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

Abstract

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.

Dangerous and Unprofessional Content: Anarchist Dreams for Alternate Nursing Futures

“…In the history of nursing, the specter Florence Nightingale is regrettably the first image conjured to mind. Nightingale serves as sort of a golden spike, fixing the popular and professional imaginary of nursing in a rigid Victorian schema, articulated through such virtues of Christian femininity as obedience, sacrifice, modesty, order, cleanliness [4]. Nightingale, however, was not the first nurse or only nurse.…”

“…For nursing, this is manifested and enforced through the image of Nightingale, a projection of a "mythic violence is the means by which that system sustains itself" [5], razor edges softened by romantic visions of care and entrustedness. Nursing is afforded one history, one image, one ontology-a singular trope on which our history and present balances, at the expense of all other possible pasts, all other stories of what nursing has been, could be [4]. This singular vision forecloses on alternate narratives while simultaneously stifling dissent, denying complicity, demanding obedience, enforcing white heteropatriarchy, establishing and reinforcing nursing's place in the paternalist hospital family [6], and by turns mobilizing the Janus faces of archism to consolidate power and enforce discipline [7].…”

“…Because it currently operates fully enclosed by the logics of late-stage capitalism in concordance with the carceral, economic, political, and pastoral logics that structure the healthcare-industrial complex (HIC), American nursing-organized nursing-is funda-mentally at odds with the generative unruliness of anarchism's epistemology [10]. This irreconcilability grows from professionalized nursing's colonial roots; conjured into being as the managerial practice we know today by Nightingale, nursing as a discipline has been loath to loosen its grip on-or even directly engage with-the white cisheteropatriarchal phallogocentrism that structures its hegemony [4]. Nursing's foundation of and continued adherence to the values of obedience, religiosity, white supremacy, imperialism, and capitalism allows nursing to derive its power from existing dominant power structures, which are squarely at odds with the ethos and praxis of anarchism.…”

Another nursing is possible: Ethics, political economies, and possibility in an uncertain world

“…Picking up my presentation at last year's International Philosophy of Nursing conference, I now want to think about history a little bit. In telling a different story, I want to be clear that I'm not asking folks to let go of anything, necessarily (Dillard‐Wright, 2023). Rather, I invite folks to think about the way the stories we choose to define ourselves as a discipline have ethical and ontological implications.…”

“…An artificially uncomplicated vision, at least if you do not look too close. While I do not really care to go further into the Flo narrative to avoid once again centreing all that she has come to represent, I do want to think about what kinds of worlds we build when we root nursing's origin myth in the virgin birth of the discipline with Florence Nightingale (Dillard‐Wright, 2022b, 2023). Because this matters.…”