Ed iforial Is Paternalism Alive and Well in Nursing?

According to Mariann Lovell (1992), paternalism is evident in every aspect of nursing, past and present. She believes that paternalism keeps nurses powerless and dependent by duplicating the childhood phenomenon of ”Daddy’s little girl,” which silences and fvagments nurses by embeddingfears. ”Daddy’slittle girl bends to the unacknowledgedfear that she will fall into disfavor with Daddy and incur his wrath, or men worse, be ignored or dismissed as ungrateful and unfeminine. . . This paternal control has efectively kept women and nurses in their proper placefor over a centuy”(pp. 18-29). One of thefirst nurses to recognize that being Daddy’s little girl was oppressive, Lovell claims, was Florence Nightingale. Modern nursing began at a time when Victovian ideas dictated that the role of women was to s m e men‘s needs and convenience. Graduating nurses at the John Hopkins Hospital in 1897 were told by America’s only titled physician, ”You have made the practice of medicine easier to the physician” (Lovell, 2992, p. 22). What he neglected to add, Lovell claims, is that nurses have made the practice of medicine more profitable to physicians as well. With nurses caringfor God’s poor, she asserts, “Physiciansarefiee to serve God’s rich and make a handsome profit at nursing’s expense . . . [they]assume that nursing is tied to medicine as a legal, subservient partner, much like many wives are tied to their husbands” (Lovell, 1992, p. 21). Just as wives are expected tofurther their husbands’ careers in various ways, so too are nurses expected to serve the physician. ”The medical patriarchy has suppressed women into a subsmient categoy which worksfor, but does not profitfvom, the business of medicine” (Lovell,pp. 21-22). Prior to the turn of the centuy, nursing promised to be viewed as important to the health of society as the medical PeIspectivesin Psychiatric Care Vol. 28, No. 4, October-December, 1992

profession. Since nursing knowledge threatened to undwmine medical stature and authority, as well as threafcw their jobs, nurses were led to believe that they needed the advice and pidance of this mle-dominated profesibn. To validate this point, Lovell cites a 1906 edition of JAMA, which states: ”Every attempt of initiative on the part of nurses should be reproved by physicians . . . The prtfksional instruction of nurses should be entrusted ex& sively to the physicians who only car1 judge what is necessary for them to know” (p. 23). Indeed, physicians charged with this instruction were urged to stress in Liieir lectures how dangerous it would befor nurses to step out ’)?om their proper sphere“ (p. 23). But this was a long time ago. Are such issues releziarit today? What about paternalism and the rise of nurse practitioners? Fiorino’s historical study on the nurst’ practitioner movement led her to conclude that thc development represented ”patriarchymasked as progress” (Lovell, 2992, p. 110). While maintainitz

Is paternalism alive and well in nursing?

Ed iforial Is Paternalism Alive and Well in Nursing? According to Mariann Lovell (1992), paternalism is evident in every aspect of nursing, past and...
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