AN ORAL MSTORY OF A GROUP OF WOMEN WHO BEGAN THEIR PROFESSIONAL LIVES AS NURSES IN THE SCHOOL OF NURSING, ROYAL INFIRMARY, GLASGOW SCOTLAND BETWEEN 1938 AND 1945

Margaret Anne Highet

Submitted in partial Mfillment of the requirements for the degree of Master of Nursing

Dalhousie University Halifax, Nova Scotia October 2000

8 Copyright by Margaret Anne Highet National Library Bibliothèque nationale l*I ofCanada du Canada Acquisitions and Acquisitions et Bibliographic Setvices services bibliographiques 395 Wellington Street 395, nm Welligldori Ottawa ON KiA ON4 ûüawaON K1AW Canada Camb

The author has granted a non- L'auteur a accordé une licence non exclusive licence dowing the exclusive permettant à la National Library of Canada to Bibliothèque nationale du Canada de reproduce, loan, distniute or sel reproduire, prêter, distribuer ou copies of this thesis in microform, vendre des copies de cette thèse sous paper or electronic formats. la forme de microfiche/film, de reproduction sur papier ou sur format électronique.

The author retains ownership of die L'auteur conserve la propriété du copyright in this thesis. Neikthe droit d'auteur qui protège cette thèse. thesis nor substantial extracts fiom it Ni la thèse ni des extraits substantiels may be printed or othetwise de celle-ci ne doivent être imprimés reproduced without the author's ou autrement reproduits sans son permission. autorisation. Dedication

This work is dedicated to my parents, Mary and Robert Richardson of

Kilmarnock, Scotland, in appreciation of their continuous love and support and in recognition of the impact that the omet of World War II had on thek early married and family life. Table of Contents

List of Illustrations and Tables ...... vi Abstract ...... vii Acknowledgments ...... viii Introduction ...... 1

1 Setfing ...... 6 The School of Nuning ...... 17 2 Methodology ...... 30 Method ...... 31 DataCollection ...... 33 Data Reliability and Validity ...... 35 ResearcherBias ...... 36 Theparticipants ...... 37

PreseatationofData ...... 43 Preparation for War ...... 44 AirRaids ...... 46 Blackout ...... 49 Rationing ...... 51 Social Conditions ...... 54 Effects of War ...... 56 Nurses' Work ...... 59 LeisureTime ...... 64 War'sEnd ...... 66

4 Analysis ...... 69

5 Summary ...... 83 Conclusion ...... 88 Implications for the Future ...... 92

Appendices ...... 94

References ...... 103 List of Figura and Tables

Figure1 . Royal Infïrmary 1839 ...... 6

Figure 2. Glasgow Royal uifirmary 1939 ...... 16

Figure 3 . Glasgow Royal Infirmary Emblem ...... 17

Figure 4. Photographs fiom 1892 and 1939 ...... 29

Figure 5 . Bedmaking Class 1939 ...... 61

Figure 6. Bandaging Practice 1939 ...... 62

Table 1 . Appendix A ...... 94

Table 2 . Appendix 1 ...... 102 Abstract

The purpose of this study was to document the recollection and lived experiences of women who were student nurses in the Royal Infimary, Glasgow, Scotland between 1938 and

1945. This time period covers one ofthe major events of the 20' century, World War II, which impacted on and shaped the lives of al1 who lived through it. The effects of war on the day to day lives of shident nurses were explored with a particular focus on their recollections of how their lives, work environment and nuning curriculum were afFected and changed as a result of the war.

Oral history was the method used in this project with semi-stnictured interviews and open ended questions guiding the process. Participants were invited to describe their experiences in theit own words and with their permission the interviews were recorded on tape.

Newspapen, professional joumals of the period and hospital records were secondary sources of information.

Fourteen women who had been student nurses in Glasgow Royal infirmary between

1938 and 1945, took part in the study. Their names were obtained fiom the hospital Nurse's

League membenhip list and interviews were conducted over a 3 week period and later transcribed and the findings presented. Feminist methodologies were used to conduct the study and common themes were identified fiom the data and presented and cntiqued from a feminist perspective.

Unlike traditional nursing history which describes the working conditions and evolution of the profession fiom pre-Nightingale days to the present, this qualitative historicai study explored the day to day activities, and perceptions of selected student nurses during a significant worid event.

vii Acknowledgments

It is a pleasure to acknowledge the many people who have assisted me in the pmcess and successful completion of this study. To my farnily, fiiends and colleagues for their continuous encouragement and support. To my employer, the Sisters of Charity, Halifax, especially Sister Doris Schoner who, as administrator ofMother Berchmans Centre, provided me with study leave to conduct the inte~ewsfor this project. To Dr. Barbara Keddy, who has always been encouraging and whose advice has keninvaluable, and to Dr. Carol Srnillie and Professor Mardi Arnirault for your assistance and advice as committee members. 1 am especially indebted to my fnend and committee member, Rosemary Weir, of the University of Edinburgh, Scotland, for her assistance in accessing the names and addresses of Glasgow

Royal Infirmary League members who met the study criteria. A sincere thank you aiso to

Alistair Tough, Archivist of the Greater Glasgow Health Board, for facilitating access to the records of the Royal Infirmary Board meetings and to Miss Margaret Smith, Director of

Nursing and Quality, Royal Inhary Glasgow, for her interest and support.

Finaily a very speciai appreciation and thank you to those wonderfûl women who so willingly offered me hospitality and enthusiasticaily shared their experiences and mernories with me.

viii Introduction

This is a war of the unknown warriors, the whole of the warring nations are engage4 not only soldiers, but the entire population, men ,women and children. The fionts are everywhere. The penches are dug in the towns and streets. Every village isfortified Every road is barred. ï7tefiont lines run through the factories. The workmen me soldiers with dtyerent weapons but the same courage. (WINSTON CHURCHILL,1940)

This study documents the recollections and lived experiences of fourteen women who were student nurses in the school of nursing of the Royal Infimary, Glasgow, Scotland. between 1938 and 1945. This time period covered one of the major events of the 20' century, narnely World War II, which impacted on and shaped the lives of al1 who lived through it.

World War II began for the British people on Sunday September 3" 1939 after the

Gerrnan army's invasion of Poland, and lasted until August 1945 when Japan surrendered.

Although Hitler never did invade Britain, the hardships of a country at war afZected the day to day lives of al1 the population. For example, being an island, Britain depended on üade with Europe and what were at that time the countries of the British Empire, (now members of the Commonwealth) for many of its food supplies and raw materials, including gasoline.

During the war years, however, these products were in short supply, due in part to the effectiveness of the Gennan navy in sinking many of the merchant supply ships and also to the necessity of providing for ail the demands of the large anned services. A system of rationing was therefore imposed on the British public to control and ensure the equitable distribution of food, clothing and fuel (Calder, 1969; Kendall, 1972). In the first months and 2 years of the war the threat of invasion was ever present and in the larger industrial cities and also the southem ports on the English Channel, regular night bombing raids were a reality, and caused a great deal of property damage and loss of lives. The industrial city of Glasgow, situated in south west Scotland on the river Clyde, was a major ship building centre, which was a critical industry during the war years when so many ships were being sunk by Hitler's subrnarines. The city was therefore considered to be a prime target for aerial bombing although not as accessible as the English southem counties for the German bombing raids.

Historians have written about the impact of the war years on society as a whole, however the effects on the daily lives of women should be recognized. In 1941, as part of the national war effort at home, ail unrnmied women between 20 and 30 years of age were obliged to register for national service and many chose nursing as an alternative to being drafted into the med services or the munition factories, (Chamberlin, 1972, p.124).

Glasgow Royal Infirmary responded to the national emergency by increasing its enrollment of student nurses, and opening up some of the wards for the care and rehabilitation of wounded servicemen (Board of Management Report, September 1939; Jenkinson, Moss, &

Russell, 1994, p. 189).

Student nurses during this time period, (and for at least 20 or 30 years after) were very much an integral part of a hospital's workforce. Theu training followed the apprenticeship system whereby practical experience was acquired on the job with a small theoretical component fitted in as time and the service needs of the hospitai allowed. This study exarnined the experiences of student nurses during the war years, focusing particularly 3 on the efTect wartime conditions had on the curriculum, work environment, and their personal lives.

This historical study examined and valued the realities of women's lives by providing them with an oppomuiity to tell their stories in theu own words. The primary sources of data were the taped personal stories of a select group of 14 women who met the study criteria, which was to have been a student nurse in the Royal Infïrmary, Glasgow Scotland between

193 8 and 1945. Secondary sources of idormation were aiso used and included the hospital

Board of Management Annual Reports, newspapers from the period and letters fiom qualified participants who were unavailable at the time the interviews were conducted. The interviews were semi-sû-uctured and open-ended; this ailows fiee interaction between researcher and participant, provides oppomuiities for clarification and discussion, and explores people's views of reality (Reinha 1992, p.18). The taped interviews were transcribed, major themes identified, and the data presented using the words of the participants. Finally a feminist perspective was used to critique and analyze the data. More detail regarding a feminist methodology will be forthcoming in another chapter.

Hoopes (1 979, p. 5) has menthat oral history is the collection of an individual's spoken mernories of their iife, people known, events witnessed or participated in, and provides a window through which the past can be viewed. It gives a feel for the facts that cmonly be provided by one who has lived through them. According to Knunan (1985) a knowledge of history ailows nurses to understand how the past impinges on the present.

Without a past, she writes, thei~is no meaning to the present, aor can we develop a sense of ourselves as individuals, nor identify with each other as membea of the group we cal1 4 nursing. A sîudy of history enables nurses to place contemporary nursing practices in a broader comparative context and to consider how nursing has been conducted in other places and in other times. Traditional nursing histories describe working conditions and the evolution of the profession fiom pre-Nightingale days to the present, histories of schools of

nursing are available and also biographies of nursing leaders, however accounts by the ordinary grassroots nurse are also significant and should be documented for posterity.

Student nurses of this period were al1 women, therefore an oral history of student nurses'

experiences is an oral history of women and as such is a feminist encounter and validates

women's expenences, (Gluck, 1987, p. 223).

Kendall (1972, p. 87) documented how a striking feature of wartime life was the way

in which people adapted to circurnstances, and the way in which cnsis became a cohesive

force. Life took on a peculiar reality and people stood by each other. This study confhs

Kendall's observations. From the participants' accounts, the work of the hospital continued

and the student nurses supported each other through the rigo= of hospital rules and the

dreariness of war time restrictions,

This study is developed in the next sections which are divided into five chapters. In

order to provide the reader with an understanding of the context fiom which the data were

generated, chapter one describes the history of the hospital fiom the 18" century up to and

including the study period, and the evolution of the school of nursing. Chapter two includes

the methodology and a brief biographical description of the participants, and in chapter three

the data are presented around the common themes identified fkom the interviews and

described as much as possible in the words of the participants. The fourth chapter is the 5 discussion and analysis of the data, wherein 1 employed a feminist perspective which considered issues of power, gender and class within the context of the study period. The surnmary and conclusion are presented in chapter 5.

This research study bas significance for two reasons: kt,women who were student nurses during World War II are aging, and with their passing their unique stories will be lost forever, and aiso it provides the opportmity to enrich our knowledge of nurses' lives, work and perceptions of themselves, and their place in the community. Secondly, the last class of

Glasgow Royal Ifimary trained nurses graduated fkom the hospital in 1994. Nursing education in Scotland has now moved to the Universities and Colleges. A record of this eventfui period in the school's history can be considered to be particularly relevant for fiiture historians. Chapter 1

Figure 1. Royal Infirmary 1839

Note: Reproduced by kind permission of the Greater Glasgow Health Board Archive.

Setting

The Royal Infirmary, Glasgow Scotland was (in the pefiod to be studied) one of the

major teaching hospitais for nurses in the industrial city of Glasgow. It is located in the oldest

part of the city in what was a densely populated working class neighbourhood. It was once 7 surrounded by tenements, srnall neighbourhood shops and corner pubs which urbaa mewal in the 1960s and 70s have removed to make room for hospital expansion and highway constmction. Its immediate neighbour still remaias, the Cathedra1 of Saint Mungo which has a history as a place of worship for more than a thousand years.

The hospital has a long and proud medical tradition and the training school for nurses was begun in 1880 by Mrs Rebecca Strong one of the original graduates of the Nightingale

School of Nursing at St. Thomas's Hospital in London (Appendix G).

Founded in 1792 and pteda Royal Charter fiom King George III, the hospital was built to serve the needs of a burgeoning population drawn to the city by the expanding trade of the Industrial Revolution. The generosity of public minded citizens of al1 backgrounds enabled the entire development of the infirmary to be hded by charitable donations.

(Jenkinson, Moss, & Russell, 1994, p. 20). Glasgow at that time occupied a small heavily congested area on the north bank of the river Clyde and the site chosen for the new hospital was next to the Cathedra1 of Saint Mungo, on the site of the Archbishop's cade, now in ruins. That this was an eminently suitable location for the new hospital is supported by the

1 797 report of the Managers of the Infirmary, 3 years after it opened for patients, which said:

...and now from sufficient experience the managea have the satisfaction of

reporting that in the point of situation, good air, abundance of good water and

convenient accommodation of the patients, the Royal Infirmary of Glasgow is

not excelled by any other establishment of the kind in Britain of which they

have had information. (Patrick, 1940, p. 8) 8

The foundation stone of the Infirrnary was laid on May 18: 1792 accompanied by much pomp and ceremony. There was a great procession, which included the Lord Provost and Magistrates, University Professoa, Representatives of the Trades House and the

Merchants' House, the Faculty of Physicians and Surgeons and the general public. An anthem was specially composed for the occasion extolling the wtue of the new institution, the first verse wax

"Go bid the spacious dome arise,

And point the tunets to the skies

Not pianned for idle form and show,

But to alleviate human woe." (Patrick, 1940, p. 9)

The old Royai was a beautifully propoaioned building with a plain lower base and ornamental upper facade with delicate pillars, the whole surmounted by a dome, under which was a large operating room with viewing space for 200 medical students. There were eight wards, each containhg 17 beds, a total of 136 patients. The small wards were a distinct advance on contemporary medical thinking, the designers of the Royal deciding that the vast wards then common in al1 hospitais acted as breeding grounds for influenza and similar

ailments (Mackinven, 1966).

The illnesses suffered by the first patients admitted to the Infhnary ranged fiom leg

and hand uicers, to rheurnatism, palsy, breast cancer and diabetes. Mer a slow start the

number of patients admitted rose steadily until the Board of Managers in 18 13 were forced

to consider extending the building to accommodatethe growing population of the city which

was rapidly industrialking. Seventy two beds were added in 18 16, a 100 bed fever block 9 was added in 1829, and by 1861 with the addition of a 144 bed surgical block the total bed capacity was 572. The enlarged infirmary remained unchanged for the next 50 years.

It was in this building in the 1860s that Joseph Lister developed his principles and practice of antiseptic surgery, a process which would revolutionize the practice of surgery.

Adding to this proud distinction was Sir William Macewen, a pupü of Lister who did pioneer work on surgery of the brain and was among the first doctors in the world to operate

aseptically .

The Royal can also clah to be the foremer of systematic nursing education . As a

result of the advances in surgical practice by Sir William Macewen, a committed nursing

staff well trained in the latest methods of pre and postsperative care was required. Rebecca

Strong, a widow, who had ûained at the Nightingale School of Nursing at St. Thomas's

Hospi ta1 in London in 1867, was hired as Matron to address the standards and conditions of

nursing. Her fust task was to improve working conditions, in order to attract students from

the pnvileged higher economic groups. The hospital superintendent wrote in 1877 that:

in too many instances the applicant is one of a class who are not very elevated,

either intellectually, morally or socially, and that when there were no applicants

to fil1 a vacancy, an intelligent scrubber was sometimes promoted to serve as

night nurse! (knkinson, Moss, & Russell, 1994, p. 128)

While we can criticize these comments because of the classism inherent in this perspective,

it is important to note the historical context.

Mrs. Strong persuaded the Board to provide suitable nurses unifonns and to abandon

a plan to charge a fee for nurshg training, arguing that such a scheme would result in 10 potential trainees tramferring to other hospitals with better facilities and recognhd schools of nursing. By threatening to resign in1 882 she established the right as matron to have the sole responsibility for the ailocation of nuises to the wards, and to communicate dùectly with the medical superintendent and visiting physicians on matters relating to the nursing staff. This was a significant victory as it established her authority over the junior doctors in nursing matters in the wards.

In 1885 Rebecca Strong resigned her position at the hospital apparently due to the

Board of Management's refusal to approve construction of a new nurse's home which she felt was essential for the welfare of the nursing staff and the success of a school of nursing.

