ij 
 
 | STATE OF ILLINOIS~— 
 
 Board of Administration.| 
 
 | RULES AND REGULATIONS 
 | th Revised June 1, 1913, 
 : 
 
 for the government of the 
 
 : Zigrin State Hospital, 
 
 Kankakee State Hospital, 
 
 Jacksonville State Hospital, 
 
 - Anna State Hospital, 
 
 | Watertown State Hospital, 
 
 |. Peoria State Hospital, 
 
 Chester State Hospital, 
 Chicago State Hospital, 
 
 Alton State Hospital, 
 Psychopathic Institute, 
 Lincoln State School and Colony, } 
 
 OFFICE OF THE BOARD 
 State Capitol, Springfield. 
 
STATE OF ILLINOIS 
 
 Board of Administration. 
 
 RULES AND REGULATIONS 
 
 Revised June 1, 1913, 
 
 for the government of the 
 
 Elgin State Hospital, 
 Kankakee State Hospital, 
 Jacksonville State Hospital, 
 Anna State Hospital, 
 Watertown State Hospital, 
 Peoria State Hospital, 
 Chester State Hospital, 
 Chicago State Hospital, 
 Alton State Hospital, 
 Psychopathic Institute, 
 Lincoln State School and Colony, 
 
 Under the control of the Board of Administration. 
 
 OFFICE OF THE BOARD 
 State Capitol, Springfield. 
 
 SPRINGFIELD: 
 ILLINOIS STATE JOURNAL CO., STATE PRINTERS 
 1913 
 
ees . Pe Li - ay us 
 
 . ag ra he s? mt iv 
 PLY, oP oe AS A ele 
 DO har WP 
 f ae RS fe val 
 Pea Pa 
 ne , rial ie oF 
 5 Ale on o 
 cae v j 
 : i, “ 
 ie 
 <tfy 
 ‘ay 
 Comey. a ace 
 a es eee 
 + ae 7) At | 
 i 4) ry 
 a =?) 
 | sak Catt 
 4 ROI iy ree ae ? 9 
 gictr Ue a te, Sere | 
 “i ' : : 7 ’ MEE, | ‘ ia ios ie : 
 A f , ; Sip g A 
 ar ¥ < 7 : J Sy d 
 * ; > na 4 
 teu . / Me mes A aha a7 wt > A Cr, F 
 af, : aie i ? ‘ Pay Tier . 7 ‘ 
 “ ' 
 
rau, / > . jet r 
 , 4 \0 -* CUON pr 
 wt? 
 
 WEPART Mcwy 
 
 STATE OF ILLINOIS 
 BOARD OF ADMINISTRATION. 
 
 ———— 
 
 FRED J. KERN, President. 
 B. R. Burroucus, Secretary. 
 FRANK D. Wuirep, Fiscal Supervisor. 
 FRANK P. Norpury, M. D., Alienist. 
 
 KJ THomaAs O’ConNorR. 
 aay 
 9 
 eT Kankakee State Hospital, Hospital, Illinois. 
 
 < 
 
 ' Elgin State Hospital, Elgin, Illinois. 
 .>dacKsonville State Hospital, Jacksonville, Illinois. 
 Anna State Hospital, Anna, Illinois. 
 
 Watertown State Hospital, Watertown, Illinois. 
 Peoria State Hospital, Peoria, Illinois. 
 Chester State Hospital, Menard, Illinois. 
 ie y Chicago State Hospital, Dunning, Illinois. 
 Alton State Hospital, Alton, Illinois. 
 Psychopathic Institute, Kankakee, Illinois. 
 
 at Lincoln State School and Colony, Lincoln, Illinois. 
 
Digitized by the Internet Archive 
 in 2022 with funding from 
 University of Illinois Urbana-Champaign Alternates 
 
 A 
 
 fe 
 
 https //archive.org/details/rulesregulationsOOilli_6 
 
RULES AND REGULATIONS. 
 (Revised June 1, 1913.) 
 
 The activities of these institutions shall be divided 
 into the following departments: 
 
 The Medical Service. 
 
 The Nursing Service. 
 
 The Business Administration. 
 
 The Mechanical Department. 
 
 The Farm. 
 
 The Garden. 
 
 Tue MEDICAL SERVICE. 
 
 The Medical Service shall consist of the superin- 
 tendent, the assistant superintendent, physicians, 
 assistant physicians, medical internes, dentist, dental 
 interne, pharmacists, stenographers for the medical 
 service, and clinical clerk. 
 
 THE NURSING SERVICE. 
 
 The Nursing Service shall consist of a chief nurse, 
 supervising nurses, charge nurses, nurses, pupil 
 nurses, attendants and hydrotherapist. 
 
 Tue BUSINESS ADMINISTRATION. 
 
 The Business Administration shall consist of the 
 following divisions: 
 
 The Accounting Department. 
 
 The. Store. 
 
 The Industrial Service. 
 
 The Domestic Service. 
 
 The Culinary Service. 
 
 The Driving Department. 
 
 The Accounting Department shall consist of a 
 chief clerk and necessary assistants. 
 
 The Store shall consist of a storekeeper and neces- 
 sary assistants. 
 
The Industrial Service shall consist of an indus- 
 trial teacher, a shop foreman, and necessary assist- 
 ants for each. 
 
 . The Domestic Service shall consist of a head house- 
 keeper, a head laundryman and a head seamstress, 
 and necessary assistants for each. 
 
 The Culinary Department shall consist of a dieti- 
 tian, a pasteurizer, head cooks, cooks and necessary 
 assistants. : 
 
 The Driving Department shall consist of a coach- 
 man. 
 
 THE MECHANICAL DEPARTMENT. 
 
 The Mechanical Department shall consist of the 
 following: A chief engineer, assistant engineer, 
 engineers, boiler maker, steamfitter, plumber, elec- 
 trician, firemen, engineer’s helpers, a head mason, 
 masons, plasterers, laborers, a head carpenter, car- 
 penters, a head painter, painters, a blacksmith and 
 a tinner. 
 
 THE FARM DEPARTMENT. 
 
 The Farm Department shall consist of a head 
 farmer, a dairyman, a poultryman and necessary 
 assistants for each. 
 
 THE GARDEN DEPARTMENT. 
 
 The Garden Department shall consist of a head 
 gardener, a florist and necessary assistants for each. 
 
 THE SUPERINTENDENT. 
 
