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Ordered to Care Chapter 7 Professionalism and its Discontents. Angela Bridges Wendy DuBose BEF 644 Fall 2012. Introduction. Trained Nurse and Hospital Review (1889) Discussed need for national organization for nursing Intent was to: Limit number of nurses

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Ordered to Care Chapter 7 Professionalism and its Discontents

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Ordered to Care Chapter 7 Professionalism and its Discontents

Angela Bridges

Wendy DuBose

BEF 644

Fall 2012


Introduction

  • Trained Nurse and Hospital Review (1889)

    • Discussed need for national organization for nursing

    • Intent was to:

      • Limit number of nurses

      • Standardize education requirements

      • Increase education requirements


Obstacles for Reform

  • Womanly character vs “unladylike” conduct

  • Service oriented work ethic vs self-interest

  • Wages vs commercialism

  • Female vs Male gender

  • Admission standards

  • Exploitation of nursing students

  • Criterion for education

  • Lack of public buy-in for educating nurses

  • Alienation from working nurses


Professional Reformation

1893

Isabel Hampton Robb

  • Instrumental in founding the American Society of Superintendents of Training Schools (ASSTS)-known today as the National League of Nursing Education (NLNE)

  • ASSTS drafted and approved bylaws that set standards for admission into nursing schools


History of Nursing Reformation

  • 1897- Funds collected for official nursing journal

    (American Journal of Nursing)

  • 1889-proposition for organization called the American Nurses Association (ANA)

  • State Board examinations

    On left from top, clockwise:

    Lillian Wald, Lavinia Dock, & Adelaide Nutting


Hostility and Indifferencein the Public Realm

  • Environment changing

    • Nursing education/training more accepted in medicine

    • Growing hostility from administrators and physicians

  • Dr. Catlin

    • Endowed home for nurses

    • Training by physicians

    • Fees determined by physicians


Nursing: Ununited

  • Worker-Nurse Perspective

  • Concern with wages, working conditions, practical skills, independence

  • Resisted professionalization through registration and educational reform

  • Selection of nurses through character

  • Some adept in skills, modifying hospital techniques

  • Some inadequate based on training.

“Where there is one nurse with a missionary spirit,….there are forty-nine others who are obliged to make the humiliating confession: I am a nurse because I must earn a living for myself and those dependent on me, because my nursing is well paid, honorable and to me is interesting.” Trained Nurse (1888)


Traditionalists versus Rationalizers

Annette Fiske-private duty nurse and educator

Charlotte Aikens-nurse and hospital superintendent

Character/service; not education

Raise nursing standards through organizational power

Provide hospitals with cheap labor

Proposed grading/classification of nurses.

  • Character/service; not education

  • Private duty most important

  • Attacked elitism of leadership

  • Objected to routinization

  • Recognized problems-no solutions


References:

Reverby, S. M. (1987). Ordered to care: The dilemma of American nursing, 1850-1945.

Cambridge, United Kingdom: Cambridge University Press


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