TRAINING SCHOOL FOR NURSES.

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admitted to the hospital 42 pay patients and 29 free patients, and that other physicians sent to the hospital 41 pay and 31 free patients. The sanitary officer of the District of Columbia sent 35 free patients. Thirty-nine pay patients and 187 free patients were admitted to the hospital, and 15 free patients were admitted from the various institutions in the District of Columbia. The total number of patients treated at the hospital during that year was 451; an increase of more than 50 per cent over the number treated during the previous year. Of these, 54 were colored. In the dispensary 2,890 patients were treated.

In 1894 the hospital received from the bequest of Mrs. Nancy B. Scudder the sum of $5,000, to constitute a fund, the income from which is devoted to the endowment of a free bed. Mrs. Scudder also left to the hospital many books and pictures, which have added to the attractiveness of the building. In 1889 extensive improvements were made to the hospital building, at a cost of $8,500. In 1890 the fourth floor of the hospital was completed and thus 16 rooms were added, including a surgical operating room, at a cost of $2,800. The next year an Otis elevator was placed in the hospital, at a cost of $3,500; in 1892 a commodious and nicely equipped kitchen was built, at a cost of $2,000, and the next year a laundry was constructed at a cost of $2,700.

In the summer of 1893 the training school for nurses was organized, under the superintendence of Miss S. W. Wartman, who had been in charge of a similar school in Wilmington, Del. From the first the school gave promise of complete success, and proved of great practical benefit to the hospital. The course of training was fixed at two2 years the first year exclusively in the hospital, the second year both in hospital and outside nursing. A diploma is provided for those who successfully complete the course and pass the final examination, the medical staff of the hospital and the superintendent constituting the faculty of the school. The first admission to the school is upon application, with proper indorsements as to health and character. The first month is probationary, without compensation; and if the candidate is found satisfactory, the probationer is enrolled as a pupil nurse, upon signing an agreement to pursue the course to the end. The candidates must not be under 18 nor over 35 years of age. The compensation the first year is $7 per month, and the second year $12 per month, a part of which sums are retained until the end of the course. Four nurses, who were in the hospital when the school was started, entered as pupil nurses, and were given a reasonable credit on the two years' course for knowledge and experience already acquired.

The salary of the superintendent, $900, was assumed by the Ladies' Aid Association, and a diet kitchen for the use of the training school

This room has recently been completely refitted, and is now one of the most complete operating rooms in Washington.

2 The course is now three years; the compensation is $7 per month during the first year; $10 per month during the second year, and $12 per month during the third year.

was also provided. The sum of $250, given to the hospital by the inaugural committee from their surplus, was used in fitting up nurses' quarters. In November, 1890, the Nordhoff Guild, a sewing circle, was organized as an auxiliary to the Ladies' Aid Association. The officers of the guild for 1893 were, president, Mrs. John Dalzell; vice-president, Mrs. John Tweedale; secretary, Mrs. Rufus Choate; treasurer, Mrs. J. H. Whitaker; executive committee, Mrs. Lewis Clephane, Mrs. G. H. Wilcox, and Mrs. E. M. Marble. This guild has given many entertainments, all of which have resulted in considerable additions to the funds of the institution.

During 1894 the wisdom of establishing the training school for nurses was shown, not only by the increased efficiency of the hospital nursing, but also by reason of the fact that the nurses brought to the hospital a revenue of $1,434.15, the sum paid for outside nursing done by them. During this year a mortgage of $6,000, at 6 per cent interest, was placed upon the buildings and grounds of the hospital, and the proceeds were used to extinguish the indebtedness that had been accumulating for several years for improvements, repairs, and maintenance. The trustees also borrowed $3,384.91 to improve the building, the Ladies' Aid Association guaranteeing to raise $3,000 of the amount.

