Collecting Nursing History 31
Florence Catherine Puddicombe 1867-1943
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Cape Badge of Princess Christian's Army Nursing Reserve.
This beautiful badge was worn by members of Princess Christian's Army Nursing Reserve as a cape badge. Jennifer Meglaughlin describes the badge in her book, British Nursing Badges:-
"The centre shows a Geneva Cross, with four equal arms termination in a royal crown. Between each of the arms are shown some of the British emblems: top right facing as in medicine and heraldry* the rose that represents England; top left, the thistle of Scotland; lower right, the shamrock of Ireland; and lower left, an acorn with two oak leaves. The badge became obsolete in 1908." (22) * (i.e. as if being worn on self).
It has a unique identifying number on it, which is thought to correspond directly to the individual's army number. Number 497 is that given to Florence Catherine Puddicombe. Florence's records for WW1 survived the official culling of some Nurses war service records and are held at the National Archives at Kew (1), along with her South African Service records. (2)
Florence was born in St Aubin, Jersey in about 1867, her mother Helen Frances Victor, was born in Portsmouth in 1841 and father, Joseph Domett Puddicombe, was born in Plymouth in 1834, and became a seaman. They married by special licence on February 27th 1867 in St Saviours Church, in Jersey.(6)Florence appears to have been an only child. On the 1871 census, her mother is not a widow, and is living on the mainland. By 1881, her mother is recorded as being a widow and "annuitant"- a pensioner and they are back living in St Helier, where her mother had been at school in 1861. In the 1891census Florence is living and working at St Bartholomew's Hospital, London, where she trained as a nurse, and is shown as a "nurse".(4)
Florence was appointed in February 1891 as a probationer at St Bartholomew's Hospital, London, without a trial period. She gave her address as 13, Royal Crescent, St Helier, Jersey. Her father had been in the merchant navy, and she confirmed that he was dead. In a detailed report, made over one year, Florence had varying reports, many comments being in keeping with language and the strict discipline at the time. Every quarter a report is written; by the ward sister from the ward, Florence had just worked on. Each quarter there are 11 statements beside which the ward sister can make comments, in agreement or otherwise. Florence is "obedient," and a sister replies to the statement "attentiveness and kindness to patients" with: "her patients like her and she was particularly nice to children." She was "fairly accurate "when reporting observations, and "very good tempered", but also had less positive comments made about her "she means well but I do not think her suited to her work" and was not considered neat; in her work or person "she is not neat". (29)
Florence took her first exams in November 1891, which she passed, and then had three attempts at her second exam, finally passing it in November 1894.From November 1892 to May 1894 she is recorded as working as a "staff nurse" actually staff probationer) on three wards: medical, surgical and medical for six months each. Florence leaves St. Bartholomew's in May 1895; no cause is given. (29) Her "general conduct and efficiency as a Staff Nurse were moderate". (29)
This seems broadly in line with this explanation of the training at Bart's, which had been implemented by Ethel Manson (later Mrs Bedford Fenwick):
"The training school had been reorganised by Miss Manson between 1880 and 1887. The period of training was three years and, besides practical work in the wards, the probationers received lectures on medical and surgical nursing from members of the medical staff of the hospital. Six years after her appointment, Miss Stewart revised the regulations of the training school as follows:
The age of probationers on appointment must be between 23 and 35. They must produce evidence of good health, moral character, and general fitness of disposition and temperament for the duties of a sick nurse.
They must engage to serve at the hospital for a term of four years, three years as probationers, and one year (after obtaining their certificate) as Staff Nurses.
The times for the commencement of the term of training are 1st February, 1st May, 1st August and 1st November, but no one can be appointed at those times unless she has previously been in the hospital on trial for at least a month.
The hospital shall make the following quarterly payments; £2 during the first year, £3 during the second year, £5 during the third year, and £7 10s (£30 p.a.) during the fourth year.
They must provide, at their own cost, all requisite uniform for wear during the time they are on trial for probationership. In the event of their being appointed probationers, after their period of trial, a certain supply of dresses, caps and aprons will be allowed them by the hospital during the remainder of their term of service. They will be required to wear this uniform at all times when they are in the hospital.
