No charity or institution, I believe, could possibly bear the expense of a single-bed ward, or even of a four-bed ward lying-in establishment, for a pretty constant succession of thirty-two patients, unless there were a training school. [Thirty-two single-bed wards, an administrator would say, would require sixteen nurses, independently of midwives!!] Even with a training school, the first year would be one of great difficulty, since all well managed training schools ‘take in’ pupils as much as possible at only two periods of the year, so as never to have the whole of the pupils fresh hands at once. But the _first_ batch must necessarily be all fresh hands. A raw girl cannot be turned in to sit up with a newly-delivered woman and new-born infant. And a midwife cannot be spared to each girl all to herself, to teach her how to handle an infant. [That is, in each single-bed ward.] The whole nursing service of a large four-bed or one-bed ward lying-in institution is so complicated, so different from that of a general hospital with its 20 or 32–bed wards, that it is difficult to provide for. In even guessing at what the nursing accommodation should be for so completely new an experiment as a lying-in institution of 40 beds in single-bed or four-bed pavilions, we must begin by stating the probable requirements, the whole being tentative. The staff would have to be at least as follows:— One matron. One head midwife. One assistant midwife. One deputy assistant midwife (for the first year). To establish a really good training school, Thirty pupil midwives. [Two experienced good nurses in addition might be necessary for the first year.] One cook. One housemaid. One or two other female servants, such as scourers—or more (number required depending on the flooring used). Though this staff appears enormous, it is calculated upon the plan of giving only one night nurse to every four beds,—upon the supposition that 32 occupied beds will give a constant succession of cases, enough to provide instruction for almost as many pupil midwives;—upon the principle that for systematic instruction there must be a fair number of pupils; as, if every moment of their time is occupied in active duties, they cannot be well trained;—and also upon the obvious fact that it would be impossible, from its extravagance, to nurse such a construction without pupils. [For the _second_ year, if a portion of the pupils are to be made thorough midwives, and their time of training two years, possibly the deputy assistant midwife, and probably both the nurses, might be dispensed with. The second-year pupil midwives ought to be quite competent, each to be in charge of two or three first-year’s pupils and several patients, taking these patients from the beginning, and teaching pupils to handle new-born infants, look after ordinary lying-in cases, and the like; and most excellent practice it is for the young teachers.]