RULES 
FOR THE 
INTERNAL GOVERNMENT 
OF THE 
HOSPITAL OF THE UNIVERSITY 
OF PENNSYLVANIA. 
AMENDED MARCH 10th, 1892. 
PHILADELPHIA: 
Allen, Lane & Scott’s Printing House, 
Nos. 229-31-33 South Fifth Street. 
1892. RULES 
FOR THE 
INTERNAL GOVERNMENT 
OF THE 
HOSPITAL OF THE UNIVERSITY 
OF PENNSYLVANIA. 
AMENDED MARCH 10th, 1892. 
PHILADELPHIA: 
Allen, Lane & Scott’s Printing House, 
Nos. 229-31-33 South Fifth Street. 
1892. RULES 
FOR THE 
GOVERNMENT OF THE HOSPITAL. 
I. Director. 
1. The Director of the Hospital shall be elected annu- 
ally at the January meeting by the Trustees upon nomina- 
tion by the Managers, and shall be a physician skilled in 
hospital construction and management. 
2. He shall be the special adviser of the Managers, shall 
be present at their regular and special meetings, and shall 
be ex officio a member of the Board without a vote, and 
under their direction shall have general control of all De- 
partments of the Hospital, except as to the medical and 
surgical treatment of patients. He shall keep the Man- 
agers informed as to the condition and needs of the Hos- 
pital, and shall promulgate and enforce all rules and regu- 
lations made by the Board. 
3. A Superintendent, an Assistant Superintendent, a 
Clerk, and an Apothecary shall be elected annually at the 
January meeting by the Managers, the qualifications of 
each being first reported upon by the Director. 
4. The Director shall have power to suspend, in case of 
emergency, any of these officers or any of the Resident 
Physicians, reporting at once his action and the reasons 
therefor to the President of the Board of Managers, or, in 
case of his absence, to the Visiting Committee. 
5. The appointment and discharge of subordinate em- 
ployes shall be under the control of the Superintendent. 2 
II. Superintendent. 
1. The Superintendent shall act for the Director in his 
absence, and, under his instructions, shall have the general 
control of all the Departments of the Hospital, of all sub- 
ordinate officers, attendants, and domestics, and the charge 
of the grounds, buildings, and appurtenances. 
2. She shall hold her office during the pleasure of the 
Board, and shall reside in the building, in apartments to 
be designated by the Board for that purpose. 
3. She shall, under the direction of the Board or of the 
Visiting Committee, purchase all provisions and stores re- 
quired for the use of the Hospital, and shall see that they 
are properly and economically used. 
4. She shall keep, or cause to be kept, regular accounts 
of all moneys received or disbursed by her on behalf of the 
Hospital, with a record of all contracts, and shall submit 
the same to the Visiting Committee at each meeting, and 
to the Director whenever required. She shall also prepare 
a statement of such receipts and disbursements for the 
Board at each monthly meeting, together with a statement 
of the amount of outstanding indebtedness and a requisi- 
tion for the probable amount required for the current ex- 
penses of the ensuing month. 
5. All bills, together with the pay-rolls, shall be sub- 
mitted to the Visiting Committee at its regular meetings. 
6. She shall make no purchases exceeding $100, or of an 
unusual nature, without the sanction of the Director or of 
the Visiting Committee. 
7. She shall take charge of money or other valuables 
belonging to patients, and keep a record of the same. In 
case any patient dies leaving money or articles of value, 
she shall take charge of them and shall report the same to 
the Visiting Committee, who will give the necessary direc- 
tions for the proper disposal of them. 
8. She shall see that a proper inventory is kept of all fur- 
niture and other property belonging to the Hospital, and 3 
shall make an annual report of articles injured, destroyed, 
or missing. 
9. She shall receive all moneys paid for the board of the 
patients, and from other sources, and shall pay it over to 
the Treasurer of the Hospital. 
10. She shall suspend from duty any subordinate or em- 
ploye of the institution willfully disregarding or breaking 
the rules thereof, or refusing to perform his or her proper 
or necessary duties. She shall immediately report in writ- 
ing such suspension to the Director and to the Visiting 
Committee, with the facts in the case. Except as regards 
the Assistant Superintendent, Clerk, Apothecary, and Resi- 
dent Physicians, she shall have the right of summary dis- 
missal, reporting the facts, as in other cases, to the Director 
and to the Visiting Committee. 
11. She shall, in consultation with the Assistant Super- 
intendent, select the probationers and pupil nurses in the 
Training School for Nurses. 
12. She shall admit patients to, and discharge them from, 
the Hospital upon recommendations made by the Medical 
Staff or by the Resident Physicians, in accordance with 
such instructions as she may receive from the Managers or 
from the Director as to the number of free beds which are 
available. 
13. She shall communicate to their friends information 
of the decease of patients, and shall cause the bodies to be 
delivered to their friends, or, if not claimed by them, to the 
proper authority. 
14. In any case requiring the attendance of the Coroner 
at the Hospital it shall be her duty immediately to send 
notice to that effect to the Coroner’s office. 
15. She shall furnish to the Director, in time to be pre- 
sented to the stated meeting of the Managers in December 
of each year, an annual report of all matters pertaining to 
her office during the year. 
