[Sidenote: Query as to depriving certain Patients of Visitors.]
1. Proper military and medical advice should be taken as to whether it
would be advisable to draw a distinction between the venereal and the
other patients.
In the Vienna Military Hospital they are locked up by themselves in
particular wards, but are allowed to see their comrades at visiting
hours.
In the Berlin Military Hospital they are locked up in wards, and
allowed to receive no visits whatever, excepting, of course, from the
Chaplain and the proper Military and Medical Officers; and in the case
of dying patients from their nearest friends.
Nor are they allowed exercise in the grounds.
This excellent regulation makes them heartily tired of the venereal
wards, and even this is a very salutary thing.
In the Vienna and Berlin Civil Hospitals, the venereal patients of both
sexes are also placed in locked wards, and allowed no visitors. Nor are
they allowed exercise in the grounds or garden.
In the two Paris Venereal Hospitals no visitors are allowed.
Now, as the more disagreeable the subject, the more necessary it is to
be explicit upon it when entered upon, this wholesome discipline exists
in a very faint degree in our great Civil Hospitals,--a thing not to be
lost sight of in introducing any change in the Army Hospitals.
The three greatest London Hospitals have venereal wards. The female
patients never leave the ward. The male patients take exercise in the
court. In one case the rule is, that this should be at different hours
from the other patients; the rule is not strictly adhered to.
The exercise question should, in Military Hospitals, be left entirely
to the Surgeons; they may fairly consider it enters into the question
of treatment, which is different from the Continental treatment. The
enforcement of different hours of exercise from those of the other
patients is good, as is every brand which can, quietly and effectually,
affix disgrace to these wards.
Deprivation of visitors, if it could be done, would be very salutary.
In the great London Civil Hospitals, men and women visit the male
venereal wards; women alone the female wards (and melancholy things
are the visiting hours there; here and there a heart-broken mother,
abundance of prostitutes, and no lack of procuresses. A firm and
vigilant Head Nurse will sometimes refuse admitting one of the two
latter sorts to some patient, whom she knows they are endeavouring
to make sure of again; but as the rules admit female visitors, and
she is by rights only entitled to eject a visitor whose behaviour
is disorderly in the ward, the Head Nurse can only do this in point
of fact by straining the rules, and cannot do it often). The female
visitors of the male venereal wards are usually, on the average, much
less disreputable than those to the equivalent female wards; and are
generally wives, mothers, and sisters, seldom prostitutes. There can
be no doubt, however, that it would be much better if the patients of
neither male nor female foul wards were allowed visitors, unless in
the comparatively very rare cases of extreme danger; it would, in that
case, be necessary that the Hospital should supply them with linen, and
either supply them with groceries or forbid their receiving them from
without.
In various essential respects the patients of a Military Hospital are
different from those of a Civil Hospital. Were it possible to prevent
all female visitors to the wards, except in dangerous cases, this
would be best. If the existing rules or practice do not compel the
sentries to refuse entrance to all disorderly women, however orderly
their behaviour, such a rule, at any rate, should be enforced. And if
all visitors, male and female, including, of course, soldiers, could
be refused admittance to the venereal wards, always excepting cases of
great danger, it would be very desirable. At all events, it would be
very desirable to have all female visitors, without exception, excluded
from these wards. These things are, I do consider, very important. But
I would not press them, if refused.
Let the female service obtain, please God (I do not write these words
_pro formâ_,--if possible, I feel every day more intensely how solely
it is to Him we must trust in this difficult work,--the more so that,
if possible, I feel every day more intensely the importance of, if He
grants it success, improving secular Hospital nursing, leaving the
English Sisterhoods, which will always have great advantages, and, I
believe, great disadvantages, with reference to Hospital nursing, to
take their share in this great field, which has plenty of room for
both), let, I say, the female service obtain a firm footing in the Army
Hospitals, and with it, and by cautious degrees, sundry ameliorations
will creep in insensibly as to decorum among other things. Those solemn
beautiful words I have always felt so full of meaning to us, “In
quietness and in confidence shall be your strength.”
[Sidenote: Query as to Numbering Patients.]
2. Military as well as Medical advice should also be taken upon the
following point:
In most, not all, the great London Hospitals the patients, whose names
are on their bed-tickets, are called by the numbers 1, 2, 3, &c.,
suspended over each bed; sometimes a patient’s name is never heard in
the ward.
Now, very possibly, this would not at all do in a Military Hospital,
and, if so, there is not another word to be said about it.
Otherwise, very few things so effectually save time, as the numbering
plan. (In Civil Hospitals it is also excellent in other ways, of much
less consequence in a Military Hospital, which will never, I conclude,
be afflicted with “gentlemen,” Mr. So-and-So, and Master So-and-So,
which latter inscription is frequently to be read on the letters of
little boys in Hospitals, whose friends, on visiting days, also enquire
for them by that title). But few things, I repeat, so effectually
save time as numbering instead of naming the patients (names, of
course, to be on bed-tickets). If, however, the officers consider it
“unsoldierly,” give it up at once.
[Sidenote: Regulations as to Swearing.]
3. The regulations lately in force contained in plain strong language
prohibition of swearing and indecent language in Hospitals; they are
quoted from the Articles of War. It would be well to retain this in
any new Regulations; and the retention of this Rule is not the less
important when women are put in charge of Military wards, since, though
it is not their business to maintain discipline, it is their duty to
call in those whose duty it is when discipline is infringed. And it is
important that this prohibition of swearing and foul language should
not be looked upon as an individual or collective crotchet, or female
innovation, but remain the rule of the Service. Such language would
never be used in the Nurse’s presence unless by her own fault. But it
should be unheard in the ward, whether she is in it or not. The old
definite words should be transcribed.
[Sidenote: Conclusion.]
I do not like writing any part of the above, not because it can, in
any sense, be said to strain the necessary principle of reserve, save
for strictly business purposes, as to all which is, strictly speaking,
Hospital business, but because of the extreme caution necessary as
to this sort of topics. Still life is so uncertain that the possible
introduction of permanent Female Service into Army Hospitals has
determined me on writing what I had rather not have written.
ADDITIONAL HINTS AS TO PAVILION HOSPITALS SUGGESTED BY THE CONSTRUCTION
OF THE LARIBOISIÈRE HOSPITAL AT PARIS.