THE ILLS OF MAN

Evening Star, Issue 22032, 18 May 1935, Page 10

THE ILLS OF MAN

That relationship does exist be- •> tween the public of Otago and the Dunedin Hospital, and in May every year it is strengthened by the observance, of ; National-Hospital .W.eek, commemorating noble,-self-sacrificing work of the nurses under the guidance of skilled surgeons and physicians. The public is then given very definite evidence of the zeal of (the doctors and nurses, of the smoothness with which this great community 1 institution is conducted/and of the unsparing care and skill devoted to the alleviation of suffering humanity and the cure ; of its ills. - Modernly equipped and staffed, Hie, Dunedin Hospital is a self-contained institution, possessing every appliance, instrument, plant, and comfort for the sick and ailing. A profqundly appealing humanitarian service is conducted in that big block of buildings, under smooth and able administration and organisation. Only by a study of the Hospital and its workings can one obtain. an impression of the industry and thought involved in the maintenance of the high standard of efficiency in all departments to bring relief and cheer to the suffering patients. COOKING PROBLEMS. To cook for approximately 280 ' patients, many of them on varying diet, resident doctors, and the domestic ' staff and porters, necessarily entails the best of appointments and careful organisation and management. The . kitchen, like the other departments of the institution, is a model of orderliness cleanliness. Here, a staff of three ■ cooks, a maid for keeping the spacious kitchen tidy, and a kitchen man who carries tint the menial and heavier tasks, work under the direction of a

Cures and Relief in Hospital ORGANISATION IN PUBLIC INSTITUTION

T-o pfoperly interpret and appreciate a hospital, and in order that the hospital in turn may correctly gauge both the desires and the necessity of the people in respect of hospital care, there must be established a, most intimate, sympathetic relationship between the community and its institutions.

sister. Mammoth gas stoves for roasting meat, cooking certain puddings that ■ require such treatment, and for pre- j paring other foods, are grouped at one I end of the room. Then there is a row | of largo steam-jacketed canisters, which i appear to, hold an unlimited supply ot I unprepared foods. Into these are j placed on trays all kinds of- vegetables, I puddings,' fish, fruits—in fact, any j thing edible that will respond to cooking by steam. And whether cooked by this method or by gas, the food is done to a turn. •. When ready for eating, ( it j is placed into cabinets heated by steam to await delivery by dust and germ- ; proof trolley-cars to the different serverics, or ward kitchens, .attached to eacli ward.. Until the food reaches the ipatient it is given no chance of cooling; these “ distributing depots” contain apparatus for maintaining the temperature of the food and for warming plates. All the washing and drying of eating and drinking utensils is done in the ward kitchens, where they are kept. The systematic' efficiency with which the kitchen and its allied departments are governed is amazing. There is ho apparent rush to have the food cooked in time for the scheduled meals. In- ; deed, one marvels at the Smooth organisation of it all. Promptly at 7 a.m., 11.45 a.m., and 4.40 p.m., the delivery wagons of food leave the kitchen to enable breakfast, dinner, and tea respectively to be served on the tick of time. special diet department, housed off the entrance to the kitchen, caters for patients whose state of health necessitates specified foods. It is a most important adjunct of the . hospital, for often the correct diet is ; an integral part of the medical treat- ; ment, and can speed up or retard tho recovery of the sick. In the pantry, leading from the kitchen, the daily j stores are kept. And it is here also j that pastry and scones aro prepared. I For foods that require a cool atmo- , sphere, the larder is an eminently suit- ! able place, and when the reporter paid . it a visit it held, among other things, |

several inviting jellies and two large cans containing stock for soup. So as I not to stretch the limits of economy ! too far, it is important that a careful j estimate bo taken of the amount of ! food required daily. Tho sister in ! charge of each ward chooses tho menu j of the patients, and the approximate I quantity needed is made known to the j kitchen sister, who is thus able to I keep a record that is a reliable gauge of tho daily consumption. *' Eat more fruit” is a slogan never disregarded, and fruit in some form always lias its place on the menu of most patients, about 401 b being used cadi day in season. Daily tho hospital uses 20 41b loaves of. bread, three-quarters of a sack of potatoes, and between 50 and 51 gallons of milk and 12 pints of cream, contained in carefully sterilised cans. And those are only a few of the supplies in bulk needed for the three meals. NURSES’ DIETARY LABORATORY. Many bequests to the institution for general purposes have enabled its scope to he considerably broadened. A branch of tho hospital that has benefited in this manner is tbo diet department, which was built without any cost to the ratepayers. The need for a special dietary laboratory for instructing nurses in invalid cookery was at one time urgently felt, ns the only suitable placo where provision was. inside for teaching was at tho Technical College. However, general bequests from the estates of James Powell, Louis d’este Oliver, and Susanna Jamieson made the establishment of the department possible, the widow of one benefactor requesting that part of the fund bo devoted to tho advancement of nurses’; training. Tho laboratory is a model of modernity in every respect. It is spacious and well laid out. Twelve gas stoves are arranged at intervals along benches, with room for a trainee at each stove. Here students in their first month of hospital work receive part of their dietetic schooling before being appointed to wards, s

