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In the 'Grey Battalion': Launceston General Hospital Nurses on Active Service in World War I

Kirsty Harris


Nearly fifty nurses from the Launceston General Hospital served with the Australian Army Nursing Service or the British nursing service during World War I. These nurses served in countries that included Egypt, France, India, Greece, Italy and England. They worked in various roles including as a surgical team nurse close to the front working under fire; nursing on hospital ships carrying the wounded; or managing wards overrun with patients on ships at Gallipoli in 1915, whilst dealing with a lack of hospital necessities. This case study, of one group of nurses, shows that their experiences reflected the skills and roles needed to be a military nurse of the time, significantly different to the skills required to nurse in Australia.


World War I brought extraordinary opportunities for trained nurses in Australia. Across Australia, according to the official medical historian A.G. Butler, practically every trained nurse who was eligible rushed to join up, either to serve in the Australian Army Nursing Service (AANS) or with British nursing services.1 Of more than 3,200 Australian nurses who did gain military nursing experience overseas, nearly fifty nurses who had either trained or worked at the Launceston General Hospital (LGH), Tasmania enlisted for overseas service. Thirty-six of them joined the AANS. In view of the fact that in 1909 the hospital's staff totalled fifty trainees and nurses, the impact on the institution was significant.2 1
      Local histories inadequately tell the story of LGH nurses who served. Clifford Craig's history of the LGH makes no mention of World War I (WWI) and the work the nurses performed, and Linda Brown's book on Launceston nurses focuses largely on the WWII period.3 The Tasmanian Government's publication Tasmania's War Record: 1914–1918, also regretted the absence of, 'some sort of connected account of the work of the Tasmanian nurses,' which naturally included Launceston nurses.4 This paper identifies the LGH women who went on active service in WWI. It explores their contribution to the war effort, and highlights some of the events that made military nursing very different to their lives at the LGH. The LGH nurses' collective experience of wartime nursing reflects the diversity of work skills and roles acquired by Australian military nurses of the time serving overseas. Thus the focus in this paper is on nursing practice, which earlier nursing historians such as Marianne Barker and Rupert Goodman have downplayed in their concentration on the administration and organisation of the AANS or the experiences encountered by nurses, that is, what happened to them rather than what they actually did.5 2
      This case study examines how Australian military nurses in WWI met new challenges and adopted new work practices, including work that challenged existing expectations of institutional roles and gender. The work experience of the Launceston nurses at war, and comparison of their civilian lives with their military roles and skills, throws further light on the crucial experiences of Australian nurses at war. The story of a compact group of nurses from one hospital in Australia also adds significantly to our understanding of the establishment and development of Australian military nursing. 3
   

LGH Training School

 
In the early years of the twentieth century, the LGH nurse training school had such a good reputation it attracted trainees not just from Launceston, or even Tasmania, but also from interstate country towns such as Tocumwal, Victoria and Singleton, New South Wales.6 Registered as a Training School early in the twentieth century by the Australasian Trained Nurses Association (ATNA, a forerunner of nursing registration boards), LGH probationers faced a four-year training program based on Florence Nightingale's principles of nursing. In Australian hospitals, the period of training was proportional to the number of beds, with a fixed minimum of beds and a minimum period of training of three years.7 In the case of smaller hospitals, four years and in some cases five years training were necessary before graduation.8 Of the twenty-six large general hospitals registered as training schools with the ATNA in 1913, only eight of them which included the LGH, offered a four-year training period.9 The fourth year was alternatively seen as part of the movement towards state registration of nurses (Brisbane Hospital), a postgraduate year (Royal Prince Alfred Hospital) or even preparation for promotion to sister (Melbourne Hospital).10 In reality, the fourth year often became a year of work where the hospital could still pay their probationers to work at cheaper rates.11 It is likely that this was the case in Launceston. LGH nurses and probationers had to be single and live in the nurses' home. Numbering around fifty, they looked after seventeen wards with, 'a daily average of 160 patients,' in 1910.12 The chaos of war was to overturn this ratio of nursing staff to patients; in 1915, one military nurse with some untrained orderlies took responsibility for a ward of two hundred patients, and one Australian hospital with 53 nurses looked after nearly one thousand patients.13 4

 
Image 1
    Image 1. Launceston General Hospital nurses enlisting in the Australian Army Nursing Service c. 1917. May Tilton is on the far right. Courtesy of the Australian War Memorial.
 
 
Through lectures by both medical staff and matron, the nurses learnt a wide range of medical and surgical nursing practices as well as invalid cooking. Laura Grubb, from Lefroy, Tasmania, who began her training at the LGH in 1913, later recollected: 'In our time off there were at least three lectures a week by Drs or Matron & two exams each year to pass & 3 in the last year.'14 The nurses experienced practical work in general, working in isolation wards for contagious cases and children's wards, and even received psychiatric patients.15 Most of their skills would be of value during the war.16 5
      The title of this paper reflects the memoirs of one AANS nurse, May Tilton, who published a book of her WWI memoirs in 1933 titled The Grey Battalion.17 Tilton had trained at the LGH from 1909 to 1913 before enlisting in July 1915. She published the book at the urging of friends and with the aim of giving, 'a true, and I hope interesting, account of my "trail with the warriors".'18 6
   

