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Les cartes, planchas, tableaux, etc.. peuvent être filmée è dea taux da réduction différents. Lorsque le document est trop grand pour être reproduit en un seul cliché, il aat filmé è partir da l'angle supérieur gauche, d* gauche è droite, et de haut an bas. •n prenant la nombre d'images nécessaire. Les diagrammes suivants illustrant la méthode. 1 ^^^ V 3, ,1 1 2 3 .-.-V- 4 6 * ' « - "i 32 X , ■;*- -* m j'Ai -^■%"^fer'*i^ •4)' :# fe-^ <*t * r&^é'M'^tfî' *H-VvlWi?*^^ ■if- ^'• yTT RULES AND REGULATIONS ) or THB Mlii Al IflfiRMT OOSPim or AD QUEBEC; * ■# OPTED JANUARY, 1 8 6 4r 4 . Printéd by order or the TruHées» *"'*'*■' '■--- ' i 'i i - i rw^.\joo. QUEBEC : PRINTED BY T. CARY. ■e m i.m i^ •&'.... vseoçô^ W3%m AM® UEOTMTIKDMS ■ .1 CHAPTER I. Of THE Trustées. K, ■"'■' ' iJ!^\ T»?^ J'"'î^f '^^!^ ^°^^ hebdomadary ' meet- ings at the Hospital ; sickness alone to be considered a valid excuse for absence.' ^^% fh^^^t^H^^^v'^"»,'?! f''^%'l>etween themselves that the Hospital shall be vis^ited by one of them three times a week in summel-, and twice a week in wmter ; and the Trustée so visiting shall make a note of his visit in a book to be kept in Ihe Trustées'' room, for that purpose. y< 3rd. They shall report quarterly, thi^ough theîr Secretary, to the Provincial Secretary, on the state progress or wahts of the Institution. 4th: The Trustées shall not entertain any serious charge affectmg any of the Officers of the Institution, unless such charge be made in writing, and dulv submittedto the Trust through its Secretary, and they shall adopt the same rule themselves when addressing the Médical Staff, House S^urgeon or Apothecary on any point connected with the conduct or duty of their respective offices. 5th. They shall appoint the House Surgeon and Apothecary by and with the consent of the Visiting Fhysicians, who shall submit the candidates for thèse oflices to examination by concours or otherwise. 6th. They shall appoint the Steward, Matron, Or- derhes, and Maie and Female Servants. 7th. No money shall be drawn without the chèques bemg signed by the Chairman (or in his absence by one of the Trustées) as well as by the Secretary. \ V CHAPTER II. I ■ ■ ^ Of THE SeCRETARY-TreASURER. Ist. The Secretary shall visit the Hospital at least twice a week, at suoh hours as he may deem fit ; occasionaljy selecting those at which the diflferent meals take place, so that on such occasions he may satisfy himself that the diet is good, measured out according to the Hospital scale, properly cooked and decently served. At. thèse visits he shaliàlso enquire and examine into the condition of the several wards, their state of cleanliness, ventilation, and the conduct of the Officers. He shall enter thèse visits in the book kept for that purpose, and report to the Board, at their weekly meeting, anything he may see amiss. He shall also occasionally visit the- dead house and out-buildings of the Institution. 2nd. He shall act as Secretary to the Trustées, keep a minute of their proceedings, conduct the correspondence of the Board, give notice of extraor- dinary meetings,- and in 'case of any emergency, shall summon a meeting of the Board. 