Old Bega Hospital History - Chapter 4
ELLEN Clarke was appointed as the first matron of the hospital. For many years she had a fruit and confection shop in Upper Gipps Street, and also sold cakes and pies. Although she had no formal nursing training she had assisted Bega's only medical men, Dr Shiels and Dr Evershed, as a midwife and nurse when patients were nursed at home. Her husband., Robert, who was described as bluff, bulky, bearded and cheerful was wardsman. Presumably they lived in the only bedroom for staff on the site, the one behind the kitchen. It is not known how many nurses were on staff but a photo taken not too long after the opening has Mr and Mrs Clarke in a group with four nurses, and in another early photo three women are obviously nursing staff and another looks like the servant. Names of three members of the nursing staff were Miss E Bell, Miss L Hill and Mrs W Atfield. Nurses were being trained in the colony from 1868 when the first school was started at the Sydney Infirmary by five Florence Nightingale trained nurses from England, but it is doubtful that any nurses at Bega Hospital in its first decade had any training.
At the hospital's annual general meeting reported in the Bega Standard of 31st January, 1890, the Board was very gratified by the institution's operations and satisfied with the manner in which the matron and wardsman had conducted their ward and general duties. The premises had uniformly been maintained with thorough efficiency, the doctor's wishes as to patients had been observed scrupulously, patients have been nursed with skill and kindness, and the directions of the Board had been obeyed. In recognition of faithful service during the year a gratuity of five sovereigns to the matron was recommended. The Board thanked Dr Marshall for his careful attention to every requirement of patients, but it was agreed that further honorary duty could not be expected from a medical practitioner and financial arrangements must be made for medical services:
Much had had to be done to bring the establishment into working order; but by degrees everything was fitted into its place. Experience gained by successive house committees has suggested the best present method of supplying wants; and, as the occasion came, additions were made to furniture, and house and ward necessaries; and improvements were gradually carried out by fencing, tree-planting and otherwise.
The Board has constantly tried to combine efficiency with economical administration of the revenue, and has much pleasure in reporting that the incoming committee will begin the new year with no debt to struggle against. The building and premises are in creditable order, and the buildings are insured for £1,750 in the Australian Mutual Company.
Members of the outgoing board were very critical of Sydney medical officers who they said had forced them to have the two earth closets practically under the same roof as the wards. This closet accommodation sanctioned by the Government officer has proved an intolerable nuisance. The disuse of these arrangements have been ordered, and detached conveniences were being provided for male patients. It is unclear how the female patients managed. They also said the fire grates in the rooms were useless and had to be removed to allow the open hearths to be used.
Three members of the Board acted as the house committee for a month at a time. They had purchased furniture and looked after the fencing, laid out the garden and improved the land. From all sides assistance and support has come when an appeal was made. Cash donations were received from a number of individuals and the Bega Royal Orange Lodge, while W Allen and H Otton had each supplied a cow, so comparatively little has been spent on milk and butter. Mr Stiles has paid the butcher's bill and Mr Gowing paid the baker's account. Candelo residents gave £20 11s, the proceeds of a ball and Albert Montgomery's recital added to the funds. The Bega Minstrels and Cottier and Walton's troupe are to pay a donation of £11 12s 9d. The Debating Club contributed £4 12s 9d. Messrs Guthrie and Besky's road camp sent a nice Christmas box of £10 12s 6d. Many ladies have sent linen, flowers, preserves and sundry casual, but acceptable donations of books and other articles, direct to the hospital.
In March, 1890, the Standard mentions that there were two new patients in the hospital, one with a broken thigh and the other with a gunshot wound. Nothing at all in the paper as to how the person was shot, but quite a bit on the fact that someone came by night to the hospital and stole a collie pup off the chain:
Nobody has any business on the premises after nightfall without the regular order for admission, and anyone trespassing without this will be prosecuted. The committee has resolved to give £5 reward for conviction of any trespassers after dark on the hospital grounds.
In May there was a Children's Ball held in aid of the hospital. Tickets were available at the door with children charged one and six, and adults two shillings. Not more than two adults could accompany the family but spectators were admitted if they paid two and six.
