Chaos and order in hospital Nursing

1. Chaos and order in hospital Nursing Haley Strickland Roger Burnett Michelle Cheshire

2. 19th Century Hospitals Hospital was a home for: • Sick • Dependent poor • Poor with long term illness Not for… • Middle class • Upper class • Acute care

3. Public Vs. Voluntary • Public hospitals were hospitals by increments as urban almshouses to provide space for the sick among the indigent inmates. • Voluntary hospitals were established by wealthy benefactors because of personal ties to physicians, a belief in moral stewardship, and the belief that the “deserving and respectable poor” who were ill should have a place other than the almshouses.

4. Hospital Funding Public and Voluntary Hospitals funded by: • Church societies • Donations and bequests • Charity • Governmental outlays

5. Special Care • Voluntary hospitals reserved some space for “pay patients” who would pay extra for their care. • These patients received preferential treatment and resided in special rooms equipped with expensive draperies and furniture. • Hospitals had only 1-2 of these type rooms available.

6. Hospitalism • Filth and neglect characterized many of the wards in public hospitals. • “Hospitalism” was very common and included: • Dirt • Vermin • Rampant cross-infections

7. Hospital nursing vs. Home nursing Hospital nursing = not respected job Home Nursing = respected job

8. 19th Century Hospital Organization Hospital trustees Hospital superintendent Hospital Matron Physicians Nightwatchers Laundresses Nurses Cooks Kitchen helpers

9. 19th century hospital nurse Hospital nurses were women who were… “too old, too weak, too drunken, too dirty, too stolid or too bad to do anything else”…….Florence Nightingale

10. 19th century Nurses Georgia Sturtevant- Massachusetts General served 1862-1895 Eliza Higgins- Boston Lying- In Hospital served 1873-1913 These hospital matrons kept journals and notes related to their responsibilities as matrons… this gives us a glimpse of nursing prior to the time when nurses were formally trained.

11. Hospital Nurses living conditions • Hospital nurses most times lived in the hospital with the patients, the nurses were in attic spaces or corners of the wards with the patients. • Food was provided for patients but not always for nurses. • Patients many times had sterling silver utensils to eat with, nurses if they had food, used pewter utensils.

12. Nurses hours and duties Work day from 5 am – 9:30 pm Duties included: • Feed patients • Wash dishes • Sweep • Dust • Changing and washing surgical dressings • Assist with some operations • Continuous cleaning of patient areas

13. Nurse Hiring and Retention • Hospitals willing to hire anyone who would take the job. • Eliza Higgins hired sisters and sisters-in-law of reliable nurses. Also used word of mouth and newspaper ads. • Constant personnel changes • Young nurses: willing to do anything else that came along. • Older nurses: willing to dedicate their lives to institutions.

14. Some things have not changed One thing that existed in the 19th century was tension between doctors and nurses. At that time nurses complained that doctors were “ungentlemanly” in two categories 1. Behavioral Lapses smoking pipes in the wards yelling at nurses too physically attentive to nurses. 2. Professional Lapses leaving the hospital while on duty Not following proper procedures making unreasonable demands

15. We’ve come a long way…. 19th century 21st century nurse nurse