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January  1971 


U'^TVEHSITY   OF  OTTA'-YA 

SCaCOL   0?   KU?.SI:.3  LIBRARY 
OTTAWA   2,    ONTARIO. 

12-7I-12-7C-CN-PD 


The 


Canadian 

Nurse 


Happy  New  Year! 

Nursing —  evolution 
or  revolution? 

Congenital  rubella 

—  an  approach  to  preventio 


Graduation  just  around  the  Corn< 


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There's  no  way  airborne  contaminants  can  accidentally  get  into 
viAFLEx  plastic  containers  unless  you  inject  them.  Unlike  gfass 
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It's  the  only  completely  closed  I.V.  system;  airborne  contami- 
nants are  locked  out,  and  the  system  remains  sterile  throughout 
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cannot  get  in — because  the  spike  completely  occludes  the  port 


opening  before  it  punctures  the  internal  safety  seal.  A  self- 
sealing  latex  cap  on  the  second  port  is  provided  tor  adding 
supplemental  medication,  viaflex  is  the  first  and 
only  plastic  container  for  intravenous  solutions,  ^h-j^- 
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2       THE  CANADIAN   NURSE 


I 

JANUARY  1971 


The 

Canadian 
Nurse 


^ 

^^p 


A  monthly  journal  for  the  nurses  of  Canada  published 

in  English  and  French  editions  by  the  Canadian  Nurses'  Association 


Volume  67,  Number  1 


January  1971 


27     CNA  Report  to  the  Minister  of  Health  on  the 
Recommendations  of  the  Task  Forces  on 
Cost  of  Health  Services 

3 1  Information  for  Authors 

32  Nursing  —  Evolution  or  Revolution? L.C.Ford 

38     Congenital  Rubella  —  One  Approach  to  Prevention W.M.  Reid 

4 1     Selection  and  Success  of  Students  in  a 

Hospital  School  of  Nursing E.A.  Willett,  Rev.  P.A.  Riffel 

L.J .  Breen,  Sister  E.J .  Dickson 

46  Idea  Exchange  P.Hayes 

47  MEDLARSandYou A.D.Nevill,M.L. Parkin 


The  views  expressed  in  the  various  articles  are  the  views  of  the  authors  and  do  not 
necessarily  represent  the  policies  or  views  of  the  Canadian  Nurses'  Association. 


4  Letters 
1 7  Names 
23     In  a  Capsule 


7  News 
22  Dates 
64     Index  to  Advertisers 


Executive  Director:  Helen  K.  Mussallem  • 
Editor:  Virginia  A.  Lindabury  •  Assistant 
Editor:  IJv-Ellen  Lockeberg  •  Production 
Assistant:  Elizabeth  A.  Stanton  •  Circula- 
tion Manager:  Beryl  Darling  •  Advertising 
Manager:  Ruth  H.  Baumel  •  Subscrip- 
tion Rates:  Canada:  one  year,  $4.50;  two 
years,  $8.00.  Foreign:  one  year,  $5.00;  two 
years,  $9.00.  Single  copies:  50  cents  each. 
Make  cheques  or  money  orders  payable  to  the 
Canadian  Nurses'  Association.  •  Change  of 
Address:  Six  weeks'  notice;  the  old  address  as 
well  as  the  new  are  necessary,  together  with 
registration  number  in  a  provincial  nurses' 
association,  where  applicable.  Not  responsible 
for  journals  lost  in  mail  due  to  errors  in 
address. 


Manuscript  Information:  "The  Canadian 
Nurse"  welcomes  unsolicited  articles.  All 
manuscripts  should  be  typed,  double-spaced, 
on  one  side  of  unruled  paper  leaving  wide 
margins.  Manuscripts  are  accepted  for  review 
for  exclusive  publication.  The  editor  reserves 
the  right  to  make  the  usual  editorial  changes. 
Photographs  (glossy  prints)  and  graphs  and 
diagrams  (drawn  in  India  ink  on  white  paper) 
are  welcomed  with  such  articles.  The  editor 
is  not  committed  to  publish  all  articles 
sent,  nor  to  indicate  definite  dates  of 
publication. 

Postage  paid  in  cash  at  third  class  rate 
MONTREAL,  P.O.  Permit  No.  10,001. 
50  The  Driveway,  Ottawa  4,  Ontario. 
C  Canadian  Nurses'  Association  1970. 


r 


Guest  Editorial 


JANUARY  1971 


As  you  are  aware,  the  Report  of  the 
Royal  Commission  on  the  Status  of 
Women  was  tabled  in  Parliament  on 
December  7.  The  Prime  Minister  stated 
that  the  Government  would  study  it 
before  making  any  decisions  in  regard 
to  its  recommendations. 

Regardless  of  differences  of  opinion 
that  may  be  held  on  various  recom- 
mendations, this  could  be  a  very  im- 
portant document  as  far  as  the  po- 
sition of  Canadian  women  is  concerned. 
For  example,  if  implemented,  the  pro- 
gram of  day  care  centers  could  be  vital 
in  protecting  the  home,  the  children, 
the  mother,  and  society,  which  must 
bear  the  ultimate  burden  of  neglect. 
Many  other  recommendations  could 
be  extremely  useful  in  helping  women 
to  achieve  the  position  of  equality 
with  men  which  is  essential  in  today's 
world. 

As  the  only  woman  Member  now 
in  the  House  of  Commons,  I  am  deeply 
concerned  that  Parliament  may  fail  to 
give  this  matter  the  priority  it  needs. 
Your  help  in  getting  action  is  essential. 
Many  women's  groups  appeared  before 
the  Commission  and  presented  their 
views.  A  strong  and  sustained  campaign 
by  your  organization  is  crucial  now  for 
the  success  of  the  Report. 

As  a  beginning,  I  would  suggest  a 
"write-in"  campaign  as  soon  as  Par- 
liament reconvenes  about  mid-January. 
Letters  and  petitions  should  tlood  the 
office  of  the  Prime  Minister,  House  of 
Commons,  Ottawa,  urging  legislation 
on  the  Report  this  session.  And  if  your 
Member  of  Parliament  needs  conver- 
sion to  the  recommendations  (I  do  not!) 
a  letter  to  him  would  be  useful  as  well. 

On  the  principle  of  first  things  first, 
your  letter  might  deal  with  two  specif- 
ic matters: 

The  first  is  to  urge  that  a  Minister 
of  the  Cabinet  be  designated  to  consid- 
er the  Report  as  a  whole  and  assign 
the  responsibility  for  legislative  action 
to  the  appropriate  departments  of 
government. 

The  second  is  to  press  for  immediate 
action  to  secure  a  program  of  day  care 
centers  as  the  first  step  in  a  broader 
scheme  of  child  care  as  recommended 
by  the  Commission.  This  was  the 
single  item  most  often  requested  by 
Canadian  women  in  their  briefs  to  the 
Commission. 

But  let  me  urge  the  absolute  neces- 
sity of  action  now.  Otherwise  there  is 
grave  danger  of  this  fine  Report  slipping 
into  one  of  those  forgotten  filing  cab- 
inet drawers.  —  Grace  Maclnnis, 
M.P.,  Vancouver-Kingsway. 

THE  CANADIAN   NURSE       3 


letters 


Letters  to  the  editor  are  welcome. 

Only  signed  letters  will  be  considered  for  publication,  but 

name  will  be  withheld  at  the  writer's  request. 


Editor's  Note:  Copies  of  tite  Canadiun 
Nurses'  Association's  Stand  on  The 
Physician's  Assistant  were  sent  to 
many  other  professional  associations 
and  to  individuals  concerned  with 
health  care.  We  believe  some  of  the 
responses  would  be  of  interest. 

I  am  in  complete  agreement  with  this 
statement  and  wish  to  associate  myself 
fully  with  your  stand.  Having  had  a 
great  deal  of  experience  outside  Canada 
in  the  use  of  various  categories  of  health 
workers.  1  cannot  see  the  need  for  the 
development  of  a  separate  category 
of  individual  for  the  physician's  assis- 
tant or  associate. 

It  seems  to  me  that  many  members 
of  the  medical  profession  have  not,  in 
the  past,  fully  used  the  modern  well- 
educated  nurse.  In  many  instances,  the 
nurse  has  been  operating  at  a  level  of 
responsibility  which  is  far  below  that 
of  her  training. 

Quite  clearly,  the  best  person  to 
operate  as  a  physician's  assistant  is 
the  nurse,  and  we  should  use  this  pool 
of  experience  and  devotion  for  the 
development  of  health  services.  .  .  . 

It  appears  to  me  there  are  too  many 
academics  involved  in  the  planning  of 
our  health  services.  There  are  very  few 
of  them  who  have  actually  run  and  op- 
erated a  health  service. 

If  these  people  who  advocate  the 
development  and  traming  of  a  physi- 
cian's assistant  have  the  responsibility 
of  running  an  efficient  health  service 
at  a  reasonable  price,  I  do  not  think 
they  will  be  so  enthusiastic  in  trying  to 
develop  new  personnel,  manv  of  whom 
will  find  this  a  dead-end  occupation. 
—  W.  Harding  le  Riche,  M.D.,  M.P.H., 
professor  and  head,  department  of  epi- 
demiology and  biometrics.  University 
of  Toronto,  Toronto,  Ontario. 

From  the  discussions  which  our  com- 
mittee has  had  about  this  matter  I 
would  think  the  feeling  of  the  majority 
of  doctors  would  be  in  line  with  the 
policy  set  out  by  your  association.  — 
Glen  Sawyer,  M.D.,  general  secretary, 
Ontario  Medical  Association,  Toronto. 

In  my  opinion,  most  doctors  would 
take  no  exception  to  what  is  in  your 
statement,  which  makes  me  wonder 
if  the  medical  profession  and  the  nurs- 
ing association  are  not  agreed  on  the 
type  of  professional  that  should  fill  this 
intermediate  role. 
4       THE  CANADIAN   NURSE 


Since  your  association  is  concerned 
about  the  term  "physician's  assistant," 
you  might  find  that  members  of  the 
medical  profession  are  likewise  con- 
fused as  to  what  is  really  meant  by 
this  term.  It  is  obvious  more  dialogue 
will  be  necessary  in  the  near  future.  — 
D.L.  Kippen,  M.D.,  president,  Cana- 
dian Medical  Association,  Ottawa. 

A  copy  of  the  CNA  statement  on  the 
physician's  assistant  has  been  mailed 
to  the  dean  of  every  Canadian  Medical 
school. — John  B.  First  brook,  M.D., 
Ph.D..  executive  director,  The  As.so- 
ciation  of  Canadian  Medical  Colleges. 

Telegram  supports  abortion  reform 

November  editorial  superlative.  Con- 
cur CNA  needs  to  take  a  visionary  stand 
on  the  abortion  issue  for  removal  from 
Criminal  Code.  Inherent  are  the  eco- 
logical and  social  concerns  of  popula- 
tion control  through  education.  Health 
personnel,  ethical  codes,  and  World 
Health  Organization  definition  of  health 


MOVING? 
BEING  MARRIED? 

Be  sure  to  notify  us  six  weeks  in  advance, 
otherwise  you  will  likely  miss  copies. 


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reg.  no. /perm,  cert./  lie.  no. 

r~|    I  am  a  Personal  Subscriber. 

MAIL  TO: 

The  Canadian  Nurse 

50  The  Driveway 
OTTAWA  4,  Canada 


should  be  guides  to  effective  actioi 
rather  than  statutory  laws.  —  Dr.  Shir 
ley  R.  Good,  Director,  School  of  Nitrs 
ing.    University   of  Calgary,   Calgary 

A  student  who  cares 

Recently,  my  patient  assignment  in 
eluded  a  very  old,  blind,  and  partiallj 
immobilized  man.  I  have  never  criec 
as  much  in  my  whole  life  as  I  did  wher 
caring  for  this  patient,  who  groped  foi 
all  the  caring  and  love  he  could  get. 
grew  to  love  him,  as  he  needed  to  bt 
loved  so  much. 

I  did  not  cry  because  I  felt  sorrjx 
for  him,  but  because  this  old  man,  in 
significant  as  he  sounds,  made  me 
really  think  for  the  first  time  abou 
how  little  love  there  is,  even  in  tht 
world  of  nursing. 

Little  things  mean  so  much  to  peo 
pie  who  need  to  be  loved.  Once  II 
brought  my  patient  a  rose  that  my  boy 
friend  sent  me  on  St.  Patricks  Day 
When  I  approached  him,  I  told  him  I 
had  a  present  for  him.  He  looked  un 
happy  and  said  to  me,  "But  I  can't  set 
it,  I'm  blind."  I  said,  "I  know,  but  1 
want  you  to  smell  it  and  feel  how  sofi 
it  is."  He  did,  and  I  felt  like  a  millior 
dollars. 

I  do  not  believe  many  prople  car 
take  the  time  to  sit  down  and  think 
about  loving  and  caring  for  people 
I  realize  how  fortunate  1  am  to  be  £ 
nurse  and  to  be  exposed  to  this  tremen- 
dous need  for  love. 

I  did  not  feel  sorry  for  this  man,  bui 
I  did  identify  with  him.  I  saw  how  selfish 
I  must  have  been  before  meeting  him. 
I  sometimes  find  myself  thinking  about 
all  the  caring  that  is  needed  in  this 
world  for  people  who  can,  should,  and 
need  to  be  loved.  If  this  love  could  be 
given,  it  would  bring  fullness  to  many 

I  washed  this  patient's  socks,  scrupu- 
lously cleaned  nis  dentures,  and  telt 
pleased  at  his  reactions.  I  told  him  he 
had  other  senses  to  make  up  for  his 
blindness.  When  he  smiled,  squeezed 
my  hand,  and  laughed,  he  gave  me 
so  much. 

I  learned  much  about  myself  when 
caring  for  this  elderly  patient.  Now 
I  realize  how  secondary  practical  know- 
ledge can  be  when  compared  to  self- 
understanding.  It  takes  a  long  time  to 
know  yourself,  but  when  you  do  you 
never  forget  what  you  have  learned  — 
Shannon  Cruikshank,  second-year 
nursing  student  at  St.  Joseph's  School 
of  Nursing,  Hamilton,  Ontario.  '§ 

JANUARY  197- 


i'V 


# 


« 


O 

1 

This  decongestant  tablet  contends  that  a 
cold  is  not  as  simple  as  it  seems  on  television 


Coricidin*  "D"  tablets 
shrink  swollen  mem- 
branes with  the  best  of 
them  (note  the  10  mg.  of 
phenylephrine). 

Unfortunately,  the  mis- 
ery of  a  cold  doesn't  end 
with  unblocked  passages. 

That's  why  Coricidin  "D" 
also  contains  two  anti- 
pyretic and  analgesic 
agents.  They  cool  down 
the  steaming  fever  and 
suppress  the  aches  and 


pains   that   go   with   the 
adult  cold. 

That's  why  we  also  help 
perk  up  sagging  spirits 
with  30  mg.  Caffeine. 
And  why  we  also  include 
2  mg.  of  Chlor-Tripolon* 
to  combat  rhinorrhea  . . . 
and  strike  out  at  the  very 
root  of  congestion. 
Know  of  another  cold 
reliever  that  gives  your 
patient  so  many  helpful 
also's? 

Coricidin  "D 
comprehensive  relief 
of  cold  symptoms 


"^xJicUna 


Corporation  Limited 
Pointe  Claire  730,  P.O. 


DESCRIPTION:  Each  CORICIDIN 
'  D"  tablet  contains  2  mg. 
CHLOR-TRIPOLON'  (chlorpheni- 
ramine maleate).  230  mg.  acetyl- 
salicylic  acid,  160  mg.  phena- 
cetin.  30  mg.  catleine.  10  mg 
phenylephrine. 

DOSAGE:  Adults:  one  tablet 
every  4  hours,  not  to  exceed  4 
tablets  in  24  hours.  Children  (10- 
14  years):  '/j  the  adult  dose. 
Children  under  10  years:  as  di- 
rected by  the  physician. 


SIDE  EFFECTS:  Adverse  reac- 
tions ordinarily  associated  with 
antihistamines,  such  as  drowsi- 
ness, nausea  and  dizziness  occur 
infrequently  with  Coricidin  "D" 
when  administration  does  not 
exceed  recommended  dosage. 
PRECAUTIONS:  May  be  injurious 
if  taken  in  large  doses  or  lor  a 
long  time.  Additional  clinical 
data  available  on  request. 

■  reg   Trade  Mark. 


5'4i 


24  tMirti 


® 


For  colds  of  all  ages: 
Coricidin  tablets, 
Coricidin  with  Codeine, 
Coriforte     for  severe  colds. 
Nasal  tvlist,  Medilets 
and  Coricidin  "D"  Medilets 
for  ctiildren. 
Pediatric  Drops, 
Cough  Mixture 
and  Lozenges. 


A  ward-winning 
combination 


With  Dermassage,  all  you  add  is  your  soft 
touch  to  win  the  praises  of  your  patients. 

Dermassage  forms  an  invisible, 
greaseless  film  to  cushion  patients 
against  linens,  helping  to  prevent 
sheet  bums  and  irritation.  It  protects 
with  an  antibacterial  and  antifungal 
action.  Refreshes  and  deodorizes 
without  leaving  a  scent.  And  it's 
hypo-aUergenic. 

Dermassage  leaves  layers 
of  welcome  comfort  on 
tender,  sheet-scratched       f  _ 
skin.  And  there's  another 
bonus  for  you:  While 
you're  soothing  patients 
with  Dermassage,  you're 
also  softening  and  | 

smoothing  your  hands.    \ 

Try  Dermassage.      \ 

Let  your  fingers 

do  the  talking.  ' 


m 


MEDICATED 


mi 


.  lakeside  U»boratories  (Canada)  lAi\. 
G4  Colgate  Avenue.  Toronto  8.  Ontaric 


*Tratie  mark 


i 


£: 


news 


Social  and  Economic  Welfare 
Committee  Meets  At  CNA  House 

Ottawa  —  The  White  Paper  on  Tax- 
ation, a  nurse  lobbyist,  unemployment 
insurance  legislation,  means  whereby 
staff  turnover  may  be  minimized,  were 
discussed  at  length  by  the  standing 
committee  on  social  and  economic 
welfare  of  the  Canadian  Nurses" 
Association  at  its  meeting  November  9 
and  10. 

David  Weatherhead.  MP-  chairman 
of  the  House  of  Commons  standing 
committee  on  labor,  manpower,  and 
immigration,  was  on  hand  to  answer 
questions  on  the  subject  of  the  inclusion 
of  nurses  within  the  legislation  on  un- 
employment insurance. 

The  CNA  standing  committee  is 
comprised  of  the  chairmen  of  the  pro- 
vincial committees  on  social  and  eco- 
nomic welfare  as  follows:  chairman, 
Marilyn  Brewer  of  New  Brunswick; 
Louise  Nicholas  of  Newfoundland; 
Frances  Reese  of  Prince  Edward  Island; 
Roy  Harding  of  Nova  Scotia;  Berna- 
dette  LeBlanc  of  New  Brunswick; 
Gertrude  Hotte  and  Sheila  O'Neill  of 
Quebec;  Margaret  O'Connor  of  On- 
tario; Shirley  J.  Paine  of  Manitoba; 
Evelyn  Fyffe  of  Saskatchewan;  Iris 
Mossey  of  Alberta;  and  Rosemary 
Macfadyen  of  British  Columbia. 

CNA  Board  Sets  Up  Committee 
To  Study  French-Language  Texts 

Ottawa  —  An  ad  hoc  committee  is 
being  set  up  by  the  Canadian  Nurses' 
Association's  board  of  directors  to 
develop  means  of  encouraging  the 
publication  and  translation  of  French- 
language  textbooks. 

The  decision  was  made  by  the  board 
at  its  meeting  October  7-9,  1970.  Hu- 
guette  Labelle,  CNA  second  vice-pres- 
ident, was  appointed  chairman  of  the 
committee. 

The  setting  up  of  the  committee 
results  from  a  resolution  passed  by  del- 
egates at  the  CNA  35th  general  meet- 
ing which  said, ".  .  .  that  the  CNA  board 
of  directors  consider  as  a  priority  ways 
and  means  of  encouraging  the  produc- 
tion of  textbooks  in  the  French  lan- 
guage." 

Members  of  the  ad  hoc  committee 
as  approved  by  the  board  are:  Claire 
Bigue,  editor,  L'infirmiere  canadienne; 
Margaret  Parkin,  CNA  librarian;  a 
representative  from  Ontario  and  one 
from  New  Brunswick;  and  three  from 
JANUARY  1971 


Quebec,  to  include  one  from  the  Uni- 
versity of  Montreal,  Laval  University, 
and  a  CEGEP  school. 

At  the  board's  request  Mrs.  Labelle 
outlined  some  of  her  ideas  for  the  com- 
mittee. She  believes  CNA  should  act 
as  a  catalyst  in  attempting  to  get  French- 
language  textbooks  published,  and 
said  the  committee  would  compile  a 
list  of  publications  available  in  French. 
(Already  underway  is  a  revision  of  a 
list  of  French-language  textbooks  and 
publications  prepared  in  1967  by 
Miss  Parkin.) 

Mrs.  Labelle  said  the  committee 
would  also  look  at  translations  that 
are  in  the  offing.  It  could  then  devise 
a  tool,  such  as  a  questionnaire,  to  be 
sent  to  institutions  where  French-lan- 
guage textbooks  are  required,  to  iden- 
tify the  need. 

The  questionnaire  would  also  as- 
sess the  willingness  of  institutions  and 
individuals  to  participate  and  coop- 
erate in  such  an  undertaking,  said  Mrs. 
Labelle. 

She  believed  the  next  step  would 
be  to  study  possible  sources  for  fin- 
ancing translation  and  publication, 
possibly  obtaining  assistance  from 
publishers,  individuals,  and  institutions 
willing  to  cooperate. 

CNA  Film  Available 
Through  Local  Chapters 

Ottawa  —  The  Leaf  and  the  Lamp,  a 
20-minute,  sound,  color  film  commis- 
sioned by  the  board  of  the  Canadian 
Nurses"  Association  in  March  1970, 
is  now  available. 

This  film  depicts  how  a  nurse,  through 
participation  at  her  local  chapter  level, 
can  strengthen  the  profession  and  con- 
tribute to  improvements  in  nursing. 
It  shows  the  activities  that  have  been 
generated  and  what  has  been  achieved 
by  the  individual  nurse  through  mem- 
bership in  her  professional  association. 

The  Leaf  and  the  Lamp,  in  English 
or  French,  is  intended  for  showings 
to  nursing  groups,  free  of  charge.  When 
ready  for  general  distribution,  all  chap- 
ters will  have  been  furnished  with  de- 
tailed information. 

CNF  Board  Of  Directors 
Hears  Membership  Up 

Ottawa  —  Finance  and  membership 
always  loom  large  in  the  affairs  of  the 
Canadian    Nurses'    Foundation.    This 


was  no  exception  when  the  CNF  board 
of  directors  met  November  10,  1970 
at  CNA  House. 

Dr.  Helen  K.  Mussallem,  secretary- 
treasurer  of  CNF,  reported  the  founda- 
tion is  assured  of  annual  financial 
support  from  the  provincial  nurses' 
associations  of  British  Columbia,  Al- 
berta, Saskatchewan,  and  Manitoba. 

These  provincial  contributions  will 
provide  over  $30,000  annually.  Dona- 
tions from  all  sources,  unless  identi- 
fied for  research,  are  credited  to  fellow- 
ship funds. 

Discussing  awards,  Dr.  Mussallem 
said  1 9  of  the  20  awards  approved  by 
the  board  in  May  were  accepted.  Four 
fellowships  were  reduced  in  amount 
because  of  receipt  of  financial  help 
from  other  sources.  In  all,  fellowships 
awarded  in  1970  totalled  $59,737. 

As  of  November  1,  membership  in 
CNF  totals  1,429,  an  increase  of  118 
over  1969. 

Plans  are  underway  for  a  program  to 
celebrate  CNF's  10th  anniversary  with 
a  program  at  the  Canadian  Nurses' 
Association  general  meeting  in  1972. 

The  selections  committee,  the  nom- 
inating committee,  the  board  of  direc- 
tors will  all  meet  early  in  May  prior 
to  the  CNF  annual  meeting. 

At  the  annual  meeting  three  pro- 
posals will  be  presented  in  the  form  of 
bylaw  amendments.  These  proposals 
will  deal  with  an  increase  in  member- 
ship fee,  the  composition  and  terms  of 
reference  of  the  research  committee,  and 
a  requirement  that  CNF  membership 
be  compulsory  for  committee  members. 

Hester  J.  Kernen  is  CNF  president, 
with  Albert  W.  Wedgery  as  vice-pres- 
ident. Members  of  the  board  are  J. 
Alice  Beattie,  Sister  Marie  Bonin,  Jean 
Church,  Dorothy  Dick,  E.  Louise 
Miner,  M.  Geneva  Purcell,  and  Ma- 
rion C.  Woodside. 

This  board  completes  its  term  in 
1971  and  a  new  board  will  be  elected 
at  the  annual  meeting  on  May  17. 

Travel  Seminars  To  Be  Held 
For  Nurse  Educators 

Ottawa  —  The  medical  services  branch 
of  the  department  of  national  health 
and  welfare  is  conducting  a  special 
project  in  nursing  in  the  form  of  "travel 
seminars"  for  a  number  of  nurse  edu- 
cators. 

The  participants,  drawn  from  uni- 
versity school  of  nursing  faculties,  will 
have  orientation  at  one  of  three  centers, 
THE  CANADIAN  NURSE       7 


news 


Edmonton,  Montreal,  or  Winnipeg, 
before  proceeding  to  assignments  in 
isolated  nursing  stations.  The  seminars 
will  take  place  in  January,  February, 
and  March,  1971. 

The  purpose  of  the  project  is  to  pro- 
vide an  opportunity  for  nurse  edu- 
cators to  observe  and  participate  in 
nursing  programs  for  people  in  iso- 
lated areas.  It  is  anticipated  that  this 
will  enable  them:  l.to  interpret  the 
needs  to  students;  and,  2.  to  adapt  and 
expand  the  education  of  nurses  to  meet 
the  needs  of  all  Canadians. 

The  medical  services  branch  hopes 
these  seminars  will  be  the  first  of  a 
number  that  will  involve  other  schools 
of  nursing. 

The  Canadian  Nurses'  Association 
will  be  represented  by  its  president, 
E.  Louise  Miner,  and  first  vice-presi- 
dent Kathleen  G.  DeMarsh. 

ANPQ  Resolutions 
—  Forty  Of  Them! 

Montreal,  Quebec  —  Promotions  in  the 
clinical  area,  a  need  to  be  heard,  and 
members'  fees  to  the  Association  of 
Nurses  of  the  Province  of  Quebec  were 
among  important  subjects  discussed 
when  40  resolutions  were  dealt  with  at 
the  asstKiation's  annual  meeting  No- 
vember 2-4. 

If  interested  in  bedside  care,  a  nurse 
should  not  be  obliged  to  climb  the 
impersonal  ladder  of  administration 
for  promotions  to  come  her  way.  This 
prompted  the  ANPQ  to  recommend 
the  granting  of  promotions  "according 
to  various  levels  in  the  clinical  area  in 
order  to  improve  the  clinical  compe- 
tence of  the  nurse,  i.e.,  bedside  nurse, 
team  leader,  nurse  clinician." 

The  ANPO  resolved  to  recommend 
strongly  to  Quebec's  minister  of  health 
that  a  representative  suggested  by  the 
ANPQ  be  named  to  the  Health  Insur- 
ance Board.  The  association  firmly 
believes  that  a  professional  corporation 
with  more  than  30,000  members,  who, 
among  them,  work  in  all  areas  included 
in  the  Health  Insurance  Scheme,  be 
given  representation  on  its  board. 

Balancing  the  budget  is  the  prime 
responsibility  of  any  business  enter- 
prise. The  ANPQ's  budget  is  so  finely 
honed  that  its  revenues  must  be  in- 
creased —  additional  fees  from  mem- 
bers could  be  the  answer.  It  was  there- 
fore resolved  that  the  ANPQ  consider 
the  needs  and  the  complexities  of  a 
possible  fee  increase,  and  present  its 
findings  at  the  next  annual  meeting, 
and  that  each  district  also  study  this 
matter  to  bring  feedback  to  the  ANPQ 
8       THE  CANADIAN   NURSE 


ANPQ  Honors  Past  Presidents 


Ten  living  past  presidents  of  the  Association  of  Nurses  of  the  Province  of  Que- 
bec were  honored  at  a  reception  at  the  Queen  Elizabeth  Hotel,  Montreal,  in 
conjunction  with  the  50th  anniversary  of  the  association.  As  a  memento,  each 
was  presented  with  the  a  sculpture  of  a  nurse.  Here,  Caroline  V.  Barrett,  ANPQ 
president  from  1932  to  1936.  receives  her  gift  from  Ann  Arundel-Evans,  staff 
nurse  at  the  Queen  Elizabeth  Hospital.  Looking  on  are  ANPQ  President  Helen 
D.  Taylor  and  immediate  past  president,  Madeleine  J  albert.  More  than  500 
attended  this  reception,  the  first  event  of  the  three -day  anhual  meeting  of  the 
association.  The  past  presidents  honored  were,  in  order  of  holding  office: 
Miss  Barrett,  Eileen  C.  Flanagan,  Annonciade  Martineau-Bergcron,  Eve 
Merleau.  Margaret  M.  Wheeler,  Sister  Mance  Dccary,  Heiene  M.  Lamont, 
Gertrude  Jacobs,  Miss  Jalbert,  and  Miss  Taylor,  the  current  president. 


from  the  members  at  large,  so  that  all 
opinions  may  be  considered  at  the  next 
annual  meeting. 

Many  of  the  other  resolutions  spark- 
ed interesting  discussions  that  in  most 
cases  led  to  referral  to  a  committee 
such  as  that  of  management  for  further 
study  or  action. 

ANPQ  President  Says  Nurses 
Must  Decide  Own  Future 

Montreal,  Quebec  —  Determining  the 
social  usefulness  of  nurses  of  the  future 
must  remain  the  challenge  of  nurses 
themselves,  individually  and  collective- 
ly. This  was  the  core  of  Helen  D.  Tay- 
lor's address  to  the  50th  annual  meeting 
of  the  Association  of  Nurses  of  the 
Province  of  Quebec,  held  at  the  Queen 
Elizabeth  Hotel  in  Montreal  Novem- 
ber 2-4. 

Miss  Taylor,  who  is  serving  her 
second  term  as  ANPQ  president,  said 
that  although  nursing  needs  to  func- 
tion interdependently  with  all  health 
professions,  it  does  not  follow  that 
solutions  to  the  problems  of  other  pro- 


fessions apply  to  nursing  or  that  other 
professions  should  be  encouraged  to 
make  decisions  affecting  nursing. 

Nurses  today  are  faced  with  a  dilem- 
ma as  to  their  future  role.  Miss  Taylor 
said.  Are  they  to  be  givers  of  tender- 
ness, or  are  they  to  be  doctors"  assist- 
ants'.'  They  must  demonstrate  a  willing- 
ness and  an  ability  to  share  in  the  tech- 
nological advances  of  the  medical 
sciences,  and  at  the  same  time  give 
expert  personal  care  and  grow  pro- 
fessionally. Otherwise,  she  said,  the 
medical  practitioner  and  the  public 
may  lack  confidence  in  the  nurses'  abil- 
ity to  cope  with  future  demands. 

Miss  Taylor  said  the  nursing  pro- 
fession needs  representatives  who  are 
informed,  articulate,  and  able  to  con- 
tribute. She  urged  individual  nurses  to 
accept  the  basic  obligation  to  become 
informed,  not  only  on  matters  directly 
affecting  nursing  care,  but  on  those 
affecting  health,  such  as  social  health 
problems,  safety  health  measures,  and 
political  and  legislative  issues. 

(Continued  on  page  10) 
JANUARY  1971 


for  use 
-on  the  ward 
-in  the  OR 


-in  training 


NEOSPORIN^ 

IRRIGATING 

SOLUTION 

Available:  Sienle  Icc   Ampoules. 
Boxes  of  10  and  1CX> 

INSTRUCTIONS  FOR  USE 

This  piewation  is  tp*C'!ic«ltv  (JBiigT^ed  'Of  oM  with  5  cc. 
■tnre«-i«»v'  c«hetef»  ix  with  othw  cAtnaiet  sv»i»ms  permn- 
ting  continuous  irrigation  of  th«  unncry  UwMm 

1  PRCPARE  SOLUTION 

Using  cicrilt  piecAuliont.  on«  (1 )  cc.  of  Neosponn  Irrrga- 
tiog  Solution  ihouM  be  added  to  a  1 .000  cc  bottle  of 
sienla  isotonic  salm*  solution 

2  INSERT  INDWELUNG  CATHETER 

C«tnet«fii«  the  patient  using  full  sterile  precautions.  The 
i/se  of  an  antibacterial  lubricant  such  as  Lubasoorin*  Uretfiral 
Aniibaaenal  Lubricant  is  recommefKted  during  insertion  ol 

INFLATE  RETENTION  BALLOON 

Fill  a  Luei  type  tyringe  with  10  cc.  of  sterile  water  or  s«line 
(5  CC   lor  balloon,  the  lemaindei  to  compensate  tor  the 
I  required  bv  the  mtlalion  channel)    Insert  syimge 

syringe 

PONNECT  COLLECTION  CONTAINER 

e  outflow  (drainage)  lumen  should  be  asepiically  con- 

a  a  sterile  disposable  plastic  lube,  to  a  sterile 
wsaUe  plastic  collection  bag  (bottle) 

ACH  RINSE  SOLUTION 

nflow  lumen  of  the  S  cc     Ifiree-way    cathetei  should 
be  connected  to  the  bottle  of  diluted  Neosporin 

prigaI>on  Solution  using  xietile  technique 

FaDJUST  FLOW-RATE 

'  for  most  palienis  inttow  rale  of  the  diluted  Neosporih 
Irrigating  Solution  should  be  adjusted  to  a  siow  drip  to 
deliver  about  1,000  cc   every  twenty  four  hours  {about 
<0  cc   per  hour)    If  the  patient  s  unne  output  exceeds  2 
lit*rs  per  day  it  is  recommended  that  the  inflow  rate  be 
■diuited  lo  deliver  2.000  cc  of  (he  sotution  .n  a  twenty- 
four  hour  period   This  requires  the  addition  of  an  ampoule 
of  Neosporin  irrigating  Solution  lo  each  of  two  1,000  cc 
bottles  of  sterile  salme  solution 

KEEP  IRRIGATION  CONTINUOUS 

II  It  important  that  irrigation  of  the  bladder  be  continuous 
The  rinse  t>ot1le  should  never  be  allowed  to  run  dry,  or  the 
inflow  d'lp  interrupted  for  more  than  a  few  minutes   The 
outflow  lube  should  always  be  inserted  into  a  st»ri)e 
COniBtiar 

Convenient  product  identify ir>g  labels  for  use  on  bottles 

of  diluted  Neosporin  Irrigating  Solution  are  available  in  each 

ampoule  packing  or  from  your    B.  W.  ft  Co.'  Representative 


Burroughs  Wellcome  &  Co.  (Canada)  Ltd. 


KtaMKll    .MAC    1 


Neosporin'  Irrigating  Solution 


INSTRUCTIONS  FOR  USE 


Designed  especially  for  the  nursing  pro- 
fession, this  Instruction  Sheet  shows 
clearly  and  precisely,  step  by  step,  the 
proper  preparation  of  a  catheter  system 
for  continuous  irrigation  of  the  urinary 
bladder.  The  Sheet  is  punched  3  holes  to 
fit  any  standard  binder  or  can  be  affixed 
on  notice  boards,  or  in  stations. 

For  your  copy  (copies)  just  fill  in  the  cou- 
pon (please  print)  noting  your  function  or 
department  within  the  hospital. 


Dept.  S.P.E. 

Burroughs  Wellcome  &  Co.  (Canada)  Ltd. 

P.O.  Box  500,  Lachine,  P.O. 

Gentlemen : 

Please  send  me  I I  copy  (copies)  of  the  N.I  S  Instructions  for  Use.  My  department  or  function 

within  the  hospital  '^  


NAME. 


ADDRESS. 


CITY  OR  TOWN. 


.PROV. 


I    PMAC    I 

'Trade  Mark 

JANUARY   1971 


Burroughs  Wellcome  &  Co.  (Canada)  Ltd. 

**  THE  CANADIAN   NUR5b 


(Continued  from  page  8) 

The  ANPQ  president  then  mentioned 
progress  being  made  in  nursing  in  Que- 
bec: the  recognition  of  male  nurses 
through  a  1 969  amendment  to  the  Que- 
bec Nurses'  Act;  the  growing  awareness 
of  the  role  of  the  nurse  in  public  health 
and  in  the  prevention  of  disease;  the 
acceptance  of  the  concept  of  collective 
bargaining;  the  freeing  of  nursing  from 
many  tasks  not  requiring  a  nurse's  spe- 
cial skills  and  technical  knowledge. 

The  tone  for  the  ensuing  meeting 
was  set  by  Miss  Taylor's  closing  re- 
marks: "We  [as  nurses]  can  be  justi- 
fiably proud  of  our  past,  but  let  us 
really  show  that  we  are  prepared  to 
render  far  greater  services  in  the  years 
ahead." 

A  Book  Is  Born 
In  French 

Montreal,  Quebec  —  The  history  of 
the  nursing  profession  in  the  Province 
of  Quebec,  Histoire  de  la  profession 
infirmiere  dans  la  province  de  Quebec, 
came  off  the  press  in  time  to  coincide 
with  the  golden  anniversary  of  the 
Association  of  Nurses  of  the  Province 
of  Quebec. 

The  book  is  first  an  overview  of 
medical  and  nursing  lore  from  ancient 
times;  then,  a  story  of  nursing  gener- 
ally from  the  Roman  era  to  the  found- 
ing of  New  France,  and  more  particu- 
larly from  the  ministrations  of  Jeanne 
Mance  to  the  hospital  services  of  the 
20th  century;  and,  finally,  a  doc- 
umented and  detailed  description  of  the 
origins  and  history  of  the  ANPQ  from 
its  inception  in  1920  to  the  present. 

Written  by  one  of  Canada's  most 
distinguished  medical  journalists,  Dr. 
Edouard  Desjardins,  emeritus  pro- 
fessor of  surgery,  University  of  Mont- 
real, editor-in-chief  of  Union  Medicale, 
honorary  archivist  and  librarian  of  the 
Royal  College  of  Physicians  and  Sur- 
geons of  Canada,  the  book  required 
two  years  in  the  making. 

In  1968,  the  committee  of  manage- 
ment of  the  ANPQ  assigned  Eileen 
Flanagan,  former  president  of  the  AN- 
PQ, and  Suzanne  Giroux,  formerly  an 
executive  with  the  ANPQ,  to  organize 
this  project.  Now  one  step  remains:  to 
translate  this  volume  into  English  for 
publication  later  this  year. 

Information  Seminar  Held 
On  National  Health  Grant 

Ottawa  —  Modified  terms  of  reference 
for  the  federal  government's  National 
Health  Grant  were  discussed  with  pro- 
vincial representatives  and  health  and 
10     THE  CANADIAN  NURSE 


Miss  Flanagan  autographs  the  first 
copy  of  "Histoire  de  la  profession  in- 
firmiere dans  la  province  de  Quebec" 
for  Judge  Roger  Ouimet,  former  legal 
consultant  of  the  ANPQ. 


educational  authorities  at  a  one-day 
meeting  in  November. 

National  health  and  welfare  min- 
ister John  Munro  said  the  national  grant 
has  provided  funds  for  some  87  research 
projects  designed  to  improve  health 
care  for  Canadians.  The  program  has 
been  in  operation  for  two  years.  The 
grant's  1970/71  budget  is  $2,100,000. 

Dr.  J.  Maurice  LeClair,  deputy  min- 
ister of  national  health,  reviewing  the 
general  objectives  of  the  program  said, 
"The  national  health  grant  is  concerned 
with  research,  demonstration  and  pilot 
projects,  and  training  personnel.  This 
means  a  good  methodology  and  evalua- 
tion of  results  .  .  ." 

The  grant's  terms  of  reference  in- 
clude provision  of  financial  assistance 
for  operational  research  in  such  areas 
as  better  utilization  of  health  manpower; 
better  management  and  coordination  of 
health  delivery  systems;  and  recruit- 
ment, training,  and  development  of 
research  personnel. 

Speakers  included  Dr.  G.  Malcolm 
Brown  of  Ottawa,  president.  Medical 
Research  Council;  Jean-Yves  Rivard, 
professor,  department  de  I'adminis- 
tration  de  la  sante,  Universite  de  Mont- 
real; Dr.  David  L.  Sackett,  professor, 
department  of  clinical  epidemiology 
and  biostatistics,  McMaster  University; 
Dr.  Aurele  Beaulnes,  recently  named 
to  coordinate  federal  health  depart- 
mental activities  concerning  non-med- 
ical use  of  drugs  and  professor,  depart- 
ment of  pharmacology  and  therapeu- 
tics, McGill  University;  Dr.  Peter  Ru- 


derman,  professor,  health  administra- 
tion, school  of  hygiene,  University  of 
Toronto;  and  Dr.  J.A.  Dupont,  assistant 
director,  health  grants,  department  of 
national  health  and  welfare. 

Health  associations  represented  in- 
cluded the  Canadian  Medical  Asso- 
ciation, Canadian  Dental  Association, 
Canadian  Hospital  Association  and  the 
Canadian  Nurses'  Association.  Dr. 
Helen  K.  Mussallem  represented  CNA. 

Dr.  John  R.  Evans,  dean,  faculty  of 
medicine,  McMaster  University,  was 
chairman. 

AARN  Warns  Nurses 
Of  Job  Shortage 

Edmonton,  Alta.  — There  are  practi- 
cally no  nursing  positions  available  in 
Alberta  cities,  said  the  Alberta  Asso- 
ciation of  Registered  Nurses.  However, 
there  are  still  a  few  openings  in  rural 
areas,  in  the  northern  part  of  the  prov- 
ince, and  in  the  Northwest  Territories, 
AARN  points  out. 

Because  of  the  scarcity  of  nursing 
jobs,  the  association  is  warning  nurses 
outside  the  province  not  to  seek  work 
in  Alberta.  Doris  Price,  registrar  of 
AARN,  said  a  nurse  from  another 
province  should  come  to  the  province 
only  if  she  already  has  a  job. 

Statistics  compiled  in  an  AARN 
survey  show  that  most  of  the  recent 
1970  graduates  of  schools  of  nursing 
in  the  province  are  employed. 

Speakers  And  Panelists  Announced 
For  Research  Conference 

Vancouver,  B.C.  —  Two  of  North 
America's  leading  nurse  researchers 
—  Dr.  Faye  G.  Abdellah  and  Dr.  Lo- 
retta  E.  Heidgerken  —  will  give  the 
highlight  presentations  at  Canada's 
first  national  conference  on  research 
in  nursing  practice  to  be  held  in  Ottawa 
February  16-18,  1971. 

Dr.  Abdellah  is  the  chief  nurse  offi- 
cer and  assistant  surgeon  general  of 
the  United  States  Public  Health  Serv- 
ice, and  associate  director  for  health 
services  development  in  the  National 
Center  for  Health  Services  Research 
and  Development.  At  the  Ottawa  con- 
ference, which  is  intended  to  bring 
Canadian  nurses  together  for  the  pur- 
pose of  stimulating  research  in  nursing 
practice  in  Canada,  Dr.  Abdellah  will 
speak  on  "The  Development  of  Nursing 
Research  in  the  Society." 

Dr.  Loretta  E.  Heidgerken,  profes- 
sor of  nursing  education,  The  Catholic 
University  of  America  School  of  Nurs- 
ing, Washington,  D.C.,  will  discuss 
"The  Research  Process"  at  the  Ottawa 
conference. 

Canadian  nurses  who  will  present 

papers,  act  as  chairmen,  or  as  panelists 

include:   Dr.   Floris  E.   King,   project 

director  of  the  conference;  Dr.  Amy  E. 

(Continued  on  page  14) 

JANUARY  1971 


Up-to-date  information 
to  lielp  you  &  your  patients 


Pharmacology  for 
Practical  Nurses,  3rd  Edition 

By  Mary  Kaye   Asperheim,  B.S.,  M.S.,  M.D. 


A  new  edition  of  this  outstandingly  useful  text.  The 
author  discusses  drugs  in  relation  to  body  systems  and 
their  diseases;  she  describes  the  physical  forms  of  the 
drugs,  the  usual  dosage,  methods  of  administration, 
symptoms  of  overdosage,  and  abnormal  reactions  which 
may  arise.  This  third  edition  includes  a  chapter  on 
antineoplastic  drugs,  and  the  drug  descriptions  and 
dosage  reflect  the  latest  research. 

171  pages  illustrated.  About  $3.80  Ready  January  1971. 


Mayo  Clinic  Diet  Manual 
4th  Edition 

By  the  Committee  on 
Dietetics  of  the  Mavo  Clinic 


Here  is  the  new  edition  of  the  most  popular  and  respected  dietetic 
guidebook  available  today.  This  manual  presents  the  latest 
concepts  in  treatment  of  diseases  requiring  dietary  regulation. 
It  has  been  revised  and  expanded  to  take  into  account  recent 
advances  in  nutrition.  A  fundamental  change  is  the  use  of  the 
Mayo  Clinic  Food  Exchange  List  as  the  basis  for  planning  most 
therapeutic  diets. 

About  170  pages.  About  $7.30.  Ready  January  1971. 


The  Management  of  Patient  Care: 

Putting  Leadership  Skills  to  Work,  3rd  Edition 


By  Thora  Kron,  R.N.,  B.S. 


This  text,  called  Nursing  Team  Leadership  in  previous  editions,  is  designed  to 
show  the  professional  nurse  the  many  ways  she  may  exercise  leadership  in 
the  management  of  patient  care.  New  material  includes  methods  to  help  the  nurse 
become  more  efficient  in  arranging  supplies  and  equipment,  in  studying  and 
revising  nursing  technhiques,  in  delegating  activities  to  members  of  the  nursing 
staff,  and  in  planning  her  own  activities. 

About  208  pages,  illustrated.  About  $3.80.  Ready  January  1971. 


The  Nursing  Clinics  of  North  America 


The  Patient  with  Tramna 

Janet  Finnegan  Carroll,  Guest  Editor 


The  Nurse  in  Community 
Mental  Health 

Lorene  R.  Fischer,  Guest  Editor 


The  December  issue  of  this  famous  hardbound  periodical  carries 
16  articles  on  topics  of  vital  importance  to  nurses.  Each  article 
covers  a  specific  aspect  of  the  subject  of  the  symposium.  This 
issue  includes  an  article  on  the  battered  child  by  Joan  Hopkins, 
and  one  on  cooperation  between  nurses  and  community  members 
in  community  mental  health  clinics,  by  Hilda  Richards  and 
Naomi  Hargrave  of  Harlem  Hospital.  The  Clinics  provide  a 
continuing  source  of  information  for  the  practicing  nurse. 

Published  four  times  yearly.  Averages  185  pages  per  issue,  with  no 
advertising.  Hardbound.  Available  only  by  yearly  subscription.  $13. 


W.   B.   SAUNDERS  COMPANY  CANADA  LTD.,    1835   Yonge   Street,   Toronto  7 

Pleose    send    on    approvol    and    bill    me: 

D  Asperheim,  Pharmacology  for  Practical  Nvnoi  ($3.80) 

D  Mayo  Clinic  Diet  Manual  ($7.30) 

O  Kron,  Management  of  Patient  Care  ($3.80) 

□  Enter  my   subscription  to  Nursing  Clinics,  to  begin   with  the  December  issue  ($13.) 

Name: 

Address:    

City:  ..........V— "--"T"--- ...—,.. 


Zona;  Province: 


JANUARY  1971 


CN  1011 
THE  CANADIAN   NURSE     11 

% 


«f 


^u^^^ 


I 


She  is  needed 
here  and  now. 

Why 

send  her  away 

for  training  ? 


Complete  in-hospital  training 

of  the  coronary-care  nurse 

is  now  possible  with  the 

ROCOM  ecu  Multimedia  Instructional  System 


* 


Constant  care,  early  detection, 
effective  treatment:  tiiese  are 
essential  to  any  Coronary  Care 
Unit.  They  come  about  only 
through  special  training  in  the 
necessary  life-saving  skills. 

The  ROCOM  CCU  Multimedia 
System,  as  its  name  suggests, 
employs  several  forms  of  instruc- 
tion and  communication:  motion 
pictures,  sound  film  strips,  audio- 
tapes and  texts  comprising  lec- 
tures, demonstrations,  problem- 
solving  and  evaluation  proce- 
dures. 

Some  hospitals  conduct  their 
own  in-service  training  pro- 
grammes for  CCU  nurses  using 
traditional  time-consuming  teach- 
ing methods;  many  others  have 
to  send  their  nurses  away  for 
training.  Both  these  methods  cost 
more  in  time  and  money  than  they 
ought  to,  involve  personnel  in 
non-therapeutic  activities  and,  in 
the  second  case,  remove  needed 
nurses  from  the  hospital. 

The  ROCOM  System  lets  the 
hospital  train  its  own  nurses 
without  sending  them  away  — 
without  losing  their  services  for 
several  weeks.  It  permits  tradi- 


tional  centres  to  do  a  quicker, 
more  efficient  job. 

The  ROCOM  CCU  Multimedia 
Instructional  System's  "hard- 
ware" consists  of  a  movie  pro- 
jector, a  rear-screen  device  and 
a  sound  filmstrip  projector,  each 
the  simplest,  most  trouble-free  of 
its  kind. 


For  further  information  or  de- 
monstration please  write  to  Pro- 
fessional Services  Department, 
Hoffmann-La  Roche  Limited,  1956 
Bourdon  Street,  Montreal  378, 
Quebec. 

*fhe  basic  CCU  course,  "Intensive  Coro- 
nary Care  —  A  Manual  for  Nurses" 
(Meltzer,  Pinneo,  Kitchell),  expanded 
and  brought  up  to  date. 


news 


(Continued  from  page  10) 

Griffin;  Mme  M.  Castonguay-Thebi- 
deau;  Dr.  Beverly  DuGas;  Dr.  Dorothy 
J.  Kergin:  Pamela  E.  Poole;  Dr.  Moyra 
Allen;  Mme  Nicole  Beland-Marchak; 
Dr.  M.  Josephine  Flaherty;  Kathleen 
G.  DeMarsh;M.  Geneva  Purcell;Verna 
M.  Huffman;  Dr.  Margaret  C.  Cahoon; 
and  Dr.  Helen  K.  Mussallem. 

The  February  conference,  sponsored 


by  the  school  of  nursing  of  the  Univer 
sity  of  British  Columbia  and  funded  by 
a  federal  government  grant,  will  be  bi- 
lingual. 

Physicians,  Administrators 

Join  Nurses  In  Hamilton  Seminar 

Hamilton,  Out.  —  If  they  agreed  on 
little  else,  panelists  at  the  seminar 
"Nursing  —  Today  and  Tomorrow," 
held  at  the  Henderson  General  Hospi- 
tal October  29,  did  share  the  belief 
that  planning  for  the  future  should 
begin  now. 

Panel     members    included    Norma 
Wylie,  director  of  nursing,  McMaster 


I  Hoilister's  complete 

U-BAG 


regular 

and  24-hour 

collectors 

in  newborn 

and 

pediatric 

sizes 


14 


gel  any  infant  urine  specimen  when  you  wani  ii 

The  sure  way  to  collect  pediatric  urine  specimens 
easily  .  .  .  every  time  .  .  .  Hoilister's  popular  U-Bag 
now  has  become  a  complete  system.  Now,  for  the 
first  time,  a  UBag  style  is  available  for  24hour  as 
well  as  regular  specimen  collection,  and  both  styles 
now  come  in  two  sizes  ...  the  familiar  pediatric  size 
and  a  new  smaller  size  designed  for  the  tiny  contours 
of  the  newborn  baby. 

Each  UBag  offers  these  unique  benefits:  ■  double 
chamber  and  noflowback  valves  ■  a  perfect  fit  on 
boy  or  girl,  newborn  or  pediatric  ■  protection  of  the 
specimen  against  fecal  contamination  ■  hypo-aller- 
genie  adhesive  to  hold  the  UBag  firmly  and  comfort- 
ably in  place  without  tapes  ■  complete  disposability. 

Now  the  UBag  system  can  help  you  to  get  any  infant 
urine  specimen  when  you  want  it.  Write  on  hospital 
or  professional  letterhead  for  samples  and  informa- 
tion about  the  new  UBag  system. 

HOLLISTER  LIMITED,  160  BAY  STREET,  TORONTO  116,  ONTARIO 

THE  CANADIAN   NURSE 


B 


University  Medical  Centre;  Dorothy 
Kergin,  director  of  the  school  of  nurs- 
ing at  McMaster;  L.  Coffey,  assistant 
director  of  St.  Joseph's  School  of  Nurs- 
ing in  Hamilton;  and  R.G.  McAuley, 
assistant  professor,  family  medicine, 
faculty  of  medicine,  McMaster.  S.W. 
Herbert,  assistant  director  of  the  Mc- 
Master University  Medical  Centre,  was 
panel  moderator. 

Several  panel  members  commented 
on  the  question  of  fear  —  the  fear  that 
both  students  and  graduate  nurses  ex- 
perience in  dealing  with  patients,  and 
the  fear  that  a  patient  and  his  family 
have  about  the  illness.  One  physician 
said  no  matter  what  kind  of  training 
nursing  and  medical  students  get,  they 
are  still  afraid  at  first.  Miss  Coffey 
agreed,  adding  that  students  must  have 
the  freedom  to  express  their  fears. 
The  patient,  too,  must  be  helped  to 
express  his  fear,  another  panelist  com- 
mented. 

Another  aspect  of  fear  was  pointed 
out  by  Miss  Wylie.  Referring  to  a  cor- 
onary care  unit  in  one  hospital,  she 
said  nurses  in  this  unit  explain  to  the 
patient's  family  —  and  to  the  patient 
when  he  is  able  to  cope  —  the  gadgetry 
that  will  be  used  in  treating  him.  The 
nurses  believe  this  helps  the  patient 
and  his  family  to  express  their  fears, 
Miss  Wylie  said.  A  physician,  question- 
ing whether  such  explanation  was  al- 
ways a  good  idea,  recalled  that  one  in- 
telligent patient  was  so  depressed  after 
all  this  explanation  that  he  became  al- 
most suicidal. 

The  current  controversy  over  whe- 
ther the  nurse  should  be  a  generalist 
or  a  specialist  sparked  lively  discussion. 
According  to  one  speaker,  "We  seem 
to  have  come  the  full  cycle:  starting  out 
with  the  generalist  type  of  nurse,  then 
moving  into  an  era  where  nurses  drop 
everything  they  don't  consider  as  being 
pure  nursing,  and  now  going  back  to 
people  saying  they  have  to  pick  up  the 
social  aspects,  dietary  aspects,  and 
welfare  aspects  of  what  was  part  and 
parcel  of  specialized  fields  before.  Are 
nurses  going  to  be  trained  to  do  specific 
tasks  in  the  hospital  or  will  they  be 
generalists  who  pick  up  little  bits  and 
pieces  from  all  the.  other  health  profes- 
sions?" 

A  member  of  the  audience,  Dr.  Ralph 
Sutherland  of  Ottawa,  predicted  that 
in  the  next  10  years  there  will  be  a 
great  deal  of  emphasis  on  what  nurses 
should  do  in  the  medical  field,  but 
not  so  much  concern  about  whether 
they  do  something  that  is  outside  the 
nursing  field.  He  also  predicted  a  growth 
in  clinical  specialist  training  below  the 
baccalaureate  level.  "If  that  doesn't 
happen,"  he  warned,  "I  feel  the  pro- 
fession is  really  in  trouble.  And,  unfor- 
tunately, I  do  not  see  a  move  in  that 

{Continued  on  page  16) 
JANUARY  1971 


Fleet 

ends  ordeal  by 

Enema 

for  you  and 
your  patient 


Now  in  3  disposable  forms: 

*  Adult  (green  protective  cap) 

*  Pediatric  (blue  protective  cap) 

*  Mineral  Oil  (orange  protective  cap) 

Fleet  —  the  40-second  Enema*  —  is  pre-lubricated,  pre-mixed, 
pre-measured,  individually-packed,  ready-to-use,  and  disposable. 
Ordeal  by  enema-can  is  over! 

Quick,  clean,  modern,  FLEET  ENEMA  will  save  you  an  average  of 
27  minutes  per  patient  —  and  a  world  of  trouble. 


WARNING:  Not  to  be  used  when  nausea, 
vomiting  or  abdominal  pain  is  present. 
Frequent  or  prolonged  use  may  result  in 
dependence. 

CAUTION:  DO  NOT  ADMINISTER 
TO  CHILDREN  UNDER  TWO  YEARS 
OF  AGE  EXCEPT  ON  THE  ADVICE 
OF  A  PHYSICIAN. 


In  dehydrated  or  debilitated 
patients,  the  volume  must  be  carefully 
determined  since  the  solution  is  hypertonic 
and  may  lead  to  further  dehydration.  Care 
should  also  be  taken  to  ensure  that  the 
contents  of  the  bowel  are  expelled  after 
administration.  Repeated  administration 
at  short  intervals  should  be  avoided. 


Full  intormation  on  request. 

•Kehlmann,  W.  H.:  Mod.  Hosp.  84:104,  1955 

FLEET  ENEMA®  —  single-dose  disposable  unit 


r. 


lANUARY  1971 


kLiTV  P»4AIIUACtUTICALa 
KSau^MCMOMTMCMl  CANADA         j 


THE  CANADIAN  NURSE     15 


news 


(Continued from  page  14) 

direction  yet."  One  of  the  major  ob- 
structions, said  Dr.  Sutherland,  is  the 
nurse  hangup  that  her  image  is  tied  to 
a  baccalaureate  degree. 

Emergency  Department  Nurses 
Form  Association  In  Edmonton 

Edmonton,  Alfa.  — The  Emergency 
Department  Nurses"  Association  of 
Edmonton  has  been  formed  to  improve 
inter-hospital  communication,  promote 
an  awareness  of  and  utilize  commun- 
ity health  resources  available  to  emer- 
gency departments,  promote  unity 
among  emergency  department  nursing 
personnel,  and  continue  education  of 
nurses. 

The  association,  which  is  open  to  all 
nursing  personnel  in  emergency  de- 
partments in  the  city's  hospitals,  will 
meet  five  times  a  year  at  the  various 
hospitals. 

Course  On  Adolescence  Discusses 
Sex,  Parents,  Epilepsy,  Acne  .... 

Vancouver,  B.C.  —  Adolescents  learn 
about  sex  mainly  from  friends.  Nurses 
and  doctors  are  a  minor  source  of  in- 
formation, Dr.  George  Szasz  told  77 
nurses  and  their  high  school  student 
guests  at  a  continuing  nursing  educa- 
tion program  on  adolescence  in  October. 

The  two-day  program  was  conducted 
by  the  University  of  British  Columbia's 
division  of  continuing  education  in  the 
health  sciences.  Dr.  Szasz  is  director 
of  interprofessional  education  at  the 
health  sciences  center  and  assistant  pro- 
fessor and  Milbank  Faculty  Fellow  in 
the  department  of  health  care  and  epi- 
demiology. 

Dr.  Szasz  suggested  nurses  could  be 
more  helpfull  to  adolescents  in  sexual 
education,  but  that  "nurses  don't  listen 
because  then  they  become  accessory 
after  the  fact." 

He  said  human  sexual  behavior  con- 
sists of  two  aspects:  social  activities, 
such  as  dating,  and  sexual  activities, 
which  are  capable  of  producing  reac- 
tions in  the  body.  The  four  types  of 
sexual  activity  are  solitary,  hetero- 
sexual, homosexual  and,  more  rarely, 
activity  involving  animals. 

Solitary  activity  was  termed  ex- 
ceedingly important,  involving  day- 
dreaming and  role  playing.  Dr.  Szasz 
said  it  is  important  for  nurses  to  rec- 
ognize whether  the  adolescent  is  day- 
dreaming or  is  in  acute  depression. 

Nurses  should  be  able  to  discuss 
masturbation  with  young  people,  he 
said,  pointing  out  it  does  not  harm  the 
person  and  there  is  evidence  it  is 
16     THE  CANADIAN   NURSE 


beneficial  to  orgasm.  Every  boy  mas- 
turbates by  the  age  of  1 6.  Less  than  a 
quarter  of  girls  masturbate  before 
age  16,  but  after  that,  80  percent  of 
girls  masturbate,  he  said. 

Speaking  on  the  physiology  of  ado- 
lescence. Dr.  John  Birbeck,  assistant 
professor,  department  of  pediatrics, 
faculty  of  medicine,  UBC,  said  all 
physical  changes  in  adolescence  are 
accompanied  by  emotional  and  intel- 
lectual changes.  Noting  that  "our 
society  is  unkind  to  late  maturers." 
Dr.  Birbeck  said  the  late  maturmg 
10-year-old  is  actually  eight  years  old 
in  development,  but  the  educational 
system  makes  no  allowance  for  maturi- 
ty lag. 

The  sequence  of  developmental 
events  is  usually  a  few  years  later  for 
males  than  females.  Athletic  -activity 
does  to  some  degree  accelerate  the 
growth  process,  and  the  athletically- 
active  adolescent  will  mature  earlier 
than  the  one  who  is  inactive.  Good 
health  and  nutrition  also  influence 
early  maturity,  said  Dr.  Birbeck. 

The  single  most  important  function 
of  the  family  today  is  to  provide  emo- 
tional security,  but  this  is  exactly  what 
the  family  is  not  doing,  said  Dr.  Sheila 
Thompson,  psychologist  and  director 
of  counseling,  Douglas  College,  B.  C. 

"Parents  ought  to  love  no  matter 
what,  but  parental  love  is  conditional," 
she  said.  She  noted  that  parents  "seem 
to  be  unhappy  in  their  parenthood 
and  are  literally  putting  their  kids  out 
now  by  saying  'you  do  this  or  you  leave" 
and  we  wonder  why  there  are  so  many 
transients." 

Nurses  can  provide  reassurance  for 
adolescent  epileptic  patients  and  sup- 
port the  parents  who  often  react  with 
fear,  guilt,  and  resentment  to  their 
child's  illness,  said  Dr.  W.L.  Auckland, 
clinical  instructor,  division  of  neurol- 
ogy, faculty  of  medicine,  UBC. 

Nurses  should  maintain  a  matter- 
of-fact  attitude  toward  epilepsy,  he  said. 
The  school  nurse  should  obtain  a  first- 
hand account  of  a  seizure  experienced 
at  school  and  write  it  down  immediate- 
ly. The  teacher  often  needs  reassurance 
from  the  nurse  that  the  patient  in  sei- 
zure won't  die  or  attack  others." 

Dr.  William  S.  Wood,  clinical  as- 
sistant professor,  division  of  dermatol- 
ogy, faculty  of  medicine,  UBC,  said 
acne  is  one  of  the  three  most  common 
diseases  of  the  skin. 

And  "no"  —  in  answer  to  a  nurse's 
question  —  Phisohex  does  nothing 
for  the  treatment  of  acne.  Many  pa- 
tients are  treated  without  medication 
by  washing  frequently  with  as  little 
soap  as  possible.  Since  heat  activates 
the  sebaceous  glands,  patients  should 
avoid  hot  baths  and  steam  baths. 

Serious  injury  resulting  from  an  ac- 
cident can  make  a  difference  in  the 


whole  life  pattern  of  the  adolescent. 
Dr.  G.  Duncan  McPherson,  clinical 
instructor,  division  of  orthopedics, 
faculty  of  medicine,  UBC,  said. 

Because  of  boys'  preoccupation 
with  sports,  they  are  involved  in  five 
times  as  many  accidents  as  girls,  he 
said.  The  injured  adolescent  has  a 
broken  body  image,  often  followed  by 
a  feeling  of  insecurity.  Boys  are  more 
modest  than  girls,  he  said,  and  intimate 
nursing  care  can  be  disturbing  to  them. 

Management  of  diabetes  requires 
a  mature  and  sensible  attitude,  and 
since  adolescents  are  not  mature,  man- 
agement of  diabetes  in  such  patients 
is  more  difficult,  said  Dr.  John  A.  Hunt, 
internist  at  Lions  Gate  Hospital,  North 
Vancouver. 

"The  child  must  be  controlled  by 
parents  who  must  be  self-controlled," 
he  said.  The  professional  person  needs 
to  direct  outside  control  from  the  par- 
ent to  the  child.  "Parents  need  help 
and  support  in  taking  on  a  scientific 
responsibility,"  said  Dr.  Hunt. 

He  noted  adolescents  sometimes 
give  themselves  too  little  or  too  much 
insulin,  and  that  those  who  reject 
diabetic  management  require  psychi- 
atric help. 

The  course  was  planned  for  nurses 
working  with  adolescents  in  health 
care  settings.  Ruth  Elliott,  instructor 
at  the  school  of  nursing,  UBC,  was 
chairman  of  the  course  committee. 

OHA  Speaker  Says 
Traditions  Will  Change 

Toronto,  Ont.  —  We  cannot  be  niggar- 
dly about  the  cost  of  health  services, 
according  to  A.  Isobel  MacLeod,  direc- 
tor of  nursing  service  at  The  Montreal 
General  Hospital.  "Concern  for  cost  is 
justified,"  she  said,  "and  costs  must  be 
controlled.  But  we  have  to  pay  what  it 
costs  to  provide  good  care." 

Mrs.  MacLeod  addressed  a  nursing 
session  at  the  annual  convention  of  the 
Ontario  Hospital  Association  in  Toron- 
to, October  26-28.  "Nursing  is  tradi- 
tional —  yes  or  no?"  was  the  topic  at  the 
session,  and  Mrs.  MacLeod's  address 
was  concerned  mainly  with  future 
changes  in  these  traditions. 

Among  her  suggestions  for  control- 
ling costs  in  nursing  was  the  justifica- 
tion of  the  number  of  nurses  employed 
in  each  unit,  suggesting  that  often  a  full 
staff  of  nurses  is  kept  on  duty  when 
fewer  are  needed.  Better  use  of  time  is 
another  answer  to  the  problem,  and  she 
suggested  that  a  definition  of  the  nurses' 
role  would  help  define  priorities 
"Then,"  she  said,  "it  will  be  relatively 
easy  to  find  time  to  do  those  important 
things  which  now  are  not  done." 

Mrs.  MacLeod  also  foresaw  changes 

in  the  future  role  of  nurses  because  of 

changing  governmental  attitudes  toward 

health  services.  "The  emphasis  now  is 

JANUARY  1971 


on  disease  prevention  and  health  pro- 
motion, rather  than  on  miracle  cures. 
This  means  that  in  future  nurses  will 
not  be  segregated  in  their  roles  as  public 
health  nurses  and  hospital  nurses.  Both 
categories  of  nurse  will  be  nursing  the 
whole  patient,  with  a  view  to  total  pa- 
tient care." 

Mrs.  MacLeod  said  that  in  future 
nurses  could  take  over  some  fields,  such 
as  the  management  of  chronic  illness 
and  the  continuity  of  the  care  of  the 
family  through  good  health.  She  suggest- 
ed that  university  schools  of  nursing 
immediately  alter  their  programs  to 
help  bridge  the  gap  between  nurses  and 
doctors,  and  convince  the  doctors  that 
another  category  of  health  worker  is 
unnecessary.  "We  must  show  the  doctors 
what  we  can  do  to  prove  another  cate- 
gory is  not  needed.  And  we  must  make 
patient  care  as  prestigious  and  finan- 
cially worthwhile  as  education  or  ad- 
ministration." 

Dean  Sane,  administrator  of  North 
York  General  Hospital  and  a  member 
of  the  five-man  reaction  panel,  em- 
phasized that  the  type  of  nursing  care 
given  was  to  a  large  extent  dependent 
on  the  doctors  and  other  departments 
of  the  institutions.  He  warned  nurses 
that  governments  —  now  involved  in 
medical  insurance  schemes  —  and  the 
consumer  are  demanding  value  for  their 
money,  and  that  nurses  will  have  to  do 
their  part  to  provide  it. 

The  session  was  chaired  by  Dorothy 
Morgan,  past  chairman  of  the  nursing 
administration  section  of  the  OHA. 
Other  members  of  the  reaction  panel 
were  Anne  Chambers,  staff  nurse  at  the 
Wellesley  Hospital,  Toronto;  Rose- 
mary Forbes,  head  nurse  of  the  emer- 
gency department,  Victoria  Hospital, 
London;  Adeline  Jack,  director  of  nurs- 
ing service,  North  York  General  Hos- 
pital; and  Jack  Campbell,  a  former 
patient  at  the  York  General. 

Three  TV  Programs 
Tell  Nurses'  Role 

Winnipeg,  Man.  —  The  place  of  the 
registered  nurse  in  the  nursing  com- 
munity was  outlined  by  Margaret  Nu- 
gent, president  of  the  Manitoba  Asso- 
ciation of  Registered  Nurses,  and 
Bente  Cunnings,  executive  director,  on 
a  Winnipeg  TV  show. 

First  in  a  series  of  three  programs 
dealing  with  nursing  care  provided  in 
the  province,  the  show  dealt  with  the 
relationship  of  the  registered  nurse  to 
the  licensed  practical  nurse  in  provid- 
ing care  for  patients. 

The  two  other  programs  will  discuss 
the  role  of  the  psychiatric  nurse  and 
the  role  of  the  licensed  practical  nurse. 
Representatives  of  each  association  will 
be  present  to  answer  viewers'  questions 
during  a  "phone-in"  portion  of  the 
show. 

JANUARY  1971 


AORN  Members  Fly 
To  Italy  On  Seminar 

Denver,  Colo.  —  The  Association  of 
Operating  Room  Nurses  held  its  first 
overseas  seminar  in  Italy  with  300 
members  making  the  October  trip. 

The  discussion  of  operating  room 
techniques  was  held  jointly  with 
AORN's  Italian  counter  parts  and  in- 
cluded visits  to  hospitals,  lectures,  and 
seminars  in  Florence  and  Rome. 

Mrs.  Caroline  Rogers.  AORN  mem- 
bership coordinator  who  arranged  the 
trip,  said  the  sessions  in  Florence  were 
planned  around  "disaster  nursing" 
based  on  the  floods  in  Florence  in 
1964. 

Because  of  the  "outstanding  success" 
of  this  year's  trip,  Mrs.  Rogers  said  the 
AORN  is  planning  a  second  overseas 
seminar  for  1971  to  be  held  in  Spain 
and  Portugal. 

AORN  is  an  international  scientific 
and  educational  organization  with  a 
membership  of  13,000  —  who  like  to 
travel! 


RNAO  Accepts  Concept 
Of  Group  Bargaining 

Toronto,  Ont.  —  1  he  concept  of  group 
bargaining,  originally  proposed  by  the 
Ontario  Hospital  Association,  is  ac- 
ceptable to  the  Registered  Nurses' 
Association  of  Ontario.  However, 
RNAO  said  group  bargaining  is  pre- 
mature for  1971. 

Group  bargaining  means  that  a  neg- 
otiating committee  might  bargain  with 
nurses  employed  by  a  group  of  hospi- 
tals in  the  same  area,  such  as  Toronto, 
or  with  a  group  working  in  the  same 
economic  area,  such  as  Sudbury,  Sault 
Ste.  Marie,  and  North  Bay.  Until  now 
nurses  in  Ontario  have  bargained  with 
the  management  of  the  hospital  hiring 
them. 

Early  last  year  the  Ontario  Hospital 
Association  established  a  "master 
committee  —  joint  bargaining  for 
nurses."  The  committee  is  comjjosed 
of  representatives  of  17  hospitals 
engaged  in  collective  bargaining  with 
nurses. 

This  committee  and  the  RNAO 
held  two  meetings  during  the  summer 
of  1 970.  Following  the  meetings,  RNAO 
staff  and  legal  counsel  reviewed  pwlicy 
statements  and  the  basic  principles  on 
which  RNAO  had  engaged  in  collective 
bargaining. 

On  September  24,  1970,  RNAO  met 
with  several  nurses'  collective  bar- 
gaining associations  as  a  first  step  in 
formulating  a  proposal  on  group  bar- 
gaining. At  this  meeting  the  approach 
by  the  "master  committee — joint 
bargaining  for  nurses"  was  described 
and  draft  proposals  developed  by  RNAO 
staff  and  legal  counsel  was  discussed. 

At  the  request  of  the  meeting,  Anne 


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imend  Vagisec  Douche  Liquid  Concentrate 
jnf  idence,  for  routine  feminine  hygiene, 
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NURSE     17 


For  nursing 
convenience... 

patient  ease 

TUCKS 

offer  an  aid  to  healing, 
an  aid  to  comfort 

Soothing,  cooling  TUCKS  provide 
greater  patient  comfort,  greater 
nursing  convenience.  TUCKS  mean  no 
fuss,  no  mess,  no  preparation,  no 
trundling  the  surgical  cart.  Ready- 
prepared  TUCKS  can  be  kept  by  the 
patient's  bedside  for  immediate  appli- 
cation whenever  their  soothing,  healing 
properties  are  indicated.  TUCKS  allay 
the  itch  and  pain  of  post-operative 
lesions,  post-partum  hemorrhoids, 
episiotomies,  and  many  dermatological 
conditions.  TUCKS  save  time.  Promote 
healing.  Offer  soothing,  cooling  relief 
in  both  pre-and  post-operative 
conditions.  TUCKS  are  soft 
flannel  pads  soaked  in  witch  hazel 
(50%)  and  glycerine  (10%). 


TUCKS  —  the  valuable  nur- 
sing aid,  the  valuable  patient 
comforter. 


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pilonidal  dressings  comfortably  in  place  with- 
out tape,  prevents  soiling  of  linen  or  cloth- 
ing. Ideal  for  hospital  or  ambulatory  patients. 


WIN  LEY-  MORRIS  l% 


TUCKS  is  a  trademark  of  the  Fuller  Laboratories  Inc. 
18     THE  CANADIAN   NURSE 


news 


Gribben,  director  of  RNAO  employ- 
ment relations,  sent  a  letter  to  the  secre- 
tary of  the  master  committee.  The 
letter  stated:  1.  that  the  concept  of 
group  bargaining  is  acceptable;  2.  that 
representatives  of  nurses'  associations 
of  hospitals  engaged  in  collective  bar- 
gaining will  enter  into  dialogue  with 
RNAO  to  explore  various  approaches 
to  group  bargaining  with  the  aim  of 
developing  proposals  for  discussion 
with  the  master  committee;  and,  3.  that 
group  bargaining  is  therefore  pre- 
mature for  1971. 

At  the  Ontario  Hospital  Associa- 
tion's 46th  annual  meeting,  October 
26-28,  1970,  James  Wilson,  chairman 
of  the  master  committee,  said  17  of 
the  36  hospitals  that  have  nurses' 
associations  or  are  in  the  process  of 
getting  one,  had  approved  the  prin- 
ciple of  joint  bargaining.  He  said  re- 
presentatives of  hospitals  had  agreed 
that  a  master  agreement  would  take 
care  of  big  issues. 

The  RNAO  board  of  directors  at 
its  November  20-2 1  meeting  discussed 
and  confirmed  Miss  Gribben's  letter 
to  the  master  committee. 


Friesen  Sponsors  Two  Awards 
To  Be  Given  Annually  By  CHA 

Toronto,  Ont.  —  Two  annual  awards, 
amounting  to  $2,500,  have  been  pres- 
ented to  the  Canadian  Hospital  Asso- 
ciation by  Gordon  A.  Friesen,  pres- 
ident of  Gordon  A.  Friesen  Interna- 
t  i  o  n  a  1  Incorporated.  Washington, 
D.C.,  an  international  hospital  health 
care  consulting  firm. 

The  executive  committee  of  CHA 
approved  and  announced  the  following 
awards  to  be  given  annually  at  the  Ca- 
nadian Hospital  Association  conven- 
tion; the  Gordon  A.  Friesen  Award  of 
$  1 ,500,  to  be  given  to  the  writer  of  the 
best  article  submitted  to  CHA  on  either 
hospital  design,  hospital  planning,  or 
hospital  administration;  a  prize  of 
$1,000  to  the  student  who,  on  com- 
pletion of  the  two-year  hospital  organ- 
ization and  management  course,  will 
most  likely  make  a  valuable  contribi'- 
tion  to  the  field  of  hospital  adminis- 
tration. 'S' 


JANUARY  1971 


names 


The  Registered  Nurses'  Association  of 
Nova  Scotia  has  announced  two  new 
appointments: 

Sister  Clare  Marie  (R.N.,  St.  Marthas 
Hospital  School  of  Nursing.  Antigonish, 
N.S.;  B.Sc.  St.  Francis  Xavier  U., 
Antigonish;  M.Sc.N..  Catholic  U., 
Washington)  as  advisor  in  nursing 
education.  Sister  Clare  Marie  has 
taught  basic  sciences  in  schools  of  nurs- 
ing and  has  been  director  of  nursing 
at  St.  Martha's  Hospital,  Antigonish, 
and  St.  Joseph's  Hospital,  Glace  Bay. 
She  has  been  both  third  and  first  vice- 
president  of  RNANS. 

Jean  Maclean  (R.N.,  Victoria  Public 
H.,    Fredericton:    B.N.,    McGill    U., 

Montreal)  as  advisor  in  nursing  ser- 
vice. Miss  MacLean,  during  World 
War  II,  served  in  Canada,  England 
and  Northwest  Europe  with  the  Royal 
Canadian  Army  Medical  Corps,  and 
later  in  the  militia  as  senior  nursing 
officer  for  the  Atlantic  area.  She  held 
the  position  of  director  of  staff  educa- 
tion at  Camp  Hill  Hospital,  Halifax, 
and  more  recently  was  director  of  nurs- 
ing education  at  Victoria  General  Hos- 
pital, Halifax.  Miss  MacLean  succeeds 
Marianne  Fightlin. 

Muriel  Violet  Lowry  (R.N..  The  Mont- 
real General  hospital  School  of  Nurs- 
ing) died  in  Ottawa  October  3,  as  a 
result  of  an  accident. 

Miss  Lowry  was  for  1 1  years  super- 
visor of  the  first  demonstration  health 
unit  established  in  the  eastern  united 
counties  of  Ontario  in  1935.  In  1946 
she  became  regional  supervisor  for 
Eastern  Ontario  for  the  Ontario  De- 
partment of  Health,  with  headquarters 
in  Ottawa.  Upon  her  retirement  in  1 962, 
the  Ontario  Public  Health  Association 
conferred  on  Miss  Lowry  an  honorary 
membershio. 

^■nHH^HB  Rita    Lussier  (R.N., 
^^^^^^^^H  Hdpital      Maison- 
h^^^^^^^B  neuve,     Montreal; 
^BPVP^^H  B.  Sc.  N., 
mf^  ^H  Marguerite    d'You- 

H| '^.Slk  if^^H  ville,  Montreal; 
pi^  r^^H  ^^-Sc-^-  in  admin- 

<[|.^^Ai^^H  istration    and    edu- 
^^"^^^^B  cation,  Boston  U.) 

•^^f  ^B  has  been  appointed 
to  the  position  of  program  coordinator 
with  the  Association  of  Nurses  of  the 
Province  of  Quebec,  effective  January 
1,  1971.  Prior  to  being  analyst  at  the 
JANUARY  1971 


Helena  Remier,  upon  her  retirement  as  secretary-registrar  of  the  Association 
of  Nurses  of  the  Province  of  Quebec,  was  honored  at  a  reception  at  the  Queen 
Elizabeth  Hotel,  Montreal,  in  conjunction  with  the  association's  November 
annual  meeting.  Hundreds  of  nurses  and  friends  came  to  express  their  personal 
good  wishes  to  Miss  Reimer  who,  for  2  years,  was  the  guiding  hand  of  the 
ANPQ.  Above,  Miss  Reimer  receives  a  bouquet  from  her  niece  prior  to  being 
presented  with  an  oil  painting  as  a  memento  of  her  contribution. 


center  for  evaluation  of  positions  in 
Quebec  hospitals.  Miss  Lussier  was  co- 
ordinator of  the  nurses'  station  at  the 
Man  and  His  World  Health  pavilion  at 
Expo  '67,  and  secretary-registrar  to  the 
Montreal  branch  of  the  Association  of 
Catholic  Nurses  of  Canada.  She  was 
awarded  a  Canadian  Nurses'  FounHa- 
tion  Scholarship  in  1969. 

Nicole    DuMouchel 

(R.  N.,  Ste  -  Justine 
Hospital,  Montreal; 
B.  Sc.  N.,  adminis- 
tration, InstitutMar- 
guerite  d'  Youville, 
Montreal;  M.Sc.N., 
U .  of  Montreal)  has 
been  appointed  Sec- 
retary-Registrar of 
the  Association  of  Nurses  of  the  Pro- 
vince of  Quebec.  Miss  DuMouchel  was 
previously  a  consultant  with  the  Cana- 
dian Council  on  Hospital  Accredita- 


tion. Having  always  been  active  in 
nurses'  professional  associations.  Miss 
DuMouchel  welcomes  the  challenge 
inherent  in  the  position  so  ably  filled 
by  her  predecessor,  Helena  Reimer. 

Alice  ).  Baumgart,  associate  professor, 
school  ot  nursing.  University  of  British 
Columbia,  and  chairman  of  the  com- 
mittee on  nursing  education  of  the 
Canadian  Nurses'  Association,  is  the 
first  Canadian  nurse  to  be  awarded  a 
Milbank  Faculty  Associate  Fellowship. 
This  three-year  $15,000  associate 
fellowship  will  be  used  to  advance 
Miss  Baumgart's  work  in  supporting 
Dr.  George  Szasz,  director  of  the  office 
of  interprofessional  education  at  the 
University  of  British  Columbia,  in 
encouraging  the  implementation  of 
the  team  approach  to  health  care.  The 
team  approach  aims  at  teaching  mem- 
bers of  the  various  health  professions 
to  work  together  through  interorofes- 

THE  CANADIAN   NURSE     19 


V 


a  show  of  hands... 


^/" 


proves  its  smoothness 


NEW  FORMULA  ALCOJEL,  with 
added  lubricant  and  emollient,  will 
not  dry  out  the  patient's  skin — 
or  yours! 

ALCOJEL  is  the  economical,  modern, 
jelly  form  of  rubbing  alcohol.  When 
applied  to  the  skin,  its  slow  flow 
ensures  that  it  will  not  run  off,  drip 
or  evaporate.  You  have  ample  time 
to  control  and  spread  it. 

ALCOJEL  cools  by  evaporation  .  .  . 
cleans,  disinfects  and  firms  the  skin. 

Your  patients  will  enjoy  the 
invigorating  effect  of  a  body  rub  with 
Alcojel  .  .  .  the  topical  tonic. 


^efresh\n9-<=°°''''&. 

ALCOJEL 

Send  for  a  free  sample 

through  your  hospital  pharmacist. 


[Jellied 

RUBBING 

ALCOHOt 


WITH 
ADDED 

UJBRICANT«" 
EMOUIENT 


mv. 


BDH  PHARMACEUTICALS 

Barclay  Ave..  Toronto  550,  Ontario 


names 


20     THE  CANADIAN   NURSE 


sional  learning  experiences  to  improve 
the  quality  of  health  care  delivery  and 
to  reduce  its  cost. 

One  of  Miss  Baumgart"s  major  efforts 
will  be  toward  devising  means  by  which 
the  school  of  nursing  can  offer  its 
expertise  to  other  professional  schools 
and  faculties  and  can  in  return  incor- 
porate the  expertise  of  other  professions 
into  the  training  it  gives  to  nurses. 

The  Saskatchewan  Registered  Nurses" 
Association  has  awarded  bursaries  to 
three  Saskatchewan  nurses.  Delia  M. 
Howe  (R.N.,  St.  Paul's  Hospital  School 
of  Nursing,  Saskatoon;  B.Sc.N.,  U.  of 
Saskatchewan  School  of  Nursing,  Sas- 
katoon) $  1 ,000  to  assist  her  in  complet- 
ing her  M.A.  degree  at  the  Regina 
Campus.  Mrs.  Howe  —  currently  on 
leave  of  absence  as  assistant  director 
of  the  Regina  Grey  Nuns'  Hospital 
School  of  Nursing  —  has  been  clinical 
instructor  at  Regina  General  Hospital 
School  of  Nursing  and  instructor  in  the 
centralized  teaching  program. 
Judith  A.  Lang  (R.N.,  Regina  General 
Hospital  School  of  Nursing)  $1,500  to 
assist  in  meeting  requirements  for  a 
B.Sc.N.  degree  at  Regina  campus.  Miss 
Lang  has  been  on  the  teaching  staff  of 
the  Regina  General  Hospital  School  of, 
Nursing,  prior  to  which  she  worked  in 
general  duty  at  Victoria  Hospital,  Lon- 
don, Ontario  and  at  the  Fort  Qu'Ap- 
pelle  Indian  Hospital. 
Kenneth  B.  Doepker  (R.N.,  St.  Eli- 
zabeth Hospital  School  of  Nursing, 
Humboldt,  Saskatchewan),  $  1 ,500 
to  assist  in  study  toward  a  B.Sc.  N. 
degree  at  Saskatoon  campus.  Mr.  Doep- 
ker has  worked  \n  the  public  health 
field  with  the  department  of  national 
health  and  welfare,  has  experience  as 
general  duty  and  operating  room  nurse 
at  Wadena  Union  Hospital  and  Sas- 
katoon City  Hospital. 

Adele  Herwitz  (R.N.,  Beth  Israel  H., 
Boston,  Mass.;  B.S.  and  M.A.,  Teachers 
College,  Columbia  U.,  New  York)  has 
been  appointed  executive  director  of 
the  International  Council  of  Nurses. 
She  had  previously  agreed  to  a  six 
months'  tenure  (The  Canadian  Nurse, 
June  1970),  and  on  permanent  appoint- 
ment in  October  stated  "...  I  know 
that  nurses  joined  together  in  a  strong 
organization  play  a  vital  role  in  up- 
grading nursing  standards  and  there- 
fore in  improving  health  care  ....  I 
see  very  clearly  the  increasingly  im- 
portant role  ICN  will  play  in  the  years 
ahead  in  helping  nurses  throughout 
the  world  to  build  and  strengthen  their 
national  associations."  i^ 

JANUARY  1971 


Personalized  CAP-TOTE 


Your  caps  stay  crisp,  sharp  and  clean 
•rtien  stored  or  carried  in  this  clever 
carry-all.  Clear,  non-creasing  flexible 
plastic  bag  with  white  trim,  has  zipper 
around  top,  carrying  strap  and  hang 
loop.  Squeezes  flat  for  easy  storage 
when  not  in  use.  Also  great  for  wiglets, 
curlers  or  whatever.  SVz'  dia.,  6'  high. 
No.  333  Tote  (no  Initials] ...  2.50  ii.  |»pd. 
SPECIAL!  6  or  more  totes,  only  2.2S  ca. 
INITIALS  up  to  3  gold  enbfssid  on  tip  . . . 
add  .50  par  Tote. 


vSmmmmm^ 


'J  <. 


Personalized  MINI-SCISSORS 

Tiny,  useful,  precision-made  bandage 
scissors,  only  3"^'  long!  Slip  perfectly 
into  uniform  pocket  or  purse.  Two  year 
-^  guarantee  included.  Choose  jewelers  Gold 
Of  gleaming  Chrome  plate  finish. 

No.  1 236  Scissors  (n  initials) , . .  2.25  ei.  ppd. 

SPECIAL!  1  itoz.  scissors  for  just  $20.  ppd. 

ENGRAVING  up  to  3  initials,  add  .50  per  scissor. 


tRS.  R.  F.  JOHNSON 
SUPERV/S/ 


■dTJOHN  WILLIAMS 
RESIDENT 


REEVES  NAME  PINS 

Largest-selling  among  nurses!  Superb  lifetime 
quality  . ,  .  smooth  rounded  edges .  .  .  feather- 
weight, lies  flat .  .  .  deeply  engraved,  and  lac- 
quered. Snow-white  plastic  will  not  yellow.  Satis- 
faction guaranteed.  GROUP  DISCOUNTS.  Choose 
lettering  in  Black,  Blue,  or  White  (No.  169  only). 

SAVE:  Order  2  Identical 
Pins  as  precaution  against 
loss,  less  changing. 


Personalized 


BANDAGE 
SHEARS 


6'  professional  precision  shears,  forged 
in  steel.  Guaranteed  to  stay  sharp  2  years. 

No.  1000  Shears  {no  initials) 230  u.  ppd. 

SPECIAL !  1  Ooz.  Shtars $24.  total 

Initials  (up  to  3}  ttched add  50c  par  pair 


W^ 


COHN.LPN. 


INaaMPIinly 

MF2Plis(saniaMl 


1  NaM  Pia  ealy 

2  Pill  (saM  aaaMi 


1.75 


2.60 


.85 


1.35 


2.05 


3.10 


1.15 


1.90 


am 
T 


All  Metal  CAP  TAGS 

Fine  selection  of  dainty,  jewelry-quality  Cap 
Tacs  to  hold  cap  bands  securely.  All  sculptured 
metal,  polished  gold  finish,  with  clutch  fas- 
teners, approi.  %"  wide.  Two  Tacs  per  set,  gift- 
boxed.  Choose  Initial  Tacs  RN,  LPN,  LVN  . . .  or 
Plain  Caduceus  .  .  .  or  RN  Caduceus.  Specify 
choice. 

No.  CT-1  Initial  Tacs         ) 

No.  CT-2  Plain  CadiCtMS    >  ...  2.50  per  sat,  ppd. 

No.  CT-3  RN  Cadw«a$       } 
SPECIAL!  12  or  iiort  sits  2.00  pir  stt  ppd. 


Personalized 
CROSS  PEN 

with 
Caduceus 


World  famous  Cross  Writing 
Instrument  with  sculptured  cadu- 
ceus emblem,  full  name  engraved  FREE 
on  barrel  (print  name  desired  on  LETTERING 
line  in  coupon).  Refills  available  at  any  store. 
Cross  Lifetime  Guarantee. 

No.  3502  Chrome  Finish SjOO  ta. 

No.  6602  12KtGoldFillad...ll30oa. 


Nurses'  White  CAP  CLIPS 

Hold  caps  firmly  in  place!  Hard-to-find  wfiite 

bobble  pins,  enamel  on  fine  spring  steel.  Eight 

2"  and  eight  3"  clips  included  in  plastic  snap 

box. 

No.  529  I  3  twxes  for  1.75,  G  for  3.25. 

Clips      \  7  or  more  49c  par  box.  all  ppd. 


Bzzz  MEMO-TIMER 

We  all  forget!  Time  hot  packs,  sitz  baths, 
heat  lamps,  even  parking  meters .  . .  remind 
yourself  to  check  vital  signs,  give  medica- 
tion, etc.  Tiny  (only  \\i~  dia.).  lightweight, 
sets  to  buzz  at  from  5  to  SO  minutes.  White 
plastic  case,  black  and  silver  dial.  Key  ring 
attached  Swiss  made. 
No.  M-22  Timer . . .  3.98  ea.  ppd. 
SPECIAL!  3  for  9.75.6  or  more  3.00  ea. 


Deluxe  POCKET-SAVER 

No  more  tired  pockets!  Sturdy  pure  white  vinyl, 
with  three  compartments  for  pens,  scissors, 
etc.  Includes  change  pocket  with  snap  closure 
for  coffee  money,  and  key  chain.  4'  wide. 

No.  791  t  6  for  2.9a  12  for  AJBO. 

Pocket  Saver  \  25  or  mora  35c  ea.,  all  ppd. 


NIGHTINGALE  LAMP 

An  authentic,  unique  favor,  gift  or  en- 
graved award)  Ceramic  ofT-white  can- 
dleholder  with  genuine  gold  leaf  trim. 
Recessed  candle  cup  at  front  (candle 
not  included).  7"  long. 
No.  F  lOOS  Lamp . . .  5.95  ea.  ppd. 
SPECIAL!  12  or  more,  3.95  ea. 
ENGRAVING  up  to  3  initials  and 
date  on  satin  gold  plaque  on  top,  add  1.00  par  lamp. 


Trl-Coior  BALL  PEN 

Write  in  black,  red  and  blue  with  one  ball  point  pen. 

'  tlie  thumb  changes  point  (and  color).  Steno  fine 

nt  (excellent  for  charts)  Polished  chrome  finish. 

Nl.921  tall  Ptn...  1. 50 11.  ppd. 

SPUIU!  3  for  3.7S,  6  cr  Hire  1.00  ••.  ppd. 

No.  2924  Utitt  letllls  ...  50c  u.  ppd 


Caduceus  CUFF  LINKS 

Sim.  Mother-of-Pearl  set  into  gold  finish  link, 
spring  arm  Sculptured  gold  fin.  caduceus  with 
or  without  Rf^.  Gift-boxed. 

No.  403900  LINKS  (plain  caduceus)  {  3.95  pr. 
No.  403RN  LINKS  (R.N.  Caducous)  \    ppd. 


i^ 


sterling  HORSESHOE  KEY  RING 

Clever,  unusual  design:  one  knob  unscrews  for  in- 
serting  keys.   Fine   sterling   silver   throughout,   with 
sterling  sculptured  caduceus  charm. 
No.  96  Key  Ring 3.75  aa.  ppd. 


EYEGLASS  CADDY  Pin 

Slip  eyeglass  bow  into  loop  for  safe,  instant 

readiness . .  avoid  scratching,  breakage.  Sturdy 

pinback.  safety  catch.  Gold  or  Silver  plated. 

No.961Csdtfy...1.50M.pptf. 

No.  961  ST  SttftiiTi  Silver  Caddy  . .    3  N  la.  ppd 


NURSES  CAP-TACS 

Remove  and  refasten  cap  band  instantly 
for  laundering  and  replacement!  Tiny 
molded  plastic  tac.  dainty  caduceus 
Choose  Black.  Blue.  White  or  Crystal 
with  Gold  Caduceus.  or  all  black  {plain)  '>• 
No.  200  Set  of  6  Tacs . .  1 .00  per  sat 
SPECIAL !  12  or  more  sets ...  .ao  per  set 


Nurses  ENAMELED  PINS 

Beautifully  sculptured  status  insignia:  2-color  keyed, 
hard-fired  enamel  on  gold  plate.  Dime-sized;  pin-back. 
Specify  RN.  LPN,  PN.  LVN.  NA.  or  RPh.  on  coupon. 
No.  205  Enameled  Pin 1.50  aa.  ppd. 


Set-Fix  NURSE  CAP  BAND 

Black  velvet  band  material.  Self-ad- 
hesh'e:  presses  on,  pulls  off;  no  sewing 
or  pinning.  Reusable  several  times 
Each  band  20'  long,  pre-cut  to  pop- 
ular widths:  Vt'  d'  per  plastic  box), 
Vi'  (8  per  bOK),  H"  (6  per  box),  \' 
(6per  box).  Specify  width  desired  in 
ITEM  column  on  coupon. 


No,  6343 

Cap  Band ...  1  box  1.50 
3  or  more  1.25  ea. 


f 


Reeves  AUTO  MEDALLIONS 

Lend  professional  prestige  Two  colors  baked  enamel  on 
gold   background    Resists   weather    fused   Stud   and 
Adapter  provided  Specify  letters  desired;  RN.  MO.  DO, 
RPh.  DDS.  DMD  or  Hosp  Staff  'Plain) 
No.  210  Auto  Medallion 5.00  aa.  ppd. 


Professional  AUTO  OECALS 

Your    professional    insignia    on    window    decal. 
Tastefully  designed  m  i  colors.  4V4"  dia.  Easy 
to  apply.  Choose  RN,  LVN.  LPN  or  Hosp.  Staff. 
No.  621  Decal...  1.00  ea.. 

3  for  2.50,  6  or  more  .60  ea. 


Uniform  POCKET  PALS 

Protects  against  stains  and  wear.  Pli^le  white 
plastic  with  gold  stamped  caduceus.  Two  com- 
partments for  pens,  shears,  etc.  Ideal  token  gifts 
or  favors. 

No.  210-E     (  6  for  1.50, 10  for  2.25 
Savers         \  25  or  more  .20  ea.,  all  ppd. 


RN/Caduceus  PIN  GUARD 

Dainty  Caduceus  fine-chained  to  your  professional 
letters,  each  with  pinback.  saf.  catch.  Wear  as  is 
or  replace  either  with  your  Class  Pin  for  safety 
GQ\i  fin.,  gift-boxed  Specify  RN.  LVN  or  LPN. 
No.  3240  Pin  Guard 2.95  ppd, 


Personalized  EXAMINING  PENUGHT 

Deluxe  model  designed  for  Nurses,  with  caduceus 
imprinted  on  white  barrel:  aluminum  band  and 
pociiet  clip.  FREE  initials  hand-etched  on  band  to 
prevent  loss  5"  long.  US.  made  Batteries,  bulb 
included  (refiiacements  any  store)  Plastic  gift  box. 
No.  007  Penlight 3.98  ea.  ppd. 


^^ 


r' 


NURSES  CHARMS 

Finest  sculptured  Fistier  charms  in  Sterling  or 
Gold  Filled  Ideal  addition  for  bracelet  or  hang 
on  pendant  chain 

Choose  No.  263  Caduceus,  No,  164  Nurses 
Cap,  No.  68  Graduation  Hat  or  No.  8  Band- 
age Shears 2.75  ea.  ppd. 

Specify  Sltrtinf  or  6J.  oe^or  COlOll  oh  coopoo. 


"Endura"  Waterproof  NURSES  WATCH 

Swiss  made,  raised  silver  full  numerals,  lumin.  mark- 
mgs  fied-tipped  sweep  second  hand,  chrome  stainless 
case    Includes  genuine  black  leather  watch  strap.  1 

year  guarantee 

No.  1093 14.95  ea.  ppd. 


Scripto  PILL  LIGHTER 

Famous   Scripto   Vu.Uehter   with   crysta|.clsar   fuel 
Cli3nit)«r  containms  colorful  airay  of  capsulK.  pills 
and  tablets  Novel,  unique,  for  yourself  or  for  unusual 
gifts  for  frienrls.  Guaranteed  by  Scripto 
No.  SOO-P  Pill  LIltlMr  4.21  u.  ppd. 


GROUP  DISCOUNTS: 


25-99  pins,  5%;  100  or  more,  10%. 

Send  cash,  m.0.,  or  chock.  No  blllinKS  or  COO'S. 


Nurses'  Personalized 

ANEROID 
SPHYGMOMANOMETER 

A  superb  scientific  instrument  espe- 
cially designed  to  fill  the  needs  of 
today's  busy,  efficient  nurses!  This 
professional  unit  is  imported  from 
precision  craftsmen  in  W.  Germany 
casy-to-attach  Velcro  cuff,  light- 
weight,compact.fits  into  soft  Sim. 
leather  zippered  case,  only 
21A-K  4"  X  7-.  Dial  calibrated 
to  320  mm.  10-year  accuracy 
guaranteed  to  ±3  mm.  serviced 
and  adjusted  if  ever  required  by 
Reeves  Co.  Your  initials  engraved 
on  manometer  and  gold  stamped  c 
case  FREE,  to  identify  permanently 
your  own  instrument  and  case  forever. 

No.  106  Sphys- .  ■  26.95  ppd.     6  or  more  . . .  22.95  ea.  ppd. 


Personalized 

Littmanri 

NURSESCOPE* 


Product 
of  the 


ft^comnuiv 


Famous  Littmann  nurses  dia- 
phragm stethoscope,  with  your 
initials  individually  engraved 
FREE!  A  fine,  precision  instru- 
ment, has  high  sensitivity  for 
blood  pressures,  general  auscu- 
lation  Only  \\i  ois..  fits  in 
pocket.  23'  vinyl  anti-collapse 
tubing,  non-chilling  snapon  dia- 
phragm, non-rotating,  correctly- 
angled  ear  tubes.  U.  S.  rnade. 
Choose  from  5  jewel-like  colors; 
Goldtone,  Silvertone,  Blue,  Green, 
Pink. 


FREE   ENGRAVED  INITIALS! 

Up  to  3  initials  permanently  engraved  into  chest  piece,  lends 

individual  distinction,  prevents  loss.  Specify  initials  on  coupon. 

No.  216  NufMSCopa  . .  1330  ppd.      12  or  mora  ia99  M 

Order  with  Reeves  coupon  below 


TO:  REEVES  COMPANY.  Box  719,  Attleboro.  Mass.  02703 


ORDER  NO. 

ITEM 

COLOR 

aUANT. 

PRICE 

NAME  PINS:         O  One  Name  Pin       D  Two.  sanw  nam* 

LETT.  COLOR   

METAL  FINISH    

LETTERINO  

2nd  lino 

INITIALS  OS  roquirod 


1  .nrln^  f                              'Sn'ry,  nn  CCtn't  r>r  hillinl  terms) 

Please  add  2S<  handling  charge  on  all  orders  under  $S. 

Strert  

City  . 


State 


:^j 


Next  Month 
in 

The 

Canadian 
Nurse 


•  Health  is  Everybody's 
Business 

•  Sending  Someone  to  a 
Conference? 

—  Here  Are  Some  Tips 

•  The  Child  With  Hurler's 
Syndrome 


Photo  Credits  for 
December  1970 


Miller  Photo  Services, 
Toronto,  cover  photo 


Barry  McGee  Photographer, 
Longueuil,  P.Q.,  pp.  8,  10,  19 


January  25-28, 1971 

American  Hospital  Association,  annual 
meeting,  Washington,  D.C. 

February  8-12, 1971 

Association  of  Operating  Room  Nurses, 
18th  annual  congress,  Las  Vegas,  Neva- 
da, U.S.A.  For  further  information  and  ac- 
commodation write:  AORN,  Denver  Tech- 
nological Center,  8085  East  Prentice  Ave., 
Englewood,  Colorado,  80110. 

February  15-19, 1971 

Occupational  Health  Nursing  course,  spon- 
sored by  the  University  of  Toronto.  De- 
signed for  registered  nurses  with  at  least 
five  years  experience  in  occupational 
health  nursing  who  work  alone  or  with  one 
other  nurse.  For  more  information,  contact 
the  University  of  Toronto. 


February  16-18, 1971 

First  National  Conference  on  Research 
in  Nursing  Practice,  Skyline  Hotel,  Ottawa. 
Purpose  of  this  bilingual  conference  is  to 
stimulate  research  in  nursing  practice 
Registration  is  limited  to  200.  Fee:  $10 
per  day;  $5  per  day  for  nurses  enrolled  in 
graduate  programs.  For  further  information 
and  registration  forms,  write  to:  Dr.  Floris 
E.  King,  Project  Director,  School  of  Nursing, 
University  of  British  Columbia,  Vancouver 
8,  B.C. 

March  31, 1970 

Canadian  Nurses'  Association  annual 
meeting,  business  sessions  only,  Chateau 
Laurier,  Ottawa,  Ontario. 

May  9-12, 1971 

National  League  for  Nursing  and  National 
Student  Nurses'  Association,  annual  con- 
vention, Dallas  Memorial  Auditorium  and 
Convention  Hall,  Dallas,  Texas,  U.S.A. 

May  10-14, 1971 

Ontario  Medical  Association,  annual  meet- 
ing. Royal  York  Hotel,  Toronto,  Ontario. 

May  19, 1971 

Catholic  Hospital  Conference  of  Ontario, 
nursing  committee,  annual  meeting.  King 
Edward  Hotel,  Toronto,  Ontario. 


May  20-21, 1971 

Catholic  Hospital  Conference  of  Ontario, 
annual  meeting.  King  Edward  Hotel,  Toron- 
to, Ontario. 


22     THE  CANADIAN   NURSE 


May  30,  31  and  June  1, 1971 

The  three-day  annual  meeting  of  the  Mani- 
toba Association  of  Registered  Nurses 
will  be  held  in  Dauphin,  Manitoba. 

May  31-)une  1,1971 

Catholic  Hospital  Association,  annual  con- 
vention, Montreal.  Convention  chairman: 
Rev.  Sister  Bernadette  Poirier,  Director  of 
Nursing,  Notre  Dame  Hospital,  Montreal, 
Quebec. 


June  1971 

Canadian  Association  of  Neurological 
and  Neurosurgical  Nurses,  second  annual 
meeting,  St.  John's,  Newfoundland.  For 
further  information  contact  the  Secretary: 
Mrs.  Jacqueline  LeBlanc,  5785  Cote  des 
Neiges,  Montreal  209,  Quebec. 

June  2-4  1971 

Canadian  Hospital  Association,  National 
convention  and  assembly,  Queen  Elizabeth 
Hotel,  Montreal,  Quebec. 

June  7-11, 1971 

Canadian  Medical  Association,  104th  an- 
nual meeting,  Nova  Scotia.  For  further 
information:  Mr.  B.E.  Freamo,  Acting 
General  Secretary,  Canadian  Medical 
Association,  1867  Alta  Vista  Drive,  Ottawa 
8,  Ontario. 

June  7-11, 1971 

Catholic  Hospital  Association  (U.S.),  56th 
annual  convention,  Atlantic  City,  New 
Jersey. 


June  9-12, 1971 

Canadian  Psychiatric  Association,  annual 
meeting.  Lord  Nelson  Hotel,  Halifax,  Nova 
Scotia. 

June  21-24, 1971 

Canadian  Society  of  Radiological  Techni- 
cians, 29th  annual  national  convention, 
Holiday  Inn,  St.  John's,  Newfoundland. 

November  28-December  4, 1971 

World  Psychiatric  Association,  Fifth  World 
Congress  of  Psychiatry,  Mexico  City.  For 
further  information,  write  Secretariado  Del 
"V"  Congresso,  Mundial  de  Psiquiatria. 
Apartado  Postal  20-123/24,  Mexico,  D.F 

May  13-19, 1973 

International  Council  of  Nurses,  15th  Quad- 
rennial Congress,  Mexico  City,  Mexico,     fi" 
JANUARY  1971 


in  a  capsule 


TV  drama  not  for  everyone 

Anyone  who  has  suffered  a  heart  at- 
tack might  want  to  take  note  of  warn- 
ings by  West  German  medical  re- 
searchers that  excitement  on  television 
shows  can  be  dangerous  for  weak 
hearts. 

A  report  in  German  Features  Sep- 
tember 25  explains  what  happened 
when  researchers  at  Heidelberg  Univer- 
sity's Ludolf-Krehl  clinic  examined  six 
volunteer  TV  viewers  during  the  inter- 
national soccer  championships  in  Mex- 
ico. With  electrodes  attached  to  the 
volunteers'  chests  and  miniature  radios 
transmitting  pulse  rates  and  other  data 
to  the  clinic  laboratories,  the  pulse 
rates    showed    significant    increases. 


Each  time  the  German  team  scored, 
the  pulse  rates  of  the  TV  fans  in  the 
clinic  jumped  from  85  beats  per  minute 
to  an  average  115  —  about  the  same 
increase  registered  by  Apollo  astronauts 
just  after  lift-off. 

During  one  tense  soccer  game,  a 
volunteer,  who  previously  had  suffered 
a  heart  attack,  tottered  for  40  minutes 
on  the  verge  of  another  attack. 

Although  the  researchers  say  that 
these  results  are  not  conclusive  proof 
that  TV  shows  can  cause  heart  attacks, 
the  doctors  are  sufficiently  convinced 
of  the  danger  to  recommend  to  those 
with  weak  hearts  to  turn  off  the  TV  set 
when  the  program  becomes  exciting. 

In  other  words,  enjoy  the  dull  stuff, 


JANUARY  1971 


but  not  to  the  point  of  getting  so  carried 
away  that  you  don't  notice  when  it's  no 
longer  dull. 

Nationalism  goes  funereally 

The  concern  in  Parliament  for  Cana- 
dian nationalism  is  sometimes  quite 
down  to  earth.  According  to  Hansard, 
an  opposition  member  asked  the  govern- 
ment to  look  into  the  takeover  of  23 
Canadian  funeral  firms  by  two  United 
States  corporations. 

Stanley  Knowles,  Winnipeg  North 
Centre,  made  the  enquiry  "in  the  hope 
that  Canadians  may  at  least  be  buried 
by  Canadians." 

Ron  Basford,  Minister  of  Consumer 
and  Corporate  Affairs,  said,  "I  can 
appreciate  the  honorable  member's 
concern  with  the  ownership  of  funeral 
parlors." 

To  which  Mr.  Knowles  further  ask- 
ed, "Will  this  investigation  be  complet- 
ed in  time  for  the  burial  of  the  govern- 
ment in  1972?" 

In  the  parliamentary  game  of  chalk- 
ing up  points,  would  the  non-partisan 
reader  score  two  for  the  NDP  and  one 
for  the  Liberals? 

It's  a  new  game 

Bottle  caps  and  not  labels  on  dietetic 
soft  drinks  tell  the  true  story  —  the 
product  is  free  of  cyclamates,  and  is  or 
is  not  free  of  sugar. 

So,  it's  hide  and  go  seek!  Look  for 
accurate  information  on  the  CAP  and 
not  on  the  bottle. 

Manufacturers  of  dietetic  soft  drinks 
are  permitted  to  use  up  stocks  of  old 
returnable  bottles  —  provided  true 
product  information  is  given.  The  cal- 
orie content  is  also  written  on  the  cap. 
That's  what  a  national  health  and  wel- 
fare news  release  tells  us. 

The  smoothest  joints  in  town 

Discussion  of  a  "lub  job"  has  al- 
ways meant  it  is  time  to  take  the  family 
vehicle  to  your  friendly  neighborhood 
mechanic  to  be  oiled. 