 The superintendent shall be the chief medical and 
 executive officer of the institution, and, subject to 
 the Board of Administration, shall exercise entire 
 official control over the subordinate officers and 
 employees in the service. He shall have the general 
 superintendence of the buildings, grounds, farm and 
 garden, together with all stock, machinery, furniture, 
 fixtures and equipment of every nature belonging 
 to the institution. 
 
 It shall. be his special duty to see that all officers 
 and employees are energetic, punctual and exact in 
 
 _ 
 
the faithful performance of their several duties. He 
 shall have entire control of the medical, moral and 
 dietetic treatment of the patients. It shall be his 
 duty to visit the wards sufficiently often fully to 
 inform himself as to their condition and to assure 
 himself that his directions concerning the care and 
 treatment of the patients are being faithfully 
 executed. He shall cause to be made, in the manner 
 prescribed by the Board of Administration, a full 
 and complete history of the admission, examination, 
 classification and treatment of each patient com- 
 mitted to the institution. It shall be his duty to 
 see each newly admitted case within five days follow- 
 ing admission and to have note of such visit entered 
 in the staff meeting record and in the clinical record 
 of the patient. He shall be charged with the respon- 
 sibility of determining when patients are sufficiently 
 recovered to warrant their parole or discharge. He 
 shall have power to parole and to extend the parole 
 of patients from time to time as may be provided 
 for by law or by rule of the Board of Administration, 
 and to discharge patients when in his judgment their 
 condition warrants such discharge. 
 
 The superintendent is charged with the carrying 
 on of all correspondence of every nature concerning 
 the institution’s administration and pertaining to 
 patients, and it shall be his duty to delegate such 
 portions of this correspondence to the assistant super- 
 intendent, members of the medical staff and chief 
 elerk as in his judgment will best serve the interests 
 of promptness, thoroughness and unfailing courtesy. 
 It shall be his duty to require subordinates who 
 assume any portion of the ccrrespondence, to answer 
 fully and promptly every inquiry, and to have the 
 letters in answer to inquiries concerning patients 
 couched in the most courteous and respectful lan- 
 . guage. The official correspondence of the institution 
 
 shall be written upon the letter-head of the institu- 
 tion, form of which shall be furnished by the Board 
 of Administration, and shall, as far as possible, be 
 signed in person by the superintendent. When 
 authority to sign his name to letters is delegated to 
 a subordinate officer, such letters shall be submitted 
 to him for his personal inspection before they are 
 mailed. 
 
 — 
 
He shall have charge of the inmates’ trust fund; 
 shall accept deposits, giving his receipt therefor; and 
 shall disburse the funds thus deposited in the man- 
 ner and for the purpose requested by the friend or 
 relative of the patient who makes such deposit, pro- 
 vided such disbursements shall not be made for any 
 purpose prejudicial to the best interests of the 
 patient or that does not have his full approval. He 
 shall cause to be kept a set of books in the manner 
 and form prescribed by the Board of Administration 
 that will readily show such receipts and disburse- 
 ments, with the balance on hand at the close of any 
 day’s business. 
 
 It shall be the duty of the superintendent to co- 
 Operate with the State Psychopathic Institute in the 
 matter of instruction of the members of the medical 
 staff, of case examinations and of case record keep- 
 ing, to whatever extent is required by the Psycho- 
 pathic Institute and approved by the Board of Ad- 
 ministration. 
 
 It shall be his duty to conduct a school of instruc- 
 tion for attendants and a training school for nurses 
 in the manner and form prescribed by the Board of 
 Administration. 
 
 He shall be charged with the duty of a full and 
 complete inspection of the accounting department, 
 the store, the laundry, the sewing room, the shops, 
 the kitchens, the mechanical department, the farm 
 and garden, and their equipment, and to confer with, 
 advise and direct the heads of all departments of the 
 institution in carrying out the directions of the 
 Board of Administration and the institution policies. 
 
 All of the property of the institution being under 
 the direct care and custody of the superintendent, 
 ‘it shall be his duty to arrange in such manner as 
 may be prescribed by the Board of Administration 
 for the interchange of farm, garden and industrial , 
 products with other institutions. When, in the judg- 
 ment of the superintendent, it becomes advisable to 
 sell any live stock, produce, condemned implements, 
 or any of the property or equipment belonging to 
 the institution, he shali make written application to 
 the Board of Administration for permission to make 
 such sale, and upon their approval, shall sell in such 
 manner as may be prescribed by the board. When 
 
the consummation of such sale is delegated to the 
 head of any department, the superintendent shall 
 issue to such person a written permit to make the 
 sale, giving full description of whatever is to be 
 sold. After the sale has been completed, the person 
 authorized to make the same shall endorse upon the 
 back of the superintendent’s permit the date of sale, 
 full name and address of the purchaser, items sold 
 with price obtained, and his own signature, and 
 shall file the permit so endorsed with the chief clerk, 
 together with the funds received in settlement. 
 
 It shall be the duty of the superintendent to have 
 prepared at the close of each day’s business, a de- 
 tailed report of movement of population, and trans- 
 mit same to the Board of Administration, as 
 provided for by the rules of the board, and to include 
 therewith carbon copies of all requisitions for sup- 
 plies issued by the storekeeper during the day’s 
 business; also carbon copies of all orders for sup- 
 plies, and carbon copy of any general or special 
 order which he may have issued during the day. 
 
 To facilitate uniformity in, making up the daily 
 report, the following order in reporting events will 
 be observed (General Order No. 62): 
 
 Report of Unusual EHvents— 
 
 1. Accidents to the plant. 
 
 2. Accidents to employees. 
 
 3. Presence of epidemic disease, 
 
 (Name the disease and number of cases.) 
 Movement of Population; Admissions; Discharges— 
 
 1. By parole. 
 
 2. By escape. 
 
 3. By death. 
 
 4.» By court order. 
 
 5. By order of the Board of Administration. 
 6. By the superintendent. 
 
 7. By any other form of discharge. 
 
 Seclusion and restraint in accordance with special 
 orders No. 170. 
 Seclusion; Seclusion and Restraint; Restraint— 
 
 Pa90'p 
 
10 
 
 Movement of Officers— 
 
 1. Managing officer, present or absent. 
 
 2. Assistant superintendent, present or absent. 
 
 3. Other officers absent from duty. 
 
 4, Other officers on sick leave. 
 
 Note—When present, managing officers must per- 
 sonally sign the daily reports in ink. 
 