3rd. He shall prépare a Quarterly Report of the Hospital to be laid before the Trustées, which is to include the morbility and mortality of the Hospital, its state of discipline, its reqùirements, its expenses, (in détail,) and the actual state o( its funds. He shall exa- mine and checkthe Steward's accounts, and shall oc- casionally also examine and compare the diet rolls taken from the différent wards, with those of the Steward. He shall countersign the chèques of the Chairman, and produce at each quarterly meeting, Touchers for the disbursements he may hâve made on account of the Hospital Ail réquisitions from, the Médical Staff are to be addressed to him and by )ital at least y deem fit ; le différent dris he mây ^asured out coeked and ilso enquire eral wards, the conduct in the book î Board, at see amiss. house and e Trustées, onduct the of extraor- ^ency, shall Dort of the vhich is to Sospital, its penses, (in e shall exa- id shall oc- î diet roUs liose of the jues of the y^ meeting, 7e made on 1 froni, the im and by him laid before the Trustées. He is not on any account to undértake the duties of any of the Médical OflScers of the Institution, or to interfère in the least either actively or otherwise, with the médical manage- ment of the patiçnts, nor is he to express, either in their présence or in that of the officers or servants of ' the establishment, any opinion concerning the nature or treatment of the diseases, unless requested so to dobyone of the Médical Officers; but should he observe anything which, in his opinion as a médical man, would require correction or interférence, he is to make known the same to the Chairman of the 1 rustees at his earliest convenience. CHAPTER III. , Of THE VisiTiNG Physiciaîîs. Ist The Visiting Physicians shall visit the Hospi- tal daily, between the hours of 8 and 10 o*clock in 5ie morning, and at each visit shall enter their namès and the hour of their arrivai at the Hospital in a book to be kept for that purpose, to be called P^idan*' vtsittng Book, and in case of absence or ir Jtelaritv shall State the cause of the same ; they shalj^ulate the whole treatment of patients, and shall be th? sole judges of the eligibility for admission and discharge of cases provided for by law ; they shall ascertain that the medicmes prescribed are of good quality, pro- perly made up, and plainly directed ; they s^all siffn ail réquisitions for drugs and médical stores ; they shall be held responsable that ail Post Mortem exami- nations are made in the présence of one or other of them, or of the House Surgeon with their concurrence, and that no Po«/ Mortem examination be held when répugnant to the wishes of the friends of the deceased ■I 6 2nd. They shall take care that the description of the appearances after death be recorded in the médi- cal register of cases, as a conclusion to the individual case. 3rd. They shall appoint any of the'pupils duly qua- litied, to act as dressers, to take charge of a ward, or oi a certain number of patients, and to perform for ihem the mmor opérations of bleeding," cupping, &c. _^ 4th. In case of misconduct on the part of the House fcjurgeon, Apothecary, Steward or Matron, they shall mvestigate the same, hâve authority to suspend them Irom their respective functions, till thé case sHall hâve been reported to the Trustées. In case of any mis- conduct on the part of any of the Nurses, Orderiies or fcïervants, they shall hâve authority to discharee the same, if they deem lit., . ^ ^?* X^?^«^ï?" verify and sign the weekiy abstracts on the LHet Rolls of their respective wards. 6th. No Visiting Physician shall absent himself irom town while on duty without procuring a substi- tute from among his colleagues ; and in the event of such absence bemg for more than 48 hours the sanc- tion of the Trustées will be required. 