Nurse History Midterm

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"... the Hospital Nurses have been frequently drunk & that they have made it a common practice to carry Spiritious Liquors into the Hospital which the Serjeants have taken from them."

Regulating Nurses and other Servants - With naval nursing, the hospitals are present - However, the number of nurses fluctuates with political/military events - Militaries change in size based on whether war is taking place or not FREE FLIP

o "All persons proposed by the respective Officers, to be entered as Labourers, Nurses, Washerwomen, or Servants of any kind, are to be carefully examined by one of the Physicians, or Surgeons, of the Hospital; and you are to be perfectly satisfied that such persons be, in all respects, fit for the employment intended,before you authorize the Agent to enter them on the Hospital muster books. You are to observe that no person, of the above description, is to be received,who may be above thirty-five years of age, if others can be obtained; and, in engaging Nurses, Washerwomen, and Seamstresses, the preference, where merit may be equal, shall be given to the widows of Seamen and Marines,who may have served in His Majesty's Navy; but no foreigners are to be entered for the above services."

FREE FLIP - HOW WOMAN WERE VIEWED IN THE VICTORIAN ERA

o "She feels herself weak and timid. She needs a protector. She is in a measure dependent. She asks for wisdom, consistency, firmness, perseverance, and she is willing to repay it all by the surrender of the full treasure of her affection. Women despise in men everything like themselves except a tender heart. It is enough that she is effeminate and weak; she does not want another like herself."

What are some aspects of historical thinking?

o Establishing historical significance § Historical significant - if it effects the events that follow o Use primary source evidence § Primary sources are sources created at the time you are studying o Identify continuity and change § What stays the same - continuity and what changes o Analyze cause and consequences § Ex: 9/11 occurred and now there much more airport security § Other times, cause and consequence is kind of "murky"/unclear o Take historical perspectives, and understand the ethical dimension of historical interpretations

FREE FLIP - MIDDLE CLASS PATIENTS

- "The middle class by the 1920s had become essentials as consumers of hospital care, to the new economic of medical progress. IN this new situation. The costs of providing modern care to all sectors of the population had to be unevenly distributed between those who could afford to pay for hospital care and those who could not. The willingness of the middle class to bear this burden was the product not only of their recent perception of the inestimable promise of modern medical science, but also of the tangible evidence, in the form of preferential accommodation and care at affordable rates, that they could avoid the Victorian stigma of poverty and dependence associated with the public wards and their non-paying clientele."

What is periodization?

- "The process or study of categorizing the past into discrete quantified named blocks of time in order to facilitate an analysis of history" - Adam Rabinowitz - "periodization represents the historian's efforts to manage time, to make change and continuity over time both more intelligible and more manageable - as opposed to the incoherence of simply listing one development after another" - Peter Stearns

What is history?

- "the bodies of knowledge about the past produced by historian, together with everything that is involved in the production, communication of and teaching about that knowledge" - Arthur Marwick

How Victorian Domesticity affect the medical space?

- Domestic elements are brought in to the medical space - The painting depicts a Christmas setting in a ward - Elements of home and the domestic space enters into the hospital wards o it brings comforts, healing, etc. - hospitals at this time were not places people "wanted" to be - the domestic nature of medical spaces decreases overtime

How did hospitals survive financially in the late 19th and early 20th century?

- Hospitals increasingly relied on the paying patients - impacted the development of Medicare REVIEW THE STATISTICS CHARTS

Who was important for the perpetuation of Victorian Domesticity?

- Role models were an important part of Victorian Domesticity o Queen Victoria and her husband were important role models for the idealized domestic space

What were the roles of MILITARY NURSES in British hospitals?

- They provided general nursing care - They changed bedding and body linen - it was key to health - Nurses also kept hospital spaces clean - Nursing was not seen as needing explicit regulation o As a woman, you were assumed to know how to be a nurse

What were the boundaries of the households? What were women in charge of in the family?

- Thresholds - there was little privacy in the households - Farmyards - Town/village squares - Women were primarily in charge of medicine in the family - they went to women first for basic medical care - nursing, medications (tea, southing things, herbs, etc.)

What was Nightingale's perspective on what nurses should be doing? Doctors?

- Where doctors prescribed treatments, nurses helped by allowing nature to heal the patient - She believed that nurses created environments for patients to heal

Who are two of the Catholic religious orders that were highlighted in class as early nursing groups?

Catholic: Daughters of Charity of St. Vincent de Paul - It was established in France in 1633 by St. Vincent de Paul and St. Louise de Marillac - Trained provincial women (rural women) to be nurses and care for the poor o These women were seen as having less access to resources and thus better care takers as they would have had to do the work from an early age - Worked in pairs in regions far from their homes and Paris - Hospital-based care - Hospital of St. John the Evangelist in Angers o Big buildings, open ventilation, beds set up for patients, altar present for Mass Catholic: Sisters of Charity (America) - They were founded by Mother Elizabeth Ann Seaton in 1807 - Strong Motherhouse structure o It fostered skill development o It produced Highly trained nursing sisters o In leadership roles - Healthcare providers

What famous hospital was established in Toronto in 1873?

Toronto Hospital for Sick Children - It was established in 1873 - the end of the period of moral reform - It was framed as a charitable religious initiative o "More than fourteen years ago, two Christian women, belonging to Toronto, became deeply impressed with the very great necessity which existed, for the establishment of a Hospital for Sick Children. In visiting the poor and sick, they found many little ones, languishing and dying from the want of pure air, good nursing, and proper nourishment. After many months of waiting on God in prayer, at length, led as they believed by the Holy Spirit, they resolved to publish in the city newspapers a plain statement of the needs of those sick children an await results (9)."

