CHAPTER V

THE ADMINISTRATOR

I have no hesitation in saying that Miss Nightingale has exhibited greater power of organization, a greater familiarity with details, while at the same time taking a comprehensive view of the general bearing of the subject, than has marked the conduct of any one connected with the hospitals during the present war.--_Sidney Herbert_ (speech at Willis's Rooms, Nov. 29, 1855).

Ostensibly, and by the strict letter of her original instructions, Miss Nightingale was only Superintendent of the Female Nursing establishment. In fact, and by force of circumstances, she became a Purveyor to the Hospitals, a Clothier to the British Army, and in many emergencies a _Dea ex machina_.

* * * * *

She became, first, Purveyor-Auxiliary to the hospitals at Scutari. My statements under this head might seem to be the inventions of a satirist if I did not disclaim credit for such ingenuity by adding that they are in every case extracted from official sources. Of the ignorance existing in high places of the true state of things at Scutari, the best illustration is the answer which the British Ambassador gave when he was asked by the Commissioner of the _Times_ Fund what things were most needed in the hospitals. "Nothing is needed," said Lord Stratford, and the only suggestion he could make to the _Times_ was that it should devote its fund to building an English Church at Pera. Miss Nightingale thought that the service of God included the service of man, and Mr. Macdonald, the _Times_ Commissioner, agreed with her. Between them, they established not a church, but a store. The Ambassador of course formed his conclusions from what he was told; and the Principal Medical Officer at Scutari "stated that he wanted nothing in the shape of stores or medical comforts at a time when his patients were destitute of the commonest necessaries. Assistance which had been discouraged as superfluous was eventually found essential for the lives of the patients."[114]

"I am a kind of General Dealer," wrote Miss Nightingale to Mr. Herbert (Jan. 4, 1855), "in socks, shirts, knives and forks, wooden spoons, tin baths, tables and forms, cabbage and carrots, operating tables, towels and soap, small tooth combs, precipitate for destroying lice, scissors, bedpans and stump pillows. I will send you a picture of my Caravanserai, into which beasts come in and out. Indeed the vermin might, if they had but 'unity of purpose,' carry off the four miles of beds on their backs, and march with them into the War Office, Horse Guards, S.W."

[114] _Roebuck Committee_, Fifth Report, pp. 20, 21.

The caravanserai was the large kitchen aforesaid (p. 173). "From this room," wrote one of the lady volunteers, "were distributed quantities of arrowroot, sago, rice puddings, jelly, beef-tea, and lemonade upon requisitions made by the surgeons. This caused great comings to and fro; numbers of orderlies were waiting at the door with requisitions. One of the nuns or a lady received them, and saw they were signed and countersigned before serving. We used, among ourselves, to call this kitchen the tower of Babel. In the middle of the day everything and everybody seemed to be there: boxes, parcels, bundles of sheets, shirts, and old linen and flannels, tubs of butter, sugar, bread, kettles, saucepans, heaps of books, and of all kinds of rubbish, besides the diets which were being dispensed; then the people, ladies, nuns, nurses, orderlies, Turks, Greeks, French and Italian servants, officers and others waiting to see Miss Nightingale; all passing to and fro, all intent upon their own business, and all speaking their own language."[115]

[115] _Eastern Hospitals_, vol. i. p. 68.

There was also in "The Sisters' Tower," as this part of the Barrack Hospital came to be called, a small sitting-room; and in it "were held those councils over which Miss Nightingale so ably presided, at which were discussed the measures necessary to meet the daily-varying exigencies of the hospital. From hence were given the orders which regulated the female staff. This, too, was the office from which were sent those many letters to the Government, to friends and supporters at home, telling of the sufferings of the sick and wounded."[116] In the Report of the Duke of Newcastle's Commission, as also in Miss Nightingale's _Statement to Subscribers_, the full list of articles supplied by her may be found, tabulated with a precision and amplitude of detail characteristic of her. It included the miscellaneous utensils, etc., enumerated above, and also various articles of food required for the "extra diets" mentioned in the preceding chapter. The supplies were furnished partly by the _Times_ Fund, partly out of moneys sent to her by benevolent persons, and partly out of the private purse of herself and her immediate friends. Much of the expenditure was ultimately refunded to her by the Government. The sick and wounded soldiers at Scutari would, I fear, have felt ill requited for the lack of linen, sheets, utensils, and extra diet by hearing that a beautiful new church was being built at Pera.

