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Laa diagrammas sulvants iilustrant la mAthoda. 2 3 1 5 6 MICROCOPY RESOLUTION TEST CHART (ANSI ai.c! ISO TEST CHART No. 2) 1.0 I.I 1.25 |5A 143 La 2.8 3.2 3.6 4.0 1.4 l!i 2,5 2.2 2£ 1.8 1.6 A APPLIED IIVHGE Inc ^^ 1653 East Main Street r.a Rochester, New York 14609 USA = (716) 482 -O'-^o - Phone ^ (716) 288 -Fax aoe 9eee ■j a jtj e 9BeC! i RULES AND REGULATIONS, ,.,■■...,...„. ^ n. ,,^ ■ ,^^ ■ ■f^ ^i-— irrtt: ll 9L ^ s f{ 1 fOB TOX MANAGEMENT OK TUB MONTREAL. "^^^T^W^i-^^^JW^itf^^**" *^ *• f* fc * r^a— u "* !. ' r* ii ' ■ "w'^ t j'^vH.^^o.j^ 'L.O MONTREAL : TEINTBD BY JOHN LOVRLL, ST. NICHOLAS SiaEET. 1854. Si ? E H < ^ ^ II Ini&trsitj Iginj-ln fosjiJal, j[ Ij ? 11 It ! 1 > J !'! jjiu:!U!. 'e euii!!3B */a> "iOT" ' "" ■ ~^\r\f-~ B m RULES AND REGULATIONS, FOR TEm MANAGEMENT or THK Inihrsitg f ging-ln f 0i5pital, MONTREAL. MONTREAL: PRINTED BY JOHN LOYELL, ST. MCHOLAS STRJEBST. 1864. M RULES AND REGULATIONS, POR THE MANAOEMlCNT OT THE lUriVEESITY LYUTG-IU HOSPITAL, MONTREAL. Th« InsUtution shall be named the Univemty LjW. m Hospital, and the prime object sought in its estabS 01 acquiring an acquaintance with the duties anH pact^e of Obstetrics, the practical informatir.hi:^ The affairs of the Institution shall be conducted under the former being under the control of a Committee of oft:'i^:i:rr^-'^^""-'»^'''««^'-rM' I—D0ME8TIC MANAGEMENT Directress Tr^Z ?o ™'' '^'"'^' ^"^ ""W wrectress, Treasurer and Secretary, who shall hoM ,^.i. -«puciire oiiices for the term of one year. 3. The Board of Management shall meet monthly, ot oftener if nec' .ssaiy. 4. Five m. rabers of the Board of Management shall constitute a (^ wrum for the transaction of ordinary business, and the Chair sliall be taken by a Directress according to seniority, if present, or in her absence, by such other Manager as may be designated by those present. 6. The Board of Management shall appoint, either by ballot or otherwise, from their own number, a certain number of Ladies to act as a Visiting Committe, who shall visit the Institution weekl)^, or oftener, if necessary, preside immediately over its interests, inquire into the conduct of the Institution, ascertain its wants, order such purchases as may be required, for the amount of which their draft or order for payment on the Treasurer will be sufficient, and do all such other business as the state and comfort of the Patients, and necessities of the house may require. 6. The Visiting Committee shall make a monthly report in writing, of the management of the Institu- tion, to the monthly Meeting of the Board of Manage- ment : the following shall be the order of proceeding : Ist. The Reception of the Report of the Visiting Com- mittee. 2nd. The Report of the attending Physician. 3rd. The Treasurer's Report. 4th. The transaction of such other business as the interests of the Institution may require. 7. The Visiting Committee shall appoint certain days to admit and discharge Patients and servants, they may, (in urgent cases,) admit as Patients, poor women unsuccessful in their endeavodra to obtain presentations from Subscribers, Clergymen, or others. 8. The Visiting Committee may make temporary orders for the service of the Institution, but all their proceedings must be reported to the Monthly Meeting. 9. The Patients with their Infants shall attend the Visit rs, in order to their being discharged, when inquiry shall be made by the Visitors, how they have been used in the Hospital ? whether they have any complaints to make against any of the officers, nurses or servants, or concerning the quantity or quality of the provisions ? and wliether any money or other things have been demanded or taken from them ? and if any complaint be made, it shall be enquired into by the Visitors, before the Patient or Patients making the same be discharged, and such orders made thereon as may be thought proper. If there be no complaint, a letter of thanks shall be given to each Patient, which she is directed to carry immediately after her discharge, to the Subscriber or other who recommended her, to return thanks for the benefit she had received. A paper shall also be given to each Patient for her to hand to the Clerk or Minister of the Church or Chapel she attends, to offer up to Almighty God, thanks for her safe delivery :— after which, the Matron shall be called in, and asked whether she has any complaints against any of the Patients, nurses or servants ; and if any complaints be made, the Visiting Committee shall make the necessary orders thereon. Inquiry shall also be made of the Matron as to the quality if the provisions, and whether anything is wanting for the service of the house or Patients ;" and tie may be requisite 6 Visitors shall make such ordere as thereon. 