Life expectancy for men is 45, free school meals are introduced and Nursing Times is launched

_..,..,.,.,. The country that Nursing Times' first readers knew was worlds away from contemporary society. The population of over 38 mi llion had an average life

..,_. __ expectancy of 45 for men and 49 for women, and 63

per cent died before the age of 60. Today men can expect to live 76 years and women 81, while only 12 per cent die before they reach 60. Infant mortality in 1905 - when NT was launched - was 140 per 1,000, compared with 5.5 per 1,000 today.

The Edwardian period before the Great War is often seen as a golden age, when the empire brought huge wealth. However, the distribution of that wealth was far from equal.

At the start of the century about one-third of the population lived in extreme poverty in overcrowded and unsanitary conditions. In a report on poverty in York, published just before the launch of-NT, seebohm Rowntree had concluded that while gambling, drinking and 'general shiftlessness' were the cause of many cases of poverty, for most the immediate cause was inadequate wages.

Living conditions and malnutrition meant large swathes of the population had poor health. This is illustrated by the fact that more

NT 10 May2005 Vol 101 No 19 www.nursingtlmes.net

KEY EVENTS

1905 • Nursing Times is launched, promising an unbiased alternative to other nursing journals of the day • A select committee of the House of Commons reports that ' it is desirable that a Register of Nurses should be kept by a central body appointed by the state' • The first heart transplant takes place. Two US doctors transplant a heart into the neck of a dog, which dies two hours after the surgery 1906 • Free school meals are introduced by the Liberal government 1907 • Florence Nightingale is awarded an Order of Merit • The Public Health (Regulation as to Food) Act (7 Edw.VII, c.32) enables regulations to be made on the importation, preparation, storage and distribution of food 1908 • The National Council of Nurses is founded • Old age pensions are introduced to people over 70 with a weekly income of 12 shillings or less • The Report of the Royal Commission on the Poor Laws and Relief of Distress calls for extension of public assistance to all those In need, not just people who are destitute 1910 • Florence Nightingale dies, aged 90

than one-third of would·b recruits to the Boer War in 1903 were turned down on health grounds. Recognising the effects of childhood nutrition on health In later life, the Liberal governm nt in 1906 introduced free school meals

Politically the country s dominated by the Liberals and Conservatives, although the Labour Party won its 111st two seats in the 1900 general electton. Wh1I most men over 21 could vote In

former 1; s

redoubtable Ethel Bedford Fenwick, a rich and suffragette. she campaigned for state re91str tt n of a law to limit the use of the Job title tot o

training. Nursing Mirror was the mouthpiece of S1

for the Hospitals' Association, which repr He too campaigned for nurse reg1stra I n should be non-selective Ethel Bedford Fen 1

'Nursing was one of the

few careers considered

respectable for middle

dasswomen'

'a central registry office similar to that for domestic servants'. There was slow progress towards compulsory registration, which had

been implemented for midwives in 1902, and bills were introduced to Parliament almost yearly. However, none made it onto the statute books.

Selecting and training 'probationers' was a big issue, and NT questioned the policy of many Poor Law guardians, who insisted on controlling selection. 'How can a committee of men in one interview judge the fitness of nurse candidates beyond a hasty impression of their appearances and their clothes?' it asked in 1908. It told a possibly apocryphal story of a short-sighted guardian insisting a candidate be selected on the strength of a bright green feather in her hat.

Key changes in other spheres would shape the country over coming decades - transport and communications were set to revolution ise society. Local transport was largely horse-drawn, with 22,000 miles of ra ilway catering for those travelling further afield. Although the age of the car was on the horizon, with only about 10,000 cars on the roads most of the population had not even seen one, let alone travel led that way.

In communications a telephone system was developing, although only the wealthiest could afford it. However, mass media would soon

18

bring affordable news and entertainment to the whole population. The organisation of health care in 1905 was haphazard and largely

unregulated. Most care was delivered privately in the community, and district nurses had an important role, particularly for people who could not afford a doctor. There were concerns, however, about illicit agencies sending out private nurses without checks on training.

