HOSPITAL MANAGEMENT.

Taranaki Daily News, Volume LI, Issue 126, 19 May 1908, Page 4

HOSPITAL MANAGEMENT.

EXPLANATION AI THE BOARD MEETING. At tin* liu-piiui lizard meeting yesterday the cUii'iiti.iu. Mr. 1. llcilnngci. submitted a length\ repull upon matter- tii,* Board in tinform ui complaints at the April meetiiJL'.

i'«.r female patients This, under the present arrangement ui the building. ct>uid nut U 1 arranged. It the male and female patients used the xame dining room It would be necessary t«> have another coo!;, a-'two dinlie - would have to be prepared. The di ng of both macs together war. quit"

laetieable. lie iuuhl not advise an; tu. uer addition-, pending the ere t inn 0! a now \\muit eventual!} »e. lu regaru to the mali-.j ati'i the senior uui>e<j Iving absent at ihe a;' ..e time, thi- practice had lu--n in lor tht part ten year?, an I ii.ul -u far worked The ma tron only left the building fur a few hours and then only a n.-rtilicated nurse was in cliarge and auolhcr eeitilicated nurse within call, and unbthis could be arranged, the mairon never leave> tlie inrtitution. U hum be borne in mind that mider ilie present >y>tem tlie head nurse did aer houis the siinie as the except when th>« matron was a/at mi leave, when -die took her duties. J'iicreU'ie it would be unrearonable to expect the head aur>e to stay on if Mis> lirowu required to leave the institution, and it would also , be as unreasonable to keep the matrontrom taking outdoor exercise absolutely necessary for the preservation of health. To carry out the suggestion made by Mr. -los. Drown, which Dr. Leatham and the matron considered a good one (especially now there- was so much more work thrown on the matrou, s ut 'h as bUpervision of the annexe and nurses' honie and helping with the X-ray) it would be nece-.-ary to appoint the two senior nurses matron's assistants, who shouM do the duty in rotation, three months at a time. They would have no night duty but would work twelve hour* a day instead of eight as at present. Nurse O'Krien would be senior matron and take charge of the institution during the matron- abr-emc on leave. lather when not acting a* malum"- assistant would t-akf charge of a ward af at present. They suggested that the

M'nior nurse—Nursi' (TBrien—receive £B4. and Xurse lampUdl Uj2. They also suggested that Nurses Trask and Crozier receive Oiu p»-r annum and that in future a nurse gi'tting her certificate and being kept on (he„(aff receive at th* rate of t!4.» per annum for the first six montlu aud then if appoint-

inent be made permanent, to receive CSU, and then if promoted to si-ter C-V> ior the first year and €OO for the second. Imported are not to be compared with the ones trained in our own institution. To -how that other hospital* are paving higher salaries he quoted Auckland, who had just revised their -alaries:— Senior nuive ,C7O to C 7-"». junior n;ir-«- 4 Jm to €»'♦. stall

i nur-f- L"4H t<» c l»>. inle.*iiim- nurse* ' c.V> Ii« - wa- infunned tlnit j Dunedin mir-e„ \wre getting p ( ' r j week for nursing infection- ta-e* ;U the I j re»ent, time. Nur*e liayly. who ivj wived €45 le-re. received an appointment at Hamilton—First y<*ar Cm. second year tt>". Dr. Viilintiup had urged that nurse>* must Im* increased bylhe Hospital Hoard if they wi-h to n*tain certificate*! nm>e- -ervice-. ; He six nurses being at tin* one ! ti.u «l<w>trtr •iiifl matron as>nred ill**

chairman that the efficiency of the institution would not Mifl>r as there was alwav- a full complement of nurse* on duty. A nurse deputed to take charge o! i-olation was sometimes kepi six week* iu isolation from her friends and only allowed to talk to the patients. !Slk* was not even allowed to write to her friend* or relation*. Nurses were engaged attending to isolation cases for nine months of last year. -i» recreation, when available, should not lie denied.

In regard to a night nurse going to sleep at duty. This happened three vears ago and was dealt with by the chairman, doctor and matron at the tune, and the nurse resigned. lie had al*) to report that Dr. U'atham considered that the a*nstant gardener's duty *)ionld he altered so thai without a male attendant. When it was considered tint the hospital was Iwmnd to look after iu own mental and D.T. cases, it wa- that directly a v.ardsman went otf duty hi* deputy -liouM either U* on the prentices or within call.