the work .embracing the rudiments -of cooking, such as the making of toast, porridge, and drinks. ■ The course is continued in the nurses’ third year. The demonstrations of the two teachers, one of whom is a sister and the other the possessor of a diploma of home science, are elucidated by the use of a blackboard. RECORDS DEPARTMENT. “ A hospital without records is like a doctor without hands. .. . Case records are as necessary to a hospital as water is to a river,” reads portion of the quotation that greets the eye when one steps into the records department. When 'a person is admitted to hospital, exhaustive tests and notes bearing on diagnosis and the resultant treatment, to mention only a few of the many things tabulated are carefully preserved for filing. Placed against the walls of a small room, which is at present only the temporary quarters of the department pending the completion of the new administrative block, are rows of steel tiling cabinets, each containing 20 commodious drawers of just enough combined space to hold the average of 5,000 discharge records collected annually. As Dunedin is a medicalcentre, it is imperative that every card’s detailed matter be correct, for the system is of inestimable value to the 'students, as well as to the medical staff. Since the hospital was instituted this system has been in operation, and it is no .uncommon occurrence for reference to be made to the, earliest ter cords, which in the meantime are being kept in the basement of the hospital. Only Recently a card dating back to 1870 was required for perusal. Medical terminology is essential to tii.e record clerk for it the key to a system which is praised b’y doctors as equal to the best used iu any of the larger overseas hospitals. Jn 1934, 4,905 persons were admitted to the institution, an increase of 305 over the previous year, and with approximately 440 patients being discharged each month, the task of keeping the individual records up to date—some of them are an inch thick—is extremely arduous. I THE OPERATING THEATRES. Of the two operating theatres, the original one has recently been entirely renovated, and also possesses the latest electric equipment. But perhaps its best feature from the student viewpoint has been the building of a gallery from which a close view of operations can be obtained, whereas, formerly, the students were grouped rod ml the patients. The gallery is entered from a semi-circular staircase, the entrance of which is near the door leading into the theatre. As with the theatre itself, the floor of the gallery is covered with a foundation of felt, to obviate all unnecessary noise. Fronting its balcony is a thick plate glass panel; every article in the theatre is thoroughly treated in the adjoining sterilising room, alul it is as a safe- 1 kuard to prevent the entry into the theatre of organic germs that may ho dropped through coughing by the audience above that the glass is so placed. From the coiling hangs an ascitiquc light, equipped with reflecting discs. It is so designed that no shadows arc cast from its penetrating beams to hinder the work of the surgeon. Included in the paraphernalia inseparable from any theatre, is a viewbox for examining X-ray photographs. The instruments arc kept in glass-fronted cabinets in an adjacent room. RADIOLOGICAL BRANCH. As with most of the branches of the hospital, the radiological department is self-contained, and occupies a small and compact block. Both the diagnosis and the treatment of disease are dealt with, and provision is made for the investigation and also the treatment of three classes—the indoor and out-patients, and the private patient, the last-named type often coming from outside districts for treatment. The diagnostic phase of the work is most interesting. There is the usual apparatus ler the X-ray of patients, consisting of the radiology plant, which takes. X-ray pictures, and the screening or fluoroscopic unit for the special examination of chest and abdominal conditions. For treatment /here is the deep-therapy plant which is consistently in operation, and is considered to bo inadequate alone to cope with the demands for the treatment of malignant diseases in this branch. The supply of radium, weighing approximate 800 milligrams, and valued in the vicinity of £IO,OOO, is

kept in the artificial sunlight branch. Its quantity is quite sufficient to meet the needs of the community at present. The work in the diagnostic and therapeutic sections has increased between 20 and 25 per cent, in the last three years, and it will not be long before enlargement of accommodation and equipment will have to be undertaken in order to fulfil the department’s everwidening obligations. The staff consists of two medical officers, a radio therapeutist, who supervises all treatment and has control of administration, and a radio diagnostician. There are also a radiographer or technician, a sister, two nurse's, and the records clerk. THE NEW BLOCK. The new administrative block, which is to replace the present quarters that comprised part of the Dunedin Exhibition in 1865, is rapidly nearing completion, and indications point to the building being tenanted in the course of the next three months. Solidity has been the keynote of construction; reinforced concrete has been used throughout the structure, which is partly faced with brick and partly with coloured cement. Even the roof is reinforced with concrete, and covered with a bituminous material. In the centre of the building, which conforms to earthquake structure regulations, is situated the main hall, at the end of which is a staircase, and on the left a lift. There are separate entrances for patients on the extreme north of the block, where the casualty department and the waiting rooms (almost twice .the size, of the .existing one) are situated. Provision has been made fdr the staff matron, the sub-matron, house surgeon, office, and for the staff, including medical and honorary medical officers. On the first

floor are three wards, the records department, and house surgeon’s quarters, the metabolic room, and other essential services; while the upper floor comprises a complete unit for eye, ear, and throat cases. Hero are two large and four small wards, operating theatre, dark room, and other conveniences. When complete the building will provide an additional 20 beds, and increased accommodation for the hospital staff. Both the new entrances are linked up with the existing buildings by covered passages. The commodious basement is to be used by the domestic staff as change rooms, and is also to house stores and the telephone batteries,. , OTHER BRANCHES. Established in 1913, the massage department, the only, one of its kind in the dominion, is at present training 15 senior 1 and 14 junior students for the twp-year course, which embraces different massage exercises, ultra-violet ray treatment, and medical electricity and light. The department is run on the same lines as the training schools in England, and is staffed by certificated teachers) The- voluntary blood transfusion service, with a membership of approximately 40, is controlled by the medical staff and the St. John'Ambulance Association. The call station is at the hospital, and members can he called at-any time of the day or night. The out-patients’ department carries out a valuable humanitarian service to the community', ;It is one of the busiest:branches of the hospital; on a recent afternoon 168 patients received treatment. Besides dealing with most phases of human ailments; it also distributes medicine from the adjoining dispensary room.