Keep those nurses under control!

By 1916 it was becoming obvious that there were not enough trained nurses to staff the ever-increasing number of military hospitals both at home and abroad, while continuing to maintain essential services for civilians. A Committee was set up by the War Office to look at the supply of nurses, and to suggest what measures might be taken to improve the numbers available. This confidential memo, originating from the British Red Cross Society, and dated 1 December 1916, sets out some of the ideas that were put forward during the early days of the Committee.

MEMORANDUM ON W.O. CENTRAL CONTROL OF TRAINED NURSES

1. A Register to be kept of all Trained Nurses who leave their training schools.
2. All independent trained nurses (private, retired, etc.,) to be invited to volunteer for War Service. (The difficulty of this is that you will get all the cast-offs, unsuitables etc., but it is worth risking as you may also get a proportion of useful women).
3. By this means the names of all available trained nurses would gradually be carded on a Register.
4. No Auxiliary Nursing Services such as Joint Committee, Anglo-French, Scottish Women, French Flag etc., would be allowed to draw upon Trained Nurses except through the W.O. Register.
5. All War Hospitals could draw upon the War Office Register.
6. Auxiliary and V.A.D. Hospitals would not be allowed more than a certain number of Trained Nurses, all of whom would be registered on War Office cards.
7. Establishments of Civil Hospitals, Nursing Homes, Co-operative and other Private Nurse Organisations etc., would be carefully enquired into and limitations laid down.
8. No transfers of Trained Nurses would be allowed except through W.O. Register.
9. All Nurses registered who do not wear either the uniform of the Q.A.I.M.N.S. or the T.F.N.S. to be allowed to wear a badge or something to show that their work is recognised by the W.O. whether for the Army, Navy or Civilians.
10. Instead of closing the Nursing Homes in order to get the Nurses, it would be advisable to encourage them and to insist upon the rich Civil Population which usually employs private nurses being nursed in such Homes, where more than one patient share a trained nurse. This would effect a greater economy as Probationers could be used for minor duties.
11. This W.O. Register would necessitate the setting up of a new Department. This could only be a gain as the present system by which there are innumerable War Hospitals, Auxiliary, Private and V.A.D. Hospitals practically not supervised by the W.O. so far as the organisation, control and efficiency of the Trained Nurses and Probationers is concerned, tends to both wastage and inefficiency and want of proper discipline. From our point of view at Devonshire House, the present methods are most unsatisfactory. Only in the case of hospitals staffed by Miss Becher and Miss Sidney Browne are we certain of being able to get attention to anything affecting the comfort, welfare, control and discipline of the V.A.D. members we appoint. The War Hospitals are the most unsatisfactory of all.
12. One more point. The raising of salaries or bonus. This is very desirable from one point of view, but we must not lose sight of the fact that both Miss Becher* and Miss Sidney Browne** have repeatedly stated that they have no difficulty in procuring sufficient Trained Nurses. Theirs are the popular services and yet it is only in these services that it is proposed to raise the salaries. Where the shortage of Trained Nurses really exists is in the hospitals which can ill afford an equivalent rise in salaries or the proposed bonus. We must not forget the Civil population and practically bribe nurses to neglect it in order to volunteer for what is already the most popular work. Is it fair to the Civil Hospitals to raise the standard of salaries for Trained Nurses at the moment when they are probably shorter of funds than ever before? We all agree that Nurses' salaries are too low, but is it fair to take advantage of the Country's need at a time of stress and to raise them now?

* Matron-in-Chief (War Office) Queen Alexandra's Imperial Military Nursing Corps
** Matron-in-Chief, Territorial Force Nursing Service