(The historical material in this article was drawn from the excellent pamphlet Witches, Midwives, and Nurses by Barbara Ehrenreich and Deidre English) Nursing today is one of a number of highly trained "semi-professions" like teaching and social work, distinguished from the "real" professions, law and medicine, to a great extent by the large proportions of women in these fields. In the early 1800's, a "nurse" was simply a person, usually a woman, who happened to be nursing someone who was ill or crippled. The hospitals of that era. did employ a few people called nurses; but back then, hospitals served mainly as last refuges for the dying poor, did very little treatment, and by and large, thé nurses were a disreputable lot, whose job consisted of disposing of corpses. The hospital situation became so scandalous that in the 1870's, a committee investigating conditions at New York's Bellevue Hospital could not find one bar of soap in the place. If nursing was not the most attractive field for women workers, it was wide open territory for wome'n reformers. To reform hospital care. nursing had to be reformed. It had to become "respectable," acceptable to doctors, and had to project an image of the nurse as a sober, disciplined woman of "good character." Florence Nightingale introduced the "new nursing" in the Crimean War, and Dorothea Dix brought the new breed of nurses into Union hospitals during the Civil War. The new nurse, "the lady with the lamp," selflessly tending the maimed and wounded, caught the popular imagination. After the Civil War, as hos pitáis evolved toward curing the ill instead of simply waiting for them to die, as caring for the sick moved from the home to the hospital, and as medical education became linked to training hospitals, nurses became an indispensible part of the system. They kept the hospitals running, they cared for the sick, and they freed the emerging "scientifically trained doctor" to diagnose and treat, prescribe then move on. Who were the women who invented nursing? Most pioneering nurses were upper class, unmarried, Victorian "ladies" faced with the dull prospect of long, useless spinsterhood. They were refugees from the deadening enforced leisure of upper class Victorian life. So they focused their energies on caring for the sick because it was a "natural" acceptable interest for ladies of their background. Nightingale and her disciples shaped nursing in the mold of their own class biases. Training emphasized "character," not skills, like at a finishing school. The finished product, the New Nurse, was simply the Ideal Victorian Lady transplanted from the home to the hospital and relie ved of reproductive responsibilities. To the doctor, she brought the firmbut kindly discipline of a household manager accustomed to dealing with servants. But, despite the hyped image, most nursing was just low-paid heavy-duty housework. Before long, most nursing schools were attracting only women from the lower middle and working class, whose only other options outside the home were clerical or factory work. The recruits changed, but the philosophy didn't. Nursing education became the imposition of upper class values on working class women, stressing skills like tea pouring and art appreciation. Regular doctors, the men who were fighting through the young and vigorous AMA to secure medical practice as an all male, upper middle class profession, were skeptical of the new nurses at first. They were afraid of competition from these industrious, skilled women. But they were won over by the nurses' devotion to the Victorian ideal of unflagging female subservience to men. The doctors were overjoyed. Here at last were women in health care who not trying to become doctors, who were ready and willing to do the day to day menial dirty work that the super-trained physicians didn't have the time to bother with. Indeed, nurses seemed to have no other mission in life but to serve. While the average regular GP of the late 1800's was making the new nurses welcome in "his " world, the scientifically trained professionals of the early 2Oth century were making them necessary. The new specialists never condescended to hang around and watch or particípate in che progress of their cures. They diagnosed, they treated, they moved to the next patiënt. Bedside care was a mere tedious detail. True, it was necessary, but it was better left to those who were "naturally" patiënt, obedient, and nurturing- the nurses. And so, healing, which in the fullest sense consists of both curing and caring, was forever split in two. Curing became the exclusive and glamorous province of the doctors; caring was relegated to the nurses. As late as the 1960's, the nurses' situation was little improved. ever, today, it is fast becoming a field that is wide open for energetic, innovative activist women and men who are reuniting curing and caring. Women with a consciousness about woraen's liberation are attempting to redefine the hidebound role of subservient nurse, and the rigid sex roles and hierarchies that pollute medicine altogether. It's a real struggle. Ann O'Connor, a nurse working at the Free People's Clinic, recalls her days in nursing school in the late '60's: "I was the most flaming radical there, and I shocked people, but I was really very mild at the time. Wlien I said I was interested in the women's