NURSES' REQUIREMENTS.

Taranaki Daily News, 20 July 1916, Page 7

NURSES' REQUIREMENTS.

DISCUSSION BY HOSPITAL BOARD. The matter of providing additional accommodation for the nurses at the hospital formed the subject of considerable discussion at the meeting of the Taranak' Hospital and Charitable Aid Board yesterday. The report of the House Committee, which enquired into the protests from the nurses regarding accommodation and salaries, recommended:— That the old hospital building be converted into an isolation block and that "Tariki" and adjacent buildings lie suitably prepared for use as extra accommodation for the nurses. The report further stated that the house stewt ard had been instructed to have ropes placed from the upstairs windows in the Nurses' Home, so is to overcome any danger arising from insufficient fire escapes; to have the pipe to the califont fixed so as to get increased pressure for the upstairs bath, and to have the walls around the califont lined with asbestos. The town clerk has been written to, to have the light in the drive, at present paid for by the Board, altered to a position so to light the steps. The Committee also recommended that the medical superintendent be requested to en- 1 close with his report a monthly report from the matron. Dr Walker (medical superintendent) and Dr Leatham were present. DR WALKER'S VIEWS. Dr. Walker thanked the Board for the opportunity of speaking on a subject so intimately related to the progress of the institution, and he said progress advisedly, because it was a matter thnt should be discussed on a sound business basis, and not from the point of view of sentiment. He then produced figures to show how the present difficult position over the accommodation of nurses had been reached. In 1!)11-1!)12, there had been 413 admissions to the hospital, and 210 operations carried out, 'whilst the staff .had numbered 21.. In I!)15-191G, there had been 777 admissions and -WO opera tions, whilst the stall' had increased to 33. On the basis of the 11111-12 patients 33 nurses should have treated only 649 patients. It would thus be seen that they were not overstaffed." Moreover, the daily average cost had dropped from Ob 9%d'in 11)12-1913 to (is 4'/,d in 101515)10, despite the enhanced cost of hospital supplies. The medical stall' felt that the arrangements for hoii-ing the nursing staff were inadequate. The most that could be done at present was to utilise "Tariki "' and the isolation block, and even that was only a temporary expedient. He doubted whether it would be sound finance, or consistent with economy, to spend any more money on these buildings than would serve to tide them over the present crisis. The ratepayers now possessed a modern, commodious and comfortable hospital. There was an operating theatre and regime of which the staff need not be ashamed. Thije was an X-ray department equal to the best in the Dominion, and the work of diagnosis and treatment was carried out in a manner that left little, to he desired. These features, combined with the reduction in cost, and the big increase in the number of patients, spoke volumes for the progress of the hospital. A progress, too, that he fell would continue, though, of course, one could not foretell whether there might not be a wave of depression. However, as he had contended years ago, provision had to be made for 100 patients, and that this had been justified was proved by the fact that the accommodation provided was already taxed. Referring to the nurses' protest, he would like the Board to regard this as a petition. He considered that the House Committee had .adopted rather a stern altitude in conducting the enquiry. It had failed to realise that it was dealing with ladies of limited experience, as was shown by the wording of the protest. He also asked them not to miss the main point, viz., the lack of accommodation, in their wrath at the list of minor details. He considered also that he had been grossly insulted during the enquiry by a member of the Board. During his eighteen years' connection with the hospital, he had been cordially treated until this enquiry, when he was accused of sitting on the fence, as was also the matron. He knew nothing of the petition until it was presented to him by Miss Browne, who, he was convinced, knew nothing of it until it was presented'to hoi. Miss Browne was very vexed over the petition, as she considered that the time was very inopportune for the nurses*o make a protest in a body. It was clearly his duty to forward the petition 911 to the Hoard, because if he had not, and there had been trouble in the future, he would have been deserving of censure, lie then detailed the position, pointing out that in the Xiuses' home only 111 nurses occupied single rooms; there \tvro four rooms occupied by two muses each ami one by three nurses. Four nurses slept in IJie annexe, their rooms being situated between two shelters in wiiich were eases of tuberculosis. .Although this did not constitute a danger to these muses, it was certainly undesirable. In the isolation block two nurses occupied a room adjoining a ward with live diptheria cases. This association t)f nurses in their sleeping hours with infectious eases was also undesirable. Moreover, these nurses had to have their meals in the scullery, and there wej-e bathrooms and lavatories etc., coinmoiy to both patients and nurses. Nurses were nNo accommodated in the maids' quarters at the new hospital, There were still three nurses not in the institution, one be-