Active service

 
On the morning of 5 August 1914, Australia went to war.19 The first LGH nurse to enlist was Ella Tucker who quickly signed up in the same month although she did not embark for overseas until December 1914. The experience of Launceston nurses who were to serve was broad. Sister Julia Johnson was one of the nurses who accompanied the first contingent of Australian Imperial Force (AIF) soldiers to war in October 1914. She had been in training at the LGH in 1888, a year before the training school had officially opened, but what deficiencies this might have created in her nursing education, her later military nursing experience during the Anglo-Boer War in South Africa in 1900–02 ameliorated. In addition, she had been the New South Wales matron for the Australian Army Nursing Service Reserve and therefore had the advantage of some knowledge of the military and its medical systems. Sara Williams was the last of the hospital's nurses to leave Launceston, heading for British hospitals in India in December 1917. In between is a remarkable cross-section of Australian military nurses whose postings and work experiences mirror the overseas war service of most Australian WWI army nurses. Most enlisted with the AANS although Imelda Coffey, who finished her training in May 1913, and Annie Florey both served with the British service: the Queen Alexandra's Imperial Military Nursing Service.20 Annie Florey was one of two Launceston nurses to receive the Royal Red Cross for her nursing work, awarded for special devotion and competency displayed in military nursing duties.21 7
   

International work

 
Australian nurses had a very international experience during the war. Unlike soldiers who often served in a battalion of men from their hometown or district, Launceston nurses worked with others from hospitals all over Australia. They also worked in many countries and at sea with allied services including the British, Canadian, Indian and South African armies. Some of the more unusual locations where there were no Australian soldiers included the North West Frontier in modern Pakistan (then part of India), Basrah in Iraq (then Mesopotamia), and German East Africa.22 Consequently, many Australian nurses had exposure to the medical systems and procedures of other nations, all of which affected their nursing. 8
      Most Australian Army nurses, to their surprise, served in both Australian and British hospitals and often nursed allied soldiers other than Australians. Seven nurses including Frances Prescott and Alice Macdougall went to malaria-infested Salonika in Greece, and ten LGH nurses went to various military and station hospitals in India; they all worked solely in British hospitals, largely replacing British nurses. In some ways, this was an advantage; Australian nurses were hands-on in their work practices compared with the British nurses who usually took a supervisory role over their orderlies.23 Consequently, doctors often chose Australians to work as their all-important theatre nurses or to work in surgical teams.24 9
   

Managing men

 
A significant change for military nurses was managing male nursing orderlies in their wards. In Australian hospitals, most probationers were female, and the LGH was no exception.25 In the last thirty years of the nineteenth century, women replaced the male attendants or wardsmen who had previously attended male or insane patients and whose numbers then declined significantly.26 Apart from male nurses in mental institutions, there was no body of trained male nurses to draw upon as 'nursing orderlies' in the Australian military hospitals.27 Therefore managing male military orderlies was the first time that most of these military nurses had needed to direct men in their ward environment. Many orderlies had no medical or nursing experience, and the standard of a nurse's ward depended entirely on how well she could train them. Naturally, there were some issues regarding status and obeying orders, but most nurses managed admirably. Training often began on the outward voyage from Australia and continued during the war.28 Ella Tucker transferred to the hospital ship Sicilia in April 1915 in preparation for the landing at Gallipoli and gave her orderlies, 'bandaging lessons, & later on pad splints – We pad & pad splints morning & afternoon; every day, there seem to be hundreds of them.'29 10
   

Military nursing

 
In some countries such as Greece, work conditions in tented hospitals were very primitive. Marion Geddes went with No. 3 Australian General Hospital to Lemnos island in Greece during the Gallipoli campaign, where, for the first few weeks, the patients lacked accommodation, food and water. Nurses had to improvise medical equipment by using boxes and bags. They tore up their own clothes to make bandages and wash cloths, and they learnt to manage their ward tents, which tended to fall down in strong winds and leak.30 11
      Just as difficult was the situation on board the hospital and transport ships off Gallipoli; Ella Tucker and Helen Lawrence were the only Launceston nurses out of one hundred Australian nurses to serve in this theatre, nursing onboard ships off the Turkish coast. Nurses in this environment, sometimes only one mile from the beach, often found their ships under fire from the guns on Turkey. Ella Tucker noted on 25 April 1915, 'all this time we can hardly hear ourselves speak, with the [bombing] which is going on outside, the ship just shivers with the extra heavy reports.'31 The volume of patients nearly always exceeded the ward capacity, and the state of the men's wounds and their poor, often emaciated, condition created the need to throw out all the 'technique and fuss' as one nurse put it, and move to emergency nursing.32 The work required courage, high level skills in prioritising patient-care, and coping with the shock of terrible wounds previously not seen. On 15 May 1915, Ella Tucker wrote in her diary of how different it was to working at home:
Every night there are 2 or 3 deaths, sometimes 5 or 6; its [sic] just awful flying from first one ward into another; & dreading to hear what the orderly might have to tell you, when you get there, how you wished you could be in the 4 wards at once, the Orderlies hav'nt [sic] had much training, but they do their very best, each night is a nightmare.33
 Ship nursing had its own difficulties with limitations on supplies, including water shortages. Tucker wrote of how the nurses had to improvise:
On the return journey to Gaba Tepe, we work hard getting our wards ready, can't get clean pyjama suits; pick out the cleanest, & about 40 pairs of blood stained ones, with the orderlies assistance, we do our best to wash in salt water, & then dry on the deck. Every spare minute is spent in making up dressings, & padding splints which the ship's carpenter is making for us.34
 The nature of war nursing was remote from the organised life in Australian hospitals. The volume of work meant that it was impossible to perform nursing duties to the level required at home. LGH nurses on day shift learnt that, 'If we were not finished and the patients comfortable and Wards tidy by 6 p.m. ... we would be considered bad managers.'35 However, the chaos of war changed life for many nurses who had to work hard in a physical environment very different to home hospitals. As one wrote: 'Everyone has to work very hard and would still have to work hard if the staff was doubled.'36		 12
   

