HOSPITAL FEVER WARDS

New Zealand Herald, Volume XXXIV, Issue 10427, 27 April 1897, Page 6

HOSPITAL FEVER WARDS

IMPORTANT LETTER FROM DR. MACKELLAR. SOME SERIOUS DEFECTS. EMPLOYMENT OF INEXPERIENCED NURSES. ])R. BALDWIN'S REPLY. A veby important question regarding the internal management of the fever wards in connection with the Auckland Hospital came up for consideration at the meeting of the Hospital and Charitable Aid Board yesterday afternoon in the form of a letter from Dr. Mackellar and a reply from Dr. Baldwin (the medical superintendent). As a matter of fact, Dr. Mackellar's communication was received at the Board's meeting as far back as March 29, but for some reasons nob explained the matter was considered in private and the representative)) of the press were asked to retire. Ik appears, however, that tbe letter win then referred to Dr. Baldwin, for his report on the matters contained therein. The question was again referred to at the meeting held on April 12, and the reporters were again requested to withdraw. Yesterday Dr. Baldwin's reply was read and the management and condition of the fever ward briefly discussed. Dr. Jliiesellar's letter, which is addressed to the chairman of the Hospital Board, and which on the face of it bears no indication that it was intended to be regarded as private, is as follows :—

I am desirous of drawing your attention to the question of the employment of junior nurses in the fever wards. I need nottronble : you at an) length, as you are aware of the communications (of a partly private character) that have passed in the matter, and as you yourself and the medical superintendent holi definite opinions regarding the matter I am briuging under your notice. The objections to the employment ofyoun" nurses in fever wards are mainly :-(a) It is a bad system of instruction that allows novices to begin with what is most difficult, (b) It does not give patients the advantage of experienced nursing. (I need hardly add that typhoid is a disease that above many others requires akill in uursing.) (o) Young nurses (for reasons into whicli I need not enter at present) are more liable to infection than those that are older or more experienced. In answer to (b) it might be said that in the fever wards the junior nurses are always under supervision, but this would be an excuse rather than a reply, «nd it is evident that this very supervision throws unnecessary and distracting responsibility and etrain 6u the nurses in charge. At present, it may surprise you to learn that there are four first year nurses in the fever wards, some of whom have merely been a few months in the hospital. This is not 41. Applicants for admission as nurses I am iuformed, have been put into the fever wards during their three months of trial, and their fitness for training as nurses partly decided.by the results of work that they should never have been called upon to perform. Is it a small mutter that young women fresh from home are in our Hotpital needlessly exposed to the infection of a dangerous disease before even ■it has been decided whether or not they are to be allowed to enter upon a course of training in the Hospital? What would be the feelings of the management and the public (I do not speak of private sorrow) it one of these women were to take typhoid and die? Iβ jt impossible to keep the srst year nurses in the main building, and confine fever nursing to those of the second and third year? No doubt the wards in the main building are alternately left without charge nurses in the afternoon, butatthat time nf day the duties are occasionally light, and it is surely not too much to expect a charge nurse on the same floor to take supervision of her colleagues' wards during a few hours of absence. Does not one superintendent look after the entire buildiug at night ? Ido not forget that the management has been hampered by sickness among nurses, and by resignations ot the seuior members of the nursing staff, and in connection with this matter, I may remind you that three important questions have never been adequately answered:—l. The frequency of typhoid among nurses, nearly all of whom have been in the fever wards. i. The resignations of senior mines. 3. The difficulty found in inducing nurses trained in the Hospital to return to duty there, though paid as highly as if they were nursing in private. The importance of the matter (as it seems to me) is my apology for troubling yon.

Mr. McCabe moved that) Dr. Mackellar's letter (which was not read, its contents being doubtless known to member*) be received, and that he be informed that the matter Imd been settled.

The Chaihman (Mr. Stichbury): Had we not better fired read the answer of the Medical Superintendent ? Dr. Bulii win's letter (dated April 12) wai then read aa follows :—

Dr. Mackellar's letter of March 29: 1 quite agree with Dr. Mackellar's objection to the employment of young nurses iu the fever wards. At the present time there are three first-year nurses at work, one of whom is, in point of time iu the hospital, a second year nune; the other two joined on May 8 and June 22, 1896, respectively. Much as I should like tu have no nurses under their second year in the hospital, in the present state of th« staff it is unavoidable. We lmve nine certificated nurses, of whom eight are disposed of at once as charge nurses and night charge nurse. Eitrht nurses [in addition to charge nurses) are required for the fever wards, and we have nine second and third year nurses only, so that if the full complement is taken, one nura« witli any training is left for the main building, and all the work has to be done by probationers. As it is now, arrangements have been made to put as few firat-year nurses as possible in the fever wards, and of these only ones who are near the completion of their year. The questions Dr. Maokellar asks are three-to the first I can only Bay that I believe the fever ward to be saturated with typhoid germs; the second and third I am unable to answer,

Mr. Gordon said that the matter had not exactly been settled in the way indicated by Or. Mackellar; but Dr. Baldwin stated that arrangements had been made to put as few first year nurses as possible in the fever wards,

Mr. Bruce remarked that the Board had been told from time to time in the periodical reports submitted to them that the buildings were in a satisfactory condition, and now they were informed that the fever wards were saturated with typhoid germs. He would like to look into the previous reports. It seemed strange that the matter should not have been reported before this. Mr. Swales interjected that it was a new discovery. Mr, Begroft laid it appeared that the relapses had been caused by the typhoid germs. Mr. Swales stated that he believed it was Dr. Baldwin's opinion that there was no cure unless by destroying the building, Mr. Bollard moved, " That the secretary notify Or. Mackellar that the employment of probationary nurses in the fever wards was being attended to, and il was hoped satisfactory arrangements would be made." As regards the germs Mr. Bollard thought the place should be fumigated. It was done all over the world.

The Chairman pointed oat that they had just spent £130 in drainage worki, ai they had been told the institution was badly drained; and now they were informed that the place was no good and ought to be burned down. However, he believed something would have to be done as soon ns the wards were emptied. Mr. Bollard'* motion was carried.

Dr. T. Hope Lewis, hon; secretary of the Honorary Visiting Staff, wrote stating that, though the complete control of the Hospital buildings is vested in the Medical Superintendent the Visiting Staff is quite willing to render the Medical Superintendent any assistance he may need in drawing up a report on the present condition of the typhoid fever ward. The letter wa* received.