Fanny Bré in the Spanish Civil War (1936-1939): The meaning of nursing care in the international brigades.

Fanny Bré was a volunteer nurse in the International Brigades, who fought in the Spanish Civil War (1936-1939) on the side of the democratically elected Republican government. The objective of this study is to understand the relationship between Bré's antifascist ideas, her conception of care and the activities she carried out in the Spanish hospitals of Casa Roja (Murcia), Villa Paz (Selices, Cuenca) and Vic (Barcelona). We use narrative biography to describe Bré's personal, political and professional trajectory. To do so, we conducted a content analysis of primary sources archived in Spain, Russia and France and secondary sources that emerged from a thorough literature review. We identified three thematic axes: (1) a concept of nursing in the service of the antifascist struggle, (2) nursing activity for high-quality care and (3) political action for improving hospital organisation and care. The interest of Bré's texts transcends the war in Spain because, in them, Bré questions the neutrality of care by revealing that care can itself be a political act.

Telling a different story: Historiography, ethics, and possibility for nursing.

With this paper, I will interrogate some of the implications of nursing's dominant historiography, the history written by and about nursing, and its implications for nursing ethics as a praxis, invoking feminist philosopher Donna Haraway's mantra that 'it matters what stories make worlds, what worlds make stories.' First, I will describe what I have come to understand as the nursing imaginary, a shared consciousness constructed both by nurses from within and by those outside the discipline from without. This imaginary is fashioned in part by the histories nursing produces about the discipline, our historical ontology, which is demonstrative of our disciplinary values and the ethics we practice today. I assert that how we choose to constitute ourselves as a discipline is itself an ethical endeavour, bound up with how we choose to be and what we allow as knowledge in nursing. To animate this discussion, I will outline the received historiography of nursing and dwell in the possibilities of thinking about Kaiserswerth, the training school that prepared Nightingale for her exploits in Crimea and beyond. I will briefly consider the normative values that arise from this received history and consider the possibilities that these normative values foreclose upon. I then shift the frame and ask what might be possible if we centred Kaiserswerth's contested legacy as a training school for formerly incarcerated women, letting go of the sanitary and sanitised visions of nursing as Victorian angels in the hospital. Much energy over the past 250 years has been invested in the professionalisation and legitimation of nursing, predicated (at least in our shared imaginary) on the interventions of Florence Nightingale, but this is one possibility of many. I conclude with a speculative dream of the terrain opens up for nursing if we shed this politics and ethos of respectability and professionalism and instead embrace community, abolition and mutual aid as organising values for the discipline.

For the flaring up of the flu: The nurses of the Maggiore Hospital in Milan hit by the Spanish fever.

In the last year of the Great War, Italy was also hit by the Spanish flu. The Civic Hospitals faced a deadly disaster with insufficient resources. All the heavy workload fell on the female nursing staff, who were the only ones able ensure the continuity of the hospital services. This study aimed to explore the impact of the influenza on the health of the nurses at the Maggiore Hospital in Milan during the second and third epidemic waves. Historical research was conducted between February and May 2020. Primary sources were retrieved from the historical archives of the Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico and the daily newspaper Corriere della Sera. In the autumn of 1918, the Maggiore Hospital in Milan changed its organization to hospitalise patients affected by the influenza pandemic. Although the hospital managers wanted to protect their healthcare staff from the risks of contagion by means of prophylaxis rules, 388 lay nurses and 80 religious sister nurses were affected by this insidious disease. The second and third waves of the pandemic claimed 25 victims of duty. Remembered for their altruism and spirit of abnegation, the hospital community honoured their sacrifice, and the citizens expressed their gratitude.

Revealing historical perspectives on the professionalization of nursing education in Norway-Dilemmas in the past and the present.

