Ordered to Care - College of Education
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Transcript Ordered to Care - College of Education
Ordered to Care
CHAPTER 2
CHAOS AND ORDER IN HOSPITAL NURSING
19th Century Hospitals
Institutions for sick, poor, or displaced members of
the lower working class.
1873 – 120 hospitals in the country
Hospital 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 classes
Intended for deserving and respectable poor who
were ill
Space was reserved for those that could pay for care
Rooms for paying patients had nice furniture and
drapes.
Early Hospitals
Public Institutions
Served Chronically ill & those with venereal diseases
Harpers 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 household
Strict order was expected
Rigid Rules for behavior
Daily hours and visiting was regulated
Tobacco and Liquor consumption was limited
Dietary restrictions were imposed if rules violated
Punishment cells were used
Rules were constantly broken and easily ignored
Hospital Authority Structure
Trustees ( Usually Male) controlled daily activities
Main responsibilities were financial:
Admissions
Pay rates
Extensions of Free care
Screening out of incurable patients
Hospital Authority Structure
Hospital Superintendent:
Ordered supplies
Hired and fired servants
Hired and fired nurses
Oversaw running of institution
Frugality 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 hospital
Patients and caregivers are the same
Patient
Kitchen
Help
Nurse
Laundress
The Hospital Nurse
Poor, working class
Hospitals would hire anyone for the position
Courage, self- possession, and snap
Frequent staff turn-over
Nurses and patients were not separated.
Cleaning and laundry were typical tasks
Worked from 5AM- 9:30PM
An Order of Their Own
Small hospitals- matrons directed the nurses
Large hospitals- head nurse guided the state of the
unit
Physicians and Nurses
The Rights of Caring
Hospital management attempted to control the
nurses’ lives.
Home care, institutions, or another profession
Culture of nurses
Caring was rare
Autonomy
Transformation Needed