Ann Bradshaw - The Nurse Apprentice, 1860–1977

Ann Bradshaw

First published 2001 by Ashgate Publishing

Published 2017 by Routledge
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Copyright 2001 Ann Bradshaw

The author has asserted her right under the Copyright, Designs and Patents Act, 1988, to be identified as the author of this work.

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British Library Cataloguing-in-Publication Data
Bradshaw, Ann
The nurse apprentice, 18601977. (The history of medicine in context)
1. Nurses Training of Great Britain History 19th century. 2. Nurses Training of Great Britain History 20th century. 3. Nursing students Great Britain History 19th century. 4. Nursing students Great Britain History 20th century.
I. Title
610.7'3'0941'0904

US Library of Congress Cataloging-in-Publication Data
Bradshaw, Ann
The nurse apprentice, 18601977 / Ann Bradshaw.
p. ; cm. (The history of medicine in context)
Includes bibliographical references and index.
1. NursingGreat BritainHistory. 2. NursingStudy and teachingGreat BritainHistory. I. Title. II. Series.
[DNLM: 1. History of NursingGreat Britain. 2. History of NursingUnited States. 3. Education, NursinghistoryGreat Britain. 4. Education, NursinghistoryUnited States. WY 11 FA1 B812n 2001]
RT11 .B73 2001
610.73'0941dc21

00-042042

ISBN 13: 978-0-7546-0172-2 (hbk)

This book examines the apprenticeship model of nurse training from its inception at St Thomas's Hospital in 1860, until its ending in 1977, the date of the last syllabus published by the General Nursing Council (GNC) for England and Wales. Thereafter, following the Act of 1979, the GNC was replaced by the United Kingdom Central Council for Nurses, Midwives and Health Visitors; a new preparation for nursing practice was developed which was no longer based on the apprenticeship method of learning how to nurse.

Where this book differs from other contemporary nursing histories is in its central theme, the systematic analysis of the framework of principles and values which have underpinned the apprenticeship mode of training. Since the 1960s nursing histories have tended to minimise the significance of the vocational tradition for the development of the nursing profession and the motivations of individual nurses. This book questions that interpretation. In order to understand the impact of this tradition on the parlous state of early nineteenth-century nursing care, and to appreciate its subsequent development in the twentieth century, the beliefs, values and assumptions that have underpinned it need clear exposition. By moral, intellectual and practical learning of appropriate knowledge, skills and techniques, the student nurse was initiated into a practical tradition of service. The ward sister was its guardian. Through apprenticeship training the nurse was taught to see the patient as central to all her learning.

examines the principles and practices of nursing in historical context by clarifying the origins of the apprenticeship training between 1860 and 1896. It considers the nature of apprenticeship and its principles, as envisaged by Nightingale in her writings, and shows how this developed over the century at St Thomas's Hospital. This chapter demonstrates how the apprenticeship training was intended to prepare nurses with biomedical knowledge, technical skill and a virtuous character.

In system of nursing was the core structure for the development of the profession for a century.

The political and parliamentary context of nursing from 1888 to 1925 is set out in examines the factions involved in the dispute, highlights the reasons for conflict and shows where consensus was reached.

considers the further development of the apprenticeship training and contextual factors from 1923 to 1948. The first nationally prescribed syllabus was followed by several governmental and professional reports concerning the nature of nursing, nursing recruitment and the method of training nurses. These reports are critically reviewed with particular reference to the significance and implications of the apprenticeship method of training nurses for patient care.

In , I examine the British nursing tradition and the American influence from 1948 to 1960. The views from both inside and outside the profession on the proper role of the nurse, and how she should be prepared for this role, are considered in detail. The discussion brings to light evidence that North American nursing ideas began to influence British nursing leaders, and shows why several nursing leaders were concerned with this development. Debates centred on whether 'basic' bedside care, together with training in technical skills and techniques, should remain the province of the British registered nurse. The counter-argument was that apprenticeship training should be replaced by a college-based North American model of education which would prepare the nurse to take on a more specialist function, and leave bedside care to the less qualified.

involves an analysis of the years from 1960 to 1972, and a detailed examination of the process which led up to the professional consensus breaking. The apprenticeship model of nursing, its values and presuppositions, began to be strongly challenged. Radical change was proposed by the influential Briggs Committee, although evidence from the period, known to Briggs, including their own commissioned data, raises important questions about the analysis of the report and its recommendations.

changes were being questioned at all levels, is further supported by studies of nurses' and patients' opinions, which provide additional insight into the motivations of nurses and the effectiveness of nursing during this period.

Finally, the period from 1972 to 1979, which marked the beginning of the end of the nurse apprentice, is considered in . Ideological changes at the General Nursing Council during the 1970s led to the ending of the national prescribed syllabus and record of instruction for state registration, and brought fundamental legislative change to nurse education in the following decades. This change in ethos is examined in order to cast light on the movement away from apprenticeship training towards college-based education, and to highlight the possible consequences for the future preparation for, and practice of, nursing.

For simplicity, and because throughout this period the vast majority of nurses in general nursing were women, the feminine gender will be used to refer to the nurse. This should not, however, be seen to exclude the minority of nurses who were male.

From 1860 until 1977 nurses were inducted into an apprenticeship tradition of care. This tradition, which rested on a vocational ideal of service to humanity as the primary Christian virtue, originated with religious orders and was remodelled and rearticulated by Florence Nightingale to make it acceptable to her contemporary context. This chapter will examine Nightingale's principles of nursing, and seek to understand to what extent they formed the self-understanding of the nursing profession as it developed at St Thomas's Hospital. The analysis will take account of modern revisionist interpretations which have questioned the influence of Nightingale's training school, her own motives, and the effectiveness of nursing reforms.