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EARLY NURSING |
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HOSPITALS |
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WORKHOUSE INFIRMARIES |
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ASSOCIATIONS |
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Many
of the largest hospitals founded in the Middle Ages, were run originally
by monks or nuns. During the 18th and 19th Century many more were founded.
Some of the older hospitals were rebuilt often by private
benefactors, like Thomas Guy. |
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These volunteer hospitals were unable to cope with an increasing population. During this time most people who needed nursing were nursed at home. Those who were not nursed at home ended up in workhouses, with primitive wards, for the sick and infirm. Many of them would never recover and spent their lives there. The wards would be full of old, unwanted insane, alcoholic and dying. The sick could not be cared for properly, as there were no facilities for training nurses. |
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On the continent of Europe, there was a strong Roman Catholic influence, with nuns and sisters of Mercy to administer to the sick and dying. |
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King`s College Hospital had founded the Nursing Sisters of St. John the Divine in 1848. St Mary`s Convent was built in 1896, in the gardens of the old Corney House, part of the Duke of Devonshire`s Estate at Chiswick, which was bought from him for £2,700. It established St John`s House as a training institute. |
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In 1854 a number of nurses were recruited to go to the Crimean War by Florence Nightingale |
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The Kaiserwerth Institution had started 1833, Theodore Fliedner and his wife Caroline Bertheau, placed a bed and a chair in a Summer House in their back garden, converting it into a refuge for a single destitute discharged prisoner. By 1851 the small bed in the Summer House had grown. It included a hospital with one hundred beds, an infant school, a penitentiary, an orphan asylum and a school for training school mistresses. The beds, furniture and other equipment were donated by local families. It was staffed by 116 deaconesses of who 94 were `consecrated` by a `solemn blessing in the church without vows of anykind`. Their vocation was to be the servants of Christ, the sick and the poor. They were expected to work and study for five years. Twenty seven of the consecrated deaconesses were permanently at Kaiserwerth and sixty seven were sent out to other parts of Germany. Life for staff at Kaiserwerth was Spartan, and they worked rigorously hard. They had ten minutes for each meal, and had to rise at five. They had to wear a uniform which was a plain blue gown, white apron, large white turned down collar and a white muslin cap which was tied under her chin with a bow. |
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A candidate entering the Institute could choose to train as a teacher or a nurse. A candidate choosing to be a nurse would go onto the surgical and medical wards. A candidate choosing to be a teacher went for training at the kindergarten school. Both nurses and teachers were taught general housekeeping tasks such as cooking, sewing and cleaning. They were also given lessons in book-keeping, letter writing and reading aloud to patients. No one was paid, but were given free board and adequate clothing. |
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In 1849, Fliedner decided to establish branch houses abroad. He travelled to Pittsburgh in America, then to Jerusalem, founding a `Mother House` on Mount Zion in a building presented by the King of Prussia. He also established branch houses in Constantinople, Alexandria, Beirut, Smyrna and Bucharest (there was already a home in London), Fliedner had met Elizabeth Fry, in London, he had visited her Institute of Nursing in Newgate. She was the third daughter of a Quaker Banker, John Gurney of Earlham near Norwich. She had married Joseph Fry in 1800. Her interest was in the conditions of Women prisoners in Newgate, travelling around Britain visiting prisons. In 1820 she founded a shelter for homeless people in London, she died at Ramsgate on October 12th 1845. |
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In 1859, Mr William Rathbone of Liverpool, founded District Nursing, which he funded himself. He began in his own district with one trained nurse, a Mrs Robinson (she was the former private nurse of his late wife). The idea had come to him when his wife was ill, and he employed a nurse to look after her. He knew what a comfort it was for her to be nursed at home. |
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It was the fact that their was a shortage of trained nurses, that he wrote to Miss Nightingale asking her for help. She suggested that the Royal Liverpool Infirmary should be approached regarding the training of District Nurses. Mr Rathbone financed a nurse`s home built near Liverpool Hospital. Nurses were to be trained for both hospital and district nursing. He sent two ladies; Misses Merryweather . To St Thomas`s as observers. Under the Merryweather Superintendence nurses were trained to work in the Liverpool Royal Infirmary and the eighteen districts which Liverpool was divided, with a nurse working in each. |
