The anomaly of autonomy: space and status in early nursing reform

As the focus of care begins to shift from the hospital to the community, it is perhaps timely to look back at the contrasting trend which established the hospital as the dominant locus for nursing care and the space within which nursing skill would be reformed during the middle of the nineteenth century. This paper argues that one of the paradoxical consequences of nursing's shift into the hospital was the loss of a level of autonomy which nurses have struggled to achieve ever since, and considers the campaign which sought to squeeze the ostensibly more autonomous and skilful domiciliary nurse out of the healthcare market and replace her with a more professional and pliant hospital counterpart.