BOSTON UNIVERSITY
SCHOOL OF NURSING yy
LIBRARY i
LABORATORY EXERCISES AND OUTLINES IN , i
MICROBIOLOGY FOR NURSES 7 &
by Anna M., Fisher, R.N., M.S., and x
Lucta Zylak Lewis, Ph. D. L p T i i
A workbook for use with any basic micro- rf
biology text. Standard procedures are 33
simplified. Includes outlines, laboratory a a
exercises, problems, assignments and a ax
reference list. q
115 Pages - Illustrated - $3.00 | x
. , 3
- ANATOMY AND PHYSIOLOGY LABORATORY T FY T S {
GUIDE (5th Edition) ?
by Edmond J. Farris, Ph.D. -
A laboratory guide for use with any stand-
ard anatomy and physiology text. Sub-
ject covered completely with emphasis on
student participation. Explicit directions
and explanations.” -
146 Pages - 132 Illustrations - $3.00
AND
SOURCE BOOKS
PHYSIOLOGY AND ANATOMY (6th Edition)
by Esther M. Greisheimer, Ph.D., M.D.
__ An authoritative text stressing both struc-
ture and function, designed to meet the
professional needs of students. Sound
clinical applications provided. Summaries
follow each chapter.
841 Pages | $5.00
478 Mvsrations, 52 in Color
ESSENTIALS OF CHEMISTRY—with Laboratory
Manual (5th Edition)
by Gretchen O. Luros, M.A., “and
' Florence Oram, M.A., RN.
Concise and comprehensive coverage of |
the basic principles of chemistry with
applications from everyday life and nurs-.
ing procedures to meet the needs of
student nurses. Inorganic, organic chem-
ESSENTIALS OF MEDICINE (16th Edition)
by Charles Phillips Emerson, Jr., M.D., and
Jane Elizabeth Taylor, R.N., M.Ed.
An established text now presenting a
more detailed discussion of nursing care
as it applies to the prevention and treat-
ment of disease. Considers the patient as
a person, his rehabilitation, and psycholo-
gic and sociologic aspects of illness.
815 Poges | $4.50
191 illustrations, 5 Color Plates
SURGICAL NURSING (9th Edition)
by Eldridge L. Eltason, M. D., Se. D.,
F.A.C.S.;
L. Kraeer Ferguson, M.D., F.A.C.S.; and
Lillian A. Sholtis, R.N., A. S.
A comprehensive critical survey of mod-
em surgical treatment with emphasis on
bedside nursing. Highlights the social,
economic and public health factors in-
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istry as well as chemistry of the digestive volved in caring for the surgical patient. af
and body processes are studied. 728 Pages $4.50
637 Pages -
Hlustrated - $4.00
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336 Illustrations, 9 Color Plates
V4 B, LIPPINCOTT CO., to Weseri= Sears, ritetpie 5, Po
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JULY, 1954 | 7 _ 529 .
Ao . .
THE CANADIAN NURSE
LInjinmiine Canadienne
VOLUME 50 NUMBER 7
JULY 1954 |
SOSTON UNIVERS!
' §CHOOL OF NURSING
- LIBRARY
630 New Propucts _ -
641 Live THroucn THE SUMMER
B43 ABDOMINAL PAIN. nnn ]. Bingham, M.D.
548 SURGERY OF THE Cite BLADDER
AND BILIARY SYSTEM ccccscccscscsccssssssnsssscsesessecsssesescenson E. Elnicki
666 Parasites, Fish AND MAN....W.WW0.. L. Margolis, Ph.D.
661 THe Pusric Heatran Nurse in THE HEALTH SERVICE
OF A GENERAL HOSPITAL... sceccneeneen G. Creelman
6665 A Nurse Looks at Pustic Rerations......D. Af. Dent
~~
666 THe Present Status AND NEEpsS ais
oF Nurse INnstrucrors..........Sr. Denise Marguerite
669 Au Cuevet pu Matape TuBercuLeux.........J. Ouimet
G72 Nursinc PrRori.es
6768 News anp EcnHoes
676 Nouvetces er Ecuos
682 Peptic 85 oe) 1 eee ec ere eee ene a Soak I. Nordwich
é
The views ex
686 Boox Reviews : ays presses
tn the vartous articles
are the views of .
the authors and
do not necessarily
‘ represent the policy
or views of
| THE CANADIAN Nurse
nor of the Canadian
Nurses’ Association.
689 INstrrutTe on Nursinc EDuCATION.......... Sr. M. Felicitas
692 News Nores
608 Orriciat Directory
Editor and Business Manager
MARGARET E. KERR, M.A., R.N.
Assistant Business Manager
Virginia Miller
Subscription Rates: Canada & Bermuda: 6 months, $1.75; one ead $3.00; two arses
Student nurses — one year, $2.00; three years, $5.00. U.S.A. & "foreign: one hid $3. me years $6.00.
In combination with the American Journal of Naan or Nursing Outlook: one ve 7.00
Single copies, 35 cents
Make Detailed 0 and money orders payable to The Canadian Nurse.
Directory appears in June & December.
ive one month’s notice of Change of Address.
Pe a as d-Class Mail, Post Office Department, Ottawa.
National Advertising Poe: Edwards & Finlay Ltd., 34 Kin St. E. E., Toronto 1, Ont.
ber of Canadian Circulations Audit Boar Board. .
1522 Sherbrooke Street, West, Montreal 25, Quebec
Vol. 30, No. 7
Canadian Distributors: McAinsh & Co. Ltd., 1251 Yonge St., Toronto 7 .
cis 2,
+ 7
Ld :
important SAUNDERS books
for every nurse!
“4 *
( r
Millard and King's 2
Human Anatomy and Physiology "
- -*y
* eG
a
Structure and function applied to nursing.
By Neue D. MiLvarp, R.N., M.A., Science Instructor, University
of Illinois, Cook County School of Nursing, Chicago; and Barry
GriFFITH Kinc, Ph.D., Medical Division, Aviation Safety,
C.A.A.; Lecturer in Physiology, University of Maryland. 596
pages, with 309 illustrations (55 in color). $4.50. Third Edition.
Montag and Filson’s Nursing Arts
Presents the total care of the patient.
By Mitprep L. Montac, R.N., Ed.D., Associate Professor of
Nursing Education, Teachers College, Columbia University; and
MarcGareT Fitson, A.M., R.N., Formerly Associate Professor of
Nursing, University of Minnesota School of Nursing. 619 pages,
illustrated. $4.50. _ Second Edition.
Brown's Medical Nursing
-. Stresses actual nursing care of common diseases.
By Amy Frances Brown, R.N., M.S. in N., Associate Professor
of Medical Nursing, State University of Iowa College of Nursing,
Iowa City. 1099 pages, with 387 illustrations, 32 in color on 24
figures. $5.50. Second Edition.
DeLee's Obstetrics for ae,
by Davis and Sheckler
Gives basic principles, how-to-do it descriptions. —__ 2 2 i
- By M. Epwarps Davis, M.D., Joseph Bolivar DeLee Professor of
Obstetrics and Gynecology, University of Chicago; and CATHERINE
E. SHECKLER, R.N., M.A., Assistant Director of "Nurses, Michael
Reese Hospital, Chicago. 673 pages, with 387 illustrations, 28 in 2
color. $475. Fifteenth Edition. ie
W. B. Ley COMPANY
West Washington Square Philadelphia 5, Pennsylvania
JULY, 1954 “< , S31
Between Ourselves
Each year as summer vacation time rolls
around we are thankful that we do not have
to prepare holiday schedules for hundreds
of staff members. On the other hand, with
a larger staff there would probably be
greater ease in shifting responsibilities from
One person to another. Be that as it may,
the cumulative sighs of relief from directors
of nursing all over the land when all
vacations are completed and everyone is
safely back at work would create quite a
breeze. Our own office is no exception! — -
This year’s vacation time at The Canadtan
Nurse office will be marked by the loss of
our assistant business manager, Mrs. Kath-
leen Williams English. After 16 years in the
Journal's employ, Mrs. English is going to
devote her time to problems of pediatrics,
nutrition and the like. She is being succeeded
this month by Mrs. Virginia Miller, our
new assistant business manager. a
* *€ *
Pain is a disagreeable sensation that all of
us experience at one time or another. Philos-
ophers and physicians have considered it
for centuries. One view that held sway un-
til comparatively recently was that pain,
like pleasure, was simply a feeling state —
an emotional reaction. The accumulated evi-
dence now makes it clear that pain is a
specific sensation not only perceived as .
such, but provided with a special mechanism
for transmission of pain impulses. In_ his
discussion of abdominal pain, Dr. John
Bingham, illustrates how the person who is
able to tell how he at first had epigastric
distress, then nausea and vomiting, and that
the pain finally settled in the right lower
side of the abdomen, is much more apt to’
have appendicitis promptly diagnosed than
the person who, weeping and excited, claims
“my whole stomach hurts.”
There are some dangerous fallacies about
prenatal environment, such as that the mar-
riage of first cousins produces mentally de-
fective children. This is certainly not con-
firmed by the studies of the Levinson Foun-
S32
We are grateful to the Ontario Medical
Review for giving us permission to share
this useful article with you. It was published
in their February, 1954, issue.
* * *
The vartetics of parasites with which
nurses are most familiar are those that still,
unfortunately, abound in the hair and on
the bodies of some of the school children
and patients admitted to our hospitals. Dr.
Leo Margolis points out that every creature
is susceptible to ravages of some form of
parasite. He is particularly concerned with
those that are found in fish. Because of the
universal use of fish as a source of food, the
information he shares with us in this article
has importance for every nurse. The pre-—
ventive measure is so simple — thorough
cooking. Nor is it only in distant foreign
lands that persons are still being infected
with fish parasites. We heard only recently
of a child who was being treated in the
pediatric department of a hospital in a
Canadian city for a fish tapeworm. Eighteen
feet had been recovered at that time and the
head was still adherent!
* * *&
We commend to the directors of nursing
in our .general hospitals and their staffs,
the article by Gladys Creelman describing
the organization of an adequately function-
ing public health department within the
Victoria General Hospital in Halifax. Fre-
quently, when a qualified public health nurse .
is appointed, the greater part of her time
‘seems to be spent in curative work in the
student nurses’ infirmary instead of develop-
ing active preventive programs. Here is a.
pattern that might serve as a pilot to schools
of nursing contemplating some changes.
dation for the Mentally Retarded, in:
Chicago. While an occasional case of feeble-
mindedness can be found in such offspring,
people of unusual talent and intelligence are
often born from these marriages.
Vol. 50, No. 7
4
Designed expressly
for the nutritional
and digestive —
requirements of infants.
Eva sotated Whole Milk
o. 1 Red Label
Concentrated
Partly Skimmed Milk
No. 2 Blue Label
Concentrated Skimmed Milk
No. 3 Yellow Label
“SPECIALISTS IN THE PROCESSING OF MILK FOOD FOR INFANT FEEDING”
anoteR XDPST ror
CONCENTRATED FORMULA MILKS
NOW
800 1.U.
Effective immediately, the Vitamin D content of
Farmer's Wife Formula Milks is almost doubled...
increased by the addition of pure Vitamin D3 in
crystalline form, from 480 International Units to
800 International Units per pint of concentrated
milk (24 I.U. now increased to 40 I.U. per fluid —
ounce). Farmer’s Wife Formula Milks give the
infants in your care this extra assistance in prevent-
ing rickets and developing sound bones and teeth,
by supplying the average infant's full daily re-
quirements of this important Vitamin.
This is the FOURTH important ‘‘First’’ introduced
in Farmer's Wife Formula Milks over a period of
10 years. Farmer's Wife was first to introduce Con-
centrated Pardly Skimmed Milk, firse to introduce
Concentrated Skimmed Milk and also the first to
have all three formula milks specially designed
for infant feeding. t.3
4
Professional
enquiries invited
on milk formulae.
COW & GATE
BROCKVILLE ONTARIO
73-4A
te ow
*
.
Edited by DEAN F. N. HUGHES _
PUBLISHED THROUGH COURTESY OF Canadian Pharmaceutical Journal
BLUTENE CHLORIDE
Manufacturer—Abbott Laboratories Ltd., Montreal.
Description—Each tablet contains 100 mg. Blutene (Toluidine Blue) Chloride.
Indications—For use in j
in idiopathic uterine bleeding provided Organic disease is not
the cause. 7
Administration—Usually 200 to 300 mg. daily during the course of treatment. In
menometrorrhagia, 2 to 3 tablets dail
daily at the time of bleeding. To prevent excessive
bleeding, 2 to 3 tablets daily during the 5 or 6 days prior to estimated time of the
menses.
DIPRONE
fac - uticals Ltd., Toronto. ett Ae
Description—Each tablet contains: Methampyrone 0.200 gm; salicylamide 0.200
gm.; ascorbic acid 0.010 gm.; vitamin B, 0.005 gm.
Indications—A non-narcotic, non-steroidal anti-rheum
gesic. Used in rheumatism, neuralgias, lumbago and arthriti
Administratio
physician.
Manufacturer—W ebber Pharmace
atic, anti-pyretic and anal-
S. a
n—QOne to two tablets, three or four times daily, or as directed by
GERITAINE
Manufacturer—Anglo-French Drug Co. Ltd., Montreal.
Description—Each capsule contains:
citrate 50 mg.; liver extract (fraction 1)
flavin 1 mg.; niacinamide 5 mg., calcium
min By crystalline 0.5 mcg.: vitamin A
C 25 mg.; vitamin E (alpha-tocopherol acetate) 2 I.U.; vitamin K; 0.2 mg.
Indications—In all conditions where a specific lipotropic treatment is indicated.
Administration—Two to four capsules three times a day.
Betaine (base) 500 mg.; choline d
40 mg.; rutin 10 mg.; vitamin B, 1
d-pantothenate 1 mg., pyridoxin 0.
(acetate) 800 I.U., vitamin D 500 I
thydrogen
mg.; ribo-
2 mg.; vita-
.U.; vitamin
ETAVERAL PLAIN, AND WITH PHENOBARBITAL
Manufacturer—Desbergers Limited, Montreal.
Description—Plain—Each tablet contains: Ethaverine HCI 25 mg.; dihydroxypropyl
theophylline 500 mg.; with phenobarbital—Same as plain with phenobarbital 20 mg, added.
Suppossttories—Each suppository contains:
Ethaverine HCl 30 mg.; dihydroxypropy!]
theophylline 500 mg.; with phenobarbital — Same as flain with phenobarbital 35 mg.
Indications—Coronary spasm, anginous pains, dyspnea, cardiac
: : a : or renal edema,
hypertension of spasmodic origin, asthmatic attacks.
Administration—Tablets: One or two tablets every four hours or one or two before
each meal. Suppositories: One suppository at bedtime, or one morning and evening.
: GUANIMYCIN
Manufacturer—Allen & Hanburys Company Limited Toronto.
Description—Combined antibiotic and sulphonamide therapy. Each bottle of Guani-
mycin contains: Streptomycin sulphate 1 gm.; sulphaguanidine. Presented as a stable
dry powder from which a smooth, palatable, homogeneous suspension is made by the.
simple addition of water.
_ Indications—Treatment of common infections of the gastrointestinal tract inclu-
ding: bacillary dysentery, gastroenteritis, salmonella food poisoning.
Administration—Adults: 1 fl. oz. should be given four times a day, at approximately
four hourly intervals, and before, rather than after food.
Infants and Children: V4 fl. oz. should be given every three or four hours.
A
PAGITANE Hydrochloride
Manufacturer—Fli Lilly & Co. (Canada) Ltd., Toronto. | |
Description—Cycrimine hydrochloride, tablets of 1.25 mg. and 2.5 mg.
Indications—Parkinsonism, postencephalitic, arteriosclerotic or idiopathic.
Administration—Individualization of dosage essential. Suggested starting doses,
three times daily, are: postencephalitic 5 mg.; idiopathic 2.5 mg.; arteriosclerotic 1.25
mg.
oA Vol. 580, No. 7
PSYCHIATRIC
NURSING COURSE
“The ALLAN MEMORIAL INSTITUTE OF
PSYCHIATRY OF THE ROYAL VICTORIA
HospPitav offers six-month courses in
Theory and Practice in Psychiatric
Nursing to Graduate Nurses in good
standing in their own province.
~ Courses begin February 8th, 1954,
and May 3rd, 1954, and are con-
ducted on an eight-hour day, six-
day week basis. They include lectures,
‘ medical and nursing conferences, and
visits to community agencies. A lw-
ing-out allowance, meals at the hos-
pital, and uniform laundry will be
given during the first three months.
General duty rates will be paid for the
second three months.
For further information write to:
H. M. Lamont, Director of Nursing,
Revel Victoria Hospital, Montreal 2, eee
or Miss Kathleen Marshall, Supervisor
Nurses, Allan Memorial Institute of Psy-
chiatry, Royal Victoria Hospital, Montreal
. 2, Que. ss,
THE WINNIPEG GENERAL
HOSPITAL
Offers to qualified Registered Grad-
uate Nurses the following oppor-
tunities for advanced preparation:
1A six-month Clinical Course in
Obstetrics.
: 2. A six-month Clinical Course im
Operating Room Principles and
Advanced Practice.
These courses commence in JANUARY
and SEPTEMBER of each year. Main-
tenance is provided. A reasonable sti-
pend is given after the first month.
Enrolment is limited to a maximum
of six students in each course.
For further information please write to:
DIRECTOR OF NURSING
| GENERAL HOSPITAL
WINNIPEG, MANITOBA
-, JULY, 1954
tilt. a
e@
SIXTIETH ANNIVERSARY
of the
NOVA SCOTIA HOSPITAL
SCHOOL OF NURSING
and
© REUNION OF GRADUATES OF THE
Nova Scotia HospitaL, DARTMOUTH,
Nova Scoria
| will be held on September 14 to
16, 1954, inclusive, in Dartmouth.
e All Graduates of the Hospital are
invited to attend. An interesting pro-
gram has been arranged.
MES. CHESTEB SMITH, B.B. 1,
COLE HARBOUR, HALIFAX CO., N.S.
VICTORIAN ORDER OF
NURSES FOR CANADA...
requires
PUBLIC HEALTH NURSES
for Staff and Supervisory positions in
various parts of Canada.
Applications will be considered from
Registered Nurses without _ Public
Health .training but with University
| SALARY, STATUS AND PROMOTIONS
| ARE DETERMINED IN RELATION
| TO THE QUALIFICATIONS OF THE
i
Director in Chief,
Victorian Order of Nurees
for Canada,
193 SPARKS STREET,
Ottawa 4, Ont.
For further information please write: |
ee
She er
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Soy” Bee we Ps
Pramd . &~ ¥- ws ry
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aes
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THE CANADIAN NURSE
ACTYLAPHEN
Manufacturer— Rougier Fréres, Montreal.
Description—Acetylsalicylamide 0.50 gm.;
Indications—For salicylotherapy and sedation in acute articular rheumatism, chronic |
polyarthritis, neuralgia.
Phenobarbitone 8 mg,, per tablet.
Administration—Average dose, 6 to 8 tablets daily.
BIONETS
Manufacturer—F rank W. Horner Limited, Montreal. _
Description—Each peppermint-flavored lozenge contains: 5 mg. of Bicetonium
(Cetyldimethylbenzy! ammonium chloride, Horner) a potent new germicide, fungicide,
and wetting agent with 7.5 mg. of benzocaine, a non-toxic local] anesthetic.
Indications—For the treatment of mouth and throat infections, particularly in
patients who exhibit sensitivity to antibiotics. Active against Gram-positive and Gram-
negative organisms, fungi, yeasts, and molds.
Administration—Allow lozenge to dissolve slowly in the mouth. Repeat hourly or
S
as required, until infection subsides.
a aa ee
7 PERITOL _.
Manufacturer—Dymond Drugs Limited, Brantford, Ont.
Description—Each tablet contains: Pentaerythritol Tetranitrate 10 mg.
Indications—To control precordial pain or angina pectoris.
Administration—One tablet 3 or 4 times daily, before meals.
RARICAL TABLETS |
Manufacturer—Ortho Pharmaceutical Corporation (Canada) Limited, Toronto.
Description—Contains iron and calcium in one molecule; white, tasteless, odorless,
causing no gastrointestinal upset and giving prompt hematinic response. Each tablet
contains 25 mg. iron and 85 mg. calcium.
Indications—For the treatment of iron deficiency anemias and conditions requiring
calcium supplementation especially during pregnancy and lactation.
Administration—Adults—two tablets three times daily with meals. Children—tablets
whole or crushed and dissolved in milk or food, only as directed by physician.
TROPHITE Tablets
Manufacturer—Smith, Kline & French
Description—Each tablet contains 25
10 mg. crystalline vitamin B,.
Inter-American Corporation, Montreal.
mcg. vitamin Bu (activity equivalent) and
Indications—To promote appetite and growth in the below-par child, during con-
valescence, and as a nutritional supplement—e.g., in chronic diarrhea and celiac disease. —
Administration—One tablet daily, or as prescribed.
ZETAR |
Manufacturer—Can. Agents: Fidelity Pharmaceutical Company, Toronto. é
Description—Standardized “whole” crude coal tar, irradiated; miscible with water
yielding a colloidal solution, also miscible with collodion, fixed oils, glycerin, pastes and
" fatty bases.
Indications—As for coal tar—eczema, psoriasis, pruritus, seborrheic dermatitis, etc.
How Supplied
Zetar (Decolorized)—purified, fractionated Zetar. |
Zetar Emulston—S0% emulsion of Zetar for use in the bath when extensive tar
therapy desired.
Zetar Shampoo—1% in_ bland, superfatted soap shampoo, for scalp dermatoses.
Zetar Ointment and Lotion—contain 2% Zetar. zinc oxide, talc, fatty acids, sperma-
ceti, etc.; both are greaseless, soap free, and flesh colored. ' Pr a
Even in heavily infested areas, babies
under six months old never seem to catch
malaria, says Dr. F. Hawking, of the Na-
tional Institute for Medical Research, in
London. His explanation: These babies are
fed almost entirely on human or cow’s milk.
Both are deficient in one of the B vitamins.
This substance is essential for the growth of
536
malaria organisms in the human body. A
double-check on the theory is provided by
other British workers, who found recently
that rats fed on a milk diet are resistant to
malaria. If the milk diet is supplemented
with the B > vitamin, the resistance is
destroyed. .
— Science Information Service -
Vol. 50, No. 7
b
— Varidase’ comes in
Streptokinase-Streptodornase Lederle
| VARIDASE Streptokinase-Streptodornase
Lederle is now available in jelly form
which may be applied tinder gauze or plas-
tic dressings. VARIDASE Jelly maintains
its enzymatic action for a full 24 hours,
and eliminates the need for wet packs.
With VARIDASE Jelly, many lesions
that formerly required prolonged hos-
pitalization or daily office visits can
now be treated by the patient at home.
LEDERLE LABORATORIES DIVISION
NORTH AMERICANCyanamid LIMITED
5550 Royalmount Avenue
r I
jelly form, too !
VARIDASE in jelly or in solution is be-
ing used increasingly for enzymatic
debridement of infected burns, purulent
ulcerations, necrotic wounds, empyema,
suppurative arthritis, infected bedsores,
abscesses and suppurating cavities.
VARIDASE retains therapeutic effective-
“ness for seven days or longer under
refrigeration.
- Town of Mount Royal, Montreal, Quebec snes. rrave-nane
aoe : Wee # *
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JULY, 1954
_ «
e
th. eee
ROYAL VICTORIA
‘HOSPITAL
School of Nursing, Montreal
COURSES FOR GRADUATE
NURSES
1. A four-month clinical course in|
Obstetrical Nursing.
2. A two-month clinical course in
Gynecological Nursing.
Salary—After second month at |
General Staff rates.
For information apply te:
Director of Nursing
Royal Victoria Hospital
Montreal 2, Que.
THE JOHNS HOPKINS
HOSPITAL
SCHOOL of NURSING
Offers to qualified Registered Nurses
a 16-week supplementary course in
OPERATIVE ASEPTIC TECHNIC
with instruction and practice in the
general surgical, neurosurgical, plastic,
orthopedic, gynecologic, urologic and
ear, nose and throat operating room
services. Maintenance and stipend are
provided.
For information write to:
Director, School of Nursing
The Johns Hopkins Hospital
Baltimore 5, Maryland, U.S.A.
THE MOUNTAIN
SANATORIUM
HAMILTON, ONTARIO
TWO-MONTH
POST-GRADUATE COURSE
IN THE IMMUNOLOGY,
PREVENTION & TREATMENT
OF TUBERCULOSIS.
This course is especially valuable
_to those contemplating. Public
|
Health, Industrial, or , Tuber-—
culosis Nursing.
For further information apply to:
Director of Nursing,
Mountain Sanatorium,
Hamilton, Ontario. |
THE VANCOUVER ©
GENERAL HOSPITAL.
Post-Graduate Courses offered in:
1, Obstetrical Nursing — 4 months,
commencing in September to coin-
cide with medical lectures given to
Medical Students, to which the
post-graduate students are invited.
2. Operating Room Technique and
Management — 6 months, com-
mencing March and September. —
REGISTRATION FEE — $25.00. -
Gross Salary: $75.00 for Ist 2 months
100.00 for 2nd 2 months
150.00 for 3rd 2 months
Residence accommodation available, if
desired, at $35.00 a month.
‘Meals obtainable at reasonable rates
in cafeteria. Laundering of uniforms
provided.
For further information write to:
DIRECTOR OF NURSING
GENERAL HOSPITAL
VANCOUVER 9, B.C.
Vol. 50, No.
DALHOUSIE UNIVERSITY
HALIFAX - NOVA SCOTIA
Founded 1818
sy 3
ig .
Courses for Graduate Nurses
TERM 1954-55
The School of Nursing offers one-
year Diploma Courses in the fol-
lowing fields: |
1. Public Health Nursing.
2. Teaching and Supervision in Schools
of Nursing. ;
The Director
DALHOUSIE UNIVERSITY
SCHOOL OF NURSING
HALIFAX - N.S.
For further information write to:
NOVA SCOTIA SARATORION
KENTVILLE |
PSYCHIATRIC COURSE
for
GRADUATE NURSES
Tue Nova SooTia Hospitat offers to
qualified Graduate Nurses a_ six-
Offers to Graduate Nurses a Six-
- Month Course in Taberculosis Nursing,
including Immunology, . Prevention, |
Medical & Surgical Treatment.
1. Full series of lectures by Medical
and Surgical staff.
month certificate course in Psychiatric
2. Demonstrations and Clinics. ;
Narsing.
3. Experience in Thoracic Operating
Room and Post-Operative Unit. © Classes in June and December.
. Full maintenance, salary . all staff
privileges.
e Remuneration and maintenance.
. Classes start May Ist and Novem- For further information apply to:
ber Ist.
Superintendent of Nurses
Nova Scotia Hospital
Drawer 350
Dartmouth, Nova Scotia
For information apply to:
SUPT. OF NURSES, NOVA SCOTIA
SANATORIUM, KENTVILLE, N.S.
JULY, 184 , 539
Py net We, e We ay
~ a : ‘
540
|
mS
she's heard the call for
VI-DAYLIN
. TRADE ane
(mOMOSERiZES MIXTURE OF VITAMINS A, B, By, By, Bis, © AND NICOTINAMIDE, assert)
Y.. can cement vitamin-time relations between
-mother and child by prescribing VI-DAYLIN, a liquid
multivitamin treat as eye-appealing as yellow honey,
as taste-tempting as lemon candy. Children like it
right out of the spoon —no coaxing here. Sound
therapy, too, for VI-DAYLIN now supplies seven im-
formula at left. And Vi-DAyYLin is stable at room
temperature, doesn’t require valuable - refrigerator
space. Mixes with milk, fruit juice, cereal for infants.
No fishy odor, no resistant stains on clothing. At all
pharmacies in three sizes: 90-cc.,
8-fluidounce and 16 oz. bottles.
ABBOTT LABORATORIES LIMITED, MONTREAL
Vol. 50, No. 7
portant vitamins, including vitamin B,3. Note the
THE CANADIAN NURSE
— LU afinmiine Canadtenne
A MONTHLY JOURNAL FOR. THE NURSES OF CANADA
PUBLISHED BY THE CANADIAN NURSES* ASSOCIATION
VOLUME 50
MONTREAL,
a”
NUMBER 7
JULY, 1954
live Through the Summer...
ee ER! Sort, fluffy clouds in a sun-
ny sky. Warm sand and cool, spark-
ling water. Picnics under a shady tree. .
Relaxing vacation hours when the
hospital ward or the child health centre
- seem a million miles away. Summer!
Summer! The scream of a helpless
victim who ventured too far and could
not swim. The agony of a severe sun-
burn. The chill silence after the car did
not make the curve safely. Summer!
The summer months are here and,
like thousands of other Canadians,
nurses are investing their cautiously
guarded savings to secure their cherish-
ed vacation. One would think that, of
all people in the community, nurses
who see the aftermath of car accidents,
sunstroke and near drownings would
be the most safety conscious of citizens.
