Chapter 9

THE WORK OF A NURSE

There are many wise sayings about the trained nurse, two among which may be given here. One of these was spoken by a woman who is herself a distinguished trained nurse, and the other by a woman in a public position who has met many people and is a good judge of character. The nurse said, "Trained nursing will make a woman very good or it will harden her." The other woman said, "I have never known a nurse who was not glad to be a nurse and who was not thankful for a nurse's training." These two sayings show that the work of a trained nurse is no ordinary occupation. The girl who becomes a nurse-in-training is preparing to enter an employment which will have a great effect upon her character.

A girl must be twenty, in some hospitals twenty-five, years of age before she is accepted by a training school of good standing. If she prefers to enter a school connected with a children's hospital, she may be accepted when she is twenty. The work of a nurse calls for physical strength and endurance, and it has been found that girls under twenty or even under twenty-five are not strong enough to stand the strain of hospital work. A very strong healthy girl under twenty may say, "Oh, but I am strong enough to stand the strain." She is mistaken. It is not only physical strength which is required, but physical endurance, and these extra years are needed to develop this endurance. If a girl who hopes to be a nurse leaves school when she is seventeen or eighteen, the best work she can undertake in order to prepare for nursing is work in her own home. Another way in which she may spend part of her time profitably is in the reading of good books, so that she may store her mind with thoughts and information which will be helpful to her in dealing with her patients. No woman who is a nurse can be too well read, or too well informed in art, music, biography, history, and the public affairs of the day. If a girl, who feels that nursing is her real work, prefers to earn her living between the time when she leaves school and the day that she is accepted as a probationer, she may enter some other calling, and meanwhile may add to her useful knowledge both of people and of work. She should also save some money, for while the training of a nurse is not expensive, still as probationer and, later, as nurse-in-training, she will need money for necessary expenses.

The intending nurse should make a few financial calculations before she begins her course of training. The hospital will give her exact directions as to the clothes she will need for her work while she is a probationer. She will require some spending money, and she should be provided with a good stock of clothes, especially underwear, shoes, and stockings. When she is accepted as a nurse-in-training, she may be given by the hospital a monthly allowance which is supposed to provide her with clothes and the books required for her studies. This sum varies in different hospitals. Generally speaking, it is fifteen or twenty dollars a month. In any case, the sum will be hardly sufficient to cover all her expenses, although it is wonderful on how little money nurses-in-training have been able to manage. Some hospitals do not give their nurses-in-training any money and require that the nurse should pay a sum for her instruction. It is usual for these hospitals to provide nurses-in-training with uniforms, caps, and aprons.

Most training schools require from applicants an educational standard of four years in a high school or matriculation status. Young women who are college graduates may take the training of a nurse after they leave the university. The business girl or the girl in any other occupation who means to be a nurse and who has left school before reaching the necessary standard can prepare for her training by attending evening classes or studying by herself or with a friend.

The intending nurse should choose with great care the hospital in which she means to train. The standing of the hospital will have a marked influence onher career as a nurse. Some hospitals are justly famous for the excellent training which they give. The usual length of time required is three years. A number of hospitals, however, have courses of two years.

The time of probation lasts three, four, or six months. During this time the probationer will be tested for endurance, neatness, earnestness, and ability. No probationer who is untidy or who is wanting in personal cleanliness is accepted in a training school. The professional appearance of the nurse is essential to her success. Few women are more attractive in appearance than a nurse in uniform.

Nurses-in-training live in a nurses' home which is one of the hospital buildings. In these buildings the nurse will spend by far the greater part of her time for two or three years. The hospital is a world in itself, and the nurse will have few interests outside its walls. Most nurses regard their years of training as a time of growth and wonderful experience, and the average nurse is very happy during this time, although a great deal of the work is not pleasant and almost all of it is hard. The nurse learns that work of any kind may come within her province. She will have to do anything which helps toward the recovery of her patients or contributes to their comfort. Some of her experiences will teach her resolution and bravery. Speaking of such experiences a nurse once said: "As long as you can do anything to help, you can manage. It is the being able to help that matters." The life of the nurse-in-training is regular, and the hospital regime is such that as a rule nurses-in-training are healthy.

