Shortage of Staff

Hawke's Bay Herald-Tribune, Issue 134, 23 June 1937, Page 6

Shortage of Staff

MATRON'S EVIDENCE AT INQUIRY Lack of Accommodation for Bigger Personnel DAY OFF IN SIX WEEKS s ' Tio fact tliat trainee " nurses at the Napier Hospital worked 70 • iiours a week on. some occasions, "but that tlie usual number of hours was " 59 in oue week and 50i 'the nest, was revealed by the matron, Miss • Xi. M, Croft, last night upon giving . evidence to the Royal Commission on tlio phase of its inquiries dealing with the health, of nurses and the ' eteps taken to regulate hours. Miss • Croft attributed the long hours to jthe lack of staff, which. she was t unahi© to increase until further accommodation had heen provided In the Nurses' Homo - Dr. J. J. Foley, medical superintendent, explained to ,tKe Oommission that lie took * an active interest in seeing that'the health of the nurses was safeguarded. On the first symptom of illJiealth a nurse was instructed to Teport to the matron and then to himself. He explained that all trainees were first examined by private doctors. In addition to that, all trainees were thoroughly examined by himself, including an X-ray of the chest before accepted, as a member of the staff. The question of whether a girl would be retained was not decided upon immediately, as there may be reasons, apart from health, why she should not continue her course. Certain tests, on admission, were carried out and an X-ray test of the chest was carried out annually. Mr. Foden : I understand that the nurses at the Napier Hospital have to work long hours and the roster, drawn np was not in their general welfare ? ' Witness; All things being equal, 1 •ay that the nurses do not work* any harder than they do at other hospitals. A nurse's week consists of how many days? — l'Seven." There isn't a 40-hour week about it? — "No, there is nothing of the 40-hour week about the medical or nursing profession." Do the nurses have a regular day or half-day off per week ?— "The Matron arranges that, but I can say that they are not overwcrked." Matron Worried You don't know if they get a day off a week or a fortnight? — "Not each week, but 1 know that the matron has been worried about it and has asked that the Nurses5 Home be made larger to accommodate moro. The matron has discussed this question with me many Hines and has been very worried about it as she has wanted to give them their time off. There is not the room to accommodate the number we require and the work goes on.5' Witness stated that annual holidays being given without warning would be exceptional. Mr. Fojlen: Do you treat them well tn regard to dance leave? Witness: They don't apply to me for that. is the matron quite fair about it? — 4tYes, I think if any nurse asks the matron for dance leave skc receives it." I understand that the dance leave la linuted to 11 p.m. ? — "Yes, and 1 think that it is late enough." The chairman: And 1 agree with you, Dr. Foley. Witness: Late leave sometimes interferes with the State examinations. On oue occasion a lecture was to be given the night following late leave, and some of the nurses conccrned asked that the lecture be postponed as they felt tired. instructions to Nurses. To Sir James Elliott, witness said that instructions were given for all nurses to report without delay uuv aigns of ill-healtli. To Mr. Fodcn, witness said that there wero nurses who would hesitato to report siek. Nurses, even if they did not report sick, were never allowed to get jnto such a condition that tliey were unable to carry on. They were always under the uotice of the matron and the kome-sister, and if they were off their food they were iustantly questioned about it. If a nurse were not feeling well she was asked to say so. The matron, Miss L. M. (JroiL, explained tliat tlie necd for keeping in good health was stressed by hersoll uiicl the tutor. They were advised tliat any ill-health was to be reported to the medical superintendent, and tlie serviees of the lionorary doctors were available to them. In regard to organised divexsions, witness explained that the nurses did organise social- eveniiigs. L'nfortun-at-ely there was not a room at tlie bonio whieh lcnt jtself to daneing. Witli' a view to detecting ill-healtli, a'l ward sisters and tlie lioiuu sisters were instructed to report to witness any nurse not lc-oking well. 'If a nurse were reported not to bo eating her meals, witness sent for her and questioned her about it. If necessary a t-onic was given. The weigliing of all nurses was carried out bi-monthly, and if any nurse sliowed a decline in weight it was reported. , Nurses Observed On her dailv reeords of the hospital she observed whether nurses were loching'well or. otherwise. In the case of afnurse being a little off-colour witness would.draw the attention of the sister to ifer. In the case of a nurse havmg to^go to bed she was nursed by tLe staff. TFnfortunately a sick bay was ,ii^ Pffiyitigti in the hospitoJ^ Ja the