The professionalization of modern nursing education from 1850 and forward is closely linked to values and virtues underpinned by Christian ideals, sex-based stereotypes and class. Development in the late 19th century of modern hospital medicine, combined with a scientific understanding of antisepsis and asepsis, hygiene, contagion prevention and germ theory, were highly influential insights to the dominant position of modern medicine in health care. This development constituted a key premise for what nurses, by virtue of being women, and combined with their education, could offer in terms of medical assistance. It enabled them to challenge the prevailing sex-based stereotypes- and class-based hierarchies, allowing modern nursing to retain aspects of both traditional Christian and womanly values, while at the same time adhering to the medical science paradigm. In this paper, we argue that modern nursing education developed in a context characterized by traditional female and religious values, while at the same time being increasingly dominated by the influence of scientific and medical progress. This conflict between traditional and modern values caused dilemmas and tensions as the nursing profession developed. We argue further that similar dilemmas and tensions continue to pervade contemporary nursing and nursing education.

Reflections on the nursing theory movement.

This manuscript represents one segment of a philosophical conversation held in a virtual webinar in February 2021 to consider some of the current debates in nursing theory, education and practice, and their relationship to philosophy. The webinar was sponsored by the International Philosophy of Nursing Society and the Centre for Nursing Philosophy at University of California, Irvine as an opportunity provide a venue for important philosophical and theoretical thinking to a wide audience of nurse educators and practitioners around the world.

Midwives in Health Sciences as a Sociocultural Phenomenon: Legislation, Training and Health (XV-XVIII Centuries).

Background and Objectives: The first inquisitorial processes were developed against Muslims and Jews. Then, they focused on women, especially those dedicated to care. Progressively, they were linked to witchcraft and sorcery due to their great assistance, generational and empirical knowledge. The health historiography of the 15th-18th centuries still has important bibliographic and interpretive gaps in the care provided by women. The main objective was to analyse the care provided by midwives in the legislative and socio-sanitary context of New Castile, in the inquisitorial Spain of the 15th-18th centuries. Materials and Methods: A historical review was conducted, following the Dialectical Structural Model of Care. Historical manuals, articles and databases were analysed. Results: The Catholic Monarchs established health profession regulations in 1477, including midwives. However, all legislations were annulled by Felipe II in 1576. These were not resumed until 1750. Midwives assumed a huge range of functions in their care commitment (teaching, care and religion) and were valued in opposing ways. However, many of them were persecuted and condemned by the Inquisition. They used to accompany therapeutic action with prayers and charms. Midwives were usually women in a social vulnerability situation, who did not comply with social stereotypes. Conclusions: Midwives, forerunners of current nursing and health sciences, overcame sociocultural difficulties, although they were condemned for it. Midwives achieved an accredited title, which was taken from them for two centuries. They acted as health agents in a society that demanded them while participating in a "witch hunt".

Nursing in the 21st century: results of a pilot survey on attitudes towards nurses and nursing.

Nursing is one of the most trusted professions, yet it is poorly defined. There are many definitions and characterisations of nursing. This study sought to pilot a survey exploring the views of nursing in the 21st century. METHODS: This study piloted an electronic survey with open and closed questions. Descriptive statistics were collated for closed questions using Excel. Open-ended questions were analysed using the text analysis program Linguistic Inquiry and Word Count (LIWC) for tone, emotion and criticality. RESULTS: This pilot study recruited 72 participants from professional and non-professional backgrounds. Respondents displayed diversity in their perceptions of nursing, the role of nurses and the role that nurses perform. CONCLUSION: Nursing is a complex, multifaceted profession. The view of nursing was generally positive and authentic although not easy to define. Nursing was felt to be an inclusive profession; however, it is extremely diverse in nature. Further research is required to explore these concepts in greater depth.

Structural Dialectic Model of Care: A Guide to Beliefs, Scenarios and Social Actors Analysis in Nursing Research.