7th. There shall be one day in the week set apart as the consultation day, and the jvhole Staff, if pos- sible, should be présent on thèse occasions. On this day, and m ail cases of emergency, eyery important casej whether surgical or médical, shall be submitted by the Visiting Physician in charge for the opinion of his colleagues and the line of treatment decided by the majority shall be binding upon such Visiting Physician. In the event, however, of the décision bemg m favor of the performance of an opération, the Surgeon under whose care the patient may be plâced may refuse to operate, if he be still opposed to the t x X scription of a the medi- 3 iodividual s duly qua- a ward, or lerform for pping, &c. the House they shall pend them shall hâve " any mis- Orderlies discharge 1^ abstracts 3t himself g a subslK e event of th€ sanc- : set apart r, if pos- On this important submitted opinion of scided by Visiting décision ation, the )e placed ed to the opération ; but m that case the patient shall be allowed to place himsetf under the care of oneof the Sur- geons favorable to the opération, provided "he should so request. ^ CHAPTER IV. Of THE, House Surgeon. Ist. It shall be the duty of thë House Surgeon to receive such patients as are provided- for by law. or recomnnended by one Trustée, to attend to them and perlorm such duties as the nature of their cases mav require, until the visitof the prescribing PhVsiciaiL m the event of a patient being admitted affer the mornmg visit, he shall prescribe his diet for that day entering the same on the diet roll as extfas. ' ro.!J •ÎÎ^J^^ÎIt^""^^"^^®^^» 'ts proper place the Sf Ir^^^^^v"^' '^^^' ^«"'^^'-y» Religion, &c.. of the patient, and if a mariner, the nameofthe vessel.' He shall, ajso, without delay, enter tHe î>atient»s name L I ^^f ^"^ Ï^P* ^""'^^^^^ purpose, leaving blank ' Ae columnfor the na^e ofthe Disease. which he must obtam as soon as possible fromthe Visiting Fhf'^ aJJ^' ^°-^" F^^f emel-gency, he shall, without S/^iP"'®' ? **"«' thO^isiting Physician under whose charge the patient falls? 4th. In cases virhere he Is informed that the Visiting h« Œ*"' ?»not attend at thç regular stated hours! he shall perfprm the necessary duties, and cause to «nH Jîff ?-^ -'" î.^ •^^"'•'*'^' *" '•'«c*» prescriptions 5"uit s^ r nce/ " '' "^' "^ P"P^^ '^''^' 5th. It shall be his dtitytoaccompany the Visiting ^ ^itgt^ \ • ~y: 8 f i ; tentcn ne tnaUvmt Me wards twice at least durine thé diate^r after the visîts, and he shall âai?sf/?hSf ,7thf Should any symptom ^Hse in a patient neces- sitating, in h»s opinion, a change in the prescrimfon ing Physïbian,,or to change such treatment or pres- cnptioi,, and wfite the same in thè pZcriptim Book s ^uW^^^^^ the VisitingPhysicia^attheen- Sth. He shall hâve charge^of ail the surgical instru- ments belonging to the Hospital, causing hem To be stamped with the letters -m! &E ïf » wTere practicahle, and shall be responsible for the same see S^^aL'r^^'^^^^ of the médical lVsa„d the'mo^triId:c:nX^ order and used with nlv îf* u^ ^Y^' *^^^ ""^'^ t^ ^^^« «n adéquate sup- . plyofall médianes m ordinary use andMl not fail to hâve the stock prescriptions always made up ac- ^ CiSy '''"^°" Dispensatoiy'or the. H^al lOth. He shall submit to the Visiting Physicians for of the medicines required and their quantities befoA being purchased ; the Pa,8 Book to be returaed ^ him with the nr ces of Ae several articles eS' llth.He shall see that the directions of the medi- cmes ordered and,the number of the bed of the pa- { ■ a\ f .r*;"? î*? "^ ordered. are plainly writlen andlabelled ànd that the nurses hâve clear^ insCc" lions, to gu.de then,, as tothe quantiUes to be given H^f^rp •?•" .w ''"' ,''"'y '° »sslst and instruct the House Pupil ,n (he performance of 6is several duties sS'çî'^rn l;'.