Nights on the ward - the Night Superintendent's Report

This week, Alice has been looking at a little-used but fascinating set of records that shed light on the daily workings of the Royal Infirmary of Edinburgh

In order to reform nursing and nurses training at the Royal Infirmary of Edinburgh (RIE), in the 1870s trained ‘Nightingale Nurses’ were recruited and a training program instituted. Under this new system, the nurses reported to the Lady Superintendent of Nurses, rather than individual ward doctors. In addition to the Lady Superintendent there was the Night Superintendent, who monitored staff and patients throughout the night.

As there was little cross-over in their hours, the two used small bound notebooks as a means of communication between night shift and day shift. The left-hand pages of each book contains instructions recorded by the Lady Superintendent at the end of her day; and on the corresponding page the Night Superintendent would record the happenings of the night).

These little volumes are a fascinating way to supplement some of the other records we hold. Some pages contain snippets about staff which paint a vivid picture of the differing personalities of nurses, such as this entry:

27^th-28^th March 1876

“I made 3 rounds, nurses all in their places but Louise of 4 M[edical] I found her twice in one hour absent from her ward. She was with the night nurse in 5 M[edical] each time. I told her I would report it to you…

Nurse McLeod was not well at 5am but thought she could do her work so I let her” - (LHB1/103/7)

LHB1/126/50 - Christopher's entry in the General Register of Patients

Others add life to the lists of patient names that are recorded in the General Registers. For example, where in the register 8 year-old Christopher Yeoman appears as one name amongst many, this small detail from the Night Superintendent’s report paints a picture:

30^th – 31^st March 1876

Lady Superintendent: “The mother of the child in 3 S[urgical] is staying with him tonight so Nurse Black is not there”.

Night Superintendent: “The boy has had a quiet night; he is always much better with his mother”.

 The job of nurse was a risky one; often, the Superintendents’ notes to each other either request or provide details about unwell colleagues. There are numerable instances of nurses falling ill, and and Mary Anne Barclay is one such nurse.

LHB1/97/1 - Nurse Fraser's training record shows the perils of the job

Mary Barclay entered the RIE as a probationer on 19^th January 1876 having previously been employed for a time at Chalmers Hospital in Banff. According to her training record, she spent three months working in the Infirmary’s medical wards before she fell ill.

LHB1/97/1 - Nurse Barclay's training record

The first mention of Nurse Barclay’s illness in the Night Superintendent’s reports comes at the start of April 1876. As part of her general instructions for the night of the 6^th April, the Lady Superintendent requested that the Night Superintendent “please visit Nurse Barclay [in] 1 lower dormitory”. The return reply records that “Nurse Barclay has not had a bad night – Nurses Brown and McLeod each gave her a fermentation”. The following days’ correspondence suggests continuing concern for her well-being:

7^th - 8^th April 1876

                Lady Superintendent: “Nurse McDonald will stay on duty with Nurse Barclay til Dr McLeod has seen her.”

Night Superintendent: “Nurse Barclay had some sleep but had pain when awake so I told Nurse McDonald to stay with her.”

The next night shows a further downturn as Nurse Barclay was admitted into the hospital as a patient:

8^th - 9^th April 1876

Lady Superintendent: “Nurse Barclay was warded in 14 M[edical]. Will you report of her in the morning.”

Night Superintendent: “Nurse Barclay has been quiet but has not slept much : she looks very bad.”

Her recovery was slow but ultimately successful, with her training record noting that she was “about ten weeks absent” before continuing her training with “nine months in surgical wards”. Ultimately, her hard work and commitment to the vocation paid off. She was described as “patient, obedient and industrious, of slow intelligence but very painstaking, high principled and kind”, and after two years working on the night staff of the RIE she left to take up the post of Matron of Wallasey Cottage Hospital in Birkenhead.

The Superintendents were also there to offer guidance and mentor the novice nurses and support them in carrying out an often difficult vocation, as can be seen from these snippets:

                19^th – 20th^th April 1876

Lady Superintendent: “Bad case in 3 M[edical]. The nurse there is timid, please assist as often as you can”

Night Superintendent: “3 M[edical] - The poor old man died at 3.40am”

                1^st – 2^nd May 1876

Lady Superintendent: “Nurse Collins being off duty, Nurse Munro is in 16 S[urgical]. Nurse Macrae is also off duty, and Nurse Wyllie is on 4 M[edical]. Both these are young nurse and will need some looking up, especially as there is a sharp typhoid case in 4 M[edical]”

                8^th – 9^th May 1876

                “7 M[edical] - Nurse Small is taking charge of the tracheotomy case and Nurse Callow to do the rest of the work. The latter being new to us, give good heed to this ward.”

Although intended as administrative records, these volumes are a wonderful way to experience more of life on the ward, and the nurses’ concern for their patients really comes through. 

'A most peculiar bird...'

This week, Archivist Louise celebrates International Nurses Day with a spotlight on a resource that charts the history of nurse education from the first half of the twentieth century right up to the present day…

Happy International Nurses’ Day 2017! Since 1974, the International Council of Nurses has celebrated the amazing achievements of the nursing profession throughout the world. 12 May was chosen since it’s also the birthday of Florence Nightingale – whom I’m sure needs no introduction, but you can read more about our Florence Nightingale letters here. Around each International Nurses’ Day in the UK, there’s a service at Westminster Abbey in London, in which a symbolic lamp is passed, and more local celebrations in hospitals and health organisations. There are also annual events across the world (including these impressive displays in China).

