10. The Colney-Hatch Lunatic Asylum has a diet system worth inquiring into; nothing is fetched by the Nurse, the Medical Officer writes the diets on a large slate which is ready for him outside the ward.
The great advantage of this seems to be, that the Nurse’s time is set free from a good deal of arithmetic and some writing; also that each man’s portion is served him hot from the kitchen, not cut up laboriously by the Nurse. In most Hospitals the Nurse cuts and divides the diets; in the London Hospital she moreover weighs them. All this takes a great deal of time. If the patients can get the divided portions hot from the kitchen, it is far preferable.
At St. George’s Hospital the portions are sent hot and divided from the kitchen.
11. The less any Patient is made into an Orderly by the Surgeon the better. The Nurse should have Regulations to invoke to allow her to do her duty.
11. It should be distinctly settled by whom poulticing, fomenting, and all minor dressings, applying leeches and blisters, and giving enemas,[13] are to be done.
It would be advisable to consider whether the Nurse ought not to instruct the Orderlies in some things. This, if it did not clash with Orderlies’ Rules, would make these men, especially those ordered for foreign service, much more useful than they are now, without such teaching.
It will, however, be essential that there should be no clashing between the Nurses’ Regulations and those already or to be issued to the Orderlies. And for this, among other reasons, it is essential to establish a direct channel of communication between the Director-General and Superintendent-General of Nurses.
Ward Medical Officer to give Directions to Nurse.
I think, upon the whole and with reference to preventing, as far as rules can do it, the obstruction of the Nurse’s duty, by adverse or inexperienced Medical Officers giving orders to Ward or Assistant Ward-Master, Orderlies, or patients, instead of to her, that it is better to charge him to give the Nurse his orders as to the sick.