In 189 1 however she returned, three years after completion of an 88 bedroom nurses' residence which was comected to the main building by a glazed covered walkway (still in existence), which provided shelter for nurses going to and from the wards. In 1893 she introduced a distinct system of training for nurses. Two programmes of tuition were developed, the first, of three months duration, was the original prelirninary training school, which the nurse attended before going on the wards. The curriculum consisted of physiology, anatomy and hygiene. Merpassing examinationson these subjects she was ailowed to work on the wards. The second programme consisted of medical, surgical and practical nursing.

This systematic nursing education was the foremer of al1 other systems of nursing education in the country (Jenkinson, Moss, & Russell, 1994, p. 24).

By the end of the 19' century there was tallc of replacing the old building to offer new specialist treatments and meet the needs of a rapidly increasing population and der a great deai of controversy plans were approved for a new building on the site of the old and the Il foundation Stone was laid in 1907 by the then Prince of Wales, later King George V. The new infirmary was designed for 660 beds, every bed to have its individual share of a window and ventilation, and with a promenade on the roof for convalescent patients.

Apart from necessary additions and modemization carried out as required, the Royal

Infirmary stands very much as when it was completed in 1915, when the first patients were admitted, many of them wounded soldiers direct fiom France. Between 1914 and the end of

19 19, 2,345 servicemen were admitted to the Royal which also admitted men and women fiom the munitions factories who suffered toxic jaundice as a result of trinhotohene (TNT') poisoning.

The volume of work during the war years and the loss of experienced nursing and medical staff to serve with the forces and in military and other war hospitals placed a great strain on those who remained. Working hours were far longer than would have been tolerable in peace time. Nurses were required to work through every sixth night and until midnight on most other days.

The end of the First World War brought to a close a most stresshl time in the history of the Royal as the demands on its services stretched the human and material resources almost to breaking point, and the post war years posed new challenges with the advances in medical technology and demand for new services. The Royal's reputation as a centre of medical research and a leading medical teaching hospital required that it keep abreast of the latest developments in medicai technology. The managers made fiequent appeals to the munificence and civic pride of its wealthy benefactors, to secure bds to establish prestigious new departments, or obtain expensive items of equipment. In 1939 a meeting of 12 contributoa was told that "no sooner was the infhary equipped with every possible contrivance than some gentleman in a distant country invented some highiy expensive appliance which the specialist concemed would certainly desire to have" (Jenkinson et al,

1994, p. 74); a sentiment no doubt echoed by hospital administrators to this day.

Among the innovative technologies during the inter-war years were the introduction of insulin as treatment for diabetics (1923), a biochemical department and metabolism unit and dietetic kitchen in 1926, and the fkst burns unit in the United Kingdom with a resuscitation room for burns and scalds cases, a urological clinic and a clinic for nervous diseases. In 193 1 the forerunner of the Physiotherapy school, a School of Massage for men was opened and in 1932 the Royal became the National Radium Centre and a lead lined safe weighing two tons was required to store radium needles when not in use. The Royal's capabilities for providing specialist advice and treatment were expanding.

Until the introduction of the National Health Service in Scotland in1948, the Royal

Infirmary was one of the country's voluntary hospitals, that is independent of state control and self financing, being supported by bequests and other endowment fûnds. The provision of expensive equipment and specialist facilities was made possible by the annuai subscriptions, legacies and other financial gifis, which reflected the confidence of the benefactoa in the fùture of the Royal as a major teaching hospital under voluntary management.

In 1938 with the threat of war the Secretary of State for Scotland organized an

Emergency Medical Service to receive and treat casualties in the event that war was declared,

and the Board of Managers received a letter fiom the Department of Hedth requesting their 13 cooperation in preparing for the expected influx of wounded servicemen, and of heavy civilian casualties (Jenkinson et al., 1994, p. 188). Eight hundred and fi@ beds were resewed in the Infirmary for civilian casualties. The Royal was considered to be in a danger spot if the city was bombed, and was designated as a clearing house for casualties

(Emergency Board meeting, 4' September 1939, Chairman's [sic], report).

The 145 General Report of the Managers of Glasgow Royal Infirmary (December

1939) records that the normal work of the Infumary was seriously interrupted by the outbreak of war on 3rd September. Up to that date the number of in-patients and out-patients had exceeded the previous year's figures. At the request of the govemment these patients able to be sent home or transferred to other institutions were moved according to a pre-arranged plan and 850 beds were held in readiness for civilian casualties arising from air raids.

Patients not fit to be sent home were transfened to designated convalescent homes. A number of the infïrmary nurses were lent to these institutions with the necessary medicai supplies and equipment to enable the medical staffto continue the treatment of their patients.

Fortunately the expected air raids did not occur, but the introduction of the blackout led to so many accidents that a nurnber of the beds reserved for air raid casuaities had to be used for accident cases (p. 7).

With the outbreak of war donations decreased, due in part to volunteer efforts king redirected to war needs and to the introduction of black out; a part of Britain's defense system which required that in the evenhg after dark dl windows be covered with black blinds or shutters to prevent even a glimrner of light shining through to the outside, Street 14 lights were nonexistent, bus and car headlights reduced and flashlights forbidden. In a

January 1940 report to contributors the manager said:

that the blackout had been as big a trouble as Hitler: whist drives and dames

could not be held and collections had to be made during the hours of daylight.

The money did not corne so easily but we had to deal with ail the accidents

caused by the blackout.

Other costs incurred as a result of the war conditions were for construction of air raid shelters, the purchase of sand bags and bricks, wire and fabric to protect the windows nom bomb blast damage, and blackout materid and rails for dlwindows. An interesting notation from the Managers' report of October 3" 1940 is a recommendation that the maids be instnicted to make the blackout curtains.

Fortunately the numbers of civilian casualties admitted to the Royal during the war years were far fewer than had been predicted in 1939, only 247 king admitted to the wards.

Apart from the roof being damaged by fire when a few incendiary bombs fell nearby in 1941, the infirmary survived the war intact. Medical and surgical teams fiom the Royal responded to provide vital seMces when the massive bombing of Clydeside shipyards occurred in

March and May of 1941. Over 1,000 people died and over 4,000 were wounded in the bombing of the cornmunity of Clydebank on the western edge of the city.

The demands of wartime led to the introduction of new and innovative treatments.

The Royal became the only hospitai in the United Kingdom to establish a special unit for the

treatment of bums and the Medical Research Council appointed a bacteriologist to the

hospitai to investigate the treatment of burns and wound infections. The unit was given an 1s experimental supply of penicillin in 1942, two years before it became geaerally available for treatment in the wards.

The Annual Report of the Board of Managea (1944) records:

The managers are now able to report that in 1942 the Royal Ibarywas

especially selected by the govemment as a Research Centre into the use of

penicillin. This experirnental supply was used in the Burns ward. During 1944

a considerable supply was issued to the infirmary, 22,000,000 units were used

in the treatment of military cases, lO2,OOO,OOO units in the treatment of civilian

cases in the infirmary and large supplies were distributed to other hospitals. The

infmary is not only a distribution centre but an advisory centre for the use of

penicillin. This work and the making up of the various preparations of

penicillin has involved an added burden to an already depleted staff ( p.6).

The effectiveness of this new drug is also noted with a report fiom the bums unit in

the same report. There were 3 18 patients in the previous 12 months, with a decrease in the

mortality rate to 5.6%, and elimination of streptococcal infection.

Indeed the Royal had a proud war record. Although there were severe shortages of

staff, medicai supplies and equipment, the range of services were maintained and care given

to civilians and service personnel alike.

In the Board of Managers Report of 1945 it was noted that "in spite of staffing

difficulties which so far as the nursing staff is concemed have greatly increased during 1945,

the work of the institution has not only been carried on but has increased. In the latter months 16 of 1944 there was a decrease in the admission of civilian cases to the inhary owing to the

large nurnber of Service cases king tmited."

Figure 2. Glasgow Royal Mrmary, 1939

Note: Reproduced by kind permission of the Greater Glasgow Health Board Archive. The School of Nursing

The first reference to a training programme for nurses in the

History of Glasgow Royal Infimiary (1994) is a report written in

1877 by the then superintendent Moses Thomas that a systematic

training be ofSered at the Royal to address the problem of applicants

who were "not very elevated, either morally, intellectuaily or

socially." As a result a course of lechues on medical and surgical

nursing was inaugurated in 1878, which was also "open to ladies" on

Figure- 3. payment of a fee (p. 144).

Although the importance of obtaining the services of educated and committed

hospital nursing staff had been recognized since the Cnmean War in 1854-56 when the

neglect of sick and wounded soldiea was reported in the Nationai press, and Florence

Nightingale actively advocated for better education for nurses, the nature of the job and the

poor wages did not attract young women to the profession. Indeed in the 1860s the nurse's

duties included scrubbing the unvarnished wooden flooa of the wards, washing clothes,

fetching meals and changing beds. Patient care did not involve much more than feeding and

washing the faces of the very sick and living accommodations were very poor, often in

makeshift bedrooms off the wards.

Carol Helmstadter (1993) describes the organization of the 19" century hospital;

"staff were organized in much the same way as the staff of the larger landed estates, with a

matron or housekeeper in charge of female servants and patients." She quotes a young doctor

fiom St. Thomas's Hospital in 18 19 who describes the matron as: The superior female of the establishment...... to her belongs the direction

of al1 femde domestics. She presides over their mords and good behavior,

and sees that they execute the several duties of their stations with propriety

(p. 45).

Innovations in surgical technique which required the assistance of a committed nursing staff and the introduction of Joseph Lister's system of antiseptic surgery provided the impetus for changes in the recruitment and training of nurses in the hospital. At the same time there was a growing public awareness of the benefits of providing good nursing care for the sick, and the Royal, which relied on public subscnptions and donations for its survival could not be seen to lag behind improvements elsewhere. In 1879 an advanced and systematic course of instruction for nurses was proposed by the Chairman of the House Cornmittee. Mrs Rebecca

Strong one of the original graduates of the Nightingale School of Nursing at St. Thomas's

Hospital in London was hired in 1879 to be matron, a position which she held (with a few year's interval when she operated a pnvate nursing home), until 1907 when she retired

(Appendix A).

Mrs. Strong was aware that in order to attract better educated women working conditions had to be improved, and during the first six years of her appointment she persuaded the Board to provide suitable nurses' uniforms and improve their living accommodations. She also clarified the role and responsibilities of the matron by fighting for the right to make decisions about the disposition of nursing staffwithin the hospital and to communkate directly with the superintendent and visiting medical staff on matters relating to the nursing staff. However it wasn't until 1893 that she introduced the systematic 19 education programme for nurses which was the foremer of al1 other systems of nwsing education in the country. Lasting for 3 month?it was in two parts. The first part, of 6 weeks duration consisted of twelve lectures each in anatomy and physiology and ten lectures on hy g iene. These were conducted by professors in eac h speciality and delivered in St. Mungo's

Medical College. The second part, of 4 weeks' duration related theory to practice in the clinical areas of the Royal Infimary. It consisted of seventeen lectures and dernomitrations on surgicd cases. thirteen on medical cases, ten lectures on practical nursing and ten on cooking. Both of the latter were given by Mrs Strong. Examinations were held at the end of each part and certificates awarded (Gillespie, 1991). It was oniy after passing the exarninations on these subjects that the nurse was permitted to go on the wards.

This programme became known as the Preliminary Training School, in later years familiarly referred to by Royal nurses as the P.T.S. The foundation of the P.T.S. at Glasgow

Royal Infirmary demonstrated the value of separating nursing education fiom nursing work and was based on sound educational principles (Weir, 1994).

Introductory remarks given by Mrs. Strong in 1893, at the commencement of the second course of training offered advice which has still relevance to nurses of today as we consider the patient assessrnent and documentation which is so required as part of the nursing process.

It is by close observation and correct reporting of what you observe that you

can render much valuable aid to the medicai attendant. Nursing is not

mechanical work for which hard and fast niles can be given to guide you in

an unerring road. It is ever-varying work, therefore keep an open miad, guard against too mwa view of things, thinking your own little bit of

knowledge conclusive (G.R.I.Nurses' League Journal 1 99 1, p. 27).

Nursing's role is described as aiding the medical attendant and implies a complementary relationship with the medical staff.

Rebecca Strong was concemed not only with professional skills but the need for a code of professional conduct, for specialist training to follow elementary training, and the need for standardization by an independent body of examiners in co~ectionwith registration. As a matter of interest, the registration of nurses occurred following the passing of the Nurses Registration Act in 192 1 and state registration examinations were first held in March 1925 (Baly, 1995, p.153).

Mrs. Strong lived 101 years and on the occasion of her centenary on 23 April 1943 she broadcast a message of thanks to al1 her well wishen:

to al1 you younger nurses who may be listening to me 1 would say this- rejoice

to have lived to see your calling raised fiom the humble profession it

occupied when 1 was a probationer to that of honoured profession. 1 feel

proud to have had a small share in the early days of this refom. I knew Miss

Nightingale, indeed 1 can claim to have acquired some of my enthusiasm

fiom the Lady of the Lamp herself, and 1 can therefore appreciate better than

you the truly great advance that has been made since those days (Glasgow

Royal Inhary League Journal, 199 1, p. 28).

Agnes, one of the snidy participants remembea caring for Rebecca Strong. She tells:

1 nursed Rebecca Strong, she was in the side room (private room off the main surgical ward), she was about 97 at the time, she wore a wee cap on her head and she used to tell me about when she started nursing in Florence Nightingale's days. She was one of her students and she used to tell me what to do and how to do it. She always thanked me and told me lots of stories, unfortunately 1 can't remember them now. 1 was so pleased, as a junior, when she told the (ward) Sister how pleased she was with me. That was something! She would tell me how things were in her time, how they didn't get any pay at htand the long hours, it was just the start of nurse training you see. Mostly (she advised) to keep good discipline and respect and keep your dignity. I'm sorry 1 can't remember more, but the fact that 1 nursed someone who actually knew and worked with Florence Nightingale - well she was my heroine, 1 had wanted to become a nurse just like Florence Nightingale!

The Royal Infumary Nursing School was closely modeled der the St. Thomas's

School and in the period of this study the 19& century mode1 was still in effect. Student nurses were the work force of the hospital and there was a strict hierarchy in place within the nursing school and throughout the hospitai. Student nurses deferred to those more senior to hem, even fellow students who may have entered the school a few months before them.

Margaret describes the staEng pattern in one of the larger female surgical wards,

"there was a junior probationer and senior probationer, a junior senior and a senior who would fil1 in for the ward sister when she was off duty. Al1 were students, rarely was there a qualified staff nurse in the ward." Many aspects of the Nursing tasks were taught on the ward by the ward sister or staff nurse, or occasionally by senior student nurses. Senior students were responsible for al1 nursing care during the evening and night hours. In addition to caring for patients, student nurses performed many household tasks, for example cleaning 22 ward hunishings, arranghg patients' flowen and even preparing and serving breakfast for up to forty patients (Maggs, 1987, p. 186).

Agnes, when asked about her responsibilities as a student nurse on the ward recalls,

"my recollection of my earliest contact with the ward was simply as a cleaner. I seemed to spend a lot of time dusting and polishing." Margaret describes the junior probationer's

morning tasks, "your fktjob in the morning was to pull al1 the lockers out fiom the wal1 and

scrape al1 the fluffof the bottom of hem, then after bedpan rounds for the patients one was

relegated to the sluice room to clean al1 the bedpans and the linen which would be bagged

for the laundry." On reflecting on these experiences she observes, "1 didn't like it much at

the time, al1 this etemal cleaning, but looking back when 1 visit the wards now they don't

keep them as clean as we did, there was a lot more work involved in those days."

As the nurses becarne more advanced in their training they were given more

responsibility, a lot depended on the time and cornmitment to the students of the ward sister.

Nancy recalls, "if you were luch enough to get a ward sister who was interested in teaching

and concemed about the students in her care then your experience could be quite wide but

there were some sisters that looking back 1 realize were not al1 that good at their job and it

was left to the senior students to make decisions about what you could do and not do."

Nurse tutors with post registration courses in education taught nursing procedures and

lectures on disease processes and anatomy and physioiogy were taught by physicians and

surgeons fiom the hospital medical staff. One of the participants was particularly criticai of

the testing system in the preliminary training school. She said "it was quite ridiculous really,

here we were youngstea only educated for three months in anatomy and physiology and they 23 brought the professor nom the univeaity at the end of the three months to take the oral exam. It was absolutely ridiculous and the head of the public health services for Glasgow interviewed us for materia medica."

Students had to pas al1 the exams in the pupil school (P.T.S.) before being finally accepted as a Ml fledged student in the hospital. Al1 those who didn't pass the exams had to Ieave.

No discussion about the history of the School of Nursing in the Royai during this penod is possible without acknowledging the influence of Miss MacInroy, Sister Tutor in the school fiom1930 until her retirement in1959. She is remembered with affection by the

participants of this study, and many had personal anecdotes to share of her personai interest, encouragement and promotion of the hospital standards. Mary rernembers, "Miss McInroy, the darling - we loved her. When we were preparing for our state exams (final registration

examination) we had our lectures and then stayed in the classroom and she went over

anything we needed help with, she was wonderful, no wonder the pas rate was so high."