FREE FLIP - Romantic Myth of Nightingale

- "A large part of the problem, of course, is the persistence of the romantic myth about the ministering angel of Scutari. Few individuals in their own lifetime - and in such a comparatively short period of it, too - have achieved the level of adulation, fame and stature that Nightingale did. By the age of 35 she had already been the object of the most extraordinary outpouring of adoration. She returned from the Crimea in 1856 and chose to live and work for the next half-century in almost complete seclusion, a decision which only further cemented her legendary status." - "The myth has to a very large extent obscured the fact that Nightingale's Crimea experience was only the prelude to her more important postwar career. It has prevented us from assessing accurately her achievement at Scutari; when examined closely, the accepted doctrine that she saved soldiers' lives in her hospital suddenly dissolves before our eyes. And it has also allowed us to forget that Nightingale's priority on returning from the Crimea was not the reform of civilian nursing in Britain, but rather a thorough overhaul of the health of the army in peacetime."

FREE FLIP - Regulating Military Nurses

- "Every regimental hospital will be provided with a steady sergeant; with one orderly man, or more, according to the exigency of the service; and one woman nurse; and for every ten men confined to bed by fever, an additional nurse, or orderly man; and all the patients who are able, are every morning and evening to assist in cleaning and airing the hospital, carrying away dirt, &c. and by every means to assist the helpless." - William Blair

Enslaved women were employed for perceived immunity to tropical diseases FREE FLIP

- "In addition to or Order to you of the 25th Instant you are hereby directed and required to pay the Nurses employed at [blank] their Salaries Monthly, in the same manner you are directed by the said Order to pay Assistant Surgeons &c." - "We would always have those who have been longest in the Service enjoy the benefit of employment." - "There is something very singular in the constitution of the Negroes, which renders them not liable to this fever; for though many of these were exposed as the nurses to the infection, yet I never knew one instance of this fever amongst them, though they are equally subject with the white people to the bilious fever."

FREE FLIP - Women Religious and Nursing

- "In the nineteenth century, long before diplomas or training registers, these religious women nursed. They tended the sick, cared for the dying, assisted at surgery, and ran apothecaries. They knew the sick and the poor of their cities and towns. They took over during epidemics, and set up well organized hospitals - sites of philanthropy and medical practice. In this way, the vocational wave of energized pious women translated itself into a new form - the religious nurse. The Marthas of the nineteenth century kept quiet but they did not keep still. Beneath the attention of men of power, unnoticed or dismissed by women with voice and ideas, driven by vocational ideals that obeyed God's call, they went to work." - Sioban Nelson

FREE FLIP - THE IDEAL NURSE

- "One of the first requirements a physician exacts of a nurse is obedience, but he expects that obedience to go hand in hand with comprehensiveness and judgement. The more thoroughly qualified and the better trained a nurse is, the less she is liable to assume responsibilities which belong to her doctor (McNeill, 1910, pp. 393)." o This quote aligns with the notion that nurses are the handmaids of the doctors

FREE FLIP - What is a profession?

- "The shift in the connotations of the word profession from the religious to the secular - such that the term came to include first medicine and law, then nearly everyone - is a fair recapitulation of the history of work in Western countries. The word profession is not a mere reflection of this history, but an integral and active part of it. The term is a reminder of the way in which each succeeding generation, and each new group of would-be professionals, used the examples of history in order to define, organize, and publicize their own particular expertise and cultural authority. In successive generations of would-be professionals, the language or predecessors became, through the ingenious use of metaphor, ready-made and usable tradition."

FREE FLIP - PERCEPTIONS OF BLACK NURSES

- "While superintending the treatment of those people, I was led to an improvement in the Servants department of the hospital, which I shall do my utmost to establish on a permanent footing, I mean the introduction [sic] of Black creole nurses, instead of white Soldier or even Soldier's Wives to attend on the Sick. I was satisfied there were of great use latterly, in attending upon those of their own colour amongst the recruits that fell ill after they arrived at Barbados, and I am sure that in the white wards they will prove far better nurses than either of the two Classes just mentioned."

How has social history impacted nursing?

- 1960s and the development of social history o Considers questions about society at large, not just elites § "History from below" o Augments 'traditional' history (political/military) o You can see both the influence of the Civil Rights Movement and Second Wave Feminism § Historians considered questions of race, class and gender o It starts with academic historians and then the methods become adopted by nurse and physician historians

What did hospitals have to do to attract paying patients?

- Architectural changes o There was the introduction of private and semi-private rooms o The Queen Victoria Wing of the Hamilton General Hospital was built § In 1897, you could have a private room for 10$ a week and semi-private room for 8$ a week - There was also the choice of physician o It could be arranged for one to have their family doctor or own nurse be brought in o Private duty nursing - There were also huge advances in technology and medical treatments - Hospitals would also use the social status of their patients to attract status of other individuals of the same social status

What is are the key points of chapter 1 in the textbook?

- As Canada developed and war/famines/diseases occurred, nursing fluctuated - In the time of illness and childbirth, early colonists had to rely on their own resources and nursing care fell to the women of the family. - Unlike in New France, the British colonial government did not finance health services for civilians - The cholera and typhus epidemics in the 1830-40s, demonstrated the lack of service the British colony provided. - In Partridge Island, arrivals were often forced to sleep in open air. - There were no nurse training programs at this time and the physicians were relying on experienced but untrained nurses. - As populations increased, there was a demand for private nursing and during the 19th century, increasing numbers of working class women worked as privet nurses as their careers. - once hospitals became better organized, they began to attract women with more competence and respectability.

What are some of the different medical theories that were discussed in class lectures?

- Based on the humors o Black bile - earth, Phlegm - water, Yellow bile - fire, Blood - Air - Hippocrates (c. 460-370 BC) - Known for the Hippocratic oath - Galen o He is a user of the four humors and is known for his treatment - Humoral theory - it is extremely malleable - many theories can be connected to it o Based on the balance of the four humors - Neo-Gallenic and Neo-Hippocratic o It is also based on each individual's constitution - Astrological influences o The movement of planets in celestial bodies o The Will of God remains - it doesn't go away with the Protestant Revolution - in Calvinists circles, it intensifies - connects with the view of pre-destination

Who were included in "households?

