Tag Archives: Nursing

Why Did Florence Nightingale Oppose the British Nurses’ Association?

Nursing Emerges as a Profession

Nightingale entered nursing at a time when women had few respectable employment options. The few women of the upper class who chose the occupation did it out of duty or a sense of service, rather than the desire for a paycheck. Nurses often came from the working class and had little formal education outside their nursing training, which was more hands-on training during a probationary period than book- or lecture-based instruction. It’s also important to note that the wealthy still mostly received their medical care at home, resorting to hospital care only in dire emergencies. Hospitals were used for administering care to the poor and, during wartime, to soldiers.

Thus nursing fell short of being considered a true profession; some even thought of nursing as being only slightly better than prostitution! Behavior like stealing food from patients or demanding bribes for administering care was not uncommon; nor was inappropriate fraternization between female nurses and male patients. One of Nightingale’s first priorities was to establish standards for nursing as an “art” or “calling.” Nightingale placed considerable emphasis on nurses’ morality, noting that the best nurses were kind, moral, and decent. She strongly believed that lack of formal education did not preclude a woman from making an excellent nurse, so long as she possessed these other qualities.

Nightingale spoke positively about making nursing a profession early in her career. She also took substantial steps to remove opportunities for amoral behavior on her wards. For example, during the Crimean War, Nightingale did not allow any other female nurses to stay in the ward past 8:00 pm; during the night, male patients received care from male orderlies. This practice is what earned Nightingale the nickname “Lady of the Lamp.” She would pace the ward by lamplight virtually all night long, resting only briefly, intent on ensuring that her patients got exceptional care around the clock.

The BNA Moves Toward Exclusion

British_Nurses_Association_First_Annual_Report

The First Annual Report of the BNA

The British Nurses’ Association (BNA) was founded in 1887 through the efforts of Ethel Bedford-Fenwick, Catherine J Wood, Isla Stewart, and a number of prominent male physicians. Princess Christian, Queen Victoria’s daughter was the BNA’s royal patron. The organization changed its name to the Royal British Nursing Association in 1891 and received its royal charter two years later. Its primary aim from the beginning was to establish a national registry of nurses. To be included in the registry, nurses would have to complete their training and pass a written examination.

With the written examination, the founders’ tacit goal was to exclude working-class women from nursing–thereby raising the social status of the profession. Nightingale didn’t deny that higher social status had its merits for administrators in nursing, but she argued that working-class nurses could provide equally excellent care despite their lack of formal education. She also pointed out that nurses weren’t “dictionaries,” and that passing a written exam did not necessarily indicate that someone would make a good nurse: “Some of our best could not pass an examination with credit, while some of our worst could gain the most credible place.” Nightingale’s fundamental opposition to the BNA stemmed from their efforts toward exclusion. She advocated improving the overall quality of nursing care through better training instead.

An Immediately Outdated Registry

The BNA wanted to create a registry listing all the nurses who had completed training and passed a written exam. Hospital administrators could then use the registry as a resource to ensure that they were hiring qualified nurses. Nightingale objected to the registry for multiple reasons. First, the registry would be out of date almost from the moment of publication, as new nurses constantly entered the profession; some nurses would not even be included for years after they completed training, when a new registry was finally printed.

But the registry had an even greater flaw, in Nightingale’s eyes: no mechanism existed for removing the names of nurses who were subsequently found to be unfit for the profession. Nightingale said that it often proved difficult to fire nurses even in extreme cases, such as drunkenness on the job or egregious amoral behavior. If a fired nurse had her name printed in the registry, that would give her undue legitimacy when she sought new employment in the profession. Nightingale asked the BNA how a nurse’s name would be removed from the registry, outside of death or criminal conviction, but she never received a satisfactory answer.

Furthermore, as it was conceived by the BNA, the registry would not indicate where or when a nurse had received her training. Nor would it list any additional advanced training she may have completed. Nightingale saw this lumping together of all nurses, regardless of training qualifications, as a fatal flaw. Training programs varied widely in technique, quality, and duration. And a nurse trained during wartime, or under a leading physician, for instance, were often better equipped to handle the demands of specific nursing positions. Nightingale argued that omitting such information from the registry made the document virtually useless.

