Part 1

WORKHOUSE NURSING:

THE STORY OF A SUCCESSFUL EXPERIMENT.

London: MACMILLAN AND CO. 1867.

The accompanying account of the Improvements introduced by the Select Vestry of Liverpool into the Workhouse Hospital Wards under their control, may perhaps be interesting to you, and possibly might prove suggestive and serviceable, if similar improvements should be required in your district.

As the time and strength of the Lady Superintendent of the Nurses employed in the Workhouse Hospital are very fully occupied, enquiries or requests for further information should not be addressed to her, but to the Chairman of the Workhouse Committee of the Select Vestry (and of the Hospital Sub-Committee),

T. H. SATCHELL, Esq. 48, Lord Street, Liverpool;

Or,

H. J. HAGGER, Esq. Parish Offices, Liverpool.

WORKHOUSE NURSING: THE STORY OF A SUCCESSFUL EXPERIMENT.

The following pages contain a brief account of the experiment successfully tried by the Select Vestry of Liverpool (the guardians of the poor)—the introduction of trained Nurses into the male wards of the Workhouse Infirmary. That experiment having resulted so successfully as to induce the Vestry to extend the system to the remainder of the infirmary, it may be interesting to those who are concerned in the management of workhouses elsewhere to learn something of its history and progress. It is the writer’s object to explain—

1. The grounds on which the Vestry were led to undertake the experiment, as stated in the preliminary report of Mr. Carr, the governor, and that of the sub-committee of the Vestry appointed to consider the proposed scheme; and the replies received to inquiries addressed by them to institutions and persons connected with the training and employment of skilled nurses in London and Liverpool, with letters on the subject from Miss Nightingale and Sir John M^cNeill.

2. The results of the experiment, so far as hitherto ascertained.

The Liverpool Vestry had previously made considerable efforts to improve the workhouse infirmaries. The medical men had been encouraged to make requisition for every material appliance that could facilitate the cure of the sick; and paid female officers were appointed at the rate of one to each 150 or 200 beds, to superintend the giving of medicines and stimulants, and so forth: but of course so small a number, even had they been trained nurses, could do no real nursing, and could exercise little supervision over the twenty drunken or unreliable pauper nurses who were under the nominal direction of each paid officer. An appeal was made to the Vestry to consummate the good work they had thus partially commenced, and it was urged that Liverpool should assume the lead in the task of workhouse reform. The following considerations were submitted to the Select Vestry:—

“That Liverpool could commence this movement with great effect, and with the certainty that her example would be widely followed.

“That she had in times past taken a leading part in such reform. The introduction of the New Poor Law produced little change in Liverpool; so many of its wisest provisions were already in operation there, some of them for twenty or thirty years.

“That she had already established a system of attention to the sick poor in their own houses, which, if only by restoring heads of families to health and work, saved the parish many times the sum that it cost to private benevolence.

“That, lastly and especially, the proposed reform ought to commence in Liverpool, because in her workhouse the guardians had already, by their liberality, provided the sick with everything in the shape of diet and medical comforts that could conduce to recovery; and what was now wanting to give effect to their wise benevolence was, that their system should be administered and their intentions carried out by efficient and reliable nurses, in the stead of unreliable paupers.”

The appeal further urged that—

“Successful efforts have been made in many directions to improve the nursing of the sick, and the workhouses must soon be the object of similar endeavours. Those poor sufferers whose disease is protracted and hopeless are refused admission into ordinary hospitals, and must come to the workhouse; and the mere duration of the illness is in such cases sufficient to reduce to poverty the most industrious, careful, and temperate—men who, while they could work, paid regularly their contribution to the poor-rate. Surely, these are entitled to at least as great care as that which sickness at once assures to the imprisoned felon, however criminal, for whom well-paid nurses are provided by the State.

“As to the other class of inmates of the workhouse infirmary—those whose ailments are curable—mere economy requires that the most efficient means should be taken to cure them as speedily as possible, so as to preserve them and their families from becoming paupers.

“Thus justice and expediency alike counsel the introduction into the workhouse of the best known system of nursing. Probably nothing which the skill and kindness of medical men can do, no food or physical appliances which the guardians can supply, no oversight or care which they, acting through pauper nurses, can bring to bear, are wanting in the Liverpool workhouse; but it is to be feared that much of this care, liberality, and thought fails of its object for want of a sufficient number of reliable and duly qualified nurses to carry out the instructions given, to administer food and medicine to the patients, to dress their wounds, and so forth.”

This appeal was supported by two letters of Miss Nightingale and Sir John M^cNeill, G.C.B., President of the Board of Supervision (the Scotch Poor Law Board).

Letter from Miss Nightingale.

115, Park Street, W. February 5, 1864.

My dear Sir,

I will not delay another day expressing how much I admire, and how deeply I sympathize with the Workhouse plan.

First let me say that Workhouse sick and Workhouse Infirmaries require quite as much care as (I had almost said more than) Hospital sick. There is an even greater work to be accomplished in Workhouse Infirmaries than in Hospitals.

In days long ago, when I visited in one of the largest London Workhouse Infirmaries, I became fully convinced of this.