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WONDERS OF THE WORLD

A pioneer's commitment with women's rights. Lavinia Lloyd Dock (1858-1956)

Angel Alfredo Martínez Ques,¹ Flora Fernández Romero^2
1 Coordinador Grupo gallego EBE. ² Miembro Grupo gallego EBE. Complexo Hospitalario de Ourense, Galicia, España

Mailing address: Angel Alfredo Martínez Ques. Dirección de Enfermería, Complexo Hospitalario de Ourense. c/. Ramón Puga, núm. 52-56 32005 Ourense, Galicia, España

Manuscript received by 10.05.2006
Manuscript accepted by 30.08.2006

Index de Enfermería [Index Enferm] 2007; 56: 62-65

How to cite this document

Abstract

This text refers to Lavinia LLoyd Dock's (1858-1956) role, a nursing pioneer who also was committed to fight for women equality. Born in a rich family, she coursed higher studies, something unusual in that time. She also acquired importance as public health nurse, writer, historian, educator and moreover, committed activist. Her biography is an example to follow by women that develope professional and social roles and claim for a place among the society they live.
Lavinia broke many of the paths that were conceived then about woman and nurse. She was aware that without rights for women, nursing progress could never be reached.

"The good of history is in its lessons for life"
Lavinia Ll. Dock¹

Introduction

     Most women wouldn't have any way to participate in goverment politics without right to vote. With participation the goal of equality can be obtained, otherwise unreachable. It's a well-known fact that participation in public life must be opened to both men and women and they must be equally represented in goverment medium. All the historic course in the last two centuries has elapsed by the search of women particiation and achievement of a wished equality. Despite of the reached goals, it must be remembered that political rights for women has been recent. And despite of formal declaration that settle legal equality, there's still practical unequality in many areas. This text refers to Lavinia Lloyd Dock (1858-1956), a pioneer in nursing who also was committed with fight for women equality². We can appreciate what nurses do today if we understand how their work was developed in the past.

