Sylvelyn Hähner-Rombach, ed. Alltag in der Krankenpflege: Geschichte und Gegenwart / Everyday Nursing Life: Past and Present. Stuttgart: Franz Steiner, 2009. 307 pp. $72.00 (paper), ISBN 978-3-515-09332-3.
Reviewed by Aeleah Soine (Saint Mary's College of California)
Published on H-German (October, 2012)
Commissioned by Benita Blessing
Everday Nursing in International Perspective
Alltag in der Krankenpflege: Geschichte und Gegenwart / Everyday Nursing Life: Past and Present is a unique compilation of papers from the Second International Conference on the History of Nursing, which was sponsored in 2008 by the Robert Bosch Foundation in Stuttgart, Germany. Contributors represent leading scholars in German, British, and American histories of nursing but also include a few recognized scholars in the broader fields of German history and the history of medicine. As the organizer of the conference and editor of the book, Sylvelyn Hähner-Rombach seeks to "provide the opportunity for comparative studies that transcend national boundaries and time periods," which she further breaks down into three points (p. 20). First, she argues that the German-language historiography of nursing is moving past commemorative and institutional narratives of "heroes" and events, and sees this volume as a step toward embracing interdisciplinary and international analyses of broader historical nursing experiences. Second, the conference and the volume were designed to facilitate cross-cultural exchange among historians of nursing and to broaden their audiences by publishing the contributions in their original German or English with brief summations in the other language. The full introduction appears in both German and English. Third, the volume focuses on the comparative question of what nurses do on a day-to-day basis and how they make sense of these "everyday" experiences in Europe and the United States. Accomplishing any of these three goals would be a welcome addition to the historiography of international nursing, but tackling them collectively represents something even more significant--a new direction in nursing history rooted in international collaboration and aspiring toward a more transnationally integrated body of scholarship relevant not only to nursing scholars, but historians more broadly.
The task of organizing an edited volume of conference papers on so broad a scale is not an easy one. Hähner-Rombach has chosen arrange the fifteen chapters into two sections. "The Working Environment" encompasses case studies of nursing work in the community, private homes, special care institutions, psychiatric hospitals, and by guest workers abroad. "Effects on Everyday Routine and the Professional Image" reaches behind the façade of professional rhetoric and idealism to explore how nurses and other health care workers prevented or responded to their own illnesses, incorporated professional procedures and personal or religious values into their own practices, and recognized their own value as independent practitioners and profit-generating professionals. Although thematically organized, it was refreshing to see both sections of the book reach back into the early nineteenth century, which has been less integrated into international nursing historiographies than the professionalization movements and war nursing of the twentieth century. The resulting breadth of overlapping topics makes the organization of the volume appear somewhat unwieldy at the outset, but it also seems to be evidence and justification of the book's purpose to move beyond heroic narrative history and toward the illumination of opportunities for meaningful transnational collaboration and comparative analysis in nursing history.
Within the two main sections of the volume, chapters focus on everyday nursing experiences by embedding localized case studies within a broader cross-cultural and/or historical context. The chapters are most effective when they cluster around a similar topic tightly enough to collectively illuminate differences among national or temporal contexts. For instance, the inclusion of two chapters on Korean guest worker nurses in West Germany adds greater nuance to the meaning of international nursing, but might have collectively contributed to the book's overall theme better if there had been two different cases of nurses working abroad, such as the case of Filipino nurses in the United States, which was raised by both authors as a comparative counterpoint. More successful on this point were the chapters from Patricia D'Antonio, Carlos Watzka, and Sabine Braunschweig, which analyze psychiatric hospitals and asylums in the United States, Austria, and Switzerland during various eras of the nineteenth and twentieth centuries and comparatively illuminate how changing expectations of psychiatric nurses required reconciliation of their religious values, gender, and/or sexuality with everyday nursing practice. By isolating one aspect of nurses' roles for deeper consideration, these scholars are able to delineate the importance of unique community values, such as Quaker beliefs about self-control and moral treatment, from the shared professional expectations of psychiatric nurses. Likewise, the focus of the first four chapters on community and home nursing by Karen Nolte, Stuart Wildman, Arlene W. Keeling, and Susanne Kreutzer could be the core of its own transnational and comparative study of how nurses in the field, freed from the hierarchical constraints of the hospital or institution, adopted, challenged, and reinterpreted the ideological impetuses of religion, charity, and patriotism in nursing work.
