|Dr. Iain Hutchinson, University of Glasgow||The UKAHN Bulletin|
|UKAHN Prize Winning Article 2018||Volume 7 (1) 2019|
Glasgow’s Royal Hospital for Sick Children (RHSC) opened in an inner-city townhouse in 1883. In 1914, it relocated to a new 200-cot, purpose-built facility at Yorkhill, resulting in appointment of RHSC’s first medical superintendent, a development that weakened the previously-supreme authority of the matron. The RHSC minute books suggest that the diminution of the role of the matron and her nurses was thereafter complete, their contribution to the hospital being regularly summed up at directors’ meetings in six words: ‘The Chairman submitted the Matron’s report’ (RHSC, 1929, 1937). The content of these reports was not recorded and so the nursing role at the RHSC was largely expunged from the formal record of the hospital’s management and operation. Annual reports likewise gave scant recognition to RHSC’s nurses.
Until hospital-based training was discontinued at RHSC in the mid-1970s, nurses began their careers by joining a three-year probationary programme. Until 1944, they had to attend some theoretical and practical classes, but their training was primarily gained through experience. RHSC was a popular choice for aspiring nurses because they could join when seventeen, adult hospitals stipulating a minimum age of eighteen years. Although nurses under training worked long hours, had to reside in the nurses’ home, and were governed by strict regulations, demand for places was high. At an inter-war peak in 1932, there were 777 applications for seventy-two places, but for most years there were approximately 300 applications for around fifty places. Yet the dropout rate between 1923 and 1941 was often in excess of sixty percent (RHSC, 1923-41).
Between 2000 and 2003, members of the fraternal Yorkhill Nurses League (YNL), recognising that their unique training and nursing experiences should be recorded, undertook forty-three oral interviews, while a forty-fourth nurse elected to contribute written testimony. When a social history of the hospital was embarked upon in 2011, these testimonies, many from nurses who had since died, proved invaluable for illuminating their contribution to key aspects of hospital life (Hutchison et al, 2016).
Of the forty-four testimonies, eleven recounted experience before absorption of the RHSC into the National Health Service in 1948. Additionally, in 1987, one nurse, Rosa Sacharin (trained 1943-46) recorded her life-time memories, including those of her nursing experiences, for the Scottish Jewish Archive Centre. Sacharin was also co-author, with Margaret Hunter, of a book on paediatric nursing (1964, 1969), sole author of another (1980, 1986), and later published an autobiography (2014). The pre-NHS era oral history testimonies relate to the 1930s and 1940s, but a written account by Margaret Dorman, covering her training between 1926 and 1929, was provided by her daughter for the 2011 historical investigation. Dorman was not a participant in the 2000-2003 YNL project, but her written memories have special value, expanding the chronological scope of personally-narrated nurse experiences back to the late 1920s. This article therefore considers a selection of Glasgow paediatric nurses’ reflections, from 1926 to 1948, from thirteen personal testimony sources.
Personal testimony as an historical methodology
While not always recognising flaws, such as sanitisation, distortion and omission of events and processes, within written ‘official’ records, some historians disapprove personal testimony as reliable, or valid, source material. Historian John Tosh voiced his scepticism about the efficacy of oral testimony as a methodology yet acknowledged that it ‘… promises a sense of place and community accessible to ordinary people, while at the same time illuminating broader features of social history’ (1991). Indeed, the role of oral testimony has grown in its validity, Alessandro Portelli arguing that, ‘[oral history] interviews often reveal unknown events or unknown aspects of known events; they always cast new light on unexplored areas of the daily life of the nonhegomonic classes’ (1998). The accounts of nurses working in Glasgow’s RHSC, especially those undergoing training, reflect this dynamic within the wider context of the hospital.
The YNL interviews were undertaken by the League’s own members. A major benefit was that the interviewers were insiders, former nurses well-versed in the profession and the RHSC. They had full understanding of the topics being explored and the experiences recounted by the interviewees. Additionally, gauging nursing experience among women who were mostly recalling the earliest impressions from their nursing careers may have been especially beneficial simply because ‘… memories of late adolescence and young adulthood are remarkably resistant to diminution …’ (Yow, 2005).
