ST THOMAS’S – LONDON
St Thomas’s was founded in 1213, making it one of the oldest foundations in the country. It was established as an ‘almery’ in connection with the Catholic Priory of Bermondsey. Later poor people were allowed in, many never left, they lived and died there. It was surrendered to Henry VII, during the dissolution of monasteries. At that time it had forty beds for the Poor, it was later enlarged and opened as a medical hospital for the poor, under the patronage of Edward VI. During the Reformation it was used as a military hospital. St Thomas`s was improved in 1732, and had a grand entrance from Wellington Street. Wards at this time were under the care of an untrained sister helped by two or three rough nurses.
On November 29th, 1855, a public meeting was held at Willis’s Rooms, in St James’s Street. A committee was formed with Sidney Herbert as honorary secretary, the Duke of Cambridge was chairman. It was held to give recognition to Florence for her work in the Crimea. Speeches were made by the Duke of Cambridge, the Duke of Argyll, Lord Stanley, Sidney Herbert and Richard Monckton Milnes. They spoke of their and the country’s gratitude for the work Florence had carried. Many people had given donations and it had been the first thought to present her with an item of gold or silver suitably inscribed, but they received so much money, they felt the setting up of a Fund for the training of nurses would be better, so began The Nightingale Fund. The money was to be spent on nurse training in all aspects, hospitals, infirmaries, midwifery etc.
By 1859, Florence had £45,000 at her disposal to set up a training school. She felt that the most suitable place for the training to take place was at St Thomas’s in London. Florence would be the patroness and organiser. He health and work load at that time did not allow her to take an active part in training, or of being superintendent. The sub-committee of the Fund was Sidney Herbert, Sir James McNeil, Sir James Clark, Dr Bowman and Arthur Hugh Clough. Clough was later succeeded as secretary by Henry Bonham Carter.
Miss Nightingale had been writing to Mr Whitfield, the Resident Medical Officer of St Thomas`s, since she was in the Crimea. He had supplemented his earnings by taking nursing students. It was during his correspondence with him in 1859, the South Eastern Railway wanted to buy part of the land which was occupied by St Thomas`s Hospital. Miss Nightingale at this time, was wellknown for her articles on the building of hospitals. This was a subject Mr Whitfield was also interested. A decision had to be made whether to sell all of the land, and move the hospital, but there were objections to its new site. Miss Nightingale analysed the hospital records and found the majority of patients lived in the suburbs. She suggested that Blackheath, with offices and casualty at Southwich would be suitable. The patients could be transported by train. Mr Whitfield however wanted the hospital site to be in a healthy area, he gained much support from the Doctors. The Superintendent General for Health, John Simon wanted the site to be in a well populated area to serve the poor at Lambeth.
An injunction was made so that the railway company would have to buy the whole of the St Thomas`s site, for which they paid £296,000.
The site for St Thomas`s had been decided, it was to be built on the Albert embankment. Miss Nightingale was furious. The Nightingale Fund Council disliked the new site and there were many letters between the Fund and the hospital authorities. Not only was the new site suitable to the Council, but also the Hospital Building plans. The main objections were the probationers quarters, the size and situation of the accommodation. .the fact that probationers should have their own dining rooms, and dormitories, and that the Matrons office and probationers residence should be near.
Miss Nightingale wanted to choose her own Superintendent for the training hospital, she had asked Dr Elizabeth Blackwell, who was the first woman to be put on the English Medical Register. She was not willing to take the post, as she wanted a private practice.
Mrs Wardroper was to be Matron, she was without formal training, and did not take up nursing until she was 42. It was only through her sheer force of character that she rose to become Matron in 1853. Miss Nightingale found that Mrs Wardroper had raised standards of nursing, and she was willing to take charge of training.
On 7th March, 1860, The Fund Council Committee, Sir John McNeil, Sir James Clark, Mr William Bowman and Sir Joshua Jebb met. Certain wards were to give instruction to probationers, and that the Matron should also be Superintendent, under control of the council of the Fund. The Matron would have the power to select probationers, and dismiss them. She should also recommend the number of sisters to give instruction, the Medical Officer to give medical instruction.
