Though a great deal has been written on hospital nursing--though it has been led before the public in many guises, has been treated to laudatory, cavilling, and depreciatory remarks--it still seems to necessary to say a few more words on the subject, at the risk, perhaps, of a little wearisome reiteration; but we must remember that 'it is repetition, not novelty that produces the strongest effect; and phrases, like tunes, are a long time making themselves at home in the brain.'
This paper, if it needs any apology, finds it in the fact that it is the outcome of anxious thoughts born of experience and nourished at the side of the stern mother reality. For there are some who, while living in this particular sphere of usefulness, try to weigh truly for themselves and their fellow-workers the many serious difficulties and temptations which balance the joys and pleasures. And these long to speak words of warning or advice, which will open the eyes of those young ardent souls who wish, or fancy that they wish, to join the band of hard-working hospital nurses. They long, too, to help those who, having begun the life well, fail to live it truly, lacking the force of the best motive; or those who take each step with the unwholesome consciousness that they would like to be martyrs in the eyes of others.
We talk of motives, and I think of some that bring probationers to our hospitals. I know of one girl who acknowledged that she took up nursing because she found her dress allowance quite inadequate for the demands of a London season. Another came with the boasted purpose of getting married.
Many keep their reasons to themselves, but often cannot find in their hearts much worthier motives than these.
How infinitely better it would be for all concerned, if they could know the weight and labour of the plough to which they are so lightly putting their hands! Then let me try to give them and others a wider conception of the life than that expressed by a certain lady acquaintance.
'Oh, how beautiful your work must be!' she said to a hospital nurse. 'How happy you must feel, going up and down those interesting wards, putting a poultice here and a poultice there!' *
We hear and read a great deal about the hardships of a nurse's life or of the inconsiderate treatment she receives at the hands of the hospital authorities. Almost every magazine or daily paper wishes to say something upon the subject. As a natural consequence, nurses stand before the eyes of the world in the double characters of martyrs and 'ministering angels.' The former they most emphatically are not; the latter--well, they do minister to the sick and suffering, whether rich or poor, and it is the glorious badge of their office that they may do so. But it is not good that this kindly babel of applauding tongues should chatter so unthinkingly in admiration of or pity for them. Of course, those who work in large city hospitals know full well how many improvements must be made before a nurse's surroundings are idealistic; but they should not forget how infinitely superior their lot is to that of their sisters who went before them. They should rather be content to wait, knowing that those in authority are trying their utmost--slowly, it may be, but surely--to improve the position of all who call themselves by he beloved name 'nurse.'
Twenty years ago--perhaps ten, or even five--we find, on looking back, how real were the hardships endured by those who first entered the nursing ranks. We read of herculean efforts to reform important public institutions; of lasting results accomplished by undaunted women possessing no greater physical calibre than our own--women, in many cases, who said nothing of themselves, who toiled on patiently in obscurity, doing their work and laying down their lives, unknown of men, untouched by fame, who not only said nothing of themselves, but had no one to say it for them.
It is reserved for those who tread more easily the beaten track, which tore the feet of those pioneers, to receive the meed of praise, which is hardly in part their due. And they forget this. Thirty-nine years ago, Florence Nightingale, in the face of the world--and a very perplexed world too--stepped quitely from the ranks of educated women and entered a breach which she alone could fill. The hearts of men and women will always quicken and throb with enthusiasm whenever her name is mentioned, and well may those who try to follow in her footsteps thank God for her bright example. For she it was who showed them first the way--who drew back the curtain of conventionality which hung before the crowds of English women, sitting waiting in the twilight of inactivity for an emancipating hand. She led them into the daylight and sunshine of consecrated work, and herself showed that we may go into the thick of life's battle and yet remain modest and true, pure and holy, the truest women still.
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What is a nurse? What is required of her? What powers of mind and body must she be prepared to offer up in the cause for which she lives? What will she be?
It is easy enough to look round and then to tell you what she must not be. To define in a few words an ideal nurse is almost impossible. But I can tell you three qualities which every nurse, or would-be nurse, must possess: she must be a good woman; she must be a tender woman; she must be a brave woman.
