FIFTY YEARS OF MEDICAL PROGRESS MEDICINE AS A SOCIAL INSTRUMENT, NURSING E. KATHLEEN RUSSELL RN* TORONTO, CANADA re ATTEMPT to discuss the progcess in nursing during the past 50 years is to face a baffling jask. It must be admitted at once that the story 's one of confusion —great enough that it might be considered by some critics to exclude altogether the use of the word progress. But before we con- cede any such decision, much needs to be said, and much can be said. Let us Sook, then, at this half-century, namely, the years between 1900 and the present. What has [been happening, be it labelled progress or other- ywise?, What are the boundaries of this service called ‘nursing? What does the’ word nursing indicate ‘today? Why, as is obvious, has the quantity of -service expanded so greatly during this time? Why, jin spite of the phenomenal growth in numbers, is there always a shortage of service? Why is there .so'much discontent with the quality of nursing, and ‘particularly with the quality as given in hospital? Why the extraordinary lack of reasoned argument concerning the conduct of nursing schools? Why are nurses themselves always on the defensive, and almost everyone else on the offensive in regard to nursing? Why must I myself dread the effort to discuss nursing with even my most intelligent friends, when I know that seldom will such dis- cussion get past prejudices based upon ignorance of the real fundamentals of the argument? Why are these fundamentals so elusive? Why am I won- dering now how many hospital administrators or medical practitioners — or even what number of nurses — will read this article patiently and with a desire to understand, or with the thought that some new light might appear? It will serve no pur- pose to open a discussion of nursing unless these questions are recognized at the outset. So much controversy cannot be ignered. Can we find a reasoned and convincing argument to explain the i past and give promise for the future? This is my } hope in this present writing, THE NEW ENGLAND JOURNAL OF MEDICINE Mar. 22, 1951 p. 439