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A. I should think very good. I think he is not called upon to give judgment in that matter, however.

Q. Suppose he had a man in his employ as a male nurse and that he discharged this nurse, because, as he stated, he was unfaithful, untruthful, inefficient, and insolent, and that he told the superintendent of the Long Island Hospital that such was the fact, and that, nevertheless, the superintendent of that hospital employed such a person as nurse at the hospital, would you say that that was a proper act of the superintendent?

A. I should think he had very good reason for not employing such a person.

Q. And do you think it would have been prudent for him to employ such a person to watch over the welfare of the patients in the hospital? Not unless he had evidence to disbelieve the statement of Dr.

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Rowe.

Q. Would you believe the statement of Dr. Rowe?

4. It depends. somewhat.

Q. On what?

A.

not.

Whether he had some personal antagonism to this individual or

Q. You think, then, he is capable of making a statement because of his personal feeling?

A. I think all our statements may be more or less colored under circumstances.

Q. Well, in the selection of a nurse, would you not be careful not to take some one who was a subject of suspicion ?

1.

I should prefer to take some one that he approved of, and not disapproved; but I do not wish to be understood that I would employ any one he recommended. I don't mean that Dr. Rowe's opinion would necessarily be faultless.

Q. Well, isn't this a fact in regard to the selection of a person for a position of great trust and you consider a nurse to be that?

4. I do.

Q. In the selection of a person for a position of great trust, would you take some one who was charged by a person in whom you had confidence with being unfaithful, untruthful, inefficient and insolent ?

A. I should not take such a person unless I had investigated the charges and had formed an opinion in regard to the accuracy of them. But would you do it if you had investigated it?

Q.

A. Not if I found the charges correct.

Q. And you would be inclined to place great credit on what Dr. Rowe said?

4. Yes. I should, certainly.

Q. Well, now, doctor, passing to the question of nursing, you said that you thought there ought to be one nurse to, say, twenty-five or thirty patients?

A. Yes.

Q. And the class of cases which you had observed?

A. Yes.

Q. And what do you mean by one nurse

nurse?

4. One night nurse on duty all the time. Q. One night nurse and one day nurse?

A. Yes.

one day and one night

Q. And in the ease of a hospital of some size where there are a good many wards, how would you provide for the necessary contingent arising from time to time of absences?

A. I should provide, or wish to see provided, a nurse for each ward; and from the character of the patients I saw I should make very general use of the patients for nursing, etc. Many of them ought to be set about to help; and I don't doubt that they were.

Q. Now, to whom would you intrust the preparation of the medicine in this place, this hospital, of from 150 to 200 patients?

A. I think a person of distinctly medical training should look after the medicines.

Q. Would you think it proper, then, that at this hospital medicines should be mixed or prepared for these patients and the out-patients, making in all an aggregate of about 7,000 patients a year that they should have been mixed by one of the nurses who in addition, had very many other duties to perform, and has under him some 75 or 100 patients ?

A. It would require special training on the part of this person.

Q. Well, supposing he had no training at all except what he has picked up?

A. I can hardly conceive that a person without any training should be called upon to mix the medicine — certain medicines which might be necessary.

Mr. BRANDeis.

Well, let us read you the fact.

At this point, at 6.01 P.M., the committee took a recess until 7 o'clock.

EVENING SESSION.

The committee reassembled in the Aldermanic Chamber at 7 o'clock P.M., when the hearing was resumed, Chairman HALLSTRAM presiding.

CROSS-EXAMINATION OF DR. REGINALD H. FITZ. Continued.

Q. (By Mr. BRANDEIS.) Doctor, returning a moment to the subject of nurses, I want to ask you whether, from your experience, assuming the statement of figures that Dr. Harkins makes here to be correct, he is also correct in his statement that more nurses were needed? He says: Ward 7, Long Island, has sixty-one patients, in care of one nurse by day and one nurse by night."

A. Well, it would depend, of course, upon the nature of the sixtyone patients as to what the diseases were.

Q.

Well, that list that I furnished you shows the nature of the cases on which he was giving his opinion.

Mr. REED.· What ward was that?

Mr. BRANDEIS. At that time Ward 7. I am asking him upon that list of diseases.

Mr. REED. — That was the old hospital.

The WITNESS. - I should have to know what the nature of the diseases were at the time that statement was made.

