Charlotte A. Aikens

“ It is time that the system of arranging a nurses’ bill of fare for months ahead were forever abandoned in every institution. The very monotony of it makes one weary at the thought. To know that on a certain day of the week one is doomed to a dinner of corned beef and cabbage is certainly not likely to create enthusiasm for the morning’s work. ”

“ Do we realize that mincing meat is an important method of preparation? Do we appreciate how much more satisfactory fresh vegetables are than canned? Don’t we forget the natural craving for fruit? Couldn’t we, with a little forethought, give our nurses and employes salads, ices, etc., at practically no greater cost than the routine dishes? Did you ever realize the variety of ways such common articles as potatoes, rice, apples, etc., can be cooked and served? ”

“ Every careful hospital housekeeper has found the necessity of a special closet, for the storing of extra linen of all kinds for times of special emergency. It is poor management to have the full supply in circulation at one time. Attention to this emergency closet will save embarrassment many times. What could be more embarrassing than to have a patient injured in an accident, brought in grimy and dirty, and not have a clean gown to put on him? ”

“ Pecuniary economy, a large part of it at least, and also hygienic economy of food and nutrition, depend greatly on the manner of handling of food in the kitchen, in transit, and in the wards. Success in fitting the food to the consumer, then, demands skill and care in cooking and serving. It demands discrimination, a proper sense not only of the physiological demands of the consumer, but of his tastes, and it demands, besides, proper facilities for getting the food to the patient in its most palatable and attractive form. Without these three factors being recognized, waste is inevitable. ”

“ Among the chief staple foods of any institution is bread. While with many in the hospital it is not exactly the “staff of life,” yet it is perhaps the one thing in demand for every meal of the major portion of the household, and fills no small part in the hospital dietary. ”

“ It is quite possible to be systematic about methods and work, and strict in the observance of the rules of the institution, and at the same time thoroughly kind and tender hearted and womanly. The housekeeper who lets her servants know that she sympathizes with them in the trials and difficulties incident to their life will have much less trouble in governing them than the one who maintains a frigid air, shuts her eyes and ears to things that are large to them, and treats them like machines. ”

“ Let such a system once take root and then, be the institution large or small, rich or poor, hampered with old traditions or brimming over with untried theories, a spirit of true economy will reign throughout every department, worth far more, indeed, than the trifling secretarial labor expended in its production. ”

“ If in the very beginning of an interne’s or nurse’s course in a hospital, some pointed, practical and definite instruction could be given as to the cost of supplies, and the avoidance of common methods of waste, much might be accomplished. If a sense of individual responsibility can be cultivated at all, efforts in that direction cannot be begun too soon. It is lamentably true that there is perhaps no class of employees who carelessly destroy so much that is useful as those whose names appear as students and employees of our institutions. ”

“ The hospital housekeeper needs, if anyone needs it, reliability of judgment, and poise of soul. If she is to control others, she must know how to control herself. The ability to reprimand without arousing antagonism must be hers. She should endeavor to cultivate the feeling of personal responsibility in all over whom she has authority, and to make them understand that the success of an institution depends not on perfection of equipment, nor in numbers, but in thorough co-ordination of the work in all the departments, and faithful service on the part of all. ”

“ It is a melancholy comfort to relatives and friends to be with the patient in his last hours, and this cannot be permitted in a ward without confusion and discomfort to other patients. When planning a ward for the care of the sick or the poor, the object, of course, is the saving of lives, but people will die in hospitals in spite of the best skill and care, and the poor man is surely entitled to a quiet place to die in. There is much in hospital life to blunt the sensibilities of those who live in such institutions constantly. ”

“ No one should enter an institution as a worker, and especially as head of a department, who is not prepared to have her interests centered in the people for whose benefit the institution was brought into existence. Ability to see things from more than one standpoint, to work comfortably with different classes of people, an infinite capacity for detail, and systematic business habits—these are a few of the qualities that should characterize the woman who undertakes to manage the domestic affairs of a hospital. ”

“ There may be abundance of linen to meet the needs of the hospital, and yet if constant supervision over the work of the laundry is not exercised, three-fourths of the linen supply may at times be found piled in the laundry, the linen room shelves empty, and the nurses flying hither and thither on borrowing expeditions when a clean towel is called for.
A wise philosopher has said, “Every man is as lazy as he dares to be,” and the average laundry employee is like the rest of the world in that respect. ”

“ Plenty of screens in a hospital ward is a necessity to proper nursing. The poor appreciate privacy and refinement and delicacy as much as many of their wealthier neighbors, and they have a right to such privacy as a screen affords. The timid, frightened little woman who has just been admitted, and who shrinks from the gaze of everybody, ought to be screened off till the first awful feeling of strangeness wears away. The patient who is critically ill needs also to be screened. The general work of the ward requires the constant use of screens. ”

“ While it is important for every hospital to know something of the quality of the food and water supplied to its inmates, it is of still greater importance to know that in every department of the hospital there is provision for the entrance of pure air and the exit of impure air. We may live without food for days or weeks, but the breath of life is the first great essential of existence. ”

