April 28, 1876.

My dear Friends,—Again another year has brought us together to rejoice at our successes, and, if to grieve over some disappointments, to try together to find out what it is that may have brought them about, and to correct it.

God seems to have given His favour to the manner in which you have been working.

Thanks to you, each and all of you, for the pains you have taken to carry out the work. I hope you feel how great have been the pains bestowed upon you.

You are not “grumblers” at all: you do try to justify the great care given you, the confidence placed in you, and, after you have left this Home, the freedom of action you enjoy—by that intelligent obedience to rules and orders, to render which is alone worthy of the name of “Trained Nurse,” of God’s soldier. We shall be poor soldiers indeed, if we don’t train ourselves for the battle. But if discipline is ever looked upon as interference, then freedom has become lawlessness, and we are no “Trained Nurses” at all.

The trained Englishwoman is the first Nurse in the world: if—IF she knows how to unite this intelligent obedience to commands with thoughtful and godly command of herself.

“The greatest evils in life,” said one of the world’s highest statesmen, “have had their rise from something which was thought of too little importance to attend to.” How we Nurses can echo that!

“Immense, incalculable misery” is due to “the immoral thoughtlessness”—he calls thoughtlessness immoral—of women about little things. This is what our training is to counteract in us. Think nothing too small to be attended to in this way. Think everything too small of personal trouble or sensitiveness to be cared for in another way.

It is not knowledge only: it is practice we want. We only know a thing if we can do it. There is a famous Italian proverb which says: “So much”—and no more—“each knows as she does.”

What we did last year we may look upon not as a matter of conceit, but of encouragement. We must not fail this year, and we’ll not fail. We’ll keep up to the mark: nay more, we will press on to a higher mark. For our “calling” is a high one (the “little things,” remember: a high excellence in little things). And we must answer to the call ever more and more strenuously and ever more and more humbly too.

We live together: let us live for each other’s comfort. We are all working together: grasp the idea of this as a larger work than our own little pet hobbies, which are very narrow, our own little personal wishes, feelings, piques, or tempers. This is not individual work. A real Nurse sinks self. Remember we are not so many small selves, but members of a community.

“Little children, love one another.” To love, that is, to help one another, to strive together, to act together, to work for the same end, to bring to perfection the sisterly feeling of fellow-workers, without which nothing great is done, nothing good lasts. Might not St. John have been thinking of us Nurses in our Training Schools when he said that?

May God be with us all and we be one in Him and in His work!

I

These are some of the little things we need to attend to:

To be a Nurse is to be a Nurse: not to be a Nurse only when we are put to the work we like. If we can’t work when we are put to the work we don’t like—and Patients can’t always be fitted to Nurses—that is behaving like a spoilt child, like a naughty girl: not like a Nurse.

If we can do the work we don’t like from the higher motive till we do like it, that is one test of being a real Nurse. A Nurse is not one who can only do what she does like, and can’t do what she does not like. For the Patients want according to their wants, and not according to the Nurse’s likes or dislikes.

If you wish to be trained to do all Nursing well, even what you do not like—trained to perfection in little things—that is Nursing for the sake of Nursing, for the sake of God and of your neighbour. And remember, in little things as in great—No Cross, no Crown.

Nursing is said, most truly said, to be a high calling, an honourable calling.

But what does the honour lie in? In working hard during your training to learn and to do all things perfectly. The honour does not lie in putting on Nursing like your uniform, your dress; though dishonour often lies in being neat in your uniform within doors and dressy in your finery out of doors. Dishonour always lies in inconsistency.

Honour lies in loving perfection, consistency, and in working hard for it: in being ready to work patiently: ready to say not “How clever I am!” but “I am not yet worthy: but Nursing is worthy; and I will live to deserve and work to deserve to be called a Trained Nurse.”

Here are two of the plain, practical, little things necessary to produce good Nurses, the want of attention to which produces some of the “greatest evils in life”: quietness, cleanliness, (a) Quietness in moving about the “Home”; in arranging your rooms, in not slamming every door after you. No noisy talking on the stairs and in the lobbies—forgetting at times some unfortunate Night Nurse in bed. But if you are Nurses, Nurses ought to be going about quietly whether Night Nurses are asleep or not. For a Sick Ward ought to be as quiet as a Sick Room; and a Sick Room, I need not say, ought to be the quietest place in God’s Kingdom. Quietness in dress, especially being consistent in this matter when off duty and going out. And oh! let the Lady Probationers realise how important their example is in these things, so little and so great! If you are Nurses, Nurses ought not to be dressy, whether in or out of their uniform.

