Agnes Warner and the Nursing Sisters of the Great War

by Shawna M. Quinn

  At least nine nurses from Saint John, New Brunswick, went with this first contingent to work in the No. 1 General Hospital, commanded by Colonel (Dr.) Murray MacLaren of Saint John. Among them were Miss Grace Domville and Margaret Parks, who was actually a medical doctor in civilian life. No female doctors or male nurses were recruited, though a few female doctors circumvented the red tape and cooperatively founded special non-military hospitals, like Saint John doctor Catherine Travis’s baby hospital in Serbia. Moreover, no female staff went with the stationary hospitals and casualty clearing stations of the C.E.F. in the first contingent. These hospitals, located closer to the front, were in danger of enemy fire and their personnel had to be ready to evacuate at a moment’s notice. The larger general hospitals, though, were accommodated in abandoned schools, donated mansions, or other reasonably suitable buildings in safer zones.

  Before conditions convinced military authorities of the need to install nurses at advanced hospitals, a wounded soldier had to pass through several gruelling stages before he even saw a nurse. From the place he fell, he would have to wait for stretcher bearers to find him under cover of darkness and take him to the nearest first aid post, or try to crawl there by himself. From there he might be sent to an advanced dressing station or be conveyed by horse-drawn or motorized ambulance over appalling roads to a main dressing station to have his condition classified. If gravely wounded, he might be operated on immediately, then sent further back to the casualty clearing station as soon as he could be moved. If the wound was less serious, he would have an opportunity to recuperate somewhat before returning to the front. Casualty clearing stations (C.C.S.s) were set up on railway sidings less than five miles from the front. Earlier in the war, their staff chiefly dressed wounds and loaded casualties onto trains bound for larger hospitals in the rear: the (misleadingly named) stationary hospitals, with up to five hundred beds but designed to be mobile, or the larger general hospitals, with a thousand to fifteen hundred beds and as many as a hundred nurses. Before long, however, C.C.S.s evolved into advanced surgical hospitals that provided life-saving operations before wounds became infected beyond hope. An obvious need for nurses trumped any lingering misgivings about putting women in harm’s way, and before long select nurses held coveted positions in the casualty clearing stations, too. Duty so close to the firing line demanded the utmost efficiency — the best of the best — and nurses considered it a personal honour to be assigned to this work.

  Back home, Canadian nurses continued to sign up in droves for active service. Applications flooded the desk of Matron-in-Chief Margaret Macdonald — too many to process, never mind accept, in 1914. As the front settled into a static line of trenches stretching from the Belgian coast to the Swiss border and casualty numbers mounted, the demand for Canadian nurses grew steadily but still could not keep pace with the number of applicants waiting anxiously to find out if they’d be next to steam across the Atlantic. Colonel Guy Carleton Jones, head of what was by now called the Canadian Army Medical Corps (C.A.M.C.), did his part to dissuade fair-weather recruits. Addressing a meeting of the Ottawa Graduate Nurses’ Association, he sternly warned that “Active service work is extremely severe. A very large proportion of regular nurses are totally unfit, physically and mentally, for it.” If his caution gave some women pause, it did not appear to curb interest. And no wonder: with slogans such as “Come on Boys!” and “Your King and Country Need You,” Canada was enjoining its young men to enlist and face unknown horrors. For nurses, too, the call to defend civilization resonated loudly in both the conscience and the imagination. Here was an opportunity to stand on the same ground as their countrymen and restore them with comfort and healing if they fell — to serve the nation in a way for which nurses were uniquely qualified. There is little doubt that the active service posters targeting Canadian men struck nurses more forcibly than messages pleading women to knit furiously and economize on the home front. What is more, nurses were free to go. The vast majority were unmarried, with an unusual degree of independence and a salary, and although most would never have considered international travel before, the war now facilitated their going and there was nothing standing in their way. Canadian army nurses would see service in England’s cities and countryside, France’s coastal resort towns, Belgium’s villages, scorching eastern Mediterranean islands, and even, for four “fortunate” women, Russia in the midst of revolution. As Canadian soldier recruits rushed overseas with enthusiasm, so did Canadian nurses. One nursing sister put it very plainly in retrospect: “I wanted to be in the Army because I was curious; I wanted to see what it was like.” Once contracted, most nurses were locked into service “for the duration” of the war, and only personal illness, daughterly duties (such as those resulting from death or illness in the family), or matrimony could release them. Few nurses traded service for marriage during the war, but it was not unheard of.

