LI E> R.ARY OF THE U N 1VE.R5ITY or ILLINOIS EEPLY REY. W. I^IYEN^S LETTER ^tster|)ociU purses. LORD JOSCELINE PERCY. RIVINGTONS^ WATERLOO PLACE ; TEINITT STEEET, HIGH STREET, C'amtritrgr. 1866. LONDON : GILBSHT AND lilVINGTON, PRlNTEh?, ST. John's square. REPLY, My Loeds and Gentlemen, The letter which Mr. Niven has addressed to you on "Sisterhood" nurses seems, notwithstanding its mistakes and inaccuracies, to have had some effect in checking the progress of improvement in the system of nursing in your hospital. This improvement has been eftected in other hospitals by the employment of " Sister- hood " nurses, condemned by that letter, but gratefully recognized as an improvement by the most competent judges. Mr. Niven 's letter informs you of the " favourable opportunities such institutions (hospitals) present for the religious and moral improvement of their inmates," but he neglects to inform you that the time employed for such improvement by the chaplain, the Homan Catholic priest, or Protestant Dissenter, is short as compared with tlie hourly influence of an ignorant, a vicious, or a scoffing nurse. He seems also to forget that the primary object in a hospital is the cure of disease. The letter alludes to " the dangers which threaten our A 2 4 EEPLT TO THE RET. W. ^ITEN S LETTEE IS'ational Church," among them, " the disposition to find fault with, and if possible to overthrow the system which has so long worked well in our hospitals, workhouses, and similar institutions." There has not been any disposition whatever on the part of the Committee or Weekly Board to find fault with, or overthrow, the system of religious minis- tration in your hospital, which obtains at present, as the above allusion to " the dangers which threaten our National Church." &c., would lead you to infer, but most certainly to find fault with and alter the system of nursing, for that is the question at issue. Mr. Niven does not entertain the question of the present system of nursing in your hospital, but I do not suppose he is prepared to approve of the system of nursing in worJcJiouses . The proposal of the Committee was to introduce an improved system of nursing only, and not in any way to interfere with the present system of religious ministrations in the hospital. The present system of nursing, if system it can be called, consists in hiring women, chiefly of an inferior class, with such a character as can be obtained. Tou may judge of the difficulty of obtaining a true character from your own experience. This system works, at times, very badly for the health, the comfort, and even the lives of the patients (committed to your charge as governors of the hospital), and injuriously to medical knowledge, in which all are con- cerned, as it is palpable that a lying and careless nurse may lead medical experience completely astray ^ ' " It is truly incomprehensible that the value of good nursing and the need of instruction to make good nurses, should have been so little appreciated in past times ; for there can be no question that the best ON SISTERHOOD NUESES. 5 Among other objections, the letter states that the arrangement proposed by the Committee is expensive. This can scarcely be the case, as the Sisters, thanks to their charity and the liberality of the founder, required no pay- Tlie letter informs you that the Committee "are intro- ducing a new religious element into the establishment." The Committee proposed the introduction of Protestant ladies, persons of an education superior to that of the common nurses, approved by the Bishop of London, in the place of the, usually, low, uneducated class now employed, of whom, with some remarkable exceptions, there are general complaints, and also the introduction of nurses with some degree of religious feeling, in the place of nurses who, generally speaking, have little or none at all. This was the only " new religious element " contemplated by the Com- mittee. To this, I hardly think, Mr. Niven would object, and believe it to be perfectly possible, as in other hospitals, to introduce such persons without " seriously affecting the religious tone (if any) and teaching of the institution " in the obnoxious sense which Mr. N. appears to indicate. Sisterhoods, or persons residing together (if from econo- nomical reasons alone), like all other Societies, must liave rules, and those who are to nurse must make engagements not to leave their duty at the caprice of a moment ; and I see no reason why they should not make reasonable "solemn engagements" (sanctioned by such an authority as that of the Bishop of London) as well as soldiers and sailors. efforts of medical skill are frustrated by the absence of proper watching and attendance in the