The Rise of Mental Health Nursing
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The Rise of Mental Health Nursing

By Geertje Boschma
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Book Description

Examining the relations between the rise of scientific psychiatry and the emergence of mental health nursing in Dutch asylums, this study analyses the social relationships of class, gender and religion that structured asylum care in the Netherlands around 1900. Drawing on archival collections of four Dutch asylums, the book highlights the gendered nature of mental health nursing politics. Seeking to model the asylum after the forceful example of the general hospital, psychiatrists introduced new somatic treatments and designed mental nurse training which aimed at creating a nursing staff skilled in somatic care. The training system, based on the projected image of the civilized, middle-class female nurse, bringing competence and compassion to the care of the mentally ill, created new opportunities for women, while at the same time restricting the role of men in nursing. Capturing the contradictory realities of hospital-oriented asylum care, the book illustrates the social complexity of the care of the mentally ill and forms an important addition to the historiography on European psychiatry.

The Rise of Mental Health Nursing onderzoekt de tegenstrijdigheden in de op het ziekenhuis georiënteerde inrichtingszorg, die rond 1900 opkwam. Bovendien illustreert het boek de sociale complexiteit van de psychiatrische zorg. Op basis van archiefmateriaal uit vier Nederlandse psychiatrische inrichtingen onderzocht Geertje Boschma de sociale verbanden die de psychiatrische verpleging rond 1900 kenmerkten. De introductie van nieuwe somatische behandelingsmethoden door psychiaters creëerde destijds een vraag naar verplegend personeel dat geschoold was in somatische zorg. Het opleidingsmodel, dat (overwegend mannelijke) psychiaters ontwikkelden, was gebaseerd op het beeld van de beschaafde vrouwelijke verpleegster uit de middenklasse die competentie en compassie in de zorg verenigden. De nieuwe kansen die hiermee gecreëerd werden voor vrouwen legden tegelijkertijd een beperking op aan de rol van mannen binnen de verpleging.

Table of Contents
  • Contents
  • Acknowledgments
  • Introduction
    • Care of the Mentally Ill
    • Asylum Attendants and Mental Nurses
    • The Historiography of Mental Health Nursing
    • Four Asylums as Case Studies
    • The Chapters in Brief
  • Chapter I • Asylum Reform Ideals: Personnel Matters
    • The Appeal of Institutional Care and Moral Treatment
    • A Legal Basis for Asylum Reform
    • Increased Medical Influence
    • Liberal Views, Reform Rhetoric, and the Problem of Personnel
    • Lower-Class Institutions
    • The Position of Attendants and Patients in the Asylum Hierarchy
    • Different Responses and Different Solutions: Roman Catholic Initiatives
    • Reform Ideals Frustrated: Asylum Growth and a New Law
    • A Second Law on the Insane
    • Awakening of Protestant Duty
    • Conclusion
  • Chapter II • The Ideal of a Mental Hospital
    • New Medical Opinions: Scientific Psychiatry
    • Medical Views in Veldwijk: A Christian Psychiatry
    • Bed Rest
    • Architectural Changes and the Increased Application of Bed Rest
    • Hydrotherapy and Bath Treatment
    • Work Remained
    • The Inspiring Example of the General Hospital: A New Demand for Skilled Nursing
    • Conclusion
  • Chapter III • Female Compassion: Mental Nurse Training Gendered Female
    • Religious Roots
    • Female Compassion, Domestic Ideology and the Women’s Movement
    • Growing Demand
    • A New Educational Structure for Nurses
    • A Respectable Salaried Occupation
    • Female Influence
    • Hospital Hierarchy
    • Raising the Status of Psychiatry: The Introduction of Mental Nurse Training
    • Gendered Ideals: Raising the Morality of Asylum Personnel
    • Het Wilhelminahuis (The Wilhelmina Home)
    • Conclusions
  • Chapter IV • The Burdensome Task of Nurses
    • The Invisible Role of Nurses
    • The Nurse as Object and Agent of a Disciplined Asylum Routine
    • Threat, Repression, and Abuse: The Division of Wards as a Control Mechanism
    • An Analysis of Patient Records
    • Responding to Dependency
    • Growing Old and Demented
    • Sick since Youth
    • Suffering from Mania, Acutely or Periodically
    • The Care of Paralyzed and Handicapped Syphilis Patients
    • They Wished to Be Dead: The Risk of Suicide
    • Overcome by Delusions: The Risk of Refusing Food, Self-Mutilation, Violence and Escape
    • Nervous Afflictions and Brain Trauma: Rare Cases in the Turn-of-the-Century Asylum
    • Conclusion
  • Chapter V • Negotiating Class and Culture
    • A Gendered Structure
    • A New Discipline and Morale
    • Culture Shock
    • The Orthodox Protestant Perception of Mental Nurse Training: A Family Ideology
    • Gendered Nursing Leadership in Veldwijk
    • Implementing an Educational Structure
    • Mental Nurse Training at Veldwijk
    • Debate over The Boschhoek
    • The Boschhoek Revisited
    • Roman Catholic “Resistance”
    • Conclusion
  • Chapter VI • The Marginalization of Male Nurses
    • Nursing, a Respected Occupation – but not for Men
    • Squeezed out
    • Nurse Artisans
    • The Home of a Married Nurse: A Place of Family Care?
    • Growing Class Consciousness
    • Male Nurse Activism and the Career of P.N. Bras
    • Gendered Politics versus Expertise
    • Conclusion
  • Chapter VII • Controversy and Conflict over the Social Position
    • An Ambiguous Social Position
    • Growing Social Awareness among Asylum Nursing Personnel
    • Activism among the VCV Nurses
    • Seeking Legal Protection from the State
    • Controversy over Training
    • Ambivalence over Morality and Class Background
    • The Threat of Private Duty
    • Tension over the NVP Exam Criteria
    • Controversy over the Somatic Approach and Biomedical Footing of Psychiatric Care
    • Conclusion
  • Conclusion • The Politics of Mental Health Nursing
    • The Disappointment of Somatic Explanations in Turn-of-the-Century Psychiatry
    • A Gendered Notion of Civilized Care
    • The Educational versus the Social Value of Mental Nurse Training
    • Economic Problems, Growing Costs
    • Ideals and Limitations
  • Appendix
  • Notes
  • List of Illustrations
  • List of Abbreviations
  • List of Archives
  • Bibliography
  • Index
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