Asylum nursing and institutional service: A case study of the South of England, 1861-1881

Nursing History Review

Volumn 7, Issue , 1999, Pages 153-169

  Wright, David ^a  

^a UNIVERSITY OF NOTTINGHAM   (United Kingdom)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; ECONOMICS; EMPLOYMENT; HISTORY; HOSPITAL SERVICE; HUMAN; MENTAL HOSPITAL; NURSING STAFF; PSYCHIATRIC NURSING; SALARY AND FRINGE BENEFIT; UNITED KINGDOM;

EMPLOYMENT; ENGLAND; HISTORY, 19TH CENTURY; HOSPITALS, PSYCHIATRIC; HOUSEKEEPING, HOSPITAL; HUMANS; NURSING STAFF, HOSPITAL; PSYCHIATRIC NURSING; SALARIES AND FRINGE BENEFITS;

EID: 0032602069     PISSN: 10628061     EISSN: None     Source Type: Journal    
DOI: 10.1891/1062-8061.7.1.153     Document Type: Article

References (71)

1. Louise Tilly and Joan Scott, Women, Work and Family (2nd ed.) (London: Routledge, 1989); Theresa McBride, The Domestic Revolution: the modernisation of Household Service in England and France 1820-1920 (London: Croom Helm, 1976).
2. Louise Tilly and Joan Scott, Women, Work and Family (2nd ed.) (London: Routledge, 1989); Theresa McBride, The Domestic Revolution: the modernisation of Household Service in England and France 1820-1920 (London: Croom Helm, 1976).
3. J.A. Banks, Prosperity and Parenthood: A Study of Family Planning among the Victorian Middle Classes (London: Routledge and Kegan Paul, 1954); Pamela Horn, The Rise and Fall of the Victorian Servant (Gloucester: Alan Sutton, 1986); Edward Higgs, Domestic Servants and Households in Rochdale, 1851-1871 (New York: Garland, 1986).
4. J.A. Banks, Prosperity and Parenthood: A Study of Family Planning among the Victorian Middle Classes (London: Routledge and Kegan Paul, 1954); Pamela Horn, The Rise and Fall of the Victorian Servant (Gloucester: Alan Sutton, 1986); Edward Higgs, Domestic Servants and Households in Rochdale, 1851-1871 (New York: Garland, 1986).
5. J.A. Banks, Prosperity and Parenthood: A Study of Family Planning among the Victorian Middle Classes (London: Routledge and Kegan Paul, 1954); Pamela Horn, The Rise and Fall of the Victorian Servant (Gloucester: Alan Sutton, 1986); Edward Higgs, Domestic Servants and Households in Rochdale, 1851-1871 (New York: Garland, 1986).
6. See, for example, Anne Marie Rafferty, The Politics of Nursing Knowledge (London: Routledge, 1996); Nursing History and the Politics of Welfare, ed. Rafferty, Jane Robinson and Ruth Elkan (London: Routledge, 1997); Robert Dingwall, Anne Marie Rafferty, and Charles Webster, An Introduction to the Social History of Nursing (London: Routledge, 1988).
7. See, for example, Anne Marie Rafferty, The Politics of Nursing Knowledge (London: Routledge, 1996); Nursing History and the Politics of Welfare, ed. Rafferty, Jane Robinson and Ruth Elkan (London: Routledge, 1997); Robert Dingwall, Anne Marie Rafferty, and Charles Webster, An Introduction to the Social History of Nursing (London: Routledge, 1988).
8. See, for example, Anne Marie Rafferty, The Politics of Nursing Knowledge (London: Routledge, 1996); Nursing History and the Politics of Welfare, ed. Rafferty, Jane Robinson and Ruth Elkan (London: Routledge, 1997); Robert Dingwall, Anne Marie Rafferty, and Charles Webster, An Introduction to the Social History of Nursing (London: Routledge, 1988).