[116] _Scutari and its Hospitals_, by S. G. O., p. 24.

But, it may be asked, were the things which Miss Nightingale procured and issued really wanted? May they not have been her fads? and was not hers perhaps a work of supererogation, for could not the official Purveyor have supplied them? Such statements were widely made at the time, and one can readily understand the reason. By drawing upon her own stores, Miss Nightingale not only furnished the soldiery with the things they were needing, but "administered to the defaulting administrators a telling, though silent, rebuke; and it would seem that under this discipline the groove-going men winced in agony, for they uttered touching complaints, declaring that the Lady-in-Chief did not choose to give them time (it was always time the males wanted), and that the moment a want declared itself, she made haste to supply it herself."[117] But such complaints were entirely unfounded; for it was shown by the Duke of Newcastle's Commission that she never issued anything from her stores, nor did she allow any one else to do so, except upon the demand of the medical officers, and after inquiry of the Purveyor if he could supply them. I find among Miss Nightingale's papers a few of the original requisitions from medical officers. Here is one of them:--

PALACE HOSPITAL, 18_th January_ 1855. MADAM--I have the honor to forward a requisition for 50 shirts and 50 warm flannels. The Purveyor has none. Knowing the extensive demand, I have limited my request to meet the urgent requirements of the most serious cases in my charge. I have the honor to be, Madam, your most obedient humble servant, EDWARD MENZIES, Staff Surgeon in Charge.

[117] Kinglake, p. 430. He cites an example of the complaints in a private letter from Sir John Burgoyne to Lord Raglan (March 27, 1855). The complaint of the "groove-going men" has been revived in our own day by Lord Stanmore, who complains of Miss Nightingale (_Memoir of Sidney Herbert_, vol. i. p. 381) that she got things (which the Purveyor had failed to get) instead of informing him where they could be got. She acted on what is a golden rule in cases of emergency. When she wanted a thing done without delay, she did it herself.

The list, said the commissioners drily, "must not be regarded as conclusive proof that the articles mentioned in it were invariably wanting in the [Government] stores." Goods, they explained, "have been refused, although they were, to our personal knowledge, lying in abundance in the store of the Purveyor." Why refused? Because the Purveyor took it upon himself to override the requisition of the medical officers? Not at all. "This was done because they had not been examined by the Board of Survey. On one occasion, in the month of December last [1854], we found that this was the case with respect to Hospital rugs, and it is probable that this has not been the only instance of such an occurrence." Miss Nightingale's letters to Mr. Herbert show that it was a frequent occurrence. For instance, in February 1855, she received a requisition from the medical officers at Balaclava for shirts. She knew that 27,000 shirts had at her instance been sent by Government from home, and they were already landed. But the Purveyor would not let them be used; "he could not unpack them without a Board." Three weeks elapsed before the Board released the shirts. The sick and wounded, lying shivering for want of rugs and shirts, would have expressed themselves forcibly, I fear, if it had been explained that they must shiver still until the Board of Survey's good time had arrived.

Miss Nightingale's impatience at such delays was the origin, doubtless, of a story which had wide currency at the time that on one occasion she ordered a Government consignment to be opened forcibly, while the officials wrung their hands at the thought of what the Board of Survey might presently say. The story was mentioned in the Roebuck Committee; and, though it was not confirmed, I think that Miss Nightingale was quite capable of the dreadful deed. Certainly she often insisted on obtaining first-hand evidence for herself, instead of trusting to the report of others; for in one of her letters to Mr. Herbert (Dec. 21, 1854), I find this passage: "This morning I foraged in the Purveyor's Store--a cruise I make almost daily, as the only way of getting things. No mops, no plates, no wooden trays (the engineer is having these made), no slippers, no shoe-brushes, no blacking, no knives and forks, no spoons, no scissors (for cutting the men's hair, which is literally alive), no basins, no towelling, no chloride of zinc." Then she enumerates the things which Mr. Herbert should send from London, adding, "The other articles mentioned above as not now in store can be had at Constantinople" or Marseilles; whence, I imagine, she proceeded to get them. Shopping at Scutari was not an afternoon's easy amusement:--

