Hospital staff

“ For before a nurse can help to reconstruct a distorted mental outlook and restore a normal attitude toward life, she, herself, must have an understanding and a sympathy and a power to help that can only come from steady inspiration, constant study, and serenity of mind.
Second in importance locally is the recognition on the part of the commanding officer of each hospital and each member of the hospital staff of the real place of nurses in the endeavor to return the patient to normal health and life, and emphasis upon an attitude of helpfulness and cooperation in all matters concerning them. ”

“ 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. ”

“ Occasionally a lady would be fortunate enough to evade the loss of a valuable man by sending him into the city on an errand, or by keeping him out of sight while an inspection was going on. In this way my chief of staff, as I used to call a certain German youth, was kept a year in the hospital. His efficiency and constant interest in the patients made him a valuable auxiliary in my little department; and I know that his services were appreciated by others than myself, for one of the chief surgeons advised me to keep him by all means, even if hiding him in the ice-chest were necessary. ”

“ I have a considerable number of these men. I believe that every complete n.p. hospital should have a department with definite numbers assigned from the staff who are particularly clever in handling this line of case. I think that they should be handled in your regular n.p. hospital as a separate unit.
Now there is just one thing in connection with that statement I wish to emphasize. There are a certain number of these men who do eventually make an adjustment. ”

“ He stated further that he believed that the specialized patient in a general hospital is better off than if in a special hospital, but that if he had a son who had a special ailment he would much prefer him in a hospital which had upon its staff men in active practice of the kind he was going to need. ”

“ The authorities of the Prince’s Hospital, lacking obstetrical wards, had made this course the opportunity for establishing an Out-patient Department that could deal with ten cases a week at the nominal charge of five shillings each. The students worked in pairs, and though they could never be sure of attending their cases together, the resident staff of the hospital, and, if necessary, a consultant physician, were always available in case of an emergency. Edwin and Boyce were housed in one of p. 467the faded Georgian buildings that faced the hospital. ”

“ The regular routine business of the Hospital is about equally divided among the resident medical staff. A number of wards constitute the department of one physician or surgeon, to which his labor and attendance are mainly devoted. The Physician-in-Chief has the general supervision. The assistants have to report to and to consult with him, and to carry out his suggestions or orders. The Medical Board meets regularly every fortnight, to Medical Boardconsult upon all matters relating to the Hospital and the welfare of its inmates ”

“ Object of the Hospital.—The hospital is established for the purpose of treating prostitutes who are suffering from venereal diseases, consumption, and other contagious maladies contracted or developed in the Yoshiwara brothel-quarters.
Staff.—The permanent staff consists of about fifty people, including several surgeons, a secretary, four pharmacists, nurses, clerks, servants, etc., and is presided over by a chief doctor. The hospital arrangements are subject to Police supervision. ”

“ We have a medical department well equipped with all the facilities of a first-class hospital. The regular staff of that department consists of four physicians and two trained nurses who live on the grounds, besides specialists who visit the institution at regular intervals. In addition to this we have a staff of consulting surgeons and physicians, each of whom visit the department at least once a week. No better attention is given patients in any hospital than our inmates receive. ”

“ REQUIREMENTS FOR ALL HOSPITALS 1. The hospital should maintain a service whereby at least one resident physician is on duty at all times. 2. There should be an organized medical staff composed of men competent in their respective fields of medicine and actively meeting their responsibilities for the direction of the professional policies, for the medical work of the institution and also for the professional care of the patients in the hospital. 3. Provision for examination and treatment by dentists and specialists in eye, ear, nose and throat and genitourinary work. ”

“ Cub Sterling gave himself an angular brace and replied:
“Must be something other than natural causes, Doctor. Everything has been checked. Everything! Dr. MacArthur and I have combed the department. The superintendent of nurses has checked the supervisor, the head nurse, the graduate floor nurse, and I’ve gone over my internes thoroughly ... man by man ... and woman by woman.... The reason I’m bringing it before the staff is I’m stumped. Your experience ... then, too, medical patients are often in the hospital six weeks to two months. ”

“ While in the aggregate those who in the course of the year receive gratuitous out-door advice far exceed the in-patients in number, the out-door branch of the Hospital work is, of course, the least important. The real work lies in the wards; all the in-patients being under the care of an Honorary Medical and Surgical Staff of nine gentlemen elected annually, with the addition of the resident House Surgeon and his assistant. ”

“ The staff is so appointed that every medical man in the city has in turn the advantage of hospital practice; whereby the best medical and surgical skill is fairly equalised through the whole community. ”

“ It is expressly understood that all the work in Occupational Therapy should be upon prescription of the Medical Officer in Charge of the Hospital or his designated agent, and a proper cooperation between the Medical staff and the staff of the Reconstruction Section will insure most satisfactory results, and that this cooperation of the work will be very necessary in order to secure proper efficiency. ”

