_Ladies and Gentlemen and Class of 1888_: We are apt to claim the
trained female nurse as the outcome of the more rational treatment of
disease, in modern times, but this is wide of the truth. So far as I can
ascertain, in my researches among the ancient Vidas of Hindostan, and
the literature of Egypt, Greece and Rome, I find no allusion to female
nurses as a class, until the third century of the Christian era. Surgery
and medicine had attained a high degree of perfection, many operations
which to-day we claim as new to the nineteenth century were successfully
performed 4,000 years ago; but the special nursing of them seems to have
been done by the medical student, or by the practitioner himself. The
earliest record I can find of women devoting themselves to the care of
the sick, and attending to all the duties of a trained nurse, is that of
Empress Helena, mother of Constantine the Great. This noble woman, who
lived nearly fifteen hundred years ago, not only founded a hospital and
endowed it, but herself, with the ladies of her court, there gave the
most devoted and tender care to the sick poor. The Emperor Valens
presented the most beautiful grounds and buildings in the neighborhood
of Cæsarea to Archbishop Basil, “for the benefit of the poor whose
bodies were afflicted with disease,” as being those who stood most in
need of assistance. And as early as A. D. 373, the Archbishop had
organized at Cæsarea an immense hospital, called the “Basilides,” which
Gregory Nazienza thought worthy to be recorded among the wonders of the
world; so numerous were the poor and sick who came thither, and so
admirable was the care and order in which they were served. The charge
of these sufferers was not at first assigned to humble hands; the most
illustrious ladies of the empire participating in the offices of mercy.
At Constantinople the Empress Flacilla, wife of the elder Theodosius, in
the year 380 was watching with solicitude over all those whose bodies
were mutilated, or who had lost limbs. She visited them in their own
dwellings, waited upon them herself, and supplied their wants. She
repaired with the same zeal to the public hospitals of the church, where
she attended the sick, made ready their culinary utensils, tasted their
broth, carried the dish to them, broke the bread, divided the meal,
washed the cups, and performed for them all the offices which usually
devolve upon servants. One might justly be proud to be in such royal
company, and regard, as she did, nothing degrading which is necessary to
be done for a sick patient.
In modern times, the revival of nursing by trained women is due in great
measure to that noble and accomplished woman, Florence Nightingale. As
early as 1844, at the age of twenty-one years, she began to exhibit her
interest in and the alleviation of suffering, and the improvement of the
care of the sick poor in the hospitals of Great Britain. She visited and
inspected the hospitals of Europe, and in 1851 entered into training as
a nurse, in the institution of Protestant Deaconesses, at Kaiserworth on
the Rhine. On her return to London she put into thorough order the
Sanitarium for Governesses, in connection with the London Institute. She
served ten years of apprenticeship before entering on her life work.
In the spring of 1854 war was declared with Russia, and an army of
25,000 men was despatched to the Crimea. The faulty arrangements of the
British government for the care of the sick and wounded furnished the
theatre in which Florence Nightingale was to win her first laurels. The
hospitals were soon crowded, and the mortality in the wards so great
that the casualties of the fiercest battles were as nothing in
comparison.
The war office recognizing the condition of affairs, gladly accepted the
offer of Miss Nightingale to go to the seat of war and organize a
nursing department.
Her devotion to the sufferers can never be forgotten, she has stood
twenty hours at a time, directing and assisting in the care of the sick
and wounded. Her unfaltering devotion and incessant work undermined her
health; but though sick and feeble, she never left the field of duty
until Turkey was evacuated by the English troops. Major Delafield (who
with Maj. Mordecai and Capt. Geo. B. McClellan, U. S. A., had been sent
to Europe by our government, to study the art of war in the Crimea), in
his report to the War Department, remarks, in speaking of the English
hospital at Scutari, “It was in this well-arranged hospital that that
most estimable lady, Miss Nightingale, exercised her powerful influence
in alleviating the condition of the sick and wounded from the
battle-field. Women as nurses were employed to attend upon the men in
the wards, under the kind and beneficent guardianship of this good lady,
with the many advantages that would naturally follow the most gentle,
painstaking, and cleanly attendance of women as nurses. Miss
Nightingale’s efforts have resulted in the establishing, in connection
with the English army, an office known as the ‘Superintendant General of
Army Nurses,’ the office to be always filled by a woman. She has under
her a corps of female nurses, who take care of the sick in the military
hospitals.” The Sanitary and Christian Commission of our late war was
the outcome of the volunteer nursing in the English war of the Crimea
and the fruit of these efforts in this country are the training schools
for nurses which have sprung up all over this land.
