General Hospital, London,December 1894.
After my last letter to you I was bundled off for my holiday. I was glad enough to get it, but I missed the last two physiology lectures. This was rather a bore, as the exam. was the day after I got back; so I had no chance of borrowing any one's notes of those lectures, as I was supposed to do. However, I came out third, and my stable companion was first amongst the lady pupils—not so bad for two juniors; and we heard that four or five of the seniors had a little interview with the Matron in her office, and were advised to work rather harder before the next exam.
Now we are having lectures on dispensing, and they are the most interesting lectures I have struck yet. We go down to the dispensary, and the head-dispenser makes us mess about, and make up prescriptions, and make pills, powders, &c. We fire off questions at each other at odd moments, when we meet—and also in bed at night—as to the various doses of different drugs, and what they are prescribed for, and the antidotes for different poisons, &c.
I was sent to a very nice women's medical ward on my return from my holiday, and had some interesting work there. The Sister was very nice to me (she has been here for years, and many of the lady pupils don't like her, but she is a first-rate nurse), and she gave me very good cases. One of my first cases was alittle girl of ten with typhoid fever. She was very ill for some weeks, and then such a poor little wasted skeleton of a child! It was very nice feeding her up, when once it was safe to do so; and her great big eyes used to follow me about the ward, wondering what the next feed was going to be.
Sister said that I could hardly have had a more instructive case, as she had nearly all the bad symptoms a typhoid case can have, including a good deal of hæmorrhage.
I was horribly proud one day when the senior physician was going round and lecturing to the students and speaking to them of the necessity for good nursing in typhoid; and he made Sister show them the child's poor, bony little back and legs, with not a red mark on them; and he told them it had taken all her strength to battle with the fever, and if she had also had a bed-sore to sap her strength away, she could never have pulled through.
We had two diphtheria tracheotomies while I was in that ward; and though they were not my cases (as they both had special nurses), I was present at the operations, and I learnt a good deal about their treatment, as Sister used to let me relieve their nurses for meals, &c. And she taught me to change and clean their tubes, and so on; so that when I was put on as a special later on, I was not so much afraid of accidents as I should otherwise have been.
It must have been a very bad form of diphtheria, as one of the specials became infected, and had to go away to the Fever Hospital; and then Sister took it, but she was not very ill with it, and she was nursed in her own room. It has made them talk about the necessity for some isolation ward to put these cases in.Of course they are only taken in here if they are too ill for it to be safe to send them on to the Fever Hospitals.
We had a busy time when Sister was ill, but the staff nurse was very good and to be depended upon, and things went on all right.
I must tell you of a little joke we had one night in the Matron's house, where all the lady pupils live. Late one evening in September, when we were all undressed, one of them came to my room and said there was a wretched cat on some leads outside the bathroom window, and it was making such a row, as it could not escape. We went to inspect, and agreed that a rescue was necessary. By this time most of the lady pupils had assembled, and we fetched a ladder from the boxroom. It was too short; but we tied bath towels to it, and lowered it through the window to the leads. Then the stupid cat would not come up, and only cried the more; so I was shoved through the window in my dressing-gown, and they held on to me until I got my feet on the ladder, and could climb down to the cat. Just then Matron's door opened, and they all slipped away to their rooms. I heard something about "too much noise" and "lights out," and then she came into the bathroom and shut down the window. It was lucky the ladderwastoo short, or she must have seen it. It was pretty dark, and I was sitting down consoling the cat and waiting till the coast was clear, when I heard a smothered laugh, and then for the first time I remembered the gardens at the back, that belonged to some of our visiting doctors. I had looked at their houses and seen all the blinds down, and I had never thought they might be sitting under the trees at that time of night. After that, I very carefully kept my faceto the wall; and soon the window was cautiously opened, and with some difficulty the cat and I were hauled in, and very quietly we pulled up the ladder. Then I told them I was certain we had been watched, and we located the garden from which the laugh had come; and next morning, sure enough, there were two basket-chairs under the trees, so we knew which doctor it was. But he never gave us away, and I don't know to this day whether he recognised me; but I often fancied there was a twinkle in his eye when we met.
Then the question arose what to do with the cat, as it appeared to be hungry, and not inclined to be quiet; so eventually the most innocent-looking lady pupil was deputed to go to the home sister, and tell her she had caught this strange cat in the bathroom, and, as it seemed starving, might she go down and feed it, and then turn it out? The home sister was fond of cats, and her sympathies were aroused; so she assisted in providing it with supper and seeing it off the premises.
In November I was sent on night duty. The lady pupils are not obliged to do night duty, as they are only here for one year; but Matron was short of senior probationers, and asked me if I would like it, and I thought I would. Part of the time I have been an "extra," just helping wherever they were busy, and helping in the theatre for any night operations. Then I was put on as "special" with a tracheotomy (diphtheria) in a men's medical ward—such a nice boy, called Albert, aged eight. And, when he was getting better, another little chap of three came in, so desperately bad that they had to do tracheotomy in the receiving room; and then he was brought over and put in a cot by my boy's bed, and I looked after them both. Poor Albert was rather jealous at first, andwhenever I was attending to the small boy he began to "wheeze" too, thinking I should rush to his rescue; but he soon found that that did not pay.
After these boys had both recovered, I disinfected, and had a night off to air myself; and then Matron let me do the staff nurse's nights off—very interesting, but rather anxious, work.
You go to a ward which perhaps you have never been inside before, and you don't know where anything is kept. There are from twenty to forty patients; if the latter, there is a probationer to help you. Most of them are sleeping quietly; the few who are awake are probably wondering what sort of a rise they can take out of the strange nurse.
Some of the sisters are very good about giving one a full written report; but other sisters are rather casual, telling you much of what you may or may not do for number eight or number eleven, but seeming impatient if you try to jot down notes.