The last chapter of the book, John C. Kirchgessner's "'Krankenpflege überschreitet Budget … ': Eine Neubewertung der Pflegekosten an der Klinik der Universität von Virginia, 1945-1965 ("'Nursing Service is Over Budget … ': A Reappraisal of the Cost of Nursing at the University of Virginia Hospital, 1945-1965"), deserves singular mention for demonstrating what might be lost without international exchanges such as this conference and publication. This chapter went beyond the expectations set by its title by embedding the ongoing economic undervaluation of American nursing staff into the broader history of hospital economics and internal gender and labor customs. As a German study written mainly for a German audience but of great importance to American scholars as well, Kirchgessner argues, "nurses, the providers of the care--the commodity sold by the hospital--continued to be economically invisible as their work was subsumed in the room rate and remained there throughout the post-war era" (p. 282). In other words, Kirchgessner's chapter demonstrates with an arsenal of accounting charts how nurses in the early twentieth century claimed to work for love not money, which guaranteed them professional respectability as working women in the short term, but also inhibited them from adapting to a new fee structure prompted by technological innovation and adopted by physicians and technicians in the long term. Given the increasingly contentious labor negotiations between American hospitals and nurses' unions, Kirchgessner's analysis is a welcome reminder that the economics and politics of modern nursing are more complicated than the time-worn Anglo-American rhetoric of Victorian female calling, which has dominated institutional and heroic narratives of nursing history and continues to inform contemporary public discourse.
The most important contribution of the volume is its representation of the increasing international exchange and collaboration of German- and English-speaking scholars engaged in the history of German, British, and American nursing. Unfortunately, the practical challenges of transcribing and translating this contribution for an international readership seems to have undermined the impact of the original event. For H-German readers, this collection will be of mixed value. For those interested in the much-needed integration of nursing into German history, only nine of the fifteen chapters address nursing in German-speaking Europe, but they are worthwhile reading for historians of medicine, gender, and transnationalism. Scholars particularly interested in comparative or transnational history will find significant food for thought in this book, but may be frustrated by its lack of comparative analysis and intellectual synthesis within and among the chapters. Even the introduction only briefly addresses German scholarship related directly to nursing, providing neither the necessary orientation to American and British nursing traditions and historiographies to be useful as a comparative guide for nursing history, nor connection of nursing history with larger historiographic literatures in German, British, or American history. For a conference publication intent upon nurturing comparative history and international exchange, the book itself reflects little of the stimulating discussion that must have percolated out of the paper presentations in Stuttgart. The book would have benefited greatly from a more detailed introduction, some concluding reflections on the conference discussions, or the self-reflexive integration of comparative themes within the chapters.
In all, this volume has opened up new directions and opportunities for international exchange and comparative histories of nursing practice. As the field of nursing history continues to grow, it will surely continue to incorporate interdisciplinary scholarship and new methods. Hopefully, this conference will represent just the beginning of such collaborations as the real work of giving the local more global significance will come through more sustained and focused comparative analyses of such themes as guest worker nurses, district nursing, nursing care in psychiatric asylums, or the commodification of nursing labor
. For readers interested in making such a comparison for themselves, see Catherine Ceniza Choy, Empire of Care: Nursing and Migration in Filipino American History (Durham: Duke University Press, 2003).
. See Nursing History Review, no. 16 (2008) for other recent reflections on international nursing history and examples of German nursing historiography in English, including an introduction by Sylvelyn Hähner-Rombach and Christoph Schweikardt.
If there is additional discussion of this review, you may access it through the list discussion logs at: http://h-net.msu.edu/cgi-bin/logbrowse.pl.
Aeleah Soine. Review of Hähner-Rombach, Sylvelyn, ed., Alltag in der Krankenpflege: Geschichte und Gegenwart / Everyday Nursing Life: Past and Present.
H-German, H-Net Reviews.
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