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How Much Politics is Permissible in the Nursing of the “Insane”? The History of the Unionisation of Psychiatric Nurses in the German Reich through the Lens of the Uchtspringe Prussian State Asylum 1900–1933

  1. Anna Urbach ORCID iD Department for Medical History, Theory and Ethics, University of Magdeburg, Germany


This article sheds light on nurses’ early ventures into union work, it analyses the conditions, circumstances and boundaries the unionisation of psychiatric nurses entailed during the German Reich in the early 20th century. I use the staff files of selected nurses and orderlies from the former Uchtspringe Prussian State Asy-lum to reconstruct case histories of unionised nursing staff. We can say that until the ban on organising was lifted in 1918, the nurses of the “insane” were strictly forbidden to act independently of the institution’s man-agement within a trade union. Nonetheless, there is evidence that a number of nurses and orderlies of Uchtspringe were members of the German Association of Nurses and Orderlies (Deutscher Verband der Krankenpfleger und Krankenpflegerinnen) even before the beginning of the First World War. In 1919, a branch of the Association of Municipal and State Workers (Verband der Gemeinde- und Staatsarbeiter, VGS), which had close ties to the Social Democratic Party of Germany (SPD), was founded at Uchtspringe, and dur-ing the Weimar period it became the main union representative of Uchtspringe’s committed staff. When the National Socialists seized power, they abruptly ended the activity of the Uchtspringe branch board members, which were branded as “politically unreliable”. Through the investigation of diverse historical sources includ-ing ego documents this article focuses on the self-perception and perception others had of the unionised nurses, in the context of changing management and political systems and the impact of gender issues. Be-yond that I investigate the input the VGS headquarters had to a new concept of nursing ethics which provid-ed an alternative to the ethical basis of denominational and secularised sisterhoods.


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1. Introduction

Spring 1933: after the National Socialists had gained power at the beginning of the year, they immediately began to restructure Germany. Leading Communists and Social Democrats were deposed from their political offices, and Jews and politically unpopular civil servants were removed from their positions. The new leaders occupied the offices (and editorial offices) of the “free” unions [1], took leading functionaries into “protective custody” and confiscated the union assets. In the weeks following the remaining unions were likewise forced to join and submit to the newly founded Deutsche Arbeitsfront (German Labour Front). [2] The rapid removal of the democratic political order and the destruction of the German labour movement could be felt in the cities as well as the countryside. Similarly, in healthcare institutions changes of staff took place on the management level. In the Landes-Heil- und Pflegeanstalt Uchtspringe (Uchtspringe State Asylum) in the Prussian Province of Saxony the National Socialists abruptly ended the appointment of the leading consultant for psychiatry Heinrich Bernhard (1893–1945). The parliament of the province decided to dismiss the practising Jew and Social Democrat based on the recently enacted Gesetz zur Wiederherstellung des Berufsbeamtentums (a law for the restoration of the professional civil service). [3] Bernhard was murdered in 1945 in a concentration camp. His fate is representative of many other Jewish doctors during the time of National Socialism.

In 2017 the medical historian Annette Hinz-Wessels published an article on Bernhard [4] in which she also describes the circumstances of his deposition in 1933. Bernhard who had been the head of the asylum in Uchtspringe since 1929, was accused of having preferentially hired staff with Marxist convictions. Furthermore he was supposed to have misused his professional role to invite both personnel and patients to become members of the Sozialdemokratische Partei Deutschlands (SPD) (Social Democratic Party of Germany) and the union Verband der Gemeinde- und Staatsarbeiter (VGS) (Association of Municipal and State Workers). His behaviour was one of the reasons, according to his accusers, that the asylum was also nicknamed “Red Uchtspringe”. [5]

Hinz-Wessels does not mention in her article that while the proceedings to dismiss Bernhard were under way, three orderlies and four nurses were also let go from the asylum due to engaging in union activities. [6] The report states that the nursing staff had largely been Marxist in attitude and organisation in the past. It attributes the responsibility for this to a few agitators and continues that these had to be removed today in order to rule out further Marxist influence on nursing staff in the future if possible. [7]

The accusations against Bernhard and the nursing staff were based on interviews that the National Socialists conducted among the doctors, administrative staff and nurses at Uchtspringe. At the time of the interviews both the respondents and the accused had already experienced the violent events of the National Socialists’ assumption of power. Yet while the interview transcripts as a historical source must be regarded with due caution, they depict an unusual image of psychiatric care.

At the beginning of the 20th century when the system of psychiatric institutions in the German Reich underwent a founding boom and was largely put under the control of the authorities, the nurses of the “insane” were regarded as uneducated, crude and hardly organised in terms of unionisation. We can deduce this much from the debates between psychiatrists and politicians about the issue of nursing assistants around 1900. [8] Other sources – mainly written by both orderlies and nurses themselves – are rare for the time period in question. Yet, this is only one possible explanation for the blind spot that existed for a long time in the historiography. Rather, the prejudices – prevalent to this day – about nursing in general and psychiatric care in particular [9] are the reason for the limited research that has been conducted on the engagement of mental health care workers in vocational policy matters. Even though newer studies in the history of nursing contradict the prejudices, in the public eye in the German speaking countries in Europe, members of the nursing professions are still considered as uncritical and apolitical. In contrast to doctors they supposedly would not fight for their own professional interests on a larger scale. “To let nursing speak and decide for itself is still unusual and the nurses themselves hardly demand to have their say.” [10]

2. Objective and Sources

The history of nursing focussed for a long time on those women who worked in general nursing care, in particular on sisters of religious orders and communities and on those nurses who worked on battlefields. In addition, so-called “elite nurses” who pushed within nursing associations for a more academic approach to nursing care, were early subjects of historical studies. This angle manifested the image of female nursing even further. [11] Psychiatric care tended to be overlooked in the histories of nursing and psychiatry which only changed a few decades ago. The reason was that the staff consisted to a large part of attendants and carers who had not been formally trained. In addition, psychiatric institutions have provided a substantial area of work for men in nursing.

Only in the last three decades have nurses who did not serve in denominational sisterhoods but worked as professional nurses become increasingly noticed for their contribution to shaping a heterogeneous landscape of psychiatric nursing in Europe. [12] In addition, various unions have been analysed more closely either as traditional representatives of the “nursing proletariat” or because of their contribution to the professionalisation of psychiatric care in Europe. [13] The researchers focussed here mainly on full-time trade union officials that included some former psychiatric nurses. However, nursing historians are also increasingly focusing on the involvement of psychiatric nurses at the grassroots level in professional associations and trade unions. Such work specifically focuses on the self-perception and perception others had of the nurses involved. One example is Barbara Douglas’ publication from 2015 on the impact of the National Asylum Workers’ Union (NAWU) in the United Kingdom. Drawing on narratives by nurses and attendants Douglas recreates the reform processes of psychiatric care that culminated in the implementation of the Mental Treatment Act in 1930. [14]

This present work sheds light on psychiatric nurses’ early ventures into union work in the German Reich and the Weimar Republic. My subjects are selected nurses from the former Uchtspringe state asylum during the period from the opening of the institution in 1894 and the seizure of power by the National Socialists in 1933. Which issues did these nurses put on the agenda for union activities? What shape did their commitment take within the highly hierarchically organised psychiatric institution? How did colleagues and superiors react to their endeavours? How did the collaboration with officers at the trade union headquarters and the administration at the provincial level evolve? How important was the gender of the specific participants? Using the example of Uchtspringe in the context of changing management and political systems I will reconstruct the conditions, circumstances and boundaries a union involvement of “nurses of the insane” entailed during the aforementioned time period.

I expanded the corpus of my sources (the interrogation of transcripts from 1933) with further files from the Provincial Administration, including staff and complaint files, reports from the inspection commission that had been established by the province, and annual reports of the asylum. Another, very special, source is Die Irrenpflege [15], the first monthly journal for mental and nursing care for the instruction and further training of nursing staff to be published in the German speaking countries. It was first published by Konrad Alt (1861–1922) in 1897. [16] Alt was the first and long-time director of the Uchtspringe asylum. [17] In the articles of Irrenpflege not only doctors, economists and educators from many different institutions but for the first time also nurses themselves got a chance to have their say. For the time period of the Weimar Republic I further cite articles from the trade union journal Die Sanitätswarte (Paramedic Guardian), published from 1901 to 1932 as the trade union organ of the Reichssektion Gesundheitswesen (RG) (Empire Health Services Branch) in the VGS. In particular the reports of the local meetings of the RG that were published in Sanitätswarte attracted my attention.

3. The Vocational Policy Landscape of Nursing at the Beginning of the 20th Century

For some time psychiatric care remained untouched by the developments that occurred in general nursing care. “For long periods of time the conditions in psychiatric institutions were different for the staff which consisted in the German speaking countries – and for longer periods than in general hospitals – often of untrained or semi-trained attendants.” [18] Furthermore the proportion of men working as nurses in psychiatry had always been quite high. The general assumption that the attendants belonged to the working class and were thus not very politically involved proves problematic. [19] Indeed, Anja Faber was able to contradict the common prejudice on the social origins of “nurses of the insane” as being lower class in her analysis of the carers of the Illenau asylum in Baden. [20] In 1906 the State of Prussia had issued Regulations on the State Examination of Nursing Personnel for general nurses, while nurses of the “insane” were completely excluded from them for a long time. There is evidence that the Kingdom of Saxony [21] was an exception. Here a systematic, binding training of psychiatric nursing staff was already centralised and organised by the state in 1888. [22] In the remaining areas of the Empire, the following rule continued to apply for nurses of the “insane”: “Since this was not a recognised profession, the staff was subject to the (Prussian) Servants’ Law that included compulsory board and lodging at the institutions.” [23] This Servants’ Law, in place in the German Empire longer than in other Western countries, regulated the legal situation of servants, among others. It was characterised by the disparity between the rights of the employees and those of the employers. For instance, the servants could be let go without adhering to a notice period, servants were forced to live in celibacy and banned from organising. Thus the servants were denied the opportunity to found and join trade unions and employee organisations. [24] However, the reach of the Servants’ Law cannot be clearly established for nursing staff because there are no reliable figures as to how many nurses were indeed subject to it. [25] Nursing staff who were civil servants, such as the senior nurses and nurses in wards of public institutions, had limited freedom to organise because they were stripped of the right to go on strike. [26]

At least for the orderlies, professional celibacy required in the state institutions was slowly abolished. The low wages, however, made it impossible for married nurses to raise a family. There was a lot of turnover among the staff. The situation became even more precarious when around 1900 the institutions were increasingly over-crowded, new labour and nursing-intensive therapies such as the bed and bath treatments were introduced [27] and nurses drifted increasingly towards more attractive occupations. The issue of nursing assistants was discussed in the German Reichstag as part of the “social issue”. [28]

At the same time numerous professional associations and trade unions were founded in the German Empire that claimed to represent the nurses. The two largest nursing organisations around 1900 were the nurses of the denominational motherhouse organisations. [29] Here the nurses did not represent themselves but “clergymen negotiated on behalf of nurses”. [30] Before World War I no fewer than three competing organisations were founded to represent nurses from middle-class backgrounds: the Evangelischer Diakonieverein (Protestant Diaconia), the Rot-Kreuz-Schwestern (Nurses of the Red Cross) and the association Agnes Karll (1868-1927) founded in 1903 titled Berufsorganisation der Krankenpflegerinnen Deutschlands (BOKD) (Professional Organisation of Female Nurses in Germany). [31] The BOKD was supported by the middle-class women’s movement and it was the only association of nurses that demanded a thorough programme for professionalisation following the Anglo-American model. [32] They did not want to leave the regulation and development of nursing to strangers of the profession. [33] Furthermore access to the nursing profession was supposed to be strictly regimented and nursing was supposed to become an academic profession by introducing university courses. [34] Orderlies were prohibited from joining the BOKD. Overall the political influence of this professional association was weak as the BOKD was not represented in any political decision-making body. [35]

Just as the bourgeois female nurses failed in establishing a unified representation of interests, so too did the male and female asylum attendants. In 1900 two unionised organisations were established that targeted this group. In 1903 the Christian-oriented Deutscher Verband der Krankenpfleger und Krankenpflegerinnen (German Association of Orderlies and Nurses) was founded, later to be called the Streiter-Verband (Streiter Association) after one of its chairmen. This association strove for a relative autonomy of political parties and churches. Georg Streiter (1884–1945) urged the development of the profession of nurse from a “transient job to a profession for life”. [36] To achieve this goal he demanded improvements to the economic and social situation of professional nursing, ensure a regulated training of nurses and the expansion of the involvement of women in Christian unions. The Streiter-Verband was outspoken against socialism and communism and declared that a strike was a justified means only during the initial years of the unions’ fights. [37] By 1909 the organisation had reached a size of 1,400 members. Nonetheless it could only indirectly, i.e. through lobbying, influence the legislation – comparable to other trade unions in the German Empire. The political activities of the organisation focused mainly on discrediting the competing VGS. [38]

