• Lynn McDonald.
• Department of Sociology, University of Guelph, Guelph, ON, Canada.
• J Clin Nurs. 2014 Sep 1;23(17-18):2424-33.

Aims And ObjectivesTo challenge statements made about 'Careful Nursing' as a 'distinctive system' of nursing established by the Irish Sisters of Mercy, prior to Florence Nightingale, and which is said to have influenced her.BackgroundNumerous publications have appeared claiming the emergence of a 'distinctive system' of nursing as 'Ireland's legacy to nursing', which, it is claimed, influenced Nightingale's system. One paper argues that the Irish system has its philosophical roots in Thomist philosophy. Several papers argue the ongoing relevance of the Irish system, not Nightingale's, for contemporary nursing theory and practice. Nightingale's influence on and legacy to Irish nursing are not acknowledged.DesignA Discursive paper.MethodsArchival and published sources were used to compare the nursing systems of Florence Nightingale and the Irish Sisters of Mercy, with particular attention to nursing during the Crimean War.ResultsClaims were challenged of a 'distinctive system' of nursing established by the Irish Sisters of Mercy in the early nineteenth century, and of its stated influence on the nursing system of Florence Nightingale. The contention of great medical satisfaction with the 'distinctive' system is refuted with data showing that the death rate at the Koulali Hospital, where the Irish sisters nursed, was the highest of all the British war hospitals during the Crimean War. Profound differences between the two systems are outlined.ConclusionsClaims for a 'distinctive' Irish system of nursing fail for lack of evidence. Nightingale's principles and methods, as they evolved over the first decade of her school's work, remain central to nursing theory and practice.Relevance To Clinical PracticeNightingale's insistence on respect for patients and high ethical standards remains relevant to practice no less so as specific practices change with advances in medical knowledge and practice.© 2014 John Wiley & Sons Ltd.

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