They will be lodged and boarded within the hospital. At the end of their first year, they will be required to pass an examination in the subjects covered in the year. If they pass the examination, and are otherwise efficient, they will be employed as Staff Probationers for the remainder of the three years. During the second and third year of training, they will receive lectures in medical and surgical nursing from members of the hospital staff. At the end of the third year, they will be examined on their knowledge of nursing.
They will be subject to dismissal at any time for misconduct, inefficiency or repeated neglect of duty. Failure to pass the examination at the end of the first year will be considered a sufficient cause for the termination of a probationer's contract.
At the end of the third year, a certificate of competency as nurses will be awarded to those who, besides having discharged their ward duties efficiently, have passed both examinations and conducted themselves in all respects to the satisfaction of the hospital authorities.
At the end of a year after obtaining their certificate, they will be free to quit the hospital. By arrangement, they may remain in the service of the hospital as Staff Nurses after that time; and they will be paid £35 p.a. for the first year, and £40 p.a. subsequently.
Before being admitted on trial, applicants must undergo a medical examination and, as proof of general education and intelligence, pass an examination inn elementary anatomy, physiology and science." (38)
In the 1891 census Florence's mother, Helen is recorded as a widow living in Jersey and on her own means. Helenís life takes a tragic turn, which is reported in the nursing press in 1899:
"We regret to hear of the death of Mrs Puddicombe, Matron of the Trained Nurses Institute at Jersey, who is alleged to have committed suicide by taking a large quantity of carbolic acid on Sunday evening. Suicides in the Nursing Press are becoming painfully frequent, and are no doubt due in a large measure to the high pressure at which we live at the present day, resulting in over-strain, and consequent derangement of mental balance"(8)
This is the only recorded evidence that Florence's mother, Helen was also a nurse. During this period, there are several reports in the nursing press on suicide among the profession. In 1894, this report covers another suicide:
"SUICIDE AMONGST NURSES.
During the last few months there have been several lamentable cases in which Nurses engaged in Hospital work have taken their own lives. There is too much reason to fear that the pressure of work and responsibility, which devolve in some Institutions upon the Nursing staff, is too great a strain for the nervous system of some women to bear with safety. The latest case is that of Nurse Bevan, of the London Hospital, who committed suicide there last week. It was stated at the inquest that she had been strange and subject to delusions for about three months, and
that one of the doctors arrived at the conclusion that she was suffering from lunacy, a month ago. It certainly appears strange that the authorities should have kept a person-whom they believed to be a lunatic-on duty as a Nurse, and that no precautions should have been taken to prevent it---with the unlimited means at
her disposal-doing harm to herself or to anybody else."(17)
Much later in 1907an editorial in a nursing journal edited by Mrs Bedford Fenwick reported the following:
"THE SUICIDE OF NURSES.
The frequency with which suicide occurs amongst nurses naturally arouses enquiry
upon the part of the public as to why this should be the case, and it is 'apt to assume, in most instances quite incorrectly, that the over severity of the discipline enforced in hospitals and institutions is the cause of such rash actions. Thus in the recent case of the suicide of a probationer at the Carshalton Cottage Hospital, it was reported that she took her life by drinking strychnine after being reprimanded by the Matron for a slight fault. Many people would draw the conclusion that the reprimand was over severe, but the evidence at the inquest showed that the Matron, Miss Rose B. Mustard, was both kind and gentle, and that the deceased probationer was of a very passionate nature and violent temper and resented being told, even gently, of any small failing. Dr. Cressy, Medical Officer to the Hospital, stated also that she was neurotic. This brings out a point to which we are of opinion, too little consideration is given in the selection of probationers, namely, that of temperament.
It is right that enquiries should be made as to physical and moral fitness, but no less searching questions should be asked in regard to the temperament of the applicant. A great strain is imposed upon the nervous system, both of probationers in training and of certificated nurses in the course of their work, and bearing this fact in mind those of equable temperament should be selected, as they are most able to stand the strain of nursing life, and consequently make the best nurses." (18)
Approximately six reports were found in the nursing press between 1894-1907which suggested that suicide among nurses was a frequent occurrence. Suicide was generally by some form of poisoning; strychnine, nitric acid and phenic acid with drowning also mentioned. Most reports from inquests reported that the nurses were mentally unstable (volatile temperament and religious fervour were given as causes). It was generally felt that more thorough nurse recruitment was the best method of reducing the risk of unsuitable candidates becoming nurses.
