CHARITABLE AID BOARD.

Globe, Volume XX, Issue 1638, 21 May 1879, Page 3

CHARITABLE AID BOARD.

The above Board met yesterday evening at half-past seven o’clock, there being present— Mr H. Thomson (chairman), Mr J. E. Brown, the Mayor of Christchurch, Mayor of Sydenham, and Mr Montgomery. The minutes of the previous meeting having been duly read and confirmed, The Chairman said the meeting had been specially called to take into consideration a report from the house surgeon in reference to the hospital staff. The report referred to was read as follows: — “The Chairman cf the Hospital Staff.

Sir, —It is my intention to bring before the Board at their next meeting the whole sxxbjoct of the nursing at this hospital. “The main points I wish to bring forward are:—

“Ist. That the present number of nurses is insufficient for the wants of the hospital. “ 2nd. That the salary of the head nurses docs not offer suffie’ent inducement for them to remain any length of time in the hospital. “3rd. The great difficulty of obtaining any nurses.

“4th. The inconvenience that arises from having to take inexperienced girls at a comparatively high salary, and the difficulty in teaching them their duties. “ I would wish for the opinion of the medical staff o.i th. se matters.

“With regard to the first point, there is in each ward a head nurse and an under nurse, the number of patients in the male wards averaging twe. ty two ; in the female wares about fifteen. The under nurse is an-iwerable to the head nurse for the cleaning and general condition of the wards, and takes charge of the patients only in the absence of the head nurse. As our wards are almost altogether of wood, the under nurse’s time is almost exclusively occupied during the mornings by cleaning and fetching food, whilst in the afternoon, one or other of the two nurses claim the right to be out; thus it will be seen that for all practical purposes the real nursing of the ward devolves upon the head nurse. “ I append an abstract of the salaries of the nurses now in the institution. The medical staff will see that at present the head nurses receive .£4O per annum ; the night nurses, .£45 ; the under nurses, ,£35 * that is to say, th .t a totally inexperienced girl, who in most cases is an immigrant, receives within <£s of the amount a woman who has spent the greater part of her life in obtaining a practical knowledge of her professien receives. Also, that the only inducement offered to a girl to become a good nurse, and to hold a responsible po-ition, is £5, whereas she receives the sum of £lO more if she can obtain sufficient confidence from the House Surgeon to induce him to appoint her to the far less important post of night nurse. Ali salaries here arc fixed, irrespective of the length of service. This rule has only once been broken in the case of Mrs Kindloysides, who receives £5 extra for her sixteen years’ service. At the present moment one of the best nurses in the Hospital wishes to leave the institution for no other reason than that she do better for herself outside.

“ I would propose that the salary of the bead nurse of a ward be at least equal to that of a night nurse, thus doing away with the inducement to a girl to become a night nurse, in preference to the important position of bead nurse in the same ward. “ I need hardly bring forward any arguments on this point. As far as my experi nee goes, good nurses—that is, women with any experience —are exceedingly rare in this colony, and many of our nurses have been matrons on board ships, but beyond that have no knowledge of either bandaging, nursing, or management. The staff will thus see th it the replacement of a nurse is an important consideration in the dismissal of a previous one.

“ I experience the greatest difficulty in training girls ; as a rule wo have to take what we can get, mostly off emigrant ships, avid not one in six becomes fit for any other position than that of a mere cleaner, and the staff will understand that there is absolutely no provision in this Hospital for teaching girls their work. They are under the entire control of the house surgeon, and the stuff will readily see that ho has neither the time nor the opportunity for teaching them even such things as temper dure taking, bandaging, &c., whilst as to the most important point, their becoming good nurses, no one, not even the heal nurse in the ward, is authorised, or indeed has the time, to attend to them.

