Today, on this 100th anniversary of the armistice that ended the long bloody battle of World War I, I am reminded of the odd, and to me, unfortunate, relationship between war and nursing. Since I currently live in the land of Florence Nightingale, the lasting legacies of war nursing surround me.
From the Crimean War during Nightingale’s time, through the two World Wars, and on to the more recent wars in Afghanistan and Iraq, modern nursing developed alongside modern warfare. Of course, many medical advances have come from battlefield medicine. But nursing as an entire discipline (and only more recently a profession) in Britain came directly from wartime nursing practice. The legacies of this include a rigid, hierarchical, old-fashioned, and sexist nurse practice structure that is almost exclusively hospital based. The old-fashioned and sexist parts are how I view it, especially given the fact that British hospitals still have “ward sisters” and “hospital matrons.” And, nurse practitioners exist here in name only—they are not allowed to perform any of the expanded scope of nursing practice that we are able to do in the US. (Happy National Nurse Practitioners Week to all of you nurse practitioner colleagues back home. I have loved being a nurse practitioner now for a total of thirty-two years.)
How—and why—has American nursing developed in a different direction from that of British nursing? While I do not pretend to be an expert on the history of nursing, I imagine that the comparatively youthful cheekiness of early American nurse pioneers has something to do with our country’s diverging development of modern nursing. The American nurse pioneers like Dorothea Dix (mental health reformer/Superintendent of Women Nurses for the Union Army—if not a nurse herself she was certainly influential on nursing) and especially Lillian Wald, of Henry Street Settlement in New York City and founder of public/community health nursing.
Public/community health nursing does not and never has existed in Britain. Since public health/community health nursing and the expanded primary care role of nurse practitioner were what inspired me to even consider nursing in the first place—and are what continue to inspire me–I have come to realize that I would not be a nurse if I had been born in Britain or in any of the many countries which are former colonies of the British Empire (including Australia, New Zealand, and Canada.) Yet (and this is a big plus), the UK and these three countries/former British colonies all have some form of national health care. And, for the most part (Scotland where I am living is an exception), they all manage to have healthier populations overall for much less healthcare spending.
The photograph in this post is one I took in the Te Papa Museum, Wellington, New Zealand in 2016. It was part of an exhibition on WWI nursing and WWI’s effects on New Zealand in general. It was appalling to realize that entire populations of “fighting age” men (including Maori men) of New Zealand villages were killed in the war. WWI commemorative statues, along with the ubiquitous red poppies, abound throughout the tiny nation of New Zealand.