In the VGS which was close to the Social Democratic Party, the nurses also represented themselves. Founded in 1895 by Berlin gas workers of the local plants, the organisation initially developed into an organ of the male nursing attendants. [39] The Reichssektion Gesundheitswesen (RG) (Empire Health Services Branch) was founded as a subgroup of the VGS. It represented all healthcare workers. [40] Like the Streiter-Verband the VGS made the case for recognising nursing of the “insane” as an integral part of nursing care. [41] To counter a further fragmentation of nursing, the VGS suggested that all future nurses should complete a common basic training for one year and specialise afterwards. [42] However, the VGS also favoured opinions that were clearly opposed to a professionalisation of nursing. For instance, nursing was supposed to remain an auxiliary medical profession (hierarchically below the doctors), and doctors were supposed to maintain their responsibility for the examination and hiring of nurses. [43] Contentious ideas concerning more academic approaches to, and for the self-administration of, nursing were vehemently combated. “It would have contradicted the idea of a unified working class and hence it went against the socialist attitude of the unions.” [44] Until the beginning of World War I the Prussian Government successfully fended off the social-political demands of the VGS. One contributing factor here was also a lack of sympathy between the “proletarian” VGS and the “bourgeois” doctors which was absent in the Streiter-Verband. [45]

With the beginning of World War I the work of the numerous unions that nurses organised stopped because many members were drafted into military service. Only the abolition of the monarchy and the major radical social changes that accompanied it facilitated the strengthening of the trade unions in Germany. As a result of the November Revolution from 1918, unions were recognised as representatives of employees both by law and through contracts with employers. The Servants’ Law was abolished and the complete right to organise and assemble was announced. From 1918 the Reichssektion Gesundheitswesen (RG) became the largest subgroup of the VGS. It quickly evolved into the healthcare organisation with the most members in the Weimar Republic. [46]

In 1918 civil servants were given for the first time the unrestricted right to organise including the right to strike. Immediately the Deutscher Beamtenbund (DBB) (German Association of Civil Servants) was founded as an umbrella organisation of unions for civil servants and teachers. At the beginning of the Weimar Republic, the DBB managed to enshrine the interests of its members in the new constitution mainly because of the integration of its leaders in political parties. As a result of the subsequent restorative tendencies, the right to strike was withdrawn from civil servants again in 1922. [47] Both the Bund der höheren Beamten (Association of Higher Officials) and those civil servants who were more oriented towards “free” unions left the DBB at the beginning of the 1920s and formed their own umbrella organisations. After the fusion with the branches for civil servants of the Christian unions (1926) and the liberal trade unions (1928) the DBB comprised two thirds of all people organised in unions for civil servants. [48]

Before discussing how the nurses at Uchtspringe were organised in unions, I begin with a description of the state asylum.

4. “Pioneers for the Less Restrained Treatment of the Insane” – Nursing staff at the Uchtspringe Asylum

The institutional landscape of psychiatric care at the beginning of the 20th century in Prussia was decisively shaped by the Law on Extended Care of the Poor (Gesetz über die erweiterte Armenpflege) of 11 July 1891. This law made the “preservation, cure and care of the mentally ill people who required help, idiots and epileptics, the deaf and blind” obligatory. Before then this care had been optional. The public duty of care was explicitly defined as care in an asylum. [49] Because of that a large proportion of this group of patients was hospitalised and put under state supervision. [50] In 1894, Landes-Heil- und Pflegeanstalt Uchtspringe opened as the “first link in the chain of large newly founded institutions” of Prussia. [51] It was answerable to the Provincial self-administration of the Provincial Association whose executing bodies were the Provincial Governor and the Provincial Committee. [52] Uchtspringe was set up in the rural area of the Altmark to provide treatment, schooling and occupational therapy for approximately 500, later 1000 “epileptics”, “epileptic lunatics”, “idiots” and “mentally deranged people”. About one-forth of the patients were children and adolescents. [53] Uchtspringe gained model status for the whole of Europe by successfully implementing both the concept of the “agricultural colony” to grow its own supplies and the “doctor-supervised foster family care”, an approach that had already been demanded in 1867 by the German reform psychiatrist Wilhelm Griesinger (1817–1868). [54] Furthermore, the first head of the institution, the psychiatrist Professor Dr Konrad Alt, was highly committed to experimental and clinical research and pathological anatomy. [55]

To master the numerous tasks at the institutions, it became necessary to train dedicated permanent staff and provide them with special skills. The institution’s compound with its buildings in pavilion style was divided by gender into two areas. Orderlies cared for the male patients while the nurses were entrusted with the care of female patients and children. The role of head nurse was open to both orderlies and female nurses. [56] The nursing staff at Uchtspringe consisted almost completely of “free” orderlies and nurses. [57] Preferred employees were former servicemen and craftsmen. The nurses served as foremen in the numerous workshops at the institution and at the agricultural farm that belonged to it. They were also “pioneers of foster family care” using so-called “attendant villages” [58] in direct proximity to the asylum. Furthermore, the nursing staff at Uchtspringe was decidedly involved in the documentation and implementation of interventions during events that were interpreted as epileptic seizures, and into the implementation of new somatic therapies and clinical trials. The staff received specific training to that purpose within the institution. [59] Konrad Alt also introduced financial incentives and improvements in nurses’ work and life conditions, including an increase of nursing staff to such an extent that one nurse looked after only seven patients. This also paved the way for the introduction of night shifts and paid holidays. [60] In addition, beneficial for the development of staff were the provisions for the state asylums of the Province of Saxony which came into effect in 1908 and provided significantly higher salary rates and entitlement to earlier retirement for the entire nursing personnel. Nurses were granted the status of civil servant after only ten years of service. [61]

5. Only with the Aid of the Medical Gentlemen – Uchtspringe’s Call to Found an Association

By 1899 the asylum already consisted of 15 buildings with 870 beds, and the staff consisted of “among others nine junior doctors, 73 (trained) orderlies and 53 nurses and 16 (non-trained) male attendants and 15 female attendants”. [62] Alt worked his entire life to “elevate” the position of the nursing attendants. Accordingly, he started the aforementioned journal Die Irrenpflege (Nursing of the Insane) that he edited until 1902 and for which he wrote numerous articles himself. Yet, as much as Alt gave impulses for a professionalisation of psychiatric care through qualifications linked to the institution, he was just as much interested in preserving the hierarchy within the asylum. The director was very keen to keep the power of control over the nursing staff entirely to himself. This patron-like relationship to nursing is also reflected in the early editions of the journal Irrenpflege. [63] In this publication in 1901 an orderly wrote: “We do have a journal that represents our interests, we are allowed, thanks to the honourable editor, to share our opinion in it [...].” In line with Alt the author declared with respect to the foundation of a professional organisation: “I want to issue a warning against illusions: only an association with a director of an asylum as its head can help us [,] today’s nursing staff can never by itself think of acting independently.” [64]

Two years later, in 1903, the Uchtspringe nurse Hans Gattringer called for the foundation of an association for psychiatric nurses. According to Gattringer the new organisation was supposed to promote “specialist training”, “socialising” and networking as well as the fight for a base salary and the creation of retirement and benefit funds. He also favoured an arbitration court consisting of experienced directors, a lawyer and an electable committee consisting of orderlies and nurses with an impeccable record of at least ten years of service that was to act impartially in difficult situations – similar to trade courts. [65] Gattringer’s call for the foundation of an association was only successful in Silesia. Between 1903 and 1908 Irrenpflege also served as the mouthpiece of the Verein schlesischer Irrenpfleger (Association of Silesian Nurses of the Insane). [66]

6. Acting in Secrecy – Uchtspringe Nurses in the Streiter-Verband

Not all nurses in Uchtspringe followed the well-meaning advice with respect to the relationship of nurses of the “insane” and trade unions. Thus, in 1905 it emerged for the first time that some of them were members of the Christian Deutscher Verband der Krankenpfleger und Krankenpflegerinnen (German Association of Orderlies and Nurses) that had been founded two years earlier. Georg Streiter asked the staff at Uchtspringe in a letter to keep their membership in the Christian union a secret and to report complaints about superiors directly to him:

Everyone should act as if they do not belong to the association. We will achieve much more than, as happened in some instances, when some would go wild and damage our reputation. That said I do not want to imply that everyone should act as if they were asleep. All supposed injustices can still be reported to me; but be calm towards your superiors. Rather swallow it and write it down for me instead of kicking up a row [...]. [67]

What was the possible strategy behind this request? At this point in time Streiter was probably still working as an orderly himself, yet he was also acting as honorary manager of the association and editor of its newsletter. [68] The letter certainly served to avoid tainting the reputation of the young association by imprudent actions of individual members. Simultaneously, by asking the nurses and orderlies to bypass the official complaint channels, i.e. writing to the Provincial Administration, Streiter offered himself as a new confidante to the members with whom they should share their issues. This helped him to collect valuable, “unfiltered” information about the working and living conditions of nurses in the institutions and to use it later in the interests of the association.

However, Streiter’s letter to the members in Uchtspringe fell into the hands of the asylum’s directors. The director of Uchtspringe and the governor of the Province could not tolerate meddling with the internal matters of the institution. [69] Those nurses who were exposed as members of the association were dismissed. The staff rules at Uchtspringe were supplemented with the phrase “that membership of associations that interfere with the interior matters of the institution’s administration is not compatible with discipline at the institution”. [70] Yet, only two years later, in 1907, a large number of nurses was dismissed again “merely because of their membership of association”. [71] Streiter who in the same year became the full-time chairman, manager and editor in the central office of the association in Berlin, complained to the governor. After the governor swiftly dismissed his complaint, Streiter turned to the local press and denounced in his article how the personal freedom of the personnel in Uchtspringe was curtailed by measures such as the censorship of letters addressed to the nursing staff. [72]

In 1910 Streiter published his book “Die wirtschaftliche und soziale Lage des Krankenpflegepersonals in Deutschland” (“The Economic and Social Situation of Nursing Staff in Germany”) that was later revised and repeatedly reprinted and is regarded as the first academic book on German nursing care. Among Social Democrats there was approval of the study since it was at this time an unparalleled collection of data for the German speaking countries. [73] It was based on publicly accessible sources but also on Streiter’s interviews with nurses and orderlies that had partially been conducted in secrecy as the example in Uchtspringe illustrates. One year after the publication Streiter travelled to various asylums, and as an official of the association, negotiated the working conditions of the nursing staff with the administrations. [74] No evidence of such a visit can be found for Uchtspringe which is not surprising given the previous history. Instead another agent became significant for the trade union representation of Uchtspringe’s nursing staff. From 1919 the VGS decisively shaped the vocational commitment of nurses and orderlies in all state asylums of the Prussian Province of Saxony. This is the topic of the next section.

7. The Foundation of the Uchtspringe Chapter of the Empire Health Services Branch in the Association of Municipal and State Workers

During the time from 1918 to 1933 the RG contributed to essential improvements of the working and living conditions, in particular for psychiatric nurses. Even though their demand for a one-year common training in nursing with a subsequent specialisation was not implemented and nursing became even more divided, the nursing attendants now had the opportunity to sit a state exam. The RG succeeded in obtaining social benefits for their members. [75] Even though compulsory board and lodging was abolished, in most cases unmarried nurses and orderlies continued to live in the institutions. Here, collective bargaining agreements could certainly accomplish improvements, even if they did not reach all – and in nearly all cases only the public – institutions. The same applied to regulations on working hours, payment of overtime and sick-pay. [76]

When during the 1920s occupational therapy was increasingly used in the treatment of mental patients, this also changed the everyday working routine of the nursing staff. Both the VGS and the Streiter-Verband took this as an occasion “to bring about a social and economic betterment for themselves and – pointing to the argument of an increased risk of accidents [...] – admittance to the accident insurance of the Empire from which [nurses and orderlies] had so far been excluded.” [77] Many positive reforms for the nursing staff had their origin during the Weimar Republic in Prussia. For the RG it was beneficial that, until 1932, the Social Democrats had continuously led the Prussian state government. [78]

I will now take a closer look at the trade union commitment to the RG by the nurses and orderlies at Uchtspringe. Central to my analysis is the ward orderly August Karl Barth (1879–?) who was found guilty in 1933 by the National Socialists of having been the “soul of the social-democratically-minded nursing staff in Uchtspringe”. [79] His commitment to the trade union and politics can be traced in the sources from 1919. Throughout the entire period of the Weimar Republic, and against the background of changing management of the staff and the political and economic turmoil throughout Germany, he succeeded in making a name for himself as an important representative of the Uchtspringe staff. But when the National Socialists seized power, he was branded as a “politically unreliable orderly” and was removed from his job.