Statistics kept by the Office for National Statistics (ONS) started in 1861; however, the statistics for the year Helen in which possibly committed suicide (she was buried in a consecrated grave) are not formulated by occupation, only by gender. It is not therefore possible to a direct comparison. In 1899, among the female population there were 733 suicides, of which 98 were in Helens age group (55-65). Of the 733 suicides, 92 were from the same method used as by Helen: carbolic acid. It does not report whether or not these were officially proven suicides, i.e. at inquest. (25)
The Liberal Democrat Party obtained the suicide statistics of nurses, supplied by the UKCC and ONS, which The Independent Newspaper published in 2000. It said that 342 nurses committed suicide in the six years to 1998, a rate of 11 per 100,000, with the average suicide rate among women being three per 100,000. The report suggested that nurses were at 50 per cent greater risk. Ninety per cent of nurses are female, and when compared with the female population, their suicide rate was almost four times the average. (23)
"These shocking figures show being a nurse carries a unique risk of suicide. It is tragic irony that when you commit yourself to saving and caring for the lives of others, you appear to be more likely to take your own life." (24)
However, Dr S. Kelly, in a report on suicide for the ONS in 1998, said nurses did have high suicide rates but it was not as high as four times the population. "I can't support that at all," she said. In the general female population aged over 15, the suicide rate was 5.6 per 100,000, higher than the three per 100,000 cited by the Liberal Democrats. The ONS report found that, nurses had a suicide rate 37 per cent above that of the population between 1991 and 1996.
The Independent concluded that
"The pressures of stress and isolation cause depression and to drive some people to take their lives, but for the medical professions, access to the means of suicide also increases the risk. Health professionals, including nurses, have higher than average suicide rates because they work in a stressful environment in which there is ready access to drugs." (23)
Dr Kelly said:
"Occupations with high suicide rates are dominated by the medical professions. It is not just access to the means of committing suicide that counts but knowing how to use them" (23)
It seems tragic that nurses were apparently committing suicide frequently in the 1890's, and that they continue to do so in the 21st century. Despite being a century apart there are many common reasons cited in the press:
∑ the stressful nature of the work,
∑ people with the knowledge about how to commit suicide successfully
∑ ready access to the drugs/chemicals with which to commit suicide
∑ isolation, leading to depression
∑ financial hardship
Records from Croads undertakers in Jersey:
"Helen Frances Victor widow of Joseph Domett Puddicombe Esq. Died at Springfield Crescent Trinity Road 12th March 1899 aged 58 years and 2 months. Buried Wednesday 15th at St Helierís general cemetery in the grave 14 N in the name of Florence Catherine Puddicombe" (11)
Three weeks later probate of Helen's estate is granted to her daughter Florence, to a value of £4,448(4) (approx £250,000 today).(9) It appears unlikely that Helenís death was caused by financial hardship- perhaps she drank from the wrong bottle by mistake? Alternatively, perhaps she was suffering from severe pressure as a nurse -although so far we have no evidence of her having any formal training as a nurse. Helen was on Jersey in 1861 as a 20-year-old scholar, and married Joseph in1867. She could perhaps also have trained between 1881-1899, but is living on her own means in the 1891 census. (A relative of mine was shown as being both a hospital nurse and living on her own means on the 1911 census). Perhaps Helen was about to lose her job as Matron as she was not trained? Nursing records for the Hospitals on Jersey exist from1920.