Soon  the  term  will  be  applied  to 
arthritic  patients  who  will  go  to  have 
their  joints  oiled.  Human  joints  are  oil- 
ed naturally  by  synovial  fluid,  and 
British  doctors  believe  that  by  adding 
to  this  natural  lubricant,  wear  on  the 
affected  joint  could  be  slowed  down. 

Actually,  the  idea  is  not  new,  but 
scientists  at  Leeds,  England,  are  hope- 
ful of  finding  the  right  kind  of  lubricant. 
They  are  working  on  the  development 
of  water  soluble  plastics  for  this  use.  ^ 
THE  CANADIAN   NURSE     23 


From 

.  bosk 
science . . 


New  8th  Edition!  Anthony-Kolthoff 

TEXTBOOK  OF  ANATOMY  AND  PHYSIOLOGY 

The  most  widely  adopted  text  in  its  subject  area,  this  new  8th  edition 
effectively  correlates  precise  discussions  with  remarkable  illustrations  to  clearly 
delineate  basic  facts  and  principles  relative  to  human  anatomy  and  physiology. 
Though  the  popular  format  of  this  book  remains  unchanged,  the  review 
questions  at  the  beginning  of  each  chapter  have  undergone  extensive  revision  to 
help  your  students  understand  likenesses,  differences  and  relationships,  and  to 
help  them  develop  their  discriminatory  powers. 

An  entirely  new  chapter  examines  the  causes  of  physiologic  stress  and  the 
body's  responses.  The  inclusion  of  the  most  current  information  on  the  effects 
of  age  on  body  structure  and  function,  significant  new  knowledge  on  cytology, 
and  the  concepts  of  adaption  and  maladaption  and  their  relationship  to 
homeostasis  and  disease  enhance  this  text's  educational  value.  A  time-saving 
Teacher's  Guide  is  furnished  without  charge  to  instructors  adopting  this  text. 

By  CATHERINE  PARKER  ANTHONY,  R.N.,  B.A.,  M.S.;  with  the  collaboration  of 
NORMA  JANE  KOLTHOFF,  R.N.,  B.S.,  Ph.D.  April,  1971.  8th  edition,  approx.  600 
pages,  8"  x  10",  320  illustrations,  119  in  color,  and  a  Trans-Vision  «  insert  of  human 
anatomy. 


New  8th  Edition! 


Anthony 


ANATOMY  AND  PHYSIOLOGY 
LABORATORY  MANUAL 

Carefully  correlated  to  the  author's  new  8th  edition  of  Textbook  of  Anatomy 
and  Physiology,  this  flexible  manual  clearly  presents  the  steps  of  the  scientific 
method  to  your  students  in  a  systematic  approach  to  problem  solving.  To 
provide  them  with  as  rich  an  educational  experience  as  possible,  labeled 
drawings  now  require  them  to  collect  specific  data  and  use  this  information  to 
answer  questions  at  the  end  of  each  chapter. 

Of  particular  interest  to  you  is  the  uncomplicated  and  relatively  inexpensive 
nature  of  the  requisite  laboratory  equipment.  The  incorporation  of  more 
procedures  enables  you  to  tailor  your  lab  sessions  to  those  objectives  you  judge 
most  valuable,  and  clear  directives  enable  students  to  work  without  constant 
supervision  and  instruction.  Finally,  the  format  provided  for  students  to  write 
up  their  conclusions  permits  you  to  rapidly  check  their  answers  against  those  in 
the  answer  book  furnished  when  you  adopt  this  manual. 


By     CATHERINE     PARKER     ANTHONY,     R.N. 
approx.  232  pages,  8"  x  10",  76  illustrations. 


B.A.,    M.S.    April,    1971.    8th    edition, 


New  2nd  Edition! 


Brooks 


BASIC  CHEMISTRY 
A  Programmed  Presentation 

Especially  useful  in  introductory  courses  for  students  with  little  or  no 
chemistry  background,  this  new  2nd  edition  eliminates  time-consuming  rote 
study  and  memorization  from  your  classroom.  On  their  own  time  and  at  their 
own  speed,  students  teach  themselves  important  principles,  and  add  to  and 
reinforce  their  understanding  of  what  they  learn  from  text  and  lecture.  Topics 
range  from  such  basic  ones  as  matter  and  energy  to  biochemistry  and  nuclear 
chemistry.  Virtually  all  frames  from  the  1st  edition  have  been  rewritten  to 
reflect  current  advances  in  each  topic.  In  addition,  suggestions  from  instructors 
who  used  the  previous  edition  have  been  incorporated  throughout. 

By  STEWART  M.  BROOKS,  M.S.  January,  1971.  2nd  edition,  approx.  144  pages,  7"  x 
10",  12  illustrations,  paper  cover.  About  $S.5S. 


MOSBY 


TIMES  MIRROR 

THE  C.V.  MOSBY  COMPANY.  LTD.  •  86  NORTHLINE  ROAD  •  TORONTO  374.  ONTARIO,  CANADA 


i 
I 


New  3rd  Edition! 


Brooks 


INTEGRATED  BASIC  SCIENCE 

The  meat  of  four  books  in  one,  this  unusual  text  is  a  compact  fusion  of  basic 
physics,  chemistry,  microbiology,  anatomy  and  physiology.  Unmatched  for 
breadth  and  scientific  accuracy,  this  timely  revision  incorporates  recent 
advances  in  microbiology,  and  a  new  chapter  which  concisely  explains  the  gene 
and  its  chromosomal  content.  The  discussion  of  the  body's  defenses  against 
disease  and  foreign  bodies  applies  this  data  to  problems  in  heart  trans- 
plantation. Your  students  will  especially  appreciate  the  clear  explanation  of  the 
metric  system  and  its  terminology.  To  help  your  students  master  scientific 
vocabulary,  all  key  terms  appear  in  italics.  Instructors  adopting  this  text  will 
receive  a  Teacher's  Guide,  furnished  without  charge. 

By  STEWART  M.  BROOKS,  M.S.  April,  1970.  3rd  edition,  508  pages  plus  FM  l-XIV,  7"  x 
10",  316  illustrations.  $10.50. 


New  2nd  Edition! 


Brooks 


LABORATORY  MANUAL  AND  WORKBOOK 
FOR  INTEGRATED  BASIC  SCIENCE 

Correlated  to  the  new  3rd  edition  of  Brooks,  Integrated  Basic  Science,  this 
newly  revised  manual  clearly  and  realistically  presents  the  basic  sciences  as  an 
integrated  and  interrelated  body  of  knowledge.  The  logical  sequence  that  leads 
the  student  smoothly  from  one  subject  to  another,  the  interesting  experiments 
that  demonstrate  the  "how"  and  "why"  of  scientific  principles,  and  the 
manner  in  which  the  student  is  required  to  use  previously  learned  knowledge 
all  add  to  this  edition's  educational  value. 

By  STEWART  M.  BROOKS,  M.S.  January,  1971.  2nd  edition,  approx.  352  pages,  7V«"  x 
lOVz",  258  illustratioif^.  About  $5.75. 


A  New  Bool<! 


Rodman  et  al. 


THE  PHYSIOLOGIC  AND  PHARMACOLOGIC 
BASIS  OF  CORONARY  CARE  NURSING 

The  first  book  to  provide  in-depth  knowledge  consistent  with  the  increased 
professional  responsibility  assumed  by  ICU  nurses,  this  forward-looking  text 
can  prepare  your  students  to  function  at  this  upgraded  level.  Besides  important 
scientific  background  and  clinically  oriented  analyses  of  specialized  nursing 
procedures,  this  significant  volume  includes  vital  material  on  the  therapeutic 
role  of  interpersonal  relationships  in  caring  for  the  coronary  patient. 

By  THEODORE  RODMAN,  M.D.;  RALPH  M.  MYERSON,  M.D.;  L.  THEODORE 
LAWRENCE,  M.D.;  ANNE  P.  GALLAGHER,  R.N.,  B.S.N.,  M.S.B.;  and  ALBERT  J. 
KASPER,  M.D.  February,  1971.  Approx.  248  pages,  7"  x  10",  103  illustrations. 


A  New  Bool<!  Given-Simmons 

NURSING  CARE  OF  THE  PATIENT 

WITH  GASTROINTESTINAL  DISORDERS 

This  effective  new  text  provides  all  the  information  your  students  need  to 
evaluate  gastrointestinal  patients,  to  plan  and  implement  the  best  nursing  care, 
and  to  understand  the  "why"  behind  their  actions.  A  systematic  approach  to 
each  condition  includes  normal  anatomy  and  physiology,  pathogenesis, 
symptoms,  diagnostic  procedures,  and  principles  of  therapy.  Throughout  this 
book,  the  authors  stress  the  nurse's  vital  role  in  observation,  interpretation  and 
intervention. 

By  BARBARA  A.  GIVEN,  R.N.,  B.S.N.,  M.S.;  and  SANDRA  J.  SIMMONS,  R.N.,  B.S.N., 
M.S.  March,  1971.  Approx.  416  pages,  7"  x  10",  70  illustrations.  About  $12.10. 


Specialized 

nursing 
cQfe- 


timely 

Mosby  bool<s 

tailored 

to  your 
students' 
needs! 


THE  C.V.  MOSBY  COMPANY,  LTD.  •  86  NORTHLINE  ROAD  •  TORONTO  374.  ONTARIO.  CANADA 


no  OTHER  BAG  PERFORfTU  LIKE  fTlE 


My  safety  chamber 
really  stops  retro- 
grade infection. 
There's  simply  no  way 
for  the  bugs  to  back 
up  and  go  where  they 
don't  belong.  And  by 
tucking  the  BAC- 
STOP  chamber  in- 
side the  bag,  it  can't 
be  kinked  acciden- 
tally to  stop  the  flow. 


Cysttrio 


My  hanger  is  the 
hanger  that  works 
well  all  the  time.  Hang 
it  on  a  bed  rail  or  a 
belt,  it  is  always  se- 
cure and  comfortable. 
I'm  always  on  the 
level  with  this  hanger, 
whether  my  patient  is 
lying,  sitting,  or  walk- 
ing around. 


igm 


IBSC 


I'm  clear-faced  and 
easy  to  read.  My  white 
back  makes  my  mark- 
ings stand  out  unique- 
ly, whether  you  look 
at  my  backbone  scale, 
or  tilt  me  diagonally 
to  read  small  amounts 
with  the  corner  cali- 
brations. 


mofi 


400 


I  have  the  only  shortie 
drainage  tube  around, 
and  it's  miles  better 
than  any  other 
you've  ever  used.  It's 
easier  to  handle,  and  it 
won't  drag  on  the  floor, 
even  with  the  new  low 
beds.  So  out  goes  one 
more  path  lo  possible 
contamination. 


I'm  the  unique  new  CYSTOFLO"  drainage  bag,  a 
true-blue  friend  to  nurses,  physicians  and  patients. 
Why  don't  we  get  acquainted? 


BAXTER  LABORATORIES  OF  CANADA 


OIV'SiON  Of  TflAVtNOl   lABOflATORlfS   INC 

6405  Northam  Drive  Malton.  Ontario 


REPORT 

to  the 

Minister  of  National  Health  and  Welfare 

on  the 

Recommendations  of  the  Task  Forces 
on  the  Cost  of  Health  Services  in  Canada 

from  the 
Canadian  Nurses'  Association 

October  1970 


The  Task  Force  Reports  on  the  Cost  of  Health  Services  in  Canada  have  been  discussed 
in  considerable  detail.  Most  of  the  recommendations  covering  nursing  or  with  nursing 
implications  have  been  accepted;  some  with  no  comment  because  their  intent  was 
clear  and  conformed  with  the  philosophy  and  objectives  of  the  CNA.  Only  a  very 
few  of  the  recommendations  were  rejected,  either  because  they  were  thought  to  be 
premature  or  certain  aspects  of  the  recommendations  could  not  be  supported  because, 
in  our  opinion,  they  were  not  in  the  best  interests  of  the  public  or  members  of  the 
nursing  profession.  The  details  of  our  conclusions  in  respect  to  the  recommendations 
studied  are  presented  in  Appendices  I  —  VII.  [Too  extensive  for  inclusion  in  The 
Canadian  Nurse] 

In  the  following  pages  we  present  some  general  impressions  of  this  report  and  set 
down  for  your  information  what  we  consider  the  most  urgent  concerns  of  the  organ- 
ized nursing  profession. 

The  suggestions  to  improve  the  operational  efficiency  of  our  present  system  of  de- 
livering health  care  to  the  people  of  Canada  are  commendable,  particularly  in  res- 
pect to  the  management  and  administration  of  hospitals  for  acute  illness,  but  we  are 
of  the  opinion  that  at  best  the  changes  suggested  will  make  a  relatively  small  saving 
in  the  cost  of  health  care.  It  would  seem  that  if  there  is  to  be  any  restraint  in  the  in- 
crease of  the  cost  of  health  services,  certain  fundamental  changes  must  be  made  in 
our  present  system  of  delivery  of  health  care.  Some  of  these  changes  are  indicated  in 
the  report  but  others,  such  as  the  rapidly  increasing  costs  of  personal  medical  care 
and  the  widely  recognized  gaps  in  medical  services,  have  been  given  little  considera- 
tion in  the  report. 


lANUARY  1971  THE  CANADIAN   NURSE     27 

% 


In  respect  to  the  changes  suggested  in  our  system  of  delivery 
of  health  services,  we  should  like  to  see  priority  given  to  the 
recommendations  dealing  with  the  following  aspects  of 
reorganization: 

1 .  The  development  of  a  complete  health  care  system  under 
one  authority  at  the  provincial  government  level,  rather 
than  thedistribution  of  services  amongseveral  departments 
or  ministries. 

Recommendation  (no  number),  volume  I ,  page  13: 
"Administrative  arrangements  should  be  made  to  provide 
full  coordination  of  the  total  health  care  delivery  system 
at  the  provincial  level,  with  health  services,  welfare  serv- 
ices, mental  health  care,  hospital  care,  and  medical  and 
ancillary  care  as  elements  of  a  single  function  and  overall 
plan.  Greater  emphasis  should  be  placed  on  defining  the 
needs  of  elderly,  low-income  and  other  disadvantaged 
groups,  and  on  evaluating  the  programs  now  directed  at 
these  groups,  in  order  to  achieve  a  judicious  allocation  of 
resources  in  relation  to  anticipated  results." 

2.  The  organization  of  all  health  services  in  well-defined 
regions  under  the  jurisdiction  of  a  regional  health  board. 

Recommendation  1 ,  volume  2,  pages  147-148: 
"That  each  province  develop,  at  the  earliest  possible  time, 
a  comprehensive  health  system  based  on  the  coordination  of 
planning,  operation  and  financing  through  regional  health 
boards  which  have  the  authority  to  provide  organizational, 
management  and  consultative  services  to  a  broad  spectrum 
of  health  care  facilities  in  a  prescribed  area.  The  provincial 
authority  would  continue  to  maintain  its  overall  control 
and  coordinating  functions,  through  a  direct  relationship 
with  regional  health  boards." 

Recommendation  15,  volume  2,  page  152: 
"That  the  principle  of  progressive  patient  care  within  an  in- 
dividual hospital,  a  hospital  system  and  a  health  region  be 
adopted  as  a  basic  requirement  for  the  efficient  operation  of 
a  regional  health  system." 

Recommendation  12,  volume  2,  pages  283-284 

(a)  "That  each  provincial  health  planning  body  establish 
individual  regional  health  planning  boards  within  the 
province,  as  required,  which  would  be  responsible  for  the 
continuing  planning,  development  and  implementation 
of  a  regionalized,  comprehensive,  integrated  and  ba- 
lanced health  care  system  of  services  and  facilities 
within  the  context  of  the  region's  total  spectrum  of 
health  services  and  coordinated  with  the  planning  of 
other  community,  regional,  provincial,  and  national 
health  and  social  agencies. 

(b)  "That  the  regions  be  based  on  the  health  service  market 
area  to  be  serviced  rather  than  on  municipal,  county  or 
other  defining  boundaries  withinaprovincialjurisdiction. 
There  may  be  some  regions  which  are  interprovincial  in 
scope  and  the  provincial  planning  bodies  involved  should 
cooperate  where  health  service  market  areas  cross  pro- 
vincial boundaries." 

28     THE  CANADIAN   NURSE 


(c)  "That  uniform  regions  be  established  in  each  province 
where  feasible  for  those  functions  which  relate  to  health 
in  its  broadest  sense,  including  health  related  facilities 
which  are  usually  the  responsibility  of  other  departments, 
e.g.,  homes  for  special  care;  that  departments  of  Pro- 
vincial Government  recognize  and  adopt  the  establish- 
ed regions  for  the  purposes  of  planning,  organizing,  and 
implementing  programs;  and  that  voluntary  agencies 
be  encouraged  to  use  the  same  uniform  regions." 

(d)  "That  regional  health  planning  boards  be  broadly  rep- 
resentative of  providers  of  health  care,  government 
and  non-governmental  agencies  and  other  groups  such 
as  consumers  who  are  concerned  with  health  care." 

(e)  "That  regional  boards  be  financed  by  Government  and 
be  responsible  to  the  Provincial  Government  Body 
responsible  for  overall  Provincial  health  planning  as 
referred  to  in  Recommendation  1 1  ."^ 

3.  The  inclusion  of  insurance  coverage  to  all  public  institu- 
tions and  agencies  serving  the  health  needs  of  a  com- 
munity. 

Recommendation  9,  volume  3,  page  364: 

"That  the  patient  who  occupies  other  than  an  acute  care 

bed  should  not  be  faced  with  an  increased  personal  cost." 

Recommendation  10,  volume  3,  page  364: 
"That  the  alternatives  to  acute  care  provide  an  effective 
means  of  reducing  or  limiting  the  number  of  acute  care 
beds  required." 


4.  Some  more  effective  and  less  costly  method  of  providing 
personal  medical  care. 

Recommendation  1 ,  volume  3,  pages  21-22: 
"That  a  Committee  on  Personal  Medical  Services  reporting 
and  making  recommendations  to  the  regular  conferences 
of  the  federal  and  provincial  Ministers  of  Health  through 
the  Dominion  Council  of  Health  be  established  and  con- 
tinue for  at  least  five  years  to  carry  out  the  following  func- 
tions: 

(a)  continuing  evaluation  of  the  delivery  of  personal  med- 
ical services  and  the  recommending  of  indicated  re- 
search and  changes  in  the  medical  care  delivery  system 
or  systems; 

(b)  convening  of  an  annual  working  conference  on  the 
delivery  of  personal  medical  care  with  participation 
by  invited  experts  to  exchange  information,  to  discuss 
methods  of  research  and  to  evaluate  innovations,  there- 
by providing  a  channel  of  communication  between 
individual  research  workers  across  Canada  and  the 
Committee  on  Personal  Medical  Services; 

(c)  evaluation  of  systems  of  delivery  of  medical  care  in  other 
countries  which  might  be  relevant  to  the  C  a  n  a  d  i  a  n 
situation; 

(d)  receiving  and  evaluating  progress  reports  and  final  reports 

JANUARY  1971 


of  all  research  activities  related  to  the  delivery  of  personal 
medical  services  which  have  been  carried  out  by.  or  with 
financial  support  from,  the  Federal  Government;  and 
(e)  the  submission  of  reportsof  the  activitiesoftheCommittee 
on  Personal  Medical  Services  at  least  twice  yearly." 


5.  Greater  emphasis,  with  financial  support,  placed  on  exper- 
imental and  demonstration  projects  with  the  general 
objective  of  improving  our  system  of  meeting  the  health 
needs  of  a  community. 


Recommendation  21 ,  volume  2,  page  156: 
"That  priority  be  given  to  the  development  of  graduate  educa- 
tional programsforclinical  specialists  in  nursing,  and  forpost- 
basic  specialty  programs  in  clinical  nursing." 

Recommendation  21 ,  volume  3,  page  367: 
"That  university  educational  programs  in  public  health  be 
strengthened  through  increased  financial  support  to  enable 
them  to  meet  expanding  needs." 

Recommendation  22,  volume  3,  page  367: 
"That  there  be  more  stress  in  these  programs  on  training  key 
members  of  the  public  health  team  together  in  joint  classes 
and  seminars." 

In  respect  to  cost  of  hospital  services,  we  feel  that  those 
recommendations  dealing  with  integrated  and  shared  fa- 
cilities under  a  regional  plan  and  improved  management 
of  health  agencies  should  be  given  priority. ^  Progress  in 
these  respects  would  lead  to  the  patient  being  assigned  to 
the  most  appropriate  institution  or  agency  for  his  care,  be 
it  on  an  in-patient  or  ambulatory  basis. 

Some  important  aspects  to  be  considered  in  bringing  about 
improvement  in  the  delivery  of  nursing  service  are:  exami- 
nation of  the  structure  of  nursing  service  to  ensure  a  work- 
ing environment  which  allows  registered  nurses  to  achieve 
their  objectives  in  nursing  care;  the  appointment  of  nurse 
administrators  with  a  knowledge  of  current  concepts  in 
nursing  practice  as  well  as  management  skills;  the  availa- 
bility and  use  of  consultant  services. 

In  the  improvement  of  personal  medical  care  urgent  con- 
sideration should  be  given  to  assistance  to  physicians  in 
institutional  and  office  practice  as  well  as  in  all  types  of 
ambulatory  and  home  care.  It  is  our  conviction  that  there 
are  sufficient  assistants  to  the  physicians  at  the  present 
time,  but  these  assistants  need  to  be  used  to  a  greater  ex- 
tent by  the  physicians.  The  Committee  is  of  the  opinion 
that  the  preparation  and  potential  of  the  nurse  is  not  being 
exploited  to  its  full  capacity.  "The  physician  has  permitted 
her  greater  technical  responsibility  in  the  care  of  patients 
recovering  from  major  operations,  and  even  greater  tech- 
nical responsibility  in  the  operating  room.  It  is  in  relation 
to  personal  medical  care  that  the  physician  has  not  ye' 
accepted  the  necessity  of  sharing  and  delegating  some  o 
his  respionsibility  to  the  nurse. "3 
lANUARY  1971 


The  Committee  believes  that  the  majority  of  activities  de- 
scribed for  the  physician's  associate  are  either  presently 
being  carried  out  by  the  nurse  or  could  be  carried  out  by 
the  nurse  if  she  could  utilize  her  present  abilities  to  a  greater 
extent  and  if  capable,  nurses  were  given  more  latitude  to 
develop  their  skills.''  The  extended  role  of  the  nurse  could 
be  realized  in  all  health  services  and  it  is  to  be  hoped  that 
there  will  be  demonstration  projects  to  show  this. 

The  Committee  firmly  believes  that  there  is  an  immediate 
need  for  experimentation  with  various  patterns  of  delivery 
of  health  care,  utilizing  the  nurse  in  an  extended  and  more 
independent  role.  This,  however,  is  only  part  of  our  think- 
ing in  respect  to  priorities  in  experimenting  with  new 
departures  in  the  system  of  providing  health  care.  Experi- 
ments and  demonstrations  are  needed  in  respect  to  regional- 
ization  of  the  total  health  services,  in  the  development  of 
a  wider  variety  of  centers  for  ambulatory  care  and  in  the 
integration  of  treatment  and  preventive  services. 

We  recommend  that  the  CNA  give  special  support  to  the 
development  of  the  following  areas  of  research: 

1 .  Task  Force  on  Salaries  and  Wages 

Recommendation  7 ,  volume  2,  page  150: 
"That  the  nursing  components  of  health  care  be  assessed  and 
reorganized  to  provide  for  the  better  utilization  of  available 
personnel  as  follows: 

(a)  by  the  adoption  of  current  management  organi- 
zation and  techniques; 

(b)  by  the  development  of  methods  to  improve  the 
utilization  of  nursing  personnel,  based  on  care- 
fully formulated  work  standards  and  in-service 
education.  In  part,  this  could  be  accomplished 
by  development  in  the  in-patient  care  areas  of 
the  health  care  center  of  a  system  of  identifying 
the  specific  nursing  needs  of  each  patient,  and, 
therefore,  the  staffing  pattern  of  each  nursing 
unit.  The  development  of  nursing-team  staffing 
patterns  should  be  on  a  minimum  base,  rather 
than  on  a  maximum  patient<are  basis,  supple- 
mented by  an  adequate  'float'  or  'flying  squad' 
pool  of  full-time  and/or  part-time  staff  nurses; 

(c)  by  the  development  of  methods  of  evaluating  the 
quality  of  patient  care;  and 

(d)  by  the  development  of  criteria  for  measuring 
productivity  and  evaluating  performance  of  pro- 
fessional and  technological  personnel  in  the 
health  field." 

Recommendation  10,  volume  2,  page  151: 
"That  a  national  committee,  composed  of  experts  in  nurs- 
ing, medicine,  hospital  administration  and  allied  health 
fields,  be  established  to  develop  a  continuing  operational 
.-itseai^phsDrogram  to  maintain  progress  in  health  care  or- 
^  "ganization  ^nd  management  techniques." 

tion  26,  volume  2,  page  157: 
nal  committee  composed  of  experts  in  nurs- 
THE  CANADIAN  NURSE     29 


ing,  medicine,  hospital  administration  and  allied  health 
fields,  be  established  to: 

(a)  devise  methods  for  the  development  of  standards 
for  nursing  care; 

(b)  develop  methods  of  evaluating  the  quality  of 
patient  care; 

(c)  develop  criteria  for  measuring  productivity  and 
evaluating  performance  of  professional  and 
technological  personnel  in  the  health  field;  and 

(d)  establish  a  continuing  operational  research  pro- 
gram to  maintain  progress  in  health  care  organ 
izational  and  management  techniques." 


2.  Task  Force  on  Method  of  Delivery  of  Medical  Care 

Recommendation  28,  volume  3,  page  63: 
"That  promising  proposals  for  more  effective  employ- 
ment of  allied  health  personnel  in  the  delivery  of  medical 
care  be  evaluated  using  well  designed  demonstration 
projects." 


References 

7 .  Recommendation  1 1 ,  volume  2,  page  283: 

"That  administrative  arrangements  be  established  which 
will  provide  for  full  coordination  of  the  total  health  care 
delivery  system  at  the  provincial  and  higher  levels.  This 
implies  arrangements  whereby  the  fields  of  health,  wel- 
fare, mental  health,  hospital  plan  operation  and  medical 
care  plan  operation  can  be  viewed  as  elements  of  a  single 
function  and  health  planning  body.  In  one  province,  as 
an  example,  there  are  five  agencies  involved  in  these 
functions." 

2.  Recommendation  20,  volume  2,  page  84: 

"That  nursing  service  administrators  should  be  prepared 
through  educational  programs  and  experience  for  the  po- 
sition of  management  of  the  nursing  service  department." 
Recommendation  1 ,  volume  2,  page  60: 
"That  hospitals  be  encouraged  to  develop  along  lines  of 
proven  industrial  organizational  structure  where  lines  of 
authority  to  an  individual  known  as  president  or  exec- 
utive vice-president  for  the  day-to-day  control  of  all 
operations  are  clearly  defined." 
Recommendation  3a,  volume  2 ,  page  1 1 : 
"That  all  hospital  administrators  be  licensed  and  that 
this  license  be  graded  using  education  and  experience 
as  the  main  yardsticks.  All  hospitals  should  be  graded  as 
to  the  type  of  license  its  administrator  requires." 
Recommendation  3b,  volume  2,  page  II: 
"That  this  licensing  program  be  the  responsibility  of  a 
national  body." 

Recommendation  28,  volume  2,  page  89: 
"That  the  objectives  and  functions  of  each  department 
within  the  hospital  should  be  clearly  stated  and  each  de- 
partment should  be  responsible  for  carrying  out  its  func- 
tions." 

Recommendation  29,  volume  2,  page  89: 
"That  the  services  supporting  nursing  be  reorganized  to 

30     THE  CANADIAN   NURSE 


increase  efficiency  in  the  delivery  of  nursing  care  to 
patients  and  so  that  the  needed  supplies  and  equipment, 
i.e.,  food,  drugs,  sterile  supplies,  linen,  etc.,  are  available 
at  the  time  needed,  in  the  place  needed,  and  in  the  most 
usable  form." 

Recommendation  1 1 ,  volume  2,  page  151: 
"That  all  hospitals  be  encouraged  to  establish  goals,  ob- 
jectives and  functional  organizations  through  organized 
management  programs,  and  that  such  programs  include 
provision  for  the  close,  inter-departmental  relationships 
required  for  effective  operation." 

3.  Hamilton,  John  D.  Health  Services  Fifty  Years  Hence. 
Nursing  Education  in  a  Changing  Society,  ed.  Mary  Q. 
Innis.  Toronto,  University  of  Toronto  Press,  1970,  pp. 
193-208. 

4.  Paragraph  1 ,  volume  3,  page  62: 

"Some  of  the  roles  and  tasks  which  now  devolve  upon 
physicians  but  which  could  be  handled  in  whole  or  in 
part  by  practitioner-associates  include:  home  visits,  mid- 
wifery, well  child  care,  considerable  military  medicine, 
triage,  ambulance  attendant  service,  emergency  calls 
service,  frontier  and  outpost  coverage,  some  geriatric 
care,  industrial  medicine,  periodic  health  examinations 
on  well  persons,  administrative  duties,  dispensing,  im- 
munization programs,  operating  room  and  clinical  sur- 
gical assistance,  some  anesthetics,  service  in  intensive 
care,  recovery  room  and  cardiac  care  units,  health 
counselling,  school  health  services,  intern  service  in  non- 
teaching  hospitals,  and  the  diagnosis  and  treatment  of 
less  complex  or  serious  clinical  problems  generally."    ^ 


The 

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Nurse 

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JANUARY  1971 


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The  Canadian  Nurse 

OFFIOAL  JOURNAL  OF  THE  CANADIAN  NURSES'  ASSOCIATION 

THE   CANADIAN   NURSE     31 


Nursing —  evolution 
or  revolution? 


If  nursing  does  not  address  itself  to  reality,  it  won't  be  around  to  plan  for  the 
future,  the  author  warns. 


Loretta  C.  Ford,  R.N.,  Ed.D. 


Whenever  I  talk  with  Canadians,  I 
always  ask  them  to  remember  that  many 
of  my  assumptions  are  based  on  my 
own  experience  and  education  in  the 
United  States.  It  follows  that  occasional- 
ly I  may  not  be  addressing  myself  to 
issues  that  are  pertinent  to  health  in 
both  our  countries  and  our  respective 
groups  of  nurses.  However,  I  usually 
find  that  we  have  similar  problems  in 
health  and  in  nursing. 

I  have  been  a  change  agent  of  sorts, 
one  who  has  been  involved  in  a  highly 
controversial  (and  often  maligned) 
project  directed  toward  expanding  the 
role  of  nurses.  Perhaps  I  am  expected 
to  debate  the  issue  of  whether  or  not 
nurses  should  assume  expanded  res- 
ponsibilities for  care.  If  the  year  were 
1960,  a  debate  would  be  appropriate. 
In  1960  we  may  have  even  debated 
whether  or  not  change  should  be  accom- 
plished by  revolution  or  evolution. 
Today  these  debates  are  post  ipso  facto. 
Changes  are  being  made  —  rapidly 
and  without  the  usual  evolutionary  pace. 

My  anxiety  stems  from  my  observa- 

Dr.  Ford  is  Professor  and  Chairman, 
Community  Health  Nursing,  University 
of  Colorado  School  of  Nursing,  Denver, 
Colorado,^  U.S.A.  This  article  was  adapt- 
ed from  a  paper  Dr.  Ford  presented  at  a 
forum  sponsored  by  the  University  of 
Western  Ontario's  School  of  Nursing 
faculty  on  October  16,  1970. 


32     THE  CANADIAN   NURSE 


tion  that  nursing  is  moving  at  an  evolu- 
tionary pace,  while  the  world  around  us 
is  exploding  in  revolutionary  ways. 
Nursing  needs  to  be  in  the  forefront  of 
the  action,  determining  its  own  destiny 
as  it  seeks  to  fulfill  its  mission  to  care 
for  people.  Nursing  must  be  responsive, 
flexible,  timely,  and  timeless  within 
the  realities  of  the  total  mosaic  of  health 
and  its  present  chaotic  state. 

A  quick  review  of  this  health  care 
crisis  is  supplied  by  Dr.  Ward  Darley 
who  said: 

"One  has  only  to  look  back  25  years 
to  appreciate  the  exponential  rate  with 
which  change  has  taken  place  and, 
barring  a  world  catastrophy,  it  is  inevi- 
table that  both  the  direction  and  speed 
of  this  change  will  continue.  The  com- 
ponents of  this  change,  all  of  which  are 
inevitables  in  themselves,  constitute  a 
chain  reaction,  the  links  of  which  arrange 
themselves  in  the  following  sequence: 
(1)  increasing  knowledge,  (2)  increasing 
specialism,  (3)  increasing  demands  for 
service,  (4)  increasing  costs  of  service, 

(5)  increasing  shortages  of  personnel, 

(6)  increasing  complexity  and  efficiency 
in  data  processing  and  communication, 
and  (7)  increasing  institutionalization 
(organization)."  1 

A  less  erudite  wag  blamed  these  phe- 
nomena on  social  trends.  He  sum- 
marized them  with  this  alliteration: 
population,  pollution,  protest,  protein, 
promiscuity,  prices,  pot,  the  pill,  the 
JANUARY  1971 


Protestants,  and  the  Pope.  My  suffixal 
approach  is  to  summarize  the  problems 
as  effluence,  affluence,  influence,  and 
confluence. 

Our  major  problems  stem  from  our 
myopic  view  of  health.  Reaching  for 
high  level  wellness  for  all  people  through 
continuous, coordinated,comprehensive 
health  care  is  an  espoused  goal.  How- 
ever, to  mount  such  a  program,  com- 
mitment and  change  in  the  systems  that 
prepare  practitioners  and  those  that 
deliver  health  care  will  be  required. 
How  then  shall  we  change?  Just  for  the 
record  and  a  quick  reminder  that  nurs- 
ing has  changed,  listen  to  these  rules 
for  nurses  that  were  uncovered  recent- 
ly in  a  Denver  Hospital.  The  date  is 
1887: 

"In  addition  to  caring  for  your  50 
patients,  each  bedside  nurse  will  follow 
these  regulations: 

1 .  Daily  sweep  and  mop  the  floors  of 
your  ward,  dust  furniture  and  win- 
dow sills. 

2.  Maintain  an  even  temperature  by 
bringing  in  a  scuttle  of  coal  for  the 
day's  business. 

3.  Light  is  important  to  observe  the 
patient's  condition.  Therefore,  each 
day  fill  kerosene  lamps,  clean  chim- 
neys and  trim  wicks.  Wash  windows 
once  a  week. 

4.  Nurses'  notes  are  important  to  aiding 
a  physician's  work.  Make  your  pens 
carefully.  You  may  whittle  nibs  to 
your  individual  taste. 

5.  Each  nurse  on  day  duty  will  report 
at  7  a.m.  and  leave  at  8  p.m.  except 
on  the  Sabbath  on  which  day  you 
will  be  off  from  12  noon  to  2  p.m. 

6.  Graduate  students  in  good  standing 
with  the  director  of  nurses  will  be 
given  an  evening  off  a  week  for 
courting  purposes  or  two  evenings  a 
week  if  you  regularly  go  to  church. 

7.  Each  nurse  should  lay  aside  from 
each  pay  day  a  goodly  sum  from  her 
earnings  for  her  benefits  in  her  declin- 
ing years  so  she  will  not  become  a 
burden.  For  example  —  if  you  earn 
$30  a  month,  set  aside  $15. 

8.  Any  nurse  who  smokes,  uses  liquor 
JANUARY  1971 


in  any  form,  gets  her  hair  done  in  a 
beauty  shop  or  frequents  dance  halls 
will  give  the  director  of  nurses  good 
reason  to  suspect  her  worth,  inten- 
tions, and  integrity. 
9.  The  nurse  who  performs  her  labors, 
serves  her  patients  and  doctors  faith- 
fully and  without  fault  for  five  years 
will  be  given  an  increase  by  the  hos- 
pital administration  of  five  cents  a 
day  providing  there  are  no  hospital 
debts  that  are  outstanding." 

These  rules  indentify  concepts  of  duty, 
reward,  and  destiny  of  another  day. 
However,  they  are  engrained  in  us  from 
our  traditions,  our  ideals,  and  our  herit- 
age. In  the  past  we  emphasized  duty  as 
a  basic  value.  Currently,  reward  and 
destiny  gain  much  more  of  our  attention 
in  the  here  and  now. 

But  basic  to  these  is  the  concept  of 
duty:  in  the  modern  sense,  it  is  com- 
mitment. Nurses  talk  glibly  about 
their  contribution  and  uniqueness  in 
caring  about  and  for  people.  In  socio- 
logical terms  of  role  theory,  we  as  nurses 
claim  our  role  to  be  an  expressive  one, 
while  we  assign  to  the  physician  an  in- 
strumental role. 

The  kind  of  role  I  am  proposing  for 
nurses  is  a  blend  of  expressive  and  in- 
strumental components  that  can  provide 
ways  of  meeting  the  "here  and  now" 
and  the  future  needs  of  people,  parti- 
cularly those  people  whose  conditions 
are  primarily  non-pathological  in  nature 
and  whose  care  requires  non-medical  or 
minimal  medical  supervision. 

To  explain  more  fully  this  role,  I 
will  describe  briefly  the  special  project 
at  the  University  of  Colorado,  the  pe- 
diatric nurse  practitioner  program, 
designed  to  meet  "here  and  now" 
child  health  needs  and  to  influence  the 
future  of  nursing. 
University  of  Colorado  program 

The  project  was  developed  in  1965 
by  representatives  of  the  school  of  nurs- 
ing and  the  school  of  medicine,  under 
the  combined  auspices  of  the  two  schools 
of  the  University  of  Colorado. ^'^  The 
purposes  of  the  program  were:    1 .  to 


establish  a  new  educational  and  train- 
ing program  in  pediatrics  for  profession- 
al nurses  which  will  prepare  them  to 
assume  an  expanded  role  in  child  health 
as  practitioners  of  nursing  within  the 
scope  of  the  Colorado  Professional 
Nurse  Practice  Act;  and  2.  to  place  the 
nurses  who  have  received  this  new  and 
augmented  educational  experience 
where  they  would  have  opportunities  to 
practice  their  newly  acquired  skills  in 
pediatrics  in  organized  community 
health  services,  such  as  health  stations, 
pediatricians'  offices,  and  neighborhood 
health  stations. 

Specifically,  the  project  was  con- 
ducted in  two  phases.  Phase  I  was  a  four 
months  educational  experience  for  the 
nurse  at  the  University  of  Colorado 
Medical  Center.  During  this  time  as 
a  graduate  student  in  the  school  of 
nursing,  she  learned  theory  and  prac- 
tice in  pediatrics  in  clinically-oriented 
courses  that  included  management  of 
the  well  child,  identification  and  care 
of  acute  and  chronic  conditions  in 
childhood,  and  the  care  of  the  child  in 
emergency  situations. 

Under  the  direction  of  the  pediatric 
and  public  health  faculty  members  of 
the  schools  of  nursing  and  medicine, 
project  nurses  focused  on  increasing 
their  knowledge  and  skills  in  assessing 
the  physical  and  psycho-social  develop- 
ment of  well  children;  studying  varia- 
tions of  growth  patterns;  learning  to 
perform  necessary  developmental  tests 
and  evaluative  procedures,  such  as  his- 
tory taking,  basic  physical  appraisal 
and  some  laboratory  procedures;  under- 
standing family  dynamics;  counseling 
parents  in  child  rearing  practices;  and 
carrying  out  immunizations. 

Physical  examination  of  children 
included  the  basic  skills  of  inspection, 
auscultation,  percussion  and  palpation, 
as  well  as  the  utilization  of  the  otoscope 
and  stethoscope.  Through  these  tech- 
niques, nurses  are  capable  of  securing 
data,  assessing  their  importance,  and 
making  wise  decisions  for  nursing 
action. 

Management  of  the  sick  child  was 
THE  CANADIAN  NURSE     33 


also  part  of  the  subject  matter  covered 
in  Phase  I.  Project  nurses  learned  to 
assess  astutely  the  overall  condition  of 
the  child  in  terms  of  the  severity  of  the 
illness  and  the  need  for  appropriate 
referral  if  medical  care  were  indicated. 

Since  project  nurses  were  likely  to 
be  readily  available  in  a  particular 
neighborhood  or  locality  and  might  be 
called  on  to  function  in  various  emer- 
gency situations,  learning  experiences 
in  the  care  of  childhood  accidents, 
poisonings,  and  injuries  are  also  includ- 
ed in  the  educational  program. 

From  October  1965  through  June 
1969,  48  nurses  entered  our  project. 
All  had  baccalaureate  degrees;  13  had 
master's  degrees.  What  were  these  nurses 
doing?  Four  were  continuing  in  gradu- 
ate school;  25  were  practicing  in  the 
Denver  area  health  departments  and 
pediatricians"  offices;  8  were  from  out 
of  state,  practicing  from  Bolivia  to 
Alaska,  California  to  Massachusetts; 
3  were  in  teaching  positions;  8  were 
temporarily  retired  to  marriage. 

Our  general  findings  indicated  that 
the  nurses  were: 

1 .  extremely  competent  to  make  the 
judgments  required  of  them; 

2.  delighted  with  their  own  role  develop- 
ment because  they  felt  competent 
and  confident; 

3.  highly  acceptable  to  families,  phys- 
icians, and  many  nursing  colleagues; 

4.  experiencing  some  difficulties  when 
confronted  with  ancient  patterns  for 
the  delivery  of  service,  aging  agency 
structures,  and  antiquated  ideas  of 
nursing  supervision. 

Acceptance  of  this  expanding  role  for 
nurses  by  families,  physicians,  and 
nurses  is  an  interesting  phenomenon  to 
study.  Our  findings  indicate  that  fami- 
lies were  overwhelmingly  accepting 
of  this  talented  nurse.  One  nurse  ob- 
served, ".  .  .patients  seen  regularly  by 
the  pediatric  nurse  practitioner  (PNP) 
have  a  much  lower  failure  rate  for 
return  well-child  appointments:  9  per- 
cent in  PNP  clinics,  against  a  range  of 
25-40  percent  failure  rate  in  other 
clinics;  field  public  health  nurses  re- 
34     THE  CANADIAN   NURSE 


ported  mothers  were  following  the 
advice  given  them  by  the  PNP,  and 
patients  seen  by  the  PNP  had  a  far 
lower  failure  rate  [compared]  to  the 
consultants"  clinics,  which  were  clinics 
established  to  screen  children  for  speech, 
hearing,  dental  and  nutrition  defects 
conducted  by  allied  health  personnel.""'' 
A  survey  of  parent  attitudes  toward 
the  PNP  was  conducted  by  indigenous 
workers.  They  reported  high  acceptance 
of  the  PNP,  making  specific  comments: 

1 .  Mothers  especially  viewed  counsel- 
ing concerning  such  child  care  prob- 
lems as  feeding,  toileting,  growth 
and  development  as  the  responsi- 
bility of  nurses  and  consequently 
felt  more  comfortable  in  bringing 
these  problems  to  the  nurse. 

2.  Parents  tended  to  feel  that  the  PNP 
provided  them  with  more  specific 
and  individualized  health  counsel- 
ing for  their  child  than  they  had 
received  from  nurses  not  having 
this  type  of  preparation. 

3.  A  physical  assessment  with  the  "lay- 
ing on  of  hands,"  so  to  speak,  was 
considered  by  parents  as  an  important 
aspect  of  well  child  management  and 
increased  their  confidence  in  the 
health  professionals"  decision  as  to 
the  "wellness'"  of  their  child.  ^ 

Assessment  of  PNP  acceptance 

The  Institute  of  Behavioral  Science 
at  the  University  of  Colorado,  under 
United  States  Public  Health  Service 
funding,  studied  the  acceptance  of  the 
PNP  role  by  professional  nurses  and 
physicians.  Using  Dr.  Jay  Jackson's 
Return  Potential  Model,  a  64-item 
questionnaire  was  constructed  from 
statements  of  prescriptions  and  pro- 
scriptions from  content  taught  by  the 
PNP  faculty.  Respondents  were  asked 
to  indicate  their  level  of  approval  or 
disapproval  of  certain  independant 
acts  of  nurses.  The  following  findings 
were  reported: 

1.  In  general,  doctors  and  nurses  in  the 
State  of  Colorado  approve  of  the  role 
of  the  Pediatric  Nurse  Practitioner  .  .  . 


2.  There  are,  nevertheless,  differences 
among  groups  of  doctors,  groups  of 
nurses,  and  doctors  and  nurses  as  well 
as  among  the  different  kinds  of  items 
on  the  questionnaire.  .  . 

3.  Different  kinds  of  nurses  have  different 
levels  of  approval-disapproval  of  the 
role.  Nurses  on  teaching  faculties  at 
schools  of  nursing  and  public  health 
nurses  approve  the  role  of  the  PNP 
more  than  do  hospital  nurses,  office 
nurses,  or  school  nurses.  Among  doctors, 
pediatricians  who  are  associated  with 
the  faculty  of  the  University  of  Colo- 
rado approve  the  role  of  the  PNP  more 
than  pediatricians  in  private  practice, 
general  practitioners  in  private  practice, 
or  other  physicians  on  the  faculty  at 
the  Medical  Center.  There  is  more 
agreement  among  nurses  than  there  is 
among  physicians. 

4.  The  age  of  the  respondent  and  the 
extent  of  his  knowledge  about  the  PNP 
program  appear  to  affect  the  responses. 
With  respect  to  age.  the  following 
generalization  may  be  made,  although 
samples  are  small  in  certain  age  groups; 
the  younger  the  nurse,  the  more  she 
approves  the  role;  the  older  the  nurse, 
the  less  she  approves  the  role.  Among 
the  doctors,  the  situation  appears  to  be 
reversed.  The  younger  the  doctor,  the 
less  he  approves  the  role,  the  older  the 
doctor,  the  more  he  approves  the  role. 
With  respect  to  knowledge  of  the  pro- 
gram, approval  appears  to  be  directly 
related  to  the  amount  of  knowledge 
—  the  more  informed  the  respondent 
reports  himself  to  be,  the  higher  is  his 
approval  of  the  role. 

There  are  four  different  ways  of  classifying 
the  64  items  which  appear  on  the  question- 
naire. One  classification  deals  with  dif- 
ferent methods  of  characterizing  independ- 
ence from  the  physician;  the  second  deals 
with  patient  type;  the  third  type  deals 
with  the  traditional  classification  of  in- 
strumental versus  affective  role  perform- 
ance; and  the  fourth  deals  with  the  stage 
of  treatment  (pre-assessment,  assessment, 
management,  and  follow-up).  Within 
the  independence  item-class,  most  approv- 
al is  given  for  independence  from  the 
JANUARY  1971 


physician  on  specific  acts  for  which 
nurses  might  traditionally  receive  doctors' 
orders.  By  and  large,  the  respondents 
approve  the  nurse's  performance  when  it 
is  most  independent. 

Least  approval  is  given  for  acts  which 
involve  judgment  about  patients'  condi- 
tions. This  suggests  a  tendency  for  re- 
spondents to  prefer  that  at  some  point 
the  nurse  seek  confirmation  of  her  judg- 
ments. 

Patient  Type 

Both  respondents  and  faculty  approve 
independence  most  for  well  child  care 
and  least  for  accident-injury  cases. 

Instrumental- Affective  Acts 
Independence  is  most  approved  for  acts 
which  are  affective  in  nature  and  least 
for  those  which  are  instrumental  as  might 
be  expected  since  the  affective  act  is  part 
of  the  traditional  nursing  role. 

Stage  of  Treatment 

Finally,  acts  which  are  classified  in  the 
follow-up  category  receive  most  approval 
at  the  independance  end  of  the  continuum. 
While  assessment  (basically  diagnostic 
in  function)  items  receive  least  approval, 
pre-assessment  and  management  items  fall 
in  between. 

In  general,  the  groups  which  express 
least  approval,  show  low  levels  of  agree- 
ment among  themselves.  This  suggests 
that  resistance  to  the  role  of  the  PNP  is 
not  well  crystalized  or  solidified  in  the 
health  professional  population  in  Colo- 
rado.^ 

Another  aspect  of  this  evaluation 
was  a  study  of  a  small  sample  of  PNP 
students'  ability  to  assess  physically  the 
condition  of  children  in  pre-  and 
post-training  test  situations. 

Findings  from  video  tapings  and 
written  reports  were  corroborated  by 
students'  verbal  reports.  Nurses,  follow- 
ing their  educational  experience,  in- 
creased the  comprehensiveness  and 
systematicity  of  their  assessments. 

Students'  self-perceptions  were  also 
studied.  "Both  before  and  after  training 
the  students  failed  to  perceive  that  phy- 
lANUARY  1971 


sicians  would  be  less  approving  of 
their  role  than  would  nurses."'  This 
was  probably  due  to  the  high  approval 
of  the  physicians  in  general  and  the 
relatively  low  approval  of  some  nurse 
faculty  in  the  Medical  Center.  Students' 
confidence  to  perform  the  role  is  chang- 
ed significantly  upward  from  prior  to 
post-education  experience.  "Training 
not  only  affects  the  students'  general 
attitude  toward  their  qualifications, 
but  also  affects  the  intensity  and  the 
cohesiveness  with  which  they  hold 
these  attitudes."^ 

This  project  was  completed  as  a  spe- 
cial demonstration  in  June  1969.  Notice 
I  said  "special  demonstration,"  because 
the  melody  lingers  on.  At  the  University 
of  Colorado,  the  educational  aspect 
(Phase  I)  is  now  conducted  in  our  con- 
tinuing education  services.  Twenty-six 
nurses  have  been  admitted  since  Sep- 
tember 1969  through  October  1970. 
Nurses  admitted  to  these  courses  have 
baccalaureate  preparation  in  nursing, 
are  required  to  make  a  statement  of 
commitment  to  a  clinical  role,  and, 
further,  to  submit  a  plan  for  adaptations 
in  the  health  care  system  that  will 
permit  them  to  practice  their  expanded 
role. 

The  prototype  of  the  pediatric  nurse 
practitioner  was  used  to  formulate  a 
role  for  the  school  nurse  practitioner 
initiated  at  the  University  of  Colorado 
in  the  fall  of  1970.  Using  the  core-type 
approaches  from  the  basic  prototype, 
the  school  nurse  practitioner  will  con- 
cern herself  also  with  learning  problems 
of  school  children.  Sponsorship  for 
this  project,  funded  by  the  Burner 
Foundation,  has  evolved  from  the 
cooperative  efforts  of  the  schools  of 
nursing  and  medicine  at  the  Univer- 
sity of  Colorado  and  the  Denver  public 
schools. 

Challenges  AMA  plan 

Providing  for  nursing  leadership  on 
the  advanced  level  of  nursing  prepara- 
tion remains  a  crucial  and  pressing 
problem,  especially  as  the  idea  of 
nurse   practitioners   is  seen   by  some 


people  as  the  answer  to  all  the  health 
manpower  shortages!  Other  groups, 
among  them  the  American  Medical 
Association,  have  designs  to  use  nurs- 
ing resources  to  solve  their  own  man- 
power shortages. 

I  challenge  this  effort  vehemently. 
Practitioners  such  as  those  described 
are  not  physician's  assistants.  Physi- 
cian's assistants  serve  to  contribute  to 
the  role  of  the  doctor.  Without  the  doc- 
tor, the  physician's  assistant  cannot 
function.  Tasks  and  functions  perform- 
ed by  the  physician's  assistant  are  dele- 
gated to  him  by  the  doctor.  His  account- 
ability is  to  the  physician. 

A  professional  nurse  who  assumes  an 
expanded  role  as  practitioner  is  per- 
forming "  .  .  .increasingly  complex 
acts  in  health  care  based  on  a  scientific 
background  which  permits  increasing 
sophistication  in  her  clinical  judgment 
as  advances  in  physical,  biological  and 
social  sciences  become  medically  signif- 
icant."^ The  key  words  are  professional 
nurse,  scientific  background,  sophisti- 
cated clinical  judgment,  and  advances 
in  knowledge. 

Inherent  in  this  role  is  a  concept  of 
foreseeability  and  accountability.  The 
concept  of  forseeability  is  one  in  which 
the  nurse  practitioner  has  adequate 
scientific  preparation  to  predict  with  a 
high  degree  of  accuracy  the  outcome 
or  consequences  of  her  act.'°  She  there- 
fore can  avoid  harm  and  insure  some 
measure  of  successful  results.  The 
concept  of  accountability  is  that  the 
nurse  must  recognize  and  fulfill  com- 
petently her  responsibilities  for  the 
care  of  people.  It  involves  taking  risks 
at  times,  and  nurses  are  not  known  for 
their  adventurous  risk-taking  behavior. 

From  my  observations  of  public 
health  nurses,  their  practice  is  often 
characterized  by  carefully  constructed 
clandestine  maneuvers  to  make  the 
physician  believe  he  is  the  Lord  of 
Health.  It  is  time  all  of  us  —  nurses, 
physicians,  social  workers,  and  so  on  — 
stopped  catermg  to  obsessive,  compul- 
sive, neurotic  behavior  of  our  own 
and  our  colleagues  who  are  so  preoc- 
THE  CANADIAN   NURSE     35 


cupied  building  boundaries  of  profes- 
sional domains  that  we  have  forgotten 
our  "raison  d'etre.'^ 

Now  ril  deviate  and  address  myself 
to  a  pertinent  and  current  issue  in  nurs- 
ing in  Canada.  Via  the  grapevine,  I 
understand  you  are  hearing  rumblings 
from  the  wise  men  in  the  east  about 
making  nurses  into  physician's  assist- 
ants, particularly  in  the  north  country. 
Your  reaction  may  be  varied,  but  gener- 
ally I  presume  it  is  negativistic  and 
hostile.  I  well  recall  similar  feelings  — 
my  own  and  others  —  in  the  United 
States  over  the  past  six  years.  Let  me 
point  out,  however,  that  you  are  get- 
ting a  message.  You  may  not  like  it, 
but,  listen  carefully  before  you  blindly 
strike  back. 

Giving  advice  is  a  waste  of  time. 
I'll  avoid  that.  Instead,  I'll  share  my 
experiences  as  a  change  agent  who,  in 
five  short  years  —  though  it  seemed 
like  the  millennium  at  the  time  — 
learned  a  great  deal  about  nursing  and 
its  various  individual  and  collective 
publics  and  problems. 

As  I  reflect  on  our  experience  with 
change,  I  have  come  to  these  conclu- 
sions: Basically  we  have  been  involved 
in  the  process  of  social  change  —  chal- 
lenging territorialities,  questioning  the 
status  quo,  conditioning  the  public  to 
expect  more  sophisticated  and  expert 
nursing  care,  shaking  the  foundations 
of  unresponsive  institutions  in  an  effort 
to  bring  quality  nursing  care  to  people. 
It  has  not  been  easy,  but  it's  never 
been  boring.  Now,  of  course,  it's  actual- 
ly fun.  A  quick  summary  of  my  exper- 
riences  can  be  encapsulated  in  an  allit- 
eration: communications,  collegiality, 
change  agents,  and  challenge. 

Communication 

Physicians  and  nurses  speak  different 
languages.  Doctors  say  training,  phys- 
ical examination,  and  medical,  when 
they  mean  education,  physical  assess- 
ment or  appraisal,  and  health.  The 
latter,  of  course,  is  nursing's  termino- 
logy. Semantic  roulette  is  the  name  of 
the  game.  Nurses  won't  level  with  doc- 
36     THE  CANADIAN   NURSE 


tors  and  tell  it  "like  it  is."  We  are  not 
interpreting  trends  and  directions  in 
nursing  education  or  nursing  service. 
We  have  been  sneakily  creating  pro- 
fessionals who  expect  Dr.  Rip  Van 
Winkel  to  wake  up  and  accept  contem- 
porary nursing  as  he  finds  it  —  changed! 

Communicating  by  role  models  is  a 
very  effective  eyeball-to-eyeball  learn- 
ing experience.  Nursing  service  must 
provide  the  opportunities,  the  climate, 
and  the  rewards.  None  of  us  should 
develop  our  role  in  isolation  from  the 
other,  anymore  than  we  should  plan  to 
change  another's  role  without  his  par- 
ticipation. 

The  biggest  fiasco  in  communications 
recently  was  promulgated  by  the  Ame- 
rican Medical  Association's  board  of 
trustees,  when  it  adopted  a  motion  to 
utilize  nurses  for  the  expansion  of 
medical  service.  Nursing's  response 
was  swift  and  hard-hitting.  Deploring 
the  unilateral  action,  the  American 
Nurses'  Association's  president  re- 
quested an  opportunity  to  examine 
collaboratively  the  parameters  of  the 
respective  physician  and  nurse  roles. 
Now,  months  after  the  first  shots  were 
fired,  constructive  negotiations  are  un- 
derway. But  if  doctors  and  nurses  en- 
joyed colleague  relationships,  this  ex- 
plosion would  never  have  occurred. 

Colleague  relationships 

Few  nurses  in  education  or  service 
experience  true  collaboration  with 
physicians.  Many  physicians  and 
nurses  are  educated  at  the  same  med- 
ical center  and  university  campuses, 
but  they  hardly  know  each  other  as 
students.  As  faculty  members  in  schools 
of  nursing  and  medicine,  we  have  not 
presented  models  of  collaboration  for 
our  students. 

I  contend  that  if  students  of  nursing 
and  medicine  (and  other  disciplines) 
learn  together,  they'll  earn  together. 
They'll  also  be  able  to  function  effec- 
tively as  team  members.  In  my  experi- 
ence, mutual  respect  and  colleagueships 
are  enriched  as  the  nurse  gains  compe- 
tence,   makes    sophisticated    clinical 


judgments,    and    is    socialized  in   her 

role  as  a  professional  person.  Part  of 

that   socialization    is   directed  toward 
becoming  a  change  agent. 

Change  agents 

Assuming  a  new  role  is  a  hazardous 
task.  Early  in  their  preparation,  our 
students  at  the  University  of  Colorado 
experienced  role  reorientation  jitters. 
Complete  emersion  in  the  theory  and 
clinical  aspects  of  the  new  role  and 
faculty  support  proved  effective  in 
changing  behavior.  This  was  a  relatively 
minor  internal  project  problem  compar- 
ed to  the  flak  all  of  us  received  from 
others.  Vicious  abuse  and  the  lack  of 
trust  of  nursing  colleagues  were  most 
difficult  for  me  to  tolerate. 

Our  students  experienced  some  of 
this,  but  their  major  problems  were 
fitting  into  the  health  care  system,  carv- 
ing out  and  interpreting  their  existing 
personnel  and  programs  to  prevent 
overlapping,  duplication,  and  fragmen- 
tation. Buddy  assignments,  empathetic 
and  prepared  supervisors,  medical 
team  support,  and  faculty  confidence 
helped  greatly  in  the  early  years.  Today, 
agency  structures  and  pediatric  nurse 
practitioner  models  provide  for  the 
relatively  smooth  transition  from  stu- 
dent to  practitioner. 

Nursing  is  now  exploring  with  some 
degree  of  understanding  and  interest 
the  potential  of  this  expanded  role. 
Two  things  are  needed:  1 .  the  develop- 
ment of  a  climate  in  nursing  that  will 
permit  and  indeed  encourage  nurses  to 
try  our  new  ideas;  and  2.  statesmen  who 
have  the  courage,  vision,  and  stamina 
to  influence  nursing  education  and  nurs- 
ing service  to  meet  the  nursing  needs  of 
society.  If  we  don't  soon  assume  our 
share  of  providing  health  care  in  our 
country,  we'll  price  ourselves  out  of  the 
market. 

Further,  change  agents  must  be  select- 
ed with  care.  Maybe  we  should  choose 
"change  artists"  —  those  who  have  a 
high  degree  of  tolerance  for  ambiguity 
and  can  live  fearlessly  with  uncertainty. 
Anyone  who  needs  to  have  the  world 
JANUARY  1971 


about  him  completely  organized  and 
structured  every  day  should  not  try 
being  a  change  agent.  The  risk  is  too 
great,  the  rewards  too  few  and  too  far 
away. 

Still  the  challenge  is  before  us.  I 
believe  we  have  demonstrated  —  in 
some  measure  —  achievement  of  the 
goals  nursing  has  espoused.  You  will 
recognize  these  as:  a  patient-side  role, 
functioning  at  level  of  preparation; 
exclusion  of  non-nursing  duties;  auton- 
omous functioning;  coUegiality '  with 
physicians;  clinical  nursing  research 
opportunities;  emphasis  on  wellness 
and  prevention;  and  influence  on  the 
health  care  delivery  system. 

Will  the  nurses  in  Canada  read  into 
the  message  "from  the  east"  opportu- 
nity or  threat?  Will  you  creatively  and 
constructively  answer  with  a  willingness 
to  "assist  the  patient"?  And  if  that  helps 
the  physician  in  some  way,  that's  a  great 
spin  off!  Think  carefully  about  your 
answer.  Recognize  opportunity.  Reduce 
threats.  Renew  your  commitment  to 
society,  for  here  is  where  the  future  of 
nursing  lies. 

Attack  the  bottlenecks 

Let  us  attack  the  bottlenecks  in  the 
health  care  delivery  system.  One  cru- 
cial area  is  the  entry  point.  Physicians 
have  been  the  gate  keepers,  and  the 
gates  are  stormed  continuously  by  peo- 
ple demanding  all  different  kinds  of 
care,  be  they  sick  or  well.  Garfield 
suggests  that  a  new  delivery  system 
which  "...  would  separate  the  sick 
from  the  well.  It  would  do  this  by 
establishing  a  new  method  of  entry,  the 
health  testing  service  .  .  ."  i' 

Regardless  of  the  delivery  service, 
nurses  must  be  increasingly  influen- 
tial in  the  entry,  progression,  and  exit  of 
people  through  the  health  care  system, 
and  should  be  investigating  their  roles 
as  primary  care  takers.  Further,  they 
should  be  developing  active  collegial- 
ities  with  physicians  and  other  health 
care  workers. 

Unfortunately,  in  this  area  of  con- 
cern for  health  care,  the  least  respon- 
lANUARY  1971 


sive  institution  has  been  nursing  edu- 
cation. Nursing  educators  have  been 
relatively  slow  to  provide  leadership  in 
trying  out  and  trying  on  new  roles.  Our 
"head  in  the  sand"  search  for  the  defi- 
nition of  nursing  will  only  result  in  our 
tails  in  the  air,  while  the  world  flies  by 
us.  We  have  been  reluctant  to  explore 
with  physician  colleagues  our  respective 
abilities  to  provide  adequate  opportuni- 
ties and  continuing  education  to  help 
practicing  nurses  assume  expanded 
roles. 

We've  given  lip  service  to  preparing 
clinical  specialists  in  the  graduate 
programs  to  be  colleagues  of  the  physi- 
cian. Yet,  as  Dilworth  points  out,  the 
physician's  influence  and  acceptance  in 
the  development  of  this  role  is  a  "potent 
variable"^^  in  providing  and  rewarding 
role  models  in  the  health  care  system. 
More  importantly,  Dilworth  asks  who  is 
to  fill  the  gap  between  the  medical  care 
provided  by  the  specialized  physician 
and  the  inadequate  attention  give  to 
people's  total  health  needs. 

My  posture  is  that  nursing  has  a 
vital  role  to  play  in  filling  this  gap. 
Coordinated,  continuous,  comprehen- 
sive health  services  will  not  be  possible 
if  the  dynamic,  humanistic  component 
of  nursing  care  is  omitted.  Nor  will 
nursing  fulfill  its  destiny  or  reap  its 
rewards  if  it  shirks  its  duty.  Dilworth 
warns,  "Nursing  as  a  profession  will 
either  change  by  becoming  more  re- 
sponsive to  the  people's  needs  for 
health  care  or  it  will  go  the  way  of 
other  species  which  have  become  ex- 
tinct because  of  inability  to  adapt  to 
changing  conditions."'-' 

The  changing  conditions  today  are 
revolutionary  in  nature.  Traditions, 
values,  and  processes  are  challenged. 
Systems  of  education  and  service  are 
experiencing  chaos.  But  you  will  re- 
cognize the  current  chaos  as  opportunity, 
and  make  the  most  of  it.  The  concepts 
of  duty,  reward,  and  destiny  are  well 
known  to  you.  You  will  not  shirk  your 
duty.  You  will  reap  the  rewards.  You 
will  carve  out  your  destiny.  But  you'd 
be  well  advised  to  start  whittling  today, 


because  your  duty,  your  reward,  your 
destiny,  are  here  and  now. 


References 

l.Darley.  Ward.  American  medicine 
and  the  inevitables  in  its  future.  JAMA 
196:267-8.  April  18,  1966. 

2.  Bellaire.  Judith.  Paper  presented  at 
the  Academy  of  Pediatrics  38th  An- 
nual Meeting  in  Chicago  on  Oct.  23, 
1969.  p. 6. 

3.  Ihid.p.l. 

4.  Silver,  Henry  K.  and  Ford.  Loretta  C. 
Physician's  assistants;  the  pediatric 
nurse  practitioner  at  Colorado.  Aiiicr. 
J.  Nurs.  67:1443-4.  July  1967. 

5.  Silver.  Henry  K.,  Ford.  Loretta  C. 
and  Stearly.  Susan.  A  program  to  in- 
crease health  care  for  children:  the 
pediatric  nurse  practitioner  program. 
Pcclkitrics  3,9:156-60.  May  1967. 

6.  Hunter,  Robert.  "Notes  on  Findings," 
(preliminary  report)  on  Pediatric 
Nurse  Practitioner  Project,  fail  1969. 

7.  Ihicl.  p.8. 

8.  IhiiL  p.8. 

9.  Murchison.  Irene  A.  and  Nichols. 
Thomas    S.    Unpublished    definition. 

10.  Murchison,    Irene    A.    and    Nichols, 

Thomas    S.     Le^al    Fouiuhtions    of 

Nursing   Pnictke.   New   York.    Mac- 

millan,  1970.  529  pages. 
1  I .  Garfield.   Sidney   R.  The  delivery  of 

medical  care.  5</.  Aiiicr.  222:4:15-23 

April  1970. 
12.  Dilworth.    Ava   S.   Joint   preparation 

for    clinical    nurse    specialists.    Nitrs. 

Outlook  18:22-25,  Sept.  1970. 
\i.  Oi7.cii.  p.22.  ^ 


THE   CANADIAN   NURSE     37 


Congenital  rubella  — 
one  approach  to  prevention 

Description  of  a  program  set  up  by  one  hospital  to  minimize  the  risks  to 
personnel  who  come  in  contact  with  children  excreting  the  rubella  virus. 

Winifred  M.  Reid,  B.Sc.N. 


Early  in  1969  a  boy  was  born  in  Burn- 
aby  General  Hospital  to  a  woman  who 
had  contracted  rubella  early  in  her 
pregnancy.  Mother  and  babe  were  dis- 
charged apparently  healthy,  but  the 
baby  was  soon  readmitted  for  investi- 
gation. The  diagnosis  was  encephal- 
opathy and  congenital  rubella  (rubella 
syndrome).  Virology  studies  confirmed 
that  the  child  was  excreting  rubella 
virus  from  his  nasopharynx  and  urine. 

We  were  aware  that  rubella,  contract- 
ed during  the  first  trimester  of  pregnan- 
cy, could  cause  a  number  of  anomalies 
in  an  infant.  We  had  not,  however, 
considered  an  infant  who  did  not  have 
symptoms  of  the  disease  as  a  potential 
source  of  infection.''^ 

But  little  Joe  was  a  living  fact,  irref- 
utably the  result  of  the  "harmless" 
little  virus,  rubella.  Then  we  thought 
of  some  of  the  other  tiny  patients  we 
had  cared  for  in  the  past  —  the  blind; 
the  mute;  the  retarded;  those  with  bone, 
blood,  and  brain  damage;  and,  the 
most    common,    those    with    cardiac 

Mrs.  Reid,  a  graduate  of  the  University  of 
Alberta  School  of  Nursing,  is  Director  of 
Nursing  at  Burnaby  General  Hospital, 
Burnaby,  British  Columbia.  This  paper  is 
adapted  from  an  article  she  wrote  for  the 
June/July  1970  issue  of  RNABC  News. 


38     THE  CANADIAN   NURSE 


lesions.  Were  they  also  excreting  rubella 
virus  while  they  were  in  hospital? 

The  usual  isolation  precautions  were 
taken  while  caring  for  Joe.  He  was  in  a 
separate  room,  and  all  those  with  whom 
he  came  in  contact  wore  a  gown  and  a 
mask. 

As  rubella  is  highly  contagious,  most 
pediatric  units  make  every  effort  not 
to  admit  these  patients  unless  admission 
is  absolutely  necessary  due  to  complica- 
tions. Although  hospitals  have  a  re- 
sponsibility for  establishing  policies 
and  procedures  for  isolation  cases 
and  providing  the  necessary  facilities 
and  equipment,  they  cannot  guarantee 
safety.  Nurses  have  always  been  ex- 
posed to  hazards  that  most  hospitals 
do  their  utmost  to  minimize. 

We  were  most  concerned  about  the 
young  married  women  on  our  staff, 
particularly  those  working  in  the  pedi- 
atric and  obstetric  areas.  A  good  many 
healthy  babies  had  been  born  to  these 
nurses  over  the  years,  but  not  all  were 
as  fortunate.  Although  we  recognized 
our  responsibility  to  these  nurses,  we 
also  believed  each  nurse  had  a  re- 
sponsibility to  protect  herself  from  a 
variety  of  diseases  and  to  consult  her 
physician  about  both  prevention  and 
treatment  of  illness. 

How  could  we  determine  which 
JANUARY  1971 


nurses  could  safely  be  placed  in  these 
high  risk  areas?  Fortunately,  our  pedi- 
atricians had  done  a  good  deal  of  re- 
search on  this  subject  and  guided  our 
study  of  the  literature.  At  the  risk  of 
oversimplifying  our  findings,  the  fol- 
lowing summary  may  be  of  interest. 

History  and  clinical  manifestations 

Although  rubella  has  been  recognized 
as  a  clinical  entity  for  more  than  100 
years,  it  was  not  until  Gregg  reported 
congenital  malformations  following 
maternal  rubella  infection  during  the 
1940  Australian  epidemic,  that  the  full 
implications  became  apparent .3 

Over  the  next  20  years,  many  re- 
searchers attempted  to  assess  the  risk 
of  congenital  malformations  following 
rubella  in  pregnancy.  However,  a  study 
of  disease  during  this  period  was  dif- 
ficult, with  no  recourse  to  experiments 
using  monkeys  and  human  volunteers. 
The  advent  of  the  use  of  tissue  culture 


in  virology  advanced  the  study  of  many 
diseases,  such  as  poliomyelitis,  and  re- 
sulted in  isolation  of  the  rubella  virus 
in  1962.^ 

Subsequent  epidemics  in  Great  Bri- 
tain in  1 962  and  1 963  and  in  the  United 
States  in  1964  and  1965,  provided  nu- 
merous cases  for  study.  The  United 
States  epidemic  resulted  in  one  percent 
of  the  population  contracting  rubella, 
and  between  10,000  and  20,000  infants 
born  with  congenital  rubella  malfor- 
mations.5  These  children,  now  of  school 
age,  are  a  phenomenal  cost  to  the  tax- 
payers as  they  require  specialized  serv- 
ices. 

History  has  shown  that  rubella  may 
be  expected  to  reach  epidemic  propor- 
tions every  six  to  nine  years.  Reports 
from  many  areas  of  the  country  today 
indicate  a  high  incidence  of  the  disease, 
which  some  authorities  claim  to  be  of 
epidemic  proportions. 

Prior  to  1964,  the  clinical  features 


lANUARY  1971 


usually  associated  with  rubella  syn- 
drome were  cataracts,  cardiac  defects, 
and  deafness  occurring  singly  or  in 
combination.  Following  the  1964 
epidemic,  however,  a  wide  variety  of 
signs  and  symptoms  were  recognized 
in  addition  to  the  classical  symptoms. 
These  included  neonatal  purpura, 
thrombocytopenia.  hepatosplenome- 
galy,  jaundice,  bone  lesions,  pneumo- 
nitis, myocardial  damage,  and  central 
nervous  system  involvement. 

Although  embryopathy  occurs  more 
frequently  in  the  first  trimester  of  preg- 
nancy, a  lower  incidence  has  been  re- 
ported during  the  second  trimester  and 
later. 

Dudgeon  compiled  data  from  several 
studies  showing  that  rubella  contracted 
3  to  4  weeks  after  the  onset  of  the  last 
menstrual  period  gave  a  60  percent 
chance  of  anomalies  in  the  infant;  5  to 
8  weeks,  35  percent  chance;  9  to  12 
weeks,  15  percent;  and  13  to  16  weeks, 
a  7  percent  chance  of  defects.^ 

Subclinical  infections  in  the  mother 
may  result  in  a  baby  with  rubella  anti- 
bodies but  no  clinical  manifestations  of 
disease  at  birth.  As  the  baby  can  ex- 
crete the  rubella  virus  for  a  year  or 
two,  an  obvious  hazard  faces  hospital 
personnel. 

Preventive  measures 

Many  women  in  early  pregnancy 
come  in  contact  with  rubella  despite  all 
precautions.  In  these  cases,  gamma 
globulin  has  been  used  to  prevent  or 
diminish  the  severity  of  the  disease.  In 
rubella,  the  object  is  to  prevent  trans- 
mission of  the  disease  to  the  fetus. 

Robert  Green  reports  that  gamma 
globulin  does  not  protect  against  vir- 
emia,  but  rather  reduces  the  occurrence 
of  clinical  rubella.  He  therefore  suggests 
that  its  use  be  restricted  to  susceptible 
mothers  who  are  exposed  to  rubella 
and  in  whom  clinical  evidence  of  the 
infection  is  not  yet  evident.' 

Therapeutic  abortions  are  considere' 
THE  CANADIAN   NURSF 


by  many  abortion  committees,  provid- 
ed that  disease  is  demonstrated  by  viral 
cultures  in  pregnant  women* 

H.I.  test 

A  relatively  simple  method  of  deter- 
mining the  immune  status  to  rubella 
is  the  hemagglutination  inhibition  test 
(H.I.)  presently  done  in  provincial 
virology  laboratories. 

Natural  rubella  infection  usually  in- 
curs lifetime  immunity,  and  85  percent 
of  young  adults  have  this  natural  im- 
munity. However,  unless  an  antibody 
test  is  done,  there  is  no  way  of  identi- 
fying the  1 5  percent  of  nurses  who  are 
susceptible  to  the  disease. 

In  June  of  1969,  little  Joe  was  still 
on  our  pediatric  unit  and  continued  to 
excrete  rubella  virus.  Our  staff  and 
pediatricians  were  becoming  more 
informed  and  concerned  about  the 
problem.  The  following  steps  were 
taken,  which  have  since  led  to  a  pro- 
gram of  H.l.  testing  in  the  hospital: 

1 .  Discussion  with  the  director  of  the 
hospital  laboratory  to  determine  the 
feasibility  of  and  the  program  for 
drawing  blood  from  female  em- 
ployees. 

2.  Discussion  with  the  director  of  the 
provincial  virology  laboratory  to  re- 
quest that  testing  of  staff  proceed. 

3.  Development  of  an  "employee  rubel- 
la antibody  test"  form  to  be  complet- 
ed by  the  employee  and  left  with  the 
blood  specimen  in  the  laboratory. 

4.  Discussion  with  department  heads 
whose  personnel  are  in  contact  with 
high  risk  areas,  for  example,  physio- 
therapy, laboratory,  radiology,  diet- 
ary, and  housekeeping. 

5.  Initiation  of  the  H.I.  test  for  all  exist- 
ing pediatric  and  obstetric  staff. 

6.  Initiation  of  routine  preemployment 
testing  of  pediatric  and  obstetric 
staff  and  others  who  might  wish  to 
take  the  test. 

The  H.I.  testing  program  has  been  im- 
40     THE  CANADIAN   NURSE 


plemented  in  this  hospital  with  min- 
imal problems.  Although  the  number  of 
persons  tested  to  date  is  too  small  to  be 
statistically  reliable,  our  results  show 
1 8  percent  of  those  tested  to  be  essen- 
tially negative,  i.e.,  a  titre  of  less  than 
1:8. 

Employees  with  negative  tests  are 
advised  to  discuss  this  with  their  per- 
sonal physicians  who  receive  a  copy  of 
the  results.  Although  vaccine  has  not 
been  readily  available,  we  belie\e  an 
employee  should  be  aware  of  her  im- 
mune status  to  rubella.  It  then  becomes 
her  responsibility  to  take  appropriate 
action.  We  have  offered  to  transfer  to 
other  hospital  areas  nurses  with  nega- 
tive H.I.  results. 


Rubella  vaccine 

A  live  attenuated  rubella  virus  vac- 
cine is  now  available  and  being  used  by 
many  provincial  departments  of  health 
to  control  the  impending  rubella  epi- 
demic. Litde  as  yet  is  known  about  the 
effect  on  the  embryo  if  a  woman  is  vac- 
cinated shortly  beforeorduring  pregnan- 
cy. However,  as  the  ability  of  the  atten- 
uated live  virus  to  cross  the  placental 
barrier  is  known,  the  vaccine  should 
be  used  in  sexually  active  women  of 
child-bearing  age  only  if  pregnancy 
can  be  excluded  and  the  use  of  effec- 
tive contraceptives  assured  during  the 
ensuing  two  to  three  months  while 
antibodies  are  developing. 

Little  Joe  is  now  nearly  two  years 
old  and  still  with  us.  Although  he  is  no 
longer  excreting  rubella  virus,  we  have 
been  unable  to  find  a  foster  home  for 
him,  which  is  necessary  as  his  mother 
cannot  cope  with  her  other  children 
and  Joe.  He  is  blind,  spastic,  and  se- 
verely retarded,  and  yet  a  small  spark  of 
the  essence  of  Joe  comes  through  as 
a  nurse  familiar  to  him  calls  his  name, 
and  his  eyes  move  to  the  direction  of 
the  voice. 


If,  by  our  program  at  Burnaby  Gen- 
eral Hospital,  we  can  prevent  one  em- 
ployee from  having  a  baby  with  congen- 
ital rubella,  we  will  more  than  justify 
the  existence  of  such  a  program. 

References 

1.  Monif,  G.R.  et  al.  Postmortem  isola- 
tion of  rubella  virus  from  three  chil- 
dren with  rubella-syndrome  defects. 
Uincet  1:723-4,  Apr.  3,  1965. 

2.  Bayer,  W.L.  et  al.  Purpura  in  congen- 
ital and  acquired  rubella.  New  Eng.  J. 
Med.  273:1362-6,  Dec.  16,  1965. 

3.  Gregg,  N.M.  Congenital  cataract  follow- 
ing German  measles  in  mother  (1941). 
Trans.  OtUhal.  Soc.  Aii.st.  3:35-46.  1942. 

4.  Dudgeon,  J. A.  Maternal  rubella  and 
its  effect  on  the  foetus.  Arch.  Dis.  Child. 
42:110-25.  April  1967. 

5.  Ibid. 

6.  Ibid. 

1.  Green.  R.H.  end.  Studies  of  the  natural 

history    and     prevention    of    rubella. 

Amer.  J.  Dis.  Child.  110:348-65,  Oct. 

1965. 
8.  Douglas,  G.W.  Rubella  in  pregnancy. 

Amer.  J.  Niirs.  66:2665-6,  Dec.  1966. 

Bibliography 

Douglas,  Gordon  W.  Rubella  in  pregnancy. 

Amer.     J.     Niirs.,    66:2664-66,     Dec. 

1966. 
Drug  and  Therapeutic  Information  inc.. 

The  Medical  Letter.  1 1:89-92.  Oct.  31, 

1969. 
Kettyls.    G.D.    Test    for    rubella.     B.C. 

Medical  Journal.  11:373,  Nov.  1969. 
Krugman,  Saul.  Rubella  —  new  light  on 

an  old  disease.  Amer.  J.  Niirs..  65:126- 

127,  Oct,  1965 
Congenital  rubella  syndrome.  B.C.  Medi- 

calJoiirnal  11:291,  Sept.  1969. 
Vince,   Dennis  J.   Prevention  of  rubella 

embryopathy.  CMAJ  100:777-8,  April, 

1969.  ^ 


JANUARY  1971 


Selection  and  success  of  students 
In  a  hospital  school  of  nursing 


The  authors  suggest  that  the  use  of  pre-entrance  selection  tests  for  nursing 
candidates  can  lead  to  better  selection  procedures  and  possibly  fewer  dropouts. 


Elizabeth  A.  Willett,  Ph.D.;  Reverend  Pius  A. 
Riffel,  S.).,  Ph.D.;  Lawrence  J.  Breen,  Ph.D.; 
and  Sister  Elinor  J.  Dickson,  C.S.|.,  B.A. 


Screening  procedures  that  utilize  gen- 
eral and  specialized  tests  of  vocational 
and  educational  aptitudes  have  been 
incorporated  into  the  selection  pro- 
grams of  professional  nursing  training 
institutions  in  the  United  States  over 
the  past  four  decades.'  Although  not  as 
widespread  in  Canada,  screening  pro- 
cedures that  make  use  of  standardized 
tests  are  being  used  indirectly  by  the 
admissions  committees  of  some  hos- 
pital schools.  St.  Michael's  School  of 
Nursing  in  Toronto,  through  the  coop- 
eration of  the  hospital's  psychological 
services,  has  made  use  of  a  relatively 
comprehensive  battery  of  standardized 
tests  since  1964  as  part  of  its  pre-en- 
trance selection  process. 

Reasons  for  testing 

The  reasons  usually  given  for  the 
use  of  such  tests  have  been  summarized 
by  Dent  and  include  the  following: 
First,  the  admission  of  students  who 
later  withdraw  involves  a  financial  loss. 
Second,  the  morale  of  some  students  or 
of  an  entire  class  may  be  affected  by 
the  admission  (and  later  withdrawal) 
of  students  who  encounter  considerable 
difficulty  with  the  program.  Third,  the 
quality  of  instruction  can  be  seriously 
affected.  Fourth,  some  highly  qualified 
candidates,  especially  should  they  apply 
late,  may  be  rejected  because  of  the 
acceptance  of  less  qualified  candidates. 
Last,  but  certainly  not  of  least  impor- 
lANUARY  1971 


tance,  lack  of  success  may  seriously 
affect  the  psychological  growth  and 
development  of  those  less  qualified 
candidates  who  are  later  forced  to  with- 
draw.^ 

Scope  of  present  research 

To  determine  the  predictive  value 
of  the  tests  used  in  the  St.  Michael's 
Psychological  Services  Nursing  Candi- 
date Selection  Battery,  the  present  re- 
search project  was  established.  Specif- 
ical.ly  it  had  as  its  objective  the  evalu- 
ation of  the  effect(s)  of  the  pre-entrance 
testing  program  on  students  selected 
for  the  1967.  1968,  and  1969  graduat- 
ing years. 

It  was  with  predictability  that  the 
present  study  was  primarily  concerned. 

Both  Dr.  Willett  and  Dr.  Riffel  have  held 
the  position  of  consultant  to  St.  Michael's 
School  of  Nursing.  Dr.  Willett  is  now 
Assistant  Professor  of  Psychology  at  Sag- 
inaw Valley  College.  Michigan.  Dr.  Riffel. 
who  is  Associate.  Department  of  Psychia- 
try. University  of  Toronto  and  Adjunct 
Professor,  Department  of  Psychology. 
University  of  Windsor,  retains  the  posi- 
tion of  Director  of  St.  Michael's  Hospital 
Department  of  Psychology.  Dr.  Breen 
is  now  Assistant  Professor  of  Psychology 
at  the  University  of  Manitoba.  Sister 
Elinor  Dickson,  now  at  the  University  of 
Ottawa,  is  working  toward  a  master  of 
arts  degree  in  psychology. 


but  not  in  a  singular  way.  Rather  it  was 
an  investigation  that  attempted  to  as- 
sess: l.the  efficacy  of  pre-entrance 
screening  procedures  in  nursing  candi- 
date selection;  2.  the  predictability  of 
specific  psychometric  instruments  in 
relation  to  success  during  the  three- 
year  period  as  well  as  on  the  Register- 
ed Nurses'  Association  of  Ontario  (RN) 
examinations;  and  3.  the  factors  that 
differentiate  successful  candidates 
(»lass)  from  those  who  withdrew  from 
t\\  program  (dropouts),  accepted  can- 
didates who  did  not  come  into  the  pro- 
gram. (ADNC),  and  those  candidates 
who  were  rejected  (rejects). 

Description  of  tests  used 

Although  the  battery  of  tests  used 
by  St.  Michael's  Hospital  psycholog- 
ical services  in  screening  nursing  can- 
didates has  been  modified  from  time 
to  time,  basic  instruments  such  as  the 
College  Qualification  Tests  (CQT), 
F'orer  Structured  Sentence  Completion 
Test  (FSSCT)  and  the  GeneraJJnfor- 
mation  Questionnaire  (GIQ)  were 
used  for  the  1967,  1968,  and  1969 
graduating  classes  —  those  classes  for 
which    pre-entrance    assessment    data 

Copies  of  the  full  research  report  are 
available  on  request  to  Sister  Marion  Bar- 
ron, C.S.J.,  Reg.N.,  B.Sc.N..  M.Ed.,  Dir- 
ector, St.  Michael's  School  of  Nursing, 
35  Shuter  St..  Toronto  25."!.  Ontario. 

THE  CANADIAN   NURSE     41 


were  analyzed  in  the  present  investi- 
gation. 

The  CQT  is  a  series  of  scholastic 
ability  tests  developed  by  Bennett, 
Bennett,  Wallace,  and  Wesman  for  use 
by  colleges  and  other  post-secondary 
educational  institutions  in  admission, 
placement,  and  guidance  procedures.^ 
The  three  tests  involved  in  the  series 
yield  six  scores:  Verbal;  Numerical; 
Information,  from  which  score  can  be 
derived  two  separate  scores  for  Science 
and  Social  Science;  and  Total.  The 
Verbal  test  consists  of  75  vocabulary 
items;  50  of  these  require  identifica- 
tion of  synonyms,  and  25,  identifi- 
cation of  antonyms.  The  Numerical 
test  contains  50  items  drawn  from 
arithmetic,  algebra,  and  geometry.  The 
Information  test  is  composed  of  75 
items,  half  of  which  deal  with  the  na- 
tural sciences  (physics,  chemistry,  and 
biology),  the  other  half  with  social 
studies  (history,  government,  econ- 
omics, and  geography). 

Verbal  and  numerical  tests  have  a 
long  history  of  success  in  predicting 
academic  achievement.  Research  has 
shown  vocabulary  to  be  one  of  the  most 
efficient  measures  of  verbal  ability. 
Although  not  effective  in  as  many  areas 
as  tests  of  verbal  ability,  those  tapping 
numerical  ability  have  also  been  usefyl 
predictors  "even  in  fields  which  do  not 
obviously  require  numerical  ability.'' 

The  inclusion  of  the  Information 
subtests  of  the  CQT  (Science  and  So- 
cial Science)  in  the  St.  Michael's  Hos- 
pital Psychological  Services  Nursing 
Candidate  Selection  Battery  represents 
the  widely  held  belief  that  a  measure 
of  the  educational  background  a  stu- 
dent brings  to  any  institution  of  higher 
learning  will  be  indicative  of  his  or  her 
future  academic  success.  Although  the 
!  student's  high  school  record  is  a  retlec- 
\tion  of  her  formal  educational  history, 
and  may  he  a  good  predictor  of  later 
academic  success,  there  are  serious 
limitations  attendant  to  its  exclusive 
use. 

Bennett  et  al  have  summarized  the 
major  difficulties  inherent  in  placing 
any  critical  reliance  on  high  school 
records: 

"Grading  standards  vary  from  one 
42     THE  CANADIAN   NURSE 


high  school  to  another  so  that  grades 
may  not  be  at  all  comparable.  Students 
may  take  courses  quite  different  in 
inherent  difficulty,  one  student  earn- 
ing A's  in  easy  courses  while  another 
earns  B"s  in  more  challenging  subjects. 
Informal  education,  the  learning  which 
takes  place  outside  the  school  setting, 
is  only  accidentally  reflected  in  high 
school  grades."^ 

The  inclusion  of  the  Information 
subtests,  originally  prepared  to  pro- 
vide a  uniform  survey  of  the  student's 
academic  knowledge,  served  as  an  in- 
dicator of  the  breadth  of  information 
she  had  previously  acquired,  and  on 
which  she  would  be  expected  to  build 
in  the  future. 

In  addition  to  providing  a  predictive 
tool  as  well  as  uniform  information 
about  candidates"  academic  background, 
the  use  of  the  CQT  allowed  for  compar- 
isons between  St.  Michael's  Hospital 
School's  candidates  and  those  college 
freshmen  entering  a  university  program 
leading  to  a  degree  in  nursing.  Such 
comparisons  were  possible  as  the 
24,000  students  from  37  colleges  and 
universities  in  22  states  on  whom  the 
tests  were  originally  standardized, 
were  grouped  from  all  schools  accord- 
ing to  degree  sought. 

Another  psychometric  tool  that  has 
always  been  a  part  of  St.  Michael's  Hos- 
pital Psychological  Services  Nursing 
Candidate  Screening  Battery  is  the 
Forer  Structured  Sentence  Comple- 
tion Test  (FSSCT).  The  FSSCT  can 
best  be  described  as  a  projective  tech- 
nique that  allows  for  indirect  assess- 
ment of  the  candidate's  personality 
dynamics. 

Forer  structured  his  sentence  stems 
to  elicit  responses  (completions)  re- 
flecting the  subject's  reactions  to  inter- 
personal figures  (mother,  females,  fa- 
ther, males,  groups,  authority);  wishes; 
causes  of  own  aggression,  anx- 
iety and  fear,  depression,  failure,  and 
guilt;  reactions  to  aggression,  rejec- 
tion, failure,  responsibility,  and  school. 
Forer  states,  "...  the  use  of  highly 
structured  items  allows  for  wide  cover- 
age of  the  attitude-value  system  and 
points  up  evasiveness,  individual  dif- 
ferences, and  defense  mechanisms."^ 


One  of  the  major  advantages  of  a 
technique  such  as  the  FSSCT  is  that 
it  is  indirect  in  its  approach  to  per- 
sonality assessment.  Distortion  of 
personality  due  to  the  subject's  own ' 
"halo"  effect  is  largely  precluded  when 
projectives  are  employed.  Unfortunate- 
ly, the  major  disadvantage  of  tests  such 
as  the  FSSCT,  also  stemming  from  its 
indirect,  qualitative  approach,  is  that 
the  completions  do  not  lend  themselves 
well  to  quantification  for  purposes  of 
research.  Although  some  research  in-, 
roads  have  been  made  into  the  use  of 
sentence  completion  tests,  they  still 
present  the  problems  which  obtain 
when  data  has  to  be  coded  on  a  subjec- 
tive, judgmental  basis. 

Also  subject  to  difficulties  inher- 
ent in  projective  techniques,  such  as 
the  FSSCT,  is  the  General  Information 
Questionnaire  (GIQ).  The  GIQ  was 
originally  developed  at  St.  Vincent's 
School  of  Nursing  in  New  York,  and 
later  copyrighted  by  Coville.''  The 
responses  to  this  questionnaire  were 
used  directly  by  both  Psychological 
Services  and  St.  Michael's  School  of 
Nursing  admissions  committee  in 
screening  candidates.  Included  in  the 
GIQ  are  27  self-rating  scales  that  re- 
flect the  subject's  level  of  self-confi- 
dence, ability  to  make  decisions,  cour- 
tesy, tact,  ambition,  and  so  on. 

Additional  screening  instruments 

In  addition  to  the  GIQ,  FSSCT,  and 
CQT,  other  instruments  used  at  St. 
Michael's  include  the  Raven's  Pro- 
gressive Matrices  (Ravens),  Minnesota 
Multiphasic  Personality  Inventory 
(MMPI),  and  the  Sixteen  Personality 
Factor  Questionnaire  (16PF).  The 
Ravens  assesses  an  individual's  cap- 
acity to  apprehend  meaningless  figures, 
see  the  relations  between  them,  con- 
ceive the  nature  of  the  figure  com- 
pleting each  system  of  relations  pre- 
sented, and,  by  so  doing,  develop  a 
systematic  method  of  reasoning.^  Thus, 
in  broad  terms,  the  Ravens  can  be  con- 
sidered a  test  of  intelligence. 

The  MMPI,  a  test  for  assessing  per- 
sonality functioning,  was  devised  by 
Hathaway  and  McKinley  partly  to 
"...  lessen  the  conflict  between  the 
JANUARY  1971 


psychiatrist's  conception  of  the  ab- 
normal personality  and  that  of  psy- 
chologists .  .  .  who  must  deal  with  ab- 
normality among  more  nearly  normal 
persons,"  and  partly  "in  the  hope  that 
it  might  be  nearly  universal  in  both  its 
interpretation  and  its  applicability  to 
individual  cases. "^  The  MMPI  allows 
for  the  assessment  of  personality  char- 
jacteristics  on  the  basis  of  scores  on 
jthe  following  nine  clinical  scales: 
I  hypochondriasis,  depression,  hysteria, 
psychopathic  personality,  masculinity- 
femininity  characteristics,  paranoia, 
psychasthenia,  schizophrenia,  and 
hypomania.  Other  MMPI  scales  that 
are  useful  in  personality  assessment 
include  the  lie  (L)  score,  validity  (F) 
score,  and  a  measure  of  social  iso- 
lation (Si). 

The  MMPI,  used  as  a  post-entrance 
test,  was  administered  to  all  appli- 
cants accepted  into  the  1967  gradua- 
ting year  at  St.  Michael's.  In  the 
present  study  it  was  used  to  assess  the 
personality  differences  between  the 
class  and  dropouts. 

Another  instrument  devised  by  more 
basic  research  in  psychology  to  give 
the  most  complete  coverage  of  person- 
ality possible  in  a  brief  time  is  the 
16PF.  Cattell  and  Eber  report,  "The 
personality  factors  measured  are  not 
just  peculiar  to  the  16PF  Test.  They 
have  been  established  as  unitary,  psy- 
chologically-meaningful entities  in 
many  researches  in  various  life  situa- 
tions."^" It  is  this  very  meaningfulness 
that  makes  the  16PF  an  attractive 
instrument  for  use  as  a  screening  device. 
The  16PF  assesses  personality  along 
the  following  dimensions:  Reserve, 
Intelligence,  Emotional  Stability,  Hu- 
mility, Prudence,  Expediency,  Res- 
traint, Self-reliance,  Trust,  Practicality, 
Forthrightness,  Confidence,  Conser- 
vatism, Dependency,  Control,  and 
Tension. 

Although  the  literature  is  replete 
with  studies  assessing  the  success  of 
selection  procedures  used  in  nursing 
schools,  none  of  them  have  used  bat- 
teries identical  with  those  employed  by 
St.  Michael's  Hospital  psychological 
services.  Thus,  it  seemed  logical  that 
St.  Michael  batteries  be  studied  to  de- 

lANUARY  1971 


termine  the  effectiveness  of  the  speci- 
fic tests  used  in  each  battery  and  their 
differential  predictability.  Success  in 
nursing,  for  the  purposes  of  the  present 
research  project,  was  operationally 
defined  in  terms  of  the  candidate's 
academic  and/or  clinical  performance 
during  her  three-year  training  period 
as  well  as  in  terms  of  her  RN  examin- 
ation results. 

Statistical  procedures 

All  scores  for  candidates  in  their 
respective  year  were  subjected  to  cor- 
relational analyses  to  determine  which 
of  the  screening  devices  provided  scores 
that  were  valid  predictors  of  success 
in  the  nursing  program,  that  is,  showed 
significant  correlations  with  academic 
and/or  clinical  marks  and  RN  examin- 
ations results.  To  determine  the  psy- 
chological differences  between  accept- 
ed candidates  (class),  accepted  appli- 
cants who  did  not  enter  the  school 


(ADNC),  rejects  and  dropouts,  indi- 
vidual analyses  of  variance  of  each  of 
the  psychological  variables  were  also 
carried  out.  All  analyses  were  handled 
by  an  IBM  360/60  computer. 

Intellectual  ability  test  results 

Correlations  between  CQT  scores 
and  RN  examination  results  that  reach- 
ed statistical  significance  (p  =  0.05) 
are  presented  in  Table  /.In  terms  of 
the  magnitude  of  the  correlations  as 
well  as  their  number,  the  CQT  Total 
score  appeared  to  be  the  best  predictor 
of  success  in  nursing  as  measured  by 
the  RN  examinations.  Although  not 
consistent  predictors  across  the  three 
years,  the  Verbal  and  Science  scores 
also  showed  significant  correlations 
with  RN  examination  results. 

As  far  as  correlations  between  CQT 
scores  and  school  marks  were  concern- 
ed, it  was  also  the  CQT  Total  that 
showed  the  greatest  number  of  cor- 


TABLE  1 

Significant  Correlations  Between  CQT 
Scores  and  RN  Examination  Results 


Social 

CQT  Scores 

Numerical 

Verbal       Science 

Science 

Total 

RN  Examinations 

1967;  N  =  58 

Medical  Nursing 

.31 

.37 

Surgical  Nursing 

.25 

.24 

.37 

Obstetric  Nursing 

.32 

.32 

.38 

Pediatric  Nursing 

.28 

.39 

.45 

Correlation  (r)  =  .21 

,p<.05;  r  = 

=  .30,  p  <  .01 ;  r  =  .40 

p  <  .001 

1968;  N  =  83 

Medical  Nursing 

.20 

.25 

.29 

.35 

Surgical  Nursing 

Obstetric  Nursing 

.25 

.22 

Pediatric  Nursing 

.25 

.22               .18 

.31 

r=.18,  p  <.05;r  = 

.26, 

p<.01; 

r  =  .36,  p  <  .001 

1969;  N  =  84 

Medical  Nursing 

.33 

.28 

.29 

Surgical  Nursing 

.30              .23 

.30 

.32 

Obstetric  Nursing 

.31 

.23 

.31 

.35 

Pediatric  Nursing 

.31 

.34 

.34 

r  =  .20,  p  <.05;  r=: 

.28, 

p<.01; 

r  =  .39,  p  <  .001 

THE  CANADIAN  NURSE 


43 


relations  with  marks.  For  the  1967 
year,  significant  correlations  were 
established  between  COT  Total  scores 
and  1 3  out  of  27  (48  percent)  academic 
and/or  clinical  marks;  for  the  1968 
class,  8  out  of  20  (40  percent)  of  the 
academic  and/or  clinical  marks;  and 
for  the  1969  class,  9  out  of  19  (47 
percent)  of  the  academic  and/or  clinical 
marks. 

Science  scores  followed  closely  by 
those  of  the  Verbal  test  also  showed 
significant  correlations  with  marks, 
although  correlations  were  not  found 
to  exist  between  these  test  scores  and 
as  many  marks  as  was  the  case  with 
the  COT  Total  scores.  Approximately 
one-quarter  to  one-third  of  the  aca- 
demic and/or  clinical  marks  each  year 
were  found  to  be  correlated  with  COT 
Science  and  Verbal  scores.  An  even 
lower  percentage  of  marks  was  found 
to  be  correlated  with  the  Numerical 
and  Social  Science  scores,  the  latter 
showing  the  least  number  of  correla- 
tions with  marks. 

The  mean  COT  percentiles  for 
each  group  averaged  across  the  three 
years  are  presented  in  Table  2.  In  each 
year  the  five  scores  were  found  to  dif- 
ferentiate the  rejects  from  the  other 
three  groups  at  the  0.05  level  of  sta- 
tistical significance  or  higher. 

Since  the  COT,  a  measure  of  scho- 
lastic ability,  the  Ravens,  a  test  of  intel- 
ligence, and  the  intelligence  dimen- 
sion of  the  16PF  are  all  instruments 
that  tap  intellectual  functioning,  it 
seemed  reasonable  to  compare  them 
in  terms  of  predictive  value.  Because 
of  the  many  significant  correlations 
established  between  COT  scores  and 
school  and  RN  examination  results, 
the  COT  stands  out  as  an  excellent 
predictive  instrument.  On  the  other 
hand,  the  Ravens  test  employed  in  the 
screening  of  the  1967  and  1968  appli- 
cants to  St.  Michael's  School  of  Nurs- 
ing, was  found  to  be  correlated  with 
only  two  school  marks  in  1967  and 
four  in  1968,  although  it  did  show 
significant  correlations  with  three  or 
four  RN  examinations  in  1967,  but 
only  one  in  1968. 

The  intelligence  dimension  of  the 
16PF  was  found  to  be  correlated  with 
44     THE  CANADIAN   NURSE 


TABLE  2 

Mean  CQT  Percentiles  for  Each  Group 
(N  =  665) 


Class 

(N=246) 

Drop-Outs 

(N=65) 

ADNC 

(N=130) 

Rejects 

(N=224) 

CQT  Percentile 
Total 

68.37 

66.66 

65.96 

40.37* 

Science 

51.19 

48.84 

55.28 

35.21* 

Social  Science 

49.84 

50.99 

40.21 

32.54* 

Verbal 

65.34 

63.66 

66.82 

42.43* 

Numerical 

82.55 

77.35 

75.99 

63.76* 

*  p  <  .05 

all  four  RN  examination  results  in 
1968,  but  showed  no  correlations  with 
the  1 969  RN  examination  results. 

Personality  test  results 

Although  the  intelligence  dimen- 
sion of  the  16PF  was  not  shown  to  be 
a  consistent  predictor  of  success  in 
nursing  as  defined  in  terms  of  RN  ex- 
amination results,  this  is  not  to  say  that 
the  other  dimensions  of  the  16PF  were 
not  valuable  predictive  tools.  For  the 
1969  group,  the  reserve,  emotional 
stability,  humility,  restraint,  practicali- 
ty, conservatism,  and  control  factors 
showed  significant  correlations  with  the 
RN  examination  results.  In  addition, 
the  1 6PF  was  a  valuable  instrument  in 
differentiating  between  the  groups. 

The  dimensions  on  the  16PF  that 
differentiated  between  the  class  and 
dropout  groups  in  1968  were  those  of 
emotional  stability,  self-reliance,  and 
practicality,  and,  in  1969,  reserve.  As 
far  as  differences  in  reserve  were  con- 
cerned, the  dropouts  were  much  more 
outgoing,  warmhearted,  easygoing,  and 
participating.  These  are  desirable  char- 
acteristics; but  when  they  are  operating 
in  a  student's  personality  to  the  extent 
that  she  is  spending  considerable  time 
fulfilling  such  aspects  other  personality, 
she  is  not  likely  spending  as  much  time 
as  is  required  at  her  studies. 

As  far  as  the  1 6PF  factors  that  dis- 
criminated between  these  two  groups 
in  the  1968  year  are  concerned,  the 
class  were  found  to  be  more  stable  emo- 


tionally and  less  easily  upset;  more 
self-reliant  and  realistic;  and  more  prac- 
tical, that  is,  careful,  conventional, 
more  regulated  by  external  realities 
than  were  the  dropouts. 

Another  instrument  used  in  the  Pre- 
entrance  Nursing  Candidate  Selection 
Battery  was  the  General  Information 
Ouestionnaire.  Analyses  of  variance 
indicated  that  the  following  scales  dif- 
ferentiated between  the  class  and  drop- 
out groups:  decision-making,  courtesy, 
moral  standards,  responsibility,  science, 
persuading  others,  listening,  tolerance 
and  study  habits.  In  most  cases  it  was 
the  dropouts  who  rated  themselves  high- 
er on  these  scales.  This  is  consistent 
with  the  unrealistic  attitudes  reflected 
in  their  16PF  profiles. 

Although  the  self-ratings  taken  from 
the  General  Information  Ouestionnaire 
differentiated  between  the  class  and 
dropouts,  they  were  not  particularly 
valuable  predictive  instruments  in  terms 
of  their  ability  to  establish  significant 
positive  correlations  with  academic 
and/or  clinical  marks  and  RN  examina- 
tion results.  Also,  the  Wish-To-Be-A- 
Nurse,  Reaction-to-Failure,  and  Atti- 
tude-to-School  scores  derived  from  the 
FSSCT  were  not  particularly  valuable 
as  far  as  their  predictive  ability  was 
concerned.  Because  the  Wish-To-Be- 
A-Nurse  score  was  found  to  be  correl- 
ated with  school  marks  as  well  as  RN 
examination  results  in  1967,  it  was  also 
analyzed  for  the  1 968  and  1 969  classes. 
In  1968  it  was  found  to  be  correlated 
JANUARY  1971 


with  only  one  mark,  that  of  psychology 
II,  and  in  1969,  with  one  RN  examina- 
tion, that  of  medical  nursing  in  which 
a  negative  correlation  (r  =  -.20)  was 
established.  In  other  words,  the  greater 
the  applicant's  wish  to  be  a  nurse  as 
reflected  in  her  FSSCT,  the  poorer  her 
performance  on  the  medical  nursing 
examination. 

Such  an  inverse  relationship  sug- 
gests strongly  that  the  applicant  who 
responds  to  sentence  stems  of  the  FSSCT 
with  completions  reflecting  an  inter- 
est in  becoming  a  nurse,  may  not  have 
the  necessary  abilities  required  to 
achieve  her  goal,  nor  the  abilities  that 
make  for  relative  success  in  nursing  as 
measured  by  RN  examinations. 

The  Wish-To-Be-A-Nurse  score,  de- 
rived from  the  FSSCT,  significantly 
differentiated  between  the  rejects  and 
the  other  three  groups  in  the  1967  year, 
with  the  rejects  obtaining  much  higher 
scores  than  those  of  the  other  groups. 
Such  a  finding  is  consistent  with  the 
inverse  relationship  discovered  between 
Wish-To-Be-A-Nurse  scores  and  RN 
examination  results,  and  can  be  inter- 
preted in  the  following  way:  Those 
applicants  who  are  rejected  presented 
an  aggrandized  view  of  themselves,  a 
possible  reflection  of  the  use  of  a  great 
deal  of  psychological  denial,  whereas 
those  applicants  who  were  accepted  had 
a  more  realistic  view  of  themselves. 

A  similar  choice  of  interpretation 
can  be  made  regarding  the  significantly 
higher,  that  is,  more  positive,  Reaction- 
to-Failure  scores  obtained  by  the  1967 
dropouts.  On  the  other  hand,  the  signif- 
icantly higher  Reaction-to-Failure 
scores  obtained  by  the  dropxiuts  could 
well  have  been  a  reflection  of  the  very 
realistic  attitudes  toward  failure  in  that 
they  were  either  failing  academically 
or  at  least  were  not  performing  par- 
ticularly well.  They  were  able  to  look 
at  their  performance  in  a  realistic  light 
and  make  the  appropriate  decision. 

The  former  explanation  of  the  drop- 
outs' higher  Reaction-to-Failure  scores, 
however,  is  more  consistent  with  the 
findings  on  the  MMPI.  The  dropouts 
had  significantly  lower  depression  scale 
scores  than  did  the  class  members  in 
the  1967  group.  On  the  surface,  it 
JANUARY  1971 


would  appear  that  the  dropouts  were 
less  depressed  than  were  the  class  mem- 
bers; such  an  interpretation  is  highly 
unlikely  however.  Rather,  it  seems 
more  probable  that  the  dropouts  were 
using  a  certain  degree  of  psychological 
denial  and  this  resulted  in  lower  de- 
pression scale  scores  for  them.  A  similar 
use  of  denial  was  demonstrated  in  the 
dropouts'  somewhat  unrealistic  16PF 
profiles.  These  relatively  consistent 
findings  regarding  the  dropouts'  dif- 
ferential performance  on  the  personality 
tests  strongly  supports  the  need  for  the 
inclusion  of  such  instruments  in  any 
pre -entrance  nursing  candidate  screen- 
ing battery. 

Conclusion 

In  terms  of  predictive  ability,  as 
measured  by  correlational  relationships 
found  to  exist  between  psychological 
tests  and  marks,  the  instruments  em- 
ployed in  the  St.  Michael's  Hospital 
Psychological  Services  Pre-Entrance 
Nursing  Candidate  Selection  Batteries 
can  be  ranked  in  the  following  order: 
COT.  16PF,  GIQ,  FSSCT,  Ravens, 
and  MMPI.  The  CQT  and  16PF,  in 
particular,  were  found  to  be  valuable 
predictive  tools:  the  former  in  assessing 
achievement  factors,  the  latter,  person- 
ality. In  addition,  the  COT  was  a  valu- 
able instrument  in  differentiating  be- 
tween the  rejects  and  the  other  three 
groups  (class,  dropouts,  and  ADNC); 
the  16PF  was  valuable  in  differentiat- 
ing between  the  four  groups  (class, 
dropouts,  ADNC,  and  rejects),  and  be- 
tween the  class  and  dropouts. 

The  GIO  also  made  an  important 
contribution  in  discriminating  between 
the  class  and  dropouts.  These  three 
tests  (CQT,  16PF  and  GIO)  could  be 
used  to  advantage  in  any  pre-entrance 
nursing  candidate  selection  program. 
The  use  of  such  tests  is  of  no  small  im- 
portance; it  can  lead  to  better  selection 
procedures  with  the  possibility  of  at 
least  one  important  result  —  fewer 
dropouts. 

The  exciting  area  of  study  of  which 
Ogston  and  Ogston  recently  wrote"  is 
no  longer  in  the  discussion  stage,  at 
least  at  St.  Michael's  Hospital  in  To- 
ronto.   Analyses    of    personality    and 


achievement  tests  have  been  conducted 
and  have  differentiated  successful  stu- 
dents from  unsuccessful  ones. 

References 

1.  Dent,  D.E.  A  study  of  the  predictive 
efficiency  of  one  pre-entrance  nursing 
test  battery  at  one  selected  accredited 
three-year  diploma  school  of  nursing. 
Unpublished  M.Sc.Ed.  Thesis.  Ann 
Arbor.  University  of  Michigan.  1962. 

