Our Story:
What Is Nursing A Way Out Of?

Intro: How we did it?

For What is nursing a way out of? , we combined primary and secondary sources, and incorporated the voices of relevant individuals to enrich our data and explore our research questions in depth.

We first applied AI-assisted scanning to digitise the original paper-based Nurse Training Register: Private Records (1856–1888) during data collection. Using ↗ CamScanner, we ensured high-precision scans, preserving the format, detail, and integrity of the historical documents. We used ↗ ChatGPT-assisted text recognition to handle the handwritten entries. This dual approach allowed us to cross-check results, improving accuracy, especially with blurred or irregular handwriting.

Once digitised, we organised the data around key aspects, including the location of each training ward, records of promotion and grade changes, dates and reasons for leaving, and career outcomes. We also looked at work frequency to understand service length and scheduling patterns. In total, we collected 232 valid records, which we then cleaned and standardised for analysis. This resulted in a structured ↗ Database [download].

Our analysis focused on three central themes: career mobility, promotions, and reasons for leaving. These themes helped us trace how nurses moved through the profession, whether they advanced, and why they might have left. Using the ↗ Flourish data visualisation platform, we transformed these findings into visual charts, offering a clearer view of how historical nursing careers unfolded.

This digital and visual approach allowed us not only to engage more effectively with historical archives but also to reflect on how nursing has functioned as a possible path for social mobility, and for whom that path was accessible.

Why Nursing?

Nursing is often romanticized as a profession filled with compassion, heroism, and fulfilment. However, behind this idealized portrayal, there is a significant gap between perception and reality. Through examining the historical collection, Training Register: Private Records , we discover two core themes that have persisted since the 19th century, which are social mobility and occupational pressure. Thus, our research question is: ↗ What is nursing a way out of? By exploring this special collection, we aim to bridge the gap and reveal their authentic experiences.

According to the British Red Cross (2025)¹, nursing wasn’t really respected in the early 19th century. But after Florence Nightingale took care of soldiers professionally during the Crimean War and got great results, people started to realize how important nursing was. Soon, proper training and nursing schools appeared, turning nursing from casual caregiving into a respected, professional job.

Paths to Promotion

Our special collection covers the period from 1856 to 1888. It records nurses’ entry and departure dates, previous occupations, subsequent employment, leaving reasons, and other information. The ↖ database shows that during that time, nurses were basically all women from the working class, such as servants, housekeepers, governesses, and dressmakers. This Sankey diagram shows the career paths of women who have been promoted.

In the collection, there is a successful ↗ example. Mary worked at home, but by entering the nursing industry, she eventually became the Matron of a hospital. These data and information indicate that in the 19th century, nursing provided career opportunities for low-income women, which helped women realize their self-worth and improve their status. It tells a story of upward movement, but only for a few.

Voices from Today

This phenomenon continues today. We have an interview with Katherine, a student who majored in BSc Nursing Adult at the University of Birmingham. She shared her opinions about the nursing major.

Pressure and Mental Strain

Although nurses are appreciated in public, they are unable to avoid physical and mental pressure. We counted the reasons why Victorian nurses left their jobs and generated a pie chart.

The data in this chart comes from the special collection. This collection records the different time points and locations of each nurse’s training and work after joining the nurse training school. We judged their ‘work intensity’ by analysing the frequency and location of nurses’ rotation records, and visualised it in three forms: low, medium, and high. For example, a nurse who rotates through multiple departments over a long period would be classified as ‘high intensity,’ whereas a nurse who remains in the same department for a shorter period would be seen as ‘low intensity.’ This logic is based on our daily understanding of ^{↗ the relationship between job mobility and the level of exertion.}

In the chart, most of them left their jobs because of misconduct, unsuitability and health issues. In further investigation, we found that the workload of these departing nurses was essentially in the low and medium range. This suggests that workload may not be the main reason for their departure. We assume that people with low workloads may have weak stress tolerance, which makes them unsuitable for the nursing profession. We also guess that nurses face great mental stress at work due to the heavy workload. This stress trend continues today. Although modern nursing still offers low-income women the possibility of financial independence and advancement, similar stress and economic challenges make it a hard job for them.

Salary and Value

According to the Nurse Training Register, their pay ranged from £40 to £60, with only two head nurses recorded as receiving an annual pension of £25, equivalent to about 24 quarters of wheat at that time. Clearly, this wouldn’t cover the living expenses as it is a relative low pay. Comparing with other jobs’ earnings and average income back then, even matron nurses in the 1870s and 1880s didn’t earn much, whether working or retired.

In modern society, according to NHS Employers, the starting salary for most nurses is £29,970, significantly lower than the average income of UK employees. Nurses, as a profession that involves long hours of labour, do not receive an income commensurate with the amount of labour they put in.

In 2022, NHS experienced ^{↗ the largest nurse strike in history}. It is worth noting that the government has strict requirements on nurse strikes, as prolonged strikes would lead to the collapse of the healthcare system. During our interview, Vicky, a nurse at a GP practice, repeatedly mentioned the issue of low pay. However, her attitude toward the strike reflected a reluctant compromise:

Strauss and Hughes (2024)² reported that Nicola Ranger, general secretary of the RCN, in a letter to the health minister, Wes Streeting, expressed the hope that the government would come up with concrete actions to address the poor care sector, rather than just verbal promises. According to UNISON Northern (2024)^{3, NHS staff have been campaigning for pay levels to be adjusted to those in the NHS reform agenda to more accurately reflect the work they do and ensure a fair settlement for unpaid wages.}

Still a Woman’s World?

Surveys show that although the number of men entering the profession has increased over the past few decades, it has been slow (Ford, 2019)^{4. Compared to the past, the number of male nurses are increased. This chart shows the gender ratio in NHS England statistics for 2023. Females make up 88-90% of the total, and males make up 10-12% (NHS England, 2023)5. According to Professor Mark Radford, the persistence of gender-based images of nursing that cater for the notion that nursing is ↗ “women’s work” influences men’s perceptions of nursing and joining the profession (Ford, 2019)4.}

Whose Voices Are Heard?

Beyond data, this project explores how voice and accent influence representation. Visit ↗ Rethinking the politics of listening to see how dubbing styles raised questions about inclusion in a diverse NHS.

Conclusion

Nursing has long been seen as a potential pathway for social mobility, especially for working-class women seeking to escape poverty or domestic servitude. Our exploration of historical records revealed that while some succeeded, many faced structural barriers — from low pay to high mental strain. Today, although the nursing profession remains a path to independence for some, it continues to carry burdens of underappreciation, gender bias, and systemic pressure.

What is nursing a way out of? It is a way out of invisibility, but not yet a guarantee of dignity. It is a step away from economic dependency, but not free from inequality. Understanding these tensions helps us see nursing not just as a profession, but as a site where social struggles continue.