History and Nursing Knowledge: Guest Editor'S Note

GUEST EDITOR’S NOTE
History and Nursing Knowledge
A worn, purple-covered nursing textbook rests in a recess of my library

shelves, a marker to a professional homecoming; to recognition of the free-
dom, sentience, and creativity of the nursing imagination; and to the idea
of distinctively nursing knowledge that can illuminate and guide practice.
The purple book, An Introduction to the Theoretical Bases of Nursing, focuses
on a particular approach to nursing knowledge. But arguably, the most
enduring legacy of its author, Martha Rogers, was a love of ideas, oft in-
scribed with affection to her students: “Best wishes for an exciting future
in ideas.”
Martha loved the idea of nursing history. In the prologue of her purple
book, she sketches nursing’s history in ideas and symbols from earliest times.
Perhaps drawing on the etymological root of the word history, “to know” or
“to see,” she believed that in developing nursing knowledge, nurses must never
lose sight of the historical commitment of nursing to human service or to the
age-old principle that “nurture of the human race has been its ever-present
and central concern.”
This historical commitment is compellingly illuminated in nurse sym-
bols evident in archaeological literature reaching back around 7,000 years;
from the Bear Madonna of Anatolia1 who symbolized the nourishment and
protection of human life as it was continuously regenerated, to the “gentle-
handed” Hygeia of Ancient Greece,2 the compassionate bearer of life’s trans-
forming power who nurtured the human spirit and fostered health in the
injured and infirm. Such symbols are by nature timeless, living on in nurses
today, embodied in their practice attitudes and actions. Yet they appear never
to have been studied seriously from a nursing viewpoint, still awaiting a re-
searcher with specialized preparation in the history of ancient cultures and
their languages.
A more accessible example of this historical commitment to human service
is the development of nursing in Ireland during the early to mid-19th century.
Following Henry VIII’s dissolution of the monasteries in the 16th century,
Nursing History Review 21 (2013): 10–13. A Publication of the American Association for the History
of Nursing. Copyright © 2013 Springer Publishing Company.
http://dx.doi.org/10.1891/1062-8061.21.10
Guest Editor’s Note 11
nursing as a public service in Britain and Ireland had been virtually extinct for
almost 300 years. However in Ireland of the 1820s, as soon as the infamous
penal laws3 were relaxed, the human need for nursing services could be re-
sponded to again, and the human desire to practice nursing reemerged with
alacrity and determination. This endeavor was led by Catherine McAuley4 and
Mary Aikenhead5 who, to achieve their aims within the social structures of the
time, formed new organizations of religious sisters—Sisters of Mercy and Irish
Sisters of Charity, respectively. They, and the mainly well-educated women
who joined them, went out daily to nurse the sick poor in their homes provid-
ing physical, emotional and spiritual care, education about how to cope with
and prevent diseases and contend with adverse social conditions, and comfort
and spiritual consolation for the dying. Gradually, skilled nursing as a public
service was reformulated as a system composed of principles, concepts, and
activities. In 1832, during a major cholera epidemic, they further developed
their nursing system through working closely with surgeons and apothecaries
in hospitals. In 1834, three Sisters of Charity went for a year to hospitals in
Paris for specialized nurse training; and in 1835, Mary Aikenhead founded
St. Vincent’s hospital in Dublin, the first major hospital to be owned and
operated by nurses in Britain and Ireland in modern times.
By the time of the Crimean war (1853–1856), they had “attained bril-
liant prestige in nursing.”6 When the British War Office looked to Ireland
for nurses to accompany Florence Nightingale, 12 Irish nurses volunteered
and served with and alongside Nightingale. Their nursing contribution was
largely eclipsed by overriding cultural and political conflict between Britain
and Ireland, but some measure of it can be had from Nightingale herself. To
one of the nurses, Mary Clare Moore, she wrote,
You were far above me in fitness for the General Superintendency, both in
worldly talent of administration, & far more in the spiritual qualifications which God
values in a superior. . . . what you have done for the work no one can ever say.7
And in a later reflection “ . . . how I should have failed without your help.”8
Although the Irish nurses considered it unbecoming to “broadcast” about
their knowledge and practice, they kept private records. A range of others
who worked with them or observed their practice also recorded their impres-
sions. Thus, a 19th-century nursing system of purported “brilliant prestige”
was documented and left available for research and translation into a 21st
century version of nursing knowledge; a nursing philosophy and professional
practice model called Careful Nursing,9 the term used indirectly by the nurses
12 Guest Editor’s Note
to describe their practice. Careful Nursing is constructed from four concepts:

