THE EXPERT'S TOUCH
Write that, when pride of human skill
Fell prostrate with the weight of care,
And men pray'd out for some strong will,
Some reason 'mid the wild despair,--
The loving heart of Woman rose
To guide the hand and clear the eye,
Gave hope amid the sternest woes,
And saved what man had left to die.
R. M. M.: "A Monument for Scutari,"
_Times_, Sept. 10, 1855.
Miss Nightingale arrived at Scutari, as we have seen, on November 4, and
was immediately in the midst of heavy work in nursing. The Battle of
Balaclava was fought on October 25; and on the day after her arrival,
the Battle of Inkerman.
* * * * *
"Miss N. is decidedly well received," reported Mr. Bracebridge to Mr.
Herbert (Nov. 8). A few days later, the Commander of the Forces, in a
letter dated "Before Sevastopol, Nov. 13th, 1854," bade her a hearty
welcome, tendering to her a "grateful acknowledgment for thus charitably
devoting yourself to those who have suffered in the service of their
country, regardless of the painful scenes you may have to witness." With
some of the military officers she had difficulties; from the Commander
she received nothing but courtesy, sympathy, and support.
"Miss Nightingale cannot but here recall," she wrote after the war,
"with deep gratitude and respect, the letters of support and
encouragement which she received from the late Lord Raglan, who
invariably acknowledged all that was attempted, for the good of
his men, with the deepest feeling, as well as with the high
courtesy and true manliness of his character. No tinge of petty
jealousy against those entrusted with any commission, public or
private, connected with the Army under his command, ever alloyed
his generous benevolence."[94]
[94] _Statement to Subscribers_, p. vii.
The behaviour of some (but not all) of the military officers, and of the
men who caught their manners from the officers, was at first different.
There was sometimes ill-disguised jealousy, and consequent sulkiness.
Outwardly, there was politeness; but difficulties were put into the way
of "the Bird," as some of them called her behind her back, and she was
left to shift for herself, when a little help might have eased the
burden. "It is the Bird's duty," they would say. Miss Nightingale,
however, kept perfect command of her temper. "She was always calm and
self-possessed," says one of the Roman Catholic Sisters; "she was a
perfect lady through everything--never overbearing. I never heard her
raise her voice."
Upon most of the medical men on the spot she made a good impression at
once, because she proved herself to be efficient and helpful. She
applied the expert's touch. But there were doctors and doctors. Some
welcomed her and her staff, and made as much use of them as possible.
Others resented their presence, and threw obstacles in their way. There
was one ward in which the junior medical officers had been advised by
their superior to have as little to do with Miss Nightingale as
possible. She showed exemplary patience under this kind of opposition,
and gradually won her way into the confidence of most of the
doctors.[95] "Miss Nightingale told us," says one of her staff, "only to
attend to patients in the wards of those surgeons who wished for our
services, and she charged us never to do anything for the patients
without the leave of the doctors."[96] "The number of nurses admitted
into each division of a hospital depended," Miss Nightingale herself
explained, "upon the medical officer of that division, who sometimes
accepted them, sometimes refused them, sometimes accepted them after
they had been refused; while the duties they were permitted to perform
varied according to the will of each individual medical officer."[97]
That this ill-defined state of things called constantly for tact and
diplomacy on the part of the Lady Superintendent, and often for severe
self-restraint, will readily be perceived.
[95] See _Pincoffs_, p. 79.
[96] _Eastern Hospitals_, vol. i. p. 71.
[97] _Notes_, p. 152.
On the first arrival of Miss Nightingale and her staff, the wounded were
pouring in fast, and the nurses were told off to the worst surgical
cases:--
"Comfort yourselves," wrote Mr. Bracebridge to her parents (Nov.
20), "that what the good Flo has done and is doing is priceless,
and is felt to be so by the medical men--the cleanliness of the
wounds, which were horribly dirty, the general order and
arrangement. There has not been half the jealousy I expected from
them towards her."
"As to Miss Nightingale and her companions," wrote Mr. Osborne to
Mr. Herbert (Nov. 15), "nothing can be said too strong in their
praise; she works them wonderfully, and they are so useful that I
have no hesitation in saying some 20 more of the same sort would be
a very great blessing to the establishment. Her nerve is equal to
her good sense; she, with one of the nurses and myself, gave
efficient aid at an amputation of the thigh yesterday. She was just
as cool as if she had had to do it herself."[98]
[98] _Stanmore_, vol. i. p. 349.
