Nursing Profession

Kai Tiaki : the journal of the nurses of New Zealand, Volume XV, Issue 2, 1 April 1926, Page 65

Nursing Profession

SERVICE TO THE PATIENT.

By Malcolm T. MacEachern, M.D. [Prior to leaving Wellington, Dr. M. T. MacEachern, M.D., Associate Director College of Surgeons and Director of Hospital Activities, supplied the following article for "Kai Tiaki." During his visit to New Zealand Dr. MacEachern has been a very busy man, working each day from early morning till late at night m connection with hospital policy and administration. His visit should be of great value to the Dominion. "I came here primarily," he said, "not m the interests of the Department of Health nor of the New Zealand Branch of the Medical Association. I came here primarily m the interests of the patient and the to-be patient."— Editor "Kai Tiaki."] After twelve years' intimate and active contact with schools for nursing during my period of hospital administration, I have a firm conviction that good nursing plays no small part m the success of any institution caring for the sick, and has an exceedingly important bearing on the successful administration of every hospital. History proves conclusively that nursing is essentially a woman's work. In the early and dark days of nursing, men tried the art at various times but failed. Down through the ages it has been recognised as an art for women to follow. History shows us that nursing, like the other two professions, medical and hospital, has had its evolution down through the years, only first finding its dignified status after 1854, due to the work of Florence Nightingale. Since that time, trained nursing has become developed, and of recent years nursing education is being given more attention. , History and our own everyday experiences show us clearly that nursing is intimately associated with medical and hospital practice; m tact, in-

separately related and dependent one on the other. The combination is necessary for the right care of the sick, and one cannot function adequately without the other. History reveals that nursing has had its struggle also. This is true m the present day, even m the most enlightened communities. Not infrequently do we find intelligent groups opposing nursing education, ordinary human working conditions, a living wage for graduates and the universally recognised three-year students' course.

VITAL IMPORTANCE TO THE HOSPITAL.

I believe we sometimes are inclined to underestimate the real value of good nursing service m a hospital. Perhaps m some instances it is regarded, m part at least, as an unavoidable luxury. This is not true. Owing to the very nature of hospital work, and the obligation of every hospital to provide the most effective care for each patient treated therein, and to obtain the best end results from such treatment, the would-be successful administrator must at all times give the nursing service serious and sympathetic consideration. While hospital service is composite m nature, being made up of many well coordinated unit services it must be admitted that nursing plays a major part m the care of the patient and the end results obtained. The success of the treatment of any patient m a hospital depends largely upon the effectiveness of the unit services rendered, and this applies particularly to nursing because of the intimate relation it has at all times to the physical welfare of the patient. In making this statement, I do not want m any way to leave the impression that I am under-estimating the value of the numerous other important services contributory to the patient's welfare. All are necessary, and each must be performed m a thor-

ough manner. To every patient the doctor stands first and the nurse next m relation to their best welfare. The doctor m charge of the patient makes the diagnosis, treats the condition, and leaves the necessary orders to be followed m his absence. However, all his work might be for naught if the nursing service failed to carry out these instructions and render proper routine general care. A study of the relation of good nursing m a hospital to the results obtained will convince any administrator that it is worth while to have a thoroughly competent nursing service available for every patient treated therein.

PROPER LIVING AND WORKING CONDITIONS.

The past few years have witnessed an effective movement for the improvement of living and working conditions. We are all agreed that living conditions for nurses have greatly improved. There are very few instances now when building new hospitals, or making extensions, that proper provision is not made for the housing of the nursing force. It is a well recognised fact that our nurses should have as a minimum a well ventilated, heated and lighted room, comfortably furnished, and, if possible, with running water. All modern nurses' homes provide the necessary sitting and social rooms and when at all possible, such other accommodations as libraries, gymnasium, swimming pool and outdoor games. We must remember that these young women usually come from fine, comfortable homes where they have been accustomed to proper living conditions. It is, therefore, the duty of the hospital to provide similar conditions for them when student nurses or nurses This means a great deal to the nurse^ not only from the standpoint of health but also m the increasing of her nursing efficiency. BEDSIDE NOTES. The importance of the nurses' bedside or clinical notes has not yet been fully realised by the hospital, medical

and nursing professions. The nurse has a broader function than to carry out orders and to attend to the physical needs of the patient. She must keep an ever' watchful eye on the patient to make accurate minute-to-minute observations on the development, progress and course of the disease during the 24 hours. The nurse's ever watchful eye is on the patient continuously, whereas the doctor sees the patient m more of an intermittent manner, through a brief visit once or twice a day as a rule. On his visit he can only formulate a proper bird's-eye view of the progress of his patient during the past 24 hours by a study of the repeated observations made and recorded by the nurse m his absence. Through such findings he is not infrequently influenced as to the course of treatment or procedure to be laid down so far as the patient is concerned. How very important it is, therefore, to have these observations made accurately and expressed comprehensively. This alone is one strong argument for a higher standard of education for nurses. Indeed, I would like to see every young woman who contemplates entering the nursing profession take a preliminary course m psychology and training of observation and judgment.

CRUCIAL TEST OF GOOD NURSING SERVICE.

The real test of an efficient nursingservice m any hospital is reflected m the care of the patient. The nurse, to render good service, must know her patient Physically and psychologically. I wish every nurse could have a course m of i ll CC SS be included m her course nL^i 7 ' Til 8 Would hel P her to better understand the patient and adapt her BdStf* 0 - A *™ d nuSl ananTf, n read S her P atient ' s needs, and is prepared to respond immediately exnPdiffn T l7 h / r du *y t0 carry out and Sl f- and "Kwately all orders mtienf Str : ictlo . ns f °r the care of the charTe £* f?* 1 by the doctOT m charge, and the routine as laid down

by the hospital authorities, but m addition must minister subconsciously from herself through her personality something which plays a substantial part m the care of the patient, bringing m particular mental comfort and happiness. We must never forget the need and importance of close personal touch between patient and nurse. The larger the institution, the greater the tendency to get away from this feature. Therefore, it behoves those who are connected with such institutions to always try and keep up the personal touch atmosphere m the hospital.

FUTURE OF NURSING.

Nursing as a profession, m the hospital or elsewhere, will only succeed insofar as we can appraise it through the service rendered to the patient. All standards of the past and future will stand or fall on the type of service rendered to the patient, the "hospital per-

spective," on which all the services must directly focus. This, therefore, is the message for all who take up nursing or hospital work: Let us keep m mind that all is for the patient, whether m the hospital, m the home, or elsewhere. The nurse should have inculcated m her the inspiration to conform with the words of the author who wrote: — Wherever or whenever there is life to be tended, nursed or cared for, whether that life be unborn, new born, young or old, regardless of social status, race, colour or creed, there the nurse finds her field of service with its opportunities and consequent satisfaction m endeavour, m exercising the greatest function of woman, through providing means of utilising science and good will to make life worth living for every man, woman and child.