What needs to be done

I was struck by the descriptions of nursing in Louisa May Alcott’s Work: A Story of Experience  (not the greatest novel, but a fascinating take on women’s careers in 1860s Boston). The last of the professions our heroine turns her hand to is wartime nursing, just as the author did in the Civil War.

A senior nurse commends the heroine:

“You are a treasure, my dear, for you can turn your hand to any thing and do well whatever you undertake. So many come with plenty of good-will, but not a particle of practical ability, and are offended because I decline their help. The boys don’t want to be cried over, or have their brows ‘everlastingly swabbed,’ as old Watkins calls it: they want to be well fed and nursed, and cheered up with creature comforts. Your nice beef-tea and cheery ways are worth oceans of tears and cart-loads of tracts.”

. . . . Mrs. Sterling, Jr., certainly did look like an efficient nurse, who thought more of “the boys” than of herself; for one hand bore a pitcher of gruel, the other a bag of oranges, clean shirts hung over the right arm, a rubber cushion under the left, and every pocket in the big apron was full of bottles and bandages, papers and letters.

The 1860s were a pivotal time in the development of nursing – in England, Florence Nightingale was just founding the first secular nursing school. Clara Barton, “the angel of the battlefield”, was gaining the experience that she would use to professionalize American nursing. But at the time Alcott trained, nursing involved no formal education, no study of biology. Both nursing and medicine in general were at such a basic stage that nurses were basically trying to keep the patients from bleeding to death, and if possible to keep them comfortable and in good spirits.

Given how much actual medical care nurses are now responsible for, I’d much rather have a nurse who can put the right drug in the IV line than one with “cheery ways.” But some combination of both would be nice.

Currently, medical and social services are segmented enough that I’m a little envious of 19th-century nurses’ ability to actually do tasks that they saw needed doing. Help a client call his mother? No, that’s the caseworker’s job. Get a client in solitary confinement the Danielle Steel novel she’s asking for to pass the time? That’s the librarian’s job, except he never seems to make it up to the tenth floor. Helping a bulimic client brainstorm about how to drink more fluids – that would probably be the nutritionist’s job if he hadn’t been laid off.

At its best, I think social work includes things beyond talk therapy. Getting a cup of coffee for a woman who just arrived at the domestic violence shelter with two children and a trash bag of belongings. Spending a therapy session helping a client write a resume. Getting a pair of reading glasses for the hospital patient who lost hers. Getting a Spanish-language Koran for the prisoner who wants to read his holy book in his own language. No, it doesn’t take a master’s degree to do any of these things, and when they need to be done en masse it’s worth having someone whose job that is. But when random needs come up, sometimes it’s better to just get the job done.

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