16. Before leaving the Hospital she shall notify the 
Assistant Superintendent, who shall discharge her duties 
during her absence. 4 
17. She shall perform such other duties connected with 
the office as may, from time to time, be required by the 
Director or Managers. 
III. Assistant Superintendent. 
/ 
1. The Assistant Superintendent shall have, under the 
direction of the Superintendent, the general supervision of 
all the nurses of the Hospital. 
2. She shall visit each ward of the Hospital at least three 
times daily, and shall be responsible to the Superintendent 
for their cleanliness, neatness, and order. 
3. She shall conduct all correspondence relative to nurses, 
and make from time to time such reports on their conduct 
and efficiency as may be called for by the Superinten- 
dent. 
4. She shall hear the reports of the head nurses each 
morning, and receive from them requisitions for the day’s 
supplies, taking such requisitions to the Superintendent to 
be signed at the time when she makes her report. 
5. She shall give directions to the Night Superintendent 
before going on duty, and shall receive from her a written 
report in the morning. 
6. She shall keep an account of the time nurses are off 
duty on account of illness or other causes, and furnish a re- 
port on the same to the Superintendent on the last day of 
each month. 
7. She shall not be absent from the Hospital during the 
absence of the Superintendent, and she shall at all times 
report before leaving the building, and again on her re- 
turn. 
8. She shall attend at all the lectures given by the phy- 
sicians to the nurses, and shall inspect and correct the 
notes taken by the nurses at such lectures. 
9. She shall give instruction from the text-books, and 
shall be present at all times when instruction is being 
given to nurses by any person or persons outside of the 
wards, except when relieved by the Superintendent. 5 
10. She shall perform such other duties connected with 
her office as may be required by the Superintendent. 
IV. Medical Staff. 
1. The Medical Staff shall be composed, in accordance 
with the resolution of the Board of Trustees, of the follow- 
ing members:— 
The Professor of the Theory and Practice of 
Medicine and of Clinical Medicine, 
The Professor of Surgery, 
The Professor of Obstetrics, 
°fPjC^°- 
The Honorary Professor of Clinical Surgery. 
The Professor of Clinical Medicine. 
The Professor of Gynaecology. 
The Professor of Clinical Surgery. 
The Clinical Professor of Diseases of the Eye. 
The Clinical Professor of Diseases of the Ear. 
The Clinical Professor of Nervous Diseases. 
The Clinical Professor of Diseases of the Skin. 
The Clinical Professor of Children’s Diseases. 
The Professor of General Pathology and Morbid Anatomy. 
The Clinical Professor of Orthopaedic Surgery. 
The Clinical Professor of Diseases. 
2. Special meetings of the Staff may be called at any 
time by the Managers, by the President of the Medical 
Staff, or by the Secretary of the Medical Staff at the re- 
quest in writing of three of its members. 
3. The members of the Medical Staff shall be present 
when requested by the Managers, or by the Visiting Com- 
mittee, to confer with them on the management of the 
Hospital. 
4. The Medical Staff shall advise the Managers, through 
the Visiting Committee, in all matters pertaining to the 
sanitary arrangements of the Hospital, and to the health 
of the inmates. 6 
5. The Medical Staff shall hold annual examinations to 
determine the merits and qualifications of such graduates 
of the Medical Department of the University of Pennsyl- 
vania as may apply for the position of Resident Physician 
in the Hospital; and shall report, after each examination, 
the names of the four candidates whose grade is the highest 
to the Board of Managers for confirmation. 
6. The Medical Staff shall elect, semi-annually, by ballot, 
two of its members to serve as a committee on the Apothe- 
cary’s Department, whose duty it shall be to examine fre- 
quently into the quality of the drugs and medicines fur- 
nished for the use of the Hospital, to maintain a general 
supervision over this department, and to report to the 
Medical Staff as occasion may require. 
7. In all cases of death in which the Attending Medical 
Officer regards an autopsy as desirable, he shall give a 
written order for such examination, and shall see that it is 
properly performed, the consent of the immediate relatives 
having been first obtained in all cases in which it is possible 
to ask it. 
8. The Medical Staff shall appoint annually a committee 
to be known as the “ Committee of the Medical Staff on 
the Training School for Nurses.” Its duties shall be as 
follows:— 
(a.) The Committee shall elect the lecturers for the com- 
ing year, and shall designate the subjects which are to be 
included in the course of instruction given to the nurses. 
(b.) The Committee shall procure from the various 
lecturers a number of questions to be used in the stated 
examinations of the nurses, from which number it shall 
select those to be used in each case. 
(c.) The Committee shall provide in all respects for the 
proper examination of the nurses, and shall see that it is 
conducted in such manner as satisfactorily to determine 
their fitness for promotion or graduation. 
(d.) The Committee shall sign the diplomas of the grad- 
uates as the representatives of the Medical Staff of the 
Hospital. 7 
9. Each member of the Medical Staff may appoint, sub- 
ject to confirmation the Managers, annually, one or 
more assistants, to be called Assistant Physician, Surgeon, 
Obstetrician, &c. (as the case may be), to the Hospital. 
