“Nurses know nursing in a way that no one else does, and yet the reflections you have, though often well meant, are created by others” (White, 2012). What Nicola White captures here is that the story of British Army nurses has largely been told by others. There are few published accounts of the wartime work of Army nurses (although there are more by VADs). Where nurses did write letters home or keep diaries and journals there was a great deal of self-censorship.  


“One of the most important questions to ask when considering any written source is, ‘What was the intended audience?’ Letters were probably almost always written for private rather than for public consumption. However, the term ‘private’ here may be rather misleading. Letters were often circulated around family members and friends. They were seen as vital channels of communication that permitted communities ‘at home’ to stay in touch with the realities of the war. It was partly for this reason that, from the earliest months of the war, censorship was very strict. Those who wrote letters had to be extremely circumspect about what they conveyed to their readers. In particular, they were not permitted to convey any ‘factual information’ relating to locations or the movements of troops, hospitals or medical and nursing personnel. Hence, letters are often written from ‘somewhere in France’, in a style of ‘forced cheerfulness’, omitting any information that might be either objectionable to the censor, or useful to family and friends at home” (Hallet, 2007: p322).

On top of this there has always been a reluctance on the part of nurses to write about their work. As nurses we are bound by a code of professional conduct which includes maintaining patient confidentiality. Nursing is a complex art and science and is not necessarily well understood by those outside the profession. In order to talk about our work to others we would need to either write in an overly simplistic way, or spend much time explaining what we are talking about. It is easier to stay on subjects which we know our audience will understand.

We also have to consider the cultural and social norms of the time in which any letter was written. Certainly in WW1 it would not have been ‘proper’ for nurses writing home to speak of intimate care given to wounded and sick soldiers. So what could they write about? It is not uncommon for letters to be about travel and social engagements which give a potentially biased view of wartime nursing from the outside looking in.  

Journals and Diaries

Although diaries were to some degree written for the author, many were made up of the content of the letters written home and mirrored the censorship discussed above. Watson (2013) wrote about the diaries of Alice Slythe, a TFNS nurse in France: “The diaries contain episode after episode in which Slythe describes her tourist activities while working as a nurse at a base hospital in Wimereux. Presented almost as a travel journal for the uninitiated (the diaries are addressed to Maud, her older sister), these descriptions of the sights and sounds of wartime France are punctuated by photographs, picture postcards, and other souvenirs” (cited in Fell & Hallet, 2013: p7).

There are also differences between original diaries kept contemporaneously, and those accounts published later. Later accounts by the nature of the publishing process will have been edited, and also the passage of time changes what an author may wish to be made public.There are likely to be a number of diaries written by wartime nurses that remain in their families and which will hopefully surface over time. If families are willing for such accounts to be published without over editing then we may yet get a better picture of what life was like for wartime nurses, and what nursing care constitutes that of Army nursing. 


Recently there has been a lot of interest in the writings of Army nurses. In a poignant journey from Northern France to the Scottish Highlands, poet Simon Armitage commemorated World War One with seven new works capturing the stories of the conflict. He wrote a poem called Sea Sketch based on the writings and paintings of Edith Appleton.

Her great nephew Dick Robinson reads Sea Sketch, which recalls Edie’s care of soldiers and the comforting effect of the English Channel where she swam.

Sea Sketch
by Simon Armitage
Dear Mother, I have come to the sea
to wash my eyes
in its purples, blues, indigos, greens,
to enter its world and emerge cleansed,
to break the surface
then watch the surface heal and mend.
Behind me the land lies mauled and wrenched,
but I have not flinched
from uncommon holes in the flesh of men
or heads oozing with shattered minds,
and have not shied
from livers and lungs exposed to the light,
and have balanced and carried faltering hearts
in my cupped hands
through the egg and spoon race of death and life.
Some men I kissed: boy soldiers
raving and blind,
begging for love from a mother’s lips,
and when death stands with its black shawl
at the foot of the bed
a white cotton handkerchief eases the soul …
So allow me the beach, the sea,
its handwritten waves,
the act of making a simple sketch
of a simple ketch, or stick figures plunging
into the depths,
or a cormorant baring its breast to the sun,
or at dusk, Venus robed in her wedding dress,
her silver train
like a path on the water heading west. 


Fell, AS. & Hallett, C. (2013) First World War Nursing: New Perspectives. London: Rutledge
Hallett, C. (2007) The personal writings of First World War nurses: a study of the interplay of authorial intention and scholarly interpretation. Nursing Inquiry 2007; 14(4): 320–329
White, N. (2012) Good Nurse, Bad Nurse: Images of nursing in literature and on screen. (A Leverhulme Residency public talk. Presented on October 2nd, 2012 at the Teviot Lecture Theatre, University of Edinburgh) [WWW] accessed 13 April 2015