American Nursing

In American Nursing: A History of Knowledge, Authority, and the Meaning of Work (2010), American nursing historian Patricia D'Antonio offers an in-depth study of modern nursing in the United States from the 19th century to the present day. This volume traces the trajectory of the nursing profession as it evolved from an informal and unpaid caregiving role to that of a respected medical professional on the literal frontlines of illness and injury, a vital lynchpin to health and healing in the contemporary age. American Nursing received first prize at the 2010 American Journal of Nursing Book of the Year Awards in the category of History and Public Policy.

D'Antonio presents her examination in seven chapters. The first, "Nurses and Physicians in Nineteenth-Century Philadelphia," looks at the origins of American nursing through the experiences of medical providers in Philadelphia. The approach to nursing practice here was similar to other progressive cities in the Eastern United States, but it was a different approach than the one first advocated by Florence Nightingale. Nightingale's theory of nursing focused on the sort of sanitary knowledge that was common among the white, middle-class women of her era. But now, in Philadelphia, Boston, and New York, the knowledge required for effective nursing was nothing short of medical training, taught by doctors and learned in hospitals. As a result, nursing was less the maternal caregiving role Nightingale imagined and more that of a separate, educated, and highly skilled professional.

In "Competence, Coolness, Courage—and Control," D'Antonio shifts the narrative to the late 19th and early 20th centuries. During this time, white, middle-class nurses largely dominated the conversation about nursing, placing a particular emphasis on the importance of medical education and knowledge, as well as character. These conversations shaped the identity and perception of nurses, and though these conversations left out nurses of color, African American nurses were still able to craft their own identities in relation to their jobs and their communities.



"They Went Nursing—in Early Twentieth-Century America" documents the lives of nurses as they went about their work. It contrasts the experiences of nurses on the East Coast, where the profession had deep roots, with those of nurses on the West Coast, where trained nurses were more of a rarity. D'Antonio also discusses how female African American nurses were afforded more opportunities than male African American doctors, underscoring the fact that whiteness often trumped education, skill, and experience.

In the chapter "Wives, Mothers—and Nurses," D'Antonio profiles the working identities and lives of a specific group of white nurses who graduated from a Salt Lake City nursing school in 1919. Their training gave them a means of self-empowerment and self-sufficiency while allowing them to maintain their commitment to their LDS faith.

"Race, Place, and Professional Identity" explores nursing in the Deep South, where the profession was racialized and sexualized. White nurses and nurses of color both encountered challenges in practicing their chosen profession. They had to surmount racial and gender stereotypes to carry out the functions of their work, and they had to draw on larger social support systems willing to actively challenge these barriers to ensure women could nurse as they were fully able to do.



"A Tale of Two Associations: White and African American Nurses in North Carolina" looks at how state and national nursing associations represented nursing interests. D'Antonio trains her assessment specifically on the battle for desegregation in the North Carolina State Nurses Association following World War II. The records of this battle voice the positions and concerns of those on both sides of the issue and eventually show an agreement—however tenuous—that a commitment to the goals and ideals of nursing surpasses racial divisions.

In the final chapter, "Who Is a Nurse?", D'Antonio analyzes how nursing has progressed. It became more socially acceptable for women to become doctors. The development of advanced nursing programs and degrees gave nurses more opportunity and authority in their field. Education standards rose to make nursing a highly specialized field of study. D'Antonio reframes the language and politics of nursing to encompass race, class, and economic status. Through this lens, nursing transforms the way women see themselves and their communities. But there remains work to do, as nursing still benefits certain women (and men) differently than it does others.

American Nursing closes with an appendix, notes on the text, an essay on the source materials cited, and an index.



Ultimately, this assessment serves as a commentary—often laudatory, occasionally critical—of contemporary nursing. In a larger sense, it reflects broader themes of women's empowerment and the challenges women have long faced in reconciling work and family obligations. But above all, it shows the complexities of the nursing profession and its indispensable role in a civil society.