The structural dialectic model of care provides a data analysis method that facilitates the identification of beliefs and structural and functional characteristics. To demonstrate the relevance of the structural dialectic model of care for data analysis integrating beliefs, scenarios and social actors. The characteristics and functions of the model are described and explained through an analysis of its application in fifteen doctoral theses (2009-2017). This model has three structures, the functional unit (beliefs), the functional element (social agents), and the functional framework (scenarios). The Structural Dialectic Model of Care constitutes a useful methodological tool for studies of nursing, organizing analysis of the data according to the dynamic and dialectical nature of their structures.

'Normal birth': Time to change our tune?

Recent research indicates that atraumatic 'normal vaginal birth' only occurs in 33-40% of women who intend to achieve a vaginal delivery, depending on how the term 'normal birth' is defined. In contrast, the NSW birth policy continues to promote 'normal birth', suggesting that the majority of women will achieve 'normal birth' and that 'normal birth' produces optimal maternal outcomes. Our continued use of the term 'normal birth' may be outdated. This article will consider the term 'normal birth' with regard to history, politics, policy and obstetric practice, and recommend a reconsideration of terminology.

Human rights and nursing codes of ethics in Canada 1953-2017.

Human rights are foundational to the health and well-being of all individuals and have remained a central tenet of nursing's ethical framework throughout history. The purpose of this study is to explore continuity and changes to human rights in nursing codes of ethics in the Canadian context. This study examines nursing codes of ethics between the years 1953 and 2017, which spans the very first code in Canada to the most recently adopted. The historical method is used to compare and contrast human rights language, positioning and descriptions between different code editions. The findings suggest there has been very little change in how human rights have been included within the Canadian nursing codes of ethics. Furthermore, we consider how changes within the nursing profession have influenced the authority of codes of ethics and their ability to support nurses in carrying out ethical obligations specific to human rights. Finally, the impacts and implications of these changes are discussed concerning the protection of human rights in today's healthcare landscape in Canada.

A female genealogy of humanitarian action: compassion as a practice in the work of Josephine Butler, Florence Nightingale and Sarah Monod.

Taking the Second Conference of the International Abolitionist Federation as a starting point, this article reconstructs a female genealogy of humanitarian action by shedding light on the transnational connections established by Josephine Butler, Florence Nightingale and Sarah Monod between the abolitionist cause against the state regulation of prostitution and the nursing movement. By using gender and emotion histories as the main methodologies, their letters, journals and drawings are analysed in order to question their alleged natural compassion towards the unfortunate by examining this emotion as a practice performed according to gender, class, religious and ethnic differences. As an expression of maternal imperialism, this essentialist vision provided them with an agency while taking care of victims. However, Butler, Nightingale and Monod's care did not only work in complicity with late-nineteenth century British and French Empires, as it frequently came into conflict with the decisions taken by male authorities, such as those represented by politicians, military officials and physicians. By carefully looking at the conformation of their subjectivities through their written and visual documents, their compassion ultimately appears more as a tactic, for asserting their very different stances concerning Western women's role in society, than as an authentically experienced emotion.

Nursing history as philosophy-towards a critical history of nursing.

Mainstream nursing history often positions itself in opposition to philosophy and many nursing historians are reticent of theorizing. In the quest to illuminate the lives of nurses and women current historical approaches are driven by reformist aspirations but are based on the conception that nursing or caring is basically good and the timelessness of universal values. This has the effect of essentialising political categories of identity such as class, race and gender. This kind of history is about affirmation rather than friction and about the conservation of memory and musealization. In contrast, we will focus on how we imagine nursing history could be used as a philosophical, critical perspective to challenge the ongoing transformations of our societies. Existing reality must be confronted with strangeness and the historically different can assume the function of this counterpart, meaning present and past must continuously be set in relation to each other. Thus, critical history is always the history of the present but not merely the pre-history of the present - critique must rather present different realities and different certainties. In this paper, we use this approach to discuss the implementation of the nursing process (NP) in Germany. The nursing process appears to be a technology that helped to set up an infrastructure - or assemblage - to transform nursing interventions into a commodity exchangable between consumers and nurses in a free market. In our theoretical perspective, we argue that NP was a step in the realization of the German ordoliberal program, a specific variety of neoliberalism. In order to implement market-orientation in the healthcare system it was necessary to transform hospitals into calculable spaces and to make all performances in the hospital calculable. This radically transformed not just the systems, but the ways in which nurses and patients conveived of themselves.

