PREVIOUS - OCTOBER 1st – 31st 1918



09.10.18
After lunch I left with Miss Hill, VAD and went to GHQ taking the names of those members of the Nursing Services who have been recommended for Honours or Mention in the New Years’ Despatch. Explained that there was a very large increase this time, the result of a greater number of workers in France, and in addition the serious nature of the work in which they have been employed since June.

10.10.18
Abbeville
Left for Headquarters, DMS, L of C at 11 o’clock, taking with me the remainder of the lists of Honours and Mentions which had to be passed through his office before going to Headquarters, L of C. The DMS was away. The DDMS was very pleased with the way in which they had been typed and with the care which had been taken in compiling them. I discussed with him the necessity of giving the Dietitians a recognised position and more authority, if they were to be of any real value, and submitted various suggestions for the DMS approval. We also discussed the need of extra Nursing accommodation in Trouville for members of the Almeric Paget Corps, and for the staff of VAD members who had not been taken into consideration when building these large Hospitals. I pointed out that this was an urgent need if Trouville was now to take in battle casualties, which had not been anticipated earlier when this new Base was established, it being thought that merely light cases would be accommodated there. I also spoke about the necessity of my having a competent chauffeur, and the difficulties I had had to contend with since leaving Abbeville, my permanent chauffeur being then withdrawn.
I spent the night at the Annexe, and went round the Sick Sisters’ Hospital, which was full of seriously ill cases. I saw the Matron of No.2 Stationary Hospital, who spoke of the heavy and continuous work, and said that the Nurses were feeling the strain. She pointed out that unless further help were provided, she was afraid that many of the Nurses would knock up. I told her that when reinforcements arrived she, with many other hospitals, would be remembered, but owing to the heavy work in the United Kingdom, reinforcements which should have arrived, have had to have their orders cancelled, and that the position in France had already been reported officially.

11.10.18
Left early for Gournay and arrived at 2.30. I inspected the Detention Hospital there in consequence of an official letter having been received from the War Office written by a parent quoting what her daughter, a VAD, had been required to do in connection with a highly infectious case. Found the Hospital established in a very fine building, composed of a main block for the Hospital and two wings, one for the Nursing Staff, and the other for the Medical Officers, recreation room, kitchen, etc., situated in beautiful grounds. The work of this Hospital was drawn from a large Veterinary Camp which is situated in the locality, and they have very good accommodation for both officers and men; the usual class of case being medical and accidents, mainly kicks. Anything of a serious or infectious nature is sent by Ambulance to Rouen; occasionally infectious cases have to be accommodated until conveyance can be supplied, and all Pneumonias are always nursed there. The building is supplied with a certain number of small rooms, so that it is always possible, if necessary, to nurse a seriously ill case in a separate room, or to isolate a patient. The staff is composed of 1 Trained Nurse, 4 VAD Nursing members, a cook, a house-maid, an Ambulance Driver and a Secretary, all VADs and voluntary workers, who draw rations and are allowed 7 francs a week for washing, and 1 franc a day towards mess expenses. I learnt that a highly infectious case suffering from pneumonia had recently been nursed there, that the Sister in charge and a VAD who had just left had been mainly responsible for the nursing with a specially appointed orderly to assist. I advised the Sister in charge, in future, when nursing a case of this kind, to apply always through her CO for extra skilled nursing help, and I told her that a Nurse could always be provided at short notice from Rouen, if the DDMS were approached, from No.2 British Red Cross Hospital. The Hospital seemed well managed and the accommodation for all excellent. There were beautiful grounds and lovely lawns, all kept in perfect order by the convalescent patients.
I went on to Rouen, where I reported to the DDMS Office. I told him of my visit to Gournay which had been instructed to make by the DDMS, L of C and said that the correspondence would be forwarded to him officially for investigation, but that I was anxious for him to know beforehand what had happened. I had tea with the Principal Matron, Miss Rannie, QAIMNS who had recently arrived from Havre to fill the vacancy made by the transfer of Miss Tunley, who had just taken over duty as Principal Matron in the 2nd Army, a post which had become vacant in consequence of Miss Hartigan’s withdrawal for duty in Northern Russia. I stayed the night at “La Poste”, where I met the DGMS, Colonel Burtchaell, and also Lady Ampthill and Miss Crowdy.

