Health of Nurses

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

Health of Nurses

NAPIER HOSPITAL CONDITIONS Complaint of Overwork Investigated TRAINEE'S FATAL ILLNESS Further evidence relating to the measures taken to detect symptoms of ill-health among the nurses, and also on the general conditions of work prevailing at the Napier Public Hospital, was given at this morning 's session of the Royal Commission investigating the affairs of the Napier Hospital. The evidence concerned mainly the medical examinations of a particular nurse whose mother complained that she had been overworked and whose illness had been wrongly diagnosed. Two doctors admitted that it was distinetly possible that the nurse had been affected by scarlet fever but' that this fact had' not been detected at the time. Concerning , the question of working conditions, arrangements were made for three nurses to appear before the commission, but their evidence is being taken in camera. Mr. Frank R. Burnley, Cominissioner of Crown Lands at Napier, was the first witness called this morning. He eaid- that liis daughter had been a pupil-nurse at the Napier Hospital for the two years before her death on No^ember 1G. When she joined the staff sho was a fine, athletic girl, strong swimmer, ardent basketbali player and good at tennis. Her weight was then 9-°t. 121bs. During the first few months of her duty she had frequently to work for from four to six weeks at a time, and on one occasion for eight weeks, without a day off. She would then have three days off, but two of these would have to be spent recuperating so as to enjoy the third day. No Need to go Off Duty, About six cnonths before her death she complained of acute pain in the sinall of the back. After a few days she went to the matron and later was told that Dr. Foley had diagnosed her complaint as inuseular trouble, and that there was no need for her to go off duty. She was given electrical treatment and certainly sliowed some iinprovement, but the pains recurred at intervals. About this time the staff was increased and she obtaiued miore days off. However, in October she was again sick, and by this time she was weighiiig only Sst. On her last night on duty she was obviousJy not fit for work. but despite her mother 5s proteste she did work. The following day she was found to be running a high temperature, and^he was put mto the sick-room for about two weeks. Then the matron rang the mother and said that the daughter could go home and have the balance of" sick leave. On October 30, witness added, his daughter reported to the matron for sick leave, and on the following day she left with her mother for Taupo. For several days the girl appeaTed to be improving, but on Tuesday she was again ill and Dr. Armstrong was called. Later witness, himself, went to Taupo and found his daughter ill. Within a day or so the girl had a nervous conrulsion and Dr. Armstrong expressed

me opinion that the girl was in a very cntical condition and should ha\ c akilled treatment. Witness arranged for a special car to luke his daughter to the Napier Hospital and arrived there about seven u'clock. After that the girl was very well cared for. Three days after, witness was informed that the girl was suli'ering from tuberc-ular meningitls and that there was no hope of her recovery. "I cannot speak too highly of the care and attention given my daughter by the acting-medical superintendent, the acting-matron, the doctors and the nursing staff,55 said Mr Burnley in conelusion. "They did all they could possibly do for her, and were very kind to my wit'e and myself. "1 am here soiely in the interests of tho, nursing staff,55 he added. "I understand that these nurses are entitled to one day off, in a fortnight, and I think it is wrong for them to have to work 13 days for one day off. This occurred during the whole of the year of my daugiiter 5s • service at least. ' 5 Dr. Arthur G. Clark^ of Napier, who st one time was acting-medical superintendent of the Napier Hospital, said that he had examined the nurse whose mother complained of lack of consideration. Witness examined her once and then. about three weeks later, with Dr. Berry in attendance, a further examination was made and it was deouded that the girl should be given a month 5s holiday and have certain treatment and a minor operation. To Mr W. E. Bate, witness said that when he first examined the girl she was eager to return to work and said that she was feeling fit. Witnes3 said that when he saw her she certainly vyas not suffering from scarlet fever. She had been ill some weeks before that and might have had scarlet fever, but there was no suggestion of that^ at the time he examined her. Regarding the second examination, the girl was slightly cmotional and excited, but ner only complaint was chronic tonsil trouble. The mother was greatly concerned over her child and had informed witness of her auxieties. Saw the Nurse Twice. Sir James Elliott: How many times did you see her while Dr. Focey was away ? Witness : Only two, medically. So you have no ccncern with the diagnosis or treatment? — "No, Sir; uot in the first •place.'" I suggest that the bacteriologicaJ examination would uot have revealed scarlet fever? — "That is so, tliough it is tlie usual procedure to have one.55 You agree there is no way of tcsting by the throat to show scarlet fever?— "That is so.55 Are you aware that slie had had six weeks without holiday? — "So 1 have heardv55 She (would be tired out, then? — "Probably.55 She worked in the isolation ward, wliere there was a scarlet fever case? — "Yes.5.5 With all the facts as you now know them, would you be (justified in saying slie had not scarlet fever? — "I would not; nor would I be justified in saying she had. She probably did Tiave it.55 Further questioned, witness said that the symptoms certainly did BUggest scarlet fever. If the nurse was so suffering she undoubtedly would have been a menace to the staff and should iiave been isolated. Sir James : Ok, I am being ventureyou would like to tell me? Witness : Well, no ; there doesn't seem to be anything. We've covered the ground pretty well, then, and have a fairly shrewd idea in our minds that she did have scarlet 'fever? — "Well, it looks that way.55 Sir James: Oli, Iam being venturesome in saying that. Tonsil Trouble and Nerves. Dr. Thomas Gilray said that he was asked by the mother to examine the nurse and did so, finding that the girl was suffering from tonsil trouble and was very nervous. Witness knew noth-

