H.—3l.

these base hospitals should be reimbursed for giving this training, and to avoid small hospitals being put at a disadvantage in this matter it could be overcome if all applicants for training as pupil-nurses paid for this preliminary training. As these girls do no ward duty during this period, but are receiving instruction which is going to be of value to them even should they not continue with their hospital training, it would not appear a hardship to ask for a fee, provided it is not excessive. There is a second consideration which also requires to be studied, and that is the period of this preliminary course. At present, as already stated, with the exception of one hospital—Christchurch— which has recently extended the period to three months, the instruction covers three to four weeks. This is far too short a period if the necessary syllabus is to be given. For instance, modern medical practice is to a large extent based on bacteriology, and if nursing procedures are to be carried out in an efficient manner so that the health of both patients and staff are safeguarded, it is essential that the young nurse should also have a good foundation in this subject. This cannot possibly be given in three weeks. Further, it is necessary for her to understand the principles of general and personal hygiene, and to be familiar with simple nursing procedures and simple cooking duties which she will be required to perform directly she enters the ward. If this pupil has also been given some knowledge of elementary anatomy and physiology, she will take a much more intelligent interest in her patients and their condition. Then, last, but not least, she must be given some instruction in the ethics of her profession so that she will not make mistakes in dealing with the many personal situations she will be faced with. If this period of training is extended to three months, as has already been done in Christchurch, it would be possible to give the nurse of the future a much sounder foundation on which to base her future instruction and her adaptation to her ward duties, and it would give the authorities more opportunity for carefully selecting candidates, but it is questionable if Hospital Boards would be justified in giving this instruction without a fee being paid. In suggesting such a scheme, lam only quoting what is already in operation in the majority of hospitals of Great Britain. Nubsing Technique. In visiting hospitals the necessity for more detailed care in our nursing technique is very noticeable This cannot be brought about unless the sister in charge of the ward is a carefully selected and wellprepared nurse with ability to teach and supervise. Further, this sister must be left long enough in one ward to become a specialist in the nursing of the particular type of patient cared for in that ward, and she must have adequate trained assistance in the form of staff nurses so that she can be free to supervise. Recently in visiting one of our large hospitals I was surprised by the fact that in only one instance was the same sister in charge of a ward as had been on my last visit a year previously. When this fact is further aggravated by senior pupil-nurses never being left in one ward longer than two months and juniors one month, it is quite understandable why the detailed nursing care suffers in that no one has that stability of effort which only time and constant repetition can give. Sisters should have at least five years in one ward, staff nurses four to six months and pupil-nurses at least three months. Days off can be provided for by giving each ward a relieving nurse as part of the routine staff or where only two days off a month are given a relieving nurse between two wards. The opposite extreme to the previous instance I have mentioned is where sisters remain indefinitely in one ward for many years. This again has its disadvantages in that this sister in time sees all nursing procedures in terms of her own ward and no other, while it also limits the experience of other sisters. Ideal staffing is not easy to arrange. The problem of giving pupil-nurses varied experience, sickleave, &c., all make for difficulties, but there cannot be good nursing without more stability among ward staffs than there is at present. Recreation. Many of the most eminent educational authorities frequently stress the importance of planned leisure. Leisure is essential for every one, and nurses as much, if not more than the average member of the community, need mental and physical refreshment if they are to bring freshness of mind and body to their work. Some Hospital Boards have been very generous in providing recreational facilities such as tennis-courts, &c., but these will be far more appreciated if there is a definite tennis club formed with competitions. Again, the nurses in other hospitals have been very active in getting up entertainments of various kinds for charitable purposes. Any effort of this kind is to be highly commended as it broadens the interests of the staff, develops an espirit de corps, and, above all, is itself a training in responsibility which cannot but react successfully on the work of the hospital. Every Nurses' Home requires some recreational activity, even if it is of the simplest, which should be controlled and organized by the nurses themselves. Exchange. I hope the time is not far distant when a definite system of interchange will be established not only between the senior members of our own hospitals nursing staff, but also with overseas nursing services. New Zealand is an isolated community and lacks the stimulus that the older lands enjoy where it is possible to visit other countries easily and cheaply, therefore if our nurses are to remain in the van of their profession it is important for them to have a broader personal contact. In conclusion, again I would like to express my appreciation of the assistance given to me not only by the-other members of the departmental staff, but also by the staffs of the Hospital Boards and the voluntary nursing organizations. In addition, the New Zealand Registered Nurses' Association has worked in close co-operation with the Nursing Division. M. I. Lambie, Director, Division of Nursing.

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