BMJ Reports on the Nursing and Administration of Provincial Workhouses and Infirmaries, 1894-5.

ABERYSTWITH.

It was quite refreshing to turn from the dreary squalor of the infirmary of Haverfordwest to the cheerful little infirmary attached to this workhouse. The matron took us round the wards, and showed the various departments with justifiable pride.

The workhouse is in the town of Aberystwith; it is a cheerful-looking place, clean and well cared for; the wards have eleven beds on the men's side and seven on the women's. The men's wards are of a good size, the eleven beds being in two rooms. The women's ward is crowded; the seven beds are in one room, while some of the necessary air space has been curtailed by the erection of a high wooden screen, so as to take off a passage. The bedsteads are the usual width; the laths are covered with cocoanut matting, on which is the straw bed; these are filled with the long straw, and appeared to be quite comfortable. The labour ward is small; it has no offices, and all refuse must be carried outside. There is no receiving ward.

There is practically no classification of patients, as there are no separate wards for the imbeciles or idiots, and it seemed to us that there was a possibility of the imbeciles of both sexes mixing together, as the nature of the building hindered complete separation. There is no machinery for dealing with a case of insanity except by placing the patient in the fever wards. These same fever wards are utilised for lock cases, when such are under treatment, or for infectious diseases. At the time of our visit there were no patients in bed on the women's side and only two on the men's. One of these was very ill with consumption, and the other was a case of old age; there could be no doubt about the care bestowed on the sick as far as circumstances would admit.

The nurse, whom we saw, is not trained, but she was quite capable for the nursing in that infirmary, as she had had some previous experience, and her wards looked businesslike and clean. A midwife is engaged from the town for the lying-in ward; no trained nurse is employed in the fever wards; the patients are placed under the care of an inmate.

The sanitary arrangements are quite modern; all the closets are flushed automatically, except those on the sick landings, which are done by hand. Hot and cold water is laid on to the wards, but there are no bath rooms for the sick, though there is ample supply in the other parts of the house.

The diets are ordered by the medical officer, and are liberal. We saw milk on the bed cards, and the sick are allowed as varied a food as possible. The last meal is at 6 P.M., and the first at 8 A.M., which represents a long interval for sick people.

There are no day rooms for the sick, nor are the airing courts available for them; this is especially hard for the men, who must either smoke in the ward — a dangerous and unhealthy custom — or go into the able-bodied part of the house. The infirm on both sides are placed on the ground floor, and have dayrooms off their bedrooms. The garden at the back of the house is of very little use for the sick, as there is no means of keeping the sexes apart.

RECOMMENDATIONS.

The infirmary requires to be enlarged to give more space in the wards, especially for the women, and to provide wards for isolation. Separate quarters for the imbeciles and idiots, and a safe ward for the detention of insane patients until their removal. The provision of bathrooms attached to the wards. A new lying-in ward, if possible further away from the living part of the house. The employment of trained nurses for the fever cases. The employment of a paid attendant in the sick wards during the night.