THE HERBERT HOSPITAL WOOLWICH
REPORT ON A VISIT TO THE WOOLWICH HOSPITALS BY THE DIRECTOR-GENERAL, ARMY MEDICAL SERVICES, AND DR. GALLOWAY
[The National Archives WO30/133]
These hospitals are at present in charge of Colonel G. G. N. Leake. They consist of three different establishments –
1.The Herbert Hospital
2.The Auxiliary Hospital
3.The Hospital for Women and Children
THE HERBERT HOSPITAL
This hospital contains accommodation for 940 sick. Specially built for the purpose it serves, it is arranged in separate pavilions connected by covered corridors. The situation on the western slopes of Shooter’s Hill is an excellent one, and there is sufficient space surrounding the hospital to admit of exercise and recreation ground for convalescent patients. The administrative portion of the hospital lies immediately to the south of the old Dover road; the hospital pavilions stretch at right angles to the road in a southerly direction behind the administration buildings.
The surroundings of the hospital and the hospital yards are only in fairly good order, in several places leakage from external drain pipes was noticed, litter from a swill tub was observed in one doorway, and at one portion an untidy display of old building material was observed, stated to be the property of the Royal Engineers. The attention of the Officer in charge was drawn to these points. They give rise to a suspicion of carelessness in general management. On part of the ground to the west of the main building a number of hospital huts are erected, and are stated to be in occupation during times of pressure, as during the invaliding season from India.
The general sanitary arrangements seem to be fairly good, but in certain of the lavatories and latrines more tidiness and cleanliness could be wished for. As a rule in this hospital separate sinks are provided for washing the eating dishes and for washing the bed utensils, etc. The bathroom accommodation is quite inadequate for the number of patients in hospital. The bathrooms are small, the walls are often dingy and stained; the baths, sinks, and water-closets are usually of old types, and some of the latter, enclosed with soft wood, must be insanitary.
The wards themselves are light, airy, and well ventilated, and capable, with a little trouble and re-arrangement of details, of providing excellent accommodation. In such a hospital as this it seems to be unnecessary to allow the unsightly ward tables, some of them of the iron-trestle type, others upon wooden legs, and of a very rough pattern, to remain.
The corridors and main passages leading to the wards are clean and sufficiently well kept, but on descending to the basement, where the kitchen and other offices are situated, there was much to be desired in the way of cleanliness of the passages and corridors.
The hospital kitchen itself is commodious, is fitted with modern cooking arrangements, and the provision of food seems to be efficiently provided for, and the food itself seems to be of good quality and well served.
A special operating room has been provided, which is well lighted and commodious, and there appears to be a sufficient amount of modern surgical apparatus.
In this hospital, and the Auxiliary Hospital to be mentioned, carelessness was to be observed in the storing of material for surgical dressings. These and other matters of detail appear to be within the province of the Officer in charge, and should be strictly regulated by him.
The steward’s stores appeared to be kept in order. The linen stores seemed to be rather small for such an institution, but are otherwise in fairly good condition; but we observed the foul linen being sorted in the immediate vicinity of the clean linen, as at Rochester Row.
A portion of the administration buildings in the occupation of the Nursing Sisters was inspected. The building has a north-eastern aspect and may be cold; but the accommodation provided is sufficient if well arranged. There appears to be an unnecessary inclination to divide off the rooms in this part of the building into closets and dark corners by means of wooden partitions. This should be avoided when the re-arrangements under consideration are undertaken. A much larger amount of space will be necessary when the additional nursing establishment is provided for conducting the hospital under the new system.
The wards for the insane patients are situated on a separate corridor of the hospital. Four or five patients were under treatment. In one small ward we saw a lad under 20 years of age who was under observation, as he said he saw ghosts. He appeared to be in excellent general health, and suffered only from this illusion, of which there appeared to be some doubt; but along with this boy, sharing the same room, was a patients in an advanced state of general Paralysis. This unhappy grouping of patients should have been avoided.
