The Life of Florence Nightingale Volume I Part 16

The behaviour of some (but not all) of the military officers, and of the men who caught their manners from the officers, was at first different.

There was sometimes ill-disguised jealousy, and consequent sulkiness.

Outwardly, there was politeness; but difficulties were put into the way of "the Bird," as some of them called her behind her back, and she was left to s.h.i.+ft for herself, when a little help might have eased the burden. "It is the Bird's duty," they would say. Miss Nightingale, however, kept perfect command of her temper. "She was always calm and self-possessed," says one of the Roman Catholic Sisters; "she was a perfect lady through everything--never overbearing. I never heard her raise her voice."

Upon most of the medical men on the spot she made a good impression at once, because she proved herself to be efficient and helpful. She applied the expert's touch. But there were doctors and doctors. Some welcomed her and her staff, and made as much use of them as possible.

Others resented their presence, and threw obstacles in their way. There was one ward in which the junior medical officers had been advised by their superior to have as little to do with Miss Nightingale as possible. She showed exemplary patience under this kind of opposition, and gradually won her way into the confidence of most of the doctors.[95] "Miss Nightingale told us," says one of her staff, "only to attend to patients in the wards of those surgeons who wished for our services, and she charged us never to do anything for the patients without the leave of the doctors."[96] "The number of nurses admitted into each division of a hospital depended," Miss Nightingale herself explained, "upon the medical officer of that division, who sometimes accepted them, sometimes refused them, sometimes accepted them after they had been refused; while the duties they were permitted to perform varied according to the will of each individual medical officer."[97]

That this ill-defined state of things called constantly for tact and diplomacy on the part of the Lady Superintendent, and often for severe self-restraint, will readily be perceived.

[95] See _Pincoffs_, p. 79.

[96] _Eastern Hospitals_, vol. i. p. 71.

[97] _Notes_, p. 152.

On the first arrival of Miss Nightingale and her staff, the wounded were pouring in fast, and the nurses were told off to the worst surgical cases:--

"Comfort yourselves," wrote Mr. Bracebridge to her parents (Nov.

20), "that what the good Flo has done and is doing is priceless, and is felt to be so by the medical men--the cleanliness of the wounds, which were horribly dirty, the general order and arrangement. There has not been half the jealousy I expected from them towards her."

"As to Miss Nightingale and her companions," wrote Mr. Osborne to Mr. Herbert (Nov. 15), "nothing can be said too strong in their praise; she works them wonderfully, and they are so useful that I have no hesitation in saying some 20 more of the same sort would be a very great blessing to the establishment. Her nerve is equal to her good sense; she, with one of the nurses and myself, gave efficient aid at an amputation of the thigh yesterday. She was just as cool as if she had had to do it herself."[98]

[98] _Stanmore_, vol. i. p. 349.

A letter from Miss Nightingale herself to her friend of Harley Street, Dr. Bowman, the ophthalmic surgeon, gives a lively account of some of her difficulties, and a vivid picture of the horrors amid which her work was done (Nov. 14):--

"_I came out, Ma'am, prepared to submit to everything, to be put upon in every way. But there are some things, Ma'am, one can't submit to. There is the Caps, Ma'am, that suits one face, and some that suits another. And if I'd known, Ma'am, about the Caps, great as was my desire to come out to nurse at Scutari, I wouldn't have come, Ma'am._"--_Speech of Mrs. Lawfield_.--Time must be at a discount with the man who can adjust the balance of such an important question as the above, and I for one have none: as you will easily suppose when I tell you that on Thursday last we had 1715 sick and wounded in this Hospital (among whom 120 Cholera Patients), and 650 severely wounded in the other Building called the General Hospital, of which we also have charge, when a message came to me to prepare for 510 wounded on our side of the Hospital who were arriving from the dreadful affair of the 5th November from Balaklava, in which battle were 1763 wounded and 442 killed, besides 96 officers wounded and 38 killed. I always expected to end my Days as Hospital Matron, but I never expected to be Barrack Mistress. We had but half an hour's notice before they began landing the wounded. Between one and 9 o'clock we had the mattresses stuffed, sewn up, laid down--alas! only upon matting on the floor--the men washed and put to bed, and all their wounds dressed. I wish I had time. I would write you a letter dear to a surgeon's heart. I am as good as a _Medical Times_! But oh! you Gentlemen of England who sit at Home in all the well-earned satisfaction of your successful cases, can have little Idea from reading the newspapers of the Horror and Misery (in a Military Hospital) of operating upon these dying, exhausted men. A London Hospital is a Garden of Flowers to it.