Yet every summer there are nurses
among the casualties. In order that
they may live through the summer —
and like it — let us take a look at some
of the hazards and some of the es-
sential items that will act as preven-
tives. |
Perhaps the most dangerous time of
all on a vacation, especially for those
with or travelling in a car, is the
_ driving’ involved in getting there and
JULY, 19%4
coming back. Even though an alarm
clock is an abhorrence on a holiday,
rise early and travel while fresh phys-
ically. Accidents are more common
when jaded nerves and tired eyes fail
to give warning of impending trouble.
Start and stop early. Don't let a
“wreck creation” spoil the fun!
Every nurse should know how to
swim. Even experts go into cold water
gradually. Try not to swim alone or
when tired, overheated, chilled, or right
after a meal. If there is any ‘trouble
keep the arms and legs still. Even with
cramps, one can stay afloat by keeping
still. When help comes, don’t grab the
rescuer — or try to climb into a boat
over the side. Wait until it is safe to
be pulled in — over the stern.
Boating is fun if managed correctly.
Point the bow into the wind if a storm
should blow up. Get the weight into
the middle of the boat but don’t let
more than one person shift position at
a time. Stay with the boat if it is
swamped or overturned. It is much
easier for rescuers to spot a boat hull
than a bobbing head.
Hiking or climbing calls for strong,
comfortable shoes that grip well. Relax
if you feel yourself falling. Always try
41
e
THE CANADIAN
to make camp before dark. If lost, mark
the trail obviously as you move about.
Heat stroke and heat exhaustion
have very different symptoms. Long
exposure in a hot sun may precipitate
sunstroke while heat exhaustion may
occur even when one stays in the
shade. In the former, the symptoms are
headache, nausea, dizziness and an
overheated sensation. In heat ex-
haustion the face becomes pale, the
pulse weak, temperature subnormal
and the skin cold and clammy.
Different first aid measures are in-
dicated in the two conditions. Sun-
stroke calls for the head to be raised
and ice or cold cloths applied, cool
drinks, and cold water splashed on the
body. In heat exhaustion, keep the -
head low, apply warmth, drink strong
tea, or water containing salt.
Insects and slamming screen doors
are two of summertime’s most common
annoyances. No sooner are all the
mosquitoes cleared out of the house
than half a dozen people flock in, leave
doors ajar and there is another mos-
quito! To lick these warm weather
comfort destroyers, spray 5 per cent
DDT on porches and on both sides of
screen doors. Use 16-mesh-to-the-inch
screens on doors and windows to keep
out everything that flies. Hang screen
doors to open outward. Treat mos-
NURSE
_quito bites with calamine lotion or am-
monia water. .
An added pest in some areas is the
tick — a tiny brown insect that bur-
rows under the skin. If holidaying in
such a area, check the clothes and skin
surfaces daily. Should a burrowing
tick be found put the lighted end of a
cigarette against its body. If the head
stays in the skin, dig it out with a
sterilized needle. Use iodine on the
wound.
There are few varieties of poisonous
snakes in Canada, fortunately. The
areas are well known, so any nurse
holidaying in these places should carry
a snake kit. A fiery pain, two small
punctures, discoloration or swelling
are signs of a bite. Apply a tourniquet
above the bite, loosening it every
quarter of an hour for one minute. Cut
a cross through each puncture and
suck the wounds for half an hour. If
alone, walk slowly for help.
Poison tvy causes intense itching
and a burning pain. Wash the skin
with laundry soap, rinse well, then
sponge with rubbing alcohol. Have
. contaminated clothing dry-cleaned.
In spite of all the unpleasant pos-
sibilities sketched here, we hope every
nurse will have a happy, refreshing
vacation this summer.
To any observer of the political scene, the
general attitude towards public life is start-
ling. Many institutions, fearful of inviting
economic or political reprisals, refuse to
permit their people to take any active part.
The ordinary voter, as a result of timidity,
laziness, and for a variety of purely selfish
reasons, is indifferent.
The basic reason, however, is not eco-
nomic fear, timidity,’ or selfishness. It is
Ignorance, and the indifference of those
with the background of knowledge and wis-
dom who are capable of giving leadership.
Constitutional government, its history, and
the climate and conditions which enable it
to operate successfully, are neither generally
known nor understood. Its strength and
virtue, though little realized, lie in diversity
and the distribution of responsibility and not
in uniformity. We do not live in a political
S12
or economic strait jacket. We progress by
trial and error. We make mistakes but those
mistakes are corrected automatically without _
serious damage.
This country needs the leadership of in-
dividuals with moral courage founded on
knowledge and understanding. Where else
should it be found more readily than among
university people, the men and women who
have had an opportunity to learn the lessons
of history and economics, to study the wis-
dom of those who have preceded us, to
acquire breadth of viewpoint and clarity of
thinking. That comes as the result of read-
ing, thinking, and free discussion of ideas in
schools and colleges — in short, of educa-
tion. Out of it should emerge intelligent
leadership of a moral, informed and rugged
character.
' —H. R. MILNER
. Vol. 50, No. 7
7 The localization of pain produced
‘Abdominal Pain
JOHN BINGHAM, M.D. .
As UNDERSTANDING OF THE mechan-
ism of abdominal pain is essential
for the accurate diagnosis of gastro-
intestinal diseases. To help us under-
stand this problem, let us review some
of the less controversial aspects of the
subject. Let us follow pain from its
stimulus of origin, along the nerves to
the brain, and observe the characteris-
tics of the sensation recorded there.
What are the stimult which produce
stomach and intestines.
. JULY, 1954
pain? The digestive organs, in the
healthy state, are insensitive to most
forms of painful stimuli. They can be
cut or burned without pain. Because of
_ this fact, it was believed for many years
that the pain of visceral disease did not
arise in the diseased organ, but in
surrounding tissue supplied with so-
matic or spinal nerves. Then, in 1911,
Sir Arthur Hurst, proved that the
viscera were sensitive if the proper
\/
Figure 1. .
by balloon distension of various parts of the esophagus,
3
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THE CANADIAN NURSE
stimulus was used. This stimulus was
smooth muscle tension or stretching.
Many still believe that muscle tension
.is the only pain-producing stimulus.
This is true when the viscus is healthy.
Recent evidence suggests that when
the viscus is diseased other stimuli may
evoke pain; pinching, pressing, chem-
ical stimuli, or even powerful peristaltic
waves produce painful sensations. >, ;
What ts the pathway for transmis-
sion of the painful impulse? The nerve
impulses, produced by the painful
Stimulus, pass along nerve fibres
in sympathetic nerves to the spinal
cord and then to the brain. Al-
though the pain fibres travel in sym-
pathetic pathways, they are not sym-
pathetic nerves. They travel in sympa-
thetic bundles for “convenience.” The
vagus nerves do not appear to carry
painful stimuli from the abdominal
viscera. Thus a sympathectomy may
relieve abdominal pain but a vagot-
omy is ineffective., : :
What sensation is felt when the im-
pulse reaches the brain? When the
pain impulse reaches the brain, the
brain localizes the origin ‘of the pain,
not in the diseased organ, but to a
particular area in the abdominal cavity
which could be called the visceral
segment. The pain is felt deep with-.
in its visceral segment. It is usually
described as a sickening or gnawing,
steady or crampy distress. Often the
patient is unable to find words to de-
scribe the pain. The location of the
visceral segments canbe seen most
easily from artificially produced pain.
The heavy black dots in the central
figure (Fig. 1) represent the balloon
of a Miller-Abbott tube.placed in the
various parts of the gastrointestinal
tract. The balloon was distended until
pain was produced and the site of the
pain, or the visceral segment, was re-
corded. Each dot in the peripheral
figures represents the studies in one
patient. —
Esophageal pain — The distension
of the upper esophagus produced pain
felt either in the neck or deep to the -
upper sternum. Pain arising in the
lower esophagus was felt deep to the
lower end of the sternum or in the
Figure 2.
The localization of pain produced by water distension of biliary passages.
Vol. 50, No. 7
ABDOMINAL PAIN
t
HEAD
~ BODY
Figure 3.
TAIL
The localization of pain produced by electrical stimulation of the head, body and tail of the
pancreas. (After Bliss, et al.)
upper epigastrium. If the pain stimulus
was excessive, the pain was felt in the
back.
- Gastric pain — is not shown in
Fig. 1, but corresponded to duodenal
pain in the situation in the epigastrium.
Pain from the jejunum was felt in
the epigastrium whereas pain arising in
the ileus was periumbilical. 7
Pain from the rectum was felt below
the umbilicus. : oe
Bihary tract pain was _ artificially
produced by water distension, under
pressure of the biliary tract (Fig. 2).
The pain was felt in the epigastrium
and was indistinguishable from duo-
denal pain. The author has simultane-
ously produced duodenal pain and bil-
-jary tract pain in the same patients at
the same time and found the patients
unable to differentiate one from the
other. ©
We are indebted to the recent work
of Bliss and his co-workers; for in-
formation on pancreatic pain (Fig. 3).
These workers inserted electrodes into
the head, body, and tail of the pancreas
during surgical operations. The wires
from these electrodes were brought out
through the operative incision. A few
days later the various parts of the pan-
creas were electrically stimulated and
the pain produced was recorded. Pain
arising in the head of the pancreas was
felt to the right of the midline and ex-
tended from the xiphoid to slightly
below the umbilicus. Pain arising
from the body was located in the mid-
line from the xiphoid to the umbilicus.
Pain arising in the tail of the pancreas
was felt anywhere from the xiphoid to
just above the groin with the majority
just to the left of the midline. Stimu-
lation of all three produced a band-like
pain radiating across the abdomen.
We may now summarize the visceral
segments for pain arising in the vari-
ous digestive viscera (Table J).
Table I.
Site Stimulated
Upper esophagus . 4
Lower esophagus _
Stomach, duodenum, biliary tract, pancrea
Upper small bowel
Lower small bowel and appendix
’ Colon
JULY, 1954
free,
a Visceral Segment
Upper sternum or neck |
Lower sternum or upper epigastrium
Upper epigastrium /
Lower epigastrium
Periumbilical region
Subumbilical region
THE CANADIAN NURSE
-PEPTIC ULCER
APPENDICITIS
CHOLECYSTITIS
SPASTIC COLON
Figure 4.
_ The localization of pain arising from disease of the digestive organs.
With these visceral segments in
mind let us turn briefly to the pain of
clinical disease.
The most common location of pain
of peptic ulcer, cholecystitis, and pan-
creatitis is shown in Fig. 4. As one
Dr. Bingham is clinical teacher in
medicine, University of Toronto, and
attending staff physician, Toronto West- |
ern Hospital. ;
S46
would expect from the experiments al-
ready mentioned, the pain of all three
will be similar and will be felt in the
epigastrium. ‘This, unfortunately, adds
to the difficulty in the diagnosis of
upper abdominal disease. Many pa-
tients with cholecystitis have pain pre-
dominantly in the right upper quadrant
or even the right shoulder.
The common site of pain of appen-
dicitis and a spastic colon is also
' Vol. 50, No. 7
PANCREATITIS —
ABDOMINAL PAIN
shown in Fig. 4. The pain of appen-
dicitis resembles the pain produced by
distension of the ileum, that is, it is felt
in the periumbilical region. The pain
of the colon is in turn felt below the
umbilicus. Here again it is noted that
the pain of an appendicitis does not
- always occur in the periumbilical re-
gion, but is often felt in the right lower -
quadrant.
Now what is the explanation of the
right upper quadrant, or right shoulder
pain, of cholecystitis and the right
lower quadrant pain of appendicitis? .
You can think of many other examples
of variations of pain from the typical
visceral locations already described.
This second type of pain has been
called referred .pain. Very little is
known about this pain and various
theories have been advanced to explain
its mechanism. None adequately ac-
counts for all the aspects.
REFERRED PAIN
Referred pain appears to occur in
the following circumstances: |
When inflammation develops — In
_the early stages of acute appendicitis,
if appendicular colic 1s prominent, the
pain is periumbilical. As inflammation
develops, the pain moves to the right
lower quadrant. Biliary colic is usually
felt in the epigastrium. As inflammation
develops in the biliary tract the pain
moves to the right upper quadrant.
This type of referred pain apparently
occurs without any involvement of sur-
roundings tissues innervated by so-
matic nerves. |
When the disease process involves
parietal structures supplied by somatic
nerves, — The parietal peritoneum and
the roots of the mesenteries are sup-
plied by somatic and spinal nerves.
Stimulation of these tissues produces
pain referred along these nerves. For
example, the pain of cholecystitis may
be referred to the shoulder if the dia-
phragm is irritated. In this case the
pain is referred along the phrenic
nerve.
As an accompaniment of visceral
pain of extreme severity — In certain
cases we can only explain referred
pain as an accompaniment of visceral
pain of extreme severity. The pain
produced by balloon distension of the
duodenum is felt in the epigastrium.
If the balloon is distended further the
pain becomes agonizingly severe and
is felt over a wider area and in the
back.
_ Cutaneous hyperasthesia, muscle
tenderness, and muscle spasm should —
be sought for in all cases of abdom-
inal pain. They frequently accompany
referred pain and appear to depend on
the same reflex arcs.
The difference between true vis-
ceral pain and referred pain are sum-
marized in Table II, ~ :
Table II
TRUE VISCERAL PAIN
Origin of Pain Viscera
Type of Pain
Location
Muscle spasm and |
cutaneous hyperesthesita Absent
Anesthetizing skin and
muscles over painful area No relief of pain
Sympathectomy Relieves
REFERENCES
1. Hurst, A. F. The Sensibility of the
Alimentary Canal. London, H. Frowde,
911. |
2. Bentley, F. H. Observations on
JULY, 1954
a -4e
_ REFERRED oR SOMATIC PAIN
Viscera or somatic area
Sickening, gnawing, boring Sharp, burning, aching
Visceral segment
_ Referred over somatic nerves
Frequently present
Frequent relief
No relief
Visceral Pain. Annals Surgery, 128:
881, 1948. oa
3. Wolff, S. G. and Wolff, H. G.
-_ Human Gastric Function. London, Ox-
ford University Press, 1943.
4. Bingham, J. R., Ingelfinger, F. J.
KP
THE CANADIAN NURSE
and Smithwick, R. H. The Effects of
Sympathectomy on Abdominal Pain in .
Man. Gastroenterology, 15: 18, 1950.
5. Bliss, W. R. Burch, B., Martin,
M. M. and Zollinger, R. M. Local-
Surgery of the Gallbladder :
and Biliary System
EMILY ELNICKI
ANATOMY
| bee EXTRA-HEPATIC BILIARY TRACT
of man consists of: the gallbladder,
the cystic duct, the hepatic duct and the
common bile duct. The gallbladder is
pear-shaped, situated in the lower sur-
face of the liver between its right and
quadrate lobes. When filled it holds
about 35 cc. of bile. On its free surface
the gallbladder is covered by perito-
neum continuous with that on the
inferior surface of the liver. On its -
anterosuperior surface it is united to
the walls of the hepatic fossa by areolar
tissue. The neck of the gallbladder
‘continues into the cystic duct. The
cystic duct unites with the hepatic duct
at right angles in the hepaticoduodenal
ligament. The hepatic duct is formed
by channels from the right and left
lobes of the liver. The common duct is
formed by the junction of the hepatic
and cystic ducts and extends to the
duodenum. It passes into the hepatico-
duodenal ligament in front of the portal
vein and to the right of the hepatic
artery, going behind the duodenum
through or along a sulcus in the head
of the pancreas and into the left side
of the intestine below the mediam level
of the duodenum. It passes obliquely
through the walls of the duodenum,
joins the pancreatic duct at the ampul-
la of Vater, in most cases, and termin-
Miss Elnicki, who prepared this
article when she was a senior student,
is now engaged in general nursing in
the pediatrics department at Royal .
Columbian Hospital, New Westminster,
B.C. |
S48
ization of Referred Pancreatic Pain In-
duced by Electrical Stimulation. Gastro-
enterology, 16: 317, 1950. :
6. Morley, J. Visceral Pain, Brit. Af. J.,
2: 1,270, 1937.” |
ates ina papilla in the mucosal surface
of the duodenum 8-10 cm. from the
pylorus. | _
PHYSIOLOGY
The gallbladder has the general prop-
erties of: absorption, secretion and
motor activity. The secretion of bile by
the liver is a continuous process, but
the amount secreted fluctuates. The
daily output varies from 500-1,200 cc.
Bile is composed of about 97 per cent
water and 3 per cent solids, including
‘1 per cent bile salts and lesser quanti-
ties of mucin and pigments, cholesterol,
lecithin and fat. The presence of bile in
the intestine is necessary for the main-
tenance of life, it being vitally con-
cerned with the digestion and absorp-
tion of food, particularly fats, and
with the elimination of a variety of
excretory products such as bile acids
and cholesterol. Bile salts are effective
cholagogues, stimulating the liver t
increased biliary secretion. :
The gallbladder is a reservoir for the
bile. It 1s of small volume and great
concentrating activity. Thus it is able
to store great quantities of hepatic bile
which will be discharged into the duo-
denum during the early stages of
digestion, providing bile salts which
are absorbed, and stimulating the liver
to further activity. The gallbladder cor-
relates the secretory activities of the
liver with those of the gastrointestinal
tract during the various phases of di-
gestive activity. The mechanism by
which it accomplishes this appears to
be as follows: The gallbladder is caused
to fill with bile during the fasting pe-
riod by closure of the sphincter at the
Vol. 30, No. 7
= JULY, 194
SURGERY OF THE
“Hepatic Duct
common Bile Duct
GALLBLADDER’
Pancreas
Liver (under surface), gallbladder, biliary apparatus, pancreas and Wirsung's Duct. :
| duodenal end of the common bile duct.
The bile is thus forced through the
cystic duct into the gallbladder where
it is concentrated, allowing the storage
of all bile secreted during the inter-
digestive period. After ingestion of
food there is a reciprocal action be-
tween this sphincter at the duodenal end
of the common duct and gallbladder
which permits the evacuation of the |
contents of the gallbladder when the
- bile is needed. The tone of the sphinc-
ter is decreased or abolished by the
passage of gastric content into the duo-
denum. At the same time cholecysto-
kinin is released from the duodenal
mucosa and after absorption by the
blood stimulates the gallbladder to
contract and empty the contained bile
- into the duodenum.
PATHOLOGY
Diseases of the gallbladder and the
ducts are largely concerned with the
problems of infection and the formation
of stones. Infections of the gallbladder .
may be divided into two general types
— acute and chronic — and may or
may not be accompanied by gallstones.
- Improper drainage of the gallbladder
probably has ses to do with the
development of the infection, and the
presence of stones hinders drainage. In
an acute infection the gallbladder may
be a real bag of pus with a thick, in-
- flamed wall which may become gan-
grenous leading to perforation and
peritonitis — local or general. The
acute inflammation may subside, leav-
ing a thickened damaged gallbladder
which may exist over a period of
years. The stones may form in the gall-
bladder (cholelithiasis) ; in the cystic
duct, in the hepatic duct, or in the
common duct (choledocholithiasis).
They are most commonly composed of
cholesterol, but some may consist
chiefly of bile pigments. The presence
of bacteria is said to be one of the pre-
disposing causes of gallstones. Stones
are more common in persons of middle
age.
SURGICAL JAUNDICE
Normally, the bile flows freely from
the liver to the intestines. In disease,
the presence of jaundice means an
obstruction to the flow and absorption
of bile by the blood. This obstruction
may be caused by stones in the com-
mon duct or by a severe inflammatory
reaction sufficient to obstruct the duct.
In cases of jaundice severe hemorrhage
may occur from the region of the oper-
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THE CANADIAN NURSE
ation or from the gastrointestinal tract.
In such cases the liver is damaged and
since the liver manufactures pro-
thrombin, this vital factor in the mech-
anism -of blood clotting is reduced.
Also, since the presence of bile in the -
intestines is necessary for the absorp-
tion of vitamin K, its absence (as in
Jaundice) prevents this absorption.
Vitamin K (powdered alfalfa’ leaf)
stimulates the production of prothrom-
bin and, in the presence of jaundice
must be administered in combination
with bile salts by mouth to ensure its
assimilation. Temporary improvements
may be maintained by giving whole
transfusion of blood.
THe Patient
Mr. Bruce, a middle-aged widower
of 47, has been a railway clerk for 26
years. He is short, heavy set and pale,
with a rather sallow complexion. He
‘Is a quiet, retiring man who spends
most of his spare time reading. He
is the sole supporter of his family and
therefore has many responsibilities. He
lives with his father who is blind his
stepmother and one sister who ig a
cripple. His health practices do not
seem to have been very good. He did
not seem to use much discretion in his
diet and worked long hours. This may
have made him susceptible to infection
_ and lengthened his illness. At first he |
was a very cooperative patient but, as
his condition worsened, he became de-
presséd, afraid, distrustful and even
rather obnoxious at times.
Mr. Bruce had been in hospital with
a tentative diagnosis of coronary oc-
clusion and a final diagnosis of acute
pancreatitis, Then, he had complained
of terrific pain in his chest and upper
| abdomen, and nausea with vomiting of
what seemed to be blood. After careful
examination, E.C.G. — which was nor-
mal, various laboratory tests — show-
ing an infection; strict bed rest: nar-
cotics for his severe pain; bicveen ther-
apy and general supportative nursing
care, his condition improved and he was
discharged. He returned to work but
had persistent epigastric discomfort and
bloating. He was re-admitted two
months later.
Signs, symptoms and methods of diag-
550
nosis: On his admission Mr. Bruce
gave a history of what he called “gall-
bladder attacks,” including persistent
indigestion after meals, severe pain in
the ‘upper right quadrant, nausea and
vomiting, and a definite intolerance to
fat. His temperature was 101, pulse 96
respiration 24. He was pale and hare
spiring profusely. His abdomen was
slightly. distended, rigid across the up-
per right quadrant on palpation. Within
the next few days he complained of a
more excruciating pain that radiated
to the costal margin of his back and
Shoulders. He also had chills and fever
Jaundice became increasingly nouce:
able. His urine appeared very dark, his
| Stools clay-colored. He also complained
of some pruritis. Those signs and symp-
toms indicated biliary colic resulting —
- from. obstructi
| on of the
re common bile
ee confirm the diagnosis of acute
c olecystitis, cholelithiasis, and choledo-
_ Cholithiasis which these symptoms seem-
ed to suggest, a number of tests and |
Xaminations were carried out. Several
laboratory tests were made: the sedi-
mentation rate of 60 mm. and white
blood count of 11,700 showed infection
The icterus index was only six units
(normal) the day of admission but
rose to 29 units, then 84 units on later
| tests, suggesting a high concentration of
bile pigment present in the blood. His
prothrombin time was 60% showin
some decline below the normal of 84-100
% which further suggested a bile |
- duct obstruction. The urine appeared to
be quite normal exce
of 3 + bile. |
— gallbladder x-ray was done. This
owed the gallbladder lying high and -
ransverse apparently filled wi i
wit -
ferous material. : oe
7 The surgical consultant who was cal-.
ed in advised exploration of the gall-
pleas and biliary system in 10 or 12
ays when he hoped the acute symptoms
would have subsided and it would be
safe to operate. In the meantime palli-
ative measures were carried out.
pt for the presence
PALLIATIVE M EASURES
On admission Mr. Bruce was given
morphine gr. Y% with atropine gr. 1/150.
The atropine in combination with the
Vol. 50, No. 7
SURGERY OF THE GALLBLADDER
‘morphine helps to overcome biliary
colic by relieving the spasm of the in-
voluntary muscle caused by the stones
trying to pass through the ducts. These
drugs were used q. 4 h., p.r.n. with great
- relief. Other analgesics and antispas-
modics were also used to relieve pain as
the surgeon did not want him to be-
come addicted, by continued use, to any
one drug. When he complained of pain
in his right shoulder he was given a
hot water bottle and a mild analgesic
but with only slight relief. As his se-
vere epigastric discomfort persisted,
tincture of belladonna minims 10, q.id.,
was given. This drug has the same effect
as atropine in overcoming the spasm
of involuntary muscles in biliary colic.
Nitroglycerin gr. 1/100 (another anti-
spasmodic) was given sublingually a
few days later, but with little effect.
Demerol hydrochloride (a milder nar-
cotic) 100 mg. was given intramuscu-
larly. This gave relief only once and
was discontinued. It was found that -
the best result was obtained from the
atropine and morphine. It was used
until his infection was sufficiently ar-
rested and his pain much decreased. -
Seconal gr. 14 was given as a sedative
q.hs., p.rn., to ensure a good night's
rest. As Mr. Bruce suffered a great deal
from indigestion, Amphojel (an antacid)
was given p.r.n. with some relief. Forti-
cillin (an antibiotic), 400,000 units, was
given daily until the operation to further
aid in counteracting and localizing the
_infection. : | |
Mr. Bruce was placed on strict bed
rest for the first few days. Hot foments
to the upper quadrant were applied regu-
larly until the operation. These helped
both to rélieve the pain and to localize
the infection. At times we had to put —
oil on his skin as it became very red-
dened and there was a danger of it
blistering. ~ tube
A fat-free diet high in carbohydrates,
proteins, and vitamins was ordered.
Fluids were forced to replace those lost
by diaphoresis and also to dilute the
toxins of the infection. . Special stress
was placed on the intake of swectened
drinks to increase the storage of glyco-
gen in the liver to be used by the body
in the post-operative period. Due to
nausea Mr. Bruce could not retain fluids
JULY, 194
very well. His intake was recorded and
glucose was given intravenously to main-
- tain a high level of carbohydrate. As-
corbic acid 500 mg. and vitamin B
complex 2 cc. were given intramuscu-
larly. :
The presence of jaundice, which
usually indicates an increased bleeding
‘time, made Mr. Bruce a poor operative
risk. To make up for the deficiency of
bile in the © gastrointestinal tract,
Kavitan 10 mg. I.M. was given daily to
reduce the risk of post-operative hem-
orrhage. Caroid and bile salts tablets,
2 bi.d., were also administered to de-
‘crease the bleeding time. This drug
aids the absorption of vitamin K from ,
the intestines.
Thus dehydration having been over-
come, renal function sufficiently good
to allow a safe margin for increased
post-operative demands, and his acute
condition having subsided sufficiently,
Mr. Bruce was prepared for surgery.
PRrE-OPERATIVE DETAILS
As Mr. Bruce was now feeling much
_ improved, most of his previous medica- .
tions and treatments were discontinued.
The last bedpan used pre-operatively
was checked and the color of the stools
and urine recorded. They still showed
the presence of bile so the surgeon
knew that an obstruction was still pre-
sent and that the operation was neces-
sary to find its cause.
As this was not the first time he had
undergone surgery, Mr. Bruce did not
require much reassurance pre-Oper-
atively. He did, however, have the rea-
sons for the pre-operative details, the
proposed operation, and what he should
expect post-operatively, explained to
” him. On the day before the operation, he
was given 72 mg. of Hykinone IV.
Hykinone was used instead of vitamin
K for it increases prothrombin time to
a satisfactory level in a much shorter
time. Mr. Bruce’s prothrombin time was
taken six hours later and found to be
90 which was satisfactory for surgery.
That evening Mr. Bruce was locally
prepared as for a laparotomy. Partic-
ular attention was paid to the gall-
bladder region. A large area was pre-
pared because of the possibility that a
‘more extensive operation than was
31
THE CANADIAN NURSE
Originally anticipated might be required.
Seconal gr. 11% was given that even-
ing to ensure a good night’s rest. On
the morning of the operation, Mr. Bruce
was wakened at 6:30 a.m. as his oper-
ation was slated for 8:00 a.m. He was
encouraged to void to prevent the pos-
sibility of a distended bladder, with the |
danger of injury during the operation,
infection, and possibility of voiding
while under anesthesia. At 7:00 am.
Demerol 75 mg., with atropine gr.
1/200 I.M., was given to allay excite-
ment and - dry secretions.
OPERATION
In the anesthetic room Mr. Bruce was
given a general anesthetic by the inhala-
tion method. Nitrous oxide in combi-
nation with oxygen and cyclopropane
was used.
The liver showed does of severe -
chronic obstruction. It was dark green,
enlarged, diffusely fibrotic with rounded
edges. The gallbladder was subacutely
inflamed and densely adherent to the
omentum. It was thickened and con-
tained faceted stenes. One large stone
was palpated at the head of the pan-
creas near the ampulla. The common
duct was surrounded by inflamed fat.
The gallbladder was separated from the
omentum. The duodenum -was_ sepa-
rated from the common duct and rolled
downwards. In order to dissect the
junction of the ducts a trocar was put
into the gallbladder and a moderate
quantity of white bile withdrawn. The
gallbladder was opened and numerous
soft faceted pigment stones were re-
moved with a scoop. The common duct
was explored with a needle and opened.
An impacted stone near the ampulla was
fragmented with the scoop and brought
out in pieces. Eventually the ampulla
was dilated one cm. A probe was passed
from the gallbladder into the common .
duct to identify the cystic duct which
was enlarged. The cystic duct was dis-
sected free, ligated and the gallbladder
removed in a retrograde manner. The
gallbladder bed was satured. There was:
some oozing which was fairly easily
controlled. The common bile duct was
re-explored and three more stones were
removed from the left hepatic duct. The
whole duct system was re-explored with
S82
- Mr. Bruce was taken to the post- |
anesthetic’ recovery room. He was -
o~
scoops but no more stones were found.
Eventually all the ducts were flushed
out with saline and catheter. The cath-
eter passed easily into the duodenum.