Next to our entrance into this world and our departure from it,
occasions such as the present, when we have completed our education and
are about to enter upon our chosen vocation, are the most important
events in our lives. The calling which you have chosen, while not a new
one, is comparatively new in having special schools, and courses of
study provided for it. Nursing has always been considered peculiarly
woman’s work—more or less adaptation to such work is inborn in woman.
What man can smoothe the pillow of the sick, or soothe an aching brow as
gently and acceptably as one of the gentler sex! Who can move as
quietly, and approach the bed of pain so gently as woman!
I have seen sick men, absent from home and friends, sigh for a mother,
sister, or wife who is not at hand.
Thanks to this school, and others, everyone can now have skilled female
care when sickness and disease are upon them.
You who are about to go out from us to-day, are entering upon a calling
which will require all the skill, faithfulness, courage, patience,
forbearance, endurance, watchfulness, self-possession, tenderness,
cheerfulness and tact, that a human being can possess, and above all, “a
conscience void of offence toward God and man.” “To thine own self be
true, and it doth follow as the night the day, thou canst not then be
false to any other.” You have each and all of you received, at the hands
of your admirable Superintendent, and the lecturers of the College, such
definite and varied information in all the departments in which you may
be called to act, that you ought to be prepared for most emergencies,
and have shown by your examinations that you have heard and understood
them.
The fault will be yours, and yours alone, if you do not treasure them in
your minds, so that you may be not only trained but _skilled_ nurses.
The responsibility for the proper management of a sick-room and the
patient in it is a very high and grave position, and requires the utmost
faithfulness on the part of the nurse. Unless you are willing to put
aside everything that may interfere with your giving _yourself_ entirely
and conscientiously to the care of your patient, do not assume the
charge. But when you once receive that charge remember that you are
dealing with that which disease can destroy by your negligence, and no
human power can restore—a precious human life. You therefore owe to each
case all that a faithful mind can suggest and the body endure; and such
faithfulness has not been wanting in the former graduates of this
school.
I can never forget the scene when one of our graduates, after having
charge of over thirty cases of typhoid fever among some orphan children,
and we had to lose one, whom she had nursed as faithfully and tenderly
as its own mother could have done, how, when she had done her all and
death claimed him, there were tears shed for one who had no mother to
shed them. And it was due largely to her unremitting faithfulness that
we were able to record but two deaths in thirty-three cases. That woman
has not had an idle day to my knowledge in several years.
When any unexpected emergency arises, which to your educated eye teaches
you that your patient is in extreme danger, do not alarm the friends
unnecessarily; try not to show in your voice or conduct that you are
demoralized and have lost courage. While doing the best you can (until
the arrival of the physician, whom it was your first duty to have
summoned), encourage those around you, and keep them busy if you can,
as, unless they are occupied, the coming of the physician will seem to
them unreasonably delayed, even though he be at hand when called. Above
all, do not let every physician within reach be sent for, unless the
situation is one of great urgency, as I believe many patients have been
frightened to death by the demoralization of solicitous friends.
If you can show yourself capable and maintain your own composure of
mind, you will be able in nearly every instance to avert a panic, and in
many cases prevent disastrous results to your patient. But if you fail
at times for want of proper courage, do not give up with a feeling that
you are unequal to emergencies, only be the more determined not to show
the white feather again.
It is a well known fact to military men, that veteran troops who have
stood the brunt of the fight in many a battle, become demoralized
unexpectedly and retreat, to the utter surprise of their officers. But
in their next battle their courage and deeds of prowess again surprise
every one. So be it with you.
In the sick-room nothing so distresses the helpless sufferer as a want
of frankness on the part of the attendant. You may refuse or neglect to
answer, or turn the subject if possible, but never tell what are called
“white lies.” One lie always requires another to cover it, and sooner or
later you will be caught. If it is not best to tell, say outright it is
better for me not to answer that question; or it may be the least of two
evils to answer it faithfully as patients often imagine that things are
far worse than they are. I believe that we of the medical profession
often err in withholding from patients that which it is best in the end
that they should know. This is one of our most difficult lines to draw.
If you have not learned or are not determined to learn to endure the
caprices and demands of unreasonable men and women in the most
unreasonable hour of their lives, you have mistaken your calling; as
without Christian patience, I do not believe it possible for a nurse to
succeed for any length of time. The trials and vexations of a nurse’s
life are so numerous and so constant, that it is a wonder to me that
there are so many who are ready to enter this calling in life. There is
no need since the revival of professional nursing for women to torture
themselves or do penance. Be as ready to minister to disagreeable people
as a person who two years ago wrote that she would take a fresh air
child, saying “send me one of the dirtiest, most unattractive and unruly
of the children, one whom nobody else wants.” An unreasonable, selfish
and wilful patient is a purgatorial discipline for both nurse and
doctor.
