The Good Nurse: Women Philanthropists and the Evolution of Nursing in Nineteenth-Century Dublin

University of St. Thomas (Center for Irish Studies)

The Good Nurse: Women Philanthropists and the Evolution of Nursing in Nineteenth-CenturyDublinAuthor(s): Margaret PrestonSource: New Hibernia Review / Iris Éireannach Nua, Vol. 2, No. 1 (Spring, 1998), pp. 91-110Published by: University of St. Thomas (Center for Irish Studies)Stable URL: http://www.jstor.org/stable/20557475 .

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Margaret Preston

The Good Nurse:

Women Philanthropists and the

Evolution of Nursing in

Nineteenth-Century Dublin

Women philanthropists were integral to the improvement in the quality of nine

teenth-century nursing in Ireland. Victorian women nursed family members be

cause British society advocated that women had those characteristics that made

them particularly able to care for others. Florence Nightingale noted that "Every women, or at least almost every woman ... has, at one time or another of her life,

charge of the personal health of somebody, whether child or invalid?in other

words?every woman is a nurse."1 Upper-class philanthropists who called for

nursing reforms believed that nursing was a woman's sphere of activity as well

as an integral part of the fight for sanitary reform.2 However, owing to the servile

nature of nursing, the majority of upper-class women would not enter nursing

for fear of risking their respectability. The few upper-class women who did ac

cept paid positions in nursing, generally served only in an administrative capacity.

Nevertheless, upper-class women became integrally involved in the day-to-day

operations of hospitals by voluntarily providing direction and advice, improv

ing nurse training, fund-raising, and a host of administrative functions. Women

philanthropists hoped not only that nurses would perform the menial chores,

but that they would also become missionaries to the lower classes. Nurses would

help to make the poor better subjects of the state by going into their homes, teach

ing sanitary practices, and by advocating hard work and moral living.3

i. Florence Nightingale, Notes on Nursing: What it is and What it is Not (London: Harrison, i860),

preface. 2. Susan Armeny, "Organized Nurses, Women Philanthropists, and the Intellectual Bases for Co

operation Among Women, 1898-1920," in Nursing History New Perspectives, New Possibilities, ed.

Ellen Condlifee Lagemann (New York: Teachers College Press, 1983), p. 33.

3. I would also suggest that the improvement of the quality of nursing was an additional func

tion of an increasingly invasive medical industry which became another part of the state agenda of

policing the masses. See Michel Foucault, The Birth of the Clinic: an Archaeology of Medical Percep tion (New York: Pantheon Books, 1973) and Michel Foucault, Power/Knowledge: Selected Interviews

and Other Writings, 1972-1977, ed. Colin Gordon (New York: Pantheon Books, 1980).

NEW HIBERNIA REVIEW/lRIS ?IREANNACH NUA, 2:1 (sPRING/EARRACH, 1998), 9I-UO



The Evolution of Nursing in Nineteenth-Century Dublin

Importantly, at the same time that philanthropists endeavored to reform nurs

ing, they also helped to establish another career to add to working women's lim

ited list of employment options in the nineteenth century. The support of nursing reform and efforts to make nursing a career for

women was a logical step for philanthropists. Upper-class women in the nine

teenth century were expected to nurse family members. Women were believed

to have characteristics which made them particularly able to care for others. So

ciety assumed that women were naturally gentle, kind, and nurturing; these were

the characteristics nursing reformers associated with a "good"

nurse. Hence,

women of charity easily incorporated nursing into visiting the poor or volun

teering in hospitals. Susan Armeny argues that what linked women philan

thropists to nursing was not necessarily

a striving for women's rights

or equal

ity, but a commonalty in the desire for sanitary reform and improvement

particularly because the unsanitary state of the working classes, philanthropists

believed, lead to indigence and immorality.4 Evidence supporting this specula tion includes the establishment by philanthropists of visiting societies, which

went to the homes of the poor and discussed sanitary techniques, as well as the

great emphasis by reformers in their writings over the need for sanitary train

ing for the poor. Ladies showed their interest in nursing reforms in a variety of

ways, including learning nursing techniques. For example, in 1880, Dublin's Bag

got Street Hospital allowed its ladies committee to use the hospital's theater "to

hold a class to instruct Ladies in the preliminary treatments of accidents, etc."5

As Monica Baly notes, Florence Nightingale argued for the improvement of

nursing as

only one part of her overall reform agenda, and "for this reason she

saw nursing

as more than a mere handicraft but rather a sanitary mission."6

The evolution of nursing in nineteenth-century Ireland is characterized by the fact that Irish women had few employment options, particularly after the

Famine.7 Prior to the Famine, while farmland continued to be divided up among the sons, many women found husbands and work on the farm. However, after

the Famine, farms were consolidated, tillage turned to pasturage, and the land

4- Armeny, p. 33. Armeny argues that nurses and laywomen in America came together not out of

feminist solidarity, but over the Victorian desire for sanitary reform and the push to organize and

professionalize nursing.

5. Royal City of Dublin Hospital (R.C.D.), 12 March 1880.

6. Monica Baly, Florence Nightingale and the Nursing Legacy (London: Croom Helm, 1986),

pp. 22-3.

7. See: Joanna Bourke, Husbandry To Housewifery: Women, Economic Change, and Housework in

Ireland 1890-1914 (Oxford: Clarendon Press, 1993); Rita M. Rhodes, Women and the Family in Post

Famine Ireland: Status and Opportunity in a Patriarchal Society (New York: Garland Publishing,

1992).

92




was almost always left to the eldest male, while the other children were left to

fend for themselves and women's options were more limited. Many Irish women

found work as domestics or in factories?particularly in the North.8 Not sur

prisingly, as employment opportunities for women became increasingly scarce

and as the age of marriage rose and the numbers getting married declined, many

Irish women had little choice but to emigrate.9 Thus, throughout the nineteenth

century, Irish women emigrated almost as frequently as Irish men and, by the

end of the century, were leaving the country in equal and sometimes greater numbers than their male counterparts.10 Increasingly, nursing, along with

teaching, became another among the few employment options for Irish women

in the nineteenth century, and Irish nurses found use for their skills both at

home and abroad."

The medical community in Ireland, and in Dublin in particular, was work

ing to improve the nursing profession even before Florence Nightingale left for

the Crimea. By the nineteenth century, Ireland had a well-developed medical

system and this, combined with the dramatic increase in numbers of women

entering the convent?for nuns lead the charge in nineteenth-century nursing

reform?helped to lay the basis for improvement of medical care. The upper class women of Ireland were fundamental to the reform of nursing and its cre

ation as a career for working-class Irish women. Through their important work

on hospital's ladies committees, their efforts to establish nursing schools and

visiting charities, and through their employment as lady superintendents, upper class women worked to mold a career which they believed would emphasize the

8. Mona Hearn, Below Stairs: Domestic Service Remembered in Dublin and Beyond 1880-1922

(Dublin: Lilliput Press, 1993) and Women Surviving: Studies in Irish Women s History in the 19th and

20th Centuries, ed. Maria Luddy and Cliona Murphy, (Dublin: Poolbeg Press, 1990).

