Florence Nightingale

Subsidiary Notes as to the Introduction of Female Nursing into Military Hospitals in Peace and War

Published by Good Press, 2019
goodpress@okpublishing.info
EAN 4064066152611

Table of Contents


ILLUSTRATION.
DIGEST.
Thoughts submitted by order concerning
I. Hospital-Nurses.
II. Nurses in Civil Hospitals.
III. Nurses in Her Majesty’s Hospitals.
Note in Regard to the Russian Nurses Employed in the War-Hospitals of the Crimea.
Subsidiary Notes as to the Introduction of Female Nursing into Military Hospitals in Peace and in War.
I.
II. Nurses.
III.
IV.
Addenda with regard to Female Nursing in a Military Hospital on the Pavilion or Lariboisière Plan.
Addenda as to Mixed Nursing by Nurses and Orderlies in Military Hospitals on the Double Pavilion Plan.
Orderlies’ Duties
II. Nurse’s Room , &c.
III. Regulations.
Additional Hints as to Pavilion Hospitals suggested by the construction of the Lariboisière Hospital at Paris.
I.— Ventilation.
II.— Oiled Boards versus Parquets .
III.— Cautions in Hospital-Building.—Often repeated, but oftener neglected.
Note on Contagion and Infection.
Note.
THOUGHTS SUBMITTED AS TO AN EVENTUAL NURSES’ PROVIDENT FUND.
I. Wages and Prospects of Nurses.
II. Desirability of some further Provision.
III. Of what Nature?
IV. Rules to be followed in giving Assistance.
V. Prospects of eventual Support.
Note as to the Number of Women employed as Nurses in Great Britain.
TABLES OF AGE AND DISTRIBUTION.
Note as to teaching Nursing.
Course of Instruction for the Class of Sick Nurses, at the Military Female Orphan Asylum.

ILLUSTRATION.

Table of Contents
Plan of the Lariboisière Hospital at Paris p. 63

DIGEST.

Table of Contents
PAGES
THOUGHTS SUBMITTED BY ORDER 1–28
CONCERNING
I. Hospital Nurses.  
II. Nurses in Civil Hospitals.  
III. Nurses in Her Majesty’s Hospitals.
I. Hospital Nurses 1–9
  Twenty Observations on how to improve Hospital Nursing.  
II. Nurses in Civil Hospitals 9–14
  Twenty-three Heads for Regulations as to Nursing in Civil Hospitals.  
III. Nurses in Her Majesty’s Hospitals 15–19
  Twenty-two suggestions in the event of the introduction of Female Nursing into Military Hospitals.  
Various systems of Female Nursing during the Crimean War in the Military Hospitals 19–28
Of the French and Sardinians 19–22
Russians 22, 23, 26–28
English 23
Proposed Duties of Female Nurses in Military General Hospitals 23, 24
The Hospital Serjeant, or Ward Master will not be superseded—he will still have too much to do for any one man properly to perform, and part of his duties must be given to another officer 24–26
Note in regard to the Russian Nurses employed in the War-Hospitals of the Crimea 26–28

