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- Susan McGann
Ethel Gordon Fenwick (1857–1947)
Fenwick [née Manson], Ethel Gordon (1857–1947), founder of the International Council of Nurses and leader of the campaign for state registration of nurses in Britain, was born Ethel Gordon Manson on 26 January 1857 at Spynie House near Elgin, Moray, the third child of David Davidson Manson (d. 1858), physician and farmer, and his wife, Harriette (d. 1908), formerly Palmer, of Thurnscoe, Yorkshire. Her father died when she was a baby and her mother took her young family back to Yorkshire. When Ethel was three years old her mother married George Storer, MP for South Nottinghamshire, and Ethel grew up at his country house, Thoroton Hall, in the Vale of Belvoir, where she was educated privately.
From an early age Manson showed a strong will and sense of purpose and decided that she would be a nurse. She started her training at the age of twenty-one at the Children's Hospital, Nottingham, and went on for a further year at the Royal Infirmary, Manchester. She was then offered the position of sister at the London Hospital. She proved herself to be a capable manager and two years later, at the age of twenty-four, was appointed matron of St Bartholomew's Hospital, one of the most prestigious hospitals in London. It was a time of rapid advances in medical knowledge and nursing was undergoing many changes as it strove to keep pace with the expanding role of the hospital. Manson accepted the challenge of her new job with enthusiasm and spent six happy years at St Bartholomew's achieving many improvements in nursing practice and in the nurses' working conditions. She enjoyed hard work and expected the same from her nurses, setting high standards which were appreciated by the medical staff. In 1887, having decided that she wished to have a family, she resigned her position to marry, on 6 July that year, Dr Bedford Fenwick (1855–1939), a successful London physician. They had one son, Christian Bedford Fenwick (1888–1969), who became a county court judge.
Following her marriage, Ethel Gordon Fenwick was in a position to devote her time and energy to the cause which became her passion, the professional development of nurses, and it is for her achievements in this field that, as Mrs Bedford Fenwick, she is best known. In November 1887 she held a meeting of matrons at her home in Wimpole Street, London, and the outcome was the establishment of the British Nurses' Association (BNA). The founders of the association considered that nursing should be a profession for educated women and they believed that these trained nurses needed a system of state registration to distinguish them from untrained nurses, similar to the register for doctors. Princess Helena, Queen Victoria's daughter, accepted the presidency of the association and became a friend of Fenwick. The very success of the BNA provoked opposition from doctors and hospital managers who saw in it the threat of organized labour and women's rights. The campaign for registration also aroused the opposition of some nursing leaders, in particular Florence Nightingale, who considered that a system of registration based on theoretical examination was not an appropriate way to determine a good nurse.
The opponents of the BNA had a powerful spokesman in the person of Henry Burdett, an authority on hospital administration and finance, founder of the Hospital Association and editor of its journal, The Hospital. When the BNA became the first professional association of women to be granted a royal charter in 1891, Burdett led a counter attack and within five years the opponents of registration had gained control of the BNA. This experience made a lasting impression on Fenwick and confirmed her view, which she had first stated in 1887, that 'the nurse question is the woman question pure and simple. We have to run the gauntlet of these historical rotten eggs' (Dock, 3.33). For the rest of her life she opposed the involvement of the medical profession and hospital managers in the professional concerns of nurses.
As the RBNA slipped out of her influence, Fenwick set up an alternative organization, the Matrons' Council of Great Britain and Ireland. In this she was supported by her successor in the matronship of St Bartholomew's, Isla Stewart, who became her great friend and professional colleague. Together they worked for nurses' higher education and professional independence. Fenwick also became involved in the women's movement and was appointed to the women's committee of the British Control Commission for the world fair in Chicago in 1893, at which she organized an award-winning exhibition. As president of the British nursing section, she visited America twice and while there met Mrs May Wright Sewall, the founder of the International Council of Women (ICW), and also leading American nurses, most notably Lavinia Dock, a pioneer feminist.
