tration law. Like many another State, we have many discouragements in trying to protect our interests, and to regulate the work of unqualified nurses.

I believe thoroughly in the old policy of "Live and let live," but it is observed by many others than nurses that in this State many physicians are following a policy as regards untrained nurses, which is productive of a very unjust and depreciating estimate of the work of trained nurses and hospitals.

We who have been studying this problem for ten years past, know that a surprising number of untrained women are being employed or recommended for employment by doctors in cases where justice to trained nurses, and the safety of the sick public would demand that trained nurses should be employed and recommended.

My policy is to recommend domestic or untrained nurses for only such cases as would not be endangered by said nurses' lack of advanced knowledge in nursing subjects. I consider it both dishonest and even criminal for any doctor to represent an untrained nurse as a trained nurse, or to assure the sick that an untrained nurse is just as competent to do nursing as a trained nurse. Yet, this injustice is perpetrated all over our State.

such a reputation before taking up nursing. Professional nurses are not free from fault, or infallible in skill; but it is an affront and indignity for physicians to pass by reputable and skilful trained nurses and to take up such women as I describe.

It has been observed by nurses and others, that the women thus chosen by said doctors, to pose as their trained nurses, are usually intelligent, tactful, suave, artful and designing. But, it cannot be comprehensively explained why any reputable physician should be so blind as to think that there is no difference between the capabilities of women who have had two, three or more years of hospital training, and those who have but a smattering of nursing knowledge, picked up hit-or-miss in course of a few years or less of experience as nurses in private families.

While not vindictive, I am bold to say that I am glad that now and then a doctor gets the reputation he merits for promulgating such a policy, i, e., he is suspected of having other than professional interests in his so-called nurses.

Let me ask what would be thought of trained nurses if they made a business of recommending to the sick public the employment of so-called magnetic healers, Christian scientists, quacks and other selfappointed medical (?) men in place of regularly graduated physicians? Or if they recommended as being as competent as graduate physicians, the would-be medical student, or those who had been but a few weeks in some medical school?

as trained nurses."

The average family regards their family physician as well-nigh infallible. If he recommends a woman as a good and competent nurse, or asserts that an untrained nurse in his employ is as competent as a trained or hospital nurse, the family usually accepts her as such, without any personal investigation as to her character or proficiency. Thus is a double injustice and wrong perpetrated: The family is endangered by the possibility, and in many cases, the probability of errors and incompetence on the nurse's part; and the hardearned skill of the trained nurse is depreciated to a par with the untrained.

Worse vet, many of these pseudo nurses to whom I refer have a reputation for decidedly immoral proclivities, or have had

There is much talk on part of some physas to the loyalty which should characterize the attitude of the nurse toward physicians. But when physicians show the basest kind of disloyalty toward trained nurses in the ways I have mentioned, it is a difficult thing for us to feel anything but resentment and disgust toward them.

We appreciate the fact that a large number of worthy doctors are strong advocates of thorough education for nurses, and appreciative of the effort trained nurses have to make to attain that education. Their it would advise the best nursing to be had, policy is a safe-guard to the sick, in that and would not countenance pretenders. On the other hand, those physicians who employ and recommend, for personal or other reasons, untrained nurses, of perhaps questionable honesty and morals, are not only cheating reputable trained nurses out

of work due them, but are creating an erroneous public opinion as to the qualifications and moral and social status of trained nurses.

If people wish to hire untrained nurses on their own initiative, and pay them the same fees charged by trained nurses, they have that right; but the right - minded physician should not lend his aid or commendation to any such nursing frauds as are being daily perpetrated by designing, unqualified and undesirable pseudo nurses.

[The writer cites the case of a pretender in her town who, without any experience whatsoever, has been nursing for several local doctors. She has at last won the good graces of a surgeon.-EDITOR.]

He has employed her in preference to graduate nurses, and has represented her to his patients as a "trained nurse," or "as competent as a trained nurse." She is fairly capable in nursing convalescents and mildly-ill persons; but in caring for serious. cases she has made many blunders; and her ignorance of the symptoms of serious complications has several times nearly several times nearly proved fatal to her patients. Only a system of lies and subterfuge on the part of

The responsibility of replying to the above letter falls on the Editor of this department who realizes that it is easier to plead the cause of the trained nurse than to suggest the right remedy for the ills that confront her. Our correspondent has stated her case clearly and forcibly. She tells a story that could be duplicated, with variations, in every community, big and little, in this free country of ours. With or without State registration-it makes little difference to-day-the trained nurse in every State is subjected to the most atrocious competition of unqualified and unregulated upstarts whose operations remind us of the mythologic harpies. By dint of much effort and perseverance trained nurses have, within a few years, elevated themselves to the rank of a profession and, incidentally, made big business for the untrained nurse. The sterling reputation which the trained nurse has won for herself confers added dignity and honor on every amateur who assumes the name and dress of a nurse; and ambitious

herself and the doctor, has saved them from prosecution.

