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The following article was submitted by Rick Stewart, psychologist at CMHIP.

 

RULES AND REGULATIONS OF THE COLORADO STATE INSANE ASYLUM

Adopted by the Board of Lunacy Commissioners, December 5th, 1899, Pueblo, Colorado. Chieftain Publishing Co, Printers and Binders, Pueblo CO.

 

Officers of Colorado State Insane Asylum: Dr. A.P. Busey, Superintendent. Jos. H. Loor, Steward.

 

Board of Lunacy Commissioners: Dr W.W. Grant, President (Denver) I.D. Chamberlain, Secretary (Pueblo); N.D. Owen (Central City).

 

CHAPTER 1: RULES OF THE SUPERINTENDENT

 

The superintendent shall have entire charge of the Asylum subject to the approval of the Board of Commissioners.

 

He shall see that every ward in the Asylum is named and every room in each ward is numbered.

 

He shall see that a clinical chart of each patient is kept in the nurses room of each ward and that on the chart is written the patient's, name, age, color, sex, nativity, time of admission and diagnosis. He must have the temperature, pulse and respiration of the patient recorded on this chart for the first few days after the admission, and at such other times as the condition of the patient demands it. The chart must accompany the patient in case removal to another ward becomes necessary. In the event of death or discharge of the patient, the chart must immediately be taken by the ward, nurses to the Superintendent's office and placed on file kept for that purpose.

 

The Superintendent must see that all charts, records, prescriptions and books are preserved for future reference.

 

He shall see that a prescription book, a requisition book, a day record book and a night record book are kept in the nurses room of each ward, and the proper daily and nightly records are made in them.

 

He shall visit all the wards at least once a day and oftener when the condition of the patients demand it. He shall daily read the record of the nurses, visit every patient, prescribe when necessary and give direction to the nurses. His general directions to the nurse may be given verbally, but he shall see that they immediately commit them in writing to the record book.

 

He shall immediately upon entering one of the departments of the Asylum summon the chief nurse of the department, who shall accompany him during the entire visit through the asylum building. The nurse of each ward shall also accompany the superintendent and chief nurse through the ward immediately under his or her charge, unless excused.

 

He must see that the chief or ward nurses write in the record book, all directions that he gives them.

 

He must write in pen and ink, in the ward prescription book all prescriptions that he gives patients, and see that all prescriptions given by other physicians are copied with pen and ink into the ward book the same day that they were written.

 

He must keep a prescription book in his office in which he shall write all prescriptions to be put up at the expense of the Asylum for anyone who is not a patient of the institution.

 

He shall thoroughly examine or cause to be examined all patients as soon after their admission into the Asylum as possible, including an analysis of the urine, and have the result of such analysis be recorded in a record book kept for that purpose. He shall reexamine such patients or have it done as often as it is necessary. A chemica11 analysis of the urine of all patients in the Asylum he must make or cause to be made at least, once every two months and oftener of those patients who are suffering from renal trouble

 

He shall daily inspect the ward records of the nurses, see that they are properly kept and that all the nurses do their duty faithfully and treat the patients kindly.

 

He shall at least once a week, inspect all other records kept in the Asylum, or oftener if he finds it necessary, and see that they are properly made.

 

He shall O.K. with pen and ink all requisitions for supplies.

 

He shall sign all death certificates, but he or the assistant must view the body before granting such certificate.

 

He shall engage and discharge all employees subject to the approval of the Board of Commissioners. He must report to the Board of Commissioners the reason for the discharge of any employee.

 

He must listen to all complaints made to him by any employee, investigate them at the earliest possible moment, and report the same to the Commissioners at the first regular or special meeting held thereafter.

 

He may instruct the nurses or cause them to be instructed when he thinks it necessary

 

He shall keep a general supervision of all employees and interests of the Asylum, and report to the Commissioners all occurrences in the Asylum that they should know. He must also enforce all rules adopted by the Commissioners.

 

He must see that no one who is not an employee or patient is allowed to eat or sleep at the Asylum without his permission.

 

He must report to the Board of Commissioners at each quarterly meeting while in session, the names of all those that he has permitted to eat or sleep at the Asylum during the previous quarter. This rule shall not include visitors of himself and family.

