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The Liverpool Workhouse Infirmary
- Wilfrid Laurier University Press
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The Liverpool Workhouse Infirmary T hat the Liverpool Workhouse Infirmary became the first to provide trained nursing services is thanks to the intervention of William Rathbone, the philanthropist who had, a few years earlier, instituted district nursing in Liverpool (related in a nursing volume). Nightingale was ready to respond with a plan in mind when he made his generous offer to provide funds for improvements, the third and fifth items below. What is remarkable is the great gap between she modest reform Rathbone initially proposed (a lady visitor) and the institution of fully professional nursing care of the same quality as that ‘‘in the best nursed hospital.’’ Rathbone had sufficient confidence in Nightingale’s judgment to go along with her vastly more ambitious proposal, but later correspondence will show him much more oriented to personal charity and averse to ‘‘central administration,’’ while the system change Nightingale sought required a carefully devised, centralized administration and financial structure. The two worked successfully together for decades, although Rathbone ’s tactics often riled Nightingale. He tended to be impetuous, changed his views and underestimated difficulties Nightingale clearly saw coming. He ignored her strictures about keeping certain information ‘‘private.’’ Yet, as the late letters especially show, a warm friendship developed. One of the first things Nightingale did was to consult the person she most esteemed as a nurse, Mary Jones, of St John’s House, an Anglican sisterhood that provided care at King’s College Hospital. Indeed Nightingale tried several times to recruit her friend to workhouse infirmary nursing, without success (Jones did assist behind the scenes with advice). The person who in 1865 did take on the superintendent’s position was Agnes Jones, no relation, whom Mary Jones had initially considered unsuitable. The St Thomas’ matron, Sarah Wardroper, worked ‘‘like a / 231 horse’’ to organize the nursing.1 Wardroper visited the Liverpool Workhouse again in 1867 and prepared a detailed report on the buildings, beds, schedule for inmates, origin of the patients and training of servants.2 A major theme that runs through at least the early letters here concerns the use of ‘‘pauper nurses.’’ Nightingale was sceptical from the beginning, but the Liverpool authorities were insistent that pauper inmates be used, for obvious reasons of economy. Agnes Jones went along with the scheme, as appears below. The compromise was to select the most promising candidates and separate them—they could hardly receive hospital training in the circumstances, but presumably they were given some instruction in their duties. Nightingale was more optimistic about the possibility that workhouse girls, that is, the daughters of inmates, might become nurses, but the complication here was that children normally left about age fourteen (girls often for domestic service), too early to train as nurses. Nightingale entertained the possibility of their going into jobs in hospitals or workhouse infirmaries, as kitchen maids, cleaners, etc., then being accepted for nurses’ training at the usual age of about twenty-four. Whether this was ever tried in any systematic way is not clear. It is interesting to note that Dr Rumsey, who did not appreciate the difficulties of getting trained nurses into the workhouse infirmaries, was most insistent on the inadequacy of pauper nurses, using language very similar to Nightingale’s. Allowing for ‘‘exceptions,’’ he argued that the ‘‘training, habits, notions and associations of female paupers . . . are such as to render them most unfit for an employment in which the strictest decency, cleanliness and morality, with some delicacy of feeling, are essential to the welfare of the patient.’’ He also thought it ‘‘a great mistake to suppose that the very poor ought to be nursed only by those equally low in habits and depressed in circumstances as themselves.’’3 An undated letter to Harry Verney (c1865), when Nightingale was working on the extension of nursing into the London workhouse infirmaries, said that she was ‘‘up to my neck’’ working on a ‘‘great plan’’ of Mr Farnall’s ‘‘to train girls from union schools (under our 1 Letter to Frances Nightingale 20 August 1864, Wellcome (Claydon copy) Ms 9001/51. 2 Report 29 July 1867, Add Mss 47714 ff241-53. 3 Rumsey, Essays on State Medicine 411. 232 / Florence Nightingale on Public Health Care [18.205.114.205] Project MUSE (2024-03-19 12:06 GMT) head nurses) in workhouse infirmaries as nurses.’’4 She suggested adding a postscript about workhouse girls to the new, cheap edition of Notes on Nursing for the Labouring Classes, but only ‘‘quite at the bottom’’ as it...