NUR 6130 Module 1 Historical Method Paper: Sources, Census Records and Nursing's Place in Clinical History Example

Three Gray Boxes: Planning a History of One Hospital's Student Nurses

Student Name

M.S. in Nursing, Thomas Edison State University

NUR-6130: History of American Nursing

Mentor Name

Month Day, Year

Three Gray Boxes: Planning a History of One Hospital's Student Nurses

Introduction

Before this course, nursing history for me was a short list of founders. A visit to the archive of our hospital's former training school, which closed in 1972, showed me how much that list leaves out. Three gray boxes hold admission ledgers, the superintendent's annual reports, rotation schedules and twenty years of yearbooks, describing hundreds of young women whose names appear in no textbook. This paper explains how historians turn records like these into history, why the choice of sources shapes the story that gets told and what the method means for the project I plan to complete in this course.

Why Method Matters

Lewenson and Herrmann (2008) present historical research as a disciplined form of inquiry with its own steps. A researcher starts from a question small enough to settle, then gathers primary sources created at the time, such as letters, minutes, case records and photographs, and reads them alongside secondary sources, the work of earlier historians. Each primary source is tested twice. External criticism asks whether a document is what it claims to be: who produced it, when and under what conditions. Internal criticism asks whether its content can be believed: what the author was in a position to know, what she wanted readers to think and what she may have left out. Only after this weighing does the historian build an interpretation, and the contributors stress that it should be argued, not merely narrated. The guide also treats oral history as a method in its own right, in which the recorded memories of retired nurses become sources that need the same critical reading as any document.

Counting Nurses

D'Antonio and Whelan (2009) show what happens when historians widen their sources. Histories of the profession have leaned on the records of schools, journals and associations, which describe nurses who graduated, registered and joined organizations. D'Antonio and Whelan turned instead to federal census returns, in which individuals reported their own occupations to an enumerator. The census captured everyone who called herself or himself a nurse, whether or not that person had attended a training school. Their analysis revealed a broader and more varied group of workers than the professional record suggested, differing in training, race, marital status and place of work. Census data, in other words, brought into view people the official story of nursing had quietly set aside, and the authors argue that any account of the profession should reckon with them.

Nursing in the History of Clinical Care

Fairman and D'Antonio (2008) make a related argument about where nursing belongs. Histories of medicine and of hospitals, they observe, have often treated nurses as background figures, even though nurses delivered much of the care patients received and built clinical knowledge through that work. The authors call for histories that put nursing practice at the center of accounts of health care, asking what nurses knew, how they made decisions at the bedside and how their work changed alongside technology and hospital organization. For a graduate student, the argument is a reminder that our predecessors were practitioners whose knowledge deserves study, not simply assistants to physicians.

Applying the Method to a School Archive

My project asks how student nurses at our hospital spent their working hours between 1945 and 1960. The superintendent's annual reports are the obvious starting point, but internal criticism urges caution: they were written to persuade the hospital board that the school was efficient and its graduates excellent. The rotation schedules, which record each student's hours on each ward and on night duty, give a less polished view. The admission ledger lists each student's age, hometown and religion, and the yearbooks add the students' own voices, though written for classmates and families. Reading these records against one another, instead of trusting any single one, is the core of the method.

Gaps and Silences

The boxes also show what is missing. Students who left before graduation appear only as a line in the ledger, and no surviving document records what it was like to be the only student on a ward at night. Following D'Antonio and Whelan's lead, I will check the 1950 census returns for our city to see whether practical nurses and aides without diplomas worked at the same hospital. I also hope to interview two graduates now in their nineties, treating their memories as evidence that needs the same questioning as a written report.

Ethics in Historical Research

Old ward books can contain patient names and diagnoses, and admission ledgers contain personal details about students. I will not copy or publish patient names, I will follow the hospital archivist's rules about access and the interview participants will give written consent and may review their transcripts before anything is quoted.

Why History Matters to Practice

Seeing how student nurses once carried much of a hospital's workload helps explain debates that continue today, such as how much support new graduates receive in their first year. History does not tell nurses what to do, but it shows that present arrangements were made by people with particular interests and can be changed.

A Working Timeline

I will build the project in three stages over the term. In the first month I will read the superintendent's reports and transcribe the rotation schedules for three sample years, 1945, 1952 and 1959, so that changes over time can be compared. In the second month I will work through the ledger and census returns and conduct the two interviews. In the final month I will write, testing each claim against at least two kinds of source before I make it.

Limits

One school's archive cannot stand for American nursing as a whole. As a nurse at the same hospital, I may be inclined to tell its story sympathetically. The archive, hospital and project described here are invented for this paper.

Conclusion

Lewenson and Herrmann describe historical research as a disciplined process of finding and testing sources, D'Antonio and Whelan show that new sources such as census returns reveal nurses the official record left out and Fairman and D'Antonio argue that nursing's clinical work belongs at the center of health care history. Reading the school's reports, schedules, ledgers and yearbooks against one another, and adding census data and oral histories, will let me write a history of the students who did much of the hospital's work.

References

D'Antonio, P., & Whelan, J. C. (2009). Counting nurses: The power of historical census data. Journal of Clinical Nursing, 18(19), 2717-2724. https://doi.org/10.1111/j.1365-2702.2009.02892.x

Fairman, J., & D'Antonio, P. (2008). Reimagining nursing's place in the history of clinical practice. Journal of the History of Medicine and Allied Sciences, 63(4), 435-446. https://doi.org/10.1093/jhmas/jrn018

Lewenson, S. B., & Herrmann, E. K. (Eds.). (2008). Capturing nursing history: A guide to historical methods in research. Springer Publishing.