 

He shall submit a written quarterly report to the Commissioners giving the information now required, and such other information as may be required from time to time.

 

He shall see that the patients are in the open air as much as possible.

 

CHAPTER II: RULES OF THE ASSISTANT PHYSICIAN

 

The assistant physicians shall be a graduate of a recognized medical college, have five years experience as a physician and have a good education. They shall have immediate care of the patients and oversight of the nurses in their work, they shall at a11 times so conduct themselves as to be worthy of imitation. They shall visit all the patients in their respective divisions every morning and again in the after part of each day and oftener when necessary. In making their rounds they shall carefully inquire after any patients that are sick or in seclusion, or not taking their meals, they must visit such to see their condition.

 

They shall inquire as to any mental change that may have taken place, they shall examine all side rooms and give attention to the neatness and order of the wards.

 

They shall give personal attention to the use in treatment of patients of every method or appliance that will benefit, as employment of massage, calisthenics, exercise, etc., and to manifest a humane kindly interest in the welfare of the patients at all times, and in every way contribute to their comfort.

 

They are not to absent themselves from the institution without the consent of the Superintendent.

 

The assistant physician on their rounds shall make such notes as are required to complete to date the history of each patient, and shall also write prescriptions in books for the purpose and make such changes in the medicines as may be required.

 

They shall write daily if necessary their medical notes in the clinical records kept for the purpose, including the treatment, the result thereof, shall be made in such a manner that a full history will be the result, representing the progress or decline of each case, and the attending symptoms, carefully observed with the aid of instruments and apparatus.

 

Obscure and critical cases of organic brain or spinal disease shall be followed closely throughout their course, and where the result is fatal, and an autopsy had, a full and complete record of the same must be added to complete the history.

 

They shall acquaint the Chief Nurses, ward nurses and night watches with suicidal and homicidal tendencies of patients.

 

Assistant physicians shall faithfully carry out all directions given them by the Superintendent and freely communicate with him concerning anything for the best results in their respective departments, they shall be watchful to detect any neglect or abuse, and constantly exert an influence promotive of kindness and faithful care of the insane and guard against harshness, thoughtlessness and inefficiency of others, and if they have reason to believe wrong is being done they shall report the same promptly to the Superintendent.

 

Extra diet when needed in any case is to be entered upon the diet book, with name of patient and date. The diet books and prescription books are to be frequently inspected, and whatever therein is no longer needed is to be discontinued.

 

They shall see that the medicines are promptly given, and in the absence of apothecary one of them shall prepare medicines.

 

They shall assist in preparing statistical tables, and shall use especial care that nay matter of importance, as sickness or accident occurring to any patient is promptly brought to the notice of the Superintendent.

 

They shall personally examine each newly admitted case and report his or her condition on the clinical records.

 

Letters of patients which are proper to be sent shall be examined by the assistants and promptly sent to the Superintendent.

 

In the absence of the Superintendent the assistants will be applied to for advice and orders.

 

CHAPTER III: RULES FOR THE STEWARD

 

The Steward shall be appointed by the Superintendent and his appointment be and is subject to the approval of the Board of Commissioners.

 

He shall give bond in the sum of five thousand dollars ($5,000) to the Board of Commissioners, and subject to its approval.

 

She shall receive such salary as the Board of Commissioners decide.

 

He shall be the accountant of and have full charge of the mercantile books of the Asylum.

 

He must keep said books in a thorough business-like manner, showing a balance every three months or oftener, as required by the Superintendent or Board of Commissioners.

 

He must be a practical bookkeeper and give reference as such. His books at all times to be under the supervision of, and at the demand of the Superintendent and Board of Commissioners for inspection.

 

He shall keep in addition to the Invoice Book, Journal, Ledger, a Stock Book in which he shall enter the number of each invoice and the amount of supplies in the debtor column. All requisitions of employees shall be numbered consecutively through each quarter, beginning with number one with each quarter. These requisitions to be extended and totals made, and the number, and amount entered in the credit column of said Stock Book.

 

He shall also keep a Voucher book, in which shall be entered the date, number and amount and name of person or firm to whom issued.

 

He shall purchase all material used for the maintenance and repair of the Asylum and only upon requisition of the Superintendent.

