What is now known as The Royal London Hospital was once known as the London Hospital, a key site of East End history. Eva Luckes, who became the hospital’s matron at the age of  26 in 1880, noted that the London Hospital was ‘the largest hospital in the kingdom,’ the wards being filled with patients ‘drawn chiefly from the immediate densely populated neighbourhood’ and the outpatient department being ‘immense.’ The position of matron gave Luckes a huge amount of responsibility, involved intense hard work and allowed her to contribute significantly to the development of the nursing profession.

Interestingly, Luckes only had four years of nursing experience when appointed to this role. Looking at the history of nurse training in the nineteenth century, it seems that Luckes being given such an important role with so little experience was not that unusual and was based on ideas about class in the medical field. In ‘Building a New Nursing Service: Respectability and Efficiency in Victorian England’ Carol Helmstadter notes that nursing was considered to be similar to domestic service, so that in the early-nineteenth century ‘upper-class ladies took the same training as the working-class nurses and then worked as sisters (in the sense of head nurses, not religious sisters) and matrons.’ Middle-class women had the same training as their working-class counterparts but were assumed to be more suited to being in a charge of a team of nurses, just as a middle-class housewife would be in charge of a team of servants; the hierarchy within nursing was therefore fundamentally shaped by understandings of class. 

Under Luckes’ reformed training system at the London Hospital, there were paying probationers, the ladies, and ‘regular probationers’ who were paid throughout their training period. In her article on the system of nursing at the hospital, Luckes claims that the ‘work is exactly the same for probationers of every class and upon whatever terms they enter.’ However, it seems that this was not exactly true, as Luckes even notes that paying probationers did not have to work night shifts, something that must have greatly impacted their experiences of nursing work. 

One particularly influential reform that Luckes introduced was the focus she placed on theoretical understanding as part of a nurses training at the London Hospital. Lectures were given to first year probationers by Luckes and doctors, while the second year of training was hands-on.  This combination of theoretical and practical learning means that the training process from the early 1890s was not so different from the mixture of theoretical study and placements that make up nursing degrees today. Today, however, there is no individual person that had as much power over individual nurses’ fates in the way that Luckes did as matron. This was a power Luckes seemed reluctant to let go; the main argument Luckes made against the campaign for the registration of nurses was that the training schools attached to individual hospitals ‘alone’ had the ability to judge individual nurses’ ‘personal qualities.’ Luckes’ philosophy seemed to be that you could not “make” a good nurse just by teaching, as there were women that were intrinsically suited to being nurses and women who were not and, more importantly, she and the hospital sisters were the only ones able to judge. At a time when a matron was an important part of the hospital management but was still somehow seen as lesser than the (almost always male) doctors, Luckes’ argument seems to be a desperate attempt to cling on to the power that her class made her feel entitled to.

Coincidentally, in 1919 Eva Luckes died while in post as matron and the Nurses Act, which finally set up a register for trained nurses, was passed. Despite her personal views, Luckes’ reforms seem to have been a key part of the movement towards the professionalisation of nursing, a movement that had a huge impact on the working life of women of all classes who were drawn to nursing.

Author

Florence Heath is a prospective PhD student at the University of Leicester, where she recently completed an MA in Victorian Studies.  

Sources

Helmstadter, Carol, “Building a New Nursing Service: Respectability and Efficiency in Victorian England.” Albion: A Quarterly Journal Concerned with British Studies, vol. 35, (2003) pp. 590-621

https://doi.org/10.1093/ref:odnb/49192

https://www.nursingtimes.net/opinion/history-of-nursing-08-05-2014/

https://www.nursingtimes.net/opinion/history-of-nursing-08-05-2014/

https://www.rcn.org.uk/about-us/our-history 

Luckes, Eva C. E., “The System of Nursing at the London Hospital.” The Hospital vol. 1, (1887) pp. 227-228.