To be “in charge” is certainly not only to carry out the proper measures yourself but to see that every one else does so too; to see that no one either wilfully or ignorantly thwarts or prevents such measures.  It is neither to do everything yourself nor to appoint a number of people to each duty, but to ensure that each does that duty to which he is appointed.  This is the meaning which must be attached to the word by (above all) those “in charge” of sick, whether of numbers or of individuals, (and indeed I think it is with individual sick that it is least understood.  One sick person is often waited on by four with less precision, and is really less cared for than ten who are waited on by one; or at least than 40 who are waited on by 4; and all for want of this one person “in charge.)”

It is often said that there are few good servants now:  I say there are few good mistresses now.  As the jury seems to have thought the tap was in charge of the ship’s safety, so mistresses now seem to think the house is in charge of itself.  They neither know how to give orders, nor how to teach their servants to obey orders—­i.e. to obey intelligently, which is the real meaning of all discipline.

Again, people who are in charge often seem to have a pride in feeling that they will be “missed,” that no one can understand or carry on their arrangements, their system, books, accounts, &c., but themselves.  It seems to me that the pride is rather in carrying on a system, in keeping stores, closets, books, accounts, &c., so that any body can understand and carry them on—­so that, in case of absence or illness, one can deliver every thing up to others and know that all will go on as usual, and that one shall never be missed.

[Sidenote:  Why hired nurses give so much trouble.]

NOTE.—­It is often complained, that professional nurses, brought into private families, in case of sickness, make themselves intolerable by “ordering about” the other servants, under plea of not neglecting the patient.  Both things are true; the patient is often neglected, and the servants are often unfairly “put upon.”  But the fault is generally in the want of management of the head in charge.  It is surely for her to arrange both that the nurse’s place is, when necessary, supplemented, and that the patient is never neglected—­things with a little management quite compatible, and indeed only attainable together.  It is certainly not for the nurse to “order about” the servants.

IV.  NOISE.

[Sidenote:  Unnecessary noise.]

Unnecessary noise, or noise that creates an expectation in the mind, is that which hurts a patient.  It is rarely the loudness of the noise, the effect upon the organ of the ear itself, which appears to affect the sick.  How well a patient will generally bear, e.g., the putting up of a scaffolding close to the house, when he cannot bear the talking, still less the whispering, especially if it be of a familiar voice, outside his door.