖Hospital‖Management Board minutes provide some
information about the staff but do not give details of the patients.
This‖research‖forms‖part‖of‖a‖wider‖history‖of‖the‖Atkinson‖Morley’s‖hospital‖as‖a‖small‖community‖
within‖the‖wider‖context‖of‖Wimbledon‖and‖St‖George’s‖Hospital, Hyde Park Corner, London.
Methodology:
The census enumerator books for the hospital were transcribed and analyzed using Excel for the
decades 1871-1911.
The‖findings‖were‖cross‖referenced‖with‖the‖St‖George’s‖Management‖Board‖minutes‖and‖secondary‖
sources‖such‖as‖Gould‖and‖Uttley’s‖ ‘A History of the Atkinson Morley’s Hospital 1869-1995’
Findings:
The Census data provides an insight into the name, age, marital status, occupation and place of birth
for the staff and pients on a given night every ten years from 1871-1901. The 1911 census data only
provides information about the staff.
The occupations of the patients show that they came from poor backgrounds and reflect the way of
life of Victorian England e.g. carman, coach fitter, still room maid, washerwoman.
This data gives no indication as to the medical problems from which the patients were suffering.
The data also gives an insight into the development of the hospital and its workload e.g. the 1871
census showed 16 staff and 56 patients
whereas in 1901 there were 17 staff and 88 patients.
Conclusions
The census data provides information on the social history of the patients and an insight into the
occupations and workloads of the staff and patients and development of the hospital.
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WHEN THEIR WORK IS DONE:
THE FOUNDING OF THE RETIRED NURSES NATIONAL HOME
Eileen W. Richardson, MA(Ed), BA(Hons), RN
Retired Senior Lecturer from Bournemouth University
+44 1425 479993
[email protected]
Aim
This presentation will address the situation of retired nurses between the two World Wars when
many found themselves with the absolute minimum of money and nowhere to live. It will give a
documented account of a unique project set up to meet these needs.
Rationale and significance
Until the early 60’s it was common for Nurses to live their lives in a Nurses’ Home where unless
they were very senior they had only one room to live in and shared the common rooms with their
colleagues. Their pensions, if any were small and many became distressed by their situation.
The social status of nurses in the 30’s will be explored together with the social attitudes of the
time which led to the voluntary giving particularly amongst the upper echelons of society to
causes such as this.
This presentation demonstrates how the vision of one dedicated nurse led to fundraising on a
national level. Many famous and titled names were enlisted from different parts of the country as
Patrons of the Appeal Fund.
Methodology
Sociological and historical texts will be used to explore social attitudes of the time particularly
towards the Nursing profession.
Documents from the home including the detailed minutes of the Committees set up and responsible
for the development and eventual management of the Home will be used to provide a picture of
events as they unfolded. The presentation will also make use of photographic evidence of events
surrounding the early days of the Home.
Findings
The Appeal Fund was successful in providing sufficient funds so that in 1937 the Foundation Stone
of what is now the central portion of the Home was laid on a site of some 2 acres donated by the
Misses Cooper-Dean and within the bounds of their estate. This land was in a rural area and despite
local development the Home has retained its peaceful setting.
Conclusion
The Home is still in existence today and although many changes have occurred over the years
reflecting both the changes in Society in general and in the status and social standing of nurses in
particular it continues‖to‖provide‖nurses‖with‖a‖Home‖‚when‖their‖work‖is‖done‛.
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Concurrent Session 4
Session 4a: Panel Presentation: Towards Histories in Nursing
TOWARDS HISTORIES IN NURSING
The Barbara Bates Center for the Study of the History of Nursing
Faculty Group
University of Pennsylvania School of Nursing
Philadelphia, PA 19104
Jean Whelan, PhD, RN
The Power of Private Duty
The private duty registry system provides the most compelling example of how nurses took action to
shape the contours of their working lives. Private duty registries, agencies which helped patients find
nurses and nurses find jobs, provided the connecting link between nurses and patients. The
registries supplied a reliable way for nurses to seek patient cases and for patients and physicians to
obtain nurses and verify their capabilities. But, private duty nursing was hard work, with
problematic financial security, and often too few nursing position. Yet within these constraints,
nurses created a system which offered the potential for independent practice for nurses by nurses.
The professional registry system faded as the American hospital assumed responsibility for all
aspects of the care of the sick. Yet, the story of nurse owned and operated registries provides a critical
historical illustration of the power nurses have held over their professional lives.
Cynthia Connolly, PhD, RN
The Power within Institutions
This research explicates the power of nursing in the context of the preventorium, an institution for
children aimed at preventing tuberculosis in children from indigent families. Drawing on the case
example of nurse J. Palmer Quimby, who practiced for 30 years at the nation's first preventorium in
New Jersey, this paper argues that at first glance it appears that Quimby lacked the social or
professional power of her physician colleagues. Set in the context of the campaign to mitigate the
tuberculosis epidemic and the child-saving consciousness infusing the nation in the early twentieth
century United States, not only did Quimby's work position her at the nexus of two powerful, highly
visible, public health campaigns, her status as the only on site health care provider afforded her with
a vantage point through which she not only cared for children directly, but was also able to design
and implement new systems of care.
Barbra Mann-Wall, PhD, RN
The Power of the Personal
This research examines the power of the personal through the experiences of a Catholic nursing sister
who refused to consider herself as powerless. In particular, it explores Sister John Gabriel Ryan, a
member of the Sisters of Providence congregation in Seattle, Washington, who worked extensively
with social and legislative issues as they related to hospitals, nursing education, and nursing practice.
Sister John Gabriel was active in policy initiatives and in local, state, and national hospital and
nursing associations. The paper argues that, rather than being distracted by addressing issues of
gender discrimination that were predominant within American society and the Catholic Church of
that era, Sister John Gabriel chose alliances that would wield the greatest power for her areas of
interest, particularly with those who led hospital associations.
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Patricia D’Antonio, PhD, RN, FAAN
The Power of Politics
This research focuses on the battle for among white and African American nurses for the
desegregation of a nursing organization in one southern American state, North Carolina. On one
level, this story might be told in a fairly straightforward manner: the desegregation of the North
Carolina State Nurses Association (NCSNA) presented no immediate threat to white supremacy and
the Jim Crow laws that supported it. The model established after negotiations between the respective
white and African American state nursing organizations included high dues to impede black
membership and a new organizational structure that planned educational presentations in
desegregated venues but social gatherings in those that prohibited black clients. But the stories
surrounding the desegregation of the NCSNA in 1949 might also suggest an understanding of power
as complicated calculus of competing interests with eyes turned toward a wider world. North
Carolina’s‖African‖American‖nurses‖agreed‖to‖this‖model‖because‖they‖believed‖in‖the‖importance‖of‖
nurses as leaders race relations in what they acknowledged would be incremental assaults on white
supremacy in their particular communities.
Julie Fairman, PhD, RN, FAAN
The Power of Practice
This research examines critical care as a broadly rendered historical construct and architectural space.
Critical care illustrates the complexity of health care change and offers powerful lessons that can
guide policy makers. For example, we tend to see innovation as orderly and controlled, but the
development of critical care depended on chance, personal relationships, and the entrepreneurship of
nurses and physicians willing to try new models of care. It also shows the importance of
understanding the various social, political, and economic forces that shaped hospitals’‖responses‖to‖
the care of the acutely ill patient. To see the development of this type of care as the result of
technology gives a very skewed view of how institutions, the public, and health care providers make
decisions. The process of deciding how to care for vulnerable, acutely ill patients was not always
rational or logical, but relied on individual relationships, a workforce of nurses and physicians
willing to experiment, the availability of space in hospitals of the 1950s, and the ability and
willingness of the public to pay for these services—all culminating in the development of different
models of practice.
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Session 4b: War and Practice
THE INFLUENCE OF FLORENCE NIGHTINGALE ON SOUTHERN WOMEN PROVIDING
NURSING CARE DURING THE AMERICAN CIVIL WAR, 1861-1865
Barbara Maling, RN, MA, MSN, ACNP, PhD
The University of Virginia in Charlottesville VA, USA
434-296-3515 (home), 207-669-259 (mobile)
[email protected]
1514 Westwood Road, Charlottesville VA 22903, USA
Aim of Study:
The purpose of this research is to discuss and analyze the influence that Florence Nightingale had
on Southern women providing nursing care to Confederate (Southern) soldiers during the
American Civil War, 1861-1865. Issues of race, class, gender, the status of nursing, and the need for
women to give nursing care are also considered within the context of the War.
Rationale and Significance: On the eve of the American Civil War Florence Nightingale was as
much a heroine to Southern women in the United States as she was to women in England.
Nightingale had revolutionized the inadequate British army medical services in the Crimea. She
had also dignified nursing as a profession in many places throughout the world including the
antebellum South.
Methodology:
Primary sources include but were not limited to letters, diaries, and hospital rosters from: The
National Archives in Washington, DC, USA; Alderman Library at the University of Virginia in
Charlottesville, VA, USA; The Smith Library at the University of Virginia in Charlottesville, VA,
USA; The Richmond Battle Field Archives at the site of Chimborazo Hospital in Richmond VA, USA,
and The Museum of the Confederacy in Richmond VA, USA. Secondary resources were also used.
Discussion:
In the antebellum South nursing care provided to strangers outside of the home was regarded as
employment appropriate only for individuals of the lower classes and preferably of the male gender.
In the military, nurses were usually detailed or disabled soldiers who fit within military hierarchies.
Findings and Conclusions:
Published one year prior to the American Civil War, Florence Nightingales book, Notes On Nursing,
was‖widely‖read‖in‖the‖Southern‖United‖States‖by‖prosperous‖white‖women.‖Nightingale’s‖book‖
established a conceptual legitimacy for middle and upper class females giving nursing care outside
of the home. As manpower shortages, escalating casualty rates, and patriotic ambitions, overrode
custom, a number of prosperous white women gave nursing care to Confederate soldiers and found
in Nightingale a model for female heroism.
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THE WORK OF THE NURSES OF THE CRACOW SCHOOL – THE ORGANIZERS, TEACHERS
AND GRADUATES DURING THE FIRST AND SECOND WORLD WAR
Helena Matoga, RN
The graduate of the Cracow School for Nurses
The Catholic Association for Polish Nurses and Midwives
+48602414135‖(Mrs‖Matoga’s‖son,‖fluent‖in‖English)
[email protected]
Paper presented by Ms Brykczynska as translator.
Aim of study
The paper aims to reveal the efforts of many young women, volunteers from a hundred years ago,
inspired by the achievements of Florence Nightingale, to organize in Cracow the first School for
Professional Nurses in Poland in 1911. The author also wants to show the efforts and attempts to reestablish the school after its collapse caused by the war activities in 1914.
Rationale and significance
The author intends to present the heroic profiles of the nurses of the Cracow school during war
activities. Due to the prolonged lack of access to the majority of archives, these facts are not wellknown even in Poland. Therefore, the findings may shed a new light on the issues concerning the
history of military nursing.
Methodology
The investigation was primarily conducted on the basis of personal research into the documents,
reports, programmes, and provides the verification of some widespread opinions. The author used
various archives, including the National Archives in Cracow, the Archives of the Cracow School, the
National Army, the Institute of National Remembrance, as well as literature and the press.
Findings
Until the close of the 19th century, Polish nursing was based on the socio-charity model,
predominantly monastic. The establishment of the first Cracow school and its relation to the
university teachers, made lay nursing much more prestigious and effected in its growth in numbers.
The development of the profession, hindered by the outbreak of two wars, continued driven by the
determination of nurses serving in military, front-line and epidemic hospitals. The teachers and
graduates usually managed nursing and voluntary teams. From among the volunteers many joined
the nursing profession. They carried out dangerous and heroic work protecting the endangered and
providing medical and material care to the masses of civilian, displaced population.
Conclusions
The significance of the efforts of the nurses from the Cracow school seems indisputable in view of the
documents studied. Currently, the trial proceedings are carried out in Vatican concerning two
teachers from the Cracow school. They are expected to be declared Blessed. Furthermore, five
Cracow nurses received the Florence Nightingale Medal, an order of merit in wartime.
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Session 4c: Community and Public Health Nursing
PESTILENCE (PEST) HOUSES AND THEIR ROLE IN THE BEGINNINGS OF
PUBLIC HEALTH NURSING.
Alison Mary Wall, BSc Hons Social Science and Administration, SRN, SCM, FP Certificate, Dip HV,
MSc Public Health.
Nursing and Midwifery Council (NMC)
UK Professional Adviser for Specialist Community Public Health Nursing
01923 – 777340/ mob. 07590 217705
[email protected]
Aim of study
The aim was to identify the origins of the public health movement in nursing across the UK.
Rationale and significance.
The assumption is that public health started in the middle of the nineteenth century alongside the
developments in industry, transport and scientific advances. A key turning point in 1854 was the
discovery by Jon Snow that water was a principal vector for disease, thereby eventually dispelling
the miasmic theory. However, the author set out to test the belief that a public health approach was
only adopted from this time. The author studied the history of former health care institutions from
the monastic infirmaries to the beginnings of the isolation hospitals and the hospital voluntary
movement.
Methodology
The research question was formed. A literature review was completed using a combination of
database searches. Grey literature and national, regional and local history archive material was
included. Quantitative data was collated and some qualitative information was gained through
interviewing individuals who had lived, or still live in the few remaining pest houses still standing
across the country. The findings were then analysed and triangulated.
Findings
There is little formal textual material, but a range of electronic and grey literature. Pest houses were
set in statute in 1665 by Charles 11, and heralded the beginnings of partnership working in every
parish. There are no texts at all devoted to the subject of their significance or their function, but many
texts make reference in passing to their existence. Diarists of the time mention the pest house but do
not elaborate on their function as presumably their use was well recognised at the time. (Pepys;1660 1665). The collection of diverse data has enabled the author to identify that the pest house was used to
actively promote health and wellbeing and was managed within a joined up system overlooked by
parish unions.
Conclusions
It can be argued that the setting up of a parish pest house from 1665 was the clear beginning of a
formalised approach to public health nursing. The principles of public health were addressed by a
belief in the importance of partnership working, reducing health inequalities and protecting those
who had not succumbed to disease. The author makes the case that the origins of the public health
movement should be revisited and researched further.
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‚RESTORING AND KEEPING THE PUBLIC HEALTH AND PEACE‛:
THE AMERICAN NURSE VOLUNTEER MOVEMENT IN AUSTRALIA c.1887
Madonna Grehan, RN, RM, Cert Sex. Hlth. & Repro., Gr. Dip. Hlth. Ethics, PhD
School of Health Sciences, The University of Melbourne (awaiting Honorary appointment)
613 9484 8076
[email protected]
Aim of study
To examine the relationship between trained nurses in late nineteenth-century colonial Victoria,
Australia, and international movements in nursing, through the prism of the nurse volunteer
movement.
Rationale and significance
In early 1887, a representative of the American Nurse Volunteer Movement, Mr Charles Bowles, gave
a‖public‖address‖to‖the‖people‖of‖Victoria‖for‖the‖benefit‖of‖the‖Victoria‖Trained‖Nurses’‖Association,‖
a newly-formed professional organisation. Mr Bowles evangelised on nursing the sick and wounded
as‖an‖‘outgrowth’‖of‖Florence‖Nightingale’s‖work‖in‖the‖Crimea,‖urging‖Victoria’s‖nurses‖to‖join‖this‖
international network.
Connections between trained nurses in colonial Australia and international developments, such as
the American Nurse Volunteer Movement, have enjoyed little consideration in Australian nursing
history.‖Received‖narratives‖have‖concentrated‖on‖Australia’s‖relationship‖with‖nursing‖in‖Britain,‖on‖
professionalising efforts in the early twentieth century and on nurse training schemes. This paper
examines nursing in the last two decades of nineteenth century, specifically via a relationship
between nursing in two different spheres: the United States of America and the colony of Victoria.
Methodology
Primary sources accessed include: published pamphlets and Victorian newspapers, the British
Nurses‖Association’s‖Journal‖Nursing Record and Hospital World, the Medical Journal of Australia, and
Victorian hospital records. Secondary sources include journal articles and texts on Australian, British,
and American nursing history.
Findings
Contrary to accepted wisdom, by the end of 1886 at a time when the British Nursing Association was
in its infancy, trained nurses in colonial Victoria, also, were promoting their work as professional, in
tandem‖with‖international‖professionalising‖trends‖in‖Britain‖and‖in‖America.‖Victoria’s‖nurses‖
shared the aspirations of their international peers, that nurses had a civic role in restoring peace in
society and contributing to public health via their professional work. Evidence of these shared
aspirations is found in the visit of Mr Charles Bowles and his treatise on a volunteer nurse reserve to
provide professional nursing care in times of war and epidemics.
Conclusions
The findings question long-held‖assumptions‖about‖nursing’s‖development‖in‖the‖Australian‖
colonies,‖particularly‖nursing’s‖engagement‖with‖civic‖responsibilities,‖and‖its‖relationships‖with‖
nations other than Britain. This perspective may resonate in other British dominions.
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Session 4d: Professionalization
HISTORICAL EVOLUTION OF THE NURSING PROFESSION IN GREECE
Eleni Kyriakidou, RN, MSc, PhD, Professor of Nursing, Nursing School,
Technological Educational Institute of Athens (TEI)
HELLENIC NURSES ASSOCIATION (H.N.A.)
2,‖MESOGION‖Ave,‖Athens‖Tower‖C’‖Building,‖
GR -115 27 ATHENS
+00 30210 7702861 , + 00 30210 7485307
+00 30210 7790360
[email protected]
Aim of study: To share information and culturally related experiences with nurses worldwide
Rationale and Significance
Rationale: Nursing as anthropological science is affected by the culture, beliefs, ethics and civilization
of each nation.
Health Care in Greece emerged very early in Prehistoric and historic times. Asklipios was
worshipped as the God of medicine and his daughter Hygea as Goddess of Health. We find hospitals
in the 5th Century‖ BC‖ the‖ ‚Asklipiea‛,‖ named‖ after‖ the‖ God‖ of‖ medicine.‖ The‖ heart‖ of‖ such‖ a‖ place‖
was Hippocrates, the father of medicine.‖Epidaurus‖is‖a‖very‖well‖preserved‖‚Asklipieon‛‖(Mesolora,‖
A.).
Nursing as a profession started officially in 1924 with the establishment of the first three-year School
of Nursing by the Hellenic Red Cross with the prerequisite of twelve years of schooling by those
attending the school. Many more nursing schools followed soon after, all of them functioning as
Hospital Schools supervised by the Ministry of Health (Papamikrouli, S.).
What made nursing flourish were the needs of the second world war and its consequences
afterwards. These flourishments offered prestige and honour to the profession. Many rich, highly
educated Greek women offered their services to the wounded soldiers and decided to follow the
profession. Among them, a very special personality,‖‚The‖Florence‖Nightingale‖ of‖ Greece‛,‖Athena‖
Mesolora, a person with determination, broad education and vision who grasped the challenges and
needs of the times.
From 1986 all Hospital Nursing Schools were transferred to the Ministry of Education as Educational
Technological Institution (TEI) of 4 years duration. In the Meantime University of Athens established
the first Nursing Faculty which accepted students in 1980 also 4 years duration (Lanara, V.).
At present, nursing profession is a science studied at the University level offering BS, MS and PhDs.
More than 300 nurses in Greece are PhD holders.
Continuous efforts were made and changes came up to promote and develop bedside nursing,
primary health nursing and community nursing following the International and European standards.
Nurses by law are equal members in the multidisciplinary team within the reformed health care
system and partners in the formulation planning and implementing of health policy (Lanara, V.).
Methodology: Information collected by literature review and historic documents.
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THE CARE OF THE SICK AND DEBATES ON THE PROFESSIONALIZATION OF NURSING
WITHIN THE JEWISH COMMUNITIES IN AUSTRO-HUNGARY
Elisabeth Malleier, Mag. Phil. ,Dr. Phil.
University of Vienna
Austrian National Library
Telephone number:
0043-(0)1-48 92 0 62
[email protected]
In my paper I want to present some results of my research about Jewish hospitals, early sick care
organizations and nursing schools in Austro-Hungary during the 19th and early 20th centuries.
My focus will be on self organization, working conditions and gender aspects within sick care.
I will be concentrating on the development of three cities with big Jewish communities: Prague,
Budapest and Vienna. The main topics of the paper will be:
1. Forms of self organization within voluntary sick care associations.
2. Working conditions at the hospital in the late 19th century.
3. Debates and initiatives on the professionalization of nurses within the Jewish communities.
Within the Jewish communities of Austro-Hungary there existed a whole network of organizations
dedicated to the care for the sick and the dead. The oldest one was the chewra kadischa, the Jewish
burial society. While religious duties could be performed only by men women were involved in the
care of female sick and death. The grade of participation of women within secular sick care
associations developing during the 18th and 19th centuries differed. While they were explicitly
excluded from some organizations, there existed also female only associations. Within the Jewish
hospital of the 19th century‖women‖were‖present‖as‖part‖of‖the‖‚working‖couple‛‖on‖the‖management‖
level (sometimes with the help of other family members), as maids or as sick attendants. On the
example of Prague and Vienna I want to explain labor organization and working conditions.
In late nineteenth century when modern Jewish hospitals were built, this led to an increased demand
for nurses and debates about nursing as a female profession started. These discussions were initiated
from such different actors such as hospital directors, feminists and Jewish organizations. In the paper
I want to present their arguments and strategies and the result of their efforts to improve nursing.
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THE PORTUGUESE NURSING EVOLUTION: RECENT LANDMARKS
Morais, Ernesto Jorge, Associated Professor of Nursing, RN
Specialist in Community Nursing
Master in Health Economics and management
Nursing School of Porto, Portugal.
+351 914 502 058
[email protected]
Aim of the Study: This study is part of an ongoing Nursing PhD investigation and aims to describe
the academic and professional evolution of Nursing in Portugal, in the last two decades.
Rationale and Significance: This investigation appears from the necessity felt in trying to
understand a phase of enormous development of the Portuguese Nursing discipline.
Throughout the decades, contributes of individualities and groups have been fundamental in the
most varied scopes and responsible for what it is today Nursing in Portugal.
In the recent times, other actors and scenarios disclose themselves as having a decisive and
transversal role in the delineated trails at the different levels of this science.
Methodology: A qualitative approach where, through documental analysis, interviews to keyinformers and case studies of Nursing organizations of reference, was built a social-historic
referential with the identification of a set of actors and scenarios considered fundamentals in the
actual Portuguese Nursing context.
Findings: It was only in 1988 that the Nursing Course was integrated in the Portuguese Educational
System, at the polytechnic level, what permitted the accomplishment of the degree of Bachelor to the
undergraduate nursing students.
This integration also allowed the continuity of the postgraduate education, mainly in what respects
to the attainment of academic degrees of Master and Doctoral in and out the specific area of Nursing,
gotten from the frequency of courses provided by Portuguese Universities.
In 1996 was published the Regulation of the Professional Exercise of Nurses, fundamental to clarify
and to consolidate the functions of Nurses in Portugal.
In 1998, with the necessity of proceeding to the creation of conducive mechanisms to the regulation
and control of the professional exercise, the National Board (Order) of Nurses was created. From this
date on, the exercise of the profession of Nursing is conditional to the attainment of a professional
license, emitted from this Board.
In 1999 was initiated the License degree level to the undergraduate course of Nursing, passing from
three to four years long, in polytechnic and university institutions.
Conclusions: By the research carried out emerged a set of actors and scenarios that disclose a
detached role in the current Portuguese Nursing, namely the National Board (Order) of Nurses, the
Unions of Nurses as well as some individualities with unquestionable importance to the present
evolution of the Portuguese Nursing Science and Profession up to international levels and
recognition.
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Session 4e: Global Perspectives on Nursing Education
ELLA HASENJAEGER: AMERICAN NURSE IMAGE AND
NEW BRAZILIAN NURSING EDUCATION
Paulo Fernando de Souza Campos, Doctor in History, PhD of Nursing History
São Paulo University Program, School of Nursing
+55(11)30850876
[email protected]
Aim of study: This paper is part of a study conducted in the Post-Doctorate program at the
University of Sao Paulo, which analyzed the development of nursing in Brazil after 1930. For this
communication, we focus on the role of Ella Hansenjaeger, Navy nurse, adviser to the Rockefeller
Foundation chosen to monitor the work of training at the School of Nursing, Faculty of Medicine,
University of São Paulo from 1944 to 1951.
Rationale and significance: The U.S. cooperation in training and development of modern nursing in
Brazil is historically recognized. However, events of this process still remain poorly studied and may
be revisited from biographical studies. When allowed to restore the role of subjects in the
construction of social ties, the biography reveals aspects relevant to nursing research.
Methodology: The recovery of the individual in history can be evaluated as a reaction to
structuralism approaches. The micro-historical research and biographical studies, resides in the
interpretation of events less visible, tested individually and considers involving unexplored evidence
by the traditional historiography. The primary sources were institutional records (minutes, reports,
and letters) that document the performance of the American nurse consultant. The secondary sources
consist of papers and memorials written by the Brazilian nurses, specifically.
Findings: The proposals made by Ella Hasenjaeger reflected positively in different areas of the
Brazilian nursing education, praised and recommended for services of health care as the Section of
Nursing, from the Department of Sanitary Organization of the Ministry of Education and Health,
who in 1946 published the making of the American‖nurse‖to‖the‖traditional‖Brazilian’s‖schools. The
role of Ella Hasenjaeger favored the creation of internship programs in Psychiatric Nursing that
didn’t‖happened,‖back‖then,‖in‖nursing‖schools‖in‖Brazil,‖as‖well‖as‖interest‖in‖scientific‖research,‖
showing new perspectives to nursing working, and finally, a new professional identity.
Conclusions: It was possible to conclude that both actions and the permanence of the consultant at
the Nursing School of Sao Paulo was part of the project to impose their American health care model,
as well as reorganization of services of health care in Latin America through whit the new model of
Brazilian Nursing training. In this sense, it is concluded that the history of nursing allows reviewing
the past of the profession and professional identity in the American way of life.
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IMPLEMENTATION OF THE BOLOGNA DIRECTIVE: FROM PEPPERMINT FREEDOM TO
THE FOUNDING OF THE GERMAN SOCIETY OF NURSING SCIENCE – THE
DEVELOPMENT OF ACADEMISATION OF NURSING IN WEST GERMANY FROM 1945 1989/90 (REUNIFICATION OF GERMANY AND FOUNDING YEAR OF THE SOCIETY)
SHOWN ALONG THE BIOGRAPHY OF NURSE ANTJE GRAUHAN MA WHO WILL
CELEBRATE HER EIGHTIETH BIRTHDAY IN 2010.
Christine R. Auer, PhD
Emmertsgrundpassage 33
69126 Heidelberg
Federal Republic of Germany
+49 6221 167335
[email protected]
Objective of the study:
The study will assist in the implementation of the Bologna Process. The problems in the
implementation of study courses in West Germany between 1945 and German reunification are
pointed out. Along the biography of nurse Antje Grauhan MA the first three attempts of
academisation of nursing in Germany after 1945 (Heidelberg, Ulm, FU Berlin) as well as their failures
are described. The fourth successful attempt in Osnabrueck with Prof. Ruth Schroeck (now living in
Edinburgh), a companion of Antje Grauhan, is the conclusion of the study.
Importance of the study:
In the Federal Republic of Germany currently Bachelor and Master courses are being established
(implementation of the Bologna Directive). Through this study the historical foundations of nursing
courses are to be documented and included in the curricula.
Methodology of the study:
Narrative interviews of nurse Antje Grauhan who experienced all these attempts of academisation.
Analysis of the curricula of Heidelberg, Ulm, Free University of Berlin and Osnabrueck.
Sources of medical history regarding physicians relevant for these nursing courses (for example Prof.
Dr. Eduard Seidler, Prof. Dr. Thure von Uexkuell, Dr. Karl Koehle).
Findings and conclusions:
After the war had ended in 1945 the US Army established headquarters at Heidelberg. Heidelberg
doctor‖Alexander‖Mitscherlich‖documented‖the‖Doctors’‖Trials‖at‖the‖Nuremberg‖Military‖Tribunals‖
(NMT) and in 1965 he got emigrated Jewish physicians to participate in the psychoanalytic congress
at Frankfurt am Main. The U.S. occupation forces in Heidelberg wanted an academisation of nursing
analogous to the development of the United States after World War I.
Before the year 1989/90 (German reunification) this desire could not realised.
Three failed attempts of academisation at Heidelberg, Ulm, and the FU Berlin were a paralyzing
shock for nursing in the former Federal Republic of Germany. In order to study nursing so many
German nurses chose the road to Edinburgh.
For the discussed period research of the history of nursing lags severely behind the history of
medicine (Mitscherlich), making it difficult to this date to connect the West German nursing science
to international developments. Equally difficult seems the connection to the nursing science of the
countries of the former Eastern Bloc (DDR). In the case of the implementation of the Bologna
Directive exactly that connection is of utmost importance. The study is supposed to help to facilitate
the implementation of the Bologna Directive in nursing history and nursing science.
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THE DEVELOPMENT OF PULI CHRISTIAN HOSPITAL'S NURSING SCHOOL—
THE FIRST NURSING PROGRAM FOR THE ABORIGINAL PEOPLE IN TAIWAN
Hui-ping (Selina) LIN
386 Ta-Chung 1st Rd., Kaohsiung, Taiwan 81362, R.O.C
CICU, Kaohsiung Veterans General Hospital
Kaohsiung
Taiwan , R.O.C
81362
[email protected]
886-953028727
Aim of study: The purposes of this study were: (1) to review the development and connotation of
Puli Christian Hospital's Nursing School and (2) to examine the transmission and practice of the
mission of the school.
Rationale and significance: The modern Nursing education in Taiwan was founded by western
Christian missionaries at hospitals in late 19th century. Today, Christian hospitals still play very
significant roles in taking care aboriginal people sparsely domiciled in remote districts. However, the
literatures related to history of both training programs and nursing schools established by Christian
hospitals are very few. This study serves as a pilot research on the development of Puli Christian
Hospital's Nursing School (1958-1970) from a historical perspective.
Methodology: Literature reviews, document analysis and oral history research methods were
adopted by this research. Data were collected from commemorative albums, archives, photos and indepth interviews. A semi-structured interview guide was designed by the researchers for each
interview. This study recruited seven interview participants, including graduates and teachers from
the school and hospital administrators. Content analysis was used for the data analysis.
Findings and conclusions: The development and connotation of Puli Christian Hospital's Nursing
School were categorized as: core values and missions, theory and practice, values of religion and
farewell‖to‖the‖Puli‖Christian‖Hospital’s‖Nursing‖School.‖The‖transmission of the mission of the
nursing school could be illustrated as ‚cultivation of caring‛; ‚practice of caring‛,‖and ‚role model of
caring‛.
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Session 4f: Courage in Adversity
PRISONER OF PUDONG:
THE IMPRISONMENT OF BETTY GALE IN JAPANESE-OCCUPIED CHINA
Sonya Grypma, RN, PhD, Associate Professor,
School of Nursing
Trinity Western University
Langley, BC CANADA
1-604-513-2121 (3283)
[email protected]
Funded by the Social Sciences and Humanities Research Council of Canada
Aim of Study
To‖explore‖and‖analyze‖Canadian‖missionary‖nurse‖Betty‖Gale’s‖response‖to‖increasingly‖devastating
conditions as a civilian prisoner at Pudong [Pootung] Camp in Shanghai during the last two years of
the Japanese Occupation of China (1943-45).
Rationale and Significance
As one of six China-born‖children‖of‖Canadian‖missionaries‖(‚mishkids‛)‖who chose to return to
China‖as‖nurses‖during‖the‖Japanese‖Occupation,‖Betty‖Gale’s‖China‖life‖represents‖a‖largely‖
unknown phenomena in Canadian mission history – the internment of Canadian nurses. Part of a
larger biographical study of the China life of Betty Gale (1911 – 1945), this paper focuses on her last
two years in China as a civilian prisoner with 1200 other enemy aliens in the notorious Pudong
Camp. This study adds to the body of scholarship on the imprisonment of American and Australian
military nurses under the Japanese in the Philippines and Indonesia by adding a civilian perspective
of China-born Canadian nurse-prisoners in Japanese war camps.
Methodology and Sources
Building‖on‖the‖author’s‖established‖research‖program‖on‖Canadian‖missionary nurses in China, this
study utilizes a biographical method as a lens through which to better understand not only the life of
one person, but the broader social phenomena of mishkid nurse internment. Sources included Betty
Gale’s‖unpublished‖diary‖kept during internment, photographs, film footage and hundreds of pages
of private letters, memorabilia, newspaper clippings and internment camp newsletters. Also included
were taped interviews of Betty Gale and five other internees. The United Church of Canada Archives
and National Archives of Canada provided official mission communiqués and International Red
Cross‖reports‖on‖conditions‖in‖China’s‖internment‖camps‖respectively.‖‖Finally,‖fieldwork‖was‖
conducted‖in‖China‖as‖the‖researcher‖joined‖Betty‖Gale’s‖family members on visits to sites where
Betty lived and was interned.
Conclusions
Betty‖Gale’s‖decision‖to‖remain‖in‖China‖against‖consular‖advice‖in‖1941‖marked‖a‖new‖epoch‖in‖the‖
history of Canadian missions in China. For the next four years the missionary gaze was turned from
the Chinese populace outside mission walls to fellow prisoners within them.‖‖Betty’s‖arrest‖and‖
subsequent four-year imprisonment in a series of camps culminated in two final years of neglect,
starvation and terror during the eventual‖months‖of‖unrelenting‖air‖raids‖over‖Shanghai.‖Betty‖Gale’s‖
personal quest for survival and purpose mirrored the collective missionary pursuit of equilibrium in
the increasingly unstable and unrecognizable world of China missions – a pursuit that was
effectively abandoned after the release of surviving internees in 1945.
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OCCUPIED BY THE ENEMY: BRITISH NURSES AND GERMAN OCCUPATION 1940-45
Barbara Mortimer, PhD
Dr Mortimer is currently working as a Research Assistant with the Oral History Archive of the Royal
College of Nursing on a history of nursing in Britain during World War 2.
