Hospital housekeeping

by Charlotte A. Aikens

CHAPTER V.

The Hospital Laundry

Perhaps no part of the hospital housekeeper’s domain will call for a greater expenditure of her energy and patience than the laundry. Though out of sight, its results are always in evidence, and failure in the laundry means that every part of the work of the establishment is handicapped. There may be abundance of linen to meet the needs of the hospital, and yet if constant supervision over the work of the laundry is not exercised, three-fourths of the linen supply may at times be found piled in the laundry, the linen room shelves empty, and the nurses flying hither and thither on borrowing expeditions when a clean towel is called for.

A wise philosopher has said, “Every man is as lazy as he dares to be,” and the average laundry employee is like the rest of the world in that respect. Few of them love the work for the work’s sake, and if the weekly wage is not sufficiently large to be attractive, they will be lazy and neglect their work if they have opportunity.

Manager’s Duties

A competent manager for the laundry is essential for successful work, especially in a large institution. This person should know how to manage his staff of helpers so as to secure the best possible service, and should have a knowledge of the needs of the institution where his own department is concerned, and of the work that is important to be done without delay. Good common sense in arranging the time when the different parts of the work should be done, will prevent much trouble in any laundry. Nurses’ clothing and articles not in constant demand, that are returned but once a week, can be laid aside to make way for the things in constant demand. When once a competent manager is secured, the buying of supplies may be safely entrusted to him.

But, unfortunately for the hospital housekeeper, few except the larger hospitals can afford the luxury of a skilled manager for the laundry. A head laundress is the nearest they can approach to such a luxury, and even that much needed individual is often out of reach. In many cases the hospital housekeeper, in addition to her other duties, has really to take the place of manager of the laundry.

Where several laundresses are employed, and none are fitted for directing the work of others, it is a wise provision for the housekeeper to personally divide the work and assign it, and have each laundress responsible to her. The servant problem has assumed such an acute form that it requires delicate handling in any household, and where the character of the work is as important as that of the hospital laundry, every possible tendency to friction should be avoided.

Laundry Workers

Let laundry workers understand fully what their hours of work shall be, and that they are expected to be in their places promptly at the hour. Explain the importance of having the supplies for the wards and operating rooms constantly kept up to the mark, and also the linen for the trays. Prohibit visitors during working hours. It is always better to make such prohibitions when engaging help rather than wait for some occasion to call it forth. The occasion will certainly come unless it is anticipated and prevented. Make some provision for them to do their own personal washing, and let it be plainly understood they are not to take in washing from other sources to increase their income. That is sometimes tried and carried on very successfully, if it is found that the laundry has not careful supervision. If it is not desirable for their own washing to be done in connection with the hospital, then a time must be arranged for it.

Where the laundresses are mothers of families, as is often the case, this point is worth mentioning at the time of engagement. Their washing must be done—the question is, when and where. It is better to have a plain understanding about the matter than to have them attempt a course of deception. Feed the laundresses well and arrange for them to make a cup of tea or coffee between meals if they want it. The work is hard and exhausting, and they cannot put their best into it if they are hungry. Take an interest in their health and see that their minor ailments are attended to when necessary. Arrange for an afternoon off at least once in two weeks. They have little matters of business to attend to, and they need the recreation as much as other people. Arrange to visit the laundry at least every day—twice a day if possible, and not always at the same hour. Commend their work and their promptness when there is room for it. A word of appreciation will often do more to inspire them to better service than a severe rebuke. When they have worked overtime in some unusual rush, do not forget to mention your appreciation of it. Then see that they have proper things to work with. It is impossible to have satisfactory service if proper facilities are not provided.

Starching

The housekeeper, where no manager of the laundry is employed, will have the purchasing and giving out of supplies and should have an idea of how much is needed for each week’s work. Provide a good quality of soap and starch. The cheaper grades are almost always more expensive owing to the additional amount necessary for the work. The better grade of starch will produce better finished work. See that the vessels used for starching are well cleansed after use. Know something about the methods used in starching. If collars, cuffs and belts are not stiff, inquire the reason. To produce a proper stiffness, the starch should be used as hot as can be borne by the hand, and well rubbed in. Clothing that is starched should be put to dry as soon as the starching is completed. If left around in baskets the articles will inevitably come out discolored. It is well to give a list of the articles requiring starching rather than trust to their judgment. Aprons and coats for the operating room that are to be put in the sterilizer need no starching, while other aprons and coats must be starched. They will not know the difference if they are not told.

Bluing

If the clothes are streaked with blue, make some inquiries into the washing process. It may be the clothes have not been rinsed thoroughly free from soap. They should pass through at least two rinsing waters (three is better) to free them from soap. The first rinsing water should be quite hot. The bluing should be done in plenty of water, so that every part of the garments may be under water. In preparing the bluing water see that the blue is dissolved in a separate pail before being put into the vessel in which the articles are to be blued. In mixing the bluing water, it is easy for parts of the vessel to become deeply stained with the strong bluing solution, which will be rubbed into the clothes and leave streaks. When plenty of soda is used to soften the water there will be less trouble with black specks from the soap. Impress on them the fact that the nurses’ uniforms and colored shirt waists are not to be boiled. If the uniforms are thoroughly soaked over night in a strong salt solution they will retain the color better. When uniforms are dried in the open air see that they are hung wrong side out.

