'Nursing: Years Ago and Today\r'

'The history of treat, a particle of the white collar service sector, reflects the prevalent trends in the transformation of work that gave eject to the clean, dependent, salaried, white collar workforce, in battle e very(prenominal)place the construct of commercealism. Although antecedently free lance practitioners, by the end of World fight II, a decisive majority of deems were strained to find employment in the impertinently emerging bureaucratic infirmarys as their opportunities for self-directed imbibe- forbearing relationships diminished (Melosh 32).\r\nIn the nations infirmarys, nurses were subject to processes of bureaucratic keep in line very practic all toldy comparable those described by Ed struggleds for twain fruit and nonproduction workers (Edwards 17). Invisible mechanisms of control, including the human seat of g all overnment look of professingalism and the enjoyment of written rules to govern nurses tasks and supervision, were invoked to a rrest this white collar workforce. Historically, nurses replys to these constraints withstand been fill with conflict.\r\nIn the 18th nose candy, nurse was scarce a nonher of women’s house servant chores. By the early 19th century, save, treat had emerged as an occupation per organize by respectable labor movement women, primarily widows and spinsters. It was a specialty in spite of appearance home(prenominal) service, consisting primarily of cleaning a longanimouss body, linen, and dressings. This kind of labor was considered by close 19th-century men and women as an extension of womans â€Å" innate” biological capa city for nationality, docility, nurturance, and willingness to sacrifice (Berg 21).\r\nA fine line separated the 19th-century nurse from the domestic servant, as twain were evaluate to perform household chores. By 1868, however, they were much(prenominal) clearly differentiated by fee; the nurse earned $1.00 to $2.00 a daylight whereas the servant earned only $2.22 per workweek (Reverby 9). Because of the close association with dirty domestic work, few gist- folk women entered treat. Until the polished contend, treat remained an occupation performed by poor, older, single women with no formal education or training. These women were a great deal drawn from rural areas into the cities in assay of paid work, where their options were generally sewing, lodging b ranks, domestic service, or nurse. By 1870, in that location were over 10,000 women officially employed as nurses in the United States.\r\nUntil the 20th century, infirmary nursing was less prevalent than household nursing since most births, deaths, and illnesses occurred in the home. The majority of Americans did not see the inside of a infirmary until the turn of the century. Hospitals were barely hospitals as we instanter know them. They were charitable institutions built by philanthropists at the end of the 18th century for the poor, the soc ietally marginal, or the unemployed. Indeed, m all hospitals evolved push through of usual almshouses.\r\nPatients in both public and voluntary hospitals were incarcerated for dependence as much as for disease in the 1870s (Vogel 105), and their hospital stay was often for weeks or months, not years. Impermeable walls and guarded gates encircled the institutions, enabling hospitals to assert some control over the working class, immigrant, or desolate patient.\r\nAlthough benevolent, hospitals treated their patients disdainfully, with authoritarianism and paternalism. Their drive was to offer the patient with consummate(a) uplift bandage instilling friendly control. Hospital administrators believed their patients were from â€Å"the very lowest; from abodes of drunkenness and vice in almost every form, where the most cast down and corrupting influences were acting on both body and mind” (Vogel 24).\r\nChildren were decontaminated upon arrival and taught â€Å" chec ker, virtue and kindness.” The trustees hoped this regimen would reform the children, who would then realise â€Å" nakedly refined manners, quickened intellect and wearisome hearts” back to their homes. Some hospitals act to reform adults as well because they believed ordination benefited not just by legal transfer these workers but also by â€Å"rekindling in them their faith in social rove” (Vogel 26).\r\nNurses in these hospitals were generally ambulatory patients themselves, bid for fellow â€Å"inmates.” If not actual patients, hospital nurses originated from the same poor and working-class sectors of corporation as the patients. They often held several jobs simultaneously and were frequently reprimanded for â€Å"sewing-out” (manufacturing garments on the ward) mend on duty (Reverby 24).\r\nThe status of the 19th-century hospital nurse was very low, comparable to the status of all distaff patients at this time. The female patient of 1870 was characterized in a letter to the capital of Massachusetts Evening Transcript as â€Å"a woman who has fallen into the sins of the wayside… excessively weak to resist the temptations which have encrust their unguarded footsteps” (Vogel 26). Similarly, the hospital nurse was characterized by Florence Nightingale, the 19th-century British reformer, as â€Å" also old, too weak, too drunk, too dirty, too sensual or too bad to do anything else” (Reverby 26). Hence, stringent rules governing general behaviors regarding sex, language, and use of alcohol and tobacco were en coerce for both patients and nurses in the hospital.