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 a little 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 ladder was too 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 face to 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, and whenever 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 them their breakfast in the morning, but "would I 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 8 A.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!