‘Always remember that you are in your senses: from keeper to attendant to nurse’

Chatterton, Claire (2014). ‘Always remember that you are in your senses: from keeper to attendant to nurse’. In: Knowles, Thomas and Trowbridge, Serena eds. Insanity and the Lunatic Asylum in the Nineteenth Century. Perspectives in Economic and Social History (36). London: Pickering and Chatto., pp. 85–98.


In the large, expanding Victorian asylums with a small number of medical staff, ruled by a powerful but often remote Medical Superintendent, it was the nursing staff that played a crucial role as intermediaries between the everyday life of the institution and contemporary theories about insanity. Pioneering Medical Superintendents relied on nursing staff to carry out their instructions and implement their theories, as the latter occupied the middle ground between doctors and patients.
In this chapter the working lives of the nineteenth century predecessors of today’s mental health nurses will be examined. Long and comprehensive rule books gave detailed instructions about every aspect of asylum life and towards the end of the Victorian period, textbooks had also began to appear for ‘attendants on the insane.’ How large however was the gulf between rhetoric and reality?
By examining Victorian rule books and textbooks, and comparing these with staff records, asylum annual reports and contemporary journal articles and debates, the question of how wide this gulf was and how great was the dissonance between the theoretical base of the nineteenth century asylum and its lived reality is discussed and analysed.

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