We have had such a Sea in the Bosphorus, and the Turks, the very men for whom we are fighting, carry in our Wounded so cruelly, that they arrive in a state of Agony. One amputated Stump died 2 hours after we received him, one compound Fracture just as we were getting him into Bed--in all, twenty-four cases died on the day of landing. The Dysentery Cases have died at the rate of one in two.

Then the day of operations which follows....

We are very lucky in our Medical Heads. Two of them are brutes, and four are angels--for this is a work which makes either angels or devils of men and of women too. As for the a.s.sistants, they are all Cubs, and will, while a man is breathing his last breath under the knife, lament the "annoyance of being called up from their dinners by such a fresh influx of wounded"! But unlicked Cubs grow up into good old Bears, tho' I don't know how; for certain it is the old Bears are good. We have now _four miles_ of Beds, and not eighteen inches apart.

We have our Quarters in one Tower of the Barrack, and all this fresh influx has been laid down between us and the Main Guard, in two Corridors, with a line of Beds down each side, just room for one person to pa.s.s between, and four wards. Yet in the midst of this appalling Horror (we are steeped up to our necks in blood) there is good, and I can truly say, like St. Peter, "It is good for us to be here"--though I doubt whether if St. Peter had been here, he would have said so. As I went my night-rounds among the newly wounded that first night, there was not one murmur, not one groan, the strictest discipline--the most absolute silence and quiet prevailed--only the steps of the Sentry--and I heard one man say, "I was dreaming of my friends at Home," and another said, "I was thinking of them." These poor fellows bear pain and mutilation with an unshrinking heroism which is really superhuman, and die, or are cut up without a complaint.

The wounded are now lying up to our very door, and we are landing 540 more from the _Andes_. I take rank in the Army as Brigadier General, because 40 British females, whom I have with me, are more difficult to manage than 4000 men. Let no lady come out here who is not used to fatigue and privation.... Every ten minutes an Orderly runs, and we have to go and cram lint into the wound till a Surgeon can be sent for, and stop the Bleeding as well as we can. In all our corridor, I think we have not an average of three Limbs per man. And there are two s.h.i.+ps more "loading" at the Crimea with wounded--(this is our Phraseology). Then come the operations, and a melancholy, not an encouraging List is this. They are all performed in the wards--no time to move them; one poor fellow exhausted with haemorrhage, has his leg amputated as a last hope, and dies ten minutes after the Surgeon has left him. Almost before the breath has left his body it is sewn up in its blanket, and carried away and buried the same day. We have no room for Corpses in the Wards.

The Surgeons pa.s.s on to the next, an excision of the shoulder-joint, beautifully performed and going on well. Ball lodged just in the head of the joint and fracture starred all round. The next poor fellow has two Stumps for arms, and the next has lost an arm and a leg. As for the b.a.l.l.s they go in where they like and come out where they like and do as much harm as they can in pa.s.sing. That is the only rule they have....

I am getting a Screen now for the amputations, for when one poor fellow, who is to be amputated to-morrow sees his comrade to-day die under the knife, it makes impression and diminishes his chance.

But, anyway, among these exhausted Frames, the mortality of the operations is frightful. We have Erysipelas, fever and gangrene, and the Russian wounded are the worst.

We are getting on nicely though in many ways. They were so glad to see us. The Senior Chaplain is a sensible man, which is a remarkable Providence.... If you ever see Mr. Whitfield, the House Apothecary of St. Thomas', will you tell him that the nurse he sent me, Mrs. Roberts, is worth her weight in gold.... Mrs. Drake is a Treasure. The four others are not fit to take care of themselves, but they may do better by and bye if I can convince them of the absolute necessity of discipline. We hear there was another engagement on the 8th and more wounded, who are coming down to us.

This is only the beginning of things.

