THE NURSING PROFESSION

Otago Daily Times, Issue 19952, 20 November 1926, Page 9

THE NURSING PROFESSION

HIGHER STANDARDS OF TRAINING. THE FINANCIAL DIFFICULTY. PROBABLE APPEAL TO PUBLIC. It is a far cry back to the days ol Florence Nightingale's first fame, out the struggle to raise the status of the nursing profession and more adequately equip it for its high calling still goes on. By none is the need for fuller training more keenly realised than by the most efficient and alert members of the profession themselves, and for the past four years in New Zealand they have been prominent in a movement to establish extended courses of nursing training of a standard high enough to claim university recognition. Probably it is not generally realised by the public how meagre and inadequate is the provision for the training of nurses offered in this coun try at the present time. The essential requirement before a nurse sits for her certificate of State registration _is three years hospital experience, but this period is so fully occupied with practical activities that very little time remains for any theoretical instruction. The nurse is trained for bedside nursing, and this is the basis of the whole system. At the end of three years she is eligible to sit for examination and, if successful, become a State re (r i-tcred nurse. Should she be ambitious and desiro to learn more about her profession, the only other course* open to her are the brief ones loading to the midwifery certificate and to the Plunket certificate. Having gained those, there are in New Zealand no further Helds for her U eonqm-i The whole position was fully discussed yesterday by an Otago Daily Times reporter with Miss Tennant man-on of tin Dm i - Hospital, Miss Young, the president of the Otago branch of the Trained Nurses’ Association and Dr A. R. Falconer, medical superintendent of the Hospital. They pointed out, among other things, the remarkable fact that though there are estimated to be quite 600 nurses in course -it training in the Dominion at the present time, there is %io provision whatever for training anyone to instruct them There ara systemactically-trained teachers to give instruction in every branch of education with the -single glaring exception of the nursing profession. One of the main oh jects of the present movement, therefore, is to train a supply of tutors in our own country, so that in time to come there shall he no school of nursing, without u properly-equipped instructor. At the present time Dunedin and Christchurch have the only full-time nursing tutora_ in the country, though every hospital is to a greater or less extent a nursing school. Wellington and Auckland are arranging to get tutors from the Old Land. At the present time the minimum educational requirement for entrance to the profession is the possession of a proficiency certificate or its equivalent. Ill’s is considered not nearly high enough, and efforts are being made to have it raised. In practice Miss Tennant seeks to avoid accepting any probationer who has not had at least two years’ secondary -education. The whole of the trained nurses throughout the Dominion are solidly behind this movement for the improvement of the status of their profession. A conference of the New Zealand Trained Nurses’ Association held at Wellington on November 1, 1922, adopted the following resolutions—“ That in. view of nursing in Leeds, British Columbia, and United States of America being accepted as_ a university course, combined with hospital training, the N.Z.T.N.A. takes active steps to obtain some recognition for their profession from the New Zealand University, provided that such university course is preliminary or supplementary to the three years’ intensive practical and clinical teaching in the hospital, which must not be interfered with; and that, pending the recognition of the New Zealand University of academic status to nursing, the Otago University bo requested to institute a diploma course in nursing.” The matter was placed before the Otago University Council in due course, and th» subsequent history of the nurses’ training scheme was recently thus summarised in a statement by Dr J. Fitzgerald to the coun cil:—“Towards the close of 1923 the council decided on the establishment of the nurs ing course on the definite understanding that there would ho no expense involved to the University. The fifth year of the course was to include three options:—(l) Institutional and nursing education work; (2) public health nursing; (3) specialised nursing. It was thought that the teaching of one of the options—namely, “specialised nursing,” could bo done by the University staff, together with the staff already employed by the Hospital Board. Early in 1924 the registrar was instructed to communicate with the Health Department asking it to assist the University to provide a teacher to do teaching for institutional and nursing education. Before any letter was sent, however, wo received a letter from Dr Valintine, dated May, 1924, offering to send a lady Home for this special training, and the council interpreted this letter to mean that the department would not only send her Home, but would pa,y her salary after her return. That this was the council’s meaning was clearly borne out by the terms of its acceptance of the offer—namely, “The committee wishes to thank you very sincerely for the offer which you have made, an offer which it gladly accepts for the carrying out of the specialised training in branch 1 of the fifth year course.” If the council had understood that it would be required to find the salary it is obvious it would not have agreed to the proposed arrangement without ascertaining what its financial obligations would be. Miss Moore was duly sent Home and returned to New Zealand in time to take up teaching at the beginning of the year 1926. It then transpired that the depart ment had no intentions of paying the salarv. and the University was not only financially unable to carry the additional burden, but was also prevented by its previous resolu tion (viz., that the council was to incur no financial obligation) from undertaking this duty.” After some correspondence a letter was received from the Director-general of Health in November, 1925, including the following statement; —“Despite my cer tainty that in this matter your council has taken up a regrettable attitude, I. have decided to recommend to the Minister that in view of the importance of the suggested course and the fact that the appointed officers will presently return to New Zea-» land, the Government will_ provide the salaries of the tutorial nurses it has selected. But since they become thus whollv officers of the department, the department obviously has the right to decide in what district these officers shall carry on .their duties, and though they may bo stationed at Dun edin for the first year the department wishes it to be clearly understood that they may thereafter he transferred to some °ln er centre where their tutorial abilities may be made available in a wider field.” Unfortunately, however, this recommendation, if made, did not bear fruit, and the ds partmont in January. 1926, advised that the Minister did not approve of the paying of the salaries of the nurse tutors. You will observe, therefore, that the present impasse has been created by a misunder standing of the letter of the department It is to bo explained that the department, at the request of the University, sent Homo a further teacher for training in public health nursing, hut that the same misunderstanding occurred in this ease also. The Trained Nurses’ Association had offered £225 to assist in the matter, hut the Government had refused to subsidise this amount.

