H.—3l.

Hospital each for a period of six months. The experience has been greatly appreciated by the New-Zealanders, and will be a definite benefit particularly where the senior nursing staff is concerned with assisting in the training of medical students. It is hoped in the near future to extend this system of exchange to include one of the large Sydney hospitals on the general side of the hospital administration. Five staff nurses have been sent during the past year for service under the Shanghai Municipal Council. Experience in the East is so varied and differs so considerably from New Zealand that these nurses, too, are greatly appreciating the opportunity thus afforded them. The agreement between Fiji and New Zealand is now thoroughly established. Three Sisters from New Zealand, in addition to the Matron are on the staff of the Colonial AVar Memorial Hospital, Suva, and several candidates from this hospital have also passed the New Zealand State examination. Arrangements are being made for nurses trained at Suva to come to New Zealand for their obstetrical training, and it is hoped to also assist the recruitment of pupil nurses for training in the Suva Hospital as required from the staffs of the small North Auckland Hospitals where suitable candidates are offering. Tropical Nursing Service. During the year Miss Roberts, the Matron of the Government Hospital, Apia, Western Samoa, while she was on furlough, was relieved by Miss A. J. North, Nurse Inspector from the Poverty Bay Health District. In conjunction with one of the Mission Schools opportunity was taken to establish a short course of training in Baby Welfare for senior Native nurses and consultation centres have been started under the guidance of these girls supervised by the Matron. While in New Zealand Miss Roberts undertook a refresher course in obstetrics and infant welfare and since her return to Apia, ante-natal clinics are in course of establishment in the same way. At Rarotonga, in the Cook Islands, a second Sister was appointed, an experienced Maori nurse —Miss E. Paora —being sent. It is hoped in this way to extend the function and usefulness of the Polynesian nurse. Nurses and Midwives Registration Board. The personnel of the Nurses and Midwives Registration Board has remained the same. This has been of definite advantage as experienced members have been able to give valuable advice. Meetings of the Board were held in April, July, and November. Reports covering twenty-four General Hospitals and nineteen Maternity Hospitals which are used for trainingschool purposes were received, and suitable action was taken where it was considered necessary. This action comprised requests for reduction of hours of work where thought excessive; cancellation of a small hospital as a training-school because there was not sufficient domestic assistance; requests for alteration in the type of medical lectures and for better teaching equipment. Following on recommendations made to the Board from a conference of training-school Matrons, a careful review of the syllabus was undertaken and a review of the present system of State examinations. As a result of this study recommendations have been drawn up which are being submitted to a further meeting of Matrons in April of this year. These are as follows: — (1) The introduction of a Preliminary State Examination to be held at the completion of the first year of training and before nineteen months of training. This examination to consist of two papers—a paper on anatomy and physiology to be set by a Medical Examiner and a paper on Elementary Nursing and Hygiene to be set by a nurse examiner. The fee for this examination to be 10s. (2) The substitution of the present Oral Section of the Final State Examination by a practical examination in) the wards of the hospital by a nurse examiner who will be in uniform. The reason for these two recommendations is to bring about a standardization of the preliminary teaching of pupil nurses and to lay more emphasis on the detailed finish of a nurse's practical work. Both examinations should tend to strengthen the clinical instruction of the nurse. The Staffing of General Hospitals which are Training Schools.—During the latter part of this year there lias been a shortage of staff nurses and some Hospital Boards are of the opinion that this has been caused by cancelling the smaller hospitals as training-schools. In point of fact the only hospitals which have been cancelled as training-schools during the past four years are Patea—with an occupied bed rate of twenty-four and a total pupil nurse staff of ten —and Rotorua —with ail occupied bed rate of forty-four and a total pupil nursing staff of sixteen. Between the two there would not have been more than ten nurses a year qualifying. In addition, five hospitals have been regraded from " A " to " Bgrade .training-schools because of lack of clinical instruction, but this action tends to increase the pupil nursing staff as an additional nurse has to bei carried to allow for the nurse who is away doing duty in the " A " grade hospital.

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