9. "... Singulate mean age at marriage for women in 1821 was 26.2 rising to 27.5 in 1861 while the

percentage of females never marrying rose from 12.5% in 1841 to 17.1% in 1881 to 24.9% in 1911 " Cor

mac ? Grada, Ireland: A New Economic History 1780 1939 (Oxford: Clarendon Press, 1995), p. 215.

10. Between 1896 and 1905, more Irish women between the ages of 20-24 emigrated than men of

that age. David Fitzpatrick, "A share of the honeycomb: Education, Emigration and Irishwomen "

Continuity and Change, 1,2 (1986), 224.

11. Regarding Irish women's emigration, see, Pauric Travers, "Emigration and Gender: The Case

of Ireland, 1922-60" in Chattel Servant or Citizen: Women's Status in Church, State and Society, ed.

Sabine Wiehert and Mary O'Dowd (Belfast: Institute of Irish Studies, 1995), pp. 187-99. Travers notes

that between 1948 and 1951 over 5,000 Irish nurses emigrated to England alone (189). See also: Irish

Women and Irish Migration, ed. Patrick O'Sullivan (London: Leicester University Press: 1995); Janet

A. Nolan, Ourselves Alone: Women's Emigration from Ireland 1885-1920 (Louisville: University of Ken

tucky Press, 1989); Pauline Jackson, "Women in Nineteenth Century Irish Emigration," International

Migration Review, XXIII, 4 (1984), 1004-112; Hasia Diner, Erin's Daughters in America (Baltimore:

The Johns Hopkins University, 1983).

93




importance of sanitary living to all. As reformers realized that they could not

recruit upper-class women to nursing, they decided to mold working-class women into the respectable nurses and sanitary reformers. Then, by sending

these working-class nurses into hospitals and poor neighborhoods, philan

thropists were able to implement their sanitary agenda and thereby, they hoped, create a more moral and honest working-class population.

John Fleetwood in his The History of Medicine in Ireland notes that St. Patrick

established one of the first hospitals in Ireland and recruited St. Brigid and her

companions to minister to the sick.12 The first physicians were generally in ser

vice to nobles or chieftains and their position was hereditary. Additionally, there

were monastic infirmaries that generally catered to the leper communities, as

did, for example, the Lazar House of St. Stephen founded in Dublin in 1344.13

By the eighteenth century, Dublin was in great need of a place in which the poor, and particularly children, could receive medical assistance. Hence, in 1740 the

government permitted part of the Elizabethan workhouse to become the

Foundling Hospital for Dublin's many abandoned children.14 In 1774 the gov ernment named Cork, Dublin, Limerick, and Waterford as the four cities where

it would build homes to place poor, helpless persons along with vagabonds and

sturdy beggars.15 The administrators of these "Houses of Industry," as they were

called, put healthier inmates to work; provided medical facilities, which in

Dublin eventually became the Whitworth Medical Hospital; hired physicians to

care for the inmates; and enlisted unpaid female inmates to nurse. When Eng

12. John F. Fleetwood, The History of Medicine in Ireland (Dublin: The Skeliig Press, 1983), p. 12.

13. Flack, "Nursing in Ireland," p. 435. See: David Mitchell, A Peculiar Place: The Adelaide Hospital,

Dublin, Its Times, Places and Personalities 1839 to 1989 (Dublin: Blackwater, 1989); Mark Hennessy,

"The Priory and Hospital of New Gate: the Evolution and Decline of a Medieval Monastic Estate"

in Common Ground Essays on the Historical Geography of Ireland, ed. William J. Smyth and Kevin

Whelan (Cork: Cork University Press, 1988), 41-54; and Anonymous, "The Medical Charities of Ire

land,'' Dublin University Magazine, XX (July, 1842), 88-101.

14. Originally for adult paupers, when the Foundling Hospital opened its object was two fold. First,

to prevent exposure and death of children, and second, to educate children "in the reformed or

Protestant Faith, and thereby to strengthen and promote the Protestant interest in Ireland." Beat

rice Bayley Butler, "Lady Arabella Denny, 1707-1792" Dublin Historical Record, IX, I (December,

1946-February, 1947), 4. See also: Joseph Robins, The Lost Children: A Study of Charity Children in

Ireland 1700-1900 (Dublin: Institute of Public Administration, 1980); Mary Haydon, "Charity Chil

dren in 18th Century Dublin," Dublin Historical Record, 2 (1942-3), 94.

15. See: J. D. H. Widdess, The Richmond, Whitworth and Hardwicke Hospitals (Dublin: Beacon

Printing, 1972), p. 10; E. Evans, "History of Dublin Hospitals: House of Industry Hospital," The Irish

Builder, 39 (1897), 159-60; William Thornley Stoker, "The Hospitals of the House of Industry" Dublin

Journal of Medical Science, LXXX (December, 1885), 469-86.

94




land passed the New Poor Law of Ireland Act in 1838, Dublin's House of Indus

try was turned into a workhouse and the medical facilities became public

hospitals.16

In 1718, prior to the establishment of the Whitworth Hospital, a small num

ber of surgeons established the Charitable Infirmary in order to take in accident

victims.17 In 1724, Mary Mercer, the wealthy daughter of a Dublin doctor, pro

posed to build a refuge for twenty poor girls in a home she owned on Stephen's Street. Ten years later in 1734, Mercer permitted the house to be turned into a

hospital?known as Mercer's Hospital?for those with diseases, "such as falling sickness, lunacy, leprosy and the like."18 Dr. Steevens' Hospital was established

in 1733 by the will of Dr. Richard Steevens, a successful Dublin physician.19 In

1745, Bartholomew Mosse opened the first lying-in, maternity, and teaching

hospital in the British Isles.20 At the end of the century in 1784, the Royal Col

lege of Surgeons of Ireland was founded in a building next door to Mercer's

Hospital to which it officially became affiliated.21

By the nineteenth century, Dublin's medical landscape also included St.

Patrick's Hospital (1745), Royal Hospital for Incurables (1792), Cork St. Fever

Hospital (1804), Coombe Hospital (1823), Royal Victoria Eye and Ear Hospital

(1814); National Children's Hospital (1821) and National Maternity Hospital

(1884).22 In 1839 Albert Walsh established the Adelaide Institution and Protes

tant Hospital which catered exclusively to Protestants. This hospital also founded

one of the first nursing schools in Dublin which, when it opened in 1861, ac

i6. Widdess, p. 73.

17. See: The Charitable Infirmary Jervis Street, 1718-1987: A Farewell Tribute, ed. Eoin O'Brien

(Dublin: The Anniversary Press, 1987); Eoin O'Brien and Anne Crookshank, A Portrait of Irish Med

icine: An Illustrated History of Medicine in Ireland (Dublin: Ward River Press, 1984); Anon., "History of Dublin Hospitals and Infirmaries from 1188 till the Present Time," The Irish Builder, 38 (Sep

tember, 1896-January, 1897).