\r\nAlthough nurses lived in close law of proximity to the patients, they were forbidden to socialize with them. In order to prevent them from socializing or tipsiness with the patients, nurses were kept busy from 5:00 a.m. until 9:30 p.m. They were continually scrubbing patients, garments, and wards, since sanitization was the only method of disease bar in the 19th-century hospital. When they had completed these tasks, they were given unfathomable others to keep them in line.\r\nIn humanitarian to such domestic tasks, nurses were often answerable for providing more serious health care in the doctors frequent absence as well. They often managed labor and delivery cases independently. This forced nurses to exercise independent health check judgments, disdain doctors prevailing expectation that nurses would be in all subservient to them. With the taste of autonomy, nurses began to expect greater latitude in their work. They began to see themselves as adult rent workers, not children to be controlled by the hospital â€Å"family,” as the hospital trustees portrayed the workplace.\r\nThe face of nursing changed during the Civil War. Middle- and upper-class women, motivated by patriotism, familial duty, or simply a appear for meaningful work, began to work in hospitals, nursing wounded men, and raisi ng funds for the war (Mottus 65).\r\nThe unsanitary and disorganized conditions in regular regular army hospitals led to the emergence of relief associations. In 1861 the Womens Central Association of Relief was formed with the explicit purpose of â€Å"furnishing comforts and aesculapian examination stores, and especially nurses in aid of the medical staff of the army… and to take measures for securing a system of well trained nurses against any possible demand of war” (Mottus 24). design on Nightingales British model of army nursing, the Registration Committee on Nurses desire prospective applicants with specific qualifications: they were to wear dresses without hoops, depict references confirming their high moral character, and be no older than 45 eld of age. Nurses trained according to Nightingales nursing model, fixing the laws of both morality and hygiene.\r\nThe post-Civil War years, characterized by remarkable economic growth, the rise of industrial corp orations, the decline of small entrepreneurs, and the emergence of urban America, engendered the expansion of relief judicatures and the development of impudently charity plaques. Both were controlled in mountainous part by middle- and upper-class female reformers.\r\nThese women, many of whom had participated in organized nursing during the Civil War, focused on reforming the moral character of the poor, soiled by the ravages of urban society (Lubove 4-5). The expansion of the charity validation movement represented another response by a troubled middle class to the social dislocation of the post-Civil War industrial city: â€Å"Charity organization was a crusade to save the city from itself and from the evils of pauperism and class antagonism. It was an instrument of social control for the conservative middle class” (Lubove 5).\r\nIn the post-Civil War hospital, bourgeoisie women fall in forces with hospital trustees and developed training schools for nurses. The ref ormers purpose was to â€Å"save” the country girl from the city, sustain a vocation of nursing, and reform the hospital. They attempt to carry out this goal by developing a cadre of trained, professional, middle class nurses. The hospital trustees, however, seek nurses as a cheap labor force for the hospital.\r\nDuring the falling off years of the mid-nineties, the hospital moved outside(a) from being a charity organization (Rosner 119). Philanthropists, affected by financial crises themselves, were no longer able to be the put forward on agreeers of the institutions. Hospital trustees turned to the middle-class patient as a naked origin of income for hospitals. This change motivated trustees to alter the hospitals architecture as well as its workforce. Its motion picture became more hotel-like, with reclusive rooms, backstage doctors, and private nurses.\r\nThe reformers convinced the trustees that young, educated nurses of middle-class origins would be more appropriate caretakers for wealthier patients than untrained, working-class nurses. Hence, while the middle-class reformers were attempting to create a profession for respectable middle-class women, embodying Victorian Americas idealized vision of upper-class womanhood (empathy, gentility, and lettering to service), the trustees were still seeking an inexpensive all the same disciplined workforce. The middle-class student nurse was their answer.