forty beds. The Sister is a first-rate nurse and a splendid manager. She
works hard herself, and expects every one else to do the same; so the
ward always looks trim, and the patients are very comfortable.
My short experience at N. has been very useful to me, and I don't feel
so much at sea in doing things for the men.
I find that, as lady pupil, I am really acting as "sister's assistant."
I go round with Sister with the doctors, and if she is engaged with one
doctor and another one comes, I have to escort him round; and it is
necessary for me to know all about the cases, so as to be able to report
about them. Another of my duties is to give all the medicines, and that
for forty medical cases takes up a good deal of time. I also have charge
of four beds, and do everything for the patients in them.
There are two staff nurses and two probationers (also two ward-maids),
and I fill in my spare time with helping them in bed-making, carrying
round meals, &c.; but I don't seem to be expected to do any of the
cleaning work, and if I am busy helping Sister, the routine work goes on
just the same without my assistance. I am not quite sure that it is a
good arrangement, as one of the staff nurses in this ward has been here
for years and years, and the other one for over three years, so of
course they know more about the cases than I do; and I should think a
brand new lady pupil, who had had no training before, might find it
rather difficult. But I must say the staffs have been very nice to me. I
didn't mean to let it be known that I "had been out before," but it
leaked out.
There are about twenty of us lady pupils, and we live in the Matron's
house. We have all our meals in the large nurses' dining-hall--but at a
separate table--except supper, which we have in the sisters'
dining-hall. The food is ever so much better than it was at the
Children's Hospital. Some of the nurses grumble at it; but I think
wherever people feed in a crowd there are always some who grumble. At
any rate, it is not _necessary_ to buy food here.
At first I had rather uninteresting cases in my beds, but now Sister is
giving me some good ones. I have one jolly fat baby of two and a half
with tonsilitis, who was sent to us from a women's ward, because they
were not sure that he was not going in for diphtheria, and they had
other children in the ward. I had to do a good deal of treatment for him
at first, and he hated it; but now he has forgiven me, and we are
excellent friends, and all the men are doing their best to spoil him.
Then I have a poor man with Bright's disease, who is very ill. He is a
curious-looking object, as he is quite bald, and he likes to wear a red
knitted cap in bed. He is often delirious now in the evenings, and then
he uses very bad language. When Sister is out in the evening, I have to
read prayers in the ward. At first I was very shy of reading before all
these men, especially when some of them are of quite a superior class;
and when I was in the middle of prayers the other evening, my
bald-headed man chimed in with a lot of bad language. It was really very
trying, and I knew if either of the nurses went to remonstrate with him,
he would only continue in a louder voice; so I had to shorten the
prayers somewhat. If he continues like this, I am afraid he will have to
go to the strong-room; but up there they have only male attendants, and
we are rather loth to send him off, as he is really very ill, and needs
a lot of nursing.
A sad thing happened the other day. We had an old man in very ill with
angina pectoris; he had great difficulty in breathing, and could not lie
down at all. I was always trying to prop him up and make him
comfortable. He got very little rest, but he was always so good and
grateful. He was not one of my own cases; but he was on several
medicines (to be given as required), so I had to go to him very often
for one thing and another. One day I was going round giving the two
o'clock medicines, and when I got to his bed, he was lying back on his
pillows apparently asleep. It was so unusual for him to look at all
comfortable, I thought I would certainly not disturb him for his
medicine. Sister was talking to a doctor a few yards away, and I was
just going to point out to her that the old man was resting, when
something made me turn back and look at him more closely, and I found he
was quite dead. Poor old fellow, he was indeed "resting." I just pulled
a screen round him, and then called Sister and the house surgeon; but he
was quite gone, and even the man in the next bed had not noticed any
change.
XIII
GENERAL HOSPITAL, LONDON,
_August 1894_.
With much sorrow I left my nice and interesting men's medical ward, and
found myself landed in a smaller surgical and accident ward for women
and children. There could hardly have been a greater contrast. There
everything was done with order and method, and well done; here every one
seems to rush about in a breathless way, and the ward never looks tidy,
and I am quite sure that the bustle that goes on is bad for the serious
cases.
