(1)
Flinders University of South Australia School of Medicine, Adelaide, SA, Australia
“The sister in charge of the school should at the end of the month make a special examination of her pupils as to their knowledge … and test the quickness and beauty of their bandaging by their performance on the ‘dummy’ used for instruction, and upon one another” [1]
Lees (1894)
Care of the sick and injured by well-trained professionals is a relatively recent development in healthcare. For several hundred years religious orders provided care in what became asylums or hospitals and was aimed at repairing the soul as much as repairing the body. In those times disease and pain were often seen as punishment for bad deeds. The link between sin and suffering was broken during the Enlightenment and improved knowledge and understanding of the workings of the body led to new medical treatments and an expansion of surgery.
In hospitals post-surgical care , including dressings, was at first provided by surgical trainees, sometimes known as dressers. Late in the nineteenth century it was shown that poor care of patients in hospitals led to worse outcomes and trained nurses took over the care of patients in hospitals. There are some references to simulation in nurse training in the United States before this but the teaching was actually on midwifery.
Teaching aids and patient simulators were used to demonstrate procedures to classes in the new schools of nursing (see Fig. 9.1) and then for practice (see Fig. 9.2).
Fig. 9.1
A mannequin being used to demonstrate a procedure to class of student nurses. (Credit: Archives de l’AP-HP)
Fig. 9.2
Student nurses practice transferring a patient from bed to a trolley using a mannequin. The teacher is using a checklist to assess team performance. (Credit: Archives de l’AP-HP)
In a Handbook for Hospital Sisters published in 1874, Lees wrote that nursing schools should have “A mechanical dummy, like those in the Dutch training schools” [1, p. 34]. Also, “The Sister in charge of the school should at the end of the month make a special examination of her pupils…and test the quickness and the beauty of their bandaging by their performance on the ‘dummy’ used for instruction” [1].
Auxiliary nurses in Japan were trained on simulators at the beginning of the twentieth century in preparation for casualties from a war with Russia. The Graphic Artist in 1904 had an illustration of “Japanese ladies practising bandaging on a dummy” (see Fig. 9.3) and reported that, “The Japanese women are as enthusiastic about the war as the men. Ladies join the Red Cross Society and eagerly listen to the instruction given by nurses and practice bandaging on a dummy so that they may be of service attending the wounded.” A painting by the French artist Clovis Didier (b. 1858) also shows bandaging being practised on a mannequin (see Fig. 9.4).
Fig. 9.4
Démonstration du pansement sur mannequin by Clovis Didier (1916). (Credit: The work belongs to the Museum of Publique-Hôpitaux de Paris. © f.marin/AP-HP)
Mrs Chase
“A Patient
I think that I shall never see a patient who so patiently lets strangers wash her feet and face, as our phlegmatic Mrs. Chase . A patient who in calm repose, lets “probies” irrigate her nose. Or when they give her a hot pack, and happen to expose her back he never murmurs nor complains, but in her state of calm remains. A credit to the human race, a blessing on thee Mrs. Chase!
Lea Smith” (1939) [2]
Martha Jenks Chase (1851–1925) had started making dolls in 1889 as a hobby and gave them to children in the neighborhood. The doll business began when a buyer for a Boston department store happened to see one she had made and insisted she took an order [3, p. 114]. Dolls at that time were either imported from France and Germany and had fragile bisque heads and were typically overdressed in adult fashions or locally made folk dolls which had flat heads and were generally crude. The Chase dolls, made of stockinette and with round heads and raised, hand-painted facial features looked like babies and were soft to touch, durable and realistic. The Chase dolls were popular and production was scaled up they became available nationally through major department stores. The dolls were made in a workshop behind the Chase’s house in Pawtucket, Rhode Island which was known as the Doll House.
In 1910 Miss A. Lauder Sutherland, principal of the Hartford (CT) Hospital Training School for Nurses asked Chase to make an adult-sized doll with same characteristics of realism and durability as the play dolls that could be used for teaching nursing skills. Apparently the school already had some straw-filled mannequins that were unsatisfactory [4, p. 85–86]. A prototype adult female doll was tested at Pawtucket’s Memorial Hospital [5] and the first “Chase Hospital Doll” was delivered to Hartford in 1911 where it was called Josephine Chase [6]. The height of the doll (5′ 4″) and proportions were based on Martha Chase. Several early Chase Hospital Dolls have survived including one at Hartford where she was conceived (see Fig. 9.5). Another, purchased in 1914 by the Auxiliary of JC Blair Hospital, Huntingdon, Pennsylvania is now on display there [7, p. 31].
Fig. 9.5
Josephine, one of the first Chase Hospital Dolls, now in retirement at Hartford Hospital. (Credit: Hamilton Archives at Hartford Hospital)
Early in the twentieth century Chase introduced “sanitary” play dolls that had a base layer of zinc-based paint to make them cleanable. Martha Chase’s interest in children’s health led the company to begin production of a new line of “sanitary dolls” in 1913 that were used to teach the urban poor how to raise healthy children [8, p. 25–29]. There were five sizes of sanitary doll babies, infants, and young children based on standard measurements set by the American Medical Association and they were weighted for added realism. These dolls were used in public demonstrations of proper maternal behaviour and to teach young girls and new mothers how to care for infants. The US Department of the Interior used Chase dolls made with red-brown skin tones and black hair (see Fig. 9.6) in child welfare work among American Indians on reservations [8, p. 47].
Fig. 9.6
Martha Jenks Chase Indian Doll. (Credit: The Strong, Rochester®, New York)
In 1914 Chase exhibited a new Adult hospital doll that had an arm for injections and other features at a conference in St Louis. The improved doll was sold across the United States and internationally in two designations known as “model A” and “model B”. The “model A” doll had ear and nasal passages and the “model B” had an internal reservoir connected by tubes to a urethral opening, vagina and rectum so that bladder catheterization, douching and enemas could be practised (see Fig. 9.7) [6]. The company also made “hospital babies” that had nasal and ear passages (see Fig. 9.8) and a rectum (see Fig. 9.9) for practical skills teaching in nursing schools.
Fig. 9.8
Detail of a Chase simulator showing aural and nasal orifices
Fig. 9.9
Detail of Chase “Hospital doll” showing rectum and label describing precautions to ensure correct operation when using this feature
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
