Table Of ContentRaising professional confidence: The influence
of the Anglo-Boer War (1899 – 1902) on the
development and recognition of nursing as a
profession
A thesis submitted to The University of Manchester for the degree of
Doctor of Philosophy in Nursing
in the Faculty of Medical and Human Sciences.
2013
Charlotte Dale
School of Nursing, Midwifery
and Social Work
2
Abstract
........................................................................................................................................................
5
Declaration
...........................................................................................................................................................
6
Copyright
Statement
.........................................................................................................................................
7
Acknowledgements
...........................................................................................................................................
8
The
Author
............................................................................................................................................................
9
Introduction
.......................................................................................................................................................
10
Chapter
One
........................................................................................................................................................
17
Nursing,
War
and
the
late
Nineteenth
Century
Woman:
a
review
of
the
literature
and
background
to
the
thesis
.........................................................................................................................
17
Introduction
.............................................................................................................................................
17
Women
of
The
British
Empire
..........................................................................................................
18
Nineteenth
century
civilian
nursing
..............................................................................................
27
Raising
the
professional
profile:
regulating
nursing
..............................................................
32
Victorian
nurses
in
war
.......................................................................................................................
36
Conclusion
.................................................................................................................................................
44
Chapter
Two
.......................................................................................................................................................
47
Historical
Methods
Used
..........................................................................................................................
47
Nursing
History
as
a
discipline
........................................................................................................
47
The
use
of
secondary
sources
...........................................................................................................
51
Personal
writing
as
a
historical
source
.........................................................................................
52
Archival
research
...................................................................................................................................
56
Attending
the
archives
.........................................................................................................................
59
Interpretation
of
findings
...................................................................................................................
60
Conclusion
.................................................................................................................................................
65
Chapter
Three
....................................................................................................................................................
66
The
motivations
of
nurses
for
wartime
service
.............................................................................
66
Introduction
.............................................................................................................................................
66
Danger
alongside
Duty:
‘it
is
an
experience
one
would
get
only
once
in
a
lifetime’.
68
Social
exploits:
‘She
dined
once
at
Major
Bagots
[sic]
with
us,
has
an
18
inch
waist,
scarlet
belt
and
makes
up’.
.................................................................................................................
78
3
Conclusion
.................................................................................................................................................
91
Chapter
Four
......................................................................................................................................................
93
The
boundaries
of
practice:
Nurses
in
the
sphere
of
war
.........................................................
93
Introduction
.............................................................................................................................................
93
Army
nurses
and
the
orderly
as
a
substitute
nurse
................................................................
95
An
influx
of
civilians:
The
British
and
the
Colonials
............................................................
108
‘A
plague
of
women’
on
the
veldt
.................................................................................................
114
Conclusion
..............................................................................................................................................
122
Chapter
Five
....................................................................................................................................................
125
The
challenges
of
Army
life:
Traversing
the
veldt
with
Tommy
Atkins
...........................
125
Introduction
..........................................................................................................................................
125
Life
on
the
veldt
and
under
canvas
..............................................................................................
126
Continually
exhausted:
The
health
of
the
nurses
..................................................................
135
Conclusion
..............................................................................................................................................
146
Chapter
Six
.......................................................................................................................................................
148
The
challenges
of
practice:
The
clinical
nursing
routine
........................................................
148
Introduction
..........................................................................................................................................
148
The
clinical
nursing
routine
............................................................................................................
151
The
role
of
surgery:
weaponry
and
wounds
...........................................................................
157
A
growth
of
personal
and
professional
confidence
..............................................................
166
Conclusion
..............................................................................................................................................
173
Chapter
Seven
.................................................................................................................................................
175
The
last
of
the
Typhoid
campaigns
...................................................................................................
175
Introduction
..........................................................................................................................................
175
The
aetiology
of
typhoid
fever
and
the
nursing
care
regime
...........................................
177
The
intensive
nature
of
nursing
fever
patients
......................................................................
183
Recognition
of
the
‘expert’
nurses’
work
..................................................................................
189
Conclusion
..............................................................................................................................................
192
Chapter
Eight
..................................................................................................................................................
