Licence: In copyright
Credit: The problem of fever nurses / by John Brownlee. Source: Wellcome Collection.
Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.
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![THE NURSING TIMES 579 the problem of fever NURSES I. Bv John- Brownlee, M.A., M.D., D.Sc. (Physician Superintendent of the City of Glasgow Ferer and Smallpox Hospitals, Bclvidere.) The position of nui'ses trained in fever hos- pitals discussed in your issue of June 15th is one which admits of two opinions, according to the point from which it is approached, the advantage of the public or that of the nurses. It becomes necessary, whether State registration be instituted or not, to inquire how the interests of both public and nurses might be best safe- guarded. To settle this question some agree- ment is necessary concerning what knowledge and training are required by a nurse prior to regis- tration, and how far this knowledge and training can be obtained in hosi^itals devoted in greater or lesser measure to meet special needs. To summarise briefly, the following are the requirements of a good nurse. She must be able to attend on the sick person so as to enable that person to pass through the illness in the most favourable circumstances. This is the basis of all nursing, and is essentially the same, no matter what disease the patient suffers from; a crumpled sheet is a crumpled sheet, whether the patient* be surgical or medical. Whether a patient be collapsed by a severe fever or by a severe opera- tion matters not, as the needs of a patient suffer- ing from exhaustion differ httle in any disease. The capacity to handle each patient, indeed, demands some special experience of the illness from which he suffers, but the great bulk of the knowledge necessai*y is common to all nursing. A nui*se must also have an accurate knowledge of the means of ventilation; of the care of the ward as regards hghting, bed and bedding, cleanliness, care of furniture and utensils, &c.; she must devote attention to the cleanliness of her person, of her dress, and especially of her hands; she must be able to cook to a certain extent and to feed intelligently; she must be to keep her patient clean and tidy with the num of disturbance, and, in the case of female patients, perform many smaller duties; she must be able to record observations accurately, the degree of temperature, the char- acter of pulse and respirations, the effect of diet and remedies, the state of the patient as regards mental outlook, sleep, appetite, &c., the condi- tion of the skin and the presence of eruptions. Apart from these she must possess the ability 'o apply that mass of minute detail which lifferentiates a good from a bad nurse. Evep^ ne of these can be taught just as thoroughly almost any other form of disease, and it is on the trustworthiness of the nurse’s power of observation that the physician in attendance on the case is most dependent. Powers of observa- tion are rarely native 'to any extent; their development and training is one of the chief duties of an educational institution. In a hospital, such as many of the large fever hospitals in Scotland, to which are admitted cases of diphtheria, scarlet fever, typhus fever, enteric fever, measles, whooping cough, ery- sipelas, and cellulitis, and puerperal septicsemia, with the great variety of complications which these diseases supply, and with the large number of general medical cases admitted under wrong diagnoses, it is ridiculous to say that* there is a properly equipped fever hospital as in any ther, for, after all, “fever, above all other any lack of material on which to procure a thorough training of all varieties of medical nursing such as just outlined. In addition, a nurse trained in such a hospital has experience in the treatment of many varieties of disease, such as acute eye infections, which are very common in measles, acute nose and throat infections, and broncho-pneumonia in children, experience, as a rule, only to be gained in special or children’s hospitals. As regards surgery her training is less com- plete. She is, however, familiar with the tech- nique of the administration of chloroform, with dressings and instruments, and with the more simple routine of surgical operations, and with regard to one special procedure, namely, the treatment of tracheotomy at and after operation she is, as a rule, an adept. With this experi- ence she is in a position to acquire the full technique in a comparatively short time. Were all nurses trained in general hospitals thoroughly equipped as regards surgical measures, this would be a somewhat serious objection, but in many of the smaller general hospitals and of the poorhouse infirmaries which give a certificate of three years’ training, there is no opportunity for the nurses to become abreast of the best modem surgi’pal technique, which at the present moment requires a considerable period of con- stant and elaborate drill. Further, ja these fever hospitals the nurses are as carefully lectured and taught _ as in the general hosjitals, and at least in this hospital their general medical training is considered of as great impor lance as special fever training, as the latter wi ihout the former is of comparatively little use. Probationers are only accepted for three years’'training, and we can get as many as w'e 'wish. Nurses with the hospital certificate have no di^culty in obtaining engagements m the nursing homes in England at a higher salaiy than we are willing to pay to retain their ser- vices as staJ nurses. As rimny leave to go to these homes we have a difficulty in retaining sufficient of ])ur own certificated nurses to recruit iseases tests the nursing power and depends non this for life or death.’’ 1 In fact, m acute iseases there is more field for training the urso’s powers of observation accurately than in Florence Nightingale. the vacancies among the demand for nurses at the present time is greater than can be easily met. It seems fore, that it is for the general nurses trains d in the large fever p I](https://iiif.wellcomecollection.org/image/b24931068_0003.jp2/full/800%2C/0/default.jpg)