12.10.18
Rouen
After calling at the DDMS Office, I visited No.12 General Hospital, where I saw Major Veeder and the Matron, and discussed various points in connection with the Americans working with the BEF and the need for further reinforcements. With reference to American Nurses who are sick, he is very anxious that no stretcher case should be evacuated to Paris, but sent to England to be evacuated in the ordinary way from there, if need be to America with other American patients, now that American Hospitals are opening there, and he has undertaken to approach the American DGMS on the subject.
I then went to No.8 General Hospital, and went round with Colonel Butler, and the Matron, Miss Roscoe. I found the Hospital full of most seriously wounded, both Officers and men. Here, like everywhere else, they are asking for more help, although they happen to be absolutely up to strength, but from the nature of the cases one can quite realise that they can do with even double the number of Nurses now on duty. They had over 100 Officers and men on the “Dangerously Ill” list, and more than that on the “Seriously Ill” list, which gives some small idea of the heavy work existing everywhere.
I had lunch with the Matron, and after saw VADs who were complaining of the heavy and monotonous work, and the lack of amusement and the need for a day off, which none have been able to have for months, except the day off when they come off night duty. This Hospital being quite apart and at the other end of the town from where the large group of Hospitals are situated in Rouen, makes it difficult for them to keep in touch with the other workers, and the whole staff seem to be feeling their isolated position. I spoke to the Matron on the subject, and said that she must make every effort to arrange some form of amusement and recreation for the staff when off duty, and never let an opportunity pass of giving one or other of the Nurses a stray day off. At present and for a certain number of months past, in consequence of the heavy work, the only people who have been able to get their leave are those who have some special private reason, or who are showing signs of fatigue. Many of these young girls also are feeling the strain of continual work in the heavy fracture case wards.
I then left for Abbeville, saw the DDMS, told him of the result of my visit, and submitted a report on the Detention Hospital at Gournay, which he is forwarding to the DDMS for his remarks. I stayed the night at the Annexe.

13.10.18
I left early for Etaples, where I saw the DDMS and afterwards the Principal Matron and I lunched at his Mess. I found that everything in the Area was going on as satisfactorily as could be expected, that No.24 General Hospital was absolutely full of badly wounded Germans, and that all Units were working at very high pressure. After lunch came direct to the office, where I met Miss Crowdy and Lady Ampthill, and discussed with them the question of the General Service VAD Section to some considerable extent, mainly the question of a distinctive uniform, and the decision which has been arrived at by the War Office of thoroughly suitable General Service VADs who had served for a year in France, being permitted to transfer to the Nursing Section in England, not France.

16.10.18
Left after lunch for Moulle; found that No.10 Stationary Hospital and No.11 CCS had both moved, and were established in their new positions, and that Miss McAllister, QAIMNS, who is responsible for the accommodation and disposal of Nurses passing backwards and forwards to the Armies was still at the Hostel with the Home Sister, where she is to continue her duties until the new Hostel at Arneke, which will be attached to No.10 Stationary Hospital, is ready for occupation. There is likely to be a certain amount of delay in consequence of (1) the shortage of engineers to make certain sanitary alterations in the Hostel which must be completed before the Nursing Staff is accommodated (2) the shortage of transport owing to lorries belonging to the 2nd Army being employed in taking supplies and moving Casualty Clearing Stations further forward, which is now constantly being done in consequence of the rapid advance. In the St. Omer and Arneke district there are now No.4 Stationary Hospital, which will be shortly requiring a Nursing Staff, No.10 Stationary Hospital, which is now working and supplied with Nurses, No.3 Canadian Stationary Hospital, which is opening up on the old site of No.7 General Hospital at Malassises, and which is now taking in the sick Sisters of the 2nd and 5th Armies, and the New Zealand Stationary Hospital. These Hospitals, I understand, will shortly become L of C Units, as the Armies advance.

