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A Mind That Found Itself: An Autobiography

Creator: Clifford Whittingham Beers (author)
Date: 1910
Publisher: Longmans, Green, and Co., New York
Source: Available at selected libraries

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Can all the insane be managed without restraint or seclusion? Conolly always said "Yes" to that question. When, after consulting with him, superintendents of other institutions remarked that they would return home and try Non-Restraint in their asylums, he would coolly reply, "You will succeed if you are in earnest." Some Continental hospital officials were well-nigh exasperated by Conolly's calm, significant, qualified prediction, "You will succeed if you are in earnest." He had been in earnest. In order to attain his ends at Hanwell, he had devoted a surprising amount of personal attention to each trying, difficult patient, visiting such both by day and night, watching the conduct of attendants towards such cases with unceasing vigilance. Superintendents who hope to accomplish results which made his name famous as a philanthropic physician and skilful asylum manager must imitate the example of Conolly to the extent, at least, of giving considerable personal attention to those patients whose conduct taxes the patience and wits of the nurses. The successful management of the turbulent insane without restraining apparatus cannot be accomplished by simply forbidding its employment.


Rules to meet the exigency of every possible situation cannot be formulated in advance, since the various patients will present such dissimilar, unexpected and individual features of difficulty. Therefore, the hospital rule maker the commanding official, must intimately share with the nurses the labor and responsibility which trying cases force upon the management. I believe it is an important part of the system of instruction that each instance of friction between nurse and patient receive consideration from the superintendent, and, if thought best, that the involved nurse be commended when she acted judiciously, or be admonished when evidently failing to exercise due art as a trained nurse. When the position of the nurse was faulty, the better way should be pointed out. Such methods teach, and the physician who adopts them is soon able to identify those nurses who have special aptitude for their work, and can select for the difficult posts those best qualified for the trying duties. Nurses who possess self-poise, capacity for tact, and power to rapidly conceive expedients will naturally succeed. I have seen slender, light-weight girls manage the hardest wards quite as well as those of large stature. As an aid towards the development of such nurses at Danvers, each ward is supplied with special report slips to be used according to directions printed on each slip; viz., "When a patient escapes; attempts to escape; receives an injury, accidentally or otherwise; has to be handled with force, or is secluded; the attendant engaged in the affair, or the one in charge of the patient at the time, must send a written report to the medical officer in charge of the ward in which the patient belongs, who will countersign the same and forward it to the office of the superintendent." At a convenient time, the patients thus reported are visited by the superintendent with the slip in hand, when such personal investigation and instructions as may seem necessary can be given.


Being in earnest is the solution of the Non-Restraint question. The ruling authority over and above the nursing staff must be in earnest; and this signifies clear insight as to the evil done and its remedy; certainty as to what can be done with the insane by virtue of patience, sympathy and tact; with determination, watchfulness, faith and enthusiasm.




A PAMPHLET issued by the Department of Commerce and Labor, May 22, 1905, under the head "Daily Consular Report, No. 2264," contains an article by Hon. Frank H. Mason, then Consul-General at Berlin, Germany. It is entitled "Modern Hospital for the Insane," and reads as follows:


"Among the valuable lessons which most other nations can advantageously learn from the experience and practice of Germany is the scientific treatment of insanity in its incipient stages as a physical and possibly curable disease.


"Notwithstanding the rapid and deplorable increase of mental diseases which has followed the stress and strain of modern business and social life, it must be admitted that in the United States, and even in Great Britain, governmental beneficence has not progressed beyond the eleemosynary function of providing asylums in which the more or less hopelessly incurable victims of insanity, who have become a burden and menace to their friends, can drag out in safety and physical comfort the remnants of their stricken lives. If here and there a private clinic has made a hopeful beginning with the pathological treatment of mental diseases, it has been due to individual initiative, and the ministrations of such institutions are restricted mainly to patients of the well-to-do class, leaving the great majority of poor unfortunates to drift on to a stage of mental alienation in which they become dangerous to themselves and to those about them, and therefore entitled to the attention and support of the State. Germany has taken a long and important step beyond this, and to give a simple statement of the means employed and some of the results attained is the motive and purpose of the present report.

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