By a Nurse in the Workhouse Infirmary, Dudley Road, Birmingham, England. THE LIMITATION OF PUPIL NURSES' DUTIES IN CARING FOR MALE PATIENTS, THE LECTURE ROOM-The Hygiene of the Sick-room... SUPERINTENDENTS IN COUNCIL-Third Annual Convention of Superintendents of Training the balsamic virtues of the pine in a high degree, and is soft and refreshing to the skin."-Med. and Surg. Reporter. LITTLE CEM ICE PICK-Price 25 cents Baker's Invalid Table, (Cut is actual size) With leaf that can be tilted, extended, THE WILLIS Trained Nurse Gase It consists of a rich-looking black moroc- CONTENTS-1 metal female catheter, 1 Price, complete, $9.00 In severe Cases STRÜMPELL'S TEXT-BOOK, referring to diet in treatment of Typhoid Fever, says: "Milk is ex- THOS. LEEMING & CO., Sole Agents, New York When you write Advertisers, please mention THE TRAINED NURSE Superintendent New York City and City Hospital Training Schools, ‘Blackwell's Island, New York. Y training school registries I mean those registries for nurses-whether managed on the purely co-operative basis or by school management alonewhich have for their primary object the well-being and employment of the graduate nurse in contradistinction to those registries or directories which make the necessities of the graduate nurse a means for furnishing a lucrative business for some individual or society. The former registry extends its privileges equally to a limited number of duly qualified members, and at a nominal cost; the latter extends its membership indiscriminately, and in its efforts to obtain the largest monetary returns in membership fees, breaks down the barrier which should exist between the duly qualified nurse, the partially qualified nurse, and the aspirant who is not qualified at all. It is not surprising that this system of registration should in time crowd out the better qualified nurse from the general directory, and we now find the best nurses seeking for some other plan by which they may obtain recognition and employThis is especially true in cities ment. where the general directory for nurses has held sway from the beginning, and where the school registry has not yet been introduced. The best physicians in these cities are already finding out that the general directory is not now to be depended upon for the best nurses; and they, too, are dissatisfied and would be willing to patronize another plan. This brings us to the point of how best to establish a registry for nurses which shall limit the membership, protect the interests of the community for which it is organized, guarantee good nurses to those who seek them, and repre-. sent to the public the school or schools from which its members graduate. This close corporation protective registry for nurses may be organized in three ways: first, as a training-school registry conducted as a part of the. school management; second, as a cooperative school registry managed by a committee composed of the superintendent of the school and assistant officers and graduate nurses; third, as the purely co-operative registry composed of and managed by the graduates themselves. * Paper read at Superintendents' Convention, Philadelphia, Feb. 12, 1895. In speaking of the first-mentioned. registry, I immediately recall to mind two very well-managed registries, viz.: The Bellevue School Registry and the Illinois School Registry. Both are controlled as a part of the school management. In the Bellevue Registry the superintendent of the school is applied to direct when a nurse is wanted. The managers engage a resident messenger boy whose duty it is to notify the nurses, wherever resident in the city, of calls as transmitted to them by the superintendent. The superintendent's office is also the registry office, and the managers hold themselves responsible for the efficient work and conduct of their graduate nurses. The Illinois Training School Registry is managed on the same principle, though it has become so large, and its graduates are so so numerous that an agent, one of the graduates of the school, is engaged by the school managers for this part of the school work. Whether called agent or fourth assistant, I do not know; her office adjoins that of the superintendent in the hospital, and she can refer to the superintendent's judgment as occasion requires. In a strictly school registry none but graduates of the school can become members, and the managers assume all responsibility. In contrast to English methods, the nurse receives all the money she earns, and the remuneration due her is paid to herself personally at the expiration of the term of service in the family in which she has been engaged. The few rules which are necessary for protecting the nurse in private practice, and which define her obligations to the families which shall employ her, and also her obligations to the registry, are formulated by the school managers. Thus the same fostering care and managing power which trained and educated the nurse in the school, now, through the school registry, protects her interests and looks after her welfare when she has graduated and works for herself outside. The second kind of protective registry I have mentioned may properly be called the co-operative school registry. It is a make-shift between the school registry managed by the school, and the co-operative registry managed by the graduates. It is one which may be organized when the managers of a school do not take enough interest in their graduates to undertake the trouble and expense entailed by the management of a school registry; or, when the graduates do not harmonize in sufficient strength to manage one for themselves. Our own school, placed under exactly these conditions began a co-operative school registry some five years ago in which both the officers of the school and an equal number of graduates form a managing committee. This registry has proved a success and for those who contemplate such an organization I would refer them for a detailed account to the last December number of THE TRAINED NURSE. Undoubtedly the most-easy-to-manage protective registry is the school registry pure and simple, and next to that the graduates' co-operative registry. The graduates' co-operative registry is still in the future, but I hope in the near future. The first step towards such a registry should be a graduates* club chartered and legally authorized. This club might be composed of graduates of one school or of several schools. We will suppose a club thus formed in some large city, with a membership of one or two hundred and in good working order. What would be easier than for such a club to appoint a committee of trusted members to consider the question of a registry in connection with club management? When the report was ready and a set of rules drafted a mass-meeting of club members could be called and the whole question submitted and voted upon. Or, better still, some popular and welltrusted member could be proposed as agent for a term of from three to six years, at a fixed salary, with the understanding that this appointment should take effect only when an assured membership for the registry would guarantee sufficient financial returns. The popular wish for the agent having been ascertained, and rules and regulations formulated, the next step of finding out the proportion of club members who would wish to benefit by and support the registry, could be easily ascertained by the pledge system. If sufficient returns were received by a set time the doctors and general public could then be notified on what day and where the registry would be opened, and the registry year could start from that day. I have suggested appointing the agent for a set term of years as only thus could an enterprising woman be secured for the office, and only thus could permanency (one of its radical requisites) be secured in the registry management. In the rules it would be well to have this term definitely fixed, also the amount of registry membership fee to be paid, the percentage on earnings, if any, and the schedule of rates. nurses will charge for their services, etc. The club-room could be used as the registry office and thus save considerable expense. A committee, probably the original committee, could be appointed on registry management. This committee should meet with, and report to, the club managers at stated meetings, and the club managers should be considered ultimately responsible for the enterprise, when once it is started. Should the percentage system be adopted and more funds accumulate than were necessary for the registry expenses, the club should have the option of using this fund for enlarging or improving its quarters, providing at club library, or for any other legitimate purpose in connection with the club or registry. It might be well, however, as a wise precautionary measure, to have a considerable floating capital in the bank in case the registry membership should fluctuate, or a year of unusual health in the community. should result in a dearth of nursing work, and of consequent low returns in percentages, to the registry. It is most important that the physicians or other patrons of the registry should understand from the first that good nurses can always be obtained by writing, telephoning, or calling at the registry. It is not necessary that applicants for nurses should see or talk with the nurse, providing the agent can guarantee a good one, though sometimes they will prefer to do so. They should never be obliged to look up the nurse herself at her lodgings. It should distinctly be the agent's duty to see that the nurse who is asked for, or to whom the call is sent, should be notified and should report herself to the doctor or at the patient's house at the specified hour. A doctor may have but a few minutes in his day to devote to the business of securing a nurse |