Be transported back in time and see some of our most treasured historical photos placed side-by-side with modern-day versions, and read about how we've transformed over the last 170 years
First in Care
Then: A nursing student practising skills in bandaging in 1948.
Now: A nurse checks the blood pressure of a patient.
Before 1890, nurses were not required to have any formal qualifications to work at The Royal Melbourne Hospital. That all changed when Lady Superintendent, Isabella Rathie, introduced the first formal teaching program for nurses in 1890.
The course was only two years long and covered basic nursing practices as well as studies in anatomy, surgery and physiology and medicine.
Today, our nurses complete a three year undergraduate degree plus a graduate nursing program, with the option of post-graduate study in a specialty area afterwards.
In 2018, we welcomed 120 new graduate nurses to the RMH as part of our Graduate Nurse Program, who will each complete two six month clinical rotations across a range of specialties.
The growth and development of nursing over centuries has led to major positive change in the workforce, with many of our nurses leading the way in medical research, nursing education and patient quality and safety.
Theatre and surgery
Then: The Theatre Sister position was created in 1912.
Now: Today, some procedures are also done outside the theatre setting,
such as the Cardiac Catheter Lab or the Angiogram Suite.
In 1913, the RMH, which was then situated on Lonsdale Street, had just four operating theatres. A new hospital and 105 years later and we now have 14 operating theatres.
In 1912, the position of Theatre Sister was created, and thereafter, all third year student nurses spent a semester in operating theatres. June Allen, the sister in charge of operating theatres from 1956 to 1972, set up a 12-month post-graduate course in operating theatre nursing, the first of its kind in Victoria.
Today our Perioperative Services includes various sub-departments such as Theatres, Post Anaesthetic Care Unit, Anaesthesia and Pain Management, Day of Surgery Admission, the Central Sterile Supply Department (CSSD) and the Day Procedure Unit.
Around 100 sterilisation cycles are performed each day to keep our 20,000 surgical instruments clean and more than 23,900 elective theatre procedures were performed in 2016/17.
In February 2016, our TUG robots Susan, Peter and DOT joined the team to transport surgical instruments to and from RMH and Peter Mac theatres to CSSD to be cleaned. They can talk, call a lift and navigate their way through the hospital using a pre-programmed GPS, together travelling 19km and making 290 deliveries per day.
Then: A Physiotherapist checks the posture and gait of a patient using a walker, 1988.
Now: A Prosthetist helps a patient to use their new prosthetic limb.
From 1898, the first allied health professionals to be employed by the hospital were masseurs, now known as physiotherapists. In 1905, the medical superintendent recommended that a school of massage be established within the hospital. So, the Australian Massage Association was formed and students paid a fee of one guinea to study.
Women were at the forefront of establishing the various other allied health departments within the RMH, including the first social worker and dietitian in 1929. Today, our Allied Health service includes more than 400 staff across Aboriginal Hospital Liaison, Exercise Physiology, Facial Prosthetics, Music Therapy, Nutrition, Occupational Therapy, Pastoral Care, Physiotherapy, Podiatry, Prosthetics and Orthotics, Psychology, Social Work, Speech Pathology and Audiology, and Transcultural and Interpreting Services.
Then: Facial Prosthetist Technician, Cliff Wellington, at work on an eye and nose piece circa 1965.
Now: The finishing touches being put on an eye prosthesis, made of silicon.
Facial Prosthetics is a combination of science and art and the Facial Prosthetics team at the RMH have long been pioneers in their field. In the early days, prosthetics were made from hard acrylics and sterling silver and much of the early work was designed for soldiers returning from World War II with horrific facial injuries.
These days, the role has expanded to include not only eyes, ears, and noses but also fingers, toes, breasts and other prostheses. The Facial Prosthetics service designs, makes, fits and maintains camouflage facial prosthetics for patients with disfiguring facial deformities as a result of surgery arising from cancers, congenital deformities, accidents and trauma.
Today, materials like titanium and silicon are commonly used and even more recently, new technology such as 3D printing has further advanced the field, enabling the team to produce more realistic facial prosthetics faster, saving hours of modelling and reducing the patient’s time spent at hospital.
The RMH Facial Prosthetics department manufactures approximately 35 new eyes, 40 ears, 25 noses and 20 other miscellaneous prosthetics per year.
First in Research
Then: A Clinical Pathologist examines blood cells under a microscope, 1955.
Now: More than 300 clinical trials are active at The Royal Melbourne Hospital.
The RMH has been at the forefront of many world-renowned innovations that have helped shape healthcare today, including the first successful kidney transplant in Australia and the development of Australia’s first cardiac pacemaker in the mid 1960s, and in the 1980s, the invention of artificial blood vessels, the first defibrillator operation in the Southern Hemisphere and the pivotal groundwork for the National Bowel Cancer Screening Program.
In the 1990s, Australia’s first keyhole coronary bypass operation was performed and in the 2000s, the RMH performed Australia’s first ABO blood incompatible kidney transplant and was one of the first hospitals in the world to introduce wireless ‘Pill Cam” endoscopy.
In the 2010s we announced a world-first investigation into the use of Botox to reduce the debilitating tremors and shakes in people with multiple sclerosis and conducted a world-first clinical trial of a new drug that kills cancer cells in people with advanced forms of chronic lymphocytic leukaemia.
