Operating room

“ In the operating-room we have better asepsis, better light and mechanical 460 appliances, better discipline of assistants and nurses, and greater opportunity of successfully dealing with unexpected complications.
In an operation which is performed in a private house something is always used which is more or less of a makeshift; and makeshifts should not be used in surgery, especially in abdominal surgery. If we hope to obtain perfect results, we must insist upon perfect surroundings and appliances. Continuous success is the result of scientific accuracy and attention to detail. ”

“ The ideal operating room for the plastic surgeon need not necessarily be large, since it requires less work to render it aseptic. Furniture and possibly amphitheater accommodation are always a means of infection unless scrupulously cleansed, a task of time, difficult at best. ”

“ The C.C.S., usually in huts or tents, is the first real hospital behind the firing zone. It may have accommodation for a couple of hundred patients; is supplied with X-Ray equipment, a well-arranged operating room with expert surgical assistance, and is the nearest place to the line that trained nurses are sent. Here for the first time since he left the line the patient gets all those little motherly attentions that only a woman can give. The injured man may be kept here days, weeks, or even months if he happens to be a case that would be endangered by moving. ”

“ It is only by constant practice and patient attention to technical details in the operating room and at the bedside, that the carrying out of surgical manipulations in such a way as to avoid bacterial infection will become an instinctive act and a second nature. ”

“ The surgeons, nurses, and staff occupied the servants' quarters on the top floor. The oak-paneled library and smoking room had become the operating theater and the X-ray studio. Our dining-room was the original servants' dining-room in the basement. The French officers and men who were cared for here received, as they deserved to receive, the best we had to give, the staff gladly taking second place in all things. And at that our life was so much easier than that of the boys in the trenches that we often felt a bit ashamed of the difference. ”

“ On one side of this hall are examination and dressing-rooms for males, with lavatory accommodation; and on the other side similar provision for females, with the addition of a nurses’ duty room. At the end of the central hall are two operating theatres, with recovery room adjoining each; one theatre for males, and the other for females. Between these theatres are rooms for sterilizers and dressings. An X-ray examination room is provided beyond the male examination room on the right of the hall. ”

“ The fourth floor contains a complete operating department with two operating rooms, one for major and the other for minor operations, each having separate sterilization facilities, together with preparation, etherizing and recovery rooms, while the remainder of the floor is given up to rooms for the male nurses and a convalescent solarium. ”

“ On the following day, the 6th of November, the hospital was ready for occupation; the plumber and gas-fitter were ejected, the pantry became an operating theatre, the greenhouse was converted into a linen room and packstore. In the evening the ambulances met the trains, and the large ward on the ground floor filled up. Before very long all the beds were occupied, and the Chief Surgeon and her two assistants were kept busy with severe cases and heavy surgery. The pressure of work continued until January; and both doctors and nurses had their hands full. ”

“ See here. We've put in a little surgery up there in the north wing, it's a peach of a place. Come and see it."
He led the way rapidly back up to the house, in at the door and up the stairs. At the end of a long corridor he threw open the door of a small room, whose whole northern side was of glass. Its equipment was as complete as could be asked by the most exacting of operating surgeons.
"Good!" Leaver cried, quite forgetting himself for the moment. "I had no idea you meant to carry things so far as this. Fine!" ”

“ On the second floor is a quantitative and qualitative laboratory; a museum, a recording room, a library and lecture rooms, and on the third floor are surgical wards, subdivided for major and minor operative cases, together with medical wards, so planned as to have ordinary and chronic medical cases in separate divisions. The hospital is to be freely used for detailed observation as well as for treatment. ”

“ The surgeon and his assistant came down from London and I with them. The room in which the operation was to be performed was hard and unsympathetic. It had been cleared of all its accustomed furniture. On the bare floor a white sheet had been placed, and in the middle of this square stood the operation table like a machine of torture. Beyond the small bed the patient was to occupy and the tables set out for the instruments the room was empty. Two nurses were busy with the preparations for the operation and were gossiping genially in whispers. ”

“ A HOUSE surgeon at a great accident hospital in the east of London happens upon strange scenes, some pathetic, some merely sordid, together with fragments of tragedy in which the most elemental passions and emotions of humanity are displayed. The chief place in which this experience is gained is the Receiving Room. I speak of a hospital not as it is now, but as it was some fifty years ago. The Receiving Room is a bare hall, painted stone colour. ”

“ The operation is so frequently carried out in private houses that it is well to make inquiries into the health of the members of the household, recent illness, and sanitation. When possible, a large, airy room with a south aspect should be chosen. ”

“ For instance, if one of the fever-patients was taking veratrum, I must see it dropped and given, and note the pulse. If one was just struggling through dysentery, I must attend to his nourishment, and generally fed him myself. Down-stairs was one large room, and three of good size, but smaller. The large one was also a ward. My business-room opposite was also the linen-room of the hospital. Shelves ran from floor to ceiling, a counter in front of them. In one corner stood my desk, and beside it a large country rocking-chair; in another a rough lounge for the convenience of visiting patients. ”