18. Fleetwood, The History of Medicine, p. 115.

19. Dr. Steevens' Hospital was closed in 1987 and the handsome building, modeled on the H?tel

des Invalides, still stands today housing the offices of the Eastern Health Board of Ireland. See: T.

Percy Kirkpatrick, The History of Doctor Steevens1 Hospital, Dublin, 1720-1920 (Dublin: University

Press, 1924); Davis Coakley, Dr. Steevens' Hospital, A Brief History (Dublin: Dr. Steevens' Hospital

Historical Centre, 1992).

20. Alan Browne, "Bartholomew Mosse 1712-59," Masters, Midwives and Ladies in Waiting: The Ro

tunda Hospital: 1745-1995^ ed. Alan Browne (Dublin: A. and A. Farmer, 1995). See also: Cormac

? Grada, "Dublin's Demography in the Early Nineteenth Century: Evidence from the Rotunda "

Population Studies, 45 (1991), pp. 43-54; Ian Campbell Ross, "Midwifery" Public Virtue, Public Love:

The Early Years of the Dublin Lying-in Hospital, ed. Ian Campbell Ross (Dublin: The O'Brien Press,

1986).

21. Fleetwood, p. 71.

22. Outside of Dublin between 1736 and 1834 there were 79 hospitals established. Margaret Reidy, "The History of Nursing in Ireland" International Nursing Review, 18 (1971), 326.

95




cepted only Protestants who were then provided a year of training.23 Through out Dublin during the nineteenth century, private medical schools and nursing schools were established to supply trained medical staff to either hospitals or to

those who could afford to pay for private medical care. One of the first inde

pendent nursing schools in Dublin was the Dublin Nurses Training Institution

established in 1866 by Maria Trench and her husband Richard Chenevix Trench,

the Protestant archbishop of Dublin.24 Other schools included the Red Cross

Nursing Sisters House and Training School for Nurses, the City of Dublin Nurs

ing Institution affiliated with the Baggot Street Hospital, and the Dublin Met

ropolitan Technical School for Nurses founded in 1893.25

Nuns played a leading role in the evolution of nursing and the establishment

of hospitals in Ireland. The nineteenth century was a time of dramatic change for the Roman Catholic Church in Ireland?particularly after the Famine, when

women took religious vows in ever increasing numbers.26 Because of changing

demographics and the rising age of marriage, society often relegated those

women who did not emigrate to the position of spinster. Hence, entering the

convent assured women occupation, support, a measure of authority, and fi

nancial security. Mary Aikenhead, born in 1787, laid the foundations for the Sis

ters of Charity, which the Vatican canonically recognized in 1833.27 During 1832

and 1833, as cholera spread rapidly through the narrow, dirty, crowded streets

of the Dublin and put great strain upon Dublin's hospitals, Aikenhead decided

to use ?3,000 of a dowry given by a young novice in order to establish a hospi tal.28 In 1835, the Sisters of Charity opened St. Vincent De Paul Hospital in a

house near the city's center on St. Stephen's Green. Aikenhead recruited Dr.

Joseph O'Farrell to be her medical advisor and sent three of her nuns to Paris

23. Mitchell, p. 88.

24. Irish Medical Directory (Dublin: Sealy Bryers and Walsh, 1890). See Anon., "Hospital Nursing

in Dublin," Dublin Medical Press (August 15,1866), p. 181.

25. See Pauline Scanlan, The Irish Nurse A Study of Nursing in Ireland: History and Education

1718-1981 (Co. Leitrim: Drumlin, 1991).

26. Catriona Clear notes that "by the close of the nineteenth century, nuns were virtually every

where^?in schools, private and state supported hospitals, in orphanages and asylums of various

kinds, even small industries." Catriona Clear, Nuns in Nineteenth Century Ireland (Dublin: Gill

and Macm?lan, 1987), p. 100. See also Emmet Larkin,uThe Devotional Revolution in Ireland," Amer

ican Historical Review, 77,3 (June, 1972), 625-52. For a good review of the literature on the devo

tional revolution in Ireland in the nineteenth century, see John Newsinger, "The Catholic Church

in Nineteenth-Century Ireland," European History Quarterly, 25 (1995), 247-67.

27. F. O. C. Meenan, St. Vincent's Hospital 1834-1994: An Historical and Social Portrait (Dublin: Gill

and Macmillan, 1995), p. 10.

28. Many women entering the convent brought a dowry. See Clear, pp. 86-100.

96




to learn hospital administration.29 When Mother Camillus Sallinave returned

from Paris, Aikenhead placed her in charge of the hospital's nurses training.30

Interestingly, Florence Nightingale went to Dublin in 1852 to see the work of the

Sisters of Charity in St. Vincent's Hospital and applied to train only with them.

However, at that time, the Charitys would train only those women who entered

the convent, and they rejected her application.31 When William Callaghan died in the early part of the nineteenth century,

he left his adopted daughter Catherine McAuley ?28,000. With her inheritance,

McAuley purchased a house on Baggot Street and joined by a few other women,

opened it in 1827 to educate poor girls.32 Eventually, McAuley organized the

women and took vows; today, the Sisters of Mercy are the largest congregation of nuns in the world. In 1851, the Sisters of Mercy bought land at the top of Eccles

Street in Dublin to establish a hospital and the Mater Misericordiae accepted its

first patients in 1861.33 The majority of women who nursed in the Mater were

nuns, as in St. Vincent's, and not until 1891 did either of these hospitals open their nursing school to lay women.

Agrarian crisis and economic downturn left Dublin with extensive poverty and ever-increasing numbers of poor arriving in to the city in search of help.34

Nevertheless, throughout the United Kingdom the industrial revolution had

brought about an expansion of the middle class and an increase in the num

ber of persons who made their wealth in business. Dublin was no exception. No longer was inheritance the sole route to political and economic power, and

the nouveaux riches sought to imitate the aristocracy. Thus, wives and daugh

ters of wealthy businessmen were no longer permitted to work, as this was per ceived as associating the family with the lower classes. So too, these women

sought to imitate the moral economy that existed between the aristocracy and

the poor and, thus, more and more spent their spare time volunteering for

29. Meenan, p. 15.

30. Meenan, p. 135.

31. Margaret Reidy, "The History of Nursing in Ireland," International Nursing Review 18 {1971),

327. See also Moira Lysaght, "The Evolution of Nursing in Dublin 1820-1970" St. Vincent's Annual

(1975)? 55

32. Maria Luddy, Women and Philanthropy in Nineteenth Century Dublin (Cambridge: Cambridge

University Press, 1996), p. 25.

33. See Edward Freeman, Centenary of the Mater Misericordiae Hospital 1861-1961 ( [Dublin, 1961?] ).

34. On Dublin, see: Jacinta Prunty, Dublin Slums 1800-1925 (Dublin: Irish Academic Press, 1997);

Mary Daly, Dublin, the Deposed Capital (Cork: Cork University Press, 1982), and Maurice Craig,

Dublin, 1660-1860 (London: Cresset Press, 1952).