Barth was by far not the only orderly at Uchtspringe who took a stand for his own profession. However, because of his superior role and his work within and outside the asylum, the source material on him is extensive and multi-faceted. The multiple sources such as Barth’s correspondence with the management of the institution and the Provincial Administration, reports of meetings of the Uchtspringe branch of the RG, newspaper articles and interrogation transcripts allow us to approach this person from different perspectives.

In 1901, as a 22 year-old, he began to work as an orderly at Uchtspringe. During the following three decades he developed into a person who sought to gradually expand his sphere of influence within the institution and who decisively helped to shape the future of the institution. From his personal file we learn that Barth, after ten years of service, was entitled to a retirement pension and a notice period of three months. Only one year later he was hired for life. He married and had four children with his wife. The file notes further that he worked as a ward orderly in a villa with forty male patients. [80] In his apartment in the nearby “attendant village” he and his wife housed three additional wards which the family looked after. During this time Barth repeatedly had arguments with the management of the institution, the Provincial Administration and both his female and male colleagues. At times, he openly opposed the instructions of the management. He was repeatedly accused by Alt and other doctors of being a “neurasthenic”, a “troublemaker” and an “informer”. [81] Nonetheless Barth managed to hold important positions within the nursing hierarchy of the institution.

We cannot determine whether Barth was already involved in (vocational) political activities before WWI began. It became only possible for the staff of public asylums to openly show their commitment after the November Revolution. When in December 1918 the government of the Empire made workers’ committees obligatory, including in general and mental hospitals, and considerably increased the scope of the tasks of the committees, Barth put himself forward as the representative of the Uchtspringe personnel, consisting of more than 150 civil servants and employees. [82] Around the same time, Barth became a member of the SPD. On 18 February 1919 he founded the local chapter of the RG in the VGS at Uchtspringe, whose chairman he was since that time. Uchtspringe was thus the third state “insane” asylum of the Prussian Province of Saxony that dared to become affiliated to the VGS. [83]

Initially many nurses and orderlies euphorically welcomed this step. They cherished a hope that, with the help of union officials, they would be able to force through their demands to the Provincial Administration for higher pay, training and better working and living conditions. The first Uchtspringe meetings were always well attended and took place at the Society House of the institution. Often the union officials of the RG took part. They had an open ear for complaints from the staff, informed members of their rights and called for a unified course of action by all employees in the interests of the labour movement. In particular, the most important concern of the local chapter in Uchtspringe was set as the implementation of a legally-required eight-hour workday, as this had not yet happened at the institution: “The organisation has to take vigorous action here. The same applies to the complaints about the living, wage, and holiday conditions.” [84] As a solution to these problems they looked to a collective wage contract for all state institutions in the Province of Saxony. [85]

Yet not all members of staff at Uchtspringe liked the affiliation with the RG and opposition grew, especially among those employees who had civil servant status. As an immediate consequence the Gauleitung (regional leadership) of the RG was asked to take action. The RG addressed the management and initially it seemed that they were successful. In his response to the board of the union Alt expressly acknowledged the staff members’ right to organise and disapproved of “senior nurses etc. who put pressure on their subordinates because they belonged to the association.” [86] In return, together with the secretary of RG in Berlin and editor of the Sanitätswarte, Georg Renner (1881–1962) [87], Barth asked the union members to “engage in a friendly manner with the non-organised colleagues because only through congenial behaviour we can win over those who are distant to the association.” [88]

In July 1919 in the neighbouring asylum, Nietleben, the long awaited collective bargaining finally took place. Representatives of the staff from all state institutions of the Prussian Province of Saxony took part in the negotiations. Directors, consultants, the senior nursing staff at Nietleben, and the representatives of the respective workers’ committees were present, “but also the newly established association of civil servants had sent a ‘silent’ participant.” [89] Initially, the Provincial Administration denied entry to the two RG Gauleiter (regional leaders) who had travelled from Magdeburg and Leipzig. Only hours later, after the entire staff of Nietleben had walked out in protest, the two leaders were admitted to participate in the negotiations. The results of the talks were sobering: instead of the eight-hour day and 48 hour working week, only a 56 hour working week was agreed and a single cost of living bonus proposed for the entire staff. [90]

The expectations of Barth in his double function as head of the RG branch and simultaneous representative of the entire Uchtspringe staff had been high. He was well aware of his negotiating role between Provincial Administration, management and staff. In a letter to the governor he wrote: “With the best intentions I have tried to present the […] contract that had been agreed with the local staff in a way to avoid any bad feeling and friction.” It is surprising that Barth wrote: “In general contentment prevailed.” [91] Surely, this was more wishful thinking than a reflection of the reality. [92] In his dealings with the Provincial Administration it was important, however, that he presented himself as a staff representative capable of negotiating but loyal to the authorities. Barth stated “that in a hospital, more than in any other organisation, order and discipline are essential.” [93] At the same time Barth tried to remove staff members from Uchtspringe who held different political views. While the director of the institution was on a three-month holiday, Barth tried to get rid of a disagreeable colleague, the ward orderly Theuerkauf, by accusing him of abusing a patient. [94]

Yet, Alt was not idle during his absence from Uchtspringe. In September 1919 he attended a conference of the Empire’s Ministry for Work during which the introduction of an eight-hour workday was discussed. Various representatives of the employees and employers and the Prussian Department of Medicine had been invited to the talks. Furthermore, representatives of the newly founded Bund der Oberpflegerschaft Preußens (Association of Senior Nurses and Orderlies in Prussia) were also present. This association acted ambivalently towards the VGS and sought to join the DBB. [95] The Sanitätswarte commented that the director at Uchtspringe declared “with all the pathos at his disposal […] ‘The day when the eight-hour workday is introduced in medical institutions is the day when orderly, humane nursing care dies.’” [96]

The opposition of the doctors, administration and competing nursing associations towards the efforts of the RG could be felt in the entire country. [97] The RG lamented that the provincial administrations especially in rural areas had shown little understanding for the implementation of the new legal regulations: “Out in the countryside where the asylums are mostly located, one is desperately trying to uphold the old order. [...] Where they cannot achieve their goals with force, they try to breed discord among the staff.” [98]

At the end of 1919 the Uchtspringe branch sent Barth to the third conference of the RG in Jena. This meeting included more than one hundred attendees including the authorities such as the Empire’s Ministry of Work. Under the newly elected head of the RG central office, Paul Schulz (1873–1953), the programmatic groundwork, in particular in the areas of training and examinations, was outlined and a resolution was passed against the preliminary version of a law on the working hours of nurses and orderlies, which had been drafted by the Empire’s Ministry of Work. Barth was one of very few delegates, who were mentioned by name in the minutes of the meeting. This suggests that even at major events like this one he was not afraid to draw attention to himself. [99]

At the first anniversary of the Uchtspringe branch of the RG, Barth tried to interpret the few concessions the administration made during the bargaining sessions as important steps on the way to a better professional life. He said to the members of the association: “We remember the amazing progress in bringing relief to the work in general. Sleeping among the patients has been abolished and, compared to before, the freedom of the individual is like day against night.” [100] However, not everyone was convinced by his words. One colleague who had quit the union questioned Barth’s leadership position. He wrote: “As a member of an association I demand that the job is done well – or not at all [...].” [101] The local chapter in Uchtspringe attempted to find additional members predominantly among the female nursing staff. For that reason, in the spring of 1920 Marie Friedrich-Schulz (1878–1967) was invited as a speaker. [102] The new secretary of the Berlin headquarters was known for her “sharp tongue”. [103] The Uchtspringe board of the RG adopted an increasingly harsh tone against competing associations: “It is time to draw a clear line between us and our opponents.” [104]

In 1920 a new body entered the structure of the advocacy across the German Reich: the Work Council. In contrast to previous regulations the say of the employees during hiring and dismissal procedures was significantly increased, but while the Work Council also had the right to look at the books and accounts, interfering with management was not allowed. The law also made it possible to merge individual Work Councils from several similar companies into a general Work Council to simplify negotiations. However, the double loyalty required – towards both the employees and the employers – prevented the Work Council from developing into a clear advocacy group for the employees. [105] “This was the beginning of a tension that has been continuing to this day between trade unions which pursued higher interests and Work Councils that pursued mainly the interests of an individual company.” [106] During the election of the first Work Council in Uchtspringe, the RG was able to gain six out of the available seven seats. [107] Later a central Work Council for all state asylums and homes for the blind in the Province of Saxony was founded. In the spring of 1921 between 80 and 85 percent of the members of staff in all institutions in the Province of Saxony were members of the RG. [108]

At the same time, after nearly three decades, Konrad Alt stepped down from his office as director of the institution due to illness. His successor was the psychiatrist Hermann Bockhorn, who had been a senior physician in the nearby institution at Nietleben until then. [109] In the subsequent period the board of the RG branch wanted to strengthen the union's influence in negotiations with the Provincial Administration. Barth still lamented that representatives of the RG branch had not been invited to the negotiations on the salary scales for the second time since it had come into existence. Now, after the national-conservative Kurt Freiherr von Wilmowsky (1850–1941) stepped down as long-time governor of the Province, the hope was that things would improve. [110] He was succeeded by the left-liberal politician Erhard Hübener (1881–1958). [111]

8. “Red Uchtspringe”

Without doubt the good train connection between the institution at Uchtspringe and both the capital Berlin and capital of the Province Magdeburg aided the pro-union efforts of the nursing staff. During the Weimar Republic the Social Democrats coined the name “Red City in the Red State” for Magdeburg. In 1922, the 9th Conference of the Federation of “Free” Trade Unions was held here. [112] In 1924 the Reichsbanner (Empire’s Banner) was founded here – a political military association that was meant to protect the Weimar Republic from its radical enemies. [113] Again, it was in Magdeburg where the SPD celebrated its party convention in 1929. “The healthcare system in Magdeburg that was established during the Weimar Republic had model character, and not only from today’s perspective. It was characterised by innovation and was clearly influenced by social-democratic ideas. [...] [This was] largely initiated and encouraged by the first Social Democratic mayor of the city, Hermann Beims (1863–1931).” [114]

There are numerous documents that illustrate how the nurses and orderlies at the state institutions and homes for the blind in the Province of Saxony were in contact with union officials in Magdeburg. [115] In addition staff representatives were well connected with each other through the common central Work Council. Because the Uchtspringe orderly Barth enjoyed the trust of his colleagues he was elected in June 1924 as one of three representatives to the central Work Council of the Province of Saxony. [116] During the subsequent years Barth managed to expand his position of union leader even more. Until the end of the Weimar Republic he was re-elected each time as the head of the RG branch at Uchtspringe and as member of the Work Council. In addition, he continued to maintain a lively exchange with the RG head-office in Berlin and the regional leaders of the cities of Middle Germany. At the nationwide RG conferences he made sure to share his opinions during the discussion sessions. [117] He moved not only in union circles but was also well connected within the SPD, which he had been a member of since 1919 and had served as its local community representative. In 1924 he joined the Reichsbanner. [118]

The Uchtspringe RG branch could celebrate the success of having received state recognition of the nursing staff of the Uchtspringe asylum in 1922. [119] In 1927 the application of the RG branch boards to introduce a standardised uniform and protective gear in all institutions of the Province of Saxony was finally implemented. The Provincial Administration committed itself to reimburse half of the costs incurred. [120] Despite the remarkable impressive network of staff representatives, the RG clearly did not succeed at all times to push through the desires of union members during the tough negotiations with the Provincial Administration. In order to weather certain political hard times, taking recourse to a trade union culture that was already well established was probably helpful. Festivities that were celebrated together, libraries, choirs, sports clubs and music organisations created space for gatherings. The boards of the RG branches supported their members’ efforts to create symbols and practices that promoted identification with the association. [121] [Fig. 1: Brooch of the Reichssektion Gesundheitswesen in the Verband der Gemeinde- und Staatsarbeiter before 1933]

