Actually, the nurses were very worried about the poor conditions in the Crimean hospitals and tried to improve the sanitation standards and regular supplies of the medicines and necessities, criticizing the authorities for their sluggishness, helplessness, neglect and mismanagement. In some hospitals, they openly fought against thievery and corruption, quite typical for the Russian army those days. Many practical doctors who worked in the field hospitals were dissatisfied with the management and administration as well and they supported nurses in their initiative to change the appalling situation with delivery and distribution of basic supplies in the hospitals. The famous Russian Surgeon Nikolai Pirogov, who was in charge of the nurses’ activity in the Crimean hospitals, favored the idea of granting nurses free hand in management and he believed that nurses should be appointed to the administrative positions in hospitals with higher responsibilities. However, just after the Crimean War he suddenly retired (allegedly, after a fierce argument with the military minister), so that Russian nurses lost their main protector and patron in supporting their interests and initiatives among hospital authorities. Regrettably, none of the other medical officials turned out to have such influence, as Pirigov had had, to defend nurses’ status in military hospitals and promote nursing as an essential element of hospital care.

Meanwhile, Russian system of hospital care was in deep decline at that time, because the authorities had not paid attention to hospital development since the Napoleonic Wars. It was yet before the Crimean War that the central authorities had been informed about the dreadful conditions in hospitals, numerous shortcomings and the outrageous abuse of power by the hospital administration almost everywhere. It was one year before the war that the Chief Inspector Kruglov reported to the Military Ministry about lack of proper care of patients, poor sanitary conditions, corruption and larceny among hospital workers at all levels, as well as numerous other failings. However, the ministry did not pay any attention to the report and it was shelved until 1859.6

The Crimean War exposed all the shortcomings and exacerbated all the drawbacks that had accumulated during the decades of neglect. The appalling conditions in hospitals, lack of basic supplies, mismanagement and corruption among the authorities played their fatal role and resulted in the huge loss of lives of the sick and wounded soldiers. Nurses, who could not stay indifferent to the horrendous conditions in hospitals, were trying to improve the situation. Being encouraged by some of the senior doctors, Pirogov inclusively, they often insistently interfered into the management and administration, which annoyed and irritated the military hospital authorities. Although the authorities admitted much of the criticism, they could not give up prejudice against female capabilities in administrating and refused to accept the idea that nurses would be delegated certain responsibilities and legal rights to take part in hospital management.

Despite nurses had demonstrated their best qualities during the Crimean war and their contribution to the improvement of hospital care had been recognized internationally, Russian authorities were reluctant to the idea of introducing female nursing in military hospitals after the war. The officialdom also strongly rejected the idea of nurses’ participation in hospital administration, though the government did attempt to reform hospital care. In 1858, the Military Ministry assigned Dr. Yanovsky, the senior medical officer in charge of the special tasks, to prepare a draft project of a new hospital statute7. The draft project called for drastic changes in hospital management at all levels and many suggestions seemed quite revolutionary those days. Among the points included into the project was the requirement to delegate the administration of every hospital to a special independent collective council that would consist of a doctor consultant, chief physician and a senior nurse. The management and all the staff responsible for maintenance and supplies were supposed to become subordinate to the above-mentioned council. Therefore, it is possible to conclude that, according to this draft project, nurses were supposed to be working in every hospital and they should have taken active part in hospital management. The draft project was sent out for consideration to all the top military officials and chief doctors of the military hospitals. A special committee was set up to discuss the proposals listed in the draft project and to introduce the concept that would be suitable for the majority of hospitals. However, all the suggestions on radical changes remained just some nice ideas on paper.
The members of the committee for elaborating the new hospital statute disagreed upon the role and mission of nurses in military hospitals. A number of officials and chief doctors were convinced that nurses would be useless; some others even claimed that nurses would do considerable harm to hospitals once they were allowed to take care of the patients. In contrast, a few members of the committee insisted on including nurses into hospital staff and put it as one of the mandatory requirements for hospital reforms. They asserted that hospitals would have benefited greatly if nurses had taken care of the patients on a permanent basis. The ones who supported the idea of nursing were mainly the doctors who personally worked in military hospitals during the Crimean campaign. They pointed to the fact that nurses demonstrated a much more conscientious and compassionate attitude towards the sick and wounded in the Crimean hospitals, comparing to feldshers and other hospitals staff.

One of the ardent supporters of nursing was Dr. Paltsev, the Chief Doctor of Moscow Military Hospital and one of the committee’s members. He wrote, based on his experience of working in Kherson hospital:

If distribution of medicines and care had been handled by the feldshers and other hospital staff, not by nurses, then the patients would not have had even a half of the prescribed medicines, food and vine, while the staff (feldshers and servants) would have been constantly drunk. It was only owing to nurses’ indefatigable toil that the hospital in Kherson had only 400 patients by September 1857, while the number of them in 1856 exceeded 5, 000 and the total majority of them recuperated.8

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