THE PLUNKET SYSTEM.

Otago Daily Times, Issue 20870, 9 November 1929, Page 3

THE PLUNKET SYSTEM.

PRE- AND POST-NATAL INSTRUCTION. A REFRESHER COURSE. WORK AT KARITANE HOSPITAL. It has always been a matter of pride in this Dominion that New Zealand mothers are now so competent that they lose only one baby out of every 100 in rearing them from 1 to 12 months of age, and this state of affairs is directly attributable to the activities of the Royal New Zealand Society for the Health of Women and Children, more popularly known as the Plunket Society, which was founded 22 years ago by Sir Truby King. During this period, however, the death rate. among babies from birth to one month has remained almost stationary. Some slight improvement has been effected in the last few years, but none of the spectacular reduction in infant deaths, of which New Zealand is so proud, has been effected in that danger-fraught first month of life. That it is possible, by adequate provision for the safeguarding of mother and child throughout pregnancy and at and after childbirth, to bring about a reduction of the risk attached to the first month has been demonstrated in Holland and Denmark, where the rates of maternal mortality and deaths of babies in the first few weeks are now only about half our New Zealand rates. This great and practical reform is attributed mainly to the fact that Denmark and Holland have given serious, sustained, and systematic attention for many years to improving the education and training of doctors, midwives, and maternity nurses, so as to qualify them for their respective callings in the community. In these countries not only has the recognised obstetric specialist, practising in the care and safeguarding of mother and child, been given a relatively high status in the medical profession, but an even greater advance has been made in the standing, education, training, qualification, (rust, and responsibility accorded to the midwife and maternity nurse as members of the nursing profession. I To bring about an improvement in New Zealand is a matter of national concern, and the Plunket Society which has already conferred incalculable benefits, has once more taken the van in the march of progress. It is to be admitted its widespread educational health mission has been the greatest factor in reducing the death's of infants over one month of age. Few babies, however, have come • under its direct influence until after the first few weeks, and it has long been felt that it would be a very valuable step in the right direction if the society’s methods and teaching could be extended more generally to the expectant mother and the mother and baby in the first month by means of a short and intensive “ refresher ” course for midwives and maternity nurses who wield so wide and universal an influence. To this end a special hostel was built by the Government a few years ago to provide accommodation, and certain initial difficulties having been overcome, the Plunket Society is now able to offer periodica! courses to all nurses engaged m maternity work. Full appreciation is lelt of the excellent comprehensive training being given in the various maternity hospitals, in which an increasing number of matrons and sisters are tally qualified Plunket nurses, and the excellent work being done by many private institutions and private nurses. At the same time, there Is a feeling that uic majority of nurses now practising this gI -*wY oric bave long bcen out of touch with the training centres and the most up-to-date methods of maternal and infant care which have been so abundantly proved wherever they have been consistently employed. bas been advanced by some that refresher courses in midwifery at the maternity hospitals would perhaps bo more valuable to nurses than the courses offered by the Plunket Society, but on rcflection it is evident that the proportion of nurses actually conducting maternity cases without a doctor is infinitesimal, whereas all maternity nurses have the daily and' hourly care of mother and oaby directly in their own hands for ihe first few weeks. During this time, the success or otherwise of natural feeding, and the fate of the premature or weakling baby is often decided for over. Uniformity of advice and practice has undoubtedly been a great factor in the success of the society’s work, and it is obvious that this unity, extended to include the advice and practice, not only of the Plunket nurses, but also of maternity nurses, thus assuring continuity throughout the pre-natal and post-natal life of the child, would add considerably to the strength and the achievements of the maternal and child welfare movement in New Zealand. The course was opened by Sir Truby King with an inspiring address. Dr Derrick, medical director of the society gave a series of lectures and demonstra' tious during the first two weeks on antenatal nursing, in accordance with the requirements for the State Ante-natal Certificate, as well as on several other allied Subjects. Dr Easterfiold Deem gave classes and demonstrations of particular interest and value in view of her special training and study in connection witn mothers and babies. Some years ago Dr Deem took the full residential course as a Plunket nurse, and afterwards was the first holder of the Lady King Scholarship, during her_ tenure of which she carried out specially important investigations regarding natural feeding, etc. Dr North and Dr Siedeberg H’Kinnon contributed several valuable lectures on midwifery and obstetrical emergencies, and the matron and sister of Batchelor Maternity Hospital gave a series of talks and demonstrations which were very helpful and much appreciated by ail the nurses who visited the institution for the purpose. Mr Renfrew White gave a stimulating address on problems affecting the health of women and children. Ail this outside assistance from already busy people has been greatly appreciated by the society ami by the nurses. Two special kinematogrnph films were shown to the nurses. The matron of Karitane-Harris Hospital (Miss Hilditch) and Miss Fitzgibbon, a former matron, have been responsible for the excellent arrangements ami the giving of classes, demonstrations, clinical instruction, and practical work. Miss Fitzgibbon had virtual charge of the class, and much of its success was due to her work and her unfailing readiness to help. The large lecture and demonstration room at Karitane was put to full use during the past four weeks, this accommodation with adequate demonstration material and a good lantern ami epidiascope affording uncommon facilities for teaching purposes. There has been, and will be, no competitive examination attached to the special short-period courses which carry no special qualification, and arc quita separate and distinct from the Plunket nursing training of four mouths, which carries a qualification by examination and certificate. The present course is simply an effort to put within the reach of each and every nurse actually doing maternity work in this country a short, simple, comraonsensc “ refresher ” course of instruction in pre- and post-natal care of mother and child, with a view to enabling them to carry on their work in accordance with proved modern knowledge, and therefore with greater safely

and advantage to mother and child, and also with greater confidence and satisfactiou to themselves. In conversation with a Daily Times representative, participants in the course expressed themselves as delighted with the welcome they had received from matron Hilditch and the staff of the Karitane-Harris Hospital, and tho facilities which had been afforded them for study at first hand of the latest methods of treatment. They had benefited greatly from the course, and they frit that they would he able to carry back with them to their own districts much useful knowledge which could be applied to case?? under their care. The lectures comprised in the course had been very interesting, and they were impressed with the enthusiasm which had characterised the efforts of everyone who bad taken part in the work of instruction and demonstration. The practical demonstrations had been a particularly illuminating feature of the course. They had paid special attention during the course to pre-natal work and the care of the infant during the first month, and in both these aspects of the work they considered the course had been one of great value. They were of the opinion that the KaritaneHarris Hospital offered excellent facilities for teaching, and seemed p,, nn excellent school for the training of Knritane and Plunket nurses.