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Manchester and Salford followed on similar lines in 1864, and Leicester in 1867, while the East London Nursing Society, the first in London, was formed in 1868. In the same year "The London Biblewomen's and Nurses' Mission" was founded by Mrs Ranyard. Birmingham appointed its first nurse in 1870; Glasgow the pioneer of district nursing in Scotland, in 1875; and other towns about the same date. |
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Mr Rathbone`s district nursing was spreading to London. Miss Nightingale was unable to spend much time of District Nursing, although she had constant correspondence with Mr Rathbone. She felt that their had not been enough information to prove if a District Nursing Association was necessary. Miss Nightingale had a questioner printed to look at the current home nursing practises by various sisterhoods, religious organisations and other nursing associations. |
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The results of this survey appeared `The Report of the National Association for providing Trained Nurses for the sick poor |
There were 26 District Nursing Institutions in London which included: |
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Only 11 of the 26 Institutions provided trained nurses. |
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The foundation of the Metropolitan and National Nursing Association in London in 1874 gave a fresh impetus to the work of district nursing, and raised the standard by demanding higher social and educational qualifications in the nurses employed. It was initiated by Order of St. John of Jerusalem, and Miss Lees (Mrs Dacre Craven), who had made a full enquiry into the conditions of nursing in London and Provincial towns, was appointed Superintendent of the Home, which was established at 23 Bloomsbury Square with the funds gathered through an appeal made by Miss Nightingale and Mr. Rathbone. This Association was the first which undertook to give nurses already trained in hospital the special district training necessary for their work. The probationers would serve an initial month in the Central Home, then trained in the hospital for a year then returning to the Central Home for specialised training. |
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Miss Nightingale felt it was important that District Nurses should be aware of the importance of their work. She was not there just to give gifts, but teach cleanliness and nursing. In 1882, she discovered that the District Nurses at Holloway near Lea Hurst her Derbyshire home, were taking paying patients, instead of doing their work. In 1876 she had written a pamphlet `On trained Nursing for the Sick Poor`. |
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In 1877 Homes were started in Holloway and Paddington, and a gradually increasing number of nurses began to be employed, until in 1887 Queen Victoria's gracious gift of £70,000 (part of the Women's Jubilee Offering) for the furtherance of district nursing consolidated the work and raised it from the sphere of individual effort to that of a national institution. A provisional Committee was formed including the Duke of Westminster, Sir Rutherford Alcock, and Sir James Paget, with whom were associated Mr William Rathbone and Mr Bonham Carter as Hon Secretaries; and it decided: |
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By the Royal Charter which in 1889 incorporated Queen Victoria's Jubilee Institute for Nurses, a link was formed with the ancient foundation of St. Katherine's Royal Hospital, and the offices of the Institute were within its precincts till 1903, when this accommodation became too limited and larger premises were taken at 120 (and later at 58) Victoria Street. In 1904 a supplementary charter was granted by King Edward VII, by which Queen Alexandra, became Patron, and the official connection with St Katherine's Hospital came to an end. |
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The pioneer of county nursing was the Rural Nursing Association which was started in the West of England in 1888 by Mrs Malleson, and the first County nursing Associations were those of Hampshire, founded in 1891, and Lincolnshire in 1894. These owe their inception to the increasing need for nurses and midwives in country district and their main objects are to provide improved means of nursing in their own homes those who are unable to employ a private nurse, and to supply certified midwives, by: |
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When a midwife settled in a district it was found that the whole population turned to her for advice and assistance in all cases of sickness. It was, therefore, not only desirable but very necessary that, in addition to midwifery training, she should be given instruction in elementary sick nursing, hygiene, the care of young children and similar subjects, and this was taken in hand by County Nursing Associations, with Plaistow as the chief training Home. The women selected for training as "Village Nurse-Midwives" were generally those belonging to the county in which they were to work. They were sent to areas where neither nor funds would permit of fully trained nurses being employed, or to work as assistants to Queen's Nurses. They carried out their duties under the close supervision of Superintendent who was herself a thoroughly trained and experienced Queen's Nurse. |
