Page 64 - QARANC Vol 20 No 4 2023

64 The Gazette QARANC Association
What makes an army nurse?
Dear Gazette,
I’m afraid that I must take you to task regarding some errors in your article about the Museum of Military Medicine in the Spring edition of the QARANC Gazette in which you imply that there were no army nurses before Florence Nightingale and the Crimean War. This is a constantly uttered fable that is clearly mistaken.
Prior to leaving the service, some 28 years ago, I worked with others to establish formal recognition of military nursing as a distinct specialty within the nursing profession through academic and fact-based research and debate.
I served for 31 years as a nurse in the Army Medical Services, leaving the Corps as its last single-service Director of Studies and Matron of the Cambridge Military Hospital. Afterwards, following which I served for more than 14 years as a trustee of the Museum, gained a PhD on the history of army nursing and published extensively on the history of military nursing, including Justice to the Maimed Soldier, 1642-1660 and Hospital Care and the British Standing Army, 1661- 1714 wrote, both of which are on the museum’s library shelves.
With Major Gary Searle, I wrote the Corps’ centenary publication Sub Cruce Candida in 2002 and have lectured as a Research Fellow at Oxford, Leicester and Birmingham Universities as well as overseas, working alongside Captain Peter Starling, I assisted in producing many of the exhibits on show in the Museum today.
Having correctly stated that military hospitals were established during the English Civil Wars, you write that “however military hospitals in the English Civil Wars employed nurses, though not regarded as military nurses, so that the Museum takes its story back that little bit further”.
In fact, nurses were employed in parliamentary military hospitals from the start of the war and continued so employed for some 15 years until the Restoration of the Monarchy. We know the names of the ward sisters working in the two army hospitals in London, the throughput of patients on their individual wards as well as the overall number of junior nurses so employed.
In 1689, when King William III took an army to Ireland and established both mobile and static military hospitals, each with an official establishment that included twelve nurses.
Later, at the conclusion of the Nine Years War (1690 to 1699), when the Physician General and Apothecary General returned to England, Joan Headley, described as a ‘nurse to the hospitals’ accompanied them. As the only ‘nurse’ listed in this group of senior medical staff, it is likely that she was the hospitals’ senior nurse or matron.
Documents from the time of the Duke of Marlborough’s wars against France between 1702 and 1714, list the wages paid to ‘nurses to attend the sick and wounded’ with a senior nurses appointed to supervise their work. Additional documentation lists the number of nurses caring for patients in each of the army’s hospitals then established across Europe.
In 1740, when the Earl of Stair was discussing the medical organisation to accompany his army during
I served for 31 years as
a nurse in the Army Medical Services, leaving the Corps as its last single- service Director of Studies and Matron of the Cambridge Military Hospital.
the War of the Austrian Succession, he studied Marlborough’s hospitals’ establishments and decided that a similar arrangement was to apply, including the appointment of nurses and matrons. Much the same structure was adopted during the Seven Years War (1756–1763) with nurses employed within both mobile and static hospitals.
In 1793, during the Revolutionary and Napoleonic Wars, a permanent static hospital, the York Hospital, was set up in Chelsea close to the Royal Hospital. This establishment continued as the army’s prime receiving hospital until the mid-1820s employing a cadre of permanent nurses. Other army hospitals followed suit.
Despite this you reiterate Museum Director Jason Semmens’ comment that “women weren’t really employed as nurses as such until the 19th century” and then proceed to skip over the ensuing 200 years until the 19th Century when, you claim, “the Army Medical Departmentgotorganisedproperlyforthefirsttime”.
However, in 1824 there were severe reductions in the armed forces following the end of the Napoleonic campaigns. The Secretary at War decided that, to preserve established military posts, there was to be no further employment of female nurses in military units. The result was an almost universal absence of female nurses in military hospitals from that point until the outbreak of the Crimean Wars.
At Fort Pitt in Chatham, the army’s main hospital and training post for newly entered military doctors, this resulted in generations of military doctors entering the service becoming familiarised with hospitals without nurses, just soldiers seconded from their regiments for short periods as orderlies. It is tempting to believe that this situation generated the reluctance of Crimean doctors to accept the arrival of Florence Nightingale in the seat of war.
Your article, in effect, regurgitates the ingrained old chestnut of ‘Florence Nightingale establishing nursing as a profession.’ Yes, until this point, they learned their skills on the job, supervised by experienced nurses in a manner undertaken by student nurses within the NHS prior to the introduction of University Nurse Training in the late 1990s. Nurse registration was not available until 1911. Until then, all nurse training was conducted throughout the kingdom by individual hospitals acting independently with on-the-job training.
In reality the situation of nurse training prior to 1911 was little different to that which had existed within army hospitals since the time of the Civil Wars and was the format in 1902 when the first members of Queen Alexandra’s Imperial Military Nursing Service joined. Having learned on the job, their training had continued to lack a formal system whereby they could achieve a universally recognised standard.
However, this does not imply that such nurses lacked the acknowledged skills of the day and a frequently heard ditty is ‘a few letters after your name doesn’t make a good nurse.’
So, in replying to your article I ask the fundamental question - What makes an army nurse?
Colonel (Rtd) Eric Gruber von Arni, RRC, PhD Swindon, Wiltshire