Hospital corps

“ For it is not only medical and surgical nursing that is learnt in a hospital ward, it is discipline, endurance, making the best of adverse circumstances, and above all the knowledge of mankind. These are the qualities that are needed at the front, and they cannot be imparted in a few bandaging classes or instructions in First Aid. ”

“ Others, on the contrary, through the energy of their original promoters and the excellence of the work they have done, have obtained a position of authority and reputation which has had a very important bearing for good upon the development of medical science in the treatment of disease. If the world had to-day to organize the very best system of hospital accommodation which could be evolved, there is no doubt that few or none of the special hospitals would find any place in that system. ”

“ A definite agreement has been reached in regard to the required personnel, nurses, doctors, attendants, social service, workers, etc., to each two hundred patients in a hospital caring for all acute patients, whether they be major surgical, acute active neuro-psychiatric, active tuberculosis, or other type of acute condition requiring active, constructive treatment. ”

“ Let us take, for example, a State hospital of one thousand patients. The staff would consist of a medical superintendent, five assistant physicians, and a woman physician. In a hospital of that capacity there would never be more than one hundred patients who would be considered curable, and the number would probably not exceed sixty. More than nine hundred patients would be hopelessly incurable, for the most part the wrecks of past disease, who practically need nothing but kindly custodial care with incidental medical treatment. ”

“ Were it the report of a Head-Nurse in a Civil Hospital to her Resident Medical Officer, it would undoubtedly cost her her place. One scarcely knows whether to pity more the sick patient or the orderly patient. One scarcely knows how to estimate the amount of medical comforts intended to be consumed by the sick patient which will actually be consumed by the sitting-up patient, and necessarily so. ”

“ Its necessity may be advocated on the ground that orthopaedic cases may require prolonged treatment, and that the pressure upon the beds of general hospitals by acute cases is nowadays so great as to render the orthopaedic hospital more necessary than ever before. ”

“ To-day, under the conditions which modern science impose upon the management, probably few hospital buildings are likely to be regarded as efficient for the purpose of treating the sick for more than from 30 to 50 years. ”

“ Another problem is the question of creating, in connection with General hospitals, wards where patients of this sort may receive at the beginning of their treatment, their preliminary examination, where they may be evacuated home with compensation or without compensation, or evacuated to a prolonged treatment hospital for further care.
It has sometimes been difficult to get enough men, trained personnel, to man these wards. ”

“ The character of cases treated and the nature of operations performed embrace all the variety of diseases to which women are peculiarly liable, and for the treatment of which this institution was established.
The general health of the hospital has been remarkably good, not a single death occurring among the patients admitted during the year. ”

“ Often a severe illness is, and oftener still would be prevented by a week’s change of air, when the peculiar hospital-languor, so well known in hospitals, and so indescribable outside of them, first fairly sets in. ”

“ For the great mass of the people, cases of severe illness or injury, or those requiring major surgical operations, can be treated more successfully in well-appointed hospitals than in private houses, and as this is becoming generally understood the old feeling against entering a hospital for treatment is rapidly disappearing. ”

“ Hospitals and infirmaries would be alike nationalised, and, in place of the present antagonism between hospitals and the bulk of the medical profession, every doctor would be in touch with a hospital, thus having behind him a fully equipped and staffed institution for all purposes of diagnosis, consultation, treatment, and research, also serving for a centre of notification, registration, preventive and hygienic measures. ”

“ In such a hospital no patient can be overlooked, no wrong or imperfect diagnosis can long remain undiscovered and unrectified, and nowhere else have the patients so continuous a guarantee that the treatment they receive will be of the best, while the provision made for their comfort and welfare, owing to the unceasing and ever varying quality of the criticism to which the work of everybody, from the senior physician to the humblest official, is subjected in a clinical hospital, is unequalled anywhere else. ”

“ In a Military Hospital, the proportion of heavy cases is in ordinary times considerably below the average proportion of such cases in a Civil Hospital, open, as the latter is, to accidents, and to the cases of dangerous disease always more or less rife in low and crowded neighbourhoods. ”

“ Much more vital, however, is the care patients receive in the hospital, for rigid adherence to surgical cleanliness is exemplified in the hospital as it can be nowhere else. Infections rarely develop there. ”

“ That has been one of the complaints on the part of T.B. workers not only in government but in civil institutions as well.
We still find relapses occurring after the patient has been discharged from the sanitarium or T.B. hospital. Men go into training, and in a short time undergo another course of treatment, and so on. The reason for that is that they have not been given the necessary physical rehabilitation while still in the sanitarium, while under institutional protection and medical supervision. ”

“ Persons labouring under any disorder of body or mind are received into this hospital, excepting such as have diseases that are contagious, and of a malignant nature; such patients, however, have the advice of the attending physicians gratis, and are supplied with medicine from the hospital dispensary. ”

“ If they be too weak to wash and comb themselves, it is to be done by their Nurses.
2. Every Patient is to be shaved and have clean Linen twice a Week, or oftener if requisite.
3. They are punctually to obey the Directions given them, and to take the Medicines ordered by the Physician; and none to be allowed to go out of the Hospital without a Ticket of Leave signed by the Physician, Surgeon, or Apothecary, of the Hospital.
4. They must commit no Disorder or Riot, but in all Respects behave themselves well. ”

“ Major operations comparable to those in any other institution are performed, and there is no limitation whatever, either medical or surgical, to the functions which the staff of the hospital undertakes. ”

