Nursing – an eternal profession

by Moritz Nestor

“The ‘sister’ was the honorary title for the human dimension of nursing. Everyone can empty chamber pots and bring food, but care is more. Care is not a technique, cannot be programmed or calculated.” (picture keystone)

In Switzerland the professional nurse was renamed “Pflegefachfrau” (“care specialist”) from the original term “Krankenschwester” (sister of sick persons). Why was this done? So that the profession might be upgraded or become “more professional”?
Recently a colleague told me that when he was in hospital, a young pretty woman came up to his bed with the greeting: “Hello! I’m Ms X, I’m a care specialist; I’m your caregiver.” For a millisecond, it had occurred to him to send her out of the room, but he knew it wasn’t her fault and he had left it at that. She did not ask, “How are you?” but immediately started to take down his medical history as a patient. The Bosnian cleaning lady always happily asked how he was feeling before she wiped the floor in the morning. After that, the room always felt warmer.
The medical doctor Viktor von Weizsäcker once described the nature of the physician’s profession as follows: “When the little sister sees her little brother in pain, she will find a way above all knowledge: Caressingly, her hand will find its way, she will want to fondle and touch him where it hurts. So the little sister becomes the first doctor. A prior knowledge of a primal effect unconsciously rules within her: it guides her urge to her hand and leads her hand to the effective touch. Because this is what her little brother will learn: This hand does him good. The sensation of being touched by his sister’s hand comes between him and his pain, and the pain retreats before this new sensation. And so the first idea of what a doctor is and the first technique of therapy are born. Actually, the being a doctor is very much centered in the small hand here ... even if the hand gets bigger and arms itself with instruments and lends its power to medicative poisons or to the talking mouth, it will always remain, equally deft in feeling and holding, in nestling and cooling, a living instrument also of later medical activity… The medical act consists … in a touching of two people; ... beholding pain one cannot remain motionless, one must either turn towards it or turn away from it.  This is actually the purpose of the career choice of becoming a medical doctor; that one turns towards the pain.” And I would like to add: That applies to all humans.
There are professions that come and go like fashions do. The profession of a doctor, according to Viktor von Weizsäcker, is “a perpetual one”, “because it is an eternal destiny, that we become ill and need help … but medicine does not come and go like a people, a culture”. The profession of the doctor, and that applies equally to that of the nurse, is not one to change with changing fashions. Because we humans are living beings, and our life is so fragile. We will always be ill – however,  good the techniques and applications of medicine may become.
But the most important thing is: The “sister” was the honorary title for the human dimension of nursing. Everyone can empty chamber pots and bring food, but care is more. Care is not a technique, cannot be programmed or calculated. In all advanced cultures it was part of the dignity of woman that she can give life. And it was as part of that dignity that women became nurses, sisters of the sick. Why did women begin to save and care for the sick and wounded in the men-led wars at the end of the 19th century? The fact that women, as sisters, did not serve war, but life, was the human light shining on the faces of the suffering men and giving them a gleam of hope: that after all, there exists something else besides killing.
In 1943, my father lay severely wounded in the reserve military hospital of Görlitz for more than half a year, until his head shot wound and his frostbite had healed. In the only preserved photograph from that time, next to his parents and his fiancée there is also sister Hilde standing at the head of the hospital bed. How my father found her after the cursed end of the accursed war, I do not know. But as long as Sister Hilde lived, she came to visit our family regularly, last with snow-white hair and a crooked back, and Father held his relationship with her in high honour. At other times rather irascible, he was another man in her presence. He affectionately called her, “Sister Hilde,” and she asked him “How are you, Nestor” drily but with warmth. When she died at the age of eighty, she left us a black stick with a silver handle on which she had leant while walking during the last few years and which Father kept as an honoured memento. She had been a sister to him at the hardest time of his life. Few men survived a head shot at that time.
In the book by Gertrud Schwing “A Way to the Soul of the Mentally Ill”1, there is the moving example of a thirty-year-old psychiatric patient who has been catatonic for months and is artificially fed. “For a few days, I sit quietly next to the bed for half an hour always at the same time. For three or four days everything is quiet in the cell. But then the coverlet rises a very little. Two dark eyes look around warily. There is fear and a deep pain in them. Slowly the whole face appears. It is empty, dead, like a mask. I stay passive and, as a result, she straightens up and starts watching me. And the next day her mouth opens, which has been silent for so long. ‘Are you my sister?’, she asks. And after my ‘No’, she continues: ‘But you came to visit me every day, today, yesterday and the day before yesterday.’”
This example should give us food for thought. Why did the patient ask if nurse Gertrud Schwing was her sister? Should not we make up for our stupidity and call our nurses sister again?     •

1    Schwing, Gertrud. Ein Weg zur Seele des Geisteskranken. Zurich 1940. English: A Way to the Soul of the Mentally Ill. New York 1954. With a foreword by Frieda Fromm-Reichmann.