Do you remember that Christ holds up the wild flowers as our example in dress? Why? He says: God “clothes” the field flowers. How does He clothe them?

First: their “clothes” are exactly suitable for the kind of place they are in and the kind of work they have to do. So should ours be.

Second: field flowers are never double: double flowers change their useful stamens for showy petals, and so have no seeds. These double flowers are like the useless appendages now worn on the dress, and very much in your way. Wild flowers have purpose in all their beauty. So ought dress to have; nothing purposeless about it.

Third: the colours of the wild flower are perfect in harmony, and not many of them.

Fourth: there is not a speck on the freshness with which flowers come out of the dirty earth. Even when our clothes are getting rather old we may imitate the flower: for we may make them look as fresh as a daisy.

Whatsoever we do, whether we eat or drink or dress, let us do all to the glory of God. But above all remember, “Be not anxious what ye shall put on,” which is the real meaning of “Take no thought.”

This is not my own idea: it was in a Bible lesson, never to be forgotten. And I knew a Nurse who dressed so nicely and quietly after she had heard this Bible lesson that you would think of her as a model. And alas! I have known, oh how many! whose dress was their snare.

Oh, my dear Nurses, whether gentlewomen or not, don’t let people say of you that you are like “Girls of the Period”: let them say that you are like “field flowers,” and welcome.

(b) Cleanliness in person and in our rooms, thinking nothing too small to be attended to in this respect. And if these things are important in the “Home,” think how important they are in the Wards, where cleanliness and fresh air—there can be no pure air without cleanliness—not so much give life as are the very life of the Patients; where the smallest carelessness may turn the scale from life to death; where Disinfectants, as one of your own Surgeons has said, are but a “mystic rite.” Cleanliness is the only real Disinfectant. Remember that Typhoid Fever is distinctly a filth disease; that Consumption is distinctly the product of breathing foul air, especially at night; that in surgical cases, Erysipelas and Pyaemia are simply a poisoning of the blood—generally thro’ some want of cleanliness or other. And do not speak of these as little things, which determine the most momentous issues of life and death. I knew a Probationer who when washing a poor man’s ulcerated leg, actually wiped it on his sheet, and excused herself by saying she had always seen it done so in another place. The least carelessness in not washing your hands between one bad case and another, and many another carelessness which it is plain I cannot mention here—it would not be nice, though it is much less nice to do it—the least carelessness, I say, in these things which every Nurse can be careful or careless in, may cost a life: aye, may cost your own, or at least a finger. We have all seen poisoned fingers.

I read with more interest than if they were novels your case papers. Some are meagre, especially in the “history.” Some are good. Please remember that, besides your own instruction, you can give me some too, by making these most interesting cases as interesting as possible, by making them full and accurate, and entering the full history. If the history of every case were recorded, especially of Typhoid Fever, which is, as we said, a filth disease, it is impossible to over-estimate the body of valuable information which would thus be got together, and might go far, in the hands of Officers of Health and by recent laws, to prevent disease altogether. The District Nurses are most useful in this respect.

When we obey all God’s laws as to cleanliness, fresh air, pure water, good habits, good dwellings, good drains, food and drink, work and exercise, health is the result. When we disobey, sickness. 110,000 lives are needlessly sacrificed every year in this kingdom by our disobedience, and 220,000 people are needlessly sick all the year round. And why? Because we will not know, will not obey God’s simple Health laws.

No epidemic can resist thorough cleanliness and fresh air.

Is there any Nurse here who is a Pharisee? This seems a very cruel and unjust question.

We think of the Pharisees, when we read the terrible denunciation of them by our Master, as a small, peculiar, antiquated sect of 2000 years ago. Are they not rather the least peculiar, the most widely-spread people of every time? I am sure I often ask myself, sadly enough, “Am I a Pharisee?” In this sense: Am I, or am I not, doing this with a single eye to God’s work, to serving Him and my neighbour, even tho’ my “neighbour” is as hostile to me as the Jew was to the Samaritan? Or am I doing it because I identify my selfish self with the work, and in so doing serve myself and not God? If so, then I am a Pharisee.

It is good to love our Training School and our body, and to wish to keep up its credit. We are bound to do so. That is helping God’s work in the world. We are bound to try to be the “salt of the world” in nursing; but if we are conceited, seeking ourselves in this, then we are not “salt” but Pharisees.