 

When the supplies are delivered at the Asylum, he shall receive same only upon an invoice. And at that time shall see that the supplies, requisitions for same and invoice correspond. If any error exists, he must immediately make correction on invoice, informing tradesman at once. All purchase must be made of contractors when possible, when no contract exists then the Steward must buy at the lowest prices, submitting bids to the Superintended for approval.

 

He must see that the "net" and not the "gross" is extended on the invoice correctly, and must at all times see that the prices charged by contractors agree with contract before entering same to the credit of contractors.

 

All requisitions made upon the Steward must be left in the Steward's office not later than 10 a. m. each Monday, and must be approved by the Superintendent. Such requisitions to be filled by the Steward not later then Wednesday of the same week if possible.

 

The Steward shall keep the minutes of the Board of Commissioners, act as their clerk, and perform such other duties as they may require of him.

 

He shall also be the time-keeper of the employees. Keep a pay-roll and submit same to the Board of Commissioner at regular meetings from which vouchers may be issued to employees.

 

He shall be the custodian of all supplies in the store-room and Asylum and hold all keys belong to said store-room. This is necessary to a correct accounting and the responsibility running to bond given.

 

CHAPTER IV: DUTIES OF THE MATRON

 

She shall have an oversight of the domestic affairs of the institution and will be particular in enforcing good order, discipline and faithful performance of duty in her department. She shall have under her care and supervision the bedding, table, linen, napkins and drapery, furniture, carpets and clothing of the female patients. She shall see it is of a proper kind and ample in quantity.

 

She shall be accountable for the clothing of the female patients, entering in a book for that purpose, a list of the articles bought, and see that they are proper marked before being used. She shall keep an account of the various articles manufactured for the institution.

 

She shall visit the wards of the male department sufficiently often to satisfy herself of the condition of the bedding and table linen.

 

In sickness of patients she will have prepared diet suitable to their wants.

 

In case of death she will see that the remains are properly prepared for burial, and perform such other duties as may be required of her.

 

CHAPTER V: RULES OF THE DRUGGIST.

 

The Druggist should be a graduate of an approved college of pharmacy.

 

He shall be appointed by the Superintendent subject to the approval of the Board of Commissioners of the Colorado State Insane Asylum on his presenting his diploma of graduation in pharmacy and other evidences showing his fitness for all the duties of a druggist in the Asylum.

 

His salary shall be fixed by the Bard of Commissioners, and he shall reside and board at the Asylum or not, as determined by the Board of Commissioners.

 

He shall open the drug room and be ready for work at 7:30 a.m.; have from 12 a.m. to) 1 p.m. for luncheon, then remain on duty from 1 p.m. to 5 p.m.; he shall be in the drug room from 7 to 8 p.m. unless excused from duty by the Superintendent. He shall have a half holiday each week. By arranging with the Superintendent he may have two weeks vacation each year, if he secures the services of a substitute acceptable to the Superintendent. The druggist must pay the substitute for his services.

 

He must keep the drug room in a neat and tidy condition.

 

He must make all preparation required of him by the Superintendent and Commissioners.

 

He must number all prescriptions consecutively, so as to correspond in number with number on labels, and date them if the physician has not done this, and paste them in a large book kept for this purpose, immediately after filling them.

 

When a prescription is ordered to be refilled by the Superintendent or other physicians connected with the Asylum, he must fill it and paste the physician's order in a large book kept for this purpose, and on this order he must write No.--- refilled, a new number, one in advance of the last number pasted in the book, and the date of refilling.

 

He shall not fill or refill any prescription on which the physician ordering the prescription, has not written the name of the patient, or the purpose for which the medicine was ordered, and signed his name on the face of the prescription or order.

 

He shall not allow any drugs to be taken from the drug store except on an order signed by the Superintendent or other physician connected with the Asylum, Such order must state the purpose for which the drug supply is to be used. He shall date this order, number it in regular order with the prescriptions, and paste it at once in the book kept for that purpose. This applies to medicines taken in the drug room by any physician or other employee of the Asylum.

 

In ordering drugs or drug supplies he must make out a list in the form of a requisition, have it countersigned by the Superintendent, and hand it to the Steward. He must keep a copy of all requisitions given by himself.