35. See E. P. Thompson, Customs in Common (New York: The New York Press, 1993). For a good

discussion of the role of the moral economy in rural charity, see Jessica Gerard, "Lady Bountiful:

Women of the Landed Classes and Rural Philanthropy" Victorian Studies, 30 (Winter, 1987), 183-210.

97




the needy.35 Like their sisters in England, Wales, and Scotland, the women of

Ireland's middle and upper classes established and raised money for charities

as diverse as orphan homes, industrial schools, bible societies, Dorcas funds,

and sailors' relief. In addition, nursing the poor was a natural role for a char

ity, and upper-class women began to establish nursing charities which enabled

philanthropists to exert a measure of influence upon the reform of nineteenth

century nursing.36

Certainly Florence Nightingale's famous foray to the Crimea (1854-56)

brought nursing to the public's attention and its reform became an ever more

popular philanthropic cause.37 Brian Abel-Smith, who has written extensively on the evolution of British nursing, argues that nursing reform was one of the

first activities that allowed upper-class women to attain a position of power.

Changes in nursing came swiftly because, as Abel-Smith asserts, "the ladies who

sought power in the hospitals moved in the same circles as the committees that

ran them."38 Most upper-class women, in order to maintain their respectability,

worked for nursing reform on a voluntary basis. Of those who did procure paid

employment, most accepted only such positions of authority as lady superin tendent or matron.39 The lady superintendent maintained her virtue because

she, not unlike her upper-class sisters who administered servants, primarily pro

vided supervision. In an essay on St. John's House, an early nursing institution,

Judith Moore notes that "It was later found best that the Lady Superintendant

[sic] should be responsible for many of the details which had first been under

taken by the master, but which lay more in the province of the lady of the

house."40 Susan Beresford is a good example of a woman who was provided with

an impressive degree of authority by a nineteenth-century hospital. First hired

by Dublin's Baggot Street Hospital in 1884 as its lady superintendent, Beresford

36. A good example of a nursing charity is the Belfast Society for Providing Nurses for the Sick

Poor founded in 1874 by lady philanthropists. The charity paid nurses who were directed by the

ladies of the committee. In other words, the ladies hired nurses but did not nurse themselves?

thereby maintaining their respectability.

37. See: Monica Baly, Florence Nightingale and the Nursing Legacy (London: Croom Helm, 1986);

F. B. Smith, Florence Nightingale Reputation and Power (London: Croom Helm, 1982); Cecil Wood

ham-Smith, Florence Nightingale (London: Constable Publishing, i960); Sir Edward Cook, The Life

of Florence Nightingale (London: Macmillan, 1913).

38. Brian Abel-Smith, A History of the Nursing Profession (London: Heineman, i960), p. 36.

39. In general, while the matron had a place of authority, if the hospital had both a matron and a

lady superintendent, the matron was then generally in charge of the other women employed by the

hospital.

40. Judith Moore, A Zeal for Responsibility: The Struggle for Professional Nursing in Victorian Eng

land, 1868-1883 (Georgia: University of Georgia Press, 1988), p. 4.

98




disagreed with some of the restrictions that Baggot Street's board of governors

placed on her position. Just two months after she began, Beresford announced

her resignation, explaining, "No Lady who has had any experience of the very

great difficulties of a training school would work under such rules."41 While im

pressed that she would take such an uncompromising position, the board of

governors nonetheless accepted her resignation. However, while Beresford lost

this battle, she eventually won the war?not long after, Baggot Street hired her

again and gradually provided the authority she sought. The reform of nursing was, however, an uphill struggle. Charles Dickens's

immortalization of early nurses in the character of Martin Chuzzlewit's Sarah

Gamp42?the elderly, unpleasant, drunk, unhelpful nurse who more often stole

from her patients than nursed them?accurately reflected British society's gen

erally low opinion of early nurses: "She may be lazy, dirty, drunken, profligate, or herself infirm, but has come upon the parish, so she is sent out to nurse her

helpless brethren and sisters."43 Historians have reinforced the truth of Dick

ens's Sarah Gamp by finding examples of nurses who were drunk, disorderly,

sexually promiscuous, or charged with criminal acts while on the job. In the

hope of changing this image, many reformers called for ladies to enter nurs

ing. However, most middle- and upper-class women could neither respectably

accept a salary nor be involved in such physically demanding labor. One nurs

ing reform advocate noted that "Middle-class women would supervise such

work; they would not do it. A lady should lead nurses but the nurses themselves

should be taken from the laboring poor."44 As reformers began to realize that they would be unable to recruit enough

upper-class women, they decided instead to train working women to be the

respectable nurse they desired. Thus, reformers advocated that the "good" nurse be

gifted with a peculiar talent for business ... healthy, [with a] cheerful counte

nance, [have] sound teeth,... not too lusty... [of a] mild and amiable disposi

41. R.C.D. February 8,1884.

42. Anne Summers, "The Mysterious Demise of Sarah Gamp: The Domiciliary Nurse and Her De

tractors, 1830-1860," Victorian Studies 32 (1989), pp. 365-86; Katherine Williams, "From Sarah Gamp to Florence Nightingale: a Critical Study of Hospital Nursing Systems from 1840-1897," in Rewrit

ing Nursing History, ed. Celia Davies (London: Croom Helm, 1980).

43. Mrs. J. N. Higgins, "On the Improvement of Nurses in Country Districts" Transactions of the

National Associate for the Promotion of Social Science 6 (1861), p. 574. See also: Summers, "Minister

ing Angels"History Today,y) (February, 1989) pp. 31-37; Carol S. Helmstadter,"Nurse Recruitment

and Retention in the Nineteenth Century London Teaching Hospitals," International History of Nurs

ing Journal, 2,1 (Autumn, 1996), 48.

44. Higgins, p. 574.

99




tion ... attentive to cleanliness; a neat appearance... a cheerful, gentle manner,

with an encouraging tone of voice... sober, of an obliging temper ... who may

be implicitly relied upon.45

If she were a good nurse, as portrayed by Mrs. Rooke in Jane Austen's Persua

sion, she might attain the unusual position of being somewhere above a servant

yet below a peer.46 "And she," said Mrs. Smith, "besides nursing

me most ad

mirably, has really proved an invaluable acquaintance ... [she] thoroughly un

derstands when to speak. She is a shrewd, intelligent, sensible woman."47 The

good nurse would know when to speak, and reformers cautioned the good nurse

against having a loose tongue. "A nursetender is necessarily a confidential per

son, above a servant and trusted with many things as a friend."48 In addition, the good nurse was to advise the poor as to the other ways that they could im

prove their lives.