We should have zeal for God’s sake and His work’s sake: but some seem to have zeal for zeal’s sake only. Zeal does not make a Christian Nurse if it is zeal for our own credit and glory—tho’ Christ was the most zealous mediciner that ever was. (He says: “The zeal of God’s house hath eaten me up.”) Zeal by itself does not make a good Nurse: it makes a Pharisee. Christ is so strong upon this point of not being conceited, of not nursing to show what “fine fellows” we are as Nurses, that He actually says “it is conceited of us to let one of our hands know what the other does.” What will He say if He sees one of us doing all her work to let not only her other hand but other people know she does it? Yet all our best work which looks so well may be done from this motive.

And let me tell you a little secret. One of our Superintendents at a distance says that she finds she must not boast so much about St. Thomas’. Nor must you. People have heard too much about it. I dare say you remember the fine old Greek statesman who was banished because people were tired of hearing him called “The Just.” Don’t let people get tired of hearing you call St. Thomas’ “The Just” when you are away from us. We shall not at all complain of your proving it “The Just” by your training and conduct.

I read lately in a well-known medical journal, speaking of the “Nightingale Nurses,” that the day is quite gone by when a novel would give a caricature of a Nurse as a “Mrs. Gamp”—drinking, brutal, ignorant, coarse old woman. The “Nightingale Nurse” in a novel, it said, would be—what do you think?—an active, useful, clever Nurse. These are the parts I approve of. But what else do you think?—a lively, rather pert, and very conceited young woman. Ah, there’s the rub. You see what our name is “up” for in the world. That’s what I should like to be left out. This is what a friendly critic says of us, and we may be very sure that unfriendly critics say much worse. Do we deserve what they say of us? That is the question. Let us not have, each one of us, to say “yes” in our own hearts. Christ made no light matter of conceit.

Keep the usefulness, and let the conceit go.

And may I here say a few words of counsel to those who may be called upon to be Night Nurses? One of these asked me with tears to pray for her. I do pray for all of you, our dear Night Nurses. In my restless nights my thoughts turn to you incessantly by the bedsides of restless and suffering Patients, and I pray God that He will make, thro’ you, thro’ your patience, your skill, your hope, faith and charity, every Ward into a Church, and teach us that to be the Gospel is the only way to “preach the Gospel,” which Christ tells us is the duty of every one of us “unto the end of the world”—every woman and Nurse of us all; and that a collection of any people trying to live like Christ is a Church. Did you ever think how Christ was a Nurse, and stood by the bed, and with His own hands nursed and “did for” the sufferers?

But, to return to those who may be called upon to be Night Nurses: do not abuse the liberty given you on emerging from the “Home,” where you are cared for as if you were our children. Keep to regular hours by day for your meals, your sleep, your exercise. If you do not, you will never be able to do and stand the night work perfectly; if you do, there is no reason why night nursing may not be as healthy as day. (I used to be very fond of the night when I was a Night Nurse; I know what it is. But then I had my day work to do besides; you have not.) Do not turn dressy in your goings out by day. It is vulgar, it is mean, to burst out into freedom in this way. There are circumstances of peculiar temptation when, after the restraint and motherly care of the “Home,” you, the young ones, are put into circumstances of peculiar liberty. Is it not the time to act like Daniel?... Let “the Judge, the Righteous Judge,” have to call us not the “Pharisees,” but Daniel’s band!

That is what I pray for you, for me, for all of us.

But what is it to be a Daniel’s band? What is God’s command to Night Nurses? It is—is it not?—not to slur over any duty—not the very least of all our duties—as Night Nurse: to be able to give a full, accurate, and minute account of each Patient the next morning: to be strictly reserved in your manner with gentlemen (“Thou God seest me”: no one else); to be honest and true. You don’t know how well the Patients know you, how accurately they judge you. You can do them no good unless they see that you live what you say.

It is: not to go out showily dressed, and not to keep irregular hours with others in the day time.

Watch—watch. Christ seems to have had a special word for Night Nurses: “I say unto you, watch.” And He says: “Lo, I am with you alway,” when no one else is by.

And he divides us all, at this moment, into the “wise virgins” and the “foolish virgins.” Oh, let Him not find any “foolish virgins” among our Night Nurses! Each Night Nurse has to stand alone in her Ward.

Let our Master be able to say some day that every one of the Patients has been the better, not only in body but in spirit—whether going to life or to death—for having been nursed by each one of you.

But one is gone, perhaps the dearest of all—Nurse Martha Rice.

I was the last to see her in England. She was so pleased to be going to Miss Machin at Montreal. She said it was no sacrifice, except the leaving her parents. She almost wished it had been, that she might have had something to give to God.

