DN exams, June 1952.

1) What part can the district nurse play in the National Campaign Against Accidents in the Home?  Give examples of some of the commoner home accidents and show how these might have been prevented.

2) You are called in to nurse a patient recently discharged from hospital after two years of treatment for poliomyelitis.  He has paralysis of both legs and is alone in the house from 8am to 5pm.  Describe the plans you would make for his care.

‘The Fussy Nurse’

Taken from Florence Nightingale’s 1859 ‘The Art of Nursing.’

‘All the results of good nursing may be spoilt or utterly negativised by one defect – petty management, or in other words, not knowing how to manage that what you do when you are there, shall be done when you are not there. A nurse must learn to think for herself: now, what does happen in my absence?  I am obliged to be away on Tuesday.  But fresh air, punctuality etc, none of these things are less important to my patient on Tuesday than they were on Monday..’

‘A firm, light, quick step and a steady quick hand are the desideration*; not the slow, lingering, shuffling foot, the timid, uncertain touch….’

Even the way a nurse walks is important! 

* Never seen this word before in your life?  Me neither.  Google barely knows what it means.  Shock horror!  But apparently it means to ‘wish or to see happen.’  Those pesky Victorians and their pesky vocabulary!

 

A District Nurse Gets Typus, 1909

An update from the December 1st issue of the Queen’s Nurses’ Magazine…

‘I can only account for catching Typhus by being in a rather low condition.  I was up all night before at a midwifery case, in a very dirty house and without food.  The next day I went to attend a paralysis case.  The house is built on a slope, the manure pit was at the back of the house, on a higher level than the house itself.  You can imagine how the filth percolated through the earth, and the heat of the turf fire must have drawn it into the house.’

Luckily, the magazine reports, this nurse recovered.  Still, it’s food for thought.  These women were dealing with serious poverty and deprivation, where disease was rife.  You have to admire their bravery for volunteering to offer their services under such dangerous conditions.  Nowadays, nurses are better prepared and protected against catching infectious diseases.  District nurses of the past could almost expect to catch them, and suffer for a few weeks (if they were lucky!) with symtoms from abdominal pain, to fever, to nausea, vomiting, coughing, muscle pain, the list goes on….

District Nurses: Hells Angels?!

By the 20s, transport for nurses has gone up a gear.  Literally.

In 1920, Nurse Radburn of Swanscombe was provided with a motor cycle by the people of her district.

In the Queen’s Nurses’ Magazine, adverts for scooters, motocycles and motorcycle attachments began to appear. 

Things weren’t changing everywhere though. On Exmoor a Queen’s Nurse still was visiting her patients on horseback in the 1930s!  And as for the West of Ireland, things were even more behind the times there.  An expectant father might still be expected to pick up a nurse on horseback, bringing a spare mount for the return journey!  Nurses were writing in to the magazine about their uniform, complaining that they needed tighter hats to stay on their heads in high winds.

District Nurses: A Doctor’s Verdict 1931

Taken from Doctor Margaret Hogarth’s ‘A survey of District Nursing in the Administrative County of London.’

‘One outstanding feature of this service is the educational value of each visit to the home.  Such a visit is not simply to give advice on general hygiene, it is the practical application of an immense amount of theoretical teaching.  A District Nurse’s visit to a tuberculosis patient is illuminating.  She sees to the crockery and the food.  Everything is made simple and easy and at every visit the education of the family proceeds.  A nurse’s influence permeates a whole neighbourhood and her opinion is respected in proportion to her immense practical value.

The altruistic attitude of the District Nurse who remains at the work for any length of time is strikingly apparent.  For her the work, distasteful and revolting in some of its aspects, becomes more a vocation than a profession.’

An ‘Organic’ Remedy

Think you’ve seen bad home-made remedies?  They won’t have anything on this one, from Galway, Ireland, in 1907.

‘Nurse has a dreadful case on her hands at present.  A man here gashed his knee with a hatchet.  To stop the bleeding his mother applied pig’s manure.  The doctor took an hour to cleanse the wound, but even so the result has been blood poisoning and the man is still very ill indeed.’

