proud of the number of times they have been "sent up," while others regard it as the inevitable. Once I had to pass a woman who was scrubbing in a doorway at Charity, and as she moved her pail I recognized her and said, "What, Mary, are you here again? I thought you weren't coming back." Her face fell as she answered, "Yis, m'm, I thought so too," and then she brightened up and said proudly, "But it was the iligantest wake you ever see."

Some of them again are decent and quiet enough when not possessed by the devil of drink, and it often happens that one of this better class will stay on as a helper after her sentence has expired, perhaps feeling that she is protected from herself while the river is between her and her boon companions, but sooner or later she is missing some day, she has "gone over," and if she comes back it is in the prison boat.

Here follows the journal of an ordinary day at Charity Hospital, by one of the head-nurses:

"Time: 7.30 a.m.

Scene: Ward 3, Medical. Beds all unmade, a few patients up-these have faces washed and hair combed - the majority in bed with this duty still to be performed for them. A part of the floor at the front of the ward has been scrubbed. Mary, one of my prison helpers, is washing dishes at the table, and Bridget, the other, is taking soiled clothes from a large can and sorting them for the wash.

The atmosphere contains none too much oxygen; this can be explained by saying that the night-nurse is finishing her work in one of the other wards, and the patients in her absence have taken the precaution to close all of the windows for fear of taking cold. After giving an order for the windows to be let down, I take up the night notes and read:

Murphy-Died at 3 A.M.

Ryan-Temperature, 108°; pulse, 120; respiration, 30. Antifebrine, grains iii., and other medicines given as ordered. Poultice applied last at 6 A.M.

Patient passed a very restless night.

And so on, through the other cases in the ward. These notes are signed by

the night nurse, who now comes in with the keys, looking pretty well fagged.

66

Good-morning; I am sorry I have kept you waiting for the keys, but I have been so busy I could not get down sooner. Had a death in Ward 4, as well as the one here, and a patient in Ward 6 suffering from delirium tremens, besides the ordinary work."

I now go over to where my assistants are putting on their caps and aprons and getting together the things necessary for work. Miss W. and Miss A. are here, but where is Miss H.? Miss W. answers:

"She was called up last night to go. on the maternity service. The superintendent missed you, and asked me to tell you that another nurse could not be spared to-day."

Oh, dear, thirty-two patients in the ward, and five of them so helpless that they have to be fed and cared for like babies, two pneumonia cases, and the usual number of phthisical and rheumatic subjects. Well, well, grumbling won't do the work, so we'll have to make the best of it.

Each of my assistants, armed with a pile of clean sheets and pillow-cases, proceeds to the lower end of the ward and commences the task of getting beds made, while I go to write the list of clothes for the laundry. Bridget counts the clothes while I stand by and take down the number of each of the different articles. This done, they are tied in large bundles and sent to the wash-house.

Now the medicines are to be given out. I measure and prepare them, while a convalescent patient carries them round to those in bed. My list is a long one, and it takes fully thirty-five minutes before they are all distributed, the bottles wiped off, and the medicine closet put in order. My next move is to take a list of medicines which need to be renewed, and leave it ready for the doctor's signature. It is now twentyfive minutes past eight, and Miss A. and Miss W. are making as good progress as possible at their respective sides; for it must be remembered that a nurse has often to stop what she is doing to attend to the wants of some particular patient, or to carry out an order if the time is due.

The "railroad beds "* are still unmade. Occasionally we have a convalescent patient who can do this part of the work very well. We had one in this ward last week, but alas, for the frailty of human nature, she showed a disposition to quarrel with the other patients on very small pretexts, so she was dismissed. With a rueful thought of what might have been, I go to work at the beds. A patient goes ahead and strips them for me. We work with all our might, and they are finished at ten minutes past nine. The side beds, too, are nearly finished. This part of the work necessarily takes much longer, as sick patients have to be placed in chairs and wrapped up in blankets, or, if they are too weak, lifted into other beds, so that their own can be made.

