Letter to Jane Senior
1873-10-31

[Page 1 of 6]
On "Memo. by Dr. Bridges" 11 London Oct 31/73
P.S.] On the "Duties" question:
As to Nurse: Article 50. No. 1, 2, 3
1. "To attend the sick,
administer Medicine,
and Medical & Surgical
applications, according
to directions of Medical Officer."
Quite right, as far as it goes.
2. "To inform the Matron
and the Medical Officer
and the Visiting Committee
on their visit of any
defects which the Nurse
may observe in the
arrangement of any Ward."
[Here is one saddle
for the 3: and any one
may put it on or take it
off ad libitum.]
-To which of these three
Superior Officers is she (the
Nurse) responsible?
-From whom is she to learn
what are defects?
How if she tells some to one
& some to another, & does not
communicate anything to another
(say to the Matron?
-Is that the best way to get
the defects cured?
-Will the Matron's authority
over the Nurse be so upheld?
Query: Omit "Medical Officer" & "Visitng Committee"
Report only to Matron.
Make Matron responsible to proper authority for
calling attention to all defects in wards.
[Page 2 of 6]
12
Would the authority of any given Supreme head be thus
in any way diminished?
Supposing the Matron remiss, would not her remiss-
-ness soon be discovered?
And would she, being responsible, be more likely to
be more geligent than the Nurse?
3. "To take care that every
Ward is duly warmed,
ventilated & otherwise kept
in order according to the
directions of the Medical
Officer; & that a light is
kept thro' the night therein".
Quite right: so far as it
applies to Warming & Ventilation;
The addition of the words:
"kept in order": implies that
the Medical Officer is to be
also Head Housemaid;
& the final sentence as to
keeping a "night-light" is rather
bathetic than pathetic.
Is the Nurse - in this particular Rush-
light - responsible to some
highest authority quite outside?
in these 3 sentences are given the whole Nurse & the
whole Nursing - apparently -
So far as regards the Matron, the Nurse's only duty &
responsibility is to inform her (amongst others) of
any defect in the Ward.
She is responsible to the Doctor - not to the Matron - 
for "keeping the ward in order" - for cleanliness, punctuality,
& all internal arrangements. 
[Page 3 of 6]
13
[Can any one expect that an educated, trained
woman, fit to take the officer of Matron at all,
would take it, if these terms were really the
custom & the terms practically of her office?]
And is it not this the most complete stopper that could
be clapped on upon any efforts to raise the status,
education & training of Matrons?]
Duties of Matron
Aritcle 49
1. "To aid the Medical
Officer and Superintendent
in enforcing orders,
punctuality, cleanliness
& the due observance
of all regulations for
the Government of the Asylum
by inmates, subordinate officers,
Assistants & servants,
And report to the Medical Officer
any negligence or other misconduct
on the part of any of the
female Officers, Assistants, and
Servants.
[Here come the "aidings"
& mizing up of authorities]
The Matron, - supposed to be
an educated woman, having
had a thorough & expensive
- one may say 'professional' -
training, - is therefore to
be the M.O.'s subordinate,
- to have no authority
over any one, not even the Nurses - but merely
to 'report' upon their
misconduct -
and to whome? -
- to the Medical Officer
with whose Department the
Nursing Staff have the most intimate
relations, and who is therefore the
least fit Official (let along his being a man)
to whom to refer such matters.
[Page 4 of 6]
14
The Matron is merely to "aid", & in a very
indefinite way, in a variety of
undefined duties.
[Here the saddle is put on two
backs: & fits neither.]
2. 3. 4. 5. 6. 7. 8.
"Cause Paupers upon admission
to be cleaned, clothed & placed
in proper wards:
making clother:
beds & bedding:
linen: washing:
meals & cooking."
She has certain other defined
duties: but these consist
entirely in supervision of
things - not persons -
solely of housekeeper's work -
which with sufficient assistance
is very proper work for a
Matron: as supplementary
to the Nursing.
[It is a case of 'lucus a non lucendo' -
an Infirmary Matron from having
no Infimary duties: "head of
the Nurses" from having nothing
to do with the Nursing.
What is to become of her "influence"?
(v. Dr. Bridges' able paper.)
The Medical Officer is invested by
the Rules with the immediate charge & supervision
of the Nurses in all respects, in matter of
conduct & discipline, as in other things.
The Matron may be occasionally used as an Assistant -
(to "aid") - but if her duty is merely to "report" the Nurse
to the Medical Officer - - who has the "influence"? -
[Page 5 of 6]
15
- to whom do the Nurses look as their head? -
There can be no Nursing Morality or real discipline.
[And if the Matron is to "influence", she must do it by
some 'occult' art, like the Rosicrucian.]
Lastly: "Duties of Medical Officer"
Article 45
2. "To attend upon the paupers etc.
and to give directions as to their
treatment, nursing & diet: & the
ventilation & condition of the wards
3-9 etc. etc. etc.
10. "To govern & control all the
Officers, Assistants & Servants
in the Asylum in comformity
with this Order & the regulations
of the Board of Management.
To inform Board of State
Asylum in every Department:
to report to Board any negligence
or misconduct on the part of
any of the Officers, Assistants or
Servants etc. etc.
To "govern & control" are
the widest possible
expressions -
As. Dr. Bridges states that
the Medical Officer is to be
"Supreme Head": and, altho'
the Matron has her "Sub-
Department", that "Sub. Dept."
does not include the charge
of the conduct & discipline
of the Female Staff; so that,
under every article, this is
directly subordinate to the
Medical Officer.
[Page 6 of 6]
16
Even were the Clauses so altered, or the practice -
(thro' the discretion of the Medical Officer: - not to act
upon his own Regulations-)
so altered as to give the Matron authority over
the Nurses as a "Sub-Department",
the Medical Officer is still left as the authority
to whom all appeals are to be made -
- both as between Nurses & Matron
and as between himself (& his Dept.)
and the Matron (& her Nurses) -
- deciding the various questions that may arise
between himself as head of his "Sub-Department"
and the heads of the other "Sub Departments".
F.N.