Difficulties with Recruitment 1903

When QAIMNS was formed in 1902, many of the staff and conditions of service were carried over from the old Army Nursing Service. At the same time, it was planned that the new Service would be an elite, forward-thinking one which would be the envy of civil hospitals and aspired to by many nurses. However, when the Nursing Board met in September 1903, it was to discuss the failure of their recruitment process to supply adequate numbers of nurses of the right calibre. The following abridged notes are taken from the minutes of that meeting, and set out some of the perceived reasons for the problems [The National Archives, WO243/20].

'The Nursing Board are face to face with the position that they cannot get nurses to join the Q.A.I.M.N.S... The terms of the service have been circulated amongst the civil hospitals, and there is but one opinion, that the terms offered are inadequate.
The Nursing Board must either be empowered to offer better terms, or the military service must be the dustheap into which is shot those nurses from civil hospitals whom the civil matrons do not want to keep, or female nursing of soldiers must be abandoned.
The Nursing Board want to attract into military nursing, firstly, the really good nurse, women who would assuredly succeed in civil nursing, and not the failures, who are many in number; secondly, women of good social position - very important.'

'When a young woman of 28 has finished her training at a civil hospital she looks round and decides what her future is to be, whether she will stay in hospital work, or, whether she will take up private nursing. In the former case, if at all good, she is quite certain of getting almost at once to be a sister, and from that position to gain, as she feels sure she will, a salary of £60 to £100... She then sees before her a matronship, perhaps first of a cottage hospital, with six to ten beds, and then of a larger hospitals, with a salary of £150, £300 and even £400...
If she stays in her civil hospital promotion is rapid. Few people realize how rapid...
But in the military service the promotion will be, and always has been, very slow. In civil work there are many openings for obtaining a better position and salary, in military nursing very few. Another reason why promotion must be slow in military nursing is that once having been in it for any length of time a nurse, never mind what her position, is absolutely debarred from any nursing appointment outside the Service. No matron of a civil hospital would take into her hospital a nurse who has been in a military hospital - a nurse who has had no experience in the nursing of women and children or of old people. It is a specialized service. So equally no committee would ever appoint as matron of a civil hospital a nurse from a military hospital; she would not have been in close touch with all the modern improvements which every year take place in the big civil hospitals. Thus all outlets are closed to women in the military service ... and the result is that "once in, always in" must be the state of affairs for any woman taking up military nursing. To sum up, if a nurse stays in military nursing she unquestionably loses her nursing pecuniary value. Her capital, so to speak, is depreciated.'

The Nursing Board solution to these problems was to offer a new, increased salary and pension scale which still did not look particularly attractive alongside the civil hospital scales that they had just set out. I find it interesting to reflect on the "once in, always in" comment, and the depressing view that on leaving the service, these well-trained and educated women would be found useless in civil nursing. Neither have the Board extolled the virtues of the Service, particularly the opportunities of overseas travel, and a certain security in their everyday life. I'm sure that many 'leavers' went on to have productive and rewarding careers after leaving military nursing, but these notes do provide an interesting angle on QAIMNS and its perceived 'elite' status.

What's in a Name?

Soon after War broke out in 1914, No.3 London General Hospital (Territorial Force) was mobilised at the Royal Patriotic School, Wandsworth Common. The Commanding Officer, Colonel Bruce Porter, agreed to take on a group of men as Royal Army Medical Corps orderlies, all members of the Chelsea Arts Club, who were either too old, or unfit for military service, but who wanted to contribute to the war. Thus, he accumulated a wonderful collection of artists, sculptors, writers and poets, and laid the foundations for a hospital journal which became a prince among all others - The 3rd London General Gazette. It contains artwork, poetry both serious and humorous, cartoons, anecdotes of daily life in the hospital - hard to describe such a treasure trove. One of these Chelsea Arts Club men, Ward Muir, became the editor of the Gazette, and continued to write prolifically throughout the war. Here he describes the problems of addressing women in general, and some pitfalls facing the unwary when in the proximity of the trained nurse.

