H.—3l.

The staffs of Queen Mary Hospital, Hanmer Springs, and of Otaki and Pukeora have remained stationary. It is most gratifying that in the taking-over by the Palmerston North Hospital Board of the Otaki Sanatorium the entire nursing staff was absorbed. Field Staff. —Miss Lea, one of the Nurse Inspectors for the Wellington District, has been granted a year's leave of absence to act as matron of the Wairau Hospital, Blenheim. Miss Helen Comrie, who has been the ante-natal clinic sister at Auckland St. Helens Hospital, has been transferred to Wellington to relieve Miss Lea. The new North Auckland Health District came into being on the Ist April of last year, Miss Wise being transferred from New Plymouth to Whangarei to act as Nurse Inspector in this area. A reorganization of the district nurses' duties has taken place along the lines of the Gisborne district, so that each nurse is responsible for the complete public-health nursing programme in her area. The Hospital Boards in this area have been most co-operative, and the work of nurses employed by them lias lioen included in this scheme, so the previous overlapping of services will be obviated in the future. The South Auckland District nurses' duties have also been reorganized as from the Ist June last, the school nurses' duties in each area becoming definitely part of the district nurse's work. The staff have been most willing to assist in overcoming the difficulties that have naturally arisen with such a complete reorganization, and I would like to take this opportunity of thanking them for their interest and co-operation. In March a one-day meeting, which took the form of a round-table discussion, was held at Gisborne of district nurses in that area. As the combined district has now been in operation four and a half years, an opportunity was taken to review the work accomplished and make plans for future development. There is no doubt that such meetings are of definite benefit in building up the morale of the staff, and it is intended to hold further meetings in other centres throughout the year. Negotiations have been entered into with various Hospital Boards so as to make the contributions from the Hoards towards the district nursing services more comparable. These have met with definite success, and transport conditions are now more favourable than ever. The work of the twenty district nurses employed by the Department deserves the greatest credit; these women are faced often with great difficulties and on their judgment much depends. The attached table gives a brief summary of the amount of work accomplished during the year : — Total number of — Patients treated .. .. .. .. .. 20,539 Treatments given .. .. .. .. . . 30,050 Maternity cases .. .. .. .. .. 546 Visits paid to pas .. .. .. .. 2,759 Visits paid to schools .. .. .. .. .. 835 Post-graduate Training. —The post-graduate course for nurses continues to be held each year, the students thoroughly enjoying the wider contact this course gives them. The New Zealand Trained Nurses Association was generous in 1932, and again in 1933, by assisting students with bursaries. It is most gratifying to those who have worked so hard in the past for the establishment of this course to see the good work the holders of this drploma are doing, and to know that their work is appreciated by those controlling them. Even from China have come remarks of appreciation where an ex-student is matron of a training-school. Unemployment. — On the whole, for the last few months the situation regarding unemployment among nurses has been more satisfactory. During last winter the position was very acute, but owing to the smaller training-schools being cancelled and staffing largely with trained nurses, and to the co-operation of the larger hospitals in employing a greater proportion of trained staff, positions were made for ninety nurses. This has considerably helped. A great deal of my time is still spent in interviewing and endeavouring to assist nurses to find work, the problem of the older women being particularly difficult. Future Developments : Nursing Education. —Consideration of the training of nurses is at present a subject which is causing much thought all over the world among hospital authorities and those concerned in the actual teaching of nurses. The American authorities are definitely committed to an alliance with the University, so as to give the nurse University status and teaching. The English authorities, on the other hand, are much more conservative in their opinion, very probably because the Universities of Great Britain do not open their doors so widely as the American ones in regard to courses of study and degrees. In New Zealand it is very apparent in visiting hospitals that too much reliance has been placed on medical teaching rather than that given by nurses. The teaching of nursing is entirely different from the teaching of medical students, in that the nurse from the beginning must be taught the study of her patient as an individual rather than as a scientific case. It is true that she must have sufficient .scientific knowledge to understand disease and its conditions, but a great deal more attention is needed in regard to the actual nursing procedures and to the humanitarian aspect of her work if she is to be a success. This can only be given to the pupil-nurse by a well qualified nurse teacher both in the class-room and ward. Probably New Zealand's greatest need at present is a well-organized preliminary training of the pupil-nurse before her entry to the wards. This ensures her being trained in simple procedures in a specified manner, having an adequate knowledge of the prevention of infection, and relieves her from much of th" study which is otherwise necessary in her first year of training, po making the adaption to hospital-life easier.

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