“ Its equipments are all modern and first-class, the staff able and the directors may well claim that "there is not a hospital in the country that is conducted on broader lines or with a more sincere desire to meet fully and fairly all possible needs of the public it serves." ”

“ Before the move was made to Spearman's Farm the Hospital was enlarged, and the staff was increased by the addition of eight civil surgeons. It is sad to report that of these two died in the camp and others were invalided. No men could have worked better together than did the army surgeons and their civilian colleagues.
The greatest capacity of the Hospital was reached after the battle of Spion Kop, when we had in our tents about 800 wounded.
Some account of the nurses who accompanied the Hospital is given in a section which follows. ”

“ The duties of nurses ought also to be distinctly confined to attendance on the sick, and no menial work, such as scrubbing floors and the like, should be demanded of them; a proper staff of servants ought to be employed for such purposes. It is also desirable that a separate pavilion for lodging the nurses should be set apart, and that fair and reasonable time for rest and recreation should be allowed. Some discussion has taken place as to the advisability of placing the nursing of a hospital in the hands of a sisterhood or a separate corporation. ”

“ That the custom has its advantages in an hospital like the one we were describing is indisputable—to the medical staff. Where a system obtains by constant worrying and painful, or at least unpleasant physical examinations, it is of great assistance to doctors and nurses to have at hand an unfailing means of putting and keeping the patient in good 133 humour and benevolent docility. ”

“ There are not enough n.p. men to go around and I have a solution of that which I have put up to numerous men and that is just this. Along with what General Sawyer said today about every one’s being a well-rounded out man, every man who has charge of a hospital, every man who is on the staff of a hospital taking care of ex-service men ought to go down and buy a copy of White’s Outlines and study it for the next six months. If you will do that you don’t need specialists on your staff. ”

“ THE WOMEN ORDERLIES The mention of the staff of the hospital calls up a picture of that splendid band of young women who responded to the call of patriotism and who, laying aside their habits of ease and pleasure, gave themselves up to the strenuous toil and restricted life of those who serve in hospitals. It is true that the staff included doctors, matron, and trained nurses; but they were professional people, carrying out their professional work ”

“ Such disadvantages might be entirely removed if parliament would decide to throw open every poor-law infirmary for clinical purposes, and to have connected with each such establishment a responsible visiting medical staff, consisting of the best qualified men to be found in the community which each hospital serves. The old prejudice against hospital treatment has disappeared, for the least intelligent members of the population now understand that, when a citizen is sick, there is no place so good as the wards of a well-administered hospital. ”

“ This does not mean that as long as special treatment along any line is needed that each patient will not have such expert examinations, care and treatment as his condition calls for. Quite the contrary, the most careful and competent examinations should be directed by hospital units composed 815of the most competent staff of men including surgical ”

“ Unless a superintendent herself knows what the nurses she has to superintend ought to do, she is always at a loss. She is never sure of her work. She must be herself the measure of their work. In a work-house, she said, this must be preëminently the case—more even than in a hospital—because on a work-house infirmary matron fall many more of the decisions as to petty medical matters than on a London hospital matron, where the medical and surgical staff are much more numerous and constant. ”

“ As the Service often makes it necessary at Military Hospitals, where the Number of Sick is great, to employ the convalescent Soldiers [163] [406] as orderly Men and Servants about Hospitals, all Men thus employed ought to have a special Leave from the Military Inspector for so doing; and no Man should be employed in any Capacity as a Servant about an Hospital, who at that Time is on the Books as a Patient. ”

“ The Commanding Officer cannot perform all the duties incident to the operation of a hospital and the care and treatment of a large number of patients, but, while he must have various types of personnel to care for the patient, he cannot delegate his responsibility for the patient’s welfare.
In the organization of our hospitals there is a proper place for social service the detail operation of which must be left to personnel which devotes its entire time to matters of a social nature, and to matters touching the personal, family and community problems of the patient. ”

“ 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. ”

“ On the intelligent administration of the functions of admission, transfer and discharge to, or from our hospitals, as the case may be, depends, in great measure, not only the economical and efficient administration of our entire hospital program, but in equal measure the recovery, the health, the happiness, the future usefulness, even the very lives of men and women, many of whom have made great sacrifices and passed through great agonies. ”

“ 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. ”

“ A field hospital, for about 200 patients, has 5 surgeons, 1 apothecary, 9 hospital stewards, and 12 attendants with 6 wagons. In the United States the sanitary organization of a corps proper comprises one medical director and a reserve of hospital corps men and material for about 2000 patients; a division has a bearer company, an ambulance company, and a field hospital for 500 patients; to each division, brisade, battalion, squadron, and battery is assigned a medical officer and a certain number of non-commissioned officers and privates of the Hospital Corps. ”