Some opponents of the BNA proposed an alternative: issuing nurses certificates when they completed training. The certificate would indicate the date the nurse completed training and the training institution. Each nurse would bear responsibility for her own certificate, and the certificate could be confiscated if she were fired for negligence or misconduct. But the prospects of forgery and the onus of replacing lost certificates made this system less appealing to Nightingale and other leaders in the field.

Too Much Control for Doctors

Nightingale sought to make nursing an autonomous endeavor, not under the jurisdiction of physicians. She believed in creating a separate hierarchy within nursing, so that doctors did not have the power to hire, fire, or discipline nurses. Nurses would still take medical orders from doctors, but only because doctors had more knowledge and expertise in determining the best treatment for patients.

Yet the BNA intended to give one half of its seats to doctors. Nightingale saw this as directly undermining its stated mission to make nursing into a true profession. This point of contention proved one that Nightingale had to handle delicately, as she had important alliances with plenty of prominent physicians.

Nightingale Combats the BNA’s Inception

Nightingale was not fundamentally opposed to the idea of a registry. Indeed, she saw merit in the small, organization-based registries that hospitals like St. Thomas already kept. Regularly updated with dismissal information, nurse obituaries, and notices of criminal conviction, these registries escaped some of the problems presented by a national registry. (Contemporary researchers also point out that they contained a healthy amount of gossip.)

But Nightingale did object to the view that nursing was strictly a profession. She was very attached to the morality of nursing, and later in her career actually used the term “profession” pejoratively in regard to nursing. In an 1888 address to probationers, Nightingale referred to the “low sense” of the nursing profession as the “book-and-examination business.”

Nightingale went to considerably lengths to prohibit the BNA’s progress. She and her supporters launched numerous campaigns to draw attention to the organization’s shortcomings. They also pointed out that the BNA claimed to have more support than it actually did; in some cases, the BNA alleged that prominent doctors and nurses supported the organization–when they had already publicly expressed the opposite stance.

The registration issue emerged in 1887 and gathered momentum the following year. In 1889, the founder of the Hospitals’ Association and editor of The Hospital, Henry Burdett proposed the National Pension Fund as an alternative. Nightingale saw the competitiveness between the two plans as highly distasteful and opposed them both. In 1889, she helped to organize a “memorial” opposing the BNA’s receipt of a royal charter.

The House of Lords committee did not meet on the matter until 1891. William Rathbone spoke against the BNA using information supplied by Nightingale. His presentation was so thorough and so convincing that the BNA was forced to drastically revise its proposal. When the organization finally received its royal charter in 1893, the BNA had much less power than its founders had hoped.

Though Nightingale’s staunch opposition to the BNA may seem strange today, her reservations were grounded in a genuine love for nursing and desire for improvement in the field. Today we remember Nightingale as a visionary of nursing whose contributions ranged from improving quality of care, to shaping the laws that governed the profession.

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Louisa May Alcott: Abolitionist, Suffragette, and Mercenary

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When Louisa May Alcott published Little Women in 1868, she immediately found the fame and fortune she’d sought since childhood. The legendary author is best remembered for this and other children’s books, but her true authorial passion was for writing cheap thrillers. Unbeknownst to most of her adoring readers, Alcott undertook her now classic novels only as a means to support her family. Indeed, Alcott has proven a much more complex individual than most of us would guess.

A Childhood of Privation

Born on November 29, 1832, Louisa May Alcott was the second of four daughters. Her mother, Abigail May Alcott, hailed from a distinguished Boston family. Her father, Amos Bronson Alcott, was a farmer who’d educated himself in philosophy. The members of the Alcott family were quite progressive for their time. In 1834, Bronson set up a school with a controversial co-ed curriculum. He managed to find students, but the community was soon turned off by his disciplinary tactics and frank discussion of religion. The final straw was when Bronson refused to dismiss a black student he’d admitted. White parents withdrew their children from the school, and Bronson was forced to shut down.

The progressive curriculum at Bronson Alcott’s Temple School

The family remained ardent abolitionists, participating in the Underground Railroad. When she was seven years old, Alcott opened an unused stove to discover a former slave hiding inside. The man was initially terrified that he’d been discovered, just as Alcott was frightened to find a man in the oven. Alcott taught the man to write his letters. This experience and others would eventually compel Alcott to serve in the Civil War so that she could contribute to ending slavery.

