Undertook nurses training at Wellington Hospital, 1909. Enlisted with the Queen Alexandra's Imperial Nursing Service in 1910, James was reported as serving with the No. 12 General Hospital, Roeun, No.37 Field Ambulance, British General Hospital.

Sister James wrote a letter about her experiences at the General Hospital, Rouen, "Our hospital, will accomodate 520 patients, and including the matron we ought to have a staff of 43 sisters and staff nurses, but for various reasons we have lost twelve, so it makes the rest of us much more hard worked. Of course, there are pursing orderlies as well, 66 in number. The hospital is well equipped, even to sheets and white blankets. The latter turned up to-day, October 3, and we had a strenuosu day changing all the brown blankest with which we were equipped at first. In the midst of all this turmoil we were suddenly called over to our own camp to remove our belongining. We began our camp life in store tents, but as these leaked last night they were hauled dwon to-day, and lined marquees put up in their places. They are much warmer, but very dark. By the same token we also had white blankets given out to us. We even had two cats - Siamese. They were presented to our matron by the Mother Superior of the convent in which fourteen of us stayed when we came to Rouen the second time. We were there ten days and we were so sorry to leave. I have never experienced such kindness as was shown to us by Revered Mother and Sisters. It was an enclosed order the second monastery of the order of the Visitation. The convent is very old and full of treasure. Well enough of our adventures. I must tell you a little about the work. Nearly all the patients here are suffering from wounds caused by shrapnel shells bursting over their trenches. I do not think there are half a dozen in the camp with bullet wounds (single); some of the wounds are awful. For instance in my section (I have a section comprising three marquees on the surgical side), I have a man with a compound comminuted fracture of the femur. He was shot at very close quarters, consequently the wound to begin with was full of powder and the femur badly split up. Fortunately, it just escaped the knee-joint. At first the medical officers thought he would lose the leg, but it is going on satisfactorily and they think in a year's time it will be sound again. I have a piece of bone - about four inches long - which was removed. It shows the mark where the bullet was struck. We have many arms which have had to be opened up and drained, but they are all doiung well. There have been many minor operations for extraction of bullets, pieces of shrapnel, etc. I saw a wound made by a German dum-dum. The wound made by the ingress of the bullet is small, but coming out it tore the tissues, terribly, and shatters bone, too, if it happens to come in contact. We also have several men who have been shot through the lungs, including a German who is at present moment dying. I was told that at the military hospital at Versailles a great many are dying from tetanus and to-night I am told there is a man in our hospital showing symptoms of it. Some of the wounds are beyond description and the men tell us appaling stories of things that have happened. Surely this ghastly war cannot last for long. It is dreadful to think that so many Royal Army Medical Corps officers and men are killed and missing; those attached to the cavalry and field ambulances. According to the accounts heard from men some of the regiments have been badly cut up. I expect you saw the account of the wonderful charge the 9th Lancers made. They come from Tidsworth where I was stationed when the War broke out. Since writing above we have had another batch of wounded in, amongst them a quartermaster-sergeant of the 9th Lancers, who was injured by fragments of a malanite shell. He was literally peppered with wounds from head to foot, none very serious. How he escaped death is a marvel. Some soldiers beside him were killed outright - one being blown to pieces. A melanite shell is quite a new thing. It weighs 90 pounds and istead of containg bullets it is filled with scarp iron which inflicts very nasty wounds. The soldiers call these 'coal boxes' Most of the men now in hospital have come from Braesiro and Soissons, where so much fighting is taking place. They are all wonderfuly bright and cheerful in spite of the hard times they have experienced. They are not kept in bed unless absolutely necessary, so they amuse themselves playing cards and other games." Published in Dominion, 10 February 1915 AWMM