The Trained Nurse and the VAD

I've recently been re-reading 'The Lamp and the Book.' Written by Gerald Bowman in 1967, it tells the story of the formation and evolution of the Royal College of Nursing from 1916-1966. I was particularly interested in Chapter 10: 'V.A.D.' in which he describes the relationship between trained nurses and members of Voluntary Aid Detachments during the Great War years. It describes all the fears of the two groups, and the fight of the trained women to maintain their professional standards and hang on to their jobs, in the face of a perceived threat from their untrained colleagues.

THE LAMP AND THE BOOK: GERALD BOWMAN: QUEEN ANNE PRESS 1916
Chapter 10: V.A.D.

Members of the Voluntary Aid Detachments have already been mentioned in passing. This was an organization which had been formed by a joint committee of the Order of St. John of Jerusalem and the British Red Cross Society as far back as 1909. Although St. Thomas’s Hospital later gave members a very short semi-training, they were for the most part completely untrained, and the idea behind their embodiment had been that they should take the place of orderlies in the Royal Army Medical Corps in the case of war.
A very different situation developed. The V.A.D. girls came from better-off families and included a number of young women of title including, for a while, the much publicized Lady Diana Manners. Many of them were employed after the outbreak of war in mansion-hospitals specially converted for the nursing of wounded officers. They all wore a red cross upon the apron-bosom and upon the uniform cap, and naturally (because of their social background) they were much photographed and belauded in the general and pictorial Press.

Equally, naturally, they were not loved by the mass of experienced, really hard-working nurses who had little chance of (and in most cases no desire for) employment in the private hospitals run by titled dowagers. Even so, in justice to the V.A.D.s, a large proportion of them did useful work throughout the war, but it was an age in which snobbery was an accepted condition of life and many of them (usually those with the least claim to gentility) allowed it to be known that they did not consider themselves to be on a level with ‘ordinary nurses’. They were, of course, right, but not quite in the way they imagined. In short they were thoroughly and very understandably unpopular with the nursing profession, and when the war ended many of the qualified nurses had reason to suspect that the V.A.D.s would be competing with them unfairly in the professional employment market.
It was said that Arthur Stanley was secretly trying to get untrained V.A.D.s admitted to College membership because so many of them had good social background. A large number of people believed this, largely because people in general are more inclined to believe a rumour than to take the simple course of going to the right source and reading simple facts. If they had applied to the College, the efficient and dedicated Miss Rundle would have forthwith provided the truth as set out in Stanley’s own statements. But few did.
Naturally, trained nurses and nurses in practice who had learned their business by doing it for many years were resentful because Dr. Addison, the Minister of Health, had added to their fears by announcing: ‘We shall need many more nurses than we have ever had before, and we are fortunate in having … thousands of women who have gained experience in V.A.D. work.

Then the Government announced a Nurses’ Demobilization and Resettlement Committee, which while it was for the benefit of all nurses, also made the point that ex-V.A.D.s were to receive some sort of training. The result was that Stanley, by reason of his known connection with the Red Cross Society (part founders of the V.A.D.) was believed to be playing a double game. Nothing was further from the truth. Stanley had stated in public: ‘Our (the College’s) endeavour will be to draw a clear line between trained nurses and V.A.D.s and to encourage such of the latter who are suitable to obtain the three years’ certificate from a general hospital, which will enable them to become members of the College of Nursing.’
Both Arthur Stanley and Cooper Perry realized that the real position concerning V.A.D.’s was not clearly known by the majority of qualified nurses. One obvious result of the war was that several million men – boyfriends and husbands – had been killed. Another result was that money had changed hands with violent effect as between social classes. A good number of people had made fortunes but a vast number had lost calamitously. All over the country ‘comfortably off’ families of 1913 were finding by 1919 that they had little or nothing. Their daughters now had to earn a living, and owing to the enormous casualty rate of the war, had infinitely less chance of marriage.
It was from these classes, the middle and upper middle, who had suffered most financially from war, that most of the V.A.D.s came. The majority of them who now faced earning their bread had only what half-skill they had learned in war hospitals to bring to the market. They were genuinely in need of help, and the Government realized it and proposed a scheme to help them train fully.