- Biological family - parents, children, grandparents, visiting relatives, etc. - Servants - Visiting Friends - Tenants - if you had a house and rented it out, the tenants were part of the household

Who was Florence Nightingale?

- Born in 1820 (Florence, Italy), she was from an upper-class family and was classically educated - Victorian domesticity - Looking after the household, organizing servants, planning menus, planning large social events, etc. - She came from a well-connected family o British and imperial governments

What are the main points of chapter 5?

- By the 1870s-80s, many Canadian hospitals sought reform - they based reforms on the system of nursing laid out by Florence Nightingale. - Nightingale, according to Mary Poovey, relinquishes the working-man/domestic-woman by making nursing a distinctly female occupation - women were able "to make the hospital a home". - From the 1870s to 1940s, hospitals and their apprenticeship staff claimed a privileged place for nurses within the female world of work, while at the same time fostering the public image of respectability for the hospital that was needed to recruit middle class patients into the "modern hospital." - After WW2, Canadian hospitals grew in size and complexity - scientific advances, affordable health care insurance and government investments made hospitals expand. Nurses were then provided greater technical tasks and specialties in nursing began to grow.

What were some of the class-based exclusions that occurred in nursing training education? What were class-based barriers the hardest to "cover-up"?

- Class was the last policy of exclusion o There was a desire to ensure that nursing remained a socially respectable profession § They thus needed to limit who was accepted by social class § Working class women had difficult entering the nursing as they didn't have the requisite education and because they also disrupted the veneer of nursing as a middle-class profession o Waged labour was also a factor - by the early 20th century, nurses were paid for their labor § The lady probationer that Nightingale implemented was changed and all nurses were being paid § The fact that wages were being paid interferes with the idea of respectability - it is seen as above the need to work for money - it thus affects the ideals of nursing as respectability § Working class women could develop a cohesive identity, receive education and elevate themselves from the working class to the middle class - Class was the easiest to overcome - gender and ethnicity was harder to "cover up" o All nurses wore the same uniforms and thus social class was harder to identify

Why does periodization matter?

- Determines how historians approach topics in their fields - It effects questions regarding continuity and change - Framing social and political trends - It affects national narratives o Ex: pre/post-Confederation, pre/post-revolutionary period

What was women's legal status during the early phases of nursing?

- Doctrine of Couverture - Women were "covered" by law - The two legal categories include: o Feme sole: § An adult unmarried woman able to act as herself under English Common Law. It includes never married women and widows o Feme covert: § Any minor girl or wife covered by father or husband under English Common Law. In terms of marriage, the husband and wife became one legal person - In general, married women have little authority to enter into work contracts

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- When sickness or hurts shall prevent any of the Labourers, Nurses, Washerwomen, or other Servants of the Hospital, from performing their duty, they are to be received into the wards as Patients, and checked of half their pay, during the time they may continue sick, provided the same shall not exceed thirty days, but such as remain sick beyond that time are to be checked of their whole pay, while they may afterwards continue so; and you are to cause proper information to be given to the Commissioners aforesaid of the probable time that will still be required for their recovery, in order that they may determine what may be necessary to be done on the occasion

How was domestic work viewed in the early history of nursing?

- Domestic work is believed to be intuitive or inherent - all women could do it - However, most domestic work is skilled work, even if it is being done regularly by most women - Waged vs. Unwaged labor o Just because it wasn't paid, it doesn't mean that it wasn't valuable § "When work is unwaged, a status or hierarchy is automatically implied. The locus of female work does not determine its importance. Whether work is described as female or situated at home is not by itself necessarily significant. It becomes significant as part of a cluster of ideas about women, work and family; the importance of 'work' is dependent on the cultural values associated with it. Thus, what matters is the value placed on that work or the meanings ascribed to being at home. Working at home did not always imply inferior tasks or domesticity. Even where division of labour existed, it was not always couched in the cultural terms associated with the nineteenth century. Thus 'work' as a concept is both historically specific and relative to the context and value systems in operation."

How was domestic work viewed in the Victorian era? What is domestic work considered?

- Domestic work was believed to be intuitive or inherent o All women could do domestic work - "societal notion" or "societal belief" - However, most domestic work is skilled work even if it is being done regularly by most women o Household management books were being written at this time for women

What are some of the progressions that led to nursing becoming a woman's profession?

- Educational credentials - Nursing registers (e.g. Registered Nurse) - Nurses also began to control the boundaries of their profession o Not just something all women can do - Gradual legislation in Canadian provinces and territories from 1910-1967 o Nova Scotia first to legislate o New Brunswick "Registered Nurses Act" 1940

What are the problems with periodization?

- Eurocentric (Medieval, Early Modern, Modern) - They pre-shape narratives - Teleological trap - where we start with the present and work our ways back - Scholarly choice - the fact that scholars can choose periodization, may cause disagreements or confusion with general public - It may be open to debate - Transition/Overlap (Long Eighteenth Century vs. Long Nineteenth Century)

CONCLUSIONS - FLORENCE NIGHTINGALE LECTURE - READ THROUGH

- Florence Nightingale was interested in nursing and the care for the sick from a young age - She believed that she had been called by God to better the conditions of the sick - The nightingale Fund Nursing School instituted a probationer style of on-the-job training coupled with lectures and strict discipline to reform hospital nursing - Victorian domesticity influenced who was acceptable to be admitted to nursing training and to work as a nurse - The need to be beyond reproach and accepted by wider communities - especially for semi-independent public health/district nursing or private duty nursing

CONCLUSIONS - HISTORY/NURSING HISTORY IN GENERAL - READ THROUGH

- History broadly defined is the study of the past and the production of knowledge about the past - The academic discipline of history relies on periodization to analyze continuity and change through historical thinking - Nursing history, and who writes it, have changed significantly in the past seventy years. - However, nursing history is still used in a professionalization project

What are some of the other views when examining the history of nursing?