Remember that the most gentle and considerate of people will say and do
things when sick unwittingly, that in health they would sooner cut out
their tongues or destroy a limb than say or do. The mind is sick as well
as the body, and the patient not responsible. Cultivate forbearance and
endeavor to sear all your tender points. Be ever ready to excuse and
believe that no slight was intended, unless it is reiterated and you are
forced to believe it.
The physical and mental strain which you are at times called to bear
will be very great; that you may be able to endure it, you must give
special care to your health. You have been taught the laws of health,
and yours is so arduous a calling you must observe them strictly. Dame
Nature is a stern mistress, and if you disobey her you will surely
suffer for it. When you are out of employment you will need recreation
and diversion to keep both body and mind in the best condition. When you
are in charge of a patient, the time away from the bedside is not yours
to do with as you please, but for rest and fresh air; as you owe it to
your patient to give the best possible service, and thus only can you do
it.
You must cultivate the habit of observing the least change in your
patient’s condition, so as to be ready to meet any emergency; it will
not do to sit down and watch your patient as a cat would a mouse. Yet in
severe cases your eye should hardly ever be off your patient; this
should be accomplished and can be done in such a way as to be almost
imperceptible to the sufferer. Every little change should be noted, and
if any importance may attach to it, it should be written down as soon as
you can conveniently do so. You are the physician’s eyes, ears, and
hands while he is absent; you cannot therefore be too watchful.
Each one of us has certain vulnerable points of character, but it is not
always easy for us to see them. If we would be self-possessed we must
seek to discover these weak points in our armor by seeing ourselves as
others see us; then by learning how to cover them, and not be
disconcerted when our weak point is attacked. No _one_ virtue is of more
value in your arduous calling than this one of self-possession.
In this world of care and trouble much can be done to ameliorate
suffering and soften the sting of pain by tender, sympathetic care; your
patients will expect less of you if all you do is done with ease and
quietness and thoughtful tenderness. You will then be likely to gain a
friend in every patient; the patient will feel that a friend has gone
when you depart.
A cheerful character rides smoothly over many rough places in this world
that otherwise would jolt terribly. A bright, cheery nurse is better
than many a dose of medicine for the patient; therefore be always
cheerful. By cheerful I do not mean frivolous, as levity is the last
thing that should appear in a room where such mighty elements are at
work as in the sick-chamber. Therefore be cheery, but not mirthful or
giddy.
There are some words in the dead languages which it is almost impossible
to put into English without, in a great measure, losing their meaning
because they contain so much in themselves; they are so difficult to
define. So there is one little word in the English language that
contains so much in itself that it is impossible to define it in a few
words, and after using many you feel that you have only sailed around it
without getting at the central and most important part of it—that word
is _tact_. But it is the want of that which has consigned some of the
brightest and noblest minds that I have known to oblivion. I call to
mind just now one of the best read and most highly cultured and gifted
men that the medical profession of Brooklyn has ever known. He lived and
died among us, unappreciated except by the few who knew him best, little
sought after by those who needed balm for their diseases, which he was
better able to apply than most of his companions, and with scanty
maintenance, while medical sky-rockets about him were riding into
lucrative practices. The suffering continued to suffer, when, if they
had only known it, skilled and efficient help was at hand, in a man who
did not know how to so bear himself as to win the confidence of the
community. Had he possessed a little tact his name would have been known
to the world.
I want to say to each one of you, consider well if you propose to follow
this arduous calling, pause and consider whether you really feel that it
is your vocation, and feel equal to its physical and mental demands.
An ideal to strive after is good for us all. I will lay before you
to-night one that was realized in the history of a friend who is now in
a better and happier clime than this, and whom I would be glad to have
each one of you strive to emulate.
Some years ago, before, as far as I know, there were any trained nurses
in this city, I was asked to go to see a lady in a neighboring village,
who had been confined to her bed for more than a year, and was supposed
to be incurable. A year from that time she was able to be about, and six
months later she determined to devote her time to the care of the sick
poor. She did so, and I never had any one who would, or could, take
better care of every case that fell to her charge. I always felt that,
as far as human skill and strength could do it, my directions would be
carried out to the very letter. Her last case was that of a little girl
who had been burned over about three-quarters of her body, a degree of
burning usually considered fatal; but in this case it did not prove so;
and for months this noble woman dressed this suffering child, and would
let no one else do it. Little Tina dreaded to have any one else touch
her. The child was almost well, and this good woman was just finishing
her morning dressing of the burn, when she suddenly fell back and
expired. The soldier died at her post of duty.
“Like a star which maketh not haste and taketh not rest, let each be
fulfilling his heaven born hest.”