8 P.M. to 10 P.M.: there is
also annual leave of fourteen days after the first twelve months,
increasing to three weeks after three years' service.

The work in a mental hospital is totally different from that in large
asylums. As there are fewer patients, individual treatment is the
rule, and the nurse gets more intimate knowledge of her patients'
condition, which she may thus do much to ameliorate. Owing to the
homelike freedom allowed, nurses need to be specially patient
and tactful. In return for this, however, by their much closer
companionship with their patients they gain the opportunity of
thoroughly knowing and therefore sympathising with and guiding them,
and on this, successful treatment largely depends. The majority of
the patients in these hospitals are suffering from acute forms of
insanity, and this adds both to the strenuousness and to the interest
of the nursing work: the fact that such patients frequently recover,
acts as a great incentive to the work.

Private asylums are on a different basis and do not as a rule offer
training.

A trained nurse may hope for promotion to posts as Sister of a ward,
Night Superintendent, Assistant Matron, or Matron. These posts demand
personal attributes in addition to good training--_e.g._, powers of
organisation and administration, a knowledge of housekeeping, laundry
work, etc. For the higher posts, training in general nursing is
essential. In all forms of mental nursing it is undoubtedly a great
advantage if the nurse has had a preliminary general training before
entering on the special branch of the work.

The conditions for private mental cases are the same as those
described under private nursing for general work (see page 184). The
fees, however, compare very favourably with those obtained for general
work, being almost universally higher. The great disadvantage is that
the hours are very long and the work necessarily exhausting.

Much has been done of recent years to improve the conditions of
service for workers in institutions, and there is still room for
amelioration. Particularly is this so with regard to the long hours
on duty and insufficient leave, due, chiefly, to shortage of staff.
Increase is also urgently needed in the salaries in every department
so that the nurses may be able to make provision for old age. When, as
now, so many of them are dependent on a pension as the only provision
for their old age, they are bound to stay at one institutio