A large T-tube was left in the common
duct, and a Penrose drain in Morrison’s
Pouch for drainage purposes; 400,000
units penicillin, 2.5 grams sulfa and 1
gram of streptomycin were left in
Morrison’s Pouch. The abdomen was
closed in the usual manner.
The gallbladder was microscopically
examined and showed a chronic chole-
cystitis, cholelithiasis, and cholestero-
' lisis.
POST-OPERATIVE PERIop
Immediately the operation was over,
conscious on admission. His blood pres-
sure, pulse, and respiration were noted
every half-hour for the next few hours,
since any increase in pulse or decrease
in blood pressure would indicate hemor-
rhage or shock. His blood pressure was
120/80, pulse 78, respiration 24 on ad-
mission and remained Satisfactory —
throughout. His bed was elevated at
the foot for the first two hours, then
lowered. He was given oxygen by mask
/ to prevent shock. His dressing was
checked carefully for signs of bleeding
and the T-tube was attached to a sterile
1,000-cc. drainage bottle which was
hooked under the bed. Care was taken
‘that the connecting tubing was neither
too long or too short and that it was
fastened securely. This was ‘very im-
portant because of the danger of the
tube being dislodged or pulled out, which
might have necessitated returning him
to the operating room for re-insertion
of the T-tube. The dressing was also
checked to make sure that it was not
too tight. If it were it would restrict
breathing and a toa DHMGHARY
complication.
Normal saline 500 cc. was given to
maintain fluid balance and to compensate
for that lost during the operation, Also
100 mg. of demerol I.M. was given at
11:00 a.m. for restlessness and post-
operative discomfort.
As he was conscious and in fair con-
dition he was sent to the ward. The ©
dressing, color, pulse, respiration and
Vol. 50, No. 7
‘Common bile duct
SURGERY OF THE memeaiaic
Incision
Adhesive flap
ey
pinned to outer
pressing or
binder
¢
--Rubber tubing
from T-tube
to drainage
bottle
’
| bottle
The coerect way to attach a T-tube.
blood pressure were checked q. 2 h. Im-
mediate post-operative nursing included
washing his face and hands, and special
care to his back, to make him more
comfortable and enable him to rest.
Lack of rest predisposes to hemor-
rhage and shock. He was placed in a
low Fowler's position on his operative
side thus allowing more freedom in
'. breathing, promoting drainage, and re-
lieving tension on the wound. However,
-he was not kept in this position for any
“length of time. At least every hour he
was turned from side to side to prevent
post-operative lung SOMDUCAH ONS =< 8s
atalectasis.
As the upper abdominal incision made
breathing painful, Mr. Bruce had- a
tendency of taking short ‘shallow
breaths. Deep breathing was encouraged
and stimulated by giving carbon dioxide
and oxygen inhalations every hour for
five minutes.
. The following post-operative orders
were carried out for the next few days:
Sedation — morphine gr. 1/6 q. 3-4 h.,
p.r.n.
t Antibiotic therapy — penicillin and
streptomycin 0.5 gm. t..d. (to prevent
further infection ). ‘
Vitamin therapy — B-Plex 2. cc.
.i.d. and ascorbic acid 500 mg. I.M. q.d.
(to improve his general condition a
promote faster healing).
JULY, 1954
oniee: therapy p.r.n. (for depressed
respirations).
Early ambulation (to prevent pul-
monary complications).
Water in sips only (to prevent post-
operative distention).
Rectal tube and glycerin suppository
(for gas).
I.V. therapy b.i.d. (to maintain fluid
intake at a high level, especially as his
was a biliary tract operation including
the common duct). -
Mr. Bruce had sips of water only at
first. As there was little nausea and
vomiting, the amounts were increased.
The water balance was maintained by
calculating the daily needs plus the
output, including vomitus and bile drain-
age. A careful record of his intake and
output was kept at all times. ,
To inform the surgeon how the com-
mon duct was functioning the color of
the skin, urine, and stools was watched
regularly. The skin and urine at this
_ time were dark indicating that the ob-
struction was still present.
On the first post-operative day several
_ laboratory tests were done, The white
blood count of 21,500 showed some in-
fection still present. His hemoglobin was
surprisingly good — 98%. A slightly
elevated N.P.N. of 44% showed the
possibilrtty of some renal impairment.
Blood chloride at 480 mg. per cent was
THE CANADIAN NURSE
below the normal of 570-620 mg. per
cent showing that he was losing a large
amount of NaCl in output and _ that
more had to be given in his I.V. fluids
to provide the normal balance in the
blood stream. A serum bilirubin was
done. This test measures the ability of
the liver to excrete bilirubin. The nor-
mal is up to 8 mg. Mr. Bruce's at this
time was 19.6 — somewhat elevated.
This showed that the mechanical ob-
struction to the flow of bile in the in- |
testine was not yet totally relieved. His
carbon dioxide combining power was
49 volume %. This was below the nor-
mal of 55-75 volume % showing a lack
of carbohydrate in his blood and the
necessity of having it added in his I.V.
fluids. |
On the second post-operative day hic-
coughs were very troublesome. Oxygen,
given almost constantly, relieved him
somewhat. His temperature remained
elevated for a few days. Diaphoresis
was quite troublesome and he complain-
ed of pain in his thoracic region, sug-
gesting a post-operative pulmonary
complication. A chest X-ray showed no
sign of atelectasis or other involvement. .
He was made as comfortable as pos-
sible with alcohol rubs, sinapisms to his
chest and sedation.
That afternoon his abdomen was
somewhat distended. A Levin tube was
passed and 510 cc. liquid (mucus and
coffee ground fluid) was withdrawn
from his stomach. An oil retention enema
followed by a s.s. enema was given with
the expulsion of much flatus. His ab-
domen became much softer and he felt
relieved.
When the doctor changed the dressing
for the first time, the incision appeared
clean. Chloral hydrate in olive oil was
. given rectally that evening for Mr.
Bruce was becoming tolerant to the
other sedatives and they were ineffec-
tive.
On the third post-operative day Mr.
Bruce was more active. He bathed him-
self and was up in a chair for ten
minutes. He was tolerating clear fluids
well with no emesis. He was, however,
coughing up thick greenish mucus and
phiegm. Jaundice was still apparent and
his urine was dark. His T-tube drain-
age was working well.
554
On the sixth post-operative day Mr.
Bruce’s temperature was 102°, pulse 140,
respiration 28. He complained of a tight-
ness in his chest and his productive
cough was more troublesome. He was
given steam inhalations and sinapisms
_ to his chest. His hiccoughs continued to
be troublesome and his abdominal dis-
comfort persisted. A Levin tube was
passed and 600 cc. of very foul smel-
ling, curdled fluid were withdrawn.
These symptomatic nursing care mea-
sures made him more comfortable and
his temperature came down to 99°.
Considerable bile drainage was apparent
at the site of the Penrose drain sug-
gesting an accessory duct was untied.
Chloromycetin 250 mg. q. 4 h. was start-
ed as the other antibiotics proved to be _
ineffective. Crude liver 2 cc. I.M. O.D.
was now commenced. ne:
Exactly one week post-operatively a
great deal of bile drained from the centre
of the wound. The skin edges gave way
though the stay sutures held. This was
precipitated by several days of severe,
persistent coughing, hiccoughs, and the
_ digestive action of the bile which drained
profusely on the incision. The surgeon .
was notified and he packed the gaping
area with sterile gauze dressing, irri-
gated it with tyrothricin, strapped the
incision, and applied a binder to aid in
holding the incision line together and
allowing it to heal. It healed in seven
days. a
Mr. Bruce was placed on a soft, low-
fat diet which he tolerated fairly well.
His intravenous therapy was continued.
Within the next few days his temper-
ature returned to normal and there was
no apparent oozing from his incision.
However, his cough continued to trouble
him and he was having abdominal dis-
comfort. A flat plate of his abdomen
showed no sign of an obstruction. The
Levin tube was again passed and a
Wangensteen tube established to keep
his stomach empty of gas and fluid
constantly. Large amounts of gas and
light brown fluid were suctioned from
his stomach. -@ :
‘Further laboratory tests were done
at this time. The hemoglobin was 75%.
The blood chloride was 400 mg. %. The
serum bilirubin was 55 mg. % showing
less jaundice. These tests showed some -
Vol. 530, No. 7
SURGERY OF THE GALLBLADDER
improvement over the last ones except
for the hemoglobin which was greatly
reduced. He was given 500 cc. of blood.
Although Mr. Bruce had a satisfactory
early post-operative period, considering
the amount of liver damage, he looked |
toxic, sweating, vomiting from time to
time, complaining of a steady low sub-
sternal pain, dyspnea and nausea. His
white blood cell count returned to nor-
mal, his chest x-ray showed no evidence |
of chest complications. The liver func-
tion tests were normal except for an al-
kaline phosphatase of 18 per 100 cc.
(the normal being 4-13 per 100 cc.).
The increase was due to a continuing —
bile duct obstruction, preventing . the
phosphatase from being excreted nor-
mally. His pulse rate was 140. He was
examined by a medical consultant and
an electrocardiogram was done. It sug-
gested myocardial enlargement and hy-
potoxemia. Digitalis gr. 11% td. for
three days and then once daily was
ordered. It slowed and strengthened his
heart and brought his pulse rate down
to 108. |
Mr. Bruce was continually asking for
“hypos” even when he did not appear to
be in pain. Placebos of normal saline
were given and proved to be effective. —
None of the complications seemed to
show anything definite and no adequate
explanation could be given for any of
them. Therefore, it was hoped that with
good symptomatic nursing care his dis-
comfort could be relieved and the rest
left for nature to heel.
’ One morning some bright red blood
~ with clots appeared in the suction bottle
showing that there was fresh bleeding.
Mr. Bruce was apprehensive and his
pulse rate jumped. The suction was dis-
continued and 1,000 cc. I.V. with 20 mg.
of Kavitan was immediately com-
menced to increase the clotting time.
Blood and other I.V. fluids were given
to replace the loss. By the next day the
_’ bleeding was controlled. It was not
known where this bleeding came from
but was believed to be from the oper-
ative area. The next day Mr. Bruce had
30 mg. of Kavitan. He was given sippy
milk and high caloric fluids. Gradually
his diet was increased to a high carbo-
hydrate, protein, vitamin, low-fat diet.
He still did not tolerate it very well.
JULY, 1954
During these days Mr. Bruce kept the
Levin tube rolled up in his pyjama
pocket and used it himself whenever he
felt he needed to aspirate his stomach
and relieve his abdominal discomfort. A
choledochogram showed failure of the
dye to enter the duodenum so that his
common duct obstruction was still net
completely relieved.
Mr. Bruce continued to make slow
progress. The choledochogram made a
month later showed the dye entering the
‘hepatic ducts with a little getting into
the intestines. The liver function tests
showed an improvement also. His oper-
ative incision was healed but an in-
cisional hernia was present.
Four months after admission, Mr.
' . Bruce was up and about, his T-tube was
draining into a small hot water bottle
and he was discharged. Now, almost a
year later, his obstruction 1s almost
completely relieved and he is working
again. He had his T-tube removed and
liver function tests showed his obstruc-
tion relieved.
NursinG CarE PROBLEMS
Some of the nursing care problems
can be sorted out as follows:
1. Discretion was required in giving
narcotics for this patient almost seem-
ed addicted to them. It was necessary
to know the difference between real
‘pain and emotional upset. Every form
of nursing care was attended to first,
‘narcotics being used as a last resort.
’ He was given an assortment of nar-
cotics, analgesics, and placebos to help
prevent addiction to any one drug.
2. The patient became very difficult
and uncooperative towards the end
of
‘his stay in the hospital. It required
great tact and patience to make him
cooperate and have the necessary treat-
ments.
3. Great encouragement was re-'
quired to carry him along when his
condition seemed so hopeless and
was so depressed.
4. It was very important to measure
he
and record his bile drainage at the end
of every eight-hour shift.
HEALTH TEACHING
Mr. Bruce’s prognosis is fair
to
good, providing he will follow the
THE CANADIAN NURSE
doctor’s orders and exercise good
health habits. The following are a few
of the teaching points we stressed:
To make a gradual return to his
'work and strenuous exercise; to stay
on a high carbohydrate low-fat diet ;
the correct way to care for his T-tube
and drainage; to visit the surgeon as
often as necessary; to report any un-
usual. symptoms as elevated temper-
ature, pain, etc., to the doctor im- ~
mediately they occured. | ie
In. conclusion, I feel that caring for
-and studying Mr. Bruce’s problems
has added to my understanding of the
vast number of details there are to
learn about the surgery of the gall-
bladder and biliary system. It has also
made me realize what modern surgery
and adequate nursing methods can do.
Parasites, Fish and Man
Leo Maroo.is, Pr.D.
(ie WORD parasite is derived from
the Greek Mapaoltos which literal-
ly means one who eats at the table of
another. In biological terms it refers
to an animal or plant that lives in or on
another living animal or plant (called
the host) at its expense. It may derive
its nourishment by feeding directly
on the tissues, including the blood, of
the host or on the partially digested
food of the host.
A parasite may cause anything from
a little inconvenience to death.
There are thousands of species of
parasites. Hardly an animal is com-
pletely free of them. Many parasites
are even known to harbor other para-
_sites. What an animal eats and where
it lives largely determines the kind of
parasites it accommodates.
Parasites can be divided into two
broad categories — ecto-parasites and
_endo-parasites. The ecto-parasites live
on the external surfaces of the host
whereas the endo-parasites live inter-
nally. There 1s no part of an animal in
or on which a parasite has not found a
home. Examples of ecto-parasites are
lice, fleas, mites, ticks, leeches, etc.
Tapeworms, flukes, roundworms and
protozoa (the causative organisms of
malaria and sleeping sickness) are
endo-parasites. Pd
Dr. Margolis is parasitologist, Fish-
eries Research Board of Canada, Pacific
Biological Station, Nanaimo, B.C.
556
The size of parasites varies consider-
ably. Some intestinal forms are 30
feet long, others are less than 1/2,500
inch in diameter. 7
_ Man plays host to relatively few of
the world’s parasitic animals. Only
about 100 species of internal parasites —
have been recovered from him. The
life history and mode of transmission
of these parasites vary considerably.
‘About one-third have simple life his-
tories, involving only one host ; the rest
have complicated life cycles requiring
two or more hosts. In the latter cat-
egory are the parasites that pass part
of their life in animals that are eaten
“by man. Such animals are referred to —
as intermediate hosts. There are sev-
eral parasites of man that utilize fish as
intermediate hosts. These are found
among the tapeworms (Cestoda) and _
Aukes (Trematoda). The remainder
of this paper will be confined to a dis-
cussion of the parasites that find their
way into man via fish.
THE BroapD or FisH TAPEWORM
The fish tapeworm, Diphylloboth-.
rium latum, like all other tapeworms
is a flat, ribbon-like, segmented worm.
It ranges in length from 6-30 feet and .
has a maximum breadth of 4 to 1 inch.
The anterior region is modified into
a holdfast organ, or scolex, followed by
a slender neck behind which occurs a
series of segments like the links of a
chain. There may be up to 4,000 of
Vol. 80, No. 7
" Fic. 1. Life Cycle of Diphyllobothrium latum
A. Man infected with adult tapeworms. B. Ovum passed in feces. C. Coracidium or ciliated
free-swimming larva. D. Copepod ingests larva. E. Procercoid larva in copepod. F. Fish |
infected by ingesting copepod. G. Plerocercoid larva in fish. H. Man infected by eating raw
fish. (From Belding, D.L., “Textbook of Clinical Parasitology.” 2nd Ed. Courtesy Appleton-
' Century-Crofts, Inc.) |
these segments each of which when
mature contains a complete set of male
and female reproductive organs. This
parasite, as other tapeworms, lacks a
digestive tract and obtains nourishment
by absorption of nutrients through the
" cuticle. — 7
The parasite occurs in the intestines
of man and other mammals. The non-
human hosts serve as reservoirs of the
cestode. It is present in practically all
northern temperate areas, but is abun-
dant particularly in the Baltic coun-
tries. In Canada it occurs from the St.
Lawrence Valley to British Columbia,
with its main focus around Winnipeg.
It is common in northern Michigan
-and Minnesota and has been reported
in Alaska.
The life history involves a very small
aquatic animal (a copepod) and a fish
in addition to the mammalian host
(Fig. 1). : a
Eggs, at the rate of several million a
day, are deposited in the intestines of
the mammal. These are passed out in
the feces and if they reach fresh water;
of a suitable temperature (60-75°F.),
with sufficient oxygen, they hatch in
about two weeks. Improper moisture,
temperature, or oxygen conditions will
retard development or kill the eggs.
The hatched larva or coractdium is
JULY, 1954
Fa
ciliated, contains an embryo with hooks
called an onchosphere, and swims freely
in the water. It has a maximum free
life of 12 to 24 hours. For further
development it must be ingested by
certain species of copepods. This is the
first intermediate host. |
In the copepod, the coracidium loses
its ciliated layer, the onchosphere pen-
etrates the gut wall and develops in the
body cavity in 2 to 3 weeks, into an
elongated larva, about % mm. long,
known as a procercoid. Further devel-
opment takes place only if the copepod
host is eaten by a fish. This is the
second intermediate host. Many species
of fresh-water fish have been implicat-
ed, although -not all species are sutt-
able. In Canada, pike, pickerel, perch
and sauger are the important hosts.
In the fish the copepod is digested
and the procercoid migrates through .
the intestinal wall to the body cavity
whence it may invade the musculature.
The procercoid increases in size and
the anterior end takes on the form
of the adult scolex. This larval stage
is called a plerocercoid and 1s usual-
ly less than %4 inch long. It de-
velops in 1 to 4 weeks. Man becomes
infected by eating raw or undercooked —
fish with plerocercoids. The fish is di-
gested and the plerocercoid develops
THE CANADIAN NURSE
into an adult tapeworm in the intes-
tines in about 3 to 5 weeks.
The presence of the parasite in man
may evoke various symptoms. They
usually take the form of a mild intes-
tinal disorder. Most cases are symp-
tomless. If the individual is aware of
the infection, he may suffer psycholog-
ical disturbances. In the Baltic coun-
tries pernicious anemia has been asso-
ciated with some infections. This has
not been observed in North America. —
The tapeworms can be eliminated by
treatment with oleoresin of Aspidium
or carbon tetrachloride, the former
being the preferred treatment.
Prevention of human infection can
be accomplished easily. The proper
cooking of fish will kill the plerocer-
coids. Temperatures. greater than
120° F. are lethal in a very short time.
Proper drying, pickling or freezing at
low temperatures are also lethal to
plerocercoids.
The tapeworm is endemic in pop-
ulations where raw or imperfectly
cooked fish are habitually part of the
diet. Positive diagnosis depends on
finding the characteristic eggs or the
discharged segments in the feces.
Several other tapeworms similar to .
D. latum have been recorded several
times from man. These cestodes are
normally parasites of other mammals
or birds. Man is just an accidental |
host.
LIVER FLUKES |
One family of flukes or trematodes,
the Opisthorchtidae, parasitizes the
liver of fish-eating mammals. Several
species have been found in man. :
Fish-transmitted liver flukes are flat,
elongated creatures. They are 1/25 to
1 inch long and 1/50 to % inch broad
near the middle and taper towards
both extremities. In common with most
other flukes, they are hermaphroditic,
possess a sucker-like anterior and
ventral adhesive organ and a digestive
tract. They live in the small bile ducts
and feed on blood and bile. _
_ The species found most frequently
in man 1s Clonorchts sinensis, com-
monly known as the Asiatic liver fluke,
_ which is endemic in southeast Asia. — -
| Fic. 2. Life Cycle of Clonorchis sinensis
A. Man infected with adult worm. B. Animal reservoir host. C. Ovum iteces D. Meta-
eee an snail. (d’. Miracidium after hatching in intestine of snail. d’. Snorceyats
: redia. d'. cercaria). E. Free-swimming cercaria. F. Fresh-water fish with encysted peta:
cercariae. G. Man infected by eating raw or insufficiently cooked fish. 'H. Reservoir animal
host infected in similar manner. (From Belding, D.L.
2nd Ed. Courtesy Appleton-Century-Crofts, Inc.)
“Textbook of Clinical Parasitology.”
Vol. 530. No. 7
.
PARASITES, FISH AND MAN
The infection has been found in North
America in Chinese and Japanese 1m-
migrants but is not indigenous to this
continent. It cannot become established
here because of the absence of suitable
first intermediate hosts. To complete
- its life cycle, the fluke requires a fresh-
water snail as a first intermediate host
and a fish-eating mammal as the final
host (Fig. 2). | |
The eggs are deposited in the bile
ducts of the mammalian host, are car-
ried into the intestines and passed out
_of the body in the feces. When ingested
by suitable species of snails the eggs .
hatch in the intestine. The larva is
known as a miracidium. It penetrates
‘into the lymph spaces of the snail and
undergoes a complicated process of
development and asexual multiplica-
tion. Eventually a larval stage known
as a cercaria develops and emerges
from the snail. This stage is free swim-
ming. If it is unsuccessful in finding
the second intermediate host, a fish, it
dies in 24 to 48 hours. The latter host,
_so far as is known, is always a member
of the carp family. If a suitable fish is
encountered, the cercaria penetrates
under the scales and usually migrates
into the meat, where it encysts. The
cyst is very small, about 1/200 inch
in diameter, and contains a larval stage
called a metacercaria. If a raw or un-
-dercooked fish is eaten by man, the
metacercaria excysts during digestion,
migrates to the common bile duct and
passes to the small bile capillaries in
the liver, where the fluke matures in 2
to 4 weeks. It can live in man as long
as 20 years. -
Another species, Metorchis con-
junctus, is found in Canada from the
St. Lawrence Valley to Saskatchewan.
Its distribution in Canada is apparently
"limited by its snail host. The fish host
of M. conjunctus is the common
sucker. Other species are not known
to carry the metacercariae. The adults
are found in man and several other
mammals.
Opisthorchiidae have been found in
man and still others are potentially .
human parasites. All opisthorchiids
have life histories similar to that of
C. sinensis, but the species of inter-
JULY, 1954
mediate hosts, particularly the snail
hosts, usually differ.
. The pathological effects of opisthor-
chiid infections are limited to the small
bile capillaries. There is an increase in
the connective tissue and the ducts be- |
come much thickened, with subsequent
atrophy of surrounding liver cells. The
extent of liver damage depends on the
number of parasites in the bile capil-
laries. |
Mild infections cause little harm, but
heavy infections may bring about se-
rious impairment of liver function and
even death. Diagnosis depends on find-
ing the characteristic opisthorchiid eggs
in the feces. A satisfactory treatment
has not been developed. Gentian violet
has been used with some success.
Prevention in man is most success-
fully attained by proper cooking of
fish before eating. Unfortunately in
many of the endemic areas it is cus-
tomary for the native populations to —
eat raw fish.
INTESTINAL FLUKES
The family Heterophyidae 1s com-
prised of very small flukes that live in
the intestines of fish-eating animals. In
the adult stage they exhibit practically
no host specificity. Most species can
develop in birds as well as in a wide
variety of mammals. About fifteen
species have been found in humans in
various parts of the world and many
other species are potentially infective
to man. |
The life histories of all species are |
very similar to those of the fish-trans-
mitted liver flukes. They involve a
snail, a fish and a fish-eating
or bird. Some species utilize marine
snails and fish as the intermediate
hosts. Others have a fresh-water cycle.
_ The most important species found in
man are Heterophyes heterophyes and
Metagonimus yokogawas. The former
species is found in southeast Asia, the
Philippines, Egypt and neighboring
. regions. The cercariae develop in
A few other species of the family
brackish water snails and encyst on the
scales or skin or more rarely in the
muscle of brackish water mullets.
Metagonimus yokogawat is a com-
mon parasite in the Orient. It has also
been found in Egypt, parts of Europe
THE CANADIAN NURSE
and Siberia. A trout-like fish and fishes
of the carp family are the second inter-
mediate hosts. |
Heterophyid infections in man result
from eating raw or uncooked fish car-
rying the metacercariae.
Light infections are usually harm-
less. However, very heavy parasite
loads may give rise to intestinal dis-
turbances. The parasite lies between
the villi of the intestine and in man they -
may occasionally penetrate the mucosa.
Since the flukes are covered with back-
wardly directed spines they are unable
to back out. They die in the mucosa,
liberate their minute eggs, of which
some may be carried by the circulatory
System to the heart where they settle
and cause serious cardiac damage.
Hemorrhage of the myocardium, ac-
companied by edema, is the commonest
lesion. Thrombus formation may also
occur. ,
Diagnosis of heterophyiasis depends
on finding the eggs in the feces. It is
difficult to distinguish the eggs of dif-
ferent species. There is no known suc-
cessful treatment. Thorough cooking of
fish kills the metacercariae and ensures
protection against infection. :
In all fish-transmitted parasitic in-
fections of humans, infection results
from eating raw or improperly cooked
fish parasitized by the larval stages.
Complete eradication of the parasite is
impractical if not impossible, since it
requires the selective destruction of an
enormous number of animals.
However, theoretically, control in
man depends solely on the proper
cooking of fish before consumption.
This appears to be a relatively simple
matter. But, to the contrary, in areas
where the parasites are endemic, this
is a difficult procedure to put into prac-
tice since the native populations habit-
ually eat raw fish or uncooked dishes _
prepared from raw fish. To educate
these people to cook fish prior to eating
is a most difficult task. They have been
eating raw fish from the earliest times
and probably will continue to do so.
Job Hints for Chapter Members
If you think your chapter meetings are
dominated by a few leaders, don't blame
them. Look at yourself. Each leader is play- .
ing his role as he sees it. But are you playing
your role as a group member? That role
need not be merely rank and file. Here is
what you can do:
You can support others. When some
member of the group presents a new idea or
plan he invariably looks for clues as to its
acceptance. If you agree or like what has
been proposed, say so. The supporter and
encourager are as important in a group as
those who initiate new ideas or plans.
You can ask questions. This is no passive
role. It is a creative role because it can
bring about sounder thinking and_ better
planning in a group. “What did the chairman
mean by that statement?” you ask, and the
chairman is forced to rethink his words.
“Where are the facts to support that con-
nection?” you ask, and the facts must be
available or the argument falls.
You can sum up. Groups sometimes reach
a point where their discussion goes in circles,
This is the right occasion for you to re-
capitulate and say, “All right, we have
reached this point. What’s next?”
You can suggest compromises. When the
group is split into factions and opinions are
divided, the one who can reconcile differ-
ences and harmonize opposing views becom
valuable to the group. :
You can release tension. When discussion
gets heated, when tempers become edgy, ©
you can throw in a light remark, a story. If
well timed, such a contribution breaks the
tension, helps group members regain their |
composure.
You can introduce a new idea. When
group discussion runs dry, it is time for
someone to throw in a new plan, a new,
way to solve a problem. No one has a
monopoly on new ideas and yours may be as
good or better than those of your colleagues.
— The Teacher’s Letter
5 !.
How awful to reflect that what people say of us is true!
—LocaN PEearsaLL SMITH
| Vol. 50, No. 7
Publie Health Nursing
GLapysS CREELMAN
Ws YOU EVER ASKED the question
“What does a public health nurse
do in a general hospital?” When I |
joined the staff in this capacity, I asked
- that question and attempted to find a
quick answer by mere inquiry, only to
learn that each hospital has its own
individual answer. By describing the
work here, I hope to give you an an-
swer that may be workable elsewhere.
The Victoria General Hospital is
operated by the Department of Health
of the Province of Nova Scotia. There
are 414 general beds and 50 beds used
for poliomyelitis cases. There are no
obstetrical or pediatric services.
For some years the hospital has had
a health service, comprising both pre-
ventive and curative aspects for its
employees. Two years ago this program
was reorganized. All phases of it, as it
affected patient and employee, were
coordinated and placed under the ju-
risdiction of a newly organized Depart-_
ment of Preventive Medicine. This de-
partment has the same status as the
various clinical departments within the
hospital set-up. The personnel of the
Department of Preventive Medicine
consists of: |
- The head of the department, who iS
a physician with public health training
and considerable experience in the
public health field. |
An associate member — the profes-
sor of epidemiology of Dalhousie Uni-
versity. He is also a physician with
public health training. ~
A registered nurse with a certificate
_ in public health nursing and experience °
‘Miss Creelman is the public health
_ nurse in the Department of Preventive
Medicine, Victoria General Hospital,
Halifax, N.S. .
JULY, 1954
The Public Health Nurse in the Health —
- Service of a General Hospital
| in the public health and hospital nur-
sing fields. _ !
‘A secretary-stenographer who 1s
responsible for records and clerical
work. |
The objectives of the department are
directed toward the patients, employees
and the environment in which they
both exist. -
Since the prime function of any hos-
pital is the “care of the patient,
I will first discuss the preventive
health measures as they affect these
individuals. Protection is afforded the
‘patient by protecting the staff and safe-
guarding the environment but, in ad-
dition, other measures are carried out,
which are directed specifically to the
patients.
Hospital regulations governing the
care and control of patients ill with
communicable diseases are in effect.
Questions that may arise from these
regulations are usually submitted to
the Department of Preventive Medi-
cine for an answer. 3 .
