Let us consider the first objection, that made by the nurse. A nurse does not feel conspicuous when on duty in her district. Her busy, daily routine, taking her in and out of homes where she is needed, soon causes her to forget her personal appearance. A self-conscious woman is hardly the right sort for this work. The only rub comes when she is off duty and going to and from her district, but this cannot be held to constitute a serious objection.
As for the patient’s objection—he would be equally conspicuous if regularly visited by any woman unknown to the neighbourhood, no matter how attired. Prying eyes would recognize her as an alien, and the neighbours would speculate accordingly. We have often heard of patients who for fear of what the neighbours would say objected to being visited by agents of the Charity Organization Society. Yet the agents of that Organization wear no sort of uniform. The truth is, it is usually really the visit itself which is objected to, rather than the costume of the visitor—the costume merely serving as an excuse. On analysing the objections of a group of patients who disliked the uniform, they were found to be, without exception, patients who strongly resented every suggestion made to them. Their one desire was to be let alone, to be as careless as they chose.
On the other hand, the advantages of the uniform are many. In the first place, all effective care given to a consumptive has to include nursing as well as teaching. Now, one can “educate” in a woollen dress, but one certainly cannot give bed-baths in anything but a cotton dress, which can be plunged into a tub and washed. And whether she enters the home to give a bed-bath, or whether she goes in merely to distribute prophylactic supplies, the fact remains that a nurse spends some eight hours a day in contact with an infectious disease. Good technique demands that she be dressed in washable material.
In summer, a dress of washable material is not conspicuous. In winter, it may be covered with a long coat. And if we admit that such a dress is necessary, what objection can there be to making it of simple and uniform design? A single nurse so arrayed looks neat and business-like; a staff of nurses looks equally so. Moreover, uniformity of dress suggests uniformity of method, standard, and character of work, and hence inspires confidence. A staff of nurses, each one dressed according to the hazard of her own fancy, would hardly create the same impression.
In itself, the uniform is a protection to its wearer. It enables her to go freely and without molestation into all kinds of tenements and lodging houses, into side alleys and back streets. The well-known dress surrounds her with recognition, affection, and respect.
The uniform is also of value to the patients and to their friends. It enables them to recognize the nurse as she passes, and to call upon her as she goes by.
The uniform worn in Baltimore consists of a plain shirtwaist suit, worn with white linen collar and black necktie. The dress is made of blue denim, such as is used for overalls. Denim of this sort has two sides, a light and a dark; the dress is made up with the light side out, as in washing it seems to “do up” better than the darker side. Black sailor hats are worn, and in winter long, dark coats protect the dresses. This uniform is not necessarily the last word as to what a uniform should be, but it is simple and inexpensive, and the nurses look well in it.
Badges. The staff of a municipal nursing force is usually provided with badges to denote that they are connected with the Health Department. These badges should never be worn conspicuously, although they should be readily accessible. They are only occasionally needed, however, as when entering some lodging or rooming houses, or houses of prostitution, or other places where there may be marked opposition. To show them when entering a private home would be bad policy. A nurse usually enters a private house as a friend, but a public house she is sometimes obliged to enter in her official capacity. In dealing with all her patients, however, no matter where they are situated, the less show made of officialdom the better. By the time her patient finds out that she is connected with the Health Department, she should be already firmly established as his friend, and then the discovery will have no terrors. Indeed, at that stage, it very often enhances her value, and patients often feel intense pride at being visited by the “city nurse.”
CHAPTER IV
Object of Work—Districts—Hours on Duty—Number of Daily Visits—The Nurse’s Office—Lunch and the Noon Hour—Bags—Prophylactic Supplies—Cups, Fillers, and Napkins—Disinfectant—Waterproof Pockets—Books of Instruction—Stocking the Bag and Distributing Supplies—Nursing Supplies.