In February, 1894, Mrs. Rennis C. Wilson succeeded to the position of superintendent, but died during July of that year. Miss Mary H. Ellison, who had been Mrs. Wilson's assistant, was appointed superintendent for three months on probation, and at the end of that time her appointment as superintendent was confirmed. In 1894 Mrs. John B. Wight succeeded to the presidency of the Nordhoff Guild. In May, 1895, the first class of the Nurses' Training School, 10 in number, were graduated, and in that year the receipts of the hospital from this source were $1,582.09. On January 2, 1895, Mrs. A. R. Quaiffe was compelled by ill health to resign the presidency of the Ladies' Aid, and Mrs. W. L. Vanderlip was elected to succeed her. In 1896 the receipts of the hos pital were $16,731.40—about $1,000 less than the receipts of the year previous. The difference is accounted for in the decrease of the receipts from the Ladies' Aid Association, which dropped from $1,650 in 1895, to $520.48 in 1896. The receipts from pay patients were $5,398.88, only $41.83 less than for the year previous. The receipts of the nurses for outside nursing were $1,374.52, a decrease of $207.32. There was an increase of $250 in the amount received from the Government.

The cash disbursements during the year left a balance of $74.36 in the hospital treasury and $312.70 in the United States Treasury. To offset this there were a trifle more than $3,000 of bills approved and unpaid and about $400 in bills awaiting approval, making a total indebtedness for current expenses of $3,417.25. Deducting the bal ance on hand left a net indebtedness of $3,030.19. This indebtedness was the accumulation of two and a half years, showing that the average deficit in the running expenses of the hospital during that time had been about $100 per month, a reduction of 50 per cent over the

THE WASHINGTON ASYLUM HOSPITAL.

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deficit of the previous three years. At the same time the report of the medical staff showed that there was a small increase over the previous year in all the departments of the hospital, the total number of hospital cases treated being 502; dispensary cases, 7,890.

In 1896, Mr. John Joy Edson resigned his position both as president of the board of trustees and as a trustee on account of the pressure of private duties. Mr. Job Barnard also resigned. The vacancies on the board were filled by the election of Mr. Charles B. Bailey and Mr. Henry Wells, and Hon. Charles Lyman was made president of the board of trustees. Mrs. A. A. Birney succeeded to the presidency of the Ladies' Aid Association, and Mrs. J. Hale Sypher to the presidency of the Nordhoff Guild. The St. Felicitas Guild was organized with Miss Frances R. Hough as president; Mrs. Frederick Gray, vice-president; Miss Lorena Barber, secretary and treasurer, and Mrs. A. L. Pope as assistant secretary and treasurer. The name was adopted by reason of the fact that St. Felicitas is the patron saint of infants, and the work of the guild is in the free dispensary and the maternal ward.

The active medical and surgical staff during 1896 consisted of Drs. Howard H. Hawxhurst, Henry Krogstadt, Richard Kingsman, T. L. MacDonald, William R. King, Lyman B. Swormstedt, Ralph Jenkins, Reginald Munson, W. F. Corey, C. A. Davis, and Margaret Hislop.

V.

Reference has already been made to the hospital that has always existed in connection with the poorhouse, better known as the Washington Asylum. This hospital occupies a portion of the grounds belonging to the asylum, and is under the general superintendence of Walter H. Stoutenburgh, the intendant of the asylum. The hospital occupies four one-story frame buildings, and for the fiscal year 1895–96 accommodated 811 patients. It is under the immediate direction of a visiting physician, appointed by the Commissioners of the District of Columbia, and two resident physicians. The hospital accommodates patients transferred from the asylum, and also those sent thither by the sanitary officer, some of whom are, at the request of this officer, transferred from other hospitals. On the grounds of the asylum also is a smallpox hospital, an institution which has existed for many years, and which has recently been rebuilt according to modern requirements, under the direction of the health officer, Dr. William C. Woodward.

The staff consists of Dr. D. Percy Hickling, visiting physician; Dr. Stuart Johnson, resident physician, and Dr. Thomas Ehleider, assistant resident physician.1

For a description of the hospital see Appendix A, Report of the Joint Select Committee on the Charities and Reformatory Institutions in the District of Columbia, 1898.