 

When goods are delivered at the drug room, he must carefully check off each item and see that it corresponds in quantity with the requisition given by himself, and in quality and price with the bid of the tradesman. Any discrepancy in quality, quantity or price must be reported at once to the Steward.

 

He must keep a daily ledger record of all goods received and dispensed in his department, and at the end of each quarter he must make a report to the superintendent and submit it to the Board of Commissioners, giving the sum total of goods received and goods dispensed together with an invoice of the drugs and drug supplies remaining on hand. This report must be in the hands of the Superintendent at least 48 hours before the regular Board meeting.

 

He shall not be permitted to be absent from the Asylum during the hours of duty, except when he is excused by the Superintendent or his substitute.

 

He shall permit no loafing or card playing in the drug room.

 

The Board of Commissioners, Superintendent, the other physicians connected with the Asylum, and the Steward shall be permitted to enter the drug room at any time during his hours of duty.

 

His books shall at all times be subject to the inspection of the Board of Commissioners, the Superintendent and The Steward.

 

He shall carefully compare the quarterly bills for drugs or drug supplies with the bids, and shall be held responsible for any loss that the Asylum sustains from his carelessness or neglect of duty.

 

 

CHAPTER VI: RULES OF THE CHIEF NURSES

 

There shall be two Chief Nurses; one for men's department and one for the women's.

 

When practicable they shall be graduates of a training school connected with a general hospital and shall receive their appointment on account of their executive powers, ability to instruct, and their general fitness for their positions.

 

They shall receive such salaries as shall be fixed from time to time by the Board of Commissioners.

 

They shall rise, breakfast and be on duty at 6:30 a.m. They shall see that all the nurses rise, breakfast and go on duty at the regular stated hours found in the rules relating to nurses and their duties.

 

They shall, as early in the morning as possible, inspect reports of the night nurses and see that the same are correct and written in a legible hand with pen and ink.

 

They shall instruct the nurses in the wards, carefully supervise their wards, and see that they perform their duties faithfully.

 

They shall not allow any restraining apparatus to be employed without an order from the superintendent.

 

They shall report to the Superintendent at once any disobedience or insubordination on the part of the nurses.

 

They shall, when required, one evening each week, except during the months of July and August, give an hour's instruction to the nurses, quizzing them on the lectures of the physicians, from the nurse book or instructing them in the theory and practice of nursing

 

They shall supervise and correct all ward records kept by the nurses, accompany the Superintendent during his visits, show him the records and report of the nursed, report to him each night and morning the condition of the patients, and notify him at once of any apparent serious or alarming change in the patient's condition.

 

They shall be allowed to leave the Asylum only when granted permission by the Superintendent or other medical officer. They must remain on duty from 6:30 a.m. to 7:30 p.m.

 

Before retiring at night, each Chief Nurse must visit all the wards under his or her charge.

 

They shall allow each nurse one-half days absence each week, but they shall select a regular afternoon for each nurse's half-holiday. This time can be changed from time to time at the pleasure of the Chief Nurses.

 

They shall have power to remonstrate with the nurses and to reprove them for slight neglect of duty if the offense is too slight to be reported to the Superintendent. They must however, report at once to the Superintendent any faults of the nurses that lessen their usefulness in the Asylum or that in any way render them undesirable.

 

They shall daily report to the Superintendent giving the conduct of the nurses under the, the efficiency of each nurse, the character of the nursing, the quality of the food, the state of the bed linen, the condition of the wards, and make suggestions and complaints if they have any.

 

They shall be allowed two weeks vacation once each year.

 

They must obey all orders of the Superintendent, and be careful not to give orders to the nurses that will conflict with these of the Superintendent.

 

If the nursed have been compelled to shut any patient in their rooms the must notify the Superintendent of the fact as soon as possible.

 

CHAPTER VII: RULES AND REGULATIONS OF THE COLORADO STATE INSANE ASYLUM

 

To All Employees:

 

It is enjoined upon all persons employed in the Asylum that the interest and welfare of the patients are always to be first considered. It is required that all patients shall be treated with kindness, receive prompt and proper attention to their bodily wants, and have such influences thrown around them as will promote recovery and add to their comfort while patients of this institution.

