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QAIMNS: Queen Alexandra’s Imperial Military Nursing Service

February 8, 2012

Although QAIMNS (The Queen Alexandra Imperial Military Nursing Service) was founded 110 years ago in 1902 its real origins lay further back in the nineteenth century and it owes a debt to Florence Nightingale. After her pioneering work in the Crimea, where she came to understand that poor prevailing conditions and lack of sanitation were amongst the slew of reasons that contributed to the soaring death rate of injured soldiers, members of government and leading figures in the army were bombarded by her campaigning work for improvements.

She used the funds sent to her by public subscription to establish the Nightingale Training School in London in 1860 at St. Thomas’ Hospital. Apart from the practical training, nurses learnt about the importance of recognising the whole person rather than simply concentrating on the problem or injury, the essential nature of cleanliness, and that professionalism was a prerequisite for success. Some of her first nurses went on to work in workhouses and thus began the break with the concept that the fit (though ignorant) rather than trained professionals should care for the sick. She also chose the demure shade of mid grey of the nurses’ dresses as it was a colour that was restrained and calm. She had proven during her time in the Crimea that wounded soldiers responded far better to a gentle and professional female carer than to the rough and ready, and often makeshift conditions that had formerly prevailed in the Army. The contribution that the unit of female nurses led by Florence Nightingale had made to the recovery of soldiers during the Crimean war was sufficient to justify Sidney Herbert’s* decision to expose ‘mere’ women to the trauma of war.  (* then Secretary of State for War and a long time friend of Florence Nightingale whom he had met when travelling in Rome back in 1848) The Army Nursing Service was formalised early in the 1880s and thus the principle of women being in or near battle zones was established by the turn of the twentieth century with nurses having seen action in the Sudan. Permanent military hospitals were also established around the country.

In 1902 the new Queen Alexandra was approached with the request that she should become the president and patron of the newly organised female nursing wing of the army. Named after her, Queen Alexandra was actively involved in the QAIMNS until her death in 1925. It was her decision that the nurses should retain Florence Nightingale’s choice of grey in their dress, and she chose the symbol of the white cross from the Danish flag, an acknowledgement of her Danish background as well as their motto of ‘candida sub cruce’ (beneath the white cross).

Lapel badge for regular QAIMNS showing the cross and motto

Lapel badge for regular QAIMNS showing the cross and motto

It rapidly became apparent that far more nurses would be needed in times of conflict that during periods of peace and so QAIMNS also had the QAIMNS(R), reserve sisters, also fully trained and qualified, (usually) single women who worked professionally in civilian hospitals but who could be called up in times of emergency. They were to prove an invaluable resource, and during the 1930s, often cherry picked by their matrons during their nursing training. On Sept. 3rd 1939, for example, all reserve sisters opened the sealed instructions they had been carrying and quietly and efficiently reported as instructed to their allocated bases, thus swelling QAIMNS ranks by many thousands

When the First World War began in 1914 there were under 300 QAIMNS nurses, a pitifully inadequate number to deal with the wide range of severe injuries and long term rehabilitation as well as the new nightmares of shell shock and the consequences of chlorine gas inhalation. This was fatal, but its victims could be a long time dying.  FANYs (Female Auxiliary Nursing Yeomanry) helped to swell the ranks, but the high level of professional training of QAIMNS nurses meant that they were the preferred choice and thousands of single, middle and upper class girls were recruited and trained.  Around 200 women are thought to have died during the First World War whilst on active service. Almost as soon as the war ended in 1918 there was the pandemic of Spanish ‘flu which assaulted the civilian population, weakened as they were by their first experience of rationing and war brought to the Home Front as bombs were dropped on civilian targets. QAIMNS nurses were immediately put back into civilian hospitals to help the overstretched resources as thousands of people, often the young, died.

