Hospital Inquiry

Hawke's Bay Herald-Tribune, Issue 129, 17 June 1937, Page 6

Hospital Inquiry

SOILED BED-LINEN IN CHILDREN'S WARD pne Parent Not Told Child Mad Contracted Disease BREAKDOWN IN NURSING? Further mentlon by the parents of cmnplaints made of the dirty condition of the bed-clothes of the ' children while in hospital; a detailed description of the procedure adopted in the giving of the hot- ' bath treatment to the children by feverdl of the nurses, who varied in their statements as to the usual temperature of the water, the range being from 106 degrees to 114 degrees; the fact that it was not nntil the inquiry commenced that one father was aware that his child had contracted the disease; a complete denial by ihe medical superintendent, Dr. J. J. Foley, that he was aware of the bath treatment being given all the children until soxrfe months after Ihe death of one of them; and the admission by the medical superintendent that the most likely explanation of the second outbreak of the disease was that it had been brought about by a breakdown in the nursing technique: these were the main features of the evidence given before the Boyal Commission investigating the affairs of the Napier Public Hospital at Ihe sitting yesterdny afternoon. On the resumption after the luncheon adjournment a third mother was called. She said that at the end of June her child was? due to be discharged from the hospital, having been admitted with an injured foot. Witness said that «he heard that her child might have the disease and, with her husband, went to the medical superintendent, 3Dr. J. J. Foley. They could not get any satisfaction, however. Witness added that she had been to additional expense owing to her child 's longer stay in the hospital but had not jreceived a bill from the board. Mr Grant: Have all the parents been fLisoussing. this matter f Witness: Yes, naturally — when we yrere all up at the hospital. Mr Foden: Ddd you give authority -for the bath treatment?— "No. I didn 't lcnow she was being bathed. } 3 A fourth mother said her little girl went to hospital in May, suffering from pneumonia. When witness went to take the child home she was told that tho child was suffering from an infectious disease. Later when she referred "the matter to Dr. Foley he said "that it was a lot of rot and to take no notice oi ti." „ Witness added that she knew nothing about the hot baths treatment. Child Feared Baths. To Mr Harker witness said that she eould not get the child to have a bath ftfter coming out of the hospital. Mr Harker: Why was that? Witness: She used to scream so. Mr Grant; Do you. know when your child had the last of the hot baths? Witness: No. She was discharged on Deeember 18 though. ' 4 After the death of the child in the ward the hot baths were discontinued. That was Deeember 9," said Mr Grant. "Ara you suggesting that your girl, who is 2 i years old, carried the memory oi the baths all that time?" Witness: Yes. Continning witness said she also found that the bed-clo'thes were stained and wet on more than one occasion. Once she had spoken about it, but was told that they could not be changed until 4 o'clock. Witness said that there was a marked improvement after one of the mothers had taken away a sheet. The father of a child was next called and ho said that this was the first time he was aware that his child had been affeeted by vulvo-vaginitis. He said he knew nothing of the treatment given the child. but he had every faith in the doctoxa. Nurses Describe Baths. This eoncluded the evidence o± the parents and the Crown Solicitor intimated that the next stage in the proeeedings would be the evidence of the jiursoss who had attended the children. A fourth-year nurse wTho was in charge of the bathing of the chiid that eventiially died, said that ou the day in question the child was given a bath, the temperature being 114 degrees. Describing tho treatment she saiu the bath was for an hour. Pulse bcate were taken every 15 minutes and the temperature of ihe water on several oeeasions. At the cnd of the hour tbe child was taken out, wrapped up in blankets and then placed in iC warmed bed. Regarding the particular day in questcon she stayed at the bedside of the child for about an hour, taking and checking the pulse beats. At the end of that period she noted that tho beats rosb sharply and the child appeared about to collapse. Witness called out twico but receiving no respouse she went to the sistei, who was in the linen-rooxn. Later the sister and doctors canie down, Witness said that the temperature of the baths was raised in stages up to 114 degrees. Once it did happen to go up to 116 degrees. Instructions to witness were given by the sister. They werd simple instructions and easy to remember. Did Not 1.00k for Developments. Mr Foden; Did anyone ask you to an eye on the patients after the baths for any untoward symptoms? Witness: No. Did anyone say to you there was a jrisk? — "No." It was just leffc to your own in-

