









































Communication, Society and Media 
ISSN 2576-5388 (Print) ISSN 2576-5396 (Online) 

Vol. 3, No. 3, 2020 
www.scholink.org/ojs/index.php/csm 

102 
 

Original Paper 

Are We Walking to the Future or to the Past? A Retrospective 

Analysis of Professional Nursing during the Pandemic of 2020, 

Dating back to the Crimean War, 1853-1856 
Christine M. Silverstein, EdD, MPA, RN1* 

1 The Summit Center for Ideal Performance, 9 Post Road, Suite M-12, Oakland, NJ 07436, USA 
* Christine M. Silverstein, E-mail: summitcenter@optonline.net 

 

Received: July 31, 2020        Accepted: August 10, 2020       Online Published: August 17, 2020 

doi:10.22158/csm.v3n3p102                     URL: http://dx.doi.org/10.22158/csm.v3n3p102 

 

Abstract 

This retrospective analysis, based on facts derived from contemporary news media, videos, and journal 

articles, scrutinizes a White House televised ceremony that celebrated National Nurses Day on May 6, 

2020 during the COVID-19 pandemic and the #MeToo movement. On the surface, it appears that 

nurses were honored by the President, but a deeper look beneath reveals otherwise. This historian 

explores two pivotal moments during the ceremony that changed the focus from a celebration to a 

campaign event, which occurred when a female nurse practitioner stepped out of line to posit that 

personal protective equipment was “sporadic” and President Trump’s reaction to it. Although 

counterintuitive, queries arise as to whether the Commander-in-Chief celebrated professional nursing 

or denigrated it, as nurses kowtowed to authoritarian rule and unwittingly abandoned the 

time-honored principles of facts, science, and caring in professional nursing extant since its inception.  

Retrospectively, documents from archives are examined and the biographies of two transformational 

leaders, Hildegard Peplau and Florence Nightingale. These questions are asked: In 2020 how would 

they uphold their high standards and teachings today that set the stage for the evolution of professional 

nursing? What role would therapeutic interpersonal interactions of caring in nursing play in the 21st 

century? 

Keywords 

Peplau’s interpersonal theory, Nightingale in Crimea, psychiatric nursing history, nursing science 

development, COVID-19 pandemic, #MeToo movement, Trump’s White House, paternalism in nursing 

 

 



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1. Introduction 

In 2020 the inhabitants of Earth are faced with a novel Coronavirus of pandemic proportions. Countries 

worldwide are working to prevent the spread of infections and to decrease mortality rates. The USA 

leads in COVID-19 cases and in deaths, which is a quandary for epidemiologists and scientists alike 

because it is a country that prides itself on its resourcefulness, its technology, its science, and its 

prosperity. The virus has been extensively politicized as a hoax by President Trump and his team at the 

White House so that the simple wearing of face masks is considered a partisan act and fodder for 

re-election campaign rhetoric. 

On TV news it is reported that the current pandemic is “unprecedented” so extraordinary measures 

must take place to gain control in hospitals, in homes, and in public spaces. Yet, historians who have 

studied the plagues of the past, such as the Black Death, inform us that pandemics of immense 

proportions have killed an estimated 200 million people worldwide at a time when there were no 

vaccines, no isolation of organisms in labs, and no knowledge of how it was spread. So how 

unprecedented is the current pandemic, and what can epidemiologists and politicians learn from it for 

future applications? 

In his book, The Great Mortality (2005), Kelly wrote about a small fishing village in Crimea called 

Caffa that was settled by the Genoese in 1266. Nearly 80 years later, with a population of 80,000 

citizens, one can envision the Genoese proconsul sitting in a white palace above the harbor of the 

fastest growing city of the Middle Ages. In the spring of 1340, residents expected that Caffa would 

continue to prosper, but human hubris, Kelly espoused, comes with a price. Conflicts arose between the 

Italians and the Mongols, and a mysterious disease began to appear in Asia and make its way to Caffa 

through trade routes. The Genoese fled the city, riddled with pestilence and the stench of the unburied 

dead, as they spread the plague to Europe from the rat-infested ships they boarded. 

Centuries later, spread from European travel, New York City (NYC), the world’s financial capital, 

became the first and largest US epicenter of COVID-19. Frontline nurses played significant roles in 

hospitals and society to stem the tide of Coronavirus and experienced many stressors of caregiving 

when overwhelmed with untenable conditions that captured newscasters’ attention. Investigative 

reporters and videographers began to inquire about why government and public health officials did not 

see it coming. Why were they slow to respond? What could have been done to prevent the widespread 

devastation? 

 

2. Method 

2.1 Contemporary Nurses in the Media 

Using psychohistorical methodology, this historian examined primary and secondary sources, beyond 

the facts and dates associated with historical events, to understand the motivations, beliefs, attitudes, 



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felt needs, and emotions of contemporary nurses during the 2020 pandemic. Inside TV camera angles 

cast light on a White House ceremony where nurses were honored as heroes by President Trump and 

how human hubris paid its price when a nurse practitioner stepped out of line to claim that Personal 

Protective Equipment (PPE) distribution was sporadic. Questions were asked as to how and why nurses, 

when pressured to conform by the Commander-in-Chief, did cleanup duty, readily acquiesced, and 

unwittingly abandoned time-honored principles of facts, science, and caring of professional nursing 

extant since the Crimean War, 1853-1856. 

2.2 Exemplary Nurses from the Past 

In addition to exploring the unfolding drama experienced by nurses during the #MeToo movement and 

pandemic, selected highlights reflected upon the lived experiences of two transformational nurse 

leaders from past centuries, Hildegard Peplau (1909-1999) and Florence Nightingale (1820-1910). 

Such reflection contributed to the understanding of how they not only stood up to authority, but how 

they became authoritative voices themselves to advance professional nursing that contemporary nurses 

are privy to in this century.  

 

3. Result 

Retrospective analysis of historic data provided substantive interpretation to answer these queries: 

Based on their past performances, how would these two nurse visionaries, Peplau and Nightingale, 

uphold their high standards and teachings today that set the stage for the evolution of the 

professionalization of nursing, based on facts, science, and caring? What role would therapeutic 

interpersonal interactions of nursing care play today when nurses are faced with social pressures to 

conform to authority, paternalism, and misogyny? What is the relevance of the foundational principles 

laid down by them in past centuries within the context of professional nursing in the 21st century? 

 

4. America Celebrates Nurses 

The World Health Organization (WHO), abandoned by President Trump during a global pandemic, has 

designated 2020 as the “International Year of the Nurse and the Midwife” to honor the 200th 

anniversary of Florence Nightingale’s birth (May 12, 1820) and to elevate the status of nursing 

worldwide, where nurses are not held with the highest regard. During the COVID-19 pandemic, 

America’s nurses have been honored as heroes because of their courageous action on the front lines. 

Thousands of citizens applauded nurses from their front porches, balconies, and rooftops in the NYC 

epicenter. While body bags piled up in refrigerated trucks and mass graves were dug on New York’s 

Hart Island, the US Navy Blue Angels flew overhead, lined up in the sky with military precision to give 

homage. At the White House the President gathered nurses at the Oval Office to honor them for their 

heroic service, but was this staged, partisan campaign event in the spirit of celebration or denigration of 



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nurses? 

