Nursing in the 1920s

Miss Evelyn Witherden was a student nurse at East Sussex Hospital, Hastings in the early 1920s. Matron’s lecture, was recorded in her note book and reminds her that a nurse should ‘never give an opinion, it is untrained to give an opinion unless asked’. I’m glad a nurses opinion is valued today.

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Evelyn’s note books also contained a copy of all her exam questions. Third Preliminary Examination in 1923 is pictured below.

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Times have changed!

Some hand written ledgers from the archive remind us how times have changed. The hospital accounts for 1917 show us that more was spent on milk than on drugs, disinfectant and dressings. In the same year, 80% of patients were discharged from the Sanatorium having shown signs of recovery from TB. A wonderful record of healthcare history to share.

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Suspended Animation?

The Medical Guide 1824

Our old medical book, that journeyed from a hospital in the Crimea to Benenden Hospital, describes the immediate treatment following drowning, strangulation or suffocation. This critical period, where vital signs are suspended, was called the state of suspended animation.

Florence Nightingale may well have practiced the treatments and techniques detailed in this medical book. First instructions are to collect the following items whilst conveying the patient to the nearest house:

  • Warm blankets
  • Flannels
  • A large furnace of warm water
  • Heated bricks
  • A pair of bellows
  • Warming pan
  • Sal volatile (ammonium carbonate/smelling salts)
  • Clyster Pipes (an instrument to inject)
  • An electrifying machine

The patient can be reclined slightly but the head must not be lower than the shoulders in case the blood rushes to the head and compresses the brain.

Step One – Restore body heat and circulation by rubbing the warm flannels over the body causing friction.

Step Two – Force air from the bellows through one nostril whilst an assistant gently presses down the ribs. Make sure the mouth is closed and alternate the inflation and compression to replicate respiration  whilst continuing to apply friction to the body.

Step Three – Pass fluid into the stomach at once, via a tube. The fluid should contain a teaspoon of sal volatile (smelling salts) and a tablespoon of warm brandy. The book suggests that heat was most likely to stimulate vital powers into actions. Water heated to about 100 degrees (Fahrenheit) may be injected into the stomach or rectum.

Step Four – The images below show the galvanic equipment in use. The patient is seated in a suspension chair, conducting wires are attached to the fluid filled stomach tube and the chest wall. Moistened linen is attached to the ends and a current is passed through.

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The Medical Guide 1824
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The Medical Guide 1824

I wonder how many patients were successfully resuscitated?

 

1940’s Surgery

The Early Introduction of Surgical Treatments

Surgical interventions in the treatment of TB became more common in the early 20th century and the Benenden team were performing artificial pneumothorax procedures in treatment rooms from around the 1940’s. The treatment involved collapsing the infected lung to allow rest and healing.

Various items in the Museum collection are related to surgical chest procedures and these are just a few.

 

Drugs Come to Benenden

Streptomycin became available in 1944, the first antibiotic to be effective against TB. Here started the modern era of TB treatment. Further drug developments over the comings years significantly improved recovery from the disease.

Vaccination

The BCG vaccine was introduced to all secondary school children in the UK from 1953, having dramatic impact of the demand for hospital services, including Benenden. The Heaf Test was performed up-to 2005, to determine whether an individual had been exposed to TB and therefore whether the BCG was needed.

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Benenden Evolved

If sanatoria were to remain open, they needed to extend their services to support other conditions. At Benenden, services were extended to treat Bronchitis in 1955, although segregated from TB patients and segregated by sex at all times.

Museum notes suggest that male and female patients were strictly separated including wards, meals and recreation.

In the same year (1955), a new unit was opened that included Upper and Lower JR Williams Wards, the first dedicated operating theatre and a new x-ray department. Up to this point, patient had been transferred elsewhere for x-rays or more complex lung surgery.

Most sanatoria had closed by the 1970s but Benenden was going from strength to strength.