‘British Military Nursing in Peace and War’ connects the contributions of Florence Nightingale and Mary Seacole in the Crimean War to the development of military nursing. Through the stories of individual nurses, it highlights experiences in war and peacetime from across the tri-service, from students, to regulars and reservists, to veterans. Also hear from their patients, NHS colleagues, and historical experts.
Visit the permanent exhibition in-person at the Florence Nightingale Museum in London. Explore more in the online exhibition at https://www.florence-nightingale.co.uk/ and the YouTube playlist.
My name is Colonel David Bates. I’m a retired British Army Colonel. I’ve been an army nurse for 35 odd years and I’m also a trustee in the Mary Seacole Trust and was a trustee previously at the Mary Seacole Memorial Statue Appeal Trust Istarted my nurse training at the London Hospital
In White Chapel in 1979, the old Queen Alexander, wrong, Princess Alexandra’s School of Nursing, and I trained there for about 18 months, and then decided that I wanted to join the Army. And so, I was recruited in Central London and successful interview and had the privilege of joining a
Shortened course, the shortened training, where I trained at the Cambridge Military Hospital in Aldershot, the Queen Elizabeth Military Hospital in Woolwich and had a detachment out to Park Prewett Hospital for psychiatric training for eight weeks in 1983. So how different is working in civilian nursing and the military environment? Well,
As military nurses, even in the past, we did a lot of our training in civilian, civilian hospitals, and civilian organisations. As I said, my psychiatric secondment was at Park Prewett Hospital near Basingstoke in Hampshire, and also my burns and plastic surgery training was
Completed in Billericay, at St Andrews Hospital in Billericay in Essex. So even as military nurses, prior to options for change and military nurses being integrated into NHS hospitals and trusts, we did have quite a lot of exposure to the NHS and our civilian colleagues. I think I have a theory
Which I’ve developed over the last probably 20 years, about what military nursing is, as opposed to nursing in the military, and as a military nurse, one has to have the survival skills that every soldier, every sailor, air person has to survive in the field. Whereas a civilian nurse,
You don’t necessarily need that, even if you’re working in a military environment, but you do need to understand the context of the military. So contractors that we took on operations with us in Iraq and Afghanistan, somewhere like Camp Bastion, where you’re in a huge base, the hospital
Is in the middle and it’s well protected, you could actually put civilians in there to actually perform a role that we couldn’t do ourselves, like Paediatrics, for instance, and Urology, because we don’t have those specialties, certainly not in the regular forces anymore. We have some reservists,
But most of the time we rely on contractors to provide that. And that’s what I call nursing in the military, as opposed to military nursing. So, the military nurses are the ones that you see who were in Afghanistan up in the Forward Operating Bases and the patrol bases with the
Troops and going out on patrol. So, my first tour of Northern Ireland was in 1993 in West Belfast, and I’d be on patrol with the Marines out on the ground, and that is military medicine or military nursing because you’re actually up the front with the troops, providing them with that
Intimate support, that intimate care. Okay, so Army Nursing or military nursing is part of a wider military health and care system, which starts with preparing troops, navy personnel and air personnel for their operational roles. So, through training and making sure that they’re healthy, they meet occupational health requirements,
Nurses are involved from the outset in that process, whether they’re Ministry of Defence, civilian nurses or uniform military. Military nurses are involved a lot throughout the whole process. And part of that wider health and care team, which obviously includes medics, doctors,
Combat medical technicians and dentists, allied health professionals and we all work as one big team. And I think you know looking at differences again between the military and the health service, the National Health Service, and probably not so much private and the voluntary sector, but in the
Military, we have had a homogeneous system where everybody belongs to the same organisation. One of the problems in the National Health Service is that it’s not one homogeneous organisation, it’s several, it’s heterogeneous, and that makes life difficult when you’re trying to do
Sometimes what you think are easy and simple tasks. So, for instance, audit in the military is easy because we’re all part of the same organisation and networking is easier and research is easier as well and that makes life easier for the individual professions
As well and facilitates working together. Most of us have had experience operating with other services and it’s symptomatic of the military, the armed forces in the 21st century that when we deploy, we do deploy as a joint formation, which means that army,
Navy, air force and sometimes civilian elements are deployed together in one force. And that brings a depth and a richness because of course, the other services have their nuances and their cultures and their ways of operating, which means that we’re
Continuously learning from one another and sharing lessons and good practise. Then of course, when those colleagues that work in civilian hospitals go back, they return from operations, they go back to their NHS units, then they can share that good practice and that experience with their
Colleagues when they get back to the UK base. One of the examples of where military nursing, health and care supported and interfaced with civilian nursing, health and care, and in particular the NHS, was during the height of the COVID-19 crisis,
Where I was privileged to be part of the Army NHS Mentoring in Crisis programme. And I mentored two senior NHS leaders during that time. And our task was to bring our experience from operations and use that experience to help our NHS colleagues to fight through the COVID-19 crisis and use some
Of the tools and the systems that we’d used in operations, and indeed combat operations, to fight through what was essentially a semi permissive or a potentially hostile situation. And some of this was a reflection back to Ebola in West Africa in 2014-2015, when some of our
Colleagues deployed to Sierra Leone to support the civilian services and the military health services there to combat that virus. And a lot of the lessons that we learned from there we brought back and shared with our colleagues during, and still are during the COVID-19 crisis.
