Notes from some of the Nursing Journals

Kai Tiaki : the journal of the nurses of New Zealand, Volume XVII, Issue 2, 1 April 1928, Page 90

Notes from some of the Nursing Journals

In the New Zealand Medical Journal of October, 1927, we note some remarks by Dr. Jellet on the training of midwives and maternity nurses. He says : " The maternity nurse of the present time is neither inferior to the midwife m her special sphere, nor "half-baked." On the contrary, she is better trained for the work she has to do — namely, attendance at midwifery cases with a medical practitioner — than was the former midwife. It is not her duty either to diagnose complications or to make vaginal examinations. The medical practitioner who attends the patient must take the whole responsibility of the former, and he is most unwise to add to these responsibilities by permitting the latter. Therefore, the maternity nurse is not taught to make vaginal examinations. The midwife, on the other hand, is trained to be able to conduct cases by herself, if necessary, and to be able to teach maternity nurses or midwives m training. One of her essential duties is to distinguish between the normal cases, which she is allowed to attend, and the abnormal cases which she is not. Therefore, a knowledge of vaginal examination is, I think necessary. . . . It is desirable that generally trained nurses should hold the maternity certificate, but when they take a midwife's training without any intention of making use of it, they are only hampering the training of women who require it for practical purposes." NOTE. — We agree with this last sentence. As we have pointed out before, it is impossible for all generally trained nurses to take their midwifery training. While they obtain their experience m general nursing on men, women and children at all stages of their existence, experience m midwifery can only be obtained on women for a very limited period of their existence. We consider, then, that while the ideal nurse should have this rounding off, it is necessary for the majority to stop short of the ideal, to confine the training to those whose future work will m some way or other have some bearing on maternity care, either m actual nursing, teaching, or ante-natal supervision.

In the Bulletin of the Hospital Boards' Association of New Zealand an interesting paper, read by Dr. T. McKibbin, contains reference to the work of trained nurses m the prevention of disease. He

says : "Perhaps the public health nurse will be the principal agent employed m disease prevention, but guidance from experienced medical practitioners is highly desirable. A demand is arising for public health nurses, and for an extension of Public Hosptial activities to include the prevention of disease, such as by following up discharged patients and entering their homes, m order not only to confirm the cure and prevent a recurrence, but generally to reduce disease and the demand for Public Hospital accommodation/ He further remarks that there are few public nurses who are widely trained m disease prevention m all its aspects. NOTE. — We can point out here that the PostGraduate Course just commenced will offer nurses the opportunity of obtaining this wider training.

Extracts given m the same journal from the report of Dr. MacEachern, the distinguished expert on hospital administration, who visited the Dominion last year, are of interest to nurses. The question of the Community Hospital, with accommodation for different classes of patients — those who can pay little or nothing, and those who can afford full fees for treatment by surgeons and physicians — is very fully discussed. The provision of private wards for the latter class is very strongly recommended, and that they should be able to choose and pay their own medical attendant. It is regrettable that while m this way the medical profession is safeguarded, no such consideration has been given to the nursing profession. It may be that it has been considered that the engagement of private doctors would naturally include the engagement of private nurses. If such a course were followed all would be well; nurses would not lose the well-to-do patients that they, quite as much as the medical practitioners, consider should be their own. This is a matter which should be watched carefully m the event of Hospital Boards adopting the suggestions contained m this report. In regard to the provision of private wards, Dr. Fox, of Christchurch Hospi-

tal, m "The History of the North Canterbury Hospital Board," writes of the nursing question for private patients : — "Trained and efficient nurses: Last, but not least, comes the nurse, co-partner of the modern surgeon and physician. One frequently hears m connection with outside institutions of an insufficiency of nursing staff. We, on the other hand, have a Nurses' Training School, and coiit sequently have a complete control of the supply. It is unnecessary to enter here into the improvements that we are constantly trying to effect m nursing education, more than to mention that they are having a marked effect on the ability of the nurses to carry out all the highly technical procedure of modern medicine and surgery — with all the elaborate structure of scientific investigation and treatment of disease." In the Bulletin of October, 1927, an extract from Dr. MacEachern's recommendation is of interest to nurses. 52. That all hospitals conducting schools of nursing have well organised and properly equipped class rooms, and adequate teaching personnel for the theoretical and practical instruction of the student nurse. 53. That the present standard of nursing m the Dominion be maintained as a minimum, and affiliation and exchange sought with other countries. 54. That serious consideration be given to the inclusion of instruction and training m maternity work as part of the standard curriculum for all nurses, as part of the regular course for graduate nurses. 55. That the nursing services m each hospital comply with the minimum standard requirements as set down m this report. 56. That the Department of Nursing, established m connection with the University of Otago, providing for a fiveyear course leading to a degree m nursing, be highly commended as the most progressive step taken m the history of nursing m the Dominion of New Zealand, and that it should have the hearty interest, enthusiasm, and legal support of the Health Department, Hospital Boards, medical and nursing profession, as well as of the citizens of New Zealand generally.