ing as to her having had scarlet fever. It was quite possible that she had had scarlet fever, but certainly. she was not suffering from it at the time of his examination. He considered her condition such that she should be given sick leave to enable her to recuperate and steady her nerves. To Mr. Grant, witness said he did not see any sign of peeling. He examined the giri purely to ascertakt whether she was fit for duty. It was quite possible that she had beeh suffering from scarlet fever before that and not been detected. Sir James: It is a well-known fact that highly qualified doctors can miss scarlet fever? Witness : It is ; because of similarity of the symptoms and the mildness of the complaint on occasions. Dr. J. J. Foley, medical superintendent of the hospital, said that when he saw the mrse he was concerned more to discovep whether she ; was suffering from diphtheria, but the swab revealed a negative case. The essential thing about scarlet fever was tlie rash, and without that it is not possible definitely to diagnose scarlet fever. TJie nurse had no rash when he examined her and diagnosed her complaint as inflained tonsilitis. • Mr. N. A. Foden: The suggestion is that you didn't diagnose her complfclnt as scarlet fever. What have you to say to that? Witness : She appeared to be jovial and anxious to return to work, but there was nofhing to suggest scarlet fever. Did Everything Possible. You think you did everything possible?— "I did.55 To Mr Bate, witness said that in the examiningi of nurses they were credited with certain special knowledge and the exanrination was not quite the same as would be the case with someone outside the profession. Mr Bate': You diagnosed tho complaint as sore throat? Witness: Yes. You have a sore throat yourself today? — "Yes.55 It has been suggested ' that you should have eliminated one complaint after the other when making the examination. Have you diagnosed your own sore throat?— "I suppose I got that from talking t.oo much Ijere.55 To Sir James, witness said /hat unJess one saw the rash it was very difficult to diagnose the case as scarlet fever. Following the evidence of Dr. Foley, Mr Foden stated that he proposed to call some of the nurses, and suggested that the publip should be excluded from the Court, and tliat the Press should be requested not to publish the evidence. "The pnblic will readily understand why, because we-want to get the truth from nervous and probably reluctant nurses,55 said the chairman. "The newspaper reporters may, if they wish, be present, but I shall ask that no newspaper report of the names or of the evidence they give be circulated. Mr M. R. Grant, representing the board : I think this is a case where the chairman of the board, and perhaps the managing-secretary should be present. Mr Foden: Oh, no, Sir. Mr Mosley: No, I am sorry, Mr Grant. Elxperienced counsel for the board will be present, and we will have to let it remain at that. Following a brief adjournment Mr Foden intimated that he proposed to call three nurses.