In June a decision was made that supplies of bread and meat be procured alternatively by the bakers and butchers who are subscribers to the hospital. There were two male and two female patients in the hospital on the 1st June and during June there were three males admitted and four males and two females discharged. In early August on a Saturday night a bit of a fire occurred at the hospital. It appears a fire was made in the fireplace in the male ward, and by some means it caught the studding of the wall. The Matron, Mrs Clarke, smelt something burning, and on opening the door found the room full of smoke. Mr and Mrs Clarke and the servant saw where the fire was, and soon extinguished it before much damage was done. There were no patients in the ward at the time, the only one in the institution being a little boy, and he was in another part of the house. This report raises the questions as why was a fire made in the male ward when there were no patients there.
Ellen Clarke has been matron for ten years when a trained nurse, Nurse Rutter from Sydney, was appointed to the hospital in August 1899. This move was so badly handled by the hospital committee that a few months later the Bega Gazette and at least two district papers were reporting on the ructions caused by Nurse Rutter's appointment, with tales of conspiracy, incompetence, drunkenness and ignorance, resulting in both Nurse Rutter and Matron Clarke's being dismissed from the hospital. After a month at the hospital Nurse Rutter she was questioned by the Board's sub-committee behind the back of the Matron, as reported in the Bega Gazette:
Whatever the nurse said, right or wrong, no chances were given to the rest of the staff to confirm or contradict. The nurse was engaged to 'act under the Matron', and we find that doctor's orders are to go direct to the nurse.” The paper criticised the committee and the Hospital Board for bad management in allowing the institution to have two heads, two bosses, a condition of management that can only provoke disorder. “The Bega public will never allow Mrs Clarke, who has given magnificent service for the last 11 years, to be sat upon . . . the Matron shall have under her charge all linen, bedding, kitchen utensils etc, and that she shall report to the House Committee when the stock needs replenishing. If anyone is allowed to interfere, how can the Matron be responsible?
The Cobargo Chronicle of 29th September weighed in on the dispute:
There may have been ructions at the Bega Hospital before the trained nurse arrived, but we never heard of them. Contemporaneously with the resignation of Mr Braine (editor of the Bega Gazette), from the committee and the advent of Nurse Rutter, we have had periodical reports of it in the Gazette of disagreement between the matron, the nurse and the kitchen maid with occasional accusations against the committee of holding secret inquiries into the conduct of the matron behind the back of the individual. In looking over then names of the committee, we find they are all well-known, level-headed and reputable men, who can be thoroughly relied upon to do their duty by the Hospital in an honest and upright manner, and we are certainly loth to think, as suggested by the Gazette, that they were doing anything so inconsistent with fair dealings as to try an employee on the institution behind the accused's back. The whole trouble seems to surround the appointment of a trained nurse, a progressive, though tardy step for which the committee deserve commendation. Perhaps it was only a coincidence that Mr Braine resigned at the meeting when the decision was arrived to engage the nurse. The fact that he jumped up from his seat and petulantly exclaimed 'the committee could accept his resignation', gives colour to the suggestion that he hardly approved the action of the committee and his subsequent hysterics in the Gazette bear out this contention. Now the kitchen squabble, as reported by the Gazette, is all wrong and we are in possession of the real facts, we will give them for the information of the subscribers of the Hospital and the inquisitive public. The matron, not unnaturally, does not like the introduction of another woman (the trained nurse) into the hospital, and has resented the intrusion on what she considers her domain. And when one women lays herself out to be is nasty to one of her sex the attempt is generally eminently successful. Nurse Rutter went into the kitchen to prepare food for a patient. Taking a saucepan, she turned some cold water into it to rinse out. This precautionary action the kitchen maid interpreted as a reflection upon her cleanliness, and, snatching the culinary utensil from the nurse's hand ordered the latter to leave the kitchen. Truly a nice proceeding on behalf of the main. The nurse, very properly, complained of this treatment to the matron, but received short shrift for her pains, for the latter instantly flew into a temper, and amidst a voluble flow or oratory referred to the nurse as a 'bit of a thing', whereupon the latter telephoned for some of the committee. The matron owned up to her conduct and a partial reconciliation was brought about, and once more harmony reigns at the Bega Hospital, and we hope it will long exist. No one denies that the matron has done good work for the institution and there is apparently no desire to part with her services. And a trained nurse is also an indispensable addition to a properly regulated hospital, and even if Nurse Rutter is goaded into resignation, there is no doubt another will be appointed into the position. We are strongly of the opinion that the Government should insist on certificated nurses being attached to every hospital, for next to the medical attendant, the welfare of the patient is dependent on the care and skill of the nurse. The matron, the trained nurse and the kitchen maid are all necessary to the efficient management of the Hospital and the sooner the Bega trio settle down to an amicable relationship the better for themselves, the committee and the public. If this is not done the only course will be to sack the most dangerous firebrand.