 0131 447 2592
[email protected]
Aim of study, To explore the professional position of the British nurses who remained to nurse in the
Island of Jersey in the only part of Britain occupied by the enemy in World War 2.
Rationale and significance: The Channel Islands of Jersey and Guernsey in the Gulf of St Malo are
geographically closer to France than Britain and following the Allied retreat from mainland Europe
in‖1940‖British‖troops‖were‖withdrawn‖from‖the‖Islands‖leaving‖the‖territory‖effectively‖an‖‘Open‖
Town’.‖
Following a rapid and rather undignified rush to evacuate the now unprotected and undefended
Islands, German forces moved in on 30th June 1940. They remained for five years. Nurses were
isolated from their Statutory Body, the General Nursing Council for England and Wales (GNC) and
their Professional Body, the Royal College of Nursing (RCN).
To date there has been no formal study of the professional or individual position of nurses in the
trying conditions of the Occupation.
Methodology:‖This‖paper‖uses‖a‖very‖rich‖tradition‖of‖published‖‘local’‖history together with oral
history accounts of nurses who experienced the Occupation and the records of the Statutory Body,
the GNC. It asks if professional standards alter in such circumstances, examines the dilemmas posed
for practitioners and explores how they perceived and met their responsibilities towards the
profession, each other, colleagues in other professions, patients and their families.
Findings and conclusions: It appears that a professional respect and detachment towards the
occupying forces was cultivated which enabled British nurses to continue caring effectively for their
patients and to meet the educational requirements of the GNC.
Following Liberation on 9th May 1945 student nurses who had undertaken training in the Island were
able‖to‖enter‖for‖the‖next‖GNC‖examinations‖and‖at‖least‖ten‖‘Jerseygirls’‖passed‖their‖examination‖
and‖registered‖‘SRN’‖on‖November 23, 1945.
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THE LIVED EXPERIENCE OF HMONG NURSES IN SOUTHEAST ASIA 1950-2000: AN
INTERPRETIVE PHENOMENOLOGICAL STUDY OF NURSING HISTORY
Dian Baker, PhD, APRN-BC, PNP, Postdoctoral fellow in nursing
Betty Irene Moore School of Nursing University of California, Davis
1-530-400-2866 or 1-530-753-6822 (USA)
[email protected]
Aims of the Study: (1) Explore the lived experiences of Hmong women and men who developed and
practiced the profession of nursing from 1950 to 2000 in Southeast Asia; (2) Develop insight into how
the nursing profession is established in region where it was previously unknown; (3) Relate the
richness and depth of the experience of the Hmong nurses, who stepped far outside their expected
role to provide healthcare; and (4) Relate their experiences to the role nurses have today.
Rationale and Significance: From 1950 to 2000 the country of Laos underwent many significant
changes. In 1960-70’s‖during‖the‖Vietnam‖War,‖the‖United States engaged in a secret war staged from
the highland plains in Laos. The U.S. built airfields in Laos with assistance from the Hmong, an
agrarian, patriarchal group that practiced animist beliefs and primarily used shaman and herbalist as
provider of healthcare. After the fall of Saigon in 1975, Southeast Asia was in political upheaval and
eventually many of the Hmong were relocated to refugee camps. During these periods of upheaval
little is known about how healthcare or nursing care was provided for the Hmong. During this time a
group of Hmong women and men established a nursing care educational system. Results from the
study add to the knowledge of nursing history through understanding the development of nursing
practice under conditions of significant societal stress and where Western medical practices align
with historically animist health belief systems.
Methodology: Individuals interviews with eight Hmong nurses, field interviews with leaders of the
Hmong community, and examination of historical artifacts such as photos were used to gather data.
Interviews took place in English. An interpretive phenomenological approach was used for analysis.
May Ying Ly served as the cultural broker for this study; she was the cultural broker for Anne
Fadiman’s‖National‖Book‖Circle‖prize‖winning‖book,‖‚The‖Spirit‖Catches‖You,‖You‖Fall‖Down‛.‖
Findings: A group of Hmong women and men established and practiced nursing during the Western
occupation in Laos and afterward in the refugee camps. The story is one of strength, determination,
resilience, and passion to provide excellent nursing care for their community. They overcame
multiple obstacles including a dominating patriarchal system that discouraged women from entering
nursing.
Conclusion: The story Hmong nursing history helps to explain how nursing establishes itself as a
profession and how the nursing profession survives during times of significant societal change.
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Concurrent Session 5
Session 5a: Panel Presentation: Nurses on the Front Line:
Representation and Autonomy
HEALERS, HEROINES AND HARPIES: LITERARY NURSES OF THE FIRST WORLD WAR
Christine E Hallett, PhD
Manchester University
Aim of the study: The aim of the project is to explore literary representations of nurses, written by
nurses who practised during the First World War.
Research questions addressed: How did those who nursed the wounded of the First World War
view their work, their role and the significance of their involvement in the war?
In‖what‖ways‖have‖a‖small‖minority‖of‖‘literary’‖nurses‖portrayed these themes through their
published writings?
Why and how did nurses use traditionalist and modernist styles of literary writing to convey their
experiences of war?
How‖may‖an‖analysis‖of‖these‖works‖create‖interpretive‖links‖or‖‘bridges’‖between literature and the
theory and practice of nursing?
Rationale: There have been other texts developing literary critiques of the writings of First World
War nurses. The work of Agnes Cardinal et al (Women’s Writing on the First World War), Dorothy
Goldman (Women and World War I: The Written Response) Margaret Higonnet (Lines of Fire. Women
Writers of World War I; Nurses at the Front: Writing the Wounds of the Great War), Sharon Ouditt,
(Women Writers of the First World War) and Angela Smith (Women’s Writing of the First World War: An
Anthology),‖have‖offered‖important‖insights‖into‖women’s‖wartime‖roles.‖‖This‖project‖is‖very‖
different in its emphasis from earlier compilations: it examines only the writings of nurses (rather
than‖on‖‘women’s‖writings’‖more generally) and it emphasises those elements of the texts that focus
on the nature and meaning of nursing and the role and position of the nurse during wartime.
Methodology: Excerpts from the works of nine nurse-writers are to be presented, categorized as
enthusiastic‖clinicians‖(‘healers’),‖romantic‖adventurers‖(‘heroines’)‖and‖detached‖critics‖(‘harpies’).‖‖
Detailed archive searches have been undertaken in order to obtain material relating to the lives of the
authors to be studied. An element of literary criticism is used in the analysis of the main texts. The
main emphasis will be on the ways in which each author projects the image of the nurse and of
herself within a nursing context.
Findings and Conclusions: The project explores the ways in which the nurse-writers of the First
World‖War‖positioned‖themselves‖as‖‘healers’,‖‘heroines’‖or‖‘harpies’.‖‖‘Healers’‖are‖presented‖as‖
individuals who adopted a traditionalist form of adventure-writing to convey a sense of the
significance of nursing work and what they saw is the admirable qualities of the nursing character.
‘Heroines’‖were‖also‖writing‖within‖a‖traditionalist‖style.‖‖Their‖intention‖was,‖primarily,‖to‖convey‖a‖
sense‖of‖the‖adventurousness‖of‖the‖‘nursing‖spirit’:‖to‖present‖themselves‖as‖exemplars of women
who traveled far from home, often to remote areas of the world, confronted danger and the
challenges presented by nursing work, in particular the need to compose oneself as a strong and
compassionate carer in the face of intense suffering. The term‖‘Harpy’‖for‖the‖third‖category‖of‖writer‖
requires some justification. Apart from the obvious lure of a neat alliterative title, this term conveys
the quite deliberate insistence of my last three writers to stand outside – both stylistically and
ideologically – the traditionalist framework of their time.
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CONFLICT, CHANGE AND CONTINUITY:
WAR AND NURSING IN THE EAST OF EMPIRE
Rosemary Wall, Ph.D., Research Fellow
Anne Marie Rafferty, PhD, Professor
Dean of Florence Nightingale School of Nursing and Midwifery
King's College London, England.
020 7848 3962
[email protected] (main contact); [email protected]
Aim of study
There were 176 British colonial nurses in the Malay peninsula when the Japanese invaded in 1941-2.
44 died and many were imprisoned in internment camps where four more died. Whilst the British
were interned, the locals kept the health services running. This paper explores the influence of the
Second World War and the Malayan Emergency on the development of nursing in Singapore and
British Malaya. The subsequent decisions regarding the levels of involvement of the Overseas
Nursing Association in the continuance of nursing services and training are examined.
Rationale and significance
This paper focuses on the area of the British Empire which hosted the largest number of colonial
nurses in the world. The history of healthcare in South-East Asia is underexplored in comparison to
historical research on Africa. A tumultuous time is explored, when Britain was trying to hold on to
an area of Empire under the threat of Japan and subsequently communism. Nurses were used as
emblematic of the benevolent aims of colonial rule, and we examine how they were represented and
self-represented in a variety of media.
Methodology
A range of primary sources are utilised: film from the Imperial War Museum archive, oral histories
conducted by the authors and from the collection at the National Archive of Singapore, memoirs,
letters, the press, and British, Malaysian and Singaporean reports. Secondary literature on South-East
Asian nursing is underdeveloped, but the paper will draw on work by Lenore Manderson on the
history of medicine in the area,‖and‖on‖colleagues’‖work‖in‖progress‖on‖white‖women,‖missionaries,‖
Eurasians and Malayan responses to Western healthcare in the Malayan peninsular.
Findings and conclusions
In 1945, the locals returned to their old positions whilst the British took charge of healthcare again.
Additionally, British military nurses who came to work in the Malay Peninsular requested to stay
and become part of the ONA, leading to difficult decision making for the organisation which wanted
to maintain elitist standards but also to fill vacant posts. From 1956-7 British nurses for general duties
were no longer required in Singapore and Malaysia. However, there were requests for British nurse
tutors to remain, but subordinate to Asian nurses. Many senior British nurses left under the
Malayanisation programme causing shortages of tutors, and the World Health Organisation was
relied upon for help. This paper examines the conflicts, representations of, and power struggle
between British and Asian nurses.
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NURSING AND WAR:
THE CINEMATIC REPRESENTATION OF BRITISH NURSES IN BIOPICS.
Elisabetta Babini, Doctoral Candidate.
Florence Nightingale School of Nursing and Midwifery/School of Arts & Humanities, Centre for the
Humanities and Health, King's College London, England.
0752 7871154.
[email protected]
Aim of study
Nineteenth and early twentieth century British history counts among its protagonists two
extraordinary women who passionately devoted their lives to others and made the nurse's
assignment a real mission: Florence Nightingale and Edith Cavell. Respectively the 'modern nursing
mother' and the 'self-sacrifice symbol', such exemplary nurses also shared experiences of active
commitment to the profession in war time. The present paper aims at analysing how the camera has
represented their profiles over the last century, with particular regard to biopics and to the war
theme.
Rationale and significance
The investigation shall be developed according to an interdisciplinary approach. Therefore, starting
from references to history of nursing and to film studies theories, the paper examines such cinematic
portrayals by involving also gender, cultural and feminist studies. The final purpose is, first, to verify
which kind of 'nurse's image' cinema has suggested and, second, to estimate whether this
representation had any social impact. In the substantial critical body, little has been written about
this comparative theme so far. Thus, it would be interesting to study the subject in depth and
widening the present knowledge on it.
Methodology
Through the screening of biopics on Nightingale and Cavell, and given both history and the history
of nursing testimonies on them, the paper shall investigate whether it is possible to parallel gender,
cultural‖ and‖ women’s‖ studies‖ theories‖ and the cinematic representation of such figures. Primary
sources are Herbert Wilcox's productions Nurse Edith Cavell (USA, 1939) and The Lady with a Lamp
(UK,‖ 1951),‖ and‖ material‖ such‖ as‖ actress‖ Anna‖ Neagle’s‖ autobiography.‖ Secondary‖ sources‖ include‖
the few publications currently available about the topic by Julia Hallam, Beatrice and Philiph Kalisch
and David Stanley as well as several key-contributions on the social history of nursing. Additionally,
works within the Film Studies field will be utilised, in particular the ones written by feminist
theorists such as Alison Butler, Molly Haskell, Laura Mulvey and Yvonne Tasker.
Findings and conclusions.
Nightingale and Cavell's biopics distinguish themselves from the rest of cinematic productions on
nursing released by the early 1950s since they communicate a new image of the category: no longer
focused on stereotypical ideas of female weaknesses but rather emphasising nurses' professionalism.
This had a more substantial impact on society than deliberate recruitment films.
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Session 5b: Maternal and Child Health
THE FIRST ENGLISH-LANGUAGE MIDWIFERY MANUAL (1540-1654):
PROFESSION, IDENTITY AND IDEOLOGY
Elaine Hobby, Professor, BA, PhD, MA
English and Drama Department,
Loughborough University;
01509 222950;
[email protected]
Aim of study This paper will introduce the first English midwifery manual, The Birth of Mankind,
which was in print from its first appearance in the reign of Henry VIII in 1540, until its usurpation by
the new information about midwifery practice that was made available by Nicholas Culpeper (of
Culpeper’s Herbal fame) during the 1650s. It will analyse the ways in which the book related to the
professional identity of English-speaking midwives, and how this connected to ideologies about the
nature and abilities of women more generally.
Rationale and significance The Birth of Mankind is a fascinating text, including sections on female
reproductive anatomy, on normal and obstructed labour, and on postnatal care of both mother and
infant. The paper shows how familiarity with it increases our understanding of the history of
midwifery, and of the struggles that early midwives faced to be seen as skilled professionals.
Methodology The key sources for this research are the many editions of The Birth of Mankind that
appeared between 1540-1654. The paper will work by analysing in close detail what the book says
about midwifery practice, and how this changes between 1540 and 1654. Because the earliest version
of the book was based on a German midwifery manual of 1513 that was intended for use in the
training of midwives, comparisons between the German original and the English version will also be
made. Also crucial to an understanding of The Birth of Mankind is its relation to the Vesalian anatomy
of the 1540s, and the paper will show how The Birth of Mankind borrowed from and changed
Vesalius’s‖ideas,‖producing‖a‖far‖more‖woman-centred understanding of the reproductive process
than characterises De Fabrica.
Findings and conclusions The paper will show how the physician-controlled model of midwifery
that characterised the German source of The Birth of Mankind was shifted for its English-speaking
audience, which consisted both of midwives, and of general readers interested in reproduction. It
will be argued that the emergence of Protestantism in Britain in the mid-1500s also played a crucial
role in changing understandings of conception and birth from the German and Italian Catholic
assumptions‖of‖the‖book’s‖originals.‖Finally,‖the‖paper‖will‖suggest‖that The Birth of Mankind is a
precious source for our history, and that it should be more widely used by historians of midwifery.
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‘WAR IS GOOD FOR BABIES’: HOW EUROPE’S WORLD WAR ONE SHAPED
MOTHERCRAFT SERVICES IN NEW SOUTH WALES, AUSTRA‘WAR IS GOOD FOR BABIES’:
HOW EUROPE’S WORLD WAR ONE SHAPED MOTHERCRAFT SERVICES IN NEW SOUTH
WALES, AUSTRALIA.
Clare F Ashton, RGON, RM, BBS, MPHIL
Public Health
64 3 755 7744
[email protected]
Aim of study
‘War‖is‖good‖for‖babies’‖was‖Dr‖Josephine‖Baker’s‖line‖summing‖up‖fund‖raising‖for‖baby‖care‖in‖
early twentieth century New York. Deborah Dwork quotes this in her work on the history of infant
welfare in that period in England. This presentation asks the question: was World War One also
‘good‖for‖babies’‖in‖NSW‖Australia?
Rationale and significance
Mothercraft services in 1920s NSW seemed a turmoil of disparate interests and historians have
focussed on feeding regimes and patronising male dominance as the rationale. This study widened
the scope for assessing the turmoil by examining the sectoral interests in baby health at the time in
NSW Australia. It also detailed the sequence of events to clarify the genesis of apparently competing
mothercraft services.
Methodology
The records of the NSW Department of Public Health and mothercraft organizations were the main
sources used to unravel the origins of the mothercraft services in Sydney. Commentary from
Australian historians of governmental welfare policies provides supporting evidence.
Findings and conclusions
Mother and baby services in NSW were shaped by the political upheavals that followed the
contentious Australian referendum on military conscription in 1916. One of the political outcomes of
the conscription divide was a conservative shift in attitudes towards welfare and this was the basis
for the 1920s controversy over baby care in NSW. The personal professional interests of the nurses
and doctors involved in mother and baby services were not immune from the effects of the War
either. They exhibited the effects of the War on the returning servicemen and women, and the
attitudes of those who had kept the health services operating at home. World War One did affect the
baby care services in NSW Australia but not as conclusively as it did in other English speaking
countries.
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WWII EMERGENCY MATERNITY AND INFANT CARE PROGRAM LETTERS:
APPEALS FROM INDIVIDUALS FOR HELP, 1943-1947
Nena Patterson, RN, MSN
PhD Student
University of Virginia
School of Nursing
434-531-3967
[email protected]
Aim of Study: The purpose of this study was to determine what themes characterize WWII EMIC
program letters and identify the level of comprehension and specific attitudes of those directly
involved with the Emergency Maternity and Infant Care program of World War II.
Rational and Significance: The Emergency Maternity and Infant Care Program (EMIC) enacted
during‖WWII‖provided‖maternal/infant‖care‖to‖enlisted‖servicemen’s‖wives‖in‖the‖4th, 5th, 6th, and 7th
pay grades of all military branches and was in operation from 1943-1947. EMIC was created from a
response to an identified medical care disparity. There remains a significant gap in the literature
about how those directly involved with EMIC comprehended the programs and its services as well
as what their attitudes were regarding the program. This analysis seeks to fill an identified gap and
explore the‖understanding‖and‖attitudes‖of‖soldier’s,‖their‖wives,‖and‖military‖as‖well‖as‖civilian‖
officials through an analysis of a group of their letters written during program operation 1943-1947.
Methodology: Social history methods were employed in this study. The primary source was a
sample‖of‖EMIC‖letters‖obtained‖from‖Children’s‖Bureau‖documents‖at‖the‖National‖Archives,‖
College Park, Maryland. Secondary sources included medical, nursing, and military historical
writings of World War II.
Findings and Conclusions: Frustration, misinformation, and attitudes about EMIC eligibility and
provisions for care were themes identified within the overall body of letters. The analysis
substantiated that the program was established to provide maternity care benefits for active duty
enlisted servicemen in the 4th lowest pay grades but physicians could opt out of this national
maternal health program and this analysis notes that they often did so. Also, during program
evolution,‖the‖Children’s‖Bureau‖had‖to‖revisit basic policy and specification of eligibility as well as
redefine‖criteria‖for‖previously‖unconsidered‖groups‖such‖as‖veteran’s‖dependents‖or‖dependents‖of‖
men‖killed‖or‖missing‖in‖action.‖Under‖EMIC‖the‖Children’s‖Bureau‖made‖standards‖of‖care‖
mandatory for approval of state plans for both, hospitals as well as individual providers and this
letter analysis corroborates this requirement. Along with the maternity care benefit of access to care,
EMIC potentiated an increase in the quality of care provided for not only EMIC participants but to
other pregnant women of the WWII era.
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Session 5c: International Collaborations
‚HOPE ARRIVES FROM THE NORTH: THE ORAL HISTORY OF THE BRAZILIAN STUDENT
NURSES WHO INTERNTED ON THE AMERICAN HOSPTILA SHIP ‘HOPE’IN THE
NORTHEAST OF BRAZIL, 1972
Glicerio Moura, BSN, RN
Lienhard School of Nursing, Pace University
Pleasantville, New York
[email protected]
Sandra B. Lewenson, EdD, RN, FAAN
Lienhard School of Nursing, Pace University
Pleasantville, New York
[email protected]
Aim of the Study: This study examines the stories of nursing students who participated in the 1972
Project Hope internship in Natal, Brazil.
Rationale and Significance In‖1972,‖Project‖Hope‖sent‖the‖hospital‖ship‖‚Hope‛‖to‖establish‖a‖yearlong health cooperation mission in Natal, Brazil, located on the northeastern coast of Brazil. During
that visit, a group of thirteen nursing students from a local public nursing school participated in an
internship program on-board the hospital ship. By collecting their oral histories, an understanding of
how this American initiative influenced the evolution of nursing and nursing education in Brazil
during the late twentieth century is gained. In addition, this international historical research project
provides insight into cross-cultural issues and collaborating partnerships that has relevance today.
Methodology: Oral histories were collected from thirteen former student nurses and one
administrator who participated in the 1972 Project Hope mission. Interviews lasted approximately 60
minutes, with open-ended questions about past participation in the Project Hope Internship
Program. An Institutional Review Board application was submitted and received an expedited
review. The interview tapes were transcribed and translated from Portuguese to English. The oral
histories served as the major primary source material for the study. Secondary sources included
materials reflecting the development of nursing education in Brazil, the background of the 1972
Project Hope mission in Natal, journal articles on historical research methodology, feminism, and
writings on nursing education in Brazil and the United States.
Findings: The internship program exposed the nursing students to American technology,
education, and culture. The students respected the technology and the way they learned to care for
patients. They also felt respected for what they could bring to the setting, even though they were
second year students. The experience allowed the students to see various ways of knowing and
doing. When the students returned home they adapted what they had learned into their own reality.
Conclusion: The students described the experience as‖‚priceless.‛‖The‖history‖shows‖the‖richness‖of‖
such a program facilitating a mutual respect between two cultures and the subsequent influence of
their experiences on health and education in Brazil. International historical research provides
evidence that can be used in developing future collaborative international cross-cultural initiatives.
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INTERNATIONAL TRANSFER OF NURSING KNOWLEDGE:
PROFESSOR LORETTA HEIDGERKENS ‚UNIT LEARNING‛ MODEL
Susanne Malchau Dietz, Associate Professor, PhD
Institute of Public Health
Department of Nursing Science
University of Aarhus
Hoegh-Guldbergs Gade 6A
DK-8000 Aarhus C, Denmark
Phone: +45 33 26 26 07
[email protected]
Aim: To do a case study of the roots, expressions, and significance of transfer of nursing knowledge
between the USA and Denmark 1945-1970.
Rationale and significance: In the 1950ies the Danish matron Sister Benedicte Ramsing (1912-1988)
introduced‖ the‖ American‖ ‚Unit‖ Learning‛‖ model‖ at‖ the‖ Saint‖ Joseph‖ School of Nursing in
Copenhagen. The starting point was when Sister Benedicte 1948-1950 studied at the School of
Nursing Education at the Catholic University of America, Washington DC. Here professor Loretta
Heidgerken (1908-1996)‖introduced‖her‖to‖the‖‚Unit Learning‛‖model‖‛that‖all‖the‖varied‖phases‖of‖
education‖ should‖ be‖ integrated‖ so‖ that‖ the‖ student’s‖ experiences‖ and‖ knowledge‖ will‖ be‖ one‖
harmonious‖ whole‛‖ (Heidgerken‖ 1946,‖ p.171).‖ Within‖ a‖ few‖ years‖ Sister‖ Benedicte‖ imported‖ and‖
refined the Unit Learning model into a Danish nursing culture and context. The question is to what
extent was the model described, put into practice and accepted in the USA? In which form was it
transferred to Denmark? In which way did region, culture and professional and religious affiliation
influence the transfer of nursing knowledge?
Methodology: The study is an empirical historical comparative study based on primary sources from
Saint Joseph School of Nursing in Denmark, the Catholic University of America and two schools of
nursing in the region of Philadelphia (Chestnut Hill and the University of Pennsylvania schools of
nursing) found in the collections at the Barbara Bates Center for the Study of the History of Nursing,
University of Philadelphia. Secondary sources are published‖ works‖ about‖ nurses’‖ education‖ in‖
Denmark and USA in the period in question. An important secondary source is a biography of Sister
Benedicte where the education at Saint Joseph School of Nursing is analyzed and described
thoroughly (Malchau 1998).
Findings and conclusions: of the study emphasize the theme profession, identity and ideology. It will
be argued that transfer of knowledge from the USA to Denmark was an important means in building
up the nursing profession as an academic discipline in Denmark and that it furthermore promoted a
sense of international shared nursing identity. When it concerns Saint Joseph School of Nursing in
Copenhagen it will be demonstrated that differences in educational legislation and culture were an
obstacle in implementing the American curriculum while religious affiliation only caused minor
problems. The results are discussed within the concepts of imperialism versus global nursing
community defined in terms of equality.
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FRENCH NURSES IN THE BRAZIL CAPITAL (1890-1895)
Tiago Braga do Espírito Santo – reporter, Master in Nurse by the Post Graduation Program of Nurse
of the Nurse School of the University of São Paulo (EEUSP),
[email protected]
Taka Oguisso, Doctor
Headmaster of the Nurse School of the University of São Paulo (EEUSP)
[email protected]
Escola de Enfermagem da Universidade de São Paulo
55-11-76619443
[email protected]
Aim: the beginning of the Brazilian nursing professionalization through the coming of French nurses,
from 1890 to 1895, to the Insane National Hospital (HNA), Rio de Janeiro, capital of the recently
installed republican government. The contract which facilitated the coming of those professionals
was one of the government strategies to solve the institutional crisis caused by the Sisters of Charity
who had gone from the hospital, where they exerted nursing care. Objectives: to identify possible
circunstances that had culminated in a contract, signed between the Brazil and France goverments,
wich has promoted the french nurse arrival to the Insane National Hospital, Rio de Janeiro, 1891; to
describe the laicization process within hospitais and the French nursing professionalization,
definning the profile of nurses educated by the Salpêtrière School; to analyse the trajetory of these
professionals comming to Brazil, within the historical context of the beginning of the First Republic;
to survey possible activities French nurses had performed at the Insane National Hospital. The
theoretical and methodological foundations were done based on the proposal Social History and
Micro-history, with dense description technique for narration. Data collected were interpreted
according to the written history of Burke, linked to the object through data triangulation.
Documental corpus is made up mainly by ministry reports of that time and on some evidences about
French nurses disposed by the Itamaraty Palace (Ministry of External Relations) documentary
archives. Another important resource was the written media. Through this study it is possible to
notice the turmoil context which gave origin to the French nursing and the existence of several
models in France, among which had prevailed the of Br Bourneville who acting as a physician,
politician and journalist established training schools and wrote nursing manuals which have
influenced several countries worldwide. The Brazilian context was much disturbed during the
transition from monarchy to the republic at the end of the XIX Century, motivating socio-political
changes which have characterized the country as an importer of European positive-evolutionist
ideas, concretizing the intention of civilizing the nation. This had as scenario the social medicine and
psychiatry development as a way of hygienezation/exclusion. Relating nursing development in
France with Brazilian republican ideas, it is noticed that bringing approximately 40 French nurses to
work at HNA was directly linked to the intention of reaffirming the recently established government
intention to create a career for women inspired on Bourneville nursing model.
Descriptors –history of nursing; nurses (1890-1895); Hospitals, Psychiatric (Rio de Janeiro)
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Session 5d: Nurse Recruitment and Nursing Education
THE RECRUITMENT AND RETENTION OF POOR LAW NURSES IN
LIVERPOOL FROM 1893 TO 1933
Carolyn Gibbon, RN, MA, BA, DPSN, RCNT
University of Central Lancashire
01772893639
[email protected]
Aim of study: To review a series of Registers of Probationer Nurses in order to examine issues of
recruitment and retention.
Rationale and significance: The Metropolitan Poor Law Act 1867 enabled Poor Law Infirmaries to
train nurses to provide care for the sick poor. Recruitment and retention has been a cause of
discussion for many years and this study identified issues that have resonance with today, including
previous experience, poor health prior to and during training, and the relatively low numbers who
completed their training and remained at the hospital as staff.
Methodology: Documentary analysis of a series of six Poor Law registers of Probationer Nurses from
Mill Road Infirmary, Liverpool. The analysis covers a period of forty years from 1983-1933 and
formed the basis of the research, supported by research by White (1978) amongst others.
Findings: The recruitment pattern altered over the period under investigation, reflecting the societal
changes that were taking place, and included a significant number who reported previous nursing
experience. At this time the majority of probationers were local to the hospital, but it is especially
noted that during the interwar years, a number came from rural areas.
Training commenced following a probationary period, or trial, though there were some exemptions.
All probationers underwent a medical examination prior to training and a number were found to be
unfit, including probationers who had transferred from other hospitals to complete their training. Ill
health amongst the probationers is also noted intermittently with cases of infectious diseases being
sent to the local isolation hospital. Arguably the rates of infection were dropping amongst the
probationers, though there were periodic cases of enteric fever. Improved nutrition, healthier
candidates, and an understanding of infection may have contributed to this.
Retention of staff largely depended on the financial position of the hospital. Over the period of study,
58% completed their training, but only 15% of this number took up staff posts. Probationers did not
complete their training for a variety of reasons, including not being suitable, or to be married.
Conclusions: It is contended that during this period of study, probationers saw nursing training as an
opportunity to work and to increase their status which in turn increased opportunities for promotion
and increased salary. Reasons for leaving included not being suitable, ill health, or not finding
nursing suited them.
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‚I WAS WORKING IN THE HOSPITAL AS AN ORDERLY‛
THE ORAL HISTORIES OF THE ALEXIAN BROTHERS HOSPITAL
SCHOOL OF NURSING GRADUATES
Susan A. LaRocco Professor, PhD, RN, MBA
Curry College, Milton, Massachusetts USA
617-721-9986
[email protected]
Aim of Study: The Alexian Brothers Hospital School of Nursing in Chicago, founded in 1898, was the
fifth all male nursing school in the United States. By the time it closed in 1969 a total of 779 lay and
religious men became nurses as a result of their education at this school. A unique aspect of their
education was that they were in a setting where all of the patients, as well as all of the nurses, were
male. Their care of female patients occurred during affiliation at other hospitals including maternity
and pediatric facilities. The aim of this study is to present the oral histories of these men, especially
their decision to choose nursing as a career and their experiences during their pre-licensure nursing
program.
Rationale and Significance: The recollections of these male nurses will add to our understanding of
what it was like for a man to choose nursing as a career at a time when less than 2% of all nurses in
the United States were male as well as what it was like to attend a religious affiliated all male nursing
school.
Methodology: Oral‖history‖interviews,‖focusing‖on‖the‖men’s‖decisions‖to‖become‖nurses,‖choice‖of‖
school, and the obstacles and opportunities that they encountered throughout their careers, and their
contributions to health care as nurse anesthetists, administrators and educators, were conducted with
23 graduates of the school. All interviews were conducted in person and were audio-recorded,
transcribed and participant checked for accuracy. MaxQDA, a qualitative software package, was
used to assist with data management and analysis. Other primary sources included the records of
the Alexian Brothers Hospital School of Nursing. Secondary sources included books and articles
referencing men nurses and nursing education in the 1950s and 1960s and nurse anesthesia in the
United States from the 1950s to the present.
Findings and Conclusions:
Men who graduated from the Alexian Brothers Hospital School of Nursing chose nursing for a
variety of reasons. The low cost of their education was often a factor. For many, their desire to
become Certified Registered Nurse Anesthetists (CRNAs) influenced their decision. All of the men
indicated that they received an excellent education that was the foundation for their continued
education and successful nursing careers. They also reflected on the values of compassion and
service that were developed in them while they were learning from the Brothers.
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INTELLECTUALIZING A GENDERED SPACE: THE BELLEVUE SCHOOL OF
NURSING LIBRARY CLASSIFICATION SCHEME
Keith C. Mages, MSN, MLS, RN
Doctoral Student
University of Pennsylvania, School of Nursing
(716) 361-4000
[email protected]
Aim of Study
This paper analyzes the creation of a unique library classification system developed specifically to
organize the texts of an early 20th century nursing library.
Rationale and Significance
Bellevue School of Nursing Instructor Ann Doyle created the Bellevue Classification Scheme (BCS)
during‖the‖early‖1930’s.‖Doyle‖surveyed‖existing‖library‖classification‖systems‖and‖found‖them‖
inadequate to the needs of nursing. The resulting Bellevue Classification System (BCS) became the
model organizational scheme for nursing libraries, and was supported and disseminated through
multiple‖editions‖of‖the‖National‖League‖of‖Nursing‖Education’s‖Library Handbook for School of
Nursing. A careful analysis of both the process of creating and the ultimate structure of the BCS offer
an‖early‖example‖of‖how‖the‖construction‖and‖organization‖of‖a‖library’s‖materials‖produced‖and‖
disseminated‖a‖gendered‖group’s‖perceived‖domains‖of‖influence‖and‖authority.
Methodology
Using the methodological‖tools‖of‖social‖history,‖this‖paper‖juxtaposes‖the‖BCS’s‖origin,‖structure,‖
and content against those of the classification schemes consulted during the drafting of the BCS: the
Dewy Decimal Classification (DDC), Library of Congress Classification (LCC), Boston Medical
Library Classification (Ballard), and the National Health Library Classification (NHLC) schemes. This
paper provides a textual analysis of data from these sources, in conjunction with associated
published and manuscript data and relevant secondary sources on gender and library classification
systems.
Findings and Conclusions
The Bellevue Classification System was intrinsically linked to turn-of-the-20th-century‖America’s‖
burgeoning library culture. The most well known products of this culture, the DDC, LCC, Ballard,
and the NHLC were carefully studied by Doyle who rejected them as neither a particularly
encompassing‖nor‖reflective‖of‖nursing’s‖dynamic‖knowledge‖domain.‖These‖systems,‖though,‖did‖
serve as both catalysts and reference points as Doyle constructed the BCS, a new scheme that
promoted a distinct perspective on nursing knowledge. In its final form, the BCS also created a
legitimate space for the organization of traditionally feminized knowledge. In total, the BCS allowed
Doyle to portray nursing as a gendered, yet intellectual, professional discipline.
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Session 5e: Nursing and Women’s Health
‘KILLED BY GOSSIP’: NURSE NAOMI JONES AND THE FAILURE OF THE
ABERTILLERY HOSPITAL BIRTH CONTROL CLINIC.
