In what ways has the nursing profession stayed the same today as it was 150 years ago? And in what ways is it different?

The Nurse's Secret offers a glimpse of what life was like for America's very first professional nurses. What were some of the most significant differences you noticed between early nursing as it's represented in the novel and your understanding of the profession today?

And in what ways has it remained the same? Were you surprised by any of these uniformities?

I was impressed with the importance of cleanliness for the time period. These ideas have been improved over the years and we still use them today. The requirements for nurses are very different. The nurses in the Guilded Age had to be Christians, which is not true today. Their upbringing and moral character was important to be accepted. While today we highly value education, religion and family background are not a consideration. In the book nurses weren't valued as important members of the medical team. Today I believe they are.

One thing that I don't think has changed is the feeling by doctors that nurses don't have valuable information to impart to them. Nurses spend hours caring for patients and are much more intune with changes and behaviors. I certainly hope that nursing supervisors have changed for the better.

One difference is that the emphasis is now on registered nurses that now requires at a minimum two year degree but most are bachelor's or even more advanced or specialized degrees and require continuing education. They still spend more time with patients and try to communicate their needs to doctors who may listen. Hospitals now have other workers who do the work nurses did more than a century ago.

While nurses today may not be involved in as much of the daily housekeeping, in addition to their other responsibilities, I feel like more has been added to their daily tasks. Record keeping is also a huge part of a nurse’s role, and this takes time away from being with patients. I don’t believe that nurses are valued as much as they should be—for some reason I’m thinking many are often asked why they didn’t continue on the become doctors, thus minimizing the contribution they make in the position they hold. I think nurses are stretched further. In each ward there was Una and a second year student. Often today, nurses are not teamed up and are responsible for just as many patients alone.

Nursing has always been about caring for a patient. Hopefully, doctors are listening to the nurses and treating them with more respect today. The amount of schooling required of nurses today is more extensive than that of doctors for that time period.

Nurses work incredibly hard (as do orderlies and others in hospitals), are now very well educated, under paid and under appreciated. They are stretched thin and yet most do not let that effect the treatment of their patients.
When you remember that prior to the era of this novel the "nurses" were untrained, uneducated and often prisoners. That the change to trained, educated, nurses happened at all is amazing, that it happened relatively quickly was miraculous. A smart doctor will listen to the nurse. Some have learned this, some refuse. I think the increasing role of nurse-practitioners is changing this dynamic for the better.

Strict uses of standards of cleanliness - so much disease and death is due to infection after a surgery or illness, not the actual injury or sickness that took them to the doctor in the first place.

I read recently that the nursing profession is the most respected of all careers. In the 1880s, as this book explores, it was just becoming a legitimate profession with new standards for each nurse.
I volunteer in a hospital and am amazed at all the various electronic and digital devices the nurses must monitor and sort various cords and hook ups. It’s a far cry from cupping patients and applying leeches.
The nurses in Bellevue were doomed their best to keep things clean; now some nurses must preform their duties in complete haze out fits. It’s a different world:

The relationship between nurses and doctors is somewhat the same today in that the doctors give the orders and the nurses carry them out. But I think nurses today can more openly question doctor orders that might harm a patient such as wrong medication dosage and doctors seem more willing to ask for a nurse’s input regarding care and treatment. Perhaps some of the changes in roles can be ascribed to the fact that there are more female doctors today.

Nursing has always been about caring for the patient. And while it has always been a profession dominated by women, there are more and more men learning to be nurses. A male nurse in the days of Una and Dru would have been unthinkable.

I'm not in the nursing profession, so I can't speak from experience--but I do think that nurses were (and continue to be) the eyes and ears of a doctor by providing regular care and communication with each patient. Doctors could not do their jobs without nurses. I believe that the male/female (read: superior/inferior, as portrayed in the book) dynamic has lessened with time, but hasn't gone away completely. I just heard today that within a decade my state is going to be short 25,000 nurses due to so many leaving the profession and not as many going into it as in the past. What hospital care is going to look like in the near future I don't want to imagine!

Nurses are critical to the care of patients since they spend much more time with each patient than a doctor. As was evident in the book, some doctors welcome input from the nurses, while a few have a "God complex" and think they always know best. I think this is still true today with some people in authority.

acstrine - that's my least favorite part of nursing today, all the charting and administrative tasks that take us away from patients and bedside care. One woman I met in another book club, who graduated from nursing school in the early 1950s, told me how she was trained to give each patient a back rub before they went to bed. I love that! But, unfortunately, it's not something we have time for today.