50. Salaries & Wages at Joyce Green Hospital.

Key words/phrases: Pay Day, pay packets, pay slips, pay rises, ATMs, definition of a wage and a salary, Project 2000, nursing as an art or a science, John Shepherd-Barron - former director of the De la Rue finance company, Barclays Bank plc (Enfield branch), Seattle and Spokane, USA

No. 50

Understandably “Pay Days” have always been popular days with employees and they are undoubtedly likely to remain so. Do you have lots of memories of people talking about “pay day”, “pay packets”, “pay slips” and even “pay rises” at Joyce Green ?

Noticing that this week marks the 40th anniversary of the installation of the first ATM (Automatic Teller Machine) in England prompted me into thinking about salaries and wages at Joyce Green.

A wage, by the way, has been defined as “a fixed payment typically paid on a daily or weekly basis to someone who has completed a task requiring the use of physical skills or physical strength, whereas as a salary is defined as “the regular renumeration paid as wages + benefits for services rendered, to a professional person or a white collar worker”.

Thus, arising from these definitions a differentiation between ancillary staff and professional and technical staff seems undeniably obvious until one recalls that nurses and student nurses have traditionally used words and phrases such as: “pay”, “pay packet” and “wage slip” when talking about their renumeration !

This tendency to slip in and out of using the terms pay & wages versus the word salary seems to me to highlight an unresolved dilemma of the 50s - 60s (and later) about whether “nursing was a job or a profession”.

I shall certainly never forget overhearing a conversation between two nurses - not at Joyce Green I hasten to add - that went something like this:

“Where did you train ?” “Me ? I’ve never b-e-e-n trained. That’s what they do to circus animals ! But I was EDUCATED at the Blah-di-blah School of Nursing”.

How does that exchange strike you ? As pretentious perhaps ? Nevertheless what it did seem to me to do was to encapsulate the prevailing desire of some nurses to see their occupational preparation and work elevated into the world of fully fledged professionals.

This urgency to change from one social class group into another was probably - at least in part - behind the proactive efforts years later by some very senior nurses to encourage acceptance of the Project 2000 approach to nurse education.

Similarly the transfer of nurse education (and midwifery & health visiting education too) into Universities in the 1990s could also be viewed as a further strategy aimed at consolidating in this change of status ?

That consideration of the "proper" status of nurses, midwives and health visitors perhaps stemmed from earlier discussions about whether nursing is actually an art or a science and thus, whether nurses are purely and simply knowledgeable and skilled craftsmen (or craftspeople) or whether they are scientifically-directed professionals of a higher order ?

Maybe this dilemma has been resolved now ? Or perhaps such pertinent discussions are still continuing - unbeknown to me ? However one question that I do wonder about is this: When nurses discuss their end-of-the-month recompense do they still refer to their renumeration as their “pay” and equally do they still refer to “pay slips” or do they now use the terms “salary” and “salary advice slips”.

The reason that I ask this is because this may give some indication (albeit unintentionally) about how modern day nurses view their occupational status, i.e. as ‘semi-skilled or skilled ‘workers’ or as pucker professionals if indeed it's true that one social class tends to use one group of pay-related words whilst another groups uses a different set of salary-related words?

But let’s return now to the topic of ATMs because although the Scotsman John Shepherd-Barron, a former director of the De la Rue finance company claims to have developed the first on-line electronic ATM it seems that a Turkish man called Luther George Simjian designed the first ever non-automatic cash dispenser in 1939, which was installed in New York.

It was a stand-alone mechanical dispenser with no link to it's host business, the City Bank of New York but since customers didn’t appear to be very keen to use it it was removed after 6 months. Simjian incidentally had originally intended to study medicine at Yale but it seems that he finally went into medical photography, eventually becoming the Director of the University’s Medical School Photography Department.

Following this commercial failure there then followed a 28 year pause in the history of ATMs until the De La Rue company launched their first electronic ATM at the Enfield Barclays branch on 27 June 1967.

This second-ever model was electronic however because plastic cards bearing encoded details had yet to beinvented customers had to feed special non-returnable personal cheques into the machine in order to withdraw the maximum allowable amount - £10 at the time. In fact the first on-line ATMs (the TABS 550s) were installed in Seattle and Spokane USA in the 70s.

So what had this to do with staff at Joyce Green Hospital accessing funds that they had previously banked ? Well nothing really because as far as I can remember none of the ‘big five’ banks had any sort of presence at Joyce Green - at least not in the 60s - and therefore most employees continued to receive “wage packets” on a weekly or monthly basis for a good many years after the launch of the Enfield “hole in the wall” in 1967.

Perhaps though someone reading this might be able to tell us if an ATM was ever installed at Joyce Green Hospital ?

