| Lt Col (Retd) Keiron Spires QVRM TD, QARANC Association Heritage & Chattels Committee | The UKAHN Bulletin |
| Lt Jack Potter QARANC, QARANC Association Heritage & Chattels Committee | Volume 7 (1) 2019 |
Context
There has been much interest in the letters and diaries of British Army nurses serving in the First World War. Some diaries have been published commercially, for example, those of Kate Luard (Stevens & Stevens, 2014) and Edith Appleton (Cowan, 2013). Others are being transcribed and published digitally, for example Emily Wood, Helen Driver and Lillian Robinson at http://britisharmynurses.com. Many diaries are in archival collections like those of the Royal College of Nursing, The National Army Museum or the Imperial War Museum. There are many more diaries publicly available written by the volunteers (VADs) working alongside Army nurses.
Researchers have looked at letters and diaries seeking to understand the motivations and intentions of those nurses who wrote diaries (for example, Hallett, 2007, 2016), or how writing helped nurses make meaning of their experiences (Alterio, 2013).
A number of Army nurses’ diaries from the First World War are held in the archives of the Queen Alexandra’s Royal Army Nursing Corps (QARANC) within the Museum of Military Medicine at Keogh Barracks, Mytchett. These diaries have not been transcribed or subject to any scrutiny since they became part of the collection.
Purpose of research
In this project we are examining a number of diaries written by British Army nurses and volunteers (VADs) working alongside them and comparing them to diaries written by German nurses supporting the German military medical systems.
In addition, we are surfacing the diaries held in the archives of the QARANC and making knowledge of their existence more widely known.
Current status
Diaries were chosen if they were contemporaneous accounts rather than reminiscences of sometime later. Contemporaneous writing can be seen as more reliable than that written later with the potential influences of public opinion and the passage of time (Hallett, 2007).
The diaries of German nurses were sourced from the Deutsches Tagebucharchiv (DTA) in Emmendingen. The DTA remain interested in this project and will hold our transcriptions and other data for researchers using the archive in Germany. A number of diary scripts were accessed but only six were identified as nurses working in a military context. This is a feature of the issues with the definition of nurses and nursing at this point in time.
The German diaries were translated and then transcribed. Most of the British diaries also needed transcription. So far twelve diaries have been analysed. A number still need translation or transcription before they can be added into the thematic analysis.
Thematic Analysis
The data from the diaries has been arranged using thematic analysis. Thematic Analysis is an approach to dealing with data that involves the creation and application of ‘codes’ to data. ‘Coding’ refers to the creation of categories in relation to data; the grouping together of different instances of datum under an umbrella term that can enable them to be regarded as ‘of the same type’. These categories are the themes of thematic analysis. There is a distinction often made between ‘open coding’ and ‘relational coding’. The former refers simply to the creation of categories and the latter to the relating of those categories to each other. Open coding is being used in this project, as the themes do not have a relationship with each other, but exist in the same context (Dey, 1993; Miles & Huberman, 1994; Flick et al; 2004).
Language is not an easy thing to make judgments about. What certainty is there that one nurse’s comment in a diary means the same as another’s, especially when the contexts and experiences may be very different? With historical documents we are further concerned that the language we are reading and making judgments on is not in the same context the researchers are operating in. In this research project this is mitigated partly by the researchers’ experiences of being military nurses, partly by an immersion in the data, and partly by reference to contemporary frame-working texts.
Challenges
Some of the challenges faced with this project are the same for any research involving historical handwritten documents, such as transcription of documents that are fading; have tiny writing to make use of all the paper; the use of personal shorthand or codes, or abbreviations that are no longer in use or mean something different in a modern context; and issues of spelling and misspelling.
More specifically there are issues relating to translating from German and also transcribing and understanding the language of nursing in that era. The use of military terms is less of a challenge as they seem to have remained constant over time and into the modern era.
Neither of the researchers are completely fluent in German, and that gives us challenges especially when nurses spell words incorrectly. Both researchers are using an extended German network to help with difficult phrases. This is where social media works well as a research tool!
Early findings
The starting point was that of nationality as the defining difference and that is shown in the tables that follow. However, the data is starting to suggest that context has a greater effect than nationality, something that supports previous work in this area (Hallett, 2007; p.322).
The themes that are emerging are listed below with an example of the text within it:
Eating and drinking: “at the head on my table I sat down and when the meat, cooked to a turn, was brought in all frizzling in the tin it had been cooked in, I laughed until the tears rolled down my cheeks! It was the funniest sight I ever met with I am sure! The almost dark marquee, the two long rows of sisters hungrily holding up their plates and saucers and the tin all grimy from off the stove; all of myself, almost in despair, as to how I should ever carve for 23 people, with my knife and fork, the largest we could produce! That was the best leg of mutton ever served to mortal man, and when we had done with it, there was only left the place it had once known!”