 

The work of caring for the insane is honorable and it is required of all who accept a position here that they conduct themselves in the institution and out of it in such a manner that they bring no discredit or disgrace upon themselves or the institution. Employees will remember that it is their duty whether in direct charge of patients or not, to treat all with whom they come in contact, with respect and kindness; see that they do not harm themselves or others, prevent them from escaping, and endeavor in every way to promote their recovery.

 

Next in importance is the care and protection of the Asylum property. All waste of supplies, destruction of property, defacing walls and furniture is to be avoided and prevented. Employees must remember their entire time is contract for, and they must be ready for duty whenever direct by an officer. To hesitate or neglect any duty or labor on the ground that laboring hours are over, will be regard as an object to the fitness of an employee for a position in Asylum work. Those who wish to deserve the confidence of the management, will avoid all questionable places or company and conduct themselves in such a manner at all times that no one can question their moral character.

 

RULES GOVERNING ALL EMPLOYEES

 

Conversation and gossip concerning the affairs of the Asylum, the actions or conditions of patients, or the voluntary or needless communication of any of the transactions of the institution to persons not connected therewith, will be cause for dismissal from service.

 

All inquiries relative to the condition of the patients, or the business of the Asylum should be referred to another officer.

 

All persons employed in the Asylum are forbidden to entertain visitors in their rooms or places of business, to take friends or relatives to meals or invite anyone to amusements or chapel service without permission from the Superintendent.

 

Employees when called upon by visitors, will see them in the reception room, and must not take them through any part of the building without permission from a medical officer.

 

Loitering about the office, or main entrance is objectionable and must be avoided.

 

No employee is allowed to absent him or herself from his place of duty without the consent of a medical officer or matron.

 

Employees, not in ward service, are not permitted to visit wards or dining rooms at any time without permission of medical officer or Chief Nurse, and such permission will extend only to that particular instance.

 

No furniture or supplies shall be removed from the room to which it has been assigned without the permission of the Matron or Chief Nurse, and no food shall be taken to bedrooms or places of employment without like permission.

 

OFF DUTY

Employees are not expected to leave the premises at any time day or night without permission. The Matron will grant permission to all employed in the domestic department, kitchen, laundry, sewing room, etc.; all others will apply to the Superintendent or assistant physician. Unless granted special permission to remain out after 10 p.m. must be in their rooms with lights out at that hour. Permission to be absent during hours of duty, or for unusual lengths of time, or to be about later than 10 p.m. will be granted only by the Superintendent, or in his absence by physician in charge.

 

Employees when business calls them to the office are expected to appear in proper dress and never with their coats off or their working aprons on, and will not linger after the business is transacted.

 

EMPLOYEES OF THE TWO BUILDINGS

The two divisions of the institution are always separate to its employees, and no person shall ever be found in the other, unless by direction of an officer. No one is permitted to enter the corridors, stairways, or basement rooms of the building of the opposite sex, without the special order of a medical officer.

 

WORKMEN WHILE ON THE WARDS

Carpenters, engineers, painters, and all other workmen, whose duties may call them on the wards temporarily, should refrain from talking with patients, be careful that all materials, tools etc. are kept from the patients, and that all doors are locked behind them.

 

In the wards occupied by female patients no male employee, without exception, shall enter the ward until a nurse has been notified of his presence. To enter any room occupied by a female patient without the presence of a nurse is positively forbidden.

 

No person but the Chief Nurse or Nurse in charge of the ward shall take any patient from the ward for any purpose, without permission of the Superintendent or assistant physician.

 

The person taking such patient out will be responsible for his or her safe return to the ward. All persons having patients in charge for labor are in all respects for the time their nurses and are subject to the same rules governing the care and treatment of patients as are nurses.

 

It is required that those taking patients out, shall see that they are properly clothed for the kind of labor which they will perform.

 

To take a patient out not properly clothed for work, or to permit him to lose or destroy his clothing while out, will be regarded as culpable negligence.