So, deployments are pretty diverse. Employment across the military and in military, nursing, health and care is diverse. And I can talk about the extremes from operating within an armoured division in the Iraqi desert to peacekeeping in the Balkans and
Building partner capacity in the Middle East and in East Africa. I think one of my most memorable deployments was with the UN in Croatia in 1992-1993 after the Yugoslavian wars, where we were operating in a European theatre. We’d deployed from Germany, from Minden,
So a lot of the countryside and the infrastructure looked familiar to us. But then, of course, a lot of the areas we were operating in had recently been subject to some pretty intensive war fighting. So just travelling through those towns and villages were deserted, the inhabitants
Had fled, they were either refugees or internally displaced, was pretty emotional and I found that harder to cope with than when we were in the desert with one UK armoured div about a year, 18 months before. Then some of the more pleasant deployments have been to Africa. So,
I’ve led a short-term training team in Malawi when we got back from Op Granby in 91, 91 to 92, and then latterly when I was in the Reserve with 77th Brigade. We did a lot of building partner capacity, so say in the Middle East, but also East Africa and Northern Nigeria,
Where we were teaching civil military cooperation, integrated mission planning and really getting involved in civil affairs. So, building capacity for disaster response and humanitarian action, so that was pretty rewarding. And I also work now for a non-government organisation NGO called Heart Humanitarian Aid Relief Trust, where we operate in a lot of those
Areas where I deployed in the army, but I call that soldering without guns because we’re doing the same or similar jobs, similar employment, but as civilians and outside of the government. Yeah so, this experience, long experience of 42 years in the military as a TA soldier,
A regular, and latterly a reservist, and now a veteran and a contractor and a teacher, experiential learning is something that I’ve been developing, probably formally since 2009, when I was privileged to be able to attend the Master’s Medical Education programme at the University of Dundee. And my dissertation was about building intelligence into
The system and identifying the requirements, the leadership and management requirements in the Army Medical Services in particular. But actually, the research showed that the principles applied across the other services, including the civilian MOD, but also outside in civilian life as well. So, building on that, realising that the system needed a transformative
Learning and leadership philosophy which identified principles but was regardful of the context building that intelligence of the system meant that you could then operate anywhere, really within any system. And that’s basically what I use now in my Disaster Response and Humanitarian
Action teaching at University of Cumbria is ensuring that our students could identify the problems, their disorienting dilemmas, using what our military audience will be familiar with, the OODA Loop. So, the Observation Orientation Decision Action cycle and when you get into the
Orientation piece, that’s where your reflective practice kicks in, which allows you to critically analyse the situation and the information that you’re being bombarded with. And then the third part of the cycle, which is the reflexive piece, that’s the transformative learning piece that
Allows you to discuss the data and then synthesise that build it back up into something which is more meaningful for the situation that you’re in. I think the main lessons are going back to what military nursing is and being able to look after oneself, that’s probably the major lesson,
And continuous learning, learning from colleagues. I think it’s about challenging yourself as well, continuously challenging your tacit knowledge and skills and remaining up to date. So, it’s what I call building intelligence into the system because we can have all the knowledge and
The skills, but it’s the experience, that wide and deep experience which only comes with time and age, which provides those lessons. And I think being able to make mistakes but learning quickly from them, so make mistakes early, preferably in training, preferably on exercise,
So that we’ve learned the lessons before we actually deploy and we’re actually caring for casualties or patients. I find it difficult because I think we’re trained to turn challenges into opportunities. And even when we have been or I have been
Put in a position which we’d call a disorienting dilemma or a wicked problem or something that you didn’t want to do but had to do, I think we just get on with it and you learn from the experience
And then turn that experience into new knowledge and sometimes even doctrine. And I think we do look for opportunities to operate, work outside our comfort zones. It’s part of being a military nurse or being a soldier is that you do have that opportunity to operate in diverse environments.