The first night off I took was in a men's surgical ward, where there was a nice lad of eighteen who had had his leg amputated that day (for a tubercular knee). He was so good and patient, but of course he needed a good deal of attention, and I wished I could stay with him all the time; but there was an old man at the other end of the ward rather delirious, and he would insist upon saying his prayers with a loud voice, and confessing his sins to me, calling me "Maria, dear." I was thankful when the house surgeon came round and ordered him a sleeping-draught; but it took me quite half an hour to persuade him to drink it, and then it was a long time before it had any effect.
In another ward the sister told me that the patients needed nothing to be done for them until I gave themtheir breakfast in the morning, but "wouldI take great care of her Persian and Manx cats, and not let them escape from the ward?"
It was also airing night, so I had plenty to do airing sheets, &c., and putting on clean sheets in the morning; but it was not exciting.
To-night I am staff nurse in the men's accident ward; but there is a bright little pro. on as well, and she seems to be accustomed to do most of the work. We have had one case in—a van-boy with slight concussion of the brain; but I have got him washed, and he is now asleep with an ice-bag on his head. There are several bad cases in the ward, but they all seem inclined to sleep; so I am actually sitting down to finish up this scribble to you.
I like night duty; you seem to have more time to fad over the patients who are really bad, and to do little things for their comfort; and the convalescent ones generally sleep and don't worry you; but it is hard work sometimes, especially between 5 and 8A.M., when every one wakes up, and every one wants something, and there are all the breakfasts to give round, and all the beds to make, and the temperatures to take, and the fomentations to change, and a hundred different things all needing to be done at once; and you rush around and expect every minute the day nurses will come in and say "What a muddle the ward is in!" and sometimes, when you are beautifully forward with your work and think Sister will be pleased, a house surgeon runs up in his pyjamas and dressing-gown to say he is sending in a bad case, and then you have to give all your attention to that case, and can't do the final clearing up for which you thought there would be heaps of time!
General Hospital, London,June 1895.
Many and various are the jobs I have done since my last letter, and now I must tell you that I am a full-blown Sister or, as they say here, I have got "my blue"; but I had better begin where I left off.
I was then bustling about on night duty, and I spent a very happy Christmas like that. Of course, we should all like to be at home for Christmas, but in hospital so much is done to make it bright and cheery for the patients, and so many of them have so little brightness in their lives, that it is nice to see how thoroughly they enjoy it.
They all have really nice presents; there is any amount of good food provided; plenty of entertainments (music, Christmas trees, &c.); and the men are allowed to smoke in the wards.
The doctors and students are really splendid in the way they work at decorating the wards, &c., and carrying the patients who are well enough about to other wards for entertainments.
The children of the slums around here will do anything to get into the hospital for Christmas, and the front surgery is full of little imps who have all got a "very bad pain!"
In January I had to retire to bed for a few days with a high temperature and a touch of influenza, and while I was in bed the day came for the dispensingexam., so I begged to be allowed to go, and vowed I was quite recovered, and they let me attend.
I made up my prescriptions (a bottle of medicine and some powders), and then I got under way with the paper, and thought it was rather a nice one, but before I reached the end my head began to swim, and I felt convinced I had mixed everything up and given all the wrong doses, and I thought what an ass I had been to try it, and I was certain I should come out at the bottom of the list!
One of my friends escorted me back to bed and took my temperature, and when she found it was 103 she went off and told the Matron; so next morning the doctor appeared, and I was kept in bed for a whole week, and then sent away for a few days' change, but before I went away Matron came to tell me that I was first in the dispensing exam., with 114 marks out of a possible 125. If I had any more exams. to go in for, I think I ought to arrange to have a little influenza beforehand, as it seems to stimulate my brain; but, thank goodness, that is my last.
You know I have always vowed that nothing would induce me to be a matron? Well, I have been rather near it; I have been acting as assistant matron for some time. First of all, the assistant matron was ill, and went away for a bit, and I did her work; then, when she came back, Matron went away for a fortnight, and I stayed on in the office helping the assistant.
It was rather interesting learning the ins and outs of the "Administrative Department," but I am still convinced that it is no catch to be a matron.
Sisters come to complain of a nurse, and you have to send for that nurse and scold her for her reported misdeeds, when, perhaps, all the time you have rathera feeling that Sister has been unreasonable in what she has expected of the girl.
Then nurses have a way of sometimes getting ill, and it always seems to be the nurse whose place it is most difficult to fill; then Matron goes out for the afternoon, saying to the assistant, "There are three extra nurses, and I have sent them to Wards A., B., and C., where they are busy, so no one is likely to ask you for another extra," and as soon as she has gone a house surgeon runs in to say he has sent in a very bad diphtheria case to Ward D. for immediate tracheotomy, and can I send specials over at once? I look on the list to see who the three extras are, and find not one of them is suitable to take on the case—one is going for her holiday in a few days and the other two are quite juniors—so I rack my brain to think which of the ward nurses is most suitable, and fix upon Pro. 1 in Ward A., as she has nursed one or two tracheotomies; so I have to interview Sister A., and she is most reluctant to give up her Pro. 1, and is quite certain Matron would not have taken her away, but I have to be firm and try to console her by sending her the best extra in place of Pro. 1 (thereby incurring black looks from Sister B., who is quite sure her ward is far heavier than Sister A.'s!); some one ought to be sent to bed to be ready to act as night special, but I conclude that can wait till Matron returns, as she may have some nurse she has promised to put on as special. That is the sort of work the assistant matron has to do—a good deal of fagging about and acting as a sort of buffer between the sisters and the Matron, much writing of letters and other work in the office, and a good deal of carving at meal times—one Sunday I carved roast beef forseventy nurses, some of them day nurses and some of them night.
I had just come to the end of my time in the office (I was still a lady pupil then), when an appeal came to the Matron to lend two staff nurses to one of the large London Infirmaries, where they had a great many nurses ill.