194
4
In
the
Army
everything
is
badly
done:
‘red
tape’,
inefficiency
and
corruption
.............
194
Introduction
..........................................................................................................................................
194
Deficiencies
within
the
Army
Medical
Service
.......................................................................
196
Red
Tape:
Working
within
the
confines
of
the
army
medical
system
..........................
208
Conclusion
..............................................................................................................................................
219
Chapter
Nine
...................................................................................................................................................
221
A
move
for
professionalisation
and
public
recognition
..........................................................
221
Introduction
..........................................................................................................................................
221
A
call
for
reorganisation
and
recognition
.................................................................................
222
A
new
era:
The
Queen
Alexandra’s
Imperial
Military
Nursing
Service
.......................
229
Nurse
registration
and
education
................................................................................................
236
Conclusion
..............................................................................................................................................
244
Discussion
and
Conclusions
.....................................................................................................................
247
References
........................................................................................................................................................
264
Appendix
...........................................................................................................................................................
295
WORD COUNT (INCLUDING TITLE PAGE AND ABSTRACT) 87,112
5
Raising professional confidence: The influence of the Anglo-Boer War (1899 –
1902) on the development and recognition of nursing as a profession
Abstract
Charlotte Dale
A thesis submitted to The University of Manchester for the degree of Doctor of
Philosophy in Nursing, 2013
The thesis examines the position of nurses during the Second Anglo-Boer War (1899
– 1902) and considers how their work helped to raise the profile of nursing. The
experience of the war demonstrated the superiority of the work undertaken by trained
nurses as compared with that of ‘amateurs’. At the commencement of war a small
cohort of army nurses worked alongside large numbers of trained male orderlies,
however these numbers proved insufficient during the period of the war and
additional, entirely untrained orderlies (often convalescent soldiers) were relied upon
to deliver nursing care. Against a backdrop of long term antipathy toward nurses at
the seat of war, the work of both army and civilian nurses in military hospitals
suggested that the clinical proficiency of trained nurses had a significant impact on
military effectiveness. The thesis will develop arguments based on the personal
testimonies of nurses who served during the Second Anglo-Boer War, relating to
clinical nursing and nurses perceptions of professionalism during the period. Personal
testimony will be used primarily to examine the working lives and experiences of
serving nurses, as many historians simply state that the excellent work of the nurses
forced changes, yet make no allusion to what this specifically entailed.
Faced with the exigencies of war, including limited medical supplies and military
bureaucracy (termed by nurses and doctors alike as ‘red tape’) that hindered nurses’
abilities to provide high levels of care, nurses demonstrated their developing clinical
confidence. Despite accusations that nurses were ‘frivolling’ in South Africa, raising
concerns over the control and organisation of nurses in future military campaigns, the
social exploits of nurses on active service was not entirely detrimental to
contemporary views of their professional status. Nurses were able to demonstrate
their abilities to survive the hardships of war, including nursing close to the ‘front
lines’ of war and the arduous conditions inherent in living under canvas on the South
African veldt. Not only were nurses proving their abilities to endure hardship
normally associated with masculine work, but they were also establishing their
clinical capabilities. This was especially so during the serious typhoid epidemics
when nurses were able to draw upon their expert knowledge to provide careful
nursing care based on extensive experience. Nurses, who had undergone recognised
training in Britain, demonstrated their professional competence and proved that
nursing was a learned skill, not merely an innate womanly trait. The war also
represented an opportunity to evidence their fitness for citizenship by using their
skilled training for the benefit of the Empire. The subsequent reform of the Army
Nursing Service, resulting in the establishment of the Queen Alexandra’s Imperial
Military Nursing Service in 1902, suggests permanent recognition of the essential role
of nurses in times of both war and peace.
6
Declaration
No portion of the work referred to in the thesis has been submitted in support of an
application for another degree or qualification of this or any other university or other
institute of learning.
7
Copyright Statement
I. The author of this thesis (including any appendices and/or schedules to this thesis)
owns certain copyright or related rights in it (the “Copyright”) and s/he has given The
University of Manchester certain rights to use such Copyright, including for
administrative purposes.
