Scheme of Night-Service for Three Orderlies watching by turns.
24. Supposing regular night duty required, in a ward of 30 men, supplied as above, and served by half a Nurse and three Orderlies, it might be worked thus: the Principal Medical Officer would decide whether the same Orderly should do the night duty for a week, or the three on successive nights: probably the latter. The Orderly might come on night duty at 9 P.M., and remain on duty until 9 A.M., thus taking his share in the heavy morning work of cleaning the ward, &c. In all well-ordered Hospitals it is required that this should be done by 10 A.M., in some by 9 A.M. Earlier is undesirable in the English latitude (in other climates it is different), unless either the patients are to be disturbed earlier than English Surgeons consider right; or the ward, &c. cleaning is hurried through. A large ward, got into thorough order by 9 A.M., is in very good time. Of course it may happen occasionally to be got ready somewhat earlier, but this refers to the average.
Scheme for Three Orderlies A. B. C. Serving Ward X.
Monday, 3 P.M. A goes to bed, after taking his share of the morning work, eating his dinner, and helping to clear away ward dinner, &c. 9 P.M. A comes on night duty, after 5 hours’ sleep, and allowing 1 hour for undressing, dressing, and eating his supper.
Tuesday, 9 A.M. A goes off duty, having watched until 6 A.M., having breakfasted, having taken his share of the morning work, and leaving the ward clean. Let him have the option of one or two hours’ fresh air, either now, or before 3 P.M.; let him sleep full three hours; let him have his hot portion of dinner taken to him at the usual hour, unless all the Orderlies on night duty are served together at a different hour; and let him, 3 P.M., return on duty, washed and shaved. B goes to bed, &c.; 9 P.M. B comes on night duty.
Wednesday, 9 A.M. B goes off duty; 3 P.M., C goes to bed, &c.; 9 P.M., C comes on night duty, &c.
I have reckoned 12 hours for the Orderly to be off duty. It is better for him to have eight than seven hours’ sleep, and one or two hours’ fresh air are more healthy, and make a man last longer than going to and from his bed and his ward. An English soldier comes on duty clean, washed, and shaved, a once national peculiarity it is highly desirable he at all events should retain—at any rate that of thorough cleanliness—the shaving is unfortunately now not certain; for this and for his meals, some little time must be given. I think you will get more, and get it longer, out of the man by giving him 12 hours on night duty and 12 hours off. Still it will not do to interfere too much with analogies, and the proper authorities must decide whether this is too much.
Exercise for Orderlies.
25. Again, leaving the question for decision to the proper authorities, I had rather each Orderly had one hour or two hours for exercise each afternoon or each alternate afternoon, care of course being taken that he did not exercise himself in some tap. He should report himself to the Nurse, or to the Ward-Master, or Assistant Ward-Master on going and on his return. So should the Night-Orderly when coming on and going off duty. Also in many emergencies of no very unfrequent occurrence at home, and constantly abroad, the Orderly must dispense with recreation time. But as a rule, it is certain that fresh air is necessary to preserve health in Hospital duty. Doctors of all kinds know and act on this as regards themselves.