DIGEST.PAGESTHOUGHTS SUBMITTED BY ORDER1–28CONCERNINGI.Hospital Nurses.II.Nurses in Civil Hospitals.III.Nurses in Her Majesty’s Hospitals.I.Hospital Nurses1–9Twenty Observations on how to improve Hospital Nursing.II.Nurses in Civil Hospitals9–14Twenty-three Heads for Regulations as to Nursing in Civil Hospitals.III.Nurses in Her Majesty’s Hospitals15–19Twenty-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 Hospitals19–28Of the French and Sardinians19–22Russians22, 23,26–28English23Proposed Duties of Female Nurses in Military General Hospitals23, 24The Hospital Serjeant, or Ward Master will not be superseded—he will still have too much to do for any one man properly to perform, and part of his duties must be given to another officer24–26Note in regard to the Russian Nurses employed in the War-Hospitals of the Crimea26–28SUBSIDIARY NOTES AS TO THE INTRODUCTION OF FEMALE NURSING INTO MILITARY HOSPITALS IN PEACE AND IN WAR1–133I.Five Conditions essential to this service1–3II.Our Nurses were of four kinds3Absolute subordination to the Medical Officer as to Medical Orders essential and practised by us4III.1. Qualified subordination essential of Superintendent-General to Director-General and Principal Medical Officer4–62. Also of Matron and Nurses to Principal Medical Officer and Staff-Surgeons6, 73. Female service can only be introduced gradually, and introduction regulated by Director-General7–9IV.1. Shall Roman Catholic Sisters be introduced?9, 102. Or Anglican Sisters?103. Power of Police in Civil Hospitals11Power of Police inMilitaryHospitals12–154. Pay and Rations of Nurses15–20On 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 nourishment17–205. Washing to be “put out”20, 216. Cleaning their own Rooms21–237. Nurses to keep keys of closet in Wards238. Pay, dress, and duties of Matrons24–28More properly named Superintendents27Lady Volunteers had better begin by being Nurses, not Superintendentsex-officio289. Sundry Regulations as to Nurses29–3110. Have the Patients’ Diets sent hot, and ready divided, from kitchen3111. What Ward duties the Nurses should do themselves31And why32, 33Patients should not be made quasi Orderlies34Visitors in Military Hospitals3512. Regulation-Number of Orderlies—depends on the size of wards whether sufficient35–41What is the regulation-attendance in Naval Hospitals37What in Civil Hospitals38Comparative Cost of Nursing in larger and smaller wards39–4113. Hospital floors42–51Sanitary necessities42Trial of Hospital floors, oiled and polished with “laque” as in Berlin Hospitals, recommended on sanitary grounds and for ease of cleaning43–5114. Ventilation of Wards51–5215. Special Wards, whether desirable or not53–5416. Opinion as to Superintendent-General paying Nurses’ wages, and as to Governor’s jurisdiction over Nurses54–5617. Wages and Pensions of Nurses56–60Three rules in raising Wages56Five general principles as to Wages and Pensions58Six applications of the foregoing principles58, 59Seven heads for Regulations as to Nurses’ Wages and Pensions59, 6018. Proportion of Nurses to Patients61, 6219. Precautions in sending Nurses on Foreign Service62Hospital Laundries63Addenda, with regard to Female Nursing in a Military Hospital on the Pavilion, orLariboisièrePlan63–90I.Four conditions to be considered in adopting the Pavilion Plan631. Economy of attendance642. Facility of supervision653. Desirableness ofdoublingthe Pavilion, in a Military Hospital, in order to give to each Nurse but one floor to serve654. Nurse to sleep near her Ward66Importance of lighting by gas67II.1. One Nurse must serve the whole Pavilion, in a Military Hospital, ifsinglePavilions be adopted682. Nurses’ day in such a Pavilion68, 693. What the responsibility of Nurses is fordiscipline of Ward or Pavilion70, 714. Importance of Lifts71III.1. “Casualty” Cases should be in a completely appointed set of Wards, apart72And