10 J^e letters of recommendation ofPatients,shall be laid before the Visitors, by the Matron, the women pro- ducmg the accepted recommendatory letter, shall be called_ m, and cautioned by the Visitors as to their behaviour during the time they may be in the Hospital, and to submit to the Rules and Regulations thereof, they shall also be informed that no persons can be per- mitted to go into the wards as Visitors, except as provi- ded for ; that no eatables, or drinkables, can be permitted to be brought in, either by themselves or their friends as everything necessary and proper is provided hy the Institution, and more might prove injurious ; that they cannot be permitted to come down into the hall to see their friends, unless their state of health may be such, as to induce the Matron to give her consent for that purpose : that those who are well and able, may be required to make themselves useful, by doing such little matters as the Matron may think fit to direct ; that they must come mto the Hospital, clean in their persons and apparel, and bring with them proper clothing for dressing their children, when they leave it. 11. The annual Meeting of the Board of Management shall be held each year on the first Fridav in October* for the election of officers, at which a geneial Report of the state of the Institution shall be read, comprising the number of admissions, the result of the cases, the annual expenditure, the prospects of the Institution, and such other matters as may be deemed of interest to the Dublin. • 12. The Board of Physicians of the Institution, may be ex-ofEcio Members of the Board of Management. MATRON. 1. The Matron shall constantly rpside in the Hos- pital, and direct the economy of it. 2. She shall keep a book, in which she shall make . entries of all sums expended by her for the use of the Hospital, and which shall be cast up monthly, and pro- duced to the Visiting Committee at the Monthly Meet- ing, or whenever required. 3. She shall receive into the Hospital such Patients, as respectively produce orders from the Monthly Visitors, for that purpose signed by a Subsciber or other, accord- ing to' the rules for the admission of patients. 4. She shall take charge of the household Dods, linen, furniture, and other things committed to her charge, and keep a con-ect inventory thereof, ready to be produced whenever required. 6. She shall take care that none of the provisions are carried out of the Hospital or wasted, and thai no spiri- tuous liquors, or articles of food, are brought into the Hospital, unless tea and sugar, if specially/ authorized by the Committee. 6. She "shall take charge of the clothes and money of any Patients who may die in the Hospital, and give immediate notice of their deaths to their relations or friends, or if strangers, to the Church they belonged to, in order to their being buried by such relations or friends or Church. 7. She shall take care that all the rules, orders and 8 II regulations, for the government of the Hospital be strictly attended to. 8. The Matron shall report to the Monthly Visitors the articles required for the Hospital, also the quantity and quality of such as have been supplied, and examine and lay before them the several Tradesmen's Bills. ^ 9. She shall take her turn with the Midwife in attend- ing Church, and see that the other servants attend Church also in turn. 10. She shall read a prayer, morning and evening, in one of the wards. 11. She shall taie, care that in winter, the Patients are m bed at 8 o'clock, and in summer at 9 ; that all the lamps are out except one, unless in case of illness. 12. In case of non-observance of the rules of the Hospital, misbehaviour, or neglect on the part of Student, Midwife, Patient, Nurse or Servant, or of any occurrence prejudicial to the interests of the Institution, she shall report the same to the Monthly Visitors. 13. She shall not receive any person to learn Mid- wifery or Nurse tending without the permission of the Committee of Management. 14. She shall use the same provision as the other in- mates of the Hospital, except tea which shall be of a superior quality. 15. She must take care that if a Patient on entering the Hospital is not clean in her person anH apparel, the Patient shall be thoroughly cleansed, and her garments changed, and free from any contagious distemper. 16. In case of severe illness of a Patient, a Priest or Minisfpr qTioII T\a oy^rvf f'^f <• " 9 17. The Matron must keep a register of the Students practising in the Hospital, calling in each in succession as his name is entered to attend T i > ds. WOMEN LEARNING MIDWIFERY OR NURSE TENDING. Women who enter the Hospital for the purpose of leaniing Midwifery, must make themselves useful in attending on the Patients and Infants, and must not absent themselves without the leave of the Matron. 2. They must attend regularly the Lectures on Mid- wifery, and pay a fee of fifteen shillings, unless the Committee of Management see fit to remit the fee. 3. Those who enter to learn Nurse tending must consider themselves for the time being as in the capa- city of engaged Nurses, and so to submit themselves to the orders of the Matron, and make themselves useful : they must not absent themselves without leave of the Matron, and can have no Visitors, 4. Only one person can be received at one time, who must produce satisfactory testimonials, and may be liable to be dismissed by the Directress or Visitors for incapa- city, inattention, or uselessness. NURSES AND SERVANTS. 1. The Nurses shall be diligent in observing the direc- tions of the Medical Officers, Midwife, and Matron, with regard to the treatment and care of the Patients in the Hospital. 