The anonymous author of A Manual for Midwives and Monthly Nurses added

to the above list that the good nurse was not only to be "of irreproachable moral

character, but she ought to have a deep sense of religion

... and tender sympa

thy for the sufferings of others... "49 Some went so far as to argue that "a good

nurse must be a good cook" and "be a light sleeper and an earlier riser."50 The

key requirement stated by all nurse-reformers, however, was that the good nurse

unquestioningly obeyed the medical man. The good nurse was to follow his or

ders without hesitation: "Your position as to the medical attendant is quite sec

ondary; you are to receive and implicitly obey his orders."51 Florence Nightin

gale advised, "let no woman suppose that obedience of the doctor is not

absolutely necessary."52 Not unlike wife to husband or nun to priest, the nurse

was not to question the doctor, only to provide his prescribed care. Hence, be

45- Mrs. Hanbury, The Good Nurse or Hints on the Management of the Sick and Lying-in Chamber

and Nursery (London: Longman, Rees, Orme, Brown and Green, 1828), pp. 65-76. See also M. Mar

tin, "Hints to Amateur Nurses," Irish Monthly, IX (April 1881), 214-17.

46. Susan Reverby notes the good nurse's intermediate status?"... neither for the drawing room

nor the kitchen"? in Ordered to Care The Dilemma of American Nursing, 1830-1945 (Cambridge:

Cambridge University Press, 1987), p, 97.

47. Jane Austen, Persuasion (New York: Penguin, 1994), p. 153.

48. A Manual for Midwives and Monthly Nurses (Dublin: Fannin and Co., 1856), p. 54. As one au

thor warned "... you [are] to keep guard over your tongue. ..it is an unruly member." A Lady, A

Friendly Letter to Under Nurses of the Sick Especially in Unions (London: A. W. Bennett, 1861), p. 7

(her emphasis).

49. A Manual for Midwives and Monthly Nurses, p. 5. See also: "Pauper Nurses in Workhouses"

British Medical Journal (May 27,1865), 551.

50. Charles Henry Hardy, Introductory Lecture on the Duties of Nurses ( Melbourne: George Robert

son, 1881), p. 8.

51. Anon., A Manual for Midwives, p. 52.

52. Nightingale, p. 86.

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cause reformers realized that most recruits would not be genteel women, re

formers desired instead to mold working women into the good nurses they wanted. The upper classes believed that illness was the result of unsanitary and

immoral conduct?a failure to work hard and live honestly.53 The good nurse,

reformers hoped, would then show the poor how to be clean, maintain a healthy

lifestyle, and subsequently how to be an example of honest, moral, and sanitary behavior.

To become a good nurse, however, reformers believed that these women

needed to be monitored. During the nineteenth century, many hospitals pro vided nurses with room, board, fuel, and other basic needs. Housing their nurses

on the premises allowed hospitals to maintain the strict supervision of nurses

and inhibit freedom of movement. For example, in Dublin, the Royal Hospi tal, Kilmainham, limited nurses' time outside the hospital and required that,

"No nurse will be allowed to quit the Hospital until after the evening meal nor

be absent from the House after curfew without the permission of the Matron."54

The board of the Royal Hospital directed the matron to "keep a constant watch

of their moral character, and see that their dress, cleanliness and personal habits, are properly attended to; and that they are at their duties at prescribed hours... ."55 Nurses at Dublin's Dr. Steevens' Hospital were "not to leave the hos

pital without the written permission of the Matron."56 The Baggot Street Hos

pital provided a strict hourly time table for its nurses. Those on the day shift

followed this schedule:

rise: breakfast: wards: dinner: wards: tea: wards: supper: dormitories:

6:15 a.m. 6:40 a.m. 7:00 a.m. 1 p.m. 1:30 p.m. 5 p.m. 5:30 p.m. 9 p.m. 10 p.m.

The nurses' free hours were:

3 P.M. TO 5:30 P.M. ONE DAY; 5:30 P.M. TO 9 P.M. THE NEXT

AND ON SUNDAYS-EITHER FROM 10 A.M. TO 3 P.M. OR FROM 3 P.M. TO 9 P.M.57

Thus, hospitals were able to both control a nurse's movements as well as exploit her by working her for long hours. What these restrictions may suggest is that

reformers, in an attempt to make her into the nurse they desired, maintained

strict surveillance of a nurse's whereabouts and behavior. Reformers may not

53- See Gertrude Himmelfarb, The Idea of Poverty: England and the Industrial Age (New York: Al

fred A. Knopf, 1984).

54. Royal Hospital Kilmainham (R.H.K.), April 26,1875.

55. Staff Surgeon William Carte to the Board of Directors of the Royal Hospital, Kilmainham,

March 28,1875. Nurses Folder for the R.H.K., National Archives of Ireland.

56. Kirkpatrick, p. 279.

57. R.C.D., May 13,1887.

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have completely trusted their working-class nurses, believing them more in

clined to immoral behavior, and they often argued that by housing nurses in the

hospital they sheltered them from the temptations of sin.58

Available evidence supports the assumption that most women who entered

nursing were not from the upper classes. For example, the records of the Queen

Victoria's Jubilee Institute for Nurses, a nineteenth-century district nursing in

stitution, show that the majority of nurses were daughters of merchants or

tradesmen.59 Although women who entered nursing were not from the lowest

levels of the working classes, most, nevertheless, depended on the income they earned. In Dublin, for example, of 107 nurses hired by the Queen Victoria's Ju

bilee Institute between the years 1897 and 1908,39 percent were the daughters of farmers, 6 percent were daughters of religious men, 15 percent were daugh ters of merchants, 10 percent were daughters of military or police, and 26 per

cent came from households of various other occupations.60

An examination of the duties of the district nurse reveals the labor-inten

sive nature of the work, which argues against nursing as an occupation for

women from the upper classes. For example, the responsibilities of a visiting nurse rendered her a composite of mother, maid, nurse, teacher, and therapist.

As one district nurse in 1878 recorded, at one home she had:

rubbed and bandaged [the] patient, [daily] washed and dressed baby and four

other children; eldest girl ['s] sore head... was poulticed and cleansed; [attended

to] little boy ['s] sore eyes; mother's hair cut, [her] head cleansed, her bed made

daily, emptied slops, prepared food; washed clothes and cleansed room.61

A district nurse was also expected to know "how to instruct the people in prac

tical domestic hygiene, how to advise mothers on the care of infants and young children?not necessarily sick, [and] how to teach them wholesome and eco

58. Reverby, p. 90.

59. Mary Stocks, A Hundred Years of District Nursing (London: George Allen and Unwin, i960), p.

89. The Queen Victoria's Jubilee Institute for Nurses was the largest and most well known district

nursing institution established in the nineteenth century. The institute was established when ?70,000

of ?82,000 raised as a gift for Queen Victoria was given by Victoria to fund an institute for district

nursing. Lavinia Dock, A History of Nursing (New York: G.R Putnam's Sons, 1912), p. 23. See: Mary

Quain, "Brief Outline of the History of Jubilee Nursing In Ireland 1876/1968" (unpublished article,

September, 1990); Mary Quaine, The Jubilee Nurses Need Your Help (Dublin: John Falconer, 1955);

Annie Michel, "Some Incidents of the Work of a Jubilee Nurse in Ireland" (n.p., 1925).

