For today’s post, I will briefly analyse the developments in nurse training from the late nineteenth century to the introduction of the 1919 Nurses Registration (Ireland) Act.
Under the 1851 Medical Charities Act dispensary midwives were appointed to work in a local dispensary district. Ciara Breathnach ‘Handywomen and Birthing in Rural Ireland, 1851-1955’ (41) argues that although, the dispensary midwife was employed in the local dispensary, ‘distances from dispensaries and union hospitals coupled with a reticence to engage with medical care under the poor law served as deterrents for pregnant women’. Many women continued to avail of the handywomen’s service rather than the district voluntary nurses due to a difficulty in the community to raise funds to support a nursing association (Ibid, 40). ‘Handywomen’ were untrained midwives and facilitated the spread of disease amongst new mothers. However, most women did not give birth in hospitals and there was no ante-natal provision available during late nineteenth century in Ireland. Joe Robins’ Nursing and Midwifery in Ireland in the twentieth century: fifty years of an Bord Altranais (the Nursing Board) 1950-2000 (14) highlights that ‘the family home was accepted as the proper place for birth’. Many women died from puerperal sepsis and other conditions related to birth.
Most nurses were untrained during the nineteenth century, with a bad reputation for drunkenness and their lack of education (Gerard Fealy, A History of Apprenticeship Nursing in Ireland, 18). However, Florence Nightingale influenced the new value of morality becoming a requirement for nursing during the second half of the nineteenth century (Ibid, 11). Apprenticeship nurse training then developed during the 1890s and nurse training schools were attached to ‘voluntary hospitals and in the large hospitals operated by religious orders’ (Robins, Nursing and Midwifery, 11). Nurse training was denominational and there were separate training schools for Protestant and Catholic nurses. Maria Luddy’s ‘‘Angels of Mercy’: Nuns as Workhouse Nurses, 1861-1998’ (106) states that religious orders, drawing recruits from educated middle classes, played a significant role in the establishment of nurse training and thereby helped to raise nursing standards including the Sisters of Mercy. To train as a nurse, women were required to have a good moral character, ‘a positive reference and an ability to pay a general fee to the training school’ (Ann-Marie Ryan, ‘General Nursing’, 79).Various nursing trainings schools were set up including The Dublin Metropolitan Technical School for Nursing during the 1890s (Robins, Nursing and Midwifery, 14).
By 1900 attempts were made to provide official training for district nurses and various organisations such as Lady Dudley’s Nursing scheme (1903) and Queen Victoria’s Jubilee Institute (1897) organised voluntary nursing services throughout rural and poor parts of Ireland. The nurses treated a range of illnesses including tuberculosis and they often arrived to treat patients following a ‘referrals from general practitioners, the Jubilee Committee and pharmacists’ (Armstrong, ‘Public Health Nursing, 127). According to Armstrong (Public Health Nursing’, 127), the district nurses were trusted by the community as they had the power to convince patients to receive vaccinations. However, they worked long hours as they held a dual role of midwife in many districts (Ibid). The voluntary nursing services were limited in Ireland as Breathnach ‘Lady Dudley’s District Nursing Scheme and the Congested Districts Board, 1903-1923’ (151) states that there were only a small number of Lady Dudley nurses: only 21 for 24 congested districts. It was a free service and the nurses travelled from areas on bicycle (Robins, Nursing and Midwifery, 12).
In 1919, the Nurses Registration (Ireland) Act was introduced, establishing the General Nursing Council, and a register for separate nursing divisions including general nurses and mental nurses and the Council would supervise nurse training, inspections and examinations. Nurses had to be enrolled in a training hospital in order to join the register. Moreover, a Central Midwives Board was founded and midwifery training would take place in maternity hospital for six months (Robins, Nursing and Midwifery, 17). Armstrong ‘Public Health Nursing’ (127) maintains that ‘the district nurses was also the appointed midwife for the area’ and they worked all day as they may be called to treat an injury or an illness. After the Irish Free State was established in 1922, the new Department of Local Government and Public Health funded Maternity and Child Welfare schemes and half the costs of local authority and voluntary nursing association nurses (Annual Report of the Department of Local Government and Public Health, -1925, 34). However, nurses were given insufficient wages by by the government and local rates (Commission on the Relief of the Sick and Destitute Poor Including the Insane Poor appointed on the 19th March 1925, 65-66). However, by 1927, general nurses in many counties only had midwifery skills (Ibid, 66).
Voluntary scheme provided an essential service to the sick poor by travelling to patients in rural parts of Ireland. By the twentieth century, most nurses were moral and middle class women trained in a voluntary hospital or training school based in Dublin. District nurses employed by local authorities or voluntary nursing associations carried out a wide range of duties such as the maternity and child welfare schemes and preventive health services. However, district nurses continued to be over-worked and underpaid by the DLGPH and local rates in the Free State.
Bibliography
Primary sources
Annual Report of the Department of Local Government and Public Health, 1925-28, (Stationary Office, Dublin, 1928).
Commission on the Relief of the Sick and Destitute Poor Including the Insane Poor appointed on the 19th March 1925 (Stationary Office, 1927).
Nurses Registration (Ireland). A bill to provide for the registration of nurses in Ireland.
Secondary Sources
Armstrong, Sheila, ‘Public Health Nursing’ in J. Robins (ed.) Nursing and Midwifery in Ireland in the twentieth century: fifty years of an Bord Altranais (the Nursing Board) 1950-2000 (An Bord Altranais, Dublin, 2000), pp.125-139.
Breathnach, Ciara, ‘Lady Dudley’s District Nursing Scheme and the Congested Districts Board, 1903-1923’ in in M. H. Preston and M. O’ hOgartaigh (eds.) Gender and Medicine in Ireland, 1700-1950 (Syracuse University Press, New York, 2012), pp. 138-153.
Breathnach, Ciara, ‘Handywomen and Birthing in Rural Ireland, 1851-1955’, Gender and History, Vol. 28, No. 1 (April 2016), pp.34-56.
Fealy, Gerard M, A History of Apprenticeship Nurse Training in Ireland, Routledge, London, 2006.
Luddy, Maria, ‘‘Angels of Mercy’: Nuns as Workhouse Nurses, 1861-1998’ in G. Jones and E. Malcolm (eds.) Medicine, Disease and the State in Ireland, 1650-1940, (Cork University Press, Cork, 1999), pp.102-117.
Robins, Joe, Nursing and Midwifery in Ireland in the twentieth century: fifty years of an Bord Altranais (the Nursing Board) 1950-2000, An Bord Altranais, Dublin, 2000.
Ryan, Anne-Marie, ‘General Nursing’ in in J. Robins (ed.) Nursing and Midwifery in Ireland in the twentieth century: fifty years of an Bord Altranais (the Nursing Board) 1950-2000 (An Bord Altranais, Dublin, 2000), pp.77-99.
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