Building a People’s Encyclopaedia of the NHS

Three months in to our People’s History of the NHS and we have an 11th Encyclopaedia entry. This is the first from a guest contributor, and we would welcome more of these. If you are interested in contributing something that you think belongs in our People’s Encyclopaedia, please do contact us.

A few themes are already surfacing in the Encyclopaedia. We have been keen to respond to current events, and this has led to several entries offering historical context that can help to situate the current Junior Doctors’ dispute: for instance, on the BMA and on student nurses. There is a strand emerging on what we might call the NHS body: on how teeth (even smiles) and hearing, for instance, may have been shaped by the experience of living in the NHS. And there’s now an emerging strand on the intriguing and important subject on age and generation: our earlier entry on being Born in the NHS, and now today’s new entry from guest contributor Professor Pat Thane on Old Age.

Pat Thane, as many of you will know, is one of the leading historians of the British welfare state and of the history of old age in Britain. She brings these two subjects together in an Encyclopaedia entry which we hope will provoke you to send us further reflections and memories about this important subject.

As Pat graphically explains, the creation of a National Health Service was hugely important for Britain’s elderly population, many of whom had been disabled until that date by lack of provision to address the natural effects of age on the body. NHS glasses, chiropody, and hearing aids (as another of the Encyclopaedia entries explains) transformed lives. But the entry also highlights that a kind of ‘age-based rationing’ developed as a feature of the NHS. Despite the emergence of a new specialism of geriatric medicine, the elderly population have been relatively neglected. There is often a tendency in debates about the NHS to see an expanding population of the elderly as a ‘burden’ and a problem. Pat’s entry offers a valuable corrective to such negative portrayal. As she points out, attending properly to the health of the elderly can increase their already growing contribution to childcare, national output, and taxation, and hence help in the funding of free health care.

We hope you will respond to Pat’s entry. We would also welcome your thoughts about the future topics that our Encyclopaedia should be addressing. You can add you thoughts via the Comments box that follows each Encyclopaedia entry. By the end of the project, and with your help, we hope to have an Encyclopaedia that is kaleidoscopic in its breadth, addressing both the obviously important and timely, and the stranger and more surprising. As it grows, you will also find that you can search for topics either through the A-Z index on the Encyclopaedia page or through one of our Search buttons (you’ll find one at the top of this page). We hope that this will develop into a valuable resource to assist and provoke thinking about the place of the NHS in British culture.

Helen Bissett Reid: Student nursing in the 1940s

Elsewhere on the site this week we’ve been focusing on student nursing under the NHS, with an encyclopaedia entry charting the history of nursing training and a gallery of 1960s nursing school prospectuses. Building on that, this blog features some extracts from a huge submission we got from the daughter of a former district nurse, Helen Bissett Reid.

Helen began her training as a student nurse in Aberdeen in 1938, eventually becoming a ward sister after the war then finally a District Nurse after her marriage. She gives a vivid personal description of her own experiences as a “probationer” before the NHS, reflecting many of the issues discussed in our encyclopaedia entry and allowing us to make some interesting comparisons on what changed under the NHS.

After leaving school at 14 and spending three years helping out at home, she decided to become a nurse at City Hospital, Aberdeen. Along with 13 other 17-18 year olds, she spent three months in Preliminary Training School studying physiology, sociology and practical nursing with tests every Friday before finally sitting their National Nursing Exam. 

In Helen’s memories, the tension around passing or failing exams is linked with everyday life as a probationer, particularly the quality of the food in the canteen.

Unfortunately we had semolina every day except Friday and Sunday. Friday was steamed pudding day and of course we did not really enjoy due to the impending exam immediately afterwards. Once the big exam was finished, came the long wait for results.