 When these rules and regulations become effective, 
 it shall be the duty of the superintendent to place 
 in the hands of every employee then in the service, 
 or who. shall enter the service thereafter, and take 
 receipt therefor, copy of a booklet which shall be 
 provided by the Board of Administration for the 
 guidance and direction of employees in their con- 
 duct and in their relations toward patients and to 
 require all employees to follow strictly the rules 
 therein set forth. 
 
 Being charged with the general supervision of all 
 of the employees, it shall be the duty of the superin- 
 tendent to require each and every employee to give 
 all of his time to the service of the institution, and 
 he shall forbid and prevent employees from engaging 
 in work of any naturé for private purposes. 
 
 It shall be the special duty of the superintendent 
 to see that each and every person who visits the 
 institution for any purpose shall promptly receive 
 the attention, courtesy and consideration that is his 
 due from each and every employee with whom such 
 visitor has to do; and so to conduct the institution 
 and its affairs that all branches of its activities 
 where they come in contact with its patrons and 
 the general public shall be such as will in every way 
 commend the institution to the public. 
 
 Tne ASSISTANT SUPERINTENDENT. 
 
 The assistant superintendent shall be the second 
 ranking officer of the institution, and shall be, as 
 his title indicates, an assistant to the superintendent 
 in carrying out the details of the administration. 
 During the temporary absence or illness of the super- 
 intendent, he shall succeed to the active manage- 
 ment and have all the rights and powers of the 
 superintendent. His engagement is for service prac- 
 tically continuous, and he shall be on active duty 
 
 & 
 
11 
 
 from 8:00 a. m. to 6:00 p. m. of each day. Subject 
 to the approval of the superintendent, he shall have 
 entire charge of the medical service. It shall be 
 his duty to divide the service into suitable assign- 
 ments for the various members of the medical staff, 
 taking into account that recently admitted patients 
 and those in the infirmaries and hospital wards re- 
 quire a larger degree of attention, and the number 
 of patients assigned to the various members of the 
 medical staff shall be in suitable proportion to the 
 requirements of the patients. Assignments in the 
 various departments of the medical service of the 
 institution may be changed from time to time at the 
 discretion of the assistant superintendent with the 
 approval of the superintendent. 
 
 Subject to the approval of the superintendent, he 
 shall regularly detail the stenographers in the med- 
 ical service to their duties, having in view that the 
 correspondence shall be promptly answered and that 
 case examinations and case record keeping shall 
 always be kept up to date. He is charged with the 
 inspection and direction of the entire system of 
 records pertaining to patients, and it shall be his 
 duty to require the clinical clerk to keep these rec- 
 ords in such manner and form as may be prescribed 
 by the superintendent. He shall have immediate 
 charge of all drugs, medicines, medical and surgical 
 supplies, and shall aid and direct the pharmacist in 
 the execution of the duties of that position. It shall 
 be his special duty closely to supervise the issuing of 
 alcoholic liquors from the pharmacy and to see that 
 none are used for purposes other than those of a 
 medical agent. 
 
 He shall receive all patients who are admitted 
 to the institutions and shall have direct charge of 
 all the official records concerning the admission, de- 
 tention, death or discharge of patients; and it shall 
 be his duty to see that these entries are properly 
 and promptly made and that each day’s business is 
 completely entered at the close of the day. In 
 receiving female patients from officers or other per- 
 sons, he shall see that the requirements of the law 
 for the proper attendance of female patients are 
 carried out in every instance. It shall be his duty 
 to report immediately to the superintendent every 
 
12 
 
 case of accident, injury or serious illness of patients 
 that comes to his attention. Illness of officers or 
 employees which renders them unfit for duty shall 
 be promptly reported by him to the superintendent. 
 
 He shall visit the hospital wards or buildings for 
 the physically sick at least once in each twenty-four 
 hours and shall make such other visits to all of the 
 wards of the institution as time will allow to famil- 
 iarize himself with the condition of each patient and 
 to know personally, as far as possible, all of the 
 patients of the institution. 
 
 He shall have immediate charge of the school of 
 instruction for attendants and of the training school 
 for nurses, and, under the direction of the superin- 
 tendent, shall carry out all of the plans for this 
 branch of the service, and shall require that proper 
 records of attendance and class work be faithfully 
 kept. 
 
 His relation to the management is of such a 
 nature that he should at all times keep in touch 
 with the policies of the administration and use his 
 best efforts to carry them out, and to this end, in so 
 far as his other duties allow, he shall, by personal 
 inspection, endeavor to familiarize himself with the 
 condition of the physical property, the mechanical 
 equipment, the farm and gardens, and all of the 
 activities of the institution, that he may be better 
 enabled to administer the affairs during any tem- 
 porary absence of the superintendent. 
 
 PHYSICIANS. 
 
 All physicians shall have equal rank in the service 
 and shall be charged with the responsibility for the 
 immediate care of the patients assigned to them 
 from time to time by the assistant superintendent 
 under the approval of the superintendent, and for 
 the carrying out in detail of all of the policies of the 
 superintendent or his assistant, together with their 
 special directions for the care and treatment of 
 patients in the application of all remedial agents in 
 use by the medical service of the institution. Their 
 engagement is for a service practically continuous, 
 and they shall be required to be on active duty from 
 8:00 a. m. to 5:00 p. m. of each day and shall be 
 subject to call whenever their services may be re- 
 quired at any other hour of the day or night. 
 
 — 
 
 af ~~ 
 
13 
 
 It shall be their duty to visit each ward assigned 
 to their care at least twice during the day and to 
 spend -in the wards under their immediate control 
 as many of the remaining hours of active duty as 
 may be taken from the other duties of their position. 
 The visitation of wards is to be of such a degree of 
 thoroughness as will enable the physician to know 
 at all times that he has accurate knowledge concern- 
 ing the mental state and physical condition of every 
 patient under his care. Whenever it becomes neces- 
 sary to administer to any patient food or medicine 
 coercively, it shall be done only at the specific direc- 
 tion of the medical officer in charge, and then only 
 in his immediate presence. In addition to the visi- 
 tation to patients, it is required that they shall give 
 constant attention to the cleanliness, order and 
 ventilation of the wards under their care, and they 
 shall require the charge nurses to report promptly 
 to the proper department needed repairs of any 
 nature. <A frequent visitation to dining rooms dur- 
 ing the serving of meals and an inspection of the 
 food served, both as to quantity and quality, together 
 with the thoroughness of its preparation and the 
 character of the dining room service, shall be a spe- 
 cial duty of physicians; if the service is found unsat- 
 isfactory in any particular, it shall be their duty to 
 make report of same by word of mouth to the 
 assistant superintendent. 
 
