THE SOLDIER’S FRIEND AT HOME
Ill Health--Unremitting Toil--Founds Nightingale Training School
at St. Thomas’s Hospital--Army Reform--Death of Lord Herbert
of Lea--Palmerston and Gladstone pay Tributes to Miss
Nightingale--Interesting Letters--Advises in American War and
Franco-German War.
Her heart it means good--for no bounty she’ll take,
She’d lay down her life for the poor soldier’s sake,
She prays for the dying, she gives peace to the brave,
She feels that a soldier has a soul to be saved.
The wounded they love her, as it has been seen,
She’s the soldiers’ preserver, they call her their queen.
May God give her strength and her heart never fail!
One of Heaven’s best gifts is Miss Nightingale.
_Ballad of the Time._
After Miss Nightingale’s return from the Crimea it was expected that
she would become the active leader of the nursing movement which her
brilliant example had initiated. “We intend to be merciless to Miss
Nightingale in the future,” said Mr. Sidney Herbert, “and see that her
abilities are not allowed to slumber. The diamond has shown itself and
must not be allowed to return to the mine. Miss Nightingale must be
chained to the oar for the rest of her life. It is hers to raise the
system of nursing to a pitch of efficiency never before known.”
Gladly indeed would Miss Nightingale have started on the great work
of nursing reform had her health permitted. The spirit was more than
willing, it was eager to start, but the flesh was weak. It was hoped
that a few months’ rest would restore her health, and that she would
herself be able to organise an institute for the training of hospital
nurses, to which purpose she proposed to devote the Nightingale Fund.
Unfortunately, as time passed it became apparent that the malady from
which she suffered was increasing, and that she would never again be
able to lead her old active life.
It was indeed a hard cross to bear for a woman comparatively young and
with a mind full of humanitarian projects, and as the first years of
waiting passed Florence Nightingale drank deep of the cup of life’s
disappointments. But she faced the situation with noble resignation.
All through the land were brave fellows who had returned from the war
maimed or shattered in health, and the soldier’s nurse showed the
soldier’s heroism in the service of her country.
But though compelled to be a recluse, not a day of Miss Nightingale’s
time was passed unoccupied. Work, work, ever work, was her great
panacea. She spent a good deal of her time in London, for she liked
to be in the “hum” of things and within easy communication of kindred
spirits in the great city.
Her sick-room might have passed for an adjunct of the War Office, so
filled was it with schemes for army hospital reform and communications
from all sorts and conditions of soldiers. Whenever “Tommy” had
a grievance, he wrote to Miss Nightingale. She was still his
Lady-in-Chief, and invested in his mind with unlimited power and
influence, and to some extent he was not mistaken. The War Office
authorities had such a profound belief in Miss Nightingale’s judgment
and discrimination that any recommendation made by her received
attention. She was able to render help to deserving men with regard
to their pensions, and in procuring civil occupation for the maimed
and disabled, while she was an ever-helpful friend to the widows and
orphans, and by her influence obtained grants from the Patriotic Fund
for many destitute soldiers’ families. The amount of work of this
kind which Miss Nightingale did in the year succeeding the war is
incalculable.
When in 1854 her name had first come before the public, nothing was
known of Miss Nightingale, but now that it was understood that she was
the daughter of a rich and influential gentleman, she was overwhelmed
with begging letters. These increased to such an extent that she was
forced to make a public protest in _The Times_ and state her inability
to reply to the letters which poured in upon her. However, let it be
stated to the honour of the army that not a single begging letter for
money was ever sent to Miss Nightingale by a British soldier.
During the first years of her illness Miss Nightingale still hoped
against hope that she might be sufficiently restored to health as to be
able to take active steps for the formation of an institute for nurses,
and in 1859 it was still thought by the Committee that she would
eventually be able to administer the Nightingale Fund, and it agreed
to hold the scheme in abeyance. At this time the sum subscribed and
the accumulated interest amounted to £48,000. After another year had
passed and her health showed no signs of improvement, Miss Nightingale
entered into an arrangement by which she placed the money in the hands
of trustees for the training of hospital nurses. The net income of the
fund amounted to £1,426 and a Council was named to administer it. Miss
Nightingale, to whom the fund had been a personal gift from the nation,
only reserved to herself the power to give advice. The Hon. Sidney
Herbert, shortly to become Lord Herbert of Lea, was the guiding spirit
of the Council.