The Chronicle then went on to say that the Gazette “was wilfully misrepresenting incidents and distorting facts with the designed object of bringing the Hospital committee into disrepute with the public and Nurse Rutter into contempt, We see no necessity for the hysterical antics of the Gazette and should advise its protegee, the Matron, to fall into line, instead of inciting her to rebel.”
A month later things had got worse. A lengthy report in the Bega Gazette of 18th October gives an indication of what was going on but it must be noted that the editor of the Gazette, William Henry Braine, starts by laying the blame on those whom thinks responsible:
Mischief may be done through ignorance or by design. In the cause of the Bega Hospital Committee some of the members are acting by design, others are led by a ring through the nose. As individual faddist like Mr Pell flits about in most public matters like a butterfly to find a new spot for egg-laying; his thorough ignorance of the internal works of the Hospital cause a butterfly simile to be not quite appropriate; be it rather as a moth rushing to the light would be more useful if let alone. The great plot is to get rid of the Matron. Mr Atkinson tells about long ago when the late Mr Robert Ritchie conceived a dislike for the Matron; so he said to Mr Atkinson: 'You go on the committee and get that woman kicked out'. Mr Atkinson was elected to that committee, went with animus and bias to view the Hospital; saw how the Matron was acting; saw how wards and passages and kitchen and all else were scrupulously clean; saw the patients were watched and tendered with experienced skill and motherly devotion and tenderness; saw that nothing was neglected. Daily visits conquered Mr Atkinson; he went to condemn the matron; he lived to tell Mr Ritchie that his estimate of 'that woman' was drawn from wrong sources; he went out like an old prophet, to curse, but his curse was turned to blessing. Mr Atkinson knew; Mr Pell and Mr Bathgate do not know; and that is why they want the Matron to go. Mr W Scott is another; he keeps the Treasurer's books as only a banker can keep them; but about the ins and outs of daily routine, of management of wards, house, kitchen, he knows little or nothing. Mr Leo writes up the minutes and attends to the Secretary's work; but he has visited the Hospital, like the others, about twice a year, and has not knowledge of house requirements, can make no estimate of the value of Matron's heaviest work.
Mr Braine then goes on to praise the Matron and the work she does:
If any woman in the district knows how to make beef-tea or other sick-room nutrient, we say that woman can teach Mrs Clarke nothing. Yet the new nurse has frequently condemned and sent back to the kitchen the food prepared by Mrs Clarke, and as such there has been needless waste. Moreover on Saturday we inspected a sample of greasy cooked rice that had been sent to the Hospital by one of his friends for the use of a patient; it was rubbish; yet the patient had been allowed to eat some of it; it was called 'sheep's head broth'; a well-bred dog would have turned up its nose at it.
This sentence shows how involved Mr Braine was in this dispute acknowledging that he had been called to the hospital to taste the alleged bad food.
Again, broth sent back by the Nurse to the kitchen, because the patient said it was not nice, was inspected by Dr Marshall, and pronounced good enough for everyone. It is easy to set a patient against food ; a word or a grimace; or an innocent suggestion can overturn the mind of any bed-ridden person. Dealing with sick people tact must be used; any effort to produce disaffection in a patients' querulous brain pan is very easily made, and must always be effective. Any nurse with experience knows this, and avoids it. As for the food, and its preparation, Mrs Clarke is, first of all, a pattern of cleanliness; one of her demonstrations of laudable pride has been to take visitors into the kitchen; after they had examined the kitchen range with its burnished and polished surface, and had noted the scrubbed and spotless states of the shelves and other wood-work and the general absence of dirt and untidiness, the Matron would pick up a saucepan, pass her hand around the sides and bottom of the utensil, and hold up her palm guileless of speck or blur. This is the sort of utensil which a good nurse, but a bad cook, sniffed at, and very unnecessarily rinsed out, with the result of rousing the anger of the girl under whose hands the kitchen arrangements were made.