We have found it very worthwhile
to channel all laboratory reports
through this Department, as in this
way a Clue to cases or suspected cases
of communicable diseases is received,
if such have not already been reported.
It is the duty of the nurse to obtain any
information required for reporting of
these cases to the Department of Pub-
lic Health. Since our patients come
from all parts of the province, close
liaison is maintained .with the provin-
cial Department of Health as well as
the city Department of Health.
~ The Department of Preventive Med-
icine assumes responsibility for arrang-
ing the transfer of tuberculous or in-
fectious cases to the special hospitals
providing care. We supervise the rou-
a
5 ty
=
Nae km gb bhi ES
« ° -t a
i ne
o.
THE CANADIAN NURSE
tine chest x-ray program on all patients
admitted to hospital. All cases or sus-
pected cases of tuberculosis are report-
ed to the Department of Heath for
follow-up.
Now let us consider the health
services provided for-employees of the
hospital. All around us in business and
industry we find a pattern of preven-
tive medical services being developed.
Hospitals have an excellent oppor-
tunity to set an example for the com-
munity, by establishing these services
within the institution.
As in any large hospital, there are
a large number of employees at the
Victoria General Hospital and_ their
duties are many and varied. They
range from the man caring for the
mice and frogs in the biochemistry lab-
oratory to the girls operating the auto-
claves m_ the central supply room;
from the preliminary Sinlent: to the
internes; from domestic help in the
dietary and household departments to
the maintenance and technical staffs, to
mention only a few. In organizing such
a large heterogeneous group for the
purpose of health services, consider-
able thought was given to an over-
all program, one that would be basic-
ally the same for all yet could be
modified to suit particular groups. It
was finally decided that the staff mem-
bers should be grouped according to
the type of work they were doing and
the department in which they worked.
For instance, it was not thought ne-
cessary to carry out the same immu-
nizing procedures for clerks in the
business offices as for student nurses.
Consequently, for health service pur-
poses the whole staff was divided into
groups (five in all) and the basic pro-
gram was arranged to meet the needs
of the various groups.
All staff members have a chest x-ray
on employment and each six months
thereafter. There is no employment
medical examination but use is made
of the “Multi-phasing Testing Tech-
nique.”” The form used is similar to the
questionnaire employed by insurance
companies. New employees report to
the Department of Preventive Med-
icine on the first Wednesday afternoon
following employment. The health
$e2
query is completed with the aid of the
public health nurse. She learns a good
deal about the employees by going over
the questions with them. If it is found
that a condition exists or did exist
that requires assessment, referral is
made to an appropriate out-patient
clinic. After the questionnaire , is
completed, such immunization proce-
dures as are essential are carried out.
A staff health clinic is carried on in
cooperation with the out-patient de-
partment. This clinic is held daily from
9:00 to 10:00 a.m. Here all minor ill-
nesses and ailments are treated. A
person with a more serious condition is
referred to the appropriate out-patient
clinic. Attendance at the clinic is not
compulsory. The employees may go to
their own physicians but they are then
responsible for any financial obliga-
tions incurred. After 10:00 a.m. any
employee reporting ill is directed to the
Department of Preventive Medicine -
and the nurse arranges for medical at-
tention.
_ The student nurses’ health program
Is part of this service. The medical
staff doctors rotate, each being on
call for a month at a time. There is a
14-bed infirmary for nurses in the
residence. A graduate nurse is in
charge of the infirmary and works in
close harmony with the public health
nurse, :
I mentioned before that the environ-
ment of the patients and staff is safe-
guarded. Of course, there are modern
plumbing and sewage disposal facilities —
and chlorinated water is used. Pasteur-
ized milk and cream are provided and
weekly reports are received from the
city Department of Health on samples
taken. Proper refrigeration and dish-
washing facilities are available.
Sight is not lost of the desirability of .
having a program of health education.
The public health nurse takes advan-
tage of the visits of the staff to the
health clinic to give individual instruc-
tions. She takes part in the lectures on
community health and welfare given to
the student nurses. Students in the out-
patient department spend some time
with her as part of their training.
This is but a brief résumé of the
work carried on by the Department of
Vol. 50, No. 7
A TOAST TO CANADA.
Preventive Medicine and will only
partly answer the question I asked in
my first sentence. Time and space do
not permit me to take you to the
laundry to find out why Joe has not
-has his semi-annual chest x-ray or to
answer the call that Susie is in her
room in the staff residence and will
not waken (Susie 1s a known diabetic)
or even to sixth floor of the hospital to
‘find out more about the patient whose
chest x-ray reports look suspicious of
tuberculosis. I can assure you though,
that the work is interesting with very
few dull moments. But then a public
health nurse, wherever she 1s, finds
her work is full of variety so perhaps
that is the answer to the question.
A Toast to Canada
N PROPOSING THIS TOAST, it 1S customary
dilate on the inexhaustible resources of
Canada, its boundless wealth of mines and
forests and fisheries, its rich sail, its vast
industrial growth. This I shall not do. For
such things have nothing to do with the
greatness of a country.
England was a small and circumscribed
land of uncertain resources when its people
lit a torch to guide the world. Scotland was
poorer still in Nature’s gifts — so poor its
sons had to go forth bearing the light of
religion, the love of learning, the virtues of
industry and thrift to deeply color the life
of Canada. | |
No land was ever great because its people
were able to wallow in luxury and lead easy
lives. Rome perished at the height of her
illusory magnificence when the stern spirit
of justice, of orderly law, of faith resolutely
kept, gave place to the material clamor for
“panem et circenses.”
What real greatness Canada possesses is
its heritage from adventurers who, seeking
new knowledge or new opportunities, dared
unknown trails and rivers; from pioneers
- who, seeing comfortless clearings walled in
by forests, set themselves to make farms
and homes; of brave men who, menaced by
alien conquest, held their land in an allegi-
ance they believed was right; of patriots
willing to be called rebels that the contagion
of British liberties might spread to Canada.
It is the product of those who sought not
ease but achievement; who spent themselves
to duplicate here the farms, the industries,
the churches, the schools, the useful institu-
tions, the free ideas of other lands; who did
not seek the easy way but, in response to
some mysterious divine call, chose to travel
the hard way. |
When that spirit is drowned in the ease
of constantly shorter working hours and
JULY, 1984 .
constantly increasing luxuries, Canada is not
achieving greatness but forgetting it.
The hope of Canada, in the years to come,
is a constantly recurrent rebirth of the
spirit which sees a far vision, not of com-
placent comfort but of hard-won achieve-
ment ;.and which, counting not the cost, fol-
lows that vision to the trail’s end, whatever
that end may be. .
— Victor Lauriston, Chatham, Ont.
‘How To Get More Sleep
_ Ten hints on how to sleep well are given
by British science writer, Chapman Pincher,
in his new book, “How To Get More
Sleep.” He advises: Shed your worries be-
fore you shed your clothes; go to sleep early
enough to get all the sleep you need; go
to bed with a satisfied but not overburdened
stomach; ensure complete darkness in the
bedroom; fix that dripping tap; take pains
to make yourself as comfortable as possible
‘in bed; never count sheep; try deliberately
relaxing your muscles; try to convince
yourself that you will go off to sleep; if you -
still have a few bad nights, don’t worry, and
do not be scared to take sleeping drugs if
these are prescribed by your doctor and you
keep meticulously to his dosage.
— Science Information Service
* ¢ &
For children and youth, dancing in the -
* parlor or on the green may be a very
pleasant and healthful amusement, but when
we see older people. dancing we are ready
to ask with the Chinese, “Why don't you
have your servants do it for you?”
— Sir JosHua REYNOLDS
563
A
Industrial Nursing —
‘Industrial Relations
LouIs-PHILIPPE BRIZARD
R* INDUSTRIAL RELATIONS Wwe mean
all the communications that are set
up between employer and employee to
secure an industrial peace. As indus-
trial organisation is as much an eco- »
nomic entity as a social one, working
relations are essentially social relations.
The personnel program is none other
than an active plan, equally understood
by management and employee, which
helps them both to attain the aims and
ends of their enterprise by:
1. Permitting the marketing of the
product or function at less cost.
2. Increasing the satisfaction of the
workers on whom the industrial organ-
ization rests.
Every function of the personnel pro-_
gram (medical services included) must
meet the general aims and ends men-
tioned above, as well as specific ones.
To attain good working relationships,
the personnel program, as well as the
medical service, must function by coun-
celling not as authority. The personnel
manager or the director of the medical -
service is an adviser to the Board of
Directors of the enterprise on all ques-
tions pertaining to his services. The
Board cannot free themselves of their
proper responsibilities in this sphere
and must not divide their authority by
placing these specialists on the same
level of authority. The personnel man-
ager or the director of medical services
has the responsibility of preparing a
budget that will demonstrate to the .
Board of Directors the costs of operat-
ing their service.
The following obligations belong
equally to the personnel and medical
Service ;
1. The necessity for these services to
fill in, with their specific aims, the ob-
jective aims of the enterprise.
2. The necessity for these services to
act only as counsellors. ,
3. The importance of budgeting these
- services in order to realize better re-
sults in their functions. |
Les Relations Industrielles
ie RELATIONS INDUSTRIELLES, ce sont
tous les rapports qui s’éetablissent en-
tre le patron ct l’ouvrier, et qui assurent
la paix industrielle. Comme l’organisa-
tion industrielle est a la fois une entité
économique et une entité sociale, des
relations de travail sont essentiellement
des relations sociales. Le programme
du personnel lui-méme n’est donc qu’un
plan d’action concu par le ‘“Manage-
ment” pour l’aider a atteindre les ob-
jectifs de l’entreprise :
1. La mise sur le marché du produit
ou service au moindre cout.
2. La satisfaction de la société de tra-
vailleurs sur laquelle repose l’organisa-
tion industrielle. 7
Tout service du personnel comme le
service médical d’ailleurs doit donc ren-
564
contrer les objectifs généraux ci-haut
mentionnes en plus de ses objectifs
“spécifiques. Pour atteindre sa fin, le
programme du personnel, comme en-
core celui du service médical, doit rem-
plir les fonctions de conseil et non d’au-
torité. Le gérant du personnel ou le
directeur du service médical est un
aviseur auprés de la haute direction de
lentreprise sur toutes les questions qui
relévent de sa compétence. La haute
direction industrielle ne doit pas se dé-
gager de ses propres responsabilités
dans ces domaines et ne doit pas mor-
celer sa ligne d’autorité en placant ces
spécialistes sur la ligne méme d’auto-
rité. Le gérant du personnel ou le di-
recteur du service médical a la respon-
sabilité de préparer un budget qui ren-.
Vol. 30, No. 7
A NURSE LOOKS AT
seignera la haute direction sur les couts
d’opération de son service.
Les trois points que j'ai developpes
devant vous sont ceux qui, a mon avis,
s'appliquent également tant au service
du personnel qu’au service médical, a
Savoir :
DorotHy M. DENT
s a “tyRO” to the Public Relations
Program Committee, I should like
to put my thoughts into words. | _
Human relations is a way of life —
true! But it is also a way to happiness
— for yourself and those with whom
‘you come in contact. Therefore, if you
have not an innate ability to sell your-
self (the commodity) and your serv-
ices (the product) to the consumer
(the public), it is an aptitude that can
be acquired through study and ap-
pliance of a good public relations pro-
gram.
In selling the nurse to the public we
find her in many settings and, there-
fore, the method used for each may
vary somewhat. For example, due to
the shortage of active nurses the one
in private nursing can no longer be
hired merely because the patient wants —
an audience. Allocation of a nurse now
rests with the physician and someone
in authority in the hospital. The de-
mand exceeds the supply but it still
remains that the “excellence of per-
formance” is the yardstick for the
marketing of this service.
The nurse in industry 1s no longer
thought of as merely a first-aid worker.
She Is now a part of the total Indus-
trial Relations program and recognized
as an asset to increased production.
The nurse acts as a liaison between
employer and ‘employee and thus be-
comes a “Public Relations Officer in
Nursing” in the business world.
In order to sell your product you -
must know it and appreciate its value
Miss Dent is a nursing counsellor
with the Department of National Health
and Welfare, Ottawa.
JULY, 1954
PUBLIC RELATIONS
1. Nécessité pour ces services de rem-
plir en plus de leurs objectifs spécifiques
les objectifs généraux de l’entreprise.
2. Nécessité pour ces services de rem-
plir uniquement les fonctions de conseil.
3. Importance de budgeter ces ser-
vices.
‘A Nurse Looks at Public Relations
to the other person. This value must be
tangible and willingly accepted by those
needing the service — ‘a man con-
vinced against his will is of the same
opinion still.” The commodity to be
sold is a human one and the services
are the composite of human relations
in its entirety. The individual not being
a creature of logic, but made up of
fears, prejudices, desires, hopes and
ambitions, a certain amount of emo-
tionalism must be injected into our
appeal.
* Tt has been said that the way to “put
a thing across” is to stimulate competi-
tion, not in the sordid money-grasping
way, but in the desire to excel. It,
then, becomes a challenge — an 1n-
fallible way of appealing to those who
require our services. Taking “bedside
nursing” as a foundation for the pro-
fession, let us combine in all other
spheres the kindness and efficiency
needed in sickness, adding patience,
tolerance, understanding, and interest
in dealing with the problems of the
physically well who need our help.
So many of us in the nursing pro-’
fession, as in all other walks of life,
forget where public relations have their
beginning — among us, of the profes-
sion. Envy, jealousy, an overabun-
dance of aggressiveness and ambition
will result in the inability to form this
unification, ‘this oneness which ulti-
mately should result in a local, a pro-
vincial, and a national team. Without
this singleness of purpose we increase
the difficulty of selling the profession.
We become vulnerable to criticism.
We find a lack of acceptance of us, as
a commodity for the preservation of
health and service in sickness.
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Institutional Nursing
The Present Status and Needs
of
SISTER DENISE MARGUERITE
| bie PAPER DESCRIBES a study whose
purpose was to obtain information
about nurse instructors that “would
contribute to an over-all appraisal of
the status of teaching personnel in
Canadian schools of nursing.” It does
not set up criteria nor measure, against
any given criteria, quality of teaching
personnel. It is thought that an ap-
proximate estimate of present re-
sources may have practical value as a
basis for planning in the development
and maintenance of a competent group
of nurse teachers.
Through the years prominent nurse
leaders have emphasized the impor-
tance of the nurse instructor, the re-
sponsibility entrusted to her, and the -
confidence placed in her. This obser-
"vation 1s confirmed by quotations from
various authoritative works written by
competent people, starting with Dr.
Weir’s Survey of Nursing Education
in Canada of 1932 and covering the
time up to Nursing Schools at the
Midcentury, 1950.
This study is confined to full-time
nurse members of the instructional
personnel in hospital-controlled schools
of nursing in Canada and to those
schools and instructors who volun-
teered to participate.
_From a total of 176 schools of nur-
sing in Canada, 100 were selected and
attempts made to obtain an adequate
representation from each province.
None of the schools employs less than
two full-time instructors. The size and
total number of. schools per province
in relation to the population were also
considered.
Sister Denise Marguerite is director
of nursing at St. Paul’s Hospital, Van-
couver, B.C.
566
_*
Nurse Instructors
A letter outlining the proposed -
study was sent to the directors of the
100 schools, asking for their coopera-
tion and that of the instructional staff,
Of these, 58 replied that they would
cooperate. To eliminate duplication,
‘two questionnaires were prepared —
one for the director of the school re-
garding policies, organization, facili-
ties, and general conditions; the sec-
ond, for completion by the individual
Instructors related directly to teaching
functions. Responses were received
from 34 directors and 180 instructors,
representing a total of 44 schools
through all the provinces from British
Columbia to Nova Scotia inclusively.
One of the limitations of a study of
this nature lies in hazards implicit in
the interpretation of the data. Some of
those due to biased or inaccurate re-
sponse were, to some extent, elimi-
nated by the author’s previous know-
ledge of some situations, and relation-
ships found between data obtained
from directors and that sent in by in-
Structors in the same school. Another
consideration regarding the reliability
of the study might be this: if all the.
blanks had been returned, might the
total picture have been significantly
different? Is it possible that there was
a definite relationship between re-
sponse or the lack of it, and existing
conditions? Responses did not include
all the nurse instructors of respective
schools, which might be taken to mean
that those who considered their qual-
ifications and preparation inadequate
preferred not to respond. On the other
hand, there were situations where the
contrary was also true. So interpreta-
_tions are subject to overestimation as_
well as underestimation. The relative
and restrictive quality of all findings
Vol. 50, No. 7
STATUS OF NURSE INSTRUCTORS
must be constantly borne in mind.
A search for pertinent literature re-.
vealed that there has been, to date, no
record made of any investigation of
nurse instructional personnel in nur-
sing schools. The only surveys made
have included information regarding
instruction but only indirectly have
they dealt with the status of the teach-
ing staffs. ; :
In Canada, the Weir Report pro-
vided the first information regarding
nurse education. Its recommendations
urge: | 4
An increase in the number of quali-
fied full-time instructors; more adequate
pedagogic and post-graduate training for
the average instructor; salaries of in-
structors equal to that of high school
teachers of the same experience; greater
attention to teaching methods; and ade-
quate liberal as well as technical edu-
cation. |
Other writers, in the next two de-
cades, make more definite recommen-
dations with much concern for instruc-
tional personnel, their numbers, and
preparation. Studies have been made
in other countries which, though not
directly affecting the position in Can-
ada, have to some extent influenced its
thinking. Without exception, commit-
tees and _ individuals investigating
nursing education agree that “stand-
ards should be formulated to govern
the appointment, status, qualifications, -
teaching and administrative loads of
instructors.” The evaluation program
for schools of nursing in the United
States places great emphasis on faculty
competence, preparation, and organ-
ization. ;
The findings of the study may be
summarized as follows:
1. Education requirements formulated
_by Dr. Weir in 1932 have been reached
and surpassed by 72 per cent of the
participants in this study.
2. None of the instructors had less
than a high school diploma or junior —
matriculation on entering the basic
course. Fifty-three per cent had senior
_ matriculation or other types of prepar-
ation beyond normal school entrance.
3. Fifty-two per cent have credit for
one to two years ef umiversity work;
22 per cent have baccalaureate degrees
JULY, 1954
in nursing, and 1 per cent have master’s
degrees. Unfortunately there are still
5 per cent of instructors with no prep-
aration beyond basic nursing, and a
further 20 per cent with certificates
from post-graduate clinical courses
which in no way prepare them for
teaching.
4. One hundred and forty of the 180
participating nurses stated that they
would be interested in advanced study
but listed the obstacles. The major one,
named by 60 per cent of the group,
related to finances.
5, The trend toward post-graduate
study has been most marked within the
past six to eight years.
6. Seventy-two per cent felt that their
most valuable experience in preparation
for an educational position had been
general staff, head nurse, and assistant
head nurse positions.
7. The median tenure in present
positions was considered to be 14
months. The major reason for change,
stated by 57 per cent, is advancement
to better educational or professional
responsibilities.
8. Sixty per cent of instructors re-
ported that their responsibilities included
administrative duties; 55 per cent re-
ported counselling activities; 55 per cent
have secretarial functions; and 17 per
cent some type of student committee
work. a
9. The lecture and discussion method
of teaching was used by over 80 per
cent of instructors; 63 per cent used
visual aids routinely; 35 per cent used
the laboratory; and 16 per cent field
trips. Projects and term papers were
the most common form of assignment
and the annotated bibliography was
used by less than 7 per cent.
10. Forty-one per cent reported prob-
lems relating to presentation of mate-
* rial; evaluation, 28 per cent; planning,
24 per cent; interpersonal relationships,
7 per cent.
11. Total contributions to nursing lit-
erature by the group are 33 book re-
views, 23 articles, and 3 books.
12, A large majority stated that time,
facilities, and opportunities for profes-
sional reading were inadequate.
-13. Nurse instructors’ chief needs,
by their own estimation, are for: in-
567
cour cel
rd
eae
THE CANADIAN NURSE
‘ service education; better organization;
greater numbers of better prepared in-
structors; more opportunity for self-
expression; and more competent leader-
ship.
RECOMMENDATIONS
Investigation, analysis, and experi-
mentation at local levels recommended
as a point of departure for attacking
problems of greater issue at regional
and provincial levels.
The analysis of teaching assign-
ments, in relation to subjects taught
and areas involved, points up an ur-
gent need for reorganization or re-
distribution of activities among in-
structors. Centralization of programs
Is recommended on an experimental
basis for smaller schools. |
Investigation and analysis of nurse_
instructors’ activities recommended
with a view to establishing standards
governing teaching and administrative
functions of instructional personnel,
‘and to determine the extent to which
additional duties are a contribution to
development of the nurse instructor.
Examination and. study of the
present system of advanced _profes-
sional education indicated, with a view
to making post-graduate study more
readily available to nurses during
summer sessions or on a_ part-time
basis. |
Formulation of definite policy re-
garding leave of absence for advance
study 1s needed. |
In the Good Old Days
(The Canadian Nurse — Jury 1914)
“It will be admitted that the average
general nurse personnally dislikes to be
called on to care for sufferers from acute
mental diseases. The higher rate of wage
which the nursing association considers is
fitting for the nurse in charge of a mental
case proves that nurses have decided mental
disease 1s one of the most serious and try-
ing maladies that can engage your ministra-
tions. . . But while this position is entire-
ly defensible from the standpoint of the
law of supply and demand, is it so as re-
gards the knowledge of mental disease and
its care by the average nurse? I would
suggest that if the general nurse receives
$3.00 per day for nursing a case of which
she knows a great deal, she should pay at
least $6.00 a day to the family which permits
her to nurse a case of insanity among its
members, for it is a disease about which she
knows nothing!”
* + * .
“For the sake of the experience they
would gain student nurses might be sent out
from city hospitals to rural, districts to
nurse in the homes of families, far from
medical care, who cannot afford to pay for
such services.” |
, * ¢ &
“The public health nurses of the Depart-
ment of Public Health in Toronto have been
increased to 32 for the four summer months
568
~~
in order to assist in preventing the unneces-
Sary waste of infant life during the hot
weather.” .
* * *
“The Canadian National Association of
Trained Nurses in endeavoring to formulate
plans by which it will assume the ownership
of our national magazine, The Canadian
Nurse. This will be a long step forward for
the National Association, indeed, we may
say, the first step which really stamps the
Association as national.”
* * ©
“It is estimated that in 70° to 80 per
cent of the cases of feeble-mindedness the
causes can be traced to heredity. Again,
it has been estimated that one in every
500-700 persons is seriously feeble-minded.
The time is not far distant when we will
have to grapple with the problem these
figures present.” 43
| * * &
Recently, a French scientist reported that
iron-deficiency anemia can be effectively
treated with transfusions of concentrated
red blood cells. An advantage of this over
other treatments, he said, is that the red
cells given in transfusion not only replenish |
the blood, but their iron content is utilized
by the patient’s bone marrow to produce
more red blood cells.
Vol. 50, No. 7
Hux Infirmlorer Canadlennes-Francalses |
Au Chevet du Malade Tuberculeux
~ JACQUELINE OurIMET, B.Sc.Ep.
ECEM MENT JE LISAIS dans un article
la citation suivante: ‘Le chevet du
malade est une chaire d’enseignement
et l’infirmiére en est le professeur.” -
Pour que l’étudiante puisse devenir
cette éducatrice, elle doit donc acquérir
durant son cours une formation morale
et professionnelle intégrale. En tuber-
culose, il est évident que dans un hopi-
tal général les ressources cliniques sont
limitées et l’étudiante ne rencontre pas
beaucoup de tuberculeux mais il s’en
glisse toujours tout de méme. Le de-
pistage de ces malades dans les services
de .médecine est donc précieux pour
‘que son expérience soit parfaite et
compléte car il ne faut pas oublier que
-_ Pétudiante d’aujourd’hui est l’infirmie-
- re professionnelle de demain.
on
A lVécole des infirmieéres, l’étudiante
.a recu en classe des cours sur la tuber-
culose, principes de bactériologie,
d’asepsie, d’hygiene personnelle et pu-
blique, de diétothérapie, de soins de
nursing; des notions de psychologie,
sociologie, pathologie et thérapeutique
médicale. | ot
C’est au département, sous la direc-
tion et. le contrdle d’une monitrice,
hospitaliére ou institutrice clinique,
tout dépend de l’organisation de I’ho-
pital — qu’elle peut appliquer dans la
pratique ses principes théoriques car la
l’enseignement est dirigé vers le malade
plutot que vers la maladie. Mais c'est
encore plus précisément au chevet du
malade, en travaillant avec l’institutrice
clinique qu’elle peut comprendre et
‘ apprécier davantage l’aspect social de
la maladie, son importance, les proble-
mes particuliers des tuberculeux et le
role de l’infirmiére professionnelle dans
le traitement de la tuberculose. C’est
la qu’elle développe son habilete dans
Mile Ouimet est institutrice clinique en
médecine, Hopital Notre-Dame, Mont-
réal. : |
JULY, 19854
les soins du nursing au_ tuberculeux,
apprend a éduquer le malade et appre-
' cie Tintervention du service medico-
social. C’est aussi prés de lui qu'elle
se familiarise sur les meéthodes em-
ployées dans la prévention et le contro-
le de la maladie. En étudiant le malade
qui souffre de tuberculose, elle s’habi-
-tue a faire de ses soins aux malades un
service individuel, familial, social; elle
le voit souvent entouré de sa famille et
elle peut ainsi atteindre les membres
qui la composent.
Dés que le diagnostic de son malade
‘ est posé, aidée de son institutrice, elle
prépare son plan de travail afin d’etre
en mesure de donner a son malade des
soins efficaces dans sa premiere expe-
rience avec un tuberculeux. En le ré-
digeant, elle se rappelle les principes
déja vus en classe. Sa premiére pensée.
est donc de voir a isoler son malade
suivant les facilités de I’hopital. Pus,
revisant ses connaissances déja acqu!-
ses, elle se souvient qu'une technique
aseptique doit étre instituée sans delai.
Elle sait déja. qu'elle doit toujours,
dans les cas de contagion, se servir
d’une blouse pour approcher le malade.
C’ést l’institutrice qui lui montre com-
ment la revétir, comment disposer du
linge contaminé dans un sac spécial,
qui lui explique la méthode adoptee
par I’hopital pour la désinfection de la
vaisselle, des ustensiles, des mains et
lui enseigne la fagon de procéder pour
détruire les restes d’aliments et les
expectorations.
Au départ du malade, guideée par son
institutrice, elle s'initie a la technique
de I’hépital dans la désinfection termi-
nale. -
> Ensuite, l’étudiante lit les prescrip-
tions du meédecin. Elle connait déja
l’importance de la thérapeutique médi-
-cale, aussi est-elle fidéle a donner les
médicaments prescrits. Ici, elle se ren-
seigne davantage sur les médicaments
nr
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r
Z
“7
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‘.
ed
THE CANADIAN
employes en tuberculose, les effets at-
tendus et les symptomes possibles d’in-
tolerance.
L’institutrice clinique attire égale-
ment son attention sur les principaux
points qu’elle doit observer chez son
malade et noter au dossier: tempéra-
ture, poids, notes sur l’appetit, freé-
quence de la toux, quantité et apparen-
ce des expectorations, réactions du ma-
lade aux visiteurs. ,
Parce que le traitement est long, 11
présente certains problemes quant a la
diete. L’étudiante étudie les gouts dé
son malade; elle en fait part a la diete-
tiste. Elle apprend avec celle-ci que la -
diete du tuberculeux doit étre substan-
tielle et variée, tout en évitant de
suralimenter le malade de facgon exces-
sive. Elle s’habitue a lui présenter des
cabarets attrayants. |
La technique d’isolement installeée,
les ordonnances médicales remplies, la
diéte établie, l’etudiante se souvient que
la mesure la plus importante est main-
tenant d’empecher la diffusion de la
maladie en eduquant et en surveillant
bien son malade. C’est la une partie
importante de sa responsabilité. Pour
atteindre son but, elle s’ingenie a com-
prendre ses réactions. Généralement,
celui-ci ne prévoyait pas son diagnos-
tic; 11 est désempare. Elle doit donc
l’approcher avec beaucoup de psycholo-
gie, de comprehension afin de I’aider a
accepter sa nouvelle vie. On lui a déja
dit que c’est souvent aprés avoir mon-
tré son habileté comme infirmiére que
le malade est dispose a l’ecouter. L’étu-
diante lui donne donc un bain d’eponge,
l’'installe confortablement tout en cau-
sant avec lui afin de gagner sa con-
flance. |
Toujours guideée par son institutrice,
elle commence l’éducation de son ma-
lade. Elle sait que l’enseignement de
I'hygiéne personnelle est de Ja plus
grande importance. Elle lui explique
donc que les sécrétions de sa bouche et
de son nez sont une source de danger
pour tout le monde et elle l’améne a
comprendre que c'est seulement par sa
collaboration qu'il protégera son en-
tourage. Par conséquent, elle lui mon-
tre comment tousser, couvrir sa bou-
che, disposer de son Kleenex. Elle lui
fait comprendre la nécessité de se laver
S76
NURSE
les mains avant les repas, aprés s’étre
porté les mains a la bouche, avant de
recevoir un visiteur. Elle parvient aussi
a lui faire accepter l’importance du
repos physique et mental. Un autre
probléme surgit bientot pour 1|’étudian-
te: les visiteurs. Elle s’initie donc de
plus en plus a son nouveau role d’édu-.
catrice. Elle explique a son malade
qu'il doit empécher ses visiteurs de se —
a
contaminer a son contact; elle lui fait
comprendre que le baiser est interdit,
que ses visiteurs ne doivent pas toucher
a ses effets personnels, ni boire dans
son verre. 3
L’étudiante, tout en soignant son
malade, s’habitue a le voir comme une
personne humaine; elle constate I’inter-
action des facteurs spirituels, moraux,
sociaux, économiques sur la santé. Elle
comprend la l’importance de soigner
tout son malade en le considérant com-
me un membre de la grande société
humaine et non pas simplement comme
un cas oubliant qu'il est une personne
humaine, un membre d’une famille,
d’un milieu, d’une société. Par conse-_
quent, elle constate vite que seule elle
_ ne peut pas reussir a lui enlever toutes
les inquiétudes qu'il peut avoir au sujet
de sa famille. C’est donc ici qu'elle en-
tre en contact avec le service médico-
social et apprécie son intervention. Dé-
ja ce service a regu une demande de
placement dans un sanatorium. |
La travailleuse sociale vient donc
visiter le malade, l’encourager, |’orien-
ter dans sa maladie, évaluer les facteurs |
physiques et psychiques et leur interac-
tion chez lui, l’assurer que tout ira bien
a la maison, que sa famille recevra une
aide financiére, si la chose est nécessai-
re, que les enfants seront placés dans
des familles a la campagne sous la sur-
veillance du service social. Le malade
est-il inquiet de son travail futur, elle
s’apercoit que la aussi le service médi-
co-social peut agir. La travailleuse so-
ciale élabore déja un plan de réhabilita-
tion et va méme jusqu’a lui affirmer
qu'il pourra retourner a son travail a
moins que celui-ci comporte trop de
risques: exces de fatigue, heures trop
longues, conditions hygiéniques non
favorables, inhalations chimiques. L’e-
tudiante note que la travailleuse socia-
le dresse au malade un plan d’instruc-
Vol. 50, No. 7
LE MALADE TUBERCULEUA
tion conforme a ses besoins individuels.