Throughout the 19th century, hospitals had been seen as places to treat poor patients who could be cured. Those who were incurable or destitute went into Poor Law infirmaries and those with mental illness were locked away in asylums. People who could afford it were cared for at home. However, by the start of the 20th century advances in su rgery, medicine and diagnostic techniques meant better-off people often needed care that could not be provided at home.

The voluntary hospitals began taki ng private patients. They also started to improve their general level of care. Many began to specialise in particular groups such as women or children, in body regions such as ear, nose and throat, or in diseases such as cancer.

Nursing appealed to a wide range of women and was one of he few careers considered respectable for middle class women -thanks

NT 10 May 2005 Val 101 o 19 www.nursing1l--..,.5·"et

mainly to Florence Nightingale. Voluntary hospitals had their own

schools, most offering three-year training modelled on Nightingale's school at St Thomas's Hospital in London. Many Poor Law nurses, however, were untrained and from far humbler backgrounds than those in the hospitals. But wherever they worked, nurses could rely on Nrs support. Unlike some of its competitors, the journal represented the interests of all nurses rather than just those who had access to proper training.

Few major national events impacted on nursing in Nrs first few years. Whi le Liberal reforms such as free school meals and old­age pensions showed increasing acceptance of the state having a role in the health and welfare of the population, these changing attitudes would mainly affect the profession in years to come.

However, the decade ended with a major nursing event that impacted on the nation. After inventing modern nursing and establishing it as a skilled and respected profession, Florence Nightingale died at the age of 90.

Ms Nightingale did far more than transform condit ions in military

hospitals during the Crimean War. on returning to England she worked to improve nursing standards and made it a respectable profession. Her strict views on acceptable behaviour for nurses and their place in the health care hierarchy is demonstrated in the 'Nightingale pledge': 'I solemnly pledge myself before God and presence of this assembly; To pass my life in purity and to practise my profession faithfu lly. I will abstain from whatever is deleterious and mischievous and will not take or knowingly administer any harmful drug.

'I will do al l in my power to maintain and elevate the standard of my profession and will hold in confidence all personal matters committed to my keeping and family affairs coming to my knowledge 1n the practice of my calling . With loyalty will I endeavour to aid the physician in his work, and devote myself to the welfare of those committed to my care.'

Ms Nightingale had an enormous influence. In addition to improving nursing, she campaigned to improve public health despite years of debilitating illness, and in 1907 she became the first woman to be awarded the Order of Merit. Without her, NT and nursing as we know it would probably never have existed. •

NT 10 May2005 Vol 101 No 19 www.nursingtimes.net

NT in 1905-1909

NT did not so much burst on to

the scene as tap on the door and

wait to be invited in. Publishing

was a genteel business in 1905, and this was very much Nrs tone in the early years.

The editor for the first 21 years

was Swanhilde Bulan, a German­

born journalist. Preferring

anonymity, she was never

identified on Nrs pages.

In the first issue, which cost a

penny, Ms Bulan emphasised the

independence that is still

cherished today. There was 'no

shadowy personality " behind"

it,' she said, and NT would report

news without bias. This was an

allusion to the fact that its

competitors promoted particular

political views.

Responding to critics who

suggested that lack of opinion

would render NT ' colourless' the

launch issue stated: '[If] we can

avoid bias, bitterness and

personalities, we are w ell

content to be " colourless".'

However, NT believed it did

have colour to offer, but that it

would be 'of the right sort ...

expert articles, interes ting

experiences, rel iable and

exhaustive news, and helpful

interchanges of opinion.' It

would also cater for ' the human

being and the w oman as well

as the nurse'.

From its early years NT kept

nurses up to date on professional

news and cl inical issues. It also

gave them a forum in which to

express their views.

An article in 1908, for example,

complained about an aspect of

mental health nursing: 'No duty

lays more stress upon the

mental nurse than her

attendance at the dances

organised for patients ... M ny of the delusions of the msan r of persecutions or of

victimisations for which nurses or doctors are blamed, and It s essential that the careful nurs

will notice the facial expr ss,ons

of her charges as a fracas m th

ballroom is greatly dread d.'

The concerns of d1ff rent

branches including district

nurses, private nurses, school

nurses and fever nurs s , r

reported, including p y nd

conditions as well as elm c I

developments. M1dw1v had