This nursing philosophy and professional practice model has been developed from historical research and content analysis of historical primary source documents which describe the knowledge and practice of early to mid-19th century Irish nurses, led by Catherine McAuley, Mary Aikenhead and their companions and followers. Their work reflects the reformulation of nursing as a public service following its long-time demise in Ireland and Britain due to Henry VIII’s 16th century dissolution of the monasteries and their medical and nursing services. Medicine had soon become re-established but nursing had been left in a neglected state.

In Ireland during the early years of the 19th century, following the gradual repeal of the penal laws, it became possible again for indigenous Irish people to form their own organisations to address social needs. Poverty and illness were widespread and a great need existed for skilled nursing services. Catherine McAuley and Mary Aikenhead responded to this need. In accordance with cultural and political circumstances, they formed organisations of religious sisters to accomplish their work, the Sisters of Mercy and the Irish Sisters of Charity, respectively. They went out daily to nurse the sick, injured and vulnerable in their homes. During recurring 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 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 Florence acknowledged privately her reliance on their nursing knowledge and skill. She wrote to Mary Clare, ‘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 the nurses accompanied the Irish Diaspora, founding hospitals and schools of nursing in several countries. They left records of their nursing knowledge and practice and the earliest of these records have been used to develop the Careful Nursing philosophy and professional practice model.

The name, Careful Nursing, was selected from a letter written by Mary Vincent Whitty in 1854, to be passed on to the British War Office. She wrote that: ‘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’.

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. The Overview page provides a relatively brief summary of the philosophy and model to date and the videos provide more detail. As the page is developed over time, more resources and information will become available.