GUY'S HOSPITAL AGAIN.
[TO THE EDITOR OF THE " SPECTATOR."]
SIR,-With a view to point out some, at any rate, of the facts of this matter, will you allow an old Guy's man, one uncon- nected with the institution for twenty years past, and knowing no more of its present circumstances than has been disclosed in the public Press, to comment very briefly on the Report of a Committee of the Governors of the Hospital, published in the Times of July 22nd,—a Committee certainly not unfavourably disposed to the new Treasurer, or the new Matron, or the new system, and seemingly well disposed to make things pleasant all round ? The part of the report on which I would comment runs thus,—the Committee say " that in about two-thirds of the wards there is now no dissatisfaction, and in many there is reason to believe that there is considerable improvement. There is no valid reason for believing that in any case is interference with the orders of the medical staff either sanctioned or connived at by the Matron ; there is no reason to think that the present nursing arrangements put any real hindrance in the way of medical observation or practice on the part of the students. In regard to the appointment and reception of the Matron, the Committee are of opinion that needful changes were introduced without sufficient consultation and preparation, and that some details were unduly insisted upon. The Matron was not per- sonally introduced to the Staff. She was apparently authorised to frame rules on which the Staff were not consulted, but which, in their opinion, affected (though unintentionally on the part of either Treasurer or Matron) the medical treatment of the patients. The Matron herself understood that no further authority than that of the treasurer was required, and he, on his part, was under the impression that the changes contem- plated would be acceptable to the medical staff. The Committee are firmly convinced that the Treasurer, the medical staff, and the Matron have had the same object in view—viz., to promote the good of the hospital and the comfort of the patients—and they see no reason for calling upon the Matron to resign."
Different persons, reading between the lines, may draw different inferences, but the report would appear to indicate at least this much,—(a), that somehow or other, there has been interference with the orders of the Medical Staff,—a curious occurrence to arise spontaneously ; (5), that there has been on the part of the matron an undue insistance on unimportant and presumedly novel details,—no great evidence of her special fit- ness and judiciousness ; (c), that some persons valued by the medical staff have left the Hospital,—the allegation being that many have been discharged remorselessly for their neglect of unduly insisted-on details ; (d), that nevertheless there is no sufficient reason for calling on the newly-appointed matron herself to resign,—the harshness being too evident of meting out to her anything like the 'measure she has meted out so freely to others ; (e), that in one-third of the wards dissatisfaction is still manifested,—and this, notwithstanding the re- pressive influence of actual and prospective evictions ; (f), that the present nursing arrangements have seemed at least to pat some hindrance in the way of medical observation and practice on the part of the students,—and this on a school dependent mainly for its eminence on the large and free opportunities for practice it has ever afforded and been re- puted to afford ; (g), that these nursing arrangements have, in the opinion of the medical staff, affected unfavourably the medical treatment of the patients,—their opinion, indeed, not counting for much ; (h), that these same nursing arrangements were introduced without any consultation whatever with the medical staff,—the allegation, moreover, being that the arrange- ments have been persevered with, in despite of their protest; (i), and lastly, that it came entirely as a surprise, alike on the irre- sponsible treasurer, and on the matron of his selection, that in determining upon a reorganisation of the nursing arrangements of Guy's Hospital, any consultation with, or deference to, the distinguished Medical Staff of the Hospital should have been thought necessary, or advisable, or to be called for by common courtesy.
Assuming the need for some improvement of the old nursing arrangements, of which I know nothing, one way or the other, but admit the inherent probability, it has not yet been sug- gested that the medical staff would have been opposed to a reform judiciously introduced, or that they were insensible to any need for reform. But they contend that, taken altogether, the present nursing is the reverse of an improvement on the former nursing ; and they intimate, rightly or wrongly, that the primary interests of a beneficent and renowned institution, great in the memories not only of its medical and surgical, but also of its clerical staff, are being capriciously sacrificed to a spirit of rampant ecclesiasticism.
The bath incident, as you rightly say, stands by itself, and remains to be fully investigated. But awaiting this fuller investigation, the obvious view of the matter would appear to be that of the coroner's jury,—that an act sanc- tioned by the ward-sister as an act of cleanliness, an act unimportant, if properly and feelingly conducted, was converted by a self-sufficient nurse of the newly-introduced and alleged superior class, whether ignorantly or worse than ignorantly, into an act of manslaughter, and this irrespective of any degree of blame for neglect of supervision being attachable or not to the ward-sister, admittedly one of the old nursing staff of the hospital.—I am, Sir, &c.,
WM. ODLING, M.A. Oxon., M.B. Loud., F.R.C.P., F.R.S.
[Mr. Odling's extract from the report is given in his letter between inverted commas, but it ought not to be so given, for though almost all quotation, and of course representing, in Mr. Odling's opinion, a fair summary of the report, it is a mere string of sentences separated from other matter equally im- portant to the understanding of the whole case, and not, in our opinion, an adequate summary of it. His letter depends for its force absolutely on the assumption that the Committee of Investigation had a bias against the medical men, and in favour of the changes made. This is, we believe, entirely untrue. So far as the Committee of Investigation had a bias at all, we should think it was rather on the side of the Medical Staff, who are great powers in the world, as well as in the hospital. We believe that the Committee reported strictly what men of the world, listening carefully to both sides, and certainly not biassed in favour of the recent arrangements, if they were 'biassed at all, felt compelled by their knowledge of the facts of the case to report.—En. Spectator.]
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