Hospital By-Laws, 1900

The following by-laws date from 1900, and are held by Dorset History Centre (reference NG/HH/DO(C)/3/3).

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DORSET COUNTY HOSPITAL.

BY-LAWS MADE IN COMMITTEE.

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COMMITTEE.

 1. Any ex-officio member of the Committee shall, on request from him, receive an agenda paper of the monthly meeting.

2. All Members of the committee are requested to visit and inspect the hospital as often as may be convenient to them, and to make their observations in the visiting committee report book.

3. Each monthly visitor, or his substitute, is expected to make a full inspection of the hospital at least once a week, and if possible the two should make a joint inspection at least once in the month. They shall see that the appliances for extinguishing fire are worked once during the month, either by the nurses, the porter, of the servants. They shall also see that the door at top of outside fire escape is opened occasionally.

4. Any member of the committee, living at a distance from Dorchester, may on request be excluded from the list of monthly visitors, with the approval of the committee.

5. The minute books of the committee shall be kept locked up, and the keys of the safe held by the chairman, vice-chairman, and clerk.

6. It shall not be competent for any committee meeting to alter the resolution of a previous meeting, unless four clear days’ notice of such intended alteration be given in writing to each member of the committee.

7. The chairman and the visitors for the month with one of the financial secretaries shall form a sub-committee to open the tenders for provisions previous to the meeting of the committee of management, and shall prepare a list of those they recommend for acceptance.

MEDICAL OFFICERS, HOUSE SURGEON, MATRON, AND DISPENSER.

8. If any out-patient of the hospital become and in-patient, he shall continue under the care of the same medical officer.

9. The surgeon of the week shall go off duty at mid-night of Thursday.

10. When a patient is admitted on account of accident or urgency without coming before the committee, the house surgeon shall attend the next meeting of the weekly board and explain the circumstances. The admission shall be entered in the minute book.

11. The house surgeon shall duly record the cases of all patients admitted to the hospital, and also of every operation performed therein, together with the name, age, and address of the patient on whom it is performed.

12. He shall commence his duties and visit the wards daily at 9 a.m., and visit them again at 7 p.m., and not absent himself from the hospital (except under pressing emergency) until after 1 p.m., unless the medical staff shall have previously visited, and then only in accordance with the existing rules.

13. He shall see that the porter properly burns the poultices.

14. He shall take care that patients likely to be discharged communicate with their friends, and that renewed tickets be properly obtained.

15. He shall not in any case attend any out-patient at his or her own home.

16. The casualty and weekly report books shall be laid by the dispenser before the weekly board.

17. The house surgeon, matron, dispenser, and porter shall not be absent from the hospital without permission during the sitting of the committee.

18. Neither the house surgeon nor the matron shall be absent from the hospital on more than three afternoons in the same week, unless by mutual agreement. (See R. 76 & 102).

19. The house surgeon shall obey the orders of the honorary medical officers in all that concerns the treatment of the patients, and shall neither administer anaesthetics nor perform operations, unless under the direction of an honorary medical officer.

This rule, so far as regards operations, does not apply to cases of emergency, nor to ordinary casual cases.

20. On the admission of any case as an accident or as an emergency, the house surgeon shall at once inform the honorary medical officer under whose care the case is placed.

21. The medical committee minute book shall be locked up, but shall be accessible to each member of the committee.

22. All cases shall be first seen by the house surgeon, who shall in the first place determine whether the case be medical or surgical. Eye cases and surgical diseases of women to go to the surgeon.

23. The house surgeon shall use the surgeons’ room for the reception and treatment of accidents and minor casualties; and the latter shall not be treated in the wards or dispensary.

24. The house surgeon shall summon the honorary medical staff regularly the Tuesday next before the monthly meeting of the committee of management, and specially whenever desired to do so by a member of the honorary medical staff.

25. The surgeon dentist, or house surgeon shall enter in a book, kept for the purpose, the names of all dental patients, and this book, together with any recommendations which have been sent in, shall be laid before the weekly board.

DUTIES OF CHAPLAIN.

26. The duties of the chaplain shall be to say prayers twice a day in the hospital, once at least in the chapel. On Sunday mornings, Divine Service shall always be performed in the chapel, on Sunday afternoons, either in the chapel, or in the wards, at the discretion of the chaplain.

MATRON.

27. The matron shall be responsible for the posting in the wards of all notices ordered to be so posted.

28. The matron shall make a report quarterly as to the state of the hospital.

29. The matron shall see that invoices be delivered with goods, and shall verify these with the goods delivered, and then initial the invoice and hand it to the clerk on the following Thursday morning.

30. As far as is possible all articles are to be ordered from the contractors for the time being (if they supply them), and no article shall be received into the hospital without an invoice.

31. Everything not ordered by the committee, shall be paid for by the matron and charged in her weekly account.

32. The weekly consumption book shall be kept by the matron, and the daily demand tickets for the diet of the patients, which are made out by the nurses, shall be daily compared by her with the cards, and signed by her in token of her having done so, before the daily issue of provisions takes place.

33. The laundry books shall be initialled by both matron and laundress on receipt of linen.

34. Each quarter, a statement of all articles of furniture to be renewed shall be laid by the matron before the committee, and other small articles wanted to be renewed from time to time shall be obtained as required.

