Daring to Care by Susan Gelfand Malka

The famous book Daring to Care written by Susan Gelfand Malka analyzes the impact of the second wave of feminism on a nursing sphere that began in the 1960s. According to the author, this movement gave autonomy and professional status to nurses. Malka (2007) marks two periods in the history of nursing. The first period she detects is linked to 1960-1980. It was characterized by the affirmation of the feminist ideas in the field of medicine after the Second World War that led to its factual independence. The second period began in 1980 with the establishment of the feminism in the educational sphere. In my opinion, in America, nurses were not associated with the feminist movement. However, I agree with Dr. Malka, who argues that this ideology helped nurses to change without difficulties the obedient values of physicians into a professional sector as it is today.

The second wave of feminism was the movement of women for equality in Western Europe and the United States, which began in the 1960s. Malka (2007) insists that the main causes of the female movement for equality were the struggle for civil rights for black people in the United States, the left student’s movement of the West, and the campaign against the Vietnam War. I think that socioeconomic changes in the West in the mid-20th century played an important role in the process, including (a) the invention of effective contraception, providing women control over reproduction; (b) a significant increase in women’s employment; (c) increase in the number of women in higher education, to list a few. In fact, the movement began with political demonstrations. In such a way, the second wave of feminism gradually moved into an autonomous phase, creating a structure of awakening consciousness of independent female groups. These ideas found a reflection in nursing as well. Women were forming professional groups and organizations.

Malka (2007) proposes in the book that the concept of nursing as the occupation of daring to care was formed at the beginning of the century with the work of Florence Nightingale. She was a famous political figure that fought for a better future for nurses. Following Malka (2007), Nightingale considered that there was a straight connection between woman’s morality and the Victorian culture, which “linked ideal womanhood with such traits as self-sacrifice, submissiveness, dependence, obedience, maternity, delicacy, and frailty” (3). Nursing, thus, originated from the traditional model of care for people.

I believe that one of the most important actions of that time was established by F. Nightingale the first training school for nurses in London hospital of St. Thomas in the 1960s, which had a strict selection according to the disciplined and moral behavior. Afterward, the reformer of the nursing field began to open model nursing schools in the U.S. As a result, the development of professional views on the concept of nursing began with the practice of Florence Nightingale. This activist convinced the public that the nurse often plays a crucial role in saving human life and, therefore, should have special knowledge and skills. Her views and beliefs were widely recognized in the world. There is an interesting fact: despite the difference in the Nightingale’s and feminist nurses’ points of view, they named her the first feminist in medicine.

Malka (2007) supposes that numerous wars, natural disasters, mass epidemic, and related crises were important social factors that contributed to the further development of nursing. Seeking the most appropriate forms and methods of nursing care in times of military campaigns have contributed to the increase of scientific researches in the field. The existence of this pattern is confirmed by the participation of nurses in the Crimean War, in the First and Second World Wars among other conflicts. Nursing practice has gradually transformed into an independent professional activity, based on theoretical knowledge, practical experience, scientific judgment, and critical thinking. Interest in the enhancement of scientific research in the area of nursing was partly due to extensive use of their results in the alternative health services support created after the Second World War. I agree with Malka that they were homes providing nursing care, where professionals monitored and supplied with comprehensive care the elderly, the chronically sick and disabled patients.

After World War 2, the perception of nursing has changed. It was the period that determined the end of the era of Victorian nursing. A nurse became “An Angel in White” (1) that showed the prestige and finally gained the respectable status of this profession. Malka (2007) writes that “By the end of the twentieth century, nurses had firmly established a level of expertise, scholarship, autonomy, authority and professionalism” (1). They shifted from caring in private homes to work in hospitals. During this period, the main conception of nursing introduced by Florence Nightingale and stating that “every woman is a nurse” (1), was turned down together with the other Victorian ideas existed in medicine. The image of the white not-married nurse was changing with the transformations in society and culture of America. Moreover, nurses received a perfect opportunity to get a good education, according to the GI Bill. Remembering the bad experience after the First World War, the government made a decision to find people that participated in the war. Hence, all women who returned from the battlefront received an opportunity to study. Drawing upon the statistics given in the Daring to Care, “By 1947, approximately six thousand nurse veterans had used their GI benefits to attend a college or a university” (14). In my opinion, it was the main purpose of the nursing boom in America in the post-war period. Many doctors then named the war as one of the major challenges in their careers. Nurses experienced clinical independence on the battlefield as well as the effects of the GI Bill. I am confident that this circumstance had a huge resonance in the world.