9. Brian Abel-Smith, A History of the Nursing Profession (London: Heineman, 1960), 4.
10. Elizabeth Roberts, Women's Work, 1840-1940 (London: MacMillan, 1988), p. 31, Table 2.1.
11. Chris Maggs, The Origins of General Nursing (London: Croom Helm, 1983); see also Maggs, "Nurse Recruitment in Four Provincial Hospitals, 1881-1921," in Rewriting Nursing History, ed. Celia Davies (London: Groom Helm, 1980), 18-40.
12. Chris Maggs, The Origins of General Nursing (London: Croom Helm, 1983); see also Maggs, "Nurse Recruitment in Four Provincial Hospitals, 1881-1921," in Rewriting Nursing History, ed. Celia Davies (London: Groom Helm, 1980), 18-40.
13. For useful case studies on asylum and hospital staff in Victorian England, see John Walton, "The Treatment of Pauper Lunatics in Victorian England: the case of Lancaster Asylum, 1816-1870," in Madhouses, Mad-Doctors and Madmen: the Social History ofPsychiatry in the Victorian Era, ed. Andrew Scull (Philadelphia: University of Penn. Press, 1981), 180-82; Anne Digby, Madness, Morality and Medicine: A Study of the York Retreat, 1792-1914 (Cambridge: Cambridge University Press, 1985), 140-70; Richard Russell, "The Lunacy Profession and Its Staff in the Second Half of the Nineteenth Century, with Special Reference to the West Riding Lunatic Asylum," in The Anatomy of Madness: Essays in the History of Psychiatry, vol. 3, ed. W. F. Bynum et al. (London: Tavistock, 1988), 307-9; Len Smith, "Behind Closed Doors: Lunatic Asylum Keepers, 1800-1860," in Social History of Medicine, 1, no. 3, (1988): 301-27.
14. For useful case studies on asylum and hospital staff in Victorian England, see John Walton, "The Treatment of Pauper Lunatics in Victorian England: the case of Lancaster Asylum, 1816-1870," in Madhouses, Mad-Doctors and Madmen: the Social History ofPsychiatry in the Victorian Era, ed. Andrew Scull (Philadelphia: University of Penn. Press, 1981), 180-82; Anne Digby, Madness, Morality and Medicine: A Study of the York Retreat, 1792-1914 (Cambridge: Cambridge University Press, 1985), 140-70; Richard Russell, "The Lunacy Profession and Its Staff in the Second Half of the Nineteenth Century, with Special Reference to the West Riding Lunatic Asylum," in The Anatomy of Madness: Essays in the History of Psychiatry, vol. 3, ed. W. F. Bynum et al. (London: Tavistock, 1988), 307-9; Len Smith, "Behind Closed Doors: Lunatic Asylum Keepers, 1800-1860," in Social History of Medicine, 1, no. 3, (1988): 301-27.
15. For useful case studies on asylum and hospital staff in Victorian England, see John Walton, "The Treatment of Pauper Lunatics in Victorian England: the case of Lancaster Asylum, 1816-1870," in Madhouses, Mad-Doctors and Madmen: the Social History ofPsychiatry in the Victorian Era, ed. Andrew Scull (Philadelphia: University of Penn. Press, 1981), 180-82; Anne Digby, Madness, Morality and Medicine: A Study of the York Retreat, 1792-1914 (Cambridge: Cambridge University Press, 1985), 140-70; Richard Russell, "The Lunacy Profession and Its Staff in the Second Half of the Nineteenth Century, with Special Reference to the West Riding Lunatic Asylum," in The Anatomy of Madness: Essays in the History of Psychiatry, vol. 3, ed. W. F. Bynum et al. (London: Tavistock, 1988), 307-9; Len Smith, "Behind Closed Doors: Lunatic Asylum Keepers, 1800-1860," in Social History of Medicine, 1, no. 3, (1988): 301-27.