2. They shall behave with tenderness to the Patients and with all due respect and civility to Visitors. 3. They shall not, nArmU o«rr ^r^^ *u^ t>-.x!-_. , r~ "V "* '^"'5 A liuciics to go 10 out of their wards without leave from the Matron, and ZtCf^^VfT ''"''"""S^ improperly, or contrary to^the Rules of the Hospital .Uey shall inform the Matron 4. They shall take care that the Patients go to bed at r T? V *' "'■""• '"'^ " o'°'«'= '" the summer. 6 The Nu«es shall from time to time during the night, regularly visit the several wards, and give what assistance the Patients may require. 6. The Nurses shall not bring any spirituous liquors mto the wards, or permit any to be brought in 7. The Nurses or Servants shall not go out of the Hospital, nor be visited by their friend^ without the Matron's leave: and no V itor shall go into the wards or be treated with the Hospital provisions, neither shall any linen be washed in the Hospital, but that belonging to the Matron, Midwife, Servants, or Patients. oflM?*"" ^^'"^'" *'' "''P'=<=tion and direction ^l^cti^^"'''"'^''^''^'^"^''''^^''"^-'''--^ 9. The Nurses shall sween nnA ^l-.o„ +1 eve^^moniing before 8 o'lelTfn stmer'tdTS PATIENTS. There shall be two classes of Patients • Ist Destitute Females requiring professional attend- ance, from who., no fee shall be exacted. 2nd Those of better circumstances, wh ^ ^vish to avail ^emselves of the advantages held out to them b/I Institution on payment of a small fee. W 11 8rd. Eveiy annual subscriber shall have the privilege of recommending a pauper Patient, supposed to be within two weeks of her confinement, subject however in this latter case to the investigation and approval of one of the Board of Physicians, or the Midwife. 4. Patients shall be attended by advanced Students of the Midwifery class of the University of McGill College, or by women desirous of acquiring a practical knowledge of Obstetrics, under the control and superin- tendence of the Midwife, but Pay Patients desiring the professional services of the Midwife exclusively, must pay an extra fee of ten shillings. 6. The fee obtained from Pay Patientsshall be handed over to the Treasurer, to be applied to the uses of the Institution, and shall be in all instances paid in advance by the parties. 6. No applicant can be admitted as Pay Patient previous to confinement, for a longer period than two weeks, and must be recommended by a Priest, Clergyman, Minister, Subscriber or Physician connected with the' Institution. She must pay ten shillings a week for Board. v. If a case of distress or destitution be presented, it being ascertained without doubt that the applicant is married, or recently a widow, the Matron can use her discretion in giving admittance, and for a longer period say six weeks, but on no account shall she admit the person on the strength of her individual assertion ; unmarried women cannot be admitted a second time. 8. Inconsequenceofthe want of proper asylums for ,„ ,.^,„, „„^ iviKiy iciiiaic. III© uomiaii,U)e reserve i'^'' 12 to themselves the right, which shall be exercised by the Visitors with the utmost caution, of departing from the foregoing rules in the following cases, viz: where a Priest, Clergyman, or Minister, or Parent or Guardian, request a refuge for some young female, but the Matron shall guide herself solely by the foregoing rules. 9. Admittance will not be refused to any Patient in labour notwithstanding any thing contained in these Rules. 10. Every Patient on entering must be clean, in person and apparel, or submit to a thorough purification. 11. Every Patient must bring with her (on coming into the Hospital), proper clothing for di'essing her child when she leaves the same, and a change for herself. 12. No Patient shall be kept in the Hospital longer than three weeks after her delivery, unless by order of the Monthly Visitors, and no Patient shall be allowed to go out of the Hospital without her child. 1 3. No Patient once admitted, shall leave the Hospital without the permission of the Matron. Any Patient obtaining leave, and presuming to stay out all night, shall bo discharged, the nthly V^isitors informing the subscriber or other who i\ commended her, the reasons thereof. 14. Every Patient on admission must give her name and residence, and state whether she is married or single, and what church she belongs to. 15. Patients who are able shall be directed by the Matron to assist the Nurses or do any other business as occasion may require, and also at proper times shall knit and sew. t 18 in ' / ,^<*X» I ii 16. Every Patient shall suckle her child while in the Hospital, unless otherwise directed by the Physician. 1 1. No Protestant will be permitted to take or send her child from the Institution, to the Foundling Hospital of the Grey Nuns, unless under very peculiar circumstances, with the permission of the Visitors. 18. The Patients shall breakfast at eight o'clock in summer and nine in winter, and shall dine at one and sup at seven. Their diet shall be according to the direction of the Medical Officers, in their respective cases. They shall go to bed at nine in summer and eight in winter. 