21. 22. 23. 24. 25.

(a) Improvements in conditions

It was required to find out how much “potential nurses” knew about nurses’ working conditions, and whether or not they were aware of the improvements in these resulting from the Rushcliffe Report.

At first the problem was approached indirectly and informants were asked: “Do you think nurses’ working conditions have improved during the last year or two?” (Question 9).

The question was put in this way because it was found in the pilot inquiry that the proportion who knew the Rushcliffe Report by name was negligible, but a considerable proportion had heard that improvements had been made. Also it was feared that a direct question such as “Have you heard about the recent improvements’ would tend to produce the answer “Yes” and not give a true measure of the extent to which people were aware of the improvements.

Replies were as follows :-

About half of the working women said that they thought improvements had been made. A rather higher proportion of schoolgirls gave this answer, a lower proportion saying they did not know.

The proportion saying that conditions had not improved is quite small in the case of both groups.

Analysis by occupation shows some differences:

A higher proportion of clerical than of other workers said they knew about the improved conditions. The proportion saying “yes” in the Distributive and Miscellaneous groups is subject to a fairly wide margin of error. However, it will be remembered that these groups showed a rather more favourable attitude towards nursing than other groups and tended to give results similar to one another. If they are considered as one group and compared with factory workers (war and non-war together) the following result is obtained:

Analyses of answers to this question by region, age and Urban and Rural areas show no significant differences.

Among education group a higher proportion of those with more than elementary education had heard of the improvements.

This difference throws some light on the difference found between clerical and other workers the clerical workers including a greater proportion of those with a higher standard of education than other groups.

Those informants who said that they had heard nurses’ conditions had improved were asked: “What improvements have you noticed particularly?” (Question 9.a.)

Proportions mentioning different improvements were as follows:

This question was entirely unprompted and it should be noted that when specifically asked whether they had heard about the increase in pay and the reduction in working hours, much higher proportions said that they had heard about these improvements.

The figures given above should therefore not be taken as showing the proportions who had actually heard of the various improvements, but only as an indication of the extent to which different improvements had aroused interest in relation to one another.

It will be seen that shorter working hours and increased pay were mentioned more frequently than any other improvements and by rather more than a third of those asked the question.

Interest is also shown in improvements in nurses’ living conditions. Other improvements are mentioned by small proportions only, suggesting that either women are not aware of them or that they are not particularly interested in them.

It will be remembered that the most frequently mentioned “disadvantages” of nursing were the hours and the pay, and the results above confirm that it is these particular aspects of nursing that “potential” nurses are most concerned about.

A higher proportion of the working women than of the schoolgirls were unable to mention specific improvements. “Less hard or heavy work” is an answer given more frequently by secondary schoolgirls, and it will be remembered that this group more frequently criticised the life as being “hard”.

Informants who mentioned improvements were asked the further question: “what do you think of them?” (i.e. of the improvements they had mentioned) (Question 9.b.)

A higher proportion of working women than of schoolgirls showed a favourable attitude towards the improvements, but more of the schoolgirls considered them good from the recruitment point of view.

The second answer “It was needed” or “About time too” implies a criticism of conditions as they were. In the case of each group about 27'% thought the improvements made were inadequate. Thus about half the schoolgirls and nearly half the working women were critical of past or present conditions.

Increased Pay

All informants who had not already mentioned the increased, pay were asked: “Have you heard of the increased rates of pay recently introduced?” (Question 10a). The figures given below show proportions of the whole sample, those who had .mentioned the increased pay spontaneously being included with those saying “Yes”.

Rather less than half of the working women and about two thirds of the schoolgirls had heard about the increased rates of pay. (This may be compared with 21% and 22% of the respective sample mentioning increased wages spontaneously as an “improvement” in answer to the previous questions).

It will be remembered that schoolgirls showed that they were rather more critical than working women of the pay when asked about the disadvantages of nursing as a career.

Of the working women who said they had heard of the increased pay, 27% had mentioned “bad pay” as a disadvantage in answer to the earlier question, as against 18% of those who had not heard about the increase. Or putting this another way, of all those (working women) who mentioned “bad pay” as a disadvantage, 54% had heard about the increase and 46% had not.

From this it appears that at least half of the criticisms of the pay made by working women were not made in ignorance of the increase, but apply to present conditions.

There are sharp differences between clerical and other workers in respect of the proportions knowing about the increase. Breakdown by occupation is as follows:

This differences is clearly related to educational differences, a high proportion of the clerks having had more than elementary education and the differences between the two educational groups being as follows:

Clerical workers and women with a standard of education above elementary were more critical of the pay in stating the disadvantages of nursing. A higher proportion in these groups knew about the increased rate.

It will be remembered too that women in the oldest age group mentioned bad pay more frequently than did younger women as a disadvantage. Here again higher proportions of the older than of the younger women, knew about the increased rate.

Thus in all cases, those groups who are most critical of nurses pay also show relatively high proportions aware of the increase in pay. Those groups who are least critical of pay and show themselves to be less interested in the subject of nursing generally (i.e. factory workers, those with elementary education only and the youngest age group) are less frequently aware of the increase.

There are no statistically significant differences between replies received from different regions or between urban and rural areas.

