Reviewed by:

• Easing Pain on the Western Front: American Nurses of the Great War and the Birth of Modern Nursing Practice by Paul E. Stepansky
• Sasha Mullally (bio)

Easing Pain on the Western Front: American Nurses of the Great War and the Birth of Modern Nursing Practice By Paul E. Stepansky. Jefferson: McFarland and Company, 2020. Pp. 244.

Paul Stepansky revisits military nursing history to position the Great War as the moment when advanced-practice nursing first emerged. Though the advent of "modern" nursing is associated with Florence Nightingale's mid-nineteenth-century education reforms, Stepansky joins the ranks of social historians who are more focused on technique, practice, and technology—as opposed to education and class identity. His book helps to refocus attention on the actual care performed at bedside. In the context of wartime, the author mines first-person narratives to extract nurses' own accounts of their "actual caregiving activities" in the American military hospital system. He situates their reactions, opinions, and memories at the center of efforts to meet the medical challenges of the first total war.

War is traumatic, and the author begins with a chapter called "Epiphanies," which describes episodes of personal transformation as nurses awaken to the scale and horror of the challenges ahead. But the book then subordinates elements of personal biography to technical and practical elements of bedside military nursing, taking inspiration from Christine Hallett's work on British nursing practice during the First World War. It follows with chapters on the evolution of wound care and management, total palliative and convalescent care, the treatment of mustard gas burns and poisoning, the debilities of shell shock, and the ultimately futile attempts to limit the spread of pandemic influenza as the war drew to a close. The focus on nursing practice foregrounds the rapid development of emergency interventions that required expedited adoption. Nurses, caught up in the exigencies of wartime medicine, expanded many elements of their work, including their scope of surgical practice, their technical expertise, their diagnostic role, and their decision-making process around medication.

Stepansky animates his analysis and supports his argument from an enormous collection of life writing. Indeed, the greatest contribution of this work is its bibliography, an impressive collection of published and unpublished memoirs, letters, diaries, and casual reminiscences put to paper by the nurses who participated in the war effort. What emerges is a lively, enthusiastic, and sometimes quite detailed exposition. Demonstrating a broad understanding of military nursing practice, the author offers comparative analyses that situate First World War nurses' practices against experiences in other key conflicts: the American Civil War, the Boer War, the Second World War, and Vietnam. He includes several Canadian nurses who trained in the United States, and often draws practical comparisons [End Page 620] between and among nursing practices as they evolved among the military hospital systems of different Allied forces.

The technical descriptions and comparative elements are the strongest parts of the book. Nurses were readily integrated into anesthesiology in American military hospitals, for instance, in contrast to the experiences of their British counterparts. American nurses on the western front were also on the front lines of convalescent and post-operative innovation. Nursing care required constant attention to Carrel-Dakin wound irrigations, critical for preventing infection in a pre-antibiotic era. And as Stepansky points out, such care often included minor post-operative bedside surgery done independently and sometimes with minimal formal training.

The author openly admires his subjects and often adopts the rhetorical styles of his subjects and their era, especially when describing nurses' commitment to duty and responses to new "psychologically unassimilable" injuries. This is part of what makes Caregiving on the Western Front an engaging read, but the celebratory tone detracts from critical analysis. One must acknowledge the affective power of war narratives. But how do these different forms of life writing compare across categories? Since most sources are published memoirs, how might these narratives have been polished and shaped to conform to a genre of war memoir...

审核人：

• 缓解西线的痛苦：一战中的美国护士和现代护理实践的诞生Paul E. Stepansky
• 萨沙·穆拉利（生物）

缓解西线的痛苦：大战的美国护士和现代护理实践的诞生保罗·E·斯捷潘斯基。杰斐逊：麦克法兰公司，2020 年。Pp。244.

保罗·斯捷潘斯基（Paul Stepansky）重新审视了军事护理历史，将第一次世界大战定位为高级护理首次出现的时刻。尽管“现代”护理的出现与弗洛伦斯·南丁格尔 19 世纪中叶的教育改革有关，但斯捷潘斯基加入了社会历史学家的行列，他们更关注技术、实践和技术——而不是教育和阶级认同。他的书有助于将注意力重新集中在床边进行的实际护理上。在战时的背景下，作者挖掘第一人称叙述，以提取护士们对他们在美国军队医院系统中“实际护理活动”的描述。他将他们的反应、意见和记忆置于应对第一次全面战争的医疗挑战的努力的中心。

战争是创伤性的，作者从名为“顿悟”的一章开始，描述了随着护士意识到未来挑战的规模和恐怖而发生的个人转变。但是，这本书从第一次世界大战期间克里斯汀·哈利特 (Christine Hallett) 对英国护理实践的工作中汲取灵感，将个人传记的元素置于床边军事护理的技术和实践元素之下。随后的章节讲述了伤口护理和管理的演变、全面的姑息治疗和恢复期护理、芥子气烧伤和中毒的治疗、炮弹休克的衰弱，以及随着战争的临近，限制大流行性流感传播的最终徒劳的尝试结束。对护理实践的关注突出了需要加速采用的紧急干预措施的快速发展。护士们陷入战时医学的困境，扩大了他们工作的许多要素，包括他们的外科实践范围、他们的技术专长、他们的诊断角色以及他们围绕药物的决策过程。

斯捷潘斯基从大量的生活著作中生动地展示了他的分析并支持他的论点。事实上，这项工作的最大贡献是它的参考书目，这是一本令人印象深刻的已出版和未出版的回忆录、信件、日记和参与战争努力的护士写在纸上的偶然回忆。出现的是一个生动、热情、有时还相当详细的阐述。作者展示了对军事护理实践的广泛理解，提供了比较分析，将第一次世界大战护士的实践与其他主要冲突中的经验相比较：美国内战、布尔战争、第二次世界大战和越南。他包括几位在美国接受培训的加拿大护士，并经常进行实际比较[End Page 620] 随着护理实践在不同盟军的军事医院系统之间演变，它们之间。

技术描述和比较元素是本书最强大的部分。例如，护士很容易融入美国军队医院的麻醉学，这与英国同行的经历形成鲜明对比。西部战线的美国护士也走在了康复和术后创新的前线。护理需要持续关注 Carrel-Dakin 伤口冲洗，这对于预防抗生素出现之前的感染至关重要。正如 Stepansky 指出的那样，这种护理通常包括独立完成的小型手术后床边手术，有时还需要最少的正规培训。

作者公开欣赏他的主题，并经常采用他的主题及其时代的修辞风格，尤其是在描述护士对职责的承诺和对新的“心理上无法同化”的伤害的反应时。这是使《西线看护》引人入胜的部分原因，但庆祝的语气有损于批判性分析。人们必须承认战争叙事的情感力量。但是，这些不同形式的生活写作如何跨类别进行比较？由于大多数来源都是已出版的回忆录，这些叙述如何被打磨和塑造以符合战争回忆录的类型......