At this point in time the QAIMNS nurses were expected to be young, fit and single. During the 1920s their duties took them to military hospitals wherever the flag of Empire held sway and a career in the service seemed an exciting way to see the world. Their duties were not expected to be onerous, and a number of veteran ladies have remarked on their surprise at being asked in interviews about the quality of their piano playing, whether they sang, spoke foreign languages and whether in tennis they preferred singles or doubles matches. These rather bizarre questions had a reason, however. The nurses were expected to be able to react to any situation calmly and with authority, and sportiness was considered an indicator of overall fitness as the work of the nurses could be very physically demanding. The other questions were aimed at establishing whether the girls would maintain ‘the standards of Empire’; an attitude of natural authority now long vanished. There were a number of expectations placed on the young women, not least that they should pay for much of their own uniform and equipment. One nursing sister recalled how, on the eve of the Second World War, they were still required to provide themselves with a parasol of white silk (as well as portable stoves, canvas baths, veils, dresses, cuffs etc). She spent many fruitless hours searching for the article, finally compromising on one which was white though lined in the wrong colour. It was lost a year later, never having been used, in the retreat from Dunkirk. During the 1920s formal changes were made to the QAIMNS uniform, and as well as the ward dresses, tippets, corridor capes and various cuffs and collars the walking out suit of mid grey wool flannel Norfolk jacket, mid calf length skirt and broad brimmed hat was introduced that girls were still wearing in 1940.

QAIMNS costume circa 1933

QAIMNS costume circa 1933

As reserve nurses were responsible for sourcing much of their uniform there is an interesting range of variations on the central theme that can be observed in the textile collection held at the Army Medical Museum down at Keogh Barracks in Aldershot. In photographs, too, a number of variations can be observed: stiff collars, ‘floppy’ or soft down folded ones, long over sleeves to the elbow or short stiff cuffs, and variations in the buttons and pocket arrangements on the Norfolk jackets.

the flattering broad rimmed hat still being worn at Dunkirk

the flattering broad rimmed hat still being worn at Dunkirk

Up until the period of Dunkirk QAIMNS nurses held an ambivalent position in the Army. They were described as being ‘of it but not in it’. They were always called ‘sister’ not nurse, in recognition of their professional training and qualifications, and were deemed to have officer status, but did not wear the associated army insignia nor did they salute at the drop of a hat as they were deemed to be nurses first and foremost. Although they served in RAPs (Regimental Aid Posts), and Casualty Clearing Stations that were near to the front line as well as working on hospital ships, trains and military hospitals at home, they were all expected to maintain impossibly high standards of dress. This meant that even though they may have been living in field tents, squelching around in ankle deep mud, they were still expected to be wearing a crisp dress and starched veils.A number of things contributed to the authorities having to rethink this, and they were well aware that the ‘scarlet and grey’ as the QAIMNS were known were held in high regard by rank and file soldiers who loved their femininity.

The embroidered oval is topped by the king's crown and there is an empty decorative scroll beneath. Total height is just over two inches by just over one in ch wide.

The embroidered oval is topped by the king’s crown and there is an empty decorative scroll beneath. Total height is just over two inches by just over one in ch wide.

