Defect in some Systems of Nursing.
10. In admiring much, very much about the German Hospitals, it becomes necessary not to omit a warning. A number of women, all equal among themselves, with no female Superior or Superiors whatever, under the sole control of men, in an ascending scale from the Abtheilungs-Inspectoren or Oberkrankenpfleger, through Doctors of sundry ranks, to the Director himself, such is the system followed, as in the great Charité Hospital at Berlin, so in the great General Hospital at Vienna; and this cardinal mistake leads to many others.
Nurses’ Exercise.
11. It is desirable that the Rules should give daily exercise to the Nurses, or rather that the Rules should give them the right of daily exercise; that the Superintendent should encourage and exhort them to take fresh air daily when feasible, leaving them sometimes to take a little quiet in their rooms. But in war service, and sundry foreign stations in time of peace, not merely exigencies of service (which at home will and ought often enough to curtail or abrogate exercise time), but various other reasons might render it very undesirable to give the Nurses right to two hours’ daily exercise. It must be impressed upon all Superintendents, that it is essential in the long run to the health of Nurses to have fresh air; but in many foreign stations it might be far better for the Superintendent to take, or rather send, them out for one vice two hours, &c.
In war and foreign service, the exercise time must be at the discretion of the Superintendent.
There may be awkwardness enough on sundry home stations in allowing each Nurse two hours at her own discretion outside of the Hospital every day. Still it is right to look things in the face. The Rules do not contemplate a Sisterhood, but a staff of secular women, bound by strict rules in all that concerns the duty they undertake, left to themselves as to sundry things which in Sisterhoods are ruled. (How and by what measures in process of time strong and quiet religious influence may be brought to bear upon this staff, is the question of vital importance as to the whole; without it, I doubt whether the service of women would, in the long run, answer in Military Hospitals, which are and must remain very peculiar places; with it, it might please God to suffer good service to be done Him). Nurses trusted to do their duty in wards must be trusted to walk out alone if they choose, and I would not attempt to restrict it, though the Superintendent must see to this, so far as she can without doing or encouraging spy-work, a thing which has many advantages, and is often done in various, very various ways, but which in the long run brings no blessing, and pro tanto, degrades all who are concerned with it.
Number of Ward-Masters.
12. In Vienna Military Hospital each set of five or six wards, with 30 or 40 patients, sometimes 20, in each, had a Sergeant and a Corporal over the Orderlies. (Berlin Military Hospital is served by Civil male Nurses).
I think a Ward-Master would be enough for each Pavilion of six wards of 30 patients each, in three stories, each couple of wards being in charge of a Nurse, and each ward served by three Orderlies.