During that era, hospital nurses and midwives were trained on the job. Schwester Selma trained and supervised all the nurses, operating-room nurses, and midwives in the hospital, teaching the former how to make a hospital bed and the latter how to diaper newborns and swaddle infants. Sometimes she also substituted for the midwives, who did not live on the premises. For many years, Schwester Selma was Dr. Wallach's right-hand assistant in the areas of uterine curettages, tracheotomies, and ritual circumcisions, accompanied him on house calls, and stood in for him as hospital director when he was away. From 1916 to 1930 she was also in charge of supplies and building maintenance, and making sure the kashrut in the kitchen met Dr. Wallach's strict standards.