NAPIER HOSPITAL

Timaru Herald, Volume CXLIII, Issue 20763, 25 June 1937, Page 11

NAPIER HOSPITAL

CONDUCT UNDER REVIEW COMMISSION HEARS EVIDENCE POWERS OF MANAGING SECRETARY By Telegraph—Press Association NAPIER, Jone 24. The investigation into questions relating to the nursing staff at the Napier Public Hospital was completed by the Royal Commission of Inquiry this afternoon. The questions considered related to the measures taken to detect symptoms of ill-health among nurses, the regulation of hours and duties, the protection of the health of nurses, and the control and training of nurses at the hospital. At the conclusion of the evidence on these subjects, the members of the Commission, Mr E. D. Mosley, S.M., chairman, Sir James Elliott, and Miss Cecilia McKenny had disposed of the fifth and seventh items on the order of reference, leaving only two items for consideration. Tire matron, Miss Croft, said she considered that the training of' the nurses was sufficient. She had given all the nurses opportunities to report sick. There had been delays in securing things from the Board, chiefly extra staffing.

Sir James: In view of your evidence of insufficient staffing and accommodation have you protested to the Board?—l have put it in my report, 'rhe present accommodation does not allow for the staffing of the new isolation block when it is completed. I also said to them that to carry the extras needed for Hastings it would be necessary to use 10 single rooms as double rooms.

You have reached an impasse in this matter?—Yes.

Don’t you think this evidence should have been brought out before this? You were aware of it before? —Yes.

Has it not come up rather late?— A year ago I mentioned it at the Hastings hospital. When you became aware of this did you take any steps in regard to the nurse?—Tire Board was handling the matter. It was out of my hands. Mr Foden: Who took the first step to dispose of . the nurse’s services ? The nurse resigned voluntarily. Mr Foden (smilingly): Oh! That’s different. Mr M. R. Grant: Did you in November learn that a nurse had been treating Dr. Whyte’s patients without his knowledge?—l learned it after the Board inquiry. When did you first learn that the nurse knew all along that Dr. Whyte did not know about it?—ln January of this year. Sir James Elliott: Was it not the nurse’s duty in the absence of the sister to enter the nature of the treatment In the ward book?—Yes it was. And she didn’t do that?—No. Training of Nurses Tire sub-matron of the hospital, Sister Christina Sophia Thompsen, stated that she also was the tutor sister at the hospital. She had occupied the position of sub-matron for about a year, but her services as tutor sister had been available for only the last six months. In spite of past breaks in the system of tuition Improvements were gradually being brought about. The matron and medical superintendent took a great deal of interest in the course of training, while, generally speaking, the nurses were very interested. In regard to the extension of the training system to the Hastings Hospital, witness could foresee difficulties in the way of organisation, but eventually the scheme should work satisfactorily. Questioned by Mr M. R. Grant, witness said that under the proposed system training nurses commencing their second year would be taken to Hastings. About half-way through their second year they would return to Napier for lectures and examinations in cooking. In answer to Miss Cecilia McKenny, Sister Thomasen said that she gave 34 days each week to the instruction of nurses. She considered that the interests of the trainees would be better served if the tutor sister could devote the whole of her time to the work. Miss McKenny: And so do I. Severe Economies The first witness called by Mr N. A. Foden, Crown solicitor, was Dr J. J. Foley, medical superintendent at the hospital, who said that during his tenure of office he had encountered no active obstruction to any matters which he desired to bring before the board. Mr Foden: Your hesitation and careful use of the * words indicates something?—Well, the managing secretary has the screw on everything. You mean that he economises very severely?—Yes. And do you think that that is detrimental to the interests cf the institution?—lt might be sometimes. Your answer almost suggests a suspicion in my mind that the managing secretary does not always consider the welfare of the patients in carrying out his duties?—He has not obstructed me while I have been medical superintendent. Did you find any delay in getting your requisitions for equipment fulfilled?—No. Once the board approves it is obtained. Have you got authority on your own Initiati to order packet of safety pins and charge it up to the board? No. It would have to be countersigned. Do you think you have sufficient authority in ordering medical supplies and euipment?—Yes. I have not had any obstructions. Have you had any requisitions refused?—Not that I can remember. What would you do if the managing secretary refused a. request?—l would speak to him about it, and if there was still a dispute I would discuss It with the chairman. Does the managing secretary regard you as his superior?—No. He probably thinks there are tw> departments. I daresay he thought I was head of tho

