General Hospital, London,
June 1895.

Many and various are the jobs I have done since my last letter, and now I must tell you that I am a full-blown Sister or, as they say here, I have got "my blue"; but I had better begin where I left off.

I was then bustling about on night duty, and I spent a very happy Christmas like that. Of course, we should all like to be at home for Christmas, but in hospital so much is done to make it bright and cheery for the patients, and so many of them have so little brightness in their lives, that it is nice to see how thoroughly they enjoy it.

They all have really nice presents; there is any amount of good food provided; plenty of entertainments (music, Christmas trees, &c.); and the men are allowed to smoke in the wards.

The doctors and students are really splendid in the way they work at decorating the wards, &c., and carrying the patients who are well enough about to other wards for entertainments.

The children of the slums around here will do anything to get into the hospital for Christmas, and the front surgery is full of little imps who have all got a "very bad pain!"

In January I had to retire to bed for a few days with a high temperature and a touch of influenza, and while I was in bed the day came for the dispensing exam., so I begged to be allowed to go, and vowed I was quite recovered, and they let me attend.

I made up my prescriptions (a bottle of medicine and some powders), and then I got under way with the paper, and thought it was rather a nice one, but before I reached the end my head began to swim, and I felt convinced I had mixed everything up and given all the wrong doses, and I thought what an ass I had been to try it, and I was certain I should come out at the bottom of the list!

One of my friends escorted me back to bed and took my temperature, and when she found it was 103 she went off and told the Matron; so next morning the doctor appeared, and I was kept in bed for a whole week, and then sent away for a few days' change, but before I went away Matron came to tell me that I was first in the dispensing exam., with 114 marks out of a possible 125. If I had any more exams. to go in for, I think I ought to arrange to have a little influenza beforehand, as it seems to stimulate my brain; but, thank goodness, that is my last.

You know I have always vowed that nothing would induce me to be a matron? Well, I have been rather near it; I have been acting as assistant matron for some time. First of all, the assistant matron was ill, and went away for a bit, and I did her work; then, when she came back, Matron went away for a fortnight, and I stayed on in the office helping the assistant.

It was rather interesting learning the ins and outs of the "Administrative Department," but I am still convinced that it is no catch to be a matron.

Sisters come to complain of a nurse, and you have to send for that nurse and scold her for her reported misdeeds, when, perhaps, all the time you have rather a feeling that Sister has been unreasonable in what she has expected of the girl.

Then nurses have a way of sometimes getting ill, and it always seems to be the nurse whose place it is most difficult to fill; then Matron goes out for the afternoon, saying to the assistant, "There are three extra nurses, and I have sent them to Wards A., B., and C., where they are busy, so no one is likely to ask you for another extra," and as soon as she has gone a house surgeon runs in to say he has sent in a very bad diphtheria case to Ward D. for immediate tracheotomy, and can I send specials over at once? I look on the list to see who the three extras are, and find not one of them is suitable to take on the case—one is going for her holiday in a few days and the other two are quite juniors—so I rack my brain to think which of the ward nurses is most suitable, and fix upon Pro. 1 in Ward A., as she has nursed one or two tracheotomies; so I have to interview Sister A., and she is most reluctant to give up her Pro. 1, and is quite certain Matron would not have taken her away, but I have to be firm and try to console her by sending her the best extra in place of Pro. 1 (thereby incurring black looks from Sister B., who is quite sure her ward is far heavier than Sister A.'s!); some one ought to be sent to bed to be ready to act as night special, but I conclude that can wait till Matron returns, as she may have some nurse she has promised to put on as special. That is the sort of work the assistant matron has to do—a good deal of fagging about and acting as a sort of buffer between the sisters and the Matron, much writing of letters and other work in the office, and a good deal of carving at meal times—one Sunday I carved roast beef for seventy nurses, some of them day nurses and some of them night.

I had just come to the end of my time in the office (I was still a lady pupil then), when an appeal came to the Matron to lend two staff nurses to one of the large London Infirmaries, where they had a great many nurses ill.

I volunteered to go (as I thought it would be a new experience), and then another lady pupil also volunteered.

It was a pouring wet evening in March when we set off in a hansom cab, the other lady pupils rather jeering at us, and saying that when they went to the workhouse they should do the thing correctly in an aged four-wheeler!

We had no idea where the Infirmary was, but trusted to the cabby, and after a long drive he turned into a stone-paved yard and drew up at a heavily-barred door; it looked more like a prison than an infirmary, but I got out in the rain to explore, and after a little while I managed to explain to the old man in charge that I did not wish to apply for admission to the Casual Ward, but to find the Infirmary. He told me that was more than a mile farther on; so the weary horse plodded on once more, and eventually brought us to an imposing building, where, in three weeks of hard work, we learnt many things.

They were very busy and very short-handed. I was sent to a women's medical ward of thirty-two beds, but the place was so full that I had thirty-six patients, the extra ones sleeping on mattresses on the floor. For the first week, whenever a patient came in, I had to consider which of those in beds was the most capable of turning out and descending to the floor, to make room for the new-comer, but after that things quieted down, and before I left the patients were reduced to the correct number.

There was a sister in charge of my ward and of another one just opposite of the same size. For a few days I worked with the staff nurse, and then she had to leave, and I was left to do the work of the ward with the help of a probationer, who came in for an hour and a half every morning, and who relieved me when I went off duty every other day; and on the alternate days, when the staff nurse from the opposite ward was off duty, I had to patrol her ward at intervals, and give the probationer any help she needed.

At first I was appalled at the small number of the nursing staff for so many beds, but I soon found that everything was done in a way very different from our hospital methods, and that if we worked hard and fast it was possible to do all that was really necessary for the patients, but quite impossible to do the little faddy things that make so much difference to their comfort.

For one thing, the convalescent patients were expected to do a great deal of the routine ward work, and, as a rule, the convalescents stayed in much longer than they do in a hospital, so they were more fit to assist, but this hardly applied to my short time in the Infirmary, owing to the great pressure on the beds; also I found that there were only about six or eight out of the thirty-six patients really acutely ill, so I was able to give most of my attention to them—three of them were absolutely helpless, and needed much care and nursing.

The rest of them were chiefly old ladies who were just not strong enough for the workhouse life, and so were drafted into the Infirmary; most of them were able to get out of bed and potter about the ward. This they loved to do with very scanty clothing on—rather to my horror—and I found that when a doctor was sighted on his way to the ward it was best to clap my hands vigorously, when all the old dames scuttled into bed like so many rabbits into their holes.

Poor old things, several of them had evidently seen better days, and there were many sad stories to be listened to, and they did so much appreciate the little I could do for their comfort.

It was very hard work, as one always seemed to be working against time, but I quite enjoyed my three weeks in the Infirmary. Matron had not told us we were to be paid for this work, so when we each received £6. 6s. for the three weeks, we felt very rich!

We were quite glad to return to our good old hospital, and since then I have been doing Sister's holiday work, and now I have just been appointed Sister in the front surgery (where all the new cases and accidents come in); it is utterly different from being in the wards, but I think I shall find it interesting—at any rate for a time. I shall wait to tell you about it until I have been here a little longer, and have taken my bearings more correctly.

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