Sioban Nelson. Philadelphia: University of Pennsylvania Press, 2001, 237 pages, Price: $55.00 US, (Hard Cover)

Sioban Nelson vividly draws an eloquent picture of nursing in the nineteenth century. In this meticulously researched and well written work Nelson describes the significant accomplishments of women with religious vocations in the field of nursing. So great are their contributions to nursing that the author questions Florence Nightingale's claim to the title "Founder of Modern Nursing". Nelson proposes this title more appropriately belongs to the Vincent de Paul's Daughters of Charity in France in the 17th century.

In a fascinating approach to historical narrative, Nelson follows the Daughters of Charity and other orders to the New World depicting their failures and successes in astonishing detail. The book is filled with anecdotes and personal stories that bring the efforts of these early nurses to establish health care facilities for the needy to life. They were true pioneers in every sense of the word who literally carved health care facilities out of the wilderness.

Traditionally religious orders have cared for the poor, the ill and society's castoffs - what we now call marginalized populations. This book will impress the reader with the dedication, skills, and political savvy of these pious women. Their stories sound like our stories - so much to do, so little resources, and so little gratitude. Yet they steadfastly pursued their goals. When Nelson recounts their accomplishments within the political, social, and economical context of the times their success is even more impressive. Readers will be amazed at the confirmation of the role of women in the establishment of health care as we know it today. These nurses created major medical centers literally out of nothing. At other times they converted hotels into hospitals, such as St. Alexius Medical Center in Bismarck, North Dakota. Last year St. Alexius cosponsored with Northeastern University the 10th Primary Care for the Underserved Conference continuing the spirit of its founders.

No one who reads this book will think of nurses or the religious as "handmaidens" of anyone ever again. These leaders in nursing bartered, bargained and cajoled very powerful men within and outside the church into meeting their demands. How they learned to use their position as religious women seemingly demure but definitely determined is a story well worth reading. We nurses who work with people who have been marginalized and have many needs will empathize with the challenges faced by the nurses described here. I highly recommend this work - it will enlighten you about life in the nineteenth century and validate your commitment to caring.

Michelle A. Beauchesne, DNSc, RN, CPNP
Associate Professor and Coordinator Primary Care
Bouve College of Health Sciences
School of Nursing
Northeastern University, Boston, Massachusetts
E-mail: m.Beauchesne@neu.edu