A letter from Miss Nightingale herself to her friend of Harley Street,
Dr. Bowman, the ophthalmic surgeon, gives a lively account of some of
her difficulties, and a vivid picture of the horrors amid which her work
was done (Nov. 14):--
"_I came out, Ma'am, prepared to submit to everything, to be put
upon in every way. But there are some things, Ma'am, one can't
submit to. There is the Caps, Ma'am, that suits one face, and some
that suits another. And if I'd known, Ma'am, about the Caps, great
as was my desire to come out to nurse at Scutari, I wouldn't have
come, Ma'am._"--_Speech of Mrs. Lawfield_.--Time must be at a
discount with the man who can adjust the balance of such an
important question as the above, and I for one have none: as you
will easily suppose when I tell you that on Thursday last we had
1715 sick and wounded in this Hospital (among whom 120 Cholera
Patients), and 650 severely wounded in the other Building called
the General Hospital, of which we also have charge, when a message
came to me to prepare for 510 wounded on our side of the Hospital
who were arriving from the dreadful affair of the 5th November from
Balaklava, in which battle were 1763 wounded and 442 killed,
besides 96 officers wounded and 38 killed. I always expected to end
my Days as Hospital Matron, but I never expected to be Barrack
Mistress. We had but half an hour's notice before they began
landing the wounded. Between one and 9 o'clock we had the
mattresses stuffed, sewn up, laid down--alas! only upon matting on
the floor--the men washed and put to bed, and all their wounds
dressed. I wish I had time. I would write you a letter dear to a
surgeon's heart. I am as good as a _Medical Times_! But oh! you
Gentlemen of England who sit at Home in all the well-earned
satisfaction of your successful cases, can have little Idea from
reading the newspapers of the Horror and Misery (in a Military
Hospital) of operating upon these dying, exhausted men. A London
Hospital is a Garden of Flowers to it.
We have had such a Sea in the Bosphorus, and the Turks, the very
men for whom we are fighting, carry in our Wounded so cruelly, that
they arrive in a state of Agony. One amputated Stump died 2 hours
after we received him, one compound Fracture just as we were
getting him into Bed--in all, twenty-four cases died on the day of
landing. The Dysentery Cases have died at the rate of one in two.
Then the day of operations which follows....
We are very lucky in our Medical Heads. Two of them are brutes, and
four are angels--for this is a work which makes either angels or
devils of men and of women too. As for the assistants, they are all
Cubs, and will, while a man is breathing his last breath under the
knife, lament the "annoyance of being called up from their dinners
by such a fresh influx of wounded"! But unlicked Cubs grow up into
good old Bears, tho' I don't know how; for certain it is the old
Bears are good. We have now _four miles_ of Beds, and not eighteen
inches apart.
We have our Quarters in one Tower of the Barrack, and all this
fresh influx has been laid down between us and the Main Guard, in
two Corridors, with a line of Beds down each side, just room for
one person to pass between, and four wards. Yet in the midst of
this appalling Horror (we are steeped up to our necks in blood)
there is good, and I can truly say, like St. Peter, "It is good for
us to be here"--though I doubt whether if St. Peter had been here,
he would have said so. As I went my night-rounds among the newly
wounded that first night, there was not one murmur, not one groan,
the strictest discipline--the most absolute silence and quiet
prevailed--only the steps of the Sentry--and I heard one man say,
"I was dreaming of my friends at Home," and another said, "I was
thinking of them." These poor fellows bear pain and mutilation
with an unshrinking heroism which is really superhuman, and die, or
are cut up without a complaint.
The wounded are now lying up to our very door, and we are landing
540 more from the _Andes_. I take rank in the Army as Brigadier
General, because 40 British females, whom I have with me, are more
difficult to manage than 4000 men. Let no lady come out here who is
not used to fatigue and privation.... Every ten minutes an Orderly
runs, and we have to go and cram lint into the wound till a Surgeon
can be sent for, and stop the Bleeding as well as we can. In all
our corridor, I think we have not an average of three Limbs per
man. And there are two Ships more "loading" at the Crimea with
wounded--(this is our Phraseology). Then come the operations, and a
melancholy, not an encouraging List is this. They are all performed
in the wards--no time to move them; one poor fellow exhausted with
hæmorrhage, has his leg amputated as a last hope, and dies ten
minutes after the Surgeon has left him. Almost before the breath
has left his body it is sewn up in its blanket, and carried away
and buried the same day. We have no room for Corpses in the Wards.