Florence is now an orphan (albeit aged 32). In October 1899, she was mentioned in The Nursing Record as being a founding member of the League of Nurses at St Bartholomew's Hospital:
"Nurses so far, have, for the most part led isolated lives, their work being commonly supposed to furnish them with an exclusive and all-absorbing interest, and should any of their number be so unreasonable as to desire more, there is always the recreation afforded by a journey on the top of an omnibus to fall back upon. Is it to be wondered at that when they take up private work their patients are apt to complain that they can only talk on one subject -their work? It is a truism that all work and no play engenders dullness, and although, with professional women everything else must take a very subsidiary place to their profession, yet there, are many occasions when they can meet for mutual help and pleasure, and may cultivate some of the hitherto neglected sides of their nature. We, therefore, must express our congratulations, that in the formation of the League of St. Bartholomew's Nurses, although it is, no doubt, primarily a professional association, there is a lighter side. We are glad also, to hear that the list of members now numbers some 200 nurses, that which we publish below being made up to September 30th. A meeting of the provisional committee met this week, Miss Isla Stewart presiding, to consider the further organization of the League, and to discuss the arrangements for a general meeting of the members. LIST OF MEMBERS.... E*.C. Puddicombe " (15)
*E.C. Puddicombe is listed- however this is a typing/printing error as there are no other Puddicombe's listed among the St Bartholomew's League of Nurses Archives from 1900-1945. (26) Florence is among the inaugural members listed in the first League newsletter. Of 400 certificated nurses invited to join the league in 1900, by 4th December 1900, 247 had joined. Florence's address is listed in every league Magazine from 1900-1945, when her death is announced. In 1900 and 1901, Florence's address is 7 Springfield Crescent, Jersey (31) the road in which her mother lived when she committed suicide.
There was overwhelming
support among members for a League badge to be designed, and by
November 1901 badges were available from the league secretary or
Sister Mark (Sister of Mark ward) for four 9d (28);
approximately £13.55 today. (9)
The badge of the League of Nurses
The Hospital coat of arms gave inspiration for the badge, which is shown in the stained glass in the hospital chapel.
"The black and white shield has been the badge of St Bartholomew's Hospital for more than 500 years. It was the Coat of Arms used by John Wakering, who was the Master of the Hospital from 1423 to 1462. Although this Coat of Arms was not granted to John Wakering or his family by the College of Arms, it became associated with the Hospital (probably because he was Master for so long) and continued to be used after his death. The shield appears as the Arms of the Hospital in a 16th Century roll in the College of Arms and, though never formally granted to the Hospital, continued use since the early 15th century presumably established the right to display them." (27)
Stained Glass Window in the Hospital Church of St Bartholomew the Less: with coat of arms beneath.
Within one year of her mother's apparent suicide Florence signed up on 28th March 1900 to become a member of the Princess Christian's Army Nursing Reserve. Princess Christian (Queen Victoria's third daughter) established the Princess Christian's Army Nursing reserve in 1897. Princess Christian's Army Nursing Reserve worked alongside the Army Nursing Service which was formed in 1881(but initially had only very few nurses - approximately 20). Princess Christian's Army Nursing Reserve was merged into Queen Alexandra's Imperial Military Nursing Service (established in 1902) in 1907.
"Lord Roberts has asked for 50 more trained nurses, and 50 more nurses are being hurried to South Africa every week; and the following 20 members of the Army Nursing Reserve sail for the Cape on Saturday 4th August 1900 - Nursing Sisters.... F. Puddicombe" (12)
Her short service history is transcribed on www.boerwarnurses.com (2) and she appears to have worked at No 5 General Hospital, Wynberg, and No. 15 Stationary Hospital, Heidelburg. Her league address in 1902 is also No. 15 stationary Hospital, Heidelburg (30). Unlike other league members Florence is not listed among the St .Bartholomew's nursing staff that had gone to South Africa to nurse during the Boer war; presumably, as she had left the hospital in the intervening five year period.
In September 1902, Florence's return from South Africa is reported in the nursing press:
"Returning from the war;
The following Nursing Sisters who have served in South Africa are now on their way home: In the Golconda- Sisters.... F.C. Puddicombe. Due at Southampton September 14th." (13)
On her return, the League members list gives her address in 1903 as
"Sisters quarters, R.V Hospital, Netley" (32)
This was the Royal Victoria Military Hospital, built near Southampton water, Southampton.
