A History of the Ministry of Information, 1939-46
INTRODUCTION
In July 1943 an inquiry was made by the Wartime Social Survey into the attitudes of women and schoolgirls towards nursing (New Series Regional. No. S. 5). The purpose of this inquiry, which was also carried out for Campaigns Division of the Ministry of Information, was to obtain information which would be of use in the recruiting campaign for nurses which is now in progress.
The present inquiry was complementary to this. In the first survey the attitudes of “potential recruits” were studied, and in the second the attitudes of those who had recently been recruited to the profession.
In this report frequent reference is made to the results of the earlier inquiry, since considered together, the results of the two surveys throw more light on the problem of getting new nurses than does. either survey considered by itself. A summary of the results of the first inquiry is given in the Appendix on page 35.
A sample of 490 student nurses was interviewed. Details of the sample are given in the first section of this report, which describes who the student nurses are, their ages, their education, and from what social and economic groups they are drawn.
The first question to be considered was “Why do people become nurses?” To know the answers to this question is clearly of importance in designing publicity appealing for nurses. Section II of this report deals with the motives for, and influences resulting in recruitment, as described by the 490 student nurses interviewed. Further, an account is given of the doubts and difficulties that these student nurses had to face in making their decision to take up nursing.
In Section III the attitudes of student nurses towards their job are considered, and these are compared with the attitudes shown by the working women and secondary schoolgirls interviewed in the previous inquiry. The attitudes of the student nurses are based on experience, but those of the “potential recruits” are based mainly on hearsay. Comparison of the two sets of opinions helps to show which of the ideas that women outside the profession have, are justifiable and which are inaccurate. It also shows which particular aspects of nursing are not considered by the public and could usefully be brought to their attention in publicity asking for recruits.
In Section IV the ideas of student nurses about recruitment are given, what they think of present publicity, what sort of publicity they think would be more useful, and what changes beyond those recommended by the Rushcliffe Commission they think would result in drawing more trainees to the profession.
Section V deals with student nurses’ views on specialising in particular branches of nursing. This information was required because the shortage of nurses is more acute in some branches than in others.
Summary of Results and Conclusions
Student nurses are drawn largely from the middle social and economic groups in the population.
Of the nurses interviewed, only 31% had finished their education at public elementary schools, 68% having some higher education. It was shown by another survey that of all unmarried women between the ages of 18 and 40, 60% had only elementary education and 40% had some higher education.
65% of the student nurses had fathers in non - manual occupations, businessmen, office workers, farmers, professional and technical workers, and 23% only were the daughters of manual workers. Manual workers form about two - thirds of the male working population, the non - manual group being a relatively small one.
Thus the majority of student nurses came from the middle class which accounts for about 20% of the population.
In the previous inquiry dealing with the attitudes of working women and secondary schoolgirls towards nursing it was shown that members of the lower economic groups were somewhat less critical of nurses’ working conditions and had quite as favourable an attitude towards nursing as other groups.
The results suggest that if it were made possible for larger numbers of girls in the lower economic and education groups to take up nursing a considerable increase in recruiting might be brought about.
Analyses of the sample showed that voluntary hospitals relied on recruiting from the middle classes rather more than did municipal hospitals. Higher proportions of nurses in municipal hospitals were the daughters of manual workers and had only elementary education.
It may be noted here that as regards the attitudes to nursing revealed by answers to the questionnaire, there are only a few small differences between nurses drawn from different sections of the population and working in the two types of hospital.
Why did you take up nursing?
50% of the nurses had had a longstanding wish to nurse before they became nurses. 20% said they took up nursing because it was a worthwhile job and they felt they would like to relieve suffering and be of use to humanity. 18% pointed out that nursing was a career, more than a mere job, and that there were opportunities of getting on. (These answers are not mutually exclusive). Further small proportions gave other answers.
Among the immediate influences resulting in the decision to become a nurse, the war was of some importance. 26% said the war had given them the opportunity to become nurses or had made them decide to do so. 23% mentioned the influence of friends or relatives already in the profession. Sickness at home also sometimes resulted in girls taking up nursing.
92% of those interviewed had taken up nursing as a career and not merely as a wartime job. Some had decided to make it their career since they had become nurses.
Doubts and Difficulties
21% of the nurses said that their parents had not altogether approved of their decision to take up nursing, and the parents of a few of them had strongly opposed it. However, amongst the working women interviewed in the previous inquiry who wished to nurse, economic difficulties were of most importance. The latter had not succeeded in becoming nurses and it seems, therefore, that economic problems are of more importance in preventing some girls from taking up nursing than is parental opposition, which was mentioned by only a few of the working women.
15% of nurses had doubts before taking up nursing as to whether they should be able to stand the hard work and long hours, and a further 6% had wondered whether their health would be equal to the strain. 11% had been doubtful about their ability to study for exams.
The advantages of nursing
34% of nurses said that the fact that they felt nursing was a worthwhile job and of use to the community was a great advantage of the job. This was also the advantage most frequently pointed out by the working women and schoolgirls interviewed in the previous inquiry. It might be of use, therefore, to stress this appeal in publicity asking for recruits.
