28 The Hospital Requirements of Sydney. 



In either case, all the wards should be placed in the pavilions 

 or wings, and the whole of the administrative accommodation 

 must be provided in the portion set apart for it. 



It is not necessary that the pavilions be placed parallel, or in 

 any other fixed relative position to each other, but it is important 

 that they shuold be detached, having ample space between them, 

 to allow the sun and air free access to the walls and intervening 

 ground. 



The aspect of the main walls should be carefully selected in 

 reference to the prevailing winds, and the rays of the sun. The 

 summit of a hill ought to be preferred. Corridors or covered 

 ways must be provided, communicating between the ground floor 

 of the administrative department and that of all the buildings. - 



The height of the pavilion should not exceed three floors, and 

 Miss Nightingale gives the preference to two. The disadvantage 

 of a third floor is considered by her to consist of the additional 

 labour and intelligence required to carry out the administration, 

 nursing, &c. Without depreciating the advantages of the two- 

 floor system, I am of opinion that a third is quite compatible with 

 health, perfect ventilation, and sufficient surveillance, to insure 

 which it is only necessary to provide those structural arrange- 

 ments and appliances which no hospital should be built without, 

 while the addition of deep verandahs to each tier of wards (which 

 should always be made in this climate) will quite remove any pos- 

 sibility that the atmosphere of an upper ward could be contami- 

 nated by that below it. 



It appears to me, therefore, that should special reasons exist 

 for designing pavilions with a third floor, and the ground is 

 favourable for the purpose, there is no valid objection to the 

 course, while the saving in cost of erection at per bed will be con- 

 siderable. 



The new St. Thomas Hospital has three tiers of wards in some 

 of the pavilions, and four in others. 



The size of the wards should be that which is best adapted to 

 perfect ventilation, efficient nursing supervision, and which en- 

 sures a proper classification of patients. In a hospital of 300 

 beds and upwards, wards containing from twenty to thirty beds 

 are found to be most suited for general use. But each ward of 

 more than thirty beds, or each two wards of twenty beds, should 

 possess a small adjoinining ward for two beds to receive cases 

 which require quier and special observation. The best position 

 for it is near to the sisters* room. 



Wards of a small size are generally objectionable, because un- 

 favourable to discipline, inasmuch as agnail number of patients 

 in a ward, without the presence of a head nurse, more readily 

 associate together for any breach of discipline than a large num- 

 ber. One sister is capable of superintending fifty patients if 



