Summer Sites: The Royal College of Nursing Library and Heritage Centre

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The Royal College of Nursing Library and Heritage Centre

Royal College of Nursing facade
Image of The Royal College of Nursing buidling by David Hawgood. CC BY-SA 2.0

The Royal College of Nursing’s major London site is located in a smart Georgian building in Mayfair. Members of the public can use the space, consult books and print journals, and access the internet using the free WiFi access. They can also use the computers and printing facilities. The College’s archives and special collections are also available by prior arrangement. Members of the College have full access to on-line journals and a dedicated mezzanine member’s area as well as book borrowing rights.

Image of RCN Library seating and journals area
RCN Library seating in the journals area

In addition to these services, the College houses exhibitions reflecting its important collections concerning the history of nursing. They also hold interesting events ranging from lectures to musical performances. There is also a shop and a cafe. For more details visit the website.

Near to the Royal College of Nursing Library and Heritage Centre:

Drawing room in the Wallace Collection
Drawing room in the Wallace Collection

A short walk away in Manchester Square you can find the Wallace Collection. Located in  historic Hertford House it contains paintings, decorative art and an armoury in a series of beautifully decorated rooms. The collection includes many world famous paintings such as Franz Hals’ ‘Laughing Cavalier’. Admittance is free and it is open seven days a week. The Photographers Gallery in Ramillies Street has fine exhibitions of contemporary photography. On a less cultural note you are very close to the shops of Oxford Street, Regent Street and Carnaby Street.

A sandwich and a cup of coffee?

The Workshop Coffee Company in Barnett Street serves a good flat white. On Wigmore Street is a branch of Comptoir Libanais which is a good place for light Middle Eastern snacks and mint teas. The Wallace Collection has a stylish restaurant in a glass atrium which serves afternoon tea and is worth a visit. Alternatively, the restaurants and cafes of Soho are a short walk away.

Royal College of Nursing Library and Heritage Centre
20 Cavendish Square, London W1G 0RN
(Henrietta Place entrance)
Tel: 0345 337 3368
Website link

Don’t forget– if you cannot make it in to St George’s Library over the summer, there are still many resources that you can access from a computer with internet access (logins may be required). See more information about our online resources.

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Summer Sites: The Wellcome Collection

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The Wellcome Collection

Situated  close to Euston Rail Station and just behind University College Hospital the Wellcome Collection is a hub for research, education and study into Medical and Health Sciences.

The_Wellcome_Building
Facade of the Wellcome Building

The library is loacted within the same building and it is open to all: you simply need to bring personal ID, proof of address and a completed application form (this can be downloaded from the Library homepage at: http://wellcomelibrary.org/using-the-library/joining-the-library/) to the library to join.

Facilities include WiFi, printing, copying and access to online collections of journals and databases. There are also study rooms which can be booked in advance. For further information and opening times see their website.

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‘Napoleon’s toothbrush’: on display in the ‘Medicine Man’ exhibition.

The Wellcome collection is particularly famous for its exhibitions, which are always imaginatively curated and cover a wide range of interesting topics. These are free of charge and can be very popular with the general public so you may have to obtain a timed ticket at peak times such as weekends. There are two permanent exhibitions: ‘Medicine Man’ displays a series of fascinating objects collected by Henry Wellcome including Napoleon’s toothbrush and George III’s hair. The ‘Medicine Now’ exhibition covers more modern medical topics such as genomes.

There is a good shop on the ground floor selling a wide range of books on popular science and historical subjects. It also has an entertaining range of gifts including cuddly bacteria and syringe ballpoint pens.

Near to the Wellcome Collection

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Archeological objects in the Petrie Museum.

The area around the Wellcome Collection is London’s university district and is particularly rich in museums. The Grant Museum of Zoology with its historical collection of specimens gives you the chance to look at the skeletons of lost species such as the Dodo and the Quagga (a now extinct form of zebra). Also nearby is the Petrie Museum which contains an amazing 80,000 ancient Egyptian artifacts, the most interesting of which are on display.  Also close by is one of the most famous museums in the world: The British Museum.

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Entrance hall of the British Museum.


A sandwich and a cup of coffee?