Pauline Brand, PhD, MSc (Nursing), BA (Hons), RN, RM, RHV
The Open University, 12 Hills Road, Cambridge. CB2 1PF
[email protected] Tel: (+44) 1223 364721
Purpose of Study
This paper forms part of a wider study of birth control nursing which has traced the contribution of
the pioneering nurses and midwives who chose to work in what was considered to be a controversial
clinical area.
Rationale and significance
In 1924 the Ministry of Health maintained its stance that women needing contraceptive advice on
medical grounds should be referred to a private doctor or a hospital. Various associations had opened
clinics throughout the country but the newly opened Abertillery Hospital, situated in an
economically deprived area in South Wales, was the first to offer such a service with a clinic staffed
by Nurse Naomi Jones.This paper explores four issues; the debates between the protagonists
concerning the establishment of the clinic; the early career of Nurse Jones; the service provided in the
clinic and finally the campaign which resulted in its closure.
Sources and Methodology
Primary and secondary sources were interrogated to produce a case study of the Abertillery clinic.
Primary‖sources‖included‖material‖from‖the‖Marie‖Stopes’‖collections‖in‖the‖Wellcome‖Contemporary‖
Medical Archives and the British Library
Findings and Conclusions
In 1924 the Secretary of Abertillery Hospital contacted Marie Stopes seeking guidance on the logistics
of establishing a birth control clinic. Stopes participated in the selection of a suitable candidate, Nurse
Naomi Jones. The clinic opened in 1925 and initially appeared to be successful but during 1926,
Nurse Jones letters to Stopes became increasingly despondent as she described the opposition she
was facing from local Churches and members of the hospital committee. Within 16 months the
project was at an end and a disappointed Jones wrote to say that the clinic had been killed by gossip.
This case study provides one illustration of the difficult task faced by those nurses and midwives
working in this controversial area during the early years of the birth control clinics.
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TERMINATION OF PREGNANCY AT CHELSEA HOSPITAL FOR WOMEN
BETWEEN THE 1930s AND 1960s.
Susan Snoxall, PhD, MEd, RGN, RNT, RCNT
07810 540277 and 01747 835991
[email protected]
This paper will consider the treatment of women requesting termination of pregnancy prior to the
Abortion‖Act‖of‖1967‖and‖the‖part‖played‖by‖a‖specialist‖women’s‖hospital.
Gynaecologists at Chelsea Hospital for Women carried out terminations in the knowledge that they
were breaking the law, the Offences Against the Person Act 1861.
Chelsea Hospital for Women was a place where women could go if they could find a medical
practitioner who was prepared to refer them. Not all medical practitioners or gynaecologists
approved of termination of pregnancy, even on medical grounds, but some were be prepared to give
the name of another colleague who would help or advise where they might seek help. Women from a
higher social class potentially had greater access to private medical care where termination, in the
form of a dilation and curettage, could be performed in a private nursing home. Women from a
lower‖ social‖ class‖ were‖ more‖ likely‖ to‖ have‖ sought‖ help‖ elsewhere,‖ possibly‖ from‖ a‖ ‘back‖ street’‖
abortionist or attempted to terminate the pregnancy themselves.
Information that will be presented includes consultant case books, clinical yearbooks and the views
of gynaecologists and nurses working during this period. It will also consider the effect of the Rex v.
Bourne case in 1939 where the judge Mr Macnaughten, held that it was not unlawful for Mr Aleck
Bourne, a consultant gynaecologist, to terminate the pregnancy of a 15 year old girl. This became
known as the Macnaughten ruling.
Figures will be presented on numbers of terminations, procedures used and the medical conditions
recorded as to why the procedure was undertaken. Exactly how gynaecologists and gynaecological
nurses assisting in these procedures dealt with their consciences is difficult to ascertain, but those
interviewed did express views on the work and the care they tried to deliver to women. Both
professional groups were undoubtedly influenced by women, who needed admission following
attempts at ending the pregnancy themselves‖or‖those‖who‖may‖have‖sought‖the‖services‖of‖a‖‘back‖
street’‖abortionist.‖Reflection‖on‖the‖history‖of‖abortion‖may‖offer‖insight‖and‖understanding‖to‖those‖
treating women with unwanted pregnancies in the twenty first century.
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Session 5f: Nursing Leadership
MATRON AND CIVIC DIGNITERY:
THE LIFE AND CAREER OF MAJORIE BELL
Stephanie Kirby, RN, PhD
Visiting Research Fellow, Faculty of Health and Life Sciences
University of the West of England, Bristol, UK
07711271538
[email protected]
Purpose: The purpose of this paper is to recover the life and work of Marjorie Bell, MBE Matron of
Lewisham Hospital, London 1948-1970. During her long career she became a respected figure in the
nursing world, and a prominent member of the local community. But like many nurses who gained
such recognition in their own life time, the memory of her contribution to professional and local life
has faded with the passage of time.
Rationale and Significance: Marjorie‖Bell’s‖story‖reflects‖the‖way‖in‖which‖a‖woman‖with vigor and
determination could make her way in the world through a career in nursing. She provides an
exemplar of a practitioner who applied theoretical and experiential knowledge to the development of
nursing practice.
Methods /Sources: The core source for this paper is a life story interview with Marjorie Bell from the
last year of her life. Interrogation of other documentary sources helped to place her life and work
within a wider sociopolitical context. Primary sources include records of the London County Council
(LCC), the National Health Service (NHS), the General Nursing Council (GNC) and newspapers.
Findings: In 1928 Marjorie joined what was to become the LCC Nursing Service as a probationer
fever nurse. Thanks to the LCC unified career structure she held positions at 15 of its hospitals,
undertaking professional development courses and gaining promotion. During World War II she
was a Night Superintendent dealing with the results of bombing on the civilian population of
London. This proved of great use when the casualties of two horrendous train crashes were received
at Lewisham Hospital. As a hospital matron in the NHS she was concerned over the weakening of
the nursing voice within the hospital management structure and worked to form a relationship with
the hospital administration that allowed more autonomy for nursing. As Matron of the hospital she
was‖invited‖to‖play‖a‖part‖in‖Lewisham‖life‖and‖was‖a‖member‖of‖local‖professional‖womens’‖groups.
Conclusion: Marjorie Bell transferred her knowledge and skills to differing contexts inspiring
confidence in her staff to deal effectively with major trauma. Equally significant was her use of
communication and interpersonal skills to enhance the voice of nursing in hospital management.
However her story raises questions over the factors which affect the remembrance of some
individuals and not others.
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ANNA CAROLINE MAXWELL: NATIONAL AND INTERNATIONAL NURSING LEGACY,
1851-1929
Sadie Marian Smalls, EdD, RN
Assistant Director, Nursing
Kings County Hospital Center
Brooklyn, New York, USA
718.245.4712
[email protected]
Aim of Study:
To highlight Anna Caroline Maxwell, influence on the development of undergraduate and graduate
nursing education and wartime nursing nationally and internationally. She was‖nicknamed‖‚the‖
American‖Florence‖Nightingale‛‖because‖she‖accomplished‖many‖of‖the‖reforms‖in‖the‖United‖States‖
as Florence Nightingale did in Britain, such as convincing the military that a permanent group of
nurses under its auspice was essential if soldiers were to survive and establishing standards for
nursing education.
Rationale and Significance:
Nurses worldwide need to know and appreciate her influence not only on undergraduate and
graduate nursing, wartime nursing in the United States, but also international nursing. She was an
expert organizer, administrator and charter member of the American Society of Superintendents of
Training‖School‖(1893),‖forerunner‖of‖the‖National‖League‖of‖Nursing,‖Nurses’‖Associated‖Alumnae‖
of United States and Canada (1897), forerunner of the American Nurses Association, the International
Council of Nurses (1899), and instrumental in the establishment of the Army Nurses Corps (1901)
and the first postgraduate nursing program (at Teachers College, Columbia University in 1901).
Methodology:
A historical descriptive approach was used to analyze her accomplishments. The framework used to
guide the interpretation of the data consisted of concepts of professional associations and training
schools of nursing; themes such as nurses as workers, socioeconomic and political issues, and reform,
and variables such as curriculum, hospitals and activities of nurses are threads to evaluate her
contributions to nursing. Primary sources included minutes of meetings, reports of committees and
speeches from archival sources such as the Adelaide Nutting Collections (Teachers College,
Columbia University); Mugar Memorial Archives (Boston University); Sophie Palmer Library
(American Journal of Nursing); the National Archives and National Library of Medicine. Secondary
sources consisted of historical nursing books, and articles from nursing journals
Findings
She was awarded an honorary Masters of Arts by the Board of Governors of Columbia University
and buried with full military honors at the National Cemetery in Arlington, Virginia. The French
Government bestowed the Medal of Honor for Public Health during World War I for her
contribution to nursing throughout the world.
Conclusions:
Anna Caroline Maxwell nursing activities were crucial to the growth of professional nursing
nationally and internationally.
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Concurrent Session 6
Session 6a: Rural and Remote Nursing
CALLED UPON BY NEIGHBORS: THE IMPACT OF FRONTIER NURSING SERVICE ON
APPALACHIAN LAY MIDWIVES
Elissa Lane Miller, CNM, FNP, PhD.
Former Assistant Professor,
School of Nursing and Health Professions
Arkansas State University
Jonesboro, Arkansas, USA
501 268 6371
[email protected]
Aim: In the first decades of the twentieth century, American public health and medical officials
recognized the necessity of improving the health and welfare of women and children. While both
medical‖and‖public‖health‖groups‖believed‖that‖solving‖the‖‚midwife‖problem‛‖was‖the‖key‖to‖
improved maternal-child care, they differed as to how the solution to the problem should look. The
American Medical Association believed that elimination of midwives and replacement by physicians
was the best solution. Public health officials believed that improved training and supervision of
existing midwives was more practical. This study looks at the impact of those attempted solutions
on a rural Appalachian community.
Significance: In 1924, Mary Breckinridge founded the Frontier Nursing Service (FNS) in rural
Kentucky to demonstrate the effect that professionally trained nurse midwives could have in
reducing the maternal-child mortality rates. Most of the scholarship on FNS has focused on the role
of the nurse midwives, their challenges, successes and failures. Very little attention has been paid to
the native midwives they supplanted.
Rationale: Despite‖Breckinridge’s‖own‖claims‖to‖the‖contrary,‖there‖was‖initially‖a‖significant‖
resistance to the British-trained midwives that Breckinridge imported. The local lay midwives that
FNS midwives replaced were well integrated into the social and kin networks that dominated
Appalachian society and their elimination was neither easy nor swift.
Methodology: Using various original and secondary sources, such as letters, birth logs, oral
histories, census records, biographies and official FNS records, this paper focuses on the native lay
midwives that FNS replaced. Questions addressed include the following: What meaning did the
practice of midwifery have for those who practiced it? What role did midwifery play in the
integration of local society? What were the economic consequences of supplanting lay midwives
with professional ones? And finally, how did lay midwives and their patients adjust to the
increasing dominance of outside influences represented by FNS?
Conclusions: Breckinridge and the Frontier nurses effectively demonstrated the ability of
professionally trained nurse midwives to improve the survival of mothers and babies, but it did so at
a‖price.‖‖Despite‖its‖success,‖Breckinridge’s‖demonstration‖project‖was‖never‖repeated elsewhere. The
resulting disruption of indigenous networks of caring created a reliance upon outsiders for provision
of health care, a problem which persists more than eighty years later.
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HOSPITALS IN FISHING HARBOURS: 19TH CENTURY NURSING IN THE ARCTIC
Professor Ingunn Elstad, RN, Mag.Art
Department of Health and Care Sciences,
University of Tromsø,
Tromsø, Norway
+47 77660273
[email protected]
Aim of study
Investigating the development of nursing in a 19th century hospital system in Northern Norway.
Rationale and significance
It is recognised that the development of hospitals in Europe was more diverse and decentralized than
previously supposed, and it is of interest to investigate the development of nursing in different
hospital contexts. Hospital nursing in 19th century Northern Norway is a case in point.
A system of small public hospitals was established at the Arctic coast of Norway in the 19th century,
financed regionally through the great seasonal export fisheries. The region was sparsely populated
and money economy very limited. Ten all-year public hospitals were nevertheless established by
1900. They were run as family farms, tenanted by economists, and with untrained nurses until
deaconesses‖were‖introduced‖from‖the‖1870’s.‖This‖study‖attempts‖to‖elucidate‖the‖development‖of‖
nursing care performed in these hospitals.
Methodology
1) Interpretation of primary, archive sources: Public hospital and county archives, archives of the
Deaconess House, Oslo. edical and Poor Law statistics. 2) Discussion of hospital histories and
research on 19th century hospital nursing.
Findings
In the middle 19th century, hospitals were established to provide housing, boarding and nursing for
acutely sick fishermen, and to isolate contagious cases. Fishermen and epidemically sick in the region
received free hospital stays. The Medical Officer was attendant and head of the hospital, while in
charge of a large and partly roadless district. The nurses were necessarily left much responsibility for
patient care. Nursing and dietetics formed the basis, while the nurses performed cupping, purging
and hydrotherapy. During the latter part of of the century, hospitals were gradually medicalized as
resident doctors and modern therapies were introduced. The well-trained deaconesses may have
effected improvement of quality rather than a new departure in the hospital nursing. Skilled nursing
was a prerequisite for the introduction of antisceptic surgery towards the end of the century. The
hospitals were transformed into surgical institutions.
Conclusions
The Arctic hospitals were neither poor law institutions for the infirm and destitute, nor institutions
for developing medical knowledge. For most of the 19th century they were predominantly nursing
institutions.
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Session 6b: Mental Health Care on the Margins
MIGRANT MENTAL HEALTH CARE HISTORY:
THE DUST BOWL ERA TO CURRENT PRACTICE
Sergio Olivares
5789 Mission Center Road
San Diego
California
USA
92108
[email protected]
619-295-2050
Purpose of Study: This paper is part of a historical study of migrant farm worker health clinics.
Migrant mental health care has been influenced by each era in which migrant health was provided
and each era provided differences in the way mental health care was provided. This paper will
discuss the migrant mental health care history focusing on west coast efforts.
Significance: Rural mental health care is rarely studied and historical analysis of rural mental health
care has focused on rural state hospitals. Migrant mental health care has received even less attention
historically. Finding any mental health care, broadly defined, can expand our understanding of
mental health needs of migrant from the past to the present. Moreover, an examination of the
attempts of those providing mental health care including nurses is needed. This type of historical
analysis can expand the definition mental health nursing and is important to the history of mental
health nursing.
Methodology: Dust Bowl migrant health care historical references were examined. World War II
Bracero historiographies were explored. Finally, Northwest newspaper archives and Northwest clinic
documents were reviewed and oral histories of nurses and mental health care providers were
obtained.
Findings and Conclusions: Dust Bowl migrant mental health care was rudimentary but some efforts
were extremely empowering. The Bracero Program mental health care was non-existent but efforts
existed to welcome and ease Braceros’‖homesickness.‖‖The‖Migrant‖Health‖Act‖of‖1962‖viewed‖mental‖
health care as supplementary and few efforts were found regarding migrant mental health. The
President’s‖Commission‖on‖Mental‖Health‖published‖in‖1978‖examined‖migrant‖mental‖health‖and‖
promised concerted efforts but recommendations were hampered by the reduction in federal mental
health‖funding‖during‖the‖1980’s.‖‖Nonetheless,‖some‖northwest‖migrant‖clinics‖provided‖care‖
through grants and other creative funding sources. Other clinics returned to the early roots of
migrant mental health care by empowering migrant women. All of these efforts provide important
insights to rural mental health nurses who aspire to provide care to an underserved group and
influence rural mental health services.
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‘ABOVE ALL A PATIENT SHOULD NEVER BE TERRIFIED’:
MORAL TREATMENT AND MANAGEMENT IN HAMPSHIRE, U.K. 1845-1914.
Diane T. Carpenter, RMN, MSc, BA (Hons.), Dip N, Dip Ned, RCNT, RNT
Lecturer (Mental Health), University of Southampton.
PhD. Student, University of Portsmouth.
02380 598438
[email protected]
Aim of Study.
The aims of the study were:
(1) to evaluate the experiences of mentally ill patients and their carers in Hampshire during
the period 1845-1914, and
(2) to synthesise data from local primary sources with national policies,
legislation, medical
science and curricula for the training of nurses and
attendants upon the insane.
Rationale and Significance.
The rationale for the study was to ascertain the extent to which our knowledge of the practice of
moral‖ treatment‖ during‖ the‖ ‘asylum‖ era’‖ has‖ been‖ represented‖ correctly‖ in‖ the‖ literature,‖ and‖ the‖
degree to which local practice conformed to any national standards and systems of care. The
significance is in the findings (please see below).
Methodology.
Case studies of two local pauper lunatic asylums were undertaken. Underpinning these was a
methodology which synthesised a micro-history deriving from the Annales School with
medical/nursing and local history.‖The‖thesis‖followed‖a‖narrative‖of‖a‖‘patient‖journey’.‖‖The‖ main‖
primary sources were medical and administrative records for the two asylums including Reception
Orders, Case-Books,‖ Visitors‖ Minutes,‖ Medical‖ Superintendents’‖ and‖ Chaplains’‖ Reports,‖ and
Hospital Journals. Additionally, recourse was made to legislation, newspapers, Quarter Session
reports, text-books, professional journal articles, photographs, postcards, personal letters and
contemporary fiction. Secondary Sources included work by Brimblecombe‖ (2005,‖ 2006),‖ D’Cruze‖
(2007), Fealy (2006), Foucault (1961), Jones (1993), Landes (2000), Longmate (2003), Nolan (1993),
Porter (1996, 2002), Scull (1981), Scull MacKenzie and Hervey (1996), Skultans (1975), and Smith
(2007).
Findings.
The principles of moral treatment and moral management were implemented differently across the
two asylums studied. The quality of life for patients was superior to the alternative of the
workhouse. Contrary to much contemporary literature, patients were not exploited, but were
managed kindly, with respect, and with very little recourse to restraint, seclusion or sedation. Order
was maintained by attention to meaningful occupation, fresh air and exercise, and participation in
activities in keeping with appropriate social mores.
Conclusions.
National generalizations about the systems and quality of care should not be made for this period,
findings must be carefully contextualised, and 1845-1914‖ could‖ be‖ considered‖ a‖ ‘golden‖ age’‖ in‖ the‖
care and treatment of the mentally ill in Hampshire.
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A REFUGE ON THE MARGINS: THE CULTURE OF PSYCHIATRIC NURSING IN
NEW ZEALAND PUBLIC MENTAL HOSPITALS 1960s-1970s
Kate Prebble, RN, PhD, Senior Lecturer
School of Nursing, Faculty of Medical and Health Sciences, University of Auckland
0064 9 9233413
[email protected]
Aim:
To explore how psychiatric nursing, a stigmatized occupation in twentieth century New Zealand,
became a refuge during the 1960s and 1970s for people marginalized by their sexual identity, culture,
life-style, or political beliefs.
Rationale and significance:
Isolation, stigma and marginalization in many ways shaped the culture of psychiatric nursing in
New Zealand mental hospitals during the first half of the twentieth century. Nurses suffered from
the‖effects‖of‖stigma‖by‖association‖with‖mental‖illness:‖their‖occupation‖was‖often‖perceived‖as‖‘dirty‖
work’,‖morally‖and‖physically‖risky,‖particularly‖for‖women.‖During‖the‖1960s‖and‖1970s,‖however,‖
social and political upheavals such as the sexual revolution, the peace movement, gay liberation and
the anti-psychiatry movement altered the environment in which mental hospitals operated.
Psychiatric nursing, although still a marginalized occupation, became a refuge for people seeking to
live an alternative lifestyle. Tolerance for diversity became a characteristic of psychiatric nursing
culture that differentiated it from mainstream nursing.
Little attention has been given in nursing historiography to the forces that have shaped the culture of
particular groups of nurses. Specifically, there has been little exploration of the impact of the 1960s
‘social‖revolution’‖on‖nursing.‖This‖paper‖addresses‖both‖these‖questions‖in‖relation‖to‖psychiatric‖
nursing in New Zealand.
Methodology:
This social history research draws on oral history interviews and archival sources. Primary sources
include archives of the New Zealand Department of Health, parliamentary debates, the Appendices
to Journal of the House of Representatives (AJHR), nursing and trade union journals and daily
newspapers. Oral history interviews were conducted with nurses who practiced during this period.
Secondary sources include national and international publications on psychiatric nursing,
stigmatization, and the social and political context of the 1960s and 1970s.
Findings and conclusions:
During the late-1960s, psychiatric nursing in New Zealand became a refuge for the disaffected young
people and those of a counter-cultural persuasion. University drop-outs, sole parents, drug-users,
hippies, lesbians and gays found a place where differences were tolerated and eccentricities
accommodated. This culture of difference was not however without its challenges. Tolerance
sometimes served to support addictive or problematic behaviors but it also created a site in which
social and political conservatism could be challenged and therapeutic innovations explored.
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Session 6c: Wartime Nursing Practice
NURSING IN THE BOER WAR
Keiron Spires, QVRM TD
Principal Lecturer Learning and Teaching
Faculty of Health and Social Care
London South Bank University
0207 815 8430
[email protected]
Aim
For army nursing, the Boer War was in retrospect a rehearsal for the two World Wars of the 20th
Century (Harrison, 2004). The Boer War was a large-scale deployment for the British Army, and for
the first time in Africa it faced an enemy equipped with modern weapons and using modern tactics
(de Villiers, 1983).
At the start of the Boer War the Army Nursing Service had less than 100 trained nurses. By the end of
the Boer War over 1,400 trained nurses had deployed to South Africa (Hay, 1953).
Who were the nurses that came forward to deploy to South Africa? Where did they come from, and
what contribution did they make to the care of the sick and wounded during the Boer War?
Rational and Significance
Although much is written about army nursing in the Crimea, and again in the Great War of 19141919, little has been published about the Boer War. This campaign was the first time that nurses had
been deployed in support of the Army in any significant numbers, and was also the testing ground
for the policies and procedures adopted by army nurses. At the end of the Boer War the Queen
Alexandra’s‖Imperial Military Nursing Service was formed based on the lessons learned.
Methodology
The‖primary‖source‖for‖the‖numbers‖of‖nurses‖and‖where‖they‖came‖from‖is‖the‖Queen’s‖South‖Africa‖
Medal Rolls at The National Archive (WO 100/229). These have been transcribed and summarised to
give a more accurate view of who cared for the sick and wounded than previously published. (see
http://www.pcansr.net)
To discover what the nurses actually did, the surviving contemporaneous accounts were analysed
using thematic analysis to determine the nursing activities they undertook. These include diaries and
journals of nurses from the UK (both in uniform and locally employed); nurses already working in
South Africa; and nurses from colonial nursing services.
Findings
It would appear that the nursing care offered in the Boer War was more complex than previously
reported, and that the relationships between the medical staff, orderlies and nurses was not always
as has been suggest in the literature.
Conclusions
Many of these nurses went on to become important figures in army nursing and took with them their
experiences from the Boer War. There is no doubt that this was a pivotal moment in the history of
army nursing.
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NURSING CARE OF SOLDIERS WITH HEAD INJURIES DURING THE VIETNAM WAR
Terri L. Yost, RN, MSN
PhD Student
University of Virginia
(434) 202-8671
[email protected];
AIM OF STUDY: The purpose of this paper is to describe and analyze the nursing management of
head-injured soldiers by military nurses serving in the Vietnam War and to explore how the process
of triage as well as changes in medicine, nursing and technology throughout the 1960s affected care
given by military nurses in a combat zone.
The work takes into account the political and social context of the times.
RATIONALE AND SIGNIFICANCE: During the period of the Vietnam War, nurses were charged
to provide medical care to some of the most acutely injured service members in the history of
military medicine. Of particular note were the numbers of head-injured soldiers surviving long
enough to reach hospital care. Although nurse historians such as Sarnecky and Norman have
provided general overviews of Vietnam War nursing, little has been documented on nursing care
specific to head injuries. This paper adds to the historical literature about direct nursing care
provided for acutely injured service members during the war.
METHODOLOGY: This study used traditional historical methods and a military history framework.
Primary sources included original military reports, letters and policies from the Vietnam War period
located in the archives of the Army Medical Department, Office of Medical History in Falls Church,
VA, journal articles of the time period and autobiographical texts. Secondary sources consisted of
biographical and historical texts and websites of historical societies.
FINDINGS AND CONCLUSIONS: The Vietnam War was a time when new theories in the
management of head injuries lead directly to overall improvements in survival. Most notably were
advances in battlefield evacuation, early resuscitation measures by non-physicians, the development
of nursing protocols aimed at early identification of emergent complications and the universal use of
antibiotic therapy in treating head wounds. Principles of head elevation and fluid restrictions to
reduce cerebral edema had become standards of nursing care as did head and neck stabilization as
noted‖by‖the‖use‖of‖Stryker‖frames‖and‖the‖terminology‖of‖‚turning‖the‖patient‖in‖one‖piece‛‖in‖the‖
nursing literature. Although the nurses were professionally and emotionally challenged on a near
daily basis, they were able to directly apply new nursing science in a combat environment;
improving survivability for those who may not have previously survived off the battlefield.
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‘DON’T LOOK AT WHAT YOU CAN’T DO, LOOK AT WHAT YOU CAN’:
CIVILIAN NURSES EXPERIENCE OF THE VIETNAM WAR, 1964-1972
Susan Sherson, RN, BA, MRCNA
The Royal Melbourne Hospital, Victoria, Australia
61 3 9342 7148 (W) or 61 3 9380 1500 (H)
[email protected]
Aim of Study:
To examine the work and experience of non-military Australian nurses who were involved in the
Civilian Surgical Teams program in South Vietnam during the war period 1964-1972.
Rationale and Significance:
In October 1964, when the first Australian Surgical Team was sent to work in Long Xuyen on the
Mekong Delta in South Vietnam there were already similar teams from the United States, Great
Britain, Korea, Japan and New Zealand deployed in other provincial capitals. Unlike the military
medical services, civilian teams were to provide medical care and advanced surgery to the
Vietnamese population not to Army personnel. The work done by each team within their local
hospital in a purpose-built Surgical Suite provided by the United States Operations Mission was very
similar, although the intensity of the war around each area varied with time and place.
In late 1964, just prior to the build-up of American and allied troops and the bombing of the North,
the civilian population of South Vietnam was about 15 million. - The country had approximately 700
doctors of whom more than 400 were working fulltime in the South Vietnamese Army. There were
therefore only 300 available to care for the civilian population, roughly one doctor to every 46,000
persons. - Supportive services were desperately needed and nursing was to be a big part of this.
Methodology: The primary sources applied in this paper are the written contemporaneous
experiences of the author who was a member of the first Australian Surgical Team and shared
reminiscences with other members of that Team and another group of nurses who worked later
(1970-71) at Bien Hoa. Secondary source are books and papers recording the work of the Australian
Surgical Teams written since the war ended.
Findings and Conclusions:
With hindsight, the volunteer nurses who went from Australia to South Vietnam as part of the
Civilian Surgical Team program were little prepared for either the nature or magnitude of the work
that awaited them. Their adaptation to such different circumstances and their contribution to the
care of individual patients and the development/education of their Vietnamese colleagues provided
both opportunities and challenges. They have resonance with the documented experiences of Army
nurses across the 20th Century but are also a unique piece of nursing history.
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Session 6d: Nursing and Community
WENDOVER: A STUDY IN CLASS, CULTURE AND COMMUNITY
Rachel E Miller, Allied Member ASID, Former Graduate Student,
Department of Interior Architecture
University of North Carolina, Greensboro
336-543-4358
[email protected]
Aim of Study
In 1924, Mary Breckenridge established the Frontier Nursing Service in Southeastern Kentucky to
provide nursing care for women and children in the rural community. In contrast to the poverty and
isolation‖of‖Appalachia,‖Breckenridge’s‖life‖was‖one‖of‖privilege‖and‖wealth.‖ Her personal residence,
Wendover, built shortly after her arrival, reflected this dichotomy.
Significance
Though much has been written about the life of Mary Breckenridge, none have taken a material
culture approach, studying the significance of Breckenridge’s‖personal‖residence‖in‖the‖context‖of‖the‖
local‖community.‖An‖examination‖of‖Breckenridge’s‖home‖in‖contrast‖to‖contemporary‖local‖
architecture‖leads‖to‖a‖richer‖understanding‖of‖the‖Breckenridge’s‖complex‖role‖in‖the‖community‖as‖
both private citizen and public health leader.
Methodology
Using primary sources such as photographs, architectural plans, FNS records, as well as the house
itself as evidence, this study seeks to interpret Wendover through the eyes of Breckenridge herself as
well as the local community. How did Wendover compare to contemporary local architecture? How
did‖Breckenridge’s‖use‖of‖local‖materials‖and‖craftsmen‖relate‖Wendover‖to‖the‖community?‖And‖
finally, how did Breckenridge use her home as a prescriptive model to the community?
Findings
Although Breckenridge employed native craftsmen and materials, she made Wendover a model of
middle-class domesticity for area residents. Built of log and stone, the house was equipped with
indoor plumbing, a modern kitchen, and many other conveniences, an extreme contrast to the one
and‖two‖room‖cabins‖of‖the‖community.‖‖Locals‖referred‖to‖it‖as‖the‖‚Big‖House,‛‖and‖although‖
Breckenridge used the home as a hospital, foundation headquarters, and guesthouse for donors, she
also used the house as a private refuge for herself and her employees.
The‖‚Big‖House‛‖is‖a‖physical‖manifestation‖of‖Breckenridge’s‖public‖agenda‖and‖private‖persona.‖
The structure reflects her desire to blend into the surroundings, while at the same time reinforcing
the rigid class structure. This paper is a study of the material culture of Wendover, illustrating how
the built environment served as a prescriptive model to the public and functioned as a refuge for her
private life.
Conclusion
This paper investigates the significance‖of‖Breckenridge’s‖home‖in‖the‖local‖Appalachian‖community.‖‖
Through an examination of the homes architectural distinctions as well as its similarities to the
vernacular‖architecture,‖one‖can‖better‖understand‖Breckenridge’s‖complex‖relationship‖with‖the
local population.
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‚WE WERE TO LIVE IN THE NEIGHBORHOOD AS NURSES‛:
BUILDING THE NURSES SETTLEMENT, 1893 TO 1923
Michele M. Materese, PhD, RN
Mansfield University
570-882-4733
[email protected]
Aim of the Study: In this historical research, I explored how nursing colleagues responded to unique
practice‖environment‖that‖Lillian‖Wald‖created‖at‖the‖Nurses’‖Settlement‖during‖the‖period‖1893‖to‖
1900
Rationale & Significance: My intention was to provide details on the women who joined Wald in
delivering‖nursing‖care‖to‖New‖York‖City’s‖working‖classes.‖The‖Nurses’‖Settlement‖offered‖nurses‖
an alternative to the private duty and hospital work. By knowing more about these women and the
work that they did, I hoped to understand how they individually contributed to the development
community based practice.
Methodology: For this study, I relied upon collective biography as a means to understand the
historical past. By examining the personal histories of the nurses who worked as staff members at the
Nurses Settlement, I attempted to explain how social networks provided opportunities for
professional change.
Major Primary and Secondary Sources: Primary source material for this study included evidence
from the following archival collections: Lillian D. Wald Papers, Columbia University; Lillian D. Wald
Papers, New York Public Library; Amherst College Archives & Special Collections. The Edward and
Mary Judson Hitchcock Family Papers; American Journal of Nursing; and the New York Times.
Primary sources books included Lillian D. Wald, The House on Henry Street, 1915; Eleanor Lee,
History of the School of Nursing of the Presbyterian Hospital New York 1892-1942, 1942; R.L. Duffus,
Lillian D. Wald neighbor and Crusader, 1938. Secondary sources included Allan Resnick,‖‚Lillian‖D.‖
Wald:‖The‖Years‖at‖Henry‖Street.‛‖Ph.D.‖Diss.,‖University‖of‖Wisconsin,‖1973.‖Evelyn‖Benson,‖As We
See Ourselves: Jewish Women in Nursing, 2001; Nan Lin, Social Capital: A Theory of Social Structure
and Action, 2001.
Findings and Conclusions: When‖Lillian‖Wald‖created‖the‖Nurses’‖Settlement,‖she‖established‖a‖
venue for practicing nurses to engage in both civic and professional activities. Individual nurses
contributed a skill set that they had learned in hospitals or in private practice. When they joined
settlement life, they entered into a network where they transposed care for individuals into care for
the community. The collaboration produced nurses who improved and expanded their profession
with innovative solutions to practice problems.
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Session 6e: Public Health
POLIOMYELITIS EPIDEMICS IN SIOUXLAND: THE IMPACT ON THE
COMMUNITY AND PUBLIC HEALTH 1952-1967
Diane L. Smith, RN, MSN
Northwestern College
Orange City, IA
712-707-7461
[email protected]
Purpose of Study, Rationale, and Significance
The purpose of this historical research inquiry is to explore a collection of 1952-1967 archives
uncovered‖and‖the‖public‖health’s‖response‖to‖a‖community‖inflicted‖by‖poliomyelitis‖epidemics.‖
Unbeknownst‖to‖her,‖Public‖Health‖Nurse‖Maud‖A.‖Brussels’‖painstaking‖record-keeping is part of a
collection of particulars from a time in Sioux City, Iowa when the polio epidemics were striking
communities in Siouxland. In a box labeled Polio, one finds her serendipitous words: 1955 Studies: Do
Not Throw Out; May need for reference some unexpected day. That‖day‖has‖come.‖The‖community’s‖
experiences‖with‖a‖public‖health’s‖response‖during‖an‖epidemic‖are‖vital‖interests‖for‖nursing‖today‖
and a reference for tomorrow.
Methodology and Primary Sources
The‖social‖history‖framework‖in‖regards‖to‖a‖community’s‖plight‖with‖polio‖and‖the‖policy‖
framework to explicate public health policy provided the structure to question and to interpret this
historical information. Primary resources are from the collection of archives from the Sioux CityWoodbury‖County‖Health‖Departments’‖documents,‖National‖Foundation‖for‖Infantile‖Paralysis‖
documents and pictures, newspaper articles, raw data, speeches, letters, published research findings,
and national awards.
