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Ordered to Care

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  1. Ordered to Care Chapter 4Training as work: the pupil nurse as hospital machine Rachel Duncan WellsUniversity of AlabamaBEF 644Fall 2013

  2. Trained to Work • A New Generation of Trained Nurses = cheap, readily available labor • Nightingale Model ideal: discipline, self-sacrifice, order, and a separate sphere within the hospital • Reality: Hospitals in the US increased from 178 (1873) to 6,830 (1923) with 1 in 4 hospitals associated with nursing schools • Reality: No overarching body for nursing resulted in lack of standards and uniformity • Reality: Nursing schools as financial support for the hospital

  3. Trained to Work • Hospital Hierarchy • Board of Trustees/Hospital Administrator/Physicians • Nursing Superintendent • Head Nurse- graduate nurse or senior nursing student • Student Nurse

  4. Trained Nurse: Hospital Machine and Industrial Slave? • Daily tasks of the student nurse: • Scrubbing bathrooms • Scrubbing floors, • Washing laparotomy pads, operating sheets, towels • Washing patients • Feeding patients • Medicating patients • Assisting in surgery (some hospitals) • Teaching other students • Attend lecture and recite what they “learned” • SMILE, SMILE, and SMILE during these tasks without asking the why, when, or how

  5. Power of the Head Nurse & Student Rebellions • Ideally, the head nurse organized the work and supervised the student nurses- she would be the most direct person involved with the shaping of the student’s nurse training • Hospital Superintendent pressured the Nurse Superintendent who pressured the Head Nurse to ensure daily tasks were done without regard to time for training • Head Nurses under such pressure often had absolute control which turned to arbitrariness and absolutism- Just Do It! • Student Rebellions- Wishful and Hospital Specific

  6. Institutionalized Subordination • Volley for Power: Hospital Superintendents, Physicians, and Nursing Superintendents • Issues with a separate department of nursing: Undermining of ideological deference to administrators and physicians • Dr. George Rowe and the “Unal” plan • Lillian Wald- director of the Nurses’ Settlement in NY- and her minority report against giving authority to the medical board • Lavinia Dock argued against the “unal” plan

  7. Educational Dilemma

  8. References • Reverby, S. (1987). Ordered to care : the dilemma of american nursing, 1850-1945 . Cambridge, NY: Cambridge University Press. Retrieved from http://www.bamaed.ua.edu/ELPTS/644/Readings/OC/4.pdf