Physical environments

 
Australian nurses faced many environmental challenges in France and Belgium from 1916 when they moved with the AIF to the European theatre of war. It was a major contrast to the tropical heat of Egypt. There were the freezing winters to adapt to, which were a major change for those used to working in more temperate climates, although Sara Williams lived in Jindabyne before commencing her training at the LGH, so may have experienced working in snowy conditions. It was very difficult nursing patients in tents covered with snow and with all liquids, including medicine and hot water bottles, liable to freeze.37 With such temperatures, the nurses struggled to keep their patients warm and dry, and there was a high incidence of frostbite. For example, during the harsh winter of 1916–17 in France, the AIF evacuated more than twenty thousand Australians with exhaustion, frostbite, or trench foot.38 13
   

Frontline work

 
Towards the frontline, there were no clean white hospital wards such as at home; usually it was just huts and mattresses with brown army blankets, often with sandbagging at the entrance to the ward.39 Lengthy standard procedures learnt during training disappeared in the face of the pressure of work. They were replaced by systems that spoke of efficiency and focussed on the continual movement in and out of patients. The numbers of wounded were enormous when 'stunts'—attacks on the enemy—occurred.40 In France a new role emerged for nine Launceston nurses, including May Grant and Ruby Hornsey—nursing in Casualty Clearing Stations (CCS). Originally designed to clear patients, these medical units became centres for surgical excellence in the largely stationary trench warfare of the Western Front.41 Hailed as, 'a mecca to which all good nurses aspire,' CCS work required superior theatre skills as well as the ability to 'triage,' to keep patients alive, and to ease the suffering of those who were dying.42 It was a stressful environment, and was often the first place behind the front line where surgical treatment was available. CCSs also existed in other theatres of war. Laura Grubb was part of a surgical team sent to help British nurses at 21 CCS Saraguel, an operating centre fairly close to the firing line on the Greek/Bulgarian border. She wrote in a letter home that it had been, 'a great experience from a nursing standpoint but heartbreaking to see the battered human frames that are sent to us to repair.'43 14
      Even minor wounds could mean surgical intervention to avoid septicaemia so common in soldiers fighting in the highly fertilised fields of Europe. Nurses such as Ella Tucker had to spend a great deal of time sterilising equipment for the constant theatre work:
The sterilizer we used for dressings, gowns, etc, was quite a good size, under which we placed a six burner primus, which had its good & bad days, the kerosene was often very inferior, & one could'nt [sic] resist a sigh of relief, when the main part of the day's sterilizing was done. For the instruments & gloves we had an ordinary one burner primus, & the trial to one's temper, when you were the only nurse, & had to take the case & change the tables between the cases, to find when you went out your instrument primus well out, & your two orderlies away, bringing along the next case, of course these trifles only occurred when both tables were going, & both theatre Sisters sterile.44
 Resuscitating patients to keep them alive was a developing skill, with rehydration, blood transfusion, and treatment for shock being integral to this type of nursing. Annie Cameron, who trained at the LGH from 1905 to 1909, had postings at both Australian and British CCSs. She was chosen to be a nursing sister on one of the dedicated surgical teams at No. 32 British CCS that provided 'state of the art' surgical intervention very close to the front line. She was shocked at the state of affairs in the operating theatre when she arrived:
I was told by the Sister in Charge the table I was to have and that I would find all I required there. I looked at the chaos & wondered where I would find anything... The surgeon I had had only recently arrived at the CCS so I had not worked with him at all. I soon found he had not been used to doing penetrating abdomen with only one Sister to assist him & would forget that I had only one pair of hands to hold retractors, sponge and thread sutures with.45
 The CCSs were liable to be bombed themselves and nurses had to help their patients cope with the stress of not being able to fight back.46 The army awarded the Military Medal to seven members of the AANS for their bravery in these situations. May Tilton, when she first arrived at No. 3 Australian Casualty Clearing Station, found it difficult to work when the CCS was under fire: 'The guns were pounding away at a terrific rate. It was so deafening, we could hardly hear ourselves speak, and shells were screaming and bursting in all directions.'47 Evacuation and admittance of patients was continuous, and Tilton, at No. 4 British General Hospital, found herself immensely busy:
My duties at night included five wards with two hundred and twenty patients in my care, both medical and surgical. Two orderlies and two V.A.Ds assisted me. Almost every night convoys arrived from the line, while evacuations were carried out at the same time.48
 Night duty itself therefore changed to be one of the busiest times, instead of the quietest.49		 15
   

War wounds

 
Bullets, shrapnel, high explosive shells, trench mortars and hand grenades caused the vast majority of soldiers' wounds.50 Consequently, medical and nursing staff treated injuries not commonly found in Australia. New military features such as aircraft, flamethrowers, great defensive belts of barbed wire crucified men; batteries of machine guns and massive concentrations of long-range artillery mechanically slaughtered soldiers.51 The phrase 'cannon fodder' was obvious to those nurses extracting metal pieces from bodies—whether the result of 'pineapple bombs' which spat tails of fire in their wake, missiles called 'coal boxes' that burst with a high explosive effect, or 'whizzbangs.'52 With the many wounds came a constant round of dressing and redressing, many men having multiple serious injuries. Unlike the casualty departments at home where doctors did any procedure, now nurses helped remove smaller pieces from wounds frequently without anaesthesia at dressing stations where they treated walking patients. Often two nurses had to dress the wounds of one patient such was the extent of the damage.53 16
   

