Caring, control and compliance: nursing's struggle to be audible

There are many situations in healthcare delivery in the UK where nurses are the dominant workforce or have expert practitioners working directly with clients, yet rarely, apparently, are they involved in national healthcare policy development nor do they have significant input into how they are expected to practise. Given the large number of nurses compared to other healthcare professions and the long history of the profession it is not immediately clear why this should be the case. However the impression is that this situation is somehow embedded in our culture and history. One clue here is the widely held perception that nursing is women’s work which in turn reveals an apparent parallel between the historical treatment of women in society and the status of nursing. The lack of value ascribed to the skills of the woman nurse can, I believe, be found in our Christian heritage In this work I have explored this phenomenon by examining the development of nursing through history to try and identify and expose the barriers to nursing being able to lead in public healthcare policy determination. I have used an historiographical approach to review the literature using, where possible, contemporaneous accounts. Through this approach I have highlighted the historical, impact of Christianity on the status and value of women in society overlaid with the struggle nursing has had with the enduring legend of Florence Nightingale. This exposure of nursing’s history and the roots of the embedded attitudes of and towards nurses offers the expectation of its use by nurse educators to better prepare future practitioners to take on the challenge of influencing national healthcare policy in Britain