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1 2 3

■ ■-■.'■■■■.■>■.■

^SSSSSSSSS^SSSSSSSSSSSSSSSSSSSSSSSSSSS^Si

BY-LAWS,

Rules and Regulations

OF THE

P F^O V I I^J e l/t Is

Lunatic Asylum

5
2
S

NEW WESTMINSTER. S. C.

R. I. BENTLEY, M. B., MEDICAL SUPERINTENDENT.

S^SSBSSSi

NEW WESTMINSTER:

British Columbian Steam Print,

1885.

. ^ * , J

BY-LAWS,

Rules and Regulations

OF THE

Pf^OVI^iei;Ma

Lunatic Asylum,

NEW WESTMINSTER, B. C.

R. I. BENTLEY, M. B., MEDICAL SUPERINTENDENT.

NEW WESTMINSTER:

Bbitish Columbian Stbam Print,

1886.

230058

By-Laws, Rules and Regulations

OP THE

PROVINCIAL LUNATIC ASYLUM

New Westminster, B. C.

THE MEDICAL SUPERINTENDENT.

The Medical Superintendent shall be the head of the estab-
lishment. He shall have the general superintendence of the
buildings and grounds, together with their furniture, fixings and
stock. To him are committed the charge of the patients, and the
direction and control of all matters regulating their admission and
management, and the conduct of all persons to look after them.

He shall cause to be kept correct accounts, in books provided
for the purpose, of all supplies received at the asylum, and of all
articles of stores and property consumed in the institution daily.
He shall keep accurate accounts of all expenditures under appro-
priate headings, taking vouchers for all moneys paid out and make
a detailed statement of the same each month. He shall also cause
to be kept a correct account of the patients received, discharged,
died and escaped. Of those received he shal', at the time of their
admission, enter in a book a condensed copy of the commitment,
together with the condition of each patient at the time of admis-
sion. In connection with the discharges, deaths or escapes, he
shall enter the date, with such remarks as he shall deem proper.

He shall have control of the patients, prescribe and direct
their treatment, and discharge such, as in his opinion have recovered
their reason.

He shall be the custodian of all bonds given to secure the
payment for keeping and clothing paying patients, and shall collect
all sums due the asylum from that class of patients, and account
for the same in his monthly reports. He shall be the executive
officer of the establishment, and shall have charge of all books and
accounts, and all matters of finance relating thereto.

[41

He shall maintain discipline among the subordinates or em-
ployees, and enforce obedience to the laws, rules and regulations
adopted for the government of the institution, and is empowered
to discharge any attendant for violation of the laws or rules.

He shall report to the Provincial Secretary any employee that
he may think unfitted to fulfil the duties required of him.

He shall have the nomination of all persons to be employed
in the asylum, after consultation and with the consent, of the visiting
committee.

He shall estimate and report to the Provincial Secretary the
amount, kind, and quality of furniture and household furnishing
goods, provisions, fuel, clothing and the materials required for the
six months ending on the 30th day of June and 31st day of De-
cember of each year.

Necessary expenditures, other than those mentioned, may be
made by the Medical Superintendent, subject to the approval of
the visiting committee.

At the end of each month he shall cause a pay roll to be
made, which shall show the name, capacity, time, rate of salary or
wages, and the amount due each person employed in the establish-
ment, and shall on the receipt of such sum, pay the persons named
on the roll the sums due them, taking their receipts on the roll for
the moneys received, which shall be his voucher.

He shall make a general report of all subjects relating to the
working and expenses of the establishment in his annual report to
the Provincial Secretary.

He shall receive and answer all correspondence addressed to
him relating to the concerns of the institution, and shall cause a
record of his correspondence to be regularly kept.

THE STEWARD.

The steward shall act as store-keeper. He shall keep a book
of the daily expenditure of all provisions and other articles deliv-
ered out of the stores. He shall take care that all stores that come
into the building are of the best sorts, and purchased at reasonable
rates; and receive no goods into the institution without an invoice,
which is to be at once checked and filed. He shall half-yearly, or

oftener if required, take an account of all articles in use in the
asylum. He shall keep a set of books showing the current expen-
diture of the asylum. He shall mark all articles belonging to the
asylum, previous to their issue from the store, with the private mark
of the asylum.

He shall keep an inventory of all the furniture and household
goods, and an account of all additions and alterations made from
time to time. He shall see that the food is of the quality and
quantity ordered, that all meals are properly served and at the right
times, so far as relates to the male patients, and the keepers and
servants. He shall attend to the distribution of the provisions re-
quired, and take care that no more are cooked than are necessary.