It was arranged with Miss Nightingale’s approval to devote two-thirds
of the income to the maintenance and instruction of nurses at St.
Thomas’s Hospital, the probationers engaging to take service in
public hospitals and infirmaries. The remaining third was to be spent
at King’s College Hospital for the maintenance and instruction of
midwifery nurses, the want of whom was at that time much felt in the
villages of England.
The movement thus begun by Florence Nightingale for the systematic
training of lay hospital nurses was first established at old St.
Thomas’s Hospital, near London Bridge, in 1860. This hospital was
one of the oldest foundations in the country, having been first
established in 1213 as an “almery” or hospital in connection with the
Priory of Bermondsey. It was later assigned for the use of the poor.
At the dissolution of the monasteries St. Thomas’s was surrendered
to Henry VIII. It had then forty beds for poor people, a master, six
brethren, and three lay sisters. Later it was enlarged and opened as a
hospital for the sick poor under the patronage of the young King Edward
VI. During the period of the Restoration it was used as a military
hospital, and is mentioned in this connection by Pepys in his Diary.
In 1732 it was rebuilt and the grand entrance made from Wellington
Street, Southwark. It is interesting to find that at this period each
ward of the hospital was under the care of a sister and two or three
nurses.
In selecting St. Thomas’s for the home and training school of her
pioneer nurses, Miss Nightingale was carrying on the traditions of the
hospital, as nursing sisters had been associated with it from early
times. It also specially commended itself to her sympathies as being
one of the oldest institutions in the kingdom where the sick poor could
be relieved. Later, the hospital was rebuilt in palatial style on its
present site on the Thames Embankment, and the Nightingale Training
Home became a part of the new hospital.
Meantime, an upper floor in a new wing of old St. Thomas’s was arranged
as the quarters for the Nightingale nurses. There was a separate
bedroom for each probationer, a common sitting-room, and two rooms for
the sister-in-charge.
In May, 1860, candidates were advertised for, and on June 15th the
first fifteen probationers were admitted. They were under the authority
of the matron and subject to the rules of the hospital. They were
provided with board and lodging, received a salary of £10 during
the first year of their probation, and were to serve as assistant
nurses in the wards and receive instruction from the sisters and
medical officers. At the end of a year those who passed examination
were certified as nurses and entered into hospital work. The first
superintendent of the Nightingale Training School was Mrs. Wardroper.
During the first year of the experiment four probationers were
dismissed and others received in their places. Out of those who were
placed on the register as certified nurses, six received appointments
in St. Thomas’s, and two entered workhouse infirmaries.
It was an anxious year for Miss Nightingale, and many heart-felt
prayers went up from her sick-room that the work might be successful,
while she encouraged the young probationers by friendly chats
and advice. The Council considered the result of the first year
satisfactory, and the scheme continued to steadily work.
It is clear, however, that the girls of England were not then all
“mad to be nurses.” The profession had not become fashionable. Mrs.
Grundy still shook her head over “young females” nursing in hospitals
and feared wholesale elopements with medical students. Parents were
afraid of infection; the fastidious thought attendance upon the
sick poor incompatible with the feelings of a lady, and there was
the conventional idea that it was derogatory to the position of a
gentlewoman to enter a wage-earning profession.
Miss Nightingale fought steadily and patiently against criticism and
prejudice, and now and again from her sick-room came stirring appeals
to the young womanhood of England that they would regard the nursing
of the sick as the noblest work to which they could devote themselves.
“We hear so much of idle hands and unsatisfied hearts,” she wrote, “and
nowhere more than in England. All England is ringing with the cry for
‘Woman’s Work’ and ‘Woman’s Mission.’ Why are there so few to do the
work?... The remunerative employment is there, and in plenty. The want
is the women fit to take it.”