During the period under study the student nurses attended lectures in their own time,

when off duty fiom their responsibilities on the wards. The purpose of the school appeared

to be to prepare the workforce for the needs of the hospital, as tirne for learning was not

a priority. Pat, records that: "ail your lectures were on your off duty, and it made it very hard.

Really you had very littie time to yourself." Jessie, reflecting on her student experiences

wonders how she managed to pass her exams:

1 slept thtough every lecture! I'm not joking. Miss Mcinroy was a wonderfûl teacher and 1 loved hearing her and 1 wanted to learn, but when 1 took notes - 1 went to sleep! My whole exercise book would have about ten words in it and then I'd fa11 asleep and then I'd waken up and start again. 1 was working so hard, 1 was very conscientious and a very hard worker and of course we had lectures in our off duty, we didn't get theoff for them with the result that 1 was just 'done.'

Betty also remembers: "1 remember coming off night duty and having a lecture at 1 1 o'clock. You had to depend on getting notes fiom someone who had kenat a day class. You just weren't awake!" Elizabeth confesses that she didn't find the lectures very chailenging;

"it's very different now, we were very spoon-fed in those days, nowadays you have to do a little bit more research and find things out for yourself."

Apart fiom the first 3 months in the preliminary training school most of which were

spent in the classroom learning such subjects as bandaging, poulticing and dietetics, in

addition to anatomy and physiology, the rest of the students' learning experiences were quite

sporadic, and oflen depended on the interest and abilities of the ward sister. As one

participant observed - "when you look back on your training, it was very sketchy, quite

honestly, it wasn't an education really. It was leaming by error." Fortunately for the patients,

cornplex medication regimes and technical equipment were not part of the treatment plan,

nursing care was primarily at the bedside and focused primarily on comfort measures and

routine procedures. Nancy describes how lectures were offered as a series and if one was at

a stage to take surgical lectures then one went dong to them. "There was no tie up between

experience and lecture, it was very difficult. For example one could have gynaecology

experience long before taking the relevant lectures. It wasn't a good system."

Applicants for the Royal School of Nursing were first interviewed by the Matron or

her assistant, then had to write an entrance exam which Betty described as "an essay to test 25 general knowledge and math." There were normally three intakes in the year with class size approximately forty. (Interview reports)

The Chairman's Report [sic] of December 1940 gave the nursing department statistics for that year. There were 532 applicants for P.T.S., 203 were interviewed and 138 were accepted. The nursing complement for the year was 416, unfortunately he does not break this down between students and trained staff. Ninetysne students completed the requirements for state registration. The daily patient census was 686. In December 1945 the year the war ended the chairman reported that the enquiries for training were 375, the lowest number received since before 1933,15 1 were intewiewed and 114 accepted. Baly (1 995, p.

175) explains this nursing shortage as partly caused by the fact that the war had opened up an enonnous range of career oppomuiities for women, and partly due to theù participation

in the arrned services as a whole.

The Chairman [sic] Merreported that:

the shortage of new applicants for the Nursing Service has been a cause of

grave concem. The managers feel that it cannot be too widely reaiized that

the present intake of students is insuficient to keep up the supply of Nurses

for the fbture. The closing of Wards in the Inharyis inevitable ifthe intake

of Student Nurses does not increase (Glasgow Royal Inf'vmary Report for

1945, p. 6).

Nursing shortages and the subsequent threat of hospital bed closures is not therefore unique

to the end of the 20" century. There is a hint that an elitist selection process for admission to the school was in place fiom the observation of Jessie who went to the Royal Infinnary in 194 1. She describes:

1 left school when 1 was 14,I had to for economic reasons and 1 worked in a chemist's shop. When the war started we al1 had to do our bit, and my mother had a fiiend who got me a job in a munitions factory. 1was inspectùig bombs, it was the most boring job and 1 hated every minute of it. 1 hated the idea of what 1 was doing especially. Then 1had very bad sinusitis and when 1told my doctor where 1 was working and the atmosphere there he said why don? you take up nursing, they're very short nowadays. 1 didn't think they'd take me as I didn't have any "highers" (Scottish university entrance certificate) but I wrote to the Matron and after an intewiew was accepted. They really needed people at that tirne, it was an experimental class, not the usual type of girl - 1 mean educational background. She was taking people fiom the work force, a cross section of people.

In spite of the criticism of the lecture system and their memories of spending a great deal of time on cleaning tasks, the hospital's reputation for producing well trained nurses is noted by many of the participants.

Betty says that God guided her to the %est teaching hospitai in Glasgow" and Jean started off her intewiew with,"I mut Say that the Royal is the best training you can get."

Joen reflecting on her student days tells of how proud they were that they had a 4 year training, 'ive felt we were realiy quite upmarket compared with other people, it was quite daft when you think of it."

Nan believed that she had been well prepared for a career anywhere in the nursing

field, -"you could go anywhere if you trained at the Royal. We used to be told that, I mean

you could go abroad and Say you'd trained at this hospital or that hospital, but if you said the

Royal everyone knew of it." Although the students were able to write the State Registmtion examinations at the end of 3 years, they were required to sganother year in order to qualify for the much valued hospital pin (badge). In the absence of staff nurses due to the war efforts this policy ensured that there were sufficient numbers of experienced senior nurses to carry out the work of the

hospital. As Mae explaineci:

You have to remember that the moment you sat your finals and before the four years were up, you were called up to Queen Alexandra's nursing services, so that you had no tmined staff and the most senior peson was the one who was sitting their finals.

The Queen Alexandra's Nursing Services is the name given to the Amy Nursing

Services and traces its origins back to the Crimean War when Florence Nightingale, with a

small tearn of nurses, proved that a caring, efficient and organized nursing service can make

a significant contribution to the health of a regiment. The service was officially recognized

in the Boer War and was graced by the patronage of the wife of Edward VII, Queen

Alexandra, and subsequently became known as Queen Alexandra's Imperia1 Nursing

Service. During World War 1 a similar service was founded as the Royal Naval Nursing

Service and in the 1920s the Air Force developed its own nursing service, the Princess Mary

Royal Air Force Nursing Service. During World War II the nurses of the armed services

worked in base hospitals, field hospitals, casualty clearing houses, ambulance trains, hospital

ships, mobile surgical tearns, refugee camps and as prisoners of war with inmates of these

camps. Their contribution and seMces were significant (Baly, 1995, p. 130). 28

The nurses who were in training at the beginning of the war were given special instructions for dealing with gas attacks and everyone had to carry a gas mask at al1 times.

Gas masks were issued to al1 citizens Great Btitain in 1938 in anticipation of the war.

Kendall (1 972, p. 25) writes that the issue of gas masks meant that every adult Briton, for the first time in the nation's history, went into a war with an item of persona1 defense, and Betty rememben being part of a decontamination team and king taught how to decontaminate patients who were gassed. Fortunately this procedure was never used; poison gas was not used against civilians in W.W. II .

According to the inte~ewreports the general curriculum and lecture series did not

include any special preparation for emergency or trauma care and did not noticeably change

in response to the needs of wartime. Presurnably it was believed and expected that the nurses could respond to any eventuality.

In 199 1 the Royal Intimiary school of nursing adrnitted its last class of students. The

reorganization of nursing education, named Project 2000, was implemented in Scotland in

1992. This linked nursing education with centres of higher education and paved the way for

the establishment of a continuum of iearning for nurses fiom registration to retirement (Baiy,

p. 309). The long tradition of hospitai based training schools came to an end as the education

of nursing students moved to the colleges and univeaity campuses. Figure 4. Photographs from 1892 and 1939

Note: Reproduced by kind permission of the Greater Glasgow Health Board Archive. Chapter 2

Methodology

Feminist methodology is used to direct the process of this qualitative research study.

Methodology differs fiom method in that it is an anaiysis of how research should proceed and addresses the purpose and process of the research (Neysmith, 1995, p.100). A feminist perspective is used to guide this study. Feminism as an ideology is premised on the belief that women, because of their gender, suffer fiom systemic social injustice and as a result their voices and expenences have not ken heard or valued (Campbell & Bunting, 1991,

Keddy, 1992). Feminist methodologies are non-hierarchd and non-judgmental, the relationship between the researcher and participant is one of mutuaiity and sharing as the participants are encouraged to tell their experiences in their own words. My own interest in this question of women's experiences with the day to &y realities of their lives in war-time was sparked by listening to the personal stories of my mother and her female contemporaries who stniggled as young wives and mothea with the hardships of daily life in those stressful times. It appears from the constant retelling of their experiences that they have a need to have their stories heard and their experiences valued. Also as a graduate of Glasgow Royal

Infirmary School of Nursing I had an interest in exploring how the day to day activities of the hospital and its nursing staff were conducted within the context of a country at war. This study therefore strives to document and validate women's experiences when they were student nurses in a major teaching hospital in Glasgow, Scotland during World War II. Method

Oral history is the method used to conduct this research. An oral history is more than the spontaneous recording of reminiscences and stories, it provides insight into past events often in the perspective of the teller and helps provide a fuller picture of the ways in which social reality is interconnected with personal expenence. Oral history differs fiom autobiography, biography and life story in that it is created through interaction between interviewer and participant, draws on the questions of the interviewer and generally covers a wide range of topics. According to Hoopes (1 979, p. S), oral history is based on documents that are spoken. It is a collection of an individual's spoken mernories of their life, people known and events witnessed or participated in, and gives a feel for the facts that cm only be provided by one who has lived through them. Yow (1994) asks the question, what is oral history? She then asks, is it the typewritten manuscript? 1s it the taped mernoir? 1s it the research rnethod that involves in-depth interviewing? The term, she says, refers to al1 three.

Sociologist Shema Gluck (1986) writes: 'komen's oral history is a feminist encounter because it creates new material about women, validates women's experience, and enhances communication among women. Ferninist oral history acknowledges the value of women's lives and allows their voices to be heard." (p. 223)

The participants in this study consist of 14 women who were student nurses in the

Royal Infirmary, Glasgow, Scotland, between 1938 and 1945. Names and addresses of women who met the study criteria were obtained from the Royal Infirmary Nurses' League membership list and initial contact was made by mail to 24 women who lived within reasonable driving distance (20 miles) of the city of Glasgow. An introductory letter was 32 sent describing myself, my purpose in contacthg them and the study description,

(Appendices B & C). A simple questionnaire was included for them to indicate their willingness, or not, in participating in the study; a stamped rem address envelope was also included for their convenience and to facilitate a good response (Appendix D). Twenty-one responses were received, five negative and 16 positive, and arrangements were made to travel to Scotland for the interviews.

Letters were also sent to the Director of Nursing and Quality, (formerly titled

"Matron"), and to the Archivist of the Greater Glasgow Health Board to introduce myself and request permission to access the Royal Intimiary records and Annual Reports of the

Board of Directors for research purposes(Appendices E & F). The study description was also included for their information. Al1 the women who agreed to be interviewed were contacted first by mail and then by telephone to arrange appointments at mutually convenient times.

Unfo rtunately due to tirne constraints and conflicting schedules only 14 appointments could be arranged. Al1 the interviews were conducted within a 3 week thespan, and al1 but one were conducted in the interviewees' homes; the other inte~ewwas held in the lounge of one of Glasgow's major hotels.

An appointment was also made with the Archivist to visit Glasgow University archives and access the Glasgow Royal Infirmary Board of Management minutes and the

Annual Reports for the study period.

The women's present ages ranged from 73 to 78,6 are widows, 3 are married, 1 is divorced, which is unusual in this age group, and 4 are single. When they comrnenced nursing training at the Royal Infimary their ages ranged from 18 to 24. AU were members 33 of the Royal InharyNurses League, a voluntary association open to dl nurses who had trained in the "Royal." Unlike an alumnae association, nurses pay a fee to job the League; membership is a choice made to maintain links with their training school and former colleagues. The objectives of the League include: to engage in benevolent enterprises connected with the Infirmary and nursing staff, to forge links with past and present members of the G.R.I.nursing staff and to publish a jodannually (Weir, 1994). By choosing to become members of the league the participants demonstrated a loyalty to, and sense of identity with the School of Nursing which is apparent as they recollect their expenences as students.

Data Collection

Semi-structwed interviews were used to conduct the research, and were tape recorded with permission fiom the participants (Appendix G ). The meetings began with small talk which included mutual sharing of personal backgrounds and shared mernories of a student nurse's life. This pre-inte~ew"setting the scene" is an important activity which helps the development of a tnisting relationship between interviewer and interviewee, and fits with the methodological femuiist cntena for this study (Gluck, 1984, p. 123). As Morse (1995, p. 90) describes: "a successful qualitative interview is like an intimate and personal sharing of a confidence with a trusted fiiend. And the information given must be treated likewise with respect."

An inte~ewguide (Appendix H) was used which provided structure to the intewiew, and after the consent procedures were completed, the interview proper was begun.

The interviewees were asked to introduce themselves and then encouraged to describe their 34 experiences in their own words. Any initial self-conscioumess due to the presence of the tape recorder were quickly forgotten once the interviewees became immersed in their persona1 stories and memones.

Occasionai prompting or cuing was required to keep the interviewee fiom becoming sidetracked and focusing on what might be, in her opinion, more interesthg aspects of her nuning experiences, but which did not apply to this particular area of research. Often they wanted to share what they had done following graduation fiom the Royal and on these occasions the interview guide was most usefui in keeping the interview focused.

Each interview lasted about 45 minutes and ended with one last question for the interviewee. '4s there anything else you want to tell me, or which I shouid have asked you about?'Before leaving each interview 1 thanked the interviewee for her time and hospitality, and described how the interview tape would be personally transcnbed by me and the information collated.

Al1 the participants were interested in the research process and were most generous with photographs and books which rnight be of interest or add further background information for my study. On my return to Canada a formai th&-you letter was sent to each participant personally, in appreciation of her cooperation, support and interest. On completion of this research study the interview tapes will be donated to the Royal College of Nursing Archives in Edinburgh, Scotland and a copy of their transcribed intervie* will

be sent to the participants. Data Reliabilitv and Validitv

Oral history is a qualitative research method which does not readily lend itself to quantitative measures of data assessment. This does not mean however that issues of data adequateness and quality are not addressed. In a qualitative study the focus is on credibility and tmth, in other words, how well does the data collected by the researcher refiect the tnie state of human experience and phenomena under study (Polit & Hungler, 1995, p. 361).

Data ûiangulation is one technique described by Polit and Hungler, to improve the credibility of the findings, and consists of inte~ewingmultiple key informants about the same topic in order to provide a basis for convergence on the tnith. In this study al1 the interviews were conducted by myself as researcher using the sarne interview guide and interview style, and every effort was made to establish a relationship of tmt and equality berneen interviewee and interviewer. When similar themes begin to emerge from the interviewees' data then the reliability and credibility of the information is strengthened and can be accepted.

The validity of the data, that is how well it describes the phenomena under study, is established by reference to secondary sources, newspapers, hospitd records and joumals which can objectively corroborate the recollections of the interviewees. In this study newspapers of the period and hospitai reports were reviewed. ?'hey supported the information given by the interviewees about the events of the times. Other sources used included a published wartime diary documenting the daily lives of one family and their fiiends during this penod (Sheridan, 1985), and books documenting the effects of the wat on civilian life in Britain (Calder, 1969; Chamberlin, 1972; Kendall, 1972). Al1 provided supporthg evidence of the validity of the data. 36

One major limitation of oral history research which has to be acknowledged and addressed is that of memory. How has the passage of time affected the ability to accurately recall events fiom the pst? Hm(1988) discusses the issue of reliability of memory and although acknowledging the need to scrutinize the data of an oral history as carefully as any other data, it should not, he says, be subject to any special doubt simply because it is generated by memory. He goes on to cite modem research on memory which States that memory is one of the most unshakeable features of the human mind, preserving the expenence of the individual with remarkable accuracy to advanced age, despite even severe organic impairment. Yow (1994) discusses memory research findings which indicate that

Frorn middle age on, most people have more memories fiom childhood, adolescence, and young adulthood than for the most recent periods of their lives, and that some periods of life are more prominent in memory because they are periods that define the individual - the fust date, first job, mariage or birth ofa child. The memories of this study group are fiom one of the most eventful periods of the 20" century, when they were young adults in what was for most of them their fiat job experience, in sum a most personally memorable tirne!

Researcher Bias

Neysmith (1 995, p. 106), writes: "the researcher is seen as having so much power in the research enterprise that only a conscious tending to this dynamic will allow others to assess how it influenced the project and thus evaluate the validity of the findings." As a graduate of the School of Nuning of Glasgow Royal Infïrrnary 1 bring a perspective to the research process which has been influenced and shaped by my own experience there as a student nurse. Although this familiarity with some of the nomand culture of the training 37 programme enabled me to identiQ with and develop a relationship witb the participants which was helpful during the inte~ewit may also have afTected my objectivity and judgement about what was important to include in the data presentation, and what to leave out. For this reason the semi-structured intenriew and interview guide were important tools which ensured that the questions remained central to the study.