2.  Ihkl. 

3.  Bennett. G.K..  Bennett.  M.G..  Wallace. 
W.L.,  and  Wesman,  A.G.  Caliche  Qtui- 
lification  Test  Manual.  New  York. 
Psychological  Corporation.  1961. 

4.  Ihiil. 

5.  I  hill. 

6.  Korer.  B.R.  A  structured  sentence 
completion  test.  Joiinuil  of  Projective 
Techniques  14;  15-30,  1950. 

7.  C'oville.  W.J.  General  Infornwtion 
Questionnaire.  New  York.  Coville. 
1966. 

8.  Ravens.  J.C.  Guide  To  the  Sfaiiilaril 
Pro)>ressive  Matrices.  London.  Lewis, 
1938. 

9.  Hathaway.  S.R,  and  Mckinley,  J.C. 
Minnesota  Multiphasic  Personality 
Inventory  Manual.  New  York,  Psy- 
chological Corporation.  1961. 

10.  Cattell.  B.  and  Eber.  H.W.  Si.xteen 
Personality  Factor  Questionnaire. 
Chicago,  Institute  for  Personality  and 
Ability  Testing.  1954. 

1  I .  Ogston.  D.G.  and  Ogston.  K.M.  Coun- 
seling students  in  a  hospital  schotil  of 
nursing.  Canail.  Nurse  66:4:52-3. 
April  1970.  ^ 


THE   CANADIAN   NURSE     45 


MEDLARS  and  you 


Nursing,  along  with  other  health  professions  in  Canada,  now  has  a  new 
reference  resource  for  bio-medical  literature.  This  resource  is  the  Canadian 
MEDLARS   Service,  which  will  be  invaluable  for  research  and  information 
required  for  current  practice. 


Ann  O.  Nevill,  B.Sc,  AMLS,  and  Margaret 
L.  Parkin,  B.A.,  B.L.S. 


When  first  seeing  the  term  "MEDLARS." 
many  nurses  might  well  ask,  "What  is 
it?"  MEDLARS  an  acronym  for  Medi- 
cal Literature  Analysis  and  Retrieval 
System.  It  is  a  computerized  system 
that  makes  possible  the  production  of 
bibliographic  services  such  as  Index 
Medicus  and  the  International  Nursing 
Index  (INI)  from  the  machine  sorted 
citations  indexed  from  some  2,300 
separate  journals  from  all  over  the 
world. 

MEDLARS  was  developed  at  the 
National  Library  of  Medicine  in 
Washington  specifically  to  facilitate  the 
widely  used  index  to  biomedical  per- 
iodical literature,  arranged  by  subject 
and  by  author.  Index  Medicus  has  been 
published  since  1879  under  various 
names  and,  since  1960,  has  appeared 
monthly  with  annual  cumulations.  The 
first  computer-based  issue  was  published 
in  January  1964.  Some  15  nursing 
journals,  including  The  Canadian 
Nurse,  are  covered  by  Index  Medicus. 

Also  produced  by  MEDLARS  is  INI, 
which  first  appeared  in  1966.  The  INI 
uses  stored  data  from  over  1 80  nursing 
journals,  and  nursing  content  from  over 
2,000  non-nursing  journals.  About  50 
percent  of  the  citations  are  in  English, 
and  about  6  percent  are  in  French. 

The  INI  is  the  only  nursing  index 
giving  access  to  French-language  art- 
icles. This  is  important  for  Canadian 
nurses  who  may  be  particularly  interest- 
46     THE  CANADIAN   NURSE 


ed  in  locating  both  English-language 
and  French -language  references.  Many 
may  not  realize  that,  although  the  titles 
are  printed  in  English  in  the  subject 
part  of  the  index  (with  a  code  (Fre)  in 
the  right-hand  margin),  the  article 
appears  in  the  author/title  listing  in 
the  French  language.  To  assist  French- 
language  users  of  INI,  a  cross-reference 
list  relating  standard  subject  headings  in 
French  to  the  INI  English  subject  head- 
ings is  available  from  the  librarian  of 
the  Amer'can  Journal  of  Nursing 
Company,  10  Columbus  Circle,  New 
York,  N.Y.,  10019. 

How  information  is  stored 

All  journals  indexed  into  MEDLARS 
are  held  at  the  National  Library  of 
Medicine  (NLM)  in  Bethesda,  Mary- 
land, U.S.A.  The  indexing,  however,  is 
done  by  trained  subject  specialists  lo- 
cated not  only  at  the  NLM,  but  abroad 
in  such  countries  as  France,  Great 
Britain,  Israel,  Sweden,  and  Japan. 
Each  article  or  item  is  listed  under 
appropriate  headings  chosen  from  a 
list,  or  thesaurus,  of  about  8,000  ap- 
proved headings,  called  Medical  Subject 
Headings  {MESH). 


Mrs.  Nevill  is  MEDLARS  Analyst,  Cana- 
dian MEDLARS  Service,  National  Science 
Library,  Ottawa.  Miss  Parkin  is  Librarian 
at    the    Canadian    Nurses'    Association. 


Articles  are  also  examined  for  special 
information,  such  as  age  groups  of 
patients,  pregnancy,  human  or  animal 
studies,  geography,  and  clinical  re- 
search, and  will  have  additional  entries 
to  cover  these  areas.  Each  article  is 
cited  in  Index  Medicus  and  the  INI  only 
under  its  most  important  concepts. 
However,  all  subject  entries  used  for  the 
article  are  stored  on  magnetic  tape  for 
future  machine  retrieval. 

For  example,  an  article  on  nursing 
care  of  diabetics  would  be  listed  in  INI 
both  under  nursing  care  and  diabetes. 
However,  it  may  also  have  been 
relevant  to  diabetes  in  pregnant  women 
between  25  and  35  years  of  age  in 
Prince  Edward  Island.  The  article  could 
be  retrieved  under  these  additional 
aspects,  that  is,  pregnancy,  age,  and 
geographic  location,  in  a  machine  search 
for  articles  involving  any  of  these 
specific  requirements. 

Each  citation  in  the  MEDLARS  stor- 
age, therefore,  contains:  1.  authors' 
names;  2.  English  title  and/or  English 
translation  and  the  original  language;  3. 
abbreviated  journal  title;  4.  volume, 
page,  date  of  publication;  and  5.  subject 
headings  describing  the  contents. 

How  information  is  retrieved 

So  much  for  how  the  information  is 
stored.  How  is  it  found  again  or  re- 
trieved? First  of  all,  in  printed  recur- 
ring bibliographies,  such  as  the  already 
JANUARY  1971 


discussed  Index  Medians  and  the 
International  Nursing  Index  and  some 
16  others  in  specialized  areas.  It  may 
also  be  retrieved  by  one-time  retro- 
spective bibliographies  called  demand 
searches.  If  an  area  of  interest  is  too 
complex  or  detailed  to  be  found 
readily  in  available  indexes  or  biblio- 
graphies, a  request  is  programmed  into 
the  computer  in  the  special  terms  of 
MESH.  The  resultant  process  in  the 
computer  is  a  matching  one.  Terms  in 
the  search  request  are  matched  against 
the  stored  citations,  and,  when  there  is 
a  match,  an  article  is  retrieved  and 
the  citation  is  printed  out. 

There  are  MEDLARS  centers  around 
the  world  where  these  demand  searches 
can  be  processed  without  having  to  go 
to  the  National  Library  of  Medicine  in 
the  United  States.  One  of  the  newest  of 
these  centers  is  the  Canadian  MEDLARS 
Service,  based  at  the  Health  Sciences 
Centre  at  the  National  Science  Library 
in  Ottawa.  Here  a  search  analyst  trans- 
lates requests  for  information  into  the 
necessary  combinations  of  terms  to 
retrieve  that  information  from  the 
computer. 

At  present,  requests  for  demand 
searches  are  programmed  by  the  Cana- 
dian MEDLARS  Service  and  processed 
through  the  computer  facilities  at  Ohio 
State  University  in  Columbus,  Ohio. 
However,  when  the  new  MEDL.ARS  II 
computer  becomes  operational  some- 
time in  197 1,  the  programs  will  be  suit- 
able for  the  NRC's  computer  facilities, 
and  requests  will  be  fully  processed  at 
the  Canadian  center. 

When  a  request  is  processed,  the 
computer  automatically  searches  the 
literature  of  the  past  2'/2  to  3  V2  years. 
Each  July,  a  year  is  cut  from  the  search 
range;  for  example,  a  search  now  runs 
from  January  1968  to  date.  After  July 
1971,  it  will  cover  from  January  1969. 
If  this  initial  search  coverage  is  not 
enough,  earlier  citations  on  any  tape, 
back  to  1964,  can  be  done. 

How  to  use  MEDLARS 

Nurses  working  in  educational  insti- 
tutions or  involved  in  clinical  or  other 
forms  of  research  will  find  the  .MED- 
LARS demand  search  service  partic- 
ularly valuable.  But  how  do  you,  as  one 
of  these  nurses,  go  about  using  MED- 
LARS? 

When  you  need  material  for  a  topic 
on  which  you  can  find  limited  or  no 
information  in  the  INI  or  Index  Med- 
icus,  you  should  first  discuss  your 
lANUARY  1971 


problem  with  the  reference  librarian  in 
your  own  institutional  library,  or  by 
correspondence  with  the  Canadian 
Nurses"  Association  librarian.  The  CNA 
library  has  prepared  many  bibliog- 
raphies that  may  either  supplant  or 
supplement  a  MEDLARS  search. 

If  it  is  definitely  determined  that  a 
MEDLARS  search  is  required,  a  MED- 
LARS request  form  should  be  obtained, 
again  from  the  relevant  institutional 
library  or  from  the  CNA  library  (50 
The  Driveway,  Ottawa  4)  or  from  the 
Canadian  MEDLARS  Service  (National 
Science  Library,  National  Research 
Council  of  Canada,  100  Sussex  Drive, 
Ottawa).  The  completed  form  can  be 
submitted  through  any  of  these  chan- 
nels. 

How  successful  a  MEDLARS  demand 
search  will  be  depends  on  such  inter- 
dependent factors  as: 

•  How  well  you  fill  in  the  narrative 
statement  on  the  form,  explaining 
the  information  you  need. 

•  The  availability  of  MESH  terms  to 
describe  the  request.  (These  are 
selected  by  the  search  analyst  at  the 
Canadian  MEDLARS  Service  prim- 
arily on  the  basis  of  your  narrative 
statement.) 

•  The  availability  of  information  on 
your  topic  within  the  time  span  (i.e., 
the  initial  21/2  or  V/z  years)  of  the 
search,  and  in  the  journals  covered 
by  MEDLARS. 

•  How  well  the  required  articles  have 
been  indexed  into  the  system,  and 
how  well  the  search  analyst  translates 
your  need  into  MESH  terms. 

When  you  receive  your  bibliography, 
it  will  usually  be  arranged  alphabet- 
ically by  author.  The  bibliography  may 
be  divided  into  two  or  three  sections  to 
separate  two  or  three  different  aspects 
of  your  requests,  to  separate  specific 
from  general  articles,  or  to  group 
articles  by  languages.  To  help  you  inter- 
pret the  bibliography,  the  terms  of  the 
search  formula  will  be  enclosed,  as 
well  as  information  about  acquiring 
articles  in  the  bibliography  and  an 
evaluation  form  that  you  should  com- 
plete and  return.  You  can  ask  for  the 
bibliography  to  be  done  on  continuing 
computer  paper  or  3"  x  5"  cards.  Each 
citation  will  include  complete  biblio- 
graphic information,  the  original  lan- 
guage of  the  article  if  it  is  other  than 
English,  and  a  list  of  all  the  indexing 
terms  that  were  applied  to  the  article. 


There  are  some  restrictions  on 
what  you  should  ask  for  as  a  MEDLARS 
search.  For  example,  you  should  not 
request: 

1.  Searches  of  the  total  MEDLARS  file 
of  stored  data,  i.e..  back  to  1963. 
Experience  has  proven  that  the  most 
relevant  data  is  usually  in  the  past 
2V2  to  3  years.  For  earlier  data, 
the  INI  and  the  Index  Medicus 
should  be  used. 

2.  Author  searches.  This  data  is  readily 
available  in  INI  and  Index  Medicus. 

3.  Verification  of  specific  bibliographic 
citafions.  Again,  this  data  is  readily 
available  elsewhere. 

4.  Bibliographies  on  single  subjects,  for 
example,  university  programs  in 
nursing,  which  may  easily  be  coor- 
dinated. This  particular  example  can 
be  found  in  the  INI  under  Nursing 
Education  —  Baccalaureate. 

5.  Specific  data  on  facts  that  can  be 
readily  found  in  handbooks  and 
directories.  For  example,  the  number 
of  graduates  from  baccalaureate 
nursing  programs  in  Canada  in  1965. 
This  is  easily  found  in  Countdown 
1967. 

MEDLARS  orientation  programs 
slide-illustrated  presentations  of  vary 
ing  lengths  (up  to  a  full  day)  are  avail- 
able to  groups  of  nurses,  health  science 
practitioners,  and  librarians  who  wish 
to  become  more  familiar  with  the  sys- 
tem. For  information  on  arranging  such 
a  program  for  a  group  or  on  participat- 
ing in  a  program  if  one  should  be 
arranged  in  your  area,  write  to  the 
Canadian  MEDLARS  Service. 


The  National  Science  Library  has 
so  far  absorbed  the  cost  of  MEDLARS, 
but  a  charge  probably  will  be  started 
during  1 97 1 .  What  this  cost  will  be  has 
not  been  decided,  but  it  will  probably 
be  between  $30  and  $50.  MEDLARS 
searches  can  also  be  done  on  a  once-a- 
month  basis  as  a  current  awareness 
service.  The  charge  for  this  service  is 
$  1 00  per  year. 

Canadian  nurses  will  undoubtedly 
make  use  of  MEDLARS  Services.  In 
doing  so,  nursing  research  and  studies, 
education  and  service  in  Canada  will 
benefit  accordingly.  ^ 


THE  CANADIAN   NURSE     47 


idea 
exchange 


Traveling  Maternity  Workshops 


In  the  spring  of  1970,  a  unique  series 
of  maternity  nursing  workshops  was 
held  in  Alberta.  Instead  of  inviting 
nurses  to  converge  upon  a  central  loca- 
tion, the  same  workshop  was  taken 
to  them  at  various  centers  through- 
out the  province.  The  series  was  co- 
sponsored  by  the  University  of  Alberta 
Continuing  Education  in  Nursing  and 
the  Alberta  department  of  public 
health,  under  the  provision  of  a  federal- 
provincial  grant.  (Project  Number 
608-13-11.) 

The  workshop  leader  in  all  centers 
was  the  coordinator  of  the  University 
of  Alberta's  advanced  practical  ob- 
stetrical course.  Because  of  the  diversity 
of  hospitals  in  the  various  sized  com- 
munities, content  was  made  pertinent 
by  including  resource  persons  from 
the  immediate  locale,  who  were  aware 
of  the  region's  problems. 

The  tlve-day  workshop,  divided 
into  four  days  of  theory  and  one  clin- 
ical day  was  to  provide  participants 
with  increased  knowledge  of  current 
concepts  in  maternal  and  newborn  care. 
Although  key  lectures  were  related 
to  new  concepts  and  trends  in  obstet- 
rics, the  central  focus  for  discussion 
was  on  nursing  principles. 

In  the  larger  centers,  groups  were 
deliberately  structured  to  allow  the 
maximum  amount  of  interchange  be- 
tween participants  from  the  different 
hospitals.  In  the  smaller  centers,  the 
workshops  were  less  structured  and, 
because  of  reduced  attendance,  much 
of  the  discussion  took  place  in  one 
48     THE  CANADIAN   NURSE 


group.  Exchanging  ideas  and  methods, 
learning  and  discussing  how  adapta- 
tions can  be  made  according  to  the 
various  working  environments,  and 
where  new  medical  knowledge  is  having 
effect  on  the  nurses'  activities,  were  the 
major  points  of  interest. 

The  workshops  were  specifically 
oriented  to  the  staff  nurse  and  the  nurse 
in  the  rural  hospital,  and  the  content 
was  arranged  so  problems  could  be 
ventilated,  possible  solutions  aired,  and 
some  of  the  cobwebs  of  routine  and 
lethargy  dusted  away.  An  aura  of  in- 
volvement and  an  eagerness  for  know- 
ledge created  a  stimulating  environment 
for  discussion. 

The  fourth  day  of  the  workshop  was 
spent  by  the  participants  as  observers 
in  the  clinical  area  of  local  hospitals. 
Without  the  pressures  of  time  or  the 
stress  of  multiple  duties,  the  nurses  were 
able  to  observe  care  being  given  and  to 
practice  interviewing  techniques  to  help 
them  assess  the  individual  patient's 
needs.  In  strange  environments,  the 
blinkers  of  routine  and  familiarity  were 
removed  and  the  total  picture  of  the 
individual  in  an  institutional  setting 
could  be  observed  objectively.  Short- 
comings were  seen  and  evaluated,  new 
ideas  were  examined  and  considered, 
and  high  quality  care  was  commended. 
Much  that  was  learned  in  the  clinical 
day  could  not  be  verbalized,  as  the 
experience  was  a  personal  reexamina- 
tion by  each  nurse  of  the  level  of  com- 
mitment to  quality  care. 

In  Alberta,  the  College  of  Physi- 


cians and  Surgeons  has  an  active  peri- 
natal mortality  committee.  Members 
of  the  committee  spoke  to  the  work- 
shop participants  about  perinatal  prob- 
lems, placing  particular  emphasis 
on  the  "high  risk"  baby.  The  physicians 
also  stressed  the  importance  of  com- 
munication, pointing  out  that,  given 
information  the  nurse,  often  the  one 
responsible  for  detecting  emergency 
situations  before  they  reach  the  hazar- 
dous level,  will  be  alert  to  the  potential 
problems  of  the  mother  and  her  infant. 

Alberta  nurses  have  been  enthusi- 
astic about  this  new  type  of  workshop. 
One  advantage  is  that  many  nurses  have 
been  reached  in  the  small  rural  hospi- 
tals, where  some  participants  might 
not  have  been  selected  to  attend  a  cen- 
tralized workshop,  and  others  could 
not  have  abondoned  their  home  com- 
mitments to  attend  an  out-of-town 
workshop.  The  reduction  in  traveling 
expenses  also  allowed  more  nurses 
from  the  same  institution  to  attend. 

Nurses  feel  the  need  for  this  type 
of  continuing  education.  They  want 
increased  knowledge  and  clinical  ex- 
pertise. We  hope  we  will  be  able  to 
answer  their  needs  by  conducting  more 
traveling  maternity  workshops  in  the 
future.  —  Pat  Hayes  is  Coordinator 
of  the  Advanced  Practical  Obstetric 
Program  at  the  University  of  Alberta, 
Edmonton.  ^ 


JANUARY  1»71 


k- 


February  1971 


The 


MRS         MT 

2368    MPWITOE    AVE^  

ONT  u^-^jOfc51 1 096 


Canadian 
Nurse 


sending  someone  to  a  conference? 
—  here  are  some  tips 

catchbasins^  debentures, 
subsidies,  and  garbage  cans  .... 


preadmission  orientation 
for  children 


A  NEW  WAY  TO  WEAR 


^ 


lAfHITE 
SISTER 


THE  PANT-A-WAY 


"SOPHISTICATION"  is  in  the  shirt  collar 
"Easily  shaped"  by  its  washable  bone  insets. 
Ottoman  designed  Fabric  attractively  placed  in 
a  placket  front  hidden  zipper  closing. 
Available  as  full  pant  dress  only.  Pants  — 
Elastic  waist,  flaire  bottoms  unhemmed  for 
individual  length  adjustment. 
#0248  —  "Luxura"  Fortrel  Polyester  Double 

Knit. 

White  only  at  S37.00 

Sizes  8-18 


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"PROFESSIONAL  ELEGANCE"  using  the  vogue- 
ish  front  wide  belt.  Back  zipper  closing. 
Available  as  full  pant  dress  only.  Pants  — 
Elastic  waist,  flaire  bottoms  unhemmed  for 
individual  length  adjustment. 
#0245  —  "Luxura"  Baby  Ottoman 

Fortrel  Polyester  Double  Knit 

White  only  at  $37.00 

Sizes  6-16 


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lai 


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A.,  a. 


wuiTC  cicTCD  iiMicriDM  iMr-    m  MniiMT  nnvAl    WP(:T   MONTREAL 


For  the  Nurse 
who  cares 
enough 
to  be 
involved . . . 


TEXTBOOK  OF  MEDICAL-SURGICAL  NURSING 

By  Lillian  S.  Brunner,  R.N.,  M.S., 

Charles  P.  Emerson,  Jr.,  M.D.,  L.  Kraeer  Ferguson,  M.D., 

and  Doris  S.  Suddarth,  R.N.,  M.S.N. 

Designed  to  develop  the  highest  degree  of  clinical 
expertise,  this  edition  emphasizes  the  pathophysiolo- 
gic/psychosocial factors  involved  in  patient  care. 
Included  is  entirely  new  or  expanded  material  on 
vascular/cardiac/ respiratory  intensive  care  nursing/ 
neurologic  and  neurosurgical  problems/ burns/gen- 
itourinary and  gynecologic  disorders/ rehabilitative 
measures. 

1031   Pages  387  Illustrations  2nd  Edition,  1970  $14.95 


Hew 

NURSING  IN  THE  CORONARY  CARE  UNIT 

By  LaVaughn  Sharp,  R.N.,  M.A., 
and  Beatrice  Rabin,  R.N. 

Concisely  written  by  well-qualified  authors  and  amply 
illustrated  with  graphs  and  charts,  this  timely  book 
guides  the  nurse  in  making  decisions  and  initiating 
appropriate  measures  for  optimum  care  of  the  co- 
ronary patient.  Coverage  encompasses  diagnostic 
measures,  including  interpretation  of  electronic  mon- 
itoring systems,  etiology,  treatment,  psychological  re- 
sponses, and  nursing  intervention  for  all  types  of 
conorary  artery  disease  —  vital  information  for  the 
student  or  graduate  who  may  be  required  to  func- 
tion as  a   nurse  clinician   in   the  CCU. 


BEHAVIORAL  CONCEPTS  and 
NURSING  INTERVENTION 

By  Carolyn  E.  Carlson,  R.N.,  M.S.,  Coordinator. 
With  Sixteen  Contributors. 

This  is  the  first  book  to  Identify  and  examine  in  depth 
relevant  concepts  from  the  behavorial  sciences  and 
to  demonstrate  their  application  to  nursing.  The  ma- 
terial in  this  pioneering  book  is  fresh,  original  and 
practical.  Content  provides  valuable  insight  into  the 
emotional  problems  of  illness  and  hospitalization  and 
their  influence  on  the  patient.  Chapter  subjects  range 
from  denial  of  illness,  empathy,  and  body  image 
through  ambivalence,  shame,  grief,  hostility,  and  con- 
trol of  the  nurse-patient  relationship. 


213   Pages 


89   Illustrations 


1970 


$8.25 


341    Pages 


1970 


Paperbound,  $5.50 
Clothbound,    $7.75 


J.  B.  LIPPINCOTT  COMPANY  OF  CANADA  LTD. 

60  FRONT  ST.  WEST 
TORONTO  1,  ONT. 


r 


Please  send  me  the  following  books: 

D      TEXTBOOK    OF   MEDICAL-SURGICAL    NURSING 

D      NURSING    IN    THE    CORONARY   CARE    UNIT 


$14.95 
8.25 


D      BEHAVORIAL    CONCEPTS    AND    NURSING    INTERVENTION D     Pap«rbound,  $5.50 

D      Clothboond,  7.75 


L 


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Address     

City   Province  .. 


n     Payment   enclosed  D     Charge   and   bill    me 

Lippincott    books    moy    be    returned    within    30    days    if    you 

are   not  fully   satisfied. 

CN  -  2-71 


FEBRUARY  1971 


THE  CANADIAN   NURSE        1 


SOME  STYLES  ALSO  AVAILABLE  IN  COLORS  .  .  .   SOME  STYLES  3I/2-I2  AAAA-E,  17.95  to  24.96 
For  a  complimentary  pair  of  white  shoelaces,  folder  showing  all  the  smart  Clinic  styles,  and  list  of  stores  selling  them,  write: 


THE  CLINIC  SHOEMAKERS 


Dept.   CN-2,   7912   Bonhomnne  Ave.    •    St.    Louis,   AAo.   63105 


The 

Canadian 
Nurse 


^ 

^^p 


A  monthly  journal  for  the  nurses  of  Canada  published 

in  English  and  French  editions  by  the  Canadian  Nurses'  Association 


Volume  67,  Number  2  February  1971 

25     A  Look  at  the  Francis  Report  on  the 
Status  of  Women  in  Canada 

27     Catchbasins,  Debentures,  Subsidies 

and  Garbage  Cans M.M.  Conroy 

29     Preadmission  Orientation  for  Children 

and  Parents M.J.  Brown 

32     Carotid  Artery  Stenosis  with  Transient 

Ischemic  Attacics G.  VanderZee 

36     Sending  Someone  to  a  Conference? 

Here  Are  Some  Tips A.  McKone  and  F.  Kuc 

38     The  Child  with  Hurler's  Syndrome M.  Brenchley 

40     Idea  Exchange M.  Schumacher,  C.  Koole 

42     Information  for  Authors 

The  views  expressed  in  the  various  articles  are  the  views  of  the  authors  and  do  not 
necessarily  represent  the  policies  or  views  of  the  Canadian  Nurses'  Association. 

4  Letters  7  News 

15  Names  18  New  Products 

22  In  a  Capsule  44  Research  Abstracts 

47  Books  50  AV  Aids 

52  Accession  List  54  Dates 

71  Index  to  Advertisers  72  Official  Directory 


Executive  Director:  Helen  K.  Mussallem  • 
Editor:  Virginia  A.  Lindabury  •  Assistant 
Editors:  Liv-Ellen  Lockeberg  •  Production 
Assistant:  Elizabeth  A.  Slanlon  •  Circula- 
tion Manager:  Bcrjl  Darling  •  Advertising 
Manager:  Ruth  H.  Baumel  •  Subscrip- 
tion Rates:  Canada:  one  year,  S4.50;  two 
years,  $8.00.  Foreign:  one  year,  $5.00;  two 
years,  $9.00.  Single  copies:  50  cents  each. 
Make  cheques  or  money  orders  payable  to  the 
Canadian  Nurses'  Association.  •  Change  of 
Address:  Six  weeks'  notice;  the  old  address  as 
well  as  the  new  are  necessary,  together  with 
registration  number  in  a  provincial  nurses' 
association,  where  applicable.  Not  responsible 
for  journals  lost  in  mail  due  to  errors  in 
address. 


Manuscript     Information:     "The     Canadian 

Nurse"  welcomes  unsolicited  articles.  All 
manuscripts  should  be  typed,  double-spaced, 
on  one  side  of  unruled  paper  leaving  wide 
margins.  Manuscripts  are  accepted  for  review 
for  exclusive  publication.  The  editor  reserves 
the  right  to  make  the  usual  editorial  changes. 
Photographs  (glossy  prints)  and  graphs  and 
diagrams  (drawn  in  india  ink  on  while  paper) 
are  welcomed  with  such  articles.  The  editor 
is  not  committed  to  publish  all  articles 
sent,  nor  to  indicate  definite  dates  of 
publication. 

Postage    paid    in    cash    at    third    class    rate 

MONTREAL,     P.O.     Permit     No.     10,001. 

50     The     Driveway,     Ottawa     4,     Ontario. 

Canadian  Nurses'  Association   1971. 


Editorial 


FEBRUARY  1971 


In  1967,  the  setting  up  of  a  Royal 
Commission  to  investigate  the  status 
of  women  in  Canada  gave  the  news 
media  a  heyday:  editorials  ridiculing 
the  investigation  appeared  in  almost 
every  newspaper;  television  commen- 
tators made  facetious  remarks  and 
were  anything  but  straight-faced  in 
their  reporting  —  in  fact,  few  tried 
to  hide  their  belief  that  the  Commissio 
was  a  big  joke,  something  that  would 
be  costly,  yet  immaterial;  cartoonists 
got  out  their  drawing  boards  —  the 
same  ones  used  by  their  predecessors 
when  women  were  struggling  to  achiev 
franchise  —  and  depicted  women  as 
farcical,  masculine  figures  trying  to 
take  over  the  male  role  in  society. 

But  the  news  media  were  not  alone 
in  deriding  the  Commission  and  its 
objectives.  Few  persons,  including 
politicians,  took  the  issue  of  women's 
rights  seriously;  men  joked  about  it, 
either  because  they  were  so  entrenched 
in  their  thinking  that  they  saw  no 
discrimination  or  because  they  wished 
to  maintain  the  status  quo;  and  women 
seemed  embarrassed  to  discuss  it, 
probably  because  they  feared  they 
would  be  labeled  "aggressive  females" 
by  the  opposite  sex. 

Well,  the  joke  is  over.  Anyone 
who  has  read  the  Commission's  digni- 
fied and  lucid  report  and  still  believes 
women  are  not  discriminated  against 
in  our  so-called  "just  society"  is  either 
a  dyed-in-the-wool  preserver  of  injus- 
tice or  a  victim  of  myopia.  But  how 
many  have  read  it?  Judging  from  the 
apathetic  response  to  the  report,  the 
answer  must  be  "few." 

Every  nurse  should  read  this  report 
(available  from  Information  Canada, 
Ottawa,  or  from  any  bookdealer  for 
$4.50),  react  to  it,  and  send  her  or  his 
response  to  members  of  parliament 
and  to  the  prime  minister.  As  the 
Commissioners  state:  "At  issue  is  the 
opportunity  to  construct  a  human 
society  free  of  a  major  injustice  which 
has  been  part  of  history  ....  Men,  as 
well  as  women,  would  benetit  from  a 
society  where  roles  are  less  rigidly 
defined "  —  V.A.L. 

THE  CANADIAN   NURSE       3 


letters    { 


Letters  to  the  editor  are  welcome. 

Only  signed  letters  will  be  considered  for  publication,  but 

name  will  be  withheld  at  the  writer's  request. 


Your  help  is  needed 

With  the  use,  in  1 97 1 ,  of  the  new  stand- 
ard registration  form  by  all  professional 
nurses'  licencing  boards  in  Canada, 
we  will  have  a  considerable  amount  of 
statistical  information  on  nurses  that 
was  not  previously  available.  The  addi- 
tional data  stemming  from  the  new 
form  will  make  it  possible  for  us  to  add 
substantially  to  our  knowledge  about 
nursing  manpower  resources  in  this 
country. 

The  data  should  provide  a  much 
more  accurate  and  detailed  picture  of 
the  composition  of  our  nursing  force 
than  we  have  had  before.  In  addition, 
it  should  be  possible  to  study  in  greater 
detail  several  facets  of  the  career  pat- 
terns of  professional  nurses  that  will 
assist  us  in  the  development  of  future 
planning  with  respect  to  our  nursing 
resources.  The  factors  we  are  particu- 
larly interested  in  as  having  a  signifi- 
cant bearing  on  planning  are  attrition, 
mobility,  and  average  working  life  of 
the  professional  nurse. 

We  would  greatly  appreciate  it,  if 
each  nurse  would  fill  in  the  informa- 
tion requested  as  completely  and  accu- 
rately as  possible.  The  social  insurance 
number  is  particularly  important  in 
studying  career  patterns  of  nurses  and 
therefore,  we  would  ask  everyone  to 
please  be  sure  to  include  her  correct 
number. 

The  results  of  these  studies  should 
be  interesting  and  of  value  to  each 
nurse  in  Canada.  —  Dr.  Beverly  Du- 
Gas,  Nursing  Consultant,  Dept.  of  Na- 
tional Health  &  Welfare,  and  Rose 
Imai,  Research  Officer,  Canadian 
Nurses'  Association. 


Nurse  makes  comeback 

1  was  prompted  to  write  to  The  Cana- 
dian Nurse  after  reading  the  letter  to 
the  editor,  "Part-time  nurse  disillusion- 
ed," from  R.N.,  Quebec  (Sept.  1970). 

I,  too,  came  back  to  nursing  —  not 
after  one  year  when  medications  and 
procedures  were  still  fresh  in  my  mind, 
but  after  14  years.  I  had  no  knowledge 
of  the  different  types  of  drugs  used,  as 
in  my  day  a  patient  was  cured  with 
aspirin,  sulpha,  and  sodium  bicarbonate. 

When  I  returned  to  work  it  took  a 
while  to  realize  that  Sparine  and  pro- 
mazine were  the  same  drug.  Once  I 
finally  learned  to  say  "dihydrostrep 
tomycin"  without  stuttering,  it  was 
removed     from     the     market.     Even 

4       THE  CANADIAN   NURSE 


medical  terms  were  vague.  When  one 
doctor  asked  me  if  his  patient  was 
having  melena,  I  replied  that  I  didn't 
know  as  I  was  on  medications. 

I  have  worked  in  two  hospitals  in 
the  1 1  years  since  I  returned  to  nursing. 
Both  have  offered  excellent  inservice 
programs.  I  have  also  been  fortunate  in 
having  a  head  nurse  who  had  also  been 
away  from  nursing  and  recognized  my 
plight,  and  instructors  and  supervisors 
who  answered  hundreds  of  my  ques- 
tions courteously. 

There  are  times  when  nurses  resent 
a  new  employee  offering  suggestions. 
There  are  also  time  when  the  word 
"part  time"  sounds  so  alien.  However, 
I  have  worked  toward  the  goal  of  being 
respected  as  a  part-time  nurse  who  did 
a  good  day's  work  with  a  smile  because 
she  liked  what  she  was  doing. 

One  thing  that  is  never  outdated  is  a 
nurse's  ability  to  give  good  nursing  care. 
When  I  returned  to  nursing  I  may  have 
been  outdated  as  far  as  procedures  and 
drugs  were  concerned,  but  I  had  14 
years  of  living  experience  that  was 
extremely  useful  in  many  instances 
when  patients  needed  someone  to 
listen.  —  M.  Doreen  Stewart,  Reg.  N., 
Chatham,  Ontario. 


Mistakes,  maybe  —  perfection,  a  must 

I  am  deeply  indebted  to  Dorothy  S. 
Starr  for  her  article  "Students  Have  a 
Right  to  Make  Mistakes"  (Dec.  1970). 
It  is,  however,  unfortunate  that  she 
places  so  much  emphasis  on  the  right 
of  students  to  fail  and,  at  the  same 
time,  writes  so  negatively  of  present 
nursing  practice. 

Surely  all  nursing  is  a  process  of 
problem-solving  and,  consequently, 
all  nurses  are  learners.  Are  not  divisions 
false?  The  onus  of  responsibility  is 
unquestionably  on  the  curriculum 
developer  and/or  the  clinical  instructor 
to:  (a)  select  experiences  appropriate 
to  the  students'  needs  and  capabilities, 
and  prior  to  these  experiences,  make 
available  sufficient  information  and 
establish  the  related  principles  to  allow 


Letters  Welcome 

Letters  to  the  editor  are  welcome.  Be- 
cause of  space  limitation,  writers  are 
aSked  to  restrict  their  letters  to  a 
maxunum  of  350  words. 


formulation  of  an  acceptable  solution: 
and  (b)  intervene  when  the  students 
selection  and/or  combination  of  data 
appears  to  be  leading  to  a  solution 
incompatible  with  safe  care  —  this 
is  the  patient's  right. 

Again,  even  in  our  most  routine 
tasks,  there  is  room  for  creativity,  i.e. 
not  merely  to  see  the  situation  as  it 
really  is,  but  to  see  it  as  it  might  be- 
come and  then  to  intervene  appro- 
priately. This  reality  of  the  situation, 
the  first  essential  phase  of  the  process 
of  creativity,  often  appears  to  rank 
low    in   the   minds  of  our  educators. 

Would-be  nurses  must  learn  to  accept 
a  difficult  and  demanding  role,  and  it 
is  best  to  begin  early.  Teachers,  minis- 
ters, and  others  to  whom  Mrs.  Starr 
refers,  do  indeed  affect  some  aspects 
of  the  care  for  human  life,  but  the  nurse 
is  concerned  with  nothing  less  than 
that  very  life  itself. 

Mistakes  do  occur  —  they  are  not 
only  acknowledged,  they  are  recorded. 
A  current  example  is  the  recording  by 
nurses  on  the  various  units  of  what  is 
seen,  heard,  or  done.  Auditors  then 
study  these  data,  attempt  to  solve 
presenting  problems  in  a  scientific 
manner,  and  continue  the  develop- 
ment of  a  better  nursing  program. 

Therefore,  in  my  opinion,  despite 
the  human  frailities  of  its  practitioners 
and  would-be  practitioners,  nursing  is 
a  one-way  street,  and  its  direction  is 
clearly  toward  perfection.  —  G.  Mid- 
dleton,  R.N.,  M.  Sc.  (A),  Ottawa: 


Are  we  for  life  or  death? 

The  recent  controversy  over  the  liber- 
alization of  abortion  legislation  is  but 
one  of  the  many  conflicts  of  contem- 
porary life.  As  such,  it  is  impossible 
to  understand  it  apart  from  some  of 
the  deeper  issues  that  challenge  civi- 
lization at  its  very  roots. 

If  one  scans  the  literature  or  at- 
tempts to  analyze  the  experience  of 
daily  living,  one  observes  on  all  fronts 
a  value  crisis.  This  phenomenon  repre- 
sents a  pattern  of  valuelessness,  a  sense 
of  emptiness,  a  lack  of  purpose,  a 
desperate  quest  for  meaning,  and  some- 
times an  unending  search  for  pleasur- 
able fascinations  both  cognitive  and 
appetitive. 

Certain  pervasive  outlooks  devel- 
oping over  the  past  four  centuries  seem 
relevant   to   the   present   value  crisis. 

FEBRUARY  1971 


They  are:  naturalism,  which,  in  its 
modern  version,  tends  to  deny  the 
existence  of  an  order  transcending 
nature  and  sense  experience;  atheism, 
a  mass  phenomenon  which  seeks  in  the 
denial  of  God  the  total  affirmation  of 
man;  and  humanism,  which  sees  man, 
himself  matter,  a  product  of  blind  ma- 
terial forces.  It  is  not  surprising,  that 
these  movements,  which  have  penetrat- 
ed every  facet  of  our  culture,  have 
influenced  our  value  systems  and, 
consequently,  the  manner  in  which  we 
approach  everyday  problems  includ- 
ing the  present  one  of  abortion. 

1  he  value  we  place  on  human  life 
is  an  expression  of  the  value  we  place 
on  the  human  person.  If  we  view  real- 
ity from  a  naturalistic,  materialistic 
humanism,  man  can  be  seen  merely 
as  a  "biological  organism,"  or  a  com- 
plex "electrodynamic  field."  If  our 
fundamental  premises  are  atheistic, 
we  allow  ourselves  the  right  to  create 
and  destroy  at  will  without  accounta- 
bility to  any  being  outside  of  or  greater 
than  ourselves.  If  we  allow  for  a  spir- 
itual, transcendent  dimension,  we  be- 
lieve that  man  has  a  principle  of  life 
that  is  a  share  in  the  divine  life.  In  this 
latter  context,  man  possesses  a  charac- 
ter of  mystery  and  a  dignity  that  evokes 
a  natural  human  response  of  reverence. 

The  right  to  life  is  one  of  the  funda- 
mental values  on  which  Western  so- 
ciety has  been  built.  Through  its  laws, 
society  has  sought  to  protect  the  right 
of  human  life  from  the  moment  of 
conception  to  the  moment  of  death. 
We  are  called  on  today  to  support  or 
not  to  support  these  laws  that  serve  as 
guardians  of  our  most  cherished  rights 
and  freedoms. 

In  this  present  controversy,  is  it 
possible  that  the  profession  of  nursing, 
with  its  life-long  tradition  of  reverence 
for  the  dignity  of  the  human  person, 
will  opt  for  a  decision  that  makes  pre- 
natal euthanasia  legally  and  culturally 
acceptable?  If  we  exercise  this  terrible 
freedom  loosely,  what  shall  be  our 
response  when  asked  to  support  the 
destruction  of  "unwanted"  older  citi- 
zens, misfits,  or  defectives?  In  either 
case,  the  same  human  life  and  the  same 
human  freedom  are  at  stake. 

The  Code  of  Ethics  of  the  Interna- 
tional Council  of  Nurses  begins  by 
asserting  that  the  fundamental  respon- 
sibility of  the  nurse  is  threefold:  "...  to 
conserve  life,  to  alleviate  suffering  and 
to  promote  health."  Under  the  guise  of 
alleviating  suffering,  it  would  seem  that 
some  of  us  assent  to  the  destruction  of 
life.  Perhaps  we  need  to  reflect  more 
on  our  ethical  responsibilities.  Shall 
we  opt  for  professional  ideals  or  deca- 
dence? —  Sister  Marie  Simone  Roach, 
Acting  Chairman,  Nursing  Department, 
St.  Francis  Xavier  University,  Anti- 
gonish.  Nova  Scotia.  '& 

FEBRUARY  1971 


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THE  CANADIAN   NURSE       5 


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news 


RNs  React  To  Abortion  Issue: 
Agree  CNA  Should  Take  Stand 


Ottawa  —  At  its  annual  convention 
last  June,  the  Canadian  Psychiatric 
Association  took  the  jxjsition  that  the 
matter  of  termination  of  pregnancy 
should  be  removed  from  the  Criminal 
Code  of  Canada.  It  was  the  first  Cana- 
dian medical  body  to  state  that  abor- 
tion should  become  strictly  a  medical 
procedure  to  be  decided  by  the  woman 
and  her  husband,  if  she  has  one,  along 
with  the  physician. 

Under  the  present  Code,  a  hospital 
committee  of  three  doctors  is  required 
to  decide  whether  a  patient  will  have 
a  legal  abortion. 

The  Canadian  Nurse  telephoned 
nurses  across  the  country  to  ask  if  they 
agreed  with  the  CPA  stand  and  if  they 
thought  the  Canadian  Nurses"  Associa- 
tion should  take  z  similar  stand.  Giving 
their  opinions  were  nurses  working  in 
many  fields  —  public  health,  educa- 
tion, psychiatry,  gynecology,  and  oper- 
ating rooms. 

Reactions  to  the  CPA  stand  ranged 
from,  "most  definitely  I  agree"  to  "I 
can't  imagine  why  it  wasn't  removed 
from  the  Criminal  Code  a  long  time 
ago,"  to  "I  agree  with  part  of  it."  All 
nurses  who  were  interviewed  agreed 
abortion  should  be  removed  from  the 
Criminal  Code. 

Deidre  A.  Giles,  instructor,  family 
care,  patient  care  services,  British 
Columbia  Institute  of  Technology, 
Burnaby,  British  Columbia,  said, 
"Prohibitive  laws  are  often  inconsistent 
with  human  behavior,  as  in  our  present 
abortion  law,  which  causes  more  tragedy 
than  the  tragedy  of  abortion  itself." 

Though  she  does  not  support  abor- 
tion as  a  means  of  birth  control.  Miss 
Giles  said:  "The  problem  seems  to  be 
out  of  proportion  because  of  the  appal- 
ling lack  of  educational  and  service 
resources  for  family  planning.  Many 
men  and  women  do  not  practice  respon- 
sible reproduction  because  of  fear, 
timidity,  ignorance,  or  poverty." 

FEBRUARY  1971 


Two  nurses  from  the  Red  Deer  Gen- 
eral Hospital,  Red  Deer.  Alberta, 
Esther  Thorson,  associate  director  of 
special  services  and  Audrey  Thomp- 
son, clinical  coordinator,  said  the  ther- 
apeutic abortion  committee  is  unnec- 
essary. "The  attending  physician  knows 
the  woman  for  whom  he  is  asking  ap- 
proval for  a  therapeutic  abortion.  He 
is  in  a  better  position  to  make  a  judg- 
ment on  the  appropriateness  of  the 
procedure  than  members  of  the  com- 
mittee." 

They  said  physicians  on  the  com- 
mittee are  notified  of  the  reasons  by 
the  patient's  physician.  "Whether  or 
not  approval  is  given  could  depend  on 
how  articulate  the  attending  physician 
is." 

Citing  the  present  procedure  as  dis- 
criminatory, they  said  the  woman  with 
access  to  information  about  the  pro- 
cedure for  securing  a  therapeutic  abor- 
tion and  who  can  afford  to  visit  a  num- 
ber of  physicians  if  necessary,  is  an 
upper  or  middle  class  Caucasian.  "Yet 
the  woman  often  in  need  ot  a  therapeu- 
tic abortion  is  not  a  member  of  these 
groups,"  said  Miss  Thompson  and  Miss 
Thorson. 

Dorothy  Aitken,  supervisor  of 
gynecology  at  Victoria  General  Hos- 
pital in  Halifax,  Nova  Scotia,  supports 
the  CPA  stand  up  to  a  point.  "We  should 
have  some  sort  of  control  until  we  have 
better  facilities.  Our  problem  is  that 
so  many  abortions  are  approved  by 
the  committee  and  we  don't  have  the 
facilities.  We  have  a  waiting  list  and 
this  is  bad. 

"We  are  trying  abortion  on  an  out- 
patient basis,  but  now  the  operating 
room  has  the  problem  of  a  backlog.  A 
{xjssible  answer  might  be  clinics  set 
up  for  the  purpose,"  she  said. 

Sister  T.  Castonguay,  director  of 
nursing  service  at  St.  Boniface  Gen- 
eral Hospital,  St.  Boniface,  Manitoba, 
said,   "Since  there  is  a  medical  and 


moral  component  to  the  decision,  I 
would  add  to  the  CPA  statement  that 
both  the  physician  and  spiritual  or 
moral  adviser  should  be  involved  in 
helping  the  woman  and  her  husband, 
if  she  has  one,  come  to  this  decision." 

Also  wanting  to  see  a  religious  per- 
son involved  is  a  nurse  from  St.  Mary's 
Hospital,  Montreal,  Quebec.  She  be- 
lieves the  committee  system  should  be 
retained  because,  "there  should  be 
consultation  in  each  case  as  abortion 
is  such  an  individual  thing.  The  com- 
mittee should  be  composed  of  doctors 
and  a  religious  person." 

Taking  the  opposite  view  —  that 
the  committee  be  eliminated  —  is 
France  St.  Martin,  head  nurse  in  the 
operating  room  at  the  Jewish  General 
Hospital,  Montreal.  She  said,  "Abortion 
procedures  are  safer  when  done  as 
soon  as  pxjssible  and  the  committee 
delays  things."  In  her  job  at  a  large 
metropolitan  hospital  she  often  sees 
the  results  of  illegal  abortion.  "People 
are  forced  to  use  illegal  methods  because 
they  don't  have  a  doctor  who  will  apply 
to  the  committee,  or  they  were  turned 
down,  or  they  were  too  late,  so  they 
resort  to  something  else." 

Also  pointing  out  flaws  in  the  com- 
mittee system  was  Dorothy  Burwell, 
director  of  nursing  service  at  the  Clarke 
Institute  of  Psychiatry  in  Toronto  and 
associate  professor  of  psychiatric  nurs- 
ing at  the  University  of  Toronto.  She 
said:  "I  hear  all  the  wrangling  that 
goes  on.  Our  patients  go  through  two 
committees,  one  here  at  the  Institute 
and  one  at  the  Toronto  General  Hospi- 
tal. How  many  committees  should  a 
woman  have  to  appeal  to?  Actually, 
the  woman  doesn't  appear  before  the 
committee,  she  really  has  no  say.  I  think 
that's  ethically  wrong. 

"There  still  is  a  lot  of  guilt  attached 
to  abortion,"  Mrs.  Burwell  said.  "So 
many  patients,  even  those  who  have 
had  a  therapeutic  abortion,  say  to  me, 
'abortion  is  still  in  the  Criminal  Code, 
so  I'm  a  criminal.'  We're  loading  more 
emotional  baggage  on  the  patient. 

"I  think  society  should  take  another 
look  at  the  unwanted  child,"  she  said. 
"In  psychiatry  I  see  so  many  of  these 
children  ending  up  as  wards  of  the 
state.  Society  makes  it  a  criminal  offense 
to  have  an  abortion  and  thus  commits 
a  crime  against  the  child." 

(Conlinued  on  page  12) 
THE  CANADIAN   NURSE       7 


CNA  Holds  Annual  Meeting 
in  Ottawa  Next  Month 

Ottawa — In  conformity  with  its  Let- 
ters Patent,  issued  July  1970,  and  By- 
laws, the  annual  meeting  of  the  Cana- 
dian Nurses'  Association  will  be  held 
March  31,  1971,  in  the  Chateau  Lau- 
rier,  Ottawa. 

Previously,  under  its  former  Act  of 
Incorporation  and  Bylaws,  the  Asso- 
ciation held  a  general  meeting  biennial- 
ly, and  combined  business  sessions, 
general  interest  sessions,  and  social 
events.  Activities  were  reported  and 
administrative  affairs  discussed  at 
the  business  sessions. 

The  board  of  directors,  while  be- 
lieving the  members  favor  the  contin- 
uance of  this  convention-type  of  meet- 
ing biennially,  realize  such  an  annual 
undertaking  would  be  inadvisable  at 
this  time.  Therefore,  the  annual  meet- 
ing in  1971  will  be  a  one-day  business 
meeting  on  March  31,  in  Ottawa;  the 
1972  annual  meeting  will  be  held  in 
Edmonton  in  June  and  combined  with 
general  interest  sessions  and  social 
events.  The  officers  are  elected  for  a 
term  of  two  years  and  the  next  election 
will  be  held  in  June  1972  in  Edmonton. 

Any  CNA  member  may  attend  the 
annual  meeting  on  March  3 1  and  each 
provincial  association  member  will  be 
represented  by  its  appointed  voting 
delegates.  The  total  votes  for  each  as- 
sociation member  are  based  on  its 
membership  at  December  31  immedi- 
ately preceding  the  annual  meeting.  The 
appointed  voting  delegates  are  the 
voting  body  for  an  annual  meeting. 

There  will  be  no  registration  fee 
for  the  1971  annual  meeting,  and  pres- 
entation of  a  current  provincial  mem- 
bership card  will  be  required  for  ad- 
mission. 

CNA  Board  Nominates 
Candidate  For  ICN  3-M  Award 

Ottawa — Jocelyne  Nielson  is  the 
nominee  of  the  Canadian  Nurses'  .Asso- 
ciation for  this  year's  ICN  3-M  Fel- 
lowship. The  CNA  board  of  directors, 
meeting  in  October  1970,  approved 
her  nomination. 

The  $6,000  fellowship  offered  by 
the  3M  Company  is  awarded  annually 
to  a  nurse  selected  by  the  International 
Council  of  Nurses  from  nomirices  pro- 
posed by  national  nursing  associations. 
The  award  is  used  for  formal  study  in 
the  nurse's  chosen  field. 

Mrs.  Nielson,  formerly  of  Montreal, 
was   awarded   the   Dr.    Katherine   E 
MacLaggan  fellowship  by  the  Canadian 
Nurses'   Foundation   in    1970  and   is 
8       THE  CANADIAN   NURSE 


studying  for  a  doctoral  degree,  major- 
ing in  psychology,  at  the  University 
of  California  School  of  Nursing. 

The  conditions  of  acceptance  of 
nomination  set  by  the  CNA  board  are: 

"If  a  Canadian  recipient  of  the  ICN 
3-M  Fellowship  receives  the  award 
during  the  term  for  which  a  CNF  fel- 
lowship has  been  accepted  by  that 
recipient,  the  second  installment  of  the 
CNF  fellowship  will  be  withheld  by 
the  Foundation,  or,  if  that  second  in- 
stallment has  been  remitted  it  shall  be 
refunded  to  the  foundation  upon  receipt 
of  the  3-M  fellowship; 

"And  a  recipient  of  an  ICN  3-M 
fellowship  may  not  reapply  for  a  CNF 
fellowship  for  the  same  program  of 
study  for  which  a  3-M  award  has  been 
accepted." 

The  criteria  for  nomination  also  set 
by  the  CNA  board  are: 

"The  CNA  nominee  for  the  ICN  3-M 
fellowship  should  be  a  recipient  of  a 
CNF  award  for  the  final  year  of  study 
for  a  master's  degree  or  for  study 
toward  a  doctoral  degree  who:  1 .  is 
under  50  years  of  age;  2.  has  been 
employed  in  nursing  in  Canada  for 
not  less  than  five  years;  3.  has  demon- 
strated concern  and  has  participated 
in  the  promotion  of  the  profession; 
4.  is  free  of  employment  commitments 
and  desires  to  continue  advanced  study 
in  nursing  with  the  current  year;  5. 
will  return  to  employment  in  Canada 
for  a  minimum  of  2  years;  6.  in  the 
opinion  of  the  selections  committee 
has  the  potential  to  give  outstanding 
leadership  in  nursing  in  Canada." 

Each  national  nursing  association 
was  asked  by  ICN  to  develop  its  own 
criteria  for  acceptance  of  nomination. 
The  CNA  criteria  does  not  conflict  with 
or  duplicate  the  ICN  criteria. 

RNAO  Removes  Greylisting 

Of  Scarborough  Health  Department 

Toronto,  Ont.  —  With  the  settling  of 
the  two-month  strike  of  Scarborough 


Official  Notice 

of 

CNA  Annual  Meeting 

The  annual  meeting  of  Canadian 
Nurses'  Association  will  be  held 
Wednesday  March  31,  1971,  in  the 
Ballroom,  Chateau  Laurier  Hotel, 
Ottawa,  Ontario,  commencing  at 
0900  hours.  Ordinary  members  of 
Canadian  Nurses'  Association  are 
eligible  to  attend  the  annual  meeting. 
Guests  may  attend  on  invitation  by 
the  President  and/or  Board  of  Di 
rectors.  (Reference  —  Rules  and 
Regulations,  Section  38.)  Presenta- 
tion of  a  current  provincial  member- 
ship card  will  be  required  for  admis- 
sion. —  Helen  K.  Mussallem,  Execu- 
tive Director,  CNA . 


public  health  nurses  in  mid-December, 
the  Registered  Nurses'  Association  of 
Ontario  has  lifted  its  greylisting  of  the 
Scarborough  Health  Department. 

The  nurses  gained  what  has  been 
called  a  "partial  victory"  in  the  two 
issues  that  caused  them  to  strike.  Car 
allowances  have  been  increased  to 
$45.50  from  an  average  of  $25  a  month. 
Those  who  drive  between  2,000  and 
3,000  miles  per  month  will  receive 
$49.50,  and  those  between  3,000  and 
4,000  will  get  $53.50. 

The  other  main  issue,  vacation  leave, 
was  settled  at  four  weeks  vacation  after 
15  years  of  service  although  they  had 
asked  for  four  weeks  after  one  year  of 
service.  The  RNAO  says  the  majority 
of  public  health  nurses  in  Ontario 
receive  such  vacation  time. 

The  Scarborough  nurses  also  receive 
a  salary  increase  of  10  percent  for  1970 
and  an  additional  8  percent  for  1971. 
Their  salary  before  increases  ranged 
from  $6,423  to  $7,577  for  a  nurse 
with  a  public  health  diploma  or  a 
bachelor  of  science  in  nursing.  The 
new  contract  also  improves  their  health 
benefits  plan. 

Cost  Is  Minimal  To  improve 
Street  Safety  After  Dark 

Vancouver,  B.C.  —  Preventive  meas- 
ures to  improve  street  safety  conditions 
after  dark  have  been  recommended  in 
a  study  report  on  the  travel  problems 
of  hospital  employees  working  night 
shifts.  The  study  was  sponsored  jointly 
by  the  Registered  Nurses'  Association 
of  British  Columbia,  the  British  Co- 
lumbia Hospitals'  Association,  the 
Hospital  Employees  Union,  and  the 
Psychiatric  Nurses  Association. 

The  findings  indicate  many  hospital 
workers  are  exposed  to  the  dangers  of 
darkened  streets  when  coming  off  late 
afternoon  shifts  and  going  on  night 
shifts,  reported  Dr.  Nirmala  d.  Cheru- 
kupalle,  assistant  professor,  school  of 
community  and  regional  planning, 
UBC,  who  did  the  study.  Many  workers 
reported  feeling  fear  when  traveling  to 
and  from  work  at  late  hours,  she  said. 

Improved  street  lighting  and  parking 
conditions,  patrolled  areas  around 
major  metropolitan  hospitals,  and  par- 
tially subsidized  transportation  are 
among  the  recommendations  made  to 
solve  travel  problems  of  such  em- 
ployees. Dr.  Cherukupalle  said  reme- 
dies for  street  safety  problems  could 
be  implemented  at  a  minimal  cost  by 
individual  hospitals  and  city  or  munic- 
ipal governments.  Residents  could  be 
asked  to  leave  their  front  porch  lights 
on  in  badly  lighted  districts. 

"While  the  study  was  confined  to 

hospital  employees,  we  are  concerned 

with  the  safety  of  all  citizens  whose 

work  requires  that  they  be  on  the  streets 

(Continued  on  page  10) 

FEBRUARY  1971 


M 


Three  good  reasons 
for  starting  your  next 
I.V.  procedure  with  a 

BUTTERFLY* 
Infusion  Set 


r 


Smoother,  Easier  Venipuncture:  Butterfly  "wings" 
give  you  a  built-in  needle  holder.  Fold  them  upward 
and  you  have  a  firm,  double  ghpping  surface.  You 
can  manipulate  freely  and  accurately.  You  have 
excellent  control  over  entry  .  . .  smooth  positive 
penetration  on  good  veins  ...  far  less  trouble  with 
difficult  or  hard-to-find  veins.  The  super-sharp  needle 
slides  through  tissue  with  a  keenness  you  can  "feel ". 

Increased  Security:  Release  the  "wings"  after 
venipuncture  and  they  fold  back  flat  against  the 
patient's  skin.  Thus  you  have  a  ready-made  anchor 
surface.  Two  strips  of  tape  over  the  wings  usually 
suffice  for  complete  needle  immobilization  . .  . 
often  W/7/70U/ armboard  restraint. 

A  Size  For  Every  I.V.  Need:  There  are  two  Butterfly 
Infusion  Sets  for  general-purpose  fluids  administration, 
two  for  pediatric  and  geriatric  use,  one  expressly 
designed  for  O.R.  and  recovery  or  emergency  room 
requirements  . . .  and  the  Butterfly-19.  INT  and 
Butterfly-21 ,  INT,  with  Reseal  Injection  Site,  for 
INTermittent  I.V,  therapy. 


I  uaoTT  ■  Ask  your  Abbott  representative  to  show 
you  the  whole  collection 


901109 


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r\]  riv  ^ 


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news 


(Continued  from  page  8) 

after  dark,"  said  Monica  Angus,  pres- 
ident of  the  RNABC,  which  initiated 
the  study.  "Many  of  the  recommenda- 
tions in  the  report  could  be  applied  to 
other  groups  of  workers,"  she  said. 

The  report  is  being  studied  by  the 
boards  of  the  sponsoring  organizations 
to  determine  the  kind  of  joint  action 
that  could  be  taken  to  promote  imple- 
mentation of  the  recommendations. 

NBARN  Gives  Brief 
To  Study  Committee 

Fredericton,  N.B.  —  The  provincial 
government's  study  committee  on  nurs- 
ing education  received  a  brief  from  the 
New  Brunswick  Association  of  Regis- 
tered Nurses  in  December 

Harriett  Hayes,  NBARN  president, 
said  the  association's  proposals  would 
improve  nursing  education  for  the 
future.  The  brief  details  inadequacies 
of  the  present  system  and  their  causes. 

The  study  committee  is  looking  into 
all  aspects  of  nursing  education. 
NBARN  hopes  the  committee's  find- 
ings will  result  in  desirable  changes  in 
nursing  education. 

Nurses'  Needs  And  Wants 
Turn  Them  To  Group  Action 

Hamilton,  Ont.  —  The  organization  of 
nurses  for  collective  bargaining  in- 
dicates feelings  of  dissatisfaction.  Dr. 
V.V.  Murray,  associate  professor,  facul- 
ty of  administrative  studies,  York  Uni- 
versity, told  100  administrative  nurses 
attending  an  October  workshop. 

"One  reason  for  organization  is 
feelings  of  dissatisfaction,  feelings  of 
rather  wide-spread  dissatisfaction. 
I  might  add  that  many  people  say  this 
is  the  main  reason.  This  is  not  the 
main  reason  because  people  get  dissa- 
tisfied and  don't  organize,"  he  said. 

"Dissatisfaction  is  a  function,  first 
of  all,  of  what  is  important  to  you  on 
the  job.  Why  are  you  working?  What 
is  the  main  thing  in  your  work  life?" 

Professor  Murray  listed  things 
people  find  important,  such  as  money, 
autonomy  on  the  job,  interesting  work, 
job  security,  opportunity  for  promo- 
tion, congenial  co-workers. 

"Three  things  influence  what  is 
important:  personal  needs,  societal  val- 
ues, and  influences  within  the  organi- 
zation. Among  personal  things  which 
seem  important  are  age,  the  generation 
gap,  education,  and  marital  status. 

"The  younger  generation  tends  to 
be  more  concerned  about  autonomy, 
freedom  to  use  nursing  diagnosis,  and 
to  work  as  a  team.  They  feel  antipathy 

10     THE  CANADIAN   NURS£ 


to  authority.  They  want  an  ability  to 
use  applied  principles  without  au- 
thority bearing  down  on  them  at  every 
point,"  he  said. 

Professor  Murray  feels  marital 
status  is  perhaps  more  important  than 
age  in  determining  a  person's  working 
needs.  Married  nurses  want  flexible 
hours  or  maybe  only  day  shifts.  "This 
can  be  hard  to  accommodate  in  terms 
of  rotating  shifts,"  he  said. 
Outlining  some  of  the  reasons  why 
small  hospitals  get  organized  tlrst,  he 
said,  "they  have  a  staff  of  married 
people  who  are  stuck  in  the  community 
and  their  choice  of  employment  is 
limited.  If  dissatisfaction  is  high,  then 
their  only  choice  appears  to  be  to 
organize. 

"Certain  needs  are  amenable  to 
being  satisfied  through  the  union 
process,  particularly  those  involving 
the  economic  side,"  said  Professor  Mur- 
ray. 

Another  speaker  at  the  workshop 
was  Dr.  F.  Isbester,  associate  profes- 
sor, industrial  relations,  faculty  of 
business,  McMaster  University. 

"As  administrators  you  are  facing 
a  new  dimension  in  an  employee-em- 
ployer relationship,"  he  said.  You  are 
not  alone  in  facing  this  new  dimension 
of  relationship.  This  has  happened 
many  times  before  and  you  have  much 
company  in  the  ground  you  are  now 
breaking." 

Professor  Isbester  prefers  to  see  a 
modification  of  the  Ontario  Labour 
Relations  Act  rather  than  a  special 
act  for  nurses.  A  modification  would 
include  many  other  professional  groups. 


^^kazam) 


TRY  AS  WE  MAY  WE  CAN'T 
GET  BLOOD  OUT  OF  A  HAT. 
WE  NEED  BLOOD  DONORS 
. . .  PEOPLE  . . .  YOU.  MAKE 
A  DATE  TODAY  TO 
GIVE  THROUGH 
YOUR  RED  CROSS. 


+ 


He  said  he  was  biased  against  arbitra- 
tion. He  would  rather  allow  strikes 
with  provisions  for  emergency  service. 
He  believes  arbitration  is  merely  the 
treatment  of  symptoms  and  not  of  the 
disease  itself,  while  a  strike  hits  the 
disease. 

"People  think  twice  about  going  on 
strike,  but  no  one  worries  about  going 
to  arbitration  as  the  government  pays 
for  it  anyway.  I  think  resorting  to  the 
existing  provisions  of  the  Labour  Re- 
lations Act  of  the  Province  of  Ontario 
would  probably  lead  to  a  quicker, 
cleaner  resolution  of  disputes  in  the 
health  care  field  than  resorting  to  pro- 
visions of  the  Hospital  Labour  Disputes 
Arbitration  Act,"  said  Professor  Is- 
bester. 

The  workshop  was  sponsored  by  a 
regional  committee  of  the  RNAO  and 
was  attended  by  nurses  who  are  direc- 
tors, associate  directors,  assistant  di- 
rectors of  nursing  service,  nursing  edu- 
cation and  health  agencies  supervisors, 
and  head  nurses. 

Persons  Contemplating  Suicide 
Can  Often  Be  Identified 
Social  Worker  Tells  Audience 

Ottawa  —  Suicidal  persons  are  ambiv- 
alent about  dying,  according  to  Sam 
M.  Heilig,  who  addressed  an  audience 
of  250  at  a  seminar  on  suicide  held 
November  27  and  28  under  the  aus- 
pices of  the  Ottawa  Distress  Centre. 

Mr.  Heilig,  co-chief  social  worker 
at  the  Suicide  Prevention  Center  and 
Institute  for  Life  Threatening  Beha- 
viors in  Los  Angeles,  California,  illus- 
trated his  point  by  telling  of  a  woman 
who  had  taken  a  lethal  dose  of  pills. 
She  had  been  brought  into  hospital  as 
an  emergency  and  showed  a  determi- 
nation to  die  by  resisting  treatment. 

A  volunteer  on  duty,  a  police  ser- 
geant in  civilian  clothes,  asked  permis- 
sion to  handle  the  case  his  own  way.  He 
entered  the  treatment  room  where  the 
woman  was  confined,  straddled  a  chair, 
and,  with  chin  on  folded  arms,  looked 
steadily  at  the  woman,  saying  nothing. 
The  woman,  becoming  more  and  more 
anxious,  finally  asked:  "Who  are  you, 
and  what  do  you  want?"  The  quiet, 
deliberate  reply:  "Well,  I'm  from  the 
coroner's  office  and  I'm  simply  wait- 
ing," prompted  her  to  scream  for  the 
doctor.   Treatment  could  then  begin. 

A  need  to  communicate  invariably 
characterizes  the  person  planning  sui- 
cide, continued  Mr.  Heilig.  Figures 
from  Los  Angeles  County,  with  a  pop- 
ulation of  7,000,000,  showed  that  75 
percent  of  those  who  killed  themselves 
had  seen  a  physician  within  two  months 
before  death,  and  that  35  percent  had 
left  notes. 

Mr.  Heilig  said  the  great  problem 
in  communication  is  that  of  recogniz- 
ing intent.  He  gave  an  example  of  a 
FEBRUARY  1971 


woman  who  made  elaborate  plans  to 
travel,  placed  her  belongings  in  storage, 
put  her  affairs  in  order,  told  her  friends 
about  her  forthcoming  trip,  yet  remain- 
ed vague  about  her  specific  itinerary. 
She  was  found  dead  when  someone 
arrived  to  take  her  to  the  airport.  In- 
vestigation showed  she  had  never  made 
airline  reservations.  Where,  in  the 
course  of  her  preparations  for  suicide, 
could  she  have  been  recognized  as  a 
suicidal  person?  he  asked. 

The  two-day  seminar  on  suicide  was 
organized  by  Patricia  M.  Delbridge, 
coordinator  of  the  Ottawa  Distress 
Centre.  Judging  from  the  written  com- 
ments on  the  seminar  by  the  trained 
volunteers  who  man  the  Ottawa  Dis- 
tress Centre  telephone,  the  high  school 
counselors,  the  public  health  nurses  and 
the  personnel  of  welfare  and  mental 
health  agencies  who  attended  the  ses- 
sions, it  was  a  worthwhile  effort. 

■New  Method  Used 

To  Develop  Curriculum 

Yarmouth,  N.S.  —  The  faculty  of  the 
Yarmouth  Regional  Hospital  School 
3f  Nursing,  in  designing  a  two-year 
integrated  program  for  student  nurses, 
held  a  special  planning  institute  to 
investigate  a  new  method  of  curriculum 
development. 

Employers  of  nurses,  supervisors, 
and  head  nurses  attended  the  three- 
day  meeting  in  November.  Robert 
'\dams,  occupational  training  consul- 
:ant  with  Nova  Scotia  NewStart  Inc., 
i  research  company  funded  by  the 
provincial  government,  directed  the 
group  in  identifying  the  skills  required 
Df  a  graduate  nurse.  Three  hundred 
ikills  were  grouped  into  13  general 
areas  and  assembled  on  a  large  chart, 
cnown  as  "develop  a  curriculum," 
)r  DACUM.  The  participants  found 
his  method  of  curriculum  evolution 
itimulating. 

Work  on  the  system  is  continuing. 
This  includes  the  development  of 
'learning  activities  batteries"  (packages 
)f  written  material,  audio  tapes,  video 
apes,  anything  which  will  help  the 
rainee  reach  the  learning  objective). 
^Juch  a  package  will  be  prepared  for 
;ach  activity  on  the  chart  and  students 
will  be  able  to  progress  at  their  own 
ate. 

Director  of  education  at  the  hospital, 

ane    C.    Haliburton,    is    enthusiastic 

Ubout   the   process   and   calls    it   "an 

tmportant    breakthrough."    She    said 

nquiries  about  the  system  are  welcome. 

urant  Helps  To  Finance 
tpecial  Course  for  BC  Nurses 

Vancouver,  B.C.  —  The  British  Colum- 
bia Medical  Services  Foundation  has 
warded  a  grant  of  $25,000  to  the  nurs- 
ing education  section,  division  of  con- 
iBRUARY  1971 


tinuing  education  in  the  health  sciences. 
University  of  British  Columbia. 

The  grant  will  partially  cover  the 
cost  of  a  special  continuing  education 
course  for  nurses  in  coronary  and  in- 
tensive care.  Margaret  Neylan  of  UBC 
is  setting  up  the  course,  co-sponsored 
by  the  Registered  Nurses'  Association 
of  British  Columbia.  The  course  will 
be  given  in  10  regions  of  the  province 
and  more  than  230  nurses  are  eligible 
to  enroll. 

A  specially  trained  team  of  instruc- 
tors will  travel  throughout  the  province 
using  a  $4,000  teaching  module  donat- 
ed by  Canadian  General  Electric  Com- 
pany, containing  components  of  a  cor- 
onary care  unit.  The  three-week  course 
will  be  preceded  by  eight  weeks  of  pre- 
paratory work  by  participants. 

Plans  include  a  preliminary  two- 
day  course  open  to  B.C.'s  12,000  reg- 
istered nurses  to  help  them  update 
their  knowledge  and  skill  in  providing 
nursing  care  in  respiratory  and  cardiac 
emergencies. 

Nursing  Student  Enrollment 
Increases  In  Province  Of  Quebec 

Montreal,  Quebec  —  The  first  substan- 
tial increase  in  the  number  of  students 
admitted  to  schools  of  nursing  in  the 
province  since  1961  occurred  in  1969, 
reports  the  Association  of  Nurses  of  the 
Province  of  Quebec's  December  News 
and  Notes. 

There  were  500  more  students  ad- 
mitted in  1969  for  a  total  of  2,907. 
This  number  includes  77  men,  the  first 
year  in  which  male  nursing  students 
were  officially  recognized.  The  growth 
in  number  of  students  has  taken  place 
in  all  areas  of  the  province  except 
Montreal,  where  the  number  has  declin- 
ed by  200. 

The  large  increase  in  admissions 
was  due  to  the  introduction  of  nursing 
programs  in  general  and  vocational 
colleges,  the  ANPQ  believes.  The  total 
number  of  students  enrolled  in  nursing 
in  all  schools,  hospitals,  general  and 
vocational  colleges  in  1969  was  7,388. 
Of  this  total,  the  largest  group  is  in 
hospital  schools,  although  this  will 
change  as  hospital  schools  are  phased 
out  and  the  majority  of  nursing  students 
will  be  studying  in  CEGEPs  and  uni- 
versity programs. 

National  Health  Grant  For 
U.  of  T.  School  of  Nursing 

Ottawa  —  A  $7,021  contribution  from 
the  federal  government's  health  grants 
was  approved  in  December  for  the  Uni- 
versity of  Toronto  school  of  nursing. 

The  grant  will  help  finance  a  project 
to  determine  the  feasibility  of  expand- 
ing nursing  services  in  family  medical 
practice.  The  project  will  establish 
further  undergraduate  and  postgrad- 
uate training  for  nurses. 


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THE  CANADIAN   NURSE 

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11 


news 


(Continued  from  pane  7j 

Some  nurses  saw  the  issue  as  an 
individual  matter.  Joyce  Nevitt,  direc- 
tor of  the  school  of  nursing  at  Memor- 
ial University,  St.  John's,  Newfound- 
land, said:  "There  are  many  circum- 
stances that  are  personal,  and  more 
should  be  considered  than  the  physical 
and  medical  sides.  It's  all  very  well  for 
people  to  sit  in  judgment  on  whether 
or  not  others  should  have  children. 
I  think  we  ought  to  be  more  realistic. 

"I  know  this  can  be  difficult  for 
certain  groups  to  accept  because  it's 
against  their  definition  of  when  life 
begins,  and  I  believe  that's  the  crux 
of  the  whole  problem.  I  think  our 
religious  overtones  and  beliefs  stand 
in  the  way  of  our  ability  to  be  objective 
in  terms  of  other  people's  needs,"  said 
Miss  Nevitt. 

Cecile  McLeary,  general  duty  nurse 
on  the  gynecological  unit  at  the  Univer- 
sity Hospital  in  Saskatoon,  Saskatche- 
wan, said,  "If  a  woman  does  not  want 
to  continue  with  an  unwanted  pregnan- 
cy, then  she  should  not  have  to;  other- 
wise, we  force  her  to  have  an  unwanted 
child." 

Another  nurse  who  believes  abor- 
tion should  be  an  individual  decision 
is  Lois  Good,  clinical  instructor,  Cha- 
leur  General  Hospital,  Bathurst,  New 
Brunswick.  But  in  meeting  the  needs 
of  the  individual,  she  would  not  want 
to  see  abortion  done  "wholesale."  She 
also  favors  a  committee  system,  but 
would  like  it  to  become  more  consulta- 
tive. "Some  pregnancies  need  not  be 
terminated  if  other  avenues  are  explored 
and  social  help  given  to  the  woman 
and  family;  but  if  the  outlook  is  bleak, 
this  is  another  story. 

"If  a  woman  has  strong  feelings 
about  abortion,  she's  going  to  have 
one  whether  it's  self-induced  or  other- 
wise. We  also  should  be  doing  some- 
thing about  getting  family  planning 
across  to  the  public,"  she  said. 

Miss  Good  conducted  her  own  poll 
on  the  issue,  consulting  18  students 
and  staff  members  at  the  hospital.  Ten 
nurses  approved  the  CPA  statement, 
five  approved  with  qualifications,  and 
three  said,  definitely  not,  on  religious 
grounds. 

"Abortion  should  be  a  person's  own 
decision,  with  her  doctor  to  advise 
her  medically,"  said  Pauline  Shaw, 
medical-surgical  supervisor,  Prmce 
County  Hospital,  Summerside,  Prince 
Edward  Island.  "The  individuals  in- 
volved have  to  cope  with  the  problem. 
The  doctors  on  the  committee  are  mak- 
12     THE  CANADIAN   NURSE 


ing  a  decision  on  someone  else's  prob- 
lem. And  in  no  way  should  abortion 
be  a  criminal  offense,"  she  added. 

Emphasizing  family  planning,  Doro- 
thy Mumby,  director  of  public  health 
nursing,  London,  Ontario,  said,  "Un- 
wanted pregnancies  should  not  happen 
if  contraception  and  methods  of  family 
planning  are  readily  available.  I  would 
not  want  to  see  abortion  for  abortion's 
sake  or  people  not  using  contraceptive 
measures,  but  I  don't  think  abortion 
should  be  a  criminal  matter.  It  becomes 
a  question  of  not  pressing  our  own 
moral  beliefs  on  other  people." 

The  nurses  interviewed  agreed  that 
the  Canadian  Nurses'  Association 
should  take  a  stand  that  abortion  be 
removed  from  the  Criminal  Code. 
"I  think  Canadian  nurses  should  take 
a  stand,"  said  Miss  Good.  One  nurse 
thought  all  members  should  be  polled 
and  a  majority  opinion  published.  Mrs. 
McLeary  said,  "Nurses  work  closely 
with  doctors  in  this  and  while  legally 
we  are  not  affected,  I  think  we  should 
follow  the  lead  of  the  medical  profes- 
sion." 

Sister  Castonguay  said,  "I  think  it  is 
important  that  CNA  speak  out.  Up  to 
the  present,  nurses  have  been  involved 
in  problems  within  the  profession.  I 
think  it's  time  we  got  involved  in  social 
issues."  She  also  believes  a  nurse  should 
not  be  forced  to  assist  in  abortion 
procedures  when  it  is  against  her  cons- 
cience. "But  a  nurse  should  not  impose 
her  views  on  the  patient,  "she  said. 

Miss  Giles  said,  "A  realistic,  res- 
ponsible decision  and  a  public  state- 
ment on  this  multi-faceted  problem 
is  long  overdue.  We  must  as  individual 
members  come  to  terms  with  our  beliefs 
and  feelings  and  confront  this  issue  by 
a  decision  through  our  organization. 

"How  long  can  we  continue  to  ig- 
nore the  desperate  plea  of  a  woman 
seeking  an  abortion?  How  long  can  we 
negate  the  word  health  in  relation  to 
abortion,  considering  the  devastating 
effects  of  unwanted  pregnancy  on  the 
woman,  her  child,  her  husband,  and 
her  family?"  asked  Miss  Giles. 

Mrs.  Mumby  said  nurses  sould  take 
a  stand  because  "nurses  are  part  of  the 
whole  health  complex.  Abortion  is  a 
question  of  health,  not  of  legal  effect 
on  the  individual."  Seconding  that 
opinion  was  Mrs.  Burwell,  who  added, 
"It  is  an  ethical  problem  too.  But  are 
we  taking  the  right  ethical  stand  in 
forcing  people  to  have  unwanted  chil- 
dren?" 

"Nurses  can't  very  well  stand  on  the 
sidelines  saying  i  believe  this  or  that,'  " 
said  Miss  Nevitt,  "We  ought  to  remem- 
ber that  we  serve  people  and  we  are 
members  of  a  'caring'  profession.  We 
don't  have  to  condone  everything  pa- 
tients do,  but  we  must  care  about 
them,"  she  added. 


Days  Of  Pill-Pushing  Nurse 
Are  Numbered 

London.  Ont.  —  The  nurse  can  no 
longer  be  a  "pill  pusher,"  but  must 
expand  her  role  to  that  of  practitioner 
and  educator,  more  than  150  nurses 
from  London  and  district  were  told  at 
an  October  seminar  on  new  trends  in 
drug  distribution  systems  and  the  role 
of  the  clinical  pharmacist. 

Both  nurse  and  pharmacist  have  a 
goal  of  better  patient  care,  and  studies 
have  shown  they  would  use  similar 
methods  to  reach  this  goal.  Methods 
include  improving  communication  be- 
tween the  departments  of  nursing  and 
pharmacy,  utilizing  the  pharmacist  on 
the  nursing  unit,  and  a  more  compre- 
hensive drug  administration  system  to 
patients. 

The  nursing  staff  would  be  freed 
from  the  non-nursing  function  of  med- 
ications, that  is,  ordering,  checking 
stocks,  and  processing  medication  or- 
ders. Nurses  would  be  involved  in 
more  therapeutic  areas,  such  as  teach- 
ing patients  about  drugs  and  their  ef- 
fects prior  to  discharge. 

Guest  speakers  were  Dr.  F.S.  Brien, 
chief  of  medicine,  Victoria  Hospital, 
London;  B.  Dinel.  director  of  pharmacy 
services.  University  Hospital,  London; 
Dr.  W.M.  McLean,  director,  pharma- 
ceutical services,  St.  Joseph's  Hospital, 
Guelph;  J.  Parks,  assistant  director, 
pharmaceutical  services,  Victoria  Hos- 
pital, and  H.  Smythe,  director  of  phar- 
macy services,  Ottawa  Civic  Hospital. 

The  seminar  was  sponsored  by  the 
committee  for  continuing  education 
for  professional  nurses,  London. 

RNAO,  OHA,  OMA  Sponsor 
Courses  In  Coronary  Nursing 

Toronto,  Ont.  —  Four  clinical  courses 
in  coronary  care  nursing,  endorsed  by 
the  Ontario  Hospital  Association,  the 
Ontario  Medical  Association,  and  the 
Registered  Nurses'  Association  of 
Ontario,  will  be  offered  in  1971  by  the 
University  of  Toronto  through  its 
continuing  education  program  for 
nurses. 

Four  consecutive  four-week  courses 
will  be  conducted  between  mid-April 
and  the  end  of  August,  1971.  Addition- 
al courses  are  planned  for  1972. 

The  purpose  of  the  program  in  cor- 
onary care  nursing  is  to  prepare  regis- 
tered nurses  to  function  effectively  as 
staff  nurses  in  coronary  care  units. 
Each  post-diploma  course  will  include 
supervised  clinical  experience  within 
coronary  care  units  of  six  hospitals  in 
the  Toronto  area. 

Guidelines  for  post-diploma  pro- 
grams, prepared  by  the  Registered 
Nurses'  Association  of  Ontario's  work- 
ing party  on  continuing  education  in 
(Continued  on  page  14) 
FEBRUARY  1971 


i 


This  decongestant  tablet  contends  that  a 
cold  is  not  as  simple  as  it  seems  on  television 


Coricidin*  "D"  tablets 
shrink  swollen  mem- 
branes with  the  best  of 
them  (note  the  10  mg.  of 
phenylephrine). 

Unfortunately,  the  mis- 
ery of  a  cold  doesn't  end 
with  unblocl<ed  passages. 

That's  why  Coricidin  "D" 
also  contains  two  anti- 
pyretic and  analgesic 
agents.  They  cool  down 
the  steaming  fever  and 
suppress  the  aches  and 


pains   that   go   with   the 
adult  cold. 

That's  why  we  also  help 
perk  up  sagging  spirits 
with  30  mg.  Caffeine. 
And  why  we  also  include 
2  mg.  of  Chlor-Tripolon* 
to  combat  rhinorrhea  . . . 
and  strike  out  at  the  very 
root  of  congestion. 
Know  of  another  cold 
reliever  that  gives  your 
patient  so  many  helpful 
also's? 

Coricidin  "D" 

comprehensive  relief 

of  cold  svmntom.'i 


DESCRIPTION:  Each  CORICIDIN 
■  D"  tablet  contains  2  mg. 
CHLOR-TRIPOLON-  (chlorpheni- 
ramine maleate).  230  mg.  acetyl- 
salicylic  acid,  160  mg.  phena- 
cetin.  30  mg.  caffeine,  10  mg. 
phenylephrine, 

DOSAGE:  Adults:  one  tablet 
every  4  hours,  not  to  exceed  4 
tablets  in  24  hours.  Children  (10- 
14  years):  Vi  the  adult  dose. 
Children  under  10  years:  as  di- 
rected by  the  physician. 


SIDE  EFFECTS:  Adverse  reac- 
tions ordinarily  associated  with 
antihistamines,  such  as  drowsi- 
ness, nausea  and  dizziness  occur 
infrequently  with  Coricidin  "D" 
when  administration  does  not 
exceed  recommended  dosage. 
PRECAUTIONS:  IVIay  be  injurious 
if  taken  in  large  doses  or  for  a 
long  time.  Additional  clinical 
data  available  on  request. 

'reg.  Trade  l^arl<. 


c 


24TMUTS 


-^yA/i 


Corporation  Limited 
^/'Jf/>Ay/f/7    Pointfi  Claire  730.  P.O. 


® 


For  colds  of  all  ages: 
Coricidin  tablets, 
Coricidin  with  Codeine, 
Coriforte     for  severe  colds, 
Nasal  Mist,  Medilets 
and  Coricidin  "D"  tVledilets 
for  children. 
Pediatric  Drops, 
Cough  Mixture 
and  Lozenges. 


news 


(Continued  from  page  12 1 

coronary  care  nursing  in  cooperation 
with  the  OHA,  OMA,  and  other  allied 
groups,  will  be  used  to  develop  the 
program.  An  advisory  committee  for 
the  project  will  include  representatives 
from  nursing,  medicine,  non-teaching 
hospitals,  and  the  three  endorsing 
associations.  Much  of  the  groundwork 
for  the  courses  was  done  by  Lucille 
Peszat,  coordinator  of  RNAO's  con- 
tinuing education  department. 

Preference  will  be  given  to  sponsored 
candidates,  although  applications  from 
other  nurses  are  invited.  Requests  for 
further  information  and  application 
forms  may  be  directed  to  Marian  I. 
Barter,  director,  continuing  education 
program  for  nurses,  School  of  Nurs- 
ing, University  of  Toronto,  47  Queen's 
Park  Crescent,  Toronto  5,  Ontario. 

Canadian  Soldiers  In  Cyprus 
Help  Crippled  Children 

Kyrenia,  Cyprus  —  Since  they  arrived 
with  the  United  Nations  Peacekeeping 
Force  in  Cyprus  in  1966,  Canadian 
soldiers  have  donated  $8,250  to  the 
Kyrenia  Red  Cross  Crippled  Children's 
Hospital. 

In  September,  the  First  Battalion, 
the  Royal  Canadian  Regiment  of  Lon- 
don, Ontario,  donated  $1,500  to  the 
hospital.  In  addition  to  financial  aid, 
the  soldiers  have  made  repairs  and 
improvements  to  existing  facilities 
and  provided  medical  supplies,  as  well 
as  showing  weekly  films  to  children. 

Federal  Grant  Approved 
For  McMaster  Project 

Ottawa  —  A  federal  government  grant 
of  $8,380  has  been  approved  for  a 
McMaster    University    study    project. 

The  grant  was  made  through  the 
health  grants  program  of  the  depart- 
ment of  national  health  and  welfare 
and  announced  in  December.  It  will 
help  finance  a  project  to  study  the  vary- 
ing responsibilities  of  nurses  employed 
in  different  medical  practices  such  as 
hospitals,  private  physicians'  offices, 
and  family  practice  units. 

Initially,  the  project  will  involve 
collection  of  data  on  nursing  activities. 
A  survey  of  patients  in  each  practice 
will  determine  acceptance  of  present 
nursing  services  and  the  projected 
acceptance  of  other  services  that  might 
be  carried  out  by  nurses.  Future  phases 
of  the  project  will  involve  educational 
programs  for  nurses  and  possible  mod- 
ification of  training  courses. 

14     THE  CANADIAN   NURSE 


I  ^.^^OKtitm^^Jm^ 


wo  H.E.G.  Baxter  of  London,  Ontario,  and  Cpl.  E.W.  Page  of  Hamilton, 
Ontario,  help  Red  Cross  nurses  serve  refreshments  to  children  at  the  Crippled 
Children's  Hospital  in  Kyrenia,  Cyprus.  During  this  party  the  hospital  received 
a  $  1 ,500  cheque  from  the  First  Battalion,  Royal  Canadian  Regiment. 


Unions  Sponsor  Health  Center 
For  The  Capital  Area 

Ottawa  —  Plans  are  underway  for 
the  development  of  a  prepaid  group 
practice  health  center  for  the  Ottawa 
area.  Backing  the  health  center  are  the 
Ottawa-Hull  Area  Council  of  the  Public 
Service  Alliance  of  Canada,  the  Ottawa 
District  Labour  Council,  Council  of 
Postal  Unions,  and  the  Council  of 
Graphic  Arts  Unions. 

To  be  called  the  Ottawa  and  Dis- 
trict Community  Group  Health  Founda- 
tion, it  will  be  established  as  a  non- 
profit corporation  to  provide  a  facility 
and  program  for  comprehensive  health 
care  for  its  subscribers.  As  part  of  the 
raising  of  capital  funds  for  the  building 
and  equipment,  subscribers  will  pay 
an  assessed  sum  by  payroll  deductions 
over  a  three-year  period.  At  two  similar 
health  centers  in  Ontario,  Sault  Ste. 
Marie  and  St.  Catharines,  the  fee  was 
$150  per  family. 

The  operating  costs  of  the  health 
center  will  be  met  through  regular 
OHSIP  premiums.  Arrangements  will 
be  made  to  permit  residents  of  Quebec 
to  use  the  health  center. 

The  group  practice  will  be  designed 
to  provide  general  and  specialist  medi- 
cal care  as  well  as  other  health  services 
to  provide  a  comprehensive  health  care 


program  for  all  members  of  the  family. 
Personal  physician  services,  prenatal 
and  obstetrical  services,  pediatric  care, 
annual  check-ups,  doctors'  office,  hos- 
pital and  home  visits,  eye  examinations, 
and  surgery,  along  with  the  necessary 
laboratory  work,  blood  tests,  x-rays 
and  physiotherapy,  are  included  in  the 
center's  plan. 

Subscribers  will  select  a  personal 
physician  from  among  the  family  phys- 
icians at  the  center.  He  will  work  with 
the  family  to  meet  the  health  care  needs 
of  the  family.  Specialists  from  the 
center  and  outside  will  be  consulted. 

The  center  acts  as  a  clearing-house 
for  patients'  calls.  Appointments  with 
the  physicians  will  be  available  Monday 
through  Saturday.  Emergency  and 
urgent  care  clinics  will  be  held  evenings 
and  weekends.  At  other  hours  a  phy- 
sician will  be  reached  for  emergency 
care  and  advice  by  calling  the  center. 

Recently,  the  Federal  Task  Force 
on  the  Costs  of  Health  Services,  the 
Ontario  Committee  on  the  Healing 
Arts,  several  committees  of  the  Ontario 
Council  of  Health,  and  the  Economic 
Council  of  Canada  reported  favorably 
on  the  concept  of  community  health 
centers.  ^ 


FEBRUARY  1971 


names 


Fanny  Annette  (Nan)  Kennedy  (R.N., 
The  Vancouver  General  Hospital 
School  of  Nursing;  dipl.  public  health 
nursing,  U.B.C.;  B.Sc.N.,  U.B.C.; 
M.A.,  U.  of  Washington,  Seattle)  has 
been  appointed  executive  director  of 
the  Registered  Nurses'  Association  of 
British  Columbia,  a  post  she  has  filled 
on  an  interim  basis  from  September  to 
December  of  last  year. 

Miss  Kennedy  joined  the  RNABC 
in  1959  as  educational  consultant.  Her 
writing  talents  were  put  to  use  in  the 
association's  1962  brief  to  the  Royal 
Commission  on  Health  Services  and  in 
its  1967  proposed  plan  for  the  orderly 
development  of  nursing  education  in 
British  Columbia. 

Prior  to  her  work  with  the  RNABC, 
her  interest  in  public  health  had 
brought  her  as  far  afield  as  Dacca, 
East  Pakistan  and  Teheran,  Iran,  under 
the  auspices  of  the  World  Health  Or- 
ganization. 

Sister  Shirley  Crozier  (R.  N.,  St.  Ma- 

rv's  School  of  Nursing,  Sault  Ste.  Marie; 
B.Sc.N.,  and  M.H.A.,  U.  of  Ottawa) 
was  appointed  administrator  of  the 
General  Hospital,  Sault  Ste.  Marie, 
Ontario.  Sister  Crozier  served  as  super- 
visor, director  of  nursing  services  and 
education,  and  assistant  administrator 
before  studying  hospital  adminstration. 
On  accepting  her  new  appointment 
to  replace  Sister  Teresa  Agatha  who 
resigned  for  health  reasons.  Sister  Cro- 
zier said,  "Generally,  it  is  inevitable 
there  will  be  a  change  in  the  trends.  I 
could  sec  this  and  realized  1  should 
continue  my  education.  Hospitals  are 
becoming  more  community  oriented 
and  more  services  are  being  amalgamat- 
ed. The  health  field  is  developing  rap- 
idly and  each  five  years  makes  a  dif- 
ference." 

Joyce  Nevltl,  director.  School  of  Nurs- 
ing. Memorial  University  of  Newfound- 
land. St.  John's,  was  elected  president 

of  the  Newfoundland  branch  of  the 
Canadian  Public  Health  Association 
at  its  November  meeting  in  St.  John's. 
Elizabeth  R.  Summers,  past  president  of 
the  Association  of  Registered  Nurses  of 
Newfoundland,  was  elected  councillor. 

The  Association  of  Registered  Nurses 
of  Newfoundland,  at  its  October  meet- 
ing, elected  the  following:  president, 
Phyllis  Barrett;  president-elect,  Elizabeth 

FEBRUARY  1971 


Wilton;  immediate  past  president,  Eliz- 
abeth Summers;  past  president.  Rev. 
Sister  Catherine  Kenny;  1st  vice-presi- 
dent, Joyce  Nevitt;  2nd  vice-president, 
Elsie  Hill. 

Mrs.  Barrett  (R.N., 
General  Hospital 
School  of  Nursing, 
St.  John's  Nfld.; 
Dipl.  Nursing  Edu- 
cation and  Admin., 
U.  of  Toronto;  B.N. , 
Memorial  U.  of 
Newfoundland), 
president  of  the 
ARNN,  has  had  experience  in  nursing 
education  and  admmistration,  public 
health  and  outpost  hospital  nursing, 
and  as  assistant  executive  secretary  of 
the  ARNN.  Recently  she  has  been  guest 
lecturer  at  the  St.  Clare's  Mercy  Hos- 
pital and  the  Salvation  Army  Grace 
General  Hospital  Schools  of  Nursing, 
St.  John's,  Nfld. 

Elsie    K.    Di    Blasio 

(Reg.N.,  General 
Hosp.,  Port  Arthur 
School  ol  Nursing; 
B.Sc.N.,  Lakehead 
U.,  Thunder  Bay) 
has  been  appointed 
curriculum  coord- 
inator at  the  Lake- 
h  e  a  d  Regional 
School  o\'  Nursing,  Thunder  Bay.  On- 
tario. She  will  be  responsible  for  coord- 
inating the  first  and  second  year  of  the 
twxi-plus-one  diploma  program.  This 
will  include  making  arrangements  for 
clinical  experience  in  the  hospitals  and 
community  agencies. 

Prior  to  this,  Mrs.  Di  Blasio  has  had 
experience  as  staff  nurse,  assistant 
head  nurse,  and  as  a  teacher  with  all 
levels  of  students  at  the  General  Hos- 
pital of  Port  Arthur  School  of  Nursing. 
She  participated  in  the  development 
of  the  first-  and  second-year  program 
ot  the  Lakehead  Regional  School  of 
Nursing  and  taught  in  the  classroom 
and  clinical  area.  Mrs.  Di  Blasio  has 
been  active  at  chapter  level  of  the  Re- 
gistered Nurses'  Association  of  Ontario 
as  secretary  and  committee  chairman. 

Elsie  Mary  Taylor  (S.R.N..  St.  George- 
in-the-East  Hospital.  London,  England 
and  St.  Alfeges  H.,  Greenwich,  London, 
England;  Dipl.,  teaching  and  super- 
vision. U.  of  British  Columbia,  Van- 


couver) IS  the  new  director  ot  nursing 
at  the  Kitiniat  General  Hospital,  Miss 
Taylor  has  been  matron  at  a  mission 
hospital  in  Biafra  prior  to  which  she 
was  on  staff  at  the  Royal  Jubilee  Hos- 
pital. Victoria.  B.C. 

Correction 

Oops!  We  slipped  in  the  December 
issue  of  The  Canadian  Nurse:  a  column 
full  of  Faculty  members  got  misplaced. 
The  following,  mentioned  on  page  19, 
are  all  members  of  the  staff  of  the 
School  of  Nursing,  Dalhousie  Univer- 
sity, Halifax:  Muriel  E.  Small,  Jo-Ann 
(Tippett)  Fox,  Margaret  ArkJie,  Eve- 
lyn Joyce  Carver,  Judith  (H  a  1 1  i  e) 
Cowan,  Margaret  Rose  Matheson, 
Nancy  Elizabeth  Riggs,  Linda  Rob- 
inson. 

Joan  Baetz  (Reg.N., 
Kitchener-Waterloo 
Hospital  School  of 
Nursing),    formerly 
on     the     staff    of 
/-Jk    V      Kitchener-Waterloo 
Hospital,    has     ar- 
rived   in    Afghanis- 
tan to  serve  a  two- 
!'»...     year   tour   of  duty 
with  MEDICO,  a  service  of  CARE. 

Miss  Baetz.  working  with  a  10-mem- 
ber  MEDICO  team  of  doctdrs,  nurses 
and  a  technologist  stationed  at  Avicen- 
na  Hospital  in  the  Afghan  capital  of 
Kabul,  will  treat  patients  and  help  train 
counterpart  personnel. 

Sally     A.     Pearson 

(Reg.  N.,  Civic  Hos- 
pital School  of  Nurs- 
ing, Peterborough, 
Ont.;  Dipl.  teaching 
in  schools  of  nurs- 
ing, Dalhousie  U.. 
Halifax)  has  been 
'"^  appointed    director 

of  patient  care  ser- 
vices of  the  Kootenay  Lake  General 
Hospital,  Nelson,  B.C.  Miss  Pearson's 
nursing  career  has  taken  her  to  Chapel 
Hill,  N.C.,  where  she  worked  at  Mem- 
orial Hospital,  University  of  North 
Carolina;  to  Los  Angeles,  California, 
where  she  became  assistant  director 
of  nursing  at  the  Shriners  Hospital  for 
Crippled  Children,  and  to  West  Covina. 
California,  where  she  was  a  supervisor 
at  the  Queen  of  the  Valley  Hospital. 
Prior  to  her  present  appointment.  Miss 
Pearson  was  instructor  at  St.  Mary's 
School  of  Nursing  in  Kitchener,  Ont. 

THE  CANADIAN   NURSE     15 


your  hospital  is 
safer,  operates  more 
efficiently  with  TIME 

NURSING 
LABELS 


names 


niiai 


MCDICATION  CHANGED      muuimam         ^^^„^ 
REOUIREO 


Safer  because  all  Time  Labels  relating 
to  patient  care  are  BACTERIOSTATIC 
to  assist  in  eliminating  contact  infec- 
tion between  patient  and  nurse.  The 
self-sticking  quality  of  Time  Nursing 
Labels  eliminates  the  need  for  hand 
to  mouth  contact  while  working  with 
patient  record. 

More  efficient  because  Time  Nursing 
Labels  provide  you  with  an  effective 
system  of  identification  and  communi- 
cation within  and  between  departments. 

Time  Patient  Chart  Labels  color-code 
your  charts  and  records  in  any  of  17 
colors  with  space  for  all  pertinent  pa- 
tient Information. 

Time  Chart  Legend  Labels  alert  busy 
personnel  to  important  patient  care 
divertives  eliminating  the  possibility  of 
error  through  verbal   instructions. 

There  are  many  other  Time  Labels  to 
assist  you  in  speeding  your  work  and 
to  assure  accuracy  in  important  pa- 
tient procedures.  Write  today  for  a 
free  catalog  of  all  Time  Nursing  Labels. 
We  will  also  send  you  the  name  of 
your  nearest  dealer. 


^. 


PROFESSIONAL  TAPE  COMPANY,  INC. 

355  BURLINGTON  RD.,  RIVERSIDE.   ILL.  60546 


16     THE  CANADIAN   NURSE 


V    4. 


D.A.  Mills 


B.  Mibu 


Norma  A.  Wylie,  director  of  nursing 
at  the  McMaster  University  Medical 
Centre,  has  announced  the  appoint- 
ment of  four  nurses  to  assist  in  explor- 
ing and  developing  the  expanded  role 
of  the  nurse  in  medical  services. 

Working  in  the  family  Health  Care 
Centre,  where  a  facility  for  family  care 
is  to  be  provided,  will  be: 
Dorothy-Anne  Mills  1  (Reg.  N.,  St.  Jo- 
seph's H.  School  of  Nursing,  London, 
Ont.;  Dipl.  Public  Health  Nursing,  U. 
of  Western  Ontario,  London;  B.N.  in 
public  health,  McGill  U.,  Montreal), 
who  has  been  employed  in  public  health 
in  Ottawa,  London,  and  the  Peel  Coun- 
ty Health  Unit. 

Barbara  Milne  (Reg.  N.,  St.  Josephs 
School  of  Nursing,  Hamilton;  B.Sc.N., 
U.  of  Toronto  School  of  Nursing),  who 
has  been  nurse  supervisor  at  the  School 
for  the  Deaf,  Milton,  has  done  child 
protection  work  with  the  Children's 
Aid  Society  and  clinical  teaching  at 
The  Hospital  for  Sick  Children,  Toron- 
to, Ontario. 

Anna  Loughlin  (Reg.  N.,  Hamilton 
Civic  Hospitals  School  of  Nursing, 
Hamilton;  B.Sc.N.,  U.  of  T  o  r  o  n  t  o 
School  of  Nursing),  who  has  been 
instructor  at  the  Hamilton  Civic  Hos- 
pitals School  of  Nursing  and  has  had 
experience  as  staff  nurse  and  supervisor 
in  the  areas  of  intensive  care,  coronary 
care,  and  surgical  nursing. 
Linda,  Clark  (B.S.c.N.,  McMaster  U. 
School  of  Nursing),  who  worked  in  a 
psychiatric  unit  affiliated  with  the 
department  of  psychiatry  at  McMaster 
University  prior  to  her  present  ap- 
pointment. 


Helen  M.  Carpenter  (B.S.,  M.P.H., 
Ed.D.)  was  awarded  an  honorary  mem- 
bership in  the  Canadian  Red  Cross 
Society  in  recognition  of  her  many 
years  of  outstanding  and  dedicated  vo- 
luntary service. 

Dr.  Carpenter  is  chairman  of  the 
nursing  advisory  committee  and  a  vice- 
chairman  of  the  health,  emergency  and^ 
welfare  committee  of  the  Canadian  Red 
Cross  Society. 

Presentation  of  the  award  was  made 
by  Brigadier  Ian  S.  Johnston,  presi- 
dent of  the  Canadian  Red  Cross  at  a 
meeting  held  in  Toronto  November  23 
and  24. 

Elizabeth  K.  McCann,  acting  director. 
School  of  Nursing,  University  of  Brit- 
ish Columbia,  has  succeeded  Margaret 
G.  McPhedran,  director.  School  of 
Nursing,  University  of  New  Brunswick, 
as  president  of  the  Canadian  Confer- 
ence of  University  Schools  of  Nursing 
(CCUSN). 

An  error  was  made  on  page  22  of  the 
November  1 970  issue  of  The  Canadian 
NL4rse.  The  correction  follows. 


A.  Loughlin 


L.  Chirk 


M.H.  Davidson 


Muriel  H.  Davidson  (Reg.N.,  Toronto 
General  Hospital  School  of  Nursing; 
cert,  public  health  nursing,  dipl.  ad- 
ministration and  supervision,  B.Sc.N., 
U.  of  Toronto)  is  the  first  director  of 
health  services  for  George  Brown  Col- 
lege of  Applied  Arts  and  Technology, 
Toronto.  With  12  public  health  nurses 
on  her  staff,  some  on  a  part-time  basis, 
Miss  Davidson  is  responsible  for  health 
services  for  close  to  7,000  students  at 
the  six  Toronto  campuses  of  the  col- 
lege. She  had  for  21  years  been  a  pub- 
lic health  nurse  with  the  Ontario  de- 
partment of  public  health,  Toronto 
office. 

Madeleine  Celia  Smillie  (Reg.  N., 
B.Sc.N.,  U.  of  Toronto;  M.P.H.,  U. 
of  Michigan,  Ann  Arbor)  has  been 
assistant  director  of  the  nursing  divi- 
sion, Toronto  department  of  public 
health,  since  September  1969.  She  has 
brought  a  detailed  knowledge  of  nursing 
service  to  her  present  position  as  she 
has  been  with  the  department  ail  her 
professional  life  —  as  staff  nurse,  assist- 
ant supervisor,  and  district  supervisor. 
FEBRUARY  1971 


Next 

to  your 

face 

the  most  comfortable 

thing  is  a  new 

SURGINE" 

mas[< 


»s  ^ 


Johnson  &  Johnson's  newly  developed  SURGINE  Face 
Mask  —  six  years  in  the  designing  —  is  so  extra- 
ordinarily comfortable  you'll  be  almost  as  unaware  of 
it  as  you  are  of  your  own  skin. 

The  fact  that  the  SURGINE  mask  fits  so  well  is  part  of  the 
reason  it  does  such  a  superior  job  of  bacterial  filtration. 
Cheek  and  chin  leaks  are  eliminated.  But  the  main 


reason  for  SURGINE's  efficiency  is  a  new,  specially 
developed  filter  medium.  In  vivo  tests  show  an  extra- 
ordinary average  filtration  efficiency  of  97%. 
For  free  samples  of  the  new  SURGINE  Face  Mask,  con- 
tact your  Johnson  &  Johnson  representative.  Or  write  to 
Mr.  Mark  Murphy,  Product  Director,  Johnson  &  Johnson 
Ltd.,  2155  Blvd.  Pie  IX,  Montreal  403,  Quebec. 

'Trademark  of  Johnson  &  Johnson  or  affiliated  companies. 


SURGINE 

the  comfortable  face  mask 

MONTREALATORONTO-  CANADA 


FEBRUARY  1971 


THE  CANAD^N   NURSE     17 


new  products 


Descriptions  are  based  on  information 
supplied  by  the  manufacturer.  No 
endorsement  is  intended. 


Daisy  Electrodes  and  GE-Jel 

General    Electric's   new    "daisy"   elec- 
trodes   and    GE-Jel    electrode    paste, 
used  together,  improve  the  monitoring 
fidelity  of  any  patient  monitoring  sys 
tern  regardless  of  equipment  used. 

These  electrodes,  combining  silver 
and  silver  chloride,  produce  a  very 
slight  offset  potential.  This  means  the 
observed  signal  on  the  monitor  will 
normally  move  very  little  when  select 
ing  different  "lead"'  positions.  The  rate 
of  change  of  the  offset  potential  is 
similarly  reduced,  providing  a  stable 
baseline  lor  patients  monitored  over 
long  periods.  The  waveform  trace  is 
accurate,  stable,  sharp,  and  clear. 

GE-Jel  electrode  paste  allows  high 
conductivity  with  minimal  skin  irrita- 
tion, and  can  be  used  for  cxtcndetl 
periods  of  time  without  drying  out. 

GE  "daisy"  electrodes  and  GE-Jel 
paste,  when  used  together,  eliminate 
the  need  for  frequent  and  time-con- 
suming electrode  changes.  Patient  com- 
fort is  increased  and  monitoring  ciists 
reduced. 

hor  more  information,  write  Gen- 
eral Electric  Company.  3."^  I  I  Bayview 
Ave.,  Medical  Systems  Department, 
Toronto,  Ontario. 


Capastat  —  Anti-TB  Drug 

After  seven  years  of  clinical  trials 
conducted  by  physicians  across  Canada 
and  research  dating  back  to  1956, 
Capastat  (capreomycin  sulphate,  Lilly) 
has  become  available  in  Canada.  As 
Capastat  has  not  shown  cross-resistance 
with  primary  anti -tuberculosis  drugs, 
it  has  achieved  wide  acceptance  in  both 
original  and  retreatment  cases. 

Worldwide  experience  has  shown 
that  Capastat  can  play  an  important 
and  sometimes  life-saving  role  in  the 
treatment  of  patients  who  have  become 
resistant  to  other  available  agents. 

With  the  problem  of  drug  resistance 
and  drug  intolerance  on  the  increase, 
an  effective,  well -tolerated,  and  cur- 
rently distinct  antibiotic  such  as 
Capastat  may  be  of  significant  help  in 
the  treatment  of  many  tuberculosis 
patients. 

Presently  marketed  in  42  countries 
around  the  world,  Capastat  is  distrib- 
uted in  Canada  by  Eli  Lilly  and  Com- 
pany (Canada)  Limited  from  their  plant 
at  3650  Danforth  Avenue,  Scarborough, 
Ontario. 

18     THE  CANADIAN   NURSE 


Daisy  Electrodes  and  GE-Jel 


Sinequan  for  Anxiety  and  Depression 

Introduced  by  Pfizer  Company  Ltd.. 
Sinequan  (doxepin  HCL),  can  be  used 
for  the  treatment  of  patients  with  anx- 
iety or  depression  if  they  exist  alone, 
or  both  when  they  exist  together,  as 
is  usually  the  case.  The  Canadian  hood 
and  Drug  Directorate  has  approved 
Sinequan  as  "'antidepressant  and  anx- 
iolytic" as  it  offers  potent  antianxiety 
and  antidepressant  action  in  a  single 
chemical  compound. 

Sinequan  is  well  tolerated  by  most 
patients,  including  the  elderly.  Espe- 
cially gratifying  is  the  fact  that  Sine- 
quan does  not  appear  to  cause  habitua- 
tion and  dependence,  even  after  pro- 
longed use.  Drowsmess  and  anticholi- 


nergic side  effects,  such  as  dry  mouth 
and  constipation,  may  sometimes  occur. 
Cardiovascular  effects,  such  as  tachy- 
cardia and  hypotension,  have  been 
reported  infrequently.  Some  of  these 
side  effects  tend  to  subside  with  con- 
tinued therapy  or  reduction  of  dose. 

Available  initially  in  10  mg..  25  mg., 
and  50  mg.  capsules,  the  usual  dose 
of  Sinequan  is  75  mg.  per  day.  Some 
patients  with  mild  illnesses  have  been 
treated  successfully  with  doses  as  low 
as  25  mg.  to  50  mg.  daily.  In  more 
severely-ill  patients,  dosage  as  high 
as  300  mg.  daily  can  be  employed. 

hurther  information  may  be  obtained 
from  the  Pfizer  Company  Ltd.,  50 
Place  Cremazie,  Montreal  35 1 ,  Que. 