A series of three swivel hand basins, for the general use of the patients, was found to be in bad order and impossible to be used. The patients used the same sink for their ablutions in which were washed the dishes, bed utensils, and all other articles in the service of this section. The civilian attendant apparently knew very little about the ward or patients, and the whole arrangements of this department were faulty and require to be improved.
We visited a large room on the basement here, occupied by one patient affected with Itch. This room was very untidy – dirty clothes, etc., being seen in different parts. On examination it was found to have been originally built as a bath-house, and had been fitted with apparatus for various forms of baths. It seems unfortunate that this room should have been diverted from the purpose for which it was built. It is now named ‘Itch Ward.’
Generally, the hospital is well situated, well built, and well arranged for the purpose of a hospital; but the mean furniture in the wards, as well as a want of neatness, and order to be observed in many of the departments, prevent the hospital from attaining a high standard.
AUXILIARY HOSPITALThe Auxiliary Hospital is situated near the barracks, and at a distance of about ¾ mile north from the Herbert Hospital. It is a low building with a wooden roof, and is fitted for the reception of about 10 patients, and has also accommodation for the examination and out-patient treatment of soldiers, their wives and children. The internal arrangements of the hospital are on a meagre scale, and there is a general air of untidiness. In a main passage near the door cobwebs were seen hanging around the gas bracket on the wall lighting the passage. In the dispensary antiseptic dressings such as cyanide gauze, boric wool and lint, were found lying free, mixed up altogether in a large loosely fitting wooden drawer. At the other end of the dispensary a rack of tin boxes for surgical appliances and dressings was situated, and over this on the wall were two or three small shelves on which were seen such articles as a dirty comb, a hair brush, a glass bottle containing a collection of foul extracted teeth, all arranged promiscuously with medicine bottles, etc., on the shelves. The whole arrangements of the auxiliary hospital require careful inspection and regulation.
THE HOSPITAL FOR WOMEN AND CHILDRENThis hospital, with accommodation for about 20 patients, arranged in two wards on each side of a central doorway, is a one-storied building situated on a plot of ground behind the auxiliary hospital just mentioned. The arrangements of the hospital are in the charge of a civilian nurse who acts as matron. It was satisfactory to observe the cleanliness and good order of this hospital. The wards, kitchen, the separate room for the accouchement of the women, and various small rooms were visited, and, throughout, the same high standard of cleanliness was noted. The matron appeared to take the greatest interest in her hospital. Several patients were in the hospital and they seemed to be comfortable and well looked after.
The majority of patients admitted to this hospital are soldier’s wives during their confinement, but other cases of general disease are admitted from time to time, and on our visit a case of Appendicitis was in the ward occupied by Puerperal cases.
The most serious criticism in the arrangements of this small hospital seems to be that general cases, possibly septic, such as the case of Appendicitis mentioned, were occupying the same ward as the women before and immediately after labour. We were informed that the case of Appendicitis had been detained in a small ward abutting on the general obstetric ward while there was any risk of operation. That no case of Puerperal Sepsis had occurred in this hospital for 14 years is a fact which argues well for the care observed in nursing both the Puerperal cases, and those of general disease.
The instruction of soldiers’ wives as obstetric nurses for the Army is carried on in this institution by the matron in charge. With the exception of the matron and a trained nurse, the nursing of the hospital is conducted by these women undergoing training. This important work is spoken of with much interest and with intelligence by the matron. It is clear that it should be specially recognized and properly supervised.
W. TAYLOR, D. G.
22nd November 1902
In March of the following year  these hospitals were inspected by Miss Sidney Browne, the Matron-in-Chief of Queen Alexandra's Imperial Military Nursing Service, to see how the new nursing arrangements were working, and to suggest any further improvements to be made. Her report is followed by another from Ethel Becher, Principal Matron, who spent three days at the hospital immediately following Miss Browne's visit.