Other advantages mentioned by considerable proportions of nurses, were that nursing is a career, that there are possibilities of doing a wide variety of interesting jobs, that one meets many different sorts of people and can “see life”.11% mentioned one advantage of communal living, and answers to a further question revealed that many student nurses found they enjoyed community life much more than they had expected to when they first decided to become nurses.
These latter advantages were less frequently mentioned by the working women and schoolgirls interviewed before, and it seems that the public are not fully aware of them.
The disadvantages o f nursing
24% of nurses said they did not have enough freedom, that there were too many rules, or that they were treated “like children”.
23% mentioned the long working hours and long night duty. The length of working hours was the disadvantage most frequently mentioned by the working women and schoolgirls interviewed before. In many of the hospitals visited Rushcliffe hours had not been put into operation owing to shortage of staff. The results suggest that when there are sufficient recruits for working hours to be shortened an increasing number of entrants to the profession might be expected.
13% of nurses mentioned that the pay was poor. However, considerably higher proportions of working women and of schoolgirls mentioned this as a disadvantage. This is partly explained by the fact that the new scale of salaries resulting from the Rushcliffe Report is not yet widely known amongst the public, and publicity could usefully point out that the rate of pay has been increased.
18% of nurses said that nursing was a job which left no room for other interests and complained of losing contact with the world outside hospital.
13% said that having to study in off - duty time was a disadvantage of the job.
Opinions of Rushcliffe improvements
Nurses were asked what they thought of the recent changes in nurses’ working conditions.
Pay: 22% thought the new scale of pay was good or satisfactory. 15% said that it was an improvement or that the increase was much needed. 11% thought that the increase was insufficient. 33% made no comment on the increased pay, and further small proportions made other answers.
Hours: Altogether 29% said that the new hours were good or satisfactory, but more than half of these said that the new hours had not been put into operation in the hospital in which they worked. 15% said that it was an improvement, or that the reduction of hours had been badly needed. 4% said that the new working hours were still too long. 49% made no comment on hours in answer to this question.
Opinions on Recruitment
Nurses thought that improvements in nurses’ working and living conditions would result in more recruits entering the profession.
The changes which they said were most necessary were: the reduction of working hours (“put Rushcliffe hours into operation”); the better adjustment of off - duty time; lectures and studying should be during working hours; nurses’ homes should be made more comfortable; there should be facilities for entertaining friends; nurses should have a kitchen to use and each nurse should have her own bedroom; discipline should be relaxed and there should be more freedom; there should be more recreational facilities for nurses.
Nurses’ Opinions of Publicity
89% of the nurses said they had looked at posters appealing for recruits. Of those who had seen posters, 30% approved of them in general, and 63% were critical. The posters were said to be too glamorous, a nurses’ job was represented in them as being easier than it really is, and some of the less important aspects of nursing were thought to have been unduly stressed.
The same criticisms were made, though by rather smaller proportions, of advertisements seen in newspapers and magazines. Only 29% has heard radio talks about nursing. Rather more were critical than approved of the talks they had heard.
In making suggestions for publicity nurses emphasised that it should be more realistic, that the more difficult side of the work should be made known, that nursing should be represented less as an easy and pleasant job and more as a job that was worthwhile and of service to the community. Factual information about pay and workings hours should be given, and the duties of a trainee should be fully described as well as those of a trained nurse. It was suggested that the variety of prospects open to nurses should be stressed and the advantages of meeting many sorts of people.
Conclusions about Publicity
By considering the present and previous inquiries together some conclusions about which types of publicity would be particularly useful, may be reached.
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(i) It would be useful to stress that nursing is a worthwhile job, that it is an important Job and of great service to the community. This is the point which appeals most both to nurses themselves and to women outside the profession.
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(ii) Factual information is needed about working and living conditions. The recent increase in the salary scale should be emphasised. It could be pointed out that an attempt is being made to reduce nurses’ working hours but that this can only be successful if more recruits come forward.
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(iii) Publicity could with advantage, be rather more realistic, and give information about the daily duties of nurses and what is involved in the job. Such publicity should also help to avoid wastage during training.
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(iv) The variety of jobs open to trained nurses, the fact that nurses meet many people and have opportunities of travelling could usefully be pointed out.
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(v) The advantages of community life and the companionship of other nurses might be stressed to offset reluctance to leave home.
Specialisation
The proportions of nurses thinking they might like to specialise in the following six branches of nursing are:
| % | |
| Children’s nursing | 19 |
| Tuberculosis nursing | 8 |
| Fever nursing | 14 |
| Mental nursing | 7 |
| Midwifery | 37 |
| District Nursing | 24 |
The main resistances to specialising are that some of these particular jobs lack variety. Children’s nursing and mental nursing are said to require too much patience. Metal nursing is said to be depressing. Relatively small proportions mention fear of infection in the case of fever nursing. Rather more are afraid of infection in the case of tuberculosis nursing.
53% of nurses spontaneously expressed a preference for theatre work and specialising in surgical work.