[2] As little reference as possible, no reference at all, if it can
be avoided, should be made, on our part, to the Confidential Report,
which, in 1855, was presented against the War-Nurses. The less scandal
about women is reverted to the better--a truth all slanderers have
always appreciated: “Calomniez, calomniez toujours: il en reste
toujours quelque chose.” It would be far preferable if Nurses could
enter the Army Hospitals quietly, and let by-gones be by-gones (the
useful experience always excepted, which has been gained).
[3] The work was done under many difficulties, some inevitable, some
which should have been spared. Things happened among us deeply to be
regretted. Rebellion among some ladies and some nuns, and drunkenness
among some nurses unhappily disgraced our body; minor faults justified
_pro tanto_ the common opinion that the vanity, the gossip, and the
insubordination (which none more despise than those who trade upon
them) of women make them unfit for, and mischievous in the Service,
however materially useful they may be in it. Of all this, the material
consequences might have been spared by some such “General Order” as
the above, which, at least, prevents others from taking advantage and
making capital of such faults.
[4] The Extra Diet Kitchens _must_, it is necessary to state, be
under a separate roof from the General Kitchens, as long as the
present system (or no-system) of cooking exists. But the sooner it is
altered the better. There should be one kitchen only. But the Nurse
should always superintend the administering of the Diets. She is
unquestionably the proper person, also, to administer the medicines,
&c. The Orderlies, to be of any use, must act under the direction of
the Head-Nurse and not independently. It would seem hardly necessary to
enunciate such a self-evident proposition.
[5] To all references which may here be made to Civil Hospitals I
should wish to say, by way of preface:--
1. That I have always believed and I believe it more and more every
day I live, that what is wrong in hospitals is to be patiently,
laboriously, and, above all, quietly mended by efforts made from within
them, if it pleases God to grant that blessing upon them without which
all human efforts are vain, and not by accusations, investigations, and
noise from without.
2. Also I have always believed, since I knew Hospitals at all, and I
believe it more and more every day I live, that, with all their faults
and shortcomings, which are easily learnt and more easily declaimed
against, our great English hospitals are places in which more is done
for the relief and cure of human misery, or, rather, of that large
branch of it arising from disease, than in any other places in the
world. Also that their faults are not essential to them, but that they
may, by God’s blessing on the patient endeavours of many years, be very
much modified.
[6] In their regulation dress they should always appear, except when
they go on holidays.
But let the Queen pay for the transport of one box and one bag only,
for each Nurse on duty; and if she takes more let her pay for it
herself.
[7] I would allow each Nurse 1½ pint of porter or ale _per diem_, or,
instead of the half-pint of porter, 1 oz. of brandy or a wineglass-full
of wine, as she likes best. Most Nurses crave, and rightly, for a
luncheon about 9 or 10 A.M., and drink some beer then. I would let them
take their own time as to when they drink their day’s allowance. But,
while trying to suit each Nurse’s varying tastes (and in Hospital duty
the taste does vary) each Nurse must keep to one thing, say for a week
or month.
[8] Better than a closet is a moveable dresser, only table-height,
under which cleaning can be carried on.
There should be no projections in a ward or recess, which are only
lodgments for flue and dust. The walls of a ward should be even,
polished, impervious.
[9] With regard to children we might look forward to a time when
a school might be formed for the children, if any, of such of Her
Majesty’s Nurses as are widows. This would be an additional bond to
the Service for the mothers. The children, of course, are not to be
admitted into Hospital; and strict rules must be made (and kept to) as
to when the mother should visit them. I do not anticipate that it would
be possible ever to have married women in the Service. And it is hardly
necessary to add, that no women but of unblemished character can ever
be admitted.
[10] Should a woman, however, out of the higher orders, be found as
efficient as one of the middle classes, as Matron, this should be no
reason for excluding her.
