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Response to Review no. 963

We thank Cynthia Toman for her thoughtful review of our book, and for her instructive comparisons between the British experience of the development of nursing unions, and the very different North American pattern. The international development of nursing is a subject that requires much more detailed examination. The World Health Organisation has long argued that nurses, with varying degrees of training, rather than the more expensive medical staff, should be in the front line of world health campaigns, but national attitudes towards the social position of nurses differ widely, and have often impeded their usefulness in this role. Within national boundaries, the definition of a ‘nurse’ has encompassed many types of worker. As Professor Toman points out, our study emphasizes issues of social class and the problems it presented for nurse training, whereas in her own country, ethnicity has perhaps been a more potent issue. Her excellent work on Canadian military nurses in the Second World War, An Officer and a Lady (1), shows how these nurses, unlike British military nurses, were automatically accorded officer rank – but that women from the indigenous Canadian peoples were systematically excluded from the Canadian nursing schools – no possibility of officer rank for them.

We would like, however to reflect on one comment made by Professor Toman that ‘institutional histories of nursing are sparse, partially due to increased interest among historians in social history, labour history, gender history, cultural and material history’. This reads as though ‘institutional’ history is somehow different in kind from the other forms listed here (though this may not have been the writer’s intention). ‘Institutional’ histories have a mixed reputation in Britain, varying as they do in extreme cases between the glossy, photograph-heavy, coffee-table items beloved of marketing departments, and the densely detailed lists of past members, boardroom decisions and events that are of interest only to insiders (or rather, to the retired ones who have time to read them). Further, ‘institutional’ histories, unless backed by a subsidy from the institution, are not favoured by publishers, and academic funding bodies are deeply suspicious of them as insufficiently independent of the institution’s views. Before we began work on this book, we were given assurances by the Royal College of Nursing (RCN) that they would not seek to influence it in any way.

Our book is indeed the history of an institution, though the RCN is a rather unusual ‘institution’ with a membership of over 400,000, the great majority of whom are women, and, as Professor Toman confirms, one of our main aims was to show how the fortunes of this ‘institution’ were inextricably linked to the status and expectations of women in Britain during the 20th century. Histories of women in the labour movement have perforce taken their tone from Mary Macarthur’s dictum in 1908 that ‘while women are badly paid because they are unorganized, they may be unorganized because they are badly paid’. The RCN has been one of the largest and most successful organizers of women (and a smaller number of men) in the UK, though it was never beloved of the labour movement. We have tried to show why this was so. We hope that, rather than being an ‘institutional history’, our book contributes to gender history, to labour history, to the history of the professions, and, more widely, to social history.


  1. Cynthia Toman, An Officer and a Lady: Canadian Military Nursing and the Second World War (Vancouver, BC, 2007).Back to (1)