Findings and Conclusion
In 1952, the Sioux City poliomyelitis epidemic was ranked the worst in the United States.
Cooperation by local and state health officials, national and community agencies, the medical society,
nursing organizations, hospital authorities, polio foundation representatives, and citizens tried to
bring the epidemic under control. In the largest human field test in medical history, Siouxland was
one of three areas selected for the 1952 Hammon Gamma Globulin Study. In 1954, Woodbury County
was again selected for the Dr. Salk Polio Vaccine Study. After the 1955 announcement that the Salk
polio vaccine had been successfully developed and tested, city and county physicians, public health
and school officials, and volunteer groups implemented the second Salk Vaccine Program. In 1967,
the last poliomyelitis case in Siouxland was reported. Poliomyelitis has gone from one of the worst
scourges of the 20th century to near eradication in 21st century. The learned knowledge from the
poliomyelitis epidemics in Siouxland and the response by the community and public health provides
a model of cooperation to prevent and control an infectious disease. The lessons learned from the
poliomyelitis epidemics in Siouxland and written historical nursing research may be a reference for
some unexpected day.
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KATE MARSDEN AND THE FIGHT AGAINST LEPROSY IN YAKUTIA
Gosia Brykczyńska, PhD, BA, BSc, RN
Registered‖Sick‖Children’s‖Nurse
Thames Valley University, Faculty of Health, Brentford, Middlx, UK
020 8560 0120
[email protected]
Aim of Study
The aim of this study is to demonstrate that some diseases appear to shape not only the course of
social history but also seem to impinge on the reputation of those involved in caring for the affected
with these diseases. Historically, nowhere has this been more evident than with the care of leprosy
patients.
Rationale
The rationale for undertaking this study is that whereas the fame of physicians and missionaries
caring for leprosy patients over the last two-hundred years has been relatively well documented,
much less is known concerning the lives of the nurses who worked alongside them, often over many
years; such as Sister Marianne Kopp, a nurse and hospital administrator who went out to the leprosy
colony of Kalaupapa on Molokai (Hawaii) and stayed there for thirty years! This paper, will address
the effect that caring for leprosy patients in Yakutia (present day Republic of Sakha) in North Eastern
Siberia, had on the professional reputation and life trajectory of Kate Marsden (1859-1931), an English
nurse who worked in a military hospital in Bulgaria during the 1877 war and as a nursing
superintendent around the British Empire.
Methodology
Based on original documents and letters held by the trustees of St Francis Leprosy Guild in London
and at The New York Public Library, Kate‖Marsden’s‖published‖writings‖and‖some‖selected‖
secondary material, I will demonstrate the effect that the fight against leprosy and working with
leprosy patients had on her professional and private life. Although acquiring fame as a lady-traveller
– she had published an account of her journeys in Siberia – and in 1892 made the first female member
of The Royal Geographic Society in London, she was not admired or understood by everyone.
Findings
Ultimately, in spite of the success of her book and royal patronage, she was vilified and avoided by
much of public. Her Christian based altruistic efforts to help leprosy patients were turned against
her. To this day there is much conflicting biographical detail about her life, although she left a lasting
legacy in the form of the St Francis Leprosy Guild (still active today) and she is still much honoured
and admired in The Republic of Sakha itself.
Conclusion
This is a very colonial biography; one which was shaped by religious and professional convictions
and most importantly - the geography of Yakutia.
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POPULATION HEALTH WITHIN DISTRICT AND HEALTH NURSING 1889-1893:
A HISTORICAL-HERMENEUTIC METHOD STUDY
Mario R. Ortiz, RN, PhD, PHCNS-BC
Institutional affiliation: Purdue University North Central
219-785-5476
[email protected]
Aim of Study: The purpose of this historical-hermeneutic method study was to examine the specialty
of population health nursing in light of district and health nursing. This was done by
hermeneutically examining historical writings, District Nursing (Craven, 1889) and Women’s Mission:
A Series of Congress Papers of Philanthropic Work of Women by Eminent Writers (Burdett-Coutts, 1893),
that serve as the foundation for the current practice of Population Health Nursing.
Rationale and Significance: There is a social and practice mandate for nurses to practice and think in
terms of the care of aggregates, and to provide and evaluate nursing services from a population
perspective (Frisch, George, Govoni, Jennings-Sanders, and McCahon, 2003). There is a need to
restructure nursing practice and education so that it is aligned with the needs of specific populations
(Radzyminski, 2006). The key elements that set population health apart from both public and
community health are its overall lack of boundaries and evaluation approach (Radzyminski, 2007). A
population health nurse is as readily able to apply population health skills within intensive care
environments as to community-based clinics. It is important, then, that there is an understanding of
the historical foundational concepts and principles that serve as the basis for population health
nursing.
Methodology: The Historical-Hermeneutic Method (Dilthey; 1883, 1996; Gadamer, 1976; Ricoeur,
1981; Schleiermacher, 1902) was utilized to interpret the foundational concepts and principles of
population health by means of the 'hermeneutic circle'. The historical-hermeneutic circle arose by
relating the meaning of the foundational concepts and principles as a whole to the foundational
historic parts of each document, and then the parts to the whole continuously until the explicit and
implicit themes emerged.
Findings: The findings of this study were found in the explicit and implicit themes of caring, religion,
health, and the professionalization of nursing. A historical-interpretive thematic sorting revealed the
themes. The findings were consistent with the principles of population health nursing: caring, social
justice, assessment, assurance, and public policy.
Conclusions: Population health nursing has developed upon the foundation of district nursing and
health nursing. Over time, various aspects of these historical principles and concepts have shaped
modern nursing practices.
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Session 6f: Radical and Progressive Nurses
ROSE HAWTHORNE’S WORK AMONG THE POOR WITH CANCER:
NEW YORK CITY, 1890S
Brigid Lusk, PhD,
Northern Illinois University
815 753 6550 [email protected]
Aim: Structured around the person and place of Rose Hawthorne and her work in the tenements of
New York City during the 1890s, this study explores how the poor with cancer were nursed at that
time. Rose Hawthorne (1851-1926) was the daughter of noted American author Nathanial
Hawthorne. Following an unsuccessful marriage and the death of her only child, Hawthorne devoted
the‖rest‖of‖her‖life‖to‖nursing‖and‖otherwise‖helping‖New‖York’s‖indigent‖who‖suffered‖from‖terminal‖
cancer. To continue this work beyond her own life, Hawthorne founded a religious order, The
Servants of Relief for Incurable Cancer. Specifically this paper explores the work of cancer nursing
care among the inhabitants of New York tenements during the 1890s, through analysis of Rose
Hawthorne’s‖early‖nursing‖work.
Rationale and Significance:
It may be argued that the development of cancer nursing as a
specialization was rooted in the period under study, yet the work of Hawthorne is rarely cited as an
early cancer nursing exemplar. Further, her care of the dying pre-dates the acknowledged innovators
of‖hospice‖care.‖Thus‖Hawthorne’s‖work‖among New‖York’s‖poor,‖as‖a‖nurse‖for‖those‖with‖hopeless‖
cancer, provides an important new perspective on this disease as it was encountered during the
progressive era.
Methodology:
Through a historical case analysis of Rose Hawthorne at the start of her life’s‖
nursing mission, this paper explores the rich contextual themes of cancer and nursing in her place
and‖time.‖Primary‖sources‖included‖Hawthorne’s‖nursing‖ledgers,‖formularies,‖and‖other‖writings‖
from the archives of the Dominican Sisters of Hawthorne, and annual reports and other papers from
the Memorial Sloane-Kettering Cancer Center, held at the Rockefeller Archives Center. Secondary
sources include biographies of Rose Hawthorne and cancer nursing histories.
Findings and Conclusions:
Cancer was feared as a disfiguring, painful, contagious, and
ultimately terminal disease. Nursing care revolved around dressings and salves for open wounds,
nourishment,‖morphine,‖and‖helping‖to‖ease‖the‖process‖of‖death.‖Hawthorne’s‖extensive‖
documentation of her patients’‖care‖reveals‖a‖treasure‖of‖information‖about‖cancer‖nursing‖of‖the‖
period‖as‖well‖as‖Hawthorne’s‖own‖experimentation‖with‖various‖remedies.‖Hawthorne’s‖writings,‖
whether for fundraising or when she documented her nursing care, present stark images of her
patients’‖struggles‖with‖cancer‖amid‖the‖abject‖poverty‖of‖living‖in‖the‖tenements‖of‖New‖York.‖‖
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SETTING UP CLEARLY DEFINED LINES OF AUTHORITY:
NURSING LEADERHSHIP UNDER SOFIA PINCHEIRA
Jeannine Uribe, PhD, RN
Assistant Clinical Professor,
Drexel University College of Nursing and Health Professions
1502 Race Street, Philadelphia PA
215-762-4017
[email protected]
Aim of Study: The aim of this paper is to examine the work of Sofia Pincheira, a nursing leader in
Chile during the 20th century whose leadership influenced nurses from many countries. Educated in
Chile and in the United States, Ms. Pincheira, a public health nurse, launched the professional public
health nursing role in Chile within a drastically changing political system from the 1920s to the 1960s.
Rationale and Significance: Sofia Pincheira was at the forefront of professional nursing in Chile
when she was sent to the United States to study under a scholarship. She gained recognition for her
studies and returned to Chile to assist in setting up a public health nursing program. Her knowledge
of the role of public health nurses allowed her to adapt a nursing system to visit the homes and
educate low-income, urban families. She published articles and worked with the Pan American
Health Organization to assist nurses in Latin America to achieve higher standards of education and
employment.‖This‖study‖of‖Ms.‖Pincheira’s‖work‖and‖leadership‖gives‖light‖to‖a‖group‖of‖nurses‖who‖
are not often thought of when leadership is discussed. Ms. Pincheira broke the traditional feminine
mold and brought new respect for nurses in Chile with her insistence that nurses could educate and
supervise nurses.
Methodology: A social history framework was used to collect and examine primary and secondary
sources in both English and Spanish. Primary documents include personal diaries of Rockefeller
Foundation staff who worked with Ms. Pincheira, as well as articles by her. Secondary sources
include nursing journal articles describing her role in the development of nursing.
Findings: Under the supervision of Ms. Pincheira, public health nurses helped to open and staff the
first community health units, visiting homes in the poorest neighborhoods. She set up the visiting
case load, gathered statistics, and fought for the establishment of a chain of command with a head
nurse supervisor for the health units. Her position allowed her to report to higher levels of authority
on the health issues her nurses saw. Ms. Pincheira influenced foreign nurses who came to Chile to
observe their health system. She was named head nurse of the national health system in the 1950s
where she brought the issues of the nurses to the top levels of the health administration.
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WEAVING A LEGACY THROUGH HER WORDS AND DEEDS:
PRISCILLA EBERSOLE’S STORY
Lee-Ellen C. Kirkhorn, PhD, RN
University Affiliation: University of Wisconsin – Eau Claire
Professor of Nursing
Department of Nursing
Introduction
Nursing history is intricately elegant and rich with wonderful examples. Perhaps more than any
other profession, nursing has reason to celebrate its many heroic historical figures.
Among the ranks of nurses, Priscilla Pierre Ebersole, RN, PhD, FAAN is a living legend who has
celebrated the voices of nurses pioneering the specialty of gerontological nursing. She chose to write
about the history of geriatric nursing as a specialty, and over the course of several years, interviewed
many luminaries on the forefront of geriatric nursing.
In November of 1990, Ebersole interviewed Virginia Stone, whom many consider the mother of the
specialty. Through her writing (Geriatric Nursing: Growth of a Specialty), Ms Ebersole traced the early
history of gerontological nursing care by chronicling stories of many of the remarkable pioneers in
the field. Her stories included patient care vignettes as well as personal narratives related to
grandparents and life events.
As former editor of Geriatric Nursing, author of award winning nursing textbooks (On Healthy Aging)
and now an octogenarian, Ebersole has made an incredible and indelible impression upon the lives of
countless nursing professionals who have become geriatric nurses or who have come to admire them.
Aim, Rationale, and Significance
The present paper will tell Priscilla‖Ebersole’s‖story‖~‖her‖life,‖interests,‖and‖accomplishments‖as‖seen‖
through the lens of a nurse historian. Priscilla was selected for her amazing contributions to nursing
practice, education, and research in the United States and internationally. The paper includes
selected writings of other geriatric nursing pioneers, and highlights the contributions of Ebersole to
the field of nursing history.
Methodology
The paper derives content from primary sources ~a series of visits over the course of nearly twenty
years, from E-mail exchanges and face-to-face meetings. Secondary sources~ excerpts from her
personal autobiography and a few journal entries that she has graciously shared were used as
background information. Other documents and scholarly publications in the area of nursing history
and‖gerontology‖were‖used‖as‖context‖to‖illuminate‖Ms.‖Ebersole’s‖life‖and‖contributions‖to‖the‖field.‖‖
Findings and Conclusions
The focus is of the present paper is biography and place. Since many people have never met Priscilla,
I feel uniquely privileged to share her background and to describe her as a real human being as well
as an accomplished leader and nurse. The heart of the paper is her story, and her imprint upon the
history of nursing will be showcased.
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Concurrent Session 7
Session 7a: Nursing and Identity
UNDERSTANDING CANADIAN WOMEN’S LABOUR:
NURSING, WORK AND PROFESSIONAL IDENTITY IN THE 1960s
Margaret Scaia, RN, MN, PhD (C)
University of Victoria School of Nursing
Victoria BC Canada
[email protected]
Aim of the Study
The aim of this interdisciplinary PhD research study is to explore and understand significant
intersections‖between‖the‖history‖of‖women’s‖labour‖and‖changes‖in‖the‖social‖construction‖of‖
nursing during the 1960s. The research is contextualized through references to the post-war period
with‖a‖primary‖focus‖on‖the‖1960s,‖and‖builds‖on‖scholarship‖in‖women’s‖labour,‖religious,‖military‖
and nursing history.
Purpose and Rational
The history of nursing is also‖a‖history‖of‖women’s‖labour‖force‖participation‖(Boris‖&‖Sangster,‖2006;‖
McPherson, 1999, Melchoir, 2004). A dramatic shift in nursing occurred in the 1960s as the
expectation‖of‖women‖‘resigning’‖from‖nursing‖when‖they‖married‖faded‖under‖the‖influence of early
second-wave‖feminism,‖in‖particular,‖the‖influence‖of‖women’s‖increased‖paid‖labour‖force‖
participation and enrollment in post-secondary education. Not only in nursing, but in many other
fields of paid employment, more married women chose to remain in the paid work force given the
opportunity to do so (Alizade, 2006; Arnup, 1990). The new workforce of married nurses shaped and
was shaped by wider changes in social patterns related to work, marriage and motherhood in the
post-war period (Gelfand, 2007). Simultaneously, gendered, religious and military traditions sought
to‖reinforce‖the‖notion‖that‖women‖are‖‘naturally‖caring’,‖and‖thus‖that‖nursing‖is‖‘women’s‖work’‖
(Tuana, 1993). Feminist theory consequently challenged these biologically determined assumptions
and thus created a controversy and collisions of ideologies about the professional identity of nursing
that remains active today (Gelfand, 2007; Ruth & Watts, 1991).
Primary and Secondary Sources
Nursing as an exemplar of this transition in‖women’s‖experience‖of‖work‖will‖include‖oral‖history‖
interviews with women who obtained their nursing education in Western Canada and who married
and continued to work in nursing in the 1960s and early 1970s. Purposeful sampling will include
women who represent diversity in terms of this experience including variables around ethnicity,
culture and class. Also included are letters written between Canadian Nursing Sisters between 19441946. Secondary sources will draw on scholarship in military, religious, feminist‖and‖women’s‖
history.
Expected Outcomes and Findings
My research question will be:
What are the significant intersections between the history of women and work in Western
Canada during the 1960s and early 1970s as exemplified in changes in the social construction
of nursing during this time period?
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THE ‚OLD INTERNATIONALS‛: IDENTITY AND FRIENDSHIP BETWEEN THE WARS
Jaime Lapeyre, RN
PhD student (contact person)
Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Ontario, Canada
416-546-5169
[email protected]
Sioban Nelson, PhD, RN
Dean and Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto
416-978-2862
[email protected]
Aim of study: To build upon the influential work on female friendships by American feminist
historians Nancy Cott and Martha Vicinus, as well as more recent scholarship by Janet Lee and
Jessica Smith, in order to explore the formation of friendships and a shared identity between the
alumni of a year-long international public health nursing course during the interwar period.
Rationale and significance: Research on the International Council of Women (ICW) has shown that
the women involved in international organizations during the early 20th century often developed
close friendships which helped to strengthen their connection to the issues at hand as well as create
what‖has‖been‖described‖as‖a‖collective‖identity‖as‖‚feminist‖internationalists‛‖(Rupp, L., 1997).
In the wake of WWI, the newly formed League of Red Cross Societies (LRCS) created a new
opportunity for nurses to come together at the international level by providing a year-long,
residential, post-graduate public health nursing course. By 1939 these courses had brought together
350‖nurses‖from‖49‖countries,‖and‖had‖led‖to‖the‖formation‖of‖an‖alumni‖association‖called‖the‖‚Old‖
Internationals’‖Association‛.
Leading research in the area of female friendships by Cott in the 1970s indicates that women
belonging to female academies often forged closer friendships than those women involved in any
other institution. More recent work by Lee (2008) on WWI nursing sisters highlights how the
homogeneity of class and age fostered a shared identity among these nurses and led to the formation
of‖an‖‚Old‖Comrades‖Association‛.‖Thus,‖this study builds upon these works to examine the
formation‖and‖maintenance‖of‖friendships‖and‖the‖identity‖as‖‚Old‖Internationals‛‖shared‖between‖
the graduates of the LRCS courses.
Methodology:‖Archival‖records‖from‖the‖‚Old‖International‖Association‛,‖Bedford‖College‖at‖the‖
University of London, as well as personal letters and journal articles, were used to examine the
activities and exchanges between the‖members‖of‖the‖‚Old‖Internationals‛‖alumni‖association.
Findings: The year-long residential experience offered to nurses by the LRCS led to the formation of
a shared nursing philosophy, close friendships and familial-like bonds which were nurtured over
time and distance through the exchange of letters, continued travel to international congresses and
meetings, and the creation of an alumni association.
Conclusion(s): A new opportunity for nurses to come together across national borders led to the
development of firm friendships. The maintenance of these connections, along with a shared nursing
philosophy,‖led‖to‖the‖formation‖of‖a‖collective‖identity‖among‖them‖as‖‚Old‖Internationals‛;‖
promoting international friendliness and the formation of an international network of nurse leaders.
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HISTORICAL THINKING AND THE SHAPING OF NURSING IDENTITY
Cynthia Toman, PhD (History), Associate Professor
Director, Associated Medical Services Nursing History Research Unit
University of Ottawa, Canada
613-562-5800, extension 8429
[email protected]
Marie-Claude Thifault, PhD (History), Assistant Professor
Associate Director, Associated Medical Services Nursing History Research Unit
University of Ottawa, Canada
613-562-5800, extension 8442
[email protected]
Aim of study: To examine how students evolve from uncritical repetition of historical facts towards
complex critical analyses of health care and how historical thinking contributes to the development
of professional identity.
Rationale and significance: Nursing history was a core component of early nurse training programs
as early as 1907 when American Adelaide Nutting published her three-volume history. It had all but
disappeared by the end of the 20th century, supplanted by myriad other subjects. A 2004 Canadian
survey revealed no dedicated undergraduate courses on nursing history although 65% of
respondents agreed to promote an online course to their students if available. Similarly over 140
historians, educators and students attending the 2005 Hannah Nursing History Conference in Ottawa
engaged in a productive public debate over the role and meaning of history within nursing
programs. They supported the value of history to the profession, calling for assistance and new ways
to include historical content in already overcrowded, science-based curricula. In response the
Associated Medical Services Nursing History Research Unit at the University of Ottawa developed
two online nursing history courses, in English and French respectively. The courses were popular
with both student cohorts, prompting a great deal of interest regarding our experiences in the reintroduction of nursing history, especially the online format.
Methodology (including primary and secondary sources): Using a case study approach and content
analysis of student postings and essays from our respective courses, we examined the concept of
historical thinking in the context of the nursing profession and the impact of primary sources and
online delivery formats. We obtained ethics approval and informed consent, and maintained
anonymity of student identities. We also examined student cohorts for differences regarding year of
study, previous exposure to history, and points of entry to the nursing program.
Findings: The online format attracted students from a variety of backgrounds which enriched
discussions. The use and critique of primary sources were essential skills for historical thinking that
enabled students to consider multiple perspectives on practice issues. Finally, the course fostered a
strong sense of professional identity among participants who frequently lamented their lack of
previous exposure to nursing history.
Conclusions: Online nursing history courses based on primary sources provide alternate
perspectives for understanding current and past professional issues while exploiting e-learning
technologies to fit crowded curricula and extend the capacity of historians of nursing to reach
beyond university walls.
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FRATERNITY BETWEEN OURSELVES, AFFECTION FOR PATIENTS, RELATIONS OF
RESPECT AND SYMPATHY WITH DOCTORS, THESE ARE THE THREE CONCEPTS
NECESSARY FOR OUR MISSION: THE NURSE’S UNION IN ITALY AT THE
BEGINNING OF THE 20TH CENTURY.
Juergen Wildner
Museum of Nursing History, Istituti Ortopedici Rizzoli, Bologna.
Aim of Study
Increase awareness of the perceptions and understanding of Italian nursing unions during the first
decades of the 20th century, listing their initiatives and political proposals, improving understanding
of‖the‖union’s‖role‖and influence.
Rationale and Significance
An important union movement, the National Federation of Nursing Leagues was founded in Rome
in 1904 contemporaneously with the first years of the foundation of the modern nursing profession
and training in Italy. Membership of these nursing leagues increased dramatically from 30 branches
in 1905 to 90 branches in November 1914, representing up to 60% of salaried lay hospital nurses.
Artioli refers to a majority of male members. According to Anna Celli in 1901 there were 8380 lay
nurses of whom 3,767 were women (Manzoni).
Methodology
Investigation‖of‖nursing’s‖place‖in‖Italian‖social‖history‖(Streubert)‖ - bibliographical study of Italian
secondary‖literature‖and‖the‖nursing‖union’s‖magazines‖and‖journals‖1905-1920.
Findings
Nursing Leagues contribute to many initiatives for the improvement of working conditions.
Conferences/enquiries, requests to the Interior Ministry (Dimonte) and publications all attempting to
unite nurses and improve their image with the public. They highlighted working conditions of
nurses in a push to improve them, argued against nursing as an exclusively female activity and
sought to reduce religious influence on caring.Close links between nursing and caring conditions.
Nursing‖unions’‖support for professional nursing colleges, in some cases actually taking the initiative
in the promotion of professional training through their journal. Unsuccessful in their attempts to
have civilian nurses assigned to the health services at the beginning of WWI to improve effectiveness.
Evidence‖of‖the‖involvement‖of‖socialist‖doctors‖in‖the‖Federation’s‖development.
The voice of the Nursing Leagues was silenced once the Fascist government came to power in Italy.
Conclusions
Little is known about even the existence of the Italian nursing unions and it is not surprising
therefore that there is almost complete ignorance of the views they sought to promulgate. This is
perhaps due to a lack of interest in a world viewed in the past as being populated by religious
figures, pious women and workers not normally associated with political and union activities.
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Session 7b: The ‘Dark Side’ of Nursing and Midwifery
NANNA CONTI – THE BIOGRAPHY OF NAZI GERMANY’S CHIEF MIDWIFE
Anja Peters, Dipl.-Pflegewirtin (FH)
Paediatric nurse
Dipl.-Pflegewirtin (FH) (degree in Nursing & Health from University of Applied Sciences
Neubrandenburg)
Scholarship holder of Friedrich-Ebert-Stiftung (FES)
Postgraduate at Ernst-Moritz-Arndt-University Greifswald, Germany
+395-450 69 48
[email protected]
Aim of study
German midwives participated in the criminal demographic development policy of
Nazi Germany as they registered malformed newborns and their parents. Probably most of these
babies were‖murdered‖in‖the‖‚children‖euthanasia‖program‛.‖Jewish‖midwives‖lost‖their‖
accreditation. In the German professional magazine Afro-Americans, Jews and East Europeans were
discriminated and slandered. One of the leading minds behind these policies was Nanna Conti.
Nanna Conti was born in 1881 into a Prussian educated middleclass family and became a midwife in
1904. She worked as a freelance midwife in Berlin raising her three children as a single mother. One
of‖them,‖Dr.‖Leonardo‖Conti,‖became‖‚Reichsärzteführer‛‖(chief‖medical‖adviser)‖in‖1939‖and‖
committed suicide before the Nuremberg trials. From 1918 on she was a protagonist for the
professional‖organisation’s‖nationalistic‖wing.‖The‖study‖shows‖how‖the‖profession‖political‖
commitment‖of‖Nanna‖Conti,‖‚Reichshebammenführerin‛‖(German‖chief‖midwife)‖from‖1933-1945,
was embedded in a context of familial, political and environmental conditioning.
Rational and Significance Peter Longerich from Royal Holloway University points out that
contextualisation is one of the challenges of modern perpetrator research. Based on his remarks the
significance‖of‖this‖study‖lies‖in‖the‖attempt‖of‖an‖explanation‖of‖a‖female‖Nazi‖perpetrator’s‖acting‖
who‖belonged‖to‖the‖health‖system’s‖managerial‖staff.
Methodology Research methods included literature review and narrative interviews with
relatives. Few letters, one book and reams of articles and commentaries by Nanna Conti are used as
primary‖sources‖for‖this‖study.‖Secondary‖sources‖include:‖her‖granddaughter’s‖autobiography,
archival‖files‖about‖Nanna‖Conti’s‖children,‖several‖books‖about‖German‖midwifery‖and‖medical‖
history as well as female Nazi perpetrators.
Findings This study provides an insight into the family system of two protagonists of the Nazi
health system. The sources used offer a lot of references for a context sensitive analysis of her career
in‖Nazi‖Germany.‖They‖contain‖her‖divorce‖decree,‖evidence‖for‖her‖father’s‖freemasonry,‖her‖last‖
will‖and‖her‖son’s‖suicide‖note.‖‖
Conclusion Nanna Conti never killed anybody while her son definitely did but she was the brain
behind‖the‖midwives’‖professional‖policies‖1933-1945. She influenced a whole generation of German
midwives‖and‖promoted‖the‖national‖socialistic‖ideology‖among‖Europe’s‖midwives.‖She‖was one of
those perpetrators who kept the system running from behind their desks. Nanna Conti was never
called to account. She died in 1951.
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NURSES AS AGENTS OF THE STATE: HEALING AND DEVASTATION
IN THE NAME OF BIOPOWER
Thomas Foth, Nurse, MSc
PhD (cand.)
Associated Medical Services, Nursing History Research Unit; University of Ottawa.
[email protected]
#: 613-249-0318
In‖the‖1930’s‖and‖1940’s,‖nurses‖were‖actively‖involved‖in‖the‖killing‖of‖nearly‖200,000‖patients in
psychiatric hospitals across germany.
Aim of the study
The general objective of this research is to better understand the subjugation of the nurses, their
frames of reference, and the way in which they were governed by and through political, economic,
and biomedical discourses.
Methodological considerations
Using‖the‖Foucauldian‖concept‖of‖‘biopower’‖and‖‘state‖racism’,‖this‖discourse‖analysis‖will‖be‖
carried out on several levels: it will analyze scientific discourses identified, for example, in nursing
journals between 1900 to 1945, and nursing notes within patient records obtained from different
psychiatric hospitals in Hamburg and elsewhere (approx. 160 files). By following this approach it is
possible to demonstrate that the production of meaning‖within‖the‖nurse’s‖notes‖is‖not‖based‖on‖the‖
intentionality of the writer but rather depends on discursive patterns construed by scientific
discourses‖of‖the‖time.‖Using‖‘institutional‖ethnography’‖(D.E.‖Smith),‖the‖study‖analyzes‖documents‖
as 'inscription devices' (B. Latour) that act as active agents by intervening into the interactions within
the institutions and that create a specific reality on their own accord. The question is not if the
represented reality within the documents is true, but rather how the documents worked within the
institutions and what their effects were. The study demonstrates how nurses were actively involved
in‖the‖construction‖of‖the‖patient’s‖identities‖and‖how‖these‖‘documentary‖identities’‖lead‖to‖the‖death‖
of the thousands‖of‖humans‖whose‖lives‖were‖considered‖to‖be‖‘unworthy‖lives’.
Findings and conclusion
Psychiatric‖hospitals‖became‖spaces‖where‖patients‖were‖reduced‖to‖‘bare‖life’‖(G.‖Agamben);‖these‖
spaces‖are‖comparable‖with‖the‖‘concentration‖camps’‖of‖the‖Holocaust. This analysis enables one to
integrate the actions of the nurses during National Socialism into the history of modernity; nursing
under Nazism was not simply a relapse into barbarism. The Nazi exclusionary practices were
extreme variants of scientific, social, and political exclusionary practices that were already in place.
Different‖types‖of‖power‖are‖identifiable‖within‖the‖Nazi‖regime‖even‖‘self-techniques’‖as‖shown,‖for‖
example,‖by‖the‖denunciation‖of‖‘disabled‖persons’‖by‖nurses.‖The‖analysis‖enables a precise
examination of nursing as a functional power technique within the multifunctional Nazi regime.
Furthermore,‖the‖analysis‖of‖the‖notes‖within‖the‖patient’s‖records‖(after‖1945)‖demonstrates‖that‖
continuities exist after 1945.
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DISTURBING HISTORICAL ANTECEDENTS IN MATERNAL
CHILD HEALTH POLICY: 1890-1930
Bonnie L. Pope, MSN, ARNP
Instructor of Community Nursing, University of North Florida
1.904.394.2784
[email protected]
AIM: The aim of this study was to investigate the disturbing interplay among health care, eugenics,
and race that influenced the development of maternal and child health policy from 1890 to 1930, the
Progressive Era. During this time, while reformers recognized the need for policy development on
state and federal levels to improve the health of women and children, some sought to address social
ills by controlling reproduction and health care for those considered the least fit.
RATIONALE: As the nursing profession contributes to the current 21st century health policy debate,
nurses must understand their history. The prominent nurse Lavinia Dock (1858-1956) urged other
nurses‖to‖‚clarify‖their‖relation‖to‖all‖else‖that‖humanity‖is‖doing<unfailing‖inspiration‖in‖the‖
consciousness of being one part of‖a‖great‖whole.‛
SIGNIFIGANCE: During the 1890-1930’s‖nursing‖demonstrated‖the‖profession’s‖steadfast‖
commitment‖to‖upholding‖the‖human‖right‖for‖better‖health‖care.‖Lillian‖Wald’s‖tireless‖efforts‖on‖
behalf of women and children countered the worst of eugenic‖principles.‖Nursing’s‖maternal‖and‖
child health programs continue to promote women's health and reproductive freedom and seek to
provide a future in which every baby can be healthy.
METHOD: Social History
Research question: What were the societal influences on developing maternal and child health
policies during the years 1890-1930?
Research question: What roles did nursing play in developing maternal and child health policies
during the years 1890 – 1930?
RESULTS: During the progressive era, increased public sympathy for the plight of women and
children provided a platform for civic leaders to expand financial and public support for significant
social causes. Public health nurses, such as Wald, played an important part in maternal and child
health policy development. But, not surprisingly given the rising influence of Darwin among the
intelligentsia of the era, the influences of eugenics and race were evident in maternal and child health
policies developed at the time.
CONCLUSION: Nursing was integral to reform efforts during this period (1890-1930), leading
eventually‖to‖society’s‖greater‖commitments‖to‖the‖health‖of‖mothers‖and‖infants‖of‖all‖races.‖It‖is‖
nevertheless disturbing to face the unsettling notion that nursing participated, if only to a small
degree, in the eugenic influences in some of these policies. One has to remember that people live
within the time, place, and belief system of their era.
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Session 7c: Transitions and Influences in Education
HOSPITAL SCHOOLS OF NURSING IN TRANSITION:
MOVING TO COLLEGIATE STATUS 1980-2010
Abby M. Heydman, PhD, RN, Professor Emeritus, Samuel Merritt University (Contact person)
Nancy Haugen, PhD, RN, Associate Professor, Samuel Merritt University
Karen A.Wolf, PhD, RN-ANP-BC, FNAP, Associate Professor, Samuel Merritt University
760-345-9992
[email protected]
Aim of the Study: The purpose of this study is to explore the transition of a select group of hospital
schools of nursing in the United States that moved to degree-granting, collegiate status in the early
1980’s‖and‖1990’s,‖and‖to‖describe‖the‖gradual‖and‖varied‖transitions‖of‖these‖institutions‖over‖the‖
period of years from 1980-2010.
Rationale and Significance: Throughout the twentieth century, the locus of nursing education has
been changing from the hospital school to the collegiate institution of higher education. The number
of‖diploma‖schools‖of‖nursing‖has‖steadily‖declined‖in‖the‖United‖States‖as‖students’‖interest‖in‖a‖
college education increased. While many diploma schools have closed their doors, others have
sought to move more fully into the mainstream of collegiate higher education. This study examines a
period of transition among hospital schools of nursing in the United States during which a select
group of diploma schools became degree-granting institutions. Barriers and resistance to this move
are explored, as well as the unique transitions among these schools that have led to diverse outcomes
by 2010. Historical changes in the organizational structure and collegiate models adopted by ten
schools of nursing are explored and documented.
Methodology: This‖study‖seeks‖to‖answer‖the‖question:‖‚What‖happened‖to‖the‖first‖diploma‖schools‖
of nursing in the United States that decided to move to collegiate status as institutions of higher
education in the last two decades of the 20th century?‛‖‖Primary‖sources‖of‖data‖include‖documents‖
and records from institutional archives, regional and professional accrediting associations,
institutional historical records, institutional publications and websites, articles written by nurse
leaders and published in professional journals and newsletters, and interviews with former and
current school administrators. Secondary data includes letters to the editor commenting on the
transition.