The Surgeons pass on to the next, an excision of the
shoulder-joint, beautifully performed and going on well. Ball
lodged just in the head of the joint and fracture starred all
round. The next poor fellow has two Stumps for arms, and the next
has lost an arm and a leg. As for the Balls they go in where they
like and come out where they like and do as much harm as they can
in passing. That is the only rule they have....
I am getting a Screen now for the amputations, for when one poor
fellow, who is to be amputated to-morrow sees his comrade to-day
die under the knife, it makes impression and diminishes his chance.
But, anyway, among these exhausted Frames, the mortality of the
operations is frightful. We have Erysipelas, fever and gangrene,
and the Russian wounded are the worst.
We are getting on nicely though in many ways. They were so glad to
see us. The Senior Chaplain is a sensible man, which is a
remarkable Providence.... If you ever see Mr. Whitfield, the House
Apothecary of St. Thomas', will you tell him that the nurse he sent
me, Mrs. Roberts, is worth her weight in gold.... Mrs. Drake is a
Treasure. The four others are not fit to take care of themselves,
but they may do better by and bye if I can convince them of the
absolute necessity of discipline. We hear there was another
engagement on the 8th and more wounded, who are coming down to us.
This is only the beginning of things.
The Senior Chaplain had the sense, among other things, to appreciate
Miss Nightingale. "The Chaplain says," wrote Mr. Nightingale to a
friend (Dec. 12), "'Miss Nightingale is an admirable person; none of us
can sufficiently admire her. A perfect lady, she wins and rules every
one, the most rugged official melts before her gentle voice, and all
seem glad to do her bidding.'"
Florence Nightingale had that "excellent thing in woman": Lady Lovelace,
in the poem already quoted, spoke of her friend's "soft, silvery voice";
but it could command, as well as charm, unless indeed it were the charm
that commanded. "She scolds sergeants and orderlies all day long," wrote
Mr. Bracebridge to her parents (Nov. 20); "you would be astonished to
see how fierce she is grown." That was written, of course, in fun; but
there was always a note of calm authority in her voice. A Crimean
veteran recalled her passing his bed with some doctors, who were saying,
"It can't be done," and her replying quietly, "It _must_ be done." "I
seem to hear her saying it," writes one who knew her well; "there seemed
to be no appeal from her quiet conclusive manner."
With regard to the nurses, Miss Nightingale, as may be gathered from the
letter to Dr. Bowman, found them rather a difficult team to drive, and
this fact should be remembered in considering an episode presently to be
related (II.). She had to send one nurse back to England at once,
filling the vacancy by a German Sister from the Kaiserswerth colony at
Constantinople. Of the six nurses supplied by St. John's House, "four,
alas! returned shortly from Scutari, not being prepared to accept the
discipline and privations of the life out there."[99] We need not be too
impatient with Mrs. Lawfield (who turned out an excellent nurse) for her
objection to the cap. The uniform, devised on the spur of the moment,
seems to have been very much less becoming than that of the "Staff
Nurse, New Style," with her "gown of silver gray, bright steel chain,
and chignon's elegant array."[100] The Nightingale nurses in the East
wore "grey tweed wrappers, worsted jackets, with caps and short woollen
cloaks, and a frightful scarf of brown holland, embroidered in red with
the words, 'Scutari Hospital.'"[101] Such is the description of the
costume worn by the seculars which is given by one of the Roman Catholic
Sisters, not without some pity as she thought of her own religious
habit. But the short cloak should not be so contemptuously dismissed.
"The red uniform cape worn by the ladies of the Queen Alexandra's
Imperial Military Nursing Service is modelled on that originally
introduced by Florence Nightingale for the nurses whom she took with her
to Scutari. This cape may therefore be regarded as a memorial to the
great founder of military nursing."[102] As for the "frightful scarf"
some such distinctive badge was a very necessary precaution amid the
rough-and-tumble of a military depot and its camp-followers. A raw
new-comer was seen to approach one of the nurses in the street. "You
leave her alone," said his mate, "don't you see she's one of Miss
Nightingale's women?" Their cloth was respected throughout the camps;
but Miss Nightingale had to dismiss two or three for levity of conduct.