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In 1877 St Bartholomew`s School opened, it had been arranged by Mr Bonham Carter that Sydney Waterlow chairman of Governors should make arrangements for a Nurses` Home and for probationers to receive lectures from Mr Dyce Duckworth. Miss Machin was to be superintendent with Helen Blower as her assistant, seven other Nightingale nurses were to join them. Miss Machin lengthened the training to two years, but was not happy as St Bartholomew`s and resigned in 1880. She was replaced by Ethel Manson from the London Hospital in 1881. The Nightingale influence at St Bartholomew`s had come to an end. |
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A superintendent had to be found for St Mary`s out of 32 candidates, Rachel Williams from Edinburgh was successful. She took up her duties in October 1876. She was concerned before she went to St Mary`s about night nursing and general lawlessness at night. Miss Enderby went with Miss Williams as assistant, and seven other Nightingale nurses. There first few years were not easy. In 1877 she dismissed a sister and a fuss was made about it Dr Broadbent put a complaint before the Committee about Miss Williams. An enquiry was drawn up, Miss Williams had 16 probationers in 1880, but there was no training school with lecturers until 1885. This was when Miss Medill from the Middlesex took over. Miss Williams last few years were not happy, she had a dispute about her salary and often spoke about leaving. There was an attack on her again by Dr Broadbent, in the end the Committee asked for her resignation (23rd January 1885). |
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Miss Nightingale felt that military and civil hospital design was wrong, therefore making nursing inefficient. Patients suffered through lack of ventilation and drainage, infection spread with speed. In Paris she had learnt hospital construction in separate units, each unit complete with kitchen and laundries etc. Each unit was well ventilated, light and airy. In October 1858, she put her ideas into two papers, read to the Social Science Congress at Liverpool. Early in 1859 the paper were expanded and published in book form as `Notes on Hospitals`, which consisted of 108 pages. Miss Nightingale received many plans for new hospitals from many British cities and boroughs. The Government of India and the Queen of Holland also sent plans. She also gave advice to the King of Portugal for a new hospital in Lisbon. The only problem was that he had omitted to tell her that it was a children`s hospital, so she had to amend the plans. |
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ST THOMAS'S - LONDON |
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St Thomas`s was founded in 1213, making it one of the oldest foundations in the country. It was established as an `almery` in connection with the Catholic Priory of Bermondsey. Later poor people were allowed in, many never left, they lived and died there. It was surrendered to Henry VII, during the dissolution of monasteries. At that time it had forty beds for the Poor, it was later enlarged and opened as a medical hospital for the poor, under the patronage of Edward VI. During the Reformation it was used as a military hospital. St Thomas`s was improved in 1732, and had a grand entrance from Wellington Street. Wards at this time were under the care of an untrained sister helped by two or three rough nurses. |
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Although Miss Nightingale was often asked for advice, it was not always acted upon, with enthusiasm, as in Winchester. A new hospital was to be built to replace the existing one in Parchment Street. Miss Nightingale was well known in Hampshire, her father was a hospital Governor. She felt that she would be able to urge the hospital committee to a `new construction`, but she was rebuffed. The Medical Staff did not want to move from the old site of the hospital and discussion continued until early in September 1861. A notice was sent out to all members of the Infirmary Committee requiring their attendance, at the special meeting to appoint a sub-committee to consider adapting the present building or the erection of a new hospital. |
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The sub committee met on the 18th September 1861, and recommended the adoption of Rawlings report, that is a new building. |
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Sir William Heathcote was appointed the chairman of the building sub-committee. In February 1862 the Medical Staff were `ordered` to consider extracts from Miss Nightingale`s `Notes on Nursing` - concerning absorption by wall floors etc., of dangerous, absorbed organic matter` Miss Nightingale`s father was occasionally present at the full meeting of the Infirmary Committee. |
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Sir William Heathcote`s committee was powerful with Lord Eversley, Lord Ashburton, Archdeacon of Winchester, Henry Compton from Lyndhurst, Melville Portal, John Bonham Carter and William Barrow Simmons, but its efforts were unlikely to prosper with Miss Nightingale`s advice. |
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In 1855 the number of sick returning from the Crimea was increasing, there was a need for more hospital accommodation. In March 1855 Sir John Burgayne, Inspector General of Fortifications was instructed by Lord Panmure to appoint an Officer to find a site for a new military hospital to accommodate one thousand patients. Captain R M Laffan was appointed, he was to find a site by the sea to give access to hospital ships returning with patients from foreign wars. He decided the site at Netley was suitable, and on 3rd January 1856, 109 acres of land was purchased from the owner Mr Thomas Chamberlayne for £15,000. In June a contract was drawn up for Mr George Myers of Lambeth to build the hospital from the plinth up, and Mr Page of Southampton to lay out the roads and the ground around the hospital. |