FEBRUARY  1971 


New  Examining  Table 

A  new  examining  table,  called  the 
"Vista  I,"  has  been  designed  and  built 
in  Canada  for  the  J.F.  Hartz  Company. 
The  contoured,  foam-padded  top  is 
adjustable  to  any  position  between 
horizontal  and  vertical  for  patient  com- 
fort. Leg  rest  and  heavy  duty,  brushed, 
chrome  stirrups  are  stored  out  of  sight 
when  not  in  use. 

A  double  electrical  outlet,  pull-out 
instrument  table,  recessed  paper  holder, 
and  two  handy  drawers  with  seamless 
heavy  duty  liners  are  additional  fea- 
tures. The  walnut  finished  table  has  two 
spacious  storage  cabinets  matching  the 
top  of  green,  blue,  white  or  tan. 

The  table  is  available  from  the  J.F. 
Hartz  Company  Limited,  34  Metro- 
politan Road,  Scarborough  and  its 
sales  and  distribution  centers  across 
Canada. 


Influenza  Virus  Vaccine 

M.T.C.  Pharmaceuticals  Limited,  a 
subsidiary  of  Canada  Packers  Limited, 
has  been  appointed  distributor  of  the 
biological  products  of  The  Institute 
of  Microbiology  and  Hygiene.  Uni- 
versity of  Montreal. 

In  October.  M.T.C.  Pharmaceuti- 
cals introduced  the  new  improved  In- 
fluenza Virus  Vaccine  bivalent  (types 
A2  t^  B)  that  includes  highly  antigenic 
strains  of  influenza  virus  isolated  by 
the  Institute. 

Developed  by  the  Institute  two  years 
ago,  Inlluenza  Virus-Vaccine  bivalent 
(types  A2  and  B)  is  the  only  influenza 
vaccine  manufactured  in  Canada.  It  is 
distributed  in  packages  containing  one 
vial  of  10  cc.  or  10  doses.  Each  cc.  of 
this  bivalent  vaccine  contains  a  total 
of  at  least  600  units  CCA  as  follows 
Strains  Type  A2/Aichi/2/6S.  Hong 
Kong  variety,  200  Units  CCA;  Type 
A2/Montreal/68.  100  Units  CCA; 
and  Tvpe  B/Massachusetts/3/66.  300 
Units  CCA. 

The  vaccine  can  be  administered 
to  all  individuals  in  good  health.  It  is 
of  particular  importance  for  elderly 
people,  very  young  children,  individ- 
uals suflering  from  heart  disease  or 
other  chronic  disease,  as  well  as  for 
personnel  of  essential  services,  such  as 
hospitals,  public  health,  armed  forces, 
transportation,  police  and  tire  depart- 
ments. 

For  good  immunization,  two  doses 
of  I  cc.  of  Inlluenza  Virus-Vaccine, 
with  an  interval  of  two  to  four  weeks 
between  each  dose,  are  recommended 
for  adults  and  children  over  12  years 
of  age.  I  or  children  under  12  years  of 
age,  doses  of  0.5  cc,  and  proportion- 
ately less  for  infants,  should  be  admin- 
istered. 

I  urther  information  may  be  obtained 
from    M.T.C.     Pharmaceuticals    Ltd.. 

FEBRUARY  1971 


^43  Marie-Victorin.  Duvernay.  Laval. 
P.O.;  1X90  Brampton  St..  Hamilton. 
Ontario;  or  Box  3030.  Calgary.  Al- 
berta. 


Soframycin  Unitulle 

Soframycin  Unitulle  is  a  lightweight 
lano-paraffin  sterile  gauze  dressing 
impregnated  with  one  percent  Sofra- 
mycin (framycetin  sulphate). 

In  an  outer  paper  envelope  carrying 
comprehensive  instructions  for  use. 
each  sterile  tulle  antibiotic  dressing 
measuring  10  cm  x  10  cm  is  protected 
by  an  individual  packaging  consisting 
of  a  piece  of  parchment  supporting  the 
tulle  on  each  side,  thus  facilitating 
handling,  shaping,  and  application  and 
a  scaled  foil  sachet  ensuring  sterility 
and  stability. 

Impregnated  with  a  non-systemic 
broad  spectrum  antibiotic,  it  rapidly 
eradicates  wound  infection;  is  not  in- 
activated by  blood,  pus.  or  serum; 
affords  excellent  physical  protection; 
does  not  adhere  to  granulating  tissue; 
docs  not  produce  maceration;  is  easy 
to  handle  and  apply.  Sterility  and  stabil- 
ity are  assured  at  all  times,  and  it  is 
economical  to  use. 

Soframycin  Unitulle  may  be  used  for 
burns  and  scalds;  lacerations,  abra- 
sions, bites,  puncture  wounds,  and 
crush  injuries;  varicose,  diabetic,  decu- 
bitus, and  tropical  ulcers;  skin  grafts 
(tlonor  and  receptor  sites);  avulsion  of 
linger  and/or  toe  nails;  circumcision; 
suture  lines;  etcetera. 

When  dressing  ulcers,  the  tulle  should 
be  shaped  to  fit  the  ulcer  crater,  thus 
minimizing  any  potential  risk  of  sensi- 


Examining  Table 

tization  due  to  contact  with  the  sur- 
rounding epidermis.  If  the  lesion 
exudes  profusely,  it  is  advisable  to 
change  the  dressing  at  least  once  a 
day. 

In  patients  known  to  be  allergic  to 
Streptomyces-derived  antibiotics  (neo- 
mycin, paramomycin.  kanamycin), 
cross  sensitization  to  Soframycin  may 
occur,  but  not  invariably  so.  In  most 
cases  absorption  of  the  antibiotic 
is  negligible.  However,  where  large 
body  areas  are  involved,  e.g.,  30  per- 
cent or  more  body  burn,  the  possibility 
of  ototoxicity  being  produced  by  pro- 
longed applications  should  be  borne  in 
mind. 

Available  in  cartons  of  10  units, 
each  unit  pack  contains  one  sterile 
antibiotic  gauze  dressing  10  cm  x  10 
cm. 

Enquiries  regarding  Soframycin 
Unitulle  may  be  addressed  to  the  manu- 
facturer. Roussel  (Canada)  Ltd..  2795 
Bates  Road.  Montreal  25  1,  Quebec. 


Plexitube  Line  Adds 
Twenty-Two  New  Items 
Baxter    Laboratories    of   Canada    has 
expanded   its  line  of  Plexitube  tubes 
and   catheters   with    the    recent   addi- 
tion of  22  individual  new  items. 

The  additions,  varying  in  gauge  and 
size,  represent  six  basic  families  of 
tubes  and  catheters,  which  include 
Levin  stomach  tubes,  nasal  oxygen 
catheters  and  connecting  lubes,  feed- 
ing tubes,  suction  catheters,  general 
iConliniicct  on  piii;e  21 ) 

THE  CANADIAN   NURSE     19 


Fleet 

ends  ordeal  by 

Enema 

for  you  and 
your  patient 


Now  in  3  disposable  forms: 

•  Adult  (green  protective  cap) 

•  Pediatric  (blue  protective  cap] 

•  Mineral  Oil  (orange  protective  cap) 

Fleet  —  the  40-second  Enema  *  —  is  pre-lubricated,  pre-mixed, 
pre-measured,  individually-packed,  ready-to-use,  and  disposable. 
Ordeal  by  enema-can  is  over! 

Quick,  clean,  modern,  FLEET  ENEMA  will  save  you  an  average  of 
27  minutes  per  patient  —  and  a  world  of  trouble. 

WARNING:  Not  to  be  used  when  nausea.  In  dehydrated  or  debilitated 

vomiting  or  abdominal  pain  is  present.  patients,  the  volume  must  be  carefully 

Frequent  or  prolonged  use  may  result  in  determined  since  the  solution  is  hypertonic 

dependence.  and  may  lead  to  further  dehydration.  Care 

CAUTION:  DO  NOT  ADMINISTER  should  also  be  taken  to  ensure  that  the 

TO  CHILDREN  UNDER  TWO  YEARS  contents  of  the  bovirel  are  expelled  after 

OF  AGE  EXCEPT  ON  THE  ADVICE  administration.  Repeated  administration 

OF  A  PHYSICIAN.  at  short  intervals  should  be  avoided. 

Full  information  on  request. 


/e\l 


t   PHARMACEUTICALS 


•Kehlmann,  W.  H.:  Mod.  Hosp.  84:104,  1955  /*V--^aa;ife4£.3iu>»t&Co. 

/     ^m^^        KWKLANO  (MONT(C*LJ  CANADA         ^ 

FLEET  ENEMA®  —  single-dose  disposable  unit     /   ^^ 


fOiltOCD  m  CAMAOA  » 


20     THE  CANADIAN   NURSE  FEBRUARY  1971 


new  products 


(Continued  from  page  19) 

purpose  connecting  tubes,  and  urethral 

catheters. 

The  tubes  and  plastic  catheters  are 
made  of  clear  polyvinyl,  the  Foley 
catheters,  of  soft  latex.  The  beveled 
eyes  and  tips  prevent  tissue  irritation, 
and  bold  markings  clearly  indicate 
insertion  depths.  Thin-wall  design 
permits  a  small  outside  diameter  with- 
out sacrificing  inside  diameter. 

Connectors  for  females,  made  of 
flexible  gum  rubber,  will  fit  the  wide 
variety  of  connectors  found  in  hospitals. 
Connectors  for  males  lit  around  the 
tube  to  prevent  reduction  of  lumen  size. 

Plexitube  tubes  and  catheters  are 
odorless,  tasteless,  and  non-toxic. 
Transparent  Pell-Pack  packaging  af- 
fords easy  visual  identification  of 
contents  and  aseptic  dispensing. 

For  additional  information  write 
Director  of  Marketing.  Baxter  Labor- 
atories of  Canada.  640,^  Northam 
Drive.  Malton.  Ontario. 

Literature  Available 

Defense  Against  Decubitus  Ulcers: 
The  Conquest  of  the  Hidden  Epidemic, 
a  comprehensive,  12-page  booklet, 
has  been  issued  by  Alconox,  Inc.  Direct- 
ed to  nurses,  nurses  aides,  adminis- 
trative and  personnel  training  staff  of 
health  care  institutions,  it  details  the 
causes,  symptoms  and  prophylaxis  or 
prevention  of  decubitus  ulcers. 

The  booklet  describes  the  use  of 
topical  applications,  pressure-relieving 
materials,  and  mentions  the  relative 
merits  of  aerosol  spray  versus  cream 
for  topical  applications,  and  natural 
sheepskins  or  shearlings  versus  synthetic 
fibers  as  pressure-relieving  materials. 

The  preventive  program  presented 
in  the  booklet  is  designed  for  convenient 


Patient-Proof  Safety  Belt  Clip 


inclusion    in    an    institution's    regular 
program  of  total  patient  care. 

The  special  appendix  includes  a 
suggested  pocket-sized  directive  manual 
for  nurses  and  aides  that  outlines  a 
seven-point  action  program,  and  illus- 
trates the  body's  10  pressure  points 
most  prone  to  decubitus  ulcers.  A  bed- 
side form  with  nursing  directions  and 
record  chart  for  position  change  is 
included. 


MOVING? 
BEING  MARRIED? 

Be  sure  to  notify  us  six  weeks  in  advance, 
otherwise  you  will  likely  miss  copies. 


> 


Attacfi  the  Label 
From  Your  Last  Issue 

OR 
Copy  Address  and  Code 
Numbers  From  It  Here 


< 


NEW  (NAME) /ADDRESS: 


Street 


City 


Zone 


Decubitus  Ulcer  Literature 
FEBRUARY  1971 


Prov. /State  Zip 

Please  complete  appropriate  category; 

I     I     I  hold  active  membership  in  provincial 
nurses'  assoc. 


reg.  no./perm.  cert./  lie.  no. 

I     I    I  am  a  Personal  Subscriber. 

MAIL  TO: 

The  Canadian  Nurse 

50  The  Driveway 
OTTAWA  4,  Canada 


For  a  free  copy  of  Defense  Against 
Decubitus  Ulcers:  The  Conquest  of  the 
Hidden  Epidemic,  write  to  Alconox, 
Inc.,  215  Park  Avenue  South,  New 
York,  N.Y.  10003. 


Patient-Proof  Safety  Belt  Clip 

A  new  safety  belt  security  slip  has 
been  introduced  by  the  Posey  Company. 
This  device  prevents  a  patient  from 
untying  the  Posey  belts  or  wristlets  that 
keep  him  from  getting  out  of  or  falling 
from  his  bed  or  wheelchair. 

Designated  the  Poseyclip,  this  spring 
steel  item  can  be  used  on  virtually  all 
Posey  safety  devices  and  fits  all  web- 
bing up  to  two  inches  wide. 

The  Poseyclip  is  easily  attached  to 
or  removed  from  Posey  safety  belts 
and  vests  by  the  nurse,  yet  is  essentially 
impossible  for  the  patient  to  remove. 

The  new  Poseyclip,  Cat.  No.  8150, 
is  obtainable  in  Canada  through  Enns 
&  Gilmore  Ltd.,  Port  Credit,  Ontario. 

New  Medical  Headlight 

An  improved  medical  headlight  has 
been  developed  by  Welch  Allyn.  It  is 
fitted  with  a  high-intensity  quartz- 
halogen  lamp,  permitting  constant  light 
intensity  without  dimming  during  the 
life  of  the  lamp.  Additional  advantages 
of  the  quartz  halogen  lamp  are  the 
absence  of  filament  shadows  and  pre- 
servation of  natural  tissue  colors. 

A  built-in  iris  diaphragm  provides 
a  spot  adjustable  from  1 V2  "  to  6"  dia- 
meter at  14"  distance.  The  level  of 
illumination  is  uniform  through  this 
iris  diaphragm  regardless  of  spot  size. 

For  complete  information  write  the 
J.F.  Hartz  Company  Limited,  34  Me- 
tropolitan Road,  Scarborough,  Ontario 
or  any  Hartz  sales  and  distribution  cen- 
ter in  Canada.  'i3' 
THE  CANADIAN  NURSE     21 


0| 


There's  one  difference 

"It's  only  a  hazard  if  you're  a  female," 
said  a  nursing  sister  during  a  press 
interview.  She  referred  to  the  jumpsuit 
style  uniform  worn  by  flight  nurses 
during  medical  air  evacuations.  "Sure, 
we  like  them.  They're  comfortable, 
even  though  not  the  latest  in  style.  One 
pattern  does  for  male  and  female  nurses 
—  the  zip  slides  up  and  down." 

"What's  the  hazard  then?" 

"Well,  toilet  accommodation  on  an 
aircraft  is  somewhat  condensed  —  you 
walk  in,  tuck  arms  to  sides  like  a  hen's 
wings,  slide  the  zip  and  suit  down,  and 
hope!" 

"Hope?" 

"Yes,  hope  you  come  out  with  sleeves 
that  haven't  wandered  down  the  pan!" 


Science  has  priority  over  people 

On  December  8,  the  prime  minister  of 
Canada  was  asked  in  the  House  of 
Commons  if  he  would  consider  desig- 
nating a  minister  of  the  cabinet  to  deal 
with  the  implementation  of  the  recom- 
mendations of  the  report  of  the  Royal 
Commission  on  the  Status  of  Women. 
He  replied  that  if  the  House  passed 
the  reorganization  bill,  which  gives 
the  government  greater  flexibility  in 
appointing  ministers,  "perhaps  [italics 
ours]  I  will  be  able  to  extend  that  flex- 
ibility .  .  .  . " 

Ten  days  later,  after  the  first  volume 
of  the  report  of  the  senate  committee 
on  science  had  been  tabled,  the  prime 
minister  was  asked  if  he  would  appoint 


22     THE  CANADIAN   NURSE 


a  minister  to  be  responsible  for  science. 
His  reply  was  in  the  affirmative.  No 
hedging  here. 

Our  conclusion  can  only  be  that  the 
P.M.  does  not  take  the  report  of  the 
status  of  women  seriously.  He  puts 
science  before  people. 

Well,  as  Leone  Kirkwood  wrote  in 
The  Globe  and  Mail,  "Commissioners 
[  of  the  Royal  Commission  on  the  Status 
of  Women]  can  always  take  hope  that 
if  the  present  prime  minister  does  not 
take  action,  they  can  look  to  a  future 
one.  She  may  be  more  sympathetic." 

Those  days  are  gone  forever 

Nurses  have  toppled  off  their  ped- 
estals, is  the  opinion  of  a  doctor  quoted 
by  Mary  Powell,  S.R.N. .  M.C.S.F., 
in  the  British  Medical  Journal  in  May 
1970. 

Picking  up  the  pieces.  Miss  Powell 
said  the  doctor  and  administrator  in 
the  past  looked  on  the  nurse  rather  as 
a  Victorian  husband  looked  on  his  wife. 

You  know  what  that  means  —  the 
little  woman  always  at  hand  to  minister 
to  the  needs  of  her  lord  and  master. 
Having  left  the  Age  of  Victoria  for  the 
Age  of  Aquarius,  wives,  nurses,  in 
fact  all  women,  want  to  be  treated  as 
equal  partners  in  life's  endeavors. 

If  the  laws  of  gravity  are  still  in  ef- 
fect, the  fall  from  a  pedestal  is  a  down- 
ward motion.  Although  there  is  conflict 
generated  on  the  health  team  by  nurses' 
struggle  for  a  new  status,  it  surely  has 
an  upward  movement. 

Wash  (?)  those  cuffs! 

You  can't  trust  anything  these  days. 
A  study  done  in  Australia  and  ab- 
stracted in  the  November  1970  issue 
of  Modern  Medicine,  shows  that  clean 
sphygmomanometer  cuffs  usually  be- 
come heavily  contaminated  with  path- 
ogenic microorganisms  soon  after  they 
are  brought  into  a  hospital  ward  and 
are  then  a  possible  source  of  cross  in- 
fection. 

The  researchers  who  conducted  the 
study  report  that  staphylococcus  aureus 
was  found  on  44  of  48  linen  cuffs  from 
sphygmomanometers  in  common  use 
in  the  wards  of  a  hospital.  Frequently 
the  staphyloccocci  were  of  the  same 
phage  type  as  those  isolated  from  pa- 
tients. 

The   researchers'   advice?   Sterilize, 

or  at  least  wash,  cuffs  that  have  been 

used  on  patients  with  overt  skin  sepsis. 

FEBRUARY  1971 


for  use 
-on  the  ward 
-in  the  OR 


-in  training 


NEOSPORir 

IRRIGATING 

SOLUTION 

Available:  Sienle  1cc.  Ampoules. 
Boxes  of  10  and  100 

INSTRUCTIONS  FOR  USE 

This  preparaiion  is  spacifically  designed  lor  use  with  5  cc. 
"ihiflo-way"  caiherers  o(  with  other  catheter  systems  permit- 
ting continuous  irrigation  ol  the  urinary  bladder. 

1     PREPARE  SOLUTION 

Using  sterile  precautions,  one  (1 )  cc.  of  Neosporin  Irriga- 


INSERT  INDWELUNG  CATHETER 
Catheieri/e  Ihe  psiient  using  full  sterile  precautions.  The 
use  of  an  antibacterial  lubricant  such  as  Lubasporm*  Utethral 
Antibacterial  Lubticani  is  recommended  during  insertion  of 
the  catheter 

INFLATE  RETENTION  BALLOON 

Fill  a  Luer  type  syringe  with  1 0  cc.  of  sterile  water  or  saline 
(5  cc.  tor  balloon,  the  remainder  to  compensate  lor  the 
volume  required  by  the  inflation  channel)    Insert  sytinge 
tip  into  valve  of  balloon  lumen,  inject  solution  and  remove 
^  syringe, 

CONNECT  COLLECTION  CONTAINER 

■he  outflow  (drainage)  lumen  should  be  aseptically  con- 


FTACH  RINSE  SOLUTION 

e  5  cc.  "three-way"  catheter  should 
V  be  connected  to  the  bottle  of  diluted  Neosporin 
■rigaiion  Solution  using  sterile  technique. 

VAOJUST  FLOW-RATE 

'  For  most  patients  inflow  rale  o(  the  diluted  Neosporin 
Irrigating  Solution  should  be  adjusted  10  a  slow  drip  to 
deliver  about  1.000  cc,  every  iweniyfoui  hours  [about 
40  cc.  per  hour)    It  the  patient's  urine  output  exceeds  2 
liters  per  day  it  is  recommended  that  Ihe  inflow  rate  be 
adjusted  to  deliver  2.000  cc   of  Ihe  solution  in  a  twenty- 
four  hour  period.  This  requires  the  addition  of  an  ampoule 
of  Neosporin  Irngating  Solution  to  each  of  two  1,000  CC. 
bottles  ot  sterile  saline  solution. 

'    KEEP  IRRIGATION  CONTINUOUS 

It  IS  important  that  irrigation  of'the  bladder  be  continuous 
The  rinse  bottle  should  never  be  allowed  to  run  dry,  or  the 
inflow  drip  interrupied  lor  more  than  a  few  minutes  The 
outflow  tube  should  always  be  inserted  into  a  sterile 


•    Convenient  product  idenlifying  labels  for  use  on  bottles 
of  diluted  Neosporin  Irrigating  Solution  are  available  in  e 


, .  . ,.,.„  .„„^,.,  ,„,  ^„  „n  bottles 

of  diluted  Neosporin  Irrigating  Solution  are  available  in  eai 
ampoule  pecking  or  from  your  'B.  W.  &  Co.'  Representativ 


ft 


Burroughs  Wellcome  &  Co.  (Canada)  Ltd. 


„»«..(7^ 


Neosporirf  Irrigating  Solution 


INSTRUCTIONS  FOR  USE 


Designed  especially  for  the  nursing  pro- 
fession, this  Instruction  Sheet  shows 
clearly  and  precisely,  step  by  step,  the 
proper  preparation  of  a  catheter  system 
for  continuous  irrigation  of  the  urinary 
bladder.  The  Sheet  is  punched  3  holes  to 
fit  any  standard  binder  or  can  be  affixed 
on  notice  boards,  or  in  stations. 

For  your  copy  (copies)  just  fill  in  the  cou- 
pon (please  print)  noting  your  function  or 
department  Within  the  hospital. 


Dept.  S.P.E. 

Burroughs  Wellcome  &  Co.  (Canada)  Ltd. 

P.O.  Box  500,  Lachine,  P.O. 

Gentlemen : 

Please  send  me  I 1  copy  (copies)  of  the  N.I.S.  Instructions  for  Use.  My  department  or  function 

within  the  hospital  is 


NAME. 


ADDRESS. 


CITYORTOW/N_ 


.PROV. . 


*TradP  Mark 

FEBRUARY  1971 


Burroughs  Wellcome  &  Co.  (Canada)  Ltd. 


THE  CANADIAN   NURSE     23 


iAD 


flBBI^^^^ 


These  features  are  what  makes 


dermicel 

Surgical  Tape 

the  tape  of  things  to  come 

—  for  its  hypo-reactivity  —  making  it  especially  well  tolerated  by  patients  with  a  history 
of  tape  sensitivity  —  and  of  course  '>'y>'~^^_^i|i/"  not  counting  Dermicel's  special 
ability  to  peel  off  the  skin  —  especially  hair-bearing  surfaces  —  pain- 


lessly and  with  an  absolute  minimum  of  skin  reaction  —  and  if  you  V-vvsv; 
disre-x^^-T^  gard  Dermicel's  single  ingredient  adhesive  mass,  something  of  an 
'innovation  in  the  evolution  of  surgical  tape  —  and  finally  of  course,  pro- 
vided you  overlook  the  ultimate  difference  about  Dermicel  —  the  fact  that  it  looks 
different  and  feels  different  and  is  better  to  work  with  than  traditional  surgical  tape 


©j&j 


dermicel 

Surgical  Tape 

another  improvement  from 

n  n  LIMITED 

'Trademark  of  Johnson  &  Johnson  or  Affiliated  Companies. 


A  look  at  the  Francis  Report  * 

on  the  Status  of  Women  in  Canada 


No  Royal  Commission  report  satisfies 
everyone,  and  the  Francis  Report  is  no 
exception.  Some  say  the  commissioners 
did  not  go  far  enough  in  certain  areas; 
others  say  they  went  too  far.  Some  say 
the  report  is  already  outdated,  that 
women's  liberation  movements  have 
outstripped  it;  others  say  it  is  ahead 
of  its  time,  that  society  is  unprepared 
to  implement  its  recommendations. 

Despite  these  differences  of  opinion, 
few  will  disagree  that  the  report  is  a 
well-documented,  carefully  compiled 
account  of  the  discrimination  against 
women  that  still  prevails  in  Canada. 
The  report  is  a  first  step,  an  important 
step,  which  can  lead  to  radical  changes 
if  both  sexes  are  prepared  to  study  it 
objectively,  react  to  it,  and  put  pressure 
on  governments  at  all  levels  to  act. 

As  the  news  media  have  given  con- 
siderable publicity  to  most  of  the  re- 
port's recommendations,  we  shall  con- 
fine ourselves  to  a  few  that  are  of 
particular  concern  to  nurses  and  nurs- 
ing in  Canada. 

Women  in  the  Canadian  Economy 

•The  commissioners  found  many  in- 
stances where  women  received  less  pay 
than  men  for  the  same  work,  even 
though  most  employees  in  Canada  are 
covered     by     legislation     prohibiting 

*  Every  commission  —  Royal  or  other- 
wise —  invariably  takes  on  the  name  of 
its  chairman  (e.g..  the  Hall  Report  on 
Health,  the  LeDain  Commission  on  the 
non-medical  use  of  drugs,  the  Davey 
Report  on  the  Mass  Media,  etc.)  We  shall 
refer  to  the  Report  of  the  Royal  Com- 
mission on  the  Status  of  Women  in  Cana- 
da (chaired  by  Anne  Francis)  as  the  Fran- 
cis Report. 


FEBRUARY  1971 


different  rates  of  pay  on  the  basis  of 
sex.  Several  of  the  report's  recommen- 
dations relate  to  this  injustice. 

It  is  apparent,  the  Report  states, 
that  equal  pay  for  equal  work  will  not 
be  a  fact  until  all  employers  and  unions 
accept  the  principle,  and  until  there  is 
effective  legislation  to  enforce  the 
principle. 

The  Report  cites  the  case  of  female 
nursing  assistants  and  male  nursing 
orderlies  as  the  most  widely  known 
example  of  controversy  over  whether 
or  not  two  occupations  are  sufficiently 
similar  to  warrant  equal  pay  under  the 
law.  Pointing  out  that  nursing  assistants 
must  be  provincially  licensed  after 
completing  a  10-month  training  course 
and  that  most  nursing  orderlies  have 
no  such  qualification  requirements 
to  meet  and  are  usually  trained  on  the 
job,  the  commissioners  said  they  were 
told  of  situations  where  nursing  or- 
derlies got  higher  pay  than  nursing 
assistants. 

While  examining  the  country's  lar- 
gest employer  of  women  —  the  fed- 
eral government  —  the  commissioners 
found  similar  discrimination:  "The 
predominantly  female  occupation 
Nursing  Assistant  and  the  predom- 
inantly male  occupation  Nursing 
Orderly  have  similar  duties  and  respon- 
sibilities. The  starting  salaries  for  the 
two  classes  in  the  Public  Service  are 
the  same.  Yet  Nursing  Assistants  are 
required  to  have  completed  a  course 
of  training,  usually  10  months  long, 
and  to  be  provincially  licensed  or 
certified.  Nursing  Orderlies,  on  the 
other  hand,  are  trained  on  the  job. 
More  than  this.  Orderlies  are  auto- 
matically promoted  to  Specialist  Or- 
derlies, with  higher  pay,  after  their 
THE  CANADIAN  NURSE     25 


training  and  a  period  of  satisfactory 
service;  Nursing  Assistants  are  not." 

The  Report  recommends:  that  the 
differential  treatment  of  Nursing  Assis- 
tants and  Nursing  Orderlies  in  the 
federal  Public  Service  be  eliminated. 

•The  Report  states  that  another  reason 
for  women's  lower  earnings  is  that 
occupations  and  professions  predom- 
inantly female  tend  to  be  lower  paid 
than  those  predominantly  male.  It 
quotes  the  brief  from  the  Canadian 
Nurses'  Association,  which  says  that 
the  cause  of  the  shortage  of  available 
nurses  is  not  so  much  an  inadequate 
number  of  trained  nurses  as  the  fact 
that  nurses  are  entering  other  occupa- 
tions with  better  pay  and  working 
conditions. 

Why  have  women  remained  in  these 
lower-paid  occupations  and  professions? 
the  Report  asks.  Because  women  sim- 
ply do  not  have  as  many  occupation..! 
alternatives  as  men.  To  change  this, 
people  must  stop  thinking  of  partic- 
ular jobs  as  the  domain  of  one  sex  or 
the  other,  the  Report  states,  and  em- 
ployers must  show  they  are  willing 
to  change  by  hiring  women  in  male 
occupations  and  men  in  female  occupa 
tions. 

The  Commissioners  believe  this 
change  in  attitude  will  take  time.  They 
urge  the  federal  government  to  show 
leadership  now  by  counteracting  some 
of  the  ill-effects  of  occupational  seg- 
regation on  women's  earnings.  In  other 
words,  instead  of  following  rates  paid 
in  the  community  —  its  usual  policy 
—  the  federal  government  should  lead 
the  way  and  "accelerate  this  adjustment 
in  .  .  .  traditionally  female  professions 
now  short  of  workers." 

The  Report  recommends:  that  the 
pay  rates  for  nurses,  dietitians,  home 
economists,  librarians  and  social  work- 
ers employed  by  the  federal  government 
be  set  by  comparing  these  professions 
with  other  professions  in  terms  of  the 
value  of  the  work  and  the  skill  and 
training  involved. 

•The  commissioners  said  the  federal 
government  has  shown  little  leader- 
26     THE  CANADIAN  NURSE 


ship  in  giving  women  a  chance  to  show 
they  have  capacities  comparable  to 
men.  A  review  made  in  1969  by  the 
Commission  revealed  that  on  the  boards 
of  directors  of  97  federal  agencies. 
Crown  Corporations,  and  Task  Forces 
there  were  639  men  and  only  42  wo- 
men. Women  comprised  only  6.3  per- 
cent of  those  appointed  and  74  of  these 
organizations  had  no  women  members. 
"We  are  convinced  that  qualified 
women  are  available,"  the  Report 
states,  "and  we  believe  that  these  bodies 
may  profit  from  management  that 
reflects  the  views  and  experience  of 
women  as  well  as  those  of  men.  There- 
fore, we  recommend  that  the  federal 
government  increase  significantly  the 
number  of  women  on  federal  Boards, 
Commissions,  Corporations,  Councils, 
Advisory  Committees  and  Task  Forces. 
Further,  we  recommend  that  provin- 
cial, territorial,  and  municipal  govern- 
ments increase  significantly  the  number 
of  women  on  their  Boards,  Commis- 
sions, Corporations,  Councils,  Advisory 
Committees  and  Task  Forces." 


Poverty 

•To  be  old  means,  far  too  often,  to 
be  poor,  the  Report  states.  "...  el- 
derly women,  single  or  widowed,  are 
left  behind  in  our  society.  Thousands 
are  living  lives  of  loneliness  and  depri- 
vation. Although  not  starving,  they 
are  undernourished  at  a  time  when 
they  need  a  good  diet  to  maintain  their 
health." 

The  Commission's  conclusion  is 
that  Canada's  old  age  security  system 
is  based  on  an  excellent  formula  of 
payments,  but  lacks  generosity.  If  so- 
cial rights  are  to  be  at  all  meaningful, 
the  standard  of  living  of  the  aged  should 
not  be  allowed  to  decline  when  the 
general  standard  of  living  in  the  country 
is  rising. 

The  Report  recommends:  that  (a) 
the  Guaranteed  Income  Supplement  to 
the  Old  Age  Security  benefits  be  in- 
creased so  that  the  annual  income  of 
the  recipients  is  maintained  above  the 
poverty  level,  and  (b)  the  Supplement 
be  adjusted  to  the  cost  of  living  index. 


Participation  of  Women  in  Public  Life 

•The  Report  states  the  obvious  — 
that  the  voice  of  government  is  still  a 
man's  voice,  and  the  formulation  of 
policies  affecting  the  lives  of  all  Cana- 
dians is  still  the  prerogative  of  men. 
It  adds  that  the  absurdity  of  this  situa- 
tion was  illustrated  when  debate  in 
the  House  of  Commons  on  a  change 
in  abortion  law  was  conducted  by  263 
men  and  I  woman. 

"Nowhere  else  in  Canadian  life  is 
the  persistent  distinction  between  male 
and  female  roles  of  more  consequence. 
No  country  can  make  a  claim  to  having 
equal  status  for  its  women  so  long  as 
its  government  lies  entirely  in  the  hands 
of  men.  The  obstacles  to  genuine  par- 
ticipation, when  they  lie  in  prejudice, 
in  unequal  family  responsibility,  or 
in  financing  a  campaign,  must  be  ap- 
proached with  a  genuine  determination 
to  change  the  present  imbalance. 

"In  pursuit  of  this  aim  women  must 
show  a  greater  determination  to  use 
their  legal  right  to  participate  as  citi- 
zens. They  must  reconsider  the  reasons 
that   have   kept   them   from   ehtering   1 

nnlitire  "  c^     ^ 


politics  . 


* 


FEBRUARY  19711 


OPINION 


Catchbasins^ 
debentures^  subsidies 
and  garbage  cans 

An  alderman,  who  is  also  a  registered  nurse,  urges  nurses  to  play  an 
active  role  in  politics. 


Mary  M.  Conroy,  B.Sc.N. 

It  is  only  since  1926  that  women  in 
Canada  have  been  legally  recognized 
as  persons.  And  whether  or  not  we 
agree  with  the  Women's  Liberation 
Movement,  most  of  us  do  believe  that 
its  ultimate  aim,  a  wider  acceptance 
of  women  as  individuals,  is  desirable. 
Women  have  a  definite  role  to  play  in 
shaping  our  society,  and  this  includes 
the  important  sphere  of  government. 
To  most  of  us,  the  form  of  government 
that  we  can  most  easily  influence  is 
municipal  government. 

Municipal  government  touches  our 
lives  daily,  and  in  many  practical  ways. 
It  touches  areas  that  are  the  special  con- 
cern of  women:  sewage  treatment,  wa- 
ter supply,  garbage  pick-up,  safe  streets 
and  roads,  and  the  education  of  our 
young.  Municipalities  now  assume  some 
of  the  responsibility  to  provide  adequate 
housing  for  people  who  lack  the  means 
to  provide  for  themselves,  especially 
the  aged. 

I  submit  that  women  have  abrogated 
their  responsibilities  as  citizens  for 
these  and  other  matters.   In  Ontario 


Mrs.  Conroy,  mother  of  three,  has  com- 
bined family  life,  a  nursing  career  as 
lecturer  in  microbiology  and  relief  super- 
visor at  Sudbury  Memorial  Hospital,  and 
political  activity.  Currently  she  is  enrolled 
in  the  third  year  of  a  law  clerk  course  at 
Cambrian  College  of  Applied  Arts  and 
Science,  Sudbury  Campus. 


FEBRUARY  1971 


last  year  there  were  7  controllers,  39 
aldermen  and  councillors  who  were 
women,  and  only  14  of  the  39  aldermen 
were  in  cities  with  a  population  of  more 
than  10,000.  There  is  only  one  woman 
member  in  the  federal  house,  and  there 
are  only  two  women  members  in  the 
Ontario  Legislature. 

Nurses  and  government 

There  is  much  to  be  done  by  women 
in  local  government,  and  nurses  should 
involve  themselves.  As  a  nurse  and  a 
citizen,  are  you  not  interested  in  the 
provision  of  a  safe,  healthful  water 
supply,  a  sanitary  sewage  system,  the 
provision  of  an  appropriate  number  of 
parks  and  open  spaces  to  allow  people 
to  thrive  in  your  community?  Are  you 
not  interested  in  adequate  housing,  the 
well-being  of  the  poor,  and  an  envi- 
ronment free  of  pollution? 

In  my  experience,  nurses  tend  largely 
to  be  content  to  serve  their  fellowman 
through  their  profession,  sometimes 
inadvertently  isolating  themselves  from 
the  other  needs  of  their  community. 
But  the  broad  general  education  they 
receive  and  the  specialized  training  and 
education  in  sociology,  psychology, 
child  development,  public  health,  ob- 
stetric and  geriatric  nursing  represent 
invaluable  knowledge  and  skills  that 
would  stand  any  person  in  good  stead 
when  dealing  with  the  wide  range  of 
problems  confronting  communities 
today. 

THE  CANADH^N   NURSE     27 


Many  nurses  with  additional  prepara- 
tion in  administration  can  understand 
and  help  to  improve  the  conduct  of 
local  government.  Participation  in 
nursing  organizations  helps  them  to 
understand  the  rudiments  of  parlia- 
mentary procedure  and  organizational 
details  that  are  part  of  a  councillor's 
job.  Nurses  are  better  prepared  to  par- 
ticipate effectively  in  municipal  gov- 
ernment than  are  most  local  politicians. 

Personal  involvement  in  politics 

For  the  past  three  years  I  have  served 
as  an  alderman  in  the  city  of  Sudbury 
as  the  only  woman  alderman  on  our 
council,  the  third  woman  to  be  involved 
in  local  politics  at  the  council  level  since 
the  founding  of  our  city  70  years  ago. 
I  can  admit  that  there  are  many  frustra- 
tions and  disappointments,  but  the 
rewards  outweigh  these. 

Politics  is  not  a  dirty  word.  Many 
people  shy  away  from  involvement, 
thinking  there  is  something  shady  about 
politics.  There  is  not,  nor  need  there 
be.  Politics  provides  the  machinery  to 
achieve  good  government.  But  politics 
is  also  service-oriented  —  there  can  be 
as  much  satisfaction  in  helping  citizens 
with  their  problems  and  improving  the 
community  as  there  is  in  helping  an 
individual  regain  his  health. 

If  politics  is  corrupt,  dirty  and  nas- 
ty, in  your  community,  it  may  be  that 
it  will  always  be  that  way  unless  women 
become  actively  involved.  Nurses  have 
a  great  deal  to  give. 

Primarily,  a  council  member  is  elect- 
ed to  represent  the  interests  of  a  group 
of  people  in  a  geographic  area  of  a  city. 
She  does  this  in  council,  on  committees 
and  boards  and  commissions.  She  par- 
ticipates in  making  decisions  that  affect 
the  city  as  a  whole.  She  can  be  an  ef- 
fective means  of  communication  be- 
tween the  people  who  elected  her  and 
the  bureaucracy  that  exists  in  gov- 
ernment. 

Women  in  politics 

Julia  Thompson,  a  lobbyist  in  Wash- 
ington for  the  American  Nurses'  As- 
sociation, once  said  that  women  in 
politics  need  firmness,  friendliness, 
femininity,  and  fortitude!*  An  effective 
politician,  of  whatever  sex,  must  be 
able  to  withstand  pressures  that  she 
considers  detrimental  to  the  common 
good.  She  has  to  be  friendly,  approach- 

*  Virginia  A.  Lindabury,  A  look  at  ANA's 
legislative  program.  Canad.  Nurse  65:7: 
22-4.  July  1969. 
28     THE  CANADIAN  NURSE 


able,  and  able  to  talk  to  people.  She 
has  to  remain  feminine.  A  woman  in 
politics  must  fight  a  tendency  to  become 
"one  of  the  boys"  or  "hard."  She  ought 
not  to  talk  like  a  man,  nor  act  or  look 
like  one.  However,  if  she  wants  to  have 
the  same  opportunities  as  a  man,  she 
must  be  prepared  to  accord  at  least 
the  same  time  and  effort  to  a  task  as 
he  does. 

A  councillor,  to  be  effective,  keeps 
uppermost  in  her  mind  the  people  she 
represents,  is  observant,  attentive,  and 
listens  intelligently.  She  has  an  open 
mind,  and  must  think  things  through 
by  considering  what  the  end  result  will 
be,  what  complications  will  be  encoun- 
tered, how  people  willbe  affected.  Recog- 
nizing that  the  mute,  passive  thinker  is 
useless,  she  enters  fully  into  discussions, 
and  participates  in  debates.  She  attacks 
a  problem,  not  people,  and  disagrees 
if  necessary,  but  does  so  agreeably. 
A  councillor  knows  enough  to  temper 
candor  with  tact,  to  avoid  agreeing  for 
the  sake  of  agreeing,  to  speak  freely 
without  monopolizing  a  meeting.  She 
guards  against  making  snap  decisions 
before  considering  all  the  implications, 
and  has  sound  reasons  for  her  own 
objections.  She  is  loyal,  honest,  and 
pleasant. 

With  experience,  other  skills  are 
developed:  how  to  explain  an  issue  to 
a  ratepayer  so  he  can  understand  it, 
seeing  another's  pxiint  of  view,  the 
ability  to  listen  and  to  learn.  A  coun- 
cillor gradually  becomes  strongly  deter- 
mined to  stand  up  for  what  she  thinks 
is  best  for  the  majority  of  the  electorate, 
even  if  she  must  stand  alone,  but  she 
retains  the  courage  to  admit  being 
wrong. 

Above  all,  a  councillor  must  have 
a  sense  of  humor  to  enable  her  to  laugh 
at  herself,  and  a  skin  thick  enough  to 
prevent  criticism  from  disturbing  her 
unduly.  However,  if  the  criticism  is 
justified,  she  will  learn  from  it. 

Municipal  politics,  like  other  fields, 
has  its  own  special  terms.  Debentures, 
assessment,  mill  rate,  catchbasins,  per 
capita  grants,  and  so  on,  are  foreign 
to  most  women  at  first.  A  few  evenings 
studying  a  text  on  municipal  govern- 
ment, a  short  course  on  municipal 
government,  such  as  those  offered  in 
most  community  colleges  and  night 
schools,  and  regular  attendance  at  coun- 
cil meetings  (which,  of  course,  are  open 
to  the  public)  will  familiarize  a  coun- 
cillor with  the  local  issues.  Regular 
reading  of  the  local  news  of  the  daily 
newspaper  will  also  help  her  become 
familiar  with  the  particular  issues  of 


her  community.  Most  fledgling  male 
politicians  are  equally  bewildered  and 
few  take  the  trouble  to  prepare  them- 
selves! 

Involvement  in  local  government 

If  being  an  active  member  of  your 
local  government,  either  on  the  munic- 
ipal council  or  school  board,  just  isn't 
for  you,  you  can  still  influence  the 
quality  of  your  civic  government  in 
many  other  ways. 

Cast  your  vote  on  election  day;  51 
percent  of  electors  are  women  and 
this  can  most  emphatically  influence 
who  gets  elected  to  office.  If  you  know 
someone  who  is  running  for  office,  make 
yourself  known  to  her;  offer  to  tele- 
phone a  list  of  people  for  her.  During 
my  last  campaign,  those  who  did  my 
telephoning  made  10  calls  each,  and 
they  said  it  took  less  than  an  hour. 
Offer  to  babysit  while  mothers  go  to 
the  polls,  have  coffee  parties  so  your 
friends  and  neighbors  can  meet  the 
candidate.  Stuff  envelopes,  address 
campaign  materials,  knock  on  doors! 
Know  the  issues  involved:  take  a  few 
minutes  a  day  to  read  the  local  news- 
paper. 

If  you  don't  want  to  run  for  office, 
investigate  the  numerous  appointed 
boards  and  commissions,  such  as  the 
library  board,  planning  board,  parks 
and  recreation  commission,  the  health 
unit  board.  In  our  community  a  nurse 
helped  me  considerably  with  my  cam- 
paign. Later,  I  was  able  to  put  her  name 
forward  to  serve  on  the  planning  board 
where  she  is  making  an  effective  con- 
tribution and  enjoying  it. 

Keep  your  councillors  informed  ofj 
problems  in  your  area  and  how  you' 
feel  about  issues.  Unless  the  electorate 
provides  councillors  with  some  "feed- 
back" it  is  impossible  to  represent  them 
adequately. 

Hats  off  for  the  political  ring 

All  of  us  wear  many  hats  in  our 
lives,  we  play  many  roles.  Less  and  less 
often  women  go  to  "pink  teas"  wearing 
the  symbolic  flowery  hat  —  a  shield 
behind  which  many  hide  from  respon- 
sibilities in  the  world.  Don't  let  your 
own  snowy-white  nurse's  cap  isolate 
you  from  your  responsibilities  as  a 
citizen.  Why  don't  you  take  off  your  cap 
and  throw  it  into  the  political  ring? 
Being  a  member  of  your  local  govern- 
ment is  an  exciting,  worth-while  activ- 
ity. Try  it;  you  won't  regret  it.  W 


FEBRUARY  1971 


i 


Preadmission  orientation 
for  children  and  parents 

How  one  hospital  helps  its  pediatric  patients  adjust  to  the  realities 
of  hospitalization. 


Margaret  Joan  Brown 


A  young  child's  first  experience  as  a 
hospital  patient  can  be  frightening. 
He  may  never  have  visited  a  hospital, 
yet  have  a  strongly  preconceived  idea 
of  one,  stimulated  by  his  active  imagi- 
nation. He  may  have  overheard  adult 
conversations  he  does  not  entirely 
understand,  or  have  been  subjected 
to  exaggerated  accounts  by  his  play- 
mates who  have  been  patients  in  hospi- 
tal. The  capacity  to  reason  and  to  dif- 
ferentiate between  fact  and  fancy  may 
not  yet  be  developed,  allowing  his 
fantasies  and  fears  to  lead  to  an  unreal- 
istic interpretation  of  what  a  stay  in 
hospital  can  be. 

Established  programs 

In  many  centers  in  the  United  States 
there  are  established  programs  design- 
ed to  make  admission  to  hospital  a 
positive  emotional  and  physiological 
experience  for  children. 

In  Oakland,  California,  nursery 
school  children  join  a  program  called 
"Through  the  Looking  Glass"  at 
Children's  Hospital  of  the  East  Bay  for 
preadmission  orientation.  These  chil- 
dren are  not  necessarily  about  to  be 
admitted  to  hospital.' 

Miss  Brown,  a  graduate  of  the  Royal 
Alexandra  Hospital.  Edmonton,  Alberta, 
is  Head  Nurse  of  pediatrics  at  Sturgeon 
General  Hospital,  St.  Albert.  Alberta. 
Previously  she  was  a  general  duty  nurse 
on  pediatrics  at  the  Royal  Alexandra. 


FEBRUARY  1971 


In  Detroit,  Michigan,  the  Children's 
Unit  at  the  Lafayette  Psychiatric  Clinic 
has  instituted  a  preadmission  conference 
where  a  child  and  his  parents  meet 
with  three  or  more  members  of  the 
medical  staff,  one  or  more  nurses  from 
the  children's  unit,  and  a  social  worker 
to  develop  plans  for  initial  care  and 
treatment.  This  is  followed  by  a  tour 
of  the  children's  ward.  ^ 

In  St.  Paul,  Minnesota,  a  student 
nurse  from  the  pediatric  unit  of  St. 
Joseph's  Hospital  visits  the  home  of  a 
preschool  child  one  or  two  days  prior 
to  his  admission  to  hospital.  Her  pur- 
pose is  to  allay  parental  anxiety  and  to 
tell  the  child,  if  old  enough,  what  to  ex- 
pect during  his  stay  in  hospital.^ 

Supporting  studies 

Vernon  has  reviewed  studies  showing 
that  unfamiliarity  or  lack  of  adequate 
information  tended  to  produce  signs  of 
stress  in  normal  children?  Among 
these  studies,  only  one  indicated  that 
preparation  for  hospitalization  result- 
ed in  psychological  benefit.  In  other 
studies,  children  with  such  preparation 
showed  no  significant  improvement 
in  immediate  responses.  However,  in 
several  studies  where  young  patients 
had  not  been  prepared  for  hospitaliza- 
tion, the  incidence  of  psychological 
upset  after  discharge  from  hospital 
was  greater  and  lasted  longer,  s 

The  results  of  these  studies  point  to 

a  decrease   in   psychological   upset  if 

THE  CANADIAN   NURSE     29 


children  are  prepared  for  hospital. 
Another  finding  is  that  time  spent 
by  personnel  in  conducting  an  orienta- 
tion program  is  offset  by  a  reduction 
in  time  needed  to  care  for  these  chil- 
dren during  their  stay  in  hospital.^ 

Orientation  program  at  Edmonton 

The  preadmission  orientation  pro- 
gram for  children  at  the  Royal  Alex- 
andra Hospital,  Edmonton,  Alberta, 
is  an  attempt  to  reduce  anxiety  in  child- 
ren about  to  be  admitted  to  hospital 
for  elective  surgery. 

The  Tuesday  before  a  child  is  to  be 
admitted,  the  admitting  officer  notifies 
the  parents  and  invites  them  to  attend 
the  preadmission  orientation  program 
to  be  held  on  Friday  afternoon.  To 
be  most  effective  an  orientation  pro- 
gram should  allow  enough  time  for  a 
child  to  think  about  hospitalization, 
30     THE  CANADIAN   NURSE 


but  not  enough  time  to  build  up  anxie- 
ties about  it.  7 

At  1.30  P.M.  on  Friday,  the  young 
prospective  patients  and  their  parents 
are  greeted  by  the  pediatric  supervisor. 
Each  child  is  given  a  "magic  number," 
that  of  the  unit  to  which  he  will  be  ad- 
mitted. 

An  information  session  follows.  The 
business  officer  says  a  few  words  about 
the  discharge  and  billing  of  patients. 
Then,  the  director  of  admitting  dis- 
cusses admitting  procedures.  While 
explaining  the  need  for  identification, 
an  Identi-Band  is  placed  on  the  wrist 
of  a  young  volunteer.  A  fashion  show 
then  captures  the  interest  of  the  chil- 
dren as  they  see  hospital  personnel  mod- 
eling their  uniforms,  and  finally  a  nurse 
and  a  doctor  appearing  in  operating 
room  dress  complete  with  mask  and  OR 
boots.  The  commentary  is  light  and 


cheerful,  in  language  easily  understood 
by  the  young  visitors. 

Toward  the  end  of  the  program  rep- 
resentatives from  the  units,  bearing 
one  of  the  "magic  numbers"  assigned 
to  the  children,  conduct  the  visitors 
on  a  tour,  beginning  with  the  coffee 
shop,  gift  shop,  and  barber  shop,  then 
the  admitting  area  and  the  laboratory. 
Later,  in  the  operating  room,  the  equip- 
ment is  demonstrated  by  a  doctor  and 
a  nurse  who  invite  the  children  to  lie 
on  the  operating  table,  to  see  how  a  res- 
traint feels,  and  to  have  a  rubber  tour- 
niquet applied. 

The  tour  ends  in  the  nursing  unit 
itself,  with  its  interviewing  and  examin- 
ing rooms  where  the  child  will  later  be 
admitted.  A  demonstration  of  beds, 
bedside  tables,  individual  equipment, 
meal  trays,  and  hospital  gowns  follows. 
Then,  in  the  dressing  room,  the  chil- 
FEBRUARY  1971 


Barbara  Wood,  R.N.,  and  Blanche 
Thompson,  C.N. A.,  serve  children  ice 
cream  and  juice  at  the  orientation  party 
held  at  the  Royal  Alexandra  Hospital, 
Edmonton. 


dren  are  told  about  having  temperatures 
taken,  being  given  suppositories,  and 
the  preoperative  injection. 

Children's  party 

Then  follows  a  party  in  the  play- 
room for  the  children  themselves.  It 
has  been  said  that  a  child  should  not  be 
told  that  his  stay  in  hospital  will  be  fun, 
or  like  a  party. s  At  the  Royal  Alexandra 
Hospital  the  party  is  considered  to 
produce  a  feeling  of  separation  from 
the  hospital  environment  and  to  give 
the  child  a  chance  to  acquire  new  friends 
whom  he  often  remembers  when  he  is 
admitted  to  hospital  the  following  week. 

The  party  occupies  the  child  while 
his  parents  are  in  the  classroom  where 
a  child  psychiatrist  and  the  pediatric 
supervisor  discuss  problems  of  hospital- 
ization. The  supervisor  explains  per- 
missive visiting,  the  facilities  available 
to  parents,  hospital  routines  and  poli- 
cies. Parents  are  encouraged  to  bring 
the  child's  "security"  item  to  hospital. 

The  child  psychiatrist  stresses  the 
importance  of  telling  the  child  the 
truth,  of  the  father  visiting  his  child, 
and  of  parents  maintaining  self-control 
in  front  of  their  child. 

He  tells  how  to  explain  surgery  to 
children  of  different  ages,  including 
the  need  to  repeat  information  to  allow 
a  child  to  remember.  The  child  psy- 
chiatrist mentions  possible  postoper- 
ative complications  and  discusses  what 
reactions  a  child  may  have  to  his  par- 
ents   after   surgery.    The    parents   are 

FEBRUARY  1971 


encouraged  to  express  their  anxieties 
and  to  ask  questions  about  their  child's 
pending  operation. 

Results  of  preparation 

Although  there  have  been  no  official 
studies  to  measure  the  effectiveness  of 
the  program  at  the  Royal  Alexandra 
Hospital,  the  nursing  staff  have  noted 
a  difference  in  the  attitudes  of  chil- 
dren who  have  participated  in  their 
orientation  program.  Anesthesiologists 
at  the  Royal  Alexandra  Hospital  have 
stated  that  they  too  can  identify  those 
children  who  have  been  prepared  for 
hospitalization  through  the  orienta- 
tion program.  This  program  seems  to 
have  the  greatest  effect  on  children 
between  four  and  six  years  of  age. 

Orientation  programs  at  several  other 
hospitals  have  shown  positive  effects. 
At  Children's  Hospital  of  the  East 
Bay,  Oakland  (where  "Through  a  Look- 
ing Glass"  is  conducted)  the  children 
participating  in  their  program  seem  to 
make  a  better  adjustment  than  those  for 
whom  hospitalization  is  a  totally  new 
experience.  9  However,  the  East  Bay 
program  may  be  of  limited  value  be- 
cause of  the  indefinite  lapse  of  time 
between  preparation  and  hospitaliza- 
tion. 

Through  the  program  at  Lafayette 
Psychiatric  Clinic,  the  staff  is  able  to 
observe  the  family  as  a  unit,  noting  the 
parents'  attitudes  and  responses  to 
their  child.  The  family  conference 
also  permits  communication  among 
all  disciplines  while  developing  a 
treatment  plan.'° 

Because  the  nurse  at  St.  Joseph's 
Hospital  has  seen  the  child  and  his 
parents  in  the  family  setting,  she  can 
better  evaluate  the  emotional  support 
that  both  child  and  parents  will  need.^i 

The  results  of  these  programs  in- 
dicate the  desirability  of  some  form  of 
pre-hospitalization  orientation.  Factors 
to  be  considered  in  determining  content 
and  presentation  of  the  orientation 
programs  are:  1 .  the  child's  age;  2.  time 
of  preparation;  3.  information  pertinent 
for  parents;  and  4.  information  neces- 
sary for  the  child. 

More  research  is  required  to  deter- 


mine the  effectiveness  of  existing 
programs  and  to  investigate  means  of 
improving  them.  A  need  exists  for  ed- 
ucative measures  that  can  reduce  the 
psychological  stress  of  hospitalization 
for  the  child. 

References 

1.  Through  a  looking  Glass.  Hospitals. 

34;47  Jan.  16,  1960. 

2.  Chace,  Kathryn  S.  The  pre-admission 
conference  —  a  tool  for  planning  nurs- 
ing care.  J.  Psychiat.  Niirs.  3:490. 
Nov.-Dec,  1965. 

3.  Geis,  Dorothy  P.  and  Rochon.  Sister 
Dolore.  Home  visits  help  prepare  pre- 
schoolers for  hospital  experience. 
Hospitals.  40:87  Feb.  16,  1966. 

4.  Vernon,  D.T.A.,  Foley,  J.M..  Sipo- 
wicz,  R.R.,  and  Schulman,  J.L.  The 
Psychological  Response  of  Children 
to  Hospitalization  and  Illness.  Spring- 
field. Illinois,  Charles  C.  Thomas, 
1965.  p.lO. 

5.  Ibid..  p.2\. 

6.  Ibid.,  p. 14. 

1 .  Blatherwick.  Carol  E.  The  pediatric 
orientation-to-hospital  program.  Al- 
berta Medical  Bulletin,  Feb.  1969, 
p.  12 

8.  Geist,  H.  A  Child  Goes  to  Hospital. 
Springfield,  Illinois.  Charles  C.  Thom- 
as, 1965,  p.22. 

9.  Through  a  looking  glass.  Hospitals, 
34:47,  Jan. 16,  1960. 

10.  Chace,  Kathryn  S.  The  pre-admission 
conference  —  a  tool  for  planning 
nursing  care.  J.  Psychiat.  Nurs. 
3:495,  Nov.-Dec,  1965. 

1 1.  Geis,  Dorothy  P.  and  Rochon,  Sister 
Dolore.  Home  visits  help  prepare  pre- 
schoolers for  hospital  experience. 
Hospitals,  40:87,  Feb.  16,  1966.       '^ 


THE  CANADIAN   NURSE 


31 


Carotid  artery  stenosis 
with  transient  ischemic  attacks 


Many  patients  with  carotid  artery  stenosis  can  now  be  helped  to  live  normal 
lives.  The  author  describes  the  surgical  treatment  and   nursing  care  of  one 
patient  who  benefited  from  this  operation. 


Gelske  VanderZee 


While  reading  the  paper  one  evening, 
Mr.  A.,  a  49-year-old  social  worker, 
suddenly  found  he  could  see  only  the 
right  half  of  the  sports  page.  This  symp- 
tom was  transitory,  lasting  a  few  sec- 
onds. The  following  day  the  same  symp- 
tom recurred.  In  addition,  he  had  a 
"funny  feeling"  in  his  left  arm,  as  though 
the  arm  did  not  belong  to  him.  He 
phoned  Dr.  J.,  his  family  physician, 
who  came  and  examined  him. 

A  neurosurgeon  was  consulted.  He 
agreed  with  Dr.  J.  that  the  patient 
should  be  admitted  for  investigation, 
and  arrangements  were  made.  The 
provisional  diagnosis  was  carotid  ar- 
tery stenosis  with  transient  ischemic 
attacks. 

On  admission  to  the  neurosurgical 
unit,  Mr.  A's  blood  pressure  was 
120/70.  He  was  able  to  move  his  arms 
and  legs,  had  no  visual  disturbance. 


Miss  VanderZee,  a  graduate  of  the  Dla- 
conessehuis  Hospital,  Leeuwarden,  in 
the  Netherlands,  is  Head  Nurse  of  a 
neurosurgical  unit  at  the  Toronto  General 
Hospital.  This  article  was  adapted  from  a 
speech  the  author  presented  in  Toronto 
at  the  June  1970  meeting  of  the  Canadian 
Association  of  Neurological  and  Neuro- 
surgical Nurses. 


32     THE  CANADIAN   NURSE 


but  said  he  had  noticed  one  of  his  "fun- 
ny attacks"  while  waiting  admission. 

He  was  allowed  to  be  up  and  around 
the  unit,  given  a  regular  diet,  and  ad- 
vised to  stop  smoking,  as  nicotine  con- 
stricts the  arteries. 

The  neurosurgical  resident  examined 
Mr.  A.  and  ordered  routine  blood  and 
urine  tests,  skull  and  chest  x-rays,  a 
blood  sugar  to  rule  out  diabetes  melli- 
tus,  and  an  electrocardiogram  to  de- 
termine his  cardiac  status.  A  coagula- 
tion screen  was  done  and  the  reports 
indicated  no  bleeding  or  clotting  dis- 
corders.  His  physical  examination  was 
normal,  except  for  a  bruit  heard  over 
the  right  carotid  artery.  This  was  a 
swishing  noise  as  the  blood  passed 
through  the  narrowed  lumen  of  the 
artery. 

To  prevent  the  formation  of  small 
thrombi,  anticoagulant  therapy  was 
instituted,  the  dosage  based  on  a  daily 
prothrombin  time.  (A  prothrombin  time 
of  20  seconds,  with  a  normal  control 
of  1 1  or  12  seconds  is  desirable.) 

A  percutaneous  carotid  arteriogram, 
performed  to  visualize  the  neck  and 
cranial  vessels,  revealed  a  75  percent 
stenotic  lesion  in  the  right  carotid  ar- 
tery. The  carotid  and  vertebral  arteries 
are  the  main  source  of  blood  supply  to 
the  brain.  In  performing  an  endarter- 
FEBRUARY  1971 


Angiography  done  preoperatively  shows  stenosis  of  the 
right  carotid  artery. 


Angiography   done   six 
a  patent  artery. 


postoperatively   shows 


ectomy,  the  artery  is  temporarily 
occluded,  so  it  is  essential  for  the  other 
vessels  to  provide  an  adequate  blood 
supply  to  the  brain. 

After  the  carotid  arteriogram,  Mr. 
A.  was  closely  observed  for  neck  swel- 
ling, bleeding  at  the  site  of  the  puncture 
wound,  speech  difficulty,  dysphagia, 
weakness  of  arms  and  legs,  and  change 
in  level  of  consciousness.  As  symptoms 
may  be  aggravated  following  an  arterio- 
gram, any  change  in  the  patient  is 
reported  immediately. 

The  decreased  blood  flow  had  caused 
the  symptoms  Mr.  A.  experienced, 
which  he  feared  was  the  beginning  of 
a  cerebrovascular  accident.  His  first 
symptom  had  been  impaired  vision; 
if  untreated,  he  probably  would  have 
developed  first  partial,  then  complete, 
hemiparesis,  and  would  have  been 
unable  to  carry  on  his  work. 

Carotid  stenosis  with  ischemic 
attacks  usually  occurs  in  the  40  to  50 
age  group,  and  is  more  common  in  men 
than  in  women.  A  stenosis  can  be  the 
result  of  calcium  deposit  in  the  lumen 
of  the  artery,  which  usually  has  a  small 
ulcer  with  resulting  thrombus.  It  is  at 
FEBRUARY  1971 


the  bifurcation,  and  sometimes  the 
thrombus  extends  upward  into  the 
intracranial  portion  of  the  artery.  As 
the  artery  narrows,  the  patient  experi- 
ences symptoms  similar  to  Mr.  A.'s. 

Treatment 

Research  over  the  last  decade  has 
made  it  possible  to  assist  patients  who 
have  a  diagnosis  of  transient  ischemic 
attacks.  Successfully  treated,  they  can 
return  to  their  employment  and  contrib- 
ute to  the  community,  rather  than  be- 
come invalids  at  an  early  age. 

The  neurosurgeon  decided  to  treat 
Mr.  A.  surgically,  and  discussed  the 
procedure  with  the  patient  and  his 
wife.  Family  involvement  is  essential, 
as  members  of  the  family  are  the  ones 
who  can  best  give  the  patient  moral 
support  preoperatively,  postoperatively, 
and  when  he  returns  home. 

The  physiotherapist  assisted  both 
pre-  and  postoperatively  by  teaching 
Mr.  A.  to  breathe  properly  and  by 
giving  him  breathing  exercises  to  do. 

In  preparation  for  surgery,  Mr.  A. 
was  typed  and  cross-matched  for  six 
units  of  blood.  Early  on  the  morning 


of  surgery,  a  prothrombin  time  was 
done.  If  the  prothrombin  time  had  been 
above  20,  the  risk  of  bleeding  would 
be  too  great  and  surgery  would  have 
been  delayed  until  it  was  20. 

The  patient  had  been  told  that  after 
his  surgery  he  would  spend  a  few  days 
in  the  intensive  care  unit,  where  he 
would  be  given  more  constant  attention 
and  care. 

The  anesthetist  was  no  stranger  to 
Mr.  A.,  and  assisted  the  surgeon  in 
planning  the  patient's  management. 
He  visited  Mr.  A.  and  examined  him 
to  rule  out  any  condition  that  would 
contraindicate  the  giving  of  a  general 
anesthetic  and  the  possible  use  of 
hypothermia  and  hypertension. 

Surgical  procedure 

The  arteries  can  be  clamped  off  for 
a  longer  period  if  surgery  is  done  with 
the  patient  under  hypothermia,  as  less 
oxygen  is  required  at  a  lower  tempera- 
ture. Thirty  degrees  centigrade  is  an 
ideal  level  for  surgery  performed  under 
hypothermia.  The  patient's  vital  signs 
and  temperature  are  monitored  and 
closely  followed,  and  induced  hyper- 
THE  CANADIAN  NURSE     33 


Postoperatively,  the  patient's  neck 
circumference  is  measured  and  a  line 
drawn  on  the  dressing  over  the  center 
of  the  incision.  This  acts  as  a  guideline 
for  future  comparison.  An  increase 
in  the  circumference  could  indicate 
bleeding. 


The  patient's  dressing  is  usually  remov- 
ed five  days  postoperatively.  If  the 
wound  has  healed  and  no  obvious 
hematoma  is  present,  the  sutures  are 
removed  on  the  tenth  day. 


34     THE  CANADIAN   NURSE 


FEBRUARY  1971 


tension  is  used  as  an  added  measure 
to  ensure  adequate  blood  supply. 

Guided  by  the  location  of  the  steno- 
sed  area  as  shown  by  the  carotid  arte- 
riogram, the  surgeon  exposes  the  artery. 
The  artery  is  then  clamped  off  with 
rubber-tipped  "bull-dog"  clamps  below 
and  above  the  stenosed  area.  An  inci- 
sion is  made  over  the  stenosed  area 
visible  through  the  artery  wall.  The 
calcium  plaque  is  shelled  out  with  a 
small,  blunt,  spoon-shaped  instru- 
ment —  the  aim  being  to  establish  a 
good  retrograde  flow. 

In  Mr.  A.'s  case,  good  blood  flow 
was  established  on  removal  of  the 
plaque.  The  artery  was  closed  with  a 
firm  5.0  running  suture. 

In  this  type  of  surgery,  care  is  taken 
to  have  the  inner  side  of  the  artery 
meticulously  sutured  so  a  smooth  suture 
line  results,  reducing  the  possibility  of 
thrombi  formation.  In  patients  where 
more  than  one  artery  is  involved,  or 
where  an  artery  is  completely  occluded, 
a  bypass  procedure  is  used. 

Postoperative  care 

When  Mr.  A.  was  returned  to  the 
intensive  care  area  on  the  unit,  his 
bedside  was  ready  with  all  needed 
equipment  close  at  hand.  Level  of 
consciousness,  vital  signs,  and  move- 
ment of  extremities  were  checked  hour- 
ly. In  addition,  Mr.  A's  neck  circumfer- 
ence was  measured  with  a  tape  measure. 
A  line  was  drawn  on  the  dressing  over 
the  center  of  the  incision,  acting  as  a 
guideline  for  future  comparison.  An 
increase  in  the  circumference  could 
indicate  bleeding. 

A  clot  can  be  disastrous,  as  the  tra- 
chea is  close  to  the  vessels  involved; 
pressure  from  the  clot  on  the  trachea 
would  result  in  dyspnea.  Anoxia, 
dysphagia,  or  any  evidence  of  bleeding 
on  the  dressing  is  reported  immediately. 
To  relieve  severe  respiratory  distress, 
an  emergency  tracheostomy  may  be 
necessary. 

Mr.  A.'s  blood  pressure  and  pulse 
were  followed  closely  for  several  days. 
A  drop  in  blood  pressure  slows  the 
blood  flow  sufficiently  to  allow  thrombi 
FEBRUARY  1971 


to  form.  Bradycardia,  or  slow  pulse,  is 
the  result  of  carotid  sinus  stimulation 
and  is  dangerous,  especially  in  a  patient 
with  a  weak  heart  that  cannot  pump 
sufficient  blood  to  the  periphery.  This 
insufficiency,  in  turn,  slows  the  blood 
flow  and  causes  thrombi  to  form.  To 
reverse  the  bradycardia,  atropine  is 
ordered,  usually  given  subcutaneously. 
In  severe  cases,  an  atropine  drip  may  be 
necessary. 

Mr.  A.  was  still  drowsy  when  he 
returned  to  the  unit.  Anticoagulant 
therapy  was  resumed  immediately 
postoperatively.  Daily  prothrombin 
times  were  done,  and  the  dosage  ordered 
accordingly.  When  fully  conscious,  he 
was  given  sips  of  water  to  make  sure 
he  had  no  difficulty  swallowing. 

Traction  on  the  9th,  10th,  and  12th 
cranial  nerves  during  surgery  can  result 
in  temporary  palsy  of  each  of  these 
nerves.  Because  of  the  possibility  of 
aspiration  with  dysphagia,  duodenal 
feeding  can  be  instituted  until  the  dan- 
ger of  aspiration  is  past.  Mr.  A.  had  no 
difficulty  in  swallowing  and  retaining 
fluids;  he  was  given  fluids  the  first  day, 
and  a  soft  diet  the  second  day. 

The  head  of  Mr.  A's  bed  was  elevat- 
ed. His  blood  pressure  was  then 
checked  and  recorded.  If  a  patient's 
blood  pressure  level  drops,  the  angle 
of  elevation  is  reduced;  if  it  remains 
constant,  the  angle  of  elevation  is  grad- 
ually increased.  As  Mr.  A.  had  no 
decrease  in  his  blood  pressure  level, 
the  angle  of  elevation  and  the  amount 
of  activity  allowed  were  gradually 
increased  until  he  was  up  and  about. 
Some  patients  require  Tensor  bandages 
on  their  legs  to  prevent  the  blood  pres- 
sure from  dropping  too  much. 

The  dressing  was  removed  on  the 
fifth  day,  the  wound  cleaned  with  80 
percent  alcohol,  and  a  light  gauze  dres- 
sing applied.  If  a  wound  has  healed  and 
no  obvious  hematoma  is  present,  the 
sutures  are  removed  on  the  10th  day. 
The  patient  is  allowed  to  move  his  neck 
as  freely  as  he  wishes.  He  can  shave, 
except  for  the  area  close  to  the  incision, 
which  is  left  unshaven  until  the  sutures 
are  removed. 


The  physiotherapist  visited  Mr.  A. 
daily  to  assist  with  the  chest  routine  to 
prevent  pneumonia. 

Preparations  for  Mr.  A's  discharge 
were  started  when  his  prothrombin 
time  leveled  off  and  the  daily  required 
dosage  of  anticoagulants  had  been 
regulated. 

Dr.  J.,  the  family  doctor,  was  con- 
tacted and  he  agreed  to  follow  Mr. 
A's  progress  and  to  manage  his  anti- 
coagulant therapy.  Mr.  A.  will  remain 
on  anticoagulant  therapy  for  six 
months.  The  neurosurgeon  explained 
to  Mr.  A.  the  dangers  of  being  on  anti- 
coagulant therapy,  such  as  excessive 
bruising,  prolonged  bleeding  from  a 
small  cut,  and  hematuria.  He  was  ad- 
vised to  report  to  his  family  physician 
immediately  if  any  of  the  above  signs 
or  symptoms  occurred. 

Mr.  A.  can  return  to  his  position 
as  a  social  worker  as  soon  as  he  feels 
able  to.  He  is  to  be  guided  by  common 
sense  and  to  curtail  or  increase  his 
activities  accordingly.  Earlier,  he  had 
followed  the  doctor's  advice  and  stopped 
smoking. 

Mr.  A.  will  be  readmitted  to  the  unit 
in  six  months  for  reevaluation.  A  carotid 
arteriogram  of  the  repaired  site  will 
be  performed  then:  if  it  shows  a  good 
patent  artery,  the  anticoagulant  therapy 
will  be  discontinued. 

When  first  admitted,  Mr.  A.  was 
nervous  and  apprehensive.  His  father 
had  had  a  cerebrovascular  accident  at 
the  age  of  52,  and  Mr.  A.  feared  a  sim- 
ilar illness.  When  he  was  readmitted 
for  reevaluation  he  was  cheerful  and 
talked  of  his  work.  In  his  own  words: 
"You  know.  Doctor,  you  did  such  a 
good  repair,  I  think  that  artery  will 
last  me  the  rest  of  my  life.  And  I  sure 
am  glad  I  am  not  an  old  man  after  all." 


THE  CANADIAN   NURSE     35 


Sending  someon 

HERE  ARE  SOME  TIPS... 


"I  enjoyed  the  conference,  but 
what  can  I  tell  the  group?    I  don't 
know  what  they  want  to  hear!  " 

This  comment  is  heard  -frequently 
when  delegates  return  from  sem- 
inars, workshops,  and  conferences. 
The    instructors    in    the    inservice 
education  department  of  the 
Winnipeg  General  Hospital  have 
identified    some    factors   that   can 
make    reporting    easier    and    more 
interesting. 

Our  thoughts  are  meant  to  serve 
only  as  a  catalyst  for  meaningful 
participation  at  workshops  and  sem- 
inars and  as  a  stimulus  for  creative 
reporting.  We  will  leave  the  actual 
presentation   to   your  imagination. 


Mrs.  Alma  McKone,  Director,  Inservice 
Education,  Winnipeg  General  Hospital, 
Winnipeg,  Manitoba. 

ILLUSTRATED  BY  FRAN  KUC  . 


1.  Hold  a  pre-conference  meeting  where  the  delegate  talks  with  those  to 
whom  she  will  report. 

Use  this  time  to: 

■  Identify  questions  people  would  like  answered. 

■  Note  areas  in  which  the  group  would  like  more  information. 

■  Reinforce  the   idea  that  the  delegate  attends  with  certain  responsi- 
bilities. 

■  Discuss  the  delegate's  expectations. 

■  Help  the  delegate  understand  that  her  precise  objectives  may  not  be 
met  and  that  unexpected  information  may  be  available. 

This  meeting  will  help  to  prepare  the  delegate  and  to  stimulate  expec- 
tations among  those  to  whom  she  will  report. 


36     THE  CANADIAN   NURSE 


0  a  oonforence  ? 


2.  Encourage  the  delegate  to  read 
ahead  of  time  the  topics  to  be 
discussed. 

This  should  stimulate  her  interest 
and  provide  a  broad  background 
against    which   she   can    relate   the 
material  presented. 


4.  Help  the  delegate  plan  ahead  of 
time  to  capture  the  spirit  and 
meaning  of  the  conference. 

Where    appropriate   you    may   sug- 
gest: 

■  Taping  of  the  sessions. 

■  Noting    "quotable    quotes' 
salient  points. 

■  Gathering  hand-out  material. 

■  Filming    impressive    ceremonies 
and  events. 


and 


3.  Encourage  the  delegate  to 
mingle  with  others  attending  and  to 
make  maximum  use  of  these 
informal  learning  opportunities. 

The  delegate  may  also  find  she  has 
information  she  can  share  with 
others. 


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t  'f'^^ 

S   M  T  IV  T   P 

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t  2 
A(J)«  r  ^  9 

\%  (9  «0  2/  2a  z 

Lr  \ 

as  «ar  2^89  3 

m      ^mm 

HHIHH 

5.  Plan  to  have  the  delegate  report 
on  the  conference  at  the  earliest 
possible  date. 

Her  enthusiasm  will  almost  certainly 
wane    in   direct   relationship  to 
the  time  that  elapses  between  the 
events  and  her  presentation. 

With  this  preparation,  the  delegate 
should  be  able  to  enjoy  the 
conference  and  make  her  report  a 
learning  experience  for  her  listeners. 

She  will: 

■  Know   the   questions  the  group 
want  answered. 

■  Be  aware  of  areas  in  which  the 
group  needs  more  information. 

■  Have  noted  "quotable  quotes" 
and  salient  points. 

■  Have  printed  material,  tape 
recordings,    or    films   from    which 
to  fashion  her  report. 

She    may    also   find    it    helpful   to 
outline:  the  issues  discussed; 
the  background  of  each  speaker; 
the  stands  taken  by  the  speakers; 
the    reasons    for    their   stand;   and 
audience  reaction  or  support. 

THE  CANAD^N   NURSE     37 


The  child  with  Hurler's  syndrome 


Description  of  the  care  given  to  children  who  have  a  rare  hereditary 
disease  for  which  there  is  no  known  cure. 


One  of  the  causes  of  mental  retardation 
in  children  is  a  relatively  rare  disease 
called  Hurler  syndrome.  This  disease 
results  in  progressive  mental  and  phys- 
ical deterioration,  usually  beginning 
in  infancy  and  culminating  in  death  by 
7  to  10  years  of  age. 

Hurler's  syndrome  is  a  mucopoly- 
saccharide storage  disease,  one  of  sev- 
eral inherited  disorders  of  connective 
tissue  resulting  from  a  defect  in  the 
metabolism  of  acid  mucopolysaccha- 
rides. Acid  mucopolysaccharides  are 
a  group  of  closely  related  macromole- 
cules  formed  by  a  series  of  carbohydrate 
units  linked  to  a  protein  core.  They  are 
normally  found,  individually  or  in 
mixtures,  as  a  dominant  component  of 
the  ground  substance  of  the  connective 
tissues  of  the  body. 

The  accumulation  of  abnormal 
amounts  of  one  or  more  acid  mucopoly- 
saccharides in  the  connective  tissues 
results  in  abnormal  development,  usu- 
ally with  gross  physical  changes,  de- 
pending on  which  organs  are  more 
severely  affected. 

The  disease  probably  is  transmitted 
as  an  autosomal  recessive  trait,  that 
is,  both  parents  must  contribute  a  defec- 
tive gene  before  the  disease  is  expressed 
phenotypically.  The  genetic  biochemi- 
cal defect  that  results  from  this  double 
dose  of  recessive  genes  is  unknown.' 

Signs  and  symptoms 

Although  the  newborn  infant  appears 
normal,  the  disease  becomes  evident 
during  infancy  or  early  childhood, 
with  progressive  mental  and  physical 
deterioration.  The  first  signs  are  usually 
lumbar  gibbus  (hump),  stiff  joints,  chest 
deformity,  and  rhinitis.  ^ 

Skeletal  development  becomes  in- 
creasingly grotesque,  and  the  child 
develops  a  prominent  forehead,  flat- 
i8     THE  CANADIAN  NURSE 


Maureen  Brenchley 

tened  bridge  of  nose,  broad  hands,  and 
stubby  fingers.  Stiffening  of  the  finger 
joints  causes  clawhand.  Facial  features 
become  coarse  and  ugly,  with  ocular 
hypertelorism  (widely-spaced  eyes), 
wide  nostrils,  large  thick  lips,  open 
mouth,  and  enlarged  tongue.  Hyper- 
trophic gums  are  common  with  small, 
widely-spaced,  peg-like  teeth. 

Nasal  congestion,  noisy  mouth 
breathing,  and  frequent  upper  respir- 
atory infections  occur  because  of  the 
malformation  of  facial  and  nasal  bones. 
Impaired  bone  conduction,  resulting 
from  malformation  of  the  inner  ear 
bones,  sometimes  causes  deafness. 

Short  neck,  deformed  chest  with 
flaring  of  the  lower  ribs,  and  enlarged 
liver  and  spleen  contribute  to  the  rotund 
appearance  of  the  patient.  Hepatos- 
plenomegaly  is  associated  with  defective 
supporting  issues,  and  commonly  causes 
hernias  and  a  protuberant  stomach. 
The  child's  entire  body  is  usually  cov- 
ered with  fine  fuzz. 

Contractures  of  hips,  knees,  ankles, 
and  elbows  develop  because  of  changes 
in  the  tendons  and  ligaments  surround- 
ing the  joints,  which  limit  extension.  In- 
volvement of  the  heart  and  its  vessels 
is  often  severe,  with  enlarged  heart 
and  extensive  occlusion  of  the  coronary 
arteries.-' 

Diagnosis  and  treatment 

The  diagnosis  of  Hurler's  syndrome, 
initially  based  on  the  clinical  picture 
and   family   history,   is  supported  by 

Maureen  Spencer  Brenchley,  a  graduate 
of  St.  Joseph's  Hospital  school  of  nursing, 
London,  Ontario,  was  employed  as  Head 
Nurse  of  the  Metabolic  Investigation 
Unit,  Children's  Psychiatric  Research 
Institute  in  London,  when  she  wrote  this 
article  for  The  Canadian  Nurse. 


abnormal  x-ray  findings;  it  is  verified 
by  identification  of  excessive  quantities 
of  specific  mucopolysaccharides,  chon-  j 
droitin  sulphate  B  and  heparitin  sul- 
phate, in  the  urine.  A  diagnostic  spot 
test  can  be  used,  but  more  precise 
assessment  is  made  by  isolating  and 
characterizing  the  mucopolysacchari- 
des in  a  24-hour  urine  sample.  White 
blood  cells  and  tissue  biopsies  are  also 
examined,  and  the  excessive  muco- 
polysaccharides are  demonstrable  by 
their  staining  reaction. 

There  is  no  known  cure  for  Hurler's 
syndrome.  Research  is  being  done,  but 
until  more  is  known,  treatment  con- 
sists only  of  alleviating  the  child's 
symptoms. 

Counseling  and  nursing  care 

On  the  metabolic  investigation  unit 
at  the  Children's  Psychiatric  Research 
Institute  in  London,  information  on 
the  likely  course  of  the  disease  and  its 
prognosis  is  outlined  by  the  physician 
to  help  the  parents  accept  the  situation 
and  prepare  for  the  difficult  time  ahead. 
He  may  also  give  genetic  counseling.        i 

Moral  support  by  our  ward  staff  is 
equally  important.  Seeing  their  child 
well  cared  for  by  conscientious  nurses 
is  often  the  parents'  only  comfort. 
Nurses  accept  their  expressions  of  fear 
and  grief,  listen  to  them,  reassure  them 
about  everyday  care,  and  refer  them 
to  the  supervisor  or  physician  for  more 
detailed  information. 

We  encourage  the  child  with  Hurler's 
syndrome  to  be  as  independent  as  pos- 
sible. We  teach  him  to  use  the  toilet 
and  feed  and  dress  himself,  according 
to  his  mental  and  physical  capability. 
If,  out  of  sympathy,  a  nurse  does  every- 
thing for  him,  his  condition  will  deterio- 
rate rapidly. 

Regular  skin  care  is  essential,  as  the 
FEBRUARY  1971 


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Child  with  Hurler's  syndrome.  Note  ocular  hypertelorism,  flattened  bridge  of 
nose,  coarse  facial  features,  thick  lips,  broad  tip  of  nose  with  flared  nostrils,  and 
clawhand.  Photo  on  right  shows  other  typical  deformities:  prominent  forehead, 
open  mouth,  short  neck,  protuberant  stomach,  lumbar  gibbus,  and  limitation  in 
extension  of  joints.  (Photographs  courtesy  of  Dr.  Bruce  Gordon,  Children's 
Psychiatric  Research  Institute,  London,  Ontario.) 


child's  skin  is  dry  and  coarse  and  his 
movements  are  limited.  We  cleanse 
him  frequently  and  rub  him  with  lotion; 
the  creases  in  his  neck  and  groin  tend 
to  become  irritated  and  require  special 
attention.  If  the  child  is  bedridden,  his 
position  is  changed  hourly  to  prevent 
decubiti;  his  limbs  are  exercised  gently 
to  lessen  the  severity  of  contractures. 

Keeping  the  child  well  nourished 
is  a  challenge  to  both  the  nursing  and 
the  dietary  staff.  Mouth  breathing  and 
a  constant  nasal  discharge  result  in 
a  dry,  coated  tongue  and  anorexia.  To 
increase  his  appetite  we  give  him  fre- 
quent mouth  care  and  sips  of  water  to 
moisten  his  lips  and  tongue. 

When  feeding  the  child,  we  position 
him  carefully  so  he  is  not  doubled  up 
FEBRUARY  1971 


with  chin  on  chest.  Some  of  our  patients 
sit  in  a  special  tilting  chair,  which 
prevents  this  "chin-on-chest"  position 
during  meals.  Food  of  a  lumpy  consist- 
ency is  better  than  pureed  foods  to  add 
bulk  to  the  child's  diet,  even  though  he 
may  not  be  able  to  chew  well  because 
of  his  poor  teeth  and  gums. 

Food  is  given  slowly  and  in  small 
amounts,  as  there  is  little  space  left 
in  the  child's  mouth  because  of  his 
enlarged  tongue.  With  some  patients, 
milk  increases  the  viscosity  of  the  al- 
ready abundant  mucus  in  his  mouth, 
so  it  is  withheld  until  the  end  of  the 
meal.  Sips  of  water  given  after  every 
few  spoonfuls  of  food  seems  to  ease 
the  child's  swallowing  difficulties. 

Rather  than  feeding  him  hash,  we 


try  to  keep  his  foods  as  palatable  as 
possible,  and  allow  him  to  taste  indi- 
vidual foods.  As  the  child  with  Hurler's 
syndrome  has  so  few  pleasures  to  enjoy, 
we  do  all  we  can  to  make  his  meals 
pleasant  and  nourishing. 

The  child  with  Hurler's  syndrome 
needs  sensory  stimulation  as  his  deaf- 
ness progresses  and  his  vision  dims. 
We  hold  him,  touch  him  frequently,  and 
give  him  furry  toys  to  play  with.  We 
play  clapping  games  with  him,  sing 
loudly  to  him,  and  turn  up  the  radio 
or  record  player  so  he  can  hear  the 
music.  In  other  words,  to  use  a  cliche, 
we  give  him  all  the  tender  loving  care 
we  can. 

References 

1.  Wheeler,  Clayton  E.  Hurler  syndrome. 
Textbook  of  Medicine,  ed.  P.B.  Beeson 
and  W.  McDermott.  Philadelphia,  W.B. 
Saunders.  1967,  pp.1254-5. 

2.  McKusick,  Victor  A.  Heritable  disor- 
ders of  connective  tissue,  3d.  ed.  Saint 
Louis,  Mosby.  1966,  p. 328. 

3.  Ibid.,  pp. 329-335. 

Bibliography 

Crawford.  S.E.  Gargoyllsm.  //(  Hughes, 
J.G.  Synopsis  of  Pediatrics.  Saint  Louis. 
Mosby,  1967.  p.600-2. 

Danes,  B.S.,  and  Beam.  A.G.  Cellular 
metachromasia,  a  genetic  marker  for 
studying  the  mucopolysaccharidoses. 
Umcet.  1:241.  Feb.4.  1967. 

Darfman,  A.  Heritable  disorders  of  con- 
nective tissue.  In  Stanbury,  J.B.  et  al. 
The  Metabolic  Basis  of  Inherited  Dis- 
ease. New  York,  McGraw-Hill.  1966, 
p.963. 

Nadler.  H.L.  Medical  progress  —  prenatal 
detection  of  genetic  defects.  J.  Paediat 
74:132.  1969.  § 


THE  CANAOyVN   NURSE     39 


idea 
exchange 


^'Nursing  Communication  Act 
Is  the  Core  of  Nursing 


The  curriculum  design  of  the  two-year 
diploma  nursing  program  at  Red  Deer 
College  has  been  developed  with  the 
belief  that  the  core  of  nursing  lies  in  the 
component  of  the  "nursing  communica- 
tion act."  This  philosophy  has  been 
expressed  by  Jourard,  who  says  the 
nurse  can  play  the  important  role  in  the 
healing  process  if  she  can  allow  the 
patient  to  be  himself,  can  communicate 
effectively  with  him,  and  can  make  him 
realize  his  feelings  and  wishes  really 
matter.  * 

Although  we  had  this  knowledge,  we 
still  had  to  determine  where  and  how 
to  incorporate  it  in  the  educational 
program.  Our  nursing  faculty  grappled 
with  the  problem  for  some  time  before 
finding  a  clue  that  allowed  us  to  move 
toward  our  goal. 

We  were  helped  by  Maslow,  who  has 
stated  that  the  real  problems  of  life  are 
insoluble  ones  of  death,  pain,  illness, 
and  the  like.  He  believes  these  problems 
need  to  be  brought  out  in  the  open, 
gradually  accepted  as  being  insoluble, 
and,  whenever  possible,  enjoyed  in 
40     THE  CANADIAN   NURSE 


their  richness  and  mystery.  **  This 
being  so,  the  learner  needs  to  under- 
stand these  concerns,  relating  them 
first  to  herself  and  then  to  the  sick  in- 
dividual. 

Our  educational  program  is  designed 
so  the  learner  is  confronted  early  with 
these  existential  phenomena,  which 
usually  become  more  apparent  in  ill- 
ness. The  student's  rapport  with  patients 
and  the  effectiveness  of  her  nursing 
communication  acts  will  to  some  degree 
be  influenced  by  her  own  ease  or  dis- 
ease when  confronted  with  these  phe- 
nomena of  birth,  life,  death,  separation, 
pain,  suffering,  loneliness,  stress,  love, 
and  hope. 

Jourard  has  written:  "I  would  like  to 
propose  that  this  complex  perceptual 
congnitive  system  —  the  phenomenal 
field  —  is  the  variable  which,  when 
'integrated'  into  medical  and  nursing 
curricula  and  practice,  will  bring  about 
the  outcomes  which  educators  have 
sought,  viz.,  more  personalized  care 
of  patients,  more  apt  diagnoses,  and 
more  effective  therapy."  *** 


In  our  program  there  are  three  areas 
of  content  that  proceed  simultaneous- 
ly, but  at  a  varying  pace.  One  of  the 
areas  includes  a  model  of  a  family 
unit  in  the  community,  which  provides 
learning  situations  in  a  continuum 
throughout  the  program.  The  family 
model  gives  the  student  an  opportunity 
to  focus  on  human  growth  and  develop- 
ment to  cover  the  growth  years,  main- 
tenance years,  and  old  age;  another 
family  model  emphasizes  the  maternal- 
child  aspects  of  nursing. 

A  second  area  of  content  focuses 
on  the  need  to  understand  self  and 
others.  Major  concepts  of  mental  health 
are  studied  early  in  the  program.  The 
sequence  moves  toward  meeting  the 
emotional  needs  of  patients,  and  allows 
for  a  breadth  of  learning  situations  on 
a  continuum  from  understanding  the 
self  to  the  care  of  the  mentally  ill  as  a 
more  complex  learning  experience. 

The  learning  situations  selected  for 
nursing  communication  acts  comprise 
diversified  experiences.  Input  through 
readings,  reflective  thinking,  experi- 
mentation with  techniques  in  a  class- 
room laboratory  situation,  and  exper- 
ience in  clinical  settings  offer  the 
learner  opportunities  for  interpersonal 
relationships  and  communication  on 
an  individual  and  group  process  basis. 

The  third  area  of  content  relates  to 
the  care  of  the  physically  ill  adult  and 
child.  General  concepts  of  the  pheno- 
menal field  are  introduced  initially, 
after  which  more  specific  concepts 
within    the    area   of  the    phenomenal 


*  Sidney  ^l.  Jourard.  The  Transparent 
Self.  Princeton,  D.  Van  Nostrand  Co. 
iJd..  1967.  p.  150. 

**  Abraham  H.  Maslow,  Further  notes 
on  the  psychology  of  being,  J.  Humanistic 
Psycholofiy  3;1:I20-135,  Spring,  1963. 

*'■'*  Jourard,  op.  cit.,  p.  123 

FEBRUARY  1971 


field,  such  as  body  image,  sensory  de- 
privation, immobility,  and  stress,  are 
discussed  for  study  and  applied  in  all 
clinical  settings. 

These  concepts  lead  to  the  concept 
of  illness,  and  the  student  then  begins 
to  grapple  with  the  symptoms  of  illness. 
The  role  that  drugs  and  nutrition  play 
in  alleviating  symptoms  is  also  present- 
ed. Technical  skills,  common  to  the 
nursing  care  of  all  patients  and  design- 
ed to  provide  for  their  fundamental 
needs,  are  developed. 

One  of  the  basic  assumptions  of  our 
program  is  that  there  is  a  core  in  nurs- 
ing which  is  applicable  to  all  clinical 
areas.  During  the  first  year,  students 
have  experience  in  learning  situations 
that  include  patients  requiring  long-term 
care;  patients  with  surgical  conditions, 
both  adults  and  children;  and  postpart- 
um mothers.  In  post-clinical  confer- 
ences, students  from  the  various  clinical 
areas  are  assigned  to  core  groups,  where 
they  compare  or  contrast  the  needs 
and  the  care  of  patients  from  their  par- 
ticular clinical  area. 

In  the  first  year  the  level  of  care 
centers  around  patients  who  are  con- 
valescing or  who  are  moderately  ill. 
In  the  second  year  the  learner  moves 
into  more  complex  learning  situations 
with  patients  in  the  acute  phases  of 
illness  who  require  either  medical  or 
surgical  intervention. 

In  the  final  semester,  situations  are 
selected  to  give  the  learner  an  oppor- 
tunity to  collaborate  with  other  mem- 
bers of  the  nursing  team.  She  begins 
to  see  herself  participating  not  only 
with  the  patient,  but  also  with  his  fa- 
mily, the  physician,  the  physiother- 
apist, and  other  personnel.  She  sees 
herself  as  part  of  a  team  that  works 
together  to  care  for  the  patient  and  help 
him  reestablish  himself  to  his  potential 
level  of  well-being.  —  Marguerite  E. 
Schumacher,  Director,  Health  and 
Social  Services,  Red  Deer  College, 
Red  Deer,  Alberta. 
FEBRUARY  1971 


00     'VSS-'^^^I 


A  Tisket,  A  Tasket,  The  Info  Is  On  My  Jacket 

A  colorful  and  clever  way  to  help  keep  young  patients'  details  straight  are 
these  information  jackets  made  by  Charlotte  Koolc,  graduating  class  of 
1970,  Foothills  Hospital  School  of  Nursing.  Calgary,  Alberta.  The  bright 
jackets  were  designed  by  Miss  Koole  as  part  of  a  pediatric  project  and  seem 
to  qualify  under  the  old  adage,  "a  stitch  in  time.  ..." 


THE  CANAC^N   NURSE     41 


The 

Canadian 
Nurse 

50  The  Driveway,  Ottawa  4,  Canada 


^Z7 


Information  for  Authors 


Manuscripts 


The  Canadian  Nurse  and  L'infirmiere  canadienne  welcome 
original  manuscripts  that  pertain  to  nursing,  nurses,  or 
related  subjects. 

All  solicited  and  unsolicited  manuscripts  are  reviewed 
by  the  editorial  staff  before  being  accepted  for  publication. 
Criteria  for  selection  include  :  originality;  value  of  informa- 
tion to  readers;  and  presentation.  A  manuscript  accepted 
for  publication  in  The  Canadian  Nurse  is  not  necessarily 
accepted  for  publication  in  L'infirmiere  Canadienne. 

The  editors  reserve  the  right  to  edit  a  manuscript  that 
has  been  accepted  for  publication.  Edited  copy  will  be 
submitted  to  the  author  for  approval  prior  to  publication. 

Procedure  for  Submission  of 
Articles 

Manuscript  should  be  typed  and  double  spaced  on  one  side 
of  the  page  only,  leaving  wide  margins.  Submit  original  copy 
of  manuscript. 

Style  and  Format 

Manuscript  length  should  be  from  1,000  to  2,500  words. 
Insert  short,  descriptive  titles  to  indicate  divisions  in  the 
article.  When  drugs  are  mentioned,  include  generic  and  trade 
names.  A  biographical  sketch  of  the  author  should  accompa- 
ny the  article.  Webster's  3rd  International  Dictionary  and 
Webster's  7th  College  Dictionary  are  used  as  spelling 
references. 

References,  Footnotes,  and 
Bibliography 

References,  footnotes,  and  bibliography  should  be  limited 
42     THE  CANADIAN   NURSE 


to  a  reasonable  number  as  determined  by  the  content  of  the 
article.  References  to  published  sources  should  be  numbered 
consecutively  in  the  manuscript  and  listed  at  the  end  of  the 
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Bibliography  listings  should  be  unnumbered  and  placed 
in  alphabetical  order.  Space  sometimes  prohibits  publishing 
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For  book  references,  list  the  author's  full  name,  book 
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publication,  and  pages  consulted.  For  magazine  references, 
list  the  author's  full  name,  title  of  the  article,  title  of  mag- 
azine, volume,  month,  year,  and  pages  consulted. 

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Photographs  add  interest  to  an  article.  Black  and  white 
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The  Canadian  Nurse 

OFFICIAL  JOURNAL  OF  THE  CANADIAN  NURSES'  ASSOCIATION 

FEBRUARY  1971 


SELF-USE  PREGNANCY  TESTING 


SIMPLE .. .  four  easy  steps. 

ACCURATE . . .  accuracy  is  greater  than  96%. 

EARLY. . .  HCG  may  be  detected  aOarly  as  four  days 
after  a  missed  menstrual  period. 


[  jTr^'^I^foi-s^gr'/'' '"  """"  ]    Suggested  retail  price: $5.50 


FEMININE  CARE  LABORATORIES  INTERNATIONAL 

451  Alliance  Avenue,  Toronto  334,  Ontario 


research  abstracts 


The  following  are  abstracts  of  studies 
selected  from  the  Canadian  Nurses' 
Association  Repository  Collection  of 
Nursing  Studies.  Abstract  manuscripts 
are  prepared  by  the  authors. 


Gorrow,  Mary  Wranesh.  A  comparison 
of  social  atliiiules  between  freshmen 
and  seniors  in  a  collegiate  school  of 
nursing.  Salt  Lake  City,  Utah.  1960. 
Thesis  (M.S.)  U.  of  Utah. 

The  trend  in  nursing  education  has 
been  toward  increased  emphasis  on  de- 
velopment of  the  student  as  an  indi- 
vidual, which  involves  acuteness  of 
understanding  of  herself  and  others, 
sensitizing  her  feelings  toward  others, 
and  arousing  sympathetic  concern  for 
others.  This  implies  that  the  social  atti- 
tudes that  the  student  has  developed  at 
time  of  entrance  into  a  nursing  pro- 
gram may  be  affected  in  the  educational 
process. 

The  present  exploratory  research 
has  attempted  to  determine  if  signifi- 
cant differences  in  social  attitudes  and 
values  are  expressed  by  selected  fresh- 
men nursing  students  and  selected  sen- 
ior nursing  students  in  a  particular 
collegiate  school  of  nursing  in  a  state 
university.  The  study  was  predicated 
on  the  hypothesis  that  the  senior  group 
by  virtue  of  the  process  of  education 
and/or  maturation  would,  when  tested 
on  social  attitudes,  obtain  "higher" 
mean  scores,  reflecting  more  liberal 
and  critical  attitudes  and  a  greater 
degree  of  tolerance  for  human  weak- 
ness than  would  the  freshmen  group. 

A  survey  of  the  literature  in  the  field 
disclosed  that  studies  relevant  to  chan- 
ges in  attitudes  in  students  as  they 
progressed  through  the  nursing  edu- 
cational program  were  limited  in  scope 
and  number.  Since  there  appeared  to 
be  no  adequate  instruments  developed 
for  testing  social  attitudes  of  nurses 
/jer  se,  a  Developmental  Status  Scale, 
which  had  emerged  from  the  Mellon 
Foundation  Studies  at  Vassar  College 
as  discriminating  seniors  from  fresh- 
men on  various  attitudes,  was  selected 
for  determining  whether  or  not  differ- 
ences existed  between  the  nursing 
students.  The  items  were  also  classified 
into  patterns  which  would  disclose 
whether  or  not  there  was  any  differ- 
ence in  degree  of  freedom  from  com- 
pulsiveness,  flexibility  and  tolerance  of 

44     THE  CANADIAN   NURSE 


ambiguity,  impunitive  attitudes  toward 
others,  critical  attitudes  toward  author- 
ity and  family,  intraception.  mature 
interests,  unconventionality  or  non- 
conformity, rejection  of  traditional 
feminine  roles,  and  freedom  from  cyn- 
icism toward  people.  A  determination 
of  the  discrimination  value  of  each 
item  was  also  proposed. 

Statistical  analysis  was  planned  to 
test,  in  null  form,  the  following  hypoth- 
eses: 

1.  There  will  be  no  difference  be 
tween   the   mean   score  of  the  senior 
group  and  the  mean  score  of  the  fresh- 
man group  on  the  total  scale. 

2.  There  will  be  no  difference  be- 
tween the  mean  scores  of  the  senior 
group  and  the  mean  scores  of  the  fresh- 
man group  on  the  classifications  of  the 
clustered  items. 

3.  There  will  be  no  relationship  be- 
tween the  correct  responses  and  the 
incorrect  responses  of  the  senior  group 
and  the  freshman  group  on  each  item. 

The  findings  indicated  that  the  differ- 
ence in  means  for  the  total  scale,  in  the 
direction  of  the  seniors,  was  signifi- 
cant at  the  .05  level,  thus  rejecting  the 
first  null  hypothesis.  A  significant  dif- 
ference, in  the  direction  of  the  seniors, 
was  obtained  on  four  of  the  thirteen 
classifications.  The  phi-coefficients  ob- 
tained on  each  item  disclosed  that  the 
responses  to  only  one  item  demon- 
strated any  significant  relationship.  On 
the  basis  of  the  statistical  findings,  it 
was  determined  that  the  seniors  achiev- 
ed higher  mean  scores  on  a  cumulative 
basis  rather  than  on  sharply  focalized 
differences  in  social  attitudes. 

The  senior  group  demonstrated 
growth  in  the  same  direction  as  did 
Vassar  seniors  and  seniors  at  other 
colleges  where  the  test  had  been  ad- 
ministered, thus  reflecting  greater 
degrees  of  "rebellious  independence" 
and  tolerance  for  "human  weakness" 
determined  as  the  central  themes  of  the 
scale  when  it  was  factor  analyzed  at 
Vassar  College. 

The  findings  of  the  study  have  ob- 
vious implications  for  the  selected 
groups  and  can  be  of  constructive  value 
for  the  selected  school  of  nursing  in  the 
evaluation  of  its  educational  objectives. 
A  foundation  for  other  studies  in  the 
area  of  social  attitudes  of  nursing  stu- 
dents has  been  established  and  several 
recommendations  for  further  research 
are  offered. 


Walton,  Elizabeth  Ann.  Hand  and  arm 

motor  behavior  in  laboring  patients. 

New    Haven,    Connecticut,     1967. 

Thesis  (M.Sc.N.)  Yale  University. 
The  purpose  of  the  study  was  to  develop 
and  test  a  tool  to  measure  two  compo- 
nents of  hand  and/or  arm  motor 
behavior  of  women  in  active  first 
stage  labor.  The  two  components 
were  the  quantity  (frequency)  of  hand 
and  arm  movements  and  the  quality 
or  nature  of,  hand  activity,  specifically 
the  presence  or  absence  of  muscular 
tension  in  the  hands.  These  two  com- 
ponents were  considered  indicators  of 
body  energy  depleting  activities. 

The  study  consisted  of  two  phases: 
development  of  the  tool  using  video 
tapes  of  women  in  labor  as  the  source 
of  data;  checking  for  clinical  validity 
in  labor  room  areas,  using  the  tool  to 
measure  the  hand  and  arm  motor 
behavior  of  seven  mothers. 

The  mothers  observed  in  the  empir- 
ical setting  showed  considerable 
individual  variation  in  both  the  amount 
and  nature  of  hand  and  arm  motor 
behavior.  The  tool  seemed  sensitive 
enough  to  detect  variations  among 
and  within  patients.  This  suggests 
that  the  two  components  of  hand 
and  arm  motor  behavior  may  be  valid 
indicators  of  body  energy  depleting 
activities. 

The  mothers  exhibited  more  hand 
and  arm  movements  and  more  tension 
in  the  hands  during  uterine  contractions. 
This  finding  seems  to  imply  that  fre- 
quency of  hand  and  arm  movements 
and/or  tension  in  the  hands  may  be 
potentially  useful  indicators  of  patient 
discomfort. 

Several  situational  factors  and 
patient  characteristics  were  found  to  be 
associated.  Moderate  to  strong  negative 
correlations  were  found  between  fre- 
quency of  hand  and  arm  movements 
and  age  of  the  patient;  frequency  of 
hand  and  arm  movements  and  length 
of  time  the  patient  was  observed;  and 
proportion  of  tension  within  the  hands 
and  length  of  observation  time. 

The  measurement  tool  was  not 
tested  for  inter-observer  reliability. 
A  discussion  of  the  advantages  and 
disadvantages  of  using  videotapes  as 
a  source  of  data  in  the  development  of 
a  behavioral  measurement  tool  is  in- 
cluded in  the  implications  of  the  study 
for  future  research. 

(Continued  on  page  46) 
FEBRUARY  1971 


Your  most  important  assets  -  Compassion, 

competence  and  current  complete  information. 

Call  upon  these  up-to-date  references. 

Creighton:  Law  Every  Nurse  Should  Know  —  2nd  Edition 

By  Helen  Creighton,  R.N.,  B.S.N.,  A.B.,  A.M.,  M.S.N.,  J.D., 

Professor  of  Nursing,  Univ.  of  Wis.  —  Milwaukee 

Here  are  the  legal  facts  that  every  nurse  should  know.  Written  by 
a  nurse  who  is  also  a  lawyer,  this  book  covers  every  aspect  of  the 
law  that  is  important  to  the  nurse,  from  her  obligations  as  an  em- 
ployee to  her  responsibilities  in  witnessing  a  will.  The  first  edition 
became  a  standard  reference  and  helped  thousands  of  nurses  avoid 
legal  entanglements.  This  new  edition  is  substantially  larger,  including 
such  topics  as  "good  samaritan"  laws,  child  abuse,  telephone  orders, 
sterilization  and  organ  transplantation. 

246  pp.  $8.10  June  1970. 

Mayo  Clinic  Diet  Manual  —  4tli  Edition 

By  the  Committee  on  Dietetics  of  the  Mayo  Clinic 

Here  is  the  new  edition  of  the  most  popular  and  respected  dietetic 
guidebook  available  today.  This  manual  presents  hundreds  of  diets 
to  help  you  plan  the  meals  the  doctor  orders.  Diets  are  classified 
by  disease  or  disorder.  In  this  edition  the  Mayo  Clinic  Food  Ex- 
change Lists  form  the  basis  for  planning  most  therapeutic  diets. 

About  170  pp.  About  $7.30  Just  Ready. 

Cole:  The  Doctor's  Shorthand 

By  Frank  Cole,  M.D.,  Editor,  Nebraska  State  Medical  Journal 

This  new  manual  is  a  handy  guide  to  medical  abbreviations,  notations, 
and  symbols.  Nurses  will  find  it  indispensable  in  reading  medical 
records  and  orders.  Nearly  6,000  entries  are  included;  a  special 
section  defines  symbols  used  in  medicine. 

179  pp.  Soft  cover.  $4.90  Oct.  1970. 


Guyton:  Basic  Human  Physiology: 

Normal  Function  and  Mechanisms  of  Disease 

By  Arthur  C.  Guyton,  Univ.  of  Miss.  School  of  Medicine 

This  new  book  is  an  ideal  size  for  use  by  nurses  and 
paramedical  personnel.  It  contains  a  lucid  discussion  of 
general  and  cellular  physiology,  without  overwhelming 
detail. 

About  650  pp.  Illustrated.  About  $13.50  Ready  March  1971. 


Guyton:  Textbook  ot  Medical  Physiology 

By  Arthur  C.  Guyton,  Univ.  of  Miss.  School  of 
Medicine 

The  4th  Edition  of  this  classic  medical  reference 
presents  the  body  as  a  single  functioning  organism 
controlled  by  a  myriad  of  regulatory  systems 
which  promote  homeostasis. 

About   1100   pp.    757   figs.    About    $20.00   Just   ready. 


W.  B.  SAUNDERS  COMPANY  CANADA  LTD.    1 835  Yonge  Street,  Toronto  7,  Ontario 


Please  send  on  approval  and   bill  me: 

Author  Book   title 

Name    Address 

City    Zone    


CN  2-71 


Proy. 


FEBRUARY  1971 


THE  CANADIAN   NURSE     45 


Next  Month 
in 

The 

Canadian 
Nurse 


•  Mind-Body  Relationships 
in  G.I.  Diseases 

•  Library  Service  for 
Shut-Ins 

•  Occult  Hydrocephalus 
in  Adults 


research  abstracts 


^ 

^^p 


Photo  Credits  for 
February  1971 


Royal  Alexandra  Hospital, 
Edmonton,  Alberta,  p.  30 

Toronto  General  Hospital, 
Toronto,  Ontario,  pp.  33,  34 

Foothills  General  Hospital, 
Calgary,  Alberta,  p.  41 


46     THE  CANADIAN   NURSE 


{Continued  from  page  44) 

Kerr,  Marion.  Nursing  in  fleeting  en- 
counters. Montreal,  Quebec,  1970. 
Thesis  (M.  Sc.  (App.))  McGill  Uni- 
versity. 

Descriptions  of  nurse-patient  inter- 
actions are  of  concern  to  nursing  as  a 
practice  discipline  in  its  quest  for  nur- 
sing theories.  This  inquiry  focused  on 
the  factors  affecting  the  nurse -patient 
relationship  in  fleeting  encounters  for 
a  single,  specific,  predetermined  task. 

Nursing  was  conceptualized  as  the 
nurse-patient  relationship  with  the 
three  observed  interaction  behavior 
patterns  being  on  a  continuum  of  nurs- 
ing. Data  were  collected  by  participant 
observation  from  two  samples  of  nurse- 
patient  interactions  that  involved  5 
intravenous  therapy  nurses  and  64 
patients,  and  3  medication  nurses  and 
38  patients. 

The  critical  factor  that  determined 
the  character  of  the  nurse-patient 
relationship  was  the  interrelationship 
among  the  following  three  variables 
that  emerged:  the  patient's  task-spe- 
cific responses  to  the  nurse's  task-spe- 
cific interaction  cues,  acquaintance  of 
the  participants  in  the  interaction,  and 
the  nurse's  perception  of  the  serious- 
ness of  the  patient's  illness. 

The  finding  th^-t  different  kinds 
of  nursing  occurred  within  similar 
periods  of  time  suggested  as  an  area 
for  further  research  nurses'  perceptions 
of  patient's  interaction  cues  and  the 
effects  on  patients  of  the  nurses'  re- 
sponses to  these  cues  in  a  variety  of 
interaction  situations. 


