Part 7

GENERAL HOSPITAL, LONDON, _December 1896_.

I think I last wrote when I had just taken charge of C. Ward for two months.

I had a most interesting time there, and was quite sorry to give it up, but it was hard work. Unlike the other wards, that "take in" new cases for a week and then have a rest, C. is always "taking in," as the men in charge see every new case that comes up to the hospital (except accidents), and they can take them in if they like, as long as there are any beds empty in the ward; and if they don't think it is a particularly interesting case, it is passed on to the house surgeons or house physicians for the other wards; but, of course, they try their best to get all the most interesting cases for themselves; consequently the sister is never free to go out with any confidence that no new cases can be landed in while she is away; and when you do go out you generally find on your return that something has happened that makes you wish you had never gone!

Still I learnt a great deal in my time in that ward, and I enjoyed it. The physicians' talks with the students over these "selected cases" were most instructive.

Soon after I took charge we had a run of tracheotomies; the first was a dear, fat baby of thirteen months, but it had diphtheria very badly, and was not a hopeful case from the first; not many hours after it was operated upon another came in--a sweet little boy of three called "Alex." He was much relieved by the operation, and got on so well; but the poor baby ran a temperature of 106° all through the second day, and died late that evening with a temperature of 108°, in spite of all we could do for it. I believe we were much more cut up about losing it than the mother was; she did not seem to mind a bit, and apparently had made all her plans for the funeral beforehand--and it was such a pretty baby too!

The special nurses I had for these tracheotomies had never nursed one before, so you can imagine I could not leave them alone much, and was thankful I had had a good many to nurse when I was a lady pupil.

We had one very curious case. A young man was brought in unconscious one afternoon about 2 P.M.; a little after five he got worse, and his respiration suddenly stopped, the pulse went on steadily, so they did artificial respiration; this went on till 9.30 P.M., and then they decided to trephine, thinking it must be a cerebral tumour pressing on the brain; of course no anæsthetic was necessary, as the poor man showed no sign of life except that the pulse was beating; they could not find any tumour, so he was put back to bed, and the men went on doing artificial respiration all through the night in turns, until the pulse suddenly stopped at 9.15 A.M., sixteen hours after the respiration had ceased--a very strange case.

We often had rushing days, when it seemed impossible to make time for meals, and scarcely time to breathe. I remember one day especially, when we took in seven new cases, two of them, curiously enough, men from quite different districts, who had both taken oxalic acid with a view to suicide; one was an old man who was very bad for a day or two, and then seemed to be getting better, but died suddenly one night from heart failure; and the other was a poor young fellow of thirty, who had been waiter in one shop for eight years, and was then turned off by a new manager and replaced by a German lad. He had a wretched wife who drank, and she took away his clothes and then disappeared; so we had to rig him up in a suit when he went off; one of the other patients gave me five shillings for him, and he asked me to keep it till he had been before the magistrates, as he thought he would be sent to prison, but he came back after his appearance in the police courts to tell me he had been let off with a caution, and he thought his old master would take him back; such a nice, quiet-mannered man, and most anxious to do anything to help the nurses in their work, or to wait on the other patients, and they all liked him.

The same day one of the house surgeons was admitted with a badly poisoned arm, and a friend of one of the students with typhoid fever; he had it very badly and caused us much anxiety, but pulled through all right in the end.

After this spell in C. Ward I expected to return to my front surgery, but instead I was offered in March (and gladly accepted) the post of Night Sister, and that is what I have been doing ever since, except for an interval for my summer holiday, and also for a few weeks when I took charge of a large male medical ward while the sister had her holiday.

Being Night Sister here means plenty of running about, and plenty of responsibility, but it also means better pay than Ward Sister, so that suited me all right.

They are talking of having two night sisters soon--one medical and one surgical--and there would be plenty of work for two, as we have a good deal of theatre work in the night, and sometimes I cannot help being worried when I am kept long in the theatre with urgent cases, and I know there are bad cases over in the medical buildings (sometimes with only rather junior nurses in charge of them), and I can't get round to visit them.

I have charge of about six hundred beds, and they are divided into twenty-one wards (of course nurses in each ward and two nurses in the large wards); I have to go all round three times every night, and run in much oftener to see any bad cases, and the nurses send for me in any difficulty; there is a slate in my office for messages, and when I return after my rounds I often find two or three messages, "Please come at once to P."; "Please come to N.--urgent," and so on, and I have to fly to whichever I think is likely to be the most urgent.

The morning round always takes the longest, as all the patients are then awake, and I have to say good morning to them all, and remember to ask after their particular aches and pains, and it is not very easy to remember what is the matter with them all, though I know very well all the details about those who are very ill and have much done for them in the night.