The porter who delivered the mail informed us that if you receive a long brown envelope, you have failed and all the passes are in small envelopes. Unfortunately only 8 of us passed and proceeded to the wards. The others could resit but I think all decided not to continue or felt nursing was not for them.“

This sort of turnover was not uncommon, with only around [40%] of nurses actually completing their training in the 1940s (something that would steadily improve under the NHS). This was a product not only of challenging examinations but often of the strict discipline imposed on new recruits:

The first ward two of us were sent to [work] for 3 months was the scarlet fever ward. Sister was Sister A… [whom] we called “Biscuit.” She was very strict but very fair and gave us a lecture at the very beginning that she would not tolerate work being done slovenly. We found the nurses who were 2nd and 3rd years very bossy and also the Staff nurse of whom we were quite afraid, more than the Sister!”

Matron, at the City Hospital, seemed to us 17 year olds as being very old but was a pleasant lady though the rules were so strict. Whatever we were doing, when she entered the ward, we had to stand with our hands behind our backs like stookies till she left. All the counterpanes on the beds had to be straight. All the wheels on the beds straight and facing away from the doors.”

Helen continued her training, first as a fever nurse then later as a general nurse, during World War Two. Moving to Stirling Royal Hospital to complete her education, she encountered more petty discipline:

I was put in a Sister’s room as she was on holiday. As I was unpacking my case I was singing –

In land or sea what matters where

Where Jesus is, tis Heaven there”

Suddenly there was a loud knock on my door and a voice bellowed “Nurse, will you stop singing. I have a terrific headache and it is annoying me!”

I said “Sorry, I don’t feel like singing anyway.””

I thought I had better tread carefully here! During my two weeks in that residence, to my knowledge all I did wrong was have a bath in the Sister’s bathroom and I was not supposed to do that so that was another row.”

Overall though, Helen confessed, a sense of camaraderie amongst the nurses made the regime at Stirling more bearable.

I found Stirling much easier than City especially on night duty when we at least got a seat. We had a great Sister on night duty. Cannot remember her name . She never reported us if she caught us having tea. One nurse usually stood watch at the end of the corridor. If Sister came early and she wasn’t there, Sister would say “Where is your watchdog tonight ?”

Sister always carried a big torch and one night she told us, she was walking up Livilands Lane where there was a battalion billeted. One soldier appeared and asked her “Can I see you home“ She shone the torch in her old wrinkled face and said “take a look at that and come if you like!”

Do you wonder why we all loved her?”

At the end of her third year, Helen sat her exams to qualify as a State Registered Nurse, with one question in particular sticking in her mind years later:

I cannot exactly remember where these were held but I do remember the huge pictures of possibly notable men, old-fashioned with long beards. The cold reception as you entered the building and treaded the long stone stairs lives on. The written was OK. The oral was preceded by a period of nail biting. Nurse W. and I were next in line. She went to the examiner on the right and I went to the one on the left. She had to explain the nervous system and I the urinary system. He also asked me to explain “Herpes Zoster” (shingles ) and unsuccessfully tried to trick me asking what is “Weil’s Disease”.

Answer :- “jaundice carried by germs in urine of healthy rats “

They could not be very healthy carrying germs, would they?”

Yes, healthy rats”
Our Sister Tutor instilled it into us. “Remember HEALTHY rats”

That over, I did not know if I passed, as they never gave you any indication. Time will tell. Quite a nice man though. …”

After qualifying, Helen was appointed as staff nurse in the outpatient department at Stirling Royal, then moved in 1945 to take up a position as ward sister (a supervisory role) at Falkirk Royal Infirmary. Soon after she got married and gave up nursing for 16 years before returning to work as a District Nurse after her children had grown up. Marriage was a common reason to abandon the profession in the 1940s, in part because of the expectation that working nurses would live-in. Mandatory living-in was abandoned in 1948 with the coming of the NHS, reflecting a more general shift towards a less rigid discipline in nurses’ lives and an expansion in work (often part-time) for married nurses. 

Helen’s return to work 16 years later as a district nurse under the NHS is described in her full memory, which you can find in our members’ section (join here), where you could also add your own recollections of life in the NHS.