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On 19th May 1856 Queen Victoria laid the foundation stone, under which was a copper box, containing the plans of the hospital, coins, a Crimean War Medal, and the first Victoria Cross. |
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By the time Miss Nightingale returned from the Crimean in August 1856, building work on the hospital at Netley was well underway. After meeting with Lord Panmure at Balmoral in September he agreed to send her copies of the plans. She did not agree with them at all she favoured a hospital which was made up of a separate Pavilions, linked together with covered passages, giving the most light and ventilation. Netley was to be a long building with a corridor running the whole length. Miss Nightingale met with Lord Palmerston at Christmas and explained the reason for her concern of the design of the hospital. He spoke with Lord Panmure and asked him to stop the building work. Lord Panmure explained that £70,000 had already been spent on building work, and how would Lord Palmerston explain this loss to the House, With much correspondence going between them Lord Panmure finally agreed to make improvements, but total reconstruction would be impossible. |
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Little improvements were made, corridors were given windows, and ward windows onto corridors were enlarged. The result was a hospital which stretched 1,400 yards, along Southampton Water. In the centre of the building was the Chapel which separated the two wings. To the rear of each wing were the two courtyards surrounded by barrack rooms and stores. Also the kitchen with dining rooms above for the more mobile patients. The Building stood three stories high. |
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The Nightingale Fund had been approached to supply nurses. There had been correspondence between the Fund and the War Office about adapting the building, to find suitable quarters for the nurses. Miss Nightingale felt that the choice for nursing staff for a military hospital should be done carefully and that preference should be given to widows of army surgeons and officers. It was also felt that there should be as few female staff as possible, and that a nursing sister should never do what could be done by an orderly. |
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Mrs Jane Shaw Stewart (Lady) had been asked to be Lady Superintendent at Netley by Miss Nightingale, at first she would not agree, but after some persuasion she did. Mrs Jane Shaw Stewart (Lady) had gone to the Crimea with Mary Stanley, and was an experienced nurse, having spent some time at St Thomas`s as a pupil of Mr Whitfield studying surgical nursing, she took up her post in 1862. |
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The Governor was Major General Wilbraham, he and Mrs Shaw Stewart did not always agree. Captain Douglas Galton became Assistant Under Secretary at the War Office, and an intermediary between Major General Wilbraham and Mrs Shaw Stewart. Mrs Shaw Stewart did not mingle with the Doctors, she had a temper which at times was uncontrollable and it was said he hit her nurses. For all her personal faults there could be no criticism of her nursing and moral tone. Wilbraham could stand no more of Mrs Shaw Stewart, and at the end of May 1868 an enquiry was set by the War Office and held at Netley. The tribunal consisted of Dr Sutherland, Dr Beaston and General Hay and lasted from 29th May until 9th June. The outcome was that Mrs Shaw Stewart was forced to resign. |
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Mrs Jane Deeble was the next choice to take over from Mrs Shaw Stewart. Mrs Deeble was 40 years old, and a widow of an army surgeon who died at Abyssinia. She had three children, and an army pension of £140 |
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Six nurses were chosen by Mrs Wardroper to go with Mrs Deeble to Netley they were; Mrs Rebecca Strong, Jane Kennedy, Jessie Lenox, Lucy Emm, Lucy Wheldon and Ann Clark. They were unable to leave for Netley until accommodation was provided for them. |
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Mrs Deeble and her party were ready to leave for Netley in October 1869, but in September the War Office said that the alterations were not completed. They suggest that a temporary arrangement could be made. Mr Bonham Carter wrote to say that no nurses would be sent until secure accommodation was provided. He also suggested that the War Office should be responsible for paying for the nurses from October. The War Office promised that the alterations would be finished by October. |
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The Fund had more or less drafted the Regulations for the Royal Victoria Hospital, Netley. It contained a clause that the Superintendent would be responsible to the Secretary of State, she would have the power to dismiss sisters, but the reasons had to be reported. |