Findings: This study documents the transition of ten hospital schools of nursing that were among
the first hospital schools to move from diploma-granting to degree-granting‖status‖in‖the‖1980’s‖and‖
1990’s.‖‖The‖study‖explores‖the‖various‖forces‖that‖led‖to‖this‖change‖in‖mission,‖describes‖the‖
hostility and resistance expressed by some nurse educators of the period, and records various
pathways taken by these schools during a period of significant change in nursing education. This
study describes the diverse organizational models and structures evident among these schools of
nursing today in their move into the mainstream of American higher education.
Conclusions: Nursing education, as reflected in the transition of a select group of diploma schools of
nursing seeking collegiate status, has adapted within the context of a dynamic and diverse higher
education system in the United States. Former hospital schools, which sought and secured collegiate
status, continue to evolve due to changes within their parent hospital organizations, as well as
changes within the broader framework of higher education.
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ORIGINS OF UNIVERSITY OF SÃO PAULO AT RIBEIRÃO PRETO COLLEGE OF NURSING,
BRAZIL, UNDER THE LIGHT OF THE NURSE GLETE DE ALCÂNTARA
Luciana Barizon Luchesi, RN, PhD, Assistant Professor
Psychiatric Nursing and Social Sciences Department, University of Sao Paulo at Ribeirao Preto
College of Nursing,
55 16 36020535,
[email protected]
The University of São Paulo at Ribeirão Preto College of Nursing, Brazil (EERP-USP) climbed a
privileged space in Latin America and Brazilian History of Nursing by creating the third Master
degree program, in 1975, the first doctoral program in the country in 1981 in partnership with the
School of Nursing of São Paulo, is a WHO Collaborating Centre for Nursing Research Development
since 1988 and had, as full professor, the current Secretary-General of Global Network of WHO
Collaborating Centres (WHOCCs) for Nursing and Midwifery Development, Isabel Amélia Costa
Mendes. Part‖of‖these‖conquests‖is‖also‖due‖to‖early‖introduction‖of‖modern‖ideas‖in‖the‖1950’‖done‖
by Glete Alcântara, responsible to create the school.
Aim of study: To understand the origins of the EERP-USP and the influences in their model of
teaching.
Rationale and Significance: Few studies about this theme were performed until now.
Methodology: It’s‖ an‖ historical‖ study‖ using‖ documental‖ analysis.‖ The‖ chronological‖ delimitation is
1951‖to‖1970,‖period‖of‖Alcântara’s‖administration‖in‖the‖school‖as‖dean.‖The sources of research were
composed by laws, decrees, thesis, books, letters, minutes of meetings, among other documents.
Findings and Conclusion: The law 1467 that established the administrative structure of the
University of São Paulo Faculty of Medicine (FMRP-USP), in December 26, 1951, in its article 13
created the EERP-USP. Glete de Alcântara degree in nursing on Faculty of Nursing of University of
Toronto, Canada, current Lawrence S. Bloomberg Faculty of Nursing, was part of an agreement
between University of Sao Paulo and Rockefeller Foundation. In the beginning of EERP Alcântara
explained‖the‖need‖for‖some‖‚innovations‛‖into‖nursing‖curriculum‖such‖as‖preventive‖aspects in all
disciplines, social sciences in nursing education, nursing administration, educational psychology and
didactics.‖ In‖ Alcântara’s‖ Canadian‖ curriculum‖ can‖ be‖ observed‖ disciplines‖ like‖ psychology,‖ war‖
administration and teaching principles, which seem‖to‖have‖influenced‖these‖‚innovations‛,‖and‖also‖
the Social Sciences degree that Alcântara obtained in Brazil in 1952. Glete de Alcântara obtainable the
first Nurse PhD thesis in Latin America, observed until now, in 1963 and had‖ the‖ ‚Master‖ of‖ arts‛‖
degree‖ by‖ the‖ Teacher’s‖ College‖ at‖ the‖ University‖ of‖ Columbia,‖ USA,‖ in‖ 1950.‖ Alcântara‖ had‖ an‖
international academic life and influenced nursing development in Brazil as president of the National
Brazilian Nursing Association twice. Alcântara died on November 3rd 1974, but her legacy is still
alive on the Brazilian History of Nursing.
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ATLANTIC CROSSING: INTERNATIONAL INFLUENCES ON
NURSE EDUCATION IN ENGLAND.
Janet Hargreaves RCN, Cert Ed, MA, Dr. Education
University of Huddersfield
01484 473411
[email protected]
Aims
This‖paper‖aims‖to‖explore‖the‖experience‖of‖one‖English‖nurse‖educator’s‖scholarship‖to‖Teachers‖
College in the USA in the1950s in order to and analyse the relevance and impact of international
education and exchange on the development of nurse education in England.
Rationale
Nurse education in England remained true to the hospital based apprenticeship system recognisable
as part of the Nightingale tradition until the late 20th Century when there was a mass migration to
University based programmes. A generation of post World War Two nurses had the vision to see an
education system radically different from their own and to seize the opportunities available to them
to create this. The ethos and curriculum content of Teachers at that time offers a fascinating insight
into the period of rapid and exciting change for nursing.
Methodology
Data gathered for doctoral study are used in this paper: Firstly, a life history of one scholar and nurse
educator, Alice, whose career runs from the 1930s to her retirement as a Director of Nurse Education
in the 1970s. Secondly, documentary analysis of the report that she produced in 1956 of her Red
Cross travel scholarship to study at Teachers College and nursing syllabi for the same period. The
paper‖will‖locate‖Alice’s‖history‖and‖her‖experience‖at‖Teachers‖within‖the‖history‖of‖nurse‖education‖
in the UK and USA.
Findings
This window into history offers insights into a number of areas. Academic courses in England for
nurses were very limited. There was no opportunity to study nursing or nursing education to full
degree‖level‖and‖all‖of‖Alice’s‖previous‖studies‖had‖been‖undertaken‖part‖time‖on‖top‖of‖
uncompromising full time working hours. By contrast the broad, liberal curriculum at Teachers
illustrates the similarities and differences in the ways English and USA nursing had developed and
the importance of international travel and exchange. What was a career enhancing event for Alice in
turn influenced nurse education in England.
Conclusion
Alice’s‖life‖is‖one‖that‖is‖both‖unique‖and‖quintessentially‖a‖story‖of‖nurse‖education‖for‖her‖times.‖
The privileged opportunity to undertake her life history in the final decade of her life and the
survival of her work from Teachers College contribute to our understanding of the development of
nursing education during a period of major political and social change.
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OUT OF THE ASHES OF A HOSPITAL- BASED SCHOOL OF NURSING
Karen Anne Wolf,
928 63rd Street,
Oakland
California,
USA
94608
[email protected]
Aim of study: This study describes the tumultuous transition of the Massachusetts General Hospital
School of Nursing (MGHSON) to degree granting status as a free standing graduate Institute, known
as the MGH Institute of Health Professions.
Rationale and significance: One of the oldest schools of nursing in the United States, founded
originally as the Boston Training School for Women, the MGHSON ‘s‖journey‖to‖professional nursing
education exemplifies the struggle to find acceptance within the academy and become congruent
with the educational goals of the nursing profession. The MGHSON operated as a hospital-based
diploma program until 1980, yet had attempted to move to baccalaureate education at least four
times. Despite strong leadership including a director of MGHSON, who was also the first president
of the National League for Nursing (NLN), the MGHSON was blocked by both internal pressures
and constituencies and external barriers posed by the profession itself. With the ultimate evolution
to a freestanding interdisciplinary institute in 1977, the MGH Institute of Health Professions met
resistance to the changes in organizational structure and to the development of an innovative
graduate degree granting entry level nursing program.
Methodology: This case study draws on re-analysis of data derived from an updated history of the
MGH‖Nurses‖Alumni‖Association’s‖archival‖papers‖done‖in‖the‖1990s,‖and‖augmented‖with‖
secondary sources such as reports, press records and historical summaries. Additional interviews
were completed with key informants from both within and outside the MGH community.
Findings: This study highlights the struggles of the MGHSON as it sought to retain control over the
clinical education and the cost of innovation, with transition to a unique structural formation. It
further demonstrates the internal ambivalence involved in shifting power and control for the
educational processes, and how the ideological shift to professionalism in nursing embodied a
rigidity of institutional isomorphism that hindered potential innovation and acceptance of diversity.
Conclusions: The MGH suffered multiple false starts in its efforts to move to a degree granting
nursing education program, ultimately establishing itself within a unique freestanding
interdisciplinary graduate institute, with entry into nursing at the graduate level. The conflicting
ideological and economic interests that blocked the path to a new educational structure exemplify the
intra-professional ambivalence and conflicts as well as the contradictory class and gendered location
of nursing in society.
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Session 7d: Colonial Practice and Postcolonial History
MARIA WHITE, MD AND THE ESTABLISHMENT
OF A SCHOOL OF NURSING IN SIALKOT INDIA, 1886-1933
Colleen Bowers, RN
Doctoral Candidate
University of Manchester
20 Dunnett Ct
Baltimore, MD 21236
USA
443-722-7248
Fax:410-661-5102
[email protected]
Aim of the study: To provide a biographical sketch of the life and career of Dr. Maria White and to
explore and analyze the political, religious and social conditions that led to the creation of a School of
Nursing in rural India.
Rationale and Significance: Maria White MD (b.1854) graduated‖from‖the‖Woman’s‖Medical‖College‖
of Baltimore in 1886, a medical college which was unique in that it also maintained a school of
nursing within the same building. Upon graduation, White accepted a call to serve as a medical
missionary with the United Presbyterian Church of North America. She sailed to Bombay, arriving
five months later and settled in the northern rural town of Sialkot, India (now part of Pakistan).
Within the first year she established a small dispensary and the following year had a ten bed clinic. In
1889‖she‖began‖training‖‚native‖girls‛‖to‖work‖as‖nurses.‖‖Her‖forty‖seven‖years‖in‖India‖saw‖many‖
changes to both the growing hospital and School of Nursing. A literature search reveals very little
scholarly work into‖White’s‖life‖and‖career;‖even‖less‖has‖been‖written‖on‖the‖early‖years‖of‖the‖school‖
of nursing.
Methodology and Sources: Theoretical constructs of imperialism, evangelism, post-colonialism and
feminist perspective were utilized to develop an analysis of the sources. A historical inquiry resting
on primary source data include original documents held in the Presbyterian Historical Society
located in Philadelphia, Pennsylvania, the University of Maryland Special Collections Department
located in Baltimore Maryland, The British Library and nursing records at the School of Nursing,
Memorial Christian Hospital, Sialkot, Pakistan. Findings were contrasted to appropriate secondary
sources that were relevant to the subject.
Findings and Conclusions: The findings provide a complex and dynamic relationship between the
balancing‖of‖‚healing‖the‖sick‖and‖providing‖peace‖to‖their‖souls‛.‖Dr.‖White‖maintained‖a‖lifelong‖
professional relationship with her medical school, alumni and medical society all of which provided
guidance‖for‖her‖school‖of‖nursing‖in‖Sialkot.‖At‖the‖time‖of‖Dr.‖White’s‖retirement‖in‖1933‖the‖school‖
had grown in both size and stature and was under the direction of registered nurses from America.
As a postscript, today the School of Nursing at Memorial Christian Hospital ranks among the top five
Schools of Nursing within Pakistan and its graduates are widely sought for employment.
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WE DEMAND TRAINED NURSES! U.S. COLONIAL WORKERS
IN THE PHILIPPINES 1898-1917
Winifred C. Connerton, CNM, MS
Doctoral Candidate
University of Pennsylvania School of Nursing
215.482.2164
[email protected]
To be presented by Cynthia Connolly
Purpose: The purpose of this paper is to highlight the role of U.S. nursing in the U.S. colonial
occupation of the Philippines from 1898-1917.
Rationale: Studies of nursing and medicine in the U.S. Philippine colony have overlooked the
importance that the colonial administration, workers and domestic population placed on having
trained nurses available to the American colonial workforce.
Significance: Trained nursing was a young profession in 1898, but it had already been so completely
accepted by the American population that trained nursing care was provided as a benefit of
employment by the colonial Bureau of Health, the Army and by missionary hospitals.
Methodology: Sources‖for‖this‖study‖include‖Episcopal‖and‖Presbyterian‖Philippine‖missions’‖
annual reports as well as correspondence from mission hospitals; annual reports of the Philippine
Commission to the Department of War; letters and articles by nurses in the Philippines published in
the American Journal of Nursing and Trained Nurse and Hospital Review; and articles published in
domestic newspapers.
Findings: By 1898 the benefits of trained nursing were widely accepted among the American
population. With the start of the 1898 Spanish American War the populous demanded nursing
services for soldiers serving in the Army when rampant illness broke out among the Army camps.
Army nurses were different from earlier military caregivers because they performed only nursing
tasks, while other ward duties like dishwashing were left to other staff. Philippine colonial workers
and their families expected the Philippine Bureau of Health to provide trained nursing care, and the
Bureau complied. There were American trained nurses in each of the Philippine medical facilities,
and the Bureau included nursing details in each annual report. Protestant missions in the
Philippines wanted access to trained nursing for missionaries struck ill while in the field. The
presence of American nurses in mission hospitals also enticed paying American patients into mission
facilities, which then supported the hospital and mission work itself.
Conclusions: The colonial apparatus in the Philippines included trained nurses in official positions
with the Army and the Philippine Bureau of Health as well as nurses in missionary hospitals. These
nurses were essential to the colonial mission because the American workers in the Philippines, and
their families in the U.S., believed that nursing was fundamentally important to adequate health care;
and adequate health care was vital for maintaining their American lifestyle in the tropics.
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HOW TO INTRODUCE WESTERN NURSING IN AN EASTERN SOCIETY?
THE INTRODUCTION OF WESTERN-TRAINED FEMALE NURSES IN
COLONIAL JAVA AROUND 1900.
Liesbeth Hesselink, PhD
Retired
+31(0)715131989
[email protected]
Aim of study:
The introduction of Western-trained female nurses in colonial Java around 1900.
Rationale and significance:
This subject has not been researched until now. The problems that occurred in those days resemble
those of to-day in third world countries.
Methodology:
Analysis of historical sources such as medical journals, governmental documents.
Findings and conclusions:
Prior to 1900, the few hospitals in the Dutch East Indies were mainly for military men; nursing was
carried out either by low-rank soldiers or by unskilled laymen. Around 1900, the Dutch colonial
administration experienced a major shift in orientation as a result of the introduction of the so-called
Ethical Policy, which was officially proclaimed in 1901. Subsequently, the colonial state began to
accept a formal responsibility for the physical health and well-being of the Native population. This
resulted in an expansion of the range of medical facilities and the construction of new hospitals and
clinics. As a result, a demand arose for more medical professionals. Simultaneously, higher demands
were made on nursing services; an increasing number of people grew dissatisfied with the bad
quality of nursing.
In 1914, Nel Stokvis – Cohen Stuart, one of the few female European physicians in the colony, started
to train young Native women to become nurses in government hospitals. Various factors made this a
difficult enterprise. There were not enough female candidates who could read and write.
Furthermore, it was not considered appropriate for middle-class girls (the ones among the local
population who could afford to study) to work outside their homes. Especially the bad reputation of
government hospitals made it difficult to stimulate Natives to work there. Finally, for girls of a
marriageable‖age‖it‖was‖considered‖culturally‖improper‖to‖live‖outside‖their‖parents’‖home.‖Besides‖
these‖problems‖arising‖from‖women’s‖position‖in‖society,‖Mrs‖Stokvis‖had‖to‖deal‖with‖ethical‖
standards regarding hygiene, accuracy, helpfulness.
Step by step these difficulties were overcome. An increasing number of candidates from primary
schools were willing to enter nursing when they started to perceive it as a proper occupation for their
social class. The improvement of civilian hospitals and the creation of special in-hospital boarding
schools for trainees helped to create a respectable image of nurses. Moreover, the presence of Dutch
nurses in the hospitals enhanced the image of the nursing occupation. Another factor was the
government’s‖decision‖to‖require a nursing diploma as precondition to enter midwifery training. In
the‖end,‖the‖government‖took‖over‖Mrs‖Stokvis’‖method‖of‖training‖for‖the‖rest‖of‖the‖colony.
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A TALE OF TWO SISTERS: DECONSTRUCTING MISSIONARY NURSING AND MIDWIFERY
IN THE BRITISH POST-COLONIAL ERA.
Francis C Biley, RN, PhD, Associate Professor
Bournemouth University
00 44 (0)1202 962214
[email protected]
Edwin van Teijlingen, PhD, MEd, MA (Hons)
Professor of Maternal and Perinatal Health Research
Bournemouth University
00 44 (0)1202
[email protected]
Aim of the Study
This presentation is based on a study that explored the issues and tensions that arose from the
Methodist‖missionary’s‖promotion‖of‖Western‖medicine and Christianity within the indigenous
cultures of two former British colonies in Africa and Asia.
Rationale and Significance
As‖worship‖of‖the‖Christian‖God‖replaced‖the‖Kenyan’s‖own‖‚Ngai‛,‖as‖the‖Indian‖lay‖midwife‖or‖
‚dai‛‖was‖replaced‖by‖Western-trained individuals, and as allopathic medicine became the treatment
of‖choice‖in‖preference‖to‖Kenyan‖Meru‖‚Urogi‛‖or‖witchcraft‖and‖the‖Indian‖Ayurvedic‖and‖Unani‖
indigenous medical systems, the health of these peoples could be said to have improved, but at what
cost? Significantly, although aspects of the general and specific health of the indigenous populations
may have been improved, this may have been at the cost of eroding traditional cultural activity.
Methodology
Emergent new insights are informed by extensive photographic and documentary evidence and
prolonged and detailed biographical oral history interviews with two very influential sisters who
spent a total of 54 years working, one as a nurse, the other as a midwife, in Methodist missionaries in
Kenya and India. This presentation will be richly illustrated with original photographs, oral history
sound files and accompanying texts.
Findings
As time passed, initial ex-patriate segregation and dominance gave way to partial integration and
tolerance,‖perhaps‖achieving‖a‖greater‖level‖of‖system‖assimilation‖and‖taking‖benefit‖from‖the‖‘best‖
of‖both‖worlds’.
Conclusions
As it will be revealed, important new insights into the work of nursing and midwifery missionaries
in the post-colonial era emerge
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Session 7e: Methodology
A NOVEL CONCEPT: THE USE OF NURSE NARRATIVES AS VALID
AND IMPORTANT HISTORICAL DOCUMENTS
Jennifer Casavant Telford, PhD, ACNP-BC, Assistant Professor
University of Connecticut School of Nursing
231 Glenbrook Rd. U-2026 Storrs, CT 06269-2026
(860) 486-4975
Fax: (860) 486-0001
[email protected]
Aim of study
The American Civil War nurse narrative Hospital Sketches by Louisa May Alcott1 and World War I
narrative We That Were Young by Irene Rathbone2 both vividly represent the role of women in caring
for injured soldiers during wartime, but can we consider them historiographical accounts? Historians
tend to discount such vivid narratives because these works are usually categorized as either fiction or
at best semiautobiographical novels. In this paper I argue that instead of being dismissed, these
works should be closely studied because they offer the reader the most detailed descriptions of
wartime conditions available and‖are‖important‖cultural‖representations‖of‖women’s‖experiences‖in‖
wartime. Distance from the events offered these authors a perspective that those chronicling their
experiences immediately, in diaries or letters, lacked. I argue also that narrative analysis of works of
this type can be as valid as the interpretation of other types of qualitative data traditionally used to
conduct historical inquiry.
Rationale and Significance
To dismiss fictionalized writing by people who were part of the experience potentially deprives the
historian of qualitative data that in concert with more traditional sources can enrich the narrative.
Methodology
Methods used in the conduct of this study included narrative analysis as a qualitative method in
social sciences, as described by Catherine Kohler Reissman.3 This culture studies approach offers the
researcher a perspective that many who dismiss these works lack.
Findings and Conclusions
Unlike many of the unpublished and published diaries and written correspondence of female war
workers, Alcott and Rathbone, to name just two, offer the readers of their works a unique perspective
of the work of women during war. As they tailored their descriptions of war for a larger audience
than a personal one, their rich description does more than make a good story. While admittedly not
writing autobiography or memoir, these authors tailored their descriptions to a broader readership
and offer accounts of the life of female nurses that would otherwise have been missed.
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THE WOMEN’S VOICES PROJECT: A WOMAN-CENTERED CAMPUS ARCHIVE
Carolyn (Carrie) J. Lee, PhD, CNE, RN, Associate Professor
University of Toledo, College of Nursing
3000 Arlington Ave, Toledo, Ohio, USA, 43614
419-383-5863
[email protected]
Nancy Collins, PhD, Professor
University of Toledo, College of Medicine
3000 Arlington Ave, Toledo, Ohio, USA, 43614
419-383-3958
[email protected]
Aim The history of any academic institution is forged, in part, by the sustained and thoughtful
efforts of faculty. As part of a campus initiative designed to support and promote career paths of
women in the health sciences and medicine, a multi-discipline effort sought to develop an archive
with a focused spotlight on the careers, contributions and voice‖of‖women‖faculty.‖‚The‖Women’s‖
Voices‛‖project,‖a‖collaborative‖effort‖between‖the‖Library,‖Creative‖Instruction‖Center,‖The‖College‖
of Medicine and The College of Nursing is intended to create a woman-focused digital archive and
research database readily accessible to a wide audience.
Rationale/Significance The education and career paths of our senior and emeriti faculty parallel the
advancement of opportunities for women during the second wave of feminism and, as such, their
stories are revealing testimony to the social and professional progress of women. These stories are
valuable not only in revealing contributions to the institution, but also for insights about the
competing demands of career and family when new definitions of what constitutes a successful life
were evolving. A need exists to document the trajectory of the career paths of these women faculty
to serve as a historical reference point for contemporary women, students, and women choosing an
academic career.
Methodology
Phase one of the project involved tape-recorded oral interviews with retired
College of Nursing Faculty in a review board approved study. A structured interview guide
garnered faculty biographical data on original and graduate nursing education, career and faculty
role development, personal parallels with societal shifts for women, and their perspective on college
history.
Finding Overarching‖themes‖in‖women’s‖stories‖was‖a‖passion‖for‖nursing‖instilled‖early‖on‖by‖
meaningful clinical experiences and quality teachers, a sustained intellectual curiosity, and a
progressive commitment to professional growth. Further, women identified personal challenges and
strategies as they made career decisions within the context of other life roles and obligations.
Conclusions
The reality is that our senior and retired faculty members are aging. It is imperative to gather the
biographies of these women before their voices go silent. Project efforts will proceed with
compilation‖of‖women’s‖biographies‖from‖all‖science‖campus‖roles‖and‖disciplines.
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MINING GEMS FROM THE G.I. GENERATION: UNDERSTANDING THE IMPACT OF WAR
FROM THE ORAL HISTORIES OF MIDWESTERN ELDERS
Lee-Ellen C. Kirkhorn, PhD, RN, Professor
Teresa Loftsgaarden, MSN, RN (Co-Author)
Institutional Affiliation: Department of Nursing at University of Wisconsin Eau Claire College of
Nursing and Health Sciences
715-836-5005
[email protected]
Specific Aims: For the past five years, sixteen elders (ranging in age from 83-100) have been followed
by baccalaureate nursing students who have obtained oral histories from them. Students spend
approximately 45 minutes twice a week asking residents questions about their life experiences and
their personal health histories.
The purpose of the present study is to analyze the themes that have emerged from these stories
through the lens of a nurse historian. The study will focus upon the impact of war and military
history upon the lives of persons who lived through World War II.
Rationale and Significance: Although learning to obtain a comprehensive health history is one of the
primary objectives of a Midwestern university baccalaureate nursing course, nursing students also
report learning about the history and culture that shaped the lives of the persons they interview.
One dominant experience among elders aged 83-101‖is‖‚the‖War‛.‖‖Elders‖are‖members‖of‖‚the‖GI‖
Generation‛‖and‖it‖has‖shaded‖or‖colored‖the‖character‖of‖their‖lives‖in‖countless‖ways.
Methodology: Using historical interview data obtained from 2005-present, examples of the influence
of war and conflict on the lives of sixteen elders who reside in an assisted living facility in Eau Claire,
Wisconsin will be described. Qualitative analysis of themes will be examined in light of current and
classic nursing and allied health literature.
Findings: Findings of the study will shed light up on the values and dispositions of elderly adults
who have lived through World War II. Results will help clarify the impact of war and military
conflict upon the lived experience of persons who now reside in a small Midwestern community in
Western Wisconsin.
Conclusions: Although much of nursing literature has emphasized the value of obtaining a health
history as one component of a more comprehensive health assessment for a single individual,
aggregated patient histories may also provide a glimpse of the impact of world history in general
(and military conflict in particular) upon the lives of patients who lived through that event. The
present study will offer insights based upon five years of systematically collected data from sixteen
members of the GI Generation.
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TOOLS OF THINKING: INTERTEXTUALITY WITHIN DISCOURSE ANALYSIS
IN NURSING HISTORICAL RESEARCH
Mayumi Kako, RN, PhD
Research Assistant (Population Health)
Flinders University
+61 8 8201 7637
[email protected]
Trudy Rudge, Professor of Nursing, RN, PhD,
University of Sydney
+61 2 9351 0700
[email protected]
Aim of study: This paper argues for the use of discourse analysis and intertextuality in nursing
historical research. Discourse analysis was employed to investigate the process of nursing
professionalisation from the 1950s to 2007 in South Australia. In particular, the use of the concept of
intertextuality will be exemplified.
Rationale and significance
The process of discourse analysis (DA) is based inherently in hermeneutics but goes beyond
exploring the meaning and context in the text. In DA, it is understood that discourses exist in every
minute, and it is difficult to define discourses without locating them in context. Contextual changes
influence where and how the discourses are constituted. Moreover, the process of discourse
production and interpretation is dialectical between context and text. Central to analysing this
interplay is the idea of intertextuality, which is a concept that highlights the very historicity of a text
– that is, reference to other texts, understandings about genre or discourses as these position author
and audience. For instance, in this paper nursing professionalisation was situated as a form of
discourse influencing and shaping nurse education through its tools for thinking.
Methodology (primary and secondary)
Primary resources such as archives from Nurses Board of South Australia, Royal College of Nursing
Australia, secondary resources such as professional nursing journals, books and unpublished theses
were used. Both forms of resources were analysed as historical textual data to reveal what
constituted the professionalising discourses from the 1950s to 2007 in South Australia.
Findings and conclusions
During the analysis process, intertextuality was an essential tool to seek the interconnectedness of
texts and their constitutive discourses. For example, texts from social and professional spheres were
influential in how discourses operated in directing the professional agenda of nursing. Observing the
mechanics of nursing professionalisation in terms of internal elements (such as professional attitudes;
knowledge; definition; autonomy) and external elements (such as the socio-political or economic
spheres) of the nursing profession indicated that these layers of discourses accelerated and promoted
certain‖forms‖of‖discourses‖about‖‘profession’.‖Although‖there‖is‖still‖room‖to‖investigate‖the‖
applicability of this analytical method to explore various discourses in nursing history, DA in
historical research can play an important role to reveal how tools for thinking came to be tools of
thinking about nursing as a profession.
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Session 7f: Education and Socialisation
‘I’M NOT YOUR CHARGE NURSE – I HAVE A PROFESSION IN MY OWN RIGHT!’: NURSES’
ATTITUDES TO TREATMENT REGIMES IN ONE ENGLISH PSYCHIATRIC HOSPITAL,
1945 – 1985
John Adams, RN, PhD
Anglia Ruskin University, UK.
0845196 5567
[email protected]
Aim
To examine the changing attitudes of nurses towards treatment regimes in one English psychiatric
hospital in the post-War period.
Rationale
Treatment regimes in mental health care remain controversial to this day, so historical studies can
shed‖light‖upon‖the‖influences‖which‖shaped‖(and‖continue‖to‖shape)‖nurses’‖clinical‖practice.
Methodology
This paper reports one element of a doctoral historical study which used evidence from archival and
published sources, and oral history interviews with nurses, psychiatrists, other staff members, and
service-users.
Findings
Fulbourn hospital had been opened in 1858 as a county pauper lunatic asylum, but the early hopes
of establishing a dynamic regime soon evaporated in the face of therapeutic impotence and scarce
resources of all kinds. Successive medical superintendents focused instead on bureaucratic efficiency
and their own sporting interests. Little was expected of the hospital attendants beyond an ability to
follow the institutional rules. After the Second World War, a range of physical treatments including
deep insulin coma therapy (DICT), electro-convulsive therapy (ECT), and leucotomy, were
introduced. At the same time, new drugs such as chlorpromazine and imipramine, began to
transform medical and nursing practice. A new medical superintendent, appointed in 1953, began a
process‖of‖turning‖the‖institution‖into‖an‖‘open‖door’‖hospital,‖with‖a‖focus‖on‖‘work‖for‖all’.‖His‖
ultimate goal, reinforced by a sabbatical year in California in the early 1960s, was to transform all the
wards‖into‖‘therapeutic‖communities’.‖All‖these‖developments‖had‖a‖major‖impact‖upon‖nursing‖
practices and the education of student nurses. Rifts developed between those nurses who
enthusiastically‖embraced‖the‖‘social‖model’‖of‖care,‖and‖those‖who‖favoured‖a‖more‖‘traditional’‖
approach. The increasing dominance of the former group of nurses was reversed when a new
professor‖of‖psychiatry‖committed‖to‖a‖‘biological‖model’‖of‖psychiatry‖was‖appointed‖in‖1976.
However,‖several‖nursing‖practices‖associated‖with‖the‖‘social‖model’‖had‖become‖so‖deeply‖
embedded in the culture of the hospital that they still continued.
Conclusion
Nurses‖are‖sometimes‖portrayed‖as‖being‖merely‖passive‖spectators‖in‖the‖‘model‖wars’‖waged‖in‖
psychiatry in the second half of the twentieth century, but in this presentation it will be argued that
they were engaged participants and sometimes influential combatants.
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"SCIENTIFIC PRODUCTION OF THE SPANISH NURSES IN THE XVITH AND XVIITH
CENTURIES: THE RULES OF THE NURSES OBREGONES (1593),
NURSES'INSTRUCTION (1617) AND NURSES' DIRECTORY (1668) ".
Antonio Claret García Martínez. Historiador, Doctor
Profesor Titular de Paleografía y Diplomática en la Facultad de Humanidades de la
Universidad de Huelva.
Manuel Jesús García Martínez. Antropólogo y enfermero, Doctor
Profesor Asociado en la Escuela Universitaria de Ciencias de la Salud de la
Universidad de Sevilla (Departamento de Enfermería).
Teléfono personal: 619 902 546
Lugar de trabajo, Universidad: 959 219 164
[email protected]
Aim of study:
To demonstrate the scientific level reached by the spanish nurses in the XVIth and XVIIth century
analyzing some of the educational and normative texts elaborated by them.
Rationale and significance:
The location in the last decades in Spain of didactic texts elaborated by nurses and directed for his
training belonging to the 17th century supposes the whole change in the vision that we had of the
origins of the modern Nursing: diet, hygiene of the patient and his environment, isolation of the
contagious patient, methodical employment of the technical nurses, control and record of the elegant
ones, elimination of superstitious practices, worry for the training of the nurse, integral vision of the
care, including the spiritual help to have a good death, between other aspects, as well as the
beginnings of the recognition of a professional identity: Nursing.
Methodology:
Research developed in several spanish and portuguees universities libraries (Sevilla, Salamanca,
Madrid, Lisbon) and in the Diocesan Archive of Toledo, where the studied texts are located. The
manuscripts texts have been transcribed; the first one, the chapter ten of the Rules of the nurses
obregones, dated about 1593, and second, a nursing book elaborated by the nurse Simón López and
finished of correcting in 1668. From the third one, printed, we have located five editions between
XVIIth and XVIIIth century, and did wide tables of contents in databases, that have allowed us to
reach a deep knowledge of the Nursing practised in this period.
Findings:
We announce the Nursing practised in Spain from ends of the 16th century until the first half of the
XVIIth for these nurses, showed in these scientific books.
Conclusions:
Books like the studied are allowing us to know the origins of the modern Nursing in Europe and the
changes experienced on the service of cares from ends of the Middle Age, marking an important
break with this historical period, and the birth of a profession: the Nursing.
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‚SOMETHING MUST BE DONE!‛:
A HISTORY OF PUBLIC HEALTH NURSING EDUCATION, 1900 TO 1950
Pamela A. Kulbok, DNSc, RN, PHCNC-BC
University of Virginia School of Nursing
434-924-0128
[email protected]
Doris F. Glick, PhD, RN
University of Virginia School of Nursing
434-924-0105
[email protected]
Aim: The purpose of this paper is to analyze and describe the history of public health nursing (PHN)
education in the United States from 1900 to 1950. The history is discussed in the context of world
events that affected the health of populations, including adverse social conditions, epidemics, the
Great Depression, and two World Wars.
Rationale and significance: Following the establishment of district nursing in London and Boston in
the 1880s and development of the Henry Street Settlement in 1893, visiting nurses began working in
schools and homes, and among immigrant populations in the tenements of industrialized cities of the
Northeast as well as in Richmond and Chicago. By the early 1900s, public health nursing leaders
recognized that graduates needed broader education than that provided by hospital training
programs. That education should prepare nurses to address social conditions and promote health
and hygiene.
Methodology: This investigation used traditional historical methods and a social history framework.
It focuses on the state of the art of medicine and nursing during the period and the social, economic
and political climate in which PHN developed. Primary sources included nursing publications of the
era, including the American Journal of Nursing, public health journals, and textbooks. Secondary
sources on the history of public health were also used.
