«MEDICAL CARE IN THE WORKHOUSES IN BIRMINGHAM AND WOLVERHAMPTON, 1834-1914 by ALISTAIR EDWARD SUTHERLAND RITCH A thesis submitted to the University of ...»
Two nurses were dismissed for being unable to carry out their duties efficiently. Jane Frost, who had previously been a ‘housekeeper for invalids’ and a children’s nurse, was the first in 1847, after two years of service.62 At this time, there were 57 patients in the infirmary, infectious disease and lying-in wards, all of which would have been under her care.63 She wrote to the guardians requesting they reconsider their decision, but they upheld it on the grounds that she was ‘far advanced in years’ when she was appointed (although only 63 years at the time) and considered that her inability to supervise pauper nurses ‘amounted to insubordination’.64 The guardians decided that her successor ‘should be able to write’ and appointed Elizabeth Careless, who was in her early 50s.65 Birmingham guardians elected Catherine Thompson as night nurse in 1852 and, despite declaring that she would not be able to read the directions of the WMO, considered her competent to fulfil the office of nurse. However, the PLB did not sanction the appointment.66 Wolverhampton guardians dismissed Sophia Siddons in 1860 after a complaint by the MO of her inefficiency, ‘harshness’ and neglect of ‘her duties’. She was given an ultimatum of resigning within the week or being dismissed and chose the former.67 The following year, she was appointed nurse at WALS, WC, 23 May 1860.
Ibid., PU/WOL/A/11, 11 May, 1 June 1860; CEB, 1861.
WALS, WBG, PU/WOL/A/5, 11 June 1847; TNA, MH12/1167, 16 July 1845.
Ibid., 16 August 1845.
WALS, WC, 23 June 1847.
WALS, WBG, PU/WOL/A/6, 16 July and 13 August 1847; CEB, 1851.
TNA, MH12/13298, 22 January, 11 February 1852.
WALS, WBG, PU/WOL/A/11, 4 July 1862.
Dudley workhouse and remained there until her death in 1876.68 Although she was not dismissed for her inefficiency, Mrs Martha Gettings tendered her resignation in 1855, within seven months of appointment, following investigation into a complaint by Benjamin Lane, an inmate, regarding his medical treatment. The nurse admitted she had failed to carry out the MO’s order to apply a poultice to Lane’s chest and admitted she had ‘a bad memory’, which resulted in her frequently forgetting directions.69 At that time, she had had the assistance of six wardsmen and seven wardswomen, who were provided with a better diet than the other inmates.70 Surprisingly, Mrs Gettings was among the nine applicants when the post became vacant again in the following year, but was not appointed.71 Another common reason for dismissal was taking leave without consent and failing to return to the workhouse, as happened with four male nurses during 1868 and early 1869. William Barley, appointed in 1866, was unfortunate to be given one month’s notice after only six months in post because he was unable to work due to a chronic leg ulcer.72 The only instance of nurses returning from leave ‘drunk’ occurred in 1881 to male nurse, Llewellin Harris, and the assistant superintendent of the male insane, Henry Jenkins, on Saturday and Sunday evenings. Harris was dismissed, but Jenkins was only required to resign.73 Another who was coerced into resigning was Joseph Darnward when it was discovered, in October 1875, that he had married Maria Cartwright, the assistant superintendent of the female insane without permission of the guardians; Cartwright Higgs, p.131.
WALS, WBG, PU/WOL/A/8, 30 March 1855; WC, 4 April 1855. For further details of the treatment of Benjamin Lane, see chapters 4 and 5.
Ibid., 29 October 1852.
WALS, WBG, PU/WOL/A/11, 22 June 1860.
WALS, WBG, PU/WOL/A/13, 18 January, 1 February 1867, 3 January 1868.
Ibid., PU/WOL/A/19, 11 November 1881.
resigned a few weeks later. He had been appointed keeper of the male insane inmates three years before and subsequently male nurse only a few months before his resignation.74 Marriage was also the reason for the resignation of two officers in March 1880, when Daniel Johnson, superintendent of the male insane married Jane Moore, assistant superintendent of the female insane. The Johnsons were reemployed as a married couple in charge of temporary workhouse accommodation.
Joseph Smith, the male nurse of over four years standing, and Mary Stanley, the recently appointed superintendent of the female insane, also resigned on exactly the same date, though the reasons were not recorded in the minutes. Mrs Stanley, a widow in her early 40s, was re-employed six months later as the assistant in the female insane wards.75 Men, as well as women, were required to resign on getting married, as nurses were required to live in the workhouse and had very little leave.
