Wednesday 20 January 2016

A Question of Equality?

Two Canadian Nurses [Imperial War Museum Q30392]

     Right at the start I have to say that I admire the work done by Canadian military nurses during the First World War - every pair of hands was sorely needed. My problem is with the way their working lives have been interpreted and reported in recent years, in particular the comparisons made between nurses of the Canadian Army Medical Corps and British nurses of Queen Alexandra’s Imperial Military Nursing Service and the Territorial Force Nursing Service. I've been aware for years that many Canadian reports, while understandably desperate to promote the virtues of their own nurses are, at the same time, lacking in knowledge of the British military nursing services that they seem so keen to misrepresent. This week I was sent a link to this recent article:

Women in North Bay's Great War

Although it’s brief and contains no references or sources, it repeats a frequently-out-of-the-mouths-of-Canadians passage:

In July 1917, Marian applied for (and was granted) a transfer to the Canadian Army Military Corp, as a lieutenant. Most Canadian nurses applied for transfer since, in the Canadian Army, the nurses were given the rank, pay and privileges of an officer.

Rank, pay and privileges of an officer.’ These are the things often held up as elevating the Canadian nurse above the British during the Great War, but they fail to accurately reflect the situation as it existed at the time. Canadian military nurses had been active for a many decades prior to the Great War, but only in tiny numbers - a few here, a few there. In 1914 there were just five regular members of the Canadian Army Nursing Corps. That must be compared with Queen Alexandra’s Imperial Military Nursing Service, formed and firmly established in the mid-19th century and which in 1914 had 300 regular members serving throughout the world in permanent, pensionable posts and who formed an elite nursing service of mature well-educated, well-trained women working under contract to the War Office. From the earliest days they had officer status even if they lacked military rank. Few British 'gentlewomen' of the time would have welcomed military rank - they knew their place and didn't yearn to be soldiers. Their place was assured, and everybody respected that.  The Library and Archive of Canada states that:

… only the Canadian nurses were under the direct control of the army and held a military rank. In comparison, the British nursing services were affiliated with the army, but not integrated into it. The higher status accorded to the nursing profession in Canada than in Great Britain may explain, at least in part, this breach of tradition by the Canadian military authorities. Most Canadian nurses with diplomas had gone to high school, and in Canada, training in a nursing school was seen as a sign of prestige.[1]

What does ‘affiliated with the army, but not integrated into it’ mean? During the Great War more than 22,000 British trained nurses served under contract to the War Office. In what way did the military rank afforded Canadian nurses make their position different from their British counterparts? And the reference to the 'higher status' of nurses in Canada is also puzzling - a turn of phrase that might be difficult to prove. The same website goes on to explain that:

... their [Canadian Nurses] authority as officers was limited to the functions that they executed in the hospitals. They had no decision making power at the military level, unlike medical officers. In addition, although they were lieutenants, they were known simply as "nursing sisters," a title reminiscent of the religious vocation with which caregiving tasks were often associated. [1]

That sounds remarkably similar to every other trained military nurse, and of course, it was. Whatever the Canadians thought was the correct title for their nurses, the fact remains that their status, work, responsibility and accountability was identical to their counterparts in the British, Australian, South African and New Zealand nursing services, all of whom were considered to have officer status. Even the Canadian Gazette made a distinction when announcing appointments - the male officers given as ‘To be Captain’ or ‘To be Lieutenant’ while the women were ‘To be Nursing Sisters.’

     There were differences.  Canadian nurses received higher pay; as a group they were younger than their British colleagues and their length of service was often short, many serving one-year contracts before returning to Canada. Canadian sources suggest that the average age for their own members was twenty-four and I assume this was their age on enlistment. The British were a good deal older and a random sample of 500 nurses from my own database give an average age in 1916 of thirty-four years. So the British were a considerably older group and most would have been trained longer as nurses and acquired a far greater depth of experience. I have rarely read any personal account or memoir by a British nurse which suggests any ill-feeling or tension existing between them and the Canadian nursing sisters, and it might be something which was perceived only by the latter, but it has worked its way into Canadian history:

