Emil Lederer · 1916
Emil Lederer’s review treats Caemmerer’s study as an important contribution to social policy: nursing reveals how charitable traditions and gendered expectations can obstruct the recognition of paid work and its rights. Moving from wartime exclusion through training, working conditions, and legal protection to occupational organization, Lederer presents professionalization as an unfinished struggle to establish nurses as workers entitled to effective collective representation.
Die Krankenpflege gehört in Deutschland zwei verschiedenen Sphären an.
English translation: Nursing in Germany belongs to two different spheres.
This division between charitable nursing, organized through religious orders and motherhouses, and nursing as a livelihood structures the review. The war intensified an existing antagonism: trained professional nurses remained unemployed while Red Cross hospitals used largely untrained volunteers. Since the professionals had offered their services for maintenance alone, Lederer rejects cost as an explanation. He locates the exclusion instead in resistance to women making nursing a paid occupation:
Hier liegt eben eine starke Abneigung gegen die berufsmäßigen Pflegerinnen vor, hauptsächlich wohl aus der Empfindung, daß es unweiblich sei, aus der Krankenpflege ein «Geschäft» zu machen.
English translation: Here there exists a strong aversion to professional nurses, chiefly, no doubt, out of the feeling that it is unwomanly to make a "business" out of nursing.
The prejudice has institutional consequences. Professional nurses suffer both from mistaken assumptions about their social origins and from inadequate training. Lederer follows Caemmerer in comparing their one-year hospital education, burdened with menial duties and narrow specialization, to the abuses of apprenticeship. American training provides a counterexample: longer study, systematic theoretical and practical instruction, and preparation for hospital administration make nursing a skilled profession rather than an extension of feminine service.
The review’s empirical centre concerns hours, rest, earnings, and accommodation. Lederer stresses that official statistics record prescribed hours rather than actual work, thereby understating the burden. Day duty can be compounded by night duty, while insufficient leave scarcely permits physical recuperation. English and American shift systems, and Australia’s three-shift arrangement, demonstrate that such conditions are neither medically necessary nor inherent in nursing.
Mit diesen anstrengenden Arbeitsverhältnissen steht die Einkommenshöhe in krassem Widerspruch, oder besser gesagt, im Einklang, da ja in der Regel ungünstige Arbeitsverhältnisse Symptome einer ökonomisch schlechten Position sind, und umgekehrt.
English translation: With these strenuous working conditions the level of income stands in crass contradiction, or better said, in accord, since as a rule unfavourable working conditions are symptoms of an economically poor position, and conversely.
The self-correction is conceptually decisive: low pay and exhausting work are not contradictory anomalies but mutually consistent expressions of weak economic standing. Crowded accommodation reinforces this dependence. Private nurses’ homes can function as exploitative employment intermediaries, appropriating substantial returns from nurses’ labour. Cooperative organization appears as a remedy. Legal exclusion compounds the problem: institutions not operated for profit generally fall outside the industrial regulations protecting women’s working hours. Administrative intervention has brought little improvement, and nurses seek inclusion in a unified law governing private employees.
Lederer then examines questions in which occupational status remains entangled with conventions of femininity. Wartime experience has largely undermined objections to women nursing male patients. Distinctive nursing dress likewise loses its justification as paid professional work supersedes a strictly charitable vocation. These issues belong to the same transformation as labour protection: nursing must be approached practically as qualified work.
The closing discussion distinguishes professional associations from organizations directed toward economic interests. Christian and free trade unions differ over whether striking is permissible. Agnes Karll’s nursing organization occupies an intermediate position, retaining the educational and moral community of a sisterhood. Following Caemmerer, Lederer argues that this attachment inhibits its development; its failure to protest hospitals’ restrictions on membership exposes the weakness of nurses’ awareness of associational rights.
Es kann aber nur eine Frage der Zeit sein, bis auch sie ihre Organisation als Gewerkschaft auffassen.
English translation: It can, however, only be a question of time until they too conceive of their organization as a trade union.
This expectation gives the review its reformist conclusion. The importance of nursing and the shortage of skilled personnel offer potential bargaining strength, but that strength requires organization. Lederer warmly endorses Caemmerer’s practical and theoretical command of her subject. The book’s wider significance lies in making neglected labour conditions visible: institutions associated with care and charity require social investigation and enforceable protections no less than other workplaces.
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