I will presently let a hospital nurse dwell--in her own words--upon the value of these three items. But I want to urge an important matter. Why will not those women who feel within themselves the stirrings of life--the soarings after any high or noble work--cultivate first, in their own sheltered homes, these golden qualities, goodness, tenderness, bravery? In their train might follow the acquisition of lesser, but very valuable habits, such as early-rising, orderliness, self-restraint in word and action, and a good memory.
Many probationers enter the large hospitals of London in absolute ignorance of what is required of them. They come, perhaps, from homes of luxury, from the artificial ways of society, from idle lives, fired by a passing idea that nursing will interest them. They come from the world of 'being-waited-upon' to another, where everything must be done by and for themselves and those dependent upon their care. The routine--especially during the usual three months' probation--is one of hard manual labour, including cleaning, scrubbing iron bedsteads, rubbing brasses, and scouring baths. The day's work extends through long hours of duty, and entails a constant strain, not only on the mind and body, but--an important detail--on the memory as well The hospital nurse finds herself face to face with disease of every kind, loathsome sights, foul smells, and death in all its saddest and most pathetic varieties. She may have to conquer an inborn sickening repugnance to the sight of blood. What will she do? A strong will prayerfully wielded must come to her aid. She must echo the brave words of the Duchess Maria Josepha, the Royal surgical nurse, who had just such a nervous shrinking to conquer, and say with her, 'What others can endure, I can bear to see.' But the battle will only be to the strong. Instead of the accustomed daily drives or healthy walks, the nurse will have to content herself with a 'pass' to the outer world for two or three hours once or twice a week, and a 'long day' once a month. If she complains of fatigue, it is only to be told cheerfully, 'Oh, we all feel the same! You will get accustomed to it by and by.'
Does not this all prove what a serious consideration even the physical qualifications become? And do you wonder that women fail and drop out of the ranks day after day? The real wonder is that many more do not do the same.
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I have pointed out some of the shadows in the dark side of this picture of hospital life. My thoughts gladly turn now to those joys--very special and very heart-filling, that lie like gleaming bars of sunlight across the canvas.
When a long hand-to-hand fight with insidious disease has strained a nurse's energies and filled her heart with alternating hopes and fears, the unexpected signs of returning consciousness and renewed strength, each feeble step safely accomplished towards convalescence, are delights indeed.
To some there comes the supreme moment when the prompt action of a firm unerring hand saves a life at a time of unforeseen peril. Then the look of warm approval in the face of a great doctor, the congratulatory hand-clasps of her fellow-workers, the strange uplifted feeling that carries her through the hours that follow, are wonderful experiences, very sweet while they last. But they are usually followed by a reaction when she sees herself as she really is--when the 'remorseful fear' of herself will come with 'every smile of partial friend,' and she can only say humbly, 'Not unto me, O Lord, not unto me.'
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A hospital nurse was asked to write a few words of advice to some probationers. The gist of what she said I have already given. 'Be good. Be tender. Be brave,' she wrote at the head of the paper; and then, because her heart was very full, she went on with eager pen, 'Be good first. You will find in your busy life no time for meditation. and very few moments for prayer. But you may cultivate that necessary habit of a faithful nurse, the practice of praying as you work. Each action may be dedicated with a silent "For Thy dear sake," for that is the thought which should live with you and be your very breath. It is possible while actually scrubbing and cleaning to raise the heart on high, and to ask for the graces which you most need. At least you may pause and repeat, with your hand upon the door before entering the Ward and beginning your day's work, that noble soldier's prayer, "Lord, I shall be very busy to-day. If I forget Thee, yet do Thou remember me." A hospital life is one of constantly recurring emergencies, calling for a continual spirit of recollectedness.
'Be tender. Do not let the sights you must see, and the work you must do, make you careless of the sufferings of the least of God's children. Remember that a heedless word or an uncontrolled look may wound the feelings of a suffering sister, if it does not sow the seeds of coarseness in your own heart. Why should we suspect the lower classes of less sensitiveness than we ourselves possess?
