An interesting article which appeared in the Birmingham Daily Post Just after the New Infirmary opened which makes good reading and a better understanding ….
About New Infirmary is graphically described. The writer says: — There is only one way, officially speaking, into the infirmary, and that way lies through the workhouse gate, for it is only as an adjunct to the workhouse that the infirmary is recognised by the Poor Law. A patient who is not an inmate of the older institution must be seen by the workhouse doctor, and formally relegated by him to the infirmary. Then the ambulance is despatched along the infirmary drive and stops under the archway of the receiving-house, which stands on the boundary between the grounds of the two establishments. At the receiving-house the patients exchange their own clothes for those which the Infirmary Committee provides, and, after a medical examination, are allocated according to their ailments to the different wards in the main building. The clothing taken from the patient is carefully disinfected and stored to await the owner's discharge from the institution. Of course, in urgent cases the reception of the patient is much less formal, but in all cases every possible precaution against the importation of infection is observed. Persons suffering from smallpox, scarlet fever, and similar complaints are not allowed to pass the receiving-house, but are sent on to the City Infectious Hospital; while those afflicted with contagious diseases, such as erysipelas, ophthalmia, and the minor infectious diseases, such as measles, are transferred at once to wards in a detached building in the infirmary grounds. Midwifery cases also are treated in a special building. In a doubtful case the patient remains at the receiving-house pending the development of distinctive symptoms. The receiving wards of the infirmary proper are on the ground floor of the building. They comprise two male and two female medical wards, two male surgical wards, one female surgical ward, and two children's wards. Patients, whose illness is likely to be chronic or of long duration, are drafted to the wards on the upper floors as soon as the acute symptoms have begun to yield to the hospital treatment, The strictly acute cases are dealt with as far as possible in the lower wards. A patient when convalescent may go home or to a convalescent ward in the workhouse. The infirmary is not used for cases of mere senility or chronic insanity; its wards are reserved for those which can be benefited or relieved by medical or surgical attendance and skilled nursing. True, the epileptic patients have been transferred to the care of the infirmary committee, but this involves no change in the locale, the unfortunate inmates of this class still occupying the building provided for them under the old regime.
The staff of the infirmary immediately concerned with the treatment of the patients consists of four resident and two visiting medical officers, and seventy-nine nurses. This does not appear to be an extravagant provision when it is remembered that the-sick population of the institution this week numbers 1,186, and that during last winter it ran up to about 1600. The nursing staff includes seven pupil nurses, each of whom pays a fee of £20, and gives her services for twelve months. The impecunious ratepayer will be glad to know that the number of these fee-paying nurses is increasing, and that it is hoped that before long half the staff will be of this class. This, which would mean an income of about £600 a year from fees and the saving of half the present amount of nurses' salaries, would be a small but gratifying set-off against the sins of extravagance which are laid to the charge of the Infirmary Committee. The nurses all take their turn at night duty, for which about twenty-two are required. Nearly all the remainder are required for day duty, which lasts from seven in the morning till nine in the evening. The nurses, however, are allowed three-quarters of an hour for lunch, an hour for dinner, and two hours for recreation each day, and each has the privilege of going out from four till ten once a week. None of the nurses take their meals in or near the wards, a pleasant messroom being provided on the ground floor of the infirmary and the Nurses' Home, where the matron and her assistants reside, is a distinct building. A very cosy place is this home. Each nurse has a small but comfortably furnished cubicle to herself for a sleeping apartment; there is an elegantly appointed common sitting room, and a thoughtful provision in the shape of a visitors' room is made for the reception of friends of the nurses. The matron and assistant matron of course have private apartments of their own. There is a large staff of male and female attendants for the administrative and domestic work of the infirmary, very little of which is allowed to take up the more valuable time of the nursing staff.
