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The Home Monthly

by Elizabeth L. Seymour [Willa Cather].

From The Home Monthly, 6 (May 1897):  3-5.
Photograph of a group of young nurses.A GROUP OF YOUNG NURSES.

Nursing as a Profession for Women.

THE fact that has nursing become so popular an occupation for women does not mean at all that men are excluded from it, or have abandoned it. Every class that graduates from the hospitals has its per cent. of male nurses, though usually the women greatly predominate.

One continually hears nursing spoken of as one of the new professions for women. Why, I have always been under the impression that it is one of the oldest of all. Away back in the Iliad and Odyssey we hear Agamede commended for her skill in nursing, and even the beautiful Helen of Argos, often wrongly called Helen of Troy, is said to have "mingled with the wine a drug to lull all pain and sorrow and anger, and to bring forgetfulness of every sorrow…. Medicines of such virtue and so helpful had she, the daughter of Zeus." So I suppose by a liberal rendering of the passage one might almost call Helen herself a nurse, though her patients seem to have been a turbulent lot and small good it was that she ever did them.

As early as 1311 we read of nurses and "women surgeons" in the old French chronicles, and they were common enough in England in King John's time. Of course it was Florence Nightingale, by her heroic services in the Crimea, who first brought nursing to the dignity of a profession. After her return to England the English people gave her a donation of £50,000 which she used in founding the Nightingale Home, the first regularly equipped training school for women nurses in England. The English women have always taken great interest in the nursing schools, and Queen Victoria's daughter Helena, Princess Christiana, has devoted much of her time to them. The first American nursing school was the Belleview Training School, established in 1873. Since then they have sprung up all over the country, and no large city is without several of them.

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Of course a training school cannot make a nurse, any more than a university can make a scholar. But the hopeful feature of a training school, or a school of any kind, for that matter, is that a few of the right people are sure to find their way into it. An aptitude for nursing is inborn. You cannot manufacture it by any process whatsoever. The profession is as old as the history of pain and compassion. There have always been nurses where there was suffering—and women. You remember in the little country town in which you grew up there was one woman who was always sent for in cases of emergency, who knew instinctively what to do and how to do it.

My own grandmother was one of those unprofessional nurses who served without recompense, from the mere love of it. She had a host of little children and cares enough of her own, poor woman, but when a child was burned, when some over-worked woman was in her death agony, when a man had been crushed under the falling timber, or when a boy had cut his leg by a slip of the knife in the sumach field, the man who went to town for the doctor always stopped for her on the way. Night or day, winter or summer, she went. And they did not send carriages or cabs for their nurses in those days. She would go alone on foot across the snow-drifted fields and through the frosty pine woods in the dead of night, with a stout hickory stick in her hand and a basket on her arm. I have often heard the old folks tell how, during those dreadful diphtheria scourges that used to sweep over the country in the fifties, she would go into a house where eight or ten children were all down with the disease, nurse and cook for the living and "lay out" the dead. Sometimes there would be half-a-dozen deaths within a few days right in one family. But you have had grandmothers of your own, you know how it went. You remember the old woman who nursed you when you had scarlet fever, and walked the floor with you when you had whooping congh. Money will never buy such attendance for you again. The trouble with these old-fashioned nurses was that they so often did the wrong thing in perfectly good faith, and often the old-fashioned doctors could not tell them much better. In medicine, unfortunately, you cannot take the will for the deed. She was always an excellent woman, that nurse of the olden time, with her hair combed down over her ears and her big breastpin with a family portrait on it, but she used to make sad blunders. She and the old doctor would go on starving diphtheria patients and keeping ice and water from fever cases, sometimes killing more people than the disease, and all the while supported by an unwavering conviction that they were benefiting their kind. But given that natural instinct for the work, and supplement it with the knowledge and training which the nurse of to-day receives, and I am surprised that patients die at all.

