History, Nursing Education and Jubilee 150

Joan Durdin, Nurse Educator (retired)

This address was delivered at the eighth Foundation Day Ceremony held at Royal Adelaide Hospital on 16 July, 1986.

To be invited to contribute to the 1986 Foundation Day Commemorative Service is an honour that I deeply appreciate. My direct association with Royal Adelaide Hospital ended more than thirteen years ago, and until recently I was not aware of the annual ceremony which has been instituted to commemorate the hospital’s founding. To take time once a year in this setting to reflect on this institution, its place in the community, and the challenges accepted by those who work here is a worthwhile activity. I understand that it was through Miss Spry’s initiative that the service was introduced. I am proud to be the second nurse to deliver a Foundation Day Address.

On such an occasion one’s thoughts turn to history, a subject of some prominence in this year of Jubilee 150. Some may ask: What is the use of history? In this address I propose to try to answer that question, and I will illustrate with mainly with reference to the history of Royal Adelaide Hospital.

First, history has an aesthetic value. It satisfies natural wonder and curiosity about the past that most of us experience at some time. The records which are the raw materials of history come to us in many forms, including documents, newspaper reports, photographs and artefacts. We derive pleasure, and sometimes amusement, from examining them. Consider the history of the chapel within the hospital. There has always been provision for services of worship here, though only relatively recently have they been held in a place designed for that purpose. Do you recall that in early years such services were held in the operating theatre? In 1866 a journalist from The Register, having been taken on a tour of the hospital, wrote

The general operating theatre is a comfortable place where divine worship is conducted on the morning of every Lord’s Day, by Dr Peel, and in the afternoon by the Wesleyans.¹

Dr Peel was the house surgeon, the only resident medical officer at the time, and evidently a man of many parts. Later the nurses’ dining-room in the East Wing of the main hospital (this was before the days of Light and Flinders Wards), did duty as a chapel. It was described as ‘a roomy apartment, furnished with table and forms, and a harmonium presented to the hospital by the Church of England.’²

In my day the chapel was in what had previously been the medical students’ lecture room and laboratory, between the Nurses’ Home and the Ophthalmic Ward. There was a refrigerator in the room at the back of the chapel. It received laboratory specimens collected in the wards overnight. Sunday evening chapel services were occasionally interrupted by the sound of a messenger (probably a nurse) hurrying in to deposit a specimen, with subsequent clatter as the refrigerator door was opened and slammed shut. Continuity of chapel services was maintained during the building of the new staff residence by the temporary siting of the chapel in the grounds of Austral House. Whereas it cannot be claimed that all history is a record of progress, the history of the Adelaide Hospital chapel shows a certain progression to the dignified building in which we worship today.

An aspect of the aesthetic value of history is the pleasure that is derived from reading a well-written historical work. I am sure that many have enjoyed Dr Estcourt Hughes’ general history of Royal Adelaide Hospital. At this time when a lively interest in history has been fostered by the Jubilee, we may anticipate that many works, presenting the history of specific sections of the hospital and its staff, will be initiated. The Heritage Office and History Committee performs important work in identifying, preserving and displaying records from the past, and in doing so, it gives pleasure to many.

Another use of history is to clarify, and if necessary dispel myths and legend which grow up over time. We can all recall tales which have a hint of substance, but if asked to verify them, we would be hard put to comply. I only began to realise that some incidents, claimed to be historical events, were more likely to be legends when I discovered them recurring in stories about different eras. There’s the legend of the flustered new nurse on the morning of a ward-round, directing a burly gentleman to a chair to await the honorary’s attention, only to discover, to her mortification, that he was the honorary. The point is that it could have happened but it’s hard to substantiate.

As a result of some work that I have recently done on the history of nursing in this State, I have learnt that one cherished myth about the Adelaide Hospital’s contribution to nursing education cannot be substantiated. The earliest formal training of nurses took place at the Children’s Hospital some ten years before a trained nurse took charge of the Adelaide Hospital and began a nursing school. An institution of this size, over a period of 146 years, must have generated many myths and legends. It is not necessary to discredit them, but they cannot be claimed as historical events unless they have been subjected to the historian’s research.

A third use of history is to pay tribute to those who have made history happen, so to speak. In the eighteenth and nineteenth centuries history was the record of kings, politicians, army generals and captains of industry who achieved fame. It was the story of progress, to which such people were seen to have contributed. More recently it has been recognised that history is not necessarily a story of progress and that all manner of people have contributed to the making of history. Medical history, and nursing history to the extent that it has been written, has tended to concentrate on ‘the greats’, perhaps with a view to inspiring the on-coming generation. I doubt if it really accomplishes this. Today, social historians are interested in all people, in their various roles. For example, interest has been shown in the experiences of patients, to give balance to an account of hospital services.

Recently I have been recording oral history from nurses who trained at this hospital in earlier days. Recalling their arrival and early experiences, many have remembered the cheery welcome of a porter, or the services of one of the domestic staff. In her written memoirs, which were included in the centenary story of nursing in South Australia, Eleanor Harrald paid tribute to ‘two of the best friends of probationer days at the hospital, Mrs Grace Lockier, the maid in charge of the dining room … and old Mr Fraser, with a flowing white beard, the porter in charge at night.’³ Mr Fraser spent his spare time at night teasing horse hair for mattresses.

At 5.30 each morning he roused the sleeping nurses with a knock on each nurse’s door crying ‘Wake up, my flower!’ – and waited until the nurse replied before moving to the next door. This was in the days before a nurses’ home was built and nurses’ rooms were scattered all round the hospital grounds. Not all recollections can be given a place in history books, but it seems fairly important to acknowledge the influence of the cheery porter, or the motherly domestic, when accounting, for example, for stability among the staff in an often stressful environment.