Dr. Leatham considered Ali-ts llrown - -ilary should be in; rented from UllU to Cl-0 j"-!" annum. He pointed out that after ten year-" service in whiHi >iie had capabiy managed and i* managing. the hospital. the increase wa* dt served. Dr. Leathani said that he had gon ■ verr fully into all the matters mentioned in the rep'Ti. Some time ago he bad obtained particulars a, to diet given t-» patient- iu other Mew Zealand li<*pitaK and he toniid that patients here were a* well as in any other hospital, it uot better. The experience of other doctor* who had worked in this ho-pital had remarked

to him that patients here were better dieted than in many uih.»r hospitals Ue submitted the "dietary list." Of course, thes # would always have to

deal with people, that even Heaven couldn't please. Again-; however. the general cxperiniee was that patient.- were very phased with their tieatimnl in th- ho-pitul, and In* read extract- iroiu letter- written >pou-taiioou-iy by i».\-p.itii>m<-. highly appi.ci- [ alive of the nailing and dieting. He made it a rule to investigate immediately an\ complaint by a nur>e about a patient or by a patieut concerning a nurse. Rehiring to thv matter of protiding a dining-room for female patient*, he -slid it wa* not the rule, evt-ii in tho larger institutions. The LHinediti llov pita! Hoard wa« now building a new wing, however, and a women's diningrooin wa* being provided. The proposal that male and lemale patients should dine together wa.* out of the question, lor reason* which the mejiilwi's could readily understand. With regard to the complaint that the matrun and head nurse had been absent from the hospital at one time, he pointed out that the nur.*e* had an eight hours' day,! the head nur-e being ,>n the Mine loot- | ing as the n>t of the .-ta!]", -except that

>lie had to take charge when the matron wib out. There wa* no reason why the iieaa uui>e and the matron could not leave the institution together. Dr. I>*atham reierrcd to the present dearth

of r-.tpable nur.-e-. which had iv.*ulted iu - 4, me rending [o Australia Ihe matron here had received letter* oliering tatter po-itien- to members <_> l t!k- Hiu-ing *tufi. Now. this hospital miw keep an « rli:-i«Mit -tail', for upon that depended tile et!i'-ieU"\ of the in--litution; and it nece-Nt'ry, salaries I must Ik> increa-tij. Another 'complaint J wa> that the -i\ uur-e* wore al*-ent from the hospital at one time. There wa- nothing to prevent that. The nurso* had their eight hour:-' day. ami had to rake eight hour.-,' re.-t. in the other eight they wi'e tree to enjoy iiiemrH'he< ,»o long a- their ph-a-ires did not affeet their'work or iuvohv any , mi-tahaviour. Dr. I>eatliani maintained j tlwt the matron -hoold leeeiw a big-ei I -alary, at lea.-t Cliin a year, undn.: tliat "he wa- a highly ipiali'lied and eapI able u.-nian w ho-e ul wa- in her work I —work that wae im-rea-im: e\«r\ da\. j ia\«dving the maj;ag« no nt of ihc'whole I iiMitniion. Mr. \V. Browne a-ked iiow it wathat chicken broth took three daymanufacture. Dr. b. at ham explained that if he ordered -iu-h a* artielc of diet in tlr the chiek« I! "could Hot he pp,i- i ' Old People'.-; Quliie till j night. and it wTntU be at !e.i-t late next ! day before the broth eould be readv. A j -uu-titute wollhl lie »iven in the jiiean- j time. I lit answer to Mr. .r. Brown'- fpu -tlon j whether there wan any rea-on why tat- i ;<r food and mop- of j: -honld noi be j given, the medical -uperintendeiu -aid j no more wa- nen.--ary. Tlie patient® I '•ere wiwt wa- good for them. I i«» humor the whim- of m<-]< peopl-- | v.oald often mean een.iin deatli to them, j T!" diet provided wa- L"»od. plain, and 1 nourishing and -uliicieutly varied. j

Mr. iliiru'--• -aid it that the ii»»nl wa> better than in -onie of the larger ho-pital*. Mr. Andrew-: M> daughter ua- in The h-t-pitai lor three we-k-. and thriv

was no need to restrict her diet. During all liiut time she never saw anything else but bread and but tor for tea, and *he didn't even yet enough of that. Un Sunday there was a currant scone. I*ol* -upper titer*- was one ihing always looked, ami she didn't like thai. >o went wilhoui. He added that the <:irl sub--jKted only by buying things outside.