 The relation of this branch of the service is of 
 such importance to the general success of the insti- 
 tution, that all its members shall diligently apply 
 themselves to the obtaining of information as to the 
 physical property, the mechanical equipment and 
 the general activities and policies of the institution, 
 and shall lend their efforts to its support in every 
 reasonable way. 
 
 ASSISTANT PHYSICIANS. 
 
 Assistant physicians are to be of a rank one re- 
 duced from that of physician, and all persons in this 
 service shall be of equal rank. They shall be, as 
 their title indicates, assistants to the superintendent, 
 assistant superintendent and physicians, and shall 
 be assigned to a service in harmony with their pre- 
 
14 
 
 scribed duties. They shall in all instances carry out 
 fully any directions given them by their superior 
 officers in the medical service, and, so far as possible, 
 contribute constantly to the care, comfort and wel- 
 fare of the patients. Their engagement is for 
 service and hours of duty similar to those of physi- 
 cians. 
 MEDICAL INTERNES. 
 
 Medical internes may enter the service in a man- 
 ner prescribed by the rules of the Civil Service Com- 
 mission, and the period of interneship shall. be 
 limited to one year of service, at the expiration of 
 which a certificate of service shall be given by the 
 Board of Administration, attested by the superin- 
 tendent of the institution. Their duties shall be 
 prescribed by the superintendent, and their hours 
 of service shall be similar to those of physicians and 
 assistant physicians. 
 
 DENTIST AND DENTAL INTERNE. 
 
 In accordance with general orders No. 71 and 
 under the direction of the managing officer or the 
 assistant superintendent, the dentist shall have 
 entire charge of the dental work for patients and 
 inmates of the institution. It shall be his duty to 
 make an examination as to the dental needs of each 
 patient or inmate received, within five days after 
 admission, and to make report of such examination 
 in the form provided for the permanent record in 
 the case history or official record. It shall be his 
 duty, with the assistance of his interne, if one is pro- 
 vided, to faithfully carry out the dental procedures 
 necessary for the comfort of the patients with special 
 reference to conserving teeth that may be benefited 
 by treatment and subsequent repairing. The hours 
 of duty for the dentist and interne shall. be from . 
 8:00 o’clock a. m. to 5:00 o’clock p. m. week days, 
 and they shall be subject to call at any time by the 
 managing officer or the assistant superintendent. 
 
 In order to secure uniformity in dental work done 
 by dentists at the institutions under the control of 
 this board, and charges made for same, the follow- 
 ing rules and regulations are hereby published for 
 the guidance of all concerned: 
 
 The work to be that usual in the practice of den- 
 tistry, consisting of extracting, cleaning and all 
 
15 
 
 necessary treatments, amalgam and various cement 
 fillings of the teeth, and repair of plates. All of 
 this work to be given free to all cases, the same 
 being service on an equal footing with that of the 
 medical service. 
 
 Porcelain crowns (anterior) will be given free to 
 patients or inmates on the recommendation of the 
 managing officer. . 
 
 In the discretion of the managing officer, plate 
 work, etc., may be done, free of cost, to patients or 
 inmates who are performing service in the institu- 
 tion. A record of this service to be made and filed 
 with the case record or official record of the patient 
 or inmate. 
 
 Gold work and plate work, in all cases, will be 
 charged for extra at the following prices: 
 
 Goldfinger. esas: Eh ih he 1 s,dpia cee ens $1 00 
 Gold crowns (incisors and bicuspids)......... 2 25 
 CrOLMCLOW NS LOL IMOLAEA By sche caterer cre caren ate 2 50 
 
 Bridge work at corresponding prices. - (Bridge 
 
 work to be recommended only in exceptional 
 
 cases. ) 
 
 PIACGM WOE PeTIeT. WD IELG wat foe te ols cel occ eae muah etece 3 50 
 (Excepting where gold clasp is used, when the 
 
 extra cost for the clasp will be charged at 
 
 the rates to be $0.75 to $1.00.) 
 
 In special work recommended by friends of the 
 patient or inmate, the prices to be agreed upon as 
 near the above prices as practicable. The managing 
 officer will notify relatives, conservators or friends 
 two weeks in advance of the proposed special work 
 needed for the patient or inmate. If no reply is 
 made to such recommendation the work will be done 
 by the dentist in the same manner and with the 
 same material as that given in the ordinary routine 
 of service. 
 
 Relatives, conservators or friends of the patient 
 or inmate are free to have dental service performed 
 outside of the institution, but such work must be 
 done at their own expense, and the charges for the 
 same are to be regulated by the dentist doing the 
 work. 
 
 The income received from all charges for dental 
 work shall be paid to the managing officer who will 
 receipt for same, and by him transmitted monthly 
 as miscellaneous receipts to the State Treasurer. 
 
16 
 
 No work will be done by the dentist for employees 
 excepting in emergencies, for which there will be 
 no charge. 
 
 Dentists and internes employed by the month and 
 giving full time between 8:00 o’clock a. m. and 5:00 
 o’clock p. m. on each week day will not be allowed 
 to practice dentistry, excepting for patients or in- 
 mates of the institution as herein provided. 
 
 No dentist will be allowed to receive fees or hon- 
 oramiums unless same are submitted to the State 
 Treasurer. 
 
 Records of the work performed by the dentist 
 should be kept properly classified, and a copy of the 
 same transmitted monthly, addressed to the Alienist, 
 Board of Administration. 
 
 ‘DENTIST AND DENTAL INTERNE. 
 
 Classification of work done to be as follows: 
 Name of patient and dates of service. 
 Number of patients examined. 
 
 Number of teeth extracted. 
 
 Number of teeth cleaned. 
 
 Number of teeth treated. 
 
 Number of roots filled. 
 
 Number of amalgam fillings. 
 
 Number of cement fillings. 
 
 Number of gold fillings. 
 
 Number of crowns, porcelain. 
 
 Number of crowns, gold. 
 
 Number of plates. 
 
 Summary of charges made for service. 
 Summary of free service. 
 
 Summary of expenses incurred, special. 
 Summary of expenses incurred, quarterly supplies. 
 
 PHARMACIST. 
 
 The pharmacist shall be a regularly licensed phar- 
 macist under the laws of the State of Illinois, and in 
 institutions where the services is not extensive 
 enough to require the services of such pharmacist, 
 all prescriptions must be filled by the physician who 
 writes them. 
 