Back in Britain Fenwick became involved in the organization of the ICW 1899 congress in London and she included nursing in the professional section of the congress. This attracted distinguished nurses from many countries and at this first international gathering of nurses, Fenwick proposed the establishment of an International Council of Nurses (ICN), similar to the ICW. Her idea was enthusiastically received and the first meeting of the ICN was held in 1901 in Buffalo, New York state. In her presidential address Fenwick set out the aim of the ICN: professional independence with the aim of raising ever higher the standards of education and professional ethics. Membership of the ICN was restricted to one national association from each country and, to comply with this regulation, Fenwick and her supporters founded the National Council of Trained Nurses of Great Britain and Ireland in 1904, with Fenwick as president.
The campaign for nurses' registration became more confrontational and Fenwick developed her natural journalistic talents as editor of the Nursing Record, a new radical journal which she had taken over in 1893 with her husband's support. In 1902 Fenwick and her supporters formed the Society for the State Registration of Nurses and she and her husband drafted the first bill for state registration. An alternative bill was promoted by their opponents and the outcome was the appointment of a House of Commons select committee in 1904. When the select committee published its report in favour of state registration, having heard evidence from many witnesses including the Fenwicks, she believed they had won the argument. But although registration had become law in several other countries by this time, the strength of the opposition in Britain meant that the government was reluctant to act. Faced with this set-back, the various organizations which were working for registration united to form the Central Committee for the State Registration of Nurses with the aim of promoting a joint bill. Several joint bills were promoted over the next ten years but it was not until after the First World War that British nurses got their first Registration Act.
The lack of government support for the cause of trained nurses was regarded by Fenwick as evidence of nurses' lack of political power. She was an active supporter of the women's suffrage campaign and saw the similarities with the nurses' campaign for registration. Writing with the same passion as with which she spoke, Fenwick used her journal to raise nurses' awareness of the two campaigns and of the importance of professional independence for nurses. She had renamed her journal the British Journal of Nursing in 1902, and two years later it was adopted as the official journal of the ICN, providing her with access to nurses all over the world. She enjoyed writing and was elected president of the Society of Women Journalists in 1910 and represented the society at the coronation of George V. Fenwick was an ardent royalist and took great pleasure in reporting royal occasions. She was extremely proud of being British and during the two world wars her passion for the British cause led her to profess anti-German feelings which, on several occasions, caused unnecessary distress to others.
War work and the College of Nursing
Like many nursing leaders of her time, Fenwick took a personal interest in the nursing of soldiers. During the Graeco-Turkish War (1897) she was appointed honorary secretary of the National Fund for the Greek Wounded and travelled, with a group of personally selected nurses, to Athens where she took on the superintendence of the military nursing, and for which she was awarded the distinguished order and the diploma of the Greek Red Cross.
When the First World War started the leaders of the campaign for state registration, like their counterparts in the suffrage campaign, declared a truce for the duration of the war. They were very disappointed to find that after over twenty years of lobbying for professional status, government departments still regarded nursing as philanthropic work and encouraged women with no training to take up nursing. Fenwick became a member of the grand council and executive committee of the Territorial Force Nursing Service for the City and county of London, and a member of the ladies' committee of the order of St John of Jerusalem. However, her biggest commitment was to the French Red Cross, and through the British committee 250 trained nurses were sent to France. She was also honorary superintendent and treasurer of the French Flag Nursing Corps, under the French war office, which selected nurses for work in France and, being responsible for their well-being, she visited them periodically. For this work she was awarded the médaille de la Reconnaissance Fran?aise and after the war was involved in selecting nurses for work in the devastated areas of France.
