Supporting or sabotaging the surgeon’s efforts: portrayals of the surgical nurse’s role in preventing wound sepsis, 1895–1935

Abstract

To examine the surgical nurse's role in preventing wound sepsis (infection) and how this was portrayed in nursing literature in the pre-antibiotic period, 1895-1935. While the history of infection control in general has been researched for the mid-20th century, more detailed research is needed of the pre-antibiotic period, specifically of the surgical nurse's role in preventing wound sepsis. Closer examination is also warranted of the way the nurse's role was perceived in specific practice areas, such as surgeons' views of the surgical nurse's role. Historical research. Analysis of historical British, Canadian, Australian and New Zealand nursing journals and British and Australian surgical nursing textbooks. Between 1895-1935 skilled surgical nurses were valued as 'supporters' of the surgeon's heroic efforts, acting as diligent 'scrubbers' and vigilant 'sentries' to guard patients from microbial attack, yet tended to be blamed as 'saboteurs' and 'slovens' when wound sepsis occurred. The most noticeable changes in knowledge and practice related to greater use of sterilised dressing materials, less reliance on unnecessarily strong antiseptics, and less intensive methods in preparing surgical materials. Although the literature related the nurse's role to the surgeon rather than the patient, interpreting it merely as a subservient relationship would ignore the more complex portrayals evident in the literature. Surgeons looked for support rather than subservience, and a conscientious approach rather than obedience. This historical research shows nurses both the enduring nature of aspects of clinical knowledge and practice as well as the slow process of change in others. It reminds nurses of the danger of infection, the constant vigilance required and the measures needed when practising without antibiotics.