DIGEST.

PAGES
THOUGHTS SUBMITTED BY ORDER[1–28]
CONCERNING
I.Hospital Nurses.
II.Nurses in Civil Hospitals.
III.Nurses in Her Majesty’s Hospitals.
I.Hospital Nurses[1–9]
Twenty Observations on how to improve Hospital Nursing.
II.Nurses in Civil Hospitals[9–14]
Twenty-three Heads for Regulations as to Nursing in Civil Hospitals.
III.Nurses in Her Majesty’s Hospitals[15–19]
Twenty-two suggestions in the event of the introduction of Female Nursing into Military Hospitals.
Various systems of Female Nursing during the Crimean War in the Military Hospitals[19–28]
Of the French and Sardinians[19–22]
Russians[22, 23], [26–28]
English[23]
Proposed Duties of Female Nurses in Military General Hospitals[23, 24]
The Hospital Serjeant, or Ward Master will not be superseded—he will still have too much to do for any one man properly to perform, and part of his duties must be given to another officer[24–26]
Note in regard to the Russian Nurses employed in the War-Hospitals of the Crimea[26–28]
SUBSIDIARY NOTES AS TO THE INTRODUCTION OF FEMALE NURSING INTO MILITARY HOSPITALS IN PEACE AND IN WAR[1–133]
I.Five Conditions essential to this service[1–3]
II.Our Nurses were of four kinds[3]
Absolute subordination to the Medical Officer as to Medical Orders essential and practised by us[4]
III.1. Qualified subordination essential of Superintendent-General to Director-General and Principal Medical Officer[4–6]
2. Also of Matron and Nurses to Principal Medical Officer and Staff-Surgeons[6, 7]
3. Female service can only be introduced gradually, and introduction regulated by Director-General[7–9]
IV.1. Shall Roman Catholic Sisters be introduced?[9, 10]
2. Or Anglican Sisters?[10]
3. Power of Police in Civil Hospitals[11]
Power of Police in Military Hospitals[12–15]
4. Pay and Rations of Nurses[15–20]
On the whole it would seem best, where practicable, to board the Nurses, not to “ration” them, nor to let them “find themselves.” Community of cooking implies economy of nourishment[17–20]
5. Washing to be “put out”[20, 21]
6. Cleaning their own Rooms[21–23]
7. Nurses to keep keys of closet in Wards[23]
8. Pay, dress, and duties of Matrons[24–28]
More properly named Superintendents[27]
Lady Volunteers had better begin by being Nurses, not Superintendents ex-officio[28]
9. Sundry Regulations as to Nurses[29–31]
10. Have the Patients’ Diets sent hot, and ready divided, from kitchen[31]
11. What Ward duties the Nurses should do themselves[31]
And why[32, 33]
Patients should not be made quasi Orderlies[34]
Visitors in Military Hospitals[35]
12. Regulation-Number of Orderlies—depends on the size of wards whether sufficient[35–41]
What is the regulation-attendance in Naval Hospitals[37]
What in Civil Hospitals[38]
Comparative Cost of Nursing in larger and smaller wards[39–41]
13. Hospital floors [42–51]
Sanitary necessities[42]
Trial of Hospital floors, oiled and polished with “laque” as in Berlin Hospitals, recommended on sanitary grounds and for ease of cleaning[43–51]
14. Ventilation of Wards[51–52]
15. Special Wards, whether desirable or not[53–54]
16. Opinion as to Superintendent-General paying Nurses’ wages, and as to Governor’s jurisdiction over Nurses[54–56]
17. Wages and Pensions of Nurses[56–60]
Three rules in raising Wages[56]
Five general principles as to Wages and Pensions[58]
Six applications of the foregoing principles[58, 59]
Seven heads for Regulations as to Nurses’ Wages and Pensions[59, 60]
18. Proportion of Nurses to Patients[61, 62]
19. Precautions in sending Nurses on Foreign Service[62]
Hospital Laundries[63]
Addenda, with regard to Female Nursing in a Military Hospital on the Pavilion, or Lariboisière Plan[63–90]
I.Four conditions to be considered in adopting the Pavilion Plan[63]
1. Economy of attendance[64]
2. Facility of supervision[65]
3. Desirableness of doubling the Pavilion, in a Military Hospital, in order to give to each Nurse but one floor to serve[65]
4. Nurse to sleep near her Ward[66]
Importance of lighting by gas[67]
II.1. One Nurse must serve the whole Pavilion, in a Military Hospital, if single Pavilions be adopted[68]
2. Nurses’ day in such a Pavilion[68, 69]
3. What the responsibility of Nurses is for
discipline of Ward or Pavilion[70, 71]
4. Importance of Lifts[71]
III.1. “Casualty” Cases should be in a completely appointed set of Wards, apart[72]