On arriving at Scutari, she had placed ten in the General Hospital and
twenty-eight in the Barrack Hospital, and in neither did she find it
easy to maintain discipline. From time to time she transferred nurses,
sending the best to other hospitals, keeping the less trustworthy under
her own eye; and sending some home, who were unwilling to stay or found
incompetent, as other recruits arrived. Of the thirty-eight in the first
party, she considered that not more than sixteen were really efficient,
whilst five or six were in a class of excellence by themselves.
[99] _St. John's House: a Record_, p. 8.
[100] W. E. Henley, _In Hospital_.
[101] _Memories of the Crimea_, by Sister Mary Aloysius, p. 17. The
"frightful scarf" was a plain band worn, I suppose, over one arm
and under the other.
[102] _Journal of the Royal Army Medical Corps_ (Bibliography B, No.
52), p. 393.
The difficulties--including the great Dress Question--which Miss
Nightingale had with her staff, appear clearly enough in the "Rules and
Regulations for the Nurses attached to the Military Hospitals in the
East," which Miss Nightingale presently sent home to Mr. Herbert, who
had them printed, and handed to every candidate for appointment as
nurse. "As it has been stated," says the preamble, "that the nurses who
have gone to the hospitals in the East, have in some instances
complained of being subject to hardships and to rules for which they
were not previously prepared, and of having to do work differing from
what they expected, it has been thought desirable to state distinctly
the regulations relative to the outfit, clothing, duties, and position
of nurses in military hospitals." The nurses, it is then set forth, "are
required to appear at all times in the regulation dress with the badge,
and never to wear flowers in their bonnet-caps, or ribbons, other than
such as are provided for them, or are sanctioned by the superintendent."
Another rule defines the precise quantities of spirituous liquor which a
nurse will be allowed; a third states that "no nurse will be allowed to
walk out except with the housekeeper, or with a party of at least three
nurses together, and never without leave previously obtained." The whole
code shows the necessity which Miss Nightingale had found for enforcing
strict discipline.[103] And even with these new regulations to back her,
she still found discipline hard to enforce. Her official letters to the
War Office complain of unsuitable recruits being sent out to her, and of
the greater number of them as being "wholly undisciplined."
[103] The manuscript of this document is preserved among the archives of
the War Office. The text of these, "the earliest rules defining the
position and duties of a female nurse in any military hospital,"
has been printed elsewhere (Bibliography B, No. 52).
II
In December 1854 Miss Nightingale was astonished to receive an
announcement that a party of forty-seven more nurses, under the care of
her friend, Miss Mary Stanley, were on their way to join her. She
remonstrated, and threatened to resign:--
"You have sacrificed the cause so near my heart," she wrote to Mr.
Sidney Herbert (Dec. 15); "you have sacrificed me, a matter of
small importance now; you have sacrificed your own written word to
a popular cry. You must feel that I ought to resign, where
conditions are imposed upon me which render the object for which I
am employed unattainable, and I only remain at my post till I have
provided in some measure for these poor wanderers."
Mr. Herbert replied, as his biographer states, in terms of courtesy and
kindliness, and without any trace of the bitterness which Miss
Nightingale's vehemence might have evoked in a smaller-minded man. There
is a letter to Mrs. Bracebridge (Dec. 27) in which Mrs. Herbert says: "I
am heart-broken about the nurses, but I do assure you, if you send them
all home without a trial, you will lose some really valuable women." The
Minister had authorized Miss Nightingale, if on full consideration she
thought fit, to return Miss Stanley's party to England at his own
private expense. Her good sense soon showed her that such a course would
be, as she wrote, "a moral impossibility"; and in the end she made the
best she could of what she considered a bad job--to the great advantage,
as it was to turn out, of the wounded soldiers, though at a great
increase to her own responsibilities and difficulties.
Much has been made in some quarters[104] of this episode, and it may be
well here to explain Miss Nightingale's position clearly; for the affair
throws strong light upon the difficulties of her task. It is essential
to know, in the first place, that Mr. Herbert had distinctly stated that
the selection of nurses was to be exclusively in Miss Nightingale's
hands. This is implied in his official instructions (p. 156), and was
stated with the utmost emphasis in a letter "to a correspondent," which
he had caused to be inserted in the newspapers of October 24. Already
the cry had been raised that more nurses should be sent, and volunteers
were clamouring for enlistment. Mr. Herbert thereupon wrote:--
WAR OFFICE, _October_ 21 [1854].... The duties of a hospital nurse,
if they are properly performed, require great skill as well as
strength and courage, especially where the cases are surgical cases
and the majority of them are from gunshot wounds. Persons who have
no experience or skill in such matters would be of no use whatever;
and in moments of great pressure, such as must of necessity at
intervals occur in a military hospital, any person who is not of
use is an impediment. Many ladies, whose generous enthusiasm
prompts them to offer their services as nurses, are little aware of
the hardships they would have to encounter, and the horrors they
would have to witness, which would try the firmest nerves. Were all
accepted who offer, I fear we should have not only many inefficient
nurses, but many hysterical patients themselves requiring treatment
instead of assisting others....
