All the wards are lime-washed three or four times a year. They are shut
up and fumigated after the occurrence of any serious case of illness.
The floors are washed daily.
The beds in the pregnant, lying-in, and convalescent wards, are
generally all or most of them occupied; but the number of occupied beds
in the delivery ward rarely exceeds four or five.
The bed clothes are changed after each delivery, and the beds, which are
of straw, after every third delivery.
The patients consist for the most part of unmarried women.[17] They are
admitted into the pregnant wards, where they remain for a varying
interval of from days to months, from whence they are removed to the
delivery ward; about a fifth part of the women are admitted directly
from the town to the delivery ward.
They remain on an average eight hours in the delivery room, whence they
are removed to the lying-in ward, where they remain five or six days.
They are then admitted to the convalescent ward, and are finally
discharged fourteen days after labour, one half to the town, the other
half into other parts of the workhouse.
An important part of the management is that the inmates of the pregnant
wards only inhabit those wards at night, being engaged during the day in
various occupations within the workhouse, but not about the lying-in
women, as in the Paris Maternité.
Cases are not taken into the lying-in division unless labour has begun,
or is supposed to be imminent.
Any case of illness occurring in the lying-in department is at once
removed to the ‘class sick nursery,’ to the lock or other division.
The nurses engaged in the lying-in division attend also cases in the
‘class sick nursery,’ and are periodically changed. Any case which they
cannot manage is referred to the resident medical officer on duty.
There are three of these officers, who relieve each other every eight
hours day and night. The officer on duty is liable to be called on to
visit any part of the workhouse or hospital during his turn of duty, so
that it might happen occasionally that the medical officer might be
called from the hospital to the lying-in division.
If feverish symptoms show themselves in any patient in the lying-in
division, the practice is to isolate the case or to transfer it to some
other division of the workhouse. The ward is then closed, fumigated,
cleansed, and lime-washed, before being again used.
This proceeding has only been necessary twice within the last four
years.
Until recently, the whole of the deliveries, which amounted to an
average of about 500 a year, were under the charge of one paid officer
and a pauper who, without any payment or extra diet, delivered nearly
every case and worked both night and day.
There are several points in this procedure which are of great
importance, as bearing on the general question of successful management
of lying-in establishments:—
1. The building, although situated in a large commercial town, is on a
high, isolated, and freely ventilated locality.
2. It is not connected with a general hospital or medical school, or
with any of their risks.
3. There is a constant change of wards:—pregnant ward, delivery ward,
lying-in ward, recovery ward, body of the house. There is, in short, as
little risk as possible of the cumulative blood-poisoning process
already referred to.