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It was felt by Miss Nightingale and Mr Bonham Carter that Mrs Deeble should do her own staff selection. Mrs Deeble felt that if she was to choose her own staff, she should also be allowed to train them herself. The Fund was against Military hospitals being used for training. |
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In 1871 Mrs Deeble wrote that the work was becoming heavier, due to the turnover of staff and the sickness rate. Lucy Emm had been dismissed and she was looking for a replacement. Sisters Clarke, Kennedy and Strong had all been ill. Miss Nightingale had predicted illness due to the hospitals poor site, and dampness. |
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Relations with Mrs Deeble and the Fund were not good. Mrs Deeble kept three of the original sisters, also Emma Berry who had been sent by Mrs Wardroper. It seemed as if the Nightingale connection with Netley was becoming slowly to an end. Miss Torrance was sent to advise Mrs Deeble, who had kept the support of the War Office. |
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During the Zulu War in 1882, Mrs Deebles took fourteen nurses to South Africa, eight to Petermaritzburg, and herself and the rest to Addington. Sister from Netley later served in Egyptian campaigns, including the Sudan War. Gradually nurses trained at Netley under Mrs Deebles were found at the Herbert, the new Cambridge Hospital, Devonport and Malta. |
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Mrs Deeble had persuaded Sir Thomas Longmore of the Army Medical College that Netley was the only place capable of training army nurses. Miss Nightingale was not happy about this because she felt nurses should be used from St Thomas`s, she could not persuade the War Office, and they recognised Netley as the main recruiting base, and should be used for training army nurses. When in 1882 Mrs Deeble was asked by the War Office to take nurses to Egypt, Miss Nightingale was annoyed. She wanted to take action, but was advised not to by Sir Harry Verney. Mrs Deebles wanted to take Mrs fellows who had trained at the Nightingale School. Miss Nightingale made sure that it was not only Mrs Fellows she took, as she did not want to be seen to be dictated to by Mrs Deebles. In the end Mrs Deebles did not go and was replaced by Miss Helen Norman, who had trained at St Mary`s by Rachel Williams. Miss Norman was accompanied by Misses Solley, Airy, Winter and Mrs Fellows. The campaign was short. In December Mrs Fellows and Miss Solley asked to come home. Sybil Airy stayed and nursed in a military hospital in Cairo. |
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In 1889 Mrs Deebles retired, the War Office had proposed to reduce her army pension by £90 a year. Letters were written on her behalf by Mr Bonham Carter to no avail. So Sir Harry Verney went direct to Lord Northbrook, and the decision was reversed. Mrs Deeble was generally regarded as having laid the foundations for the `Queen Alexandra Royal Nursing Service` Miss Norman took over as Superintendent at Netley. There was a rapid increase in numbers. Under the Patronage of Princess Christian the reserve corps was built up. In 1898 the Army Medical Department was reorganized into the Royal Army Medical Corps. An interest in army nursing had been taken by Princess Alexandra of Wales, she had organised and despatched nurses from London to the seat of War. The Red Cross Medal was initiated, among its first recipients were Miss Nightingale and Mrs Deeble. |
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The Royal Herbert at Woolwich was the first military hospital built on the pavilion plan which Miss Nightingale favoured most. It opened on 1st November 1866. It had been decided that it should be staffed by trained nurses under a superintendent. This would be the first steps to an official scheme of military hospital female nursing. It was therefore important that the right person was found. The only possible candidate was Mrs Shaw Stewart. She took up her post in 1862, but she did not get on well with the governor of the Hospital Colonel Wilbraham. They often quarrelled, Colonel Wilbraham alleged that Mrs Shaw Stewart ill treated her nurses, and struck them repeatedly, even some of the doctors corroborated what he had said. She turned to her brother for help, he was Sir Michael Shaw Stewart who was an MP. This lead to an enquiry at the War Office in 1868. There seemed to be no argument about her nursing or her nurses, only her ability to hold her temper when supervising them. None of the probationers lasted long under her. She eventually resigned. |
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There were no trained nurses at Herberts, and it had lapsed into the old regimental system. After there experience with Mrs Shaw Stewart the Fund was ignored by the War Office. There had been many disagreements between the War Office and the Fund, mainly over the supremacy of superintendent |
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The Regulations at the Herbert were those they had adapted from Netley, but the War Office adaptations were unacceptable to the Fund. A compromise had to be made. The War Office had agreed to pay nursing staff on the same scale as at Netley. They remained adamant that the superintendent would be under the Principal Medical Officer. The Principal Medical Officer was not resident, this meant that the superintendent would not be responsible to the resident Medical Officer for day-to-day nursing matters. |
