The nurse should not do anything of her own in the ward, or the ward or orderlies’ scullery, if there is such a place. This is a matter requiring some decision.
7. In each Ward to be Closet, with Shelves, Table with Drawers, Nurse with Keys. Nothing to be kept in Nurse’s Room. Linen, Dressings, Stimulants to be kept in Ward Closets.
7. Let there be in each ward a closet, or, better still, a dresser,[8] with broad shelves, and a large table with large drawers, of which closet or dresser, and drawers, the nurse has the sole keys. Let the articles of linen which are kept in the ward be there; also the bandages, lint, old linen, oilsilk, ointments, &c., &c., which should always be, some at hand, some in reserve; also the wine and brandy ordered for the men. Let the nurse never be allowed to deposit Hospital property in her room, which, if there is no place for it, she must do, and it is much better she should not.
8. Matrons 200l. per annum, Quarters, and a Maid. A woman for the Linen, ranking and paid as a Nurse, but never entering the wards.
8. With regard to the Matrons, though as Locke says of tutors, there are all kinds of persons to be found, it is certain the right persons are not always found; and these officers will take time to find, at the outset especially. Let them be (if it be possible) of the middle class; if it be possible, middle aged, active women, widows of officers or army surgeons. A vast deal of struggle is ever going on in professional life; a vast deal of silent, decorous misery ever follows on the premature deaths, the compelled early retirements, the sundry chances and changes which ever abound in the army of England. So far as it goes, and cæteris paribus, it would be right, just, and expedient to give a preference for these matronships to widows of officers and army surgeons. Try to secure thorough principle, sense, activity, and steady discreet ways; never mind a little vulgarity of manner; that the different orders should have their indefinable perpetual distinctions of manner as of other things, is perhaps for a long time to come in the essence of things. Two or three women of the stamp of the Matrons of a few of our Civil Hospitals would be very valuable. If the Matron do not get tired of what, unless one keeps one’s secret thoughts fixed on the meaning and the end of all things, is coarse, thankless, up-hill work enough—she will in the course of years accomplish great good. But she must have principle, sense, heart, and a firm cheerful mind. She must be not under thirty and, if possible, not over forty, on appointment. Should her being without children be made a sine quâ non? Children—poor little things—are wanted nowhere in the way of business, but do not be too strict about this: they are sometimes pledges to other things than fortune—thoughts, anxieties, and labours for them, concentrate and steady a mother’s heart—there will be fewer adventurers. Maternal nurses must upon the whole be discouraged, because upon the whole the disadvantages seem to overweigh the advantages.[9] But the Matron’s office and duties are different; she is not fixed to a great ward of patients; and her having children should not be a bar, especially if they did not live with her. Young and grown-up daughters are much in a Matron’s way; sons matter much less.
The greatest Civil Hospital gives its Matron 200l. and a house, the other great Hospitals, 150l., and a house. The London Hospital gives 150l., and a couple of good well-furnished rooms, and a servant. A house is an impediment to a Matron’s duty. She is seen arriving in the wards, and she is more or less hindered in entering them. From her rooms she issues and re-issues, unexpectedly, and much more efficiently. 200l. and quarters is not at all too much.
The Matron must be responsible for the storing, mending, and distribution of the linen, and for returning to the laundry any linen not properly washed or dried. Linen ought never to be dried in the wards, a process both inconvenient and unwholesome. The Matron ought to have a steady, respectable woman, certainly not below the rank and pay of a nurse, to be responsible to, and under her, for the linen, otherwise the proper care of the linen will take up far too much of her time. This is important. If, however, a Nurse should be thus set aside for the Laundry, she must not be allowed to enter the wards; otherwise she will unconsciously become a gossip and mischief-maker. I would term her “Linen Nurse,” not Assistant. The Matron should also have a steady, properly paid servant. A Matron of the proper sort has quite other things to do at a leisure moment, than to keep her wardrobe in order. She must have a servant; but it seems to be advisable to simplify things, and condense payments as much as possible; and I would rather consider this in the salary, and let the Matron find and pay her own servant. Try to have the servant’s room near the Matron’s. These minutiæ, once provided for, enter much into the daily working and comfort of things.
The dress of the Matrons is a difficult thing to settle. Sometimes a Matron is afflicted with a taste for either gorgeous or elegant apparel, which the Nurses are invariably proud of, admire and humbly emulate. This sort of thing would be really out of place in a Military Hospital, and would moreover sadly discompose the Nurses with their plain caps and gowns. How would it be to allow the Matrons the choice between a Regulation dress and a plain black or brown silk gown?
It will take much thought to decide whether the Matrons should all be paid alike, or whether climate and size of Hospital enter into this. On the one hand they undertake a service, of which almost the first regulation very properly is, that they undertake to go to all parts of the world as soon as sent; on the other hand, certainly some climates wear health and life much quicker than at home.