HEALTH OF NURSES

Evening Post, Volume CXXV, Issue 146, 23 June 1938, Page 10

HEALTH OF NURSES

NO RISKS TAKEN PRECAUTIONS OUTLINED LOW INFECTION RATE When interviewed today regarding " precautions taken at the Wellington ' Hospital to guard against infection i where nurses are attending to infec- • tious cases, the Medical Superintendent < of the Hospital (Dr. A. R. Thorne) said ; the incidence of infection was com- ' paratively low, and -he outlined the actions taken by the medical staff to : guard the health of the nurses. The. j greatest risk occurred where tubercular and diphtheria cases were being nursed, he said, and special precautions were taiceh-in those cases. As publicity had been given' to what was being done in other hospitals, said Dr. Thorne, a summary of the precautions taken at the Wellington Hospital would be of interest and reassuring to the general public. "When a girl applies for a position on the nursing staff she is asked to supply a health certificate from her own medical attendant and that involves a physical examination by her own doctor," he said. "If that certificate is satisfactory and' she is engaged, she is admitted as a probationary trainee and within the first ( few days is medically examined by the hospital staff, particular attention being given to any possible weakness of the throat or chest. Her chest is then x-rayed and various other examinations are made. If the reports on these examinations are all satisfactory she is accepted for three months' preliminary training. During that three months she is given a course in physical culture and any minor physical defects are corrected if possible. GENERAL PRECAUTIONS. ."All members of the nursing staff are instructed to report any sign of ill health, however trivial, and these reports are made through the home sister. A monthly, record of each nurse's weight is taken and charted as a check, and it is interesting to note that most of the probationers increase .their weight during the first year. Their chests are X-rayed at least once a-year. "For some time the system has been in vogue of nurses wearing overalls in the wards. This means that their uniforms are completely covered while they are at work, and the overalls are . removed and hung up at the ward before the nurse leaves for the home or elsewhere. This reduces the risk of carrying infection. "In the infectious diseases hospital a much, stricter technique is enforced," Dr. Thorne continued, "and no chance is taken of any infection being carried. The diet is liberal and varied and any suggestions for improvement are given consideration. The mam difficulty with the nursing staff at present is the shortage of accommodation and the limited dining facilities, but this will be overcome when the board starts its proposed building programme." • '.'■■ ■ ' The infectious diseases against which greatest precautions had to be taken were tuberculosis and diphtheria, Dr. Thorne • said. • The Wellington Hospital had introduced in 1935 a practice recently initiated hospitals overseas to guard against tuberculosis infection. This was the Mantpux test, and it had been carried out on all •nursing trainees when they commenced their training.

THE MANfOUX TEST. "The Mantoux test tells whether or not the person tested has been infected by tuberculosis," Dr. Thorpe "The nurses that give a negative testrthat is, if they have had no previous infection—are retested at three-monthly intervals. By this means we are able to divide those who have had a minor degree of infection and are, therefore relatively immune, and those who are negative and are consequently more susceptible to infection. So far as we are aware, the Wellington Hospital is the first ip New Zealand to carry out this test on a large scale, and the hospital pathologist (Dr. J..0. Mercer) lias published the results from the firsti two years in the 'Medical Journal. The practical importance of the test is that it enables every endeavour to be made to shield the more susceptible nurses from severe infection. In addition io this test, the X-raying of the chest is continued, and the monthly-, weight chart is also a guide. "The tuberculous rate amongst nurses in the Wellington, Hospital has not been unduly high recently," Dr. Thome added. "During the two' years there have been four actual cases of pulmonary infection and fifteen cases of eryhema nodosum, which is a minor manifestation of tuberculosis, and which does not usually result in chronic invalidity. The majority of the cases «f this type occurred together in the form of a mild epidemic, and that Vis likely to occur in any institution where tuberculous cases are nursed."

The cases of eryhenia nodosum gave : a degree of immunity, the doctor said, and each case was sent away from.the '■ nursing profession for a year to give : the nurse every .opportunity to get back to normal health. When the size of the hospital staff was compared with ' other similar staffs, the rate of infection was no more than elsewhere. DIPHTHERIA "CARRIERS." "In 1936 there were no cases of diphtheria in our nursing staff," Dr. Thome said. "In 1937 there were a number of mild cases and several of the nurses were found to be 'carriers,' These nurses were capable of transmitting the disease to others without showing infection in themselves. The position was investigated by the medical staff, and it was decided that the nurses susceptible to diphtheria should be given a preventive inoculation. Dr. Mercer tested the nursing staff last December, and found that 124 nurses, or 35 per cent., were susceptible. Since then as many as possible in this group have been inoculated.. All trainees entering the hospital are now tested and, where necessary, given immunising injections during their term in the preliminary school. "In a few cases that have been immunised mild attacks of diphtheria have developed, but the nurses concerned had been attending particularly virulent cases of the disease. It is felt that from now onwards there will be very little trouble from infection of this sort."