Beyond Nightingale: Nursing on the Crimean War Battlefields by Carol Helmstadter (review)

One could be forgiven for thinking Florence Nightingale was the only the nurse involved in the Crimean War. At last, here is a book that presents a more balanced exploration of the subject. Helmstadter’s aim is to explore and compare nursing practice across all the armies of the Crimean War, the British, Russian, French, Turkish and Piedmont-Sardinian. As she says in the short introduction, “It is a curiosity that Nightingale’s mission is so well-remembered and yet historians of nursing have largely ignored highly successful nursing in other British hospitals where she did not direct nursing services . . . [and] the equally or even more successful nursing in the Russian, French and Piedmontese armies” (p. 2).

The book is organized in three parts, each focusing on a different form of nursing management. It starts with “Government-imposed Nursing,” which focuses on Nightingale’s experiences during the war: her battles with army medics and the government; her frustrations with her “lady nurses” who were resistant to being “managed”; and her reliance on, but at the same time her distrust of, the working-class nurses who, while vastly more experienced than their lady-nursing colleagues, were not entirely trustworthy. This section of the book rehearses many of the arguments already made about Nightingale in the Crimea, but is essential to set up the next two parts that venture (to varying degrees) into new territory.

In Part II, “Religious Nursing,” Helmstadter turns her attention to the diverse groups of religious sisters who answered the call for assistance during the conflict. According to Helmstadter, “the religious Sisters were obviously the most successful as a group,” compared to the government- and doctor-directed nursing (p. 103). While an array of Irish/British religious sisterhoods (Catholic and Anglican) were present, Helmstadter focuses on two: the Sisters of Mercy (an Irish Catholic order led by Mother Francis Bridgeman) and the Daughters of Charity of St Vincent de Paul. The latter, a French Catholic order, had worked with the French army since the seventeenth century and consequently were greatly experienced, considering “their skills superior to those of apprentice surgeons” (p. 147). Helmstadter discusses the significance of religion and the impact it had on the ability of the sisterhoods to do their work, highlighting the rather tense relationship between Nightingale and Bridgeman.

Perhaps the second best-known name to be associated with Crimean nursing is Mary Seacole, but Seacole gets short shrift from Helmstadter, and is dismissed in a couple of lines within a section on French cantinieres (camp followers). Helmstadter rehearses the often-repeated historical view of Seacole: “[she] called herself a ‘doctoress,’ [but] never ran a nursing service and had no impact on the development of nursing as Nightingale did” (p. 152).

In Part III, Helmstadter examines what she terms the “doctor-led” nursing services that could be found in some of the British military hospitals and in the Russian army. This is perhaps the most interesting part of the book, covering mainly new ground for history of nursing. It includes chapters on nursing at the naval hospital at Therapia, a subject Helmstatdter points out has been entirely overlooked as a result of “historians of nursing focussing on army nursing” (p. 203), and a fascinating account of Russian army nursing provided by the Sisters of Exaltation of the Cross, a group established by Russian army surgeon Nicholas Pirgov, in collaboration with the Tsar’s sister-in-law, the Grand Duchess Elena Pavlovna. Helmstadter devotes two chapters to her exploration of the founding, deployment, and successes of this group of nurses, which up to now have been largely ignored.

As we have come to expect from Carol Helmstadter, Beyond Nightingale is exhaustively researched, based on an impressive collection of primary sources. She introduces us to new areas of research relating to non-Nightingale nursing in the Crimean War, which stand comparison with Nightingale’s own approach. In only one...