My dissertation examines military and naval nursing in the British empire c. 1763-1830. I focus on five key areas:
Cleanliness and Preventative Medicine
Medical practitioners and early modern British society viewed nursing as a female task, one often performed by female family members for their loved ones. The work of nursing — cleaning the bodies, body linen, and bedding of the sick, preparing and feeding patients correct diet, and ensuring the cleanliness and adequate ventilation of rooms — used skills that women typically possessed. This gendered view of nursing work ensured that nurses working in naval and regimental hospitals were women. Yet, these women should not be relegated to a domestic rather than a medical role. The same tasks listed above were distinctly medical within the framework of early modern medicine with cleanliness and ventilation the vanguard of preventing contagion in hospitals.
Race and Nursing
European eighteenth-century understandings of health and disease in the West Indies culminated in the belief that the region was particularly deadly to newly arrived British settlers and military personnel unseasoned to the climate. This belief appeared to be borne out in the deaths due to disease of thousands of troops sent to the region during the Revolutionary and Napoleonic War period. European women and Euro-settler women were not seen as capable to provide nursing care to the sick in military and naval hospitals. Instead enslaved African and Afro-Carribean women employed as nurses in these institutions. Focusing on a case study of Bermuda Naval Hospital I consider how concepts of immunity influenced the selection of Black nurses to care for these diseased sailors, how the use of slaves in naval hospitals conformed to local societal expectations and conceptions of Black labour, and the integration of these women within the wider labour market of the islands.
By conceiving of eighteenth century naval hospitals along household rather than martial lines it is possible to better understand the organisation of the hospitals themselves and the role of nurses. With Plymouth Naval Hospital as a case study I argue that contemporaries conceived of naval hospitals along household lines and thought of nurses and other non-medical officers as servants. I have collected 1419 naval nurses’ pay list information into a database with 18784 individual entries, in order to perform a quantitive analysis of the collective nursing staff and individual nurses’ careers. I merge this quantitive information with journals, letters, and reports to show how the number of nurses responded to the military needs of the state, the importance of nurses to the functioning of the hospital, and their role in exercising authority in the wards.
Coupled with understandings of cleanliness and preventative medicine studying changes to regulatory practices over time shows how nursing in naval hospitals became more medicalised in the period of the Revolutionary and Napoleonic Wars. The absence of change in nursing regulations within military medicine, while likely due to the lack of permanent general hospitals, suggests that significant reform was necessary in order to continue to meet the needs of an imperial nineteenth-century army. The discrepancy between regulatory practices in the army and the navy demonstrates the different conceptual and practical frameworks of the military and naval medical systems and provides a clue to the need for Nightingale’s Crimean nursing reforms.
Professionalisation of Military and Naval Medicine
Throughout the eighteenth century military and naval medical practitioners fought for professional recognition of their skills. Their perseverance was rewarded for the army in 1794, and the navy in 1805, surgeons gained officer status. Such rise in status was due to a concerted effort from medical practitioners to demonstrate their specialised skills and distance themselves whenever possible from mundane body-work associated with medical care. Naval surgeons and physicians were only required to visit their wards twice daily and would have more than 200 men under their care, while complaints from hospital administrations show that even this bare minimum was often not met. Nurses medical roles, especially the monitoring of patients for changes in symptoms, increased as medical practitioners left the bedsides of the sick. The professional identity military medical practitioners developed and their resulting conception of the nurses’ role went with them as they moved into civilian institutions with the end of the Napoleonic Wars and demobilisation.