The Girl Who Earns Her Own Living/Chapter 3
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Tue profession of nursing is just now in the throes of what might be termed a social upheaval. For ten years, when the training-school for nurses first offered an entrance to a profitable career for women, it passed through the romantic period. Would-be nurses's aw themselves as charming figures in uniform, veritable angels of mercy, particularly to good-looking young men and to elderly persons in search of heiresses. The halo of the ministering angel—always with a becoming fluff of hair under it—held a conspicuous position in their dreams of a hospital career.
To-day nursing, having passed Gaharnod through this romantic era, is reaching a purely scientific basis. The high standard, physical, mental and moral, demanded of probationers and student nurses, and the long period of relentless training, have landed the nurse where's he belongs, close to the physician's elbow. In this day of drugless cures, the intelligence, judgment and vigilance of the trained nurse mean as much in the sick-room as the prescriptions of the physician; therefore the trained nurse has dropped the halo for the mortar-board. Gradually she is finding her level in the professional world.
Asa result, while fewer girls pass the examinations for entering training-schools, those who do pass find themselves in a goodly company of real students, not emotional enthusiasts.
First: "What girls are suited to do the work, and therefore desired by superintendents of training-schools?"
The young women who are physically and nervously strong, and who are immaculately neat about their persons.
The girl who has weak sight, who is slightly deaf, who suffers from chronic throat trouble or catarrh or sick headaches or backaches should never consider this profession. Even if she manages to squeeze through her physical examination she will never pass muster during her term of probation. Physical defects must be cured, not alleviated, before an applicant—presents herself at any training-school. Canadian and Californian girls pass excellent, physical examinations.
Mentally, you should be equipped with a high school education, or its equivalent. A broader education is an advantage but not an essential. The girl who cannot indite a legible, well-spelled, clearly-phrased letter has little or no chance of receiving an application blank. A training-school for nurses is not the place in which to study the rudiments of English and arithmetic.
The girl who is slovenly about her person or her clothes need not waste money on carfare to the city where the hospital-school is located. Untidiness clips the wings of a probationer as quickly as a physical defect. The strong, straight-limbed, full-chested girl who carries herself well, and whose skin is clear and well kept, whose clothes are immaculate, whose every movement is alert, is the girl for whom the superintendent is looking. The girl who is given to violent intimacies, followed by violent quarrels, is not fitted for this work. The trained nurse must be self-contained to the point of being secretive. She must study the art of keeping to herself and her work. Neither is the training-school for nurses the place for the high-strung, emotional girl, who overestimates her importance. The path which leads to a diploma holds for a girl absolute self-effacement. Sheis only a very small part of the great hospital system with which she casts her lot. Her personality is merged into one word—"duty."
Having decided that you are fitted for the work, with its hard training and its liberal rewards at the end of the straight and very narrow path, decide where you wish to study. So far as actual training is concerned you will rereceive as up-to-date instruction in any large city near your home as in such great centers as New York or Chicago. Perhaps there is even more chance for individual work and supervision, but on the other hand the hospitals of New York and Chicago present a greater variety of experience, a broader field of work, because the wards and the clinics are much larger. Also, work in a New York or Chicago hospital is much harder, the discipline is more strict, and your ego is even more cruelly suppressed than in the less strenuous life of a smaller institution.
If you should decide to enter a training-school in your own city or the city nearest to your home, go first to your family physician and subject yourself to a thorough physical examination. Armed with a certificate of good health over his signature and a letter of recommendation from your pastor, or from the principal of the school from which you graduated, present yourself to the superintendent of the training-school for nurses. If it is a large institution you had best write for an appointment, as many superintendents have certain hours for interviewing applicants. Your fate is then in her hands. She is an absolute autocrat, and you cannot appeal from her decision to any physician connected with the hospital. Your first lesson in training-school discipline will be the power of the superintendent.
If you wish to go to a city like New York or Chicago make your application by mail. Address it to the superintendent of the training-school, and state in it clearly and unequivocally your age, height, weight, health, strength and any physical defects you may have. Do not try to gloss over any deficiency in training or condition. Be sure the superintendent will find you out. Set forth your educational advantages, your occupation from the time you left school until the hour of writing, the church of which you are a member, your reasons and motives for becoming a trained nurse, also whether you are married, single, widowed or divorced. Be equally frank as to your responsibilities, whether you have others dependent upon you for financial support. Forward with these statements, which you should make as brief as possible, your letter or letters of recommendation, and a certificate of health.
