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6. Separate plaster room.

7. A minimum of equipment for both surgical and non-surgical cases.

8. Where tuberculous children are accepted, suitable provision for open-air treatment.

Several of the special orthopedic hospitals have special training schools for nurses. There is coming to be recognized a need for special orthopedic training for all who participate in the actual treatment of the little ones. The Nebraska Orthopedic Hospital has a school of this type, special nurses' quarters, a medical library for their use, and a teaching' staff of practicing specialists.

An element of greatest importance in all institutions where crippled children are cared for is the environmental atmosphere. Many of the patients have suffered much pain, and their recovery is in a considerable degree dependent upon their psychological condition. The best institutions have an atmosphere of hope, good will, cheery laughter, and essential comfort. The word "cripple" is unknown. Sunlight, fresh air, and pleasant surroundings, as well as toys, amusements, books, companionship, and bedside instruction in occupational therapy always should be made available in the greatest possible degree.

Convalescent Care.

The depths of distress have been passed in safety and our pathway now leads to the convalescent facilities. "There are many patients who flounder aimlessly about clinics for week and months endeavoring to gain health, but who more often, because of lack of convalescent care, become one of the many 'half cured'."-1- In order, therefore, to avoid relapses, and also to relieve hospitals of long term convalescents, sanatoria, convalescent hospitals, convalescent homes, "hospital-schools," and summer homes or camps have been established to care for crippled children. These are happy places, filled with new delights and characterized by hope and improvements. Pallid, frail children find themselves becoming robust and ruddy, and delight in using their new found muscular power in games and contests in which they believed they would never be able to engage. Maturing children, approaching adolescence, learn to read and write for the first time in their lives, and apply themselves to their lessons with a zeal unheard of in the public schools.

-1- Hortense Kahn, Standards of Care for Convalescent Children, p. 3.

The orthopedic convalescent hospitals differ from the convalescent homes only in having available facilities for minor operations. They generally are operated in connection with general hospitals and retain their patients for shorter period than do the homes. Most of the former are operated independently, although some of them are affiliated with general institutions. Caution as to atmosphere is essential in these institutions of longer residence. Uniform clothing is most undesirable and usually is avoided by obtaining contribution from friends or relatives of the patients. Little trinkets and new garments are greatly prized by younger children and help to avoid institutionalization.

The Crippled Child has organized a "Round Robin," to which the children at a large number of convalescent homes contribute. The letters which are published periodically through a considerable amount of light on the activities in which the patients are engaged. Marion Smith, secretary at the Hospital School in Jersey City, writes: "During last summer the Rotarians gave us a number of theater parties. At most of our entertainments they furnished professional talent, which we enjoyed very much. ....The Rotarians also have a large radio installed." In another letter we are told:-2- "We make mats aprons, towels, tatting, lace. ....We have a good time Christmas. . . . We had a Christmas tree. . .dresses, candy, dolls, games, handkerchiefs, and other things."

-2- From the Youngstown, Ohio, City Hospital.

A letter from Mary Harty, a Round Robin corresponding secretary at the Country Home for Convalescent Children, Prince Crossing, Illinois, reveals the extent to which the "ambulatory" patients enjoy themselves. "I suppose the first thing of importance was the baseball game between our boys and the West team.. . .The score was eleven to ten in our favor. One day all of us older girls and boys went to the woods in our farmer's hay rack and had a wiener roast.-1- Another time one of the nurses who used to be here took us for a picnic.. . ."