HERBERT HOSPITAL, WOOLWICH[The National Archives, WO243/21]
I visited the Herbert Hospital, Woolwich, on March 27th and 28th  and went round the wards in the morning, afternoon, and at night to see how the new scheme was working, and how the sisters and staff nurses were getting on.
Hours of Duty – Cleanliness of the Ward
The staff nurses have their breakfast at 6. 30 a.m. and go on duty at 7 a.m., and leave their wards at 8 p.m. They have three hours off duty every day, half a day once a week, and a whole day once a month. The sisters go on duty at 8 a.m. and come off at 9. They also have three hours off every day and a half a day once a week, and a whole day once a fortnight. They find it rather difficult to get the wards quite clean and tidy by the time the Medical Officer pays his visit at 10 a.m. The work is heavier for the nurses than it is in a civil hospital, for the probationer orderlies do not give so much help as women probationers at present, but they are improving very much in this respect, I hear, and are learning to do their work in a more methodical manner, and I think soon they will do it properly without such constant supervision by the Sister and Staff Nurses.
One drawback to the morning work is the hour the orderlies have their breakfast (they have it at half-past seven and parade at eight), so they are absent from their wards at the busiest time in the morning.
Orderlies’ Hours of Duty
If they could have their breakfast at 6. 30 and do any necessary duties they may have to do in their barrack rooms and come into the wards at seven, and remain until the sister can spare them, it would make the work easier.
Improvements in Nursing Arrangements
Probably when the Medical Officers make their rounds they think there is very little improvement in the general appearance of the wards, and looking at the work from the outside point of view only there is not. But knowing the weak points of the old system and the way the nursing work has been done for years, I know in reality there is a very great improvement, and I was very glad to see how the work is done now.
There are now trained nurses as well as orderlies to do the early morning work, Formerly, though some of the more experienced orderlies did their work well, the sister could hardly expect those who were untrained to make the beds and wash the patients properly, and to be sufficiently observant to judge whether they ought to be allowed to wash themselves or get out of bed. I think it is most important that the staff nurses commence their duties at 7 a.m., and see that this important part of their day’s work is properly done.
In the afternoon when I went round, some of the sisters or staff nurses and nursing orderlies were on duty in every ward, and the wards and lavatories were as clean and as tidy as they were in the morning.
In the evenings it was the same. There was a marked improvement in the aspect of the wards and annexes, and the quietness and discipline of the patients. The evening work, which every nurse knows is so important, is now properly done; under the old arrangements this was impossible, for it used to be the rule for all the orderlies who assisted in the ordinary ward work to go away at 5 o’clock, only those who acted as special nurses in one ward (in which were the most serious cases) were left, and there was no one in the other wards to do the evening work but the sister, and as she often had in the large hospitals from 60 to 90 beds to look after, it was impossible for her to do the work and attend to the patients properly single-handed. Now every ward or block has a sister to superintend, and staff nurses and nursing orderlies to do the evening work.
The Matron and sister told me that the nursing orderlies took a great interest in their work and did it well and satisfactorily. They had the same hours on duty as the staff nurses, and were punctual and obedient. The sisters found no difficulty in maintaining proper discipline now they were put in charge of their own wards, and were without ward-masters, but on the contrary there was a great improvement in this respect.
WOMEN’S HOSPITAL, WOOLWICHI visited this hospital on 28th March 1903. The staff consists of a Matron, Miss Dryland, one trained nurse, and four pupil nurses, two are soldiers’ wives, two civilians; the two civilians are fully-trained nurses who give their services to the hospital for their maternity training, they pay 10s. a week for their food, and supply their own uniform, they sleep in the hospital. The soldiers’ wives supply their own food, and sleep in one of the large wards; I do not think this is a good arrangement, the Matron informs me she has an empty room and they shall sleep there for the future.