The Partici~ants

In the next section a brief biography of each participant is presented to provide the reader with a more in-depth sense of their lives. The biographies are arranged chronologicaily according to the date and tirne of the interview.

Margaret, a widow aged 73 years, lives aione in a pleasant apartment overlooking the river Clyde in a town, about 20 kilometers fiom the city of Glasgow. She grew up on a fm in the Highland area of Perth, and began nursing training in 1942, two days after her 18& birthday. Margaret has two sons who live with their families in the town. She is actively involved as a volunteer and fund miser for the local hospice. After completion of her nuning training she qualified as a rnidwife in her home county of Perth, then worked as a private duty nurse before gaining Mercertification in orthopaedic nursing. When her children were grown she returned to nursing working part-tirne in the local hospital in the orthopaedic department.

Margaret, aged 74 years lives in a modem bungalow with her husband in a small town approximately 20 kilometers fiom Glasgow. She is actively involved in the lives of ber family and extended family who all live in the local area. Margaret grew up on a farm in the county of Ayrshire about 15 kilometers from Glasgow. She lef€school when she was 14 (the 38 legal school leaving age in Scotland in the 1930s) and helped her mother with family and farm tasks until she was 19, when she began nursing training in November 1943. She has not been employed in nursing since her mariage at the end of the war.

Betty, a widow aged 78 years lives alone in a Victorian house in a suburb of

Glasgow. She was bom and grew up on a small island off the West Coast of Scotland and moved to Glasgow when she was 17 as there was linle employment or educational opportunities on the island. She worked as a children's nanny for a year until she was eighteen and old enough to begin nursing training in April1939. Mercompleting the 4 year programme in 1943, she trained as a midwife and practiced in the Glasgow area before going on to work in a military hospital on the outskirts of the city. She nursed both wounded service persomei and prisoners of war at that time. When her two children were grown she nursed part-time for a few years in one of Glasgow's hospitais.

Jean, a 76 year old widow lives done in a comfortable bungalow in a pleasant town located 40 kilometers south West of Glasgow. She grew up in a residential district of

Glasgow and was 20 years old in 1942 when she went to Glasgow Royal Innmiary School of Nursing having completed a 3 year training programme in infectious diseases nursing at

Belvedere Hospital, also in Glasgow. She has a daughter and grand children in Sweden whom she visits regularly. Mer she cornpleted the training programme at the Royal

Infirmary she worked in one of the operating rooms, first as staff nurse and then as charge

nurse (theatre sister); der her marriage she worked part-tirne for several years in the

operating room of the local hospital. She is very enthusiastic about the nursing profession 39 and is involved in the Nurses' League activities which allow her the opportunity to meet up with former colleagues.

Mary is 78 years old and lives alone in a small senior's apartment in a small seaside tom on the outskiris of Glasgow. She has been divorced for many years and has a son and grandchildren living in the town. Her grandson is currently an intem in Glasgow Royal

Infirmary . She grew up in Argyll County, a rural Highland area across the Clyde river estuary fiom where she lives presently. She began nursing training in 1938 at the age of 18 and on completion of the 4 year program in1942 she trained as a midwife then moved with her doctor husband to Affica to work as medicd missionaries. She retired and returned to

Scotland in the 1960s with her son.

Joen, 79 years old, never rnarried and lives alone in an apartment in suburban

Glasgow. She began nursing training in 1944 at the age of 25, having worked as a nursing auxiliary in the navy with the emergency nursing services. After completion of the 4 year programme she trained as a midwife then worked in comrnunity nursing before going back to the Royal Infirmary as staff nurse in the casualty (emergency) department. Joen had a distinguished professional career in nursing education. She studied nursing methods in

Canada and the United States and was actively involved in the implementation and evaluation of curriculum changes for nursing education in Scotland in the 1960s and 70s.

Patricia is a 73 year old widow who lives alone in an apartment in a Victorian building in a residential area of Glasgow and began nursing training in 1943 at the age of 18.

She grew up on a fmand her first experience of a large city was when she came to Glasgow to the Royal Infmary for her application interview. Merher husband died in 1969 she went 40 back to the hospital and worked in the operating theatre tirst as staff nurse and latterly as nursing officer, then was involved in research studies for Edinburghdepartment of health and

Caledonia University in Glasgow. She has three grown children and grandchildren in the

Glasgow area.

Mae aged 73 began nursing training in1943 at the age of 18. She grew up in the city of Glasgow not far from the Royal Infïrmary, left school at the age of 14 and worked in a building contractor's office until old enough to begin at the School ofbiursing. Presently she lives with her husband in a residential suburb of Glasgow. Mae has not worked outside the home since her marriage at the end of the war. Her three grown children live with their farnilies in the Glasgow area.

Barbara a widow aged 78 years lives alone with her dog in a cornfortable bungalow in the residential suburb of a pleasant Ayrshire town, 40 kilometers nom Glasgow. She was

24 years old when she began the nursing programme in 1944 at the Royal Infirmary, however was already qualified as a Registered Fever Nurse (R.F.N.) having completed a 3 year training programme in infectious diseases nursing. She did merstudies in midwifery and then returned to the Royal Infiary to work as a staff nurse then Sister in the urology department. Barbara did not work outside the home after her marriage. She has two sons living with their families in the tom.

Margaret, a widow aged 78, lives with her unmarried daughter in a seaside town about 40 kilometers fiom Glasgow. She fVst trained in infectious diseases nursing before going to the Royal inf'irmary in 1942 when she was 22 years old. She qualified as a midwife on completion of the 4 year general nursiag programme then nursed as staff nurse on the 41 burns Mtuntil her marriage in 1948. She did not continue nursing after her mamage.

Margaret has one son in addition to the daughter with whom she lives.

Agnes aged 78 lives aione in what was originally her parents' house overlooking the wide river Clyde estuary in a town about 30 kilometen fiom Glasgow. Agnes began nursing training in the Royal Infimary in 1939, then did part-one rnidwifery training before joining the medforces with the Queen Alexandra's Nursing SeMces. She stayed in the anny for

4 years, first in India then the Middle East. Agnes never mamed and spent her nursing career first as a ward sister then as assistant Matron in the local hospital.

Elizabeth, aged 77, began training at the Royal Innmiary in 1941 when she was 19 years old. Pnor to that she worked in a bank in Glasgow for 2 yean and when war broke out also did part time hours with the war time civil nursing reserve, which introduced her to nursing and fostered the desire to make nuising a career. She never married and lives alone in an apartment in a smail residential town just outside the Glasgow city boundary.

Elizabeth trained as a midwife after completing the required 4 years at the Royal Infirmary, then nursed in various hospitals before retuming to the Infirmary as a ward sister. She remained in that position for 9 years then did merstudies to qualiQ as a Health Visitor

(Public Health Nurse) then worked with psychiatrie patients in the community.

Jessie lives with her husband in a cornfortable house in a residential area of Glasgow.

She is 77 years old and was 20 when she began nursing training in 1941. She left school when she was 14 and worked first in a drug store then when the war began went to work in a munitions factory inspecting bombs, which she hated. There was a great demand for nurses at this time and Jessie was part of an extra class which included othea like herself, older than 42 the usual probationer and with some experience of the workplace. As Jessie herself descnbed her class "it was a cross section of people." On completion of the programme at the Royal

Infirmary, she completed the fïrst 6 months of the midwifery certificate, then worked as a staff nurse in the Infirmary until she was manied. Jessie has two sons and a daughter. They al1 live in the Glasgow area.

Nan, aged 74, lives alone in a small bungalow in a residential comrnunity about 10

kilometers £iom Glasgow. She started nursing training in 1942 when she was just 18.

Nursing was not her htcareer choice, she had planned to go to University to qualiQ for a

civil service position, however due to war the regulations she would have either had to

teach following graduation or enter the armed services, so she opted for nursing as she didn't

want to teach. After her 4 year training Nan like most of the other participants did a year's

training in midwifery, then practiced for a year as a midwife before moving to Canada for

a few years. Ironically given her aversion to teaching when she was 18, when she returned

to Scotland she went to Edinburgh University to qualify as a Nurse Tutor. The remainder of

her career was spent in nursing education as one of the Sister Tutors in the School of

Nursing of Glasgow Royal Infirmary.

This information is summarized in Table fom in Appendix 1 Cbapïeer 3

Presentation of Data

Al1 the interviews were penonally transcribed by myself as soon as possible after the interviews were completed. Although a time consuming activity this gave me an opportwiity to become thoroughly familiar with the data and also facilitated the beginning of analysis and reflection. In addition some of the participants used colloquialisms in their speech which could have caused some problems for a transcriber unfamiliar with the Scottish accents and local terminology . Oral history documentation provides a fuller picture of the ways in which social reality is intercomected with personal experience, and must consider the context of these experiences, that is, what is happening in society at the time. Ham (Crowiey, 1988, p. 57) writes: '?he oral record moves from these ordinary areas of historicai documentation to those aspects of every day experience about which the documentary record has little to Say. "

Scotland in the laie 1930swas a very traditional and mainly homogenous society. The occupationai opportunities open to women were lirnited, and most married women did not work outside the home. With the outbreak of war the demand for civilian workers increased and women were encouraged to train for non-traditional jobs in munition factories and other essential (for the economic well-king of the country) occupations (Calder, 1969, p. 233).

Nursing was considered an essentiai occupation and there was governmental control over deployment of qualified nurses which impacted on the decisions made by many of the participants of this study. Under a Control of Engagement order, September 1943, which 44 applied to al1 women between 18 and 40 years of age, nurses could only give up their posts to do Mertraining: without this intention they were regarded as available for work in a shortage area and directed accordingly (Baly, 1995, p. 174). Many of the study participants chose midwifery training dercompletion of the required 4 year programme at the Royal

Infirmary, rather than risk being transferred to a hospital far from home. In the patriarchal sociev of the tirne women's contribution was valued only when there was a shortage of manpower [sic], or a national crisis.

In this chapter the inte~ewdata have been organized chronolog ically and according to the main themes which emerged fiom the interviews or which were identified as particularly mernorable by the participants themselves.

Pre~arationfor War

Although Britain did not declare war on Nazi Gemany untii September 3rd1939, two days afler Hitler marched into Poland, the Governrnent had begun to prepare for war in 1938 by ensuring the country's hospitals were prepared for both wounded servicemen and civilian casualties. An Emergency Hospital Service was set up and city hospitals were urged to discharge their patients or evacuate them to rural institutions (Baly, 1995, p. 169).

The 1939 General Report by the Managers of the Royal Infirmary documents the hospital's involvement in the government's plans:

... at the request of the Government those patients able to be sent home or

transferred to other institutions were moved according to a pre-arranged plan

and 850 beds were held in readiness for civilian casualties arising nom

expected enemy air raids. Patients not fit to be sent home were transferred to the Schaw Home, Glasgow Convalescent Home and East Park Home (al1

convalescent hospitals on the outskirts of the city). A number of intUmary

nurses were sent to those institutions together with the necessary medical

supplies and equipment to enable the medical staff to continue the treatment

of their patients. (p. 2)

The Royal was identified as king in a danger spot of the city and designated as a clearing house for casualties (September 1939 emergency meeting of the Board of

Management). The Managers reported that staff were trained in fire drills by the fue department.

Mary, who began her nursing training in the infirmary in 1938 gives a personal description of the conditions in the wards at this tirne.

They brought out al1 the ernergency beds, they were lined up in the middle of the ward to be used at a moments notice. Every ward had these beds and the Royal was practically empty, because they thought the bombs would be coming at any moment you see."

She remembers:

Every appendicectomy, every hemia, the light cases, when they got to the third day and if they had no temperature they were sent to Schaw Home which was a convalescent home attached to (affiliated with) the Royal. They didn't admit (patients) if they didn't have to.

The nurses had very few patients to nurse, as this was the period known as the "phony

war" which lasted until May of 1940, when the German Amy reached the English Channel

and the British Expeditionary force began its evacuation from Dunkirk. Mary remembers

doing a lot of cleaning and polishing in these days - "there was nothing else to do." Bombing of the civilian population began in earnest in the surnmer of 1940, the main targets being London and the seaports dong the English Channel. Glasgow and the nearby shipbuilding community known as Clydebank was badly bombed in Mach and May

When the sirens sounded to warn of an ixnpending air raid the nurses who were off

duty were expected to go to the air raid shelters located in the basement corridors and below

the pathology laboratory. Nancy remembers:

When the sirens went you had to go to the shelters and you had to take your valuables with you, those that you had tirne to take, and 1 had this ponyskin coat which my father had given me and 1 would take it with me io the shelter. But even after spending half the night in the shelter we still had to go on duty in the moming.

The patients who were unable to be moved to the shelters were "protected" in a

very creative way. Agnes a student between 1938 and 1942 says:

1 do remember, it's quite fmywhen you look back on it because on night duty in the Royal on a surgical ward one worked (busy with nursing tasks) ail night. The wash basins were put out on the lockers for the moming but if there were an air raid and when the sirens went, the patients put the basins over theu heads!

None of the participants reported any safety measures king available for the nurses on duty

during an air raid, nor did they recall king concerned or questioning this at the tirne. Here

we see an example of the altruism expected of the nurses, what Reverby (1987) describes as

their "duty to care." Nurses, she says, were expected to act out of an obligation to care,

without thought of themselves or their own rights. Betty also tells of air raids and remembers particularly when the nearby community of Clydebank was bombed in March 1941:

1 was on night duty and the patients who couldn't be moved domto the basement because they'd had an operation, we placed a basin on their head and placed a rubber draw sheet round their shoulders, that was al1 the protection and we just weut round the ward and carried on as usual.

When asked if she was afraid she responded:

No. That was the strange thing, it was so calm and in the moming because 1 was on ni@ duty 1 had to stay on(duty) because we were getting patients fiom Clydebank who were injured, and my one memory of that is a yowg mother whose twins had ken killed. Strange that's the one thing 1remember about receiving the injured that moming. But every thing was very disciplined very calrn - it was quite something.

She also describes how the radium needles fiom the cancer treatment ward were removed and placed into a lead container for storage in the basement shelter "in case the hospital was bombed and the radium was scattered."

Mary, didn't appear to have too much concem about possible danger fiom bombing raids, or the mthof authority. She says:

It was the deif you were off duty, you went to the shelter and it was always at night and 1 remember looking around thinicing that if we got a direct hit, here under the pathology laboratory there wouldn't be anyone left around, so after the third or fourth time in the shelter, 1gave my name to Miss Robson (sister tutor) and walked around her, and while she was talking to somebody else 1 walked away back and crawled into my bed and had a good sleep.

The great au raids on Clydeside, on the nights 13-14 and 14-1 5 March, and 5-6 and

6-7 May 194 1 were major events in the wartime experiences of the women participants in this study. Jessie was off duty and at home in the north end of the city when Clydebank was bombed, she tells: 1 was at home when the bombing started and couldn't get back to the hospital 'til the next &y. We could hear the bombers going over Glasgow - bmnm-, brrmm--, bnnm-- , the whole night you could hear them. There were only a few of the bombs fell on Glasgow, you could hear the noise and you'd had no idea where it was. My boyfnend at the tirne lived in Clydebank and I didn't hear from hirn for a few days so thought I'd better go and see if he was ahght. 1 managed to get a bus as far as Knightswood, which is a long way fiom Clydebank - and 1 started to walk - well it was a terrible experience and dlthe houses were practically dom, and people were wallring dong with suitcases in absolute shock. They had just taken what they could fiom their houses and tears were rolling down their cheeks and they were al1 going away, getting themselves to railway stations, whatever to get away fiom the place. 1 walked and walked, there were streets and streets which were absolutely flattened. 1found out later that my boyfiiend had been bombed and been buried and wasn't found till the next day, but he was alright.

A different perspective of this event is given by Mary who during this tirne was on duty at Canniesbum, the Royal's convalescent hospital. The nurses were billeted at a large mansion house, Gancube House which she describes as being '&setin beautifid grounds on the banks of the river." She goes on to relate:

Our fust real taste of war was on the night of 13- 14th March 194 1 when waves of bombers swept over the house. It was a beautifid clear Nght and the river was like a band of silver in the moonlight. As the bus transporting the day staff fiom the hospital stopped we were met by the housekeeper and guided down the stairs to the cellars. It was eerie; ghosts could be imagined in every corner and when the bombers kept following the river especially the Clyde, we decided to get out our bed quilts and curl up in the summer deck chah until it was over. Two A.R.P. men (air raid patrol) were assigned to the grounds and we felt safer knowing they were there. About 5.a.m. al1 was quiet and we went to bed only to be disturbed by a plane flying low over the house, what a noise, and the A.R.P. men banging on the door calling for us to get up. Then there was the noise of 50-100 incendiary bombs hitting the roof. We then had to pass buckets of sand and water until al1 the fire bombs were dealt with. Clydebank was a pile of b&g nibble next morning and Clydeside was no longer a tom. The death toll for both the Clydeside raids came to 1,000 with 4,000 injured. Yet John Brown's shipyard opened every day and that must have been the target for the bombers. 49 Jean, who had trained in infectious disease nursing in Glasgow Belvidere Mectious disease hospital before cornmencing training in the Royal describes the practice in that institution when an air raid waming occurred. Most of the patients were children and all beds and cots (cribs) were pushed up to the bricked up window areas, mattresses and patients put under the beds until the "dl-clear" siren was heard. Day nurses had to run to their ward during a raid to help the night nurse. She writes:

1 remember running fiom the Nurses Home, th helmet on top of curlers, gas mask bumping over my shoulder, unifomwrapper on top of pyjamas and fiak nom the anti-aircraft guns on the Clyde(river) fdling around me!