I am responsible for eight cases instead of four, and at first I thought
I should never get them all washed in time in the morning; but now I
find so many of them can do a good deal more for themselves than the
medical cases could; also the medicines in a surgical ward are nothing
to those in a medical; so I get through all right, and keep up to time.
Three surgeons have beds in the ward, and that makes the work a little
difficult, as sometimes they all arrive at the same time, and sometimes
they all want to operate at the same time. This is most awkward, as we
have not got fittings for them all, and have to run backwards and
forwards for things. They seem to me a most amiable set of surgeons; I
know the surgeons at our Children's Hospital would not have put up with
being kept waiting as these men do; but I do hate not having everything
they want ready before they ask for it. However, I am beginning to feel
my way, and I think I shall soon be able to get different sets of things
ready to use in these emergencies.
It took me some time to find out why the ward was always in a state of
chaos, and it is only because you are so far away that I can safely tell
you the reason. I believe it is simply and solely because the Sister,
though a fairly good nurse, is really no good as a Sister. I am sorry to
say it, as she has been very nice to me, and the poor thing tries her
best. She runs about, and does many things that the junior probationers
ought to do, but she has no idea of looking after the nurses; and as the
staff nurse is rather a shirker, and is very fond of chattering to the
dressers, the probationers who are keen to work are rather overworked,
and those who are not keen don't work. Also, if there is a rush of work,
Sister rather loses her head, and runs about in an aimless sort of way;
and in the theatre, if anything goes wrong, and they want things in a
hurry, she always seems to hand the wrong thing.
I find it a bit difficult, as the doctors get in the way of turning to
me if they want things quickly. As soon as I found out what was wrong
with the ward, and that Sister was quite nice and "meant well," but just
had not got it in her to be a good manager, I made up my mind that the
ward _should_ be a smart ward, in spite of obstacles, and really it is
improving by degrees.
I have been having a good deal of correspondence lately about a small
boy who, Sister said, would have to go to the workhouse when he leaves
here, and I thought he was a suitable case for Dr. Barnardo's Homes; so
she said I could try if I could get him in there, and I have just
succeeded in doing so.
His mother died when he was born, and his father appears to be a
thoroughly bad lot, generally in prison. This boy had lived with his old
grandmother and run wild; a pretty little chap, but quite a heathen, and
fond of using bad language in the most innocent way. He came in here for
a small operation, and while he has been here his grandmother died very
suddenly. The people at Dr. Barnardo's Homes have been very good about
it, made all inquiries for themselves, and got the father's consent. Now
they have agreed to take him as soon as he is well. He is a plucky
little chap, and I suppose they will probably ship him over to Canada
one day, and that will give him a better start in life than he might get
from a workhouse.
I think we get very good times off duty here--one hour off one day, and
three hours off the next; and the sisters and lady pupils have a
Saturday to Monday once a month--that means from 4 P.M. on Saturday to
10 A.M. on Monday.
When I was moved to this ward, I just missed my Saturday to Monday; so,
to make up for it, they gave me "extra leave" last week from Saturday
afternoon to Monday night, and it just happened to be May week at
Cambridge, so I went down and had such a jolly time. B. seems to be very
happy at Clare, and to have very nice friends there. My sister was up
for all the week, and having a first-rate time, going to all the dances,
&c. It was my first visit to Cambridge, and there was so much to see. It
ought to be easy to work when you are in such beautiful surroundings.
On the way back the engine of my train broke down, and I did not get in
till 11 P.M., and I had to go and confess the next morning in the office
that I was late; but it was the first time I had been late since I came,
so I was forgiven.
We had rather an exciting "take-in" week a fortnight or so ago: first of
all a poor, tiny baby with a very badly-cut throat (done by its mother,
who had afterwards proceeded to cut her own throat, and killed herself).