No additional nurses will be sent out to Miss Nightingale until she
shall have written home from Scutari and reported how far her
labours have been successful, and what number and description of
persons, if any, she requires in addition.... No one can be sent
out until we hear from Miss Nightingale that they are required.
[104] Especially by Lord Stanmore in his _Memoir of Sidney Herbert_. He
handles it, I think, with some needless asperity, and he might have
mentioned Mr. Herbert's letter which is here quoted.
Miss Nightingale had not written home in that sense at all, but Mr.
Herbert had sent the nurses. That was what she meant when she said that
he had "sacrificed his own written word." "Had I had the enormous
folly," she wrote to Mr. Herbert (Dec. 15), "at the end of eleven days'
experience, to require more women, would it not seem that you, as a
statesman, should have said, 'Wait till you can see your way better.'
But I made no such request." She was an expert, and did not wish to be
inundated with amateurs. Moreover, everybody at Scutari knew, as she
wrote, the terms of Mr. Herbert's letter to the newspapers, and the
medical men knew that she had not asked for any more nurses. Yet here
was a new party sent out; and, to make the encroachment on her domain
the more marked, Miss Stanley had received instructions to, and reported
herself to, not the Superintendent of the Nurses, but other officials.
Miss Nightingale felt that her authority had been flouted, her position
undermined. But personal considerations were not the cause of her
vexation. It was not a case of "pique," as some people in England
imagined. Mr. Herbert and she were engaged in making a new experiment.
It was full of difficulties, and the only chance of success lay in the
maintenance of undivided responsibility and clearly established
authority. Miss Nightingale could not quietly have accepted the new
situation without sacrificing the key of the position. Had she
acquiesced, she would have admitted that Mr. Herbert might henceforth
send out nurses without consulting her, and without placing them
expressly under her orders. She would have left herself at the mercy of
any well-meaning person in England who thought that this or that might
be helpful to her. Her judgment would no longer have been the governing
factor; while yet for any confusion or failure that might follow, she
would be held responsible. Mr. Herbert thought, no doubt, that already
the experiment had been a great success, as indeed it was, and he was
eager to increase the scale of it. He might not unreasonably think that,
as the number of the wounded increased, so should the number of female
nurses be increased also. Mr. Osborne's remark, cited above (p. 183),
must have confirmed him in such an opinion. But to Miss Nightingale on
the spot the case wore a very different aspect. We must remember the
severe mental strain of her position; the high pressure of work and
emotion at which she was living, all the higher to one of her intensely
sensitive conscientiousness; the continual failure (to her critical
mind) of attempts to reform cruel abuses; the danger of real,
acknowledged failure always present. In such a position, the arrival of
a fresh batch of nurses, unexpected and unsolicited, must have seemed to
her the break-up of all her plans, the destruction of the standard of
nursing which she was painfully creating, the gravest peril to an
experiment, still on its trial, and ever subject to hostile criticism.
Immediate and practical difficulties were also great. There was no
accommodation in the hospitals at Scutari available for additional
female nurses. "The 46," wrote Mr. Bracebridge to Mr. Smith (Dec. 18),
"have fallen on us like a cloud of locusts. Where to house them, feed
them, place them, is difficult; how to care for them, not to be
imagined." The Principal Medical Officer flatly refused to have any
more, and Miss Nightingale herself felt that she could not manage any
more:--
"I have toiled my way," she wrote (Dec. 15), "into the confidence
of the Medical Men. I have, by incessant vigilance, day and night,
introduced something like system into the disorderly operations of
these women. And the plan may be said to have succeeded in some
measure, _as it stands_.... But to have women scampering about the
wards of a Military Hospital all day long, which they would do, did
an increased number relax the discipline and increase their
leisure, would be as improper as absurd."