Among the family’s closest friends were Ralph Waldo Emerson and Henry David Thoreau. Alcott grew up with their mentorship, studying in Emerson’s library and getting botany lessons from Thoreau. Despite this rich intellectual life, the Alcotts were quite poor. Bronson worked hard, but didn’t pay much attention to actually earning a living. His family often subsisted on nothing but bread and water, and they frequently moved–by the time they settled at Orchard House in 1858, the family had had around thirty temporary homes, and they could afford the home only with the support of relatives and Emerson, who wished Alcott’s sister Beth to pass her last days in comfort and security.

Fruitlands was strictly vegetarian. Residents were not even supposed to till the soil, as they might injure a worm.

When Alcott was ten years old, the family undertook a radical experiment. Bronson co-founded the utopian community of Fruitlands with English reformer Charles Lane. Their goal was to survive without animal products or any commodities that had been generated by slavery, including coffee and tea. After only six months, the project had obviously failed. The Alcotts were completely destitute, and Bronson was on the brink of suicide. Alcott resolved that she would one day be rich and famous. At first she wanted to be an actress, and she soon began writing, directing, and acting in plays.

Early Financial Responsibility

Alcott began keeping a journal when she was eight years old, and she wrote her first novel at age seventeen. Heavily influenced by Charlotte Bronte’s Jane Eyre, the novel would not be discovered and published until over a century later. Though Alcott wrote prolifically in her off time, she also worked hard as a teenager to help support her family. She had a series of jobs: teacher, governess, laundress, and even household servant. Her mother took work with an unemployment agency, and the family encountered women who had to take the roughest jobs. Moved by the plight of these illiterate immigrant and African American women, Alcott, her mother, and her sister Anna offered free reading and writing instruction.

Bronson, on the other hand, did little to support the family. He embarked on a long speaking tour–only to return with a single dollar in his pocket. The family, it seemed, would never escape poverty. The family’s dire straits gave Alcott a unique vantage point as a female author; most women writers of the era came from much more privileged backgrounds. It also hardened Alcott’s resolve “to turn my brains into money by stories.” In her early twenties, Alcott began writing romances for local papers. She rapidly learned how to tailor her writing for different markets and to experiment with different genres.

A Scandalous Little Writing Habit

Alcott also knew that writing such sensational stories would tarnish her own reputation, and she was not confident in the quality of her writing. She wrote these stories either anonymously or pseudonymously, thus protecting her own reputation. Harriet Reisen, author of Louisa May Alcott: The Woman Behind ‘Little Women,’ noted in an interview with NPR, “Louisa made herself a brand. She suppressed the fact that she had written pulp fiction that included stories about spies and transvestites and drug takers.”

It wasn’t until after her death that the full breadth of Alcott’s work was revealed. But Alcott found writing such potboilers quite thrilling, admitting that when she wrote them she slipped into a kind of “vortex” where time, food, and sleep simply didn’t exist. Scholars hypothesize that these stories were also an excellent outlet for Alcott, who never married and spent much time worrying about her family’s well-being.

Heeding the Call to Duty

Then the Civil War broke out in 1861. Alcott reported to the Concord town hall, where she sewed uniforms and made bandages. As soon as she turned thirty, Alcott entreated family friend Dorothea Dix to let her become a field nurse even though she wasn’t married. Dix relented, and Alcott went to Washington, DC, where she ministered to soldiers after the Battle of Fredricksburg. Alcott fell prey to pneumonia and typhoid fever, cutting short her tenure as a nurse. Her treatment included doses of calomel, which contained mercury. It left Alcott weak and sickly for the rest of her life.

Unable to continue serving as a nurse, Alcott decided to support the war effort through her writing. She adapted her letters home into Hospital Sketches, and the book immediately became a bestseller. It represented a dramatic departure from Alcott’s other authorial endeavors–and it was published under her real name. The book’s success renewed Alcott’s confidence and resulted in new interest in her writing.

A Parisian Affair

Alcott had always wanted to travel, and in 1866, she had the opportunity to travel to Europe as a companion to an invalid. In Switzerland, she met Ladisas Wisniewski, a Polish freedom fighter who was thirteen years her junior. The pair managed to overcome the language barrier, passing a fortnight together in Paris. Cavorting with a twenty-year-old man without a chaperone certainly raised a few eyebrows, but Alcott dismissed the allegations of impropriety, pointing out that she was 33 years old.

