Napier Inquiry

Hawke's Bay Herald-Tribune, Issue 128, 16 June 1937, Page 6

Napier Inquiry

NON-RECORDING OF HOT BATHS Honorary's Attitude to the . • * Children DR. BERRY'S POSITION That at th© board inquiry she had not been on her oath to tell the ^whol© of the truth was the reason giveo. yesterday T>y the ward sister to the Royal Commission investigating Napier Puhlic Hospital management for the fact that she did not lay any hlame on the honorary physician at the inquiry held a few months ago at the hospital into the outbreak of vulvovaginitis in ihe Shrimpton Ward* «'It may be" was her reply to a question asking if her reason for not telling the honorary physician About the hot-bath treatment was that she had not wanted him to imow anything about it. The sister -was under examination in the witness-box for 8| hours. The commission consists of Mr E. I). Mosley, S.M., of Wellington, who is presiding; Sir James Elliott, K.B., M.D., of Wellington; and Miss Cecilia McKenny, formerly matro'tf of the Wanganui Hospital. Connsel engaged in the commission 's Jnvestigation are:— Mr N. A. Foden, Crown Solicitor, jepresenting the Director-General of Health and assisting the commission. Mr M. R. Grant and Mr W. E. Bate, for the Hawke's Bay Hospital Board. Mr H; B. Lusk, appearxng for Miss H. M. Croft, matron of the Napier Hospital.. _ Mr A. E. Lawry, for Sister M. A. Vood, Dr. J. Allan Berry, the nurses in training in the institntion, and Mr 8. J. Montgomery, a patient. Mr O. G. E. Harker, for paTents of children affecte'd by the Shrimpton ^Ward outbreak, and for Mt E. Bells, a ^Gontinmng her evidence yesterday fcfternoon, the sister of Shrimpton Ward explained that a further affected chiia suffering from a skin trouble was bathed under instructions from Dr. Berrr.

Taking of Temperatures i ■fo Mr Harker, who appeared for the patents of the children affected, witness explained that after August 4 she had special assistance for the nursing of -the children. For a few days the children were given baths. at ies aegrees without their temperatures being taken during the process. She beghn taking the temperatures as the xesult of a discussion with Dr* Berry. The temperature of one of the children while in the bath reached 105 degree3. During the hot bath at 120 degrees the child's temperature was taken only once. The child. was taken out and put back when the bath temperature was * lowered to 110 deetees. Her temperature was 103. Dr. Beixy did know that the child 's tempexatuxe did go to 105. He did not snggest that that was too high for the ehild. Witness had not had previous experience of a child's temperature being artificially brought to 105 degrees and hept at that. Because of Dr. Berry 's tcqniescence witness was hot alaTmed at this temperature; otherwise she woulcl have been. Dr. Berry was preeent on several oecasions when. hot baths were being given. On one occasion when the medieal superintendent was present tho temperature of the bath was 112 degrees, and he did not comment about it. Witness did not communicate any information of tho treatment to the parents of the children. 1 Sir Jaines Elliott asked witness if she had been-told that the authorities considered lliat the treatment for" this infection was 106 to 107 degrees for a period of five years. This special treatment was by electrical appiianccs. The high temperature if this treatment were adopted was deliberate and was maintained. Witness in reply, stated that she had heard of recomraendations by authorities of high temperatures.

Not Alarmed at Pulse To Mr Harker, witness said she was not alarmed when the child 's pulse itaehed 1G8 because she had Dr. Berry 's assurance. Allhough the child with hip disease was Dr. Berry 's case, -she thought it was still his case when it dbveloped vulvo-vaginitis. It was tho duty of the doetor to charter treat-, ments, and no explanation was given by- the house surgeon as to why he did not eharter a treatment in this partiealar case. The child did not appuar to be played out after the hot-waler bath. Even after the. high temperature was preserved by means of hot water in bottles there did not appear to be any ill-eilcct. Tho child ate its nxeals as usual To Mr M. E. Grant, who appeared for the Hospital Board, witness said that it was possible that all four cases wtxe affected from the one source of infection. She knew that in 1928 when there was a similar epidemic the practice was to take swabs on all admissions. In 1934, when she returned and the practiee was diseontinued, she did not mako any inquiries concerning it. She did not tliink that it was hcr place to inake any suggestions concerning it. Witness stated that she had had wide and varied experience in uursing. 2n the diseovery of any infectious diseases she knew the precaution to take. Witness admitted that since the earthquake the board had carried on under difficulties. When an infectious case broke out in her ward there was usually a bed in isolation for it. She did Xtot make any sueh inquiries when this disease broke Out, as the arrangement of ' transfers was a matter for the doctom, With proper nursing technique there should not bd any danger from a nurse looking after two types of infec- . tions cases. She had poi heari of a • icrfiss-infectioB.. - - - . ^