 

5. The Onslaught for Nurses 

5.1 Reality TV 

In 2020 nurses ministered to ordinary people in hospital Emergency Rooms (ER) and Intensive Care 

Units (ICU) and in COVID-19 makeshift areas where patients were hooked up to all too few ventilators 

while gasping for breath. Triggering fear for onlookers, citizens saw, on Reality TV, these nightmarish 

images upfront in hospitals and felt helpless. The frantic voices of nurses, panic-stricken and 

overwhelmed by the onslaught of mounting new cases and hospital bed deficits, were heard on cable 

news. Frontline nurses expressed their fears, hysteria, and frustrations about untenable hospital 

conditions, with a lack of PPE, testing for healthcare workers and patients, and life-sustaining 

ventilators. An intense angst plagued nurses when they had to comfort patients as they lay dying and 

connect remotely with their families on Facetime to say farewell, because no visitors were permitted on 

hospital units. 

5.2 Negative Impact on Nurses and Society 

Nurses fell ill and died from Coronavirus, too. So did their relatives, colleagues, and friends. In the 

event that nurses contracted COVID-19 at work, their hospital healthcare coverage was extended for 

two weeks only. If they lingered longer, many shouldered the cost by using up their annual vacation 

and sick time. This author’s niece, who works at New York-Presbyterian/Columbia University Medical 

Center as a Registered Nurse (RN) administrator, contracted it and had to go out of State to be tested. 

There were few masks for staff members, so she gave hers to them. While she was recuperating, a 

nurse manager died at Mount Sinai West in NYC, which angered co-workers, yet the White House 

claimed no shortages. In fact, without evidence Trump denigrated nurses and other healthcare workers 

by accusing them of smuggling PPE for resale on the black market, suggesting NY officials investigate 

their shadiness (Higgins, March 30, 2020). 

5.3 Emotional Outlets for Nurses 

As the thick miasma leached out across America, not all nurses accepted empty praise for heroism. 

Protesting for heightened federal intervention for PPE production and distribution, a Brooklyn nurse 

brandished a sign that said: “Please don’t call me a hero. I am being martyred against my will” (Palus, 

April 23, 2020). Another protestor’s placard read: “20 seconds won’t scrub ‘hero’ blood off your 

hands”. 

Other nurses vehemently expressed their concerns that served not only as an emotional outlet for them 

but also as a warning to citizens to take the pandemic seriously. Nurses bravely came to the forefront 

while the President and those in his administration called the pandemic a hoax. With cowardice, in the 

absence of accountability, they abrogated their responsibilities and failed not only nurses but all citizens, 



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causing delays, inaction, ineptitude, and a lack of public health preparedness that could have prevented 

the virus’s widespread devastation to save lives (Glanz & Robertson, May 20, 2020). 

 

6. A Nurse’s Lived Experience 

Treating people who are sick and dying is nothing new to professional nursing. This historian 

(participant observer) knows this personally as an RN, who entered a hospital-sponsored, all-female 

apprenticeship nursing school at the age of 16 in Brooklyn, NY. At that time, during the 20th century, a 

cleanup duty for student nurses was to care for patients, postmortem, and to disinfect their beds and 

rooms with Lysol, while scouring bedpans for the next occupants. During her first experience of 

bathing a newly deceased person, placing an identity tag on a toe before pulling up the shroud, she 

recalled her classmates giggling nervously. Learning from her instructor on the first class day as a 

freshman that nursing care is holistic, which entailed caring for patients as persons in body, mind, and 

spirit, she told her classmates that dying was a spiritual transcendence and that they should be reverent. 

When she and other students struggled to transfer the assigned body onto the cold morgue refrigerator 

slab, she recalled feeling for the first time the true meaning of “dead weight”. Years later, engraved in 

her memory she still hears the clank of the refrigerator door closing and the lingering fetid odor in the 

autopsy room, where she felt faint, but the most important lesson she learned as a teenager taught her 

about the sanctity of human life and about how to care for and about people. 

 

7. Take One: The White House Ceremony on Camera 

7.1 Nurse Practitioner Stands out 

In the spirit of comradery, this participant observer watched on TV eight nurse colleagues (5 women 

and 3 men) who represented more than 3.5 million US nurses, proudly line up unmasked behind the 

President in the Oval Office as he signed a proclamation honoring them during National Nurses Day on 

May 6, 2020 (Mangan; CNBC). During the ceremony she felt that nurses were due credit for work 

well-done and was pleased when the president of the American Association of Nurse Practitioners, 

Sophia Thomas from Louisiana, stepped out of line when asked by a reporter about shortages and 

posited that PPE supplies were “sporadic” in pockets around the US. Her assessment was based on a 

survey she conducted by conferring with colleagues nationwide. Thomas confessed that she had worn 

the same N95 mask for a few weeks but exchanged it for a fresh one to visit the White House in case 

she needed it, for she did not want to infect the President, who did not believe in the merits of mask 

usage. 

7.2 Nurses’ Defense Unprecedented 

In her defense, the Nurse Practitioner (NP) explained that none of the sanitized, white-coated nurses in 

the lineup wore masks during the ceremony because they all tested negative for the virus. Before the 



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crisis, the standard antiseptic protocol for PPE learned as a student nurse was for single use of gowns, 

masks, and gloves, Thomas admitted. Even after her stark revelation about continued shortages, her one 

caveat during the “unprecedented” pandemic was her lame excuse that nurses’ work entailed learning 

how to adapt selflessly to make due and get the best job done for the good of patients. 

The NP mentioned that her youngest COVID-infected patient she had treated was a 4-day-old infant. 

This comment garnered no attention from the President, even though this age group was not thought to 

be adversely affected by the virus. In contrast, Governor Cuomo (May, 8, 2020) of NY during his daily 

COVID briefings expressed concern and started an investigation into the mysterious Kawasaki-like 

syndrome that was killing babies and children diagnosed with Coronavirus. 

7.3 Reports are just Fake News 

A nurse supervisor lined up on the TV screen to the right of the NP opined about how she had no 

problems obtaining PPE at her hospital in New Jersey (NJ), situated near the NYC hotspot. She 

expressed dismay in relating to the constant reports of colleagues’ shortages because it was not her 

experience. Her fears, she acknowledged, were lessened by knowing that the equipment she needed 

was at hand because it was supplied by her assistant director. The President, later calling her testimony 

“beautiful”, took advantage to jump into the fray and assert that the reports of equipment shortages 

were just “fake news”, while insulting the integrity of journalists present because he disagreed with 

their facts. Some of the nurse honorees openly giggled nervously and smiled over Trump’s expressed 

opinion about negative media coverage. The NJ nurse said nothing, but made a shrugged gesture, 

implicitly agreeing with the President. 

 

8. Presidential Rebuke 

8.1 Politics as usual 

In response to the NP’s lamentation about a lack of supplies, the President continued his partisan tirade 

about how Obama, his predecessor, was responsible for empty storeroom shelves more than 3 years 

into his own presidency (Mangan; CNBC, May 6, 2020). He stated that his reports showed that 

supplies were “tremendous” and that they were loaded up with gowns, shipping some reserves to 

foreign countries in need, although some US nurses resorted to wearing garbage bags. The White 

House, Trump repudiated, was doing the best job ever in its response to COVID-19, while listing a 

litany of administration accomplishments that included saving the Second Amendment “under siege” 

that fosters open-carry of guns and semi-automatic weapons in public places, schools, and churches.  