My next work is to take morning temperatures; when I have finished this I see a large tin can standing near my table. It contains crackers, butter, eggs, and sugar. These have to be put away in their proper place, and the quantity noted. Now, I must write my diet-sheet, and order the supplies necessary for to-morrow. It is twenty-five minutes past nine, the beds are all made, the stands in order, the floor swept, and the table scrubbed. The junior nurses are about through with washing faces and combing heads, and it is now high time that I should make a round of the ward and find out if there is any change in the patients' condition to which the doctor's attention should be called.

While this has been going on the gruel and milk have been standing on the table, and the distribution of this falls to my share to-day also, as I have no senior nurse. Each bed-patient who cares for it is served with a portion on a tray; afterward the walking patients seat themselves at the table and take theirs. Now the doctors come in to make their morning visit, the housedoctor is told of any special complaints; he examines these patients, also any new ones who may not yet be under treatment, and leaves the new orders on my book.

A "railroad bed" is one that is unoccupied during the day, and therefore, as it were, "shunted" and only rolled out at night. They stand close together in the middle of the ward.

While doing this work all morning, I have been trying to keep an eye on what my helpers are doing, and now take this time to make a thorough inspection of all parts of the ward, bath-room included. In the meantime the special diet has been divided among the patients needing it most. At eleven o'clock tonics are given out, afterward eggnogs and milk-punches are made and distributed.

We now begin to breathe freely-the worst pressure is over if we get no new patients. Our hopes along that line are doomed to disappointment, for the helpers from the women's bath-room now announce the arrival of two new patients, and Miss W. disappears to superintend their bathing.

I am congratulating myself on not having a "stretcher case at any rate, when two men come in with one. Miss A. quickly places screens round a bed, and a rubber sheet over the clean bedclothes. The woman is lifted on the bed, and her temperature, pulse, etc., taken. Her own clothes are soon removed, and a warm sponge- bath given and hair combed. These operations have effected a wonderful change in her appearance, and she now looks a little more like a Caucasian, whereas, before the bath, she might have belonged to one of the darker races of mankind.

The doctor is notified that there are three new patients in the ward. It is twelve o'clock; Miss A. and I go to dinner, and leave Miss W. to superintend the patients' noonday meal, and give out medicines afterward. We return at one o'clock, and Miss W. goes, with the right to remain off duty till four o'clock.

The ward is now to be swept again and put in order for the afternoon. This is hardly accomplished when two huge bundles of clothes are carried in, and in ten minutes time two more. These have to be sorted and counted. Before we proceed to the folding of them the afternoon milk and other extras are given out. That done and the table cleared, we fold the clothes as quickly as we can. In due time this is finished, Miss A. is making a poultice in the bath-room, and I am putting the clothes in the closet, when someone calls "Nurse, nurse!" I turn to see

where the sound comes from, and notice several patients pointing to a bed in the far corner of the ward. I hurry down and find the patient's clothes saturated with blood-a hemorrhage from the lungs. Screens are immediately placed around the bed, cracked ice given, and the doctor summoned. He comes at once, the flow of blood seems to have ceased, medicine is ordered, and the doctor goes. The patient's clothes are now changed very carefully, and she is made as comfortable as possible. The screens are just put away when another stretcher is brought in, and Miss W., who has now returned, gives the usual treatment.

It is time for the afternoon tonics, and eggnogs and punches are again distributed; after this I take advantage of a few spare minutes to enter the names and addresses of patients in a book kept for the purpose. Discharged patients are also marked off.

The patients have supper between halfpast four and five. At half-past five Miss A. retires from the ward, the remaining time till half-past seven being hers to rest. In the meantime the doctor has been in and left a few orders.

The giving out of the evening medicines falls to me, while Miss W. attends to the patients' needs in other ways. If I had a fourth nurse I might be relieved from duty; but it cannot be thought of now. This is the evening for carbolizing the side beds; the helpers do this, while we follow and restore things to order. The rest of the time till half-past seven is spent in making patients comfortable for the night, and writing down new orders and notes on the patients' condition for the night nurse. We are quite willing to deliver her the keys when she comes in, and bid her good-night, while we go home tired enough to sleep soundly."

