Discord Between VAD and Trained Nurses

VAD units were set up in 1909 to provide first aid and ambulance work in their area. For this task the required certificates were considered adequate.

Men were already able to display their patriotism by joining Militia and Territorial Units and the VAD was seized upon by ladies as a chance to make a similar commitment.

This was particularly attractive to the women who were already pre-eminent by social status in each community who were then able to use their influence to encourage membership, secure the use of facilities and equipment and from their wealth provide funding.

The immediate success of VAD throughout the country provided a large organised pool of manpower who possessed basic skills in both nursing and first aid.

With the declaration of war, there were fears of a deluge of injured men to treat which led the War Office to place control of the VAD in the hands of the County Territorial Army to develop a system of aid at auxiliary hospitals for wounded Territorials.

Given that most of the Territorial Army Officers were from the same wealthy background as the leaders of the VAD movement  and the attitude at the time in these circles that voluntary work by the wealthy was in some way much more valuable than paid work it is no surprise that the VAD hospitals developed with leaders from the voluntary VAD rather than trained nurses.

The power of the VAD leaders was in their wealth and influence in that many large homes, often owned by the VAD Commandant, were quickly made available as hospitals and personal wealth used to equip them in a fashion that the state would have found difficult to match.

The price however was that the Commandant and other senior posts in the Hospital were then taken by those individuals or people from their circle despite their medical inexperience rather than by trained health professionals.

The new auxiliary hospitals recruited trained nurses, albeit in some case nurses who had married and not practiced for a while, but these trained nurses were under the command of untrained women who were used to unquestioning control and whose reasoning and decisions did not always coincide with those of the trained staff.

In many of the smaller VAD hospitals there was only one trained nurse which was appointed as Sister in Charge working with a pool of VAD nurses.

In the early stages of the war, some VAD nurses were then given opportunities to serve overseas particularly in Belgium while trained nurses were denied the opportunity. Although in most part this was due to the fact that many of the VAD spoke French while the trained nurses did not do so it was yet another cause for discontent.

Many but certainly not all wealthy VAD members tended to treat paid employees in the same way that they treated their servants whilst accepting the less skilled  but subordinate VAD members who moved in their social circle. This again provoked resentment from trained nurses.

Trained nurses were often very hostile to VAD Nurses allocating them basic tasks, being over critical and ostracising them.

The National Union of Trained Nurses led a high profile campaign against the use of VAD Nurses seizing on the problems while giving no credit for the growing ability shown by most VAD nurses.

As the war more on there were opportunities for all nurses and the growing competence of VAD nurses coupled with the enormous number of wounded to care for earned some degree of respect from both side.

The dispute was serious enough to encourage parliament to pass the Nurses Registration Bill in 1919

Some views taken from letters to the British Nursing Journal in 1914 illustrate the problems and the divide.

September 1914 from a Sister

How is it that the rich and leisured women of title arrogate to themselves the right to interfere with our skilled work and venture to propose that unemployed servants shall be trained for use at hospitals.

September 1914 from a County Hospital Matron

I have found the Red Cross Pupils working in this hospital of a much better class than the average young woman who has applied to me for training.

November 1914 from a private nurse

I have been sent from a private nursing institution to a private Red Cross Hospital. I am the only trained nurse, and at night no one is on duty, but an untrained Red Cross Nurse. All sorts of neglect goes on which these untrained people do not realise.

November 1914 from a Hostess

Since we opened this private hospital for convalescent soldiers we have not employed any untrained nurses but after some weeks experience of them in my house one sometimes wonders what training means.

This is a well appointed house with the usual staff of servants and their complaint of the untidy manner in which the nurses leave their bedrooms with everything scattered about, the manner in which table cloths are slopped with tea and coffee at meal times and the necessity of brushing the crumbs of my nice carpets after every meal makes me wonder if such slovenly habits are permitted in hospitals.

Surely they should be taught to respect the belongings of the host and hostess. Already more damage has been done to my establishment in a few weeks by trained nurses than in years by my friends.

December 1914 from a soldiers wife

Why are untrained women allowed to take any part, however minor, in the dressing of our soldiers wounds either at home or abroad? The kind of cleanliness required in surgical nursing is not easily grasped and only those who have had a thorough surgical training really understand it.

December 1914 from a member of the RNS

I have been covering the unqualified in a Red Cross Hospital for some weeks. I have asked to be relieved from duty at  this hospital as I cannot conscientiously continue covering up all this muddle and seeing things go wrong for need of an efficient nursing staff. 

December 1914 from Marion Patten

Anyone who choses to don a nurse's uniform, however ignorant, is accorded professional rank. Indeed one may add supremacy, as social status, not knowledge, is in reality the criterion for supervision.