  For some nurses, the impetus to serve abroad came from a deeply personal need to be physically close to beloved fiancés, friends, and relatives as they struggled in the fight of their lives. Matron Macdonald recognized this motivation as an important one for keeping C.A.M.C. nurses in good spirits, and wherever possible she arranged for her nurses to work near loved ones posted with the C.E.F. For those who had lost dear ones already, the busy-work of nursing offered a way to overcome their private tragedies, feel more worthy of their beloved’s sacrifice, and keep from drowning in personal despair.

  The call to service also struck a chord with the ideology of their profession. Nurses had always protected individual humans. Now they were called to protect humankind with the angelic self-denial and maternal purity that went hand-in-hand with the ideal of the “true” nurse. Images of mother-nurses bearing angel’s wings cradling wounded men figured prominently in recruitment posters on both sides of the Atlantic. Such chaste and noble depictions also reassured families back home who feared the unwholesome effects of globetrotting and army coarseness on their daughters. Nurses themselves reinforced their maternal role by referring to the wounded as “lads” or “boys.”

  Then there were the perks. Besides the sense of importance that came with participation in active service, which excluded most other women, a C.A.M.C. nursing sister’s position came with paid room and board, amounting to about $2.60 per day, and beautiful blue uniforms that earned Canadian nurses the cheery nickname “Bluebirds” and incited envy from grey-clad Imperial and Red Cross nurses everywhere. Canadian nursing sisters loved their C.A.M.C. uniforms. The cornflower blue workday outfit with full white apron and shoulder-length white veil gave them the look of schoolgirls, nuns, or ministering angels — perfectly in keeping with the “Sister” moniker that was a carryover from the days when religious orders did full-time nursing and aptly implied exclusive membership in a carefully guarded club. The darker blue dress uniform boasted two rows of brass buttons, a scarlet-lined cape, and brimmed dress hat. It was altogether a sharp outfit, but one feature of particular significance glinted from the shoulder and distinguished the C.A.M.C. nurse from her British counterparts: the two stars of a lieutenant. For nearly a decade, C.A.M.C. nursing sisters had enjoyed officers’ rank: lieutenant for nurses, captain for matrons in charge of hospitals, and major reserved for the matron-in-chief. Army officials justified officers’ ranks for nurses (albeit without a command or full commission) on the basis of nurses’ social origins, their higher education, and the propriety of elevating them a respectful distance above the rank-and-file soldiers whose bodies they mended. C.A.M.C. historian J. George Adami recognized that the nurses’ rank was a somewhat contentious subject when he defended it in 1918:

  While . . . there are English, Scotch and Irish nursing sisters not one whit behind their Canadian sisters in any respect, socially, as a body, the nursing profession in Canada has, in the first place, a higher status than it possesses in the old country. It attracts, in general, the daughters of professional men, and those from comfortable households . . . It is a rule that Canadian Nursin
g Sisters have had, not a common, but a High School education . . . And as nurses their training has been very thorough, with fuller courses of lectures on the basal subjects than is usual in Great Britain. As a result, a remarkably large proportion of the matrons of the great hospitals in the United States are of Canadian birth and training. Add to this that the Canadian nurse embarked on her profession is paid on a scale which in Great Britain would be thought extravagant. But then she is thoroughly competent . . . [I]n this war they have abundantly “made good.”

  Adami then hastened to uphold the nurses’ humility, as if their elevation was more richly deserved because they did not demand it suffragette-style: “It should be emphasized that this step was taken . . . by the Ministry and Militia Council, not as the result of any agitation by the nursing sisters themselves — in fact, some years before the suffragettes became militant. The experience of the Canadian Army Medical Service has abundantly justified the innovation and proved it to be right and wise.”