The institutions of the Province of Saxony were hit especially hard by the decision of the Provincial Committee in 1924 to dramatically reduce staff. The number of nurses and orderlies was supposed to be reduced by a quarter. In a way this corresponded to the situation before the war. The remaining staff was supposed to make up for the resulting loss of work force. [122] Union officials of the RG tried to oppose this. In May 1925 Barth and the regional leader from Magdeburg had “announced the justification of their demands in the salary committee in a number of meetings of the delegates” at the Saxon Provincial Landtag, [123] initially without success. Yet, subsequently the RG managed to increase its political weight during the negotiations, after an internal reorganisation at the VGS, which established a “department for civil servants finally made it attractive for members of staff with civil servant status. Subsequently nearly the entire senior nursing staff at the provincial institutions sided with the VGS in 1926 and also joined the negotiations. [124] As a result of the negotiations, the number of layoffs was reduced from 219 to only 72 nurses and orderlies. [125] About 90 percent of the employees at the provincial institutions were now members of the VGS. [126] The staff representatives at all asylums and homes for the blind were now without exception VGS members. [127] The Sanitätswarte mocked the competing “dwarf organisation” of the DBB. [128]

Despite these successes the efforts of the RG-unionists during the Weimar Republic were often doomed to fail because the respective provincial committees had the final decision and in the whole country their members were largely nationalist-conservatives. For example, they blocked a standardised professional arrangement for the whole nursing staff at the provincial institutions. [129] In addition, the individual institutions differed so vastly in their conditions that “central actions” did not always seem possible. [130] The nurses at the Prussian asylums who were civil servants or about to become civil servants for the most part were particularly disadvantaged. With this status their working hours could be expanded to 60 per week. [131] At the same time because they were nursing staff they were not included in the Empire’s salary scale which meant they remained second class civil servants. [132] Not even the Great Depression of 1929 and the resulting mass unemployment moved the Provincial Administration to shorten the working hours in the institutions. [133] Instead, so-called “nurse-free wards” were introduced to save money where a dozen calm patients were looked after by a female or male patient, respectively. [134] Another dream which failed to materialise for the RG local branches was a common nursing school for the trainee staff at the institutions of the Province of Saxony. [135]

9. Silent comrades? – The Female Nurses in the RG Branch at Uchtspringe

In my previous descriptions I have nearly completely excluded the role of the female nursing staff at the state institutions of the Province of Saxony. This is not surprising because the reports by the RG branches that I studied are silent on this subject – or so it seems at a first glance. Yet, if we make the effort to “read between the lines” and find the gaps we discover next to the often quite vociferous orderlies that nurses were also involved in the vocational-political activities of the RG. They cannot have been entirely idle. After all the National Socialists wrote in their report in July 1933 “that due to the activities of some nurses nearly the entire female nursing staff at Uchtspringe had Marxist conviction and were largely also organised accordingly.” [136] Accusations that male and female colleagues made during the interrogations by the National Socialists against these female union members sound nearly identical to the accusations against their male comrades. This suggests that the nurses at Uchtspringe were just as active in their efforts at winning new members for the RG as their male counterparts. For instance, the report notes that “The ward nurse [Gertrud Cäcilia] Dassui advertised the state workers’ association during her working hours. [...] The evaluation and treatment of the nurses differed depending on their membership in the association.” [137] In the same vein, ward nurse Minna Franke was accused that she had “got trainee nurses out of bed to get them to visit social-democratic meetings.” [138] The ward nurse Käthe Flier was accused of having prevented patients from singing National Socialist songs and to have ripped off the swastika off the clothing of a female patient in the spring of 1933. [139]

Each of the three accused nurses had to fill in a questionnaire that was supposed to reveal which political party she belonged to and whether she was a member of a republican organisation. They show that Dassui, Franke and Flier had been members of the SPD for a few years until the end of 1932/beginning of 1933. The accused nurses reaffirmed their innocence, Dassui, for instance, stating:

Even though I have been a continuous member of this association since 1924, I only followed the key objective of the others. The representatives of the aforementioned organisation regularly negotiated with the Provincial Administration so that I could not detect a state or union organisation within this institution representing my economic concerns. [140]

Nurse Flier explained she was incapable of undertaking political work because of her gender: “As a woman I did not concern myself with politics, and hence I have never acted as an agitator.” [141] The new rulers were not convinced by this; the evidence seemed overwhelming:

In particular, I want to mention that during the police search of the house, Nurse Dassui [...] positioned herself next to the local policeman, smoked cigarettes and blew the smoke in his face [...]. During the house search fliers were found [...] that took a stance against the national government. [142]

The reports in the Sanitätswarte about the meetings of the RG branch at Uchtspringe at the time of the Weimar Republic mention nurses, if at all, only from the middle of the 1920s, and then only occasionally and only by name when they were elected as representatives of the Work Council. [143] Potential oral contributions that they made during the meetings have not been recorded. Neither could I find complaints to the Management or the Provincial Administration in which nurses complained about the conditions at the institution and that point to union activities.

In the higher levels of staff representation, female nurses are as difficult to find as a needle in a haystack. Instead women are mentioned in the reports of the RG branches mainly when negative issues are being discussed. Barth and other RG boards of the state institutions of the Province of Saxony repeatedly complained that the young trainee nurses were hardly interested in state training in psychiatric nursing. [144] Indeed, they would not understand the meaning of the “free” trade union. “They believed that the social services that they found here had always existed.” [145] The boards of the local branches thought that they could counter this by informing and thus warning the young colleagues about the working and living conditions of nurses of the “insane” before the time of unions. [146] Yet, only in 1931 Barth summarised: “Due to the intensive work of the officials it was possible to guide most of the female nurses towards the union.” [147]

Nevertheless the gender proportions of the members of the entire RG changed during the time of the Weimar Republic in favour of the women. The number of female comrades jumped up at the beginning of the 1920s before stabilising at a little more than half of all members. “This proportion is, however, rather low, given the proportion of 84% of women in the entire nursing staff,” as Ley points out. [148] The union officials were able to greatly increase the attractiveness of the VGS for female nursing staff against other associations and orders by founding a sisterhood within the RG. [149] This “free” union female nurses’ association received state recognition in 1929 including its uniform and badge. [150]

In parallel, the RG headquarters formulated its own “socialist ethics” of nursing. Against accusations by Christian nursing orders and the BOKD that the RG’s materialist demands would mean the end of nursing ethics, Georg Renner wrote in an editorial on Mayday of 1931 that a unified regulation of the best-possible training, moderate working hours and the appropriate payment of nurses would provide the necessary requirements for nurses or orderlies to act in accordance with ethical ideals. These ideals were to treat all patients equally, independent of their religious or party affiliations. [151] Furthermore the “free” unionist care regarded itself to be a part of the entire healthcare staff within the framework of a united workers’ movement.

So where does this seemingly silent existence at the base level of female nurses organised in unions come from? Is it only a result of the minutes of the meetings that were recorded by the male board members of the RG branches? One of the reasons for the possible rather passive membership of the female nurses within the local chapters of the RG could be the more restricted public mobility that women had in general at that time. Different break-time regulations, which clearly disadvantaged female nurses and prevented them from joining public meetings beyond the compound of the institution, were not uncommon – especially in the rural, isolated institutions of psychiatric care. [152] The working hour regulations pushed nurses to the limits of exhaustion and were even during the Weimar period noticeably tougher for female nurses than for their male colleagues. Hence, an active engagement in politics was made nearly impossible. Similarly, the interest of the young trainee female nurses in the training courses offered by the institution seems to have been small due to their extreme work load. [153] Thus it is even more unfortunate that some of the long-time senior female nurses fought against a shortening of the working hours because they feared their young colleagues would decline morally. [154]

In addition, we need to identify further reasons for the assumed silence of the female comrades, reasons that were inherent to the union itself. At least the RG headquarters were aware of the issue. The desired change from being the “mouthpiece of male orderlies” into a representation of both genders can be vividly reconstructed through the few illustrations that were printed in the Sanitätswarte. [Cf. the illustration for the 25th anniversary of the RG and the one for the 5th Empire conference of the RG, Fig. 2 and 3] The union officials demanded that “the numerically superior strength of the female members” should be considered when nominating candidates for the election of delegates at the Empire Conferences of the RG. [155] The result of the elections, however, painted a different image. In 1924, women gained only nine out of 55 available seats. [156]

Susanne Kreutzer has described similar, if not worse conditions for the proportion of female delegates in the successor organisation of the VGS after the end of World War II. According to Kreutzer, even at the beginning of the 1950s the life and work conditions of the “free” unionist female nurses were still defined by the ideal of a “labour of love”. This fundamentally differed from the other professions that the union represented. The leadership of the union declared female nurses to be a special case within the union organisation. As Kreutzer concluded, “The assigned special status resulted from the assumption of a ‘natural’ professional mentality [in female nurses] that nobody questioned and that demanded the ‘protection’ from the battling male organisation.” [157] The (self)-understanding of female nursing thus included not being able to stand up for one’s own interests, e.g. not being allowed to take part in strike actions because of a gender-specific perceived obligation towards the sick.

While female nurses were ethically superior to other female comrades, they were not perceived “as a serious competition for roles and influence within the union.” [158] Hence, it is not surprising, as Ley points out, “that the RG, despite its own demands for a gender-independent equal pay, was unable to remove its own gender-specific social injustice. In nearly all agreements, female nurses are more or less clearly disadvantaged.” [159]

10. Uchtspringe under the Leadership of a Professed Social Democrat

After the director of Uchtspringe, Hermann Bockhorn, retired in 1928, psychiatrist Dr Heinrich Bernhard was appointed on 1 April 1929 as head of the institution at the age of 35. This decision by the Provincial Parliament caused surprise because in contrast to his fellow applicants, Bernhard had no explicit experience in child and adolescent psychiatry. [160] Yet, Bernhard quickly worked his way into his new task and expanded the concepts of treatment and care that Alt had established.

That a professing Social Democrat took office was certainly a lucky coincidence for the local chapter of the RG at Uchtspringe. The board praised Bernhard’s lively interest in the continued training of his nursing staff. Accordingly, Bernhard conducted a four-week seminar with his nursing staff on “Guidelines of modern mental and medical care”. [161] The new director’s political disposition was also reflected in some of the reforms in the routines of the institution. Uchtspringe received free copies of the newspaper Volksstimme (The People’s Voice) that clearly positioned itself in the social-democratic spectrum. [162] Bernhard even agreed to a visit by a journalist of the Volksstimme. [163] Furthermore the Work group of carers at the care centres for alcoholics and other addicts in Berlin visited Uchtspringe. [164] Further visitors included the Workers' Samaritan Foundation and a social-democratic association of teachers. [165] In addition the Association of Socialist Doctors from Berlin held their 1930 conference in Uchtspringe. [166]

Bernhard’s ventures caused resentment among the national-conservative members of staff, who were organised into the Civil Servant Committee at Uchtspringe. In the summer of 1929, the inspecting committee of the Provincial Administration still offered praised during their visit:

Whereas previously, the final meeting with representatives of the civil servants and the staff would last a long time and reveal the strong tensions and misunderstandings between the Directorate and staff, this time the final meeting was pleasingly harmonious and was evidence of trust and joy of work! [167]

But, two years later, the report stated “that the relationship with the Civil Servant Committee was tense” [168], and towards the end of 1932, Bernhard was accused of redirecting state funds for party-political purposes: “The Civil Servant Committee uniformly believes that the director fails to manage his office in a manner as unpolitical and unbiased as is the case in other institutions.” [169]

Even though, at the beginning of the 1930s, nearly 90 percent of the staff at Uchtspringe were members of the RG, some departments of the institution remained for the VGS “white spots” on the map of the union. This included the department for curative and general education that had opened in Uchtspringe in 1927, consisted of eight buildings which could take a maximum of 500 “imbecile” children. While this department had modern equipment and stood for progressive medical and educational concepts, the majority of the staff were untrained nursing attendants, as the union paper critically remarked. “The managers of this department are supposedly opponents of the union and they watch like hawks that no union member works among them.” [170] The foremen of the workshops at Uchtspringe presumably did not join the RG either and found their representative in Herr Rossau, the national-conservative foreman of workshops at Uchtspringe. [171]

Furthermore, in 1932 a “badly concealed marsh plant of National Socialism”, as Barth sarcastically remarked, was forming under the guise of an allegedly politically neutral “social club”. [172] The anti-democratic military organisation Stahlhelm (Steel Helmet) also found a few supporters among the staff of the institution at Uchtspringe. Hence it is not surprising that representatives of these two groups were those who in 1933 strongly incriminated Bernhard and the former board member of the Uchtspringe RG branch during the National Socialist interrogations. The long-time ward orderly Theuerkauf who was previously mentioned also used the opportunity to express his long-cherished resentment against Barth. [173] Similarly, the orderly Paul Unger who himself was a RG comrade who was accused too, nevertheless incriminated the chairman of the RG branch. [174] Barth’s declaration of innocence could not help him at all. The final report said: “According to these statements the orderly Barth was an extremely damaging and particularly eager representative of Marxism.” [175] Together with other male and female comrades Barth had to submit to the new rulers and had to say good-bye to the Uchtspringe institution after 32 years of service. In the subsequent period, Uchtspringe became unfortunately famous as one of those state institutions responsible for numerous forced sterilisations and “euthanasia” killings of psychiatric patients and disabled persons in the Third Reich. [176]

11. Conclusion

In summary, we can say that until the ban on organising was lifted in 1918, the nursing staff of the Prussian Uchtspringe asylum were strictly forbidden to act independently of the institution's management within a trade union and were punished for such a membership with immediate dismissal. Nonetheless, there is evidence that a number of nurses and orderlies communicated regularly with Georg Streiter, the chairman of the Christian Deutscher Verband der Krankenpfleger und Krankenpflegerinnen (German Association of Nurses and Orderlies). Only after the end of the First World War and the political and social upheavals that went along with that did an open involvement in trade unions become possible at Uchtspringe. Together with the staff of other state asylums and institutions for the blind in the Province of Saxony, committed nursing staff formed a network of branches of the Reichssektion Gesundheitswesen (Empire Health Services Branch), an organisation within the Verband der Gemeinde- und Staatsarbeiter (Association of Municipal and State Workers) which had close ties to the Social Democratic Party (SPD). They received active support from full-time union officials of the RG. The good travel connections between Uchtspringe and the capital Berlin and the Provincial capital Magdeburg also proved helpful.

