Welcome to the Careful Nursing Philosophy and Professional Practice Model

Historical Background: Careful Nursing can be linked back to the essential principles of nursing as it was developed as a public service in the Western world from the 1st century CE. Specifically, it has been developed from historical research and content analysis of primary source documents which describe the knowledge and practice of 19th century Irish nurses. These nurses were faced with reformulating skilled nursing as a public service because it had been almost extinct in Ireland and Britain for nearly 300 years following Henry VIII’s 16th century dissolution of the monasteries and their medical and nursing services. Medicine had soon become re-established. But nursing had fallen into a neglected state, known as ‘the dark period’ of nursing’s history.

In early 19th-century Ireland, with repeal of the penal laws, it became possible for indigenous Irish people to again form their own organisations to meet social needs.   There 1was an especially critical need for skilled nursing.  In accordance with cultural and political customs of the time, Catherine McAuley and Mary Aikenhead formed organisations of religious sisters to serve the poor particularly, the Sisters of Mercy and the Irish Sisters of Charity, respectively. They 2went out daily to nurse the sick, injured and vulnerable in their homes. During famines and fever epidemics they provided crucial nursing services in hospitals and workhouses and became recognised as skilled nurses.  In 1832 Catherine McAuley was given ‘the fullest control’ of patient care at Dublin’s Townsend Street Depot Cholera Hospital.  In 1835 Mary Aikenhead founded St. Vincent’s Hospital in Dublin, the first major hospital in Britain and Ireland to be owned and operated by nurses in modern times.

By the time of the Crimean war (1853-1856) they had attained ‘brilliant prestige' in nursing. Twelve served with and alongside Florence Nightingale at the war hospitals, led by Mary Francis Bridgeman and Mary Clare Moore.  Cultural and political conflict between Britain and Ireland precluded their public recognition.  But Nightingale acknowledged privately her reliance on their knowledge and skill.  In personal letters she wrote to Moore, 'You were far above me in fitness for the General Superintendency’. . . ‘what you have done for the work no one can ever say’ . . . ‘how I should have failed without your help’. Their ‘nursing system’ spread internationally as their followers accompanied the Irish Diaspora, founding hospitals and schools of nursing in several countries.  Early records by them and about their ideas and practice form the basis for the Careful Nursing philosophy and professional practice model.

The name, Careful Nursing, is from an 1854 letter to the British War Office: ‘Attendance on the sick is, as you are aware, part of our Institute; and sad experience amongst the poor has convinced us that, even with the advantage of medical aid, many valuable lives are lost for want of careful nursing’.

Contemporary interpretation: Following content analysis of the historical records the categories and subcategories which emerged from the data were construed as concepts and dimensions of concepts in order to formulate the philosophy and professional practice model.  Names and definitions were derived from the historical data but are expressed in contemporary language.  While Careful Nursing reflects a particular philosophical perspective, every effort is made to link its philosophy, concepts and dimensions to the diverse philosophies and worldviews of contemporary nurses.  (See publications tab for references).

This web page: is intended to serve as a source of information and means of communication about the philosophy and model as it is further developed, critically examined, used and tested. As the page is developed over time, more resources and information will become available.