However, some interviewers had served as matrons, sisters and nurse tutors, creating potential to inhibit subjects from being fully candid with interviewers who had once been their seniors, mentors and trainers in a profession where deference was instilled from the outset of their careers. For example, Rosa Sacharin recalled her induction, in 1943, by Matron Ruth Clarkson (fl. 1941-61) who told her that:
A hospital is like the Army … the administrative staff were the superior officers, the captains, the majors. The ward sisters were the officers and we [probationers] were the privates … Those above you [even if only by one week] were more senior to you … You stood aside. You never went in front of them. You always held the doors open (2001).
A further shortcoming was that the interviews were highly structured, meaning that when answers offered scope for additional questioning and exploration, such opportunities were often not exploited. For example, when Jessica Carmichael (tr. 1946-50) revealed being ‘quite shattered [when confronting her] first acquaintance with a child’s death’, the interviewer did not then ask how Carmichael and her young colleagues handled emotional responses to child mortality, but swiftly moved on to the next, unrelated, question (2002). Yet the testimonies show that child mortality was often traumatic for young nurses. Rosa Sacharin recalled her initial terror of nursing, which she said ‘was partly due to the death rate we had … I had difficulty coming to terms with it, the suffering, the burns in particular in my first ward …’ (2001). A child’s death had associated aspects that were also disconcerting for young nurses, this being explained by Anne Niblo (tr. 1945-48) in her written testimony: ‘[A] duty which I found very upsetting was taking the corpse of a child to the mortuary during the night. It was very dark, I was alone, and I had to unlock the mortuary, find the light switch and then put the body in place’ (2000). Yet, despite deficiencies, the YNL project, and the archiving of the transcripts, means that an important part of the RHSC story can be called upon where a range of nursing experiences – such as trainee nurses’ responses to mortality – largely escapes historical discourse.
‘They hated us having fun … [but] we had our fun, and gave our all for our work’ (Dorman, c.1970s).
There are many themes that can be identified within the YNL testimonies. Discussed in this article are training, wellbeing, the RHSC Country Branch, nurses’ personal lives, and nurses’ reflections in retrospect.
In 1893, Glasgow Royal Infirmary pioneered Preliminary Training Schools (PTS) for aspiring nurses (Jones et al, 2018). Following the Nurses’ Registration (Scotland) Act, 1919, RHSC fulfilled General Nursing Council in Scotland criteria for registration of nurses, but did not consider it necessary to introduce a PTS until 1944 (RHSC, 1944).
Rosa Sacharin, a child refugee from Germany at the end of 1938, was a reluctant recruit to the RHSC when she joined in 1943, being persuaded to undertake nurse training because accommodation was also provided – indeed, it was mandatory. When interviewed, she asked the matron how long she would have to stay. Ruth Clarkson replied that ‘if you don’t like us, or we don’t like you, you can leave after three months’ (Sacharin, 1987). During the initial three-month period, a one-week induction was provided, but training was primarily on the job with occasional off-duty lectures (McNicol, 2001; Sacharin, 2001). Practical training began with a regime of cleaning, initially in the ‘back bathroom’, ‘the slunge’, ‘where all the poor, raw nurses started’, washing soiled nappies and bed clothes (Dorman, c.1970s). That initial ‘training’ was described by Moira Campbell (tr. 1941-44):
You worked in the bathrooms. I can remember the tiles up seventeen to eighteen feet and it was our job to clean these tiles. The domestics cleaned up so far and no farther. There was a lot of cleaning [of] brass, and the bedpan sterilisers were cleaned with Brasso, and the towel rails … There were heated towel rails … If we were short of nappies … we had the job of washing these [towelling] nappies and drying them. That was in the back bathroom. When you went into the front bathroom you were responsible for washing the woollies and of course they shrank. They were dried on these hot radiators. All these clothings and little nighties that they wore … had been handed in. Remember, it was a voluntary hospital, nice wee woollen jackets and gloves for babies were handed in by people. So, when we went to the front bathroom you were responsible for the bathing blankets, the bath towels for each child. Each had a little locker and there was a certain way that you folded these and tucked them in again. These were all inspected. This is where I learned to wash, dry, and iron hankies, all in a oner, because you washed these and dried them by laying them flat against the tiles in the bathroom. When they began to curl up, then they began to dry; you could put them away. There are still dodgy things I learned in Yorkhill, which I still use (2001).