17.10.18
Left early for Headquarters of the DMS 2nd Army, where the question of the duties of the Principal Matron and her accommodation as the advance continues, was discussed, as well as the position of the lady Anaesthetists. The DMS is applying officially for a Principal Matron to be authorised for the Army, who shall draw Principal Matron’s pay, so that when the Army advances her position will be assured, and she can be attached to whichever Unit is considered most suitable.
I then left for Ypres, to visit Nos.11, 36, and 44 CCS at Brielen, a little to the West of Ypres. The roads were very bad, and Ypres reduced to a heap of bricks, with the shells of a certain number of buildings still standing. I had some difficulty in passing the sentry, as the patrol considered I should have an Adjutant General’s Pass. I asked him to report the matter as I had travelled since 1914 with merely the authority I had then in my possession.
I found No.11, 36, and 44 CCS had only been open and working 48 hours, but except for the enormous shell holes in all parts of the neighbourhood, it was difficult to realise that the Units had not been working for at least a month. They were well established and the patients being well cared for. Nos.11 and 36 CCS had accommodation under canvas for the Nursing Staffs, while the staff of No.44 CCS were established in a bomb and shell proof shelter, which until the advance had been Army Headquarters since 1914. The shelter was built in and under an old farm-house, which had constantly been bombed, leaving merely the walls and part of the roof, and inside this a wonderful structure had been erected, lighted by electricity and supplied with telephonic communication to all parts of France. The structure consisted of various rooms connected by passages, and one quite nice sitting-room with a big brick fire-place. As well as being protected by several feet of concrete, which completely covered the structure, it was well sand-bagged. The staff were most comfortably established there, the only draw-back being the large quantities of rats, which had been a great nuisance, but which were gradually being got rid of.
The Nursing Staffs of all these Units were entirely satisfactory, with the exception of a Sister Williams, who complained to me that she felt her work had not been appreciated, as she was given only stretcher case patients to look after. She would not listen to reason, and I have arranged for her to be transferred to the Base. In these Units, British, Canadian and American Teams were working, and two groups from No.9 BRCS Hospital, and all was going most satisfactorily: I saw most of the Nursing Staff myself personally.
From there I went on to Remy, to Nos.10, 62 and 2 Canadian CCS. At No.62 CCS the OC was away, and the Sister in charge had sprained her ankle and was being transferred to the Sick Sisters’ Hospital, and a relief being sent. This Unit did not appear to be quite satisfactory with regard to the Nursing arrangements, but with the arrival of the new Sister in charge, I hope things will be rectified. Miss Bannister, who had been sent in relief of the Sister in charge, had unfortunately only been a week on duty when she met with the accident.
At No.10 CCS I only saw Major Marshall, the officer responsible for the training and work of Anaesthetists in the Army. He undertook to give me a list of the Anaesthetists whom he wished placed to certain Units in the Army, which he felt would work more satisfactorily so disposed. It is now thoroughly understood that Anaesthetists must be posted to Casualty Clearing Stations, and not moved except by orders from this office, unless proceeding with a Team, when on completion of duty the Anaesthetist and the Team Sister will return to their own Unit. There was no time to visit No.2 Canadian CCS. I drove back by Hazebrouck, was unable to visit Nos.8, 17, 64 CCS or the Duchess of Sutherland’s Hospital, as it was quite dark. I was obliged to return to Moulle for the night, but I instructed the Principal Matron of the Army to visit these Units and report to me.

18.10.18
5th Army, Theronne
I left early for the 5th Army, and drove to the Headquarters of the DMS. I saw the DMS and discussed the question of the Principal Matron, and the necessity of posting an Anaesthetist to each Casualty Clearing Station in the Army. This I have undertaken to do. He told me of the various changes which were taking place, and he felt that the work everywhere was becoming so enormous, that it would take everyone all their time to administer satisfactorily. He was very pleased with the news, but no-one seems to think that the war will be terminated this year.
From there I went to Lozinghem, to 32 CCS. I found the OC, with the Sister in charge and a Sister with CMB experience, had just left for Bethune, where arrangements were being made for the reception of women patients at the civil and military Hospital, if required. I then drove on to Bethune, where I met the OC and Miss Blair, and went over the house which is being arranged for women and maternity cases, if need be. It is a good solid house with great possibilities, but like all other buildings in Bethune which are still standing, without a solitary window. There is no water supply, as that has been absolutely destroyed in the recent bombardment, but the electric lighting is still intact, evidently the Germans left it for their own convenience in the advance. I arranged with the OC and the Sister in charge that no Sister is to remain with the Unit until the patients begin to arrive, and then a staff of 3 should be sent to begin with, two for day and one for night duty, and that when they are required and are detailed from 32 CCS the OC or the Sister in charge should telephone to my office for reinforcements. Bethune is practically empty of French population, but driving along it was both interesting and sad to see that here and there an odd man and woman had gone back to their partially destroyed houses, in the hopes of starting a home again.