49. Celebrities at Joyce Green Hospital.

Key words/phrases : Nicole Kidman, Virginia Wolfe, “The Hours”, Ward 2B, “Z Cars”, geriatric wards, Her Majesty’s pleasure.

No. 49

Nicole Kidman the Australian film actress (who was actually born in Honolulu, Hawaii) is 40yrs old today and whilst I was thinking about her role as Virginia Wolfe in the film “The Hours” earlier today I found myself wondering how many previous members of staff were ever involved in caring for a celebrity or someone related to a well-known personality on one or other of the wards at Joyce Green Hospital ?

I can certainly remember as I was a student nurse helping to care for the elderly father of a popular British variety-show artist on one of the medical wards and then each of the nurses (yes, even the male members of the team) being left a box of women’s tights by this famous comedian/singer & dancer because he had not realised that there were also male nurses involved in looking after his father.

I also recall being a very junior student nurse on Ward 2B when a well-known British actor (of stage & screen) from the police crime series “Z Cars” was admitted for a haemorrhoidectomy. Quite understandably he came across as somewhat less of a hero in real life, but nonetheless he was very grateful for all the care and attention he received. He was cared for in one of the ward side rooms but I always wondered why he didn’t chose a private Hospital in which to be treated ? Perhaps he felt that his "cover" could be better secured in a provincial hospital ?

Finally I can remember feeling particularly sorry for the elderly father of a traitor who compromised British defence integrity during the 60s and who ended up in jail. His father was being nursed on one of the Geriatric wards at Joyce Green (although I confess to hating the label “geriatric”) and just when he his elderly father needed him most his son was unable to visit him because of being detained at Her Majesty’s pleasure.

Perhaps YOU can remember other celebrities who passed through Joyce Green Hospital whilst you were there … or perhaps you think of all patients as celebrities in their own right ?

48. Joyce Green Hospital's own "Boots, The Chemist"

Key words/phrases: Boots, The Chemist, John and Jesse Boot of Nottingham, Methodist social conscience, E.S.Waring, Nottingham Daily Express, apothecary William Weston of St Bartholomew's Hospital London, the role of head dispenser, John (Chalky) White of the River Hospitals, Joyce Green Hospital Pharmacy.

No. 48

If you stop someone in the street of any largish English town and ask him or her to direct you to a chemist’s shop the chances are extremely high that they will point you in the direction of the nearest “Boots, The Chemist”.

Although John Boot, the herbalist-shop owner of Nottingham was the original Mr Boot, it was his son Jesse who turned the family business into the well-known chain of British retail chemist shops. John Boot died when his son was still a child and so at the age of thirteen Jesse left school to help his mother run their herbalist shop. He decided to study pharmacy in his spare-time and in 1877 he opened his own chemist’s shop.

Prior to the advent of chemist shops doctors made up their own prescriptions after diagnosing a patient’s ailment however during this period of time there was still a major problem for poor families because even if they could afford to pay the doctor for their consultation most of them couldn’t afford the medicines that he offered to make up. Thus the diagnosis, prescription and treatment cycle could not always be completed with obvious consequences for both personal and public health.

Even when chemist’s shops began to appear the charges made for medicines were still very high and Jesse Boot realised that established chemists in Nottingham had quietly introduced a cartel with a prohibitive price-fixing policy. Thus being both a Methodist Christian (with a strong social conscience) and a businessman he decided to do something to break this monopoly and at the same time to improve his own business prospects too.

By employing a young chemist called E.S.Waring to dispense patient’s prescriptions at half the price that G.Ps and local chemists usually charged both Boot and a high percentage of Nottingham patients benefited.

He went on to advertise via the “Nottingham Daily Express” that over 100 items in his shop at Goose Gate were being sold more cheaply and even employed a bell-ringer to tour the local streets informing the public about these offers. Not surprisingly these social and business strategies were so successful that within a month the takings of the shop - which he later renamed “The People's Store”- had doubled. “And the rest” … as they say … “is history” with Boot’s The Chemists expanding into a prosperous and nationally-renowned chain of quality chemist shops.

But what of the history of hospital pharmacies ?

The first recorded apothecary at St Bartholomew's Hospital, London, as an example, was William Weston in 1571 who apparently supplied drugs paid for out of his own salary.

In 1847 the role of the St Bart’s apothecary was revised and it was agreed that the apothecary “should attend the physicians on their rounds if required, visit patients in the wards each morning and night, as well as attending casualties”.

Frederick Wood, the last St Bart’s apothecary, retired in 1868. The post was then abolished and the duties were divided between the house physicians and a person fulfilling the new role of ‘Head Dispenser’, i.e someone who took over all of the pharmaceutical duties.

The head dispenser’s title was changed to that of pharmacist in 1927 although the dispensary itself did not become known as the pharmacy until as late as 1967.