Arthur Stanley had spoken with great care on the subject. He had proposed that only ‘such of them who are suitable’ should be trained further. There were left the large number who could never be turned into good nurses, as he knew in common with anyone else of hospital experience. For these, through the Red Cross, Arthur Stanley suggested a scheme which he felt would not only be workable and just, but which would not arouse the opposition of qualified nurses. He outlined the plan: ‘in every village a proper system under which V.A.D.s trained in home nursing and first aid, could work. They could perfectly well do all the small things such as attending to cuts and the like.’ In this sort of work he pointed out that it would be uneconomic to employ fully trained nurses who would be wasting most of their skill and time. In addition to this Stanley, in his negotiations with the Royal British Nurses’ Association, had agreed without question that untrained V.A.D.s should not be admitted to either of their Registers or the National Register.

In spite of all this Mrs. Bedford Fenwick blandly accused Stanley of proposing to push V.A.D.s into positions which should be reserved for trained nurses. Naturally, since her accusation was published in the columns of her British Journal of Nursing, there were many who believed it. However, the truth eventually prevailed by the unexpected – but what should have been obvious – help of the V.A.D.s themselves. They applied in large numbers for registration at the College, but found that the rule was being rigidly maintained. Only a three-year certificate of training from an approved hospital could gain them membership.
Naturally they talked about it. Naturally they reviled the College and all its works. In which they did the College a most valuable good turn, for the talk spread as talk always does, and wherever it spread it brought full confidence in the College among all the qualified and practising nurses in training for whom it had been founded.

On the Radio ... Uh Oh ...

Last night I did an interview for ABC Radio National, Sydney, which went out this morning on their 'Life Matters' programme. My subject was Dame Maud McCarthy, and what can be gleaned about her from the official war diary which I've recently transcribed. Australian born and bred, she spent most of her life in the UK, and is not well-known over there. Or over here for that matter.
I received lots of good advice from friends and family; speak slowly... don't gabble or you'll sound rushed... whatever you do NO UMMs or ERRs... no throwaway quips or jokes - they will fall on stony ground... etc, etc. These were added to by the radio station staff - hold the phone down below the level of your chin... don't move it around while you're talking or it makes everything crackle...
Due to the time difference, I was sitting to attention by 10.50pm when the phone rang, not too sure what questions I was going to be asked, and with a stack of papers ranged out in front of me (please remember, don't rustle...) I'd done a bit of homework - listened to previous programmes, and checked out Sarah Macdonald, the interviewer, so I knew who I was talking too (I thought a bit like a young Edwina Currie?) and of course it all flashed by in the blink of an eye, without me really knowing if I'd ummed or erred or mentioned anything that could be taken even vaguely to be insulting to Australia (I really hope not).
Of course the first thing I did this morning was to click on to the 'Life Matters' website, and sat for some time pondering over whether I could possibly bear to listen to myself, but eventually couldn't resist the challenge. Surely not me? That ponderous old girl? I passed with flying colours on umms and errs, and definitely didn't gabble. In fact I sounded so laid back I was positively horizontal.
Note to self for 'next time' - forget about umms and errs, and just make sure the audience know you're still alive!

This weeks 'Life Matters' broadcasts can be heard on their website:

ABC Radio National 'Life Matters'