We are told that Miss Rutter is considered by the Medical Officer to be a competent nurse; she was engaged to be a nurse, not to manage the house. The nurse was not engaged to cook, to make beef or arrowroot slops, or such like; she only had to ask Matron and all articles of that sort would be supplied. In face the nurse seems to be not only not a cook, but a bad judge of what patient's food should be and how it should be prepared. For instance one day when fish was boiled for a patient, the nurse looked at it and said that was not the kind of food cooking she wanted; she said she wanted 'soused' fish; but when requested to explain what 'soused' fish was. She said she did not know exactly but it should be fixed up with vinegar, lemons, spices and things of that sort. On another occasion she said there should be onion, parsley and herbs in beef-tea. Thus an excellent nurse, but grotesquely ignorant of house management has been allowed by the Committee to have the run of the kitchen, and to make numerous comical experiments for the delectation of the patients. There is not one single member of the Committee who knows what the domestic wants of the Hospital should be, or who is competent to draw out a bill of fare for the Matron's guidance. Drift and drivel and the end will be destitution and the debacle. Some questions ought to be asked by the public are as to the increased cost of the washing bill; the increase of the butchers' bill, the destruction of sheets and blankets, and the puffed up condition of the fowls waxing fat on condemned food.
Much is left to the order of the Medical Officer. But what is the Doctor doing now? Mr C T Stiles made a great fuss, because as he said, the Wardsman who waited on poor Jimmy Law, a typhoid patient, actually went out and about, and milked the cow; and Mr Stiles objected. Just now a patient has developed typhoid and remains in the male ward. Mrs Clarke, single-handedly last year nursed nine typhoid patients at one time; in this month of October consent to a patient remaining in the general ward (the Nurse a month ago said she would insist on this if a typhoid patient came); and for this one patient Mrs Lodge has been engaged at one pound a week. The question is where does the trained nurse come in? It's easy to see where the funds won't come in next year. And the Wardsman's bed has been moved three times, and at last he has been sent to sleep in the fever ward; perhaps he is full of joy that he has not be ordered to camp in the fowl house?
This above paragraph has some curious features. By 1884 the bacillus causing typhoid had been identified in Britain, and that typhoid was caused by contaminated water or food from the faeces of an infected patient was known, so Stiles might have been right in pointing out that the wardsman, Bob Clarke, should not have been looking after a typhoid patient and then going out and milking the cow, but why, with a trained nurse at the hospital should Mrs Law be engaged for that one patient? Also why was Bob Clarke not sleeping with his wife in the bedroom attached to the kitchen?
The Gazette went on to say:
If the full committee, as selected in January by the subscribers. resolved to something with the pretty name 'trained Matron' an honest course would have been to give Mrs Clarke at least three months' notice, and, in consideration of her long and good service, an ample gratuity or bonus, or say £5 a year or £50. The scheme has then to worry the Matron into some impulsive action so to have an excuse for discharging her. Nurse Rutter has said that she was told the Matron would resign, and the Nurse would probably step into her shoes, also that the institution was wealthy, and would grant whatever the nurse wanted, and so, between the nurse's expectations, the doctor's abstention from laying down the law, and the seemingly intentional delay in making rules for the guidance of the nurse and Matron, a very peculiar situation has been built up.
On October 20 the following comments were made in the Pambula Voice:
Serious trouble has arisen at Bega Hospital owing to friction between the trained nurse and the Matron. After a number of special meetings and several inquiries into alleged complaints the committee have given the Matron a month's notice and the nurse three months' notice that their services will be dispensed with; and a trained nurse to act as Matron is being advertised for at a salary of £65 per annum. Meanwhile the two lady officials at the hospital cannot avoid clashing occasionally and in consequence some lively scenes are reported. A Special General Meeting of hospital subscribers is called for Friday 27th instant, to consider the action of the committee, and deal with the appointment of the new Matron.
The 3rd November edition of the Pambula Voice gave a report on the Special General Meeting:
At the meeting subscribers to the Bega Hospital, held on Friday, after a lengthy discussion the action of the committee (re nurse and matron etc) was endorsed and it was decided to grant the retiring Matron Mrs Clarke, a bonus of three months' salary. Dr Marshall stated he had been informed by the Matron that the nurse's weakness for brandy was the cause of all the trouble.