Today, the RMH is based in the heart of the Melbourne Biomedical Precinct. The Precinct has established itself as a major global research and teaching powerhouse with its 30 health services and research and academic partners sharing a formidable history of ground-breaking medical discoveries and developments. Together, the Precinct partners employ around 10,000 researchers.
In 2017, we opened a $1 million Clinical Trials Centre, a purpose-built state of the art facility where clinicians and patients from all specialities can come together to provide and receive care in a dedicated centre and we published over 800 journal articles. Today, there are over 800 active research projects, of which more than 300 are clinical trials.
First in Learning
Then: Doctors meet to discuss a patient’s case, 1960.
Now: Two Junior Doctors are mentored by a Senior Consultant in ICU.
In 1862 the University of Melbourne’s Medical School was established and in 1864, just three people became the first medical students to be admitted to the Melbourne Hospital for clinical instruction.
However, while student’s access to the wards was not refused, little effort was made by the hospital to encourage their practical instruction. In 1884, the University of Melbourne Council appointed clinical lecturers from the hospital’s medical staff in an effort to improve clinical teaching for medical students.
Fast forward to today and RMH has welcomed 80 medical interns to the hospital in 2018 where they will undertake 10-week rotations in general medicine and surgery and an eight-week rotation though the emergency department, among other specialties, as part of their intern year.
In nursing, the 1980s saw the beginning of the move from hospital-based nursing to university-based nursing education. The last graduation of student nurses from The Royal Melbourne Hospital’s School of Nursing occurred in September 1993, bringing to a close 103 years of the RMH basic nurse education.
Today, post-basic courses in advanced nursing and various short courses are still taught to nursing staff at the hospital and both our doctors and nurses also have access to The Royal Melbourne’s state-of-the-art Clinical Simulation Centre, an education and training facility where staff can undertake simulation-based courses and programs, targeted towards improving patient care and reducing clinical risk.
Our support staff
Then: A staff member cleans and mops the floor of an operating theatre, circa 1920s.
Now: Today the RMH employs 170 cleaning staff, among other
support staff, who help to keep the hospital functioning.
A huge part of keeping the RMH functioning and safe for our patients is keeping it clean. Over the last 170 years the number of cleaners and the technology our cleaners use has changed dramatically.
Today, the RMH employs roughly 170 cleaning staff who are required to undertake a Certificate 3 in Health Patient Services, compared to 1952 where just 11 cleaners were rostered on during the day and seven cleaners overnight.
There are a range of other support roles at the RMH that are essential to patient care. Our 170 plus Clinical Assistants provide clinical support on the wards by transporting patients, assisting clinical staff, cleaning and providing general ward support.
We also have 80 Food Services staff who provide meals for our patients. In one year, they will serve more than 630,000 meals at RMH City Campus and our Food Production kitchen will produce more than 2 million serves of vegetables and more than 35 tonnes of mashed potato.
Then: Circa 1942 – the newly built RMH site in Parkville
when it was occupied by the 4th General Hospital, US Army.
Now: The RMH building today with a helicopter hovering above our helipad.
By the late 19th century the Melbourne Hospital buildings and facilities, then located on Lonsdale Street, were in such a state of disrepair, they were condemned by a Royal Commission in 1892.
In 1908, the decision was reached to build a new hospital on the corner of Lonsdale and Swanston Streets. The foundation stone was laid in 1912 and on 22 July 1913, the new hospital was opened.
Unfortunately the new site still wasn’t big enough for the growing number of patients. So the decision was made in 1929 to reserve an area of land that was then being used as a Horse, Cow and Pig Market in Parkville, and build what we now know as The Royal Melbourne Hospital City Campus.
With the outbreak of World War Two, the new hospital was occupied by US soldiers for two years from March 1942. After the US Army departed, the hospital moved in with the help of 16 ambulances, transferring 200 patients between old and new hospitals.
Today, the RMH City Campus has 470 beds and has undergone significant construction over the years. Most recently, the expansion of the B Building as part of the Victorian Comprehensive Cancer Centre (VCCC) project included a brand new 42-bed capacity Intensive Care Unit, a 32-bed Haematology and Bone Marrow Transplant Ward and a Central Sterile Supply Department.
Emergency and Trauma care
Then: Ambulances parked outside the Casualty entrance, circa 1965.
Now: The Australian-first Mobile Stroke Unit will help Victorian
stroke patients have the very best chance of survival.
The first ever Casualty patient of the Melbourne Hospital came through the door on 18 March 1848. His name was John Docker, a seaman from the ship Stag, who suffered a broken thigh.
In 1974 the department was renamed from Casualty to Emergency and the interior of the building was dramatically modernised.
Today at the RMH we provide emergency, trauma and critical care 24 hours a day, 7 days a week and are only one of two major adult trauma services in the state. In 2012, we achieved formal Level 1 Trauma Verification from the Royal Australasian College of Surgeons, making us the first Major Trauma Centre in the Victorian State Trauma System to achieve this status.
We treat 4000 trauma patients every year, with up to 1000 of those being classified as major traumas. Our helipad opened in 2004 and roughly 40 helicopters land each month. In 2016/17, our Emergency Department provided urgent care to more than 74,000 people – an average of 200 patients a day.
In 2017, we were proud to launch the Mobile Stroke Unit (MSU) – the first of its kind in Australia. The MSU is a fully-equipped, custom-built ambulance with an on board CT scanner capable of imaging the patient’s brain to detect the type of stroke they are experiencing to immediately start assessment and treatment.