8.2 Nurses Nod in Conformity  

Trump threaded doubt about the effectiveness of testing for Coronavirus, by saying: “I hope the test 

works, right?” The President had previously announced his opposition to testing, stating that he wanted 

to keep his numbers down to protect his record. Knocked off guard during the ceremony by Trump’s 



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rebuke, Thomas readily agreed with the President, and some nurses nearby nodded their heads in 

conformity. Of course, there was no mention of nor empathy expressed for the millions of those 

infected and the thousands of souls lost, some of whom were those of nurses and other healthcare 

workers who selflessly sacrificed their lives to save others. 

 

9. The NP Retreats 

The executive director of the NY State Nurses Association applauded the NP’s statement to Trump, 

saying she had it right because reports showed that supplies continued to be sporadic. However, 

Thomas recanted her statement the next day during a less publicized TV interview with host Craig 

Melvin on MSNBC (May 7, 2020). Melvin asked if she agreed with the President’s correction on 

shortages or was she just being polite. She remarked that she was unsurprised by Trump’s rebuke and 

had not given it much thought. 

By commending Trump’s efforts, the NP stated that the President understood that more PPE was 

needed and believed that he and his task force were doing everything they could to provide it and 

improve healthcare for all Americans. A mark of improvement she noted was better outreach to 

marginalized people through telehealth to decrease health disparities that had already been 

implemented in many hospitals but was underutilized before the pandemic. Melvin hesitated and 

appeared perplexed by the NPs clean up, commenting that the President had not agreed with her during 

the ceremony. He then asked if Trump had stated otherwise after the camera stopped rolling. Thomas 

indicated that he had not and expressed appreciation for the honor bestowed upon her and more than 

290,000 NPs she represented as president, seemingly unaware that they were all being trumped by 

President Trump. 

 

10. A Picture Says a Thousand Words 

After reviewing the TV video footage of the ceremony when Trump rebuked the NP (Mangan; CNBC, 

May 6, 2020), this participant observer noticed that there was a NYC nurse responder (male) standing 

on the left side of the screen behind the President (Eyewitness News, May 6, 2020). He clutched his 

hands in front and twirled his thumbs agitatedly while Trump spoke. When directly asked about 

shortages by the President, he did not speak up. What was his body language saying while remaining 

silent? What was his lived experience? What would have been the words spoken to Trump, given the 

gumption?  

 

11. Take Two: Discourse on the White House Ceremony 

11.1 Nurses Curry Favor 

As representatives of all nurses, eight honorees were invited to the Oval Office to celebrate their 



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heroism during the pandemic. They arrived with no apparent agenda other than accepting the honor 

bestowed upon them by the President and his task force. The White House staff, however, had a 

different intent, which was not to honor nurses or to give them a seat at the roundtable of healthcare 

provision they had earned, but to use the ceremony as a photo opportunity for Trump’s campaign. Like 

others who enter the Oval Office, the nurses, particularly the NP, found out that they had to curry favor 

with Trump who demands loyalty, or they would stand the chance of being demoralized, denigrated, or 

fired. This fear accounts for the NP’s retreat. 

It is unfortunate that these honorees were not coached on their agenda prior to receiving the dubious 

award. If they were well-versed in nursing’s history, which is an epic about rising up against oppression, 

paternalism, and misogyny as women to make professional nursing what it is today, perhaps there 

would have been a better outcome. The following discourse delineates what went wrong at the 

ceremony and why. 

11.2 Sexism and Lack of Empathy in White House 

On the surface, while watching the White House Ceremony that honored nurses, one would not 

ordinarily notice the nuances that are described in this discourse relating to sexism, that is, before the 

normalization of misogynistic and paternalistic rhetoric spoken by President Trump. For him, Filipovic 

(December 5, 2017) wrote:  

Sexism moves in two directions: Women who are young, slim, white, and attractive 

are sex objects, while women who don’t fit his narrow ideal of femininity are 

dismissed as pigs and dogs. Either way, there’s one status no woman seems to 

achieve: Human being. 

The President’s lack of empathy for the thousands of humans who died of Coronavirus in the US was 

evident in his dialogue at the ceremony. This was particularly true when he spoke about how he gave 

tax cuts to the rich, while the US has high unemployment and long bread lines, when he expressed no 

concern about infants dying from COVID-19, and when he promoted the use of open-carry weapons 

that kill thousands of Americans yearly. 

11.3 Significance of Female NP Stepping out 

One could ask: Why is it significant that a female NP stepped out of line to acknowledge the sporadic 

distribution of PPE? It holds significance not only because of her low status as a woman, at least in 

Trump’s eyes, but also because of her position as a presidential leader. RNs in the US, regardless of 

educational level, possess the same license, so those with doctorates and those with two-year associate 

degrees hold the identical credential. Advanced practice RNs (APRN), having additional training and 

State certifications and licensure, are at the hierarchy of nursing because they possess diagnostic and 

prescriptive privileges, have a master’s degree or higher, and work independently from medical doctors 

in their private practices. As experts, NPs serve as trusted professionals for other nurses and the public, 



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and must exercise vigilance in their messages. 

11.4 Nurses Blindsided 

What is most disarming about the NP’s performance at the ceremony was when she contradicted her 

own survey facts and readily acquiesced to the President’s demands while seemingly oblivious and 

blind to the objective reality captured by the media. By seeing PPE shortages as a laughing matter, 

when the President declared reports as “fake news”, these nurses being honored at the White House, 

representing millions of nurses globally, were irreverent in spirit to those absent colleagues who 

became the sacrificial lambs as a direct result of it. 

With eyes shielded what scenes were these nurses sanitizing? The NP and the other honorees present 

had to have known that the President directed Americans to inject themselves with Lysol to kill the 

infection and that he “prescribed” a non-approved drug that could kill them. They had to have observed 

that Trump does not believe in science or facts and works in opposition to epidemiologists, without 

credentials. They had to have seen nurses posing on TV, wearing garbage bags instead of PPE. They 

had to have heard their colleagues’ voices of desperate moms broadcasted on TV as they traveled home 

from exhausting shifts, reused masks besides them, while they disrobed in their garages to avoid 

infecting their families—all the while pretending to their children that everything was normal. 

11.5 Nurses Breach Scientific Tenets 

When the NP and others gave deference to Trump that supported the repeated reuse of PPE for weeks 

as the “new normal” during these “unprecedented” times, they betrayed the trust of other nurses, the 

public, and their profession, since “Nursing art, like medical art, is based on science or knowledge of 

true facts and principles” (Dock & Stewart, 1931, p. 7). According to these tenets, standard sterile 

surgical protocol cannot be blithely compromised by Presidential proclamation. Nor can they be 

breached by an edict from the Centers for Disease Control (CDC) to break precedent that runs counter 

to 19th-century scientific principles and antisepsis set forth by Joseph Lister, Robert Koch, and Louis 

Pasteur, for safety and protection.  

