Sue Hawkins, Nursing and Women’s Labour in the Nineteenth Century: The Quest for Independence (London: Routledge, 2010), pp. xii + 228, £75.00, hardback, ISBN: 978-0-415-55169-4.

Abstract

Nursing has attracted surprisingly few academic studies. In this pioneering empirical analysis rooted in nineteenth-century women’s employment, Sue Hawkins breaks new ground with her prosopographical approach. Undaunted by the shortage of traditional sources, she set about building a database of nurses at St George’s Hospital in London between 1850 and 1900. Nurse registers, wage books and minute books were scrutinised, together with the Census, The Hospital and Nursing Record, and Charles Booth’s mid-1890s survey of matrons in the capital. The resulting data were then used to examine the composition of the nursing community at St George’s and the social mobility of its members. Dr Hawkins begins by situating her novel methodology within the historiography of nursing. Unapologetic about her status as a non-nurse, she argues that, for too long, both gender and labour historians left nursing history to ‘enthusiastic amateurs’ intent upon telling stories of ‘heroic self-congratulation’ (p. 1). Critical of such hagiography, Chapter One challenges the popular assumption that, thanks to Victorian reformers, ‘working-class women had all but been excluded’ (p. 32) from hospital nursing by 1900. After reviewing nursing at St George’s between 1733 (when the hospital was founded) and 1850, Chapter Two charts the subsequent characteristics of its nurses. Some movement towards the reformers’ ‘ideal’ of younger, unmarried recruits from the higher social classes was revealed. Nevertheless, ‘by the 1890s, with just under 40 per cent of its staff still originating from Classes III and below, it cannot be said that the hospital had become an exclusive bastion of middle-class nursing’ (p. 56). In Chapter Three, probationer schemes come under that spotlight. Detailing the input of doctors and hospital managers, Dr Hawkins shows how by 1900 – after lagging behind other London hospitals due to a matron unsympathetic to nurse education – St George’s had finally established a training school. Retention is the subject of Chapter Four, which looks at the mechanisms used to attract potential recruits and ‘to stop the revolving door through which nurses came and went at rapid rate’ (p. 138). Better pay, improved accommodation, more generous leave arrangements, and a reduction in domestic chores were among the strategies adopted by St George’s to deflect the charge of ‘White Slavery in Hospitals’ made by the Pall Mall Gazette. Chapter Five tackles the development of nursing as a career through a discussion of why nurses left the Hospital. After demolishing the myth that nursing was a marriage market, and assessing the significance of dismissal, ill health, and resignation, Dr Hawkins found that by the 1880s almost ninety per cent of the nurses whom she was able to trace had nursing jobs – whether in other medical institutions or in the community. These women, she elaborates in Chapter Six, were ‘on a quest for independence, quite removed from the docile, saintly nurse of myth’ (p. 171); they had taken ‘a positive and informed decision’ (p. 182) to enter the profession and make nursing their career. The book is produced to a high standard. Each chapter is followed by a fascinating one-page pen portrait of a nurse whose life story Dr Hawkins has reconstructed. The absorption of such accounts (or extracts from them) into the text would have further animated the argument, which is well supported by graphs and occasional illustrations. For a research monograph, priced at £75, it is a pity that Routledge has opted for the Harvard system of referencing, which does not allow the author to do full justice to her primary and secondary materials. These quibbles aside, Sue Hawkins has produced an important addition to nursing history, which demonstrates persuasively the benefits of engaging with the broader historical context.