A social history of paediatric nursing 1920-1970
This is a study concerning the social history of paediatric nursing between 1920 and 1970. Oral history data was collected from past nurses of children and from people who had been in hospital as children within the period in question. The study explores the professional orientation of nurses and their role within the micro-culture of the acute hospital, their relationship with doctors on the one hand and with the child and family on the other. It is found that until the later years of the period 1920-1970, paediatric nursing was a regimented discipline, whose professional identity was intimately associated with that of medicine and with notions of 'science' and 'professionalism'. In practice, 'science' meant practicing the 'known way' as described in the literature of the time and which had been passed down by word of mouth and which could not be exposed to critique or review. 'Professionalism' meant being respectful and obedient to senior nurses and to doctors. This created a situation where nursing could not initiate change and as a result, failed to provide social and psychological care appropriate to the child and family. Nursing failed to question and develop its own practice and what changes did take place were the result of other agencies' manipulation of nursing for their own ends. The nurse participants express a strong sense of value for their work history and are proud of what they achieved. Nursing is seen as a demanding and challenging occupation, to which the system of discipline and hierarchy presented most of the challenges. Nursing was an emotionally rewarding area of work, the nurse participants obtaining most satisfaction from being able to 'nurse the child better'. Nurses cared about the children but failed to realise that the emotional neutrality associated with their professionalism was interpreted by the children as a lack of affection. It is found that the child participants tended to be traumatised by their hospital experiences. The cause of this trauma is found to be the way in which nurses practiced according to a scientific and professional paradigm. Unwittingly, this last resulted in the nurses being perceived by the child participants as lacking in affection or emotional 'care' for them as children. Many of the participants remain confused and troubled by this aspect of their experience. By the end of the period 1920-1970 the system of discipline and hierarchy was being disassembled and nursing began to evaluate itself and subject itself to scientific scrutiny. At the same time, paediatric nursing did change to become more child and family orientated and it began to present a more 'human' face to the child patients and their families. These changes are identified with broader changes in society to which paediatric nursing did eventually become aligned.