16. For useful case studies on asylum and hospital staff in Victorian England, see John Walton, "The Treatment of Pauper Lunatics in Victorian England: the case of Lancaster Asylum, 1816-1870," in Madhouses, Mad-Doctors and Madmen: the Social History ofPsychiatry in the Victorian Era, ed. Andrew Scull (Philadelphia: University of Penn. Press, 1981), 180-82; Anne Digby, Madness, Morality and Medicine: A Study of the York Retreat, 1792-1914 (Cambridge: Cambridge University Press, 1985), 140-70; Richard Russell, "The Lunacy Profession and Its Staff in the Second Half of the Nineteenth Century, with Special Reference to the West Riding Lunatic Asylum," in The Anatomy of Madness: Essays in the History of Psychiatry, vol. 3, ed. W. F. Bynum et al. (London: Tavistock, 1988), 307-9; Len Smith, "Behind Closed Doors: Lunatic Asylum Keepers, 1800-1860," in Social History of Medicine, 1, no. 3, (1988): 301-27.
17. W. A. F. Browne, What Asylums Were, Are, and Ought To Be (Edinburgh: Adam and Charles Black, 1837), 151; Kathleen Jones, Asylums and After: A Revised History of Mental Health Services from the Early 18th Century to the 1990s (London: Athlone Press, 1993), 70; Andrew Scull, Museums of Madness: The Social Organization of Insanity in Nineteenth-Century England (London: Penguin ed. 1982), 122; and Scull, The Most Solitary of Afflictions: Madness and Society in Britain, 1700-1900 (London: Yale University Press, 1993), 173, 263; Mick Carpenter, "Asylum Nursing before 1914: A Chapter in the History of Labour," in Rewriting Nursing History, ed. Davies, 12; Dingwall et al., An Introduction to the Social History of Nursing, 127; Peter Nolan, A History of Mental Health Nursing (London: Chapman and Hall, 1993), 48.
18. W. A. F. Browne, What Asylums Were, Are, and Ought To Be (Edinburgh: Adam and Charles Black, 1837), 151; Kathleen Jones, Asylums and After: A Revised History of Mental Health Services from the Early 18th Century to the 1990s (London: Athlone Press, 1993), 70; Andrew Scull, Museums of Madness: The Social Organization of Insanity in Nineteenth-Century England (London: Penguin ed. 1982), 122; and Scull, The Most Solitary of Afflictions: Madness and Society in Britain, 1700-1900 (London: Yale University Press, 1993), 173, 263; Mick Carpenter, "Asylum Nursing before 1914: A Chapter in the History of Labour," in Rewriting Nursing History, ed. Davies, 12; Dingwall et al., An Introduction to the Social History of Nursing, 127; Peter Nolan, A History of Mental Health Nursing (London: Chapman and Hall, 1993), 48.
19. W. A. F. Browne, What Asylums Were, Are, and Ought To Be (Edinburgh: Adam and Charles Black, 1837), 151; Kathleen Jones, Asylums and After: A Revised History of Mental Health Services from the Early 18th Century to the 1990s (London: Athlone Press, 1993), 70; Andrew Scull, Museums of Madness: The Social Organization of Insanity in Nineteenth-Century England (London: Penguin ed. 1982), 122; and Scull, The Most Solitary of Afflictions: Madness and Society in Britain, 1700-1900 (London: Yale University Press, 1993), 173, 263; Mick Carpenter, "Asylum Nursing before 1914: A Chapter in the History of Labour," in Rewriting Nursing History, ed. Davies, 12; Dingwall et al., An Introduction to the Social History of Nursing, 127; Peter Nolan, A History of Mental Health Nursing (London: Chapman and Hall, 1993), 48.
