Nursing: an Overview

Nursing: An Overview Nash, Herbert M. ‘‘Some Reminiscences of a No. 77 Fulton Street.’’ A similar advertisement in May Confederate Surgeon.’’ Transactions of the College of 1824 read: ‘‘Wet Nurse: A Healthy young woman, with Physicians of Philadelphia, 3rd ser., no. 28 (1906): a good fresh breast of milk, wants a situation in the 122–144. Reprinted in College of Physicians of above capacity, in a respectable family. The most respect- Philadelphia, Transactions of the College of Physicians able references can be produced, as to character, ability, of Philadelphia, 3rd series. Philadelphia: College of &c.’’ In addition, Southern plantation households used Physicians of Philadelphia, 1938. similar language when referring to slaves who worked in Smith, George Winston. Medicines for the Union Army: the nursery. The United States Army Laboratories during the Throughout American history, mothers and other Civil War. Madison, WI: American Institute of the female members of households traditionally worked History of Pharmacy, 1962, Reprint, Binghamton, within the home, where they attended to the bulk of NY: Haworth Press, 2001. their family’s medical needs. While the use of male Worsham, John H. One of Jackson’s Foot Cavalry; His physicians increased during the antebellum period, Experience and What He Saw during the War mothers still exercised great authority, because patients 1861–1865. New York: Neale Publishing Company, by and large remained at home, and only rarely received 1912. care in a hospital. Many of the first female nurses to work Carol Brennan outside the home were the spouses and daughters of male physicians, whom they routinely accompanied during house calls. These women served as an invaluable n buffer between the male physician and the household’s Nursing females, often working more as a source of comfort and NURSING: AN OVERVIEW support than as a medical care provider. Keith S. He´bert Several factors hampered the development of the ARMY NURSES antebellum nursing profession. Demand for nurses Carol Brennan existed only in the nation’s few hospitals. Such facilities were rare, except in such cities as New York, Boston, and VOLUNTEER NURSES Philadelphia. Gender-based expectations also inhibited Carol Brennan the profession. Though by and large it was men who worked as nurses, nursing was still considered a feminine NURSING: AN OVERVIEW activity and was associated with mothers, not professio- The Civil War was a watershed moment in the history of nals. A lack of training and educational opportunities the American nursing profession. The war served as the also limited the profession’s development. Most nurses learned their skills through observation rather than as primary impetus fueling an increasing demand for and part of a regimented training program. Elizabeth Black- recognition of the contributions of nurses as medical well, the first woman to receive a medical degree in care providers. Prior to 1861, men dominated the newly America, saw a need to develop such a program. In developed nursing profession. During the war, the 1858 she started the nation’s first nurses’ training school demand for nurses quickly outpaced the existing supply, at the New York Infirmary. Her efforts, however, were providing women with opportunities to volunteer out- more reflective of her own feminist program than repre- side the home. By 1865 Americans no longer considered sentative of any mass movement toward educating nursing to be a male occupation. And it was the wartime nurses. sacrifices of tens of thousands of women that made Antebellum attitudes toward women and toward sex possible the profession’s postbellum development. also hampered the profession’s development. If nursing Antebellum Nursing was conceived as a feminine activity, women were none- theless considered poorly suited to serve as professional The term nurse lacked any uniform definition during the nurses. Antebellum women were seen by American cul- antebellum period, due in part to deficiencies in nurs- ture as too weak, physically and emotionally, to endure ing’s professional development. Today, nursing is an the sight of blood. A female nurse, it was also believed, occupation within the medical profession. Prior to the would be unable to control male patients. Perhaps most Civil War, the term nurse typically described someone importantly, they would be exposed to the sight of male who cared for children or was a wet nurse. Some genitalia. While those prejudices were influential, the excerpts from the ‘‘help wanted’’ advertisements pub- principal factor hampering the profession’s development lished in the New York Evening Post in 1824 reflect such remained the lackluster demand for nursing, a reflection usage. For example, an advertisement placed on March of the domestic nature of antebellum healthcare. 