Alcott affectionately called Wisniewski “Laddie,” and he would be one of the inspirations for the character of Laurie in Little Women. The other was Alf Whitman, who was also much younger than Alcott. The two met at the Concord Dramatic Union (now the Concord Players), where they played Dolphus and Sophy Tetterby in Charles Dickens’ Haunted Man. Alcott doted on Whitman, and the two remained friends long after Whitman had married and had children. Alcott wrote to Whitman, “I put you in my story as one of the best and dearest lads I ever knew. ‘Laurie’ is you and my Polish boy [jointly].”

Challenging Gender Stereotypes

Though Alcott would have multiple ambiguous relationships with younger men, she claimed never to have loved them. In an 1883 interview with Louise Chandler Moulton, Alcott said, “I am more than half persuaded that I am a man’s soul, put by some freak of nature into a woman’s body…because I have fallen in love in my life with so many pretty girls and never once the least with any man.”

Alcott’s choice to remain a spinster was an unusual one for the time, even for a woman who had become a caregiver to her family. Yet Alcott had seen how dependent her mother had been on her father–and how poorly her father had provided for the family. “I’d rather be a spinster and paddle my own canoe,” she once wrote. That same sense of independence drove Alcott to campaign tirelessly for women’s suffrage. She attended the Woman’s Congress of 1875 in Syracuse, New York. In 1879, Alcott successfully campaigned for women’s suffrage in the election of the Concord school committee. The men of the town boycotted the vote, and Alcott was one of twenty women to cast a ballot.

Resigned to Writing “Moral Pap”

Alcott returned from Europe to find her family, predictably, in debt. Now able to “earn more from my pen than from my needle,” Alcott decided to write her way into fortune. She wrote in her journal in May, “Father saw Mr. Niles [of Roberts Brothers publishing house] about a fairy book. Mr. N wants a girls’ story, and I began Little Women. So I plod away, though I don’t enjoy this kind of thing. I never liked girls or knew many, except my sisters, but our queer plays and experiences may prove interesting.”

Alcott went about Little Women methodically over the course of a few weeks, with none of the joy she found in her thrillers. The first edition was published in 1868, when Alcott was 35 years old. It met with instant success, and Alcott’s fate as a writer was essentially sealed; she would build her career writing what she considered “moral pap for the young” because that’s what would support her family. Though Alcott was not upset to be “the goose that laid the golden egg,” she took a rather cynical view of her writing: “Money is the means and the ends of my mercenary existence.”

Alcott_Quote Because Little Women was so obviously based on Alcott’s own childhood, her family gained celebrity along with her. Bronson was quite fond of the attention. Now wealthy and widowed, he sported fine clothes and toured the country as “The Father of the Little Women.” He started publishing (very verbose) volumes of philosophy. Alcott built him the Concord School of Philosophy, so that he could again enjoy lecturing to an audience. His exploits were curtailed by a stroke, and he was forced to retire to a beautiful home in Louisburg Square, provided by his dutiful daughter, who visited almost every day. Alcott, however, wanted nothing to do with fame–perhaps because she saw so little merit in the books that had made her famous. Tourists shamelessly came calling at Orchard House, and Alcott would often pretend to be her own maid to avoid their attentions.

Then tragedy struck the Alcott family yet again. Alcott’s sister Anna Alcott Pratt had married into a wealthy family. While she was in Europe, her husband died unexpectedly, leaving her with two small children and no income. To ensure their financial comfort, Alcott again put pen to paper, this time writing Little Men. She assigned the royalties to her nephews, who would live with her until she passed away ten years later. When her sister May died in childbirth a few years later, Alcott took custody of the infant, who was named after her. Nicknamed “Lulu,” the child would call Alcott “Mother” and live with her until Alcott’s death.

When Alcott’s own health began to fail, she sought both traditional treatment and explored alternative medicine. In 1888, she went to a Roxbury convalescent home, convinced that proper rest would extend her longevity. That March, she visited her father for what she knew would be the last time. He passed away on March 4, 1888, and Alcott followed two days later.

Edith Cavell, Nurse, Humanitarian, and Traitor?

