Tuesday, July 17, 2018

Hospitals Before Air Conditioning

Vintage Hospitals had very little in the way of mechanical climate control and patient care areas on the wards often became sweltering brick ovens. High ceilings and transoms over the door of each room helped some, but hot is hot and working in an overheated enviroment was accepted as part of the deal of being a nurse. Wide open  wooden double hung windows helped a bit and as an added thrill there were no screens above the third floor. The theory that there are few high flying insects might have been true but pidgeons did not follow this rule. We used to coral them in a corner with a draw cloth and send them back on their merry way via the open window.
We all agree. It's too hot in here.

Staff nurses frequently draped towels  soaked in ice water around their necks, but such luxuries were not permitted for student nurses. Misery and suffering were vital elements in the quasi-religious initiation into the nursing world and belly achers soon found themselves on the outside.
I had it much easier than the female students who wore a heavy apron over their blue dresses. A common problem was sweat running down legs and pooling in fluid containment  vessels like Clinic shoes. A memorable sight was a student in the break room removing her shoes to drain the sweat. I had a different problem because my primary sweat generator was my back. The perspiration would slide down my back and soak my underwear and seat of my pants. I stopped one day to purchase a Chicago Tribune from the corner news stand and after producing a dollar from my hip pocket the vendor commented, "Hey..This dollar bill is soaking wet." I kept my mouth shut and just smiled rather than explaining the embarrassing source of the moisture.

Patients were the ones who really suffered in the heat. Working on the ortho floor meant dealing with a particularly uncomfortable bunch of patients. The casts often exacerbated the sweating which almost always produced itching in remote areas of the casted extremity. Clever nurses produced under cast scratching devices by taking an ordinary coat hanger and straightening it out. The business end of the scratching device was twisted into a tight loop which could be threaded down to the area of itch. They were crude but effective anti-itch devices.

The hospital director's office and operating rooms were air conditioned and clever nursing personnel learned to take advantage of an occasional whoosh of cold air. The ORs were accessed by a manually operated elevator that moved cold air down the shaft like a giant piston. An oasis of cool air greeted anyone standing near the old elevator doors when the device was on a downward plunge. We concocted a variety of excuses to linger by those doors. My favorite excuse was awaiting the arrival of a fresh post-op patient.

Hospitals were not early adopters of air conditioning. For the first couple of hundred years after it's invention, the wheel was only used for making pottery. Nobody could figure out how to make wheeled carts as effective as sleds on runners. The same situation applied to hospitals and AC. The roof of a hospital was not designed to support refrigeration units and there were no ducts in radiator heated hospitals, besides nurses and patients were meant to suffer. It was just the way the world worked.


  1. Ha! I can so relate to this, having trained in hot Sydney, Australia! We were very lucky that two years earlier to our intake our uniform was changed from long sleeves with starched cuffs to short sleeves - I honestly don't know how the nurses coped in the humid summers wearing long sleeves.

    Still we had a high collar and three layers of belts around our waists - original dress belt, apron belt and over that a coloured belt denoting our rank. Plus thick stockings and heavy shoes. And a starched cap (my hair used to be soaked from perspiration!)

    In a heatwave where we hit over 40 degrees day after day (that's over 100 degrees Fahrenheit) we had a special dispensation from Matron that we were permitted to undo the top button of our collars - but only while in the nursing school and not on the wards!

    Apart from the morning wash we had a second wash for all patients after lunch to help keep them cool.

    We also all carried a tube of deodorant in our pockets or the poor patients may have swooned from the BO of a nurse leaning over them...

    Male nurses were a rare sight during my training - it was highly unusual for men to train at our hospital.

    The best wards were the old tuberculosis wards which had wide doors opening onto shady verandahs, allowing a nice breeze to flow through the ward!

    Thanks for an interesting trip down memory lane! Cheers, Sue.

    Strange but we still loved our uniforms because we thought they looked so great.

    The best wards were the old Tuberculosis wards which had doors opening onto wide verandahs - allowing a breeze to waft through the wards.

    1. Sorry I don't know why two lines I thought I'd deleted ended up at the end...

  2. Sue, thanks so much for your comments. I always enjoy hearing from you. We used to keep a bath thermometer in the med room to monitor the unbearable temperatures. The unspoken rule was to never, ever comment about how hot it was.

    We had lots of fans and nurses were fond of tying strips of Kerlix to flutter in the breeze as a way to show patients that we were trying to keep them cool.

    I think that working in these blast furnace like conditions must have planted a seed of heat tolerance in me because hot weather rarely bothers me now or maybe I'm just getting old and my thermoregulation physiology is falling apart!

  3. I'm not sure how great air conditioning is OFRN - working at a private hospital in palliative care with the patients in little rooms off the corridor (instead of the long Nightingale wards I loved), one room would be freezing and the next would be so hot we'd be putting fans on - the poor patients were so uncomfortable.

    Plus I hated that dying patients lived their last days in grey little cubicles with dark tinted windows that could not be opened. Give me the old wards where we could open the windows and the patients could feel a breeze/hear the birds!

    Our original Spinal Unit was a little cottage in the hospital grounds where patients could be wheeled out on lovely days and their beds left under dappled shade of the trees. This was considered hugely important in helping their morale.

    When they built the new high rise air conditioned cement tower and demolished the cottage the patients could never get outside (needed two nurses and seven floors up and down in the lift - plus the lovely gardens had been demolished for car parking) and the rate of depression among spinal injury patients soared - no wonder.

    I recently moved from a mountainous part of Oz that had long snowy winters and short dry summers to the sub-tropics and the heat/humidity here just wipes me out - I hadn't realized how conditioned to cold weather I'd become! Swap you for Pittsburgh any time... don't know what your summers are like though.. but the winters must be cold at least! Winter here feels like summer to me. Summer is like being stuck in a sauna for six months - but with palm trees. Cheers, S.

  4. When patients were nearing their final hours old nurses liked to leave the windows open for the soul to escape the surly bonds of the ward environment. Dying patients always seemed to enjoy open windows. Maybe it was the connection to a more natural world.

    Pittsburg summers are unpredictable but this year we are having an unusually hot one which rekindles old memories of working in the hot hospitals.

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