During the Weimar period, the RG managed to strengthen the influence of staff representatives vis-à-vis the management of both the institution and the Provincial Administration and to achieve further improvements, such as the state recognition of nursing staff and the introduction of work uniforms and protective clothing. Many additional demands of the RG failed due to the resistance of the largely national-conservative Provincial Administration that had the last word in any matter. In addition some local factors also undermined the RG’s achievements. Yet, the lines of conflict also ran amongst the nurses and orderlies themselves, as some of the senior staff that had civil servant status boycotted the progress of the RG for a long time. Neither side of the conflict was particularly squeamish when it came to choosing the means to get rid of a competitor of the other party. The Great Depression at the end of the 1920s aggravated the difficult working and living conditions in psychiatric institutional care even more and sounded the death knell of the Weimar Republic.

We have also seen that the term “Red Uchtspringe” did not only refer to the medical director and professed Social Democrat Heinrich Bernhard who began his work at Uchtspringe in 1929 but that it had its origins also in the fiery commitment of many nurses and orderlies at Uchtspringe to their leader, the ward orderly August Barth. As founder and chairman of the Uchtspringe RG branch, Barth shaped the “face” of the nursing staff’s union work in Uchtspringe during the entire Weimar period. However, the involvement of the female nurses in the local chapter in Uchtspringe remains largely unknown. Further research and the investigation of potential further sources are needed.

12. Bibliography

12.1. Primary Sources

12.1.1. Unprinted Sources

Landesarchiv Sachsen-Anhalt (LASA), Preußische Provinz Sachsen (1816–1944/45), Institutionen der provinziellen Selbstverwaltung, C 92 Provinzialverband (1701–1953):

no. 1262. Dienstliche Verhältnisse des Warte pp.-Personals bei den Landes-Heil- und Pflegeanstalten (vol. II) (1905–1919)

no. 2710. Dienstliche Verhältnisse der Beamten bei der Landesheilanstalt Uchtspringe (vol. II) (Feb 1920–Apr 1929)

no. 2715. Beschwerden über die Direktion und die Beamten der Landes-Heil- und Pflegeanstalt zu Uchtspringe (1895–1923)

no. 4395. Berichte über Besichtigungen der Landesheilanstalt, Stellungnahme der Anstaltsleitung (1929–1948)

no. 5278. Personal file Barth, August Karl (vol. I) (Oct 1911–Nov 1916)

no. 5312. Personal file Bernhard, Heinrich (vol. II) (1933)

no. 6649. Nazi-Gegner (Nazi opponent) (1933–1935)

no. 6653. Personal file Barth, August Karl (vol. II) (1933–34)

12.2. Printed Sources

B., F.: Unsere Verhandlungen bei der Landeshauptmannschaft in Merseburg. In: Sanitätswarte 19 (1919), 18, pp. 221–222.

F[lücht], H.: Die Dienstzeit in den Landes Heil- und Pflegeanstalten der Provinz Sachsen. In: Sanitätswarte 26 (1926 a), 10, pp. 171–173.

F[lücht], H.: Konferenz für die Beschäftigten der Provinzialanstalten der Provinz Sachsen. In: Sanitätswarte 26 (1926 b), 11, pp. 187–192.

Gattringer, Hans: Die Organisation des Krankenpflegepersonals. In: Die Irrenpflege 7 (1903/04), 2, pp. 43–45.

Gesetz zur Wiederherstellung des Berufsbeamtentums. In: Reichsgesetzblatt 1933, 1, no. 34, pp. 175–177.

Hartenstein, Kurt: Wo bleibt die Arbeitszeitverkürzung in den preuß. Heil- und Pflegeanstalten?. In: Sanitätswarte 31 (1931), 11, pp. 169–172.

Köhler, L.: Koalitionsrecht. In: Lueger, Otto (ed.): Lexikon der gesamten Technik und ihrer Hilfswissenschaften (5). Stuttgart/Leipzig 1907, pp. 532–533.

Laehr, Heinrich: Die Fürsorge für Epileptische und das Gesetz vom 11. Juli 1891. In: Deutsche Medizinische Wochenschrift 18 (1892), pp. 150–152.

Lehnert, [?]: Regelung der Dienstzeit des beamteten Pflegepersonals der Provinzial-Heil- und Pflegeanstalten Sachsens. In: Sanitätswarte 26 (1926), 14, p. 235.

Levy, Paul: Die Heilerziehungs- und Schulabteilung für schwachsinnige Kinder Uchtspringe. In: Sanitätswarte 27 (1927), 13, pp. 205–209.

Neubert, Karl: Erlebnisse eines Irrenpflegers. In: Sanitätswarte 1925 (1925), 19, pp. 295–298.

Reichssektion Gesundheitswesen: Die Wahlen zur Reichskonferenz für das Gesundheitswesen. In: Sanitätswarte 24 (1924), 11, pp. 151–152.

Renner, Georg: Arbeiterausschüsse in Kranken- und Irrenanstalten. In: Sanitätswarte 19 (1919), 7, pp. 57–60.

Renner, Georg: Reichsfachkommission der Reichssektion Gesundheitswesen. In: Sanitätswarte 26 (1926), n. p.

Renner, Georg: Sozialistische Ethik der Krankenpflege. Grußwort zum 1. Mai. In: Sanitätswarte 31 (1931), 9, pp. 137–138.

N. N.: Aus unserer Bewegung. Uchtspringe. In: Sanitätswarte 19 (1919), 6, p. 56. (Sanitätswarte 1919 a)

N. N.: Aus unserer Bewegung. Uchtspringe. In: Sanitätswarte 19 (1919), 7, p. 64. (Sanitätswarte 1919 b)

N. N.: Auch die Oberpfleger organisieren sich. In: Sanitätswarte 19 (1919), 20, pp. 258–259. (Sanitätswarte 1919 c)

N. N.: Der Kampf um den Achtstundentag in den Kranken- und Pflegeanstalten. In: Sanitätswarte 19 (1919), 21, pp. 265–268. (Sanitätswarte 1919 d)

N. N.: Dritte Konferenz der Reichssektion „Gesundheitswesen“ in Jena. In: Sanitätswarte 19 (1919), 26/27, pp. 361–366. (Sanitätswarte 1919 e)

N. N.: Augen auf! Betriebs-, Haus- und Pflegepersonal in den Landes- und Provinzheilanstalten!. In: Sanitätswarte 20 (1920), 3, pp. 25–28. (Sanitätswarte 1920 a)

N. N.: Aus unserer Bewegung. Uchtspringe. In: Sanitätswarte 20 (1920), 4, pp. 53–54. (Sanitätswarte 1920 b)

N. N.: Aus unserer Bewegung. Uchtspringe. In: Sanitätswarte 21 (1921), 6, p. 47. (Sanitätswarte 1921 a)

N. N.: Aus unserer Bewegung. Uchtspringe. In: Sanitätswarte 21 (1921), 7, p. 62. (Sanitätswarte 1921 b)

N. N.: Aus den Landesheilanstalten der Provinz Sachsen. In: Sanitätswarte 21 (1921), 14, pp. 126–127. (Sanitätswarte 1921 c)

N. N.: Aus unserer Bewegung. Uchtspringe. In: Sanitätswarte 21 (1921), 17, p. 150. (Sanitätswarte 1921 d)

N. N.: Aus unserer Bewegung. Uchtspringe. In: Sanitätswarte 21 (1921), 29, p. 255. (Sanitätswarte 1921 e)

N. N.: Aus unserer Bewegung. Uchtspringe. In: Sanitätswarte 22 (1922), 11, p. 103. (Sanitätswarte 1922 a)

N. N.: Unsere Reichssektion auf dem Verbandstag in Magdeburg. In: Sanitätswarte 22 (1922), 36, pp. 261–264. (Sanitätswarte 1922 b)

N. N.: Aus unserer Bewegung. Uchtspringe. In: Sanitätswarte 22 (1922), 49, p. 391. (Sanitätswarte 1922 c)

N. N.: Aus unserer Bewegung. Uchtspringe. In: Sanitätswarte 24 (1924), 4, pp. 39–40. (Sanitätswarte 1924 a)

N. N.: Konferenz der Betriebsräte und Beamtenausschüsse der Provinzialverwaltung für die Provinz Sachsen. In: Sanitätswarte 24 (1924), 13, pp. 175–179. (Sanitätswarte 1924 b)

N. N.: Das Ergebnis der Delegiertenwahl zur 4. Reichskonferenz für das Gesundheitswesen. In: Sanitätswarte 24 (1924), 14, p. 200. (Sanitätswarte 1924 c)

N. N.: Aus unserer Bewegung. Provinz Sachsen. In: Sanitätswarte 1925 (1925), 11, p. 173. (Sanitätswarte 1925)

N. N.: Aus unserer Bewegung. Alt-Scherbitz. In: Sanitätswarte 26 (1926), 4, p. 71. (Sanitätswarte 1926 a)

N. N.: Aus unserer Bewegung. Alt-Scherbitz und Nietleben. In: Sanitätswarte 26 (1926), 8, p. 135. (Sanitätswarte 26 b)

N. N.: Aus unserer Bewegung. Magdeburg. In: Sanitätswarte 26 (1926), 11, pp. 197–198. (Sanitätswarte 1926 c)

N. N.: Fünfte Konferenz der Reichssektion Gesundheitswesen in Düsseldorf. In: Sanitätswarte 26 (1926), 21, pp. 357–365. (Sanitätswarte 1926 d)

N. N.: Aus unserer Bewegung. Uchtspringe. In: Sanitätswarte 27 (1927), 4, pp. 70–71. (Sanitätswarte 1927 a)

N. N.: Aus unserer Bewegung. Provinz Sachsen. In: Sanitätswarte 27 (1927), 5, pp. 84–85. (Sanitätswarte 1927 b)

N. N.: Bericht über die 3. Sitzung der Reichskommission der Reichssektion Gesundheitswesen. In: Sanitätswarte 1928 (1928), 12, pp. 201–210. (Sanitätswarte 1928)

N. N.: Pflegerlose Abteilungen in Nietleben. In: Sanitätswarte 29 (1929), 5, pp. 77–80. (Sanitätswarte 1929 a)

N. N.: Aus unserer Bewegung. Uchtspringe. In: Sanitätswarte 29 (1929), 6, p. 104. (Sanitätswarte 1929 b)

N. N.: Aus unserer Bewegung. Alt-Scherbitz. In: Sanitätswarte 29 (1929), 11, p. 342. (Sanitätswarte 1929 c)

N. N.: Aus unserer Bewegung. Jerichow. In: Sanitätswarte 29 (1929), 13, p. 214. (Sanitätswarte 1929 d)

N. N.: Aus unserer Bewegung. Alt-Scherbitz und Nietleben. In: Sanitätswarte 30 (1930), 9, p. 152. (Sanitätswarte 1930 a)

N. N.: Aus unserer Bewegung. Uchtspringe. In: Sanitätswarte 30 (1930), 11, p. 192. (Sanitätswarte 1930 b)

N. N.: Aus unserer Bewegung. Uchtspringe. In: Sanitätswarte 31 (1931), 3, p. 55. (Sanitätswarte 1931 a)

N. N.: Aus unserer Bewegung. Uchtspringe. In: Sanitätswarte 31 (1931), 24, pp. 391–392. (Sanitätswarte 1931 b)

N. N.: Aus unserer Bewegung. Uchtspringe. In: Sanitätswarte 1932 (1932), 14, p. 229. (Sanitätswarte 1932)

Umbreit, Paul: Freie Gewerkschaften. In: Heyde, Ludwig (ed.): Internationales Handwörterbuch des Gewerkschaftswesens (1). Berlin 1931, p. 544.