Portraits

Maud McCarthy, Matron-in-Chief in France and Flanders, had a couple of portraits done during the war. One was the work of Austin Spare, who she sat for in the spring of 1919 and although it was commissioned by the Imperial War Museum I can't track down its present home. The other is a well-known work by Frank Salisbury, which was completed in 1917. The latter is currently on display at the National Portrait Gallery, and I popped in there last week to have a look at the original.
The place was absolutely heaving with people - obviously a very popular choice for a free outing on a Saturday afternoon - and I had to weave and bob my way up to Room 30 on the first floor. Room 30 is a small room, and the theme of the 13 portraits displayed is the First World War - a selection of personalities who, by their actions during that period contributed to change within Britain. Unlike its neighbours, Room 30 was in semi-darkness, and I didn't feel that the lighting did justice to some of the works there.
The Frank Salisbury portrait of Maud McCarthy is a small work, and I felt disappointed by it on two accounts. Firstly, it just doesn't seem to bring out any of her vitality or personality; it's a very muddy portrait, the grey of her uniform barely distinguishable from the muddy brown of the background, and her face eclipsed between the strength of colour in the red of her collar trimmings and the dark brim of her hat. She looks rather pretty and womanly, but with no strength or definition in her face, and eyes that hardly look as though they have seen the world.
But worse than this, was the hanging scheme in the room. Miss McCarthy's portrait is hung above that of John Singer Sargent's portrait of Sir John French (so far so good), her eyes and shoulders inclined towards her left. On her left is a self-portrait of Dame Laura Knight with a nude figure, and I had to wonder what Maud thought of it all. The Knight picture was painted in 1913, so not actually of the period of Room 30, and the artist herself spent the entire war living in Cornwall, well away from the war - how does she come to be included here? What was her contribution to change during the Great War that puts her among Generals and Statesmen? And how can any contribution be compared to Miss McCarthy's five years in France, working 16 hour days, with just a few weeks leave during that whole period. I did think it might be some sort of joke by the staff of the NPG, on a theme of 'those who did, and those who did not.'
I don't think Maud McCarthy would have been happy with the thought that her gaze must fall in perpetuity on a nude woman who played no part in the war. But perhaps I'm prejudiced!

The contents of Room 30, the National Portrait Gallery, can be viewed by using the link below. One other slight 'oddity' there is Lady Ottoline Morrell, but even she can claim to having helped the Great War cause by allowing her house to be used as a convalescent home for officers.

Room 30 portraits, National Portrait Gallery

Books

Over time I've collected a lot of books. When I moved to my present flat I knew less space meant that I would have to prune the number of books I took with me, and after unpacking I was left with about three full shelves. Six years later the number of both books and bookshelves has increased dramatically, and despite my disciplined approach to fiction, which I discard one way or another, I have an ever increasing collection of non-fiction and reference works. Recently I found out about LibraryThing.com, and have been using the site to catalogue my books. It's an interesting concept, and in addition to providing a convenient way to keep track and view what you either own or read, it also acts as a social network, allowing you to peek into other people's libraries, and discover who has similar tastes to your own. It struck me that there might be an element of 'showing off' attached to it, but I've found it thoroughly enjoyable. I've also discovered quite a few books that I forgot I had, which results in long pauses for browsing. The site can be found here:

LibraryThing

Edith Appleton's Diary

Recently I was contacted by Dick Robinson, to tell me about his great-aunt, Edith Appleton, a member of the QAIMNS Reserve during the Great War. She kept diary throughout her time in France, and members of her family have recently transcribed the diary, and Dick has now put it online. It's a wonderful account of life and work at casualty clearing stations, in hospital and on trains, alternating between outlining the horrors of her work and describing the pleasantries of her off-duty time. Edie has a dry sense of humour which must have helped her through some of the difficult times, both physical and emotional.

War Diary of Edith Appleton

Dip into it and enjoy!

With the Italian Expeditionary Force

This is a second extract from the book 'Reminiscent Sketches', a selection of first-hand accounts by members of QAIMNS published in 1922. This one about the Italian Expeditionary Force gives an insight into a much neglected area, and one almost unknown to many people.

