On Nursing Identity: What We Can Learn from African Nurses’ Oral Histories

Port of Mauritius by Iqbal Osman, via Flickr

“I have chosen this profession and nobody can take it away from me.”—Sophie Makwangwala, study participant

In the summer of 2009, at the International Council of Nurses (ICN) Quadren­nial Congress in Durban, South Africa, a small group met to discuss collaborating on joint history projects. At that meeting, several African leaders of pro­fessional nursing associations reported that their expertise had long gone unrecognized. Seeking to have the stories of African nursing history told, they pro­posed interviews with other retired nurse leaders. Barbara Mann Wall, an American nurse researcher who was in the room that day, found herself intrigued.

The study. In keeping with Braun’s tenet that “indigenous research should be led, de­signed, controlled, and reported by indigenous peo­ple,” Wall first trained three of the African nurse leaders in the oral history method, aided by a grant from the University of Pennsylvania School of Nursing. Then the team embarked on the study reported on in this month’s original research CE, “ ‘I Am A Nurse’: Oral Histories of African Nurses.” Here’s an overview:

Purpose: The study’s purpose was to collect the oral histories of African nursing leaders who stud­ied and practiced nursing from the late colonial era through decolonization and independence (1950s–70s), in order to better understand their experiences and perspectives.
Methods: This study relied on historical methodology, grounded within the context of decol­onization and independence. The method used was oral history.
Results: Oral histories were collected from 13 retired nurses from Mauritius, Malawi, and Togo. Participants’ educational and work histories bore the distinct imprint of European educational and medical norms. Nursing education provided a means of earning a living and offered professional advancement and affirmation. Par­ticipants were reluctant to discuss the influence of race, but several recalled difficulties in working with both expatriate and indigenous physicians and matrons. Differences in African nurses’ experiences were evident, particularly with regard to language barriers, gender-related divisions, and educational and practice opportunities.
Conclusion: The data show that although institutional models and ideas were transported from colonial nursing leaders to African nursing students, the participants adapted those models and ideas to meet their own needs. The findings also support the use of storytelling as a culturally appropriate research method. Participants’ stories provide a better understanding of how time, place, and social and cultural forces influenced and affected local nursing practices. Their stories also reveal that nursing has held various mean­ings for participants, including as a means to personal and professional opportunities and as a way to help their countries’ citizens.

These findings have relevance for any nurse interested in how nursing identity is formed, which might include reconsidering one’s relationship to the status quo. Indeed, as Wall and colleagues point out, “African nurses often expanded their scope of practice in ways that advanced practice nurses did only decades later in the global North. We can learn from . . . their stories.” The authors conclude, “We hope these data will inspire the creation of African nursing archives and broaden our knowledge of nursing history. …We want to continue this important conversation.” For more, read the article and listen to our interview with Wall, both free online.