Miss Nightingale then goes on to explain the kind of training given
to her nurses at St. Thomas’s, and although this was written in the
first stage of the work, when she was asking for recruits, it remains
the basis upon which the Nightingale Training School in the present
palatial St. Thomas’s Hospital is conducted.
“We require,” she writes, “that a woman be sober, honest, truthful,
without which there is no foundation on which to build.
“We train her in habits of punctuality, quietness, trustworthiness,
personal neatness. We teach her how to manage the concerns of a large
ward or establishment. We train her in dressing wounds and other
injuries, and in performing all those minor operations which nurses are
called upon day and night to undertake.
“We teach her how to manage helpless patients in regard to moving,
changing, feeding, temperature, and the prevention of bed sores.
“She has to make and apply bandages, line splints and the like. She
must know how to make beds with as little disturbance as possible to
their inmates. She is instructed how to wait at operations, and as
to the kind of aid the surgeon requires at her hands. She is taught
cooking for the sick; the principle on which sick wards ought to be
cleansed, aired, and warmed; the management of convalescents, and how
to observe sick and maimed patients, so as to give an intelligent and
truthful account to the physician or surgeon in regard to the progress
of cases in the intervals between visits--a much more difficult thing
than is generally supposed.
“We do not seek to make ‘medical women,’ but simply nurses acquainted
with the _principle_ which they are required constantly to apply at the
bedside.
“For the future superintendent is added a course of instruction in
the administration of a hospital, including, of course, the linen
arrangements and what else is necessary for a matron to be conversant
with.
“There are those who think that all this is intuitive in women, that
they are born so, or, at least, that it comes to them without training.
To such we say, by all means send us as many such geniuses as you can,
for we are sorely in want of them.”
While Miss Nightingale was thus piloting nursing reform in the country
and endeavouring to enlist recruits, she was also actively engaged in
assisting the Hon. Sidney Herbert in carrying out his important schemes
for the improvement of the condition of the soldier, a work to which
Mr. Herbert devoted himself most strenuously in the last years of his
life.
Up to the period of the Crimean War the sanitary condition of the
soldier was utterly neglected. He was as a general rule left to his
chance. At home in barracks he was ill-lodged and ill-fed, and during
active service was practically uncared for. He was a constant victim to
preventable disease by reason of unhealthy camps and ill-managed and
defective hospitals. Fever and dysentery slew their tens of thousands.
The mortality returns showed a deplorable death rate. Seventeen out of
every thousand soldiers died annually at home as against eight in every
thousand of civilians. It was calculated at this period that of every
two soldiers who died, one died from causes which a proper attention to
his surroundings would have removed.
Miss Nightingale had probably the best first-hand knowledge of any
person in the country of the ills to which the soldiers in camp and
hospital were subjected during active warfare, and the wealth of her
experience and knowledge were given to Mr. Sidney Herbert when he
started on his campaign of reform.
We have already seen the marvellous change which Miss Nightingale had
been instrumental in bringing about in the military hospitals in the
East, and the useful work she had accomplished during the last months
in the Crimea by providing useful occupation and recreation for the
convalescent soldiers and the men in camp, and by furthering reforms in
the cooking and diet of the soldiers. The war was ended, the army was
home again, and it now remained to see that the men who took up arms
for their country should have their lives protected by the ordinary
rules of health and sanitation, and that they should be educated,
encouraged to live like self-respecting citizens of the Empire for
which they fought, and that their wives and children should be cared
for. Our heroine was not actuated by mere passing emotions easily
roused and as readily quieted. Florence Nightingale had sacrificed
her own health to cure the ills arising from the soldiers’ neglected
condition and now turned her attention to prevention.
The horrors of the Crimean War impelled Sidney Herbert to concentrate
his attention on army reform, a matter upon which he had been engaged
before the outbreak of hostilities. Now he returned to it with
redoubled vigour. Barracks as well as hospitals must be reorganised,
the soldier preserved in health as well as tended in sickness. There
must be good sanitary regulations, improved military cookery, and the
soldier must have some enjoyment in life.
