Male Nurses in the 1920s

Imperial War Museum: Army/Training 25/10

     As part of a transcription of the General Nursing Council Register (England and Wales) for 1928, I've compiled a list of male nurses who were included on a separate part of the Register. In today's NHS male nurses are so numerous and prominent that there are a great many people who don't remember a time when they were virtually absent from general nursing, so I thought it would be interesting to post some details of those few who were employed in the role more than ninety years ago.  In 1928 there were over 40,000 trained female nurses included by the GNC on the general part of the Register, and separate sections for fever nurses, children's nurses, mental nurses and male nurses. Although the names of several thousand men can be found in the section for mental nurses, there were just two hundred considered qualified as 'general' trained male nurses. Inclusion in any of these categories was subject to stringent conditions laid down by the GNC which varied from section to section and male nurses had to satisfy the following conditions to be included on the roll of 'Male Nurses':

(a) A certificate that the applicant has had not less than three years' training before the 1st November, 1919, in a Hospital or Institution approved by the Council for the training of male nurses, or evidence that he has had not less than three years' training before the date aforesaid, as a male nurse in the service of the Admiralty, the Army Council or the Air Council, or that as to part of the period aforesaid, he has had training as a male nurse in such Hospital or Institution, and as to the remainder, training as a male nurse in such service as aforesaid;

or

(b) Evidence that the applicant has had not less than one year's training in a Hospital or Institution approved by the Council for the training of male nurses, or evidence that he has had not less than one year's training as a male nurse in the service of the Admiralty, Army Council or the Air Council, accompanied by evidence in either case that he has subsequently been bona fide engaged in practice as a male nurse in the attendance on the sick for not less than two years before the 1st November, 1919.

In addition, in common with female nurses, those who started their training after 1922 were required to pass a written and practical examination.

     Of the two hundred men named as registered general nurses active in 1928, roughly three-quarters had received their nurse training in military hospitals, having previously served in either the Royal Army Medical Corps, the Royal Navy, the Royal Air Force Medical Service or the Indian Medical Service. The majority of these men received their training prior to the First World War, some as early as the 1880s, and no doubt most were actively engaged with the military medical forces in wartime. In two cases the training was split between the pre-war and post-war periods which maybe suggests that their wartime service was with some other corps or regiment of the army.

     Of the total number, 133 men qualified on the basis of holding a certificate of three years' training, while the others had a variety of training and experience that met with the conditions in paragraph (b) above. The remaining forty-six men provide an interesting insight as to which civil hospitals and institutions in England were actively training men as general nurses at that time and are as follows:

Hackney Hospital and Infirmary:  18
H.M. Prison, Parkhurst:  10
National Hospital, Queen Square, London:  8
Bradford, Municipal General/St. Luke's Hospitals:  7
Erdington Infirmary, Birmingham:  1
New End Hospital, London:  1
Royal Berkshire Hospital, Reading:  1

     It seems apparent from the addresses given that Parkhurst held responsibility for training men for the nursing service in prisons across the country, and understandable that the National Hospital, Queen Square, needed male nurses when its official title at that time was 'The National Hospital for the Relief and Cure of the Paralysed and Epileptic.'  As for the rest, it seems likely that one or two solitary men qualified on the basis of their experience in Birmingham and Reading.  However, there did seem to be a definite aim at both Hackney and Bradford to offer formal general nurse training for men both pre and post-war and who, after 1922, were qualifying by examination and not simply on the basis of previous experience.

     By 1942 the number of general trained male nurses had increased slowly, but still only stood at about 600 nationally (England and Wales).  A brief check shows that the same hospitals were still prominent in training men for the general register, but that's for a future project!

Nurses - Training and Registration

   
     At the time of the Great War there was still no national registration of nurses in the United Kingdom nor any official registers of who they were and where they were trained. Family historians trying to trace pre-war nurse ancestors still have to rely on information, letters and photos passed down over the generations. Census returns might yield up some information if caught at just the right moment, but even then only give a snapshot of where a nurse was working on one single day. Although nurses trained between 1860 and 1890 were likely to have completed just one year in hospital, by the turn of the twentieth century a three year training had become the standard required in hospitals throughout the country. As there were no national standards for nurses, those with a lesser training, or even no training at all could continue to nurse as long as they worked within the law and proved themselves safe - trained on the hedgerows of life.