By the league lists of 1904-1905 Florence is listed variously as working at
"The Junior House, Felstead School, Essex; Matron, Felstead School; and then the Infirmary, Felstead, Essex." (33) These are interpreted to all be at Felstead School as Florence is working in Felstead School, Essex as a sick nurse on the 1911cenus (4). Her address remains the same until 1920.
(I have emailed school to see if any records survive).
Among Florence's war records at Kew, (1) is her contract with the War Department signed by herself on 5th August 1914 and a contract extension signed on 9th May 1917, as a Sister in Queen Alexandra's Imperial Military Nursing Service Reserve.
Florence was posted "on mobilization" to No 2 General Hospital, which appears to be in Le Havre initially and then in Etretat.(19) Thereafter a series of hospitals are recorded on her casualty form for active service, (Army Form B.103) which include;
∑ 24 General Hospital - Etaples
∑ 14 Stationary Hospital - Wimereux
∑ 21 Casualty Clearing Station - This was in Bonn when Florence served there (from February 1919)
"Number 14 Stationary Hospital was found to be in a large hotel on the sea front in Wimereux...he directed us to the top floor, where the nurses had their quarters. Every place was packed with sick and wounded lying on the floor: you stepped between them and over them, to get along. As soon as we could get into our indoor uniform, we went straight to the wards. I relieved the matron in the theatre, where she was busily working. Operations went on unceasingly. As fast as one patient could be taken off the operating table, another was placed on-and so on all through the night: the surgeons had been at it the whole day" (25)
Florence spent 14 days in the Convalescent Hospital-Hotel de L'Esterel in Cannes in December 1917. This had 100 beds and nurses and VAD's (Voluntary Aid Detachment workers) could apply to spend their leave there, in the relative warmth of the South of France rather than returning to England for their leave. (20) Despite reports in memoirs of leave being curtailed during the war she also received four other periods of leave, each for 14 days, at least two of which were spent in England.
In 1919 prior to the "dispensing of her services," Florence was working in Bonn with the British Army of the Rhine (at 21 Casualty Clearing Station). Her report, written by the current Matron shortly before her departure states (following strict directions from the Kings regulations).
"Her general professional ability and administrative capacity are good. She shows power of initiative and ability to train her orderlies. Temper, judgement, zeal, self reliance commonsense are all good and her influence generally." (1)
Florence's service officially ended on 24th August 1919. On landing in Folkestone she signed the dispersal certificate on 16th August 1919 and gave her address as St Stephens Vicarage, Launceston, where her 1st cousin Rev E. Drewe was living (4). Throughout the war, he was also recorded as her next of kin on official documentation. Florence applied to the War Office for a gratuity, which was successfully awarded (with a note that she was not insured), on 28th August 1919.
Florence also received the Victory Medal, British Medal and 1914 Star, the latter, as she was part of the original British Expeditionary Force in France from the outbreak of WW1 in 1914.
Florence received the Royal Red Cross (2nd class) from the King at Buckingham Palace on December 11th 1919:
"The King held an investiture and conferred orders and decorations as follows:
The Royal Red Cross (Second Class)
Queen Alexandra Imperial Military Nursing Service Reserve- Miss Florence Puddicombe." (14)
Despite her war service, her address does not change in the ST. Bartholomew's League News until 1920, when her first cousins son's address is given in Cornwall:
"Puddicombe F. A.R.R.C. (Oct 1894); St Stephens Vicarage, Launceston, Cornwall." (34)
In 1922, there is a final series of papers in her war records, which refer to her request for a Certificate of Service, which directed Florence to apply to the Ministry of Pensions Nursing Service-presumably because she was anticipating retiring, or already of retirement age. Florence remains in Launceston for 6 years; and in September 1926, her new address is reported as:
"Puddicombe F. A.R.R.C. (Oct 1894); 9 Norland Square, Holland Park, SW11" (35)
Florence's address is not given in The League Members list of 1944 (36) and the following year's League News confirms her death with this announcement:
Puddicombe-on November 4th 1943, at a nursing home in Reading, Florence Catherine late of 9 Norland Sq.London W11." (37)
This confirms that she dies in Reading in1943, with her death registered in the December quarter. Probate was granted to Florence's first cousins son, Arthur Seymour Drewe MC, who also lived in Reading. (4) Probate was granted in Llandudno with Florence's address given as nursing home in Bath-this seems contraindicated by this death announcement, which presumably would have been verified with relatives before being printed.