  As lieutenants, Canadian nursing sisters could attend the entertainments hosted by other officers, enjoy relatively comfortable amenities, and claim respect and obedience from orderlies in the military hospitals. Meanwhile, the British army continued to deny rank to nurses in the Q.A.I.M.N.S., itself a non-military organization but still the chief body of nurses supporting Britain’s military. Not surprisingly, the issue of rank occasionally fuelled tension between co-working British nurses disdainful of uppity “colonials” and Canadian nurses who resented being treated as inferiors. For the most part, however, working relations between nurses of the two countries were cordial, even warm, as troubling inequalities gave way to mutual purpose.

  Some Canadian nurses even donned the uniform of the British Q.A.I.M.N.S. In September 1916, the Saint John Daily Telegraph reported that a new request for two hundred nurses for the Q.A.I.M.N.S. “will no doubt satisfy the desires of a number of trained nurses who wish to get overseas.” Sixty-six of these were to come from the Maritime provinces, and interested women applied at the Royal Victoria Hospital in Montreal. Contracts were for one year, renewable, or for the duration of the war; return passage and uniforms were provided.

  Other important routes to the front arose besides the C.A.M.C. and the Q.A.I.M.N.S. Following the Great Retreat to the River Marne in 1914, the French Army medical service (Service de Santé Militaire) found itself stretched far beyond what it could handle. Desperate for nursing personnel, officials reached out across the Channel for help and the French Flag Nursing Corps (F.F.N.C.) was born, a collaborative effort between the French government, two prominent nurses in Britain — Mrs. Bedford Fenwick and Miss Grace Ellison — and their supportive committee. The British ladies were determined to recruit a steady supply of British (and, by extension, Canadian) nurses for French medical hospitals who would not only provide much-needed care, but also “raise the whole tone of nursing in France.” In other words, they would rehabilitate the standards of French military nursing, which, by all British accounts, were adequate but cried for the precision, sanitation, and “cheeriness” that prevailed in British hospitals. Beginning in the latter half of 1914, approximately two hundred and fifty graduate nurses from Britain, Canada, Australia, and New Zealand who attested to being born of British parents and proficient in French signed up with the F.F.N.C., looking for a taste of the first aid experience behind French trenches. Because the French government expressly requested that no young women be sent, the minimum age was set at twenty-eight, later raised to thirty.

  F.F.N.C. nurses typically worked in small groups of six or fewer, joining the staff of existing mobile hospitals near the firing line and stationary hospitals in the French interior. As nurses they accepted officers’ rank in the French Army and until March 1917 the French government paid them a small salary and outfit allowance — so small as to make them nominal “volunteers.” Travel and other expenses were to be paid out-of-pocket, and deficiencies in hospital supplies — such as gloves, thermometers, soap, and hot water bottles — were to be solicited from folks back home. Beginning in 1917, the British Branch (Comité de Londres) of the French Red Cross assumed financing and oversight responsibilities.

  Evidently there were interpersonal obstacles to overcome in this arrangement. According to a contemporary (unabashedly pro-British) account, “Differences of custom and of religion . . . provide subtle opportunities for bruised feeling . . . But what may well cause wonder is that, with so many occasions of difficulty, things came to run so smoothly as on the whole they have done. The Sisters won their way to confidence by the excellence of their work.” One can well imagine the tensions this situation suggested for nurses in the wards, and the journal The Canadian Nurse acknowledged that the linguistic, cultural, and practical challenges were “difficult for us, of course, but even more so for [the French]. Both contracting parties, however, have bravely stood the test, and have broken down all the barriers which might have proved insuperable.”