And there was a further objection. A considerable number of the second
party were Roman Catholics, and Miss Stanley herself (as Miss
Nightingale well knew) was on the verge of joining the Roman Communion.
How much this factor in the case added to the force of Miss
Nightingale's objections, we shall learn in a later chapter. Mr. Herbert
thought, I suppose, that the additional nurses would be welcome to her
because they came under the escort of a friend. But so strongly did Miss
Nightingale feel on the subject, that Miss Stanley's part in the affair
rankled the more. It was in the house of her friends, she felt, that she
had been wounded. Their personal relations were further embittered by
the case of a nurse whom Miss Nightingale (with the concurrence of the
other authorities) felt obliged to dismiss, but whom Miss Stanley
believed to be ill-used. Miss Nightingale's friendship with Mr. and Mrs.
Herbert was in no way impaired. They had confessed themselves in the
wrong; and so she was deeply touched, as she wrote, by their kindness
and generosity. But between her and Miss Stanley the breach was never
healed. Their later lives took different directions, and they did not
meet again.
Miss Nightingale's resentment was perfectly justified. Her remonstrances
to Mr. Herbert were necessary. His well-intentioned action was
calculated to undermine her authority, and to aggravate her
difficulties; and, in both of these ways, to imperil the success of
their joint experiment. Her handling of the crisis which had burst upon
her was, perhaps, in relation to the subordinates unfortunate. Miss
Stanley was accompanied by Dr. Meyer, a medical man, and Mr. Jocelyne
Percy, who had gone out (as Mrs. Herbert wrote to Mrs. Bracebridge)
devoted to Miss Nightingale, "saying he would be her footman, etc."[105]
"We picked out," added Mrs. Herbert plaintively, "the two men in England
who, we thought, would help Flo most," and they returned sad and sore at
their cold reception. Miss Nightingale, acting on advice she received on
the spot, asked them to sign notes of their conversation with her;[106]
this rankled with them, and Mr. Percy made a grievance of it in
England. Mrs. Herbert, in reporting all this to Mrs. Bracebridge (Jan.
7, 1855), made the final reflection: "Perhaps it is wholesome for us to
be reminded that Flo is _still a mortal_, which we were beginning to
doubt." Mortals have to deal with entanglements as best they may on the
spur of the moment; and those at a distance hardly made enough allowance
for the difficulties with which Miss Nightingale was suddenly
confronted, for the danger which Mr. Herbert's dispatch of unsolicited
reinforcements involved, and, therefore, for the importance which she
attached to having all the conditions defined in black and white.
[105] See below, p. 241.
[106] It was Mr. Bracebridge who took the notes of the interview.
Her practical genius and good sense speedily triumphed, however, over
the difficulties of the case. In agreement with the medical authorities,
the number of female nurses at Scutari was raised to 50, and Miss
Nightingale weeded out some of her original staff in favour of
new-comers. Others of them were sent to the hospitals at Balaclava (p.
254); and others to those at Koulali (p. 174). Miss Stanley, whose
intention it had been to return to England as soon as she had deposited
her party, remained for several months in charge at the latter place,
not administering the nursing service altogether according to Miss
Nightingale's ideas,[107] but rendering aid to the afflicted of which
her brother, the Dean, has left us so charming and sympathetic a
memorial.[108]
[107] Miss Nightingale made some criticisms in an official letter to the
War Office, May 1, 1855; printed at pp. 389, 390 of the pamphlet
No. 52 in Bibliography B. And in another letter (March 5) she
begged Lord Panmure to relieve her of responsibility for the
hospitals at Koulali.
[108] In an appendix to the _second_ edition (1880) of his _Memorials of
Edward and Catherine Stanley_.
In the end, then, the scope of Miss Nightingale's experiment was
considerably enlarged; and the deeper significance of the episode is to
be found in the emphasis which it throws upon the novelty and
difficulties of Miss Nightingale's enterprise. In these days, nurses,
trained and distinctively attired, are so much part of everyday life,
women-nurses serving under the Red Cross are so normal a feature of war,
and Territorial nurses, smartly uniformed, are so familiar a unit of
auxiliary forces, that some effort of imagination is required to realize
the conditions which existed sixty years ago. We remember that a staff
of nearly 800 female nurses was maintained for service in the South
African War, and may be tempted to smile at the question between 20 and
40, or 40 and 90 for the Crimea. But it was Miss Nightingale who showed
the way, and the way of the pioneer is rough. No one who reads this
volume will suspect her of timidity, or think her wanting in
self-confidence; yet so conscious was she of the difficulties that in
this instance she under-rated her power, and was anxious to keep the
experiment within much narrower limits than it assumed. Her original
idea had been to limit the number of female nurses to 20, but at various
dates after Miss Stanley's arrival she sent home for more nurses, and,
before the war was over, she had had control of 125.