To Mr Lawry witness said that while she 'was attendcng to the child the mster came in and saw witness and tho child. Later the sister made a second call. Witness was quite certain that die instructions called for the bath temperature to be 114 degrees. That was the figure for all the baths. Mi Harker: Di.d any of the doctors attend while you were giving the baths? Witness: No. Did they jknow about the baths? — 'I don't know." To Mr Grant witness said that she aid receive one complaint that a bed dheet was damp and, she was told by tbe sister to see that the clothes were xept as dry as possible by changing them often. Some of the tsheets were stained, but this was not bechuse of any immediate discharges by the patients. Another nurse was next called. She had bathed the children on oeeasions. Her instructions were to brdng the temperatures up to 110 to 112 degrees. As far as she was concerned the temperature did not reach 114 or 116 degrees. During the bathing operations the sister would come in three or four times. The only doctor who came in during the timee she was bathing the children was Dr. Berry. Replying to Sir James Elliott, witness sai.d that she did not take the temperature of the child during their baths. She could not recall whether she was instructed to do so. Witness tsaid she was not required to look out for any untoward symptoms. On one occasion a child was crying and Dr. Foley came in to pacify dt. Cried Because Water Too Hot. Mr Mosley; Why was the child crying? Was the water too hot? — "Yes." Mr Foden: Did Dr. Foley know that the child had been receiving special bath treatment? — "I couldn't actually say." Mr Mosley: Do you think Dr. Foley came because the child was crying, or because ho wanted to inspect the child. knowing dt to have undergone a special treatment? — "Oh, because of the crying." Mr Bate; Have you any knowledge of a child being infected with lice. Witness: Before admission. Were any complaints made of wet and soiled beds? — "I heard there were some complaints about that matter." s Witness' Memory Fails. Another nurse in evidence said that she was nursing a particular child when it had a fit. Witness said she was alarmed at the time and called the sister, as she considered that an emergency situation had arisen. The sister appeared concerned about it. Witness, however, could not say what the sister said to lflsr. - The temperature of the bath had been 114 degrees. More than once the temperature rose to more than that figure. To several subsequent questions witness replied that she could not recall the facts. This prompted the chairman to ask witness if she had been talking over the matter with anyone, but he was infoxmed that she had not done so. "You know that none of the other witnesses have said so many 'Don't xemembers' as you have given," he said with a smile. Several counsel endeavoured to fix the date of the first collapse of the child but though witness was iu the box a long time they were unable to achieve their objqctive. Break-Down In Technique. ' Dr. J. J. Foley, medical superintendent at the Napier Hospital, said the first outbreak of the disease broke out in June and he was unable to account for it. The second outbreak' was in August and in his opinion was caused by a breakdown in the technique. Asked( regarding theories to account for the first outbreak, witness said that the most likely theory was that one of the patients was admitted to the hospital with the disease and this was not detected. There was a remote possibility, he admitted, that the disease had been introduced by some adult visitor to the ward and another remote possibility' was the disease existed in some other ward and .was conveyed to the children by someone in attendance or visiting them. Witness detailed the steps taken to prevent the outbreak spreading. The ward was closed to all exeept new urgent cases. All the children were ordered to be swabbed and they were segregated. Mr. Foden: Was there any tightenIng up in the technique after the first outbreak? Witness: Not that I know of. A nurse would automatically know what to do when she had to attend to a contagious ease. There was no seeret made of it all? — "No. It is a constitutional disease, and though serious there was no need for panic." Witness went on to say that he was satisfied that there had been full cooperation giveu by all concerned in the steps taken to prevent the spread of the disease. Mr. Foden: What do you rely upon in making this statement? Witness: The fact that I saw nothing contrary to the proper procedure of the hospital. Highly Contagioiis Disease. Asked how to account for the spread, wdtness said that tho diseaso was highly contagious and could easiJy sweep through the ward despite every precaution. Witness said tnat when the second outbreak oecurred he considered there had been a breakdown in the nursing technique. He conferred with the matron, who reported that there was one nurse who was not quite rcliable and had to be watched. "I said to the inatron: 'Bump kcr off,' but the matron said that to do so would be to suggcst that the nurse had actually been rcsponsible for the spread," said' witness. "The matrou considered that all that was required was that the nurse should be watched more closely." ' Unaware of Bath Treatments. Mr Foden: Now, leaving that and coming to the matter of the baths. Were you aware of the treatment prescribed by the doctors regarding tlif children? Witness: My knowledge was that thejr jyerq to. Jiavjn local tre&imont, 1

4 knew the treatment had been changed from, time to time and that one doctor had ordered the baths for his particular patients. When did you know that the children were having the baths treatment? — "I did not know that until some weeks after the death of the child." That was after the second outbreak? — "Oh, yes." So it would, in fact, be over two months after the discovery of the infected children that you were aware that' the children had been prescribed hot-bath treatment? — "It was that before I knew the treatment had been given to all the children." Witness went on. to deny that there had been any reason for him to dnfer from what he had seen that the baths treatment was being carried out. He did not go near the baths because he was well aware of the fact that frequently the nurses themselves used the bathroom. On the one occasion that he did come into contact with a child that was crying it was brought about by his desire to have the fanlight closed. He did not discuss treatments with the nurse in attendance, nor with the matron afterwards. Mr Foden: From evidence that has been given it may appcar from certain incidents that you had knowledge of the bath treatments and that you should have inferred such when the incidents came under your notice. Did you notice anything that led you to infer that the baths treatment was being given? Witness: There may have been incidents, but I have no recollection of any. No Written Record. You endeavoured to find whether any written record of the treatment had been prescribed? — "Yes, but when the board decided to have an inquiry the books were all seized and I refrained from making further inquiries. Was any mention of the baths treatment made to you? — "One did say ' Thank God my patients were not getting it,' but I found out later that his patients were getting the treatment, Is it usual that a certain course of treatment should be carried 'out without there being a record of it? — "It is supposed to be put on record." Does the fact that there was no such record suggest that there was a poliey of non-disclosure being adopt.ed? — *'No* I don't think the sister deliberately refrained from telling me. I think it more likely that she assumed I knew." - Did you take any steps to toll the parents of the outbreak? — "Some of the parents waited on me, but 1 underatood that another doctor had explained the position to them. I dended to the parents that their children had venereal disease becamse, in my opinion, it is not a venereal disease." At this stage the commission adJourned for the dav.