Florence Lees 1840 – 1922
Nurse.
31 March 1840 – 19 October 1922
A Tribute to Florence Lees by Susan Cohen
Located on the northern side of Bloomsbury Square, at the junction with Bedford Place, stands No.23, an impressive Georgian house. Its façade gives no clue to its historic connection with Florence Lees, the woman who was the largely responsible for the establishment, in 1875, of the pioneering Metropolitan and National Nursing Association (MNNA), the first training school for women whose remit was to nurse the sick poor of London in their own homes. Nor does it give any indication of the important role she played in the creation of the district nursing movement, or how the MNNA became the working model for the Queen’s Nursing Institute, the oldest nursing charity in the world.
Florence Lees was born in Blandford, Dorset, on 31 March 1840, one of six siblings and a half-brother, Edward Charles Adams. After her father, who was himself a doctor, deserted the family, it was Edward who stepped in to save his mother and half-siblings from destitution, and it was thanks to him that Florence and her three sisters were educated, she at a school in London. Edward was a fellow, tutor and dean of Worcester College, Oxford, and whilst the family were living with him there, Florence and her mother made regular home visits to the sick poor, a practice which continued when they moved to St Leonards on Sea, Sussex in 1864. Florence’s ambitions to train as a nurse were thwarted by her mother, who would only agree to her spending four months as an observer at the pioneering Nightingale School at St Thomas’s Hospital. However, it was not long before she looked elsewhere for experience.
In 1867 Florence boldly followed in Florence Nightingale’s footsteps, first studying at the Kaiserswerth Institute in Germany before exploring other hospitals in Europe. Back in England she then spent some months in charge of the male accident unit at St Thomas’s Hospital, London, before travelling to France in 1869 to nurse. The following year the outbreak of the Franco Prussian War gave her the opportunity to volunteer as a military nurse, initially as superintendent of the second fever hospital at Marange, and when that closed, as superintendent of the Royal Reserve Hospital at Homberg. Her services in these hospitals earned her the German war medal and the Cross of the German Order of Merit. After the war she embarked on a study tour of the principal hospitals in America and Canada, gaining an insight into the ideas of Dr Palmer Howard who maintained that nurses should be educated in the manner of medical students and pay for their training.
But it was back in England that her training and experience proved to be so important, for it was largely due to her influence that the district nursing movement was placed on a solid foundation. An organised system providing professional nursing for the sick poor in their own homes had already been established in Liverpool, thanks to the philanthropist and social reformer, William Rathbone. His model became the blueprint for similar schemes in various cities but, with no point of reference, the standards varied hugely. To address this it was decided that a survey of the current situation was needed, and in consultation with Florence Nightingale, William was appointed chairman of the enquiry and Florence Lees the Honorary Secretary. Her remit was to investigate the nursing scene across London, and the detailed account she produced in 1874 highlighted the deficiencies and inadequacy of district nurse training and of the home nursing which was available to the poor. Published in 1875, her report undoubtedly influenced the formation of the MNNA and the opening of the first training school for district nurses.
This is the moment that 23 Bloomsbury Square enters the picture, for it was here that the central home of the new association was set up and where hundreds of eligible women would eventually undertake six months of training to qualify them as professional ‘district’ nurses. Much of their training took place ‘on the district’ and nothing could have contrasted more with the gentility of Bloomsbury Square than the nearby slums of St Giles to the south and St Pancras to the north, whose poor residents were to benefit from the new district nursing scheme.
From the very beginning of her tenure as Superintendent-General, Florence Lees’ ideals were high. These included ‘perfect training, careful supervision and the highest possible standard both of system and personal efficiency’ and her insistence that her nurses were recruited entirely from the class known as gentlewomen. In her eyes, women of education were more responsible and were more likely to carry out the doctor’s orders. She was also adamant that probationer district nurses should be instructed and supervised by a highly trained nurse like herself rather than an untrained lady superintendent, a view which did not initially find favour with Florence Nightingale or William Rathbone. Ultimately, they both agreed with Florence Lees. It was her concept of a special and higher training for district nurses, and of their accountability to a skilled nurse, that proved crucial to the establishment of district nursing as a profession.
