Part 17

8. Scullery, Lavatory, W.C.

The necessary consumption of hot and cold water is at least double or triple that of any general hospital. Sinks and W.C. sinks must be everywhere conveniently situated.

There must be a scullery to each four beds; the scullery must needs be much larger and more convenient than in a general hospital. There is often more work to be done by night than by day in a lying-in institution.

All the ward appurtenances, scullery, lavatory, &c., must stand empty for thorough cleansing, when the ward to which they belong stands empty in rotation for this purpose, and must not be used for any other ward. For each four-bed ward, or group of four one-bed wards, or for each floor of each pavilion, there must therefore be one scullery, with a plentiful unfailing supply of hot and cold water, with sinks and every convenience. The reason for this is two-fold:—

(1) To allow each scullery, with the other ward offices, to be thoroughly cleansed and whitewashed with its own group of four beds.

(2) The work in a scullery and in all the other ward appurtenances day and night, night and day, is many-fold that which it is in a general hospital scullery.

Besides this, general hospital patients ought never to be allowed to enter the scullery.

In a lying-in scullery the infants, most exacting of all patients, must frequently be in the scullery.

Even under the very best circumstances there are many lying-in cases among weakly women where the mother’s state is such as to render it necessary for a ‘crying’ infant to be washed and dressed elsewhere than in its mother’s ward. These infants are best washed, in that case, in the scullery, which must be so arranged that infants can be washed and dressed without being exposed to a thorough draught, and that nurses and babies may not be hustling one another.

There must be a good press in each scullery. A supply of clean linen and other necessaries will have to be kept in each press in each scullery.

The slop-sink and other appurtenances must be arranged so as to make allowance for the fact that the going backwards and forwards for water, hot and cold, or to empty slops in a lying-in institution—where half the patients can do nothing for themselves, and the other half (the mothers) are supposed to be ready for discharge when they can go to the ward offices for themselves—is more than it is in general hospitals.

Fixed baths are not necessary. But there must be means for filling with hot water moveable infants’ baths at all hours at a moment’s notice, since an infant’s life often depends on immediate facility of hot-water bathing.

And this besides the daily regular night and morning washing of infants.

There must be also a moveable bath for each ward for the lying-in women, with the means for supplying it with hot and cold water and for emptying it. Lying-in patients are not able to use either fixed baths or lavatory.

Glazed earthenware sinks should alone be used, as being by far the safest and cleanest.

9. How to Ventilate Lying-in Wards.

The best ventilation is from opposite windows. Each window should be in three parts, the third or uppermost to consist of a flap hung on hinges to open inwards and throw the air from without upwards.

Inlet valves, to admit fresh air, and outlet shafts, to emit foul air, must be added to complete the natural ventilation.

10. Furniture, Bedding, Linen.

As little ward furniture as possible. As much clean linen as possible.

A very large and convenient clean linen-store, light and dry, must be assigned to the matron: very much larger than would be required for a general hospital; but no general hospital in London supplies a good standard for such.

There must be in each scullery, besides, a clean linen-press.

There should be a very ample and convenient place for bedding.

Mattresses, blankets and the like, have to be renewed, taken to pieces and washed—especially those used in the delivery ward—many times oftener than in any general hospital.

The rack for linen should be along the middle of the linen-store.

There should be space for a bedding-rack along one end, taking about three feet six inches from the length of the room for linen. Space for some spare mattresses and bolsters will be necessary; and they should be stowed near to a lift.

A linen-store requires thorough lighting, ventilating, and warming. Three windows are better than one. The linen must of course be kept dry and aired.

11. Water Supply, Drainage, Washing.