Q. Well, will you look at the list and assume that that represented the condition at that time?

A.

If the

I don't think this would give me the information I desire. Q. Well, perhaps I may put the question in another way. physician in charge, Dr. Harkins, the resident physician, declared that there were sixty-one patients in Ward 7, and that the general character of the diseases was of the kind that list indicates there, would you be inclined to say as against Dr. Harkins that another attendant was not needed?

A. If Dr. Harkins, who was in charge of the ward at the time, said that he thought more attendants were needed than were actually present in charge of the ward, I should say that his opinion was very well worth considering.

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Q. Well, now, Dr. Harkins says here that in the hospital building at Rainsford Island there are thirty-eight patients in the care of one nurse by day, assisted by Miss McDonald. The latter does the dressing and gives the medicine to all the women in the hospital building, in the infirmary (so called), and to all the women out-patients' at Rainsford." Then he says, passing to the next: “ Hospital ward — infirmary (so called), at Rainsford, forty-two patients in care of one nurse, Mrs. Dacey. The latter has the sole care also of all the laundry washing' for Rainsford Island, and three sleeping dormitories in addition to the infirmary. There is no paid night nurse in either the hospital building (thirty-eight patients) or in the infirmary (forty-two patients)." Now, if Dr. Ilarkins, the resident physician in charge, in view of the facts there stated, which we will assume to be true, recommends that another nurse, or another attendant, should be had for those wards, would you say or not that his recommendations should be acted upon? A. I should think it probable that it should be acted upon favorably. Q. Then he says in regard to the male ward :

Long Island, Wards 6 and 8, 115 patients, under one nurse (Mr. Morphy), by day, and one nurse (Mr. Murphy) by night. The former (Mr. Morphy), in addition to his duties as nurse, acts as apothecary, and prepares the major part of the drugs which may be ordered for Wards 6, 7, and 8. The day nurses are on duty from 6 A.M. to 8 P.M., with one hour for dinner and a half-hour each for breakfast and supper. During meal hour there is no one to perform "relief" duty. The night nurses. are on duty from 8 P. M. to 6 A.M.

Assuming those facts to be be true, as stated by Mr. Harkins, and on the basis of which he recommends an additional male nurse, would you say that his recommendation should be acted upon?

A. I should say that an additional nurse was desirable under those circumstances.

Q. Assuming the facts stated as follows to be true:

Should Miss O'Brien desire to make a visit to Boston, she is substituted by Mrs. Dacey, who is thus obliged to allow her wards to remain without any paid official in charge. As I said, heretofore, the medicines at Long Island are dispensed by inmates.

Assuming those facts to be as stated by Dr. Harkins, would you or would you not say that there should be some proper person to act as nurse in substituting and the dispensing of medicines ?

A. I should say that the dispensing of medicines by inmates might be very properly done. I should say in reference to alternating, that it might be possible now and then without any serious harm if the nurses did occasionally do double duty, as an exceptional circumstance. Q. What do you mean by "occasionally"?

A.

Q.

Once a week, for instance.

What do you mean by "double duty"?

4. I mean to say that if the day nurse wished to go to Boston in the afternoon and the night nurse was to go on duty at three o'clock instead of six, that she might be able to do that without neglecting her charges. Q. You mean a few hours additional duty?

A. Yes, sir.

Q. But not that the one nurse should work both the whole day and night?

A. I think the night nurse should not be called upon to do that to that extent.

Q. Now, assuming it to be true, as stated by Dr. Harkins here when he says that the keeping of the hospital records at Long Island for both islands is attended to by inmates under the direction, of course, and

the supervision of a physician, what do you think of the keeping of the records by an inmate of an institution of this character?

A. I should say that the simple writing of the records might be carried on.

Q. You mean that one of the inmates might act as an amanuensis? A. Yes, sir.

Q. But if he was something more than an amanuensis? If he actually kept the records?

4. I should not think he was competent to make any accurate medical examination of the cases which he might be making records of.

Q. Now, I was asking you just before the adjournment in regard to the person whose duty it was to prepare the medicines in such an institution, and you expressed tue opinion that the person that I indicated, one without medical training and without training in pharmacy, should not be permitted to do so, and I think you added, also, that you could not conceive of his being permitted to do so. Now, I would like to ask you, assuming this statement which I am going to read to you to be

correct

Mr. CURTIS.