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Speedy’s cafe in Gower Street.

There is a large airy cafe on the ground floor of the Wellcome Collection although it can get crowded. Fans of the television programme ‘Sherlock’ can follow in his footsteps and grab a cup of tea and a sandwich in Speedy’s cafe just down the road in Gower Street. The best coffee nearby however, is to be found in Tinderbox which is on the first floor of the Tottenham Court Road branch of Paperchase.  If all that museum visiting has made you thirsty and you are a real ale/craft beer fan the Euston Tap and Cider Tap now quirkily occupy the small stone buildings on either side of the entrance to Euston station. For the ravenous there is a branch of Brixton stalwart, Franco Manca Pizza, on Tottenham Court Road.

euston tap
The Euston Tap real ale house outside Euston Station.

Wellcome Collection
183 Euston Road
London NW1 2BE
Tel: 020 7611 2222
wellcomecollection.org/

Don’t forget– if you cannot make it in to St George’s Library over the summer, there are still many resources that you can access from a computer with internet access (logins may be required). See more information about our online resources.

Summer Sites: The British Library

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The British Library

British Library complex

Probably the most famous library in the UK, the British Library is located in King’s Cross and has the largest collection in the world. Naturally, this includes a significant number of resources concerning medical and healthcare subjects. The Library can get crowded so is not really suitable as study space, however if you are undertaking research or need to consult books on specific topics it is a very useful resource. There is a reading room dedicated to medical and life sciences on the 2nd floor and there are also subject specialists you can contact to help you with your search. To obtain a reader pass you will need to present photographic ID and proof of address, details can be found on the Library homepage: http://www.bl.uk/reshelp/inrrooms/stp/register/stpregister.html

Interior of the British Library

The British Library complex includes a conference centre and exhibition space with a gift shop. The exhibitions at the Library are temporary but have become well known for being imaginatively presented and cover a wide range of topics relating to objects in the collection. The exhibitions are not free but the student concession is generous, usually making tickets available for half the face value. The current exhibition celebrating the signing of the Magna Carta is excellent.

The Foundling Museum

 

Near the British Library

There are two interesting small museums just a short walk from the Library. One is the Foundling Museum in Brunswick Square. The Museum is well worth a visit, especially for anyone who is interested in the history of the care and social welfare of children. Apart from the often poignant displays it is a beautiful building in itself crammed with paintings and art. Not far from the Foundling Museum is the The Charles Dickens Museum, located in the writer’s London home on Doughty Street and a must see for anyone who likes the novelist’s work. Both museums charge modest admission prices but there are concessionary rates for students.

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Interior of Dicken’s dining room at The Charles Dickens Museum

 

A sandwich and a cup of coffee?

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The concourse of St Pancras Station is lined with cafes and shops

 

The remarkable St Pancras Station is virtually next door to the Library and contains a range of places to eat and drink. Of particular interest to bookworms is the cafe in the Hatchard’s book shop which sells drinks and cakes. Next door is a mini version of Fortnums and Masons including a small restaurant serving meals and afternoon tea. If you want something to eat before visiting the Library, Plum and Spilt Milk serve up-market breakfasts and coffee. If you fancy a post-study drink the Parcel Yard pub above King’s Cross Station is large and has a decent selection of beer and a full menu. Unusually for a station pub, its size means you can usually find a seat. Don’t forget to have your photograph taken pushing a trolley, Harry Potter style, onto platform 9 3/4 whilst you are there!

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Platform 9 3/4, located close to the Parcel Yard pub in King’s Cross Station

 

The British Library
96 Euston Road
London NW1 2DB
Tel: 0330 333 1144
Email: Customer-Services@bl.uk

Don’t forget– if you cannot make it in to St George’s Library over the summer, there are still many resources that you can access from a computer with internet access (logins may be required). Click here for further information.

Summer Sites: The Royal College of Physicians

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The Royal College of Physicians

Usually Royal Colleges are housed behind grand Georgian or Victorian facades. As a result of bomb damage the original home of the Royal College of Physicians was destroyed and it’s replacement, designed by Denys Lasdun is a famous example of the Brutalist style of modernist architecture.

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The Royal College of Physicians.