I call it a wide mission space, which you wouldn’t necessarily have in civilian practise. There’s been so many. So, I suppose the first one was being awarded the Associate Royal Red Cross for supporting combat operations on Operation Granby in 1991 and I was privileged to
Receive my ARRC from the late Queen, which was really good. Probably from a work perspective my proudest moment was my first staff appointment, grade two staff Officer in the Ministry of Defence, and that was a weapons staff job, being responsible for the Nuclear,
Biological, Chemical, Medical Countermeasures Applied Research Programme at Porton Down. I was the first nurse to be appointed to that, which demonstrates, as I was saying, that wide experience that you can gain as a military nurse outside of clinical, but related to supporting
Soldiers and service personnel across the piece. So, taking into account those wider determinants of health and not just the traditional health and care spheres. Another thing, my last or latter proud moment was being appointed Queen’s Honorary Nurse when I became
Director of Army Nursing Services in 2013. The best thing about being a military nurse from my experience has been the freedom, I think, to shape one’s career. I don’t think I ever had a career plan. Well, that’s not true. I did have a career plan to
Start with, which was anchored on burns and plastic surgery, nursing. And that’s probably because when I joined the regular the regular army and was finishing my training, the Falklands War was raging at the time and a lot of the casualties that were coming off the ships were burns, of
Course. So that’s really what piqued my interest in that specialty, which I stayed in till 1993, and then options for change closed the military hospitals, which included our burns facilities. I went off to staff college and then basically switched from clinical practise to more to a
Public health role in command, leadership, management, research, training, education. As a trustee of the Mary Seacole Trust, then obviously I’ve looked at this quite deeply because we’re continuously asked questions about the relationship between Florence Nightingale and Mary Seacole and what their legacies mean. And to me, looking at Nightingale’s career,
I think she was focused on, or she was proficient at the science. She had a classical nursing education in Germany, she understood mathematics and science and epidemiology and so contributed a lot to the cognitive conceptual component of nursing, and health and care in the
Round, particularly public health in the UK and army health in particular. And also, the physical component with her designing hospitals from her experience in training in Germany and also when she was in Scutari. So, I think from a capability perspective, Nightingale’s legacy contributes
A lot to the conceptual and the physical components, whereas Seacole, in my opinion, her contribution is the moral component, the will to win. She fought through adversity, when she was told she couldn’t do something, she would just get up and do it. She was on
The ground in the Crimea and her services were respected by the people that really needed them. And I think people often forget that a lot of the force in the Crimea were civilian contractors, the Land Transport Corps, the Army Works Corps, which literally surrounded where she was based,
Their camps surrounded Spring Hill. So, she had a lot of engagement with those people, as well as the troops that she looked after and the officers. And also, she was good at networking, so you read about the engagement she had with Alexis Soyer improving food in the field,
William Russell projecting what was happening on the ground in the Crimea, and she also had good relations with the Inspector General of hospitals who audited her services and also, some of the local military doctors that were deployed in the field hospitals came down and looked at what she
Was doing and some of them even asking for the medicines that she was using to treat diarrhoea and sickness and what have you, saying that a lot of her medications were better than what the army was supplied with. I think both, the legacy of both together is pretty powerful.