(This five-year course is unfortunately at present suspended owing to financial difficulties, and the Post-Graduate Course for trained nurses, m connection with the Wellington University, has, for the time being, partly taken its place.) 57. That qualified graduate dietitians be placed m charge of the dietary department of each metropolitan and base hospital. 58. That the trained social worker be added to the staff of each metropolitan and base hospital to co-operate with the administration m the investigation of the social and financial condition of patients, and with the honorary medical staff m the study of the social aspect of the patient m relation to disease, and assist m the followings of each patient — which is no necessary for the intelligent study and appraisal of best results. (This Social Service should be a further outlet for nurses, who, by their experience m dealing with the sick and knowledge thus gained of human nature, would have a solid groundwork on which to train for this special work.) Another recommendation is that "the present Dominion Hospital Boards' Association be enlarged into a Dominion Hospital Association embracing m one or other of its membership classifications hospital superintendents, superintendents of nurses, members of honorary medical staffs and others directly concerned with hospital work." (We are glad to see that the Superintendents of Nurses, whose opinion and advice, concerned as they are m the absolutely essential work of the hospital, are included m this recommendation.) Now that our post-graduate course m connection with the Wellington University has actually started, it is interesting to read m "Una" of February, 1928, that at a special meeting of the Royal Victorian Trained Nurses' Association, one item of the "business" was to be the motion by Miss Bell, matron of the Melbourne Hospital, "That the Council of the R.V.T.N.A. approach the governing body of the Melbourne University with a view to its instituting a diploma of nursing, somewhat similar to those granted by the Universities of London and Leeds, England." We will look with interest for the outcome of this movement. A difficult and serious situation has arisen m regard to nursing matters under the General Nursing Council, England

and Wales. It appears that the Minister of Health has overridden the decision of the Council as to the suitability or otherwise of a hospital applying for recognition as a training school for fever nurses, and has directed that a hospital to which the Council had refused recognition except m affiliation with a large one, should be allowed to train, though for a longer period than the usual term. It seems strange that the Minister should have the power to reverse the decision of the Council appointed to direct the registration of nurses, a council which has representation of the Privy Council, the Board of Education, and representation of the Ministry of Health. It is hoped that the matter will receive further consideration as it is felt that this setting up a separate standard is likely to lower the standard of nursing m the country. In the " Nursing Times " of January 7th we read that the Nursing Homes (Registration) Act is now an accomplished fact. Nursing Homes will now from July Ist, 1928, be registered and inspected by qualified inspectors, the sick will be afforded protection, and well conducted homes will be freed from distrust and suspicion. It is hoped that certain objections which have been advanced to the inspection by nurses may be overcome. In New Zealand experience of such inspection by trained nurses working under the Health Department, for the past twenty-two years, has proved quite satisfactory, and objection even by the medical practitioners, owning private hospitals, has not been raised. The inspection has been received m the right spirit, and the nurse inspectors have been looked upon by the matrons as friends and helpers, to whom their many difficulties could be referred. In the Canadian Nurses' Journal we see committees have been formed to make arrangements for the International Conference, to be held m Montreal m 1929. A questionnaire has been sent to the N.Z.T.N.A. asking for approval of certain proposed arrangements, and asking for subjects of discussion at the Round Table talks and the names of those who could participate m them. Should any member of the New Zealand Association be likely to travel about

the middle of 1929 it would be of great interest for them to attend this conference, and they should communicate with their branch so that arrangements might be made to appoint them delegates. We note m the New Year Honours several members of the nursing profession have been included. Miss Musson, R.R.C., having been given the Order of Commander of the British Empire. Miss Musson is chairman of the General Nursine" Council for England and Wales. Six other nurses have been given the Order of M.B.E. and 0.8. E., and two have been given the Kaisar I. Huid Medal. In the "T.C.N." for October are interesting accounts of nursing m various countries. In her commencement address at the John Hopkins Hospital, Miss Beard, who has been visiting many hospitals and schools of nursing m many parts of the Avorld, tells about a new school of nursing established m southern Europe m the city of Zagreb, near the Dalmatian coast, m Croatia. There a public health nurse from the Health Centre visited the mothers m their cottages and taught them how to keep their babies well. In Poland, m the city of Cracow, where is situated one of the oldest Universities m the world. Miss Beard found one of the "youngest and most promising of European nursing schools formerly established, housed m a University made over for its accommodation, and including m its faculty young women who have been preparing during the last seven years m America and England, and on the Continent to teach and lead the Polish nurses, who are soon to become a great force m the development of modern Poland. Nursing m Turkey is the subject of an article m which it is pointed out that "geographically Turkey can claim the beginnings of all nursing, both ancient and modern, for it was within the boundaries of the present Turkish Republic that Phoebe and her faithful associate deaconesses of the early Christian Church did their work and formed the subject of the first historical record of our profession. In Constantinople, some centuries later, we find Olympia, at the head of her deaconesses, nursing the sick. Out-

standing as are these landmarks m our history, they fade almost into insignificance when Scutari comes to our mind, where, rather less than eighteen centuries after Phoebe, modern professional nursing was begun by Florence Nightingale."

There are many other interesting items I would like to quote, but space forbids. This journal, giving as it does, a review of professional matters all over the world, is one to which every nurses' club should subscribe !