By Gabrielle Barr ~
“Don’t talk too long to patients…. Never lean against the table with one’s hands in one’s apron pockets…. Don’t be too eager to learn….” If you wanted to be a nurse in the 1890s, How to Become a Nurse and How to Succeed by Honnor Morten, could be your guide, from what books to buy to what uniforms to wear at hospitals throughout the United Kingdom. This spring I had the opportunity to catalog this monograph under the tutelage of Laura Hartman and was captivated by the level of detail associated with each topic the author covered.
Violet Honnor Morten, daughter of the wealthy solicitor, John Garrett Morten and his second wife, Wilhelmina Milroy, was born at Mayfield House, Cheam, Surrey on November 13, 1861. At the age of twenty, Morten began her nursing training at the London Hospital under Eva Lückes and went onto earn a midwifery diploma from the London Obstetrical Society and a certificate in hygiene at Bedford College in London in 1896. Morten contributed nursing articles frequently to The Hospital and Daily News and authored several manuals about nursing including: How to Treat Accidents and Illnesses: a Handbook for the Home, Health in the Home Life, The Midwives Pocket-Book, and the Nurse’s Dictionary of Medical Terms and Nursing Treatment that reached an eighth edition by the time she died in 1913. She also penned fictionalized accounts about nursing such as Tales from the Children’s Ward and Sketches of Hospital Life.
In the early 1890s, Morten founded a nurses’ co-operative and the Association of Asylum Workers and began lecturing widely on infant care, first aid, family health, and women’s rights. She advocated strongly for implementing a school nursing program in Britain at the turn of the twentieth century and campaigned while on the London School board for better facilities for mentally challenged children in addition to abolishing corporal punishment, which resulted in adverse coverage of her in teachers’ publications of the time. Around 1905, Morten established the Hoxten Settlement, a Tolstoy-inspired initiative in Rotherfield, Sussex, which functioned as a country holiday home for disabled children from the slums of London and a retreat for adults. As a lifelong activist, Morten also supported reforming prisons, vocally protested the Boer War, and was a non-militant suffragist.
Unlike some of the more progressive and editorial pieces Morten wrote towards the end of her career, How to Become a Nurse and How to Succeed is reflective of the growing number of guides about nursing published during the 1890s. Long-held attitudes about nursing changed radically in the mid-nineteenth century as evidenced by Morten’s declaration “[as] every boy is supposed at some period of his life to wish to be a sailor, so every girl when she is in her teens decides that she will be a hospital nurse,” which led to thousands of women from more well-to-do backgrounds to apply to nursing programs. How to Become a Nurse and How to Succeed imparts practical recommendations on how these young women could receive their education, where they could train, and what requirements and qualities were necessary to be accepted. Throughout the manual, Morten demonstrates her dedication in giving her audience a real sense of the process of becoming a nurse whether it be through sample exam questions and case reports found in the appendices or charts, lists, and graphs about managing patients’ health found in the text.
The book discusses at length the options available for hospital nursing in England and abroad while also providing the specifics of midwifery, infirmary nursing, district nursing, military nursing, private nursing, message therapy, and becoming an asylum attendant. There is also brief commentary on the track men should take who want to enter the profession. Morten’s extensive lists of institutions with notes about wages, hours, vacation time, training schedules, and certifications recommended provide a window into the real considerations of nurses during this period and illustrate the diversity of experiences one could have. When describing the programs, Morten is fairly objective, especially with those in the United Kingdom. She offers her opinion more readily with the training opportunities in the colonies and the United States, which she considers to be superior to those in England. With nursing education in continental Europe, Morten delves deeper into the history of nursing in each respective country and mentions the differences in nursing practices the student might encounter between that nation and the United Kingdom.
While this book was designed for those considering entering the field seen by her inspirational chapter on eminent nurses like Florence Nightingale, Sister Dora, and her own mentor, Eva Lückes, it also served as a reference to those who were already nurses and wanted to work in a different setting, join a nursing society or guild, or remain current with nursing literature. Morten advises those who wanted to become matrons of their hospitals, which involved supervising the care of patients, attending to the needs of out-patients, managing the female servants, and instructing those who were in training to become nurses. Depending on the type and size of the facility, the responsibilities of the matron varied as Morten explains throughout the chapter, but the emphasis on housekeeping and nutritional matters for both the patients and medical personnel is striking to a modern reader who is used to viewing nursing in a more scientific light.
In a review cited in the June 22, 1895 issue of The Hospital magazine, The British Medical Journal called How to Become a Nurse and How to Succeed a godsend for those frequently consulted on what steps should be taken to become a nurse, indicating its approval by the medical establishment of the time. For historians of today, this handbook reveals components involved in making nursing a laudable profession that could be learned in the classroom, by example, and by experience while also illustrating the non-uniform nature of the field during the 1890s. Certainly this manual is instrumental for understanding nineteenth-century medical knowledge and cultural attitudes, but it can also be a lens in discerning the ideas and actions of the next generation of nurses who prepared for their jobs with the tools and advice provided in Morten’s comprehensive guide.
Gabrielle Barr is currently completing a second year as a National Library of Medicine Associate Fellow at Northwestern University’s Galter Health Sciences Library & Learning Center.