I drove on to Cambrin, a few miles out of Bethune, where Nos.13 and 54 CCS have only recently opened. I arrived in the middle of the day at No.13 CCS, and was not satisfied, as I found the A/Sister in charge was away, and there seemed some mystery as to where she had gone, and what she was doing. The rest of the staff did not seem to be very satisfactory either. I left a message for the Sister in charge on her return, and reported the matter to the OC and the DMS of the Army, and I learnt later that the DGMS visited the Unit at 5 p.m. and out of a staff of 10 on duty, he found no-one in the wards.
At 54 CCS I saw the Sister in charge and most of the staff. I went round the Hospital and quarters, and found everything thoroughly satisfactory, the Sister in charge, Miss Rogers, being a very capable little woman, and the second in command, Miss Cooke, equally so.
Then I went to Estaires, through La Bassee, which large town is now absolutely nothing but a heap of bricks, not one solitary wall or vestige of a wall to be seen anywhere. Estaires is also very badly knocked about, there are still evidences of buildings, but none habitable. The Clearing Stations were established a little way out of the town. No.51 CCS was under canvas, and going satisfactorily. The Staff, like at No.44 CCS at Brielen, were accommodated in shell and bomb proof shelters, also established in the shell of a farm-house, of which the walls and part of the roof only were standing. The OC had that afternoon held a conference with the Medical Officers, the Quartermaster and Sister in charge to discuss how the equipment could be reduced to a minimum, taking into consideration the articles it would be absolutely necessary to have for the efficient working of the Unit. All unnecessary adornments are being done away with, as well as bed-side lockers, and everything which can fold up flat and which takes up as little space as possible is being reserved, and the remainder sent to the Base. This is found to be very necessary everywhere now, in consequence of the rapid advance and the nature of the ground that transport has to travel over.
I went on to No.2 Australian CCS. This Unit, as always, was first class in every way. I saw the OC and the Sister in charge. Everything was going most satisfactorily, and the quarters were exceedingly comfortable.
I then drove to Aire, and had difficulty in finding the road in consequence of the change in the surroundings made by destruction everywhere. Merville is a heap of ruins, and in the darkness the ruins of churches, chateaux, and buildings, stood out against the moonlight in a weird and curious manner. Aire is practically the same. I stayed the night at No.39 Stationary Hospital, where I was invited to dinner at the Officers’ Mess. Here I interviewed 10 of the Sisters who had been doing duty on Barges.

19.10.18
I left early for the Headquarters of the DMS 2nd Army to report on the Units which I had been able to visit in his Army, and then went on to No.10 Stationary Hospital in Arneke, where I saw Colonel Hine, and the Matron and A/Principal Matron of the Army, Miss Tunley, QAIMNS. I inspected the Hospital which is going to be a very fine Unit, and found that the Eye Surgeon, Captain White, will not allow Sisters in his wards. I went on to the Hostel, which is being made fit for accommodation with as little delay as possible, so that the detachment now at Moulle can be transferred, and when this is done it will be an enormous advantage in every way. I interviewed Miss Burke, Sister, TFNS who was sent to the Unit to be in charge of the special Aural Department. She has not been very satisfactory, and when being spoken to by Miss Tunley, was extremely rude, and said she wished to see the Matron-in-Chief. On seeing me she merely asked if she might be transferred to the Home Establishment, and was not willing to give her reason. I requested her to put in her application officially without delay, and said that it would be arranged.
From there I went on to the Headquarters of the DMS 5th Army, and saw the ADMS as the DMS was not there, and reported various things, which I felt ought to be brought to his notice with reference to the Casualty Clearing Stations in this Army.

I then went on to GHQ where I saw the DDGMS, as the DGMS had gone to Lille. I reported what I had been able to do in the Armies, and discussed the question of what arrangements should be made with reference to the Principal Matrons of the Armies as the advance continued, and was advised by him to write semi-officially to the Matron-in-Chief, asking whether she would support the proposal, if it was put up officially, of A/Matrons being attached to Casualty Clearing Stations to perform their duties, and asking that the matter might be treated as an urgent one. I told him that I had had a letter from the Lady Algernon Gordon Lennox asking how the Club Workers’ names could be brought forward for honour or Mention, and saying that HRH Princess Victoria was a little disappointed that none of these workers, who had been out since 1915, had received any recognitions whatever. I told him that I had written to the Lady Algernon asking her to forward the names without delay, as they could then be submitted with the Supplementary List. I emphasised the fact that the DGMS was only too anxious that the valuable work done by all workers in every department should be recognised. I arrived at Boulogne in the evening.

