VIII. St. Helens Maternity Hospital

Kai Tiaki : the journal of the nurses of New Zealand, Volume XVI, Issue 3, 1 July 1927, Page 126

VIII . St. Helens Maternity Hospital

St. Helens Hospital, Wellington, was built in 191 1 , but before that patients were accommodated in Colombo Street, Berhampore. These hospitals were instituted by the Hon. R. J. Seddon, and take their name from his birthplace. They were for married women only whose husbands received up to £3, but the weekly wage has now been raised to £6/10/-. The fees charged are £1 per week before confinement, and 30/- after.

Up to the present time 5,740 patients have been admitted into St. Helens, Wellington, and last year there were 489, the highest attained, and 88 district cases.

From 16 to 20 nurses are trained yearly. The beds number 29 and the staff consists of: A Medical Officer (not resident), Matron, Sub-Matron, and four Sisters, including the Ante-Natal Sister (who takes a certain amount of duty in the hospital), and 19 pupils — 4 to 6 general trained, and the remainder untrained women. Two of the staff have the general midwifery and Plunket training; three general and midwifery, and one midwifery only.

Patients are admitted in labour, or before if treatment is required, and their stay is two weeks unless not well enough to be discharged.

A certain amount of ante-natal work has always been done at St. Helens, but it was started by Dr. Gurr with Sister Robinson, in a more thorough manner, two and a half years ago, and has stead-

ily increased. This, of course, means admitting more patients for treatment before labour. These consist mostly of albumenuria and varicose veins, and the treatment has no doubt lessened the chances of eclampsia and phlebitis during the puerperium. The patients have responded splendidly to the clinic treatment, and very few decidedly refuse, and when they do very often persuasion and reasoning with them acts quite well. The children at home make it difficult, but the Residential Nursery has considerably helped in making it possible for them to take this rest.

With the Clinic we have found it necessary to admit out patients before the seventh month where there is any sign of threatened miscarriage, which is a very good thing. The Medical Officer (Dr. Bennett) attends at the clinic two days a week, or three if necessary. The Dental Department has been well attended, and where the mothers had the idea that to have teeth extracted was a most unheard-of thing, they now realise that a clean mouth is most beneficial to the health of both.

The patients are allowed chloroform if they wish it, but very few make any request for it, and even those who have very often forget all about it when the time comes.

Another feature is the district work — the treating of patients in their own homes, either with a doctor engaged or

with one of our own Sisters, and the charge is £1 for ten days. The nurse is called at time of confinement and visits daily for ten days, attending to the mother and baby. The majority of these cases are mothers with large families and of the poorer class, who object to leaving home. We try to insist on them having a responsible person in the home, but very often find she is missing on the arrival of the nurse, no arrangements having been made, and they struggle along depending on neighbours or a child of the home. There is no need for this, as the Mothers' Help Division provides for this want. The district work is a great help in the training of nurses, inasmuch as it gives them confidence and an opportunity of working with other doctors, and they also have to treat patients where everything is not at hand. The sterilisation of everything in connection with labour and the puerperium is a decided move in the right direction, and a large steriliser has been installed where all linen which comes in contact with the patient is sterilised, also two large sterilisers where bowls and other utensils are boiled. Outfits for doctors' private cases are sterilised, and the public are taking advantage of this for the small fee of 2/6. The patients on the district being of a poorer class could not afford to provide these outfits, so the nurse takes two bundles prepared by the hospital. These bundles, together with her bag, make it impossible for her to walk any distance, so where the patient cannot afford a car, the Director-Gen-eral of Health has given permission for us to have the use of the Post and Telegraph Department's cars during the day. The training of nurses has been considerably altered — the general-trained nurse is required to do eight months instead of six months, for she has four months' training and sits for Maternity Examination, and then if she desires her Midwifery Certificate, continues in training for a further four months, and then sits for her Midwifery Examination. This, of course, means that less are trained in the year. The untrained nurse does twelve months' training before sitting for her Maternity Examination, and then

goes out and works with a doctor or in a Private Hospital for a year ; then, if she desires to sit for her Midwifery Examination, returns to her Training School for a further four months' training. Except for special midwifery work the Maternity Certificate is quite sufficient for the private nurse or the general-trained nurse who is not taking it up, and even those who have the Midwifery Certificate and have been out of the work for any length of time and wish to return to it, should take a " refresher course," and I am sure the Health Department would welcome them. In fact, all nurses trained in the past would do well to come in, not necessarily for even a month, but say, a week, and I am sure it could be arranged. The past trainees of St. Helens w r ould see a change in the technique if they came for a " refresher course," and even if they could not attain to the standard, they would anyway be given an ideal to which they might strive to attain. The ante-natal work connected with St. Helens Hospital in Wellington began in 1925 under the organisation of Dr. Gurr and Sister Robinson. They then had charge of several other ante-natal clinics in the city and suburbs. Since then the work has grown and each clinic is now runing apart and has its own sis-ter-in-charge. During the first year 410 patients attended the clinic at St. Helens Hospital, making a total of 1,421 visits — an average of 118 visits per month. The second year, 466 patients have attended, making a total of 1,947 visits — averaging 162 visits per month. The work is widely known and numbers of patients call for advice, even though they do not intend having their babies at St. Helens Hospital. Many call to make enquiries while on a visit to Wellington. This shows how the people are being educated to the need of this special care during pregnancy. We commenced with two clinic days a week, but during this year we have found it necessary to have an extra day in the middle of the week, which is kept for the first visit of the new patient. By doing this we have found there are not the number of mothers held up in the waiting

room, and more time can be spent over that first interview. Owing to the large number of patients suffering with septic teeth and gums it was found necessary to have a Dental Clinic in St. Helens Hospital one afternoon a fortnight. This first began in October of last year and 53 appointments have been kept, making an average of four visits during an afternoon. This has been a great help to our mothers, as many cannot afford the expense of attending the dentist, and therefore refuse to go. On the other hand, there are those with septic mouths who refuse all treatment and would rather carry on with discomfort than suffer a short period of pain. Those patients who are unable to attend the clinic owing to family ties are visited at their own homes, also those whom the doctor advises to rest owing to bad varicose veins,, heart conditions, etc. An average of 36 visits a month has been made to homes during the last eight months, and quite a number of these homes are inconvenient to reach. Dr. Bennett visits the clinic two afternoons a week, and every Primipara is examined by her during the last month of pregnancy, or earlier if necessary, and any patient who is not running a normal course is also advised to come to see Dr. Bennett. Varicose veins are very common among our patients, almost half of our mothers are troubled with them. Frequently we have the severe cases in hospital for

complete rest with feet elevated, which proves most beneficial. During the last year we have only had fifteen cases of albuminuria. Some of these were treated in their own homes by diet and rest, but if blood pressure was high they were brought into hospital and treated, some requiring packs. Three patients who did not improve had medical induction, and the conditions of the mothers and babies were satisfactory. In three cases of contracted pelvis, labour was induced about the ninth lunar month — two medically and one (after failure of the former) had bougies inserted. The condition of the mothers and babies was very satisfactory. A patient who gives a history of previous miscarriage or delivery of stillborn child, with no apparent reason, has blood taken and sent to the Laboratory for Wassermann reaction and Kohn test. So far we have had no positive results. The only part of this work that has not proved satisfactory is the performing of version in the mal-positions. It stands to reason that a patient cannot get about her household duties with a tight binder applied ; therefore, we find she continually leaves it off or has it on so loosely that the good of it is lost, and even those treated in hospital have not proved altogether satisfactory. Frequently we have noticed where there is a mal-position in the early months of pregnancy it rights itself to a normal position before time of delivery.