|Claire Chatterton, Open University||The UKAHN Bulletin|
|Volume 8 (1) 2020|
Although this book is called ‘Beyond Nightingale’ it could also be entitled ‘Nightingale and Beyond’ as it does discuss the role of Florence Nightingale and her nurses during the Crimean War of 1853-56, but places them within the broader context of nursing on the Crimean War battlefields. Author Carol Helmstadter takes a transnational approach by examining nursing across the five armies that were fighting in this conflict; the British, French, Piedmont-Sardinian, Russian and Turkish armies, the first author to attempt this. Helmstadter examines the various historiographical debates regarding Crimean war nurses and discusses the value that the military placed on their work. In situating the development of military nursing within the varying political, social and economic forces from which modern nursing arose, she offers an in-depth study of the development of nursing. She also places this within the context of mid-nineteenth century understanding of health care.
Treating both nursing and medicine as international disciplines, she finds both commonalities and differences between the five armies under discussion. Because of this, she does not consider each army in turn but organises the book thematically into three parts, which reflects what she delineates as three different systems of nursing.
In part one she discusses what she describes as ‘government-imposed nursing’ and examines British nursing led by Nightingale, which she characterises as a politically driven nursing service that the government forced on a medical department that, she argues, did not want female nurses. Of the three systems of nursing under discussion, this was the hardest model to apply, she posits, and Nightingale faced the biggest challenge of any of the leaders of military nursing services.
Secondly, she explores ‘religious nursing’ within nursing sisterhoods. Beginning with the Irish Roman Catholic Sisters of Mercy led by Mother Francis Bridgeman, she also discusses the input and impact of the London based Bermondsey Sisters of Mercy and British Anglican sisters as well as French and Piedmontese-Sardinian Sisters of Charity. Here she finds that religious issues impacted on the Irish and British sisters due to the longstanding anti-Catholicism prevalent in the Britain at that time which she contrasts with the French and Piedmontese-Sardinian Sisters of Charity whom she argues, had a long tradition of military nursing which led to them not only to be accepted but also welcomed on the Crimean battlefields.
Lastly, she examines ‘doctor-directed nursing’; nursing services which doctors directed both in the British navy and in the Turkish, British and Russian armies. She describes the serious challenges which the Russian army, coming from a pre-industrial agrarian economy, faced in an industrial war, and how Russian nursing (under the leadership of medical director Pirogov) adapted in innovative ways.
There are also links that can be found between these narratives and the present, making a powerful plea for the importance of knowledge-based practice and the imperative for experienced staff to teach their less experienced colleagues.
As with all Helmstadter’s work, this book is written in accessible language but is supported by exemplary scholarship and has much to recommend it to those interested in this subject.
As she points out, ‘It is a curiosity that Nightingale’s mission is so well remembered and yet historians of nursing have largely ignored highly successful nursing in other British hospitals where she did not direct the nursing services. There are also no studies of the very different, but equally or even more successful, nursing in the Russian, French, and Piedmontese armies. This book seeks to redress these major omissions in the historiography of the Crimean War’ (p 2). An aim in which, it can be concluded, she succeeds admirably.