The Training of Nurses in Private Hospitals : Advantages and Disadvantages

Kai Tiaki : the journal of the nurses of New Zealand, Volume III, Issue 3, 1 July 1910, Page 98

The Training of Nurses in Private Hospitals : Advantages and Disadvantages

Having read with regret the resolution passed by the Central Council of the New Zealand Trained Nurses' Association against the recognition of the training of nurses in private hospitals for State Registration purposes, I should like to say a few words on the subject, and hope that some other members of the profession will do the same, so that we may hear all there is to be said for and against this matter. Some reasons for the recognition of the tiaining received in private hospitals are : (1) The need of more nurses. We all know there are not enough nurses coming forward to fill the positions vacant ; also, how difficult it often is to obtain the services of a nurse, even for an urgent case. (2) The diffieulty of obtaining suitable probationers owing te the training not being recognised. Many a suitable girl does not care to spend time in a private hospital learning nursing when, on entering a general hospital, she is no further on than if she had gone straight there ; she finds she still has as long to spend in gaining her certificate, and what she has learn r earns her no advantages ; she takes the same stand as the most ignorant entering. If she joins a private hospital with the idea of just filling in time till there is a vancacy on the staff of the general hospital she is never settled, and so never enters whole-heartedly into her work, anel therefore is not a great success. A matron of a private hospital generally finds that her promising probationer leaves just when she is beginning to be useful, and all the trouble of teaching a new probationer has to be gone through again. Could it be arranged that every two years spent in a private hospital counted as one year in a general, there would be some encouragement to the probationer to stay at least two years, and so give the matron of the private hospital a settled staff for a definite period. Further if the time spent in private hospital did count in some measure for registration purposes there would be, without doubt, a large number of applicants for private hospital work. Those found unsuitable would soon be weeeled out and those that remained would be girls of the right stamp, who would in the course of time

be passed on to the general hospital to complete their training. In this way the general hospital and the nursing profession would benefit by getting the best type of girl procurable. (3) The training is recognised in Australia and Tasmania, anel found to be so satisfactory, that a motion brought forward at the last General Council by Western Au stralia to abolish this recognition, was lost. While in Sydney I inquired from several matrons of private hospitals anel nurses' homes their opinions on this subject, anel found all were in favour. They thought that for private nursing and for private hospital work, the training received was more useful than that received in a general hospital, as it led, not only to greater unselfishness in the nurse, but also to the development of tact and adaptability, without which no nurse can be really successful, but which are often undeveloped in the newly certificated nurse trained wholly in a general hospital. Some advantages of the training received : The probationers are taught all the details of their work by a qualified certificated nurse, either mati on or sisters ; every detail is overseen. There is time to spend in doing the work in the best way possible. They get a more intimate knowledge of their work than is possible in a larger institution, for they see and help with everything : Preparation of the patient for operation ; sterilising ; care of instruments ; fumigating ; disinfecting ; urine testing ; household and hospital management and economy ; besides all treatments, medical and otherwise. (4) Through there being fewer nurses, and as all live and work together, the matron and sisters have a far better chance of knowing the real character of each probationer, and there would therefore be no likelihood of an undesirable girl entering the profession from the private hospitals The chief disadvantages alleged against the training in private hospitals are :— (1) The probationer would see less medical work. The opponents of private hospital training lay great stress on this : But is there not a medical aspect to all surgical cases ■

and cannot much medical knowledge be gained from every surgical case ? Taking this in connection with such medical cases as would come under her care — and in the longer course necessary in a private hospital one or more cases of most of the diseases would be admitted — a probationer would obtain a very good all-round medical training. Of course, she would not see any infectious cases, except pneumonia and typhoid ; but neither would she in most of the large general hospitals. When all is said and done, are not a nurse's chief duties to observe and report accurately, and to carry out instructions faithfully and intelligently, and cannot these be learnt as well from surgical as medical cases ? (2) The probationer would learn less discipline. This is a point also frequently advanced against the training in private hospitals ; but in a well-run private hospital, the probationer gets as much discipline as in a general — perhaps not so much red-tapism. She has her set hours of duty ; her set work. She learns obedience, punctuality, method ; she learns, in fact, that she is under authority. vShe does not, however, see and learn the strict disciplining of patients, as carried out in a general hospital ; but neither has she to unlearn it on taking up private nursing. In New South Wales the probationer in training in private hospitals spend, according to the daily average of occupied beds, up to five years in qualifying for their certificate. They attend the lectures for nurses at either che Royal Prince A If reel or Sydney Hospitals, paying a fee of one guinea a course, and sit for examination with the nurses trained in general hospitals at the central examinations held twice a year. Any private hospital wishing to become a training school has to apply to the Central Council for permission to train, so it rests with the governing body to grant or withhold permission as they deem advisable By refusing to recognise our private hospitals as suitable for the purposes of training nurses, are we not implying that they are not up to the standard of Australian private hospitals ; or that the Australian standard of nursing is lower than ours ? During the last six years the training received in private hospitals has gained in favour, not only with matrons of private hospitals, but also with the public, matrons of nurses' homes, and doctors. One matron of a nurses' home who formerly had only nurses trained in large

general hospitals on her staff, and always spoke against the training received in small general and private hospitals, now has several nurses from the latter institutions on her staff, and says they are the most satisfactory of her nurses, never having received any complaints from doctors or patients about them vSo the private hospital cr ained nurse has come to stay in Australia. Could not some scheme be devised by means of which the time spent in a private hospital should count towards the gaining of a certificate, and yet meet with the approval of those who oppose the complete training in private hospitals ? Say, for instance, that four years be spent in a private hospital, the probationer to be allowed to attend lectures at the general hospital as at Sydney A fifth year to be spent in gaining further experience, as follows : — Three months in an infectious hospital ; three months in a general — perhaps a country one, as that would be to its advantage ; and six months either between the consumption sanatorium and the incurable ward of the benevolent institution ; or in a maternity hospital. At the end of that time, their training and experience should be such as would fit them for any nursing work they might be called upon to do, and yet there would be little risk of lowering the standard of nursing in urging that such a course should qualify for State Registration, or passing the necessary examinations. I hope some other nurses interested in this question will find time to express their views, and suggest some means of overcoming the difficulties in the way of recognising the training given to probationer nurses in private hospitals. Alice M. M. Thomson, r.n. Note —We would like to draw special attention to the above. One reason why in New Zealand the work of probationers in private hospitals might be encouraged is, that the fees paid by patients in such hospitals are very low, as compared with the fees in either Australia or England, and the salaries for trained nurses are so much higher, that it would be impossible to conduct them with trained nurses only. We would like to have other papers on this subject.—Editor.