[11] If it be desired to include some War-Nurses after 40 it would
be better for the Superintendent-General, with the sanction of the
Secretary of State, to take, at first starting, a few past the age,
than, on their account, to alter the age. It stands to reason that, on
the formation of the Staff, approved Nurses of the War-Service should
be included in it, for the sake of the Service.
[12] It is better to omit the Belief. Singularly enough it is the one
thing objected to by Dissenters and Roman Catholics.
[13] If the Surgeons are for the men doing it, I would not overpress
this point. But, in the case of weak patients, it requires extra
care, and it would be much better to leave it as the duty of the
Nurse. At all events it will not answer to leave the enema and its
administrator unspecified. The Medical Staff Regulations assign it
to the Ward-Masters. It is a simple thing enough, but one by the
careless or ignorant administration of which many a man (and woman)
has been injured for life; and either the Ward-Master, the Assistant
Ward-Master, or the Nurse should be responsible for it. I should
prefer, as above stated, charging the Nurse with it; but if objected
to by the Surgeons, I should at once let them assign it to whichever
Non-commissioned Officer they chose.
[14] One Nurse might possibly be able to serve the whole Pavilion. The
highest estimate is here taken.
[15] The floors are of deal; the length and breadth of the boards
depending on circumstances. Wood skirtings run round the walls,
following the recesses of the window and doors, 2½ in. in height and
1½ in. in thickness. The skirtings should have no indents in them,
which form convenient lodgments for dust and take time to clean. A
little rim must run round the top of the skirting, edging the wall. The
skirting should thence descend, unindented, upon the floor. The boards
are coloured and prepared, as follows: A new floor is rubbed over
two or three times, with warm linseed-oil varnish, having some fine
yellow-ochre, powdered, in it; then a coat of “laque-lustre,” a species
of French polish, is laid over it, the result being a reddish-yellow
colour, in which the grain and veining of the wood is shown. If, after
being used some time, it begins to look worn, it is rubbed over with
oil and a new coat of polish laid on it; but, as this takes a long time
to dry, it is usual to fill up the worst parts with thin oil-colour,
and then to take the yellow polish and lay it on, in two successive
coats, leaving it to dry, if possible, for twenty-four hours, as it
wears the better the firmer and drier it is. For old boards, that have
been much used, considerably more laque-lustre is required than for new
ones.
After laying on the laque-lustre it is desirable that the floor should
not be trodden upon for six weeks, and it is also well occasionally,
say about once a week, to polish it, which conduces much to make it
serviceable.
[16] And this should be adhered to, the rare though extant cases of
efficiency for Hospital nursing, past this age, notwithstanding.
[17] Great caution must be used in acting upon this. The
Superintendent-General, or the Superintendents who are responsible to
her, order the service of each Nurse. How far is it just to consider
extra dangerous duties or stations meritorious in the Nurse who does
or suffers from them? Others might have done the same, if so ordered.
Others might have wished for such an order. Or a strong efficient Nurse
who, in other respects, gives anxiety, may render extra useful service
on an emergency, and suffer for it in health: and yet, during her whole
service, have given more anxiety and less satisfaction than others who
did not, perhaps had not the opportunity to, distinguish themselves by
any extra useful service.
[18] The “Superintendent” and “Matron” are here used throughout as
synonymous terms; because “Matron” is the shorter and more familiar
name; although, for reasons before given, “Superintendent” would be the
better word for Military Hospitals.
[19] If it be said that the Workhouse sick are ill-nursed, it is in
proportion as this rule is broken, not as it is kept, that they are so.
[20] To M. Baudens, whose recent death is so much to be lamented,
I cannot here but add a tribute of admiration for his wise and
enlightened sanitary views, during the year of his superintendence over
the Medical Department of the French army in the East, and of gratitude
for his ready and magnanimous acceptance of our stores, when the French
sick were really in want of them, after these had been refused by other
French authorities.
LONDON:
PRINTED BY HARRISON AND SONS,
ST. MARTIN’S LANE, W.C.
_PRIVATE AND CONFIDENTIAL._