Notes on hospitals / by Florence Nightingale.

  • Nightingale, Florence, 1820-1910.
Date:
1863
    In the best Roman Catholic orders, especially where, as in i, the secular authority comes into action, there is far more latitude given to individual character, and scope to individual capacity, than we are at all aware of. Each member is much more independent in his or her own occupation than is the case under arrangement No. 2. Nos. 2, 4, and 5^ Where there is but one authority over both hospital and nurses, whether that authority be religious or secular. The following remark applies alike to some institutions, both religious and secular, to all military, and to some civil, to Protestant and Roman Catholic establish- ments :— The want of one definite head in permanent charge of each ward, or set of wards, invariably acts disastrously for the patients. There should always be some one person in acknowledged responsibility for the nursing, with servants—call them lay sisters or brothers, or assistant nurses, or what you will—under the head. Religious motives, in some orders, a want of any practical system of nursing in many military and some civil hospitals, reproduce the above defect, in the most varied forms, in institutions of the most opposite character. No. 4. Where nurses and institution are under the same secular autho- rity. The following remark applies solely to institutions secularly nursed :— The practice of having man and wife in joint-charge of a ward or wards has in it more evil than good for the patients. It is true that a woman had better flirt with her husband than with a student or patient; it is true that the common phrase " settling" (which means marrying in some classes) has its signification here—for some women never are " settled" till they are married. But it is no less true that the Interest of the husband henceforth comes before that of the patients, in honest as in dishonest ways. The woman is no longer attached to her ward, but to her husband; and the patients are, more or less, neglected. This is still more eminently the case in regimental hospitals, where it is a common practice to choose married hospital sergeants, as being more " respectable," and to have the wife to live in the hospital. As well might the hospital head nurse have her husband to live with her in the room off her ward. Nos. I. Where the sisters are of a religious order, but the nurses are secular,—3 and 4. Where all the nurses are secular, whether governed by a separate head from that which governs the hospital, or by the same head : —The cardinal sin of paid nurses, of all classes, of all nations, is taking petty bribes and making petty advantages (of many different sorts and sizes) out of the patients. From this sin all orders, whether Roman Catholic or Protestant, are exempt; but from it their servants are by no means exempt. The rules of hospital head- nurses in London, were they really reli-
    gious women, who would neither take any present themselves, nor be guilty of any kind of impropriety, would enable them to exercise a far more efficient surveillance over assistant-nurses, as to both these things, than can be exercised by Roman Catholic or Protestant orders living in community. All kinds of things between nurses and patients may and do go on in the sisters' wards, when the sisters are out of the way. A hospital head-nurse is (or ought to be) always in command of her ward. To sum up.—Case i. There is a higher average care of the sick and a higher universal sense of morality, among hospital sisters, Protestant and Roman Catholic, provided the hospital authority be a secular one. Case 2. There is a lower average care of the sick, although an equally high mo- rality, among hospital nuns, Protestant and Roman Catholic, if the hos- pital authority be not a secular one. Case 3. There is a far greater average care of the sick, although a lower morality, among nurses under a secular female head, the authority of the hospital being a secular and separate one, than in Case 2 ; and there is a somewhat higher average care of the sick in Case 4 than in Case 2, and no morality at all, but an awful destruction of both life and soul, among nurses, where both nurses and hospital are under the same secular (male) authority. Case 5. There is no care of the sick and no morality, nor even discipline, in hospitals where the nurses are men, and where both nurses and hospital are under the same secular (male) authority. This is the worst state of things of all. Case 2 is perhaps the second worst. For, take it which way you will, the idea of the " religious order" is always, more or less, to prepare the sick for death ; of the secu- lar, to restore them for life. And their nursing will be accordingly. There will be instances of physical neglect (though generally unintentional) on the part of the former 5 of moral neglect on that of the latter. Unite the two, and there will be fewer of either. Of course to all this there are exceptions. This Appendix is dealing only with systems of nursing as systems. Note.—Two excessively foolish books by the same woman, calling herself an "English Sister of Mercy," on this question of sisterhoods,—in which the difficulty is, not to find what is false, but to find what is true, and which I should never have thought of referring to, but that she has been quoted by grave divines in Consistory,—give every reason for the comparative use- fulness or uselessness of sisterhoods but the right one, viz., that if a sisterhood cordially and frankly co-operates with and works in a secular institution, it is useful; if not, not.
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    .uadon Longman Gi^sn i
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