35. It shall be the duty of the matron at once to report to the medical officers on duty for the week any case of illness occurring to the nurses of servants of the institution. This shall not prevent any servant from receiving the attendance of any other duly qualified medical man, at his or her expense, subject to the permission of a member of the committee.

36. The matron shall fasten the front door at one o’clock each day, and not before.

37. The matron shall provide her own locum tenens at her own expense when absent on holiday.

NURSES AND PROBATIONERS.

38. No person shall be employed as head nurse under 30 years of age, or as assistant nurse under 25, or as a probationer under 23.

39. No person shall be employed as either head or assistant nurse unless she produce certificates of having undergone two years consecutive training at an approved hospital.

40. The amount of holiday allowed to the nurses shall not exceed four weeks in the year, and the amount permitted to each shall be at the discretion of the matron.

41. The wages of nurses shall be as follows, two head nurses shall receive £30 each annually, and the four assistant nurses £25. No salary shall be paid to the two probationers.

42. The probationers shall be engaged for one year and pay a fee of ten guineas in advance for their training. Uniform shall be given after six weeks trial and approval. The probationer shall pay her own laundry expenses. If after six weeks’ trial the candidate be not found suitable, the sum of seven guineas shall be returned to her. All candidates shall be examined as to health by the senior medical officer at the end of the six weeks’ trial.

HOUSE MANAGEMENT.

43. No person shall stay in the hospital as a visitor without the permission of the committee, or weekly board, and two shillings per day shall be paid for each visitor.

44. No resident officer or servant of the hospital shall give refreshment to persons not on the establishment at the cost of the institution.

45. No dogs shall be kept on the premises.

DIETARY RULES.

46. The diet table shall be posted in the wards.

47. Should any diet be used in the wards differing from that specified in the diet table, the nurse in whose ward such diet is used shall be liable to immediate dismissal. The patient using it shall be liable to be sent home. But this rule does not apply to any diet specially ordered by the physician or surgeon for any particular patient.

48. The following notice shall be posted in the wards – Any patient receiving anything to eat or drink from outside shall be liable to be immediately discharged, and the nurse of the ward reported to the committee.

49. The clerk shall present the order book weekly to the weekly board. Except in emergency, nothing shall be supplied unless ordered through it.

50. The clerk shall compare the tradesmen’s invoices every week with the order book, and report any discrepancies. He shall initial the book in each case after examination.

WARDS, BEDS, INVENTORY.

51. Notices shall be hung in the wards desiring the patients if they have any cause of complaint to state the same to the visitors when they go round.

52. On each admission day one bed in the lower and one in the upper wards shall be left vacant for the emergencies of the following week.

53. Each ward shall be equipped to the full number of patients to be accommodated, and an inventory shall be drawn up and placed in each room by the matron.

54. The convalescent wards shall be reserved for the patients, and be used for no other purpose except by special sanction of the committee.

INSTRUMENTS AND DRUGS.

55. Instruments belonging to the hospital may be lent to medical gentlemen on application to house surgeon and on their giving and undertaking to repair all damages, and return such instruments with all convenient speed to the house surgeon, who shall immediately examine their condition. The house surgeon shall keep a book in which all such loans shall be entered, with the name and signature of the borrower, and the date of issue and return.

56. No dispensing of medicine shall be allowed without admission tickets, except in case of emergency to be decided by a member of the medical staff. Such case shall be reported to the next meeting of the weekly board.

57. All poultices shall be burnt daily by the porter.

58. The porter alone shall have the key of the letter box and shall himself carry the letters to their owners, or in the case of the patients, to the nurse in charge of the ward.

59. A letter box for the receipt of out-going letters shall be placed on the ground floor, and the porter shall keep the key and post the letters regularly.

MEDICAL LIBRARY.

60. The library and museum shall be under the management of the medical officers for the time being.

61. The library shall be open during certain hours of the day for the use of any medical man of the neighbourhood or county on presenting his card to the house surgeon.

62. No book is to be taken away, except by the medical officers of the hospital, who shall enter the same in the book kept for the purpose.

PATIENTS.

63. All tickets renewed or changed shall be laid before the weekly board the Thursday following the day on which they are signed.

64. Patients shall provide for the washing of their own personal apparel.

65. Patients discharged on Thursday by the weekly board shall leave the hospital not later than the following Saturday, unless by special permission of the medical officer, or a member of the committee.

66. Male and female in-patients shall on no account be permitted to take exercise at the same time. Females shall take exercise during two hours in the day, at the discretion of the house surgeon, during which time the men shall not leave the house.

67. Whenever the house surgeon or matron find any patients refusing obedience to orders, they shall at once send for one of the visitors of the week, or, for some other member of the committee, who is empowered to discharge the offender immediately.

68. Should any patients die, their cards shall be placed on the table for the inspection of the weekly board, and their names recorded in the minute book.

69. Persons receiving casual relief shall write their name, address, and occupation in a book kept for the purpose.

VISITORS.

70. Any minister of religion desiring to visit a patient shall, in absence of the house surgeon, apply to the matron. (See R. 133).

71. No patient shall be permitted to receive on the same day more than three visitors, except by special permission of the house surgeon or matron, and written notices to that effect shall be posted at the visitors’ entrance, and in the wards.

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