The fourth use of history to which I shall refer is, I believe, the most important. An awareness of history can help us to understand the events of the present. Who would deny that we are confronted in these days with issues that are difficult to understand, and thus difficult to deal with. If asked to produce a list of issues or problems, nurses could produce one, doctors another; paramedical staff, and administrators would have their lists. In trying to come to grips with the present, it is helpful to take time to consider what led up to a situation, and why certain decisions were made; also to try and ascertain how these factors contribute to the present.

I am not qualified to consider other than nursing issues, and will therefore illustrate with reference to just one issue, that of nursing and its current interest in politics. This interest bemuses some members of the hospital staff, and may even seem to threaten others. Bemusement or threat may be modified when the issue is seen in historical context. In the past fifteen or so years there has been a surge of interest in having nursing’s voice heard where decisions are made on matters affecting health care in general and nursing in particular. Is this really new? From what background does it arise?

If we go back to the 1880s in Britain, we find that nursing leaders were concerned that nursing should be recognised as a profession. The improved form of training introduced by Florence Nightingale, and take up by many other training schools, had produced a new group of nurses who found themselves in competition with those who had less, or no formal training. The issue was professionalism, associated with registration as a means of recognising qualifications. However nurses were not united, and it took many years before registration was achieved.

By the year 1900 nurses in South Australia were beginning to feel their feet, to seek recognition of their qualifications, and to have control of nursing affairs. Despite the small number (there were about 300 trained nurses by the year 1900) there was no unity. Two associations were formed. One, the Royal British Nurses’ Association, had a membership predominantly from among nurses who had trained at the Adelaide Hospital.

Margaret Graham was the initiator of the South Australian branch of this association, and played an active part in its affairs for twenty years. But the Royal British Nurses’ Association could not represent all nurses, because membership required a training in a general hospital of not less than forty beds. No nurses other than those from the Adelaide Hospital could meet this criterion. Four years after the establishment of the Royal British Nurses’ Association in this State a branch of an Australian association, the Australasian Trained Nurses’ Association, was set up. It had a greater capacity than the Royal British Nurses’ Association to lay down regulations for training nurses throughout the State, and it did sterling work in the years between 1905 and 1920. Not surprisingly some sparring occurred as the two associations jockeyed for supremacy, but by 1909 there was relative harmony.

In 1920, one year after the passage of the Nurses’ Act in Britain, similar legislation was enacted in South Australia, as a result of which nursing education passed from nurses into the hands of the Nurses’ Board.  At this time nurses seemed entirely content with the situation. They were offered only a minority of places on the board, and their representation was reduced still further when the Australasian Trained Nurses Association invited Dr T G Wilson, a member of their Council, to be their representative. A somewhat apathetic attitude to political involvement characterised nursing for the next thirty years.

During this period conditions for nurses changed little. Various factors contributed to this state of affairs. Doctors were leaders in the health service and nurses looked to them for leadership in nursing affairs also. They accepted their own status as dedicated workers. Conservatism, reverence for tradition, and loyalty within the ranks set limits to the degree to which change was possible. The economy also set constraints. The Depression in the 1930s affected employment of nurses, as it affected other citizens, and those who obtained work recognised their good fortune and were not ready to agitate.

The contribution of nurses to the armed services during both world wars brought added status to the profession. Eulogistic remarks about nurses were made during the debate on the Nurses’ Act in 1920. In the Second World War nurses from this State, including many from Royal Adelaide Hospital, became aware of conditions for nurses in other parts of the country through their close association with interstate nursing colleagues. After the war there was a greater interest in bringing about changes in the economic status of nurses. Another change to which nurses were alerted at this time was the proliferation of careers within the health service. Nurses became aware of the need to be better prepared for their own role. Post-basic courses were a means to this end, and nurses from Royal Adelaide hospital were among those who raised funds to finance the post basic programmes, and those who took the first courses.

Through the 1960s and 1970s the drive for recognition by women, with claims for equal pay and equal employment opportunities, gave encouragement to nurses to press more strongly for changes in nursing. In the 1970s the ‘Nursing Education Debate’ began, leading to the presentation of a policy on nursing education in 1976. This expressed nurses’ need for a more broadly based education which would equip the coming generation of nurses for their roles both in hospitals and in the community. Commitment to the nursing education issue gave nurses experience in political lobbying, an exercise in which they have continued to engage in the 1980s.

A very effective record of the history of nurses’ political awakening is at present on view to the public in Speakers’ Corner at the Constitutional Museum. This is the work of members of the Nurses’ Education Fund of this hospital, and it is an exhibition in which the hospital can take great pride. It expresses, in an entirely professional manner, the developments which have led nurses to their present involvement.

Royal Adelaide Hospital has a long history, of which relatively little has been uncovered and recorded. Having had experience both of the satisfaction of historical research, and the frustration that results from limits to time, and to knowledge of available resources, I hope that many more will be challenged to become historians. In so doing, they will help others to appreciate the past, to distinguish between myths and historical facts, to recognise the contributions of the range of people who have played a part in the history of this institution, and to understand, and thus to cope more appropriately with the present.

I congratulate the Heritage and History Committee on the work that it undertakes and I express my appreciation at being able to contribute in a small way to the record of history of Royal Adelaide Hospital.


  1. The Register 29 October, 1866
  2. The Register 4 June, 1881
  3. Nurses’ Centenary Committee Nursing in South Australia: First One Hundred Years, Adelaide, 1939, p45

Publications by Joan Durdin:

  • (1991) They Became Nurses: A history of nursing in South Australia 1836-1980.
  • (1999, 2005) Eleven Thousand Nurses: A History of Nursing Education at the Royal Adelaide Hospital 1889-1993.