Managing boundaries between professional and lay nursing following the influenza pandemic, 1918-1919: insights for professional resilience today?

AIMS AND OBJECTIVES: To examine lay-professional nursing boundaries, using challenges to the New Zealand nursing profession following the 1918-1919 influenza pandemic as the example. BACKGROUND: The influenza pandemic of 1918-1919 had an overwhelming international impact on communities and the nursing profession. After the pandemic, the expectation for communities to be able to nurse the sick reflects today's increasing reliance on families to care for people at home. It similarly raised questions about the profession's role and professional boundaries in relation to volunteer or lay nursing. In New Zealand, the postpandemic challenge to build community lay nursing capacity tested these boundaries. DESIGN: Historical research. METHODS: Analysis of historical primary sources of official reports, newspaper accounts, articles in New Zealand's professional nursing journal Kai Tiaki and the memoir of Hester Maclean, the country's chief nurse. Interpretation of findings in relation to secondary sources examining similar historical tensions between professional and lay nursing, and to the more recent notion of professional resilience. RESULTS: Maclean guarded nursing's professional boundaries by maintaining considerable control over community instruction in nursing and by strenuously resisting the suggestion that this should be done in hospitals where professional nurses trained. CONCLUSIONS: This historical example shows how the nursing profession faced the perceived threat to its professional boundaries. It also shows how competing goals of building community lay nursing capacity and protecting professional boundaries can be effectively managed. RELEVANCE TO CLINICAL PRACTICE: In the context of a global nursing shortage, limited healthcare budgets and a consequently increasing reliance on households to provide care for family members, this historical research shows nurses today that similar issues have been faced and effectively managed in the past.

'Unladylike Commotion': Early feminism and nursing's role in gender/trans dialogue.

From nursing's history comes the impetus and grounding for our current voice in gender/trans dialogue. Modern nursing struggled its way into being against restrictive, unjust, and oppressive social structures. Many of the obstructions and constraints that nurses and nursing leaders faced were shared by the general populace of women, and yet nurses were different from other women. Nurses worked outside the home, caring for strangers, including unrelated men, in a period when women were otherwise confined to the home. Nurses fought for women's suffrage, for child labor laws, for the welfare of factory workers, for garment workers, for unionization, for vaccination, for housing reform, for the humane treatment of mentally ill persons, for access to birth control, for the amelioration of a panoramic terrain of terrible social injustices, and for the control of nursing education, registration, and practice. For 150 years, nursing has been intrinsically, practically, and politically feminist. The hard-fought gains would eventually position nursing in tension with emerging trans issues. And yet, its history is exactly what situates nursing for fruitful participation in the developing trans discourse and to address issues of transinvisibility and unjust social and health structures that impede dignified and respectful health care.

Research findings from the Memories of Nursing oral history project.

Capturing the stories of nurses who practised in the past offers the opportunity to reflect on the changes in practice over time to determine lessons for the future. This article shares some of the memories of a group of 16 nurses who were interviewed in Bournemouth, UK, between 2009 and 2016. Thematic analysis of the interview transcripts identified a number of themes, three of which are presented: defining moments, hygiene and hierarchy. The similarities and differences between their experiences and contemporary nursing practice are discussed to highlight how it may be timely to think back in order to take practice forward positively in the future.

Failing to protect humanitarian workers: lessons from Britain and Voluntary Aid Detachments in the Second World War.