Brough,  Sylvia.  The  relationship  of  the 
faculty  members'  perception  of  par- 
ticipation in  policy  making  to  their 
perception  of  the  usability  of  the 
policy.  Boston,  Mass.,  1S66.  Thesis 
(M.Sc.N.)U.  of  Boston. 

The  study  was  undertaken  to  determine 
whether  the  faculty  members"  percep- 
tion of  the  degree  of  participation  in 
policy-making  affects  their  perception 
of  the  degree  of  usability  of  the  policy. 
The  data  for  the  study  were  based  on 
information  obtained  through  an  opin- 
ionnaire  developed  by  the  authors  to 
discover  the  perception  of  the  degree 
of  participation  in  policy-making  in 
three  selected  areas,  namely,  students, 
curriculum  and  evaluation,  and  the 
perception  of  the  degree  of  usability  of 


these  policies.  Each  respondent  was 
asked  to  check  the  statement  that  best 
suited  her  activity  in  policy-making. 

An  opinion  inventory  developed  by 
Sister  Michelle  Lane  was  used  to  as- 
certain the  respondents'  preference  for 
autocratic  or  democratic  administration 
and  its  effects  on  their  responses.  The 
sample  consisted  of  62  faculty  members 
of  five  schools  of  nursing  in  the  Greater 
Boston  area. 

The  findings  were  as  follows: 

1 .  There  was  a  statistically  signifi- 
cant relationship  (p<.05)  between  the 
perception  of  the  degree  of  participa- 
tion in  formulation  and  the  perception 
of  the  degree  of  usability  of  policies  for 
those  in  the  sample  who  had  checked 
all  the  responses. 

2.  No  statistically  significant  rela- 
tionship (p  >  .05)  was  found  between 
the  perception  of  the  degree  of  partici- 
pation and  usability  when  the  sample 
was  divided  into  two  groups  according 
to  their  degree  of  perception  of  partici- 
pation. 

3.  A  statistically  significant  differ- 
ence (p  <  .05)  was  obtained  in  the  areas 
related  to  students,  curriculum  and 
evaluation.  This  points  to  a  relation- 
ship between  areas  with  which  the 
policies  are  concerned  and  perception 
of  the  degree  of  participation. 

4.  No  statistically  significant  cor- 
relation (p  >  .05)  was  obtained  in  re- 
lation to  age,  educational  qualifications, 
length  of  experience  as  a  faculty  mem- 
ber, length  of  employment  at  present 
school,  or  membership  on  committees. 

5.  A  significant  correlation  was  ob- 
tained (p  <  .05)  in  relation  to  the  posi- 
tion of  a  full-time  instructor,  but  no 
significant  correlation  was  found  as 
related  to  the  positions  of  dean  or  direc- 
tor, assistant  dean  or  director,  coordi- 
nator or  chairman  of  program.  These 
findings  suggest  that  the  position  of 
full-time  instructor  has  an  effect  on  her 
perception  of  degree  of  participation 
and  usability  of  policies. 

6.  All  respondents  preferred  demo- 
cratic administration.  When  the  res- 
pondents were  divided  in  accordance 
with  their  degree  of  preference  for 
democratic  administration,  a  signifi- 
cant difference  (p  <  .05)  was  found. 
These  findings  suggest  that  a  preference 
for  democratic  administration  does 
affect  their  perception  of  degree  of 
participation  and  usability  of  policies. 

The  study  demonstrated  that  there 
was  a  high  correlation  between  the 
perception  of  the  degree  of  participa- 
tion in  policy  making  and  the  percep- 
tion of  the  degree  of  usability  of  these 
policies.  The  variables  indicated  above 
do  have  some  effect  on  the  respondents' 
replies.  Therefore,  it  is  lecommended 
that  the  study  be  replicated  with  larger 
sam-^les  and  in  different  geographic 
areas.  ■$■ 

FEBRUARY  1971 


The  Human  Body  in  Health  and  Disease, 

3d  ed.,  by  Ruth  Lundeen  Memmler 
and  Ruth  Byers  Rada.  388  pages. 
Toronto,  J.B.  Lippincott  Company, 
1970. 

Reviewed  by  Roberta  M.  Ritchie, 
Assistant  Director,  Inservice  Ed- 
ucation, University  Hospital,  Sas- 
katoon, Sask. 

This  book  is  designed  to  provide  a 
basic  introduction  to  the  biological, 
chemical,  and  physical  principles  that 
relate  to  normal  and  abnormal  body 
processes.  Throughout  the  text  an 
effort  is  made  to  compare  the  normal 
with  the  abnormal. 

The  first  chapter  provides  a  gen- 
eral orientation  to  body  systems,  body 
cavities,  regions,  and  directions.  An 
overview  of  disease,  disease-producing 
organisms,  and  disease  control  is  found 
in  the  second  chapter.  Chapters  three 
to  seven  discuss  basic  concepts  in  cell 
organization,  tissue  structure  and  func- 
tions, electrolyte  balance,  and  mainten- 
ance of  homeostasis. 

The  remainder  of  the  book  is  organ- 
ized by  systems.  Each  system  is  dis- 
cussed following  the  same  general  pat- 
tern: functions  of  the  system,  anatomy 
and  physiology  of  the  system,  com- 
mon disorders  occurring  in  the  sys- 
tem. The  book  concludes  with  a  chap- 
ter on  immunity,  allergies,  and  the  re- 
jection syndrome. 

Several  features  of  this  publication 
make  it  a  valuable  teaching-learning 
tool  for  the  beginning  student.  The 
sequence  of  the  book  proceeds  from 
simple  to  complex  concepts.  For  the 
student  who  is  unfamiliar  with  medical 
terminology,  a  pronunciation  guide  is 
included  in  parentheses  following  the 
new  terms.  In  addition,  there  is  a  com- 
prehensive glossary  and  guide  to  med- 
ical terminology  at  the  end  of  the 
book.  An  appendix  summarizing  bac- 
terial, fungal,  viral,  and  protozoal  dis- 
eases and  their  causative  organisms 
provides  a  quick  reference  to  common 
diseases.  The  chapters  are  well  illus- 
trated and  anatomic  plates  of  the  body 
systems  give  the  student  a  better  visual 
orientation  of  body  organs. 

This  text  provides  an  integrated 
approach  to  the  study  of  the  human 
body.  Its  use  beyond  a  basic  introduc- 
tory text  is  limited  as  the  material  is 
not  covered  in  any  great  depth.  Even 
as  an  introductory  text  the  authors 
FEBRUARY  1971 


recognize  that  it  would  be  essential  for 
the  student  to  refer  to  other  books  for 
more  specific  and  detailed  information. 

Concepts  of  Depression  by  Joseph  Men- 
dels.  124  pages.  New  York,  John 
Wiley  &  Sons,  Inc.,  1970. 
Reviewed  by  Nessa  Leckie,  Direc- 
tor of  Nursing,  Douglas  Hospital, 
Verdun,  Quebec. 

This  volume  is  one  of  a  series  in  the 
Wiley  Approaches  to  Behavior  Pathol- 
ogy. It  is  a  rather  brief,  but  well-writ- 
ten text,  which  covers  all  aspects  of 
depression. 

The  first  section,  consisting  of  three 
chapters,  covers  clinical  syndromes 
with  the  distinction  between  bipolar 
(manic  depressive  symptoms)  and  uni- 
polar (depressive  symptoms)  clearly 
stated.  Case  studies,  briefly  outlined, 
illustrate  the  commonly  known  va- 
rieties of  depression  and  these  could 
be  useful  as  teaching  tools. 

Following  the  first  three  chapters, 
the  author  considers  the  psychologi- 
cal theories  of  Freud,  Abraham,  Klein, 
Benedek,  Bibring,  and  Arieti  as  they 
explain  .the  causes  of  depression.  Sys- 
tematic studies  of  these  theories  com- 
plete the  overall  evaluation. 

Social  and  cultural  studies  of  factors 
that  influence  the  incidence  of  depres- 
sion in  the  western  world  are  limited. 
This  chapter  is  important  and  high- 
lights the  book. 

Completing  the  picture,  the  author 
covers  biochemical,  genetic,  and  psy- 
chophysiological investigations.  A 
chapter  on  treatment  of  depressions 
concludes  this  concise  text.  The  ma- 
terial presented  is  not  new  and  does 
not  add  to  the  present  knowledge  on 
the  subject,  but  nursing  instructors 
should  find  this  book  a  useful  overview 
of  the  subject,  clearly  written  and  easy 
to  understand. 

Fifty  Years  a  Canadian  Nurse  by  Rahno 
M.  Beamish.  344  pages.  New  York, 
Vantage  Press,  1970. 
Reviewed  by  Margaret  Steed,  Ad- 
viser to  Schools  of  Nursing,  Uni- 
versity of  Alberta,  Edmonton,  Alta. 

This  book  is  the  story  of  a  lifetime  of 
dedicated  service  in  the  nursing  pro- 
fession. 

It  is  a  highly  personal  account,  but 
tells  a  tale  that  in  many  respects  must 


have  been  duplicated  by  countless 
others.  The  writer  describes  many 
experiences  during  her  professional 
life,  beginning  with  her  own  training 
as  a  nurse,  then  as  a  supervisor  of  the 
various  clinical  and  specialty  areas  in 
different  hospital  situations,  as  a  teacher 
of  nurses,  an  assistant  superintendent, 
and  superintendent  of  nurses,  culminat- 
ing her  career  as  both  an  administrator 
and  a  director  of  nursing  in  an  ultra- 
modern hospital.  Each  position  and 
experience  demanded  the  utmost  in 
ingenuity,  courage,  and  a  faith  in  the 
future.  The  writer  has  these  qualities 
in  abundance,  and  her  story  is  a  saga 
of  achievement  that  holds  the  attention 
of  the  reader. 

Miss  Beamish  has  included  accounts 
of  her  family,  medical  and  nursing  co- 
workers, students,  and  friends.  She 
comments  on  their  profound  influence 
on  her  career  and  shows  her  recogni- 
tion and  gratitude  for  the  professional 
and  personal  associations  with  each 
during  her  professional  life. 

This  book  has  a  special  interest  for 
those  associated  with  the  writer  during 
her  professional  and  personal  life, 
who  will  enjoy  reminiscing  throughout 
the  pages.  It  also  has  historical  value 
as  a  book  written  by  a  Canadian  on 
nursing  as  it  was,  unfolding  experi- 
ences that  may  be  referred  to  as  "home- 
steading  in  nursing."  This  book  is 
recommended  for  all  who  would  recall 
that  history  and  share  in  the  inspiration 
it  provides.  It  is  also  recommended  for 
those  who  enjoy  reading  books. 

Professional  Nursing:  foundations,  per- 
spectives and  relationships.  Bed.,  by 
Eugenia  Kennedy  Spalding  and 
Lucille  E.  Notter.  677  pages.  Toron- 
to, J.B.  Lippincott  Co.  of  Canada 
Ltd.,  1970. 

Reviewed  by  Ruth  At  to,  Director  of 
Education,  School  of  Nursing,  Sher- 
brooke  Hospital,  Sherbrooke,  Que- 
bec. 

The  intent  and  objectives  of  this  edition 
remain  the  same,  and  the  authors, 
cognizant  of  the  tremendous  social 
changes  and  their  impact  on  nursing, 
have  produced  an  excellent  piece  of 
work.  The  text  is  meant  to  guide  stu- 
dents and  graduates  to  an  understanding 
of  the  major  trends  and  problems 
affecting  the  profession. 

This  edition  is  considerably  changed 
THE  CANADlJ^N  NURSE     47 


from  earlier  ones.  The  book  continues 
to  be  organized  into  four  parts,  but  the 
chapters  have  been  reorganized  to 
present  the  material  in  a  more  logical 
sequence.  New  chapters  have  been 
added,  one  dealing  with  the  responsibil- 
ities for  nursing  practice,  another  with 
the  American  Nurses'  Foundation.  One 
chapter,  "Legal  Problems,  Responsibil- 
ities and  Relationships,"  has  been 
replaced  by  "Legal  Issues  in  Nursing 
Practice."  The  authors  invited  Nathan 
Hershey,  a  well-known  authority  on 
nursing  and  the  law,  to  write  this 
chapter. 

The  authors  have  revised,  either 
moderately  or  drastically,  one-half  of 
the  chapters.  The  illustrations  are  so 
current  that  they  even  include  some 
taken  at  the  International  Council  of 
Nurses'  Congress  held  in  Montreal, 
June  1969. 

Several  problems  are  presented  to 
the  reader  following  each  chapter.  These 
provide  interesting  and  challenging 
topics  for  group  discussion  and  assign- 
ments. The  suggested  references  at  the 
end  of  each  chapter  are  well  selected 
and  should  provide  students  with  more 
than  adequate  supplemental  material. 

I  particularly  like  the  chapter  on 
public  relations  in  nursing.  The  authors 
emphasize  the  need  for  nurses  to  be 
aware  of  their  responsibility  to  the 
public,  and  show  how  nurses  can  inter- 
pret the  profession  to  the  public. 

I  recommend  this  text  for  all  libraries 
in  institutions  that  have  even  a  remote 
association  with  nursing. 

Psychology  Principles  and  Applications, 

5th  ed.,  by  Marian  East  Madigan. 
392  pages.  Saint  Louis,  C.V.  Mosby 
Company,  1970. 

Reviewed  by  Julie  Rowney ,  former- 
ly of  the  Calgary  General  Hospital 
School  of  Nursing,  now  a  candidate 
for  an  M.Sc.  degree  in  the  Depart- 
ment of  Psychology ,  University  of 
Calgary,  Calgary,  Alta. 

The  author  begins  by  presenting  psy- 
chology as  a  behavioral  science,  and 
then  discusses  heredity  and  develop- 
ment, with  a  chapter  devoted  to  the 
needs  of  the  aged  and  their  nursing 
care.  The  basic  psychological  content 
encompasses  motivation,  emotion, 
sensation,  perception,  learning,  and 
measurement.  The  final  chapters  deal 
with  psychopathology  and  mental 
health.  The  glossary,  though  generally 
adequate,  tends  to  neglect  terms  asso- 
ciated with  behavioristic  psychology. 
48     THE  CANADIAN   NURSE 


The  references  are  limited  (usually  five 
per  chapter)  and  consider  only  books. 

Three  major  criticisms  are  made  of 
the  text:  1 .  it  is  over-inclusive  to  the 
point  of  inadequate  presentation  of 
basic  psychology;  2.  it  contains  limited 
references,  with  a  total  exclusion  of 
journal  articles;  3.  it  is  not  representa- 
tive of  current  trends  in  psychology. 

These  criticisms  are  elaborated  in 
the  following  discussion. 

Madigan  attempts  to  give  the  stu- 
dent information  in  too  many  areas  of 
the  broad  field  of  psychology.  As  a  re- 
sult, the  book  becomes  little  more  than 
an  outline,  giving  the  reader  superfi- 
cial content.  Also,  because  of  the  limit- 
ed reference  lists,  the  book  is  a  poor 
reference  source. 

The  book  could  only  have  utility 
as  a  basic  introductory  text.  Once  stu- 
dents have  acquired  any  sophistication 
in  nursing,  many  of  the  content  areas 
would  prove  inadequate.  For  example, 
one  of  the  six  sections  is  concerned 
with  growth  and  development.  Gener- 
ally, pediatric  nursing  texts  present  a 
more  thorough  discussion  of  the  area 
than  Madigan  offers.  A  similar  criti- 
cism can  be  directed  at  the  section 
dealing  with  personality  disorders  and 
mental  health. 

Had  the  author  restricted  her  book 
to  basic  areas  in  psychology,  the  book 
would  probably  have  proven  more  in- 
formative and  useful.  Because  of  the 
elementary  nature  of  the  book,  its 
applicability  to  nursing  situations  is 
questionable.  Its  major  shortcoming  is 
in  not  providing  the  beginning  stu- 
dent with  a  sound  knowledge  of  behav- 
ior and  behavioral  interactions. 


Nursing  Reconsidered;  A  Study  of 
Change  Part  1,  by  Esther  Lucile 
Brown.  218  pages.  Toronto,  J.B. 
Lippincott  Company,  1970. 
Reviewed  by  Alice  Baumgart,  Asso- 
ciate Professor,  School  of  Nursing, 
University  of  British  Columbia, 
Vancouver,  B.C. 

In  the  face  of  an  ever-growing  cata- 
log of  discontents  and  deficiencies 
with  nursing,  even  the  most  optimistic 
among  us  have  had  cause  to  wonder 
about  the  future  of  the  profession.  It  is 
reassuring,  therefore,  to  find  one  of 
nursing's  long  time  and  loyal  friends, 
Esther  Lucile  Brown,  pointing  to  some 
of  the  changes  taking  place  and  seeing 
in  them  evidence  of  a  stronger,  better- 
defined,  and  appreciably  enlarged  role 
for  the  profession. 

This  book,  the  first  of  a  two-part 
series,  is  basically  an  anthology  of 
innovative  ideas  successfully  applied 
in  hospitals,  extended  care  services, 
and  nursing  homes.  To  collect  her  data, 
Dr.  Brown  visited  various  parts  of  the 


United  States  and  had  an  opportunity 
to  get  a  first-hand  look  at  settings  re- 
flecting the  growing  technical  special- 
ization in  nursing  and  demonstrating 
the  trend  toward  clinical  nursing  prac- 
tice. Many  people  she  talks  about  and 
many  settings  she  describes  are  famil-' 
iar.  Among  them  are  Dean  Dorothy 
Smith  at  the  J.  Hillis  Miller  Health 
Center  at  the  University  of  Florida, 
Rosamund  Gabrielson  at  Good  Samar- 
itan Hospital  in  Phoenix,  Frances 
Reiter,  and  the  late  Lydia  Hall  at  the 
Loeb  Center  for  Nursing  and  Reha- 
bilitation. 

The  author's  tone  is  purposefully 
optimistic  for  she  says,  "What  is  prob- 
ably needed  now  is  not  further  em- 
phasis upon  problems  so  much  as 
attention  to  the  many  hopeful  develop- 
ments that  may  permit  extensive  re- 
organization, both  of  nursing  itself  and 
the  setting  in  which  it  is  practiced." 

If  Dr.  Brown  is  at  all  downhearted, 
it  is  perhaps  about  intensive  care,  one 
of  the  most  conspicuous  changes  of 
the  past  10  years.  Her  particular  con- 
cern is  well  worth  noting  —  that  the 
quality  of  regular  nursing  service  may 
be  sacrificed  for  the  very  few  patients 
served  by  intensive  care  units. 

Her  greatest  enthusiasm  is  obvious- 
ly for  the  achievement  of  a  growing 
number  ot  clmical  specialists  who  have 
succeeded  in  carving  out  a  patient- 
centered  role  with  the  prime  object  of 
providing  comprehensive,  continuing, 
and  coordinated  care. 

To  conclude,  Dr.  Brown  presents 
some  most  interesting  thoughts  on  the 
potential  leadership  that  nursing  is 
beginning  to  assume  in  meeting  the 
health  needs  of  the  aged  "sick"  in  nurs- 
ing homes  and  the  aged  "well"  in 
senior  citizens'  residences  and  retire- 
ment homes. 

This  is  a  book  that  should  be  widely 
read.  Although  based  on  the  present, 
its  focus  is,  in  effect,  on  the  future.  It 
offers  innovative  ideas  for  everyone 
of  us  to  consider  and,  hopefully,  try, 
whether  we  be  a  general  duty  nurse  or 
a  director  of  a  hospital.  Equally  impor- 
tant, it  directs  us  to  take  a  more  posi- 
tive attitude  and  get  on  with  the  busi- 
ness of  coping  with  new  realities  and 
radical  possibilities. 

Disaster  Handbook,  2nd  ed.,  by  Solo- 
mon Garb  and  Evelyn  Eng.  310 
pages.  New  York,  Springer  Publish- 
ing Co.,  Inc.,  1969. 
Reviewed  by  Evelyn  A.  Pepper, 
formerly  Nursing  Consultant,  Emer- 
gency Health  Services,  Dept.  Na- 
tional Health  &  Welfare,  Ottawa. 

Since  1964,  when  the  first  edition  of 
Disaster  Handbook  was  published, 
nurse  educators  across  Canada  have 
found  it  a  useful  reference  text,  espe- 
FEBRUARY  197' 


cially  in  the  preparation  of  lecture  ma- 
terial on  disaster  nursing,  now  includ- 
ed in  the  curricula  of  basic  nursing  edu- 
cation. Although  the  original  format 
has  not  been  greatly  changed  in  this 
second  edition,  changes  where  made  do 
enhance  the  new  text. 

The  up-dated  statistics  on  various 
types  of  disasters  reveal  that  the  num- 
ber of  casualties  from  most  disasters 
has  not  decreased.  Although  these  star- 
tling statistics  apply  mostly  to  the  Uni- 
ted States,  they  may  well  act  as  a  stim- 
ulus in  Canada  to  mcrease  govern- 
mental assistance,  expand  educational 
programs,  generate  greater  public  in- 
volvement, and  thus  give  meaningful 
support  to  those  persons  responsible 
for  preplanning  against  any  type  of 
disaster  in  this  country. 

The  expansion  of  section  II,  chap- 
ters 14  to  21,  relating  specifically  to 
first  aid,  makes  the  handbook  more 
complete.  Canadian  readers  will  find 
this  additional  material  useful  as  an 
aide-memoire.  But  for  teaching  pur- 
poses, these  chapters  should  not  re- 
place the  St.  John  Ambulance  Asso- 
ciation's publication  First  Aid — Ca- 
nadian Edition,  used  so  extensively 
throughout  our  country  in  the  instruc- 
tion of  standard  first  aid. 

A  new  chapter,  "Astrodemics,"  has 
been  added  to  section  IV.  Astrode- 
mics is  "a  term  coined  to  describe  an 
infestation  of  earth  or  earth  creatures 
by  forms  of  life  brought  back  from 
other  celestial  bodies."  As  this  has  not 
yet  occurred  on  earth,  the  information 
adds  little  to  the  text.  The  point  is 
strongly  made  however  that  the  possi- 
bility of  such  disasters  occurring  is 
much  too  important  to  be  left  with  the 
organization  related  to  space  admin- 
istration. Future  attention  and  careful 
scrutiny  by  an  impartial  agency  are 
needed. 

Section  IV  has  a  further  chapter, 
"Riots  and  Civil  Disturbances,"  con- 
taining useful  information  for  today 
and,  unfortunately,  for  tomorrow. 

For  nurses  who  do  not  have  the  first 
edition  of  Disaster  Handbook,  the  sec- 
ond edition  is  highly  recommended. 
Replacement  of  first  editions  currently 
available  in  nursing  libraries  does  not 
seem  justifiable.  ^ 


SHARE  YOUR 
GOOD  HEALTH 


BE  A  BLOOD  DONOR 


WHICH  I.V. 

HAS  INFILTRATED? 

Actually  we  don't  know  if  either  I.V.  has  infiltrated,  but 
with  the  IV-Ometer  it  is  obvious  there  has  been  a  change 
from  the  desired  flow  rate.  This  change  could  be  from  an 
infiltration,  the  patient  lying  on  the  tubing  or  any  of  a 
number  of  causes. 

A  flow  rate,  once  established  with  the  "Stay-set"  clamp, 
is  indicated  by  placing  the  marker  over  the  ball.  Then,  if 
variations  occur  they  can  be  noted  at  a  glance.  The  pat- 
ented "Stay-set"  clamp  assures  you  that  flow  variations 
are,  indeed,  products  of  something  other  than  the  clamp. 

Adaptions  are  available  for  use  with  all  I.V.  solution  con- 
tainers. For  further  information  please  complete  and  mail 
the  coupon  shown  below. 


Gentlemen:  Please  send  more  information 

Name      

Address 

City   

State Zip    


Hospital 


Title/Position  _^ 

I'V'Ometer        P.O.  box  1219  SamaCruz,  CaNf.  95O6O 


'FEBRUARY  1971 


THE  CANADIAN   NURSE     49 


AV  aids 


FILMS 

IV  Additives:  Steps  to  Safety 

Hospital  showings  of  a  15 -minute  film- 
strip  I.V.  Additives:  Steps  to  Safety 
are  being  offered  to  doctor,  nurse  and, 
pharmacist  groups  by  Abbott  Labora- 
tories. The  showings  and  distribution 
of  a  similarly  titled  booklet  are  de- 
scribed as  part  of  a  new  service  designed 
to  provide  helpful  data  on  such  addi- 
tives and  their  compatability.  For  fur- 
ther information  write  to  Abbott  Lab- 
oratories Ltd.,  P.O.  Box  6150,  Mont- 
real 101,  Quebec. 


A  Child  and  Surgery 

I'm  not  a  Small  Adult  —  Nursing  Care 
of  the  Pediatric  Patient  in  Surgery 
(CS-1066.  16mm.  color,  sound.  27 
minutes.  1970).  The  physical  and  emo- 
tional needs  of  children  are  stressed  and 
techniques  directed  al  meeting  these 
needs  arc  demonstrated  in  this  film. 
The  pediatric  surgical  patient  presents 
problems  quite  different  from  those  of 
the  adult  and  solutions  to  these  prob- 
lems are  provided  in  this  film.  Book- 
ings may  be  made  through  Davis  & 
Gcck  Film  Library,  Cyanamid  of  Ca- 
nada Limited,  P.O.  Box  1039.  Montreal 
10  L  Quebec. 


Operating  Room  Personnel 

Faces  and  Phases  ofO.R.  Management 
(CS-1067.  16  mm.  color,  21  minutes. 
1970).  This  film  is  centered  around 
the  multi-disciplinary  role  the  oper- 
ating room  supervisor  must  play.  Ac 
centing  personnel  relationship  at  all 
levels,  the  film  gives  the  impression  of 
a  whirlwind  in  motion,  moving  rapidly 
but  smoothly  and  efficiently  in  a  prede- 
termined direction.  Available  through 
Davis  &  Geek  Film  Library.  Cyanamid 
of  Canada,  P.O.  Box  1039,  Montreal 
101,  Quebec. 


Pharmacist  on  Hospital  Team 

Modern  Hospital  Pharmacy  Practice 
(16  mm.  color,  sound,  20  minutes) 
depicts  routines  and  procedures  involv- 
ing the  hospital  pharmacist  as  a  mem- 
ber of  the  total  health  care  team  includ- 
ing the  doctor,  the  nurse  and  the  social 
worker.  The  use  of  the  unit  dose  drug 
distribution  system  at  the  City  of  Hope 
is  shown,  as  well  as  new  developments 
50     THE  CANADIAN   NURSE 


in  clinical  pharmacy  and  the  utiliza- 
tion of  pharmacy  technicians. 

Enquiries  should  be  directed  to  Dr. 
Allan  J.  Swartz,  Director  of  Phar- 
macy. City  of  Hope,  1500  E.  Duarte 
Road.  Duarte,  California. 

TEACHING  AIDS 

Heart  Sounds  and  Murmurs 
On  Record 

The  Art  of  Heart  Auscultation,  a  new 
12-inch  L.P.  recording  of  the  Roche 
Scientific  Service  Series,  was  prepared 


with  the  cooperation  of  Dr.  G.W. 
Manning,  professor  of  medicine  at  the 
University  of  Western  Ontario  and 
director  of  the  cardiovascular  unit. 
Victoria  Hospital,  London. 

The  record,  produced  and  distrib- 
uted on  request  by  Hoffman-LaRoche 
Limited  as  a  service  to  the  medical 
profession,  presents  a  variety  of  nor- 
mal and  abnormal  heart  sounds  and 
murmurs  with  corresponding  phono- 
cardiographic  tracings.  The  record 
package  permits  the  physician  to  learn, 
to  test  his  diagnostic  skills,  or  to  teach 


Heart  Auscultation 


FEBRUARY  197 


auscultation.  Physician  response  to  the 
Roche  recording  included  donations 
of  $2,400  to  the  Canadian  Heart 
Foundation. 

Write  to  HotTman-LaRoche  Limited, 
1956  Bourdon  St.,  Montreal  378,  Que- 
bec for  further  information. 


Multimedia  System 
of  Instruction 

LEGS  (Learning  Experience  Guides 
for  Nursing  Education)  is  a  comprehen- 
sive, multi-media  system  of  individ- 
ualized nursing  instruction.  By  com- 
bining reading,  seeing,  hearing,  dis- 
cussing, and  practicing  experiences, 
LEGS  provides  learning  objectives 
and  motivates  students  to  meet  them. 
Orientation  for  students  and  instruc- 
tors to  the  goals  and  methodology  of 
this  program  of  individualized  nursing 
education  is  available  in  a  1 6mm  color, 
sound  film. 

LEGS  in  four  volumes  is  designed  for 
use  in  a  two-year  technical  nursing 
program.  Each  volume,  one  for  each 
term,  is  accompanied  by  its  own  set 
of  audiovisual  components.  A  teacher's 
resource  book  provides  directions  on 
how  to  use  the  program. 

For  an  illustrated  brochure  on  LEGS 
or   further   information,  write   to  the 


marketing  manager,  educational  serv- 
ices, John  Wiley  &  Sons  (Canada)  Ltd., 
22  Worcester  Drive,  Toronto,  Ontario. 


LITERATURE 


CBC  Learning  Systems  Catalog 

A  Canadian  Broadcasting  Corporation 
audio  tape  catalog  lists  signitlcant  ma- 
terial originally  presented  on  air  as  part 
of  its  broadcast  series. 

Tapes  in  this  catalog  are  available 
on  either  reels  or  cassettes  and  are  sold 
on  the  condition  that  use  of  them  is 
restricted  to  non-broadcast,  non-com- 
mercial, educational  situations  only. 
They  may  not  be  reproduced  in  any 
form. 

Among  subjects  covered  in  these 
programs  are:  social  perspectives  and 
reports,  and  natural  and  physical  sci- 
ences that  may  be  of  interest  to  nurses. 

One-hour  items  (on  reel  or  cassette) 
cost  $12.00  and  30  minute  items, 
$6.00.  These  prices  do  not  include 
shipping  charges. 

The  CBC  Learning  Systems  catalog 
of  Audio  Tapes  is  available  from  CBC 
Learning  Systems,  Box  500,  Station 
A,  Toronto  1 16,  Ontario. 


CONFERENCE  MATERIAL 


Vanier  Institute  Conference  Material 
■'Day  Care  —  A  Resource  for  the  Con- 
temporary Family"  includes  papers, 
proceedings,  and  concluding  statements 
of  a  seminar  organized  and  sponsored 
by  the  Vanier"  Institute  in  Ottawa, 
September  29  and  30,  1 969  to  consider 
day  care  services  as  a  resource  for  the 
contemporary  family. 

Single  copies  are  available  for  $1 .50 
from  the  Vanier  Institute  of  the  Fam- 
ily. 151  Slater  St..  Ottawa  4,  Ontario. 


VIDEOTAPING 


Sony  videotape  splicing  kit 

The  new  Sony  VXK-1  videotape  splic- 
ing kit  to  be  used  with  any  1/2"  Sony 
videotape  contains  everything  needed 
for  flawless  results  —  precision,  splic- 
ing block,  tape  developer,  splicing  tape, 
tape  cutter,  sanitary  gloves  to  prevent 
damage  by  skin  oils  to  the  oxide  surface 
of  the  tape.  Illustrated  instructions 
include  every  step  from  "stop-action" 
editing  to  the  final  rewind  and  allow 
even  the  novice  to  achieve  perfect 
results. 

iContiniied  on  page  52) 


THE  UNIVERSITY  OF  CALGARY 


FACULTY    POSITIONS 


July  openings  for  faculty  positions  in  a  new 
baccalaureate  program:  two  children's  nursing; 
one  community  nursing;  and  one  general  (med- 
ical-surgical) nursing. 

Master's  degree  with  major  in  nursing  content 
areas  requisite.  Preference  given  to  applicants 
with  a  doctoral  degree.  Previous  teaching  and 
nursing  practice  desirable.  Salary  negotiable. 


CONTACT: 

Shirley  R.  Good 
Director,  School  of  Nursing 
The  University  of  Calgary 
Calgary  44,  Alberta 
Canada 


MY  VERY  OWN 

STETHOSCOPE  ? 


—  but  of  course! 

ASSISTOSCOPE*  was 

designed  with  the 
nurse  in  mind. 

ASSISTOSCOPE*  gives 
you  the  acoustical 
perfection  of  the 
most  expensive 
stethoscopes. 


ASSISTOSCOPE"  Is  available  with  black  or 
hospital-white  tubing  and  ear  pieces  with  the  slim-fit 
sonic  head  which  slips  easily  under  blood  pressure  cuffs 
or  clothing. 

Order  from\ 
tCheck  with  your  Director  f 

r„rr:;nrr    \A/ winley-morrb  company  im 

i  £     SURQICAL   INSTRUMENT*    DIVISION 
mlS^  MONTRtAl  li  aUEICC 

•TRADE  MARK 


ASSISTOSCOPE  at 

special  group  prices. 


FEBRUARY  1971 


THE  CANADIAN   NURSE     51 


Further  information  may  be  obtained 
from  Sony  of  Canada  Ltd.,  21  Conneil 
Court,  Toronto  18,  Ont.  -g? 


Publications  on  this  list  have  been 
received  recently  in  the  CNA  library 
and  are  listed  in  language  of  source. 

Material  on  this  list,  except  Reference 
items  may  be  borrowed  by  CNA  mem- 
bers, schools  of  nursing  and  other  in- 
stitutions. Reference  items  (theses, 
archive  books  and  directories,  almanacs 
and  similar  basic  books)  do  not  go  out 
on  loan. 

Requests  for  loans  should  be  made 
on  the  "Request  Form  for  Accession 
List"  and  should  be  addressed  to:  The 
Library,  Canadian  Nurses"  Association, 
50  The  Driveway.  Ottawa  4.  Ontario. 

No  more  than  three  titles  should  be 
requested  at  any  one  time. 

BOOKS  AND   DOCUMENTS 

1.  L'aide  medicate  en  milieu  isole  par 
Georges  Cuvier.  Paris,  Expansion  scientifi- 
que  franijaise.  1967.  227p. 

2.  Armstrong  and  Browder's  nursing  care 
of  children  3d  ed.  by  Jean  Bulger  Mash  and 
Margaret  Dickens.  Philadelphia.  F.A.  Da- 
vis, 1970.  739p. 

3.  Arrows  of  mercy  by  Philip  Smith.  To- 
ronto, Doubleday  Canada.  1969.  244p. 

4.  The  Canadian  source  book  of  free  educa- 
tional materials,  2d  ed.  prepared  by  Cana- 
dian Educational  Resources  for  Teachers. 
Cranberry    Portage,    Manitoba.    Cert.    Co., 

1969.  239p. 

5.  Careers  in  nursing  edited  by  John  Callag- 
han  with  a  foreword  by  J.  Dunwoody.  Lon- 
don, Classic,  1970.  84p. 

6.  Challenge  to  nursing  education  .  .  .  clini- 
cal roles  of  the  professional  nurse.  Papers 
presented  at  the  sixth  conference  of  the 
Council  of  Baccalaureate  and  Higher  Degree 
Programs.  Kansas  City,  National  League 
for  Nursing,  1970.  47p. 

7.  Clinical  nursing  pathophysiological  and 
psychosocial  approaches.  2d  ed.  by  Irene 
L.     Beland.     Toronto,     Collier-Macmillan. 

1970.  948p. 

8.  Community  health  nursing  practice 
by  Ruth  B.  Freeman.  Toronto,  Saunders, 
1970.  414p. 

9.  Community  health  services.  Prepared 
in  consultation  with  the  Committee  on  Public 
Health  Administration,  American  Public 
Health  Association,  and  a  special  advisory 
committee  by  Harold  Herman  and  Mary 
Elisabeth  McKay.  2d  ed.  Wash.,  Interna- 
tional City  Managers"  Association,  1968. 
252p.  (Municipal  management  series) 

10.  Compendium  of  pharmaceutical  and 
specialties  (Canada)  prepared  by  Canadian 
52     THE  CANADIAN   NURSE 


Pharmaceutical  Association.  1971.  930p. 
\\.  La     contraception      hier,     aujourd'hui, 
demain,  par  J.  Kahn-Nathan  et  H.  Rozen- 
baum.      Paris.      LExpansion      scientifique 
franeaise,  1969.  238p. 

12.  Dans  le  sillon  de  la  psycho-  et  de  la 
socio-pedagogie;  la  vie  et  ses  conflits 
sexuels  et  socio-affectifs  par  Aurele  Saint- 
Yves.  Montreal.  Renouveau  Pedagogique, 
1970.  78p. 

13.  La  depression  nerveuse  par  Helene  Pi- 
lotte.  Montreal,  Editions  de  PHomme,  1970. 
207p. 

14.  Drugs  and  solutions;  a  programmed 
introduction  for  nurses  by  Claire  Brackman 
and  Sybil  M.  Fletcher.  Toronto,  Saunders. 
1970.  171p. 

15.  Florence  Nightingale,  nurse  to  the 
world  by  Lee  Wyndham.  New  York,  World 
Pub.  Co.,  1969.  175p. 

16.  Food  values  of  portions  commonly 
used  by  Anna  de  Planter  Bowes  and  Church. 
11th  ed.  rev.  by  Charles  Frederich  Church 
and  Helen  Nichols  Church.  Toronto,  Lip- 
pincott.  1970.  180p. 

17.  Fundamentals  of  neurology.  5th  ed.  by 
Ernest  Dean  Gardner.  Toronto,  Saunders, 
1968.  367p. 

18.  Gynecologic  et  soins  infirmiers  en  gy- 
necologic par  Fran?oise  Piquette.  Montreal, 
Editions  du  Renouveau  Pedagogique,  1970. 
143p. 

19.  Home  from  ho.spital;  the  results  of  a 
survey  conducted  among  recently  dicharged 
hospital  patients  by  Muriel  Skeet.  London, 
Dan  Mason  Nursing  Research  Committee, 
1970.  91p. 

20.  Lc  langage  de  votre  enfant;  comment 
I'eduquer,  le  corriger,  le  developper.  Mont- 
real. Editions  de  PHomme.  1970.  160p. 

2 1 .  Measuring  your  public  relations;  a 
guide  to  research  problems,  methods  and 
findings  by  Herman  Stein.  New  York.  Na- 
tional Publicity  Council.  1952.  48p. 

22.  The  measurement  of  vital  signs  by 
Russell  C.  Swansburg.  New  York,  Putman's, 
1970.  408p. 

23.  Medsirch:  a  computerized  .system  for 
the  retrieval  of  multiple  choice  items  by 
C.  B.  Hazlett.  Developed  under  the  auspices 
of  the  R.  S.  McLaughlin  Examination  and 
Research  Centre.  Royal  College  of  Physi- 
cians and  Surgeons  of  Canada  and  Division 
of  Educational  Research  Services,  Faculty  of 
Education.  University  of  Alberta.  Edmonton. 
Division  of  Educational  Research  Services, 
University  of  Alberta,  1970.  65p. 

24.  Modern  clinical  psychiatry .  7th  ed.  by 
Arthur    Percy   Noyes,    Lawrence   C.   Kolb. 


Notice 

Frequently,  packages  of  books  sent 
from  the  CNA  library  to  persons  liv- 
ing in  apartments  are  returned  by  the 
post  office,  marked  "not  picked  up." 
Borrowers  are  requested  to  tell  their 
apartment  superintendent  in  advance 
that  they  are  expecting  books  to  be 
delivered  from  the  CNA. 


Toronto,  Saunders,  1968.  638p. 

25.  Naissances  planifiees  pourquoi?  Com- 
ment? par  Hubert  Charbonneau  et 
Serge  Mongeau.  Montreal,  Editions  du 
Jour,  1966.  153p. 

26.  The  national  survey  of  audiovisual 
materials  for  nursing  1968-1969.  Conducted 
by  ANA-NLN  Film  Service,  National  League 
for  Nursing.  New  York.  1970.  243p. 

27.  Occupational  health  content  in  bacca- 
laureate nursing  education  by  Marjorie  J. 
Keller  in  association  with  W.  Theodore 
May.  Cincinnati.  Ohio,  U.S.  Dept.  of 
Health  Education  and  Welfare,  Bureau  of 
Occupational  Safety  and  Health  and  Train- 
ing Institute,  Office  of  Training  and  Man- 
power Development,  1970.  126p. 

28.  Pharmacie.  2d.  par  Yvan  Touitow. 
Paris.  Masson,  1970.  24 Ip. 

29.  Practical  nursing;  a  textbook  for  students 
and  graduates  by  Dorothy  Kelly  Rapier  et 
al.  4th  ed.  St.  Louis,  Mosby,  1970.  647p. 

30.  Problemes  actuels  d'otorhino-laryngo- 
logie  par  P.  Andre  et  al.  Paris.  Librairie 
Maloine,  1969.  22  Ip. 

31.  La  profession  d'infirmiere  en  France. 
N.  Wehrlin.  redacteur.  Paris.  Expansion 
Scientifique  Fran^aise.  1970.  Iv. 

32.  Rapport  an  ministre  de  la  sante  et  du 
bien-etre  social  sur  les  recommandations 
des  comites  d'etude  sur  le  coiit  des  services 
sanitaires  au  Canada.  Ottawa.  Association 
des  Hopitaux  du  Canada,  1970.  Iv. 

33.  Reamination  et  medecine  d'urgence, 
1968  sous  la  direction  de  M.  Goulon  et  M. 
Rapin.  Paris,  L"Expansion  scientifique 
frangaise,  1968.  367p.  (Conferences  de  rea- 
mination et  de  medecine  d'urgence  de  PH6- 
pital  Raymond  Poincare) 

34.  Les  reunions  a  I'hopital  psychiatrique 
par  Denise  C.  Rothberg.  Paris,  Centres 
d'entrainement  aux  methodes  d'education 
active.  Editions  du  Scarabee,  1968.  68p. 
(Bibliotheque  de  Pinfirmier  psychiatrique) 

35.  Saigner;  c'esi  vivre  le  deft  quotidien 
par  Rachel  Gagnon  et  Jules  Lamothe.  Chi- 
coutimi,  P.Q.  Editions  science  Moderne, 
1970.  161p. 

36.  Science  year.  The  world  book  science 
annual,  1970.  Chicago,  Field  Enterprises 
Educational  Corp.  441  p. 

37.  Teach  in  sur  la  sexualile  par  Helene 
Pilotte.  Montreal.  Editions  de  PHomme, 
1970.  172p. 

38.  Teaching  the  operating  room  techni- 
cian; written  and  compiled  by  the  Tech- 
nician Manual  Committee  of  the  Associa- 
tion of  Operating  Room  Nurses,  Margaret 
A.  Burns  et  al.  New  York,  Association  of 
Operating  Room  Nurses.  Technician 
Manual  Committee.  1967.  337p. 

39.  Operating  room  topics;  an  anthology  of 
selected  articles  from  AORN  journal.  N.Y., 
1968.  264p. 

40.  Technical  nursing  of  the  adult;  medical, 
surgical  and  psychiatric  approaches  by 
Sandra  B.  Fielo  and  Sylvia  C.  Edge.  Toronto, 
Collier-Macmillan,  1970.  588p. 

41.  Urologic  nursing  by  John  G.  Keuhne- 
lian  and  Virginia  E.  Sanders.  Toronto, 
Collier-Macmillan,  1970.  407p. 

FEBRUARY  1971 


PAMPHLETS 

42.  Collcf^c  etiiaalion:  key  lo  a  professional 
career  in  nursing.  New  York.  National 
League  for  Nursing.  Dept.  of  Baccalaureate 
and  Higher  Degree  Programs,  1970.  I9p. 

43.  Costs  and  time  analysis  of  monograph 
cataloging  in  hospital  libraries:  a  preliminary 
stiuly  by  Linda  Angold.  Detroit.  1969.  22p. 
(Wayne  State  University.  School  of  Medicine. 
Library  and  Biomedical  Information  Series 
Center.  Report  no.  5  1 ) 

44.  Developing  and  using  performance 
standards  by  Constance  M.  Ewy.  Washington. 
Society  for  Personnel  Administration.  1962. 
27p. 

45.  Diagnosis  of  hospital  assault:  presented 
by  Lome  Elkin  Rozovsky  at  annual  meeting 
of  the  Nova  Scotia  Hospital  Association 
at  Halifax  on  Oct.  30.  1969.  Halifax  1969. 
29p. 

46.  Folio  of  reports.  Quebec.  Association  of 
Nurses  of  the  Province  of  Quebec.  1970.  42p. 

47.  Manuel  de  la  .secretaire  medicale  et  de 
la  receptionniste  par  Rolland  Gagne.  Mont- 
real. Editions  Intermonde.  1969.  40p. 

48.  Nursefacuity  census  1970.  New  York. 
National  League  for  Nursing.  1970.  9p. 

49.  Pertinent  points  for  presidents  and  a 
glo.s.sary  of  terminology  for  all  by  Orlea 
Alden.  Vancouver.  B.C..  1970.  18p. 

50.  The  prevention  of  rheumatic  fever 
and  rheumatic  heart  diseases.  New  York. 
Inter-Society  Commission  for  Heart  Disease 
Resources.  Rheumatic  Fever  and  Rheumatic 


Heart  Disease  Study  Group.  1970.  34p. 

51.  Report  1969.  Toronto.  Canadian  Mental 
Health  Association.  1970.  16p. 

52.  Report.  1970.  London.  Royal  College 
of  Nursing  and  National  Council  of  Nurse 
of  the  United  Kingdom.  1970.  63p. 

GOVERNMENT    DOCUMENTS 

Canada 

53.  Bureau  of  Statistics.  Estimated  popula- 
tion of  Canada  by  province  at  June  I,  1970. 
Ottawa.  Queen's  Printer.  1970.  2p. 

54.  — .  Hospital  statistics.  Preliminary 
anmud  report,  1969.  Ottawa.  Queens 
Printer.  1970.  37p. 

55.  — .  Mental  health  statistics,  vol.  I, 
Institutional    admissions    and    separations, 

1969.  Ottawa.  Queens  Printer.   1970.   196p. 

56.  — .  Salaries  and  qualifications  of  teach- 
ers in  universities  and  colleges,  1969170.  78p. 
57-  — •  Survey  of  higher  education,  pt. 
I:  Fall  enrolment  in  universities  and 
colleges   1969-70.  Ottawa.  Queen's  Printer. 

1970.  173p. 
1970.  173p. 

58.  — .  Vital  statistics  1968.  Ottawa. 
Queen's  Printer.  1970.  248p. 

59.  Dept.  of  Labour.  Economics  and 
Research  Branch,  mige  rates,  .salaries  and 
hours  of  labour,  1969.  Ottawa.  Queens 
Printer.  1970.  436p. 

60.  — .  Legislation  Branch. /.<;/)<«//•  .s7«/it/(;r(/.s 
/"  Canada.  1969.  Ottawa.  Queen's  Printer. 
1970.  98p. 


61.  — .  Women's  Bureau.  Facts  and  figures 
about  women  in  the  labour  force,  1969. 
Ottawa.  1970.  19p. 

62.  Dept.  of  Manpower  and  Immigration. 
Requirements  and  average  starting  salaries: 
community  college  graduates.  Ottawa. 
Queen's  Printer.  1970.  15p. 

63.  — .  Requirements  and  average  starting 
.salaries:  university  gradtuites.  Ottawa, 
Queen's  Printer.  1970.  21p. 

64.  Dept.  of  National  Health  and  Welfare. 
Research  projects  1970.  Ottawa.  1970.  125p. 

65.  — .  Emergency  Welfare  Services  Divi- 
sion. Registration  and  inquiry  manual. 
Ottawa.  Queen's  Printer.  1969.  73p. 

66.  — .  Research  and  Statistics  Directorate. 
The  measurement  of  poverty.  Ottawa.  1970. 
45p.  (Its  Social  Security  Series.  Memoran- 
dum no.  19) 

Ontario 

67.  Dept.   of  Health. 
Toronto.  1970.  187p. 

68.  — .  Stillbirths    in 
Toronto.     1970.     14p. 
no.47) 
United  States 

69.  Dept.  of  Health.  Education  and  Welfare. 
Public  Health  Service.  Smokers'  self-testing 
kit.  Washington,  U.S.  Gov't  Print.  Off.. 
1969.  lip.  (U.S.  Public  Health  Service. 
Publication  1904  (rev.)) 

70.  Public  Health  Service.  National  In- 
stitutes of  Health.  Nursing  personnel  in 
hospitals,  1968.  Wash.  U.S.  Gov't.  Print. 
Off..  1970.  382p.  'g? 


Report,    45th.    1969. 

Ontario     1921-1967. 
(Its    Special    Report 


Request  Form  for  "Accession  List" 
CANADIAN  NURSES'  ASSOCIATION  LIBRARY 

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FEBRUARY   1971 


THE  CANADMN   NURSE     53 


February  15-19, 1971 

Occupational  Health  Nursing  course,  spon- 
sored by  the  University  of  Toronto.  De- 
signed for  registered  nurses  with  at  least 
five  years  experience  in  occupational 
health  nursing  who  work  alone  or  with  one 
other  nurse.  For  more  information,  contact 
the  University  of  Toronto. 

February  16-18, 1971 

First  National  Conference  on  Research 
in  Nursing  Practice,  Skyline  Hotel.  Ottawa. 
Purpose  of  this  bilingual  conference  is  to 
stimulate  research  in  nursing  practice. 
Registration  is  limited  to  200.  Fee:  $10 
per  day:  $5  per  day  for  nurses  enrolled  in 
graduate  programs.  For  further  information 
and  registration  forms,  write  to:  Dr.  Floris 
E  King.  Project  Director.  School  of  Nursing, 
University  of  British  Columbia.  Vancouver 
8.  B.C. 

March  15-16, 1971 

Workshop  on  Rituals  and  Routine,  spon- 
sored by  the  New  Brunswick  Association 
of  Registered  Nurses,  Fredericton,  N.B. 
Leader  of  this  workshop  for  head  nurses 
will  be  Pamela  E.  Poole,  nursing  consultant. 
Hospital  Insurance  and  Diagnostic  Services, 
Department  of  National  Health  and  Welfare. 

March  31, 1970 

Canadian  Nurses'  Association  annual 
meeting,  business  sessions  only,  Chateau 
Laurier,  Ottawa,  Ontario. 

April  19-22, 1971 

Canadian  Public  Health  Association,  62nd 
annual  meeting.  King  Edward  Sheraton 
Hotel,  Toronto.  For  advance  registration, 
information,  and  accommodation,  write: 
CPHA  Annual  Meeting,  1255  Yonge  Street, 
Toronto  7,  Ontario. 

May  9-12, 1971 

National  League  for  Nursing  and  National 
Student  Nurses'  Association,  annual  con- 
vention, Dallas  (viemorial  Auditorium  and 
Convention  Hall,  Dallas,  Texas,  U.S.A. 

May  10-14, 1971 

Ontario  Medical  Association,  annual  meet- 
ing. Royal  York  Hotel,  Toronto,  Ontario. 


May  11-14, 1971 

Alberta  Association  of  Registered  Nurses, 

annual  meeting,  Banff  Springs  Hotel,  Banff, 

Alberta. 

54     THE  CANADIAN   NURSE 


May  19, 1971 

Catholic  Hospital  Conference  of  Ontario, 
nursing  committee,  annual  meeting.  King 
Edward  Hotel,  Toronto,  Ontario. 

May  20-21, 1971 

Catholic  Hospital  Conference  of  Ontario, 
annual  meeting.  King  Edward  Hotel,  Toron- 
to. Ontario. 

May  26-29, 1971 

Reunion  of  The  Montreal  General  Hospital 
School  of  Nursing  graduates  to  celebrate 
the  hospital's  150th  anniversary.  Graduates 
should  send  addresses  to;  Miss  Phyllis 
Walker,  The  Montreal  General  Hospital 
{Dept.  of  nursing),  Montreal  109,  P.O. 

May  30-June  1,1971 

Manitoba  Association  of  Registered  nurses, 
annual  meeting,  Dauphin,  Manitoba. 

May  31-|une  1,1971 

Catholic  Hospital  Association,  annual  con- 
vention, Montreal.  Convention  chairman: 
Rev.  Sister  Bernadette  Poirier,  Director  of 
Nursing,    Notre   Dame   Hospital,    Montreal. 

May31-)une3, 1971 

Canadian  Tuberculosis  and  Respiratory 
Disease  Association  and  Canadian  Thoracic 
Society,  annual  meetings.  King  Edward 
Sheraton  Hotel,  Toronto.  Further  details  on 
request  to  Dr.  C.W.L.  Jeanes,  Executive 
Secretary,  343  O'Connor  Street,  Ottawa  4. 


June  6-10, 1971 

Ninth  Canadian  Cancer  Conference  under 
the  auspices  of  the  National  Cancer  Ins- 
titute of  Canada,  Honey  Harbour,  Ontario. 

June  6-12, 1971 

Annual  Meeting,  Canadian  Medical  As- 
sociation, Halifax,  N.S.  For  further  informa- 
tion write:  Canadian  Medical  Association, 
1867  Alta  Vista  Drive,  Ottawa  8,  Ont. 


June  7-11, 1971 

Canadian  Medical  Association,  104th  an- 
nual meeting.  Nova  Scotia.  For  further 
information:  Mr.  B.E.  Freamo,  Acting 
General  Secretary,  Canadian  Medical 
Association,  1867  Alta  Vista  Drive,  Ottawa 
8,  Ontario. 

June  7-11, 1971 

Catholic  Hospital  Association  (U.S.),  56th 
annual  convention,  Atlantic  City,  New 
Jersey. 


June  9-12, 1971 

Canadian  Psychiatric  Association,  annual 
meeting.  Lord  Nelson  Hotel,  Halifax,  Nova 
Scotia. 

June  21-24, 1971 

Canadian  Society  of  Radiological  Techni- 
cians, 29th  annual  national  convention. 
Holiday  Inn,  St.  John's,  Newfoundland. 


June  1971 

Special  Reunion  of  the  Alumnae  of  Ontario 
Hospital  Brockville  School  of  Nursing,  in 
conjunction  with  the  last  graduation  from 
the  School  of  Nursing.  Send  addresses  to 
Nurses'  Alumnae,  Box  1050,  Brockville,  Ont. 


June  1971 

Canadian  Association  of  Neurological 
and  Neurosurgical  Nurses,  second  annual 
meeting.  St.  John's.  Newfoundland.  For 
further  information  contact  the  Secretary: 
Mrs.  Jacqueline  LeBlanc,  5785  Cote  des 
Neiges,  Montreal  209,  Quebec. 


June  2-4  1971 

Canadian  Hospital  Association,  National 
convention  and  assembly.  Queen  Elizabeth 
Hotel,  Montreal,  Quebec. 


July  12-16, 1971 

Twenty-first  International  Tuberculosis 
Conference,  The  Palace  of  Congresses,  the 
Kremlin,  Moscow,  Russia.  Simultaneous 
translation  into  English,  French,  German, 
and  Russian  will  be  provided. 


July  13-19, 1971 

International     Hospital     Federation      Con- 
gress, Dublin,  Ireland. 

November  28-Deceniber  4, 1971 

World  Psychiatric  Association,  Fifth  World      , 
Congress  of  Psychiatry,  Mexico  City.  For     ' 
further  information,  write  Secretariado  Del 
"V"    Congresso,    Mundial    de    Psiquiatria, 
Apartado  Postal  20-123/24,  Mexico,  D.F. 

May  13-19,1973 

International  Council  of  Nurses,  15th  Quad-     | 
rennial  Congress,  Mexico  City,  Mexico.     ■& 
FEBRUARY  1971 


Index 

to 

advertisers 

February  1971 


Abbott  Laboratories  Ltd 9 

Burroughs  Wellcome  &  Co.  (Canada)  Ltd 23 

Clinic  Shoemakers 2 

Denver  Laboratories  (Canada)  Ltd 43 

Charles  E.  Frosst  &  Co 20 

LV.  Ometer 49 

Johnson  &  Johnson  Limited 17,  24 

J.B.  Lippincott  Company  of  Canada  Limited 1 

Octo  Laboratory  Ltd 6 

J.T.  Posey  Company 5 

Professional  Tape  Co.,  Inc 16 

Reeves  Company Cover  IV 

W.B.  Saunders  Company  Canada  Ltd 45 

Schering  Corporation  (Canada)  Limited 13 

Julius  Schmid  of  Canada  Ltd 1 1 

White  Sister  Uniform,  Inc Cover  II,  Cover  III 

Winley-Morris  Company  Ltd 51 


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Advertising  Representatives 
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OPPORTUNITY 

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if  you  are  a  registered  nurse  looking  for  nev\^ 
horizons  where  you  can  fulfill  the  aspirations  of 
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atmosphere  of  a  large,  progressive,  teaching  hospital 
. . .  join  us  at  the  Victoria  General.  Our  need 
is  your  opportunity.  There  are  excellent  general 
staff  openings  in  Medicine,  Neuro-surgery,  Surgery, 
Recovery  Room,  Emergency  and  Operating  Room 
and  Intensive  Care  Units.  Excellent  salary  and 
benefits  with  additional  credit  for  experience  and 
skills  learned  in  special  units.  You  will  enjoy 
living  in  Nova  Scotia  with  its  almost  unlimited 
recreational  opportunities  and  temperate  climate. 
We'll  be  glad  to  send  you  more  information. 

Write:  D.R.  Miller 

Personnel  Officer 

VICTORIA  GENERAL  HOSPITAL 

Halifax,  Nova  Scotia 


FEBRUARY  1971 


THE  CANADIAN   NURSE     71 


PROVINCIAL  ASSOCIATIONS  OF  REGISTERED  NURSES 


Alberta 

Alberta  Association  of  Registered  Nurses. 
10256 —  1 12  Street.  Edmonton. 
Pres.:  M.G.  Purcell;  Pics.-Elcct:  R.  Erick- 
son;  yice-Pres.:  D.E.  Huffman.  A.J.  Prowse. 
Committees — Nnrs.  Sen.:  G.  Clarke: 
Niir.s.  Ediic:  G.  Bauer;  Staff  Nurses:  L.A 
Meighen;  Siiperv.  Nurses:  L.  Bartlett:  Soc. 
&  Econ.  Welf.:  1.  Mossey.  Provincial  Office 
Staff— Pith.  Rcl.:  D.J.  Labelle:  Employ. 
Rel.:  Y.  Chapman;  Committee  Advisor: 
H.  Cotter;  Registrar:  D.J.  Price;  E.xec.  Sec: 
H.M.  Sabin;  Office  Manager:  M.  Garrick. 

British  Columbia 

Registered  Nurses"  Association  of  British 
Columbia.  2130  West  12th  Avenue.  Vancou- 
ver 9. 

Pres.:  M.D.G.  Angus;  Past  Pres.:  M.  Lunn; 
Vice-Pres.:  R.  Cunningham.  A.  Baumgart; 
Hon.  Treasurer:  T.J.  McKenna;  Hon.  Sec: 
Sr.  K.  Cyr.  Committees  —  Nurs.  Educ: 
E.  Moore;  Nurs.  Serv.:  J.M.  Dawes;  Soc. 
&  Econ.  Welf:  R.  Mcfadyen;  Finance: 
T.J.  McKenna;  Leg.  &  By-Laws:  Norman 
Roberts;  Pub.  Rel.:  H.  Niskala;  Exec.  Di- 
rector: P. A.  Kennedy;  Registrar:  H.  Grice; 
Communications  Consult.:  C.  Marcus. 

Manitoba 

Manitoba  Association  of  Registered  Nurses. 
647  Broadway  Avenue,  Winnipeg  1. 
Pres.:  M.E.  Nugent;  Past  Pres.:  D.  Dick; 
Vice-Pres.:  F.  McNaught.  Sr.  T.  Caston- 
guay.  Committees — Nurs.  Serv.:  J.  Robert- 
son; Nurs.  Educ:  S.J.  Winkler;  Soc.  &  Econ. 
Welf:  S.J.  Paine;  Legis.:  M.E.  Wilson;  Ac- 
crediting: ME.  Jackson;  Board  of  Examiners: 
E.  Cranna;  Ediu:  Fund:  M.  Kullberg;  Fi- 
nance: B.  Cunnings;  Pub.  Rel.  Officer:  T.M. 
Miller;  Registrar:  M.  Caldwell;  Exec.  Di- 
rector: B.  Cunnings;  Coordinator  of  Conlin. 
Educ:  H.  Sundstrom. 

New  Brunswick 

New  Brunswick  Association  of  Registered 
Nurses.  2.3  1  Saunders  Street,  Fredericton. 
Pres.:  H.  Hayes;  Past  Pres.:  I  Leckie;  Vice- 
Pres.:  A.  Robichaud,  L.  Mills;  Hon.  Sec: 
M.  MacLachlan.  Committees —  Soc.  &  Econ. 
Welf:  B.  Leblanc;  Nurs.  Educ:  Sr.  H.  Ri- 
chard; Nurs.  Serv.:  Sr.  M.L.  Gaffney;  Fi- 
nance: A.  Robichaud;  Legisl.:  M.  MacLach- 
lan; Exec.  Sec:  M.J.  Anderson;  Acting 
Registrar:  M.  Russell;  Adv.  Com.  to  Schools 
of  Nurs.:  Sr.  F.  Darrah;  Nurs.  Asst.  Comm.: 
A.  Dunbar;  Liaison  Officer:  N.  Rideout; 
Employ.  Rel.  Officer:  G.  Rowsell. 

Newfoundland 

Association  of  Nurses  of  Newfoundland, 
67  LeMarchand  Road,  St.  John's. 
Pres.:  P.  Barrett;  Past  Pres.:  E.  Summers; 
Pres.  Elect.:  E.  Wilton;  1st  Vice-Pres.:  J. 
Nevitt;  2nd  Vice-  Pres.:  E.  Hill;  Committees 
—  Nurs.  Educ:  L.  Caruk;  Nurs.  Serv.:  A. 
Finn;  Soc.  <t  Econ.  Welf.:  L.  Nicholas; 
72     THE  CANADIAN   NURSE 


Exec  Sec:  P.  Laracy;  Asst.  Exec.  Sec:  M. 
Cummings. 

Nova  Scotia 

Registered  Nurses"  Association  of  Nova 
Scotia,  603.5  Coburg  Road.  Halifax. 
Pres.:  J.  Fox;  Past  Pres.:  J.  Church;  Vice- 
Pres.:  Sr.  C.  Marie,  M.  Bradley,  E.J.  Dob- 
son;  Advisor,  Nurs.  Educ:  Sr.  C.  Marie; 
Advi.sor.  Nurs.  Serv.:  J.  MacLean.  Com- 
mittees—  Nurs.  Educ:  Sr.  J.  Carr;  Nurs. 
Serv.:  G.  Smith;  Soc.  &  Econ.  Welf:  Roy 
Harding;  Exec.  Sec:  F.  Moss;  Pah.  Rel.  Of- 
ficer: G.  Shane;  Employ.  Rel.  Officer:  M. 
Bentley. 

Ontario 

Registered  Nurses"  Association  of  Ontario. 
33  Price  Street,  Toronto  289. 
Pres.:  L.E.  Butler;  Pres.  Elect:  M.J.  Flaherty. 
Committees — Socio.-Econ.  Welf:  M.E.B. 
Purdy;  Nursing:  E.  Valmaggia;  Educator: 
A.E.  Griffin;  Administrator:  M.A.  Liddle; 
Exec.  Director:  L.  Barr;  Asst.  Exec.  Di- 
rector: D.  Gibney;  Employ.  Rel.  Director: 
A.S.  Gribben;  Coord..  Formal  Contin.  Educ 
Program:  L.C.  Peszat;  Director.  Prof.  Devel. 
Dept.:  CM.  Adams;  Pub.  Rel.  Officer:  I. 
LeBourdais;  Regioiuil  Exec.  Sec:  l.W. 
Lawson.  M.l.  Thomas.  F.  Winchester. 

Prince  Edward  Island 

Association  of  Nurses  of  Prince  Edward 
Island,  188  Prince  Street,  Charlottetown. 
Pres.:  C.  Corbett;  Past  Pres.:  B.  Rowland; 
Vice-Pres.:  B.  Robinson;  Pres.  Elect.:  E. 
MacLeod.  Committees — jV((rv.  Educ: 
M.  Newson;  Nurs.  Serv:  S.  Griffin;  Pub: 
Rel.:  C.  Gordon;  Finance:  Sr.  M.  Cahill; 
Legis.  &  By-Laws:  H.L.  Bolger;  Soc.  & 
Econ.  Welf:  F.  Reese;  Exec.  Sec-  Registrar: 
H.L.  Bolger. 
Quebec 

Association  of  Nurses  of  the  Province  of 
Quebec.  4200  Dorchester  Boulevard.  West, 
Montreal. 

Pres.:  H.D.  Taylor;  Vice  Pres.:  (Eng.j  S. 
ONeill,  R.  Atto;  iFr.):  R.  Bureau,  M.  La- 
lande;  Hon.  Treas.:  J.  Cormier;  Hon.  Sec: 
R.  Marron.  Committees —  Nurs.  Educ: 
M.  Callin,  D.  Lalancette;  Nurs.  Serv.:  E. 
Strike,  C.  Gauthier;  Labor  Rel.:  S.  O'Neill. 
G.  Hotte;  School  of  Nurs.:  M.  Barrett.  P. 
Proveni;al;  Legis.:  E.C.  Flanagan.  G.  (Char- 
bonneau)  Lavallee;  Sec-Registrar:  N.  Du 
Mouchel. 
Saskatchewan 

Saskatchewan  Registered  Nurses  Association, 
2066  Retallack  Street.  Regina. 
Pres.:  M.  McKillop:  Past  Pres.:  A.  Gunn; 
1st  Vice-Pres.:  E.  Linnell;  2nd  Vice-Pres.: 
C.  Boyko.  Committees — Nurs.  Educ:  C. 
0"Shaughnessy;  Nurs.  Serv.:].  Belfry;  Chap- 
ters &  Pub.  Rel.:  M.  Harman;  Soc.  &  Econ. 
Welf:  E.  Fyffe;  Exec.  Sec:  A.  Mills;  Reg- 
istrar: E.  Dumas;  Employ.  Rcl.  Officer:  A. 
M.  Sutherland;  Nurs.  Consult.:  E.  Hartig; 
A.\sl.  Registrar:}.  Passmore. 


yV  CANADIAN 

\yr^         NURSES' 


ASSOCIATION 


Board  of  Directors 

President  E.  Louise  Miner 

President-Elect 

Marguerite  E.  Schumacher 

1st  Vice-  President 

Kathleen  G.  DeMarsh 

2nd  Vice-President 

Huguette  Labelle 

Representative  Nursing  Sisterhoods 

...Sister  Cecile  Gauthier 
Chairman  of  Committee  on  Social  & 

Economic  Welfare  ..Marilyn   Brewer 
Chairman  of  Committee  on 

Nursing  Service  ...Irene  M.   Buchan 
Chairman  of  Committee  on  Nursing 
Education    Alice  J.   Baumgart 


Provincial  Presidents 

AARN  M.G.  Purcell 

RNABC  M.D.G.  Angus 

MARN   M.E.  Nugent 

NBARN    H.  Hayes 

ARNN   P.   Barrett 

RNANS  J.  Fox 

RNAO  L.E.   Butler 

ANPEI   C.  Corbett 

ANPQ  H.D.  Taylor 

SRNA    M.   McKillop 


National  Office 

Executive 

Director   Helen  K.   Mussallem 

Associate  Executive 

Director  Lillian  E    Pettigrew 

General 

Manager  Ernest  Van  Raalte 


Research  and  Advisory  Services 

Nursing 
Coordinator  Harriett  J.T.  Sloan 

Research  Officer  H.  Rose  Ima: 

Library Margaret   L.   Parkin 

litformation  Services 

Public  Relations  Doris  Crowe 

Editor.  The  Canadian 

Nurse   Virginia  A.   Lindabury 

Editor.  L"infirmiere 

canadienne    Claire  Bigue 


FEBRUARY  1971 


March  1971 


VL* 


►**- 


^^^ 


Q* 


The 


Canadian 
Nurse 


mind-body  relationships 
in  gastrointestinal  diseases 


health  is  everybody's  business 


occult  hydrocephalus 
in  adults 


^  NEW  WAY  TO  WEAR 


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SISTER 


THE  PANT-A-WAY 


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ribbed  Fortrel  Polyester/Nylon  Tuck 
Knit,  rich  in  texture.  It  knows  how  to 
drape  and  remembers  it's  shape. 
Minimum  of  care  required.  White 
Sister's  newest  fine  fabric  will 
delight  you. 

"ELEGANT  SHIRT"  with  dainty  loop  button 
closing.  Action  sleeve  gussets.  Available  as 
full  pant  dress  only. 
Pants  —  Elastic  waist,  flare  bottoms 
unhemmed  for  individual  length  adjustment. 
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AS  NEW  AS  1971 


Asperheim:  PHARMACOLOGY  FOR  PRACTICAL  NURSES 

Third  Edition 

By  Mary  Kaye  Asperheim,  B.S.,  M.S.,  R.Ph.,  M.D. 

A  new  edition  of  this  outstandingly  useful  text.  The  author  discusses  drugs 
in  relation  to  body  systems  and  their  diseases;  she  describes  the  physical 
forms  of  the  drugs,  the  usual  dosage,  methods  of  administration,  symptoms 
of  overdosage,  and  abnormal  reactions  which  may  arise.  This  third  edition 
includes  a  chapter  on  antineoplastic  drugs,  and  the  drug  descriptions  and 
dosages  reflect  the  latest  research. 

About  208  pages,  illustrated.  About  $3.80.  Just  ready. 


Kron:  MANAGEMENT  OF  PATIENT  CARE 

Putting  Leadership  Skills  to  Work  Third  Edition 

By  Thora  Kron,  R.N.,  B.S. 

Shows  the  professional  nurse  the  many  ways  she  can  exercise  leadership 
in  the  management  of  patient  core.  Includes  methods  to  help  the  nurse 
become  more  efficient  in  arranging  supplies  and  equipment,  in  studying 
and  revising  nursing  techniques,  in  delegating  responsibilities  to  members 
of  the  health  care  team,  and  in  planning  her  own  activities. 

About  208  pages,  illustrated.  About  $3.80.  Just  ready 


MAYO  CLINIC  DIET  MANUAL 

Fourth  Edition 

By  the  Committee  on  Dietetics  of  the  Mayo  Clinic 

Here  is  the  new  edition  of  the  most  popular  and  respected  dietetic  guide- 
book available  today.  This  manual,  developed  for  use  at  the  Mayo  Clinic 
and  its  associated  hospitals,  has  been  revised  and  expanded  to  embody 
the  latest  information  on  nutrition  and  dietary  management.  The  Mayo 
Clinic  Food  Exchange  List  is  used  as  the  basis  for  planning  most  thera- 
peutic  diets. 

166  pages,  soft  cover.  $6.45.  Published  January,  1971. 


1 

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1 

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W.  B.  SAUNDERS  COMPANY  CANADA  LTD.,  1835  Yonge  Street,  Toronto  7 

Please  send  on  approval  and  bill  me: 

D     Asperheim:   Pharmacology  for  Practical  Nunei  (about  $3.80) 
n     Kron:    Management    of    Patient    Care   (about   $3.80) 
D     Mayo    Clinic    Diet    Manual    ($6.45) 

Name  


Address: 
CHy:    


Zone: 


MARCH  1971 


Prov.:  

CN  3-71 

THE   CANADIAN   NURSE        1 


Next 

to  your 

face 

the  most  comfortable 

thing  is  a  new 

SURGINE* 

mask 


Johnson  &  Johnson's  newly  developed  SURGINE  Face 
Mask  —  six  years  in  the  designing  —  is  so  extra- 
ordinarily comfortable  you'll  be  almost  as  unaware  of 
it  as  you  are  of  your  own  skin. 

The  fact  that  the  SURGINE  mask  fits  so  well  is  part  of  the 
reason  it  does  such  a  superior  job  of  bacterial  filtration. 
Cheek  and  chin  leaks  are  eliminated.  But  the  main 


reason  for  SURGINE's  efficiency  is  a  new,  specially 
developed  filter  medium.  In  vivo  tests  show  an  extra- 
ordinary average  filtration  efficiency  of  97% . 
For  free  samples  of  the  new  SURGINE  Face  Mask,  con- 
tact your  Johnson  &  Johnson  representative.  Or  write  to 
Mr.  Mark  Murphy,  Product  Director,  Johnson  &  Johnson 
Ltd.,  2155  Blvd.  Pie  IX,  Montreal  403,  Quebec. 

'Trademark  of  Johnson  &  Johnson  or  affiliated  companies. 


THE  CANADIAN   NURSE 


SURGINE 

the  comfortable  face  mask 

MONTREAL4TORONTO- CANADA 


MARCH  1971 


The 

Canadian 
Nurse 


^ 

^^p 


A  monthly  journal  for  the  nurses  of  Canada  published 

In  English  and  French  editions  by  the  Canadian  Nurses'  Association 


Volume  67,  Number  3 


March  1971 


31     Health  is  Everybody's  Business Virginia  Henderson 

35      Mind-Body  Relationships  in 

Gastrointestinal  Disease D.J.  Buchan 

38     Care  of  Patients  with  G.I.  Diseases  That  Have 

a  Psychological  Component G.  Mowchenko 

41  Idea  Exchange V.  Millen 

42  Auditors'  Report  and  Financial  Statement  for  CNA 

46  Information  for  Authors 

47  Occult  Hydrocephalus  in  Adults C.  Shick,  E.  Yallowega 


The  views  expressed  in  the  various  articles  are  the  views  of  the  authors  and  do  not 
necessarily  represent  the  policies  or  views  of  the  Canadian  Nurses'  Association. 


4 

Letters 

7 

News 

18 

Names 

22 

New  Products 

26 

Dates 

28 

In  a  Capsule 

51 

Research  Abstracts 

52 

Books 

53 

AV  Aids 

54 

Accession  List 

71 

Index  to  Advertisers 

72 

Official  Directory 

Executive  Director:  Helen  K.  Mussallem  • 
Editor:  Virginia  A.  Lindaburt  •  Assistant 
Editor;  Liv-Ellen  Lockeberg  •  Production 
Assistant:  Elizabeth  A.  Stanton  •  Circula- 
tion Manager:  Ber>l  Darling  •  .Advertising 
Manager:  Ruth  H.  Baumel  •  Subscrip- 
tion Rates:  Canada:  one  year,  $4.50;  two 
years,  $8.00.  Foreign:  one  year,  $5.00;  two 
years,  $9.00.  Single  copies:  50  cents  each. 
Make  cheques  or  money  orders  payable  to  the 
Canadian  Nurses'  Association.  •  Change  of 
Address:  Six  weeks'  notice;  the  old  address  as 
well  as  the  new  are  necessary,  together  with 
registration  number  in  a  provincial  nurses' 
association,  where  applicable.  Not  responsible 
for  journals  lost  in  mail  due  to  errors  in 
address. 


Manuscript  Information:  "The  Canadian 
Nurse"  welcomes  unsolicited  articles.  All 
manuscripts  should  be  typed,  double-spaced. 
on  one  side  of  unruled  paper  leaving  wide 
margins.  Manuscripts  are  accepted  for  review 
for  exclusive  publication.  The  editor  reserves 
the  right  to  make  the  usual  editorial  changes. 
Photographs  (glossy  prints)  and  graphs  and 
diagrams  (drawn  in  India  ink  on  white  paper) 
.ire  welcomed  with  such  articles.  The  editor 
is  not  committed  to  publish  all  articles 
sent,  nor  to  indicate  definite  dates  of 
publication. 

Postage  paid  in  cash  at  third  class  rate 
MONTREAL.  P.O.  Permit  No.  10,001. 
50  The  Driveway.  Ottawa  4,  Ontario. 
O   Canadian  Nurses'  Association  1971. 


Editorial 


MARCH  1971 


A  coroner's  jury,  inquiring  into  the 
death  of  a  hospitalized  patient  two 
days  after  dental  surgery,  criticized 
both  doctors  and  nurses:  the  doctors 
for  not  being  available  after  the  patient's 
surgery,  the  nurses  for  not  listening 
to  the  patient's  relative. 

Apparently  the  nurses  tried  in  vain 
to  get  in  touch  with  the  dentist  who 
performed  the  surgery  and  the  physi- 
cian who  examined  the  patient  preoper- 
atively.  One  nurse  told  the  coroner's 
jury  she  did  not  believe  the  patient's 
condition  was  serious  enough  to  warrant 
calling  in  a  doctor  from  the  emergency 
ward.  The  patient's  sister  testified  she 
had  asked  the  nurses  several  times  to 
call  a  doctor,  and  finally  tried  to  call 
one  herself 

Although  evidence  showed  the  pa- 
tient would  have  died  even  if  she  had 
received  medical  treatment,  the  jury 
made  this  astounding  recommendation: 
Nurses  should  carefully  consider  the 
concerns  of  relatives  or  friends  who 
may,  from  long  personal  contact,  have 
a  better  knowledge  of  a  patient's  change 
in  condition. 

Why  is  this  recommendation  astound- 
ing? Because  a  coroner's  jury  felt  com- 
pelled to  make  it. 

All  of  us,  from  the  time  we  enter 
schools  of  nursing  until  we  put  our  cap 
on  the  shelf,  are  made  aware  of  the 
important  role  played  by  the  patient's 
relatives  in  his  overall  treatment.  Some- 
how, however,  we  have  failed  to  put 
our  awareness  into  practice.  True,  we 
are  pleased  when  our  patient  has  visi- 
tors, as  we  know  they  are  good  for  his 
morale;  we  try  to  keep  his  relatives 
informed  and  involve  them  in  his 
care;  and  we  are  sympathetic  when  a 
patient  has  died  or  is  about  to  die. 

But  do  we  really  listen  to  these 
relatives  and  friends  when  they  express 
concerns,  such  as  the  patient's  dislike 
of  certain  foods,  his  inability  to  tolerate 
drugs  he  is  receiving,  his  loneliness, 
or  a  change  in  his  condition  that  they 
recognize  because  they  know  him  so 
well?  Or  do  we  brush  aside  these  con- 
cerns, believing  we  are  dealing  with 
troublesome  visitors  who  are  trying  to 
interfere  with  the  care  we  believe  is 
best? 

Patients'  relatives  and  friends  have 
much  to  tell  us.  And  until  every  nurse 
recognizes  this,  our  profession  can  be 
justly  accused  of  paying  lip  service 
only  to  our  oft-repeated  philosophy 
that  each  patient  has  a  right  to  receive 
total,  personalized  nursing  care. 

—  V.A.L. 
THE  CANADIAN   NURSE       3 


letters 


Letters  to  the  editor  are  welcome. 

Only  signed  letters  will  be  considered  for  publication,  but 

name  will  be  withheld  at  the  writer's  request. 


Nurses  form  social  club 

A  Nurses'  Social  Club  has  been  formed 
in  Montreal  with  the  aim  of  arranging 
social,  recreational,  and  travel  activ- 
ities. The  club  is  in  its  infancy  and  we 
are  endeavoring  to  publicize  it  and  so- 
licit interest.  Membership  in  this  bi- 
lingual organization  is  open  to  nurses 
across  Canada,  their  families,  and 
friends.  Local  chapter  meetings  will  be 
held  monthly. 

The  initial  group  was  formed  by 
four  nurses  in  September.  At  present 
there  are  no  membership  dues,  but  a 
small  due  will  be  levied  if  our  group 
travel  facilities  are  utilized. 

Officers  are:  president,  Isabelle 
Adams;  vice-president,  Victoire  Audet; 
treasurer,  Gaetane  Pageau;  secretary 
and  public  relations  officer,  Ulker 
Fidan. 

A  trip  is  planned  to  Rio  de  Janeiro, 
leaving  Montreal  April  6  and  returning 
April  19.  Enquiries  should  be  direc- 
ted to  club  headquarters  at  42 1 3  Place 
Ostell,  Montreal  308,  Quebec. — 
Isabelle  Adams,  president,  Nurses' 
Social  Club,  Montreal. 

Comment  on  results  of  research 

Willett  et  al  are  to  be  commended 
for  their  study  "Selection  and  success 
of  students  in  a  hospital  school  of  nurs- 
ing" (January  1971,  p.41).  For  the 
sake  of  students,  the  profession,  and 
society  as  a  whole,  it  is  important  to 
improve  the  selection  of  applicants 
and  thereby  minimize  attrition  from 
nursing  educational  programs  and 
later  attrition  from  the  profession. 
The  authors'  findings  about  the  use 
of  specific  tests  for  predictive  purposes 
in  selecting  students  likely  to  achieve 
success  in  basic  nursing  programs  should 
be  helpful  to  educators  in  nursing  and 
other  fields. 

I  would  be  interested  in  further 
discussion  of  the  characteristics  of  the 
"dropouts."  Although  the  authors 
report  differences  in  the  College  Qual- 
ification Tests  (CQT)  percentiles  for 
the  group  of  persisting  students 
("class")  and  the  group  of  "dropouts," 
they  also  indicate  that  statistically 
significant  correlations  were  established 
between  less  than  half  the  CQT  Total 


Scores  and  in-course  marks  in  the  three 
class  years,  1967,  1968,  and  1969 
(D.44). 

On  the  same  page,  the  authors  des- 
cribe the  "dropouts"  as  differing  from 
the  class  in  a  measurement  entitled 
"reserve,"  that  is,  the  "dropouts"  are 
characterized  as  being  "much  more 
outgoing,  warmhearted,  easygoing 
and  participating."  The  authors  consid- 
er these  to  be  desirable  characteristics, 
but  conclude  that  the  student  who  may 
be  occupied  with  fulfilling  these  aspects 
of  her  personality  may  spend  less  time 
than  required  on  her  studies. 

The  data  reported  above  regarding 
differences  between  groups  on  CQT 
percentiles  and  correlations  between 
CQT  Total  Scores  and  in-course  marks 
are  insufficient  to  provide  support  for 
this  conclusion.  In  the  absence  of  sup- 
porting data,  one  wonders  if  an  equally 
valid  conclusion  might  be  that  a  number 
of  the  "dropouts"  may  have  withdrawn 
because  they  viewed  the  program  as 


Letters  Welcome 

Letters  to  the  editor  are  welcome.  Be- 
cause of  space  limitation,  writers  are 
asked  to  restrict  their  letters  to  a 
maximum  of  350  words. 


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NEW  (NAME) /ADDRESS: 


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Zone 


Prov./State  Zip 

Please  complete  appropriate  category: 

1    1     I  hold  active  membership  in  provincial 
nurses'  assoc. 


reg.  no./perm.  cert./  lie.  no. 
I  I  I  am  a  Personal  Subscriber. 
MAIL  TO: 


The  Canadian  Nurse 

50  The  Driveway 
OTTAWA  4,  Canada 


4       THE  CANADIAN   NURSE 


being  rather  rigid  and  restricting,  with 
limited  opportunities  for  their  own 
self-fulfillment  and  satisfaction. 

In  considering  attrition,  should  we 
not  examine  the  image  of  nursing  held 
by  in-course  students  and  "dropouts" 
as  well  as  assessing  the  usefiilness  of 
screening  tests  administered  prior  to 
admission?  —  Dorothy  J.  Kergin, 
Reg.N.,  Ph.D.,  Professor  of  Nursing, 
McMaster  University,  Hamilton,  Ont. 

Curricula  should  be  standardized 

Now  that  two-year  programs  for  nurs- 
ing education  are  being  phased  in  and 
national  nurse  registration  examinations 
developed,  is  it  not  time  for  educators 
to  develop  a  standard  content  for  curric- 
ula? 

At  present,  each  nursing  school  has 
to  analyze  and  interpret  the  broad 
guidelines  that  are  provided  in  the 
province.  This  means  that  nursing 
education  differs  considerably,  even 
in  schools  in  the  same  province,  and 
nurse  educators  spend  many  hours 
determining  the  content  of  their  pro- 
gram. Many  I  have  spoken  to  believe 
they  attend  far  too  many  meetings, 
which  interfere  with  work  assignments. 
One  asked  quizzically,  "Are  we  teach- 
ers, or  are  we  meeters?"  If  some  of  these 
meetings  could  be  eliminated,  time 
would  be  available  for  other  duties. 

How  much  easier  it  would  be  it  mere 
were  a  standard  curriculum  content, 
devised  by  nurse  educators  through- 
out Canada  in  cooperation  with  nurs- 
ing schools.  Individual  schools  would 
then  have  to  decide  only  on  the  type 
of  curriculum  that  is  best  for  them, 
and  where,  when,  and  how,  to  fit  in 
the  specified  content.  The  teachers 
would  then  devise  methods  of  present- 
ing the  content  in  their  own  way. 

This  would  still  allow  each  school 
sufficient  flexibility  and  opportunity 
for  creativity,  based  on  its  own  philoso- 
phy. It  would  also  allow  more  time 
for  guidance  and  evaluation  of  students. 
This  latter  area  has  often  been  neglect- 
ed because  of  the  amount  of  time  need- 
ed for  accurate,  consistent  evaluation. 

If  content  were  standardized,  re- 
searchers would  have  an  opportunity 
to  devise  or  locate  tests  of  achievement 
for  motor,  intellectual,  or  psycho-so- 
cial skills.  This,  in  turn,  would  help 
make  the  process  of  evaluation  more 
objective  and  the  guidance  of  the  stu- 
dent more  realistic.  —  Gladys  Jones. 
Reg.N.,  B.Sc.N.Ed.,  Ottawa.  ^ 

MARCH  1971 


Personalized  CAP-TOTE 


Your  caps  Stay  crisp,  sharp  and  clean 
when  stored  or  carried  in  this  clever 
carry-all  Clear,  non-creasing  flexible 
plastic  bag  with  white  trim,  has  zipper 
around  top,  carrying  strap  and  hang 
loop.  Squeezes  flat  tor  easy  storage 
when  not  in  use.  Also  great  for  wiglets, 
curlers  or  whatever.  8^"  dia..  5'  high. 
No.  333  Tote  (no  initials) ...  2.50  ei.  ppd- 
SPECIAL!  6  or  more  totes,  only  2.25  ea. 
INITIALS  up  to  3  goid  embasscd  or  top .  .  - 
add  .50  per  Tote. 


\mm^^ 


Personalized  MINI-SCISSORS 

Tiny,     useful.     precision-Tiade     bandage 

scissors,  only  3Vt"  long!  Slip  perfectly 

into  uniform  pocket  or  purse.  Two  year 

guarantee  included.  Choose  jewelers  Gold 

or  gleaming  Chrome  plate  finish 

No.  1238  Scissors  (no  initials) , . .  2.25  ea,  ppd, 

SPECIAL!  1  doi.  scissors  for  ;ust  $20,  ppd, 

ENGRAVING  up  to  3  initials,  add  .50  per  scissor. 


Irs.  R.  F.  JOHNSON 
SUPERVISOr      ^ 


-ORTOHfTwiLLIAMS 
RESIDENT 


REEVES  NAME  PINS 

Largest-selling  among  nurses!  Superb  lifetime 
quality  . .  .  smooth  rounded  edges .  .  .  feather- 
weight, lies  flat .  .  .  deeply  engraved,  and  lac- 
quered. Snow-white  plastic  will  not  yellow.  Satis- 
faction guaranteed.  GROUP  DISCOUNTS.  Choose 
lettering  in  Black,  Blue,  or  White  !No.  169only). 

SAVE:  Oriler  2  Identical 
Pins  as  precaution  against 
loss,  less  changing. 


Personalized 


BANDAGE 
SHEARS 


6"  professional  precision  shears,  forged 
in  steel.  Guaranteed  to  stay  sharp  2  years 

No.  1000  Shears  (no  initials) 2.50  ea.  ppd. 

SPECIAL !  1  Doz.  Shears $24.  total 

Initials  (up  to  3)  etched add  50c  per  pair 


B"  long 


COHN.L.PN. 


Metal 
Framed 
No.  100 

RQKl  1  Kaon  Pia  laly 
CSlJl/  2  Plas  (saae  um) 

1.75 

2.05 

2.60 

3.10 

■■■klllaMPiiii^f 
■■■f  2  Pins  (san  am) 

.85 

1,15 

1.35 

1.90 

T 


^ 

W^ 


All  Metal  CAP  TAGS 

Fine  selection  of  dainty,  jewelry-quality  Cap 
Tacs  to  hold  cap  bands  securely.  All  sculptured 
metal,  polished  gold  finish,  with  clutch  fas- 
teners, approx.  H'  wide.  Two  Tacs  per  set,  gift- 
boxed.  Choose  Initial  Tacs  RN.  LPN.  LVN  . . .  or 
Plain  Caduceus  ,  .  .  or  RN  Caduceus,  Specify 
choice. 

No.  CT-1  Initial  Tacs 

No.  CT-2  Plain  C 

No.  CT-3  RN  Cadui 
SPECIAL!  12  or  iwrc  sets  2.00  per  set  ppd. 


al  Tacs  ) 

II  Caducees    >  . . .  2.50  per  set  f  pd. 

)aduceus      ) 


Personalized    f<^. 
CROSS  PEN 
with 


Caduce 


World  famous  Cross  Writing 
Instrument  with  sculptured  cadu- 
ceus emblem.  Full  name  engraved  FREE 
barrel  (print  name  desired  on  LETTERING 
line  in  coupon).  Refills  available  at  any  store. 
Cross  Lifetime  Guarantee. 

No.  3502  Chrome  Finish 8.00  ea. 

No.  6602  12  Kt  Gold  Filled...  llJSOea. 


Nurses'  White  CAP  CLIPS 

Hold  caps  firmly  in  place!  Hard-to-find  white 

bobbie  pins,  enamel  on  fine  spring  steel.  Eight 

2'  and  eight  3'  clips  included  in  plastic  snap 

bo». 

No.  529  (  3  boxes  for  1.75, 6  for  3-25, 

Clips      S  7  or  more  49c  per  box,  all  ppd. 


Bzzz  MEMO-TIMER 

We  all  forget!  Time  hot  packs,  sitz  baths, 
heat  lamps,  even  parking  meters .  . .  remind 
yourself  to  check  vital  signs,  give  medica- 
tion, etc,  Tmy  (only  IV^"  dia.),  lightweight, 
sets  to  buzz  at  from  5  to  60  minutes.  White 
plastic  case,  black  and  silver  dial.  Key  ring 
attached,  Swiss  made. 
No.  M-22  Timer . . .  3.98  ea.  ppd. 
SPECIAL!  3  for  9.75,6  or  more  3.00  ea. 


Deluxe  POCKET-SAVER 

No  more  tired  pockets!  Sturdy  pure  wtiite  vinyl, 
with  three  compartments  for  pens,  scissors. 
etc,  includes  change  pocket  with  snap  closure 
for  coffee  money,  and  key  chain.  4"  wide. 

No.  791  (6  for  2.98, 12  for  430, 

PocKet  Saver  \  25  or  more  35c  ea.,  all  ppd. 


NIGHTINGALE  LAMP 

An  authentic,  unique  favor,  gift  or  en- 
graved award!  Ceramic  off-white  can. 
dieholder  with  genuine  gold  leaf  trim. 
Recessed  candle  cup  at  front  (candle 
not  included)  7"  long. 
No.  F  lOOS  Lamp  . . .  5.95  ea.  ppd. 
SPECIAL!  12  or  more,  3,95  ea. 
ENGRAVING  up  to  3  initials  and 
date  on  satin  gold  plaque  on  top,  add  1.00  per  lamp. 


Trl-Color  BALL  PEN 

Write  in  black,  red  and  blue  with  one  ball  point  pen. 

Flip  of  the  thumb  changes  point  (and  color)  Steno  fine 

point  (excellent  for  charts).  Polished  chrome  finish, 

Ni.921  Ball  Pen,.,  1. 50  ea.  ppd. 

SPECIAL!  3  for  3.75,  6  or  more  1 ,00  ea.  ppd. 

No.  292-lt  3-color  Refills . . .  SOc  ea.  ppd. 


Caduceus  CUFF  LINKS 

Sim.  Mother-of-Peari  set  into  gold  finish  link, 
spring  arm  Sculptured  gold  fin,  caduceus  with 
or  Without  RN  Gift-twxed. 

No.  403900  LINKS  (plain  caduceus)/  3.95  pr. 
No.  403RN  LINKS  (R.N.  Caduceus)  {    ppd. 


P 


sterling  HORSESHOE  KEY  RING 

Clever,  unusual  design:  one   knob  unscrews  for  in- 
serting  keys.   Fine  sterling   stiver   throughout,   with 
sterling  sculptured  caduceus  charm. 
No.  96  Key  Ring 3.75  ea.  ppd. 


EYEGLASS  CADDY  Pin 

Si<p  eyeglass  bow  into  loop  for  safe,  instant 
readiness .  - .  avoid  scratching,  breakage  Sturdy 
pinback.  safety  catch.  Gold  or  Silver  plated. 
No. Ml  Caddy...  1. 50 ea. ppd. 
No.  96T  ST  Starlini  Sllvir  Caddy  ...  3.00  ea.  ppd. 


NURSES  CAP-TAGS 

Remove  and  refasten  cap  band  instantly 
for  laundering  and  replacement!  Tiny    .. 
molded  plastic  tac.  dainty  caduceus.  *. 
Choose  Black,  Blue.  White  or  Crystal  '.  ' 
with  Gold  Caduceus,  or  all  black  (plain)    ^^ 
No.200Setof6Tac5..  1.00  per  set 
SPEC  lAL !  12  or  more  sets ...  .80  per  set 


Nurses  ENAMELED  PINS 

Beautifully  sculptured  status  insignia;  2-colQr  keyed. 
hard-fired  enamel  on  gold  plate.  Dime-sized;  pin-back. 
Specify  RN.  LPN,  PN.  LVN.  NA.  or  RPh.  on  coupon. 
No.  205  Enameled  Pin 1JK>  ea.  ppd. 


Sel-Fix  NURSE  CAP  BAND 

Black  velvet  band  material.  Self-ad- 
hesiVe  presses  on.  pulls  off;  no  sewing 
or  pinning.  Reusable  several  times 
Each  band  20"  long,  pre-cut  to  pop- 
ular widths;  Vi'  (12  per  plastic  box). 
^'  (8  per  box).  *4"  (6  per  box).  1" 
(6  per  box).  Specify  width  desired  in 
ITEM  column  on  coupon 


No.  6343 

Cap  Band...  l  box  1.50 
3  or  more  1.25  ea. 


# 


Reeves  AUTO  MEDALLIONS 

Lend  protessjonal  prestige  Two  colors  baked  enamel  on 
gold   background    Resists   weather    Fused   Stud  and 

•y       Adapter  provided   Specify  letters  desired   RN,  MD.  00. 

/       RPh.  DDS.  DM0  or  Hosp.  StaH  (Plain! 

No.  210  Auto  Medallion 5.00  ea.  ppd. 


Professional  AUTO  DECALS 

Your    professional    insignia    on    window    decal 
Tastefully  designed  m  4  colors.  4Vi"  dia.  Easy 
to  apply.  Choose  RN,  LVN,  LPN  or  Hosp.  Staff 
No.  621  Decal...  1.00  ea.. 

3  for  2.50,  6  or  more  .60  ea. 


Uniform  POCKET  PALS 

Protects  against  stains  and  wear.  Pliable  white 
plastic  with  gold  stamped  caduceus.  Two  com- 
partments for  pens,  shears,  etc.  Ideal  token  gifts 
or  favors. 

No.  210-E     (  6  for  1.50, 10  for  2.25 
Savers  (  25  or  more  .20  ea.,  all  ppd. 


RN/Caduceus  PIN  GUARD 

Dainty  caduceus  fine-chained  to  your  professional 
letters,  each  with  pinback.  saf.  catch.  Wear  as  is 
, .    or  replace  either  with  your  Class  Pm  for  safety 
Gold  fin.,  gift-boxed.  Specify  RN,  LVN  or  LPN. 
No.  3240  Pin  Guard 2.95  ppd 


Personalized  EXAMINING  PENLIGHT 


Deluxe  model  designed  for  Nurses,  with  caduceus 
imprinted  on  white  barrel;  aluminum  band  and 
pocket  clip.  FREE  initials  hand-etched  on  band  to 
prevent  loss.  5"  long.  U.S.  made.  Batteries,  bulb 
included  (replacements  any  store).  Plastic  gift  box 
No.  007  Penljght 3.98  ea.  ppd. 


NURSES  CHARMS 

Finest  sculptured  fisher  charms  in  Sterling  or 
Gold  Filled.  Ideal  addition  for  bracelet  or  hang 
on  pendant  cham. 

Choose  No.  263  Caduceus,  No.  164  Nurses 
Cap,  No.  68  Graduation  Hat  or  No.  8  Band- 
age Shears 2.75  ea.  ppd. 

Specify  Sterling  or  G.F.  under  COLOR  en  coupon. 


"Endura"  Waterproof  NURSES  WATCH 

Swiss  made,  raised  silver  full  numerals,  lumin  mark- 
ings Red  tipped  sweep  second  hand,  chrome  stainless 
case  Includes  genuine  black  leather  watch  strap.  1 
year  guarantee 

No.  1093 14.95  ea.  ppd. 


Scripto  PILL  LIGHTER 

Famous   Scripto   Vu-Lighter   with   crystal-clear   fuel 
chamber  containing  colorful  array  of  capsules,  pills 
and  tablets.  Novel,  unique,  for  yourself  or  for  unusual 
gifts  for  friends.  Guaranteed  by  Scripto. 
No.  300-P  Pill  Ligttter  4.28  ea.  ppd. 


fe 


GROUP  DISCOUNTS: 


25-99  pins.  5%;  100  or  more,  10%. 

Send  cash,  m.o.,  or  check.  No  billings  of  COD'S. 


Nurses'  Personalized 

ANEROID 
SPHYGMOMANOMETER 

A  superb  scientific  instrument  espe 
cially  designed  to  fill  the  needs  of 
today's  busy,  efficient  nurses!  This 
professional  unit  is  imported  from 
precision  craftsmen  in  W.  Germany. 
Easy-to-attach  Velcro  cuff,  light- 
weight.compact,fits  into  soft  Sim 
leather  zipper ed  case,  only 
2M!"x  4' X  7".  Dial  calibrated 
to  320  mm.  lO-year  accuracy 
guaranteed  to  ±3  mm.  serviced 
and  adjusted  if  ever  required  bf 
Reeves  Co.  Your  initials  engraved 
on  manometer  and  gold  stamped  on' 
case  FREE,  to  identify  permanently 
your  own  instrument  and  case  forever. 
No.  106  Sphyg. . .  26.95  ppd.    6  or  more . . .  22.95  ea.  ppd. 


Personalized 

Littmanri 

NURSESCOPE^ 


Product 

Of  trie 


3IY] 

mmammn 


Famous    Littmann    nurse's    dia- 
phragm  stethoscope,   with   your 
initials  individually  engraved 
FREE!  A   fine,   precision   instru- 
ment,   has   high   sensitivity   for 
blood  pressures,  general  auscu- 
lation  Only  2  02s .  fits  m  pocket.  1 
Full  28'  vinyl  anti-collapse  tub- ' 
ing.  New  design  metal-rim  epoxy 
diaphragm  Non-fotatmg.  correct- ' 
ly-angted  ear  tubes   U   S  made  ' 
Choose  from  5  jewel-like  colors: 
Goldtone,  Silvertorte,  Blue.  Green, 
Pmh 


FREE   ENGRAVED  INITIALS! 

Up  to  3  initials  permanently  engraved  into  chest  piece,  lends 

individual  distinction,  prevents  loss.  Specify  initials  on  coupon. 

No.  216  Nursescope  . . .  13-80  ea.  ppd. 

6-11 .. .  12.80  ea.  ppd.  12  or  more  ...  11.80  ea.  ppd. 


TO:  REEVES  COMPANY.  Box  719.  Attleboro,  Mass.  02703 


ORDER  NO. 

ITEM 

COLOR 

QUANT. 

PRICE 

NAME  PINS:         C.  One  Name  Pin       n  Two.  same  name 

LETT.  COLOR   

METAL  FINISH    

LETTERING  

2nd  line 

INITIALS  »s  required 

I  enclose  $ (Sorry,  no  COD'S  or  billing  terms) 

Please  add  25«  handling  charge  on  all  orders  under  $5. 

Send  to 

Street  

City  Stale 


Zip 


3omfortable/economic^mi^esaving/retelast* 


Available  in  9 
different  sizes. 
The  original  tubular 
elastic  mesh  bandage 
allergy  free,  indispensab' 
for  hospital  care. 
New  stretch  weave  allovi 
y  maximum  ventilation  a^ 

_    /   *    '  \  flexibility  for  patient 

-'    /  ^   '  /)  u   *  ^  -♦  -   'v  comfort  and  speedy  heal  I 

/^f      (     /        \\'>^  Demonstration  upon  requ 


news 


National  Conference  Called 
On  Assistance  To  Physicians 

Ottawa  —  A  three-day  national  con- 
ference on  assistance  to  physicians  will 
take  place  in  Ottawa  April  6-8.  Partici- 
pants in  the  conference  will  attempt  to 
determine  the  need  for  specially  trained 
personnel  to  help  physicians  meet  in- 
creasing demands  for  health  care  serv- 
ices and  the  complementary  roles  and 
responsibilities  of  the  medical  and 
nursing  professions  in  meeting  the 
need. 

Physicians,  nurses,  government  plan- 
ners, consumers,  researchers,  and 
spokesmen  for  other  sectors  of  the 
health  field  will  attend  the  conference. 
Jointly  planning  the  conference  are  the 
department  of  national  health  and  wel- 
fare, the  Canadian  Medical  Associa- 
tion, L'Association  des  medecins  de 
langue  frangaise  du  Canada,  the  Cana- 
dian Nurses'  Association,  and  the  Con- 
sumers Association  of  Canada. 

It  will  be  a  working  conference  with 
small  groups  attacking  each  problem 
area  after  examination  of  background 
papers.  The  agenda  and  speakers  are 
yet  to  be  announced.  The  conference 
will  be  held  at  the  government  confer- 
ence center. 

Recommendations  resulting  from 
the  conference  will  be  available  to  all 
interested  agencies  and  will  be  presented 
at  the  national  conference  on  education 
of  health  manpower  to  be  held  in  Otta- 
wa later  in  1971. 

One  resolution  passed  at  the  Cana- 
dian Nurses'  Association's  June  gen- 
eral meeting  in  Fredericton  directed 
CNA  to  request  the  department  of 
national  health  and  welfare  call  a  na- 
tional conference,  prior  to  the  spring 
of  1971,  to  provide  a  forum  for  discus- 
sion among  "the  major  purveyors  (nurs- 
ing and  medicine)  and  consumers  of 
health  services"  on  more  effective  uti- 
lization of  medical  manpower  with 
special  emphasis  on  the  development 
of  complementary  roles  for  nurses  and 
physicians. 


Two  CNA  Standing  Committees  Meet 

Ottawa  —  The  standing  committee  on 
nursing  education  and  the  standing 
committee  on  nursing  service  met  at 
CNA  House  January  20-22.  Both 
having  many  new  members,  they  met 
jointly  the  first  morning  for  orientation. 
As  their  separate  sessions  progressed, 
MARCH  1971 


Australian  Educator  on  Study  Tour 


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Moira  B.  (Topsy)  Moffett  discussed  the  two  categories  of  nurse  —  university 
and  diloma  school  graduate  —  with  Dr.  Helen  K.  Mussallem  during  her  visit 
to  CNA  House,  Ottawa,  on  January  22. 

Miss  Moffett,  who  is  responsible  for  the  nursing  administration  diploma  course 
at  the  Queensland  branch  of  the  College  of  Nursing,  Brisbane.  Australia,  is 
currently  on  a  Winston  Churchill  traveling  fellowship  using  nine  weeks  of  her 
summer  vacation  to  visit  the  United  States,  Great  Britain,  Sweden,  and  Finland 
following  her  stay  in  Canada.  Her  Canadian  tour  has  included  visits  to  the 
University  Hospital  in  Saskatoon,  The  Hospital  for  Sick  Children  and  the 
Quo  Vadis  School  of  Nursing  in  Toronto,  Ontario. 


members  found  their  interests  and 
functions     overlapped     considerably. 

Staff  development  and  continuing 
education  figured  largely  in  discussions 
at  both  meetings,  as  did  a  position 
paper  on  staff  education  or  develop- 
ment, and  job  description. 

The  committees  considered  amalga- 
mation into  one  committee,  meeting 
more  frequently  than  in  the  past.  They 
wanted  to  improve  communications 
both  from  and  to  the  "grass  roots," 
to  have  information  exchanged  on  a 
continuing  basis. 

Most  urgently,  they  wanted  an  "arm- 
chair," or  "thinkers"  conference  of 
not  more  than  10  nursing  leaders  to 
plot  the  course  of  nursing  for  the  seven- 
ties. They  wanted  this  soon,  so  a  report 


could  be  ready  by  the  end  of  May. 

The  above  are  but  a  few  of  the  ideas 
to  be  presented  to  the  board  of  the 
Canadian  Nurses"  Association  at  their 
next  meeting. 

Irene  Buchan  is  chairman  of  the 
nursing  service  committee,  with  prov- 
inces represented  as  follows:  Alberta, 
Gertrude  Clarke;  British  Columbia, 
Joan  Dawes;  Manitoba,  Jacqueline 
Robertson;  New  Brunswick,  Sister 
Mary  Loretta  Gaffney;  Newfoundland, 
Alice  Finn;  Ontario,  Norma  A.  Wylie; 
Prince  Edward  Island,  Sonia  Griffin; 
Quebec,  Carmen  Gauthier  and  Eileen 
Strike;  Saskatchewan,  E.  Jean  Belfry. 
Gladys  Smith  of  Nova  Scotia  was  ab- 
sent. 

Alice  J.   Baumgart  is  chairman  of 

THE  CANADIAN   NURSE       7 


the  nursing  education  committee,  with 
provinces  represented  as  follows:  Al- 
berta, Gloria  Bauer;  British  Columbia, 
Elizabeth  Moore;  Manitoba,  Sally 
Joy  WinkJer;  New  Brunswick,  Sister 
Huberte  Richard;  Newfoundland,  Leila 
Caruk;  Nova  Scotia,  Sister  Joan  Carr; 
Quebec,  Denise  Lalancette  and  Mona 
E.  Callin;  Saskatchewan,  Catherine 
O'Shaughnessy.  Amy  Griffin  of  Ontario 
and  Margaret  Newson  of  Prince  Ed- 
ward Island  were  unable  to  attend. 

Large  Number  Of  Candidates 
Write  CNATS  Examinations 

Ottawa  —  Over  6,000  candidates  wrote 
the  first  national  tests  to  be  conducted 
by  the  Canadian  Nurses'  Association 
Testing  Service  (CNATS)  in  August 
1970.  A  total  of  28,085  papers  were 
written  in  the  five  subject  areas. 

The  results  of  the  examinations,  sent 
to  candidates  in  November,  were  based 
on  the  same  scoring  system  as  that  used 
by  the  National  League  for  Nursing  in 
the  United  States,  that  is,  transformed 
scores  based  on  a  mean  of  500,  with 
a  standard  deviation  of  100. 

Eight  provincial  registering  bodies 
used  325  as  their  passing  score;  the  two 
remaining  provinces,  Quebec  and 
Newfoundland,  used  350.  The  CNATS 
board  hopes  that  agreement  will  even- 
tually be  reached  on  a  common  passing 
score  for  all  provinces. 

Translations  of  the  tests  were  pro- 
vided for  French-speaking  candidates 
in  Ontario  and  New  Brunswick.  French- 
speaking  candidates  in  Quebec  do  not 
use  the  national  tests. 

CNATS,  which  set  up  its  operation 
in  Ottawa  May  1,  1970,  is  also  under- 
taking to  provide  a  test  for  nursing  as- 
sistant registration. 

Nurse  Educators  Travel 
To  North  On  Seminars 

Edmonton,  Aha.  —  Three  seminars 
in  January,  February  and  March,  spon- 
sored by  the  medical  services  branch  of 
the  department  of  health  and  welfare, 
had  nurse  educators  traveling  north  to 
observe  the  department's  programs  for 
health  care. 

The  1 1  members  of  the  first  northern 
travel  seminar  who  left  on  January  20 
for  Inuvik  were:  Barbara  Campbell, 
school  of  nursing.  University  of  Wind- 
sor, Windsor,  Ont.;  M.  Dumont,  school 
of  nursing.  University  of  Moncton, 
Moncton,  N.B.;  M.  Kutsche,  school  of 
nursing,  McMaster  University,  Hamil- 
ton, Ont.;  June  Horrocks,  school  of 
nursing.  University  of  British  Colum- 
bia, Vancouver,  B.C.;  Mary  McCulley, 
8       THE  CANADIAN  NURSE 


Enthusiasm  Evident  As  Committee  Begins  Work 

OMOWMJtW 


The  first  meeting  of  the  Canadian  Nurses"  Association  ad  hoc  committee  on 
French-language  texts  was  held  at  CNA  House  February  1-2.  The  committee 
was  set  up  by  the  CNA  board  in  October,  1 970,  to  develop  and  encourage  the 
publication  and  translation  of  French-language  nursing  textbooks.  Committee 
members  are,  left  to  right,  Claire  Sauve  of  the  CEGEP  College  Bois  de  Boulor 
gne,  Montreal,  Quebec;  Marcella  Dumont,  Moncton  University  school  of  nurs- 
ing, Moncton,  New  Brunswick;  Marie-des-Anges  Loyer,  University  of  Ottawa, 
Ottawa;  chairman  Huguette  Labelle,  CNA  second  vice-president;  Claire  Bigue, 
editor,  L'infirmiere  canadienne;  Margaret  Parkin,  CNA  librarian;  Therese 
d'Aoust,  education  consultant.  Association  of  Nurses  of  the  Province  of  Quebec; 
Noella  Gervais,  University  of  Montreal,  Montreal;  Professor  Nicole  David, 
Laval  University  school  of  nursing,  Quebec  City.  The  committee  will  meet 
again  on  March  26  at  CNA  House  m  Ottawa.    


school  of  nursing.  University  of  Toron- 
to, Toronto,  Ont.;  Joan  Mills,  school  of 
nursing,  St.  Francis  Xavier  University, 
Antigonish,  N.S.;  CNA  president,  E. 
Louise  Miner,  Saskatchewan  depart- 
ment of  public  health,  Regina,  Sask.; 
Mary  Peever,  school  of  nursing.  Uni- 
versity of  Calgary,  Calgary,  Alta.;  M. 
Ross,  school  of  nursing.  Mount  Saint 
Vincent  University,  Halifax,  N.S.;  Dr. 
Lucy  D.  Willis,  director,  school  of 
nursing.  University  of  Saskatchewan, 
Saskatoon,  Sask.;  June  Agnew,  school 
of  nursing,  Memorial  University,  St. 
John's,  Nfld. 