20. W. A. F. Browne, What Asylums Were, Are, and Ought To Be (Edinburgh: Adam and Charles Black, 1837), 151; Kathleen Jones, Asylums and After: A Revised History of Mental Health Services from the Early 18th Century to the 1990s (London: Athlone Press, 1993), 70; Andrew Scull, Museums of Madness: The Social Organization of Insanity in Nineteenth-Century England (London: Penguin ed. 1982), 122; and Scull, The Most Solitary of Afflictions: Madness and Society in Britain, 1700-1900 (London: Yale University Press, 1993), 173, 263; Mick Carpenter, "Asylum Nursing before 1914: A Chapter in the History of Labour," in Rewriting Nursing History, ed. Davies, 12; Dingwall et al., An Introduction to the Social History of Nursing, 127; Peter Nolan, A History of Mental Health Nursing (London: Chapman and Hall, 1993), 48.
21. W. A. F. Browne, What Asylums Were, Are, and Ought To Be (Edinburgh: Adam and Charles Black, 1837), 151; Kathleen Jones, Asylums and After: A Revised History of Mental Health Services from the Early 18th Century to the 1990s (London: Athlone Press, 1993), 70; Andrew Scull, Museums of Madness: The Social Organization of Insanity in Nineteenth-Century England (London: Penguin ed. 1982), 122; and Scull, The Most Solitary of Afflictions: Madness and Society in Britain, 1700-1900 (London: Yale University Press, 1993), 173, 263; Mick Carpenter, "Asylum Nursing before 1914: A Chapter in the History of Labour," in Rewriting Nursing History, ed. Davies, 12; Dingwall et al., An Introduction to the Social History of Nursing, 127; Peter Nolan, A History of Mental Health Nursing (London: Chapman and Hall, 1993), 48.
22. W. A. F. Browne, What Asylums Were, Are, and Ought To Be (Edinburgh: Adam and Charles Black, 1837), 151; Kathleen Jones, Asylums and After: A Revised History of Mental Health Services from the Early 18th Century to the 1990s (London: Athlone Press, 1993), 70; Andrew Scull, Museums of Madness: The Social Organization of Insanity in Nineteenth-Century England (London: Penguin ed. 1982), 122; and Scull, The Most Solitary of Afflictions: Madness and Society in Britain, 1700-1900 (London: Yale University Press, 1993), 173, 263; Mick Carpenter, "Asylum Nursing before 1914: A Chapter in the History of Labour," in Rewriting Nursing History, ed. Davies, 12; Dingwall et al., An Introduction to the Social History of Nursing, 127; Peter Nolan, A History of Mental Health Nursing (London: Chapman and Hall, 1993), 48.
23. W. A. F. Browne, What Asylums Were, Are, and Ought To Be (Edinburgh: Adam and Charles Black, 1837), 151; Kathleen Jones, Asylums and After: A Revised History of Mental Health Services from the Early 18th Century to the 1990s (London: Athlone Press, 1993), 70; Andrew Scull, Museums of Madness: The Social Organization of Insanity in Nineteenth-Century England (London: Penguin ed. 1982), 122; and Scull, The Most Solitary of Afflictions: Madness and Society in Britain, 1700-1900 (London: Yale University Press, 1993), 173, 263; Mick Carpenter, "Asylum Nursing before 1914: A Chapter in the History of Labour," in Rewriting Nursing History, ed. Davies, 12; Dingwall et al., An Introduction to the Social History of Nursing, 127; Peter Nolan, A History of Mental Health Nursing (London: Chapman and Hall, 1993), 48.
24. M. Anne Crowther, The Workhouse System, 1834-1929: The History of an English Social Institution (Athens, Ga.: University of Georgia Press, 1981), chapter 7.
25. John Woodward, To Do the Sick No Harm: A Study of the British Voluntary Hospital System to 1875 (London: Routledge, 1974).
26. Robert Pinker, English Hospital Statistics, 1861-1938 (London: Heineman, 1966), 60 and Table ix.
27. Fifty-Fourth Report of Commissioners in Lunacy to the Lord Chancellor, PP [1900], vol. xxxvii, p.88, Appendix A.
28. According to Christopher Maggs, there were 28,000 "general" hospital beds in England and Wales in 1901. Maggs, "A General History of Nursing; 1800-1900," in Companion Encyclopedia of the History of Medicine, vol.. 2, ed. W. F. Bynum and Roy Porter (London: Routledge, 1993), 1309.