“ Every class of patient was accorded separate accommodation: the four halls of the hospital were set apart for those with fever and similar complaints; one part of the building was reserved for eye-patients, one for the wounded, one for those suffering from diarrhoea, one for women; a room for convalescents was divided into two parts, one for men and one for women. Water was laid on to all these departments. One room was set apart for cooking food, preparing medicine and cooking syrups, another for the compounding of confections, balsams, eye-salves, etc. ”

“ 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. ”

“ The patient's room may always have the window open. But the passage outside the patient's room, though provided with several large windows, may never have one open. Because it is not understood that the charge of the sick-room extends to the charge of the passage. And thus, as often happens, the nurse makes it her business to turn the patient's room into a ventilating shaft for the foul air of the whole house. ”

“ The nurses’ rooms should be supplied with plain comfortable furniture. In the large Hospitals the head-nurse furnishes her own room or rooms, which doubtless promotes her comfort and her care of the furniture, both desirable things ”

“ 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. ”

“ My Richmond friends never lost sight of me for one day during my service in that city. Nearly every day my little boy was sent for to play among happy children, far away from the impure atmosphere of the hospital, which was soon filled with patients suffering from almost every form of disease.
As the demand for more room became pressing, the three stories of the main building were successively utilized, as well as a large storage-room in the yard. The ground-floor contained the surgeons' and steward's offices, store-rooms, etc., while the second and third formed two immense sick-wards. ”

“ There are three hospital rooms in the upper story of the front part of the centre building, they have private water closets, bath tubs, with warm and cold water, and shower, they can be reached from the cells of the north and south wings by the gallery through the guard room and iron staircases, and also from the stairs in the front towers; they are well lighted and ventilated. ”

“ The Nurse of each Pavilion should inhabit the room on the ground-floor ward, where the heaviest surgical cases will be probably placed, whence she can better command the movements of the Pavilion, and attend the entrance of the Surgeon. ”

“ In most instances the patient who is to be delivered at home will have to occupy her accustomed room and there is no alternative. Should there be a choice of rooms, however, one should be selected that is cool and shady, if the confinement takes place during the summer, but bright and sunny for occupancy during most of the year; it should be conveniently near a bathroom if possible, and have an adjoining room for the nurse and baby to occupy. ”

“ In all well-conducted hospitals it is now arranged that the nurses on night duty have a hot meal served in the general dining-room during the night, and this is only possible where a nurse and a probationer are allowed for each ward. The nurses’ quarters should be separate from the hospital proper, and connected by a conservatory or covered way. Each nurse should have a separate bedroom, measuring not less than 12 ft. ”

“ The life of a hospital at the front is a curious mixture of excitement and dullness. One week cases will be pouring in, the operating theatre will be working day and night, and everyone will have to do their utmost to keep abreast of the rush ”

“ Still, we consider that we have a right to advise those who wish to nurse our patients.
And so this will explain the apparent anomaly of a physician writing a paper on nursing.
The sick-room must be large and airy, but free from draughts. There should be at least two windows in the room, and, if possible, they should have a south or west aspect. Before the invalid takes to this room, the floor, the windows, all the paint, etc., should be thoroughly cleaned by ways of which you know more than we do. ”

“ On my admission into hospital I was at first sent to the convalescent ward, a huge room devoted to light and unpronounced cases. It accommodates 40 patients, and the entire furniture may be roughly estimated as consisting of 40 beds, 40 tables, 40 chairs, one shovel and tongs, and one thermometer. The beds are ranged round the entire room, the tables and chairs a yard apart forming two rows down the centre; the thermometer is suspended from a beam, the shovel is chained to one fire-place, and the tongs to the other. ”

“ An extra room adjoining the sick-room is invaluable to a good nurse, for here, if it be warm weather, she can, when necessary, have a fire, can air linen, wash up any plates, glasses, etc., and do a hundred and one little duties she would otherwise be compelled to perform in the sick-room, thus saving much disturbance to the patient, and keeping the sick-room as it should be kept, free from noise or litter of any sort. ”

“ A large sky-lighted room had been set apart as an infirmary, and a little suite of rooms in the great tower adjoining as the physician’s quarters. But it was rare indeed that any one was ill at Madame’s, and when a pupil was taken sick, her parents usually took her home at once. So the doctor, having nothing to do but to hear the recitations in physiology, preferred not to reside in the school building, and the pretty suite of rooms, consisting of a parlor and three bedrooms, was assigned to us, and the hospital proper was used as a trunk room. ”

“ The sick are brought from the ships to the hospital by water, and go, or are carried up a wide stone stair to the receiving office. They are then stripped and bathed in the hospital to which they are sent, and their clothes are marked, and kept in a particular magazine. An iron crane is employed to land those who are badly wounded. In all the wards, as well as in the different store-rooms, and the apothecary room, the greatest order and cleanliness is observable.
The church does not appear to me to be arranged in correspondence with the rest of the establishment. ”

“ Surgery.— Increasing hospital and outpatient perioperative patient safety, including reducing surgical-site infections and surgical errors (such as wrong-site surgery and retained foreign bodies) . (3) Emergency Room.— Improving care in hospital emergency rooms, including through the use of principles of efficiency of design and delivery to improve patient flow. ”