We’ve no shortage of nurse-related records at LHSA – in fact, we have much more about nurses than we have for doctors! We’ve nursing ephemera, badges (like the ones featured on our new postcards – shameless plug!):

One of our new colour postcards!

… staff registers, photographs (although not always with named nurses), wage books and training records up to the early 1960s (when nurse training began to be re-organised from individual hospitals to wider local institutions – the Lothian Colleges). In fact, there’s a handy source list if you’re wanting to look into nursing records here.

One nursing history resource that I’d love to highlight, though, is The Pelican, the magazine of what is now The Pelican Nurses’ League, an organisation made up of nurses trained in the Royal Infirmary of Edinburgh. But why a Pelican?:

Royal Infirmary of Edinburgh nurses with an extraordinary patient! (LHSA photograph collection)

The Pelican had long been a symbol of the Royal Infirmary of Edinburgh, appearing on its crest. Shown as a female plucking its breast to nourish its young with its blood, it became synonymous with nurture and self-sacrifice, a fitting emblem for the work of the Infirmary as a charitable institution, and as a symbol of the RIE Nurse Training School (founded in 1872), appearing on its badge from 1917.

Pelican badge, Registered Nurse (LHSA object collection, O254)

Nursing badges were worn with pride, a very visual reminder of years of (often extremely challenging) training to meet rigorous professional standards. Back in 2011, we carried out the Unsung Heroes project with jewellery and silversmith students from Edinburgh College of Art to create new badges from our original archival holdings, taking inspiration from oral histories from retired nurses, recorded by the students themselves. You can hear some of the recordings online, here.

The first issue of The Pelican appeared in 1927, and was founded by the Student Nurses’ Association. The foreword of the first edition (written by the Lady Superintendent – the ‘Head’ -  of Nurses, Annie Warren Gill), welcomed the magazine, ‘which aims at reflecting and bringing together the many sides of a nurse’s life, and which will keep the old in touch with the new.’

Cover and first foreword from The Pelican,  1927-1928 (LHB1/190A/1)

Throughout its life, The Pelican has focused on nurse training rather than life as a qualified nurse. The PTS (Preliminary Training School) is often mentioned, where new recruits were educated before learning on the wards, along with ‘pros’ (not ‘professionals’, but ‘probationers’, who might be called student nurses now). The first magazine was a mixture of official news and events, along with anecdotes and humour:

Humour from the pages of the first edition of The Pelican, 1927-1928 (LHB1/109A/1)

'The Perfect Nurse' strikes a typical tone in early issues of The Pelican – of squinting up at an ideal, angelic nurse, but never quite reaching. It's a reminder that the (then) women who washed the bedpans, changed bandages and (as their training went on) administered treatments and aided operations were flesh and blood human beings doing their best against often unrealistic expectations that they carried with them as new starters.

A less well-known Pelican badge, that of the State Enrolled Nurse (LHSA object collection, O258). 

In 1935, the magazine recorded the suggestion of starting an ‘Edinburgh Royal Infirmary League of Nurses’, and that The Pelican be its official magazine, linking those who wore the Pelican badge. E F Bladon was elected the first President of The League at its first meeting in June 1935, and in 1936, The Pelican changed its cover to reflect its new allegiance:

Covers of The Pelican showing its name-change, and the first page of the new League edition (LHB1/109A/11, 12)

The Pelican changed its contents as the nature of nursing changed – in the 1940s, it appeared as a ‘News Sheet’ to reflect both wartime shortages and shifting priorities:

The Pelican in the Second World War, and news of nurses serving in wartime (LHB1/109A/16)

Teaching was changing too, as this 1957 feature on the new Teaching Unit shows:

Feature om the new teaching facilities for probationers (LHB1/109A/33)

In 1972, the Royal Infirmary of Edinburgh School of Nursing celebrated its centenary, marked with a special issue of The Pelican:

Special edition of The Pelican, 1972 (LHB1/109A/49)

I was heartened to see a feature by the Infirmary Archivist, answering queries about the Pelican crest in ‘most correct and proper’ terms (how else???!!):

Article by Pam Eaves-Walton, RIE Archivist (LHB1/109A/49)

 The Pelican continues to publish to this day, and the 2017 edition has just been sent to LHSA for the archive. As well as administrative matters (for example, member news, notices and meeting minutes), there are also historical features based on the editor's research in LHSA and recollections from nurses in particular specialist wards, such as Norman Dott’s Department of Surgical Neurology and the Renal Unit, where the first kidney transplant from a live donor in the UK was performed in 1960.

Appropriately for International Nurses' Day, modern editions of The Pelican also feature news on the Pelican Award, funds awarded to students on Adult Nursing Programmes in selected Lothian universities in support of electives (placements to supply experience of nursing outside their own region, but anywhere in the world) and to Registered Nurses towards funding research projects or professional development. In 2016, seventeen student electives were funded, from Birmingham to China, Sri Lanka, Australia, Tanzania and The Philippines – a truly international story for International Nurses Day 2017!

If you were the proud owner of a Pelican badge (according to the League records that we hold, Pelican badges were being issued up until at least summer 1988) and would like to join the Pelican League, new members are always welcome – you can find more details on the League’s website.

A probationer's life has always been a hard one...