Athy Workhouse
(now St. Vincent's Hospital) was the subject of a report which appeared in the
British Medical Journal in 1896. The
report gives an interesting insight into the basic almost primitive nature of
health services provided for the elderly and the insane 110 years ago.
“Athy is an important market town, and the workhouse, which is on its
outskirts, draws its inmates from a large agricultural district. The medical
officer, Dr. O’Neill, lives some distance from the house, and we were unable to
time our visit to coincide with his. [Dr. O'Neill referred to in the report
was Dr. Jeremiah who had been appointed Medical Officer the previous year in
succession to his father, Dr. P.L. O'Neill who had held the position from 1874
to 1897] The matron, however, kindly
placed herself at our disposal. In this workhouse the sick have overflowed into
the body of the house. The infirmary originally planned for 30 patients, has at
the present time to accommodate 42, and there are besides over 80 beds for
cases of chronic infirmity requiring nursing, which are placed in the infirm
wards in the body of the house. [The
Infirmary was part of the original warehouse building which opened on 9th
January 1844. As appears from the report
it catered for the infirm who required nursing]
There is an average of 95 inmates under treatment, exclusive of the
lunatics, and this out of a total of 200, the number booked as being in the
house on the night preceding our visit. The infirmary, consisting of a middle
block and two wings, is given up to the cases which require most attention; in
the middle portion is the operating room, on the first floor; below, the
surgery, and the male side the kitchen, which occupies the space of two rooms.
The walls throughout are whitewashed, the wall surface being smooth and the
ceilings plastered. A match-board lining is carried round the walls at the
height of the head of the beds. The windows are diamond paned, in heavy metal
frames.; the upper half falls inwards, the lower turns on a pivot; there is no
other ventilation. The bedsteads are principally the old harrow frame, with
fibre mattresses, but on the male side; there are some spring beds. Between the
beds were tables with a drawer on each side; there was a long table with
benches for meals, and a few arm chairs. The ward crockery was kept in
cupboards, and the linen store in a cupboard on the landing. In the operating
room we were shown the instruments, which were creditably kept; this room
contains a table, desk, and bed. On the female side the wards were not very
full; an empty room was in use as a day room; in the second ward, of ten beds,
was a child with acute chorea- we have seldom seen a worse case; another with
phithis; a case of fractured thigh; anaemia; ulceration of the legs; a strumous
child; and two women who were dressed. One of these told us that she “had her
chest bad,” and the other had some internal trouble. On this side there are ten
beds more than on the men’s side. The lower ward was used as a sleeping room
for any inmates whose services were required at night in the wards. The male
patients also were few in number. In the first ward, of six beds, they were all
up; in the second, containing ten beds, three were in bed, one with bronchitis,
another with an ulcerated leg, and the third was a case of senility. As the
visit was paid in the summer we found the sick department at its lowest. The
wards were being scrubbed, which gave them a disorderly appearance. The
lunatics in this union are kept in cells. There is accommodation for six on
each side, in three cells. [The
reference to lunatics and the cells in which they were accommodated is a
surprise revelation and the first reference I have found to the detention of
the insane in the local workhouse] The
so-called dayroom is the corridor outside the cells. These cells are bolted at
night and there is no spyhole. On the male side were five patients; they were
out in the exercise yard. On the female sides were two patients, seated on a
bench in the corridor. An infant belonging to the wardswoman was in a cot in
one of the cells. These divisions were clean, but unspeakably dreary and
cheerless. The airing court on the female side, in which we were pleased to
notice benches, is spacious and had growing flowers; it is used in common by
hospital patients and by the idiots. The epileptics are in this class. The
infirmary nursing is in the hands of three nuns who are not trained [The
Sisters of Mercy first began to visit patients in the Workhouse infirmary some
time in the 1870's. The Board of
Guardians made an approach to the Order to take over responsibility for the
Infirmary which they did in or around March 1880]; they have the usual pauper helps, one to
each ward. The nuns are also responsible for the lunatics, though on both sides
an inmate was in charge. There is no night-nurse; if necessary inmates are
placed on duty at night, and if more nurses are required by day, a larger
number of inmates is sent from the house; quantity is not stinted if the
quality be more than doubtful. The maternity ward is in the body of the house,
close to the infirm wards. It is a large room, having, however, only four beds,
one of which was occupied; there is no labour bed. The ward is not good-dark,
badly ventilated, and difficult to warm in winter; the windows are placed high
in the wall, and on one side only. The beds are straw on the “harrow” frames. A
door leads to the nursery, a small room, and beyond is a small garden in which
is an open shed with bath and cold water tap, a privy and a receptacle for foul
linen; the shed was much blocked with pails and odds and ends of lumber, making
it practically useless for its original purpose. As previously mentioned, a
large number of hospital patients are treated in the infirm wards, where 42
beds in two wards are assigned to them in each wing. These wards are fitted up
as sick wards, and here we saw helpless cases-paralysis, old age, etc. On the
male side there are 20 in bed, on the female side only 8. The matron is
responsible for the nursing of these patients, and has a wardsman or woman in
each ward. These wards are locked at night on the outside; there are no bells
to the officers’ quarters, and though they are termed convalescent wards, most
of the patients treated in them will never reach the convalescent stage. Nor
are there any appliances for nursing, no water supply, no offices, no proper
ventilation, the only light and air coming through a large window at either end
of the ward. More serious still is the great distance between these wards and
the infirmary proper, and the absence of all supervision at night. The
guardians have placed good stoves in the wards, and also by the provision of
small tables, chairs, etc. have endeavoured to overcome some of the
difficulties of nursing, but the structural defects still remain. The sunk
portion of the floor has been levelled, so as to provide space for the
iron-framed bedstead with fibre mattress. In some wards we saw a few “harrow”
beds in use. The fever hospital is a separate building [The Fever Hospital was separate from the
Workhouse and was in operation before the Workhouse opened], standing on a
higher level than the workhouse. It is better planned for the requirements of
the sick, and as there is no fever, we were told that the doctor sends thither
such patients as in his opinion require better air. It is nursed by two trained
nurses and has its separate kitchen and laundry. In the girls’ and boys’
dormitories we were pleased to notice that the guardians had superseded the
straw ticks on the floor by spring bedsteads, that they had levelled the floor,
and on the girls’ side they had removed the partition, thus improving the light
and increasing the cubic space. The fireplaces throughout are the old grates,
except in the infirm wards. The kitchen is still in its primitive
condition-huge boilers, with their separate furnaces, and no range. The water
for house use is heated in the laundry. This laundry serves all departments,
except the fever hospital. We are informed that the feeding troughs are still
in use in the dining-hall for serving the stirabout to the able-bodied. In
sanitary matters this house is on a level with others of its class.
The privies are on the trough system; they were not in a cleanly
state, and in some cases we noticed great carelessness in placing the trough.
There is one bath in the infirmary, with hot and cold water supply. There are
no indoor conveniences. Soil buckets are used in the infirmary and infirm
wards, and remain unemptied at night. The water supply is ample, and is pumped
up daily.
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