Such assistant shall aid his chief in the performance of his 
functions, and may undertake them in his absence. 
10. Each member of the Medical Staff may appoint sub- 
ject to confirmation by the Managers, annually, a Clinical 
Clerk who shall keep such records of cases as his chief may 
require. 
V. Resident Physicians. 
1. There shall be elected annually by the Managers, on 
the recommendation of the Medical Staff, four Resident 
Physicians, graduates of the Medical Department of the 
University of Pennsylvania, who shall serve for the term 
of eighteen months. They shall, on receiving notice of 
their election, sign an obligation to serve their full term, 
unless relieved by the Managers. Each shall serve six 
months with one of the physicians in the Medical Ward, 
and six months with one of the surgeons in the Surgical 
Ward, and six months under the direction of the Chiefs of 
Staff, who have charge of special cases, and in the Mater- 
nity Wards. 
2. They reside in the Hospital, and, in addition, shall 
receive their board and washing free, but shall not be al- 
lowed any other perquisites or fees. 
3. They shall not be absent from the Hospital at night, 
nor during the day, except at such hours as may be author- 
ized by the Visiting Committee. Before leaving the Hos- 
pital they shall invariably register their names and the 
hour of day in a book, to be provided and kept by the 
Superintendent, and again upon their return. They shall 
under no circumstances all be absent from the building at 
the same time, and shall, subject to the approval of the 
Visiting Committee, arrange and observe a roster, specify- 
ing on which days each must remain in the House. 8 
4. Leave of absence, when requested by any of the Resi- 
dent Physicians, may be granted by a majority of the 
Attending Medical Officers in charge of the wards in which 
he is on duty, who shall also appoint a substitute to serve 
during his absence. In cases of emergency, leave of ab- 
sence for not over twelve hours may be granted by the 
Superintendent. 
5. They shall visit all the patients under their charge 
every morning and evening, and as much oftener as may 
be necessary; and, in the absence of the Attending Med- 
ical Officer, shall administer to their relief, conforming to 
the views of such officer, and reporting their action at his 
next visit. 
6. They shall accompany the Attending Medical Officers 
in their visits, report to them all new cases, and faithfully 
carry out their directions. They shall copy all prescrip- 
tions in the ward-books kept for that purpose, and shall 
send them to the Apothecary immediately after the 
visit. 
7. All diet orders, liquor, and extra orders for patients 
must be signed either by the Attending Medical Officer or 
by the Resident Physician or Surgeon. 
8. The Resident Physicians shall give all orders for med- 
icines, and general directions for treatment, in writing, in 
a book furnished for that purpose, and shall also write in 
the same book orders for the stopping or modification of 
treatment. This book is to be under the charge of the 
head nurse of the ward, to whom all verbal explanations 
are to be given. 
9. Resident Physicians will promptly inform the Super- 
intendent of all cases in which it is proposed to make an 
autopsy upon a deceased patient, and will report when it is 
completed, which should be as soon as possible, in order 
that arrangements may be made for the prompt disposal of 
the body. 
10. The Senior Resident Physician is charged with the 
duty of seeing that the Hospital Register of the Central 
office is keptfully entered up to date, and that the provisional 9 
diagnoses are reported within twenty-four hours after the 
time when the patient is admitted. 
11. The electrical instruments shall be in the charge of 
the Senior Resident Physician. 
12. The Senior Medical Resident shall have charge of, 
and be responsible for, the books and journals of the Med- 
ical Library of the Hospital. 
13. It shall be the duty of the Junior Resident to give 
ether in all cases in which its administration is required, 
and when he is absent, or otherwise necessarily engaged 
with his own chief, the duty of administering ether shall 
devolve on the next Junior Resident. 
14. The Resident Physicians and Surgeons shall not en- 
gage in any other business than that of the Hospital, nor 
shall they practice out of the House. They shall have the 
privilege of attending all the clinical lectures delivered in 
the Hospital, and of assisting at operations, provided that 
their services are not at the time required by any of the 
Attending Medical Officers in the wards. 
15. They shall keep such clinical records of the cases in 
their charge as may be directed by the Attending Medical 
Officers. 
16. They shall further perform such duties connected 
with their office as may be directed by the Managers or the 
Attending Medical Officers. 
17. A certificate may be granted to a Resident Physician 
upon the expiration of his term of service on the recom- 
mendation of the Medical Staff, with the approval of the 
Managers. 
VI. Dispensary. 
1. The Physcians and Surgeons of the Dispensary shall 
be appointed by* the Managers on the nomination of the 
several members of the Medical Staff. 
VII. Apothecary. 
1. There shall be elected annually by the Managers, on 
the recommendation of the Director, an Apothecary, who 10 
shall hold his office during the pleasure of the Board. He 
shall reside in the building, and shall not absent himself 
except at such hours as may be authorized by the Visiting 
Committee. Before leaving the Hospital he shall invaria- 
bly report to the Superintendent, and again on his return. 
He shall receive such compensation as may be appointed 
by the Board, and his board and lodging free; but shall not 
be allowed any other emoluments, perquisites, or fees what- 
soever. 