*^ '^""'^ ^^ p-^--" -'^ 4S N 1^. He shaïl satisfy himself of the qùalitv of thé bread, meal, Sf^ sent by the centrâctors, and shalî I4th. He sfiall compare the Steward's weeklv diet saL"',f hf^n" ""^ ""'^"'"ï ^''^'''^'- and slgVt^e same il he find it correct. I5th He shallenter in détail, in the Case BooL ail cases of an interesi4ng or ejttraordinary nature, nMns as complète aj^istory of the disease froÈhs^èom? * mencenjejit as /an be ob^tained, with the treatmentTn Hospital and the resuit: in Wry instance maS he record as complète asUssible: - ^ . I6th. HeshallrepoT?we«klytothe^ Trustées, in the ^3eat JiT'-t' ""^u^^'' «f admissions, discharges a^ monthry ^nd yearly reports, the latter on each'SIst of S,Hfn™th''' '''^ "' "^"."^^" ^^^^'^ «^ practicable, and obtain the signature of the Visiting Physicians to the tîpn JIk' ^u^ '^^'^ ascertaia on the admission af a 6a- n ?K K V^ '»°!î^y>?nd effectâ arcregularly entered m the book kept'by the §[feward for thit purpose, and t?anVh.7 ^«^.«^^«l^verify by adding bis iLals there- •InnuirP^f rV*"" P^t'^"<^»«,^yes thé Hospital he shall 2ne?n! ^^^'T"^ S^-^P'"'"* '^'^ti>'« ^o his effects, Sans' "^' andifBore^portittothe Visiting 1 ^ I J =f^ B ■/-- tv / 10 •/ ISth. He shall ncjt absent himself for anv lenath nf tune from , the Ha^pital whhout the cS^'^i^ 19th. He shaH hâve under his particular câre ail 20th. Ail Posl Moriem examinations are to be oer- smng Physj^ians, or of the House Surgeon whh the concurrence of the former, and a car^ful" record of reqmre^ ,o report to the Visiting pS^siciaSs pr S Trustç/es any irregularities of conductduring?heTr^! tendance at the Hospilal or in the dead hS which S:%re! """"" .''' '""'^'«•'S^ "' f™» -y ^ed^ wajis except m company with one of the Visitte» PhTsicians or himself in thiir absence, unies, to v sf patents especially placed under their'cïârge! asrd. He shal see that no pupil attends the médical or étirgical practice ofthe H^spital, witho-ut harinJ premusly produced a card from the~ta.v Tof «nmhe shall have snbscribed his name in T^J^," 24th. He shall not upon any account engage in me- HÔsphaV"^'""' P""="^«' " °*«^ businesf -"ou. ofle 25th. He shall not be allowed to have in the Hn«. pitalany pupil, relation or friend to board or lodge » -V,^.'.'j!^j-:^ia'i.-.a's''' ■■' ■| ; - ■ ':V [ 11 any length of 3nsent of the it during the ular câre ail •elief; enter- sir name, dis- le pf the ves- re to be per- ne of the Vi- :on with the ul 'record of 3rovided for Flouse Sur- particularly jns pr to the ing their at- ouse, which i any credi- any of the the Visiting less to visit •ge." the médical out haring retary, nor the pupils' âge in me- , outofthe Il the Hos- or lodge ^ 26th. He shall not be allowed to occupy more than the two rooms now allotted to him in rear of the sur? 27th. Heshall hâve suprême control, in the ab- sence of the Visiting Physîcians, of ail OfficersTSet vants, &c., m the Institution; and be hejd generallv ScTotdut; *'";. ^^"'"^^ ^"^ - cas^eoranj ^!nnTJ\ k- ^' 1°" ^^^''^ «^ ^°y Servant, being Se^rvants îmt* ^" 'W.'^T^d such Ser;ant o? ondmy. ^^"^^^^«^t^^sitof the Visiting Physician fJ^^^\^? shallgive three months' notice of his in- tention to leave the Hospital/ CHAPTER V. ^ Op THE APOTHECARY. ' 2nd. Itshall be his duty to keepihe Surgerv the medicnes. and médical stores, clean and ."nS or the mn« ri' "?"" ''" """ ""« >"«<"-='->«» are ufed whh :b:re;^^?tr;.s^Lnt^ri?.:^td^[: 3rd. fie shall enter the medicines required in thA i« ?iîig «f the dead and dehver them to the nearest relativesof the de- ceased when they are ascertained, under the authority thVi.JT^^'.'''y^'"J"«f Physicians. Incaseof the death of a sailor he