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could be photographed, should be so done. I photographed every case the day it entered and the day it was discharged. I half-toned these photos, one of which showed the crippled boy when he was admitted to the hospital, and another when his deformity was corrected.
The publication of these photos of "Before and After" the operation were admirable exemplifications of our work-a first-class object lesson that brought coin to our coffers, for the public realized just the great amount of good we were doing. I followed this “Before and After” idea up in cases of bow legs and knock knees, and also in every case of hare-lip that had successful results.
The daily life in our wards—the nurses moving about from bed to bed-the children at their games—all had to answer the call of the camera. All material was made available for illustration, even the taking of a swab and its progress through the culture tube, the incubator, on the slide, with the stain and under the micro; a plaster jacket in all its stages; the search for the nickel in the gullet of some youngster who swallowed the coin instead of buying the candy; a needle from its point of entry, and its travels till located by the X-Ray--all these are brought to the public eye through our fifty-six-page report. We publish 12,000 of these, one for every donor; and we also issue a booklet of 24 pages with our larger report, condensed in paragraph form, and interspersed with small half-tones. Of these we send out 225,000 copies.
We advertise, and, what is more, pay for advertisements in the Toronto daily papers, and all this literature we send out just before Christmas is at a cost for postage of about $2,500, and when we count our cash about the first of March we generally average about $30,000 as the result of our appeal.
Our example has been followed to a limited extent by some of the Irish Hospitals for Sick Children. I will send all of you a copy of our next annual report.
WHERE THE MONEY COMES FROM.
During the past thirty years hundreds of thousands
of dollars have been received from voluntary contributions by the Hospital for Sick Children.
A general impression prevails that the money for the support of the hospital comes from the pockets of the wealthy. Now, an intimate knowledge of the sources that sustain our work shows that we receive the dollars and dimes of the many rather than the donations of the few.
Of course there are noble and notable exceptionsone at least in our history aided us with a gift of $10,000, the largest the hospital ever received from one individual benefactor in his life-time. The experience of one other Canadian city differs, and your experience in American cities may differ from ours.
Our experience is that the millionaire and his money are not soon parted, when the hospital has no other security to offer than that inventoried in the words of Holy Writ: “He that giveth to the poor lendeth to the Lord.”
THE LADY SUPERINTENDENTS. In all hospitals where there are training schools for nurses, the management of these schools is, as you all know, in the charge of a lady superintendent.
It has often occurred to me that these women who hold such responsible positions do not get, in some cases, the cheerful consideration they should get from medical superintendents and boards of trustees.
In fact, I know of cases in parts of this continent where, to use a familiar expression, the lady superintendent has “a hard time.” I have had the pleasure of meeting the lady superintendents of the continent in the annual meetings of their Association, and in very many of the hospitals in which they are engaged in their work of training and caring for the nurses of their schools. My opinion is that no class of women engaged in hospital work deserve more kindly treatment and encouragement than they do. The pathway of their work is not one strewn with roses and should be made as pleasant as possible by kind words and attention and consideration to the suggestions they have to make to better the condition of their pupils and to improve the routine of the daily labor that falls to their lot.
NURSES' RESIDENCE. The housing of nurses is a feature that deserves far more attention than it gets today from hospital managers all over the world. My visits to hospitals during the past thirty years have shown me that in scores and scores of institutions on both sides of the Atlantic the care of the nurse is only a minor consideration.
True, in some of our large cities of this continent and of Great Britain, conditions have materially improved, and there are perhaps fifteen or twenty residences that are models in comfort and sanitary equipment.
These young women deserve the best consideration. They come to us in good health, and should leave us on graduation in undiminished health. I have seen residences, or rather accommodation for nurses, in some parts of the United States, yes, in Great Britain, the condition of which is a serious reflection
Boards of Trustees and Managers.
A hospital is a place where health should be preserved as well as being restored. There should not be one principle for the wards and another for the nurses' residence. Most nurses don't get sufficient rest. Their labor is too continuous and severe.
Be it said that the hands of many Lady Superintendents of Training Schools are tied in their effort to get proper accommodation for the nurses. The appeal of the Superintendent for better accommodation is made to the Trustees. The appeal gets to their board room table, and either gets into the file box or into the waste basket.
RESIDENT PHYSICIANS. The selection of resident physicians—I mean the fourth and fifth year youngsters who have to put in their full year at hospital work before they can have "M.D.” upon their door plate—is very important. It is a difficult matter to pick out of thirty or forty applicants just the four or five that will fill the position satisfactorily. It is comparatively easy to find their status during their school life, but because they are good menyes, even honor men—it does not follow that they are suitable for resident positions in hospitals.
The feelings of not only Medical Superintendents but Lady Superintendents should be consulted. Table manners and general deportment may not be on the curriculum of medical colleges, but they are not a negligible quality in hospital life and administration. A careful scrutiny into personal habits and conduct should be exercised before the residents are introduced into hospital life.
When they are selected they should have proper accommodation, and made comfortable for their work. Their duties are onerous, and in food and lodging they should be under the best conditions. Every man should have a separate room—if possible, a bedroom, sitting room and bathroom. The want of space in older hospitals makes it difficult to effectively carry out the accommodation suggested.
The perfection of comfort for resident physicians is to be found in the Western Infirmary in Glasgow, where a small bedroom, with a small sitting room and bathroom attached, is provided for each resident.
It may be difficult to provide this accommodation in older hospitals, but in those now being constructed on this continent it would be a simple matter, and not so very expensive.
May I, in conclusion, express the hope that my good intentions and earnestness will not lead any of you ladies or gentlemen to assume that I regard myself as an oracle in hospital management.
It was the custom in my early days as a printer fifty years ago to ask the "devil" at the close of his first day of apprenticeship one question, and that question was: “Are you sorry you learned the printing business?"
It is just as impossible for a grown man to learn the hospital business in the years I have given to the work as it was for the boy to learn to master the secrets of “the art preservative” on the first day of his apprenticeship.
I have not learned the hospital business, but I am not sorry I tried to learn the mysteries of your work and mine.
We are all of us soldiers, not conscripts, but volunteers in the armies that keep step in the great march of mercy.
I am glad to be with you in this great council of war, where we meet as Americans and Britishers, each separated in allegiance to the ensign of our affection, but united in loyalty to the humanity which is above all nations.