Campbell’s testimony conveys the meticulous detail that became ingrained in first year trainees – and how, in her case, this had a life-long influence. In addition to the ‘free’ household labour extracted from these raw girls, such as tasks beneath or beyond those of the paid domestic staff, laundering and other duties were part of a process of instilling the need to adhere to standards, often ultimately impacting on the need for meticulous infection control measures. They were tasks that demanded discipline and reinforced hierarchy – at this stage, trainees were at the bottom of that hierarchy, several interviewees commenting on total absence of any actual nursing practice or contact with the child patients.
The training regime moved up a gear in the second year and often involved accepting a considerable level of responsibility by the third and final year. The completion certificate awarded to Mary Brown (tr. 1928-31) shows the formal aspects of training as consisting of lectures and teaching in anatomy, medicine, surgery, hygiene, dietetics, and invalid cookery, but these occurred during limited, off-duty hours (Brown, 1931). Catherine Smith (tr. 1938-42) commented on hygiene: ‘We learned about s-bends, sewers and drains. I felt … that, if I failed as a nurse, I could always be a plumber’ (2002). From 1944, the newly introduced PTS lasted twelve weeks, initial hospital exposure limited to weekends where Anne Niblo recalled being ‘just left in the bathroom … clean[ing] the equipment using Gospo … look[ing] out of the open window and wish[ing] I could escape’ (2000).
The learning curve from skivvying during probationers’ initial year, to being left alone in a Nightingale ward during night shifts in third year, was steep – ‘this tremendous overall responsibility’ in the words of Jessica Carmichael (2002). Dingwall et al note that, from the 1920s, it ‘continued to be difficult to draw a boundary between nursing and non-nursing work … [I]t is important to find a way of differentiating between “nursing work” and “work done by nurses”’ (1988). At RHSC, it was regularly emphasised that probationers, despite the responsibility thrust upon them, could not call themselves ‘nurses’ until they had qualified. Dingwall et al add that ‘[by 1939] registered nurses might share a common certificate but could have gained this out of a great variety of clinical and educational experience’ (1988). Moira Campbell observed that ‘we were all basically untrained because when you sat your Final state examination you were all ready to move on [to do General Training, midwifery, etc]’ (2001). So, while RHSC probationers, upon qualification, often continued for a few months as staff nurses, it was established custom that they leave to undertake further training in an adult hospital (Sacharin, 2001).
Qualification itself was marked with minimal formality, Sarah McNicol (tr. 1938-41) having no recollection of any ceremony when she finished in 1941 (2001), and Margaret Manwell (tr. 1939-42) recalling her completion in 1942 as being with ‘no palaver or anything’ (2001). Olive Hulme (tr. 1940-43) had vague recollections of a ceremony in the classroom in 1943, but not ‘a particularly special one’ (2002). Joan Black (tr. 1945-48) also confirmed that ‘there was no prize-giving’ when she qualified in 1948 (2001). Jane MacDonald (tr. 1937-40) said there was a ‘prize-giving’ (the term nurses used for award of their certificates) when she qualified in 1940, but her parchment was posted to her as this took place after she had begun her general training at Glasgow Royal Infirmary (2000). While Moira Campbell commented that there was a presentation upon her qualification in 1944 ‘when your parents were invited … [and] there were … various people on the platform’ (2001), that may have been an exception to the norm during Clarkson’s tenure as matron, Irene Matheson (tr. 1952-55) recalling from her training during the early NHS years that ‘Ruth Clarkson’s attitude was [that] prize-giving stopped when you left school’ (2000).
Financial and physical wellbeing
Data collected on hospital nursing in England and Wales by the Athlone Committee found that, in 1937, the average nursing complement at voluntary hospitals was 34.8% trained, 22% untrained, and 43.2% students, and that this was against a background difficulty in recruiting nurses (Abel-Smith, 1960). Shortages in the 1930s are also alluded to by Monica Baly (1980), but at RHSC, for 1937, reference was made to ‘the alleged general shortage of nurses’, and claiming that ‘there has always been a waiting-list of well-educated and otherwise well-qualified girls ready to join the Hospital Staff’ (RHSC, 1937). From her investigations on hospitals in London and Cornwall, Thomson argues that, from being ‘notoriously poorly paid’ in the early twentieth century, by the 1930s nurses were courted by advertisers as consumers and endorsers of targeted consumption:
… advertisements portrayed the nurse not only as a serious health professional but also as a young, emancipated individual with a vibrant social life, the time and money to shop and pursue outdoor activities, and a “duty” to look slim and attractive in and out of work (2005).