More tense, it seems, were the relations between Canadian and foreign* nurses, particularly the British ones. These tensions were due to the more advantageous conditions that Canadian nurses enjoyed. Their higher salaries, more distinctive uniforms, and apparent popularity with the officers seem to have inspired jealousy among their foreign colleagues. However, the greatest source of frustration with regard to the Canadian nurses had to do with their military rank. Indeed, their officer status gave them greater freedom of movement and a higher level of prestige, two elements that their foreign counterparts did not enjoy. The rules of the Canadian and British armies required that officers, female or male, communicate only with their peers unless they were in civilian clothing, so the British military nurses, without a military rank, could not spend time with their own officers or with those of the CAF if they were in uniform. On the other hand, the Canadian military nurses could spend time only with other officers because of their rank as lieutenants. It is thus understandable that the British nurses perceived the arrival of the Canadians with some apprehension. What is more, the Canadians' rapidly acquired reputation for compassion, gentleness, and hospitality made them formidable rivals. [1]

*Foreign here appears to refer not only to the British but also to the other Dominion nurses from Australia, New Zealand, and South Africa and a strange and inappropriate word to use in this context.

The paragraph above is truly confused waffle.  Who does the writer think the British nursing sisters' peers were? They had always had officer status from the earliest days. I often wonder how it was that so many British nurses married officers if they were barred from all contact – but yet another myth of course.

     It’s only right that Canada should be proud of its nurses and their work in the Great War, but there's no place for sloppy and incorrect reporting relating to British and other ‘foreign’ nurses. Canadian accounts should take care not to denigrate and demean British nurses who were easily the equal of their own and in most cases were more experienced and with a longer period of war service. Do your research Canada – find out about the history of the nursing services you seem so happy to belittle, and provide some solid and reputable sources.  Queen Alexandra’s Imperial Military Nursing Service was long-established, elite and confident in itself. It’s members were educated, well-trained women with a wealth of experience both in nursing and life in general.

Lucy Liptrot, a QAIMNS Reserve Staff Nurse

     The last word must go to Mabel Clint a Canadian nurse who served France during the First World War and who in my opinion got it exactly right:

Next to us in the fields was an English Stationary Hospital, and as Harold Begbie had some months before criticized our uniform very severely, and gratuitously assumed we would not be worth much professionally, I'm afraid the English Sisters looked upon us at first with some prejudice. Discipline and routine were carried out by them exactly the same as in the barrack military hospitals, and it did seem that some of the "Regulars", trained with a certain rigidity, perhaps failed to allow for front-line conditions, the immense mental strain, and the fact that the Territorials, and afterwards "Kitchener's Army" were different material, and not accustomed to strict regulation of their actions. If ever the "human touch" was needed, it was in the Great War. We allowed our patients more liberty, but our wards looked less orderly. We often heard men comparing systems, and sometimes had several guests at tea-time crawling under the ropes, because our Sisters were accustomed to supplement the rations with fruit, eggs, or other extras. For steady, efficient service however, sacrifice of personal comfort, ability to work without recreation, the English personnel could not be surpassed. Many of their Matrons, as someone said were "Personalities" in their own right. They had a great deal of authority, and the Sisters also completely controlled their wards, subject only to the Medical Officer. We had the military rank, and they the real, established position. Personally, I met many at home and abroad, and fraternized with them equally as with Dominion Sisters, and I think they remember us with kindness. [2]

     A clear and astute summing up and yes, you may have had the military rank Canada, but ‘the real, established position’ was ours.  There were undoubtedly differences between individual nurses but all the allied nations provided the same high-class nursing service over the course of a long and difficult war. We must celebrate the art of nursing and all that was done during the hardest of times without looking for problems which were really very unimportant.


For a fuller article on the women who made up Queen Alexandra's Imperial Military Nursing Service see:

[1]  Library and Archives Canada: Caregiving on the Front: The Experience of Canadian Military Nurses during World War 1.

[2]  Our Bit: Memories of War Service, Mabel B. Clint

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