Church and religious services: “Today we had the first service in enemy territory. In the Reformed Church, Fr. Meyer from Rethem gave a sermon before the sacrament service by Padre Rieschel from Norderney. It was a very moving celebration, you could see the many soldiers from the various regiments of all ages and all so emotional, as the word after the sacramental distribution “Go in peace” came from the heart and went to the heart. And then came the song: “Oh stay with your mercy in devotion” as is seldom the case. The church was filled to the last seat and they also stood outside the door. Prince August-Wilhelm and many officers sat in front, then came the regiments and we sisters took the last benches. They preached about the word “Be silent to God”. In this troubled time, we must still be quiet to experience God, and we would have experienced in vain this great, perhaps greatest time of our people, if we did not experience, that there is a living God. Where God is, victory is, where God is, is success, where God is, there is inner happiness.”
Personal hygiene: “I’m going to have a bath tonight so must cut my diary short, as Harry has deposited my bucket of water in my cubby hole about 20 mins ago, & if I delay much longer, it will be cold.”
Nursing milieu: “Two staff Nurses, four Orderlies and fifty beds. Our first convoy of several hundreds from Neuve Chapelle. The men don’t talk much about it. Those in bed sleep a lot, the ‘up men’ sit out in the sun all morning except when they are being fed or wounds dressed, sleep on their beds in the afternoon and play card games in the evenings or go to a concert or play a gramophone or do odd jobs for the sisters.”
Reflections: “At 8 a.m. as I was coming off duty, a large train load of wounded came in. I received the first man, a Corporal, badly hit in the thigh. There is a queer sort of feeling that I cannot explain about these wounded. It is perhaps the knowledge that they have been destined for Death, deliberate death, at the hand of a fellow man. One cannot realise it properly, but I do know that never before in my long nursing experience, have I felt anything like the sensation that came over me this morning, when I saw our first lot of wounded came in, and helped to receive them. “Les Blessés” the French call them, and I like the term.”
Descriptions of nursing care: “Then Incraszik from Poland with his delicious “German”. He should have gone on leave and a few days before, his leg wound, which was believed to have healed, must have started to fester again, so that a leave unfortunately became nothing, but became an anaesthetic operation, through which about 5 splinters were still found and removed. Incraszik was a little snivelling, but he certainly had reason for his outbursts of pain. “Not so firmly” he would say again and again when I put the bandage on him, after the Consultant “tortured” him with the probe.”
Cheerfulness or bravery of patients: “A great many badly shot, one with his lips absolutely mangled into bits. He can’t speak, but is a brick.”
Appreciation of the local environment: “In the evening we looked at the cemetery, which today on All Saints is decorated festively, no grave was unadorned, the whole was like a Chrysanthemum bed. Our German graveyards are marked by the many trees of life, these big gravestones have something depressing about them. The large monument of 1870 – the mourning of France – towered over everything. On another side was also a simple stone in memory of our fallen Germans of the 1870 war. They were also decorated with flowers. Today again mighty cannon thunder, probably from beyond Peronne. In front of a high pyramid stands a mourning female figure.”
Waiting: “Are we on our way to the War? I suppose we are – we left Chatham at 4 am and have dawdled here and there waiting to embark for France (we hope) but the last news was that we were not to go aboard till 7 pm and oh, if I could take off this bonnet and cape and collar and cuffs and lie flat under a tree – but alas, if one is going to a war, be the sun ever so hot, you just sit and wait and wonder and talk with the other nursing sisters in exactly the same plight.”
Non-nursing activities: “Later Mr. Silcock took us to see a glass factory & we watched drinking glasses & glass bottles being made. One of the men made us each a paper-weight. I gave him a German button to but in the middle of mine. They had to be baked and allowed to cool gradually in ovens of varying heat, which process took 6 hrs so that we are to call for them in the morning if we are still here.”
Orderlies: “My luck is in with orderlies as well as an MO. One of them (from the Reserve) was in the South African war and knows about tents and how to fix the roof of the ‘porch’ so that it doesn’t empty itself down your back as you come in and out on wet days, and how to construct cupboards, and how to lay tarpaulin on the floor so that you don’t trip when you are carrying trays full of dressings.”
Gifts from patients or relatives: “I had a piece of a German aeroplane given me (brought down near Mons by L. Batt. R.H.A.) by my Life G’dsman Naskell.”
Homesickness: “Feeling lonely among the people who surrounded me moved me deeply and triggered my thoughts of homesickness for my relatives in the quiet Hochdorf, and other bells that let our simple village church be heard and summoned.”
Normalising the clinical environment: “M. Josse brought me such a lovely bunch of flowers for my ward 3 days ago, “les derniers de mes fleurs” he said pathetically.”