29. They were situated in Caterham, Surrey, Leavesden, Hertfordshire, and Darenth, Kent. Gwendoline Ayers, England's First State Hospitals and the Metropolitan Asylums Board, 1867-1930 (London: Wellcome Institute, 1971), 37-48.
30. Twenty-third Report of the Commissioners Lunacy to the Lord Chancellor, PP [1868-69], vol. xxvii, Appendix A.
31. Staff Wages Book, Earlswood Asylum, SRO 392/1/12/1.
32. Ibid., p.50.
33. In the 1860s, most asylums appointed at least one night nurse to keep a watch over epileptic patients. Staff Wages Book, Earlswood Asylum, SRO 392/1/12/1.
34. Ibid., p.120.
35. Nolan, A History of Mental Health Nursing, 66.
36. The Interquartile range includes the middle 50% of a population.
37. M. Ebery and B. Preston, Domestic Service in late Victorian and Edwardian England. 1871-1914 (Reading, 1976), 100.
38. This pattern reflects similar results from the Kent County Lunatic Asylum, although Hervey does not discriminate between different types of employment in the asylum. Nicholas B. Hervey, "The Lunacy Commission, 1845-60, with special reference to the implementation of policy in Kent and Surrey," unpublished Bristol Ph.D. (1984) vol. 2, p.105, table 13.
39. Between 40% and 50% of all servants enumerated between 1851 and 1881 were under the age of 20. As quoted in McBride, The Domestic Revolution, p.45, Table 2.6.
40. Register of Officers, Attendants and Servants, SRO Ace 1523 2/2/1, p.115.
41. Hervey found that, from the women hired at the Kent Asylum between 1876 and 1880, 87 out of the 147 (60%) where previous employment was listed had worked at other asylums. Hervey, "Lunacy Commission," 105, Table 13.
42. Crowther, The Workhouse System, 177.
43. As quoted in Lindsay Granshaw, St. Luke's Hospital, London: a social history of a specialist hospital (London: King's Fund, 1985), 102.
44. Digby, Madness, Morality and Medicine, 142.
45. Higgs, Domestic Servants and Households in Rochdale, p. 340-41, Table 40.
46. McBride, The Domestic Revolution, chapter 2.
47. Though servants' wages were supplemented by gratuities. Pamela Horn, The Rise & Fall of the Victorian Servant, p. 130, Table 4.
48. Granshaw, St. Luke's Hospital, 102.
49. Margaret Railton and Marshall Barr, The Royal Berkshire Hospital, 1839-1989 (Berkshire: Royal Berkshire Hospital, 1989), 78.
50. Cope, A Hundred Years of Nursing at St. Mary's, Paddington, as cited in Abel Smith, A History of the Nursing Profession, Appendix III, p.279, f.4.
51. Charlotte MacKenzie, Psychiatry for the rich: a history of the private Ticehurst Asylum, 1792-1917 (London: Routledge, 1992), 137. MacKenzie also notes that female attendants in private asylums could also reap the benefits of cast-off clothing and gratuities from kin of wealthy inmates. Ibid.
52. Thirty-seventh Report of the Commissioners in Lunacy, PP [1883], vol. xxx, p. 364 [p.380].
53. Hervey found the average length of stay at the Kent County Asylum was 17 months. Hervey, "Lunacy Commissioners," vol. 2, p.104, Table 10.
54. Ebery and Preston, Domestic Service in late Victorian and Edwardian England, 100.
55. Higgs, Domestic Servants and Households in Rochdale, 166.
56. This method of hiring married attendants could backfire, since the firing of a married worker would necessitate the leaving of the spouse. There were at least two instances of this at the Earlswood Asylum, Staff Wages Book, SRO 392/12/1, p. 92, 313.
57. Richard Hunter, Psychiatry for the Poor. 1851 Colney Hatch Asylum. Friern Hospital 1973: A Medical and Social History (London: Dawsons, 1974), 95.