Cette intervention du service médi-
co-social est une découverte pour notre
étudiante qui souvent se demandait
comment les tuberculeux pouvaient
- tre aidés dans leur longue maladie et
aprés leur retour a la sante. ,
Cet enseignement individuel, au
chevet du malade, est généralement le
plus employé et c’est aussi le plus efh-
-cace..Malheureusement, a cause du
nombre restreint de tuberculeux dans
un hopital général, l’institutrice ne peut
pas enseigner a chaque étudiante, en
particulier, ce qu’elle veut et doit sa-
voir sur ces malades. C’est pourquoi,
en plus de cet enseignement individuel,
l’institutrice profite du séjour d’un
malade dans le service pour faire de
’enseignement clinique collectif aux
étudiantes en stage dans le service de
medecine.
Elle s’efforce de le varier pour le
rendre plus intéressant et enrichir leur .
expérience. Pour atteindre ce but, elle
tache d’obtenir la participation active
des personnes qui se rencontrent au-
prés du lit du malade: médecin, assis-
tante sociale, diététiste, technicienne et
surtout l’étudiante qui en prend soin.
A cet effet, elle organise un sympo-
sium, ou, encore, un forum dont le
sujet est le malade présentement dans
le service et que toutes les étudiantes
connaissent. Un autre jour, elle fera
une démonstration des soins de nursing
au tuberculeux, ou, encore, saisira l’oc-
casion d'assister avec les étudiantes a
un traitement spécial donné a un tu-
berculeux. : |
A ces cliniques, l’attention des etu-
diantes est attirée sur le fait que le
bacille de Koch peut se localiser ail-
leurs que sur les _poumons, soit sur les
séreuses, viscéres, ganglions lymphati-
ques, articulations, peau, etc.
' L'institutrice donnera aussi cet en-.
seignement s'il n’y a pas de malade
dans le département. Pour les etudian-
tes, la clinique aura moins d’actualite
mais elles recevront tout de meme des
notions sur la technique d’isolement,
les soins du nursing, I’éducation du
malade et l’intervention du service mé-
dico-social. | |
Quant au tuberculeux en chirurgie,
l'institutrice clinique dans ce deéparte-
JULY, 1954
ment fera l’enseignement dans le meme
sens avec en plus les soins pré- et post-
opératoires. 3
A cause de la situation vivante ou
elle se trouve au chevet du malade et
l’enseignement quotidien qu’elle regoit,
l’étudiante réalise encore plus le se-
-rieux probléme social de la tubercu-.
lose, la grande responsabilité de l'infir-
miére professionnelle dans le dépistage
et le controéle de la maladie et elle
comprend que le.nursing en tubercu-
lose ne peut pas étre envisagé sans
penser a l’infirmiére comme professeur.
Avec l’enseignement clinique, en me-
decine et en chirurgie, il est donc possi-
ble de développer chez elle une con-
naissance suffsante de la tuberculose
et l’aider 4 comprendre sa responsabt-
lité future dans la lutte contre ce fleau.
The nursing supervisor is in a position
somewhat similar to that of the middleman
in the field of commerce — the person who
sees to it that the producer’s goods are re-
layed to the retailer, who then serves the
customer. In like manner, it is the respon-
sibility of the nursing supervisor to see that
the products of administration, such as
policies and procedures, are relayed to the
staff nurse who, in turn, serves the patient
and his family.
If the consumer is not satisfied with the
merchandise, word is passed to the producer
and necessary changes are made. Similarly,
if the policies governing the services to the
patient do not meet his needs, the staff nurse
tells the supervisor who, in turn, informs ad-
ministration. Administration can then make
the changes necessary to improve the s:tua-
tion.
s
— EMMA HaARLING
A patient suffering from a serious heart
ailment generally needs lots of rest. A grow-
ing number of experts, however, are con-
vinced that the resting position should not
‘be flat on the back, but sitting up. They
point out that in the recumbent position, a
patient’s blood does not circulate as rapidly
as it does with his head up and his legs
down. Also, the patient’s lungs cannot hold
as much air.
-
‘ * ww. ote tt
eg oe Be aig
PSEC ae Ss
= aia im
“Baw me" OM at s
_ Nursing Profiles
bee ALL OVER CANADA shared in the
pride of their colleagues in Alberta when,
at the annual convocation of the University
of Alberta in May, Rae Chittick received
an honorary LL.D. in recognition of the
splendid contribution she has made to
nursing in that province. Last year Miss
Chittick transferred her interest to eastern
Canada when she became director of the
School for Graduate Nurses at McGill Uni-
versity. She has been well known by Ca-
nadian nurses everywhere since she served
as president of the Canadian Nurses’ Asso-
ciation in 1946-48,
Born in Ontario and educated in Calgary,
Miss’ Chittick received her professional
training at Johns Hopkins Hospital, Balti-
more. She holds degrees from Teachers
College, Columbia University; Stanford Uni-
versity and Harvard. For many years she
was on the faculty of the School of Educa-
tion at the Calgary Division of the Uni-
versity of Alberta.
Dr. CHITTICK tn her academic robes
following the convocation where she
was presented for her honorary doc-
torate by Miss HELEN PENHALE,
president of the Alberta Association of
Registered Nurscs and director of the
School of Nursing, University of
Alberta. |
572
Florence H. M. Emory, one of Canada’s
best known nurses who has received well de-
served international recognition, has retired
from the post she has held for the past 30
years in the School of Nursing, University |
of Toronto — professor of nursing and
associate director of the School.
Born in Niagara Falls, Ont., Miss Emory
received her basic training at the old Grace
Hospital, Toronto. The following year she
became a district superintendent with the
Toronto Department of Public Health, be-
coming supervisor of school nursing three
years later. She joined the School of Nur-
sing in 1924 as assistant director, becoming
associate director in 1943. Miss Emory is
author of “Public Health Nursing in Can-
ada,” first published in 1945. Many hun-
dreds of qualified public health nurses all -
over the world attest her abilities as a
teacher. ,
Randolph Macdonald Eaton’s
FLORENCE H. M. Emory
Professionally, Miss Emory has always
had a strong sense of obligation. She served
as chairman of the Membership Committee
of the International Council of Nurses for
20 years — 1933-53. Completing a_three-
year term as president of the Registered
Vol. 50. No. 7
NURSING PROFILES
Nurses’ Association of Ontario in 1930, Miss
Emory was elected president of the Canadian
Nurses’ Association and filled this office
effectively until 1934. In 1949 she became
chairman of the Nursing Advisory Commit-
tee, Toronto Branch, Victorian Order of
Nurses.
Miss Emory was made chairman of the
Nursing Committee, Ontario Division of the
Canadian Red Cross Society, in 1935 and
held this office until three years ago when
she became chairman of the National Nur-
sing Committee, C.R.C.S. In recognition of
all her energy and enthusiasm in this re-
spect she was awarded the Florence Nightin-
gale Medal in 1953 by the International Red
Cross, Geneva. |
A new interest has been added to all of
the committee work Miss Emory hopes to
continue — an attractive little bungalow
with a garden. Nurses everywhere will wish
her long years of happiness in her new
surroundings. |
“Irene Tola Shaw has taken over her
duties as superintendent of the Bowmanville,
(Ont.) Memorial Hospital after spending
nearly seven years as superintendent of the
Peel Memorial Hospital, Brampton, Ont.
A graduate of the Ontario Hospital, Brock-
ville, Ont., Miss Shaw had occupied admin-
istrative positions previously at Lord
Dufferin Hospital, Orangeville, and at the
Ontario Hospital in Cobourg.
A somewhat different form of honor was
conferred on Lena Polischuk by the Sas-
katoon Council of Women when she was re-
cently nominated as “citizen of the year.”
Contracting poliomyelitis while a student
nurse, Miss Polischuk completed her train-
ing despite the confining limitations of a
wheel chair and is now on the staff of the
isolation ward at the Saskatoon City Hos-
pital.
A Sarnia nurse who has a long record of
service, Mrs. Mary Elrick, was honored by
the Sarnia Business and _ Professional
Women’s Club when they dedicated a room
in the new General Hospital to her.
After graduating from the Sarnia General
Hospital, Mrs. Elrick engaged in private
nursing for 17 years then returned to her
alma mater as supervisor of the medical
department. She is a past district council-
lor of the Registered Nurses’ Association of
Ontario.
Sister Beatrice of the Protestant Sister-
hood of St: John the Divine has retired as
superintendent of St. John’s Convalescent
Hospital, Newtonbrook, Ont. The first super-
intendent, Sister Beatrice began her train-
ing in 1896 at the original St. John’s Hos-
pital, Toronto. The transfer to the conval-
escent hospital was made in 1937. Sister
Vera, assistant superintendent for many
years, succeeds her.
Sn Memoriam
Mary B. Beharrel, who graduated from
the Vancouver General Hospital in 1908,
died in November, 1953. ._
: * ¢ ;
Mrs. John (McCulloch) Benson, a grad-
uate of Lady Stanley Institute, Ottawa, died
suddenly at Edmonton on April 21, 1954, at
the age of 84. Following graduation, Mrs.
Benson took a post-graduate course with
the Victorian Order of Nurses. During her
years of service with the V.O.N.. she
organized branches in Halifax, Winnipeg
and Edmonton and opened a cottage hos-
pital at Aylmer, Ont.
: * * 6
Annie Laura Campbell, who graduated
from the Toronto General Hospital in 1913,
JULY, 1954
died at Toronto on April 13, 1954. Shortly
after graduation she enlisted with the
_C.A.M.C. She served in France with No. 4
Base Hospital, later serving on hospital
ships in Greece, Serbia and Salonika. Prior
to her retirement eight years ago she was a
member of tthe staff of the Toronto Public
Health Department.
* ¢ «8
Mary L. (Patterson) Cade, who grad-
uated from the Moose Jaw General Hospital
in 1918, died at Central Butte, Sask., in
May, 1954. |
* ¢ ®
Lucy B. Drummond-Hay, a former
member of the Queen Alexandra Jubilee
Nurses in Scotland, who was an honorary
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THE CANADIAN NURSE
parish nurse at Hondo, Alta., for 15 years,
died at Victoria on February 26, 1954, at the
age of 83. ; ;
* * *
Mamie (Brown) Hadfield, who grad-
uated from the Vancouver General Hospital
in 1916, has died.
* * *
Winnifred (Stewart) Jackson, who
graduated from the Vancouver General Hos-
pital in 1925, has died.
* *¢
Alice (Wardell) Lauder, who graduated
from the Vancouver General Hospital in
1906, has died. |
* € *
Margaret MacLellan, who graduated
from the Amasa Wood Nurses’ Training
School, St. Thomas, Ont., in 1905, died sud-
denly on April 4, 1954, in her 86th year.
Since her retirement 25 years ago, Miss
MacLellan had lived at Poplar Hill, Ont.
* * *
Doris (Burd) McCulloch, who grad-
uated from the Vancouver General Hospital
in 1929, died at Vancouver on April 3, 1954,
after a long illness, in her 48th year. Mrs.
“McCulloch took a deep interest in the work
of hospital auxiliaries and for a time was
president of their provincial organization.
* * *
Genevieve McDonald, a graduate of St.
Vincent de Paul Hospital, Brockville, Ont.,
died on April 29, 1954, following a_ brief
illness, aged 39. For a number of years Miss
McDonald was a head nurse at the Jewish
General Hospital, Montreal. At the time of
her death she was a nursing counsellor with
the Civil Service Health Division at Ot-
tawa.
Early ambulation does not mean sitting tn
the bedside chair. If walking is initiated
early in convalescence the patient has not
lost much strength and can usually ambulate
easily. If his convalescence has been stormy
he may need much support. On his early
excursions out of bed, he should be supported
by grasping him around the waist as he sits
on the edge of the bed. He can then be stabi-
lized as he steps to the floor and starts to
walk. At this time, he should be taught the
essentials of good standing and walking
Flora H. (Stevens) McQueen, who
graduated from the Winnipeg General Hos-
pital in 1918, died on March 28, 1954. Prior
to her marriage, Mrs. McQueen had served
with the Victorian Order of Nurses.
* * &
Mary Marjorie Mulligan, ‘a student
nurse at Hotel Dieu Hospital, Windsor,
Ont., died on April 13, 1954, following
brief illness, aged 20. |
_* * *
Marjorie Quinney, a graduate of St. -
Joseph’s Hospital, London, Ont., was killed
in the collision of the TCA North Star over
Moose Jaw on April 8, 1954. Miss Quinney
had been a stewardess with TCA for the
past two years.
* * *
Elizabeth (McCabe) Regan, who grad-
uated from St. Michael’s Hospital, Toronto,
in 1924, died on March 1, 1954. Mrs. Regan
‘engaged in private nursing for two years —
before her marriage.
* * *
Anne (Dolan) Scully, who graduated |
from St. Michael’s Hospital, Toronto, in
1908, died there on January 9, 1954. Mrs.
Scully was one of the first nurses to
volunteer her services in the disaster follow-
ing the Halifax explosion in 1917.
* *« * |
Muriel Isabel (Howard) Stinson, who
graduated from Royal Victoria Hospital,
Montreal, in 1927, died suddenly on January
10, 1954. Prior to her marriage she had
_served as night superintendent at Chambers
Memorial Hospital, Smiths Falls, Ont., and
as operating room supervisor in the Great
War Memorial Hospital, Perth, Ont.
posture. This will ensure him good body
balance as he walks, similar to that learned
in crutch walking. He should be encouraged
to take short steps with his feet not too
closely together. After he has become more
sure on his feet he may walk with the aid
of a chair which he can push ahead of him.
This chair should have a sufficiently high
back so that he can walk in an upright
position. |
— GERALDINE SKINNER in Nursing World
To be honest and faithful is to belong to the only aristocracy in the world — and the
smallest.
574
— ISRAEL ZANGWILL
Vol. 50, No. 7
Mews and. Echoes
_ from
Your NATIONAL OFFICE
The R.N.A.B.C. Moves
Y NOW THE Registered Nurses’ As-
B sociation of British Columbia will
be settled in to their new offices at
2524 Cypress Street, Vancouver 9.
Congratulations are certainly in order
_ as the green light was given them to go
ahead with their building plans just a
year ago. For a description of the facil-
ities, we quote from their April News
Bulletin: _ ;
Members and guests will enter a wait-
ing room which will be quiet, spacious,
and, when furnished, should be comfort-
able and attractive. Conferences and in-
terviews will take place in privacy, as
each member of the professional staff
will have her own office. Council and
committee meetings will be held in a
board room large enough to accommo-
date 35 people but which can be divided |
for smaller groups. Working space will
be ample for present and some addition-
al staff. A-soundproof workroom will
eliminate the noise of mimeograph and
addressograph machines and _ provide
adequate space for storage of supplies.
Permanent records, such as the register,
will be kept in a fireproof vault. A
small staff room and kitchenette will be
appreciated by all the staff and especial-
ly by the directory staff on evening and
_ night duty. ) :
These fine new quarters should pro-
mote greater efficiency on the part of the '
staff and should facilitate the work of
committees. The rental from the re-
maining space should carry the costs of
the building, including maintenance and
amortization of the mortgage. The build-
ing itself is conservatively modern and,
it is believed, will create pride of owner-
ship in our general membership.
Nurses’ Accommodation
in Winnipeg
A new building project in Winnipeg
is providing nurses from the General
Hospital with low rental apartments.
“limited dividend section of the Na-
tional Housing Act,” is said not to
resemble a nurses’ residence with the
usual reception rooms and community
facilities but is made up of two- and
three-room suites. These will rent
respectively for $40 and $50 a month.
Such a plan would appear to be one
solution to the serious problem of hos-
pital personnel finding suitable accom-
modation at moderate cost. Although
satisfaction through one’s work is said
to be the greatest factor in stabilizing
employment, nevertheless comfortable
and suitable housing can make the
problems seem less burdensome.
Conference at Queen's
In May nearly 40 nurses who are
connected with or vitally interested in
nursing education met together for five
days at Queen’s University, Kingston.
By means of informal discussions with
members of the faculty who were in
the field of general education, directly
or indirectly, they were stimulated to -
apply some of the principles of general
education to their own fields. This was
not a serics of lectures but an endeavor
to present ideas and principles which
are inherent in all forms of education.
There were no words of wisdom from
“nursing experts” but only the concept
that one cannot be in a group without
finding that each person in the group
knows more about some phase than the
others. Since nurses are a_ rather
strongly disciplined group, working
and often living in a traditional hier-
archy, it took several sessions of dis-
cussion to obtain the free expression of
opinion that was sought. As the con-
ference will be written up at length for
The Canadian Nurse at a later date,
_no attempt is being made here to pre-
‘sent its outcomes. It is sufficient to
say that the main issue — recognized
by all but still unsolved — is: What do
we wish to be the result of nursing
education? In other words, what do
The 50-suite block, built under the . nurses expect of nurses?
a
JULY, 1954 °*
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THE CANADIAN NURSE
We would like to sonmiaealate those
responsible for planning the conference
upon their departure from the usual in
choosing a leader. Alan Thomas, as-
sistant to Dr. Roby Kidd, director of
the Canadian Association for Adult
Education, went far in proving the
Nouvelles
Des LOGEMENTS POUR LES
INFIRMIERES DE WINNIPEG
A Winnipeg l’on projette la construction
d'une maison de rapport a loyer modeste pour
les infirmiéres des hopitaux généraux. Cet
immeuble, construit “d’aprés une clause spé-
ciale de la Loi Nationale de 1!’ Habitation,”
contiendra 50 logis. Il n’y aura pas de ces
salons communs que I'on trouve a l’ordinaire
dans les résidences d’infirmiéres. Chaque lo- —
gis contiendra deux a trois piéces qui se
loueront respectivement $40 et $50 par mois.
L’on croit par ce moyen diminuer les diffi-
cultés rencontrées par les hopitaux concer-
nant les infirmiéres. La satisfaction au travail
est un facteur important dans la stabilisation
du personnel; néanmoins un logis conforta-
ble trouvé au retour du travail aide a faire
oublier les tracas de la journée.
CONFERENCE D'ETUDE A QUEEN'S
L,,Université Queen’s de Kingston réunis-
sait en mai dernier 40 infirmiéres intéres-
Sant tout particulierement aux questions d’é-
ducation. Durant cinq jours elles discutérent
familiérement des principes généraux de
l'éducation pouvant s’appliquer aux infirmieé-
res. Il n’y eut pas une série de conférences
mais l'on tenta de présenter les idées et les
principes se rapportant au domaine de I’édu-
cation.
Il n’y eut pas d’énoncés didactiques donnés
par des spécialistes mais chacune réalisa
qu'elle ne peut faire partie d’un groupe sans
se rendre compte que chaque personne en
sait toujours plus long que les autres sur un
certain sujet. Les infirmiéres, étant un grou-
_ pe trés discipliné, habituées a vivre et a tra-
vailler sous une hiérarchie, ont éprouvé des
difficultés a donner leur opinion et il a fallu
plusieurs séances de discussion avant qu’elles
s'expriment librement. L’infirmiére Cana-
576
theory that an “able leader ‘ices not
need to be an authority in the field of
the specific discussions. An unbiased
“referee” 1s often able to analyze a
situation in a more farsighted manner
as he is not hampered by prejudice or
preconceived ideas.
et Echos
dienne donnera prochainement un compte-—
rendu de cette conférence ; nous ne nous éten-
drons donc pas sur le sujet. Qu’'il suffise de
dire que toutes ont reconnu que le fond de la
question est que “Quelle formation devons-
nous donner a l’infirmiére?” est demeuré
sans réponse. En d'autres termes: “Nous les
infirmiéres qu’attendons-nous des infir- —
mieres ?”’
Nous félicitons les organisatrices de cette
conférence qui contrairement a 1’ordinaire
n’ont pas pris pour chef un membre de la
profession. M. Alan Thomas, assistant du
Dr. Roby Kidd, directeur de 1’Association
Canadienne pour I’Education des Adultes, fut
choist. Il a prouvé qu'un homme qualifié, un
chef habile qui ne fait pas partie du groupe
intéressé, peut trés bien réussir. “L’arbitre”
est plus souvent en mesure d’analyser une
situation et de prévoir, mieux | que les partis
intéressés.
L’ASSOCIATION DES INFIRMIERES
ENREGISTREES DE LA COLOMBIE-BRITANNIQUE
EST DEVENUE PROPRIETAIRE
L’A.LE.C.B. est a s’installer dans l’immeu-
ble qu'elle commencgait a construire il y a un
an. Pour la description des locaux voyez ce
qu’en dit leur Bulletin de Nouvelles d’avril:
“En entrant, les membres de l'association
et les visiteurs trouveront une salle d’attente
vaste et tranquille et qui, une fois meublée,
présentera un aspect accueillant. Les entre-
vues se feront privément et chaque membre
du personnel professionnel aura son bureau.
_ Les assemblées auront lieu dans une salle
pouvant contenir 35 personnes. Cette salle
peut se subdiviser pour accommoder des
groupes plus petits. L’espace réservé aux
autres membres du personnel est suffisant
pour les besoins actuels et ceux .de I’avenir.
Une salle de travail a l’'épreuve du son éli-
minera les bruits des machines a polycopier,
Vol. 530, No. 7
854
‘JULY, 1954
PRESCRIBED FOR MORE CANADIAN BABIES
Doctors Agree
on Carnation
So many doctors in
Canada agree that
Carnation Evaporated
Milk is the food of choice
for the bottle-fed baby.
THEY HAVE FOUND
that Carnation is
particularly digestible.
And that a Carnation ©
formula, giving all the
nourishment of good, fresh
milk plus 480 units of .
Vitamin D per pint, is
excellent for the normal
baby as well as for difficult
cases — quintuplets,
quadruplets, and triplets.
Carnation Evaporated Milk is
. convenient and economical for
the mother to use. It meets ad-
mirably the physician’s require-
ments in a milk for the baby’s
bottle. Available everywhere.
THAN ALL OTHER BRANDS COMBINED
THE CANADIAN NURSE
a adresser et logera les magasins pour la
papeterie et l’outillage. Les dossiers perma-
nents, tel que le registre, seront gardés dans
des voutes a l’épreuve du feu. En plus une
petite salle de repos et une cuisinette feront
la joie de tous les membres du personnel,
particuli¢rement des membres chargés du
registre des infirmieres du_ service privé,
lorsqu’elles travaillent le soir.
“Ce bel édifice contribuera a faciliter le
travail du personnel et aidera également les
divers comités. Une partie de I’immeuble est
loué et les loyers suffront pour défrayer le
cout de la construction, l’entretien et le rem-
boursement de l’emprunt. L’édifice a un ca-
ractére conservateur tout en étant moderne
et fera l’orgueil des membres de Vassocia-
tion qui en sont les propriétaires.”
_ Encouraging Breast Feeding
In Nursing World of November, 1953,
Reva Rubin describes the service being given
in England throughout the antepartal and
postpartal periods, to encourage breast feed-
ing. The care includes: early examination,
diagnosis, and prophylaxis of the breasts;
instruction of the mothers; and careful
follow-up of those mothers presenting pro-
blems in lactation. The procedure followed
at the British Hospital for Mothers and
Babies at Woolwich is typical :
Each mother who registers for obstetrical
care is seen at her first or second antepartal
visit by a skilled obstetrical nurse assigned
to breast care. A notation is made of the
examination findings, diagnosis and _treat-
ment. If intensive follow-up is needed, a
colored star is attached to the record. It
then becomes a part of the antepartal chart
and after delivery it is added to the infant’s
chart.
Breasts are initially Jeanine for size,
vascularity, suppleness of the skin, and con-
dition of the nipples. The suppleness of the
skin varies from mother to mother — the
more supple the skin, the greater is the
potential for expansion. Conversely, the
tighter the epidermis, the greater the ten-
dency for painful engorgement. Any devia-
tion from normal in the nipples is noted.
One that retracts on compression of the
areola will have intensive treatment and
follow-up. Mothers with lightly pigmented
areolas usually experience tenderness . or
pain on nursing.
A history of previous lactation experience
is taken from multiparous mothers. A culture
is taken if there is any history of mastitis.
Half of the mothers have been found to be
capable of successful nursing without further
treatment.
No treatment is instituted for those
mothers whose diagnosis and prognosis for
breast feeding is good but they are seen by
the same nurse four weeks before the
expected date of confinement. At this time
areolar expression is demonstrated to them
and they are advised to do it daily for five
minutes. The object of routine prenatal
areolar expression 18 to obtatn a daily flow
of colostrum that is neither sticky nor thick.
It has been proved that colostrum that is
not drawn off will cause blockage of the
ducts. The breast massage movement is
included to give the mother comfort and
skill in the handling of her breasts. In those
whose breast skin is not sufficiently supple,
this treatment is started two weeks earlier.
Mothers with retracted, flat, or inverted
nipples are seen during the fourth month
and fitted with nipple shells. These fit tightly
over the areola and leave an opening for the
nipple. By gentle pressure on the nipple it
becomes, over a period of time, protracted.
The shells are made of glass and are very
comfortable.
The nurses continue their interest in
breast feeding throughout the lying-in
period. To give them the time that is so
necessary for the instruction, mothers who
deliver on the same day are dispersed to
different wards. During the first 48 hours
after delivery, babies are put to the breast
for one or two minutes, for a practice not
a feeding period. If he needs feeding, the
infant is given the expressed colostrum. The
nurse in charge examines the mother’s
breasts before each nursing period for en-
gorgement or nipple tenderness. |
The mothers are taught to empty their
breasts after each nursing period. This
stimulates lactation and provides an abun-
dance of milk. Treatments and the amount .
of expressed milk are recorded.
Vol. 50, No. 7
rd
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JULY, 1954 | , 579
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ra
How to Keep Your Teeth
E HAVE HEARD a lot lately about fluorine.
W The chemical has been introduced
into drinking water because it is thought
that it might help us — particularly the
children — to keep our teeth longer. Al- -
though it is too early to say what the
result may be, the evidence so far seems
to show that children who drink water with
fluorine in it have fewer cavities than those
who drink water without it.
The mouth is a kind of chemical factory.
It worked more efficiently in primitive times
than it does today. Even now, people in
areas that are not highly industrialized have
far less trouble than we do with their
chemical output.
Teeth are the chief sufferers from. the
attacks that the acids we produce in our
mouths make upon us. The most common
' of these acid-makers is a group of bacteria
that brings about fermentation of sugar and
starches, releasing destructive acids to eat
away the protective enamel of the teeth
and to lay the tissue beneath open to infec-
tion. These are the same organisms that
turn milk sour and ferment fruit.
Primitive people do not eat as much acid-
producing food as we do and their food
needs more chewing than ours. Chewing
polishes the teeth, clearing away those
particles which, if left between the teeth,
stir the acid-making bacteria into action.
Tooth decay is a disease because it de-
stroys normal tissue. It does not command
dramatic headlines and it is not found on any
list of chief causes of death. Yet it is the
most widespread malady in the world. It can
lead to intense pain, a toothless mouth,
facial disfiguration, and to ailments in other
parts of the body.