60. The average age was thirty-one and all the women were either single or widowed. The follow

ing numbers included here are found in the record books of the Irish Branch of the Queen Victo

ria's Jubilee Nurses' Records. Of the other 26 percent some occupations were engineer, builder, school

teacher, barrister, jeweler, draper, and manufacturer.

61. Belfast Society for Nurses to the Sick Poor (1878 ), appendix.

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nomical cooking... ,"62 Thus, among her varied responsibilities, the district

nurse was to be a teacher of moral and sanitary living. Yet, it is doubtful that a

lady would attempt such physical labor for fear of placing her respectability in

jeopardy and moving her into the realm of servant. Marian Stringer notes that

The district nurse of 1888 would be a 'suitable' woman, not a 'lady'... one used

to rolling up her sleeves and getting down to things. She probably did as much

midwifery as general nursing, often staying in the homes of her patients, and be

coming cook and housekeeper for a time as well.63

A lady, on the other hand, directed and watched. She guided, provided exam

ple, and advised. A lady taught nurses how to bring sanitary techniques and

proper domestic skills to those they nursed. Never, however, did she sully her

self by publicly participating in physical labor. Most importantly, district nurs

ing proved another occupation for women that provided an income and sup

plied some measure of intellectual challenge with a greater level of responsibility than was offered by the few employment options open to women.

While nineteenth-century hospital records also provide evidence to suggest that most nurses were from the working classes, these sources also reveal the ef

forts of women philanthropists to improve the quality of medical nursing. For

example, in 1831 six doctors purchased a house on Upper Baggot Street and

opened the City of Dublin Hospital. Also known as the Baggot Street Hospital, it was established to aid all but the mentally ill and accepted patients regardless

of religious affiliation.64 Baggot Street, not unlike many hospitals of the time, had a ladies committee which managed many of the hospital's daily activity

including the hiring and firing of nurses and other female employees.65 To il

lustrate, in 1878, the ladies committee requested that the board "consider the

great necessity of extra help in case nurses are invalided ..." and proposed that

the ladies committee do its best "... in assisting to defray the increased expense

[of hiring more nurses]_"66 Here the women of philanthropy show one of

their greatest assets?a willingness and an ability to raise funds for their causes.67

Like other Dublin hospitals, Baggot Street Hospital held concerts and other

62. In addition, she had to be a social worker able to point out government and philanthropic agen cies which could provide aid. Alice Cristabel Crowther, "Review of the Work Done by Queen Vic

toria's Jubilee Institute for Nurses in Ireland," An Address Delivered at the Annual Meeting of

St. Patrick's Nurses Home (February 22,1918), p. 287.

63. Marian Stringer, "Ninety Years of District Nursing," Nursing Mirror (April 13,1978), 63.

64. The Baggot Street Hospital eventually became the Royal City of Dublin Hospital in 1900.

65. R.C.D. November, 12,1878.

66. R.C.D., June 11,1878.

67. Among the many scholars to discuss the fund-raising efforts of women philanthropists, see

Luddy and F. K. Prochaska, Women and Philanthropy in Nineteenth Century England (Oxford: Ox

ford University Press, 1980).

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events and its ladies committee made constant appeals to the public for help.68 The ladies committee showed its intimate involvement in the running of the

hospital through their its requests to the board for improvements. The hospi tal provided the ladies committee with a measure of authority as shown by the

fact that the hospital's matron reported to the ladies committee. For example, in 1878, it recommended to Mrs. Finlay, the matron, that she purchase:

... uniforms for the nurses and wardmaids, blankets, 370 yards calico for women's

night dresses and men's shirts, 2 table cloths for resident pupils use and 2 for the

Matron's use also six towels and 60 yards calico for pillow covers.69

Thus, not unlike volunteers in other charities, the women who served on hos

pital committees were often integrally involved in the institution's daily opera tions. While many of these women attained influential positions, they never

theless maintained their respectability by not accepting a salary. The records of Dublin's Sir Patrick Dun's Hospital, established in the late

eighteenth century, also provide good examples of philanthropic women's in

volvement in nursing reform. In addition, the records allude to nurses' work

ing-class status through details concerning the nurses' behavior. In 1835, Dun's

Hospital resolved to dismiss Nurse Finnamore for accepting a gratuity of spir its and noted that the matron should have more fully investigated the "finding of three bottles of spirits in said Nurse's trunks."70 So, too, did the early minutes

record that the matron requested the dismissal of nurses for insolence, irregu

larity, neglect of duty and misconduct. In 1837, two nurses were dismissed, one

for drunkenness and the other for violence of temper.71 In 1851-52, Sir Patrick

Dun's Hospital accused one nurse of insubordination, another with impropri

ety and reprimanded a third because her neglect may have caused the death of

a patient.72 Then, in 1871, the lady superintendent informed Dun's board that

she twice caught four nurses dancing in the room of a resident doctor. This

shocking behavior resulted in the firing of the resident and the fining of two of

the nurses who had attended the festivities both times. In 1880, a nurse went to

the board and announced that a resident doctor, Mr. Johnston, had seduced her

68. For example, in 1881 the committee requested from the public donations of "20 blankets for the

patients use, and for dressing gowns, worn or otherwise both for men and women." R.C.D., De

cember 9,1881.

69. R.C.D., November 12,1878.

70. Sir Patrick Dun's (S.P.D.), April 28,1835. The nurses however cannot be singled out in their be

havior, in 1835 it was noted that the laundress was fired, and the value of missing items was deducted

from her wages, and in 1843 the cook, Mary Power, was dismissed. S.P.D., May 5,1835; February 28,

1843. In 1848 the apothecary, Mr. Tallis, was accused by the matron of "improper familiarity with

the housemaid." S.P.D., September 19,1848.

71. S.P.D., September 12,1837.

72. S.P.D., December 9,1851; August 10,1852; January 2,1852.

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and that she was pregnant. Given the many recorded "incidents" concerning nurses in the records of Dublin's hospitals, such examples provide evidence that

most late nineteenth-century nurses were not as restricted by the social mores

as were their upper-class sisters.

In 1865, Dun's convened a special meeting to improve its nurse training pro

gram and at this time established the post of lady superintendent. The hospital set the lady superintendent's salary at ?60 per annum and, in addition, provided room, board, coals, gas, and washing.73 The position of matron remained,

though no longer with any authority over the nurses.74 The next year Maria

Trench contacted Dun's and requested that the Dublin Nurses Training Insti

tution, which she had helped to establish, provide trained nurses to the hospi tal. This institution, which had also for a time supplied nurses to Dr. Steevens'

Hospital, guaranteed nurses "at a cost not exceeding ?30 per nurse and ?25 per assistant nurse."75 The board accepted her proposal. While the records of the in

stitute have yet to be located, from the minute books of Sir Patrick Dun's it ap

pears that the Institute was run by a number of upper-class ladies who recruited

young women to live in the institution's home, located on Hollis Street in

Dublin, and train in the hospital. The institution hired a matron to attend to

the nurses' needs in the home, though it appears that the ladies administered

the institute's governing board and held final say on all decisions.