An Accomplished Nurse with a Humanitarian Mission

By 1911, Cavell was the training nurse for three hospitals, 24 schools, and 13 kindergartens in Belgium. When World War I broke out, the Red Cross assumed control of Cavell’s hospitals. Cavell, famous for saying “Patriotism is not enough,” threw herself into her work, saving the lives of countless soldiers on both sides of the war.

Cavell’s story was adapted for the silver screen, first as propaganda in 1919, and again in 1939 when it revived anti-German sentiments.

Cavell was one of many nurses recruited by the British Secret Intelligence Service (SIS) to gather intelligence on the Germans. But in November 1914, she put these duties aside to begin funneling British and French soldiers out of Belgium and into neutral Holland. Cavell tirelessly dedicated herself to these efforts, eventually raising suspicion. On August 3, 1915, Cavell was arrested by the Germans.

Although Cavell had indeed committed espionage, the Germans chose to try her for treason. Cavell was incredibly outspoken after her arrest, making no attempt to defend herself. She openly admitted her actions in three separate written statements and multiple verbal interrogations. Unfortunately for Cavell, under the auspices of the first Geneva Convention, the death penalty was a permissible punishment for treason.

The British claimed that their hands were tied in the matter. The US government did put some pressure on Germany, reminding German officials that the country’s public reputation was already quite tarnished. Only one German intervened on Cavell’s behalf: Baron von der Lancken argued that Cavell should be treated with moderation because she had saved so many German lives. But General von Saubozweig insisted that Cavell be executed swiftly. Of the five people arrested in the case, only Cavell and one other were actually executed; the rest were later released.

Fuel for Allied Propaganda

There are numerous accounts of nursing from World War I, such as Grace MacDougal’s Nursing Adventures: A FANY in France (1917) and Violetta Thurston’s Field Hospital and Flying Column: Being the Journal of an English Nursing Sister in Belgium and Russia (1915). But Edith Cavell would leave a different kind of legacy.

Rather than leaving an account of her own experiences, Cavell would unwittingly leave her mark on British and American propaganda during World War I. She became the most famous British female casualty of the war. The British government used her story to bolster military recruitment, while the US adopted Cavell to garner favorable sentiment toward the Allied effort–and to demonize the Germans.

Soon after her death, news reports of questionable veracity emerged. Even the American Journal of Nursing printed a spurious account of Cavell’s execution, in which Cavell had refused to wear a blindfold, fainted in the face of the firing squad, and been shot point blank by a German commanding officer. Eyewitnesses later indicated that this version was false.

Cavell is one of many figures in the history of nursing who have left an indelible mark on the world. She not only made strides as a figure in modern nursing, but also set herself apart as a remarkable humanitarian.

The Rare Books of Boston

Red Sox Memorabilia

Few sports fans are more loyal than Red Sox fans. The Boston team was founded in 1901 as one of the American League’s eight charter franchises. For seven seasons, the team actually had no official name. They were referred to simply as “Boston,” “Bostonians,” or “Boston Americans,” while newspapers gave them more creative nicknames like “the Beaneaters” or “Plymouth Rocks.” In 1908, team owner John I Taylor chose the name “Red Sox,” a nod to the red socks that would become symbols of the team. Chicago journalists had started using “sox” as a headline-friendly shorthand for “stockings” already, and Taylor liked the name. But the team initially didn’t even wear red socks, but dark blue ones! And a Cincinnati team was actually the first to call itself the Red Stockings. The team were members of the pioneering National Association of Base Ball Players and hired their first fully professional team in 1869, but the club folded after the 1870 season.

Boston Red Sox memorabilia is part of America’s rich and exciting tradition of baseball. We’re pleased to offer Boston Official Programs and Score Cards from 1957 and 1958. Another interesting item is AG Dewey Company’s Genuine Dodge Davis Flannel sample book (1971). The company got its start in 1936 in Quechee, New Hampshire. Throughout the 1930’s AG Dewey Company made the uniforms for the Boston Red Sox, New York Yankees, and other teams.