I would ask the medical staff fully to consider these matters, and if they think fit to recommend to the Board the following scheme: — “That if possible throe or four girls of an ago not exceeding seventeen, and who wish to

take np nursing as a profs-sion, be obtained. That they be termed ‘ probatione-s,’ and be placed in' Nos. 5 and (5 wards; and also in th female Wards,; these girls to bo under the direc tion and tuition of the hen! nurses of thm-e wards, who shall receive some increase of pay That their duties should bo those of ordinary under nur.-cs, with the exception tint their time ie principally to be devoted to the attention to patients and to learning their work. * “As regards this scliime, 1 Would remind the medical staff that it is only what is being carried out in every hospital of any size in England, which, in fact, is utilized as a training selib-1 for nurses. , The great difficulty appears to me to bo the obtaining of respectable girls to fill such posts. Still, no difficulty is experienced in England, and thev would have the opportunity of obtaining a thorough knowledge of their profession and of subsequently rising to important posts at a go id salary, or even, in the case of their leaving the Hospital, they could always obtain a goo “I live ilidad oftt-ide: By this means, Hm great difficulty of, in .any emergen 7, c ipplyi-g a nurse’s place would lie done away with, ana from personal kuowled e of his nurses the Resident Surgeon would always bo able to appoint those in whom he had confidence. I may say I am sure the Leai nurses of those wards which I have indicated would bo willing to undertake the charge of the girls, and, in my opinion, age capable of doing so. I would recommend that these girls bo en raged, first at. a small salary, in order to cover the expenses of their clothi' g and necessaries. In connection with this matter, I wish to call the staff’s attention to the rules as re ards the mutual relations between the House Burgeon and the nurses, who are answerable exclusively to Idm, and to no one else. Whilst being strongly opposed to any alteration being made as to the resident surgeon’s reaponsibi ity. and though at present the plan works exceedingly well, yet it is my firm opinion, and I ask the belief of the medical staff on the subject, that it is radically wrong that a number of female servants should be answerable to a young, unmanned man, as the resident surgeon is bound to be.

“I would ask the staff moat strongly to recommend the li.ardto appoint either a lady superintendent or a qualified head nurse, who shall have the entire con rol of the nurses and such probationers as I have mentioned, in all matters non-professional. Some of the staff mast remember the time when there was a head nurse here (Mrs Haim), and how things worked under her management. “In conelu ion, I would beg the staff, if they think fit, to recommend these things to the Board, to consider tho increased number of patients, and tho consequent responsibility of the house surgeon i that a now ward, with its corresponding complement of nilrries, lias been opened ; that the work of the place is monthly becoming more heavy, and I feel bound to express it as my opinion that . _ - alteration is made with regard rtlSw of nurses. ~3 made for training girls, before long, wc SUau compelled to treat onr cases under the so-called milling of half trained girls and uneducated women, in toad c£ finding instruction given by the staff to competent persona carried out “ (Signed) Maurice A. Chilton, 1.R.C.P.” In reply to Mr Brmyne, The chairman said a letter was read lit last meeting signifying,.the approval of the medical staff as to tho suggestions contained in the report. The secretary read a record of the circnmstaime referred to. The chairman expressed approval of tho suggestion as to nurses. Mr Booth understood the idea of the house surgeon to bo that the assistants should have received a sort of training for tho work they were called upon to perform, and that he (Mr Booth) considered a matter of considerable irapot tance. With regard to the report he thought they couid not adopt it in its entirety until they had settled a previous matter The Chairman pointed out that they need only consider the question of the assistants at present, and their payment. Mr Booth though:; they should first come to some determination in reference to the head nurse —this in view of the complaint ve the superintendence of the under nurses. Mr Brown was averse to treating the matter piecemeal. As to the lay work of the Hospital, he thought that was a matter they should deal with at some time, and perhaps the sooner the better, particularly under the present state of affairs, where complications frequently aro e in relation to the responsibilities of the officers of different departments. He thought, however, that the Board could not deal with the question at present, it being a matter Which they as laymen required time to determine, acting of course on tho advice of the medical staff, who, in the matter of the Hospital management, were best able to understand what was required. To test the question, he should move—“ That it be an instruction to the Hospital committee to take at their earliest convenience steps to carry out the recommendations of the house surgeon and medical staff, with reference to the status, duties, and salaries of the Hospital nurses.”