Diseases of war

 
The nursing staff faced many new illnesses in their patients such as trench foot, trench fever, and shell shock. Winter conditions in Turkey, Greece and France were severe. For men standing in cold and waterlogged trenches, the inability to get the blood circulating by moving around caused trench foot.54 As with frostbite, it affected large numbers of men, causing the most number of casualties on the Western Front after venereal disease, accidents and fevers.55 Nurses found the condition revolting. Removing the men's putties and boots revealed:
feet so blistered and painful; finally came the socks; socks almost taking root in the charred and broken flesh ... Some black, swollen, and shapeless, covered with huge blisters as if they had been severely scalded; others completely gangrenous, the gangrene, in many cases, extending far up the leg.56
 The first aid treatment was gentle friction—often with snow—to try to restore the circulation in numb limbs, which could also include hands or fingers.57 But May Tilton had to cut boots and socks off feet that were stone cold and swollen, and then wrap them in cotton wool and bandages.58 Amputations of toes or feet were common.		 17
      Soldiers suffered all manner of diseases including dysentery. Laura Grubb had no experience of this illness during her training at the LGH and felt, 'so helpless knowing so little ... This dysentery is a cruel thing & a terrible thing to nurse.'59 Many of the sick soldiers had their wounds or illnesses compounded by general debility, and nurses spent significant amounts of time using primus stoves to cook invalid food for their patients to build up their strength and weight.60 Sometimes they went to great lengths to find suitable food. May Tilton and her colleagues, nursing in Boulogne, acquired what they could when their local bakery was bombed:
We searched the village for provisions and extras for our patients. Each day I would make great bowls of jelly and custard, treating alternate sides of the ward to a feast. The Tommies were often persuaded to sell their share to an Aussie for a franc (10d). When we knew of this and lights were out, we would smuggle a feast to Tommy which he would devour under the bedclothes.61
 Trained nurses were almost entirely responsible for post-operative treatment as well as fever nursing. In this pre-antibiotic era, their powers of observation and their use of initiative in the war environment meant that many men owed them their lives.62 Australian nurses also nursed prisoners of war, a psychologically difficult situation for some who found it difficult to reconcile nursing the enemy against their Geneva Convention commitment to nurse all sick and wounded, regardless of country.63 At No. 3 Australian General Hospital at Abbeville, May Tilton was one who happily worked with German prisoners of war who seemed to her to be, 'decent fellows. When I could I gave them extra food for which they expressed gratitude.'64		 18
      Strain, exhaustion, horrifying unnatural conditions and the general turmoil of war—including seeing friends killed and mutilated bodies—resulted in a new psychiatric condition often called shellshock.65 The noise of the frontline often shattered men's nerves, and even deafened or maddened them. It was described by May Tilton as a, 'continuous rumble and roar, as of an immense factory of vibrating machinery ... pulsings and vibrations worked into our bodies and brains.'66 Stammering, loss of memory, headaches, insomnia, nightmares, hallucinations, deafness and temporary blindness afflicted those with shell-shock. Some jerked, twitched or trembled uncontrollably for several days.67 Doctors generally ordered the nurses to administer bromide and other calming drugs, the regular treatment being complete mental and physical rest in bed.68 At No. 3 Australian Auxiliary Hospital at Dartford, England, where Christina MacAulay worked in October 1918, some doctors made enthusiastic attempts to use modern methods such as hypnotism and suggestion, with good effect. Often nurses tried to amuse their patients, to make them forget.69 19
   

Cultural issues

 
Language and cultural barriers often made nursing the patients more difficult; even the dialects of British soldiers proved a trial. Military nurses often had to work with local orderlies who spoke little or no English, and had a different work ethic. While nursing at sea, Ella Tucker felt exasperated by her Indian orderlies who were seasick at the slightest movement of the sea:
the moment your back was turned, they would vanish and lie down behind one of the doors, felt awfully sorry for them, but we were too busy to do without them, it was a continual run away, and if you did not find them behind one door, you would find them behind another, set them to work once again, and continue with what you were doing yourself, & in 1/2 hour you would have the same performance all over again.70
 Eileen Burke, who trained at the LGH, later wrote of her first experience of dealing with the then-called native servants at Colaba War Hospital, Bombay, India, but, 'as they were all very well trained and disciplined we had very little bother with them, and soon picked up enough Hindustani to make ourselves understood.'71		 20
      Military nurses had to supervise Greeks, Bulgarians and Indian patients whose cultural mores did not fit with Australian nursing protocols.72 Laura Grubb had Greek patients who tried her patience:
it is pathetic to try & nurse them with any degree of success for their language is quite a closed book to us, we talk to them by signs & generally succeed in making ourselves understood but one cd [could] ease their pain with greater success if one cd understand. They are good patients but being accustomed to having their women folk do everything for them; are very exacting. There are some of course who won't submit to treatment at all & in spite of having big fractures will take their splints off & just throw them away.73
 These cultural differences thus sometimes led to slower and more difficult patient recovery.		 21
   