If this informal application makes a good impression on the superintendent, she will send you a regular application blank, which you will fill out with infinite care—and please, dear girls, if you want to make a good impression with this, do not send it forth decorated with tiny blots, or, worse still, greasy thumb-marks. It will announce to the trained eye of that superintendent that you are not neat. And untidiness, as I said before, is a heinous offense.
Now, we will take up your career at your moment of acceptance as a probationer. Your name is placed on the waiting-list, and there it stays until a vacancy occurs, when you will be summoned and must report at once. In the meantime get everything in readiness. When you are notified that you have been accepted as a probationer you will receive a list of the clothing to bring with you. This varies in different hospitals, therefore I cannot give explicit directions. All this clothing you must provide and pay for. The training-school provides nothing until you have passed the period of probation and have entered upon your long term of service to the institution, when you will be paid a small salary with which to purchase uniforms, or, the uniform will be furnished. This much I will say: Show good judgment in the selection of your clothing. Have plenty of simple things rather than a few that are ornately trimmed. If you expected to wear a uniform of chambray or gingham or zephyr cloth in the familiar gray-blue and white stripe, have these simple dresses fitted carefully to give you the appearance of trimness, and have the waist and skirt joined by a narrow band to avoid the separation of skirt and waist or the use of unsightly safety-pins. Have an ample supply of perfectly plain white petticoats with simple hems or a few tucks but not a scrap of lace upon them. Do not waste your money on fancy neckwear. It is unprofessional. Have plenty of plain linen stocks or collars, and white ties plainly hemmed, with cuffs to match, and quantities of large white nursing aprons. Your shoes should be soft and easy. You will be told what quantity and sort of underwear will be needed. Everything must be clearly marked with your name.
Once more—your success as a probationer will depend largely on your neatness. A probationer is allowed a limited amount of laundry work. Do not depend solely upon this, but take with you enough money to pay for extra laundry. One nurse who made an unusual record as a probationer says she owed her success to a laundry bill of ten dollars a month.
Some girls manage to go through the entire course without receiving any money from home, but this means rigid self-denial, as the salary paid by the school is intended to meet only your expenses in the way of supplies needed for your tuition, books, uniforms, washing, etc. And every probationer should take with her the amount of her railroad fare home. The superintendent of the training-school assumes absolutely no responsibility for your future. If you fail, you must pay your own way home. And what is more, you will not be told why you failed!
Now the word comes that you are to report for duty. Pack your trunk carefully, not failing to put in a stout little strong-box with a padlock, for the superintendent assumes no responsibility for your property unless you place money, rings, etc., in the office safe, and you are away from your room or dormitory most of the time.
On reaching the city where the training-school is located do not go to a hotel, and then, with the air of conferring a favor, write to the superintendent that you are in town and ready to come at her call. She has called you. Go directly to the hospital—and drop your individuality on its front stoop. From the moment you enter you are a mere cog in this great machine of alleviation and mercy.
Just here let me tell you an incident in the first day of school of a now successful nurse. She entered the tiny room assigned to her on the top floor of the dormitory building, flung her suitcase, her umbrella, magazine, etc., on the narrow bed and seated herself thereon to remove her hat and veil. She was just tucking the latter into her diminutive locker, when—enter the superintendent of nurses! This personage gave a quick glance at the bed and remarked:
"Why, really, it looks as if some one had been sitting on that bed."
"Yes, Miss Blank," replied Miss Innocence, "I have."
"Never do it again. Once a bed is made up, nothing should be laid on it, not even a handkerchief."
Do you begin to understand that the régime is not cruel, but strict? Little blunders might cost a human life. There must be no such word as "forget" in your vocabulary. Neither must you ever say "Why?" Just do as you are told. You are not there to improve the system of the management. It has been all tried out, perhaps before you were born. For the time being you are a nonentity, whose sole duty is to obey implicitly, unquestioningly.
Every one is watching you. You are surrounded by spies who study your every movement. They will notice the lace stock that ought to be plain linen, and the raveling from your petticoat that should never have found its way to a hospital training-school. They will peer into your bureau drawers merely to see in what order you keep your personal belongings, and some one will go into your room every morning to make sure that you tidied it perfectly before going to breakfast or on duty.
Many girls ask what is expected of a probationer in the way of actual work. During the period of probation will they be given a fair test of their ability?