The Chairman would not altogether relegate the questions contained in the report to the medical staff, as there were certain matters ha should like to express an opinion unon. He did not, for instance, agree with the appointment of a lady superintendent. Other matters might be dealt with at once, whilst others again might very well be postponed. Mr Montgomery understood, in the first place, that a complaint was made in the report that there had not been a proper and efficient superintendence of the assistants, and the better course would be, he thought, to have that matter thoroughly investigated first, but he understood that Mr Brown’s resolution was asking the committee to deal with a matter which the Board could not decide upon ; whereas ho (Mr Montgomery) was of opin on that there were points in the report upon which it was highly desirable each member of the Board should be heard.

Mr Brown denied that his resolution could be made to bear the construction put upon it by the last speaker. Mr Ick agreed with the views expressed byMr Montgomery, that the report should not be dealt with as a whole by the committee, but that each member should take his share of the responsibility. Mr Brown pointed out that the resolution only pointed to the recommendations as to the status, duties, and salaries of the nurses, in regard to which the medical staff were better able to decide what was most suitable. Tt-ere were other matters in the report which might be dealt with hereafter by the Board, but in reference to this matter ho thought they cou’d not do bettor than adopt the recommendations of the medical staff. Mr Booth seconded the resolution proforma. The motion was then pnt to the meeting and negatived, It was resolved then to consider the items in the report seriatim. The first item in the report was in relation to the want of a training ground for nurses. The Chairman pointed out that that there was a differ.mce between the House Surgeon’s report to the committee and that to the medical staff as to the want of more nurses. In one ho had made no mention of it. Dr. Chilton (being called upon)_ explained that greater nursing power was required. Nothing could be more satisfactory than the way the nursing was conducted, but the medical staff recognised that a larger number of nurses was essential, especially- when there were many fever ca es.

In reply to Mr Montgomery, Dr. Chilton said, he had not reported to the committee re want of nurses before sending in the present report, his reason being that he desired first of all to obtain the opinion of the medical staff.

Mr Montgomery asked how many nurses wore required ? Dr. Chilton replied that ho required at least three additional nurses —two for the male ward and one for the female ward. He would not, however, go so far as to ask for three additional nurses ; as that would entail an expense which, though perfectly justifiable in bis opinion, might not be considered so by the Board. _ What be asked for was three girls, to act as assistants to the nurses, and they would in time become efficient nurses themselves.

In reply to Mr Montgomery, Dr. Chilton said, so far as the nurses in the hospital were concerned, ho could not speak too highly of the maimer in which they performed their duties— additional assistance being all that was required. Dr Chilton urged the opportunity of a lady superintendent, on the ground that at present ho had duties to perform which should devolve upon a responsible nurse. The person who had authority over the girls must be professional, and the lady superintendent should bo a professional and responsible person. He considered it radically wrong that all the nurses should be responsible to the medical officer. The head nurses at present engaged were efficient nurses, but were not fitted to bo superintendent. He took up the position that he ought not to have the control of the nurses, that is, it should not ho required of him to advise and direct the female nurses on every subject, matters of a domestic nature and so forth, which was in reality the duty of a lady superintendent. Such an appointment, ho added, was of the utmost importance, and had been advocated by the medical staff, not only once but many times.