No one interviewed admitted to remembering any feu. Mary said: "1 never saw anyone who was scared, the children were frightened - it was the noise that fnghtened them, but we weren't afraid that the bombs would fall on us." She expressed more fear of the wath of matron if a hospital rule was broken than of any dangers fiom the effects of war! She describes being stopped by an A.R.P man on her way back to the hospital when there was an air raid warning: "1 was racing dom Glebe Street to get into the Royal, when the A.R.P. tried to get me to go into a shelter, but 1 had to get to the hospital before my late pass

deadline."

Blackout

An important component of the British civilian defense strategy was the blackout

regulations which were in force throughout the country Erom 1" September 1939 to L7m

September 1944. It was a dreary symbol of war with dl cities and towns cloaked in total

darkness. The regulations demanded a total absence of light and citizens who were careless

and allowed a chink of light to shine through a window would be charged and fïned for 50 breach of regdations The cornmitment of the populace to upholding this regdation was supported in part by the elementary belief that if the enemy couldn't see you, then he could noi hurt you (Chamberlin, 1972, p. 20). Curtains of heavy black material were used, or shutters installed, and factories and railway stations had skylights and windows painted over.

There was a ban on the use of flashlights and car head lights were allowed on low beam only.

Streetlights of course were also unlit which made getting around at night extremely hazardous. In the Royal Infirmary the windows of the operating rooms were bricked over and the managers were informed of the extra expenses due to purchasing sand bags and matenal for blackout curtains (Emergency Board Meeting, September 1939).

Margaret, describes how the curtains in the wards had to be fixed every night before it got dark and before the lights were switched on. Of course this was a nursing responsibility. Travel at night brought its own problems for the nurses. Margaret also remembers:

Well 1 traveled by bus when 1 went home, I took two buses and of course because of the blackout it was difficult to see your stop sometimes - there were no lights and the local bus driver would take a look round before he lefi the town and he generally knew who came in and of course he knew where to stop.

Agnes in thinking about the blackout reports "the biggest difficulty was getting around outside, there were no streetlights." Difficulty not withstanding the student nurses in those years al1 had tales to tell of outings to the local dance hall or to the cinema to view the Iatest film. Rationing

Of dl the deprivations of the war years rationhg of food and clothing had the biggest impact on the mernories of the study group. Ration books were issued at the end of

September 1939, however it was not until January 8" 1941 that food rationing was introduced and the ration book becarne a prized possession. The fkst items rationed were bacon and harn, sugar and butter; meat followed then cheese, tea, cooking fat, sweets and preserves (Charnberlin, 1972, p. 76). When the peak of tationing was reached in August 1942, every citizen was entitled weekly to approximately one pond of meat, four ounces of hm or bacon, eight ounces of sugar, eight ounces of fat, two of which might be butter and eight ounces of cheese. Over 8 weeks one person was entitled to one packet of dried eggs or 12 eggs if available. Milk for the general public was about two pints a week. Invalids, pregnant women and chiidren were priority customers and were entitled to up to three eggs per week and one pint daily of milk (Charnberlin, 1972, p. 38 1). Bread was not rationed but quantities were iimited.

Mary describes her responsibility as the ward probationer to go to the stores department for the ward rations, which were allocated according to the number of patients.

"You could get biscuits, jam, margarine and tea and lots and lots of milk. The patients got one egg a week, and so did the nurses." Margaret remembers always king hungry. She describes the rations which were distributed once a week to the nurses:

We got a wee piece of butter and a wee jar of sugar, we supplied our own jars and butter dish, put them (the jars) in the day before and the next day we picked them up. Jean also recollects carrying around the jars with the two ounces of butter and sugar, 'ive made sure no one touched hem, they were very precious."

Jessie describes missing her rations because she was late putting in her request:

I really liked my butter, we ate a lot of toast in these days and 1 really needed my butter. 1 was very shy in those days, not very sure of myself and very fnghtened of the V.I.P.'s but I felt I must have my rights. Matron wasn't an easy person to approach but I made an appointment and when she asked what 1 wanted, 1 said - well, I didn't get my ration of butter! Matron - Why was that? Jessie - Well 1 was a little late puning in my jelly jar, and 1 feel 1 should get my ration because it's my due. Matron - Well Sister's quite right, if you were late you'll just have to learn to get it in on time. Well that was that, but I still felt a wee bit aggrieved.

Even from a distance of 50 years kssie's sense of injustice can be heard, and using today's perspective matron's attitude is unreasonable and shows a strict adherence to niles without consideration of circumstances.

In spite of the shortages imposed on them by the bureaucracy of hospital and state, the student nurses found creative ways to supplement and improve their diets. Some were fortunate to have access to extra food supplies if their families owned a business, and perhaps could trade service for canned foods, or if they came fiom a fam where fresh eggs were available. Agnes had a father who owned a grocery business. She says:

I was quite lucky and could get tins of beans and different things. When 1 came back fiom home after a day off my fnends waited to see what 1 brought back to eat. i was very popular then!

Powdered eggs were used by the night nurses to make French toast to eat between the night sister's rounds. Pat and her fnend were very good at '"nistling up things to eat." She descnbes one amushg incident: During the night we were always starviug because the food was atrocious. One night my fnend found some onions in the linen cupboard (a favourite hiding place of treats by the day nurses) and she sliced them up and fied them and we made French toast, which we demolished even if it didn't taste very good. The next night we went on duty and Sister gave us the report then said, '1 wonder if any of you two nurses have seen my tulip bulbs. 1 put them in the linen cupboard and they've disappeared!' Well - we didn't date tell her that we'd eaten them. We were homfied.

Christmas was still a festive time in spite of the food shortages and every effort was made to create special foods. Cream for the trifles for the ward party was made by beating margarine into comfiour pudding and "banana" sandwiches were made with mashed parsnips and banana flavouring. Everyone remembea sharing whatever extra they had..

Clothe's rationing came into force in June 194 1 (Chamberlin, 1972, p. 84)' rationing was not by the item but on a points system - each person was allocated a maximum nurnber of points to use on whatever item they wished. For the student nurses who wore hospital uniform the biggest problem was maintaining a supply of the regdatory black stockings and shoes, however as the war progressed the uniform dress was modified to refiect the shortage of material and soap for laundering.

The traditional uniforrn wom by al1 Royal Infmary student nurses was a lavender and white striped dress with starched white collar and cufXs topped by a white apron, black stockings and shoes and of course the white starched nurse's cap. Pat, who began nursing training in 1943 and was writing final exams at the end of the war describes the uniform wom at that time."We had very utility uniforms with a flat collar and the apron of course."

Margaret also remembea the war time uniforms and tells:

When we arrived (1942) they had run out of caps even. When we went from bahhgschool (P.T.S.) to the wards on Saturday we had no caps and some of the doctors objected to the girls not having caps. It was scarcity of material, it was war time you see.

When questioned about how clothing rationing affected her, she responded:

We were dlyoung and we wanted clothes but you had no money either so that was it, but we did a bit of dressmakhg ourselves and knitted 1suppose more than girls do wwadays. But 1 remember when the 'new- look' came in just after the war and some of the girls, 1 don? know where they got the coupons, got al1 dressed up, but it was amazing to see someone dressed up so fashionable.

She stated that she did not feel deprived because "everyone was the same." Not everyone was "the same" however. As Mary tells it:

Stockings were hard to come by because we didn't have many coupons. 1 had a friend who was in the V.A.D. (Red Cross Voluntary Aid Detachment) and she got free stockings and she wouldn't Wear anythng with a flaw in it so 1 got her castsffs which 1 was delighted to get. 1 didn't think it was fair that she got free stockings and 1 didn't. The A.T.S., the W.A.A.F, and W.R.E.N.S.(women's branches of the my,air force and navy) they al1 got free stockings, and not only did we have to buy them we had to use our precious coupons.

Others found a way around the bureaucracy, Margaret knew a saleswomen in one of the city department stores who gave her stockings without coupons and Jean had a patient who %ad a shoe factory, he was making shoes for the W.R.E.N.S. and he took me out to the factory to choose a pair of shoes. These were 'black-market' but 1 needed them."

Social Conditions

Many of the patients in the Infinnary lived extremely poor and socially deprived lives. The Infïrmary was located in the older part of the city and a great proportion of the patients came fxom the surroundhg tenements, where al1 the fadiesshared an outside toilet and a cold water tap and coal fkes were used for heating. The open fireplaces were a constant source of burning accidents among young children and the mas,was the centre for care of these cases.

Joen tells of an experience on night duty in the burns unit which refiects the expenences for those families:

Every child who was burned in Glasgow came to the Royal to be cared for and we had one child who couldn't get to sleep and one of the men patients said, give that child to me, he's never been in a bed by himself, so 1 handed the child over to the patient and he pacified the wee one who went to sleep. When the night sister came the patient had the child under the blanket and sister never noticed that the cot was empty. You'd never get away with that kind of thing nowadays and 1 suppose it reflected the social conditions of the times.

Jessie also provides a view of the realities and difficulties of daily life, especially for women, in those days. She describes an experience when working in the emergency department, Gatehouse as it was and still is known:

There was no appointment system and many waiting were working men who wouldn't be able to be off work and 1 was nishing about and went to the sluice room for something when 1 found this wornan doing her washing! 'What on earth are you doing?' 1 asked her. 'Well,' she said, 'it's the only place I can get hot water!'

There were public laundries available where women could go, however the Royal Infirmary was probably more convenient for this woman who had realized she could conduct her business relatively unnoticed in a busy outpatient department. On a more serious note Jessie also shares:

People were very il1 before they got to the Infirmary, they really were. 1 remember in gynaecology women coming in with their utenws hanging out! Ulcerated utenws hanging between their knees, and you'd ask them why didn't you do something before this? They would respond, '1 couldn't get away, I've got a family and my man's working, and who would 1 leave the family with?' Economic circumstances, they just couldn't look after themselves. 1thought at the time it was dreadful, and I'm a strong socialist now - and no wonder it was really so dreadfiil. Some of the doctoa at Gatehouse weren't very nice to the patients and 1 wasn't popular because 1 would stick up for them. 1 felt very sorry, for the people had a hard hard time.

Effects of War

nie Annual report of the Inhary for 1944 reported that there had been a decrease in the admission of civilian cases to the Infirmary owing to the large number of civilian cases being treated in the wards. Some of the interviewees were assigned to these wards and have varied memones of these expenences. Mae rememben:

The military took over centre block and the adjacent wards in surgical block. They were co~ectedby a balcony where we aired the pillows and rubber drawsheets. Al1 the military hospitals around the countq were filled up and they had to take wards fiom the general hospitals. It was after the Battle of Anzio (the Italian Campaign in 1943) and at the field hospitals they didn't remove any bullets or shrapnel, just put a dressing on the wound encased them in plaster of Paris and transferred them to the Royal. We had ambulance derambulance of these young men and our first job was to get the plaster off and then they went to the opemting theatre. Some of them were quite serious. The ones 1remember particularly were fiom the Welsh Guards. Some of it was awfully harrowing, there was nothing pretty about it.

Pat says:

It was towards the end of the war, when it was the invasion of Italy and we got a lot of troops over to Glasgow, a lot of wounded. There were the young fellows who were paralyzed, it was really dreadfûl - aged twenty , they wore the blue uniforms of the wounded - that was also the first time we used penicillin.

Jean also has memories of those events:

Most of the lads arriving were very badly wounded, and there were many amputations. It was very shattering and they wanted to talk to you about the war and seeing their wives and families, how they would react, although some of hem were silent but that was because of what they had been through.

The women were young, between 18 and 25 years of age and unlike today did not have access to counseloa or critical incident debriefmg teams to help them deai with the stresses of their work environment. They were not expected to show emotion while on duty

nor was there much time allowed for personal grieving when stnick with personal tragedy.

Margaret talked about the first death she experienced of one of her patients, a young man she

had been caring for who died when she was off on a meal break. She remembers being

emotionally upset and the ward sister reprimanding her for becoming so involved with the

patient. "You will not be any use as a nurse if you allow yourself to become so upset when

a patient dies." Again there is the emphasis on putting the obligation to one's patient above

one's own needs and feelings.

It was Margaret's opinion that Sister's criticism had been appropnate because "if you

were going to be soft like that - it would be mentaily exhausting. We worked hard and could

not cope with both mental and physical strain."

Agnes had a friend who received word of her fiancé's death while on duty. She was

naturally tembly upset and went to the nursing office and was:

told to go back on duty where you are needed. That was the attitude, but in a way what was she to do, we al1 lived in (the Nurses' Home), so she could only have gone back to that littie room with the two beds by herself. It was happening to everyone. There were so many things happening to people 1 knew.

Another interviewee on reflecting back to her mident days said:

As you go through life you think back on things and 1 don? think there was anythuig we had to do which one would take exception to, and as for stress - anyone who goes on about stress must have too much tirne on their han& in between to think about it They should get a move on, get on with the next thing !

Daily living in war time was stressful for everyone in very many ways, and the nursing students it would appear found support fiom each other. Joen described, "we'd come off duty and we'd moan together and feel temble about some things that happened."

The experience of "living in" and the long work hours isolated them but also protected them to a certain extent fiom the world outside the hospital. Elizabeth cornmented,

"we didn't think to cornplain about things, we felt fortunate compared to othea, perhaps because it was war-time." Obedience to the desof the hospital was instilled in the students fiom the beginning of their training experience and accepted by most without question.

The exigencies of war can have spinoff benefits for the civilian population and many of the interviewees related their fmt encounten with penicillin which was first available for use with service peao~elin 1942. Most of the women had cared for patients in the pre- antibiotic era so were well able to compare and appreciate how miraculously effective penicillin could be. Mae describes her fm expenence with the drug:

1 was senior nurse on E.N.T. (ear, nose and throat) and the patient was a boy of 10 who'd had a rnastoid operation. It wasn't uncornmon in those days after such an operation to develop meningitis and they either didn't survive or were left severely brain damaged. We still had a lot of military personnel in the infirmary and the chief surgeon asked if they could use penicillin on this young boy. He recovered with no damage at al1 and al1 the doctors came fiorn al1 over the hospital to look at this child. It was a miracle.

Margaret also remembers the drug king used on a man with a badly ulcerated leg. She says:

"With the dressings we put on and the penicillin injections, you saw this great big hole gradually filling in, it was wonderful."

Mae also describes the rnorning routine for the junior student assigned to the gynecology unit: It was two wards, nui as one, my room mate was also there - we had great fun - but oh it was hard work. The work had to be done by 9 o'clock in the rnorning, al1 the patients fed, bed pans to give, then basins for bathing, made the beds, changed the water, we refilled them twice a day and ali the glasses had to be polished. The ward sister carne round at nine o'clock and inspected our work At 9 o'clock we put on a clean apron and presented ourselves to her."

The night staff cooked breakfast and the day stafThelped serve the patients. Barbara recalls that:

There were dl sorts of extmordinary duties if you had a minute to spare, and you were expected to find some; we had to clean out the patient's lockers, and make up dressings, cotton balls and fold gauze, dl that sort of thing.

The operating room nurses were also kept busy with cleaning, making dressings and patching and powdering the rubber gloves. As Jean explained:

Things were so difficult, you see, every pair of rubber gloves were patched and we made patches fiom the old gloves, and the ody person who had new gloves was the chief (surgeon). Everything was so scarce.

Joan tells of making the large abdominal pads on a sewing machine while a student in the operating theater:

We had an electric sewing machine to sew up the big swabs, we had to stitch them up and down - this wee machine went like mad. Figure 5. Bed Making Class, 1939

Note: From "Days Gone By," 1992, Glasgow Roy1 Infinnary Nurse$ Leamie Journal, 09, p. 22.

Reprinted by kind permission of R. 1. Weir, Editor.

Not everyone thought that these tasks should be nurses work as Joan tells of the patient, a

Member of Parliament at the tirne, who said that:

The fust thing he was going to do (when re-elected) was make sure the nurses were properly paid and not be working making dressings, he thought it was ridiculous and was surprised to learn that everyone did it.

As student nurses were still making dressings in the hospitai in the 1960s and were poorly paid for the work they did, his intent as a grateful patient to advocate for betier conditions for the nursing students took more than twenty years to show results.

