Why Not Just Be a Nurse?

To be recognized as serious professionals, women doctors in nineteenth-century Britain felt compelled to differentiate themselves from other women, particularly those in nursing.

During the nineteenth century in Britain, two significant shifts in women’s roles in medicine were happening simultaneously. Nursing was becoming more professionalized, largely thanks to reformers like Florence Nightingale, while, for the first time, women were also beginning to qualify as physicians. Historian Vanessa Heggie explains that this led to a challenging question frequently posed to female doctors: why not simply become a nurse?

Heggie starts by recounting how Elizabeth Garrett Anderson, one of the pioneering women doctors, reportedly answered this question early in her training: “because I prefer to earn a thousand, rather than twenty pounds a year.”

In truth, Heggie notes, the pay gap between doctors and nurses wasn’t usually that vast. Moreover, the extensive education required to become a physician and the limited opportunities available for women often made nursing the more practical financial option. Yet, Anderson’s response captures a common sentiment among female doctors—they entered medicine to be ambitious and skilled professionals, not the compassionate caretakers that nurses were often seen as.

Female doctors had complex relationships with nurses. On the positive side, the presence of nurses in settings like prisons, workhouses, and military hospitals demonstrated that women could competently work in these environments. However, in order to be respected as physicians in a predominantly male profession, female doctors felt the need to set themselves apart from other women, including nurses.

In letters from the 1840s, trailblazing doctor Elizabeth Blackwell described nurses and midwife trainees as unsophisticated and lacking seriousness. Heggie highlights that Blackwell was occasionally critical of Nightingale, who, in turn, opposed the idea of women becoming doctors. Blackwell’s critique extended beyond just nurses; she believed that “the chief source of the false position of women is the women themselves,” citing issues like “careless mothers, weak wives, poor housekeepers, ignorant nurses, and frivolous human beings.”

According to Heggie, efforts by women doctors to establish themselves as qualified and serious were further complicated by the field of medical missionary work. This area was one of the few that welcomed women, especially in overseas missions where female practitioners were needed to treat Hindu and Muslim women while respecting cultural boundaries. While this provided opportunities, it also attracted women eager to do “good work” with little training, thus posing a danger to patients and threatening the reputation of women doctors. Medical schools began implementing measures to filter out students who might abandon their studies early and pursue underqualified missionary work.

In their struggle to combat negative perceptions, women doctors sought to distance themselves from other healthcare professionals like nurses, as well as the broader feminine associations tied to caregiving roles.

“While lady nurses might represent the ideal of fully professionalized Victorian womanhood, the distinguishing feature of the woman doctor was—however unfeminine it might seem—her intelligence and ambition,” Heggie concludes.