Problems of Hospital Administration

Kai Tiaki : the journal of the nurses of New Zealand, Volume XVI, Issue 4, 1 October 1923, Page 171

Problems of Hospital Administration

Some extracts from "Hospital and Health" for June, from a paper on the above subject read by D. H. L. Eason at the British Hospital Conference m June, are of interest to nurses :

The Matron. — What should be the position and duties of the matron? Equal on the nursing side with the superintendent on the administration, the matron should have a very real authority and responsibility m her department of the hospital. She is, of course, responsible for the engagement of nurses, their education and their discipline, and for making recommendations for their promotion to wards or administrative posts. In my opinion, however, m addition to these duties, she should be responsible for 'the purchase of such domestic articles as bedding and linen and for the supervision of the hospital kitchens. The matron, if she has been properly trained, can supervise the hospital kitchen m quite as effectual a way as a steward, and the association of the feeding of the nurses and patients with the actual administration of the nursing and domestic staff makes her position much more logical and complete. Training as a kitchen sister under a capable matron makes an admirable preliminary education for any woman who herself aspires to become a matron. The matron must also frequently visit the wards, sculleries and sanitary blocks of the hospital, and see that they are kept m good condition, and she should carefully note whether directions affecting in-patients m regard to diet, nursing, personal cleanliness, etc., arc carried out by the nursing staff. It may be said that these duties are too onerous for any one woman, and that either she should be relieved of some of them or have the assistance of advisory committees, such as education and nursing committees. My own view is that a competent matron can carry out such duties and that one efficient women at the head of affairs makes an atmosphere and sets a standard far better than any committee.

In regard to the above extract, it is of interest to look back to the report of the last meeting of the Central Council of the N.Z.T.N.A., and a paper read on "Nursing Ethics," m which the position and authority of a matron are dealt with. A reso-

lution was carried by the meeting, to be forwarded to the Director-General of Health, emphasising the importance of the sphere of a matron not being unnecessarily limited. The feeling of the more experienced members of the nursing profession is that it is "a mistake to have too many departments which are not under the direct -control of the medical superintendent or matron; that women who are prepared for responsibility should be allowed to take it. . . Increased responsibility gives added interest to any position. There are many matters with which matrons are the most competent to deal, among others, jurisdiction over nurses and domestic management and its details." Another problem touched upon m this interesting paper is the supply of nurses. This for a time was an actute problem m New Zealand, but is not so now, though it is still questionable whether of the many girls who apply for training there is a sufficient number of the truly suitable type. The question of age is dwelt upon and the earlier age of entry is not altogether approved, though the drifting off into other occupations when girls have to wait too long after leaving school is acknowledged.

Tightening the Curriculum. — The modern tendency is for the training of nurses to become more and more advanced on the scientific side, so that there appears to be a danger that the curriculum for probationers will be little less than that of the woman doctor. As most of this mental work has to be done by the nurse m her off-duty hours, when she is usually physically fatigued, the strain may soon become intolerable. As it is essential that a nurse should have a good physique, and physique and intellectual capacity do not always go hand m hand, there may be a danger that m demanding too high an intellectual standard from our probationers we shall lose those women who arc by nature physically best fitted to undertake the strenuous life of the hospital nurse. Nursing m the wards is also becoming harder and harder

every day, owing to the increased demands of medical service. Investigations are becoming so complex; bismuth meals and special diets are adding so greatly to the routine work of a ward. . . .

The pay of a trained nurse and the necessity of adequate pensions are also discussed, and it is emphasised that her professional career is short and she is usually worn out at fifty.