Decreased hours

Informants were asked: “Have you heard of the reduction in working hours?” (Question 10.b.) Those who had already mentioned the reduction in hours were of course not asked this question, but they are included below with the “Yes” answers in the case of pay.

A third of the working women as against nearly a half of the schoolgirls had heard of the reduction in working hours. These are rather smaller proportions than had heard of the increase in pay. The difference between working women and secondary schoolgirls is in the same direction as in other questions, the schoolgirls being rather better informed.

Of those who said they had heard about the reduction in working hours, 37% mentioned long hours and lack of leisure time as a disadvantage of nursing in answer to the earlier question. Of those who had not heard of the reduction, 26% mentioned this disadvantage. Or, of those who mentioned long hours and lack of leisure as a disadvantage, 44% had heard of the reduction and 56% had not.

Thus rather less than half the criticisms given depended on informed opinion and rather more than half did not.

Breakdown by occupation is as follows

There is a difference in the replies received from clerical and from other workers, but this is less sharp than the difference shown in the case of pay.

The two education groups also differ in the same direction but less markedly:

Breakdown by age-groups shows the same trend as before:

Analyses by region and by urban and rural areas again show no differences.

As with increased pay, the groups who are relatively better informed are the groups that more frequently criticise the hours of work.

26. 28.

(b) What standard of education is needed?

It was suggested by the results of the pilot inquiry that some girls might be deterred from offering their services as nurses because they thought that a high standard of education was expected of recruits, and they had not themselves had sufficient education to be accepted.

In order to test this hypothesis informants were asked: “Do you know what standard of education a girl must reach before she can begin to train as a nurse?” (Question 5).

The replies received were as follows:

In fact nurses are not required to have passed any examinations before entering hospital, and may become nurses whether or not they have had more than elementary education, subject to the approval of the matron.

Of the working women about half said they did not know what standard of education was needed, and a further 34% thought that some special standard, above the average, was necessary. It is true therefore at any rate that a considerable proportion of working women have erroneous ideas about the standard of education demanded.

In so far as the schoolgirls are concerned, although a very much higher proportion thought that a special standard of education was needed, this could not act as a deterrent to volunteering as they were all in any case receiving secondary education and most of them were either at or above School Certificate standard.

Analysis by education shows some differences.

Of those with elementary education only, more than half said they did not know. Of those with a higher standard of education nearly half thought that some special standard was demanded, and a third said they did not know.

It will be noted that both in the case of the working women with higher than elementary education, and in the case of the secondary schoolgirls interviewed, relatively high proportions mentioned the School Certificate Examination or Matriculation. These groups are, or have been in a position to know about this examination, whereas those who have attended only elementary schools are less likely to have thought very much about it, the examination not being taken at elementary schools.

However, 28% of those with only elementary education thought that a standard of education higher than the standard they themselves had reached, was demanded.

Analysis by occupation shows a difference in the case of the clerical workers. It will be remembered that a relatively high proportion of these had had more than elementary education.

Analysis by age shows higher proportions answering “Don’t know” in the younger groups than in the older.

In the older groups both correct and incorrect answers are given more frequently.

Analysis by region shows no statistically significant differences, except that in Scotland a rather higher proportion (20 ± 4%) gave the answer “Good education” etc. and rather lower proportions the more specific answers in this group of answers.

There are no statistically significant differences in replies from those living in urban and rural areas.

Owing to the higher proportion of working women replying “Don’t know”, the results of this question should be regarded as inconclusive. “Don’t know” may reflect lack of interest only. That is to say some of those giving the answer may never have thought of education in connection with nursing, or as having 27. anything to do with it. Such people when asked “What standard of education must a girl reach to be a nurse?” might suppose that some special standard was necessary and therefore say “Don’t know”, although before being asked the question, lack of further education would not have occurred to them as a drawback had they thought of volunteering. On the other hand some of those saying “Don’t know” might (before-hand) have supposed that a special standard was needed, and in this case “Don’t know” would mean that they did not know what standard was needed, and not that they did not know whether any special standard was needed.

However, it is clear that a substantial proportion of working women (34%) think that a higher standard of education is needed to become a nurse than is actually the case.

c. Careers open to fully trained nurses

In order to find out to what extent “potential” nurses were aware that fully trained nurses could do other sorts of nursing than hospital nursing, informants were asked: “Have you any idea what careers, other than nursing in hospital, are open to fully trained nurses?” (Question 12).

(Some informants gave more than one answer, and the percentages therefore add to more than 100).

It should be noted that the question was unprompted, and these results should not be regarded as showing the proportions who would have said “Yes” had they been asked whether they knew that trained nurses would take up the different types of work.

The fact that half the working women and a quarter of the schoolgirls could not think of any particular careers trained nurses could take up other than hospital nursing shows that substantial proportions had not associated the possibility of taking these up with nursing as a career.

As in the case of other questions more answers were received from the secondary schoolgirls than from the working women, and a higher proportion of schoolgirls than of working women gave positive answers.

“Miscellaneous” includes answers such as measure, radiology and “Red Cross” nursing.

Analysis by occupation shows the following proportions answering “Don’t know”:

The proportions giving other answers are correspondingly higher or lower, but apart from this no groups mentioned any particular sort of career more frequently than other groups.

Clerical workers show a lower proportion than other groups answering “Don’t know”.