The Inadequacy of Nature and Rise of Trained, Sanitary Nursing in Mid-Victorian Literature
During the nineteenth century, nursing transitioned from an industry of predominantly low-class women, to one that was largely middle class. Many scholars have attempted to explain how and why this change ocurred. I argue that literature moved nursing towards a middle-class profession by distancing it from female instinct and personal character. At the beginning of the century, nursing manuals claim that nursing ability is innate to all women and connected to personal character. Sanitary reformers wanted to make nursing a middle-class profession, therefore, sanitary tracts redefined nursing knowledge as something that was learned. If nursing ability was learned, then only those with the time and money for training (in other words, the middle class) could be good nurses. Similarly, if good nursing was associated with good character, then a good woman of any class could be a good nurse. If nursing was a skill only learned through training, however, then again only those with the resources available for such training could become good nurses. William Thackeray’s Vanity Fair (1848) and Wilkie Collins’s The Woman in White (1859) contradict the belief that nursing ability was directly related to personal character by presenting women with questionable characters as good nurses.
(Right) This image humorously portrays the dichotomy between "old-style" older, portly nurses with "new-style" young, thin, attractive nurses. Though hard to distinguish here, old-style nurses were usually low-class, whereas new-style nurses were predominately middle-class.
Source: Spurgin, Frederick. “An illustration of a young boy choosing between one nurse portrayed as a pretty sex symbol and another portrayed as a frustrated, elderly, ‘battleaxe,’ early 20th century. London, Art and Humour Publishing Co. Pictures of Nursing: The Zwerdling Postcard Collection. National Library of Medicine. 15 Aug. 2014. https://apps.nlm.nih.gov/exhibition/digitalgallery/index.cfm?gallery=1&action=browse&view=detail&asset=380 Accessed 6 Oct. 2016.
Once nursing skill was no longer considered innate, then training and technical expertise were increasingly valued. Sanitary reform literature and nursing manuals contribute to this transition by emphasizing the importance of training over natural instinct. Additionally, sanitary reform rhetoric, particularly that of the Ladies’ Sanitary Association (LSA), packaged nursing sanitary reform as a religious and philanthropic duty performed specifically by the middle and upper class for the “ignorant” poor. While nursing the sick has long had both religious and philanthropic connotations, sanitary reform literature solidified this association and established sanitary reform and nursing as a middle-class woman’s province, which empowered middle-class women as the providers and enforcers of the nation’s health. Yet while this rhetorical maneuver empowered middle-class women, sanitary reform’s associations with religion and charity simultaneously justified these middle-class women’s actions as domestic and socially-appropriate. I examine multiple tracts from the Ladies’ Sanitary Association (LSA), an organization managed by aristocratic women who published pamphlets predominantly for lower-class women. These texts demonstrate that, contrary to the universal reforms desired by Nightingale, sanitary nursing was framed as a specifically middle-class mission, a rhetorical move that permanently altered the class-associations of reformed nursing.
(Below left) This cartoon depicts the changed expectations between old-style nurses and new-style trained nurses. Old-style nurses were often criticized for sleeping while tending the patient. Above, however, the trained nurse is not expected to sleep at all while on duty.
Source: Raven-Hill, Leonard. An exhausted nurse who has been looking after her patient for many hours asks when she may go to bed, the patient's mother retorts that she thought she was a trained nurse. Wellcome Library. Record no. 15626i, http://catalogue.wellcomelibrary.org/record=b1164177. Accessed 6 Oct. 2016.
(Upper right) This image portrays the ignorance of the lower-class mother as compared to the middle-class district nurse. The mother (right) tells the district nurse, "There ain't no danger of infection. Them children wot's got the measles is at the 'ead of the bed, and them wet ain't is at the foot." By portraying the lower-class mother as ignorant regarding basic childcare, it paved the way for middle-class women to serve as carriers of sanitary knowledge.
Source: Wood, Starr. Four children, two with measles, in the same bed: their mother tells the district nurse that there is no risk of infection. London Mail, London, 23 Oct. 1915. Wellcome Library. Record no. 16901i, http://catalogue.wellcomelibrary.org/record=b1174787. Accessed 6 Oct. 2016.
(Above right) This cartoon also depicts the class and education difference between the patient and district visitor. The poor, ignorant woman is concerned that she will literally "shake off" her head if she takes the pills the doctor gave her for headache.
Source: "A Drastic Measure." Punch, vol. 121, 1901, pp. 219. Wellcome Library. Record no. 1714437. http://catalogue.wellcomelibrary.org/record=b1312142. Accessed 6 Oct. 2016.
(left) These two images reflect the image of the new-style nurse that sanitary reformers worked to achieve. These women are young, attractive, and middle-class.
(Far left) Source: An English hospital nurse in full uniform. [1899?] Watercolour drawing. Wellcome Library. Record no. 17431i, http://catalogue.wellcomelibrary.org/record=b1175312. Accessed 6 Oct. 2016.
(Near left) Source: A district nurse with her outdoor uniform and bag. Watercolor drawing, Wellcome Library, no. 17436i, http://catalogue.wellcomelibrary.org/record=b1175317. Accessed 6 Oct. 2016.