Negotiating nursing

British Army sisters and soldiers in the Second World War

Jane Brooks

• Publisher: Manchester University Press
• Year: 2018
• Print ISBN: 9781526119063
• eBook ISBN: 9781526119087
• Edition: 1
• Topic: History
• Subtopic: World War II
• Index: History

Negotiating Nursing explores how the Queen Alexandra's Imperial Military Nursing Service (Q.A.s) salvaged their soldier-patients within the sensitive gender negotiations of what should and could constitute nursing work and where that work could occur. The book argues that the Q.A.s, an entirely female force during the Second World War, were essential to recovering men from the battlefield and for the war, despite concerns about women's presence on the frontline. Using personal testimony the book maps the developments in nurses' work as they created a legitimate space for themselves in war zones and established their position as the expert at the bedside. Yet, despite the acknowledgement of nurses' vital role in the medical service, their position was gendered. As the women of Britain were returned to the home post-war, it was the military nurses' womanhood that stymied their considerable skills from being transferred to the new welfare state.

1

Salvaging soldiers, comforting men

On 2 September 1939, the eve of the Second World War, the Nursing Mirror declared that a nurse ‘is not brought up to expect ease and comfort, but rather to learn to create ease and comfort for others’.¹ This chapter examines the role of military nurses in war zones across the globe in providing this ‘ease and comfort’ for their combatant patients, and doing so in increasingly confident and humanitarian modes. Preparations began for the mobilisation of the Queen Alexandra’s Imperial Military Nursing Service (QAs), their Reserve and the Territorial Army Nursing Service (TANS)² from the mid-1930s as war seemed ever more inevitable. Orders then commenced on 1 September 1939, when at one o’clock the War Office in London contacted the QA Matron-in-Chief: ‘Mobilisation orders received. Complete mobilisation of QAIMNS + QAIMNS Res came into effect. Matron-in-Chief QAIMNS to move her office from 3 Spring Gardens to 3 Thames House on 2.9.39.’³ The first members of the QAs and their Reserve left for France on 10 September. By 25 September, 570 nurses had embarked for France. Nursing sisters of the British Army were eventually posted to all war zones of the Second World War to care for combatants.

The chapter maps the nursing practices on active service overseas that recovered men, including body care, feeding work, the management of pain and support for the dying. These four areas of nursing practice are commonly associated with nursing work, yet, in war zones, they demanded complex gendered brokery. The intimacy of body care, the moment when the single young female nurse meets the young male patient, required skilful negotiations in order to alleviate the spectre of unrestrained sexuality.⁴ Feeding work was quintessentially part of women’s domestic role, but during the Second World War it took on political import as women fed the nation on rations and saved Britain from waste. Military nurses demonstrated that they too had the skills and ingenuity to scavenge, prepare and administer nutritious food to recover men for battle. The care of pain was crucial to patient recovery and yet, in the masculine space of war, the combatant was often reluctant to admit to it. Thus nurses needed to use skilful techniques of assessment and management in the face of the soldier’s stoicism to provide him with adequate pain relief. As part of the formation of skills to manage their combatant patients in war zones overseas, nurses developed the artistry of their practice from task orientation to a humanitarian service that healed men physically, socially and emotionally, in order to prepare them for return to the battlefield, or support them in death.⁵

As men were laid waste across the globe by the destructive forces of modern weaponry, military nurses were posted to all war zones in unprecedented numbers, and contrary to gendered expectations. Cynthia Toman argues in regard to the Canadian military nursing service that ‘It was gender, not nurses’ abilities that constrained their work’.⁶ But gender also was the key to their war work. Combatants in dangerous war zones had historically been cared for by male orderlies. By the Second World War, medical military authorities were armed with the knowledge that successful medical outcomes were more likely with earlier treatment. In order to provide prompt, expert care, trained nurses were needed close to the fighting. Despite the fact that some of the orderlies were themselves registered nurses, the decision was taken to post female nurses to front-line duty.⁷ Although as Crew wrote, ‘male and female nurses can be completely equal in response to professional knowledge and skill’, he continued that the chief and most important difference was their gender. The ill or injured combatant ‘is a child-like creature, often dependent and insecure, who sees in the female nurse a mother-figure, tender and compassionate’.⁸ Nevertheless, nurses’ training had not necessarily prepared them for the tender ministrations needed to salvage their soldier-patients.