Unsurprisingly, on a modest ‘allowance’, RHSC’s probationers were not seen as consumers with significant disposable income in the 1920s. This is demonstrated by Margaret Dorman (tr. 1926-29) who recalled using lemonade bottles ‘filled with hot water … to put into our beds … [because such was] the level of our poverty [that] to buy a hot water bottle would be quite an item’ (c.1970s).
In contrast to Thomson’s findings, conspicuous prosperity for RHSC probationers had not arrived by the 1930s either. Jane MacDonald contended that she came close to declining her probation:
I didn’t think I could start because of the expense. We had our own uniforms to buy … and they were eight guineas. And also I had to have a trunk and a whole list of stuff … three pairs of ward shoes, etc, and the books. … and also [for] the first three months there was no pay … (2000).
However, her older sister insisted that she should go, ‘but it was quite an expense’ (MacDonald, 2000). Sarah McNicol also baulked at the list of shoes, stockings, outfits, aprons, belts, and books, but added with apparent relief that ‘Yorkhill supplied our caps’ (2001). By the mid-1940s, nurses’ wages had improved a little, but it seems only ‘a little’ – Joan Black reminisced that ‘we sometimes went to The Locarno dancing, but … only at the beginning of the month … when you got your salary’ (2001).
Long hours, little time off, and exposure to infection, inevitably impacted on health. Olive Hulme recalled that, at breakfast, ‘there were vitamins on the table … vitamin C and Adexolin … and we were expected to take these’ (2000). In addition to vitamins A, C and D, ‘one ‘tiny’ underweight student … was given two glasses of extra milk daily’ (Niblo, 2000). Carmichael remembered that ‘there was a sick bay to which we reported if we were sick, but you had to be really sick … You were not encouraged to be sick’ (2002). Hulme, recalling her arrival, concurred: ‘[Home sister] greeted us … and gave us a little pep talk. And included … was … our obligation not to be sick’ (2000). Yet, inevitably, nurses did become unwell. McNicol spent three months in the sick bay with rheumatic fever but added that Matron Mary Robinson (fl. 1935-41) ‘was really very, very good to me’ (2001). Niblo highlighted the constant presence of fatigue: ‘I enjoyed my days and nights on the wards, but I was always tired’ (2000). Nurses recruited from rural settings had a particular vulnerability to illness. Catherine Smith, from Argyllshire, succumbed to jaundice shortly after arriving at the RHSC, then ‘having come from the country, I took every infectious disease that was going. I had mumps, I had measles, I had German measles, and I had this jaundice’ (2002). Pre-NHS RHSC nurses’ memories suggest distinct absence of glamour; rather than ‘vibrant social lives’, they had little free time, surplus energy, or disposable income.
Eight years before it moved from 74-cot Garnethill to 200-cot Yorkhill, RHSC opened a Country Branch at Drumchapel, chosen because of the rural location that prevailed there in 1906. Largely because of poor and over-crowded housing conditions, from its earliest days the hospital had used church-run and charity-run convalescent homes to aid post-treatment return to health for many of its children. The creation of its own Country Branch became part of this convalescent process, but unlike those other convalescent arrangements, this was a direct extension of the hospital. The Country Branch therefore played a role in nurse training, probationers at the early stages of their training, for example, being seconded to accompany children who were being transferred from Yorkhill, while later in their training they usually had to spend three-month hands-on postings to Drumchapel.
Bearing in mind that most trainee nurses originated from fairly comfortable family circumstances, the Country Branch convalescence facility gave them revelationary insight to the reality of the social deprivation experienced by many working-class families across central Scotland. Moira Campbell observed that ‘you would guess by the parents what the home conditions would be like,’ this being amplified by her description of the perennial problems of dealing with the head lice and impetigo encountered in her small charges (2001). Recovering children went through a recuperation process spanning what was usually a two-week period of transition from hospital to home. However, Drumchapel was also used for children requiring longer-term recovery from the likes of osteomyelitis, tuberculosis of the bones, and rickets (Campbell, Sacharin, 2001).
