that while it is for the Sister to support them when they are right, it is certainly not for her to uphold them when they are wrong! A Sister need not blame her Nurses before the patients for defects of which the latter are conscious, and she must be careful to ascertain that the complaint is just, reproving the patient if it is not. But the sooner she clears up her Nurses' minds on the point of her right to speak to them whenever she sees the necessity, the better it will be. It requires more moral courage on the part of the Sister than the Nurses have any idea of sometimes, but the Sister must inspire Nurses and patients with confidence in her justice, and she will fail to do this if she apparently ignores what she perceives to be a reasonable ground for complaint. There are many exceptions; but a Sister will find in the long run that patients are slow to complain, unless they get roused up by an irritating manner, or they chance to have a passionate temper. As a rule, they are more likely to refrain from speaking when they have cause than to speak without, alleging if inquiries are made that they "do not like to get Nurse into trouble." It is for the Sister to try to be perfectly fair to both, and to make both aware that this is her desire. Another matter which the Sister should make a point of keeping in her own hands is the decision whether patients shall be allowed to get up for an hour or two in the morning to help with the early morning work. Nurses will be scrupulously careful in keeping patients in bed when they are not allowed to get up at all; but many of them appear to think that directly a patient is "ordered up" for an hour or two in the evening, they may be expected to help in the same way as patients who are up for half the day, and who are quite strong enough for the exertion. I do not wish to imply that Nurses are actually unkind enough to insist upon patients doing what they have not sufficient strength for, but Hospital Sisters are aware that many Nurses are apt to be thoughtless in this respect. They will either ask a patient to get up, or yield to their not infrequent desire to do more than is good for them in the way of helping, as soon as the doctor's sanction to their beginning to "get about again" has once been obtained. In some cases there is no possible objection to this; but to ensure a careful judgment in the matter, the Sister should insist that the Nurse refers to her in each instance before a patient is allowed to get up and help with the morning work. The recreation for the patients of a kind adapted to their individual tastes and condition is another detail that claims the Sister's attention, and one in which she should encourage her Nurses to interest themselves. Many of them will like reading, but they will probably wait for it to be suggested to them before they ask for a book. It is worth a little trouble to see that a patient who is able to amuse himself in this way has the kind of book likely to suit him. Some of them enjoy games of draughts, dominoes, or other amusements of this kind. Women are usually glad to occupy themselves with a little needlework, if the nature of their illness permits them to pass the time in this way, but they will probably need some one to produce it, with a question as to their feeling inclined to do it. Much depends upon making the long hours pass as cheerfully as possible, and this cannot be done without constant trouble. The days are very monotonous to those who can only hope to get well slowly, and who can count the length of their sojourn in the Hospital by many weeks. The right kind of visitor from outside will receive an eager welcome; her presence has the brightening effect of a breath of fresh air upon those who have become weary in the Hospital atmosphere. It is a great deal to those who are well enough for it to have any one who has time and patience to listen to them, and who can give them something new to think about. Sisters should realise the importance of variety and change in the mental surroundings of their patients, and procure it for them as much as they can. As I have previously said, there is scarcely any limit to the demands that the patients make upon a good Sister. They need, and for the most part will gratefully accept, every sort of help that she can give them. Hospital Sisters can fully realise the truth of Miss Proctor's words "And as material life is planned That even the loneliest one must stand In one great brotherhood Divine.” CHAPTER VI. NIGHT SISTERS. FINAL DETAILS. As yet I have said nothing about the work of Night Sisters, or of the relationship which they and Ward Sisters bear to each other. There is much need to understand the points of resemblance and the points of difference in the work allotted to each, as there is room for mutual helpfulness, and indeed a constant necessity for it. There is nothing in the nature of their respective duties to engender rivalry; and misunderstandings, which may arise without care, should be studiously avoided for the sake of the common work, which cannot but suffer if they occur. The Night Sister's object is to help the Day Sister by giving the supervision to her patients and Nurses which the latter cannot exercise both night and day. Fortunately, much less attention is required in each set of wards at night than is essential for efficient management during the day, but this fact in itself may prove a source of difficulty if the Night Sister has any tendency to be officious. On the other hand, very serious responsibility rests with the Night Sister, and she must have no hesitation in exercising her authority from fear of giving offence if the exigencies of the work appear to demand it. At one time any trustworthy person was considered competent to walk through a Hospital as Night Superintendent, the chief duty attached to her appointment being to see that the Nurses were awake, and apparently attending to their duties in their own wards, instead of wandering about the building, to the obvious neglect of their patients. Any knowledge of nursing which could enable them to judge of the condition of the patients, or form any adequate idea as to the manner in which the various orders given for each case were being carried out by the Nurses, was considered superfluous. Of late years this has entirely altered, and although the Night Sister is still responsible for the orderly conduct of Nurses and wards during the night, this has become merely an incidental duty which she carries out as a matter of course, whilst discharging her duty towards the patients as far as circumstances will allow. The extent to which she is able to do this will depend considerably upon the clearness of the instructions and report left for her guidance by the Day Sister, as well as upon the capability of the Night Sister herself. The welfare of the patients for the time being must of necessity be much influenced by the degree of efficiency with which each Sister enables the other to do her duty towards them. The Day Sister should remember that she cannot easily estimate the anxiety of the Night Sister's position. She has to judge of the existing condition of the patient with very little knowledge sometimes as |