- History from a patient's perspective begins in the 1980/90s - It is a result of the influence of Roy Porter and his work - "The Patient's View: Doing Medical History from Below" - Social construction of disease categories was developed by Charles Rosenberg

What was the role of paying patients in the early 20th century medical hosptials?

- Hospitals were initially financed for the public good - however, there is a crisis o Preventing the spread of disease - typhoid, smallpox and tuberculosis - In the 1890s, there is a transformation of hospitals from places to care solely for the poor o Paying patients could underwrite the hospital/city financed public wards o Poorer patients are often relegated to other parts of hospital buildings - There was also a desire to attract paying patients - they needed to have paying patients to come in for the survival of the hospitals and the training of the medical students

What is the ideology of separate spheres? How are men and women seen in the framework of the separate spheres ideology?

- Ideology that there are separate spheres for men and women, most commonly used to describe 19th Century Victorian middle-class life o In this ideology, men are in the Public Sphere - public sphere meant "work" § They are providers § Involved in politics - women could not vote at this time § They have free movement - men could go into private clubs · The rise of the department store is an interesting space that allows women to interact with men clerks o Women in the Private Sphere § Consumers - consumption is seen as a means to showcase your space in society - more and better things was a status symbol § Cult of Domesticity

Where did Nightingale get her first exposure to nursing training?

- In 1851, Nightingale attends the Kaiserwerth Deaconess institution in Prussia o She stayed for 3-months o It stressed importance of discipline and order o It also stressed religious vocation o This would have been the first time Nightingale experienced working with nurses and patients from working-class backgrounds - She said: "the nursing there was nil. The hygiene horrible. The hospital was certainly the worst part of Kasierwerth. I took all the training that was to be had—there was none to be had in England, but Kaiserswerth was far from having trained me."

Where/when did Nightingale begin to work in the nurse industry?

- In 1853, Nightingale becomes the superintendent of London's Institute for the Care of Sick Gentlewomen o It was an unpaid role - thus a position that only the wealthy could afford to pursue - In 1854, Nightingale leads 38 volunteer nurses to Scutari during the Crimean War o This is where she gets the nickname "the Lady with the Lamp" - Nightingale has respectability as being upper-class and thus wrote to British officials and offered to take nurses to serve in the Crimea

What is are the key points of the textbook's introduction?

- the general public holds nurses in high regards - most have ideas of the dirtier jobs they completed. - Where some had viewed the nurse as a white-collar profession, Kathryn McPherson combined the insights of labor and women's history and began to see the nurse as a worker. - In general, nurses are seen as relatively privilege - from a race, language, educational and economic lenses. - The strategy of devaluing lay nursing was a necessary step in the evolution of a new and insecure profession but now that nursing has its rightful respect in Canadian historiography, historians can begin to research nursing in all of its contexts throughout history.

What are the main points of chapter 13 in the textbook?

- In Quebec, nursing developed within the French hospital system in 1639 - It was established by skilled and devoted religious women (such as the Augustines). - Early leaders assumed the nurse was a professional - they were paid full-time and received formal training. - This paper argues that nursing leaders did attain professional status - they achieved: "Post-secondary education and training in a subject requiring scientific or esoteric skill and knowledge; a certification test; a degree of self-regulation by practitioners...[and] service to the public. - Several events changed the public perception of nurses: The First World War, the Halifax Explosion, the Spanish flu epidemic of 1918-19, etc. - However, the nightingale model was foreign to the Catholic religious tradition - nursing was seen as a mission or vocation - This created divisions in the French nursing population with those who worked with Protestant Anglophones and those who did not. - Increasing demands for nurses coincided with the growing dominance of lay nurses. Between 1931 and 1941, the number of nurses who were religious dropped from 51% to 23%. - By 1945, many nurses were enrolled in universities across Canada.

What is the main driving periodization in nursing history?

- In nursing history, the main driving periodization is pre and post Florence Nightingale

How did the "home" influence the career of Florence Nightingale? What/when did Nightingale publish? What did she outline in this work?

- In the home setting is where Nightingale would have learned how women were caregivers for the sick - As a member of the upper-class, she would have done home visiting - where upper-class citizens would travel to lower-class households and provide medicines, meals, etc. - Notes on Nursing - Florence Nightingale posted it in 1860 o It was a domestic health manual - From nursing at home, Nightingale believed she was in a "gilded cage" - she wanted to get out of the gilded cage - important in relation to her promoting a female hierarchy o She wanted nursing to be transformed to include a female hierarchy and would allow women in management positions

What were "households" seen as? What was the role of women in the households?

- It is a residence and an authority o "...a unit of residence and of authority: a group of people living under the same roof and under the authority of the household head - usually, though no always, an adult male" - Production: o "...an institution "geared for work": work directed towards the satisfaction of the household's needs as a unit not only of consumption and reproduction but also of production" - Women have a very important role in maintaining the household - they make clothing, they cook, etc. o Men, for legal and other reasons, would work outside of the household

Children's hospitals were being developed in this time. What is their development? What was going on in the 19th century? What about the early 20th century?

- Its origins are in the Foundling Hospital o Care for children of the poor and unmarried women - In the 19th century there is a focus on moral reform and medical treatment o There is a connection between reforming morals in the working class and its impacts on medical practice - Early 20th century, there is specialized medical care and the middle class o The children's hospitals are very strict - minimized role of parents o There was immediate separation of the child from parents widespread until the 1950s o If you had a higher social status, those patients saw their parents more often

What are some of the views of pre-nightingale nursing?