He shall constantly observe the conduct of the keepers and
servants, see that they do their duty, and report to the Medical
Superintendent any instance of neglect or misconduct that he may
observe or of which he may be informed, and see that everything
pertaining to the asylum property is kept in order. He shall be
required to devote his whole time to the interests of the institution,
preserve order in the house and faithfulness in employes, and see
that all rules and regulations are fully observed. He, with the aid
of such patients as. can be taken out for that purpose, shall have
the care of the orchard, garden, and grounds about the asylum, as
directed from time to time by the Medical Superintendent. He
shall see to the opening and closing of the asylum, that the keep-
ers rise and commence work at the appointed time, that the fires
are regularly lighted and extinguished, and shall see that the
directions of the Medical Supierintendent are faithfully carried out.
He shall keep in a book a record of all clothing or other property
belonging to male patients on admission, and on their discharge see
that all articles belonging to them are carefully put up and returned.
He shall inform every male keeper and servant that he will be held
responsible for the loss of any article entrusted to his care. He
shall see that the sick in the male wards are properly attended to
and treated with the greatest care, and make the necessary arrange-
ments for the burial of the dead. He shall instruct new keepers
and servants in their duties and furnish them with the by-laws of
the institution. He shall see that all cleaning in the male wards
is properly performed by the prescribed hour every morning; that

the V>eds are in good order; that their clothes are taken good care
of; that their food is properly served and distributed; that the
rooms, halls, yards, out buildings, and other apartments, including
the keepers' bed rooms under his care, are kept clean and in good
order and properly warmed and ventilated. He shall attentively
observe the state of all buildings, water-closets and pipes, and
report to the Medical Superintendent any defects or want of repairs.
He shall, when requested, accompany the Medical Superintendent
in his visits to the male wards, and shall not ?bsent himself from
the institution without the sanctio;^ of ihe Medical Superintendent.

THE MATRON.

The matron, under the direction of the Medical Superintendent,
shall have charge of the female department of the institution. She
shall be with the female patients in the wards as much as possible;
see that they are kindly treated, that their food is properly cooked,
served and distributed; that their apartments are kept clean and in
;;ood order and properly warmed and ventilated; that their clothes
and bedding are always clean; that the female employes attend to
their duties in all respects. Sh: shall accompany the Medical
Superi.itendent in his visits, and shall not absent herself without
the permission of the Medical Superintendent. She shall keep a
book with a record of all clothing and other property belonging to
the female patients on their admission, and on their discharge she
shall see that all articles belonging to them are returned. She shall
direct the employment and recreation of all the inmates of the
female wards. She shall superintend the cutting out, making up
and repairing of the clothes, bedding, &c.7 appertaining to the
patients, and all other occupations of the female patients.

THE KEEPERS.

I. The keepers shall have the immediate care and supervision
of the patien s.

A few general facts and principles should be constantly kept
in mind by all persons connected with the management of the
insane, but more especially by their attendants, into whose never
ceasing care and keeping they are entrusted.

1st. Insanity is always connected, in some manner, with bodily
infirmity.

[71

2nd. There is usually a loss of all sense of moral obligation,
or ability to distinguish between right and wrong, and therefore
irresponsibility for words and actions.

3rd. There is a full appreciation of all acts of kindness or
cruelty, and, in general, a perfect recollection of them after restora-
tion, and in after life.

4th. There is usually a morbid sensitiveticss in relation to what
is due to them in attention and gene-il deportment, and conse-
quently irritation, excitement or ange., at either real or imagined
ncgiecL or improprieties of treatment.

5th. The frequent recurrence of excitement aggravates or per-
petuates the disease.

6th. The more the mind dwells upon, or is reminded of
hallucinations or delusions, the more permanently are they fixed;
so is the reverse true, that the more they are driven from the mind,
by occupation with other thoughts and ideas, the sooner do they
disappear altogether.

These few principles are the basis of the following rules and
regulations for attendants:

2. Deportment to Patients. — In all intercourse with the
patients they must treat them with respect and civility, address
them in a mild and gentle tone of voice, avoiding all violence and
rudeness or undue familiarity, nicknames, or disrespectful terms.
All civil questions are to be properly answered. All reasonable
requests promptly attended to. They must never speak to them of
their delusions, nor to others in their hearing; never allow them to
be laughed at, or ridiculed, or harshly spoken to, on account of their
delusions or peculiarities. Deception '*<: never to be used nor prom-
ises made without expecting their fuifiluient.

They should never manifest fear of a patient, should keep cool
under every provocation, never scold them, or dictate authoritatively.
When firmness and decision are required, they should be softened
by mildness and kindness. When force is required, if it be used
with tact and kindness, a pleasant smile, cheerful and explanatory
words, and sympathizing manner, but little will be needed. UNDER
NO CIRCUMSTANCES WILL A KICK, A BLOW, OR SIMILAR VIOLENCE,
BE EXCUSED, EXCEPT IN THE CLEAREST CASE OF SELF-DEFENSE.

