Hospital work

“ Now well-appointed hospital trains move backwards and forwards from the clearing hospitals to the base. For the first time we enter the nurse's sphere. Everything changes when the nurse appears upon the scene. She loves order. Cleanliness is her life. She is trained in all the little arts of nursing which bring comfort and peace. She can do what no man can do. The doctor is splendid at his own special work, the stretcher-bearer, the ambulance man, and the hospital orderly at his. ”

“ Always full to overcrowding, never less than 600 patients where we had only the equipment for 200, the whole hospital looked to her for the nursing that is so essential in modern medicine and surgery. For nurses are now an absolute necessity for medical and surgical work of modern times, and we could get no other sisters. The railway was broken, the bridges down, and where could we look for help or hospital comforts or medical necessities? We had pushed on faster than our supplies, and with the equipment of a Casualty Clearing Station we had to do the work of a Stationary Hospital. ”

“ We know now that from 10 to 40 per cent of the patients of the gynecologist, the gastroenterologist, and the internist generally would be better treated if a study of the life problems were added to that of the special organs and functions. To meet this need it should be possible to have enough workers in this branch of the Hospital to take their share of the consulting and co-operation work in the wards and dispensary of the General Hospital, and perhaps even in the schools provided for the same type of people from which you draw your patients. ”

“ It is the only book I ever read that I feel ashamed to admit having read, though now I have only the faintest recollection what it was all about.
Our hospital life was a full one—much work and many emotions crowded in the days: patients coming to be [Pg 253] operated; many operations meaning life or death, and even the less serious ones always approached by the patients with dread and apprehension. It fell to the house-officers to receive and reassure patients and their friends; to calm their anxiety; to inspire their confidence in the operators, and their hope for the outcome. ”

“ I visited the hospital a day or two ago, and, from what I saw there, can assure the relatives at home, that the sufferers are well provided for. If they could only be seen, how comfortable they look in their neat white-spread beds, much pain would be spared them. One of the surgeons informed me that all the appliances are bestowed either by the Government or the Sanitary Commission. ”

“ In this great hospital these ladies found, for a time, full employment for the hearts and hands of the Committees who, on their designated days of the week, ministered to these thousands of sick and wounded men, and from the depôt of supplies which the Association had established at the hospital, prepared and distributed fruits, food skilfully prepared, and articles of hospital clothing, of which the men were greatly in need. ”

“ The rest of the staff were well-to-do society people who not only financed the institution but also did the nursing and orderly work, gave their automobiles as ambulances, and their personal servants and chauffeurs to act as servants in the hospital. ”

“ No one nurse ever has more than seven patients to care for, and because of the arrangements it is easily possible for a nurse to care for seven patients who are not desperately ill. In the ordinary hospital the nurses must make many useless steps. More of their time is spent in walking than in caring for the patient. This hospital is designed to save steps. Each floor is complete in itself, and just as in the factories we have tried to eliminate the necessity for waste motion, so have we also tried to eliminate waste motion in the hospital. ”

“ 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. ”

“ 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. ”

“ Experience has taught us that, where there are 50 beds there will be 20 or more men available for this work, and that in such small groups trade work should not be undertaken, but in hospitals of 200 beds or more the work should 514be organized on the following lines—Occupational Therapy for ward work and pre-vocational training, to include academic, commercial, agricultural and trade work, as the survey of the hospital indicates and as the Medical Officer in charge may approve. ”

“ This little hospital unit, which is so complete in equipment that it can do a limited amount of every kind of work that any base hospital can perform, was designed for the express purpose of giving earlier attention to wounds of this kind, principally those of the abdomen. From the first we saved a great number of men who would otherwise never have survived to reach the base hospitals ”

“ On the other hand, an extra mercantile spirit has come in—of forcing up wages, regardless of the truism that Nursing has been raised from the sink it was, not more by training, than by making the Hospital, Workhouse Infirmary, or District Home a place of moral and healthful safe-guards, inspiring a sense of duty and love of the calling. ”

“ Every one, who knows anything of the subject at the present moment, is well aware, that no matter where it may be situated, whether opened at the first need, or the creation of yesterday, still “our Hospital” will be, to the speaker, the most perfect in arrangement, discipline, and ventilation; the medical staff connected with it the most efficient, skilful and faithful; the corps of subordinates the most competent, systematic and thorough. Such is human nature, and we all find the weakness a pardonable one. ”

“ The general health of the institution has been good, and no disease of a hospital or local origin has existed. Although the wards of the hospital are crowded beyond their intended limits, care has been taken to secure ample ventilation, and to this, together with good management in the treatment of patients, the satisfactory sanitary condition of the hospital may be attributed. ”

“ 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. ”

“ Attached to the voluntary hospitals are the principal medical and nursing schools upon which the public depend for the supply of doctors and nurses. The education of students and nurses in a clinical hospital makes that hospital the most desirable place for everybody when they are really ill. ”

“ 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. ”

“ 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. ”

“ 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. ”

“ 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. ”

“ 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. ”

“ They pass through a kind of turnstile and take their seats in the order of their arrival on rows of benches in a large waiting-room, provided with a stove, a lavatory, and a drinking-fountain, with an attendant nurse and a woman to sell cheap, wholesome buns baked in the Hospital; for they may have to wait all the morning before their turn arrives to go in to the doctor, who sits from nine to twelve seeing and prescribing for child after child; and, if the matter is very serious, sending the poor thing on into the Hospital to occupy one of the cosy cots. ”

“ 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. ”

“ I don't think there is any hospital up this side where the men are more comfortable and happy, and I think the sisters here are better fed and their mess bills are no higher than at any of the hospitals—indeed, lower than most of them. ”

“ 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. ”

“ 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. ”

“ 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. ”

“ If the hospital nurse was till lately untrained and untrustworthy, what must the workhouse nurse be, in the still lower depth of social life from which she is taken? It is a fact that those who have once been employed in hospitals come, as a last resource, to the workhouse, and are there set in office over wards of sick and dying persons. ”

“ 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. ”

“ 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. ”

“ It is most important, in all things, in none more than in hospital matters, to moderate expectations, not to hope too much from any measure, or set of measures, and to keep well in view the stern prosaic realities of things. The hospitals of great towns are not asylums where a few or many selected patients can be received and petted; but great receptacles of all sick comers. ”

“ The other serious problem of hospital management was to keep those not really suffering from serious disease, malingerers of various kinds, from occupying beds and claiming attention, to the deprivation of those who were genuinely ill. ”

“ 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. ”

“ 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. ”