The nurse should have good health and a good constitution. In some cases, however, a girl may be in poor health because she has no definite occupation or object in life. Training as a nurse has often helped to establish good health. The girl who applies at a hospital training school requires a doctor's certificate, and the doctor will be able to tell her whether she is strong enough to undertake the work of a nurse. She should be a girl of strong character, steady nerves, clear mind, and good judgment. She must acquire the habit of obedience if she does not already possess it. A nurse, like a soldier, is under authority and has to carry out directions exactly as if they were commands. In her work she will need tact, discretion, and firmness, and with her firmness she must be always and unfailingly kind. Her voice and manner should be as pleasing as possible. No unkind or rough woman should ever have anything to do with the work of nursing.

Short courses in nursing are given in some cities by the Young Women's Christian Association. The St. John Ambulance also has given instruction in nursing for a number of years. Since the beginning of the War, various courses have been arranged for Red Cross nurses. The honourable work of what are known as V. A. D. (Voluntary Aid Detachment) nurses proves how valuable any good instruction in nursing is, not only for the individual, but also for the community. It is not too much to say that the whole service of nursing in the world would not have been adequate if it had not been for the training and work of volunteer nurses. The War has proved beyond all question the extraordinary value of the trained nurse.

After graduating from the training school, the nurse may undertake private nursing or she may follow her profession in institutional work. Private nursing is exacting, and the nurse must be strong and capable. Her hours are longer and much more irregular than when she was in training, and often she will be on her own responsibility. She will feel, however, that she is doing work of great value, and she will win the regard of many of her patients and their families. The good standing of the training school is an assistance to the nurse when she looks for cases. If she is favourably known to doctors, she is likely to have as much work as she can manage. Hospitals often engage their graduates to return for private cases. A usual charge for a graduate nurse is from twenty-one to thirty-five dollars a week according to the nature of the case. A nurse in private work cannot work uninterruptedly throughout the year. Her name is on a nurses' registry, which is generally conducted by an association of nurses or by a private individual. Returns from these registries show that the average nurse is employed about ten months in the year. Many graduate nurses earn from eight to nine hundred dollars a year in private nursing, while some earn a thousand or twelve hundred, but this is exceptional.

Nurses who are not graduates are sent out by some registries. Their charges vary according to the case. These women are sometimes called convalescent nurses and, in cases where a graduate nurse is not required, they fill a real need in the community.

As a general rule, a trained nurse does not continue in private nursing longer than ten or twelve years. Frequently, at the end of that time, her health necessitates a change of occupation. Others continue their work successfully for many years.

Many trained nurses prefer institutional rather than private nursing. Head nurses in hospitals receive from thirty to sixty dollars a month. There are also nurses who superintend private hospitals. A few nurses of executive ability, business knowledge, and experience in nursing, become superintendents of hospitals, but not of the largest hospitals. A number are heads of training schools. Such leading nurses receive salaries varying from one thousand to two thousand dollars a year, with living expenses in addition. The work of a woman superintendent who is a trained nurse includes the financial management, responsibility for the nurses, training of the nurses, the care of patients, and the oversight of the hospital. Few individuals are equal to such work and responsibility. Other trained nurses become matrons and housekeepers in private hospitals, sanitaria, and colleges. Some are district nurses. Public health nurses assist in supervising the health of a city and give instruction in cleanliness, sanitary science, and the care and feeding of infants. Private schools, colleges, factories, and departmental stores employ the services of trained nurses.

A few children's hospitals give short courses in training for children's nurses--an employment for which many girls are specially fitted. This course must not be confused with the regular instruction of the trained nurse, as it is not on a level with the profession of trained nursing. A children's nurse with hospital training will receive twenty or twenty-five dollars a month; in some instances such a nurse is paid higher wages.