The Senior Chaplain had the sense, among other things, to appreciate Miss Nightingale. "The Chaplain says," wrote Mr. Nightingale to a friend (Dec. 12), "'Miss Nightingale is an admirable person; none of us can sufficiently admire her. A perfect lady, she wins and rules every one, the most rugged official melts before her gentle voice, and all seem glad to do her bidding.'"

Florence Nightingale had that "excellent thing in woman": Lady Lovelace, in the poem already quoted, spoke of her friend's "soft, silvery voice"; but it could command, as well as charm, unless indeed it were the charm that commanded. "She scolds sergeants and orderlies all day long," wrote Mr. Bracebridge to her parents (Nov. 20); "you would be astonished to see how fierce she is grown." That was written, of course, in fun; but there was always a note of calm authority in her voice. A Crimean veteran recalled her pa.s.sing his bed with some doctors, who were saying, "It can't be done," and her replying quietly, "It _must_ be done." "I seem to hear her saying it," writes one who knew her well; "there seemed to be no appeal from her quiet conclusive manner."

With regard to the nurses, Miss Nightingale, as may be gathered from the letter to Dr. Bowman, found them rather a difficult team to drive, and this fact should be remembered in considering an episode presently to be related (II.). She had to send one nurse back to England at once, filling the vacancy by a German Sister from the Kaiserswerth colony at Constantinople. Of the six nurses supplied by St. John's House, "four, alas! returned shortly from Scutari, not being prepared to accept the discipline and privations of the life out there."[99] We need not be too impatient with Mrs. Lawfield (who turned out an excellent nurse) for her objection to the cap. The uniform, devised on the spur of the moment, seems to have been very much less becoming than that of the "Staff Nurse, New Style," with her "gown of silver gray, bright steel chain, and chignon's elegant array."[100] The Nightingale nurses in the East wore "grey tweed wrappers, worsted jackets, with caps and short woollen cloaks, and a frightful scarf of brown holland, embroidered in red with the words, 'Scutari Hospital.'"[101] Such is the description of the costume worn by the seculars which is given by one of the Roman Catholic Sisters, not without some pity as she thought of her own religious habit. But the short cloak should not be so contemptuously dismissed.

"The red uniform cape worn by the ladies of the Queen Alexandra's Imperial Military Nursing Service is modelled on that originally introduced by Florence Nightingale for the nurses whom she took with her to Scutari. This cape may therefore be regarded as a memorial to the great founder of military nursing."[102] As for the "frightful scarf"

some such distinctive badge was a very necessary precaution amid the rough-and-tumble of a military depot and its camp-followers. A raw new-comer was seen to approach one of the nurses in the street. "You leave her alone," said his mate, "don't you see she's one of Miss Nightingale's women?" Their cloth was respected throughout the camps; but Miss Nightingale had to dismiss two or three for levity of conduct.

On arriving at Scutari, she had placed ten in the General Hospital and twenty-eight in the Barrack Hospital, and in neither did she find it easy to maintain discipline. From time to time she transferred nurses, sending the best to other hospitals, keeping the less trustworthy under her own eye; and sending some home, who were unwilling to stay or found incompetent, as other recruits arrived. Of the thirty-eight in the first party, she considered that not more than sixteen were really efficient, whilst five or six were in a cla.s.s of excellence by themselves.

[99] _St. John's House: a Record_, p. 8.

[100] W. E. Henley, _In Hospital_.

[101] _Memories of the Crimea_, by Sister Mary Aloysius, p. 17. The "frightful scarf" was a plain band worn, I suppose, over one arm and under the other.

[102] _Journal of the Royal Army Medical Corps_ (Bibliography B, No.

52), p. 393.

The difficulties--including the great Dress Question--which Miss Nightingale had with her staff, appear clearly enough in the "Rules and Regulations for the Nurses attached to the Military Hospitals in the East," which Miss Nightingale presently sent home to Mr. Herbert, who had them printed, and handed to every candidate for appointment as nurse. "As it has been stated," says the preamble, "that the nurses who have gone to the hospitals in the East, have in some instances complained of being subject to hards.h.i.+ps and to rules for which they were not previously prepared, and of having to do work differing from what they expected, it has been thought desirable to state distinctly the regulations relative to the outfit, clothing, duties, and position of nurses in military hospitals." The nurses, it is then set forth, "are required to appear at all times in the regulation dress with the badge, and never to wear flowers in their bonnet-caps, or ribbons, other than such as are provided for them, or are sanctioned by the superintendent."