Now she has had something to give to God: her life.

“So young, so happy: all so happy together, when in their room they were always sitting round the table, so cheerful, reading their Bible together. She walked round the garden so happy that last night.”

So pure and fresh: there was something of the sweet savour of holiness about her. I could tell you of souls upon whom she made a great impression: all unknowing: simply by being herself.

A noble sort of girl: sound and holy in mind and heart: living with God. It is scarcely respectful to say how I liked her, now she is an angel in heaven; like a child to Miss Machin, who was like a mother to her, loved and nursed her day and night.

“So dear and bright a creature,” “liked and respected by every one in the Hospital,” “and, as a Nurse, hardly too much can be said in her favour.” “To the Doctors, Patients, and Superintendent, she was simply invaluable.” “The contrast between these Nurses and the best of others is to be keenly felt daily”; “doing bravely”; “perfectly obedient and pleasant to their Superintendent.”

Was Martha conceited with all this? She was one of the simplest humblest Christian women I have ever known. All noble souls are simple, natural, and humble.

Let us be like her, and, like her, not conceited with it all. She was too brave to be conceited: too brave not to be humble. She had trained herself for the battle.

“With a nice, genial, respectful manner, which never left her, great firmness in duty, and steadiness that rendered her above suspicion”: “happy and interested in her charge.”

More above all petty calculations about self, all paltry wranglings, than almost any. How different for us, for her, had it not been so! Could we have mourned her as we do? The others of the small Montreal staff who miss her so terribly will like to hear how we feel this. They were all with her when she died. Miss Machin sat up with her every night, and either she or Miss Blower never left her, day or night, during the last nine days of her illness. She died of typhoid fever: peritonitis the last three weeks; but, as she had survived so long, they hoped against hope up to Easter Day.

About seven days before her death, during her delirium, she said: “The Lord has two wills: His will be done.” It is when we do not know what God’s will is to be, that it is the hardest to will what He wills.

Strange to say, on Good Friday, though she was so delirious that there was difficulty in keeping her in bed, and she did not know what day it was, Christ on the Cross was her theme all the day long. “Christ died on the Cross for me, and I want to go and die for Him.” She had indeed lived for Him. Then on Easter Day she said to Miss Blower: “I am happy, so happy: we are both happy, so very happy.” She said she was going to hear the eighth Psalm. Shall we remember Martha’s favourite psalm? She spoke often about St. Thomas’.

She died the day after Easter Day. The change came at 7 in the evening, and she lived till 5 o’clock the next morning, conscious to the last, repeating sentences, and answering by looks when she could speak no more. Her Saviour, whom she had so loved and followed in her life, was with her thro’ the Valley of the Shadow of Death, and she felt Him there. She was happy. “My best love,” she said, “tell them it is all for the best, and I am not sorry I came out.”

Her parents have given her up nobly, though with bleeding hearts, with true submission to our Father’s will: they are satisfied it is “all for the best.”

All the Montreal Hospital shared our sorrow. The Doctors were full of kindness in their medical attendance. Mr. Redpath, who is a principal Director, and Mrs. Redpath were like a real father and mother to our people. Martha’s death-bed and coffin were strewed with flowers.

Public and private prayers were offered up for her at Montreal during her illness. Who can say that they were not answered?

She spoke of dying: but without fear. We prayed that God would spare the child to us: but He had need of her.

Our Father arranged her going out: for she went, if ever woman did, with a single eye to please Him and do her duty to the work and her Superintendent. “Is it well with the child?” “It is well.” Let us who feel her loss so deeply in the work not grudge her to God.

As one of you yourselves said: “She died like a good soldier of Jesus Christ, well to the front.” Would any one of us wish it otherwise for her? Would any one of us wish a better lot for herself? There is but one feeling among us all about her: that she lived as a noble Christian girl, and that she has been permitted to die nobly: in the post of honour, as a soldier thinks it glorious to die. In the midst of our work, so surely do we Nurses think it glorious to die.

But to be like her we must have a mind like hers: “enduring, patient, firm, and meek.” I know that she sought of God the mind of Jesus Christ, “active, like His; like His, resigned”; copying His pattern: ready to “endure hardness.”

We give her joy; it is our loss, not hers. She is gone to our Lord and her Lord, made ripe so soon for her and our Father’s house. Our tears are her joy. She is in another room of our Father’s house. She bids us now give thanks for her. Think of that Easter morn when she rose again! She had indeed “another morn than ours”—that 17th of April.

Florence Nightingale.