21.10.18
Boulogne
Miss Fletcher, Principal Matron, BRCS called with reference to the appointment of a new Matron for No.2 British Red Cross Hospital, to replace Miss Carr, who had been there since October, 1916, and who had been employed by the BRCS since the beginning of the War. The Commissioner and the OC wished this change. Miss Fletcher pointed out that there were a great many things to be said in favour of Miss Carr, and she was anxious that before a move was made that a confidential report should be asked for to be passed through the ordinary official channels. She was also anxious that I should go into the matter with the DGMS. She pointed out that Miss Barry, who had been as Sister at that Hospital since September, 1914, and who the OC wished to promote, was a very good Sister, but would not be capable of fulfilling the post, which was an extremely difficult one.
Miss Crowdy, Principal Commandant, VAD Department, also called at the office before going to England to attend a large Conference on the VAD question, and we discussed the General Service VAD Section.
Left at 5 o’clock for St. Pol, and arrived there at 9 o’clock. I saw the OC of No.12 Stationary Hospital, Colonel Crombie, and the A/Principal Matron, Miss Bond, QAIMNS and found that everything was going satisfactorily, and that there were a certain number of Nurses waiting to go forward to the new Casualty Clearing Stations which were opening up. There is a great difficulty now in consequence of the lack of transport and the length of the journeys which have to be taken.

22.10.18
1st Army
With Miss Bond, Principal Matron, I went to Headquarters of the DMS at Arras, which are now established in a big house, devoid of any kind of light or water supply, and with most of the windows broken. We discussed the question of the best method of arranging to keep a supply of Nurses, the best procedure to be adopted when Nurses go on leave, and when they go sick, as the distance now even to Abbeville is very great.
Left with the DMS of the Army to visit Casualty Clearing Stations. Went first to Bois de Busche, to No.2 and 57 CCS – heavy rain, roads very bad, and mud beyond description. Both the Clearing Stations had opened up side by side under canvas, and were working under very great difficulties in consequence of the mud, in some cases the trench mats being entirely covered with mud and hardly to be seen. Both Units were very busy, and everything inside the marquees exceedingly comfortable. The question of washing bed linen was becoming extraordinarily difficult, and I advised that sheets should only be used as draw sheets, except in very exceptional circumstances with patients who it was not possible to evacuate. Had lunch at No.57 CCS. In both the Units the Staffs are well, and everything was going smoothly and satisfactorily.
After lunch went on to Escadoeuvres, East of Cambrai. Nos.1 and 30 CCS were opening up under the same difficulties, only 48 hours since they had closed at Boisleux. No.1 was ready to receive, No.30 would be ready the next day. The staffs were working splendidly under the most trying conditions – mud, rain and wind. There were plenty of supplies and well established Camp kitchens already working.
From there we went to Cambrai – absolutely empty of French – the English establishing offices, and places for the reception of patients. There was no very great damage to the town, except lack of windows and no water or light supply. One big building had already been opened for walking wounded, and there No.22 CCS was opening up, the Nurses being expected to arrive the next day. No.30 CCS was also establishing itself, the Nursing Staff had been working for 48 hours in Cambrai helping to get things in order. I made arrangements that one big wing of this building should be set apart for the sick and wounded refugees, who were expected to arrive in the morning. Returned by Arras and arrived St. Pol at 9 p.m.

Left early with Miss Bond, QAIMNS and met the DMS of the 1st Army at Arras, and found that already large number of refugees were streaming into Arras, Cambrai, and Douai, many wounded, many gassed, and many sick, of all ages and conditions, and apparently nothing but what they stood up in. I arranged at once for 4 Nurses to go to each town from those whom I know had women’s experience and could speak French.
Drove with the DMS to Douai, the roads were very bad, and scenes of desolation and remains of the recent battle to be seen everywhere; large bodies of Labour Battalions were already busy mending the roads, and erecting pontoon bridges. Outside Douai No.23 CCS were pitching their new Camp in a fine open space next to a Wireless Station which was busy establishing itself also, the personnel and officers being accommodated in comfortable German dug-outs, boarded and shell-proof. No.23 CCS should be ready the next day to take in patients. The need for this Unit is very great, as at present the patients have to be driven 95 kilometres, in consequence of the rapid advance. We had some difficulty getting in to Douai, owing to the bridges having been blown up, and the roads very bad. The town, a splendid one, must have been very rich and prosperous, there were large schools, Hospitals, barracks, and luxurious residences. No.42 CCS was opening up in a very fine building fit for a Stationary Hospital, a large block with a quadrangle in the centre: there were no windows, hardly any furniture that had not been absolutely destroyed, no water supply or light, and most of the leaden pipes dragged down. Opposite a fine house has been secured for the Nursing Staff, situated in a beautiful garden, there are remains of beautiful furniture totally destroyed, and the dirt in the building was beyond description. With the DMS looked over a very large house with a view to taking it as a Hostel for Nurses, setting apart a wing for Sick Sisters. This house must have belonged to some very wealthy people, and had been simply left as it stood. Covers had been taken off all the mattresses and pillows, and heaps of flock and lovely pillows were strewn all over the place. Most of the furniture was completely spoilt, heavy wardrobes and beds smashed to pieces, and the tapestries and brocade torn off the Louis XV furniture, one leg broken off a chair, and so forth, making everything quite useless; the kitchen and outhouses were filthy.