- Lavina Dock and Adelaide Nutting published A History of Nursing (1907) o They wrote that the pre-nightingale nursing was the darkest known period in the history of nursing § The seventeenth to mid-nineteenth centuries; a time when nursing "sank to an indescribable level of degradation (499)" - In Josephine Dolan's Goodnow's History of Nursing (1963) o "these women were more to be pitied than criticized. They had no desire for their job, nor did they have preparation for it, for they lacked the ability to comprehend it if an education were given to them" - M. Patricia Donahue Nursing the Finest Art (2011) o 1500-1860 "The Dark Period of Nursing" o Nurses were "illiterate, rough and inconsiderate, oftentimes immoral or alcoholic" o "when a woman could no longer earn a living from gambling or vice, she might become a nurse. Nurses were drawn from among discharged patients and prisoners and from the lowest strata of society"

FREE FLIP - RISE OF THE MODERN HOSPITAL LECTURE

- Middle-class patients began to see hospital care as not only medically effective, but trained nursing care, private and semi-private rooms and elevated social status of fellow patients, removed the stigma associated with Victorian medical institutions - As more patients became paying patients, hospitals relied on this income to function and state/local funding lessened - In many rural and isolated areas, cottage hospitals were "modern hospitals" in the same way general hospitals were in urban areas

CONCLUSIONS OF EARLY NURSING HISTORY - READ THROUGH

- Most sick and injured were taken care of in their homes until the end of the 19th century when hospital care became more prevalent - Although military hospitals had female nurses as careers, their role was assumed to be covered by their gender and not as delineated as the role of naval nurses - Female nurses in the naval medical system were crucial providers of care and represent the largest role of women in the naval medical system and illustrate women's mobilization in time of war

What were the working opportunities for women at this time in the late 19th and early 20th century?

- Most working-class women worked - Where you worked was determined by social class Middle class individuals: o Ladies maids, housekeepers - Nursing was creating a space for working middle-class woman o This was less acceptable before the Nightingale reforms but becomes more acceptable after - respectability, vocational aspects, etc. Working Class: - Domestic service - Factory work was under the purview of working class woman - Clerical work o With the rise of the typewriters, women began to work as typists o Working class women could take courses and work to become a typist

Domesticity was happening at the same time as the industrial revolution. Women were thus encouraged to view the home as their place of industry. What were some of the expectations that were associated with Victorian Domesticity? (4)

- Motherhood o This included the importance of education for children § The mothers provided education of gender/social roles for children § Mothers also provided early education - reading, writing, etc. § Victorian domesticity does not mean uneducated mothers - mothers were highly educated and involved in their children's education - There is also an emphasis on Morality/Purity - the home was a moral space, keeping the purity of the household in tact - Christian piety was also important - Submissiveness - the woman was meant to be submissive to her husband. The husband is the head of the household

What was the Nightingale Fund School? What are the two classes of trainees at the school Nightingale opens? What is the role of home sisters?

- Nightingale's fame came from the Crimean War o There was 44,000 pounds raised by public subscription § Approx. 250,000 dollars o A lot of this money came from soldiers who were injured and famous figures - i.e. Queen Victoria - In July 1860, the Nightingale home and training school for nurses opens to trainees at St. Thomas' Hospital - There were two classes of trainees - probationers and lady probationers o Lady probationers were meant to become Lady Superintendents o Probationers were one-year training to become a nurse The "home sister" or "mistress of probationers" organized the training, under the matron; she was based at the Probationers' Home and acted as tutor for the classes given by doctors. She also organized remedial classes as necessary. - The two classes were represented by either the probationers/Nurses' home o Mistress of probationers/Home Sister § Tutor § Monitor of discipline - Hospital matron was at the head of the nursing system o Mrs. Sarah Elizabeth Wardroper § She and the Bonham Carter (Henry Bonham Carter) made sure that the Nightingale model of nursing was spread

What is are the key points of chapter 4 in the textbook?

- Nursing in Quebec, in particular, and in the rest of Canada is connected with the history of female religious orders. - 50 religious orders were associated with the development of the Catholic hospital network- these establishments were based on the human being, health and illness based on the Christian faith. - the early hotels and Hotel-Dieu in Quebec were owned and operated by the Catholic Church and were supported by the state. - The apothecary - the knowledgeable nun - was responsible for the cures and was usually at the top of the hierarchy since she had the most responsibility for caregiving. - Gradually, the new requirements of science led to the modernization of infrastructure, new equipment and a rise in the numbers of caregiving personnel. Over time, the Catholic Church lost its authority to those in the medical establishment/physicians who ensured that the biomedical model was primary and relegated the religious institutions to more administrative tasks.

How did nursing fit in the separate spheres ideology? What did women in leadership positions desire?

- Nursing leaders work within the Separate Sphere framework and creating nursing as part of their sphere - Nursing was outside the home but within the bounds of respectability and the domains of Victorian Domesticity - it still reflects the beliefs of Victorian Domesticity - Women in leadership positions (such as Florence Nightingale and other nursing leaders) wanted nursing to have a female hierarchy o They could be managers, nurses, etc. - entering the hierarchy as probationers - Influence of first wave feminism - it was about allowing women to vote, operate in the public sphere

What were the ideal characteristics of nurses for Nightingale?

- Nursing was seen as a middle-class respectable occupation o There was a vocational aspect to the nursing profession o They were to be chaste - worked until they were married o They needed to be obedience to the nursing hierarchy o They needed to be sober o There was a notion of Victorian Domesticity - that they were ideal mothers/ladies, etc. o And they needed to be white

How did the Nightingale system of nurse training benefit hospitals?

- Probationers provided cheap labour and were industrious (hard working) - Nursing reforms o They provided trained and obedient nurses o There were no requests for tips from patients o Nurses were knowledgeable observers - they began doing simple medical checks o They helped with Hygiene and sanitation § Antisepsis

What was the impact of student labor on hospital hierarchy?