 The pharmacist shall be under the immediate 
 direction of the assistant superintendent, and shall 
 
- 
 
 * 
 
 ah 
 
 have charge of all drugs, medicines and medical and 
 surgical supplies; and shall promptly fill prescrip- 
 tions and issue goods from the department upon 
 proper prescrition or requisition. It shall be a spe- 
 cial duty-of the pharmacist to keep the assistant 
 physician advised of any apparent excess in the issue 
 of intoxicating liquors, sedative or narcotic drugs. 
 Subject to the approval of the assistant superintend- 
 ent, the pharmacist shall prepare estimates for the 
 requirements of this department. 
 
 In accordance with General Orders No. 70, all phar- 
 macists or officers in charge of the drugs and phar- 
 maceuticals in the State charitable institutions under 
 the control of the Board of Administration are here- 
 by directed not to receive drugs or pharmaceuticals 
 which do not conform with the specifications fur- 
 nished by the Purchasing Committee of this board. 
 No officer of an institution -will be allowed to de- 
 termine whether the brands of certain drugs or phar- 
 maceuticals, other than those specified, are equal to 
 those specified. All such articles will be rejected 
 and the firm is to be duly notified, in the name of 
 the Purchasing Committee, that the articles are held 
 at the institution. subject to its order. 
 
 Copies of specifications may be obtained upon appli- 
 cation to the board at Springfield. If the specifica- 
 tions in any way appear to be ambiguous to the phar- 
 macist or the responsible officer, then he is to obtain 
 an interpretation from the Purchasing Committee. 
 
 A copy of this order is to be posted in the drug 
 room or wherever the drugs and pharmaceuticals are 
 stored. 
 
 The hours of duty shall be from 8:00 a. m. to 5:00 
 p. m. week days, but subject to call of the assistant 
 superintendent at any time. 
 
 STENOGRAPHER FOR THE MEDICAL SERVICE. 
 
 The stenographers for the medical service shall be 
 subject to the detail of the assistant superintendent 
 in answering correspondence concerning patients and 
 in taking and recording examinations and case his- 
 tories of patients. There shall be a sufficient number 
 of stenographers provided, and it will be expected 
 that the work in this department be kept up and 
 
18 
 
 finished as nearly as possible to the close of business 
 each day. The hours of duty shall be from 8:00 
 a. m. to 5:00 p. m. week days. 
 
 CLINICAL CLERK. 
 
 The clinical clerk shall be under the immediate 
 direction of the assistant superintendent. The hours 
 of duty shall be from 8:00 a. m, to 5:00 p. m. -The 
 duties of the position require a full and complete 
 entry of every change or movement of patients. He 
 shall have charge of all official records concerning 
 patients, and shall aid the medical staff and the ste- 
 nographers in obtaining necessary information from 
 such records. It shall be his further duty to aid in 
 the preparation of statistics and other information 
 needed from time to time, and for the preparation 
 of all reports from this department required by law 
 or by rule of the administration. 
 
 THE NURSING SERVICE—UNIFORMS. 
 
 The uniform of the chief nurse shall be of white 
 material, to be made in such style as shall be agreed 
 upon between the superintendent and the chief nurse. 
 She shall wear no cap. 
 
 The uniform for female supervising nurses shall 
 be of white material, to be made in such style as shall 
 be agreed upon between the superintendent and the 
 chief nurse. They shall wear the cap of a graduate 
 nurse, as hereinafter described. 
 
 The uniform of the charge nurse of a hospital or 
 infirmary shall be of white material, to be made in 
 such style as shall be agreed upon between the super- 
 intendent and the chief nurse. She shall wear the 
 cap of a graduate nurse as hereinafter described. 
 
 The uniform for all graduate nurses, other than 
 those above mentioned, shall be of the striped mate- 
 
 rial prescribed by the Board of Administration, to ~ 
 
 be made in such style as shall be agreed upon be- 
 tween the superintendent and chief nurse. They shall 
 also wear a white apron and bib and the cap of a 
 graduate nurse, which shall be a cap of white mate- 
 rial and style to be agreed upon between the superin- 
 
 - 
 
 @ 
 
19 
 
 tendent and chief nurse, and shall have a black band. 
 This black band upon the cap shall be the special 
 designation of the rank of graduate nurse. 
 
 The uniform for pupil nurses shall be exactly sim- 
 ilar to that of graduate nurses, except that the caps 
 shall be without the black band which is the badge 
 of rank of the graduate nurse. 
 
 The uniform for attendants shall be exactly similar 
 to that of pupil and graduate nurses, but without cap 
 of any kind. 
 
 The uniform for male supervising nurses shall 
 consist of a coat and trousers of a blue material, 
 quality of goods and style of making to be agreed 
 upon between the superintendent and chief nurse, 
 and a vest of white material. The buttons for the 
 coat shall be of brass and bear on their surface the 
 word “Illinois.” The buttons for the vest shall be 
 of mother-of-pearl, and removable. The shoes worn 
 while on duty shall be black and always neatly pol- 
 ished. © 
 
 The uniform for male graduate nurses shall consist 
 of a white duck coat of military cut, to be of ample 
 proportions and neatly made; the trousers shall be 
 of a dark material, closely approaching black, neatly 
 cut and at all times worn supported by suspenders 
 or braces. The shoes are to be black and always 
 neatly polished. Male graduate nurses shall wear in 
 the left lapel of the coat a button on the surface of 
 which is a red cross, this to be the special designa- 
 tion of the rank of graduate nurse. 
 
 A male charge nurse of a hospital or infirmary for 
 male patients, may, on the approval of the superin- 
 tendent, wear a uniform exactly similar to that of 
 the male supervising nurses, but shall also wear the 
 red cross button in the left lapel. In the summer 
 season this nurse may wear a uniform entirely of 
 white, with the red cross button. 
 
 Male pupil nurses and attendants shall wear the 
 uniform described for graduate nurses, but shall not 
 
 “be entitled to wear the red cross button. 
 
 It shall be required that in so far as the duties of 
 the service will permit, each employee in the nursing 
 service shall be in full uniform during the entire 
 
 vhours of duty. 
 
20 
 SERVICE STRIPES. 
 
 When a male employee shall have completed five 
 years of service in the nursing force of the institu- 
 tion, he shall be entitled to wear upon the left sleeve 
 of his uniform coat and extending from the inner to 
 the outer seam, a red stripe three-eights of an inch 
 in width, material for which shall be furnished by 
 the Board of Administration. For each additional 
 five years of service he shall be entitled to wear an 
 additional stripe in like manner on the left sleeve of 
 his uniform coat. 
 