The College has a study space, The Wellcome Reading Room, that is available to those interested in medical subjects. The College’s particular strengths are in the history of medicine, medical education and health and social policy. Services include access to print and e-journal collections and also e-books. Rare books, manuscripts and archives can be consulted by making an appointment.

The_Censors_Room_of_The_Royal_College_of_Physicians_in_London
Recreation of the ‘Censors’ Room’.

The College is a fascinating place to visit, apart from it’s light and airy modern interior it is full of interesting objects such as paintings, silverware and a collection of historical medical objects. These include the very rare 17th century anatomical tables and the interior of the ‘Censors’ Room’ which was moved from the old building. They also hold temporary exhibitions throughout the year. The college is open to the general public and even provides a free headset guide for visitors who are interested in its architecture or displays. Unusually, the College also has a beautiful Medicinal Garden which contains a range of plants used in medicine, this is also open to the public and tours are available on several dates over the summer.

Near the Royal College of Physicians

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Regent’s Park.

The main attraction in the area is literally right next to the College: Regent’s Park. The park contains gardens, memorials and an open-air theatre. On the northern edge of the park is London Zoo who offer ‘Sunset Safaris’ throughout the summer, late night opening when many of the animals are at their liveliest. Also in the northern part of the park is Primrose Hill which offers one of the finest views of London’s skyline and is a favourite place for kite flyers.

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People enjoying the view from Primrose Hill.


A cup of coffee and a sandwich?

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The Primrose Bakery.

If it is sunny the best thing to do is take a picnic and sit in the park. The most varied selection of places for food and drink are near Primrose Hill. The Queen’s Pub has good food and is always full of dogs and their walkers. The Primrose Bakery in nearby Gloucester Avenue is famous for its cupcakes. A Regent’s Park Road institution, the Lemonia Greek Taverna has good value set lunches during the week and is a pleasant light airy space full of plants and ferns.

Royal College of Physicians
11 St Andrews Place
Regent’s Park
London NW1 4LE

Tel: 0203075 1649

Email: enquiries@rcplondon.ac.uk

Don’t forget– if you cannot make it in to St George’s Library over the summer, there are still many resources that you can access from a computer with internet access (logins may be required). Click here for further information.

Summer Sites: The Royal College of Surgeons

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Over the coming months, our ‘Summer Sites’ series will be featuring interesting Libraries and Institutions that are linked with medicine or healthcare studies and research which you can visit. They may have useful study resources, fascinating museum displays or be housed in historic buildings. Included in the posts will be details of nearby sights and attractions and we will suggest places where you can get a good snack, meal or cup of coffee to fuel your day. We hope these will encourage you to go out and enjoy London this summer.

The Royal College of Surgeons

The Library

Summer is (hopefully) coming, providing us all with chances  to get out and explore London. One of the best things about studying in this city is the number of Libraries  some of which are attached to famous medical institutions and colleges. One of these is the Library at the Royal College of Surgeons.

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The facade of the Royal College of Surgeons

It is based in an elegant Georgian building overlooking Lincoln’s Inn Fields. Situated close to both Chancery Lane and Holborn Tube stations. There are also plenty of bus routes, many of these running to and from South London.

You can use the Library Reading Room during the College’s opening hours by contacting the Library. The Library has a famous historical medical collection but also keeps a number of journals in print and online. There are also printing and copying facilities and access to WiFi. The College’s strength is naturally in the field of surgery but it also covers anatomy, medical history and natural history. The Reading Room itself is a graceful space with high ceilings, lined with books and journals. It is a quiet and peaceful place in which to study or consult reference materials.

Image of interior of the Hunterian Museum
Interior of the Hunterian Museum

There are other reasons to visit. You could contact the Library and ask to have a look at the Reading Room and combine it with a trip to the Hunterian Museum. John Hunter was, of course, a St George’s man but when the government bought his collection, it was given over to the care of the Royal College of Surgeons. It forms the nucleus of the current collection and the Museum is full of fascinating objects displayed in an interesting interactive manner. This is reflected by the fact that it is popular with the general public. Temporary exhibitions take place across the year and there are also a range of lectures and events, details of which can be found on their website: https://www.rcseng.ac.uk/museums/hunterian. You can also visit the shop, which sells, amongst other things, glow in the dark eyeballs. Entry is free and it is open from Tuesday to Saturday, 10.00am – 17.00pm (note that the Library is not open on Saturdays).