What is this that you are going to read, Mr. Brandeis ?

Mr. BRANDEIS. Mr. Morphy's testimony.

Mr. CURTIS. - You have been reading from a report of a man who did not testify here at all, and assuming the statements contained in it to be true, and I wanted to know what you were going to read

all.

that is

Mr. BRANDEIS. - Well, I don't think you should question Mr. Morphy's

statement.

Mr. CURTIS. No; but you have been reading statements by some one who has not testified here, and I don't know why you should not place him on the stand.

Mr. BRANDEIS.

Well, we have wanted to get several people on the stand. We wanted to put Dr. Cogswell on the stand. Mr. PROCTOR. - You will have Dr. Cogswell; don't fret.

Mr. BRANDEIS.

isn't he?

Mr. PROCTOR.

Mr. BRANDeis.

assume to be correct

I guess he is pretty well prepared by this time,

He always has been.

This is the testimony, doctor, which I wish you to

Ald. LEE. What page is that?

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Mr. BRANDEIS. Page 569. (Reading) :

Q. Well, now, before you went there as nurse, what had been your experience and training as a nurse?

A. Nothing, whatsoever.

Q. Hadn't had any?

A. None at all.

Q. What sort of work had you done before you went there?

A.

Well, I was engaged as steam-fitter's helper.

Q. Steam-fitter's helper ?

4.

Yes, sir; heavy work.

Q. Had you had any work to do connected with nursing?

A. No, sir.

Q. Had you had anything to do with medicines?

A. Know nothing about them.

2. Now, in September, 1891, you began to do the apothecary work?

4. Yes, sir.

Q. What training had you had in September, 1891, in medicine?

A. Just the little that I had acquired during the period that I was on nights. I became familiar with the names of the drugs and tried to pick up as much as I could.

He came there about three months before.

2. Did you ever study pharmacy in any form?

A.

Well, I read a little down there, but not before going there.

Q. And when you began to mix the medicines, in September, 1891, you hadn't had any experience except what you picked up the three months before that?

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Q. Well, how much of the time since then have you been compounding the medicines?

4. Since the apothecary left, in May, 1891, until, I should say, June of 1893.

Now, I ask you, doctor, assuming the facts to be as stated by that witness concerning himself, was he a proper person to administer medicines to a hospital of that nature and with the class of diseases there treated?

A. Not if the process of mixing was at all complicated.

Q. Well, assuming that the list of diseases as there given is correct, and assuming that the medicines were given which would naturally be given by a proper physician for those diseases, would or would not Mr. Morphy, on the facts as testified to by him, be a proper person to compound the medicines?

4. Many of these diseases would not require much of any medicine, and for many of them the medicine would be in a pill form, and all that he would have to do would be to give them.

Q. He didn't say "dispensing" them, but "compounding " them. A. I don't know what he meant by "compounding" them.

Q. Well, I will ask you whether, if you had charge of the Long Island Hospital at that time, you would have chosen as à man to do the compounding of the medicine a man with the experience that Mr. Morphy says he has had?

A. No, sir, I should not.

Q. Would you think it proper for a superintendent of a hospital to choose such a man to compound medicine?

A. If he was a very intelligent person he might have been selected, if there was any particular reason for selecting him.

Q. Well, he stated that he did it as an additional duty.

Mr. CURTIS. He didn't say that.

Mr. BRANDEIS.

Well, assuming that he did.

Mr. PROCTOR. Oh, that is right. Assume all the facts that you want, and go ahead. We won't object.

Mr. BRANDEIS. — I will assume it on his testimony, and I believe it is absolutely correct.

Mr. CURTIS. Well, I am looking at his testimony, too.

Q. I ask you whether you would deem the selection of such a man proper in a large hospital in the city of Boston?

A. I should not.

Q. To compound the medicines ?

A. I should not.

Q. Now, doctor, you testified to what you had found to be the condition of the sanitary arrangements, etc., in regard to cleanliness down and now I will ask you also to make a — But, first, I would like to ask you if you know Mr. Brown, the Inspector of the Board of Health of the city of Boston?

there;

A.

I do not.

Q. I will ask you to assume the statement which he makes here, dated February 28, 1894, and which is found on page 326 of the record, to be correct; and I will ask you whether in your opinion, assuming the facts therein stated to be correct, it was a condition in which a first-class hospital ought to be in?

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