Page:A short history of nursing - Lavinia L Dock (1920).djvu/201

185 Extensions of Nursing Field 185 prevention of sickness, through home hygiene and particularly through better child care. The difficult question of specialization enters to a surprising extent in private nursing, and the more so, as medical and surgical specialists grow more exacting. Nurses tend to limit themselves to surgical, or maternity, or children's cases only, or to the care of nervous and mental cases and so on. Medical demands tend to create specialties in nursing, as, for example, the recent calls for nurses trained to assist in the management of "meta- bolism" cases. In these cases the nurse must cook all the patient's food, make chemical tests and keep accurate records of a very technical kind. The average "all-around" nurse would not know how to meet these requirements. In view of the rising necessity for serious specialization it should be a matter of concern with nurses to avoid all frivolous or wilful limitations of their variety of work. Private nursing has developed two sub-sections, as they may be called : The first is hourly nursing, where the nurse divides her time among several patients, and collects smaller fees, proportionately, from each. This plan is a very good one for many cases, as when someone in the family can take part charge, or when the patient lives in re-