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The best training schools now have a three years' course, though many competent nurses are graduated under the two year system. All training schools are conducted in connection with some hospital, indeed, the hospital is the school. Hospitals usually have many more applicants than they can admit at once, so the prospective nurse files her application and letters of recommendation and waits her turn. When there is a vacancy she is admitted on a month's probation. The probationer begins in the charity hospital and is occupied with making the beds, changing the linen, and such duties as involve little responsibility. If at the end of the month she has proven that she has some adaptability for the work, she is examined in the common school branches and regularly admitted into the first year course. I have never talked with a nurse who found that first year a very pleasant one. There are distressing sights and sounds to become accustomed to, and, above all, there are most dis- tressing odors. The drudgery is especially unpleasant in that profession, principally because of the inexplicable prejudice against cleanliness that exists in certain classes of the human family.

The first thing the new nurse does with charity patients is to try to get them clean, and though this sounds simple enough it is not always easily done. A young nurse told me only a few days ago of her struggle with one old woman in the charity ward. First she used alcohol, but it made no impression; then ether, then turpentine; finally she resorted to a stiff scrubbing brush and sapolio.

Moreover, the hours are very trying to the novice, and the discipline is as rigorous as that in a convent school. The nurses must rise at just six o'clock, breakfast at just half-past six, and report for duty in the ward exactly at seven. Then they are constantly on duty until seven in the evening. Of course with the night force the hours are just reversed; but a first year student is seldom given any night work. Usually they have one day out of the seven for themselves, in the busy season only Photograph of a class of graduating nurses.A CLASS GRADUATING FROM THE TRAINING SCHOOL. half a day. There is no way in which a nurse can earn a little time for herself by working over hours, for it is quite as important that she shall get her rest as that she does her work. The superintendent has no use for a nurse whose heavy eyes tell that she has not had sleep enough.

The nurse often imagines that she understands the profession pretty thoroughly before she enters the school. She is perhaps a girl who has always attended to her little brothers' cut fingers, and set the dog's broken leg, and was celebrated among the neighbors for being able to endure the sight of a wound unmoved. She has only come to the hospital for a few finishing touches. If she has cherished any such delusion she soon discreetly forgets it and holds her peace. If the novice has her own ideas she had best keep them to herself. Ideas are supposed to come from the head nurse, who has an exclusive patent on them.

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During her second year the nurse is usually put in charge of one of the night wards. Although the duties there involve less drudgery than she has been accustomed to, the responsibilities are heavy and it is, in the long run, the most wearing work of all. This is especially true in the larger cities, where all the worst accident cases invariably come in at night. Dear me, the stories that a night nurse at Belleview hospital used to tell me! If that young lady should take to making realistic novels she could outdo M. Zola himself in grewsome descriptions. Men with delirium tremens,—and sometimes women with the same disease—men who had been torn to pieces by machinery or burned in some tenement fire; men with several ounces of cold lead in them, and women with their throats gashed from ear to ear; and, most pitiful of all, little waifs who had been run over by a carriage or struck by some brute who was not even merciful enough to kill. So they would keep coming in from the ambulances all night long, poor waifs and strays of every class, nature's misfits, literally the wounded and slain of the weaker side that is forever being defeated in the battle of life. Peace hath its victories, they say; yes, and its victims. Every time the ambulance stops at the door it means another victim; a woman who has given up the fight that went always against her, and has taken carbolic acid; an unknown man from the West who has been shot in a bar-room brawl; and so on through the whole dreadful catalogue. And almost every accident could be traced to some direct ethical cause.

If ever any one had a right to be a pessimist, that nurse had. But, on the contrary, she had managed to preserve a deep and abiding faith in humanity. She used to say, though, that it was sometimes almost too much for her when those big, sodden-faced fellows, whose skulls had been fractured by a policeman's club, got to building water-wheels beside some little creek out in the mountains, or flying kites on a hillside or telling their mothers how they had bumped their heads. Those were the hours when she used to wonder what it was all for, anyway.