I volunteered to go (as I thought it would be a new experience), and then another lady pupil also volunteered.
It was a pouring wet evening in March when we set off in a hansom cab, the other lady pupils rather jeering at us, and saying that whentheywent to the workhouse they should do the thing correctly in an aged four-wheeler!
We had no idea where the Infirmary was, but trusted to the cabby, and after a long drive he turned into a stone-paved yard and drew up at a heavily-barred door; it looked more like a prison than an infirmary, but I got out in the rain to explore, and after a little while I managed to explain to the old man in charge that I did not wish to apply for admission to the Casual Ward, but to find the Infirmary. He told me that was more than a mile farther on; so the weary horse plodded on once more, and eventually brought us to an imposing building, where, in three weeks of hard work, we learnt many things.
They were very busy and very short-handed. I was sent to a women's medical ward of thirty-two beds, but the place was so full that I had thirty-six patients, the extra ones sleeping on mattresses on the floor. For the first week, whenever a patient came in, I had to consider which of those in beds was the most capable of turning out and descending to the floor, tomake room for the new-comer, but after that things quieted down, and before I left the patients were reduced to the correct number.
There was a sister in charge of my ward and of another one just opposite of the same size. For a few days I worked with the staff nurse, and then she had to leave, and I was left to do the work of the ward with the help of a probationer, who came in for an hour and a half every morning, and who relieved me when I went off duty every other day; and on the alternate days, when the staff nurse from the opposite ward was off duty, I had to patrol her ward at intervals, and give the probationer any help she needed.
At first I was appalled at the small number of the nursing staff for so many beds, but I soon found that everything was done in a way very different from our hospital methods, and that if we worked hard and fast it was possible to do all that was really necessary for the patients, but quite impossible to do the little faddy things that make so much difference to their comfort.
For one thing, the convalescent patients were expected to do a great deal of the routine ward work, and, as a rule, the convalescents stayed in much longer than they do in a hospital, so they were more fit to assist, but this hardly applied to my short time in the Infirmary, owing to the great pressure on the beds; also I found that there were only about six or eight out of the thirty-six patients really acutely ill, so I was able to give most of my attention to them—three of them were absolutely helpless, and needed much care and nursing.
The rest of them were chiefly old ladies who were just not strong enough for the workhouse life, and sowere drafted into the Infirmary; most of them were able to get out of bed and potter about the ward. This they loved to do with very scanty clothing on—rather to my horror—and I found that when a doctor was sighted on his way to the ward it was best to clap my hands vigorously, when all the old dames scuttled into bed like so many rabbits into their holes.
Poor old things, several of them had evidently seen better days, and there were many sad stories to be listened to, and they did so much appreciate the little I could do for their comfort.
It was very hard work, as one always seemed to be working against time, but I quite enjoyed my three weeks in the Infirmary. Matron had not told us we were to be paid for this work, so when we each received £6. 6s. for the three weeks, we felt very rich!
We were quite glad to return to our good old hospital, and since then I have been doing Sister's holiday work, and now I have just been appointed Sister in the front surgery (where all the new cases and accidents come in); it is utterly different from being in the wards, but I think I shall find it interesting—at any rate for a time. I shall wait to tell you about it until I have been here a little longer, and have taken my bearings more correctly.
General Hospital, London,January 1896.
I think I shall be rather glad when I get a ward of my own and settle down; but every one seems to think I am lucky in getting such varied experience, so I suppose I ought to be grateful, and it is not yet two years since I first entered here.
I spent six months as Sister in the front surgery, and it was very interesting.
There had never been a sister in charge there before, but just one old staff nurse, who had let the dressers do just what they liked, and there was a lot of waste and much disorder.
Matron gave me a very good probationer, and she was just as keen on getting the place nice and trim as I was. It took us a week or two to get all the drawers &c., scrubbed out and tidy, and a good many more weeks before we got all the splints sorted and padded.
The Medical Superintendent was pleased, because I managed to reduce the cost of dressings every week from £10 to £7 before I had been there a month, and it was still further reduced after a few more weeks.
Of course it is difficult for young dressers (who come on for only three months at a time) to understand how much difference a little extravagance in each dressing makes in the weekly bills; and they can't be expected to know the relative value of different kinds of wool, &c., unless it is pointed out to them,but as a rule, when they do understand, they are quite willing to use the cheaper dressings (for cases where they do just as well) provided that we keep a supply ready to their hands.
I often wonder whether, when people go round a hospital and see the rows of white beds and clean patients, and everything neat and tidy, they think the patients arrive here looking like that. Very often in the wards, when the porters have carried up an accident case on the stretcher, I have hardly known how to get the man's dirty clothes off, and it takes time before you can get them reasonably clean; but in the wards you always receive a note or a message by the porter from the house surgeon, with a rough diagnosis of what the case is, so that you know which limb to be especially careful in moving. But it is different when you receive a patient in the front surgery; the policemen tramp in and deposit the stretcher on the floor, and there is much mopping of their foreheads before they tell you roughly what they know of the accident, and then you have to proceed to find out for yourself what is the extent of the injury, and often the patient is quite unconscious, so he cannot help you at all.
I think at first I had a dim notion that every case that was carried in on a stretcher was sure to be admitted to the wards, but one soon learns that a good many of these cases are more frightened than hurt, and after a little rest and a thorough overhaul by the house surgeon they are able to go home again; on the other hand, every now and then a man who has had a very serious accident will manage to walk up to the hospital, and he may even sit down amongst the other waiting patients and quietly wait his turn tobe seen, unless you happen to be on the look-out, and note that he is looking ill, and get him on to a couch for immediate attention.
There is generally plenty doing in the front surgery, and whenever any of the men have nothing better to do they stroll in to see what is going on, so one hears all the gossip of the place; very quaint, too, are the tales the patients tell of their symptoms. I am not good at remembering these things, but there was one old lady who said the doctor told her that she had "the brownkitis, and that all her tubs (tubes) were full up."
