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

In 1894-5, the British Medical Journal — as part of a campaign to improve the nursing and medical facilities in workhouse infirmaries — conducted site visits to around fifty workhouses in England and Wales. Below are extracts from their report on the Sedgefield union workhouse.


Under the shadow of the great county asylum we found the small workhouse and infirmary, if the latter deserves the name, as it is only composed of a few wards under the same roof as the workhouse, and is deficient in everything that the sick require. The sick department consists of two wards at the back of the building; there are nine beds for the men and five for the women, all on the ground floor. We were glad to hear that the Board is conscious of these deficiencies, and that there is some talk of building.

The men are located in two rooms, one that is used also as a dayroom; in the ward proper we saw an old man dying of old age, and he was also blind; there was no one at hand to see to his requirements, not even a pauper; he was there alone, a sad picture of lonely helplessness. The matron told us that the nursing of the sick is in the hands of the master and herself, that they visited this old man constantly, but in the nature of things their work must take them away from him; there did not appear to be any want of care on their part, but an inability to be master, or matron and nurse combined. Under these circumstances there can be no isolation or separation between the imbeciles and the other patients. There is no lying-in ward, the matron has to confine the women in the women's ward, with such makeshift screens as she can improvise. The female ward has no indoor closet attached to it; they have the use of that for the women in general; for the men there is a convenience, but the water supply is quite inadequate, and it was in an insanitary condition at the time of our visit.

There is one bath in the house, and that is at the foot of the staircase, unscreened, in the lobby. On the men's side there are fixed basins behind a partition taken off the day-room; for the women there is not even that means of washing. No hot water is laid on, it is all heated in a copper.

The matron informed us that the diets were practically in her hands; that she tried to give the sick any little thing from their table that they could eat. The medical officer had a free hand in ordering extras for the sick.

The matron took us into the nursery where the little ones had been having their tub; they ran up to be kissed in the most confiding manner, and appeared to be on good terms with everyone. They were under the care of a pauper inmate. The little ones and the older children are together, and the older children go to the village school. The house being so small, it is more like one family than a workhouse.

The management appeared to be humane and considerate, but no officers, with the best intentions in the world, can undertake duties for which they have neither time nor training. The efficient control of a workhouse is ample employment for the master and matron, and they ought to have the aid of another officer, a trained nurse or midwife responsible for the care of the sick. When the nurse is found, then it will be necessary to improve the infirmary department, for as it now stands the sick and infirm are the most neglected among the inmates.

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