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Book and Media Reviews
November 24, 2010

American Nursing: A History of Knowledge, Authority, and the Meaning of Work

JAMA. 2010;304(20):2301-2302. doi:10.1001/jama.2010.1732

As a nurse and a historian, Patricia D’Antonio recounts and analyzes the multifaceted history of nursing in America, drawing largely from nurses' own stories as revealed in letters, reports, diaries, nursing alumni surveys, and other sources. Her examination begins in Philadelphia in the decades prior to the Civil War—a time when nurses had no formal education and their work took place almost exclusively in the patient's home on a fee-for-service basis. During ensuing decades, the knowledge base of nursing began to grow as hospital-based care took hold in large eastern cities and a few hospitals opened nursing education programs. But it was not until the influential writings of Florence Nightingale that hospital-based nursing education programs flourished. The consequences are well known: a steady supply of inexpensive student nurses trained to be disciplined, loyal, obedient, and accepting of a gendered and hierarchical medical structure benefited the interests of hospitals and physicians. However, rather than dwell on or bemoan these powerful influences on nursing education or the professional identity of nurses, D’Antonio makes clear that after 3 years of enduring unimaginable work demands, graduating nurses emerged as “competent, cool under pressure, courageous, and under control.”