Friday, 1 September 2017

Nights on the ward - the Night Superintendent's Report

This week, Alice has been looking at a little-used but fascinating set of records that shed light on the daily workings of the Royal Infirmary of Edinburgh

In order to reform nursing and nurses training at the Royal Infirmary of Edinburgh (RIE), in the 1870s trained ‘Nightingale Nurses’ were recruited and a training program instituted. Under this new system, the nurses reported to the Lady Superintendent of Nurses, rather than individual ward doctors. In addition to the Lady Superintendent there was the Night Superintendent, who monitored staff and patients throughout the night.

As there was little cross-over in their hours, the two used small bound notebooks as a means of communication between night shift and day shift. The left-hand pages of each book contains instructions recorded by the Lady Superintendent at the end of her day; and on the corresponding page the Night Superintendent would record the happenings of the night).

These little volumes are a fascinating way to supplement some of the other records we hold. Some pages contain snippets about staff which paint a vivid picture of the differing personalities of nurses, such as this entry:

27th-28th March 1876
“I made 3 rounds, nurses all in their places but Louise of 4 M[edical] I found her twice in one hour absent from her ward. She was with the night nurse in 5 M[edical] each time. I told her I would report it to you…
Nurse McLeod was not well at 5am but thought she could do her work so I let her” - (LHB1/103/7)

LHB1/126/50 - Christopher's entry in the General Register of Patients
Others add life to the lists of patient names that are recorded in the General Registers. For example, where in the register 8 year-old Christopher Yeoman appears as one name amongst many, this small detail from the Night Superintendent’s report paints a picture:

30th – 31st March 1876
Lady Superintendent: “The mother of the child in 3 S[urgical] is staying with him tonight so Nurse Black is not there”.
Night Superintendent: “The boy has had a quiet night; he is always much better with his mother”.

 The job of nurse was a risky one; often, the Superintendents’ notes to each other either request or provide details about unwell colleagues. There are numerable instances of nurses falling ill, and and Mary Anne Barclay is one such nurse.
LHB1/97/1 - Nurse Fraser's training record shows the perils of the job
Mary Barclay entered the RIE as a probationer on 19th January 1876 having previously been employed for a time at Chalmers Hospital in Banff. According to her training record, she spent three months working in the Infirmary’s medical wards before she fell ill.

LHB1/97/1 - Nurse Barclay's training record
The first mention of Nurse Barclay’s illness in the Night Superintendent’s reports comes at the start of April 1876. As part of her general instructions for the night of the 6th April, the Lady Superintendent requested that the Night Superintendent “please visit Nurse Barclay [in] 1 lower dormitory”. The return reply records that “Nurse Barclay has not had a bad night – Nurses Brown and McLeod each gave her a fermentation”. The following days’ correspondence suggests continuing concern for her well-being:

7th - 8th April 1876
                Lady Superintendent: “Nurse McDonald will stay on duty with Nurse Barclay til Dr McLeod has seen her.”
Night Superintendent: “Nurse Barclay had some sleep but had pain when awake so I told Nurse McDonald to stay with her.”

The next night shows a further downturn as Nurse Barclay was admitted into the hospital as a patient:

8th - 9th April 1876
Lady Superintendent: “Nurse Barclay was warded in 14 M[edical]. Will you report of her in the morning.”
Night Superintendent: “Nurse Barclay has been quiet but has not slept much : she looks very bad.”

Her recovery was slow but ultimately successful, with her training record noting that she was “about ten weeks absent” before continuing her training with “nine months in surgical wards”. Ultimately, her hard work and commitment to the vocation paid off. She was described as “patient, obedient and industrious, of slow intelligence but very painstaking, high principled and kind”, and after two years working on the night staff of the RIE she left to take up the post of Matron of Wallasey Cottage Hospital in Birkenhead.

The Superintendents were also there to offer guidance and mentor the novice nurses and support them in carrying out an often difficult vocation, as can be seen from these snippets:

                19th – 20thth April 1876
Lady Superintendent: “Bad case in 3 M[edical]. The nurse there is timid, please assist as often as you can”
Night Superintendent: “3 M[edical] - The poor old man died at 3.40am”

                1st – 2nd May 1876
Lady Superintendent: “Nurse Collins being off duty, Nurse Munro is in 16 S[urgical]. Nurse Macrae is also off duty, and Nurse Wyllie is on 4 M[edical]. Both these are young nurse and will need some looking up, especially as there is a sharp typhoid case in 4 M[edical]”

                8th – 9th May 1876
                “7 M[edical] - Nurse Small is taking charge of the tracheotomy case and Nurse Callow to do the rest of the work. The latter being new to us, give good heed to this ward.”

Although intended as administrative records, these volumes are a wonderful way to experience more of life on the ward, and the nurses’ concern for their patients really comes through. 

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