Findings: By 1906, some schools offered post-graduate courses to prepare public health nurses to
provide‖care‖in‖the‖broader‖community.‖In‖1912,‖the‖NOPHN‖was‖founded,‖and‖‚it‖became evident
that‖something‖must‖be‖done‖<‖to‖regulate‖these‖courses‖for‖the‖preparation‖of‖public‖health‖nurses‛‖
(Stewart, 1950, p. 228). In the following decades, the public health movement progressed beyond
simple sanitation problems to address broader challenges such as infectious diseases, mental
hygiene, industrial hygiene, and well care of families and children. By the 1950s, education for public
health nurses had progressed from the early postgraduate courses to incorporation into
baccalaureate nursing‖programs.‖Yet‖public‖health‖nurses‖faced‖concerns‖about‖‚vague‖and‖visionary‖
ideals‛‖which‖were‖viewed‖by‖some‖as‖‚less‖dramatic‖and‖less‖practical‛‖than‖the‖care‖of‖the‖
‚desperately‛‖sick.‖
Conclusions: Today educators confront the need to prepare nurses to address extant challenges, such
as disaster preparedness, the impact of global infectious diseases on local populations, and increasing
health inequities. Many current issues in professional nursing have their roots in the early discourse
about PHN education. It is instructive to reflect upon this historic development.
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SHARED GOVERNANCE AND PROFESSIONAL SOCIALIZATION:
STUDENT NURSES’ ASSOCIATION (UNITED KINGDOM) AND
NATIONAL STUDENT NURSES’ ASSOCIATION (UNITED STATES OF AMERICA)
Diane J. Mancino, EdD, RN, CAE
Executive Director
National‖Student‖Nurses’‖Association,‖Inc.
45 Main Street, Suite 606
Brooklyn, NY 11201
(917) 328-3016
(718) 210-0705 Ext. 103
[email protected]
Aim of Study:
There are two purposes for this study:
1. Trace the history (1925 – 1968) of the Student Nurses Association (SNA) in the United
Kingdom (UK) with emphasis on shared governance and professional development;
2. Identify parallels for the trends and issues influencing the Student Nurses Association (UK)
and‖the‖National‖Student‖Nurses’‖Association‖(USA)‖(1952-1968).
Rationale and Significance:
The role of pre-professional organizations in the socialization of nursing students has not been
extensively studied. This historical inquiry examines the role that pre-professional organizations play
in the practice of shared governance and the development of professional values, identity, loyalty,
and good citizenship.
Methodology:
Primary and secondary documents are utilized for this investigation. These include--Primary
Sources:‖‖Both‖organizations’‖Constitution‖and‖Bylaws,‖Minutes,‖Annual‖Reports,‖and‖Letters;‖
Secondary Sources: Publications
Findings:
The Student Nurses Association (SNA) (UK) was organized as part of the Royal College of Nursing
(RCN) in 1925. Twenty-five years later, the SNA became independent of the RCN, managing their
own affairs yet retaining a close relationship with the parent organization. In 1968, SNA re-affiliated
with the RCN where it remains today. The National Student‖Nurses’‖Association‖(NSNA)‖(USA)‖was‖
formed in 1952 and was, at that time, invited to affiliate with the American Nurses Association
(ANA). NSNA founders chose the path of independence—a decision supported by the ANA. The
purpose/function of both the NSA (UK) and the NSNA (USA) are, for the most part, similar.
Conclusions:
1. Shared governance gives voice to nursing students in pre-professional organizations.
2. Parallel trends and issues emerge in the data for these two organizations.
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Session 7g: Nursing Skills Revisited
SKILLED NURSING OR SKILLS OF NURSING: AN AUSTRALIAN PERSPECTIVE
Wendy Madsen, BA, RN, MHSc, PhD, GCFL
CQUniversity
0617 4150 7031
[email protected]
Aim: To explore the tension between skilled nursing as it relates to holistically attending the patient
and skilled nursing as a technologically driven process. While this tension has been explored by
other nurse historians in other contexts, this paper adds an Australian and community-based flavour
to the debate.
Rationale and significance:‖Nursing‖has‖often‖depicted‖itself‖as‖a‖‘practical‖profession’,‖but‖it‖is‖one‖
that has increasingly incorporated a hierarchy of practices whereby some are valued over others. This
has resulted in fracture lines occurring within the profession between the various nursing services
and settings. Understanding how these fracture lines came to be and how they are perpetuated may
contribute to the profession better understanding itself, including its own strengths and weaknesses.
Methodology: This paper draws on a national historical analysis of district nursing in Australia to
explore‖the‖changing‖conceptualisations‖of‖‘skilled‖nursing’‖from‖the‖late‖19th century to the 1980s.
The study accessed primary source materials from six major district nursing services from across
Australia,‖including‖annual‖reports,‖nurses’‖notes,‖matrons’‖and‖supervisors’‖reports,‖photographs‖
and oral testimonies.
Findings: Skilled nursing was sought after by philanthropists of the 19th century to address the health
needs of the poor. At that time it consisted of assessing the patient, home and family circumstances
and applying and adapting the skills and knowledge of nursing at the time to those particular
circumstances – skills that were dependent on whatever could be carried in a bag or commandeered
from the surroundings. As district nurses incorporated more technologically-dependent tasks, such
as‖injections‖and‖blood‖pressure‖monitoring,‖their‖conceptualisation‖of‖‘skilled‖nursing’‖was
challenged. Some district nurses continued to see skilled nursing in terms of assessing, applying and
adapting skills and knowledge, while others linked skilled nursing with the use of technical
equipment and the skills of nursing.
Conclusion: This paper proposes this latter perspective took a more limited view of skilled nursing
and has contributed to the devaluing of traditional skilled nursing as a holistically centred adaptation
of interventions and knowledge. It argues that while nurses have articulated‖and‖endorsed‖‘skilled‖
nursing’,‖they‖have‖simultaneously‖often‖not‖recognised‖or‖valued‖the‖‘skill’‖inherent‖in‖their‖own‖
routine work.
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‚QUENCHING THE FIRE‛: A HISTORICAL ANALYSIS OF THE ROLE OF
AMERICAN NURSES IN TREATMENT OF CROHN’S DISEASE, 1945-1985.
Carol S. Brotherton, RN, MSN
The University of Virginia School of Nursing
434-924-0113
[email protected] ;
Aims: The purpose of this paper is to describe and analyze‖the‖nurses’‖role‖in‖responding‖to‖the
rising‖incidence‖and‖severity‖of‖Crohn’s‖disease‖that‖occurred‖in‖the‖United‖States‖during‖the‖20 th
century. It focuses specifically on the response by hospital nurses who delivered care to individuals
with‖Crohn’s‖disease‖when‖recurrent‖bowel‖inflammation often resulted in repeated life-saving
bowel resections. Their role will be discussed particularly within the medical and nursing context of
the period.
Rationale and Significance: Since‖its‖seminal‖description‖in‖1932,‖Crohn’s‖disease‖has‖remained a
puzzling‖and‖significant‖health‖care‖challenge.‖The‖estimated‖annual‖U.S.‖cost‖for‖Crohn’s‖disease‖of‖
$3.6 billion contributes to ongoing concern for the overall cost of U.S. health care. Thus, good reason
exists to evaluate past lessons learned about the‖treatment‖of‖Crohn’s‖disease,‖including‖the‖nurses’‖
role in teaching about diet- the‖effect‖of‖diet‖on‖Crohn’s‖disease‖remaining‖a‖critical‖and‖unanswered‖
research question today.
Methods /Sources: Traditional historical methods are being used for data collection, data immersion,
the development of a chronology and themes. Critical analysis of the state of the art of nursing,
public health, and medicine are also being done. Primary sources include medical and nursing
textbooks and journals from the period, transcripts, and procedure documents from Mount Sinai
Hospital, New York, and other hospital collections located in the Gustave L. and Janet W. Levy
Library at the Mount Sinai Hospital.
Findings: From 1945 to 1985, the public health threat of chronic disease grew as the threat of
infectious disease diminished. Because new drugs conquered old adversaries, pharmacologicallybased hopes for chronic problems were high. New surgeries developed when drugs failed. Nurses
rose to new challenges caring for patients with ostomies and short bowel syndrome. Themes that are
emerging‖are‖‚creative‖problem-solving,‛‖‚meeting‖more‖than‖physical‖needs,‛‖‚need‖for‖a‖new‖
specialty,‛‖and‖‚nurses‖leaving‖research‖questions‖to‖non-nurses while busy delivering standard
care.‛
Conclusion: The‖state‖of‖the‖art‖of‖medicine‖and‖nursing‖affected‖nurses’‖response‖and‖patients’‖
experiences‖with‖Crohn’s‖disease‖from‖1945‖to‖1985.‖A‖low‖fiber‖diet‖was‖thought‖essential‖to‖
‚quenching‖the‖fire‛‖of‖bowel‖inflammation.‖‖Nurses‖delivered‖the accepted diet teaching and
handled challenges that resulted from surgical interventions performed on individuals whose
intestinal inflammation failed to respond to the accepted diet.
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‚CONTRARY TO APPROVED METHODS OF PRACTICE‛:
MASSAGE THERAPY, POLIO, AND NURSING, 1900-1945
Audrey Snyder, PhD, RN, ACNP-CS, FAANP, CMT
Assistant Professor, University of Virginia School of Nursing
434-924-0094,
Fax: 434-982-1809,
[email protected]
Aim of Study: The purpose of this study is to examine the use of nurse massage therapy during the
early years of the 20th century. The use of massage in the history of polio treatment is used to
highlight the return to massage as a therapy.
Rationale and Significance: Despite the focus on new scientific therapies and the turning away from
physical treatment, in the early 20th century, nurses still used massage in the care of the sick. Early
nursing texts provided chapters dedicated to massage covering the history, nursing requirements,
and procedures to be followed; yet, little has been written on nurse massage therapy.
Methodology: Traditional historical methods with a social history framework were used for data
collection, data immersion and the development of chronology and themes. Primary sources
included medical and nursing textbooks and journals of the era, the autobiography of Sister Kenny
and publications of the National Infantile Paralysis Foundation. Secondary sources were also used.
Findings: Massage was provided by nurses only on physician order. Massage required training and
knowledge of the movement cure and the nature and course of the disease being treated. Nurses
were instructed in bed-making, baths and care of the back. The polio epidemics brought heightened
awareness to the uses of massage in preventing long-term disability. Moreover during the polio
epidemics of 1931 and 1944 some nurses, including Sister Elizabeth Kenny, used massage therapy
despite early criticism of its use. Treatment for infantile paralysis consisted of massage for 15 minutes
morning and night, warm baths and gentle passive movements to prevent deformity during the
acute phase of spasms whereas conventional treatment was immobilization with splinting and
casting to prevent deformities which often left the patients crippled.
Conclusions: Nurses have long used massage for comfort measures and for specific treatment of
many orthopedic complaints, yet its use in the treatment of a major illness like polio was met with
great controversy. The medical community was focused on new scientific methods of cure, not on
something as basic as nurse-provided massage. Particularly in Australia and Europe, there was much
resistance. By the 1940s, with the rise in scientific research and a better understanding of polio,
American physicians accepted massage as part of the recommended therapy. Its scientific merit had
been established; simply put, it worked. Today, massage is used as a treatment for symptoms
associated with numerous medical and surgical conditions.
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CULTURES OF CONTROL: A HISTORICAL ANALYSIS OF THE ROLE OF THE
INFECTION CONTROL NURSE IN IRELAND
Martin McNamara EdD MA MEd MSc BSc
UCD Irish Centre for Nursing and Midwifery History, UCD School of Nursing Midwifery & Health
Systems, UCD Health Sciences Centre, Belfield, Dublin 4 , Ireland
+353 (0)1716 6486 , [email protected]
Gerard Fealy PhD MEd BNS
UCD Irish Centre for Nursing and Midwifery History, UCD School of Nursing Midwifery & Health
Systems, Health Sciences Centre, Belfield, Dublin 4 ,
+353 (0)1716 6461, [email protected]
Ruth Geraghty MSc MA BA
UCD Irish Centre for Nursing and Midwifery History, UCD School of Nursing Midwifery & Health
Systems, Health Sciences Centre, Belfield, Dublin 4
+353 (0)1716 6466, [email protected] , +353 (0)1716 6498
Aim: This paper examines the history of the infection control nurse in Ireland and locates the
emergence and development of the role within wider historical contexts, including the emergence
and evolution of microorganisms and infectious diseases, advances in medical and surgical
techniques, expanded nursing roles, interprofessional working and disciplinary identity.
Rationale and significance: Self-described‖as‖‘the‖first‖of‖the‖clipboard‖nurses’,‖infection‖control‖
nurses were appointed to the major urban teaching hospitals in the late 1970s as a response to the
growing problem of healthcare-associated infections, cross-infection and multi-drug resistant
microorganisms. The experiences of the first incumbents of the role and the nature of their work
have not been examined by historians. This study offers a historical case study with which to explore
key themes in the history of nursing, including the emergence and development of specialist nursing
roles and the contribution of the nursing standpoint to interprofessional working.
Methodology: The study was based on the oral testimonies of eight of the first incumbents of the role
in‖Ireland.‖These‖were‖obtained‖using‖Wengraf’s Biographic-Narrative-Interpretive Method (BNIM).
BNIM elicits narratives of past experience, rather than explicit assertions of remembered positions,
by inducing particular incident narratives (PINs). PINs permit the researcher to access vanished and
mutated times, places and subjectivities. Other primary sources included notes and diaries,
contemporary journal articles, some authored by informants, and reports of the period under review.
Findings: Although the role emerged from and was shaped by contemporary developments in
healthcare, the early infection control nurses pioneered a highly complex role that combined a
distinctive nursing standpoint with knowledge from microbiology, epidemiology, engineering and
hospital design. They quickly set about defining the scope of their practice and established
themselves as scientists, clinical specialists, consultants and professional leaders. Acting as links
between the laboratory and the wards and operating rooms, and working at local and institutional
levels,‖they‖gradually‖overcame‖nursing‖and‖medical‖colleagues’‖resistance‖and‖were‖able‖to‖change‖
practices and techniques, secure better equipment and gradually improve the physical environment.
Conclusions: Informants’‖testimonies‖shed‖light‖on‖the‖founding‖and‖evolution‖of‖a‖truly‖advanced‖
nursing role with a broad organisational remit. Always nurses first, they were able to support each
other, and to secure the necessary resources elsewhere, to shape a specialised, autonomous and
coherent role derived from a clear nursing standpoint and strengthened by evidence from their own
observations, systematically recorded, and from laboratory data.
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Poster Presentations
Wednesday 15th September 2010
BRAZILIAN NURSING PROFESSIONALIZATION: THE PIONEERING OF THE
ALFREDO PINTO NURSING SCHOOL (1890-1920)
Almerinda Moreira, RN, PhD. Associate Professor
Clinical and Medical-Surgical Department Alfredo Pinto School of Nursing
Federal University of Rio de Janeiro State, Brazil.
55 21 2236-5295,
[email protected]
Luciana Barizon Luchesi, RN, PhD, Assistant Professor
Psychiatric Nursing and Social Sciences Department
University of Sao Paulo at Ribeirao Preto College of Nursing.
55 16 36020535,
[email protected]
Aim of study: to rescue the origins of the nursing professionalization in Brazil.
Rationale and significance: to understand the origins of professionalization in Brazil by the light of
the‖first‖School‖of‖Nursing‖the‖‚Professional‖Nurses‖School‛,‖currently‖University‖of‖Rio‖de‖Janeiro‖
(UNIRIO), Alfredo Pinto Nursing School, the pioneer for education of these professionals within the
country.
Methodology: developing this historical study an original documentation was found out for the
nursing historiography. The chronological delimitation was established from 1890 to 1920. The
utilized methodology was an analysis of documents, above all those textual, such as minutes, reports,
books,‖student’s‖frequency‖documents,‖newspapers‖and‖scientific‖journals.‖
Findings and Conclusion: The final results showed: a) the importance for researchers to vary the
research sources; b) that the nursing trajectory in several studied countries presented a similar
interface considering the social-historical point of view; c) the scenario where nursing
professionalism has started off was indeed the Professional Nurses School, considered the very first
official school in the country, set out at the Psychiatric National Hospital; d) that this educational
institution had a positive influence within the Brazilian society.
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HISTORY OF NURSING RESEARCH: DEVELOPING UNDERGRADUATION TALENTS
Luciana Barizon Luchesi, RN, PhD, Assistant Professor
Psychiatric Nursing and Social Sciences Department
University of Sao Paulo at Ribeirao Preto College of Nursing,
55 16 36020535,
[email protected]
Wellington Mendonça de Amorim, RN, PhD, Adjunct Professor of Nursing
Department of Public Health and Coordinator of Graduate Program in Nursing
[email protected]
Fernando Porto, RN, PhD, Adjunct Professor
Federal University of Rio de Janeiro State School of Nursing Alfredo Pinto
[email protected]
Aim of study: to identify the impact of the use of a pedagogical strategy for teaching research
methodology in History of Nursing in a course designed for undergraduate students.
Rationale and significance: The History of Nursing research is still a young movement in Brazil and
developing talents to Nursing History research is a big challenge.
Methodology: descriptive, quantitative research, which had as source of data a self-administered
questionnaire with closed and open questions and an essay prepared by Nursing students at the end
of the course about their perception of the importance of study History of Nursing during
undergraduation program. The course was called ‚Introduction to History of Nursing Research
Methodology Course‛ and had the University of Sao Paulo at Ribeirao Preto College of Nursing, in São
Paulo state and Federal University of Rio de Janeiro State School of Nursing Alfredo Pinto in the
organization. The goal was to allow the students to experience all stages of a research project and its
consequences, also provide a valuable abstract publication in a Brazilian History of Nursing
Congress‖ that‖ enriched‖ the‖ student’s‖ curriculum.‖ In‖ it’s‖ first‖ edition‖ the‖ course‖ had‖ 18‖ participants‖
and as a pedagogical strategy, in addition to dialog classes, the students had the chance of
experienced a period of "immersion", where they visited two of the pioneering Nursing Schools in
Brazil, in the city of Rio de Janeiro, their research centers on the History of Nursing and took classes
taught by teachers of these institutions about History of Nursing research for three days. The course
was conducted from March to June 2009, with 40 hours of theory classes and 8h of visits. With this
methodology, the goal was to sensitize the student to the History of Nursing research context from
the perspective of an alive and dynamic History, using strategies to stimulate critical thinking and
teamwork.
Findings: among the course participants 33.3% participated in the study. It was concluded that the
course‖was‖successful‖in‖the‖student’s‖evaluation‖and‖the‖course‖contributed‖for‖more‖professional‖
mature, scientific and cultural development. Conclusion: there were use of concepts described in the
scientific literature by the students and also presented as impact the production of five micro
research projects and consolidation of an partnership between the two institutions involved in the
course in an Laboratory Studies in History of Nursing (www2.eerp.usp.br/laeshe).
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Page 137 of 137
THE CHALLENGES AND REWARDS FOR THE INTERNATIONALLY EDUCATED
NURSE (IEN) ACTING AS A CLIENT ADVOCATE IN RURAL NEWFOUNDLAND
AND LABRADOR (NL), CANADA
Marilyn Beaton, MScN, MBA, Professor
MUN School of Nursing
300 Prince Philip Drive
St.‖John’s,‖NL,‖Canada
A1B 3V6
709 777 7039
709 777 7037
[email protected]
Jeanette Walsh, MScN, BN, Assistant Professor (retired)
Aim of the Study: To capture the history of nursing in Newfoundland and Labrador (NL) as related
through the stories of nurses who immigrated to practice nursing in a variety of settings throughout
the province. To identify the challenges they faced in their nursing practice? How did nursing
practice in NL compare to their own country? How did they adapt?
Rationale and Significance:
Overseas recruitment of nurses has been a strategy to supplement the nursing workforce in NL for
over a hundred years. It began in 1893 to provide nurses to work in nursing stations in Labrador and
expanded in the 1920s to provide nurses to work in cottage hospitals and as district nurses in rural
areas of the province. Many of the recruits came from large teaching hospitals in the UK only to find
themselves as the lone health care provider in small isolated communities. Many of the nurses did
not feel prepared for the roles and responsibilities expected of them. There is no recorded history of
the experiences of a group of internationally educated nurses who immigrated to NL to practice
nursing. This is the first documentation and analysis‖of‖these‖nurses’‖experiences.
Methodology:
This is an oral history study. Forty-one nurses who immigrated to NL and opted to stay were
interviewed using a semi-structured interview guide. The interviews were transcribed and the data
analyzed for themes and subthemes.
Findings:
Two of the identified themes focused on adaptation to a different nursing and health care system and
the culture of the province. Despite the challenges encountered in their work environment and
adapting to the local culture, these nurses were not deterred when advocating to improve the health
of clients and the communities in which they lived. The poster presents stories illustrating how and
under what circumstances they acted as client advocates.
Conclusion:
Using the provincial professional standards for advocacy the poster reflects findings that
demonstrate the leadership and initiative of IENs acting as advocates to improve the health care of
NL patients and their communities.
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EXPERIENCE REPORTS OF BLACK NURSES ABOUT
RACIAL PREJUDICE AT THE UNIVERSITY
Bárbara Barrionuevo Bonini, RN
Master’s‖student‖in Management of Nursing Services
School of Nursing, University of São Paulo, Brazil.
55 11 94536123.
[email protected]
Introduction: In order to rescue the historical memory of the black presence within the University of
Sao Paulo, more specifically in the School of Nursing (EEUSP) we proposed a study on the
perceptions of nurses trained in this institution of higher education in relation to racial suffered
within the University.
Significance: This proposal is linked to the art and science of care to the extent that forms of
prejudice and intolerance can powerfully influence the action of care, as disqualifying care and who
runs it.
Objectives: To identify and capture perceptions of those people about the prejudices against them at
the University as graduate students in nursing during their academic trajectories.
Methodology: This was, at first, identified through the admittance forms of nurses trained by
EEUSP, between 1942 and 2006, the black graduates. After this, a search within the Regional Council
of Nursing of the State of Sao Paulo raised the contacts of these graduates to offer them participation
in the study. Next, we used the Oral History as a theoretical and methodological framework for data
collection, because this reference enables people to speak freely in their respective contexts. Data
discussion took place after transcription and transcreation of the thirteen interviews.
Results: Since its foundation until the year 2006, EEUSP graduated 2886 nurses, of whom 128
identified‖themselves‖as‖‚not‖white‛‖preferring‖the‖terminology‖‚moreno‛‖for‖self-declaration of skin
color. Were found in the State of São Paulo, 45 black graduated nurses, of which 15 we could have
contact with. Of these, only 2 refused to participate in the study. The reported experiments show that
racial prejudice was a phenomenon present in the academic life of these graduates, manifesting itself
in different situations in the relations of those subjects with three groups: teachers, colleagues and
employees of the University.
Conclusions: For this being a quali-quantitative study, data collection should be limited or for the
largest possible number of interviews, wich was the case, or the repetition of statements. The latter
has become an unlikely event, since there was no significative matching view in reports about
percceptions of the object of study. Although most reports had experienced prejudice at some point
in their academic life, they experiences bring differents points of view, wich reiterates the importace f
advancing and futher research on this topic.
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RED CROSS CONTRIBUTION TO THE NURSING HISTORY
Tiago Braga do Espírito Santo - reporter
Master in Nurse by the Post Graduation Program of Nurse of the Nurse School of the University of
São Paulo (EEUSP).
[email protected]
Taka Oguisso, PhD
Headmaster of the Nurse School of the University of São Paulo (EEUSP)
[email protected]
Escola de Enfermagem da Universidade de São Paulo
55-11-76619443
This paper has the object to‖ study‖ the‖ Red‖ Cross‖ influence‖ on‖ the‖ nurse’s‖ profession‖ in‖ Brazil,‖
through texts by Ms Melle Y. Hentsch, Director of the Nurses Secretariat at the League of Red Cross
Societies,‖whose‖presentation‖was‖done‖at‖the‖IX‖Quadrennial‖Congress’s‖of‖the‖International‖Nurses‖
Council (ICN), held in New Jersey, 1947.
Objectives: to describe the Red Cross internationalization movement; to analyze Ms Melle Y.
Hentsch’s paper‖content;‖and,‖to‖discuss‖the‖influence‖of‖this‖organization‖upon‖nurse’s‖profession.‖
Method - it is a descriptive, historical and social study with domain on the Women´s History and the
theoretical framework on gender by Joan Scott.
Outcomes: regarding the Red Cross internationalization in the Americas it was identified the
presence of at least one representation in each country by the end of the 19 th Century and the
beginning of the 20th.
Conclusion:‖the‖organization’s‖ influence‖on‖ nursing‖ had‖a‖double focus because on one side it has
created a certain mistaking between the concept of the Red Cross nurse and the professional one; but
on the other side, it has contributed to the process of improving professional capacities. It was also
identified a goal to link nursing to women, reaffirming specific social roles to insert them in the
education and labor world.
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Page 140 of 140
‚WORKING DRESS, UNIFORMS, ROBES‛ SWISS NURSES AT
BEGINNING OF THE 20TH CENTURY
Nathalie Briffod, MA, UZH
(History and Philosophy of Education, Social and Economic History, Child and Adolescent
Psychiatry)
Research Unit for Social and Economic History, University Zurich, Switzerland
+41 76 497 4154
[email protected]
Aim of study: A historical perspective regarding vestimentary constructs between 1908 and 1957.
How do vestimentary identities influence the relationship between fashion, professionalization and
the image of women in the healing arts? What power relationships do they create between the sexes?
Rationale and significance: Complex webs of attributions of meaning and connected associations
underlie the uniformed body. For the individual, the uniform embodies a second skin, in which it
subjects the person to symbolic communication. Implicitly, both competencies and duties are
conveyed together.
Methodology: In the foreground stands the legacy of the Swiss Nursing School of Zurich (1901) and
La Source (1859). Annual reports, protocols from nursing organizations along with artifacts,
professional journals and pictorial material will be methodologically prepared and sorted into
filtered categories and a structured content analysis will be undertaken, which should lead to further
and newly developed interpretations. This interdisciplinary method also leaves room for
quantification of the data.
Findings: Critical discussions about vestimentary liberalization were defeated in the years 1908 (the
Bundestracht-national costume), 1918, 1923, 1938 (and then later in 1947 and 1957). In the board of
the‖ nursing‖ association,‖ which‖ convoked‖ a‖ ‚costume‛‖ commission‖ in‖ 1918‖ and‖ included‖ diverse‖
representatives‖of‖nurse’s‖homes‖and‖nursing‖schools‖in‖Switzerland,‖a‖number‖of‖different‖concerns‖
were discussed, including the material production of costumes, negotiations for new models and
disagreement‖about‖the‖terms‖‚uniforms‛‖versus‖‚costumes.‛‖Positions‖and‖opinions‖could‖be‖easily‖
influenced‖by‖the‖persons‖in‖power.‖Here‖and‖there,‖the‖cap‖and‖the‖‚city‛‖uniform‖provoked‖great‖
excitement. Fashionable and technological changes such as wearing colored and decorated shoes
and stockings could not be stopped; on the one hand, after 1929, there were more advertisements for
nurses‖ in‖ the‖ newspaper‖ ‚Blättern‖ der‖Krankenpflege‛.‖ On‖the‖ other‖ hand,‖ people‖ did not want to
forego what was new. However, another element needed to be taken into consideration: healthrelated reasons. Until 1938, the requirements were not relaxed. The rambunctious nurse was
censured for her behavior and created a public sensation.
Conclusion: Intensified discipline and control were implemented as the answer to a rising fear of
modernization. The establishment of a strictly hierarchical dress code brought worldly professional
recognition to female nursing personnel, but also exclusion.
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UNKNOWN ANESTHETIST IN WHITE - OLIVE BERGER, 1922-1967:
AN EMBODIMENT OF NURSE ANESTHESIA IN THE UNITED STATES
Rebekah L. Carmel, CRNA, MSNA, MSN
Student, University of Virginia
Background: A‖black‖and‖white‖photo‖that‖documents‖the‖second‖‚blue baby‛‖surgery‖on‖November‖
29th 1944.‖The‖‚Blalock-Taussig‖procedure‛‖was‖a‖ground‖breaking‖procedure‖that‖would‖save‖the‖
lives of countless children, and is widely considered the dawn of modern cardiac surgery. Identified
in that picture was surgeon Alfred Blalock, chief resident William Longmire and intern Denton
Cooley all giants of cardiac anesthesia in the United States. But like many historical photos some
members‖of‖the‖surgical‖team‖go‖unidentified.‖The‖‚unknown‛‖anesthetist‖in‖white‖at‖the‖head‖of‖the
table is Olive Berger, nurse anesthetist at Johns Hopkins for more than 30 years and who
administered anesthesia for most of the cases performed by Blalock. Olive Berger maintained a
detailed‖notebook‖labeled‖‚Tetrologies‛‖of‖the‖first‖100‖cases,‖as‖well as, the 475 succeeding cases.
During the post-WWII years many changes in anesthesia evolved.
Methods: Traditional historical methods with a social history framework were used in this
investigation. Primary sources included documents from the American Association of Nurse
Anesthetists (AANA) archives (Park Ridge, IL) and Olive Berger Collection located in the Alan
Mason Chesney Medical Archives of the Johns Hopkins Medical Institutions (Baltimore, MD).
Secondary sources, including periodicals, visual media and history texts were also utilized.
This‖investigation‖explores‖Olive‖Berger’s‖life,‖work‖and‖professional‖contributions.‖It‖also‖describes‖
background information about her education, her roles, her publications, her professional endeavors,
as well as, her clinical pioneering efforts and her leadership and advocacy for the development of
nurse anesthesia as a specialty.
Findings: Olive‖Berger’s‖contribution‖to‖the‖practice‖of‖nurse‖anesthesia‖and‖the‖specialty‖of‖cardiac‖
anesthesia was shaped by medical, surgical and anesthetic advances post WWII. The relationships
that she made by being an active member in the AANA assisted her with equipment and anesthetic
technique development, as well as, publication of her work.
Conclusions: Nurse anesthetists have been providing care to patients in the United States for nearly
150 years. Olive Berger and other nurse anesthetists clearly played a significant role in the
development of pediatric and cardiac anesthesia. Their contributions did much to improve healthcare
in the United States.
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Page 142 of 142
THE HEALTH CARE PROVIDED TO HANSEN'S DISEASE PATIENTS HOSPITALIZED IN
THE 1930s AND 40s IN ESPÍRITO SANTO, BRAZIL
Maria Carlota de Rezende Coelho, RN, MSc, Professor at the Escola Superior de Ciências da Santa
Casa de Misericórdia de Vitória,
55 27 33257975 / 55 27 81674433 / 55 27 33343573, [email protected]
Vanezia Gonçalves da Silva, RN, MSc, Professor at the Escola Superior de Ciências da Santa Casa de
Misericórdia de Vitória, 55 27 99456128, [email protected]
Sara Martins de Barros Maestri, RN, MBA, Professor at the Escola Superior de Ciências da Santa
Casa de Misericórdia de Vitória,
55 27 32250323 / 55 27 33343573, [email protected]
Maria da Luz Barbosa Gomes, RN, Professor guidance at the doctor Science the Escola de
Enfermagem Anna Nery da Universidade Federal do Rio de Janeiro,
[email protected] ,
Glivan Ventura da Silva, Historiam, Professor Doctor Science the Program the Postgraduation at
History – PPGHIS the Universidade Federal do Espirito Santo, [email protected] ,
This study aims at analyzing the health care nurses provided for Hansen's disease patients in the
1930s and 40s. The setting was Dr. Pedro Fontes Hospital, in Cariacica, Espírito Santo, Brazil. In this
context, isolation was the only method to treat this disease.
Objective: to describe and analyze the participation of the Vincentian Sisters in nursing care for
patients in this hospital.
Methodology: socio-historical and documental qualitative research using the oral history method.
The primary sources were recorded and fully transcribed reports made by the elderly who are still in
this hospital. The reports were subject to theme analysis after meeting the standards set by the
National Health Board 196/96, which controls ethical aspects of research. Documents and
photographs provided by the hospital were used as primary sources. The secondary sources were
obtained through review of current literature on Hansen's disease, and on Health and Nursing
History in the 1930s and 40s.
Results: As well as other countries, Brazil also adopted the "isolation policy" for the mandatory
hospitalization of Hansen's disease patients in asylum-colonies in the early 1930s. In the Espírito
Santo state, this study hospital was built in 1937 to host Hansen's disease patients, removing them
permanently from external social life. These practices, added to the prejudice and stigma around the
disease, made health care difficult. At that time, the Vincentian Sisters and the patients in better
health conditions who were trained for this task were the ones in charge of nursing care. The
Vincentian Sisters organization was created in the 17th century, founded by Father Vincent De Paul,
in France. The sisters came to Brazil in order to improve and renew health care techniques, which
had been performed by unskillful volunteers. The distribution of the activities developed by the
sisters included coordinating nursing services, and supervising and training nursing actors.
Conclusion: from the data collected through reports, a remarkable history experienced by these
patients could be understood. This included loss of freedom; social life among people who were
often mutilated and disfigured; and recruiting to be health care providers, which was the source of
striking reports.
By the end of the study, we realized the relevance of our contribution to the
records‖of‖this‖institution’s‖history,‖and‖to‖rescuing‖nursing‖care‖history‖in‖ES.
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MERCIFUL ACTS: REREADING THE VINCENTIAN SISTERS MANAGEMENT AT
THE HOLY HOUSE OF MERCY IN VITÓRIA - ES - BRAZIL
Maria Carlota de Rezende Coelho, RN, MSc, Professor at the Escola Superior de Ciências da Santa
Casa de Misericórdia de Vitória,
55 27 33257975 / 55 27 81674433 / 55 27 33343573, [email protected]
Vanezia Gonçalves da Silva, RN, MSc, Professor at the Escola Superior de Ciências da Santa Casa de
Misericórdia de Vitória, 55 27 99456128, [email protected]
Sara Martins de Barros Maestri, RN, MBA, Professor at the Escola Superior de Ciências da Santa
Casa de Misericórdia de Vitória,
55 27 32250323 / 55 27 33343573, [email protected]
Allan Acaiaba Dilly, Undergraduate nursing, Escola Superior de Ciências da Santa Casa de
Misericórdia de Vitória, 55 27 92514287, [email protected]
Jusley Kelli Teixeira Campos, Undergraduate nursing, Escola Superior de Ciências da Santa Casa de
Misericórdia de Vitória, 55 27 98225049, [email protected]
This‖ study‖ aims‖ at‖ analyzing‖ the‖ beginning‖ of‖ the‖ Vincentian‖ Sisters’‖ management‖ in‖ the‖ nursing‖
service at Holy House of Mercy in Vitória; because we understand that this is the rescue of an
important part of Nursing History in our state.
