General Hospital, London,
August 1894.

With much sorrow I left my nice and interesting men's medical ward, and found myself landed in a smaller surgical and accident ward for women and children. There could hardly have been a greater contrast. There everything was done with order and method, and well done; here every one seems to rush about in a breathless way, and the ward never looks tidy, and I am quite sure that the bustle that goes on is bad for the serious cases.

I am responsible for eight cases instead of four, and at first I thought I should never get them all washed in time in the morning; but now I find so many of them can do a good deal more for themselves than the medical cases could; also the medicines in a surgical ward are nothing to those in a medical; so I get through all right, and keep up to time.

Three surgeons have beds in the ward, and that makes the work a little difficult, as sometimes they all arrive at the same time, and sometimes they all want to operate at the same time. This is most awkward, as we have not got fittings for them all, and have to run backwards and forwards for things. They seem to me a most amiable set of surgeons; I know the surgeons at our Children's Hospital would not have put up with being kept waiting as these men do; but I do hate not having everything they want ready before they ask for it. However, I am beginning to feel my way, and I think I shall soon be able to get different sets of things ready to use in these emergencies.

It took me some time to find out why the ward was always in a state of chaos, and it is only because you are so far away that I can safely tell you the reason. I believe it is simply and solely because the Sister, though a fairly good nurse, is really no good as a Sister. I am sorry to say it, as she has been very nice to me, and the poor thing tries her best. She runs about, and does many things that the junior probationers ought to do, but she has no idea of looking after the nurses; and as the staff nurse is rather a shirker, and is very fond of chattering to the dressers, the probationers who are keen to work are rather overworked, and those who are not keen don't work. Also, if there is a rush of work, Sister rather loses her head, and runs about in an aimless sort of way; and in the theatre, if anything goes wrong, and they want things in a hurry, she always seems to hand the wrong thing.

I find it a bit difficult, as the doctors get in the way of turning to me if they want things quickly. As soon as I found out what was wrong with the ward, and that Sister was quite nice and "meant well," but just had not got it in her to be a good manager, I made up my mind that the ward should be a smart ward, in spite of obstacles, and really it is improving by degrees.

I have been having a good deal of correspondence lately about a small boy who, Sister said, would have to go to the workhouse when he leaves here, and I thought he was a suitable case for Dr. Barnardo's Homes; so she said I could try if I could get him in there, and I have just succeeded in doing so.

His mother died when he was born, and his father appears to be a thoroughly bad lot, generally in prison. This boy had lived with his old grandmother and run wild; a pretty little chap, but quite a heathen, and fond of using bad language in the most innocent way. He came in here for a small operation, and while he has been here his grandmother died very suddenly. The people at Dr. Barnardo's Homes have been very good about it, made all inquiries for themselves, and got the father's consent. Now they have agreed to take him as soon as he is well. He is a plucky little chap, and I suppose they will probably ship him over to Canada one day, and that will give him a better start in life than he might get from a workhouse.

I think we get very good times off duty here—one hour off one day, and three hours off the next; and the sisters and lady pupils have a Saturday to Monday once a month—that means from 4 P.M. on Saturday to 10 A.M. on Monday.

When I was moved to this ward, I just missed my Saturday to Monday; so, to make up for it, they gave me "extra leave" last week from Saturday afternoon to Monday night, and it just happened to be May week at Cambridge, so I went down and had such a jolly time. B. seems to be very happy at Clare, and to have very nice friends there. My sister was up for all the week, and having a first-rate time, going to all the dances, &c. It was my first visit to Cambridge, and there was so much to see. It ought to be easy to work when you are in such beautiful surroundings.

On the way back the engine of my train broke down, and I did not get in till 11 P.M., and I had to go and confess the next morning in the office that I was late; but it was the first time I had been late since I came, so I was forgiven.

We had rather an exciting "take-in" week a fortnight or so ago: first of all a poor, tiny baby with a very badly-cut throat (done by its mother, who had afterwards proceeded to cut her own throat, and killed herself). They did tracheotomy for the baby, but it lived only a few hours. Then came a poor little girl of eight, very badly burnt. She had had to get up to light the fire while her mother lay in bed (from her looks, I should think the mother had been drinking), and the child managed to set herself on fire. I think she will pull round, but it will be a long time before she will be able to walk again. She does not have much pain now, and I think she is quite enjoying herself here. The next case was another cut throat—a poor, feeble-looking woman, whose husband had first cut her throat and then his own. He is in the male accident ward, and not very much damaged; she is a good deal damaged, but I think they will both recover.

I had arranged to go to the Academy with L., as it was my free afternoon; but this poor woman came in soon after dinner, and I knew she would have to go up to the theatre, so I wired to L. that I could not meet her. And it was just as well I did, as three more accidents came in that afternoon, and one of these too had to go to the theatre (a compound fracture of the tibia and fibula); so we had a rushing time.

Yesterday was theatre day for our ward; and as Sister had had to retire to bed with a sick-headache, I had the honour of taking our cases up to the theatre. I was rather nervous, as it was the first time I had been up alone for our senior surgeon, and he had one bad case—an excision of knee. But the other three cases were not very bad ones, and we got along all right.

For the last three months we have been having a very interesting course of lectures on physiology, and the girl who shares my room and I spend all our spare minutes in reading up the subject. She is clever, but has not read much physiology before, so I have been able to help her a bit; and I should not be surprised if she does better in the exam. than I do. We are both of us looked upon as quite juniors amongst the lady pupils; but I don't fancy the seniors are taking much trouble, beyond just writing out their notes of the lectures, so I hope we shall do pretty decently. It is not easy to get much time to read when you have a heavy ward to wrestle with; but I am sure it helps you in exams. if you can manage to read rather more than you are absolutely obliged to about what the lecturer is trying to stuff into you in a condensed form.

I have been here six months now, and may get sent off for my holiday any day; but there has been some delay on account of Sister not being very well. She does not seem to want me to leave, as I shall probably not get sent back to this ward afterwards; but it has been very hot of late, and I shall be glad of a rest.

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