Convicts and care giving in colonial Australia, 1788–1868

Historical Context of Custodial Health Nursing in New South Wales, Australia

“…Around 1788, the convict Ann Smith was allocated the specific role of caring for female patients at the Sydney Cove Hospital becoming what could be considered the first recognized nurse of convicts in colonial Australia and therefore the original CHN (Cushing, 2005). Similarly, Martha Entwistle has been documented as Australia's first mental health nurse, working at the Castle Hill Asylum from 1814 until 1819 (Raeburn et al, 2018).…”

“…Although this legislation specifically compelled prison medical officers (the term “medical officer” is still used for medical doctors in NSW custodial health services) to keep a daily record of the health and care of the patients for whom they were responsible and required reporting to the Comptroller General of Prisons, it did not mandate or describe in any detail the personnel required to provide the day-to-day care. This is an example of the typically nebulous historical references to those actually delivering daily care to prisoners (and in healthcare settings in general), such as wardsmen and other attendant figures, who have been collectively referred to in historical documents as “caregivers” (Cushing, 2005, p. 109). One notable exception to this is Dr. James Bowman, Principal Surgeon and Inspector of Colonial Hospitals (1819–1836), who established a ratio of one nurse and one wardsman to every seven patients in the general hospitals (Cummins, 2003, p. 29).…”

“…In these institutions, the allocation of duties that could be described as nursing care was made along gender lines, whereby men cared for male patients and women cared for female patients. The care consisted of basic duties such as delivering food and burial, which later progressed to maintaining hygiene and more complex care tasks (Cushing, 2005; Starr, 2017). The overall responsibility for care and specific therapeutic tasks such as wound dressing, hygiene, and medication fell predominantly to visiting doctors (Hobbins, 2017; NSW State Archives and Records, n.d.; Starr, 2017; please see Supplemental Digital Content 1, http://links.lww.com/JFN/A77—Historical Timeline of the Origins of Custodial Health Nursing in NSW, Australia, 1788–2021).…”

“…Despite extensive exploration of local and national historical records, nursing and prison literature, and first-person stories (Burton, 2021), the only references to CHNs have been in relation to staffing numbers, characters in prisoners' personal stories, and ill-defined roles documented in correctional records. This lack of description of caring work is not a unique phenomenon and reflects the lack of acknowledgment in historical studies of the female contribution to the foundation and development of the colony in general (Cushing, 2005). Furthermore, it has been suggested that, although the population of female convicts sent to Australia (11% of the total convict population) was a relatively skilled workforce, these women were underutilized and not recognized for their potential value in building the new colony, either at the time or in historical analysis since (Nicholas & Shergold, 1988, p. 10).…”

“…Nurses have long worked in prisons, but there seems to be a consensus that their work is hidden and misunderstood (Goddard et al, 2019; Woods & Peternelj-Taylor, 2021). This view continues to be held, not only by the general community but also by the partner agencies with whom they work (the correctional bodies) and the nursing profession at large (Choudhry et al, 2017; Cushing, 2005; Raeburn et al, 2018; Wakem & McGee, 2012). It could be argued that, because the State of NSW is the original place of white settlement in Australia, the first nurses in Australia were people who cared for those in custody in the penal colony, that is, CHNs.…”