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
But small-pox has appeared after labour.
There might be danger in taking a patient from the institution to this
ward through the open air, in all weathers, unprotected by any covered
passage.
On the other hand, when once the patient is in the ward, complete
isolation is by far the best, for the sake of all the others.
And there is by no means the same necessity for a passage as in the
other parts of the institution where any night there may be three or
four ordinary delivery cases to be conveyed through the passages.
A covered ambulance for sick cases is not, however, a nice thing, though
often suggested.[22]
3. The first two may be called universal and essential principles of
good management in every lying-in institution, large or small, however
perfectly constructed.
Here is a third, hardly less essential, wherever there is more than one
bed to a ward, viz. to remove a lying-in woman three times during her
stay in the institution.
The average course of an ordinary case may be reckoned thus:—
Seven or eight hours in the delivery ward.
Five or six days in the lying-in ward.
Nine or ten days in the convalescent ward.
The nearer wards to the delivery ward in use should always be made the
wards for women immediately after delivery; the farther wards for the
same women when removed for their convalescent stage.
In a single-bed ward the woman may remain in her own ward from after her
delivery till her discharge; that is, no further removal after her
delivery is necessary.
4. Cases of extreme exhaustion after delivery, which are better out of
the delivery ward yet cannot be moved many yards, should be carried _in
their beds_ to the bye-ward adjoining the delivery ward, till they are
somewhat recovered.
These must have a constant watcher by them.
5. In a lying-in institution about three times the quantity of linen and
bedding for each patient is necessary of what is used at a general
hospital.
The day’s and night’s provision of linen is kept in each ward scullery,
and in the scullery of each delivery ward in use.
The linen-store in the store-room, and the bedding-store, need to be
very complete and ample.
The bedding, that is, the mattress and blankets, of any one bed in the
delivery ward should not be used for more than three or four delivery
cases in succession without undergoing some process of purification—and
this quite independent of any accident, the mattress of course being
protected by Macintosh sheeting.
_III. TRAINING SCHOOL FOR MIDWIVES._
The few words which will here be added on the management of a midwifery
training school are not at all to be understood as a manual for
practical instruction, which it is quite impossible to introduce here,
but as simply treating of the management, in so far as this determines
some constructive arrangements as imperative, and others as to be
avoided.
Public-domain text, read in full here on John Shaqi.
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