shall: conform as regards his effecu, to the Impérial Act providfcg for the^same. 16th. He shall not absent himself from the Hospi- HouSgT^^^^^^^^ "*^"^ ^'^ P^™«^'- ^' ^^ CHAPTER IX. ^ Op THE MaTROW. Ist. The Matron shall visit the wards eyerv morn- ' mg and as frequently as she can during the day, par- I ticulariy those occupied by females, aSd see that the ' nurses are attentive to the sick, and thàt the wardfl ^patients are keptclean, »"« «e wards 2nd. She shall take particular charge of the lincn-^ and keep rt m good repair, and see that the articles seni to be washed are duly returned by proper lists. Whcn- llVTl <>ftl»«ï'nfnistoafar womtobe repaired, she shall separate die same from the rest to W hinded m m 4. % t 18 ê tr overtothe Steward, who shall submit the same to the Trustées as already provided for. 3rd. She shall arrange with the Steward for the due entry of such in his book of gênerai stores. 4th. She shall see that the drinks and little comforts forthesick are neatly and properly prepared, atid especially that the Nurses treat their patients with tenderness and watchfulness. 5th. She shall report any misconduet of patients or servants or any other irregularity occurring in the House to the Ho use Surgeon. *^ CHAPTER X. Of THE Ordsrues and Nurses. •/ Ist. Those onlyof good charaWer and of active habits shall be engaged. *2nd. Their duties are to attend the sick, to afford* them ail the assistance their infirmities calUor, to give them their food and medicines as directed, and to keep their persons clean, as also thç wards, passages, &c., under their charge. 3rd. They shall take care that 'every patient is washed and the wards swept before the morning visit of the Visiting Physicians. 4th. They must mjnutely watch over the patients, and report to the Physicians ail the observations they hâve made since the previous visit. If unfavorabil symptoms appear in the intervais, they shall imme- diately inform the^House Surgeon of the same. , 5th. They shall serve the meals comfortably at stated hours. ^ 6th. They shall immediately report to the House Surgeon ail improprieties of conduct. 7th. They shall bé on their guard, lest improper he same to for the due tie coroforts pared, aïid Uients with ' patients or 'ring in the s. 1 of active if to afford* (for, to give ind to keep sages, &c., patient is jrning visit e patients, ationsthey infavorabla lall imme- ime. , fortably i^t he House improper \ 19 articles of food are brought to the patients, and report ail who are guilty of the same. 8th. They shaîl be assisted in cleaning the Wards and m nursing the sick during the day by such conva- lescents as may be pointed out by the Visiting Phv- sicians or House Surgeon. \ » J 9th. They shall obey ail o'rders they may receive Irom the House Surgeon, Steward or Matron. lOth. They shall be particular to remove imme- diately ail offensive matters from the wards, and see that^the beds and personal linen are regularly changed. 11 th. They shall not absent themselves from Hos- pital without permission of the House Surgeon. CHAPTER XI. Of THE CooK, House-Maid, Porter and ASSISTANT-PORTER. 1 St. The Cook shall be held responsible for ail articles placed under her charge by the Steward or t Matron. She sha l keep her kitchen and cooking utensils clean. She shall be punctual in the i>repa- ration of the meals, and upon no account whatever sùall She permit any patient to' enter the kitchen except when accompanied by a nurse. She shali fortabr^^ ^^^^^ ^° ^^^ servants in their hall corn- 2nd. The House-Maid shall receive her instruc- tions from the Matron. 