II. Copies of this thesis, either in full or in extracts and whether in hard or electronic
copy, may be made only in accordance with the Copyright, Designs and Patents Act
1988 (as amended) and regulations issued under it or, where appropriate, in
accordance with licensing agreements which the University has from time to time.
This page must form part of any such copies made.
III. The ownership of certain Copyright, patents, designs, trademarks and other
intellectual property (the “Intellectual Property”) and any reproductions of copyright
works in the thesis, for example graphs and tables (“Reproductions”), which may be
described in this thesis, may not be owned by the author and may be owned by third
parties. Such Intellectual Property and Reproductions cannot and must not be made
available for use without the prior written permission of the owner(s) of the relevant
Intellectual Property and/or Reproductions.
IV. Further information on the conditions under which disclosure, publication and
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(see http://www.campus.manchester.ac.uk/medialibrary/policies/intellectual-
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University Library, The University Library’s regulations (see
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policy on presentation of Theses.
8
Acknowledgements
I should first and foremost thank my supervisors Professor Christine Hallett and Dr.
Jane Brooks for their kind and unfailing support at all stages. I cannot thank them
enough for everything.
I also especially wish to acknowledge my family for their continued assistance,
encouragement, support and tolerance throughout my studies.
9
The Author
Charlotte Dale is a student at The University of Manchester. She undertook her initial
nurse education at The University of Hull and graduated as a Registered Nurse
(Adult) in 2006. She worked as an orthopaedic nurse before leaving to pursue
academic study in 2009 with a particular interest in pursuing a career within research.
Charlotte has presented work at both national and international conferences and work
deriving from her thesis has been published in the Royal College of Nursing History
Newsletter and the UK Association for the History of Nursing Bulletin. She received
the Mona Grey Prize from The University of Manchester for her research proposal
and the Monica Baly Bursary from the Royal College of Nursing Foundation to
pursue this work, alongside financial support from the Wellcome Trust. Data
gathered as part of this thesis has informed a chapter to be included in a compilation
on wartime nursing practices intended for publication in 2014.
10
Introduction
This thesis explores the way in which the influence of the Second Anglo-Boer War
(1899 – 1902), hereafter referred to as the Anglo-Boer War, impacted on the
development and recognition of nursing as a profession.1 It will offer an insight into
the emerging role of the nurse in the sphere of war and will explore the ways in which
their work demonstrated to the military and medical authorities that the planning and
preparation for future wars necessitated a permanent female military nursing service.
The thesis will suggest that, although women had no defined place in the public
sphere, and nurses were not as yet registered practitioners, their experiences of
wartime service raised their confidence in their practice, enabling them to become
more assertive in their claim to professional status. The Anglo-Boer War
demonstrated the expediency of nurses in times of war and peace and also challenged
perceptions of where women should be located in respect of the ‘front line’ and in the
male dominated sphere of war. Many medical men in positions of authority and
within the War Office objected to women serving within the army system, an
objection derived from the Royal Army Medical Corps’ (RAMC) longstanding
antipathy to women working ‘in any role other than as supervisory sisters within the
base hospitals, far from the seat of war’.2
1 For further details of the Anglo-Boer War see Appendix.
2 Christopher Schmitz, ‘We Too Were Soldiers’: The Experiences of British Nurses in the Anglo-Boer
War, 1899 – 1902 In Gerard J. DeGroot and Corinna Peniston-Bird (Eds), A Soldier and a Woman:
Sexual Integration in the Military (Essex, Pearson Education Ltd, 2000), 49 – 65, 53 See also: Anne
Summers, Angels and Citizens: British Women as Military Nurses 1854 – 1914 (London, Routledge
and Kegan Paul, 1988), 65, 175; Jan Bassett, Guns and Brooches Australian Army Nursing from the
Boer War to the Gulf War (Melbourne, Oxford University Press, 1997), 9; Anna Rogers, While You’re
Away: New Zealand Nurses at War 1899 – 1948 (Auckland, Auckland University Press, 2003), 14 – 15
Description:of the Anglo-Boer War (1899 – 1902) on the to patriarchal rule capabilities in order to empathise with and understand the challenges their
