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The Trained Nurses Institution was established by Edward Hearbord Lushington, Treasurer of Guy's Hospital, in June 1884. The original memorandum he issued stated that "The Governors of Guy's Hospital have sanctioned the establishment of a Nursing Institution in connection with the hospital, wholly independent of the Hospital for its support, though subject to Regulations to be approved by the Governors".
The objects of the Institution were to: provide the public with skilled nurses trained in the hospital and of good character, to supply the hospital with extra nurses when required in emergencies and remove the need to hire casual nursing staff, and to provide nursing free of charge to those in the locality who could not afford other care.
Subscriptions were invited and £968.10.0 were received for the establishment of the Institution, its furnishing and the training of nurses. It was hoped that the Institution would be self-supporting within the first year. In September 1884 the Institution opened its doors for the first time at No.12 St Thomas' Street. The expansion of the Institution led rapidly to a need for further accommodation, therefore nos. 14 and 10 St Thomas' Street were leased from the Governors of St Thomas' Hospital in 1890 and 1899; the Institution took applications from women aged 23-32 yrs. Applicants were interviewed by the Lady Superintendent; they then had to work a month's probation on the wards before commencing their training. They were trained in medical and surgical nursing for a period of three years on the wards of Guy's Hospital, after which they were required to engage in private nursing on account of the Institution for a further year and a half.
Between 1884-1892 the management of the Institution was in the hands of Edward Lushington, in consultation with the Matron of Guy's Hospital and the Lady Superintendent of the Institution. In 1892 an Indenture was signed that vested all the property, funds and monies of the Institution in a body of Trustees, however the day to day administration was still in the hands of Mr Lushington. It was not until 1896 that an amendment was made to the Indenture and to the management of the Institution. The Deed Poll of 1896 created a body of managers to govern the Institution, this was to consist of four ex-officio members, the President, the Treasurer and the Matron of Guy's, and the Lady Superintendent. There were also three representatives from the Governors and two representatives drawn from the Medical and Surgical staff of the Hospital.
The Trained Nurses Institution was also responsible for the maintenance of two maternity nurses. These women were paid by the Institution to nurse in their homes, women attended by students of Guy's during their confinement who were subsequently suffering complications. In 1900 a Midwifery Training School was established in No.10 St Thomas' Street with a resident midwife to prepare pupils for the examination of the Central Midwives Board. Nurses on the staff of the Institution took the course on completion of their four and a half years training. Other Guy's Nurse could pay to undertake the course, or were trained free of charge on the condition that they served on the staff for nine months after qualification. The Midwifery School began as a charity, and then became a source of income, as a means of attracting nurses to the Institution.
During the First World War a large number of nurses from the Institution saw active service. They were serving with the War Office (Civil Hospital Reserve), the British Red Cross and the St John's Ambulance Associations and other organisations. This was to have a direct impact on the future of the Institution. The shortage of staff due to the number participating in war nursing led to a decrease in receipts and increased expenditure. This resulted in the Institution operating at a loss. From as early as 1917 the minutes of the Board of Managers show the concern that was felt over the financial situation and discussions were taking place about the institution's future. On 10th November 1921 a resolution was passed unanimously by the Managers "That having regard to the financial position of the Institution and being satisfied the same cannot be continued without further loss and that it is advisable that the affairs of the Institution be wound up. The Managers acting in pursuance of the powers conferred upon them Hereby resolve that the Institution be wound up as from the 31st December next." The Institution was liquidated as from 31st January 1922 and the remaining nurses entered into private practice.