Another rule defines the precise quant.i.ties of spirituous liquor which a nurse will be allowed; a third states that "no nurse will be allowed to walk out except with the housekeeper, or with a party of at least three nurses together, and never without leave previously obtained." The whole code shows the necessity which Miss Nightingale had found for enforcing strict discipline.[103] And even with these new regulations to back her, she still found discipline hard to enforce. Her official letters to the War Office complain of unsuitable recruits being sent out to her, and of the greater number of them as being "wholly undisciplined."

[103] The ma.n.u.script of this doc.u.ment is preserved among the archives of the War Office. The text of these, "the earliest rules defining the position and duties of a female nurse in any military hospital,"

has been printed elsewhere (Bibliography B, No. 52).

II

In December 1854 Miss Nightingale was astonished to receive an announcement that a party of forty-seven more nurses, under the care of her friend, Miss Mary Stanley, were on their way to join her. She remonstrated, and threatened to resign:--

"You have sacrificed the cause so near my heart," she wrote to Mr.

Sidney Herbert (Dec. 15); "you have sacrificed me, a matter of small importance now; you have sacrificed your own written word to a popular cry. You must feel that I ought to resign, where conditions are imposed upon me which render the object for which I am employed unattainable, and I only remain at my post till I have provided in some measure for these poor wanderers."

Mr. Herbert replied, as his biographer states, in terms of courtesy and kindliness, and without any trace of the bitterness which Miss Nightingale's vehemence might have evoked in a smaller-minded man. There is a letter to Mrs. Bracebridge (Dec. 27) in which Mrs. Herbert says: "I am heart-broken about the nurses, but I do a.s.sure you, if you send them all home without a trial, you will lose some really valuable women." The Minister had authorized Miss Nightingale, if on full consideration she thought fit, to return Miss Stanley's party to England at his own private expense. Her good sense soon showed her that such a course would be, as she wrote, "a moral impossibility"; and in the end she made the best she could of what she considered a bad job--to the great advantage, as it was to turn out, of the wounded soldiers, though at a great increase to her own responsibilities and difficulties.

Much has been made in some quarters[104] of this episode, and it may be well here to explain Miss Nightingale's position clearly; for the affair throws strong light upon the difficulties of her task. It is essential to know, in the first place, that Mr. Herbert had distinctly stated that the selection of nurses was to be exclusively in Miss Nightingale's hands. This is implied in his official instructions (p. 156), and was stated with the utmost emphasis in a letter "to a correspondent," which he had caused to be inserted in the newspapers of October 24. Already the cry had been raised that more nurses should be sent, and volunteers were clamouring for enlistment. Mr. Herbert thereupon wrote:--

WAR OFFICE, _October_ 21 [1854].... The duties of a hospital nurse, if they are properly performed, require great skill as well as strength and courage, especially where the cases are surgical cases and the majority of them are from gunshot wounds. Persons who have no experience or skill in such matters would be of no use whatever; and in moments of great pressure, such as must of necessity at intervals occur in a military hospital, any person who is not of use is an impediment. Many ladies, whose generous enthusiasm prompts them to offer their services as nurses, are little aware of the hards.h.i.+ps they would have to encounter, and the horrors they would have to witness, which would try the firmest nerves. Were all accepted who offer, I fear we should have not only many inefficient nurses, but many hysterical patients themselves requiring treatment instead of a.s.sisting others....

No additional nurses will be sent out to Miss Nightingale until she shall have written home from Scutari and reported how far her labours have been successful, and what number and description of persons, if any, she requires in addition.... No one can be sent out until we hear from Miss Nightingale that they are required.

[104] Especially by Lord Stanmore in his _Memoir of Sidney Herbert_. He handles it, I think, with some needless asperity, and he might have mentioned Mr. Herbert's letter which is here quoted.

Miss Nightingale had not written home in that sense at all, but Mr.

