Read Ebook: Subsidiary Notes as to the Introduction of Female Nursing into Military Hospitals in Peace and War by Nightingale Florence

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Systems of Female Nursing in the War Hospitals of the different Nations engaged in the Crimean War 19-26

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 1-63

Addenda with regard to Female Nursing in a Military Hospital on the Pavilion or Lariboisi?re Plan 63-90

Addenda as to Mixed Nursing, by Nurses and Orderlies, in Military Hospitals, on the Double Pavilion or Vincennes Plan 91-117

Additional Hints as to Ventilation, Hospital Floors, and Cautions in Ward-building suggested by the Lariboisi?re Hospital 118-127

Note on Contagion and Infection 128-132

Note on Observations by the Principal Medical Officer of the Army in the East 132, 133

Thoughts submitted as to an Eventual Nurses' Provident Fund 1-19

Note as to the Number of Women employed as Nurses in Great Britain 20, 21

Note as to Teaching Nursing 22, 23

ILLUSTRATION.

Plan of the Lariboisi?re Hospital at Paris p. 63

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PAGES

THOUGHTS SUBMITTED BY ORDER 1-28

CONCERNING

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The Hospital Serjeant, or Ward Master will not be superseded--he will still have too much to do for any one man properly to perform, and part of his duties must be given to another officer 24-26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

ADDENDA, WITH REGARD TO FEMALE NURSING IN A MILITARY HOSPITAL ON THE PAVILION, OR LARIBOISI?RE PLAN 63-90

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

ADDITIONAL HINTS AS TO PAVILION HOSPITALS SUGGESTED BY THE CONSTRUCTION OF THE LARIBOISI?RE HOSPITAL AT PARIS 118-127

"CONTAGION" AND "INFECTION" DEFINED 128-132

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

THOUGHTS SUBMITTED BY ORDER CONCERNING

In England the channels of female labour are few, narrow, and over-crowded. In London and in all large towns, there are accordingly a large number of women who avowedly live by their shame; a larger number who occupy a hideous border-land, working by day and sinning by night; and a large number, whether larger or smaller than the latter class is a doubtful problem, who preserve their chastity, and struggle through their lives as they can, on precarious work and insufficient wages. Vicious propensities are in many cases the cause, remediless by the efforts of others, of the two first classes: want of work, insufficient wages, the absence of protection and restraint, are the cause in many more.

Perhaps the work most needed now is rather to aim at alleviating the misery, and lessening the opportunities and the temptations to gross sin, of the many; than at promoting the spiritual elevation of the few, always supposing that this latter object is best effected in an Order.

At any rate, to promote the honest employment, the decent maintenance and provision, to protect and to restrain, to elevate in purifying, so far as may be permitted, a number, more or less, of poor and virtuous women, is a definite and large object of useful aim, whether success be granted to it or not.

The Orders remain for the reception of those women who either are or believe themselves drawn to enter them, or who experience their need of them.

I confess that, subject to correction or modification from further experience or information, my belief, the result of much anxious thought and actual experience, is, that their introduction is certain to effect far more harm in some ways than it can effect good in others; that a great part of the advantages of the system of Orders is lost when their members are partially incorporated in a secular, and therefore, as they consider, an inferior system; and that their incorporation, especially as regards the Roman Catholic Sisters, will be a constant source of confusion, of weakness, of disunion, and of mischief.

It might be better not to invite this element; to let it come if it will learn, understand, and do what has to be learnt, understood, and done: if not, it is better away.

It appears to me, but I may be quite mistaken, that, in the beginning, many such persons will offer themselves, but few persevere; that in time a sufficient number will form an important element of the work; more is not desirable.

It seems to me important that ladies, as such, should have no separate status; but should be merged among the head-nurses, by whatever name these are called. Thus efficiency would be promoted, sundry things would be checked, and the leaven would circulate.

There are many women, daughters and widows of the middle classes, who would become valuable acquisitions to the work, but whose circumstances would compel them to find their maintenance in it. These persons would be far more useful, less troublesome, would blend better and more truly with women of the higher orders, who were in the work, and would influence better and more easily the other nurses, as head-nurses, than as ladies. Whether or not the better judgment of others agrees with mine, my meaning will be understood.

In truth the only lady in a hospital should be the chief of the women, whether called Matron or Superintendent. The efficiency of her office requires that she should rank as a lady and an officer of the hospital. At the same time, I think it important that every Matron and Superintendent, should be a person of the middle classes, and if she requires and receives a salary, so much the better. She will thus disarm one source of opposition and jealousy, and enough will remain, inseparable from her office.

St. John's House, if it steers clear of the rock of prudery, undoubtedly possesses great advantages over a system of hospital nursing by promiscuous instruments. Not because it includes a Sisterhood, a system, in which I, for one, humbly but entirely disbelieve; but because the laborious, servile, anxious, trying drudgery of real hospital work , requires, like every duty, if it is to be done aright, the fear and love of God. And in practice, apart from theory, no real union can ever be formed between sects. The work now proposed, however, must essentially forbear to avail itself of the bond of union of the National Church.

They will thus contribute materially to the comfort and well-being of the sick; the real difficulties which undoubtedly beset the introduction of women into ward service will be avoided; and, an important consideration, not lightly to be discarded, their exclusion from the ward service will materially diminish the opposition of adverse masters, some of whom are also unscrupulous masters.

That the experience of many surgeons is identical, their conduct has proved; no other testimony, under present circumstances, can rationally be expected from them.

Sisters of Mercy, as regards the ward service, are decorous and kind, and sometimes inefficient and prudish. Nurses are careful, efficient, often decorous, and always kind, sometimes drunken, sometimes unchaste.

Misconduct of women is far more pernicious in a Military or Naval Hospital than in any other, as regards the result of things--the crime is, of course, equally crime everywhere.

There are many pros and cons to the formation of convalescent wards.

It is a question whether convalescent or chronic patients require female nurses at all.

Of such chronic cases, probably 100 would be efficiently served by one nurse, having orderlies under her. Of acute cases, probably, one nurse should take charge of not more than fifty, possibly not more than forty.

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