Mr. Sydney Herbert had to endure his share of blame with the other
members of Lord Aberdeen’s Government for the terrible sufferings
of the troops during the Crimean War, but for which in the light of
history no one seemed less to blame than he, if blame there was, and
he atoned for it now by a long penance of work for the good of the
soldier. For every man who had perished in those bitter trenches before
Sebastopol, died in the ill-fed camps of hunger or disease, or groaned
his life away in the crowded and pestilential hospitals, Sidney Herbert
saved at least the life of one British soldier by his labours.
He was the mainspring of the Royal Commission which, after the return
of the troops from the Crimea, was appointed to inquire into the
sanitary condition of the army, and on his suggestion and with his
assistance four supplementary Commissions were issued on the subjects
of Hospitals and Barracks, Army Medical Department, Army Medical
Statistics, and on a Medical School at Chatham, and he drafted the
code of regulations for the Army Medical Department which appeared in
October, 1859.
With the return of Lord Palmerston to power in the summer of that year,
Sidney Herbert again took office as Secretary for War. He now laboured
more assiduously than ever in army reform, and in the furthering of
those schemes which he had been compelled to abandon on the outbreak of
hostilities. To his efforts were due the constitution of the militia,
the reconstruction of the artillery system, the amalgamation of the
Indian and the general forces, and the consolidation of what were
then the “new” volunteers. At Aldershot he established instruction in
barrack and hospital cookery, and in place of that peculiar method
which required that the soldier should fit his foot to the boot, had
the machinery of the boot-factory constructed to secure a variety
of sizes to suit different feet, thereby adding to the comfort and
marching power of the troops.
Sidney Herbert began the overwhelming task of reorganising the War
Office, but the strain of work unfortunately compelled him to retire
from active official position, and in 1859 he accepted a peerage and
entered the House of Lords as Baron Herbert of Lea.
Lord Herbert still continued his efforts on behalf of bettering the
condition of the soldier morally and physically, but his beneficent
career was soon to be cut short. To the deep regret of all classes in
the country Lord Herbert of Lea died on August 2nd, 1861, at Wilton
House, Salisbury. Just before his death he had reformed the Hospital
Corps, and the very day on which he died saw the opening of the General
Hospital at Woolwich, which had been planned under his auspices as
a model of what a military hospital should be. It was ultimately
transformed into the present magnificent building, on which Queen
Victoria fittingly bestowed the name of the Herbert Hospital.
Next to his devoted widow and children there was no one who felt more
keenly the loss of Lord Herbert of Lea than Florence Nightingale. To
his inspiration and support she owed in great measure the success of
her mission to the Eastern hospitals, and since her return she had
laboured with him to promote the betterment of the soldier’s condition.
How much the nation really owes to Miss Nightingale for her labours
in the sanitary and educational reform of the army during the years
1857–60 in which, though a prisoner in her sick-room, she toiled
with Lord Herbert, will not be known until the private records of
that period are published. At the request of the War Office she drew
up an exhaustive and confidential report on the working of the Army
Medical Department in the Crimea, which materially assisted in the
reorganisation of the medical branch of the service then taking place.
In writing on “The Sanitary Condition of the Army” in _The Westminster
Review_ for January, 1859, Lord Herbert frequently quotes the opinions
of Miss Nightingale, based on her experiences of the defects of the
military hospitals’ nursing system, and mentions her recommendations
for reform.
Her services and advice were not only highly valued by Lord Herbert,
but were acknowledged by the first statesmen of the day. In the
tributes paid to the memory of Lord Herbert at the time of his death,
the name of Florence Nightingale was coupled with his in the work of
army reform.
At a meeting held in Willis’s Rooms on November 28th, 1861, to
consider the erection of a memorial in London to Lord Herbert of Lea,
Lord Palmerston, then Prime Minister, speaking of the work in army
reform accomplished by Lord Herbert, with the assistance of the Duke
of Cambridge, Commander-in-Chief, said: “There were not only two;
there was a third engaged in these honourable exertions, and Miss
Nightingale, though a volunteer in the service, acted with all the zeal
of a volunteer and was greatly assistant.”
