The Tuberculosis Nurse: Her Function and Her Qualifications / A Handbook for Practical Workers in the Tuberculosis Campaign

by Ellen N. La Motte

Hours off Duty. At this point we should like to speak of the nurse’s hours off duty, though strictly speaking they are not within our scope. As a rule, the hours on duty are eight—from 9 a.m. till 5 p.m., with an hour in the middle of the day for lunch. This is a long day, and at the end of it, any woman is in a condition of mental and physical fatigue. The constant nervous strain occasioned by contending with the ignorance and stubbornness which a nurse must encounter, is particularly wearing.

The hours off duty are for recuperation from the day’s toil, and if this recuperation is insufficient, it will manifest itself in various ways. A tired nurse is of no use as a teacher—she cannot cope successfully with the obstinate wills of her patients, nor with the trying demands of the daily routine. Moreover, a physically tired person is one who offers ready soil for the development of tuberculosis. These two facts must be constantly borne in mind. Therefore we should like to impress upon all nurses who undertake this work that they must take excellent care of themselves. Rest, sleep, and food are the three essentials to good health, and any scheme of life which reduces these below a certain level is bound to lead to disaster.

No one condemns reasonable pleasures, and in no other work is relaxation and recreation so much required, but one must be careful not to burn the candle at both ends. It is no part of the superintendent’s duties to regulate the life of her nurses outside of working hours, but when their life off duty diminishes their working ability, she is then called upon to interfere. Tuberculosis work is trying, serious, and difficult, and demands a high degree of mental and physical strength and freshness. If a nurse is not willing to give this, she should not undertake public health work.

Afternoons Off. Each nurse should be given one afternoon a week off duty. It is more satisfactory to give this half-day in the middle of the week, on Wednesday or Thursday, rather than on Saturday, at the week’s end. In this way, the rest period breaks the long stretch of days, and the nurse is enabled to rest before she becomes too tired. Sundays, of course, should always be free. Under no consideration should the nurse be subject to night calls and it is well to have this fact understood at the outset of the work. A nurse cannot be on duty night and day both, and certain rules should be established, regarding her hours on duty, and be rigidly adhered to.

Character. The questions of training and of health having been satisfactorily answered, there remains a third great essential to be considered—the question of personality. Social nursing differs from all other branches of nursing, since in this specialty there is a wider departure from the routine and mechanical duties which form so large a part of nursing work. Those qualities which make a good institutional, or a good private nurse, do not necessarily make a good social or public health nurse. Something more is demanded.

Broadly speaking, apart from professional training, the more highly educated and cultivated the woman, the better will she be qualified. This, one may say, would apply to all branches of the profession, but we believe these qualities are more necessary in the tuberculosis nurse than in the operating-room nurse, for example. The latter does work which demands mechanical quickness and coolness; the former requires a personality capable of dealing with human beings in all stages of refractoriness, over whom she has no authority, but from whom she is expected to obtain results. As every one knows, it is far easier to deal with things than with people.

The qualities of a teacher are requisite. No matter how well one may know a subject, if one cannot present it clearly and impressively, small progress will be made. Nor is it the patient alone that the nurse is called upon to deal with. Her activities bring her into close relations with physicians, social workers, politicians, boards of directors, and “benevolent individuals” of all classes, whose interest and good-will it is necessary to secure. She must be as well able to meet people of this sort, as to teach the humblest patient in her district.

Since this is social work, the so-called social virtues are a necessity—and these exclude a bad temper or a quarrelsome disposition. It is as essential to work in harmony with other social workers as with the patients themselves—the two relationships are interdependent.

Needless to say, a nurse who cannot get on with her patients is a failure. No matter how experienced she may be, or how well trained, if she cannot gain the confidence and friendship of her families she is unfitted to deal with them. It frequently happens that for the first few visits a family may be uncordial and suspicious, but within a short time a well trained, sympathetic nurse should be able to change this attitude into one of confidence and appreciation. A few, a very few families remain unchangeable of course, but their number is so small that they form a negligible quantity.

Neither should a nurse fraternize with her patients. Through familiarity she loses the personal dignity which means so much to her authority. Authority is a term somewhat subtle in its definition—it means that hint of power, of sureness, of knowledge, which enables one to speak with a confidence which transmits itself to others, and compels them to accept one’s point of view. A strong personality easily conveys this sense of authority, but it may also be conveyed by a personality less strong, when the nurse is well assured of her facts and cannot be caught tripping. It is the hall-mark of the successful teacher—this ability to impress her points upon others, and to make them see that what she proposes is right, reasonable, and advantageous.