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Extending Nightingale Nursing in Hospitals London Hospitals O ver the course of Nightingale’s life, St Thomas’ trained nurses went out as nurses and some as matrons to the major London hospitals.1 Nightingale looked for opportunities to improve nursing wherever she had an opening. Desirably a team of matron and nurses would be sent, with the hope that the hospital would start its own training school. She looked to nursing schools at hospitals being as common as medical schools were (see p 61 below). King’s College Hospital was the first to have Nightingale Fund training in London, after St Thomas’, but its purview was confined to midwifery nursing, and the school closed in 1868.2 The next hospital to invite Nightingale nurses in was St Mary’s, Paddington, in 1876. St Thomas’ trained nurses were sent out often singly to other hospitals right from the start, but this turned out not to work well and Nightingale urged that this not be done. (Of course it continued to happen , for nurses were free to go where they wanted when their ‘‘obligation ’’ was completed.) In the first years of the school’s operation the matron, Mrs Wardroper,3 did almost all of the selecting for these positions . She also did most of the preparation for the outgoing teams. Nightingale increasingly took on this task herself as problems emerged with inadequate preparation and some bad choices for positions. 1 For background see Geoffrey Rivett, The Development of the London Hospital System 1823-1982, and Gwendoline M. Ayers, England’s First State Hospitals and the Metropolitan Asylums Board 1867-1930. 2 The unhappy story of its unacceptably high rate of deaths from puerperal fever is told in Women (vol. 8). 3 On whom see the biographical sketch, Appendix A (12:885-87). / 27 Mixed in is correspondence on cases Nightingale referred for treatment , business of the Nightingale Fund, requests for advice or help, replies to potential nurses and letters to friends and colleagues to encourage applications from suitable candidates. We begin with general letters and those covering more than one hospital. After that there are specific sections for the major hospitals, in chronological order by first contact. The extent of coverage of course reflects the number of available letters and notes. Among London hospitals there are major sections for St Bartholomew’s Hospital; Charing Cross; St Mary’s, Paddington; the London, Whitechapel; Guy’s; the Royal Hospital for Incurables, Putney; and the Homerton Fever Hospital. There was no fully satisfactory way of organizing this disparate material. The decision was made to divide the correspondence by region by hospital, chronologically within each section. That makes for some oddities, as for example the matron and nurses arrive at St Bartholomew’s (in London) before they left Montreal (in Canada), the reverse order of what happened, but London comes before Canada in our (geographical) order. The section begins with a short paper, ‘‘Thoughts Submitted as to an Eventual Nurses’ Provident Fund,’’ 1858, which was published with Subsidiary Notes as to the Introduction of Female Nursing into Military Hospitals in Peace and in War, but which deals entirely with regular, civil hospital nursing. It is useful for showing that, when winding up her work on the Crimean War, and before writing Notes on Nursing and the opening of the training school at St Thomas’, Nightingale was working on such practical matters as pensions for nurses. She accepted that nurses would have long hours of heavy work, to concentrate on what clearly she did as negotiable: adequate salaries, holidays, laboursaving devices and backup assistance, decent housing and meals and personal safety in what were (and are still) dangerous places to work. Pension provision was essential, as Nightingale considered that a nurse’s working life would be over at age sixty. Adequacy of salary to contribute to a pension fund was a consideration. An opportunity to develop a provident society for nurses opened up in 1879 (12:354-57). 28 / Florence Nightingale: Extending Nursing Thoughts Submitted as to an Eventual Nurses’ Provident Fund Source: Florence Nightingale, ‘‘Thoughts Submitted as to an Eventual Nurses’ Provident Fund,’’ published with Subsidiary Notes, dated 23 January 1858 Private and Confidential 1. Wages and Prospects of Nurses 2. Desirability of some further provisions 3. Of what nature? (1) With regard to kind? (2) '' to persons? (3) '' to objects? 4. Suggestions as to the rules to be followed 5. Prospects of eventual support 1. Wages and Prospects of Nurses The...


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