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PART V.—NURSING. I have the honour to submit my annual report for the year ended 31st March, 1941. During the past year, owing to the war and the subsequent calling up of nurses for overseas services, plus the retirement of several senior officers, a great deal of internal reorganization of staff has taken place. Every one concerned with these changes has wholeheartedly made every endeavour to overcome the difficulties presented. The activities of the Nursing Council increased the work of the Division to a large extent, while additional work has also been involved in connection with the inauguration of the courses in occupational therapy and dietetics, and in assistance to hospitals in planning for sufficient staff to meet the needs of increasing bed states. Obituary. Miss M. Mangakahia and Miss M. 0. Gould passed away during the year. General Hospitals. The usual inspection of hospitals has been carried out. A conference of general hospital trainingschool matrons was held at the time of the Registered Nurses' Association Conference. A report circulated to hospitals regarding a special study made by the Department of the teaching of dietetics to pupil-nurses was the basis of discussion at this meeting. The principal conclusion arrived at was the necessity for increased interest in and a knowledge of the subject both by pupil-nurses and registered staff. The problem of securing adequate and efficient staff for maternity annexes of general hospitals was also discussed, and it was agreed that suitable nurses should be selected for midwifery training and that such nurses could then be used, if necessary, on the staff of the annex. Though the Sister in charge of the annex requires to be a specialist and a permanent officer, the remainder of the trained staff should be rotated through this service, as is done with ward Sisters in the general hospital. Additional classes of pupil-nurses have been taken on during the year in order to provide adequate staffing for the anticipated increased number of patients resulting from social security medical benefits and war casualties. In taking in such large classes there is a danger that the ratio of registered staff to pupil staff will fall too low. To ensure efficient nursing and teaching in a training-school it is necessary to maintain a ratio of 1 registered nurse to 2-5 pupil-nurses. The block system of arranging the theoretical and practical instruction is now working successfully in two hospitals. A. Daily Average Occupied Beds for all Training-schools. 31st December, 1932 .. .. .. .. .. .. 3,981-72 31st December, 1933 .. ~ .. .. 4 ,059-30 31st March, 1935* .. .. .. .. .. .. 4,220-05 31st March, 1936 .. .. .. .. .. .. 4,467-41 31st March, 1937 .. .. .. .. .. ... 4,734-85 31st March, 1938 .. .. .. .. .. .. 4,911-26 31st March, 1939 .. .. .. .. .. .. 4,981-39 31st March, 1940 .. .. .. .. .. .. 5,331-80 31st March, 1940 .. .. .. .. .. .. 6,040-01 * Statistics changed from calendar to financial year. B. Total Nursing Staff for all Training-schools. 1932. 1933. 1934. 1935. 1936. 1937. 1938. 1939. 1940. Total nursing staff .. 1,769 1,967 2,116 2,264 2,442 2,534 2,710 3,028 3,504 Total pupil nurses on staff .. .. 1,257 1,412 1,502 1,640 1,803 1,849 1,985 2,219 2,590 Total registered nurses on staff .. 512 555 614 624 639 685 725 809 914 C. Total Number of Nurses Sitting and Passing State Examinations. 1932. 1933. 1934. 1935. 1936. 1937. 1938. 1939. 1940. Number sitting .. 385 448 403 354 380 478 455 490 569 Number passing .. 272 338 280 262 315 366 364 374 458 Number obtaining partial passes .. .. .. .. .. .. .. .. .. 74 Obstetric Hospitals. At the meeting of the Matrons of St. Helens Hospitals held during the year, it was agreed that a proportion of vacancies in each term should be reserved for those hospitals who wished to nominate selected nurses for midwifery training. Refresher courses for obstetric nurses have been held in thirty centres during the year, and the attendance at these, on the whole, was satisfactory.

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