The development of rural district nursing in Gloucestershire 1880-1925
This Thesis examines the development of trained district nursing in rural Gloucestershire from the 188Os, when Elizabeth Malleson, founder of the Rural Nursing Association (RNA), moved to the area, until 1925, when the first State Registration examinations were held and a new era began for the entire nursing profession. The transition from local provision of aid by untrained women to the organised delivery of care by specially trained nurses employed by the RNA is described, and the expansion of this local charity into a national scheme is traced to its affiliation and eventual amalgamation with Queen Victoria's Jubilee Institute for Nurses (QVJI), the organisation from which the current system of district nursing has evolved. The aims and motivation of the midde- and upper-class ladies who became involved in the administration of the rural district nursing movement are considered, with particular reference to religion, politics and the opportunity to expand their lives beyond the limited role prescribed for them by the cult of domesticity. The official aims of the district nurses themselves, of curative care and preventative education, are traced, and theory and practice are then compared and contrasted. The working lives of the district nurses are described, including their duties, workload, salaries and living conditions, with additional reference to the contemporary ideologies of 'fit work for women', social isolation versus independence, and relationships with administrators and local doctors. Consideration is also given to the question of whether the service provided by those who believed that they knew what the sick poor needed was, in fact, what the poor themselves actually wanted. To this end, the educative aims of QVJI are examined in comparison with two of the most fundamental and sustaining elements of life amongst the poor, especially in isolated rural communities - neighbourliness and intergenerational support.