Professor Guttorm Toverud, dental health
consultant for the World Health Organiza-
tion, believes that nearly all young people
in industrialized areas suffer from tooth
decay. Almost all their elders suffer, in
addition, from disorders of the gums and
the body structures supporting the teeth.
During World War II the U.S. Army
found that more conscripts were rejected
for dental disorders than for any other
cause. In New Zealand, nearly half of the
young men called up had artificial teeth
and one-fifth were toothless.
580
The official view now is that it is hopeless
to try to cope with the problem merely by
filling cavities as they occur. The American)
Dental Society, for example, has estimated
that if all the dentists in the U.S. worked
at full speed repairing teeth alone, there
would be six new cavities for every one
filled. While the position is serious, medical
science does not despair of finding a solution
as it has for so many other problems.
Research workers are concentrating on find-
ing preventives for tooth decay. Some
progress has been. made, though much more
remains to be done. The enamel-destroying —
acid is formed with very great speed — in
fact, within five to 20 minutes after food
has entered the mouth. We can help, there-
fore, by brushing our teeth immediately
following meals, before the acid has been
liberated.
Some people seem to be immune from
decay. They have the capacity of producing
in their mouths a natural ammonia com-
pound that prevents the formation of acid.
Attempts have been made to reproduce this
natural armor-plating by using ammonia-
liberating dentifrices. Should any effective
substance be found, it will probably be
applied with the toothbrush, so we can see
how necessary it is for everyone to use the
toothbrush properly and regularly.
Bad as tooth decay is, it 1s usually less
serious than the diseases that affect the .
gums and the bony tissues surrounding the
teeth. Infections such as ‘gingivitis and
pyorrhea are among the chief causes of loss
of teeth. They occur mainly in elderly or
middle-aged people but they can attack
children and young people. It was true in
the past that pyorrhea was a disease from
which no sufferer was cured until he had
lost all his teeth. Fortunately, this is no
longer the case. This condition has been
“successfully treated with the new antibiotic
drugs.
The best advice, at the moment, if you
wish to keep your teeth, is to use the tooth-
brush faithfully and well, visit the dentist
regularly, and keep to as wholesome a diet
as possible.
—SIS: Medical Features
* ¢ 8
Vol. 530, No. 7
ae 5
Gerber’s Meats
for Babies
f
i 7 | Careful processing of Gerber’s Strained Meats re-
mibritive velus! —> sults in high retention of valuable meat-protein,
B-Vitamins and minerals.
as easy to digest as milk.
- i “D: “Ae. { | Free of sinew and connective tissue, with a low fat
| 4 qpthility —>> value (never more than 5.5%), Gerber’s Meats are:
; All solid meat with just enough broth added to give
“ia. Meat! > the smooth, easy-to-swallow consistency babies like. —
7 | ° | | Gerber’s Meats are made from selected cuts, graded
uabcty ! —_———-> by Government Meat Inspectors.
6 Strained Meats to stimulate little appetites. Beef
Bacon, Lamb, Veal, Pork. Also: 3 Junior Meats for
tots learning to chew: Chopped Beef, Chopped
Liver and Bacon, Chopped Veal. —
7 Mealtime Vonicty!—> and Beef Heart, Beef and Beef Broth, Liver and
Gerber's
BABY FOODS
Gerber-Ogilvie Baby Foods Ltd.,
Niogora Falls, Canada
5 CEREALS © 47 STRAINED & JUNIOR FOODS, INCLUDING MEATS
JULY, 1954 | z * | 631
Student Nurses
Peptic Ulcer
IRENE NorpDWICH
Iss GORMAN, a 39-year-old office
worker, was admitted to the public
ward on March 25, complaining of
nausea, vomiting, and intermittent pain
in the episgastric region that increased
In severity during the night. Pallid and
very emaciated, Miss Gorman had first
noticed a burning sensation and slight
pain after meals six months previously.
Her physician prescribed medication
and a special diet which was carefully
followed. After gaining five pounds,
she felt so well she stopped taking her
medicine and discontinued the diet. A
month later, vomiting started again.
She would feel well for days, then be-
. come exceedingly nauseated. The
doctor placed her on a strict fluid diet
-and, as soon as a bed was available,
-sent her to hospital.
DIAGNOSIS
A barium series of x-ray plates re-'
vealed a duodenal ulcer with pyloric
obstruction.
A peptic ulcer is an excavation
formed in the mucosal wall of the
stomach, in the pylorus or in the duo-
denum. It is due to the erosion of a
circumscribed area of the mucous mem-
brane. This erosion may extend to the
peritoneum. Peptic ulcers are more apt
to be in the duodenum than in the
stomach but, whether on the gastric or
the duodenal side, most of them occur
near the pylorus, a few being situated
in the pylorus itself. As a rule they
occur singly but there may be a num-
ber of them present at once. |
The etiology of peptic ulcer is poorly
understood. The disease occurs with
the greatest frequency between the ages
of 20 and 40 but has been observed in
childhood, even in infancy. It seems to
Miss Nordwich is a recent graduate
of the Misericordia General Hospital,
Winnipeg.
develop in persons who are emotionally
tense but whether this is the cause
or effect of the condition is. uncertain.
Predisposing factors most important in
the development of peptic ulcers are:
irregular eating habits, overindulgence
in alcohol, and the season of the year,
for this disease tends to appear and
recur must commonly in the spring
and the fall.
PERSONALITY
Brought up on a farm, Miss Gorman
had to work hard to support herself
during her earlier years. After complet-
ing Grade XI she took a job as a
domestic and also worked in a laundry
while she prepared herself for some-
thing better. She has held her present -
position for six years. She enjoys her
work in the mail order department
very much and has had no difficulties
with her co-workers or superiors. De- .
scribing her work as “quite respon- |
sible,” since she is “the worrying kind”
Miss Gorman often became quite tense
and nervous if the figures did not add
up correctly.
On the surface she appeared to be
a very quiet, unemotional: person who
_approached the prospect of an oper-
ation with a grim determination to “get
it over with.” On closer acquaintance -
she revealed a fine sense of humor and
a better than average intelligence.
Though she worried about her slow
recovery and convalescence she was
very cooperative and unselfish. She
was assured of her job when she was
well enough to return to work and an
employees’ welfare plan helped her
financially throughout her illness.
PRE-OPERATIVE CARE
After admission to the hospital con-
servative treatment was _ instituted.
Miss Gorman was put on a strict con-
valescent sippy diet later supplemented
Vol. 530, No. 7
re
- Problem:
Which contains the most protein ?
Answer: 1 Ib. of Borden's Starlac contains
almost double the protein of 1 lb. of edible
beef! Yet Starlac costs under 40¢ a pound.
The high protein content and relatively
low cost of Borden’s Starlac make it
_ valuable in cases where a high protein diet
is prescribed. :
What is Starlac? Starlac is dry skim milk
—a creamy white powder made by removing
- most of the water (97.5%) and fat (997%)
_ from high quality, fresh whole milk. ‘It
takes about 11 pounds of fluid skim milk ©
You can safely recommend Borden’s Starlac
wherever a high protein diet has been prescribed.
If you would care to learn more about this ‘wonder
- milk’, just send a postcard with your name and
address to The Borden Company, Formula Foods
Dept., Spadina Cresc., Toronto and our booklet
““STARLAC IN HIGH PROTEIN DIETS” will be
sent you. —
— Bordens
JULY. 1954
eee
to make one pound of Starlac. Starlac
thus contains about 11 times the food
value of liquid skim milk, (except thiamine
and vitamin C, slightly reduced during
processing.)
Easily and quickly reliquefied, a one
pound tin of Borden’s Starlac makes 4
quarts of delicious milk. It also combines
well with other ingredients—makes possible
recipes containing large amounts of protein
with only slight increases in bulk in the end
product.
STARLAC
K ve i
“ADERED SKIM *°
THE CANADIAN NURSE
by a bland ulcer diet of 2,200 calories.
Additional vitamins were given orally
in capsules and as injections. Ampho-
jel after each meal helped to reduce
‘pain after the nauseating effect was
overcome. This treatment continued
until April 3, when the doctor decided
to operate. By that time vomiting had
ceased completely, pain was reduced
greatly and the patient had gained
considerable strength. Two evenings
before the operation her stomach was
lavaged and on the morning of surgery
a Levin tube established.
Laboratory findings: WBC 5,050 nor-
mal — RBC 5,160,000 normal — Hb.
, 80%. Urinalysis: Negative except for
phosphate crystals. Gastric analysis:
Fasting total acidity 3, after test meal
35. Free HCI fasting 0, after meal pre-
sent, otherwise negative. Stool for occult
blood, negative.
X-ray report: Chest negative. Stomach
normal. Duodenal cap grossly deformed
with very small ulcer crater close to
base, approx. 1 mm. in diameter. Sum-
mary: Duodenal ulcer without retention.
POST-OPERATIVE CARE
On April 4 a gastroenterostomy and
vagotomy were performed. On return
from the operating room gastric suc-
tion and intravenous were working.
No oral nourishment was taken for the
following four days. On April 8, the
suction was clamped off for six hours
after which time the stomach was as-
pirated and 800 cc. of greenish content
obtained. Miss Gorman had a bland
diet dinner that day. Suction was re-
established and continued till April 25, |
being clamped off in changing intervals
according to her tolerance. Nourish-
ment-was supplied chiefly by intra-
venous therapy and _ whole blood
amounting to 4,000 cc. daily. The in-
take and output were well balanced.
Beginning April 14, small meals
were introduced such as junkets, milk,
baked potatoes, soft cooked rice, melba
toast, poached eggs, custards. The
main concern was that the stomach
did not empty properly through the
new opening. The surgeon called a col-
league in consultation. His report
reads:
This patient is now 19 days post-
Soi
operative. No passage of food or gastric
secretion into jejunum — perhaps some
flatus last evening while up. Patient is
in fairly good condition in spite of this
but biochemistry probably affected by
some dehydration. X-ray does not show
any actual mass in stomach (intussus-
ception). I would favor having patient
sit up a bit, give her soft solids and
prescribe sodium luminal gr. 1 by hypo.
If her condition does not improve, sur-
gery might have to be repeated.
Laboratory findings: Serum protein:
total protein 8.25 g/100 cc.; globulin 3.8
g/100 cc.; albumin 4.45 g/100 cc.; so-
dium and potassium S — 148.8 m. Eq/1.
P.3.07 m. Eq/l. CO; combining power
68 vol. % (Normal — 50-75 vol.%):
serum chloride 595 mg.% (Normal —
585-620 mg.%) ; hb. 125%. .
Barium meal — stomach dilated and
at onset of. the examination, even on
second day, there is gross retention. At -
no time was any barium forced through
the stoma of the gastroenterostomy. All
the flow through pylorus and there is
demonstrated marked dilatation of the
third portion of the duodenum and to a
lesser degree some dilatation of the
second portion. Gross cap deformity
exists without any apparent crater
visible. Reverse peristalsis in duodenum
~ was noted.
NuRSING CARE
Environment: It is a well known
fact that many patients with acute,
proved ulcer symptoms derive complete
temporary relief from termination of all
connections with environmental anx-
lety-producing factors, unfavorable -
diet and poor hygienic conditions. Per-
fect conditions are rarely obtained, par- -
ticularly those connected with internal
emotional problems. The nurses’ suc-
cess will depend on teaching the patient
to realize the importance of and ad-
herence to a_ regular, sound diet
routine, good hygienic habits, necessity _
for relaxation, as well as the avoidance
of fatigue and worry.
General nursing care: To promote
the full therapeutic effect, Miss Gor-
man was put on complete bed rest and
sedated comfortably. Particular atten-
tion was given to skin care since she
was expected to lie quietly. Later oc-
Vol. 50, No. 7
oe ree em oe
PUBLIC HEALTH NURSES,
REGISTERED NURSES
and NURSES’ ASSISTANTS
Wanted for —
Federal Indian Health Serstees
in hospitals at
Oshweken, Manitowaning, Fort William, Moose Factory and
Sioux Lookout, Ont.; Hodgson, Pine Falls and Norway House,
Man.; Fort Qu’Appelle, North Battleford, Sask.; Edmonton, Hob-
bema, Gleichen, Cardston, Morley and Brocket, Alta.; Sardis,
Prince Rupert and Nanaimo, B.C., and in Public Health positions at
outpost Nursing Stations and Health Centres.
SALARIES:
(1) Pustic Heattu Nurses, for field duty: $2,730 to
~ $3,300 per year, depending on qualifications.
(2) HospitaL Nurses: $2,580 to $3,120 per year, de-’
- pending on qualifications.
(3) Nurses’ ASSISTANTS AND Practical Nurses: Up
to $185 per month, depending on qualifications.
- ©@ Room and board in hospitals — $30 per month. Statutory holidays.
Three weeks’ annual leave with pay. Generous sick leave credits.
Hospital-medical and superannuation plans available. Assistance may be
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® Higher salary rates and special compensatory leave for those posted
to isolated areas. . ,
For interesting, challenging, satisfying work apply to:
Superintendent of the hospital in which you are particularly interested
| or to
7 Chief, Personnel Division
Department of National Health and Welfare
Ottawa, Ontario.
_ ‘ULY, 1954
yO, ee . . >
Cr Oe oe ae a a a oS
THE CANADIAN NURSE
cupational therapy was introduced.
Psychological approach: The often
agonizing ulcer pain, and the monotony
of a bland diet tended to discourage
Miss Gorman before her operation. The
nurse had to watch for signs of it, since
the patient gave little evidence of her
feelings. However, it was obvious that
reassurance and a chance to talk things
over freely with the nurse were greatly
appreciated. The somewhat delayed re-
covery after the operation added to the
strain. Miraculously, when her mental
resistance had reached a low point the
turning point came. The new opening
in the stomach began to work, thus
avoiding another operation. This in
itself was the best medicine that could
have been provided.
Personal care: Before the operation
the most important factor was to follow
rigorously and punctiliously the diet»
and medication schedule day and night,
to keep the patient free of pain by ob-
serving symptoms and time of pain,
and adjusting the antacid therapy.
After the operation a constant watch
on the gastric suction and administra- _
tion of intravenous fluids were neces-
sary. A very accurate intake and out-
put record had to be kept. Also, any
passage of feces through the bowel was
of importance as it indicated the suc-
cess or failure of the operation.
Medications and diet: 40 mg. of pot.
chloride and one ampoule of Folbesyn
daily into 1 Vs. Demerol 100 mg. for
Book Reutews
Storming the Citadel — the Rise of the
Woman Doctor, by E. Moberly Bell, 200
pages. Longmans, Green & Co., 215 Vic-
toria St., Toronto 1. 1953. Price $3.75.
Reviewed by Matilda R. Dhtederschs,
Providence Hospital, Moose Jaw, Sask.
This book was written at the suggestion
of the Dean and Governors of the Royal
Free Hospital, School of Medicine, London,
England. It is an account of the struggle
for recognition of women in the medical
profession. The book is authoritative since
pain as required; Uricholine one
ampoule subcutaneously as ordered;
Sodium luminal gr. 1 per hypo. b.1.d.;
five bottles of whole blood between
April 4 and 25; 3,000 cc. glucose daily.
RESULTS
- Jt remains to be seen whether the |
operation was a complete success. The
indications are favorable. A supportive
dietary treatment will have to be con-
tinued at home for some time. Through
health teaching Miss Gorman came to
realize that her eating habits and choice
of food called for improvement and is
very willing to revise them. - The
prognosis is good if definite care will
be .exercised; otherwise the ulcers are
almost certain to recur.
No social or occupational readjust-
ment was necessary. Since Miss Gor-
man is an intelligent, very cooperative
and willing woman, the dietary prob-
lems should be easily solved. The
patient realized that any recurrence of
symptoms should be reported immedi-
ately to her doctor as early treatment ©
assures best results.
A study of this case from all angles
of nursing and medicine has taught
me a great deal about the close inter-
locking relationship of the anatomical
and mental physiology in the human
being, ;and its importance in adjusting
nursing care and treatment. The Ro-
man said: “In a healthy body lives a
healthy soul.”
the author gives reliable sources from both
official records and unpublished material.
The status of women in the Victorian Age
is surveyed and the story of their gradual
emergence, through their own efforts, from
the home into the fields of education, jour-
nalism, and employment, is briefly told. Then
the author contrasts the characters of three
outstanding women — all famous pioneers in
the era of the rise of the woman doctor. A
description is given of the attempts, with all
their disappointments, made by these wornen
Vol. 50, No. 7
to be admitted to a medical school, to re-
ceive clinical instruction, and to be placed on
the Medical Registry. |
In the closing chapters, the author con-
solidates the gains made in the latter years
of the 19th century. She relates the oppor-
tunities offered to medical women by the
outbreak of World War I and how, in_the
post-war period, they filled the gap resulting
from war casualties. The federation of the
various associations for medical women and
its acceptance by the British Medical hal
sociation closes the account. |
In this book the author has succeeded not
only in writing a fascinating story but also
in assembling a mass of facts helpful to any-
one wishing to trace the rise of the modern
woman and her entry into fields outside. the
home.
Scientific Terminology, by John N. Hough.
231 pages. Rinehart & Co. Inc., 232 Madi-
son Ave., New York City 16. 1953. Price
$3.50. |
Reviewed by Adelaide Haggart, Director,
Nursing Education, Royal Victona Hos-
pital, Montreal.
This book has been written ‘stanly for
_ those who are teaching scientific terminology
or for students who are studying such a
course. The book progresses from simple
material to more complex. As a reference, it
will be helpful to those who can recall con-
siderable Latin. For those who have forgot-
_ ten much or all of their Latin studying it
would mean considerable work. The index
will be of particular value to those who use
-it for reference purposes.
' Considering this book from the point of
view of its usefulness in nursing, I realize
that there is no time for such a course.
~ However, it would be most beneficial for
teachers to have a good background of such
material so that they can make terms more
meaningful to their students. Relatively few
terms are taught or required in anatomy and
pathology or pharmacology. Principles are
taught in microbiology rather than lists of
names of organisms. Everyone who studies
chemistry has to become familiar with chem-
ical nomenclature which has been stand-
ardized within recent years.
Far too few people have a sound apprecia-
tion of the English language and its origin
from Greek and Latin as well as the influ-
ence of French upon it. After reading this
book one wonders why the studies of the
JULY, 1984
BOOK Ree
NURSES PREFER
sure its
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About January 1, 1955
ASSISTANT DIRECTOR OF
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NURSING ARTS INSTRUCTOR
C.S.R. SUPERVISOR
O.R. SUPERVISOR |
SUPERVISORS—
MEDICAL & SURGICAL
CLINICAL INSTRUCTORS
_ Full details concerning these positions
may be obtained by writing: Directer ef
Nursing, University Hespitel,
Son.
Seskateen,
~
nae on eae st
* tek Leg Ta EY wh ti
-
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Pra
. re oe
Fa. we “ps
o es 4g
i Sat are
i
. " a*
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iM Ly
_& er ey >
a
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8 Ee Oe wit a. *
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THE CANADIAN NURSE
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above languages are not made more vital and
useful with respect to our own language.
Such a course in scientific terminology
would be of great interest to a student who
has secured a basic knowledge of Latin or
Greek before she delves far in the sciences.
Introduction to Medical Science, by Gulli
Lindh Muller, M.D., and Dorothy E.
Dawes, R.N., M.A. 609 pages. McAinsh
& Co. Ltd., 1251 Yonge St., Toronto 5.
3rd Ed. 1953. Price $4.75. .
Reviewed by Olive Wilson, Clinical In-
structor in Medicine, Royal Jubilee Hospi-
tal, Victoria, B.C. a
The authors have accomplished their aim,
in this third edition, of bringing us up to
date on the rapid advancement of medical
science. The book provides a good basic
background, covering causes of disease,
methods of diagnosis, treatment, preventive
measures and control. The newer methods
have been carefully incorporated discarding
outmoded practices.
A new section has been added on Geria-
trics, which is becoming more important —
today with the lengthening of the life span.
In the chapter, Examination of the Patient,
a complete case history has been added. This
will give the student a better insight into
the correlation of the hospital team.
The organization of the health programs
— federal, regional, community, industry,
home, and the individual — have been dis-
cussed in a clear, concise manner showing
their interdependence. The control and pre-
vention of disease have been dealt with in °
relationship to the World Health program.
The section on antibiotics has been entirely
revised, new ones added, keeping us abreast
of the rapid advancement of this field.
The style of the book is clear and -to the
point. It would be an asset to the library of
any school of nursing for both the instructor
and students.
A Handbook for Nursery Nurses, by A.
B. Meering, S.R.N. 555 pages. The Mac-
millan Co. of Canada Ltd., 70 Bond St.,
Toronto 2. 2nd Ed. 1953. Price $4.00.
Reviewed by Mrs. Christine Senger, Head
Nurse, Kootenay Lake General Hospital,
Nelson, B.C. <
This is a book worthy of careful study
by both nurses and mothers. The author has -
. successfully covered the major aspects of
normal healthy child development along with
Vol. 30, No. 7
VICTORIAN ORDER OF NURSES
the diseases that are more prominent in
childhood. She not only covers the specific
methods of treatment but enlarges on the
dietary and mental outlooks of both the well
and the invalid child.
Miss Meering has written with clarity and
interest. The simplicity of the information
would be of great benefit to the average
mother and I would recommend it as.a most
comprehensive reference for the different
phases of growth and development.
Victorian Order of Nurses
The following are staff changes in the
Victorian Order of Nurses for Canada:
Appointments — Rouyn-Noranda: Mrs.
Mary Coté (Sacré-Coeur, Hull, Que.). Sas-
katoon: Mary Ann Petrone (St. Joseph's
Gen. Hosp., Port Arthur). Winnipeg:
Anastasia Sokulskt (Winnipeg Gen. Hosp.).
Transfer — Thérése Gaudette from La-
chine to Pointe Claire, Que.
* ¢ &
Two of aluminum’s main attributes, light-
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anodized aluminum and canvas stretchers.
Weighing only 15 pounds, this lightweight
stretcher folds into a compact and easily
stacked bundle when not in use, while its
lightness in operation enables the stretcher-
bearers to work even in the most rugged
terrain. — The Alcan Ingot
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Institute on Nursing Education
HE CANADIAN CoNFERENCE of Catholic
Schools of Nursing held an institute in
Montreal when facilities were provided by
the new Maisonneuve Hospital school of
_ nursing. The program was led by Rev. Henri
Légaré, O.M.I., executive director of the
Catholic Hospital Council of Canada, and
Sister Denise Lefebvre, s.g.m., chairman of
. the Canadian Conference of Catholic Schools
of Nursing. More than 150 Sisters attended —
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THE CANADIAN NURSE
“BUT NURSES
ARE ALWAYS
IN DEMAND”
Maybe so — but will you want to go
on nursing forever? You may marry,
but if not, and you continue your
nursing career, some ‘day you will
wish to retire and possibly travel. Life
insurance is the best method of build-
_ ing your own retirement income and
saving for the future. For details of
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The sooner you start,
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THE
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AATERS GO ONTARIO
from nine provinces of Canada, with repre-
sentation from 71 schools of nursing.
The aim of the institute was to provide
an opportunity for the delegates from the
various localities to study the present trends
in nursing education which affect Catholic
schools of nursing throughout the country.
General sessions were held each morning
and in the afternoons small work groups dis-
cussed various aspects of the general pro-
blem. Much was gained from this exchange
of ideas and experience, largely because
everyone had an opportunity to participate
"- an the discussion.
The general topic — the Catholic school
of nursing — was viewed from three aspects:
systems of education, teaching staff, and
student nurses; its relations with other
organizations, chiefly the hospital and the
various professional organizations; and
finally with reference to the future of nurs-
ing) education.
The greatest amount of study was allotted
to the school itself. The religious and moral
education of the student nurses was stressed
and the obligation of the school to provide
opportunity for development of the student
as a whole person. Nursing education that
is based on Christian philosophy recognizes
the spiritual, intellectual, emotional, physical,
and social needs of the student. A lengthy
and detailed paper on the organization and
content of a course in medical ethics provided
a basis for considerable discussion.
The preparation and availability of teach-
ing personnel is a general problem. Though
no definite solution was offered, many sug-
gestions were made. The most useful way
to meet this need seemed to be by making
scholarships available to interested and suit-
able nurses, with a definite commitment to
return to the school providing the funds for
a period of time as an instructor.
~“The Psychology of Human Relations” by
M.L.T. Dayhaw, Ph.D., professor at the
University of Ottawa, reviewed the impor-
tant points that contribute to good morale.
Some of the highlights included discussion of
incentives to work, consideration of individ-
ual differences, and the need of each individ-
ual to be aware of the organizational pattern
and berauonshipe of all within the organiza-
tion.
Among the various systems of nursing
education that were discussed were: the
two-year program, the block system, cen-
tralized schools, centralized teaching pro-
Vol. 50, No. 7
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grams, and teaching of auxiliary workers.
-"- Miss Margaret Foley, M.Sc., nursing educa-
tion secretary of the Catholic Hospital
Association of the United States and Cana-
da, gave a clear and concise description of
central schools, their a@vantages and dis-
advantages, and the difference between these
and a centralized teaching program. She
stressed that centralization 1s a means to-
wards the improvement of educational pro-
grams by the pooling of resources. It 1s not
- a cure-all but a technique that is useful in
some situations, undesirable in others.
- A forum on the social formation of the
student nurse occupied one evening session.
Many of the Sisters described their pro-
grams for social activities. It was generally
agreed that a committee of students, with
. faculty advice, can plan and inaugurate a
satisfactory program according to the local-
ity and facilities available. Its necessity in
‘the life of a student nurse is quite obvious.
- School-hospital relationships were dis-
cussed from the point of autonomy of the
school, financial status — including an’ in-
dependent budget — and relationships of
nursing education and nursing service. Pat-
terns of organization were discussed in
regard to the latter but no agreement was
~ reached as to which is preferable.
JULY, 1954
we oes
On
hae 7
The discussion on professional relationships
pointed out the necessity of all nursing
Sisters actively participating in their na-
tional, provincial, and local professional
nursing organizations. Student nurses’ as-
sociations were briefly commented upon.
Teamwork and non-professional personnel
also occupied an important place in the
matter of professional relationships.
The work of international organizations to
relieve poverty, illiteracy, and misery was
ably presented by André Renaud, O.M_I.,
who worked with UNESCO. He pointed out
that through the Economic and Social Coun-
cil, a non-political body, specialized agencies
have been set up to assist millions towards
higher standards of living and culture. The
‘nfluence of the Christian nurse through
WHO cannot be overestimated.
Nursing education of the future is of
concern to all. There are many trends and
many experiments in different directions. It
is necessary for all schools of nursing to
keep abreast of the times in order to
meet the changing patterns of medical care
by an adequate preparation of the nurse of
tomorrow.
Sister M. Fericrras, M.Sc.
_ Director of Nursing
St. Mary's Hospital, Montreal
‘
Soi
FtteeteeeeE eee Hews Totes —
+ OPPORTUNITIES FOR > —
+GRADUATE NURSES+
IN THE
RCAF
+t ht
CALGARY |
Holy Cross Hospital
The annual School of Nursing Day was
held in May and more than 150 students
registered from Calgary high schools, as
well as from many other smaller centres.
Several teachers were present. The student
nurses conducted tours of classrooms, labora-
tories, demonstration rooms, nurses’ resi-
dence, several wards, and special services.
Sisters and instructors served refreshments.
+++ ++
- BRITISH COLUMBIA
LANGLEY PRAIRIE
were guests of honor at the annual dinner
Bursary students L. Sater and R. Marron
NEWS NOTES
xa Erg ory
SCHOOL for GRADUATE NURSES
AGI UNIVERSITY
PROGRAM LEADING TO THE DEGREE OF BACHELOR OF NURSING
Two-year program for Graduate Nurses holding McGill Senior Matriculation
(or its equivalent) or three-year program for candidates holding McGill Junior
Matriculation. Students may elect to major in: |
Teaching & Supervision in Hospitals & Schools of Nursing.
Administration in Hospitals & Scheols of Nursing.
- Supervision & Administration in Public Health Nursing.
PROGRAM LEADING TO A DIPLOMA
Graduate Nurses who are candidates for the diploma must possess either
_ McGill Junior or Senior Matriculation standing or equivalents. Candidates |
may elect to major in:
Classroom & Clinical Teaching in Schools of Nursing.
New experiences and new fields for
nursing—across Canada and overseas—
are opened to the graduate nurse who
enrols and serves as a Nursing Sister in
the Royal Canadian Air Force, with
opportunities foc an interesting and
rewarding career. o .
Duties include clinical and operating
foom supervision, staff positions, in-
struction of medical assistants, general
pee health work on RCAF stations,
ght nursing and possibly para-rescuc
nursing.
Accepted applicants are granted a Short
ice commission and receive regular
Force officer rates of pay—with an al-
lowance for officers’ uniforms; nursing
uniforms, food, living accommodation,
ce a important benefits are pro-
vi .
Openings for Nursing Sisters are limited,
so act now. If you are a Registered Nurse
(two years’ graduate experience pre-
ferred), are between 23 and 35 and a
British subject, apply for further in-
tion to:
CAP-44-8N_ mg
(SECTOR OF PERSONNEL MANNING,
Neos Tae ee, oer
Nesta cagrter, Ottaa
5 eS Se at eee ae
+, * wo. At Meta feng un.
meeting of South Fraser Chapter. A wel-
come was extended by Mrs. F. D. Sinclair.