“ The hospital wards, for the exclusive care of bed patients, may well be detached. The larger part of the hospital population, consisting of the quiet, orderly, chronic, custodial cases, can be cared for just as well in the large buildings as in groups or cottages.
The reception building, from the standpoint of the patient, is the most important building in the hospital. It should be equipped to care for from five to ten per cent of the hospital population, depending entirely upon the location and special problems of the institution in question and the community which it serves. ”

“ And all Men employed about the Hospital ought to be reviewed once a Week by the Military Inspector, and likewise whenever a Party of Convalescents is going to join the Army, or their Regiments; that no Man may be allowed to remain with the Hospital, after he is fit to do Duty in his Regiment. ”

“ The preparations for operations in hospitals are all so carefully planned and systematized that in the presence of such emergencies the nurse will merely have to carry out the customary routine, but in a patient’s home she may have to exercise a good deal of originality in attempting to meet the needs of the occasion and imitate hospital provisions. ”

“ The surgical department of hospitals is of special importance to the poor, as it is almost impossible for them to have the conditions in their homes necessary to insure a fair chance of success and recovery in cases of operations. Remarkable success has been attained in this department in some of the hospitals I have named, where the greatest of abdominal operations are performed by surgeons connected with the hospital, with a percentage of recovery equal to that of other good hospitals here or in Europe. ”

“ HEALTH IN THE HOSPITAL. In preparing to do the duty of society towards the wounded or sick soldier, the first consideration is, What is a Military Hospital? No two nations seem to have answered this question in the same way; yet it is a point of the first importance to them all.
When England went to war last time, after a peace of forty years, the only idea in the minds of her military surgeons was of Regimental Hospitals. There was to be a place provided as an infirmary for a certain number of soldiers; a certain number of orderlies were to be appointed as nurses ”

“ Every medical officer in charge of a hospital is faced with the problem of de-hospitalization of patients of this Bureau who have reached the maximum amount of recovery afforded by hospital treatment. I believe there is not a medical officer here who is not facing this problem at the present time and who knows that patients are in hospital not actually requiring further hospital treatment but who do need further medical attention and careful medical observation to enable them to make a complete recovery. ”

“ Special Hospitals.—Up to about 1840 the general hospital was, speaking generally, the only hospital in existence. Twenty years later, as the population increased and medical science became more and more active, some of the more ardent members of the medical profession, especially amongst the younger men, pressed continuously for opportunities to develop the methods of treatment in regard to special diseases for which neither accommodation nor appliances were at that time forthcoming in general hospitals. ”

“ Hospitals built of coarse logs, with ground floors, with fire-places in the middle of them, and a hole in the roof, for the discharge of smoke, were found to be very conducive to the recovery of the soldiers from the hospital fever. This form of a military hospital was introduced into the army by Dr. ”

“ The disadvantages, inseparable from general hospitals, are such as can never be counterpoised by all the regularities of medicine and regimen. Nature and kind nursing save a much greater proportion in our plain way, at a smaller expense, and with less abuse. One branch only of hospital institution is wanting with us; that is, a general establishment for those laboring under difficult cases of chirurgery. ”

“ As the men were discharged from Army Hospitals the burden of the Public Health Hospitals became greater, and many of the individuals who had been active in the Army work became associated with the Public Health and established as a part of their hospital program the Section of Physical Reconstruction, to include Occupational Therapy and Physiotherapy. ”

“ It might also be right to have reserve wards for what must occur every now and then in a Military Hospital, an influx of patients beyond the usual number, or an outbreak of cholera, or some malignant epidemic, which it might be desirable to isolate from the other patients. ”

“ While this method of treatment is best carried out in the well-appointed hospital, there is no real reason why it cannot be fairly well carried out in a well-regulated private home, provided the necessary preparations have been made, a trained nurse is present, and provided, further, that the physician is willing to remain in the home with the patient the length of time required properly to supervise the treatment. ”

“ There are one hundred and twenty beds. There is much to admire in this hospital, the humane arrangements, the obvious comfort of the patients, and the admirable ventilation and perfect cleanliness of the beds and wards, but the system adopted is one of the most antiquated quackery, and when I think of the unspeakably horrible state of the wounds, the mortifying limbs, and the gangrened feet ready to drop off, I almost question Governor Hennessey's wisdom in stamping the hospital with his approval on his "State Visit." ”

“ In each of the six wards, of which four are on the ground floor, there is a head-nurse and an assistant, with six helpers for the children's, and four for the adult department, beside the night nurses, who sit up in case of any emergency. There is accommodation for 250 sufferers and for the 40 nurses, attendants, and domestics required for the service of the hospital; so the 220 patients there now, represent the approaching period when a new wing will have to be added, even if only the urgent cases are to be admitted. ”

“ It is intended that the hospital should be a model to the whole kingdom of what such an institution ought to be; the latest and best of modern appliances, both sanitary and surgical, will be introduced. There will be in and out departments, completely isolated one from the other, though with a door of communication. From sixty to seventy beds will be provided, special wards for a certain class of cases, adequate waiting-rooms for out-patients, and the necessary rooms for the officers and medical attendants, all being on an ample scale. ”

“ More than four thousand persons are admitted into this hospital annually. About two thirds of the sick are under the care of the physicians, the remainder under that of the surgeons of the establishment. ”