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At the end of April, the War Office was still not ready to receive nurses. Many of the nurses who were waiting to go to the Herbert had become fed up with waiting and had applied for other positions. The Fund never succeed in altering nursing at the Herbert, there was little improvement until Miss Caulfield from Netley became superintendent. She had insisted on having nurses already trained in civilian hospitals, having proper rules and regulations. Miss Caulfield insisted on the need for army nursing sisters to be `Superior educated persons` so as they might command respect of the soldiery. |
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Miss Nightingale and the Fund never successfully established a military nursing service on the lines laid down in her ` subsidiary Notes.` |
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The parish workhouse in the 17th and 18th century, was either a purpose built building or local houses used for providing employment for the destitute, often a private contractor would look after the parish's poor, who would be employed by him and in return would receive board and lodging. |
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The workhouse infirmaries were often filled with patients from the hospitals who could not be cured. As the local authorities did not want to encourage paupers to laze in bed, the conditions were horrendous. They became so bad that only those who had resigned themselves to death would stay. The usual reason that people ended up in the workhouse was an economic change in their personal circumstances of the family breadwinner, illness and old age. The most vulnerable were orphan and foundling children, and the families of men who had been transported or were in prison, unmarried pregnant girls and the old who were no longer able to earn a living. |
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Although workhouses earned a reputation for strict discipline and cruelty, there were a few good things to be said for them. Men were encouraged to work harder to save their families the disgrace of becoming inmates. There were schools where children up to the age of 14 received rudimentary education. Had they been at home they might have had less to eat and would have foregone any education because of the need for child labour. Some workhouses even had classes of instruction in some trades, some children were apprenticed and others were helped to emigrate. Many of the elderly people at the end of the 19century, were at some time obliged to seek relief. While many ended up in the workhouse, some relief was administered to elderly people in their own homes by the more sympathetic guardians. |
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Usually the infirmary was a freezing cold and draughty room. There were iron beds with thin mattresses, the only furniture in the room. Nurses were usually untrained inmates, mostly over 50. Mental cases were unkindly described as "imbecile", "idiot" and "lunatic" and a survey undertaken in 1858 produced a figure of around 30,000 such unfortunates. Many of these may have been epileptic or suffering from some treatable complaint, and no doubt the surroundings led many to a state of chronic depression and melancholy. Expectant mothers needed the care of the workhouse infirmary and many children were born in the workhouse due to the fact that the infirmary acted as the lying-in hospital for deserted mothers to be, and unmarried pregnant girls. |
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Vagrants often ended up in the workhouse and were known as "sturdy beggars". They occupied a separate "Vagrant Ward ", many came from distant places and were granted food and shelter in return for their labour. Their rooms unheated, their bedding was sparce and they were subjected to a compulsory bath on admission. |
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Usually Masters of the Workhouse were retired Officers and sometimes former policemen. Generally speaking though, workhouse matrons were slightly less unkind than their husbands. There were however, some Masters with a real sense of vocation, sometimes staying in the post for 20 years or more. Porters at the House gate had a kindly reputation and no doubt saw much sadness and desperation in the poor and infirm. tramps and vagrants nevertheless received little of their sympathy. Staff were paid badly,and far less than their counterparts in the prison service. For instance a prison governor in charge of 900 convicts might receive £600 per year, whereas the workhouse Master and his wife, with 600 inmates, responsible for newborn infants, senile lunatics and every other type of person might receive about £80 per year. |
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Separately a Matron`s salary would be £50, for a Chaplain £100, a Surgeon £78 and a Porter £25per year. All worked intolerably long hours with no regular holidays. Sometimes the Chaplain would be non-resident, combining the work with a curacy nearby. His duties would be to read the prayers, preach at least once on Sundays, visit the paupers receiving outside relief when they were sick, and baptise the children. |
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The Clerk of the workhouse was an important person, dealing with the finances and general administration, sometimes these duties were undertaken by the Master. The Master had a great influence on the happiness or otherwise of those in his care, and a kindly man probably turned a blind eye to the harsh rules and regulations. |
