"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.
 Sairey Gamp, 1843Sairey Gamp, from Charles Dickens's Martin Chuzzelwit (1843), is the most famous hired nurse, yet she is not the only one by far. She is described as a woman who enjoys snuff and spirits. (Image 44) |  Nurse, 1801This nurse fits the stereotype of hired nurses as older, unattractive women. (Image 73) |  Slumbering Nurse, 1807A convalescing woman trying in vain to rouse her slumbering hired nurse: the cat scavenges her food and the candle sets light to the carpet. This image conveys the stereotype of the incompetent hired nurse. (Image 58) |
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 Distracted NursesIn the beginning of the nineteenth century, doctors also had poor reputations. This image depicts nurses and the doctor playing cards and enjoying themselves, thus ignoring the patient. (Image 45) |  Obese Midwife, 1811This image of a midwife from 1811 depicts an older, ugly, and obese woman, which reflects the stereotype of the time. (Image 59) |  The Good Nurse, 1828The image is the frontispeice image in Hanbury's 1825 nursing manual The Good Nurse. Though not sinister looking, she is older and portly, stereotypical of old-style nurses. (Image 77) |
 Nurse, 1833This nurse is also depicted as old and grandmotherly. (Image 32) |  Monthly Nurse, 1836Leigh Hunt interprets Meadows's drawing as showing the monthly nurse settling down in her armchair after the mother and baby have both gone to sleep, taking snuff, a cup of tea, and a glass from a bottle of spirits. (Image 49) |  Dishevelled nurseThis image portrays a disheveled nurse and a disgruntled patient, fitting the stereotype of the time. (Image 41) |
 Home nurseThis "home nurse" is older and portly, fitting the stereotype. (Image 51) |  Drunk wet-nurse, 1841This cartoon depicts drunk the wet-nurse of Queen Victorian and Prince Albert giving Edward VII alcohol, much to the royal parents' horror. It was widely believed that hired nurses were drunks. (Image 3) |  Drunk nurse.jpgThe bottle in the background of this image implies that the nurse has been drinking, a common stereotype of hired nurses. (Image 50) |
 Sairey Gamp and Betsey Prig, 1843These two women from Dickens' Martin Chuzzelwhit (1843) became synonymous with everything that was bad about hired nurses and needed to be changed with reform. In this scene they are brushing the patient's hair with such violence that “his very eyelids were red with the friction" (Dickens 301). (Image 61) |  Nurse, 1869Though a cartoon from 1869, the nurse is the background is still depicted as older and unattractive. The work of transforming the stereotype of hired nurses would take decades. (Image 60) |
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.