The  first  seminar  began  with  a  two- 
day  briefing  session  at  the  northern 
region  office  of  medical  services  in 
Edmonton.  After  a  one-day  orientation 
session  at  Inuvik,  the  educators  were 
flown  to  isolated  nursing  stations  to 
participate  in  nursing  activities. 

They  undertook  such  assignments  as 
conducting  a  medical  clinic,  assessment 
of  a  patient's  condition  and  admission 
to  the  nursing  station,  and  planning 
with  a  community  health  worker.  They 
also  met  with  local  health  committees 
or  with  the  community  chief  and  coun- 
cillors. The  field  experience  will  enable 
the  nurse  educators  to  interpret  to  their 


students  the  needs  of  northern  Cana- 
dians and  perhaps  to  expand  nursing 
education  to  meet  those  needs. 

The  second  travel  seminar  originated 
from  Montreal  in  February  and  the 
third  leaves  from  Winnipeg  this  month. 
Representing  CNA  on  the  second  sem- 
inar was  first  vice-president  Kathleen 
G.  DeMarsh.  Helen  Taylor,  president 
of  the  Association  of  Nurses  of  the 
Province  of  Quebec,  will  represent 
CNA  on  the  third  seminar. 

Fellowships,  Research  Projects 
Funded  By  National  Health  Grant 

Ottawa  — The  $2,100,000  National 
Health  Grant  has  funds  available  to 
nurses  interested  in  research,  said 
Pamela  Poole  when  explaining  the  re- 
finements of  the  federal  government 
grant  to  staff  at  CNA  House  January 
27.  Miss  Poole  is  nursing  consultant 
for  the  hospital  services  study  unit, 
health  insurance  and  resources  branch 
of  the  department  of  national  health 
and  welfare. 

The   grant   is   designed   to   support 
health-care  research  projects,  demon- 
stration   models,    special    service/edu- 
cational programs,  and  personnel  (na- 
(Conliniied  on  page  10) 
MARCH  1971 


BOOKS  FOR  PROFESSIONAL  GROWTH 


1, 


New    ADVANCED  CONCEPTS  IN  CLINICALNURSINC 


edited  by  Kay  Carman  Kintzel,  R.N.,  M.S.N.  With  20  Contributors 

This  is  the  first  text  designed  to  foster  expertise  in  the  more  complex 
as  well  OS  little-explored  aspects  of  clinical  nursing.  Sixteen  areas 
requiring  sophisticated  nursing  intervention  are  presented  in  in- 
depth  studies.  Each  subject  includes:  the  mechanism  producing  the 
health  problem;   manifestation   ond  course  of  the   problem   in   relotion 


to  the  producing  mechanism;  data  fundomenfal  in  assessing  patients' 
needs  and  formulating  nursing  goals;  appropriate  nursing  inter- 
vention. Emphasis  is  on  prevention,  continuity  of  care,  the  nurse's 
role  in  relation  to  the  patient's  family  and  the  community,  and  the 
nurses'   responsability    in   patient  teaching   and   rehabilitation. 


500   Pages 


100   lllustrotiom 


April    1971 


$13.50 


2.  New    (5frh)  Edition  SIGNS  AND  SYMPTOMS:  *"-"•*'  •""•"'''•«''  '""^'"'-'^ 


Edited  by  Cyril  Mitchell  MacBryde,  M.D.,  F.A.C.P., 

Associate  Editor,  Robert  Stanley  Blacklow,  M.D.  With  39  Contributors 

Extensively  revised  and  expanded  in  the  light  of  current  knowledge, 
this  text  approaches  diagnosis  through  the  analysis  and  inter- 
pretation of  presenting  signs  and  symptoms.  Each  chapter  presents 
a   major   symptom   or  sign,  clarifies  the   mechanism   of   its   production, 

1025   Pages 


and  Clinical   Interpretation 


and  describes  its  correlation  with  other  symptoms  ond  with  physical 
ond  laboratory  findings.  Exceptionally  helpful  to  nurse  clinicians 
in  assessing  patient  problems,  and  a  valuable  guide  in  teaching 
students    to    develop    the    skills    of    observation. 


241    Illustrations,  4   Color   Plates 


5th    Edition,    1970 


$23.75 


3.    New       (4th)     Edition    SURGERY:      Principle,  and  Praeti.. 

By  Jonathan  E.  Rhoads,  M.D.,  D.Sc.   (Med.);  J.  Garrott  Allen,  M.D.;  Carl  A:  Mayer,  M.D.; 
and  Henry  Harkins,  M.D.,  Ph.D.  With  39  Contributors 


Revised  and  updated  to  reflect  the  most  modern  concepts  of 
surgical  intervention,  this  book  provides  the  blend  of  basic  sciences 
and  operative  techniques  essential  for  a  fundamentol  understanding 
of  surgical  procedures.  Anatomic,  pathologic,  physiologic  and  bio- 
chemical  factors  relevant  to  surgical    problems   are    interwoven. 


Virtually  all  surgical  disciplines  ore  covered  including  such  important 
subjects  as  fluid  and  electrolytes,  shock,  blood  transfusions  and 
related  problems,  tissue  and  organ  transplontotion,  pre-  and  post- 
operative   core,    and    the    moleculor    attack    on    cancer. 


1864   Pages 


758    Illustrations 


4th   Edition,   1970 


$25.00 


4  New  CLINICAL  GERIATRICS 

Edited  by  Isadore  Rossman,  M.D.,  Ph.D.  With  29  Contributors 

The  geriatric  patient  is  exomirfeot  in  totality  by  a  cross-disciplinary 
team  of  specialists  in  this  comprehensive  work.  All  organ  systems 
and  their  diseases  ore  fully  covered,  with  emphasis  on  prevention, 
diagnosis    and    therapy.    Recent    geriatric    advances    included    range 


from  anesthesia  and  pharmacology  to  joint  replacement  and  sexual 
patterns.  A  section  dealing  with  psychologic,  psychiatric  and  en- 
vironmental   aspects    of    aging    patients    is    of    special    value. 


512  Pages 


170   Illustrations 


March,   1971 


$25.00 


Lippincott 


J.  B.  LIPPINCOTT  COMPANY  OF  CANADA  LTD. 
60  Front  St.  W.,  Toronto  1,  Ont. 


D  ADVANCED    CONCEPTS    IN    CLINICAL    NURSING    $13.50 

D  SIGNS    AND    SMPTOMS,    5lh    Edition    $23.75 

D  SURGERY,    4lh    Edition    $25.00 

D  CLINICAL    GERIATRICS    $25.00 


Name  Position  

Address   

City    Province    

D    Payment  enclosed  D     Charge  and  bill  me 


CN  -  3-71 


MARCH  1971 


THE  CANADIAN   NURSE 


(Continued  from  page  8) 

tional  health  research  scientists,  na- 
tional health  fellows,  and  visiting 
scientists). 

"Canada  needs  people  highly  quali- 
fied in  research  methodology,  and  these 
include  nurses,"  Miss  Poole  said. 

Research  training  fellowships  should 
be  of  particular  interest  to  nurses. 
Although  generally  offered  to  persons 
under  35  years  of  age,  there  are  a  limit- 


ed number  of  senior  fellowships  avail- 
able to  older  candidates  who  wish  to 
obtain  training  in  health-care  research, 
and  who  have  demonstrated  ability 
and  practical  experience  in  one  of  the 
health  professions  or  a  discipline 
relevant  to  health  care  research. 

Miss  Poole  said  that  if  nurses  in- 
terested in  research  would  write  to  her 
at  Ottawa,  she  could,  in  the  course  of 
her  travels,  talk  to  groups  regarding 
the  National  Health  Grant. 

The  department  of  national  health 
and  welfare,  entrusted  with  the  ad- 
ministration of  this  fund,  has  appoint- 
ed a  review  committee  of  which  Miss 
Poole  is  a  member.  This  committee 


your 
waiting  room 

^^%|  I  I    1^^  ^^  a  quieter  place 


A  sound  that  echoes  around  all  the  doctors'  waiting  rooms 

from  September  until  Spring  is  the  sound  of  coughing. 
Now  Parke-Davis  introduces  an  additional  formula  for  your 

coughing  patients:  BENYLIN®  DM  cough  syrup. 

This  Is  a  specifically  antitussive  formula  designed  to  control 

unwanted,  ticklish  coughs.  As  its  name  Implies, 

BENYLIN  DM  offers  the  powerful  antitussive  qualities  of 

Dextromethorphan  together  with  the  antihistamine 

BENADRYL®  which  also  has  antispasmodic  action 

INDICATIONS;  Antitutllve  and  aipec-  Each  5  cc.  contains: 

toranl  for  rtllaf  of  couuti  dua  to  colda  or  Daxtromethorphan  Hydrobromlda 15     mo. 

■"*'°''  Banadryl  (dlohanhydramlna  hydrochlorlda  P.D.li  Co.)  12.5  mg. 

PRECAUTIONS:  Paraona   who    hava  Ammonium  Chlorlda 125  mg. 

bacoma  dtoway  on  thia  or  othar  anilhlata-  Sodium  Cltrata 50     mg. 

mtne-contalnlnsdruoa,  orwhoaatolaranca  -i.,      ,    _  o«     «.- 

la  not  known,  ahould  not  drive  «ehlclaa  or  Chloroform 2g     mg. 

angaga  in  other  activities  requiring  Itean  Menthol 1       mg. 

raaponaa  white  using  this  preparation. 

Hypnotica,   aadatives.   or  tranauliiiers.   If  ^^^  ^^H  ^H  W  ■       ■  ^Hl^^^^  Hi  ^M 

used  with  BENYUN-DM.  should  be  pra-  ■■  ^^  Bl  ■■   ■       I  Bl        la  HS 

caution  because       possible  MM  ^^    ^H  ^m    ■       ■  ^H        ■  ■  ^^^1 

additive  effect.  Diphenhydramine  has  an  ^^^  ^^    ^^1    W     I       ■  ^^l^lll^PI 

atropine-lliie  action  which  should  be  con-  MM  *        IV     ■      ■_  ■  ■■  ^  MM  ■■! 

aidered  when  prescribing  BENYLIN-DM.  HV  ^H  ■  ■     ■      ^H  ■  ■  ■         I^V  ■  W  ■ 
SIDE  EFFECTS:  Side  reactions  may  affect 
the  nervous,  gaatrointeallnal,  and  cardlo* 
vascular  systema.  Most  frequent  reactiona 
are  drowsiness,  dizziness,  dryness  of  the 

mouth,  nauaea  and  narvouaness.  Paiplta-  _  .    _  .  _.,„ 

Hon  and  blurring  of  viaion  have  bean  ra-  Parke,  DaviS  &  Company,  Ltd.,  Montreal  379 
ported.  Aa  with  any  drug,  allergic  reactiona 

may  occur.  Further  Information  la  available  on  request. 

CP.757 


PARKE-DAVIS 


10     THE  CANADIAN   NURSE 


meets  three  times  a  year  —  in  Febru- 
ary, June,  and  October.  Although 
applications  are  made  directly  to  the 
department,  processing  them  does  take 
time  she  said.  To  be  considered  at  the 
research  committee's  next  meeting 
in  June,  an  application  should  reach 
the  department  by  May  1 . 

Prospective  grantees  may  request 
a  National  Health  Grant  prospectus 
and  application  forms  by  writing  to 
the  Health  Grants  Directorate,  Depart- 
ment of  National  Health  and  Welfare, 
Ottawa  3,  Ontario. 


Migrant  Nurses  To  Attend 
French-Language  Classes 

Montreal,  Que.  —  Bill  64,  the  con- 
troversial language  legislation  enacted 
by  the  government  of  Premier  Robert 
Bourassa,  means  that  professionals 
immigrating  into  the  province  will  have 
to  acquire  a  working  knowledge  of 
French  (and  a  certificate  to  prove  it) 
before  they  can  join  their  professional 
associations. 

Without  French,  newcomers,  who 
are  not  Canadian  citizens,  will  be  barred 
from  the  College  of  Physicians  and 
Surgeons,  the  Association  of  Nurses  of 
the  Province  of  Quebec,  the  College  of 
Pharmacists,  and  1 6  other  professional 
groups. 

Cecile  Gauvin,  ANPQ  assistant 
secretary-registrar,  said  the  association 
is  pleased  with  the  new  law.  She  ex- 
plained that  language  classes,  funded 
by  the  federal  government  and  admin- 
istered by  the  provincial  government, 
are  available  to  immigrants.  The  ANPQ 
provides  information  about  the  classes 
to  nurses  arriving  from  other  countries. 

Classes  run  for  35  weeks.  The  lan- 
guage student  takes  a  basic  course  in 
elementary  French  for  20  weeks  and 
receives  a  weekly  stipend.  The  last  15 
weeks  of  the  course  are  given  as  an 
extension  of  the  basic  course  and  the 
student  receives  no  stipend.  However 
the  immigrants  must  successfully  com- 
plete this  part  of  the  course  to  receive 
the  language  certification  necessary 
for  them  to  enter  the  19  listed  profes- 
sions. 

Although  the  course  is  free,  Miss 
Gauvin  thought  the  immigrants  would 
likely  have  to  find  another  job  for  the 
almost  four  months  of  the  last  part  of 
the  course.  She  did  not  suggest  what 
kind  of  temporary  work  they  might 
find,  but  said  they  would  not  be  eli- 
gible for  employment  as  auxiliary 
nurses.  She  added  that  if  there  were 
problems  the  immigration  branch  would 
provide  assistance. 

Miss  Gauvin  pointed  out  a  loophole 
in  the  law.  The  law  states  the  immi- 
grant must  acquire  a  working  knowl- 
(Continued  on  page  12) 
MARCH  1971 


LA  CROSS  HAS 
BEAUTIFUL  IDEAS 
IN  WHITE 


There's  more  to  La  Cross  than  pro- 
fessional good  looks.  Count  on  La 
Cross  for  comfort,  long  wear  and 
easy  care  fabrics.  La  Cross  ...  the 
name  to  trust  for  value  in  quality 
nursing  fashions. 


Back  zipper  opening.  "Skimmer"  with  action  sleeve 
gussets. 

RIBBED  KNIT  JERSEY  TRICOT 


Style  2749 
SIZES  8-20 


Retails  about  $16.98 


This  and  other  styles  available  at  uniform  shops  and 
department  stores  across  Canada. 


PROFESSIONAL  UNIFORMS 

o 
For  a  copy  of  our  latest  catalogue  and 

for  the  store  nearest  you,  write ; 

La  Cross  Uniform  Corp. 
4530  Clark  St., 
Montreal,  Quebec 
Tel :  845-5273 


names 


{Continued  from  page  10) 

edge  of  French  as  a  requirement  of 
accreditation  from  the  professional 
associations,  but  nothing  is  said  about 
the  language  used  in  actual  practice. 
"So  we  feel  legislation  such  as  Bill  64 
is  just  a  start,"  said  Miss  Gauvin. 

To  make  the  law  more  attractive  to 
the  immigrant,  the  provincial  gov- 
ernment has  abolished  the  requirement 


of  Canadian  citizenship  to  join  the 
professional  associations.  The  immi- 
grant will  only  have  to  undertake  to 
apply  for  citizenship  "as  soon  as  he 
may  do  so  under  the  Canadian  Citizen- 
ship Act." 


Manitoba  Nurses  Now 
Accept  Bargaining  Concept 

Winnipeg,  Man.  —  The  province's 
nurses  are  gradually  accepting  the  con- 
cept of  collective  bargaining,  but  it's 
been  a  slow  process,  according  to  Glen 
Smale,  chairman  of  the  provincial  staff 
nurses'  council  established  by  the  Man- 


Who  Prefers 

explosion-proof  suction 
units?   "We  do/' 
say  most  0.  R.  nurses. 

Here's  why :  Gomco  Explosion-Proof 
Suction   Pumps  are  ready  for  life- 
protecting  service  because  of  their 
dependable,  quiet  operating  pump, 
precision  regulating  valve  and  gauge, 
explosion-proof,  heavy-duty  motor 
and  sealed-in  switch.  Cabinet, 

portable,  and  stand-mounted  units. 

Are  your  operating  rooms  prop- 
erly equipped  with  Gomco?  For 
latest  catalog,  see  your  dealer 
or  write:  GOMCO  SURGICAL 
MANUFACTURING  CORP.,  828 
E.  Ferry  St.,  Buffalo,  N.Y.  14211 

^5mC^  Dept.C-2 


12     THE  CANADIAN   NURSE 


itoba  Association  of  Registered  Nurses 
at  its  May  1970  annual  meeting. 

The  new  council's  objective  is  to 
overcome  misconceptions  nurses  have 
about  collective  bargaining.  The  council 
is  making  available  information,  ad- 
vice, and  facilities  to  assist  nurses  form- 
ing bargaining  units  and  conducting 
collective  bargaining. 

The  council  executive  includes  Jean 
Burrows  of  St.  Boniface  Gejieral  Hos- 
pital, vice-chairman;  Patricia  Rathwell 
of  Brandon  General  Hospital,  secretary; 
and  Greer  Black  of  Red  River  Com- 
munity College,  treasurer. 

"Nurses  have  had  paternalism  pxjund- 
ed  into  them  since  the  day  of  Florence 
Nightingale,"  said  Mr.  Smale  in  a 
Winnipeg  Free  Press  interview.  "We 
don't  pressure  collective  bargaining. 
It  has  to  start  from  within  a  hospital." 

Mr.  Smale,  who  is  working  to  develop 
regional  collective  bargaining  units  for 
registered  nurses,  said  support  for  staff 
associations  increases  as  nurses  realize 
they  can  have  a  say  in  improvements  in 
the  services  provided  by  their  hospital. 

Within  the  past  three  years  staff 
associations  were  formed  by  registered 
nurses  working  in  the  St.  Boniface, 
Misericordia,  and  Victoria  general 
hospitals  in  greater  Winnipeg;  in  the 
Brandon  and  Assiniboine  general  hos- 
pitals in  the  Brandon  area;  and  the 
Winnipeg  Civic  Registered  Nurses' 
Association. 

These  seven  associations  recently 
formed  a  negotiating  committee  to 
consist  of  a  representative  from  each 
association  to  bargain  on  behalf  of 
members  on  a  regional  basis. 

Nova  Scotia  Nurses 
Sign  1971  Contracts 

Halifax,  N.S.  —  Contract  negotiations 
for  1971  are  well  underway  for  Nova 
Scotia  nurses.  Eight  staff  associations 
have  completed  agreements.  Two  staff 
associations,  the  Aberdeen  Hospital, 
New  Glasgow,  and  the  Colchester 
Hospital,  Truro,  are  in  conciliation 
and  the  staff  association,  Payzant  Me- 
morial Hospital,  Windsor,  is  negotiating 
a  contract. 

At  Dawson  Memorial  Hospital, 
Bridgewater,  the  Registered  Nurses 
Association  of  Nova  Scotia  and  the 
hospital  board  signed  an  agreement  in 
January  for  a  twenty-month  contract 
terminating  on  December  31,  1971. 

Kay  Buckler,  president  of  the  staff 
association,  said  the  agreement  provides 
a  means  of  improving  communications, 
working  conditions,  and  salaries.  A 
professional  practice  committee  was 
formed  to  deal  with  developments  and 
difficulties  related  to  nursing.  The 
agreement  provided  a  salary  increase  at 
the  general  staff  level  of  $50  per  month 
from  May  to  December  1970,  plus  a 

MARCH  1971 


bonus  of  $200;  a  further  increase  of 
$25  is  scheduled  for  1971,  raising  the 
monthly  salary  to  $500. 

Nurses'  staff  associations  in  five 
Cape  Breton  hospitals:  St.  Elizabeth 
Hospital,  North  Sydney;  St.  Joseph's 
Hospital,  Glace  Bay;  New  Waterford 
Consolidated  Hospital,  New  Waterford; 
St.  Rita  Hospital  and  Sydney  City 
Hospital,  Sydney,  signed  their  first 
collective  agreements  with  their  hospital 
boards  in  January. 

The  agreement,  in  effect  for  1971, 
provides  for  a  sum  of  $600  to  be  paid  to 
each  nurse  for  1 970  and  a  new  starting 
salary  of  $500  per  month,  a  raise  of  $25 
per  month.  The  contract,  similar  for  all 
five  hospitals,  emphasized  provision 
for  improved  communication  between 
nurses  and  hospital  officials  to  deal 
with  problems  outside  the  collective 
agreement,  as  well  as  the  usual  griev- 
ance and  arbitration  procedures. 

Negotiations  began  locally  but  it  was 
necessary  to  proceed  to  conciliation. 
During  this  time  the  presidents  of  the 
staff  associations,  Eleanor  MacNeil  of 
New  Waterford,  Beverly  O'Neil  of 
North  Sydnev,  Mabel  Latham  of  Sydney 
City,  Olive  MacKinnon  of  St.  Rita's  and 
Esther  Turner  of  St.  Joseph's,  met  on  a 
joint  basis.  At  negotiating  sessions, 
M  argaret  Bentley  of  Hal  ifax  represented 
the  staff  associations  and  Freeman 
Jenkins  of  Glace  Bay  the  involved 
hospital  boards. 

AARN  Brief  Presented 
To  Premier  And  Cabinet 

Edmonton,  Aha.  —  The  tightening  of 
the  job  market  and  the  shortage  of 
nurses  for  leadership  positions  were 
two  issues  the  Alberta  Association  of 
Registered  Nurses  discussed  with  Pre- 
mier Harry  Strom  and  members  of 
his  Cabinet  in  the  January  presentation 
of  the  association's  annual  brief. 

Noting  that  the  supply  of  practicing 
nurses  in  the  province  mcreases  each 
year,  AARN  statistics  show  an  increase 
of  7.1  percent  in  total  active  practicing 
memberships,  compared  to  an  increase 
of  5.5  percent  last  year. 

The  brief  states,  "Three  to  four  years 
ago  while  health  services  were  expand- 
ing rapidly  there  was  a  severe  shortage 
of  nurses  in  Alberta,  however,  this 
situation  no  longer  exists." 

The  AARN  surveyed  the  schools  of 
nursing  in  October  since  there  were 
worries  about  unemployment  of  nurses 
especially  in  graduating  classes.  The 
survey  revealed  that  of  total  graduates 
—  616  from  diploma  schools  of  nurs- 
ing and  234  from  the  University  of 
Alberta  —  not  more  than  36  nurses, 
seeking  employment,  were  unemployed. 

"Nursing  positions  have  been  diffi- 
cult to  locate  in  the  larger  cities,  partic- 
ularly in  Calgary,"  said  the  brief, 
but  there  continues  to  be  vacancies 

MARCH  1971 


m  rural  areas  and  m  the  Federal  Health 
Services." 

The  problems  of  directors  of  nurs- 
ing, especially  in  rural  hospitals,  is  a 
matter  of  "grave  concern"  to  AARN. 
"There  is  a  dearth  of  nurses  prepared 
for  leadership  positions  in  nursing 
service  in  Alberta  and  in  all  provinces 
of  Canada.  Positions  of  nursing  admin- 
istrative resjxjnsibility  are  still  being 
filled  with  persons  having  no  further 
preparation  than  their  basic  program. 

"Although  many  hospital  boards 
recognize  the  importance  of  a  well- 
prepared  director  of  nursing,  and  ad- 
vertise in  this  manner,  they  too  fre- 
quently have  no  alternative  but  to 
appoint  a  less  prepared  nurse  who  also 
recognizes  the  inadequacy  of  her  prep- 
aration. There  is  no  pool  of  prepared 
nurses  from  which  to  draw." 

Some  AARN  recommendations  to 
alleviate  the  problem  are:  1 .  minimum 
qualifications  for  a  director  of  nursing 
and  administrator  be  established;  2. 
the  goal  of  adequate  preparation  be 
facilitated  by  incentives  in  the  form  of 
bursaries  and  sabbatical  leave;  3.  reg- 
istered nurses  with  a  baccalaureate 
degree  be  encouraged  to  seek  experience 
and  preparation  in  management  tech- 
niques; 4.  in  the  interim,  crash  pro- 
grams in  the  form  of  seminars  or  work- 
shops be  made  available  immediately 
to  directors  of  nursing. 

To  get  the  "crash  program"  under- 
way, the  AARN  is  providing  financial 
assistance  for  a  series  of  workshops  as 
a  beginning  step  in  supplementing  the 
knowledge  of  present  directors  of  nurs- 
ing. A  spring  workshop  is  planned 
using  the  resources  of  the  department 
of  health  service  administration. 

The  brief  also  noted  that  the  AARN 
is  a  member  of  the  Coordinating  Coun- 
cil on  Nursing  established  on  a  vol- 
untary basis  during  1970  by  five  nurs- 
irig  groups. 

Task  Force  Discussion 
By  Quebec  Chapter 

Quebec  City,  Quebec  —  The  Quebec 
chapter  of  the  Canadian  Association 
of  University  Schools  of  Nursing  is 
against  the  creation  of  a  new  category 
of  health  worker  such  as  the  physician's 
assistant.  Members  believe  the  role  of 
nurses  educated  in  university  schools 
should  be  widened. 

Discussing  the  report  of  a  provincial 
commission  on  health  and  welfare 
at  a  general  meeting  in  January,  mem- 
bers said  the  report,  particularly  the 
section  on  the  role  of  the  nurse  clini- 
cian, should  be  clarified.  They  said 
the  government  and  public  do  not  seem 
to  be  aware  of  resources  offered  by 
nurses  educated  at  the  baccalaureate 
level.  A  brief  will  be  presented  by  the 
association  to  the  Minister  of  Health. 

The    association,    which     includes 


professors  from  the  McGill  University 
school  of  graduate  nurses,  the  Univer- 
sity of  Montreal  faculty  of  nursing, 
and  the  Laval  University  school  of 
nursing  sciences,  was  formed  to  de- 
velop and  promote  nursing  university 
programs.  Olive  Goulet  is  president 
and  Michele  Charlebois,  secretary- 
treasurer. 

RNANS  Sponsors 
Three  Courses 

Halifax,  N.S.  —  The  first  continuing 
education  program  for  the  province's 
nurses,  sponsored  by  the  Registered 
Nurses'  Association  of  Nova  Scotia, 
was  held  at  Mount  Saint  Vincent  Uni- 
versity, Halifax.  The  course  on  the 
changing  role  of  the  nurse  was  given 
in  eight  night  sessions  beginning  in 
November  and  finishing  in  January. 

Designed  for  head  nurses,  the  course 
focused  on  the  new  managerial  skills 
required  by  nurses,  the  altering  role  of 
the  patient,  and  the  legal  responsibil- 
ities of  the  nurse. 

The  RNANS  program  was  to  be'' 
repeated  at  Xavier  College,  Sydney, 
in  February  and  at  Mount  Saint  Vincent 
University  in  April. 

Ontario  Government 
Proposes  Change  In  Structure 
Of  Health  Disciplines 

Toronto,  Ont.  —  A  new  and  "greatly 
improved"  structure  for  health  dis- 
ciplines in  Ontario  was  forecast  by  the 
provincial  minister  of  health  Thomas 
L.  Wells  at  a  press  conference  held 
January  25.  The  proposals  to  update 
and  revise  procedures  of  regulation 
and  education  in  the  health  disciplines 
stem  from  recommendations  in  the 
Report  of  the  Committee  on  the  Heal- 
ing Arts. 

Mr.  Wells  said  the  proposals  he  was 
presenting  would  serve  as  a  basis  for 
discussion  with  the  various  health  pro- 
fessions and  lead  to  drafting  new  legisla- 
tion governing  these  professions.  The 
major  principles  and  recommendations 
are: 

1.  The  public  interest  should  be  the 
basic  principle  underlying  the  regu- 
lation of  all  the  health  disciplines.  Since 
safe-guarding  the  public  interest  is  a 
primary  concern  of  the  government, 
the  government  must  assume  responsi- 
bility for  ensuring  that  satisfactory 
arrangements  exist  for  the  regulation 
of  health  disciplines. 

2.  Self-regulatory  procedures  which 
have  evolved  within  the  health  dis- 
ciplines should  be  preserved.  The  role 
of  the  public  would  be  recognized  by 
appointing  a  significant  number  of  lay 
members  to  the  regulatory  bodies. 

THE  CANADIAN   NURSE     13 


3.  The  right  of  individuals  to  use  the 
services  of  health  practitioners  of  their 
choice  should  be  respected.  Any  limi- 
tations on  these  rights  should  be  design- 
ed specifically  to  protect  the  public 
interest. 

4.  A  health  disciplines  regulation  board 
should  be  established  by,  and  be  respon- 
sible to,  the  minister  of  health  for  reg- 
ulation of  all  health  disciplines.  Existing 
colleges  (of  physicians,  dentists,  nurses, 


pharmacists,  and  optometrists)  would 
be  essentially  self-regulatory,  but  res- 
ponsive to  the  requirements  of  the 
board. 

The  board  as  seen  by  the  minister 
would  be  composed  of  five  or  seven 
members  of  the  general  public  who  are 
not  members  of  any  health  discipline. 
The  board  would  be  self-contained  and 
not  be  part  of  the  department  of  health. 
5.  One  of  the  functions  of  the  board 
would  be  to  act  as  an  appeal  board. 
Within  their  areas  of  responsibility, 
colleges  and  divisions  would  initially 
handle  complaints  from  the  public  and 


disposable  medical  devices  developed  by 
doctors  to  meet  basic  OB  requirements 


AMNIHOOK 


disposable  amniotic 
membrane  perforator 

Offers  a  better  way  to  rupture  the 
amniotic  membrane  when  inducing 
labor.  Its  operative  end  Is  rounded 
and  blunt,  with  a  protected  point. 
Because  it  is  not  spear-shaped, 
there  is  less  likelihood  of  trauma- 
tizing the  cervix  and  vaginal  vault. 
With  the  AmniHook  the  doctor  does 
not  poke  at  the  membrane  but 
merely  snags  it.  By  drawing  back 
on  the  instrument,  he  ruptures  the 
membrane  without  endangering  the 
fetus.  Approximately  101/2  inches 
long,  the  unit  is  made  of  high-grade 
plastic.  Each  sterile  AmniHook  is 
individually  packaged. 


DOUBLE-GRIP® 

CORD-CLAMP 


^iiuissJJ^jjjr 


quick  and  secure  ligation 
of  the  umbilical  cord 

The  serrated  jaws  of  the  Hollister 
Cord-Clamp  hold  the  clamp  firmly 
in  place  and  maintain  a  constant 
pressure  on  the  cord  as  it  dries, 
eliminating  the  dangers  of  seep- 
age. No  dressings  are  needed.  The 
Cord-Clamp  has  a  wide  jaw  opening 
and  contoured  fingertips  for  easy 
application.  To  Insure  against 
opening,  the  Cord-Clamp  has  a 
permanent  blind  closure.  For  re- 
moval, usually  after  24  hours,  the 
clamp  is  cut  at  the  hinge  with  the 
special  clipper  provided.  The  light- 
weight, disposable  Cord-Clamp  may 
be  autoclaved  or  purchased  in  In- 
dividual sterile  packets. 


write  for  free  samples,  prices  and  Information 


a  HOLLISTER 
HOLLISTER  INCORPORATED  •  211  EAST  CHICAGO  AVENUE,  CHICAGO,  ILLINOIS  60611 
14     THE  CANADIAN   NURSE 


health  practitioners,  but  the  board 
would  hear  appeals  resulting  from 
their  decisions. 

6.  Education  of  all  health  workers 
should  be  the  responsibility  of  edu- 
cational rather  than  regulatory  bodies. 
The  education  of  health  disciplines 
should  be  the  responsibility  of  those 
bodies  charged  with  the  province's 
educational  programs  under  the  minis- 
ter of  education. 

Mr.  Wells  also  announced  the  form- 
ation of  a  workgroup  with  deputy  min- 
ister of  health.  Dr.  K.C.  Charron,  as 
chairman.  This  group  will  meet  with 
the  health  discipline  associations  and 
complete   discussions   by   March    15. 


AARN  Brief  Supports 
Status  Of  Women  Report 

Edmonton,  Aha.  —  In  its  annual  brief, 
presented  in  January  to  Premier  Harry 
Strom  and  his  Cabinet,  the  Alberta 
Association  of  Registered  Nurses  drew 
attention  to  areas  of  specific  interest 
to  nurses  in  the  report  of  the  Royal 
Commission  on  the  Status  of  Women 
in  Canada. 

•  Day-Care  Centers:  A  single,  most 
often  requested  item  by  Canadian 
women  is  for  day-care  centers  accord- 
ing to  the  report.  "Such  a  system  would 
be  of  great  value  to  the  nursing  profes- 
sion," said  AARN.  Day-care  centers 
are  seen  as  the  "first  step  in  a  broader 
scheme  of  child  care." 

•  Salary  Differentials:  The  commission 
has  established  that  discriminatory 
practices  involving  salaries  exist  in 
many  areas  of  female  employment. 
"Nursing  is  no  exception,"  said  the 
AARN,  endorsing  the  recommendation 
that  "the  concept  of  skill,  effort,  and 
responsibility  be  used  as  the  objective 
factors  in  determining  what  is  equal 
work;  with  the  understanding  that  pay 
rates  thus  established  will  be  subject 
to  such  factors  as  seniority  provisions." 

•  Taxation:  The  Association  agrees 
with  the  Commission  section  on  taxa- 
tion wherein  joint  tax  returns  options 
and  child  care  allowances  would  be 
of  great  value  to  women. 

•  Family  Planning  Clinics:  Establish- 
ment in  public  health  units  is  empha- 
sized by  the  Association  to  provide 
better  health  services  to  the  public. 

•  Maternity  Leave:  The  AARN  en- 
dorses the  recommendation  of  adoption 
of  provincial  and  territorial  maternity 
legislation  to  provide  for  an  employed 
woman's  entitlement  to  1 8  weeks  mater- 
nity leave,  mandatory  maternity  leave 
for  the  six-week  period  following  her 
confinement  unless  she  produces  a 
medical    certificate    stating    working 

(Continued  on  page  16) 
MARCH  1971 


This  stimulating 
educotionol  pocJcoge 

mokes  \i  easier  to  teoch- 
_^_eosier  to  leorn! 


Myotin  filoment 


Fig.  6-3.  Scheme  to  show  how  myosin  interacts 
with  actin  to  shorten  muscle  fibers. 


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(Continued  from  page  14) 

will  not  injure  her  health,  and  prohibi- 
tion of  dismissal  of  an  employee  on 
any  grounds  during  the  maternity  leave 
to  which  she  is  entitled. 

The  AARN  stressed  the  recommenda- 
tion that  federal,  provincial,  territorial, 
and  municipal  governments  each  estab- 
lish a  committee  to  plan  for,  coordi- 
nate, and  expedite  the  implementation 
of  the  recommendations  made  by  the 
Status  of  Women  Commission  and 
report  to  its  government  on  progress 
made. 

Public  Hospital  Nurses 
Sign  New  Agreement 

Fredericton,  N.B.  —  Nurses  employed 
in  New  Brunswick's  public  hospitals 
signed  their  first  collective  agreement 
under  the  new  Public  Service  Labour 
Relations  Act  on  February  2.  The 
21 -month  agreement  expires  March 
31,  1972  and  is  retroactive  to  July  1, 
1970. 

The  new  contract  covering  2,100 
nurses  in  public  hospitals  was  signed 
by  representatives  of  the  provincial 
treasury  board  and  the  provincial 
collective  bargaining  council  of  the 
New  Brunswick  Association  of  Regis- 
tered Nurses. 

Salaries  will  increase  16  percent 
over  the  contract  period.  The  schedule 
raises  the  basic  salary  for  a  registered 
nurse  employed  at  the  general  staff 
level  from  $430  per  month  to  $460 
per  month,  effective  July  I,  1970  to 
March  31,  1971.  Effective  April  1, 
1971  the  beginning  salary  for  a  regis- 
tered nurse  will  be  $500  per  month. 
Four  increments  within  the  scale  will 
place  the  general  staff  nurses  at  a  max- 
imum of  $580,  effective  April  1 . 

Increases  in  educational  increments 
were  granted  for  a  masters  or  bacca- 
laureate degree,  a  one-year  university 
course  in  nursing,  a  special  six-month 
clinical  preparation,  and  the  nursing 
unit  administration  course.  The  contract 
also  states  that  management  recognizes 
the  desirability  of  encouraging  educa- 
tion and  will  grant  leave  of  absence  for 
such  purposes. 

Among  the  other  benefits  is  a  re- 
duction in  the  hours  of  work  from  40 
to  37-and-one-half  hours  per  week.  The 
article  on  retirement  states  that,  follow- 
ing normal  retirement  at  age  65,  the 
nurse  can  return  in  a  casual  or  part- 
time  capacity.  Pension  plans  not  al- 
ready in  existence  will  be  established 
by  March  31,  197 1  unless  this  deadline 
is  extended  by  mutual  agreement. 

Portability  is  another  new  benefit. 
If  a  nurse  resigns  from  one  hospital 
16     THE  CANADIAN   NURSE 


in  the  province  and  accepts  a  position 
in  another  New  Brunswick  hospital, 
she  will  take  with  her  any  unused  sick- 
leave  and  vacation  credits,  providing 
that  no  more  than  30  days  elapse  be- 
tween the  resignation  date  and  the  date 
of  the  new  position. 

The  contract  also  provides  for  a 
professional  practices  committee  to 
make  recommendations  for  the  im- 
provement and  quality  of  patient  care. 
Committee  members  will  include  the 
director  of  nursing  and  representatives 
from  the  staff  association  and  hospital 
administration. 

Signing  of  the  new  agreement  marks 
the  conclusion  of  negotiations  that 
began  on  August  1 1,  1970. 


NBARN  Wants  End 
Of  Hospital  Schools 

Fredericton,  N.B.  —  The  New  Bruns- 
wick Association  of  Registered  Nurses 
continues  to  urge  the  provincial  govern- 
ment to  phase  out  hospital  schools  of 
nursing  and  to  establish  nursing  educa- 
tion at  the  diploma  level  in  institutions 
similar  to  junior  colleges. 

In  a  brief  presented  on  January  22, 
to  the  provincial  study  committee  on 
nursing  education,  NBARN  recom- 
mended "that  basic  nursing  education 
be  placed  within  the  educational  system 
of  the  province  in  an  institution  whose 
primary  purpose  is  education."  NBARN 
states  the  present  system  of  hospital 
schools  is  inadequate  due  to  the  con- 
flict created  when  an  institution  holds 
two  objectives  —  service  to  the  patient 
and  education  of  nurses. 

"The  primary  purpose  of  a  hospital 
is  to  provide  service  to  the  sick.  All 
else  within  a  hospital  must  take  second 
place  to  this  purpose,  and  this  includes 
its  school  of  nursing,"  said  an  NBARN 
release  following  presentation  of  the 
brief. 

Opposition  to  the  phasing  out  of 
hospital  schools  has  come  from  the 
New  Brunswick  Hospital  Association. 
NBARN  was  criticized  for  holding  too 
much  power  and  authority  in  relation 
to  nursing  education  and  registration. 
The  area  of  standard  setting  and  reg- 
istration is  under  scrutiny  by  the  com- 
mittee which  is  expected  to  submit  its 
findings  to  the  government  in  early 
June. 

Reiterating  its  respect  for  the  integ- 
rity of  present  hospital  schools,  NBARN 
said  the  schools'  deficiencies  result 
from  an  "archaic  system"  which  the 
schools  cannot  control.  "The  schools 
in  hospitals  have  neither  the  educational 
facilities  nor  the  level  of  qualified  in- 
struction to  prepare  nurses  to  work 
effectively  in  the  rapidly  changing 
field  of  health.  This  is  not  the  fault  of 
the  student,  the  school,  or  the  hospital. 
The   first   call   on   available   hospital 


funds  is  to  provide  facilities  to  care 
for  the  sick.  Providing  for  education 
processes  is  a  secondary  purpose  of  the 
hospital,  borne  out  in  budgeting,  pro- 
gramming, and  staffing. 

"One  example  of  the  inefficiency  of 
the  present  system  is  in  the  area  of 
practical  experience.  The  student  in  the 
hospital  school  receives  practice  by 
giving  service  to  the  hospital.  This 
is  borne  out  in  hospital  budgets  where 
the  student  service  is  calculated  at  the 
rate  of  30  percent  for  staffing  pur- 
poses," said  NBARN. 

"The  student  is  working  to  meet 
service  requirements  of  the  hospital, 
not  to  meet  the  learning  needs  of  the 
student.  She  is  frequently  required 
to  work  evening  and  night  shifts  al- 
though no  instructor  is  available.  This 
method  of  approach  is  haphazard  and 
often  irrelevant  to  the  student's  class- 
room program. 

"This  present  apprenticeship  method 
of  training  nurses  is  no  longer  effective 
in  educating  nurses  ....  The  change  to 
ajunior  college  type  of  institution  would 
combine  the  best  features  of  the  hospital 
programs  with  a  more  extensive  educa- 
tion," said  NBARN. 

The  impossibility  of  staffing  hos- 
pital schools  with  qualified  instructors 
is  also  caused  by  the  subordination  of 
an  education  program  to  a  service  pro- 
gram, states  NBARN.  "Approximately 
61  percent  of  the  instructors  in  these 
schools  do  not  have  the  recommended 
requirement  of  a  baccalaureate  degree. 
The  concentration  of  facilities  and 
qualified  instruction  now  spread  among 
1 1  hospital  schools  into  three  or  four 
junior  college  schools  would  alleviate 
this  problem,"  said  NBARN. 

Noting  that  the  change  from  the 
apprentice-type  training  to  an  aca- 
demic-type training  should  be  gradual, 
the  NBARN  brief  recommended  that, 
"the  present  hospital  schools  be  phased 
into  a  limited  number  of  independent 
diploma  schools.  That  these  be  large 
enough  to  be  economical  and  to  be 
geographically  placed  so  that  optimum 
use  IS  made  of  the  clinical,  physical, 
and  human  resources  for  offering  the 
program." 

Other  recommendations  in  the  brief 
were: 

•  that  the  association  continue  to  be 
the  body  to  set,  maintain,  and  upgrade 
as  necessary,  the  standards  for  nursing 
education  and  practice. 

•  that  nursing  assistant  programs  be 
phased  out 

•  that  any  registered  nurse  or  registered 
nursing  assistant  who  demonstrates 
ability  have  the  privilege  of  further 
study  ....  that  this  upward  mobility  be 
so  structured  as  to  maintain  standards 

•  that  all  basic  nursing  programs  con- 
tinue to  be  general  nursing  courses. 

MARCH  1971 


Nova  Scotia  Lacks 
Nurses  With  Degrees 

Halifax,  N.S.  —  The  province  is  be- 
low the  national  average  in  percentage 
of  nurses  holding  degrees,  according 
to  a  review  committee  report  on  Dal- 
housie  University's  School  of  Nursing. 

Only  2.8  percent  of  Nova  Scotia's 
nurses  hold  a  bachelor  of  nursing  de- 
gree, compared  with  the  Canadian 
average  of  six  percent. 

Meanwhile  the  need  for  well-pre- 
pared health  personnel  increases  as 
demands  for  better  health  care  grow, 
said  the  report.  The  review  committee 
recommends  135  bachelor  of  nursing 
graduates  as  a  minimum  objective  for 
Nova  Scotia.  In  May,  1970,  the  univer- 
sity graduated  38  students  of  nursing 

—  seven  were  graduates  of  the  new 
four-year  program. 

■'The  nurse  with  a  degree  is  expect- 
ed to  give  leadership  to  nurses  who 
provide  bedside  care.  She  is  not  an 
administrator,  unless  she  has  special- 
ized as  such,  although  she  is  some- 
times precipitated  into  this  role,"  said 
the  report. 

"To  improve  nursing  services,  both 
institutional  and  community,  a  high 
proportion  of  nurses,  about  25  percent 
of  graduates,  should  have  at  least  a 
baccalaureate,"  the  committee  advo- 
cated. 

Now  in  its  twenty-first  year,  the 
Dalhousie  nursing  program  offers  a 
four-year  basic  degree  program;  a  three- 
year  degree  program  for  registered 
nurses;  a  one-year  diploma  program 
for  public  health  nurses  and  nursing 
service  administration;  and  a  unique 
two-year  program  leading  to  a  diploma 
in  outpost  nursing. 

Dr.  Helen  Nahm,  recently  retired 
dean  of  the  University  of  California 
School  of  Nursing,  was  visiting  con- 
sultant. She  suggested  use  of  outpost 
nursing  program  experience  in  other 
health  professions;  establishment  of 
a  master's  degree  program  in  nursing; 
interim  admission  of  qualified  nurses 
to  allied  departments  —  M.A.  or  M.Sc. 

—  and  a  program  of  continuing  edu- 
cation for  nurses. 

Dr.  H.B.S.  Cooke,  of  the  univer- 
sity's faculty  of  arts  and  science,  was 
committee  chairman.  Other  committee 
members  were:  Dr.  G.  Ross  Langley, 
faculty  of  medicine;  Dr.  Kenneth  M. 
James,  college  of  pharmacy;  Dr.  Edwin 
G.  Belzer,  school  of  physical  education; 
and  Dr.  Robert  M.  MacDonald,  dean 
of  the  faculty  of  health  professions.     § 


[ 


BE  A 
BLOOD 
DONOR 


B 


For  nursing 
convenience... 

patient  ease 

TUCKS 

Offer  an  aid  to  healing, 
an  aid  to  comfort 

Soothing,  cooling  TUCKS  provide 
greater  patient  comfort,  greater 
nursing  convenience.  TUCKS  mean  no 
fuss,  no  mess,  no  preparation,  no 
trundling  the  surgical  cart.  Ready- 
prepared  TUCKS  can  be  kept  by  the 
patient's  bedside  for  immediate  appli- 
cation whenever  their  soothing,  healing 
properties  are  indicated.  TUCKS  allay 
the  itch  and  pain  of  post-operative 
lesions,  post-partum  hemorrhoids, 
episiotomies,  and  many  dermatological 
conditions.  TUCKS  save  time.  Promote 
healing.  Offer  soothing,  cooling  relief 
in  both  pre-and  post-operative 
conditions.  TUCKS  are  soft 
flannel  pads  soaked  in  witch  hazel 
(50%)  and  glycerine  (10%). 


TUCKS  —  the  valuable  nur- 
sing aid,  the  valuable  patient 
comforter. 


Specify  the  FULLER  SHIELD^  as  a  protective 
postsurgical  dressing.  Holds  anal,  perianal  or 
pilonidal  dressings  comfortably  in  place  with- 
out tape,  prevents  soiling  of  linen  or  cloth- 
lr}g.  Ideal  for  hospital  or  ambulatory  patients. 


w 


WIN  LEY- MORRIS 


LTU. 


MARCH   1971 


TUCKS  Is  a  trademark  of  the  Fuller  Laboratories  Inc. 

IHt    CANADIAN    NUK^t 


17 


names 


"Fifty  Yean  A-Nursing" 


j  To  mark  her  50th  anniversary  of  graduation,  fellow  workers  honored  Jane 
Thomas  at  an  informal  gathering.  In  the  photograph,  Graham  Edwards,  a 
health  inspector,  presents  a  yellow  rose  corsage  as  Anne  Beckwith,  public 
health  nurse,  looks  on.  Florence  Tomlinson,  director  of  nursing,  presented  the 

,  guest  of  honor  with  a  purse  from  the  staff.  A  native  of  Northern  Ontario,  Miss 
Thomas  graduated  from  the  School  of  Nursing,  Toronto  General  Hospital,  on 
June  6,  1920,  and  attended  the  first  public  health  nursing  course  given  at  the 
University  of  Toronto,  receiving  her  PHN  diploma  in  June  1 92 1 .  Miss  Thomas 

j  was  the  public  health  nurse  in  Sudbury  schools  for  39  years,  and  following 
retirement  from  the  school  board  in  1959,  joined  the  Sudbury  Health  Unit  staff. 
She  is  highly  respected  and  all  who  know  her  marvel  at  her  proficiency  and 
cheerfulness  as  she  carries  on  the  valuable  nursing  role  of  training  and  super- 
vising the  registered  nursing  assistants  as  audiovisual  technicians  to  give  service 
in  the  Health  Unit  schools  of  the  Chapleau,  Gogama,  Manitoulin,  Espanola. 
Elliot  Lake  and  Sudbury  areas. 


Patricia    S.B.    Stan- 

ojevic(Reg.N.,  The 

Hospital  for  Sick 
Children  School  of 
Nursing,  Toronto; 
B.Sc.N.,  U.  of  Brit- 
ish Columbia;  M.Sc 
(App.),  McGill  U.) 
formerly  assistant 
research  and  plan- 
ning officer  (nursing)  with  the  research 
and  planning  branch  of  the  Ontario 
Department  of  Health,  became  director 
of  the  school  of  nursing,  Toronto 
General  Hospital,  in  January  1971. 
She  succeeds  Mary  Horton,  who  re- 
signed for  family  reasons. 

Mrs.  Stanojevic  has  had  a  wide  range 
of  experience  in  nursing  endeavors. 
18     THE  CANADIAN   NURSE 


She  has  served  as  a  general  duty  nurse 
and  as  a  clinical  instructor  at  the  Hos- 
pital for  Sick  Children.  She  was  also 
the  first  supervisor  of  inservice  nursing 
education  at  that  hospital.  She  has  been 
an  inspector  of  schools  of  nursing  in 
Ontario;  an  assistant  director  of  pro- 
fessional standards.  College  of  Nurses 
of  Ontario,  and  a  lecturer,  faculty  of 
nursing,  Queen's  University  Kingston. 

Constance  A.  Holleran  (R.N.,  Massa- 
chusetts General  Hospital  School  of 
Nursing,  B.Sc,  Teachers  College, 
Columbia  U.;  M.Sc.N.,  Catholic  U. 
of  America,  Washington,  D.C.)  was 
appointed  director  of  the  government 
relations  department  of  the  American 
Nurses'  Association  in  January  1971. 


This  department  is  located  in  Washing- 
ton, DC. 

Miss  Holleran  has  been  a  faculty 
member  at  the  Massachusetts  General 
Hospital  School  of  Nursing  and  taught 
at  the  Royal  Victoria  Hospital,  Belfast, 
Northern  Ireland.  Prior  to  joining  the 
ANA  staff  in  1970  as  project  coordina- 
tor, Miss  Holleran  had  been  for  four 
years  chief  of  the  project  grant  section 
of  the  nurse  education  and  training 
branch  of  the  division  of  nursing,  na- 
tional institutes  of  health,  department 
of  health,  education  and  welfare. 


Mary  Russell  was  named  acting  regis- 
trar of  the  New  Brunswick  Association 
of  Registered  Nurses,  to  replace  Lois 
Gladney.  Mrs.  Gladney  resigned  for 
reasons  of  health,  but  continued  on  a 
part-time  basis  as  consultant  until  the 
end  of  the  year. 

I L  o  i  s    L.    Gladney 

(R.N.,  Royal  Victor- 
ia Hospital  School 
of  Nursing.  Mont- 
real) retired  for 
health  reasons  in 
December  1970 
I  from  her  position 
as  registrar  of  the 
New  Brunswick 
Association  of  Registered  Nurses. 

Joining  the  NBARN  in  1957  as 
assistant  to  the  secretary  registrar, 
Mrs.  Gladney  became  registrar  two 
years  later.  In  this  time,  the  association 
membership  has  more  than  doubled, 
an  indication  of  the  registrar's  respon- 
sibility. 

Mrs.  Gladney  was  honored  by  friends 
and  colleagues  at  the  Lord  Beaver- 
brook  Hotel,  January  18,  when  she  was 
given  a  presentation  in  appreciation 
of  her  service  to  NBARN. 

This  occasion  also  marked  New 
Brunswick's  premiere  showing  of  The 
Leaf  and  the  Lamp. 


ERRATUM 

Helena  Reimer  retired  as  secretary- 
registrar  of  the  Association  of  Nurses 
of  the  Province  of  Quebec  after  12 
years  of  service,  not  two,  as  was 
erroneously  stated  on  page  1 9  of  the 
Jai.uary  1 97 1  issue  of  the  CNJ. 

MARCH  1971 


Joyce     E.     Gleason 

(R.N.,  Regina  Gen- 
eral Hospital  School 
of  Nursing;  B.Sc.N., 
U.  of  Saskatchewan) 
has  been  appointed 
employment  rela- 
tions officer  of  the 
Manitoba  Associa- 
tion of  Registered 
Nurses  to  replace  Laurel  Rector,  who 
has  resigned  for  family  reasons. 

Mrs.  Gleason  has  worked  in  nurs- 
ing education  and  nursing  service;  has 
been  responsible  for  nursing  personnel, 
their  welfare  and  development;  and 
has  kept  in  tune  with  the  younger 
generation  in  schools  of  nursing. 

Sister  Marie  Simone 
Roach  (R.N.,  St. 
Joseph's  Hospital 
School  of  Nursing, 
Glace  Bay.  N.S.; 
B.Sc.N.,  St.  Fran- 
cis Xavier  U.,  An- 
tigonish,N.S.;M.Sc. 
Nursing  Adminis- 
I  tration,  Boston  U.; 
Ph.D.,  School  of  Education,  Catholic 
U.,  Washington,  D.C.)  has  been  ap- 
pointed acting  chairman  of  the  nursing 
department  of  St.  Francis  Xavier  Uni- 
versity, Antigonish.  Prior  to  earning 
her  Ph.D.,  Sister  Roach  was  on  the 
faculty  of  the  Catherine  Laboure  School 
of  Nursing  in  Boston. 

Beth    (Bullis)    Allan 

(Reg.N..  Toronto 
^^-  /i  Western  Hospital 
-ffl^L.  __iu  School  of  Nursing; 
W'^iiwaj^  Dipl.  Nursing  Ad- 
*  '^v.  *  min.,U.  of  Toronto) 
has  been  appointed 
coordinator  of  pa- 
tient relations  at 
the  York-Finch 
General  Hospital,  Downsview,  Ontario. 
Through  Mrs.  Allan,  the  home  care 
program  of  Metro  Toronto  is  being  of- 
fered to  patients  of  this  community 
hospital.  She  makes  arrangements  to 
enable  patients  to  go  home  sooner  than 
usual,  assists  in  transferring  patients 
to  convalescent  or  chronic  hospitals, 
and  works  with  other  community  or- 
ganizations to  obtain  special  help  for 
patients  who  need  it. 

Mrs.  Allan's  supervisory  experience 
in  many  Toronto  hospitals  and  her 
experience  in  organizing  refresher 
and  reorientation  programs  for  reg- 
istered and  public  health  nurses  will 
be  put  to  good  use  in  her  present  chal- 
lenging position. 

Currently,  she  is  studying  toward 
a  B.Sc.N.  degree  through  the  extension 
division  of  the  University  of  Toronto, 
and  is  a  director  of  the  Rexdale  unit 
of  the  Canadian  Cancer  Society. 
MARCH   1971 


IF  YOU'RE  HAVING 
PROBLEMS  WITH  I.V.s 
TRY  THE  IVOMETER 

Varying  flow  rates,  bottles  emptying  too  fast  or  too  slow, 
infiltrations  and  stopped  needles  are  common  I.V.  prob- 
lems. 

The  I  VOmeter,  a  disposable  metered  I.V.  set  has  been 
shown  to  reduce  the  severity  and  frequency  of  these  prob- 
lems. The  nurse  can  now  observe  an  indicator  which 
shows,  at  a  glance,  the  current  flow  rate  compared  to  the 
deslTed  flow  rate.  Because  of  the  Stay-Set  clamp  the  nurse 
can  be  assured  that  any  change  in  flow  is  patient  oriented. 

To  find  how  IVOmeter's  patented  meter  and  clamping 
technique  can  eliminate  drop  recounting  and  assist  in 
improving  patient  care,  just  complete  and  mail  the  coupon 
shown  below  to: 

I'V'OMETER,  INC.    P.O.Box1219     Santa  Cmz,  Callf.  95O6O 


.Zip. 


Hospital 


Title/Position 


I  VOMETER,  INC.    p  o  box  1219 

A  subsidiary  of   Intermed  Corporation 


Santa  Cruz,  Calif.  95060 


THE  CANADIAN   NURSE     19 


Next  Month 
in 

The 

Canadian 
Nurse 

•  Basilar  Aneurysms 

•  Management  of  Parkinson's 
Disease  with  L-dopa  therapy 

•  The  Subcutaneous  Injection 


IL/KJ 


Photo  credits  for 
March  1971 


Crombie  McNeill  Photography, 
Ottawa,  p.  7 

Studio  Impact,  Ottawa,  p.  8 

The  Sudbury  Star, 
Sudbury,  Ont.,  p.  18 

Hans  I.  Blohm,  Ottawa,  p.  20 

The  University  of  Western 
Ontario,  London,  Ont.,  p.  32 

Roy  Nichols  Photographer, 
Willowdale,  Ont.,  p.  41 

The  Winnipeg  General  Hospital, 
Wmnipeg,  Man.,  pp.  48,  49,  50 


names 


20     THE  CANADIAN   NURSE 


Ethel  M.  Gordon,  R.N.,  was  honored 
by  the  Professional  Institute  of  the 
Public  Service  of  Canada  in  Ottawa 
during  celebrations  marking  its  golden 
anniversary  year.  K.J.  Harwood,  pres- 
ident, presented  her  with  an  Institute 
Service  Award  in  recognition  of  her 
outstanding  service  to  the  association 
and  its  13,000  members. 

Miss  Gordon,  a  member  of  the  In- 
stitute since  1950,  was  cited  for  her 
valuable  service  to  federally  employ- 
ed nurses  as  chairman  of  their  bar- 
gaining unit  and  to  the  Institute  as  a 
whole  during  her  three-year  term  on 
its  board  of  directors. 

Following  retirement  from  the  fed- 
eral public  service  in  January  1969, 
Miss  Gordon  was  appointed  special 
consultant  with  the  Institute  in  the 
field  of  health  services  groups. 

John      V.      Briscoe 

(R.N.,  Sefton  Gen- 
eral H.;  dipl,  Brit- 
ish Orthopaedic  As- , 
sociation)  has  been 
appointed  assistant 
administrator  (nurs- 
ing) and  director  of 
nursing  services  at 
Trenton  Memorial 
Hospital,  Trenton,  Ontario. 

Before  coming  to  Canada  in  1961 
Mr.  Briscoe  was  senior  nursing  officer- 
in-charge  (Base  Hospitals)  in  Iran  with 
the  Seven  Year  Plan  for  the  Middle 
East  (United  Nations  Organization). 

After  holding  a  number  of  superviso- 
ry positions  at  Hamilton  Civic  Hospi- 
tals, Hamilton,  Ontario,  he  accepted 
an  appointment  with  Abbott  Laborato- 


ries Limited  in  1966.  For  the  past  two 
years  Mr.  Briscoe  has  been  with  the 
Royal  Victoria  Hospital,  Montreal, 
first  as  manager  of  central  supply,  then 
as  administrative  assistant.  Women's 
Pavilion  and  then  as  manager,  oper- 
ating services. 

Betty  Drury  (R.N.,  Edmonton  General 
Hospital  School  of  Nursing:  Dipl.  in 
teaching  and  supervision,  U.  of  Al- 
berta) was  appointed  director  of  nursing 
of  the  Sturgeon  General  Hospital,  a 
new  hospital  near  St.  Albert,  on  the 
outskirts  of  Edmonton,  Alberta.  Miss 
Drury  was  previously  on  the  staff  of 
the  Charles  Camsell  Hospital,  Edmon- 
ton. Earlier,  she  had  been  clinical 
instructor,  pediatrics,  at  the  Edmonton 
General  Hospital  School  of  Nursing. 

T.M.  Miller,  public 
relations  officer  of 
the  Manitoba  Asso- 
ciation of  Register- 
ed Nurses,  was  pres- 
ented with  a  life, 
membership  in  the 
Canadian  Public  Re- 
lations Society  ear- 
ly in  October.  A 
founding  member  of  the  Manitoba 
branch  of  the  society,  Mr.  Miller  is  a 
past  president,  and  was  awarded  the 
Presidents  Medal  in  1965  for  "'service 
to  the  Society,  to  public  relations  and 
to  public  welfare." 

Yolande     Albert 

(R.N.,  Hotel  Dieu 
Hospital  School  of 
Nursing,  Edmuns- 
ton,  N.B.),  a  former 
staff  nurse  at  the 
Montreal  Children's 
Hospital,  has  just 
begun  another  10- 
month  mission  with 
the  hospital  ship  Hope. 

On  January  8,  the  hospital  ship 
left  Baltimore,  Maryland,  bound  for 
Kingston,  Jamaica,  on  a  medical  teach- 
ing mission  in  the  West  Indies  with  Miss 
Albert  on  board  as  one  of  its  permanent 
specialized  staff  of  125. 

Miss  Albert  completed  another 
"Hope"  project  in  Tunisia  a  few  months 
ago  where  she  also  participated  in 
emergency  relief  activities  undertaken 
by  "Hope"  during  the  devastating 
floods  of  1969.  Her  role  as  nurse  and 
teacher  was  featured  in  a  documentary 
film.  Doctor  .  .  .  Teacher  .  .  .  Friend. 

Further  phases  ot  the  project's  cur- 
rent three-year  hemispheric  program 
will  bring  the  S.S.  Hope  to  Brazil  in 
1972  and  to  Venezuela  in  1973.  Project 
"Hope"  is  the  principal  activity  of  the 
People-to-People  Health  Foundation, 
Incorporated,  of  Washington,  D.C., 
an  independent,  nonprofit  international 
health  organization.  'te? 

MARCH  1971 


SCHERINB 


For  effective  relief 

of  cold  symptoms 

take  the  clear-headed 

family  approach. 

Recommend  Coricidin. 


Coricidin'  is  a  whole  family  of  cold  fighters.  Each  form  is 
formulated  for  maximum  effectiveness  in  controlling 
cold  symptoms. 

Coricidin  'D',  for  Instance,  has  five  ingredients 
to  combat  every  head  cold  symptom:  a  top-rated  anti- 
histamine to  stop  running  noses,  two  pain  relievers  and 
fever  fighters,  caffeine  to  brighten  spirits  and  a  decon- 
gestant to  shrink  swollen  membranes. 

For  the  junior  cold  sufferer,  Coricidin  'D'  Medilets* 
offer  the  same  relief  in  a  dosage  suitable  for  the  young 


patient,  in  a  pleasant-tasting  chewable  tablet. 

For  everyone  in  the  family,  there  is  a  member  of  the 
Coricidin  family  to  bring  real  relief:  Adult  tablet  forms 
packaged  in  the  new,  easy-to-use  pop-out  blister  packs, 
spray,  lozenges  and  a  pleasant-tasting  cough  mixture. 

Recommend  Coricidin.  Your  charges  will  be  glad 
you  did.  For  further  information,  consult  your  physician 
or  write  Schering  Corporation  Limited,  Pointe  Claire 
730,  P.Q. 

•  Reg.  T,M. 


i 


Coricidin 


PEDIATRIC 


Coricidin 


THROAT    ■ 
LOZENGE% 

soothing  HONEY  MEN 


Coricidin 


COLOTABLHS 


Coricidin 


COUGH  MIXTURE 

iL_£i±t'n  'OUNCES 


N«Ml  Child*  Ptolaclrv*  P*Oh 


Coricidin'D' 


MEDILETS* 


24  CHCWAtlf  TAALTTS 

f ot  fMt  reltBl  of 
chltdren'i  ttuffy  tod 
runny  noMi  du«  to 
th«  common  cold 


Coricidin'D' 


tfOOMSIMT  MTW 


24    TABLET^ 

tor  ra4Mf  of  coW  tyrtviom* 

•nd  KCOmpAnying 


Coricidin 


MEDIIETS 


A  Family  of  cold  products. 


new  products     j 


Descriptions  are  based  on  information 
supplied  by  the  manufacturer.  No 
endorsement  is  intended. 


Bassinet  Sheets 


Ornex 

Ornex,  for  the  treatment  of  sinus  con- 
gestion and  sinus  headache,  is  now 
available  from  Smith  Kline  &  French 
Canada  Ltd.  It  is  a  decongestant  anal- 
gesic, combining  acetaminophen  and 
salicylamide  (both  with  analgesic  and 
antipyretic  action)  with  phenylpropa- 
nolamine (nasal  decongestant). 


Ornex  does  not  generally  produce 
drowsiness  as  it  contains  no  antihis- 
tamines. Containing  salicylamide, 
the  risk  of  gastric  side  effects  for  pa- 
tients allergic  or  sensitive  to  acetyl- 
salicylic  acid  is  avoided. 

The  usual  dose  for  adults  is  two 
capsules  every  four  hours,  and  for 
children   10  to   14  years  of  age,  one 


i 


I 


Cystometer 


22     THE  CANADIAN  NURSE 


capsule  every  four  hours.  Ornex,  in 
bottles  of  100,  blue  and  white  taper- 
end  capsules,  does  not  require  a  pres- 
cription. 

Smith  Kline  &  French  Ltd.,  300 
Laurentian  Blvd.,  Montreal  379,  Que- 
bec will  provide  further  information, 
on  request. 

Saneen  Bassinet  Sheets 

Facelle  Company's  Saneen  Bassinet 
sheets  cost  little  enough  for  single  use 
in  the  hospital  nursery.  Their  size, 
strength,  and  softness,  combined  with 
disposability,  make  them  the  ideal 
substitute  for  nursery  linen. 

Measuring  28"  x  35",  the  sheets  are 
large  enough  to  cover  the  bassinet  and 
allow  for  a  good  tuck-in,  under  either 
mattress  or  baby.  They  are  made  of 
two  layers  of  cellulose  tissue,  rein- 
forced with  strong,  synthetic  threads, 
and  their  softness  eliminates  any  risk 
of  irritation  to  a  newborn's  skir. 

Pre-folded  for  maximum  conveni- 
ence, single-use  Saneen  bassinet  sheets 
are  poly-wrapped  to  ensure  cleanliness 
and  to  facilitate  storage  and  quantity 
control. 

For  further  information  write  to  the 
Facelle  Company  Limited,  1350  Jane 
Street,  Toronto  15,  Ontario. 

Cystometer  Gauges  Bladder  Function 

An  air  cystometer  recently  introduced 
by  Modern  Controls,  Inc.,  provides  a 
safe,  rapid,  and  accurate  method  to 
evaluate  bladder  function. 

Because  of  its  speed  and  because 
small  cathers  are  used,  the  test  pro- 
vides a  practical  clinical  method  to 
evaluate  bladder  function  in  infants 
and  children. 

As  air  cystometry  requires  no  prep- 
aration other  than  catheterization,  the 
test  may  be  performed  in  the  ward, 
clinic,  cystoscopic  suite. 

The  air  cystometer  provides  a  con- 
tinuous recording  of  intravesical  pres- 
sure changes  on  a  SVi"  x  11"  form, 
which  later  may  be  placed  directly  in 
th  -  patient's  chart.  Pertinent  precys- 
» jmetric  data,  sensory  changes,  and 
che  cystometric  evaluation  are  also 
recorded  directly  on  the  cystometro- 
gram.  The  cystometer  features  a  built- 
in  mercury  manometer  for  easy  cal- 
ibration and  variable  flow  rates  from 
0  to  150  ml.  per  minute.  An  exchange- 
able fiber-tip  pen  assures  a  contin- 
uous recording  free  of  ink  skips. 

{Continued  on  page  24) 
MARCH  1971 


no  OTHtR  BflG  PERFORfTU  UH€  mC 


My  safety  chamber 
really  stops  retro- 
grade infection. 
Tttere's  simply  no  way 
for  the  bugs  to  back 
up  and  go  where  they 
don't  belong.  And  by 
tucking  the  BAC- 
STOP  chamber  in- 
side the  bag,  It  can't 
be  kinked  acciden- 
tally to  stop  the  flow. 


I'm  clear-faced  and 
easy  to  read.  My  white 
back  makes  my  mark- 
ings stand  out  unique- 
ly, whether  you  look 
at  my  backbone  scale, 
or  tilt  me  diagonally 
to  read  small  amounts 
with  the  corner  cali- 
brations. 


II 


^. 


Cystofln* 

uiiMnt  kM 


"« 


m 


^ 


I'm  the  unique  new  CYSTOFLO'  drainage  bag.  a 
true-blue  friend  to  nurses,  physicians  and  patients. 
Why  don't  we  get  acquainted? 


My  hanger  Is  the 
hanger  that  works 
well  all  the  time.  Hang 
it  on  a  bed  rail  or  a 
belt,  it  is  always  se- 
cure and  comfortable. 
I'm  always  on  the 
level  with  this  hanger, 
whether  my  patient  is 
lying,  sitting,  or  walk- 
ing around. 


I«1 


I  have  the  only  shortie 
drainage  tube  around, 
and  it's  miles  better 
than  any  other 
you  ve  ever  used.  It's 
easier  to  handle,  and  it 
won't  drag  on  the  floor, 
even  with  the  new  low 
beds.  So  out  goes  one 
more  path  to  possible 
contamination. 


BAXTER  LABORATORIES  OF  CANADA 

DIVISION  Of   TBAvtNQi  LABORATORIES   iNC 

6406  Nonham  Onve  Mallon  Ontano 


your  hospital  is 
safer,  operates  more 
efficiently  with  TIME 

NURSING 
LABELS 


new  products 


Safer  because  all  Time  Labels  relating 
to  patient  care  are  BACTERIOSTATIC 
to  assist  in  eliminating  contact  infec- 
tion between  patient  and  nurse.  The 
self-sticking  quality  of  Time  Nursing 
Labels  eliminates  the  need  for  hand 
to  mouth  contact  while  working  with 
patient  record. 

More  efficient  because  Time  Nursing 
Labels  provide  you  with  an  effective 
system  of  identification  and  communi- 
cation within  and  between  departments. 

Time  Patient  Chart  Labeis  color-code 
your  charts  and  records  in  any  of  17 
colors  with  space  for  all  pertinent  pa- 
tient information. 

Time  Chart  Legend  Labels  alert  busy 
personnel  to  important  patient  care 
divertives  eliminating  the  possibility  of 
error  through  verbal  instructions. 

There  are  many  other  Time  Labels  to 
assist  you  in  speeding  your  work  and 
to  assure  accuracy  in  important  pa- 
tient procedures.  Write  today  for  a 
free  catalog  of  all  Time  Nursing  Labels. 
We  will  also  send  you  the  name  of 
your  nearest  dealer. 


(jfi. 


PROFESSIONAL  TAPE  COMPANY,  INC. 

355  BURLINGTON   RD.,  RIVERSIDE,   ILL.  60546 


24     THE  CANADIAN   NURSE 


Complete  information  on  the  Mo- 
comMerrill  Cystometer  may  be  ob- 
tained from  Modern  Control,  Inc, 
Minneapolis,  Minnesota. 

Oratrast  and  Barotrast 

Oratrast  (barium  sulfate),  pleasantly 
flavored  for  oral  administration,  pro- 
vides the  prolonged  and  uniform  coat- 
ing necessary  to  achieve  films  with 
excellent  definition,  even  in  the  gastric 
antrum  and  duodenum. 

Barotrast  (barium  sulfate),  a  versa- 
tile barium  preparation  for  rectal  or 
oral  administration,  can  be  mixed  to 
provide  the  density  and  viscosity  needed 
for  a  wide  variety  of  gastrointestinal 
studies. 

These  radiological  aids  have  been 
developed  by  the  Barnes-Hind  Labora- 
tories, P.O.  Box  69,  Adelaide  Street 
Post  Office,  Toronto  1,  Ontario. 

New  Posey  Catalog  Now  Available 

The  latest  Posey  Catalog  describes 
more  than  200  items  manufactured 
by  the  Posey  Company.  The  publica- 
tion features  a  new  material  called 
Breezeline,  a  dacron  mesh  that  is  avail- 
able for  all  types  of  Posey  safety  vests. 

It  includes  15  new  items  in  its  nine 
product  sections:  bed  safety  belts;  limb 
holders;  safety  vests;  wheelchair  safety 
products;  pediatric  control  products; 
safety  belts  for  guerneys,  stretchers,  and 
operating  tables;  rehabilitation  pro- 
ducts; orthopedic  products;  and  miscel- 
laneous. An  index  is  provided  for  easy 
reference. 

A  free  copy  of  the  new  197 1  catalog 
may  be  obtained  by  writing  the  Posey 
Company.  The  Canadian  distributor 
of  Posey  products  is  Enns  &  Gilmore 
Ltd.,  1033  Rangeview  Rd.,  Port  Credit, 
Ontario. 


Pwsey  Company  «-,»».. 


Posey  Catalog 


IV  Storage  Unit 
Storage  Module  for  IV  Solutions 

Market  Forge  has  introduced  a  storage 
unit  for  intravenous  solutions  to  be 
located  next  to  the  IV  Preparation 
Station.  Called  FIFO  (First  In,  First 
Out),  the  storage  module  simplifies 
rotation  of  IV  bottles,  thus  assuring 
availability  of  fresh  solutions.  Bottles, 
held  on  inclined  slides,  are  loaded  from 
the  rear  by  pulling  out  the  entire  FIFO 
unit. 

The  IV  Preparation  Station  itself 
is  used  in  high  IV  usage  areas  such  as 
recovery  rooms,  intensive  care  units, 
anesthesia  workrooms,  surgical  and 
medical  wards.  It  may  also  be  used  by 
an  IV  team,  or  in  a  pharmacy  provid- 
ing centralized  additive  service. 

For  information  on  the  IV  prep- 
aration station  and  its  companion  FIFO 
Storage  Module,  write  Market  Forge, 
1875  Leslie  St.,  Don  Mills,  Ontario. 

Disposable  Carafe 

The  "Tempo"  Carafe,  a  new  liquid 
dispensing  system  for  personal  patient 
care,  is  sanitary  and  economical  and 
is  designed  to  simplify  the  work  of 
paramedical  personnel  in  hospitals, 
nursing  homes,  and  other  extended 
care  facilities. 

The  carafe  has  three  components: 
body,  cap,  and  molded  base  with  handle. 
The  body  and  cap  are  of  expanded 
polystyrene  to  provide  high  insula- 
tion for  hot  or  cold  liquids.  The  base 
and  handle  components  of  polyethylene 
are  molded  into  one  piece  to  facilitate 
handling. 

The  carafe,  holding  32  ounces,  is 
designed  to  be  stacked  and  thus  allow 
efficient  jise  of  central  supply  storage 
space. 

Further  information  is  available 
from  The  General  Tire  &  Rubber  Com- 
pany, Chemical/Plastics  Division,  I 
General  Street,  Akron,  Ohio  44309.   ■§> 

MARCH   1971 


Fleet 

ends  ordeal  by 

Enema 

for  you  and 
your  patient 


Now  in  3  disposable  forms: 

*  Adult  (green  protective  cap) 

*  Pediatric  (blue  protective  cap) 

*  Mineral  Oil  (orange  protective  cap) 

Fleet  —  the  40-second  Enema*  —  is  pre-lubricated,  pre-mixed, 
pre-measured,  individually-packed,  ready-to-use,  and  disposable. 
Ordeal  by  enema-can  is  over! 

Quick,  clean,  modern,  FLEET  ENEMA  will  save  you  an  average  of 
27  minutes  per  patient  —  and  a  world  of  trouble. 

WARNING:  Not  to  be  used  when  nausea.  In  dehydrated  or  debilitated 

vomiting  or  abdominal  pain  is  present.  patients,  the  volume  must  be  carefully 

Frequent  or  prolonged  use  may  result  in  determined  since  the  solution  is  hypertonic 

dependence.  and  may  lead  to  further  dehydration.  Care 

CAUTION:  DO  NOT  ADMINISTER  should  also  be  taken  to  ensure  thai  the 

TO  CHILDREN  UNDER  TWO  YEARS  contents  of  the  bowel  are  expelled  alter 

OF  AGE  EXCEPT  ON  THE  ADVICE  administration.  Repeated  administration 

OF  A  PHYSICIAN.  at  short  intervals  should  be  avoided. 


Full  information  on  request.  I ^n^  ou.l,.v -M..M.ct>,T,c.L. 

•Kehlmann,  W.  H.:  Mod.  Hosp.  84:104,  1955  I f^^. 

FLEET  ENEMA®  —  single-dose  disposable  unit 


T_-7  CAonfei&^noMt  &.C'a 

p^J         ItfWUWCMOWTStAU  CANADA  J 


tOijnoiD  nv  CJWAXut  w  mi 


MARCH   1971  THE  CANADIAN   NURSE     25 


March  11-12,1971 

University  of  British  Columbia,  Division  of 
Continuing  Nursing  Education,  Course  on 
Maternal  Health  Nursing  for  practicing 
maternity  nurses.  Fee:  $23.00.  For  further 
information  write:  Margaret  S.  Neylan, 
Associate  Professor  and  Director,  Univer- 
sity of  British  Columbia  School  of  Nursing, 
Division  of  Continuing  Education,  Van- 
couver 8,  B.C. 

March  15-16, 1971 

Workshop  on  Rituals  and  Routine,  spon- 
sored by  the  New  Brunswick  Association 
of  Registered  Nurses,  Fredericton,  N.B. 
Leader  of  this  workshop  for  head  nurses 
will  be  Pamela  E.  Poole,  nursing  consultant. 
Hospital  Insurance  and  Diagnostic  Services, 
Department  of  National  Health  and  Welfare. 

March  25-26, 1971 

University  of  British  Columbia,  Division  of 
Continuing  Education,  Course  on  Psychia- 
tric Nursing  for  nurses  providing  care  for 
psychiatric  patients.  Applications  from 
other  professions  are  welcomed.  Fee: 
$23.00.  For  further  information  write:  Marg- 
aret S.  Neylan,  Associate  Professor  and 
Director,  University  of  British  Columbia 
School  of  Nursing,  Division  of  Continuing 
Education,  Vancouver  8,  B.C. 

March  31, 1970 

Canadian  Nurses'  Association  annual 
meeting,  business  sessions  only.  Chateau 
Laurler,  Ottawa,  Ontario. 

Aprils,  1971 

Conference  on  cooperation  in  the  health 
care  of  patients  with  cancer,  in  conjunc- 
tion with  the  Canadian  Cancer  Society, 
Ontario  Division.  Speakers  will  be  Dr. 
Ruth  E.  Alison,  Princess  Margaret  Hospital, 
Toronto  ("Cancer  Prevention  and  the 
Hopeful  Outlook")  and  Dr.  Elizabeth 
Kubler-Ross  of  Chicago  ("Death  and  Dying"). 
Regiistration  fee:  $5.00.  For  further  Infor- 
mation contact:  Summer  School  and  Ex- 
tension Department,  The  University  of 
Western  Ontario,  London  72,  Ont. 

April  17, 1971 

Homecoming  for  graduates  of  Stratford 
General  Hospital,  Stratford,  Ontario.  For 
further  information  contact:  Mrs.  Angus  J. 
MacDermid  Jr.,  President,  Alumnae  Asso- 
ciation, 204  Delamere  Ave.,  Stratford.  Ont. 

April  19-22, 1971 

Canadian  Public  Health  Association,  62nd 
annual  meeting,  King  Edward  Sheraton 
26     THE  CANADIAN   NURSE 


Hotel,  Toronto.  For  advance  registration, 
information,  and  accommodation,  write: 
CPHA  Annual  Meeting,  1255  Yonge  Street, 
Toronto  7,  Ontario. 

April  29-May  1, 1971 

Annual  Meeting,  Registered  Nurses' 
Association  of  Ontario,  Royal  York  Hotel, 
Toronto,  Ontario. 

May  4-7, 1971 

Workshop  on  Test  Construction  for  Teachers 
in  Nursing  Education  to  be  conducted  by 
Professor  Vivian  Wood.  Tuition  fee,  includ- 
ing meals  and  accommodation:  $120.00. 
For  further  information  contact:  Summer 
School  and  Extension  Department,  The 
University  of  Western  Ontario,  London  72. 

May  10-28, 1971 

Three-week  intensive  course  in  Developing 
Human  Resources  for  Improved  Nursing 
Care,  offered  for  nurses  who  take  respon- 
sibility for  the  work  of  others.  It  is  designed 
to  assist  the  nurse  to  improve  her  skills  in 
fostering  development  of  the  abilities  of 
individuals  and  work  groups  giving  nursing 
care.  For  further  information  write:  Continu- 
ing Education  Program  for  Nurses,  Univer- 
sity of  Toronto,  47  Queen's  Park  Crescent, 
Toronto  5,  Ont. 

May  11-14, 1971 

Alberta  Association  of  Registered  Nurses, 
annual  meeting,  Banff  Springs  Hotel,  Banff, 
Alberta. 

May17-|une11,1971 

Rehabilitation  Nursing  Workshop,  a  four- 
week  intensive  course  for  registered  nurses 
working  in  acute,  general,  and  chronic 
illness  hospitals,  nursing  homes,  public 
health  agencies,  and  schools  of  nursing. 
For  further  information  write:  Continuing 
Education  Program  for  Nurses,  University 
of  Toronto,  47  Queen's  Park  Crescent, 
Toronto  5,  Ontario. 

May  26, 1971 

Registered  Nurses'  Association  of  British 
Columbia,  59th  annual  meeting,  Bayshore 
Inn,  Vancouver,  B.C. 

May  30-June  1,1971 

Manitoba  Association  of  Registered  nurses, 
annual  meeting,  Dauphin,  Manitoba. 

June  1971 

Reunion  in  conjunction  with  the  closing  of 
St.  Joseph's  General  Hospital  School  of 
Nursing,  Vegreville,  Alberta.  For  further 
information    contact:    Sister    Mary    Ellen 


O'Neill,  Alumnae  President,  St.  Joseph's 
General  Hospital,  Vegreville,  Alberta. 

June  2-4  1971 

Canadian  Hospital  Association,  National 
convention  and  assembly,  Queen  Elizabeth 
Hotel,  Montreal,  Quebec. 

|une  6-11, 1971 

Canadian  Orthopedic  Association,  annual 
scientific  and  business  meeting,  Jasper 
Park  Lodge,  Jasper,  Alberta.  For  further 
information  write:  Carroll  A.  Laurin,  Cana- 
dian Orthopedic  Association,  Suite  619, 
3875  St.  Urbain  St.,  Montreal  131,  P.Q. 

June  7-11, 1971 

Canadian  Medical  Association,  104th  an- 
nual meeting.  Nova  Scotia.  For  further 
information:  Mr.  B.E.  Freamo,  Acting 
General  Secretary,  Canadian  Medical 
Association,  1867  Alta  Vista  Drive,  Ottawa 
8,  Ontario. 

June  11-13, 1971 

Reunion  of  the  Kingston  Psychiatric  Hos- 
pital School  of  Nursing  graduates.  For 
further  information  write:  Mrs.  N.  R.  Fer- 
guson, 312  College  St.,  Kingston,  Ontario. 

June  16-19, 1971 

Canadian  Congress  of  Neurological  Sci- 
ences, sponsored  by  the  Canadian  Neuro- 
logical Society,  Canadian  Neurosurgical 
Society,  and  the  Electroencephalography 
Society,  St.  John's,  Nfld.  Further  informa- 
tion available  from:  Dr.  J.  Hudson,  Secretary, 
Canadian  Neurological  Society,  Victoria 
Hospital,  London,  Ontario. 

June  21-23, 1971 

Seventh  annual  conference.  Operating 
Room  Nurses  of  Greater  Toronto,  Royal 
York  Hotel,  Toronto,  Ontario.  Enquiries 
may  be  directed  to:  Miss  Marilyn  Brown, 
2178  Queen  St.,  E.,  Apt.  4,  Toronto  13,  Ont. 

July  8-10, 1971 

Reunion  and  Saskatchewan  Homecoming, 
St.  Paul's  Hospital  Nurses'  Alumnae.  Send 
addresses  and  enquiries  to:  Mrs.  Rita 
Taylor,  433  Ottawa  Ave.  South,  Saskatoon, 
Saskatchewan. 

July  24-25, 1971 

Alumnae  reunion  for  graduates  of  St. 
Joseph's  Hospital  School  of  Nursing, 
Saint  John,  N.B.,  in  conjunction  with  closing 
of  the  nursing  school.  Please  contact: 
Sister  A.M.  McGloan,  St.  Joseph's  Hospital, 
Saint  John,  N.B.  §■ 

MARCH  1971 


I 


HCWSTHIS  FOR  OPENERS? 


It's  nice  when  you  can  peel  the  metal  cap  off  a  glass  bottle  of 
intravenous  solution  with  just  your  fingers.  But  all  too  often,  it  pre- 
sents a  risk  to  the  nurse  who  does  it.  The  raw  metal  edge  you 
leave  behind  can  result  in  a  cut  finger.  Painful?  Of  course,  and 
time-wasting  too.  viaflex  plastic  containers  for  intravenous  solu- 
tions have  abolished  this  hazard.  You  don't  have  to  fumble  with 
twist-off  caps  or  risk  the  sharp  edges  of  tear-off  caps.  This 
makes  set-ups  and  changeovers  easier,  faster,  safer.  And  the 
containers  are  shatterproof,  so  they  may  be  dropped  on  the 
floor  without  danger  of  smashing.  Since  the  containers  are  much 


lighter  and  easier  to  handle  than  glass  bottles,  one  nurse  can 
easily  carry  several  containers.  Sterility  is  easier  to  maintain  with 
the  VIAFLEX  system,  too,  because  the  system  is  completely  closed. 
Additives  can  be  added  swiftly,  surely,  without  danger  of  con- 
tamination, with  the  VIAFLEX  exclusive  self-sealing  ports.  There 
is  no  vent,  so  airborne  contaminants  cannot  get 
into  the  system,  viaflex  is  the  first  and  only 
plastic  container  for  intravenous  solutions.  For 
easier,  faster,  safer  procedures,  it's  the  first  and 
only  solution  container  you  should  consider  using. 


BAXTER  LABORATORIES  OF  CANADA 


DIVISION  OF  TRAVENOL  LABORATORIES   INC 

6405  Northam  Drive,  Malton.  Ontario 


D 

Viailex 


in  a  capsule 


Chuckle 

Dr.  Roch  Martin  sent  the  following 
story  to  Canadian  Doctor,  which  pub- 
lished it  in  its  November  1970  issue. 
We  don't  know  whether  or  not  the  anec- 
dote is  true,  but  it's  good  for  a  chuckle. 
"A  patient  suffering  from  a  perianal 
abscess  was  advised  by  his  physician 
that  he  required  surgery.  He  agreed 
readily,  but  asked  for  a  heart  check-up 
first.  'There  is  no  use  repairing  the 
muffler  if  the  engine  is  no  good,'  he 
reasoned." 


How  did  he  miss  it? 

The  Globe  and  Mail  asked  this  ques- 
tion in  a  recent  editorial,  after  congrat- 
ulating novelist  Morley  Callaghan 
"on  surviving  the  clubbing  dished  out 
by  a  burglar  and  eventually  putting 
him  to  flight  by  lifting  a  heavy  oak 
chair  —  the  first  weapon  that  came  to 
hand. 

"It  distresses  us,  however,"  the  edi- 
torial continues,  "that  a  man  of  Mr. 
Callaghan's  acute  perception  should 
have  missed  the  early  warning  signal 


28     THE  CANADIAN   NURSE 


of  the  whole  affair.  The  man  introduced 
himself  as  a  tax  collector  and  proferred 
a  card.  While  reading  the  card,  Mr. 
Callaghan  was  attacked.  Surely  any- 
one confronted  with  a  tax  collector 
knows  right  away  he  is  dealing  with  a 
robber  and  should  instantly  reach  for 
the  nearest  oak  chair  instead  of  fussing 
with  cards." 


It's  still  the  birds  and  bees 

In  an  area  where  there  are  several  ski 
resorts,  one  has  a  children's  ski  program 
called  the  ski-birds  and  another's  pro- 
gram is  called  the  ski-bees.  It  was  bound 
to  happen  that  a  child  from  one  group 
would  get  mixed  up  and  board  the 
wrong  bus.  After  some  confusion  the 
child  was  finally  located  and  returned 
to  the  proper  slopes.  The  ski  director 
commented,  "Perhaps  now  he'll  know 
about  the  birds  and  bees." 


Appropriate 

Between  Ourselves,  a  bulletin  published 
for  the  staff  of  the  Douglas  Hospital  in 
Verdun,  Quebec,  tells  of  the  psychiatrist 
who  had  two  baskets  on  his  desk.  One 
was  marked  "Outgoing"  and  the  other 
"Inhibited." 

On  talking  to  plants 

Studies  have  been  published  showing 
that  plants  flourish  with  equal  doses 
of  light,  water,  fertilizer,  and  tender 
loving  care.  Apparently  the  attitude 
of  the  gardener  affects  the  growth  rate 
of  plants.  Plants  who  feel  loved  and 
appreciated  respond  with  an  out-pour- 
ing of  vegetation. 

One  plant  of  our  acquaintance  was 
inadvertently  exposed  to  a  window 
draft  and  showed  its  misery  by  drooping 
and  shriveling.  With  apologies  and 
expressions  of  concern,  the  owner  put 
it  in  a  more  comfortable  spot  and  now 
waits  to  see  if  the  plant  sensed  her 
sincerity. 

Both  Mrs.  and  Miss  outdated 

Arbiters  of  etiquette  tell  us  that  a 
woman's  signature  should  not  indicate 
whether  she  exists  in  a  state  of  married 
or  unmarried  bliss,  but  the  eye  is  still 
caught  when  Mrs.  receives  a  letter 
addressed  Miss.  The  problem  of  such 
business  faux  pas  can  be  eliminated  by 
the  use  of  the  letters  Ms.  to  take  in 
both  categories.  ^ 

MARCH   1971 


for  use 
-on  the  ward 
-in  the  OR 


-in  training 


NEOSPORir 

IRRIGATING 

SOLUTION 

Available:  Sterile  Ice  Ampoules. 
Boxes  of  10  and  100 

INSTRUCTIONS  FOR  USE 

This  piepaistion  is  specifically  designed  fo>  use  i*ilh  5  cc. 
■mree-w»y"  catheieis  Of  WTth  other  cathete*  systems  peimii- 
Ting  continuous  'mgation  of  the  urmary  bladdet 

1  PREPARE  SOLUTION 

Using  stenle  precautions.  on«  (1 )  CC  of  NKXponn  Irriga- 
ling  Solution  shooid  b*  added  to  •  1.000  cc  bonie  of 
starila  isotonic  salina  solution. 

2  INSERT  INDWELUNG  CATHETER 

Calhelefiie  the  patient  using  full  stenia  precautions.  The 
use  of  an  antibacterial  lutxicant  tuch  as  Lubasponn*  Urethral 
Antibacterial  Lubricant  is  recommerxled  durir>g  insertion  of 
the  caineter 

INFLATE  RETENTION  BALLOON 

Fill  a  Luer  Type  lynr^ge  Mith  10  cc  of  steiile  water  or  Mline 
(5  cc  for  balloon,  the  lemainder  to  compensate  for  the 
volume  required  by  the  inflation  channel)    Inaert  syringe 
tip  into  valve  of  balloori  lumen,  m^ea  solution  and  remove 
^  synge 

pONNECT  COLLECTION  CONTAINER 

e  outflow  (diamsge)  lumen  should  be  asepticalty  con- 
^cted.  via  a  sterile  disposable  plastic  tube,  to  •  sterile 
Lposable  plastic  collection  bag  (bottle). 

[tACH  rinse  SOLUTION 

inflow  lumen  of  ttie  5  cc  "three-way"  catheter  shouM 
e  connected  to  the  bonie  of  diluted  Neosponn 
}ation  Solution  using  sterile  technique. 

IJUST  FLOW-RATE 

most  patients  inflow  rate  of  i^e  diluted  Neosporin 
rrigating  Solution  should  be  adjutted  to  a  slow  drip  to 
deliver  atwul  1.000  cc  every  iwenty-tou'  hours  [about 
40  cc    per  houi)    If  the  patient's  unne  output  exceeds  2 
liters  per  day  it  is  recommended  that  the  inflow  rate  be 
adjusted  to  deliver  2.000  cc  ol  the  solution  m  a  twenty 
four  hour  period.  This  requires  the  addition  of  an  ampoule 
of  Neosporin  Irrigating  Solution  to  each  of  two  1.000  cc 
bottles  of  sterile  saline  sotuiion. 

I    KEEP  IRRIGATION  CONTINUOUS 

It  IS  imponant  that  irrigation  of'the  Wedder  be  continuous 
The  rinse  bottle  should  never  -        ■ 
inflow  drip  mlenupted  for  mo 
outflow  tube  should  always  b 


I    Convenient  product  identifying  labels  for  use  on  bottles 
of  diluted  Neosporin  Irrigating  So(utioi%  are  availabte  m  e»ch 
ampoule  paclcing  or  from  yoM   B.  W.  ft  Co.'  Representative 


Burroughs  Wellcome  &  Co.  (Canada)  Ltd. 


Neosporin'  Irrigating  Solution 


INSTRUCTIONS  FOR  USE 


Designed  especially  for  the  nursing  pro- 
fession, this  Instruction  Sheet  shows 
clearly  and  precisely,  step  by  step,  the 
proper  preparation  of  a  catheter  system 
for  continuous  irrigation  of  the  urinary 
bladder.  The  Sheet  is  punched  3  holes  to 
fit  any  standard  binder  or  can  be  affixed 
on  notice  boards,  or  in  stations. 

For  your  copy  (copies)  just  fill  in  the  cou- 
pon (please  print)  noting  your  function  or 
department  Within  the  hospital. 


Dept.  S.P.E. 

Burroughs  Wellcome  &  Co.  (Canada)  Ltd. 

P.O.  Box  500.  Lachine.  P.O. 

Gentlemen : 

Please  send  me  I 1  copy  (copies)  of  the  N.LS.  Instructions  for  Use.  My  department  or  function 


within  the  hospital  is_ 


NAME. 


ADDRESS. 


CITY  OR  TOWN. 


.PROV. . 


■JradP  Mark 

vlARCH   1971 


Burroughs  Wellcome  &  Co.  (Canada)  Ltd. 


THE   CANADIAN    NURSE     29 


A  ward-winning 
combination 


With  Dermassage,  all  you  add  is  your  soft 
touch  to  win  the  praises  of  your  patients. 

Dermassage  forms  an  invisible, 
greaseless  film  to  cushion  patients 
against  linens,  helping  to  prevent 
sheet  burns  and  irritation.  It  protects 
with  an  antibacterial  and  antifungal 
action.  Refreshes  and  deodorizes 
without  leaving  a  scent.  And  it's 
hypo-allergenic. 

Dermassage  leaves  layers 
of  welcome  comfort  on 
tender,  sheet-scratched       f  _ 
skin.  And  there's  another 
bonus  for  you:  While 
you're  soothing  patients 
with  Dermassage,  you're 
also  softening  and  \ 

smoothing  your  hands.     \ 

Try  Dermassage.      \ 
Let  your  fingers  jf 

do  the  talking. 


MEDICATED 


H 


HH 


M 


.  Uikeside  Laboratories  (Canada)  I,t<l. 
G4  Colgate  Avenue.  Toronto  8.  Ontario 


*Tra(le  mark 


Health  is  everybody's  business 


The  author,  known  internationally  for  her  many  contributions  to  nursing,  was 
granted  the  honorary  degree  of  Doctor  of  Laws  at  the  University  of  Western 
Ontario's  May  convocation.  This  article  is  adapted  from  the  address  Dr. 
Henderson  gave  at  that  time. 


Virginia  A.  Henderson,  R.N.,  B.S.,  M.A.,  LLD. 


When  a  friendly  secretary  was  typing 
my  answer  to  the  letter  that  told  me 
what  would  happen  this  afternoon,  she 
said,  "Miss  Henderson,  if  you  are  to 
speak  to  all  these  people,  won't  you 
have  to  say  something  sort  of  univer- 
sal?" I  said,  "'Yes,  absolutely  global!" 
Then  she  said,  "Don't  you  think  you'd 
better  start  writing  your  speech  today?" 
My  answer  —  that  it  would  make  no 
difference,  that  it  would  sound  just 
the  same  whether  I  wrote  it  in  March 
or  just  before  I  came  to  the  University 
of  Western  Ontario  in  May  —  seemed 
to  depress  her  —  as,  in  fact,  it  did  me! 
Since  then  I've  been  to  meetings 
from  Boston  to  Miami  and  in  between. 
Many  of  the  addresses  have  dealt  with 
"global"  topics  such  as  war  and  peace, 
overpopulation,  pollution,  racial  antag- 
onisms, the  generation  gap,  and  drug 
abuse.  If  I  were  someone  like  Lady 
Barbara  Ward  Jackson,  Dr.  Mark 
Inman,  or  Dr.  Choh  Ming  Li,  I  might 
use  the  few  minutes  I  have  with  you 
to  speak  on  one  or  more  of  these  sub- 
jects. Like  everyone  else,  I  consider 
them  of  overriding  importance. 

Dr.  Henderson,  a  graduate  of  the  Army 
School  of  Nursing.  Washington.  D.C.. 
and  Teachers  College,  Columbia  Univer- 
sity. New  York,  is  Research  Associate 
and  Director  of  the  Nursing  Studies  Index 
project  in  the  School  of  Nursing  at  Yale 
University,    New    Haven.    Connecticut. 


MARCH  1971 


In  case  you  think  this  just  talk,  I 
present  the  following  evidence  of  my 
"involvement"  (the  term  used  today). 

For  as  long  as  I  can  remember  I've 
been  an  avowed  pacifist.  Believing, 
as  I  do,  that  every  person  is  a  mixture 
of  constructive  and  destructive  forces, 
I  think  it  wrong  to  put  a  man  or  woman 
in  a  situation  where  he  must  either  kill 
or  be  killed.  I  subscribe  to  the  view 
that  warfare  is  legalized  murder.  This, 
in  a  fashion,  takes  care  of  war  and 
peace. 

To  dispose  of  overpopulation,  I 
merely  report  that  I  am  childless,  ex- 
cept for  the  foster  children  I  claim  as 
a  doting  aunt  and  a  teacher  devoted 
to  many  students. 

To  demonstrate  my  horror  of  pollu- 
tion —  I've  never  smoked  or  even 
owned  a  car. 

To  illustrate  my  belief  in  racial 
equality  and  my  faith  in  the  younger 
generation.  I  might  list  a  variety  of 
experiences.  But  I  will  confine  myself 
to  one;  On  the  invitation  of  five  of  our 
graduate  nurse  students,  I  went  to 
Washington  with  them  several  weeks 
ago  to  talk  with  senators  and  congress- 
men about  our  mutual  concern  over 
what  is  happening  in  the  United  States 
Government,  especially  as  it  affects 
youth  and  equal  opportunity  for  all 
races. 

Finally,  to  dispose  of  the  topic  of 

drug  abuse,  I'll  merely  say  that  by  the 

THE  CANADIAN   NURSE     31 


grace  of  God,  I've  escaped  addiction. 
I  think  this  may  be  because  I  have 
believed  suffering  —  for  others,  as 
well  as  for  oneself —  to  be  inescapable. 
I  know  what  Dr.  Albert  Schweitzer 
meant  when  he  said  he  had  never  known 
a  happy  day  in  his  life.  I  suppose  1  don't 
"take  trips"  because  I  accept  the  pres- 
ent reality  and  want  to  stay  right  here 
braced  for  it.  I  am  not  a  "pleasure  seek- 
er," as  I  tend  to  enjoy  work,  find  it 
rewarding,  and,  in  fact,  indistinguisha- 
ble from  play. 

None  of  this  should  be  interpreted 
as  advice.  A  remark  on  parental  advice 
made  by  a  cousin  of  mine  has  persuaded 
me  to  avoid  anything  that  smacks  of  it. 
32     THE  CANADIAN   NURSE 


She  told  me  that  once  when  she  was 
telling  her  daughter  she  had  used  too 
much  makeup,  she  mentally  heard  her 
mother  saying  exactly  the  same  thing 
to  her  when  she  was  her  daughter's 
age.  It  occurred  to  my  cousin  that  pa- 
rental advice  is  a  "keepsake"  —  some- 
thing one  values,  in  a  way,  but  doesn't 
use,  so  it  is  passed  on,  in  mint  condi- 
tion, to  the  next  generation.  The  oft- 
quoted  speech  of  Polonius  to  Laertes 
is  most  convincingly  interpreted  as  a 
string  of  platitudes,  collected  over  the 
centuries,  to  be  delivered  by  oldsters 
to  youngsters  who  listen  only  for  the 
inflection  that  suggests  the  end  of  the 
speech. 


But,  instead  of  telling  you  what  I'm 
not  going  to  talk  about,  it  might  be  more 
to  the  point  to  tell  you  the  subject  of 
this  brief  address.  Because  you  have 
cited  me  for  my  york  in  health  promo- 
tion and  the  care  of  the  sick.  I  think  it 
appropriate  to  say  something  about 
health  —  especially  the  contribution 
the  nurse  makes,  or  could  make  to  it. 
Actually,  this  topic  is  just  about  as 
"global"  as  those  I  have  dismissed,  and 
you  will  see  that  nursing  —  as  I  inter- 
pret it  —  includes  them. 

Although  it  is  the  fashion  —  at  least 
in  the  United  States  —  to  talk  about 
"delivery  of  health  services"  and  the 
roles  of  the  so-called  "professionals," 

MARCH  1971 


"paraprofessionals,"  and  '"indigenous 
workers"  (and  nursing  personnel  fall 
into  all  these  classes),  I  believe  even 
these  terms  fail  to  stress  the  most  im- 
portant health  concept.  They  leave  out 
the  role  of  every  man  —  the  patient  or 
client  with  whose  health  the  whole 
argument  is  concerned. 

The  first  questions  to  be  asked  about 
health  in  each  society  are:  do  its  people 
value  human  life  and  do  they  value 
health  as  a  quality  of  life? 

When  a  society  such  as  ours  in  the 
United  States  spends  about  half  of  its 
public  funds  on  its  military  program, 
and  more  of  its  national  income  on 
tobacco,  liquor,  narcotics,  and  cosmetics 
than  it  does  on  education  or  health; 
when  it  grossly  pollutes  its  urban  envi- 
ronment and  distributes  its  food  sup- 
plies so  unequally  that  some  are  hungry 
—  no  amount  of  health  care  that  all 
health  workers  combined  can  "deliver" 
can  be  more  than  the  application  of  a 
"Band-Aid"  to  a  hemorrhaging  artery 
of  the  society. 

In  other  words,  1  am  saying  that 
respect  for  life  —  and  health  as  a  qual- 
ity of  life  —  is  firry  mans  business 
and  his  most  important  business. 

Collectively,  a  society  must  learn 
how  to  protect  and  conserve  life,  to 
value  a  sane  mind  in  a  healthy  body. 
The  "professionals"  and  "paraprofes- 
sionals" cannot  "deliver"  health  to  a 
society.  What  health  workers  do  as 
citizens  to  create  a  world  in  which  life 
is  conserved  and  health  valued,  is  more 
important  than  their  services  to  those 
in  life's  crises  and  the  loveless  custodial 
care  they  offer  the  chronically  ill  and 
dependent. 

Those  of  us  in  today's  so-called  west- 
ern culture  are  proud  of  having  extended 
the  average  life  span  by  more  than  20 
years  since  1900.  Doctors  and  nurses, 
the  principal  "deliverers"  of  health 
care,  tend  to  point  to  this  accomplish- 
ment as  evidence  of  a  successful  system 
of  medical  care.  But  should  they? 

The  average  life  span  in  the  United 

MARCH  1971 


States,  for  example,  has  risen  from 
about  50  years  in  1900  to  about  71 
years  in  1969,  chiefly  because  infant 
mortality  has  dropped  dramatically  and 
because  children  die  far  less  often  from 
infectious  diseases  in  this  century  than 
in  the  last.  This  drop  in  infant  and 
child  mortality  is  not  so  much  because 
doctors  and  nurses  have  given  good 
medical  and  nursing  care  to  infants 
and  children,  but  because  the  water 
they  drink  and  the  food  they  eat  is 
cleaner,  and  because  protective  sera, 
antibiotics,  and  specific  drugs  have 
been  developed  to  protect  the  young 
against  the  pathogenic  organisms  that 
in  the  last  century  could,  and  sometimes 
did,  wipe  out  even  large  families. 

Those  who  have  so  greatly  increased 
the  life  span  therefore  include  not  only 
doctors  and  nurses,  but  bacteriologists, 
chemists,  sanitarians,  and  legislators 
—  all  who  have  identified  dangers  in 
the  environment,  developed  controlling 
agents,  and  devised  protective  legisla- 
tion. Credit  is  also  due  biological  scien- 
tists and  educators  who  have  raised  the 
general  level  of  nutrition. 

Children  of  this  age  talk  knowingly 
about  food  values,  about  protecting 
teeth  from  decay  and,  in  fact,  about 
health  hazards  and  health  practices 
that  were  unknown  to  our  great-grand- 
parents. What  American  school  child, 
for  example,  would  not  be  aghast  to 
see  a  doctor  spit  on  his  boot,  sharpen 
a  knife,  wipe  it  off  and  lance  a  boil? 
Yet,  I'm  told  this  is  what  the  country 
doctor  did  when  he  treated  the  boys 
in  my  grandfather's  school. 

What  child  of  today  has  not  heard 
the  danger  of  air  pollution  discussed? 
A  six-year  old  friend  of  mine  said  to 
her  brother,  who  was  wishing  dire 
disaster  on  her  as  a  result  of  a  quarrel, 
"I  wish  I  was  pollution  and  you  had 
to  breathe  me." 

Health  care  is  indeed  the  business 
of  every  person.  It  is  the  business  of 
the  humanist;  the  philosopher;  the 
priest;  the  physical,  biological  or  social 


scientist:  the  physician  to  man  and 
beast;  the  specialist  in  any  branch  of 
therapy;  the  nurse;  the  educator;  the 
legislator;  and  the  parent  and  child. 

I  believe  promotion  of  health  is  far 
more  important  than  the  care  of  the 
sick.  I  believe  there  is  more  to  be  gained 
by  helping  every  man  learn  how  to  be 
healthy  than  by  preparing  the  most 
skilled  therapists  for  service  to  those 
in  crises. 

As  a  member  of  five  committees  — 
national,  regional,  and  local  —  all 
working  to  improve  health  science 
libraries,  I  listen  to  endless  discussions 
of  their  functions.  Some  of  us  on  these 
committees  believe  that  every  citizen 
should  have  access  to  what  is  known 
or  has  been  written  about  the  science 
and  art  of  keeping  well,  curing  disease, 
adjusting  to  a  necessary  limitation  of 
living,  or  dying  well  when  the  time 
comes.  Other  members  of  these  li- 
brary committees  seem  to  consider 
the  medical  library  the  possession  of 
a  guild  that  guards  its  secrets!  Oppo- 
sing the  idea  of  the  medical  library 
as  a  public  institution,  one  physician 
said,  "We  have  enough  trouble  with 
our  patients  who  ask  for  treatments 
described  in  the  Readers  Digest!" 

Fortunately,  there  are  always  other 
members  of  these  library  committees 
who  believe  as  I  do  that  the  goal  of 
every  health  worker  should  be  to  help 
those  they  serve  acquire  or  regain  their 
independence.  The  great  beauty  of 
medicine,  to  my  mind,  is  its  ethical 
principle  of  cooperation  as  oppwsed 
to  the  industrial  principle  of  competi- 
tion. A  medical  worker  does  not  patent 
and  protect  his  discovery,  but  freely 
shares  the  knowledge  and  skills  he 
develops  with  all  who  can  use  them. 

So,  in  discussing  health  and  health 
service,  I  believe  the  concept  that  the 
average  man  has  of  health  will  deter- 
mine the  future.  Each  of  us  will  strive 
for  what,  in  our  hearts,  we  value  most. 
We  are  each  the  hero  or  anti-hero  of  our 
lives,  and  the  best  doctor  or  the  best 
THE  CANADIAN  NURSE     33 


nurse  can  only  help  us  reach  the  goal  we 
set  ourselves. 

For  every  health  team  (another  pop- 
ular term)  the  patient  is  really  the  cap- 
tain: if  he  wants  to  stay  sick  or  die, 
the  rest  of  the  team  is  nearly  impotent. 
So  all  health  workers  are  actually  assist- 
ants to  the  patient. 

Under  our  western  system  of  medi- 
cine, the  physician  is  best  prepared 
to  help  the  patient  identify  the  nature 
of  his  illness  or  handicap  and  to  develop 
the  most  effective  therapeutic  plan  or 
regimen  with  him,  his  family,  the 
nurses,  the  social  workers,  and  others 
who  know  the  patient  and  his  setting. 
I  hope  that  some  day  all  countries  will 
have  enough  physicians  to  go  around; 
at  present  the  corner  druggist  is  often 
the  poor  man's  doctor  in  the  United 
States.  Some  physicians  there  —  and 
here  too,  I  believe  —  would  like  to 
turn  over  certain  categories  of  patients 
to  nurses  —  specifically,  the  well  child, 
the  chronically  ill  and  aged,  and  those 
who  must  be  visited  in  their  homes. 

