Friday, 25 April 2008

The Trained Nurse and the VAD

I've recently been re-reading 'The Lamp and the Book.' Written by Gerald Bowman in 1967, it tells the story of the formation and evolution of the Royal College of Nursing from 1916-1966. I was particularly interested in Chapter 10: 'V.A.D.' in which he describes the relationship between trained nurses and members of Voluntary Aid Detachments during the Great War years. It describes all the fears of the two groups, and the fight of the trained women to maintain their professional standards and hang on to their jobs, in the face of a perceived threat from their untrained colleagues.

Chapter 10: V.A.D.

Members of the Voluntary Aid Detachments have already been mentioned in passing. This was an organization which had been formed by a joint committee of the Order of St. John of Jerusalem and the British Red Cross Society as far back as 1909. Although St. Thomas’s Hospital later gave members a very short semi-training, they were for the most part completely untrained, and the idea behind their embodiment had been that they should take the place of orderlies in the Royal Army Medical Corps in the case of war.
A very different situation developed. The V.A.D. girls came from better-off families and included a number of young women of title including, for a while, the much publicized Lady Diana Manners. Many of them were employed after the outbreak of war in mansion-hospitals specially converted for the nursing of wounded officers. They all wore a red cross upon the apron-bosom and upon the uniform cap, and naturally (because of their social background) they were much photographed and belauded in the general and pictorial Press.

Equally, naturally, they were not loved by the mass of experienced, really hard-working nurses who had little chance of (and in most cases no desire for) employment in the private hospitals run by titled dowagers. Even so, in justice to the V.A.D.s, a large proportion of them did useful work throughout the war, but it was an age in which snobbery was an accepted condition of life and many of them (usually those with the least claim to gentility) allowed it to be known that they did not consider themselves to be on a level with ‘ordinary nurses’. They were, of course, right, but not quite in the way they imagined. In short they were thoroughly and very understandably unpopular with the nursing profession, and when the war ended many of the qualified nurses had reason to suspect that the V.A.D.s would be competing with them unfairly in the professional employment market.
It was said that Arthur Stanley was secretly trying to get untrained V.A.D.s admitted to College membership because so many of them had good social background. A large number of people believed this, largely because people in general are more inclined to believe a rumour than to take the simple course of going to the right source and reading simple facts. If they had applied to the College, the efficient and dedicated Miss Rundle would have forthwith provided the truth as set out in Stanley’s own statements. But few did.
Naturally, trained nurses and nurses in practice who had learned their business by doing it for many years were resentful because Dr. Addison, the Minister of Health, had added to their fears by announcing: ‘We shall need many more nurses than we have ever had before, and we are fortunate in having … thousands of women who have gained experience in V.A.D. work.

Then the Government announced a Nurses’ Demobilization and Resettlement Committee, which while it was for the benefit of all nurses, also made the point that ex-V.A.D.s were to receive some sort of training. The result was that Stanley, by reason of his known connection with the Red Cross Society (part founders of the V.A.D.) was believed to be playing a double game. Nothing was further from the truth. Stanley had stated in public: ‘Our (the College’s) endeavour will be to draw a clear line between trained nurses and V.A.D.s and to encourage such of the latter who are suitable to obtain the three years’ certificate from a general hospital, which will enable them to become members of the College of Nursing.’
Both Arthur Stanley and Cooper Perry realized that the real position concerning V.A.D.’s was not clearly known by the majority of qualified nurses. One obvious result of the war was that several million men – boyfriends and husbands – had been killed. Another result was that money had changed hands with violent effect as between social classes. A good number of people had made fortunes but a vast number had lost calamitously. All over the country ‘comfortably off’ families of 1913 were finding by 1919 that they had little or nothing. Their daughters now had to earn a living, and owing to the enormous casualty rate of the war, had infinitely less chance of marriage.
It was from these classes, the middle and upper middle, who had suffered most financially from war, that most of the V.A.D.s came. The majority of them who now faced earning their bread had only what half-skill they had learned in war hospitals to bring to the market. They were genuinely in need of help, and the Government realized it and proposed a scheme to help them train fully.

Arthur Stanley had spoken with great care on the subject. He had proposed that only ‘such of them who are suitable’ should be trained further. There were left the large number who could never be turned into good nurses, as he knew in common with anyone else of hospital experience. For these, through the Red Cross, Arthur Stanley suggested a scheme which he felt would not only be workable and just, but which would not arouse the opposition of qualified nurses. He outlined the plan: ‘in every village a proper system under which V.A.D.s trained in home nursing and first aid, could work. They could perfectly well do all the small things such as attending to cuts and the like.’ In this sort of work he pointed out that it would be uneconomic to employ fully trained nurses who would be wasting most of their skill and time. In addition to this Stanley, in his negotiations with the Royal British Nurses’ Association, had agreed without question that untrained V.A.D.s should not be admitted to either of their Registers or the National Register.

In spite of all this Mrs. Bedford Fenwick blandly accused Stanley of proposing to push V.A.D.s into positions which should be reserved for trained nurses. Naturally, since her accusation was published in the columns of her British Journal of Nursing, there were many who believed it. However, the truth eventually prevailed by the unexpected – but what should have been obvious – help of the V.A.D.s themselves. They applied in large numbers for registration at the College, but found that the rule was being rigidly maintained. Only a three-year certificate of training from an approved hospital could gain them membership.
Naturally they talked about it. Naturally they reviled the College and all its works. In which they did the College a most valuable good turn, for the talk spread as talk always does, and wherever it spread it brought full confidence in the College among all the qualified and practising nurses in training for whom it had been founded.

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