Margaret, in talking about the typical day, reflected:

There was a lot of bed bathing to do in those days because even the hemia patient was kept: in (bed) for 3 weeks and lying flat for the first week ,and by the tirne they were getting up to go to the bathroom they were getting home the next day. The patients were aiways in bed. One interviewee when asked if she minded al1 the dusting and sweeping replied:

"Not really - we just accepted every thing in those days." Jessie was more critical about these first expenences:

When 1 look back 1 think 1 spent most of that first year cleaning - it seemed a waste of tirne really. 1 didn't feel we were getting trained. The sisters were far too busy to teach us, so we just had to pick up as we went dong, but that first year 1 could have done with more clinical teacbg.

Fiwe 6. Baadaging Praaice, 1939

Note: From "Days Gone By," 1992, Glaseow Roval Infimaxy Nurses Leamie Journal, 64, p. 27.

Repnnted by kind permission of R. 1 Weir, Editor.

The emphasis on domestic work was wt unique to the Royal Infirmary and was the nom in nursing schools of the period and in some smaller hospitals for another 10 to 20 years, to some extent (Baly, 1995, p. 170; Maggs, 1987, p. 140). Historically hospitals were organized in such a way that hospital work ( that is patient care in al1 its aspects, as opposed 63 to medical treatment) was dependent on the labour of the nursing force, mainly the untrained student. The students received training in exchange for labour. In the early years of the infimary the first nurses appointed were hired servants, whose duties included washing and dusting the wards every moming, senhg the patients their meals and prescribed mediches daily, and changing and ainng beds between admissions. The sole medicai aspect of their duties was that of observation of patients in order to report any unusual symptoms to the medical staff, (Jenkinson et al., 1994, p. 35).

In the penod under study the ward staff complement included one ward maid who was responsible for the heavy cleaning, but the dusting and polishing was nursing's responsibility. As they progressed through their training the students were expected to take on more responsibilities, what Cade (Maggs, 1987, p. 18) describes as healing functions - the dressings and injections. Senior nurses assisted with dressing changes, medications and teaching the junior nurses proper procedures for patient care. Jean remernbea spending three hours each night testing urines while working night shift, and on a busy medical ward weighing the diabetics' diet for breakfast. She says:

In the years before sulphonamides and penicillin, there was four hourly sponging and the bathing in bed, medical wards were heavy nursing, and we didn't always have two people to help lift the patient up. We often had aching backs, but to see the patient comfortable was a great thing. It was a satisQing job, 1'11 never regret doing it.

Al1 the interviewees talked about the responsibility that was theirs on night duty.

There were no trained staff on the wards, only the Night Sisten who did rounds two thes during the eleven hour shift, 9 p.m.- 8 am. The burden they felt on being left alone when the senior student went off the ward for a meal can still be heard in their accouats: "It was really quite frightening when you were left in charge and a tremendous responsibility for young nurses." (interview report).

Jessie describes one experience from these days:

1 was the senior on duty (nights) and would probably be at the beginning of my third year and 1 had a junior on with me. One of us had to go to the splash (sluice roorn) to count the laundry, it took a long time because there was a lot of dkty laundry to be counted and listed and bagged. Well this night one of the patients asked for a drYik and when I went to the kitchen to get it a patient fell out of bed. What a carry on - 1 had to write a report and present it to Matron in the rnorning and the doctor had to get out of bed to examine the patient, and 1 felt then that we shouldn't have to spend an hour in the washrooms counting the laundry, it was more important to stay on the ward to look after the patients.

Leisure Time

The long working day of the student nurse left little time for leisure pursuits. The work week averaged 50-54 hours, with one Mf day off, and one complete day off per month.

Pat says:

Really you had very little theto yourself, al1 your lectures were in your off- duty and it made it very hard. 1 used to go out to the Mitchell Library to study because 1 felt that if I got away from the hospital atmosphere for a while it was better.

The café across the road fiom the hospital was a favourite venue for the students. Although

they were not supposed to leave the hospital premises if they worked until9 p.m. there were

several reports of slipping out, coats over unifoms (also forbidden), to enjoy a cup of coffee

or tea after coming off duty with CO-workers.Margaret remembea:

On the day before pay day going across to the café, four of us, and everyone turned out their pockets, we'd have money for three coffees so we'd ask for an empty cup and share the three coffees. Everyone could have some CO ffee." Due to the live-in requirements of the period most leisure activities were conducted within the confines of the Nurses' Home which Pat describes as being like a little town of its own.

There was much socializing in and out of each other's rooms shariag tea and providing mutual comfort and support. Margaret remembers the camaraderie and making fneadships which lasted for life. One memory she shares, "The nights when the people with sore feet sat around the tub soaking their feet and sharing the ups and domof the day."

Betty wondered how it was possible to follow the advice of the Matron, Miss

Husband, to keep up their outside interests, when they had only the one day off a month and their off-duty was fiequently changed at short notice. She tells:

We went to films occasionaily and to the locai churches on Sunday if we were off, sornetimes went dancing in the evening but not an awful lot because by the time you were off maybe your friends weren't off at the same time.

Mae tells of dances at Saint Mungo's medical school, located on the hospital grounds, and there were tennis courts next to the Home, but none of the interviewees talked of making much use of those facilities. Mae tells:

To be honest, 1 didn't have the energy to do any of these activities. There were a few activities in the Nurses Home, like Halloween parties when we dressed up, but they were dl female, just the nurses in the Home and sorne of the sisters.

Betty shared:

We went dancing sometimes at the Albert (Glasgow dance hall), and we maybe danced with the soldiers and the different people at the time, but they were moving through so there was no time for any long term relationship. There were a lot of young people away (on war related duties). She merreflects: "Life seemed to be al1 work and study." When asked if they ever complained to each other, she responded, 'No, 1 don't remember ever complaining among ourselves about anything, it was a way of life, wasn't it? You know the war years were difficult in lots of ways."

The desand regdations which permeated hospital life extended into the off duty hours of the student nurses of this period. Matron was a figure to be reckoned with; her authority reached out to al1 aspects of the students7lives. Pat tells of coming in to the hospital fiom an aftemoon off spent in town:

We had to rush back to go on duty at 5 o'clock and my hair was up in a page-boy (fashionable hair style of the period), and the make-up was on. We get on the lift (elevator) in the basement and when it stopped on the ground floor, in cornes Matron, she looked at my friend and 1 and said, 'Where do you work?' Pat and Mae: 'Ward 18' Matron: 'When you get there just get that muck off your faces and that hair off your collar.'

In spite of the heavy burden of responsibility which they carried when on duty, especially the night rotations, they were not fiee to come and go fiom the Home in their off duty hours without permission.

War's End

As the war proceeded on into 1944 more wounded se~cemenwere admitted to the hospital and some of the nurses have vivid mernories of the young wounded service men they nursed in the military wards. Jean recalls:

Most of the lads we had were very badly wounded, there were many amputations. They wanted to taik, about the war, seeing their wives and families and how they would react. She also tells of using sphagnum moss packs to treat draining infected wounds - the moss was first stitched into gauze bags before king stenlized in the autoclave.

Pat remembers a lot of troops coming after the invasion of Italy (1943 ):

I can remember the wounded king brought over, they wore the blue uniforrns of the wounded and there were young fellows who were paralyzed - it was really dreadful, aged 20 - and that was the first time they used penicillin.

Hospital life, with the livingin requirement, unsocial hours and lack of contact with the outside world tended to isolate the students fiom the war news. Also news was censored in the interest of maintainhg national security and public morale, and with what was considered at that time the best of reasons, the public were left in ignorance of many of the important details of the war (Calder, 1969, p. 507).

Mae remembers king on night duty in a fernale medical ward when news of what turned out to be the Battle of Arnhem (Septernber7t8th 1944) was reported in the moming newspapen. As she reports:

There was the most strange silence in the ward, when 1 looked round they were al1 crying - they heard that there was this battle that tunied out to be a disaster. These women possibly had husbands or sons involved. It was a chance the army took to jump behind the Gemüui lines and cut off their troops fiom the Rhine, but they miscalculated and landed among the German troops and there were many casualties.

Mae was visibly moved when recollecting this memory. She shared that when she had taken a trip with her husband down the River Rhine the previous year she had been too upset by what she had expenenced with these women in 1944 that she had been unable to visit the battlefields. "1 couldn't go, 1 still get upset thinking about that day." 68

The war in Europe finally came to an end on May 1945 when the Geman Army surrendered; May 8' was the official &y of victory celebration, subsequently referred to as

VE Day (Calder, 1969, p. 567). Ten of the participants in the study were stili present in the

Infirmary at this tirne and some memories are of fireworks, crowds dancing in the city square and some high jinks by the residents (intems) who fastened one of the red hospital blankets to the steeple of the neighbouring Cathedral.

Although the war in Europe was over, the country took many years to recover and rebuild. The women of this study continued with the pattern of their lives, they completed the required 3 years as students and remained for the fourth as staff nurses and to qualify for the valued hospital pin which identified them publicly as "Royal Nurses!" Eleven of the 14 took

Mertraining and qualified as midwives, 3 completed part 1 of the midwifery certificate,

2 of these joined the armed forces and 1 retumed to the Royal as staff nurse before being married. Al1 have a loyalty to the Royal Infinnary and a respect for their profession and the quality of nursing training they received during those years. Chapter 4

Analy sis

This discussion is organized amund the main themes which developed fiom the interviews, some of which were included in and facilitated by the semi-stnictured inte~ew guide. A feminist perspective which considers issues around power relationships, gender and ch,is used to explore and interpret the data.

In 1938 the School of Nursing had ken in existence for 47 years and the Muence of Florence Nightingale and Rebecca Strong can still be detected. The rules and regdations which governed al1 aspects of the student nurse's life can be traced to both the military and monastic origins of hospital nursing (Baly, 1995; Bunting & Campbell, 1990). Also

Nightingale's concept of the ideal nurse, "forged out of the virtues of a good women,"

(Reverby, 1987, p. 7) infiuenced the attitudes of hospital matrons and nursing super- intendents towards trainee nurses. As Baly @. 120) observed however, this emphasis on obedience and discipline long after hospitals ceased to be undisciplined or lawless institutions, bred conformity and an unquestioning profession that was cesistant to change.

The curfews in the Nurses' Home and criticism of their activities and mode of dress when off duty were accepted at least nominally as part of the nurses' life. In spite of the heavy responsibilities the nurses carried when on duty on the wards, they were not treated as responsible adults when their ward duties were over.

The social mores of the times must be acknowledged when considering these data.

It was the custom in the Scottish culture for young women (and men), to live with theu parents until they married. Matron was therefore "in loco-parentis" and Mae and Pat's 70 encounter with her, in theù off duty hours, when she commented on theù use of "make-up" and ordered them to remove it forthwith is one example of the authonty which the matron assumed over ail aspects of their lives. By today's standards such comments would be unacceptable and considered disrespectfùi to the young women's autonomy, however would not be unusual in the patriarchal society which existed in Scotland at that thne. Most of the participants told of evading the curfews on occasion and bending the desfrom time to time when they believed their freedom was being challenged. Rarely did they publicly or collectively challenge the stahis quo, and even although the country was at war and there were personal tragedies and general hardships to be accepted, the rules of the institution were unquestioned. As Dorothy Sheahan, quoted by Reverby (1987, p. 8), noted: "the training school was a place where women learned to be girls. The range of permissible behaviours for respectable women was nanowed merthrough training." Interestingly the women who reported they had complained about some of the restrictions or unfair deswere those who had previously been in the work force and in some cases were older when they began nursing training (Jessie's cornplaint about her food ration king an example). She, and others like her, had had an opportunity to observe and reflect on the world and other workplaces withln it. There is no doubt that the "living-in" requirement which was the nom for trainee nurses in those days led to a thorough integration of working and non-workhg life, fostered the culture of the hospital and isolated the nurse from the mainstream society (Cade, 1988, p. 19). This dong with unsocial hours led hem to rely on each other for companionship and social support. 71

Not al1 aspects of "living-in" were negative however, the Nurses' Home was centrally heated and well equipped with comfortably fùmished communal sitting rooms, and most of the students had their own bed room. In a period when in most families a "room of one's own" was a luxury and sharing a bed with one's sibling was comrnon, the living conditions were more than adequate. Although there was also a tennis court within the hospital property, none of the participants of this study reported making use of it, they either did not have the time or were too tired when work was over to pursue this energetic leisure activity.

The students were somewhat sheltered fiom the daily wartime stmggles of rationing and food shortages, lack of fuel and poorly heated homes, and the constant queuing for supplies. Their daily needs were taken care of; clothing in the form of uniforms was provided and laundered, and even if the quality and quantity of the meals left much to be desired - they did not have the responsibility of shopping for or preparation of food. Indeed the daily work of the hospital continued, the nurses adapted to the conditions and more or less unquestioningly accepted "the way things were." The support in stressful situations which they derived fiom each other was therapeutic and provided a necessary antidote to the apparent coldness and indifference to their feelings, of those in authority. One rnight question what motivated this attitude and lack of ca~gfiom women whose basic training had been, in what is generally considered to be, a cxing and numiring profession. From an administrative perspective they had a responsibility to ensure that the work of the hospitai went on, no matter what; a disciplined workforce was required which would perform regardless of personal fears or emotions, therefore givhg in to one's feelings was not to be 72 encouraged. A cornparison with the discipline expected of soldiers preparing for battle can be made and is congruent with nursing's military roots. Here also is an example of the altruism expected of women and described by Reverby (1987, p. 473) as nurses' "duty to care without thought of their own needs" which is exploited by the hospitai system. The primary function of the trainee nurses was to be the work force of the hospital, the role of student was a secondary consideration. This apprenticeship style of training whereby the students learned nming procedures on the job either fiom the ward sister or a more senior student, tended to hamper progress and development of new knowledge. The system perpetuated one way of doing things, the goal apparently to prepare the nurse for ward duties as quickly as possible; it would appear that the service needs of the hospital were paramount, not the personal or professional development of the student nurse. Good habits and bad were learned, depending upon the interest and skills of the ward sister. The fact that the students were expected to attend lectures in their own, not hospital tirne, is an indicator of how much value the hospital placed on education, indeed one wonders how much the students gained from the lectures when by their own admission they were ofien too tired after a night's work to concentrate on the topic.

Rebecca Strong's insistence that the matron had authority and responsibility for the nursing activities within the hospitai (Jenkinson et al., 1994, p. 130) was in effect within the hospital throughout the study period. Indeed the matron, Miss Husband, was the most visible symbol of authority in the hospital for the nursing students, and visits to her office for ward reports or to request a speciai favour (perhaps a late pass for a special night out), were approached with trepidation (and a clean apron and regdation cap and shoes). in contnist 73 the male administrator of the hospitd was unknown to the students and never a presence on the wards. Although the students were also in awe of the medicai or surgical consultants whose daily rounds were accompanied by the ward sister, various medical staffpersons and possibly a senior student nurse, the ward visits made by Matron made a greater impact.

Matron was nicknamed "the Hoover," because as one participant observed, when she made a ward visit "she went into al1 the corners and swept everythuig in front of her" (reference to the most popular vacuum cleaner in Britain which was mmufactured by the Hoover company). There was no doubt in the students' eyes that Matron was the key figure in the hospital. Matron, however was accountable to the al1 male Board of Management, a decision making body which approved hospital policies, including the number of nursing recniits and al1 expenditwes (Board of Management Report, 1945).

The historical roots of the profession could still be detected in the mode of dress and duties of the students of this period. The traditional uniform of lavender striped dress, starched white apron and cap which the nurses wore closely resembled that wom by a domestic servant in a middle or upperclass British household at the end of the 19~centwy.

Until hospitals established a reputation for improving health and /or curing disease, the care of a sick member in a household was maidy the responsibility of the females in the family aided by the domestic help (Reverby, 1987). The lot of the lowly probationer nurse as described by the participants bars close resemblance to that of the junior female domestic of 50 years earlier with the emphasis on cleaning, running errands and other domestic chores.

Although al1 the participants recailed clearly the housekeeping tasks which took up so much

of their time, most seem to have accepted them at the time as part of an "initiation" into 74 women's work world and the hierarchy of nursing. The separate roles of men and women were clearly defined in the society of the period. Most women if they married did not work outside the home, and domestic duties were considered to be a woman's responsibility.