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In 1879 Miss Twining, (daughter of a wealthy tea merchant) a Poor Law reformer, set up `The Association for Promoting Trained Nursing in Workhouse Asylums to provide better trained nursing William Bowman, a Fund Council member was on the Central Committee. Miss Nightingale did not always agree with Miss Twining, but much within the Associations aims she agreed with. |
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Mr Boulnoise, chairman of St Marylebone Guardians, approached the Fund for advice on nursing for the new Infirmary they were building in Ladbrook Grove. In May 1881 the Fund agreed to supply a Superintendent and a team of nurses. They would contribute to the expenses of a training school as they did at Highgate. Contributions were not to exceed £200 a year. |
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Elizabeth Vincent was to be Superintendent. Mrs Wardroper was not impressed with Miss Villers, who trained in 1872. She had worked as matron in Lincoln, but had to return home to nurse her sick father. She returned to work for the Fund as Miss Machin1s assistant at St Bartholomew`s. The Medical Officer appointed at the same time was Dr Lunn. |
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Before any nurses went to Ladbrook Grove there was much correspondence between Mr Boulnoise and Henry Bonham Carter about the plans for the new nursing home. Miss Nightingale felt that more bathrooms were needed, better ventilation and a sick room. The Ladbrook Grove Board would not authorise expenditure on nurses not required in running the hospital. The Fund was asked to assist, and they agreed to pay for the cost of probationers, but they would not bind themselves to any specific time. |
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A five year contract was signed with the Fund, requiring each probationer to receive board, lodging, washing and uniform. They would be under the authority of the Matron. |
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Miss Vincent with two head sisters, and seven ward nurses, took up their posts in the new hospital. Gertrude Wyld was training sister until 1887, when she was replaced by Miss Moriarty. |
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In 1883 the Fund sent nursing staff to Paddington New Parochial Infirmary, in due course it opened its own training school. |
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The Fund Councils interest, in Workhouse Infirmaries grew. In 1878 Sir William Wyatt came on to the Council, and in 1889 he was joined by Mr Edward Boulnoise MP, both with long experience for workhouse infirmary reform. |
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William Rathbone had been in correspondence with Miss Nightingale since 1861, regarding District Nursing. He was also concerned about the conditions of workhouse infirmaries. He had been to visit Brounlow Hill Liverpool, where there were over one thousand helpless, aged, mostly incurable people. No women were trained in nursing they were mainly pauper women from the workhouse, many of these were alcoholics and prostitutes. It was therefore that many people would prefer to die in their own homes than go to Brounlow Hill. The food was badly cooked, the stronger of the patients would get the bigger share, the wards were patrolled by policemen. The Infirmary was controlled by he Parish, and although the conditions were appalling, it was the same all over the country. |
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William Rathbone had written to Miss Nightingale, to persuade her to allow nurses to go to the Liverpool Workhouse Infirmary. This was not an easy task as although Miss Nightingale was willing, the Vestry controlled the Infirmary , co-operation was needed. Permission was not granted until March 1865 |
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Miss Nightingale sent Agnes Jones to act as Superintendent. She was the daughter of Colonel Jones of Londonderry. She had spent two years at Kaiserwerth (1860 ` 62), and entered the Nightingale School at St Thomas`s in 1863. On completing her training she went to the Great Northern Hospital. She tried hard to train the workhouse women to become nurses, and even arranged for them to be paid. They failed to learn anything, and could not be trusted to carry out anything without supervision. It was pointless trying to train them, so trained nurses were bought in. By 1868 she became run down (after 3 years at Brounlow). She refused to rest, and caught typhus fever and died (February 19th 1868). |
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In February 1864, an Association was set up for improving Workhouse Infirmaries. The Committee included the Arch Bishop of York, The Earl of Carnavon, Charles Dickens and John Stuart Mills. Miss Nightingale felt that they did not pay enough attention to nursing. Mr Villiers, President of the Poor Law Board, set up an enquiry in July 1865. The Metropolitan Workhouse Bill was drafted, but it fell short of requirements of the reformers. Miss Nightingale and Mr Farnall, Poor Law Inspector for the Metropolitan District, with the support of Palmerston prepared a new draft. |