They did tracheotomy for the baby, but it lived only a few hours. Then
came a poor little girl of eight, very badly burnt. She had had to get
up to light the fire while her mother lay in bed (from her looks, I
should think the mother had been drinking), and the child managed to set
herself on fire. I think she will pull round, but it will be a long time
before she will be able to walk again. She does not have much pain now,
and I think she is quite enjoying herself here. The next case was
another cut throat--a poor, feeble-looking woman, whose husband had
first cut her throat and then his own. He is in the male accident ward,
and not very much damaged; she is a good deal damaged, but I think they
will both recover.
I had arranged to go to the Academy with L., as it was my free
afternoon; but this poor woman came in soon after dinner, and I knew she
would have to go up to the theatre, so I wired to L. that I could not
meet her. And it was just as well I did, as three more accidents came in
that afternoon, and one of these too had to go to the theatre (a
compound fracture of the tibia and fibula); so we had a rushing time.
Yesterday was theatre day for our ward; and as Sister had had to retire
to bed with a sick-headache, I had the honour of taking our cases up to
the theatre. I was rather nervous, as it was the first time I had been
up alone for our senior surgeon, and he had one bad case--an excision of
knee. But the other three cases were not very bad ones, and we got along
all right.
For the last three months we have been having a very interesting course
of lectures on physiology, and the girl who shares my room and I spend
all our spare minutes in reading up the subject. She is clever, but has
not read much physiology before, so I have been able to help her a bit;
and I should not be surprised if she does better in the exam. than I do.
We are both of us looked upon as quite juniors amongst the lady pupils;
but I don't fancy the seniors are taking much trouble, beyond just
writing out their notes of the lectures, so I hope we shall do pretty
decently. It is not easy to get much time to read when you have a heavy
ward to wrestle with; but I am sure it helps you in exams. if you can
manage to read rather more than you are absolutely obliged to about what
the lecturer is trying to stuff into you in a condensed form.
I have been here six months now, and may get sent off for my holiday any
day; but there has been some delay on account of Sister not being very
well. She does not seem to want me to leave, as I shall probably not get
sent back to this ward afterwards; but it has been very hot of late, and
I shall be glad of a rest.
XIV
GENERAL HOSPITAL, LONDON,
_December 1894_.
After my last letter to you I was bundled off for my holiday. I was glad
enough to get it, but I missed the last two physiology lectures. This
was rather a bore, as the exam. was the day after I got back; so I had
no chance of borrowing any one's notes of those lectures, as I was
supposed to do. However, I came out third, and my stable companion was
first amongst the lady pupils--not so bad for two juniors; and we heard
that four or five of the seniors had a little interview with the Matron
in her office, and were advised to work rather harder before the next
exam.
Now we are having lectures on dispensing, and they are the most
interesting lectures I have struck yet. We go down to the dispensary,
and the head-dispenser makes us mess about, and make up prescriptions,
and make pills, powders, &c. We fire off questions at each other at odd
moments, when we meet--and also in bed at night--as to the various doses
of different drugs, and what they are prescribed for, and the antidotes
for different poisons, &c.
I was sent to a very nice women's medical ward on my return from my
holiday, and had some interesting work there. The Sister was very nice
to me (she has been here for years, and many of the lady pupils don't
like her, but she is a first-rate nurse), and she gave me very good
cases. One of my first cases was a little girl of ten with typhoid
fever. She was very ill for some weeks, and then such a poor little
wasted skeleton of a child! It was very nice feeding her up, when once
it was safe to do so; and her great big eyes used to follow me about the
ward, wondering what the next feed was going to be.
Sister said that I could hardly have had a more instructive case, as she
had nearly all the bad symptoms a typhoid case can have, including a
good deal of hæmorrhage.
I was horribly proud one day when the senior physician was going round
and lecturing to the students and speaking to them of the necessity for
good nursing in typhoid; and he made Sister show them the child's poor,
bony little back and legs, with not a red mark on them; and he told them
it had taken all her strength to battle with the fever, and if she had
also had a bed-sore to sap her strength away, she could never have
pulled through.
We had two diphtheria tracheotomies while I was in that ward; and though
they were not my cases (as they both had special nurses), I was present
at the operations, and I learnt a good deal about their treatment, as
Sister used to let me relieve their nurses for meals, &c. And she taught
me to change and clean their tubes, and so on; so that when I was put on
as a special later on, I was not so much afraid of accidents as I should
otherwise have been.