sick room." — From an Address by Dr. Artldge. Physician to the North Staffordshire Infirmary, 1864. A 3 b REPLY TO THE EET. W. NIVEN S LETTER It is unfair to say that the matron, under the new system, would not have been permitted to interfere in the manage- ment of the wards. The Committee recommended, as in common sense they should have recommended, that the persons responsible for, should have the management of, the nursing ; but it would still have been the duty of the matron, the visitors, and the Board, the orders of which the Sisters stipulated to obey, to visit the wards and to prevent irregularities of any kind. Mr. N. did not cer- tainly " rightly understand " the report of the Committee as I, a member of that Committee, understood it. What may be the secret and mysterious proceedings which the letter insinuates, I can only gather from the remarks it contains on other sisterhoods, Miss Sellon's in particular (not a nursing sisterhood) ; and because in her case, besides absurd or reprehensible, an evil influence was, according to Mr. Niven's letter, exercised to induce a testamentary dis- position in her favour, he would have us to infer that this evil influence is the rule in all sisterhoods, a most unchari- table insinuation of a fraudulent tendency in all sisterhoods, to which the Law, I imagine, applies a remedy. Or because in another instance a parishioner of Mr. ^N'iven's was in- duced to desert his ministrations for that of a " highly ritualistic church," this crime committed by an individual (not, I am told, of a sisterhood at all) is used as an argu- ment agaiDst sisterhoods ! I cannot suppose it is meant to be insinuated by the allusion to Miss Constance Kent that the class of nursing ladies are usually ladies of her character, and must therefore conclude that her confession was the gravamen, and that it was meant to convey that the Sisterhood of St. Peter's ON SISTERHOOD NURSES. 7 would teach auricular confession under the sanction of the Bishop of London, a practice so repugnant to the Church. Our Church authorizes confession in the case of a person "who cannot quiet his own conscience" in the matter of going to the Holy Communion and in sickness ; " if he feel his conscience troubled with any weighty matter," accord- ing to the Prayer Book. Whether this or auricular confes- sion was the means employed in Miss Constance Kent's case, I do not know, but whatever the means used, her case is an unfortunate one to cite, as there are so many persons who cannot understand that the end does not justify the means, and they will consider that it was highly meritorious to persuade Miss Constance Kent to make the only repara- tion in her power in this world for her crime, and to relieve her own father and other innocent people from a horrible imputation. Is it fair to insinuate that because Miss Sellon's sister- hoods have gone into extremes from a " quiet and moderate beginning," therefore we must expect the same "in that of Su. Peter's ? Low Church as well as High Church clergy have gone into extremes from moderate beginnings ; are we therefore to condemn the clergy altogether? Yerily, I think, we ought to condemn extreme parties whose charity seems to be that which "believeth all things" evil. Some kind of proselytism by sisterhoods seems to be apprehended; but it also seems to be forgetten that the proselytism introduced by an ignorant infidel, or vicious nurse, of whom we have known instances, is a worse evil than High Churchism, if indeed a hard worked sister could find the time to proselytise. The scoffer has a great advan- tage in this latter respect. Using Mr. Niven's reasoning A 4 8 REPLY TO THE REV. W. NIYEK's LETTER we should be wrong to appoint even a Low Church chaplain to the hospital. For what "guarantee have we" that lie would not change his views, as so many others have changed theirs. He might introduce auricular confession, for its introduction lies at the door of the clergy not of their victims — the women. Whether sisterhoods have been unknown to the Church of England for the last 3Q0 years may be a question. She does not profess infallibility. They have been known in French, German, and Swiss Protestant countries, from a very early period of the Eeformation,^ and we should do well therefore to follow the example of our foreign brethren noto- riously excellent as far as hospital nursing is concerned, instead of continuing our own system, notoriously bad, even if 300 years old. With equal unfairness, the Eoman Catholic m.ight plead that certain doctrines were unknown to the Church of England for more than 300 years before its Reformation. Reformation in the matter of nursing we urgently require. 