Sunday, 15 June 2008

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

Saturday, 7 June 2008

Dear Father

While re-reading Penny Starns book Nurses at War I was temporarily halted at a paragraph outlining the elitist nature of Queen Alexandra's Imperial Military Nursing Service during its early days. She writes:

The military nursing services were the only female units to be retained by the forces at the end of the First World War, and had been afforded nominal officer status since the Crimean War. However, this status was based purely on social class. Military nurses were recruited primarily from the ranks of officers' wives, widows and daughters, and this elitist recruitment practice, combined with royal patronage, ensured that the military nursing services occupied a prestigious position within the profession overall. They had also adopted the aristocratic military view that a person's 'character was more important than their intellect' (military nurses, therefore, were born not made).Nurses at War - Woman on the Frontline 1939-45: Penny Starns: Sutton Publishing, 2000: ISBN 0 7509 2387 3
After thinking about this for a while, I felt that I didn't entirely agree on a couple of points. Although the women were certainly selected with social status in mind - they had to be 'ladies' - they also came from families who could afford to educate their daughters, and most had achieved a high level of learning. Therefore, while some highly intelligent working class women would have been excluded from the service owing to the lack of the right accent, the right social connections, and the required level of 'manners', I don't think it necessarily follows that those who were chosen were deficient in either intellect or professional expertise. As for the question of candidates being primarily recruited from the ranks of the wives, widows and children of the military, this is also at odds with my own findings. Certainly it was the intention during the early days of the Army Nursing Service, but it just didn't turn out that way; except for one or two very early occurrences, the service was one of single women without dependants; wives and widows were unknown, and the daughters were a very mixed bunch.
I've recently been doing some research on the background of the 496 women who joined QAIMNS between its inauguration in March 1902 and the outbreak of the Great War in August 1914, looking at things like age, father's profession, training school and previous experience prior to 'joining the Army.' Their fathers' occupations covered a wide range of professions, and included, among many others, missionaries, artists, stockbrokers, commercial travellers, maltsters and millers. At the top of the list came clergymen (60) followed by farmers (57) merchants (49) and in fourth place, army officers (46). However this picture is somewhat complicated by the fact that in an effort to be found acceptable, not all the women told the truth. Cross-checking the father's occupation with that given in the 1901 census throws up all sorts of anomalies, even taking into account a gap of some years between the census and their declaration on application. One very bold woman, who went on to serve for many years (and shall remain nameless) gave her father's occupation in 1904 as 'Count of the Austrian Empire and Colonel of Austrian Hussars', whereas the 1901 census shows him to be a British subject, born in Moldavia, and a Relieving Officer in a small town in the Cotswolds!
The statistics turn up all sorts of interesting trends which deserve more work, and hopefully this will be ongoing work for some considerable time.