WITH THE ITALIAN EXPEDITIONARY FORCE

By D. M. Taylor

On a cold bleak morning, early in December 1917, I and my party arrived at the Italian Frontier on our way to join the Italian Expeditionary Force. The ground was white with snow, and it was exceedingly cold. The railway station was guarded by Italian soldiers, and even at the door of the refreshment room there was a sentry with a fixed bayonet. We were informed by the Railway Transport Officer that food was very short in Italy, and that he did not know where we were to go, but he would send us on to Turin, where we arrived about 5 p.m. No one appeared to know anything about us at Turin, so we were again sent on – this time to Genoa – and arrived there about midnight. Again we were not expected, so were taken to No.11 General Hospital to be kindly received and housed until quarters could be found for us.
There was one General and two Stationary Hospitals at Genoa. The first in a large hotel, the others in schools. Two of them already had patients and the other was being put in order. As there was no heating in the hotel, the building was intensely cold; it was, however, a very fine hotel with a marble staircase and beautiful baths, though at the time the baths were of little use, as there was no hot water. In the schools were some stoves which the patients thoroughly enjoyed. Later on we had an Infectious Hospital at Genoa, also a very nice hostel for sisters coming from the United Kingdom or moving about the country.
Although the weather was very cold, there was often bright sunshine by day. Shortly after I arrived I went to Arquata (which was the Base), where there was a nice little hospital close to the railway. The building had originally been a wine factory, and was compact and workable. The nursing staff consisted of the matron and sisters, who were attached to the Artillery unit, and who had been in the retreat. They had lost all their kit and possessions, and were spending their off-duty time in making cotton dresses out of grey material purchased in the village.
Arquata is a most beautiful spot, standing very high and surrounded by mountains. There was deep snow on the ground that day, and it was not at all certain that we would be able to cross the pass on our return journey. In spring and summer Arquata was a perfectly ideal spot, and the wonderful wild flowers there were a constant joy to us, while the sunsets were both grand and impressive.
Shortly after, I journeyed north to Cremona, where there were two Stationary Hospitals, both in schools. It was when arriving in Cremona in the early hours of the morning – on account of a bad breakdown with the car – that we were received by an Italian soldier who spoke English with a very strong Glasgow accent. He was employed as interpreter at the Sisters’ Mess. He had been born and brought up in Glasgow, where his father, an Italian ice-cream vendor, had married a Glasgow woman; but the Matron explained that he was not of great use as an interpreter as he hardly knew any Italian. There was deep snow on the ground, and it was snowing hard when we went round the hospitals later in the day. A large convoy was arriving at the station, and every one was very busy. The hospital was full, and there were beds in all the corridors.
In these hospitals there was a great deal of Italian hospital equipment (they had been used as hospitals previously by the Italians) which had been left for us. The beds were of several different patterns – some folded up lengthwise when not in use and had canvas laced on instead of wire springs, somewhat to our old pattern beds, but they did not look very comfortable. Fuel was very scarce in Italy in these days, and the buildings with their stone floors were very cold and somewhat damp. The Nursing Staff were drawing Italian rations, as no English rations were then available; they were, however, well fed and sometimes able to obtain butter in the town – which was not procurable in other places.
A few days after my return I went to Bordighera; the drive down from Genoa being most beautiful. The road is by the sea the whole of the way; up steep slopes, round sharp curves, and down steeper hills on the other side; the wonderful blue Mediterranean Sea being always in view. I have gone down that road on dull days; on may sunny days; by moonlight; and when the sun was setting; and each time thought it more beautiful than the last. There are groves of pine and olive trees, and wonderful gardens where roses and carnations grow, also plantations of palms. It is said that a shipwrecked sailor who was rescued and landed at Bordighera took as a thanks-offering palm leaves to St. Peter’s at Rome, and ever since then palms are sent to St. Peter’s from Bordighera for Palm Sunday. There is an ever-constant change of view as you go along, and quaint little villages where the inhabitants can be seen at work, making pottery, drawing in fishing nets, or building boats. At Bordighera it was warm and sunny, with a profusion of roses, mimosa, and heliotrope, to greet one. No one wore great coats, so that we felt rather ridiculous in our fur coats and the warm clothes so necessary at the time of the year in the North.
There were two large General Hospitals at Bordighera situated in six hotels, also some under canvas. They were exceedingly nice and the wards were always bright with flowers. Some of the hotels had nice gardens so that the patients could have their beds taken out in the sun, and those who were well enough used to go and sit by the sea. The Casualty Clearing Stations were right up in the forward area. There were no sisters with the Casualty Clearing Stations at the time of my first visit, but they were sent shortly after. The General Headquarters was at Padova at that time, and we drove from Padova to the Casualty Clearing Stations. It was a wonderful run on exceedingly good roads. Most of the roads, however, had a ditch on either side which proved a pitfall for many of our cars, transport waggons, etc.
New Year’s Day, 1918, was passed at Padova. The night being spent at the hotel – a dreary and dreadfully cold place – the people had no fuel by which to heat the hotel, and even cooking was a great difficulty, as was also food. They had three meatless days at Padova each week – we hit upon one of them and dined in one corner of a large cold dining-room. Most of the night was spent in the cellar as the place was being bombed. We were politely informed that as they had only one charcoal fire for everything, we could not be supplied with both coffee for breakfast and hot water to wash in, but must forego one or the other. We chose the coffee – hoping to wash in the water that was in our hot bottles – this hope, however, had to be abandoned as on pouring out the water it was evident that it had been used for washing the dishes in from the previous night’s dinner.
The scenery right up by the mountains was magnificent. Later on in the summer, one of the Casualty Clearing Stations was moved to a wonderful shooting box standing on a hill, looking across to the Austrian mountains. The shooting box was used as the officers’ hospital for Casualty Clearing Stations and a beautiful hospital it made. Some of the rooms had wonderful embroidered silk hangings. The sisters’ quarters were on the top floor, and were very compact; they had a kitchen and a delightful mess room with the most wonderful views right over towards the mountains. There was also a very beautiful garden with quantities of flowers.
At the camp outside Taranto there was a large General Hospital. It was in the process of reconstruction at the time I was there, the Nissen huts were being replaced by brick huts with verandahs and tiled floors. The Sisters had good quarters with rooms opening out on to a verandah and a nice large mess room. There was also a hostel at this hospital for nurses passing to and fro from the East. As a large number of nurses were accommodated in this hostel, the post of Sister-in-Charge was a very responsible one. Large parties frequently arrived at very short notice, but they always met with a hearty welcome. I remember one sister telling how she remembered being one of a large party who arrived late one Christmas Eve, and how surprised they all were to find that a Christmas dinner was forthcoming for the whole of the party. The staffs of the Scottish Women’s hospitals, lady doctors and others, shared the hospitality of the Taranto hostel with members of our own services. In Taranto there was a Nurses’ Club, run by the British Red Cross Society, which was a great boon to those nurses who had to spend some time at Taranto waiting for boats.
There was a very nice little hospital at the Rest Camp at Faenza. It was situated outside the town, which was a quaint old place. From a hill close to the hospital, a most wonderful view of the surrounding country and some very beautiful cypress trees, could be obtained. At Turin there was a small hospital which was taken over from the British Red Cross Society. It had been equipped privately and used as a women’s hospital before it was given to the British Red Cross Society. Originally it had been a private house and additions had been made to it. There was a nice garden and the part that had been intended for sick officers was used as a convalescent hospital and hostel for sisters passing through. Later there was a small hospital at Fiume, where the nursing staff had an exciting experience when the British Forces left the town in September. The hospital had to be evacuated hurriedly, the most serious cases being put in an ambulance, while the nursing staff and convalescent patients had to walk a distance of several miles to Abbasia, where the patients were put into an Italian hospital and the sisters in a hotel till they could rejoin their headquarters. The hospitals at Taranto, Faenza and Turin were on the lines of communication to the East, and used for troops passing backwards and forwards, not for the Italian Expeditionary Force.