3. Deportment Generally. — Attendants are required to be
neat and cleanly in their dress, courteous and respectful to the
officers, to one another, and to all persons, never wearing their hats
within doors, or going in their shirt-sleeves, NEVER TO USE PROFANE
OR VULGAR LANGUAGE, never to lounge upon the tables, or other
furniture, or floor, never to be noisy or boisterous, to becheerful without
levity, and to be respectively gentlemanly and ladylike in all things.

4. When abroad, or to visitors, or to any one not connected
with the asylum, they are directed never to report the conduct,
conversation, peculiarities, or even the names of patients, and never
to speak disrespectfully of the institution, its officers, or any of the
employes.

5. Of Rising and Morning Duties. — They must rise
punctually at the hour appointed, open the bed room doors of the
patients, give them a cheerful greeting, see that they are properly
washed and dressed, hair combed, and clothing and shoes in good
order. All beds are to be opened for airing, foul ones are to be
removed and cleansed, dried and refilled; and when sufficiently
aired they are to be made up, the bed rooms and corridors swept,
and everything put in the best possible order by the earliest possible
time, and thus maintained throughout the day.

6. Of Meals. — They must see that all patients are up and pre-
pared for breakfast at the prescribed time, and duly ready for all other
meals. All patients must take their meals at the table, when sick, ex-
cept when confined to their rooms, or when otherwise directed. The
food is to be promptly served by the attendants while warm and in
good order, not only to those at the table, but to those in their rooms.
Those confined are to be served first. At the table, the preferences
of patients, their likes and dislikes, and peculiarities of taste, are as
far as possible to be attended to. Knives and forks or other
dangerous weapons are never to be left in the possession of patients.
After each meal they are to be counted, and if any are missed they
are to be sought after without delay. Immediately after each meal
the dining room must be put in complete order. Patients must not
be hurried away from the tables before they are done eating; care
must be taken to give ample time to the aged and feeble.

7. The meals of the patients shall be served promptly at the
hour appointed by the resident physician.

[9]

8. Of Cleanliness. — Every part of the corridors, halls and
rooms must be kept scrupulously neat and clean; "Nothing is

CLEAN ENOUGH THAT CAN BE MADE CLEANER" is a rule that must be

strictly observed. All the floors must be scrubbed weekly, and oftener
when necessary, and must be swept each day as often as required to
keep them clean. When unpleasant odors are observed the cause
must be removed instantly. Clean sheets and pillow cases are to
be put on each bed, at least once a week, and oftener if required
by being soiled.

8. Medicines. —The attendants must give all medicines as
directed. Any striking or unexpected effect of medicines must be
reported to the steward at once. All new cases of sickness, and all
alarming or dangerous symptoms in those already sick, must be
reported at once.

g. Bathing. — All patients must be bathed in tepid water at
least once a week, unless otherwise directed. Cold baths are to be
used only under special directions.

ID. Clothing. — The attendants must see that all patients
change their clothes regularly, at stated intervals, or oftener if
required for cleanliness. They must be kept tidy and neat,
shoes tied, stockings drawn up, clothing buttoned,
hooked, pinned, tied, as the case may be, and all clothing
properly adjusted. they must be constantly kept from
CARELESS OR SLOVENLY HABITS. When patients wet or soil their
clothes they are to be changed immediately, and as often as is
neces.sary to keep, them dry and comfortable. The attendants, with
the aid of the patients, shall do the repairing of patients' clothing.

11. Walking. — All patients not too feeble or violent should
be got out into the grounds and open air when practicable and the
weatiier is suitable. Each attendant will be responsible for his or
her own patients.

12. OUT-DoOR Work. — For the benefit of the patients they
will be permitted and encouraged to engage in out-door work,
under the care of attendants. They must not be permitted to
over-work themselves, nor are they to work against their will,
neither must they be asked to do that which they may feel to
be degrading. The attendants must work with the patients,
and be careful not to appear to be ordering or superintending, but

[10]

to direct by example, assistance, and advice. Any disposition to
escape must be reported.

13. Amusements and Employments. — Patients should be
as constantly as possible engaged in some pleasant kind of employ-
ment or amusement, and every effort should be made to induce
them to do so. The attendants should constantly devise ways and
means to this end.