Special care needs to be used in washing blankets. They should be dealt with separately and gotten through with quickly. The suds should be quite hot and a little ammonia added. The rinsing should be in water of the same temperature and they should be dried in the open air.

Drying

Whenever possible have all the hospital clothes dried in the open air. No drying room, however well constructed, can compare with nature’s process of drying by fresh air and sunshine. The best method of bleaching is by the use of the sun rays while the clothes are wet. However, in planning for laundry work, it is never wise to depend entirely on open air drying. An artificial dryer is a necessity where promptness is required. Quick drying is essential to good work. Where bad work is done, the trouble is oftener in the washing than in the drying.

Ironing

In planning for the ironing much may be done to facilitate the work. Little labor-saving devices can be introduced which will increase the amount of work done in a day. Ironing boards of special shapes, and for special purposes, and tables of various designs can be had for a trifle and will result in a saving of time and more finished work. A box of thin pine boards with a hinge cover and with perforations in the sides is a convenient receptacle for storing dampened clothing waiting to be ironed. See that they have proper irons for the different parts of their work and that they have wax to use as needed. Supply unbleached muslin for ironing sheets or the hospital sheets will be found covering the ironing boards. Instruct them to keep their ironing sheets clean. Well-finished work cannot be produced on a dirty ironing sheet.

Routine of Work

Let the laundresses understand that bad work will not be accepted, and they will not send it. Bad work that was passed in the linen room has often caused embarrassment in the operating room. As far as possible, have a routine order for laundry work, and expect the laundresses to comply. If they understand that clothing sent from the wards on Tuesday morning must be returned to the wards not later than Thursday morning, they can arrange to have it done, while if no limit is set for the clothes to be in the laundry, the haphazard results will be constantly felt in the wards.

Have a method of folding linen and insist on that method being followed. It is impossible to have neat-looking shelves in the linen room if no uniformity be observed about folding in the laundry.

Then see that the work rooms are kept clean. It is useless to expect clean linen unless the laundry and its furnishings are kept in proper condition. The woodwork and windows and floors should be as scrupulously clean as any other part of the hospital. But they will not be kept so unless a time is set for the cleaning, and someone sees that it is done.

Greasy towels or clothes, from the kitchen, pantries and bake rooms, should either be entirely washed by those who use them, or have a preliminary washing before being sent to the laundry. Such articles cannot be washed with any other clothing; a special suds must be gotten ready and time spent that would have counted for more if spent on other work.

A false economy in planning a hospital often results in a space entirely inadequate being set apart for the laundry. As the general work of the hospital increases it is then found impossible to meet the demands, and recourse has to be had to the public laundry—always an expensive arrangement. Another common mistake, is to place the laundry in the basement, where lack of light and air is always a hindrance to good work. Whenever possible, the laundry should be located in a separate building, where plenty of light and air and sunshine can penetrate, and where there is room to separate the clothing while in its different processes and proper work can be done. All clothing should be well aired and thoroughly dry before it leaves the laundry, so that it may immediately be placed on the shelves for use.

The Laundry Plant

It is difficult to give an accurate estimate regarding the cost of installation and operation of a laundry plant, as conditions vary greatly. A list of the articles required for a plant capable of doing the work of a sixty-bed hospital is appended. In preparing this list the elimination, so far as possible, of all expensive features, has been attempted. A laundry plant, like nearly everything else, can be figured on in various ways, and at largely varying cost, so that, with different machines, a plant with the same amount of machinery will cost three times as much as another of practically equal capacity and actual working value. It is well, therefore, before purchasing a plant, to be thoroughly informed regarding the actual needs of a hospital, the various makes and grades of machines, cost of operating, etc.

A very serviceable laundry equipment for a hospital of fifty to sixty patients, is made up as follows:

One 12 h. p. vertical boiler, complete with suitable injector and regular boiler trimmings.

One 6 h. p. horizontal engine, complete with all engine trimmings, and a sight feed lubricator.

One 36 × 30 wood washer.

One 20-inch solid curb extractor, countershaft attached.

One 40-gallon galvanized steel soap tank, with circular boil pipe.

One sectional dry room, arranged to handle plain or fancy clothes, and complete with three metal trucks, ventilating fan, etc.

One 66-inch steam mangle.

One 30-inch reversible body ironer.

Two ironing tables.

One truck tub.

This outfit will cost about $1,100 to $1,200, including pipes, pipe fittings, valves, shafting, etc., and will require a floor space of about 24 × 48 feet. The accompanying diagram gives a good idea of an economical arrangement of such a plant.

In one institution having about one hundred patients, a plant similar to this is used. All the work is done with two women and one man, the man looking after the power and the washing. If the hospital employs a man who can look after the power for two or three days in a week, the cost for help may be reduced.

Where the laundry work of a hospital runs up to $750 or $1,000 a year, there are but few instances where a direct financial saving will not be effected by the hospital operating its own laundry plant.