2. He shall, under the Superintendent, have charge of 
all medicines and •other articles pertaining to his depart- 
ment, shall make requisitions on the Superintendent for 
their purchase, and shall keep exact accounts of their quanti- 
ties, qualities, and prices, and shall furnish duplicates of such 
accounts to the appropriate committee of the Medical Staff. 
3. He shall compound medicines and prepare all prescrip- 
tions agreeably to the formulae from time to time directed 
by the Attending Medical Officers or Resident Physicians, 
which shall be recorded in a book, to be kept in each ward 
for that purpose. 
4. He shall also prepare all prescriptions ordered by the 
Medical Officers in charge of the various departments of 
the Dispensary Service. 
5. He shall deliver no medicines which are not ordered 
by the Attending or Resident Medical Officers, and which 
are not recorded in the prescription-books, or properly 
ordered in connection with the Dispensary Service. 
6. He shall report monthly in writing to the Visiting 
Committee a detailed statement of the operations of his 
department, the expenditure for drugs, and the consump- 
tion of the same. 
7. He shall furnish the Superintendent with a monthly 
report showing the amount of liquor and soda-water ordered 
by each Physician, Surgeon, Resident Physician or Surgeon, 
or other officer of the Hospital. 
8. No prescriptions shall be put up free for Dispensary 
patients, except those specially marked free by Chiefs of 
the Dispensary Staff. 11 
9. The Apothecary shall perform such other duties con- 
nected with his office as may from time to time be required 
by the Board. 
10. All orders from the wards and private rooms from 
the Resident Staff for supplies, such as medicines, dressings, 
and soda-water, should be handed in each day before 9 
A. M. and 4 P. M. The stimulant order for the twenty-four 
hours must be sent in by 11 A. M. 
11. On Sundays and legal holidays all supplies should 
be procured before 12 119011. 
12. Free patients when about to leave the Hospital will 
not be furnished with medicine free, except upon an order 
by the Chief, countersigned by the Superintendent. 
13. Out-patients, when treated by Resident Physicians, 
are not to receive medicine free, except when approved by 
the Superintendent. 
14. Out of hours, and at night when it becomes abso- 
lutely necessary to enter the Apothecary Shop, the Apoth- 
ecary must be called. If he is not in the building, the 
Superintendent must be notified, they only lawfully hold- 
ing keys of same. 
15. No drugs nor supplies are to be taken from the Apoth- 
ecary Shop by any person without the sanction of the 
Superintendent or Apothecary. 
16. All orders for the better government of the Apothe- 
cary Shop, issued by the Superintendent, are to be respected 
by the Resident Physicians and the Apothecary. 
VIII. Nurses. 
1. All nurses shall be appointed and discharged by the 
Superintendent, as above provided. 
2. The nurses shall attend faithfully to the patients un- 
der their charge, and shall obey implicitly the directions 
of the Attending Medical Officers and Resident Physicians 
in regard to them. 
3. The nurses shall see that patients behave with pro- 
priety and observe all the regulations of the Hospital, and 12 
they shall report any irregularity or breach of rules to the 
Resident Physicians and Superintendent. 
4. They shall give receipts to the Laundress for all bed 
linen or clothing issued to their wards, and shall be fur- 
nished with an acquittance for the same on returning the 
pieces to the laundry. 
5. They shall carry the ward prescription-book to the 
Apothecary immediately after the visit of the Attending 
Medical Officer, and shall return for the same at the hour 
directed by the Apothecary. 
6. They shall carefully attend to the administration of 
all medicines, and shall return to the Apothecary all 
phials not in use in which medicine has been sent. 
7. They shall pay strict attention to the diet ordered by 
the Attending or Resident Physicians. 
8. In no cases shall all the nurses of any ward be absent 
at the same time. 
9. They shall perform such other duties connected with 
their office as may be required. 
10. Night nurses and subordinate nurses will receive 
their orders from the head nurse of the ward. If addi- 
tional orders are deemed necessary by the Resident Phy- 
sician, he will give them in writing in the book above re- 
ferred to. 
IX. Clerk of the Hospital. 
1. The Clerk of the Hospital shall, under the direction 
of the Superintendent, keep the books of the office and the 
accounts of the Hospital, shall receive the money paid by 
private patients, attend to the correspondence, and perform 
such writing as may be required by the Superintendent. 
2. She shall prepare the weekly written report to be sub- 
mitted to the Visiting Committee, and monthly report of 
accounts for the Board of Managers. 
3. Her hours of duty shall be from 8.30 A. M. to 6 P. M. 
on week-days, and on Sunday half a day. 
4. During her hours of duty she shall answer telephone 
calls ; she shall have charge of the patients’ library, of such 13 
stores as are kept in the office, and will perform such other 
duties connected with the office as may be required by the 
Superintendent. 
X. Admission and Discharge of Patients. 
1. All cases of recent accident, occurring in the State of 
Pennsylvania, which are brought to the Hospital within 
twenty-four hours after their occurrence, shall be admitted 
at any hour of the day or night. 
2. Other patients shall be admitted daily from 12 M to 
2 P. M. They must apply in person at the waiting-room, 
where they will be examined and recommended for admis- 
sion by the Attending Medical Officers or the Resident 
Physicians. 