hospital when the Royi.l Commission was coming. (Laughter.) I What machinery exists by which you I are able to ascertain the treatment ordered for patients by the honorary staff?—There are the reports and dally rounds. At this stage the chairman made an order excluding the public from the Commission chamber and forbidding the publication of evidence which might be damaging to any member of the medical profession. When certain questions had been asked, the public were re-admitted. The honoraries, Dr Foley added, had conferences on difficult cases every Saturday. They entered into the consultations in the true spirit of a conference and in the interests of the public. Mr Foden: What resident medical staff have you?—Three. We could do with four. Admission System. What is the procedure during an admission?—Urgent cases day or night, and others at specified times. Is the bell system up to date?—No, but it is under review now. Do you get the utmost support from the matron?—Yes. Does she pass her reports to you before they go to the Board?—No. Does she report all matters regarding nurses to you?—Yes. Do you see any of the matron’s reports?—Anything of a special nature. The case of Mr Berry indicates weakness on the part of the admission system. What would happen if an outside doctor sent in an urgent case?— Usually the doctor rings the hospital and warns us. I take it you will revise the admission procedure?—l do not think we got proper assistance from the man concerned in the case. Do you inspect the food?—Yes; usally during meal time. I will say now that the food is good. Sisters sometimes stay in the wards for years. Is that in the best interests of the hospital?—None of them has been there long. I think it is a good thing to change them round. Do you interview the nurses in the presence of the matron?—Always except on one occasion where I wished the matron to be absent.

How many hours a day is the theatre sister on duty?—Twenty-four hours, but it is not really as bad as it seems. She is liable to be called out in an emergency. Does the ward sister go to the theatre with the patient?—Yes, she calls again later for the patient and is then given the special instructions necessary. Mr M. R. Grant: I take it that you and Mr Rees are the greatest of friends and work in harmony?—Yes. He holds the purse strings?—Yes. The only thing is that if there is any spending of money Mr Rees is on your tracks at once? —Yes. You think the honorary staff should be strengthened?—Yes. Constant Changes. Mr A. E. Lawry (for Dr. J. Allan Berry): I understand that there have been constant changes in the nursing staff? —Yes. Some find the examinations difficult and will not stay, and they leave for many reasons. Part of the duty of this commission is to be informed as to why such things occur. Do you think there is anything in connection with wages?—■ The Board decided at a recent meeting to raise the wages. On the suggestion of Mr Foden, it was decided that the schedule of wages should be furnished to the commission.

Mr Grant: Do you know if the Board makes a practice of revising salaries annually?—Yes, and liberally. And are you called Into consultation? —Yes. I should say that the Hospital Board Is very good to its employees. Mr Lawry (to witness): It seems clear that there is going to be some amelioration in the matter of hours? —Yes. I understand that the nurses have not had reasonable accommodation in the past and have been crowded? —Yes. There are additions going on. Do you think that will remove one cause for discontent?—Yes. It is not only the nurses in training who have been doing long hours; it is the whole of the nursing staff?—Yes. Sir James Elliott: What is the difference between a secretary and a secretary manager?—An ordinary secretary would keep the books and watch the financial side. I can’t explain the secretary manager. Sir James: He is a man who has the powers of a secretary and also wider powers. By giving the secretary the extra name of “manager” creates a situation which might bring his duties to an equality or superiority over those of the medical superintendent?—Yes, that is so. Witness said he could apply to the Board for requirements but everything had to go through the managing secretary. He did not think a first class man would apply for the position if witness resigned. Sir Janies: Have past superintendents left after a short time?—Dr. Allen Berry stayed seven years, Dr. Biggs 34 and myself three. An Unhappy Lot Dr. A. C. B. Biggs, formerly medical superintendent, said that up to the time of the earthquake his lot had been a happy one, but after it was not. Mr Foden: Was the managing secretary below you?—The name was a misnomer. I was the chief executive officer. ; What happened after the earthquake?—There was a fight between Napier and Hastings as to where the hospital should be. I held independent views and my unpopularity commenced for expressing certain views with the idea of saving money. I was attacked In open board meeting. I complained to the Department, the Director endorsing my attitude. Mr Foden: Your wages were reduced from £llOO to £7OO during the slump?— Yes. Were the wages of the managing secretary reduced? —I am certain they were not. I was left with a name only and without authority. Once I ordered a proprietary medicine three times but it was refused each time. That was humiliating. Mr Foden: Would a good man take the job now?—lf he did he would not stay long. Can you make any proposals?—The office staff is too large. What was the secretary’s position in your time?—He would get up and say anything. After a discussion he would say that a preparation was not needed or something else would do. Dr. Biggs said that the Board made a mess of things after the earthquake and even scrapped the Department’s plans for re-bullding, resulting to-day

in there being trouble over the isolation block. Mr Mosley: What steps would you take to notify parents of the treatment of patients?—lt the treatment was special they would be advised. Sir James Elliott: Would an honorary medcial man on the board be able to do what others could not?—l would not say that. He would have a sheltered position? —Yes, I suppose so.

The Commission adjourned till tomorrow.