 

BARGAINS

 

No person shall make any bargain with patients, purchase any article for them, or accept any fee or present from patients or friends

 

CORRESPONDENCE

 

Should any clandestine correspondence between patients occur and it should come to the knowledge of an employee he must not fail to report it. No letter or writing of a patient shall be mailed or delivered to anyone without the consent of the Superintendent

 

ASSISTANCE FROM PATIENTS

 

No employee shall ever accept the services of any patient in the performance of any labor for himself personally without the consent of the Superintendent.

 

VISITING DURING WORKING HOURS PROHIBITED

 

Loafing in the shops, kitchen, bakery, engine rooms, and other departments is forbidden and employees off duty must not visit those who are engaged in the performance of their duty.

 

 

PRECAUTIONS AGAINST FIRE

 

No employee shall use matches other than a kind furnished by the institution. All cloths which have been saturated with oil, turpentine, or other inflammable material shall immediately be removed form the building and must not be thrown down the dust shafts.

 

In case that fire should be discovered in any part of the building, prompt notice should be sent to the Superintendent and Chief Engineer.

 

BE QUIET

 

All employed in the Asylum should cultivate a calm and deliberate method of performing their daily duties. Loud talking, running up and down stairs, rude language, untidy or unsightly styles of dress, are wholly out of place and must not occur.

 

All persons employed in and about the Asylum must give 15 days notice before leaving.

 

RULES FOR NURSES

 

In addition to being governed by the general rules binding upon all employees, nurses will also be governed by the following regulations:

 

Nurses, both male and female, when practicable will be selected from graduates of a good training school, or from those who have had long experience and training in some good insane Asylum.

 

Those employed as nurses will learn that proper deportment, faithfulness to duty, and strict observance of rules will alone keep them in the position in which the are placed.

 

Nurse should remember that their first duty is to treat the patients with unvarying kindness, respect and attention. No one is fit for the position who can not regard with good humor whatever a patient may say or do.

 

Constant quarreling between nurse and patient is strong evidence of the unfitness of a nurse for his or her position. A nurse should always address a patient in becoming language, and abusive or impolite expressions will not be tolerated.

 

ABUSE OF PATIENTS

 

Blows, kicks, punching, pulling ears or hair, twisting arms, shaking, or any other form of physical abuse inflicted upon a patient will not only be cause for immediate discharge, but will lay the person inflicting such abuse liable to prosecution. When a patient manifests opposition to the direction of a nurse, the point should never give rise to a protracted argument or in scolding on the part of the nurse. When resistance occurs and the order is important the aid of the Chief Nurse should be called before proceeding further.

 

Nurses must rise in time for breakfast, be in their wards ready for duty at 6:30 a.m. and remain on duty until 7:30 p.m. They shall assist the patients in dressing, washing and in getting them in the dining rooms in as neat a condition as possible in time for breakfast.

 

They shall give the patients ample time to eat and never send them from the table in less than 20 minutes.

 

Patients must never be refused food unless by order of a physician, and never for the purpose of discipline. They shall carry food to those who are unable to leave their rooms and feed them.

 

Patients should not be allowed to use carving knives, when nurse is through with the knives must lock them up, nurse must count knives before patients enter and before they leave dining rooms.

 

They shall give all medicines as prescribed, keep written record of the same and such other records as they are required to write by the Superintendent or chief nurses.

 

They shall remain on duty in their wards during the entire day except during the time necessary for meals, and keep out of their rooms.

 

They shall give assistance to the patients during dinner and supper as each may need or as required by the Superintendent or chief nurses.

 

They shall obey all orders from the Superintendent and chief nurses implicitly and without questioning.

 

They shall bathe patients, change their clothes and bed linen at least once a week, and oftener when require by the Superintendent or Chief Nurses.

 

They shall make the beds of the patients who are unable to attend to their own beds, and shall take the lead in all other work in and about the wards.

 

They shall take the patients out in the open air whenever requested by the Superintendent or chief nurses.

 

They shall not attempt to put any restraining apparatus on any patient unless they are directly instructed to do so by the Superintendent or chief nurses. If any patient becomes unruly they may shut them in a room but they must immediately notify the chief nurse of the fact.