11.6 Rebound Effect 

During the siege, frontline nurses (women) were targeted by the media to be interviewed on TV so they 

could express their fears of contracting the virus at work with supply shortages, a lack of ventilators, 

relief staff, and beds. Their effusive language served as an emotional outlet. In the absence of federal 

and public health leadership and healthcare initiatives, it also served as a warning to the public of the 

seriousness of the virus. Nurses viewed their actions as part of their roles as patient advocates. However, 

this “advocacy” runs counter to nursing theory and therapeutic interpersonal interactions, according to 

Peplau (1991), where nurses are expected to monitor their own emotional reactions to stressors to help 

patients recover. Otherwise, they run the risk of empathically transmitting their anxieties to them, thus 

impeding progress (Silverstein, 2006). This rebound effect may have occurred when citizens became 



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agonizingly fearful about catching the virus, being sick, and dying from it, without the availability of 

ventilators, so they deferred going to hospitals for testing and treatment and died at home, skewing the 

actual death rates initially computed by hospitals (Hogan, April 7, 2020).  

11.7 The Mind and Body are One 

As if it were a recent phenomenon, frontline nurses expressed feeling overwhelmed with the physical 

care of intubation and with talking to dying patients and families on Facetime to convey messages of 

condolences. Starting from 1952, the Theory of Interpersonal Relations has been incorporated into the 

way nurses communicate with patients as persons, and not merely as objects of care, which sets nursing 

apart from the medical model of the 17th century promulgated by Descartes, where the mind and body 

were separate (Silverstein, 2003). This theoretical concept of nursing care began at the turn of the 20h 

century when mind-body principles became embedded into nursing curricula. It was further developed 

into practical uses at a time when women’s voices were squelched, as illustrated in the short story The 

Yellow Wallpaper by C. P. Gilman (1892). These changes occurred as the Mental Hygiene Movement 

began by Clifford Beers in 1908 and the Women’s Suffrage Movement took hold simultaneously.  

 

12. Father Knows Best: Paternalism in Nursing 

12.1 Nurses Stereotyped 

The fact that a female nurse voiced her opinion at the White House ceremony to address issues of 

insufficient supplies and lack of preparedness during the pandemic was significant, but so was her 

prompt retreat. The NPs fall back is interpreted in this retrospective analysis as a missed opportunity 

for women, based on women’s studies, and as a step backwards for nurses, based on a quote from 

Nightingale, who stated: “No system can endure that does not march. Are we walking to the future or to 

the past? Are we progressing or are we stereotyping?” (Ulrich, 1992, p. 11) 

Although nursing in the US has been ranked as the most trusted profession, this has not always been 

the case. Prior to the professionalization of nursing through Nightingale’s efforts, “nurses” were 

prostitutes of ill repute, prisoners, and drunkards. Entering the alms houses was the kiss of death. To 

counter these negative views and to improve clinical outcomes, Nightingale upheld high standards for 

women, by saying, “A good Nurse must be a good woman—to say this is like saying, put your hats on 

your heads & your shoes on your feet” (Nightingale Papers, 1874).  

12.2 Derogatory Name-Calling 

Throughout nursing history, female nurses, who were always in the majority and remain so today at 91 

percent in the US, have experienced paternalism and misogyny. They were called derogatory names 

and were stereotyped as battleaxes, tyrants, jailers, Nurse Ratched (Forman, 1975) and handmaidens, 

and were portrayed as dumb sex idols in movies and on TV. Their practical knowledge and expertise 

were disparaged by scientists as being thoughtless and mundane (Silverstein, 2003). 



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12.3 Unquestioned Obedience 

Paternalism was rampant when student nurses were not permitted to speak unless spoken to by 

physicians. American nursing’s founders insisted that “implicit unquestioning obedience must be the 

foundation of nurse’s work” (Callaway, 2002, p. 47). Peplau, psychiatric nurse of the 20th century, 

described her student nurse days in a hospital-sponsored, all-female apprenticeship nursing school in 

1928. She grew up in a working-class family of German descent. Many student nurses were immigrants 

who wanted to secure a career and raise their standard of living. When Peplau expressed an interest in 

nursing at 19, her mother was appalled. She did not understand why her daughter would want to clean 

up the filth of others. Since the labor needs of hospitals were a high priority, there was rigid and 

paternalistic discipline. Her first assignments were to scour bedpans, scrub floors, and disinfect rooms.  

12.4 Doctors Patronize Nurses 

Physicians were the main educators of student nurses. Most doctors believed that nurses were incapable 

of assimilating complex material. A fatherly physician named “Daddy Bushong” spoke baby talk to 

Peplau (Callaway, 2002, p. 39). Such talk was illustrative of the nurse-doctor relationship. Having high 

intelligence, Peplau was encouraged by doctors to attend medical school with a scholarship because she 

was too bright to be just a nurse. She declined because she saw nurses’ work as caring for ill patients to 

get them well to save lives, unlike that of medical doctors. Peplau’s viewpoint of nurses as women in 

American culture is summarized in the following quote (Peplau, 1991): 

The culture has rewarded nursing in terms of prestige for the ability of nurses to 

express a womanly role in an active way; it also takes cognizance of the passive 

aspect in total nursing functions. The valuable role played by male nurses is 

recognized; but, the culture usually refers to women when the symbol of nurse comes 

to mind (p. 45). 

 

13. Peplau Enters World War II  

Against all odds, in June, 1943, Peplau earned a bachelor’s degree from Bennington College, where 

women were educated as free thinkers. Peplau’s education there included studying at the Chestnut 

Lodge in Maryland with Harry Stack Sullivan and other noted psychologists of the time, which 

supplied her with a strong concentration and background in psychology. After graduation, she enlisted 

in the Army Nurse Corps and maneuvered her way to the 312th Station Hospital and School for Military 

Neuropsychiatry, located on the estate of the Earl of Litchfield, Staffordshire, England, where 

psychiatrists from around the world came to study. At the 312th, Peplau lived in a Nissen hut with six to 

seven other people, slept on a cot, and was warmed by a pot-bellied coal stove that polluted the air 

(Callaway, 2002). 

 



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14. Wartime Unpreparedness Evident 

Psychiatry was unprepared for the onslaught of war. Adding to the challenge, there was a lack of 

knowledge of the ideology of mental illness, a lack of adequate methods, and a lack of understanding 

of the role of prevention. Military nurses had little preparation to care for the mental reactions of 

soldiers and for the hardships they had to endure. A nurse, who served in the South Pacific, related her 

travail (Brown, 1944): 

Top of all this with the major emotional shocks—grief for the laughing comrade 

suddenly and grotesquely dead beside him, compassion for the suffering of the 

wounded, fear itself, and the physiological reaction to the unfamiliar smells of fear 

and pain and to the stench of the unburied dead (p. 1135). 

In Norman’s (1999) account of the challenges American nurses trapped on Bataan by the Japanese 

during the war, she told of the struggles of women in nursing:  

Before the buckets of bloody limbs and the white crosses on the jungle floor, the women of 

the Army Nurse Corps did not really think themselves part of the profession of arms. Yes. 

They were in the army…but they were healers, not soldiers…The army was an arena for 

men, and women were on the periphery of that domain, that place of male passage (p. 39). 

Since there were so few “trained” psychiatrists, many physicians took a one-to-six week crash course 

on how to become one (D’Antonio, 1985; Peplau, 1992). Peplau knew all of these men personally and 

became acquainted with Menninger, Chief US Psychiatric Consultant to the Office of the Surgeon 

General (Callaway, 2002). During evenings at the Officer’s Club, she was the sole nurse permitted to 

audit courses and was the only nurse in charge of her unit without a physician. 

 

15. Experimental Treatments 

15.1 Deep Sleep Therapy 

Soldiers pinned down by mortar fire were brought to the 312th to be treated for combat exhaustion and 

were given Deep Sleep Therapy (DST) induced with sodium amytal for 8 days (Silverstein, 2008). 

