to promote health—specifically what Nightingale
referred to as “the health of houses,” that is, the
“health” of the environment, which she espoused.
Nursing, to her, was clearly situated within the con-
text of female duty.
In Ordered to Care: The Dilemma of American
Nursing (1987, p. 43), historian Susan Reverby
traces contemporary conflicts within the nursing
profession back to Nightingale herself. She asserts
that Nightingale’s ideas about female duty and au-
thority, along with her views on disease causality,
brought about an independent field—that of
nursing—that was separate, and in the view of
Nightingale, equal, if not superior, to that of medi-
cine. But this field was dominated by a female
hierarchy and insisted on both deference and loy-
alty to the physician’s authority. Reverby sums it up
as follows: “Although Nightingale sought to free
women from the bonds of familial demand, in
her nursing model she rebound them in a new
context.”
Does the record support this evidence? Was
Nightingale a champion for women’s rights or a re-
gressive force? As noted earlier, the answer is far
from clear.
The shelter for all moral and spiritual values,
threatened by the crass commercialism that was
flourishing in the land, as well as the spirit of criti-
cal inquiry that accompanied this age of expanding
scientific progress, was agreed upon: the home. All
considered this to be a “sacred place, a Temple”
(Houghton, 1957, p. 343). And who was the head of
this home? Woman. Although the Victorian family
was patriarchal in nature, in that women had virtu-
ally no economic and/or legal rights, they nonethe-
less yielded a major moralrole (Houghton, 1957;
Perkins, 1987; Arnstein, 1988).
There was hostility on the part of men as well
as on the part of some women to women’s eman-
cipation. Many intelligent women—for example,
Beatrice Webb, George Eliot, and, at times,
Nightingale herself—viewed their sex’s emancipa-
tion with apprehension. In Nightingale’s case, the
best word might be “ambivalence.” There was a fear
of weakening women’s moral influence, coarsening
the feminine nature itself.
This stance is best equated with cultural femi-
nism,defined as a belief in inherent gender differ-
ences. Women, in contrast to men, are viewed as
morally superior, the holders of family values and
continuity; they are refined, delicate, and in need of
protection. This school of thought, important in
the nineteenth century, used arguments for
women’s suffrage such as the following: “[W]omen
must make themselves felt in the public sphere be-
cause their moralperspective would improve cor-
rupt masculine politics.” In the case of Nightingale,
these cultural feminist attitudes “made her impa-
tient with the idea of women seeking rights and ac-
tivities just because men valued these entities.”
(Campbell & Bunting, 1990, p. 21).
Nightingale had chafed at the limitations and re-
strictions placed on women, especially “wealthy”
women with nothing to do: “What these [women]
suffer—even physically—from the want of such
work no one can tell. The accumulation of nervous
energy, which has had nothing to do during the day,
makes them feel every night, when they go to bed,
as if they were going mad....” Despite these vivid
words, authored by Nightingale (1852/1979) in the
fiery polemic “Cassandra,” which was used as a ral-
lying cry in many feminist circles, her view of the
solution was measured. Her own resolution,
painfully arrived at, was to break from her family
and actualize her caring mission, that of nurse. One
of the many results of this was that a useful occu-
pation for other women to pursue was founded.
Although Nightingale approved of this occupation
outside of the home for other women, certain other
occupations—that of doctor, for example—she
viewed with hostility and as inappropriate for
women. Why should these women not be nurses
or nurse midwives, a far superior calling in
Nightingale’s view than that of a medicine “man”
(Monteiro, 1984)?
Welch (1990) terms Nightingale a “Christian
feminist” on the eve of her departure to the Crimea.
She returned even more skeptical of women.
Writing to her close friend Mary Clarke Mohl, she
described women that she worked with in the
Crimea as being incompetent and incapable of in-
dependent thought (Woodham-Smith, 1983;
Welch, 1990). According to Palmer (1977), by this
time in her life, the concerns of the British people
and the demands of service to God took precedence
over any concern she had ever had about women’s
rights.
In other words, Nightingale, despite the clear
freedom in which she lived her own life, nonethe-
less genderized the nursing role, leaving it rooted in
nineteenth-century morality. Nightingale is seen
constantly trying to improve the existing order and48 SECTION II Evolution of Nursing Theory: Essential Influences