There is one place I don't enjoy visiting, and that is the strong room at the top of the surgical buildings. Lately we seem to have had so many men who go off their heads (generally from drink), and if they are left in the wards they disturb the other patients so much that it is better for them to be moved, and then they have male attendants up there; but these male attendants are not members of our regular staff (I wish they were), and I never feel that I quite know their capabilities, or how much I can trust them, and more than once I have found them asleep; so I have to go up very often when any patient is bad there.

I remember one night we had a very lively time of rushing about. We began with a man who had cut his throat--not very bad, but he had to go up to the theatre; then a lady who had taken three ounces of laudanum, and the doctors had to keep her walking up and down the corridor, with a weary porter on each side of her, for six hours before they thought it safe to let her turn into a bed; then I was called to a poor man in Ward P., who got worse, and died rather suddenly--a phthisis case; next a tracheotomy came in, and had to be done at once, and while we were all busy with it a baby was born in Ward D.; but the day sister had to be called to attend to that, as I was mixed up with the diphtheria case, and could not go near a confinement; then a fractured femur came in, and next an acute pneumonia--rather delirious. In the intervals of receiving these new cases and sorting them to the different wards we had to brew strong coffee and administer it to the lady who had taken poison, and provide refreshments for the porters who were minding her. In the early morning she was allowed to go to bed and to sleep; she recovered very soon, and I don't think she will do it again!

I joined the Royal National Pension Fund for Nurses a few months ago; it seems to be a good thing, and if I can only keep up the premiums I shall have the noble pension of about £20 or so when I am fifty; it will keep me in extras when I retire to the workhouse, as I am certain no one can go on nursing for a great many years at the pace we have to go in hospital.

Just now I am having a rest (and another sister is rushing about on night duty), as I have been warded for the past fortnight, and in a few days I hope to go home for a change.

I had a cold for many weeks, and did not pay much attention to it, as I thought it was only because I was about all night and did not get enough sunshine to help me to throw it off; but then I got very bad headaches, so I had to see a doctor, and he passed me on to our nose specialist, who has been most awfully kind, coming down every day, and sometimes twice a day, to see me. It was not really a cold, but some disease in the antrum, and he has done two small operations for me, and it has been horridly painful, but now it is getting well rapidly, and every one has been most awfully good to me, and I am beginning to feel less of a limp rag than I have done for some time past.

It was funny spending Christmas as a patient instead of running about looking after the patients; but it was nearly my first day up, so I was glad enough to be lazy, and I have had many visitors, so it has not been dull at all.

XVIII

GENERAL HOSPITAL, LONDON, _September 1897_.

Just now I am feeling so sorrowful at the prospect of leaving this hospital (my home for the last three and a half years) that I hardly know how to give my attention to telling you how the last few months have been spent.

No, I have not been turned out, and they have given me a first-class certificate, and are good enough to say that they are very sorry I am going, and perhaps they will have me back again some day!

I think I was warded when I wrote to you last, and after that they sent me home for a little rest. Whenever I go home some one in the village gets ill, or some child gets scalded, or some accident happens; they seem to think it is necessary to keep my hand in; but during that visit home my only patient was poor Jessie, the family cat! It was Sunday evening, and we were all sitting in the dining-room just after prayers, when poor Jessie hobbled in, really screaming with pain. One leg had evidently been caught in a trap, and there was a bad compound fracture which she could not bear me to handle, so I said we must either have some chloroform or the poor dear must be shot. The nearest doctor (and chloroform) was three miles away, but C. volunteered to fetch some, and went off on his bicycle, while I prepared some splints and strapping, &c., and poor Jessie used bad language under the table.

I have sometimes had to hold an obstreperous child while it has been given chloroform, but that is nothing to holding a cat! However, at last we got her under, and then put the fracture in good position and stitched up the wound, securing the leg very firmly on splints; this operation was watched with much interest by all the family and most of the servants; at first the cat would not come to, but we put her in a hamper with plenty of fresh air, and when she _did_ come to, the language she used was "something awful," but she soon settled down and made a good recovery. My people were very anxious for me to say I could not go back to the hospital at the end of my fortnight's sick leave as the cat was still in splints, but I had to leave her to my assistant.

Then I returned to duty as Night Sister again, and everything went on much as usual--generally rather more work than I could do well, and sometimes rushing nights of accidents and emergencies, when it seemed almost impossible to fit in all that had to be done.

It seems that every year more operations are done; the cases are sent out more quickly, and so make room for more acute cases, and so the work grows, but the number of nurses does not grow in the same proportion.