This physician is a bright man in his professional work, with this exception, that he has, so to speak, literally swallowed this woman whole, and seems to be willing to accept any kind of work she has a mind to give, or to excuse any mistakes or delinquencies she is guilty of. What can be said of such a situation?

Many quite similar instances have come to my notice in this State. I believe you will agree with the graduate nurses who wish to protest earnestly against such things. We believe that such a policy on part of even a part of the doctors of this State, cannot fail of proving a hindrance to the advancement of nurses' education and training, and that it lowers the moral status of our profession.

Hoping that you will feel that you can give us an editorial in THE GAZETTE, I must ask that for ethical reasons my name be not used in connection with the matter. Thanking you in advance for any help you may feel able to give in this way, I am Yours very truly, N.

women who lack the patience or the ability to fit themselves for doing good work are not slow to see their opportunity and rush into the business by any short cut that they can take. The dear public, supplying the sick folk and the money wherewith to pay the nurse, has neither time nor inclination to look into the ethics of the case; a nurse is a nurse. Even the doctor is self-centered enough to be oblivious to the real situation; all he asks is some one who will obey his orders while he is busy with serums and pills, or the bali gameand there's the rub!

So, between the innocent, unsuspecting layman on the one hand, and the conscienceless, busy physician on the other hand, the enterprising, "practical" nurse -well named if not well trained-sails in, and easily appropriates the "case;" the trained nurse, all this time, to whom the "case" logically belongs-what does she do? Well, in our town she stands afar off and pretends not to see the episode.

The trained nurse pretends that she

doesn't see the pirate because she doesn't like pirates and she doesn't want to have anything to do with pirates-even to look at them! Does this strike you as a logical attitude? Not long ago the Editor attended a meeting of nurses in which one young nurse, more venturesome than the rest, dared to drag in this bogey, the practical nurse, and to ask what the nursing profession were going to do about it. Then up rose a very prominent and eminent trained nurse who asserted that the nursing problem was simply no problem at all. She said that the trained nurse was rapidly driving all other sorts of nurses out of the field, and she predicted "on the very best authority" that within a very few years there would not be a single untrained nurse left in our large centers to compete with the graduates. When this eminent nurse sat down she sat on the young and venturesome nurse, metaphorically speaking, and brought the house down with her. There was much applause and clapping of hands, although several impetuous delegates were observed to clap their hands over their mouths for fear of talking back to the prominent one. Most of the delegates looked as if they felt better-they had heard what they wanted to hear; in this case the wish was father or mother-to the thought. every city nurse in that big room knew very well that the eminent one was talking the most arrant nonsense, and the Editor would have bet his derby hat against her cap (if Roberts' Rules of Order had permitted it) that there were more "cases" in her own home town at that minute under the care of untrained nurses than there were under care of all the trained nurses in the town!

But

A few months after this little comedy the Editor was honored by an invitation to meet one of the officials of a certain state board of registration, who happened to be visiting in his city. Of course he accepted. the opportunity so graciously offered and had the privilege of a quiet and earnest conference on matters of mutual interest

to nurses and physicians. The official asked if the GAZETTE could not get along without criticising the words and deeds of some of the conspicuous leaders in her profession. The Editor replied that while he saw many things to praise in the official administration of nursing affairs, he believed with many other people, that the nursing profession was making some serious mistakes and that it was the humble function of the GAZETTE to point them out and give its readers a chance to think about them; one of these mistakes was the attitude of the profession toward the untrained and partly trained nurse. "Have patience with us a little while longer" said the official. "This problem is a very difficult one to handle and is vexing us greatly, but I can promise you that some time we will take official cognizance of the untrained nurse and give her the recognition that rightfully belongs to her." Virtually, this woman admitted that a state law which regulates trained nurses and does not so much as mention the motley mob of untrained nurses, who do the lion's share of the nursing, is far from adequate. This has always been our contention. Several years ago the GAZETTE said that the trained nurse ought, logically, to have complete control of the nursing situation in this country. To-day we find this sentiment slowly creeping into the deliberations of "official" circles. Some day it will find expression in the form of amendments to our present registration laws and the untrained nurse will discover that they are taking notice of her higher up. Then it will come to pass that women who wish to tend the sick will have to "qualify" and take out a license-just like midwives, pharmacists, teachers, plumbers, embalmers, etc. In most cities a man can not run a rag shop or junk yard without securing an annual permit from the mayor, but his wife and daughters can come and go among the élite, tending them through the most critical illnesses and dosing them with all sorts of poisons, and no one dares molest them. It is a business proposition

now, and the public is pouring money into hospitals and training schools and raising up a body of educated nurses who are perfectly capable of directing all the nursing of all the people all the time if they are given the chance. When will they speak up and demand this right?