Transforming nursing care

The testimonies of nurses acknowledged that their regimented and highly disciplined training was in many ways ‘dehumanising’. For those who qualified as registered nurses and went on active service overseas, there was also an appreciation that this training toughened them and thus enabled them to manage the challenges of war nursing. The long hours, hard work and sometimes overly harsh regimes prepared them for war and its human tragedy as the skills they learnt as student nurses became embedded in their ‘nursing-selves’. Writing in her diary after arriving in Normandy shortly after D-Day, Sister Ann Radloff stated, ‘This was the moment for which I had prepared for four long years, and during which, as well as fun and friendship, I had suffered depersonalisation, despair, discipline and desolation.’⁹ Sister Brenda McBryde landed in Normandy with the 81 British General Hospital also in June 1944. In her memoir she described ‘the trauma’ of her first day in the resuscitation department:

Everything I had learned during four hard years of training suddenly made sense. My hands had a sure and certain skill and my brain was unflustered as I replaced dressings over gaping wounds, gave injections of morphia and the new wonder drug, penicillin, charted blood pressures. I began to see, for the first time, that the disciplines of the training school were a necessary part of the whole. That tent, full of men, whose clammy bodies overpowered me with the nauseous sweet smell of shock were my fulfilment, since they could no longer help themselves.¹⁰

The regimented training of nurses in British hospitals in the 1930s and early 1940s thus enabled those nurses who went on active service overseas to perform bodily care and clinical nursing work, despite the alien environments in which they found themselves. In a letter to her mother from active service in Italy, Sister Agnes Morgan described her elation at being able to engage in ‘real war-nursing … bandaging, giving injections, washing, lifting, dressing – no red tape, no beds to make, no rules or regulations to observe’, and with no supervision.¹¹ Here she offered a list of the same work that all nurses would have engaged in on wards in civilian hospitals in Britain, work that was the backbone of their duties. The lack of supervision and the new delights at a more autonomous mode of practice were novel experiences. Just like Hana in The English Patient who muses that ‘She would not be ordered again’,¹² it was this autonomy that Morgan, like many of her Army nursing colleagues, welcomed as part of active service. Yet two years earlier, in a letter from Egypt, she had acknowledged the need to care not only for the bodies of the men, but also for their humanity.

By night they came on convoys broken and maimed and what could we do but give them everything we had in the way of nursing skill and bodily comforts, and by day they came in walking (like the Welchmen from Benghazi), often maimed in mind, but only exhausted in body, and now what comforts had we for these? What wise council, what heroic words would sooth a haunted mind?¹³

Nurses’ training had clearly prepared them to care of the ‘broken and maimed’ bodies of men. Morgan was not so sure how it prepared them for the emotional care required to recover men from the physical and psychological trauma of war and to see the patient as a person.¹⁴ As Radloff argued, her posting to active service overseas was the ‘beginning of involvement in such courage, patience, tragedy, torment and laughter that was to transform us all into different people’.¹⁵

Caring for bodies, recovering men

Sister Angela Bolton maintained that her nursing routines in India during the Second World War had been very similar to those in England before the war. The day started with sisters’ and doctors’ rounds, dressings, medicines and patients’ meals.¹⁶ Despite body care being the mainstay of nursing work, she does not list it in her daily duties. Over the past century areas of nursing practice have been transformed and transferred to other professions. Massage became the province of physiotherapists, nutrition the work of dieticians and X-rays that of radiographers.¹⁷ Hygiene and elimination care stayed with nursing, yet are the least discussed areas of nursing practice in the personal testimonies, as the reference to Bolton’s daily work above suggests. There are arguably three reasons for the hidden nature of this work, given censorship rules and nurses’ self-censorship. One reason is body care’s self-evidence as nursing work. Second, body and hygiene care are inextricably associated with dirt; third are concerns that the potential sexual undertones in the encounter between the female nurse and her male combatant patient could not easily be nullified.¹⁸

War should be a masculine space,¹⁹ and yet the status of being a patient is bound in dependency.²⁰ Dwelling on the weakness of the ill or injured soldier may have provided a safer narrative for the nursing sisters, but it did not render body care benign. Joanna Bourke argues that for those disabled from birth, a level of passivity surrounds their being. The injured soldier was, however, both mutilator and mutilated; he was a man whose passivity is contingent: ‘He was the fit man, the potent man rendered impotent.’²¹ The mobility of the Second World War meant that female nurses were often far away from the supervision of older nurses. Their work and relative autonomy carried with them dangers of impropriety and sexual frisson.²² The patriotic duty of female nurses may have been to salvage men for the battlefield or to return them to their loved ones at home, but such unfettered closeness could carry with it public and private fears of sexual freedoms and a disruption of accepted social relations.²³

Discussions on the difficulties that war created for anticipated female propriety fill texts on women’s wartime work. According to Sonya O. Rose, with the advent of the war, concern over the behaviour of young women was brought into stark relief.²⁴ Even for those women on home soil there was a great deal of suspicion about women in uniform,²⁵ the wearing of which suggested gender bending²⁶ and women’s active participation in the conflict.²⁷ The shifting of nurses’ space from the hospital in Britain to the ward in a war zone transformed her from feminine home-maker to war worker. As Cynthia Enloe argues, military nursing sat on an ‘ideological knife-edge’,²⁸ exacerbated by nurses’ proximity to nak...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright
• Contents
• List of figures
• Acknowledgements
• List of abbreviations
• Introduction: Nursing work and nurses’ space in the Second World War: a gendered construction
• 1 Salvaging soldiers, comforting men
• 2 Challenging nursing spaces
• 3 Nursing presence
• 4 Negotiating the boundaries of nursing practice
• 5 Reasserting work, space and gender boundaries at the end of the Second World War
• Conclusion
• Bibliography
• Index