 When a male employee shall have completed one 
 year of service in the nursing force of the institution 
 and presents credible evidence of service in any 
 similar institution, either in America or any foreign 
 country, he shall then be entitled to wear the service 
 stripes indicating the total number of years he has 
 served in such institutions. 
 
 When a female employee shall have completed five 
 years of service in the nursing force of the institu- 
 tion, she shall be entitled to wear upon the upper 
 side of the left sleeve of her uniform, a white chevron 
 with a red stripe thereon, design and material of 
 which shall be provided by the Board of Administra- 
 tion, and each additional five years of service shall 
 be indicated by an additional stripe. When the 
 employee entitled to wear a chevron is a graduate 
 nurse, a red cross shall also be placed upon the 
 chevron. 
 
 When a female employee shall have completed one 
 year of service in the nursing force of the institution 
 and presents credible evidence of service in any 
 similar institution, either in America or any foreign 
 country, she shall then be entitled to wear the chev- 
 ron with service stripes indicating the total number 
 of years she has served in such institutions. 
 
 CHIEF NURSE. 
 
 The engagement of the chief nurse is for service 
 that is continuous. The hours of active duty shall 
 be from 7:00 a. m. to 6:00 p. m. She shall be under 
 
 the direction of the assistant superintendent, subject ~ 
 
 to the approval of the superintendent. It shall be 
 
 r 
 
 ¥ 
 
21 
 
 her duty to take charge of the entire nursing service 
 of the institution, and all the employees in this serv- 
 ice are subject to her assignment. She shall assign 
 the supervising nurses to an equitable division of 
 the labors of supervision and require them to keep 
 an accurate account of current supplies for ward 
 use and of ward furnishings; and to Supervise the 
 reception, marking and care of patients’ clothing; - 
 and to see that no waste is permitted in any depart- 
 ment of the service requiring the use of supplies. 
 She shall further require a supervising nurse to be 
 present at the reception of each patient and to re- 
 main with and in the presence of such patient dur- 
 ing the entire process of reception, including bath, 
 reclothing or assigning to bed, as the case may re- 
 quire; it being the intent of this rule that there 
 shall be a constant and effective supervision of the 
 management of patients during a period wherein 
 often arises resistance on the part of the patient 
 which leads to violence, to prevent the occurrence 
 of unusual or unnecessary friction. 
 
 The chief nurse shall be responsible for the carry- 
 ing out the directions of the superintendent and the 
 assistant superintendent concerning the housekeep- 
 ing, cleanliness, sanitation and general management 
 of all the wards under her care, as well as the 
 general and medical care and treatment of the 
 patients. She shall require all charge nurses to exe- 
 cute faithfully every direction and order given them 
 by the superintendent, his assistant, or any physician 
 in the medical service. 
 
 She shall be the principal of the school of instruc- 
 tion for attendants and of the training school for 
 nurses. 
 
 SUPERVISING NURSES. 
 
 ' After the adoption of these rules and regulations, 
 supervising nurses shall occupy the position hitherto 
 Known as supervisor and supervisoress. They shall 
 be graduates of a training school for nurses, of a 
 hospital for the insane, or of a general hospital. , 
 They shall be under the immediate control and direc- 
 tion of the chief nurse, subject to the approval of 
 he superintendent and assistant superintendent, and 
 shall perform the duties assigned to them by the 
 
22 
 
 chief nurse. Their engagement is for a service that 
 is continuous, and they shall present themselves in 
 uniform for duty at the rising hour each day and 
 be present and in constant supervision of the depart- 
 ment assigned to their care until the patients are 
 seated for their morning meal. They shall spend 
 practically all of their time in the department as- 
 signed for their supervision, and shall fully carry out 
 every direction given them by the chief nurse. — 
 
 CHARGE NURSES. 
 
 e 
 
 Charge nurses shall be graduates of a training 
 school for nurses, of a hospital for the insane, or 
 of a general hospital. They shall, be under the im- 
 mediate control and direction of the chief nurse, 
 subject to the approval of the superintendent and 
 his assistant, and shall perform every duty assigned 
 to them by the chief nurse. Their engagement is for 
 a service that is continuous, and they shall present 
 themselves in uniform for duty at the rising hour 
 each day. In addition to the ordinary obligation 
 which a charge nurse owes the institution and its 
 nursing department, charge nurses shall be held per- 
 sonally responsible for the execution of every order 
 of the medical department pertaining to the wards 
 or patients under their charge and for the kindly 
 and considerate treatment at all times of the patients 
 entrusted to their care. They shall have direct 
 charge, and consequent responsibility, for the condi- 
 tion of cleanliness and order of their wards and of 
 the patients therein and their clothing, and shall 
 require helpful service and obedience from all nurses, 
 pupil nurses and attendants who may be assigned 
 as their assistants. 
 
 NURSES. 
 
 Nurses shall be graduates of a training school for, 
 nurses, of a hospital for the insane, or of a general 
 hospital. They shall be under the immediate control 
 and direction of the chief nurse, and their assign- 
 ment to place of duty may be for any length of time 
 required by the chief nurse. They shall faithfully~ 
 aid in all- of the work of the department to which 
 
23 
 
 they may be assigned for duty and they shall be 
 responsible to the charge nurse for such work as 
 may be assigned them. 
 
 Pupit NURSES. 
 
 Pupil nurses shall be those employees of the nurs- 
 ing force who have completed the course of instruc- 
 tion prescribed for the school of instruction for 
 attendants and are selected to take the course of 
 training in the training school for nurses. They 
 shall be under the immediate control and direction 
 of the chief nurse, and during the course of training 
 shall be subject to such detail and assignment to 
 duty as the course of study or the judgment of the . 
 chief nurse may require. 
 
 ATTENDANTS. 
 
 All employees engaged in the nursing service who 
 have had institution experience, as evidenced by a 
 certificate of attendance upon a course of instruction 
 of a school of instruction for attendants, shall be 
 assigned to duty without detail to further attendance 
 upon such course of instruction. All others will be 
 required to take up the course as prescribed for the 
 instruction of attendants and to carry it on in such 
 manner as may be prescribed by the assistant super- 
 intendent and the chief nurse during the period of 
 their first year of service. At the expiration of this 
 period, if deemed worthy by the superintendent, they 
 shall be given a certificate which shall render them 
 eligible for selection to take the course in the train- 
 ing school for nurses. 
 