58. Twenty-fifth Report of the Commissioners in Lunacy to the Lord Chancellor, PP [1871] xxvi, p.210 [220].
59. The Brookwood Asylum, like many other county asylums, followed the 1st and 2nd class Attendant hierarchy, where the 1st class Attendants, also called "Charge Attendants," acted roughly as ward-supervisors and were intermediaries between regular ward attendants (2nd class attendants) and Head Attendants. Brookwood Asylum, Rules for the Guidance of the Attendants, Servants, and all person engaged in the service of the Surrey County Asylum, at Brookwood (1871), SRO Acc. 1523/2/1/1.
60. MacKenzie, Ticehurst, 137. The calculation of patient:staff ratios is complicated by the work of patients as staff "assistants" or as part of their therapy. In Brookwood 27 women assisted in the laundry, 8 in the kitchen and 40 to 50 cleaning vegetables. Others sewed, knitted and book-bound. Twenty-fifth Report of the Commissioners in Lunacy, p. 228 [238].
61. First (Annual) Report of the Asylum for Idiots, SRO 392/1/1, p.6.
62. Maggs, The Origins of General Nursing, passim.
63. Jones, Asylums and After, 70; Scull, Museums of Madness, 122; Scull, The Most Solitary of Afflictions, 173; Mick Carpenter "Asylum Nursing before 1914: a chapter in the history of labour," Rewriting Nursing History, ed. in Celia Davies, 134; Robert Dingwall et al., An Introduction to the Social History of Nursing, 127; Nolan, A History of Mental Health Nursing, 48.
64. Jones, Asylums and After, 70; Scull, Museums of Madness, 122; Scull, The Most Solitary of Afflictions, 173; Mick Carpenter "Asylum Nursing before 1914: a chapter in the history of labour," Rewriting Nursing History, ed. in Celia Davies, 134; Robert Dingwall et al., An Introduction to the Social History of Nursing, 127; Nolan, A History of Mental Health Nursing, 48.
65. Jones, Asylums and After, 70; Scull, Museums of Madness, 122; Scull, The Most Solitary of Afflictions, 173; Mick Carpenter "Asylum Nursing before 1914: a chapter in the history of labour," Rewriting Nursing History, ed. in Celia Davies, 134; Robert Dingwall et al., An Introduction to the Social History of Nursing, 127; Nolan, A History of Mental Health Nursing, 48.
66. Jones, Asylums and After, 70; Scull, Museums of Madness, 122; Scull, The Most Solitary of Afflictions, 173; Mick Carpenter "Asylum Nursing before 1914: a chapter in the history of labour," Rewriting Nursing History, ed. in Celia Davies, 134; Robert Dingwall et al., An Introduction to the Social History of Nursing, 127; Nolan, A History of Mental Health Nursing, 48.
67. Jones, Asylums and After, 70; Scull, Museums of Madness, 122; Scull, The Most Solitary of Afflictions, 173; Mick Carpenter "Asylum Nursing before 1914: a chapter in the history of labour," Rewriting Nursing History, ed. in Celia Davies, 134; Robert Dingwall et al., An Introduction to the Social History of Nursing, 127; Nolan, A History of Mental Health Nursing, 48.
68. Jones, Asylums and After, 70; Scull, Museums of Madness, 122; Scull, The Most Solitary of Afflictions, 173; Mick Carpenter "Asylum Nursing before 1914: a chapter in the history of labour," Rewriting Nursing History, ed. in Celia Davies, 134; Robert Dingwall et al., An Introduction to the Social History of Nursing, 127; Nolan, A History of Mental Health Nursing, 48.
69. Sally Alexander, "Women's Work in Nineteenth-Century London: A Study of the Years 1820-50," in The Rights and Wrongs of Women, ed. Juliet Mitchell and Ann Oakley (London: Penguin, 1976), 59-111.
70. Digby, Madness, Morality and Medicine, 140.
71. Scull, The Most Solitary of Afflictions, 263.