movement, people were scandalized, and couldn't believe it." Mary Isham agrees: 'in 1969, 1 was attending a Big Ten nursing school. Everyone wore dresses. My roommate and I showed up in jeans one day, and were branded as "weird" fast. But after a while, the overall cultural changes seeped into the school." Ann continúes: "When I was in school, they perverted nursing education. My book on obstetrical nursing didn't even mention midwifery which was the only form of obstetrics practiced from 2000 B.C. until 1910. All it talked about was obstetrics as a medical specialty, and how us nurses could help the doctor. It glorifïed the obstetrical fórceps which doctors used to prove that they were technically superor to midwives." But things are changing. Mary says: 'i am amazed at a lot of nursing students today. The level of frustration with the stodginess of the field is much higher now. Nursing students and nurses have become more vocal. They want to learn and practice real skills. They're siui ui jusi uuung uu uutiuib, ixjyiug. 'Doctor, do you want this? Do you want that? Doctor, what can I do for you?'" Doctors' attitudes, however, are changing much more slowly. In a recent MS. Magazine survey, most doctors said they thought nurses as a group were: shiftless and slow, needed supervisión, were incapable of handling responsibility, were fulfilling frustrated motherhood needs, and were masochistic. Doctors continue to see nurses as a lower life form. "It's true!" says Lenore Kaplan, a former coördinator of the Free People's Clinic, now in school: "In my biochemistry class, the profs are unbelievably patronizing. This one woman was going to miss an exam-like a lot of people do, and the schmuck demanded a written excuse from the woman 's mother! She stood there and took it, but after cluss I told him in no uncertain terms tlmt my mother had nothing to do with the decisions I made ubout my life, and the people in the class are mature adults." Ann, Mary and Lenore all see nursing as a vital field in health care. Lenore: "The nurse is the crucial person in the patients' actual care. The nurse directly relates to the patients, every 'day, doing the real caring. At U. Hospital, the doctors rarely even touch their patients. They prescribe and they're gone. Nurses and other staff have all the physical contact with the patients." Mary: "Doctors are trained to see people as machines, to overlook emotions. A lot of nurses forget about emotions, too. Nursing school tauglit me to see doctors as colleagues, so when my first patients complained that the doctors were heartless and unfeeling, I defended them : well, they're busy; they have their problems, too- but after a while the mechanical approach to healing began to disgust me, and I moved over to psychiatrie nursing where there 's more room for all staff: doctors, nurses, everybody, to work as a team, and where you can openly relate to the patienfs emotions. You have to work with and care for the whole person." Ann: "F went to a school that wasn't very kiss-ass about doctors. But the subtle message was always there: his time is more valuable than yours. A nurse is an extended secretary and cleaning lady with responsibility for everything the doctor forgets. It really abuses women who are highly trained and could be doing many more things with their skills." Because so many nurses feel stifled in the traditional "helper" role, many nurses are redefining their professional roles. Mary: "I see a lot of women I graduated wifh disgusted with the System and breaking away. A friend of mine is now setting up a Lamaze natural cliildbirth thing, and really working with a community. Another friend has set up her own psychiatrie consulting service. People all over are disillusioned with the System, and are creating alternatives." Ann: "Yeah, midwifery for instance. Midwifery is coming back. Actually, it's survived down through the years througli the Frontier Nursing Service in rural Kentucky. The AMA never got around to crushing it because they didn't care about Appalachia. Now many nurses are becoming nurse-practitioners continued on page 26 "ƒ went to a school that wasn 't very kiss-ass about doctors. But the subtle message was always there: his time is more valuable than yöurs. A nurse is an extended secretary and cleaning lady with responsibility for eyerything the doctor forgets. Women Healers continued from page 23 ana working witn communnies, staying in touch with people at their own daily levéis. That's why I wanted to become a nurse in the first place. I come from a working class community and I wanted to work in a community setting. Doctors too often remove themselves from communities, tliough that's finally beginning to change, too." Lenore: "There are some nurses who are idiots, who are exactly the sweet dumb things the traditional role demands they be. But many many nurses are higlily skilled. and they can really do a lot more than they're usually alíowed to do. I think people should do what they're capable of doing. Now, of course, you have doctors feeling threatened that nurse-practitioners are going to take their role away from them. But I'm going to be a nurse-practitioner, and try to work with people. I really feel that curing and caring have to be shared collectively. That's how I see myself in the health care system, working with other people collectively."