“ A hospital or any institution that has to deal with infirm, aged or unfortunate members of society, is no place for a person of strong racial [Pg 14] antipathies. It is no place for the tale-bearer or the gossip, nor for the person who has a grudge against fate and feels she has never received justice. It is no place for the person who is discouraged, or who assumes the air of a martyr, and leads a crushed life, bemoaning the fact that her highest motives and best efforts are never appreciated. ”

“ Large bouquets on an invalid’s tray are in bad taste, as are many flowers that elsewhere would be appreciated.
Every hospital experience ought to be a practical lesson to the patient in how to serve food. A taste for the dainty and beautiful, for wholesome and simple things, may be created there that will permanently influence the sick one to higher ideals of living. And certainly the manner of serving food is a pretty fair indication of the tone of the institution. Refinement or absence of refinement will be detected at a glance by one who has a keen appreciation of the aesthetic. ”

“ When one considers the numbers of boxes of good brass pens, the quarts of ink, and the reams of paper (to say nothing of such cheap things as brains and time and vitality) that have been consumed within the last score of years, in bringing forward “solutions of the servant problem;” when one sees that self-same problem, still to the front, dangling in the air as it were, refusing to settle itself or be settled, it surely ought to be sufficient to deter all but the most audacious from touching it. Instead of being solved, it is growing larger and more difficult to deal with. ”

“ For all these reasons the housekeeper, where the help are housed on the premises, should insist that the same hours that nurses are obliged to observe in getting home, and getting lights turned out should be observed in the servants’ quarters. Whether she wants the responsibility or not, whether she thinks it or not, the influence of the head of the domestic department is felt in the lives of her servants. Characters are being molded and built up that will leave their impress on future generations. The world of the average servant is as a rule very small. They live on the surface of things. ”

“ It is nothing uncommon to find six or eight people crowded into one dormitory not larger than 10x15, and that not only in a New York tenement but in a modern hospital. Every intelligent person professes to believe that “Pure air is as important as pure food in the production of vital energy of the body and mind, but it is another case of not living according to one’s belief. What we greatly need is a realization of the fact that hygiene is not alone a science to be studied, but an art to be practiced, in the hospital, in all its departments and elsewhere.” ”

“ Is it too much to hope, that, sometime, all hospitals will have a [Pg 140] servants’ dining room, where, apart from the heat and odor of the kitchen, they can take their meals in comfort like respectable people? Many of those who have labored on the servant problem seem to have begun at the top for a solution, instead of getting down to the foundations to build up a system. They have sought to establish training schools and give diplomas, believing that was the one thing needful to dignify the position of servants and make them happy and contented in that kind of work. ”

“ It is hardly possible for every hospital to have a trained chef or a diet cook. Much of the cooking must needs be done by the ordinary servants, but the hospital housekeeper should have an intelligent appreciation of the needs of her family, her influence should pervade the domestic region constantly, and her standards and methods be understood by every one who handles food for the patients. ”

“ Certainly when so much value is being placed on the food supplies sent from the kitchen as weapons in the fight with disease no hospital built in the twentieth century should have in it a kitchen that is not in keeping with the rest of the building, that will not bear critical inspection, that cannot be shown with as much confidence and satisfaction as the operating room or the wards. And not only in the situation, construction and equipment of the hospital kitchen is this lack of progress evident, but in no part of the hospital is the germ theory so little regarded in practical work. ”

“ If he does not keep his financial eye on the expenditures of different departments, if he does not give time and study to the question of how to keep current expenses down to the minimum and at the same time do good work, if he does not, up to a certain point, regulate the purchase and distribution of the enormous quantities of supplies needed in the hospital, and insist on his colleagues in charge of departments doing the same thing, then waste is inevitable. ”

“ If the person in charge has had in addition to the training in dietetics practical experience as a hospital nurse, still better service may be expected. A genuine sympathetic interest, or as some one else has termed it, “an affectionate interest,” in the people for whom the food is prepared, a keeping in mind the Golden Rule in serving and preparing food, as in other departments of the hospital, is fully as important as a knowledge of the science of nutrition. The soul life of the individual can find abundant opportunities for its expression in the diet kitchen as in the ward. ”

“ Pure blood is regarded as one of the great essentials of health, and much study has been devoted to that important part of the human system. The most perfect apparatus for examining the blood is considered none too good, but how often in the average hospital are tests applied to the materials from which blood is made? Are all butchers and bakers and grocers and dairymen so honorable that occasional analysis of the products supplied is quite unnecessary? ”

“ Now in a general hospital where a hundred or more or less trays have to be prepared for each meal, it is out of the question to devote as much time to artistic serving as could be wished, but one thing is certain, if nurses are not impressed with the importance of taking pains to serve food attractively, and taught how to do it while in the hospital, [Pg 106] they cannot be expected to secure the best results in serving food in private practice. Even a thing as simple of preparation as a slice of toast gives room for the production of dainty and artistic and wholesome meal more attractive. ”