- Reliance on Student Labor perpetuates hospital hierarchies o The first year of nursing was a probation, then you become a nursing student and then at the end of the third year you were a graduate nurse o They needed to showcase an ideal labour system - the nurses were constantly living and working in the hospital

FREE FLIP

- Separate spheres take on an important role in America o Alexis de Tocqueville comments on this - "In no country has such constant care been taken as in America to trace two clearly distinct lines of action for the two sexes and to make them keep pace one with the other, but in two pathways that are always different. American women never manage the outward concerns of the family, or conduct a business, or take a part in political life; nor are they, on the other hand, ever compelled to perform the rough labour of the fields, or to make any of these laborious exertions which demand the exertion of physical strength. No families are so poor as to form an exception to this rule. If on the one hand an American woman cannot escape from the quiet circle of domestic employments, on the other hand she is never forced to go beyond it." o De Tocqueville's quote is relevant to white woman - slavery was occurring at this time o Class also is important for this quote - the professor disagrees o He also comments that the two spheres were separate but equal § This has also been used to justify Jim Crow laws in the US

What are rural hospitals? What are some of their characteristics? (1) Advantages? (4) How did the Victorian order of Nurses contribute to the growth of rural hospitals?

- Small hospitals were designed to serve rural communities o They are not very big - they don't take care of hundreds of patients, but there are advantages § It limits travel for care § It also provides a place to provide acute care with trained medical and nursing care § Nurses were always at the hospital, physicians might have to be brought in § Most of Canada's population lived in rural areas, thus these are important - Role of the Victorian Order of Nurses - VON o They build 44 cottage hospitals established from 1898-1924 § They were transferred to local communities

What are the components of academic history? (3)

- Source material o Secondary - academic, peer-reviewed sources from other historians o Primary sources - produced at the time of study - Citations o We need to use citations - we can use Chicago style footnotes when we write or APA 7th edition - Formality o Language choices § When we write academic history, we use more formal language o Conventions § There is usually an introduction with a thesis, method, background, historical discussions, etc.

What were the ratios of nurses to patients in the naval hospitals?

- there should be one nurse for every 10 patients - the ratio changed in regulations in 1802 - 1:7 - There were at least two nurses per ward - "Shifting wards"

FREE FLIP - VICTORIAN DOMESTICITY LECTURE - CONCLUSIONS

- Tenets of Victorian Domesticity continued to influence the professional boundaries of the nursing profession in medicine in the early 20th century. o Negative stereotypes of nurses endure from this time - The idea that nurses were doctor's "handmaidens" (it persists into the second half of the 20th century) - Nursing leaders wanted to make nursing a sphere dominated by women to allow women in positions of leadership, in so doing they continued to envision nursing as a space for white middle-class women. o It is separate, allows for progression/opportunities, but it is also an exclusionary space - Hospital hierarchies were ridged and although nurses, physicians, and other medical professionals worked together, all were seen by contemporaries as assistants to the physician with nurses in the most skilled role. o Less of a health-care "team" and more of a rigid hierarchy

Who does the separate spheres not apply to? What does it create?

- The Separate Spheres are socially constructed - they don't apply to most members of the working class o It creates a restriction which working class women were not always under - they were involved in being providers, their income was needed, participation in labor unions

What are the key points of the "Instructions for Haslar and Plymouth Naval Hospitals" primary source?

- The instructions were a strict set of guidelines for nurses in naval hospitals - The sacking of cradles, beds, mattresses, blankets and coverlets were to be kept clean and in good order. - Nurses were to have good conduct, attend with assiduity and kindness - they needed to behave with propriety. - Nurses should be cautioned to not bring spirits or other articles into the Hospital and alcohol, such as wine, porter, etc., was to only be drunk by the person they were intended for. - Names of those who neglect their duty had to be submitted to the Governor. - On proof of abuse of these rules, the nurses were to be discharged/punished.

What was the role of nurses in naval hospitals? What were the ward duties?

- The nurses provide general nursing care: o They observe the medical condition of the patient, they wash patients, help them shave, administer medicines, supervise meals/assist with feeding, changing body linen and bedding - Ward duties o Muster books - it keeps track of who (which patients) is supposed to be in the ward o Maintain cleanliness of the ward § fumigation § ventilation

What was the role of gender in military nursing care? - I.e. Nurses vs. Orderlies (a male)

- The role of gender in nursing care is quite blurred in a military sense - "It is a perversion, in some degree, of a man's nature, to make him a sick nurse; and the worst woman will generally make a better one as being more handy and compassionate than an awkward clumsy man" - William Fergusson o However, orderlies were often selected from men who weren't the best warriors - older, maybe injured, etc. - they weren't the ideal people to be selected for nursing care

What are the main points of "Halifax Infirmary School of Nursing Regulations"?

- The rules of that nurses were to follow were quite strict. - No jewelry, early curfews (10 pm), late permission was granted once a week (11 pm), no smoking was allowed, punctuality and obedience were to be practiced at all times, etc. They show how nursing was becoming more professional overtime.

What were nurses in training under the Nightingale system paid? What was their training system? What did they get after their graduation?

- The wages for probationers was 10 pounds a year plus room and board o This meant that they were self-selecting from the middle-class § Working women were not able to work for only 10 pounds a year - Training primarily happened on the Ward o Nurses answered to the Matron - From the first day of the work, nurses did tasks that they were able to do without medical knowledge - changing bedpans, bedding, etc. - They also had lectures from physicians and medical students - At the end of the year, nurses would get certification o Employment was found by the Nightingale Fund o Groups of trained nurses were sent to other hospitals § Such as the Liverpool Royal Infirmary - Private duty and Public Health Nursing

FREE FLIP - Nightingale and Public Opinion

- There were telegraphed dispatched from the Crimean War to the Times: o Both Newton and Struthers, it may be a consolation to their friends to know, were tended in their last moments, and had their dying eyes closed, by Miss Nightingale herself. Wherever there is disease in its most dangerous form, and the band of the spoiler distressingly nigh, there is that incomparable woman sure to be see; her benignant presence is an influence for good comfort even amid the struggles of expiring nature. She is a "ministering angel" without any exaggeration in these hospitals, and as her slender form glides quietly along each corridor every poor fellow's face softens with gratitude at the sight of her. When all the medical officers have retired for the night, and silence and darkness have settled down upon those miles of prostrate sick, she may be observed alone, with a little lamp in her hand, making her solitary rounds. The popular instinct was not mistaken which when she set out from. England on her mission of mercy, hailed. her as a heroine; I trust that she may not earn her title to a higher though sadder appellation. No one who has observed her fragile figure and delicate health can avoid misgivings lest these should fail. With the heart of-a true woman, and the manners of a lady, accomplished and refined beyond most of her sex, she combines a surprising calmness of judgment and promptitude and decision of character. - In February 9, 1855, she was called a "ministering angel" - They describe her as a hero, a women of class, etc.