Boston Training School for Nurses

The Boston Training School for Nurses was only the second of its kind in the country, preceded by the Bellevue school in New York. At the time, nursing was still not viewed as a vocation that required much training; women would often take up the career simply due to financial need, and in many cases nurses had no special qualifications to recommend them. In New York, this resulted in patients’ immense suffering at the hands of inept nurses. No such condition emerged in Boston, however; nurses there were considered some of the best in the nation. Thus the push to start a training school met with some resistance; why would good nurses need further training?

Eventually, however, nurses and doctors saw the potential advantages of such a program. The Boston Training School for Nurses was established in 1873. It was affiliated with Massachusetts General Hospital and eventually evolved into the Massachusetts General Hospital School of Nursing. The organization published annual reports, which are quite enlightening regarding nursing history. This copy of the report from 1892, in very good condition, shows us how the organization and nursing have evolved in only a few decades.

Dinners for Dickens

Charles Dickens made two visits to the United States, first in 1842 and again in 1867. Boston proved an important city during both tours. In 1842, Dickens arrived to find himself already quite the celebrity, and his presence was in great demand. The “Young Men of Boston” had already extended an invitation to Dickens before he’d even left England. The dinner in his honor, documented by Thomas Gill and William English of the Morning Post, was held on February 1, 1842. Dickens made an almost fatal move during the course of the evening: he introduced the concept of an international copyright law. Dickens failed to gain the support of fellow authors as he’d anticipated. Instead he sparked a battle with the American press, who accused Dickens of creating a “huge dissonance” by broaching the subject of international copyright at such an inappropriate occasion. Dickens would further disenchant his American audience when he published American Notes and Martin Chuzzlewitt, both of which painted America in a less than favorable light.

But Dickens’ genius soon won over his American audience once again. Swayed by the promise of £10,000 from a group of Boston intellectuals, Dickens headed back to America in 1867. Prior to his departure, a public banquet was held in the author’s honor at London’s Freemason’s Hall, on November 2, 1867. A record of the meeting was made, which includes speeches by Dickens, Lytton, Trollope, and other luminaries. Dickens’ second visit to the US proved a dizzying tour, jam packed with readings and public appearances. During one of his early appearances, he noted that both he and America were much changed since his first visit and vowed to issue appendices to American Notes and Martin Chuzzlewitt to temper his critical tone towards the US.

News from a Moving Train

In May, 1870, the Boston Board of Trade journeyed over 3,000 miles to San Francisco to meet with the San Francisco Chamber of Commerce. During the trip, twelve issues of the Trans-Continental were published on a Gordon press located in the baggage car. The paper reported the normal business of the train and its passengers, along with other news. The first issue, for instance, reports that the Athletics of Philadelphia beat Harvard Base Ball Club 20-8. The newspaper’s office was located in the train’s second car. The train was also equipped with “two well-stocked libraries, replete with choice works of fiction, history, poetry, etc.” Each issue recorded a different locale on the masthead. The newspaper is generally regarded as the first newspaper to be printed on a moving train.

A Political Discourse on Abolition

Boston was a hotbed for abolitionism. One Bostonian’s abolitionist work, though denounced at the time of publication, is now recognized as a groundbreaking tour de force in American abolitionist literature. Lydia Maria Francis Child published An Appeal in Favor of That Class of Americans Called Africans in 1833 and immediately shocked even fellow abolitionists. Unlike her colleagues, Child eschewed religious or scriptural justifications for ending slavery. She also ignored traditional, emotional arguments about the cruelties of slavery. This was because Child had a larger and more ambitious objective; she sought to end discrimination against free African Americans. Such a stance was hardly popular, which Child had predicted in her preface, saying, “Though I expect ridicule and censure, I cannot fear them.” Child’s tone and style of argument at the time were seen as more masculine than feminine, which didn’t ameliorate reception of her work. Her book sales plummeted, and the Boston Athenaeum even rescinded her free library privileges.

But Child’s work would prove incredibly influential in the movement, making it a desirable addition to a collection on abolition, African American history, and the history of ideas. The book is relatively scarce in the trade; only three copies have appeared at auction in the last thirty years. The last copy, sold in 2000, was imperfect. This edition of An Appeal in Favor of That Class of Americans Called Africans is bound in the original publisher’s cloth and has the errata slip tipped in. All in all, it’s a very good copy of a hard-to-find work.

Boston’s place in history intersects with the world of rare books in so many ways! What’s the most interesting item of Bostoniana in your collection?