State Examination of Midwives

Kai Tiaki : the journal of the nurses of New Zealand, Volume XIII, Issue 3, 1 July 1920, Page 117

State Examination of Midwives

The State examination of midwifery nurses was held on Wednesday and Thursday, the 3rd and 4th of June, at Auckland, Wellington, Christchurch, Dunedin, Invercargill, and Gisborne. The questions were as follow: — 1. What is the function of the umbilical cord? Describe its structure. Why is the cord tied before it is cut after the birth of the child? 2. Describe the management of the first stage of labour. 3. What would make you suspect a danger of eclampsia? What precautions would you take to prevent it? 4. What precautions would you take m usuig a vaginal douche m the puerperium? Name three antiseptics suitable for such douche, giving their proper strength and mentioning their special dangers, if any. 5. After completion of the third staige, what symptoms would make you suspect uterine haemorrhage? What would you do m such circumstances? 6. What are the causes and symptoms of puerperal septicaemia? What precautions would you take to avoid its occurrence? 7. What are the dangers of a precipitate labour? How would you seek to prevent them? 8. In a new-born child, how would you treat — (a) flatulence? (b) swollen breasts? (c) ill-smelling umbilical cord? The examiner's comments were that on the whole the papers were fairly good. He was disappointed that a large proportion of the candidates avoided the question of septicaemia, but it was gratifying that those who attempted the question did creditably. He remarks that there is a tendency m the answers to write familiarly of " asepsis " and " aseptic" methods without a proper appreciation of the meaning of these terms. A confusion between ''aseptic precautions" and "precautions against sepsis" is frequent. For example, several would use "aseptic precautions m dressing an ill-smelling cord."

Others "would use strict aseptic precautions during all stages of labour." One "would maintain absolute asepsis of external genitals, bed and clothing." There is also confusion between sterilisation and disinfection. The examiner says he mentions this matter not because the general idea is wrong, but because of the danger that the loose use of the term "aseptic methods'* will give a false sense of security m proceedings and under conditions where really aseptic methods ane not possible and the trust m an attempt to use them is wrong. Aseptic midwifery may be a possibility under special conditions of hospital work, but not m the conditions under which the average midwife will for the present require to work. A large number would use solution of perchloride of mercury m a douche, m a strength too weak to be of real service (1-1,000), and even then would follow with saline solution. This is evidently the result of teaching, which is a re-action from the previous indiscriminate use of strong antiseptics, but makes one suspect a real danger of faulty provision against septic infection. The examiner goes on to remark that meddlesome midwifery still has its votaries, and quotes some replies which, we hope, do not mean that the nurses would employ the methods mentioned against haemorrhage, such as inserting the hand into the uterus to remove fragments of or an adherent placenta until other means had failed and medical assistance could not be got. The examiner adds that "A great part of these faults is the result of a want of a proper sense of proportion, which can only come from experience ; and of keen teaching which has attempted too much rather than too little, and more than many of the candidates have been able. to digest. The following candidates were successful m passing the examination: — ■ Passed First. St. Helens Hospital, Christchurch. — Effic Mence (R.N.).

Obtained 75 % or Over. St. Helens Hospital, Auckland. — Dorothy E. Windsor, Patrea E. Scott, Grace M. Cobb, Gladys Nock, Evelyn M. Butler (R.N.). Whangarei Hospital. — Mina H. F. Stuart. McHardy Maternity Hospital, Napier. — Beatrice M. Harvey (R.N.). Townley St. Helena Hospital, Gisborne. — Enid P. Knight (R.N.), Gladys Berry, Sybil Treveek, St. Helens Hospital, Wellington. — Rachel Knowles, Ella E. Davey, Eliza A. Wills, Eliza Smailes (R.N.). Batchelor Hospital, Dunedin. — Jessie M. Verey (E.N.). St. Helens Hospital, Invercargill. — Daisy Garrick. The following were also successful: — St. Helens Hospital, Auckland. — Florence Stewart, Margaret R- Holmes, Nora McCrae. Mangonui Hospital. — Hilda Brown.

Whangarei Hospital. — Bessie Keyte (R.N.), McHardy Maternity Hospital, Napier. — Eileen V. Cronin (R.N.). Salvation Army Maternity Hospital, Napier. — Christina Forsyth. St. Helens Hospital, Wellington. — Teresa Sullivan, Annie F. Rae, Alice Jones (R.N.), Rita M. Gilbert (E.N.), Margaret Allison. Alexandra Home, Wellington. — Martha Daniel (R.N.), Lillian G. M. Shortt, Grace Crawford, Laura McNamara. St. Helens Hospital, Christchurch. — Martha Thompson, Mary Eyes, Annie A. Davies.St. Helens Hospital, Dunedin. — Thursa Atkin, Emma Macale, Elsie M. Bourn. Batchelor Hospital, Dunedin. — Alice Hendry, St. Helens Hospital, Invereargill.— Ruby Burns, Mabel R. Reynolds. N.B. — The above names are NOT m "order of merit. — Deputy-Registrar of Midwives. . ,