Peplau detailed the treatment of Dr. Sampliner. She viewed his obscene experiments with “utter 

contempt” because she believed them to be dangerous (Callaway, 2002, p. 111). Voicing her views 

early on, Peplau urged for modification in the prescribed treatments. She hated experimentation with 

young soldiers, “who could not say no” and were so trusting (Peplau, 1992).  

15.2 Insulin Shock Therapy 

Another treatment used on the front lines was sub-coma insulin shock therapy that lasted from 5 to 7 

days. Peplau set up protocol on her unit to get the solders to talk and calm down during the treatment. 

She trained the corpsman to sit between the beds of patients as they entered a sub-conscious twilight 

stage. When the soldiers heard food carts rolling down the plank-board walkways, they became 



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hysterical because they thought they were cannons (Peplau, 1992; Silverstein, 2008). 

15.3 Development of PTSD Protocol 

Peplau developed the first treatment for combat exhaustion, now called posttraumatic stress disorder, 

when she introduced the concept of walking and talking with soldiers. She spoke about her protocol 

(Peplau, 1992): 

I was permitted to have groups of patients in the kitchen. Sitting around the table and 

talking. I was not a sophisticated interviewer or psychotherapist. But I was 

interested—I’d make eggnog and buttered toast. They were amazingly useful…Also I 

was allowed to talk with individual patients. There was no private place—so it was 

hard to do. I took them on walks, I would listen (p. 33). 

 

16. Nurse Casualties Post WW II 

Since one out of every three casualties returned home from war with neuropsychiatric illness, nurses on 

the home front were advised to prepare themselves for the returning servicemen. A physician, Gregg, 

(1944) suggested that homebound nurses needed acceptance to reconvert to civilian life because “They 

changed, irrevocably; they have been changed by experiences too deep and lasting to be erased, 

forgotten, or ignored” (p. 923). Despite the doctor’s admonitions, nurses discharged from military 

service felt their suggestions had little value to or impact on hospital administrators (David, 1947): 

Being an ex-Army nurse and familiar with the “suggestion box”, I believe such a plan 

would be welcome at a large hospital such as the one I am employed by. A nurse can 

see many times…just what changes might save work…At our hospital, no 

suggestions whatever are taken from a nurse (p. 457).  

A nurse from Bataan, Eleanor, became despondent and depressed when she was looked over for 

captaincy. Norman (1999) spoke about Eleanor’s challenge: 

Her disquiet really came from the war. She simply could not reconcile the sacrifice 

she’d made—the suffering that had earned her the sobriquet of hero—with the 

indifference and anonymity she was experiencing in everyday life (p. 256). 

 

17. Nursing Theory Development Postwar 

17.1 Psychodynamic Nursing  

Postwar, Peplau developed and taught a world-renowned course on psychodynamic nursing at 

Columbia University (Silverstein, 2013). She published her book, Interpersonal Relations in Nursing in 

1952, based on the frontline notes she took. Initially, the publication was challenged when publishers 

felt uneasy about a nurse being the sole author without a physician’s input. Her book is considered a 

classic and is still in print today in 6 languages, although she never received royalties for it. 



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17.2 Therapeutic Interpersonal Relations Theory 

Peplau’s book is considered the first nursing theory in which nurses were taught to “know themselves” 

by observing, examining, and monitoring their own emotional and behavioral responses to others and 

by applying this self-knowledge to enhance their therapeutic relationships with patients (Peplau, 1991). 

It was posited by Peplau that “The kind of person each nurse becomes makes a substantial difference to 

what each patient will learn as he is nursed throughout his experience with illness” (p. x). This theory 

was extended to nurse-nurse relationships, doctor-nurse relationships, as well as those of other 

disciplines (Peplau, 1984). These principles of interpersonal relations were later incorporated into all of 

nursing by psychiatric nurses through federally-funded “integration grants” (Silverstein, 2006).  

 

18. Workshops and Research Studies 

18.1 Improved Humanistic and Effective Treatments 

For over ten years, starting in 1954, Peplau gave complimentary one-to-three week workshops across 

the US to nurses during summers off from Rutgers, to teach nurses more humanistic and effective ways 

to work with warehoused patients in mental hospitals who had no hope. They were placed in restraints 

and cuffs, and were subjected to ice packs, electroshock, and lobotomies. Patients were deprived of 

personal items, even dentures and eyeglasses. By the late 1940s the deplorable conditions prevalent in 

mental institutions could no longer be hidden from the public, as dramatized in the movie The Snake 

Pit (Litvak, 1948), based on a novel by Mary Jane Ward and in Deutsch’s explosive book, The Shame 

of the States (1948).  

18.2 Nursing Distinct From Medicine through Science 

Peplau believed that nurses could play a pivotal role in the recovery process of persons in mental 

hospitals. A goal for her was to promote nursing’s impact on patient care that was distinct from 

medicine so as to define its unique scope of practice through research and scientific investigation. 

Against the closed mindset of many nurses, Peplau was a proponent of infusing science and scientific 

methods into nursing education. She encouraged workshop participants to build on their own strengths 

and to integrate theory into practice, to take notes, to record, to articulate, to understand the dynamics 

of the nurse-patient relationship, and to publish the research results of their ward studies (Callaway, 

2002; Silverstein, 2003). 

18.3 Nurses Learn to Talk Therapeutically 

The importance of this contribution is significant when it is put into context in the 1950s. At this time, 

nurses in mental hospitals performed custodial care (Silverstein, 2006). As Peplau saw it, nurses only 

dealt with patients when they had something in their hands, such as a thermometer, bedpan, or lunch 

tray. Talking to patients was discouraged for fear that nurses would say something wrong. Nurses were 

taught to report observations of patients to doctors so they could diagnose and treat. Absent was the 



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concept that interpersonal interactions by nurses with patients could be therapeutic and that they could 

fill the gap of one-on-one care that was non-existent, in part, because of low funding. In the hospitals 

where Peplau gave workshops, patient care improved, sometimes dramatically, and nurses began to 

take interest in learning, making an overall positive impact on health care. 

 

19. Standing up and Speaking out 

19.1 Never to Denigrate Nurses 

Peplau practiced what she preached while standing up for herself and nurses. She never deserted 

nursing or betrayed it, nor did she ever suggest that it was less than other professions. More importantly, 

she never let anyone denigrate nursing or devalue it in any way (Callaway, 2002).  

19.2 Setting the Standards for Advanced Practice 

In 1954 Peplau traveled the US, promoting the revolutionary idea of specialization in nursing and 

encountered much opposition, mostly from nurses (Silverstein, 2013). After obtaining funding, she 

developed the first accredited master’s program for psychiatric nursing in the US and created the 

curriculum for the clinical nurse specialist, a forerunner for nurse practitioner education. She predicted 

that APRNs would someday be allowed to hang out their shingles in private practice, as seen today 

(Peplau, 1962). 

19.3 Peplau Talked the Talk 

On one occasion, Peplau was invited by the director of the Yale Psychiatric Institute to discuss a case 

with a distinguished psychiatrist (Callaway, 2002). The physicians expected her to be deferential. 

Appalled with the way the teen was treated and analyzed by the psychiatrist, Peplau tore his case apart, 

while suggesting meaning. The physicians became defensive because they were out staged by a mere 

nurse. 