Biography

     Lavinia's life spans almost a century in one of the decissive periods for recognisement of women rights and nurses. Lavinia Lloyd Dock was born in 1858, ten years after Seneca Falls Statement (New York, 1848), one of the foundational texts in suffragism. Some years before, a woman called Florence Nightingale was famous by taking care of ill and wounded people during the War of Crimea (1854-1856). In any way, these referents would have a special importance in Lavinia and would settle one of her features that accompanied her during her life: her activism for women's rights, activism linked to the fight for professional developement of nurses. In fact, Lavinia always emphasized herself during her long life (she died in 1956 at 98) as a suffragist, acting at the head of fight for women's rights³. She also was Public Health nurse, writer, historian, educator, and mainly, a commmited activist. Her biography turns in an example to follow by women that develope professional and social roles and claim for a place in the society they live.
     Lavinia was one of the six children from a rich family, and both her father and mother wanted their children to study, something unusual for women. So whe graduated in 1886 in Bellevue Nursing School. This school was opened in 1873 following the path proposed by F. Nightingale, answering the poor conditions of USA hospitals, and she was one of the first in detach the importance of using trained nurses once medicin and procedures turned more complex. Graduated people in these schools would be decissive in constructing the future of the profession. Although in 180 there were some primary efforts to educate nurses, there wasn't an important change until after 1873, when the first nursing schools that included the method proposed by F. Nightingale⁴ in nursing education were opened^5,6.
     In that Bellevue Hospital she worked as a night supervisor, where she wrote one of the first textbook for nurses: Medical subject for nurses. She was aware of the problems that nurses faced to learn about drugs and solutions. Unfortunately, the editor didn't want to assume the risk, so the firs investment was made by her father, but it was quickly respansed by selling 10.000 copies. She also worked to settle adequate practics for nursing during the yellow fever epidemic in Jacksonville, Florida, in 1888, where she had the opportunity to work with Jane Delano and a similar effort during the consequences of Johnston flooding in Pennsilvanya, in 1889.
     In 1890 she was supervisor under Isabel Hampton and John Hopkins. In 1893 she had the opportunity to speak at the Columbia Exposition in Chicago, and she presided the foundation for teaching school superindentednts. The same years she was nominated nursing superintendent at the Illinois Training School in Chicago, experience that she considered a failure, so she went to New York to the establishment known as House on Henry St.⁷ in order to work with Lillian Wald, were she were for 20 years. With Lilian Wald she was pioneer of nursing in comunity service⁸, contributing to the integration of public health and clinic experiences in training schools for nurses⁹. One of the greatest innovations in the establishment in Henry St was a first aid room. It was a kind of public clinic where inmigrants could have easy acces to nursing care for ordinary health problems. Doctors, however, soon complained about "nursing took salves and pills that were out of medical control".¹⁰
     Lavinia served to nursing in several aspects. She carried a study about regulation of professional nursing, being important for the creation of American Society of Superintendents of Training Scools for Nurses, and she became the first secretary of the organisation and International Council of Nursees (ICN, 1899). She was an active member of practic regulation in nursing movement. For Fenwick and Dock, first leaders of ICN, vocational and religious influence in education must be removed to understand cares as a civic service to the comunity¹¹. For british and american nurses, her profession regulation supposed the end of vocacional-religious nurse and the beginning of professional nurse. The new elite estabilshed the ICN in London, in 1899. Through the ICN, Mrs Bedford Fenwick (president) and Lavinia Dock (secretary), a strong and radical voice for care world was listened to (Lewenson, 1993)⁷. These nurses saw the ICN as a International Federation of National Asociation of nurses, ruled by nurses, free of the goverment control and representing nurses only.¹²
     Aware of the taboo in veneral diseased, she published in 1910 a book called Hygiene and morality, that scandalised people of that period. In it, she held a keen campaign against venereal diseases and prostitution, denouncing double morality of men in that area.
     She wrote several articles that were published in the first issues American Journal of Nursing. She's the autor of History of Nursing in four volumes, written in collaboration with Adelaide Nutting. She did a condensed version in collaboration with Isabel Stewart. Finally she published History of American Red Cross Nursing. These studies make of Lavinia one of the most important historian in nursing.¹³
     In her aspect as a fighter for woman's rights, she wast suffragist and radical feminist, she was actively committed with social protest, formed squads, was at the women's rights marchs and she positioned herself against war. Suffragism seems to be a way of gathering of women from all social classes, despite of the different ideologies and goals, coinciding claiming the right of political participation, whose requirement is voting, to reform laws and costumes, and, in consequence, society¹⁴. All these activities weren't proper for a dame neither a nurse, although always she had the opportunity, she expressed her opinions about social questions. This keen fight achieves a special relevance if we remember that in that period, married women were subordinated to their husbands, so they were legally unexistent, also, the same was applied to single women that stayed under their parents' ruling and protection¹. It's no surprising then, that nursing leaders in the late XIX century were specially concerned about women wellfare and the elevation of her social position¹. It caused that Lavinia, in her fight for women sufragy, spent time in prison because of her efforts for women liberation movement. her interest had an influence. So, in 1896, the former police comissar T. Roosevelt, after president of the USA, rejected imprisonating her when she was arrested because of manifestating for right for vote in new York.