3. Any member of the Medical Staff may send to his own 
department of the Hospital any patient that he may see fit, 
with a written order for admission, provided that there is a 
free bed vacant in that department. 
4. There shall be posted in the office daily the number of 
vacant beds, both free and pay, in each department of the 
Hospital, for the information of the Examining Physicians. 
5. The Resident Physicians shall fill up the proper ad- 
mission blank and bed-card within twelve hours after the 
admission of each patient. 
6. No patient affected with small-pox, typhus fever, scar-"'' 
let fever, measles, diphtheria, whooping-cough, or rotheln 
shall be admitted. —1 
7. Pay patients may be admitted to the extent of the 
capacity of the Hospital for that purpose, at a rate of not 
less than seven dollars per week. 
8. In cases where separate apartments, or articles not ' 
usually furnished in the Hospital, are provided, such pay- 
ment shall be paid therefor as the Visiting Committee may 
deem reasonable. Patients occupying private rooms shall 
be entitled to receive the professional services of the Resi- 
dent Physicians without extra charge, but shall have no 
claim upon the services of the Attending Medical Officers 14 
without proper compensation, as may be agreed upon in 
each instance, unless such patients consent that their cases 
shall be utilized for purposes of clinical instruction, as with 
patients in the general wards. No charge for medical or 
surgical attendance shall be made to ward-patients. 
9. No patient who is not likely to recover shall be re- 
tained on the free list of the Hospital for more than three 
months. 
10. No patient having acute venereal disease or delirium 
tremens shall be admitted as a charity patient. No deli- 
rium tremens patient shall be admitted to a public ward. 
XI. Discharge of Insubordinate Patients. 
Whenever, in the opinion of a Resident Physician or of 
the Superintendent, it is desirable to discharge a patient for 
disobedience of orders or misconduct, the case shall be re- 
ported at once to the member of the Medical Staff under 
whose charge the patient may be, and also to the person 
who has sent such person to the Hospital, in case such 
person has endowed a bed in the Hospital, and twenty- 
four hours shall be allowed them to make such arrange- 
ments as they may deem necessary in the case. Pending 
such action, however, if the patient is unruly and trouble- 
some in the ward, the Superintendent is authorized to 
have him placed in a separate room pending the final 
action in the case. 
XII. Rules for Head Nurses. 
1. Head nurses shall be in their wards promptly at 7 
A. M. 
2. Each head nurse shall make out a census of her wards, 
and present it at the office with the cards for discharge, by 
9 A. M. each day. 
The weekly store-book shall be presented at the office of 
the Assistant Superintendent at 8 A. M. on Thursday. 
3. Each head nurse shall see that the soiled linen is care- 
fully counted, placed in bags, and sent down the chute 15 
three times daily, at 8 A. M., 1 P. M., and 5 P. M. Wet or 
stained clothes must be put at once in a zinc vessel and car- 
ried immediately to the laundry. 
4. Head nurses shall see that a nurse accompanies any 
patient sent from her ward to a dispensary department. 
5. Head nurses shall see that a nurse accompanies all 
cases going to clinic, and remains for instruction. 
6. Head nurses will give day nurses written orders, and 
require each order to be checked when carried out. 
7. Head nurses will give the night nurses written orders, 
and will receive a written report from them in the morning. 
8. Head nurses shall see that no patient leaves her floor 
without permission, and that patients do not accompany 
their friends farther than the bounds of their wards. 
They shall see that all patients are in bed at 8 P. M. 
(those in private wards at 9 P. M.), and that the lights are 
turned down and all quiet at that time. 
9. Head nurses are responsible for the order and disci- 
pline of their wards. They will see that the pupil nurses 
conduct themselves with propriety and care faithfully for 
the patients under their charge. 
10. Head nurses book their pupils’ time off to suit the 
head nurses’ convenience; but only one head nurse on the 
same floor shall be off duty at the same time, unless by 
special permission. 
11. Head nurses, when on duty, must report in person in 
the dining-room three times daily, unless excused by the 
Superintendent or Assistant Superintendent; and no nurse 
shall go to her ward in the morning before reporting in the 
dining-room. 
XIII. Rules for Pupil Nurses. 
1. Nurses shall be in their wards promptly at 7 A. M. 
2. Nurses are required to keep their rooms in order, well 
ventilated, and free of dust. Gas must be turned off punc- 
tually at 10 P. M., after which time there must be neither 
talking nor noise of any kind. 16 
3. Nurses must not leave any of their personal effects 
scattered about the parlor, or any part of the house used 
publicly. 
4. Nurses must not go out after dark, without special 
permission from the Superintendent or Assistant Superin- 
tendent, except on Sunday, or on their afternoon off. 
5. Nurses who cannot go on duty in the morning will 
communicate at once with the Night Superintendent. A 
nurse must not go off duty without reporting to the head 
nurse, or nurse in charge. 
6. Nurses, when ill, must report to the Assistant Superin- 
tendent, who will notify the Resident Physician, whose 
duty it is to furnish medical attendance to nurses. 