She had reported to the doctor that an unusual amount of brandy had been used lately, that not only had Nurse Rutter been drinking the brandy but she was getting grog up to the house and doing away with the bottles. The committee asked the matron what quantity of brandy had been supplied to Nurse Rutter during her two months' residence. The quantity was carefully checked with the diet cards from day to day, and allowing for 25 ounces to the bottle, every ounce was accounted for as consumed by the patients according to the medical officer's directions. Nurse Rutter was exonerated from these charges made against her. Ellen Clarke's husband Bob had been appointed hospital wardsman, and he lost this job when his wife was given 27 days notice in October 1899. The hospital committee moved that Matron and Wardsman be given £25 bonus, equal to three months' salary. Mr and Mrs Clarke left on the 7th November after ten and a half years good service. He died not five months after from stomach cancer at 76. Mrs Clarke also died at 76, in 1911.
A shocking accident in Carp Street in 1902 highlighted the need for an ambulance. A coachman was unloading the mail at the Post Office when the horses bolted. As they turned into Gipps Street the coach overturned killing Mr Roger Heffernan of Moggendoura, and seriously injuring Miss Allen, a hospital nurse, who had both legs broken. It was noted that “the injured had to be lifted up bodily and carried away and the torture Miss Allen endured while she was being carried away was something frightful”. At a public meeting in 1906 a wagonette ambulance, locally built by Whyman and Brooks at the cost of £67, was handed over to subscribers.
In 1904 extensions and outdoor toilets were provided by replacing the wooden western men's section wing with a new brick extension at the cost of £1,094 7s 6d. Mrs R Ritchie donated an operating table, Dr Bruce a surgeon's stool and Dr Marshall a glass-topped table. The matron was now Miss Moore and her work was described as one of the best of managers and was both conscientious and trustworthy both in her general duty as Matron and in the care of patients.
At the annual general meeting in January 1909 the Bega Standard reported:
A tender has been received for pulling down the old wooden ward on the eastern side of the building and erecting in its stead a fine brick ward which will meet the requirements of the institution for many years to come. The contract price for these additions amounted to £1,413. The building is nearing completion and will overcome the difficulties so long experienced owing to the ravages of the white ants on the old wooden building. A proposal to provide a septic tank has been under consideration. Nothing conclusive has been arrived at. The system is excellent but a satisfactory water supply is a major problem. Owing to the increased importance of the Institution since its status has been recognised as a Training Home for Nurses, the steady growth of the number of patients admitted for treatment, and the very large number of surgical cases requiring attention in the wards, your Committee has deemed it necessary for the welfare of the patients that an additional trained and qualified nurse should be appointed at £50 per annum. Applications have then been called for a thoroughly qualified trained nurse, to commence duties with the opening of the new addition. The medical gentlemen have had a very busy time, 419 visits being made by them, and the work of the staff has been exceedingly heavy. One hundred and ninety-nine patients were treated in the wards, and 183 received outdoor treatment an medicines. Thirteen people died and some of the deaths were due to intestinal problems and peritonitis, enteritis and haemorrhage, malignant disease of omentum, epilepsy, rodent ulcer, appendical abscess and general peritonitis, pleurisy and septic arthritis, cholecystitis and peritonitis, acute enteritis and bronchitis and heart failure.
Eighty operations were performed under a general anaesthetic, the great majority being done by Dr Ramsay Sharpe, and many minor operations under local anaesthetic. Over the past year there were three cases of typhoid, five of influenza, four of pneumonia, three of bronchitis, four of pleurisy, three of phthisis, two of empyena, seven of heart disease, three with a gastric ulcer, four with dyspepsia, three with enteritis, three with internal obstruction, six with appendicitis, two with peritonitis, five with hernia, four with anal fistula, one had cholecystitis, four with nephritis, one with a tubercular kidney, one with pyosephrosis, two with cystitis, one with enlarged prostrate, five with phimosis, urethral carbuncle, one with neurasthenia, one with chorea, one with hysteria, one with epilepsy, two with rheumatism, one with varicose veins, two for herpes zoster, two with eczema, one with enlarged cervical glands, 21 with enlarged tonsils and adenoids, one with a hare lip, one each tumour of the breast, the leg and the side, one each of malignant disease of the liver, omentum and lip, three had rodent ulcers, one from peritonitis, two with synoritus of knee, two with concussion of the brain, one each injured their elbow, finger, rib and lip, two with ankle, feet and leg injuries, there were four poisoned wounds, two with cellulitis, two with burns, one with abscess of the lachrna and two with a mammary abscess and leg abscess, six with leg ulcers, fractures of the scapula (two), clavicle (one), arm (one), ankle (one) and leg (two), 31 uterine complaints, one ectopic gestation and one pelvic cellulitis.
