Midwifery Examination

Kai Tiaki : the journal of the nurses of New Zealand, Volume X, Issue 1, 1 January 1917, Page 51

Midwifery Examination

The Midwifery Examination was held m the four chief centres, Wellington, Auckland, Christchurch, and Dunedin. There were candidates from the five St. Helens Hospitals, the Balclutha Maternity Hospital, Alexandra Home, the Female Refuge Christchurch, the Maniototo District Hospital, the Monganui and Kawa Kawa Hospitals, Bay of Islands, The Salvation Army Maternity Hospital, Wellington. It will thus be noticed that the number of training schools has been increased since the first St. Helens Hospitals were established. The country hospitals, while unable to give the necessary number of cases to many pupils, can give a very good training to a limited number, and thus aid m increasing the qualified mid wives of the Dominion, who are rapidly taking the place of those practical but untrained women first registered under the Midwives Act. There were thirty- one candidates, only one of whom partially failed passing the oral but not written test. The questions were as follows : — 1. How do you diagnose the onset of labour ? What do you learn from abdominal palpation ? When is vaginal examination indicated 1 What common abnormalities may be found. 2. Give the cause, symptoms, and treatment (within the nurse's province) of indigestion m infants. 3. Describe briefly the symptoms and management of a " breech "case. 4. What various obstetric positions adopted during confinement do you know ? When is each position, respectively, to be preferred ? What is the use of Clover's crutch ? 5 . When is douching aft er delivery i ndicat ed ? What solution would you use m the douche, and at what temperature (a) ordinarily, (b) for stopping haemorrhage? To what height should the douchecan be raised ? 6. What are the causes of abortion, and what is the treatment ? What is the size of the ovum at the end of the first, second, and third months respectively ? The examiner for the written paper reports whilst only one failed to obtain half marks, there were about ten others whose

answers were poor m most questions. Taking the questions seriatim we find that : — Question 1 was, m many instances, not well answered. It was surprising to find that several nurses failed, m their paper, to diagnose the onset of labour. Early rupture of membranes was referred to by very few, and yet it is not uncommonly the first sign of labour. Almost all the candidates recognised that few vaginal examinations were necessary. In the last paragraph the word " common " was ignored by many. One candidat e included "lax abdominal walls" m her list of " common abnormalities." Question 2 was only fairly well answer cd . Most candidates ignored the fact that too rapid feeding is an important cause of indigestion. It was exceptionally well answered by a few. Question 3 was very indifferently answered. Candidate twenty-three would have been easily first if she had not failed m this question. It is essential for a midwife to be able to manage a breech case, and her responsibility does not end when she sends for the doctor ; m fact, if she is many miles from the doctor, she should " carry on " without sending for ihe doctor until difficulties arise. Yet , judging from their answers, only two or three (notably 24) were capable of conducting a breech case. Almost all were willing to give nature a chance until the umbilcus appeared, and then most seemed to consider it time to "meddle," oblivious of the following paragraph m Jellett : — " If we can wait sufficiently long to allow the uterus to expel the body of the child, theie is little fear of the arms becoming ext ended above t he head." Question 4 was, on the whole, well answered, but most candidates omitted to mention the dorsal position for the third stage of labour. I began to think I was old-fashioned, but on turning to Jellett I was pleased to read : ; ' We turn the patient on her back the moment the child is born." Question 5 was well answered by most candidates. There is considerable diversity of opinion expressed as to the height of the douche can. The answer given by 7 is easily the best. Question 6 was fairly well answered. Almost everyone seemed to know the size of the ovum. As regards treatment where the os is patulouSj the abortion incomplete, and the haemorrhage severe, to save the patient's

life, if no doctor is available, the midwife would be quite justified m removing the remnants of the ovum with aseptic fingers. On the whole the remarks of the oral and practical examiners are more favourable. One writes : " This batch of nurses is, m my opinion, a particularly good one and t here was no question of failure with any of them." Another says: "They were all well up m their work and showed evidence of good training and hard study." A third remarked that the majority of the candidates showed " a very thorough knowledge of their theoretical and practical work." The passes are as follows :— December, 1916. Name. Training School. Passed First : — Lord, Corbetta G. (R.N.), St. Helens Hosp., Auckland. The following obtained 75 per cent, or over : Pickles, Evelyn, St. Helens Hosp., Wellington. Matheson, Helen D., St. Helens Hosp., Wellington. McNicol, Marion (R.N.), St. Helens Hosp., Wellington. Smith, Ethel W. X., St. Helens Hosp., Christ church. Johnstone, Mary, St. Helens Hosp., Christchurch Smith, Flora E., St. Helens Hosp., Christchurch Dryland, Mrs. Hilda, St . Helens Hosp., Auckland Bishop, Lucy 8., St. Helens Hosp., Dunedin Dahl, Pearl C, St. Helens Hosp., Dunedin Da vies, Catherine, St. Helens Hosp., Dunedin Laird, Maggie McA, St. Helens Hosp., Dunedin Alderton, Mrs. Janet Julianna, St. Helens Hosp., Gisborne Gray, Alice, Maniototo District Hosp., Naseby Wood, Marjorie, Hospital, Kawa Kawa Baldock, Edith, Hospital, Manganui Quickfall, Flora M., Salvation Army Maternity Hosp., Wellington Jefferson, Florence, Alexandra Home, Wellington Wilkinson, Zillah X., Batchelor Hosp., Dunedin

Symington, Robina, Batchelor Hosp., Dunedin The remaining were also successful : — Russell, Mildred, St. Helens Hosp., Wellington Cobb, Grace, St. Helens Hosp., Wellington Todd, Ida S., St. Helens Hosp., Wellington Wilson, Mary A., St. Helens jHosp., Wellington Edkins, Ruth, St. Helens Hosp., Christchurch Coppell, Annie Maria, St. Helens Hosp., Christ church Smith, Ethel W. X., St. Helens Hosp,, Christ church Hughes, Agnes, St. Helens Hosp., Auckland Keay, Mrs. Eliza J., St. Helens Hosp., Dunedin Griffin, Florence May, French Refugees, Linwood, Christ church