Weber, Ludwig Wilhelm: Zur Feier des zwanzigjährigen Bestehens der Landesheilanstalt Uchtspringe. In: Allgemeine Zeitschrift für Psychiatrie und psychisch-gerichtliche Medizin 71 (1914), pp. 805–807.

Werner, Gustav: Betrachtungen über die Frage der Bildung des Irrenpflegepersonals. In: Die Irrenpflege 5 (1901/02), 2, pp. 44–47.

12.3.  Secondary Literature

Ankele, Monika: Arbeitsrhythmus und Anstaltsalltag. Eine Einführung in den Sammelband. In: Ankele, Monika/Eva Brinkschulte (eds.): Arbeitsrhythmus und Anstaltsalltag. Arbeit in der Psychiatrie vom frühen 19. Jahrhundert bis in die NS-Zeit. Stuttgart 2015 a, pp. 9–18.

Ankele, Monika: „[…] dass diese Heilmethode auch von anderen als ärztlichen Gesichtspunkten aus bewertet und beurteilt werden muss.“ Zu den sozial- und gesellschaftspolitischen Debatten um die psychiatrische Arbeitstherapie in der Weimarer Zeit. In: Ankele, Monika/Eva Brinkschulte (eds.): Arbeitsrhythmus und Anstaltsalltag. Arbeit in der Psychiatrie vom frühen 19. Jahrhundert bis in die NS-Zeit. Stuttgart 2015 b, pp. 157–185.

Beddies, Thomas/Heinz-Peter Schmiedebach: Die Diskussion um die ärztlich beaufsichtigte Familienpflege in Deutschland. Historische Entwicklung einer Maßnahme zur sozialen Integration psychisch Kranker. In: Sudhoffs Archiv. Zeitschrift für Wissenschaftsgeschichte 85 (2001), pp. 82–107.

Böhm, Boris: 125 Jahre Ausbildung von psychiatrischem Pflegepersonal in Sachsen. In: Ärzteblatt Sachsen 25 (2014), pp. 248–250.

Borsay, Anne/Pamela Dale (eds.): Mental Health Nursing. The Working Lives of Paid Carers in the Nineteenth and Twentieth Centuries. Manchester 2015.

Boschma, Geertje: The Rise of Mental Health Nursing. A History of Psychiatric Care in Dutch Ssylums, 1890–1920. Amsterdam 2003.

Braunschweig, Sabine: Die Entwicklung der Krankenpflege und der Psychiatriepflege in der Schweiz. In: Walter, Ilsemarie (ed.): Wider die Geschichtslosigkeit der Pflege. Vienna 2004, pp. 113–122.

Braunschweig, Sabine: Zwischen Aufsicht und Betreuung. Berufsbildung und Arbeitsalltag der Psychiatriepflege am Beispiel der Basler Heil- und Pflegeanstalt Friedmatt, 1886–1960. Zürich 2013.

Braunschweig, Sabine: Berufsbildung und Pflegealltag. Entstehung und Etablierung des Psychiatriepflegeberufs am Beispiel der Klinik Breitenau. In: Historischer Verein des Kantons Schaffhausen, Spitäler Schaffhausen (ed.): 125 Jahre Psychiatrische Klinik Breitenau Schaffhausen, 1891–2016. (Schaffhauser Beiträge zur Geschichte, 89). Schaffhausen 2018, pp. 177–210.

Brinkschulte, Eva/Stefanie Fabian: Krankenhaus und öffentliches Gesundheitswesen in der Weimarer Republik und die Entlassung der jüdischen Ärzte 1933. In: Brinkschulte, Eva (ed.): Zweihundert Jahre Krankenhausgeschichte(n). Vom städtischen Krankenhaus Altstadt zum Klinikum Magdeburg. Magdeburg 2017, pp. 124–147.

Douglas, Barbara: Discourses of Dispute. Narratives of Asylum Nurses and Attendants, 1910–22. In: Borsay, Anne/Pamela Dale (eds.): Mental Health Nursing. The Working Lives of Paid Carers in the Nineteenth and Twentieth Centuries. Manchester 2015, pp. 98–122.

Faber, Anja: Pflegealltag im stationären Bereich zwischen 1880 und 1930. (Medizin, Gesellschaft und Geschichte, 53). Stuttgart 2015.

Fisch, Stefan: Zwischen Kaiserreich und Republik. Vorgeschichte und Gründung des Deutschen Beamtenbundes. In: Bundesleitung des dbb beamtenbund und tarifunion (ed.): 100 Jahre dbb 1918–2018. Einheit in Vielfalt. Berlin 2018, pp. 9–40, 208–214.

Gijswijt-Hofstra, Marijke (ed.): Psychiatric Cultures Compared. Psychiatry and Mental Health Care in the Twentieth Century: Comparisons and Approaches. Amsterdam 2005.

Hähner-Rombach, Sylvelyn: Einführung. In: Hähner-Rombach, Sylvelyn (ed.): Alltag in der Krankenpflege. Geschichte und Gegenwart. Stuttgart 2009, pp. 7–14.

Hähner-Rombach, Sylvelyn: Probleme der Verberuflichung der Krankenpflege im Deutschen Reich Ende des 19., Anfang des 20. Jahrhunderts im Vergleich mit den Vereinigten Staaten. Ein Diskussionsbeitrag. In: Medizinhistorisches Journal 47 (2012), pp. 129–159.

Hähner-Rombach, Sylvelyn: Männer in der Geschichte der Krankenpflege. Zum Stand einer Forschungslücke. In: Medizinhistorisches Journal 50 (2015), pp. 123–148.

Hähner-Rombach, Sylvelyn/Karen Nolte (eds.): Patients and Social Practice of Psychiatric Nursing in the 19th and 20th Century. (Medizin, Gesellschaft und Geschichte. Suppl., 66). Stuttgart 2017.

Hainbuch, Dirk/Florian Tennstedt: Sozialpolitiker im Deutschen Reich 1871 bis 1918. (Biographisches Lexikon zur Geschichte der deutschen Sozialpolitik 1871 bis 1945, 1). Kassel 2010.

Helmerichs, Jutta: Krankenpflege im Wandel (1890–1933). Sozialwissenschaftliche Untersuchung zur Umgestaltung der Krankenpflege von einer christlichen Liebestätigkeit zum Beruf. Göttingen 1992.

Herlemann, Beatrix: Der Gau Magdeburg-Anhalt des “Reichsbanners Schwarz-Rot-Gold”. In: Internationale wissenschaftliche Korrespondenz zur Geschichte der deutschen Arbeiterbewegung 35 (1999), 2, pp. 225–248.

Hinz-Wessels, Annette: Verfolgt als Arzt und Patient. Das Schicksal des ehemaligen Direktors der Landesheilanstalt Uchtspringe, Dr. Heinrich Bernhard (1893–1945). In: Beddies, Thomas/Susanne Doetz/Christoph Kopke (eds.): Jüdische Ärztinnen und Ärzte im Nationalsozialismus. Entrechtung, Vertreibung, Ermordung. (Europäisch-jüdische Studien, 12) 2017, pp. 92–102.

Hoffmann, Reinhard: Zum Streikrecht der Beamten. In: Gewerkschaftliche Monatshefte 15 (1964), pp. 610–616.

Höll, Thomas/Paul-Otto Schmidt-Michel: Irrenpflege im 19. Jahrhundert. Die Wärterfrage in der Diskussion der deutschen Psychiater. (Werkstattschriften zur Sozialpsychiatrie, 44). Bonn 1989.

Kolling, Hubert: Konrad Alt. In: Wolff, Hans-Peter (ed.): Biographisches Lexikon zur Pflegegeschichte. (Who was who in Nursing history, 3). Munich 2004 a, pp. 6–8.

Kolling, Hubert: Georg Renner. In: Wolff, Hans-Peter (ed.): Biographisches Lexikon zur Pflegegeschichte. (Who was who in Nursing history, 3). Munich 2004 b, pp. 236–237.

Kolling, Hubert: Marie Friedrich-Schulz. In: Kolling, Hubert (ed.): Biographisches Lexikon zur Pflegegeschichte. (Who was who in Nursing history, 4). Munich 2008, pp. 96–102.

Kreuter, Alma: Hermann Bockhorn. In: Kreuter, Alma: Deutschsprachige Neurologen und Psychiater. Ein biographisch-bibliographisches Lexikon von den Vorläufern bis zur Mitte des 20. Jahrhunderts (1). Munich a. o. 1995, p. 156.

Kreutzer, Susanne: Eine “rote” Schwesternschaft in der Gewerkschaft Öffentliche Dienste, Transport und Verkehr (ÖTV). Zur Attraktivität einer gewerkschaftlichen Problemgruppe, 1949–1968. In: WerkstattGeschichte 34 (2003), pp. 6–28.

Kuhn, Andrea: Die Errichtung einer Pflegekammer in Rheinland-Pfalz. Der fehlende Baustein zur Professionalisierung?. Wiesbaden 2016.

Ledebur, Sophie: Die historischen Lebens- und Arbeitswelten der Pflegenden der Wiener psychiatrischen Anstalten am Steinhof im ersten Drittel des 20. Jahrhunderts. In: Gabriel, Eberhard (ed.): 100 Jahre Gesundheitsstandort Baumgartner Höhe. Von den Heil- und Pflegeanstalten Am Steinhof zum Otto Wagner-Spital. Vienna 2007, pp. 207–220.

Ley, Christian: Beiträge der Reichssektion Gesundheitswesen im Verband der Gemeinde- und Staatsarbeiter zur Professionalisierung der Pflege zwischen 1918 und 1933. Münster 2006.

Lilla, Joachim: Kurt von Wilmowsky. In: Lilla, Joachim: Der Preußische Staatsrat 1921–1933. Ein biographisches Handbuch. Mit einer Dokumentation der im „Dritten Reich“ berufenen Staatsräte (Handbücher zur Geschichte des Parlamentarismus und der politischen Parteien, 13). Düsseldorf 2005, pp. 179–180.

Lorenz, Robert: Gewerkschaftsdämmerung. Geschichte und Perspektiven deutscher Gewerkschaften. (Studien des Göttinger Instituts für Demokratieforschung zur Geschichte politischer und gesellschaftlicher Kontroversen, 6). Bielefeld 2013.

Meyer, Martin: Die Rolle der Pflegenden in der Psychiatrie. In: Gaßmann, Mirjam/Werner Marschall/Jörg Utschakowski (ed.): Psychiatrische Gesundheits- und Krankenpflege. Mental Health Care. Heidelberg 2006, pp. 65–84.

Müller, Thomas: Ein altmärkisches Modell medizinischer Versorgung im europäischen Kontext der Jahrhundertwende. In: Krämer-Liehn, Martin (ed.): Mikro-, Makro-, Weltgeschichte. Wandervögel in böhmischen Dörfern. (Comparativ 14, 4). Leipzig 2004, p. 64–78.

Nyhoegen, Lars: Konrad Alt und die ersten Patienten der Landes- Heil- und Pflegeanstalt Uchtspringe. Diss. med. Magdeburg 2012.

Randzio, Barbara: Von der “Beheimatung” zur Gemeindepsychiatrie. In: Benad, Matthias/Hans-Walter Schmuhl (eds.): Bethel-Eckardtsheim. Von der Gründung der ersten deutschen Arbeiterkolonie bis zur Auflösung als Teilanstalt (1882–2001). Stuttgart 2006, pp. 195–241.

Rübenstahl, Magdalene: “Wilde Schwestern”. Krankenpflegereform um 1900. Frankfurt am Main 2011.