It should be noted that no babies were born at the hospital as most women were still having their babies at home with midwife care and there was now a private maternity hospital in Newtown.
The new wing was opened on March 6, 1909. The Bega Budget of the 6th March, reported:
Mr J J Ritchie, president, opened the new wing in the presence of a large attendance of the public. Mr William Manning was the contractor for the work, and it is almost supercilious to say that it was carried out in a faithful manner, as is the case with all this tradesman's jobs. A short history of the original building and subsequent additions will be interesting at this stage. The original building consisted of a centre brick position which still exists and two wings built of wood — a male and female ward. Five years ago the male ward on the western side of the building was pulled down and a handsome and commodious brick structure erected in its place, also a new operating theatre which was much needed. The latest addition was to replace the remaining wooden wing (the female ward) on the eastern end of the building, and to provide private wards, and suitable accommodation for the growing staff.
It consists of: a main ward for women 36ft 6in by 22ft, overflow women’s ward 22ft by 15ft, private ward 15ft by 15ft, private ward 15ft by 13ft, dining room 15ft by 15ft, night nurses' bedroom 15ft by 12ft, an office and bathrooms. A feature of the new building is the magnificent verandah facing north, and 12ft wide, which, by hanging a substantial screen, can be utilised in case of an emergency as a ward capable of accommodating five patients. The views from the verandahs are very beautiful. The water supply provided with the additions is equal to 20,000 gallons. Acetylene gas and hot water supply are laid on through-out the building. The work will cost £1,500, and the necessary furniture £160. The Government gave £600 towards the building fund.
Mr Ritchie said it gave him much pleasure to see so many present and to welcome them on this very important occasion. They all had had an opportunity of seeing the addition to their fine institution, and he was sure they would agree with him that the money had been spent to the best possible advantage.
The new addition would have been seen to better advantage had the furniture arrived and been placed in position. It had been shipped but owing to the rough weather was 'still on the sea'. He would ask them to bear with him while he gave a short history of the Bega District Hospital since its very inception. It was only right that on an occasion like the present they should remember the men who were really responsible for the initiation of the movement for the establishment of a hospital in Bega.
Mrs Clark was the first matron, but a trained nurse was subsequently, appointed. In 1904 a new wing [now the male ward] was added, but before many years had passed the demands on the hospital were so great that the addition of another wing became an urgent necessity. That addition he had now the honour of opening, and he thought it spoke volumes for the generosity of the people that the institution was free of debt. For a long time there was a prejudice on the part of many people to entering a hospital for treatment, but he was glad to know that the splendid medical treatment and the kindness and expert attention of the nursing staff had been the means of popularising the institution.
He thanked the collectors of last year, and was pleased to know that Bega people, and especially the subscribers, had confidence in the committee.
Mr Thomas Atkinson congratulated the people on the opening of the new wing. They were hampered for want of room, and he would like to see the old building at the back which serves as an isolation ward, removed, and something of a more up-to-date character substituted. The building was of wood, primitive, and so eaten with white ants that you could poke your finger through the walls almost anywhere. And the fences were also devoured by ants. He was sure the Bega district people would not be afraid of these urgent works. Mr C T Stiles was pleased to be present. His idea from the first was to obviate the necessity for people having to go to Sydney for medical treatment. The expense was very heavy and frequently people had to suffer because they could not afford the money. This was all changed now, and we had a medical staff equal to anything out of Sydney, and to him it was a gratification to see patients treated locally. They had a noble nursing staff, and it was almost a pleasure to be sick under such circumstances.
The total complex for the Bega Hospital now comprised the main brick building, operating theatre connected by a walkway, laundry, nurses' quarters, morgue, isolation building and several minor outbuildings and extensions.