Page:EB1911 - Volume 19.djvu/954

 hospitals the training is shorter, being for one or two years. There seems to be a constant tendency to increase the requirements. At St Bartholomew’s, St George’s, the London Hospital, St Thomas’s and others, probationers must enter for four years, and at St Bartholomew’s they have to pass an entrance examination in elementary anatomy, physiology and other subjects. At all the more important schools the number of applications is many times greater than the vacancies.

In Great Britain trained and certificated nurses generally belong to a society or association. The most noteworthy of the associations is Queen Victoria’s Jubilee Institute for Nurses. It was founded in 1887 with the object of providing skilled nursing for the sick poor in their own homes. A great many of the provincial nursing associations are affiliated to it. The number of nurses supported by each branch varies. The qualifications for a Queen’s nurse are as follows: (1) training at an approved general hospital or infirmary for two years; (2) approved training in district nursing for not less than six months, including the nursing of mothers and infants after child-birth; (3) nurses in country districts must in addition have had at least three months’ approved training in midwifery. Candidates possessing the first qualification are received on trial for one month, after which they complete their six months’ training for the second qualification, at the same time entering into an agreement to serve as district nurse for one or two years at the end of the six months. The salary during training is £12, 10s., and afterwards £30 to £35 a year, with board, lodging, laundry and uniform. With regard to the earnings of nurses in general, the salaries paid in hospitals have already been mentioned; for private work the scales in force at different institutions vary considerably, according to the other advantages and benefits provided. At some the nurses receive all their own earnings, minus a percentage deducted for the maintenance of the institute; at others they are paid a fixed salary, as a rule from £25 to £30 a year, plus a varying percentage on their earnings or a periodical bonus according to length of service. This is perhaps the commonest system, but some of the best nursing homes give a somewhat higher fixed salary without any percentage. In all these cases the nurses receive in addition board and lodging, laundry and uniform, or an equivalent allowance. For special cases—infectious, massage, mental and maternity—nurses on a fixed salary usually receive extra pay. The fees commonly charged by high-class institutions for the services of a trained and certificated nurse are—for ordinary cases £2, 2s. a week, for special cases £2, 12s. 6d. or £3, 3s. a week; but many provincial associations supply nurses for £1, 1s. a week and upwards. The discrepancy between the fees paid by patients and the salaries received by nurses, especially in London, has occasionally excited unfavourable comment, but it is to be remembered that the nurses are maintained when out of work or ill, and have other advantages; many institutions either provide pensions or assist the members of their staff to join the Royal National Pension Fund.

In the more important British colonies—Australasia, Canada and South Africa—there are now a considerable number of hospital schools and other institutions formed and conducted on the English model. Salaries and fees are very much the same in Australia; in Canada and South Africa they are higher.

In the United States a similar system prevails in New York, Boston, Brooklyn, Chicago, Baltimore, Philadelphia, New Haven and many other large towns. The period of training is either two or three years. At the Johns Hopkins School at Baltimore twelve scholarships of $100 and $120 each are awarded annually; graduate nurses are paid $360 (£72) a year. Salaries are altogether much higher in the United States. At the Boston City Hospital graduate nurses receive $420 (£84) a year, and at the Indianapolis City Hospital those on private duty are paid $72 a month, which is equivalent to £172 a year, with board, lodging, laundry and uniform. This may be taken to indicate the possible earnings of trained nurses working independently, as they usually do in America. The fees charged for trained nurses run from $12 to $25 a week, and even more for special cases. Male nurses are trained at the Bellevue Hospital, New York, the Grace Hospital, Detroit, and elsewhere. In the American schools more attention is paid to the preparation of nurses for private work than in the British (Burdett), and a directory or registry of them is kept in most large towns.

In Germany, their original home, both training schools and societies have multiplied and developed. The period of training appears to be considerably shorter than in Great Britain and America. Members of the Albert Society of Saxony, however, spend two years in the wards at Dresden, and a third at Leipzig, attending lectures and demonstrations. They are sent out to nurse rich and poor alike, and their pay is very small. Most of the German institutes have pension funds.

In France a great deal of the nursing was formerly in the hands of religious orders, but there too the hospital school system, inaugurated in 1877, has grown. The schools managed by the Assistance Publique in Paris give a very thorough course of instruction.

In Russia nursing is mainly in the hands of the Red Cross Society, whose members are, however, trained in the hospital schools.

In Italy, Spain, Portugal and Belgium scientific nursing is in a backward state. The old religious system still prevails to a large extent, and, though some of the orders do their work with great devotion, the standard of knowledge and skill is not up to modern requirements. At San Remo and Rome institutions have been established for providing English trained nurses to private cases.