The nurses are members of Queen Alexandria's Imperial Military Nursing Service (QAIMNS). The small cape they wear is called a tippet. There are two tippets: the completely scarlet ones denote professional military nurses; the gray one with a scarlet band denotes a reserve nurse; that is, a civilian nurse who enlisted for the duration of the war. The small ribbon on the left side of the tippet is the Royal Red Cross, created by Queen Victoria, was the first British Military Order awarded only to women. The badge hanging on the right side of the tippet is the tippet medal for QUAINs and QUAINS(R)s. The ribbons are the same for both groups; professional nurses have an oval medal with a cross on it; reserve nurses have a round medal with the letter R. Both denote that the wearer was a State Registered Nurse and that she was a military nurse. It's the military equivalent of civilian Registered Nurses wearing their nursing school pin on their uniform. At the time of World War I, being a Registered Nurse was a big deal, a symbol that a woman had completed a rigorous training program and met all the qualifications for state registration.