What are the characteristics of medical schools in the early 20th century?

- They are different as they have both medical schools and nursing schools - Hospital spaces were training grounds for physicians - They needed patients to learn - Most hospitals before 1900 were opened to treat those who could not afford medical care in the home setting - NOTE* - Operating theatres were also being utilized at this time. § The Medical Gaze - a term coined by Foucault § Under the medical gave, you needed a hospital "space", a clinic

What are the characteristics of nursing schools in the early 20th century?

- They provide training for nurses - Most training happened in hospitals - Although not all hospitals had a medical school, most had nursing schools - They also provided disciplined workforces that were recognized as part of medical care - "Our hospitals are the fortress and our nurses are the soldiers who fight manfully against the enemy"

What is the importance of professionalization in nursing ? Who writes nursing history?

- to be a profession, you have to be able to self-regulate - nurse registration - it allowed for the CNA to regulate who could be called a nurse - it produces a shared identity through historical understanding - the organized approach provides a shared identity - Nursing history is written by "nurse historians" (nurses who are interested in history)

What was seen in history as necessary for health?

All Things were Medicine: "The Non-Naturals" - The importance of regime and regularity - food, drink, sleep, exercise - Leaky bodies would be the result if you were not keeping up the balance of this regime

Who wrote "Two Narratives, One History: Mary Seacole and Florence Nightingale"?

Darnisha Pitts - Nightingale has been the face of nursing for many - However, she overshadowed other nurses - such as Mary Seacole. - Seacole provided skilled nursing care during the Crimean War - she was interviewed and rejected by Nightingale's companions. - Despite this, she traveled to a British base at Balaclava with medical supplies and created the "British Hotel". - She provided nutrition, nourishment, comfort food and remedies. - Seacole was not funded by the government but rather paid her own fare to assist - Some debate her influence as a pioneering nurse, however. - Both broke the standard conventions of the day and advanced the status of women. - However, nightingale came from a privileged background - She had access to education, influential people and press. - Ultimately, both should be honored and revered by the nursing profession.

Who wrote "Woman's Mission and Professional Knowledge: Nightingale Nursing in Colonial Australia and Canada"? What are the main points?

Judith Godden and Carol Helmstadter - the Nightingale's stressed order, regularity, economy and providing services only to the deserving poor and rejecting those who were able to pay. - Bleeding, purging, vomiting, salivating, and blistering formed the basis of the old medical therapeutics. Under the Nightingale practice, the first duty of the nurse was to keep her ward clean. - By 1874, technologies such as the hypodermic syringe and clinical thermometers were being used - Nurses had to understand some of these physiological processes. - Florence Nightingale's genius lay in her success in harnessing 'the vocational wave of women in a way that removed religious tensions yet maintained its pious energy'. - New nurses needed to be good woman - sober, honest, truthful, trustworthy, quiet, etc. - To Florence Nightingale, class based character, vocation, and gender were as essential as nursing training in creating an effective nurse. - However, not all Nightingale experiments work - both Lucy Osborn and Maria Manchin did not succeed in their work in promoting Nightingale nursing - conflicts, challenges, failures occurred

Who wrote "Gender, Class and Ethnicity: Reconceptualizing the History of Nursing"? What are the main points?

Kathryn McPherson - Nursing is an important part of the history of women's work - it has transformed from unpaid care to wage labor. - Modern medical practices, new theories/technologies, government funded health care all played a role in transforming the nursing profession - This study argues nurses occupied a unique position - one influenced by the gender, racial, national and ethnic categories. - Nurses were defined by their subordination to medical men another important characteristic. - The first generation was the nurses who graduated between 1875-1899 - they pioneered trained nursing in Canada. - In the 1900s, the second generation of Canadian nurses had been established in the medical profession. - The era of expansion was very different from the third generation which suffered during the 1920-1940s. - After WW2, the fourth generation experienced large growth as the war inverted the "economic and structural basis of work for Canadian nurses". - The fifth generation came after the public establishment of Medicare.

Who wrote "Nursing Classes: The Second Generation of Trained Nurses, 1900-1920"? What are the main points?

Kathryn McPherson - There were several challenges with the "old" style of nursing - alcoholism, small enrollments, usually from lower classes of society - The hierarchy of nursing was highly organized: The ideological components of discipline and subordination help secure nursing's place in the category of respectable femininity - thus making the hospital a place where middle-class individuals could be treated. - Nursing was seen as a "border case" according to Mary Poovey - it was between a normative working man and a nonworking woman - it was thus unique for Victorian society - Florence Nightingale was key in ensuring that this work did not destabilize societal conceptions of gender and work. - With women as nurses, there was a gender division that served the "household" of the hospital: As symbolic wife, the nursing superintendent supported the male head of household by ensuring the smooth functioning of daily patient care. Like daughters, or female servants, apprenticing students were expected to maintain the reputation of the family. - Administrators also had to balance conformity for etiquette with the understanding that nurses were provided valuable skilled labor. - The second generation of Canadian nurses used resistance and other tactics to improve their work conditions - They also developed collective voices - there were many associations and organizations that merged eventually in 1920s to form the Canadian Nurses' Association (CNA).