This paper draws on official records of international and British organizations, newspaper reports, and volunteer memoirs to study the failure to protect humanitarian workers in the Second World War. The Second World War saw a significant expansion in the use of air warfare and flying missiles and these technological advances posed a grave threat to civilians and humanitarian workers. In this context, the International Committee of the Red Cross advocated unsuccessfully to restrict air warfare and create safe hospital zones. The British Government grappled with the tension between military and humanitarian objectives in setting its bombardment policy. Ultimately, humanitarian principles were neglected in pursuit of strategic aims, which endangered civilians and left humanitarian workers particularly vulnerable. British Voluntary Aid Detachment nurses experienced more than six-fold greater fatality rates than civil defence workers and the general population. The lessons from failures to protect humanitarian workers in the face of evolutions in warfare remain profoundly relevant.

Nurses as therapeutic agents in the extreme environment of the desert war, 1940-44.

AIMS: The purpose of this article is to explore therapeutic nursing with combatants in the extreme environment of the desert in World War II. BACKGROUND: The notion of nursing as therapy gained credence in the 1990s and is currently experiencing resurgence, as nurses seek to find meaning in their work and improve patient care in the post-Francis environment. DESIGN: This discussion paper will use the hostile space of the desert war zone in World War II to explore nurses' therapeutic engagement with their combatant patients. It will examine how nurses provided care and comfort through the use of self, fundamental nursing skills, improvisation and innovation and the manipulation of the environment. DATA SOURCES: The data used are a combination of letters, diaries, memoirs and published archival material. Much of the personal testimony is part of an uncatalogued archive of correspondence between nurses and the Matron-in-Chief of the Queen Alexandra's Imperial Military Nursing Service. IMPLICATIONS FOR NURSING: Nurses sometimes struggle to identify the importance of their work, compared with other members of the multidisciplinary team. By understanding nursing as therapy, the profession can articulate how their work is fundamental to the healing, or support to a dignified death of their patients. This article illustrates how the therapeutic engagement with patients, even in the most difficult of environments, is possible and brings comfort. CONCLUSION: Deserts are among the most hostile of any space inhabited by people. Yet, even in a place where survival is difficult, therapeutic nursing can support healing and recovery.

Educational silos in nursing education: a critical review of practical nurse education in Canada.

Changes to practical nurse education (with expanded scopes of practice) align with the increasing need for nurses and assistive personnel in global acute care contexts. A case in point is this critical exploration of Canadian practical nursing literature, undertaken to reveal predominating discourses and relationships to nursing disciplinary knowledge. The objectives of this poststructural critical review were to identify dominant discourses in practical nurse education literature and to analyze these discourses to uncover underlying beliefs, constructed truths, assumptions, ambiguities and sources of knowledge within the discursive landscape. Predominant themes in the discourses surrounding practical nurse education included conversations about the nurse shortage, expanded roles, collaboration, evidence-based practice, role confusion, cost/efficiency, the history of practical nurse education and employer interests. The complex relationships between practical nursing and the disciplinary landscape of nursing are revealed in the analysis of discourses related to the purpose(s) of practical nurse education, curricula/educational programming, relationships between RN and PN education and the role of nursing knowledge. Power dynamics related to employer needs and interests, as well as educational silos and the nature of women's work, are also revealed within the intersection of various discourses.

Illuminating and inspiring: using television historical drama to cultivate contemporary nursing values and critical thinking.

As the world prepares to commemorate the centenary of the First World War, it is timely to discuss meaningful learning activities that students of nursing could be engaged in to encourage them to reflect on the nurse's role then and now. Several films and television series about the war and featuring nursing have already been aired. No doubt there will be many more stories to come. Such stories have the potential to do more than eulogise nursing for students and practitioners. Stories, such as The crimson field, have potential to stimulate serious contemplation about values and cultural practices that have remained constant or have changed and to assist students to develop and articulate values that will be fitting for contemporary practice. Recently, excerpts from the series were examined with a group of nursing students and key learnings were found. These are shared in this paper for the benefit of educators planning to utilise public discourse as triggers to engage nursing students in discussions about nursing values, nursing history and representations of the profession.