When?

When they ask they will receive. But now the average trained nurse, in order to preserve her proper dignity, simply ignores the untrained nurse in public although she worries about her a good bit in private. She thinks that an untrained woman ought not to put on airs and claim to know it all and demand the same price as a graduate nurse; but the other woman doesn't think so she is getting easy money. She thinks that a doctor ought to know better than to tolerate the assistance of an ignorant nurse when the best can be had; but some doctors are perverse and think differently. She thinks that the layman ought to know a good thing when he sees it, ought to know when he is swindled and when he is getting value received for his money; but the layman doesn't know anything about it.

It remains for the trained nurse to translate her thoughts into action. She will have to show the people the right way out of this nursing snarl and she will have to agitate until she secures legislation that will cover the whole field and not a part of it. She need not wait for the medical

Give thanks for what?

The things you had forgot

sort.

profession, or the lawyers, or the grangers, to draft suitable laws for the regulation of nursing; they will do nothing of the The medical practice laws in our States were enacted through the persistent influence of doctors. The laws that nurses would like to see enacted must be framed and presented and advocated by the nursing body.

After the nurses have worked the legislatures they must work their own towns— a more difficult and less picturesque task. They must give a helping hand to the partly trained nurses who have legal status; they must weed out and suppress those who are legally debarred from nursing, just as doctors are all the time prosecuting illegal practitioners of medicine. must educate the public, and even the doctors, up to a more kindly interest in the comfort of sick folk, to the end that more of the nursing may be entrusted to competent hands and less of it undertaken by tired mothers and awkward sisters who ought to work in other lines of usefulness.

They

When all this has been accomplished we shall still have to wait some for the millennium.

We would be glad to have a free discussion of this topic by any of our readers.

IF "R. Nurse," Indianapolis, will kindly comply with our requirement by sending us her name and address we will be glad to answer her questions.

The fire on hearth, the cheerful kettle's hum,

Dear faded books-perhaps a friend has

come

To share your day-someone has sent a flower,

Or else to one in need you gave an hour. Give thanks for what?

The things you had forgot.

Give thanks to whom?
The servant in your room,

The mother here, the stranger on the way,
The faithful dog, the child that smiles.

To say

"I thank three" to the best or least of these Is giving thanks to Him upon your knees. Give thanks and say,

"A good Thanksgiving Day."

ADA DAVENPORT KENDALL.

Vol. XXVIII.

No. 12

IT is a curious fact, but not the less a fact, that discussions as to alcohol lead to a kind of inebriation in the debaters. Those who are opposed to the use of alcohol and deny that it is of any value whatever, are the ones who generally become most intoxicated when speaking or writing on the subject. They seem to be inebriated with the exuberance of their own verbosity and more intolerant of the views of others than the most strong lunged or blatant politician, or the most narrow sectarian.

It appears that discussion of alcohol has some insidious effect on the system, in the same way that alcohol itself when imbibed in sufficient quantities prevents sane and reasonable argument. So intolerant have the opponents of alcohol become that they are inclined to stigmatize as knave or fool anyone who is bold enough to suggest that even alcohol may have its uses.

This tendency on the part of the advocate of total abstinence is not confined to the unscientific, those who regard the matter chiefly from the moral standpoint, but is evident also in the scientific who approach the question from the physiological and health point of view. In Great Britain. not long ago Professor Kar! Pearson, the high priest of eugenics, and the man on whom the mantle of Galton has fallen, a man, needless to state, of the highest scientific knowledge, made a series of investigations with regard to the effect of alcohol drinking of parents upon progeny. He found that the effect was so small as to

be almost negligible and published the results of the findings. His action aroused the ire of the antagonists of alcohol of whom Sir Victor Horsley made himself the mouthpiece and a violent discussion arose in which doubt was cast on Pearson's figures and it was hinted that his deductions were altogether wrong.

In these times no reasonable person argues alcohol is good for any normal individual and he will not dispute the fact that its use does irremediable harm directly and indirectly, but it still may be open to question whether alcohol is such an absolutely deadly poison as many aver and that its remote influence upon the yet unborn is quite so pernicious as is now constantly being preached. On the other hand, perhaps it is well that the general public should be led to believe the worst because there is no doubt that the abuse of alcohol has wrecked, and at the present time wreaks more harm to health and decency than any one agent.

The argument that it is better to do without alcohol at all than to suffer from the fearful ills that it brings in its train. may be sound although not entirely scientific.

A very favorable aspect of the situation is that the drunkard or even the man who drinks is not regarded with the goodnatured tolerance of yore. The drunkard is looked upon as a pariah or diseased, while it is recognized that moderate drinking does not make for efficiency. In the strenuous stress and strain of modern existence drinking moderately handicaps the