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“From her autobiography, you got the sense that she got dragged away from nursing with suffragette campaigning and politics, then finds her way back to it,” says nurse, academic and historian Dr Janet Hargreaves, who has been studying the life of Molly Murphy, a nurse whose career played out on the urban battlefields of the Spanish Civil War and the Blitz, via the more sedate settings of countryside sanitoriums and private nursing homes. “There is that sense of nursing always having a pull on her.”

Born in 1890, Molly’s life was extraordinary in many ways. She took direct action as a suffragette and member of the Women’s Socialist and Political Union (WSPU), postponed marriage so she could pursue her career, and took a covert journey to Russia to experience the aftermath of the revolution. Yet, she wanted to be remembered as a nurse, and her autobiography Nurse Molly reveals fascinating details about nurse training, pre-NHS forms of nursing care, and issues in care homes.

Janet has been studying the version of Molly's biography edited by Ralph Darlington, Molly Murphy: Suffragette and Socialist, which is currently out of print, as well as the original unpublished manuscipt, which is held in the People’s History Museum. Although influenced by the voice and politics of husband Jack who ghost-wrote it with her, it offers rich detail about nursing examinations, the day-to-day life of a probationer in the 1920s, and the brutal reality of nursing wounded soldiers and civilians during the Spanish Civil War and World War Two.

Political upbringing

Molly was born in Lancashire, one of the older children of a large group of siblings. “She talks about how she observed the district nurse coming in to see her mother when she was having children,” Janet explains. “She’d spent a lot of time organising and caring and interacting with the district nurse.”

She refused his offers of marriage in preference for her independence and career

She grew up in a left-wing household, with parents actively fighting for the rights of workers and women. Her father was involved in the independent labour party and, when Molly was a teenager, her mother joined the WSPU, bringing her daughter along with her.

Working for the WSPU in Sheffield, she met engineer and trade unionist Jack – although it would be years before she agreed to marry. Janet says: “She refused his offers of marriage in preference for her independence and career.”

Molly finally began nurse training in 1915, aged 25. At a tuberculosis sanitorium in the Worcestershire countryside, she had a mixed experience. “In one way, it was nice because patients were out in the open air, in pavilions, it was quite gentle nursing work,” says Janet. On the other hand, many patients were poor workers from nearby carpet factories – the awful conditions lead to lung problems and TB and she questioned why no one was helping them out of this cycle.

Hospital training

After a few months, Molly moved to the West London Hospital. It was the middle of the First World War and in her book she described the hospital as: “a vast clearing house of the sick and wounded.”

Molly talks about training being long and arduous, and probationers being at the bottom of the pile

She had to share a room with four other nurses at first, and was expected to do lots of manual and menial work, such as cleaning, filling hot water bottles and making cups of tea for more senior nurses. “She talks about the training being long and arduous, lots of hard work, and probationers being at the bottom of the pile,” Janet says. 

Molly recorded many details about her training and examination, including how Millicent Ashdown, author of one of the era’s primary nurse education textbooks, delivered Molly’s oral examinations. “There are plenty of nurses’ diaries out there from this period, but I’m surprised by how much detail there is in her diaries about examinations,” Janet says. “It was an example of a classic training at the time.”

Nursing co-ops and agencies

It was Molly’s plan to join a nursing co-op when she left West London Hospital. In the late 1800s, demand for nursing care grew and nursing agencies appeared to fill the demand. “Nurses would sign up with the agency, which might also provide bed and board. You lived there then went out and worked for various people and the agency took a cut of your salary,” Janet explains.

“There was a lot of controversy. This was an unregulated practice and there were unscrupulous organisations involved: some were thinly disguised brothels. Others really exploited both the patients and the nurses. They’d say: ‘This is a qualified nurse.’ But it might be someone who had only three weeks of experience.”

Nursing co-ops were created to counter these issues and sit comfortably with Molly’s politics. “They were an attempt to have a fair and just system of providing nurses, so that patients knew they were buying somebody who had some skill and the nurses weren't being completely exploited,” Janet says.

Before she fulfilled this plan, Jack returned from Russia and once again proposed. This time, Molly said yes. In the years following, the couple had a son, Gordon, and lived between London and Moscow. Jack was a founding member of the Communist Party of Great Britain (CPGB) and also wrote for Pravda. 

These years meant a step away from nursing, but in 1932 Jack left the CPGB due to policy disagreements and the family were left without income. Despite the marriage bar, which prevented married women from being employed in certain professions, including nursing, Molly decided she would become the family’s breadwinner. 