Mr. O'Sullivan mentioned the case of another ex-patient who wondered at aiiyuju- linding fault wiih Cie loud, cither in epiautity or quality.

Mr. Andrew* said he bad heard more tliau half-a-dozen complaints similar to hi* daughter's since last meeting. I)l\ Leatham: Those complaint- should be made ai the time. Mr. McDonald said there was no room lo growl. At any rate it wa« beyond the province of the Board to interTero with the diet, lie had never heard a I complaint the remarks were always highly comphnieniary—dnnnu hi\ eighI teen vears on the Hoard.

Mr. Andrews was surpri-ed at the j reviuii- speaker. W ere the ineinbei> to ignore the ratepayer' complaints? lie iiotanced the ea>e of uiie of the mgge>t ratejiayers in liis di-tricl wln». alter three days in the ho>pital. -liiiud to the Tenniuus Hotel becaii>c he \va-< beitiLj starved. Mr. McDonald said he made it a landing rule mH lo r.tmjdaiiilui the Hoard unUf-s they \wiv in b!a< k and white. Jle ehallengcd Mr. Andrew - io name his informants.

Mr. Andrewo: 1 can MihsUniiate everything J have .said. Tin.- chairman said he vi>iled tiie hospital regularly and alone, and lie could not *uecced ill getting one complaint.

Dr. Leatham instanced the case of a man, perilously ill with apj-endicilis. crying for food. "Why, it would spell certain death," he said. Bome patients were* too reticent, and did not state their likes aud dislikes. Pronounced repugnance to any article of diet wa* studied as far a» possible.

Ml*. Brown Haid the members were barking up the wrong tree. The sick people's diet was apparently all right, but the convalescents complained, lie had no intention of interfering with Dr. U'atham, whom be eulogised. But lie didn't believe, in noticing only the written complaints. Ifc was their duty to investigate and ventilate the ratepayer*' grievances. Me Imd been the author of all thi,„ Iwthcr. aud had goi a ••■dating" in the papers, but he didnt mind that >o long as he \\n> in the right. II" didn't deny the nurses their rights, but. contrary to the opinions «>i the chair man and the doctor, he believed that lo a reasonable extent the l>oard i-ouid iji'ect lrt)w tlt<' time oil' duly wa> to be ■pent. He diiln't agree with the olijeitloii n to the patients' common diningroom, and wa> not going to let the matter drop. He would not be <>iiided by the practice elsewhere. The thing was nece->ary. and would have to be brought about. The chairman and the medical superintendent agreed, he was glad to -co. with his contention that the matron and the head nurse should not be away

trom the brildiiig at one time. The Hoard would gel a nice time of it it a reries of accidents came in when both the principal nur.-es were out. Tiie chairman: We want a belter * t \>- lem.

Mr. lirown: Yes. Vet I got hnwled al in the papers for bringing this up. Coneluding, lie said hj« lliul lll ' v< ' r on ~ deavorod to restrict the nurses, and claimed always to have treated them fairly, even to the extent of being the first to support reasonable increases ot pay. Mr. Andrews, hearing that the "sleeping nurse*' incident was three years old. in- had not known that when he aired the complaint.

The report wa h then received. Air. llrowno asked Dr. Wtham if ho considered the .weekly charge to patient* wa.s suflicient. Most of the hospitals charged from 3t>s to ojs a week, hut here only 28., wa H charged, and about half of t'lwt wan lost.

The chairman said that was hardly within the province of the doctor. The secretary said that New Plymouth charges were high enough. Many Hospitals charged only a guinea. It was decided to ratac the statu* and

salaries of the nurse- as recommended in tire report, and to raise the matron's *a)ary to £l*2o per nnuum.