SISTER by J. Ward Muir

"There is a deal of difference, in hospital, between the word Sister and the word Nurse. Sister is, of course, a Nurse. But Nurse is not a Sister. However, there is nothing to prevent you calling Nurse 'Sister' - provided that Sister herself is not at your elbow. If she is, you had better be careful, both for your own sake and for Nurse's.
Some wearily-wise orderlies, and many patients of my experience, apostrophise all the female officials of a hospital as 'Sister.' The plan has its merits... Apart from the fact that it can offend none, and will cajole not a few, some universal appellation of this sort is - the soldier finds - almost a necessity in his constant dealing with women who are strangers to him.
He comes into contact with a host of women, especially after he is wounded; not only nursing women, but women on the ambulances, women who serve refreshments at halting places, women clerks who take his particulars, women who trace casualties, women who transact postal errands, and so on... To address them each indiscriminately as 'Miss' is absurd... 'Madam' is pedantic. 'Nurse' is in many instances manifestly ridiculous; you cannot call a clerical V.A.D. or a Y.M.C.A. waitress 'Nurse.' So, by a process of elimination, 'Sister' is reached.
Thus is comes to pass, the Mlle. Peroxide of the Frivol Theatre who takes a turn at ladling out cups of coffee in a railway-station canteen (with a press photographer handy) finds that the mud-stained Tommies are saying 'Another slice of cake, please, Sister,' or 'Any fags for sale here, Sister?' The Duchess, too, who is cutting bread-and-butter hears herself hailed by the same designation. And if both Miss Peroxide and the Duchess are not flattered (and maybe a little moved, too) I should be surprised.
For really, you know, 'Sister' is the happy word. It fits the situation - all such situations. Wouldn't it be possible to add one perfect touch; that our women comrades should drop into the habit of addressing us as 'Brother'? Officers and men alike - 'Brother'! It would be a symbol, this, of what the war ought to mean to us all; a fine collaboration of high and low, equals in endeavour...

When I was first put into a ward to serve as an orderly I was instructed beforehand that the only person to be entitled Sister was the goddess with the Stripes. Eager to be correct, I addressed the Staff Nurse as 'Nurse.' At once I divined there was something wrong. Her lips tightened. In a frigid voice she informed me of the significance of the Cape: all Cape-wearers held a status equivalent to that of a commissioned officer in the army, and must be treated as such by privates like myself. All Cape-wearers were to be accorded the proper courtesies and addressed as Sister. Furthermore, the speaker, realising that I was now a recruit, and therefore perhaps ignorant, would have me know that all Cape-wearers had undergone certain years of training... The speaker concluded by a sketch of her past career - I was held up in the midst of an urgent job to hearken to it - and a rough estimate of the relative indispensability of the female compared with the male staff. Finally I was dismissed with an injunction to hurry, and finish my incompleted task. 'Very good, Sister,' I replied.
Half an hour later, in a pause in the morning's rush, I was beckoned aside into the ward kitchen by Sister herself. She gently apprised me that, as I was a new recruit, she thought perhaps I was not yet aware of the accurate modes of address and the etiquette customary in a military hospital. Etcetera, etcetera. She had overheard me call the Staff Nurse 'Sister.'

Enough. One may smile at these exhibitions of feminine human nature (and I could match them, absolutely, on the male side), but when all is said and done 'Sister' is a beautiful title, and most of the women who receive it - whether correctly or because, by war service, they have had it bestowed upon them - richly deserve it as a token of gratitude and honour."

Blue Plaque - an update

In May this year I wrote about English Heritage Blue Plaques, and said that I'd sent in a proposal for a plaque to be placed on one of the two houses in Chelsea that was home to Dame Maud McCarthy. Born in Australia, she came to England in 1891 and trained as a nurse at The London Hospital. She served as a member of the Army Nursing Service Reserve in South Africa during the Boer War, and joining QAIMNS in 1902 she later became Matron-in-Chief with the British Expeditionary Force, serving in France and Flanders from 1914 to 1919.
This plaque proposal was considered (with many others) at English Heritage's Committee meeting in October, and yesterday I heard that it has been considered worthy to go forward for full historical research. They always have many proposals in the pipeline, and this next step is likely to take at least two or three years, but it's very encouraging that the first hurdle has been overcome.

English Heritage Blue Plaques