In  Russia,  physician's  assistants  or 
"feldshers"  share  responsibility  for 
diagnosing  disease  and  prescribing 
therapy.  Physicians  (more  than  three- 
quarters  of  them  are  women)  supervise 
the  feldsher  and  the  nurse.  In  Russia, 
nurses  have  no  autonomy  and  there  is 
no  nursing  profession.  In  other  countries 
where  western  medicine  is  practiced, 
the  physician  is  the  authority  on  cure 
and  the  nurse,  the  expert  on  care. 

In  1934,  Ira  A.  Mackay,  then  dean 
of  arts  and  sciences  at  McGill  University 
in  Montreal,  spoke  of  these  two  essen- 
tials: care  (by  the  nurse)  and  cure  (by 
the  physician).  He  added,  "I  do  not 
know  which  is  nobler."  1  would  say, 
I  do  not  know  which  is  more  necessary 
—  or  which  is  more  difficult. 

I  see  nursing  as  a  highly  complex 
service  demanding  broad  social  exper- 
ience and  a  continuing  study  of  the 
physical,  biological,  and  social  sciences. 
I  believe  it  is  the  nurse's  unique  function 
to  help  the  individual,  sick  or  well, 
34     THE  CANADIAN   NURSE 


to  carry  out  those  activities  contributing 
to  health  or  its  recovery,  or  to  a  peace- 
ful death  that  he  would  perform  un- 
aided if  he  had  the  necessary  strength, 
will,  or  knowledge.  I  believe  the  nurse 
should  fulfill  this  function  in  homes, 
hospitals,  schools,  industries,  prisons, 
ships,  or  anywhere  else,  whether  or  not 
a  physician  is  in  attendance. 

This  is  an  elastic  definition,  as  there 
is  infinite  variety  in  the  needs  of  individ- 
uals and  the  circumstances  under  which 
they  must  be  met.  The  nurse  may  have 
to  help  a  woman  deliver  her  baby,  help 
pass  a  tube  into  an  asphyxiated  man's 
windpipe,  or  even  perform  a  tracheot- 
omy. It  includes  helping  a  patient  decide 
whether  or  not  he  needs  a  physician. 

If  a  physician  sees  a  patient  and 
prescribes  for  him,  the  nurse  must  help 
the  patient  understand,  accept,  and 
carry  out  the  treatment.  Notice  I  do 
not  say  the  doctor's  orders,  for  I  ques- 
tion a  philosophy  that  allows  a  phy- 
sician to  give  orders  to  patients  or  other 
health  workers. 

The  nurse's  role  as  just  described, 
requires  her  to  know  the  patient;  to 
get  inside  his  skin,  assess  his  physical 
and  emotional  needs;  to  walk  for  him 
if  he  is  bedfast;  to  speak  for  him  if  he 
is  mute,  or  unconscious;  to  protect  him 
if  he  is  suicidal  until  she  can  help  him 
regain  his  love  of  life. 

When  we  consider  the  difficulty  of 
maintaining  our  own  physical  and  emo- 
tional balance,  we  must  see  that  help- 
ing others  to  do  it  is  indeed  a  complex 
service.  The  nurse  must  constantly 
assess  the  patient's  need  for  strength, 
will,  or  knowledge  and  know  how  to 
withdraw  this  complement  of  any  one 
of  them,  so  that  he  gains  or  regains  his 
independence  as  soon  as  possible.  The 
nurse  must  tailor  her  service  to  the 
patient's  chronological  and  intellectual 
age,  his  life  experience  and  setting,  his 
values,  his  temperament  and  the  lim- 
itations imposed  by  his  handicap  or 
illness.  Since,  in  addition,  she  must  help 
the  patient  or  client  understand  and 


carry  out  the  prescribed  therapy,  the 
nurse  must  be  a  continuing  student  of 
medicine,  for  she  can  teach  only  what 
she  knows. 

Summary 

Although  I  did  not  pretend  to  speak 
as  an  authority  on  any  of  the  major 
threats  to  human  well-being,  1  did  admit 
to  a  deep  concern  about  them  and  ven- 
tured to  say  that  what  each  o.'  us  does 
as  a  citizen  to  help  create  a  world  in 
which  life,  and  health  as  a  quality  of 
life,  is  valued,  is  as  important  —  per-     ] 
haps  more  important  —  than  the  nar-      ' 
rower  task  we  each  set  for  ourselves      ' 
as  members  of  a  profession  or  occupa- 
tion. 

However,  those  of  us  who  elect  the 
ministry,  nursing,  or  medicine  occupy 
a  privileged  place  in  society,  for  it 
never  asks  us  to  perform  a  destructive 
act.  On  the  contrary,  we  are  expected 
to  help  the  sinner  as  we  might  the  saint, 
to  serve  the  hypothetical  enemy  as  we 
might  our  own  people.  We  profess  a 
non-judgmental  cooperative  ethic, 
which,  if  generally  adopted,  might 
transform  society. 

Mark  Twain,  in  some  of  his  more 
audacious  writings,  published  posthu- 
mously, seems  to  despair  of  the  human 
race.  However,  he  described  a  brief 
period  of  history  when  "bottled 
thought"  was  available  to  all,  and  dur- 
ing this  period  there  were  no  wars.  He 
claimed  the  formula  was  lost  and  with 
it  all  its  beneficent  effects.  But  here, 
I  think,  he  left  out  of  his  argument  the 
power  of  emotion. 

If  society  needs  "bottled  thought," 
it  also  needs  "bottled  compassion." 
Thought  without  emotion  is  cold  and 
harsh,  and  emotion  without  thought 
is  maudlin.  If  we  could  bring  into  public 
affairs  the  ethical  concepts  health  work- 
ers profess,  we  might  have  justice  tem- 
pered by  mercy.  And  no  individual  or 
nation  would  be  considered  outside  the 
pale,  as  far  as  our  obligation  to  help 
is  concerned.  § 

MARCH  1971 


Mind-body  relationships  in 
gastrointestinal  disease 


Often  it  is  difficult  to  demonstrate  a  causal  relationship  between  a  patient's  emotional 

upset  and  the  disease  state.  The  author  describes  this  complexity  and  some  of  the 

diseases  believed  to  be  caused  or  aggravated  by  emotion. 


D.  |.  Buchan,  M.D.,  F.R.C.P.  (C) 


Emotional  upset,  such  as  worry  or  fear, 
has  been  recognized  as  a  cause  of  gas- 
trointestinal disturbances  in  literature 
and  folklore  for  centuries.  In  the  twen- 
tieth century,  beginning  with  the  work 
of  Professor  Cannon  and  his  colleagues 
at  Harvard,  attempts  have  been  made 
to  relate  more  closely  specific  emotional 
upsets  or  personality  characteristics 
to  gastrointestinal  diseases.  These 
attempts  have  been  imperfect  because 
of  the  complex  nature  of  the  problem. 
The  relationship  is  often  seen  in  the 
clinical  situation  as  the  simultaneous 
occurrence  in  time  of  an  emotional 
disturbance  and  a  gastrointestinal  dis- 
ease or  symptom. 

There  are  three  possible  explana- 
tions for  this  simultaneous  occurrence: 
first,  the  emotional  event  caused  the 
gastrointestinal  upset;  second,  the  gas- 
trointestinal upset  caused  the  emo- 
tional upset;  or  third,  there  was  no 
causal  relationship  between  the  two. 
We  see  all  three  situations  occurring 
in  patients  with  gastrointestinal  com- 
plaints, and  appropriate  management 
of  the  patient's  problem  depends  on 
the  accurate  recognition  of  which  situa- 
tion is  present. 

The  problem  is  complicated  by  the 
variety  of  bodily  responses  to  an  emo- 
tional upset  or  life  stress.  This  response 
may  be  seen  as  a  change  in  organ  struc- 
ture or  a  change  in  organ  function 
without  any  recognizable  structural 
change.  We  tend  to  call  this  latter  type 
MARCH  1971 


Dr.  Buchan  is  with  the  Department  of 
Medicine.  University  of  Saskatchewan. 
Saskatoon,  Saskatchewan. 

of  resfxjnse  "functional"  or  "neurotic," 
depending  on  our  own  orientation  and 
value  judgments. 

The  psychological  disturbance  in 
other  circumstances  leads  to  changes 
in  organ  structure,  a  process  commonly 
referred  to  as  "psychosomatic."  Actu- 
ally, it  is  incorrect  to  view  the  patients 
response  as  either  "psychic"  or  "somat- 


ic" exclusively,  as  the  total  response  of 
any  patient  is  usually  compounded  of 
both  psychic  and  bodily  elements  in 
varying  degrees.  It  may  be  of  some  help 
in  understanding  and  dealing  with  the 
patient's  gastrointestinal  problem  to 
decide  whether  the  psychological  prob- 
lem initiated  structural  bodily  change, 
or  whether  some  change  in  body  struc- 
ture caused  a  change  in  the  patient's 
psychological  responses. 

The  study  of  psychosomatic  diseases 
of  the  gastrointestinal  tract  has  been 
difficult  because  of  our  inability  to 
demonstrate  a  causal  relationship  be- 
tween the  emotional  upset  and  the 
disease  state.  We  have  no  final  proof 
that  the  diseases  discussed  in  this  ar- 
ticle are  psychosomatic;  however, 
clinical  experience  seems  to  indicate 
that  in  these  states  an  emotional  com- 
ponent is  often  a  major  factor  and,  as 
such,  should  be  recognized  and  if 
possible  dealt  with  adequately. 

In  most  psychosomatic  diseases  in 
which  there  is  a  definite  structural 
change,  such  as  ulcerative  colitis  or 
duodenal  ulcer,  controversy  has  arisen 
about  the  nature  of  the  process,  with 
mechanisms  other  than  psychologic 
being  implicated  by  some  observers. 
It  is  possible  those  symptoms  consid- 
ered functional  are  due  to  a  molecular 
disturbance  that  is  not  seen  as  a  change 
in  structure  by  our  present  diagnostic 
methods.  A  significant  practical  im- 
plication of  structural  change  is  that 
THE  CANADIAN   NURSE     35 


PSYCHIC 
FACTORS 


SOMATIC 
FACTORS 


PATIENT  A 


ENTB 


in  most  cases  it  carries  a  more  serious 
prognosis  of  morbidity  or  mortality 
than  purely  "functional"  syndromes. 

An  important  concept  in  understand- 
ing the  cause  of  psychosomatic  diseases 
is  that  of  variation  of  the  contribution 
of  psychic  or  somatic  factors  in  any 
given  patient.  The  figure  above  illus- 
trates this  concept.  Patient  A,  with  any 
given  disease,  such  as  ulcerative  colitis, 
may  be  thought  of  as  having  major  psy- 
chologic components  —  for  example, 
the  loss  of  an  important  figure  —  and 
minor  somatic  components.  Conversely, 
Patient  B  has  minor  psychological  fac- 
tors and  major  somatic  factors,  such 
as  hypersensitivity,  genetic  predisposi- 
tion, and  so  on.  Such  a  scheme  can  be 
expanded  to  include  in  the  psychic  ef- 
fects, social  and  cultural  factors;  and 
on  the  somatic  side,  genetic  predis- 
position, hypersensitivity,  and  physical 
environmental  factors  leading  to  tissue 
change. 

The  following  discussion  will  deal 
first  with  those  situations  in  which 
there  is  no  structural  change,  that  is, 
functional  gastrointestinal  responses 
and,  second,  where  structural  change 
is  present  either  as  a  consequence  ot 
emotional  factors  or  as  a  cause  of  psy- 
chological upset. 

Functional  Gl  syndromes 
without  change  in  organ  structure 

Glossodynia 

Sore  or  burning  tongue  without 
evidence  of  any  change  in  the  epithel- 
ium of  the  tongue  is  seen  most  frequent- 
ly in  middle-aged  women.  It  is  often  ac- 
companied by  some  evidence  of  depres- 
sion and  occasionally  by  decreased 
salivary  flow.  Antidepressive  drugs 
or  tranquilizers  may  help,  but  the  symp- 
tom tends  to  persist. 
36     THE  CANADIAN   NURSE 


Disturbances  in  Swallowing 

Globus  hystericus  is  characterized 
by  complaints  of  a  sense  of  constriction 
or  a  "lump"  in  the  throat  not  unlike 
that  associated  with  grief.  There  is 
difficulty  in  a  "dry"  swallow,  but  none 
with  either  solid  foods  or  fluids. 

Diffuse  esophageal  spasm  leads  to 
temporary  difficulty  in  swallowing 
foodstuffs  and  often  burning  retro- 
sternal pain.  This  may  occur  in  sit- 
uations the  patient  is  unable  to  accept 
or,  in  organ  language,  "to  swallow." 

Aerophagia 

Excessive  gaseousness  with  swallow- 
ing of  air  and  often  loud  belching  is 
most  often  a  functional  symptom.  Al- 
though traditionally  "flatulent  dyspep- 
sia" is  associated  with  gall  bladder  dis- 
ease, patients  with  aerophagia  and 
belching  as  the  main  symptoms  are 
seldom  found  to  have  organic  disease. 

Psychogenic  Vomiting 

Nausea  and  vomiting  accompany  a 
variety  of  emotional  disturbances  and 
are  rarely  severe  enough  to  threaten 
life  by  loss  of  potassium  with  conse- 
quent hypokalemia  and  muscular  paral- 
ysis. Pernicious  vomiting  of  pregnancy 
may  be  a  psychologic  rejection  of  that 
pregnancy;  conversely,  psychogenic 
vomiting  may  accompany  pseudocyesis 
or  false  pregnancy  in  some  patients. 
Occasionally  a  husband  responds  to  his 
wife's  pregnancy  by  vomiting  in  the 
morning. 

Disturbances  of  Food  Intake 

Anorexia  nervosa,  in  which  food 
intake  may  be  reduced  by  refusal  to 
eat  or  by  induced  vomiting,  is  a  well- 
recognized  syndrome  in  adolescent 
girls.  Psychologically  it  appears  to  be 
a  rejection  of  the  feminine  role  by 
inducing  a  malnourished,  non-feminine 


body  image  and  amenorrhea.  The 
indifference  of  the  patient  to  her  obvi- 
ous wasting  is  characteristic,  with  com- 
pulsive exercising  adding  to  the  weight 
loss. 

One  of  the  commonest  causes  of 
decreased  appetite  and  weight  loss 
is  depression.  In  any  patient  with  these 
symptoms,  the  other  characteristics  of 
depression,  such  as  feelings  of  guilt 
and  worthlessness,  early  morning  wak- 
ing, and  constipation,  should  be  sought. 

There  are  many  minor  forms  of 
appetite  suppression  caused  by  psycho- 
logic factors.  The  "picky"  eater,  both 
in  child  and  adult  forms,  may  attempt 
to  dominate  and  influence  others  in  his 
environment  by  food  rejection  and  a 
failure  to  thrive. 

Abdominal  Pain 

There  are  many  varieties  of  abdom- 
inal pain  associated  with  psychological 
upheaval,  but  only  a  few  will  be  dealt 
with  here.  Motility  disturbance  of  the 
stomach  with  increased  tonus  is  ac- 
companied by  epigastric  burning,  in- 
distinguishable from  that  caused  by 
peptic  ulcer. 

Steady  pain,  particularly  at  the  co- 
lonic flexures,  may  be  associated  with 
irritable  colon ;  other  patients  sometimes 
have  diarrhea  and  suffer  more  from 
intestinal  colic.  These  abdominal  pains, 
which  seem  to  be  related  to  motility 
disturbances,  are  sometimes  referred 
to  as  "imaginary,"  but  may  be  severe 
enough  to  lead  to  narcotic  addiction. 

Disturbances  of  Colonic  Function 

The  syndrome  called  irritable  col- 
on is  thought  to  be  due  in  part  to  factors 
of  tension  and  anxiety,  and  is  charac- 
terized by  diarrhea,  constipation,  ab- 
dominal pain,  and  excess  mucus  in  the 
stools.  Any  of  these  symptoms  may 
be  present  alone  or  in  combination. 
Frequently  the  bowel  symptoms  are 
only  part  of  a  multi-system  response 
to  stress,  with  headache,  chest  pain, 
palpitation,  and  so  on,  also  present. 

Constipation  may  occur  alone,  with- 
out any  other  irritable  colon  symptoms; 
it  often  is  found  in  patients  who  are 
precise,  over  meticulous,  and  constrict- 
ed in  their  approach  to  life.  As  noted 
previously,  constipation  may  be  the 
presenting  symptom  in  the  depressed 

MARCH  1971 


patient  who  is  middle-aged  or  elderly, 
and  is  best  treated  by  relief  of  the  de- 
pression. 

Psychosomatic  diseases 

with  change  in  organ  structure 

The  first  group  consists  of  diseases 
that  seem  to  follow  or  are  caused  by  a 
psychological  disturbance.  These  dis- 
eases include  duodenal  ulcer,  ulcerative 
colitis,  regional  enteritis,  and  celiac 
disease. 

Duodenal  Ulcer 

The  evidence  for  some  relationship 
between  stress  and  duodenal  ulcer  is 
derived  from  experimental  studies, 
epidemiological  surveys,  and  clinical 
experience.  Experimental  studies  on 
human  gastric  function  have  shown 
that  emotions,  such  as  anger,  hostil- 
ity, and  resentment,  may  increase  the 
secretion  of  hydrochloric  acid  and 
susceptibility  of  the  mucosa  to  ulcera- 
tion. As  patients  with  duodenal  ulcer 
show,  on  the  average,  double  the  hydro- 
chloric acid  secretion  than  normal,  it  is 
believed  that  stress  may  cause  ulcer 
by  increased  hydrochloric  acid  secretion 
and  decreased  mucosal  resistance  to 
ulceration. 

Studies  of  population  groups  in- 
volved in  stressful  occupations  or  sub- 
jected to  increased  environmental  stress 
provide  some  evidence  of  an  increased 
incidence  of  peptic  ulcer.  Clinical 
studies  have  shown  in  some  patients 
with  duodenal  ulcer  the  onset  and  ex- 
acerbation of  their  disease  with  stress. 
Some  attempts  have  been  made  to 
define  a  "personality  type"  in  patients 
with  ulcer,  but  this  has  been  unsuc- 
cessful. 

Ulcerative  Colitis 

The  literature  on  the  relationship 
of  life  stress  to  ulcerative  colitis  is 
extensive  but  inconclusive.  There  are 
studies  of  individual  patients  that 
describe  conflicts  over  dependency 
with  consequent  hostility  being  related 
to  the  onset  of  colitis.  Others  have 
described  the  loss  of  an  impwrtant  figure 
in  the  patient's  life  as  a  precipitant  of 
this  disease.  Recent  studies  of  large 
groups  of  patients  with  colitis  seem 
to  indicate  that  these  patients  are  no 
different,  either  qualitatively  or  quanti- 
MARCH   1971 


tatively,  in  their  response  to  life  stress 
than  a  control  group. 

The  patient  with  colitis  often  displays 
an  inability  to  establish  meaningftil 
relationships  with  others,  hostility, 
excessive  dependency,  and  depression; 
but  whether  these  charactristics  are  a 
cause  of  the  disease  or  a  result  remains 
unresolved.  Certainly  some  of  these 
characteristics,  such  as  depression, 
disappear  with  succesful  medical  or 
surgical  treatment  of  the  colitis.  The 
present  position  of  regional  enteritis  as 
a  stress-related  disease  is  much  the 
same  as  ulcerative  colitis. 

Celiac  Disease 

Some  have  claimed  that  exacerba- 
tions of  celiac  disease  are  related  to 
stress.  However,  the  underlying  prob- 
lem is  the  genetically-determined  sen- 
sitivity of  the  small  bowel  epithelium 
to  the  cereal  protein,  gluten,  in  the 
diet.  Since  this  predisposition  persists 
throughout  life  despite  periods  of  good 
health  without  symptoms,  stress  may 
indeed  be  the  added  factor  causing 
symptoms. 

Organic  Disease 

With  Psychologic  Manifestations 

The  second  group  consists  of  dis- 
eases with  structural  changes  that  lead 
to  psychological  symptoms.  As  noted 
before,  some  of  the  psychological  symp- 
toms in  patients  with  ulcerative  colitis 
may  be  caused  by  the  activity  of  the 
colitis.  An  interesting  example  of  this 
kind  of  relationship  is  pancreatic  car- 
cinoma, in  which  a  significant  propor- 
tion of  patients  show  depression  before 
any  physical  manifestations  of  the 
carcinoma  are  obvious. 

Perhaps  related  to  this  group  of 
patients  with  underlying  structural 
disease  are  those  who  continue  to  have 
problems  following  surgery,  such  as 
gastrectomy  or  colectomy  with  ileosto- 
my. Some  post-gastrectomy  patients 
complain  of  weakness,  fatigue,  and 
abdominal  discomfort  following  eating. 
There  is  some  evidence  that  these  symp- 
toms may  be  more  related  to  psycho- 
logic maladjustments  than  to  any  in- 
trinsic defect  in  the  surgical  procedure. 
A  careful  appraisal  of  the  patient's 
total  Hfe  situation,  his  expectations  from 


the  operation,  and  the  real  cause  of  his 
symptoms  is  necessary  if  optimal  results 
are  to  be  gained  from  surgery. 

Many  patients  with  the  so-called 
post-cholecystectomy  syndrome  com- 
plain of  abdominal  pain,  dyspepsia,  and 
nausea,  which  continue  after  removal 
of  the  gall  bladder.  Often  these  patients 
have  a  functional  illness  with  the  chole- 
lithiasis being  incidental,  so  removal 
of  the  gall  bladder  is  ineffective  in 
controlling  the  symptoms. 

Complete  colectomy  with  construc- 
tion of  an  ileostomy  presents  the  pa- 
tient with  a  major  adjustment,  and 
certainly  some  of  the  ileostomy  prob- 
lems relate  to  his  psychological  rejec- 
tion of  the  stoma.  In  general,  the  more 
the  patient's  life  has  been  disrupted 
by  illness,  diarrhea,  or  incontinence 
before  colectomy,  the  more  likely  he 
will  adjust  to  ileostomy  life.  Again, 
preoperative  explanation  and  educa- 
tion may  prevent  many  ileostomy  prob- 
lems. 

Treatment 

Rational  treatment  depends  on  our 
ability  to  analyze  and,  if  possible,  cor- 
rect the  various  factors  causing  the 
patient's  symptoms.  In  some  psycho- 
somatic diseases  such  as  ulcerative 
colitis,  where  there  are  major  nutri- 
tional disturbances,  appropriate  mana- 
gement includes  physical  and  psycho- 
logical therapy. 

Subtle  or  overt  rejection  of  the  pa- 
tient with  functional  disease  by  those 
caring  for  him  is  often  an  impediment 
to  successful  therapy.  This  rejection 
may  be  potentiated  by  the  patient's 
hostility  resulting  from  the  dependency 
induced  by  his  disease  or  as  a  more 
basic  response  in  his  life  adjustment. 
On  occasion  one  sees  a  distinct  change 
in  the  attitudes  of  nurses  and  physicians 
toward  a  patient  thought  to  have  a 
functional  problem  when  organic  dis- 
ease is  discovered.  The  patient  is  ac- 
cepted as  having  a  "real"  problem  when 
his  irritable  colon  symptoms  are  found 
to  be  due  to  a  carcinoma  of  the  colon. 

If  we  are  to  help  the  patient,  we  must 
see  him  as  a  whole,  with  his  symptom 
or  disease  process  as  the  result  of  many 
different  forces  exerted  through  physi- 
cal and  psychological  pathways.  ^ 
THE  CANADIAN   NURSE     37 


Care  of  patients  with 
G.I.  diseases  that  have 
a  psychological  component 

". . .  what  is  in  us  must  out;  otherwise  we  may  explode  at  the  wrong  places  or 
become  hopelessly  hemmed  in  by  frustrations."*  The  "wrong  places"  at  which 
we  may  explode  can  be  the  mucosal  lining  of  the  duodenum  or  the  small  bowel; 
our  "hopeless  frustrations"  may  be  manifested  by  an  irritated  colon,  chronic 
diarrhea,  or  an  aversion  to  food.  The  patient  who  presents  a  gastrointestinal 
disease  that  relates  in  some  way  to  anxiety  or  neurosis  requires  the  nurse's 
skill  and  ingenuity. 


Gloria  Mowchenko,  B.S.N. 

What  is  within  a  person,  that,  if  denied 
expression,  turns  into  a  destructive 
force  and  sends  him  to  hospital,  com- 
plaining of  pain,  discomfort,  and  an 
inability  to  meet  his  need  for  adequate 
nutrition?  How  can  we  understand  this 
"stress  response"  in  the  patient,  and 
how  can  we  help  him  cope  with  this 
response? 

Stress,  as  described  by  Selye,  is  a 
condition  that  reveals  itself  by  meas- 
urable changes  in  the  organs  of  the 
body.^  In  conditions  affecting  the  gas- 
trointestinal tract  of  an  individual,  the 
stress  response  may  be  a  manifestation 
of  unhealthy  ways  of  relating  to  other 
persons  or  of  reacting  to  situations. 
For  example,  the  person  with  a  peptic 
ulcer  has  been  described  as  meticulous, 
perfectionistic,  ambitious,  and  driving. 
He  may  be  unable  to  resolve  the  con- 
flict between  what  he  wants  to  do 
and  what  he  can  do,  and  contains  the 
frustration    and    resentment    resulting 


Miss  Mowchenko  obtained  her  B.S.N, 
degree  from  the  University  of  Saskat- 
chewan School  of  Nursing,  where  she  Is 
a  lecturer  in  fundamentals  of  nursing. 

*  Hans  Selye,  The  Stress  of  Life,  New 
York,  McGraw-Hill.  1956,  p.  269. 


38     THE  CANADIAN   NURSE 


from  this  conflict  within  his  growing 
"pot  of  hostility." 

The  individual  who  develops  ulcer- 
ative colitis  may  be  dependent,  con- 
trolled, sensitive,  and  fastidious.  He 
may  be  unable  to  be  aggressive  and 
angry,  translating  these  emotions  in- 
stead into  diarrhea.  Indeed,  he  may 
succeed  so  well  in  hiding  the  anger 
and  frustration  he  feels,  that  he  con- 
vinces himself  his  condition  is  due  to 
physical  causes  only.  He  may  discuss 
freely  the  frequency  of  his  bowel  move- 
ments, the  relative  merits  of  his  medi- 
cations, or  his  special  bland  diet,  but 
not  give  vent  to  feelings  he  has  long 
suppressed. 

The  challenge 

Here,  then,  is  the  challenge  to  the 
nurse  who  cares  for  these  patients: 
to  help  them  identify  and  accept  their 
feelings  and  to  encourage  their  expres- 
sion. 

The  nurse's  approach  is  based  on 
the  concept  that  all  behavior  is  mean- 
ingful to  the  individual  expressing  it. 
If  she  realizes  the  individual  is  the  sum 
total  of  all  his  experiences  and  that  he 
reacts  to  stressful  situations  in  ways 
that  lessen  unbearable  anxiety,  she 
will  understand  that  the  diarrhea  of 
ulcerative  colitis  may  represent  a  sit- 

MARCH  1971 


MARCH  1971 


uation  where  anger  was  felt,  but  the 
patient  could  not  become  angry. 

During  hospitalization,  the  patient 
needs  to  feel  safe  from  the  stresses 
that  may  have  precipitated  his  illness. 
Although  his  demands  for  attention 
and  his  dependency  may  tax  the  nurse's 
patience,  she  should  be  protective  and 
gentle  in  her  ministrations  to  him. 
When  trust  has  been  gained,  she  can 
help  him  identify,  explore,  and  accept 
some  of  his  feelings.  He  may  not  be 
able  to  settle  his  conflict,  but  he  may 
learn  to  turn  the  anger  to  the  outside 
where  it  can  dissipate,  rather  than  keep 
it  inside  where  it  can  destroy. 

Along  with  the  nurse's  expressive 
functions  goes  the  important  task  of 
administering  the  patient's  medical  or 
surgical  regimen.  His  cooperation  is 
essential,  and  depends  on  his  under- 
standing of  the  treatment  and  its  im- 
portance. Sometimes  the  nurse  and 
other  members  of  the  health  team  are 
thwarted  in  their  attempts  to  help  the 
patient  get  better,  as  he  may  reject  the 
treatment  program,  apparently  denying 
the  fact  of  his  illness.  This  patient  poses 
an  extra  challenge  to  those  giving  him 
care,  as  they  have  to  deal  first  with 
their  own  anger  and  frustrations,  caus- 
ed by  their  inability  to  help. 

Just  being  sick 

The  physical  aspects  of  caring  for 
the  patient  with  a  gastrointestinal 
disease  associated  with  anxiety  or  neu- 
rosis include:  planning  for  nutritious 
food  and  fluid  intake;  general  and 
specific  measures  for  hygiene;  and 
those  activities  that  relieve  pain  and 
promote  comfort  for  the  patient  plagued 
by  cramps,   tenesmus,  and  weakness. 

Of  prime  importance  is  the  patient's 
need  for  rest,  a  need  that  Selye  notes 
is  present  in  all  illnesses  where  the 
stress  response  is  evident  or  in  the 
syndrome  of  "just  being  sick."^  Rest 
is  needed  to  allow  an  ulcer,  a  diseased 
colon,  or  a  damaged  spirit  to  heal. 

If  surgical  intervention  is  necessary, 
the  nurse  helps  to  create  a  climate  in 

THE   CANADIAN   NURSE     39 

% 


which  the  patient  can  clarify  his  under- 
standing of  the  procedures.  He  and  his 
family  may  require  specific  informa- 
tion and  instruction  about  habits  of 
elimination,  skin  care,  and  the  use  of 
appliances,  such  as  colostomy  or  ileos- 
tomy bags. 

The  story  of  Lynn 

Share  with  me  the  story  of  Lynn, 
a  15-year-old,  deaf  since  birth,  who 
had  developed  a  clinging  dependency 
on  an  oversolicitous  mother,  an  inabili- 
ty to  function  socially  with  her  peers, 
and  an  intractable  case  of  ulcerative 
colitis.  That  her  colitis  related  to  her 
unhealthy  patterns  of  reacting  to  stress- 
ful situations  was  evident  during  hos- 
pitalization: her  relatively  quiescent 
bowel  would  become  inflamed  and  dis- 
charge frequent,  loose,  bloody  stools 
when  her  mother  visited  and  encourag- 
ed her  child's  dependency  on  her. 

To  help  this  child,  we  tried  to  create 
a  consistent  approach  by  the  nursing 
staff:  patiently,  Lynn's  nurses  treated 
her  with  firmness,  gentleness,  and  kind- 
ness. She  was  encouraged  to  help  carry 
out  her  own  care  and  keep  her  room 
neat. 

Slow  improvement  was  noted,  which 
was  sufficient  to  warrant  Lynn's  dis- 
charge from  hospital  after  several  weeks. 
She  was  readmitted  a  few  days  later, 
however,  with  severe  rectal  hemorrhag- 
ing. An  abdominal-perineal  resection 
and  ileostomy  were  performed  as  life- 
saving  measures. 

What  conflicts  were  there  in  this 
mother-daughter  relationship  and  in 
other  relationships  in  the  home  to  pre- 
cipitate such  severe  symptoms  in  Lynn? 
What  feelings  was  she  unable  to 
express  and  transferred,  instead,  into 
organic  changes'.'  What  part  did  her 
deafness  play  in  her  total  adjustment 
to  growing  up  and  to  life?  Here  we 
can  guess,  perhaps  with  some  accuracy, 
the  relationships  between  the  mind  and 
body  components  of  Lynn's  disease; 
but  these  remain  guesses,  not  proven 
facts.  As  mentioned,  the  causal  relation- 
40     THE  CANADIAN   NURSE 


ship  between  the  emotional  upset  and 
the  disease  state  has  not  been  clarified 
in  the  classical  case  of  ulcerative  colitis. 

Following  surgery,  Lynn  required  a 
great  deal  of  her  nurse's  time,  patience, 
and  tact  in  dealing  with  all  aspects  of 
care.  She  transferred  her  dependency 
from  her  mother  to  her  nurse  and  be- 
came reluctant  to  move,  sit  up,  or  take 
fluids  without  the  nurse's  sustaining 
presence  at  her  side.  She  wept  at  the 
merest  disturbance  in  her  room,  at 
every  adjustment  made  in  her  intrave- 
nous infusion,  every  blood  pressure 
check,  every  suggestion  that  she  move 
her  legs  or  change  position. 

Again,  through  a  patient,  consistent 
approach,  Lynn  developed  trust  in  her 
nurses  and  was  able  to  tolerate  even  the 
dressing  changes  with  equanimity.  She 
gradually  replaced  some  of  her  tears 
with  smiles,  and  began  to  ask  hesitant 
questions  concerning  her  incisions. 

It  was  evident  that  little  concrete 
progress  could  be  made  toward  the 
goal  of  having  this  patient  identify 
and  verbalize  strong  negative  feelings 
until  her  physical  condition  became 
less  of  a  primary  concern.  Certainly 
the  establishment  of  a  protective, 
accepting  atmosphere  was  helpful  in 
calming  some  of  her  more  overt  fears. 
The  nurses  who  cared  for  her  believed 
they  had  gained  her  trust  and  that  she 
had  matured  somewhat  during  her 
hospital  stay. 

Throughout  both  of  Lynn's  hospital- 
ization periods,  attempts  were  made 
to  involve  family  members  in  her  care. 
A  surprising  ally  was  discovered  in  her 
younger  sister,  who  seemed  to  possess 
the  maturity  that  Lynn  lacked.  She  was 
the  one  who  was  able  to  reassure  Lynn, 
calmly  and  in  a  matter-of-fact  tone, 
and  help  her  comply  with  the  treatment 
program.  Projected  plans  for  follow- 
up  care  in  the  home  involved  this  sister 
because  she  showed  a  desire  and  an 
inclination  to  help.  However,  we  con- 
tinued to  attempt  to  improve  the  re- 
lationship between  Lynn  and  her  mo- 
ther, as  we  believed  she  could  prove 


to  be  the  most  significant  figure  in 
Lynn's  total  adjustment  to  her  illness. 

Another  guide 

Perhaps  Selye's  concepts  of  stress 
can  provide  us  with  yet  another  guide- 
line as  we  strive  to  understand  the  mind- 
body  relationships  in  gastrointestinal 
disease.  If  man's  ultimate  aim  is  to 
express  himself  as  fully  as  possible, 
according  to  his  own  lights;  and  if  the 
goal  is  certainly  not  to  avoid  stress  as 
stress  is  part  of  life,  then  to  express 
himself  fully,  he  must  first  find  his 
optimum  stress  level,  and  then  use  his 
adaptation  energy  at  a  rate  and  in  a 
direction  adjusted  to  the  innate  struc- 
ture of  his  mind  and  body.  ^ 

Can  we  help  our  patients  express 
themselves  as  fully  as  possible?  Can 
we  help  them  find  the  best  way  to  use 
their  adaptation  energy?  Can  we, 
and  will  we,  let  them  grow?  If  we  are 
to  help  the  patient  with  a  gastrointes- 
tinal disease  that  has  a  psychological 
component,  our  answers  to  these 
questions  must  be  in  the  affirmative. 

References 

l.Selye,  Hans.  The  Stress  of  Life.  New 
York,  McGraw-Hill,  1956,  p.  54. 

2.  Ibid.,  p.  26. 

3.  Ibid.,  pp.  299-300. 

Bibliography 

Beland,  Irene  L.  Clinical  Nursing:  Patho- 
physiological and  Psychosocial  Ap- 
proaches 2ed.  London,  Ont.,  Collier- 
Macmillan,  1970,  pp.  497-528. 

DeLuca,  Jeanne  C.  The  ulcerative  colitis 
personality.  Nursing  Clinics  of  North 
America.  5:1:23-33.  March  1970. 

Gregg,  Dorothy.  Reassurance.  In  Skipper, 
James  K.  and  Leonard,  Robert  C,  So- 
cial Interaction  and  Patient  Care. 
Philadelphia,  Lippincott,  1965,  pp. 
127-136.  -§> 


MARCH   1971 


idea 
exchange 


Library  service  widens  horizons  for  "shut-ins" 


Librarians  wiio  make  house  calls?  In 
Toronto,  you'll  find  them  —  as  part 
of  a  special  service  offered  by  the 
Toronto  Public  Libraries. 

This  type  of  service  is  especially 
designed  for  those  who  are  too  old 
to  go  out  or  for  those  who  are  not  ill 
enough  to  be  confined  to  hospital,  yet 
not  well  enough  to  leave  their  homes. 
Many  of  these  people  live  alone,  and 
for  them  the  days  can  be  endless. 
Although  friends  and  neighbors  may 
come  to  visit  or  to  bring  necessities 
such  as  groceries  and  medicines,  it 
may  be  difficult  to  ask  them  for  more 
service  —  to  bring  books  from  the 
library.  This  may  seem  an  unnecessary 
imposition. 

Since  September  1970,  there  has 
been  no  problem  for  shut-ins  to  get 
reading  material.  The  shut-in  service 
operated  by  the  Travelling  Branch  of 
the  Toronto  Public  Libraries  provides 
a  regular  delivery  service  every  three 
weeks  for  those  who  cannot  go  to  the 
library  themselves.  Margaret  Garstang 
and  Jack  McGinnis  visit  homes  from 
Monday  to  Friday,  and  after  only  a 
few  months  of  traveling  can  count  more 
than  100  persons  among  their  regular 
borrowers  of  books.  The  number  is 
constantly  growing,  and  the  station 
wagon  that  serves  as  a  delivery  van 
may  soon  be  too  small. 

The  service  is  free  to  any  resident 
of  the  City  of  Toronto  who  has  been 
confined  to  his  home  for  three  months 
or  more  because  of  age  or  illness.  As 
in  a  library  branch,  any  reasonable 
number  of  books  may  be  borrowed  for 
the  three-week  period.  Fiction,  non- 
fiction,  foreign-language  books,  and 
books  in  large  print  are  most  sought 
after. 

Individuals  may  telephone  to  request 
service,  but  referrals  from  doctors, 
nurses,  social  workers,  clergy,  friends, 

Mrs.  Millen  is  publicity  and  public  rela- 
tions officer  of  the  Toronto  Public  Li- 
brary, 40  St.  Clair  Ave.  East.  Toronto 
290.  Ontario. 

MARCH  1971 


Vivian  Millen,  B.A.,  B.|. 

or  relatives  are  welcomed  by  the  li- 
brary. Doctors,  nurses,  and  visiting 
nursing  associations  have  been  of 
particular  help  in  making  referrals  and 
have  commented  on  the  value  of  this 
service. 

Borrowers  of  books  are  of  any  age 
from  20  to  90  years;  live  anywhere 
from  the  expensive  residences  of  Rose- 
dale  and  Forest  Hill  to  the  low  rent 
apartment  blocks  of  Moss  Park  and 
Regent  Park;  and  read  anything  from 
history  and  philosophy  to  mystery  and 
westerns. 

The  librarian's  visit  often  seems 
just  as  important  as  the  books  borrow- 
ed. The  personal  attention,  the  time 
and  care  in  selecting  books  to  suit  the 
reading  tastes  of  each  individual  are 
rewarded  by  the  warm  "Hello,  come 
in,"  when  the  next  visit  is  made.  Without 
doubt,  the  shut-ins  are  among  the  most 
appreciative  of  any  borrowers  to  whom 
the  Toronto  Public  Libraries  provide 
service. 


Jack  McGinnis  of  the  Toronto  Public 
Libraries  "Shut-In"  Service  staff  sorts 
books  for  residents  of  an  Ontario  Hous- 
ing Project  in  downtown  Toronto. 


Robert  Lefevre,  a  frequent  borrower,  browses  through  the  selection  of  books 
brought  for  him .  ^ 

THE  CANADIAN   NURSE     41 


Auditors'  Report 


CANADIAN    NURSES'    ASSOCIATION 
BALANCE  SHEET 

as  at  December  31,  1970 
(with  comparable  figures  at  December  31,  1969) 

ASSETS 

Current  Assets  1970  1969 

Cash  in  bank  —  current  account        $  32,480  $  17,398 

—  savings  account  —  5V2%   186,705  223,904 

—  short  term  deposits  plus  accrued  interest    104,060  203,020 

Accounts  receivable   32,760  20,784 

Membership  fees  receivable  141,932  33,260 

Prepaid   expenses   9,398  10,118 


Sundry  Assets 

Marketable  securities  —  at  cost  

(Quoted  value  $10,981;  1969  —  $12,205) 
Loans  to  member  nurses  


Fixed  Assets 

C.N.A.  House  —  land  and  building  —  at  cost  less 

accumulated  depreciation  on  building  647,401 

Furniture  and  fixtures  —  at  nominal  value  


507,335 

508,484 

3,779 
18,465 

3,779 
17,565 

22,244 

21,344 

647,401 
1 

679,268 
1 

647,402 

679,269 

1,176,981 

1,209,097 

Approved  by  the  Board: 

MISS  E.  LOUISE  MINER  President 

DR.  HELEN  K.  MUSSALLEM  Executive  Director 


42     THE  CANADIAN  NURSE  MARCH  1971 


Auditors'  Report 


CANADIAN  NURSES'  ASSOCIATION 
BALANCE  SHEET 

as  at  December  31,  1970 
(with  comparable  figures  at  December  31,  1969) 

LIABILITIES 

Current  Liabilities  1970  1969 

Accounts  payable  and  accrued  liabilities      $  36,448     $  97,443 

Unearned  subscription  revenues  24,900         24,750 


Mortgage  Payable  —  6  V4%  due  1976  —  repayable  in  blended  monthly  instalments  of 
$3,548  including  principal  and  interest  


Surplus 


61,348 

122,193 

413,479 

428,001 

702,154 

658,903 

1,176,981 

1,209,097 

We  have  examined  the  balance  sheet  of  the  Canadian  Nurses'  Association 
as  at  December  31,  1970  and  statement  of  income  and  surplus  for  the  year  then 
ended.  Our  examination  included  a  general  review  of  the  accounting  procedures 
and  such  tests  of  accounting  records  and  other  supporting  evidence  as  we 
considered  necessary  in  the  circumstances. 

In  our  opinion,  these  financial  statements  present  fairly  the  financial  position 
of  the  association  as  at  December  31,  1970  and  the  results  of  its  operations  for 
the  year  then  ended,  in  accordance  with  generally  accepted  accounting  principles 
applied  on  a  basis  consistent  with  that  of  the  preceding  year. 


GEO.  A.  WELCH  &  COMPANY, 
CHARTERED  ACCOUNTANTS. 
Feb.  8,  1971. 


MARCH  1971  THE  CA^IADIAN   NURSE     43 


CANADIAN  NURSES'  ASSOCIATION 
STATEMENT  OF  REVENUE  AND  EXPENDITURE  AND  SURPLUS 

for  year  ended  December  31,  1970 
(with  comparative  figures  for  year  ended  December  31,  1969) 


Revenue: 

Membership  fees  $ 

Subscriptions  

Advertising    

Sundry  revenue  


Expenditure: 

Operating  expenses: 

Salaries    

Printing  and  publications  

Postage  on  journal  

Building   services    

Staff  travel   

Committee  meetings  

I.C.N,  affiliation  

Commission  on  advertising  sales 

Computer  service      

Office  expense  

Legal  and  audit  

Translation   services   

Consultant  fees  

Sundry  

Production  of  film  

Furniture  and  fixtures   

Landscaping  and  improvements 
Depreciation  —  C.N.A.  House 


Non-operatii^  expenses: 

C.N.A.  Testing  Service  —  per  statement 

1970  Biennial  convention  

LC.N.  Seminar  

Canadian  Nurses'  Foundation   

Commonwealth  Foundation  Fund  


1970 

1969 

768,914 

$  697,754 

36,137 

30,903 

217,508 

249,194 

10,102 

13,249 

1,032,661 

991,100 

384,473 

384,534 

208,972 

216,511 

113,416 

79,304 

73,752 

72,930 

9,391 

9,684 

22,976 

28,582 

32,567 

31,214 

17,225 

18,261 

18,397 

30,775 

21,428 

25,559 

3,120 

4,750 

935 

2,533 

11,494 

9,322 

5,112 

938 

13,373 

— 

3,780 

4,826 

1,736 

16,157 

31,867 

31,867 

974,014 

967,747 

67,492 

12,276 

145 

899 

— 

5,940 

3,131 

529 

— 

87,136 

3,276 

1,061,150 

971,023 

Excess  of  revenue  over  expenditure  (expenditure  over  revenue) 

before  investment  income  (28,489)  20,077 

Investment  income  27,946  25,126 

Excess  of  revenue  over  expenditure  (expenditure  over  revenue) 

for  year  (        543)  45,203 

Surplus  at  beginning  of  year  658,903  482,737 

I.C.N.  Congress: 

Transfer  from  reserve  account  130,963 

Grant  from  Quebec  Provincial  Government  25,000  ' — 

Credit  on  settlement  of  Congress  accounts  18,794  — 

Surplus  at  end  of  year  $    702,154     $    658,903 


44     THE  CANADIAN   NURSE 


MARCH   1971 


CANADIAN  NURSES'  ASSOCIATION 

STATEMENT  OF  REVENUE  AND  EXPENDITURE 

C.N.A.  TESTING  SERVICE 

for  year  ended  December  31,  1970 

Revenue: 

Examination  fees  $    127,264 


Expenditure: 

Salaries  37,119 

Travel  and  committee  meetings  —  general  23*043 

—  item  writing                      9,839 

Payment  to  R.N.A.O.  for  testing  service  60,000 

Operations  (data  processing,  printing,  warehousing)  16^359 

System  design  and  programming   19^133 

Rent  ; 5^644 

Office  expenses   5  739 

Furniture  and  fixtures  15^792 

Sundry   2^088 


194,756 


Excess  of  expenditure  over  revenue  for  year $      67,492 


MARCH   1971  THE  CANADIAN   NURSE     45 

% 


The 

Canadian 
Nurse 

50  The  Driveway,  Ottawa  4,  Canada 


Information  for  Authors 


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Bibliography 

References,  footnotes,  and  bibliography  should  be  limited 
46     THE  CANADIAN  NURSE 


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article.  References  to  published  sources  should  be  numbered 
consecutively  in  the  manuscript  and  listed  at  the  end  of  the 
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Bibliography  listings  should  be  unnumbered  and  placed 
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available  on  request  to  the  editor. 

For  book  references,  list  the  author's  full  name,  book 
title  and  edition,  place  of  publication,  publisher,  year  of 
publication,  and  pages  consulted.  For  magazine  references, 
list  the  author's  full  name,  title  of  the  article,  title  of  mag- 
azine, volume,  month,  year,  and  pages  consulted. 

Photographs,  Illustrations,  Tables, 
and  Charts 

Photographs  add  mterest  to  an  article.  Black  and  white 
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Tables  and  charts  should  be  referred  to  in  the  text,  but 
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The  Canadian  Nurse 

OFFICIAL  JOURNAL  OF  THE  CANADIAN  NLIRSES"  ASSOCIATION 

MARCH  1971 


Occult  hydrocephalus 
in  adults 

The  authors  describe  the  care  of  patients  who  have  a  type  of  hydrocephalus  in 
which  distension  of  the  cerebral  ventricles  has  occurred  after  union  of  the 
cranial  sutures.  As  a  result  these  patients  do  not  have  enlargement  of  the 
head.  They  generally  show  some  degree  of  mental  deterioration,  gait 
disturbance,  and  incontinence. 


In  most  cases  of  hydrocephalus,  the 
cerebrospinal  fluid  pressure  is  elevated. 
Only  in  the  last  several  years  have 
cases  of  hydrocephalus  been  described 
in  which  the  CSF  pressure  has  never 
risen  above  180  mm.  —  the  figure 
usually  considered  to  be  at  the  upper 
limits  of  normal.^ 

An  explanation  for  hydrocephalus 
with  normal  CSF  pressure  has  been 
postulated  as  follows:  The  pressure 
within  the  ventricles  probably  is  high 
in  the  initial  stages  of  the  disease;  this 
raised  pressure  causes  the  ventricles  to 
enlarge  and  the  brain  tissue  around  the 
ventricles  to  yield  gently.  Once  enlarged, 
the  ventricles  are  maintained  in  this 
state  by  CSF  pressures  lower  than  those 
that  caused  the  initial  enlargement. 
The  system  reaches  an  equilibrium 
because  the  more  the  ventricles  dilate, 
the  more  CSF  they  absorb.^ 

The  symptoms  of  low-pressure  hy- 
drocephalus vary  from  patient  to  pa- 
tient, but  most  seem  to  have  one  or 
more  of  the  following  symptoms: 

1 .  Mental  deterioration  of  some  degree. 
This  is  the  principal  manifestation  and 
the  reason  that  many  patients  were 
formerly  diagnosed  as  having  pre- 
senile dementia.  The  patient  may  lack 
interest  and  initiative,  have  a  short 
attention  span,  be  apathetic  and  slow 
in  thought  and  action. 

2.  Gait  disturbance. 

3.  Bladder    and    bowel    incontinence. 
In  almost  all  cases,  headache  is  either 

absent  or  negligible. 
MARCH  1971 


Carol  Schick,  R.N. 

and  Elizabeth  Yallowega,  R.N.,  B.A. 

Symptoms  may  develop  over  a  period 
of  weeks  to  months.  Because  of  the 
relatively  insidious  progress  of  this 
disease,  the  signs  vary  with  the  dura- 
tion of  the  illness. 

Preoperative  nursing  care 

As   with   all    neurosurgical   admis- 
sions, the  nurse  bases  her  plan  of  care 
on   her  observations  of  the  patient's 
signs  and  symptoms. 
Physical  care  includes: 

Intake:  The  patient  may  show  lack 
of  interest  in  eating,  and  have  difficul- 
ty selecting  what  and  when  he  should 
eat.  The  nurse  and  dietitian  can  help 
him  with  this  problem.  Hydration  may 
be  a  problem,  and  oral  intake  is  pre- 
ferred. 

Elimination:  There  is  usually  some 
degree  of  incontinence.  The  nurse  tries 


Miss  Schick,  a  graduate  of  the  Winnipeg 
General  Hospital,  is  presently  Head  Nurse 
in  Neurology  and  Neurosurgery  at  the 
Winnipeg  General  Hospital.  Miss  Yallo- 
wega, a  graduate  of  the  Winnipeg  General 
Hospital,  is  presently  Administrative 
Assistant,  Intensive  Care  Nursing  Serv- 
ices, at  the  same  hospital.  This  article 
was  adapted  from  a  paper  presented  in 
Toronto  at  the  June  1970  meeting  of  the 
Canadian  Association  of  Neurological 
and  Neurosurgical  Nurses.  The  authors 
acknowledge  the  assistance  in  research 
they  received  from  the  neurosurgeons 
and  residents  at  the  Winnipeg  General. 


to  establish  a  regimen  for  the  patient 
by  assisting  him  to  the  bathroom  at 
regular  intervals.  Some  patients  require 
an  indwelling  catheter  and  bowel  dis- 
impaction. 

Skin  Care:  Tub  baths  are  preferable 
to  any  other  method  of  cleaning  the 
skin;  frequent  turning  and  skin  care 
is  essential. 

Ambulation:  The  patient  may  need 
help  to  get  in  and  out  of  bed,  and  the 
signal  cord  should  be  pinned  to  his 
gown.  Side  rails  help  to  prevent  him 
from  falling  out  of  bed. 

Sleep:  Sedation  is  not  usually  nec- 
essary, as  these  patients  tend  to  be 
drowsy  and  apathetic.  Also,  a  sedative 
usually  is  contraindicated  as  it  inter- 
feres with  assessment  of  the  patient's 
level  of  consciousness  and  with  diag- 
nostic testing. 

The  psychological  care  is  based 
primarily  on  the  patient's  need  for 
independence  and  feelings  of  self- 
worth.  Often  he  has  become  overly 
dependent  on  others  for  basic  require- 
ments. Because  of  his  marked  demen- 
tia, he  is  often  rejected  by  his  family 
and  alienated  from  group  involvement. 
He  needs  to  be  accepted  on  the  ward 
and  treated  as  an  individual. 

Members  of  the  patient's  family  are 
upset  because  they  cannot  understand 
what  has  caused  this  change  in  his 
behavior.  The  nurse  must  be  alert  to 
their  needs  and  be  available  to  allow 
them  to  voice  their  concerns;  at  the 
same  time,  she  must  protect  the  patient 
THE  CANADIAN   NURSE     47 


from  becoming  involved  in  this  conflict 
of  feelings. 

While  the  patient  is  undergoing 
diagnostic  testing,  the  nurse  explains 
the  tests  to  him,  whether  or  not  she 
believes  he  understands  her  explana- 
tions. Sometimes  repetition  is  nec- 
essary. Not  only  is  explanation  re- 
quired, but  also  continued  vigilance 
on  the  part  of  the  nursing  staff  to  have 
the  patient  remain  flat,  not  eat,  drink, 
and  so  on,  before  and  after  the  tests. 

The  tests  (angiogram,  pneumoen- 
cephalogram,  electroencephalogram, 
echoencephalogram,  Risa  Scan)  may 
or  may  not  involve  anesthetics.  In 
several  instances  it  has  been  found 
that  patients  deteriorate  following  diag- 
nostic procedures,  mainly  after  pneu- 
moencephalography. 

Once  the  patient  has  been  diagnosed, 
preparations  for  surgery  are  made. 
Usually  the  morale  of  both  staff  and 
family  improves  at  this  point. 

The  physiotherapy  department  may 
be  consulted  if  the  patient  needs  deep 
breathing  exercises.  If  he  smokes,  he 
is  advised  to  stop  several  days  before 
an  anesthetic  is  given. 

The  patient's  head  is  completely 
shaved  the  evening  before  surgery.  The 
nurse  explains  this  procedure  to  the 
patient  and  the  family  as  it  may  be 
upsetting,  particularly  to  female  pa- 
tients. 

Treatment  and  postoperative  care 

Low  pressure  hydrocephalus  is  treat- 
ed by  inserting  a  ventriculo-atrial  shunt, 
utilizing  a  low  pressure  valve  (usually 
the  Pudenz  valve)  to  drain  off  the  CSF. 
The  pump  is  positioned  behind  and 
above  the  right  ear,  with  the  proximal 
end  passing  through  a  burr  hole  in  the 
skull  and  through  the  cerebral  mantle 
to  lie  within  the  right  lateral  ventricle 
of  the  brain. 

The  distal  end  of  the  shunt  passes 
downwards,  subcutaneously  behind 
the  ear,  to  reach  the  neck  where  it  is 
threaded  into  the  common  facial  vein 
and  down  into  the  superior  vena  cava 
and  right  atrium.  Thus,  the  subara- 
chnoid space  block  is  bypassed  by 
shunting  the  fluid  from  the  ventricles 
of  the  brain  to  the  right  atrium  of  the 
heart.  The  correct  placement  within 
the  atrium  or  lower  superior  vena  cava 
is  determined  by  a  chest  x-ray  at  the 
time  of  surgery. 

Postoperative  care  of  the  patient  is 
mainly  one  of  observation.  Vital  signs 
are  checked  and  the  patient's  level  of 
consciousness  is  assessed  carefully. 
Occasional  flushing  of  the  shunt,  by 
48     THE  CANADIAN   NURSE 


pressing  the  skin  covering  the  pump, 
is  necessary  to  maintain  patency. 

Complications,  which  the  nurse  tries 
to  prevent,  are: 

•  Wound  Infection:  These  patients 
invariably  pick  at  their  dressing  and 
wound  postoperatively. 

•  Chest  Infection:  Early  ambula- 
tion and  frequent  turning  and  position- 
ing will  help  prevent  this.  Fluids  must 
be  forced,  but  at  the  same  time  the 
level  of  consciousness  must  be  ob- 
served carefully  because  of  the  hazard 
of  aspiration  pneumonia. 

•  Urinary  Tract  Infection:  This  may 
occur  if  the  patient  has  had  an  in- 
dwelling catheter  or  repeated  catheter- 
ization. 

•  Phlebitis:  This  is  a  hazard,  par- 
ticularly if  the  patient  has  not  been 
ambulant  preoperatively.  Exercising 
and  elevating  the  lower  extremities 
is  an  important  aspect  of  f)ostoper- 
ative  care. 

Early  ambulation,  continuous  ob- 
servation, and  stimulation  are  bene- 
ficial to  the  patient  both  physically  and 
psychologically.  Independence  is  en- 
couraged. Teaching  him  to  care  for 
himself  and  to  pump  his  own  shunt 
depend  on  the  results  of  the  surgical 
intervention.  Sometimes  these  results 
are  dramatic:   the  patient  wakes  up. 


stops  soiling  himself,  has  improvement 
in  his  mental  state,  and  becomes  a 
useful  citizen  again. 

Patient  histories 

Mrs.  B.,  a  51 -year-old,  obese  dia- 
betic was  admitted  to  the  Winnipeg 
General  Hospital  on  July  11,  1969, 
because  of  weakness  of  the  legs  and 
mental  confusion.  On  admission  she 
was  incontinent  of  urine,  appeared  dull, 
but  was  able  to  obey  simple  commands. 
While  in  hospital  her  condition  dete- 
riorated: she  became  drowsy,  more 
confused,  and  had  marked  ataxia, 
falling  to  the  right.  A  left  facial  weak- 
ness and  a  left  hemiparesis  were  also 
noted.  When  she  was  transferred  to  the 
neurosurgical  ward  she  had  a  Foley 
catheter  in  place,  was  unable  to  bear 
weight,  smiled  inappropriately,  and 
talked  only  in  monosyllables. 

Mrs.  B's  differential  diagnosis  was 
frontal  lobe  tumor,  senile  deteriora- 
tion, arteriosclerosis,  or  hydrocepha- 
lus. Her  skull  x-rays  were  normal, 
and  she  was  found  to  be  slightly  hyper- 
tensive, a  blood  pressure  of  140/95. 

A  right  carotid  angiogram  was  done 
July  30,  showing  a  wide  sweep  of  the 
anterior  cerebral  arteries.  (Figure  1 .) 
A    pneumoencephalogram,    done   two 


Figure  I .  Carotid  angiogram  showing  sweep  of  anterior  cerebral  artery. 


MARCH   1971 


days  later,  showed  greatly  dilated 
lateral  ventricles  with  no  air  spread 
over  the  convexity  of  the  hemispheres. 
(Figure  2.) 

On  August  15,  a  Pudenz  valve  was 
inserted.  By  August  18  Mrs.  B.  was 
more  spontaneous,  her  level  of  cons- 
ciousness seemed  elevated,  and  she  was 
able  to  feed  herself.  Four  days  later  she 
was  able  to  go  the  bathroom  unassisted. 

She  was  discharged  on  August  26, 
able  to  look  after  her  basic  needs,  but 
without  having  mastered  the  care  of  her 
shunt. 

On  December  2,  1969,  four  months 
after  her  first  admission,  Mrs.  B.  was 
readmitted  to  hospital.  When  she  re- 
turned for  a  check-up,  the  doctor  found 
the  shunt  to  be  working  poorly  and 
suspected  a  partial  shunt  block. 

The  shunt  was  revised  on  December 
8.  Apparently  the  proximal  end  of  the 
shunt  was  blocked  because  the  ventricle 
had  contracted  down  so  far  that  the 
walls  of  the  ventricle  were  against  the 
intake  end  of  the  mechanism.  The  dis- 
tal end  was  emptying  perfectly.  At 
surgery,  the  proximal  end  was  shorten- 
ed and  reconnected. 

A  follow-up  was  done  on  December 
12.  1969.  This  showed  the  ventricular 
size  to  be  greatly  reduced  since  the 
pneumoencephalogram  had  been  done 
four  months  earlier.  (Figure  3.) 

Mrs.  W.,  a  68-year-old  patient,  was 
admitted  to  hospital  October  20,  1969, 
with  a  two-  to  three-year  history  of 
falls  because  "her  legs  wouldn't  hold 
her."  She  used  a  cane  to  get  about. 

On  examination  she  was  alert,  happy, 
oriented  to  name  and  place  but  not  to 
time,  and  slow  to  answer  questions. 
She  had  difficulty  with  memory  and 
calculation.  For  the  past  few  months 
she  had  experienced  urgency  with 
both  urine  and  feces,  and  was  inconti- 
nent during  the  examination.  Her  left 
hand  and  arm  coordination  was  poor, 
and  power  in  both  legs  was  diminished. 
She  walked  on  a  broad  base  with  short 
halting  steps. 

X-rays  of  this  patient's  skull  and 
cervical  spines  were  normal,  except 
for  some  spinal  degeneration  at  the 
level  of  C5,  6,  and  7.  An  echoence- 
phalogram  showed  no  shift  of  midline 
structures,  but  did  demonstrate  enlarge- 
ment of  the  ventricles.  The  3rd  ventri- 
cle measured  24  mm.  (normal  10  mm.); 
the  right  lateral  ventricle,  34  mm. 
(normal  20  mm.);  and  the  left  lateral 
ventricle.  46  mm.  (normal  20  mm.). 

A  pneumoencephalogram  showed 
dilated  lateral  and  3rd  ventricles.  The 
MARCH  1971 


Figure  2.  A  pneumoencephalogram  done  before  surgery  shows  vastly  dilated 
lateral  ventricles. 


Figure  3.  Follow-up  show;: 
pneumoencephalogram . 


ventricular  size  greatly  reduced  since  the  earlier 


THE 


CAN^ 


DIAN   NURSE     49 


Figure  4.   The  Pudenz  valve  being  in.scnca  during  surgery. 


pneumogram  was  repeated  with  up- 
right views,  which  showed  moderate 
enlargement  of  the  4th  ventricle  aque- 
duct. 

On  November  3,  a  Pudenz  valve  was 
inserted  (Figure  4). 

Postoperatively,  Mrs.  W.'s  vital 
signs  remained  stable,  but  within  48 
hours  she  complained  of  vertigo  and 
nausea  on  leaning  to  the  right.  This 
was  presumed  to  be  a  brain  stem  in- 
farct. These  symptoms  disappeared 
within  24  hours  and  she  was  discharg- 
ed November  19,  1969,  with  follow- 
up  by  Home  Care. 

We  requested  a  report  from  Home 
Care  and  received  the  following: 

"I  visited  the  above  lady  every  two 
days  for  the  first  two  weeks  after  her 
discharge,  until  I  was  certain  she  was 
carrying  out  instructions  regarding  the 
Pudenz  valve.  Mr.  W.  has  been  carry- 
ing out  the  procedure  since  her  dis- 
charge, and  to  make  it  easier  for  them 
to  locate  the  pump  1  have  clipped  the 
hair  immediately  over  it. 

"Mrs.  W.  has  not,  to  date,  assumed 
this  responsibility.  I  am  not  sure  she 
feels  she  can  do  a  good  job  as  she  has 
difficulty  finding  the  spot  and  apply- 
ing the  necessary  pressure. 

"Mrs.  W.  walks  with  one  cane  and 
usually  forgets  where  she  has  put  it 
She  does  her  own  cooking;  however, 
someone  must  do  the  heavy  housework. 
50     THE  CANADIAN   NURS£ 


She  and  her  husband  usually  go  down- 
town one  afternoon  a  week  to  shop. 
They  do  not  seem  to  have  too  many 
visitors,  nor  do  they  join  in  community 
activities. 

"1  visit  this  couple  monthly,  and  I 
must  be  prepared  to  stay  the  minimum 
of  one  hour.  Mrs.  W.  seems  to  dwell  in 
the  past  and  I  have  each  time  attempted 
to  encourage  her  to  become  more  inde- 
pendent. I  feel  she  and  her  husband 
are  doing  exceptionally  well." 

References 

I.Adams,  R.D.,  Fisher,  CM.,  et  at. 
Symptomatic  occult  hydrocephalus 
with  "normar"  cerebrospinal  fluid 
pressure:  treatable  syndrome.  New  Eng. 
J.  Mw/.  273:3:121,  July  15,  1965. 

2.  Hakim,  S.  and  Adams.  R.D.  The  spe- 
cial clinical  problem  of  symptomatic 
hydrocephalus  with  normal  cerebro- 
spinal fluid  pressure.  J.  Neiirolog. 
Science  2-301 ,  1965. 

Bibliography 

Adams,  et  at.  Symptomatic  occult  hy- 
drocephalus with  normal  C.S.F.  pres- 
sure, NEJM  273:  1 17-26,  1965. 

Baska.  R.E.  ei  iil.  Symptomatic  occult 
hydrocephalus  —  a  case  report  and 
review.  Soitiliern  Medicid  Journal 
61:242,  March  1968. 

Diagnosis  of  normal  pressure  hydrocepha- 
lus by  RHISA  cysternography.  J.  Nu- 


clear Medicine  9:457-61,  August 
1968. 

Gschwind,  N.  The  mechanism  of  normal 
pressure  hydrocephalus.  J.  Ncurolog. 
Science  7:481:93,  November-Decem- 
ber 1968. 

Hakim,  S.  and  Adams,  R.D.  The  special 
clinical  problems  of  symptomatic  hy- 
drocephalus with  normal  CSF  pres- 
sure. J.  Neurolog.  Science  2:307-27, 
1965. 

Messert.  B..  and  Baker,  N.H.  Syndrome 
of  progressive  spasticataxia  and  apra- 
xia  associated  with  occult  hydroce- 
phalus.   Neurology    16:440-52.    1966. 

Messert,  B.,  Henke,  T.K.  and  Longheim, 
W.  Syndrome  of  akinetic  mutism  asso- 
ciated with  obstructive  hydrocepha- 
lus. Neurology  16:635-49,  1966. 

Moore,  M.T.  Progressive  akinetic  mutism 
in  cerebellar  hemangioblastoma  with 
normal  pressure  hydrocephalus.  Neu- 
rology. 19:32-6,  January  1969. 

McDonald.  J.V.  Persistent  hydrocephalus 
following  the  removal  of  papilloma  of 
the  choroid  plexus  of  the  lateral  ven- 
tricle —  report  of  two  cases.  J.  Neuro- 
™r^.  30:736.  June  1969. 

Isotope  cisternography  in  hydrocephalus 
with  normal  pressure  —  case  report  — 
technical  note.  J.  Neurosurg.  29:555- 
61,  November  1968.  ^ 


MARCH  1971 


Pinsent,  Amelia.  A  study  of  mother- 
nurse  interaction  during  feeding 
time  when  the  mother  is  feeding 
her  baby.  Montreal,  1970.  Thesis 
(M.Sc.  (App.)  McGill  University. 

The  purposes  of  this  study  were  to 
determine  the  main  concerns  of  the 
nurse  and  the  new  mother  during  feed- 
ing time  when  the  mother  is  feeding 
her  baby;  the  assistance  given  by  the 
nurse  to  the  mother  who  needs  help  in 
feeding  her  baby;  and  some  of  the 
factors  that  influence  the  nurse's  activity 
in  assisting  the  mother  in  feeding  her 
baby. 

Thirty-two  English-speaking  mar- 
ried women  who  were  bottle  feeding 
their  babies  comprised  the  sample  of 
mothers,  all  of  whom  had  semi-private 
accommodation.  The  sample  of  nurses 
was  made  up  of  six  graduate  nurses 
and  three  nursing  assistants. 

Data  were  collected  during  48  ob- 
servations of  mothers  while  feeding 
their  babies.  A  total  of  124  mother- 
nurse  interactions  were  recorded  dur- 
ing the  feeding  time. 

A  content  analysis  of  the  mother- 
nurse  interactions  revealed  that  the 
nurse  and  the  mother  had  different 
concerns  in  feeding  the  baby.  The 
nurse's  main  concern  was  to  have  the 
baby  take  the  desired  amount  of  for- 
mula during  the  feeding  time,  and  her 
activities  were  directed  toward  this 
goal.  The  mother's  main  concerns  were 
with  the  condition  of  the  baby  and 
with  her  own  ability  to  feed  him,  man- 
ifested by  seeking  information  regard- 
ing the  baby's  condition  and  by  evaluat- 
ing her  own  ability  to  feed  him. 

Assistance  given  to  the  mother  by 
the  nurse  was  directed  toward  her  goal 
of  having  the  baby  take  the  desired 
amount  of  formula.  The  mother  ac- 
knowledged the  concern  of  the  nurse 
regarding  the  amount  of  formula  the 
baby  was  expected  to  take,  or  had  taken 
during  the  feeding,  by  stating  the 
amount  when  the  nurse  approached  her 
or  by  answering  the  nurse's  question 
regarding  the  feeding.  The  mother 
added  her  concerns  once  she  had  given 
the  information  sought  by  the  nurse. 

The  nurse  acknowledged  the  state- 
ment of  amount,  but  gave  varied  re- 
sponses to  statements  of  the  mother's 
concerns.  She  answered  the  mother's 
questions  or  statements  of  concerns 
by  suggesting  how  the  baby's  intake 
could  be  increased  and  by  giving  the 

MARCH  1971 


reasons  why  the  stated  amount  was 
desirable;  by  changing  the  subject 
to  that  of  facilitating  the  present  and/or 
future  feedings;  by  feeding  and/or 
burping  the  baby  herself;  by  stating 
that  she  did  not  know  the  answer  to 
the  question  asked;  or  by  completely 
ignoring  the  mother's  question  or  state- 
ment. 

The  environment  in  which  the  nurse 
functioned  was  conducive  to  providing 
physical  care  for  the  mother  and  baby. 
The  unit  was  divided  into  three  sec- 
tions, each  with  a  separate  nursing 
staff.  Within  the  nursery,  feeding  sched- 
ules were  at  times  when  only  some  of 
the  staff  were  available  to  assist  moth- 
ers. This  meant  that  three  different 
nurses  could  have  contact  with  a  moth- 
er during  the  three  phases  of  feeding, 
so  that  a  nurse  who  had  helped  the 
mother  during  one  phase  of  the  feeding 
could  miss  the  opportunity  to  evaluate 
the  immediate  results  of  assistance 
given  to  the  mother. 

Two  questions  arising  from  this 
study  are: 

1 .  What  does  the  nurse  understand  her 
role  to  be  in  maternity  nursing?  Is  she 
ready  or  willing  to  assist  mothers  with 
their  problems? 

2.  When  the  organization  of  the  unit 
and  the  staff  is  strongly  delineated 
and  specialized,  who  solves  the  prob- 
lems regarding  the  baby's  condition 
which,  in  turn,  can  create  difficulties 
sufficient  to  interfere  with  the  mother's 
healthy  recovery? 

Munro,  Margaret  F.  A  study  of  liter- 
ature selection  in  baccalaureate 
students  in  nursing.  Minneapolis, 
Minn.,  1967.  Research  study  (M.Ed.) 
U.  of  Minnesota. 

This  study  was  seen  as  a  pilot  project 
to  investigate  the  frequency  and  reason 
for  reading  a  selected  variety  of  books 
as  demonstrated  by  students  in  a  bac- 
calaureate program  in  nursing.  The 
writer  was  particularly  interested  in 
the  correlation  between  use  of  specific 
types  of  literature  and  (a)  the  philos- 
ophy underlying  the  school's  curric- 
ulum, (b)  the  level  of  nursing  educa- 
tion and  experience  of  the  individual 
student,  and  (c)  the  concept  of  what 
constitutes  "educational"  literature. 

An  instrument  was  developed  con- 
taining 133  publications.  These,  con- 
sidered by  the  investigator  to  be  of 
current  value  to  nurses,  were  selected 


from  the  literature  specific  to  nursing, 
from  related  sciences,  or  from  bio- 
graphical works  focused  on  problems 
of  health.  The  items  were  arranged 
alphabetically  within  a  system  of  the 
eight  following  categories:  general 
references;  communications;  commu- 
nity health  and  welfare;  neuropsychia- 
tric  studies;  pediatric  studies;  maternity 
and  newborn  studies;  medical-surgical 
studies;  and  psychosocio-cultural  sub- 
jects. These  categories  were  seen  as 
an  arbitrary  method  of  handling  the 
data  and  did  not  necessarily  reflect 
publishers'  classifications  or  curricu- 
lum design. 

Respondents  were  given  a  copy  of 
this  bibliography  and  requested  to 
reply  to  two  specific  questions  for 
each  item:  frequency  of  contact  with 
the  item,  and  why  it  was  used.  The 
frequency  of  contact  was  given  a  four- 
point  scale:  very  often,  often,  seldom 
and  never.  The  purpose  of  use  was 
given  a  three-point  scale:  as  an  aid  to 
current  education,  as  an  aid  to  current 
employment,  for  personal  pleasure. 

All  respondents  were  enrolled  at 
the  same  university  and  were  in  their 
final  or'next-to-final  year  of  the  bac- 
calaureate program  in  nursing.  They 
represented  students  enrolled  in  a 
generic  program  and  those  completing 
a  degree  following  graduation  from  a 
hospital  program.  In  this  school,  the 
curriculum  was  based  on  broad  con- 
cepts of  nursing  and  did  not  reflect 
the  traditional  clinical  areas. 

The  findings  indicated  a  positive 
correlation  between  the  philosophy 
of  the  program  of  study  and  the  cate- 
gories of  publications  most  frequently 
chosen,  in  that  publications  in  medical 
specialties  were  selected  less  frequently 
than  those  in  communications  or  psy- 
chosocio-cultural programs.  No  signif- 
icant difference  was  found  between 
students  in  the  generic  program  and 
graduates  from  diploma  programs, 
nor  between  levels  of  students. 

The  findings  also  indicated  that 
students  tended  to  read  biographical 
publications  for  personal  interest  rather 
than  for  value  in  relation  to  their  educa- 
tion or  practice  of  nursing. 

This  study,  though  limited  in  scope, 
appears  to  have  implications  for  nurs- 
ing educators  in  selecting  bibliographic 
material  for  students  or  in  directing 
students  into  areas  of  further  investiga- 
tion in  accordance  with  the  philosophy 
of  the  educational  program.  § 

THE  CANADIAN   NURSE     51 


Psychiatric  Nursing,  5ed.,  by  Ruth  V. 
Matheney  and  Mary  Topalis.  346 
»  pages.  Toronto,  C.V.  Mosby,  1970. 
Reviewed  by  Peter  Boyle,  Instruc- 
tor, The  Saskatchewan  Hospital, 
Weyburn,  Saskatchewan. 

The  fifth  edition  of  this  book  is  marked 
by  changes  in  format  and  content.  The 
new  format  of  larger  print  and  marginal 
sub-headings  is  pleasing  to  the  eye. 

Content  has  been  expanded  to  give 
a  wider,  more  balanced  overview  of 
the  subject  matter. 

Presentation  of  current  theories  of 
personality  development  and  psycho- 
pathology  is  brief  but  will  serve  to 
direct  the  more  serious  student  toward 
those  constructs  that  are  influencing 
psychiatry  and  psychiatric  nursing. 

Unit  two,  the  heart  of  this  text, 
remains  little  changed.  The  principles 
of  psychiatric  nursing  are  valid  for  all 
patients  regardless  of  diagnosis  and 
treatment  area. 

Chapter  20  (drug  addiction,  the 
nurse,  and  the  community)  is  a  pleasure 
to  read. 

The  authors  present  facts  with  ob- 
jectivity and  understanding,  avoiding 
the  moralizing  tone  that  permeates 
much  of  the  literature  on  the  subject 
of  drug  use  and  abuse.  Practical  con- 
siderations for  the  nursing  care  of  the 
drug  user  make  this  chapter  a  partic- 
ularly welcome  addition  to  the  book. 

The  unit  "Crisis  Intervention"  is 
disappointingly  weak  in  the  nursing 
activities  related  to  suicide  and  grief. 
Perhaps  the  sixth  edition  will  contain' 
amplification  of  these  topics. 

As  an  introduction  to  psychiatric 
nursing,  this  book  is  recommended  as  a 
basic  text  for  all  nurses,  regardless  of 
status  or  specialty. 

The  Nurse  and  the  Cancer  Patient;  A 
Programmed  Texbook  by  Josephine 
K.  Craytor  and  Margot  L.  Pass.  260 
pages.  Toronto,  J.B.  Lippincott  Co. 
of  Canada  Ltd.,  1970. 
Reviewed  by  Phyllis  Burgess,  Direc- 
1  tor  of  Nursing,  Ontario  Cancer 
Clinic,  Princess  Margaret  Hospital, 
Toronto,  Ontario. 

This  excellent  contribution  to  nursing 
literature  brings  together  an  outline  of 
scientific  facts  on  malignant  disease  and 
its  treatment.  It  also  describes  how 
patients'  physical  and  emotional  needs 
,  can  be  met  by  a  close  nurse-patient 
52     THE  CANADIAN   NURSE 


relationship.  The  patients  described, 
with  their  problems  and  triumphs, 
become  real  to  the  reader. 

This  textbook  aims  to  help  the  nurse 
find  answers  for  herself.  Particularly 
helpful  to  those  charged  with  bedside 
care  are  the  samples  of  conversations 
concerning  fear,  anxiety,  and  pain. 
Palliative  treatment  is  well  discussed, 
with  emphasis  on  the  pleasures  of  even 
short-term,  partial  independence. 

The  chapter  on  death  is  written  with 
sensitivity.  Of  merit  is  the  author's 
ability  to  help  us  understand  the  lone- 
liness of  final  illness  for  the  patient,  his 
family,  and  the  professional  staff  caring 
for  him. 

The  suggested  readings  at  the  end  of 
each  chapter  are  readily  available  to 
most  nurses  and  should  encourage 
further  study.  Review  questions  with 
answers,  a  glossary,  and  a  bibliography 
conclude  the  text. 

Although  primarily  written  for  stu- 
dents. The  Nurse  and  the  Cancer  Pa- 
tient will  also  make  a  useful  short-study 
course  for  the  staff  nurse.  Inservice 
coordinators,  head  nurses,  and  team 
leaders  will  find  it  a  worthwhile  desk 
manual,  suitable  for  medical,  surgical, 
pediatric,  long-term,  and  radiation 
therapy  units. 

Nursing  in  the  Coronary  Care  Unit  by 

LaVaughn  Sharp  and  Beatrice  Ra- 
bin. 2 13  pages.  Toronto,  J.B.  Lippin- 
cott, 1970. 

Reviewed  by  M.  Campbell,  Head 
Nurse,  Medical  and  Coronary  Inten- 
sive Care  Unit,  St.  Paul's  Hospital, 
Vancouver,  B.C. 

A  large  portion  of  the  book  deals  with 
the  anatomy  and  physiology  of  the 
heart,  diagnostic  procedures  used  to 
determine  a  myocardial  infarct,  and 
the  complications  that  could  arise  along 
with  cardiac  arrhythmias.  Drug  therapy 
and  nursing  measures  outlined  in  this 
portion  are  well  detailed. 

A  smaller  pwrtion  of  the  book  deals 
with  the  general  organization  and  func- 
tions of  the  coronary  care  unit,  its 
physical  plant  and  contents  in  regard 
to  drugs  and  equipment. 

The  text  concludes  with  a  small 
section  on  inservice  education.  There 
are  some  excellent  chapters  in  the  book. 
Those  worth  special  mention  are:  1. 
Organization  and  Function  of  the  Cor- 
onary Care  Unit,  where  such  topics  as 
the  criteria  for  admission,  discharge 


and  policy  making  are  discussed;  2. 
Psychological  Responses  in  the  Cor- 
onary Care  Unit,  where  the  advanced 
thinking  of  the  authors  is  quite  evident 
when  describing  the  progressive  care 
area  for  the  patient  with  myocardial 
infarct. 

One  of  the  weaker  areas  is  the  sec- 
tion on  electrocardiography.  Here 
the  authors  attempt  to  capsulate  where 
volumes  have  been  written,  which  is 
a  difficult  task. 

It  is  stated  in  the  preface  that  this 
book  would  be  of  value  to  the  student 
nurse,  the  nurse  specialist,  and  the 
nursing  administrator.  A  noble  attempt 
is  made  to  meet  the  needs  of  these 
various  levels,  but  I  do  not  feel  the 
authors  have  succeeded. 

For  the  student  nurse,  certain  topics, 
such  as  electrocardiography  and  recog- 
nition of  basic  arrhythmias,  could  be 
simplified,  and  more  emphasis  could 
be  placed  on  the  psychological  support 
of  the  patient.  However,  the  nurse 
specialist  requires  more  depth,  particu- 
larly in  the  field  of  electrocardiography. 
The  nurse  administrator  requires  more 
information  regarding  the  organization 
and  functions  of  the  coronary  care 
unit  and  about  inservice  education 
programs,  although  the  book  does 
give  her  an  overview  of  the  subject 
matter  and  problems  related  to  coronary 
care  nursing. 

References  used  show  that  each 
topic  has  been  well  researched  and 
should  be  of  value  to  hospitals  contem- 
plating construction  of  a  coronary  care 
unit. 

Principles  and  Practice  of  Intravenous 
Therapy  by  Ada  Lawrence  Plummer. 
262  pages.  Boston,  Mass.,  Little, 
Brown  and  Company,  1970.  Cana- 
dian Agent:  J.B. Lippincott,  Toronto. 
Reviewed  by  Alice  MacLaren,  In- 
structress and  Head,  Intravenous 
Team,  Saint  John  General  Hospital. 
Saint  John,  N.B. 

This  book  provides  a  text  to  help  pre- 
pare members  of  the  intravenous  ther- 
apy team.  With  the  increase  in  drug 
therapy  via  the  venous  route,  better 
understanding  of  fluid  and  electrolyte 
balance,  improvement  of  blood  and 
blood  products  used  in  transfusions, 
specialized  training  in  the  techniques 
and  responsibilities  involved  in  intra- 
venous therapy  is  required  by  nurses. 
The  book  is  well  planned.  It  starts 
MARCH  1971 


with  a  short  history  of  intravenous 
therapy,  including  the  legal  implica- 
tions of  its  use.  Then  it  describes  the 
types  of  equipment  and  their  use,  with 
illustrations  and  references  to  support 
the  material.  Applied  anatomy  and 
physiology  are  concisely  presented. 
Techniques  used  in  venipuncture,  the 
preparation  of  infusion  fluids,  hazards 
and  their  prevention,  and  the  respon- 
sibilities of  the  attending  nurse  are 
clearely  delineated. 

The  administration  of  drugs  by 
venous  infusion  is  well  outlined.  The 
advantages,  dangers,  and  incompat- 
abilities  of  additives,  and  the  respon- 
sibilities of  the  hospital  committee, 
the  physician,  the  IV  therapist,  and 
the  attending  nurse  are  given  due 
emphasis. 

The  author  devotes  three  chapters 
to  the  transfusion  of  blood  and  blood 
components,  and  the  withdrawal  of 
blood  samples.  She  includes  tables  of 
normal  values  of  blood,  plasma,  and 
serum. 

Improvements  in  the  collection  and 
storage  of  blood  have  added  to  the 
knowledge  of  blood  antigens  and  their 
antibodies  (immuno-hematology),  and 
have  allowed  blood  transfusions  to 
become  an  integral  part  of  daily  treat- 
ment for  certain  patients.  The  author 
again  stresses  the  dangers  and  respon- 
sibilities inherent  in  this  type  of  treat- 
ment. 

Although  hypodermoclysis,  the  in- 
jection of  fluids  into  subcutaneous 
tissues,  has  become  less  widely  used 
for  fluid  replacement,  the  writer  dis- 
cusses this  method,  citing  its  advantages 
and  disadvantages. 

A  chapter  on  the  organization  of  an 
intravenous  therapy  department  com- 
pletes the  volume. 

The  author  is  to  be  commended  for 
providing  a  text  for  prospective  mem- 
bers of  an  intra\enous  therapy  group. 
Though  written  from  an  American 
point  of  view,  the  material  in  this  edi- 
tion is  nevertheless  easily  adaptable  to 
Canadian  circumstances,  and  should 
prove  valuable  study  material  for  the 
general  duty  nurse  and  the  IV  therapist. 


AV  aids 


FILMS 

The  Leaf  and  the  Lamp 

The  Leaf  and  the  Lamp  (English)  or 
L' Infirmiere  au  Canada  (French),  the 
film  produced  by  the  Canadian  Nurses' 
Association,  may  be  borrowed  by  writ- 
MARCH  1971 


a  show  of  hands... 


-^ 


V 


C 


^J. 


y 


proves  its  smoothness 


NEW  FORMULA  ALCOJEL,  with 
added  lubricant  and  emollient,  will 
not  dry  out  the  patient's  skin— 
or  yours! 

ALCOJEL  is  the  economical,  modern, 
jelly  form  of  rubbing  alcohol.  When 
applied  to  the  skin,  its  slow  flow 
ensures  that  it  will  not  run  off,  drip 
or  evaporate.  You  have  ample  time 
to  control  and  spread  it. 

ALCOJEL  cools  by  evaporation  .  .  . 
cleans,  disinfects  and  firms  the  skin. 

Your  patients  will  enjoy  the 
invigorating  effect  of  a  body  rub  with 
Alcojel  ...  the  topical  tonic. 


'•efreshio9-<=°°''''&. 

ALCOJEL 

Send  tor  a  free  sample 

through  your  hospital  pharmacist. 


BDH  PHARMACEUTICALS 

Barclay  Ave..  Toronto  550,  Ontario 


IJellJed 

RUBBING 
ALCOHOL 


WrTH 

ADDED 

UJBRlCANTani) 

>^OLUEIIIT^ 

,1*2lSHOI»U6HOUSf5 


THE  CANADIAN   NURSE     53 


i ^ 

Busy,  busy 
little  fingers. 
Busily  spreading 
pinworms. 


Depend  upon 

(pyrvinium  parr 

to  eliminate 


(pyrvinium  pamoate  Frosst) 


pinworms 
a  singie  dose 


Early  detection,  and  treatment  with 
Pamovin,  can  bring  the  usual  unpleasant 
course  of  pinworms  to  an  abrupt  halt. 

It  has  been  shown'  that  single-dose 
treatment  with  pyrvinium  pamoate 
achieves  an  overall  cure  rate  of 
96  percent. 

In  the  family  or  in  institutions,  pyrvinium 
pamoate  (PAMOVIN)  offers  the  advantages 
of  "low  cost,  ease  of  administration, 
and  effectiveness."^ 

Dosage:  for  both  children  and  adults,  a  single 
dose  of  1  tablet  or  1  teaspoonful  for  every 
22  lbs.  of  body  weight. 

Cautions:  Occasionally,  nausea,  vomiting  or 
gastrointestinal  complaints  may  be  encoun- 
tered but  are  seldom  a  problem  on  such 
short-term  treatment.  Stools  may  be  coloured 
red.  Suspension  will  stain  clothing  and  fabrics. 

PAMOVIN  Tablets  of  50  mg.  (red,  film-coated), 
boxes  of  6,  and  bottles  of  24  and  100. 
Suspension  (red),  50  mg.  per  5  ml.  teaspoonful, 
bottles  of  30  ml.,  4  and  16  fl.  oz. 

References:  1.  Beck,  J.  W.,Saavedra,  D., 

Antell,  G.  J.  and  Tejeiro,  B.:  Am.  J.  Trop.  Med. 
8:349,  1959.  2.  Sanders,  A.  I.  and  Hall,  W.  H.: 
J.  Lab.  &  Clin.  Med.  56:413,  1960. 

Full  inlormation  on  request. 


3hj[yyA: 


AV  aids 


ing  to  Modern  Talking  Pictures  Ser- 
vice, 1943  Leslie  Street,  Don  Mills, 
Ontario. 

The  Spark  of  Life 

A  full-color,  eight-minute,  1 6-mm  film. 
The  Spark  of  Life,  especially  produced 
for  pacemaker  users  and  their  families, 
is  now  available  from  the  General 
Electric  Compay. 

This  film  defines,  in  lay  terms,  normal 
heart  performance  and  the  effects  of 
heart  block.  It  includes  a  demonstration 
and  explanation  of  asynchronous  and 
demand  cardiac  pacemakers,  and  shows 
how  these  devices  help  restore  normal 
cardiac  activity.  Dr.  Richard  D.  Judge, 
clinical  associate  professor  of  internal 
medicine,  University  of  Michigan, 
narrates  the  film. 

Copies  of  the  Spark  of  Life  can  be 
obtained  from  General  Medical  Sys- 
tems Limited,  3311  Bayview  Avenue, 
Toronto,  Ontario. 

New  Canadian  Film  Catalog 

The  newly-organized  Association  of 
Canadian  Film  Cooperatives  has  pub- 
lished a  bilingual  catalog,  through  the 
efforts  of  all  the  Canadian  film-makers' 
cooperatives  in  Vancouver,  Toronto, 
Montreal,  and  London,  Ontario.  The 
112-page  catalog  was  printed  with 
the  aid  of  a  Canadian  Film  Develop- 
ment Corporation  grant  and  includes 
over  350  films  ranging  in  length  from 
one  second  to  two  hours.  It  is  the 
largest  source  of  Canadian  films  outside 
the  National  Film  Board  and  includes 
over  20  feature  films.  Nearly  all  the 
filmmakers  represented  are  indepen- 
dent. The  films  include  almost  every 
cinematic  style  with  emphasis  on  the 
experimental.  The  free  catalog  is  avail- 
able from  the  ACFC,  2026  Ontario  St., 
E.,  Montreal  133,  Quebec. 


parcel  post,  or  ordinary  mail  —  not 
freight)  a  roll  of  videotape  appropriate 
to  any  of  the  five  modes  listed.  The 
program  requested  will  be  recorded 
on  the  videotape  supplied  and  returned 
to  the  client.  Used  tape  is  acceptable, 
if  its  quality  has  not  deteriorated  beyond 
reasonable  standards. 

All  duplicates  are  monochrome  and 
at  present  only  the  following  video- 
tape recording  modes  are  available 
from  NMAC: 

•  Ampex  1100,  Lowband,  two-inch 
standard  broadcast.  Playable  only  on 
standard  broadcast  videotape  recorders. 
Recorded  at  1 5  ips  Only. 

•  Ampex  7500,  Helical  Scan,  one- 
inch  videotape  recorded  at  9.6  ips. 
Playable  on  7000  series,  6000  series, 
5000  series,  using  standard  Ampex 
one-inch  format. 

•  Ampex  660- B,  Helical  Scan,  two- 
inch  videotape  recorded  at  3.7  ips. 
Playable  on  660  series  and  1500  series. 

•  IVC  820-C,  Helical  Scan,  one-inch 
videotape  recorded  at  6.9  ips.  Playable 
on  all  IVC  one-inch  series  and  on  Bell 
&  Howell  2000  series  machines. 

•  Sony  EV-310,  Helical  Scan,  one- 
inch  videotape  recorded  at  7.8  ips. 
Playable  on  any  Sony  one-inch  video- 
tape machine. 

Requests  for  the  NMAC  listing  or  for 
duplicating  service  should  be  addressed 
to  the  National  Medical  Audiovisual 
Center,  Atlanta,  Georgia  30333, U.S.A., 
Attention:  Videotape  Duplicating 
Service. 


Film  Rejuvenation 

A  new  film  rejunevation  service  is  now 
available  to  Canadian  film  libraries 
through  Bonded  Services.  Bonded 
Filmtreats'  process  can  treat  film  stock 
that  is  scratched,  damaged,  stained,  or 
worn  out.  The  process  treats  negative 
or  positive,  16  mm  or  35  mm,  black 
and  white  or  color  film  and  the  base 
and  emulsion  on  films.  For  further 
information  write  Jack  McKay  at  Bon- 
ded Filmtreat,  205  Richmond  Street 
West,  Toronto  2B,  Ont.  ^ 


CHARLES  e  FROSST  A  CO.   KMKLANO  (MONTRCAl,!  CANADA 


U.S.  Medical  Videotapes 
Available  for  Duplication 

The  videotape  duplication  service  of 
the  National  Medical  Audiovisual 
Center,  U.S.  Department  of  Health, 
Education,  and  Welfare,  is  now  avail- 
able to  Canadian  schools  of  nursing  at 
no  charge,  except  for  the  Canadian 
customs  fee. 

All  videotapes  listed  by  the  National 
Medical  Audiovisual  Center  (NMAC) 
may  be  duplicated  without  charge  on 
videotape  that  requesters  must  provide 
to  the  Center.  The  Center  supplies  this 
service  only  and  does  not  honor  loan 
requests. 

To  secure  this  service,  send  (by  air 


accession  list 


Publications  on  this  list  have  been 
received  recently  in  the  CNA  library 
and  are  listed  in  language  of  source. 

Material  on  this  list,  except  Reference 
items  may  be  borrowed  by  CNA  mem- 
bers, schools  of  nursing  and  other  in- 
stitutions. Reference  items  (theses, 
archive  books  and  directories,  almanacs 
and  similar  basic  books)  do  not  go  out 
on  loan. 

MARCH  1971 


Requests  for  loans  should  be  made 
on  the  "Request  Form  for  Accession 
List"  and  should  be  addressed  to:  The 
Library,  Canadian  Nurses"  Association, 
.SO  The  Driveway.  Ottawa  4.  Ontario. 

No  more  than  iliree  titles  should  be 
requested  at  any  one  time. 

BOOKS  AND   DOCUMENTS 

1.  Li's  aspects  mUrobioto)iiqiies  de  I' hygiene 
lies  denrees  idimenuiires.  Geneve.  Organisa- 
tion mondiale  de  la  Sante.  Comite  dexperts 
de  rOMS  reuni  avec  la  participation  de  la 
FAO,  1968.  71p.  (Its  Serie  de  rapports  tech- 
niques no. 399) 

2.  Associate  degree  education  for  nursing  — 
current  issues,  1970;  papers  presented  at 
the  Third  Conference  of  the  Council  of 
Associate  Degree  Programs  held  at  Hono- 
lulu, Hawaii.  March  4-6,  1970.  New  York. 
National  League  for  Nursing.  Dept.  of  Asso- 
ciate Degree  Programs,  1970.  69p. 

3.  The  Canadian  annual  review  for  1969 
edited  by  John  T.  Saywell.  Toronto,  Univ. 
of  Toronto  Press,  1970.  514p. 

4.  Elementary  textbook  of  anatomy  and 
physiology  applied  to  nursing  by  Janet  T.E. 
Riddle.    London,    Livingstone,    1969.    155p. 

5.  The  government  of  Canada.  .'>th  ed.  edited 
by  Robert  MacGregor  Dawson,  revised  by 
Norman  Ward.  Toronto,  University  of  To- 


ronto Press,  1970.  569p.  (Canadian  govern- 
ment series) 

6.  Histoire  de  la  profession  infirinii're  au 
Quebec  par  Edouard  Desjardins.  Suzanne 
Giroux  et  Eileen  C.  Flanagan.  Montreal, 
Association  des  Infirmiers  et  des  Infirmie- 
res  de  la  Province  de  Quebec.    1970.  270p. 

7.  Maternity  nursing  by  Constance  Lerch. 
Saint  Louis,  Mosby,  1970.  360p. 

8.  National  Conference  on  Cataloguing 
Standards.  Ottawa,  May  19-20,  1970,  papers. 
Ottawa,  National  Library  of  Canada,   1970. 

9.  Nursing  studies  index:  an  annotated  guide 
to  reported  studies,  research  methods,  ami 
historical  and  biographical  materials  in 
periodicals,  books,  ami  pimiphlets  published 
in  English,  vol.  2,  1930-1949  by  Virginia 
Henderson.  Philadelphia,  Lippincott,  1970. 
1037p. 

10.  Obstetrics  by  J. P.  Greenhill  from  the 
original  text  of  Joseph  B.  DeLee.  13th  ed. 
Philadelphia,  Saunders.  196.'i.  1246p. 

1  1 .  Papers  presented  at  the  Interprovincial 
Conference  on  French-language  Textbooks. 
Ottawa,  Feb.  27  and  28,  1970.  Ottawa,  Ca- 
nadian Teachers  Federation,  1970.  6pts  in  1. 
12.  Proceedings  of  American  Library  Asso- 
ciation annual  conference.  1969.  Chicago, 
American  Library  Association,  1970.  160p. 
\'i.  Public  education  about  cancer,  recent 
research  and  current  programmes  1969. 
Geneva,  International  Union  Against  Can- 
cer, 1970.  104p.  (UICC.  Technical  Report 
Series,  vol.6) 


14.  Who's  who  of  American  women  with 
world  notables.  6th  ed.  Chicago,  A.N.  Mar- 
quis, 1970-71.  1386p. 

PAMPHLETS 

\5.  The  accreditation  progriunme  of  the 
Canadian  Council  on  Hospital  Accredita- 
tion by  Nicole  Du  Mouchel;  conference 
given  at  the  Joint  Staff  Meeting.  Registered 
Nurses"  Association  of  Ontario,  Mar.  9, 
1970.  Toronto,  1970.  1 3  p. 

16.  L'eaii  par  W.V.  Morris.  Ottawa.  Direc- 
tion des  Eaux  interieures,  Ministere  de 
TEnergie  des  Mines  et  des  Ressources,  1969. 
.'i9p. 

17.  Public  Affairs  Committee.  Pamphlets. 
New  York. 

no.38A  The  facts  about  cancer  by  Dallas 
Johnson.  1957.  28p. 

no.l  18A /l/(o/(o//.s7?i  ((  sickness  that  can 
be  beaten  by  Alton  L.  Blakeslee.  1964.  :8p. 

no.l20A  Toward  mental  health  by  George 
Thorman  and  Elizabeth  Ogg.  1967.  28p. 

no. \26A  Rlieiiinaiic  fever  by  Marjorie 
Taubenhaus.  19.^8.  20p. 

no.  1 37  Kiww  your  heart  by  Howard  Blake- 
slee. 1948.  20p. 

no.l49  Woii'  /()  tell  your  child  about  se.x 
by  James  L.  Hymes.  1959.  28p. 

no.l56C  What  we  can  do  to  wipe  out  TB 
by  Alton  L.  Blakeslee  and  Jules  Saltman. 
1968.  20p. 

no.  1 68  Your  blood  pressure  <md  your 
arteries  by  Alexander  L.  Crosby.  1951.  20p. 


SCHOLARSHIPS  IN  FAMILY  PLANNING 

In  1969  G.  D.  Searie  of  Canada,  Linnited,  established  the  Searle  Scholarship  Progronn  for  Canadian  nurses. 
This  Program  is  being  continued,  and  during  1971  up  to  8  scholarships  in  family  planning  will  be  offered 
under  the  following  conditions: 

1.  Applications   will    be  considered   from  any  graduate  nurse  employed  full-time  in  Canada,  regard- 
less   of    citizenship    or    training    school    attended. 

2.  Awards   will    be   made  on   the   basis   of   expressed   interest  in  family  planning  education  and  the 
applicant's   present  and   future   prospects  for  making   use  of  family   planning  clinic  training. 

Successful  applicants  will,  at  Searle  expense,  travel  from  any  point  in  Canada  to  Chicago,  be  provided 
with  accommodation  in  that  city,  attend  a  2  week  course  at  the  Chicago  Planned  Parenthood  Clinic,  and 
receive   $150   for   meals   and    incidental   expense.    Instruction   is  available  in   English  only. 

Applications  for  the  first    1971    course  must   be   received   no   later  than  April    15,    1971. 

This  program  should  be  of  special  interest  to  nurses  engaged  in  Public  Health  work,  or  in  School  or 
College  Health  Programs,  but  is  not  restricted  to  these  groups.  Awards  are  made  entirely  at  the  dis- 
cretion of  the  Scholarship  Selection  Committee.  Names  of  the  12  previous  scholarship  winners  are 
available  on  request. 

Application  forms  may  be  obtained  from: 
Reference  and  Resource  Program, 

C.  D.  SEARLE  &  CO.  OF  CANADA,  LIMITED 

390    Orendo    Road 
Bramalea,  Ontario 


MARCH  1971 


THE  CANADIAN   NURSE     55 


accession  list 


no.295A  Blindness — ability,      not 
hilily  by  Maxine  Wood.  1968.  28p. 


disii- 


(Continued  from  page  55) 

no.  172  When  mental  illness  strikes  your 
family  by  Kathleen  Cassidy  Doyle.  1951.  28p. 

no.  1 82  Getting  ready  to  retire  by  Kathryn 
Close.  1952.  28p. 

no.  184  Won-    to   live    with    heart    trouble. 

1959.  28p. 

no.220A  Cigarettes  and  health  by  Pat  Mc- 
Grady.  1960.  20p. 

no. 229  Psychologists  in  action  by  Eliza- 
beth Ogg.  1955.  28p. 

no. 234  Coming  of  age:  problems  of  teen- 
agers by  Paul  H.  Landis.  1956.  28p. 

no. 264  Your  child's  emotional  health  by 
Anna  W.M.  Wolf.  1958.  28p. 

no. 267  Your  operation  by  Robert  M. 
Cunningham.  1958.  20p. 

no.272  IVill  my  baby  be  born  normal  by 
Joan  Gould.  1958.  20p. 

no. 274  Yoii  and  your  adopted  child  by 
EdaJ.  LeShan.  1958.  28p. 

no. 286  When  a  family  faces  cancer  by 
Elizabeth  Ogg.  1959.  28p. 

no.288  How  retarded  children  can  be 
helped  by  Evelyn  Hart.  1959.  29p. 

no. 291 A  Your  child  may  be  a  gifted  child 
by  Ruth  Carson.  1959.  20p. 

no.293  The  only  child  by  Eda  J.  LeShan. 

1960.  20p. 


GOVERNMENT    DOCUMENTS 

18.  Women's  Bureau.  Utws  of  interest  to 
women  of  Alberta.  Rev.  Edmonton,  Queen's 
Printer.  1970.  38p. 

Canada 

19.  Bureau  of  Statistics.  Canadian  statistical 
review.     Annual    supplement.     1969.     42p. 

20.  Conseil  du  Tresor  du  Canada.  Negocia- 
tions  collectives  et  procedures  de  reglement 
des  griefs  dans  la  fonction  puhlique  federale; 
manuel  d'enseignement  sequentiel  prepare 
par  Claire  C.  Nault  avec  la  collaboration  de 
la  Division  des  relations  de  travail,  service 
du  personnel,  Ministere  de  la  Main-d'oeuvre 
et  de  I'lmmigration.  3.ed.  Ottawa,  Conseil 
du  Tresor  du  Canada,  1970.  I57p. 
21.Dept.  of  Energy.  Mines  and  Resources. 
Water  by  W.V.  Morris.  Ottawa,  Queen's 
Printer.  1969.  59p. 

22.  Dept.  of  National  Health  and  Welfare. 
Commission  of  Inquiry  into  the  Non-Med- 
ical Use  of  Drugs.  Interim  report.  Ottawa, 
Queen's  Printer.  1970.  320p. 
23. — .Research  and  Statistics  Directorate. 
Earnings  of  dentists  in  Canada.  1959-1968. 
Ottawa.  1970.  41  p. 

24.  Equipe  specialisee  en  Relations  de  Tra- 
vail. Le  syndicalisme  an  Quebec:  structure 
et  moiivement  par  J.  Dofny  et  P.  Bernard. 
Ottawa.  Imprimeur  de  la  Reine,  1968.  1 17p. 
(Canada.  Equipe  specialisee  en  relations 
de  travail  etude  no. 9) 


25.  Ministere  du  Travail.  Bureau  de  la  Main 
d'oeuvre  feminine.  Les  meres  an  travail  et 
les  modes  de  garde  de  letirs  enfants.  Ottawa. 
Imprimeur  de  la  Reine,  1970.  57p. 

26.  Minister  of  Veterans'  Affairs.  Pensions 
for  disability  and  death  related  to  military 
service.  Ottawa,  Queen's  Printer,  1969.  16p. 

27.  Royal  Commission  on  Bilingualism  and 
Biculturalism.  Bilingualism  and  hicultiira- 
lism  in  the  Canadian  House  of  Commons 
by  David  Hoffman  and  Norman  Ward. 
Ottawa,  Queen's  Printer,  1970.  295p.  (Can- 
ada. Royal  Commission  on  Bilingualism 
and  Biculturalism.  Documents  no. 3) 

28. — .Constitutional  adaptation  and  Cana- 
dian federalism  since  1945  by  Donald  V. 
Smiley.  Ottawa,  Queen's  Printer,  1970.  155p. 

29.  Task  Force  on  Labour  Relations.  Re- 
sponsible decision-making  in  democratic 
trade  unions  by  Earl  E.  Palmer.  Ottawa, 
Queen's  Printer,  1970.  423p.  (Canada.  Task 
Force  on  Labour  Relations  study  no.  1 1 ) 
Quebec 

30.  Commission  d'Enquete  sur  la  Sante  et 
le  Bien-etre  social.  Rapport,  tome  4,  La 
Same.  Quebec,  Ville,  Gouvernement  du 
Quebec,  1970.  4pts. 

31. — .Rapport,   tome    7.    Les  professions   et 
la  societe.  Quebec,  Ville,  Gouvernement  du 
Quebec,  1970.  102p. 
United  States 

32.  Dept.  of  Health,  Education  and  Welfare. 
Public  Health  Service.  Bibliography  of  the 
history  of  medicine.  Bethesda,  Maryland, 
U.S.  Government  Printing  Office,  1968.  299p. 


Request  Form  for  "Accession  List" 
CANADIAN  NURSES'  ASSOCIATION  LIBRARY 

Send  this  coupon  or  facsimile  to: 

LIBRARIAN,  Canadian  Nurses'  Association,  50  The  Driveway,  Ottawa  4,  Ontario 

Please  lend  me  the  following  publications,  listed  in  the  issue  of  The 

Canadian  Nurse,  or  add  my  name  to  the  waiting  list  to  receive  them  when  available: 

Item  Author  Short  title  (for  identification) 

No. 


Requests  for  loans  will  be  filled  in  order  of  receipt. 

Reference  and  restricted  materia!  must  be  used  in  the  CNA  library. 

Borrower Registration  No. 


Position 


Address    

Date  of  request 


56     THE  CANADIAN   NURSE 


MARCH   1971 


DO  YOU 

WANT  TO  HELP 

YOUR  PROFESSION? 

Then  fill  out  and  send  in  the  form  below 

REMITTANCE  FORM 
CANADIAN  NURSES'  FOUNDATION 

50  The  Driveway,  Ottawa  4,  Ontario 

A  contribution  of  $ payable  to 

J      the  Canadian  Nurses'  Foundation  is  enclosed 
and  is  to  be  applied  as  indicated  below: 

IVIEMBERSHIP  (payable  annually) 

Nurse  Member  —  Regular  $     2.00  

Sustaining         $   50.00   

Patron 


$500.00 

Public  Member —    Sustaining         $  50.00 
Patron  $500.00 

BURSARIES  $ RESEARCH  $      . 

MEMORIAL  $ in  memory  of  . 


Name  and  address  of  person  to  be  notified  of 
this  gift  


REMITTER 

Address  . 
Position  . 
Employer 


(Print  name  in  full) 


N.B.:  CONTRIBUTIONS  TO  CNF 
ARE  DEDUCTIBLE  FOR  INCOME  TAX  PURPOSES 


Index 

to 

advertisers 

March  1971 


Baxter  Laboratories  of  Canada 23,  27 

BDH  Pharmaceuticals 53 

Burroughs  Wellcome  &  Co.  (Canada  Ltd 29 

Charles  E.  Frosst  &  Co 25,  54 

Gomco  Surgical  Manufacturing  Corp 12 

Hollister  Inc 14 

LV.  Ometer,  Inc 19 

Johnson  &  Johnson  Limited 2 

LaCross  Uniform  Corp 11 

Lakeside  Laboratories  (Canada)  Ltd 30 

J.B.  Lippincott  Company  of  Canada  Limited 9 

McCallan  &  Associates  Limited Cover  IV 

C.V.  Mosby  Company,  Ltd 15 

Octo  Laboratory,  Ltd 6 

Parke,  Davis  &  Company  Ltd 10 

Professional  Tape  Co 24 

Reeves  Company 5 

W.B.  Saunders  Company  Canada  Ltd 1 

Schering  Corporation  (Canada)  Limited 21 

G.D.  Searle  &  Co.  of  Canada  Limited 55 

White  Sister  Uniform,  Inc Cover  II,  III 

Winley-Morris  Co.  Ltd 17 


Advertising 

Manager 

Ruth  H.  Baumel, 

The  Canadian  Nurse 

50  The  Driveway 

Ottawa  4,  Ontario 

Advertising  Representatives 
Richard  P.  Wilson 
219  East  Lancaster  Avenue 
Ardmore,  Penna.  19003 

Vance  Publications, 
2  Tremont  Crescent 
Don  Mills,  Ontario 

Member  of  Canadian 
Circulations  Audit  Board  Inc. 


MARCH  1971 


THE  CANADIAN   NURSE 


71 


PROVINCIAL  ASSOQATIONS  OF  REGISTERED  NURSES 


Alberta 

Alberta  Association  of  Registered  Nurses, 
10256 —  1 12  Street,  Edmonton. 
Pres.:  M.G.  Purcell;  Pies. -Elect:  R.  Erick- 
son;  Vice-Pres.:  D.E.  Huffman.  A.J.  Prowse. 
Commillees — Niirs.  Serv.:  G.  Clarke; 
Niirs.  Ediic:  G.  Bauer;  Staff  Nurses:  L.A. 
Meighen;  Siiperv.  Nurses:  L.  Bartlett;  Soc. 
&  Econ.  Welf.:  1.  Mossey.  Provincial  Office 
Staff — Puh.  Rel.:  D.J.  Labelle;  Employ. 
Rel.:  Y.  Chapman;  Committee  Advisor: 
H.  Cotter:  Registrar:  D.J.  Price;  Exec.  Sec: 
H.M.  Sabin;  Office  Manager:  M.  Garrick. 

British  Columbia 

Registered  Nurses'  Association  of  British 
Columbia.  2130  West  12th  Avenue.  Vancou- 
ver 9. 