Nurses must not obtain medicines or drugs of any kind 
which have not been prescribed for them, nor may they 
take medicines or drugs from the wards for their own 
use. ■ 
7. Nurses must not have visitors in the wards, nor take 
them through the Hospital, without permission, nor leave 
their duty to see them. All male visitors will be received 
in the reception-room of the Hospital, and all visitors, after 
7 P. M., in the same room. Friends of the nurses may not 
remain in the Home over night, nor in the nurses’ rooms 
during the day, nor partake of meals without permission 
from the Superintendent. 
8. Nurses must not take food or table furniture from the 
dining-room without permission from the housekeeper. 
9. Nurses are required to rise upon the entrance of the 
Superintendent, or of a Physician, or any officer of the Hos- 
pital, and to remain standing while they are in the wards. 
They are to be polite and courteous to all strangers coming 
to the Hospital. 
10. Nurses are required to treat patients with gentleness 
and consideration, and to maintain a dignified demeanor 
on all occasions. Loud laughing and talking in the Hos- 
pital wards and corridors are strictly prohibited. 
11. Nurses must always be in uniform when in the Hos- 
pital, on duty. Only the plainest jewelry may be worn. 17 
Promptness, general order, and personal neatness are abso- 
lutely essential. 
12. Nurses must not employ any patient in any way for 
their own personal service. 
13. Each nurse is under the supervision and direction of 
the head nurse of the department, to whom she is required 
to be respectful and obedient. The night nurses are under 
the supervision and direction of the Night Superintendent, 
to whom they will apply for orders in case of difficulty or 
emergency. 
14. When the hours of duty are over nurses are required 
to leave the wards promptly. Loitering on the stairs or 
in the corridors strictly prohibited. Visiting from one 
ward to another is not allowed without permission. 
15. All nurses are expected to put forth every effort to 
protect the interests of the Hospital in every way, seeing 
that there is no waste of anything. 
XIV. Rules for the Admission of Pupils to the 
Training School. 
1. Application for admission to the School must be made 
(in writing only) to the Superintendent of the Hospital, who 
will furnish blank form for such application. 
2. Candidates should be over twenty-three and under 
thirty-five years of age, and must accompany application 
with testimonials (from two responsible people) certifying to 
good moral character ; also a certificate of health. 
3. Applicants will be received for one month on probation, 
at the end of which time the Superintendent will decide as 
to their fitness for the work. 
4. Accepted pupil nurses shall engage to serve the Hos- 
pital for a full term of two years, at the expiration of which 
time a diploma will be given to those who pass a satisfactory 
examination. Nurses will have five examinations—one on 
entering, two in the first year, and two in the second year. 
Accepted pupil nurses shall receive: First year, ten dollars 
per month ; second year, fourteen dollars per month, for 18 
necessary expenses. (This is not considered to be in any 
way remuneration for their services, as their instruction is 
supposed to cover that.) 
Graduated nurses will receive a salary of twenty-five 
dollars per month for the first six months, and after that 
thirty dollars a month. 
Nurses are boarded and lodged by the Hospital. Twenty- 
four pieces are allowed for the laundry each week. 
Accepted candidates, when coming to the Hospital, should 
bring with them the following articles : Two or three dresses 
(light ground, small figures), gingham or calico, made 
plainly; six large white aprons, made of bleached cotton, 
with bibs, plain at the top and gathered slightly at the 
bottom, plain band, buttoned ; two bags for soiled clothes ; 
one pair of scissors and pin-ball ; a good supply of plain 
under-clothing, and every article to be distinctly marked 
with the owner’s name. Also, suitable outer-garments for 
all kinds of weather. Nurses are required to wear broad- 
toed and flat-heeled boots. 
If the teeth are out of order in any way they must receive 
attention before coming for the probationary month. 
Nurses are required to wear the Training School uniform 
after they join the School. Material for dresses will be sold 
at cost price; caps are furnished free of charge. 
Hours of duty for day nurses, from 7 A. M. to 8 P. M.; 
for night nurses, 8 P. M. to 7 A. M. No nurse is required to 
do both day and night duty on the same day, except in rare 
emergencies. Each nurse on day duty is allowed one hour 
each day for rest and recreation, one-half day after 2 
P. M. each week, and four hours on Sunday. Two weeks 
vacation is allowed each year. If nurses are sick they are 
cared for in the Hospital, but wages are stopped. Nurses on 
night duty are required to be in bed from 9 A. M. until 4 
P. M. Nurses may be called upon for four months, or more, 
night duty during the two years’ training. 
5. The Superintendent can at any time dismiss any nurse 
for misconduct or inefficiency. 19 
6. All pupils will receive board, lodging, washing, and 
medical attendance free. 
7. The instruction consists:— 
(a.) Ward work, including bed-making, change of pa- 
tients’ position and linen, cleanliness of patients and utensils. 
(6.) Making, application, and administration of various 
remedies, such as poultices, fomentations, &c. 
(c.) Use of baths, friction, &c. 
(d.) Attendance on doctors, dressing of wounds and 
bandages, padding of splints. 
(e.) Observation on general condition of patients with 
regard to appetite, skin, secretions, appearance of eruption, 
chill and fever, &c. 
