H.—22

10

private nurses a private-hospital training is of great value. If nurses could be arbitrarily divided into two classes —one for public service and one for private work —it would no doubt be possible to train well in both public and private hospitals for each separate purpose; but for sisters of wards or matrons of training schools it seems essential to have the training and discipline of a public hospital. During the passage of the Hospitals and Charitable Institutions Act a clause regulating the hours of nurses in training was incorporated in the Act. Fortunately for the working of the smaller hospitals, maternity hospitals, and private hospitals, the eight-hour limit was confined to the pupils of the hospitals of 100 beds. In the smaller and special hospitals the work is so ii regular, sometimes being very light and at others extremely heavy, that it would have been almost impossible to have kept a staff large enough to work eight hours a day only, without having at times very little indeed for them to do. The nurses of the Dominion protested strongly against the inclusion of the registered nurses in such limitation of their hours of work. They considered that as professional women, whose work concerned the sick and suffering, they should be at liberty to work for longer hours when needed by the exigencies of their patients. There is indeed no need for complaint as regards long hours or very exacting duties in the hospitals of the Dominion as a whole. The nurses are treated with consideration, usually very comfortably housed and catered for, and, in comparison with other countries, are well paid. The backblocks district nursing scheme is opening out for the nurses of the Dominion a large field for their activities. It is slowly but surely developing, and women of high character and good training and experience will be required to undertake the great responsibility which will be laid upon them. A similar scheme is shortly to be instituted in Australia, called "bush nursing," but it is more on private-charity lines. It is advocated by Lady Dudley, the wife of the Governor-General; and Miss Amy Hughes, the Lady Superintendent of the Queen Victoria Jubilee Nurses, is coming out to help to organize the work. Funds are being collected to finance the scheme. In New Zealand the financial part of the scheme is on a surer basis. The people themselves in a backblocks district are to find the money for it—partly by a special guarantee, and partly by the rates which they already pay to the Hospital Board; the amount is then supplemented by the usual Government subsidy. Further, the nurse being actually settled in a district, those who require her services must, if they can afford it, pay for them. If she were not there, they would probably do without her rather than have the added expense of bringing her from a distant centre and waiting perhaps until their urgent need were over. Twenty-three nurses from overseas hospitals were registered in New Zealand during the year, the total now on the register being 882. Maori Nurses. The training of the Maori nurses presents much difficulty, chiefly owing to the reluctance of the hospital authorities to take these girls into their training schools. The two nurses who have so far been trained and obtained certificates, both for general and midwifery work, have been appointed to the staff of the Native Health Department. Their services have been utilized with good result in several outbreaks of illness in the pas, mostly typhoid. They endeavour to teach some of the first principles of sanitation, and the Natives have in some cases responded well, and drained and cleaned their pas. When stationed at a pa the sick are brought to them from the whole surrounding district, and, though frequently their treatment is abandoned for that of the tohungas, still little by little their influence will tell. One nurse is stationed at New Plymouth, the other at Taupo; but for a recent outbreak of typhoid at Jerusalem, on the Wanganui River, both were required. They improvised a hospital, and had seven or more patients at a time —undoubtedly preventing a widespread outbreak of the disease. There are also three pupils in regular training at the Napier, Wanganui, and Palmerston North Hospitals, and five or six girls who have gone through a preliminary training as daypupils attending the Auckland and Napier Hospitals from the Native colleges. It is hoped to find vacancies shortly for these girls as regular trainees. The Midwivbb Act, 1908. There have during the last year been two examinations of pupils trained at the State Maternity 'St. Helens Hospitals, the Medical School Maternity Hospital, and other institutions authorized to train in conjunction with lectures at the St. Helens Hospitals. Fifty-two candidates came up for examination and passed, and are now registered as midwives. Twenty-two trained and certificated midwives from overseas were also registered during the year. The standard of education of the women training as midwives varies more than that of those coming forward for general nursing, and frequently also the women are older, and find it more difficult to study. Despite these drawbacks, however, the examiners have expressed themselves as well satisfied with the general standard of the pupils' knowledge. The medical officers and the matrons and submatrons are to be thanked for the whole-hearted way in which they devote themselves to the teaching of their pupils, both in theory and practice. The charitable institutions, such as the Refuges for Single Women and the Salvation Army Maternity Home, have trained a few pupils; but these, if they pass the examinations at all, are not commented upon favourably by the examiners. Their practical knowledge is poor. The stimulus of a training school is missing, and, although they have the benefit of attending the