The following program of the first eight weeks' work laid out for probationers in a New England hospital will convey some idea of the scope and nature of the work:
"Hospital etiquette and rules, nurses' ethics; washing, nourishment dishes, care of refrigerators, gas-stoves, cupboards, trays, serving meals, nourishment; care of lavatory and utensils in lavatory; bed-making; bed bath; patients' morning and evening toilets; admitting stretcher cases, undressing patients, entrance bath, listing and care of clothing and valuables; filling and applying ice-caps, hot-water bags; care of linen press; washing hair, care of back, mouth, teeth, etc.; feeding helpless patients; taking and recording temperatures, pulse and respiration; mustard plasters, poultices, etc.; giving of medicines; special class instruction in printing, charting and diets."
Once you have proven your worth as a probationer, and are accepted as a student nurse, you virtually turn yourself and your services over to a hospital for a term varying from two to three years. During that time you will be provided with lodging, food and care in case of illness. Hither your uniforms, laundry and text-books will be provided or you will receive a small allowance which will cover these expenses. Your hours will be practically twelve a day, with brief respites during each day for outdoor exercise, a half-holiday each week, and generally half of each Sunday. Two weeks' vacation is granted during the summer. You will live at the home for nurses connected with the hospital and will be subject to its rules and regulations, precisely as if you were a hospital patient instead of a nurse.
If you are unwilling to give up this much time, this much strength, this much liberty, to prepare for the profession, do not aim to be a trained nurse. Nothing short of this will prepare you.
It seems hardly necessary to outline the career of a nurse after graduation, but as many girls desire such particulars, I will add that in cities of any size the graduate nurse who has aroused the favorable interest of physicians connected with the hospital seldom lacks work at $25 a week. On the other hand, experienced nurses declare that the work is so exacting and so wearing, physically and nervously, that no graduate nurse should attempt to work more than ten months in a year, which means that her cash income will be a thousand dollars a year. Her board is of course included wherever she nurses, but she generally maintains a residence in some registry or good rooming house. Her uniforms and laundry form a heavy item of expense.
Graduate nurses do not always take up general practice, but may secure positions on hospital staffs, perhaps in the very school from which they have just graduated, or in smaller out-of-town hospitals. All large State institutions and private charities employ trained nurses. This list includes houses of correction and refuge, asylums and homes for crippled, blind and mentally defective children, homes for the aged, and large schools where the nurse works under the matron. Factories and department stores also employ nurses to guardthe general health of employees and act in case of accident. In many cities the Board of Education maintains a corps of nurses, health departments also give them employment, and nearly every large city has its visiting nurses. The highest salaried posts are those of superintendents in hospitals and sanitariums, but experienced nurses agree that a period of general practice is desirable as preparation for any salaried position in an institution.
If you cannot take a complete course, and you are still determined to work for the sick, then you must select different lines from those followed by the trained nurse. You may become what is known as a convalescent nurse, or a trained nursemaid, or you can specialize on massage or cookery for the sick, or you can make a business of reading aloud to the sick. But do not imagine for one instant that among doctors you will have the same standing as the trained nurse, nor will you command the same income.
Several organizations, notably the Young Women's Christian Association in large cities, offer courses in convalescent nursing. In this course you are prepared to take the place of the trained nurse, when the patient is so close to recovery that scientific vigilance may be relaxed and mere attendance and entertainment substituted. Convalescent nurses are employed to relieve trained nurses while the latter take their daily outdoor exercises; also in some households to wait upon chronic invalids who have become fretful and captious, and who require diversion as well as light attendance. Work of this sort is secured through registries and physicians, and pays from seven to fifteen dollars a week, according to the amount of attendance and work required.
Trained nursemaids are now in great demand in the nurseries of the rich. They step into the shoes of the trained nurse, take complete charge of the new baby in the household and often assume direction of the nursery complete, ordering the meals, and guarding the health of the older children. In such instances there is generally an under-maid who performs the menial nursery duties. The semi-trained nurse wears a uniform and is a sort of upper servant in the household. Her salary varies from twenty to thirty dollars a month, together with board, lodging and laundry, according to her duties and training. Such training is secured in charity hospitals for babies, and the course runs from six to nine months. The responsibilities, however, are very great, as the woman who employs a semi-trained nurse generally has many outside interests and throws all responsibilities upon her employee.
An expert masseuse can build up a good business in this day of nervous womanhood, of high-strung society women and overworked professional and business women. Hither the Swedish system of massage or the Weir Mitchell system, physicians say, should be mastered by the masseuse who expects to succeed. Both require many months of study, superb strength and that peculiar quality of personal magnetism which makes the exhausted patient respond to the efforts of her masseuse. A masseuse is paid by the hour or by the treatment, and secures work through physicians, registries for nurses, sanitariums, Turkish baths and beauty parlors, where nervously exhausted women go to recuperate.
General massage is taught in all hospital training-schools, but the specialist should take private instruction from scientific experts.