(1.) That, by all accounts, at home and abroad, in the English and in
foreign armies, the proportion of severe cases is very considerably
less, in time of peace, in a Military Hospital than in a Civil one,
especially in the surgical wards.
(2.) That the Nurse’s time, being relieved of the waste incurred by
fetching and waiting for things, the cleaning of the ward being done by
Orderlies, and, an important item, the Ward-Master being responsible
for the serving the patients’ food, twenty-five sick are not enough, on
an average, to occupy, properly, her time.
(3.) That idleness, always pernicious, is never more so than to
Hospital-Nurses.
(4.) That petting the patients, by way of filling up time, would be, of
the two, more pernicious than idleness.
(5.) That it is most important, apart from these reasons, to train and
accustom these Nurses to serve efficiently large numbers of patients,
so as to make them useful in war-service, where every woman who can be
spared is better away; and where a small efficient staff would, please
God, do excellent service.
(6.) That it is not in human nature, taking its average, supposing the
Regulations lay down that the proportion is not to exceed 25, for many
Nurses not to murmur at having more; whereas they ought from the first
to understand, that the service is a very laborious one, and that none
but women able and willing to undergo and render laborious service,
ought to enter it, or be suffered to remain in it.
(7.) Care must be taken therefore that in fixing this minimum, no use
may be made of it dangerous to the service, either in the Hospital work
itself, or in provoking adverse criticisms upon these Regulations in
quite different places. Twenty-five cases are not generally enough.
[Sidenote: 19. Precautions in sending Nurses abroad.]
19. It would be expedient to take the advice of an able and honest
man of business as to whether the Superintendent-General should, on
engaging a Matron or Nurse, have her signature to a bond or not.
On the one hand, we know what bonds are to loose consciences, and
if the promulgation of the Regulations give undoubted power to the
Superintendent-General and to her Matrons on foreign stations, I
should prefer having no bond. But this is for a man of business to
answer. It is important to remember that the power of instant dismissal
for misconduct, and of sending the Nurse home must be retained,
which renders the service different from ordinary female service. A
discharged governess or servant, if she insisted on remaining at her
own expense at the foreign station, could not be sent home forcibly
by her late mistress; now it is essential that an offending Nurse be
forthwith passed on board the first returning ship. Also performances
similar to those of one or two of the women in the War-Hospitals who,
on hearing of good situations, misbehaved in order to be discharged,
ought to be effectually prevented. A lawyer must advise, first, if
it can be; secondly, how it can be done. The Superintendent-General,
on sending abroad Nurses, ought to have some security either that
they remain there and do their duty, or that they be sent home for
her judgment if they fail in duty. To have them either going abroad
as Nurses by way of securing a free passage, and then looking out
for lucrative situations, or accepting the offers which might, and,
occasionally, undoubtedly would, be made to them, would be most
injurious to the Service. Can it be prevented by any stronger measure
than the instant forfeiture of all claim to the eventual pension? If
so, it should. Could this power be extended to the washerwomen who
would probably be sent with the Nurses ordered to War or out-of-the-way
foreign stations? Perhaps it will simplify things not to include them
in the Regulations.
[Sidenote: Hospital Laundries.]
The persons provided by the Officer, whoever he may be, to attend to
the hospital linen under the orders of the Matron, will be pretty
sure to give the Matron trouble. But it is much better to begin very
modestly, and to avoid alarming the Attendance Department; and so to
be content with the people provided in the linen store, and not at
all to invade the regions of the kitchen. By degrees, please God the
work prospers, it may be extended. I fear a laundry of men, except in
war-service, will be a costly and inefficient concern. Yet a laundry
of women, exempt from the control of the Matron, would be probably the
worse evil of the two. And it is both right and expedient to move very
slowly, and to begin with the nursing service alone. Ultimately, if we
invade both laundry and kitchen, I should still wish, in both, to have
as few women as possible. The fewer women are about an Army Hospital
the better.
ADDENDA WITH REGARD TO FEMALE NURSING IN A MILITARY HOSPITAL ON THE
PAVILION OR LARIBOISIÈRE PLAN.
[Illustration: _PARIS_