Nowhere are hospital and private nurses so badly trained as in England;
and Miss Nightingale well says that half the symptoms which are
considered symptoms of disease are, in reality, indications of a want of
air, light, warmth, quiet, or cleanliness, which properly instructed
nurses would know how to supply. A want of punctuality in administering
food, and of watchful care in detecting its effects upon the patient,
create other classes of symptoms. The beer-drinking habits of the people
lead to much intoxication; and we ourselves have seen ladies of quality
lying on a sick-bed, where they suffered for the attention which a
thoroughly stupefied nurse was incapable of giving. No amount of wealth,
as Miss Nightingale testifies, can secure such nurses as wealthy
patients often need, and for which a thorough hospital-training is
required. The society strengthens her appeal by extracts from Dr.
Howson's paper, read at the meeting of the Social Science Association in
1858.
The Liverpool school has erected a building, to carry out its purpose,
eighty-five feet by forty. It has three stories, each of them eleven
feet high; and, by a single glance at the plans which accompany the
pamphlet, one sees that the arrangements for bathing and ventilation are
what those of our new city hospital ought to be. One lady
superintendent, with three servants, has charge of this building. It has
thirty-one nurses under training. By the wages which they earn in the
second and third years, the expenses of this Home are nearly paid,
leaving a margin of about three hundred pounds to be supplied by
donations. It is expected to be a self-supporting institution, except so
far as it becomes a benevolent charity, by supplying to the poor, food
and nursing. When the institution was ready to begin its work, the lady
superintendent having been some months in training at St. John's College
and the London Hospital, where the nurses educated by the Nightingale
Fund are to be found, took possession of her building. Her head-nurses
had been thoroughly educated. Pupils then offered: they were engaged for
three years, the first year to be strictly probationary. Each head-nurse
was to take charge of an entire ward of the hospital, to be responsible
for the medicines and stimulants, always assisted by one pupil. Each
pupil went first for two months to a surgical ward; then for two to the
medical; then four at the surgical, and four again at the medical,--one
course helping the other, and both filling the entire year under a
thoroughly trained head. For the next two years, the pupil is employed
without such superintendence wherever need is; and, for each of the
three years, receives, in addition to board and lodgings, seventy
dollars. At the Home there is a good library, and evening classes are
held for the disengaged pupils. A superannuation fund has been started,
to encourage respectable women to enter the Home. At the end of the
third year, the Home has twenty-eight pupils under training, fourteen
hospital nurses, fourteen district or gratuitous nurses, and ten
employed in private families.
This gives an idea of the training process; but our chief interest lies
in the district nursing. As soon as the Home had nurses it felt willing
to trust, one of the experiments recommended by Miss Nightingale was
tried. The wife of a Scripture-reader undertook to prepare sago,
necessaries, &c.; the clergyman of the parish furnished a list of
patients, and a central lodging for the nurse. The Home sent her out,
supplied with cushions, blankets, and bed-rests. She went into the
families, showed them what to do, and helped with her own hands. At the
end of the first week, she came back, crying and begging to be relieved;
she thought she never could bear the sight of the misery she
encountered. But, in a short time, she was so strengthened by seeing the
results of her labor, that she positively refused to take employment
among the rich. It is easy to see what great advantages wait on this
form of charity. As instruction is precisely what she comes to give, the
poor cannot resent this from the nurse; she fears no imposition, for she
is in the house at all hours of the day and night; her little gifts do
not wound, but cheer like neighborly kindnesses. It is Miss
Nightingale's idea, that such nursing is a far greater good than the
establishment of hospitals. In six months, this nurse found two cases
where the prolonged sickness of the wife had made drunkards of two
otherwise steady husbands, and brought their families to the brink of
ruin. The wives were cured, the husbands reformed, the families saved. A
leaf from her report of cases will show what she did.
1. _Asthma and bed-sores._--Lying on a floor; so thin, had to lift
her on a sheet. Dirt, bad air: two children. Husband said he "was
forsaken by God and man." Our nurse goes in, washes her, changes
linen; lends bedstead and bedding, and air-cushions; cleans and
whitewashes. The woman now sits up, and the man is again hopeful.
2. _Internal cancer._--Nurse attended to the surgical operation,
and administration of subsequent remedies. The woman is now at
work.
3. _Paralysis._--Nurse attended; gave instruction and food.
Recovery complete.
4. A girl--as the doctor said--in a consumption. Hospital refused
her as incurable. Beef-tea, wine, sago, and cod-liver oil supplied;
and, in one month, she could walk to the nurse's lodging.
Out of all this success, the perfect plan developed. It had been proved,
that the poor were willing to be taught _how_ to nurse, and to keep
their houses clean; that intense distress might be mitigated, and coming
poverty arrested. It was also proved, that the nurse so employed could
notify the health commissioners of incipient epidemics, and obtain for
ignorant tenants, in return, necessary whitewashing, drainage, &c.
The city of Liverpool was now divided into eighteen districts, each of
which, for practical convenience, was made to correspond to two church
cures. The Home undertook to furnish a nurse to each district, provided
it would elect for itself a lady superintendent, and raise a
subscription for food, medicines, and necessaries. As soon as the
superintendent is found, meetings are held to interest the district;
each district having an average population of twenty-four thousand and
over. A central lodging is then to be supplied for the nurse, and the
district must furnish, for loan and use, the following articles:--
One iron bedstead, six pairs of sheets, six blankets, cushions,
bed-gowns, shirts, flannels, wine, meat, sago, bread, coals,
arrow-root, preserves, and vinegar.
If any thing excites one's envy in the current expenses, it is the
amount of coals required. To think of warming forty people for one year
for twenty-six pounds!
The superintendent is supplied with a map of the district, forms of
recommendation, rules for patients and nurses, and slates and pencils to
be hung at the head-board, to receive the directions of the doctor, and
the inquiries of the nurse. In seven of the districts, the lady
superintendents furnish the supplies at their own cost! How gladly ought
any wealthy woman to avail herself of so sure a method! A strong woman
is hired for scrubbing; and very often the first thing a nurse does is
to demand whitewashing and repairs of the Board of Health. In each
district, a person is provided to cook the necessary food; the nurse
giving notice, through the superintendent, of her wants. The nurse
herself confers with the doctors, waits on the surgeons, changes and
cleanses the patient, and administers poultices, blisters, leeches,
enemas, and the like. One Liverpool lady defrays the whole cost of
washing the loaned linen for the eighteen districts! A registry of it is
kept by the nurse.
We need not be surprised to find that this admirable plan has such
marked success, that all the Liverpool charities are eager to play into
its hands. Each district superintendent is appointed locally; but the
Home has an out-door inspector, who looks after the district nurses. The
superintendents make quarterly reports to the Home, and hold meetings of
conference by themselves.
There is, at the seaside town of Southport, a hospital, which furnishes
sea-bathing to invalids.
The Committee of Central Relief for the city of Liverpool are so
delighted with this nursing charity, that they have already offered
butcher's meat, three weeks of seaside bathing at Southport, and coals
and money to any convalescing patient when deemed needful. The
workingmen's dining-rooms offer, on proper application, warm dinners to
convalescents; and the Home, through its inspector, superintendents, and
nurses, makes sure there is no waste nor misuse.