Tuesday, 5 February 2013
Talented Tuesday - A Queen's Nurse
This very plain little card invites my great aunt, Lillian Barton, to attend St James's Palace - no less! - for a presentation by Queen Elizabeth the Queen Mother of a long service award to Lillian's sister "Nancy" Thompson.
The award from the Queen's Institute of District Nursing reflected the 25 years that Nancy had spent as a midwife and district nurse since completing her training at the Battersea General Hospital in 1936.
Nancy's elder sister Marjorie was also a district nurse - her membership certificate for the Queen's Institute is shown below - but unfortunately, died early in 1945 at just 35, shortly after being appointed deputy head of district nurses in the county of Norfolk.
The role of the "district nurse" was established in 1859 by Florence Nightingale and a Liverpool businessman, William Rathbone, who recognised that poorer families needed, but couldn't afford, ante-natal, palliative and general medical care from trained nurses in their own homes. For many, the alternatives were, no care at all or the infirmary in the local work house.
The provision of district nurses by local voluntary associations spread rapidly following the success of the scheme in Liverpool, where Rathbone ensured there were trained nurses available for each Liverpool "district". And in 1887, the role of the district nurse was formalised with the creation of the Queen's Nursing Institute which was founded with money collected by women across the country for Queen Victoria's jubilee.
Until the foundation of the NHS in 1948, the Queen's Institute in tandem with local associations provided district nurses throughout Britain. The local associations provided management and funding whilst the Institute provided training and accreditation. Funding was partially raised by "provident" subscriptions from working class families at a rate of for example, in 1929, 1 penny a fortnight.
Separate from the medical establishment within the British Medical Association and the hospitals, the Institute emphasised that the skills required of a district nurse were very distinct from those of a hospital nurse.
‘A nurse may have had complete hospital training and be perfectly fitted for work in the wards or in the houses of the richer classes, and yet feel very much at a loss when first starting to attend a case in a wretched room, where perhaps a whole family are living and sleeping and there are absolutely no decent appliances at hand…it takes three or four months before she can learn how to face these difficulties and discomforts.’ (1)
However, on the creation of the NHS, questions were raised about the quality of accreditation provided by the Queen's Institute and the management provided by local voluntary associations. 4,000 nurses practising district nurses were found to have no nursing qualifications. (2)
By 1959 all management of district nurses had passed to local government authorities and training and accreditation was provided by the NHS.
The role of the Queen's Institute, which had done so much over 75 years to provide home nursing care to deprived communities and families, became purely honorary. The value of a long service award from the Institute should not however be under estimated. I can imagine the pride and excitement with which Nancy and her sister went to St James's Palace in 1961 - it was fitting tribute to Nancy's many years of work for those most in need.
If you are are interested in nursing history you might enjoy these two blogs History of District Nursing and British Military Nurses. And if you enjoyed this post do come and talk history and genealogy on Twitter and Google+.
A footnote: The picture above, which I found in my great-aunt's belongings, is actually a picture of Queen Mary who died in 1953. There is no inscription and I haven't been able to identify either Nancy or Marjorie in the picture so I don't know what event it actually is, but it provides another example of the role of the royal family in honouring district nurses.