2 In " La France Protestante," by Haag, we find that Henri R. de la Marck, a Protestant prince of Sedan, instituted, about a.d. 1560, the '■'^demoiselles de chariti" and says that they "se chargerent de visiter et secourir a domicile les veillards et les infirmes." St. Vincent de Paul, usually considered the originator of such institutions, did not establish his "Sisters of Charity" till a.d. 1634. Dr. Fliedner, the founder of the Deaconness' Institution at Kaiserswerth, cites many instances of such or kindred institutions, by the Waldenses, Moravians, and various other denominations of early Protestants, among them the congregation of the English Nonconformists in 1600—1620. No doubt they lost vitality from poverty, or the want of special training institutions, &c., now, happily for the sick and poor of Germany, and other foi-eign lands, revived by the admirable Pastor Fliedner, who was neither Roman Catholic nor High Church, but a poor pastor of the Protestant Prussian Reformed Church. I hope the Deaconnesses' Institution of Burton ON SISTETIHOOD NTJRSES. 9 Nor is there any force in the objection that these insti- tutions " have not originated with the authorized rulers of our Church." If Mr. IS'iven is prepared to contend that no institution can be good, unless so originated, he will have to condemn many other institutions. If St. Peter's Home was not so originated, its rules and practice were approved, and are so still, by the Bishop of London. Mr. Niven would have it inferred that all the sisterhoods have originated " with that party within her pale (of the Church), who are now causing much anxiety and trouble to the Episcopal Bench." Some of them, no doubt, have so originated, and much mischief have they done to a good cause ; but the Committee selected a sisterhood to which the Bishop of London has given his approval, after a per- sonal and practical attention to its rules and working. Is it right or reasonable, therefore, to say the least, to decry with insinuations and on hearsay evidence, an insti- tution cordially approved by " an authorized ruler of our Church?" Mr. Niven takes upon himself to define the qualifications of deaconnesses of the primitive Christian Church, but he seems to have forgotten that Biblical critics differ on this point, as " any one who is acquainted with Church history" can affirm. Common sense seems to be on the side of those critics who think that Phoebe, "our sister," the servant (StaKovo5, or deaconuess) of the ^Church at Cenchrea, the Crescent, an English branch of the great Kaiserswerth Institution, may soon have a hke success. Their rules, their dress, approved by the Bishop of London, are such as I think would satisfy the most fastidious critic, if free from prejudice. This sisterhood has undertaken the nursing of a small hospital. 10 REPLY TO THE REV. W. NIVEN's LETTER " succourer of many," and of St. Paul himself, travelling to Rome, could scarcely have been one of the aged widows, in fact one of the aged paupers, whom he identifies in the injunction, "If any man or woman that believeth have widows, let them relieve them, and let not the Church be charged." This systematic relief of the aged and friendless widow by the Church, as directed by St. Paul, has scarcely found more favour than the Sisterhood of Deaconnesses. The extracts from Mr. Hobart Seymour's work are wholly irrelevant, as applying to parochial ministrations. I will not stop to inquire whether the ministrations of clergymen, their wives and daughters, are sufficient to meet the wants of our crowded town parishes, but the clergy, their wives and daughters, cannot be expected to undertake the nursing of the sick in hospitals. Not living within half a mile of St. Peter's, like Mr. Niven, but within a few paces, I can deny from my own knowledge, and not from hearsay, the absurd charges made against it, and bear a grateful testimony to the value of their works of charity, and to their visits to the " veillards et les infirmes a domicile," like their ancient Protestant sisters of Sedan. With the Bishop of London's approval of their religious qualifications, any real and reasonable member of the Church of England ought to be content. I hope Mr. Niven' s omission of all mention of Miss Goodman's favourable testimony ^ to the 3 Miss Goodman says at p. 238, " I think that the working and rules of the Sisterhood at Brompton (St. Peter's Hume) offers, in some re- spects, a favourable contrast to many others, with regard to the zeal and care shown to guard against abuses, as well as for the broadness of the views manifested by the little band," and at p. 260, " It seems im- possible for abuses to creep in under such a system as that pursued by the Sisterhood." ON SISTERHOOD NUHSES. 