Sometimes we had exciting times. I remember one morning when I came on duty the night nurse reported that a bad case of compound fracture of the jaw and other injuries had come in, and been taken straight up to the theatre, and that the house surgeon and all the available dressers were busy with it then. She had no sooner gone away than in tramped four big policemen with a stretcher, which they deposited on the floor; on uncovering the patient I found a poor man on whose head several heavy planks had fallen. Part of the scalp was torn up, and it was bleeding profusely. I sent my probationer flying to the theatre to ask for some one to come to help, and then I made one policeman put pressure with his finger on an artery on one side of the head and another policeman on the other, while I collected some dressings, forceps, &c. Much to my astonishment, first one policeman fainted and subsided on the floor, and then the other one did the same (the other two had gone outside); then the probationer returned to say the man in the theatre was bad, and they could not spare any one, but some one would come as soon aspossible. Just then the police inspector walked in, and his look of astonishment at his two prostrate men was very fine, but he called the other two men to move them, and then he gave me the help I needed, while the probationer and I did what we could to stop the hæmorrhage; it was pretty well subdued by the time the house surgeon got down, but he saw at once it was a bad case, and took the man straight up to the theatre. As soon as he had gone we dosed the two policemen with Mist. Ammonia, but it was a little while before they were fit to return to duty, and then we were just thinking we would begin our much delayed morning's work when, strangely enough, two men were carried in dead, the two stretchers arriving within a few minutes of each other; one was a suicide from the Thames, and the dressers tried artificial respiration for some time, but the poor chap was quite dead; the other was a poor old gentleman who had apparently died of heart failure when hurrying to catch a train.
We saw a great many infectious diseases in the front surgery, and had to keep them in an isolation room till the fever ambulance came to fetch them. I remember one day when we had samples of nearly all the infectious fevers to despatch—first came a case of smallpox, then one of scarlet fever, then one of diphtheria, and there were also cases of measles and chickenpox, but these had to be sent back to their homes. There was quite an outbreak of smallpox just then (I think we had twenty cases in the front surgery in one week), so everybody in the hospital who had not been recently vaccinated had to be done, and we were all very sorry for ourselves for a time.
Another little episode in the front surgery was whena baby took us all by surprise by being born there! We should have sent it on to the Infirmary, but the mother was rather bad, so we had to take them in.
One Sunday evening I was in chapel when I heard some one come to the door, and then the porter came to fetch me, and at the door I found one of the dressers who told me there was a bad compound fracture in the surgery, and the house surgeon would be glad if I would come, as he wanted to give an anæsthetic. When I got there I found a crowd of men all standing round a poor little dog with a badly crushed leg! so we got some suitable splints, and they gave it an anæsthetic and put up the fracture; then they sent word to the male accident ward to get a fracture bed ready for a patient, and the porters were secured to carry it along on a big stretcher. It was in the hospital for some weeks, and got quite well again.
Just before Christmas the Matron was obliged to go home for a time, so once more I was asked to go on duty as assistant matron. Christmas is always a busy time all over the hospital, and in the office (with the Matron away) we had more than enough to do—so many presents to receive and acknowledge and distribute, and many visitors to show round, &c. Then, after Christmas, a good many nurses got ill (some with influenza), and every one seemed to be wanting special nurses at the same time, and all were quite hurt that I could not make new nurses to order.
So I was not sorry when the sister of the nicest ward in the hospital told me that she had been appointed Matron of another hospital (she had been here for years), and as she knew nothing of office work she wanted to ask Matron if she would have her in the office for a few weeks' experience. I thought itwould mean that I should go back to the front surgery, and I was quite pleased, but instead of that, Matron wrote to ask me to take over that sister's ward for a couple of months, as she had not got a suitable sister ready to take it permanently (it is always given to one of the seniors here); so I was still more pleased, especially when I found that the pay was at the rate of £10 a year more than for the other wards.
This is an awfully nice ward of thirty-two beds, in two divisions—one for men, and one for women and children. It is chiefly for medical cases, but there is a small theatre attached, and a good many abdominal operations are done; there is also a private ward, to which the surgeons can send any operation cases that need especial attention; and they have special nurses.
In the wards I have a good staff, as it is always considered the most acute ward in the hospital, and I can generally get an extra nurse if I want, so I don't do much actual nursing myself, but there seem to be doctors constantly going round whom I have to attend, and somehow I always seem to be busy.
The longer I am in hospital the more I see how much harder it is to be responsible for other people's work than just for your own, and I can quite understand why so many of the staff nurses much prefer to do all the best part of the nursing themselves than to teach the probationers and let them do it; but it is a wrong principle, as the probationers must be taught, and we must learn to trust others (even when we know we could do things quicker and better ourselves), and to increase the trust just in proportion as we find them worthy of it; that is where the art of the teacher comes in!
General Hospital, London,December 1896.
I think I last wrote when I had just taken charge of C. Ward for two months.
I had a most interesting time there, and was quite sorry to give it up, but it was hard work. Unlike the other wards, that "take in" new cases for a week and then have a rest, C. is always "taking in," as the men in charge see every new case that comes up to the hospital (except accidents), and they can take them in if they like, as long as there are any beds empty in the ward; and if they don't think it is a particularly interesting case, it is passed on to the house surgeons or house physicians for the other wards; but, of course, they try their best to get all the most interesting cases for themselves; consequently the sister is never free to go out with any confidence that no new cases can be landed in while she is away; and when you do go out you generally find on your return that something has happened that makes you wish you had never gone!
Still I learnt a great deal in my time in that ward, and I enjoyed it. The physicians' talks with the students over these "selected cases" were most instructive.
