IX
NURSING IN THE COLONIES
Colonial nursing is usually undertaken by those who possess the spirit of adventure, and do not mind the prospect of pioneering work. Love of novelty, strong interest in fresh scenes and peoples, a desire to make more money than can in most cases be made in England, help a nurse in colonial work, provided that work really means her life, and she loves it. But let it be emphatically stated that the nurses who are not wanted in the colonies, in any capacity, are those who are failures in their work in England, or who simply leave the dull work of the old country with the object of having a good time abroad. Such women may do immense harm in countries where it is essential to the Empire that English people should be looked up to with respect and admiration, and where almost the most important part of an English nurse's work (quite the most important if she is working in a hospital), is to make the native nurses, of whatever race they may happen to be, see the dignity and possibilities of their profession, and be stirred with the desire to become proficient themselves.
No special training is required for colonial work. A thorough all-round training, including midwifery, a high standard of nursing ethics, a knowledge of hospital organisation, and good business abilities are needed. The rest is chiefly a matter of temperament and constitution. It goes without saying that a nurse for foreign climates, whether tropical, as in the majority of colonial posts, or subject to extremes of heat and cold, such as in Canada, must be physically strong; she should also be of an even temper and philosophical disposition, easily adaptable to climate, conditions, circumstances, and racial peculiarities.
The nature of the work will vary greatly with the locality and the kind of post undertaken. The colonial nurse who does private work will find patients and their needs much the same all the world over; she must, however, be prepared for anything, and ready to make the best of all things in emergencies.
In tropical hospitals it is altogether another matter. If the nurse taking a Matron's post in such a hospital is the first European to have occupied that post, she will probably have every detail to organise and put in order, from providing dusters for use in the wards, to arranging off-duty time for the nurses. She will mostly likely see at once that everything wants altering, and yet she will have to "make haste slowly," very slowly, or she will have everything in a ferment, and every one in open rebellion against her.
If she is working in the East, she will have the endless complications of caste and race and religion to deal with, and will have for some time, to learn vastly more than she teaches. Her success or failure will depend very largely upon how she gets on with the medical department—in other words, upon her own tact and common-sense, and whether she can so approve herself to the various medical officers that they will loyally back her up in her attempts at reform. Once things are established in working order, it is a question of constant supervision, day by day, for in no tropical hospital is it possible to expect that native nurses will do their work well and conscientiously, without the constant example and supervision of their trained Matron and Sisters.
Colonial posts are chiefly to be obtained through the Colonial Nursing
Association, of which offices are at the Imperial Institute, South
Kensington.
Salaries vary considerably, according to climate and the nature of the work. In very unhealthy climates, such as the west coast of Africa, the salary is high, and the risks proportionately so.
Private nurses, and those holding subordinate posts in hospitals get salaries varying from £60, which is the minimum, to £120 a year. An Assistant Matron may in some few cases get a salary increasing to £150 or £200. In a large hospital there is the ordinary chance of promotion—a Sister may be made Assistant Matron, or an Assistant Matron become Matron; but most colonial posts are simply for a certain term of years, at the expiration of which the nurse seeks fresh fields, her passage, both out and home, being paid. If, however, there should be a desire on both sides for a renewal of the engagement, the nurse can usually obtain an increase of salary.
A Matron's salary will vary from £100 to £250, in large Government hospitals in the Colonies where, it must be borne in mind, leave entails a journey to England, and a very expensive passage. In colonial posts there is usually six weeks leave yearly (which may be taken as three months together in the second year), but in most places there is no bracing climate within a reasonable distance. This, of course, does not apply to India and Ceylon, where the hills are easily accessible.
Each Government has its own arrangements with regard to pensions; some posts include pensions, but not all. The retiring age is usually sixty years. There is, unfortunately, no pension obtainable from the Colonial Nursing Association itself. This is certainly one respect in which it would be well if an alteration could be made; it is a question of funds and has already been brought forward for consideration. There would be vastly more inducement for really capable nurses, no longer very young (the age limit for joining is thirty-five) to join the Colonial Nursing Association, and serve their country in foreign dependencies, if they were assured of even a small pension after ten years' hard work in trying climates.