New roles

 
The impact of war on nursing was widespread; the lack of resources created opportunities for the employment of nurses in fields not officially open to them in Australia. For example, some trained as anaesthetists; although after completion of their official course, Australian military hospitals did not use them.74 Certainly, there is no evidence that this was a role for nurses at the LGH; although Matron Adelaide Gluyas at Tasmania's other major hospital, Hobart Hospital, gave most anaesthetics for major surgery for the duration of the war.75 Other nurses such as May Tilton, who had been sister in charge of the LGH operating theatre, had new responsibilities. When working with an American surgeon, she took up 'scalpel work' on patients with multiple injuries, attending to minor wounds to allow him to concentrate on more major ones.76 Some nurses gained experience in x-ray work, a relatively new apparatus for many medical staff as well as nurses.77 This new technology impressed Ella Tucker with how efficient it made surgery; she remembered the table and patient were, 'just wheeled into the X–Ray room, the F.B. [foreign body] located, & the patient wheeled back to the theatre, & the operation proceeded with.'78 Others worked as dispensers and compounders of drugs.79 Of perhaps greater significance, the roles of the military nurse spilled out of the realm of nursing in to military duties such as orderly officer and administration officer, typical staff roles.80 Even the role of home sister dramatically changed from ministering to the morale and morals of nurse probationers to providing food and accommodation for hundreds of nurses while in foreign countries.81 22
      There were unusual places to nurse. Those working in the Sea Transport Service nursed convalescent soldiers on the high seas between Australia, Egypt and England; some made as many as ten voyages to and from Australia.82 Shipboard nurses had to manage seasickness and humid conditions in their wards below deck. Beryl Tucker was one member of the AANS who had the extraordinary experience of sailing on the hospital ship Madras in late 1918 to Vladivostok, Russia where the British were assisting anti-Bolshevik forces in the Russian civil war. The Allied Forces also used ambulance trains in Egypt, India, France and England. Doris Rudge nursed on a surgical ambulance train in and out of Salonika, Greece. This work required those who could work autonomously, as there was little medical support and nurses had to act quickly to arrest haemorrhage, a common problem in wounded men.83 23
   

Home service

 
As well as working overseas, military nurses could serve in home hospitals. An order in June 1915 created military general hospitals in each Australian state to meet the medical needs of injured or sick returned servicemen. In these hospitals the patients were, ostensibly at least, under military discipline.84 Consequently, in December 1915, part of the LGH also became a military hospital—No. 12 Australian General Hospital. Violet Grace Jenkins, from Premaydena, Tasmania was one of the first LGH nurses to serve there having returned from Egypt with casualties from Gallipoli in October 1915. No. 12 treated almost all types of acute, chronic and special cases. By June 1918, it had 127 beds. There were three sisters and nine nurses on staff but, unlike the civilian area of the hospital, no probationers.85 Other military nurses who served there included Eileen Burke, Bertha Falkland, Ruby Hornsey, Mary Stephens and Sara Williams. Many nurses served there for some months as a prerequisite before being called up for active service. It enabled them to learn something of the aftermath of war wounds and illnesses as well as military systems, ranks and etiquette. These were important in terms of ward management and patient discipline. 24
   

After the war

 
All the LGH nurses had returned from the war to Australia by 1920. In a later speech, Laura Grubb expressed thanks for her 'faithful training' at the LGH; she said that it had prepared her for all the types of diseases she had to contend with as well as the wounded during the war.86 Katherine Heerey returned to Launceston in January 1919 to take up home service duties at No. 12 Australian General Hospital at the height of the so-called Spanish influenza pandemic. Mary Stephens was one of the last AANS to return in December 1919 after serving in Bombay, Bangalore and Rawalpindi in India. Some nurses returned to civilian nursing after the war, mostly not in Tasmania. Following the pattern of moving to find appropriate work established pre-war, Marion Geddes went to Queensland and became matron of the Goondiwindi Hospital, remaining there for twenty years. Laura Grubb trained in midwifery in West Australia and became a bush hospital matron. Florence Power took her war skills back to the Melbourne Eye and Ear Hospital; she had worked there after her LGH training. Similarly, Linda Acres returned to Beaconsfield Hospital where she had worked before enlisting. A number of AANS nurses also remained associated with the military, nursing in repatriation hospitals in Hobart and Melbourne.87 However, there is no evidence that any of the military nurses who had trained or worked at the LGH returned to there in its civilian form. 25
   

Conclusion

 
No matter how hard and strenuous civilian nurse training and work, it could not compare with the work of military nurses. WWI provided LGH nurses with an experience well outside the range of civilian nursing. Military nursing gave Australian civilian nurses the opportunity to develop new roles and have work experiences unique to military service. These nurses were also able to demonstrate their skills to an international audience while learning to manage patients from different cultures and with unusual injuries and ailments. This paper not only gives recognition to the military work of the representative group of nurses from the Launceston General Hospital, but also, to all those who served. 26


Notes

This paper is an expanded version of a presentation given at the ASHM conference in Launceston, 2006.

1.  A.G. Butler, Official History of the Australian Army Medical Services 1914–1918 (Canberra: Australian War Memorial, 1943), 3:636–7.

2.  Linda M. Brown, Histories and Memories of Nursing at the Launceston General Hospital (Launceston: Launceston General Hospital Ex-Trainees Association, 1980), 74.

3.  Clifford Craig, Launceston General Hospital: First Hundred Years 1863–1963 (Launceston: Board of Management of the Launceston General Hospital, 1963).

4.  Tasmanian Government, Tasmania's War Record 1914–1918 (Hobart, 1921) cited in L.A. Deacon, Beyond the Call (Launceston, 1999), vii. It is a pity that A.G. Butler, who commissioned Matron A. Kellett, AANS to interview 128 army nurses at the end of the war, did not include one from Launceston. See "Interviews containing accounts of Nursing experiences in the AANS," Australian War Memorial (hereafter AWM) 41 1072.

5.  Kirsty Harris, "Not just 'routine nursing': the roles and skills of the Australian Army Nursing Service in World War I," (PhD thesis, School of Historical Studies, University of Melbourne, 2006). See for example Rupert Goodman, Our War Nurses: The History of the Royal Australian Army Nursing Corps, 1902–1988 (Brisbane: Boolarong Publications, 1988); Marianne Barker, Nightingales in the Mud: The Digger Sisters of the Great War 1914–1918 (Sydney: Allen and Unwin, 1989); Jan Bassett, Guns and Brooches: Australian Army Nursing from the Boer War to the Gulf War (Melbourne: Oxford University Press Australia, 1992); Elizabeth Burchill, Australian Nurses Since Nightingale 1860–1990 (Melbourne: Spectrum Publications, 1992).

