Nursing. There are few subjects affecting our social and domestic life in which more interest is taken at the present time than in the nursing of the sick, and there are not many in which time has brought about so great an improvement. Fifty years ago a well-trained and qualified nurse was almost unknown, and, consequently, the care of the sick often devolved upon persons totally unfit for, and ignorant of, the duties required of them. Now there are large numbers of refined and sympathetic women, thoroughly trained in all the different branches of nursing, whose services can be obtained at a moment's notice. It was Miss Nightingale (q.v.) who first awakened the public mind to the need that existed for trained nurses, and who thus opened up, what has proved to be, such a large field for the employment of women taken from all classes of society. Dating from the time of her heroic services in the Crimea, the interest taken in sick-nursing has gone on steadily increasing. As a national recognition of her self-devotion the first training-school for nurses was in 1860 founded in London in connection with St Thomas's Hospital, under the title of the 'Nightingale Fund Training-school for Nurses.' The number of probationer nurses, at first 15, had in 1871 increased to 32; and up to 1889 upwards of 500 trained nurses had been sent out from the school. The different branches of nursing are hospital nursing, private nursing, district nursing, army and navy nursing, and workhouse infirmary nursing. Monthly nursing, massage, and attendance on the insane may be regarded as special developments arising out of ordinary sick-nursing.
For those who desire to make nursing a profession, a thorough hospital training is now absolutely necessary. Hospital training may be had in two ways, either by paying a certain board for a limited period, or by receiving wages and being under agreement to remain in the hospital for a certain term after training. The duties of a hospital nurse are arduous, and can only be successfully performed by those who are possessed of both bodily and mental strength, as well as of a real interest in attending on the sick. Some of the work is simply that of a housemaid, such as dusting the ward and cleansing the utensils. At the Glasgow Western Infirmary, for instance, the probationer is trained in 'the dressing of blisters, burns, sores, wounds, and in applying fomentations, poultices, and minor dressings; in the application of leeches, both externally and internally; in the administration of enemas; in the best method of friction to the body and extremities; in the management of helpless patients—i.e. feeding, moving, changing, their personal cleanliness, preventing and dressing bedsores; in bandaging, making bandages, padding and lining splints; in making the beds of patients, and removing sheets while the patients are in bed; in sick-cookery, such as the making of egg-flip, gruel, &c.' The probationer has usually to wait on the doctor and staff-nurse or sister as well as on the patients, and she must attend the lectures on various medical and surgical subjects that now form part of the training in most hospitals. After training as a probationer in the management of medical and surgical cases, including both day and night work, the usual course is to become ward- or staff-nurse, or to leave the hospital for the special kind of nursing which is intended to be followed. A certificate is usually given at the close of the period of training. The age at which probationers enter the adult hospitals is from twenty-five to thirty-five, and from twenty to thirty at the children's hospitals. The salaries are usually £10 the first year, £15 the second, £20 the third. Uniform is provided in addition, and a certain amount of washing allowed for. Sisters or head-nurses receive from £30 to £60, matrons from £100 to £250. It is often necessary to wait for months before getting into any of the large hospitals, as there are always many more applications than vacancies. At the Edinburgh Royal Infirmary there are usually over 500 applications yearly for the 25 vacancies. The principal training-schools in London are London Hospital, St Bartholomew's, St Thomas's, Guy's, and St Mary's; in Scotland, the Edinburgh Royal Infirmary and Glasgow Western Infirmary; in Ireland, the principal hospitals in which training may be obtained are Sir Patrick Dun's, Adelaide, and Meath in Dublin, and the Royal Hospital in Belfast.
Probationers are also trained at the Hospital for Sick Children, Great Ormond Street, W.C.; Manchester General Hospital and Dispensary for Sick Children, Pendlebury; and Royal Hospital for Sick Children, Edinburgh. Application should be made in writing to the matron of any of these hospitals. Many of the Irish hospitals, such as the Mater Misericordiae in Dublin—the largest and finest hospital in Ireland—are nursed by Sisters of Mercy.
Private nursing is in some respects both more difficult and more trying than hospital nursing. The responsibility is greater as the doctor is not always at hand, and the nurse has sometimes to attend to her patient both night and day. The pay is usually from 1½ to 3 guineas per week.
Queen Victoria, taking great interest in district nursing, devoted the surplus of the Women's Jubilee Offering, amounting to £70,000, to the foundation of a systematic scheme for the training and support of district nurses, to which was given the name of Queen Victoria's Jubilee Institute for Nurses. The interest of this sum, about £2000, is employed in the maintenance of central institutions, where nurses are trained for this special work. There are at present four of these centres, in London, Edinburgh, Dublin, and Cardiff. Nurses who have gone through the required training at any of these Homes are eligible to be entered on the roll of the Queen's Institute, and are entitled to wear the badge as Queen's nurse. The special teaching required, after a year of hospital work, consists of six months' approved training in a central district home, and, for country members, three months' approved training in midwifery. The scheme, started in 1887, has already made great progress, and in different divisions of the United Kingdom many branches are now working with much acceptance. This system offers a rapidly extending field of usefulness to those who wish to follow the profession of nursing, and there is an increasing demand for candidates to fill the growing number of vacancies created by the spread of the movement.
The army and navy nurses must all be ladies of good social position, and require to undergo three years' training in a general hospital. They are called Her Majesty's Nursing Sisters, and may be ordered on active service in any war. As a reward for special service they receive the order of the Royal Red Cross. It is only of late years that trained nurses have been employed in our workhouse infirmaries, but it is now becoming quite common to find them there. There is a great demand for trained nurses to go abroad. The Royal National Pension Fund for nurses was established in 1887, and promises to be of signal service in providing for those who spend themselves in the struggle against disease and death.
Most of the large hospitals in the British colonies follow the example of the mother-country in regard to nursing arrangements. In America the practice of nursing is very thoroughly taught in many of the hospitals, particularly those in the north-eastern states, such as the Bellevue Hospital in New York, the Long Island Hospital in Brooklyn, the Philadelphia and Pennsylvania Hospitals in Philadelphia, and the Massachusetts General Hospital in Boston. On the continent of Europe the employment of male nurses to attend male patients is common, and in the Roman Catholic countries the nursing of the hospitals is for the most part in the hands of Sisters of Mercy. In Germany a great impetus was given to improvements in nursing by the late Empress Augusta, the Empress Frederick, and the late Princess Alice of Hesse. The training of nurses on the lines adopted in Britain was instituted in Paris during 1877, by the establishment of l'École de Garde-malades et d'Ambulancières.
See Miss Nightingale's Notes on Nursing (1860; 2d ed. 1876); Dr J. W. Anderson, Medical Nursing (1883); Handbook of Nursing (Phila. 1879); S. Weir Mitchell, Nurse and Patient (Phila. 1877); Eva C. E. Lückes, Lectures on General Nursing (1884), and Hospital Sisters and their Duties (1886); Dr C. J. Cullingworth, Manual of Nursing, Medical and Surgical (1883; 2d ed. 1885); J. C. Wilson, Fever Nursing (Phila. 1888); E. T. Bruen, Outlines for the Management of Diet (Phila. 1888); and for much useful information, Burdett's Hospital Annual.