The course for the diploma nursing, which started last year with three students, has been carried on as part of tho activities of the Homo Science Department of Otago University, and the details of the syllabus appear in the Homo Science Bulletin. The course provides for two years of scientific a-’d t-chmc.il training with three months probationary ward work in between, for veers of ward work and general hos pital training and for a fifth year with the alternatives of specialism- in Teaching and Administration in Schools of Nursing or in Public Health Nursing The importance of post graduate training for nurses already qualified has been strongly felt and consequentlv there is provision for the admis eion of registered nurses for post graduate training to either of the courses prescribed for year five. Thev can come in without having matriculated or taken the earlier part of the diploma course. . Four more students took up the diploma course this year, and the University f ouncil recognises that it will have to bilfil its obligations to them; but at the same time in view of the complete withdrawal of the. expected Government °ipnort it has *-*Vled that it can only refuse to accept

further candidates and to withdraw the course from the calendar. The council, however, intimated at its last meeting that any further proposals, not involving in it additional financial obligations, would receive its consideration. The fact of both the Medical School and the Schooj Homo Science being located in Dunedin, makes this the natural centre for the training of nurses. “We are not striving after an impossible standard for every nurse,’’ said Miss Young, 'out we are striving to provide opportunity for those who desire to become teachers or administrators.” The 'Trained Nurses’ Association has oeen following with close attention every step in the progress—or retrogression—of the movement, and on November 9 representatives of the New Zealand Association waited on the Red Cross .Executive in Wellington to ask its assistance in overcoming the financial difficult that has arisen. Ur Collins, the president, expressed keen sympathy with the movement, but said the Red Cross had no funds available at present to devote to such purpose. The Nurses’ Association, however, is not without hope that some financial help may be forthcoming from this source at a later stage. The Red Cross has sent lome four nurses from New Zealand to receive training at Bedford College, and the results of their work have been so entirely satisfactory that the Red Cross authorities have no doubts about ti great value of post graduate training or the importance of having it available in this country. The necessity and importance of providing specialised training in public health was thus indicated by the Hon. J. A. Young, Minister of Public Health, when opening the, nurses' homes at Blenheim; The future,” he said, “would open up very great possibilities lor hospital boards. Instead of waiting for the people t become sick and come to the hospitals, the authorities would, in the cities and towns, more especially endeavour to prevent ill-health. He predicted a system under which outdoor nurses would go into the homes with a- lew to investigating social and hygenic conditions and so advise and take step- to ward off illness. The health of he individual was everything to the community. The sick person was . burden on someone else even if he were rich —thug more would be heard about preventive medicine as distinct from curative medicine. The aim should be to build up a healthy community and so lessen the necessity for hospitals. ’ It is estimated by those who have 'lieny interested themselves in this matter f hat a capital sum of £IO,OOO placed at the disposal of the University would enable the needs of the case to be met. This would allow the University to provide one lecturer at a salary of £450 or £SOO, and it is felt, that in all the circumstances the Health Department could not long sscapo the responsibility of providing an instructor in public health. Once the course is esianlished it is hoped that hospital boards throughout the country will take advantage of it by selecting specially qualified nurses and sending them f< r training that would enable them in turn_ to become efficient instructors of nurses in their own centres. The Trained Nurses’ Association intends to make an appeal for the funds necessary to see this course established, but m view of the present Plnnket appeal it does not propose to nnsh the matter in the time. Probably the whole case will be placed stron»rl v before the public early in the coming year. After all. it is the nubile that will derive the benefit from more kmhiv skilled and efficient nursing, and it will he strange indeed if it >s slow to recognise that fact.