Though all the QAIMNS sisters who were with the BEF returned safely from Dunkirk, it became apparent that the Germans chose not to recognise their dresses as an army uniform, and therefore they were not covered by the Geneva Convention. The stabbing of Lillian Gutteridge when she was trying to drive an ambulance of wounded men to the evacuation point is an example of this, as the German did not recognise her non combatant position. During the horrific conditions of the siege of Malta the nurses were trapped there along with the island’s residents and endured persistent bombing attacks where the hospital was considered a legitimate target. They experienced desperate shortages of everything, especially medical supplies, but as their living quarters were bombed they also came to lack other items such as changes of underwear and spare garments, as even veils were cut up to add to bandage supplies. Consequently when the Matron’s desperate pleas for new uniform resulted in a supply of male battledress arriving they took to them gratefully and discovered that although the fit left much to be desired it gave them far greater freedom of movement. When Singapore fell in 1942 the QAIMNS nurses were amongst the evacuees. One of the ships carrying them was bombed and sank in the harbour, and survivors and naval personnel subsequently reported that the Japanese dive bombers were using the white veils of the helpless girls struggling in the water as targets. The cruelty experienced by the QAIMNS nurses who were not fortunate enough to escape and who subsequently became prisoners of the Japanese could cover many pages. Fundamentally their captors simply could not understand their role: they were women therefore they could not fight; therefore they could not be treated as soldiers. They did not wear an army uniform so they had no protection. This seemed sufficient grounds to permit rape and abuse. It is a testament to their professionalism and strength of spirit that these girls and women would still care for and nurse their tormentors when the need arose. A chapter in the excellent memoir ‘Scarlet and Grey; Letters from the War Areas by Sisters on Active Service’, edited by Ada Harrison and commissioned by Matron in Chief Dame Katherine Jones which was published during the war makes for compulsive reading even today. Lastly, as there was a rush to recruit more nurses, many of them TANS (Territorial Army Nursing Service), it was realised that the QAIMNS sisters were missing out on parity of pay and conditions despite their qualifications. Simple factors like the shortage of materials also came into consideration, and during 1942-3 QAIMNS nurses dropped their distinctive dresses and veils, moving into battledress with a distinguishing lanyard and thick boots. Insignia was also worn, and the sisters adopted a new scale of ranks which gave exact parity with those of regular army officers. Saluting was also adopted and the nursing sisters of QAIMNS became full members of the armed services. Once the war was over further changes were made to coordinate the various groups of military nurses and in 1949 the QAIMNS became QARANC, the Queen Alexander Royal Army Nursing Corps.

The design of the cap badge for QAIMNS(R) nurses was also used for the tippet medal. After uniform changes, Matrons wore these in bronze rather than silver, and senior Matrons had a gold version. Both bronze and gold badges are extremely rare

The design of the cap badge for QAIMNS(R) nurses was also used for the tippet medal. After uniform changes, Matrons wore these in bronze rather than silver, and senior Matrons had a gold version. Both bronze and gold badges are extremely rare

To my shame, I had barely heard of QAIMNS before I was asked to participate in the 70th anniversary of Operation Dynamo, when English Heritage and Black Knight Historical organised the commemorative event at Dover Castle as I have always tried to avoid two areas of re enactment, namely anything military or within living memory as it is so easy to get things wrong and because there are enough specialist re enactors in the field. However, I have found the research of this unique body of women absorbing. They write and speak of their experiences (when they can be persuaded) with such straightforwardness and no sense of their heroism or devotion. They are all convinced of their ‘ordinariness’ and yet they were there in the thick of battles, quietly doing their best for their patients, often in appalling conditions and with bombs dropping around them. They used their initiative and ingenuity time and again to work around shortages and limitations, and were – and still are – united by their single minded devotion to getting the best for their patients, whether they are friend or foe.

The photographs included in      this article were all taken, with permission, at the Army Medical Museum ( and are reproduced here with the permission of the Museum’s curator. If, for any reason you wish to use one of them, please check that they are happy for you to do so.


Grey and Scarlet: letters from the war areas from sisters on active service. (Long out of print but occasionally available from Amazon)

A Nurse’s War by Brenda McBryde

Quiet heroines by Brenda McBryde

Sisters in Arms: British Army  Nurses tell their story by Nicola Tryer

 think the original may be in the Hulton Picture Archive, though it apeared in a number of newspapers at the time. propagation of news was slower then, so personnel were back home whilst the story was still breaking.

think the original may be in the Hulton Picture Archive, though it apeared in a number of newspapers at the time. propagation of news was slower then, so personnel were back home whilst the story was still breaking.

Later style of cap, introduced during WW2, showing the slightly different badge worn by a QAIMNS(R)

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