Читать книгу Kelly Vana's Nursing Leadership and Management - Группа авторов - Страница 166

Women and men practiced nursing whenever human beings gathered. Nurses helped people through illness, childbirth, and death. These nurses were often friends or family members or local women and men who were known for their healing and consoling skills. The past few hundred years have provided more evidence of these nurses' work as they gained in specialized knowledge. Military religious nursing orders, known as Hospitallers, were men who undertook nursing in the Crusades of the Middle Ages (Donahue, 2011). English midwives in the seventeenth century trained in unofficial midwifery apprenticeships and were licensed by the church (Evenden, 2000). Historian Nina Rattner Gelbart (1998) relays the fascinating history of Madame du Coudray who, on the orders of the King, traveled all over France educating midwives in the eighteenth century. For her teaching demonstrations, Du Coudray invented a model doll and pelvis, her “obstetrical machine,” made of wicker, fabric, leather, stuffing, and sponges. From du Coudray's time through to the start of the nineteenth century, when medicine in Europe had become increasingly based on science, more educated nurses were needed (Helmstadter & Godden, 2011).

In the United States (U.S.), Native Americans had a long history of nursing their ill with natural remedies, rituals, and prayer when the European settlers arrived in the seventeenth century (Keeling, Hehman, & Kirchgessner, 2018). Unfortunately for these settlers, they chose to fight the Native Americans rather than learn from them. As the decades progressed and thousands of settlers had died through famine and/or disease, rudimentary order began to surface. The diary of Maine midwife, Martha Ballard, written from 1785 to 1812, offers a detailed and intimate picture of her work as meticulously presented by historian Laurel Thatcher Ulrich (1991). We learn that Ballard was a highly skilled midwife who delivered 816 babies over the 27‐year period of her diary. She was also a wife, the mother of nine, and an accomplished nurse. Ulrich notes that Ballard “knew how to manufacture salves, syrups, pills, teas, and ointments, how to prepare an oil emulsion, how to poultice wounds, dress burns, treat dysentery, sore throat, frostbite, measles, colic, “Whooping Cough,” [sic] “chin cough,” “St. Vitus dance,” “flying pains,” the salt rhume,” and “the itch,” how to cut an infant's tongue, administer a “clyster” (enema), lance an abscessed breast, apply a “blister” or a “back plaster,” induce vomiting, assuage bleeding, reduce swelling, and relieve a toothache, as well as deliver babies (Ulrich, 1991, p. 11).

We have less information about most other nurses' work, but there are some things to be elicited from surviving records. For example, Susanna Emlen's letters describing her breast amputation because of a tumor in 1814, without anesthesia of course, note that a nurse came with the surgeon, as well as his sister and his daughter. Four other doctors also attended. “About one o'clock,” Emlen wrote, “Nurse Hooke came into the chamber I was in to tell me the Doctors waited my coming in my own room. She covered my head with a handkerchief, as she led me in, hoping it might save me the sight of the preparations—I however saw Dr. Dorsey with his sleeves tucked up and his cloaths [sic] covered with a large apron …. My suffering was severe beyond expression” (Garfinkel, 1990, p. 21). We may extrapolate from this that Nurse Hooke was an experienced nurse. She was brought by the lead doctor to attend Susanna Emlen, and she had the skill to try and protect her patient from the visual impact of the impending surgery.

Sadly, it was wartime, in this period we are thinking of the U.S. Civil War, lasting from 1861 to 1865, which publicized and even romanticized nurses' work. Thousands of women volunteered as nurses during the Civil War. In all, the Union Army's hospital records alone listed approximately 5,600 women as nurses. However, historian Mary Holland notes that no African American women were recorded as nurses. They were listed as “laundress” or “cook.” Of course, these women were actually nurses (Holland, 1998). Most Northern nurses worked in the Army hospitals and their work was primarily concerned with the patient's diet, his physical needs such as laundry, and his emotional and spiritual care. From these nurses came the impetus for the first U.S. Training Schools. Matilda Morris, one Union Army nurse, recalled the scene after the second battle of Bull Run. “A sadder sight one could not imagine than those loads of wounded men. That day my life as a hospital nurse began. Our hearts and hands were full, tending to so many. Some died before they reached the building. Each ward had 50 beds and two nurses…first we gave each a drink of cold water, as that was their only cry. I shall never forget one who was lying near an old building. He looked as if he were dead, but I stopped to make sure, and I thought I saw his lips move. The man who was carrying the pail cried: “Come along! He is dead, fast enough.” “No, wait a minute,” I replied, and began to wet his lips. Very soon I had him revived enough, so much that he could drink out of my cup” (Holland, 1998, p. 187).

Further, as historian Christopher Maggs has pointed out, in times of war, nurses could and did substitute for doctors (Maggs, 1996). For example, Civil War nurses, just years after the discovery of ether and chloroform anesthesia, administered anesthesia on the battlefield before surgery (Lusk, Cockerham, & Keeling, 2019). At that time, administering anesthesia was typically a physician's responsibility.

These Civil War nurses were exemplars of nursing management and leadership. Note that Matilda Morris had the charge of 50 patients, along with one other nurse, and note that she overruled the man accompanying her who wanted her to leave a dying man. Imagine having the care of 50 wounded men in need of food and dressings and sanitation. Thus, modern nursing began in the United States.