The First World War had highlighted the unorganized state of nurses' training and as the War Office, desperately short of nurses, urged all women who possibly could to volunteer, trained nurses felt increasingly vulnerable. By the end of 1915 a small group, led by by Sarah Swift and Arthur Stanley, respectively matron-in-chief and chairman of the British Red Cross Society, proposed an alternative to state registration. They urged the establishment of a College of Nursing, similar to the medical colleges, which would be responsible for the education of nurses and maintain a register. Despite Fenwick's complete opposition to the scheme, Swift and Stanley got the support of the majority of the matrons and hospital training schools around the country and the College of Nursing was established early in 1916. Whereas before the war the majority of trained nurses had taken no interest in the campaign for registration, now the balance of opinion among them was beginning to swing in its favour. Their experience of the war brought them into contact with nurses who were untrained and with VADs (Voluntary Aid Detachments), volunteer nurses with six weeks' training, who were increasingly relied upon to supplement trained nurses. Fenwick and her supporters saw the college as a distraction from the real cause of state registration, and were suspicious of the involvement of hospital managers and the Red Cross, which was responsible for training the VADs. The founders of the College of Nursing made considerable efforts to allay Fenwick's fears but she refused to compromise on what she regarded as the principle of self-government for nurses.
General Nursing Council for England and Wales
After the war the campaign for registration resumed and, largely as a result of nurses' contribution to the war, the government passed the Nurses' Registration Acts in December 1919, introducing a system of state registration for nurses in England and Wales, Scotland and Ireland. Fenwick watched the passage of the bill from the public gallery of the House of Commons in a state of jubilation. She was appointed to the new statutory body, the General Nursing Council for England and Wales (GNC) and when the register of nurses was opened, she was entered as number one. However, she found that she and her supporters were outnumbered in the GNC by the College of Nursing party. Given the strength of her feelings about the college, it was not surprising that she found it difficult to work with its supporters, and the proceedings of the GNC were dogged with personal animosity and questions in the House of Commons. Fenwick's conduct as chairman of the registration committee of the GNC was considered autocratic and unacceptable by the GNC's chairman and the majority of the council, who resigned in protest in December 1921. Fenwick refused to resign and the minister was forced to intervene: a new chairman was appointed, the council members were reinstated, and the rules were altered to enable the council to remove the old office holders and appoint new committees. Fenwick found herself with only the full council as her debating ground.
When the first election to the GNC was held in 1922, Fenwick lost her seat. She gave her view of the election in a series of articles in her journal, under the title 'How the college caucus captured the council'. Although excluded from the GNC, she followed its proceedings closely with a hyper-critical eye, and was particularly outspoken about its failure to make the training syllabus compulsory. She lobbied members of parliament to intervene and, following questions in the Commons, a select committee was appointed in 1925 to consider this and other aspects of the GNC's rules. Fenwick was one of the witnesses who gave evidence to the select committee but when the report was published it did not recommend making the syllabus compulsory. At the next election for the GNC, in 1927, she did not stand, realizing that she did not have enough support to beat the candidates of the College of Nursing.
In 1926, with the financial support of an anonymous benefactor and her husband, Fenwick set up the British College of Nurses as an alternative to the College of Nursing. She intended her college to provide its members and fellows with professional education, legal protection, and benevolent help. She was elected president and those nurses who had supported her campaign, such as Rebecca Strong and Margaret Huxley, were rewarded with fellowships.
Fenwick's last campaign was fought over the issue of a second grade of nurse. By the 1930s the shortage of registered nurses had led to a growing number of assistant nurses in the workforce and their unofficial status was of great concern to the profession. The College of Nursing and the British Medical Association recommended their enrolment by the statutory body, but Fenwick and her supporters regarded this proposal as a threat to the professional standards of registered nurses. In the end the status of the assistant nurse was largely determined by the Second World War and, despite Fenwick's protest meetings and parliamentary lobbying, the Nurses Act of 1943 regularized their position as enrolled nurses. She compared the legislation to the registration of quack doctors and wrote to the prime minister, Winston Churchill, in a last attempt to defend nursing as a profession.