19. No liquors or provisions of any kind shall be brought to Patients by their friends 20. Patients who may feel aggrieved by any person in the Hospital must complain to the Visitors. Patients finding fault with the rules of the Hospital, to be reported by the Matron to the Physician, Directors, or Visitors. Patients transgressing the rules are liable to be expelled by the Directresses or Visitors. 21. Patients are not without permission to leave their respective wards. VISITORS. 1. Ladies who are subscribers may at any time visit the Wards, and such visits will be esteemed a favour by the Committee. 2. Subscribers and Physicians connected with the Institution may also bring their friends or others desirous of inspecting the Hospital. 14 VISITORS TO PATIENTS. 1. By permission of the Matron or confidential person in charge of the Hospital, the husband or near relative of a Patient can be admitted into the ward. 2. After delivery, the admission of Visitors must be regulated by the state of the Patient, and the direction of the Physican or Midwife. 3. No Visitor can remain longer than half an hour. WET NURSES. A fee of ten shillings shall be required of families, non subscribers to the University Lying-in Hospital, who obtain Wet Nurses from the Institution. Unmarried women, who send their children to the Grey Nuns, or otherwise part with them, to pay a fee of one pound each, on obtaining situations as Wet Nurses. The families they enter into to be responsible that it be paid within the first quarter after their being engaged. THE SECRETARY. The Secretary shall attend all Meetings and Com- mittees, &c., and takfc Minutes of the Proceedings, and enter the same in proper Books. 2. The Secretary shall se(} that the annual Subscriptions are collected in tile proper ;ime, which should be between 1st October and the last diy in February in each year, and keep a list of the Subscribers. 3. The Secretary shall send out all circulars, cards, &c., answer all letters according to direction of the Committee, draft annual reports, prepare petitions, &c. 4. The Secretary shall notify every annual Subscriber when the subscription is due. 15 THE TLI^aSURER. The Treasurer shall receive all subscriptions, dona- tions, fees, and all monies for the use of the Hospital, and shall not pay any money without the approval or sanction of the Directress and Lady Managers, except the rent and taxes of the building occupied by the IIos- pital, and the salaries of the Matron and Midwife, which may be paid in due course, unless directed to the contrary. 2. The Treasurer shall render a statement of accounts up to the last day of every month, to be presented to the Monthly Meeting held on the first day thereafter. 3. The Treasurer shall deposit the monies belonging tothe Institution, in some chartered Dank, to be approved of by the Lady Managers, whenever the same shall exceed £12 10s. 4. The Treasurer shall keep the accounts of the Hospi- tal in a methodical manner, file all bills, receipts, and other papers, at the Hospital, in order that the same may be inspected by the Committee. 6. The Treasurer shall lay before the Annual Meeting the names of Subscribers, the list of arrears, the amount given by Subscribers opposite their names, the amount of the preceding year's receipts, expenses, &c. PROFESSIONAL MANAGEJMENT. 1. Tlie Professional Management of the Hospital, shall be under the control of the Faculty of Medicine of the University of McGill College, the Lecturer on^ Midwifery of which shall be the Attending Physician, 16 other Members of the same Faculty forming a Board of Consulting Physicians. THE MIDWIFE. 1. The Midwife shall, if possible, be thoroughly edu- cated, whose duties shall, as far as practicable in a professional point of view, be similar to those of the resident Physician of analogous Institutions in Great Britain and the United States. 2. She must act under the directions of the Medical Officers, and in cases of doubt or emergency, shall have recourse to the attending Physician, or in his absence, to one of the consulting Physicians. 3. The Midwife shall not attend any labour out of the Hospital for her own emolument, or on any purpose whatsoever. 4. She must give the Matron timely notice when a Patient's labour is commencing, in order that the Stu- dent in waiting may be sent for. 6. The Midwife, who must constantly reside in the house, shall be present at every birth, and never trust the Patient to the Medical knowledge of any Student. 6. She must assist in nursing and attending upon the patients after delivery, shall attend to their diet, and for whatever is required for the Patient, shall apply to the Matron. 7. If a Physician, Priest or Minister be required, she is to give the earliest notice to the Matron, or in the Matron's absence shall send herself. 8. She shall take her turn with the Matron in attend- ing Church, and shall board at the Matron's table^ 17 MEDICAL REGISTRAR. The Medical Registrar must bo either a Physician, or an advanced Medical Stu< cijt. ITo shall keep the Ward Book with regularity, wherein shall be stated each case and its peculiarities. He shall also keep the General Registry with punctuality and exactness, shewing the name of each Patient, dates of admission and discharge, whether married or un-married. Religious persuasion,