776 



SCIENCE. 



[N. S. Vol, XI. No. 281 



administrative work as superintendents of 

 hospital training-schools for nurses. 



The entrance of women into hospital life 

 and work is one of the sociological advances 

 for which the medical profession is mainly 

 responsible, a responsibility having a serious 

 ethical as well as an important economic 

 side. 



Under present conditions the training- 

 schools furnish to the hospitals a much 

 better service than could otherwise be ob- 

 tained, one which has contributed much to 

 the precision and fidelity of the work done 

 and which has moreover exercised a gen- 

 erally beneficial effect upon the morale of 

 the patients. 



The course of stiidy of the hospital-trained 

 nurse is a severe one, usually of two years' 

 duration, but now being lengthened to three 

 and four years ; the woman who enters 

 upon, and continues in it, has a liberal edu- 

 cation in the deterrent side of human life 

 and, if she graduates well, comes out of the 

 hospital to enter individually upon a voca- 

 tion in which she is likely to find herself 

 set apart from the society about her, even 

 more than is the physician. 



For, while the physician has his medical 

 societies and other social relationships with 

 his fellows, the nurse has only the aflSlia- 

 tion with her training-school and hospital ; 

 that she often finds it difficult to cope with 

 the competition in her profession and the 

 discomfort of an uncertain income, is shown 

 by the tendency to re-enter institution-life, 

 even at moderate salaries, among nurses 

 who have been in private practice. 



The trained nurse has now been in ex- 

 istence, as a community factor, a sufficient 

 length of time to make statistical estimates 

 possible, and it appears that the active pro- 

 fessional life of the nurse, outside of insti- 

 tutions, is covered by an extreme limit of 

 fifteen years, and that her average annual 

 income is that of the average woman 

 teacher. 



The teacher has a regular stipend, al- 

 lotted hours of work, and a definite holiday ; 

 the nurse, in private practice, has no regu- 

 lar stipend, no protracted leisure, and leads 

 an economically irregular life, with oc- 

 casionally extraordinary demands upon her 

 strength and powers of endurance. 



The medical profession, which has created 

 the trained nurse, to its own great advan- 

 tage and with considerable extension of its 

 helpfulness, owes a debt which should be 

 acknowledged not onlj'^ individually but 

 generally. 



The provision for lodgment of nurses in 

 separate buildings where they may, when 

 off duty, have the comforts of a home, is a 

 step in this direction ; here also the training 

 in the hospital is supplemented by instruc- 

 tion in housekeeping, purchasing, and diet- 

 kitchen work, and the nurse thus educated 

 who goes into private practice and becomes 

 temporarily the member of a household, 

 does so with a better knowledge of the per- 

 plexities which may beset the housemother 

 when illness cuts across the line of home 

 affairs. 



Another question which is coming to the 

 front is that of the establishment of co-oper- 

 ative training schools, in which a nurse, 

 having served her probationary period and a 

 year or more in one hospital, is passed on to 

 a second and third hospital, either of a dif- 

 ferent class or in another city, returning to 

 the first hospital for her final service and 

 graduation. Under this plan the nurse, ad- 

 mitted only on an entrance examination 

 and first trained in a general hospital 

 would continue her studies in a lying-in 

 hospital, a children's hospital, some special 

 hospital, and in a hospital for contagious 

 diseases, and the higher educational stan- 

 dard required of applicants, the length of 

 the course and its completeness, would tend 

 not only to furnish a better class of women, 

 more competent to succeed in private prac- 

 tice, but would help to prevent that over- 



