Subsidiary Notes as to the Introduction of Female Nursing into Military Hospitals in Peace and War

by Florence Nightingale

A very large proportion of nurses are mothers, often widows, with large families, whom they support and put to service out of their wages, too often eked out by improper means, i. e., bribes and petty dishonesty. Many of these women are moral, sober, industrious, and doubly anxious to retain their places, on account of their children; still there are serious embarrassments in employing them. The wages of hospital nurses are not and never can be enough to supply a proper support for children, in addition to the support the mothers ought themselves to have. Consequently when children are in whole or in part lodged, fed, clothed, “educated,” and put to service out of the £50 a-year of the head-nurse, or out of the 12s. a-week of the nurse, the mother either stints herself of proper food, proper strong drink (we deal with practice not with theory), proper warm clothing, for the children’s sake, or she supplies the deficiency by improper means. If the nurse cannot afford to live well and abstains from dishonesty, one of two things infallibly happens—either she takes to drink, as the fallacious support of an exhausted frame, or her strength fails and she breaks down, after a few months’, sometimes a few years’ struggle. When once she has taken to drink, one of two things invariably follows (dishonesty may be presumed to ensue upon, though it often does not precede habits of drink); she is or becomes unguarded, and is soon found out, and sinks into the miserable second and far too numerous class of characterless hospital nurses, unless drink shortly finishes her; or, in the other case, she is cautious and guarded—she then becomes sly, dishonest, and thoroughly venal; she extorts gifts and takes bribes from her patients and their friends—and the friends of hospital patients, like others, are of various kinds; she commits constant acts of petty but often most dangerous dishonesty, possibly remaining an efficient and clever nurse, sometimes a favourite nurse; and, so far as regards the crime which has taken the name of immorality, a moral woman. A certain proportion of nurses are all the above, excepting drink; for though, almost without exception, every nurse who drinks takes bribes, some take bribes and do not drink.

Of course widows and unmarried women who are not mothers do the above things; but there cannot be a doubt of the additional and terrible temptation to women burdened with children, to make money in various ways out of their patients. Even in the most favourable cases (and it is to be feared they are few) where the real good principle of the mother restrains her from venality, there are still serious objections. The time when a nurse can go out must necessarily be comparatively very limited. The time that is enough for the moderate demands of friendship or acquaintance is miserably insufficient for the natural yearnings of the mother, especially if the children are young and helpless. The consequence is that, either openly or by stealth, she goes to them or has them brought to her at unallowed times; or, if the rules of the hospital are lax as to visitors, the children are perpetually with her: and let it be remembered, that the head-nurse’s room or rooms are usually at the entrance of the ward, that being infinitely the best place. It is difficult to say whether such a practice is most objectionable as regards the children, or the patients, or the hospital; and whether it is most objectionable when the children are young, or adolescent, or grown up. It is objectionable in all and every one of these cases. And no less objectionable is it in the case of the assistant-nurse, who where the rules are lax will receive her children either in the ward or in the nurses’ kitchen; or where they are strict, will have the children come about the hospital and will meet them on the sly.

These things enter immensely, minute as they seem, into the discipline of wards and of the hospital; and discipline means a great deal.

Sanitary objects.

Sanitary Objects.

To discourage admission of women physically unfit.

A good many nurses enter hospital service who are quite unfit for it. Often consumptive and ruptured women, those suffering from piles or prolapsus, &c., present themselves, are admitted, struggle on for a time, and break down with or without taking to drink. Undoubtedly, none but strong healthy women should enter hospital service; the work will wear them out quite soon enough, and some of the above complaints are particularly liable to follow the work.

Here again men of business must advise: the fund ought to have some efficient though not infallible security as to the average good health on joining of its members. Life Insurance rules as to this would be to the point.

Believe me, all these things are important.