Soon after I took charge we had a run of tracheotomies; the first was a dear, fat baby of thirteen months, but it had diphtheria very badly, and was nota hopeful case from the first; not many hours after it was operated upon another came in—a sweet little boy of three called "Alex." He was much relieved by the operation, and got on so well; but the poor baby ran a temperature of 106° all through the second day, and died late that evening with a temperature of 108°, in spite of all we could do for it. I believe we were much more cut up about losing it than the mother was; she did not seem to mind a bit, and apparently had made all her plans for the funeral beforehand—and it was such a pretty baby too!
The special nurses I had for these tracheotomies had never nursed one before, so you can imagine I could not leave them alone much, and was thankful I had had a good many to nurse when I was a lady pupil.
We had one very curious case. A young man was brought in unconscious one afternoon about 2P.M.; a little after five he got worse, and his respiration suddenly stopped, the pulse went on steadily, so they did artificial respiration; this went on till 9.30P.M., and then they decided to trephine, thinking it must be a cerebral tumour pressing on the brain; of course no anæsthetic was necessary, as the poor man showed no sign of life except that the pulse was beating; they could not find any tumour, so he was put back to bed, and the men went on doing artificial respiration all through the night in turns, until the pulse suddenly stopped at 9.15A.M., sixteen hours after the respiration had ceased—a very strange case.
We often had rushing days, when it seemed impossible to make time for meals, and scarcely time to breathe. I remember one day especially, when we took in seven new cases, two of them, curiously enough, men from quite different districts, who had both taken oxalicacid with a view to suicide; one was an old man who was very bad for a day or two, and then seemed to be getting better, but died suddenly one night from heart failure; and the other was a poor young fellow of thirty, who had been waiter in one shop for eight years, and was then turned off by a new manager and replaced by a German lad. He had a wretched wife who drank, and she took away his clothes and then disappeared; so we had to rig him up in a suit when he went off; one of the other patients gave me five shillings for him, and he asked me to keep it till he had been before the magistrates, as he thought he would be sent to prison, but he came back after his appearance in the police courts to tell me he had been let off with a caution, and he thought his old master would take him back; such a nice, quiet-mannered man, and most anxious to do anything to help the nurses in their work, or to wait on the other patients, and they all liked him.
The same day one of the house surgeons was admitted with a badly poisoned arm, and a friend of one of the students with typhoid fever; he had it very badly and caused us much anxiety, but pulled through all right in the end.
After this spell in C. Ward I expected to return to my front surgery, but instead I was offered in March (and gladly accepted) the post of Night Sister, and that is what I have been doing ever since, except for an interval for my summer holiday, and also for a few weeks when I took charge of a large male medical ward while the sister had her holiday.
Being Night Sister here means plenty of running about, and plenty of responsibility, but it also means better pay than Ward Sister, so that suited me all right.
They are talking of having two night sisters soon—one medical and one surgical—and there would be plenty of work for two, as we have a good deal of theatre work in the night, and sometimes I cannot help being worried when I am kept long in the theatre with urgent cases, and I know there are bad cases over in the medical buildings (sometimes with only rather junior nurses in charge of them), and I can't get round to visit them.
I have charge of about six hundred beds, and they are divided into twenty-one wards (of course nurses in each ward and two nurses in the large wards); I have to go all round three times every night, and run in much oftener to see any bad cases, and the nurses send for me in any difficulty; there is a slate in my office for messages, and when I return after my rounds I often find two or three messages, "Please come at once to P."; "Please come to N.—urgent," and so on, and I have to fly to whichever I think is likely to be the most urgent.
The morning round always takes the longest, as all the patients are then awake, and I have to say good morning to them all, and remember to ask after their particular aches and pains, and it is not very easy to remember what is the matter with them all, though I know very well all the details about those who are very ill and have much done for them in the night.
There is one place I don't enjoy visiting, and that is the strong room at the top of the surgical buildings. Lately we seem to have had so many men who go off their heads (generally from drink), and if they are left in the wards they disturb the other patients so much that it is better for them to be moved, and thenthey have male attendants up there; but these male attendants are not members of our regular staff (I wish they were), and I never feel that I quite know their capabilities, or how much I can trust them, and more than once I have found them asleep; so I have to go up very often when any patient is bad there.
I remember one night we had a very lively time of rushing about. We began with a man who had cut his throat—not very bad, but he had to go up to the theatre; then a lady who had taken three ounces of laudanum, and the doctors had to keep her walking up and down the corridor, with a weary porter on each side of her, for six hours before they thought it safe to let her turn into a bed; then I was called to a poor man in Ward P., who got worse, and died rather suddenly—a phthisis case; next a tracheotomy came in, and had to be done at once, and while we were all busy with it a baby was born in Ward D.; but the day sister had to be called to attend to that, as I was mixed up with the diphtheria case, and could not go near a confinement; then a fractured femur came in, and next an acute pneumonia—rather delirious. In the intervals of receiving these new cases and sorting them to the different wards we had to brew strong coffee and administer it to the lady who had taken poison, and provide refreshments for the porters who were minding her. In the early morning she was allowed to go to bed and to sleep; she recovered very soon, and I don't think she will do it again!
I joined the Royal National Pension Fund for Nurses a few months ago; it seems to be a good thing, and if I can only keep up the premiums I shall have the noble pension of about £20 or so when I am fifty; it will keep me in extras when I retire to the workhouse,as I am certain no one can go on nursing for a great many years at the pace we have to go in hospital.
Just now I am having a rest (and another sister is rushing about on night duty), as I have been warded for the past fortnight, and in a few days I hope to go home for a change.
I had a cold for many weeks, and did not pay much attention to it, as I thought it was only because I was about all night and did not get enough sunshine to help me to throw it off; but then I got very bad headaches, so I had to see a doctor, and he passed me on to our nose specialist, who has been most awfully kind, coming down every day, and sometimes twice a day, to see me. It was not really a cold, but some disease in the antrum, and he has done two small operations for me, and it has been horridly painful, but now it is getting well rapidly, and every one has been most awfully good to me, and I am beginning to feel less of a limp rag than I have done for some time past.
