Abstract
In this article, prayer is represented not as a single or individual action, but as an entirely integrated part of nursing work. Case examples from American, Irish, and Australian Catholic women's religious congregations who nursed in hospitals in the 19th century are used to analyze the significance of prayer to Catholic sisters' nursing. The issue highlighted in this historical examination of prayer is the power of the sickroom (particularly the deathbed scene) in the battle for souls. Sisters' prayers functioned as invitations to religious experiences and means for patients to meet God. Although based on an ancient religion that embraced medieval notions of penance and Counter-Reformation evangelism through good works, sisters' practices, in the turmoil of 19th-century immigration and social upheaval, contributed greatly to the production of the modern hospital and the modern nurse.
During one hectic week in November of 1889, sister-nurses from the Congregation of the Sisters of Charity of the Incarnate Word at St. Joseph's Infirmary, Fort Worth, Tex, admitted 19 patients, discharged 6, transferred 1 to another room, and cared for 24 others, some of whom were critically ill. This prompted the annalist to remark, "Our heels are praying very hard all day." 1(November 24) The following month, the annalist recorded the nuns' care of a dying patient. The patient was not Catholic, but he expressed his wish to be received into the Catholic Church. The sisters prayed with him, and he was baptized 30 minutes before he died. 1(December 7) These examples highlight the complex place of prayer in the working lives of sister-nurses in the 19th century.
In this article, the authors will argue that rather than representing a single or individual action, prayer for sister-nurses was an entirely integrated part of their work. Conversely, the sisters' work also formed an essential part of their spiritual practice. The issue highlighted in this historical examination of prayer by Catholic sister-nurses is the power of the sickroom (particularly the deathbed scene) in the battle for souls. The case presented is that Catholic sisters' comforting, feeding, and sheltering the sick and dying, and their whispers of consoling prayers to the patient in pain or near death served as an independent means for women to acquire spiritual authority. Although sisters did not require ordination, their prayers functioned as invitations to religious experiences and means for patients to meet God. The sister-nurses held a unique position. They could strengthen the sick or dying person's soul and help him or her more easily bear illness and resist temptations, particularly at the hour of death. By means of nursing, these women could enter into the male domain of evangelism and even sacramental power through their command of the deathbed. Thus, nuns could be mediators to God. 2
To analyze the significance of prayer to sisters' nursing, case examples from American, Irish, and Australian Catholic women's religious congregations who nursed in hospitals in the 19th century are featured. Catholic hospitals developed under a variety of circumstances: in response to medical and nursing needs of local and regional communities resulting from epidemics, wars, and industrial injuries; as vehicles for the promotion of medical careers; and as a means to serve the needs of immigrant Catholics. 3-5 In the United States, many hospitals built before 1860 were primarily Protestant institutions. This posed a significant problem for Catholic patients who feared Protestant proselytizing, and who often were denied priests' visits and opportunities to perform important religious practices.
As immigration more than doubled the total number of Catholics by 1860, and even larger increases occurred after 1890, church leaders sensed that significant Catholic populations existed with inadequate spiritual institutions, which included hospitals. 6 In response, the Catholic Church created separate hospitals, as well as schools and orphanages-often in the same building as the hospital. Moreover, proselytizing had been a major problem in hospitals in Ireland, England, and Germany, causing many immigrants in the United States to be highly suspicious of so-called secular philanthropic activities. 7-9
Catholic institutions were of particular importance where they concerned children, such as orphanages, Magdalene homes (where illegitimate babies would be available for adoption), and in the highly controversial school system. These battles between Catholic and ostensibly secular but functionally Protestant authorities and institutions played out locally and variously in the old and new worlds. The competition for souls and a proprietal regard for the welfare of its flock made the Catholic Church keen to defend its territory from intrusions. 6,8
In Catholic hospitals, sisters played key roles in establishment, financial backing, administration, and nursing. These institutions had the dual purpose of healing and comforting the sick and the dying, as well as providing the opportunity for repentance and spiritual solace. An overriding principle for the sisters was the salvation of souls. 6,10 A nursing tradition developed during the early years of Christianity when the benevolent outreach of the church included not only caring for the sick but also feeding the hungry, caring for widows and children, clothing the poor, and offering hospitality to strangers. 4 The religious ethos of charity continued with the rapid outgrowth of monastic orders in the fifth and sixth centuries and extended into the Middle Ages. Monasteries added hospital wards, where to "care" meant to give comfort and spiritual sustenance. This caregiving provided a rationale for nursing the sick to become a function of community life for both male and female religious orders. The fact that nuns were nursing in hospitals did not mean, however, that they became nuns specifically to nurse and do other good works. Wittberg argues, "the performance of some ministerial work [such as charity] was usually not a defining element" that "early religious orders constructed for their lives. Whether or not the early medieval monk or nun [horizontal ellipsis] engaged in any ministry at all was irrelevant to his/her fundamental goal: personal sanctification through asceticism or prayer." Thus, whatever work they performed was done not as a ministry but rather as "ascetic training" for the soul's perfection. 11(p133)
Compared to early Christian and medieval nursing, when devotion was to God and to personal sanctification, an innovation emerged in the 17th century that included an intentional rather than incidental devotion to nursing and independent roles for women. At this time, women across Europe, both Catholic and Protestant, responded to their churches' calls for evangelical conversions and revival. 12-14 In particular, the Catholic Counter Reformation in France witnessed a rapid expansion of new communities of religious women. An important development for nursing was the foundation of the Daughters of Charity by Vincent de Paul and Louise de Marillac in 1633. This "active" community of unmarried women and widows lived together and dedicated themselves to charitable works, including serving the sick poor. They contracted with government and medical authorities to run hospitals, combining evangelism with nursing skill. 4,15,16* Many other women in the 17th century followed the Vincentian framework, which joined humility, obedience, and simplicity to good works, and they practiced nursing as an imitation of Christ's charitable qualities. 12,15-17
Although they believed their actions enhanced their own sanctification, the sisters in these active communities saw themselves as serving God's poor. The vocation that had drawn them to a religious life was commonly the call to help God's most precious-the sick poor. The sisters retained medieval notions of poverty that framed the poor as God's children, rarely demonstrating more common 19th-century moralizing views of the poor. To serve God's most deserved children, the sisters devoted their lives to the poor, the orphans, and the needy. In addition to this act of devotional care, the sisters were also watchful of the state of souls of all (poor and otherwise) who came within their realm of influence. Since the Counter Reformation these active communities of sisters, influenced powerfully by Vincent de Paul, believed that people would be held to account for those around them. 12,15,16
De Paul instructed the sisters to be devoted and hardworking, but also mindful of the opportunity to save a soul on its way to hell. He urged them to whisper cautions and admonitions to the sick and the dying for this reason. It was considered a great privilege to bring relief to the bedside, to assist the suffering one (for their was little relief to the torment), and to witness and remain with the person on his or her painful and perhaps long journey to death.