Salaries are on the whole lower than in the County Asylums, beginning at anything from L15 rising to L19 in the third year with a bonus of L3 on passing the final examination of the Medico-Psychological Board.  There must, however, be set against this lower rate of remuneration, the fact that these mental hospitals are often situated more centrally than the county asylums, thus making less expenditure necessary for travelling to and from the hospital when out on leave.  The usual free board, lodging, washing, medical attendance, and uniform are also given after three months’ satisfactory service.

The hours of duty are from 7 A.M. to 8 P.M. with two hours off for meals, etc.  Leave during a month varies with the different hospitals, but is usually two whole days, three half days, four evenings from 6 P.M. to 10 P.M., and four evenings from 8 P.M. to 10 P.M.:  there is also annual leave of fourteen days after the first twelve months, increasing to three weeks after three years’ service.

The work in a mental hospital is totally different from that in large asylums.  As there are fewer patients, individual treatment is the rule, and the nurse gets more intimate knowledge of her patients’ condition, which she may thus do much to ameliorate.  Owing to the homelike freedom allowed, nurses need to be specially patient and tactful.  In return for this, however, by their much closer companionship with their patients they gain the opportunity of thoroughly knowing and therefore sympathising with and guiding them, and on this, successful treatment largely depends.  The majority of the patients in these hospitals are suffering from acute forms of insanity, and this adds both to the strenuousness and to the interest of the nursing work:  the fact that such patients frequently recover, acts as a great incentive to the work.

Private asylums are on a different basis and do not as a rule offer training.

A trained nurse may hope for promotion to posts as Sister of a ward, Night Superintendent, Assistant Matron, or Matron.  These posts demand personal attributes in addition to good training—­e.g., powers of organisation and administration, a knowledge of housekeeping, laundry work, etc.  For the higher posts, training in general nursing is essential.  In all forms of mental nursing it is undoubtedly a great advantage if the nurse has had a preliminary general training before entering on the special branch of the work.

The conditions for private mental cases are the same as those described under private nursing for general work (see page 184).  The fees, however, compare very favourably with those obtained for general work, being almost universally higher.  The great disadvantage is that the hours are very long and the work necessarily exhausting.