At this station Dr. Chiitoil’s pro-once was dispensed with, ami the board resumed the consul ratio ■ of the first itnu in the report It, was resolved th .t three young women be selected as assistants in the hospital and placed under training. With reft mice to salaries, it was resolved that the head nurses receive each £4f> per annum. It was resolved also, that When vacancies in the wards o ru • for assis'ants, they be cug iged at a salary not exceeding ,£3O per annum. At th a'staga the house surgeon was re-called, and questioned further as to the position of the present female staff. After some discussion on the questiori of appointing a person, as described by Dr. Chi ton, to act, as “lady superintendent.” It Was resolved - ‘ That a matron boappointed who shall be a trained, Hospital mu* e, to ,be responsible for the entire musing, and training and efficiency of the female dim stic sti ff ” It was th*n resolved to communicate with the Agent-General through the Government, requesting him to be good enough to engage a comp, tent person in terms of the above r; solution, it being understood tint the duties of the office wo'itld be cl arly defined. This concluded the discussion in connection with this report. A letter was then read from Dr. Guillen as follows: “ To the Chairman of the Hospital and Charitable Aid Board. “ Sir, —I have to aekn uvlcdgc the receipt of a letter from the secretary, enclosing the resolutions of the Board passed at the last meeting. “ 1 regret exceedingly that the Board should have pass, d a resolution tantamount to an expression of censure towards me, that 1 had mis understood the late action of the coroner, without giving me, the complainant, an opportunity of stating my case, and my reasons for calling the attention of the Board and the public to what I believe, to be an illegal action on the part of the coroner. ‘‘l would most respectfully ask the Board not to confirm the minutes containing that resolution until some chance has been given to me to set the matter right before the Board, and to state to them the vi-.ws which I took of the laws affecting the coroner and myself mutually. “ The principal points upon which i take my stand are “ 1. That up to this time such a casfe hs the one brought before the Hoard has never hap period at this hospital. I have never heard of, nor can I find any record of a body being taken away from the dead house of a hospital when an inquest is pending ; indeed I believe I am right in stating that in a recent work written especially for the direction of house surgeons, by Mr Christopher Heath, he says that the housu surgeon must on no account allow a body awaiting an inquest to be removed from a ho pital dead house. The Board, I am pleased to find, agree with' the medical sti ff and myself that the proceeding was unprecedented. “2. I can find nothing ih any work, on the laws affecting medical men, or in any work on medical jurisprudence, justifying the coroner's aaii? D; bidced they assert over and over again" the extreme importance of not touching or interfering with a body awaiting an inquest in any way. “ I beg to submit to the Board an extract from Mr Ju tice Johnston’s work on the iaws of New Zealand ‘‘‘l. The coroner having received notice of th 6 finding 6f a dead body* or of a death under . ircumstancca which render an inquest desirable, ought to proceed to' the place where the body is, and to take immediate steps for holding the inquest. “ 1 11. The inquest shall be holden at the nearest convenient place to that where the body is ; but it is not absolutely necessary that it should bo held at the place where the body is viewed.’ “ Also, an extract from “ The Cabinet Lawyer and Digest of English Laws,” page 103: “ ‘ The coroner must sit if convenient at the place where the death happened.’ “ I would remind the Board that some time ago they passed a resolution that it was highly inexpedient that I should be taken ont of the hospital; I would most respectfully submit that with the law as it stands, and with that resolution before me, I did not misunderstand the coroner’s action and that I was perfectly justified in making my protest and in asking the Board to support me. “ With regard to the request from the Board that I would not engage in public correspondence without consulting them or their chairman, I would ask for the chairman’s recollection of the fact that on the morning of the inquest I took down to him a copy of everything that was published, containing the 1 threat ’ that I would publish in tlie press and forward to Minister of Justice, a statement of the facts and the onesided correspondence with Di. Coward, i o this he offered no objection. I would remind the Board that it was quite open to me to have made comments in the public press upon Dr. Cowarn’s action, but that I contented myself with simply publishing the statement of facts which was shown to the chairman, and allowed the whole business to go forth to the Board, the public, and the Minister of Justice, without one word from me, or any one else, that might be taken as a bias. I would, therefore, beg the Board most respectfully to reconsider their decision. I have the honor to be, Sir, Your most obedient servant, Maurice A. Chilton, Resident Medical Officer. It was resolved —“ That the chairman communicate with the Government, setting forth the facts of the case re the removal of Daniel Breene from the Hospital, and to state that in the opinion of this Board it is objectionable that a dead body should be removed from the Hospital and placed in the custody of private persons when an inquest has to be held. The Board would feel obliged by the Colonial Secretary bringing this matter under the notice of the Law officers of the Crown, and communicate to the Board such instructions as the Colonial Secretary may deem necessary.” A resolution was also passed as follows: — “That the secretary be instructed to reply to the letter of the House Surgeon, stating that the Board adheres to its decision, ‘that the House Surgeon shall not engage in public correspondence on Hospital matters without the consent of the chairman,’ and inform him that the chairman will lay the whole circumstances of Breene’s case before the Government.” The Board then adjourned.