'Lastly, be brave. Do not be ashamed to stand to your colours. Be brave enough to refute gossip, the bane of hospital life. Be brave enough to say a good word for, or to, some one who may have got a bad name by misunderstanding perhaps, or by mistake. Be brave, again, in overcoming any tendency to carelessness in your life. It must be either advance or retreat. It requires, believe me, a constant courage, a courage of the highest type, to resist the tendencies which crowd upon us from every side to blunt our susceptibilities, and make our natures lower instead of higher than they are. For when we leave our quiet homes to live between hospital walls, our view of life is suddenly widened to such an extent that we must fix our eyes upon the boundaries, lest in the confusing details--the seemingly contradictory facts--which move before our eyes, we lose sight of the great truth that its horizon merges in the infinite, and that God is our Father.
'If we fail in this, we see only the seamy side of human life, and by constantly dwelling upon that we, perforce, become lower, coarser, more impure. Once again, be brave to take up the manual labour that must be part of your life--not as a duty beneath you, as something to be hurried over, or handed on to an inferior, but in the spirit of appreciative cheerfulness. It is quite right that some amount of scrubbing, cleaning, and dusting should fall to your lot. How can you teach others if you cannot do yourself ? What should we become if there were no possibility of counteracting the depressing influences of our surroundings by a little wholesome labour? You will find the sweeping and scrubbing can have quite an exhilarating effect upon you, and no satisfaction exceeds that of looking round upon your ward done from beginning to end by yourself and your probationer. I am quite sure that, in the working of a nurse's life, there are many improvements still to be made--that more nurses might be provided to do the work now accomplished by the few. But many others share my opinion, that it is a great mistake to try and make the life of a nurse into that of a fine lady instead of a working woman.
'By all means let the educated women of England--the highest ladies in the land, if you will--become the nurses of the poor. But let them come among us with a thorough knowledge of what it is they undertake, and willing, with that knowledge and a pure motive, to live the lives of earnest working women.
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It remains for us to treat, with a few practical suggestions, of the distinctly business aspect of the subject.
We will say that the would-be hospital nurse, having attained the age of twenty-three, which has been wisely decided to be the earliest at which it is well to enter on the life of a probationer, has decided in her own mind which institution she wishes to enter, choosing probably one in a large city, where the system is good and the experience likely to be wide and profitable. Her next step will then be to write to the matron, asking for rules and regulations for the nursing staff. These are returned to her, and in many cases are accompanied by a note to the effect that there will be no vacancy for some months, unless she should wish to enter as a paying probationer.
She has now two ways open to her: either to wait, we will say, for twelve or for eighteen months--an interval which might be wisely spent, as I have already said, in useful matters of self-training in her own home; or to begin as a 'special' probationer paying, usually, one guinea a week. If she decides upon the latter course, she can step into an ordinary probationer's position afterwards, should the opportunity offer before she is a qualified staff nurse.
In the general run of hospitals, the special probationer and the ordinary probationer live in separate houses and have to keep rather different hours. The former has the lighter work, and so, probably, a less useful training. She is on duty from 8.30 in the morning to 7 or 8 at night; but has two hours off duty every afternoon, when she can always obtain a pass to the outer world. In some hospitals she is exempt from the scrubbing, rubbing, and cleaning that falls to the lot of an ordinary probationer.
For her--the ordinary probationer--the day begins at six o'clock. Breakfast is at 6.40, and she is on duty in the wards from 7 A.M. until 8 P.M., with the exception of three hours off duty every alternate day, and a whole day once a month. Half an hour is allowed for dinner, and the same length of time for tea.
A probationer's duties vary in detail in different hospitals; but there is no doubt that these first months of training are by far the most arduous, when we remember that spare moments should be spent in reading up certain books that will be recommended to her, and in other practical ways coaching herself for the examination she must pass, at the of her first year, before she can become a staff nurse.
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And, then, what about an occasional amusement, a change of scene and sights? These certainly are welcome and helpful, but while a probationer is serving her time--indeed, during the first year or two of hospital work--if she can persuade herself to refuse, as a rule, all evening engagements that will keep her out late at night, she will soon reap the full benefit of her self-denial in the good that she will receive from her regular, full measure of sleep and rest, every hour of which she will find she needs.
And, lastly, one small matter occurs to me. When you are preparing to leave your home, and are looking round your pretty bedroom, while you ask yourself which, and how many, of these best treasured possessions and dainty 'knick-knacks' you shall take with you, give a thought to the hard-worked maids of the nurses' home, who will have to dust and tidy for you. Take only what will rest your eyes and tune your mind to homeward or upward thoughts.
* A fact.