Taken from the Queen’s Nurses’ Magazine, September 1907.  No word as to whether the unfortunate man survived, or ever recovered having manure rubbed into his leg.  I’m told he must have had septicaemia.

A Letter From Berlin….

In 1904, a group of district nurses attended the International Women’s Congress in Berlin.  One of them wrote to the Queen’s Nurses’ magazine.

‘How to begin telling you about the conference I don’t know.  We have been living in a perfect whirl and have hardly had time to breathe, let alone write…

We have visited Victoria House, a training home for nurses founded by the Empress Frederick….the home is a splendid building: great white corridors, distempered walls with murals painted here and there, with charming little bedrooms decorated with ferns and pictures, everything spotless.  The linen room was a sight to behold, all the towels and dusters etc, arranged crosswise one upon the other, and all the new linen tied with blue ribbon.

The children have a playroom and a schoolroom, for it appears the fatherly state will not allow the sick little German to spend his convalescence in idleness, but provides him with a teacher and lessons so no time may be wasted.’

Ten years later, the British and the Germans were facing each other across the trenches.

Drs vs. DNs. Round two.

More on the often antagonistic relationships between Doctors and Nurses.

In the early years of the Queen’s Nursing Institute, they were at each others throats, as doctors became increasingly convinced that nurses were taking work out of their hands.

In 1908 the Penrith medical union complained that ‘by tending to cuts and bruises, nurses are depriving doctors of work.’  One doctor even went so far as to say ‘it is reversing the natural order of things that the nurse shold send for the doctor, it should always be the other way round.’  He and his fellow doctors decided not to attend cases given to them by nurses.  They were backed by the British Medical Association.

A member of the Queen’s Institute governing body commented that ‘the two bodies – the Queen’s Nursing Institute and the British Medical Association – are not on the same planet in this matter.  The whole object of the Institute is in the welfare of the sick poor, whereas the aggrieved doctors are fighting for their own hand.’

District Nurses of today, what do you think?  Do doctors behave themselves a bit better now?!

Complaints about DNs?! Never!

Sadly, in 1921, one nurse was well and truly caught in the act.  A member of the public complains to the editor in the May 1st edition of the Queen’s Nurses’ Magazine:

‘Since visiting a nursing conference and exhibition, I have constantly had in my mind the figure of a Queen’s Nurse I saw there.  My attention was riveted by the bonnet, the straw of which was almost indiscernable, so caked was it with dirt.  The ribbon had faded to the last possible degree and was broken and frayed.  The whole bonnet appeared to be rotting with age.  The nurse had brown hair, which was lustreless and unkempt, and very dusty.  She wore no collar and the neck of her cloak was greasy and dusty.  I saw her from behind for a few moments only, and moved on, feeling distressed that a District Nurse should so abuse her influence as to appear in such a dreadful state.  I do not see how that nurse could insist on cleanliness in her patience and their homes.’

What do you think?  Would you say this man/woman (it would be nice to blame it on a man!) is in the right?  Maybe the nurse was just having a bad day!  My hair often looks ‘lustreless’ and unkempt, I’m afraid.  But should nurses be held to a higher standard?  Remember at this point that District Nursing was as much about teaching patients about proper hygiene as it was treating illness.  Should a nurse wear her uniform with pride?

Treating Bronchitis With a Peashooter

Florence Lees had some ingenious (and possibly lethal) nursing methods!

For cholera cases, she recommended that nurses ‘maintain an exceptionally high temperature in their patients rooms.’ 

In order to achieve this, they might usually use bronchitis kettles.  If a nurse hasn’t got one to hand, ‘A good substitute can be made by fitting long tin ‘pea shooters’, as children term them, one inside the other until the required length is obtained, when this extemporary tube can be fitted over the spout of an ordinary kettle, half filled with boiling water and placed on the fire.  This extemporary tin tube can be bent to any shape required, and made of any length.’

Taken from ‘A Guide to District Nurses’, 1890.