From handmaiden to right hand—the infancy of nursing

AORN Journal,  Feb, 2004  by Victoria L. Holder

• E-mail
• Print
• Link

Editor's note: This is the third in an ongoing series about the history of perioperative nursing in the United States. The first two articles in this series appeared in the September and October 2003 issues of the AORN Journal.

Before the US Civil War, it was expected that women would be the primary caregivers in their homes, and nurses were men who served in the military. During the Civil War, however, women were called upon to act as caregivers to the wounded because there were not enough male nurses to care for the mass casualties. These women started by offering whatever assistance they could. They provided first aid and food and gathered supplies, but before long, they found themselves in much more demanding roles. For example, Dorthea Dix, who already had devoted much of her life to helping the mentally ill, was appointed superintendent of the United States Army Nurse Corps. Her job was to select and train nurses for the Union Army. (1)

This was a time of new experiences for the military and for the women who volunteered to serve as caregivers. There were no nursing schools in the United States at the time, and social customs of the day did not encourage women to leave their homes and families to tend to the injuries and illnesses of men other than family members. When Dix called for female volunteers to join the Army Nurse Corps, she realized that the work would require women of "good health, courage, and character." (2 (p36))

Although they wanted to serve, many women had difficulty finding their place in the war effort. Crusaders, such as Clara Barton and Mary "Mother" Bickerdyke, chose different paths. Instead of joining Dix's Army Nurse Corps, they volunteered in other ways. While Dix's nurses were trained to care for the wounded and sick in large hospitals, Barton served on the battlefields and Bickerdyke served by gathering supplies and organizing hospitals for the Union. It is estimated that 10,000 women provided care to sick and wounded soldiers during the Civil War. (3)

When the war ended in 1865, the women who had served as nurses returned to their homes. The war was over, but resurrected social customs dictated once again that nursing was not a job for women. Fortunately, underlying currents of change were beginning to stir.

ONE WOMAN'S QUEST

The women who served during the Civil War were strong, intelligent, independent, and useful outside of the home, and many young women found much to admire in these pioneers. Women like Linda Richards, who eventually helped to establish nursing as a legitimate role for women, had goals that did not include marriage and children.

From early childhood, Richards wanted to care for the sick. When she was nine, she helped care for her ailing mother, and at the age of 13, she traveled with a local country physician to visit and care for patients on his rounds. It was 1854, however, and there were no female nurses in the United States. The Crimean War had just started in southern Russia, and Florence Nightingale was just beginning her work as a British military nurse.

By the age of 15, Richards had lost her parents and was living with her ailing grandfather, who, concerned about her future, insisted she enroll in the St Johnsbury Academy for teachers near their home hi Vermont. Richards agreed to attend to please her grandfather, but she hated the curriculum and barely passed her examinations. Upon graduation, she returned to her grandfather's home and was hired as the local schoolmistress. To her surprise, many of her students were old friends she had helped care for when working with the physician several years earlier. They were eager to remind her of the competent and compassionate care she had provided them in times of need.

Richards continued to teach until her grandfather died in 1858. She then sold the family farm and hired out as a tutor in private homes, in 1860, at the age of 19, she took a room with a widow in Newport, Vt, and met the widow's nephew, George Poole. Richards and Poole fell in love and planned to marry in May of 1861. History intervened, however, when the Civil War began in April and Poole joined the ranks of the Union Army, thus postponing the wedding.

During the four years of the Civil War, Richards continued to teach. Sadly, Poole was seriously injured during the war, and upon his return home, he refused to marry Richards, knowing that he did not have long to live. She cared for him, however, until his death in the winter of 1869.

Following Poole's death, a devastated Richards decided to pursue her lifelong dream of becoming a nurse. She had heard of the Nightingale School and Home for Nurses in London, and she knew several women who had served as nurses during the Civil War. At the time, however, she could not know how difficult the path would be that led to her goal. (2)

A TURNING POINT

In 1870, at the age of 29, Richards moved to Boston and began to look for work in area hospitals. She was turned down numerous times because most physicians simply refused to train a woman as a nurse. Finally, she was offered a position as a ward maid at the Boston City Hospital. The job duties consisted of housekeeping, cooking, and doing laundry, for which she was paid $7 a month. (2) Richards continued to ask physicians for training as a nurse, but they would not hear of it. After working 16 hours a day, six days a week for several months, she was exhausted and reluctantly gave up the job because of illness.