The Crimea - and Now

July 1916

The C.O. describes some further striking contrasts in War Hospital efficiency

While Miss Florence Nightingale was short of female nurses, think what she had as male.
The ambulance men all died of D.T.s or cholera. The orderlies were raw corporals and untrained men, over-worked, ill-fed, and underpaid; in fact a rabble. The rations were drawn 'uncooked' for each patient, so that by the time the food was drawn it was too late often to cook it, and so it was kept all night in the wards. It remained for this wonderful woman to suggest that diets should be issued in bulk. Her suggestions were practically embodied into the Royal Warrant for the Medical Staff Corps of 1855; and, while she condemned the medical officers severely for failure as administrators, it is a satisfaction that she bore willing testimony to their skill and devotion as doctors. The Records of the hospitals were scanty to a degree, and the only note kept was that a man died on a certain day. In the base hospital at Scutari they died at the rate of a hundred a day. Compare that with the present war. In many thousands of cases which have passed through our hospital and sections since the outbreak of the war we have had an average of deaths from all causes of 1 in 150, though many of the patients admitted were almost dead when they arrived.

The mental distress to a woman like Florence Nightingale, seeing brave men die for want of proper food and nursing, must have been awful. The thousand and one things she did show how she valued the personal touch in dealing with the sick and wounded. This, after all, now as then, is the most valuable faculty that can be possessed by a doctor or a nurse - to let each patient realise he has a personality and is not merely a number. It is, as we all know, the dominant note of the 3rd London, and has done more to make it successful from the patients' point of view than anything else. The bright wards, the flowers, and the skill of the surgeons all count; but, in my opinion, they rank after the 'personal interest' of the staff for the patients. A few cheery words from the Medical Officer, which shows he knows the patient's name and regiment, will give more stimulus to the patient and help him more towards recovery than any amount of physic.

Florence Nightingale took the trouble, amid all her business, to send a line now and then to the relatives of the patients, often conveying their last message. I know many of our nurses here do the same, for I have heard outside of such; but if any of the staff who read this article have spare time, let them use it by sending a line now and then to the near relatives of their serious cases; it will be appreciated more than many realise. This is especially the case when the patient is far from his home. Under Florence Nightingale's influence the class of orderly improved, and we find a tribute from her to her orderlies that they carried out duties which would never have been done for the sake of discipline, and 'there was never a word or look which a gentleman would not have used.'

In the spring of 1855 the mortality had fallen from 42% to 2.2% at Scutari, and so Miss Nightingale went to the Crimea to inspect the hospitals there. Worry and overwork had undermined her health, and she had a severe attack of fever. When convalescent she refused to go to England, but went back to work. The joy of England at her recovery manifested itself in a fund to be hers, and she wished it used for the training of nurses and their sustenance. The amount of drunkenness was awful, and men actually died of drink; and, till Miss Nightingale took the matter in hand, no one appeared to mind. It had been the custom; why interfere or bother? She interfered, and set to improve the men's conditions by giving counter attractions, especially to give them means of being educated, as the soldier of those days was very often unable to read or write. But, in spite of their want of education, when in the reading huts their manner was quiet and well-bred. Their good manners made a lasting impression on Miss Florence Nightingale.

Time has brought a very different class of men to the Colours, and in the present war men of all standards and education are in the ranks; but it is as well for those who may think that their presence in the ranks is adding lustre to the Army that they should remember the soldier of all times has been a gentleman, and, if he possessed vices of the period, they were those met with in gentlemen of the period. I have seen many thousands of men through this hospital, and when a man has forgotten to behave as a gentleman it has been in spite of his uniform and position as a soldier. In civil life, away from the good example of other soldiers, the same man would have been worse. The so-called common soldiers, taken as a class, are always gentlemen in manners and feelings.

Florence Nightingale's task in breaking down vested interests was colossal, and it was only by irregular methods that she succeeded in getting things done. She had to soothe over the medical profession owing to an over-zealous admirer making an attack on the medical officers which was not fair, and in many ways she had to smooth the religious jealousies of the nurses. Her persistence was rewarded, and she did was she set out to do, i.e., she made the experiment of female nursing in military hospitals successful, reduced the death rate, and saved thousands of lives.