The guest speaker was Alice Wright,
R.N.A.B.C. registrar, who showed colored
Slides taken during the I.C.N. Congress in
' Brazil.
PRINCE GEORGE
At a dinner meeting of Fort George
Chapter recently, A. L. Wright, R.N.A.B.C.
registrar of nurses, told of her experiences
as provincial delegate to the I.C.N. in Brazil
and her subsequent visits to some other
countries. Her enffhasis on the importance
of work done at the Congress and her
description of the lighter aspects of her
travels combined to make an extremely in-
teresting address.
TRAIL ree
At a recent regular meeting of the chap- -
ter, a motion donating up to $50 (subject
to the final decision of the executive) to the
district delegate to the C.N.A. Biennial
Convention in Banff was made. Mrs. J.
Mayers is now social convener. Miss Eidt
reported that all available help would be
needed to transfer patients and set up the
new hospital. All nurses in Trail were re-
_ quested to leave their names at the hospital
so that they might be reached when needed.
VANCOUVER
St. Paul’s Hospital
At the recent graduation exercises of the
school of nursing the following participated :
Invocation, Rev. F. W. Hill; opening ad-
dress, His Worship, Mayor F. Hume; vocal
selections, the school choir conducted by M.
Fewster; address to the class, The Hon. E.
Martin, Minister of Health and Acting
Premier of B.C.; presentation of diplomas,
Rev. P. Monahan who also congratulated
Vol. 50, No. 7
BRANDON
Public Health Nursing.
Students enrolled in both the Degree and Diploma programs in the Hospital
and School of Nursing field may elect to specialize in one of the following:
Medical-Surgical Nursing
Teaching of Sciences
Obstetric Nursing .
Psychiatric Nursing
Paediatric Nursing
For further information write to:
Director, McGill School for Graduate Nurses,
1266 Pine Ave. W., Montreal 25, Que.
the graduates and Mr. A. H. J. Swencisky ;
presentation of medals, Srs. M. Celina and
Denise Marguerite, G. Wahl, E. Black;
award winners, B. Moody, E. Quenville;
valedictory, S. Twentyman.
x
MANITOBA |
The first venture of the Association of
- Graduate Nurses in providing a program to
benefit the entire membership was launched
‘when delegates from Brandon, Souris, and
Hartney attended the opening sessions re-
cently of the nurses’ institute. For the two
days scheduled, the discussion — “Ward
Supervision, Administration and Teaching’”’
— was directed by Hazel Keeler, director
of the University of Saskatchewan School
_ of Nursing, Saskatoon. E. M. Cranna, chair-
man of the educational committee, intro-
duced Miss Keeler and outlined the work
completed since the first scholarship was
given in’ 1942, noting that of nine nurses
who received additional post-graduate edu-
_ Cation eight had returned to Brandon. Ad-
dresses of welcome were given by Dr.
JULY, 195%
J. R. C. Evans, president of Brandon Col-
lege; A. K. McTaggart, administrator of
Brandon General Hospital and president of
the Manitoba Associated Hospitals; and
Dr. A. H. Povah, medical superintendent,
Brandon Hospital for Mental Diseases. The
president, Mrs. C. Hannah, conducted
the first afternoon session and the institute
concluded with a banquet at Brandon Sana-
torium.
Annual reports at a meeting of the as-
sociation, chaired by Mrs. Hannah, revealed
definite progress and accomphshment. E.
Cranna reported the nursing institute a
success with 89 nurses attending. Red Cross
first aid lectures were planned. M. Gemmell,
one of the first presidents, gave an interest-
ing résumé of the early days of the associa-
tion, recalling the flu epidemic of 1918, of
.cases far removed from the city, and her
attendance with C..Macleod in 1918 at the
convention in Vancouver when Jean Gunn
was the speaker. Miss Gemmell nursed in
the U.S. in 1914 and was a city nurse in
Brandon and with the Bigelow Clinic before
joining Dr. McDiarmid’s staff.
The following were announced for office
583
THE CANADIAN NURSE
fe lat Soh
but ts S Shiai
15 Denier Nylon.
ly-[ocks
HAIR NETS |
TIDY LOCKS hair nets are com-
pletely unobtrusive, yet hold
coiffure neatly in place all day
long.
in the fall: President, Mrs. G. Brereton;
vice-presidents, Mmes H. Harris, W.
Dechka; secretary, Mrs. R. McCallum;
treasurer, Mrs. F. Durnin; social convener,
L. Millions.
Among the nearly 100 guests attending
the annual dinner of the Association of
Graduate Nurses were 34 new graduates
from the Hospital for Mental Diseases and
the General Hospital. The president, Mrs.
Hannah, presided and the following partici-
pated in the program: Mrs. A. Lewis pro-
posed the toast to the graduating classes and
J. McDonald responded; Mrs. D. Johnson
voiced a vote of thanks to the retiring
officers; Mrs. A. Harris introduced and L.
Millions thanked the guest speaker, Mr. C.
504
- General Hospital
Bjarnason of Brandon Collegiate, whose
theme, “People Run Upstairs to Run Down
People,” dealt with the results, such as
heart diseases and heartache, of the speed in
the living of today.
General Hospital
At the recent graduation exercises of the
School of Nursing, 23 nurses were presented
with diplomas by H. McCullough and pins
by M. E. Jackson. W. Fotheringham wel-
comed the guests and introduced Rev. J.
Patrick who addressed the class. Others
participating were: J. Woodmass, valedic-
tory address; Dr. R. Myers, presentation of
medals and prizes; Mr. McCullough, scholar-
ships and bursaries. Those winning awards
were: J. McDonald, J. Douglas, J. Allen, E.
Templeton, M. Chalmers, F. Reeve, G. Col-
lier, M. Spratt, G. Harder, L. McClement,
O. Nawalkowski. E. Hinks won The Cana-
- dian Nurse Award. Bursaries went to F.’
Fordyce and F. Larson.
WINNIPEG
The alumnae association held its annual
dinner in honor of the 1954 graduating class
when there was a good attendance with a
very fine program. An interesting feature
was a roll call of each year since the incep-
tion of the school of nursing. The guest
speaker was Dr. A. R. Huband, minister of
Westminster Church. The 1929 class cele-
brated their 25th anniversary with a repre-
sentation of 27 nurses.
Mtsericordia General Hospital
At the commencement exercises recently,
Msgr. I. E. Zielonka, assisted by Dr. A. R.
Gordon, presented diplomas to 22 nurses and
Dr. E. R. Gubbay addressed them briefly.
Sr. St. Odilon, director of the nursing
school, administered the Florence Nightin- °
gale Pledge while Mrs. G. Evoy, hospital
auxiliary president, handed’ the = spectal
awards to the following: Srs. Arthur Marie
and Marie de la Providence, A. Schellen-
berg, L. Wilvers, and R. Morris. The first
award ever given for the best bedside
student nurse went to N. Rieger, Class ’56,
and The Canadian Nurse Award to D.
Balcaen who also gave the va euiony ad-
dress. :
Victotia Hospital
Rev. G. R. Service extended a welcome to
those attending the recent graduation exer-
cises of the school of nursing and Rev. G. F.
Dyker addressed the graduating class. There
were nine graduates and Mrs. L. Wolfe,
superintendent of nurses, presented the di-
plomas. After the Florence Nightingale
Pledge, Wanda Dunn gave the valedictory
address and J. Stewart, instructor, directed
the presentation of the following awards:
C. Badowich, D. Wardrop, S. Burnside. J.
Lawler received The Canadian Nurse Award.
Vol. 530, No. 7
NEWS NOTES
NEW BRUNSWICK
NEWCASTLE
A good representation of members was
evident at the May meeting of Miramichi
Chapter and plans for the annual dinner
reunion, with Dr. Poser as guest speaker,
were discussed. Miss Lynds, administrator
of the Miramichi Hospital, reported that it
was decided at the N.B.A.R.N. executive
meeting to hold the annual provincial meet-
ing in Edmundston on Sept. 22 and 23. Sr.
Skidd of Hotel Dieu Hospital was appointed
. chapter delegate. New legislation is being
sought for licensing all who nurse the sick
for hire. The Council is considering the idea
of an independent school after relinquishing
_ that of central schools in N.B. They believe
the former to be more feasible and generally
acceptable. Srs. Skidd and Nowland, and
Mrs. Jarvis participated in an interesting
_ panel discussion.
MonNcTOoN
Nurses’ Hospital Aid
The president, Mrs. J. Innes, netics at
the May meeting when Mrs. S. Sinclair re-
_ ported on the dinner and dance in honor of
the graduating class of Moncton Hospital.
Mrs. J. Morrell was named convener for the
annual Tag Day and Mrs. Young won the
Mystery Box.
NOVA SCOTIA
HALIFAX |
Victoria Gencral H re
A year of achievement and interest was
reviewed at the annual meeting of . the
alumnae association in May. Projects such
as the Red Feather drive, Red Cross, March |
of Dimes, and Cancer Society benefited by
_ substantial donations and three food parcels
were sent to an elderly nurse in England. .
The student body was assisted as follows:
Volumes of The Canadian Nurse were -
bound for their use; $25 was contributed to
the Year Book Fund; and $100 to the
Students’ Council enabling them to send a
delegate to the C.N.A. Biennial Convention
in Banff; the expenses of a student to the
annual meeting of the R.N.A.N.S. in New
Glasgow were paid and a prize offered to
the one making the highest marks in sur-
gery in the final exams.
Sister alumnae associations of the Nova
Scotia and the Children’s hospitals were
entertained in March. Two speakers during
the year were: Dr. H. B. Atlee and Mrs. E. .
McCara. Mrs. C. Johnstone was appointed
delegate to the R.N.A.N.S. annual meeting. °
Mmes C. Hodgson and D. Foster formed a
group to assist the Cancer Society in mak-
ing dressings while members able to do so
volunteered for Civil Defence nursing. A
successful Christmas tea and sale were held.
The completion of the alumnae room fur-
nishings was a notable part of the year’s
efforts and this room is now used for execu-
tive meetings. Plans to re-establish the War
JULY, 1954
s
Relieve
HEADACHES
NEURALGIA
RHEUMATIC
ronate |
ARTHRITIC
PAIN
ond
COLDS
THE CANADIAN NURSE
By Lena Dixon Dietz
Michael Reese Hospital, Chicago, Illinois
PROFESSIONAL ADJUSTMENTS |
In this edition of a widely-used text-
book, chapters have been added on
professional nursing, personality and
philosophy. Preventive medicine is
stressed. 266 pages, third edition, 1953.
$3.50. .
PROFESSIONAL ADJUSTMENTS Il
Just off the press. For this new edition,
the greatest change has been in Unit
IV, Organizations. Class exercises and
bibliography follow each chapter, as in
Volume I. 510 pages, fourth edition,
1954. $5.00.
. THE RYERSON PRESS
TORONTO
TORONTO HOSPITAL
FOR TUBERCULOSIS ©
Weston, Ontario
Pest-Graduate Course: in the
Treatment, Prevention, and
Cestrol of Tabercalosis:
1. A nine-week certificate course in_
surgical and medical clinical ex-
perience, lectures and demonstra-
‘tions. Rotation to all departments.
2. An extra month in special de-
partments may be arranged for
those nurses preparing for Public
Health, Operating Room or Sur-
gical Nursing.
For further particulars apply to:
Director of Nurses, Toronto
Hospital, Weston, Ontario
Memorial Plaque for nurses lost in World
_ War I were discussed. ; |
At the close of the business meeting,
President Mrs. H. S. T. Williams spoke on
the history, achievements, and aims of the
association formed in 1920. Serving with
Mrs. Williams are: Vice-presidents, S.
‘Nott, G. Flick; secretary, J. Candle; treas-
urer, Mrs. L. Bell; program convener, E.
Haliburton; board of directors, Mmes T.
Carpenter, W. Hunt, J. Cameron.
ONTARIO
' District 1
WINDSOR 3
Once a year the Industrial Nurses’ Edu-
cational Association of Essex and Kent
Counties holds a dinner meeting to which
are invited representatives from top man-
agement, personnel directors, and industrial
physicians and surgeons. A special speaker
is obtained for these occasions. On April 20
approximately 90 industrial nurses met at
the Elmwood Hotel, Windsor, and included
in the group were: presidents, general man-
agers, personnel directors, and doctors from
-industry. Because of the special interest in
the speaker’s topic, planning engineers from
. industry, hospital heads from local and dis-
trict hospitals, and the president of the
Essex County Medical Association were
also present. The speaker was Marion
Wright, associate director of Harper Hos-
pital, Detroit, Mich. The topic of her ad-
dress was “The Better Utilization of Hos-
pital Personnel,” dealing with the study that
she has made in applying industrial manage-
ment principles to the field of nursing. This.
has been accomplished by the guidance of
outstanding industrial engineers who did the —
rescarch for the project.
He
Windsor Daily Star Photo
In the photo may be seen (left to nght):
R. THompson, director of nurses, Metro-
politan General Hospital, Windsor; Mr. O.
R. Goopricu; Packard Motor Car Co., De-
troit; Marion Wricut; Doris E. PICKEL,
Chrysler Corp. of Canada Ltd., Windsor,
and president, I.N.E.A. of Essex and Kent
Counties. .
District 6. |
CoBOURG |
The semi-annual meeting of the district
Vol. 30, No. 7
" meeting followed the banquet and the chair-
_ men of Chapters A, B, and C reported on
their group activities. Miss, Peart sum- °
- Joseph’s Hospital, Sudbury, since 1948, was
‘ Hospital, Lowell, Mass., in January. Grad-
" . intendent of nurses from 1922 to 1940;
. sponsored annual memorial service for
communion breakfast when Rev. Morrocco,
— Royal Victoria Hospital
NEWS NOTES
was held in May with Mrs. F. Leeson, chair-
man of Chapter B, as hostess. The business
marized the highlights of the R.N.A.O.
convention she had attended and the last
Board meeting. The guest speaker was the
provincial secretary of public relations, E.
Fenton, who gave an excellent talk on “Are
We Professional Women?” The next district
meeting will be held in the fall in Peter- .
borough.
District 8
OTTAWA
General Hospital
Sr. Flavie Domitille, superior . of St.
appointed to a similar position at St. Joseph's
uating from O.G.H. in 1913, Sr. Do-
mitille has served the hospital in such
capacities as: supervisor of the children’s
ward and later the operating room, super-
superior till 1943 and finally supervisor of
the ward for sick sisters till her departure
to Sudbury.
Seventy-five nurses attended the alumnae-
nurses who died in both World Wars and
over 150 nurses were present at the annual
as guest speaker, chose the subject
“Vocation”. :
-
Lady Stanley Institute
- The annual meeting of the alumnae asso-
ciation was well attended and the following
were elected to office: Honorary president,
Mrs. W. S. Lyman; honorary vice-pres-
idents, M. Stewart, E. Young; president,
Mrs. G. O. Skuce: vice-presidents, Mmes
C. Port, H. M. Ellard; secretary, Mrs. R.
B. Bryce; treasurer, M. Scott; in various
other capacities, C. Pridmore, E. Johnston,
D. Booth, Mmes M. Jones, L. Gisborne, J.
Steele, E. Aust, W. Fraser, G. Bennett, J.
Waddell.
District 12
KIRKLAND LAKE
Prior to a regular business meeting of the
chapter, an instructive film on “Teamwork,”
relating to the R.N. and co-workers in the
hospital, was shown. The fashion show con-
vened by Mrs. M. Eady was a complete
success. The proceeds, as well as those of
the recent rummage sale, will be used for .
winter projects.
QUEBEC
MONTREAL.
Rev. G. Cragg was guest speaker at the
JULY, 1954
SPECIALIZATION
Exclusive Designers
of the New
LAMEL
DRESSING GOWN
(VAT-DYED SANFORIZED)
MATERIAL WOVEN
TO OUR SPECIFICATIONS.
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25
ge RE ig DRA OSS a:
« sat a:
Ny. af” 1 Owe 2 as
pene Ri ste Pence tee = 7
=
THE CANADIAN NURSE
L£fficiency
EFcononyy
| ed bk ok on OY 2,
. ’ THAT ALL UNIFORMS
—, 4 CLOTHING AND
OTHER BELONGINGS
ARE MARKED WITH
CASH’S Leemwevea NAMES
Permanent, easy identification. Easily sewn on, of attached
with No-So Cement. from dealers or
CASH’S: 3 Doz. $1.98; 9 Doz. $8.90; NO-SO
NAMES: 6 Doz. $2.40; 12 Doz. $3.50; 2S¢ per tube
ee i a TIN
THE CENTRAL REGISTRY
OF GRADUATE NURSES
: - TORONTO
Furnish Nurses
e at any hour e
DAY or NIGHT
TELEPHONE Kingsdale 2136
427 Avenue Road, TORONTO 5.
_ Juan C. Brown, Rec. N.
Lo work tn
CANADA - U.S.A. -ENGLOND?
Write and send snap to:
International Employment Agency
29 Park W., Room 209
Windsor, Ontario
recent graduation exercises for 97 graduates
of the school of nursing. Prize winners
were: B. Pritchard, A. Hathaway, M. Mc-
Killop, M. Monahan, A. Johnston, J. Hen-
derson, T. Pattenden, C. Walkem, and J.
Loney who won The Canadian Nurse
Award. A reception followed the ceremonies.
Parents and friends attended a parent and
daughter tea in honor of the class. During
graduation week those present at the 25th
anniversary reunion of Class '29 were: E.
(Archibald) Rand, M. (Bowers) Ambrose,
398
L. (Cameron) Smith, M. (Cosgrove) De- ©
carie, C. (Dart) Johnston, E. (Davidson)
Ross, M. (Douglas) Pond, J. Dunning, H.
(Eberle) Cranston, D. Gibson, G. (Green)
Woods, M. (Hamilton) Tremble, H.
(Horncastle) Brigg, E. (MacCrimmon)
Daly, K. (Martin) Hodgson, A. Peabody,
M. (Perley) Pilkney, M. (Steeves) Mor-
rell, J. (Stewart) Sampson, R. (Swan)
Clibbon, M. Swartz, E. (Ward) Clark. A
tea was held in their honor and 21 of the
group attended the annual alumnae dinner.
New officers elected at the annual meet-
ing of the alumnae association are: Pres-
ident, M. Purcell: vice-presidents, H. La-
mont, M. Butler; recording secretary, L.
Rosevear. -
Guest of honor at a tea recently was
J. Rainboth who resigned to be - married.
I. (Macmillan) Applegarth was a recent
visitor to the school. C. Hodge is on the
staff of Valley Hospital, Ridgewood, N.J., .
and J. Whittier, the staff of the Children’s
Hospital, Boston, Mass., the latter planning
to later attend Smith College, Northampton,
Mass., for further study. |
Officers of the new chapter in Fredericton
are: President, A. (Barnet) | Crewdson;
vice-president, D. Loane; secretary, K.
(Janier) White. Graduates living in Wood-
stock, McAdam, and Oromocto are invited
to join. Eleven members attended a recent
meeting of Sydney Chapter. Fourteen mem-
bers of London Chapter were present at a
tea held by A. (Bigelow) Kennedy in honor
of M. (Hannah) Nivens, a graduate of the
Class of 1898, on her 92nd birthday. D.
(Rice) Storer has resigned as secretary of
Moncton Chapter.
, SASKATCHEWAN
SASKATOON
Nurses from St. Paul’s and City hospitals
formed the choir at the annual vesper service
of the chapter recently. The topic of Dr.
L. Campbell’s sermon was “The Glory of
the Common Man.” -
City Hospital ——
The Alumnae association entertained the
graduating class recently and Mrs. A. Mac-
Millan, president, welcomed the guests. Each
Student received a year’s membership in the
alumnae with best wishes for .the future
and a social evening under the convenerships
of Mmes D. Parkinson, D. Andres, and J.
Levers ensued. .
Members of Class ’55 Zave a banquet in
honor of their “big sisters,” Class ’54, at- |
tended by some 120 students. Rey. H. Joyce,
guest speaker, was introduced by E. Kearney
and thanked by R. Miller. Toasts were
Proposed by B. ‘Gibson and Mrs. H. Wilson, :
with J. Brown and N. Badham responding.
During the evening D. Morgan gave a reci-
tation and D. Kindrachuk and L. Russell
accompanied by B. Smith, musical selections.
Guests of honor were: Rev. and Mrs. Joyce,
Mr. and Mrs. J. Armstrong, Mr. and Mrs.
L. Muirhead, Mrs. Wilson and members of
the nursing office staff.
~~
Vol. 50, No. 7
- Guelph, Ontario. :
tail a
POSITIONS VACANT
CANADIAN RED CROSS SOCIETY
invites applications for ADMiInsTRATIVE and Star? positions in HosPrrat, doa? sata
Nursinc Szarviczs, and BLoop Tramsrusion Szavice for various parts of a.
: in British Columbia,
® rity of opportunities are in Outpost SEavices
rg plate Manitoba, Ontario, Quebec, New Brunswick, and Nova Scotia.
| ation arrange-
e urate salaries for experience and qualifications. Transport
area ps certain circumstances. Bursaries are available for post-graduate
study.
| For further particulars apply:
NarionaL Direcror, Nursixa Seavices, CanaDiaw Rep Cross Socirr,
| 95 WELLESLEY Sr., Toronto 5, Omranio.
— Positions Vacant |
ADVERTISING RATES — $5.00 for 3 lines or less; $1.00 for each addstional line.
U.S.A. & Foreign — $7.50 for 3 lines or less; $1.50 for each additional Ine.
| Matron for 24-bed hospital. Salary: $265 per mo. less $40 board & lodging. 1 mo. holli-
i i - hnician. Attractive town.
ay after 1 yr. Staff: 4 nurses, 4 aides, x-ray lab. tec
pak Sate Apple Administrator, Terrace & District Hospital, Terrace, B.C.
Director of Nursing for new 87-bed hospital for Chronically I!] which ts combined with
. new 165-bed Home for the Aged. Salary according to qualifications & experience. Apply
Mr. M. Rosenberg, Administrator, Jewish Home for the Aged, 3560 Bathurst St.,
-Toronto 12, Ontario.
i i ity post-graduate course
. Supervisor for Obstetrical Dept. Obstetrical or university po (
ad coe agiick adequate experience. Good salary & personnel policies. Apply Director
of Nursing, Victoria Hospital, London, Ont.
ing — 60 students. New hospital
ing Arts Instructor for School of Nursing — approx. 6 ide
ceanal Western Ontario. | yr. university in teaching essential. Living eal ae ink
in newly decorated residence. Good personnel policies. Apply Director o ursing,
General Hospital, Stratford, Ont. 3
Nursing Arts & Nursing Science Instructor. Also Graduate General Staff Nurses. New
ici king conditions.
- | Hospital. 44-hr. wk. Good personnel policies & wor
Aco Dice of Nursing. South Waterloo Memorial Hospital, Inc., Galt, Ont.
Instructor — capable of teaching Psychiatric Nursing to affiliating students. Good
salary. Living accommodation available. Apply Supt. of Nurses, Homewood Sanitarium,
i i i ia. Salary:
for 650-bed Teaching Hospital in Central California
Sora a eer kek “i Liberal vacation, holiday & sick leave plan. Apply Person-
nel office, 510 E. Market, Stockton, California.
General Duty Nurses. Those registered start at $160 per mo. plus full maintenance.
i Graduate Nurses
A | increment — $5.00 per mo. for each of 3 yrs. 4 wks. vacation. (
Sree "$150 plus full maintenance.) Apply Supt., Alexandra Marine & General Hos
pital, Goderich, Ont.
: lus full
N 2) — one each for July 1 & Aug. 1. Salary: $180 per mo. p
creole paigoet ee of $5.00 per mo. for each yr. experience to a Hager of
$195. 3 wks. holiday with pay plus all statutory holidays. Separate nurses’ residence.
Apply Matron, Municipal Hospital, Fairview, Alta. -
; eT : m4
1 Duty Nurses for Children’s Orthopedic Rehabilitation Centre,
BC Neer vou City. das. 40-hr. wk. Liberal personnel policies. Ce TS
residence. Write, stating qualifications, Director of Personnel, Blythedale, Valhalla,
New York. . | .
atholic Children’s Aid Society — public health or children’s hospital expe-
nee ered Salary commensurate with training & experience. Penna aaa ee
lowing progress & development of infants in foster homes & piers oo : pate
retirement & medical plans. For details, write Miss J. Allen, Director, Catholic i
dren's Aid Society, 67 Bond St., Toronto 2, Ont. |
. 899 ‘
JULY, 194
2
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THE CANADIAN NURSE
WANTED |
a for |
GENERAL HOSPITAL, GUELPH, ONTARIO.
INSTRUCTORS
(qualified)
Nursinc Arts (1) and Crinicat (1) by August 1,
200-bed hospital — 65 students. One class
per year enters in September. Allowance
made for degree with experience.
For further information apply: -
DIRECTOR OF NURSES
Supt. of Nurses & General Duty Nurse (1). Salaries: Su t — O en; G D t —
$170-190 plus full maintenance; also half MHS.A. & MMS. New S6-bed hospital with
separate residence — private suite for Supt. Apply Mrs. L. W. Borthwick -
District General Hospital, Morden, Man. ee - ick, Sec.-Treas.,
Se 4
Supt. of Nurses & O.R. Supervisor for General Hosp} i 7
: a pital, Dauphin, Man. 86-bed hospital
with Nurses’ Training School. Community of 6,500. Excellent living conditions. Supt
of Nurses must be good organizer & disciphnarian. Salary open for both positions.
For further information apply A. J. Schmied], Sec.-Megr.
Se ee
Supt. of Nurses for modern 60-bed General Hospi : i ificati
pital. Apply, stating qualifications,
Dr. M. R. Stalker, Honorary Medical Supt., Barrie Memorial Hospital, Ormstown, Que.
_ TT eee
Asst. Supt. with X-Ray experience or willing to learn X-Ray technique preferred
Apply Dr. W. A. Oakes, Public Hospital, Clinton, Ont. See, | ,
aC
Director of Nursing Education: Nursing Arts Instructor; Operating Room Supervisor.
Nursing School — 65 students — with 1 class per yr. Good personnel policies & fa-
cilities. Full maintenance in residence if desired. Apply B. A. Beattie, Director of
Nursing, Public General Hospital, Chatham, Ontario.
eee
Instructor in Science & Surgical Nursing for new school taking in one class yearly.
Responsible for teaching Chemistry, & Anatomy & Physiology in Ist term & the
Surgical portion of an integrated course in Medical-Surgical Nursing in 2nd term.
Splendid opportunity to help develop new school being established on sound educa-
tional lines. For further information apply Di i
: : y Director, School of Nursing, M
General Hospital, Windsor, Ont. eo perbopoltan
eee.
Instructors for: Science Teaching followed by Clinical Ward Teaching: Clini
‘ : ical Ward
Teaching & lectures in Medical Nursing. Commencing salary: $250 (additional ior
pope viens): een ere contract in effect. 65 students; one class per yr. For
nation about position. communit ly Di
Heipial Ke aicsne ne unity pi irector of Nurses, Royal Inland
eee
Instructor in Nursing Arts. Clinical Instructor in Medicine. Clinical Instructor in
Surgery. For School of Nursing by Aug. 1. 177-bed hospital; affiliation arranged in
Tuberculosis & Psychiatric Nursing. Maximum of 60 students. One class per yr. Com- .
lete maintenance available. Excellent personnel polici i
| ; policies. For further particulars appl
Miss E. A. Bietsch, Director of Nursing, General Hospital, Medicine Hat, Albena”
———————
Science Instructor for June or Sept Complete maintenance in comfor i
: table suite. 120-bed
hospital — 35 students. New 150-bed hospital under construction. Apply, stating ex-
dale & salary expected, Director of Nurses, Jeffery Hale’s Hospital, Quebec City,
ebec. |
= : x
Clinical Instructor (Nursing Arts). Modern 400-bed hospital. Student body — 100.
Salary commensurate with position. Good personnel policies. Apply Di
i irecto
Kitchener- Waterloo Hospital, Kitchener, Ont. - ee tor of Nursing,
600
Vol. 50, No. 7
' Director of Nursing, General Hospital, Saint John, N.B
POSITIONS VACANT
VANCOUVER GENERAL HOSPITAL
The Vancouver General Hospital requires:
General Staff Nurses. 40-hr. week. Salary of $231.00 as mini-
mum and $268.50 as maximum, plus shift differential for evening
and night duty. |
New Paediatric Unit now open. Applications from qualified Paediatric
Nurses welcome, | ;
Residence accommodation is available.
Applications should be accompanied by letter of acceptance of registration in B.C.
from Registrar of Nurses, 1101 Vancouver Block, Voncouver 2, B.C.
Apply to: Personnel Dept., General Hospital, Vancouver 9, B.C.
Science Instructor (1) & Nursing Arts Instructor (1) for Sept. School with approx.
90-100 students. Apply Director of Nurses, Victoria Public Hospital, Fredericton, N.B.
Nursing Arts Instructor for School of Nursing. 150 students—450-bed hospital. Apply
Clinical Supervisors & Instructors: Surgical (2) & Medical (2). Also General Staff
Nurses. Personnel policies based on R.N.A.O. recommendations. For full details apply
Director of Nursing, General Hospital, Port Arthur, Ont.