Charity Hospital, as I have said, has chiefly chronic cases. The work in the accident or emergency hospitals is somewhat different, as will be seen by the following notes:

"Leaving the Island at 7 A.M., after three-quarters of an hour's ride in boat and car, I reach Gouverneur Hospital.

On my arrival I receive from the night nurse both a verbal and written account of all that has happened of importance during the night-arrival of new patients, serious symptoms which may have developed in certain cases, new orders which have been given by the doctor, or old ones which may have been countermanded, etc.

Then begins the work of the day. The ward is thoroughly scrutinized, to discover little things which the helpers are apt to do slightingly, or not to do at all; stands are dusted, clean covers and curtains put on, if necessary; every patient and bed must undergo thorough inspection.

Everything is done as quickly as possible, for the "visiting" may be looked for at any time after 9 A.M., and it is the ambition of each nurse to have her ward spotlessly clean.

I have six pneumonia cases, who are poulticed regularly every three hours; they are also kept on milk diet, and, of course, require particular attention. I have just finished putting on my last poultice when the visiting" comes in, followed by the house surgeons, senior and junior. I accompany them to the different beds, ready to receive all orders, and impart any information which may be required of me. During the rounds of the physicians, an ambulance call is given; in due time the man is carried in on a stretcher; I rush to prepare a bed, which consists in turning down the covers, and protecting the whole with a rubber sheet; with the assistance of one of the helpers the patient is placed in bed. It proves to be a poisoning case. As quick as possible I get ready pitchers of tepid water, a pail, and a stomach-pump. The doctor then begins his operations, and I stand near to assist him. If the patient is very weak, I administer stimulants hypodermically; an emetic is given. Fortunately, the case has been attended to in time, and is soon out of all immediate danger, although very weak. A little boy has been brought in with hand and wrist literally pulverized; the poor little fellow's cries are heartrending; an anæsthetic is administered, I carefully sponge the blood away from the injured parts, get ready the different solutions, gauzes,

bandages, splints, etc., and stand near to assist in any way that I can. (I took care of the little boy for six weeks after that, and he was sent home cured, having lost but two fingers.)

Standing by, awaiting his turn, is a stonecutter. He must have taken his thumb for a stone, for he has simply hammered it off. The compression of his lips and the pallor of his face give evidence of the pain he is suffering. A thin piece of skin on one side keeps the thumb from being entirely severed from the hand; the doctor replaces it and sews it on, but eventually, to save the hand, it had to be amputated.

Fortunately there are no more accident cases on hand, and I am free once more to attend to my other patients. I give out the three-hour medicines, renew my poultices, and take the temperature, pulse, and respiration of a patient who came in about an hour ago; but, finding his temperature normal, I let him remain seated until the doctor comes in.

After dinner I give out the noon medicines, examine the beds of the helpless patients, and find out from them if there is anything I can do to add to their comfort. After attending to their wants, and performing numberless duties which it would be impossible to relate, I finally feel satisfied that every patient has been made comfortable; then I tear up bandages, which are given to the convalescent patients to roll; prepare solutions and different kinds of gauzes to be used during operations; in the meantime keeping a watchful eye on all around, so that no patient shall suffer from want of attention.

About 4 P.M. I have to take the temperature, pulse, and respiration of each patient, which, in a ward where there are twenty, takes quite a length of time. After the temperatures are taken, I see that each patient has his supper, then write an account of all the orders I have received, which are to be continued during the night, renew the poultices, give out the medicines, see that the ward is in perfect order, and am relieved at 6 P.M. by the night nurse."

The following is an account of the routine of a night at Gouverneur Hospital:

"The night nurse of Gouverneur does not often arise with bright face and laughing eye, feeling as fresh and happy as a lark, at half-past four in the afternoon of a hot July day, but she scrambles out of bed and dons the "stripes as quickly as possible, that she may not be late for the dinner at five o'clock. At six we get to the wards to relieve the day nurses from duty, and are often greeted with, "Well, I think you will have rather a hard night."