ill;; 011 leave, whilst the others were recovering respectively from, enteric and dintheri*. They had not only to find a stii ll' to cope with the actual work, but they must be prepared to gu'ard against any emergency in the shape of sickness on the stall', and to provide for each nurse having the statutory holidays. To do this required a surplus of 2 1-3 nurses. Moreover, he pointed out that the administration of the annexe and isolation ward from the main stall' further complicated matters, as in the event of one serious isolation case coming in, a night and day nurse had to be detailed to look after it. 'Regarding the sitting rooms, lie said that there was no place where the nurses could indulge in that relaxation which was so necessary after facing still' problems of life for hours, as they did. It was never suggested that a sitting room should be provided in the main building. That, he said, would have been wrong in principle and, he added, it would be remembered that they had a stiff light to obtain even what they now had in the new hospital. The position was a very'simple one. Steps must either be taken to provide, at an early date, the necessary accommodation, or they would have to I limit the number of patients and so restrict the progress and usefulness of the institution. He felt that the stall' had always tried to give of their best in every way, and had made many sacrifices. Tn concluding, lie said that he thought he was entitled to some explanation. In reply to Mr. 0. H. McDonald, Dr. Walker said that he did not think it right tluit probationers and sisters should share, the same sitting-room. It was recognised in all hospitals that such would not be conducive to discipline. I "AN 7 ABOMINATION." Dr. Lcathain considered that the building known as "Tariki" .was not lit to be utilised lor nurses. x It was an abomination, and should be burnt down. It had been •built prior to 1880. He outlined several inconveniences suffered by the nurses. ■■ The chairman said that regarding the heating, electricity, gas and open fireplaces had been provided. The first was said to be ineffective, the second unhealthy, and the third were not approved by the matron. He would therefore like suggestions as to any improvement. Building operations couki not <be entertained at present, and even if they could, it would be several months before the building could be erected. Meanwhile, .what could be done at present'; lie had spent hours in thought and could not see any way out. He bad looked round, but could not see a suitable house in the locality that could be rented. Dr. Walker said that he knew and so, he thought, did the nurses, the difficulty that the Board had in the way of finance, but be thought that the nurses would appreciate it if the Board would resume the stigma that they had done something that they should not have done over the petition. The nurses appreciated wnat had been done for them and were a most loyal and conscientious stall', willing to do anything they conhl ito tide over the present difficulty.

FORCINC THE BOARD'S HANDS. | Mr. Browne thought, the nurses were il advised in their course of action. He had never known a request that had been submitted by the nurses that had not received full consideration. If they lad put their complaint through Dr. tWilkcr, there would have been no need of the petition, and it looked as if there | vas someone behind the petition who ■vauted to force the Board's hand. For cieral years the Board had recognised ilir need for further accommodation for the nurses, and were making provision i'or it., but the Board would be wrong in •luiiding at the present time, when the •ost of materials was almost double, and men were scarce, lie, for one, would not tlio Board wasting the ratepayers' money in building a nurses' home at present. He was quite prepared to make what provision was possible, but the nurses, like other people, must be willing to put up with some inconvenience. It was no use appealing to the Covernmeut for money at present, and the nurses knew this, so why did ! I hey wish to make the Board's troubles harder than they were at present'; NO INSULT MEANT. Mr. McAllum, whose remarks Dr. Walker had taken exception to, disclaimed any intention of insulting him. He wa- the last man to insult any member of the medical profession, and he tendered an apology if an' insult had been conveyed. By sitting on the fence, he meant that Dr. Walker had not expressed a definite opinion, because, in the first place, his report said that the liurses were setting a "quid pro quo" in the shape of experience, and then sail! that if the Board found out that the sahirie- paid were below other hospitals they should accede to .the request, lie still felt that there was something behind the petition, but could not asucrlain what il was. Regarding the management, lie felt that the matron should have given some lead, or should have known that the complaints were coming forward, and should have brought them before the Board in a-different way. The petition should never .have coiiie before the Board in the' way it had. Dr. Walker said that the salaries should be universal throughout the Dominion. Mi™ Browne (the matron) had nutliine to do with the petition. He had questioned the nurses, who all denied lluit anyone had prompted them. Dr. Leathani remarked that Miss Browne could not have suppressed the petition had she known of it. WHERE'S THE, REMEDY? The Chairman: We have got to the xtaj><» that there is no accommodation. The question is: Where's the remedy'; .Mr. Maxwell said that it was the duty of the Board to provide reasonable accommodation for the nurses. Dr. Walker had previously pointed out the necessity of this and it was the intention of the Board to tackle it. when a suitable opportunity arose. The Board did not desire the nurses to be placed at any undue disadvantage, but he thought that they had adopted an undesirable course in presenting the petition. The Board luid' a reputation of getting through its dealings with the hospital without any disagreeable features, and this hitherto unblemished character had now been destroyed. If accommodation -'was lacking, it was the nuvses' business to have said so immediately through the proper channel. If this failed to bring redress, then there might have been an excuse for a petition, but he did not think that it was right to pile it up with trivialities that caused the public to remark that the conditions were disgraceful, and that the nurses were suffering adversely through the Board being neglectful of their comfort. To include trivialities such as a light at the steps, working of