It was funny spending Christmas as a patient instead of running about looking after the patients; but it was nearly my first day up, so I was glad enough to be lazy, and I have had many visitors, so it has not been dull at all.
General Hospital, London,September 1897.
Just now I am feeling so sorrowful at the prospect of leaving this hospital (my home for the last three and a half years) that I hardly know how to give my attention to telling you how the last few months have been spent.
No, I have not been turned out, and they have given me a first-class certificate, and are good enough to say that they are very sorry I am going, and perhaps they will have me back again some day!
I think I was warded when I wrote to you last, and after that they sent me home for a little rest. Whenever I go home some one in the village gets ill, or some child gets scalded, or some accident happens; they seem to think it is necessary to keep my hand in; but during that visit home my only patient was poor Jessie, the family cat! It was Sunday evening, and we were all sitting in the dining-room just after prayers, when poor Jessie hobbled in, really screaming with pain. One leg had evidently been caught in a trap, and there was a bad compound fracture which she could not bear me to handle, so I said we must either have some chloroform or the poor dear must be shot. The nearest doctor (and chloroform) was three miles away, but C. volunteered to fetch some, and went off on his bicycle, while I prepared some splints and strapping, &c., and poor Jessie used bad language under the table.
I have sometimes had to hold an obstreperous child while it has been given chloroform, but that is nothing to holding a cat! However, at last we got her under, and then put the fracture in good position and stitched up the wound, securing the leg very firmly on splints; this operation was watched with much interest by all the family and most of the servants; at first the cat would not come to, but we put her in a hamper with plenty of fresh air, and when shedidcome to, the language she used was "something awful," but she soon settled down and made a good recovery. My people were very anxious for me to say I could not go back to the hospital at the end of my fortnight's sick leave as the cat was still in splints, but I had to leave her to my assistant.
Then I returned to duty as Night Sister again, and everything went on much as usual—generally rather more work than I could do well, and sometimes rushing nights of accidents and emergencies, when it seemed almost impossible to fit in all that had to be done.
It seems that every year more operations are done; the cases are sent out more quickly, and so make room for more acute cases, and so the work grows, but the number of nurses does not grow in the same proportion.
In February there was an urgent call for nurses to volunteer for plague duty in India, so I sent in my name—thought it would be a useful experience—and I wasted much time hanging about the India Office for interviews, &c., but eventually they were unkind enough to say I was not strong enough, and refused to send me.Whowould look very strong after acting for a year as single-handed Night Sister for a hospital of six hundred beds?
Then the authorities made a change, and they decided to increase the night staff by the addition of eight more nurses and one more sister. I was only on for a short time after this came into force, just to set things going, and then I was appointed day sister of M. Ward, the women's surgical ward, where I had worked as a lady pupil, and knew and liked the surgeons so much.
Since I was lady pupil there, and before I was appointed Sister of the ward, they had had several changes of sisters, and no one who had been there long enough to take much interest in it; so there was room for improvement, and the surgeons have been so awfully kind to me that I have had a very nice time.
In that ward my bedroom opened out of my sitting-room (attached to my ward), and we had one very exciting night there.
Since the night staff were increased the nurses have had one meal during the night down in the dining-hall, and there are some probationers who relieve our staff nurses while they go down to this meal. I was fast asleep one night when a probationer rushed into my room, "Oh, Sister, come quick, it's all blazing!" I seized my dressing-gown, and was in the ward in a few seconds thinking that she had set the place on fire with the airing sheets (of course my proper nurse was down at her meal); but it was a house just across a narrow road that was indeed all blazing, and my ward was brilliantly lit up by the flames, and the poor patients were all awake, and some of them quite terrified.
I turned on all the lights, so that they should not see the glare, and then we did our best to reassure them that there was no danger. Two poor womenwith fractured femurs and their legs slung up to Hodgin splints had already hopped out of their beds, and were literally tied by the leg, and they were all begging for their clothes; so I let two convalescents go to the clothes cupboard and put round the clothes to each bed, or dressing-gowns for the helpless ones, while we got our fire-hose out in case of need; but the firemen very soon got the fire under.
Two of our students, who lived in the house which was on fire, had to jump for their lives, and lost all their belongings, and one of them broke his leg.
It was really a bit alarming, as the ward got so hot and smoky, but the patients soon settled down again, and after we had readjusted splints, &c., no one was any the worse.
I had to take my month's holiday in June this year, rather earlier than I like (as it always seems more difficult to work when you come back to face all the hot weather), but we can't all have our holidays in the best months.
A young brother and a sister and I agreed to spend a fortnight about our old haunts in Switzerland, and we had such a jolly time together.
Of course we went first to Paris, and were fascinated with the shops, but tore ourselves away from them to visit the venerable Notre Dame, and then to spend a little time in the Louvre, but it was only time enough just to make us determined to stay longer in Paris on our way back. In the afternoon we took one of the boats up the Seine, and afterwards went for a walk in the Bois de Boulogne—a delightful breathing-place for the Parisiennes—good roads, lovely trees, and greenery, and yet quite near to all the bustle of the town.
The next day we had a hot and dusty journey on to Geneva, rather afflicted by the presence of some old ladies who wished to keep all the windows shut—it is strange how these petty discomforts fix themselves in one's mind!
At Geneva we had vast, big rooms just looking over the lake, in the Hotel des Bergues, and we took a Sabbath-day's rest there, finding a nice service in the English church, and for the rest of the day wandering about near the lake and up the river.