It must have been a very bad form of diphtheria, as one of the specials
became infected, and had to go away to the Fever Hospital; and then
Sister took it, but she was not very ill with it, and she was nursed in
her own room. It has made them talk about the necessity for some
isolation ward to put these cases in. Of course they are only taken in
here if they are too ill for it to be safe to send them on to the Fever
Hospitals.
We had a busy time when Sister was ill, but the staff nurse was very
good and to be depended upon, and things went on all right.
I must tell you of a little joke we had one night in the Matron's house,
where all the lady pupils live. Late one evening in September, when we
were all undressed, one of them came to my room and said there was a
wretched cat on some leads outside the bathroom window, and it was
making such a row, as it could not escape. We went to inspect, and
agreed that a rescue was necessary. By this time most of the lady pupils
had assembled, and we fetched a ladder from the boxroom. It was too
short; but we tied bath towels to it, and lowered it through the window
to the leads. Then the stupid cat would not come up, and only cried the
more; so I was shoved through the window in my dressing-gown, and they
held on to me until I got my feet on the ladder, and could climb down to
the cat. Just then Matron's door opened, and they all slipped away to
their rooms. I heard something about "too much noise" and "lights out,"
and then she came into the bathroom and shut down the window. It was
lucky the ladder _was_ too short, or she must have seen it. It was
pretty dark, and I was sitting down consoling the cat and waiting till
the coast was clear, when I heard a smothered laugh, and then for the
first time I remembered the gardens at the back, that belonged to some
of our visiting doctors. I had looked at their houses and seen all the
blinds down, and I had never thought they might be sitting under the
trees at that time of night. After that, I very carefully kept my face
to the wall; and soon the window was cautiously opened, and with some
difficulty the cat and I were hauled in, and very quietly we pulled up
the ladder. Then I told them I was certain we had been watched, and we
located the garden from which the laugh had come; and next morning, sure
enough, there were two basket-chairs under the trees, so we knew which
doctor it was. But he never gave us away, and I don't know to this day
whether he recognised me; but I often fancied there was a twinkle in his
eye when we met.
Then the question arose what to do with the cat, as it appeared to be
hungry, and not inclined to be quiet; so eventually the most
innocent-looking lady pupil was deputed to go to the home sister, and
tell her she had caught this strange cat in the bathroom, and, as it
seemed starving, might she go down and feed it, and then turn it out?
The home sister was fond of cats, and her sympathies were aroused; so
she assisted in providing it with supper and seeing it off the premises.
In November I was sent on night duty. The lady pupils are not obliged to
do night duty, as they are only here for one year; but Matron was short
of senior probationers, and asked me if I would like it, and I thought I
would. Part of the time I have been an "extra," just helping wherever
they were busy, and helping in the theatre for any night operations.
Then I was put on as "special" with a tracheotomy (diphtheria) in a
men's medical ward--such a nice boy, called Albert, aged eight. And,
when he was getting better, another little chap of three came in, so
desperately bad that they had to do tracheotomy in the receiving room;
and then he was brought over and put in a cot by my boy's bed, and I
looked after them both. Poor Albert was rather jealous at first, and
whenever I was attending to the small boy he began to "wheeze" too,
thinking I should rush to his rescue; but he soon found that that did
not pay.
After these boys had both recovered, I disinfected, and had a night off
to air myself; and then Matron let me do the staff nurse's nights
off--very interesting, but rather anxious, work.
You go to a ward which perhaps you have never been inside before, and
you don't know where anything is kept. There are from twenty to forty
patients; if the latter, there is a probationer to help you. Most of
them are sleeping quietly; the few who are awake are probably wondering
what sort of a rise they can take out of the strange nurse.
Some of the sisters are very good about giving one a full written
report; but other sisters are rather casual, telling you much of what
you may or may not do for number eight or number eleven, but seeming
impatient if you try to jot down notes.
