ii COMPLEMENTARY AND ALTERNATIVE MEDICINE (CAM) IN BRITISH NURSING PRACTICE, 1960-2000 by CHRISTINE MARY GOWING A thesis submitted to the University of Birmingham for the degree of DOCTOR OF PHILOSOPHY Institute of Applied Health Research College of Medical and Dental Sciences University of Birmingham MAY 2016 University of Birmingham Research Archive e-theses repository This unpublished thesis/dissertation is copyright of the author and/or third parties. The intellectual property rights of the author or third parties in respect of this work are as defined by The Copyright Designs and Patents Act 1988 or as modified by any successor legislation. Any use made of information contained in this thesis/dissertation must be in accordance with that legislation and must be properly acknowledged. Further distribution or reproduction in any format is prohibited without the permission of the copyright holder. iii ABSTRACT Most nursing history has focused on the politics, identity and development of the profession. This study focuses on practice. It examines the surge of interest in complementary and alternative medicine (CAM) in British nursing during the second half of the twentieth century and explores how and why some nurses used CAM in their practice. It examines the therapies that nurses employed and how these practitioners were supported. The merit of this research lies in exposing evidence of a more clearly designed organisation of CAM in nursing than has been suggested previously and places it within a discrete timeframe, one already recognised as a period of reform in medicine. In using the methodology of oral histories, archives and nursing journals, the research is rooted in nursing history, importantly demonstrating that CAM practice in nursing was not only part of a shift in consciousness away from a medical model, but was an extension of the patient-centred nature of nursing culture in the late twentieth century. In presenting a movement that challenged the dominance of biomedicine, this thesis demonstrates the emergence of a changing model of healthcare and contributes an important perspective to the history of modern medicine and healing. iv Dedicated to JFG and AHG My grandfather and grandson v ACKNOWLEDGEMENTS Dr Helen Sweet was a major motivator when I was considering undertaking this study. It would never have left the starting block without her confident encouragement, and, for that, I thank her enormously. I am indebted to those who generously participated in the research by granting me interviews: Sybil Allen David Mayor Julia Ayres Ruth Message Nicky Baker Sue Myring Edward Baldwin Inga Newbeck (Lord Baldwin of Bewdley) Patrick Pietroni Roger Beeching Denise Rankin-Box Elizabeth Cranham Jane Salvage Paula Dunleavy Jean Sayre-Adams Michael Dixon Ruth Sewell Christine Eberhardie Jacqui Stringer Hermione Elliott Denise Tiran Alison Ellis Angela Taylor Steven Ersser Alice Temple-Bruce Sheila Forrest Annette Turton Annie Hallett Pat Turton Elizabeth Hill Mary Walker Caroline Hoffman (née Stevensen) Rosie Winyard Dan Jones John Walton George Lewith Shirley Watkins Peter Mackereth Stephen Wright Fiona Mantle I am grateful also to those people with whom I had valuable conversations: Hilary Barber, Theresa Bentley, Alison Coates, Amanda Cheesley, Collette Clifford, Katie Dabin, Jacqui Davis, Bernard Gibbons, Mary Johnson, Michael Macintyre. Staff in archives were especially supportive, and, in particular, I thank Fiona Bourne at the RCN archives in Edinburgh and the librarians at RCN HQ in London who, over the two years of data collection, uncomplainingly retrieved piles of heavy bound journals from the store. vi I acknowledge with gratitude the permission from Nursing Times to reproduce the cartoons on pages 304 and 360 and the Royal College of Nursing for the images on page 156. I appreciate the feedback I received from delegates at the 2015 UKAHN history of nursing conference on my ‘work in progress’ paper, and the Oral History Society annual conference in 2015 following my paper on nostalgia, which is now incorporated into this thesis. Dr Stuart Wildman has kindly advised me on nursing history, for which I am very grateful. Most importantly, Professor Jonathan Reinarz and Dr Nicola Gale have been not only rigorous but inspiring supervisors and mentors. It is hard to express how grateful I am for all that they taught me, for the stimulus of their supervisions and for steering me through to the end with their advice, guidance and encouragement. On a personal note, I especially thank my family for their loving support. __________________________ vii TABLE OF CONTENTS CHAPTER ONE: INTRODUCTION .................................................................. 1 1.1 Introduction ............................................................................................... 1 1.2 The aims of the thesis .............................................................................. 3 1.3 The context, the problems and the gaps in knowledge ........................ 4 1.4 Background themes ................................................................................. 6 1.4.1 Definition of CAM ................................................................................ 6 1.4.2 Medical context ................................................................................... 9 1.4.3 Nurses and CAM ............................................................................... 11 1.4.4 Caring and wellbeing ........................................................................ 14 1.4.5 Florence Nightingale ......................................................................... 19 1.5 The research design: questions and timeframe ................................... 22 1.5.1 Research questions .......................................................................... 22 1.5.2 Timeframe (1960-2000) .................................................................... 22 1.6 Thesis limitations and delimitations ..................................................... 26 CHAPTER TWO: LITERATURE REVIEW ..................................................... 34 2.1 Introduction ............................................................................................ 34 2.2 History of Nursing .................................................................................. 35 2.3 Complementary and Alternative Medicine (CAM) ............................... 48 2.4 CAM and nursing .................................................................................... 61 CHAPTER THREE: METHODOLOGY .......................................................... 69 3.1 Introduction ............................................................................................ 69 3.2 Oral histories .......................................................................................... 72 3.2.1 Sampling ........................................................................................... 75 3.2.2 The interview ..................................................................................... 78 3.2.3 Memory ............................................................................................. 79 3.2.4 Practicalities ...................................................................................... 90 3.2.5 Challenges ........................................................................................ 92 3.3 Archives ................................................................................................... 95 3.4 Nursing Journals .................................................................................... 99 3.5. Analysis ................................................................................................. 106 3.6 Personal Reflections ............................................................................ 108 CHAPTER FOUR: ENVIRONMENT AND AWAKENING ........................... 110 4.1 Introduction ........................................................................................... 110 4.2. Terminology .......................................................................................... 112 4.3 Historical Context ................................................................................. 118 4.3.1 Healthcare ....................................................................................... 118 4.3.2. A paradigm shift or an awakening? ................................................. 129 4.3.2 The Zeitgeist ................................................................................... 136 4.3.3 Nursing ............................................................................................ 141 4.4 Nursing and CAM .................................................................................. 165 4.4.1 Latent pluralism ............................................................................... 165 4.4.2 Role enhancement .......................................................................... 167 4.4.3 CAM: prompts and motivations ....................................................... 170 4.5 Conclusion ............................................................................................ 173 viii CHAPTER FIVE: INCORPORATION 177 5.1 Introduction ........................................................................................... 177 5.2 The nurse-patient relationship ............................................................ 179 5.2.1 The nurse-patient relationship: touch .............................................. 189 5.2.2 The