Near the Royal College of Surgeons:

Just on the other side of the field  is the Sir John Soane’s Museum. Based in the famous architect’s former London residence it is full of wonderful things that he collected. Objects range from works by Hogarth to an Egyptian sarcophagus and entry is free. The Courtauld Gallery in Aldwych is part of the Courtauld Institute which is, like St George’s, part of the University of London. It’s permanent collection of paintings is popular with tourists and visitors, but St George’s students should be able to get free admission by showing their Student ID.

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Eduard Manet’s ‘A Bar at the Folies- Bergere’, on display in the Courtauld Gallery


A cup of coffee and a sandwich?

In Lincoln’s Inn Field itself, there is a nice café with outside tables. There are also several supermarkets nearby so if it is sunny it is a good place for a picnic. If the weather is not so good there are several historic pubs in the area notably the Seven Stars in Carey Street and the Olde Cheshire Cheese on Fleet Street. The best coffee in the area can be found in the Fleet Street Press cafe (3 Fleet Street).

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People enjoying the sun in Lincoln’s Inn Fields

Note:  The RCS Library is going to be closed due to unforeseeable circumstances from 1 August to 4 September inclusive, further information is on the library webpages.

Library and Surgical Information Services
The Royal College of Surgeons
35-43 Lincoln’s Inn Fields
London
WC2A 3PE

Tel: 020 7869 6555/6
Email: library@rcseng.ac.uk

Don’t forget– if you cannot make it in to St George’s Library over the summer, there are still many resources that you can access from a computer with internet access (logins may be required). See our online resources post for further information.

Patients and the First World War

Patients and the first world war

One of the primary purposes of military medicine during the war was to preserve a precious resource. Patients were ‘repaired’ to be battle ready and a field surgeon or hospital was as much a part of the military complex as a sapper or gun emplacement. Patients were assessed for fitness to fight at every point during their care, with all but the most severely wounded in a loop that inexorably led back to the battlefront. Those undergoing treatment were aware of the situation they were in, one convalescing soldier described every patient such as himself in terms of being a:

‘…wheel in a complicated machine [and] all must work together otherwise disorder and chaos would inevitably result’ (Recollections of the Hospital Keighley and its Auxillaries, 1919, pp: 32–33).

If this seems harsh it should be remembered that the concept of an ordinary soldier as a valuable asset was a major driver in providing care. Just a century before, an injured combatant could expect little more than a place on a floor, minimal attention and most likely a painful death from disease or infection. Paradoxically, during the first world war, whilst injuries were inflicted on a hitherto unseen scale, medical services actually managed to deliver a higher chance of survival than ever before.

arraWounded waiting to be evacuated after the Battle of Arras in 1917 (image courtesy of the Imperial War Museum).

Patients during the First World War were treated differently according to rank and local conditions but there were established processes that most would have experienced in some form. The first was evacuation and ‘triage’, a term popularised during this period. Only the very seriously ill would get a ‘Blighty Ticket’ sending them back to hospitals like St George’s for care and convalescence.

blighty caseA postcard showing a wounded soldier being evacuated to ‘Blighty’ (image courtesy of WW1 postcards.com)

Established hospitals such as St George’s put beds aside for injured servicemen from the very outset of the war (St George’s Hospital Gazette, October 1914). Whilst wards followed the conventional layout of beds and treatment stations the buildings they were set up in varied widely. There were large ‘hut’ hospitals constructed especially to deal with the influx of wounded but a diverse range of buildings were also commandeered for use as ad hoc hospitals. However the treatment for all injured soldiers followed the medical mores of the time; bed rest, a ‘soft diet’, fresh air, and activities to promote good morale were all prioritised.

craigleath hospitalPatients at Craigleath hospital (image courtesy of WW1 postcards.com).

