Hospital ward

“ The medical officers attached to the hospital in our model city are allowed to hold but one appointment at the same time, and that for a limited period. Thus every medical man in the city obtains the equal advantage of hospital practice, and the value of the best medical and surgical skill is fairly equalised through the whole community.
In addition to the hospital building is a separate block, furnished with wards, constructed in the same way as the general wards, for the reception of children suffering from any of the infectious diseases. ”

“ 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. ”

“ The hospital orderly is never—in theory at any rate—off duty. His free moments are regarded not as a right but as a favour: no freedom, at any time, can be guaranteed. He is liable to be called on in the middle of the night, or at the instant when he is going off duty, or when at a meal, or when resting, or when on the point of walking out in pursuance of the gentle art of courtship. ”

“ Each building, except those designed for stores and general purposes, is made to contain in itself all that is absolutely essential for an independent hospital ward-room; so that, by the lengthening of the corridors, and the addition of any number of these buildings, the hospital may be extended to any degree. ”

“ One of these trips was to the Armory Hospital, the neatness, comfort, and convenience of which makes it an honor to its presiding genius, and arouses all the covetous propensities of such nurses as came from other hospitals to visit it.
The long, clean, warm, and airy wards, built barrack-fashion, with the nurse's room at the end, were fully appreciated by Nurse Periwinkle, whose ward and private bower were cold, dirty, inconvenient, up stairs and down stairs, and in every-body's chamber. ”

“ Work in the wards has its compensations: here there is the human element. But only a portion of a unit such as ours can be detailed for ward work: the rest are either hewers of wood and drawers of water or else have their noses to a grindstone of clerical monotonousness beside which the ledger-keeping of a bank employee is a heaven of blissful excitements. You will find few hospital orderlies who are not "fed up"; you will find none who do not long for the war's end. And I fancy you will find very, very few who would not go on active service if they could. ”

“ In this second year of the war, the first army of V.A.D.'s, now promoted, has everywhere been succeeded by a fresh levy, aglow with the same eagerness and the same devotion as the first. Or I could dwell on the women's hospitals—especially the remarkable hospital in Endell Street, entirely officered by women; where some hundreds of male patients accept the surgical and medical care of women doctors, and adapt themselves to the light and easy discipline maintained by the women of the staff, with entire confidence and grateful good-will. ”

“ It is in the hospital ward that the major portion of routine hospital work is accomplished, and where the nurses who will have much of the responsibility of the hospital work of the future will be trained in habits of accuracy and neatness, in proper systems of ward work and good hospital housekeeping. ”

“ All patients in the hospital who are seriously ill, whether they have been long in the wards or have been only just admitted, are placed on "the dangerous list" and have their names posted at the gate so that their relatives might be admitted at any time of the day or night.
A man very gravely injured had been taken into the accident ward. ”

“ If it should appear that those demanding shelter in the Municipal Emergency Home should be afflicted with any physical illness, it should be the duty of its superintendent to transfer such individuals to a hospital ward, which may be a part of the Municipal Emergency Home, or to the city or county hospital where each man or woman may be thoroughly cured of any illness which has put them into destitute circumstances or is unfitting them to perform any kind of labor to make existence possible. ”

“ Its great Dining Hall is a splendid Receiving Ward for the sorting-out and clearance of newly-arrived convoys of patients. We should be poorly situated indeed if we had not our [Pg 72] Scottish baronial main building to be the hub of the hospital's activities, or rather the handle from which springs the fan of the hospital's great extension—the huts. Approaching the hospital the visitor sees nothing of those huts. As he walks up the drive he flatters himself that he has reached his destination. ”

“ The barracks look upon the Barrack Square, which is filled with lounging prisoners. The windows of the hospital-ward also look upon Barrack Square, and the prisoners are in constant communication with the patients. The hospital is a low stone building, capable of containing about twenty men, and faces the beach. ”

“ It ought not to be necessary to mention the necessity of plenty of tools and the right kind of tools for ward work—plenty of basins, and syringes, and dressing pans, and instruments, and drinking-cups, and medicine glasses, and the thousand and one little things that go to make up the complete furnishings of the hospital ward. But, as a matter of fact, many nurses go through their course of training hampered by a lack of facilities for proper work. ”

“ Unlike the other wards, that "take in" new cases for a week and then have a rest, C. is always "taking in," as the men in charge see every new case that comes up to the hospital (except accidents) , and they can take them in if they like, as long as there are any beds empty in the ward; and if they don't think it is a particularly interesting case, it is passed on to the house surgeons or house physicians for the other wards; but, of course, they try their best to get all the most interesting cases for themselves ”

“ It is a mere matter of common sense to arrange some centre to which the patient can repair and employ his leisure when he is sufficiently well to potter about though not well enough to be discharged from hospital. Instead of idling in his ward and disturbing the patients who are still confined to bed—and who, often, are urgently in need of quietness—the convalescent departs to one or other of the recreation rooms, morning and [Pg 162] afternoon, where he can make as much noise as he likes and where he can meet and fraternise with his comrades from every front. ”