We then went to the Base Commandant with reference to the question of what would be the best way of dealing with the refugees who had already begun to come in. We left Miss Bond with an Interpreter to go and inspect the building at which the people were arriving, and to see what accommodation could be arranged for some Nurses until French help could be obtained. The DMS and I intended to go to Montigny to see what was being done in the way of opening up No.6 CCS and No.1 Canadian CCS, but after spending an hour and a half trying to find various roads and bridges which we could cross, we had to give up the effort, as we found the town could not be approached from Douai at present. Everywhere we went we saw evidences of absolute destruction of furniture and property, even to the very poorest houses. We passed an enormous German cemetery in most beautiful order, and realised how recently the Germans had been in the town, for many of the people had been buried that month and the crosses were up, though over a large number of graves there had apparently not been time to erect crosses, and beautiful flowers were lying on them. We arrived at Arras after dark, and found that the refugees had begun to arrive in very large numbers. We went into the building which had been secured for them, and found the place filled with men, women and children, many of them lying on stretchers in the corridors, the only light being a stray light here and there. I had already ordered Nurses, who were on their way from St. Pol. Returned to St. Pol for the night, and found a message waiting for me from GHQ asking me to visit No.51 CCS in the 5th Army, and on my way back to call at GHQ.

24.10.18
Before leaving I arranged for Miss Bond to visit Agnes-les-Duisans to see what was happening at No.4 Canadian CCS where French men and women, as well as English, were being taken in and operated on, and then to go on to Arras to see how the 4 Nurses were getting on with their very large number of refugees.

Estaires
Left for the 5th Army. Visited No.51 CCS where I saw both the OC and the Sister in charge, Miss Hook, and learnt from the OC that things were not entirely satisfactory, and that Miss Hook was not capable of managing so responsible a post and keeping her staff under control. I saw Miss Hook, and arranged that as she had considerable experience in the nursing of women and children, she should be transferred to take charge temporarily of one of the Hospitals where the refugees were being admitted and looked after, until French help could be obtained. I also arranged that four members of the Staff, who were not considered suitable, should be replaced without delay. While I was there I saw the Medical Consultant, who informed me that No.39 Stationary Hospital, and two Casualty Clearing Stations, No.63 CCS and one other, had gone to Lille, and that the Headquarters of the 5th Army had moved to Lebussier.
I went on to the Headquarters hoping to see the DMS, but found both he and the ADMS were out, so I wrote a letter explaining what I had done, and under whose instructions.

I had lunch at St. Pol, and then went on to GHQ, where I saw the DGMS and explained to him what I had been able to do, and discussed the question of the shortage of Nurses, and the necessity of having a recognised establishment for Casualty Clearing Stations in Front Areas. We discussed also the lady Anaesthetists, and the training as Anaesthetists of trained Nurses belonging to the BRCS; also the complicated monthly return sent from this office shewing the wastage which has occurred in members of the Nursing Service during the Month, the total requirements of Trained Nurses and VADs, and the total number now in the country, and he suggested that in the future a simpler return should be submitted. We discussed the appointment of senior Nursing members in each Army to act as A/Principal Matron, as is done on the Lines of Communication, and the question of whether if GHQ and HQ, L of C advance, the Matron-in-Chief’s Office should not advance too: I pointed out the great difficulty I was already experiencing owing to the long journeys I had to take before I even got into the Areas where I needed to work. The DGMS then told me of various complaints which were being made concerning the nursing and administration of No.8 Stationary Hospital, and of a statement which had been made by the OC in consequence of the shortage of Nursing Staff. He also read me a private letter which he had received from London speaking of the inefficiency of the Nurses, and the need for proper supervision with regard to the food, the way it was cooked, and the way it was served. At the time of the complaint there were 41 patients suffering from bed-sores, stated to be due to the inefficiency of the Staff. I undertook to visit the Hospital at once, to go into the question, and to report. I told him that there had been constant difficulties in this Hospital as far as the Nursing arrangements were concerned in consequence of the Matron not receiving the support she should from the OC; that I had gone into the matter with the DDMS Boulogne, and he had repeatedly gone personally to the Unit to investigate the matter, and until he went, the OC had never been round the wards with the Matron. The DGMS told me that the DMS, L of C, General Carr, had gone to Boulogne to enquire into the matter, and he instructed me to go to HQ, L of C before returning to Boulogne. I pointed out that No.8 Stationary Hospital was a very heavy and a very difficult Unit, that the staff was 93, and that as they had accommodation for 102, as far as it was possible I had kept their staff up to that number, as I knew quite well of what a serious nature the cases always were. I said that collecting the fractured Femurs into huts set aside for this class of case alone was a very extravagant way of nursing the patients, as it meant that to ensure these people being properly looked after in such large numbers, the other wards had to suffer in consequence, and that in my opinion, had the Fractured Femur cases been distributed here and there in the wards, it would have been much easier to distribute the Nursing Staff to the best advantage, and to ensure all patients getting individual attention.