5rd. The Porter shall receive ail patients and con- duct thein to the House Surgeon. He shall be civil and obligmg to ail visitors and _,accompany them to the Surgery, and on receiving permission shall con- duct them to the patient whom they may be desirous ^ T il' 20 of seeing. He shal! be careful that no article of diet or spjrituous licgors bé surreptiUously admifted iito ae shall warn off tbe premises ail strangers or im- gâte and main approach to thè Hospital clean bf sno7 lood'ordT" "'" '^^P *^^ same'swept n^aTaXn rJr^'J^^ Assistànt-Porter, 0p outside servant, shall çarry al messages and shall otherwise receive his instrucuons from the Steward. from^hJHl^^*!:' °^'^ "'L^^^^" '^'y may^eceive Th Th S h"'^^°î* ^^^^^^d or Matron. nw! Jr^y ?*" °°* ^^'«eût themselves from Hos- pital wuhout the permission of the House Surgeon CHAPTER XII. Op th£ Patients. Ist. No patient shall smoke in the Hospital exceot ^ specia permission of the Visiting PhysiS • Sit^' no 7^' T ^^ -^^ ^^«^«»« °r proS Tan: S^!k ^'^ ^^""^ thewardinwhichheorshe shall ?endinf?liP -^' '''%'''' Permission from the At- S^vfc^^ "•"'' Surgeon, or unless re- ^ o J r?,"*"? *o g>ve assistance. rpZ;* ; *t^ ^^i"^" ^'^^^^^^^ themselves with dOe Hosphll ^'^''"' ^""^^ ^"^ S^^^ts of t| eve?;haliemi'rfk!''"''r^'''"^P'*^^^^^^ ^hatso- nnill enter the apartments or wards for females ' unless required by the Physician to give assLance wardS'^^^^^ thi apartXts of l^Wchen except wta ^^^„^|S - id^ I ^ \ ôth. Friends àffcl relations will W allowed admis- sion to patients on Mondays, Wednesdays and Fri- :days, from 1 to 4 o'clock, P. M. ^application to the House Surgeon; he shall al^o admit at other times such visitors as the spécial nature of. the case mav require» . / • ^ j 6th. No friend or relative shall be permitted on m pretext whatever to intro^uce into the Hospital for^the use of any of the patients, béer, wkie, spirits or any article of diet whatever, #ithouf permission irom the Yisitisg Physician. 7th. Every patient shall retire to bed at NiwEi p. m., gom the first of May to the first of Novei^er ; at EiGHT, p. w., from the first of November to the first of May; and those who are able shall rise at Six, a. m., during summer. and at Seven, a. m., during winter. 8th^ Such patients as shall be considered able, shall assistlhe Nurses and other servants of the Hospital in nuràing the patients, makin"g the beds, cleaning the wards, and doing such other work as the Attending i'hysician or Surgeon may direct. Any patient or patients notconformingtotihe ByrLaws of the Hos- pital shall incuf thep^l^of expulsion, , 9th. Allcomplaintson'thepartof the patients to i*!! u ^rî? ^^^ Visiting Physician at bis next visit. lOth. The»body of no patient, dying in the Hospi- taf, shall be removed for interment until twenty-four hpurs m summer, and thirty-six in winter, shall bave elapsed after the death, except by the spécial per- mission from either the Attending Viisting Physician or House Surgeon. * ^ JAS, A. SEWELL, M. D., Chaibjman, A. C. BUCHANAN, , Cnr^F EuioRAtioN Officer. O^ ROBITAILtE, M. D. PH. WELLS. SeCRETARY-TreA SIIRER. «n v m s INDEX. ''V' x-'t'é Chapter I. — Of the Trustées 3 " " II. — Of the Secretàry-Treasurer. .,..'. 4 .Ç/'—'Of the Visiting Physicians 5 ly. — Of the House Surgeon j^ V. — Of the Apothecary^ '...,. VI.— Of -«^ -»■*:'• ■". • t ,_. .« .*< » ., > \, ^^ ' PAGE. . 3 4 • ••••• 0- • • * • • J|| * * * */fb<' ^'^ .'.... i4 15 • • • • • il • • • • • lo Porter ..... 19 » . • . • ^1/ fi. i 5^' »'?i y u_^ f?" '■ •l- -1 . ' 4- V \ , - ; ' " . ' ^ *- \ ^< ' -• M ' ' l! —-^ ■ • ■ *. - S V - . 4 , - • - .i-".. f »>•■, •• ' * . ^ ' ..:-^.:V: ■' N^ <; "^. v