The first probationers arrived on 9th July, 1860.
The Fund agreed to pay:
£22 a year to the Court of Governors for board and lodging of each probationer.
£100 a year to the Matron (Mrs Wardroper already getting £150)
£50 a year for the medical officer to give instruction.
£10 a year to teaching sisters
These amounts were above the salaries already being paid, Mr Whitfield was already earning £643, his average income together with a house, and an allowance for coal. Not a bad income at all when consultant physicians, surgeons were receiving an average of £239 and £488.
Probationers fees were as follows (worked out in groups of 5).
£110 Board and lodging
£32 Washing/use of furniture
Miss Nightingale drew up a `Monthly Sheet of Personal Character and Acquirements` in two parts. The first part was a moral record, punctuality, quietness, trustworthiness, personal neatness, and cleanliness, also ward management. The second part was technical record which gave grades; Excellent, Good, Moderate, Imperfect and nil. Mrs Wardroper would also add her personal comments.
Not everyone welcomed the new scheme for training women to become nurses. A senior Consulting Surgeon at St Thomas`s, Mr J.F. South was very much opposed. He had old fashion ideas, and believed that nurses needed little training. His view of an ordinary nurse was that `the day-nurse or ward-maid performs for the ward the usual duties of a house maid as to cleaning and bed making.` In a pamphlet published in 1857, when the idea of nurse training school was being discussed. In the same pamphlet he referred to another (anonymous) pamphlet which had been published in 1851 on the system of training at the Kaiserwerth Institution , (he probably knew the pamphlet had been written by Miss Nightingale), he denied charges of drinking and immorality bought against the English nurses by the anonymous writer. Most of his remarks seem to have been aimed at Miss Nightingale. In a letter to Mr Baggellay who was the Treasurer of St. Thomas`s he made many complaints about the new nurses. He felt that many of the surgeons should have been consulted as to their feelings on this matter `the remarkable fact remains to be pointed out that of the ninety-four physicians including principal assistants and consulting physicians, and of seventy-nine principal and assistant surgeons of the seventeen hospitals of London, only three physicians and a surgeon from one, and one physician from a second hospital are found among the supporters of the scheme.
Mr South was over sixty when the nurse training school began. He retired in 1863, the reform of nursing went on in spite of his angry protests.
Miss Nightingale felt that the stand of candidates they were getting was poor, and wider advertising was needed. A statement of what the object of training and the type of women who would be suitable was made by Chairman Joshua Jebb. Although the need of probationers was great, hospitals only provided 11,000 beds. Most of the sick were nursed in their own homes. After the publicity about women for nursing Mr Bonham Carter received many letters from hospitals who wanted trained nurses, many asked for advice about staff.
The new St Thomas`s was opened on June 21st 1871, by Queen Victoria. It consisted of eight separate pavilions (blocks), which stretched one thousand and seven hundred feet. From Westminster Bridge (north) to Lambeth Palace (south). The six centre pavilions were for patients. There was a double corridor, and each pavilion had three tiers of wards above the ground floor. The north pavilion was for staff, including a special wing set apart for the Nightingale Home. The south pavilion contained lecture rooms. St Thomas`s also had an operating theatre which could hold six hundred students.
The first patients were admitted in September. Many enquires were received from instruction on advice for the training of nurses. Mr Henry Bonham Carter felt that Mrs Wardroper was not capable of dealing with such correspondence, and took it over himself.
In 1872, Miss Torrance (previously at Highgate) was transferred back to St Thomas`s. Anne Hill took over, but she did not have the same support. The relationship between Miss Torrance and Mrs Wardroper was not very good. Mrs Wardroper resented her, and felt she had returned as a watchdog. Dr Whitfield also objected to Miss Torrance being made Assistant. Miss Nightingale compromised by renaming her position `Home Sister` in charge of education and training.
Miss Torrance took up her position as `Home Sister`, in November 1872. She found Mrs Wardroper`s book-keeping, and that the Fund had been subsidising house keeping for ordinary nurses. In January 1873, Miss Torrance became ill, and had to leave. Her intention to leave anyway was known to Miss Nightingale, that she was to marry Dr Dowse the Medical Superintendent at Highgate.