6.  Brown, 74. Author's database shows twenty-three of the thirty-six AANS were born interstate or overseas.

7.  Butler, 3:533 footnote.

8.  Surgeon-General Fetherston in a report to the War Office in 1916, in Butler, 3:533.

9.  "List of General Hospitals in Australasia," in Australasian Trained Nurses Association Register of Members 1913, University of Melbourne Archives, ANF 32/3 Box 28. A large general hospital was defined as having an average of more than forty occupied beds.

10.  Helen Gregory and Cecilia Brazil, Bearers of the Tradition: Nurses of the Royal Brisbane Hospital 1888–1993 (Brisbane, Boolarong Publications: 1993), 23; Dorothy Armstrong, The First Fifty Years: A History of Nursing at the Royal Prince Alfred Hospital, Sydney from 1882 to 1932 (Sydney: Royal Prince Alfred Hospital Graduate Nurses' Association, 1965), 84; Susan Sherson, Being There: Nursing at 'The Melbourne' Victoria's First Hospital (Melbourne: The Royal Melbourne Hospital Graduate Nurses' Association, 2005), 192. In 1913, the only RVTNA-registered general hospitals that had a four year training period were the Melbourne Hospital and Ballarat Hospital. Source: Author's database on AANS.

11.  Alan Gregory, The Ever Open Door: A History of The Royal Melbourne Hospital 1848–1998 (Melbourne: Hyland House Publishing Pty Limited, 1998), 200, citing Una: the Journal of the Victorian Trained Nurses Association (16 March 1918): 3; Sherson, 192.

12.  J. Milne, LGH to Miss Malcolm, Secretary RVTNA, memorandum, n.d., Royal Victorian College of Nursing Archives, The University of Melbourne, Box 4, Correspondence 1909–1910.

13.  Elsie Sheppard Cook, diary 2 May 1915, AWM PR 82/135; Colonel T.N. Martin, Report, "Ghezireh Hospital," reprinted in Una (30 August 1915): 179.

14.  Laura Grubb, handwritten notes of a speech, AWM PR 83/40 (14), 1–2. Grubb also spent six months in the operating theatre as part of her four year training program.

15.  Launceston General Hospital Training School for Nurses, "Rules and Regulations," 18 August 1904, Royal Victorian College of Nursing Archives, The University of Melbourne Archives, Box 4, Correspondence 1909–1910.

16.  Papers of some Launceston nurses who served with the Australian Army are available at the Australian War Memorial, and the National Archives of Australia (NAA) in Canberra holds most of their personal files. These often include details of where nurses trained and sometimes their nursing experience prior to the war. This paper is largely possible through the author's development of an extensive database for all Australian Army nurses who served overseas in WWI. This has been necessary due to the lack of a complete nominal roll for the AANS, or a comprehensive list of those Australian nurses who served with other allied nursing services. While secondary sources such as Jan Bassett's well-regarded Guns and Brooches record the official medical historian's oft quoted total of 2,139 AANS nurses, the NAA holds more files than this and Butler himself gives a higher figure of 2,286. There appears to be no explanation for the contradiction. However, my database shows primary records of 2,498 nurses serving overseas in the AANS and some additional 720 Australian nurses who worked with other services. For further details consult, Kirsty Harris, "Rubbery Figures: the puzzle of the number of AANS on active service in WWI", Sabretache 49 (2008): 5–10. The database includes details of their lives before, during and after the war. This allows sorting of records by the nurses' training hospital or where they worked prior to enlistment in the AIF. It makes the identification of the war experiences of a collective group of Australian military nurses from one hospital possible for the first time. While larger metropolitan hospitals such as the RPAH and Melbourne Hospital had many more of their nurses at WWI, selecting and examining a smaller regional hospital adds to the diversity of material concerning Australia's nursing history. I was able to identify almost fifty nurses connected with the LGH, but only a small number of this hospital's nurses, including May Tilton, Laura Grubb, Ella Tucker, Eileen Burke and Annie Cameron left diaries or detailed papers now publicly available for review. This does not detract from the fact that we can see the work of this group of LGH nurses as being representative of WWI military nurses, particularly the AANS. This paper shows that they worked in the same theatres of war, in the same countries, in the breadth of hospitals and in similar positions to the majority of WWI nurses.

17.  The first edition was May Tilton, The Grey Battalion (Sydney: Angus & Robertson, 1933).

18.  May Tilton, The Grey Battalion, 2nd ed. (Sydney: Angus & Robertson, 1934), Author's Note.

19.  Stuart Macintyre, The Oxford History of Australia, 1901–1942: The Succeeding Age (Melbourne: Oxford University Press, 1986), 4:142.

20.  Papers for nurses serving in the British service are held at the National Archives, London.

21. The Australasian Nursing Journal, Australasian Trained Nurses Association, Sydney, August 1915, 266; Anne Summers, Angels and Citizens: British Women as Military Nurses 1854–1914 (London: Routledge & Kegan Paul, 1988), 175.

22.  E.L. Horne, AWM41 981; Gertrude Frances Hogan (nee Moberly), Experiences of a "Dinki Di" R.R.C. Nurse (Sydney: Australasian Medical Publishing Company, 1933), 71.

23.  Butler, 3:583; Bassett, 67; Bessie Pocock, diary, 26 July, 2, 4 October 1915, copy in author's possession.

24.  Butler, 3:552; Colonel Barber, memorandum, AWM41, item 1/4/3, Michael B. Tyquin, Neville Howse: Australia's First Victoria Cross Winner (Melbourne: Oxford University Press, 1999), 122.