SUBSIDIARY NOTES AS TO THE INTRODUCTION OF FEMALE NURSING INTO MILITARY HOSPITALS IN PEACE AND IN WAR 1–133
I. Five Conditions essential to this service 1–3
II. Our Nurses were of four kinds 3
  Absolute subordination to the Medical Officer as to Medical Orders essential and practised by us 4
III. 1. Qualified subordination essential of Superintendent-General to Director-General and Principal Medical Officer 4–6
  2. Also of Matron and Nurses to Principal Medical Officer and Staff-Surgeons 6, 7
  3. Female service can only be introduced gradually, and introduction regulated by Director-General 7–9
IV. 1. Shall Roman Catholic Sisters be introduced? 9, 10
  2. Or Anglican Sisters? 10
  3. Power of Police in Civil Hospitals 11
  Power of Police in Military Hospitals 12–15
  4. Pay and Rations of Nurses 15–20
  On the whole it would seem best, where practicable, to board the Nurses, not to “ration” them, nor to let them “find themselves.” Community of cooking implies economy of nourishment 17–20
  5. Washing to be “put out” 20, 21
  6. Cleaning their own Rooms 21–23
  7. Nurses to keep keys of closet in Wards 23
  8. Pay, dress, and duties of Matrons 24–28
  More properly named Superintendents 27
  Lady Volunteers had better begin by being Nurses, not Superintendents ex-officio 28
  9. Sundry Regulations as to Nurses 29–31
  10. Have the Patients’ Diets sent hot, and ready divided, from kitchen 31
  11. What Ward duties the Nurses should do themselves 31
  And why 32, 33
  Patients should not be made quasi Orderlies 34
  Visitors in Military Hospitals 35
  12. Regulation-Number of Orderlies—depends on the size of wards whether sufficient 35–41
  What is the regulation-attendance in Naval Hospitals 37
  What in Civil Hospitals 38
  Comparative Cost of Nursing in larger and smaller wards 39–41
  13. Hospital floors 42–51
  Sanitary necessities 42
  Trial of Hospital floors, oiled and polished with “laque” as in Berlin Hospitals, recommended on sanitary grounds and for ease of cleaning 43–51
  14. Ventilation of Wards 51–52
  15. Special Wards, whether desirable or not 53–54
  16. Opinion as to Superintendent-General paying Nurses’ wages, and as to Governor’s jurisdiction over Nurses 54–56
  17. Wages and Pensions of Nurses 56–60
  Three rules in raising Wages 56
  Five general principles as to Wages and Pensions 58
  Six applications of the foregoing principles 58, 59
  Seven heads for Regulations as to Nurses’ Wages and Pensions 59, 60
  18. Proportion of Nurses to Patients 61, 62
  19. Precautions in sending Nurses on Foreign Service 62
  Hospital Laundries 63
Addenda, with regard to Female Nursing in a Military Hospital on the Pavilion, or Lariboisière Plan 63–90
I. Four conditions to be considered in adopting the Pavilion Plan 63
  1. Economy of attendance 64
  2. Facility of supervision 65
  3. Desirableness of doubling the Pavilion, in a Military Hospital, in order to give to each Nurse but one floor to serve 65
  4. Nurse to sleep near her Ward 66
  Importance of lighting by gas 67
II. 1. One Nurse must serve the whole Pavilion, in a Military Hospital, if single Pavilions be adopted 68
  2. Nurses’ day in such a Pavilion 68, 69
  3. What the responsibility of Nurses is for
  discipline of Ward or Pavilion 70, 71
  4. Importance of Lifts 71
III. 1. “Casualty” Cases should be in a completely appointed set of Wards, apart 72
  And why 73
  2. Restraint or non-restraint in Violent Cases 74
IV. Simplicity of Construction essential to Discipline 75
  Polished impervious Walls.
  Covered Exercising Place.
  Reserve Wards 76
V. Nurses’ Meals to be sent them Cooked 76
VI. Arrangements for a Pavilion and its Wards 77–90
  2. Where should Wardmaster sleep? 77
  3. And Orderlies sleep? 77
  4. And dine? 78
  7, 8, Scullery to each Ward, and what to be done in it 79
  Poultice-making 79
  9. Presses in Ward 80, 81
  10. Nurses’ Room 82
  Lavatory, Water-Closet, Sink 83
  Baths 84
  11. Summary of arrangements 85
  Scullery Appurtenances 86
  12. Nurses’ Sleeping Quarters 86
  Ward for Sick Nurses 87
  13. Classification of Patients 88
  14. Nurses to be called by their Wards 88
  15. Foul Linen 88
  16. Washing Bandages 89
  17. Splints, &c., where to be kept 89
  Cotton Lint never to be used 89
  18. Classification of Nurses 90
  Superintendent’s Store Room 90
Addenda as to Mixed Nursing by Nurses and Orderlies in Military Hospitals on the Double Pavilion Plan 91–117
I. Orderlies’ Duties 91–108
  Proportion of Nurses, Ward Masters, and Orderlies to Sick 91–93
  Wine to be always administered by Nurse 93
  Orderlies—their Duties vary according to appurtenances of Ward 94
  If Hot and Cold Water are laid on, and there are Lifts, one Orderly’s Service saved to each 30 Sick 94, 95
  Night-Duty of Orderlies 95–108
  Scheme of Night-Service for three Orderlies watching by turns 96, 97
  Exercise for Orderlies 97
  Night Refreshment for Orderlies 98, 99
  Where are the Night Orderlies to sleep? 100
  Comparative Merits of different Systems of Night Nursing in Home and in Foreign Hospitals 101–3
  An Assistant Ward Master should go round the Wards at Night 104
  Extraordinary System of Night-Nursing in the Army at present 105–8
II. Twelve Sundries in organizing a Military Hospital 108–114
  1. Nurses’ Room 108
  2. Medical Officer’s Room 108
  3. Water-Closets 109
  4. Warm and Cold Water Supply 109
  5. Corridors 109
  6. Lobby 110
  7. Material of Ward Utensils 110
  8. Reserve Wards 111–112
  Necessity of Annual Cleansing of the whole of a Hospital
  9. Occasional Revision of Rules 113
  10. Defect in German Organization of Nursing 113
  11. Nurses’ Exercise 113
  12. Number of Ward Masters 114
III. Regulations 114–117
  1. Deprivation of Visitors salutary in certain Wards 114–16
  2. Numbering Patients saves time 117
  3. Prohibition of Swearing 117
  Conclusion 117
Additional Hints as to Pavilion Hospitals suggested by the Construction of the Lariboisière Hospital at Paris 118–127
I. Ventilation 118–120
  Artificial Ventilation never freshens a Ward  
II. Oiled Boards versus Parquets 120–124
  Cleaning polished and oiled Boards much less laborious, and freshens the Ward much more than the frottage of Parquets.  
  Mode of Cleaning them at Berlin 122–124
III. Ten Cautions in Building Hospital Pavilions 124–127
  Size of Wards. Our own Regimental Hospitals extraordinary for their many holes and corners 125
Casualty Wards 126
“Contagion” and “Infection” Defined 128–132
  Idea of “Contagion” invented by Men to excuse themselves for the neglect of all Sanitary arrangements 128
  In the ordinary sense of the word, no such thing as “Contagion” 129
  Nor as inevitable “Infection” 130
  “Infection” and Incapable Management, or Bad Construction, convertible terms 131
  “Epidemics” do not spread—they develop themselves in Constitutions made ripe for them by Sanitary neglects 131
  Note on certain “Observations” by Sir John Hall  132, 133

Thoughts Submitted as to an Eventual Nurses’ Provident Fund 1–19
  Actual Wages and Prospects of Nurses 1–3
  Some further Provision desirable 4–6
  Of what Nature? 6–15
  With regard to Kind? 6–8
  With regard to Persons? 8
  With regard to Objects? 9–15
  Material Objects? 9–12
  Children, in the case of Nurses, a Temptation to Petty Dishonesty and taking Bribes 11, 12
  Sanitary Objects? 13
  Moral Objects? 13–15
  Hospitals not places for Penitents 14, 15
  Rules to be followed in giving Assistance 15–17
  Prospects of Eventual Support 18, 19
  Note as to the Number of Women employed as Nurses in Great Britain 20, 21
  Tables of Ages, &c. 21
  Note as to Teaching Nursing—Institution at Madras 22, 23