 

Nurses should be especially vigilant that patients do not have in their possession any dangerous implements, matches or other improper articles, and to this end are required to frequently examine the clothing and bed rooms of patients

 

Patients shall be taken out for exercise whenever the weather is suitable unless the patient is ill or improperly clothed, or has been excused by the physician. No patient should be permitted to remain on the ward without a nurse and if unable to go out for exercise or to meals the fact should be reported to the chief nurse.

 

Nurses must use great care in preventing the escape of patients. It is required that nurses taking out patients for exercise must count them when leaving the ward and again count them when leaving the exercise grounds and also before entering the ward. The escape of a patient without the knowledge of a nurse and without prompt report being sent to the office will be treated as gross negligence.

 

The nurses and night watches must wear a uniform adopted by the Commissioners and the Superintendent while on duty, except before 9 a.m. each day while putting the ward in order, they shall not appear in the wards with coasts off or unsightly or improper dress.

 

No one shall be admitted on the wards not officers or employees of the Asylum, and known to have legitimate business in the wards.

 

Visitors to nurses and patients will first receive permission from a medical officer before being allowed to see their friends, and nurses hall not permit visitors to see patients or entertain visitors themselves without permission.

 

SMOKING NOT PERMITTED

 

Nurses and patients are not permitted to smoke in the wards, in the halls, landings, nurses rooms, or the center, reception rooms or halls.

 

Nurses must refrain from loud talking, or boisterous conduct on the wards or in their rooms; especially is it important that quiet be preserved after patients have retired for the night, nurses must be in going to their rooms open and shut doors quietly and pass through the wards with as little noise as possible.

 

During their hours of duty they shall not leave their wards without special permission from the Superintendent or Chief Nurse.

 

Nurses shall take temperature, pulse and respiration, note bowels, appetite of the patients as required of them by the Superintendent or chief nurse.

 

All washing and ironing shall be done in the laundry

 

No nurse shall accept a present of any kind from a patient. The patients shall not be permitted to embroider or do any special work for nurses without permission from the Superintendent.

 

Nurses will be allowed a half holiday each week and two weeks vacation each year when possible to grant it. Nurses when off duty shall always leave their keys in the office in a box provided for that purpose.

 

SHAVING

 

All male patients shall be shaved once a week or oftener when necessary.

 

RULES FOR BATHING

 

Patients must never be permitted to bathe without the presence of a nurse, who will prepare the water and see that the temperature is proper, and the bath room is never to be left by the nurse until all the patients are out and the door is locked.

 

Nurse must use care and gentleness in bathing patients. No patient should be permitted to enter a bath tub until the water has been turned off and hot water is never to be turned on while a patient is in the tub.

 

CLOTHING

 

When patients are admitted whatever property is brought, shall be immediately committed to the chief nurse who will record all articles in a book for that purpose. Money, jewelry and all other valuable s must be delivered to the Steward and a receipt taken. A list of the clothing belonging to a patient shall be entered in a book kept by the Chief Nurse, into which will be entered whatever may afterward be received or purchased for the patient's use.

 

All clothing in each division of the Asylum shall be kept in the ward clothing rooms properly placed in the boxes provided.

 

All articles worn by the patient shall be plainly marked by the Chief Nurse and the nurses and the chief nurses are expected to see that the clothing of each patient is devoted to his use.

 

WARD PROPERTY

 

Articles invoiced to one ward shall not be transferred to another, permanently or temporarily without permission of the Chief nurse.

 

No article of clothing or ward property shall be destroyed or removed from service, until it has been inspected and condemned by the Chief Nurse.

 

When so condemned the article shall be properly listed on a blank for that purpose and be signed by the person condemning.

 

Condemned articles shall be removed to the condemning room.

 

INVOICE

 

Every article in each ward shall be invoiced once every quarter by the Chief Nurse in a book provided for the purpose and turned over to the store-keeper. Nurses shall facilitate invoicing by presenting everything on the wards.

 

LAUNDRY WORK

 

Nurses shall before sending clothing to the laundry carefully count and list them, filling out the column on the laundry list, mark the number sent, on both the dup0licate and original. The original is to be pinned securely to the clothes sack and sent to the laundry.

 

After reaching the laundry, the clothing from each ward is to be counted and the list verified. In case an error is claimed on the part of the nurse by the laundry, the Chief Nurse will be notified and the nurse will be sent to the laundry to correct the error.