And why[73]
2. Restraint or non-restraint in Violent Cases[74]
IV.Simplicity of Construction essential to Discipline[75]
Polished impervious Walls.
Covered Exercising Place.
Reserve Wards[76]
V.Nurses’ Meals to be sent them Cooked[76]
VI.Arrangements for a Pavilion and its Wards[77–90]
2. Where should Wardmaster sleep?[77]
3. And Orderlies sleep?[77]
4. And dine?[78]
7, 8, Scullery to each Ward, and what to be done in it[79]
Poultice-making[79]
9. Presses in Ward[80, 81]
10. Nurses’ Room[82]
Lavatory, Water-Closet, Sink[83]
Baths[84]
11. Summary of arrangements[85]
Scullery Appurtenances[86]
12. Nurses’ Sleeping Quarters[86]
Ward for Sick Nurses[87]
13. Classification of Patients[88]
14. Nurses to be called by their Wards[88]
15. Foul Linen[88]
16. Washing Bandages[89]
17. Splints, &c., where to be kept[89]
Cotton Lint never to be used[89]
18. Classification of Nurses[90]
Superintendent’s Store Room[90]
Addenda as to Mixed Nursing by Nurses and Orderlies in Military Hospitals on the Double Pavilion Plan[91–117]
I.Orderlies’ Duties[91–108]
Proportion of Nurses, Ward Masters, and Orderlies to Sick[91–93]
Wine to be always administered by Nurse[93]
Orderlies—their Duties vary according to appurtenances of Ward[94]
If Hot and Cold Water are laid on, and there are Lifts, one Orderly’s Service saved to each 30 Sick[94, 95]
Night-Duty of Orderlies[95–108]
Scheme of Night-Service for three Orderlies watching by turns[96, 97]
Exercise for Orderlies[97]
Night Refreshment for Orderlies[98, 99]
Where are the Night Orderlies to sleep?[100]
Comparative Merits of different Systems of Night Nursing in Home and in Foreign Hospitals[101–3]
An Assistant Ward Master should go round the Wards at Night[104]
Extraordinary System of Night-Nursing in the Army at present[105–8]
II.Twelve Sundries in organizing a Military Hospital[108–114]
1. Nurses’ Room[108]
2. Medical Officer’s Room[108]
3. Water-Closets[109]
4. Warm and Cold Water Supply[109]
5. Corridors[109]
6. Lobby[110]
7. Material of Ward Utensils[110]
8. Reserve Wards[111–112]
Necessity of Annual Cleansing of the whole of a Hospital
9. Occasional Revision of Rules[113]
10. Defect in German Organization of Nursing[113]
11. Nurses’ Exercise[113]
12. Number of Ward Masters[114]
III.Regulations[114–117]
1. Deprivation of Visitors salutary in certain Wards[114–16]
2. Numbering Patients saves time[117]
3. Prohibition of Swearing[117]
Conclusion[117]
Additional Hints as to Pavilion Hospitals suggested by the Construction of the Lariboisière Hospital at Paris[118–127]
I.Ventilation[118–120]
Artificial Ventilation never freshens a Ward
II.Oiled Boards versus Parquets[120–124]
Cleaning polished and oiled Boards much less laborious, and freshens the Ward much more than the frottage of Parquets.
Mode of Cleaning them at Berlin[122–124]
III.Ten Cautions in Building Hospital Pavilions[124–127]
Size of Wards. Our own Regimental Hospitals extraordinary for their many holes and corners[125]
Casualty Wards[126]
“Contagion” and “Infection” Defined[128–132]
Idea of “Contagion” invented by Men to excuse themselves for the neglect of all Sanitary arrangements[128]
In the ordinary sense of the word, no such thing as “Contagion”[129]
Nor as inevitable “Infection”[130]
“Infection” and Incapable Management, or Bad Construction, convertible terms[131]
“Epidemics” do not spread—they develop themselves in Constitutions made ripe for them by Sanitary neglects[131]
Note on certain “Observations” by Sir John Hall [132, 133]
Thoughts Submitted as to an Eventual Nurses’ Provident Fund[1–19]
Actual Wages and Prospects of Nurses[1–3]
Some further Provision desirable[4–6]
Of what Nature?[6–15]
With regard to Kind?[6–8]
With regard to Persons?[8]
With regard to Objects?[9–15]
Material Objects?[9–12]
Children, in the case of Nurses, a Temptation to Petty Dishonesty and taking Bribes[11, 12]
Sanitary Objects?[13]
Moral Objects?[13–15]
Hospitals not places for Penitents[14, 15]
Rules to be followed in giving Assistance[15–17]
Prospects of Eventual Support[18, 19]
Note as to the Number of Women employed as Nurses in Great Britain[20, 21]
Tables of Ages, &c.[21]
Note as to Teaching Nursing—Institution at Madras[22, 23]

PRIVATE AND CONFIDENTIAL.

Thoughts submitted by order concerning