The next day we felt more energetic, and B. went off for a trip round the lake by steamer, while we went up Salève by steam and electric tram, a lazy way of proceeding, but it was rather an exciting journey crawling up the face of the mountain, and then such a view from the top; mountains, mountains everywhere, and grand old Mont Blanc poking his head over the top, and down below the lake so still and blue, with green trees down to its edge, and then the trees growing darker as they grow higher up, until they stop and the snow-line begins.
The next day we moved on to Chamonix; the train went only as far as Cluses, and from there we had a drive of twenty-five miles by diligence.
It was a delightful drive on a bright, sunny day; at every turn we seemed to get fresh views of Mont Blanc, and each view seemed more beautiful than the last.
We walked a good part of the way while the horses climbed the hills, and we found many varieties of wild flowers and plenty of wild strawberries.
Chamonix is a charming place, but one wanted more time just to loaf about and enjoy the views. The Mer de Glace is, perhaps, the most noted glacierin Switzerland; it is within easy distance of Chamonix (about two hours' walk), and it is a wonderful sight, but somehow I can't describe it, it is all too solemn and grand. I always feel the truth of what the Psalmist says about the men that go down to the sea in ships: "These men see the works of the Lord and His wonders in the deep," and I think the same applies to those who climb into the heights of the mountains, but I suppose he had not had that opportunity!
We left Chamonix with regret, and walked from there over the Col de Balme to Martigny; I think it was about twenty miles, but you can walk twice as far in Switzerland as you can in England without being tired, the air is so clear and bracing. It was a lovely tramp, beautiful flowers and ferns, and rushing streams and waterfalls; the last part of the way was trying, as it was very steep going down into Martigny, and the path was paved with little cobbles, so that we arrived rather footsore.
From there we trained to Glion, a very favourite place with us, just perched above Chillon, with lovely views of Lake Leman, of Chillon Castle, and the fine old Dent de Midi at the end of the lake, and it is within easy walking distance of Montreux. There are many nice walks and climbs about Glion, and the flowers—gentians, narcissi, &c.—were perfectly lovely.
Then we had to turn homewards, and found that we could spare only one night again in Paris (we had meant to stay longer): still it gave us a little more time to examine the treasures of the Louvre.
We had a small excitement in the afternoon. We had been walking through the flower market when a shower of rain came on. We sheltered under one of the stalls, and while we were there we heard whatwe thought was a sharp clap of thunder, but it proved to be a bomb exploding in the Place de la Concorde, but no one was seriously hurt.
When we got back to London it was very busy with preparations for the Queen's Diamond Jubilee, which was duly celebrated with much rejoicing all over the country before I returned to work in town.
Now, I had better explain why I am leaving here. I have promised to go as nurse to one of the hotels up the Nile (either to Luxor or Assouan, where they always have a doctor and one nurse through the winter season), with a patient who has spent the last eight winters in Egypt. He is now very ill, and still he wants to go, as he can live so much more comfortably in that climate. His mother can't go with him at present, and they can't bear to let him go alone, so I have promised to go to see him through the voyage (we are going by long sea) and to be at hand in case he should get worse before his mother can join him.
You know I love travelling, so in a way I am glad, but I don't think I am fitted for private nursing, and I am a bit nervous, and also it will be anxious work if my patient gets worse out there, but somehow I could not refuse. It is just horrid saying good-bye to every one and everything here.
I will write again soon from the sunny south.
Helouan, Egypt,November 1897.
Here we are in lovely sunshine (the thermometer at 80° in the shade), just on the edge of the desert, and quite contented to rest a while (after a very anxious voyage) before we move on up the Nile.
We sailed from London on October 1st, and had a smooth trip down the Channel, but I soon found my patient was much more of an invalid than I had expected, and was afraid he would get cold before we got into a warmer climate.
The first Sunday out we ran into a dense fog off Cape Finisterre, and our morning service was somewhat disturbed by the constant hooting of the foghorn; some of the passengers jumped up from their knees at each hoot, and the captain cut the service rather short and went up on the bridge. In a couple of hours we emerged into lovely sunshine, which soon dried the wet decks and awnings, but the next day, as we were putting on full steam to get into Gibraltar before sunset, we again ran into a thick bank of fog, and eventually had to change our course and put out to sea until the morning, as they are not allowed to run through the Straits after sunset.
The next morning I was up on deck before five, just as we were running into Gibraltar, and to watch the sun rise from behind the great rock was a most impressive sight.
We had a pleasant trip down the Mediterranean until we entered the Gulf of Lyons, and then the wind got up, and there was a nasty cross sea which made most of us feel squeamish and not sorry when we anchored at Marseilles early one morning; but there we had to tranship to a smaller steamer, and it was raining and cold, and when we got on board theClydewe found they were still coaling, and that the lighter with all our baggage on board was not likely to come for some time, so we could not establish ourselves in our cabins. As there seemed no comfortable place on the boat, we concluded the best thing to do was to take a cab and drive up to a hotel to get warm. Then I went out to buy fresh cream and grapes, and to find out exactly at what time it was necessary to be on board.
I shall never forget the storm of that night after we left Marseilles. I tried to make some hot arrowroot; with much patience I managed it over a spirit lamp, which I wedged into my washing basin with supports; of course the tin of milk could not be trusted to sit on the top of the lamp, so I had to hold it there, and it was not an easy matter as I was flung from side to side in my cabin; then I found that a linseed poultice was indicated, so I again retired to my cabin and wrestled with the spirit lamp, and thought how little one appreciates the conveniences of a modern hospital until one has to do without them.
After that the groans and fearsome noises from other cabins around us were very bad, and I, who have always prided myself on being a good sailor, actually succumbed for an hour or two; but I dragged myself up again in the early hours of the morning to make another poultice, and by breakfast-time the seabegan to go down, and the sun came out, but it was several days before some of the passengers crawled up on deck, looking like limp rags, and the tables in the saloon were very empty until just before we reached Alexandria.
We stayed some hours at Malta, and I had an interesting drive round the place.
