By Alannah Tomkins


C. Helmstadter, Beyond Nightingale. Nursing on the Crimean War Battlefields 

(Manchester: Manchester University Press, 2020)


This volume was published in Manchester University Press’s Nursing History and Humanities series at the time of the first wave of Covid-19 across the globe.  This timing perhaps explains the rather limited number of published reviews so far, which is a shame.  This is an excellent book which focusses on nurses other than Nightingale and compares the experience of army nursing across different national contingents.

Part one rehearses the best-known aspects of Crimean nursing by reviewing the consequences of the British government’s imposition of female nurses on to a reluctant army medical department.  This involves scrutinising the myths of Florence Nightingale’s legacy, and depicting some of the realities of nursing for women who may or may not have qualified as ‘Ladies’ (whatever their credentials as nurses).

Part two offers a new analysis of religious nursing in the region, by British Sisters of Mercy and by French Daughters of the St Vincent de Paul charity.  An unpromising set of cultural suspicions between Irish and English women – the English resented Catholicism, not least as the faith of their traditional French enemy, while the Irish anticipated proud, cold-hearted bigotry – initially impeded good understanding between Anglophone women from different faiths.  The journals of Mother Francis Bridgeman and two of her nursing Sisters permit Helmstadter to compare and contrast the nuns’ system of nursing to Nightingale’s alternative (but not entirely different) system.  Nonetheless, Bridgeman and Nightingale criticised each other strenuously.  The Bermondsey Sisters of Mercy, by contrast, collaborated with Nightingale and English colleagues from the first.  When the founder of this convent, Mary Clare Moore, returned home ill in 1856, Nightingale described her loss as ‘the greatest blow I have had yet’ (p. 137).  Of ten Anglican sisters in British army hospitals, five were returned home for various reasons, while the other five proved excellent.

The Daughters of the St Vincent de Paul charity nursed French combatants, having established a reputation for their service to the sick since 1633.  They worked across eleven French military hospitals in or near Constantinople and practiced in quite a different way to the English-speaking women: they did not apply or change dressings, for example.  Patients were vocal in their gratitude for the women’s physical care of them, if less keen on attention to their souls.  Male French ‘soldier’ nurses, meanwhile, impressed medical observers with their professional knowledge and seemingly achieved good outcomes for hospitalised men yet were unremarked by patients.  Helmstadter wonders ‘Was it the theorised inherently feminine qualities of tender-heartedness which made the Daughters of Charity such outstanding and well-loved nurses?’ (p. 187), to which I would reply with a firm ‘yes’.

Piedmont-Sardinian forces entered the conflict on the side of the British, and casualties were nursed by Daughters of Charity from the same region.  The Sisterhood established hospitals in Turkey and Balaclava, plus a field hospital (which was an unusual setting for any female nurses at this time).  Sisters supervised male soldier nurses, despite being outnumbered by the men by about sixteen to one. The sixty-four women who served had all received training in military hospitals, and were required to speak both Italian and French.  They were highly impressive, and were rewarded accordingly, including when eight of the women were given medals by Queen Victoria: Nightingale was broadly in agreement but regretted the Daughters’ failure to stem drunkenness among patients, and their standing back from corporeal care.

Part three evaluates the nursing that was directed by doctors in British civilian and naval hospitals, and in the Russian army.  Trained nursing did not begin in Turkey, or for the Turkish army, until after 1900 (with dire consequences for the hospitals which catered to Turkish soldiers).  The British navel hospital at Therapia initially struggled to recruit nurses, but then benefitted from the arrival of a small group headed by Eliza MacKenzie, the wife of a retired Presbyterian minister.  The party was welcomed more readily than Nightingale’s ladies had been, and MacKenzie was less critical of her nurses ‘accepting their failings and considering them basically respectable’ (p. 212).  They, too, achieved ‘excellent results’ (p. 218) for patients.

British civilian hospitals in Turkey, such as at Smyrna, employed a mixture of Ladies and working-class women.  Collectively the female nursing staff overcame doctors’ reservations more readily than had been the case for Nightingale’s party, Helmstadter posits, because they were not trying to establish a female nursing service in the army. The women at Renkioi were chosen by doctors rather than by Ladies, and (coincidentally or not) seemed to display a higher rate of inebriety than other groups.

At entirely the opposite ends of the social and wartime spectra, a female nursing for the Russian army was first organised by Grand Duchess Elena Pavlovna, sister-in-law to the Tsar, at the request of surgeon Nikolai Pirogov.  The result was the Sisters of the Exultation of the Cross.  The Sisters took year-long vows and recruitment was open to women of any faith, making this sisterhood quite different to its European counterparts.  The 236 Sisters who served during the war displaced local women employed on an ad hoc basis.  They met resistance from male medical practitioners when they were put in charge of hospital administration as well as care, because the women’s actions effectively barred entrenched forms of army corruption.  Pirogov was ‘extremely proud of their work’ (p. 275), albeit that his praise had to be tempered as a result of infighting among the women.

There is just one notable misjudgement on Helmstadter’s part, her claim that ‘there is nothing to support [these] historians’ interpretation of nurses as agents of empire’ (p. 6).  The nurses did not have to impose either policy or medicine on people of different nationalities in order to advance an imperialist view.   At the same time, clearly, they were not simply either nurses or agents.  They were women whose humanitarian impulses were played out in a context that elicited attitudes born of cultural norms: see for example forthcoming work on nursing memoirs to be published in the journal Women’s Writing that detects the use of orientalist tropes by women wanting to signal belonging to the British army or side.

In sum, this book provides essential comparative research to stand alongside the well-worn histories of the British army and Nightingale, treated thus far in isolation. Other nationalities, other Ladies, and particularly other ordinary women and men who nursed in the Crimea deserve this thoughtful evaluation of their roles.