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Lecture 6

HMED 3075 Lecture Notes - Lecture 6: Stethoscope, Moral Character, Paternalism


Department
History of Medicine
Course Code
HMED 3075
Professor
Tobbell D
Lecture
6

Page:
of 4
HMED 3075 Lecture Notes 10/3/16
Gendered Technologies, Gendered Practice
Lecture: Nursing in the Early 20th Century
Reading: Margarete Sandelowski, “The physician’s eyes.”
Hospital Nursing before the Civil War
Nurse confined to hospital for both home and workplace-shared physical space with
patients
No formal training
Considered dregs of female society
Hospitals as sites of discipline
Paternalistic and hierarchical
Rigid rules for behavior to regulate daily life of patients and hospital workers
Civil War Nursing:
“invention” of the modern hospital depended on the invention of the trained nurse
Increasing numbers of native-born young rural women looking for work in the cities
(urbanization)
Nursing reform was to help reorder the hospital and provide suitable employment for
respectable women
Nursing was to become an “apprenticeship to duty”
oCharacter-behavior and demeanor (as much as bed-making skill) was to
distinguish the trained nurse
Nightingale Model of Reform
oSought to bring efficiency and moral order
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Emphasized hierarchy, duty, and discipline
oMoral training and nursing education
Self-discipline
Absolute obedience
Technical competence (complete repetition until the task became
automatic)
oFemale hierarchy with deference and loyalty to physician authority
Hospital Training Schools
oFirst established in Boston, New Haven, and New York 1873
oSegregated training
African American women could only train at schools established at black
hospitals
First schools established in Virginia in 1891 and Raleigh and Atlanta in
1896
oHospitals required student nurses to provide labor
Admissions standards low enough to ensure sufficient hospital labor
Ideally “middle class” women between 20 and 35
Medical content provided by physicians: nursing content and moral
education by nursing educators
The goals of nursing education
oMoral character
oMedical content
oLanguage of scientific medicine
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oDiscipline and detachment
Reading Analysis:
What did nightingale see as the nurse’s essential role in caring for sick patients?
oObservation of symptoms- nurses were experts based on what they could see,
feel, smell, or hear
oTo listen to the patient
oTo be the “physician’s eyes”- nurses had more frequent access to the patients
oDiagnosis and treatment- nurses expected to be able to diagnose, but usually
done by physicians
Why and under what conditions were nurses given responsibility for some sense-
extending technologies but not others?
oSkill level
oNeed for subjective, “expert” knowledge
oLabor-saving
In what ways is nursing a gendered profession?
oRoutine work
o“low-skill” technological work
o“skillful manipulation” or manual dexterity
oCheap labor
oNursing as caring
What role has technology played in that gendering process?
oEnskilling technologies (increasing opportunities available to nurses) ex.
thermometers and x-rays
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