Our Hospital ABC

T are the Tents whos inmates maintain,
They are fine healthy places in spite of the rain

Several years ago I bought a copy of a book called 'Our Hospital ABC'. Published in 1916, it's a variation on a child's alphabet book, but based on a VAD's life in a military hospital. All the illustrations are by Joyce Dennys with verses by Hampden Gordon and M. C. Tindall. Joyce Dennys died in 1991, and since then there has been a great surge of interest in her work, and I thought it might be of interest to include a couple of the pages from this small book which is becoming increasingly rare. Some difficulty with scanning has resulted in the image colours not being quite true, and the uniforms are more blue in the original, but they are still a delightful look back at life as it was then.

N are the Nurses, the right sort of wenches,
To look after the lads who are back from the trenches

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

Military Medals

In June 1916 the Royal Warrant for the Military Medal was amended so that women could also be eligible for the award. Since 1883 the Royal Red Cross had been awarded to nurses for outstanding acts of bravery and devotion to duty during the course of their work, and was much revered by the profession as a reward for services above the normal call of duty. However, during the Great War the RRC was separated into two classes, 1st class (RRC) and 2nd class (Associate or ARRC) and was issued by the thousand to women who although engaged in some way in the nursing of sick and wounded soldiers, were not necessarily trained nurses. It became an anomaly that due to a 'quota' system, the untrained Commandant of a forty-bedded Red Cross Hospital could receive the RRC for running her small unit efficiently, while the Matron of a 2000-bedded British General Hospital who was working sixteen-hour days on the Western Front went without. When nursing sisters and other women workers in France and Flanders became increasingly subject to the dangers of German air-raids and shelling, many of them showed the most outstanding bravery and disregard for their own safety in order to protect and care for the patients in their charge. The amendment of the Royal Warrant extending the award of the Military Medal to women provided a prestigious alternative to the Royal Red Cross, and one which would recognise a small group of women who had acted with great courage under fire.

During the Great War 135 Military Medals were awarded to women, both civilians and those working in military hospitals. Fifty-five of those awards were to members of Queen Alexandra's Imperial Military Nursing Service and the Territorial Force Nursing Service, and I've recently put details of these women, with citations for their awards, on the Scarletfinders website. The citations are those written by the officer responsible for submitting the names for consideration, and vary in their content and descriptive quality, but give an excellent picture of the magnificent work and outstanding actions of nurses during the normal course of their work during the Great War.

The pages can be found by following this link:

Scarletfinders - Military Medals awarded to members of QAIMNS and TFNS

Training Hospitals 1902

As I've got an enforced period of sitting at home at present, I've had some time to go through documents I've found, and re-read some of those I'd forgotten about. When QAIMNS was formed in 1902, it was planned to improve its exclusivity by only accepting applications from women who had been trained at the best hospitals in the country. In the event it soon became obvious that this method would never provide enough applicants, and the rules were rapidly relaxed, but this extract from the minutes of the QAIMNS Nursing Board that year gives the list of preferred institutions - I wonder what a similar list would look like today?

The National Archives WO243/20
Minutes of Nursing Board, Queen Alexandra's Imperial Military Nursing Service 1902

List of approved hospitals and training schools
The Board has at its disposal information concerning hospitals with accommodation for about 100 patients and upwards in the UK and British Dominions, in which training for nurses is provided. It has come to the conclusion that the training in these institutions varies greatly, and also varies from time to time in individual institutions. In many of these institutions it is clear that the training provided for nurses is not of the standard which should be recognised for the purposes of the QAIMNS.
The Board concludes that it will not be advisable at present to draw up a definite list of hospitals and nurse training schools, but for convenience of the Board it recommends that the Nurse Training Schools attached to Schools of Medicine in the UK should for the present be recognised for the purposes of QAIMNS. In the case of nurses applying for admission from other training schools, the application of each nurse should be specially considered by the Nursing Board and recorded in its minutes.
List of approved institutions:

England
Metropolitan
Charing Cross Hospital
Guy's Hospital
King's College Hospital
The London Hospital
Middlesex Hospital
Royal Free Hospital
St. Bartholomew's Hospital
St. George's Hospital
St. Mary's Hospital
St. Thomas' Hospital
University College Hospital
Westminster Hospital

Provincial
Birmingham General Hospital
Birmingham, The Queen's Hospital
Bristol General Hospital
Bristol Royal Infirmary
Addenbrooke's Hospital, Cambridge
Cardiff Infirmary
Leeds General Infirmary
Liverpool General Infirmary
Manchester Royal Infirmary
Newcastle-on-Tyne Royal Infirmary
Radcliffe Infirmary, Oxford

Scotland
Aberdeen Royal Infirmary
Dundee Royal Infirmary
Edinburgh Royal Infirmary
Glasgow Royal Infirmary
Glasgow Western Infirmary

Ireland
Belfast, Royal Victoria Infirmary
Dublin, Adelaide Hospital
Dublin, Mater Misericordiae
Dublin, St. Vincent's Hospital
Dublin, Sir Patrick Dun's Hospital
Dublin, The Richmond Hospital

Dear Father revisited

I've written previously about the social status of members of the 'Regular' QAIMNS service, and in June I commented this extract from a book by Penny Starns:

'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'

Doubting that most of these women were the daughters of army officers (there were definitely no wives or widows after 1902) I've now done a little more work on the profession of the fathers of those women who joined the service between its inauguration in March 1902 and the outbreak of the Great War (August 4th 1914).
There were 495 women who were appointed to Queen Alexandra's Imperial Military Nursing Service during this period, and I've fitted them in to one of fifty-eight occupational categories. As I have worked from the applicant's own description of her father's profession, there are varied descriptions of what is likely to be a similar job. For instance, I've used 'Minister of the Church' to include 'clergyman', 'clerk in holy orders', 'Weslyan minister' etc., and similarly 'Merchant' encompasses a multitude of trading - yarn, silk, gold and silver, corn, iron, wine, granite etc; the list is very long, but does not include shopkeepers, who were not very numerous in the list.
I found that of those fifty-eight categories, the top five accounted for half of the 495 women, and the top ten covered 350 in total - here are the top five:

Minister of the Church - 60
Farmer - 57
Merchant - 49
Army Officer - 46
Doctor/Surgeon - 35

There is no bottom five as such; twenty-three fathers have a profession unique to the list, and they include a museum curator, lithographer, a public analyst, the manager of a salmon fishery and a Writer to the Signet (I'll leave that to Google!).
This is a rough and ready appraisal, but certainly shows that there was considerable diversity in the background of QAIMNS nurses which probably veered rather more to peace and love than to war.