The most interesting educational movement, at this moment, in that country, is Miss Nightingale's "Training-school for Nurses," which has been in operation for three years in Liverpool. It was founded, after a correspondence with her, in strict conformity to her counsel. As a training-school, it may be said to be self-supporting; but it is also a beneficent institution, and, in that regard, is sustained by donations. A most admirable system of district nursing is provided, under its auspices, for the whole city of Liverpool, all of whose suffering sick become, in this way, the recipients of intelligent care, and of valuable instruction in cooking and all sanitary matters. It is too tempting an experiment to dwell upon, unless we could follow it into its details. Its report occupies a hundred and one pages.
It seems worth while to look into this report, and examine in detail its method of dealing with sickness among the poor. When Miss Nightingale drew especial attention to the want of such schools in England in 1861, some ladies and gentlemen in Liverpool came together, and entered into correspondence with her. Out of that correspondence grew the Liverpool school. The Liverpool Infirmary, the most considerable hospital in that city, entered into the plan, and offered its wards for the instruction of the nurses. The society proposed to itself three objects:—
1. To provide thoroughly trained nurses for hospitals.
2. To provide district or missionary nurses for the poor.
3. To provide trained nurses for private families.
Nowhere are hospital and private nurses so badly trained as in England; and Miss Nightingale well says that half the symptoms which are considered symptoms of disease are, in reality, indications of a want of air, light, warmth, quiet, or cleanliness, which properly instructed nurses would know how to supply. A want of punctuality in administering food, and of watchful care in detecting its effects upon the patient, create other classes of symptoms. The beer-drinking habits of the people lead to much intoxication; and we ourselves have seen ladies of quality lying on a sick-bed, where they suffered for the attention which a thoroughly stupefied nurse was incapable of giving. No amount of wealth, as Miss Nightingale testifies, can secure such nurses as wealthy patients often need, and for which a thorough hospital-training is required. The society strengthens her appeal by extracts from Dr. Howson's paper, read at the meeting of the Social Science Association in 1858.
The Liverpool school has erected a building, to carry out its purpose, eighty-five feet by forty. It has three stories, each of them eleven feet high; and, by a single glance at the plans which accompany the pamphlet, one sees that the arrangements for bathing and ventilation are what those of our new city hospital ought to be. One lady superintendent, with three servants, has charge of this building. It has thirty-one nurses under training. By the wages which they earn in the second and third years, the expenses of this Home are nearly paid, leaving a margin of about three hundred pounds to be supplied by donations. It is expected to be a self-supporting institution, except so far as it becomes a benevolent charity, by supplying to the poor, food and nursing. When the institution was ready to begin its work, the lady superintendent having been some months in training at St. John's College and the London Hospital, where the nurses educated by the Nightingale Fund are to be found, took possession of her building. Her head-nurses had been thoroughly educated. Pupils then offered: they were engaged for three years, the first year to be strictly probationary. Each head-nurse was to take charge of an entire ward of the hospital, to be responsible for the medicines and stimulants, always assisted by one pupil. Each pupil went first for two months to a surgical ward; then for two to the medical; then four at the surgical, and four again at the medical,—one course helping the other, and both filling the entire year under a thoroughly trained head. For the next two years, the pupil is employed without such superintendence wherever need is; and, for each of the three years, receives, in addition to board and lodgings, seventy dollars. At the Home there is a good library, and evening classes are held for the disengaged pupils. A superannuation fund has been started, to encourage respectable women to enter the Home. At the end of the third year, the Home has twenty-eight pupils under training, fourteen hospital nurses, fourteen district or gratuitous nurses, and ten employed in private families.
This gives an idea of the training process; but our chief interest lies in the district nursing. As soon as the Home had nurses it felt willing to trust, one of the experiments recommended by Miss Nightingale was tried. The wife of a Scripture-reader undertook to prepare sago, necessaries, &c.; the clergyman of the parish furnished a list of patients, and a central lodging for the nurse. The Home sent her out, supplied with cushions, blankets, and bed-rests. She went into the families, showed them what to do, and helped with her own hands. At the end of the first week, she came back, crying and begging to be relieved; she thought she never could bear the sight of the misery she encountered. But, in a short time, she was so strengthened by seeing the results of her labor, that she positively refused to take employment among the rich. It is easy to see what great advantages wait on this form of charity. As instruction is precisely what she comes to give, the poor cannot resent this from the nurse; she fears no imposition, for she is in the house at all hours of the day and night; her little gifts do not wound, but cheer like neighborly kindnesses. It is Miss Nightingale's idea, that such nursing is a far greater good than the establishment of hospitals. In six months, this nurse found two cases where the prolonged sickness of the wife had made drunkards of two otherwise steady husbands, and brought their families to the brink of ruin. The wives were cured, the husbands reformed, the families saved. A leaf from her report of cases will show what she did.
1. Asthma and bed-sores.—Lying on a floor; so thin, had to lift her on a sheet. Dirt, bad air: two children. Husband said he "was forsaken by God and man." Our nurse goes in, washes her, changes linen; lends bedstead and bedding, and air-cushions; cleans and whitewashes. The woman now sits up, and the man is again hopeful.
2. Internal cancer.—Nurse attended to the surgical operation, and administration of subsequent remedies. The woman is now at work.
3. Paralysis.—Nurse attended; gave instruction and food. Recovery complete.
4. A girl—as the doctor said—in a consumption. Hospital refused her as incurable. Beef-tea, wine, sago, and cod-liver oil supplied; and, in one month, she could walk to the nurse's lodging.