THAT NOBLE REFORM: THE EMERGENCE OF PSYCHIATRIC NURSING IN THE UNITED STATES, 1882 - 1963

摘要

This historical study investigates critical social forces and events that influenced the emergence of psychiatric nursing in the United States, 1882-1963. Psychiatric nursing as a specialized segment('1) of the nursing profession emanated first, from psychiatry and later from within nursing in separate and organized efforts to provide what each discipline saw as necessary clinical and educational preparation. As it emerged, psychiatric nursing was claimed by organized nursing as a segment after it had already served in apprenticeship programs developed by psychiatrists. The development of psychiatric nursing is explored in light of traditional inter- and intra-professional conflicts which served as counterpoints in historically shaping the role and status of psychiatric nursing. Late nineteenth century, psychiatric/medical professionals provided the initial "workplace" for "mental" nurses, complete with standards and specific expectations. Early training programs, begun in isolation from the rest of nursing, were dominated by limitations imposed by the psychiatrists' vision of what a nurse/woman could or should do. The isolationism of early psychiatrists influenced their expectations of nurses, which, in turn, contributed to isolation of the nurses as well. Society's pervasive customary neglect of the mentally ill also contributed to and perpetuated the abstention of organized medicine and organized nursing from actively incorporating psychiatric care in the professional preparation of practitioners for each discipline.;Efforts toward self-reliance and professionalizing psychiatric nursing resulted from attempts by nursing pioneers to circumvent their position of subordination and apprenticeship. Yet, acceptance of psychiatric nursing by nonpsychiatric nursing was largely rhetorical until escalation of public dissatisfaction with inadequate care of the mentally ill culminated in the passage of the Congressional Mental Health Act of 1946. The significance of this federal intervention is examined along with the role federally funded programs have played in the development of psychiatric nursing.;The transition of psychiatric nursing's position during its.;development from custodial caretaking to a legitimate and unique.;segment within nursing reveals the interplay of influential social.;and professional forces. Current renegotiations of professional.;boundaries in the field of psychiatric care requires an historical.;awareness of previous attempts in defining each discipline's scope.;of concern. Documentation provided by this study is a contribution.;to the endeavor.;('1)The term segment is used here as defined in R. Bucher.: Pathology: A study of social movements within a profession. Social Problems 10: 42-51, 1962.