Mr. Gladstone, then Chancellor of the Exchequer, followed with
a similar appreciation. Referring to the above remarks of Lord
Palmerston, he said: “My noble friend who moved the first resolution
directed attention to one name in particular that ought never to be
mentioned with any elaborate attempt at eulogy; for the name of Miss
Nightingale by its own unaided power becomes a talisman to all her
fellow-countrymen.”
Mr. Gladstone then proceeded to summarise the work of Lord Herbert in
which our heroine had so signally helped. “To him we owe the Commission
for Inquiry into Barracks and Hospitals, to him we are indebted for the
reorganisation of the Medical Department of the Army. To him we owe the
Commission of Inquiry into and remodelling the medical education of the
army. And lastly we owe him the Commission for presenting to the public
the vital statistics of the army in such a form, from time to time,
that the great and living facts of the subjects are brought to view.”
Such was the perfect knight, the gallant gentleman, and the high-souled
reformer whose loss Florence Nightingale now deplored. From her
sick-room she followed with interest the schemes to honour his memory.
It was proposed to erect his statue outside the War Office in Pall
Mall, and to endow an exhibition of gold medals in connection with
the Army Medical School at Chatham, which had been founded under his
auspices. At Salisbury, the city where the names of Lord and Lady
Herbert were household words as benefactors to the sick and distressed,
a public meeting was held to promote a fund for erecting a bronze
statue to Lord Herbert and for the support of a Convalescent Hospital
at Charmouth as a branch of the Salisbury Hospital, to which he had
been such a liberal benefactor.
Miss Nightingale had also the satisfaction of knowing that the reforms
at which she had laboured with him were already bearing fruit. This was
being demonstrated in China at this time (1860–64) where General Gordon
was waging war against the Taiping Rebellion. While, during the first
seven months of the Crimean War, the mortality amongst the soldiers
had been at the alarming rate of sixty-one in every hundred per annum,
exclusive of those killed in action, in the Chinese campaign, when
the army had been sent half across the globe to an unhealthy country,
the death-rate, including the wounded, was little more than three men
in every hundred per annum, while the loss of those killed in action
amounted to less than six men in every hundred per annum.
But now her chief was gone, cut off in the prime of his manhood,
and at the pinnacle of public estimation and usefulness, and Miss
Nightingale’s usually hopeful spirit grew despondent. The following
letter, written fourteen months after Lord Herbert’s death, reveals how
sorely she was suffering in body and in spirit. She writes:--
“_October 22nd, 1861._
“DEAR SIR,--
“... In answer to your kind inquiry, I have passed the last four
years between four walls, only varied to other four walls once a
year; and I believe there is no prospect but of my health becoming
ever worse and worse till the hour of my release. But I have never
ceased, during one waking hour since my return to England five
years ago, labouring for the welfare of the army at home, as I did
abroad, and no hour have I given to friendship or amusement during
that time but all to work. To that work the death of my dear chief,
Sidney Herbert, has been a fatal blow. I assure you it is always a
support-giving strength to me to find a national sympathy with the
army and our efforts for it--such a sympathy as you express.
“Believe me, dear sir,
“Sincerely yours,
“FLORENCE NIGHTINGALE.”
Happily the succeeding years brought some improvement in health,
and the gloomy forebodings of this letter were not realised. After
her recovery from the shock occasioned by Lord Herbert’s death,
Miss Nightingale continued to give her experience and advice in
matters of army and hospital reform both at home and abroad. She had
correspondents in all parts of the globe, and the builders of hospitals
and pioneers in nursing and sanitary reforms all drew from the fount of
her practical knowledge.
She took a deep and sympathetic interest in the Italian War for
Liberty, for she had herself been born on Italian soil, and felt
something of the patriot’s spirit as she followed the progress of
the Italian arms both in the struggle for independence and in the
Austro-Prussian War of 1866.
