Night Nurse is filled with pulp fiction plot twists and characters, such as the degenerate mother, the malnourished children, attempted and actual rape, and Hart’s liquor-dealing and gun-packing boyfriend. It is also a nurse’s coming-of-age story that is very descriptive of nursing training, describing the difficulty of getting into nursing school, competition among nurses and hazing by interns, the long hours, “hospital etiquette,” relationships with supervisors, and assisting at surgery, as well as the ideals of nursing, including the “Florence Nightingale Pledge.” The reader gets a detailed sense of what was involved in nursing training and the different approaches to practice.

Nurse Hart was abandoned by her mother and landed on her feet by getting into nursing school. While Hart works the night shift and dedicates herself to the welfare of her patients, her friend, Vivian Finch, works the day shift for the paycheck and moonlights with side jobs to earn as much as possible. The novel represents nursing as a means of not only surviving but financially thriving, one that competes with (although it often loses out to) marriage as a means of female survival and well being.

The novel’s detailed descriptions of nursing make it of interest to nurse scholars, historians, and educators. It illustrates the degree to which nurses were oppressed by the hierarchy within nursing and by physicians’ authority. In particular, “ethics” in this novel is understood as professional etiquette and even obedience to authority. After she is socked in the jaw by the chauffeur for attempting to call a physician when she finds her employer dangerously drunk, Hart thinks to herself, “What I wouldn’t have said to Dr. Ranger or Dr. Beaston right about then!...Ethics be damned” (p. 43). Elsewhere she reflects, “I’ve been pussying with ‘ethics’ and ‘professional reticence’ and silence long enough. Now I’m going to talk” (5). When she does talk, Hart is fired and loses her reputation and thus her ability to find work (even though she has been honored with a medal for saving a woman’s life). Even the physician who helped her get into nursing school and had been a moral compass for her tries to convince her not to testify against the rapist, arguing that it would give her the reputation of a “meddler.”

The novel ends with Hart accepting the marriage proposal of the liquor smuggler. The ending is rather tragic for nursing. The nurse is banned from nursing for speaking out against a serious offense and marries a gun-toting criminal, thus ending her independent career. However this is less tragic than if Hart had allowed herself to be silenced. She responded to the suffering of the young woman who was raped by promising to testify against her assailant, when the physicians working on the case not only failed to do so but tried to convince Hart not to testify. When one physician, worried that it would cast a negative light on the senior physician on the case, refuses to testify, he says, “‘I don’t want to do anything that reflects upon him in the profession….’” Hart replies, “‘The profession. Always the profession. Well, I’ll do it. I haven’t anything at stake. I don’t care what it costs me!’” (p. 248). What she has at stake, however, is her career, and she sacrifices that in the pursuit of justice. The novel illustrates how institutions and authority can attempt to define and co-opt what should be an independent standard of ethics and how nursing has struggled historically within that hierarchy and its restricted notions of justice.