A Visit to the Women's Clinique and Midwives' Training School, Cologne.

Kai Tiaki : the journal of the nurses of New Zealand, Volume VI, Issue 1, 1 January 1913, Page 26

A Visit to the Women's Clinique and Midwives' Training School, Cologne.

This is one of the most up-to-date midwifery hospitals it has been my good fortune to see. It has not been built quite three years, and consists m the main building of three floors. There are bed? for 104 patients. The staff consist of five obstetric physicians ; seven mid wives and 35 pupils. Three classes of patients are admitted. The first class who have single rooms pay 8 marks per week, independent of their medical attendance. The second class 3 marks, and the third clas^ 2 marks, the doctor's fees inclusive. The last fee is that required from single girls. A flight of broad steps from the gate, leads into a lobby on either eide of which is a portress's room and a waiting room for visitors. When we were shown m a woman was there with two small children, who ha'i evidently come to see a new arrival. Presently a nurse appeared with the bal-y , and there was great joy m the little group. From here we passed by large glass swingdoors, into a long corridor running the whole length of the building. Here is the medical and residential part of the building. The walls are prettily tiled half way up and the rest painted. We were first taken into the Rontgen rays room, this contains all the latest appliances. The light is largely used m the treatment of uterine cases, and all the appliances are of the best. We were shown some beautiful slides which made me wish that my knowledge of anatomy was fresher. From here we passed m to the boardroom, dining rooms, matron's room, pupils bedrooms. The corridors are open to the garden on one side, and the other buildings looked very pretty with ledges below the windows full of flower boxes, showing geraniums of all colours. The pupils lecture hall is m the principle students' gallery m an operating theatre. There are diagrams and models and all of the latest publications and designs, and the cinematograph is used to aid the illustration. There were some pupils studying there as we passed through. The doctor showed us

the very interesting museum of old instruments used m midwifery and the evolution of the midwifery forceps was quite wonderful. From here we passed into the hospital proper, and one floor describes all. except that the four private wards, are on the top floor. There is the room the patient first occupies, if she has come m before labour has actually begun, the bath -room, very new, and plenty of hot water when she has a bath. There is a special theatre for first examinations fully equipped. While m the first stage, the patients walk about the long corridors and look on to the garden, or talk with the nurses passing. Our doctor stopped and had a chat with one who was so occupied. This use of the corridor seemed to me a splendid one for there is nothing more trying to a patient than walking backwards and forwards m a small room. On several occasions, I have heard patients recall the feeling of disgust with which they have come up against the wall only a few feet away from its opposite neighbour. In the labour ward were four beds (all the wards here are simply huge ; we should have made two large rooms out of this one, consequently there is plenty of space everywhere). On the first the patient rested during first stage, the next bed was used during the second stage, the delivery and end of third stage take place m a bed entirely covered with jaconet, and a pillow to match. When she is quite comfortable she is put on the fourth bed for one or two hours, until she can be wheeled away. Two nurses were here with one patient, and two others were m the sterilising room, cleaning gloves, nail brushes, etc In the labour room, as well as m the sterilising room enamel sinks with hot and cold taps take the place of basins. A large mirror is over the basins m the labour ward so that the obsteric physician or the midwife when washing hands can see the patient. The bowls of disinfectants for the hands are of glass on a swing stand. They have not the pc: 7 al washstands, but

they have pedal dressing cases, so that the dressing can be taken out of their sterliser without the hands touching the dressing receptacle. In the sterlising room, the instruments after being cleaned were put into a steamer and there steamed. The sterilisers were most up-to-date and the boiling water is stored m elaborate boilers overhead, and then it is always ready and the steam can be regulated so that there is no waste. T should have liked to see a case through m the ward, but it took three hours hard going to see everything as it was. We began at four and it was seven when we said good-bye. The next interesting spot was the nursery, — again a huge room with plain walls and enamel sink-like basins going down the room on each side. Here the babies are bathed. The nurse stands to bathe the baby ; it is then covered with a warm towel and taken to the table — a long plain very white one. The baby is placed on a red flannel blanket, which has a large white c over, and dried and powdered, this part I did not see, but this i? what I understood took place The doctor who took us round knew a little English — the German lady who accompanied me, a very little more of the ordinary language. I know just three German words, so as it was very difficult to find the English words, there may be a few mistakes m some of these facts. I did see a baby put into a little flannel long sleeved vest and squares, these were put on with the baby on its face. A long straight square was then put on ; coming from under the arms and the binder finished it. The baby was then wrapped m the red blanket with its white cover and carried away — no pins were used, the diapers being passed over and under the thighs from opposite sides. The nurses excel m dressing the babies. We saw three attended to and not a whimper from any of them. The first class patients have single rooms, the second class two beds m a room, and the third class four beds. The bedsteads and cots are of white enamel. The babies beds are iron cots, such as we- use for a baby from six months to a year, and they are not placed close beside the mother. The cots are covered with white butter muslin, which keeps away the flies and a little of the light from the baby's face. Beside eaoh bed is an iron stand with enough^table toehold soap and sponge and a glass, and m a rim