"English people," she wrote to Mr. Herbert (Dec. 10), "look upon Scutari as a place with inns and hackney-coaches, and houses to let furnished. It required yesterday, to land 25 casks of sugar, four oxen and two men for six hours, plus two passes, two requisitions, Mr. Bracebridge's two interferences, and one apology from a quarter-master for seizing the _araba_, received with a smile and a kind word, because he did his duty; for every _araba_ is required on Military store or Commissariat duty. There are no pack-horses and no asses, except those used by the peasantry to attend the market 1-1/4 miles off. An _araba_ consists of loose poles and planks, extended between two axle-trees, placed on four small wheels, and drawn by a yoke of weak oxen.... Four days in the week we cannot communicate with Constantinople, except by the other harbour, 1-1/4 miles off, to which the road is almost impassable."

But, somehow or other, Miss Nightingale was able to supply from her stores in hand, or to obtain from Constantinople or Smyrna or elsewhere, many things which the Purveyor-General could not, or would not, obtain. She had the forethought, as already related, to lay in at Marseilles on her way out a large supply of articles which she deemed likely to be useful; and at Scutari Mr. Macdonald of the _Times_ was untiring and resourceful. In the course of time, as funds continued to pour in, and the Government purveying became more efficient, Miss Nightingale was able on emergency to supply, not only the British, but their allies. In the spring of 1856, when the scourge of typhus committed sad ravages among the French, and the _amour propre_ of the _Intendance_ prevented the acceptance of the humane offer of medical comforts as a loan from the British Government, Miss Nightingale paved the way in overcoming this scruple by sending, as a present to the French Sisters and Medical Officers, large quantities of wine, arrowroot, and meat-essence. The Sardinian Sisters of Mercy also experienced much kindness at her hands when the destruction of a supply-ship by fire had left them without many things needed by their patients. She sent supplies also to the Prussian Civil Hospital, where many Britishers were treated; for this good office she received a letter of thanks from the king of Prussia (Sept. 1856). To her quarters at Scutari, the Turks, too, often resorted for medicine and advice. In her, says an eye-witness, the sickly and needy of all nations found an active friend.[118] "She embraced in her solicitude," said a French historian of the Crimean War, "the sick of three armies."[119]

[118] _Pincoffs_, pp. 82-83; and see _Hall_, p. 378.

[119] _La Guerre de Crimée_, by M. L. Baudens, p. 104. Miss Nightingale paid a tribute to the "wise and enlightened sanitary views" of M. Baudens. See her _Subsidiary Notes_, p. 133 _n._

Miss Nightingale's initiative was further useful in extracting needed articles which were contained in the Government store, but yet had not been forthcoming, either because nobody else had asked for them, or because somebody had not been lucky enough to hit upon the right moment for asking. The system in force was most ingeniously contrived to bring about such a state of things. Articles were only supplied to the hospitals by the Purveyor on the requisition of a medical officer. The medical officers were overburdened with work, and perhaps omitted to send in a requisition. Or they sent in a requisition, and the form was returned, marked "None in store." The articles may subsequently have been obtained or have arrived from England, but no note was kept in the Purveying Department of unfulfilled requisitions, and unless the medical officers requisitioned again, the articles were not supplied. The Commissioners found that from this cause patients were sometimes left without beds, though there were bedsteads in store at the time. Happily Miss Nightingale had laid in a good many at Marseilles.

II

There was another sphere in which Miss Nightingale came to the rescue of the sick and wounded from the blunders of official administration. She clothed them, 50,000 shirts in all having been issued from her store. The history of this private clothing department is curious. The regulations of the War Office assumed that every soldier brought with him into hospital an adequate kit, and it was no part of the Purveyor's duty to supply such a thing as a shirt. But three of the four generals of division in the Crimea had decided not to disembark the men's knapsacks. Sebastopol, it was confidently expected, would fall in a few days' time, and the men were to march light. In most cases they never saw their knapsacks again.[120] Hence the sick and wounded who arrived at Scutari immediately after the Battle of the Alma were destitute of all clothing except what was on their persons, and that was in many cases fit only for the furnace. No regulation existed whereby, if the soldier had for military reasons been deprived of his kit, the deficiency could be made good. The supply of a change of linen for the sick and wounded while in hospital, and of clean shirts to wear when invalided home or returned to the front, was perhaps a better allocation of benevolent funds than a supply of altar-cloths for a new church at Pera. At any rate Miss Nightingale thought so; and thus she and her coadjutors were in some measure the clothiers as well as the purveyors of the wounded soldiers.