Who wrote "Is nursing a profession?" What are the main points?

M. A. Messer - nursing requires not only skill/intelligence but also education. - The nurse has become as essential to the community as the physician. - The nurses in modern times must be educated, broad-minded and of a high character. - If only skills are necessary, then women are foolish to spend three or four years preparing for their work. - Nurses must continue until they are recognized as a profession.

Who wrote "Servants to the hospital and the state: nurses in Plymouth and Haslar Naval Hospitals, 1775-1815"? What are the key points?

Prof. Spinney - fighting and wars, naval forces and employing sailors, resulted in the first clinical naval hospitals. - In the naval hospitals, experience was more valuable than following set regulations. - Labor organization in naval hospitals were tied together by contractual agreements - the hospital workforce was divided between medical officers and laborers, nurses, other servants - Within in this framework the Hospital Governor assumed the role of the patriarch, the matron that of the housekeeper, and the nurses as the servants - the article looks at hospital organization in a household model - a domestic framework - which allows for the consideration of gender, class and the importance of nurses in everyday functions. - Military hospitals are unique because female servants, i.e. nurses, were in a position of moderate authority over the bodies and medical care of male servants of the state, namely sailors.

Who are two of the Protestant religious orders that were highlighted in class as early nursing groups?

Protestant: Kaiserwerth - 1836 - Kaiserwerth Deaconess Institution in Prussia o it stressed the importance of discipline and order o it used the language of religious vocation for Protestant women - Florence Nightingale went to Kasierwerth - she said: "the nursing there was nil. The hygiene horrible. The hospital was certainly the worst part of Kasierwerth. I took all the training that was to be had—there was none to be had in England, but Kaiserswerth was far from having trained me." Protestant: Institution of Nursing Sisters - 1840: Founded in London by Elizabeth Fry - They work a dark brown uniform - It was a focus on nursing care o They worked in communities § They believed that the poor were to be cared for in their own homes, the same as the wealthy

Who wrote "The ideal nurse"? What are the main points?

R. H. McNeill o It does not require strength, but rather attention to detail and to preserve a high moral, mental and physical standard. o Nursing is a special vocation for women is a grave responsibility. o Nurses are required to: "to suppress her own heartaches and to give herself bravely and brightly to the work with patience, enduring all things, and with faith, hoping all things". o Nurses must be also able to understand her physician's orders and execute them when asked. o The life of a nurse is that of a Christian:

Who wrote "Good night, Florence: with nursing in crisis, some say it's time to retire Nightingale as a symbol"?

Roxanne Nelson - Florence nightingale has been considered the founder of modern nursing. - However, the largest trade union representing nurses argued a new figure was needed - Some believe her model was holding back the profession and causing the shortage whether others disagreed and still regarded her as a significant figure in the 19th century. - Nightingale has been targeted of keeping nurses in a poor social position because of her opposition to the British nurses seeking professional registration. - However, other factors play into the past successes and modern challenges in the history of nursing.

Who wrote "The Nightingale Imperative"? What are the main points?

Sioban Nelson and Anne Marie Rafferty - This chapter deals with the impact of the idea of nightingale and its role as a transnational unifying discourse. - The Nightingale ideal has become synonymous with nursing. - Nightingale sought to repay the support she was given through charity by exporting trained nurses and establishing nursing school through the British Empire. - Nightingale's success and influence was key in the Anglicization of nursing. - Yet, community was established through Nightingale as a tradition and the inculcation of consistent values. - The nightingale tradition invokes that the nursing profession is a higher service to humanity - ideals of the profession instead of a technical or subordinate profession.

What are some limits in the definition of history?

o It requires history to be done by historians o It can discount oral history o It tends to require written documentation - In the United States, you do not need ethic board approvals whereas you do need approval in Canada - History is also affected by the contemporary culture and current views

What were some of the racial exclusions that occurred in nursing training education?

o Mary Mahoney was the first African American nurse to graduate from an American hospital training school in 1879. She co-founded the NACGN in 1908 after hostility from the American Nurses Association o In Canada, there were also policies that excluded First Nations, Philipino women, etc.

What was the expectations for women in the victorian era? Which groups of women would work as waged labor?

o The expectations for middle-class woman was to clean the house, cook, take care of children, etc. § Men would work outside of the house - For nurses, domestic work does not have negative connotations in the Victorian era o Waged labor - domestic servants, private duty nurses were waged labor

What were some of the gender exclusions that occurred in nursing training education?

o The policies of exclusion perpetuate the gender hierarchies of women nurses being submissive to the male physician o It was difficult for men to enter the nursing profession § Some men did want to enter the nursing profession and did become nurses · But it is rarer - they work more in psychiatric, although some do work in public health/private duty nurses o It is also difficult for women to become physicians § They aren't permitted for men to enter into the male dominated physician schools

How did hospital training schools impact nurse's identity? (3)

o Working and living together helped to create a distinct 'nurse' identity § There is less of an identity/cohesiveness when nursing transitions to a Ba degree system in the universities o The uniform one had would change with skill progression o This involved a ceremonial progression - Capping ceremonies (religious icons, candles, etc.) § The cap was the transition from probationer to a student nurse (After their first year) § It was similar to a graduation - families were invited - you made a public declaration, similar to vows in a religious order - There was also strict discipline and regulation - they aligned with perceptions of morality, piety, etc. - part of Victorian domesticity

How were nurses viewed in the hospital hierarchy?

o the nurse was viewed as the primary assistant - the most "trained" assistant to the physician, but was still an assistant - it aligned with perceived gender hierarchies o Women were to be obedient to men in the same way nurses were to be obedient to physicians - the "Doctor's Handmaidens" is a stereotype that has a cornel of truth in the late 19th and early 20th century - it was perpetuated by professional hierarchies