 All attendants shall be under the immediate direc- 
 tion of the chief nurse and shall faithfully carry out 
 every direction given them by supervising nurses or 
 charge nurses. 
 
 BooKLET OF INSTRUCTIONS. 
 
 On Jan. 1, 1910, at the taking effect of this 
 zy set of rules and regulations,.each employee then in 
 the service, and thereafter those who enter the 
 
24 
 
 service, shall receive from the superintendent, and 
 give him their receipt therefor, a booklet concerning 
 the conduct and relation of employees toward 
 patients. This is for the special guidance and in- 
 struction of those employees who are entrusted with 
 the immediate care of patients and who work in any 
 department with patients as helpers. All employees 
 shall be held to a strict accountability for any failure 
 to follow out the rules and directions therein given 
 for their conduct and relations toward patients. 
 
 THE BUSINESS ADMINISTRATION. 
 
 The business administration shall be under the 
 general direction of the chief clerk, subject in all 
 things to the approval of the superintendent. The 
 chief clerk is charged with the accounting of every 
 nature concerning the institution’s business activi- 
 ties. At the direction of the superintendent, he shall 
 prepare, in the form and manner prescribed by the 
 Board of Administration; the monthly estimates for 
 supplies, estimates for such longer periods as may 
 be required, and such special estimates as the busi- 
 ness conditions of the institution may demand from 
 time to time. He shall also prepare in such form 
 and manner as may be prescribed from time to time 
 by the Board of Administration, the necessary finan- 
 cial reports, including the quarterly, annual and 
 biennial reports. When the vouchers covering any 
 period of business have been fully prepared, and 
 approved by the superintendent, it shall be the duty 
 of the chief clerk to forward both the original and 
 duplicate vouchers to the fiscal supervisor of the 
 board of administration in Springfield and to retain 
 the triplicate vouchers in the files of the institution. 
 
 It shall be the duty of the chief clerk and some 
 other employee, to be designated by the superin- 
 tendent, to make application for a commission as a 
 notary public, that acknowledgments of every nature ?\ 
 required in the business affairs of the institution 
 may be made without charge. 
 
 It shall be the duty of the chief clerk to require 
 all clerks and stenographers except those in the , 
 medical service, to perform such duties as the prompt ~ 
 execution of all business transactions may require. 
 
25 
 
 He shall maintain an effective supervision over the 
 store, and be constantly advised of the receipt and 
 disbursement of supplies of every nature, and at fre- 
 quent intervals shall inspect, check and approve the 
 store room accounts. He shall require of the farm 
 and garden departments, together with their sub- 
 departments, such reports as to farm and garden 
 products used or consumed by the institution as will 
 enable him to open and constantly keep a compre- 
 hensive system of accounting with these departments. 
 When required by the superintendent, the general 
 duties of the position ordinarily known as “steward’’ 
 may be assigned to him, the duties thus assigned 
 from time to time to be clearly defined and set forth 
 in the special order issued by the superintendent. 
 
 THE STORE. 
 
 The store shall be under the immediate charge 
 of the storekeeper, who shall be a bonded official, 
 giving such bond as may be required by the Board 
 of Administration. He shall be held responsible for 
 the receipt, safe-keeping and proper issue of supplies . 
 of every nature. Nothing whatever shall be issued 
 from the store except by requisition drawn upon the 
 regular form and signed by the superintendent. He 
 shall keep the store room accounts in the form and 
 manner prescribed by the Board of Administration, 
 and such accounts shall be kept up to the close of 
 business each day, that balances of every commodity 
 on hand may be quickly ascertained. He shall, at 
 least once each quarter, make report to the Board of 
 Administration of all supplies received and issued 
 during the quarter, together with balances of com- 
 modities on hand, on the forms prescribed by the 
 Board of Administration. 
 
 } THE INDUSTRIAL SERVICE. 
 
 The system of accounting in the industrial service 
 shall be under the immediate supervision of the chief 
 clerk. Complete records shall be kept for each sub- 
 
 7 department in the form and manner prescribed by 
 the Board of Administration showing materials re- 
 ceived and articles manufactured and delivered to 
 
 é 
 
26 
 
 the store of the institution, or to any person author- 
 ized by the superintendent to sell the same; together 
 with amount of loss or waste of raw materials and 
 
 the balance of materials on hand. These depart-— 
 
 ments will make out quarterly reports which are to 
 be filed with the Board of Administration at the 
 time the regular quarterly statement is filed. 
 
 The industrial teacher shall have charge of the 
 industrial employment of female patients and shall 
 take up and carry out such work of manufacture, 
 including fancy work and repair and mending, as 
 may be required from time to time by the superin- 
 tendent. 
 
 The shop foreman shall have charge of the indus- 
 trial employment of male patients. He shall be re- 
 sponsible for the care and use of all materials, sup- 
 plies, tools and fixtures of the shop. 
 
 THE DOMESTIC SERVICE. 
 
 The domestic service shall be under the imme-- 
 
 diate direction of a chief housekeeper, with such 
 assistants as may be required for the successful car- 
 rying out of this work. All of the housemaids and 
 dining room helpers, other than those engaged in the 
 service of patients, shall be under her immediate 
 charge and supervision, subject to such sub-division 
 as the superintendent may from time to time direct. 
 The chief housekeeper shall have special supervision 
 of the laundry, and the manner of handling cloth- 
 ing; especially the care of clothing against damage 
 by employees or patients during the process of 
 laundering; and the supervision must be kept up 
 daily and reports of inefficiency, carelessness or 
 neglect are to be made to the superintendent daily. 
 Where institutions maintain a kitchen for the prep- 
 aration of food for the officers and employees, or 
 where a department of a general kitchen is set apart 
 
 for this special service, the chief housekeeper shall? 
 
 have charge of all its activities. She shall prepare 
 
 bills of fare and submit them to the superintendent. 
 
 at such times and covering such periods as he may 
 
 from time to time require; when these have been . 
 
 approved by the superintendent, it shall be her spe- 
 cial duty to see that they are faithfully followed out. 
 
 & 
 
 ? 
 
27 
 
 THE CULINARY SERVICE. 
 
 The culinary service shall be under. the immediate 
 charge of a dietitian, who, subject to the approval 
 of the superintendent, shall prepare estimates for 
 food supplies and requisitions upon the store for 
 their delivery to the various kitchens. The dietitian 
 shall present to the superintendent, at such times as 
 may be directed, a bill of fare for whatever period 
 may be agreed upon and when same has been ap- 
 proved by the superintendent, it shall be the duty 
 of the dietitian to personally. supervise the prepara- 
 tion of the food and its delivery to the various din- 
 ing rooms of the institution. To this end, the dieti- 
 tian shall have under immediate control all of the 
 cooks, assistant cooks, and helpers in the various 
 kitchens, together with the baker and his assistants, 
 and the pasteurizer, and shall require all of them to 
 perform such duties as may from time to time be 
 delegated by the superintendent. 
 
