3 ACCIONES PROPUESTAS PARA EL SEGUIMIENT, LA MEJORA Y EL CONTROL DE LOS IMPACTOS
15 OPORTUNIDAD DE MEJORA
5.1 Fase I: Identificación de Oportunidades de Mejora
patients
found it hard to rest [fromJ ... the nightly visitation of bed
bugs'.28 When a bed was vacated a blow lamp applied to the wire-wovekilled the bugs
prior to theroutine disinfecting process. These invasions of bugs also attacked nurses. Saucers
of kerosene around the legs of chairs and hair wound in turbans kept the bugs
at baywhile nurses wrote their night reports.
Alocust swarm caused a stir among the New
Zealanders as nurses rushed around to close doors and windows. The heat took its
toll also and night duty did have one advantage; it was cooler. Nurses complained
about working in the heat and this influenced the arrangements of duties. While a
26
27
28
F. Speedy, 3 October 1915. E. Pengelly, p. 30. E. Lewis, p. 55.nurse's day ran from 7a.m. to 8p.m., with night duty from 7p.m to 7a.m., it became
common practice to work a half day on alternate days to have a break from the
daytime heat. On days when there were large numbers of admissions, a shift might be extended to fifteen or seventeen hours regardless of the heat. On night duty nurses took charge of a military hospital, making judgements to call out the doctor for emergencies. According to Speedy, night superintendent at the Deaconess Hospital which could have 300 to 1000 patients at any one time,
The responsibility is great to my way of thinking, for except in cases of urgent emergency like haemorrhage the Night Superintendent must decide if the Orderly Medical Officer must be called or not.29
To combat military control, nurses attempted to ignore the restrictions of the army. Tents erected on the hospital grounds to make extra beds available for convalescing patients made it easier for convalescents to abscond, unaccounted for, to the prohibited bars for a little alcoholic sustenance.30 This practice created a dilemma for some of the nurses while others saw it as a necessary feature of soldiers' lives. A conspiracy between nurses and soldiers developed. A nurse could use her discretion as to whether she closed her eyes to the comings and goings of the convalescents and 'fail' to notify the duty sergeant. The men arrived back from a few hours at the hotel with 'broad smiles' and sometimes a bunch of flowers for the nurses. This camaraderie worked to the advantage of the nurses, a subtle means to combat their impotence within military institutions. Patients, in tum, spoke favourably about nurses who contravened the rules, with soldier patients also seeing the conspiracy as an act of defiance against military discipline.
Although nurses might attempt to frustrate the military organisation they had compassion for the soldier patients. While working at No 19 British General Hospital, Alexandria, Susannah McGann wrote to a friend describing her feelings:
29 F. Speedy, 5 October 1915. 30 E. Lewis, p. 55
One is doing a big dressing
(I
am in the surgical wards) and you look up at the boy's face, perhaps about 1 8 years, and you know he has little chance of going out with both legs. Its(sic)
truly awful the number of maimed men that will be set adrift after the war.31Even those soldiers described as 'shirkers' and who 'primed each other up in the latest method of how to swing the lead' were regarded tolerantly. The soldiers had a capacity to play the system, which was, in many instances, admired by the nurses. The devastation of war, the loss of lives, and the ghastliness of wounds, realities held in common by soldiers and nurses, drew patients and nurses together against the authorities.