From Alexandria we had meant to go straight on to Cairo, but eventually agreed it was best to stay a night at a hotel in Alexandria to rest before the dusty train journey.
We had a wretched night, and, not knowing how to find a good doctor if I needed one, I felt very lonely in a vast hotel where no one seemed to speak English.
The next day we managed to journey on to Cairo in the morning, and rested at Shepherd's Hotel until the evening, and then moved on to this place—about half an hour by rail from Cairo, and actually on the borders of the desert.
We have many friends in Cairo, and there is a good train service, so they often come out to spend the day with us, or for the afternoon, and then sometimes I go into Cairo to do necessary shopping or to pay some visits. Cairo is a very gay place, and the people very pleasant and friendly.
One day I went to lunch with some friends, and they drove me to see the Citadel (driving all through the native quarter of the town), and then we had tea with the sisters at the Military Hospital—a rambling big place, designed for a palace and not for a hospital—and they seemed very full up with enteric patients.
Then we went to see the Mosque, and were seized by the feet by several Arabs, who tied on sandals forus before we went inside, and in these we were allowed to flop about. The Mosque is a vast dome, nearly all marble and alabaster, with a lovely alabaster fountain, where the people wash their feet before going in to pray.
We walked all round the fortifications, and had a splendid view of Cairo, and then drove back to town just in time to see the Khedive arrive from Alexandria; a stout, sad-looking young man, his native escort very smart, and riding such beautiful little horses.
Another day I was invited to bicycle out from Cairo to Mena House; so I went into Cairo by the early morning train, and mounted a hired bicycle for the nine-mile ride to Mena House Hotel. The first two miles seemed very perilous, as our route lay all through the town, and many water-carts made the roads very slippery, and electric trams and steam trams rushed about in a most confusing way, and natives in swarms (many of them blind) seemed to take a pleasure in strolling in our track, and stupid donkeys and sad-eyed camels with unwieldy loads kept turning about in unexpected directions, and looking at us in a reproachful way, as much as to say they thought bicyclesquiteout of place in their country.
The narrow bridges over the Nile were thick with traffic, and I was quite glad when we got out to the open country and on to a good road with trees all along.
We left our bicycles at the hotel, and walked out to the great Ghizeh Pyramids, really a most marvellous sight.
The big Pyramid covers as much ground as Lincoln's Inn Fields; enormous blocks of stone, apparently just tumbled one on the top of the other, and yet thewhole worked into such perfect shape. To think of how they can have brought these vast blocks of stone down, without mechanical help, from Upper Egypt (for there was no such stone to be found near there) is indeed wonderful.
The Temple, also, is a thing to marvel at, great blocks of granite and alabaster cut and fitted together so perfectly, the doorway as straight as possible, and to think that all this work was done from 3000 to 5000 years ago and is still as sound as ever.
We had not time to climb the Pyramid, but of course we paid our respects to the Sphinx, and wished we could stay to see her by moonlight, when she is said to be even more impressive than in the daylight.
They gave us a very good lunch on the balcony of the hotel, which is said to be the best managed in Egypt; and I should think it would be a very pleasant place to stay at, nice airy rooms and a lovely marble swimming-bath at the back.
As we rode back there was a good deal of wind against us, and I was out of practice and rather tired, so I found the crowded streets of Cairo alarming, and was much relieved to give up my bicycle without having run over any one or damaged the machine.
I think there was more of a crowd than usual, as the Khedive had driven to the station to meet the King of Siam, and we saw the whole procession pass on their way back to the palace.
The King of Siam was very gorgeous in a white uniform with much gold lace, and his two sons were a somewhat curious contrast to the natives around, in their Eton suits and top-hats; they are going up the Nile on a private boat.
Helouan is beginning to fill up for the season (wewere about the first arrivals), and we have many visitors. We are in comfortable lodgings, quite on the outskirts of the village; the servant who chiefly waits upon us is a fine Arab with a black moustache, who stalks about in a white night-gown down to his heels, tied round with a red sash; he wears a red fez cap with a blue tassel, and red sandals on his feet; he does most of the housework, for which purpose he puts a housemaid's apron with a bib over his night-gown! His name is "Abdul" (the "slave of God"); and there is a small Arab boy called "Ishmael," who runs messages, and is most interested in our doings.
The mosquitoes are pretty bad at night here, and we have to sleep in nets. Last week we had two days with a south wind blowing, and then the beasts—creeping, crawling, and flying—werea trial; there were great wasps (quite three times as large as English ones), and horrid little beasts that look like bugs (only they fly and don't bite) settling on our dinner-table;—I am sure the south wind must have been blowing in the time of the plagues of Egypt!
I am busy collecting things that we want to take up the Nile for our house, as we shall then be 450 miles from the nearest shop, and it is rather difficult, as I don't know at all what the house is like.
There are so many things that I should like to do and see in Cairo, but I have not time, as we are leaving by the first tourist steamer that goes up the Nile, and I don't like to be out for any length of time, but I did manage a visit to the great native hospital, the Kasr-el-Aini, where I know several of the sisters.
It is a very fine place with a very up-to-date theatre; the nurses are all natives (men for the male patients), but they all work under the English sisters.
The sisters have a most delightful Home, their dining and drawing rooms are very spacious apartments, and they each have a very large room, which most of them screen off into bed and sitting rooms.
There is a special fund which provides a carriage and pair for their use, and they have a very good tennis court in their garden, in which they are "At Home" one day each week, and the Cairo people go to tea with them and to play tennis.
I have not told you a word about the native bazaars and all the quaint sights of the Cairo streets, but every one writes about them, and I find them too dazzling to describe. I could sit for hours on the balcony at Shepherd's Hotel just doing nothing but watch the people. Take my advice, and come to see Cairo some day, for it is a most fascinating place, and I am quite loth to leave it.