Drumchapel became the location of large-scale council construction during the 1950s, but before this time it was a rural idyll. This is demonstrated by Margaret Dorman’s recollections of accompanying children to the Country branch in the 1920s:
Every week, poor children who had not recovered enough to go home – to their slum homes – were sent to recuperate to Drumchapel, which was the Country Branch, and it really was in the country, surrounded by green fields. Two poor junior night nurses were commandeered as they were going off duty in the morning and told to get their coats on … and accompany about six or seven babies and toddlers to Drumchapel. The horse cab had a rail on top with room for baskets with carbolic, boracic, Lysol, etc., and drums of sterile dressings. They clanked about as we slowly bumped along Dumbarton Road to Anniesland Cross. The cabby sat up front using his whip sparingly. The babies would cry and the poor wee mites with their snivelly noses were too ill or miserable to enjoy it (c. 1970s).
When trainee nurses were assigned to the Country Branch on night duty, they travelled back to Yorkhill by bus, single fare three pence, for lectures (MacDonald, 2000). But there were periods around the war years when nurses were sent to the Country Branch not to work, but to sleep in overflow nurse accommodation after working night shifts at Yorkhill. According to Black, this arrangement was cumbersome: ‘I remember girls saying … they used to get off the bus on Great Western Road and have to walk through the fields to Drumchapel hospital’ (2001).
On the nights of 13th and 14th March 1941, the town of Clydebank was devastated by aerial bombardment (Macleod, 2010). Catherine Smith, as a trainee on duty at the Country Branch, explained the muted reaction of her and her colleagues to the initial raids as they had been forewarned that an air raid practice was scheduled. When the reality became apparent, ’we lifted the children – mattresses and everything – down, and put them underneath the beds, and had a great laugh with the children to make them calm’ (2002). Children and nurses stayed under the beds all night where, miraculously, they remained safe despite shattered glass and debris throughout the buildings, and several undetonated incendiaries landing in the grounds. Next day, the children were evacuated to Lennox Castle Hospital, a psychiatric facility in the lea of the Campsie Fells, where Smith remained for nine months until the last of the children were discharged. So this was another aspect of Country Branch experience for trainee nurses seconded to the care of convalescing children in 1941 (Smith, 2002).
Aside from war-time disruptions to established routines, placements at the Country Branch were an integral part of the wider three-year training programme. Rosa Sacharin was one of those for whom duty at the Country Branch was not just part of her wider training regime, but was a component of her wider grounding. Matron had specific intent when she sent Sacharin there in 1943, aged eighteen: ‘I started my training, and after three months, I handed in my resignation. [Matron] said I was making the wrong choice and [Miss Clarkson] sent me to the Country Branch … and I grew up there … I really decided there and then that I really should make a go of it’ (1987).
Debbie Palmer writes that, following the report of the Lancet Commission in 1932, ‘large sections of the nursing profession remained convinced of the value of military-style discipline that included uncritical obedience, punctuality and loyalty …’ (2014).
This is seen at the RHSC where it was obligatory for all probationer nurses to reside in the strictly-regulated nurses’ home and where, for example, late passes were a special privilege. Joan Black acknowledged the matron’s responsibility for girls aged between seventeen and twenty (2001). Indeed, Moira Campbell considered probationers compliant: ‘… we were used to the discipline of school, used to the discipline of the home … We accepted the imposed discipline’ (2001). Carmichael suggested a more pragmatic reason for obedience: ‘We didn’t have a lot [of time off] and you were quite tired at the end of the day.’ (2002). Life in the Nurses’ Home revolved around bells for awakening and breakfast, prayers – to which Sacharin lodged objection, bedroom inspection, and centrally-operated ‘lights out’ at 10pm (Campbell, 2001; Smith, 2002; Sacharin, 2001).
However, rules were broken, such as abuse of late passes even although there was a particular hazard to be negotiated without being caught: ‘The floors were wooden; if you tried to creep in, someone would always hear you’ (Hulme, 2000). RHSC attempts at strict surveillance of nurses’ illicit nocturnal movements resulted in other forms of subterfuge. The hospital had a warren of basement passages that led to the likes of the mortuary, and which provided another avenue of egress: ‘… you could nip in [to the hospital], down to the basement, through all the basement tunnels and right up to the nurses’ home …’ (Black, 2001).