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Disaster then stuck, on 18th October 1865 Lord Palmerston died, and the Whig Government fell, and with it the hopes of reformers. Charles Villers was also a member of the Whig Government. The Tory administration was under Lord Derby, and Mr Villiers was replaced by Mr Gathorne Hardy. Miss Nightingale wrote to him offering her help. He never met her, or asked her advice, or even wrote to her. He appointed a committee to report on the requisite amount of space, and other matters in relation to Workhouse Infirmaries. Sir Thomas Watson, President of the Royal College of Physicians was Chairman. Miss Nightingale tried to put forward her ideas on nursing, but failed. |
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When the Bill was drafted the advice of Edwin Chadwick, Mills, and Miss Nightingale were ignored. Edwin Chadwick (1801-1890) was a sharp minded north country man who since 1834, was Secretary of the Poor Law Commissioners. In 1842 the `Report on the Sanitary Conditions of the Labouring Population` was published. It reported details of overcrowding, filth, bad drainage, inadequate water supplies, which bought disease, and an early average of death among the, poor, also led to drunkenness, crime, prostitution and vice. The Government set up a commission of inquiry into the `Health of Towns`. Two reports were published in 1844 and 1845, based on enquires into sanitary conditions in a group of large industrial towns. This led to reforms in the 1840`s and 1850`s. The Public Health Act in 1848, setting up central Board of Health Act which contained detailed regulations about sanitation. The Central Board had little real power or money to spend and only survived 10 years, Chadwick was dismissed in 1854 |
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A hospital authority for lunatics and fevers was set up, which left the non-infectious poor sick under the Poor Law Boards Union. Miss Nightingale read Sir Harry Verney's advance copy of the Bill. Sir Harry and other Fund Council members who were MP`s urged for amendments. In the end a clause was inserted that the new hospital should be used for training nurses. |
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The Metropolitan Poor Act became law on 29th March, 1867 the following year the Poor Law Amendment Act gave similar powers to provincial authorities. |
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The main objectives of the Bill was to provide separate accommodation for fever cases and lunatics. The Metropolitan Asylums Board was then set up with the power to build and run hospitals from a Common Fund. It became unlikely that paupers would go either to the fever or the lunatic asylum, to get preferential treatment. The sick Asylums Districts and Poor Law Unions were reorganised and encouraged to build separate infirmaries for non-infectious cases. One of the first Unions to take advantage of the Bill Was St Pancras. It was improved and partly rebuilt, and had sixteen pad non-pauper nurses. |
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The Chairman of the Reform Group Mr Wyatt had decided that a new Infirmary should be built at Upper Holloway, Highgate. He appealed to the Nightingale Fund to help in providing nursing staff for part of the new hospital. During the planning and building of the new Infirmary there were changes in control and the Fund found difficulty in setting up a nursing system. The Infirmary was controlled by the Central London Sick Asylum, and the old Poor Law Board was replaced by a new Local Government Board. |
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Permission was in the end received for a training school for the London Sick Asylums District. There was doubt never the less about the legality of the Matron having the power to select or dismiss probationers without reference to the authority |
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The Red Cross came into being as a result of the war between France and Austria in the late 1850's. There was no medical organisation on either side other than the regimental surgeons. The wounded were left where they lay. The morning after the battle of Solferino, a young civilian Henri Dunant rode up a hill and looked out over the battlefield, and was shocked by what he saw. He then rode to the nearest village and got all the villager to take water, to the wounded, and to dress and bandage them, as best they could. He also arranged for the wounded to be found shelter. On his return home he wrote a pamphlet caused `Un Souvenir de Solferino`, which was translated into a number of languages. In it he described the appalling circumstances in which the bravest men of their countries were left to die. He attended a conference in Geneva, with the representatives from sixteen countries. This established the Geneva Convention, which treated all wounded as neutrals. Following this was the foundation of the International Red Cross, the symbol of which was a red cross on a white background. Each nation agreed to form its own Red Cross society, being affiliated to the Central Committee in Geneva. Its object was `to create international agencies in war time for the relief of victims of war, especially prisoners of war, and to maintain fundamental Red Cross principles`. In 1872 he visited London and read a paper on the work of the Society. His first words were `Though I am known as the founder of the Red Cross and the originator of the Convention of Geneva, it is to an Englishwoman that all the honour of the Convention is due. What inspired me to go to Italy during the war of 1859 was the work of Miss Florence Nightingale in the Crimea.` |
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