event of a serious illness witness. always advised the parents of nurses. Siok nurses could only be visited by the nursing staff on permission from witness. Resuming her evidence at the evening session the matron said that the pupil nurses were on duty for 8£ hours, including an hour and a-quarter for meals. Staff nurses were on duty for nine hours, including meal times. The niglit pupil nurses worked 59 hours in one week and in the next week 50-J hours. Mr Foden: Did you know that the law since 1932 required that unregistered nurses employed by a hospital board should not work more than 56 hours a week? — No. The hours are dependant upon the staff available. The chairman: The matron may be forgiven for not knowing, but someone should have told her. Mr Foden ; I assume than when members of the board give evidence this question is one that should be pertiaent to them? The chairman: Most assuredly. Nurses' Overtures. Mr Foden to witness: 1 think you should tell the whole sfory of the nurses5 overtures t.o you regarding the betterment of their conditions. You have a letter, I think? Witness : I have the letter and can produce it if necessary. Mr Foden to the chairman : The letter was left with her, sir, by the nurses. I think it should be produced. The chairman: We would like it to be made available to the Commission. Mr Foden: Will you tell the Commission about the letter? Witness: It was addressed to me. There was a covering letter was there not? — "Yes.55 Who was the letter enclosed addressed to?— -"The managing tary.55And did you forward it? — "I appreciated that the nurses5 going to a lawyer regarding internal matters was not quite proper3/ and I referred the matter to the medical superintendent. We agreed that we would have a general meeting of the staff pointing out that they had myself to refer to in all of their problems, and after a discussion the question of whether the- letter should be forwarded to the managing secretary was left to me. Later it was agreed that the letter be witbdrawn and I was advised accordingly by the solicitor.5' And you, in effectf dissuaded them ? — "I referred it to the medical superintendent.55 Continuing, witness said that she was to deal with the various problems herself and those which she could not deal with were to be referred by her to the board. Detaits of Roquests. Mr Foden: One request was for a full day5s holiday each week. — "That matter is to come before the board.55 Another was that when coming off night duty, the whole of the following day should be a sleeping day, and on no account should not be taken as the trainees5 day off? — "There are two methods of doing tliis. Oue is by having a broken day between the cliange from day to night duty and the other by a full day or more off.?5 Another prop.osal was that the change from afternoon duty to morning duty should take place twice a month, on the first and the fiiteenth day of every month. What have you to say about that? — "The nurses are now changed weekly.5' * Theu they have been given moie than they asked for in this regard? — "Yes.55 Now it was asked that the hours should be eight hours on and eight off? — "The Registered Nurses5 Association adopted a resolution favouring 10 hours on and 14 hours off." Chairman: That did not concern unregistered nurses? — "That is so.55 Mr Foden : With the trainees, did ifc happen that they did work 70 hours a week? — "Yes. But 1 have not the staff always to let" the nurses have a day off a week.55 To a iurther question witness 6aid that she had always endeavoured to give the nurses at least a wcv.v »• notice of annual leave. Very rarely had it not been possible to do this. Regarding dance lea-'e, wituess said that morning nurses were givoa this if desired twice a year • Requests to Board. The chairman: You are complaining, rigbtly or wrongly, ,of insufficient staff. Have you made representations in this direction to the board? — The matter has been discussed time and time agam with the chairman, and' I have been told that no further accommodation can be provided at the nursps5 home.55 You say that to give reasonabie conditions you require more staff — "Yes.55 "Well, that is oue of the matters the Commission is here to consider, and it will make recomniendations, and urgent recomniendations on it,55 said the chairman. Mr i.''oden: Wlien tlie nurses made their atlvanees to you did you give some assurance of loyalty to them if they did not pursue the matteT further? Witness: I appealed to them lo leave the matter with me. It was a spontaneous decision, Mr Foden said that he considered it perhaps advisablo to call the nurses to give their view of the discussion. Mr II. B. Tusk, representing Ihe matron: Wlial, Ihe whole 40 of them? Mr Foden: Well, if necessary. Tho chairniaii: The question of wilnesses and who shall be called is a matter for the Conimiesion to deeide. "VYe certainly shall require some of tho nurses to give evidence. , ' ' Extraordinary Thing, Mr Foden then asked that some assurance be given that their interesfcs would not be prejudiced. Mr Lusk: What an extraordinary thing! Is there any suggestion that the matron is likely to penalise them? The chairman: I should not think it possible. Stffl, if such should, oceur we5d know how to handle it. Mr Foden: During the -last eight days I have heard a good many things that have opened my eyes to what may happen at the Napier Hospital. Questioned by Mr M. E. Grant, representing the board, witness said that j whau granfring d^nce JLeaYe# 'which coulc