Another situation when Peplau spoke out with authority was when she met with the secretary of Health, 

Education, and Welfare (HEW), Elliot Richardson, while American Nurses Association’s (ANA) 

president (Callaway, 2002). Prepared to present her agenda of 15 major points, Richardson showed 

disrespect by reading his mail while she spoke. With a measured reaction, Peplau emptied the contents 

of her purse onto Richardson’s desk, explaining that as he opened his mail, she would sort out her 

pocketbook. With this action, she gained respect, and thereafter the secretary invited her to a State 

dinner and to Washington luncheons. 

 

20. Hollywood Debut of Documentary 

20.1 Film Showcasing Peplau’s Work 

In 1957 Peplau was approached by Smith, Kline, and French (SKF), the drug company that produced 

the first psychotropic drug, Thorazine, that served to decrease severe anxiety and open up patients to 



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therapeutic dialogue. The company wanted to finance the making of a film that showcased Peplau’s 

work (Callaway, 2002). A writer from SKF attended a workshop Peplau had given and made a 

transcript that was developed into a pamphlet. When the director, Peter Hickman, at the medical film 

department of SKF read the pamphlet, he was impressed. The film would present a vignette that 

demonstrated Peplau’s method of a nurse interacting with and examining her reactions to a patient, 

while keeping detailed notes. The movie was to be filmed at Greystone State Hospital in NJ, using 

professional actors and two scriptwriters. Peplau rejected the scriptwriters’ version because they missed 

her point, so she perfected and wrote the script herself, for which she did not ask or receive any credit 

or fee. 

20.2 Box Office Hit 

The film, The Nurse Patient Relationship (1958) was a great success, and all 160 prints were in 

constant use, with 1,200 showings to an audience of 58,550 (Callaway, 2002). After the first year, the 

ANA was given distribution rights, and it was marketed to all hospital and college schools of nursing, 

to physicians and nursing organizations, to every graduate program in psychiatric nursing, and 

throughout the mental hospital system, as well as the Public Broadcasting System (PBS). 

20.3 Nomination at the Oscars and Film Festivals 

In March 1959, Peplau was informed that the film had been nominated for an academy award by the 

Academy of Motion Picture Arts and Sciences in Hollywood in the full-length documentary category 

with 3 other films, including Disney’s White Wilderness (Callaway, 2002). The film was also accepted 

by the Edinburgh Film Festival Council, the Vancouver International Film Festival, and the Festival of 

Contemporary Arts. In addition, it received an award in the sociological film category at the Yorktown 

International Film Festival in Canada. 

20.4 Honored on the International Stage 

Peplau held honorary degrees from nine universities and was the only nurse to be named one of “Fifty 

Great Americans” by Marquis Who’s Who and the Library of Congress. There was one honor that she 

received and rejected simultaneously on June 27, 1998, nine months before her death, because of the 

adversarial relationship she faced from “old guard” nurses at the ANA. To everyone’s surprise, her 

speech was uncharacteristically brief as follows (Callaway, 2002): 

I haven’t been in the ANA headquarters in Washington, D. C., for several decades 

now. I don’t know if there is a hall for the Hall of Fame. Or whether it is just a photo 

album. Or maybe it’s just a folder in a Steelcase file drawer. Whatever. I thank you (p. 

440). 

20.5 International Positions Held 

In 1948 Peplau held her first advisory position at the WHO. By 1965 she accepted the Surgeon 

General’s appointment as the National Nurse Consultant to the Air Force (Silverstein, 2013; Callaway, 



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2002). Elected onto the board of the International Council for Nursing, she lectured globally. During 

her career, Peplau’s primary goal was assiduously focused on promoting professional nursing and its 

contribution to patient care that was distinct from medicine so as to define its unique scope of practice 

through research and scientific investigation. This was encouraged through the development of nursing 

theories and studies that countered the prevailing beliefs of scientists that nurses lacked the intellect 

(Silverstein, 2003). 

 

21. Overcoming Science Biases 

21.1 Facts Clutter Women’s Minds 

Science took giant leaps during the Victorian Era, and this provided scientists and doctors with a new 

misogynistic campaign (Gill, 2004). It was feared that girls’ intellectual training weakened their bodies, 

fed hysteria, and impaired reproduction. Once her mind was trained, questions arose: “What would a 

woman gain from thinking for herself or having a great many facts at her disposal? What man would 

care for her if she did?” (p. 120) It was fortunate that Nightingale’s education prepared her as a leader 

to overcome biases held against women. 

21. 2 Nightingale: A Formidable Opponent 

William Nightingale was Cambridge-educated. He taught his daughters Greek. At 16, Florence had 

already read works of Homer and Plato (Gill, 2004). Fluency in Greek had enormous symbolic import 

in the high-caste system. Encouraged by her father to compete handily with men, Nightingale was 

accepted as both colleague and adversary. Growing up in an upper-echelon family, she presented at 

Court as a debutant. Her family had friends in Parliament and was privy to the latest court gossip. 

 

22. Nightingale’s Preparation for Nursing Career 

22.1 Training Infused with Spirituality  

In 1837, God called Nightingale to service at 16 (Gill, 2004). Known in social circles for her expertise 

in healthcare provision, she prepared by studying the psychosocial conditions of the poor and statistics 

with her father. At this time during the evolution of epidemiology and medical statistics circa 1842, 

William Farr, known as a founder of statistics as a science, began to compile data on mortality and 

morbidity and issue reports. By the age of 25, she was eager to start her life’s work as a nurse to care 

for the sick in public institutions, feeling ashamed and tired of her idle socialite life, but she was met 

with family opposition. “How could one imagine fine, fastidious, cultured Florence cleaning up human 

waste, stripping the rags and vermin off diseased bodies, and holding howling patients down during 

amputations?” (p. 195) Nightingale’s mother accused her daughter of having a lascivious relationship 

with a surgeon. 

 



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Despite discouragement Nightingale in 1851 got her chance to study at a religious institute in 

Kaiserswerth, Germany, that trained lay-deaconesses to serve the indigent (Gill, 2004). The founder 

was a pastor not a doctor, so the main concern was to care for the soul rather than the body. She noticed 

that the wards smelled cleaner and fresher than in public hospitals in England. Gill suggested that by 

assisting with an amputation on a patient who later died, while taking copious notes of her keen 

observations, she learned how to care for patients during the Crimean War. 

22.2 Nursing Based on Public Service 

In mid-19th century England, middle-and upper-class women took care of the sick at home. Nightingale 

did not aspire to become a physician (Gill, 2004). The mere concept of a lady doctor was considered 

aberrant in Victorian society, and medical men were committed to deny women that option. Medicine 

was not advanced, except for the burgeoning sciences applied to antisepsis. Surgery was glorified 

butchery, and most patients treated died. Nightingale’s vision for nursing was based on an ethic of 

public service—an area tolerated by men. She was convinced that with sufficient knowledge and 

intelligent care, it was possible to ease pain and to make people healthy. Nursing, as she saw it, was an 

avenue for middle-class women to enter the workforce for the first time and be useful to the community 

more than doctors could ever achieve. 

 

23. Nightingale Enters Crimean War 

23.1 Poor Provisions for Nurses 

The horrific conditions in Crimea were telegraphed by journalists back to England to inform the public. 