why732. Restraint or non-restraint in Violent Cases74IV.Simplicity of Construction essential to Discipline75Polished impervious Walls.Covered Exercising Place.Reserve Wards76V.Nurses’ Meals to be sent them Cooked76VI.Arrangements for a Pavilion and its Wards77–902. Where should Wardmaster sleep?773. And Orderlies sleep?774. And dine?787, 8, Scullery to each Ward, and what to be done in it79Poultice-making799. Presses in Ward80, 8110. Nurses’ Room82Lavatory, Water-Closet, Sink83Baths8411. Summary of arrangements85Scullery Appurtenances8612. Nurses’ Sleeping Quarters86Ward for Sick Nurses8713. Classification of Patients8814. Nurses to be called by their Wards8815. Foul Linen8816. Washing Bandages8917. Splints,&c., where to be kept89Cotton Lint never to be used8918. Classification of Nurses90Superintendent’s Store Room90Addenda as to Mixed Nursing by Nurses and Orderlies in Military Hospitals on the Double Pavilion Plan91–117I.Orderlies’ Duties91–108Proportion of Nurses, Ward Masters, and Orderlies to Sick91–93Wine to be always administered by Nurse93Orderlies—their Duties vary according to appurtenances of Ward94If Hot and Cold Water are laid on, and there are Lifts, one Orderly’s Service saved to each 30 Sick94, 95Night-Duty of Orderlies95–108Scheme of Night-Service for three Orderlies watching by turns96, 97Exercise for Orderlies97Night Refreshment for Orderlies98, 99Where are the Night Orderlies to sleep?100Comparative Merits of different Systems of Night Nursing in Home and in Foreign Hospitals101–3An Assistant Ward Master should go round the Wards at Night104Extraordinary System of Night-Nursing in the Army at present105–8II.Twelve Sundries in organizing a Military Hospital108–1141. Nurses’ Room1082. Medical Officer’s Room1083. Water-Closets1094. Warm and Cold Water Supply1095. Corridors1096. Lobby1107. Material of Ward Utensils1108. Reserve Wards111–112Necessity of Annual Cleansing of the whole of a Hospital9. Occasional Revision of Rules11310. Defect in German Organization of Nursing11311. Nurses’ Exercise11312. Number of Ward Masters114III.Regulations114–1171. Deprivation of Visitors salutary in certain Wards114–162. Numbering Patients saves time1173. Prohibition of Swearing117Conclusion117Additional Hints as to Pavilion Hospitals suggested by the Construction of theLariboisièreHospital at Paris118–127I.Ventilation118–120Artificial Ventilation never freshens a WardII.Oiled Boards versus Parquets120–124Cleaning polished and oiled Boards much less laborious, and freshens the Ward much more than thefrottageofParquets.Mode of Cleaning them at Berlin122–124III.Ten Cautions in Building Hospital Pavilions124–127Size of Wards. Our own Regimental Hospitals extraordinary for their many holes and corners125Casualty Wards126“Contagion” and “Infection” Defined128–132Idea of “Contagion” invented by Men to excuse themselves for the neglect of all Sanitary arrangements128In the ordinary sense of the word, no such thing as “Contagion”129Nor asinevitable“Infection”130“Infection” and Incapable Management, or Bad Construction, convertible terms131“Epidemics” do notspread—they develop themselves in Constitutions made ripe for them by Sanitary neglects131Note on certain “Observations” by Sir John Hall132, 133Thoughts Submitted as to an Eventual Nurses’ Provident Fund1–19Actual Wages and Prospects of Nurses1–3Some further Provision desirable4–6Of what Nature?6–15With regard to Kind?6–8With regard to Persons?8With regard to Objects?9–15Material Objects?9–12Children, in the case of Nurses, a Temptation to Petty Dishonesty and taking Bribes11, 12Sanitary Objects?13Moral Objects?13–15Hospitals not places for Penitents14, 15Rules to be followed in giving Assistance15–17Prospects of Eventual Support18, 19Note as to the Number of Women employed as Nurses in Great Britain20, 21Tables of Ages,&c.21Note as to Teaching Nursing—Institution at Madras22, 23