It might have been expected, even if some surroundings were basic, that everyone would be happy to be away from the battlefield but responses to the care offered were mixed. Many were relieved to have a bed and a bit of peace. However for others the confinement to a bed itself was sometimes resented. As one author noted in a hospital magazine:

‘The clothes [being] tucked in to such an extent that it is well-nigh impossible for [the patient] to move . The bed is no longer a bed, it is a nightmare’ (Ammonite, 1917, pp: 286–287).

Others were not happy with the general conditions they encountered. In 1917 one soldier, admitted for injuries caused by gas, described the Royal Naval Hospital as:

‘the closest combination of prison and workhouse I know’ [with] ‘infamous rules galore, scanty ill-cooked grub and general treatment rotten’ (Liddle Collection, 1917).

The military hospital was as full of distinctions, rules and constraints as any army base. Whilst patients were spared the shells and gas at the front, treatment itself could be painful and recovery was far from guaranteed. However those hospitalised had the shared experience of fighting at the front and an ‘esprit de corps’ did exist amongst patients. Much like the ‘Wipers Times’ (which was produced in Ypres by soldiers to entertain each other) hospital patients produced newspapers with a content that often satirised hospital life (Reznick, 2004).

The ordinary soldier was inclined to view his time in hospital with a grim, chippy, resignation and the therapies to encourage morale and recovery were often pilloried. One was the insistence on playing music, many soldiers enjoyed singing but sometimes the endless use of a gramophone grated. Another irritation was the attention of well-meaning upper class women making ignorant comments. When she was a volunteer nurse, the writer Enid Bagnold wrote exasperatedly of ‘the lady who comes in to tea and wants to be introduced to everyone as though it was a school treat’ (Bagnold, 1918, p.15).

cartoonwellcome“What will you do when leave hospital, my poor fellow?”

“Oh! I’ve got a splendid job in a brewery making ‘ops, and my friend here he’s going in for short’ and !”

Cartoon satirising well to do hospital visitors (image courtesy of Wellcome Images).

Soldiers recovering in Britain were required to wear a loose blue uniform, known as the ‘convalescent blues’. The reasons for this were partially practical. Uniforms from the front were worn, tatty, full of lice and had to be disinfected or replaced. A hospital uniform was the cheap utilitarian answer. However it also had a psychological role, that of reinforcing a sense of institutionalisation and discipline. Moreover there was also an undeniable propaganda purpose in forcing convalescents to wear the ‘blues’. It marked them out as heroic ‘Tommies’ whilst highlighting that they were being cared for by the government; reassuring for those whose family members remained at the front.

conbluesPainting of convalescent soldiers in their blue uniforms by Robinson (1920), (image courtesy of Wellcome Images).

The patients themselves had mixed feelings about them. To start with officers were exempted; they received an armband and an allowance to help them buy new clothes. Everyone else had to wear the outfit at all times and some found it undignified whilst others felt that it took away their individuality. Produced in one size only, they were often ill-fitting and some complained that the uniforms resembled pyjamas. There were advantages to wearing the uniform however, the attention could be positive and there was no risk of being presented with the dreaded white feather for cowardice. The injured soldier also gave the public at home the opportunity to be charitable and help the war effort. They would often be be given free entrance to theatres or gifts by grateful citizens.

A popular gift for someone wearing the convalescent blues was tobacco. It sometimes appeared that the army at the front ran on nicotine. Some frowned on this but the general consensus was that any small comfort was to be encouraged. In fact there were official charity drives to provide ‘Smokes for Soldiers’ and ‘Fag Day’ was the flag day for collecting funds in order to do so. Tobacco obtained with the fund could was also distributed to wounded and convalescing soldiers and sailors.

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Poster promoting ‘Fag Day’  (image courtesy of the Imperial War Museum).

It might have been expected that the stress on cleanliness and hygiene would preclude smoking on wards and whilst there were sometimes limitations this does not appear to have been generally the case. Gifts of cigarettes and tobacco were regularly presented to the men at many London hospitals.

Alcohol was more problematic. At the front, despite some opposition, soldiers received a rum ration. The known tendency for it to dull reactions was considered to be outweighed by its ability to lift morale and comfort the troops. In clearing stations it was sometimes used as a disinfectant and pain suppressant. Those on leave in France and Belgium could also buy wine and spirits from the local population.

drinking postcardCartoon ridiculing the drinking prohibitions introduced during the war (image courtesy of WW1 postcards.com).

