chapter 2 chaos and order in hospital nursing ordered to care
TRANSCRIPT
CHAPTER 2CHAOS AND ORDER IN HOSPITAL NURSING
Ordered to Care
19th Century Hospitals
Institutions for sick, poor, or displaced members of the lower working class.
1873 – 120 hospitals in the countryHospital Nurses were at the very bottom of
the paid labor hierarchy “Professed “ nurses became members of a
household for the duration of illness Hospital Nurses were confined to the
institution as their home and workplace.
Early Hospitals
Voluntary Hospitals Established through charitable efforts of
middle and upper classesIntended for deserving and respectable poor
who were ill Space was reserved for those that could pay
for careRooms for paying patients had nice furniture
and drapes.
Early Hospitals
Public InstitutionsServed Chronically ill & those with venereal
diseasesHarpers Weekly 1860 drew attention to
problems with filth, vermin and cross infection in hospitals
Rampant cross infection was called “hospitalism”
Benevolence did not equate to cleanliness
Early Hospitals
Seen as a home or householdStrict order was expectedRigid Rules for behavior Daily hours and visiting was regulatedTobacco and Liquor consumption was limitedDietary restrictions were imposed if rules
violatedPunishment cells were usedRules were constantly broken and easily
ignored
Hospital Authority Structure
Trustees ( Usually Male) controlled daily activities
Main responsibilities were financial:AdmissionsPay ratesExtensions of Free careScreening out of incurable patients
Hospital Authority Structure
Hospital Superintendent:Ordered suppliesHired and fired servantsHired and fired nursesOversaw running of institutionFrugality was expected and skimming of
funds common.Matrons (usually superintendants wife) was
responsible for overseeing the cooking , washing and cleaning.
The Hospital Nurse
Lived at the hospitalPatients and caregivers are the same
Patient Kitchen Help Laundres
s
Nurse
The Hospital Nurse
Poor, working classHospitals would hire anyone for the positionCourage, self- possession, and snapFrequent staff turn-overNurses and patients were not separated.Cleaning and laundry were typical tasksWorked from 5AM- 9:30PM
An Order of Their Own
Small hospitals- matrons directed the nursesLarge hospitals- head nurse guided the state
of the unitPhysicians and Nurses
The Rights of Caring
Hospital management attempted to control the nurses’ lives.
Home care, institutions, or another profession
Culture of nursesCaring was rareAutonomyTransformation Needed