A peep into one or two of the wards is a very pleasant experience. Those who have not Visited the infirmary, and who have heard some of the talk about the expensiveness of the structure, may be surprised to learn that the interior walls consist mostly of plain whitewashed bricks, relieved with a modest dado in colour. Those who have visited the institution probably will have been almost as much surprised to see how cheerful and cosy such a place may be made to look. The plain D-end bedsteads, set off by clean white sheets and bright coverlets, the neat furniture, the polished wood-block floors, and the contented looks of most of the patients the men, whether in bed or sitting up, looking quite picturesque in their piratical red nightcaps, or the women wearing quite unworkhouse-like little white headdresses, and the nurses in their neat uniform form the elements of a scene of comfort which in itself must be refreshing to those accustomed to the sordid homes from which the inmates come. But this is not all. The members of the Kyrle Society have left traces of their visits in the shape of pictures and screens and wall decorations, and some of the nurses have beguiled not only hours of watching for themselves, but for their patients, by similar efforts. The ground-glass of the doors and screens has been utilised in many cases for the painting of transparencies representing birds and flowers; decorated drain-pipes and flower-pots, and other bits of amateur art, are beginning to find their way into unoccupied spaces, and foliage plants, thriving here and there, show the purity of the air in the wards. A children's ward in the Infirmary is a very pretty sight. In the iron cots wisely painted a bright blue or vermilion may be seen some faces betokening privation and patient suffering; others, however, full of the roguish-ness of returning health. One of these wards has been furnished by the Kyrle Society with a frieze of coloured Kate Greenaway pictures, and in. all there is evidence of a loving care quite out of keeping with old-fashioned notions of workhouse nursing. Miss Gibson evidently is an excellent organiser. A spirit of strict but kindly discipline seems to pervade the institution, and order, cleanliness, and cheerfulness reign throughout
The thing that strikes the visitor most is the immense scale on which everything has to be done. There are the kitchens with their immense steam and gas cooking ranges, in which yesterday were prepared three hundredweight of meat, a hundred gallons of gruel, three sacks of potatoes, sixty gallons of tea, besides thirty or forty gallons of beef-tea, and innumerable special items of sick diet. In the steam laundry about 20,000 articles are washed, wrung, and mangled, or ironed all by machinery every week Communication between the different departments is kept up by means of fifteen miles of telephone-wire, and there are twenty-five miles of gas, steam, and hot and cold-water piping. The wards, if placed end to end, would make a passage a mile long and 26ft. wide, and making the tour of the corridors means a walk of a mile and a quarter. The staircases, if placed one above another, would go up 1,000 feet, overtopping the Eiffel Tower, and there is not far short of half a mile in the total length of the open-air bridges which connect the wing's, and which in the summer will form excellent airing places for the patients. At present the patients who can take the air walk or are wheeled about the grounds, which will be very pleasant when the laying-out and planting are completed. The main corridor one of the finest architectural vistas to be seen anywhere would not leave much change out of a quarter of a mile. Under it is a passage of corresponding length, in which all the main supply pipes are suspended, and on either side of which are the boiler-houses calorifers, workshops, and other engineering and mechanical adjuncts necessary to keep so vast an establishment going. Along this passage are wheeled the baskets containing the supplies of food for the patients, to be hoisted by the lifts to the different levels at which the distribution takes place. The lifts are large enough to take a patient up and down on an ambulance or bed. And if a patient, in spite of all that doctors and nurses can do, takes his discharge at once from the infirmary, and from this world of care, his body is removed, without the necessity for shocking the other sufferers, by means of the lift and the underground passage, to the mortuary. This account does not exhaust the wonders and merits of this unique institution, which are shown twice or thrice every week to deputations of guardians and other authorities from distant places. Apart from the financial aspect of the question with which it is not our business in the present article to deal one cannot but feel admiration for the skill of the architect, and Mr Ward has brought more than professional zeal and thought to bear on the work for the administrative power displayed in working the establishment by the superintendent and matron; and, above all for the voluntary and self-denying work of the chairman of the committee, Mr. E. J. Stout, who has watched over the development of the scheme with unremitting care, and who still exercises a close and most efficient supervision over every detail of its management.