the c&lifont, etc., was absurd and ridiculous. If that was the only method of having such small details rectified., then there must be a great lack in the management. The appointment of a house steward and dispenser should remedy this. The speaker also agreed that some one was at the bottom of the trouble. Evidently the desire of the Board to do its best for the stall' was not recognised in some quarters. It was the desire of the Board to give full accommodation to every member of the stall', for whom the Board had the greatest admiration, but he agreed that it would, be unbusinesslike at present to tackle the building of a nurses' home, if extra accommodation could be arranged otherwise without imperilling the health of the nurses. He was satisfied that the present was not the time for any business firm to undertake new work. The present high cost of material would saddle the Board with a capital expenditure of from 70 to i>o per cent above what would be required in normal times, and this would not be advisable unless the cost of the makeshift would be so 'heavy as to be a. set off against it. Referring- to the question of staff, he pointed out that comparison of returns with other hospitals showed New Plymouth to be one of the most heavily stalled. In 1915, Wanganui, with an average of 78 patients, had nine trained nurses and 21 probationers; Palmerston North, \yith 58 patients, had six trained nurses and 15 probationers, whereas New Plymouth, with S3 patients, had seven trained nurses and 23 probationers. As a layman, he considered the accommodation and stall was astounding compared with the number of cases dealt with. It bad been reported that the nurses had been treated badly, lie was glad, therefore, to learn that they were paid better than other institutions, and that the 'hospital had a greater proportion of nurses to patients than at other hospitals. He considered thai a great deal of the pressure had been due to gratuitously treating recruits, and it did not strike him that the position was now very serious, at least such as to warrant the condemnation of the Board by the public. All were satisfied that the staff performed their duties well—and a very good well. REPORTS UNHEEDED. Dr Walker said that the matron had frequently reported on various matters. He himself had several times reported on the need for accommodation. As regards comparisons of staff, lie said that it was also necessary to compare the character of the work done. They had several times imported sisters from outside hospitals, but the experiment had not been successful, as the nurses said that there was far more work to do here tkan in the hospitals they had come from. Mr. Maxwell wanted to combat the statements in circulation that the hospital was understaffed, and that the nurses were underpaid or neglected. The Chairman, in reply to questions, said that he had never heard a complaint relative to the hot water until the present petition. Provision had been made in the ensuing year's rate for £2OOO for a nurses' home. Dr. Walker said that one cause of the increase in patients was the diptheria epidemic. A number of minor operations were due to treating recruits. The average for last month would be well over SO patients daily in the hospital. The Chairman asked for some suggestion to meet the crisis. Mr. Meßeynohls moved that the recommendation of the House Committee be given effect to. POSITION SHOULD BE FACED. Dr Walker said that it would be an absolutely undesirable proceeding, and he would only sanction tile use of the buildings mentioned as a very temporary expedient. . It was a question for the building charges would be any easier in live years' time. Personally, he did not think so. They must either increase the accommodation or decrease tile number of patients admitted. Mr. A. H. Halcombe thought that the Board should receive a report from the matron at each meeting. The w#!ole Board should be in possession of the matron's requirements. If this had been done the nurses need not have laid their complaints by petition before the general public. The Chairman said that as £2OOO had been placed on the estimates by the Board, applications might be called for designs. Dr. Walker, referring to future requirements, said that the original hospital reserve contained a small site on the top, and the remainder was made up of knolls and gullies. These grounds did not lend themselves to hospital extension. An urgent requirement was a steam disinfecting plant, the lack of which was referred to liv the Health Department in a recent communication. An up-to-date destructor was also necessary. DEPARTMENT'S HEAVY DEMANDS. The Chairman Considered that each year the Health Department's demands were becoming greater. He thought that this would lead to State control shortly. Mr. McAllnm said that it was as well to let the public know that they hud taken into consideration the question of building a nurses' home, but could not obtain any assistance from the Coverment. Mr. Maxwell suggested that designs should be called for and submitted to ■the Department. If the money was forthcoming the work could be proceeded with. This would take time, and some temporary arrangement would have to be made. Dr.. Walker suggested demolishing '■'J'ariki,'' and erecting a temporary wooden building there for the night nurses. Mr. G. V. Tale considered that the papers should have used greater discretion and waited until after that meeting instead of framing the public mind beforehand. Mr Maxwell seconded the adoption of the report, pointing out that it was not restricted to the use of the present buildings, and as a purely temporary expedient. This was carried.