I then went on to Abbeville, arriving at 9 o’clock. After dinner I went to HQ, L of C and saw the DDMS, the DMS being still in Boulogne. I discussed the question with him and found that he had already heard that as far as the distribution of the Nursing Staff was concerned, everything was absolutely satisfactory, and that the Nurses in the Boulogne Area had been distributed to the best advantage. All Hospitals in this Area were full to overflowing, and the Sick Sisters’ Hospital full of a large number of seriously ill patients, many suffering from Influenza with complications.

25.10.18
Before leaving Abbeville I called at the DMS Office with reference to the shortage of General Service VAD members, and the question of the change of Matron at No.2 British Red Cross Hospital, and the DDMS telephoned to the DDMS Boulogne to let him know that I was on my way back and that I would call at his office at once with reference to No.8 Stationary Hospital.
Then I drove to Boulogne to the DDMS Office, where I saw the DDMS, the DMS, L of C not being in Boulogne, and discussed the question of No.8 Stationary Hospital, and he quite agreed that the Staff had been kept up to over the authorised establishment, and he felt the fault lay in the administration of the Unit. He said that he and the DMS, L of C had visited the Unit and gone thoroughly into the question.
After lunch I visited No.8 Stationary Hospital. The CO was out, and I saw the Matron and the Assistant Matron. I went round the wards and thoroughly into the question of food, general attention to the patients, as well as the question of bed sores. I found out, as I expected would be the case, that a large proportion arrived from the Front suffering from bed sores, and that in other cases the condition of the patient, and the position of the septic wound, made it impossible to prevent bed-sores. I asked what steps were taken when a patient was transferred suffering from bed-sores, and emphasised the fact that the Sister who had been nursing the case should never permit the patient to be evacuated without writing a small account, which should be attached to his particulars, so that the Sister in charge of the ward where the man is next admitted, will know everything in connection with the case. I spoke at length of the necessity for all Nurses to recognise the fact that bed-sores are a reflection on the nursing of a patient, and that when they exist, it is necessary to make a point of explaining how they originated, and how they had been treated. After having been round the wards I was confident that the Matron and the Assistant Matron were thoroughly capable of managing their big charge, and that the very best was being done for the patients under Active Service conditions. Everywhere the Hospitals are full, fuller than they have ever been before, and the need of more Nurses is being felt. Application has already been made to the War Office for reinforcements which are urgently needed, and which we learnt were unable to be supplied in consequence of the heavy work existing in England also, and the DGMS was writing again to put the matter forward in a very forcible manner, emphasising the fact that unless more help can be sent, one cannot answer for the consequences. The rapid advance, the constant fighting, the difficulty of evacuating as many patients as one would like to the United Kingdom, and in addition the large numbers of Officers and members of the Nursing Staff and of women workers who are suffering from the epidemic of Influenza, is making the position of affairs an exceedingly serious one.