 THE COACHMAN. 
 
 The coachnian shall be under the immediate direc- 
 tion of the superintendent and shall have entire 
 charge of the coach barn, driving horses, carriages 
 and vehicles used in the driving department. Under 
 the direction of the superintendent, he shall give effi- 
 cient care to all of the animals in the department 
 and to al] of the equipment, keeping it in a high 
 state of order and repair. Where theinstitution owns .« 
 an automobile for passenger or truck service, the 
 coachman shall be charged with its care and man- 
 agement, and shall report from time to time to the 
 chief engineer any mechanical defects which require 
 repair. 
 
 AUTOMOBILES. 
 
 ’ The following order (No. 74) is hereby published 
 for the guidance of officials and employees at insti- 
 tutions owning and controlling automobiles: 
 
 1. All automobiles, owned by the State charitable 
 jnstitutions, under the control of this board, shall be 
 ‘operated exclusively for carrying on the business of 
 the institutions and for the judicious use of the man- 
 
28 
 
 aging officers and their families within the counties 
 in which the institutions are located, but not outside 
 of the counties, unless special permission is obtained 
 from the Board of Administration. 
 
 2. The managing officers of the institutions will 
 be held responsible for the wear and tear of the 
 automobiles and shall not permit them to be used 
 excessively. They shall not be used for returning 
 escaped patients. Passenger cars are not to be used 
 for hauling express, baggage or freight. The chauf- 
 feurs, or whoever the managing officers may place 
 in immediate charge of the machines, shall keep 
 a detailed record showing the amount of gasoline 
 used monthly together with a detailed account of 
 repairs. This record shall be open for inspection by 
 any member of the Board of Administration, or rep- 
 resentative thereof. 
 
 3. The managing officers of the institutions are 
 directed to deliver a copy of this order to the chauf- 
 feurs, or whoever they may place in immediate 
 charge of the machines, and the secretary of this 
 board is directed to furnish a copy of this order to 
 the State Civil Service Commission. 
 
 THe MECHANICAL DEPARTMENT. 
 
 The mechanical department, as set out under that 
 head in these rules, shall be under the immediate 
 control of the chief engineer, subject to the approval 
 of the superintendent. When in his judgment, the 
 service may be better carried on, the superintendent 
 may trom time to time, make specia] directions for 
 the carrying out of the institutions’ activities in this 
 department through the heads of the various sub- 
 departments under the chief engineer. The chief 
 engineer shall be held responsible for the condition 
 of the mechanical equipment of every nature and he 
 shall be charged with the care and efficiency of oper- 
 ation of the steam, water and power plants, together 
 with the plumbing and electrical equipment; and 
 shall maintain a constant supervision over the sewer- 
 age system and have the necessary cleansing and 
 flushing done at regular intervals and may be 
 required by the conditions at the institution. 
 
 It shall be his special duty to require the heac;. 
 of all departments under him carefully to inspect and 
 keep in as good a state of repair as may be all of the 
 appliances of every nature in this department. 
 
 of 
 
29 
 
 | THE FARM DEPARTMENT. 
 
 The farm department shall be under the immediate 
 
 control and management of the head farmer, with his 
 assistants under the direction of the superintendent, 
 
 shal] carry out ail of the plans prescribed from time 
 to time by the Board of Administration. He is 
 charged with the special duty of inspection and the 
 efficient operation of the dairy and the poultry depart- 
 , ment, and shall have charge of all the live stock, 
 vehicies and implements of every nature used in 
 carrying on the farm department. Under the direc- 
 tion of thé superintendent, he shall apportion the 
 teams and vehicles to the garden and grounds in an 
 equitable way that these departments may always be 
 supplied with the necessary equipment for carrying 
 on their work. 
 
 THE GARDEN DEPARTMENT. 
 
 The garden department shall be under the imme- 
 diate supervision of the head gardner, who shall, under 
 the direction of the superintendent, plan and arrange 
 for the use of garden products in such a way as to 
 secure the best results for the benefit of the insti- 
 tution. 
 
 When, in the judgment of the superintendent, it is 
 necessary to engage the services of a florist and land- 
 scape gardener, such florist shall have charge of the 
 greenhouses, lawns, drives and walks, together with 
 the trees, shrubs and fiowers, and the general orna- 
 mentation by such agencies. Under the direction of 
 the superintendent, he shall carry out all of the 
 duties of this department as may be from time to 
 time prescribed, and he shall perform such other 
 duties as may be delegated to him by the superin- 
 tendent. 
 
 FARM AND GARDEN PRODUCTS. 
 
 ll products of the farm or garden to be used for 
 <hé consumption of the institution shall be delivered 
 at whatever place may be designated by the dietitian, 
 and upon their delivery a receipt in such form as 
 may be prescribed by the chief clerk shall be given 
 therefor, either by the dietitian or the storekeeper, 
 and such receipts shall be filed with the chief clerk. 
 
30 
 
 PATIENT HELP. 
 
 The employment of patients in the various depart- 
 ments of the institution service is necessary to the 
 successful and economic administration of its affairs. 
 The detailing of patients to the various departments 
 as helpers will be at all times subject to the approval 
 of the superintendent, and the requirements shal] be 
 of such a nature as shall not become burdensome to 
 the patient detailed to the service. It shall be kept 
 constantly in mind that in employing patients in a 
 helpful service, the institution has a pecuniary gain, 
 but that primarily, the patient’s welfare shall have 
 every consideration and the labor shall not be of 
 such nature as will be burdensome or exhausting. 
 The head of every department, with the sub-heads, 
 who have patient labor detailed to them will be held 
 strictly accountable for the care and supervision of 
 patients so detailed, and for their kindly and con- 
 siderate treatment, and all employees who have 
 patients assisting them shall be required to work 
 with the patients rather than to observe and direct 
 the patient’s labor. 
 
 Be 
 
7 f 
 oe 6 (ne 
 r Bi ace ‘a 
 Be TAY meee | 
 a Senate 7, ' i 
 i ae New .) f he yg i* ; j 
 3 : ’ 
 
 s 
 io & 
 
3 0112 061925100