Before, We Were Always There—Now, Everything Is Separate: On Nursing Reforms in Western Germany

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In West Germany in the early 1950s, it was taken for granted that a good nurse would consider her occupation not just a job but a vocation. For her, nursing was not a labor but a service. The large motherhouse sisterhoods of Caritas, the Inner Mission, and the German Red Cross still dominated the nursing vocation in West Germany. When joining a sisterhood, women vowed to subordinate their lives completely to the of the community and to the of the sick and needy. In return, the motherhouse provided training and lifelong support. Food and accommodation apart, the motherhouse sisters received only a minimal amount of pocket money. The beginning of the twentieth century saw the founding-as an alternative to the motherhouse system-of so-called sisterhoods. Their members did not establish a permanent bond with their sisterhood and they did receive a salary for their work.1 Nevertheless, in the early 1950s, the concept of a religious still shaped the working and living conditions of these free nurses. They lived just as the motherhouse sisters did, in hospital residences. It was understood that nurses would be single and be prepared to work, more often than not, seventy to eighty hours a week, and that, even when working in the public service, their income would fall somewhere very near the bottom of the salary scale. However, in the 1960s, this vocational image changed thoroughly. The traditional ethos of dedicated became less and less compatible with the lifestyle expectations of a new generation of women; the formerly celibate and self-sacrificial charity service (Liebesdienst) was revamped into a modern female occupation that could also be engaged in part-time by married women. In addition, medical progress had profoundly changed the demands made of nursing personnel. It was less and less a calling for charity.2 Now the demands were for nurses with far more soundly and theoretically based training and qualifications. The present article has a twofold purpose: to present an overview of this process of transformation, and to explore the history of this reform process as it was manifested in everyday life and experience, using a north German motherhouse-the Henriettenstiftung in Hanover-as an example.3 Christian nursing proves particularly interesting when used as a prism through which to examine the modernization process. The pronounced patient orientation of Christian nursing was hardly compatible with the demands made by a modern-day rational and professional value system. Consequently, the ambivalence of the modernization process can clearly be observed.4 The article deals with three aspects of this phenomenon. First, I outline the traditional concept of nursing as a religious and analyze its basic tenets. I explore the place in the system of sick care that the sisters occupied, and the way they organized their everyday nursing activities. My focus then shifts to the modernization of nursing in the 1960s. By looking at reforms in training and working hours, I show that modernization meant fragmentation-with far-reaching consequences for the self-concept and everyday practice of nursing. Finally, I locate this process of transformation within the general history of society and medicine. The article is based on contemporary publications and health care periodicals, as well as interviews with the deaconesses of the Henriettenstiftung. I have also analyzed the comprehensive archives of the Henriettenstiftung, which contain the personnel files of about 900 sisters belonging to the motherhouse in the post-World War II period. Through these means, the everyday life as well as the self-image of the sisters and their perspectives on modernization can be clearly traced. Nursing as a Religious Calling In the course of the nineteenth century, the motherhouse system developed into the dominant form of nursing organization in Germany, remaining relatively unchanged well into the second half of the twentieth century. …