25.  In the early years of the twentieth century, the nursing associations registered a small number of men following their hospital training; some were male nurses, others were masseurs. The "ATNA Register of Members, 1916", 175 records seven male nurses. The RVTNA Membership Roll of July 1911 (Una, 31 July 1911, 122) notes four male attendants.

26.  Bartz Schultz, A Tapestry of Service: The Evolution of Nursing in Australia (Melbourne: Churchill Livingstone, 1991), 1:122, 265; Beverley Kingston, My Wife, My Daughter and Poor Mary Ann (Melbourne: Nelson, 1975), 89; See also histories of various hospitals: Craig, 66, 70; J. Frederick Watson, The History of the Sydney Hospital from 1811 to 1911 (Sydney: Government Printer, 1911), 168; G.C. Bolton and Prue Joske, History of Royal Perth Hospital (Perth: Royal Perth Hospital, 1982), 36, 61; Anthea Hyslop, Sovereign Remedies: A History of Ballarat Base Hospital, 1850s to 1980s (Sydney: Allen & Unwin, 1989), 157; Gregory, The Ever Open Door, 149–50.

27.  Butler, 3:537.

28.  A.G. Butler, Official History of the Australian Army Medical Services 1914–1918, 2nd ed., (Melbourne: Australian War Memorial, 1938), 1:36, 40, 521; Sister I.G. Lovell, AWM41 998, 1; Avenell, letter, 10 June 1915, State Library of Victoria (hereafter SLV) MS 12567 Box 3409/8.

29.  Sister Ella Jane Tucker diary, AWM41 1053, 1.

30.  Sister Lilian Leitch, speech for Anzac Day, 1964, AWM PR 00444, 5; Miss Florence Howitt, AWM41 1072, Kellett interview No. 41; "Extracts from Letters," in Una (30 April 1918): 39; Nita Selwyn Smith, AWM41 1045, 8; "Notes by Sister Pierre Humbert concerning work at Lemnos & in Egypt," AWM41 1024, 1; "Experiences of Sister L.E. Young AANS with No 3 AGH at Lemnos," AWM41 1065, 1.

31.  Tucker, diary, 25 April 1915, AWM41 1053.

32.  Alice Kitchen, diary, 11 July 1915, SLV MS 9627 MSB 478; Michael B. Tyquin, Gallipoli: The Medical War – the Australian Army Medical Services in the Dardanelles Campaign of 1915 (Sydney: University of New South Wales Press, 1993), 31 citing Captain P. Davenport.

33.  Tucker, diary, 15 May 1915, AWM41 1053.

34. Ibid., 26 April 1915.

35.  Matron Oakes quoted in Craig, 73.

36.  Sister Elsie May Tranter, diary, AWM DRL 4081A, 122. At 26 BGH Etaples.

37.  Goodman, 58; Olive Haynes, diary, 9 December 1916 in Margaret Young, ed., 'We Are Here, Too': Diaries & Letters of Sister Olive LC Haynes, No 2 AGH, November 1914 to February 1918, 2nd ed., (Adelaide: Australian Down Syndrome Association, 1993), 173; Effie M. Looker, AWM41 997; LtCol D'arcy Power, RAMC, Wounds in War: Their Treatment and Results (London: Oxford War Primers, 1915), 8; Leela Brown in Mutiny on the Western Front (Sydney: Mingara Films, 1979) (VHS) (93 mins.).

38.  Bill Gammage, The Broken Years: Australian Soldiers in the Great War (Canberra: Penguin, 1975), 187. See also T.J. Mitchell and G.M. Smith, Medical Services: Casualties and Medical Statistics of the Great War (London: His Majesty's Stationery Office, 1931), 88.

39.  See AWM photo E02602.

40.  E. Cuthbert, AWM41 958.

41.  Colonel Sir Anthony Bowlby, "The Care of the Wounded," British Medical Journal, reprinted Una (27 February 1915): 385.

42.  Butler, 2:368.

43.  Laura Grubb, My dear Al, letter, September 1918, AWM PR 83/40 (2), 1–2.

44.  Sister Ella Jane Tucker, 2AGH Boulogne, AWM41 1053, E253/1/11, 1.

45.  Annie C. Cameron, AWM41 951, 13.

46.  "Return of Miss Conyers," Herald, reprinted Una (30 November 1917): 278; Cynthia Enloe, Does Khaki Become You?: The Militarisation of Women's Lives (London: Pluto Press Limited, 1983), 108; Alys Ross King in Chris Coulthard-Clark, "A Tribute to an Army Nurse of Two Wars," in Sabretache 18, no. 3(1977): 164.

47.  Tilton, 214.

48. Ibid., 207.

49.  Bonnin, diary, 22 July 1916, in Joan Durdin, They Became Nurses: A History of Nursing in South Australia 1836–1980 (Sydney: Allen & Unwin, 1991), 65; Anne Donnell, letter, 20 January 1917, Mitchell Library MSS 022/1, 8; Queenie Avenell, letter, 24 August 1915, SLV MS 12567 Box 3409/8.

50.  Power, 11.

51.  Jeffrey Grey, A Military History of Australia (Melbourne: Cambridge University Press, 1990), 102; Tim Cook, "'Against God-Inspired Conscience': The Perception of Gas Warfare as a Weapon of Mass Destruction, 1915–1939," War & Society 18, No. 1, (2000): 47; Joan Beaumont, "Australia's war," in Joan Beaumont, ed., Australia's War 1914–18 (Sydney: Allen & Unwin, 1995), 17.