(/.) Methods of observing and recording temperature, 
respiration, and pulse. 
(g.) Lectures and class instruction. 
8. Nurses will be required to keep the rules and regula- 
tions of the Hospital Nurses’ Home. 
Nurses must come prepared to pay for uniform after pro- 
bation month ; cost will not exceed twelve dollars. 
9. All nurses are -expected to be truthful, honest, trust- 
worthy, punctual, quiet, orderly, cleanly, neat, patient, 
kind, and cheerful. 
XV. Rules for Nurses’ Home. 
1. Every pupil nurse is to make her bed and keep her 
room in order. 
2. All gas must be put out at 10 P. M. No nurse must 
be out of her bed-room after 10 P. M., or talk or make any 
noise. 
3. Pupil nurses, whilst in the Plome, will be under the 
supervision of the Assistant Superintendent. 
4. Pupil nurses will receive no visitors except during 
hours of recreation. 
5. Pupil nurses are allowed a reasonable amount of laun- 
dry, not to exceed twenty-four pieces per week. 20 
XVI. Form for Application of Candidate for Pupil 
Nurse. 
This paper is to be filled out (in the candidate’s handwriting) and sent to 
, Superintendent of the University of Penn- 
sylvania Hospital Training School for Nurses. 
1. Name in full, and present address of candidate 
2. Name in full, and the address of some relative 
3. Are you a single woman or widow ? 
4. Your present occupation or employment? 
5. Age last birthday, and date and place of birth ? 
6. Height and weight? 
7. Where educated ? 
8. Are you strong and healthy? and have you always been so ? ... 
9. Have you any physical defect? Are your hearing and eyesight 
good ? 
10. If a widow, have you children? How many? Their ages? How are 
they provided for ? 
11. Are you otherwise free from domestic responsibility, so that you 
will not be liable to be called away ? 
12. Where (if any) was your last situation? How long were you in it? 
13. The names in full and addresses of two persons to be referred to. 
State how long each has known you. If previously employed, one 
of these must be the last employer; one of them shall not be a 
relative 
14. Have you ever been in any training school ? If so, where ? . . . . 
15. Have you read and do you clearly understand this paper? 
Having read and clearly understanding the foregoing conditions and regula- 
tions, I declare the above statement to be correct. 
Date, 
Signed, 
' Candidate. 
Present address, 
XVII. Regulations for Private Patients. 
1. The charges to private patients include room, board as 
per diet list, attendance of Resident Physician, medicines 
and surgical dressings, and general attendance of nurses. 
But articles of food, especially expensive or troublesome to 
obtain, and medicines of an unusual or costly character 
will be charged extra. 21 
2. When a special nurse is furnished there will be an 
extra charge. No special nurse can be demanded by the 
patient to be on duty more than eighteen hours out of 
twenty-four. When she is not on duty the patient will be 
attended by the general nurse, except in dangerous cases, 
where the Chief or Superintendent considers it unsafe for 
the patient to be alone. 
3. Visitors to private floor are admitted from 8 A. M. to 
8 P. M. All visitors are expected to leave the Hospital 
promptly at 9 P. M. N 
4. Whisky is included in medicines to be furnished. 
Brandy, wine's, and beer are an extra charge. 
5. Patients’ clothing cannot be laundried in the build- 
ing. Arrangements can be made, by applying at the office, 
to have it sent out, at the owner’s risk and expense. 
6. Patients’ friends requiring meals or cot in room will 
be charged fifty cents per meal and fifty cents per cot per 
night. Meals will be served only at 7 A. M., 12.15 P. M., 
and 5.15 P. M. 
7. Patients or their friends are not allowed to visit other 
patients without permission from the Attending Physicians. 
8. Writing-paper, stamps, and postal-cards may be bought 
at the office. All business arrangements must be transacted 
at the office. 
9. Books for patients’ use may be obtained from the 
Librarian at the office. 
10. Patients and their friends are expected to comply 
with the general rules of the Hospital. 
XVIII. Rules for the Government of the Patho- 
logical Department. 
1. Building, Apparatus, &c. 
1. The Pathological Building shall be in charge of the 
Pathologist, who shall be the Professor of General Pathol- 
ogy and Morbid Anatomy in the University. He shall be 
responsible for the condition of the building to the Director 
of the Hospital and the Managers. 22 
2. The building shall be used exclusively as a mortuary 
and for the work connected with the Pathological Depart- 
ment. 
3. The mounted specimens, apparatus, and instruments 
shall not be taken from the building without a request in 
writing, and the permission of the Pathologist. They shall 
never be taken outside of the University grounds. 
<2. The Pathologist. 
1. It shall be the duty of the Pathologist to conduct, in 
person, all the necropsies except those made by the Cor- 
oner’s Physicians, and he shall keep a record of the same. 
2. He shall make all necessary microscopic examinations 
and investigations relating to the necropsies and to other 
subjects in Pathology that may concern the special interests 
of the Hospital. He shall keep a record of the same, which 
shall be accessible to the members of the Staff. 
3. There shall be a Curator of the Museum of the Hos- 
pital, who shall be an assistant to the Pathologist and shall 
see to the preservation of specimens under his direction. 