In its turn, a high request of the education entailed the opening of numerous schools and colleges and developed different medical programs. In the 19th century, the work of nurses was not considered to be something so complex that it required special preparation, though there were schools for nurses in different communities. Following the above reasoning, there is a substantial background to assert that feminism helped to change the shape and meaning of the education and work of nurses in the late twentieth century relating it to science. As a result, the bachelor’s and associate’s degree programs eroded the traditional apprenticeship programs offered in hospital diploma schools. Students and followers of the ideas of Florence Nightingale advocated for nursing education. They were fighting for its worthy place in the colleges and universities. The first university programs for nurses appeared in the United States at the end of the 20th century, but their numbers increased significantly in higher education in America and Europe after the Second World War. Later, such institutions appeared on the grounds of new theories and models of nursing and even schools with their authorities.

In the 1980s, many new questions were raised up in the social life and culture that regarded nursing. The development of nursing theory and new science of nursing care moved this sphere towards major independence from physician control. Women were questioning: what is the difference between nursing practice and medicine? Difference feminism that developed in those years raised the issues of ethics in caring and the place of a nurse in the medicine at large. The term of difference feminism was introduced by Carol Gilligan’s In a Different Voice (1982). Her ideology influenced nursing autonomy and gave it a greater alignment with feminist ideals. Women of that period were trying to relate the concepts of nursing, care, and feminism. Many nursing practitioners thought that their position was inferior to doctors that remained mainly male positions. Malka (2007) described this situation in the book with the next thoughts: “Master’s and doctoral nurse graduate programs grew, producing a leadership corps of nurses with doctorates that profoundly influenced the direction of the field with many of its leaders identified as feminists” (8). However, according to my researches, for many women, the feminist movement became a capture, not an opportunity. Although according to the book, feminism influenced the nursing field, second-wave feminists saw this profession facilitating and supporting, they called it the ultimate “female ghetto” (9). Meanwhile, the return from the war took away the freedom and independence of nurses. They lost their autonomy and were obliged to keep the rules, instructions, and subordination. I think that developing nursing knowledge required further discussion, verification, implementation, and dissemination.

In the period of 1945-1965, the concept of nursing changed and received modern features. The modifications in the organization of healthcare and the introduction of managed healthcare systems helped in the transformation of nurses from passively being ‘ordered to care’ to choosing the assertive stance in ‘daring to care’. A number of hospitals increased, as well as the complexity and multi-task of the nurses’ job. Medicine has become more technical, and the expectations of patients grew. A multilevel system of nursing education, nursing staff, ranking by the level of professional qualifications were determined, primarily for economic reasons. This situation was because of that the health care system in the United States has evolved as a profitable business providing conditions of rapid technological progress and creating a wider market of medical services.

History of the development of nursing as a unique profession introduces the factors that influenced and affected the evolution of this healthcare branch throughout the world and our country’s advancement. The book Daring to Care investigated the relations between nursing and feminism in the post-war period. It also gave a detailed description of changes in the sphere of nursing from the foundation for its establishment as an occupation. Nurses all over the globe declare their desire to make a professional contribution to the creation of a qualitatively new level of medical care. In terms of global and regional, social and economic, political and national transformations, they otherwise see their role in society, speaking at times not only as a health worker but also an educator, teacher, lawyer of the patient.

The identity of a nurse has always reflected a woman’s role in society. It was challenged through numerous changes in the perception of females by the community. As woman fought for the rights and became independent, her role in the nursing professional sphere also transformed.