52.  Tyquin, 83; Pte H.E. Gussing (1st Field Ambulance) in John Laffin, The Battle of Hamel: The Australians' Finest Victory (Sydney: Kangaroo Press, 1999), 108; Private F.J. Brewer (20th Battalion, 5th Brigade, 2nd Division), diary, in Laffin, 112; Sister L.G. Moreton, letter, 27 August 1915, 2 AGH Cairo, in, "Typed Extracts from Letters of Nursing Sister L.G. Moreton, A.A.N.S. A.I.F. World War 1914–1918," AWM2 DRL 0097.

53.  Elsie Sheppard Cook, 4 May 1915, AWM PR 82/135.

54.  Butler, 2:96; Sergeant Harry Kahn in Patsy Adam-Smith, The Anzacs (Melbourne: Thomas Nelson, 1978), 338; Juliet Piggott, Queen Alexandra's Royal Army Nursing Corps (London: Leo Cooper, 1990), 50; Woods Hutchinson, "Victories of the Doctor and the Sanitarian," Una (30 March 1918): 12.

55.  Adam-Smith, 338.

56.  Sister R.A. Kirkcaldie, In Gray and Scarlet... (Melbourne: Alexander McCubbin, 1922), 95–96.

57.  MajGen Sir W.G. Macpherson, MajGen Sir A.A. Bowlby, MajGen Sir Cuthbert Wallace, and Col Sir Crisp English (eds), History of the Great War Medical Services: Surgery of the War (London: His Majesty's Stationery Office, 1922), 1:175; Cuthbert, AWM41 958, 14; Violetta Thurstan, A Text Book of War Nursing (London: G.P. Putnam's Sons, 1917), 185–6; Kirkcaldie, 96.

58.  Tilton, 259.

59.  Laura Grubb, diary, 3 December 1917, PR 83/40 (4).

60.  Butler, 3:565; Miss Bickmore, "Life on an Ambulance Train in France 1914–1917", in Joyce Marlow, ed., The Virago Book of Women and the Great War (London: Virago Press, 1998), 71; Selwyn Smith, AWM41 1045, 8.

61.  Tilton, 206.

62.  Russell Howard, Surgical Nursing and the Principles of Surgery for Nurses, 2nd ed. (London: Edward Arnold, 1913), vii, 3; Sister G. Collins, AWM41 955, 6.

63.  Butler, 1:814; "The Sick and Wounded in War," The Hospital, reprinted Una (27 February 1915): 385.

64.  Tilton, 211.

65.  Nicholas Boyack and Jane Tolerton, In the Shadow of War (Auckland: Penguin, 1990), 248–249; Dr Joanna Bourke, "Shell Shock and Australian Soldiers: in the Great War," Sabretache 36, no. 3 (1995): 3–15.

66.  Tilton, 217.

67.  Steadman, AWM PR 86/302, 1; "Neurasthenia,"' The American Journal of Nursing, reprinted Una (29 May 1915): 76.

68.  Harvey Cushing, From a Surgeon's Journal 1915–1918 (Boston: Little, Brown and Co., 1936), 33–234; Ben Shephard, A War of Nerves: Soldiers and Psychiatrists 1914–1994 (London: Pimlico, 2002), 73 in Joy Damousi, Freud in the Antipodes: A Cultural History of Psychoanalysis in Australia (Sydney: University of New South Wales Press, 2005), 34.

69.  Thurstan, 139; Miss Kate Laity, AWM41 1072, Kellett interview No. 58.

70.  Tucker, diary, 26 September 1915, AWM41 1053.

71.  "Experience in the A.A.N.S. of Miss Eileen A. Burke," AWM41 949, 1.

72.  Butler, 3:572.

73.  Laura Grubb, letter, in AWM PR 83/40 (2), 1–2.

74.  MajGen Sir W. Macpherson, History of the Great War Medical Services: General History (London: His Majesty's Stationery Office, 1923), 2:165–6. See also Kirsty Harris, "'Giving the dope': Australian Army Nurse Anaesthetists during World War I," Australian Military Medicine 12, no. 3, (2003): 138–43.

75.  Craig, 42 citing Dr T.H. Goddard.

76.  Tilton, 264.

77.  See Cora Turnbull, Louise Crosby-White, Margaret Thomas and Alexandra Stewart, NAA B2455; "The Hospital Transport, 'Kyarra'" in Una (30 January 1915): 342. Information based on "letters from Egypt."

78.  Tucker, 2 AGH Boulogne, AWM41 1053, E253/1/11, 1.

79.  For example, see Army Nursing Services, Australian Imperial Force, Extracts from Regulations and Orders, issued with M.O. 471/1917, Sea Transport Nursing Staff, 9.

80.  Goodman, 98 citing Butler, 3:556.

81. Standing Orders, Australian Imperial Force MO 50/1918 applicable to the AANS, AWM25 509/05.

82.  See Chapter XIV, "Sea Transport of Australian Soldiers" in Butler, III, 665–772; "Reports on Nurses," Minute, Copy of Report of Matron Quarterman on Nursing Staff of No. 4 Sea Transport Section as Individuals, 19 October 1916, AWM11 1519/2/28; Although Butler states (2:829) that only 57 nurses served with the STS, the author's database shows at least 112 nurses served on these ships.

83.  Butler, 2:578; Sister E.G. Dobson, AWM41 964, 8; Macpherson et al, 1:160; Sister Leila Smith, AWM41 1042, 2–3.

84.  Butler, 1:534.

85.  Butler, 3:751 (table).

86.  Laura Grubb, speech, AWM PR 83/40 (14), 3.

87.  Details from author's database.

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