Her thoughts

     Soledad Mújica Smith as author of a thesis about social responsibility in Lavinia Dock¹⁵, remarks three main features: her progresism, the idea of nurse's social responsibility and her role as patient's advocate.
     Her actions, work and ideas about life have important impolications for theory and praxis in nursing, education, democratic ideals and civic vaules. Her vision of care, social responsibility and holistic wellfare for all individuals has been enriching for nursing. She added several social tendencies, includint the phylosophical one that were succesful then. In fact, despite many of her ideas were unique, they match with progresism, pragmatism, feminism and suffragism. In that sense, Lavinia Lloyd Dock defied "victorian canon" for women, pursuing a better education, leaving home to live in comunity among other progresist women, becoming a social activist for the poor, and promoting racial integration in a highly segregative society. Lavinia´s progresism mixed feminist ideas with her experience as nurse and educator.
     Lavinia was concerned about problems that nursing suffered and the long term effects of women's subbordination to men and that other nurses were accomplices of their own subbordination. Finally, nursing opression would be traslated to laws and educative system through legality of paternailsem and the stablishment of learning. She denounced that a powerful combination of male dominion and sexual unequiality existed, and it made impossible the recognisement of nurses as professionals equal to medics and their right to independent practice.
     She was convinced that traditional feminine vaules such as nutrition, collaboration and comunal virtues woul allow reach more goals in society, which required more confraternization that carried by promoting asociations and professional unions. Also, as a devotional pacifist, she considered war an evil fed by nationalist ideas of "defending country".
     Traditionally, nursing has been subordinated to medical control, considered as non qualified working force, unable to get experience neither knowledge. Dock defied medical concepción of unnecessity of nursing education, unconsidered as a basis of improvement and providers of cares to the patients. She demonstrated that education for nurses has an important role in work group maximization and knowledge maximization. While medical comunity suggested that a six weeks technical course was enough for nursing learning, Dock proponed a two years Standard training¹⁶. It must be remarked that nursing training was in hospital schools where their scientific and human education was almost inexistent, being subordinated to medical control and often reciving education not enough to provide minimal quality cares. Dock exposes the nursing necessity of freeing patriarchal paths, and the necessity of a complete and individualistic from medicine education in order to carry their tasks, and also to actino as a social motive to drive individual and family wellfare mentioned before.
     Dock considered nursing as a political agent of change and nurses as democratic agents that contributed to society wellfare. Because of it, as Dock as HSS nurses provided cares conceived as help for patients and presion for the improvement of the poors life conditioni, providint these cares virtually independent from medical department. It meant a change in society, because it happened when women hardly hadn't legal rights.
     Lavinia L. Dock's main ideas were based, in addition to her progresist and feminist convictions, in an integral vision of nursing cares, and considering nursing as a social responsibility. In fact, nowadays it's still preserved professional's necessity of emphasize the role of patient's advocate in serious nursing cases, to provide this proponed vision of cares¹⁷. In her opinnion, cares must be provided in a socially responsable setting, related to individual featured, and not as a singular situation.
     Her biggest concerning, relating this element to nursing field, was fighting against male prejudices, and recognisement of nurse as a professional. It is possible assure that she became a symbol, often not very appreciated, of fight for equality in and out of sanitary field, and even she has been considered as a symbol of equality of woman and not of equality at sanitary field.
     Her progresist ideas are compiled in some reports, too, Duch as A History of Nursing, where she presents the existence of two kinas of nursing: one for the rich and other for the poor. Lavinia remarks the importante of social responsibility (of woman) with the needful ones and the nurse's role as a defender of citicen's health. In this case, she remarks her criticism to nursing because it doesn't implicate in massive health elements Duch as veneral diseases, and the accepted vision of woman as a victim of male desires.
     Regarding her feminist beliefs, she exponed nursing historia as an example of professionals to stop the expansion of these evils. Although Lavinia L. Dock meant an impulse to nursing world, it is necessary to remember that nursing in the early XX Century was deeply influenced by feminist and suffragist ideas living political connotation to this concept that, although it is an historical inevitability, it must not be reused because of being an improvement in health professional conception. Definitively, Laivina, such as other pioneers of her time, broke the tradicional silence and helped by the nurses talked clearly about suffragy, women's rights and local unfairness related to health.

The permanence of her ideas

     Nowadays, inequality in health cares field is still an obstacle to the developement of nursing empowerment. Also, the main challenge is overcoming the deficit of woman's social participation. Overcoming unequality in order to get the whole use of their rights. Lavinia based in democratical hypothesis, understanding that without rights for women it could never be talked about nursing improvements.
     To be recognised as citizen in equality of rights among men, women had to carry organized fights, so suffragism was the first part in the history of feminist movements. Feminism, such as other feminine beliefs of different wing, is parto f political history and it's deeply related to the political aspects of this matter. It can be said then, that women have acted politically since the exclusion of political system and throug several ways of expression. This participation has political content, although it is hidden when it is studied from a traditional conception of power and participation. Providing cares in a system that segregates people by social level o pathology is a difficult task, because providing cares is, Gastaldo dixit, promoting human being in a holistic way and with equito¹⁸. Equality is the basis for nursing developing. Without more participation and implication of women, changes will be slower. As another pioneer said, in case F. Nightingale, "if nobody would be unsatisfied with what is reached, work would never improved", so no system that thinks of developing can remain unchanged¹⁹. Nurses must advance in participation to use their rights. The fight started by Lavinia deserves be continued. Perhaps today, vote is not a priority, but being present in decission places. Or changing a culture that promotes violence against women, if not referring worse situations. Laivinia's keen fight to women's vote achieved a correction in USA Constitution that allowed women to vote²⁰. Continuing this fight is necessary to get this equality to be real. Nurse's work is underrated, and women's necessities in general are not recognised. Work structure, home and workplace can be redefined¹⁶.
     Finally, her vision of responsibility can be considered useful nowadays, when in some of the richest countries have the worst medical systems, quality of cares per nurse and patiend has decreased and even 90% of nursing profesión is female.so it can be said that XXI century nurses challenges are the same that the ones that were faced in the early XX century.

Acknowledgements

     To Laura Torres Fernández, by helping in the text translation and her patience.

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