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Nursing training in New Zealand over the last 125 years

Dorothy - 15/07/05

Part 1

Nurse Maude’s experiences and influence on nursing training at Christchurch Hospital

Many changes have taken place in the training of nurses and their conditions of work since nursing in Christchurch came under the spotlight with the work of Sibylla Maude, best known just as Nurse Maude. . The following articles are based on library information and interviews with nurses who have recalled their experiences.

Nurse Maude’s training
The account of the nursing training of Christchurch’s famous Nurse Maude in A Friend in Need: Nurse Maude: her Life and Work by E. M. Somers Cocks is based on the earliest sources of information on hospital training of nurses in closing years of the nineteenth century and is the main source of information for this article.

After childhood in the country a short distance from Christchurch and four years’ education in a London school described as “a select establishment for the daughters of gentlemen”, Sibylla Maude spent time at home helping her mother with the younger children, riding, gardening and visiting the poor in the parish. Many lived in distressing conditions and there was no help for people who were not well off. Sibylla was concerned that she did not have sufficient knowledge to relieve sickness. She decided to follow the example of two of her mother’s sisters and train as a nurse.

She sailed for England in 1889 when she was twenty eight and entered Middlesex Hospital as a paying “Lady Probationer”.

The trainees worked long hours with no labour-saving devices. There was no consideration for the health of the nurse. The ordinary probationers were given the most unpleasant jobs and the best they could hope for was to become a staff nurse under a Sister. In contrast the Lady Probationers, who paid for their training, had a year’s intensive training and lectures and planned to work as sisters.

All the nurses had only three hours free time twice a week. The ordinary probationers worked from 7 a.m. to 9 p.m. The Lady Probationers worked from 8.30 a.m. to 9 p.m. They had to sleep at the hospital every night except for sixteen days holiday.

The Lady Probationers each had a cubicle into which were squeezed a camp bed, a washstand, a chest and a wicker chair. The small sitting room for the Lady Probationers offered little comfort and was usually empty.

The ordinary probationers were in shared rooms.

The staff nurses had their own rooms and the bathrooms were in their building.

The Sisters slept in rooms adjoining their wards and had to go to a separate building to have a bath after which they would have to dress fully to return to their rooms – a discouragement to hygiene.

The matron was a very strict disciplinarian and insisted on perfection in the nurses’ uniforms. The Lady Probationers wore deep violet full length uniforms. They had a three inch train to ensure that their ankles were hidden when they had to lean over a bed. They had to wear frilly caps with violet coloured ribbons tied under the chin.

Sibylla Maude tolerated the unrelenting discipline partly because she had had to submit to rigorous discipline when she was at school and partly because she was doing the work she had chosen and learning many skills.

There was friction between the ordinary probationers and the Lady Probationers. One cause of the friction was that in the absence of the sister the Lady Probationer was left in charge of the ward, no matter how inexperience she was. Another sore point was that the Lady Probationers, but not the non-paying nurses, were allowed to accompany the Medical Officers on their rounds of the patients. Another privilege granted to the Lady Probationers was that they were the only ones who had lectures.

Sibylla Maude stayed for a second year as sister in charge of a surgical ward where she worked under two famous surgeons, Sir Henry Morris and Sir J. Bland Sutton, pioneers in new types of surgery.

She worked long hours – 8.30 a.m. to 11 p.m. She was supposed to have a two-hour break five times in a week, but that seldom happened. She had 24 hour responsibility as she slept in a room opening off the ward. Her bedroom, sitting room/office and dining room were all dreary.

Return to New Zealand and appointment as matron
Sibylla Maude returned to New Zealand and was appointed matron of the Christchurch Public Hospital in 1893.

The situation at the Public Hospital
At first only the resident surgeon was qualified. The manager was possibly trained as a dispenser, and his wife who had no training was the matron in charge of the nursing and domestic staff. The nurses were any men and women prepared to do the work and no training was required.

The accounts of the period for all New Zealand hospitals included a daily ration of one pint of beer for the staff or four ounces of brandy in lieu thereof.

In 1881 the first trained nurse was appointed as matron of the Christchurch Hospital, but her nurses were still untrained. Improvement began but proceeded slowly because of financial difficulties.

By 1901 there were more trained staff and almost all wards were in the charge of a trained nurse. Young probationers were now taken in for training which included lectures from the matron and the resident surgeon. The only qualification required was the ability to read and write, and there was little discipline. Nurses would absent themselves without letting the authorities know, sometimes for several days. The matron would promote a wardsmaid or laundrymaid to nursing duties if she was short of staff.

The hospital was small with only sixty to seventy patients, and consisted of a mixture of buildings.

Dr Clennell Fenwick described the hospital in 1895. “Ward 2, the upper floor of a two storey building, consisted of two rooms, the outer for chronic cases, and the inner for those suffering from some condition of the eyes. The cases in the outer ward consisted of bad legs, a typhoid case, and two patients very ill with consumption. The eye-ward was a most dismal place, the black walls and darkened windows made it the most depressing ward I have ever seen. The male attendant was an elderly man, whose sole claim to nursing skills was a kind heart and a Scotch accent.”

He had high praise for the sister in charge of the ground floor which was for chronic female cases, and some children, and for the Sisters in charge of the other wards. The operating theatre was spotless. It was used for both operations and inquests!

The living conditions of the nurses were far from satisfactory. They worked, ate, and slept in or near the wards and worked a twelve to fourteen hour day. (Eight-hour shifts were not introduced until 1907.) Their sleeping quarters were shared attics above the wards. Their meals were monotonous and of very poor quality.

There were no well-organised systems for the training of the young nurses, the work of the domestic staff, or the maintenance of hygiene in the hospital. The Board members were constantly quibbling about financial management and resisted suggestions for improvements which would cost money.

This was the hospital situation which greeted Nurse Maude when she arrived to take up her duties as matron. From the time of her arrival until her resignation in November 1896 she struggled to lift the standards of the hospital, especially in regard to the nursing staff.

There was constant friction between her and the Board about the expenditure involved in new buildings. Then Mr Hyman Marks, a wealthy Jewish businessman, died and left a large sum of money for additional buildings and a large new ward was built. Nurse Maude continued to agitate for new accommodation for the nurses and the public of Christchurch supported her. After a public meeting prominent citizens promised financial assistance, and in 1895 a fine stone building was built on the corner of Lincoln and Riccarton Roads. As the nurses moved out of their attic rooms the wardsmaids moved in.

Nurse Maude did not enjoy an organising role and continued to be deeply concerned about the lack of care for the chronically ill patients for whom there was little room in the hospital and who could not afford the cost of a pound a week.

With the support of a small group of people she resigned from her position at the hospital in 1896, and began her work as a district nurse starting an initiative which still continues today as “The Nurse Maude Association”.

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