General Hospital, London,
January 1896.

I think I shall be rather glad when I get a ward of my own and settle down; but every one seems to think I am lucky in getting such varied experience, so I suppose I ought to be grateful, and it is not yet two years since I first entered here.

I spent six months as Sister in the front surgery, and it was very interesting.

There had never been a sister in charge there before, but just one old staff nurse, who had let the dressers do just what they liked, and there was a lot of waste and much disorder.

Matron gave me a very good probationer, and she was just as keen on getting the place nice and trim as I was. It took us a week or two to get all the drawers &c., scrubbed out and tidy, and a good many more weeks before we got all the splints sorted and padded.

The Medical Superintendent was pleased, because I managed to reduce the cost of dressings every week from £10 to £7 before I had been there a month, and it was still further reduced after a few more weeks.

Of course it is difficult for young dressers (who come on for only three months at a time) to understand how much difference a little extravagance in each dressing makes in the weekly bills; and they can't be expected to know the relative value of different kinds of wool, &c., unless it is pointed out to them, but as a rule, when they do understand, they are quite willing to use the cheaper dressings (for cases where they do just as well) provided that we keep a supply ready to their hands.

I often wonder whether, when people go round a hospital and see the rows of white beds and clean patients, and everything neat and tidy, they think the patients arrive here looking like that. Very often in the wards, when the porters have carried up an accident case on the stretcher, I have hardly known how to get the man's dirty clothes off, and it takes time before you can get them reasonably clean; but in the wards you always receive a note or a message by the porter from the house surgeon, with a rough diagnosis of what the case is, so that you know which limb to be especially careful in moving. But it is different when you receive a patient in the front surgery; the policemen tramp in and deposit the stretcher on the floor, and there is much mopping of their foreheads before they tell you roughly what they know of the accident, and then you have to proceed to find out for yourself what is the extent of the injury, and often the patient is quite unconscious, so he cannot help you at all.

I think at first I had a dim notion that every case that was carried in on a stretcher was sure to be admitted to the wards, but one soon learns that a good many of these cases are more frightened than hurt, and after a little rest and a thorough overhaul by the house surgeon they are able to go home again; on the other hand, every now and then a man who has had a very serious accident will manage to walk up to the hospital, and he may even sit down amongst the other waiting patients and quietly wait his turn to be seen, unless you happen to be on the look-out, and note that he is looking ill, and get him on to a couch for immediate attention.

There is generally plenty doing in the front surgery, and whenever any of the men have nothing better to do they stroll in to see what is going on, so one hears all the gossip of the place; very quaint, too, are the tales the patients tell of their symptoms. I am not good at remembering these things, but there was one old lady who said the doctor told her that she had "the brownkitis, and that all her tubs (tubes) were full up."

Sometimes we had exciting times. I remember one morning when I came on duty the night nurse reported that a bad case of compound fracture of the jaw and other injuries had come in, and been taken straight up to the theatre, and that the house surgeon and all the available dressers were busy with it then. She had no sooner gone away than in tramped four big policemen with a stretcher, which they deposited on the floor; on uncovering the patient I found a poor man on whose head several heavy planks had fallen. Part of the scalp was torn up, and it was bleeding profusely. I sent my probationer flying to the theatre to ask for some one to come to help, and then I made one policeman put pressure with his finger on an artery on one side of the head and another policeman on the other, while I collected some dressings, forceps, &c. Much to my astonishment, first one policeman fainted and subsided on the floor, and then the other one did the same (the other two had gone outside); then the probationer returned to say the man in the theatre was bad, and they could not spare any one, but some one would come as soon as possible. Just then the police inspector walked in, and his look of astonishment at his two prostrate men was very fine, but he called the other two men to move them, and then he gave me the help I needed, while the probationer and I did what we could to stop the hÆmorrhage; it was pretty well subdued by the time the house surgeon got down, but he saw at once it was a bad case, and took the man straight up to the theatre. As soon as he had gone we dosed the two policemen with Mist. Ammonia, but it was a little while before they were fit to return to duty, and then we were just thinking we would begin our much delayed morning's work when, strangely enough, two men were carried in dead, the two stretchers arriving within a few minutes of each other; one was a suicide from the Thames, and the dressers tried artificial respiration for some time, but the poor chap was quite dead; the other was a poor old gentleman who had apparently died of heart failure when hurrying to catch a train.

We saw a great many infectious diseases in the front surgery, and had to keep them in an isolation room till the fever ambulance came to fetch them. I remember one day when we had samples of nearly all the infectious fevers to despatch—first came a case of smallpox, then one of scarlet fever, then one of diphtheria, and there were also cases of measles and chickenpox, but these had to be sent back to their homes. There was quite an outbreak of smallpox just then (I think we had twenty cases in the front surgery in one week), so everybody in the hospital who had not been recently vaccinated had to be done, and we were all very sorry for ourselves for a time.

Another little episode in the front surgery was when a baby took us all by surprise by being born there! We should have sent it on to the Infirmary, but the mother was rather bad, so we had to take them in.

One Sunday evening I was in chapel when I heard some one come to the door, and then the porter came to fetch me, and at the door I found one of the dressers who told me there was a bad compound fracture in the surgery, and the house surgeon would be glad if I would come, as he wanted to give an anÆsthetic. When I got there I found a crowd of men all standing round a poor little dog with a badly crushed leg! so we got some suitable splints, and they gave it an anÆsthetic and put up the fracture; then they sent word to the male accident ward to get a fracture bed ready for a patient, and the porters were secured to carry it along on a big stretcher. It was in the hospital for some weeks, and got quite well again.

Just before Christmas the Matron was obliged to go home for a time, so once more I was asked to go on duty as assistant matron. Christmas is always a busy time all over the hospital, and in the office (with the Matron away) we had more than enough to do—so many presents to receive and acknowledge and distribute, and many visitors to show round, &c. Then, after Christmas, a good many nurses got ill (some with influenza), and every one seemed to be wanting special nurses at the same time, and all were quite hurt that I could not make new nurses to order.

So I was not sorry when the sister of the nicest ward in the hospital told me that she had been appointed Matron of another hospital (she had been here for years), and as she knew nothing of office work she wanted to ask Matron if she would have her in the office for a few weeks' experience. I thought it would mean that I should go back to the front surgery, and I was quite pleased, but instead of that, Matron wrote to ask me to take over that sister's ward for a couple of months, as she had not got a suitable sister ready to take it permanently (it is always given to one of the seniors here); so I was still more pleased, especially when I found that the pay was at the rate of £10 a year more than for the other wards.

This is an awfully nice ward of thirty-two beds, in two divisions—one for men, and one for women and children. It is chiefly for medical cases, but there is a small theatre attached, and a good many abdominal operations are done; there is also a private ward, to which the surgeons can send any operation cases that need especial attention; and they have special nurses.

In the wards I have a good staff, as it is always considered the most acute ward in the hospital, and I can generally get an extra nurse if I want, so I don't do much actual nursing myself, but there seem to be doctors constantly going round whom I have to attend, and somehow I always seem to be busy.

The longer I am in hospital the more I see how much harder it is to be responsible for other people's work than just for your own, and I can quite understand why so many of the staff nurses much prefer to do all the best part of the nursing themselves than to teach the probationers and let them do it; but it is a wrong principle, as the probationers must be taught, and we must learn to trust others (even when we know we could do things quicker and better ourselves), and to increase the trust just in proportion as we find them worthy of it; that is where the art of the teacher comes in!