Florence Lees married the Reverend Dacre Craven in 1879 and as Mrs Craven became non-resident Superintendent General of the MNNA without a salary. She saw the organisation through years of financial struggle. However, the timing of Queen Victoria’s Golden Jubilee in 1887 presented an unexpected opportunity of benefitting from the £70,000 Women’s Jubilee Offering. Several parties competed for the money but the Queen decided it was to be used for the welfare of nursing, and ultimately chose William Rathbone’s scheme. This meant that Florence Craven’s conviction of the importance of the role of the highly trained district nurse became the bedrock of the newly founded Queen Victoria Jubilee Institute for Nurses. Consequently. in September 1889, the organisation was awarded a Royal Charter.
The publication, in 1889, of Florence Craven’s Guide to District Nurses and Home Nursing met with Florence Nightingale’s overwhelming approval and, for many years, was the bible for district nurses. She was awarded the Jubilee Medal and the Cross of St John of Jerusalem and until her retirement in 1918, she and her husband maintained their connection with district nursing. Florence Craven died at her home in Walton on the Naze, Essex, on 19 October 1922.
© Susan Cohen 2023
Susan Cohen is a social historian with a special interest in the history of nursing and district nursing. She works closely with the Queen’s Nursing Institute, researching the charity’s rich history, and her many publications include several nursing-related books.
Cohen, Susan, The District Nurse, Bucks, Shire Books, 2010
Cohen, Susan, The District Nurse, a Pictorial History, Barnsley, Pen & Sword, 2018
Cohen, Susan, Nurses and Nursing, Stroud, Amberley Publishing, 2019,
MINI BIOGRAPHY
Education
1866 Nursing school at St Thomas’ Hospital.
Studied healthcare in nursing in Dresden and Kaiserswerth, Germany.
1870 Worked as a volunteer nurse for the military during the Franco-Prussian war.
Some Key Achievements and Interests
Cared for her sick mother while growing up in St Leonards, England, sparking her interest in nursing and medicine.
1870 Earned the recognition of Crown Princess Victoria of Germany for her work with the military and was put in charge of hospitals in Marange and Homburg.
1870 Received a German war medal.
1870-1873 Travelled to Holland, Belgium, Denmark, Austria, Italy, France, the US, and Canada to visit chief hospitals and study medicine around the world.
1873 Published A Handbook for Hospital Sisters with the help of Florence Nightingale and a preface by Dr Henry Acland.
1873 Began work at King’s College Hospital, in charge of the male and female surgical wards.
1874 Surveyed community nursing in London, finding a need for more trained nurses. Took a position in support of nursing as an educated profession rather than an amateur one.
1875 First superintendent and founder of the Metropolitan and National Nursing Association (known at the time as the Metropolitan and National Nursing Association for Providing Trained Nurses for Visiting the Sick Poor at their Own Homes). Set up a home at 23 Bloomsbury Square, housing the first district nurses in London.
Received Queen Victoria Jubilee Medal and Cross of the German Order of Merit.
1889 Helped Florence Nightingale and William Rathbone convince Queen Victoria to create the Queen’s Jubilee Fund and promote district nursing.
Published A Guide to District Nurses as a training manual in association with the fund.
1890 Supported district nursing work as a member of the Nightingale Fund Council.
Issues
Father abandoned her and her siblings at a young age.
1866 Mother did not want her to become a ‘probationer’ while at nursing school.
1876 Faced disagreement from William Rathbone, Florence Nightingale and The Lancet medical journal on her idea that district nursing should be an independent medical profession for educated women.
1879 Gave up salary and work upon marriage to Reverend Dacre Craven and birth of her children, as society at the time expected of a wife and mother.
Connection to Bloomsbury
1875 First superintendent and founder of the Metropolitan and National Nursing Association, set up at 23 Bloomsbury Square.
Female Networks
Florence Nightingale, Louisa Twining and nursing community.
Writing / Publications include
1873 A Handbook for Hospital Sisters.
1889 A Guide to District Nurses.
Various published articles on district nursing.
Further Reading:
Florence Lees: District Nursing’s first ‘expert’ 1890: Contents of a DN’s bag. History of District Nursing (wordpress.com)
Florence Sarah Lees – Wikipedia Florence Sarah Lees – Wikipedia
UCL Bloomsbury Project UCL Bloomsbury Project