beside this is the basin for washing. By means of a swivel arrangement, this is turned across the bed when the patient is washed, or washing herself ; this enables the washing operation to be performed with the minimum of discomfort to the patient. The feeding hours are strictly kept and all over the hospital the mothers were feeding their infants at 6 p.m. They stay with their mothers for a short time after the feeding, but they must not keep them m the arm or lying across the chest. After visiting the three floors, we were taken across the garden to the isolation block and thence to the engine room, I thought this was simply a case of look m and out, but no, the engineer came out of his sanctum sanctorum and the medical guide retired into an onlooker and the engineer showed us every part of his machinery as carefully as though it was the patient and he the nurse. I tell you quite what it all meant, but I did notice the quality of the coal, and it was just like our slack. Upstairs was the wonderful pumping apparatuS; which sent the water to all the buildings. The electric light is also made here and climax, to utilise all the steam and heat, another machine is introduced, which softens the water and the feel of that water is like satin. I enquired through my interpreter the object of softening the water. The characteristic answer came, " To save the soap." That is so typical of Germany, initial outlay is never grudged if a definite saving is to be gained. ]n this case the gain is m increased comfort also to both patients and nurses. Next to the engine room is the wash house, but quite a little walk awaj from it. Here were wooden tubs cradle shaped m two rows down the room or house ; boilers heated by steam from the engine room ; a drying press like a house full of clothes. The piece de resistance here was a mangle, worked by machinery, and fed and emptied by a girl on each side. On each side is a light copper shelf over which the clothes pass, there are five rollers and the garments look as though they had been ironed. The engineer was still acting as guide and he was very proud of another " special " mangle which did away with ironing of some things, but as he did not give us a practical demonstration, I did not quite grasp his meaning, but I think that possibly it was used for uniforms. I think come of

us would have liked a few blouses put through it. Tn the ironing room only electric irons are used, heavy and effective. From this block we passed to the kitchen and store-rooms. Bigness impresses one everywhere, the space round everything. The cooking vessels stand on the floor and I think four people can walk almost between that and the iron cupboard where the plates are heated, and the same feeling of space exists everywhere. There is a large stove fed by coal for cooking small quantities or for frying. Fried potatoes and milk is a light meal often seen m Germany. The potatoes, vegetables, and milk are cooked m double lined boilers, fed by steam from the engine room, and o/er each is two taps for hot and cold water for cleansing. The milk looked so good m its own vessel, sacred to it. These vessels are about the size of the coppers that are built into the wash-houses m small New Zealand houses. The administration of the hospital is m charge of the church sisters, and well they supervise their department. There is no matron, but a head midwife who is respons

ible to the doctors, and whom we did not see at all. There are seven midwives altogether. The visit to the kitchen finished the round. I much enjoyed the bright faced sisters we saw here and in the laundry and the pleasant feeling of good comradeship between the doctor and the sisters, and the other officials we came across. This v»as missing in the hospital part, as we did not meet any woman in a position of responsibility. To return to the hospital for a moment, there were no signs of artificial feeding. A breast pump in a basin beside one bed elicited the query from the doctor, " Have 3^ou drawn any food for the other baby ?" He then told us this mother had more than her baby required, and so another baby's feeding was assisted with satisfactory results. The third class women waiting sleep in a dormitory, and along the wall are pigeon holes, and each has her brush and comb, soap and a tumbler there. They wash at the basins attached to the bath-rooms, many things are simplified to the utmost. C. H.