General Hospital, London,
December 1896.

I think I last wrote when I had just taken charge of C. Ward for two months.

I had a most interesting time there, and was quite sorry to give it up, but it was hard work. Unlike the other wards, that "take in" new cases for a week and then have a rest, C. is always "taking in," as the men in charge see every new case that comes up to the hospital (except accidents), and they can take them in if they like, as long as there are any beds empty in the ward; and if they don't think it is a particularly interesting case, it is passed on to the house surgeons or house physicians for the other wards; but, of course, they try their best to get all the most interesting cases for themselves; consequently the sister is never free to go out with any confidence that no new cases can be landed in while she is away; and when you do go out you generally find on your return that something has happened that makes you wish you had never gone!

Still I learnt a great deal in my time in that ward, and I enjoyed it. The physicians' talks with the students over these "selected cases" were most instructive.

Soon after I took charge we had a run of tracheotomies; the first was a dear, fat baby of thirteen months, but it had diphtheria very badly, and was not a hopeful case from the first; not many hours after it was operated upon another came in—a sweet little boy of three called "Alex." He was much relieved by the operation, and got on so well; but the poor baby ran a temperature of 106° all through the second day, and died late that evening with a temperature of 108°, in spite of all we could do for it. I believe we were much more cut up about losing it than the mother was; she did not seem to mind a bit, and apparently had made all her plans for the funeral beforehand—and it was such a pretty baby too!

The special nurses I had for these tracheotomies had never nursed one before, so you can imagine I could not leave them alone much, and was thankful I had had a good many to nurse when I was a lady pupil.

We had one very curious case. A young man was brought in unconscious one afternoon about 2 P.M.; a little after five he got worse, and his respiration suddenly stopped, the pulse went on steadily, so they did artificial respiration; this went on till 9.30 P.M., and then they decided to trephine, thinking it must be a cerebral tumour pressing on the brain; of course no anÆsthetic was necessary, as the poor man showed no sign of life except that the pulse was beating; they could not find any tumour, so he was put back to bed, and the men went on doing artificial respiration all through the night in turns, until the pulse suddenly stopped at 9.15 A.M., sixteen hours after the respiration had ceased—a very strange case.

We often had rushing days, when it seemed impossible to make time for meals, and scarcely time to breathe. I remember one day especially, when we took in seven new cases, two of them, curiously enough, men from quite different districts, who had both taken oxalic acid with a view to suicide; one was an old man who was very bad for a day or two, and then seemed to be getting better, but died suddenly one night from heart failure; and the other was a poor young fellow of thirty, who had been waiter in one shop for eight years, and was then turned off by a new manager and replaced by a German lad. He had a wretched wife who drank, and she took away his clothes and then disappeared; so we had to rig him up in a suit when he went off; one of the other patients gave me five shillings for him, and he asked me to keep it till he had been before the magistrates, as he thought he would be sent to prison, but he came back after his appearance in the police courts to tell me he had been let off with a caution, and he thought his old master would take him back; such a nice, quiet-mannered man, and most anxious to do anything to help the nurses in their work, or to wait on the other patients, and they all liked him.

The same day one of the house surgeons was admitted with a badly poisoned arm, and a friend of one of the students with typhoid fever; he had it very badly and caused us much anxiety, but pulled through all right in the end.

After this spell in C. Ward I expected to return to my front surgery, but instead I was offered in March (and gladly accepted) the post of Night Sister, and that is what I have been doing ever since, except for an interval for my summer holiday, and also for a few weeks when I took charge of a large male medical ward while the sister had her holiday.

Being Night Sister here means plenty of running about, and plenty of responsibility, but it also means better pay than Ward Sister, so that suited me all right.

They are talking of having two night sisters soon—one medical and one surgical—and there would be plenty of work for two, as we have a good deal of theatre work in the night, and sometimes I cannot help being worried when I am kept long in the theatre with urgent cases, and I know there are bad cases over in the medical buildings (sometimes with only rather junior nurses in charge of them), and I can't get round to visit them.

I have charge of about six hundred beds, and they are divided into twenty-one wards (of course nurses in each ward and two nurses in the large wards); I have to go all round three times every night, and run in much oftener to see any bad cases, and the nurses send for me in any difficulty; there is a slate in my office for messages, and when I return after my rounds I often find two or three messages, "Please come at once to P."; "Please come to N.—urgent," and so on, and I have to fly to whichever I think is likely to be the most urgent.

The morning round always takes the longest, as all the patients are then awake, and I have to say good morning to them all, and remember to ask after their particular aches and pains, and it is not very easy to remember what is the matter with them all, though I know very well all the details about those who are very ill and have much done for them in the night.

There is one place I don't enjoy visiting, and that is the strong room at the top of the surgical buildings. Lately we seem to have had so many men who go off their heads (generally from drink), and if they are left in the wards they disturb the other patients so much that it is better for them to be moved, and then they have male attendants up there; but these male attendants are not members of our regular staff (I wish they were), and I never feel that I quite know their capabilities, or how much I can trust them, and more than once I have found them asleep; so I have to go up very often when any patient is bad there.

I remember one night we had a very lively time of rushing about. We began with a man who had cut his throat—not very bad, but he had to go up to the theatre; then a lady who had taken three ounces of laudanum, and the doctors had to keep her walking up and down the corridor, with a weary porter on each side of her, for six hours before they thought it safe to let her turn into a bed; then I was called to a poor man in Ward P., who got worse, and died rather suddenly—a phthisis case; next a tracheotomy came in, and had to be done at once, and while we were all busy with it a baby was born in Ward D.; but the day sister had to be called to attend to that, as I was mixed up with the diphtheria case, and could not go near a confinement; then a fractured femur came in, and next an acute pneumonia—rather delirious. In the intervals of receiving these new cases and sorting them to the different wards we had to brew strong coffee and administer it to the lady who had taken poison, and provide refreshments for the porters who were minding her. In the early morning she was allowed to go to bed and to sleep; she recovered very soon, and I don't think she will do it again!

I joined the Royal National Pension Fund for Nurses a few months ago; it seems to be a good thing, and if I can only keep up the premiums I shall have the noble pension of about £20 or so when I am fifty; it will keep me in extras when I retire to the workhouse, as I am certain no one can go on nursing for a great many years at the pace we have to go in hospital.

Just now I am having a rest (and another sister is rushing about on night duty), as I have been warded for the past fortnight, and in a few days I hope to go home for a change.

I had a cold for many weeks, and did not pay much attention to it, as I thought it was only because I was about all night and did not get enough sunshine to help me to throw it off; but then I got very bad headaches, so I had to see a doctor, and he passed me on to our nose specialist, who has been most awfully kind, coming down every day, and sometimes twice a day, to see me. It was not really a cold, but some disease in the antrum, and he has done two small operations for me, and it has been horridly painful, but now it is getting well rapidly, and every one has been most awfully good to me, and I am beginning to feel less of a limp rag than I have done for some time past.

It was funny spending Christmas as a patient instead of running about looking after the patients; but it was nearly my first day up, so I was glad enough to be lazy, and I have had many visitors, so it has not been dull at all.