26.10.18
Boulogne
General Carr, DMS, L of C, came to the office with reference to No.8 Stationary Hospital, the shortage of Nurses. He has gone into the question and is satisfied that the Nurses have been distributed to the best advantage. We discussed the question of what would be the best thing to do with reference to moving this office, should this be considered necessary in consequence of the rapid advance, and he approved of my putting up the matter officially to the DGMS, as well as the question of obtaining a recognised war establishment for Nurses belonging to Casualty Clearing Stations.
I then went to Headquarters of the BRCS and saw Sir Arthur Lawley with reference to the Christmas entertainments. We discussed the question of the VADs and in conversation he said that he felt that the best had not been done for the VAD with regard to their training. I pointed out that the VAD had come out as a VAD, that those who wished to be properly trained should have gone to a Civil Hospital for that purpose; that at a time like this it was impossible to attempt, or for anyone to ever think that the training of VADs as Nurses could be undertaken; that I fully appreciated the value and worth of the VADs but that it must never be forgotten that they have most wonderful opportunities of gaining practical experience, and have had ever since they came out to France, through working under the very finest surgeons and consultants in the world, and with the most highly trained women, but that naturally if they wish to be certificated Nurses they will require a little more that the practical experience they have gained while on Active Service, and which had been such an enormous help in assisting in the nursing and care of the sick and wounded.
I received a letter from Miss Macdonald, Matron-in-Chief, CEF, suggesting that Miss Ridley, Principal Matron, Canadians, should be detached from my office and attached to the office of the DMS, Canadians, GHQ, 1st Echelon. I replied that this was a matter which would have to be dealt with officially, as Miss Ridley had been appointed officially and attached to the Matron-in-Chief’s Office in France.

27.10.18
Boulogne
The DGMS and the DDMS Boulogne came to the office. We discussed the question of No.8 Stationary Hospital, which they were going to visit, the shortage of Nurses, the need for Nurses in the Front Areas. I spoke of my visit to London to attend a luncheon given by representative women, and in consequence of the heavy nature of the work, he advised that I should return as soon as possible, and attend an Investiture later when things in France were more settled. Afterwards he went round the office and expressed himself very satisfied with the arrangements, and the work being done. He was introduced to all the VADs, unfortunately it was Sunday and only half were on duty, the rest having a half-day off.




Establishments opened
5 Stationary Hospital, on 1.10.18: Staff supplied – 11 Trained, 9 VADs

Establishments re-opened
2 CCS, on 16.10.18: Staff supplied – 15 Trained

Establishments closed
Nil

Arrivals
Trained – 62
VADs – 32

Sent home sick
Trained – 22
VADs – 12

Returned from sick leave
Trained – 13
VADs – 12

Total at present sick in England
Trained – 129
VADs – 72

Resignations sent forward
Trained – 5 (all for marriage)

Transfers
To Home Establishment, Trained – 28
Miss Hartigan, QAIMNS to England for duty in Northern Russia

Approximate No. of leaves granted
To United Kingdom – 601
To Paris – 17
To Donzy (France) – 1
Total – 619

VADs returned to England
Resigned – 12 (3 for marriage)
Termination of contract – 9
Transferred to Home Establishment – 8
Total – 29

Casualties
R/Nurse R. Rapp, USANC: died from Pneumonia, 4.10.18
R/Nurse C. Trank, USANC: died from Malignant Measles, 8.10.18
N/Sister M. E. Green, CAMC: died from Pneumonia, 9.10.18
Sister S. Hilling, QAIMNSR: died from Pneumonia, 12.10.18
R/Nurse E. Groves, USANC: died from Influenza, 19.10.18
Miss S. V. Barrett, VAD: drowned on “Leinster”, 12.10.18

Units shelled
Nos.12, 44 and 53 CCS at beginning of month. No casualties to N/Staff.

Units bombed
No.38 CCS. No casualties to Nursing Staff.

Total No. of CAMC
Transferred to England – 24
Arrived in France – 52
Now in France – 780

Total No. of AANS
Transferred to England – 47
Arrived in France – 4
Now in France – 407

Married and retained in the Service in France
A/Sister E. E. Bray, QAIMNSR (Mrs. Cottier)

Total requirements of Nurses in BEF according to War Establishment on L of C
(excluding Stationary Hospitals in Front Areas and including Barges and Trains)
Trained Nurses – 2221
VADs and Special Probationers – 1480

Total requirements in Front Areas
(including CCSs and Stationary Hospitals in Front Areas)
Trained Nurses – 906

Total requirements in BEF
Trained Nurses – 3127
VADs and Special Probationers – 1480

Total British Staff now in BEF
(Not including 5 Dietitians, 86 Anaesthetists, 3 Embarkation sisters, 4 employed at Hostels)
Trained Nurses – 2454
Americans attached to British Units nursed by British Personnel – 119
Canadians attached to British Units nursed by British Personnel – 35
Total – 2608
VADs and Special Probationers
(Not including 8 Secretaries to A/Principal Matrons, 7 employed at Hostels) – 1708

Shortage
Trained Nurses – 519
Surplus
VADs and Special Probationers – 228

Grand total in BEF (including Overseas and Americans)
Trained Nurses – 4882
VADs and Special Probationers* - 3179
*This includes 811 General Service VADs working in British Units