In response to a request in 1866 from Cavaliere Sebastiano Fenzi, one
of the committee for organising a system of volunteer assistance to
the hospital department of the Italian army, that she would come to
Florence to give advice and personal superintendence, Miss Nightingale
replied giving a lengthy series of recommendations. We quote the
conclusion of the letter for its personal interest:--
“Thus far,” writes Miss Nightingale, “I have given dry advice as
drily as I could. But you must permit me to say that if there is
anything I could do for you at any time, and you would command
me, I should esteem it the greatest honour and pleasure. I am a
hopeless invalid, entirely a prisoner to my room, and overwhelmed
with business. Otherwise how gladly would I answer to your call and
come and do my little best for you in the dear city where I was
born. If the giving my miserable life could hasten your success but
by half an hour, how gladly would I give it. But you will not want
for success or for martyrs, or for volunteers or for soldiers.
“Our old General, Lord Clyde (he is dead now), was standing at the
port of Balaclava when, eleven years ago, the Italian Bersagliere
were landing; and he turned round and said to his companion (a man
high in office), ‘I wish to hide my face--I blush for ourselves
when I see the perfect way in which those glorious troops are
brought up to their work.’ And what have not the Italians done
since, in those eleven years?--the work of almost eleven centuries!
“I, too, remember the Italian (Sardinian) hospitals on the heights
of Balaclava, and their admirable government; and since then what
has not the progress been? I wish you God-speed with my whole
heart, and by that you will believe me, sir, your ever faithful
servant,
“FLORENCE NIGHTINGALE.”
“_Cavaliere Sebastiano Fenzi, Florence._”
Miss Nightingale would certainly have been cheered in her sick-room if
she could have seen the enthusiasm and emotion excited in her native
city when her letter was read to the people.
The United States, which has to-day such an efficient organisation
for the succour of the sick and wounded soldiers, owes the inception
of the movement to Florence Nightingale. When the American Civil War
broke out in 1860, her name had become a talisman not only to her
fellow-countrymen, but to English-speaking people all over the world,
and to her example the women of the United States looked when their
land became devastated by war. Soon after the outbreak of hostilities,
women in the leading cities of the States formed themselves into
working parties to provide lint and bandages and suitable clothing for
the suffering soldiery. But as the colossal needs of the regiments
being formed all over the States became apparent, a special Sanitary
Commission was, at the instance of various Medical and Relief
Associations, founded by the Secretary of War to deal with the sick and
wounded in hospital and camp. Hundreds of women volunteered as nurses,
and in time a most efficient organisation was built up.
[Illustration: MISS NIGHTINGALE AFTER HER RETURN FROM THE CRIMEA.
(_Photo by Keene, Derby._)
[_To face p. 272._ ]
The observations and advice of Miss Nightingale were continually
laid before this Commission, and her name became almost as much a
household word in the States as at home. She was regarded as the great
friend of the American soldiers and the beneficent genius of their
hospitals. Had Miss Nightingale been in a more robust state of health,
there is little doubt that she would have visited America during
this great crisis, to give personal help in the initial work of the
establishment of army nursing.
About this period, also, the seed of her example bore fruit in the
establishment of the Red Cross Society, the branches of which to-day
cover the civilised world. The honour of the inception belongs to M.
Henri Dunant, a citizen of Geneva, who, appalled by the fearful carnage
and disease among the soldiery in the Italian campaign, succeeded in
drawing together an International Congress at the city of Geneva on
October 26th, 1863, to consider how a neutral body might be formed for
the relief of the wounded in battle. The result of Henri Dunant’s grand
scheme was the extension of the work begun by Florence Nightingale in
the Crimea over the entire Continent of Europe by means of the Red
Cross Societies, which act in close relationship with their respective
Governments and in conjunction with the army.
The work thus begun spread rapidly when that most sanguinary struggle
of modern times, the Franco-German War, broke out in 1870. During that
period Miss Nightingale’s advice was repeatedly sought and she was
specially appealed to by the German authorities when organising their
medical and nursing corps.