See Nursing Ethics, 1880s to the Present:
An Archaeology of Lost Wisdom and Identity 
by Marsha D. M. Fowler

I must begin with an admission that, having lost my home and my possessions to the Altadena wildfire, I have become entranced by fire in both its destructive and constructive power.  Technically my home was not destroyed by a wildfire. It was destroyed by a structure-to-structure fire, precipitated by the wildfire, but likely by the embers that swirled in the fierce winds and landed in the nooks and crannies of my home.

Cinders are charred, sparking fragments of combustion that contain unburned material.  As cinders break apart they become smaller glowing embers of material that continue to burn. An ember can be carried aloft on the winds, traveling for several miles.  It can land harmlessly where it will continue to burn until the material is expended, and the ember extinguishes into flakes of ash. Or an ember might land in a more hospitable site where there is enough fuel to keep it smoldering until it reaches ignition and bursts into a consuming flame.

As we have looked at the current demolition of the NIH, the probable loss of the NINR, the disassembling and misdirection of the CDC and public health system, the assaults on educational institutions, the dissemination of false health information, the denigration of nursing science, the frontal attack on reproductive rights, the strikes against health care structures for the poor and elderly, some of us have become embers, perhaps extinguished to ashes;  we have burned too much fuel over the years and now we are spent and there is little left to reignite. Some of us never caught fire. Yet, some of us, perhaps most of us, have been embers feeding on the bits of kindling and tinder of intractable injustices that perpetrate the social harm and illnesses that we see everyday among those we care for.  We smolder. Some of us have been cinders, sparking from almost spent fuel, seeing now the additional fuel that inflames us.

Early modern nurse leaders, fresh into the fray to create a profession, united.  Their passions were enflamed against the manifold structures of social fuel: the disenfranchised social and legal status of women; laws that prevented education on reproduction; the cruel exploitation of women, children, and workers in danger-ridden factories; the grinding poverty of slums; contaminated water, milk and food supplies; business and political corruption; income disparities; contagion, and more. Lavinia Dock called for “unladylike commotion,” calling all nurses to participate at some level, any level, in social reform. Their unladylike commotion was really an unladylike conflagration, wreaking destruction upon the ills of society that harmed persons, their health, and the health of the nation.

Society tried to extinguish their fire through intimidation, resistance, obstruction, fear, arrest, even brutality, beating, manacling, incarceration, and force-feeding.  Dock, herself, was thrice arrested.  Make no mistake, their opposition openly threatened power, greed, corruption, and hardened gender norms.  And make no mistake, their opposition required that they work together to bring change.  They claimed attention with incisive and pointed speeches, engaged in a scholarship of outrage; developed Settlements among the poor for education, health and nursing care, and for social services; they appeared in marches, legislatures, and the halls of Congress and Parliament. They organized, and organized others.  They linked arms with one another in activism and supported those who could lead, though not all joined the fray. They worked together for women’s suffrage, and to establish nursing education and the profession of nursing.  They bicycled streets to reach patients, crossed rooftops and traversed slums to create district and public health nursing, rode horses to deliver babies, entered conflict zones to care for the wounded, developed the theory and science of nursing from acute and experienced observation, and after 1920 they voted — all this was driven by the intrinsic relational ethics of the profession that sought the good of individuals, families, neighborhoods, the nation, and the common good.

A wildfire creates its own weather.  It has dynamics that create within it thunderstorms, wind storms, fire whirls, downdrafts, and pyrocumulus clouds. Early nursing was a firestorm seeking to burn down structures that were destructive of health and well-being.  But fire is also a reconstructive, a healing, force that can help to restore the natural and human ecosystem.  It can clear invasive flora and plant disease, provide the scarification or heat necessary for some seeds to germinate, increase soil fertility, and correct ills wrought by human activity.  Human activity is now creating a destructive fuel load of pain, illness, and injustice; there exists a raging politics that is fueling harm to the human, natural, and global environment.

If we burn together we do not burn out. If we burn together we honor our tradition, our  ethics, and our founders. It is time for nurses to stand upon the shoulders of our forebearers, to be the unquenchable firestorm that forestalls further harm and burns down unjust social structures; and to be the downdraft firewind that rejuvenates communal life and ecobalance, bringing about healing for our patients, our nation, and our world.  

Action opportunities

• Join “The Truth About Nursing” Statement condemning the Trump Administration’s attack on healthcare
• Sign the NurseManifest 2025 Declaration of Solidarity and Resistance