Introduction

The successful functioning of any private or public nineteenth-century asylum largely depended on reliable, caring staff at all levels, and this chapter will explore how Brookwood Asylum and Holloway Sanatorium utilized their attendants and other employees to their best advantage. From the superintendent, his medical officers, attendants, nurses and the chaplain, to the maids and the cook, the gardeners and the lowliest servants, all contributed to the efficient daily running of institutions that required strict routine and continuity of service. At both asylums, the first medical superintendents and their supporting officers held their posts for relatively long periods of time which provided stability; arguably, they also imposed their beliefs and personal styles upon the daily routines and the implementation of any therapeutic regime. Asylums experienced difficulties in recruiting and retaining good attendants; once employed, the management's, strategy of monitoring and regulating their staff in order to maintain standards will be discussed and measured. The middle-class patients at Holloway meant that at this sanatorium some specific staffing strategies were employed in order to satisfy the expectations of the inmates and their families. It also becomes apparent that despite the many rigours of institutional life, asylum nursing did offer security of employment for many, and career opportunities for some.

By the mid-nineteenth century, the descriptive term ‘mad-doctor’ had all but disappeared from common parlance.