( be given twice a year, she had to con- : sider the nurses5 health and the work s of the hospital. Mr Grant: Additions have been conipleted? — "Yes. 55 And there will be accommodation for : how many? — "91.5' The chairman: And that will get over the difficulty of accommodation. State of Rehabilitation. Further questioned witness said that during the past six years there had been a rebuilding programme, and it , had not been possible to have everything that there should have been. Rep lying to Miss Cecilia McKennie, witness said she had appealed to the nurses to form their own amusement clubs, but there had not been much progress in this direction. Eeplying to Mr Foden, witness said that the nurses received an excellent diot. Tne average milk allowance was a pint a head, but they did not always take it. Every encouragement was given to them to drink milk, but without a great deal of success. Is Superintendent Ignored? Sir James Elliott: How many channels have you with the board? Witness: I address all my communieations to the managing-secretary at the request of the chairman of the board. So the superintendent is ignored? — "1 have discussed with liiin all the matters.5 ' Discussed or merely shown? — "Discussed and sometimes also shown. 55 "If he is the superintendent it seems to me strange that he is not in chargo of the whole medical staff.5' said Sir James. Witness: I have simplv followed instructions. Mr Foden mentioned a case of. a nurse working for six weeks without a day off, and witness said that sho reported this and similar occurrences to the board. It was not possiblo to give all the staff days off, but she did her best to epread the days off over tho staff. There was a shortage of nurses, and it was difficult to arrange for reliefs. The chairman: You inean to say there was a nurse working for six weeks without a day off? Witness: This parlicular nurse was. Mr Foden: But you said there were cthers? Witness: That is so. The chairman: It is quite wrong. Do you not thdnk tliat the burden should not have been laid on those better able to bear it? — "I tried to spread it as much as possible.5' Nurse's Physical Condition. To Mr. Grant witness said regarding the particular nurse mentioned by Mr. Foden, that she did report the matter to the board. The nurse had three days off to go to Palmerston North and returned with a cold. She was concluding her second year. Witness said that she and the medical superintendent deelined at first to engage the nurse o'wing to health reasons, but witness was told by Miss Lambie of tlie Health Department that the change of climate was a fa'ctor in the applicution for engagement. The nurse was still on the staff and her reports wero fairly satisfactory. The mother of the nurse gave evidence to the effect that she considered there had been a case of neglect in that her daughter had been asked to go on duty too soon after 18 days in bed. Witness also contended that her daughtey's complaint had been wrongly diagnosed and that her complaint was scarlet fever and not oierely acute septic throat. Witness also thought that her daughter had not had the medical attention and supervision that her condition warranted. Witness admitted that her daughter was anxious to get back on duty after her illness, but she should not have been permitted to do so. "If a nurse can be treated like that,55 said witness, "how are they going to treat the patients?5' Replying to Mr. W. E. Bate, witness said that actually her daughter had done 10 weeks5 work in her first 20 weeks of service. Witness considered tkat her daughter was infeeted with scarlet fevcr while on duty in the isolation ward. . Witness admitted that her daughter had no desire to have tho authorities note her illness because she was very keen on her work; Sir James Elliott pointed out that Dr! Clark had reported that the bacteriological examination of tho throat did aot reveal scarlet fever. "I want to know a lot more about this matter, 5 ' he said. 1 ' We have no medical evidence about it yet. The number of questions I want to put cannot be put to this witness.55 Mr. Foden intimated that he would call medical witnesses -and the Commission adjourned uutil the morning.