III
Miss Nightingale's reluctance to assume the superintendence of
additional nurses will be the more readily understood when we pass to
the multifarious duties which circumstances led her to discharge.
"Having understood," she wrote to Lord Stratford de Redcliffe (Nov.
7), "that Your Excellency has the power of drawing upon Government
for the uses of the sick and wounded, I beg to state that there is
at present a great deficiency of linen among the men in the
Hospitals until the Government Stores can arrive and be
appropriated to them. A hundred pairs of sheets and 200 shirts
might be applied to such a temporary purpose, and would never be
_de trop_. Also a few American stoves, upon which we might prepare
delicate food for the worst cases, who require to be fed every two
or three hours, which is of course impossible for the Medical
Officers and Orderlies to attend to; many deaths are necessarily
the consequence."
This suggestion to the Ambassador, made on the third day after Miss
Nightingale's arrival, serves to introduce two main directions in which
she applied a woman's insight to the condition of things at Scutari.
Efficient nursing requires, she well knew, cleanliness and delicately
cooked food. She set herself with characteristic energy to supply these
necessities. She found "not a basin, nor a towel, nor a bit of soap, nor
a broom," and instantly requisitioned 300 scrubbing brushes. "The first
improvements took place," said Mr. Macdonald, "after Miss Nightingale's
arrival--greater cleanliness and greater order. I recollect one of the
first things she asked me to supply was 200 hard scrubbers and sacking
for washing the floors, for which no means existed at that time."[109]
Miss Nightingale had foreseen that washing would be one of the first
things necessary. During the voyage out, as the ship was approaching
Constantinople, one of the party went up to her and said earnestly, "Oh,
Miss Nightingale, when we land, don't let there be any red-tape delays,
let us get straight to nursing the poor fellows!" "The strongest will be
wanted at the wash-tub," was the reply. Until Miss Nightingale arrived,
the number of shirts washed during a month was six.[110] Up to the date
of her arrival, the Purveyor-General had contracted for the washing of
the hospital bedding, and of the linen of the patients. Simultaneously,
however, with the arrival of the wounded from Inkerman, it was found
that the contractor had broken down in the latter part of his contract.
And even with regard to the former part, the bedding was washed, Miss
Nightingale discovered, in cold water. She insisted upon hot; the more
since it was found, as the Duke of Newcastle's commissioners reported,
that many of the articles sent back from the wash as clean, had to be
destroyed as being in fact verminous. Miss Nightingale accordingly took
a Turkish house, had boilers supplied in it by the Engineer's Office,
employed soldiers' wives to do the washing, and thus gave the sick and
wounded the comfort of clean linen. All this was paid for partly out of
her private funds and partly by the _Times_ fund.
[109] _Roebuck Committee, Q_. 6140.
[110] This fact, reported by the Roebuck Committee, barbed one of
Mr. Kinglake's sarcasms against the males (vi. 427 _n._). It also
greatly impressed John Bright. See Mr. G. M. Trevelyan's _Life_ of
him, 1913, p. 242.