The situation on the Home Front was different. In fact it was women who caused the greatest consternation as they were drinking more than men. This was particularly worrying in the case of munitionettes and drivers but the government was also concerned about productivity and morality in more general terms. The result was that one of the most unusual laws in British history was passed in some areas in 1916. The so called ‘Treating laws’ forbid anyone to buy a drink for someone else, even a family member or spouse.

As a result there were no mass public drives to provide soldiers with gin or brandy or to encourage them to drink. However it was common for pub landlords to give drinks to serving and recuperating soldiers. Gifts of alcohol to convalescents in hospitals were not unusual. In the case of officers alcohol was freely available, a Canadian officer being treated at King Edward VII’s Hospital for Officers recalled that:

‘The butler used to come round the wards before meals and take one’s order for dinner. Liquor was available in any form by request’ (Reznick, 2004, p.64).

At the beginning of the war recruiting officers had been dismayed by the health of many volunteers, the results of poverty and poor nutrition amongst the general population. This, combined with the privations in the trenches might have been expected to ensure that food, at least, would be gratefully received. However patients complained about both the ingredients and the portion size of their meals. As one soldier drily observed in 1917:

‘Unless you are on a starvation diet, your food, consisting mainly of fish, soup and eggs, is fit for the gods – the gods being ethereal creatures and not standing much in the need of solid sustenance’ (In hospital,1917, p.80).

The First World War hospital was not simply about care and recovery.  A military hospital, in which an injured soldier could spend months recuperating, was often also a community. It emphasised the soldier’s continuing role in the war, his job was to recover and this was part of his service. The use of uniforms and team activities was designed to ensure the recovering serviceman remained institutionalised. Towards the end of the war, when Russia had undergone a revolution and soldiers were increasingly mutinous the British government was particularly worried about morale. Hospitals, with their concerts, music and cheery patriotism were part of the effort to prevent rebellion and foster comradery amongst an increasingly brutalised and weary fighting force.

amputeeAmputee being treated at Queen Mary’s Hospital, Roehampton (image courtesy of Imperial War Museum).

Nonetheless, the wounded, especially those from poor backgrounds received free treatment they would have been unused to prior to the conflict.  After the war many continued to benefit from medical care provided by charities and hospitals such as St George’s.

Bibliography.

Ammonite, ‘Beds and bed making’, (1917) Southern Cross: Magazine of the First Southern General Hospital, pp.286-287.
Bagnold, E. (1918) A Diary without Dates. London: William Heinemann.

Cayley Robinson, F. (1920) Acts of Mercy: The Doctor [paint on panel]. Available at: http://blog.wellcomelibrary.org/label/frederick-cayley-robinson/ (Accessed: 4 November 2014).

Imperial War Museum Collection. Available at: http://www.iwm.org.uk/collections-research (Accessed: 4 November 2014.
‘In hospital’ the magazine of the Fourth Northern General Hospital (1917).
Wallis, S. J.(1917) Letter from S.J Wallis to his brother George Wallis, 3 and 6 November. Leeds University Library, Liddle Collection.
Recollections of the Hospital Keighley and its Auxillaries. (1917) London: Wadsworth and Co.
Reznick, J. S. (2004) Healing the Nation. Manchester: Manchester University Press.

Wallis, S. J.(1917) Letter from S.J Wallis to his brother George Wallis, 3 and 6 November. Leeds University Library, Liddle Collection.

Wellcome Images. (2014) Available at: http://wellcomeimages.org/ (Accessed 11th November 2014).

WW1 Picture Postcards. (2014) Available at: http://www.worldwar1postcards.com/ (Accessed 11th November 2014)

Nursing and the First World War.

 

Nurses and the first world war

Nursing before the War.
Until the 19th century nurses had been regarded as low level domestic servants with very basic skills. In 1865 the Medical Superintendent of Glasgow Municipal Hospital, Dr J. B. Russell, described the profession thus:

‘at present nursing is the last resource of female adversity. Slatternly widows, runaway wives, servants out of place, women bankrupt of fame or fortune from whatever cause, fall back on hospital nursing‘ (Gaffney, 1982, p.140).

