Florence Nightingale on Nursing, Part 1: Initial Observations

The ancient Greek philosopher Aristotle began his Metaphysics with the statement that “All men by nature desire to know.” Consistent with this statement, but not because of it, a major pattern in my life has been a drive to continue learning. I recently began taking stock of my nursing knowledge and experience in relation to other areas of my life, a quest to refine my professional identity, if you will. One way I have decided to do that is to spend time exploring the history of nursing and considering my place in relation to it. Over time, I anticipate drawing upon many sources, but my first choice is Florence Nightingale’s short work Notes on Nursing, published in 1860.

In the preface to her Notes, Nightingale states that her writing is not intended to be a “rule of thought” or manual to teach nursing. Instead, she states that her intention is to “give hints for thought to women who have personal charge of the health of others.” I find it intriguing that Nightingale subtitled her Notes “What it is, and what it is not.” That would seem to provide more than a “hint” as to the author’s understanding of nursing. It is the kind of subtitle I would expect of a work that defines a field rather than offering “hints for thought.” There must have been some definition of nursing in Nightingale’s mind for her to have chosen 13 specific categories of nursing to address.

As one of the fewer than 10 percent of nurses in the United States who are male, I am well aware that I am in the minority within the field. Further, I have always been aware that there are deeply rooted gender-related cultural understandings that define what nursing is and who can or should become a nurse or provide nursing care. I realize from personal experience that there is gender bias in nursing. I know there are reasons for it that have developed throughout the history of human civilization. So I hope nothing I ever say on this topic will be seen as a naive attempt at equality in all aspects between male and female nurses.

I think it is a worthwhile exercise to consider whether or not Florence Nightingale’s presentation of and advocacy for nurses as specifically female may have served to reinforce the predominance of women in the history of modern nursing. I know there is etymological precedent for the notion that nurses are female by definition. Consider the connection to being a wet-nurse or a female caretaker of children. On the other hand, consider also the connection to the “sexless” nature of a worker insect or celibate member of a religious order. Can and should the full range of connotations of the term nurse be reflected in contemporary nursing?

A question I am left with at this point is, given culturally defined meanings of the term nurse, am I in fact a nurse, given the kind of work I do in taking charge of the health of others? Or am I something else? If the latter, is that something else compatible with nursing in some profound way that has yet to be explored in the field of nursing?