11 merits of the St. Peter's Home, while quoting her book against Miss Sellon's Sisterhood, was an unintentional, otherwise it was not an ingenuous omission. And this is not the only sisterhood which has avoided the abuses and puerilities of certain others. I am acquainted with another sisterhood which has done a very great amount of good, the details of which I regret not having space to give. This sisterhood was originated by a lady, who laboured and studied for the purpose at the Protestant sisterhood of Kaiserswerth and elsewhere. More liberal and less narrow-minded Christians, the clergy and dissenters of different denominations, gave their countenance and aid to the hospital of the sisterhood, even dissenting ministers giving sermons for it. I was present when the poor foreman of some neighbouring works brought his offering of £1 in pure admiration of their care of the sick, not from any benefit he had himself received there. To the Hospital of the same sisterhood at Middlesborough, the working men subscribed a few years ago £90 out of their earnings, and quite recently £15 towards refurnishing the beds. Besides these testimonies to the value of the good work, some of them contributed their time also in assisting to nurse the sick. Such is the genuine appreciation of a sis- terhood by the patients and the poor of these towns. I have before me a very different account of the feelings of London patients for a London hospital. Many of you are not perhaps aware that the nursing of the University College Hospital has now for some years been exclusively in the hands of the sisterhood of All Saints, to the great satisfaction of all concerned ; and that in a fearful epidemic of typhus fever two of the Sisters were invited by the guar- 12 REPLT TO THE EEV. W. :NT:V"EN's LETTER dians of the Manchester workhouse, in their extremity, for nurses, to nurse about seventj-five typhus fever cases. These two heroic women effected so wonderful a change in the infirmary in the course of about a fortnight, that the guardians, with true humanity, and setting aside all narrow prejudices (if they had any), entreated that sisterhood to undertake the entire charge of the infirmary, where they still furnish an example to hospitals, as well as workhouse infirmaries. The following is an extract from a letter I received from a friend, one of the medical officers of the hospital at Smyrna in 1855, which may be a hint to military as well as civil hospitals: — " The sisters aud nurses are, as you may expect, of inexpressible service. Many and many a life have they saved. I have no hesitation in saying that I could name some men whose lives were sacrificed to the militai'y system of orderlies before the nurses came. Nursing is what our patients want, aud not physic. It is by the strong broths, gentle care and kindness which they can alone supply, that our poor fellows are to be rescued. If it were not to direct their energies, and perhaps moderate their enthusiasm, we surgeons might leave the care of nine out ten of our patients in their hands and nwt fear the result." Without the stimulus of an exceptional enthusiasm, the Sisterhood of All Saints have, be it observed, done as much for a workhouse infirmary. The evils with which we have to contend under our present nursing system, evils, which it must be remem- bered either add to the sufferings or endanger the health and life of patients, let alone their comfort, are as follows, viz. : — Neglect of nurses in leaving a patient unaided when the patient is helpless, to his great distress, his seripus injury. ON SISTEEHOOD KITKSES. 13 or his death, or neglecting hiin when he is likely to do in- jury to others. Careless and dirty habits, to the fostering, or perhaps creating, of diseases engendered in hospitals, or affecting the food of the patients, to the disgust of all but perhaps the very lowest class. Bad and cruel language to patients, even in the last stage of illness, embittering, and perhaps hastening, the last moments of life. jS'ot carrying out the directions of the medical officer, and giving fictitious statements of the effects of treat- ment. Compelling a patient, in order to save trouble, to exertion which may be fatal, or, for the same reason, neither sum- moning the medical officer, nor even applying simple reme- dies themselves at a critical moment. Taking presents, of food or money, from patients or their friends, and favouring them to the prejudice of others. Persisting in some practice injurious to the health, or disgusting to the senses of the patients, either from indif- ference or the fear of complaining and being thought troublesome by their superiors — a feeling not confined to hospitals or hospital nurses. Allowing, or even encouraging, bad language and con- duct, to the injury or the ruin of the young, male and female. Making night nursing a mere name, the patients not daring to disturb the comfortable nurse, death sometimes the consequence. Allowing the friends of patients to introduce spirits or food, to the injury or the death of the patient. 