The Matron gives the necessary lectures and practical instruction to prepare the pupils for their L.O.S. examination; they are very successful so she has no difficulty in obtaining pupils. This arrangement is an advantage to the hospital as the pupils are trained nurses. They stay after they are qualified and the hospital has the benefit of their services.
All the wards and annexes looked beautifully clean and tidy though the Matron and head nurse had been up most of the night with two maternity cases. The hospital appears to be popular amongst the women, they have had 14 cases already during the last month, and a good many more have entered their names for admission. The women said they were very comfortable. The Matron states that she never puts any medical nor surgical cases now into the wards with the maternity cases, but keeps them separate.
There are only a few articles which require changing, the Matron says she had nearly everything she requires. The screens were made of towel horses covered with sheets which were washed every week, and looked clean, but others with washing covers would be better, some boat-shaped feeding bottles, a low chair or two, new pattern night-stools were all she asked for.
HERBERT HOSPITAL, WOOLWICH
I visited the Herbert Hospital on Tuesday the 29th ultimo, and remained there till Thursday, the 31st ultimo. From my own observations and from reports of the Matron and nursing staff, the new nursing scheme seems to be working well. The principal Medical Officer of the hospital told me the same thing adding that everything was working smoothly, and much better than it had done the first few weeks.
There is no discontent amongst the orderlies as far as the Sisters and Nurses can discover during their daily work with them, nor do they appear to resent in any way being under the direct orders of the Matron and sisters for the carrying out of the nursing and general ward work. The Matron has 44 nursing and general orderlies for her wards; this number she finds ample for day and night duties. These orderlies are not moved from these wards without the previous knowledge of the Matron. Several orderlies have expressed a wish to join the nursing section, but they are all most anxious to have some definite idea as to their chances of promotion, etc. Colonel Whitehead himself told me he would be very glad when he could have some printed regulations to give them for the information they are always asking for, both for the nursing and general duty sections, and for those men who are recommended for Q.A.I.M.N.S.
I visited the wards at all times, before the Medical Officers’ visits in the morning, at dinner and tea time, and again at 10.30 p.m. with the Matron and night sister. They appeared neat, and orderly, and very clean. The orderlies’ sculleries were in good order. All cupboards were open for inspection. The newly joined recruits find it hard to get the ward work done up to time in the morning, but they soon improve when taught some method in their work.
The annexes were clean and tidy, all utensils in a satisfactory condition, but it would be hard to make these places look as nice as one would wish until something is done to the walls which are begrimed with dirt. The sisters have had these scrubbed as far as it is possible to reach. The bathroom floors are in many instances constantly wet from leakage either of the baths or washing basins. These have all been reported for repairs.
There are at present 10 wards under the Matron’s charge. The nursing staff is distributed as follows:
Day Duty – Six sisters; nine staff nurses
Night Duty – One sister; three staff nurses.
The night staff is on duty from 8 p.m. to 7 a.m.
The day nurses go on duty at 7 a.m.; the day sisters at 8 a.m.
The Medical Officers visit the wards at 9.30 a.m.
The meals are so arranged that the wards are never left without either a sister or nurse.
The day nursing staff comes off duty at 8 p.m.
They have three hours off duty daily, half-day once a week.
A whole day, sisters, once a fortnight.
Staff nurses, once a month.
The nursing orderlies have the same time off duty as the staff nurses.
The work in the wards is much lighter than it was some weeks ago, the bad cases being fewer. The sisters and staff nurses are now taking their holidays in turn. I was struck by the improvement in the condition of the wards and annexes in the afternoons and evenings, also the quiet and order in the wards at night. The men have now not the same chance of turning up lights as they had when the sister was only able to visit the less serious cases at stated intervals.
The quarters of the staff are most comfortable and well kept; the meals nicely served and excellent; and apart from the small difficulties which must always arise from time to time in any work, everyone appeared to be working smoothly and well.
(Signed) E. H. Becher
Principal Matron, Q.A.I.M.N.S.
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