‘Suffering through war is not confined to our soldiers and their families, but is felt accutely in unemployment and consequent privitation, sickness and general misery in every corner of the land.’
Queen’s Nurses’ Magazine, October 1914.
In 1914, district nursing faced its most difficult challenge to date. The First World War broke out and the government was putting huge pressure on women to enlist as nurses. Trained nurses like the Queen’s Nurses were under even more pressure. Many of them signed up immediately to do their patriotic duty and flocked to the Red Cross hospitals of the South Coast. The Queen’s Nursing Institute immediately began to debate whether or not it was in fact in the nation’s interest to keep district nurses out of war work. Was their work at home equally as valuable? Click here to read about a district nurse who chose to remain behind.
‘A large proportion of Queen’s Nurses are now working in territorial hospitals. It seems a quaint reversal of things to find experienced superintendants of many nurses practically doing probationers duties in the wards. The often unpractical details of military institutions must be something more than irksome to women accustomed to being guided by common sense and their own initiative. But one and all are cheerfully accepting the situation’, the editor of the Queen’s Nurses’ Magazine reported in October 1914. One can’t help but sense the hint that this was something of a setback for the progress of district nursing as a profession separate from the body of nursing as a whole.
The Queen’s Nurses who worked in territorial hospitals faced horrendous challenges and devastating injuries far more severe than anything they had ever come across on the district. By 1916, 500 of them were either receiving the wounded in hospitals along the south coast, or working in treacherous conditions along the front in France. By the end of the war in 1918, another 100 had joined them. They dealt regularly with men who had been blinded by gas, men who had lost some or all of their limbs by bomb or artillery. Worse still were the men who were needlessly injured: the most popular injury to come out of the trenches was in fact frostbite. Nurses who were used to dealing with minor ailments and diseases were suddenly confronted by the psychological trauma inflicted by war: shell-shocked soldiers were widely agreed to be the most bewildering and untreatable cases.
World War Two was a little different. With its increased emphasis on the work to be done on the home front, more district nurses stayed in their localities and contributed in a variety of ways to the war effort. For example, many were called upon to organise the evacuation of children from major cities under threat from air raids. They carried out medical assessments on each child before their departure for the comparative safety of the countryside. District nurses in areas threatened by bombing outshone themselves in their usefulness to their local communities.
‘The noise, the whistling, the crashing of bombs was alarming. Passers-by were glad to almost fall into our home and along to our shelter. Our dining room was complete with sandbags and other protection and there we led them. Only two of the nursing staff were in the home, others were all out on their districts, for it was but 3pm’, one nurse wrote to the Queen’s Nurses’ Magazine from East London in the midst of the Blitz, 1940.
Times were tough, but it was in the interwar and post war periods when things really changed for district nursing. After the First World War, sex barriers were falling rapidly. As women finally achieved the vote, district nurses could expect to be taken gradually more seriously as professionals. Women had filled men’s jobs during the war and were now more free to work as they pleased. In 1919, State Registration for nurses began. Though some nurses disagreed with it, having a list of approved practioners did an infinite amount of good for nursing: bogus quacks and the ill-qualified need no longer apply. District nurses began to follow the fashions of the twenties, wearing more streamlined and practical outfits, whilst some of them even took to getting on their motorbikes!
The Second World War fundamentally changed Britain. A disillusioned public voted out Winston Churchill’s government, which had undoubtedly been a resoundingly powerful force for good during the war years. People in Britain were looking to the future. The vision of Clement Atlee’s Labour Party appealed. During the war, Britain had become more amenable to taxation than ever before. Atlee decided that he would use that taxation to expand social services and public health. The ‘sick poor’ for whom district nurses had catered in the past were disappearing at a rapid pace and society was becoming less stratified.
Where would district nurses fit in this new world, the world of the NHS?