14 EEPLT TO THE EEV. W. NIYEN's LETTER Drinking the wine and spirits ordered to sustain even the life of patients. Drunkenness and dram-drinking, too common a fault, and the fruitful source of many of the evils which our present nursing system is heir to. The existence of the above shortcomings, no one conver- sant with hospitals will, I think, venture to deny. They can only be prevented or diminished in frequency by the constant presence in the wards of nurses of a high tone of moral or religious feeling, and of an education superior to that of most of the head nurses now employed. No other kind of superintendence or possible vigilance under our present system will prevent the occurrence from time to time of these blots upon our hospital management, and for one instance detected many must remain undiscovered. So fully have I been convinced of this for years past, that I have made it a rule to visit, as far as possible, each patient I have sent to a hospital of which I was a Grovernor, in the faint hope that my presence as his friend in the ward, might in some degree protect him at least from bad nursing. Had there been no means of improving the existing state of things, as was the case a few years ago, I would not have exposed the evils to which our present system is liable. They are already too well-known to many of the poor, are a sad drawback to the usefulness of hospitals, and unfor- tunately the bad name of the nurses of one ward casts a suspicion on all the others. I believe, however, that there are some excellent nurses in hospitals, whom I have long known and to whom I would willingly entrust my own life ; but they have great difficulties to contend with, among otliers, their status does not give them the authority re- ON SISTEEHOOD IfUESES. 15 quired for the control of subordinates and to keep iu check the evil tendencies of others. The matrons also have much difficulty in ascertaining the true character of the women employed, and though they may have extra nurses on their lists, they cannot always secure them in an emergency, and must put up with what they can get. Sisterhoods can always fall back on some of their own trained sisters, one of the advantages afforded by a trained and disciplined body with an espnt de corps of a high order. Many of the donors and subscribers to Hospitals, and testators also, will, I feel sure, in the course of time discover where patients are certain to receive kindly, gentle, careful, and Christian nursing, and will leave to unfair prejudice, to sectarian animosity, or to thoughtless indifference to the welfare of the sick, the maintenance of hospitals under the present system. "Wherever sisterhoods (under proper, as Miss Nightingale writes in her " Notes on Hospitals," secular control), have undertaken nursing in hospitals, whether at home or abroad, whether Protestant or Eoman Catholic, their great merits are acknowledged, and scarcely one of the evils enumerated above finds a place. I had hoped that, as an improved system is now within our reach, we might have shaped a safe course between the two extreme parties of the Church, and done our part in directing the religious zeal and energy of women of our Church into that mcst useful channel of charity — the nursing of the sick. I grieve that it should be considered " one of the high privileges which Divine Provi- dence has bestowed on our Protestant England " to deprive our English poor of so great a benefit, and that the patients of your hospital should not be permitted to share in the 16 EEPLT TO THE EEY. W. NTVEN's LETTEE, &C. advantages of a reformed system of nursing, wliichj under ! the influence of the highest motives, would secure a kindly and Christian attention to their wants and sufferings, now too often neglected or aggravated under the influence of irreligion, indifference, ignorance, or drink ; and would also secure to your medical officers a better certainty that their directions would be carried out, and a truer value thus aflbrded to their experience, in which we are all so much interested. As a visitor of the poor for many years, and for more than twenty years not inactively employed in the management of hospitals, I also may lay claim to address you, and Beg leave to subscribe myself, Your obedient humble servant, JOSCELINE PEECT. THE END. G-ILBEET AND EIYINaTON, PEINTEES, ST. JOHN's SQUAEE, LONDON. ^" K^A m %', »*%^ ..^*/