The only opportunity for a married couple was joint employment, for instance William and Mary Parker, husband and wife in their early 40s, appointed in January 1861 as superintendents of the male and female insane respectively.76 They resigned
successors as superintendents of lunatics, Mr and Mrs Lack, resigned when he was appointed ‘Collector of Local Rates’ for Wednesfield Heath.78 Thirteen years later, another married couple, Richard and Sarah Owen, were chosen as superintendents of the insane. When Mrs Owen died in 1893 in her mid-50s, her husband continued in his post.79 In 1873, Mrs Elizabeth Careless retired in her 80th year as nurse in the female infirmary, suffering from ‘partial paralysis’. She had been an officer in the WALS, WBG, PU/WOL/A/16, 13 August, 1, 22 October 1875.
Ibid., PU/WOL/A/18, 19, 25 March, 23 April, 24 September 1880.
Ibid., PU/WOL/A/11, 11 and 18 January 1861.
Ibid., 9 and 23 May 1862.
Ibid., PU/WOL/A/12, 25 January, 8 February 1867.
Ibid., PU/WOL/A/18, 2 April 1880; PU/WOL/A/24, 12 January 1893.
workhouse since 1847 and had also worked briefly on the fever ward (during the smallpox epidemic in 1849) and as matron’s assistant. The guardians approved a superannuation allowance of £20 per annum.80 Catherine Cox, appointed nurse in the female infirmary in 1855, resigned after her request for an increase in her annual salary of £15 after 18 months in post was refused.81 The female nurse’s salary was increased to £20 seven years later and Thomas Alldridge, the male nurse, had his annual salary increased in 1865 to £30, after dispensing had been added to his other duties.82 In light of the difficulties in retaining nursing staff at that time, one of the guardians, Mr Sidney, intended to propose a motion to replace pauper nurses with paid employees. Regrettably, he died before he could bring the motion before the board.83 Two years later, the WMO suggested that all the nurses should be paid, but the master judged the nursing situation satisfactory ‘considering the class of nurses employed’. The guardians took no action, as appointing extra nurses would involve providing extra accommodation for them.84 Around this time, recruitment of nursing staff began to be problematic.
When Edwin Ladbrook, who had commenced work in October 1870, resigned nine months later, the guardians had no response to their initial advertisement for his replacement, but were able to appoint William Humphreys two months later.85 When he contracted smallpox the following year, the master was unable to find a temporary replacement, but he recovered and resumed his duties after a few weeks.86 Four years later, the guardians adopted a new schedule of officers’ salaries, after obtaining Ibid., 13 June 1873; WC, 18 June, 30 July 1873.
WALS, WBG, PU/WOL/A/9, 12 and 19 September 1856.
WALS, WBG, PU/WOL/A/12, 4 August 1865; WC, 19 April 1865.
Ibid., 24 April, 17 July 1868.
WALS, WC, 6 July 1870.
Ibid., 25 August, 8 September 1871.
WALS, WBG, PU/WOL/A/15, 29 December 1871, 5 January 1872.
information from 47 other unions. This involved increasing the starting salaries by an increment of £1 every second year to a fixed maximum, obviating the necessity for officers to apply at intervals for an increase (Table 6.5).87 The maximum salaries differed little from those they were paying at the time and were in line with wages in other poor law institutions and in the General Hospital, Birmingham.88 Although the guardians paid the superintendents of the insane the same wages as the nurses, they disagreed with the LGB that they were on ‘the same footing’ as the nurses, as they did not consider they performed nursing duties.89 In the early 1880s, there were 27 applications for the post of male nurse and 13 for that of assistant superintendent of the male insane, demonstrating that recruitment was no longer a difficulty and it would remain as such throughout that decade.90 Table 6.5: Salary Schedule for Officers in Wolverhampton Workhouse, 1876
At the time the workhouse opened, the nursing staff had consisted of only one nurse, until 1856, when a second was appointed. Two superintendents of the insane were added to the nursing complement 11 years later and two assistant superintendents five Ibid., PU/WOL/A/16, 11 February 1876.
White, p.74; Wildman, ‘Nursing at the General Hospital’, p.22.
WALS, WBG, PU/WOL/A/18, 18 June 1880.
