Globally, the profession and academic discipline of nursing are in turmoil at the same time that vast numbers of the protégés of pioneers in modern nursing continue to disappear from the scene. Nursing continues to struggle to find its voice in a rapidly changing, ever more complex, and increasingly regulated health care context. It is at such a time that examination of great nursing leaders in history can provide inspiration and insight that are relevant for the present time. The book, Nursing’s Greatest Leaders: A History of Activism, provides ten lessons in courage, each of which has the potential to resonate not only with nurses and professional women but also with leaders under fire in all sectors today. To accomplish this feat, David Anthony Forrester has assembled a team of wise and seasoned scholars of nursing to profile each nurse leader using a particular theoretical lens.
The five practices of exemplary leadership of Kouzes and Posner, including modelling the way, inspiring a shared vision, challenging the process, enabling others to act, and encouraging the heart, provide the framework for analysis of the accomplishments of these ten leaders.Footnote 1 This approach has the potential to help readers understand parallels between the situations and responses being described and contemporary challenges.
The stories of these ten women are unique. Florence Nightingale, Mother Mary Aikenhead and Dorothea Lynde Dix were born into privilege, while Margaret Higgins Sanger and Clara Louise Maass experienced poverty. Several of these women experienced a profound spiritual calling to their work, including Nightingale, Aikenhead, Dix, and Edith Louisa Cavell. While Aikenhead’s cause for canonisation is reportedly progressing at this time, not all of these leaders were saintly; at least one, Margaret Sanger, openly engaged in sexual experimentation and was associated with such prominent socialists as Jack Reed and Emma Goldman, another notable nurse. The nurses profiled in this collection were selected according to specific criteria: their contributions to the nursing profession, health, health care, and society were both significant and enduring, and they demonstrated courage and innovativeness.
While most of the nurse leaders selected for inclusion in this book are familiar to aficionados of nursing history, several, including Mother Mary Aikenhead, the founder of the Sisters of Charity, and Edith Louisa Cavell, who was executed by a German firing squad for her resistance efforts in Belgium during World War I, have garnered less attention over the years. The academic preparation of these nursing leaders was not consistent throughout these stories but keen observation of and interest in people and politics were. This is a particularly important finding. Susan B. Hassmiller has observed, in her foreword, that a journey on which she retraced Nightingale’s life from England to Turkey changed her life forever by showing her possibilities of the kinds of contributions she could make. Forrester has noted that he sought to inspire readers in this way. Yet Forrester and Salmond conclude that few contemporary nurses are able to view the profession within the broad context of making change in society (270); rather, they focus internally. Concurrently, society views nurses not as leaders but as people who implement physicians’ orders. These stories illustrate for contemporary nurses the value of political activism and advocacy on behalf of the people whom they serve.
The stories contained in this book are powerful and engaging. Readers will recall stories such as these far better than research about theories of leadership. More importantly, although it is widely recognised that western countries, including the United Kingdom and the United States, have been highly successful in advancing health care while acute illnesses, particularly infectious diseases, were our greatest threats to mortality, there is now widespread global agreement that health systems require transformation to focus on health promotion, disease prevention, and the management of populations with chronic illness. So far, at least in the United States, true systemic change is occurring at a glacial pace.
The stories shared in this book show contemporary readers that within nurses’ disciplinary heritage there exists vast knowledge and skills to address these challenges, if nurses will broaden their view to encompass not just a narrow slice of current scientific evidence but also the sound evidence and theoretical wisdom that the discipline has amassed since Nightingale sailed for Scutari and transformed military medicine. She saved lives and money, both of which are pressing concerns today.
The women whose stories are shared in this volume exuded a powerful sense of mission, whether spiritually or socially motivated. Each faced considerable odds in furthering her cause. Because of this, we find their stories compelling and their accomplishments inspiring even today. These kinds of stories always offer hope that sociopolitical structures can be breached or altered when social justice demands it. Just as social justice demanded that vulnerable populations be served during the lives of these ten women, and just as they responded to and surmounted the challenges they faced, so must we all be galvanised to advocate health care that is accessible, safe, and effective in promoting population health today.