Private nursing work

According to her memoir, she walked the wealthy streets of west London looking for a private nursing home that she liked the look of. She began working alongside famed Harley Street doctors, including Lord Dawson of Penn, physician to the British Royal Family.

“She’s a bit disparaging about the patients, saying these are rich, idle people, but she gets the chance to nurse them properly and is given respect by the consultants,” says Janet. “She contrasts this with what it would’ve been like in hospital. She’d have found it difficult because she was married and had a child, and she would’ve had no control over her shifts.”

What happens when you privatise the care of the vulnerable? People will be exploited

In the nursing home, middle and upper-class people would pay to stay and be looked after, allowing them to avoid mingling with the poor inside hospitals. When they got a little better, they might move home or to a nearby hotel and have nurses such as Molly visit them there to continue care. During Molly’s time at the home, she nursed children with meningitis, people recovering from operations, and a wealthy woman who returned from India with gonorrhoea – likely passed on via an unfaithful husband.

“Sexually transmitted diseases come up regularly in Molly’s autobiography and they’re not written about very much. She talks about the sexually transmitted disease ward in her training, where she learned all the regimes. Pre-antibiotics treatment for gonorrhoea was intensive nursing because it was all about washing and douching and cleaning, being meticulous with sterilising to reduce the effects of the infection.”

Janet was fascinated by the parallels between care home nursing in Molly’s time and issues facing the care sector today. The Nursing Homes Registration Act of 1927 was an attempt to regulate the sector to ensure patients were receiving adequate care and nurses weren’t being exploited.

“The CQC is basically the grandchild of that original act but is still struggling with the same problems they had then,” says Janet. “It’s a really interesting, intractable problem, which is what happens when you privatise the care of the vulnerable. When you make that something that someone can make profit out of, people will be exploited.”

Spanish Civil War

When the Spanish Civil War broke out in 1936, there were appeals via the Spanish Medical Aid Committee in London for nursing volunteers. For years, Molly had supported Jack’s dedication to his politics. Now, this was a chance for her to do the same. Molly recalled: “I suddenly felt it to be nauseating to continue this kind of nursing when splendid young men were dying on the international battlefield of Spain because there were so few nurses and doctors to help them to keep alive. I volunteered to serve.”

“She’s accepted partly because she’s got the socialist credentials and because she’s a qualified nurse,” says Janet. “But she is one of the older nurses who goes out there, she’s 46 by this point.”

When she arrived in Spain in 1937, she found a complete lack of infrastructure and an endless stream of wounded and dying soldiers. She and her unit would relocate at short notice, quickly turning any building into a makeshift hospital. Janet says: “Staff, water and electricity were in short supply and the often bombed out buildings lacked windows, heating or security.”

Molly and other medical staff were working flat out, collapsing onto mattresses fully clothed to get sleep, alongside the wounded and the dead.
After eight months, Molly requested leave and returned to England. “She’s obviously unwell when she gets back,” says Janet. “She’s exhausted and spends time being looked after, trying to recover.”

Nursing in the Blitz

It wasn’t long before World War Two broke out. “Because she has battle experience in Spain, she is an absolute gift,” says Janet. “She signs up and becomes sister in a mobile medical unit.”

Based at Highgate Hospital in north London, Molly and her unit would travel to buildings that had been bombed in the Blitz and tend to the victims. Just as in Spain, she witnessed catastrophic injuries, people killed outright by aerial bombardment, and day after day of destruction. 

With Spain and the home front, for Molly it was: right place, right time, right spirit

By 1942, she “reached a personal breaking point”, says Janet. She’d been working 100-hour weeks, plus she witnessed public officials misusing public funds and resources, for example selling  rationed goods on the black market for personal gain. “Her feisty mouth gets her in trouble – she whistle-blows over misappropriation of funds,” Janet explains.

But she was also exhausted: “She might not have got over her post-traumatic stress and she’s unwell and tired.” The tables turned and she ended up being treated by one of the consultants she had previously worked for in the west London nursing home.

Pandemic parallels

Janet observed some parallels between Molly’s nursing career and the situation that nursing staff have faced during the COVID-19 pandemic. “With Spain and the home front, for Molly it was: right place, right time, right spirit. I think that happens to a lot of people. Many who went back and worked during the pandemic did the same thing. It may have been really life-affirming, but also really traumatic. Or maybe just traumatic.”

Janet continues to research the life of Molly and the areas of nursing she spent time in – particularly care homes and sexually transmitted diseases. “From a nursing perspective, it’s same and different,” she says. “To use a well-known maxim: if you don't know your own history, you’re doomed to repeat it.”