윌리엄 라스본(William Rathbone)과 플로렌스 나이팅게일(Florence Nightingale) 그리고 영국 지역사회간호(District Nursing) 제도의 성립과 성격

Abstract

William Rathbone has been regarded as the founder of the district nursing which was first implemented in Liverpool, England in 1860s and is now a major part of the nursing system throughout the world. Historians have argued that the district nursing was a part of Rathbone’s philanthropic work for the poor, and that much of work in the initial state was carried by Rathbone alone. However, the making of the district nursing system in Liverpool was impossible without the active participation of the nursing experts such as Florence Nightingale and Florence Lees. This article seeks an balanced perspective on the birth of the district nursing in the United Kingdom. Nightingale has been mainly known as one of the hospital reformers. However, she paid even a greater attention in the improvement of health of the poor. Nightingale’s Notes on Nursing(1859) indicates implicitly her concern about the public health. The correspondence between Rathbone and Nightingale shows how deeply Nightingale involved in the Liverpool district nursing project. Her role was not just a counsellor, but a designer and a supervisor in the project. Rathbone took her design that Liverpool should have its own training school for nurses. The introduction of the lady superintendent against Nightingale’s plan should be seen as a compromise to meet the financial need, not as a limit of her influence on Rathbone. The introduction of the district nursing in London shows how deeply Nightingale involved in the implementation of her design. Nightingale made sure that the supervision on the district nurses should been done not by a wealthy layperson or any religious organization, but by a medical expert. Florence Lees, a disciple of Nightingale was the most active tool for her design as the first superintendent general in London. Nightingale was an active defender of professionalism of the district nurse. She argued for the necessity of educated women in the district nursing as they had to be health educators. Nightingale’s contribution to the financial independence was no less great. With help of other political leaders including Rathbone, she won queen Victoria Jubilee fund, which brought the existence of Queen Victoria Jubilee Institute for Nurses (QVJI). With queens money the QVJI was able to establish the nationwide control and uniformity. All the district nursing organisations came under the control of the QVJI in 1890s, as it laid down the regulations on the training and practice in the district nursing.