The first night off I took was in a men's surgical ward, where there was
a nice lad of eighteen who had had his leg amputated that day (for a
tubercular knee). He was so good and patient, but of course he needed a
good deal of attention, and I wished I could stay with him all the time;
but there was an old man at the other end of the ward rather delirious,
and he would insist upon saying his prayers with a loud voice, and
confessing his sins to me, calling me "Maria, dear." I was thankful when
the house surgeon came round and ordered him a sleeping-draught; but it
took me quite half an hour to persuade him to drink it, and then it was
a long time before it had any effect.
In another ward the sister told me that the patients needed nothing to
be done for them until I gave them their breakfast in the morning, but
"_would_ I take great care of her Persian and Manx cats, and not let
them escape from the ward?"
It was also airing night, so I had plenty to do airing sheets, &c., and
putting on clean sheets in the morning; but it was not exciting.
To-night I am staff nurse in the men's accident ward; but there is a
bright little pro. on as well, and she seems to be accustomed to do most
of the work. We have had one case in--a van-boy with slight concussion
of the brain; but I have got him washed, and he is now asleep with an
ice-bag on his head. There are several bad cases in the ward, but they
all seem inclined to sleep; so I am actually sitting down to finish up
this scribble to you.
I like night duty; you seem to have more time to fad over the patients
who are really bad, and to do little things for their comfort; and the
convalescent ones generally sleep and don't worry you; but it is hard
work sometimes, especially between 5 and 8 A.M., when every one wakes
up, and every one wants something, and there are all the breakfasts to
give round, and all the beds to make, and the temperatures to take, and
the fomentations to change, and a hundred different things all needing
to be done at once; and you rush around and expect every minute the day
nurses will come in and say "What a muddle the ward is in!" and
sometimes, when you are beautifully forward with your work and think
Sister will be pleased, a house surgeon runs up in his pyjamas and
dressing-gown to say he is sending in a bad case, and then you have to
give all your attention to that case, and can't do the final clearing up
for which you thought there would be heaps of time!
XV
GENERAL HOSPITAL, LONDON,
_June 1895_.
Many and various are the jobs I have done since my last letter, and now
I must tell you that I am a full-blown Sister or, as they say here, I
have got "my blue"; but I had better begin where I left off.
I was then bustling about on night duty, and I spent a very happy
Christmas like that. Of course, we should all like to be at home for
Christmas, but in hospital so much is done to make it bright and cheery
for the patients, and so many of them have so little brightness in their
lives, that it is nice to see how thoroughly they enjoy it.
They all have really nice presents; there is any amount of good food
provided; plenty of entertainments (music, Christmas trees, &c.); and
the men are allowed to smoke in the wards.
The doctors and students are really splendid in the way they work at
decorating the wards, &c., and carrying the patients who are well enough
about to other wards for entertainments.
The children of the slums around here will do anything to get into the
hospital for Christmas, and the front surgery is full of little imps who
have all got a "very bad pain!"
In January I had to retire to bed for a few days with a high temperature
and a touch of influenza, and while I was in bed the day came for the
dispensing exam., so I begged to be allowed to go, and vowed I was
quite recovered, and they let me attend.
I made up my prescriptions (a bottle of medicine and some powders), and
then I got under way with the paper, and thought it was rather a nice
one, but before I reached the end my head began to swim, and I felt
convinced I had mixed everything up and given all the wrong doses, and I
thought what an ass I had been to try it, and I was certain I should
come out at the bottom of the list!
One of my friends escorted me back to bed and took my temperature, and
when she found it was 103 she went off and told the Matron; so next
morning the doctor appeared, and I was kept in bed for a whole week, and
then sent away for a few days' change, but before I went away Matron
came to tell me that I was first in the dispensing exam., with 114 marks
out of a possible 125. If I had any more exams. to go in for, I think I
ought to arrange to have a little influenza beforehand, as it seems to
stimulate my brain; but, thank goodness, that is my last.
You know I have always vowed that nothing would induce me to be a
matron? Well, I have been rather near it; I have been acting as
assistant matron for some time. First of all, the assistant matron was
ill, and went away for a bit, and I did her work; then, when she came
back, Matron went away for a fortnight, and I stayed on in the office
helping the assistant.