Nursing before Nightingale, 1815–1899

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  • Carol Helmstadter and Judith Godden
  • Series: The History of Medicine in Context
  • Nursing Before Nightingale is a study of the transformation of nursing in England from the beginning of the nineteenth century until the emergence of the Nightingale nurse as the standard model in the 1890s. From the nineteenth century on historians have considered Florence Nightingale, with her training school established at St. Thomas's Hospital in 1860, the founder of modern nursing. This book investigates two major earlier reforms in nursing: a doctor-driven reform which came to be called the 'ward system,' and the reforms of the Anglican Sisters, known as the 'central system' of nursing. Rather than being the beginning of nursing reform, Nightingale nursing was the culmination of these two earlier reforms.

    Recent historians of nursing have ascribed the nineteenth century makeover of nursing to two causes: medicalization by hospital doctors who found the old independent nurse practitioners a threat, and the inculcation of middle class values by philanthropists. By contrast this volume demonstrates that the real cause of nursing reform was the development of the new scientific medicine which emphasized supportive therapeutics and, as a result, became heavily dependent on skilled nursing for successful implementation of these treatments. The pre-industrial work ethic of the old hospital nurses could not meet the requirements of the new medicine. Recruitment and retention of working-class persons was also extremely difficult because nursing in the early nineteenth century formed the lowest rung of the occupation of domestic service and was a job of last resort. It was still more difficult to recruit educated women or 'ladies.' There were intricate interactions between the requirements of clinical nursing under hospital medicine's new regime on the one hand, and on the other, the contemporary ideal of a lady, class structure, economic realities, the reformation of manners, and the detrimental impact of violent denominational controversies in a very religious society. This book, therefore, will be of great value to those studying the history of medicine, labour, religion, gender studies and the rise of a respectable society in the nineteenth century.
  • Contents: Preface; Glossary; The new medicine and its dependence on good nursing; Hospital nursing in the first part of the century; The ward system: a doctor-driven reform; Early efforts at training; Nursing at the crossroads, part I: ladies and religious sisters in the Crimean war; Nursing at the crossroads, part 2: working-class nurses in the Crimean War; St John's House and its mission; The St John's House central nursing system; The demise of sisterhood nursing and the central system; Conclusion; Bibliography; Index.
  • About the Author: Carol Helmstadter wrote this book when Adjunct Assistant Professor at the Faculty of Nursing, University of Toronto and Judith Godden when at The University of Sydney as Senior Lecturer in the School of Public Health and later Honorary Associate of the Department of History. Carol is an award-winning nurse historian who publishes widely on nineteenth-century nursing. Judith now works in Sydney as a professional historian specialising in the history of medicine.
  • Reviews: Prize: Winner of The Lavinia L. Dock Award for 2012
    A Choice Outstanding Academic Title for 2012
    '… bridges the historical gap in nursing scholarship, bringing a fresh perspective on the contributions of many over centuries to the development of the nursing profession. Valuable for anyone interested in the history of medicine, or religious, labor, or gender studies. Summing Up: Essential. All academic readers.' Choice

    'Nursing before Nightingale excels in linking the micro-practices of nursing to macro-issues of gender, medicine, class, and denominational prejudice. It is essential reading for anyone wanting to venture beyond the famous figures of Gamp and Nightingale and delve into the complex world of Victorian nursing.'
    Victorian Studies

    'This is the first work that has proposed a model for changes in hospital nursing that spans the whole of the nineteenth century and puts the Nightingale system as the culmination of these attempts at reform, not the start… essential reading for all those interested in the history of British nursing.' Social History of Medicine

    'This is a highly readable and fascinating account of the struggles faced by early nurse reformers. It will be of interest to historians, nurses, and anyone interested in medical history at both an undergraduate and postgraduate level. But perhaps Helmstadter and Godden’s greatest achievement is to look at the early history of modern nursing and show how relevant this story is to nursing today. In the end, Nightingale’s more secular model of nursing prevailed in our memory and nurses continue to fight for full professional recognition today.' Journal of Religious History

    'This book is extremely valuable because it presents a new image of pre-Nightingale nursing in England and illuminates the overlooked importance of religious nurses to the reforms in England, which should encourage further historical research on this topic.' Canadian Bulletin of Medical History

    'In their compelling book, the authors meticulously analyze extensive primary sources, including hospital records and papers of Florence Nightingale and Anglican sisters. … [It] places nursing history in broad sociocultural contexts and challenges historians in other fields to consider healthcare as central to the nineteenth-century master narrative.' The Historian

    '… thought-provoking and timely.' Bulletin of the History of Medicine

    '… a clear and concise analysis of nursing reform before Nightingale became the iconic figure of the nursing profession.' Medical History