Discussion Questions:
1. The Nurse's Secret offers a glimpse of what life was like for America's very first professional nurses. What were some of the most significant differences you noticed between early nursing as it's represented in the novel and your understanding of the profession today?

2. While reading this novel, in what ways did you notice the nursing profession has remained the same today as it was 150 years ago? Were you surprised by any of these uniformities? Did any scenes or details from the story resonate with your own experiences with modern-day nurses?

3. To survive in the slums of Gilded Age New York, Una is a liar, a thief, and a con artist with little compassion for the suffering of others. Do you think this makes her immoral? Did you find her to be a likable character?

4. Did any of the qualifications required to apply to the Bellevue Nurse Training School surprise you?

5. Great wealth and extreme poverty existed side by side in Gilded Age New York with almost no middle class in between. The rich lived in European-inspired mansions along Millionaires Row while the poor crowded into tenements-sometimes living a dozen people to a room. How was this reflected in the novel? Does the same degree of class stratification exist today?

6. How do you think the death of Una's mother shaped her outlook?

7. Una has a list of rules to survive life on the streets. How did those rules help her? How did they hurt her? Do you think any of the rules are worth carrying over into her new life?

8. Do you think Edwin and Una are a good fit for each other? Do you think their relationship will endure? Why or why not?

9. When Edwin tells Una he doesn't care who knows about their romance, she replies, "Easy for you to say. You don't have anything to lose" What gender dynamics are at play in the novel? Do those same dynamics exist today?

10. Dr. Joseph Lister came to America in 1876 to share his ideas about germ theory and asepsis, but it was several years before the medical community fully embraced his ideas. Why do you think there was such reluctance? Aside from germ theory, what medical advances in the past 150 years do you think have had the biggest impact?

Discussion Questions by the publisher

Book Club Talking Points:
Una's journey is unique. She has very little education and no social skills. After her mother dies, she survives by being a pick-pocket. It's the 1880s, so social safety nets do not exist- life is hard for people experiencing poverty. The book also goes into the first nursing school and piques your interest in Florence Nightingale.