Very recently, I nursed a lady who was a student nurse in 1931. She had kept all the notes she had written during her nurse training. She let me read these notes as I was very interested in the history of nursing, and gave me permission to copy extracts to show others. These notes are taken from her work.
Isolate the patient at once and all clothing is to be considered infectious. Wash out in 1 in 20 Carbolic before sending to the laundry where they are to be treated separately. A complete set of utensils such as spoons, thermometer, bedpan, medicine glass, sputum mug and so on to be kept in the room which after use must be boiled.
One nurse to be detailed to all the duties. All excretions to be covered with 1 in 20 Carbolic and allowed to stand for 2 hours before being thrown away. The Nurse is to wear long overall to cover dress underneath. Hair to be secure well under cap. Hands to be well disinfected after every attendance and sleeves rolled up.
After the patient has left the room block up the chimney. Paste brown paper over the windows, ventilators and any cracks. Open all the drawers and spray the room with Formalin. Place a Formalin lamp with tablets ready for burning in the centre of the room. The lamp should be placed in a bucket of water in case of fire. Light the lamp, shut the door and paste brown paper over the cracks, plug the keyhole and leave the room alone for 24 hours. After the 24 hours remove all the paper and plugs and allow the room to ventilate freely. Scrub floors, furniture windows and walls with soap and water in a 1 in 20 Carbolic solution.
Infectious diseases were life-threatening at this time. Alexander Fleming did not discover penicillin until 1928 and antibiotics were not prescribed to patients until the late 1930′s. When this procedure was written, infection control was the only means of preventing the spread of infections. Being a Nurse at the time came with a high risk of catching infections that could be life threatening. Nurses took their work very seriously, and religiously completed the tasks to a high standard. Some of these processes we still use today, while most are long gone. The smell of Carbolic was always linked to hospitals and one of the jobs of student or junior nurse was to scrub the sluice and bedpans twice a day. Students often saw this as a punitive exercise, and underestimated how important it was. But the students or juniors efforts were inspected by the ward sister to make sure nothing had been missed, as this was deemed so important an issue. The smell of Carbolic was a psychological link to cleanliness, and people would often say that the hospital smelt clean. We lost carbolic in the 1980′s as it was deemed too toxic and did not kill the new bacterias.
Romantically, maybe this is a shame; if we could replicate the smell then maybe patients and visitors would feel more reassured. But with hospital aquired infection rates always hitting the headlines, we clearly need to do so much more.