In 1867 Florence Nightingale dismissed her predecessors as: ‘those who were too old, too weak, too drunken, too dirty, too stupid or too bad to do anything else‘ (Gaffney, 1982, p. 194).

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Barnard, F. (1874) Mrs. Gamp, on the Art of Nursing. This image depicts Dickens’ dissolute, drunken and slovenly stereotype of the early Victorian nurse.

Nursing often involved close physical contact with strangers. This, combined with the cleaning and feeding elements of the role, led to it being regarded as somewhat degrading and thus unsuitable for respectable women. Furthermore, a social stigma attached itself to any woman required to work for a living rather than being supported by her husband or family. As the 19th century advanced however, the social class of hospital patients had begun to diversify. Advances in surgery and care at hospitals resulted in the presence of patients who had previously been tended to at home under the management of personal physicians. This, along with developments in medical science and technology, fuelled the demand for skilled presentable nurses.

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Professional nurses at George’s circa 1900 (St George’s archive).

By 1914 there were an estimated 12,000 nursing personnel with some kind of recognised training in Britain (Dingwall, Rafferty and Webster, 1988, p. 47). Such training might have included lectures in pharmaceuticals, hygiene, anatomy and nutrition. There was also plenty of work available as hospitals expanded and new ones opened but there remained no recognised formal skill base. Old prejudices towards the profession lingered and very few middle class women were recruited (Maggs, 1983, p. 47). Nurses, who were largely drawn from respectable working class backgrounds, regarded themselves as educated and genteel. Nursing itself however, remained a new and vulnerable profession.

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Advertisement for St George’s Hospital Institute for trained nurses (St George’s Hospital Gazette, May 1914).

Nurses operated within a regimented, hierarchical system with their status demarcated by their uniform and experience. They were expected to be obedient and calm under pressure. Most would have had experience of treating wounds and infections. To modern eyes it seems surprising therefore that they were not immediately acknowledged as an indispensable resource in fighting the war. However 1914 Britain remained a patriarchal culture and there was a resistance to placing women anywhere near the fighting. Nurses were therefore initially regarded as being most useful where they could free able-bodied men for service. Nevertheless due to the sheer numbers of wounded being evacuated from the front, it rapidly became clear that professional nurses were urgently required as close to the battlefields as possible.

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Photograph of St George’s nurses taken close to 1914 (St George’s archive).

Professionals and Volunteers.
As the casualties mounted it also became apparent that the number of nurses deployed was, in fact, grossly insufficient. Voluntary Aid Detachment Workers (VADs) were recruited to carry out the auxiliary, unskilled parts of the job such as laundering, cleaning and applying basic dressings. It was dirty, challenging work yet paradoxically recruits were usually drafted from the middle and upper classes. This was partially because the other opportunities to aid the war effort such as work in munitions factories were considered socially unacceptable. There was also a perception that these young women were, due to their class and temperament, ‘natural’ nurses. Providing light care to the poor and elderly had long been considered appropriate pastimes for wealthy young women, as long as they did so out of charity rather than the need to earn a wage. VADs received a salary but were expected to pay for their uniforms and basic training themselves.

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Dennys, J. (1915) VAD Recruitment poster (image courtesy of the Imperial War Museum).

As a consequence professional nurses found themselves cast in the role of manager and educator of VADs alongside their nursing duties. Moreover they had to supervise women from higher echelons of society than themselves and may have felt threatened by this influx of unskilled labour. This caused some friction. The professional nurses were occasionally irritated by the sense of entitlement of young, untrained women whom after the war would naturally occupy higher social positions than them. The volunteers in turn, unused to the discipline of the nursing system sometimes found their supervisors harsh and disciplinarian (Hallett, 2014). The VADs however, generally admired the professionalism and skills of their seniors and more often than not the challenges of dealing with the dying and wounded brought them together. The VADs’ contribution was essential and many finished the war as highly capable nurses (Hallett, 2014).