Schott, Heinz/Rainer Tölle: Geschichte der Psychiatrie. Krankheitslehren, Irrwege, Behandlungsformen. Munich 2006.

Schweikardt, Christoph: Die Entwicklung der Krankenpflege zur staatlich anerkannten Tätigkeit im 19. und frühen 20. Jahrhundert. Das Zusammenwirken von Modernisierungsbestrebungen, ärztlicher Dominanz, konfessioneller Selbstbehauptung und Vorgaben preußischer Regierungspolitik. Munich 2008.

Svedberg, Gunnel: Nurses in Swedish Psychiatric Care. In: Gijswijt-Hofstra, Marijke (ed.): Psychiatric Cultures Compared. Psychiatry and Mental Health Care in the Twentieth Century: Comparisons and Approaches. Amsterdam 2005, pp. 359–378.

Synder, Kriemhild: Die Landesheilanstalt Uchtspringe und ihre Verstrickung in nationalsozialistische Verbrechen. In: Hoffmann, Ute (ed.): Psychiatrie des Todes. NS-Zwangssterilisationen und “Euthanasie” im Freistaat Anhalt und in der Provinz Sachsen. Landeszentrale für politische Bildung Sachsen-Anhalts. Magdeburg 2001, pp. 75–96.

Tullner, Mathias: Geschichte des Landes Sachsen-Anhalt. Magdeburg/Opladen 1996 (2nd ed.).

Tullner, Mathias/Wilfried Lübeck (eds.): Erhard Hübener. Mitteldeutschland und Sachsen-Anhalt. Halle (Saale) 2001.

Urbach, Anna: Auf leisen Sohlen das Fallen fixieren. “Epileptikeranstalten” als Wegbereiter einer spezifischen Qualifizierung von psychiatrischen Pflegekräften um 1900. In: Nolte, Karen/Christina Vanja/Florian Bruns/Fritz Dross (eds.): Geschichte der Pflege im Krankenhaus. (Historia Hospitalium, 30) 2017, pp. 65–87.

Vormbaum, Thomas: Politik und Gesinderecht im 19. Jahrhundert (vornehmlich in Preussen 1810–1918). (Schriften zur Rechtsgeschichte, 21). Berlin 1980.

Watzka, Carlos: Working and Living Conditions for Nursing Staff at the Provincial Asylum and Hospital for the Metally Ill Feldhof near Graz (Austria) around 1900. In: Hähner-Rombach, Sylvelyn (ed.): Alltag in der Krankenpflege. Geschichte und Gegenwart. (Medizin, Gesellschaft und Geschichte, 32). Stuttgart 2009, pp. 133–146.

Wolff, Horst-Peter/Jutta Wolff: Georg Streiter (1884–1945). Ergobiographische Studie über einen Berufspolitiker der Krankenpflege Deutschlands. (Schriften aus dem Institut für Pflegegeschichte, 15). Qualzow 2002.

12.3.1. Online documents

Blessing, Bettina: Review of: Schweikardt, Christoph: Die Entwicklung der Krankenpflege zur staatlich anerkannten Tätigkeit im 19. und frühen 20. Jahrhundert. In: H-Soz-Kult, May 26, 2009, www.hsozkult.de/publicationreview/id/rezbuecher-12424, accessed February 2, 2020.

Rehling, Andrea: Betriebsrätegesetz vom 4. Februar 1920. In: 100(0) Schlüsseldokumente zur deutschen Geschichte im 20. Jahrhundert, n. d., https://www.1000dokumente.de/pdf/dok_0133_brg_de.pdf, accessed February 2, 2020.

12.3.2. Images

Fig. 1: Emig, Klaus-Peter: Brosche der „Reichssektion Gesundheitswesen“ (RG) [Pin of the Empire Health Services Branch] im Verband der Gemeinde- und Staatsarbeiter (VGS) [Association of Municipal and State Workers] before 1933, https://www.kpemig.de/5635b-Verband-der-Gemeinde-und-Staatsarbeiter-Reichssektion-Gesundheitswesen, accessed May 27, 2020.

Fig. 2: Klimesch, F.: Illustration for the 25th Anniversary of the RG and Illustration of the 5th Empire Conference of the RG. In: Sanitätswarte 26 (1926), 1, n. p.

Fig. 3: Klimesch, F.: Illustration for the 25th Anniversary of the RG and Illustration of the 5th Empire Conference of the RG. In: Sanitätswarte 26 (1926), 19, n. p.

[1] “Free” unions was the term for unions of the 19th and 20th century that promoted a socialist agenda. The term evolved during the 1890s to delineate these unions both from older liberal and also from younger Christian unions. Umbreit 1931.

[2] Lorenz 2013, pp. 49–50.

[3] Reichsgesetzblatt 1933.

[4] Hinz-Wessels 2017.

[5] Commissarial Governor of the Province of Saxony [Comm. Governor] to the Prussian Minister of the Interior [Pruss. Minister]: Bericht über die Kündigung des Direktors Heinrich Bernhard (Report on the dismissal of director Heinrich Bernhard), 01/07/1933. LASA, C 92, no. 5312, fol. 2–3, here fol. 2.

[6] LASA, C 92, no. 6649.

[7] Comm. Governor to Pruss. Minister: Bericht über die Kündigung des Pflegers August Barth (Report on the Dismissal of Orderly August Barth), 13/05/1933. LASA, C 92, no. 6653, fol. 8.

[8] For more details see: Höll/Schmidt-Michel 1989.

[9] Psychiatric care within nursing is a specific and marginalised area that had been linked to an idea of a preventive detention until a few decades ago and it has been fighting for being respected as an independent discipline. See here for more details: Meyer 2006.

[10] Instead different agents of healthcare policy discuss the issues on behalf of the nurses. Kuhn 2016, p. 54.

[11] For more details see: Hähner-Rombach 2015.

[12] As examples see: Gijswijt-Hofstra 2005; Hähner-Rombach/Nolte 2017; for Germany: Faber 2015; Urbach 2017; for Austria: Ledebur 2007; Watzka 2009; for Switzerland: Braunschweig 2013 and 2018; for the United Kingdom and Ireland: Borsay 2015; for the Netherlands: Boschma 2003.

[13] For Germany: Helmerichs 1992; Wolff/Wolff 2002; Kreutzer 2003; Ley 2006; Ankele 2015 b; for Switzerland: Braunschweig 2004 and 2018.

[14] Douglas 2015.

[15] The full title of this journal is Die Irrenpflege: Monatsschrift für Irren- und Krankenpflege zur Belehrung und Fortbildung des Pflegepersonals.

[16] In 1904, the Austrian psychiatrist Heinrich Schlöss (1860–1930) became the editor. The journal Irrenpflege was published until 1930.

[17] For more details see: Nyhoegen 2012.

[18] Hähner-Rombach 2009, p. 10.

[19] Schweikardt gives this attribution without reference to the applicable source material. Blessing 2009.

[20] Accordingly, the staff during the period from 1900 to 1930 came from the lower middle class, i.e., mainly from families with farming and craftsmen backgrounds. The lower class represented less than one tenth of the carers. There were no significant differences between orderlies and nurses. Faber 2015, pp. 86–89.

[21] The Kingdom of Saxony was located to the south of the Prussian Province of Saxony.

[22] In connection with other improvements of the professional and personal circumstances, including the promise to be taken on into the Saxon civil service and to work in one of the state institutions, the fluctuation of male staff in particular could be eliminated. Böhm 2014.

[23] Kuhn 2016, p. 43.

[24] Vormbaum 1980, p. 15.

[25] Ley 2006, p. 19.

[26] Köhler 1907.

[27] Schott/Tölle 2006, p. 440.

[28] Höll/Schmidt-Michel 1989, p. 58.

[29] In the US denominational care faced a recruitment problem at a much earlier time, since it was easier for women, due to the excess of men, to get married there. To remain attractive to women from the upper middle classes, the denominational nursing institutions supported the academic professionalisation of the profession, including the setting up of nursing schools. Hähner-Rombach 2012, p. 148.

[30] Schweikardt 2008, p. 171.

[31] Schweikardt 2008, p. 171.

[32] Kuhn sees a reason for the difficult and long path towards professionalisation of nursing in Germany in its close connection to the professionalisation efforts the physicians pursued at the same time. Kuhn 2016, p. 35. In the United Kingdom, Florence Nightingale (1820–1910) established a nursing training school in the 1860s which was independent of both doctors and denominational sisterhoods.

[33] Karll had already proposed, in 1906, the foundation of a board of nursing to get nurses directly involved in the legislation. Kuhn 2016, p. 46. In the UK, The College of Nursing was founded in 1916, which led in 1919 to the foundation of the General Nursing Council and the introduction of registration for all trained nurses. In the US the first boards of nursing were established in 1903 in the states of North Carolina and New York.

[34] Schweikardt 2008, p. 171.

[35] Schweikardt 2008, p. 165. Cf. here the situation of “trained nurses” in the USA around 1900: “Nursing care in the US included a powerful and financially strong bourgeois women’s movement that could achieve much more in a shorter period of time than was the case in the German Empire. The reason for this was the vast number of their members, their scope of influence and their relative unity.“ Hähner-Rombach 2012, p. 153.

[36] For more details see: Wolff/Wolff 2002.

[37] Schweikardt 2008, p. 168.

[38] Wolff/Wolff 2002, pp. 30, 33.

[39] Schweikardt 2008, p. 172.

[40] Until 1919 the branch was referred to as Sektion des Krankenpflege-, Massage- und Badepersonals Deutschlands (Branch of Nursing, Massage and Bathing Personnel in Germany) in the VGS.

[41] Ley 2006, p. 41.

[42] Kuhn 2016, p. 44.

[43] Kuhn 2016, p. 44.

[44] Kuhn 2016, p. 44.

[45] See here the conditions in Switzerland: After 1900, the Verband des Personals öffentlicher Dienste (VPOD) (Organisation of Personnel in Public Service) gained a lot of influence in the large state-asylums. The active members of the VPOD united in 1920 and founded an asylum cartel. To increase the union’s chances for success it sought to collaborate with doctors. Due to the commitment of the psychiatrist Walter Morgenthaler (1882–1965) they were able to close ranks with the professional association of Swiss psychiatrists. Subsequently, in 1922 they began to jointly publish the journal Kranken- und Irrenpflege (General and Mental Nursing). Braunschweig 2004, p. 117–118.

[46] It remains unclear, however, to what degree the healthcare workers were indeed organised. In particular, the proportion of unskilled attendants cannot be reconstructed. Ley 2006, pp. 30–31.

[47] Hoffmann 1964, p. 612.

[48] For more details see: Fisch 2018.

[49] Laehr 1892.

[50] Randzio 2006, p. 197.

[51] Weber 1914, p. 805.

[52] Tullner 1996, p. 110. From 1877 to 1900 Wilko Levin Graf von Winzingerode (1833–1907), a Protestant theologian and conservative politician, who was the Provincial Governor of the Province of Saxony. Hainbuch/Tennstedt 2010, p. 175.

[53] Nyhoegen 2012, p. 42.

[54] On the historical origins and the various types of “foster family care” in Europe see for more details: Beddies/Schmiedebach 2001. Specifically on Uchtspringe see: Müller 2004.

[55] Kolling 2004 a, p. 7.

[56] In contrast in the Netherlands around 1900 the only leading role that orderlies were offered in the institutions was that of foreman at the workshops. This resulted in the formation of the Nederlandse Verplegers Vakvereniging, the first association of orderlies in 1906. Boschma 2003, pp. 187–188. See also: Svedberg 2005, pp. 364–365.

[57] So-called “free” nurses emerged at the beginning of the 20th century as an alternative to the motherhouse system. The members of this very heterogeneous group shared a lack of lifelong commitment to a motherhouse or a sisterhood and received a salary for their work. Therefore they were also called “professional” nurses or, more derogatorily, “wild” nurses. For more details see: Rübenstahl 2011.

[58] With the construction of apartment buildings for married male caregivers, up to three fosterlings per apartment were able to live and work in the caregiver families over a longer period of time. This enabled Alt to provide more cost-effective care for patients capable of working than in an institution, to retain suitable nursing staff in the long term and to reduce prejudices in the population against mentally ill persons, so that additional families could be won over to take in fosterlings. Nyhoegen 2012, pp. 108–111.

[59] For more details see: Urbach 2017.

[60] Nyhoegen 2012, p. 110.

[61] Governor of the Province of Saxony to all directors of state asylums, 15/04/1908. LASA, C 92, no. 1262, fol. 111–113).

[62] Kolling 2004 a, p. 6.