In 1854 Nightingale was asked by Sydney Herbert, Secretary of War, to go to the front lines and 

minister care (Gill, 2004). Although promised otherwise, upon arrival the nurses found rat-infested 

accommodations that were appallingly squalid, without space or privacy. There were no tables, chairs, 

or beds in the Barrack Hospital. Each woman had a copper basin that she used for drinking, eating, and 

washing. Potable water was at a premium. Under these circumstances, retreat for Nightingale could 

have been a welcomed option, “How easy it would have been to act the woman, to weep, and 

expostulate, and explain” (p. 330). 

23.2 Learning to Navigate a Man’s World 

During the time when Nightingale stepped forward as a noble leader of nursing, women could not own 

property and were considered little more than mere chattel. Although she was well-educated and of 

high intellect, she faced paternalism and misogyny in British society and on the front lines of the 

Crimean War that excluded her from the coterie of a man’s world. Women of her social status were 

expected to head households and to marry. Any woman, except for those who had taken religious vows, 

risked falling into disgrace, especially in the military (Gill, 2004). Nightingale spoke about how she 

saw her status as a female: “A woman must bring the best she has whatever that is, to the work of 



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God’s world whether the world judges it to be woman’s work or not…woman’s work if done for men is 

considered ‘men’s work’ ” (Nightingale Papers, n.d.).  

23. 3 Deplorable Conditions Beset Soldiers in Crimea 

Arriving in Scutari with hospital kitchen equipment Nightingale purchased, she began to improve the 

unsanitary conditions that beset soldiers who were filthy, despondent, and racked with fever. They were 

“dying like flies” (Gill, 2004, p. 337). Before the nurses’ arrival, the wounded soldiers took care of 

each other. Despite being greeted with hostility by military officials, the soldiers loved her and she had 

the deepest respect for them, as is evident in her letter written to Rev. T. G. Clarke (Nightingale Papers, 

1895):  

And what I speak in my heart is something like this—the soldier has such good stuff 

in him. He really “loves” his comrades “as himself”—when he himself returns safe 

out of gunshot and finds his comrade or his officer missing, he goes back to bring 

him off.  

Nightingale had a calm and confident demeanor. She never gave or took an excuse. Much of her time 

was spent changing wound dressings and offering individualized care as the soldiers died, often within 

hours of arrival.  

23.4 Fallacy and Fatal Deception 

In her notes on the conditions at Scutari, Nightingale wrote that the hospital buildings appeared 

spacious and magnificent from the outside but that the external appearance was “fatally deceptive” 

(Nightingale Papers, 1855). This was so because underneath these grand structures were sewers and 

cesspools. She contended that the wind blew effluvia up to the wards where the sick were dying. Since 

Nightingale studied modern scientific principles, she was aware of the new germ theory that viewed 

causation of disease as stemming from ingestion of contaminated food and drink. Living in close 

quarters, cholera spread like wild fire. Based on statistics, Nightingale knew that high death rates were 

caused more from lack of adequate nutrition and from diseases than battle wounds. Supplies and 

bedding were lacking, and the soldiers’ filthy, tattered clothing “seemed moving with lice” (Gill, 2004, 

p. 34). 

23.5 Never Backing Down 

Lacking military status, Nightingale never backed down from the purveyor who reluctantly distributed 

supplies or from the commissary officer she called an “unfeeling fool” (Nightingale Paper, 1855). She 

wrote letters home, stating: “In England you go upon a fallacy, you think we want to save Men’s 

lives—we don’t—we don’t care whether the men live or not…” (Nightingale Papers, 1855). By setting 

high standards for sanitary protocol, she saved lives. Within a short time, she disinfected and cleaned 

up the hospitals. Nightingale spoke about a marked improvement in the health of solders, stating:” In 

the first 8 days of February, we buried 506 from the Hospitals of Scutari alone—on the 9th day 



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72—during the last twenty four hours we have lost only ten (out of twenty-one hundred in the 

Hospital” (Nightingale Papers, 1855). 

23.6 Nightingale Walked the Walk 

At night she walked the wards for hours with her lamp and comforted soldiers, some just boys crying 

for their mothers. Although befallen with Crimean fever, she expressed this sentiment in a letter: “If it 

is any consolation to his family to know that he was not neglected, but had every care that medical skill 

& female nursing could give him, they may be certain of this” (Nightingale Papers, 1855.) The hospital 

and public health statistics Nightingale calculated proved that trained nurses made significant 

differences in the care of the sick in body, mind, and spirit, while saving many lives. By raising the 

standards of care, she improved the feasibility of having clean, well-run hospital options fit for 

consumers extant in the 21st century. 

 

24. Nightingale Postwar 

24.1 Postwar Honors 

Queen Victoria sent Nightingale a brooch, designed by Prince Albert, to express her personal gratitude 

for her work. By the end of her tour in Crimea, Nightingale had become the most conscientious and 

supportive superintendent, “worrying over her nurses like an old sheepdog with her prized ewe lambs” 

(Gill, p. 412). She was adored by her nurse subordinates. When she returned from war, sleep was 

problematic, being haunted by the faces of dying soldiers. She refused to see anyone and did not accept 

the gifts, honors, and letters that poured in. 

24.2 Royal Commission and Achievements 

In 1857 she was invited by Queen Victoria to visit Balmoral where Nightingale received a Royal 

Commission to improve the state of the army. During 1858-1872, she had the greatest influence over 

public affairs, and wrote her book Notes on Nursing (1859), still in print today. The Nightingale fund 

was set up in 1855 and was used to start the first hospital training schools. After 1857, she voiced her 

opinions as a recluse because of lingering illness. Regardless, racked with pain and exhaustion, she 

completed her greatest achievements from her bed until her death, as she laid down the rudiments of 

the nursing profession that were firmly rooted on hallowed ground. 

 

25. Discussion: Does History Repeat Itself? 

25.1 The Fountain of Youth 

It is said that “Youth is wasted on the young”. In the case of the spread of Coronavirus in Florida (FL), 

this adage has relevance, as the beaches filled up with young adult sun-worshipers during spring break 

of 2020. While not socially distancing or wearing face masks, they brazenly upheld their right to party, 

regardless of the CDC’s warnings. Although they were at low risk of getting lethally ill from 



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Coronavirus, they were asymptomatic spreaders, like “Typhoid Mary”. Governor DeSantis of FL, 

lacking accountability, agreed with youthful beachgoers because he endeavored to open up the 

economy before cases and deaths abated (Davis, April 17, 2020). As a consequence, hotspots emerged 

in FL and virus death rates soared in a State that has one of the largest vulnerable senior populations in 

the US. The question for historians of today is how will the events of unpreparedness of the 2020 

pandemic be recorded to reflect upon what actually occurred, and how will history impact lessons 

learned for future generations? 

25.2 Black Death Wisdom 

We can look back to the writings of 14th century St. Julian of Norwich (1342-1416) to understand what 

could occur in the 21st century, since a syndrome killing children diagnosed with Coronavirus has been 

reported. St Julian’s, Revelations of Divine Love, is the oldest known preserved writing of a woman 

written in the English language (Coleman, 2014). Nightingale took a copy of it to the Crimean War, 

which is recommended reading during the C0VID-19 pandemic. 

