Nursing Book Club: A review of Pivotal Moments in Nursing, Volume II

May 01, 2019

Often, we get caught up in reading only about the current issues or trends in nursing. With so many different nursing journals and articles, it can be difficult to find time to assimilate all the new knowledge into our practice. Because of this, we rarely spend time looking back at the history of where nursing came from and reading about key nurses who have helped move the nursing profession forward over the years.

Pivotal Moments in Nursing, Volume II by Beth Houser and Kathy Player (2007) gathers stories of 11 different nurse leaders who have made a difference in the nursing profession. You may not know any of the names at first glance. This is a great reason to spend some time with the stories and learn some of the historical details of how nursing has changed. After reading this book, Leah Curtin and Florence Skyhorse Ward are two nurse leaders that resonated with me.

Leah Curtin fought for societal changes and the rights of patients as well as nurses. She is known as the mother of nursing ethics. The chapter tells the story of Curtin learning to stand up for patient care in a time when nurses were to be seen, not heard. “For better or worse, nurses create nursing. We – you and me – are the profession…and often the patient’s last line of defense” (as cited in Houser & Player, 2007, p. 77). In 1969, Curtin was one of the first nurses to encourage the development of a nursing ethics center. She was instrumental in developing interdisciplinary courses where healthcare providers could talk about ethical dilemmas in their daily jobs. By 1975, Curtin was asked to serve on the first board for the National Center for Nursing Ethics. The Board developed the first Code of Ethics and encouraged the National League of Nursing to include nursing ethics in the core curriculum for nursing education.

Florence Skyhorse Ward centered her work on promoting a pain-free, dignified life while facilitating the dying process. In 1974, Ward started the first hospice program in America (Houser & Becker, 2007, p. 367). She believed that a holistic hospice approach to caring for patients is the ‘essence of nursing’.

Ward was a firm believer in education for women. She fought her father to be allowed to enter an undergraduate program for nursing. Her belief in herself and the right to an educational pursuit served Ward well throughout her career.  One ideal that seemed paramount to her was the ability for nurses to think more broadly about the role of nursing in healthcare. According to Ward, “one’s image of what one does in the nursing profession may not fit with what is going on in the industry at a particular time. The real question a leader must ask is, “How are you planning to correct your professional course when the environment no long matches your original vision?” (as cited in Houser & Becker, 2007, p. 373).

Ward’s background in psychiatric nursing lead her to work on finding ways for the nurse to advocate for patient care. She worked with other visionaries of her day, including Virginia Henderson and Ida Orlando, to develop different approaches for teaching nursing students. Some of their ideas were successful; many were not. However, Ward’s work kept her in the forefront of new approaches to nursing education. In 1959, Ward became the fourth dean of Yale University’s School of Nursing. She served in that capacity until 1967 when she stepped down to pursue hospice work.

Ward’s journey to understand the dynamics of caring for dying patients led her to work with Cicely Saunders, a social worker and physician who had studied pain relief. Saunders promoted the idea of viewing the patient and their pain beyond just physical discomfort. Instead, Saunders wanted to look at the patient’s heart and mind and was a strong advocate for the spiritual and psychological support needed to care for dying patients. This work articulated what Florence had been seeking for her entire career.

Ward and Saunders’ work and association took on many avenues including writing a small grant to conduct a study of 22 dying patients (1969-1971) entitled “A Nurse’s Study of the Care of Dying Patients and Their Families”. The results demonstrated that the New Haven community did not serve dying patients and their families appropriately. Ward’s original question, “How are you planning to correct your professional course when the environment no long matches your original vision?” had come full circle and, ultimately, lead to the establishment of Hospice Inc. a not-for-profit, tax-exempt institution.

I would encourage you to take some time and learn about the nurses that came before us and the ways in which they have enhanced and grown the profession of nursing.

Lynette Savage, PhD, RN, COI
Houser, B. & Player, K. (2007). Pivotal moments in nursing: Volume II. Indianapolis, IN: Sigma Theta Tau International.