As I look around the ward I find the man in the first bed is a sunstroke case, with a temperature of 105°, and the orders are to keep ice-bags on head and abdomen, give ice-baths, and take temperature every fifteen minutes until the temperature falls below 102°. The child in the corner has pneumonia and has on a jacket poultice of linseed-meal, which must be changed as often as it becomes cold, and the child watched very closely. The delirious patient in the other corner is to have an ice-cap on his head, which must be kept well filled with cracked ice. He has a fracture of the base of the skull, and he raves and shouts most of the night.

We have two patients more than we have beds, consequently we must prepare four patients to be transferred to Bellevue, in order to have beds for the patients who will come in during the night.

At nine o'clock the doctors make their rounds, and oftentimes there are dressings that the doctor has had no time to do during the day, and the nurse must always be ready to wait upon the doctor the moment he enters the ward.

At eleven o'clock there is an ambulance call and a man is brought in with three stab wounds. He is covered with blood, hands, face, and clothing, has a long wound on the face, a deep one in the shoulder, and a small one in the abdomen. The wounds are sewed and dressings put on. These dressings are scarcely finished, when there comes another call, and the ambulance brings in this time a fine-looking young man with a deep wound in the forearm. From his nervous tremor and restlessness I conclude he has been drinking heavily, and

The uniform of the school is blue and white striped

seersucker.

Then things quiet down for perhaps an hour, which time must be devoted to the man with sunstroke and the child with pneumonia. These, however, have not been wholly neglected, for there was time to make a poultice for the child, and the helper has attended to the bathing of the man, whose temperature has fallen only one and one-half degree.

Now it is time to begin the morning's work of the wards, for they must be all in order for the day nurse when she comes on duty at eight o'clock. The temperature, pulse, and respiration of each patient in the wards must be taken and noted upon the chart, also any new treatment ordered during the night, and anything noteworthy in the condition of the patient. Each bed is to be made, bed-linen and patient's clothing to be changed, if soiled, while the floors are swept and washed by the helpers.

The medicines are given out at various times through the night, as each becomes due. Then there is the patients' breakfast to look after, and to see that all are served who may eat the food, and that those who are on special diet may get nothing but that allowed them, whatever it may be."

prepared, being boiled and soaked and wrapped in antiseptic towels, or kept until needed in large glass jars. The nurse is further responsible for having everything in the room which the surgeon may possibly want, such as hot water, ice, hot-water bottles, stimulants, etc., and must be prepared for every emergency which, during the operation, may possibly arise. The patient is prepared by the nurse, who gives a full bath, braids the hair, puts on clean and suitable clothing, and arranges her on the table, where she is always covered with a sheet or a single blanket if necessary. Another nurse helps the doctor give the anaesthetic, and in fact, there are usually three nurses at an operation of any importance, the head-nurse being in charge and the other two her aids. She herself keeps her best eye on the operator and stands in a certain place where she can readily hand him hot towels, sponges, bowls of solution, anything he may need. The second nurse watches the supply of hot towels, solutions, sponges, hot and cold water, etc., while the third helps the junior doctor who is etherizing the patient, and fetches and carries, i.e., empties out water and puts it outside the door, where some patient is stationed to carry it away and fill up empty pitchers. In running an operation a nurse always aims at having it go off without a hitch, and sometimes it does, sometimes not. Occasionally an operator is unreasonable and asks for the moon, and occasionally he makes a mistake and loses his head, and then the nurses have a poor time of it, being blamed if they have no boiling-hot beeftea or brandy when there is no means of heating it in the room, the operation having already lasted over an hour. doctor, if he is a gentleman, usually thanks the nurse after a long operation, and then she feels like doing anything for him."

A

Their hard day over, the nurses go to the Home, which is the stone building at the south end of Blackwell's Island. There they have a comfortable sitting-room with books and magazines and a piano, and in summer they can play lawn tennis outside, or rest and watch the crowd of boats that is always