Yet more important, perhaps, to the comfort and recovery of the sick,
were Miss Nightingale's "Extra Diet Kitchens." When she came to the
Barrack Hospital she found that all the cooking was done in thirteen
large coppers, situated at one end of the vast building. The patients'
beds extended over a space of from three to four miles (including, of
course, both wards and corridors); it took three or four hours to serve
the ordinary dinners, and there were no facilities whatever for
preparing delicacies between times. Within ten days of her arrival, Miss
Nightingale had remedied this defect. She opened two "extra diet
kitchens" in different parts of the building, and had three
supplementary boilers fixed on one of the staircases for the preparation
of arrowroot and the like. As explained more fully below (p. 201),
nothing was supplied except in accordance with medical directions; and
she met the doctors' requisitions out of her private stores only when
the government stores failed. "It is obvious," she explained, "that Miss
Nightingale would have shielded herself from heavy responsibility by
adhering, and by obtaining the adherence of the medical officers, to the
strict precedents of Military Hospital Regulations, according to which
the materials for the Extra Diets would have been sent in to her by the
purveyor without requisition, in the same manner as is practised in the
case of the ordinary diets; but she felt that in doing so she would most
frequently be defeating the object she was sent to carry out, for in the
majority of cases the purveyor had either no supply, or a supply of a
very indifferent quality of the articles required."[111] It is safe to
say that many lives were saved by the application by Miss Nightingale of
the good housewife's care to the kitchen of the hospitals. The woman's
eye was not above distinguishing between bone and gristle and meat in
the men's dinner, and she wanted to have the meat issued from the stores
boned, so that one patient should not get all bone, another all gristle,
and another all meat. But on this point she was beaten. The
Inspector-General informed her that it would require a new "Regulation
of the Service" to "bone the meat"!! The notes of exclamation are
hers.[112] In the culinary department an invaluable volunteer arrived in
1855 in the person of Alexis Soyer, once famous as the _chef_ of the
Reform Club, and still alive as M. Mirobolant in Thackeray's
_Pendennis_. M. Soyer rearranged and partly superseded Miss
Nightingale's kitchens at Scutari. We shall meet with him and his good
work again when we accompany her to the Crimea.
[111] _Statement_, p. 26 _n._
[112] Letter to Mr. Herbert, Feb. 5, 1855.
Miss Nightingale was not long at Scutari without being touched by the
pitiable condition of the women camp-followers, separated often from
their regiments, and in a very forlorn state. Miss Nightingale deputed
the care of them in large measure to Mrs. Bracebridge, who, with her
husband, collected and administered a separate fund for giving
assistance to the wives, women, and children of soldiers at Scutari. A
Lying-in Hospital was organized; and Miss Nightingale found employment
for many of the women, both in washing as aforesaid, and in making up
old linen into various hospital requisites. Here, too, helpful
volunteers presently arrived. The Rev. Dr. and Lady Alicia Blackwood
were moved after the Battle of Inkerman to go out to Scutari and see if
they could be of use. Dr. Blackwood asked and obtained an appointment as
a military chaplain; and, on their arrival, Lady Alicia went straight to
Miss Nightingale and asked what she could do to help:--
"The reply she gave me," wrote Lady Alicia, "or rather the question
she put me in reply, after a few seconds of silence, with a
peculiar expression of countenance, made an indelible impression.
'Do you mean what you say?' 'Yes, certainly; why do you ask me?'
'Because I have had several such applications before, and when I
have suggested work, I found it could not be done, or some excuse
was made; it was not exactly the sort of thing intended, it
required special suitability, &c.' 'Well,' I replied, 'I am in
earnest; we came out here with no other wish than to help where we
could.' 'Very well, then, you really can help me if you will. In
this Barrack are now located some two hundred poor women in the
most abject misery. A great number have been sent down from Varna;
they are in rags, and covered with vermin. My heart bleeds for
them; but my work is with the soldiers, not with their wives. Now,
will you undertake to look after them? If you will take them as
your charge, I will send an orderly who will show you their
haunts.'"[113]
[113] _Narrative of a Residence on the Bosphorus_, p. 49. Any reader who
wishes to be harrowed should read the following pages in Lady
Alicia's Journal. She died in July 1913 in her 95th year.
Lady Alicia went, and with her husband was of great assistance. Miss
Nightingale was mindful also of the families of her nurses. Some of them
were wives and widows who had left children at home. "Many things turn
up," wrote Lady Verney to a friend, "for us to do for Florence; as in
looking after the children of her nurses." And Mrs. Nightingale wrote
similarly (April 1855):--
Flo has been writing incessantly lately about her nurses' families,
for whom the best seem getting very anxious, and she scarcely
mentions anything else. We have seen and heard much in visiting
them which is a great pleasure to us.
Before the Roebuck Committee, Dr. Andrew Smith, the head of the Army
Medical Department in London, was asked, "What do you think was the
result of Miss Nightingale's mission?" "I daresay," he answered,
apparently with some reluctance, "it was very advantageous"; and then,
pulling himself together like a man and seeking to be just, he added:
"There is no doubt about it; because females are able to discover many
deficiencies that a man would not think of, and they will look at things
that a man will have no idea of looking to." A very true statement; and
perhaps as much as could reasonably be expected from an official on the
defensive. But I think we shall find in the next chapter that some of
the things which Miss Nightingale saw and did were not unworthy of the
more comprehensive sweep claimed by Dr. Smith for the male faculty of
vision.