This blog formed part of a speech delivered at Erskine Home, Renfrewshire to celebrate the International Day of the Nurse 2023.
As many of you might know from some of my blogs and talks – I come from a family of strong Highland women!
When I was growing up there were two professions which dominated my family environment – both occupied by strong women – teaching and nursing.
One of those I want to talk about is my great aunt who had she been alive would be over 140 years old. She was ‘widowed’ in the First World War – though in truth she was never married but engaged to a young man who lost his life in the trenches but for whom she ever after wore the black of widowhood and never married.
She was an astonishingly literate and widely read woman who was a headteacher with an indomitable and quite ferocious spirit. In fact, she was quite scary! But she had wonderful stories and being a bit of a sponge, I soaked many of them up only realising their significance a lot later. She had an array of friends all over the country and indeed the world. Many of them like her were strong characters.
One of the people she occasionally talked about was someone a good 14 years younger than herself but with whom she shared a real affinity. Her name was Mairi Chisholm whom some of you may know though I suspect many of you might not – but in her day she was probably one of the most famous and photographed nurses of her generation.
Mairi Lambert Gooden Chisholm, of Chisholm (1896-1981), known as Mairi Chisholm, was an ambulance driver and first aider and then nurse on the Western Front in Belgium during the First World War.
Brought up in England but from very Highland stock, Mairi was deeply influenced by her older brother, Uailean, who owned a Royal Enfield 425cc motorcycle. She adored motorcycles and persuaded her father to buy her one which she spent days stripping down and putting back together. She was 18 years old when she met the 30-year-old Elsie Knocker, who shared the same passion for motorcycling, and they became good friends
At the outbreak of the First World War, Mairi and Elsie travelled to London on motorcycles to offer their services to the War Office. It was when working as dispatch drivers that they were spotted by Dr Hector Munro, a Scottish doctor and founder of the volunteer Flying Ambulance Corps (FAC), who invited them to join him on the front in Belgium from September 1914.
Mairi Chisholm and Elsie Knocker, became known as the ‘women or angels of Pervyse’ and together they saved the lives of thousands of soldiers and won numerous medals for bravery.
What marked them out as different was that they soon came to the conclusion that they could save more lives by treating the wounded directly on the front lines rather than transporting casualties to hospitals. They set up one hundred yards from the trenches and they called their place “Poste de Secours Anglais” (“British First Aid Post”). They spent the next three and a half years tending to the wounded.
It was an astonishingly hard time, not least in that they had to raise their own funds for their new station. Then in March 1918, they were both badly affected by a bombing raid and gas attacks on their field hospital and were invalided home. Chisholm was able to return briefly to Pervijze, before being gassed again; she was only 22 years old.
She went on to live a colourful and fulfilling life and after many more adventures died in Argyll in 1981.
Back to my great aunt. She recalled conversations she had with Mairi about what it was like to nurse and what she learned from the experience in the First World War. There are several things which both Mairi and Elsie showed which I think on this International Day of the Nurse still are apposite and are the essence of nursing.
The first is that at the start of their work Mairi and Elsie were not nurses – they had received the most basic of training but over the years developed real experience and skill so much so that they were feted by the media and others as exemplars of what nursing should be both during the war and for the decade after.
But my aunt always pointed out that Mairi consistently said that what mattered most was not the uniform you wore, the unit you belonged to, but the skills and talents you developed and displayed.
There is a lot of necessary debate about what should constitute the core skills and competencies of modern-day nursing. Indeed, I have written and commented about how important that debate is, not least when we are faced with the shortage of registered nurses working in social care. It is fundamental that we know and agree what for instance are the boundaries of role and competence between a nurse and say a senior carer.
But what was intrinsically true for Mairi was that regardless of training or title, what ultimately mattered was the ability to use skills in the service of the individual rather than the validation of personal nursing identity. What was critical was the whole team and group effort rather than the elevation of one role, however important, over another.
And a care home is an exemplar par excellence of that – it is only when acting in concert and together that we ensure the individual resident receives the best possible care and support that they deserve.
The second thing I remember being told about Mairi was that she had a passionate belief that treatment and care must go to the person and not the other way around. Now that’s a relatively easy statement to make – in fact it is the ethos of the developing concepts and delivery of hospital at home programmes and approaches – we have many of us known for long that the community should be the cradle of clinical care and not the acute hospital alone.
For Mairi that belief and conviction was one that was immensely dangerous and harrowing. It meant that quite literally she was under fire all the time – a reality that caused damage to her health which would result in a life-long impact both physically and psychologically.
But in truth that is what is still true today – we go to where people need us and when they require that support. For Mairi nursing was about being useful where you were needed – nursing was in the place and space it was necessary to be.
The third thing I heard from my aunt was that nursing and care in general was first and foremost about relationship. In an emergency war situation, you might think there was a risk that with real life and death pressures that care and support became transactional, perhaps even mechanistic and automatic.
Far from it- in her writings and in her conversation Mairi Chisholm emphasised how important it was that we see care and support, whether given by a nurse or a carer as something which if it was to be effective had to be grounded in the formation of a close and meaningful personal relationship with the person being supported and cared for.
That insight seems almost a taken for granted view of care and support today but at the time it was something that was not all that commonplace. The citations for the many medals they received demonstrated the personal care and compassion that the ‘Angels of Pervyse’ displayed.
Nursing and care were for them and must be for us today about making people feel that they mattered, that you listened to them and heard what they were wanting and needing.
And perhaps finally that is no more than true in a context of nursing in the face of death.
Those of us in this room who have been granted the privilege to be present with someone as they die; to nurture their leaving of life in a way that gives them comfort, that reduces fear and offers solace; those who have felt the pulse of life leave a body, will be well accustomed to the special character of those times, and to their continual hardness.
I suspect the majority of us will not like Mairi and Elsie have had to deal with trauma quite as severe, but each death brings its own special moment of memory for those left behind, and the care and compassion, the practical assurance and skill that is shown at such times to a care home resident are our gift to a family starting the steps of their grief journey.
I could go on about Mairi Chisholm and the memories of my great aunt a lot – but those key aspects I feel have something to say to us nearly 120 years later.
They are that nursing and care and support have to do with recognising the intrinsic value of the person who occupies a nursing role and the critical role of being part of a team; they are that for care and support to be effective nursing and care needs to go to where the person is and to their space and place; that relationship which discovers the person is at the heart of nursing and lastly that it is the accompanying of another in the last hours and moments of their living that the humanity of our roles comes to the fore.
Social care nursing and care are many things – it is a discipline and profession which has been so grossly under-appreciated and valued – and which slowly is coming out of the shadows to shout and celebrate its unique complementary offer to the whole of care support and nursing.
Social care nursing is in some senses – a bit like Mairi Chisholm’s attempts to describe her role – beyond description – but its dynamic is the presence of familiarity in the midst of uncertainty; the valuing of individuality ; the creation of space that heals and holds; the ability to listen beyond and below what is said; the instinctive knowingness which comes from presence which goes beyond the physical.
But in the end of the day whether for a nurse, or a carer, or a domestic member of staff it all boils down to the person inside that uniform.
Mairi Chisholm, challenged expectation and displayed a humanity of compassion and courageous care to the end of her days; she became a pin up of the media of her time ; but she sought not fame or fortune; but to make a difference and in everything you do you can be assured that that is what you do every day – and for that we thank you. You truly make a difference.
Biographical Details taken from: Our Records: Mairi Chisholm (1896-1981), ambulance driver and first aider in the First World War | ScotlandsPeople