Although army discipline could be thwarted in subtle ways, discipline remained a powerful feature within nursing. Discipline which had formed the basis of nurse training in the civilian nursing structures, also acted to promote the image of the capable military nurse who could successfully work in a variety of situations without loss. of control or overt emotional outbreaks. Even by military standards nursing discipline could
be
exacting. The desire tobe
seen as competent developed into patterns of work which guarded against insinuations of indolence. The expectation that nurses would work hard and avoid idleness became a dominant theme. A busy nurse meant a needed nurse. Nurses repeatedly emphasised how busy they were attending to dressing wounds and giving out medication and, even in a l ull when patient numbers fell, they found work diligently rolling bandages, tidying linen, sterilising the equipment and preparing for the next convoy of patients. Caustic comments made about those nurses considered lazy or lacking in organisation reinforced the belief in a work ethic.While nurses could express sympathy for the heroic soldier, comments on their own personal misfortunes were more restrained. In some ways, the nurses took on the masculine characteristics of bravery expected of the soldiers in a desire to
be
associated fully in military structures. To be strong meant not to cry and not to express sorrow for the loss of relatives. Those who lost brothers or fiancees seemed unwilling to express any sadness and kept their feelings to themselves, gaining praise from other nurses for their ability to 'make the best of it the same as everyone else these days'.32 Self pity, or sympathy for the soldiers, was expected to be
channelled into nursing duties. The soldiers required every ounce of nursing ability and any duty was welcomed as an expression of patriotism, of being at one with 'the boys'. Showing emotions, for example crying, appeared to occur only in private. One nurse used the linen cupboard to cry over the frustration she felt when nursing sick soldiers. Another was said to have 'howled' in her room when notified of her transfer to a new hospital}3 Being able to continue to nurse the sick while 'bullets were flying about our heads and striking the wood work ... and the iron sides of the ship' became a source of pride.34 Those nurses who had duties close to the front line, on hospital ships at Anzac Cove, on barge, or train duty, were envied for their good fortune to be chosen for 'real' military nursing. When nurses had the opportunity to work at No 1 New Zealand Stationary Hospital in France from mid-
1 9 1 6, competition to be selected became intense as everyone wanted to go. The
more unsafe the nursing situation the greater the excitement and the importance of nurses' work.
Nurses recorded in their letters, notes and diaries their good health, weight
gain and avoidance of even the slightest cold. Personal illness was resented as it represented the possibility of being returned to New Zealand and losing any further
32 Violet Petersen, letter to her mother, 13 August 1916. Petersen (22/l90) trained at Palmerston North Hospital registering in 1914. She joined the NZANS in January 1916. On her marriage in 1917 to Doctor Barclay, a member of the Medical Corps, HS Makena. she retired from the Army.
33 F. Speedy, 4 December 1915.
34
M. Crooks MS (this file has no accession number), handwritten notes post war cl960s, Queen Elizabeth IT Army Museum, Waiouru, p. 5. Crooks (22/l2) trained at Palmerston North Hospital and registered 191 1. She worked on the British HS Nevassa. September 1915 to June 1916.opportunity to experience the excitement of military nursing. A number of nurses suffered from enteric fever, rheumatic fever or 'disordered heart action' and others received treatment for appendicitis or tuberculosis.35 While they faced up to the fact that they were ill, there appeared to be a general feeling that illness was a sign of weakness. They commented on the numbers of nurses still able to work while doctors,
V
ADs and orderlies suffered a variety of illnesses. Even sea-sickness became a cause for concern and a number of nurses continued to work while suffering severe sea-sickness. One nurse stubbornly persisted with her hospital ship duties while her nurse friends 'sought out hotels [at each port of call] and brought her brandy as that was the only thing she could keep down'.36 Another nurse who suffered a neurosis became the target of nurses' comments for having 'no control of herself}7 She, like the soldiers who suffered battle fatigue, was seen as cowardly.One major difficulty experienced by New Zealand nurses related to promotion, which remained at the discretion of the army authorities. Most often promotions resulted from length of time in military service, but in some instances individual doctors manipulated a promotion for nurses with whom they had a close working relationship. This drew criticism from nurses overlooked in the promotion round. Length of service also became a source of contention, as record keeping had been neglected in the early part of war. The names of some nurses who left with the second contingent in May 1915, were not recorded in either the army records or the
New Zealand Gazette.
Nor were promotions recorded accurately which meant that a35
36
37
Disordered heart action (DHA and sometimes DAH), also known as soldier's heart. became a common diagnosis for tachycardia of unknown
cause.
It was often stated to be caused by stress but valvular involvement could also be present. Two New Zealand nurses were treated for this condition.B.E. Taylor, MS 1291, WTU, p. 4. Bertha Taylor (22/383) was referring to Ada Taylor (21/382) who was continually sea-sick and fmally accepted the fact she was a bad sailor, returning to New Zealand immediately on reaching Southampton. Her period of military nursing lasted five months. Bertha Taylor