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A hospital ward is no canny place to be at night. Even the nurses who are used to it feel its gloom. The delirious patients are always wildest at night, and those who suffer much groan continually, and those who cannot sleep stare at you with big, hollow eyes that have whole life-tragedies in them. The mental pain, the desand pair disappointment that looks out of those people's faces is sometimes more pitiful than their groans. You rebel against the waste and suffering of it all. The patients have a most disagreeable custom of dying about four o'clock in the morning. And so many of the accident cases don't want to die, and fight to the last. Then there are the bodies to be attended to. The nurse usually has to make a brave "spurt" to get through the last four hours of the night. And a good nurse never calls the doctor unless it is absolutely necessary, for hospital physicians are always driven to death.

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In her senior year the nurse usually has charge of the food, superintends giving the medicines, and assists the surgeons at the operating table. Then her life becomes comparatively easy. Usually the nurses all live in a dormitory near the hospital. When they are off duty they go in for recreation very heartily. The girls get along well together—perhaps because they do not see too much of each other. Often the occupants of the same room in the dormitory will scarcely see each other for days. The novices, at least, have very little time or life outside of their duties.

The compensation a nurse receives while in the hospital is very small, as the training is supposed to reward her for her services. Her necessary expenses, such as board, lodging, washing, etc., are defrayed by the hospital, and during the first year she usually receives ten dollars a month in addition to this. During the second year this is increased to fifteen dollars. When she has completed her course at the school she usually prefers nursing in private families to remaining at the hospital, as the pay is better. When she is nursing she receives from twenty to twenty-five dollars a week beside her board and lodging. The only trouble is that she can never be sure of steady employment. Nine or ten months' steady nursing is considered a very good average for the year. If she could get work enough to occupy all her time she would not be able to stand the physical strain. Even if she takes good care of herself a nurse breaks down early. If she can stand the work for fifteen years she does very well indeed. After that she usually goes back to a hospital where the work is lighter. That is, if she has not married some susceptible physician in the mean time.

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Nurses tell me that the children, even the very little ones, are the easiest patients of all to handle. They can he coaxed into almost anything and will stand an operation very bravely if their favorite nurse is with them. Myself, I do not see how the nurses can ever accustom themselves to seeing children in pain, or how they can get over that feeling of the unfairness of it. If you have ever gone through the children's ward and seen the white-faced little fellows lying so patiently in their cots, perhaps forgetting their own suffering in caring for the imaginary ailments of their doll baby, you will not wonder at the enthusiasm of the Flower Mission folk. Those hospital babies always seem so much older than other children of their age, and usually are much more tractable.

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Nurses have decided preferences as to their patients, though they seldom express them. Most of them prefer the men's ward to the women's. The men are more easily pleased, more grateful for what is done for them and more considerate of the nurse. The women are often disposed to be quarrelsome and to continually find fault. Usually the better class of patients are more easily suited than the charity cases. People who have always lived in poverty and squalor expect to be treated like princes of blood while they are at the hospital. All the vagrant class of patients have one common aversion, a hatred of soap and water. During her first year one of the nurse's principal tasks is scrubbing up dilapidated pieces of humanity. As a rule Photograph of a nurse."ONE OF THEM". women nurses prefer to work under male physicians. They are unanimous in declaring the doctors courteous and considerate.

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Occasionally a nurse has the good fortune to be employed from year to year by some chronic invalid who is able to pay her liberally. Some few of the nurses study medicine and eventually practise, but this is not a usual sequel. The schools all over the country are graduating more nurses than there are patients able to employ them, and this has already hurt the profession from a business standpoint. But in this, as in every other trade, there is always room for the best. The world has never yet been over-stocked with excellence in any business. Native adaptability, a vigorous constitution, honest work and a strong personality will make their way anywhere. And above everything else a nurse needs a strong physical personality, the sort of positive and active good health that influences weaker people and acts like a stimulant upon the patient.

Photograph of the interior of a hospital ward.INTERIOR OF A HOSPITAL WARD.