Ibid., 2 February 1882.
years after that. By comparison, inmates had increased from just over 300 to almost 1,000 and patients from 55 in 1842 to 423 in 1888.91 In 1874, one of the guardians considered it a disgrace that there was only one female paid nurse, Mrs Mary Wedgebarrow, as she had over 100 sick inmates under her care.92 The two nurses employed to care for patients with physical illness saw their patients increase from 87 each in 1866 to 157 each 22 years later.93 There is no evidence from Wolverhampton that the increasing number of sick inmates influenced length of service, as there was a
deterrent, as they were comparable to most other medium-sized and large workhouses in the third quarter of the century.94 Of those who resigned, only a few took up nursing posts elsewhere and a substantial proportion may have done so out of a dislike for the type of work they were required to carry out.95 The impact of loss due to marriage would have been lessened to a degree in Wolverhampton by the guardians’ preference for appointing older widows, and male nurses left employment after a short period as frequently as their female counterparts. A major factor causing the high turnover was the exhausting nature and the demanding pace of the work, which applied also to nursing in voluntary hospitals. For instance, the average length of stay of seven nurses at St Thomas’ Hospital in 1847-48 was eight weeks.96 WALS, MJ, PU/WOL/U/2, 16 April 1842; WBG, PU/WOL/A/22.
WALS, WBG, PU/WOL/A/16, 31 July, 21 August 1874; WC, 17 February 1875.
BPP, 1867-68 (4), p.153; WALS, WC, 11 July 1866 and 4 April 1888; WBG, PU/WOL/A/22, 6 April 1888. The figures are not directly comparable, as the first excludes those ‘of unsound mind’ from the patient total, and the second ‘idiots and imbeciles’, but they give a fair estimate of the increase in the nurses’ workload.
White, pp.26, 74.
Maggs, ‘Nurse Recruitment’, p.33; he found that 16% of probationers in the early twentieth century left their training early for this reason.
Helmstadter and Godden, pp.53, 188, 191.
Paying Nurses and Paupers in the First Birmingham Workhouse Although the NPL facilitated the employment of paid nurses, many boards of guardians were slow to implement the new arrangements while some large workhouses included remunerated nurses among their servants under the Old Poor Law arrangements. In 1818, Birmingham guardians gave the surgeons they employed instructions to appoint ‘one chief nurse’ to each ward in the Town Infirmary and resolved that the nurses were to be ‘entirely under the direction of the Surgeons’.
Furthermore, each nurse would be allowed as many assistants as was necessary from among the female paupers in order to keep the wards clean.97 Five years later, they increased the nurses’ salaries to 2s 6d and the assistants to 1s per week when they discovered the ‘pernicious custom’ of the nurses receiving gratuities from patients due to the inadequacy of the salaries.98 The nurses’ annual pay of £6.10s was better than that of £4.13s paid to the nurses at the General Hospital in Birmingham at that time.99 The nursing arrangements continued unchanged after 1834, but in 1842, they advertised for ‘several females as nurses in the Town Infirmary’, with the requirements that the women were ‘of good character, of assiduity and determination, and possessed of kind feelings towards sick patients’.100 The House Committee interviewed 11 applicants, some of whom were already employed, while others were pauper nurses. For instance, Elizabeth Higgs, a pauper nurse, who was 41 years of age and had a boy in the guardians’ facility for pauper children, was continued as nurse in the lying-in ward at an annual salary of £10. Ann Rose, a spinster aged 46 years, remained as nurse of the old and infirm women’s wards on £8 per annum. Six other appointments, all widows, were made to the infirmary wards, women’s fever, BCL, BBG, GP/B/2/1/2, 11 February 1818.
Ibid., 1 July 1823.
Wildman, ‘Nursing at the General Hospital’, p.22.
BCL, HC, GP/B/2/3/1/1, 29 March 1842.
venereal and insane wards and the bedridden ward. The annual salaries ranged from £8 to £13 and the nurses were allowed a ration of tea, sugar and butter.101 The matron was instructed to appoint fit, able-bodied women as assistants, but the house surgeon considered only Elizabeth Harrington, a widow ‘with no encumbrances’ competent to perform the duties required. In addition, he pointed to the need for night nurses, as many of the more disabled patients required as much attention at night as by day.102 Mary Mills, aged 22 years, who was retained as nurse in the women’s fever ward, was later considered to be too young after accusations of her misbehaviour with William Purnell, the male nurse on the fever wards. As a pauper, she could not be dismissed, but was transferred to duties elsewhere in the workhouse. Purnell was retained, although, one month later, he was dismissed for further misconduct.103 Table 6.6 shows those acting in nursing roles in August 1842 and nearly all the non-pauper nurses were employed on the female side, while some of the male wards, for instance, venereal, did not have any pauper assistance. It is also interesting to note that Elizabeth Higgs’ payment had been reduced by half.