In February there was an urgent call for nurses to volunteer for plague duty in India, so I sent in my name--thought it would be a useful experience--and I wasted much time hanging about the India Office for interviews, &c., but eventually they were unkind enough to say I was not strong enough, and refused to send me. _Who_ would look very strong after acting for a year as single-handed Night Sister for a hospital of six hundred beds?

Then the authorities made a change, and they decided to increase the night staff by the addition of eight more nurses and one more sister. I was only on for a short time after this came into force, just to set things going, and then I was appointed day sister of M. Ward, the women's surgical ward, where I had worked as a lady pupil, and knew and liked the surgeons so much.

Since I was lady pupil there, and before I was appointed Sister of the ward, they had had several changes of sisters, and no one who had been there long enough to take much interest in it; so there was room for improvement, and the surgeons have been so awfully kind to me that I have had a very nice time.

In that ward my bedroom opened out of my sitting-room (attached to my ward), and we had one very exciting night there.

Since the night staff were increased the nurses have had one meal during the night down in the dining-hall, and there are some probationers who relieve our staff nurses while they go down to this meal. I was fast asleep one night when a probationer rushed into my room, "Oh, Sister, come quick, it's all blazing!" I seized my dressing-gown, and was in the ward in a few seconds thinking that she had set the place on fire with the airing sheets (of course my proper nurse was down at her meal); but it was a house just across a narrow road that was indeed all blazing, and my ward was brilliantly lit up by the flames, and the poor patients were all awake, and some of them quite terrified.

I turned on all the lights, so that they should not see the glare, and then we did our best to reassure them that there was no danger. Two poor women with fractured femurs and their legs slung up to Hodgin splints had already hopped out of their beds, and were literally tied by the leg, and they were all begging for their clothes; so I let two convalescents go to the clothes cupboard and put round the clothes to each bed, or dressing-gowns for the helpless ones, while we got our fire-hose out in case of need; but the firemen very soon got the fire under.

Two of our students, who lived in the house which was on fire, had to jump for their lives, and lost all their belongings, and one of them broke his leg.

It was really a bit alarming, as the ward got so hot and smoky, but the patients soon settled down again, and after we had readjusted splints, &c., no one was any the worse.

I had to take my month's holiday in June this year, rather earlier than I like (as it always seems more difficult to work when you come back to face all the hot weather), but we can't all have our holidays in the best months.

A young brother and a sister and I agreed to spend a fortnight about our old haunts in Switzerland, and we had such a jolly time together.

Of course we went first to Paris, and were fascinated with the shops, but tore ourselves away from them to visit the venerable Notre Dame, and then to spend a little time in the Louvre, but it was only time enough just to make us determined to stay longer in Paris on our way back. In the afternoon we took one of the boats up the Seine, and afterwards went for a walk in the Bois de Boulogne--a delightful breathing-place for the Parisiennes--good roads, lovely trees, and greenery, and yet quite near to all the bustle of the town.

The next day we had a hot and dusty journey on to Geneva, rather afflicted by the presence of some old ladies who wished to keep all the windows shut--it is strange how these petty discomforts fix themselves in one's mind!

At Geneva we had vast, big rooms just looking over the lake, in the Hotel des Bergues, and we took a Sabbath-day's rest there, finding a nice service in the English church, and for the rest of the day wandering about near the lake and up the river.

The next day we felt more energetic, and B. went off for a trip round the lake by steamer, while we went up Salève by steam and electric tram, a lazy way of proceeding, but it was rather an exciting journey crawling up the face of the mountain, and then such a view from the top; mountains, mountains everywhere, and grand old Mont Blanc poking his head over the top, and down below the lake so still and blue, with green trees down to its edge, and then the trees growing darker as they grow higher up, until they stop and the snow-line begins.

The next day we moved on to Chamonix; the train went only as far as Cluses, and from there we had a drive of twenty-five miles by diligence.

It was a delightful drive on a bright, sunny day; at every turn we seemed to get fresh views of Mont Blanc, and each view seemed more beautiful than the last.

We walked a good part of the way while the horses climbed the hills, and we found many varieties of wild flowers and plenty of wild strawberries.

Chamonix is a charming place, but one wanted more time just to loaf about and enjoy the views. The Mer de Glace is, perhaps, the most noted glacier in Switzerland; it is within easy distance of Chamonix (about two hours' walk), and it is a wonderful sight, but somehow I can't describe it, it is all too solemn and grand. I always feel the truth of what the Psalmist says about the men that go down to the sea in ships: "These men see the works of the Lord and His wonders in the deep," and I think the same applies to those who climb into the heights of the mountains, but I suppose he had not had that opportunity!