 

Special laundry work as articles of clothing and bedding rendered filthy by dejections and discharges shall be listed on a special list, and sent to the laundry early in the morning, laundered at once and sent back before evening when possible.

 

DUTIES OF NIGHT WATCHES AND NURSES

 

The night watchman shall begin his duties before or as soon as the day nurses duties have ceased for the day. He shall visit the basement, engine room, boiler room and other departments, extinguish all lights unnecessary. Securely lock all doors not locked, look after conditions of all places where fire has been used during the day.

 

He shall patrol the wards at least once an hour, administer to the wants of patients, giving medicine when directed, change the wet or filthy, quiet disturbances, attend to the heating and ventilation, visit rear buildings and have general care of the male division and the center building.

 

He shall report all persons entering after 10 p.m. or found out of their bedrooms. It is his duty to report all lights burning contrary to rules, to observe that night nurses, firemen, engineers are constantly at their posts and do not sleep while on duty, to report any unusual occurrences and to watch carefully for any signs of fire.

 

He shall remain on duty until the rising signal at which time he shall call al nurses and turn the wards over them in good condition.

 

DUTIES OF THE FEMALE NIGHT WATCH

 

The duties of the female night watch shall be similar to those of the male, but shall be exclusively confined to the female wards.

 

Night watches shall keep a close watch on patients who are suicidal and report immediately any tendency in that direction of any patient.

 

Night watches and nurses shall make a written report of the night work, and deposit it in the Superintendent's office before 6 a.m.

 

They shall hold themselves in readiness to show visitor through or perform such other duties as may be assigned them.

 

COOKS

 

The baker, chief cook, and assistant cook in addition to being governed by the general rules binding on all employees shall perform their duties under the general direction of the Matron.

 

They are responsible for the stores, utensils, and property under their charge, and are required to securely lock at night and at any time when not in use the bakery, bread room, pantries and kitchen.

 

They must not allow employees to loaf in their departments and are forbidden to permit any to lunch in or take nay food from the bakery or kitchen.

 

DOMESTIC DEPARTMENT

 

The laundry, sewing room and ironing room are under the general direction of the Matron who will from time to time instruct those employed therein as to the details of their work. All employed in the domestic department receive their instructions from the Matron and it is her duty to see that they obey the rules of the Asylum and to report to the Superintendent any one who willfully violates rules or who is unfit for Asylum work.

 

The farmer, gardener, hostler and dairyman shall under the direction of the Superintendent and Steward perform the duties belonging to their several stations and shall be responsible for safe keeping of all stock, tools and implements entrusted to them.

 

The carpenter, painter, shoemaker and all other artisans shall receive their orders from the Superintendent.

 

RULES OF ENGINEER'S DEPARTMENT

 

The engineering department shall consist of the boiler and engine rooms and all machinery therein and all laundry and kitchen machinery and all pipe in the building and grounds and all fire hoses, fire apparatus and lighting.

 

The Chief Engineer shall be the head of the engineering department under the Superintendent. He shall report daily to the Superintendent the condition of his department.

 

He shall have charge of all engineers, firemen, steam fitters, plumbers pipe layers or other men employed in the department. He shall be responsible for all heating, ventilating, fire protection and sanitary conditions of the buildings.

 

The fireman at the male department shall come on duty at 4:30 a.m. during the summer months and remain on duty until 6 p.m. or longer if necessary. During the winter months, when there are two firemen, they shall work twelve hours each per day, relieving each other at hours fixed by the Superintendent.

 

The Chief Engineer shall make daily inspection of the buildings and examine into the conditions of the pipes, heating and fire apparatus, and shall make such repairs as may be required under the direction of the Superintendent.

 

He is further expected to regulate his hours of duty according to the requirements of his position. He shall never absent himself from the premises without the consent of the Superintendent. Assistant engineers and firemen are not permitted to leave the premises without the knowledge of the Engineer, and never to be absent from duty with the permission of the Superintendent.

 

APPROVED, DECEMBER 5, 1899

 

W.W. Grant, President

I.D. Chamberlain, Secretary

N.D. Owen

 

Board of Lunacy Commissioners.

 

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