Objective: to describe the insertion of the Vincentian Sisters in the modern nursing service
organization at Holy House in Vitoria.
Methodology: socio-historical study on the 19th century. This is a historical synthesis based on a
review of the relevant literature. The primary sources are photographs and documents available at
the Public Archive of the State of Espírito Santo, whereas the secondary source is the literature about
Nursing History in Brazil and in Espírito Santo; History of Brazil and the State; and Public Policies.
The analysis of documents was carried out through the inductive research approach, aiming at
identifying the social, political, and religious position of the authors. The photographs were analyzed
with the theoretical support of Cardoso and Vainfas (1997).
Results: The creation of the first Holy House of Mercy took place in 1498, in Portugal. In Brazil, the
first ones were created in 1543 in Santos, and in 1545 in Vitória so as to provide services to meet the
moral, bodily and religious needs, by people with no scientific qualification. Although the institution
needed educated personnel, who were willing to apply the scientific knowledge of this profession,
the concern about the type of care provided had always been constant. Therefore, in the early 19th
century, the Hospital management resorts to the French Sisters of Charity in order to improve the
techniques used and to renew the health care methods at the Holy House. The Vincentian Sisters
organization was created in the 17th century, founded by Father Vincent De Paul, in France, and it
has been in existence since then. In 1900, the first Vincentian Sisters arrived at the Holy House in
Vitoria. They were: Sisters Luíza Pirnay, Maria Luíza Maynardier, and Vicência. The activities
developed and assigned by the sisters were the coordination of general nursing services, pharmacy
supervision, nursing actors training, and even direct care of hospitalized patients. The photos and
documents show the veneration and respect these sisters earned, especially sister Pirnay.
Conclusion: The historical analysis of the sisters allowed us to understand that the evolution of
nursing‖is‖related‖to‖the‖sisters’ history in such way that they have also influenced the dynamics of
the profession in this state.
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HISTORY OF NURSING: EDUCATION, TRAINING AND PROFESSIONAL ORIENTATION
Alessandra Rosa Carrijo, RN
PhD student of Program Graduate Nursing
School of Nursing, University of Sao Paulo.
(55-11) 9814-7360.
[email protected]
Maria Madalena Januário Leite, RN
Associate Professor of Department Guidance School of Nursing
University of Sao Paulo, Director of Education. Brazilian Nursing Association.
Aim of study: The work proposed here is part of a study in development, which analyzes the
teaching of Nursing History in the School of Nursing, University of São Paulo - EEUSP. Based on the
presuppositions of skills for pedagogy, the study wants to identify, in the training of nurses, the role
that subject in the teaching-learning process.
Rationale and significance: The subject Nursing History is taught in the undergraduate course of
EEUSP since its foundation in 1942. After the implementation of the Law of Directives and Bases of
National Education (1996) and the National Curriculum Guidelines for Undergraduate Courses in
Nursing (2001), both guided by the Report of the International Commission on Education for the 21st
Century, UNESCO, the process of teaching and learning in nursing came to value the prospect of
teaching competences, which aims to establish a holistic professionals, your skills, abilities and
knowledge, as recommended by Philippe Perrenoud.
Methodology: Exploratory-descriptive, with a qualitative approach, the research use documents to
retrieve aspects of the teaching of Nursing History in EEUSP, given the importance of its history in the
reconfiguration of the Brazilian nursing post-1930, significantly influenced by the American model
brought by nurses of the Rockefeller Foundation. The primary source documents are the syllabus
used in the 1960-1970 decades and the secondary sources are characterized by periodic publications.
Findings: The syllabus consulted have contents bout the systematization of pedagogical actions.
They have, initially the identification of the areas of education, with workload, period and number of
students; goals for both the scope of the teacher, and the student; content, in chronological order of
events; teaching methods used; evaluation and bibliography. The proposal resized the nursing
education in Brazil.
Conclusions: It is believed that the subject contributed decisively to the legitimacy of the profession,
supporting the practice in the aspects related to care, management, teaching and research. The
documents reviewed show that the training of nurses was guided through the formation of cognitive
skills and attitudes, even if this new pedagogy was not actually implemented. The syllabus of the
Nursing History contemplated the steps to academic planning recommended by present-day
academic didactic-pedagogical currents and demonstrated that their teachers planned the lessons
aiming to achieve congruent objectives to skills training while they strengthened professional
identity.
144
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TRAINING/EDUCATION OF NURSES AND MIDWIVES IN PORTUGAL
XIX-XX CENTURY
Maria Alice dos Santos Curado, Pediatric Nursing, Coordinator Professor, Superior School of
Nursing of Lisbon; Master Degree Child Development, Statistic Degree in Universidade Nova de
Lisboa and ‚Doctorate‛‖in‖Human‖Development,‖Specialist‖Mathematical‖Methods‖in‖Universidade‖
Técnica de Lisboa;
+351 962523284
[email protected]
Marília Pais Viterbo de Freitas, Nursing Degree, Public Health Nursing Specialization, History
Degree Universidade de Lisboa, Master Degree in Women Studies Universidade Nova de Lisboa;
Maria Isabel Soares, Nurse, History Degree and Master Degree in Education Sciences Universidade
de Lisboa.
The aim is‖to‖give‖a‖contribution‖to‖the‖Nursing‖education‖and‖midwifery’s‖history‖in‖Portugal‖in‖the‖
XIX-XX century.
Rationale and significance: To share some aspects of nursing/midwiferies education and training in
Portugal.
Methodology: is supported in different kind of documents: Official Papers, bibliographies and
selected documents from the schools archives.
Findings:‖Since‖the‖seventeen‖century‖there‖was‖a‖concern‖to‖‚instruct‛‖the‖nurses‖so‖they‖could‖take‖
care of the sick and obey with medical prescriptions, as shown in works published in Portugal, under
the‖title‖‚Guide‛‖or‖‚Manual‛. However, historically speaking, the schools for midwives where the
first to formally be created in 1836 following a change to the curriculum of the University of
Coimbra, and 1837 in the medical schools of Lisbon and Porto. First attempt to start training nurses
in an organized way begun in 1881, in the University Hospitals of Coimbra, followed in 1886 the
creation of the course for nurses in the Royal Hospital of St. Joseph in Lisbon and then in 1896, in the
Hospital de Santo António in Porto. In the first decades of the twentieth century other schools of
nursing were created, public and private schools. In 1940, the Rockefeller Foundation supported the
creation of a nursing school attached to the Portuguese Institute of Oncology, which would
contribute greatly to the development and training in nursing. In 1942, 1947 and 1952 occurred
reforms of the curriculum and regulation of schools. But it is with the establishment of the Ministry
of Health in 1958 in which its structure contained a Department who was coordinating all nursing
education both public and private that took place significant changes in nursing education.
Meanwhile, there were created specialized courses in nursing. Later in 1982 these courses also
prepared for teaching and for management positions in nursing services. Until 1988 the
education/training of nurses is under the responsibility of the Ministry of Health and changed in this
year when the education of nurses was integrated into a national education system at the polytechnic
level. In 1999 the network of nursing schools was reorganized and education in nursing is grants a 4
year
degree.
Conclusions: The development of nursing education since the fifties was visible due to the
commitment of professionals to their role. The political and social changes that occurred in 1975 had
a decisive influence on the development of the profession and working conditions of nurses. So at the
end of the 20th century, nurses could enter the universities and apply to a master and PhD degrees in
nursing and other subjects.
Keywords: nursing, midwives, education, training, history.
145
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HEATH CARE IN PORTUGAL FROM 13TH CENTURY TO 20TH CENTURY
Maria Alice dos Santos Curado, Pediatric Nursing, Coordinator Professor, Superior School of
Nursing of Lisbon; Master Degree Child Development, Statistic Degree in Universidade Nova de
Lisboa and ‚Doctorate‛‖in‖Human‖Development,‖Specialist‖Mathematical Methods in Universidade
Técnica de Lisboa;
+351 962523284
[email protected]
Marília Pais Viterbo de Freitas, Nursing Degree, Public Health Nursing Specialization, History
Degree Universidade de Lisboa, Master Degree in Women Studies Universidade Nova de Lisboa;
Maria Isabel Soares, Nurse, History Degree and Master Degree in Education Sciences Universidade
de Lisboa
We have only a few studies about Nursing History in our country.
The aim of this study is to show what Portuguese nurses have done in the past until now and to
understand future nurse competences.
Rationale and significance: To share the evolution of care and healthcare in Portugal from 13th
Century to 20th Century.
Methodology: Official papers, Manuals, Hospital Regulations and professional papers.
Findings: From the 13th to 15th Centuries, care is done by the monastic orders that take care of
voyagers as patients. There where also small hospitals organized by rich people or by workers. Only
poor people go to the hospitals; the families that could pay have home care. At the 15 th Century King
John‖ the‖ second‖ starts‖ to‖ build‖ the‖ ‚Hospital‖ de‖ Todos‖ os‖ Santos‛‖ and‖ Queen‖ Leonor‖ creates‖ the‖
Charitable Institution both of them in Lisbon. These Charity Institutions were developed all over the
country. Caring is done by nurses (men and women) and by midwiferies (only women). All of them
learn‖ from‖ each‖ other‖ because‖ nursing‖ and‖ midwifery‖ education‖ doesn’t‖ exist‖ at‖ the‖ time.‖ Their‖
competences were established on the Hospital Regulations and on the Manuals. Only the
midwiferies have to do an official examination since 16th century. The midwiferies education starts in
1936,‖when‖the‖Medical‖Surgical‖Schools‖are‖created‖in‖Portugal.‖The‖nurse’s‖education starts in 1891
in‖ Coimbra‖ and‖ in‖ 1896‖ in‖ Lisboa‖ and‖ Porto.‖ Since‖ 1949‖ the‖ nurse’s‖ career‖ in‖ the‖ hospitals‖ were‖
regulated by law. This law changes almost twenty years later in 1967 including for the first time the
three‖ areas‖ of‖ nurses’‖ intervention,‖ practice care in hospital, in community care and nursing
education. During more than 100 years the nurses and midwiferies education changed not only
because of the science evolution but also because of the study and engagement of these professionals.
At the end of 19th Century (1895) the midwiferies create their first professional organization and the
nurses create their first Trade Unions in the beginning of the 20 th Century (1926). Finally in 1998 was
created the Nurses Order. The nursing career evolved in different occasions. Conclusions: The
political and social changes that occurred in 1975 had a decisive influence on the development of the
education, profession and working conditions of nurses. The development of quality of care was due
to the organization of the National Health Service in 1976, but also and specially by the commitment
of nurses in different areas of practice care
Keywords: nursing, midwives, training, profession, history.
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Page 147 of 147
REVOLUTIONARY MEDICAL TECHNOLOGY AND THE DEVELOPMENT OF
INTENSIVE CARE NURSING AT THE UNIVERSITY OF VIRGINIA HOSPITAL 1954-1975
Sarah White Craig, BSN, RN, CCRN
MSN candidate May 2010
University of Virginia School of Nursing Masters Student
1-434-770-3739
[email protected]
Aim of study: The purpose of this study is to examine cutting edge medical technology and the
development of intensive care units (ICUs) at the University of Virginia Hospital, and the impact of
the development of ICUs on the nursing profession, interdisciplinary collaboration, and patient care.
Rationale and Significance: The development of intensive care units (ICUs) in the mid-1950s and
early‖1960’s‖influenced‖sweeping‖change‖in‖the‖nursing‖profession.‖‖ICU‖nursing‖was‖a‖bridge‖to‖
interdisciplinary education and collaboration between nurses and physicians. The call for higher
level nursing care units aided in nursing education expansion and higher expectations and respect
for the nursing profession. ICU nurses mastered new technology at the bedside in order to care for
critically ill patients. The University of Virginia serves as a case study to add to the existing
knowledge of the development of ICUs, and contributes significant information about the history of
a large medical center in central Virginia.
Description of Methodology: This study used traditional historical methods with a social history
framework. Primary sources include the UVa hospital newsletter, personal interviews with former
staff, and personal papers from physicians, administrators, and nurses involved in the ICU
development. Secondary sources include historical accounts of the development of intensive care
units across the U.S. in the1950s-1960s for comparison to data on the development of an ICU at the
University of Virginia Hospital.
Findings and Conclusions: The concept of intensive care units emerged in 1953 and early 1954 in
Chestnut Hill, PA, Chapel Hill, NC, Albany, NY, Manchester, CT, and Hines, Ill. On par with other
growing medical centers, UVa Hospital opened a post anesthesia care unit (PACU) in 1954 and
subsequently K-Unit‖opened‖in‖March‖1956,‖as‖UVa’s‖first‖ICU.‖‖The‖application‖of‖new‖skills‖and‖
technology in the ICU fostered the growth of interdisciplinary collaboration among health care
teams. Emphasis on medical technology and pathophysiology in nursing education improved
nursing knowledge and advanced the nursing profession. The ability of the bedside ICU nurse to
recognize lethal arrhythmias and defibrillate patients epitomizes the role of technology in the
evolution of nursing care. The intensive care unit was made successful through the innovative,
pioneering work of nurses who blended their compassion with knowledge and technology to
improve care of the critically ill patient.
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‚THE BLUEBIRDS‛: REMEMBERING AND FORGETTING
CANADIAN NURSE CASUALTIES OF THE FIRST WORLD WAR
Dianne Dodd, PhD, Historian
Coordinator,‖Women’s‖History‖Initiative
Parks Canada,
5th Floor, 25 Eddy Street (25-5-R)
Gatineau, Quebec
Canada
K1A 0M5
819-994-5537
[email protected]
Aim of Study: To present a poster session on research-in-progress concerning the commemoration of
over 60 Canadian nurses who died while serving as Nursing Sisters for the Canadian Expeditionary
Forces during the First World War. This proposal relates to the‖theme‖‚military‖history,‖power‖and‖
conflict.‛
Rationale and Significance: There is a great deal of ambivalence and outright silence surrounding
the deaths of nurses during war. While some deaths were exploited for their propaganda value, there
has been little official recognition at the commemorative level that nurses made, in the nationalist
discourse,‖‚the‖ultimate‖sacrifice.‛‖This‖session‖will‖report‖on‖research‖to‖examine‖commemorations‖
of nurses in Canada and investigate the impact of gender on notions of wartime service and sacrifice.
Further, the study will tell the stories of these largely forgotten women.
Methodology: The study draws on recent historiography in the history of nursing and the field of
historic memory. The author will present visual and textual analyses of several national, and some
provincial, monuments and historic markers as well as an official war art program. Using website
databases, secondary literature and primary sources, the author will examine local commemorative
plaques, monuments and other remembrances to determine whether these differ from national
markers.‖The‖study‖will‖also‖use‖the‖nurses’‖service‖records‖to‖provide‖a‖sketch‖of‖how‖the‖they‖lived,‖
served, and died, and to examine how they saw their role during wartime.
Findings and Conclusions: Approximately half of the nurses died as a direct result of enemy attack,
six from hospital bombings in France and, fourteen from enemy attack of a hospital ship. The latter
event was exploited to motivate Canadian troops in the‖war’s‖final‖offensive.‖Many‖nurses‖also‖died‖
as a result of illness, particularly during the Spanish flu pandemic. Despite this, with one exception -a memorial in Parliament funded entirely by nurses -- little has been done to publicly recognize their
sacrifices. For example, there appears to be a reluctance to put the names of nurse-casualties on
monuments, especially at the national level. The names of military nurses are buried among those of
the thousands of soldiers whom they served. While their nurturing work has been acknowledged,
military nurses have never been accorded status as war heroes who in some case gave their lives for
the‖‚cause.‛‖
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WIDOWED DURING PREGNANCY: REALITIES FROM SEPTEMBER 11TH
AND THE WARS IN IRAQ AND AFGHANISTAN
Mary Ellen Doherty, PhD, RN, CNM
Professor of Nursing
Western Connecticut State University, Danbury, CT, USA
(978) 807-5320
[email protected] [email protected]
Elizabeth Scannell-Desch, PhD, RN, OCNS
Professor of Nursing
Mount Saint Mary College, Newburgh, New York, USA, 12550
(845) 702-0800
[email protected] [email protected]
Aim of the Study: This study describes the lived experience of widowhood during pregnancy as
defined by ten widows whose husbands were killed in the September 11, 2001 terrorist attacks or
while they served in the U.S. military during the Iraq and Afghanistan wars.
Rationale and Significance: Most widowhood research is generally found in the
gerontological literature. The majority of studies have focused on widows in their sixties or older.
These studies have primarily examined specific variables such as depression, social support,
loneliness, grief response and anxiety in older widows. No studies, to date, have examined the
experiences‖of‖widows‖who‖were‖pregnant‖at‖the‖time‖of‖their‖husbands’‖death.‖‖We‖need‖to‖only‖
look at recent history to see that the numbers of childbearing age widows are rising. Recent terrorist
acts, such as the attacks in New York City, Washington, D.C., Israel, Madrid, Bali, and London, and
the wars in Iraq and Afghanistan have contributed to the increase in young widows.
Methodology: Purposive sampling was used and data were generated using four core questions.
The research methodology was phenomenology, and interviews were conducted until data
saturation was achieved. Data were analyzed using procedures adapted from Colazzi and the
constant comparative method. Findings were integrated into an exhaustive description of
widowhood during pregnancy. Thematic content was validated by study participants.
Findings: Eight‖themes‖emerged‖from‖data‖analysis:‖Denying‖vs.‖dealing‖with‖reality:‖‖He’s‖not‖
coming home; Navigating pregnancy: Flying solo while running on empty; Planning for birth:
Gathering my team; My safety net: A band of sisters; Unplanned journey: A bittersweet
homecoming; Being there: Network of family and friends; Not being there: Let down by others; and
Re-creating home: A new normal. The themes described the emotions, vulnerability, challenges, and
issues experienced by these women. This study gave the women who became widowed while
pregnant a voice.
Conclusions: Women’s‖health‖care‖providers can serve as advocates for widows as well as teaching
others about the grieving process. People are looking to midwives, maternity nurses and other
health professionals for advice, support, and guidance to help those families affected by loss during
pregnancy.
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STRESSORS LIVED BY PATIENTS OF INTENSIVE THERAPY AND COPING STRATEGIES:
A STUDY DIRECTED TO NURSING ASSISTANCE.
Maria Edla de Oliveira Bringuente,
Isabel Cristina dos Santos Oliveira
Objectives: describe the stressful situations lived by patients of Intensive Care Unit (ICU); analyze
the coping strategies used by the patients; and to discuss about the interrelation of the situations and
the coping strategies used by those patients.
Rationale: This study is research of descriptive nature, a case study with qualitative approach. It was
chosen as theoretical referential, the Neuman’s‖(1989)‖studies for patient and environment concepts;
the‖ Geertz’s‖ (1989),‖ Thompson’s‖ (1999)‖ anthropological‖ concepts‖ about‖ the‖ culture;‖ and‖ Heller’s‖
(1993) theory of feelings.
Methodology: Eleven (11) patients of both genders participated of the study, and they kept conscious
during the internment period, on average four days in the ICU of a university hospital in Brasil. It
was used semi-structured interview and free observations with annotations in field diary. Based on
statements and observations, it was realized the thematic analyses. The empirical categories were
coming‖ up‖ from‖ the‖ patients’‖ speeches‖ and‖ they‖ were‖ named:‖ environmental‖ stressors,‖ stressors
produced by the care deficiency and stressors originated from the relation between nursing/patient.
The feelings category received two subcategories, the impulsive and the affective feelings. Finally,
the coping strategy category.
Results: The analyze of the‖patients’‖speeches,‖it‖was‖proved‖that‖the‖environmental‖stressors,‖such‖
as, the noises produced by equipments, by the dynamic of care in the attendance to the urgencies and
emergencies, the moan of pain, the sensory and cultural deprivation were noticed of different ways
by all the patients. The stressors originated from the care deficiency were related to the position,
immobilization and limitation in the bed, difficulty in the communication due to respiratory
prosthesis. The stressors related to the relationship between nurse/patient were originated by the
deficiency of interactive and empathetic elements. The feelings lived by the patients were: fear of
death, loneliness, sadness, shame due to the lack of privacy and liberty. Regarding to the coping
strategies: pray, call for God, escape and death desire.
Conclusions: The stressful demands lived by the patient in the ICU were many. About the coping
strategies prevailed the ones considered ineffective. It was identified the need of humanization care
and systematization of the assistance; the culture and the feelings were considered important to the
care of nursing to that patient.
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ART SENSITIZING STUDENTS TO NURSING HISTORY
Maria Edla de Oliveira Bringuente,
Elda Coelho de Azevedo Bussinger,
Roseane Vargas Rohr,
Eliane de Fátima Almeida Lima,
Dherik Fraga Maxson de Paula Souza.
Doctor in nursing, teacher of the Nursing School of Federal University of Espírito Santo – Brazil.
55- 027 -32220620.
[email protected]
Objectives:To report the experience in the extension project that associates education and research,
and uses art through drawings, painting and photography to arouse nursing students' interest in the
history of their profession.
Rationale: Art has always been strongly related to science. In the 17th century, art revealed the
studies of anatomy when dissecting bodies was not possible. The works of Debret show some health
care practices in Brazil.‖ ‖ Oswaldo‖ Cruz’s‖ expeditions‖ in‖ the‖ 20th‖ century‖ used‖ photography‖ to‖
portrait‖ people’s‖ life‖ conditions‖ in‖ the‖ countryside‖ of‖ Brazil.‖ ‖ The‖ arts‖ reveal‖ historical,‖ social,‖ and‖
cultural aspects in the construction of knowledge and health, and they could be better explored in
nursing‖history‖classes.‖‖‖The‖project‖‚life images: drawing, painting and photography revealing health care
throughout history‛, started in January 2007, in Vitória-ES, Brazil. It approaches extension, teaching
and research, involving nursing students and professors in the process of linking art to nursing
history.
Methodology: A national and world historical study on nursing was carried out identifying images
and personalities that played an important role in this profession. The internet, books, and historical
archives were used as bibliographical sources. Miniatures reproducing the clothes worn by nurses in
different periods of history were made. The criterion to select the personalities who had an
important part in nursing history was the availability of information and photographs about them.
These‖personalities’‖life‖history‖was‖investigated,‖and‖their‖miniature‖uniforms‖were‖made‖according‖
to the images found. The project counted on the help of fashion design students.
Results: Thirty uniforms were made to represent periods in the nursing history and the memorable
personalities of this profession. These miniatures were exposed in cultural exhibitions hosted by
nursing schools, health care units, and scientific events, sharing information on nursing history. It
was verified that the clothes worn by nurses in different periods of history show a religious and
military influence.
Conclusions: Carrying‖ out‖ this‖ project‖ aroused‖ students‖ and‖ professors’‖ interest‖ in‖ the‖ history‖ of
nursing. This encouraged further studies and the participation in events in this area. Also, it
triggered the process of creating the first Center for Nursing History in the state. Approaching art
and history of nursing is fundamental in teaching history in this field. This project has shown
favorable results, which allows developing new methodological strategies in nursing history
teaching.
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INCORPORATION PROCESS OF HERMANTINA BERALDO NURSE SCHOOL TO THE
FEDERAL UNIVERSITY OF JUIZ DE FORA/MINAS GERAIS/BRAZIL
Mariangela Aparecida Gonçalves Figueiredo – rapporteur
Suely de Souza Baptista
University Hospital of the Federal University of Juiz de Fora/Minas Gerais/Brazil
Rua Catulo Breviglieri , s/nº - Bairro Santa Catarina - Juiz de Fora/Minas Gerais/Brasil
32 99791183
[email protected]
Introduction: This is a historical – social study which aims at describing the process of incorporation
of Hermantina Beraldo (FEHB) to the Federal University of Juiz de Fora/MG (UFJF), within the
period of 1977 to 1983. Aims: describe the implications related to the creation of the Nursing Course
of UFJF to FEHB; analyze the power relations which determined the extinction of FEHB; and discuss
the symbological struggles that went through the incorporation process of FEHB to UFJF.
Methodology: Primary sources: written documents from the extinct archives of FEHB and of UFJF,
and oral testimonies of the agents involved in this process. For collecting the testimonies it was
necessary to make use of the theme based oral history telling, by means of semi-structured interviews
with 16 different agents. Secondary sources: thesis, essays, books which talk about educational and
health public policies, of the History of Brazil, of the History of Education and of the History of
Nursing. The discussion towards the results was directed by Pierre Bourdieu concepts of: habitus,
fields,‖ social‖ space,‖ capital,‖ power,‖ fight‖ and‖ symbolic‖ violence.‖ Results:‖ During‖ the‖ 1970’s‖ The‖
University Issues Department of Culture and Education Ministry (DAU/MEC) undertook efforts to
create nursing courses at many federal universities. Thereby, UFJF, under the pressure of DAU/MEC
to create its own Nursing Course, kept negotiations with the leaders of FEHB looking to incorporate
this school to UFJF. As these negotiations came to a failure, in the end of 1977, UFJF opened its own
nursing course. In 1978 UFJF took over, once more, the negotiations with FEHB in order to
incorporate only its social board, represented by teachers, workers and students. It was also fund a
Nursing Department connected to the Medicine College in order to allocate both Nursing
Department and Medicine School at the same social space of the University. It is important to say that
these negotiations took place without the participation of neither board of directors nor FEHB board
of teachers. Conclusion: According to this context, it is possible to ascertain that the leaders of
DAU/MEC held the authorized speech to validate the idea that the incorporation of FEHB social
board would be consolidated to make possible the creation of the Nursing Course of UFJF, as in fact
happened.
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FOUR PORTUGUESE NURSES TO REMEMBER
Marília Pais Viterbo de Freitas, Nursing Degree, History Degree, Master Degree in Women Studies,
+351 962596781 Unable to attend
[email protected]
To be presented by Maria Isabel Soares
The Aim is to remember Portuguese nurses that have changed the nursing care in our country.
Rationale and significance: To share the contribution of 4 important nurses in and their contribution
in different areas of nursing
Methodology: Institutional processes, personal curriculum, interviews with colleagues and family.
Findings: Fernanda Alves Diniz was a holder of a scholarship of Rockefeller Foundation to Canada;
Director of Technical Nurses School was invited by WHO as advisor to the nursing service area. She
was invited as an advisor to the nursing services to European Region and later on to Sponsor of
Nursing Unity at World-Wild. Until now she is remember in many countries and many colleagues.
Maria Fernanda Resende, Teacher at Dr. Angelo da Fonseca Nursing School and General Nurse of
the University Hospital in Coimbra. She was the first nurse to have this high position in a Portuguese
Hospital. Later on was invited to be Director of Santa Maria Hospital and Santa Maria Nursing
School Hospital in Lisbon. In 1962 was nominated Director of the Hospital Nursing Services of
Ministry of Health, which was responsible for nursing practice and nursing education. Maria de
Nazareth Palheiro, paediatric Chief Nurse in Santa Maria Hospital, fought for the nurses autonomies,
for carrier of childhood educators and most important of all it was her work with the hospital
administration with the parents where they could stay with their children during their
hospitalization in the paediatric units. She influenced legislation that allowed the presence of the
parents in the units published in 1981. Rosélia Ribeiro Ramos studied public health in the United
States of America and Canada. She was the first nurse working in The Lisbon Health Centre, founded
and supported by the Rockefeller Foundation. She introduced the maternal and child care in public
health centres. She was also responsible for the introduction of the teaching of public health in
schools of nursing.
Conclusions: These nurses were very import for the development of nursing in Portugal and we can
never forget their work. They are Nurses to remember when we talk about the history of nursing in
Portugal.
Keywords: nurses, profession, care, education, history.
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"THE «HOUSES OF APPROVAL» OF THE NURSES OBREGONES IN THE SPAIN OF
THE 16TH CENTURY: PRECEDENTS OF OUR SCHOOLS OF NURSING?"
Manuel Jesús Profesor Asociado en la Escuela Universitaria de Ciencias de la Salud de la
Universidad de Sevilla (Departamento de Enfermería).
Antonio Claret García Martínez Profesor Titular de Paleografía y Diplomática en la Facultad de
Humanidades de la Universidad de Huelva.
619 902 546
954 551 484
[email protected]
Aim of study:
To demonstrate how in the Spain of the second half of the 16th century, the nurses'
congregation founded by Bernardino de Obregón designs and creates a whole network of centers
specialized for the education of the nurses, based these in the contemplation of the patient in his
three side: biological, psicogical and social.
Rationale and significance:
In the history of the Nursing, the knowledge of the contributions of the nurses' congregation
obregones, investigated from beginning of the decade of the 90 of last century, is an important
change in the vision that we had of the modern Nursing, aspects known from the 19th century: the
diet, the hygiene, isolation of the patient, methodical employment of the technical nurses, control and
record of the elegant ones and other aspects start being clearly implemented in this period. This
education was obtaining in called "houses of approval" of the nurses obregones.
Methodology:
Research developed in different centers of documentation of Spain and Portugal (nationals archives,
libraries and other Institutions).
As sources we emphasize administrative documentation generated by nurses, biographies,
rules of congregations, scientific agreements elaborated by nurses of the XVIth and XVIIth centuries
(manuscripts and printed), that have been transcribed and analyzed, which has provided an
abundant and valuable information of the object of study, besides chronicles of cities, iconographic
material, hospitable buildings, maps and planes, etc.
Findings:
We announce the existence in the Spain of the 16th century of centers specialized for the
training: the "houses of approval" of the nurses obregones; the formative process of the nurses
obregones and the education they were receiving, recognized to the current Nursing: assistance,
teaching, research and management - administration.
Conclusions:
Of all, it is possible to conclude that in the 16th century very significant changes are produced
in the way of understanding‖the‖service‖of‖nurses,‖in‖what‖it‖influenced‖decisively‖these‖‚houses‖of‖
approval‛,‖ which‖ there‖ were‖ providing‖ nurses‖ qualified‖ for‖ the‖ assistance‖ in‖ many‖ hospitals,‖
penitentiary institutions, army and navy and, even, for the domiciliary assistance.
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THE PUBLIC IMAGE OF THE NURSING PROFESSION: HOW DOES IT INFLUENCE THE
SELF-CONCEPT OF NURSES AND THE WAY THEY PRESENT THEMSELVES?
Yvonne ten Hoeve,, MA
Petrie F. Roodbol, RN, MScN, PhD
University Medical Center Groningen
Hanzeplein 1, P.O. Box 30.001
9700 RB Groningen, The Netherlands
+31 50 3619272
[email protected]
Aim of the study
This study will try to map out the factors that determine the public image of the nursing profession.
In addition, the consequences this conceptualization has on the self-concept of nurses and the way
they present themselves will be examined.
Rationale and significance
Despite the advanced standard of nurses, achieved by bachelor or master level education, the image
of nurses in the Netherlands leaves much to be desired. Nurses have developed themselves into
professionals with a great deal of knowledge, amongst others translated in nursing protocols and
guidelines. However, the public still does not recognize nurses for the skills they have; the
quintessence of their work is unclear. The way the media portray nurses, may give a clue to this
perceived image.
Methodology
Relevant articles were identified through the electronic databases of Pubmed, Cinahl and Psychinfo.
Key‖words‖used‖were‖‚nurses/psychology‛,‖‚nurses‛,‖‚nurse’s‖role/psychology‛,‖‚public‖image‛,‖
‚professional‖image‛,‖‚self-concept‛,‖‚perception‛‖and‖‚social‖identification‛.‖Inclusion‖criteria‖
included: original research (written in English); published between January 1997 and December 2009.
Findings
What‖is‖known‖about‖nurses’‖image‖is‖from‖the‖perspective‖of‖the‖media,‖the‖public,‖other‖healthcare‖
professionals and nurses themselves. This image is not corresponding with the professional standard
nurses have achieved by education. The different levels of education and accompanying skills are not
clear to the general public.
The‖public‖image‖may‖also‖be‖related‖to‖the‖nurses’‖self-concept. According to the social identity
theory, everybody aims at a positive self-concept, which not only consists of a personal identity, but
also of a social identity. This social identity refers to the groups among which people reckon
themselves, together with the emotional interest and the value they attach to these groups. When a
group is evaluated in a positive way, the members of this group will accentuate their membership,
because this will boost their morale and self-concept.When a group, like nurses, is evaluated in an
underestimated way, this can negatively contribute to their self-concept and to the way they promote
themselves.
Conclusion
The‖public‖image‖of‖nurses‖may‖influence‖nurses’‖self-concept and presentation. This study indicates
that nurses must work together, as a group, to level up the image of their profession. Studies on this
subject need to be further enhanced, since the image of the nursing profession has a strong impact on
the recruitment and retention of nursing staff in the Netherlands.
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THE GREEK MILITARY NURSING AND ITS PASSAGE
FROM THE PAST TO THE PRESENT
Karathanasi Kostantinia, Captain, RN
Specialized in Operating Room in BAMC TX USA,
M.Sc cand., in Management of Health Departments,
Malliarou Maria, Sarafis Pavlos
Nurse Department of Non-Commissioned Officers School
00306942470814
[email protected]
Aim of study: The history of Greek military nursing and its importance to
Greek nursing
Methodology: The history of Greek military nursing starts in the late 19th century. The parallel
development of Greek Red Cross, founded in 1877 and‖ it’s‖ creation‖ of‖ the‖ School‖ Nurses‖ in‖ 1911,‖
fueled Greek Army with nurses which were mobilized in 1940 and framed 58 military hospitals, and
treated nearly 50,000 wounded. Many of them lost their lives in the performance of duty and others
followed the Armed Forces in the Middle East. Top of the above, was named Athena Mesoloras.