11, 1824, read: ‘‘A Nurse Wanted—wanted, a middle Florence Nightingale (1820–1910) and Mary Sea- aged woman, capable of taking care of children. Apply at cole (1805–1881), British nurses during the Crimean 32 GALE LIBRARY OF DAILY LIFE: AMERICAN CIVIL WAR Nursing: An Overview War (1853–1856), directly influenced Civil War nursing. Estimating the number of nurses who served during Nightingale’s efforts to improve sanitary conditions for the Civil War is difficult, due to the destruction of Con- British soldiers in Scutari, Turkey, attracted international federate Medical Department records, the large number attention and directly influenced the duties of Civil War of volunteer nurses, and the haphazard manner in which nurses. Her focus on sanitation was unprecedented. Like the military identified nurses. While an exact figure is Nightingale, Mary Seacole—a woman of mixed racial impossible to provide, it has been estimated that there ethnicity—nursed soldiers serving in frontline units and were as many as 400,000 Civil War nurses, though that frequented the battlefields tending to the wounded. number includes individuals who performed duties asso- Both women were acclaimed by American newspapers, ciated with but not directly related to nursing. During which printed many stories documenting their heroism. the war, the term nurse was associated with a variety of Those stories helped to recast the image of the nurse in duties and types of individual. It did not by any means the American imagination. refer only to trained medical professionals. For example, In 1860 Nightingale opened the Nightingale both armies still referred to slave women charged with Training School at St. Thomas Hospital in London. the care of children as nurses. Men whose work in the That same year, she published Notes on Nursing: What hospital involved such menial chores as chopping wood It Is, and What It Is Not. This book served as the stand- or transporting soldiers were often referred to as nurses. ard nursing text for decades. In it, Nightingale clearly The word was also used for agents of the Sanitary Com- defines nursing as women’s work: ‘‘If, then, every mission or Christian Commission, and for nuns from the woman must at some time or other of her life,’’ she Sisters of Mercy or Sisters of Charity. It might also be wrote, ‘‘become a nurse, i.e., have charge of somebody’s used to describe a person charged with caring for an health, how immense and how valuable would be the ailing soldier within the privacy of their home, or a produce of her united experience if every woman would woman who accompanied her husband in camp, tending think how to nurse’’ (Nightingale 1860, preface). The to the sick and wounded. book also established a set of practical guidelines that Some generalizations can be made about Civil War defined nurses’ distinctive role in providing health care. nurses. A majority were enlisted soldiers pressed into Nightingale fashioned nurses as sanitary crusaders and duty as nurses. While many soldiers fulfilled this assign- observers who monitored the health of men—duties that ment admirably, others did not. After the Battle of formed the daily life of Civil War nurses. Shiloh, Union Army surgeon Robert Murray advocated for future use of fulltime nurses, a group that included Civil War Nursing a large number of women. Murray complained that Nurses, both male and female, have cared for wounded wounded soldiers were ‘‘left partially attended to by an soldiers in every American war. During the Civil War, unwilling and forced detail of panic-stricken deserters nurses worked in hospitals, on the battlefield, and in their from the battle-field’’ (The War of the Rebellion, ser. 1, homes. The war significantly altered the course of Amer- vol. 10, p. 299). Soldier nurses were routinely accused of ican nursing in two major ways. First, the carnage of the shirking the more dangerous duties of the frontline war created an unprecedented demand for nurses. This soldier. Both armies created strict regulations that gov- need made it possible for nursing to become a standard erned who among the enlisted ranks would serve as occupation within the American medical profession. Sec- nurses. While most regiments detailed active soldiers, ond, while the majority of wartime nurses were male, the male nurses in general hospitals tended to be convalesc- contributions of thousands of female nurses helped alter ing soldiers recovering from their injuries. the image of the professional nurse and changed Ameri- There were several ways for women and men to can nursing from a male-dominated to a largely female become nurses. Some were mustered into service by profession. The Civil War set the stage for subsequent

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