Atlanta semi-weekly journal. (Atlanta, Ga.) 1898-1920, 1909-11-09

| each institution now had what is
known as a psycopathic or reception
| and detention building, wnere acute
cases are put to bed for a sufficient
length of time for diagnosis, and then
| transferred to the section Tor further
treatment 1t is claimed by many SUI
perintendents that this method or
dealing with patients, not only short
ems the stay in the hospital Of many,
but not infrequentIy they recover With
out being sent to the main section or
division.
In this building examinations are
made and careful histories taken so as
to get all possible light upon each in
| dividual case; the records are then
written UP to be carefully filed away
In a suitable fire proof safe or vault.
The great Importance of keeping these
records is patent not only from med
ico-legal standpoint, but for easy ref
erence. The writing up OF these pa
pers should be done by stenographers
as the physicians dictate, and so save
| a great. deal of work. Your commit
| tee believes that a building for the
purpose just named would be Of great
value, but If not able TO get this, then
some part of the present ones should
be fitted up for this purpose
Along with this suggestion comes the
adoption of some good form of records
and requiring the STAFF to carry them out.
In order to further facilitate the work
of taking. and keeping the records the
employing of at least thre typewriters
will be needed. 10. f+
TRAINING SCHOOLS.
With but one exception we found a
training school for nurses in connection
with insane hospitals. 1t is now looked
upon as a necessity for thorough and
systematic training Of nurses renders
them able to give more intelligent and
better care to the patients under their
charge. We hereby recommend the estab-
lishment of a training school in your san
itarium, the plans for which we have,
they having been drawn up at the re-
quest of the board in 1907, and with
few changes should be adopted. Along
with the establishing of a training
school for nurses there should be
nurses home, independent and apart from
the. other buildings, where their rest and
recreation would be undisturbed.
Looking into the per capita cost OF
maintaining patients we find that 1t is
computed differently in the different hos
pitfalls; some not including all expenses
in their calculations, as is done in this
institution. From a close and careful
analysis of the per capita (per' dieml of
70 insane hospitals in this country, the
the lowest with but two exceptions, 1. e.,
Louisiana state hospital, "a cents and the
Central state hospital (negro), Peters
burg, Va. Your cost of maintenance is
entirely too low as shown by the fact
just stated, and it should be increased.
That the state sanitarium has been run
for so small an amount, S4.7 cents, also
reflects great care and credit upon its
management.
SEPARATION OF PATIENTS.
The necessity for keeping the sane and
insane epileptics. the criminal insane and
the feeble minded IN the same buildings
and wards is condemned and deplored,
and should not be allowed. 1t is unjust,
and not for the best interest of the pa
tients or sanitarium.
Attention to this was advocated in the
report of the trustees in 1902. Your COM
mittee earnestly hopes that the recon-
nnendations so often made by the board In
connection with the class of patients just
mentioned be continued, and the necessi-
ty urged upon the legislature Of estab-
fishing separate and distinct buildings for
their care.
The MANAGEMENT of the tubercular in
sane seems to have been a problem in
many insane hospitals. The Importance
of this subject cannot be overestimated,
and it Is the desire of those in charge
Of every hospital to segregate these peo-l
pie. In this connection we found in
some Institutions their manner of isolat-
Ing and caring for these patients was no
better than yours. the cause of this, as
with your institution, is the need of
money. In some instances recreating
piazzas have q, been turned into tubercu-
lar wards In others, they are kept in
the large wards OF the buildings. At
Wards Island, N. Y, Philadelphia hos
pital and at St. Elizabeth's, Washington,
d. C., they have cheaply built pavilions
or wooden shacks like the one now in
use at your negro building. In some
Instances they are kept with the old bed
ridden and harmless insane for the want
of sufficient room, and secondly on the
idea that these poor unfortunates can
do each other but little harm. While no
doubt this plan is the best that can be
done for the want of room and money,
still it does not seem just or fair to the
poor unfortunates of either class.
Your committee again begs leave to re-
fer to the pathetic appeal OF the late
Superintendent Powell for the tubercular
patients under his care, as shown In his
report of 1902. Along this line let 1t also
be remembered that appeal after appeal
for means to properly care for these pa
tients has been made In every report from
this DOarQ the past CiBhl years.
until your requests are granted your
committee suggests and urges that the
appeal be continued. We also suggest
the advisability Of seeing If some parts
of the present buildings cannot be set
aside and arranged for these people. 1t
must also be kept In mind that our re-
ouirements, like those of other institu-
lions in the south, demand not only the
separation of the races in distinct wards
and buildings, but also means greater
expense for their care.
In the matter of infirmaries and hos
pitfalls in connection with insane hospitals,
we found that while infirmaries were in
the same buildings, the hospitals are
separate. and distinct, and are used for
the acutely sick and injured. In the hos
pftal buildings there are not only rooms
for nurses and attendants, but nicely ar
ranged and equipped operating rooms in
which the emergency or surgical opera
lions can be safely done. Surgical oper-
ations, however, are never performed ex-
cept by the written consent of the family
or relatives, or for extremely urgent
cases.
In the matter of care, treatment and
cleanliness of patients, and the sanitary
conditions of the institutions visited we
RuR n ZEWETEA EWEVERg