Book Review: Handling the Sick: The Women of St. Luke’s and the Nature of Nursing

Tom Craig Olson and Eileen Walsh are famous writers and scientists who became famous after publishing their book Handling the Sick: The Women of St. Luke’s and the Nature of Nursing, 1892-1937 in 2004. Eileen Walsh wrote a number of books dedicated to different practical issues in the field of general biology. Tom Olson’s most famous book is Don’t Die with Your Helmet on about the power of personal responsibility.

In the book Handling the Sick, Olson and Walsh discussed the main concepts of nursing of the studied period. This small and practical book describes various issues related to nursing history. It’s narrative mode is very fresh and simple. The book raised provocative questions from nursing history. During the research conducted for the book, Olson and Welsh explored the work of 838 women that studied nursing at St. Luke’s Hospital Training School in the period from 1892 to 1937. The hospital was situated in St. Paul, Minnesota and was closed in 1937. It was the first school for nurses opened in Minnesota that provided good education: “St. Luke’s represented the norm for hospitals and training schools” (Olson & Walsh, 2004, p.48). The authors used all available primary sources in their research. They worked with students’ application materials, reports of all accrediting agencies, instructors’ assessments and nursing evaluations about their professionalization. The authors used personal papers and interviews with nurses. The main argument of the book is to discuss the concept of nursing and answer the question of whether it is a profession or predisposition due to certain skills.

During approximately the first five centuries, nursing care consisted mainly in the implementation of hygienic measures and the creation of favorable conditions for the patients, the homeless, and the sick. It was provided for the most part by the Christian Church. In such a way, the nursery was created on the basis of the care about people. The authors of the book raised the question of whether the nursery is a profession.

The book is very controversial. It contains different points of view on the craft tradition in the nursery. According to Olson and Welsh, the nurses from the Hospital of St. Luke valued experience, loyalty, and strength of the character in their work the most. Women described in the book evaluated practical pieces of training rather than academic theoretical learning. They developed pragmatic skills in different situations during their work with patients. Nursing was a difficult physical job that required man’s strength and fortitude: “Moral character, although important, was actually part of a larger focus on the nurse’s personality. As the comments of physical strength, the descriptions of personality were frequent, detailed and emphatic. Two themes stand out in these descriptions: motivation and strength of will” (Olson & Walsh, 2004, p.46). In such a way, Olson and Walsh individuated the main qualities a good nurse had to have in the 1900s. A little had changed since that time.

Scientific research made for the book allows imagining how the profession of nurse looked like in the past. There is a possibility to compare it with the present state of facts. Nowadays, nurses still need to be emotionally and physically strong. A model of education described in the book could have changed nursing in the future. The new model combined both professional and occupational traditions. The authors widened the meaning of apprenticeship and included in the concept knowledge got during the academic learning and practical experience. Nowadays, nurses widely use the concept developed by Olson and Walsh.

The book narrows the issue very logically. The first chapter is called “The First Impression”. The authors described all details of nurses’ education and work process as well as the conditions in which they studied. The book begins with the description of their appearance on the first day at school and underlines that there is “no hospital more perfect in its adaptation to all the requirements of its work can be found in the land” (Olson & Walsh, 2004, p. 9). The hospital was newly built with perfect accommodation and conveniences. In the Hospital of St. Luke, nurses worked mainly with patients with general and surgical needs. The decision to construct the Hospital of St. Luke was made due to the medical boom in America related to the increasing number of immigrants looking for working places in the region.

In 1886, the first Society of Nurses was created in the United States. In fact, it has become the world’s first professional nursing organization. In 1899, with the active participation of nurses from the U.S., Canada, UK, and Germany, it established the International Council of Sisters defining nursing philosophy and policies all over the world. The development of professional views on the concept and theory of nursing began with the practice of Florence Nightingale. Her views and beliefs were widely recognized in the world. She created the first theoretical conceptual model of nursing, which Olson and Walsh studied on the example of the Hospital of St. Luke. In 1860, Florence Nightingale established the first training school for nurses in the London Hospital of St. Thomas, which had a strict selection according to the discipline and moral behavior. Soon, she began to open model nursing schools in the U.S.

The second chapter is called “Ready for Work”. In the beginning, there were two groups of physicians in the school of St. Luke: homeopaths and practitioners. They had opposite points of view on the curing process and argued a lot. In the 1900s, the medical staff was reorganized. The hospital was rebuilt and became bigger. Since then, its main specialization was nursing. According to the authors, the duties of nurses were not limited to the use of medicines and medical procedures. The most important task was the creation of good conditions for the patient in which nature can provide its healing effect and regenerative processes in the body.

All nurses in the hospital were white women. They were not married to be “free from the domestic responsibilities” (Olson & Walsh, 2004, p. 14). Among the accepted nurses, there were only single or widow women. Divorced women were not acceptable to the school as they were considered suspicious. There was a line in the entrance filling form about the color; during the years of slavery in America, it was a crucial issue. It was surprising to know that women were so tolerant that filled in “blonde” or “brunette” avoiding the direct answer on the question. The authors underlined that a century ago, the homeless and the poor had been mainly treated in the hospitals. In such hospitals, only women of questionable behavior, which could not have been taken on any other job, had been working. It was the main distinctive feature of new hospitals in America. All staff was carefully selected.

In the chapter “The Limits of Duty”, the authors raised critical issues of the nurses’ duties at the hospital during the educative process. As their patients were prevalently the workers from the nearest rail stations and farms, they studied surgery and general health issues. They had an opportunity to address all cases in the hospital. In the authors’ point of view, it was very useful as they could study all unexpected situations.

The most interesting part of the book is called “Lasting Impressions”. It contains the material based on the memories of nurses, who participated in the educational program at the Hospital of St. Luke.

The authors also included the chapter called “Reclaiming the Past Remarking the Future”. In this last chapter, Olson and Walsh summed up their research comparing the obtained results with the modern concept of the nursery. In summary, they underlined that nurses were devoted to their job and saw it as their main craft. The book described good but difficult conditions of studying that required young fragile women to be strong and sustain incredibly difficult cases. In the last chapter, the authors indicated the importance of the nurses’ practice in the hospital for the future of nursery. They tried to relate all nursing achievements from the described period with contemporary technologies. The authors came up with the conclusion that similar schools in America created a basis for the contemporary nursery, but at the same, time they underline that the Hospital of St. Luke had particular educative programs: “St. Luke’s was an exception to other training schools” (Olson & Walsh, 2004, p. 48).

In conclusion, the book is a result of huge research work. It is the anthology of nursing in America of the early 20th century. This study can be added to the works of Patricia d’Antonio, Florence Nightingale, Barbara Melosh, and other scientists who were exploring the issue of the nursery. Despite difficult working conditions and serious cases, the nurses from the Hospital of St. Luke were devoted to their craft. They did not consider themselves victims of an oppressive system of education. Tom Craig Olson and Eileen Walsh focused on the development of nursing as a profession.