Taking on responsibility: “To the War Office at 10 am! Hiding, with what courage I could muster, a very nervous ‘interior’. Fortune was kind in the shape of the Matron-in-Chief, who was most charming and friendly. My fears vanished and I received my orders with a glad and proud bearing. Acting Matron of the new Hospital Ship ‘Salta’ of 460 beds. Just out of dock and about to start for France.”
Newspapers: “We hear today the Germans are in Brussels & I saw a Mirror of Aug. 17. I do miss Eng. papers.”
Ethics: “With much sorrow I had to pick my 6 most conval. men to go tomorrow to the Rest Camp. I shall be sorry to say goodbye to them & know to what they are going back. One of them said to me, “It’s alright sister when you are fighting, you forget everything, but it’s awful the going back to what we know now, & after the awful things we have seen”. I understand perfectly. They are heroes, they go back because Eng. needs them & it is their duty to, but I don’t think I cd do it.”
The table below (Table 1) shows the themes ranked by frequency of occurrence, and the percentage of each theme relative to the total number of entries in the thematic analysis.
| Table 1: Themes ranked by frequency of occurrence | |
| Theme | % |
| Eating and drinking | 11.76 |
| Church and religious services | 11.34 |
| Personal hygiene | 8 |
| Nursing milieu | 5.46 |
| Reflections | 4.62 |
| Descriptions of nursing care | 4.2 |
| Cheerfulness/ bravery of patients | 3.36 |
| Appreciation of local environment | 3.36 |
| Waiting | 2.94 |
| Non-nursing activities | 2.94 |
| Orderlies | 2.94 |
| Gifts from patients/ relatives | 2.52 |
| Homesickness | 1.6 |
| Normalising the clinical environment | 1.6 |
| Taking on responsibilities | 1.2 |
| Newspapers | 0.8 |
| Ethics | 0.4 |
Ranking the nationalities (Table 2) does show some differences, although this is likely to change a little as we add more material in. Some variations may be due to the differences in the structure of the systems for evacuating and caring for the sick and wounded. With a small number of diaries there is also variation because of personal differences, which we hope will be mitigated as we continue to add more material into the analysis.
| Table 2: Ranking by nationality | |||
| Theme | Percentage | German | British |
| Eating and drinking | 11.76 | 1 | 3 |
| Church and religious services | 11.34 | 2 | 1 |
| Personal hygiene | 8 | 4 | 2 |
| Nursing milieu | 5.46 | 4 | |
| Reflections | 4.62 | 5 | |
| Descriptions of nursing care | 4.2 | 5 | 9 |
| Cheerfulness/ bravery of patients | 3.36 | 6 | 6 |
| Appreciation of local environment | 3.36 | 3 | |
| Waiting | 2.94 | 8 | |
| Non-nursing activities | 2.94 | 7 | 10 |
| Orderlies | 2.94 | 7 | |
| Gifts from patients/ relatives | 2.52 | ||
| Homesickness | 1.6 | 8 | |
| Normalising the clinical environment | 1.6 | 9 | |
| Taking on responsibilities | 1.2 | ||
| Newspapers | 0.8 | 10 | |
| Ethics | 0.4 |
Conclusions
As we are reading and transcribing the diaries, we can see some differences based on the context or contexts in which the nurses served, so we will expand our data table to include the context for each example in the thematic analysis, which will allow us to do some comparisons not only between nationalities, but also between the contexts of service. The ranking table (Table 1) looks very alike Maslow’s Hierarchy of Needs. We both know from our own operational military service that military nurses are usually confident in their skills and abilities, so it makes sense that it is the other things that occupy their minds and that they write about. We have both been cold and hungry and tired on operational service – and yes, we have had to wait around – a lot!
One thing that is strikingly different is the role of religion – and in that we can see space for someone to write another paper!
References
Alterio, MG (2013) Memoirs of First World War Nurses: Making memory of traumatic experiences. Unpublished PhD Thesis. Victoria University of Washington.
Cowan, R (2013) A Nurse at the Front: The First World War Diaries of Sister Edith Appleton.London: Simon & Schuster.
Crewsdon, D. (2014) Dorothea’s War: A First World War Nurse Tells Her Story. London: Wiedenfeld & Nicholson
Dey, L. (1993). Qualitative Data Analysis: a user-friendly guide.London: Routledge.
Flick, UE.,von Kardorff,V. and Steinke, I. (Eds) (2004). A Companion to Qualitative Research.London: Sage.
Hallett, CE. (2007) Writings of First World War nurses. Nursing Inquiry. 14(4), 320-329
Hallett, CE. (2016) Nurse Writers of the Great War.Oxford: Oxford University Press.
Miles, M. and Hurberman, M. (1994) Qualitative Data Analysis: an expanded sourcebook.2ndEd. Thousand Oaks: Sage.
Stevens, J and Stevens, C. (2014) Unknown Warriors.London: The History Press
