ABSTRACT
The introduction of systematic nurse training was as much a part of nineteenth-century reform of the profession as changes in class and age profile discussed in the previous chapter. In traditional histories, Nightingale is credited with this innovation but, as with many such claims, this is now questioned. As Monica Baly and Carol Helmstader have argued, her contribution to nurse training represented a continuum of a process which began with nursing sisterhoods, rather than a revolution (Baly 1987; Helmstadter 1996). Whoever was responsible, it is indisputable that nurse training became longer and increasingly sophisticated as the century progressed. Originally an informal arrangement, whereby women acquired their skills through experience on the wards, by the end of the century nurse education had metamorphosed into a structured three-year course of theoretical and practical study. Advances in medicine, particularly its emergence as a more scientific discipline, created an evolutionary pressure on the role of the nurse. From being little more than simple carers with a main responsibility to keep patients comfortable, nurses were increasingly expected to perform technical interventions (Helmstadter 2002). Such changes brought benefits to nurse leaders and doctors alike. For nurse reformers, the technical nature of ‘new nursing’ offered the opportunity to define a body of knowledge, which could be used to redefine nursing as a profession rather than a quasi-domestic service occupation (Simonton 2001). For doctors, the availability of better educated nurses created opportunities for delegation of their more routine (or mundane) tasks. However, advances in medical science do not provide the only explanation for the emergence of formal nurse training. Pressures in Victorian society also contributed to the phenomenon: not least the ‘surplus women problem’, and a new interest in education for young middle-class women. Improved nurse training, it was argued, would attract such women – who were entering the workplace for the first time in significant numbers – by offering an opportunity for further study. At the other end of the social scale, it also resonated with Victorian society’s obsession with controlling
and moulding the lower classes. Laden with middle-class ideals of morality and character, nurse training would instil such values in lower-class recruits (Dean and Bolton 1980). This chapter explores the impact of these social pressures on the development of nurse training, specifically from the perspectives of the main protagonists: the nurses, the medical men and the hospital managers.
