The written history of the largest health care occupation, nursing, is remarkable for its lack of competing viewpoints. Two factors explain this. First, professionalization has long been the dominant strategy of nursing leaders. Second, historians of nursing have used this strategy as a framework from which to interpret nursing history. An alternative framework has been suggested, however, in work that draws on the craft tradition of nursing. The tension between these competing approaches points to the primary research question: Which set of ideas most accurately describes the occupational evolution of nursing as seen through the records of apprentice nurses at a Midwestern hospital?.

The study findings indicate that the women of the St. Luke's Hospital Training School for Nurses, that operated in St. Paul, Minnesota, from 1892-1937, viewed nursing as an intensely physical occupation that emphasized the superiority of practical work and training over academic pursuits. Their view of nursing, although in opposition to that of nursing leaders, persisted throughout the period of study. The lasting quality of this view can be understood in terms of the combined forces of gender and class.

The training experience reinforced the craft-based image of nursing that was held by the women prior to entering the hospital. Work and practice remained the core of this experience, with no real evidence of movement in the direction of a profession. Accordingly, nursing was defined in action-oriented, forceful, and pragmatic terms. The craft focus endured after training as well. But it was a craft shaped by gender-based values. These values stressed the centrality of home and family in women's lives.

This research challenges the basic assumption of the professionalization framework, that a process of professionalization accurately describes the evolution of nursing. It points instead to the strength of the craft tradition within nursing. In so doing, it helps to explain the deep divisions that continue to characterize nursing and expands the usefulness of the concept of craft in discussions of women and work.