[120] For a reference to this matter by Miss Nightingale, see below, p. 224.

III

Miss Nightingale assumed responsibility on one occasion as a builder, and this was at the time the usurpation which was most condemned in some quarters and the most commended in others. Some wards in the Barrack Hospital were in so dilapidated a condition as to be unfit for the reception of patients. The Commander-in-Chief had warned the hospital authorities that additional sick and wounded might shortly be upon their hands. The uninhabited wards might by prompt expenditure be made capable of accommodating 800 cases. The expenditure, however, would be considerable, and no one seemed willing to incur it without superior authority. Miss Nightingale stepped into the breach. With the concurrence of Dr. McGrigor, a senior medical officer of the hospital, she represented the urgency of the case to Lady Stratford de Redcliffe. The Ambassador had been empowered, as we have seen, to incur expenditure; and his wife, as she had given Miss Nightingale to understand, was the authorized intermediary between the Ambassador and the authorities of the hospitals. Lady Stratford saw the urgent necessity of the work, and Mr. Gordon, the chief of the engineering staff, was instructed to put it immediately in hand. The workmen, 125 in number, presently struck, whereupon Miss Nightingale, on her own authority, succeeded in engaging 200 other workmen, and the work was rapidly completed. Lord Stratford subsequently disclaimed any responsibility,[121] and Miss Nightingale paid the bill out of her own private resources. The War Department, when the affair came to their knowledge, approved her action, and reimbursed her. This instance of "the Nightingale power" made a great impression, and she herself regarded it as the most beneficent thing she did in the East. The fame of the affair was noised abroad, and reached the British camp at Balaclava, where our unfailing friend, Colonel Sterling, heard of it with hot indignation. Miss Nightingale, he wrote, "coolly draws a cheque. Is this the way to manage the finances of a great nation? _Vox populi_? A divine afflatus. Priestess, Miss N. Magnetic impetus drawing cash out of my pocket!" In normal times it would certainly not be the way to manage the finances of a great nation. And even in times of emergency the way which would of course have occurred to any well-regulated slave of routine was that Miss Nightingale should have spoken to some officer on the spot, that he should have represented the case to the Director-General of the Army Medical Department in London, that the Director-General should have moved the Horse Guards, and the Horse Guards the Ordnance, that the Ordnance should then have approached the Treasury, and that after process of minuting and countersigning, the work should in due course have been officially ordered. But meanwhile Lord Raglan's wounded would have arrived at the hospital, and there would have been no wards ready to receive them. As it was, "the wards were ready," as Miss Nightingale reported to Mr. Herbert (Dec. 21), "to receive 500 men on the 19th from the ships _Ripon_ and _Golden Fleece_. They were received in the wards by Dr. McGrigor and myself, and were generally in the last stage of exhaustion. I supplied all the utensils, including knives and forks, spoons, cans, towels, etc., clearing our quarters of these."

[121] My statements are based on a letter from Miss Nightingale to Mr. Sidney Herbert of Dec. 5, 1854.

IV

In all these things Miss Nightingale may be warmly commended, but the officials need not be too hotly condemned. They were but doing their duty, as they had learnt it; and for the rest, it was the system, or want of system, that was at fault. Just as in London there was no co-ordination among the Departments, so at Scutari there was no unity of action, and no clear personal responsibility. "It is a current joke here," wrote Miss Nightingale from Scutari, "to offer a prize for the discovery of any one willing to take responsibility." It was never awarded, for Miss Nightingale herself was, I suppose, "barred." In writing to Mr. Herbert, she called many of the officials at Scutari by very hard names, but in other letters she admitted that the ultimate fault lay elsewhere. "The grand administrative evil," she said (Dec. 10), "emanates from home--in the existence of a number of departments here, each with its centrifugal and independent action, uncounteracted by any centripetal attraction, viz. a central authority capable of supervising and compelling combined effort for each object at each particular time." Mr. Herbert might write, but the officials would not act. The force of custom was too strong. Miss Nightingale showed the Purveyor a letter from the Minister. "This is the first time," he said, "I have had it in writing that I was not to spare expense. I never knew that I might not be thrown overboard." "Your name," she had told Mr. Herbert (Nov. 25), "is continually used as a bug-bear. They make a deity of cheapness, and the Secretary at War stands as synonymous here with Jupiter Tonans, whose shafts end only in a _brutum fulmen_. The cheese-paring system, which sounds unmusical in British ears, is here identified with you by the officers who carry it out. It is in vain to tell the Purveyors that they will get no _kudos_ by this at home."