The Diary

Three months since the last entry - where on earth has that time gone? I've bee working fairly hard, and with the addition of Christmas have found that I had to give something a miss - hence, no Blog. So, an update.
In September I finished the transcription of the official war diary of the Matron-in-Chief, France and Flanders, the original document being held at The National Archives in class WO95. Many unit war diaries run to a couple of hundred pages at the most, but this is a truly massive document, with more than 3,600 pages and over a million words; perhaps it can be more easily understood as the length of about 13 average length novels joined back to back. There are not many official documents which outline the day-to-day life of nurses in France during the Great War, and this certainly seemed a great opportunity to make available information about the workings of the nursing services during the period. Publication in book form rapidly became a non-option; unless it was stripped and edited within an inch of its life, it would remain an unwieldy beast, and such an editing process would veer completely away from my original intention of making even the 'boring bits' available to all, leaving just its skeleton behind.

So I decided to put it online on my Scarletfinders website (link on the right-hand menu) and began the process of turning my Word document into web pages. Unfortunately this isn't a simple job of cutting and pasting from one into the other, but I've managed to work at a steady rate and am currently working on June 1917, so nearly three years down and a couple more to go. From the beginning of 1917 the content of the diary expands massively, so three years of the diary isn't even half the work, and it means a great deal more to come, but on the whole I'm happy with the way it's going. I've already received quite a few emails from people who are finding it interesting/helpful, and I hope it will become a useful resource for all sorts of different reasons. But if I am a bit quiet here, it's just a sign that I'm usefully occupied elsewhere!