"An Unavoidable Evil": The Threat of Indepdendent Hired nurses and Importance of Subordination
Early-nineteenth-century literature and cartoons depict hired nurses as low-class, coarse, negligent, and drunk old women. Elizabeth Hanbury, the author of the 1828 nursing manual The Good Nurse, describes hired nurses as “vulgar and ignorant persons,” and claims that they are an “unavoidable evil” (28). This negative stereotype dominated representations of nurses during the first half the nineteenth century (and continued to resurface well into the twentieth century), as seen in the images below.
The images above capture the negative steretype of hired nurses during the first half of the century, yet the negative stereotype of hired nurses did not disappear after Florence Nightingale's fame in the 1850s. As the image below shows, this stereotype was still prevalent in 1871. Here the nurse is chiding the patient for snoring because the noise is preventing the nurse from sleeping.
(Left) Source: Graves, C. L. “Our Nurses.” Mr. Punch History of Modern England. vol. 2, 1921, pp. 249. Wellcome Library. L0004463, wellcomeimages.org. Accessed 6 Oct. 2016.
Even in 1906, when reformed nursing was established and was largely unrecognizable from old-style nursing, these negative hired-nurse images continued. In this cartoon, the nurse is trying to wake the patient in order to give her the sleeping draught. The nurse does not realize that her patient is dead. This cartoon makes note in the caption that this nurse is Irish, thus this London periodical could be trying to make a joke without insulting his English nurses. Still, the bottle on the mantlepiece behind the nurse perpetuates the negative stereotype that all hired nurses are drunks.
(Right) Source: King, Gunning. A nurse attempts to wake up one of her patients who has just died. 1906. Wellcome Library. Record no. 15346i, http://catalogue.wellcomelibrary.org/record=b1163866. Accessed 6 Oct. 2016.
I claim that even while literature perpetuated the negative stereotype of hired nurses, it redefined the relationship between hired nurses and doctors from one of competition to one of subordination. A nurse was a potential rival to the doctor because she could be hired instead of him – for a cheaper rate – and she could contradict the doctor’s instruction in his absence and slander his reputation. As historian Anne Summers succinctly states in her article “The Mysterious Demise of Sarah Gamp” (1989), “In the domiciliary nurse the medical practitioner might encounter either an outright rival or a contentious partner” (377). Establishing a clear gender-based hierarchy that mirrored the hierarchy of the home helped alleviate this threat and made hired nursing less threatening and more socially acceptable.
Historians Mary Poovey and Arlene Young have discussed this hierarchy, yet they focus specifically on Nightingale’s role, whereas I illustrate in my dissertation that this shift was already taking place a decade before Nightingale’s fame in the Crimean War in 1854 and before the publication of Notes on Nursing in 1859. Using Leigh Hunt’s sketch “The Monthly Nurse” (1836), Charles Dickens’ Martin Chuzzelwit (1843), Charlotte Brontё’s Shirley (1849), and George Eliot’s Silas Marner (1861), as well as Elizabeth Hanbury’s nursing manual The Good Nurse (1825, 1828), I demonstrate that literature increasing emphasized the value of a nurse’s subordination to the doctor years before Nightingale’s later emphasis on this hierarchy.