Travel and retirement
Fenwick enjoyed travel and derived great pleasure from the meetings of the ICN held in different cities all over the world. At the fourth congress, held in Cologne in 1912, she proposed the setting up of an educational memorial in the name of Florence Nightingale, who had died in 1910. Her idea was unanimously accepted but because of the First World War it was over twenty years before the Florence Nightingale International Foundation was inaugurated for the benefit of nurses from all countries. The last ICN congress before the Second World War, held in London in 1937, was attended by over 3000 delegates from 44 countries. Fenwick was by then eighty, and her regal appearance and commanding presence added to the splendour and dignity of the occasion. As the founder of the ICN, she was proud to receive honorary membership of the national nurses' associations of the USA, Germany, Finland, and India. This was to be her last congress: when the ICN next met, in Atlantic City, USA, in 1947, it was two months after her death. It had been intended to present the founder with a citation in recognition of her 'unique and life-long contribution to the advancement of the nursing profession throughout the world', but in her absence a memorial service was held.
Fenwick's husband died in 1939. They had lived apart for many years but he had remained a supporter of all her campaigns on behalf of the nursing profession. For many years Fenwick had lived in a small eighteenth-century house in Westminster, surrounded by her priceless collection of Chinese and English porcelain, mahogany furniture, and miniature animals. During the Second World War she moved into accommodation at the headquarters of the RBNA in Kensington. In June 1946 she fell and fractured her femur and although she was nursed at St Bartholomew's Hospital, with the care due to a former matron, the fracture never healed. In November she was transferred to the home of a friend, the wife of the vicar of London Colney, St Albans, and died there on 13 March 1947 at the age of ninety. Her remains were cremated at Golders Green on 18 March and the next day a memorial service was held at St Bartholomew's. In April her ashes were interred in the precincts of Thoroton church, Nottinghamshire, where her mother was buried.
As a young woman Ethel Manson Fenwick was beautiful, elegant, and educated and loved bright colours and fine clothes but she was also driven by a sense of purpose. She realized as early as the 1880s that nursing and nurses needed educational standards, professional status, and professional organization. Her social background, combined with her intellect and foresight, produced a formidable leader to champion the cause of professional nursing. She was recognized by her contemporaries as 'a great leader', and she inspired steadfast loyalty from her supporters. But she was also a fearless autocrat who could be devastatingly critical and destructive. As she grew older she became more uncompromising and isolated from the policy makers. Her opposition to the Royal College of Nursing was continued by her loyal followers after her death and left the profession of nursing in Britain divided for many years. This legacy has contributed to her lack of due recognition from the British nursing profession and it is at an international level that her genius has been celebrated. Her outstanding work was in the promotion of international standards in nursing through the ICN and her journal, making her one of the most influential figures in nursing of the twentieth century.
- Nursing Record (1888–1902)
- British Journal of Nursing (1902–47)
- S. McGann, The battle of the nurses: a study of eight women who influenced the development of professional nursing, 1880–1930 (1992)
- W. Hector, The work of Mrs Bedford Fenwick and the rise of professional nursing (1973)
- M. Breay and E. G. Fenwick, History of the International Council of Nurses, 1899–1925 (1931)
- MSS relating to Ethel Manson, St Bartholomew's Hospital Archives
- Matron's report books, 1880–87, St Bartholomew's Hospital Archives, MO1/1–3
- b. cert.
- m. cert.
- d. cert.
- L. L. Dock, ed., A history of nursing from the earliest times to the present day, 3 (1912)
- Royal British Nurses' Association, corresp. and papers
- Royal British Nurses' Association, records
- Royal College of Nursing Archives, Edinburgh, MSS relating to Mrs Bedford Fenwick
- St Bartholomew's Hospital, London, MSS relating to Ethel Manson
- group photograph, 1901, Royal College of Nursing Archives, Edinburgh
- photograph, 1929, Royal College of Nursing Archives, Edinburgh roll the ball for windows phone[see illus.]
- Elliott & Fry, photograph, 1945, Royal College of Nursing Archives, Edinburgh
- photograph, repro. in British Journal of Nursing (22 Nov 1913), 425
- photograph, repro. in British Journal of Nursing (April 1947), 41
- photograph, repro. in Nursing Mirror (13 May 1955)
- photograph, repro. in Nursing Record (13 June 1896), 474
Wealth at Death
￡4303 3s. 10d.: probate, 12 Aug 1947, CGPLA Eng. & Wales