After the World War 2 and the dramatic adventures of the Medical Corps, there was a strong need of
trained and military capable nurses in order to staff the Military Hospitals. So in 1946 by decision of
the political and military leadership, the first Military School of productive women established with
the task to supply the armed Forces with Nursing Officers who are appropriately trained and able to
fulfill their double mission, both as officers and as nurses. The first educational staff of the School,
which was comprised of graduates of the Nursing School of the Greek Red Cross and the hospital
‚Evangelismos‛,‖was‖significantly‖assisted‖by‖the‖Nursing‖ Officers‖of‖the‖English‖ Military Mission.
An important assistance in organizing the first steps for the operation of the School was given by
Colonel Hambly an Englishwoman which served in the English Military Mission of the Queen
Alexandra.
The first students Irini Stauridou, Sotiria Chatzifotiadou, Zoi Pahia and Alexandra Xomeritaki
entered the school on 14th November of 1946 and their zeal and selflessness displayed was
exemplary. After the departure of the English women officers, the above new Greek women officers
were transferred to military hospitals outside of Athens in 1949. Thus, the School and the College had
desperate need for a Director to be effectively organized. Cleopatra Avagianou was selected to fill
this position, the Management of "Military School Nurses Queen Frederica"(as the School was then
named).
Conclusion: In 1956, ten years since its inception, the Military School of Nursing (MSN) became
interdisciplinary nature and began staffing the hospitals and the three branches of the Armed Forces.
Today and from 1992,‖the‖MSN‖acquired‖its‖own‖permanent‖facilities‖in‖‚Saketta‖A‛‖military‖camp‖in‖
Athens and since 2004 the academic training is provided from the Department of Nursing Studies at
the University of Athens.
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ORAL HISTORIES OF IRISH CIVILIAN NURSES IN ENGLAND DURING WW2
Jacinta Kelly, MSc, RN, H. Dip. FFNMRCSI
School of Nursing and Midwifery
Trinity College Dublin
24‖D’‖Olier‖Street
Dublin 2
Ireland
00353-1-8964031
[email protected]
Aim
The aim of this study is to understand the role and contribution of Irish civilian nurses in England
during WW2 – 1939-45.‖The‖objectives‖of‖study‖are‖to‖reconstruct‖Irish‖civilian‖nurses’‖experiences‖in‖
England during WW2.
Significance
From 1939-1945, World War II was the largest and most violent conflict in the history of mankind.
The rate of emigration from Ireland, especially for single women remained high during this time,
with England the main destination. A large number of Irish women came to England to work or
train as civilian‖nurses‖thereby‖contributing‖to‖the‖‘war‖effort’‖and‖indirectly‖to‖the‖‖further‖image,‖
identity and professionalization of nursing. However, their contribution has largely gone
unacknowledged and the half century that now separates us from that conflict and period of nursing
evolution is exacting its toll on our collective knowledge.
Rationale
This study would reconstruct and preserve the legacy and heritage of the role and contribution of
Irish civilian nurses in England during this time. It would also provide the basis for answering the
question‖‘why‖do‖we‖do‖it‖this‖way?‛‖as‖nursing‖practice‖of‖the‖past‖elucidates‖and‖clarifies‖
rationales for present practice and can at its best, set a tone and direction for the future. The
questions are asked What is it that nurses feel is important to share with collegues? What view of the
past do they wish to promulgate?
Methodology
This study would employ oral histories both as a data collection tool and also as research design as
oral history accounts provide an accurrate picture of the past in the absence of other reliable sources
of evidence and also offers an alternative to the reliance upon documentary evidence. Therefore, oral
histories will be obtained following an advertising campaign in Ireland and UK and receipt of ethical
approval commencing in December 2009. Data will be analysed using thematic content analysis and
both participant and documentary data will be subjected to internal and external criticism.
Expected Findings
It is anticpated that this oral history project will provide an integrated, written record of past events
during‖this‖period‖based‖on‖the‖results‖of‖a‖search‖for‖truth‛‖clarifies‖past‖events‖in‖light‖of‖what‖is‖
known‖today,‖and‖will‖also‖tells‖a‖good‖‚once‖upon‖a‖time‛‖story.
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THE CONTRIBUTION BY IRISH SISTERS OF MERCY TO THE EARLY FOUNDATIONS OF
MODERN NURSING DURING THE CRIMEAN WAR
Eamon Leonard, RPN, RGN
Retired Assistant Director of Nursing (Mental Health Services)
Until December 2008 worked in North Lee Mental Health Services, Health Service Executive (HSE) –
South, Ireland
Visiting Lecturer in the Department of Nursing and Midwifery, University College Cork (UCC)
0044 353 21 4872124
[email protected]
Aim of Study: To explore the motivation that inspired the Sisters to take on the Crimean
commitment and from a local history perspective to illustrate the personal qualities and experiences
of at least 3 of the Sisters
Rationale and Significance:
The Irish nuns who undertook the mission to the Crimean War casualties brought with them
particular skills and experiences gained in their earlier care of impoverished people suffering the
ravages‖of‖cholera‖and‖famine‖in‖1840’s‖Ireland
Methodology:
I propose a poster presentation showing
1840’s‖Ireland -the emergence of newly founded religious orders in the provision of nursing
care, both in the home and the workhouse
From Clare to the Crimea: An overview of the personality and life of Mother Bridgeman who
led the group of 15 Sisters of Mercy from Ireland to the Crimea
Strains in the clinical setting of the Crimean: Reference to differences between Mother
Bridgeman and Florence Nightingale and the close rapport between Florence Nightingale and
Mother Moore, an Irish Sister of Mercy‖who‖(unlike‖Mother‖Bridgeman’s‖group)‖travelled‖
from England as a member of the original Nightingale group.
A Century Later: Brief overview of how the conflict, compromise and learning experience of
the early pioneers of nursing in the Crimea influence the profession developing of nursing
Poster content will be compiled from:

Review of nursing history publications
 Visit to local archives of Cork, Galway, Sisters of Mercy to gain specific accounts of the
backgrounds and personal accomplishments of individual nuns (at least 3)
 Search for archive photos of the Crimean nursing facilities
 Present day photographs of some of the locations in Ireland relevant to the nuns who served
in the Crimea
Findings and Outcome:
This presentation will include an overview of the practical experience that the nuns gained in
providing nutrition, sanitation, and literacy training as well as nursing care during the 1800’s
This served as ideal preparation for the Crimean mission. On arrival in the Crimea these Irish nuns
became part of what could be described as an international task force which was instrumental in
informing Florence Nightingale in setting out the foundations of the nursing profession that
continues to evolve today.
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BRIGHAM YOUNG UNIVERSITY’S COLLEGE OF NURSING
FLORENCE NIGHTINGALE CELEBRATION
Karen Lundberg, MS, RN, CNE (contact person)
Assistant Teaching Professor, College of Nursing
Brigham Young University, 440 SWKT, Provo, UT. 801-422-2747, [email protected]
Cheryl Corbett, RN, MSN, FNP-C
Assistant Teaching Professor, College of Nursing
Brigham Young University, 542 SWKT, Provo, UT, 801-422-7191, [email protected]
Glenda Christiaens, PhD, RN, AHN-BC
Associate Teaching Professor, College of Nursing
Brigham Young University, 428 SWKT, Provo, UT, 801-422-7305, [email protected]
Beth Cole, PHD, APRN, FAAN
Dean and Professor, College of Nursing
Brigham Young University, 500 SWKT, Provo, UT, 801-422-4144, [email protected]
Aim of the project: To increase awareness of the contributions of Florence Nightingale to nursing
and nursing education through a yearlong celebration involving university students, faculty and
community members.
Significance of project: Nursing history provides a framework for the understanding of how
nursing is practiced today and the societal trends that shape the profession. Understanding
nursing’s‖history‖and‖growth‖helps‖modern‖nurses‖to‖appreciate where nursing is today and may
provide stimulus for future changes.
Methodology: The BYU College of Nursing formed a Nightingale Celebration Committee comprised
of faculty, alumni, and a student representative. The committee worked closely with the‖University’s‖
library to create an impressive exhibit of original letters written by Nightingale and other original
artifacts. The exhibit includes a video question-and-answer kiosk featuring current nursing students,
English and History department faculty,‖and‖an‖original‖recording‖of‖Nightingale’s‖voice.‖Other‖
events planned throughout the year include a university lecture given by the College dean, a college
conference featuring renowned Nightingale scholar Barbara Dossey, a student writing contest, a
homecoming‖parade‖float‖highlighting‖Nightingale’s‖legacy,‖and‖a‖declaration‖by‖the‖Governor‖of‖
Utah to officially declare February 21-27, 2010 as Florence Nightingale Recognition Week.
Findings: Our first event, the‖Dean’s‖lecture‖was‖attended‖by‖over‖200 students, faculty and
community members from distant Utah towns. General comments have been positive and can be
summed up in this quote from a pre-nursing‖major‖student‖at‖BYU‖‚One‖person-one woman-made the
difference‖in‖the‖lives‖of‖millions‖of‖people‖<‖I‖hope‖I‖can‖make‖a‖difference‖in‖someone’s‖life‖as‖she‖
(Florence‖Nightingale)‖has‖made‖a‖difference‖in‖mine‛.‖‖We‖are‖pleasantly‖pleased‖with‖the‖responses‖
generated from this single event and expect equal enthusiasm in our future events celebrating
Florence Nightingale and nursing history.
Conclusions: Celebrating the legacy of Florence Nightingale has been a major undertaking for this
College of Nursing with many people contributing time and talent. The response from the
university, students and the general community has been overwhelmingly positive and supportive.
Other nursing schools across the country are highly encouraged to find a way, large or small, to
honor the memory and contributions of Florence Nightingale to the history of nursing and global
health.
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CLÉLIA SOARES BURLAMAQUE: A LIFE POLITICALLY SITUATED IN THE
HISTORY OF BRAZILIAN NURSING
Joel Rolim Mancia, RN, PhD.
Centro Universitário Metodista,IPA,Brazil.
55 51 3223-4041,
[email protected],
Mara Ambrosina O. Vargas, RN, PhD.
Unisinos,Brazil.
Maria Itayra Coelho S. Padilha, RN, PhD.
UFSC,Brazil.
Flávia Regina Souza Ramos, RN, PhD.
UFSC,Brazil.
INTRODUCTION: This is a social-historical‖study‖guided‖by‖Foucault’s‖analytics‖and‖whose
subjectmatter‖is‖Clélia‖Burlamaque’s‖life‖story.‖GOALS:‖put‖the‖biographical‖data‖collected‖in‖order;‖
to clearly show the connections between her Life Story and the Brazilian Nursing History; to tie her
Life Story to the impacts of the Participation Movement on/of the Brazilian Nursing Association.
METHODS:‖Text‖written‖based‖on‖our‖primary‖source‖and‖brought‖together‖by‖the‖subject’s‖
testimonial on her story, documents from the School of Nursing attended by our subject and from the
Brazilian Nursing Association, in addition to a thesis and memoirs. The RESULTS show that our
leading‖character’s‖life‖journey‖is‖based‖on‖a‖certain‖way‖of‖doing‖politics‖at‖a‖specific‖point‖in‖time,‖
which stands out in the categories: the behavior of someone politically shaped in the 1940s, 1960s and
1980s of the 20th century.‖Foucault’s‖analytics‖allowed‖us‖to‖find‖the‖political‖features‖in‖Clélia’s‖
personal, professional, social and cultural life instances. Furthermore, we were able to draw a
panoramic map that shows the fits-and-starts in the ways power has been exercised in Brazilian
nursing.‖First‖we‖highlighted‖the‖issues‖of‖schooling‖and‖being‖a‖woman.‖Next,‖one’s‖choice‖for‖a‖
nursing career and insertion in the job market. The third and most prominent matter in this study, as
the data collected allowed us to do so, shows a shift from a not very democratic, centralizing
association policy, albeit necessary at a certain point in time as it sought to engage and reinvigorate
nursing, to a policy that decentralizes the associative issue, first on a dichotomous, partisan way, but
which understands the pertinence of valuing others. In short, the shift from a centralizing current to a
dichotomous, partisan outlook arises as a condition allowing Brazilian nursing to branch out its
associative life by expanding topics, discussions, and the types of conferences and meetings in an
effort‖to‖reach‖nursing‖professionals‖via‖different‖routes.‖CONCLUSIONS:‖our‖leading‖character’s‖life‖
story is iconic for us to tie a given historic period to a place where politics and power are exercised in
a‖way‖that‖effectively‖marks‖Brazilian‖nursing‖and‖gives‖new‖meaning‖to‖one’s‖joining‖the‖
Participation Movement.
KEY WORDS: Nursing, Nursing History, Biography,Brazil.
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PERSISTENCE, COURAGE, HUMOUR AND KINDNESS: STORIES OF GRASSROOTS
LEADERS OF MENTAL HEALTH NURSING IN QUEENSLAND, AUSTRALIA
Margaret McAllister, RN, MHN, Dip App Sc(Nursing), BA, Ed D, FACMHN, Professor
University of the Sunshine Coast, Maroochydore, Qld 4558
61 7 5456 5032, [email protected]
Brenda Happell, RN, RPN, BA (Hons), Dip Ed., B Ed, M Ed, PhD, Professor
CQUniversity Australia,
61 7 49306971, [email protected]
Julie Bradshaw, RN, RPN, B Hlth Sc, M Nursing (Hons).
CQUniversity Australia, [email protected]
Mental Health Nurses play an invaluable, yet often invisible, role in our communities. Whilst
internationally, mental health nursing history has been researched, in Queensland the topic has not
been systematically investigated. Students of mental health who know their history are likely to
have a stronger appreciation for, and commitment to the unique contribution of nursing to social and
health systems and they may be more likely to have a stronger sense of identity as a mental health
nurse.
Because‖little‖is‖known‖about‖notable‖peoples’‖influences,‖motivations,‖successes‖and‖challenges,‖the‖
punitive Nurse Ratched image of mental health nurses persists. This exacerbates stigma and is one
reason why nurses are not attracted to the specialty. A study was implemented in 2009 that aimed to
explore the experiences of a sample of grassroots mental health nursing leaders to help gain a greater
knowledge about leadership in action. In-depth semi-structured interviews were held with nineteen
mental health nurses, or grassroots leaders in their field from Queensland. They were selected
following nomination by other mental health nurses, who responded to an invitation sent to them via
the Australian College of Mental Health Nursing. The criteria for selection were that these nurses had
made a significant contribution to the profession, or held admirable or inspirational qualities.
The paper reflects on findings in regard to the formative experiences that‖impacted‖upon‖the‖leaders’‖
direction in life, their beliefs and ideas about what it means to be a leader, the strategies they use to
lead and challenges they continue to face. Contrary to notions of mental health nurses being
custodial, world-weary or harmful healers, this study found that each leader had highly developed
ways of demonstrating their compassion and effectiveness in working with people with mental
illness. They were also admired by others for their passion, persistence and humility as change
agents.
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CHALLENGES IN NURSING EDUCATION IN BRAZIL: (RE)TELLING A HISTORY
Glicerio Moura, BSN, RN
Lienhard School of Nursing, Pace University
Pleasantville, New York
[email protected]
Abigail Moura, RN, DNSc – Professor Honoris Causa FAEN/UERN
Grupo De Pesquisa: Marcos Teoricos do Ensino e Pratica de Enfermagem UERN/CNPQ
Moemia Gomes de Miranda, RN, MSN, EdD (Cand.)
Professor FAEN/UERN
Maria das Gracas Alves Lima, RN,
Professor Emeritus FAEN/UERN
Aim‖of‖the‖Study:‖‖To‖explore‖the‖history‖of‖the‖State‖University‖of‖Rio‖Grande‖de‖Norte‖(‚UERN‛).
Rationale and Significance: Accurately preserving the circumstances surrounding the creation of the
‚FAEN‛‖(the‖College‖of‖Nursing‖affiliated‖with‖the‖State University of Rio Grande do Norte) for the
historical‖record‖has‖always‖interested‖the‖authors.‖‖Our‖personal‖connection‖with‖that‖space‖―‖
which‖relates‖to‖the‖process‖of‖teaching‖nursing‖―‖helped‖us‖to‖identify‖lacunas‖present‖in‖other‖
telling of this story.
Methodology: We used the analyses of documents and of oral history as our primary sources.
Findings: This study enabled us to identify four distinct historical periods: (i) Creation of the
Program: This was possible because there was political support for the idea of establishing a
university in the town of Mossoro, in Rio Grande do Norte, Brazil, which needed to further develop
its‖health‖education‖infrastructure.‖‖In‖the‖case‖of‖nursing,‖that‖expansion‖resulted‖in‖the‖WHO’‖
recommendation to provide nurses to a part of the country that lacked a sufficient number of them.
The character of the instruction was primarily technical, with the hospital being the hub for teaching.
(ii) Movement Towards Accreditation: The Program moves towards accreditation‖by‖the‖‚CFE‖
(Federal‖Council‖of‖Nursing)‖‖&‖MEC‛‖.‖‖The‖technologically‖oriented‖teaching‖model‖of‖the‖
instruction‖remains‖dominant;‖it‖undergoes‖through‖several‖‚adaptations‛‖to‖gain‖accreditation‖from‖
CFE/MEC without major changes being made to the references that the policies for instruction are
based on. (iii) Development of the Political Pedagogical Project: This Project arose in connection with
the‖national‖movement‖favoring‖the‖development‖of‖the‖‚critical/reflexive‖Nurse,‛‖meaning‖one‖who:‖
(a) is able to deal with the realities of Brazilian heath; (b) contributes to the positive transformation of
those realities; (c) is equipped with the technical/scientific and ethical/political skills that will enable
them to tackle the coordination of nursing work (as materialized in the processes of work); and (iv)
Consolidating‖FAEN’s‖Policies:‖‖The‖articulation‖of‖FAEN’s‖education/work‖model‖and‖its‖
integration in other health services contexts.
Conclusion:‖‖The‖cumulative‖success‖of‖the‖FAEN’s‖teaching methods, with their use of a theninnovative and daring process of instruction that went beyond that which was merely focused on the
technological and instrumental, led to their recognition and implementation in other contexts on the
local and national levels.
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THE POTENTIAL OF BIOGRAPHICAL STUDIES FOR TEACHING NURSING IDENTITY
Maria Itayra Padilha, PhD, Professor of Nursing Leader
Federal University of Santa Catarina/Brazil (UFSC)
Rod. Amaro Antõnio Vieira, 2371/818. Ed. Paris. Itacorubi.
Florianópolis, Santa Catarina, Brazil CEP 88034-10
0055 48 32064510
[email protected]
Sioban Nelson, PhD, Dean and Professor,
Lawrence S. Bloomberg Faculty of Nursing,
University of Toronto,
55 College Street, Toronto M5T1P8 Ontario
[email protected]
Aim of Study: This article reviews the historiographical elements of the professional identity of
nursing, focusing on what historians have denoted the "history of the present." Professional identity
interacts with elements of power, gender, politics, philosophy, and history, and its value is tied to the
importance it assumes at any given time in any given society.
Rationale and significance: The collective identity of the profession is elucidated by the construction
of nursing history, linked to the history of women and gender relationships in professional care and
educational, organizational, and class practice, and also by the biographies of individuals who have
shaped this identity through their reputations and life stories. In this light, it is argued that
biographies could help illuminate the elements of identity formation of interest to nursing scholars
and further the development of the profession; they could also bring discussions of the past and
present into the teaching-learning process for nursing students. The authority and significance of
these identities will also be discussed.
Conclusions: We conclude that the biographies help illuminate the elements of identity formation of
interest to nursing scholars and further the development of the profession; they could also bring
discussions of the past and present into the teaching-learning process for nursing students. The
biographies help students and professionals understand what to expect from a nurse.
Keywords: nurse biography, professional identity; historiography; education
163
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THE MYSTIC OF SILENCE - THE NURSING PRACTICE AT THE
SANTA CASA DE MISERICORDIA OF RIO DE JANEIRO/BRAZIL AT THE 19TH CENTURY
Maria Itayra Padilha, PhD, Professor of Nursing Leader
Federal University of Santa Catarina/Brazil (UFSC)
Rod. Amaro Antõnio Vieira, 2371/818. Ed. Paris. Itacorubi.
Florianópolis, Santa Catarina, Brazil CEP 88034-10
0055 48 32064510
[email protected]
Aim of Study: This is a social-historical research that regards the investigation upon the nursing
assisting practice developed at the Santa Casa de Misericórdia of the Rio de Janeiro at the 19th
century, especially since the forthcoming of the Sisters of Charity of St. Vincent Paul at Brazil.
Rationale and significance: The delineated assumptions were: the forthcoming of the Sisters served
the managing needs of the Purveyor upon all the activities of the Santa Casa; the nursing executors in
the‖hospital’s‖hierarchy‖are‖held‖responsible‖for‖the‖daily‖functions,‖dominated‖by‖the‖medical‖and‖
religious orders; the Regiment of the Hospital was the device that regulated the power of the Sisters
of Charity upon everything regarding the Santa Casa of Rio de Janeiro.
Methodology It is based theoretically and methodologically upon the ideas of Michel Foucault,
especially‖those‖regarding‖power’s‖genealogy,‖focusing‖on‖disciplinary‖technology‖at‖the‖hospital’s‖
environment. The primary source documents were: the provisional rules of procedure of the Santa
Casa de Misericórdia from 22/11/1852, the Internal employees of the Santa Casa de Misericórdia from
23/12/1827, and Treaty between the Santa Casa de Misericórdia and the Sisters of Charity of
21/09/1852.
Results: The‖Purveyor‖José‖Clemente‖Pereira‖was‖the‖mentor‖and‖the‖operator‖of‖the‖hospital’s‖
integrating project to the civilizing process of the empire, aided by the Sisters of Charity and the
physicians. The visibility of the Purveyor’s‖power‖was‖conceived‖through‖the‖Superior Mother, who
silently determined the control and the surveillance upon everything that occurred at the Santa Casa.
The actions of the lay nursing executors were filled with humble feelings, obedience and submission
to the orders of the Sisters of Charity and of the physicians, with little or no resistance to this power.
The‖configuration‖of‖spaces‖at‖the‖hospital’s‖environment‖consolidated‖the‖basis‖that‖served‖as‖
support‖to‖today’s‖nursing‖practicing,‖mainly‖regarding the aspects that compose the ideas of
nursery up to the present days, prioritizing the ideals of fraternity and altruism at care.
Conclusions: The Provisional Regiment of the Hospital enabled the Sisters of Charity to become
disciplined agents and discipliners of a speech that prioritizes the teaching of the bodies of those who
take care, collaborating in the diffusion of a practice where the abnegation and the spirit of giving,
the humbleness and the simplicity, main points in charity care, unfold as the support at the process
of taking care in nursing.
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RECOVERING LOST THREADS OF THE STORY OF NURSING:
ILLUMINATING PATTERNS OF PARTNERSHIP
Teddie M. Potter, RN, MSc
University of Minnesota, USA
Minneapolis College, Minneapolis, Minnesota, USA
W- 612-659-6407
H- 612-822-5669
[email protected] minneapolis.edu
Aim of study
Social theorist Riane Eisler describes human history as a persistent conflict between two patterns of
social organization. Her Cultural Transformation Theory identifies ideological differences between
dominator and partnership paradigms. The first objective of this study was to determine if nursing
fundamental textbooks in the United States use the story of the history of nursing to support a
dominator paradigm. The second objective was to illuminate historic exemplars of partnership in
nursing.
Rationale/significance
Nursing fundamental textbooks initiate socialization and profoundly impact the self-identity and
practice of future nurses. Therefore the assumptions and ideologies within the texts must be
critically evaluated. Assumptions and beliefs are most evident in chapters describing the history of
nursing. These sections offer powerful images that initiate development of nursing identity in
novices. Recent nursing research has demonstrated patient outcomes improve with implementation
of collaborative care. Yet new nurses are exposed to limited models of collaboration. To shift the
current health care paradigm, nurses need to be educated in partnership. History provides
inspirational stories of nurses who partnered with patients to create new models of care.
Methodology
This study applies a Critical Theory approach to reveal and deconstruct current ideological messages
embedded in the history of nursing chapters in nursing fundamental textbooks. The writings of
Mary Seacole, Lillian Wald, Sister Elizabeth Kenny, and Mamie Odessa Hale are analyzed for themes
that support an alternative paradigm of partnership and collaboration.
Findings
Nursing has a rich history of collaboration and partnership but currently dominator stories are used
more frequently to socialize novices. The writings of nurses through history provide inspiring
examples of partnership care. Despite dominator pressures, nursing pioneers offered alternative
models of care based on respect and empowerment.
Conclusions
The history of nursing in nursing textbooks is essentially a subjective story carefully crafted to impart
select values to new nurses. Currently nursing is defined by the needs of health care systems. Loss of
identity promotes powerlessness and decreases meaning and career satisfaction for nurses. This
contributes‖to‖attrition‖and‖the‖critical‖shortage‖of‖nurses.‖‖Eisler’s‖theory‖offers‖insights‖about‖the‖
historic roots of the dominator paradigm which limits the art of caring today. This research
demonstrates collaboration and partnership have been part of the nursing identity through history.
Recovery of this lost thread of history may improve patient care outcomes and enrich nursing
practice.
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SYSTEMS OF CARE AND WAYS OF WORKING CARING IN A
CULTURALLY SAFE NURSING ENVIRONMENT – FLORENCE NIGHTINGALE’S LEGACY
Louise Rummel, RN, BA (Soc Sc.), MA (Nursing), PhD (Nursing), Senior Lecturer
Department of Nursing and Health Studies, Manukau Institute of Technology
Manukau City 2241, Private Bag 94006
Auckland, New Zealand
+64 9 9688000 x8309
Grace Benson, RN, BA (Ed), MA (Applied), (Nursing), Senior Lecturer
Department of Nursing and Health Studies, Manukau Institute of Technology
Manukau City 2241, Private Bag 94006
Auckland, New Zealand
+64 9 9688000 x8325
Annette Delugar, RN, RM, BA (Nursing), MA (Applied ), (Nursing), Senior Lecturer
Department of Nursing and Health Studies, Manukau Institute of Technology
Manukau City 2241, Private Bag 94006
Auckland, New Zealand
+64 9 9688000 x8320
This‖poster‖presentation‖focuses‖on‖Nightingale’s‖legacy‖within‖a‖system‖of‖care‖in‖modern‖day‖New‖
Zealand nursing. Historical research critically evaluates the events of the past. The Nurses
Registration Act of 1901 established the profession of nursing in New Zealand based upon the
Nightingale‖system.‖‖Nightingale’s‖first‖influence‖took‖place‖at‖the‖request‖of‖Governor‖Grey‖(1845–
53), (McDonald, 2004) who corresponded with her concerning the health of the indigenous Maori
people. That concern has persisted to this day.
Maori Health professionals claim that a lack of cultural dimensions in the education of health
programmes‖was‖partly‖to‖blame‖for‖poor‖Maori‖health.‖‖Hence‖a‖movement‖was‖begun‖in‖the‖1980’s‖
resulting in the inclusion of cultural safety in nursing education (Board of Health Standing
Committee on Maori Health, 1985).
Florence‖ Nightingale’s‖ pledge‖ to‖ provide‖ nursing‖ services‖ regardless‖ of‖ colour‖ race‖ or‖ creed‖ was‖
redefined in the New Zealand context by the late Dr Irihapeti Ramsden (1991) in cultural safety.
Cultural Safety is a uniquely New Zealand concept born out of the experience of Maori and rests
upon understanding the Treaty of Waitangi and the partnership between the Crown and Maori. A
nurse must undergo a three step process of becoming culturally safe in that s/he first is aware of
their own culture before the second step, that of becoming sensitised to the difference of another but
also recognising the imbalance of power within the nurse patient‖ relationship‖ due‖ to‖ the‖ nurse’s‖
specialised expertise. This power must be equalised and used to benefit the client. The third step,
Cultural Safety, is defined by the person receiving nursing services.
Cultural Safety incorporates much of Florence‖ Nightingale’s‖ concern‖ for‖ the‖ client‖ who‖ is‖ being‖
nursed. The nursing services she provided were born out of a moral conscience but also a social
conscience which ultimately established health reform for the British Military (McDonald, 2004).
From her careful records, social change was initiated. A parallel can be drawn in the concept of
cultural safety as it embodies a moral, social and political awareness in the nurse. The culturally safe
nurse works within a system of care that epitomises the caring legacy of Florence Nightingale which
aims to provide a socially just system of nursing care for all whom they nurse.
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MARIA ROSA SOUSA PINHEIRO AND THE
BRAZILIAN NURSING RECONFIGURATION
Taka Oguisso, RN, AHHN Member
Full professor at Universidade de São Paulo.
(55-11) 3061-7559
[email protected]
Paulo Fernando Souza-Campos, PF , Historian
Doctor in the History, Independent researcher
(55-11) 3085-0876
[email protected]
Emiliane Silva Santiago, ES , RN, Candidate‖for‖Master’s‖degree.‖
(55-11) 8751-7856
[email protected]
ABSTRACT: This exploratory descriptive study funded on historical method aimed at identifying
the female participation in the social transformations arising out of the Americanization process in
Brazil, post-1930.‖For‖this‖purpose,‖the‖Maria‖Rosa‖Sousa‖Pinheiro’s‖trajectory‖is‖presented.‖Data‖used‖
for analysis were collected through documents found in the archives of the Historical-Cultural
Center for Iberian-American Nursing. They have allowed recognizing the person in focus who acted
decisively for the reconfiguration of the caring art and science in Brazil. Through results found it is
possible to state that nursing may help to disseminate the ideals of the American way of life as the
model for professional training and practice from countries such as Canada and the United States.
The research suggests that the role of she embodies the spread of a new representation of women
within the social and labor scope. As one of the most prominent leaders of modern nursing in Brazil,
participated in national and international scientific events such as those sponsored by the Pan
American Health Organization (PAHO) and the World Health Organization (WHO) in which she
participated as a member of the Expert Group in Nursing, and several other meetings in Geneva
(between 1951 and 1968) at the International Labor Organization (ILO) and in London (1954). In all
these meetings she always represented the art and science of nursing care in Brazil. In 1966, Ms
Pinheiro acted as an advisor, through PAHO / WHO for the Ministry of Health in Portugal for
planning of graduation programs for nurses and examined other under-graduate nursing programs
which existed in Latin America, at that time. Reports were presented in Washington in 1973. Ms
Pinheiro believed that only through extensive study and training of appropriate methods and
procedures nurses would be able to provide care effectively. For this purpose she exercised strong
leadership through the Brazilian Nursing Association claiming improvements for nursing education
and working conditions as its president for two terms, 1954-56 and 1956-58, also being editor among
several other positions at the Brazilian Nursing Journal. In 1947, she acted actively for the
organization of the First National Nursing Congress and later the X Quadrennial Congress of the
International Council of Nurses (ICN), held in Rio de Janeiro, in 1953. During her second term she
held the Survey on Resources and Needs of Nursing in Brazil, the most outstanding study done at
this level which became a national reference.
DESCRIPTORS: Women. Nursing History. Nursing schools.
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WHAT’S BEHIND MEDICAL PEDAGOGY? ABOUT THE SCIENTIFIC BASIS FOR NURSES’
ACADEMIC EDUCATION IN THE GERMAN DEMORCRATIC REPUBLIC (1949-1989)
Andrea Thiekoetter, PhD
Professor for Nursing Science
Carinthia University of Applied Sciences
School of Health and Care
Hauptplatz 12
9560 Feldkirchen/ Kaernten
Austria
0043-5-90500-4128
[email protected]
Aim of study:
This poster presentation shows the results of my research analyzing the diploma and doctoral theses
in the field of medical‖pedagogy‖as‖the‖scientific‖basis‖for‖nurses’‖academic education in the German
Democratic Republic (GDR).
Rationale and significance:
In relation to academic education of nurses in the GDR, in 1963 the first study program called
Diploma Medical Pedagogy‖was‖offered‖for‖nurses’‖teachers‖already;‖the‖second‖one‖called‖Diploma‖
Nursing was offered since 1982 and focused on leadership for nurses. Ca. 1700 diploma and ca. 35
doctoral theses were produced from 1967/68 until 1989, which dealt with different topics in the field
of nursing and medical pedagogy.‖They‖give‖information‖about‖what’s‖behind‖medical‖pedagogy‖as‖
a scientific basis for the nursing professions in the GDR which established earlier compared to
nursing as a scientific discipline in (West) Germany.
Methodology:
The diploma and the doctoral thesis were used as primary sources. The process of collecting the data
is not finished yet, because after the re-unification with Germany in 1990 lots of documents were lost.
The main questions are: What is behind medical pedagogy? Which research fields in nursing did the
diploma and doctoral thesis focus? How did the science medical pedagogy develop, and how was it
influenced by the political ideology of the state of the GDR? The primary sources are analyzed
oriented on the historical critical method while using the following criteria: Topic of the theses,
contents, focused research fields and questions, applied used methods, results, kind of academic
thesis, locality, year of publication etc.
Findings:
The results show that medical pedagogy was used as the scientific basis for nursing in the GDR and
pushed forward research in the field of nursing like e.g. history, knowledge and competencies of
nurses, and biographies. Even if medical pedagogy can be understood as medical-oriented nursing, it
contributed forward the development of professionalization in nursing.
Conclusions:
Medical pedagogy can be evaluated critically as a scientific basis for nursing and its targets. All
research fields and topics of the diploma and doctoral thesis were always related to the socialistic
ideology. The results of the study contribute to a critical understanding of nursing (education) within
the political context of the GDR.
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Display In the Foyer
THE MUSEUM OF DANISH NURSING HISTORY
The Museum of Danish Nursing History
Inger-Marie Børgesen, Curator
0045-65501781
[email protected]
The museum is all about the nursing profession, its identity and its ideology in a historical
perspective. The exhibitions are established after several years of research on the Danish nursing
profession and its developments within different fields of patient care.
ST GEORGE’S NURSES LEAGUE
St‖George’s‖Nurses‖League
Room 1.032 Grosvenor Wing
St‖George’s‖Hospital
London SW17 0QT
[email protected]
Information will be available about the League and they will have items for sale including "Muriel
Powell Remembered" by Elizabeth Scott.
169