American Nursing vs. English Nursing 1950s

Nursing in the 1950s looked very different from today. Uniforms were starched, wards were regimented, and nurses were expected to follow strict rules—yet their daily routines varied depending on whether they worked in Britain’s newly formed National Health Service or in the bustling hospitals of the United States.

Let’s step into the shoes of two nurses: one in post-war England, the other across the Atlantic in America.

Morning routine

• England : Much of the morning was spent on bedpans, washing patients, changing linens, and recording temperatures with glass thermometers. Training nurses learned by doing—and by being corrected if they missed a detail. Silence on the ward was strictly enforced.

• America: US nurses had a similar routine: medication rounds, cleaning, and charting with pen and paper. But American hospitals were often larger, with more private rooms. Trainee nurses rotated through specialties, from surgery to pediatrics, while senior staff oversaw their every move.

  
  
  
  

Meal Breaks

• England: Nurses had scheduled tea breaks in the ward kitchen, but only when work was finished. Lunch was plain, usually in the hospital canteen. Many nurses worked straight through, with little time to sit.

  
  

• America: Cafeteria meals were part of dormitory life, and breaks were more common—but still controlled by supervisors. Coffee became the nurse’s best friend in the long shifts.

  
  

Evening Duties

England: Evening rounds included administering medications, writing patient notes by hand, and preparing patients for Matron’s inspection. Junior nurses were expected to stay late if needed—obedience and service were part of the culture.

America: Evening shifts could be lively, especially in urban hospitals. Nurses often dealt with emergencies, admissions, and surgeries running late into the night. Night nurses kept the wards running quietly while patients rested.

Off Duty

England: After a long day, nurses returned to the nurses’ home, where curfews were enforced—often 10 p.m. Lights out meant no late-night socializing, though whispers and giggles in shared dorm rooms were common.

America: In the US, nurses had more freedom outside hospital life. Some enjoyed dances, movies, and the rising rock & roll scene. However, dorm rules still applied, and training schools often kept strict oversight of young nurses’ reputations.

Two paths, One calling.

Though life differed between English and American nurses, both faced long hours, strict discipline, and modest pay. What united them was their dedication—serving patients with skill, care, and a pride that defined the nursing profession in the 1950s.

Real examples, Real experiences.

Quote: "Nursing, especially that most important of all its branches nursing of the sick poor at home - is no amateur work." Florence Nightingale 1865.

• English Nursing history: Taken from: The History and Development of The UK National Health Service 1948 - 1999 by Peter Greengross, Ken Grant, Elizabeth Collini Second Edition Revised July 1999. https://assets.publishing.service.gov.uk/media/57a08d91e5274a31e000192c/The-history-and-development-of-the-UK-NHS.pdf?utm_source=chatgpt.com

  1950s: Command & Control Having created an enormous nationalised health industry, the various government of the day began to look critically at how the services could be managed efficiently. The prevailing management style for hospitals was "command and control", reflecting the practise of the war years, with central instructions being passed down a chain of authority from central government to local hospital boards. The same was partly true of the community services but with the differences that these services were under the management of elected local government. In contrast, GPs were independent contractors and could not be 'managed' in this sense but were influenced through a centrally agreed national contract for services. Because of these differences, the emphasis for change was on hospitals, where the most direct influence could be exerted. Three-way professional hospital management had broadly persisted since 1948, with various combinations of medical, nursing and lay administration². In 1948 hospitals were managed by a medical superintendent, a matron and a lay administrator. Lay administration was then about enabling hospitals to function in clean, well-supplied and well-maintained buildings. It was not necessarily the job of administrators to ensure that the hospitals functioned efficiently, nor to question medical or nursing practise unless something went wrong. A report published in 1956³ expressed early concern about many issues which are still familiar in the 1990s. These included: · Changing trends in health and illness. · The importance of prevention of illness. · The needs for GPs and hospitals to work closely together. · The need to make adequate provision for the care of old people in their own homes. · Whether the NHS would in practice be able to meet every demand justifiable on medical grounds. Despite these concerns - which were all variations on the danger of demand out-stripping the ability to supply health care - a national resource allocation formula was rejected. In other words, the allocation of funds amongst the regions was not determined centrally. Instead, hospitals were funded on the basis of historical budgets (ie. What had been spent the previous year), regardless of use or need. It was to be another 20 years before the problem of historical budgeting was seriously addressed.

  
  

• American Nursing history: Taken from: Histories of Nursing:The power and possibilities: https://pmc.ncbi.nlm.nih.gov/articles/PMC2907354/?utm_source=chatgpt.com : Power and Practice: In the early 20^th century United States, the private duty registry system, rather than hospitals and health care agencies shaped the work lives of graduate nurses. These registries, agencies which helped patients find nurses and nurses find jobs, provided the vital connection between nurses and patients. Private duty registries supplied a reliable way for nurses to seek patient cases and for patients and physicians to obtain nurses and verify their capabilities. Typically, nurses enrolled with a registry indicating their availability for work. The registry checked the nurse's qualifications, serving as a rudimentary credentialing system. Patients who needed a nurse made their requests directly to the registry which in turn sent out a suitable nurse for their situation.⁴

  In the late 19th century, as the proliferation of schools of nursing proceeded, many alumnae associations of schools of nursing began establishing and operating private duty registries. By the turn of the 20^th century, the success of these ventures motivated many in the nursing community to establish larger enterprises operated by nurses to deliver a wider spectrum of nursing services to community. Registries, owned and operated by professional nursing groups, and often local professional nurse associations affiliated with the national American Nurses Association, cropped up throughout the country. The combination of small alumnae association registries with the larger professional association affiliated agencies formed the backbone of the professional nurse registry system in the United States, operating until the mid to late 20th century.

  These registries also served a second and equally significant function in setting up the conventions of nurses' work such as establishing standards for nurses' hours of work, fee schedules with both patients and hospitals, and minimum criteria for professional practice. In the case of alumnae association registries, for example, the alumnae themselves took responsibility for the decision making processes required in day-to-day registry operations. For the larger professional association affiliated registries, control over registry operation depended on the extent of participation by nurse members. A large amount of historical evidence exists documenting that the nursing workforce frequently demanded and very often received positive consideration of changes in conditions of work beneficial to their employment.⁵

  
  

Different but the same.

English nurses appear to have a similar work routine but their free time looks less fun than the American nurses! In the next blog I will look at free time and the entertainment of the day.

English and American Nurses