Knew the Prooedure, When an infection occurred, witness knew the procedure to follow without instructions from superior offieers.- On the second outbreak on August 4, witness discovered four or five cases. Knowing the period of incubation, witness came to the conclusion that someone had failed to observe a proper precaution about the end of July. Itegarding the: administering of treatments, witness said it was the duty of a nurse to carry out treatment as prescribed by the doctor until he varied it. Without his authority a nurse could not alter it, but she was permitted to discontinue it if she found that it was not doing the patient any good until she could put it before the doctor in charge of the patient. If she thought that an honorary had uot prescribed for g, patient when he should have done it was her duty to report it to the house surgeon or the medieal superintendent. Mr. Grant ; What was there that the matron should have told you about it that she didn't? Witness : I suppose nothing. What about the medieal superintendent "He c5uld have discussed the latest technique with me." It was- the medieal superintendent who ordered all the children in the ward to he swabbed? "Yes." Did you ever find a member of your staff not obeying your orders? — "Yes." You immediately reported her to the Matron? — "Yes." Did the "Matron not eay : "If this girl is not obeying orders we must ask her for her resignation." — "No." Witness then explained that the Matron lyid sent this nurse to the ward, having" had bad reports from other sisters, so that she oould have an ombiassed report. Witness told her that she was not prepared to say that this nurs© was the cause of the spread of .the infection. Witness was not even now prepared to say that this nurse was the one who had failed to carry out the proper techniaue.

& Why Reports Were Not Kept. Mr. Grant: "Pid you at any time feel that your technique was faulty ? Witness; No. When you secured the special nurses most of the trouble was over? — "They still required supervision, and the worry was still there." Hegarding the hot baths, witness said that reports were not kept, as she thought that up to 106.8 degrees they were only routine treatment. Mr. Grant: Were you and Dr. Berry carrying out an experiment with theso children? — "No. At first I thought the baths were only routine treatment. When the temperatures of the baths were raised I regarded it as an experiment." Did you not become worried when you got away from the routine treatment?-—"! wanted to do something for the children." After the final collapse did not a nurse come to you and plead with you to tell the Medieal Superintendent what was going on? — "No." You insist that the honorary doctor did not order any treatment? — "Yes." Did he not tell you that one per cent. silver- nitrate was too strong for children? — "I don't remember it." He did not know that his patients were receiving the hot baths? — "He could see them wrapped up in bed, different from other patients." Was it. not part and parcel of the scheme to keep the - hot-bath treatment away from the honorary's knowledge by not recording the baths on the sheet? *"It may be." . You still say that despite the honorary being. in the ward.on August 9 and discussing .with you treatment for his patients. — "I say that he did not give me any instructions."

Routine Treatment Diseontinued. Despite the fact that the honorary was in the ward the day the first bath was given the routine treatment was diseontinued? — "Yes." You say that someone told you not to give your evidence as fully and freely at the inquiry in October as you have done to the commission. — "Yes." * Why not? — "Because I was told not to." Mr. Foden; Who told you that? Witness-.. My legal adviser. At the inquiry at the hospital you did not consider that the honorary was to bl^me?— "No." Why at this late 'date are you attaching tbe blame to him? — "I have sworn to tell the truth." I take it that it was your not being sworn at the inquiry at the hospital to tell the truth and nothing but the truth that is the soie reason why the honorary gets any blame in the matter ? —"Yes." Mr. H. B. Lusk (who appeared for the Matron): Am I right in thiiiking that the Matron could not liave given you any further instruction that would Imve helped you ,as you were "au fait" with technique ? * Witness; That is so. There was no such thing as lectures by the Matron? Sisters are fullytrained nurses? — "They are." * You would not expeot instruction? You already know the technique? — "Yes." How did you keep it up-to-date? — "By my own efforts." You know of no faulfc in your technique? — "No. I would have remedied it if I had had one." When you made application for an extra nurse, didt not the matron tell you that she would consult with tbe medieal superintendent ? — ' ' Y es. ' ' Big Influx of Patients. Do you not know that at ttiat time there was a big influx of patients into tlie hospital and a number of nurses were away siek? — "That is so." You say that you complained to the matron about the nurse who, you considered, was not competent and that she made no comment wha$ever?— "Yes, I do." You told her that the nurso was unreliable and no remark was made by the matrdn . Were yci not surprised? —"I was." » In reply to a further question, witness explained that in a discussion witli the matron concerning this particular nurse the - matrojk had. paid Jhaji nfie

did not blame witness for . the outbreak of the infection because of tlie incompetent nurse that she had had. Replying to a further question, witness admitted that she was suspended by the matron for insubordination and that on appealing to the board, she was reinstated. She was again suspended after the Shrimpton Ward inquiry. "The major portion of your ordeal is now over," said the chairman to the sister at the conclusion of her very lengtby examination. "Whatever conclusions wc come to will not affect our sympathy ln the ordeal you have gone through. We want you to feel, when you leave this Court to-night, that you have the consolation of the committee and also, I am sure. of the gentlemen sitting around the i legal table. In saying this I am not holding any hope regarding the finding. That will he considered later." "As tlie sisler will be giviug evidence on other matters in the order of refcrence, I think it would be prudcnt lor the commission to ask her not to discuss the matter with other witiiesses, " said Mr Foden. "I.will give that undertaking," said Mr Lawry, counsel on behalf of the witness. The cliairman: Oh, no; 1 can't expect counsel to give undertakiugs oi" that nature. I have been conversant with the legal- profession for '44 years. and I know something about it. Ho added that the witness would understand tlie suggestiou made by the ■ Crown Solicitor* . . .