NOTES ON DOCTOR MACKELLARS SCHEME FOR THE TRAINING OF V.A.D.'S.

Kai Tiaki : the journal of the nurses of New Zealand, Volume XII, Issue 2, 1 April 1919, Page 80

NOTES ON DOCTOR MACKELLARS SCHEME FOR THE TRAINING OF V.A.D.'S.

Recognising the advisability oi' assisting those who desire to provide themselves with a knowledge of the rudiments of nursing m order to be of assistance at such times when nursing services of the country are overstrained, the scheme of introducing these people into our hospital wards — especially m hospitals that are recognised training schools for nurses — is beset with too many difficulties to commend itself to me, and I will endeavour to explain why : 1. Hospital patients should not be subjected to any more amateur attendance than they experience at present at the hands of our regular probationers m their training, under skilful supervision well thought out and well guarded with a regard to the patients' safety, comfort and feelings. 2. For the sake of the public m general we must endeavour to keep raising instead of lowering the standard of nurse qualification. Not so much that I consider this teaching of V.A.D.'S. would m itself lower the standard — although there is some risk of this too, no matter what the wording of certificates might be. Any hospital that attempts to conduct two schemes o° nurse training m its wards must inevitably damage its main scheme, viz., the training of nurses, to a very great extent, and at the same time fail m the second object attempted, surely a far lesser one — because of its uncertain success, viz., the teaching of the rudiments of nursing to V.A.D. women who may or may not ever use what they might thus acquire. To explain m more detail the difficulty of conducting the two trainings together m the wards. Hospital discipline is necessarily military m its character, any interference would be subversive of that discipline ;

it is due to the women who give up their whole time for a period of from three to four years at a minimum salary, and often risk their health and lives m so doing, m order to become efficient nurses, that they should receive the full benefit of the teaching facilities. If it is possible for the hospital to train more let them be those who will train fully, and those only. Ward Sisters have more than sufficient duties with the responsible care of their patients and the teaching of their own staff probationers graded m first, second and third year courses, to have the addition of an outside class added.

I do not see how the teaching could be conveniently filled m to avoid upsettingward routine supposing our hospital authorities agreed to admit V.A.D. women to the wards. The very times of the day at which the Sisters could undertake to teach them anything would be those times when patients were fixed and resting, except with very bad cases, the handling of whom Sister would probably not entrust to her own probationers.

I take it that all anyone would suggest should be taught would be the rudiments of nursing ; to learn these, attendance would be necessary first thing m the morning, and for the evening fix up, when toilets, enemas, bedpans, bedmaking, etc., were being administered, treatments etc., also attendance at meal times to learn not only diets, food preparation, but food administration. At these busy times the controlling and direction of her own regular staff is quite enough for the Sister, and those are the times which only benefit the V.A.D.'s.

But by all mean 3, let us if possible put some practical teaching m the way of those who . desire some knowledge of Home Nursing, and this could be much more easily done by attaching for a certain length of time — say six weeks or three months to each district Nurse) — two or three St. John members or others taking the Homo Nursing Course ; they would then learn under trained supervision m the homes of people, to much better advantage, what" would be most useful for them, also, how to improvise many things required from what they find there at hand. There are facilities also at Private Hospitals or small country hospitals that are not training schools, where those who really are m earnest to learn this little could

find ready employment and stay some months or a year, if not desirous of continuing, although it is good to know that we are so developing all our public hospital training facilities that there are not many small hospitals which, under the reciprocal training scheme, arc not now busy m conjunction with larger schools training nurses. To none of these which train nurses would I admit the V.A.D. She has field enough elsewhere—especially now that she is admitted to our military units as at Trentham, Featherston, and probably Rotorua. Dr. McKellar has brought forward his scheme by way of reviewing our experiences during the recent Influenza epidemic. In explaining the shortage of nurses at that time he only refer s to the natural leakage from the ranks of the nursing profession, and I even then question if any appreciable number leave the Dominion to seek work m larger centres, but he takes no account of the fact that we were more than 500 short of ou ' working nurses, who were out of the country on war service. Surely this large number of trained women would have s^iven us an adequate supply to have met m a pret y efficient way, even the recent epidemic. At least the}^ would have provided adequate trained help for the worst cases and supervision for the untrained helpers. Dr. McKellar \s suggestion regarding St. Helen's Hospitals would result m even more confusion seeing we arc striving there by every means to increase the number of trained midwives . With regard to V.A.D. and Had Cross workers m English Hospitals the greatest exploitation o the nursing profession goes on m England, due to this very thing. The Military Hospitals m Eng and could not have managed without the V.A.D. s, many of them splendid women who have a natural aptitude for nursing, and it is hoped many will train, and no fairminded nurse would grudge such women some curtai ment of their training time to qualify should they enter the training schools, but military hospitals are not training schools. The nursing profession m England is at present going through sore trials m its heroic fight for a level minimum standard and state registration. It is much hindered by interfering lay people, actresses etc., who, aided and abetted by the Northcliffe Press, seem to haye 1 laid themselves out to retard what makes for the best m a minimum

standard of training and the organisation and government of the nursing profession m England.