Herbert had sent the nurses. That was what she meant when she said that he had "sacrificed his own written word." "Had I had the enormous folly," she wrote to Mr. Herbert (Dec. 15), "at the end of eleven days'

experience, to require more women, would it not seem that you, as a statesman, should have said, 'Wait till you can see your way better.'

But I made no such request." She was an expert, and did not wish to be inundated with amateurs. Moreover, everybody at Scutari knew, as she wrote, the terms of Mr. Herbert's letter to the newspapers, and the medical men knew that she had not asked for any more nurses. Yet here was a new party sent out; and, to make the encroachment on her domain the more marked, Miss Stanley had received instructions to, and reported herself to, not the Superintendent of the Nurses, but other officials.

Miss Nightingale felt that her authority had been flouted, her position undermined. But personal considerations were not the cause of her vexation. It was not a case of "pique," as some people in England imagined. Mr. Herbert and she were engaged in making a new experiment.

It was full of difficulties, and the only chance of success lay in the maintenance of undivided responsibility and clearly established authority. Miss Nightingale could not quietly have accepted the new situation without sacrificing the key of the position. Had she acquiesced, she would have admitted that Mr. Herbert might henceforth send out nurses without consulting her, and without placing them expressly under her orders. She would have left herself at the mercy of any well-meaning person in England who thought that this or that might be helpful to her. Her judgment would no longer have been the governing factor; while yet for any confusion or failure that might follow, she would be held responsible. Mr. Herbert thought, no doubt, that already the experiment had been a great success, as indeed it was, and he was eager to increase the scale of it. He might not unreasonably think that, as the number of the wounded increased, so should the number of female nurses be increased also. Mr. Osborne's remark, cited above (p. 183), must have confirmed him in such an opinion. But to Miss Nightingale on the spot the case wore a very different aspect. We must remember the severe mental strain of her position; the high pressure of work and emotion at which she was living, all the higher to one of her intensely sensitive conscientiousness; the continual failure (to her critical mind) of attempts to reform cruel abuses; the danger of real, acknowledged failure always present. In such a position, the arrival of a fresh batch of nurses, unexpected and unsolicited, must have seemed to her the break-up of all her plans, the destruction of the standard of nursing which she was painfully creating, the gravest peril to an experiment, still on its trial, and ever subject to hostile criticism.

Immediate and practical difficulties were also great. There was no accommodation in the hospitals at Scutari available for additional female nurses. "The 46," wrote Mr. Bracebridge to Mr. Smith (Dec. 18), "have fallen on us like a cloud of locusts. Where to house them, feed them, place them, is difficult; how to care for them, not to be imagined." The Princ.i.p.al Medical Officer flatly refused to have any more, and Miss Nightingale herself felt that she could not manage any more:--

"I have toiled my way," she wrote (Dec. 15), "into the confidence of the Medical Men. I have, by incessant vigilance, day and night, introduced something like system into the disorderly operations of these women. And the plan may be said to have succeeded in some measure, _as it stands_.... But to have women scampering about the wards of a Military Hospital all day long, which they would do, did an increased number relax the discipline and increase their leisure, would be as improper as absurd."

And there was a further objection. A considerable number of the second party were Roman Catholics, and Miss Stanley herself (as Miss Nightingale well knew) was on the verge of joining the Roman Communion.

How much this factor in the case added to the force of Miss Nightingale's objections, we shall learn in a later chapter. Mr. Herbert thought, I suppose, that the additional nurses would be welcome to her because they came under the escort of a friend. But so strongly did Miss Nightingale feel on the subject, that Miss Stanley's part in the affair rankled the more. It was in the house of her friends, she felt, that she had been wounded. Their personal relations were further embittered by the case of a nurse whom Miss Nightingale (with the concurrence of the other authorities) felt obliged to dismiss, but whom Miss Stanley believed to be ill-used. Miss Nightingale's friends.h.i.+p with Mr. and Mrs.

Herbert was in no way impaired. They had confessed themselves in the wrong; and so she was deeply touched, as she wrote, by their kindness and generosity. But between her and Miss Stanley the breach was never healed. Their later lives took different directions, and they did not meet again.