The Fund was facing criticism, that they were financing the hospital rather than nurse training. Many of the probationers complained about lack of teaching with no lectures in anatomy or physiology. Most of the complaints were attributed to the dislike of discipline.
There were problems at St Thomas`s between Mr Whitfield and Mrs Wardroper. It was felt that Mr Whitfield was a bad influence on Mrs Wardroper, he drank heavily and would make his rounds at night tipsy more that sober. He had done nothing for the probationers in the last 4 to 5 years. He did not even attend them when they were sick. Mr Bonham Carter asked Mr Whitfield for his resignation, he told him that he had taken no active part for many years. In the early years he did attempt to give instruction but as the years went by he became disenchanted. When Mr Whitfield left, he gave his mechanical skeleton, diagrams and books to St Thomas`s. He died a few years later in 1877.
A suggestion was made that a second training school should be started so that the Nightingale School could be moved. There were many difficulties at St Thomas`s with the `Home Sister` being unable to teach on the wards, it would also take the probationers out of Mrs Wardropers hands. Miss Nightingale felt that Mrs Wardroper should visit her more often, to report on the progress being made. Mr John Croft was appointed to organise instruction in consultation with the Fund Committee, and Miss Nightingale. A syllabus and reading list was prepared. Weekly lectures were printed. After 1873 Mr Croft attended the Fund Committee`s yearly meeting, he provided full reports, progress and examination.
Mary Crossland became `Home Sister` at St Thomas`s in 1875. She would report to Miss Nightingale at South Street about the teaching of sisters, Miss Nightingale would keep notes on the progress of the school. It included ward instruction, doctors lectures, taking of case notes and the keeping of diaries. Mrs Wardroper had forbade the `Home Sister` to give tuition on the ward so this was a weak point in training. The ward sister had neither the time or ability to teach, even probationers trained under the Nightingale Fund were unable to teach each other. It was also impossible for probationers to spend long periods in a classroom as they were required to assist on the wards. A number of the probationers were unable to keep up with the writing in lectures, many had great difficulty during examinations, it was beginning to show that the back ground of a probationers education was becoming important.
Dr Bernay took over lectures, which he made clear and simple they were enjoyed and he helped them with spellings. Dr Peacock also lectured and supervised note taking with medicine advancing as it was, it was difficult to be sure how much a nurse should do and learn.
In 1878 a report showed that the sanitary conditions at the new St Thomas`s were unhygienic. Windows were difficult to open, linen chutes were not used and chamber pots were left under beds, hidden by quilts pinned down. In August Mr Bonham Carter put an end to training for six months. When admissions resumed the Fund Committee agreed `to afford some means of training in the duties of supervision` the following year no such appointment had been made.
In 20 years of 604 probationers admitted for training, only 357 completed a years training, at a cost of £580 each. Women were often unfit for the duties they were to undertake. A woman`s role in the community had changed and there were many more opportunities. Although with much opposition when entering medicine. Many middle class educated women were becoming Nightingale Nurses.
There had been little improvement in hospitals or homes, in 1885 Mrs Wardroper reported that the sickness rate was exceptional. The probationers had become ill due to the defects in the House.
By 1882 Nightingale Fund nurses had become matrons at:
Sidney Hospital – New South Wales
Royal Victoria Hospital – Netley
Edinburgh Royal Infirmary
St Mary`s Hospital – London
Westminster Hospital – London
Liverpool Royal Infirmary
Southern Hospital – Liverpool
St Marylebone Workhouse Infirmary
Royal Hospital for Incurables – Putney
After this the Funds share of superintendent posts in large hospitals began to fall, other hospitals were also running training schools.
In 1886 Mrs Wardroper retired, she was presented with a tea service, and a pension of £100 a year from the Fund. Mrs Wardroper died in 1892.
Miss Pingle returned to St Thomas`s as superintendent and Matron. She was not to stay long, and was to return to the Church of Rome (Catholic), she left London to run a private nursing home in Belfast.