B—H. 31.

H.—3l

Further, the university graduate has demanded that her position should in no sense come under the matron's jurisdiction. The matrons have felt this separates them from a most important aspect of hospital work—the feeding of the patient and the nursing staff. For the latter she is responsible and the first forms such a definite part of the nurse's duty it is regarded as important that she should be considered. On the other hand no nurse during her ordinary course of instruction receives sufficient instruction to give her the scientific background which a university course gives, and which is essential to the position of a dietitian. It is too much to expect women to undergo a four-years university course leading to a degree in home science and then a four-years course leading to State registration as a nurse. Further, this does not give the experience in handling staffs, which only experience in an administrative position will give. In Great Britain courses varying in length from six months to two years are now available, and many nurses are by these means qualifying themselves. The trouble in New Zealand is there are not enough positions to make the holding of such a course successful here. The Almoner. —Hospital social service as known in New Zealand at present simply deals with the relief of distress due to varying causes; Hospital social service as carried out by the almoner —that is, the interpretation of the home circumstances to the hospital in order to assist in the treatment and discharge of the patient —is unknown except in a modified form as carried out by the visiting out-patient service of the Auckland Hospital. This is another field that the nurse is very fitted for provided she has special training. It may be possible to extend the present post-graduate course to include such a course as would train workers for this type of work. Occupational Therapy and Hospital Libraries. —For the child and the chronic patient occupation is essential. Every nurse who has had experience in a sanatorium for tuberculosis, for instance, knows that providing she can keep her patient interested half the battle is won. But every patient is not interested in the same type of thing, and it is rarely that a nurse is highly trained in handcrafts. In the same way the library forms a most important part of the hospital. It should be both fictional and technical, and should provide for the interests of both patients and staff. In Denmark an excellent system has been established by co-operating with the local district libraries ; in Great Britian an endeavour has been made to set up a separate hospital library system. These spheres lie beyond the work of the nurse, and require skilled assistance, but they are aspects which nurses should be interested in and should plan for future development. Preliminary Training. —Gradually the value of preliminary training is being realized by Hospital Boards, but much yet remains to be done. It is the foundation of a good training and from an economic point of view alone will prove its value. One month, though better than nothing, is too short. Three months allows for better teaching, more careful observation of the pupil, and gives time to cover much of the subject material which must be given during the first year of training and so relieves the pupil when she is adapting herself to ward routine. I would again emphasize that if the smaller hospitals would co-operate with the main centres in regard to this matter a great improvement would be brought about. In conclusion, I would desire to thank all the members of the Health Department staff for their ready co-operation and assistance, without which it would be impossible to carry out much of my work. I would also like to thank the staffs of the various Hospital Boards, particularly the matrons, and also the various voluntary organizations such as the Royal New Zealand Society for the Health of Women and Children, the New Zealand Red Cross Society, and the various voluntary district nursing organizations. Their close working agreements have made possible various developments which otherwise would have failed. M. I. Lambie, Director, Division of Nursing.

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