In 1867, three ladies from the Dublin Nurses Training Institution?the Hon

orable Mrs. Trench, Miss Maria Trench, and Lady Laurence?were invited to act

as "Lady Visitors and co-operate with the visiting Governors during the year."76 Here was an example of philanthropists being the force behind the establish

ment of a nursing institution but also becoming integrally involved in the daily

workings of the hospital. According to the minutes of Sir Patrick Dun's, a lady visitor was to see that basic items be supplied for the patients and staff of the

hospital, thereby improving the quality of life and service of Sir Patrick Dun's.

For instance, the minutes record:

It was referred to the Economy Committee, to invite the Lady Visitors, and the

Ladies of the Committee of the Dublin Nurses' Training Institution, to cooper

ate with the Board in establishing the Children's Ward in the Board Room, and

to take the necessary steps for its immediate furnishing and decoration.77

73- S.P.D., December 26,1865; February 26,1867.

74- S.P.D., December 26,1865.

75. S.P.D., December 24,1866. This does not mean that the women were being paid ?30 a year. In

1866 nurses' salaries were raised to ?12 per annum with assistant nurses paid ?8. S.P.D., December

11,1866.

76. S.P.D., February 26,1867.

77- S.P.D., February 12,1878.

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Additionally, lady visitors worked to raise funds for the hospital for which,

in 1870, the board of governors offered thanks to the ladies "for the zeal and

charity with which they have collected subscriptions for the hospital."78 These

were all among the duties of charity women, who not only saw to the day-to

day operations and fundraising, but also were active in enforcing the moral and

sanitary reform of the poor. Most important, however, these ladies facilitated

the employment of other women and the evolution of a career that would pro vide women with extensive opportunity.79

However, problems between Sir Patrick Dun's and the Nursing Institution

began to appear. In 1869, while the board "had no cause of complaint" against

the head maternity nurse, the institute dismissed her for insubordination and

maintained that it was "unwilling to give her a permanent engagement [in the

hospital]."80 Gradually, the relationship between Dun's and the Nursing Insti

tution deteriorated. In 1872, the board requested that the institution cease using the Sir Patrick Dun's name in its recruiting advertisements after the hospital dis

covered that the Nursing Institution was soliciting only for women who were

members of the Church of Ireland. Dun's Board believed that "the sectarian

character of the advertisement is calculated to be very injurious to the hospi tal."81 The hospital, throughout its books, appears to have maintained a non

sectarian stance. For example, Dun's provided the Douai version of the Bible

for Roman Catholic patients and ensured that patients received a minister or

priest as they desired.82 In fact, the minutes noted that when, in 1873, the Rev.

Thomas Doyle wrote to ask permission for the Association for Visiting Roman

Catholics in Hospitals to visit Sir Patrick Dun's, the board of governors re

sponded that "[they] with pleasure grant the permission sought."83

Finally, on January 23,1883, the lady superintendent of Sir Patrick Dun's,

Margaret Johnson, wrote to the board to inform them that Miss Maude Trench

of the Nursing Institution, "has ordered me to dismiss three of my best proba tioners and one hospital nurse because they are dissenters."84 The probationers

were Presbyterian and the nurse a Baptist. Johnson argued that this would "par

alyze" the hospital and revealed that, "I have great difficulty just now in secur

ing probationers belonging to the Irish Church [Church of Ireland], but can get

78. S.P.D., December 27,1870. They raised ?273 for the hospital.

79. For discussion of women's employment in nineteenth-century Ireland, see Mona Hearn (1993),

Luddy and Murphy (1990).

80. S.P.D., July 13,1869.

81. S.P.D., February 27,1872.

82. Morehead, A Brief History, p. 148.

83. S.P.D., February 11,1873. The Association for Visiting Roman Catholics, established in 1873, sent

ladies to hospitals and workhouses to console, pray, and read to Roman Catholic patients.

84. S.P.D., January 23,1883.

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sufficient numbers of highly respectable girls from the North who are Presby terians."85 Johnson finished the letter by begging the board not to force her to

dismiss these women as they were skillful nurses. The board permitted Johnson

to keep both the probationers and the nurse. Then, in a letter to the Nursing In

stitution, Sir Patrick Dun's terminated its contract and stated that "it is now ab

solutely necessary for the welfare of the hospital to throw it open for the train

ing of nurses of all religious denomination."86 The board noted that it would

keep without charge the present probationers and, in the future, charge the in

stitution for the nurses it desired to send for training. The Dublin Nurses Training Institution was not alone, for many nineteenth

century Dublin charities were sectarian, and Dun's policy of nondiscrimination

was possibly more practical than charitable, allowing for the hospital to hire a

more diverse population and, thus, a better quality of nurse. T Percy Kirkpatrick defends Trench's Nursing Institution and argues that it was constrained as to

whom it could accept because "an institution fathered by a Protestant Arch

bishop was likely to be looked on as suspect by a Roman Catholic community, while it would have too much flavor of a Roman Catholic religious order to be

acceptable to some Protestants."87 The sectarian climate of nineteenth-century

Dublin necessitated that the institution confine itself to Church of Ireland or

England recruits, though it explicitly noted that trainees were to be "strictly non

sectarian in the work."88 While the Nursing Institution's hiring policies were sec

tarian, it nevertheless did not want to restrict its nurses' care giving efforts, and

Kirkpatrick notes that the institution did not associate itself with the Adelaide

Hospital which cared only for Protestants.

As part of Dun's continuing efforts to improve the quality of nursing, and

as further example of upper-class women's involvement in hospital reform, Sir

Patrick Dun's appointed Margaret Huxley to the position of lady superinten dent in 1884.89 Huxley immediately changed the nurse training program, length

ening it from one year to three. Next, she added a final examination, and ex

tended to two years the time nurses needed to work in the hospital before

receiving their diplomas.90 Finally, Huxley added courses in anatomy and in

cluded lectures by Dun's surgeons.91 In 1890, the board of governors gave her

permission to take part in the founding of a private surgical home where Dun's

85. S.P.D., January 23,1883.

86. S.P.D., March 13,1883.



89. The post offered ?100 per annum plus room, board, and extras.

90. Susan McGann, "Margaret Huxley: Pioneer of Scientific Nursing in Ireland" in The Battle of the Nurses (London: Scutari Press, 1992), pp. 130-59 and Morehead, p. 158.