If Florence had a League badge, was it engraved and if so where is it, and where are her medals?
With many thanks to all those, people who answered my many email questions, in particular:-
Will Burgess, for editing, encouragement and uploading (S.o.N).
The archivists at St Bartholomew's Hospital Archives.
Boerwarnurses.com. Peter for extra back ground research and lastly
but not least for proof reading, my very supportive husband, Harry.
1. http://www.nationalarchives.gov.uk/WO 399/6799
3. http://rcnarchive.rcn.org.uk/The Nursing Record and Hospital World, March 18 1899 pg216
4. ancestry.co.uk/ 1861/1871/1881/1911 censuses
5. http://www.findmypast.co.uk/1891 census
6. Jersey archives D/EB8/7.
7. Jersey archives; D/AV/C1/1
8. http://rcnarchive.rcn.org.uk/The Nursing Record and Hospital World, 18th March 1899 pg 216
10. Ancestry.co.uk; England & Wales, National Probate Calendar (Index of Wills and Administrations), 1858-1966
11. Jersey Archives; Croad's funeral directors; L/A/41/B1/5
12. http://rcnarchive.rcn.org.uk/The Nursing Record and Hospital World, Army Nursing Notes; August 4th 1900, pg 93
13. http://rcnarchive.rcn.org.uk/The British Journal of Nursing, September 6th 1902 pg 200
14. http://rcnarchive.rcn.org.uk/The British Journal of Nursing, December 20th 1919 pg 379
15. http://rcnarchive.rcn.org.uk/The Nursing Record and Hospital World, The Barts League, October 14th 1899 pg 312
16. http://rcnarchive.rcn.org.uk/The British Journal of Nursing Supplement, The Midwife, March 20th 1920 pg 179
17. http://rcnarchive.rcn.org.uk/The Nursing Record and Hospital World, February 10th 1894, pg 90
18. Http: //rcnarchive.rcn.org.uk/The British Journal of Nursing No, 984. SATURDAY, FEBRUARY 9, 1907. Vol. XXXVlll
21. www.nationalarchives.gov.uk /DV7/18
22. Meglaughlin, Jennifer. 1990.British Nursing Badges, An Illustrated Handbook. 1st Edition, London, The Vade-Mecum Press Ltd.
23. http://www.independent.co.uk Doctors and nurses 'most likely to commit suicide'BY JEREMY LAURANCE, HEALTH EDITOR
24. The Independent, 28 SEPTEMBER 2000, Nick Harvey, Liberal Democrat spokesperson.
25. Members of Her Majesty Queen Alexandra's Imperial Military Nursing
Service (1922). Reminiscent
Sketches 1914-1919.Walker, A.L.,
25. The Registrar General of Births, Deaths and Marriages in England (and Wales): Sixty-Second Annual Report; 1899.
26. St. Bartholomew's Hospital Archives, League News: SL6, 1900-1903
28. St. Bartholomew's Hospital Archives, League News: SL6, 1900-1903 pg112
29. St. Bartholomew's Hospital Archives: SBHB/MO/54/2, pg 104
30. St. Bartholomew's Hospital Archives, League News: SL6, 1900-1903 pg154
31. St. Bartholomew's Hospital Archives, League News: SL6, 1900-1903 pg117
32. St. Bartholomew's Hospital Archives, League News: SL6, 1900-1903 pg 221
33. St. Bartholomew's Hospital Archives, League News: SL6, 1904-08 pg 41
34. St. Bartholomew's Hospital Archives, League News: SL6, 1918-22 pg 43
35. St. Bartholomew's Hospital Archives, League News: SL6, 1923-28 pg 60
36. St. Bartholomew's Hospital Archives, League News: SL6, 1939-44
37. St. Bartholomew's Hospital Archives, League News: SL6, 1945, pg18
www.rcn.org.uk: St Bartholomew's Hospital Records HA/3/20, 7 Dec
Fig 1& 2. COPYRIGHT; Sarah Rogers.
Schools of Nursing.
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