It should not be supposed, however, that Miss Nightingale was a spurner of rules, and a despiser of discipline, routine, and subordination. The very reverse is the case. Her whole career makes it probable, the character of her mind suggests it, and the administration of the funds placed at her disposal, with which the present chapter has mainly been concerned, proves it. If she shocked and staggered some official minds by her daring innovations, it was her strictness and insistence upon rules and regulations that was most criticized in unofficial quarters. She explained the matter very clearly in her final _Statement to Subscribers_. She had been placed by the Government in two positions of trust, each independent of the other. She had been appointed superintendent of the nursing establishment; and she further had received authority, as almoner of the "Free Gifts" (as the Royal Bounty was called), to apply them, and any other gifts derived from private sources, in the War Hospitals. In the second of these capacities, she could, if she had chosen, have administered her stores solely at her personal discretion, and have delegated a like discretion to other superintendents, sisters, or nurses appointed by her. But, except in a few special cases, which it were superfluous to enumerate, she rejected the liberty of personal discretion, and administered her funds only upon the requisition of medical officers. (She lays repeated stress on this fact, but I daresay that she herself was often the originating source of the requisitions. We have seen that in Harley Street she had learnt the art of managing overworked doctors.) Her statement of the reasons which governed her action is characteristic of her good sense. The exercise of personal discretion alone would have been the easier course; but the objections to it were "the abrogation of ordinary rule; the impossibility of preventing irregular issues, or at least of disproving the charge, and the unfitness of a large proportion of the women, who efficiently discharge the duty of the Nurses, to be the judges of the wants of soldiers and distribution of supplies to them; and, farther, the abuse which some would undoubtedly make of the power. To those to whom the charge of dishonesty would not apply, religious partiality either would, or, what in matters of this kind is only less mischievous, would be believed to, apply." Next, there was the danger of patients being given other food than what the medical officers ordered. "It is needless to state to any sensible person, even without hospital experience, the manifold dangers of issuing to Nurses, whether 'Ladies, Sisters, or Nurses,' stores or facilities for procuring stores, to be distributed at their own discretion through the Wards. It is to be remembered that the employment of women in Army Hospitals is recent, that many experienced and able Surgeons are opposed to it, that, among these, some are honestly, and some are unscrupulously prone to find objections to it, and to exaggerate mischiefs arising from it; that the Surgeon can, to a considerable extent, allow the Nurse to be useful, or force her to be comparatively useless, in his Wards; that the War Hospitals are a bad field for investing the Nurse with powers and offices which she never exercises in Civil Hospitals. On these grounds, as strict an adherence to existing rules as was possible appeared to be the only course.... Miss Nightingale exacted and she rendered adherence to rules to a large extent, and she strictly reverted to them when any emergency, during which, at the instance of authorities, she had departed from them, had ceased. A position such as hers necessarily exposes the holder to attacks from different quarters upon opposite grounds. While previously existing authorities are disposed to complain of all novel expenditure as lavish, and tending to the relaxation of discipline by over-indulgence, others, who feel themselves checked or restrained by regulations in the distribution of comforts according to their ideas of benevolence, will naturally object to the obstruction, in their view unnecessarily, interposed to the current of public liberality. While the experience of all who have conducted the operations of any extensive charity proves that the application of the ordinary axioms of business is the only road to success, it also sufficiently shows that such application is surely attended by no small measure of unpopularity."[122]

[122] _Statement_, pp. 19, 26. How greatly Miss Nightingale's strict rules were resented is shown by attacks upon her administration printed by certain of Miss Stanley's nurses. The most bitter of these is to be found in the text and appendix of _The Autobiography of a Balaclava Nurse_, 1857 (No. 13, Bibliography B). See also _Eastern Hospitals_, 3rd ed., pp. 44-5, 52-3.

