THE LOYALTY OF NURSES
To the Editor:
My attention has just been called to an article published in The Journal-Lancet, August 1, 1914, it being an address by Dr. George D. Head to the graduating class of the Asbury Hospital. The advice Dr. Head gives to the nurses seems very good, and very elevating to our profession, but I would like to analyze it to show that it is not quite practical.
It has taken considerable effort on the part of nurses to convince the people, and to convince some doctors, that they are any more than machines. Because we ask for three hours rest out of the twenty-four, and because we asked for a fixed rate for service, Dr. Head says that our loyalty to high ideals is diminishing. Unfortunately, in the nursing profession, as in all other professions, there are some who are incapable and unconscientious; and, if Dr. Head had the experience of having a nurse leave a patient, unattended, at a critical time, she probably was one of the few incapables, or was so overtired from loss of sleep that it was necessary for her to have rest. When Dr. Head says that a nurse should waive her rest hours for days or a week at a time, if necessary, I think he is making a mistake. A nurse cannot do her duty by a patient if she does not have proper rest. It is unfair to both the patient and the nurse. Dr. Head may say that most patients are not in need of constant attention for more than a few days or a week, and that a nurse can stand it for that length of time without rest hours. This is true; but we have to consider that the next case may be just as critical, and so the nurse must reserve some strength for the cases to follow. And more often than not, the nurse is obliged to take cases with very little or no rest between them.
In the second place, Dr. Head thinks that the nurses ought to have a varying scale of charges for service. The doctors do it; why shouldn’t the nurses? Dr. Head does not seem to consider the fact that the nurse has one patient, while the doctor has many. Suppose a nurse takes care of a poor patient for five or ten dollars a week, where is the rich patient who is willing to pay forty or fifty dollars a week to make up the loss? The nurses have found that twenty-five dollars a week is the price that is necessary for them to live on in order to keep themselves clothed, pay for their laundry (no small item), and carry them over the few weeks of rest or over the dull season. The average life of a nurse, as a nurse, is, I believe, not more than ten years. In that length of time, at the wages she gets, she is not able to lay away a great amount for a rainy day, which usually comes all too soon.
We have a number of good hospitals in Minneapolis where people in moderate circumstances can be very comfortably cared for at a considerably less expense than employing a nurse in their homes. The poor in our city, I think, are fairly well taken care of in the city hospitals and by the visiting nurses, who are paid for such work.
As for nurses refusing cases because they are afraid of them: I think there is usually some just cause. If a nurse has a tendency towards tuberculosis, she should refuse such cases; or if she has a tendency towards throat troubles, she should refuse diphtheria and scarlet-fever cases. A nurse who is constantly with a patient runs considerably more risk of infection than the physician, whose visits are usually short. There are nurses who make a specialty of such cases, and usually there is no trouble finding such a nurse. Nurses who make a specialty of obstetrical cases or of children should not take contagious work. As for a nurse refusing a typhoid case because she is afraid of it: I cannot believe that any real nurse would do such a thing.
It also seems to me very ridiculous, and it surely cannot be a common thing for a nurse to inquire before she consents to take a case whether or not the plumbing is modern and how many servants are kept.
As to just what Dr. Head means by saying that a nurse should be willing to do any kind of service about a house. I do not know; but I do know that nurses are not usually physically fit for washing or scrubbing, yet, as a rule, nurses are glad to perform duties which are not just in their line, in order to help the household to run smoothly.
Most of the nurses in general work are engaged in nursing because they are obliged to earn their living, and in most cases because they are especially interested in this particular field; and, although most nurses take some charity cases, it is impossible for them to take many, even to satisfy what Dr. Head calls “the inner, higher longings of the soul.”
Harriet M. Prime, R. N.
Minneapolis, February 4, 1915.