Hulme commented that the on-the-job relationship between Residents and nurses was ‘very close because we depended on one another’ (2000). But off duty, fraternisation was the greatest sin of all: ‘[A probationer] was having an affair with one of the Residents. That scandal was passed on as each [new recruit] came in. Oh, no, there was no fraternising’ (Black, 2001). With echoes of Ena Lamont Stewart’s play Starched Aprons (1945), set in the 1920s, Sister Agnes Jay [fl. 1935-38] revealed that prohibition of fraternisation not only applied to probationers: ‘One day I went to the motor show with one of the doctors. It was on a Saturday and he was told he had no right to take the sister out. They did not want you to mix’ (2000).
Margaret Manwell (tr. 1939-42) related a story, repeated by other interviewees, surrounding the major concession of an annual ‘at home’ gathering held in the nurses’ drawing room. Partners had to be vetted, corridor doors in the nurses’ lounge were removed from their hinges, ‘so that no one had any fun’ in the words of Sarah McNicol (2001), and the stairway entrance was boarded up. ‘It was the sort of thing that could only happen in Yorkhill’, commented Manwell (2001) or, as Gavin Arneil, a house officer in 1945, put it, ‘they took the doors off all the rooms so that people couldn’t sneak behind the door and have quick snog’ (2010).
The nurses’ home at RHSC was appreciated by most probationers, not least because they had single rooms whereas most other hospitals’ nurses’ homes tended to offer only shared accommodation. So, despite the compulsory obligation to ‘live in’ while under training, and despite the many restrictions on their movements, the nurses did at least have this element of personal space. The rooms were not, of course, en suite, so at certain moments there was inevitable overcrowding in the communal bathrooms serving each floor of the home. But Niblo also saw this as social space that embraced camaraderie: ‘… As we were bathing about the same time, we all sang the hit song of the moment, “Meet me in St Louis, Louis” (Judy Garland, 1945) … I can still hear it reverberating round the corridors’ (2000).
After qualifying as paediatric nurses at RHSC, the women whose testimonies are the primary source material for this article variously went on to do other nursing and midwifery training, and several had careers that encompassed worldwide experience. Olive Hulme returned to the RHSC where she ultimately had a long tenure as matron from 1961 to 1983. Conversely, despite their several years of arduous training, some nurses’ careers were short because ‘marriage … usually meant in the interwar years [and after] a reorientation of a woman’s working life from outside to inside the home’ (McIvor, 1990). As suggested earlier by Margaret Dorman, nurse training at the RHSC was defined by long hours, hard work, regimentation and hierarchy, and by the perception of there being little appreciation of probationers’ efforts. Yet, as some of the testimonies reveal, there were aspects of training at the RHSC that had such impact that they remained with respondents throughout their lives.
Undergoing training during the two decades running up to the creation of the National Health Service, there were many experiences that these young nurses later felt cause to be nostalgic about as they pursued their further careers and domestic lives. The interviewees were also generally aware of later changes to nurse training, particularly from the mid-1970s, arising both from their professional observations as they reached retirement, and from their experiences as patients, notably in old age. While it is easy to judge such nurse reflections as being embedded in the past, a past that is resistant to change and new-fangled ideas from the perspective of septuagenarians and octogenarians, it is none-the-less instructive to gauge their views on modern nursing.
Joan Black did not mince her words: ‘… I cannot believe that a real nurse can be trained in the university. To me, nursing is hands on … when we were training, we had stipulated bedpan rounds. But not nowadays. Either the child is very forward and tells you that he wants to go the bathroom, or they get up and go to the bathroom, or they wet the bed …’ (2001). Having been trained, like her colleagues, in a regime of washing and scrubbing, Sarah McNicol was critical of what she saw as poor understanding of aseptic technique in modern hospital settings, notably there being little focus on hand-washing (2001). Black added, ‘I think a lot of basic training has been lost. But that’s my generation. It’s not a generation gap. It’s three generations. (2001)’ MacDonald’s views differed from those of Black, perhaps with the benefit of insight from a daughter and two granddaughters who had become nurses, and she felt that ‘… nurses today need to know a great deal more than what we needed to know. I don’t know if I could still do it. (2000)’
When interviewed in 2000, Olive Hulme felt that:
… [today] the nurturing part of nursing has gone. We didn’t have the technical assistance in order to help us with what we were doing. We had to use our common sense and our ingenuity … we had to look at the person. What grieves me now is, and I make no bones about it, to see the children attached to all these machines and the nurse very competently dealing with the machines, but that’s all. There’s the hum of the machines, there’s the noise of music because sometimes they’re playing music, but there’s no humanity … it’s all machines.
