Hospital Housekeeping

Hospital Housekeeping by Charlotte A. Aikens

Hospital Housekeeping by Charlotte A. Aikens is a practical manual laying out the duties, qualifications, and methods required of the woman who manages the domestic side of a hospital. It opens by insisting that the hospital housekeeper must combine an organizer's breadth of vision with tact, justice, self-control, and freedom from gossip or self-pity, since her position also typically merges the roles of matron and superintendent of nurses. The text stresses that success depends on system rather than personal presence, so the housekeeper must train a deputy able to run the household in her absence, and it details bookkeeping methods, including a general expense book, a day book of receipts and disbursements, an order book, and an annual inventory listing furnishings by room. It moves through the physical plant department by department. The main entrance and porter's post are described as first impressions that reveal an institution's laxity or competence, with anecdotes of poorly managed hospital doors. Private rooms are covered in detail: enamel furniture, combination dresser-washstands, light blankets, tapestry Brussels rugs, plain sash curtains instead of lace, the "den couch" for nurses on special duty, and guidance on wall finish, window shades, and the controversial use of pictures and memorial plaques. Cleaning procedures follow, including fumigation with formaldehyde, daily sweeping and dusting technique using damp cloths, and bathroom disinfection with an "American Standard" chloride-of-lime solution. The hospital ward receives extensive treatment: architecture, tiled walls, clothes chutes for soiled linen, standards for buying beds (length, back rests, castors, mattresses), bed-making as an index of nursing character, ward lockers, clothing records, the case against bedside medicine cabinets and hanging clinical charts, the need for isolation "quiet rooms" for the dying, and a full itemized equipment list for a twenty-bed ward. Linen room management covers marking systems, accounting to prevent laundry theft (illustrated by a barber-shop towel anecdote), discarded-linen policy, and shelf organization. The laundry section addresses staffing, starching, bluing, drying, ironing, and gives a full equipment list and cost estimate for a plant serving fifty to sixty patients. The kitchen chapter covers sanitary construction (tile floors, rounded corners, metal cabinets), cold storage with separate compartments for meat, produce, and dairy, storerooms, dishwashing routines, and argues nurses receive too little practical training in institutional housekeeping compared to nursing skills, recommending diet-kitchen rotations for nurses. Food purchasing and dietetics form a long section: judging quality in bread, milk (including adulteration testing and fat-content valuation), cheese, eggs, meat cuts (beef, veal, mutton, chicken, fish, pork), and butter, with quantity tables for 25-, 50-, and 100-bed hospitals. It classifies diets (fluid, semi-solid, light, regular), gives cooking principles for broths and vegetables, discusses meal timing, and reproduces sample dietaries from the New York Hospital, Roosevelt Hospital, and the New York Infirmary for Women and Children, plus special menus for nitrogenous, farinaceous, typhoid, and convalescent diets. Tray-setting etiquette and attractive food presentation are illustrated with a magazine writer's description of an artfully served hospital tray. A hygiene section credits Florence Nightingale's reforms at Scutari, discusses germ theory, water filtration weaknesses, dust composition, flies as disease vectors, and argues for garbage cremation, citing correspondence from hospitals using Morse-Boulger crematories. The servant-management section addresses hiring contracts, a merit/wage-increase system, a printed set of institutional conduct rules, servants' dining and sleeping quarters, and the housekeeper's disciplinary and pastoral relationship to her staff. A closing section on waste prevention discusses surgical-supply overuse (citing Dr. Brannan's Bellevue gauze-consumption reduction and Dr. Washburn's Massachusetts General Hospital gauze-washing and soap-making experiments), tax-free alcohol savings, and the importance of daily supply accounting. An appendix gives formulas for disinfectant solutions, fumigation procedure, and vermin extermination methods for bedbugs and lice.

By Charlotte A. Aikens · First published 1910 · Genre: Non-fiction, Instructional Manual, Professional Reference · 13 chapters · 48,452 words

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[Sidenote: The Hospital Housekeeper]

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hospital-housekeeping · professional-standards · institutional-management · organizational-systems · bookkeeping-and-accounting · ward-management · patient-care · patient-dignity · disease-prevention · sanitation-procedures · disinfection-procedures · fumigation

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