Nurses in the classroom in 1900

     Nurses trained in hospitals received a certificate at the end of their one or three year period which was precious as it provided proof for future employers of their training and experience. Some hospitals insisted that nurses stayed on for a further year at the end of their training before receiving their certificate. Hospitals considered they'd spent a lot of time and effort on the training and the fourth year ensured they would retain a good supply of newly-trained nurses on their staff, at least in the short term.  Women were not compelled to stay for a fourth year but to leave without their certificate could have serious implications for their future careers.

     The fight for the national registration of nurses continued over more than three decades and was not universally supported by hospitals, doctors or nurses themselves. Ideas and suggestions as to the need for highly-educated nurses at that time throw up alarmingly similar parallels to the current debate on whether nursing has been improved by making it an all-degree profession. In 'The Lamp and the Book' Gerald Bowman writes of nurse reformer Ethel Bedford Fenwick:

'She was a crusader of almost fanatical spirit, a close friend of Mrs. Pankhurst who was leading the campaign for the women's vote.  She believed that only educated women could have a chance of winning freedom for womankind who were debarred from almost all professions and who, until 1882, five years beforehand, had no legal right to their own money after marriage.  She wanted her own profession of nursing to be brought into the same category, if not on a level with, the profession of medicine. That was the object of her first proposed state register to be exclusive to those who were fully trained and could pass an examination demanding a high educational standard. Only those women were to bear the honoured title of Nurse.  For the rest, her original proposal was that those who could not or would not train and sit for the examination, no matter how efficient they had been in practice, should drop the work.' **

     By the time the Nurses' Registration Act passed into law on the 23rd December 1919 the conditions for inclusion in the register were far broader than Mrs. Bedford Fenwick had desired. In addition to those nurses who held hospital certificates it was also possible for both women and men to be included if they had been in practice for a minimum of three years prior to November 1919 and had adequate knowledge and experience of nursing the sick.  The Act contained various clauses with regard to training, but it was Rule 9(1)g which set out the conditions by which a nurse without a hospital training or certificate could be registered:

'In the case of a nurse who was at 1st November 1916, engaged in actual practice and who produces the following evidences of knowledge and experience:
(a)  a certificate of good character;
(b)  a certificate signed by the matron of a general hospital or an infirmary or by two medical men setting out that the applicant has been in attendance upon the sick in the capacity of a nurse for a period of not less than three years prior to the 1st November, 1919; and
(c)  a certificate signed by a registered nurse and by two medical men, one of whom shall be on the staff of a general hospital, setting out that the applicant has adequate knowledge and experience of medical and surgical nursing and is competent to attend upon the sick in the capacity of a nurse.

     Registers of the General Nursing Council for England and Wales were published yearly from 1921 and from then all newly qualified nurses could apply to be included.  After 1923 it was a requirement that all women and men undertaking nurse training must pass a written and practical examination at the end of their course and from 1927 the GNC Register shows nurses qualified 'by certificate,' 'by examination' or by one of the other avenues, usually Rule 9(1)g.

A page from the General Nursing Council Register for 1928 showing nurses trained in the three ways mentioned above (click to enlarge)

     Almost one hundred years later medical care has advanced and nursing care has had to keep pace. However, the parallels in nurse training are still present; there are nurses working in hospitals today with various levels of educational achievement and training according to the regulations in place at the time. There are men and women with degrees, diplomas and still some qualified by examination at the end of their course. The latter group are fading fast as they work their way toward retirement. With nursing currently an all degree profession for new entrants in the United Kingdom, one hundred years on Ethel Bedford Fenwick finally seems to have come into her own. Of course, as might be expected, not everybody agrees with her, neither then nor now.

***

** The Lamp and the Book, the story of the RCN, 1916-1966; Gerald Bowman; The Queen Anne Press Ltd., 1967