Public Health Nursing Supervisor & Public Health Nurses for generalized public health
program. Attractive salary & working conditions. Blue Cross, Workmen's Compensa-
tion & other benefits. For information or application forms apply Mr. J. R. Coleman,
Sec.-Treas., Simcoe County Board of Health, Court House, Barrie, Ont.
General Supervisors, Charge Nurses & General Duty Nurses for new 150-bed hospital.
Starting salary for General Duty Nurses — for B.C. Registered, with annual
increases up to $30. 40-hr. wk. 14% days cumulative sick leave. 28 days vacation. 11
statutory holidays. Apply Supt. of Nurses, Trail-Tadanac Hospital, Trail, B.C.
Supervisor for 327-bed Tuberculosis Sanatorium & General Duty Nurses for Surgical
- Unit handling Thoracic & Orthopedic Surgery. For further information apply Director
of Nursing, Fort William Sanatorium, Fort William, Ont.
Evening Supervisor & General Duty Nurses for General Hospital. 88 adult beds plus
30 bassinets. For particulars apply Director of Nursing, Norfolk General Hospital,
Simcoe, Ont. ;
Public Health Nurse — Grade 1 — British Columbia Civil Service, Dept. of Health &
Welfare. Starting salary: $255-260-266 per mo. depending on experience, nsing to $298.
Promotional opportunities available. Candidate must be eligible for registration in B.C.
& have completed University degree or Certificate course in Public Health Nursing.
(Successful candidates may be required to serve in any part of province.) Cars are
provided. 5-day wk. in most districts. Uniform allowance. Candidates must be British
subjects under 40, except in case of ex-service women who are given preference. Fur-
ther information may be obtained from Director, Public Health Nursing, Dept. of
Health & Welfare, Parliament Bldgs., Victoria, B.C. Application forms obtainable from
~ all Govt. agencies, Civil Service Commission, Weiler Bldg., Victoria, or 411 Dunsmuir
St., Vancouver 3, to be completed & returned to the Chairman, Victoria, B.C.
Public Health Nurse for Health Unit for géneralized program. Proximity to Toronto
permits urban living conditions to be combined with rural-urban work. Excellent
transportation arrangements, group insurance & other attractive working conditions.
Apply Dr. R. M. King, York County Health Unit, Newmarket, Ont.
Nurse Technician Team (intravenous & intramuscular therapy). Apply Dr. H. Feather-
ston, Asst. Supt., Civic Hospital, Ottawa, Ontario.
JULY, 1954 - * @Ol
Pay
oe
“ae
* og
THE CANADIAN NURSE
GENERAL STAFF NURSES
QENERAL WARDS OPERATING ROOM OBSTETRICS $=:
for |
200-bed hospital
| Pleasant city of 33,000. Two colleges.
Good salary and personnel policy.
For further information apply to:
DIRECTOR OF NURSES, GENERAL HOSPITAL, GUELPH, ONTARIO.
Public Health Nurses (bilingual) for Prescott & Russell Health Unit. Minimum salary:
$2,600 with allowance for previous experience & annual increments. Car provided or -
allowance for own car. Blue Cross & sick leave. Apply Dr. R. G. Grenon, Director,
Prescott & Russell Health Unit, Hawkesbury, Ont.
Public Health Nurses for Dept. of Health, City of Kingston. Salary range in effect.
Transportation provided. 5-day wk. Pension & hospitalization plans available. Apply
Medical Officer of Health, City Hall, Kingston, Ont.
Public Health Nurses (qualified & experienced). Salary schedule: $2,500-3;100 depend- —
ing On experience. Annual increment, $100. Pension plan. Car provided or car allowance.
Apply Dr. Charlotte M. Horner, Director, Northumberland-Durham Health Unit,
Cobourg, Ontario.
Public Health Nurse for generalized program in Alberta East Central Health Unit
(Stettler office). Minimum salary: $2,520. Experience recognized up to 3 yrs. Annual
increments. Pension plan; Blue Cross. For details apply Dr. D. MacKay, Medical
Officer of Health, Stettler, Alta. . :
Registered Nurse for General Duty: for 8-bed hospital immediately. Salary, holidays
& sick leave according to M.A.R.N. Must be able to speak both French & English — |
preferably R.C. Those interested apply Sr. Marie Jean, Superior, Notre-Dame de
Lourdes, Manitoba. ; ;
Registered Nurses (2) for General Duty. 40-bed Municipal Hospital. Starting salary:
a per mo. plus full maintenance to maximum $220 according to nursing experience.
5.00 per wk. extra for night duty. 44-hr. wk. 3 wks. holiday with full pay after 1 yr.
service. Statutory holidays. Modern nurses’ home on grounds. Apply Sec., Municipal
Hospital, Box 560, Taber, Alta.
Registered Nurses for General Duty Staff. Salary commences at £37-10-0 per mo. with
full maintenance. Transportation allowance. For full particulars apply Matron, King
Edward VII Memorial Hospital, Bermuda.
Registered Nurses for new 30-bed hospital. R.N.A.B.C. policies in effect. Apply Matron
Creston Valley Hospital, Creston, B.C. 3 |
Registered & Graduate Nurses for General Duty for 100-bed hospital. Apply, giving
experience, references, etc., Supt., The Cottage Hospital, Pembroke, Ont.
Graduate Nurses for completely modern West Coast hospital. Salary: $230 per mo. less
$40 for board, residence, laundry. $10 annual increments. Special bonus of $10 per mo.
for night duty. 1 mo. vacation with full salary after 1 yr. service. 1% days sick leave
per mo. cumulative to 36 days. Transportation allowance not exceeding $60 refunded
after Ist yr. Apply, stating experience, Miss E. L. Clement, Supt. of Nurses, General
Hospital, Brace Rupert, B.C. an pr
Graduate Nurses (3) for 24-bed hospital. Salary: $230 per mo. if B.C. registered; less
$40 board, lodging, laundry. 1 mo. vacation after | yr. on full pay. 1% days sick leave
per mo. cumulative. Apply, stating experience, Matron, Terrace & District Hospital
Terrace, British Columbia. ; 3
602 | | Vol. 50, No. 7
POSITIONS VACANT
CENTRAL SUPPLY ROOM SUPERVISOR
Victoria Hospital, London, Ontario
Applications requested for this position in.700-bed active hospital.
The Central Supply Room is to be trans-
ferred to new area with modern equipment, in
the new wing, to be opened in September.
Good Salary and Personnel Policies.
Apply a 2 .
Director of Nursing, Victoria Hospital, London, Ontario.
Do You Want a Change? Do You Want to See the Pacific Coast? Do You Like
Nursing? Langley Prairie has a busy 50-bed General Hospital & will have several
- vacancies on the permanent nursing staff. Salary: $235. 44-hr. wk. Other personnel
practices according to R.N.A.BC. recommendations. If interested apply Miss M. R.
Ward, Langley Memorial Hospital, Langley Prairie, B.C.
Graduate Nurses (3) at once owing to present nursing staff leaving to get married.
30-bed hospital on C.P.R. main line & Trans-Canada Highway, 2 hrs. from Calgary.
Modern nurses’ residence & garage. 8-hr. day, 6-day wk. with rotating shifts. Starting
salary: $170. $5.00 increase at end of each 6 mos. 3 wks. holiday & statutory holidays.
Sick leave with pay & free hospitalization. Apply Matron, Municipal Hospital, Bassano,
Alberta. —
Graduate Nurse (qualified) to conduct Certified Nursing Assistant Course & Staff Edu-
cation in 100-bed hospital. Apply, stating qualifications & experience, Director of
- Nursing, Norfolk General Hospital, Simcoe, Ont.
Graduate Nurses for General Duty. Living-in accommodation if desired. Apply Supt.
of Nurses, Homewood Sanitarium, Guelph, Ont.
* «
i
General Duty Nurses. Gross salary: $200 per mo. with 1 yr. or more of experience,
$190 per mo. with less than 1 yr. experience; $20 per mo. bonus for evening or night
duty. Annual increment, $10 per mo. 44-hr. wk. 8 statutory holidays. 21 days vacation
& i4 days sick leave with pay after 1 yr. employment. Apply Director of Nursing,
General Hospital, Oshawa, Ont. _ 9
i
General Duty Nurses. Salary: $182.43 (one hundred eighty-two dollars & forty-three
cents) monthly, paid on a bi-weekly basis; 26 pays in a yr. Salaries have scheduled -
rate of increase. 48-hr. wk. 8-hr. broken day; 3-11, 11-7, rotation. Cumulative sick leave.
Pension Plan in force. Blue Cross. 3 wks. vacation after 1 yr. service. Apply Supt. of
Nurses, Muskoka Hospital, Gravenhurst, Ont.
a TL
“General Duty Nurses — “You will like it here.” Placement in the service of your choice
in Teaching Hospital. Beginning salary : $240 per mo. for 40-hr. wk. Scheduled increases,
| payment for overtime, 6-hr. evening duty. $270 per mo. for night duty. Sick leave, 6
olidays, 3 wks. vacation. Residence facilities if desired. Tuition-free courses after 6
-mos. service. Opportunities for advancement. Apply Director of Nursing Service,
University Hospitals of Cleveland, Cleveland 6, Ohio.
ge —e
| General Duty Nurses for 920-bed General Hospital. Starting salary: $190-210 per mo.
plus meals & laundry. Credit for past experience, annual increments. 44-hr. wk;, rotating
shifts. Statutory holidays, 21 days vacation,.cumulative sick leave, hos italization sub-
sidized, pension plan. For further informatién apply Supt. of Nursing Service, Univer-
sity of Alberta Hospital. Edmonton, Alta.
re 9 A PP
General Staff Nurses for 400-bed Medica. & Surgical Sanatorium, fully approved.
Student affiliation & post-graduate program. Full maintenance. Recreational facilities.
Vacation with pay. Sick benefits after 1 yr. Blue Cross coverage. Attractive agrees
For further particulars apply Supt. of Nurses, Nova Scotia Sanatorium, Kentville, N.S.
JULY, 1984 603
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THE CANADIAN NURSE
-
HOSPITAL NURSES
GRADE 1 — $2,430-$2,820 GRADE 2 — $2,730-$3,120 |
Department of Veterans Affairs Hospitals
Camp Hill, Halifax Deer Lodge, Winnipeg
- Ste. Anne’s, Montreal Veterans Hospital, Saskatoon
Sunnybrook, Toronto Colonel Belcher, Calgary
Westminster, London Shaughnessy, Vancouver
A pplication forms, available at your nearest Civil Service Commission Office, National
Employment Office or Post Office, should be filed- with The Civil Service Commission,
Ottawa.
CIVIL SERVICE OF CANADA
~ General Duty Nurses for United Church of Canada hospital, 300 miles north of Van- |
couver on B.C. coast. Salary: $215 per mo. less $40 for board, room & laundry of
uniforms. 2 annual increments of $5.00 per mo. Cumulative sick time — 114 days per mo.
mo. annual holiday plus 10 days in lieu of statutory holidays. Transportation refunded
after 1 yr. Apply Matron, R.W. Large Memorial Hospital, Campbell Island P.O.,
Bella Bella, B.C. . 7 :
eee
General Duty Staff Nurses for 515-bed General Hospital. 40-hr. wk. Beginning salary:
$260 per mo. with advancement to $285; $20 additional for evenings & nights. Hospital
& School of Nursing fully approved. Apply Director of Nursing, The G Hospital
4160 John R. St., Detroit 1, Michigan. ing, : race Hospital,
TEP Ch PUP eer
General Duty Registered Nurses for large city hospital. Vacancies in Medical, Surgical
& Pediatric Wards. Salary: $50-56 per wk. 44-hr. wk. Vacation, 3 wks. Illness allowance,
18 days per yr. after 1 yr. service. Apply Director of Nursing, General Hospital, Hamil-
on; Ont. . , ,
Operating Room Nurse (experienced, preferably with post-graduate course). Operating —
Room Staff Nurses. Opportunity for advancement. Full maintenance. Travel allowance.
State qualifications & date available. For full particulars write Matron, King Edward
VII Memorial Hospital, Bermuda. : |
eee
General Duty Nurses for new 100-bed hospital. Basic salary: $170 plus maintenance. |
3 wks. vacation. 8 statutory holidays. Rotating shifts. Apply, with full particulars, Supt
Lord Dufferin Hospital, Orangeville, Ont. | . soe
General Duty Staff Nurses for 175-bed hospital, located 20 miles from .Detroit. Ex-
cellent personnel policies with opportunities for advancement. Apply Director of Nur-
sing, St. Joseph Hospital, Mount Clemens, Michigan.
eee
General Duty Nurses for Obstetrical, Surgical & Pediatric Wards. 375-bed hospital
- with Training School. Residence accommodation if desired. Progressive city on main
line to Toronto & Montreal. Apply Director of Nursing, General Hospital, Brantford,
nt.
eee
General Duty Nurses for 430-bed hospital. Salary : $230-260. Credit for past experience.
Annual increments. 40-hr. wk. Statutory holidays; 28 days annual vacation. Cumulative
sick leave. Apply Director of Nursing, Royal Columbian Hospital, New Westminster,
British Columbia. °
oa $$ Pa
General Duty Nurses for Medical & Surgical Wards. Personnel policies based on
R.N.A.O. recommendations. $50 towards transportation refunded after 1 yr. service.
Apply Director of Nursing, General Hospital, Port Arthur, Ont.
Clinical Instructors for Obstetrical & Medical Depts. (qualified). Also General Duty
Nurses for 500-bed hospital. Attractive personnel policies. Apply Director of Nurses,
St. Joseph’s Hospital, Victoria, B.C. | _
eee
General Duty Nurses for Medical, Surgical, Pediatrics, Obstetrics. Good salary &
personnel policies. Apply Director of Nursing, Victoria Hospital, London, Ont.
604 Vol. 50, No. 7
POSITIONS VACANT
WOODSTOCK GENERAL HOSPITAL
WOODSTOCK, ONTARIO
Operating Room Nurse (General Duty)
. Apply, stating qualifications, to: -
_ DIRECTOR OF NURSES, GENERAL HOSPITAL,
| WOODSTOCK, ONTARIO.
Nurses (2) for 20-bed hospital. Modern nurses’ residence. Salary: $190 per mo. plus
_ full) maintenance. Usual holidays with pay, sick leave, etc. Apply Matron, Union
Hospital, Vanguard, Sask. | | ,
Nursing Arts Instructor for General Hospital, Sarnia, Ont. Post-graduate in Nursing
Education from recognized university. 50 students at present & estimated 22 in Sept.
preliminary class. New & well equipped hospital & School of Nursing. Minimum gross
salary : $250 per mo. Apply Mr. H. K. Krafft, Supt. ;
Obstetrical Supervisor for 70-bed General Hospital. Salary : $200 per mo. & up, depend-
ing on qualifications. Good personnel policies. Apply Supt., Ross Memorial Hospital,
Lindsay, Ontario. . :
‘Operating Room Head Nurse (experienced) with post-graduate training for 117-bed .
General Hospital in the Okanagan Valley. Also Registered Nurses for General Duty.
Basic salary: $225 -— credit for experience. 40-hr. wk. Annual increments. 28 days
annual vacation. Apply Director of Nursing, Jubilee Hospital, Vernon, B.C.
Matron immediately for 27-bed hospital. Graduate complement: matron & 4. 8-hr. day,
44-hr. wk. 28 days holiday after 1 yr. service. Customary sick leave. Knowledge of
x-ray essential. Apply, giving full details & salary expected, Sec., Slocan Community
Hospital, New Denver, B.C. — :
General Duty Graduate Nurses (2). Salary: $220 with annual increments of $5.00 per
mo. Full maintenance in hospital — $40 per mo. 28 days holiday after 1 yr. segvice.
Customary sick leave. Apply, with full particulars, Sec., Slocan Community Hospital,
New Denver, B.C.
Public Health Nurse immediately for rural program. Minimum salary : $2,000; adjust-
ment made for experience. Statutory holidays & 1 mo. vacation after 1 yr. Write for
particulars Dr. J. I. Jeffs, M.O.H., Lennox & Addington County Health Unit, Napanee,
Ontario. oy
General Duty, Operating Room & Obstetrical Nurses. Salary : $200 for recent graduates
’ Laundry. 8-hr. day, 44-hr. wk. — straight shift. $20 differential evenings — $15 nights.
Vacation, sick time, statutory holidays on salary. Semi-annual & annual increments.
Financial recognition for yrs. of experience, post-graduate or university study. Apply
Director of Nursing, General Hospital, Winnipeg, Man. 7
General Duty Graduate Nurses for 60-bed Acute General Hospital, 150 miles northwest
of Vancouver on B.C. coast. Salary: $222 per mo. with increments; less $25 complete
' maintenance. 4 wks: holiday per yr. with pay plus 10 statutory holidays. Transporta-
tion advanced if desired. Apply Matron, St. George’s Hospital, Alert Bay, B.C.
- General Duty Nurse for 14-bed hospital. R-hr. shift (alternating). Salary, vacation, sick
- leave as set by M.A.R.N. Apply Mrs. Eva Green, Memorial Hospital, Crystal City,
Manitoba. -
General Duty Nurses for 404-bed hospital. Starting salary: $245 per mo.; $255 for
afternoons & nights. Apply Nursing Service, St. Vincent’s Hospital, 2475 N.W. West-
over, Portland 10, Oregon.
JULY, 1954 | | 605
THE CANADIAN NURSE
NURSING SCIENCE INSTRUCTOR
for
McKELLAR GENERAL HOSPITAL, FORT WILLIAM, ONT.
e New and modern 435-bed hospital with School of Nursing comprised of 8&0
students. @ Living accommodation. ¢ Salary commensurate with qualifications
and experience. | |
Apply
DIRECTOR OF NURSE EDUCATION,
McKELLAR GENERAL HOSPITAL,
FORT WILLIAM, ONTARIO.
_General Duty Nurses for 110-bed hospital in scenic Fraser Valley, 65 miles east of
Vancouver On Trans-Canada Highway. Salaries, holidays, etc., in accordance with
R.N.A.B.C. personnel practices.’ Residence accommodation available. Apply Director
of Nursing, General Hospital, Chilliwack, B.C.
Registered Nurses for Supervision & General Duty tn 145-bed hospital for Tuberculosis.
Full maintenance available. Salary & personnel policies on applicati i
; able. S { pplication. Apply Director
of Nursing, Grace Dart Hospital, 6085 Sherbrooke St. E., Montreal 5, Que. sea
Nursing Instructor to teach Tuberculosis Nursing to affiliating students in 200-bed
sanatorium. Living accommodation in new modern residence. Apply Director of Nur-
sing, Essex County Sanatorium, Windsor, Ontario.
General Duty Nurses for new hospital opening latter part of Aug. 65 miles from Mont-
real. Excellent bus & train service. Salary: $140 per mo.; full maintenance. 8-hr. duty .
—- rotating shifts. 14 days off per wk. 30 days annual holida 1
] y plus 7 statutory holidays.
12 days sick leave allowance. Blue Cross. Personnel policies on application. Apply Sink
~ Brome- Missisquoi-Perkins Hospital, Sweetsburg, Que. "
General Duty Nurses for 175-bed Pediatric Hospital. A.N.P.Q. salary scales & per-
sonnel policies in force. Apply Di i ’ : .
Montreal 25, Quebec. Apply Director of Nursing, The Children’s Memorial BtOspitat,
Nurses: Operating Room (1) & Obstetrical (1) — each responsi : |
ponsible for small dept. N
hh work. Also General Duty Nurses. Modern 35-bed General Hospital near Toronte.
ave & up, less $30 for full maintenance. Rotating shifts. Apply, giving details
of training & experience, Supt., Stevenson Memorial Hospital, Alliston, Ont.
Public Health Nurse — Yukon Territory. Applications will be received for
mentioned appointment with headquarters at Whitehorse, Y.T. Applicants err
age, academic & nursing qualifications, public health qualifications & experience & for-
ward references as to character, ability, training & experience. Appointment effective
as from Sept. 1. Salary range: $3,900-4,500 per annum. Usual holiday & sick leave
regulations in effect. Apply Dr. Malcolm R. Bow, Chief Medi
Territory, 9544 Riverside Drive, Edmonton, Alta. ie ee aes ai poaaat
Municipal Nurses for Province of Alberta. Rural service i
, emergency treatment, public
health & maternity program. Salary: $2,520-3,300 depending on ial AcAlioHe & Shere
ence plus modern furnished cottage. Excellent sick leave, vacation & pension benefits.
Apply Director, Nursing Divisi D Publi me I
Edmonton, Alberta. & on, ept. of Public Health, Administration Bldg.,
Public Health Nurses for Stormont, Dundas & Glengarry Health Unit for generalized
program. Starting salary dependent on experience. Apply Dr. R. :
Officer of Health 104-2nd St. W, Cornwall, Ont. P ply aD her Bee eat mecaleal
606 7% Vol. 50, No. 7
Stop Press!
‘ELEN G. McArtnur, immediate past
president of the Canadian Nurses’ As-
- sociation, will leave shortly for a year's
service in Korea, the Canadian Red Cross
Society has announced. Miss McArthur has
been selected to represent the League of
Red Cross Societies as Associate Co-Or-
dinator of Relief for Korea. She will replace
Mr. Albert Batten, National Director of
‘ Kirst Aid for the Canadian Red Cross
Society, who has been the League's re-
presentative in Korea for the past year.
In addition to coordinating all foreign
Red Cross Aid in Korea, Miss McArthur
will act as adviser to the Korean Red Cross.
This struggling Society, having lost approx-
imately two-thirds of its’ professional staff
- and most of its supplies during the war
-there, has been making a determined effort
-to rehabilitate itself. It has been receiving
substantial support from the Canadian Red
Cross Society in the form of an annual
grant of $15,000 towards its administrative
expenses, an annual grant of $20,000 from
the Junior Red Cross to finance a self-help
sewing project for the Korean Jun‘ors, as
well as shipments of clothing and bedding
for its hospital and sanatorium.
Miss McArthur, who for the past eight
years has been national director of nursing
services for the Canadian Red Cross Socie-
ty, is eminently qualified for this appointment
as, apart from a strong Junior Red Cross,
the programs of the Korean Red Cross are
mainly of a medical and nursing type. A
200-bed hospital is operated in Seoul and a
100-bed tuberculosis sanatorium for children
in Inchen. In addition, ten Chapters operate
both permanent and mobile medical clinics,
The Society has its own small school of
nursing in connection with which Miss
McArthur’s advice and assistance will be
invaluable.
The Korean Society is also depending
upon Miss McArthur to help in organizing
new Chapters. Her varied experience also
includes this type of knowledge as she was
responsible for organizing the Newfoundland
Division of the Canadian Red Cross Society
when Newfoundland became Canada’s tenth
province. 3
RS
Public Health Nurses for City of Guelph for: generalized program. Car allowance or
car provided. Allowance for experience, annual increment, sick benefits. For particulars
apply Dr. G. Q. Sutherland, M.O.H., City Hall, Guelph, Ont.
shat Baal a ee eS SSS
General Duty Nurse for 17-bed hospital, about 100 miles from Calgary. Salary: $170
with full maintenance. Increase of $5.00 pe
r mo. after each 6 mos. service up to 3 in-
creases. Transportation refunded after 6 mos. service. Usual vacation & statutory
holidays. Apply Municipal Hospital, Elnora, Alta.
i a SS
General Duty Nurses for 40-bed hospital on all-weather highway to Vancouver. 42-hr.
wk. 28 days annual holiday plus 10 statutory holidays. Rotating shifts, annual increases,
‘cumulative sick leave. Self-contained residence. Monthly salary: $250; full maintenance,
$45 per mo. Travelling expenses advance
General Hospital, Princeton, B.C.
d if necessary. Apply Director of Nursing,
a
Senior Instructor to teach Nursing Arts & Surgical Nursing & aid with admjnistration
of school program. One class per yr. of approx. 20. Salary: $260-290; credit given for
experience. 40-hr. wk. 1% days per mo. sick leave cumulative. 11 statutory holidays.
1 mo. vacation. May live in or out of residence. Apply Director of Nurses, Royal
Inland Hospital, Kamloops, B.C.
i
General Duty Nurses for 108:bed modern hospital. Starting salary: $175 per mo. plus
meals & laundry of uniforms. Additional for evening & night duty. Increase at 6 mos.
& annually thereafter for further 2 yrs. 44-hr. wk. 8 statutory holidays. 21 days holidays
after 1 yr. service. Travelling expenses from point of entry into Ontario refunded after
6 mos. service. Cumulative sick time. Medical & hospital plans available. Apply Supt. of
Nurses, Kirkland & District Hospital, Kirkland Lake, Ont.
JULY, 1954
pay vary
Official Directory
CANADIAN NURSES’ ASSOCIATION
1411 Crescent St., Montreal 25, Que.
President .............2:. Miss Gladys J. Sharpe, Western Hospital, Toronto 2B, Ont.
Past President ........... Miss Helen G. McArthur, 95 Wellesley St. E., Toronto 5, Ont.
First Vice-President ..... Miss Trenna G. Hunter, Metropolitan Health Com., City Hall, Van-
couver, B.C.
Seeond Vice-President ... Miss Alice Girard, University of Montreal Hospital, Montreal, Que.
Third Vice-President ..... Miss Muriel Hunter, Provincial Health Dept., Fredericton, N.B. .
General Secretary ........ Miss M. Pearl Stiver, Ste. 401, 1411 Crescent St., Montreal 25, Que.
OTHER MEMBERS OF EXECUTIVE COMMITTEE
Presidents of Provincial A ssociations—
Alberta. .......... cece eeee Miss Helen E. Penhale, School of Nursing, University of Alberta.
Edmonton. 5
British Colambia.......... Miss Alberta Creasor, 1645 West 10th Ave., Vancouver 9.”
Manitoba...............8.. Miss Evelyn M. Watts, 580 Spruce St., Winnipeg. .
New Brunswick........... Miss Murlel Hunter, Provincial Health Dept.. Fredericton.
Newfoundland ........... Miss Elizabeth Summers, 55 Military Rd., St. John’s.
Nova Seotia............... Miss Jean Forbes, V.O.N., 504 Roy Bldg., Halifax.
Cntario. .... 2. cece ce eae Miss Bianca Beyer, Runnymede Hospital, Toronto.
Prince Edward Island..... Miss Verna Darrach, 62 Prince St., Charlottetown.
Quebec... . 1... ccc cece eee Mile Eve Merleau, Apt. 52, 3201 Forest Hill, Montreal 26.
Saskatchowan............. Miss Grace Motta, General Hospital, Moose Jaw.
Religious Sisters (Regional Representation )—
Maritimes ................ Rev. Sister Helen Marie, St. Joseph's Hospital, Saint John, N.B. —
Quebec ........ 0.0... cee Rev. Sister Denise Lefebvre, Institut Marguerite d’Youville,
1185 St. Matthew St., Montreal 25. _
Ontario .................. Rev. Sister M. de Sales, St. Michael's Hospital, Toronto 2.
Western Canada ......... Rev. Sister Mary Lucita, St. Joseph’s Hospital, Victoria, B.C.
Chairmen of National Committees—
Nursing Serviee .......... Miss Alice Girard, University of Montreal Hospital, Montreal, Que,
Nursing Education ....... ; , ,
Pablicity & Public
Helations ............
Finance ...............000 Miss Trenna G. Hunter, Metropolitan Health Com., City Hall, Van-
couver, B.C. : .
EXECUTIVE OFFICERS
Alberta Ass'n of Registered Nurses, Mrs. Clara Van Dusen, Ste. 5, 10129-102nd St., Edmonton.
Heslesered avaeees: Ass’n of British Columbia, Miss Alice L. Wright, 2524 Cypress St., Van-
Manitoba Ass’n of Registered Nurses, Miss Lillian E. Pettigrew, 247 Balmoral St., Winnipeg.
New Brunswick Ass’n of Registered Nurses, Miss Alma F. Law, P.O. Box 86, Fredericton.
Ase’n of Registered Nurses of Newfoundland, Miss Paullne Laracy, 203 Water St., St. John’s.
Registered Nurses’ Ase’n of Nova Scotia, Miss Nancy H. Watson, 301 Barrington St.. Halifax. ‘
Registered Nurses’ Ase’n of Ontario, Miss Florence H. Walker, 515 Jarvis St., Toronto 5.
Ase’n ef Nurses of Prince Edward Island, Miss Muriel Archibald, Riley Bldg., Charlottetown.
Asseciation of Nurses of the Province of Quebee, Miss Winonah Lindsay, 506 Medical Arts
Bldg.. Montreal 25.
Naskatechewan Registered Narsee’ Ase’n, Miss Lola Wilson, 401 Northern Crown Bldg., Regina.
R
ASSOCIATION OFFICERS
Canadian Nurses’ Association: 1411 Crescent St., Montreal 25, Que. General Secretary-Treasurer,
Miss M. Pearl Stiver. Secretary of Nursing Education, Miss Frances U. McQuarrie. Secretary
of Nursing Service, Miss F. Lillian Campion.
Iatermational Council of Nurses: 19 Queen’s Gate, London S.W. 7, England. Executive Secretary,
Miss Daisy C. Bridges.
“
608 Vol. 30, No. 7
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