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H. —31

PART VI.—DIVISION OF NURSING.

I have the honour to present my annual report for the year ended 31st March, 1937. The year has been a very busy one, and a very definite advance has been made in nursing-conditions both in public and private service. Training of Nurses. The nurses and Mid wives Board met four times during the present financial year — i.e., in April, August, December, and February. There was one change in the personnel of the Board, Miss Muir's term of office being completed, and, as in future she intends to live in Australia, the New Zealand Registered Nurses' Association's nominee, Miss B. Campbell, Matron of the New Plymouth Hospital, was appointed to the Board. Mr. W. Wallace of the Auckland Hospital Board was renominated by the Hospital Board's Association and appointed for a further term of three years. The principal business of the Board this year has been the consideration given to the alteration in the system of examinations for nurses. In April the Kegistrar met the matrons of training-schools to discuss points arising out of the proposed changes, and the Registration Board is grateful for the assistance and ready co-operation given to it. It was decided in future the following system should be followed :— (a) On the completion of one year of training and some time prior to one year and seven months, every pupil nurse must sit for a Preliminary State Examination, which will comprise one paper in anatomy and physiology, and one paper in elementary nursing and hygiene, and the pupil nurse must pass this examination before she can proceed further with her training. The object of this examination, which substitutes the preliminary examination held by each individual training-school, is to as far as possible ensure a similar standard of teaching in these subjects throughout the various schools of the Dominion, and to also ensure that the pupil nurse is being taught the preventive as well as the curative aspect of disease. (b) The Final State Examination has also been altered, and now consists of three papers — one in surgical nursing and one in medical nursing, both set by doctor examiners ; and also a paper in nursing procedures (set by a nurse examiner). (o) The oral examination of nurses at examination centres has been cancelled and replaced by a practical clinical examination conducted in the wards of all hospitals which are training-schools by specially selected nurse examiners wearing the nursing uniform. This examination is conducted a week after the written examination. The change was made in December and after the first experience of this examination the reports from the matrons of the training-schools and nurse examiners are all in its favour. It is realized that this will ensure more attention being focused on the actual manner in which nursing procedures are carried out, and will emphasize the importance of the nurses' practical work. Thirty-seven inspectional reports on training-schools were received and the necessary action taken to have various reforms and amendments recommended therein carried out in the training-schools affected. Reconsideration was given by the Board to its decision to cancel one training-school, and on condition that certain definite changes were made the institution was permitted to continue as a school. The applications of several small hospitals to be approved as training-schools also received consideration during the year. One maternity training-school was cancelled, as the Board considered, through the failure of the Hospital Board to engage sufficient domestic assistance, the training of the maternity trainees was being adversely affected. Disciplinary action was taken in regard to several nurses and midwives. One midwife applied to the Board for further consideration of its decision to reprimand her, and, in consequence, an inquiry was conducted by the Board in the town to which she belonged, and the result of this was that the previous decision of the Board was confirmed. The public hospital at Wairoa has been approved as a " B " grade training-school, with permission to prepare nurses for the Preliminary Examination. The Jessie Hope Gibbons .Hospital, Wanganui, and the Otaki Maternity Hospital, have been approved as maternity training-schools. Hospital Inspection. Hours of Work. This year, as a result of the policy of the Government to introduce shorter working-hours, a great deal of time has been spent in investigating the possibilities of reducing hours of work, both of nursing and domestic staffs. An amendment was made to the Hospitals and Charitable Institutions Act, giving the Government power to draw up regulations governing the hours of work in all hospitals, both public and private. Various difficulties have been met with. It may therefore be of interest to summarize them as follows :— (a) Nurses in General Hospitals. In the majority of training-schools, and in hospitals which are not training-schools, the pupil nurses and other nursing assistants work a three-shift duty—from 6 a.m. to 2 p.m. : 2 p.m. to 10 p.m. ; 10 p.m. to 6 a.m. ; with a day off a week. This means that exclusive of meal-hours they are on duty fortytwo hours a week. Some additional time —generally not more than two hours a week—is also required to be spent at lectures.

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