91. Morehead, p. 158.

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nurse-probationers would receive training.92 In 1894, Huxley was named hon

orary secretary of the Dublin Metropolitan School for Nurses. The Dublin Met

ropolitan School arranged that it would supply trained nurses to six Dublin area

hospitals. The school's minutes recorded that, "the object of this school shall be

to instruct Probationer Nurses in Anatomy, Physiology, Hygiene Invalid Cook

ery [and] such other subjects outside hospital training, as may be deemed nec

essary for the sufficient training of nurses."93 The committee rented rooms in

the Royal College of Surgeons and eventually established a sophisticated test

ing and grading system in order to provide the most qualified of candidates.

In 1895, Huxley added her own weekly lectures to nurse-probationers.94

Teaching nurse-probationers was a common requirement for lady superinten

dents. For example, the first matron of the nursing school for the Mater Mis

ericordiae in Dublin, Miss McGivney, also taught her nursing probationers.95 The Baggot Street Hospital required its lady superintendent to:

... take charge of, and be responsible for, the training of all Probationers engaged

in the Hospital. She shall carefully attend to their instruction, and give them all

proper opportunities of learning their duties as Nurses.96

As in the relationship between upper-class ladies and their servants, lady su

perintendents taught, assigned duties, and ensured the good behavior of their

nurses. Like many active nurse reformers, Margaret Huxley was very involved

in the fight for improved education and standardized qualification of nurses.

Through the work of such reformers and the supporting cast of philanthropic women nursing became a professional occupation. These philanthropists de

sired to improve the quality of nursing and, in so doing, provided women an

opportunity to enter a more challenging occupation. Among those who de

manded longer training and more stringent qualifications for nurses were phil

anthropists and nurse-reformers alike who believed that being a nurse required more than a gentle voice and the ability to cook a good meal. In addition, how

ever slowly?and as a result of the efforts of Margaret Huxley, Susan Beresford,

and Maria Trench?these women created a career to which, eventually, even

women from the upper classes could enter with dignity and without the loss of

92. S.P.D., July 8,1890.

93. Dublin Metropolitan School for Nurses, April 20,1894. See also McGann.

94. S.P.D., December 23,1895.

95. Nolan, p. 12.

96. R.C.D., February 22,1884. A number of the lives of hospital matron's whose lives are detailed

in McGann's Battle of the Nurses were teachers and trainers as well.

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respectability. As the women of philanthropy contributed to the improvement of not only nursing conditions but also nurse-training and education, they were

at the same time working to sever the social ties that restrained them from en

tering paid employment.

Eventually, increasing numbers of ladies did enter nursing as paying proba tioners. Early on, most hospitals supplied these women with special privileges such as separate sleeping quarters, separate places in the chapel, different uni

forms, and less stringent requirements necessary to receive a nursing certificate.97

For example, Dublin's Baggot Street Hospital divided its nurses into paying and

articled probationers. Paying probationers were charged 70 guineas and awarded

a certificate after two years of training, while articled probationers paid 30 guineas and were required to work two additional years before, awarded their certificate.98

However, the entrance of ladies into the profession did not occur with ease. There

was great hostility, and it was feared that these women would have the social

standing to allow them to ignore or make demands of doctors: by admitting ladies, nursing would be placed "in the hands of ladies who will never be con

tent till [sic] they become the executives of the hospitals...."" In Dublin, for ex

ample, the directors of the medical board at Dublin's Adelaide Hospital noted

that they feared "disrepute" if a lady were allowed to enter the nursing school

and, as Percy Kirkpatrick suggests, they feared the loss of total control over staff.100

However, there was no flood of ladies into nursing; rather, it was working-class women who became the foot soldiers of nineteenth-century nursing.101

As Judith Moore argues in the introduction of A Zeal for Responsibility: The

Struggle for Professional Nursing in Victorian Englandy it is ironic that society con

sidered women to be nurses by instinct, while at the same time, throughout the

late nineteenth century, nurse training became more technical and increasingly

specialized. Whether a nurse's skills were innate or developed through training, reformers wanted a nurse to be strong, moral, kind, gentle, personable, diligent,

intelligent, womanly, and, above all, obedient. They wanted a woman with upper

class breeding combined with the experience, strength, and familiarity with fol

lowing orders of a working-class domestic servant. When nursing reformers re

alized that most of their recruits would be working-class women, they then

attempted to train them to be hard working, honest, and loyal employees.

97- Able-Smith, p. 31. Though he notes that this was done away with in the early part of the twen

tieth century. In the minutes of Sir Patrick Dun's Hospital, on December 14,1880, Miss Maria Trench

of the Dublin Nurses Training Institution asked the board to allow two "ladies" to receive nursing

instruction in the hospital during the month of January.

98. They were paid ?10 the first year which gradually rose to ?18 by the fourth. See Coakley, p. 31.

99. Abel-Smith, p. 27 (his italics).


101. Many ladies who were nursing pupils did not remain in nursing. Hehnstadter, p. 61.

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Through philanthropy, women of Dublin's upper classes involved them

selves in the public world from which they had been sheltered. Dublin's chari

table women helped to make nursing an occupation for working-class women.

Knowing that society expected these women to involve themselves in charita

ble works, working with hospital administrations toward improvement of nurs

ing seemed an acceptable choice for the women of charity. The records of nine

teenth-century Dublin hospitals and nursing organizations suggests that

charitable women were intimately involved in the reform of Irish nursing.

Upper-class women were able to influence the training, improvement of facil

ities, and rules governing the lives of not only nurses but all female hospital em

ployees. These women established their own nursing schools and nurse-visit

ing organizations and, thus, provided employment for women who might have

otherwise emigrated, entered a factory, become a domestic, or have taken vows.

Efforts by philanthropists contributed to the professionalization of nursing in

Ireland which, in the twentieth century, garnered a reputation of providing the

best trained nurses who traveled to countries worldwide to provide care.

Evidence from Dublin exemplifies a common trend in nineteenth-century

nursing: upper-class women worked to improve nursing standards, while work

ing-class women filled nursing's ranks. The evolution of nursing as a profession in Ireland came about in the mid-nineteenth century because of a variety of fac

tors: an increase in the number of hospitals and medical facilities established to

cater to the poor; the greater number of women who entered the convent and

the call for nuns to tend to the sick; the international call for women to nurse

in the Crimean War; the increase in middle-class women's involvement in phil

anthropy and in the sanitary reform movement, which was part of the philan

thropic agenda.

Dublin's hospital and district nursing records reveal the formation of a nurs

ing career for women who needed to earn an income. The hard work, long hours, low salary, and strict regimen argue against nursing

as a career attractive

to women from the upper classes. Most hospital records also illustrate that

upper-class women were integral to the reform of nursing and its furtherance

as a career. In addition, the records reveal that a small percentage of upper-class

women were willing to accept the paid position of administrator, and here may be the beginnings of the weakening of the social restrictions against these women

holding paid employment. Through a strict regimen, restricted freedom, and

close surveillance, nursing reformers in Ireland attempted to mold a "lady" out

of a "woman" and make her into a nurse.

r^> BOSTON COLLEGE

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The Good Nurse: Women Philanthropists and the Evolution of Nursing in Nineteenth-Century Dublin

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