But Hulme also made clear that there were deficiencies in systems and methods during her time too, notably in awareness of emotional needs:
Looking back on it, and in comparison with what is done now, we were almost neglecting the children, but we didn’t know any better … I regret sometimes that I wasn’t sufficiently aware of the needs of parents in my early days. I regret that very much because … looking back, the number of children we were dealing with … And we excluded siblings altogether. We didn’t think siblings were part of the … And yet, that’s wrong. That’s wrong. (2000)
Catherine Smith highlighted gradual opposition to the inflexibility of limited parental visiting arrangements. This challenge came from formidable women emboldened with worldly experience – grandmothers: ‘Mother … was in the background … Granny was the voice’ (2002). Granny’s voice could no longer be ignored during World War Two when fathers were away on military service, mothers were undertaking munitions work, and ‘granny took over the work of the household’ (Smith, 2002).
Jane MacDonald made interesting comparisons between her training and her later experience as a staff nurse. In hindsight, she felt that by beginning careers at age seventeen trainees were still themselves children, children who didn’t appreciate how ill some of the small patients were, and within a regime where they had neither time, nor encouragement, to engage with bedfast children, some of whose admissions may last for several months and with extremely limited parental visiting. When she resumed duties later in her career, MacDonald believed she ‘… was a much better nurse … because I had my own children and I treated the child in a bed as I would want my own children treated. (2000)’
Jessica Carmichael, despite initial training largely consisting of drudgery, spoke of how, once on the wards, she developed skills, two of these being observation and responsibility: ‘In an adult hospital, people would tell you what was wrong, or that they hadn’t had a drink … Children didn’t, and if you didn’t observe it, it went unnoticed. So I think you did learn to be very observant.’ (2002). But from her experience of a recent hospital sojourn, McNicol considered that there was a passive attitude to adult patients’ needs, claiming lack of nurse interest: ‘A patient was five or six days without a bowel movement; nobody asked, no record kept’ (2001). Pressures, methods, resources and perspectives had of course changed over the three-generation time span highlighted by Black. Olive Hulme reflected on her RHSC training equipping her ‘to stand on my own two feet’: ‘… very early on, we had to make decisions because we weren’t supported by medical staff [who] weren’t there all the time (2000).’ The debate over how much has changed, improved, or deteriorated from pre-NHS days when resources, working conditions and subordination were perceived very differently from the situation at the dawn of the new millennium when the YNL interviews were conducted, is inevitably very subjective.
It was the informal environment of modern hospital settings that came as a shock to Catherine Smith when she was admitted to Glasgow’s Western Infirmary following a heart attack in 1998, when she was in her mid-seventies. ‘I just couldn’t get over the difference. I mean, a nurse came in and said, “I am Jean and I am your nurse for the night”.’ When the consultant came to see her, she addressed him as ‘Sir’, to which he responded, ‘I see we have an old nurse here. Nobody ever gives the consultant “Sir” nowadays.’ Smith was taken aback: ‘He said I was an old nurse! I couldn’t speak to the man without saying “Sir”. I mean, it was drummed into me years ago’ (2002).
This study has explored some facets of nurse’s lives during the final years of Glasgow’s Royal Hospital for Sick Children as a voluntary hospital. The use of oral testimony, despite the challenges presented when passage of time interferes with clarity of memory, fills important gaps in the RHSC’s formal archival records. Although the YNL interviews were tightly structured and opportunities to explore themes and issues in greater detail were sometimes missed, the interviews benefitted through interviewers’ own exposure to RHSC nursing and training regimes. In addition to the themes explored above, the transcripts cover many other aspects of first-hand experience that offer scope for further historical exploration. These include nurses’ insights to the social deprivation endured by families and their children. Testimonies highlight nursing and clinical procedures, including such innovations as the transition from M&B693 and sulphonamides to early use of penicillin. They reveal the impact of the war-time environment on nurses. And they examine focussed nursing activities such as night duty, and occasional responsibilities in the RHSC’s Outpatients & Dispensary where large numbers of children were treated and where procedures such as tonsillectomies and circumcisions were performed. Also, they give key insights to another group largely written out of the formal record – the child patients and their families, the ways in which patients were expected to conform to hospital regimes, and the clinical insensitivity to the emotional trauma that hospitalisation might be causing them.