4. In the absence of the Pathologist, the authority to 
loan specimens invested in him may be exercised by the 
Superintendent of the Hospital. 
o. One of the Junior Resident Physicians shall act as 
Assistant to the Pathologist. 
3. The Necropsies. 
1. The necropsies shall be made, when practicable, at 
1 o’clock P. M. If a change of the hour becomes neces- 
sary, a timely notice shall be sent to the member of the 
Staff under whose charge the patient was while living. 
2. The record of the necropsies shall be kept by the 
Pathologist in the Pathological Building, and shall be 
accessible to the members of the Staff. 
3. A copy of the record shall be made by the Resident 
Physician, to be filed with the clinical record of the case. 
4. All specimens shall become the property of the Uni- 
versity, and shall be kept in the Hospital Museum, unless 23 
the Medical Officer who had charge of the patient should 
request that a specimen be placed in the Wistar and 
Horner Museum. 
5. Upon a written request a specimen shall be delivered, 
before mounting, for exhibition outside of the Medical School, 
to the member of the Staff under whose charge the patient 
was wrhile living; the specimen to be returned within 
twenty-four hours. 
6. Operation specimens shall be subject to the same rules 
as those derived from necropsies, with the exception of 
calculi, which may be retained by the operator. 
A The Museum. 
1. The Curator shall see that the specimens are properly 
labeled and catalogued. 
2. The mounted specimens, microscopic slides, apparatus, 
instruments, and other property of the Museum may be 
used in the lectures of the medical course. They shall be 
delivered only upon written request. 
3. With the exception provided for under Rule 5, sec- 
tion 3, they shall never be removed outside the University 
grounds. 
4. The specimens in the Museum shall consist of two 
classes: Permanently mounted specimens and hand speci- 
mens, to be used for demonstrations. 
5. The Laboratory 
1. All work in Morbid Anatomy and Experimental 
Pathology connected with the routine work of the Hospital 
shall be performed in the Laboratory under the direction 
of the Pathologist. 
2. The Laboratory may undertake the investigation of 
specimens forwarded by individuals or institutions not con- 
nected with the University. 
3. Such specimens shall be addressed to the Laboratory, 
and the Pathologist shall be responsible for the opinion ex- 
pressed. 24 
4. A fee may be charged, fixed by tariff, for such exam- 
inations ; the fee to be paid to the officer who conducts the 
examination and makes the report. 
5. A limited number of students in Pathology or investi- 
gators in special work may, with the approval of the Path- 
ologist, be admitted to work in the Laboratory, on condition 
that they pay to the Hospital a fee of fifteen dollars a 
month while they are engaged in the Laboratory. 
6. The Mortuary. 
1. All bodies brought to the Mortuary shall be accom- 
panied with a report stating name, age, sex, color, date, and 
hour of death, clinical diagnosis, attending Staff Physician, 
Resident Physician in charge, whether a necropsy is or is 
not desired. 
XIX. Fire Regulations. 
Precautions against fire. 
1. The only kind of matches allowed in the Hospital are 
those which can only be lighted by striking on a strip of 
specially-prepared paper attached to the box. 
2. Oiled or greased rags, bandages, or waste must not be 
allowed to collect, or to remain in contact with wood. Put 
all such refuse into tin receptacles and burn the accumula- 
tion daily. 
3. Hose, with nozzles, are to be kept constantly attached 
to the stand-pipes in the main hall and at the south end of 
the old pavilion. It is the business of the engineer to 
carefully examine these daily and to see that they are 
always in good order and ready for use. 
4. Buckets of water are to be kept constantly ready for 
use in each bath-room of the Gibson pavilion, and on each 
floor at the west end of the main hall. The night watch- 
man and night nurses are required to see that these buck- 
ets are filled and in their proper place. 25 
Alarm of fire. 
If a fire breaks out, the person discovering it shall imme- 
diately notify door porter, if it is in the daytime, or the 
night watchman, at night. The porter or watchman 
shall at once ring a continuous alarm on the doctor’s bell, 
and shall see that the Superintendent, the Resident Physi- 
cians, and the firemen are promptly notified of the location 
of the fire. The Superintendent or the Night Superintend- 
ent shall decide as to the desirability of calling for fire 
engines. 
Means of subduing fire. 
Use water provided in the fire buckets. A single pail of 
water used promptly and judiciously will frequently stop a 
fire. 
Draw a bath-tub full of water, form a line of patients, and 
pass the water along in pails to the point where it is 
needed. 
If the fire is at a point where it can be reached by one of 
the hose pipes, let an attendant uncoil the hose, turn the 
wheel to let on the water, and play upon the fire. It is the 
special business of the engineer and firemen to use the 
hose and to make with it such connections as will be of 
most advantage. 
Care of patients. 
The securing the safety of the patients is the special busi- 
ness of the Resident Physicians, the Apothecary, and the 
nurses. 
Remember that the main building is practically fire- 
proof, that there are fire-escapes at the south ends of the 
pavilions, and that there will be ample time to secure the 
removal of the patients if these means are properly used. 
Do not be frightened by smoke.