We left Chamonix with regret, and walked from there over the Col de Balme to Martigny; I think it was about twenty miles, but you can walk twice as far in Switzerland as you can in England without being tired, the air is so clear and bracing. It was a lovely tramp, beautiful flowers and ferns, and rushing streams and waterfalls; the last part of the way was trying, as it was very steep going down into Martigny, and the path was paved with little cobbles, so that we arrived rather footsore.

From there we trained to Glion, a very favourite place with us, just perched above Chillon, with lovely views of Lake Leman, of Chillon Castle, and the fine old Dent de Midi at the end of the lake, and it is within easy walking distance of Montreux. There are many nice walks and climbs about Glion, and the flowers--gentians, narcissi, &c.--were perfectly lovely.

Then we had to turn homewards, and found that we could spare only one night again in Paris (we had meant to stay longer): still it gave us a little more time to examine the treasures of the Louvre.

We had a small excitement in the afternoon. We had been walking through the flower market when a shower of rain came on. We sheltered under one of the stalls, and while we were there we heard what we thought was a sharp clap of thunder, but it proved to be a bomb exploding in the Place de la Concorde, but no one was seriously hurt.

When we got back to London it was very busy with preparations for the Queen's Diamond Jubilee, which was duly celebrated with much rejoicing all over the country before I returned to work in town.

Now, I had better explain why I am leaving here. I have promised to go as nurse to one of the hotels up the Nile (either to Luxor or Assouan, where they always have a doctor and one nurse through the winter season), with a patient who has spent the last eight winters in Egypt. He is now very ill, and still he wants to go, as he can live so much more comfortably in that climate. His mother can't go with him at present, and they can't bear to let him go alone, so I have promised to go to see him through the voyage (we are going by long sea) and to be at hand in case he should get worse before his mother can join him.

You know I love travelling, so in a way I am glad, but I don't think I am fitted for private nursing, and I am a bit nervous, and also it will be anxious work if my patient gets worse out there, but somehow I could not refuse. It is just horrid saying good-bye to every one and everything here.

I will write again soon from the sunny south.

XIX

HELOUAN, EGYPT, _November 1897_.

Here we are in lovely sunshine (the thermometer at 80° in the shade), just on the edge of the desert, and quite contented to rest a while (after a very anxious voyage) before we move on up the Nile.

We sailed from London on October 1st, and had a smooth trip down the Channel, but I soon found my patient was much more of an invalid than I had expected, and was afraid he would get cold before we got into a warmer climate.

The first Sunday out we ran into a dense fog off Cape Finisterre, and our morning service was somewhat disturbed by the constant hooting of the foghorn; some of the passengers jumped up from their knees at each hoot, and the captain cut the service rather short and went up on the bridge. In a couple of hours we emerged into lovely sunshine, which soon dried the wet decks and awnings, but the next day, as we were putting on full steam to get into Gibraltar before sunset, we again ran into a thick bank of fog, and eventually had to change our course and put out to sea until the morning, as they are not allowed to run through the Straits after sunset.

The next morning I was up on deck before five, just as we were running into Gibraltar, and to watch the sun rise from behind the great rock was a most impressive sight.

We had a pleasant trip down the Mediterranean until we entered the Gulf of Lyons, and then the wind got up, and there was a nasty cross sea which made most of us feel squeamish and not sorry when we anchored at Marseilles early one morning; but there we had to tranship to a smaller steamer, and it was raining and cold, and when we got on board the _Clyde_ we found they were still coaling, and that the lighter with all our baggage on board was not likely to come for some time, so we could not establish ourselves in our cabins. As there seemed no comfortable place on the boat, we concluded the best thing to do was to take a cab and drive up to a hotel to get warm. Then I went out to buy fresh cream and grapes, and to find out exactly at what time it was necessary to be on board.

I shall never forget the storm of that night after we left Marseilles. I tried to make some hot arrowroot; with much patience I managed it over a spirit lamp, which I wedged into my washing basin with supports; of course the tin of milk could not be trusted to sit on the top of the lamp, so I had to hold it there, and it was not an easy matter as I was flung from side to side in my cabin; then I found that a linseed poultice was indicated, so I again retired to my cabin and wrestled with the spirit lamp, and thought how little one appreciates the conveniences of a modern hospital until one has to do without them.

After that the groans and fearsome noises from other cabins around us were very bad, and I, who have always prided myself on being a good sailor, actually succumbed for an hour or two; but I dragged myself up again in the early hours of the morning to make another poultice, and by breakfast-time the sea began to go down, and the sun came out, but it was several days before some of the passengers crawled up on deck, looking like limp rags, and the tables in the saloon were very empty until just before we reached Alexandria.

We stayed some hours at Malta, and I had an interesting drive round the place.