“ This is especially the case with district nursing, which is the highest and most exacting branch of the profession, because it imposes the greatest responsibility with the fewest resources and demands the most varied qualifications, while affording none of the attractions incidental to hospital work or private nursing among the rich. It is comparatively easy to fulfil routine duties, when every means is at hand and the standing conditions are the most favourable possible ”

“ Allusion has been made above to the subject of male nursing. It hardly finds a place in the British civil system, and was condemned for hospitals in Germany, where it is at its best, by so eminent an authority as Professor Virchow. In the South African War of 1899-1902 it was even suggested that female nurses should replace orderlies at the front. The only valid reason for preferring women to attend men rather than members of their own sex is the difficulty of obtaining a supply of equally well qualified and satisfactory male nurses. ”

“ It is true that state training schools for male nurses had previously existed in Prussia, the oldest having been founded at Magdeburg in 1799; but the employment of men in hospital wards is a feature of the German system which has not been copied by other advanced countries, and seems to be in process of abandonment in Germany. It is a heritage from the middle ages, when the Knights Hospitallers undertook for men the duties discharged in female institutions by the nuns. ”

“ In Great Britain trained and certificated nurses generally belong to a society or association. The most noteworthy of the associations is Queen Victoria's Jubilee Institute for Nurses. It was founded in 1887 with the object of providing skilled nursing for the sick poor in their own homes. A great many of the provincial nursing associations are affiliated to it. The number of nurses supported by each branch varies. The qualifications for a Queen's nurse are as follows: (1) training at an approved general hospital or infirmary for two years ”

“ Private nursing staffs are attached to several of the hospitals; they are recruited from the staff nurses and probationers on completion of their course, and supply nurses to private patients. In the special hospitals the training is shorter, being for one or two years. There seems to be a constant tendency to increase the requirements. At St Bartholomew's, St George's, the London Hospital, St Thomas's and others, probationers must enter for four years, and at St Bartholomew's they have to pass an entrance examination in elementary anatomy, physiology and other subjects. ”

“ The fees charged for trained nurses run from $12 to $25 a week, and even more for special cases. Male nurses are trained at the Bellevue Hospital, New York, the Grace Hospital, Detroit, and elsewhere. In the American schools more attention is paid to the preparation of nurses for private work than in the British (Burdett) , and a directory or registry of them is kept in most large towns.
In Germany, their original home, both training schools and societies have multiplied and developed. The period of training appears to be considerably shorter than in Great Britain and America. ”

“ Nursing does not appear to be regulated by law in any country, though attempts in this direction had been made in Training and organization. England. [1] Its organization is voluntary, and even in state or municipal institutions is dependent on the direction of the administration. In Great Britain nearly all the general and special hospitals and many of the poor-law infirmaries offer systematic professional training to nurses. ”

“ The outcome has been to raise the dignity of the calling, to induce persons of a superior class to adopt it in increasing numbers, to enlarge the demand for their services, and to multiply the means of educating them. ”

“ For one thing women do not possess the physical strength which is often required. They cannot lift a heavy man, and ought not to be asked to do it. Then it is excessively irksome to a sensitive man to be attended by women for various necessary offices. ”

“ The salary during training is £12, 10s., and afterwards £30 to £35 a year, with board, lodging, laundry and uniform. With regard to the earnings of nurses in general, the salaries paid in hospitals have already been mentioned; for private work the scales in force at different institutions vary considerably, according to the other advantages and benefits provided. At some the nurses receive all their own earnings, minus a percentage deducted for the maintenance of the institute ”

“ In the more important British colonies—Australasia, Canada and South Africa—there are now a considerable number of hospital schools and other institutions formed and conducted on the English model. Salaries and fees are very much the same in Australia; in Canada and South Africa they are higher. ”

“ Many candidates approach the calling with a very imperfect appreciation of its exacting character. The work is not easy or to be taken up lightly. It demands physical strength, sound health, scrupulous cleanliness, good temper, self-control, intelligence and a strong sense of duty. ”

“ These institutions were managed by the clergy, and throughout the dark and middle ages the hospital and nursing systems were connected with religious bodies. Nurses were provided by the male and female monastic orders, an arrangement which still continues in most Roman Catholic countries, though it is gradually being abandoned through the increasing demands of medical science, which have led the hospitals to establish training schools of their own. ”

“ They must have had three years' training in a general hospital. Foreign Service must be taken as required. Nurses are eligible for a pension after 10 years' service, the amount increasing up to the age of 55 when retirement is compulsory. The Royal Naval Nursing Service is organized on much the same basis. Other organizations are The Army Nursing Reserve and Queen Alexandra's Imperial Military Nursing Reserve, and there is also a nursing reserve attached to the territorial forces. ”