the therapeutic milieu, practice competence and excellence, management of
practice and influence in health systems, and professional authority, together
with their total of 18 dimensions. Its philosophical foundation concerns the
unitary, rational nature of the human person; patient, and nurse; the spiri-
tual dimension of nursing and human life; and health as human flourishing.
These ideas also are explained using rich historical sources including Aristotle
and Aquinas, the latter being a master at explicating at least one dilemma
of nurses: how to practically understand themselves and patients as unitary
(holistic) persons. Careful nursing has a long way to go in its development,
but nurses in hospitals and health systems in the United States and Ireland are
drawing on its ideas and finding it relevant to their practice (evidence-based
practice and nursing outcomes included).
And so it is that history naturally informs nursing knowledge, both imag-
inatively and practically. As historian Joan Lynaugh has observed, nursing
history is “our source of identity, our cultural DNA.”10 Nurses love nursing
history when it illuminates their imaginations and they can feel its mean-
ing in their bones. Indeed, nursing history offers all nurses an exciting future
in ideas.
Notes
1. Marija Gimbutas, The Gods and Goddesses of Old Europe: 7000-3700 B.C.
(Los Angeles: University of California Press, 1974).
2. Marie-Therese Connell, “Feminine Consciousness and the Nature of Nursing
Practice: A Historical Perspective,” Topics in Clinical Nursing 5, no. 3 (1983): 1–10.
3. Laws imposed in Ireland under British rule which discriminated against Catholics
and Protestant dissenters in favor of members of the established Church of Ireland. They
severely restricted the civil liberties of the indigenous Irish: forbidding them the most basic
human rights.
4. Mary Vincent Harnett, A Member of the Order of Mercy, The Life of Rev. Mother
Catherine McAuley (Dublin, Ireland: John Fowler, 1864).
5. Sarah Atkinson, Mary Aikenhead: Her Life, Her Work, and Her Friends (Dublin,
Ireland: MH Gill & Son, 1879).
6. Lavinia Dock and Adelaide Nutting, A History of Nursing: The Evolution of Nursing
Systems from the Earliest Times to the Foundation of the First English and American Training
Schools, Vol. 3 (London: GP Putman’s Sons, 1907), 86.
7. Letter from Florence Nightingale to Mary Clare Moore, April 29, 1856 (Archives
of the Convent of Mercy, Bermondsey, London).
8. Letter from Florence Nightingale to Mary Clare Moore, October 21, 1863
(Archives of the Convent of Mercy, Bermondsey, London).
Guest Editor’s Note 13
9. Therese Meehan, “The Careful Nursing Philosophy and Professional Practice

Model,” Journal of Clinical Nursing (in press); and http://www.carefulnursing.ie
10. Joan Lynaugh, Editorial, Nursing History Review 4 (1996).
Therese Connell Meehan, RGN, PhD

Adjunct Senior Lecturer in Nursing
School of Nursing, Midwifery & Health Systems
University College Dublin
Belfield, Dublin 4, Ireland
Adjunct Professor, Graduate School of Nursing, Midwifery and Health
Victoria University of Wellington, New Zealand
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.

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GUEST EDITOR’S NOTE

History and Nursing Knowledge

A worn, purple-covered nursing textbook rests in a recess of my library

to describe their practice. Careful Nursing is constructed from four concepts:

9. Therese Meehan, “The Careful Nursing Philosophy and Professional Practice

Therese Connell Meehan, RGN, PhD

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