  Cool, brave heads were critical in the milieus of F.F.N.C. service. While some of its hospitals were permanent structures located well behind the front, many others took the form of ambulances volants, or “mobile ambulances.” Not to be confused with motor ambulances, which were transport vehicles, these were rough barracks and tents erected close to the front, ready to be hastily dismantled and re-established as the army advanced or retreated. When the wind wasn’t blowing the canvas down around their heads, nurses caught precious sleep in tiny bell tents while aircraft growled overhead and not-so-distant guns convulsed the ground. Night-duty nurses slept in broad daylight as convoys rumbled through and soldiers drilled just outside their tent flaps. “For a woman to be part of an ambulance like this is quite a new order of things,” Grace Ellison wrote to her readership, for the F.F.N.C. promised acute danger and long hours at a time when the Canadian army had not yet introduced nursing sisters into its casualty clearing stations near the firing line. Recruitment appeals were fairly blunt about conditions: only women animated by a “pioneer spirit” need apply for this situation of discomfort and danger, surrounded by ruins and mud and sometimes lacking in basics such as four walls and someone to look after laundry. But, Ellison’s letters urged, the satisfaction of lending desperately needed help to grateful poilus, the affectionate term in general use for the mustachioed and bearded French soldiers, was reward enough for the “true nurse.” Indeed, F.F.N.C. nurses could boast of being in the vanguard — for example, they were among the first to occupy the devastated districts across the Hindenburg Line in 1918 — and many took home prestigious French military honours such as the Croix de Guerre and Médaille des Épidémies, awarded for persistent bravery under bombardment.

  The scope of the F.F.N.C. sisters’ mission differed in another major way from that of their Canadian military sisters: F.F.N.C. hospitals were less exclusively military and more available to the civil population. Whether or not the founders originally intended it that way, the F.F.N.C.’s mandate came to embrace whole villages, not just fighting men. F.F.N.C. work was as varied as it was relentless. In the absence of civilian doctors, F.F.N.C. nurses cared for local civilians, and fed and clothed refugees, often on their own time:

  We had a sad experience two nights about ten days ago when we were asked to meet two trainloads of refugees from the invaded districts . . . These poor, miserable people, so cold, hungry and travel-worn . . . all huddled up together in carriages without either light or warmth. . . . The snow lay thickly on the platform and it was bitterly cold. Being a very wretched night the Red Cross ladies were conspicuous by their absence, and we F.F.N.C. Sisters had the work to ourselves. This consisted in going from carriage to carriage with warm milk for the babies and small children, and plates of soup for the adults, with large chunks of war-bread. . . . Poor things! . . . Our work being finished, we went off to our various abodes to snatch a few hours’ sleep before getting-up time. On getting into my comfortable bed I thought of those tired homeless people spending such dreary hours on the hard trai
n seats, after their trying dreadful experiences. The following night we were again told to meet a train of refugees.

  On Christmas Day 1915, a contingent of ten Canadian nurses supervised by Miss Helen McMurrich, former instructor at Montreal General Hospital, sailed from Saint John, bound for the F.F.N.C. For their passage and equipment, they relied on the generosity of the Canadian public to the amount of $400 per nurse. During their stopover in England, they were invited into London’s drawing rooms and theatres to catch an “idea of the greatness of London,” all the while fortifying themselves with inspiration for their upcoming sacrifice. It was a breathless whirlwind of entertainments, sightseeing, and receptions that would stand in sharp contrast to next month’s accommodations. By March, McMurrich and at least one other Canadian F.F.N.C. nurse were set up at Ambulance Mobile No. 1, a new surgical unit in the village of Rousbrugge, Belgium, and a gift of wealthy New Yorker Mary Borden Turner, herself a war nurse and author. Sister Agnes Warner had already been at this hospital for almost four months, looking forward eagerly to the extra pairs of Canadian hands that were rumoured to be on their way. She would soon praise them for being “a joy to work with, for they have had splendid training and are the kind that will go till they drop.”

  Trained nurses were not the only ones intrigued by the prospect of high adventure and the pleasures of travel abroad. Thousands of other young, talented Canadian women longed to make a tangible contribution and see the world beyond their provincial neighbourhoods, but was there a role for them? Many could not produce a graduate certificate from an accredited nursing school, but had taken a St. John Ambulance course on basic nursing and were more than eager to learn on the job. In the face of the tens of thousands of young men who needed care, could not dogmatic insistence on formal training be set aside and non-nurses be allowed to serve for the duration? In Canada, the answer was a resounding “no”: under no circumstances would the C.A.M.C. recruit untrained women for overseas nursing.