HHH column: Bridging the gap between histories of nursing and medicine by Hugo Schalkwijk
The HHH column is a monthly blog in which History, Health & Healing members share their thoughts on research, current affairs, or anything to do with medical history. Each edition is written by a different member – in due time, we hope to offer everybody a chance to publish a contribution. This month, the floor is for Hugo Schalkwijk, PhD candidate at the University of Amsterdam and curator at the Florence Nightingale Institute. In this column, he addresses perceptions of nursing history. The nursing world often tends to be set aside as a world of its own, which obscures the multiple roles that nurses have taken, and promotes stereotypes of the profession, such as it being simple ‘women’s work’. To do justice to the past and present work of nurses, Hugo argues that the history of nursing should be situated in the broader history of healthcare.
Bridging the gap between histories of nursing and medicine
Every year on May 12, in honour of the birthday of history’s most famous nurse, Florence Nightingale (1820-1910), we celebrate International Nurses Day. Historically, this day has had different purposes: to laud the profession and its professionals, to enhance its image amongst the general public, to up nursing recruitment numbers and – if necessary – to critically reflect on the state of the profession. To me, a historian who spends most of his time working with nurses, this day also mirrors nurses’ ambivalent relation with their profession’s history. During the celebrations, nurses interact with the past in different ways. On the one hand, the past serves as a source of pride: accounts of Florence Nightingale’s pioneering work are (re)told as a way of legitimation. They underscore modern day nurses’ roots in (secular) sick-nursing as proclaimed by Nightingale herself, who envisioned a strong (female-dominated) nursing profession that worked alongside the (male-dominated) medical profession. On the other hand, the past is also seen as a burden. Stories from the past often illustrate nurses’ inferior position to, for example, physicians and thus carry the danger of confirmation by reiteration. They are thus something nurses need to ‘let go’ in order to ‘progress’.
This ambivalence towards history is reflected in, or perhaps in part caused by, the relatively under-researched field of nursing history. In the Netherlands, historians (with notable exceptions) have largely ignored nurses in their analyses of healthcare, especially when compared to their Anglo-Saxon colleagues. As a result, much of society’s knowledge of nursing history is based on foreign nursing histories (see for example the prominence of Florence Nightingale in the history of nursing literature). Ideas about nursing or nursing work in turn are heavily influenced by historically grounded and heavily gendered stereotypes, which are repeated and reinforced by mass media and film. Such stereotypes include nurses being trained to be the physician’s assistant, nursing work that is characterized by being dirty and simple ‘women’s labour’ and nursing being a calling instead of a professional job. These stereotypes do not only hamper our knowledge of healthcare, they also damage the profession’s position amongst other healthcare professionals.
In 2019, nurse historian Ellen Baer stated that nurses long had, and in some cases still do have, the tendency to “view nursing’s place in the world from within nursing, rather than as part of an entire historical era”. Historical developments in this case, seemingly took place in nursing’s “little world of their own” rather than in the wider contexts of healthcare or society. More recently, nurse historian Patricia D’Antonio wrote a position paper in the Bulletin for the History of Medicine in which she called for more, or better, co-operation between historians of nursing and medicine. Rather than analysing both fields in isolation of one another (and thus strengthening a dichotomy between the two) Antonio aims to include histories of nursing in a broader history of healthcare, which includes everyone involved in networks of care.
Taking into account this broader field of healthcare might be something that nurses are reluctant to do, fearing an inferior position of ‘their’ histories in comparison to histories of medicine. I argue that those fears should be set aside. Rather, analysing nursing histories in wider histories of healthcare enables us to enhance our understanding of the profession. Some existing studies already highlight nurses’ roles in settings beyond the walls of healthcare institutions, such as their place within care networks in communities or within global health initiatives. By further adopting these approaches we can explore roles that are typically not associated with nurses, such as (healthcare) activists, policy-makers, scientists or change agents. These roles extend beyond the traditional perception of nurses’ well-known place beside the patient’s bedside and thereby challenge the earlier mentioned stereotypes.
To conclude, I hope that these reflections can contribute to a discussion on how to bridge the gaps between histories of nursing and medicine. I believe that widening the scope of histories of nursing does more justice to the sheer diversity of the profession in terms of both nursing work and the people that perform that work. Let’s hope that such research can contribute to more meaningful discussions surrounding the nursing profession and its place in society, for example during future International Nurses’ Days.
Baer, Ellen D., ‘Nursing Diploma to University Education: A Memoir’, Nursing History Review, 27.1 (2019), 104–9 <https://doi.org/10.1891/1062-8061.27.104>
Carryer, Jenny, ‘Letting Go of Our Past to Claim Our Future’, Journal of Clinical Nursing, 29.3–4 (2020), 287–89 <https://doi.org/10.1111/jocn.15016>
D’Antonio, Patricia, ‘Toward a History of Health Care: Repositioning the Histories of Nursing and Medicine’, Bulletin of the History of Medicine, 96.3 (2022), 285–308 <https://doi.org/10.1353/bhm.2022.0027>
Flynn, Karen, ‘Nurses Politically Engaged: Lillie Johnson and Sickle Cell Activism’, in Nursing History for Contemporary Role Development, ed. by Sandra Lewenson, Annemarie McAllister, and Kylie Smith, 2017
Irwin, Julia F., ‘Connected by Calamity: The United States, the League of Red Cross Societies, and Transnational Disaster Assistance after the First World War’, Moving the Social, 2017, 57-76 <https://doi.org/10.13154/MTS.57.2017.57-76>
 See for example: Jenny Carryer, ‘Letting Go of Our Past to Claim Our Future’, Journal of Clinical Nursing, 29.3–4 (2020), 287–89.
 Ellen D. Baer, ‘Nursing Diploma to University Education: A Memoir’, Nursing History Review, 27.1 (2019), 104–9 (p. 107).
 Patricia D’Antonio, ‘Toward a History of Health Care: Repositioning the Histories of Nursing and Medicine’, Bulletin of the History of Medicine, 96.3 (2022).
 See for example: Karen Flynn, ‘Nurses Politically Engaged: Lillie Johnson and Sickle Cell Activism’, in Nursing History for Contemporary Role Development, ed. by Sandra Lewenson, Annemarie McAllister, and Kylie Smith, 2017; Julia F. Irwin, ‘Connected by Calamity: The United States, the League of Red Cross Societies, and Transnational Disaster Assistance after the First World War’, Moving the Social, 2017, 57-76 Pages.