[63] “After 1902, i.e. when Schlöss, Thoma and Schott were the editors, the nurses’ articles became braver and were increasingly political.” Höll/Schmidt-Michel 1989, p. 11.

[64] Werner 1901/02, pp. 46–47. Werner worked at the Charité in Berlin.

[65] Gattringer 1903/04.

[66] Höll/Schmidt-Michel 1989, p. 11.

[67] Georg Streiter to nurses and orderlies at Uchtspringe (certified copy of excerpts), 23/03/1905, contained in: Alt to Governor, 22/06/1907. LASA, C 92, no. 2715, fol. 195.

[68] Serving for the Inner Mission, he had also gained experience in caring for mental patients. In 1901/02 Streiter worked at the Johannesstift für Alte und Sieche (St John’s Home for the Old and Sick) in Cracau/Magdeburg. He later wrote that “because of the lack of an adequate apartment [he] had to ‘live’ in an attic chamber in which [he] could barely ‘walk’ upright. The staff slept behind a curtain on the ward with 20 psychotic patients.” Cited in Wolff/Wolff 2002, pp. 6, 16. It is possible that Streiter was already in contact with the staff at the nearby asylum in Uchtspringe.

[69] From 1908 to 1921 the nationalist-conservative politician Kurt Freiherr von Wilmowsky (1850–1941) served as the Governor of the Province of Saxony. Lilla 2005.

[70] Alt to Governor, 22/06/1907. LASA, C 92, no. 2715, fol. 195.

[71] Georg Streiter to Governor, 04/06/1907. LASA, C 92, no. 2715, fol. 193.

[72] Alt to Governor, 16/07/1907. LASA, C 92, no. 2715, fol. 197. Unfortunately, the original source is no longer available so that potential reactions to Streiter’s article cannot be verified.

[73] Wolff/Wolff 2002, p. 28.

[74] Wolff/Wolff 2002, p. 33.

[75] Kuhn 2016, pp. 41–43.

[76] Ley 2006, p. 45.

[77] Ankele 2015 a, p. 15.

[78] Ley 2006, p. 26.

[79] Comm. Governor to Pruss. Minister: Bericht über die Kündigung des Pflegers August Barth (Report on the Dismissal of Orderly August Barth), 13/05/1933. LASA, C 92, no. 6653, fol. 8.

[80] Table with an overview of service ranks. LASA, C 92, no. 5278, n. p.

[81] Senior physician Dr Bufe to Governor, 22/03/1916. LASA, C 92, no. 5278, fol. 3–4.

[82] In this first workers’ committee at Uchtspringe members were appointed during a staff meeting. In March 1919 regular elections were held. Renner 1919.

[83] Sanitätswarte 1919 a.

[84] Sanitätswarte 1919 b.

[85] Sanitätswarte 1919 b.

[86] Sanitätswarte 1919 b.

[87] Renner was a former orderly i. a. at the Bunzlau Provincial Insane Asylum and the Dresden City Insane Asylum and Infirmary. Since 1905 he had been a VGS member, and from 1907 the association had appointed him as secretary to the board of the RG and from 1918 to 1933 he was the editor of the Sanitätswarte. Kolling 2004 b.

[88] Sanitätswarte 1919 b.

[89] B.[?] 1919.

[90] B.[?] 1919.

[91] Barth to Governor, 14/08/1919. LASA, C 92, no. 2715, fol. 222–225, here fol. 225.

[92] After the bargaining negotiations the staff at Nietleben expressed “bitter disappointment” in a resolution it published. B.[?] 1919.

[93] Barth to Governor, 14/08/1919. LASA, C 92, no. 2715, fol. 222–225, here fol. 225.

[94] The deputy director, senior physician Josef Hoppe to Governor, 06/09/1919. LASA, C 92, no. 2715, fol. 228–229, here fol. 228.

[95] Sanitätswarte 1919 c.

[96] Alt cited in: Sanitätswarte 1919 d, p. 266. 

[97] Already in February 1919 – “in view of the vigorous efforts of the workers and ‘lower’ civil servants and employees” – an association of civil servant psychiatrists was founded at the state institutions in the Province of Brandenburg. Sanitätswarte 1920 a, p. 25.

[98] Sanitätswarte 1920 a, p. 25.

[99] Sanitätswarte 1919 e.

[100] Sanitätswarte 20 b, p. 53.

[101] Sanitätswarte 1921 a.

[102] Sanitätswarte 20 b, p. 54.

[103] Kolling 2008, p. 96.

[104] Sanitätswarte 1921 b.

[105] Rehling n. d., pp. 3, 12.

[106] Lorenz 2013, pp. 25–26.

[107] Sanitätswarte 1921 d.

[108] Sanitätswarte 1921 c, p. 127.

[109] Kreuter 1995. On Bockhorn’s political views no documents could be found.

[110] Sanitätswarte 1921 e.

[111] Hübener, member of the Deutsche Demokratische Partei (DDP) (German Democratic Party), remained in office until the National Socialists seized power. After the war, in 1945, the Americans appointed him again as Provincial Governor. Hübener became a founding member of the Liberal-Demokratische Partei Deutschlands (LDPD) (Liberal Democratic Party of Germany). For more details see: Tullner/Lübeck 2001.

[112] Sanitätswarte 1922 b.

[113] The Reichsbanner Schwarz-Rot-Gold (Black-Red-Gold Banner of the Realm) was founded in 1924 in Magdeburg by the three parties of the Weimar coalition (SPD, DDP, German Central Party). See here for more detail: Herlemann 1999.

[114] Brinkschulte/Fabian 2017, p. 127.

[115] See for instance: Sanitätswarte 1926 c.

[116] Sanitätswarte 1924 b, p. 179.

[117] Sanitätswarte 1919 e, Sanitätswarte 1926 d, p. 361, Sanitätswarte 1929 d.

[118] Comm. Governor to Pruss. Minister: Bericht über die Kündigung des Pflegers August Barth (Report on the Dismissal of Orderly August Barth), 13/05/1933. LASA, C 92, no. 6653, fol. 8.

[119] Sanitätswarte 1922 c.

[120] F[lücht] 1926 b, p. 189.

[121] Sanitätswarte 1922 a, Sanitätswarte 1929 b, Sanitätswarte 1929 c.

[122] F[lücht] 1926 a, p. 171.

[123] Sanitätswarte 1925.

[124] Sanitätswarte 1926 b.

[125] F[lücht] 1926 a, p. 171.

[126] F[lücht] 1926 b, p. 190.

[127] Sanitätswarte 1926 b.

[128] Sanitätswarte 1930 a.

[129] Hartenstein 1931, p. 172.

[130] Lehnert 1926.

[131] As civil servants they were not included in the directive on the working hours at nursing institutions from 13 February 1924. Hartenstein 1931, p. 169.

[132] Sanitätswarte 1926 d, p. 361.

[133] Hartenstein 1931, p. 169.

[134] Sanitätswarte 1929 a.

[135] Sanitätswarte 1927 b.

[136] [Representative of the Provincial Administration in implementation of the law on the restoration of the professional civil service] Hans Tiessler to Comm. Governor, July 1933. Court files on Dassui, Gertrud Cäcilia. LASA, C 92, no. 6649, fol. 10.

[137] Statement by ward nurse Hedwig Voß, 15/05/1933. LASA, C 92, no. 6649, Court files on Dassui, Gertrud Cäcilia, fol. 11.

[138] Hans Tiessler to Minna Franke, 08/07/1933. LASA, C 92, no. 6649, Court files on Franke, Minna, fol. 7.

[139] Hans Tiessler to Käthe Flier, 08/07/1933. LASA, C 92, no. 6649, Court files on Flier, Käthe, fol. 8.

[140] Statement by Gertrud Cäcilia Dassui, 10/07/1933. LASA, C 92, no. 6649, Court files on Dassui, Gertrud Cäcilia, fol. 8–9, here fol. 9.

[141] Statement by Käthe Flier, 13/07/1933. LASA, C 92, no. 6649, Court files on Flier, Käthe, fol. 9.

[142] Hans Tiessler to Comm. Governor, Juli 1933. LASA, C 92, no. 6649, Court files on Dassui, Gertrud Cäcilia, fol. 10.

[143] The nurses Käthe Flier and Frieda Klaas were suggested for the Work Council elections in 1924. Sanitätswarte 1924 a, p. 39. Nurse Dassui was mentioned once in 1930 in the report of the Provincial Control Commission as a representative of the Work Council. Inspection of the Uchtspringe state asylum on 28/11/1930, report from 20/03/1931. LASA, C 92, no. 4395, fol. 15–18, here fol. 15. It is telling that Dassui, in her position as the first secretary taking the minutes at the RG branch at Uchtspringe was wrongly titled “[male] colleague”. Sanitätswarte 1931 a.

[144] Renner 1926. See also: Sanitätswarte 1926 a.

[145] Sanitätswarte 1927 a, p. 70.

[146] See also the contributions of long-time nurses that increased from the middle of the 1920s in the union journal of the RG, including Neubert 1925.

[147] Sanitätswarte 1931 a.

[148] Ley 2006, p. 33.

[149] Until the nurses’ association was banned in 1933, it organised approximately 10,000 nurses. “Thus the nurses’ association of the RG was the largest organisation of its kind in the German Empire.” Ley 2006, p. 34. According to Friedrich-Schulz “as support and additional guidance during particularly important professional issues, the leadership of the [RG] should be accompanied by a committee consisting of 6 nurses. [Furthermore] local groups were to be established that were to join the local [RG] branch.” 1928, p. 205. I have not been able to discover evidence for a local group of the nurses’ association in Uchtspringe.

[150] Ley 2006, p. 33–34. Only trained and state certified nurses were accepted. The foundation of the RG sisterhood was the result of the tireless efforts of comrade Marie Friedrich-Schulz whom I mentioned above. Especially in her role as secretary to the board of the RG between 1920 until 1929 she was made responsible for the “unforeseen uptake” of the RG during the Weimar period. Kolling 2008, p. 99.

[151] Renner 1931.

[152] Faber 2015, p. 131.

[153] Boschma 2003, pp. 230–231.

[154] Sanitätswarte 1927 b.

[155] Reichssektion Gesundheitswesen 1924, p. 152.

[156] Sanitätswarte 1924 c.

[157] Kreutzer 2003, p. 21.

[158] Kreutzer 2003, p. 21.

[159] Ley 2006, p. 44. Cf. “A particular hardship is the considered salary deduction of ten percent from the unmarried female civil servants, since the unmarried staff is already under extreme pressure from increases in rent and utilities.” Sanitätswarte 1931 b, p. 391.

[160] Hinz-Wessels 2017, p. 94.

[161] Sanitätswarte 1930 b.

[162] Hinz-Wessels 2017, p. 96.

[163] Bernhard to Governor, 23/01/1930. LASA, C 92, no. 4395, fol. 14.

[164] Governor to Bernhard, 25/01/1930. LASA, C 92, no. 4395, fol. 13.

[165] Inspection of the Uchtspringe State Asylum on 24/09/1932, report from 02/12/1932. LASA, C 92, no. 4395, fol. 41–43, here fol. 43.

[166] Statement by the secretary of the institution Girle, 23/06/1933. LASA, C 92, no. 5312, fol. 12.

[167] Inspection of the Uchtspringe State Asylum on 15/08/1929, report from 11/11/1929. LASA, C 92, no. 4395, fol. 6–9, here fol. 9.

[168] Inspection of the Uchtspringe State Asylum on 28/11/1930, report from 20/03/1931. LASA, C 92, no. 4395, fol. 15–18, here fol. 16.

[169] Inspection of the Uchtspringe State Asylum on 24/09/1932, report from 02/12/1932. LASA, C 92, no. 4395, fol. 41–43, here fol. 43.

[170] Levy 1927, p. 209.

[171] Das Handwerk in einer modernen Landesheilanstalt. Denkschrift, bearbeitet im Auftrage der Werkstättenvorsteher-Gruppe der Landesheilanstalt Uchtspringe von Werkstättenvorsteher Rossau, 25/01/1927. LASA, C 92, no. 2710, fol. 167–171.

[172] Sanitätswarte 1932.

[173] Statement by ward orderly Theuerkauf, 18/05/1933. LASA, C 92, no. 6653, fol. 13.

[174] Statement by orderly Paul Unger, 18/05/1933. LASA, C 92, no. 6653, fol. 11.

[175] Bericht über die Kündigung des Pflegers August Barth (Report on the Dismissal of Orderly August Barth), 13/05/1933. LASA, C 92, no. 6653, fol. 8.

[176] For more details see: Synder 2001.



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