As far as Joyce Green Hospital was concerned John White (or “Chalky” as he was affectionately known) qualified as a pharmacist in 1938 and he came to Joyce Green Hospital in 1953 as Chief Pharmacist for the River Hospitals.

I am struggling at present to remember exactly where the Pharmacy was at Joyce Green Hospital (believing for the moment that it’s last resting place was near to the hospital library, on the corridor leading away from Nursing Admin ?) but I certainly have crystal clear memories of Mr White peddling around the hospital on a bike delivering urgent items to the wards, wearing a long white open fronted hospital-issue long jacket or coat.

I wonder if you have any memories of the pharmacy services at Joyce Green or of Mr White and his staff ?

47. Aussie v. pommie tensions : Joyce Green Hospital.

Key words/phrases : Aussie and pommie soldiers, the Australian Army Nursing Service, Sydney Hospital School of Nursing, the 3rd Australian Army Auxiliary Hospital, Jessie Tomlin, Fred Tomlin, 1st Australian Light Horse Regiment, war-related nerves and neurotic conditions, Joyce Green Hospital cricket ground, The Orchard Military Convalescent Hospital, stone-throwing Dartford civilians.

No. 47

“There have been riots in Dartford between Aussie soldiers and civilians during the past three nights and extra police and others have now been drafted into the town to keep order. In fact Dartford town centre is now completely out of bounds to us Aussies. We, the other sisters and I, now have to get signed passes from our Commanding Officer before we can leave the hospital and for our own safety we all have to be back here by 7.0 p.m. and so going to the theatre and some of the other things we enjoy are completely out of the question at the moment.

An ambulance was held up by pommie civilians last night too and it was only because a couple of our Sisters were on board that was it allowed to continue on its journey, and even then it was stoned as it moved on !”

Race riots in Dartford ?! Not exactly ! No ... these words formed part of a letter from an Australian nurse working on the combined Orchard Hospital/Joyce Green Hospital site to her brother during the Spring of 1919.

Jessie Tomlins (whose Father originally moved to Australia from Shropshire) had joined the Australia Army Nursing Service in 1919 - after completing her nurse’s training at Sydney Hospital - and had promptly been posted to Dartford to work in the 3rd Australian Army Auxiliary Hospital (which was what the Orchard Hospital was called at that time).

At the same time Jessie’s brother Fred was a soldier in the 1st Australian Light Horse Regiment in Palestine and/or Egypt and the lines penned above were some of the many written by this young Australian nurse (although in fact she was a commissioned officer), to her brother who was serving in the Middle East.

Jessie Tomlins was based on the Orchard/Joyce Green Hospital site for two months between 27 April - 27 June 1919 alongside a contingent of Aussie nurses.

World War I had produced thousands of wounded soldiers in Europe and many, many of them had been evacuated to England for treatment or simply to recover.

Not many of us are aware of the fact but the total number of world-wide casualties arising from the 1st World War was - wait for it - 27.5 MILLION souls ! Not only is this a breathtaking figure in its own right but perhaps it is also begins to give some slight idea of the scope of the evacuation programme that was required to get vast numbers of injured servicemen and women out of the various continental battle zones and into more peaceful surroundings.

According to Army records the results of this conflictproduced countless soldiers suffering from “war-related nerves and neurotic conditions” and from historical accounts it seems that the Orchard Hospital (which was situated on the area of the Joyce Green Hospital cricket ground) earned itself a reputation for its good work in this particular sphere of rehabilitation.

What was once called The Orchard Military Convalescent Hospital (which contained 1,200 beds in 75 ‘huts’ built on either side of a central roadway) was loaned by the British government to the Australian military authorities in 1916 and eventually numbered 1,400 beds.

However to return to Jessie Tomlin’s earlier comments it seems that one of the results of having an Army Hospital based on the Joyce Green site was the creation of a palpable degree of social unrest. Why was this ? Well because on returning to Dartford a large number of “Tommy” soliders found that some of their sweethearts had either ‘become engaged to’ or had married Aussie soldiers !

It’s not hard to imagine that dealing with stone-throwing Dartfordians was NOT something that Jessie Tomlin and her fellow nurses had been taught how to deal with during their nurse’s training at the Sydney Hospital School of Nursing .

It seems that Sister Tomlin only stayed at the Orchard Hospital for 2 months before she was transferred elsewhere but I wonder what long-term memories of Dartford and these two hospitals remained with her when she left England and returned to live in Australia ?

Her letters at least tell us that she was certainly touched by the calm and natural beauty of the apple orchards on the site, after which the Orchard Hospital was named. Maybe the orchards inspired some of the mentally traumatised soldiers too ?

I'm sure though that these physically and mentally scarred men would have been glad to have received at least some of their care from Australian nurses such as Jessie Tomlin ?