NURSES, TRAINED. 



453 



Edinburgh, has a world-wide reputation, and so 

 has the Adelaide Hospital, Dublin. Cork, also, 

 lias excellent training schools. Indeed, Ireland 

 was better off for nurses than England in former 

 days, for she always kept the Sisters of Mercy, 

 and some of these in late years have come under 

 modern training. All over the United Kingdom 

 district nursing of the. sick poor is now carried 

 on under certain associations and supported by 

 voluntary contributions; most villages even have 

 their parish nurse, and in England these are under 

 the auspices of the Queen Victoria Jubilee Insti- 

 tute for nurses. 



As to rules, the schools are about the same as 

 those in America, which were modeled after them. 

 The supreme authority is usually centered in a 

 matron or superintendent, who herself must have 

 gone through all the curriculum of trained nursing. 

 In large London hospitals, under her are assistant 

 matrons, or head nurses, and " home sisters," who 

 attend to affairs in the house in which they live. 

 Over each ward of 20 to 30 beds is a sister, who 

 is directly responsible to the household and visit- 

 ing physicians for all the patients of her ward; 

 under this woman is generally a responsible staff 

 nurse to every 10 or 15 beds, and under her as 

 many pupil nurses as the necessities of the ward 

 demand. The routine order is, if the inferior 

 nurse notes any change in the sick she must report 

 to the nurse above her, the latter to the head 

 nurse, the head nurse to the house doctor, the 

 latter in turn to his superior, the visiting surgeon. 

 Much red tape is connected with trained nursing. 

 There are also rules innumerable about provisions, 

 storeroom supplies, medical supplies, bedding, 

 cleanliness of wards, closets, kitchens, etc., for all 

 of which the superintendent must be responsible 

 to the house committee. 



Nursing in America, although it has not under- 

 gone the vicissitudes that attended it in Europe 

 especially on the Continent has yet had a some- 

 what checkered history. In early days the best 

 nursing here, as elsewhere, was done by Sisters of 

 Charity, who did the best they could both in hos- 

 pital and district nursing in such cities and towns 

 as would let them in. They had little or no 

 chance in New England, and hardly any in New 

 \ork; and to allay the Puritan spirit of opposi- 

 tion against them in Philadelphia the Society of 

 Friends founded a nursing school in 1838. It does 

 not appear, however, that the nursing was carried 

 out on more scientific plans than that done by the 

 sisters. It is said that as early as 1770 Dr. Sea- 

 man used to lecture to a class of 24 nurses in New 

 York city in what was then the nucleus of the 

 present Bellevue Hospital. But the practice ap- 

 pears to have died with him. It was through 

 the exertions of a committee of ladies of the State 

 Charities Aid Association that permission was ob- 

 tained of the medical board to start the Bellevue 

 School. They secured a house opposite the hos- 

 pital, on East Twenty-sixth Street, as a home for 

 nurses, and, receiving assurance that the necessary 

 changes would be completed on May 1, 1873, they 

 agreed to begin work in the wards on that date. 

 It was not easy to secure a competent superintend- 

 ent, but at last they induced Miss Helen Bowden, 

 of the University College Hospital of London, to 

 fill the post. This lady was known in England 

 as Sister Helen. She possessed a thorough train- 

 ing and wide experience in all matters pertaining 

 to hospital nursing, and had also a reputation for 

 energy and executive ability. She had for assistant 

 one as energetic as herself Miss Van Rensselaer, 

 of New York. Together they guided the infant 

 school during its first and most trying years. To 

 quote from the records: " The standard of qualifi- 



4UOL 



cations was placed high, and, although there was 

 not the large number of applicants for admission 

 looked for by the managers, the standard was not 

 lowered. Only 4 appeared for the place of head 

 nurse, and Sister Helen accepted 3 of them. Only 

 29 sought admission to the school in the first seven 

 months, and 10 of these were rejected. The Board 

 of Managers, of which Mrs. William H. Osborne 

 was chairman and Mrs. A. P. Woodward secretary, 

 received in this year donations to the school from 

 many citizens of New York to the amount of 

 more than $22,000, and many of the necessaries 

 for furnishing the house besides." 



To quote again from the records, those employed 

 before the opening of the school were to the " last 

 degree incompetent. They were ignorant, indif- 

 ferent, dishonest. They were eye servants. Sairy 

 Gamp and her ' pardner,' Mrs. Prig, were ubiqui- 

 tous. They r ' drank fair ' and only attended to their 

 patients when ' so dispoged.' Nurses and general 

 helpers about the hospital were heirlooms from 

 primitive times. . . . Most of them had just served 

 enforced time at the island, and worked without 

 pay for the sake of the board and lodging and 

 the dishonest perquisites they obtained." 



In the second year 4 more wards were placed 

 in charge of Sister Helen, making 9 in all 3 fe- 

 male medical and 3 male medical and 3 female 

 surgical wards. Already trained nursing was 

 growing in popular favor. There were this year 

 118 applicants, of whom but 29 were accepted, 

 and only 20 of these were kept longer than the 

 probation month. The first class, graduated in 

 1875, included 6 nurses. The best one of these 

 went to superintend the training school then es- 

 tablished at Boston. 



This same year another training school was es- 

 tab.'.shed on Blackwell's Island, and it is still in 

 vigorous life, having completed its twenty-fifth 

 year, with about 60 regular nurses, who have a 

 connection with the City, Maternity, Gouverneur, 

 Fordham, and Harlem Hospitals. The City Hos- 

 pital male training school is also on Blackwell's 

 Island. 



The aim of the mother school at Bellevue will 

 explain the aim of all the others that followed 

 it, viz., first, to improve the condition of the hos- 

 pital sick; second, to utilize the hospital as a 

 clinical school for instruction in the art of nurs- 

 ing the sick among rich and poor alike. These 

 objects have been achieved. All authorities now 

 admit that neither the practice of antisepsis nor 

 the application of modern sanitary law could be 

 made practical without the co-operation of intelli- 

 gent nurses. The fact that in 1893 there were 

 1,860 applications for entrance into the training 

 school at Bellevue will suffice to show how nursing 

 has grown in favor among women. Out of these. 

 39 were accepted on probation. The probatory 

 period covers one month. If found acceptable at 

 the end of that time, the applicant enters as pupil 

 and pledges herself to remain two years. The 

 standard number of nurses at Bellevue is 64. The 

 best of the class each year, after passing through 

 examination, are selected for the place of head 

 nurse, one of the responsibilities of which is the 

 training of pupil nurses. The training covers the 

 care of men, women, and children in medical, 

 surgical, gynaecological, and obstetrical cases, 

 through all the vast range of diseases admitted to 

 Bellevue. The curriculum includes, besides in- 

 struction by the medical and surgical staff, didac- 

 tic teaching by a corps of lecturers and by the 

 assistant superintendent in anatomy, physiology. 

 materia medica, and practical nursing. There are 

 also lessons in cooking by the cooking school. 

 Special training is given in care of the insane. 