\r\nOne of the first training schools for nurses emerged in 1889 at the Johns Hopkins Hospital as a joint effort between the women reformers and the hospital trustees. They sought applications from Episcopalian and Presbyterian daughters of the clergy and the professions (James 214). The reformers hoped such a school would become the new social incubator for daughters of the new middle class. They sought only educated and refined students; women who had previously worked in the mills or domestic service were discoufadd from applying. The r eformers argued that only women with proper, virtuous backgrounds could enhance the moral atmosphere of the hospital.\r\n savant nurse training meant working 13-hour days at domestic duties under uncompromising military discipline. Understaffing and medical emergency continually forced students into positions for which they were unprepared. These poor work conditions of overwork, inadequacy of adequate training, bad food, and arbitrary discipline took their toll on the students, resulting in the 1910s in strikes against nursing supervisors (Reverby 37).\r\nDuring the 1930s and into the 1940s the private duty market collapsed altogether (Melosh 197). The new array of hospital techniques for both patients and nurses fostered a new role for some nurses, however: that of hospital foreman, supervising a new hierarchy of subsidiary nurses. The nursing professionalizers urged hospital administrators to hire educated graduate nurses of middle-class origins for these positions. Administrat ors were not hard to persuade on this point since they were able to hire nurses with more education and experience for the same wage as the student nurse, given depression-era unemployment.\r\nAt first, grateful for work, graduate nurses accepted this condition. In time, however, graduate nurses responded to this situation with unrest, high rate of absenteeism, and turnover. Conflicts between adherents of the more elitist, human capital interpretation of professionalism and proponents of the need to work rest to resonate from staff and head nurses today. more staff nurses claim that besides pickings care of patients, they’re working to launch shoes on their children’s feet and nursing administrators just dont see that they work to support their life outside the hospital too. such(prenominal) a comment was just as appropriate in the 1880s as it was in 1985. The same debates still rage on.\r\nBesides, there are two accredited health care issues facing the profession of nursing today: a misdistribution of nurses across the United States and burnout, both noted as causes for a nursing shortage.  There is a misdistribution of nurses across the United States and there are at least two ostensible reasons for this: geographic immobility and a neglect of incentives for rural and inner-city hospitals. nursing is a very demanding and stressful profession.\r\nBurnout is described by Annette T. Vallano in Your Career in Nursing, as a form of mental, physical, emotional, spiritual, and interpersonal exhaustion that is not easily restored by sleep or rest.  Nurses experience burnout when they are overwhelmed and unable to wangle with the day-to-day stress of their work over long periods of time.  Burnout may also be a reason that many nurses have decided to work only part-time, hence burnout may be a modify factor to the nursing-shortage problem.\r\nAll in all, nursing has evolved from the days of Florence Nightingale to a passing respected and educated profession.  But there are challenges for the future.  In short, â€Å"the nursing profession needs to begin to recognize new trends and patterns” (Lowenstein1), while also recognizing â€Å"it is crucial that nurses learn to generate new ideas for care, utilizing the new medical and communication technologies that are blossoming daily, but also keeping our high touch together with the high tech” (Lowenstein 1).\r\n work cited\r\nEdwards, Richard. Contested Terrain: The Transformation of the lockplace in the Twentieth Century. bleak York: Basic Books. 1979.\r\nBerg, Barbara. The Remembered opening: Origins of American Feminism: The Woman and the City, 1800-1860. New York: Oxford University Press. 1978.\r\nJames, Janet. â€Å"Isabel Hampton and the superiorization of Nursing in the 1890s”. In Charles Rosenberg and Morris Vogel (eds.), The Therapeutic Revolution. Philadelphia: University of Pennsylvania Press. 1979.\r\nLowenstein, Arlene. à ¢â‚¬Å" view for the future of nursing.” ICUS NURS WEB J, 16, Oct/ Dec 2003 http://www.nursing.gr/editorialLowenstein.pdf.\r\nLubove, Roy. The Professional Altruist: The Emergence of Social unravel as a Career, 1880-1930. Cambridge: Harvard University Press. 1965.\r\nMelosh Barbara. The Physicians Hand: Work Culture and Conflict in American Nursing. Philadelphia: Temple University Press. 1982.\r\nMottus, Jane E. New York Nightingales: The Emergence of the Nursing Profession at Bellevue and New York Hospital, 1850-1920. Ann spike: University Microfilms International. 1980.\r\nReverby, Susan. Ordered to Care: The Dilemma of American Nursing, 1850-1945. New York: Cambridge University Press. 1987.\r\nRosner, David. A Once forgiving Enterprise: Hospitals and Health Care in Brooklyn and New York, 1885-1915. New York: Cambridge University Press. 1986.\r\nVallano, Annette. Your Career in Nursing. Kaplan; 3rd edition. January 3, 2006.\r\nVogel, Morris. The Invention of the Modern Hos pital, Boston, 1870-1930. moolah: University of Chicago Press. 1980.\r\n;\r\n'