She saw the value of rules, and respected them, sometimes even when they were ridiculous. On a cold night in January 1856, she was by the bedside of a dying patient; whose feet she found to be stone cold. She requested an orderly to fetch a hot-water bottle immediately. He refused, on the ground that his instructions were to do nothing for a patient without directions from a medical officer. Miss Nightingale stood corrected, and trudged off to find a doctor and make requisition for the bottle in due form. On a night in the following month, there was an unusually cold east wind, with a heavy snowfall. The patients in the ward attended by a civilian doctor were exposed to the wind and complained bitterly of the cold, but the regulation supply of fuel had given out. As the Government store was closed, Miss Nightingale waived the rule about applying first to the Purveyor, and gave the doctor fuel from her private stores. Next day the civilian doctor requisitioned in due form for an extra supply of fuel. He was refused. He carried his case to the Inspector-General. That official pleaded that he could not depart from the regulations which allowed only a certain quantity of wood for each stove. But, urged the civilian, exceptional cold calls for an extra allowance. Possibly, replied the Inspector-General with exemplary gravity, but "a Board must first sit" upon the question. The civilian smiled good-humouredly, and begged the great man to supply the wood first, and let the Board sit upon it when the weather was milder. The Inspector-General consented. These little incidents[123] throw a flood of light upon the difficulties through which Miss Nightingale had to thread her way. She was a firm believer in rules; but she was one of those able administrators who have the sense to know, and the courage to act upon the knowledge, that rules sometimes exist only to be broken.

[123] I take them from _Pincoffs_, pp. 58, 79.

And this was precisely the kind of initiative that the state of things in the hospitals at Scutari demanded. Miss Nightingale's adherence to rules may have brought unpopularity upon her from some of her subordinates or subscribers; but her departure from rules, on due cause of emergency, and her cutting of knots--perhaps even her breaking open of consignments--brought from her official superior, Mr. Sidney Herbert, nothing but commendation and support. One sees this sometimes in his letters to herself, sometimes in those which he addressed to others, and which reflect the impression made upon him by her vigour and resource. "Pray recollect," he wrote to the senior medical officer (Dec. 1, 1854), "in your demands upon us here, whether for more men, more comforts, or more necessaries, that there is no question of pounds, shillings and pence in such matters, but that whatever can be got _must_ be got." And to the Purveyor-General he wrote: "This is not a moment for sticking at forms, but for facilitating the rapid and easy transaction of business. There is much mischief done to the public service by the stickling for precedence and dignity between departments." Thus he wrote to many others also; but he confessed to Mr. Bracebridge that he had "small hopes of these men. I have been writing in this sense before, and in vain; but I trust there is some improvement. They are so saturated with the cheese-paring economy of forty years' peace, that there is no getting them to act up to a great occasion."[124] Miss Nightingale's initiative alone saved the situation.

[124] _Memoir of Sidney Herbert_, vol. i. pp. 357, 360. It will be noticed that he adopts some of Miss Nightingale's expressions.

I have in this chapter separated various illustrations of that initiative from others which, in the preceding chapter, were attributed to "the woman's insight." But perhaps the separation, though convenient, is imaginary, and all the cases of Miss Nightingale's administrative energy are ascribable to the same cause. Such was Mr. Kinglake's opinion; yet I have always suspected that the exceeding prominence given by him to the woman's touch in Miss Nightingale's work may in part have been caused by a desire to heighten the contrasts, and to barb with deadlier point his brilliant satire upon incompetence in official places. Let those who believe that it is possible to make a sharp delimitation between the "masculine" and the "feminine mind" settle this matter as they may. It seems to me that as there are old women of both sexes, so in both sexes there are men of business. My object in this chapter has been to show that Miss Nightingale brought to bear upon the task which confronted her at Scutari those high powers of the administrative mind, be they masculine or feminine, which, in moments of emergency, are capable of resource, initiative, decision.