Nursing tasks were allocated very strictly according to the hierarchy within the ward which was based on seniority and also to some extent modeled the class structure which still existed in Scotland at that time. Thus the beginning probationer was responsible for the most menial tasks, mainly domestic, which emphasized her lowly statu on the ward and cannot have done rnuch for her self-esteem. The participants described themselves at this stage in derogatory terms, such as "we were just skiwies" (a derogatory terni for a female domestic servant), "poor lowly probationers," "we were menials," "used as slave labour," but apparently gained an intrinsic satisfaction fiom the status and role of "nurse" which they were able to separate fiom the tasks perfonned. This emphasis on domestic tasks is a carry over fiom the early days of the infirmary. Before there was any specialized training, the nurses appointed were hired servants, whose duties included washing, dusting ,serving meals and changing and airing beds between admissions (Jenkinson et al., 1994, p. 35). This existing state of &airs would not have pleased Miss Nightingale who did not believe in nurses doing non-nursing tasks and in 1853 wrote that for aunes "to scour was a waste of power" (Baly, 1995, p. 1 14). For the hospital administrators however the nursing students were a reliable source of labour, and king women were reliably docile and obedient which was the expected behaviour of women at the the. There is no doubt that they were exploited to the extent that their labours were cheaply obtained however in remthey received a professional designation in which they took pride. Nursing had become a 75 respectable occupation for young women, and at the thne had no other serious cornpetitor other than teaching as suitable for a middle class girl (Baly, 1995, p. 125). As the students

gained seniority they had more complex patient care responsibilities and eventually as senior

students deputized for the ward sister in her absence.

The pride which, without exception, al1 the participants expressed at king a Royal

trained nurse was part of the culture of the institution. This belief that the Royal Infmary

training was superior to any other was of?en part of the reason they chose the Royal Infirmary

as a training school and was engendered sometimes by mentors usually former trainees of

the hospital who encouraged them to apply; ''there's only one place in Scotland and that's

Glasgow Royal Infmary," sometimes by the prestige that surrounded a large teaching

hospital, and for some the adjective "Royal" had a superior connotation. The concept of

being "the best" was reinforced in the students especially by the words and actions of Miss

McInroy the principal tutor in the Infhmary at that time. Most of the participants had

mernories which indicated the regard they had for her, and her infiuence on the students

perceptions was profound. For exarnple at the beginning of their training, while still in the

Preliminary Training School, students were infonned that if they did not pass the fmt

examination der6 weeks, or the second examination at the end of the 12 week preliminary

training school, they could not remain as students of Glasgow Royal Infirmary. "You may

go to other hospitals, but you can never corne back to the Royal," Miss Mclnroy wamed. She

was also remembered for her devotion to the students and the support she provided them at

examination times. Apparently she was always available for extra tutorials and especiaiiy 76 when it was tirne to prepare for their final examination for registration, a practice still much appreciated 50 years later.

The system of hiring graduates of the school as ward sisters and nursing administrators also served to perpetuate the hospital culture and belief system and fostered an elitist attitude towards nurses fiom other training schools. Those nurses who had previously trained in the infectious diseases hospitals and therefore did not participate in the

P.T.S. felt that they had lower statw than the othen. One participant reported that she was not one of the "Royalites" and felt she was sometimes looked down on as a result.

Interestingly the nurses who came fiom the children's hospital training school were considered of higher status than the fever trained nurses. Was it because the children's hospital was named the Royal Sick Children's Hospital, the word "Royal" again confemng status in a class conscious society? One would have expected that the expanded knowledge base of these nurses would have given them an advantage, but not so. Was it a concern that these previously trained nurses would question and bring other ways of doing things into the established patterns in the Innmiary?

The four year cornmitment to the hospital expected nom the students was an inexpensive method of retaining relatively experienced nurses and was a relic of the beginning days of the modem hospital training schools. Baly (1 995) writes of the hospitals in the 1900s that "as far as the hospitals were concemed, the longer the training the better"

(p. 123), and "ironically the hospitals best able to select pupils with the most suitable attributes now required the longest training, and the length of training became the hallmark of prestige" (p. 125). Joen's comments, as prevously cited, support this concept: "We 77 considered this four year training as very upmarket." However fiom the distance of 50 years she re flects, "that was daft, really ." It was only at the end of their fourth year that the students received the coveted hospital pin.

This apprenticeship training system produced nurses who were loyal to and identified with their training school, in this example they are first and foremost Glasgow

Royal Infirmary Nurses. Their primaiy loyalty is to the hospital and not to the profession of nursing, and may be a factor which bas contributed to the slow Pace of change and professional developrnent of nursing as a whole. To be fair, this pride in and belief that their hospitai had the best training school was based on some real data. The Preliminary Training

School was the fm nursing education system to demonstrate the value of separating nurses' education from nurses' work, without denying that theory must relate to practice, it led the

way for other hospitals and by the 1930s the adoption of the G.R.I. scheme was becoming

widespread in Bntain and eventually throughout what was the (then) British Empire (Weir,

1994, p. 63). Also the hospitai had a long history of, and reputation for, king at the leading

edge in performing complicated and innovative medical treatments (Jenkinson et al., 1994).

The nursing staff therefore were exposed to complex care cases and gained valuable

technical expertise which was recognized and valued by medical practitioners wherever the

nurses chose to practice.

Before the war the hospital was in the fortunate position of having more applicants

than it could accommodate, and a screening process was in use which included a written test,

persona1 interview and often a high school certificate (Scottish Higher Leaving Certificate).

As the war progressed it was necessary to increase the workforce in the hospital, and the 78 annual intake of students was increased fiom two classes to three; evidence enough that hospital administrators considered trainee nurses a necessary component for the successfut operation of their facility. The normal admission requirements were waived a had been in the workforce and somewhat older than the average student were accepted into the school. This fact was noted with approval by Matron who told a 23 year old entrant that she was "very wise" as she henelf had been 27 years old when she began training. These women brought a fresh outlook to the school and within the participant group were the most critical of the system and its hierarchy of des(Jessie and Ioen being examples). The custom of accepting young women straight fiom high school and their parents' home, into the cloistered environment of the Nurses' Home and surroundhg them with role models who have also been initiated into the culture of the system can be compared to the practice in religious ordea whereby young women, novices, go through a process called formation which trains them in the culture of unquestionhg obedience to the Rules of the comrnunity.

Histoncûlly nursing has ties to religious orders, this practice therefore does not stray far

from these roots (Baly, 1995, p. 23).

In examining the relationships the student nurses had with other health professionals

it would appear that these were minimal. When questioned about their contact and

relationships with other heaith professionals, and in particular the physicians, the responses

ranged fiom, "we didn't have much to do with them," to an indeterminate "good." in

contrast to the modem hospital with its multitude of para- health professionds present on the

wards, the hospital in the 193 0s and 1940s was prharily the domain of the nursing staff who

were the most visible work force. Physiotherapy was in its infancy and located mainly in the 79 orthopaedic wards, and conversation or social interaction by a student num with anyone, whether patient, medical resident or family member was actively discouraged. The nurses, when not involved in direct patient care were expected to occupy themselves with making dressings or other "busy work" such as cleaning cupboards or tidying the linen cupboard, which was a favomite make-work task for the students. The chief physicians or surgeons, usually also referred to as professors in recognition of their role within the medical school, did not relate to the student nurses. Al1 collaboration and patient treatment directions were via the ward sister, who then directed the nursing staff accordingly. The Professors were considered God-like figures within the hospital and noone and nothing could interfere with their schedules. It is possible that they took advantage of theû positions of power and some abuse and harassment of the nursing students occurred. Two examples were shared by participants of situations which no doubt were not isolated incidents. One participant was not permitted to take enough time off fkom operating room duties to write an examination; the surgeon had instructed her to retwn in one hour when she had two hours scheduled off for it. The other situation occurred in P.T.S. during an oral Anatomy examination conducted by one of the senior Professors. The student was embarrassed by the questions which the professor was asking. Neither of the participants had complained about the behaviour of these men, they had learned to cope with and accept the reaiities and poweriessness of being women in a paternalistic society. Although it would appear that Matron had autonomy within the hospital, the student nurses as the most Milnerable group were dominated by both the hierarchal system within their own department and also by the physicians. Class inequalities, not only gender played a factor here. Historically physicians came nom a higher 80 class in society than the nurses, whose backgrounds in this study were mainly middle class.

The reaiity that physicians paid for their University based education, automatically put hem in a different category than nurses whose education or training was in retum for their labour.

This placed a higher value on the physician's knowledge base and conferred higher statu, curing was more valuable and important than caring. Although they were not fully aware of it at the time, these nurses were witness to innovations and new technologies which would impact and change many aspects of their work. Many witnessed the fmt use of penicillin and marveled at its miraculous effects, also the war led to al1 kinds of experimentatioa and cutting corners which resulted in patients ambulating earlier and recovering quicker (Baly,

1995). Some of their skills would become outdated and rarely would poultices, four-hourly tepid sponge baths, or barrier nursing be part of their daily routine. In some ways the personal patient nune interaction was diminished as technology took over and less time was spent at the bedside.

The notable experiences of the participants can be divided according to whether they

began nursing training in the first three years of the war, between 1939, and 1941, or fkom

1942-44, the latest entry to training date identified in the study. Between 1939 and 1941-42,

the hospital prepared for the emergency care of civilisas who were casualties of bombing

attacks, and the students tell of air raid precautions, difficult night-the travel and food

rationing. From their own accounts there was not any special disaster plan or training to

prepare them for such emergency nursing care. On completion of their training these nurses

were affected by the Nurse Act of 1943 and the government's control of engagement order,

whereby nurses could only give up their present positions in order to do Mertraining; 81 without this intention they were regarded as available for work in a shortage area and directed accordingly (Baly, 1995, p.174). This government policy was an attempt to retain qualified nurses for the civilian hospitals, however the result was that most chose to begin

midwifery training to ensure they would not be arbitrarily posted far from home. Two of this

group later went on into the anned forces. The government's scheme to influence the

retention of nurses in the country's hospitals did not meet with any great success either

nationally or with this small sample. Nine of the 14 participants began training in the

hospital in 1942 or later, and 4 had chosen nursing as an occupation in order to avoid some

other fom of war service, such as working in a munitions factory or other designated

essential service. The major air raids on Clydebank were over in May 194 1, however by then

the shortages of food and supplies were more acute. The lack of qualified staffis particularly

noted by these participants. Although the war provided employment opportunities for women

which had not previously been open to thern, their keedom of choice was Iirnited. Nan, for

example, chose nursing instead of teaching, into which she had been directed when applying

for university admission. She had hoped to qdify for a civil seMce career afler graduating

with an arts degree and was infonned that she would only be accepted in the University

programme if she agreed to become a teacher. Fomuiateiy she enjoyed her second career

choice, others were not quite so satisfied as according to reports, many did not stay in the

programme. Jessie reported îhat out of her class of 40 only about 20 nwived the four years

and Joen's class in 1944 began with 65 and only 40 finished trainiog.

Al1 of the participants stated that they had no regrets about their decision to become

nurses, their careers had ken satisfyiag, and fiiendships made as students had lasted over 82 the years. Obviously these relationships were an Unportant part of the whole student nurse experience, reinforcing the observation made by Anderson, Annitage, Jack and Wittner

(1990) that relationships with others has always ken a central component of female activity and identity.

The experience of conducting this research has been a personally enriching experience, as 1 became deeply immersed in the experiences of those women who were young students half a centwy ago. As 1 strove to understand the realities which shaped their lives 1 developed new insights into my own journey. Many of the influences which impacted on their thinking and decision making 1 realize were also part of my own experience as a student in the same hospital in 1960. Although by that time stuclents did not have to attend lectures in their own time, Miss Mc Inroy was still a presence, retiring while 1 was a junior student and we still believed without question that we belonged to that elitist group, Royal

Infirmary nurses! Rebecca Strong was a legend and her comection with Florence Nightingale very important to us students, as it was to the students of this study. Thus the thrill 1 expenenced when listening to Agnes tell of nursing Rebecca Strong, was sparked by the realization that by sharing Agnes's experience 1 was tangibly co~ectedwith Florence

Nightingale. This persona1 experience supports the observation made by Reinharz (1 992, p. 127), "that feminist historical research provides a sense of connection and continuity with women of the past." Cbapter 5

smary

Oral history research provides a written record of an individual's life fiom their own perspective and in their own words and as such is a unique document which provides a window through which events of the past cm be viewed. This oral history study has focused on the every day experiences of a small and select group of student nurses in a large civilian teaching hospital in Glasgow, Scotland, within the context of World War II.

The Royal IbarySchool of Nursing's strong comection with the Nightingale model of hospital nursing is evident fiom the descriptions of nursing life and work which is presented here. Matron's authority over al1 matters pertaining to nursing within the hospital is based on Miss Nightingale's vision (Baly, 1995, p. 119), and Rebecca Strong, who died in 1944 at the age of 101 years, has still a visible influence in this snidy penod. Her direct comection with Florence Nightingale enhanced the selfssteem of students of this training school which was further encouraged by the words and actions of Matron and the

Sister tutors who acted as role models for the students. The discipline of the ward and within the Nurses Home, also a legacy fiom the Nightingale model was accepted by most as part of nursing life and served to encourage the formation of supportive relationships and fi-iendships among the -dents. Their isolation fÎom the mainstrearn of society, a result of unsocid working hours and the living-in requirement also strengthened these relationships, many of which have been maintained and valued over a lifetime. 84 Throughout the war, the city of Glasgow was fortunate in not suffering the extensive bombing raids experienced by London and the southem parts of England. Aithough the bombing of the Clydebank shipyards West of the city in March and May of 1941 caused severe damage, most of the civilian casualties were treated in hospitals on the western side of the city. The Royri Infimary, king located on the east side of Glasgow was required to receive only 237 of these casualties, and although one might expect that an oral history of student nurses of this penod would include their experiences caring for victims of air raids, there is only one such documented incident fiom these interviews. An examination of the table in Appendix 1, reveals that only 5 of the participants were nursing students in 194 1, and

2 of these began training at the end of 1941 when the Clydebank Blitz, as it was later referred to, would have been over. The majority of the women in the study began nursing training midway through the war years and being in theu late teens or early twenties at that tirne, had little experience of adult li fe in the prewar years. From today 's perspective it may appear that their lives were restricted by hospital regulations and war time conditions however the interview data indicate that they made the most of what opportunities for fun and entertainment were available to hem, and compared their situation favourably with their contemporaries in other fields, both male and female. It has to be considered also that most men of their age group were required to serve in the armed forces and several had brothers or male cousins who were in one of the services and whose whereabouts and safety were unknown. In comparison these women were close to home and reasonably safe fiom hm.

A picture of the progress of the war on the home front can be detected fiom the interviews, and correlated with the year of entry to the School of Nursing. From the earlier 85 entry to training dates for example, the emphasis is on the blackout, air raid precautioas and gas mask use, however by 1943-44 there are mernories of nursing wounded servicemen and the first documented use of penicillin. Rationing impacted on everyone throughout this period and most of the populace including the student nurses from this sample learned creative ways to obtain necessary items and used substitutions to create prewar treats, for exarnple mashed tunup with banana flavouriag for mock banana sandwich filling, and cornstarch and margarine whipped together as a substitute for dairy cream. Some of these creations are not appealing to the palates of the present day but it must be remernbered that there were few luxury items available and people became weary of their monotonous diets

(Calder, 1969, p. 71).

A description of the social deprivation experienced by many of the Infirmary patients is acknowledged in the data and reflects not only the economic reality of the depression years but also the social inequalities existing in the city. The wealthy industrialists, shipping

magnates and merchants of industrial Glasgow lived in the large mansions and Victorian

villas on the outskirts of the city. The inner city working class population lived in over-

crowded one or two room tenernent flats with minimal sanitation services. The country was

well primed for the socialist govemment and fke national health services which emerged in

the post-war years.

As the focus of this study was an exploration of the realities of women's lives a

feminist approach was used to conduct the research and analyze the data. The object being

to validate and value their experiences and examine them fiom a feminist perspective and

in relation to the context of the times. Every attempt was made to collect the data in a non- 86 hierarchal environment and to encourage the women to tell theû story in their own words, and without too much direction fiomthe interviewer which might have added researcher bias to the content of the interviews.

The transcnbed data were presented and anaiyzed using gender, power and class as a frame of reference. Here we find that a greater part of the nurses' time is taken up by what could be considered domestic tasks, those which would be traditionaily a wornan's responsibility. Al1 of the women make a point of describing these responsibilities in the interviews, indicating that even if they accepted the tasks at the time, they have dso since reflected on the appropriateness of delegating them to junior nurses. The issue of patient safev being cornpromised when so much of the nurse's time was spent on non- nursing care tasks was identified by two of the interviewees. The hierarchy of the infmary which promoted unquestionhg obedience by the nursing staffinhibitedany discussion with nursing administration about this concem. It would not be until afler the war years that a study of, and job analysis of nursing would be conducted (Baly, 1995, p. 2 15). In 1948 the Ministry of Health asked the Nuffield Provincial Hospitals to set up an advisory panel to carry out a complete job analysis of the work of the nurse and other memben of the hospital team to investigate 'what is the proper task of the nurse?' Gradually, in response to this and other reports, and to the changes brought about by new dmgs and technology, nurses were no longer responsible for hospital housekeeping tasks.