It has been speculated that St. Julian survived the Black Death as a child when a large portion of the 

population died in Norwich, a thriving commercial trade center in England. Besides mentioning in her 

revelations that Christ thanked her for her service as a youth, it is unclear what that labor entailed, but 

one can speculate that at 19 she ministered to others during a revisit of the plague, where thousands of 

infants and children 10 and younger died from lack of immunity (Binion, 2009; Encyclopedia.com). In 

this historical narrative, St. Julian became devastated by her lived experience during the plague, seeing 

young children die, and turned to God for answers by becoming a recluse and mystic to help others 

spiritually (Chopra, 2000). Could a second wave of Coronavirus occur in this century that harms 

innocent children? The Trump administration demands that children return to the classroom before it is 

safe and threatens repeal of school funding for non-compliance, while asking teachers to become 

“heroes”, too (Manjoo, July 15, 2020). 

25.3 Nursing History is History 

Another saying that is relevant in this discussion is: “Nurses eat their young”. However, in this case 

they eat their “old”. This is not to say that nurses have reverted to consuming human flesh but have 

selflessly fed on human sacrifice of their colleagues and predecessors and have discarded the backbone, 

scraped clean, that supports the structural foundation of nursing, like the spine supports the physical 

body. This is because nurses are not taught their history and its relevance to today’s world and because 

nursing history has been watered down through interpretation of secondary and tertiary sources over 

time that discredits nursing’s own contribution to society.  

One can easily view past historic events with present-day values and mores and pass judgement on 

them based solely on what is known in current times. In the field of historiography the term used to 

describe this phenomenon is called present-mindedness, and historians are cautioned to avoid this 



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pitfall. The use of present-mindedness by interpreters of nursing history is evident when discussing 

issues pertaining to whether unmarried Nightingale was a lesbian. The legacy of Nightingale has been 

maligned by “third-party” interpretations. The following quote of R. van der Peet (1995) is an example: 

It cannot be said…that there is an unbroken thread joining the elements of modern 

nursing to elements in Nightingale’s thinking more than a century ago. Indeed, many 

of her ideas were long-forgotten or unknown to modern nurses and their relevance to 

modern nursing is, it may be argued, largely coincidental…And as for her image of 

the lady with the lamp…it remains to be seen whether this image has not been 

detrimental rather than beneficial to the development of nursing (p. 81). 

25.4 Truth or Consequence? 

In 2008, this historian presented at a conference in Paris on the history of Nightingale and Peplau’s 

work with PTSD during wartime. Afterwards, she was approached by a noted historian who informed 

her that archival investigation for primary sources is no longer necessary because all Nightingale’s 

papers are now available online and open for interpretation. In addition, he asked her if Nightingale 

was a lesbian: Was it true what they say? In 2020 disparaging a person’s sexual identity is 

politically-incorrect, even if it is true. This was not the case in the past. Gill (2004) viewed the lesbian 

innuendos of such historians as F. B. Smith, a man who found Nightingale to be power-hungry and 

overrated, to be lacking in evidence, as stated: 

Florence Nightingale was not a lesbian. History, as opposed to imaginative literature, 

is based on evidence…Given the immense volume of documentation we have about 

Nightingale’s life, this lack of evidence must be given full weight…From everything 

we know about Florence Nightingale, if ever there was a woman conspicuously 

chaste, resolutely celibate, and absolutely virginal, it was she (p. 187). 

25.5 McCarthyism Evident in Nursing 

In January 1953 during the McCarthy Era when communists and homosexuals were deemed 

anti-American, Peplau was accused of being immoral, psychotic, alcoholic, and lesbian as a result of 

unsubstantiated rumors circulated by the Director of Nursing Education at Teachers College, Columbia 

University, R. Louise McManus (Peplau, 1992; Callaway, 2002). Insecurity and professional jealousy 

felt by the new director were contributing factors in the proliferation of rumors by her, for Peplau had 

already achieved worldwide acclaim through her book, her courses, and her creative teaching methods.  

25.6 Unjust Charges 

All unjust charges such as those waged against Peplau destroyed careers for nurse educators at this time. 

The immorality rumor arose because she had a child out-of-wedlock during the war, who was adopted 

by her brother. Being a disgrace, it was inconceivable to be an unmarried single mother in 1953. The 

charge of being mentally “sick” arose from a stigma-by-association for those working with 



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mentally-challenged people. However, the charge that Peplau was a lesbian was the most damaging, 

since it affected her relationships with her students who did not want the stain of homosexuality 

jeopardizing their nursing careers. She was forbidden to talk to her students outside the classroom. Her 

colleagues shunned her, and only one asked for evidence as proof (Peplau, 1992; Callaway, 2002).  

25.7 Investigation Denied 

Peplau demanded an investigation but was denied. She was asked to remain silent if she wanted to 

complete her doctoral dissertation (1953) and graduate. Devastated by the scandal, she resigned but had 

difficulty finding a new teaching position. It is impressive that Peplau, psychiatric nurse of the 20th 

century, was silenced from the start as a student nurse and then as a graduate educator but found the 

voice to continue her great achievements into what she called the “growing fringe” of professional 

nursing. 

25.8 Walking to the Future or the Past? 

Are nurses walking to the future or to the past? What would Peplau and Nightingale say today? It is 

clear from the substantive interpretation in this retrospective analysis that both these visionaries had a 

high Intelligence Quotient (IQ) and a high Emotional Quotient (EQ), according to Goleman (1998). 

Their personal and social competencies were used to induce desirable responses in others since the 

Crimean War. The same therapeutic interpersonal tools they applied can be used by nurses in the 21st 

century to combat compassion fatigue during a disaster, as evidenced in this quote (Van Eyck, 2005): 

The lazy breeze belies the inner frenzy of the walking wounded, those survivors still 

traumatized but not showing their internal wounds. They are scarred so deeply that 

they cannot function. I wish I remembered more about post-traumatic stress 

syndrome and active listening! (pp. 28-29) 

 

26. Conclusion 

Defying the odds, Peplau and Nightingale, buttressed with strong backbones, laid a solid foundation for 

how nurses can stand up for their hard-fought principles, for themselves, and for those they serve in 

this century, based on facts, science, and caring. During the pandemic this participant observer has felt 

burdened by the dead weight of horrific images and stories of people agonizing needlessly but what 

feels heaviest now is the denigration of nurses both living and deceased, the degradation of 

Nightingale’s legacy, and the depreciation of valued endowments Peplau (1983) left behind for future 

generations. At this time of turmoil, in a conciliatory tone, nurse honorees abandoned their high 

standards of care slyly wrested from them and kowtowed to authoritarian rule. By doing so, they were 

unwittingly duped by President Trump who lacks empathy and does not uphold scientific principles, 

germ theory, and statistics as truth. 

 



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On the surface it appears that nurses were being honored by Trump in the Oval Office to celebrate 

National Nurses Day, despite his misogynistic and paternalistic overtures. However, underneath it all, 

like the crawling vermin and the underground cesspools in Crimea, nurses were used as political pawns 

while they did cleanup duty for Trump in the absence of Presidential accountability. During this fatal 

deception, nurses risked their lives under untenable conditions, and their mental health has been 

compromised, which may weigh heavy on them with depression, anxiety, drug addiction, and suicide 

long after the pandemic has passed (Wan, May 4, 2020). Fortunately, however, this nurse and others 

can take solace in a final note from Nightingale to lighten our steps marching forward: “Let us be 

anxious to do well, not for selfish praise but to honor & advance the cause, the work we have taken up” 

(Ulrich, 1992, p. 111). 

 

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