“ There was also a separate ward for delirious patients, with two beds, and a dwelling-house and sleeping apartments for two nurses and servants. The building of the hospital was commenced in July, 1883, and it was first used in the autumn of this year. ”

“ Two trained nurses attend to each corridor, and connected with the hospital is a school for nurses, under the direction of the medical superintendent and the matron. From this school, nurses are provided for the town; they are not merely efficient for any duty in the vocation in which they are always engaged, either within the hospital or out of it, but from the care with which they attend to their own personal cleanliness, and the plan they pursue of changing every garment on leaving an infectious case, they fail to be the bearers of any communicable disease. ”

“ The ward contains 39 children at present, suffering from injuries and being treated for various ailments. Perhaps some of them will never have another Christmas. But if you had closed your eyes and heard them laughing and singing, you would never have thought you were in a hospital. Many of them were able to sit up, and so that they could all be in one room, two were put in some beds. Those who could sit up had little red wrappers over their nighties, and propped up around the sides of the room, they looked for all the world like little animated red holly berries. ”

“ We were about leaving the hospital, when my friend exclaimed: 'You must see this ward.' So saying, she led me to a small building by itself in the garden, where the patients take exercise when convalescent. Certainly it was a pleasant spot. The sun shining in, made it seem the brightest of the wards. It is divided into two rooms, one for male, the other for female patients. The cases are chiefly bronchitis and similar acute diseases. It is presided over by a sweet-looking Sister. She has her little establishment all to herself including a separate room for any desperate case. ”

“ If we close the ward to visitors ... we have never in all the years the hospital has been in existence done ... that! Public confidence is our greatest asset. Has been. What shall we do? The newspapers, the police, the reputation of the hospital, d’y’see?”
“Too well, sir.”
But the tension was wearing itself out in speech and Dr. MacArthur went on:
“The hysteria among the nursing and medical staffs was bad enough, God knows, but before today is over, we must face the hysteria manifesting itself among the menial staff. How can a hospital run without orderlies, electricians, cooks? ”

“ The wards are all contiguous, and, as has been said, under the charge of a remarkably efficient Sister, who has charge also of the male operation ward immediately above. The little casualty wards, of course, add to the work, and greatly to the anxiety of watching; but certainly violent delirium tremens’ cases, alone and in a secure ward which can be darkened, appear often to quiet much sooner than where several of these wretches lie shouting to and at each other. Delirium tremens will never be a thing unknown in a Military Hospital. ”

“ It is just these badly defined functions in a base hospital which a chaplain can discharge so well.
We think also that women might be used in base hospitals as stenographers, ward maids, telephone operators, and the like. Base hospitals in the future are not likely to be housed in tents, and under rough conditions. At present, trained nurses are sent to the Stationary Hospitals. It seems a pity to waste fine young men, who could be combatants, as orderlies in a base hospital. ”

“ It was an admirable hospital in every way, and it is doubtful if we to-day surpass it. It was isolated, the ward separated from the other buildings, it had the advantage we so often lose of being one story high, and more space was afforded each patient than we can afford.
Now as to the management of these medieval hospitals. In the monasteries the superintendency was in the hands of the abbot or prior and the institution was subject to monastic rule. Even in the privately endowed hospitals practically all the hospital attendants were members of some religious community. ”

“ 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. ”

“ The current system of large hospitals is abandoned, as being equivalent to 'warehousing diseases on the largest possible scale;' while special hospitals are deemed unnecessary—'as if the different organs could walk out of the body and present themselves for separate treatment.' Each hospital has an ambulance ready to be sent out to bring any injured persons to the institution; the ambulance drives straight into the hospital, where a bed of the same height on silent wheels receives the patient, and conveys him or her to a ward. ”

“ It is very desirable that in every regimental hospital, there should be an apartment appropriated to convalescents, whose diet and mode of living must remain under the direction of the surgeon, and who must themselves be in every respect, subject to the hospital regulations. A trusty non-commissioned officer must be appointed to the superintendance of the messing, and conduct of this particular ward. ”

“ There can be no doubt that the children’s ward or wards in a big voluntary hospital is a most valuable asset to the managers, so long as the children are treated in separate wards. There is no reason of course why a hospital should confine its work to the treatment of children, exclusively. Still this special hospital is popular with the public; it has led to many discoveries and developments in the treatment of children’s diseases; on the whole the administration of these establishments has been good ”

“ Also, by all means, let the scullery be opposite the Nurse’s room, and not between the ward and the room. As an invariable Hospital rule, rather more than elsewhere in Military Hospitals, publicity may be considered to be a very great police, and a still greater protection. It is far better that twenty-four patients should see the Nurse’s door than one or none; and that her room should open full upon the ward than into an intervening scullery. ”

“ The institution is not a modified or sublimated form of receiving ward for a great district hospital."
There is, of course, no reason why the reception service of an ordinary state hospital should be spoken of as constituting a psychopathic ward. This accomplishes nothing more, perhaps, than to raise some question as to what the functions of the rest of the institution may be. The designation psychopathic hospital has been rather loosely used and is, as Southard has definitely shown, of American origin. ”