14. Meghan r;al Restraint.— The use of restraining appa-
ratus is prohibited, except by express permission of the Medical
Superintendent, Seclusion to a private room, 01 the personal care
of the keepers must be employed until further directions can be
obtained. Whenever a patient becomes so noisy or violent as to
demand seclusion, ample aid should be procured, and if force be
required it should be used in a firm and decided, but mild and
gentle manner without any anger or appearance of anger. The
reasons should be pleasantly and kindly explained. ,

15. No patient's door is to be left unlocked at night. On
retiring, the patient's clothing is to be placed within the halls, lights
extinguished, and the keepers to repair to their resjjective rooms.

16. Suicidal Patients. — Persons known to be suicidal must
be kept in every way under the closest surveillance, and yet be
treated with the greatest kindness and sympathy, cheered and
enlivened, and the subject must never be alluded to. Their cloth-
ing, rooms, and beds must be often searched for any articles that
might be used for dangerous purposes. The watchman must be
kept informed of all such cases.

THE WATCHMAN.

His duties will commence at seven o'clock P. M., at which time
he shall visit the office to receive instructions for the night He
must v/hile on duty be faithful and vigilant, visit every part of the
wards at least every hour during the night, making as little noise as
possible, never conversing in a loud tone, and opening and shutting
the doors with as little noise as possible. He must use every means
in his power to tranquilize those who are excited, and to allay the
fears and apprehensions of the timid, pay particular attention to
the sick, the suicidal, and those recently admitted; see that the
patients are regularly supplied with water, when it is asked for, and

[Ill

attend to all other reasonable wai.ts; notice any unusual noise
in the patients' rooms, endeavor to ascertain the cause, and if
necessary report the same to the steward. He shall report any
irregularities, neglect of duty, or violation of rules which may come
under his notice. He must look after the heating apparatus during
the night, and be very watchful about fire, and in case of its
occurrence must report immediately to the steward and attendants
without giving general alarm; he must see that the hose, &c., are
always in good order, and in readiness for use, and shall (>erform
such other duties as may be required of him. At 6 o'clock A. M. he
will be relieved of his duties until the time for duty in the evening.

THE COOK.

The chief cook shall have the general charge, under the direc-
tion of the steward, of all the cooking for the patients and attaches
of the asylum. He shall take care of the supplies for the kitchen,
and prepare the food as may be directed and see to its proper dis-
tribution and delivery. He shall personally take care of the fires
and lights and see that the apartments are properly closed for the
night He shall be mainly responsible for such help as he may
requi/e in the performance of his duties.

GENERAL AND MISCELLANEOUS REGULATIONS.

1. The whole time of employes should be devoted to the
institution.

2. They must never work for themselves during hours of duty.

3. They shall not receive any gratuity or present from patients
or their friends without the consent of the Medical Superintendent.

4. They are not to visit each other's wards except on duty.

5. They must never leave their halls unattended.

6. They must not retire to their rooms during duty hours, for
reading, writing, sewing, napping, &c.

7. Employes must not take friends or others into the wards
without permission.

8 They must not lend their keys, and must be careful not to
lose them.

9. They must always regard the affairs of the institution as
confidential and never make them the subject of conversation with
those unconnected with it.

(II!.-,,,.. .V-. .J-

[1-2]

10. All abuses, improprieties, and violations of rule must be
reported to the Medical Superintendent or steward.

1 1. No intoricating liquors shall be used in the asylum or upon
the premises, except &s prescribed by the Medical Superintendent.

12. No person addicted to gambling, or of intemperate habits,
or of immoral character, will be employed in the institution.

1 3. Male keepers will notify the steward before leaving and
report to him on their return.

14. Female attendants will notify the matron of their leaving
and returning.

15. All employes leaving must hang up their keys in the place
provided for that purpose.

16. Non-residents will not be per: litted to remain in the institu-
tion at night, without permission of the Medical Superintendent.

17. All employes must be ready to perform extra duties in
cases of emergency.

18. All letters, or other writing, parcels or packages, to or from
the patients, must be shown to the resident physic' n before being
sent away or delivered to the patients.

19. All money, jewels, or other valuables found on patients,
and all sums left or sent for their benefit, must be deposited in the
office.

20. No conversation shall be held v/ith patients through the
windows, and no person is allowed to stand by the windows or
balconies, attracting the attention or listening to the talk of patients.

21. Visitors to patients, and to the institution, may be
admitted from 9 t'^ 11 A. M. and from 2 to 4 P. M.; Sun-
days and holidays excepted. Male visitors shall not be admitted
to the female departments except by special permission of the Med-
ical Superintendent.

Any violation of any of the foregoing rules may be visited
with a sumniary dismissal of the party offending.

Special arrangements may be made by the Medical Superin-
tendent for the visits of clergymen, or others, and for the holding of
religious services or conversation with patients.

R. I. BENTLEY, M. B.,

Medical Superintendent.

New Westminster Asylum for the Insane,
January ist, 1885.

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