With You When Needed: Historical Perspectives of Israeli Nursing 1936–2012 by Nira Bartal (review)

Nira Bartal’s second book is a continuation of her comprehensive earlier study, Compassion and Competence: Nursing in Mandatory Palestine 1918–1948.¹ In both books, Bartal examines the development of Israeli nursing by following the story of the Hadassah Medical Organization. In Compassion and Competence, Bartal focused on the growth of the Hadassah nursing school during the Mandate period, and in With You When Needed, she again seeks “to trace the principal outlines of the story of Israeli nursing . . . emphasizing the point of view of the nurses of the Hadassah Medical Organization” (p. 12). Obviously, Hadassah has played and continues to play a prominent role in Israeli nursing, but With You When Needed describes neither the development of nursing in other Israeli medical centers nor the main controversies that have molded Israeli nursing. Rather, by presenting the personal narratives of sixty-five Hadassah nurses, it literally tells the story of Hadassah by letting the nurses themselves speak in their own voices.

Oral history has become a widely used method in historical research in general and in the history of nursing in particular. In this respect, Bartal follows two leading scholars, the American Patricia D’Antonio, who combined an analysis of archival material with nurses’ life stories, and the British Christine Hallet, whose study of nursing during World War I focuses on primary sources given her by the nurses, including letters, diaries and personal accounts. In contrast to D’Antonio, Bartal chose to focus on the nurses’ professional lives, without giving much attention to their family lives or community backgrounds (p. 14). Following Hallet, she sought to tease out and assess the nurses’ originality, uniqueness and impact, and this determined her selection of interviewees, all of whom were prominent, leading nurses who served in Hadassah’s central arenas: public health, obstetrics and operating rooms (p. 15).

In contrast to the blurry, dark figure of a nurse on the book’s cover and to the title, which suggests the nurse’s marginality, the book places the nurses at the forefront of the historical stage by highlighting lesser-known aspects of their activity and underscoring their active and decisive role in the development of Israeli nursing. This goal is abetted by the use of the nurses’ own words. However, notwithstanding her lengthy and clear methodological discussion of oral history, Bartal made the surprising decision to refer to her interviewees only by their initials. This makes it difficult to follow the narratives of these leading figures, since they may be dispersed over several chapters, each time in a different historical context. Moreover, all of the interviewees were pioneers and innovators; they served in high administrative positions in Hadassah or the Ministry of Health, participated in shaping Israeli nursing systems, and some were formally recognized for their accomplishments by the Israeli establishment. The unnecessary practice of hiding them behind initials undermines Bartal’s own intention to listen to the nurses’ voices and evaluate their innovative activities in their proper historical context.

Hadassah’s dual ideal for its nurses was exemplified, as in the title of Bartal’s earlier book, by the elements of compassion and competence. The European school of nursing sees the nurse as an assistant to physicians, with a mission of performance and an emphasis on patient care. The American school, by contrast, has promoted nursing as a profession rooted in theoretical knowledge of a broad range of relevant scientific subjects.² Hadassah wanted its nurses to integrate both models.

With You When Needed analyzes how Hadassah’s nurses actualized the institution’s vision, not only within the walls of Hadassah Hospitals but also in other Israeli hospitals. Through their varied activities, inside and outside the institution, they shaped the profession in a truly revolutionary process. Even during the 1920s and 1930s, a period characterized by “surrender to iron discipline” at the hospital (p. 42), the nurses played an active role.

Bartal shows how medical developments created a need for two...