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French and British soldiers and German prisoners having their wounds dressed by nurses at a clearing station in 1918. (image courtesy of the Imperial War Museum)

Nursing at the Front.
Life for nurses near the front was difficult. Trained to preserve cleanliness and hygiene they had to struggle to even keep themselves clean and louse-free. Casualties would arrive caked in mud and dirt (Lomas, 2014, p.20) and conditions at both clearing stations and hospitals could be rudimentary. E.M. McCarthy the Matron-Chief of British Troops wrote of the clearing stations near the Western Front in 1915:

In the wards there were rows of stretchers with brown blankets only and on bare floors…There were no trolleys or dressing tables, an empty petrol can served for the soiled dressings and a clean piece of paper as a tray for the soiled dressings, and the floor or next stretcher for a table. The cases, acute and light, were all mixed in the same ward.’ (McCarthy, 1919).

Nurses also had to cope with brutal injuries and aggressive infections. Their work included carefully removing shrapnel, irrigating wounds and cutting away infected tissue; activities that more closely resembled surgery than nursing care. Due to the heavily manured soil in Belgium and France many soldiers succumbed to tetanus and gangrene, the only practical treatment for which was often amputation. Anaesthetics and pain medication could be scarce; nurses would work on wounds as orderlies forcibly held patients down. The term ‘triage’ was popularised during the First World War. Nurses found themselves making decisions that would have dramatic and lasting effects upon their patients’ lives.

Despite the damp, unsanitary conditions of the trenches this was the first modern war during which more combatants died from their injuries rather than infectious disease (Hallett,2014). In 1915 Nurse Clare Gass described the arrival of casualties:

… some terrible cases, oh so much better dead (one young lad with eyes and nose all gone- one blur of mangled flesh –and body whole and sound), heads shattered to pieces or limbs hanging by a thread of tendons. Oh why must such things be?’ (Lomas, 2014, p.21)

These wounds were the consequence of advances in conventional weaponry. The use of chemical warfare such as chlorine, phosgene and mustard gasses however, took combatants and medical staff by surprise. It was particularly hard to treat. One nurse described the effects of mustard gas:

‘Poor things burnt and blistered all over with great mustard-coloured blisters, with blind eyes… all sticky and stuck together, always fighting for breath, with voices a mere whisper, saying that their throats are closing and they know they will choke’ (Blodgett, 2009).

After the War.

handling prisoner of war over

British nurses watching a German patient being handed over in 1919 (image courtesy of the Imperial War Museum).

Hospitals such as St George’s continued to deal with the effects of the war long after the armistice in November 1918. Amputees and those poisoned by gas or suffering from disfiguring injuries required continuing care. Nonetheless, demobilisation and the closure of military hospitals naturally led to a dramatic reduction in the need for nurses, leading to a sudden loss of employment and income for many. This particularly affected married women who could no longer serve after the war (Dean, 2012).

Many nurses returned to their pre-war lives but the war had provided not only horrors but opportunities. Some had travelled to places they had never imagined visiting and experienced freedoms and responsibilities they would never have been granted before 1914. It had a lasting effect on many. Agatha Christie, for example, served as a VAD and was able to qualify as a pharmaceutical dispenser after the war. Many of her novels would subsequently feature death by poisoning. Her most famous detective, Hercule Poirot, was a Belgian refugee from the war.

nurse picnicNurses having a picnic in Egypt (image courtesy of the Imperial War Museum).

Medicine itself remained a male dominated field but it had become difficult to refute the value of a qualified, skilled nurse in the light of the resilience, stoicism and determination they had demonstrated during the war. Nurses’ fears that the large numbers of volunteers taking on nursing roles during the war would ‘dilute’ their claim to professional status proved unfounded and in 1919 official registration for trained nurses was introduced. In 1933 Blomfield described the post-war body of nurses at St George’s:

‘There is little in common between the kindly, but poorly instructed female of a hundred years ago, and the healthy, young, cultured and highly skilled woman who is the finished hospital nurse of today (Blomfield, 1933, p. 102).’

He goes on to describe the training and rigorous application procedure at the hospital concluding that:

‘The high standard demanded at St. George’s has given her nurses a reputation second to none’ (Blomfield, 1933, p.103).

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