Upon each and all of these systems or no-systems it is hardly necessary to make any comment. It is difficult to tell which is the worst.
In the principal, indeed the only General Hospital in England, “Nursing is managed by comrade-patients told off in three watches of two hours each for the night.” [sic.]
“Orderlies are likewise warned and often sit up for the purpose.”
These passages are given verbatim et literatim, because they are so remarkable.
And it is necessary to add that these patients being the relapses among the “Invalids” are nearly the worst cases we have.
Were it the report of a Head-Nurse in a Civil Hospital to her Resident Medical Officer, it would undoubtedly cost her her place. One scarcely knows whether to pity more the sick patient or the orderly patient. One scarcely knows how to estimate the amount of medical comforts intended to be consumed by the sick patient which will actually be consumed by the sitting-up patient, and necessarily so. And the expedient which turns over the man who is too ill to be left at all to the care of men who ought to be recovering themselves, but who are pulled out of their beds for two hours to nurse (for the first time perhaps in their lives,) and a very “serious” case too, is to say the least of it a singular one.
At Woolwich Artillery Hospital the cases which require constant attention are about 2 per cent. There are now 545 patients in Hospital, and 11 cases consequently, each requiring one Orderly to itself. The Orderlies, according to Regulation, are 55, so that one-fifth part of the Orderly service is required for these cases. Yet there is no system or arrangement for such. The Orderlies arrange (or do not arrange) among themselves to do the reliefs day and night. Of the 11 cases at this time in Woolwich Hospital with 11 Orderlies sitting up with them, it so happens, as I am informed, that only one would require, if such were together in wards where regular night nursing was established, an attendant specially to itself.
It is needless to enlarge upon the cruelty of the above practice. The one serious case is disturbed in the day by the goings to and fro, the noise and bustle of the light cases—while these are disturbed at night by the sitting-up necessary for the one bad case, which may be besides, and too often is, a noisy or offensive one. The bad economy is as obvious. It often happens that 11 cases who might all, if in one ward, be attended and as efficiently attended, by one Night Orderly, require each an Orderly to itself in as many different wards.
In the “Garrison Hospital” at Chatham, “when any case assumes such a character as to require more than the usual care and watching, a Requisition is immediately sent to the Commanding Officer of the Corps to which the man belongs for a steady well-conducted soldier and who generally is the man’s own comrade” [so much the worse] “to nurse him, and to attend upon him throughout his illness, but who is relieved by another as often as the Medical Officer in charge of the case considers necessary.”
The following is the average number of sick in Army General Hospitals in time of peace at home, for whom night-nursing is considered necessary by the Medical Officers. But it is important to add that this number would be probably estimated as very much higher if proper means of night-nursing were at their disposal.