Nursing's position vis-a-vis the other health professionals was also considered. As students they considered themselves to be of lowly statu within the hospital administrative structure even although they formed the majority of the work force. The predominately male 87 medical personnel were accorded great respect by al1 the nursing staffand considered a class apart, a concept which was also held by many of the patients.

The impact of the war on the development of new dmgs and progressive approaches to patient care is documented in these women's reports. Because the Infhnary was one of the first to use penicillin as reported in the Managers Report (1945)' this study documents one of the early case studies of the effect of penicillin use on the recovery of patients suffering from bacterial infections. The Board of Management reports which were primary sources of information for this study, also document the impact this new hghad in reducing the streptococcal infection rate among patients suffering fÎom burn injuries.

The nurses' training was seMce oriented and lacked standardization, being dependant on the ward sister's abilities and inclination. Often there was no link between c lassroom theory and the clinical setting as the nurse could be assigned to a specialty ward such as gynaecology before she had an opportunity to attend lectures on the subject. On the other hand because the Infirmary was a teaching hospital for the medical school and had expert medical specialists on staff it was a referral centre for serious and complex medical cases; the nurses therefore had an oppomuiity to gain a wide range of patient care experiences.

In spite of the long hours and the demands and somethes hdgery of their work

the women were fiercely loyal to their training school. They considered their training to be

among the best available and were proud to be known as "Glasgow Royal Infirmary nurses."

T'here were no regrets about the path they had chosen. Conc tusion

In the execution of this study 1have been personally both challenged and exhilarated.

The major challenge was due to distance fiom the study location and the subsequent time constraints which meant that al1 interviews and archivai research were conducted within a three week time span. The archival material was accessible by appointment only, therefore there was only one opportunity to review and consider what was important for reference purposes. Sirnilarly al1 the interviews were conducted in a single visit, there was no opportunity to seek Mer clarification or explore other avenues of interest which 1 considered important once the interview tapes were king reviewed and transcribed. As the process of transcription and analysis proceeded 1 became aware of the limitations imposed on the study due to distance and time and my own inexperience. Other questions inevitably came to mind. That being said the process was exhilarating as it not only provided me with new insights into the lives and experiences of the women in the study, but 1 aiso gained an appreciation and understanding of the conditions which have impacted and shaped my own life's experiences. Reinhan (1992, p. 127) describes this aspect of ferninist research, "Once the project begins, a circular process ensues: the woman doing the study learns about herself as well as about the women she is studying."

This study is uniquely the experiences of a small sample of women whose names were selected fiorn the membership list of the Glasgow Royal Idïrmary Nurses' League. It should not be considered to reflect the experiences of ail women who were shident nurses during this tirne period, either in the same hospital or in others. We cannot generalize the findings of the study to the wider population, however fiom the letters, newspapers, and the 89 minutes and reports fiom the Infimiary Board of Management the facts can be supported.

There is enough congruence in the intemiew reports to substantiate the data and allow inferences to be made.

The nursing programme was totally focused on acute care and based on the medical model. It was what is referred to in the United Kingdom as "General Nursing," in fact the professional designation which Scottish nurses receive on successfully completing the State

Registration examination is Registered Generai Nurse, R.G.N. The young student nurses did not have an oppomullty to nurse in the community or examine the public health problems which led to the poor health conditions of many of theù patients. Community health nursing was the domain of Health Visitors or District nurses, who were registered nurses with pst registration qualifications. In spite of Florence Nightingale's vision of nursing as separate from medicine with a focus on heaith promotion and illness prevention through improved sanitation and hygiene, the Nightingale model of nursing schools in Britain evolved as training programmes to meet the service needs of the hospitals and provide support for medical interventions (Baly, 1988, p. 13).

These women were affected by a socially constructed paternalistic society, their wor k responsibilities were organized around the traditional household tas ks and valued in relation to the support they provided to the medical profession's interventions. Cassin (1 993,

p. 3 1) *tes that when desctibing their work, nurses use concepts and descriptive terms such

as "putting patients fïrst" or "responsibility" which do not make explicit the knowledge of

their work. Much of what they do is unrecognized in their work setting, poorly understood, 90 invisible and taken for granted.. The women in this study described the tasks demanded by their roles however did not describe their nursing interventions or how they hpacted on the well being and comfort of their patients. Long periods of postsperative convalescence and bed rest were common in these days and nursing care was an important and valuable element affecting the comfort and recovery of the patients. In those pre-antibiotic years their skills in the prevention of cross infection were critical, such skills are now relevant for contemporary nurses who are meeting the challenges of the new antibiotic resistant bacteria in their practice settings.

When 1 first conceived of this research 1 assumed that there would be noticeable differences in nurses' work responsibilities, curriculum and hospital life as a result of the war. The data however indicated that the hospital work went on and fiom these women's perspective, which time has no doubt softened, the disruptions were not insunnountable They adapted to the conditions as did the total populace and the fact that these were shared experiences made them tolerable.

The nursing school and the training programme was very much as it had been when first proposed by Rebecca Strong. Progress has ken slow for the nursing profession, and the attachment of nursing education to hospital semice has hindered the rnany advances of nursing. Although the Matron was seen to be in charge of nursing matters this was at the hospital level only, the influence of Govemment policy makers on nursing as a whole impeded the development of any sense of professional autonomy.

Throughout this research process 1 have reflected not only on the factors which have shaped my own practice but also how as a nurse administrator I can use the knowledge 91 gained fiom the study to influence change in my practice setting. 1appreciate more fully the importance of supporting professional activities and encouraging and providiag opportunities for my colleagues to attend educational and professional development programmes. 1 have also learned the importance of articulating and defining those professional nursing interventions which have a positive impact on the quality of life for my clients and also on the work life of my colleagues in long term care. With health care budgets king scrutinized, and the value of professional nursing king questioned this knowledge has enabled me to advocate and lobby for the necessary resources to maintain professional standards which support safe and professional nursing practice.

This oral history study has been a feminist project. It has allowed women to tell their life experiences in their own words and viewed them fiom a feminist perspective. Also the process of documenting these experiences and making them the focus of this study has valued both the experiences and the women themselves. The value of nursing seMces in the maintenance of the hospihi's activities has been identified and documented, as has nursing's contribution to and support of the successful outcome of medical activities.

Although we can criticize the apprenticeship mode of training these women gained valuable life experiences. From the enlightened perspective of today the broad experience the nurses were exposed to did prepare them for the health care system of the times. In spite of the sometimes too unsophisticated nature of their work these women were proud of their professional designation and the respect that society at the tirne accorded to it.

Hann (Crowley, 1988, p. 54) has written that an oral record moves fiom these ordinary areas of historical documentation to those aspects of every day experience about 92 which the documentary record has little to say. This study has contributed to an understanding of popular experiences during World War II, and in particular it has focused on the personal recollected experiences of a small sample of women who were student nurses at this time.

Im~licationsfor the Future

As we move into the twenty-fust century this study validates for nurses the lives of those women who preceded us and it has forged direct links with our past. By looking back we can identify our progress and identie those factors which have helped or hindered the evolution of the profession. It seems apparent fiom this study that the system of hospital based schools of nuning hgmented the profession and discouraged political awareness.

This legacy is still with us and explains nurses' political naivety and resulting powerlessness to effect change. In Canada whenever there is a preceived nursing shortage governments still attempt to manipulate and control the profession while sllnultaneously not offering full tirne jobs or, laying off nurses in difficult economic times. A return to the hospital diploma schools is still being recommended by some politicians as the panacea to some problems in the health care system. Nurses must be vigilant about preserving their autonomy and the right to participate in policy decisions which impact on their profession.

The adaptability and resiliency of the women in this study who nursed their patients through personally stressful tixnes is an inspiration for present day nurses who are also living through stressfùl times. The complexity of care needs and the rapid technologicai changes within the health care system require that today's practitioners be adaptable and resilient.

As nursing struggles to define and determine its role in a rapidly changing and multi- 93 disciplinary healthcare system a knowledge and understanding ofwho has gone before allows

us to avoid the erron of the past and to build and gain inspiration fiom our successes. Appendix A

Reg* -No. 13 1 Sarah Nash DISMSSED - REFWSED TO SIGN AGREEMENT Mary Thomas San throat Fair ability Gloucester Inf. (Supcrintsndcnt) lndustrious 1 1 Cold RESIGNED - NOT S'fRONG ENOUGH Catherine Collins

Cold WinchestCr Nctlcy Nctlcy Matton, Glasgow Startcd 1st P15 1880 Martha John Fabricula ? 1 S.T.H. Marricd Julie Abbot

Emma Berry Cold Fair nunc S.T.H. S.T.H. Nctlcy Head Nursc I 1 Edinburgh 1116 Harrict Saunden

Janc Dukc Sorc thmat supctior S.T.H. S.T.H. MARMED---RN cdlcd Pc*n I (Sister) (Sister) her a bad influence Cold I S.T.H. S.T.H. Edinbwgh I Antelia Harris 6 mth iraining Mairon at Winchester - special I arrangement I Cold Fairly goad S.T.H. Nctlcy sorc thmat 7- Snrah Litchfield Fabricula RESIGNED - NOT STRONG ENOUGH FOR THE WORK A lady of good aùitity RESIGNED - NOT WlLLMG TO CONFOM WmiREGULATiONS

Catherine Tyrcll No comment S.T.H. AD-D AS A PATIENT TO ( BETMEHEM MYLUM El izabcih A woman of Montforte modcrate MARRED ability

Table 1. Source: M. E. Baly, 'A History of the Nightingale Fund Council, 1885-1 9 Mt,

unpublished thesis, (University of London), 1985. Appendix 9. Appendu B

Dear

My name is Anne Highet (nee Richardson) and 1 am a graduate nuning student at

Dalhousie University, Halifax, Nova Scotia, Canada, in the Masters in Nursing programme. I graduated fiom the Royal Infhary School of Nursing in 196 1, and am interested in pursuhg an oral history from women who were student nurses in the Royal

Infirmary between 1939 and 1945, with a view to documenting their expenences and

prese~ngan important period in the history of the school of nursing, and the Royal

Infirmary .

With the assistance of the Director of Nursing and Quality, Miss M. Smith, and

Miss Rosemary Weir, past editor of the G.R.1. Nurses League Journal, 1 have obtained a

list of League members who were nursing students during this penod, and who might be

interested and willing to meet with me for an hour or two to share their mernories and

experience of student days ( and nights) as "Royal" nurses.

1 am enclosing an outline of my proposal and a simple questionnaire for your

consideration, and would be grateful if you could be of assistance with my research snidy.

1 have enclosed a stamped addressed envelope for your reply.

1 thank you for your interest and tirne.

Sincerely,

Anne Highet Appendù C

The purpose of this study is to document the recollections and lived experiences of women who were student nurses in the Royal Infinnary, Glasgow, Scotland between 1939 and 1945. This theperiod covers one of the major events of the 20' century, World War Two, which impacted on and shaped the lives of al1 who lived through it. The effects of the war on the day to day lives of student nurses will be explored with a pdcular focus on their perceptions of how their lives, work environment and nursing curriculum were affected and changed. Oral history is the method proposed for this project and semi-stnichired interviews with opensnded questions will be used to obtain the data. Participants will be invited to describe their experiences in their own words, and with their pehssion the intewiews will be recorded on tape. Newspapers, professional jodsof the period and hospital records will be secondary sources of information. Unlike traditional nursing history which describes the working conditions and evolution of the profession fiom pre- Nightingale days to the present, this study will examine the day to day activities, philosophy and values of the student nurse during a significant world event. With the passage of time there is an urgency with this project as women who were student nurses between 1939 and 1945 are aging. With their passing their unique stories will be lost forever, and also the opportunity to enrich our knowledge of student nurses' lives, work and perception of themselves and their place in the community. A study of history enables us to understand how the past impinges on the present and how one generation uses the ideas, theories, practices and research of past generations, adds to them and passes them on to friture generations. As nursing education has moved fiom hospital based schools to community colleges and universities, an understanding and appreciation of the experiences of previous generations is important. Appendix D

Project: Oral history of women who were snident nurses in the School of Nursing, Royal Infirmary, Glasgow, Scotland, between 1939 and 1945.

Please indicate your interest in participating in the above project by completing this Questionnaire.

Yes, 1 am willing to participate in this project.

No, 1 do not wish to participate in this project.

Signature: Date:

Cornments:

Please retum this completed questionnaire in the stamped addressed envelope. Thank you for your interest and tirne. Sincerely,

Anne Highet Director of Nursing and Quality Royal Infirmas, Trust Glasgow, Scotland G4 OSF

My name is Anne Highet (nee Richardson) and 1 am a graduate nursing student at Dalhousie University, Halifax, Nova Scotia, in the Mastea in Nursing programme. 1 graduated fiom the Royal Infirmary School oMursing in 196 1, and am interested in pursuing an oral history nom women who were student nurses in the Royal uifirroary between 1939 and 1945, with a view to documenthg their experiences and piesenhg an important p40d in the history of the School of Nursing. 1 am requesting your permission and assistance to access and review records fiom the hospital and school of nursing which may assist me with this study and enable me to place the oral data within a broader social context. 1 would be specifically interested in perusing the board of management and department of nuaing annual reports of that era and other documents which may refer to student enrollment, nursing curricula and the impact of war-time conditions on the organbtion and management of the hospital and nursing department. In order to ensure that confîdentiality and anonymity of sources in maintained, no names will be used in the references. 1 cm be contacted at: 155 Island View Drive Boutilier's Point, Nova Scotia

Thank you for your assistance.

Sincerely,

Anne Highet Appendu F

Greater Glasgow Health Board CIOArchives Department University of Glasgow

Dear Thank you for your letter of December 15, 1997 and for your willingness to assist me with my research study. 1 am a graduate nursing student in the Masters in Nursing programme at Dalhousie University, Halifax, Nova Scotia and am interested in punuing an oral history of women who were student nurses in the Royal Infinnary, Glasgow between 1939 and 1946, with a view to documenting their experiences and preserving an important period in the history of the school of nursing and the Royal Infirmary. This study is king undertaken in partial fulfilment of the requirements for the Masters in Nursing degree. 1 am requesting your permission and assistance to access and review those school of nursing records for that period which may assist me with my study and provide background information. All information received will be used solely for academic research, participation will be entirely voluntary and participants will be able to withdraw from the study at any time if they so wish. Anonymity of participants will be assured and no names or other identifiing data will be used in the published report without first obtaining a written consent fiom the participant. The study proposal has been reviewed and approved by Dalhousie University Ethics cornmittee. I have enclosed a copy of their approval letter for your information. 1 wi 11 be in Scotland from February 15 to 25th inclusive and hope we can arrange a mutually convenient time to discuss my research. My address in Scotland is:

Thank you for your time and interest.

Yours sincerely,

Anne Highet Appendù G

Partici~antconsent

Project: Oral history of women who were student nurses in Glasgow

Royal Infirmary School of Nming between 1939 and 1945.

Researcher: Anne Highet

This is to certiQ that 1, understand the purpose of this study and have agreed to be a participant and to be interviewed.

I give permission for the use of a tape recorder to record the interview and for the information to be used for future publication with the understanding that my name will not be included, if that is rny choice.

1 undentand that the tapes will be stored in a safe facility and rnay not be duplicated except for preservation, and that 1 will receive a transcription of the interview ai the end of the study .

1 also understand that the completed study may be published.

Signature of Participant

Signature of Researcher

Date Appendu H

Interview guide

Demographic Data:

Name:

Age on entering nursing school

Year of graduation

Work experience since graduation: Home

Other

The aim of the interview is to encourage participants to describe their experiences, and

for their own topics to udold, therefore the questions are used to direct the dialogue, not

control it. Open-ended questions are prirnarily used. It is hoped that as the participants

become more cornfortable wiîh me and the process, new directions for enquiry will

become apparent.

Sample Questions:

Can you remember your fint day at the school of nursing?

Can you describe a typical day on the wards?

What stands out in your memory of those student days?

Did they (events) change anythmg at the hospital?

Other topics to explore will be working conditions, black-out effects, rationing, theoff,

niles and regulations, hierarchy in the profession. Appendu I

Demoga~hictable

Age when Year of en- Work Status beginning to the training experience triinhg school before going to

Margaret 73 years widowed 1 18 years 1 1942 1 none (fam) Margaret 74 years C78 years widowed 1 18yean 1 1938 Ichild-care 76 years widowed 1 20 yem 1 Registered Fever Nurse divorced 1 18 years 1 1938 1 none 79 years unmarried 25 years Red Cross I I I V.A.D. 73 years widowed 1 18 years 1 1943 1 none (fm) 73 years married 18 years 1943 none widowed 24 years 1 944 Registered Fever Nurse 11 Margaret 1 78 years Registered I Fevet Nurse II Agnes 1 78 years unmarried 1 l8years 1 1938 Ichild-care 1) Elizabeth 1 77 years unmarried 1 19 years 1 1941 1 bank secretary 77 years rnarried 1 20 years 1 1941 1 munitions l 1 factory 1 11 Nan 1 74 years

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