Introductory notes on lying-in institutions : $b Together with a proposal for organising an institution for training midwives and midwifery nursesNightingale, Florence
Science
Introductory notes on lying-in institutions : $b Together with a proposal for organising an institution for training midwives and midwifery nurses
Nightingale, Florence
Women's hospitals
Ought to be separate in every lying-in institution; _must_ be separate
in an institution of more than four or five beds, though in separate
compartments.
Every delivery bed should have a superficial area of not less than 200
square feet, and a cubic space of not less than 2,400 cubic feet.
5. _How many Windows to a Bed?_
One at least to each bed. Two beds and two windows on each side of the
four-bed ward.
In a single-bed ward the bed should not be placed directly between
window and door. And it must never be in an angle. There must be room
for attendants on both sides the bed.
This is still more essential in a delivery ward. Each bed should be
lighted on _both_ sides by windows, and should have at least five feet
of passage room on either side.
6. _What are healthy Walls and Ceilings and Floors?_
Oak floors, polished; furniture also; impervious glazed walls and
ceilings, or frequent lime-washing.
All that has been so justly said as to the necessity of impervious
polished floors and walls for hospitals applies tenfold to lying-in
institutions, where the decomposition of dead organic matter, and the
re-composition of new organic matter, must be constantly going on.
It is this, in fact, which makes lying-in institutions so dangerous to
the inmates.
And it may literally be said that the danger increases as the square of
the number of in cases.
Lying-in ‘infection’ is a very good illustration of what ‘infection’
really means, since _parturition_ is not infectious or ‘contagious.’
The excessive susceptibility of lying-in women to poisonous emanations,
the excessively poisonous emanations from lying-in women—these
constitute a hospital influence on lying-in cases brought together in
institutions, second to no influence we know of exercised by the most
‘infectious’ or ‘contagious’ disease.
The death-rate is not much higher among women lying-in at home in large
towns than in healthy districts. Therefore the agglomeration of cases
together and want of management required to meet it must bear the blame.
As to floors, the well-laid polished floor is _a sine quâ non_ in a
lying-in institution, where, with every care, slops, blood, and the
like, must frequently be spilt on the floor.
7. _What is a healthy and well-lighted Delivery Ward?_
There must be two separate delivery wards for each floor of the whole
lying-in institution, so arranged and connected _under cover_ that the
lying-in women may be removed after delivery to their own ward. And for
this purpose the corridors must admit of being warmed during winter,
especially at night, so as to be of a tolerably equable temperature.
Unlimited hot and cold water laid on, day and night, W.C. sink,
bath-sink, clean linen, must be close at hand.
In a pavilion hospital one single-bed ward should be attached to each
delivery ward, for an exhausted case after delivery, till she is able to
be moved to her own ward.
Public-domain text, read in full here on John Shaqi.
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