Abel-Smith, Brian (1960) A History of the Nursing Profession. London: Heinemann
Baly, Monica (1980) Nursing and Social Change, second edition. London: Heinemann
Brown, Mary, RHSC Nurses Register YH8/1/6, Qualification Certificate YH8/4/4/4
Dingwall, Robert, Anne Marie Rafferty and Charles Webster (1988) An Introduction to the Social History of Nursing. London: Routledge
Greater Glasgow & Clyde Health Board Archives (GGCHBA)
- RHSC Minute Book 9, 14 Jan 1929, YH1/2/9, p. 354.
- RHSC Minute Book 14, 8 Feb 1937, YH1/2/14, p. 2.
- RHSC Annual Reports 1923-1941, YH3/1/8 to 11.
- RHSC Minute Book 21, 24 Aug 1944, YH1/2/21, pp. 79-80.
Yorkhill Nurses League interview transcripts, RHSC YH8/7/3; also at the Royal College of Nursing:
- Black, Joan, 1 Jun 2001
- Campbell, Moira, 19 Jan 2001
- Carmichael, Jessica, 2 Dec 2002
- Hulme, Olive, 4 Oct 2000
- Jay, Agnes, 23 Mar 2000
- MacDonald, Jane, 10 Oct 2000
- Manwell, Margaret, 1 Aug 2001
- Matheson, Irene, 20 Nov 2000
- McNicol, Sarah, 17 Jul 2001
- Niblo, Anne, 22 Apr 2000
- Sacharin, Rosa, 22 May 2001
- Smith, Catherine, 12 Nov 2002
Hutchison, Iain, Malcolm Nicolson and Lawrence Weaver (2016) Child Health in Scotland: A History of Glasgow’s Royal Hospital for Sick Children. Erskine: Scottish History Press
Jones, Claire, Marguerite Dupree, Iain Hutchison, Susan Gardiner and Anne Marie Rafferty (2018), ‘Personalities, Preferences and Practicalities: Educating Nurses in Wound Sepsis in the British Hospital, 1870-1920’, Social History of Medicine, 31:3, 577-604.
Macleod, John (2010), Rivers of Fire: The Clydebank Blitz. Edinburgh: Birlinn
McIvor, Arthur J, (1992) ‘Women and Work in Twentieth-Century Scotland’ in Dickson, A and J H Treble (eds) People and Society in Scotland, Volume III, 1914-1990. Edinburgh: John Donald
Palmer, Debbie, (2014) Who cared for the carers? A history of the occupational health of nurses, 1880-1948. Manchester: Manchester University Press
Portelli, Alessandro (1998) ‘What makes oral history different?’ in Robert Perks and Alistair Thomson (eds), The Oral History Reader, 63-74. London: Routledge
Sacharin, Rosa M, and M H S Hunter (1964, 1969) Paediatric Nursing Procedures. Baltimore: Williams and Wilkins; Edinburgh: Churchill Livingstone
Sacharin, Rosa M (1980, 1986) Principles of Paediatric Nursing. Edinburgh: Churchill Livingstone
Sacharin, Rosa M (2014) The Unwanted Jew: A Struggle for Acceptance. Tullibody: Diadem Books
Scottish Jewish Archives Centre (SJAC):
- Sacharin, Rosa (and Betty Pheil), oral history transcript, 13 Aug 1987
Stewart, Ena Lamont (1945) Starched Aprons, manuscript, Mitchell Library SDf822.914STE3/STA
Thomson, Elaine (2005) ‘“Beware of worthless imitation”: Advertising in nursing periodicals, c.1888-1945’, in Barbara Mortimer and Susan McGann (eds), New Directions in the History of Nursing: International Perspectives, 158-178. London: Routledge
Tosh, John (1991) The Pursuit of History, second edition. Harlow: Addison Wesley Longman
Yorkhill History Project:
- Arneil, Gavin, oral history transcript, 26 Jul 2010
- Dorman, Margaret, written testimony, c. 1970s
Yow, Valerie Raleigh (2005) Recording Oral History, third edition. Lenham: Rowman & Littlefield