Pres.:  M.D.G.  Angus;  Past  Pres.:  M.  Lunn; 
Vice-Pres.:  R.  Cunningham,  A.  Baumgart; 
Hon.  Treasurer:  T.J.  McKenna;  Hon.  Sec: 
Sr.  K.  Cyr.  Committees — Nurs.  Edttc: 
E.  Moore;  Nurs.  Serv.:  J.M.  Dawes;  Soc. 
&  Econ.  Welf:  R.  Mcfadyen;  Finance: 
T.J.  McKenna:  Leg.  &  By-Laws:  Norman 
Roberts:  Puh.  Rel.:  H.  Niskala;  Exec.  Di- 
rector: F.A.  Kennedy;  Registrar:  H.  Grice; 
Communications  Consult.:  C.  Marcus. 

Manitoba 

Manitoba  Association  of  Registered  Nurses, 
647  Broadway  Avenue,  Winnipeg  1. 
Pres.:  M.E.  Nugent;  Past  Pres.:  D.  Dick; 
Vice-Pres.:  F.  McNaught,  Sr.  T.  Caston- 
guay.  Committees — Nurs.  Serv.:i.  Robert- 
son; Nurs.  Educ:  S.J.  Winkler;  Soc.  &  Econ. 
Welf:  S.J.  Paine:  Legis.:  M.E.  Wilson;  Ac- 
crediting: M.E.  Jackson;  Board  of  Examiners: 
E.  Cranna;  Educ.  Fund:  M.  Kullberg;  Fi- 
nance: B.  Cunnings:  Pub.  Rel.  Officer:  T.M. 
Miller;  Registrar:  M.  Caldwell;  Exec.  Di- 
rector: B.  Cunnings:  Coordinator  of  Contin. 
Educ:  H.  Sundstrom. 

New  Brunswick 

New  Brunswick  Association  of  Registered 
Nurses,  23 1  Saunders  Street,  Fredericton. 
Pres.:  H.  Hayes;  Past  Pres.:  I  Leckie;  Vice- 
Pres.:  A.  Robichaud,  L.  Mills;  Hon.  Sec: 
M.  MacLachlan.  Committees —  Soc.  &  Econ. 
Welf:  B.  Leblanc;  Nurs.  Educ:  Sr.  H.  Ri- 
chard; Nurs.  Serv.:  Sr.  M.L.  Gaffney;  Fi- 
nance: A.  Robichaud;  Legisl.:  M.  MacLach- 
lan; Exec.  Sec:  M.J.  Anderson;  Acting 
Registrar:  M.  Russell;  Adv.  Com.  to  Schools 
of  Nurs.:  Sr.  F.  Darrah;  Nurs.  Asst.  Comm.: 
A.  Dunbar;  Liaison  Officer:  N.  Rideout; 
Employ.  Rel.  Officer:  G.  Rowsell. 

Newfoundland 

Association  of  Nurses  of  Newfoundland, 
67  LeMarchand  Road,  St.  John's. 
Pres.:  P.  Barrett;  Past  Pres.:  E.  Summers; 
Pres.  Elect.:  E.  Wilton;  1st  Vice-Pres.:  J. 
Nevitt;  2nd  Vice-  Pres.:  E.  Hill;  Committees 
—  Nurs.  Educ:  L.  Caruk;  Nurs.  Serv.:  A. 
Finn;    Soc.    &    Econ.    Welf:    L.    Nicholas; 

72     THE  CANADIAN   NURSE 


Exec.  Sec:  P.  Laracy;  A.ssl.  Exec.  Sec:  M. 
Cummings. 

Nova  Scotia 

Registered  Nurses'  Association  of  Nova 
Scotia,  6035  Coburg  Road,  Halifax. 
Pres.:  J.  Fox;  Past  Pres.:  J.  Church;  Vice- 
Pres.:  Sr.  C.  Marie,  M.  Bradley,  E.J.  Dob- 
son;  Advisor,  Nurs.  Educ:  Sr.  C.  Marie; 
Advisor.  Nurs.  Serv.:  J.  MacLean.  Com- 
mittees—  Nurs.  Educ:  Sr.  J.  Carr;  Nurs. 
Serv.:  G.  Smith;  Soc.  &  Econ.  Welf:  Roy 
Harding;  Exec.  Sec:  F.  Moss;  Pub.  Rel.  Of- 
ficer: G.  Shane;  Employ.  Rel.  Officer:  M. 
Bentley. 

Ontario 

Registered  Nurses'  Association  of  Ontario, 
33  Price  Street,  Toronto  289. 
Pres.:  L.E.  Butler;  Pres.  Elect:  M.J.  Flaherty. 
Committees — Socio.-Econ.  Welf.:  M.E.B. 
Purdy;  Nursing:  E.  Valmaggia;  Educator: 
A.E.  Griffin;  Administrator:  M.A.  Liddle; 
Exec.  Director:  L.  Barr;  Asst.  Exec.  Di- 
rector: D.  Gibney;  Employ.  Rel.  Director: 
A.S.  Gribben;  Coord.,  Formal  Contin.  Educ 
Program:  L.C.  Peszat;  Director,  Prof.  Devel. 
Dept.:  CM.  Adams:  Pub.  Rel.  Officer:  1. 
LeBourdais;  Regional  Exec.  Sec:  I.W. 
Lawson,  M.I.  Thomas,  F.  Winchester. 

Prince  Edward  Island 

Association  of  Nurses  of  Prince  Edward 
Island,  188  Prince  Street,  Charlottetown. 
Pres.:  C.  Corbett:  Past  Pres.:  B.  Rowland; 
Vice-Pres.:  B.  Robinson;  Pres.  Elect.:  E. 
MacLeod.  Committees — Nurs.  Educ: 
M.  Newson;  Nurs.  Serv:  S.  Griffin;  Pub; 
Rel.:  C.  Gordon;  Finance:  Sr.  M.  Cahill; 
Legis.  &  By-Laws:  H.L.  Bolger;  Soc.  & 
Econ.  Welf:  F.  Reese;  Exec.  Sec-  Registrar: 
H.L.  Bolger. 
Quebec 

Association  of  Nurses  of  the  Province  of 
Quebec,  4200  Dorchester  Boulevard,  West, 
Montreal. 

Pres.:  H.D.  Taylor;  Vice  Pres.:  (Eng.j  S. 
O'Neill,  R.  Atto;  (Fr.):  R.  Bureau,  M.  La- 
lande;  Hon.  Treas.:  J.  Cormier;  Hon.  Sec: 
R.  Marron.  Committees — Nurs.  Educ: 
M.  Callin,  D.  Lalancette;  Nurs.  Serv.:  E. 
Strike,  C.  Gauthier;  Labor  Ret.:  S.  O'Neill. 
G.  Hotte;  School  of  Nurs.:  M.  Barrett,  P. 
Provencal;  Legis.:  E.C.  Flanagan,  G.  (Char- 
bonneau)  Lavallee;  Sec-Registrar:  N.  Du 
Mouchel. 
Saskatchewan 

Saskatchewan  Registered  Nurses  Association, 
2066  Retallack  Street,  Regina. 
Pres.:  M.  McKillop;  Pa.^t  Pres.:  A.  Gunn; 
1st  Vice-Pres.:  E.  Linnell;  2nd  Vice-Pres.: 
C.  Boyko.  Committees — Nurs.  Educ:  C. 
O'Shaughnessy;  Nurs.  Serv.:}.  Belfry;  Chap- 
ters &  Pub.  Rel.:  M.  Harman;  Soc.  &  Econ. 
Welf:  E.  Fyffe;  Exec.  Sec:  A.  Mills;  Reg- 
istrar: E.  Dumas:  Employ.  Rel.  Officer:  A. 
M.  Sutherland:  Nurs.  Consult.:  E.  Hartig; 
A.ssl.  Registrar: }.  Passmore. 


yV  CANADIAN 


ASSOCIATION 


Soard  of  Directors 

President  E.  Louise  Miner 

President-Elect 

Marguerite  E.  Schumacher 

1st  Vice-  President 

Kathleen  G.  DeMarsh 

2nd  Vice-President 

Huguette  Labelle 

Representative  Nursing  Sisterhoods 

...Sister  Cecile  Gauthier 
Chairman  of  Committee  on  Social  & 

Economic  Welfare  ..Marilyn  Brewer 
Chairman  of  Committee  on 

Nursing  Service  ...Irene  M.   Buchan 
Chairman  of  Committee  on  Nursing 
Education   Alice  J.  Baumgart 


Provincial  Presidents 

AARN  M.G.  Purcell 

RNABC  M.D.G.  Angus 

MARN   M.E.  Nugent 

NBARN    H.  Hayes 

ARNN   P.  Barrett 

RNANS  J.  Fox 

RNAO  L.E.  Butler 

ANPEl   C.  Corbett 

ANPQ  H.D.  Taylor 

SRNA    M.   McKillop 


National  Office 

Executive 

Director   Helen  K.   Mussallem 

Associate  Executive 

Director  Lillian  E.  Pettigrew 

General 

Manager  Ernest  Van  Raalte 


Research  and  Arlvisory  Services 

Nursing 
Coordinator  Harriett  J.T.  Sloan 

Research  Officer H.  Rose  Imai 

Library Margaret  L.  Parkin 

Information  Services 

Public  Relations  Doris  Crowe 

Editor,  The  Canadian 

Nurse  Virginia  A.  Lindabury 

Editor,  L'infirmiere 

canadienne    Claire  Bigue 


MARCH  197 


April  1971 


ITY  OP  OTTA'VA 

-ISRARY 


OTiAV,'A   2,    ^^_ 

l2-71-l2-.70-C.V-Pi) 


The 


Canadian 
Nurse 


research  in  nursing  practice 
—  first  national  conference 

myo-electric  control  — 

one  more  aid  for  the  amputee 

basilar  aneurysms 


so  VERY . 


WHITE 
SISTER 


IN  WHITE 

In  Super  Supreme  Flat 
Knit  Polvester/Nylon 

#0943 
$18.98 

Sizat:  8-18 


"IMAGE  SPORTIFF"  is  created  by  cresent  shaped  pockets.  Brass  ring  front  zipper  closing.  Fashion 
fitting  darts,  front  and  back.  Action  sleeve  gussets.  Available  as  full  pant  dress  only. 
Pants  —  Elastic  waist,  flare  bottoms  unhemmed  for  individual  length  adjustment 
#0943— In  "Royale"  Fortrel  Polyester/Nylon  Oxford  Knit 

Lime  and  Gold  at  S24.00 

Sizes:  8-18 
-0943  —  IN  WHITE:  "Super  Supreme"  Polyester/Nylon 

Flat  Knit 

White  only  at  S18.98 

Sizes  8-18 


Nursing  has  changed! 


Thousands  of  nurses  used  the  first  edition  of  "Stryker"  to  bring  their 
nursing  knowledge  up  to  date.  Now  the  book  itself  has  been  updated 
and  made  even  more  valuable  in  a  new  Second  Edition. 

"Back  to  Nursing"  was  designed  to  meet  the  needs  of  nurses  returning 
to  active  practice  after  an  absence.  It  worked  superbly  well.  So  well,  in 
fact,  that  nurses  who  had  been  practicing  all  along  started  using  it  to 
polish  up  their  knowledge.  In  the  new  edition  Miss  Stryker  writes,  "Since 
continuous  employment  in  itself  does  not  guarantee  current  knowledge 
and  updated  information,  some  form  of  ongoing  study  and  continuing 
education  is  needed  by  all  of  us.  For  these  reasons  the  second  edition  of 
this  book  has  attempted  to  assist  the  practicing  nurse  as  well  as  the 
refresher.  The  aims  of  the  book  are  five-fold:  first,  to  describe  the  general 
environment  in  which  nursing  must  function;  second,  to  provide  an 
overview  of  new  roles  and  current  practice  in  the  major  areas  of  nursing; 
third,  to  suggest  resources  for  further  study;  fourth,  to  assist  the  prac- 
titioner to  implement  her  ideas;  and  fifth,  to  assist  the  refresher  to  locate 
a  satisfying  work  situation." 

This  book  is  uniquely  designed  to  help  you  realize  your  aims. 

Back  to  Nursing,  Second  Edition.  By  Ruth  Perin  Stryker,  R.N.,  B.S.,  M.A., 
Director  of  Nursing  Education,  American  Rehabilitation  Foundation. 
About  368  pages,  illustrated.  About  $9.20.  Just  ready. 


Guyton:    BASIC    HUMAN    PHYSIOLOGY:    Normal 
Function  and  Mechanisms  of  Disease. 
By   Arthur  C.   Guyton,  M.D.,  University  of   Mississippi 
Medical  School. 

A  careful  condensation  of  Guyton's  standard  med- 
ical text,  this  new  book  is  designed  for  students  in 
the  health  professions.  It  emphasizes  general  and 
cellular  physiology,  biochemistry,  and  material  on 
bone,  teeth,  and  oral  physiology.  All  the  facts  are 
there;  omitted  are  discussions  of  alternative  hypo- 
theses and  extensive  references.  The  authority, 
lucidity,  and  pertinence  for  which  the  big  Guyton 
is  famous  come  through  clearly  in  this  new,  more 
compact  book. 

About  650  pages  with  430  illustrations.  About  $13.50. 
Just  ready. 


THE  NURSING  CLINICS  OF  NORTH  AMERICA 

The  latest  (March)  issue  of  the  famous  Nursing 
Clinics  focuses  on  two  problem  areas:  Care  of  the 
Newborn,  with  Laurine  Cochran  of  Cincinnatti  Gen- 
eral Hospital  as  Guest  Editor,  and  Assessment  as 
Part  of  the  Nursing  Process,  with  Prof.  Elizabeth 
Giblin  of  the  University  of  Washington  School  of 
Nursing  as  Guest  Editor.  The  18  timely  articles  that 
make  up  these  two  symposia  are  typical  of  the 
authoritative,  informative,  and  practical  information 
that  fills  every  issue  of  the  Nursing  Clinics.  Four 
issues  per  year  average  185  pages  with  no  advertis- 
ing, bold  by  annual  subscription  only,  $13. 


W.  B.  SAUNDERS  COMPANY  CANADA  Ltd.  1835  Yonge  Street,  Toronto  7. 

Please  send  on  approval  and  bill  me: 

n  Stryker:  BACK  TO  NURSING  Second  Edition  (about  $9.20) 
D  Guyton:  BASIC  HUMAN  PHYSIOLOGY  (about  $13.50) 
D  Please  enter  my  subscnption  to  the  NURSING  CLINICS,  to  start  with  the  March  issue 
($13  per  year) 


Name 


Address 
City 


Zone 


Prov. 


APRIL   1971 


CN  4-71 
THE  CANADIAN   NURSE 


THE 


(]LlfllI(] 

TRAOCMAnKS  fWa  us.   PAT.  OTF    t  CAHAOA   UADC  M  U  S  A 

SHOE 


SOME  STYLES  ALSO  AVAIUBLE  IN  COLORS  .  .  .  SOME  STYLES  3y2-12  AAAA-E,  $18.95  to  $25.95 

For  a  complimentary  pair  of  white  shoelaces,  folder  showing  all  the  smart  Clinic  styles,  and  list  of  stores  selling  them,  write: 

THE   CLINIC   SHOEMAKERS    •   Dept.  CN-4,  7912  Bonhomme  Ave.   •    St.  Louis.  Mo.  63105 


The 


Canadian 
Nurse 


A  monthly  journal  for  the  nurses  of  Canada  published 

in  English  and  French  editions  bv  the  Canadian  Nurses'  Association 


Volume    67,    Number    4 


April    1971 


33  Research,  Apple  Juice,  and  Daffodils  — 

A  Good  Combination D.J.  Kergin 

34  National  Conference  on  Research  in 
Nursing  Practice 

4 1     Management  of  Parkinson's  Disease  With 

L-dopa  Therapy E.  Tyler 

43  The  Cancer  Patient W.  Stockdale 

44  Myo-electric  Control  —  One  More  Aid 

For  The  Amputee R.N.  Scott 

49     Basilar    Aneurysms M.J.    Derdall 

53     Information  for  Authors 


The  views  expressed  in  the  various  articles  are  the  views  of  the  authors  and  do  not 
necessarily  represent  the  policies  or  views  of  the  Canadian  Nurses'  Association. 


4  Letters 

24  Names 

30  In  a  Capsule 

55  Research  Abstracts 

58  Acession  List 


1  1  News 

28  New  Products 

54  Dates 

56  AV  Aids 

80  Index  to  Advertisers 


Executive  Director:  Helen  K.  Mussallem  • 
Editor:  Virginia  A.  Lindabury  •  Assistant 
Editor:  Liv-Ellen  Lockeberg  •  Editorial  As- 
sistant: Carol  .\.  Kotlarsky  •  Production 
Assistant:  Elizabeth  A.  Stanton  •  Circula- 
tion Manager:  Ben  I  Darling  •  Advertising 
Manager:  Ruth  H.  Baumel  •  Subscrip- 
tion Rales:  Canada:  one  year.  S4.50;  two 
years,  S8.00.  Foreign:  one  year,  $5.00;  two 
years.  S9.00.  Single  copies:  50  cents  each. 
Make  cheques  or  money  orders  payable  to  the 
Canadian  Nurses'  Association.  •  Change  of 
Address:  Six  weeks"  notice;  the  old  address  as 
well  as  the  new  arc  necessary,  together  with 
registration  number  in  a  provincial  nurses' 
association,  where  applicable.  Not  responsible 
for  journals  lost  in  mail  due  to  errors  in 
address. 


Manuscript  Information:  "The  Canadian 
Nurse"  welcomes  unsolicited  articles.  All 
manuscripts  should  be  typed,  double-spaced, 
on  one  side  of  unruled  paper  leaving  wide 
margins.  Manuscripts  are  accepted  for  review 
for  exclusive  publication.  The  editor  reserves 
the  right  to  make  the  usual  editorial  changes. 
Photographs  (glossy  prints)  and  graphs  and 
diagrams  (drawn  in  India  ink  on  white  paper) 
are  welcomed  with  such  articles.  The  editor 
is  not  committed  to  publish  all  articles 
sent,  nor  to  indicate  definite  dates  of 
publication. 

Postage  paid  in  cash  at  third  class  rale 
MONTREAL,  P.O.  Permit  No.  10,001. 
50  The  Driveway.  Ottawa  4.  Ontario. 
O    Canadian  Nurses'  Association   1971. 


Editorial 


APRIL  1971 


Anyone  who  has  completed  a  research 
project  naturally  wants  to  share  her 
findings.  The  reason  is  simple:  she  has 
reached  certain  conclusions  that  may 
be  valuable  to  others  engaged  in  similar 
studies  or  to  those  working  in  clinical 
settings  who  can  test  and  perhaps  im- 
plement her  findings. 

But  how  does  she  disseminate  infor- 
mation about  her  research?  This  ques- 
tion was  raised  at  the  national  con- 
ference on  research  in  nursing  practice 
held  in  Ottawa  in  February.  There  was 
consensus  that  few  nursing  research 
projects  were  being  shared  with  others, 
and  that  in  the  long  run  it  was  the  pa- 
tient who  suffered  most  from  this  lack 
of  communication. 

We  believe  the  problem  can  be  cor- 
rected, and  we  are  willing — in  fact, 
eager  —  to  help.  However,  the  solution 
requires  the  cooperation  of  both  the 
researcher  and  the  institution  or  agency 
that  sponsored  her  project. 

The  best  way  to  bring  a  completed 
research  project  to  the  attention  of  aL 
nurses  is  to  send  a  copy  of  it  to  the 
Canadian  Nurses"  Association's  Repos- 
itory Collection.  Studies  received  ir 
this  Collection  are  listed  monthly  ir 
The  Canadian  Nurse  and  are  available 
on  interlibrary  loan  from  the  CNA 
library.  Abstracts  of  these  studies  an 
then  published  in  CNJ.  (Credit  —  lonj 
overdue  —  is  given  to  Dr.  Moyra  Allen 
associate  professor  at  McGill's  Schoo 
For  Graduate  Nurses,  who  first  suggest 
ed  that  research  abstracts  be  publishec 
in  the  journal.) 

But  how  many  individuals  or  institu 
tions  take  advantage  of  this  CNA  serv 
ice  by  sending  in  their  completed  re 
search  papers?  Very  few.  The  CN/* 
librarian  estimates  that  the  Repositon 
Collection  has  received  only  one-thirc 
of  all  studies. 

The  researcher  should  consider  ai 
additional  way  to  share  her  findings 
by  writing  ar.  article,  based  on  he; 
study,  for  publication  in  The  Canadiai 
Nurse.  Frequently  we  have  approachec 
nurses  to  write  such  articles  and  havt 
either  been  turned  down  or  have  receiv 
ed  a  "yes"  —  but  no  article. 

Perhaps  we  haven't  pushed  enough 
Maybe  our  tactics  should  change.  Ir 
future,  we  will  chase,  not  "approach,' 
these  nurses,  because  we,  too,  believ( 
research  tlndings  should  be  sharet 
with  all  those  who  are  interested  o 
involved  in  upgrading  nursing  practice 

—  V.A.L 

THE  CANADIAN   NURSE       3 


letters 


Letters  to  the  editor  are  welcome. 

Only  signed  letters  will  be  considered  for  publication,  but 

name  will  be  withheld  at  the  writer's  request. 


Student  is  "turned  off" 

Although  I  have  not  yet  graduated,  I 
have  already  been  turned  off  by  the 
great  majority  of  my  nursing  colleagues. 
The  idealistic  conception  of  "nurse" 
that  I  had  on  entering  nursing  has  deter- 
iorated as  my  contacts  with  nurses  have 
increased.  I  have  become  disillusioned 
with  this  so-called  career  in  compas- 
sion. My  greatest  fear  as  my  graduation 
approaches  is  that  I  shall  follow  the 
footsteps  of  those  who  form  the  greater 
part  of  the  nursing  profession,  for  I 
have  no  doubt  that  they  were  every  bit 
as  conscientious  as  I  at  the  outset  of 
their  careers. 

But  what  I  see  now  disgusts  me  and 
makes  me  ashamed  to  call  myself  a 
nurse.  Nursing  care  is  mediocre,  no- 
where approaching  standards  learned  in 
the  schools.  Nurses  dress  sloppily. 
They,  more  than  any  other  group  in  the 
hospital,  resist  the  change  and  innova- 
tion so  necessary  to  improve  nursing 
care  in  this  changing  world.  They  rely 
on  doctors  to  assume  the  responsibility 
that  should  be  theirs.  They  take  extend- 
ed coffee  and  lunch  breaks  and  then 
complain  that  they  don't  have  time  to 
give  proper  patient  care.  They  don't' 
support  their  professional  organization, 
yet  have  the  nerve  to  sit  back  and  com- 
plain about  the  poor  wages,  about  being 
overworked,  and  talk  about  wanting 
professional  status. 

I  see  our  nursing  leaders  fighting  for 
these  things  and  getting  no  support 
from  these  apathetic  grumblers.  And  1 
see  that  they  are  the  greatest  obstacle 
to  progress  in  nursing.  I  feel  that  I  am 
beaten  before  I  even  start.  I  have  little 
faith  in  my  fellow  nurse. 

I  see  the  day  coming  soon  when  the 
registered  nurse  will  be  phased  out. 
She  is  outliving  her  usefulness  by  cling- 
ing to  the  past  and  by  allowing  herself 
to  become  second-rate.  Hospital  ad- 
ministrators will  soon  learn  that  it  is 
more  economical  and  just  as  efficient 
to  employ  well-trained  registered  nurs- 
ing assistants,  for  they  can  perform 
every  bit  as  well  at  the  lowered  stand- 
ards nurses  have  set  for  themselves. 
No  doubt  there  will  be  an  uproar  from 
nurses  and  others.  The  patient  needs 
the  added  skill  and  training  that  the 
registered  nurse  has.  Of  course  he  does; 
but  he  isn't  getting  it  now,  so  why  should 
the  hospital  pay  for  services  not  render- 
ed? 

I  send  a  plea  to  all  nurses.  It  would 
4       THE  CANADIAN   NURSE 


take  such  a  small  effort  on  the  part  of 
each  one  to  bring  our  profession  up  to 
the  standard  I  know  it  can  reach.  Every 
nurse  has  learned  how  to  give  not  just 
good,  but  optimal,  nursing  care.  Every 
nurse  has  the  skill  and  knowledge  to 
give  that  care.  But  she  has  to  use  it. 
There  will  be  no  room  for  the  mediocre 
nurse  in  the  hospitals  of  tomorrow. 
She  will  be  replaced  if  she  does  not 
shape  up. 

If  less  effort  were  put  into  talking 
about  professionalism  and  more  into 
living  up  to  professional  standards,  we 
would  be  a  lot  better  off.  The  only  thing 
that  can  improve  the  status  of  nursing 
is  action  —  active  effort  on  the  part  of 
every  nurse  to  improve  herself.  Please 
try.  For  your  own  sakes.  —  Elizabeth 
Jordan,  4th  year  nursing  student.  Uni- 
versity of  Toronto. 


A  word  of  thanks 

The  following  letter,  dated  December 
20,  1970,  was  received  by  Mary  Burton 
of  Montreal.  It  is  printed  in  the  hope 
that  the  writer's  unknown  benefactor 
will  read  it. 

We  four  members  from  The  Japanese 
Nursing  Association  were  invited  to 
your  home  on  the  way  to  the  closing 
ceremony  of  the  International  Council 
of  Nurses  in  1969.  We  enjoyed  our 
conversation  and  thank  you  very  much. 
I  have  a  favor  to  ask  you.  When  I 


for  employment  or  bursaries  write: 

Director  in  Chief 

VICTORIAN  ORDER  OF  NURSES 

FOR  CANADA 

5  Blackburn  Avenue 

Ottawa  2,  Ontario 


arrived  at  the  Montreal  airport,  I  lost 
my  suitcase.  While  I  was  at  a  loss  what 
to  do,  a  lady  of  the  Canadian  Nurses' 
Association  tried  to  find  my  suitcase. 
She  looked  for  it  with  me  and  took  me 
to  the  airfxjrt  counter,  fxjlice  office, 
etcetera,  and  asked  them  if  they  could 
find  my  luggage.  I  do  appreciate  her 
very  much.  I  shall  not  forget  all  her 
kindness  extended  to  me.  I  would  like 
to  express  my  hearty  thanks.  Will  you 
ask  the  Canadian  Nurses'  Association 
office  about  it  and  let  me  know  her 
name  and  address?  I  tried  to  ask  my- 
self, but  I  haven't  got  the  address.  I'm 
very  sorry  to  bother  you. 

Will  all  the  kindest  wishes  for  good 
health  and  good  fortune.  —  Kimiko 
Kinoshita,  ch  Himaraya,  26-22  6, 
chotne  Kinuta-Machi,  Setagaya-ku, 
Tokyo, Japan. 


More  comments  on  abortion 

I  agree  that  the  Canadian  Nurses'  Asso- 
ciation should  formulate  a  policy  on 
abortion.  It  is  a  matter  that  affects 
Canadian  nurses  not  only  professionally 
but  also  personally,  since  the  majority 
of  nurses  are  female.  The  CNA  should 
be  one  of  the  first  to  take  a  stand,  along 
with  each  cf  the  provincial  associations, 
so  that  Canadians  in  general  will  be 
aware  of  professional  opinions  before 
making  their  own  decisions.  Nurses 
must  make  their  voices  heard  in  Otta- 
wa, where  these  important  decisions 
are  now  made. 

I  firmly  believe  that  abortion  must 
be  a  matter  between  the  patient  and  her 
doctor  and  that  it  should  be  available 
to  all. 

However,  abortion  should  not  be- 
come a  method  of  birth  control.  In 
addition  to  reform  in  abortion  availabil- 
ity, we  must  also  reform  our  methods  of 
providing  family  planning  services.  The 
departments  of  health  in  every  province 
must  become  actively  involved  in  setting 
up  enough  clinics  to  provide  full  family 
planning  services  for  the  whole  prov- 
ince. If  our  governments  and  our  profes- 
sional organizations  would  concentrate 
on  providing  this  type  of  service,  the 
urgent  need  for  abortions  would  de- 
cline. Some  abortions  would  still  be 
needed,  but  any  woman  would  rather 
prevent  a  pregnancy  than  abort.  As  the 
situation  is  now,  however,  reliable 
birth  control  information  and  services 
are  not  available  to  all  women. 

APRIL  1971 


I  believe  this  type  of  clinic  is  our 
most  immediate  need  and  the  remedy 
seems  to  be  much  simpler  and  cheaper 
than  abortion  reform.  The  operation  of 
these  clinics  would  certainly  be  less 
expensive  than  providing  the  hospital 
beds  needed  if  abortion  became  truly 
a  medical  matter  tomorrow.  —  Marsha 
Cleary,  Sudbury,  Ontario. 

In  her  letter  to  the  editor  (February, 
1971),  Sister  Marie  Simone  Roach 
raises  philosophical  and  ethical  issues 
regarding  therapeutic  abortion  and  the 
responsibility  ofnurses.  Included  among 
her  arguments  is  a  narrow  interpretation 
of  the  International  Council  of  Nurses 
Code  of  Ethics.  What  Sister  Roach 
seems  to  overlook  is  the  importance  of 
the  viability  of  the  human  family  unit 
and  the  responsibility  of  its  decision- 
making members  to  ensure  the  continu- 
ed welfare  of  that  unit. 

Nurses  do  indeed  have  an  ethical 
responsibility  "to  conserve  life,  to 
alleviate  suffering  and  to  promote 
health."  A  restrictive  interpretation  of 
the  Code  should  not  be  the  excuse  that 
prevents  nurses  from  leaving  parents 
free  to  consider  the  advisability  of  a 
therapeutic  abortion. 

The  nurse's  responsibility  is  to  pro- 
vide necessary  therapeutic  care,  includ- 
ing supjxtrt,  whatever  the  decision  may 
be.  If  the  nurse's  ethical  or  religious 
beliefs  prevent  her  from  providing  this 
care,  then  she  should  ensure  that 
another  is  available  to  do  so.  To  do 
less  or  to  impose  her  own  values  on  the 
mother  and  family  is  a  potent  violation 
of  the  ICN  Code. 

Any  ethical  proscription  against 
therapeutic  abortion  reflects  the  con- 
science of  the  individual  nurse,  not 
the  profession.  —  Dorothy  J.  Kergin, 
Professor  of  Nursing,  McMaster  Uni- 
versity, Hamilton,  Ontario. 

I  was  appalled  to  see  that  a  registered 
nurse  could  actually  believe  that  abor- 
tion is  right  and  should  be  considered 
a  private  matter  between  the  patient  and 
her  doctor  (Letters,  Dec.  1970).  How 
can  this  be  so?  Isn't  abortion  murder? 
Does  not  life  begin  with  conception? 
And  does  this  not  mean  that  the  fetus 
has  a  soul?  Therefore,  is  not  the  taking 
of  a  life,  even  a  life  in  the  fetal  state, 
murder? 

Who  are  we  to  stand  in  judgment  of 
who  should  have  the  right  to  be  born 
and  who  should  not?  Have  not  many 
of  the  mentally  and  physically  handi- 


Letters  Welcome 

Letters  to  the  editor  are  welcome.  Be- 
cause of  space  limitation,  writers  are 
asked  to  restrict  their  letters  to  a 
maximum  of  350  words. 


capped  proven  their  worth  in  this  world? 
I  don't  see  how  so  many  who  call  them- 
selves Christians  can  break  or  even 
consider  breaking  the  commandment 
"Thou  Shalt  Not  Kill." 

A  few  weeks  ago  I  read  an  article 
called  "The  Fetus  in  a  Pail."  My  feel- 
ings against  abortion  have  always  been 
strong,  but  after  reading  this  article, 
they  became  even  stronger.  I  could 
imagine  how  sick  1  would  have  felt, 
had  I  been  the  nurse  asked  to  scrub  and 
assist  in  that  abortion,  watching  a  live 
fetus  taken  from  its  mother  and  left  to 
die  in  an  operating  room  pail.  Anyone 
who  believes  in  abortion,  especially 
for  purely  selfish  reasons,  is  someone 
less  than  human. 

Why  not  practice  prevention,  then 
the  cure  would  never  have  to  be  discuss- 
ed? 

If  the  laws  on  abortion  become  so 
permissive,  just  how  far  off  is  euthan- 
asia? —  K.F.  VanDeSype,  Reg.  N., 
Radville,  Saskatchewan. 

With  few  exceptions,  the  views  of  ed- 
ucated and  intelligent  women  on  the 
subject  of  abortion  seem  to  be  ac- 
ceptance. The  views  that  are  getting 
into  print  have  almost  all  agreed:  (a) 
that  abortion  is  not  a  crime  and  should 
therefore  be  removed  from  the  criminal 
code;  (b)  that  in  the  early  stages  the 
fertilized  ovum  is  simply  "undifferen- 
tiated tissue"  —  hence  nothing  human 
is  being  killed  by  an  abortion;  (c)  that 
the  prospective  mother  should  always 
come  first,  that  her  wishes  should  be 
paramount. 

Is  abortion,  if  legalized,  going  to 
become  the  convenient  solution  to 
irresponsible  behavior  in  this  coun- 
try? Probably  it  is;  almost  all  the  res- 
pected and  knowledgeable  voices  are 
supporting  its  legalization. 

If  we  put  all  the  effort  spent  clamor- 
ing for  "free  abortions  on  demand" 
into  educating  our  young  people,  and 
into  providing  free  sterilization  for 
women  who  don't  wish  to  have  more 
or  any  children,  would  we  not  succeed 
in  solving  the  problem  of  the  unwanted 
pregnancy  without  resorting  to  murder? 
—  S.E.  Smith,  R.N.  Winnipeg,  Man. 


It  seems  strange  to  me  that  The  Ca- 
nadian Nurse  always  comes  down  on  the 
"liberal"  side  of  the  fence.  This  trend 
was  evident  in  the  fluoridation  contro- 
versy and  the  narcotics  problem.  Now 
we  nurses  are  being  brainwashed  into 
a  Women's  Lib  philosophy  on  abor- 
tion (Feb.  '7 1  issue). 

I  am  surprised  that  we  are  expected 
to  swallow  this  emotional  line  rather 
than  be  offered  a  professional,  statisti- 
cal, moral,  and  economic  argument. 
The  Planned  Parenthood  organization. 


K 

J 

1 

i  with  confidence,  for  routine  feminine  hygiene, 
;  it's  cleansing,  refreshing,  deodorizing. 

:  And  to  help  answer  patients'  questions,  a  new 
:  booklet  "The  Hows  and  Whys  of  Douching"  is 
:  available  free  of  charge.  Just  mail  this  coupon 
'.  for  your  supply. 

•  Name 

•o 

< 

Julius  Schmid  of  Canada  Ltd. 
32  Bermondsey  Road, 
Toronto,  Canada  374 

Or. 

kI;^ 

APRIL  1971 


THE  CANADIAN    NURSE 


NEW  POSEY  DEVELOPMENTS 


The  new  Posey  products  shown 
here  are  but  a  few  included  in  the 
complete  Posey  Line.  Since  the 
introduction  of  the  original  Posey 
Safety  Belt  in  1937,  the  Posey 
Company  has  specialized  in 
hospital  and  nursing  products 
which  provide  maximum  patient 
protection  and  ease  of  care.   To 
insure  the  original  quality  product, 
always  specify  the  Posey  brand 
name  when  ordering. 

The  Posey  Pelvic  Seat  effectively 
prevents  sliding  forvkiard  and  fall- 
ing from  chair.  This  device  is  se- 
cured from  behind  on  any  type  of 
chair  and  is  comfortable  for  the 
patient.     *4432  (cotton),  $7.50. 


The  Posey  "Swiss  Cheese"  Heel 
Protector  has  nevy  hook  and  eye 
fasteners  for  easy  application  and 
sure  fit.  Available  in  convoluted 
porous  foam  or  synthetic  fur  lin- 
ing. #6127  (fur  lining),  H122 
(foam),  $4.80  pr. 


The  Posey  Body  Stop  Kit  with 
soft  padded  bar  provides  a  quick, 
simple,  and  effective  method  of 
preventing  a  patient  from  "scoot- 
ing" forward  in  any  standard 
wheelchair.     #8755,  $24.95. 


The  Posey  Houdini  Security 
Suit  is  for  the  patient  that  will  not 
stay  in  bed  or  wheelchair.  Vest  and 
lower  portion  interlock  with  waist 
belt  making  it  virtually  escape- 
proof.  #3472,  J75.00  complete. 


The  Posey  Foot-Guard  with  new 
"T"  bar  stabilizer  simultaneously 
keeps  weight  of  bedding  off  foot, 
helps  prevent  foot  drop  and  foot 
rotation.    #6472,   527.00. 


Send  lor  the  free  all  new  POSEY  catalog  -  supersedes  all  previous  editions. 
Please  insist  on  Posey  Quality  —  specify  the  Posey  Brand  name. 


POSEY  PRODUCTS 
Stocked  in  Canada 

ENNS  &  GILMORE  LIMITED 

1033  Rangeview  Road 
Port  Credit,  Ontario,  Canada 


6       THE  CANADIAN   NURSE 


(Continued  fn>m  pn^e  5) 


in  a  1963  pamphlet,  stated:  "An  abor- 
tion requires  an  operation.  It  kills  the 
life  of  the  baby  after  it  has  begun." 
That  this  adds  up  to  murder  has  been 
proven  in  a  number  of  court  cases. 

Japan  is  currently  considering 
changing  its  abortion  laws  because  of 
its  2.5  million  abortions  per  year  and 
the  highest  suicide  rate  in  the  world  of 
women  in  child-bearing  age  (see  1965 
report  on  U.N. -sponsored  World 
Population  Conference  held  in  Bel- 
grade, Yugoslavia.) 

Throughout  the  world,  legislation 
to  protect  the  "health  of  the  mother" 
may  quickly  be  interpreted  as  the  "well- 
being"  of  the  mother  —  or  someone 
who  wants  to  avoid  disruption  of  her 
social  life,  or  the  inconvenience  of 
being  unable  to  wear  the  latest  mod 
fashions. 

I  do  not  believe  in  lending  my  serv- 
ices to  this  slaughter-house  butchery 
of  human  life.  Quite  frankly  I  defy  any 
nurse  who  has  taken  part  in  an  abor- 
tion on  a  six-weeks  old  fetus  to  deny 
that  the  fetus  is  almost  fully  formed. 
Personally,  I  would  sooner  turn  my 
back  and  sling  hash  for  a  living.  — 
Jocelyn  Schibild,  R.N.,  West  Vancou- 
ver, B.C. 

A  registered  nurse  stated  in  the  De- 
cember issue  of  The  Canadian  Nurse 
that  to  refuse  abortion  to  a  woman  is 
the  same  as  refusing  to  treat  a  woman 
injured  in  an  auto  accident.  When  a 
woman  gets  pregnant  and  does  not 
want  the  child,  a  nurse  would  treat  her, 
counsel  her,  and  help  her  to  accept  the 
fact;  a  nurse  would  also  treat  the 
wound,  the  mind,  the  whole  person 
if  a  woman  were  involved  in  an  acci- 
dent. They  are  both  injured  and  we 
must  help  each  person  in  her  need. 

Abortion  is  certainly  not  the  answer. 
Human  life  is  sacred.  God  is  the  author 
of  life,  and  that  life  is  under  His  do- 
main, not  that  of  society,  the  state,  or 
an  individual  mother.  Who  has  the 
right  to  pass  a  death  sentence  on  a 
totally  mnocent  being  who  possesses, 
at  least  potentially,  all  the  attributes  of 
human  life?  What  is  legal  is  not  neces- 
sarily moral. 

Reasons  advocated  for  taking  life 
by  legal  abortions  .are  flimsy:  1 .  Be- 
cause a  mother  does  not  want  the  child. 
There  are  many  children  already  born 
who  are  not  wanted.  Have  we  the  right 
to  kill  them?  Society  must  be  con- 
cerned and  help  with  education.  2. 
Because  deformity  is  feared.  Are  we 

APRIL  1971 


icertain  the  child  is  going  to  be  deform- 
ed? Why  kill  it  before  it  is  born?  There 
are  many  handicapped  who  are  happy 
and  useful  citizens;  besides  they  are 
human  beings  who  have  the  right  to 
live.  3.  Because  a  stigma  is  attached  to 
unwed  motherhood.  Why  should  there 
be  a  stigma?  Somehow  this  suggests 
that  a  child  about  to  be  born  out  of 
wedlock  has  no  right  to  live.  This  is 
an  anti-social,  heartless  attitude.  Rather 
than  an  abortion,  the  unwed  mother- 
to-be  needs  love,  acceptance,  considera- 
tion, and  someone  to  understand  her 
deep  emotional  problem  and  to  care 
for  her. 

Vatican  II,  in  its  Modern  World, 
summed  up  the  Christian  tenet:  "From 
the  moment  of  conception  life  must 
be  regarded  with  the  greatest  care, 
while  abortion  and  infanticide  are  un- 
speakable crimes."  —  Sister  A.  Hewko, 
Trochu,  Alberta. 


Nurses  on  medical  team 

It  has  been  brought  to  our  attention 
that  throught  the  Health  Care  Insur- 
ance Plan,  doctors  in  Alberta  now  have 
an  average  annual  income  of  $46,000. 
Their  offices  are  bulging,  often  with 
people  who  need  only  some  health 
instruction  and  perhaps  a  cough  mix- 
•ture  or  a  prescription  for  a  cold. 

Why  can't  the  registered  nurses' 
associations,  the  medical  insurance 
boards,  and  the  medical  men  cooperate 
to  work  out  a  less  expensive  system? 
Three  or  more  registered  nurses  could 
work  in  every  doctor's  office  to  screen 
patients,  do  routine  work  such  as  a 
junior  intern  does,  and  take  their  fin- 
dings in  to  the  doctor.  At  $3  an  hour, 
which  is  more  than  most  nurses  are 
getting,  the  cost  of  office  visits  could  be 
cut  down  to  a  more  realistic  figure, 
really  sick  patients  could  get  more  of 
the  doctor's  time,  and  no  one  would 
wait  three  hours  in  a  waiting  room. 

You  only  have  to  look  in  the  em- 
ployment section  of  The  Canadian 
Nurse  to  see  that  the  employment  sit- 
uation is  grim.  This  system  would 
increase  the  number  of  positions  avail- 
able, and  it  might  improve  the  nurse 
image  as  something  more  than  a  "yes" 
girl  for  doctors.  Nurses  are  natural 
teachers,  and  as  they  do  their  work  in 
this  screening  situation,  they  could 
give  some  instruction  in  preventive 
medicine. 

Registered  nurses'  associations  in- 
crease their  fees,  but  they  give  nurses 
very  little  service.  When  you  consider 
that  many  nurses  spend  as  much  time 
as  doctors  to  get  their  degree,  yet  earn 
a  starting  salary  of  only  one-sixth  of  the 
medical  men's  average  in  Alberta,  there 
is  something  wrong  with  our  public 
relations  department. 
APRIL  1971 


I  hope  some  of  our  voting  delegates 
to  the  Canadian  Nurses'  Association 
annual  meeting  will  try  to  do  some- 
thing to  make  nurses  a  part  of  a  medical 
team  in  our  health  insurance  plan. 
—  Nora  B.  Reilly,  R.N.,  Edmonton, 
Alberta. 

Prevention  of  congenital  rubella 

Winnifred  Raid's  article  on  "Congen- 
ital Rubella"  in  the  January  1971  edi- 
tion of  The  Canadian  Nurse,  is  of 
interest  to  us  at  University  Hospital 
in  Saskatoon,  Saskatchewan.  We  are 
carrying  on  a  similar  program  where- 
by all  female  staff  of  child-bearing 
age  are  tested  to  determine  their  anti- 
body level.  Our  program  began  Novem- 
ber 1969,  and  since  then  1,280  blood 
samples  have  been  taken.  Our  data  indi- 
cate 8.5  percent  have  no  immunity. 

Included  in  the  statistics  were  ap- 
proximately 20  reports  of  litres  done 
on  male  residents  and  interns  who  were 
on  pediatrics  and  obstetrical  services 
when  the  program  was  initiated. 

Our  employees  are  notified  if  they 
do  not  have  immunity  and  they  are 
advised  to  consult  their  physician  about 
obtaining  rubella  vaccine.  If  an  em- 
ployee does  not  wish  to  transfer  from  a 
susceptible  area,  leave  of  absence 
would  be  considered  during  the  early 
part  of  pregnancy. 

The  rubella  titre  program  is  under 
the  direction  of  Dr.  M.  Bayatpour  of 
the  virology  department  in  the  laborato- 
ry.—  C.  Hnatiuk,  R.N.,  Health  Office 
Coordonator,  University  Hospital, 
Saskatoon,  Sask. 


VON  nurse  applauds  journal 

I  enjoy  the  articles  and  even  the  nice 
magazine  layout!  I  feel  that  it  would 
be  even  better  if  more  articles  were 
printed  about  new  medical  develop- 
ments and  their  relevance  to  nursing. 

Being  out  in  the  patients  homes  as  a 
VON,  I  sometimes  feel  that  progress 
is  leaving  me  behind,  especially  the 
aspects  of  acute  hospital  nursing. 

Your  delightful  magazine  is  just 
about  the  only  way  1  have  to  'keep 
abreast'  and  be  informed  in  fields  other 
than  that  in  which  I  work.  —  Lauren 
Spilsbury,  Coquitlam,  B.C.  ■§■ 


I      GOOD  THINGS      | 
HAPPEN  ' 

I  WHEN  YOU  HELP  | 

I  RED  CROSS  I 


COLOMBIA,  LATIN  AMERICA 

Public  Health  nurses  with  experi- 
ence (rural  experience  an  advan- 
tage) co-ordinate  Public  Health 
activities  in  the  more  remote  areas 
of  the  country.  The  work  involves 
administration,  on-going  teaching 
and  supervision  of  auxiliaries  spread 
over  the  state  and  interdisciplinary 
communication  and  co-ordination 
of  all  pubUc  health  activities. 

BScN  {or  RNs  with  teaching  diplo- 
ma and/or  experience)  needed  for 
teaching  all  subjects  in  schools  for 
nursing  auxiliaries. 
Head  nurses  (RNs  with  experience) 
and  RNs  general  duty  for  all  type 
of  units  -  surgery,  medicine,  recov- 
ery, OR,  pediatrics,  OPD,  CSR, 
intensive  care. 

PAPUA  AND  NEW  GUINEA, 
SOUTH  PACIFIC 

BScNs  (or  RNs  with  diploma  in 
teaching)  needed  for  teaching  in  di- 
ploma programme,  variety  of  sub- 
jects and  clinical  teaching.  Depart- 
ure early  summer,  as  present 
teaching  staff  terminates  long-term 
contract  in  the  summer  of  1971. 

Wrile  for  full  details  of  these  and 
many  other  positions  available  in 
the  fields  of  teaching,  general  duly, 
administration  and  public  health. 
All  CUSO  assignments  are  for  a 
minimum  of  two  years. 


works 

ma   . 

,   word 

of  peop  e 

CUSO-1S1  Slater,  Ottawa4.  Ontario 


THE   CANADIAN    NURSE 


t  , 

1. 


Splashdown ! 


r 


/ 


The  major  use  for  irrigating  solutions  is 
in  pour  procedures.  Througiiout  tiie 
hospital!  Now,  with  the  Urogate*  system 
you  have  all  the  advantages  of  a  container 
specially  designed  for  use  in  pouring. 


■oT',  ■  .  ,     .(^-,  ■ 


You  can  empty  this  3,000  ml.  Urogate 
bottle  in  seconds  flat! 


There's  a  generous  38  mm.  opening  on 
the  3,000  ml.  Urogate  bottle.  It  lets  you 
pour  irrigating  solution  quickly . .  , 
smoothly . . .  copiously. 

With  a  single  easy  twist  of  the  cap,  you 
unseal  the  container.  A  special  slip-disc 
assures  easy  opening.  The  "business" 
end  of  this  Urogate  container  features 
a  pair  of  lifting  lugs  or  "ears".  With 
these,  you  can  lift  and  transport  the 
bottle  conveniently  and  safely. 

At  the  base  of  the  container,  there's  the 
unique  Nauta*  bail.  When  you  want  to 
suspend  the  Urogate  solution,  the  Nauta 
bail  snaps  upright.  (And  stays  there ! ) 
Both  your  hands  are  free  to  position 


the  inverted  bottle  on  its  hanger. 

In  addition  to  the  3,000  ml.  Urogate, 
Abbott  also  provides  a  1,500  ml.  con- 
tainer where  smaller  quantities  of  fluid 
are  required.  You  control  the  quantity 
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New  approaches 
to  specialized 
nursing  care! 


New!  THE  NURSE'S  ROLE  IN  COMMUNITY  MENTAL 
HEALTH  CENTERS:   Out  of   Uniform   and    Into   Trouble. 

By  Carol  D.  DeYoung,  R.N.,  M.S.,  and  Margene  Tower, 
R.N.,  M.S.:  with  5  contributors.  How  do  others  see  the 
nurse  and  her  role?  This  provocative  investigation  of  other 
disciplines'  attitudes  and  ideas  probes  the  nurse's 
expanding  role  in  mental  health  care,  the  dynamics  of 
interpersonal  problems  within  the  mental  health  team, 
and  such  long-standing  problems  as  education,  salary  and 
status.  Vivid  dialogues  report  the  views  of  psychiatrists, 
psychologists,  psychiatric  technicians,  and  social  workers, 
as  well  as  those  of  nurses  currently  involved  in  this  field. 
Fast-moving,  enjoyable  and  refreshing,  this  new  book 
frankly  discusses  crucial  problems.  Shouldn't  you  and  your 
students  be  listening?  February,  7977.  735  pp.,  b-1/2"x 
9-7/2".  $5.75. 


New!  PHYSIOLOGIC  AND  PHARMACOLOGIC  BASIS  OF 
CORONARY  CARE  NURSING.  By  Theodore  Rodman,  M.D.; 
Ralph  M.  Myerson,  M.D.;  L.  Theodore  Lawrence,  M.D.; 
Anne  P.  Gallagher,  R.N.,  B.S.N.,  M.S.N.;  and  Albert  /. 
Kasper,  M.D.  CCU  nursing  calls  for  a  unique  perspective 
and  unique  training.  This  unconventional  new  text  can 
help  you  offer  your  students  precisely  that!  The  first  text 
to  recognize  the  major  shift  in  professional  responsibility 
assumed  by  the  CCU  nurse,  it  comprehensively  describes 
all  aspects  of  the  coronary  care  unit,  and  all  phases  of 
coronary  disease.  It  accurately  introduces  electrocardio- 
graphy, and  emphasises  the  therapeutic  importance  of 
nurse-patient  relations.  April,  7977.  Approx.  248  pp.,  7  "x 
70",  703  illustrations.  About  $7.10. 


New  2nd  Edition!  PRINCIPLES  OF  OBSTETRICS  AND 
GYNECOLOGY  FOR  NURSES.  By  Josephine  lorio,  R.N., 
M.S.,  M.A.  The  only  nursing  text  to  effectively  combine 
obstetrics  and  gynecology  is  now  thoroughly  revised  and 
updated.  Its  principles-oriented  approach  helps  your 
students  develop  problem-solving  ability.  New  information 
encompasses  such  topics  as:  phototherapy  for  jaundice 
in  premature  infants;  emotional  factors  in  the  maternity 
cycle;  Rh  sensitivity;  saline  injection  into  the  amniotic 
sac  to  induce  abortion;  family  planning;  and  a  totally 
rewritten  chapter  on  the  labor  process.  Its  many  new 
illustrations  include  excellent  photographs  of  actual 
delivery.  May,  7977.  Approx.  396  pp. ,  6-3/4 "x  9-3/4", 
777  illustrations.  About  59.75. 


M05BV 

TIMES  MIRROR 


New  5th    Edition!    Newton's   GERIATRIC    NURSING.    By 

Helen  C.  Anderson,  R.N.,  M.S.  The  growing  number  of 
Americans  over  65  presents  a  special  challenge  to  nursing 
—  one  which  can  only  be  met  by  well-trained  specialists 
who  understand  their  total  health  requirements.  Your 
students  can  gain  perceptive  new  insight  into  these 
requirements  and  how  to  effectively  meet  them  with  the 
new  5th  edition  of  this  popular  text.  A  major  revision,  it 
reflects  the  influence  of  Medicare,  the  National  Health 
Insurance  Act  and  the  recognition  of  geriatric  nursing  as 
a  clinical  specialty.  New  chapters  discuss  nurses  and  ill 
older  persons,  and  mental  health  and  behavioral  problems. 
lune,  7977.  Approx.  334  pp.,  6-7/2  "  x  9-7/2",  59 
illustrations.  About  S9.75. 


THE  C.V.  MOSBY  COMPANY.  LTD.  •  86  NORTHLINE  ROAD  •  TORONTO  374,  ONTARIO,  CANADA 


news 


Nursing  Research  Committee 
To  Develop  Code  Of  Ethics 

Ottawa  —  Members  of  the  special 
committee  on  nursing  research,  set  up 
by  the  Canadian  Nurses'  Association, 
are  interested  in  developing  a  code  of 
ethics  for  nursing  research.  The  com- 
mittee, at  its  first  meeting  held  February 
19,  decided  to  study  the  codes  of  other 
research  groups  prior  to  discussion  at 
the  next  meeting  planned  for  May  5 
and  6. 

Dr.  Shirley  Stinson,  associate  profes- 
sor, school  of  nursing,  division  of  health 
services  administration.  University  of 
Alberta,  Edmonton,  was  elected  chair- 
man. 

Along  with  discussion  of  the  terms 
of  reference  at  this  first  "exploratory" 
meeting,  Pamela  Poole,  of  the  depart- 
ment of  national  health  and  welfare, 
spoke  on  national  health  grants,  and 
Ann  D.  Nevill,  on  medlars. 

The  committee  was  formed  by  the 
CNA  board  of  directors  at  its  October 
meeting,  based  on  a  recommendation 
of  the  CNA  ad  hoc  committee  on  re- 
search, which  reported  to  the  board  in 
June. 

The  terms  of  reference  of  the  com- 
mittee are:  to  assist  the  association  to 
implement  its  evolving  research  policy; 
to  make  recommendations  to  the  board 
regarding  the  association's  role  with 
respect  to  nursing  research;  to  serve  in 
a  consultative  and  advisory  capacity  to 
the  director,  CNA  research  and  advisory 
services;  and  to  carry  out  such  other 
activities  related  to  research  as  may  be 
assigned  to  it  by  the  CNA  board  or 
referred  by  the  CNA  membership. 

Members  of  the  committee  are: 
Shirley  Alcoe,  school  of  nursing.  Uni- 
versity of  New  Brunswick,  Fredericton, 
N.B.;  Dr.  Moyra  Allen,  associate  pro- 
fessor of  nursing,  school  for  graduate 
nurses,  McGill  University,  Montreal, 
Quebec;  Dr.  Margaret  C.  Cahoon, 
professor  and  chairman  of  research, 
school  of  nursing.  University  of  Toron- 
to, Toronto,  Ont.;  Sister  Marie  Simone 
Roach,  acting  chairman,  department  of 
nursing,  St.  Francis  Xavier  University, 
Antigonish,  N.S.;  Dr.  Lucy  D.  Willis, 
director,  school  of  nursing.  University 
of  Saskatchewan,  Saskatoon,  Sask.; 
Dr.  M.  Josephine  Flaherty,  of  Toronto; 
Helen  Glass  of  New  York:  Verna  (Huff- 
man) Splane,  principal  nursing  officer, 
office  of  the  deputy  minister,  depart- 
ment of  national  health  and  welfare, 

APRIL  1971 


CNA  Executive  Director  Appointed 
To  Economic  Council  Of  Canada 

Ottawa  —  A  Canadian  nurse.  Dr.  Helen  K.  Mussallem  of  Ottawa  and  Van- 
couver, is  the  first  member  of  the  health  professions  to  be  appointed  to  the 
Economic  Council  of  Canada.  The  announcement  of  Dr.  Mussallem's  appoint- 
ment was  made  by  the  Prime  Minister's  office  on  Tuesday  March  9,  197 1 . 

Dr.  Mussallem,  executive  director  of  the  Canadian  Nurses'  Association, 
joins  two  other  eminent  women,  economists  Dr.  Sylvia  Ostry  and  Dr.  Beryl 
Plumptre,  on  the  Council,  which  consists  of  three  full-time  members  and 
twenty-five  other  members  from  all  sectors  of  the  economy  and  the  various 
regions  of  Canada. 

The  Economic  Council  was  formed  in  1963  as  an  independent  body  to 
combine  the  expertise  of  professional  economists  with  the  talent  and  experience 
of  a  broad  spectrum  of  citizens  from  agriculture,  labor,  business,  and  the  pro- 
fessions. Private  merhbers  play  an  active  role  with  full-time  staff  in  preparing 
the  Council's  annual  reviews,  which  are  intended  to  provide  information  and 
analysis  to  assist  in  decision  making  for  both  government  and  the  private  sector. 

Dr.  Mussallem  will  attend  the  first  Council  meeting  of  her  three-year  ap- 
pointment on  April  19  and  20  in  Vancouver. 


Ottawa;  Dr.  Floris  E.  King,  associate 
professor,  school  of  nursing.  University 
of  British  Columbia,  Vancouver,  B.C.; 
Rose  Imai,  CNA  research  officer;  and 
E.  Louise  Miner,  president  of  the  Cana- 
dian Nurses'  Association,  (exofficio). 


Federal  Government  Answers 
Unemployment  Insurance  Concerns 

Ottawa  —  Nurses  will  contribute  to, 
and  be  covered  by,  unemployment  in- 
surance if  the  proposals  contained  in 
the  federal  government's  white  paper 
on  unemployment  insurance  in  the 
'70s  are  included  in  legislation  expected 
to  come  into  effect  July  1 ,  1 97  1 . 

David  Weatherhead,  chairman  of 
the  parliamentary  standing  committee 
on  labor,  manpower,  and  immigration, 
attended  the  November  meeting  of  the 
social  and  economic  welfare  committee, 
Canadian  Nurses'  Association,  to  an- 
swer questions  about  the  white  paper. 

Two  areas  of  concern  developed: 
unemployed  nurses  referred  to  Canada 
Manpower  Centers  might  be  retrained 
into  some  other  occupjition,  such  as 
clerical;  or  they  might  be  required 
involuntarily  to  relocate  to  obtain  a  job. 
Letters  were  sent  to  Mr.  Weatherhead's 
committee  and  to  the  minister  of  labor 
Bryce  Mackasey,  asking  that  further 
consideration  be  given  to  the  implica- 
tions of  referring  professional  em- 
ployees to  Manpower  Centers. 


In  December,  Peter  Connolly,  spe- 
cial assistant  to  the  labor  minister,  wrote 
to  CNA  saying,  in  part,  "it  would  only 
be  in  the  most  unusual  circumstances 
that  a  member  of  the  nursing  profession 
would  be  asked  to  accept  retraining  in 
an  area  foreign  to  her  interests  and 
experience."  He  also  said  that  "in  the- 
case  of  professional  workers  the  inten- 
tion is  to  update  or  improve  existing 
skills  within  or  closely  related  to  their 
chosen  field." 

The  Weatherhead  committee,  in 
January,  sent  copies  of  its  tlrst  report 
on  the  white  paper  to  the  CNA  pres- 
ident, the  chairman  of  the  CNA  social 
and  economic  welfare  committee,  and 
the  CNA  legal  advisor. 

In  another  letter  to  labor  minister 
Mackasey,  CNA  said  the  association 
had  been  reassured  by  Mr.  Connolly's 
comments  about  retraining,  but  is  still 
concerned  about  possible  involuntary 
geographic  relocation.  "For  the  nurse, 
who  is  a  housewife  and  mother,  this 
would  be  totally  unacceptable."  The 
letter  also  urged  that  "provision  be 
made  for  a  system  of  special  exemp- 
tions from  premium  payments  for  em- 
ployees who  would  not  under  any  cir- 
cumstances be  able  to  benefit  from  the 
plan  because  they  work  only  a  few 
months  each  year."  CNA  also  indicated 
its  hopes  "that  the  recommended  coor- 
dination and  co-operation  will  be  evi- 
dent at  all  levels  federally,  provincially, 
and  locally." 

THE  CANADIAN   NURSE     11 


(Continued  from  page  11) 


CNA  received  an  answer  in  February 
from  Mr.  Connolly,  who  said,  "The 
entire  concept  of  the  legislation  has  as 
its  roots  the  goal  of  helping  claimants, 
first  in  the  form  of  cash,  second  with 
active  assistance  in  finding  a  new  job. 
You  may  be  assured  that  the  suggestion 
to  relocate  is  made  only  after  all  other 
alternatives  have  been  employed.  On 
the  other  hand,  if  an  unemployed  person 
restricts  her  availability  to  the  extent 
that  it  becomes  impossible  to  find  work, 
it  would  not  be  unreasonable  to  assume 
that  she  has  removed  herself  from  the 
labor  market." 

Mr.  Connolly  also  discussed  the 
provision  that  would  be  helpful  to 
nurses  who  work  only  during  part  of 
the  year.  "We  propose  to  lower  the 
entrance  requirement  to  include  those 
who  have  been  in  the  labor  force  for  a 
relatively  short  period  of  time  —  eight 
weeks  during  the  preceding  52." 

After  receiving  the  comments  that 
retraining  could  mean  upgrading,  CNA 
wrote  to  the  minister  of  manpower  and 
immigration.  Otto  Lang,  asking  for 
changes  in  the  adult  occupational  train- 
ing act  to  include  provision  for  uni- 
versity courses.  Mr.  Lang  has  not  yet 
replied  to  this  letter,  although  he  has 
indicated  he  will  respond  to  the  associa- 
tion's concern. 


United  Nurses  Of  Montreal 
Begin  Unique  Training  Program 

Montreal,  P.Q.  —  An  unusual  train- 
ing program  for  its  council  repre- 
sentatives was  initiated  by  the  United 
Nurses  of  Montreal  at  the  end  of  Feb- 
ruary, with  the  first  of  a  series  of  week- 
end seminars  held  in  a  Laurentian 
resort  hotel. 

The  first  seminar  included  1 6  nurses 
from  12  hospitals  and  agencies,  who 
met  with  the  president  of  the  United 
Nurses,  Gloria  Blaker,  and  two  labor 
relations  experts.  The  subject  of  the 
weekend  seminar  was  the  role  of  the 
council  representative  as  related  to  her 
job,  her  communications  with  the 
membership,  contract  and  grievances, 
and  the  committee  on  nursing. 

Beginning  on  a  Friday  night  and 
running  until  Sunday  evening,  discus- 
sions, interspersed  with  films,  included 
subjects  such  as  "the  challenge  of 
leadership,"  "shop  steward,"  "a  case 
of  insubordination,"  and  "the  griev- 
ance."  Every   issue   that  could   arise 

12     THE  CANADIAN   NURSE 


The  first  of  a  series  of  seminars  for  council  representatives  of  United  Nurses  In- 
corporated, formerly  called  the  United  Nurses  of  Montreal,  was  held  at  Far  Hills 
Inn,  Val  Morm,  Quebec,  in  February.  Members  from  12  hospitals  and  agencies 
met  with  their  president  and  two  labor  experts  to  discuss  union-management  rela- 
tions and  how  to  do  their  job  effectively.  In  this  photograph,  labor  expert  Steve 
Wace  explains  a  point  to  the  group. 


in  relations  between  nurses  and  ad- 
ministration was  carefully  developed, 
and  the  role  of  the  council  represent- 
ative in  each  situation  was  thoroughly 
discussed. 

A  highlight  of  the  seminar  came 
when  Gloria  Blaker,  assuming  the 
role  of  the  director  of  nursing  in  sim- 
ulating negotiations  between  union 
representatives  and  hospital  adminis- 
tration, realistically  posed  some  tricky 
points  for  the  representatives  to  handle. 

Response  of  the  council  represent- 
atives was  keen.  At  the  conclusion 
of  the  seminar  Sunday  night,  the  UNM 
president  said:  "I  am  confident  that 
if  future  seminars  measure  up  to  this 
one,  council  representatives  will  be 
able  to  play  an  important  role  in  fight- 
ing for  better  working  conditions  for 
the  nursing  profession,  thereby  assur- 
ing better  service  for  the  general  pub- 
lic." 

Future  seminars  in  French  and 
English  are  being  scheduled  to  include 
all  council  representatives  of  the  38 
hospitals  and  agencies  in  which  nurses 
are  represented  by  the  United  Nurses 
of  Montreal. 

An  autonomous  professional  union 
that  negotiates  contracts  with  the  gov- 
ernment of  Quebec,  the  United  Nurses 
of  Montreal  was  formed  in  1966  by 
the  English  Chapter,  District  XI,  of 
the  Association  of  Nurses  of  the  Prov- 
ince of  Quebec. 


ARNN  And  Government 
Meet  On  Wage  Demands 

5/.  John's,  Nfld.  —  The  Association  of 
Registered  Nurses  of  Newfoundland 
is  meeting  with  representatives  of  the 
provincial  government's  treasury  board 
to  discuss  increased  salaries  for  nurses 
in  the  province,  said  Pauline  Laracy, 
ARNN  executive  secretary. 

ARNN's  executive  committee  and 
the  provincial  health  minister  Edward 
Roberts  have  decided  on  the  negotiat- 
ing procedures  to  be  followed.  Jn  a 
story  in  the  St.  John's  Evening  Tele- 
gram, Mr.  Roberts  said  procedures 
were  established  at  a  meeting  with  the 
ARNN.  In  a  release  the  ARNN  said 
the  negotiating  process  had  been  start- 
ed. 

At  the  association's  annual  meeting 
in  October  1970,  the  500  delegates 
unanimously  approved  a  proposed 
salary  recommendation  which  was  for- 
warded in  a  brief  to  the  government. 
The  recommendation  lists  25  categories 
of  nursing,  ranging  from  a  minimum 
annual  salary  of  $6,588  for  a  class  orie 
nurse  to  $10,500  minimum  annual 
salary  for  a  nursing  consultant.  The 
current  annual  starting  salary  for  a 
registered  nurse  in  Newfoundland  is 
$4,300. 

In  a  previous  brief  submitted  to  the 
minister  of  health  in  May   1970,  the 

(Continued  on  page  14) 
APRIL  1971 


Make  a  donation  to 
your  fevourite  hospital  fund 


on  our  50th  anniversary  in  Canada. 


We're  making  five  hundred  dollar 
donations  to  hospital  funds,  and 
to  help  choose  which  fund  they  go 
to,  we're  running  a  httle  contest. 
The  winner  decides  who  gets  the 
donation  and  it's  given  in  the  win- 
ner's name.  We  hope  this  gesture 
will  help  someone,  but  we  know  it 
takes  more  than  gestures.  It  takes 
care  and  reliable  surgical  products 
backing  you  up.  We  make  them. 

We've  been  making  them  for 
fifty  years.  Below  are  four  of  the 
ways  S  &  N  is  serving  you  and  your 
patient  today. 

1.  Elastoplast  Airstrip 
Ward  Dressings: 

An  entirely  new  concept  in  the  post- 
operative care  of  surgical  incisions 
combining  in  a  single  unit  all  the 
criteria  of  an  ideal  surgical  dressing. 
Low  sensitivity.  Allows  the  wound 
to  breathe,  sealing  out  infection. 


U^ 


2.  Super-Crinx  Softstretch 
Bandages: 

Single  ply  elastic  gauze  bandage 
with  woven  edges.  Exceptionally 
soft  'feel'  and  a  high  degree  of  air 
permeability  and  absorption. 

3.  Jelonet  Paraffin 
Gauze  Dressings: 

Easy  on,  easy  off  —  its  light,  gentle 
touch  is  essential  in  bum  and  wound 
therapy.  Non-adherent.  Non-co- 
agulating. Does  not  become  entan- 
gled with  granulations. 

4.  Gypsona  Bandages 
and  Slabs: 

Superior  quality  gypsum  and  spe- 
cially woven  cloth  with  non-fraying 
edges  are  used  only  in  Gypsona 
bandages.  Gypsona  casts  combine 
greater  strength  with  lightness  for 
patient  comfort. 


SMITH  i  NEPHEW  LTD. 

2100-S2nd  Avenue,  Lachlne,  Quebec 


Dress  our  best  dressed  patient. 


(Continued  from  page  12) 

nurses  called  for  a  $100  monthly  in- 
crease. The  same  month  they  rejected 
the  government's  offer  of  $45  per 
month.  This  general  increase  was  of- 
fered to  all  government  personnel. 

In  July,  the  province's  nurses  voted 
in  favor  of  a  work  slowdown,  but  a  late 
settlement  with  the  promise  of  conti- 
nued negotiations  kept  the  1 ,800  nurses 
on  the  job.  The  offer  accepted  included 
some  fringe  benefits  along  with  the 
$45  monthly  increase.  Nurses  later 
expressed  dissatisfaction  with  the  agree- 
ment and  came  up  with  the  October 
recommendation. 

The  ARNN  will  be  among  the  first 
groups  to  negotiate  with  Newfound- 
land's newly  formed  board  on  collec- 
tive bargaining. 


University  Nursing  Students 
Hold  Constitutional  Conference 

Ottawa  —  More  than  250  delegates, 
representing  22  university  schools  of 
nursing  across  the  country,  approved 
a  draft  constitution  for  the  proposed 
Canadian  University  Nursing  Students 
Association  at  a  February  Weekend 
conference. 

Hosted  by  students  at  the  University 
of  Ottawa  School  of  Nursing,  it  was  the 
fourth  annual  inter-university  nursing 
conference.  At  last  year's  conference 
in  Montreal  students  from  the  three 
attending  universities,  Ottawa,  McGill 
and  New  Brunswick,  proposed  forming 
a  national  organization  of  university 
nursing  students.  Delegates  from  several 
universities  held  further  discussions  at 
the  Canadian  Nurses'  Association  June 
meeting  in  Fredericton,  N.B. 

As  objectives,  the  association  in- 
tends to  provide  a  communication  link 
between  nursing  students  in  Canadian 
universities,  to  be  a  medium  through 
whicl.  students  can  express  opinions 
on  issues  in  nursing,  to  assist  and  initia- 
te research  in  the  nursing  field  by  using 
the  skills  of  students,  to  promote  liai- 
son with  organizations  concerned  with 
nurses. 

The  draft  constitution  includes  rec- 
ommendations for  a  bilingual  associa- 
tion with  an  annual  meetmg  ot  the 
national  executive  followed  by  a  con- 
ference for  members,  voluntary  mem- 
bership open  to  students  and  registered 
nurses  involved  in  nursing  education 
programs  throughout  Canada. 

Before  being  adopted,  the  proposed 
constitution  must  be  approved  by  dele- 
gates from  participating  universities  at 
the  1972  conference  to  be  held  at  the 
14     THE  CANADIAN  NURSE 


University  nursing  students  "come  together"  at  the  conference  for  a  proposed 
Canadian  University  Nursing  Students"  Association.  Students  from  every  prov- 
ince, representing  22  university  schools  of  nursing,  gathered  at  the  University 
of  Ottawa  to  get  acquainted  and  to  examine  conference  displays. 


University  of  Windsor,  Windsor,  On- 
tario. 

Guest  speakers  at  this  year's  con- 
ference included:  Dr.  Beverly  Du  Gas, 
nursing  consultant,  health  manpower 
studies  section,  health  resources  direc- 
torate, department  of  national  health 
and  welfare;  Rose  Imai,  CNA  research 
officer  representing  Dr.  Helen  Mussal- 
lem,  CNA  executive  director;  Eliza- 
beth Logan,  director,  school  for  gra- 
duate nurses,  McGill  University,  re- 
presenting the  Canadian  Council  of 
University  Schools  of  Nursing;  and 
Irma  Riley,  representing  the  Associa- 
tion of  Nurses  of  the  Province  of  Que- 
bec. 

Seminars  were  held  dealing  with  the 
philosophy  and  objectives,  the  name 
and  membership,  administrative  struc- 
ture, and  financing.  Conference  coordi- 
nator was  William  Anticknap.  Donna 
Mahoney,  Joanna  Emery,  Peggy  Borts, 
Joanne  Hunter,  Pat  Allen  and  Rex 
Langman  were  committee  heads.  Carol 
Ann  Godard  was  assistant  coordinator, 
Mona  Walrond,  secretary,  and  Ann 
McFadden,  treasurer. 


Nursing  Education  Committee 
Hearings  Turn  Controversial 

Fredericton,  N.B.  —  Three  issues 
turned  hearings  of  a  provincial  study 
committee  on  nursing  education  into 
free-wheeling  sessions  of  charge  and 
countercharge.  On  one  side  there  is  the 
New  Brunswick  Association  of  Regis- 
tered  Nurses  with   support   from  the 


University  of  New  Brunswick  faculty 
of  nursing,  some  hospital  schools  of 
nursing  and  boards  of  trustees.  On  the 
other  side  is  the  New  Brunswick  Hospi- 
tal Association,  other  hospital  boards 
and  directors  of  nursing,  doctors,  ad- 
ministrators, mayors,  a  senator,  an 
archdeacon,  and  concerned  citizens. 

Controversial  issue  number  one  is 
the  closing  of  hospital  schools  of  nurs- 
ing; number  two,  the  suggested  phasing 
out  of  registered  nursing  assistant 
programs;  number  three  is  a  challenge 
to  the  authority  over  the  nursing  profes- 
sion held  by  the  NBARN. 

The  NBARN  has  for  some  years 
urged  the  government  to  close  hospital 
schools  of  nursing  and  to  establish 
nursing  education  at  the  diploma  level 
in  institutions  similar  to  junior  colleges. 
In  May,  1970,  notifications  were  given 
to  hospitals  in  Chatham,  Newcastle, 
and  Woodstock,  that  their  hospital 
schools  of  nursing  would  no  longer  be 
accredited  by  NBARN. 

"A  history  of  substandard  condi- 
tions, precipitated  by  the  termination 
of  affiliation,  led  to  the  closing  of  the 
schools,"  said  NBARN.  Lack  of  satis- 
factory replacement  for  the  pediatric 
affiliation  was  a  major  reason  for 
NBARN's  stand.  It  was  also  learned 
that  obstetrical  affiliation  in  Montreal 
will  cease  beginning  September,  1971 . 

During  the  committee  hearing  in 
Newcastle,  former  health  minister  No- 
bert  Theriault  said  he  had  been  "shock- 
ed" when  the  NBARN  failed  to  notify 
him  of  its  decision  to  phase  out  the 

APRIL  1971 


three  nursing  schools.  He  said  the 
NBARN  has  a  responsibility  not  to 
close  any  schools  of  nursing  until  the 
provincial  government  decides  what 
lines  nursing  education  should  take. 

In  a  prepared  statement,  the  NBARN 
said  it  "takes  exception  to  the  remarks 
of  the  former  minister  of  health.  Mr. 
Theriault  was  well  informed  of  the 
situation  and  was  present  at  a  meeting 
in  March  1970,  held  to  discuss  these 
schools  and  their  affiliation  problems. 
Further  meetings  were  held  in  June 
with  the  former  minister  following 
NBARN's  May  stand." 

In  its  appearance  before  the  com- 
mittee, the  New  Brunswick  Hospital 
Association  said  its  view  is  "basically 
the  same  as  that  of  the  Canadian  Hospi- 
tal Association  —  that  hospital-based 
schools  of  nursing,  providing  an  ac- 
ceptable education  experience,  must 
be  retained  and  expanded." 

The  challenge  to  the  authority  of 
NBARN  came  at  the  Woodstock  hear- 
ings. The  Carleton  Memorial  Hospital 
boards,  whose  school  of  nursing  is 
being  phased  out  because  NBARN  is 
withdrawing  accreditation,  said,  "The 
provincial  government  must  bear  the 
responsibility  for  education  of  nurses. 
The  NBARN,  which  is  now  responsible 
for  training,  curriculum,  and  standards, 
should  only  retain  the  right  of  setting 
the  standard  for  admission  to  their 
association." 

The  Carleton  board  also  disagreed 
with  NBARN  over  the  abolition  of 
nursing  assistants.  The  board  said  nurs- 
ing assistants  will  play  an  "increas- 
ingly important  role"  in  such  services 
as  nursing  homes  and  extended  care 
facilities. 

A  combined  brief  was  presented  to 
the  study  committee  by  the  boards  of 
directors  of  the  Miramichi  Hospital, 
Newcastle,  and  Hotel  Dieu  Hospital, 
Chatham.  Both  schools  of  nursing  at 
these  hospitals  are  being  closed.  The 
brief  said,  "The  present  situation  is 
unacceptable,  because  the  NBARN 
has  the  sole  prerogative  of  denying 
graduates  of  a  school  of  nursing  the 
right  to  write  registration  examina- 
tions. We  recommend  that  this  pre- 
rogative be  passed  to  the  proper  gov- 
ernment department  with  the  NBARN 
retaining  an  advisory  capacity." 

Other  hospitals  took  a  milder  tone, 
suggesting  regional  schools  of  nursing 
be  established.  The  Chaleur  General 
Hospital,  Bathurst,  said,  "Nursing 
should  be  within  the  main  stream  of 
general  education,  governed  by  a  board 
of  directors  separate  from  hospital 
jurisdiction,  although  affiliated  to  a 
regional  hospital." 

Dr.  Helen  K.  Mussallem,  executive 
director  of  the  Canadian  Nurses'  As- 
sociation, visited  Fredericton  in  early 
February  on  the  invitation  of  NBARN. 
APRIL  1971 


"I  went  to  consult  with  the  NBARN 
representatives,"  she  said.  "My  role 
was  to  provide  the  national  picture. 
By  giving  the  provinces  this  kind  of 
information  to  analyze,  they  can  deter- 
mine how  to  fit  into  the  national  trend." 

During  a  series  of  press  conferences, 
radio  and  television  interviews.  Dr. 
Mussallem  said,  "It  will  only  be  a  mat- 
ter of  time  in  New  Brunswick  before 
the  present  diploma  schools  are  phased 
into  institutions  under  educational 
control.  The  plan  put  forward  in  1960 
has  now  been  implemented  in  various 
forms  in  most  Canadian  provinces. 
I  didn't  think  it  feasible  that  such  great 
strides  could  be  accomplished  in  a 
decade,  but  it  has  swept  right  across 
the  country." 

The  new  health  minister  Paul  Creag- 
han  forecast  changes  in  the  province's 
nursing  education  system.  "I  feel  the 
present  approach  is  a  little  outdated. 
Whether  this  will  mean  the  end  of  the 
hospital  nursing  school  or  not  remains 
to  be  seen.  I  think  we  will  have  to  wait 
until  the  committee  gives  us  some  sort 
of  definite  advice  and  perhaps  a  propos- 
ed plan  or  program." 

In  defense  of  its  position,  the  NBARN 
said,  "We  have  been  the  only  group 
to  try  to  protect  the  patient  and  the 
student,  yet  the  authority  of  the  associa- 
tion to  do  this  has  been  questioned. 


What  advantage  would  there  be  in 
granting  this  authority  to  another  group 
who  has  never  been  concerned  with 
protecting  these  standards  in  the  past? 

"It  is  unfortunate  that  this  concern 
for  excellence  is  only  questioned  when 
the  association  tries  to  delete  some- 
thing that  is  substandard,"  the  NBARN 
said.  "The  nurses'  association  has  spent 
much  time  and  money  since  1916  in 
upgrading  nursing  service  and  educa- 
tion. The  resources  of  the  NBARN  and 
the  CNA  will  continue  to  be  utilized 
in  this  effort,"  said  the  statement. 

Manitoba  Seeks  To  Accredit 
All  Health  Facilities 

Winnipeg,  Manitoba  —  A  program 
under  the  joint-sponsorship  of  the 
medical,  nursing,  and  hospital  asso- 
ciations of  Manitoba  has  been  started 
with  the  aim  of  achieving  standards 
of  accreditation  in  the  province's  non- 
accredited  health  care  facilities. 

The  target  date  is  March  31,  1973, 
for  completion  of  the  program  as  rec- 
ommended by  the  Canadian  Council 
on  Hospital  Accreditation. 

J.G.  Hayes  is  program  administra- 
tor. He  is  director  of  counseling  and 
education  services  tor  the  Manitoba 
Hospital  Association,  but  will  be  work- 
ing full-time  on  the  new  project. 

(Continued  on  page  16) 


Just  published . . . 
New  1971  edition  of 

Nursing 
Opportunities 

Your  annual  guide 
to  easier  job-hunting. 


NURSING  OPPORTUNITIES  contains 
up-to-date  information  on  employment 
possibilities  at  more  than  400  leading 
tiospitals  in  the  US  and  possessions 
So  whether  you  are  an  R  N  seeking 
new  employment  or  a  student  nurse, 
you  II  want  your  own  copy  of  NURSING 
OPPORTUNITIES 

This  beautiful  200-page  directory  has 
been  designed  for  your  easy  reference 
—  hospitals  are  listed  alphabetically  by 
state  and  city 

What  information  do  you  want?  Med- 
ical facilities?  Nursing  specialities?  Fi- 


nancial and  fringe  benefits?  Nursing 
philosophy  and  innovations?  Accredi- 
tation'' Recreational  and  cultural 
activities?  Its  all  there  in  NURSING 
OPPORTUNITIES 

Additional  information  on  the  hospi- 
tals of  your  choice  will  come  quickly 
and  discreetly  to  your  home  address 
when  you  use  the  free  Reader  Service 
cards  which  come  with  each  copy  of 
NURSING  OPPORTUNITIES 

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NURSING  OPPORTUNITIES.  Oradell.  New  Jersey  07649 

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each,  for  which  I  enclose  $ (check  or  money  order).  Please  print 

legibly  or  type. 

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n  Other 


THE  CANADIAN   NURSE     15 


news 


(Continued  from  page  15) 

NBARN  Leaders  Meet 
At  Presidents'  Conference 

Fredericton,  N.-B.  —  Presidents  and 
vice-presidents  from  the  eleven  chap- 
ters of  the  New  Brunswick  Association 
of  Registered  Nurses  met  at  provincial 
headquarters  for  the  association's  an- 
nual presidents' conference  held  January 
21-22.  The  conference  is  held  to  assist 
present  and  future  chapter  presidents 
and  to  provide  an  opportunity  for  chap- 
ter leaders  to  discuss  common  prob- 
lems. 

Objectives  of  the  conference  were: 
to  examine  the  different  roles  assumed 
by  chapter  presidents;  to  examine  the 
responsibilities  under  each  of  these 
roles;  to  discuss  the  democratic  pro- 
cess in  relation  to  professional  associa- 
tions and  to  relate  these  objectives  to 
increasing  the  involvement  of  members 
in  nursing  affairs. 

Drug  Symposium  Recommends 
Community  Clinics 

Montreal,  P.Q.  —  A  system  of  com- 
munity clinics  to  treat  drug  users  was 
advocated  by  Health  Minister  John 
Munro  at  a  national  symposium  held 
in  February.  Later,  participants  at  the 
Montreal  symposium,  including  nurses, 
physicians,  paramedical  personnel, 
administrators,  and  members  of  the 
young  generation  recommended  such 
clinics  be  coordinated  with  traditional 
health  institutions. 

The  symposium  on  hospital  respon- 
sibility toward  drug  users  was  spon- 
sored by  the  Canadian  Hospital  Asso- 
ciation with  the  support  of  the  depart- 
ment of  national  health  and  welfare. 

Mr.  Munro  said  that  hospitals  evolve 
too  slowly  compared  to  the  problems 
which  have  to  be  met.  He  said  drug 
users  must  receive  not  only  emergency 
treatment  but  must  also  be  given  at- 
tention, free  of  "red  tape,"  from  a 
multidisciplinary  team  in  a  position 
to  meet  their  psychological,  social, 
and  medical  needs.  These  emergency 
drug  centers  must  be  set  up  at  the 
regional  level  in  a  spirit  of  community 
assistance,  said  the  minister. 

The  symposium's  main  objective 
was  to  help  hospitals  develop  efficient 
programs  for  short-  and  long-term 
treatment  of  drug  users.  Measures 
suggested  were: 

•  induce  positive  attitudes  and  behavior 
among  hospital  personnel  who  come 
into  contact  with  drug  users. 

•  determine  standards  of  installations 
and  management  of  personnel  in  charge 
16     THE  CANADIAN  NURSE 


of  admission,   evaluation,   and  emer- 
gency treatment  of  patients. 

•  determine  guidelines  for  long  term 
treatment  and  rehabilitation  of  patients. 

•  promote  information  and  participa- 
tion of  volunteers. 

•  encourage  and  stimulate  programs  at 
the  regional  level. 

One  speaker.  Dr.  John  Unwin,  psy- 
chiatrist and  director  of  youth  serv- 
ices, McGill  University,  Montreal, 
said  the  hospitals'  reaction  to  the  drug 
problem  should  make  us  feel  ashamed. 
The  few  efforts  made  to  help  drug  users 
were  made  by  non-hospital  organiza- 
tions, he  said. 

Dr.  Unwin  said  some  hospitals  re- 
fuse to  admit  narcotic  patients  in  need 
of  care.  They  are  more  concerned  about 
the  moral  repercussions  of  drugs  than 
about  drug  users.  They  are  more  in- 
clined to  theology  than  to  therapy,  he 
added.  It  is  time  they  act  positively. 

Having  their  say  at  the  symposium, 
young  people  cited  doctors  for  their 
lack  of  information  about  drugs.  They 
felt  they  knew  more  about  drugs  than 
doctors  do.  Community  clinics  are  the 
only  organizations  that  succeed  in 
reaching  victims  of  drug  abuse,  they 
said. 

They  suggested  that  doctors,  instead 
of  trying  to  decide  whether  marijuana 
is  good  or  not,  should  get  busy  treating 
heroin,  LSD,  and  mescaline  users. 

Dr.  Aurele  Beaulnes  of  the  federal 
department  of  health  and  welfare  out: 
lined  the  government's  program  to 
fight  the  use  of  drugs  for  non-medical 
purposes.  Based  on  the  recommenda- 
tions of  the  preliminary  LeDain  Re- 
port, the  government  will  invest  4.6 
million  dollars  in  research,  information, 
treatment,  and  laboratories. 


Some  research  will  be  undertaken 
jointly  by  the  national  department 
of  health  and  welfare  and  the  medical 
research  council.  The  program,  to  be 
set  up  in  consultation  with  provincial 
health  departments,  will  include  gather- 
ing, analysis,  and  sharing  of  data.  One 
priority  item  is  the  establishment  of 
regional  laboratories  for  toxicology 
analysis. 

The  government  will  make  funds 
available  for  research  into  social  prob- 
lems resulting  from  drug  abuse.  One 
subject  to  be  investigated  will  be  the 
factors  inducing  individuals  to  abuse 
drugs.  Grants  will  be  awarded  for  pilot 
projects  and  other  types  of  short-term 
help  as  well  as  research  programs  un- 
dertaken by  existing  or  new  organiza- 
tions. Some  new  organizations  to  be  set 
up  will  be  administered  by  young  peo- 
ple. 

The  symposium  ended  by  adopting 
20  resolutions.  Some  of  them  are:  that 
the  Government  of  Canada  delay  im- 
mediately the  penalties  to  persons  in 
possession  of  cannabis;  that  health 
centers  secure  the  assistance  of  tox- 
icomania specialists;  that  the  govern- 
ment be'  more  rigid  regarding  the 
production,  import,  and  distribution 
of  prescription  drugs. 

Dr.  Helen  K.  Mussallem,  executive 
director  of  the  Canadian  Nurses'  As- 
sociation, chaired  one  of  the  panel  ses- 
sions at  the  conference.  She  said  it  was 
difficult  to  describe  the  impact  the 
conference  made  on  her. 

"I  was  made  aware  for  the  first  time 
that  drug  users  were  considered  the 
modern  leper.  The  drug  users  have 
been  rejected  by  hospital  and  established 
health  care  centers.  The  growth  of 
street  clinics  and  drop-in  centers  show 


CARDIAC  COMMENTS: 

By  Patricia  Orr,  R.N., 

New  Brunswick 


'I  Wonder  What  He  Thinks  He's  Doing  Back  Again! 


APRIL  1971 


what  happens  when  existing  institu- 
tions don't  meet  a  need  —  then,  some- 
thing else  happens. 

"It  really  came  through  at  the  con- 
ference that  there  needs  to  be  some  way 
to  reach  people  requiring  the  kind  of 
help  needed  by  drug  users.  Once  again 
we  see  the  manifestations  of  breakdown 
in  the  health  care  delivery  system.  A 
great  gap  exists  (in  what  I  call  the 
health  care  non-system)  between  the 
ever-increasing  scientific  and  medical 
knowledge  and  the  people  who  need 
help,"  said  Dr.  Mussallem. 

"But  I  was  inspired  by  the  way 
young  people  set  up  a  network  of 
drop-in  clinics.  To  hear  from  the  young 
nurses  and  doctors  —  looking  like 
hippies  themselves  —  who  work  in  the 
front  lines  with  this  problem  was  most 
exciting  to  me,"  she  said. 

MARN  Surveys 
Employment  Scene 

Winnipeg,  Man.  —  The  Manitoba 
Association  of  Registered  Nurses  is 
conducting  a  survey  of  the  employment 
situation  for  nurses  in  Manitoba. 

To  complete  the  survey  all  nurses 
who  have  recently  sought  employment 
and  were  unable  to  secure  a  position, 
are  asked  to  contact  MARN,  647 
Broadway  Avenue,  Winnipeg  1,  Mani- 
toba. 

Provincial  Monies  Support 
Intermediate  Care  Program 

Vancouver,  B.C.  — Approval  by  the 
British  Columbia  legislature  of  a 
$500,000  spending  estimate  for  the 
development  of  alternative  health  care 
facilities  is  regarded  as  a  step  in  the 
right  direction  by  the  Registered 
Nurses'  Association  of  British  Colum- 
bia, who  had  urged  this  kind  of  care 
be  given  priority. 

Monica  Angus,  RNABC  president, 
said,  "We  have  been  advocating  the 
provision  of  home  care  services  and  the 
establishment  of  intermediate  care 
facilities  as  necessary  to  a  compre- 
hensive health  care  delivery  system. 
We  will  be  interested  in  learning  pre- 
cisely how  the  government  plans  to 
implement  these  programs." 

The  RNABC  is  hopeful  the  proposed 
home  care  program  will  include  ade- 
quate supportive  services  by  nurses, 
social  workers,  and  physiotherapists, 
as  well  as  back-up  services.  Mrs.  Angus 
said  the  proposed  intermediate  care 
facilities  would  free  acute  care  hospitals 
and  extended  care  facilities  from  hous- 
ing persons  who  do  not  need  these  more 
expensive  services. 

The  association  had  reacted  strongly 
following  a  February  statement  by 
provincial  health  minister  Ralph  Loff- 
mark  that  the  provincial  government 
was  not  prepared  to  extend  hospital 

APRIL  1971 


insurance  to  cover  such  intermediate 
care.  At  that  time  Mrs.  Angus  said, 
"We  believe  the  people  needing  this 
type  of  care  are  the  least  able  of  all 
public  groups  to  exert  influence  in 
health  care  decisions. 

"The  need  is  evident  for  some  facility 
where  nursing  care  can  be  given  for 
rehabilitative  and  long-term  patients," 
she  said.  "The  needs  of  active  wage- 
earning  persons  are  relatively  well  met 
but  the  needs  of  the  elderly,  the  infirm, 
and  the  disadvantaged  are  not." 


Family  Planning  Conference 
Discusses  Federal  Program 

Ottawa  —  An  informal  two-day  con- 
ference was  held  in  February  to  discuss 
the  department  of  national  health  and 
welfare's  proposed  program  to  make 
family  planning  information  and  serv- 
ices available  to  interested  citizens. 
Representatives  of  national  agencies 
active  in  family  planning  programs 
attended  the  conference  along  with 
government  officials. 

Catherine  MacGregor,  supervisor, 
family  planning  clinic,  Ottawa-Carle- 
ton  regional  area  health  unit,  repre- 
sented the  Canadian  Nurses'  Associa- 
tion. Also  represented  at  the  meeting 
were  the  Canadian  Medical  Associa- 
tion, the  Canadian  Association  of 
Social  workers,  le  Centre  de  planning 
familial  du  Quebec,  the  Family  Plan- 
ning Federation  of  Canada,  and  the 
International  Planned  Parenthood 
Federation. 

Health  Minister  John  Munro  said 
the  federal  program  will  focus  on  re- 
ducing the  incidence  of  unwanted 
children,  of  child  neglect,  abandon- 
ment, desertion,  welfare  dependency, 
and  child  abuse.  Infant  mortality  is  a 
prime  concern  of  the  program.  The 
minister  indicated  that  his  department 
officials  will  meet  with  provincial 
government  health  and  welfare  of- 
ficials to  discuss  the  program,  which 
will  operate  in  cooperation  with  the 
provinces. 


MARN  Plans 
Citizenship  Ceremony 

Winnipeg,  Manitoba  —  The  Manitoba 
Association  of  Registered  Nurses  is 
planning  a  special  citizenship  ceremony 
for  May  12,  1971,  in  the  new  Victoria 
General  Hospital,  Winnipeg.  The  cere- 
mony, to  be  held  on  the  anniversary 
of  the  birth  of  Florence  Nightingale, 
will  be  for  nurses  who  are  not  yet  Ca- 
nadian citizens  and  who  want  to  obtain 
their  citizenship  during  1971. 

Arrangements  are  being  made  by 
the  Citizenship  Court  in  Winnipeg 
through  the  cooperation  of  the  Court 
of  Canadian  Citizenship. 


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costs  by  using  Tubegauz  instead  of 
ordinary  techniques.  Special  easy- 
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69H9 

THE  CANADIAN   NURSE     17 


American  Nurses  March 
To  Support  Nursing  Bill 

Albany.  New  York  —  Busloads  of 
nurses  from  every  area  of  New  York 
state  and  from  every  occupational  set- 
ting, marched  on  the  state  capital,  Al- 
bany, in  support  of  a  bill  which  seeks 
to  update  the  present  definition  of  nurs- 
ing written  in  1938. 


Now  pendmg  before  the  legislature, 
the  bill,  known  as  the  Laverne-Pisani 
bill,  calls  for  the  recognition  of  the 
distinct  and  independent  role  of  the 
nurse  in  such  areas  as  casefinding, 
health  teaching,  health  counseling, 
and  provision  of  supportive  nursing 
care  services.  Approval  of  the  new 
definition  is  seen  as  essential  to  the 
nursing  profession's  efforts  to  main- 
tain its  traditional  role  as  the  patient's 
assistant  and  guarantor  of  the  delivery 
of  adequate  nursing  care  services. 

Supfxjrters  of  the  bill  believe  lack 
of  understanding  of  the  independent 


Just  Press  the  Clip  and  It's  Sealed 

It  takes  but  a  moment  to  identify  your  pa- 
tient, positively  and  permanently,  with 
Ident-A-Band.  Then  just  a  glance  is  all  you'll 
need  to  be  sure  that  this  Is  the  right  patient. 

fdent-A-Bancf 

f_HoLLisr€R; 


Write  today  for  free 
samples  and  literature. 


neO    BAV   ST..   TORONTO   1 


18     THE  CANADIAN   NURSE 


role  of  nursing  poses  a  serious  threat  to 
the  profession.  They  viewed  the  march 
as  a  statement  of  solidarity  from  nurses 
and  reaffirmation  of  their  commitment 
to  the  patient.  The  rally,  held  on  March 
2,  united  both  registered  and  practical 
nurses  under  a  banner,  "nurses  for  the 
preservation  of  nursing." 

Nurses  not  able  to  attend  the  march 
supported  its  spirit  by  calling  or  writing 
members  of  the  legislature.  The  New 
York  State  Nurses'  Association  coordi- 
nated the  march. 

McMaster  School  Studies 
Role  Of  "GP's  Nurse" 

Hamilton,  Ont.  —  A  nurse  in  a  gener- 
al practitioner's  office  may  be  any- 
thing from  a  glorified  receptionist  to  a 
medical  assistant  who  makes  house 
and  hospital  visits  and  does  counseling 
and  physical  examinations. 

A  story  in  the  Hamilton  Spectator 
said  the  patterns  in  the  Hamilton  area 
will  be  studied  by  the  McMaster  school 
of  nursing  with  the  first  grant  it  has 
received  for  research. 

The  school  has  an  $8,380  national 
health  grant  for  the  first  part  of  a 
$25,000  study  that  will  cover  50  doc- 
tors' offices  in  the  area,  and  is  expected 
to  continue  until  next  tall. 

May  Yoshida,  a  nurse  with  additional 
training  in  sociology,  will  direct  much 
of  the  fact-finding,  which  includes  fol- 
lowing nurses  around  for  a  day,  and 
questionnaires  for  nurse,  doctor  and 
receptionist.  About  10  patients  from 
every  doctor's  practice  will  be  asked 
their  attitudes  and  expectations  about 
who  does  what  for  them  in  health  care. 

Dr.  Dorothy  J.  Kergin,  director  of  the 
school  of  nursing,  said  one  of  the  basic 
reasons  for  the  survey  is  educational 
planning. 

"We  want  to  see  if  there  is  a  need  for 
a  continuing  education  program  for 
nurses  in  doctors'  offices  to  give  them 
additional  skills.  We  also  want  to  know 
if  the  basic  education  program  should 
be  changed  to  equip  a  nurse  to  assume 
wider  responsibilities." 

But  the  Spectator  story  said  the  study 
has  wider  implications.  There  is  much 
concern  currently,  by  both  govern- 
ment and  the  medical  professions,  about 
rising  health  care  costs.  Use  of  people 
other  than  doctors  for  some  areas  of 
health  care  is  often  suggested  as  one 
way  of  both  cutting  costs  and  making 
better  use  of  a  limited  supply  of  MDs. 

Many  see  the  nurse  as  the  obvious 
person  to  take  over  some  of  these  du- 
ties, and  some  suggest  she  should  be 
given  a  new  title,  such  as  nurse  prac- 
titioner, doctor's  assistant,  or  doctor's 
associate. 

The  Canadian  nursing  profession 
maintains  there  isn't  a  need  for  a  fancy 

{Continued  on  piific  20) 
APRIL  1971 


EXPAND  YOUR  PERSONAL  LIBRARY 


1.  NURSING  OF   PEOPLE  WITH   CARDIOVASCULAR   PROBLEMS. 

By  Sister  Catherine  Armington,  D.C.,  R.N.,  B.S.N.E.,  and  Helen 
Creighton,  R.N.,  A.M.,  M.S.N.,  J.D.  Approx.  350  pp.,  illustrated. 
In  preparation. 

This  new  book  provides  the  nurse  with  what  omounts  to  a  post- 
graduate course  in  the  care  of  patients  with  cardiovascular  prob- 
lems. Prepared  with  the  needs  of  both  patient  and  nurse  in  mind, 
this  volume  has  been  enriched  by  the  advice  and  suggestions  of 
various    cardiologists,    cardiac    surgeons,    end    nurse    educators. 

2.  NURSING  CARE  OF  CHILDREN 

Eighth  Edition.  Florence  G.  Bloke,  R.N.,  M.A.,  F.  Howell  Wright, 
M.D.,  and  Eugenia  H.  Waechter,  R.N..  Ph.D.  588  pp.  254  illus- 
trations. 1970.  $9.50. 

Completed  revised  and  expanded,  with  an  entirely  new  format  and 
many  new  illustrations,  this  superb  text  is  without  peer  as  a  com- 
prehensive, in-depth  study  of  pediatric  nursing.  It  is  organized 
according  to  age  groups,  from  infancy  to  adolescence.  Increased 
emphasis  is  placed  on  growth  and  development  at  each  age  period. 

3.  NURSING  CARE  OF  THE  LONG-TERM  PATIENT 

Second  Edition.  Jeanne  E.  Blumberg,  R.N.,  P.H.N. ,  M.S.;  and  Eleanor 
E.    Drummond,   R.N.,   P.H.N.,    Ed.    D.    1970.    288   pp.    $3.95. 

Expanded  edition  of  this  successful  book,  largely  rewritten  end  its 
scope  broadened  by  a  new  emphasis  on  the  interrelatedness  of  eight 
key  concepts  and   by   discussion   of  new  techniques  and    procedures. 

4.  TEXTBOOK  OF  MEDICAL-SURGICAL  NURSING 

Second  Edition.  Lillian  Sholtis  Brunner,  R.N.,  M.S.,  Charles  Phillips 
Emerson,  Jr.,  M.D.,  L.  Kraeer  Ferguson,  M.D.,  F.A.C.S.,  and  Doris 
Smith  Suddarth,  R.N.,  M.S.N.,  with  a  Panel  of  Contributors.  1031 
pp.  387  Illustrations.   1970.   $14.95. 

Massively  revised  and  enlarged  in  scope,  this  edition  is  designed 
to  develop  the  highest  degree  of  clinical  expertise  in  the  care  of 
medical  and  surgical  patients.  Outstanding  in  its  depth  of  patho- 
physiologic content,  the  text  also  emphasizes  the  psychosocial  factors 
involved  in  patient  care. 

5.  NEW  DIRECTIONS  FOR  NURSES 

Selected  readings.  By  Bonnie  Bullough,  R.N.,  Ph.D.;  and  Vern 
Bullough,  PhD.,  1970.  386  pp.  $5.25. 

What's  ahead  for  the  nurse  who  is  serious  about  her,  or  his  profes- 
sion? Here,  in  40  timely  articles  assembled  by  the  editors  of  Issues 
in  Nursing,  are  the  highlights  concerning  expansion  of  the  nursing 
role  and  the  various  nursing  and  paramedical  specialties  now  em- 
erging; the  changing  nurse-doctor  telationship;  inequities  in  health 
care  and  their  meaning  for  the  nurse;  the  crisis  in  manpower  — 
what  accounts  for  the  shortage  and  how  can  it  be  overcome? 

6.  DUNCAN'S  DICTIONARY  FOR  NURSES 

Helen   A.   Duncan,   R.N.    1971.   408  pp.   $5.25;   hardcover   $7.95. 

All  the  terms  a  modern  professional  nurse  needs  to  know  in  nursing, 
medicine,  psychiatry,  the  social  and  biological  sciences  —  more  than 
10,000  entries,  compiled   for  nurses,   by   a   nurse. 


7.  MATERNITY    NURSING 


New    Edition 


Twelfth  Edition.  Elise  Fitzpatrick,  R.N.,  M.A.,  Sharon  R.  Reeder, 
R.N.,  M.S.,  and  Luigi  Mastroianni,  Jr.,  M.D.,  F.A.C.S.,  F.A.C.O.G. 
Approx.   700  pp.  320  Illustrations.   Spring    1971.   $9.75. 


Maintaining  the  same  high  goals  of  earlier  editions,  this  family- 
focussed  textbook  is  directed  toward  the  total  health  and  well-being 
of  the  mother  and  infant.  Expanded  and  updated  in  line  with  new 
medical  concepts  and  concomitant  nursing  practice,  this  is  com- 
prehensive  maternity   nursing   at   its   best. 

The  importance  of  psychosocial  factors  is  reflected  in  the  authors' 
decision  to  integrate  psychological  principles  throughout  the  text 
and  add  an  entirely  new  chapter  on  Social  Factors.  New  chapters 
also  include  Patient  Teaching  and  Fetal  Diagnosis  and  Treatment. 
A  number  of  illustrations  and  diagrams  have  been  added  to  aid 
student  comprehension.  A  new  author  joins  the  book  with  this 
edition.  Dr.  Mostroianni  has  a  distinguished  background  in  teaching 
research  and  clinical  practice. 

8.  DRUGS  IN  CURRENT  USE  AND  NEW  DRUGS  1971 
Walter  Modell,  M.D.  184  pp.  $3.95. 

Annual  standby  for  nurses.  Now  even  further  improved,  with  the 
section  on  FDA  requirements  for  new  drugs  considerably  stream- 
lined, making  it  more  precisely  applicable  to  the  nurse's  needs. 

9.  PEDIATRIC  SURGERY  FOR  NURSES 

Edited  by  John  G.  Raffensperger,  M.D.,  and  Rosellen  B.  Primrose, 
R.N.,  B.S.  Illustrated.  327  pp.  1968.  $11.00. 

Students  and  pediatric  nurses  will  find  this  text  straightforward, 
easy-to-use,  and  essential  as  a  guidebook  for  handling  pediatric 
surgical  patients  Detailed  descriptions  of  patient  conditions  and 
di-scussions  of  preoperative  and  postoperative  care  appear  throughout 
the  book.  Included  also  are  many  useful  photographs  illustrating 
surgical  procedures  and  patient  syndromes.  Authoritative  advice  on 
the  many  psychological  considerations  in  dealing  with  a  sick  child 
and  his  parents  adds  to  the  depth  of  this  recommended  text. 

10.  NURSING  IN  THE  CORONARY  CARE  UNIT 

LaVaughn  Sharp,  R.N.,  M.A.,  and  Beatrice  Robin,  R.N.  213  pp. 
89  Illustrations.  1970.  $8.25. 

Concrsely  written  by  well-qualified  authors  and  amply  illustrated 
with  graphs  and  charts,  this  book  guides  the  nurse  in  making  de- 
cisions and  initiating  appropriate  measures  for  optimum  care  of  the 
coronary  patient.  Content  covers  diagnostic  measures,  including 
interpretation  of  the  oscilloscope  and  other  electronic  monitoring 
equipment,  etiology,  treatment,  psychological  support,  and  nursing 
intervention   for  all   types  of  coronary  artery   disease. 

11.  DETERMINANTS   OF   THE    NURSE-PATIENT    RELATIONSHIP. 

By  Gertrud  Bertrand  Ujhely,  R.N.,  M.A.,  1968.  Flexible  Coyer, 
283  pp.  $4.25. 

A  highly  successful,  three-part  exposition  of  recurrent  variables  — 
in  nurse,  patient,  and  setting  —  that  makes  it  easy  for  the  nurse 
to  adapt  the  basic  demonstrations  from  the  book  to  specific 
nurse-patient  situations. 

12.  INTERPRETATION  OF  DIAGNOSTIC  TESTS 
By  Jacques  Wallach,  M.D.  450  pp.  1970.  $7.50. 

The  value  of  this  compact  book  is  immeasurable.  The  clinician  can 
use  it  quickly  and  efficiently  as  an  aid  in  choosing  the  most  useful 
laboratory  test  or  in  interpreting  abnormal  laboratory  reports.  The 
three  major  sections  include  a  tabulation  of  normal  values,  labo- 
ratory findings  on  the  most  important  diseases  (including  many  only 
recently  described),  and  deliniation  of  abnormal  test  results  and  the 
diseases  associated  with  them.  The  many  tables  and  graphs,  emphasis 
on  sequential  time  changes  in  diseases,  and  differential  diagnosis  of 
common  but  perplexing  medical  problems  make  this  a  most  con- 
venient source  of  facts  for  the  clinician. 


PLEASE   SEND   ME  THE    BOOKS    I    HAVE   CIRCLED    BELOW  _ 

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APRIL   1971 


THE  CANADIAN   NURSE     19 


(Coiuimied  from  page  18) 

new  title  —  even  with  an  expanded 
role,  the  nurse  should  still  be  called  just 
that. 

Will  doctors  give  up  some  of  the 
things  they  have  traditionally  done? 
Will  patients  accept  care  from  a  nurse, 
particularly  in  an  era  when  they  have 
insurance  that  supposedly  guarantees 
them  the  attention  of  a  doctor?  Do 
nurses  themselves  want  these  additional 
duties  and  responsibilities?  Dr.  Ker- 
gin  pointed  out  that  the  United  States' 
experience,  which  is  taking  some  of  the 
load  off  doctors,  isn't  too  useful  to 
Canadian  situations. 

So,  built  into  the  Hamilton  area 
survey  will  be  questions  that  will  reveal 
some  of  the  attitudes  toward  a  new  role 
for  the  nurse  employed  by  the  general 
practitioner. 


Nurses  Study 
Remotivation  Therapy 

Verdun,  P.Q.  —  Hospital  personnel 
from  eastern  Canada  and  the  United 
States  have  been  attending  workshop- 
training  sessions  in  remotivation  thera- 
py at  Douglas  Hospital,  Verdun,  one 
of  Canada's  most  active  centers  for  this 
type  of  training  and  therapy. 

Peter  Steibelt,  director  of  remotiva- 
tion, who  started  the  formal  program 
at  the  hospital  in  1966,  conducts  the 
five-day  course  of  lectures,  practice, 
and  workshop  training.  Usual  atten- 
dance is  between  40  to  60  volunteers 
and  staff  members  of  other  hospitals. 

The  techniques,  designed  to  help 
patients  return  to  reality,  consist  of 
group  discussion  of  concrete  subjects. 
Eight  hundred  mental  patients  partici- 
pate in  the  70  regular  remotivation 
groups  within  the  hospital.  There  are 
basic  steps  followed  by  the  remotiva- 
tors  or  leaders  in  helping  patients  build 
a  "bridge  to  reality"  and  develop  in- 
terest and  appreciation  of  everyday 
life. 

Leaders  evaluate  the  members  of 
their  group  at  the  beginning  and  end  of 
the  12-week  sessions,  on  such  points 
as,  "interest,  participation,  compre- 
hension, knowledge,  speech,  grooming, 
and  language."  The  hospital's  remotiva- 
tion council'  meets  regularly  with  rep- 
resentatives of  medical,  nursing,  social 
service,  and  occupational  therapy 
departments  to  report  progress,  ex- 
change opinion,  and  discuss  possibili- 
ties of  further  rehabilitation. 

Initially  the  average  long-term  re- 
gressed   patient    was    considered    the 

20     THE  CANADIAN   NURSE 


prime  prospect  for  remotivation  ther- 
apy. Now  all  types  of  patients,  includ- 
ing those  with  much  better  contact  with 
reality  and  pre-discharge  groups,  are 
treated. 


School  Nurses  Take 
Practitioner  Course 

New  York,  N.  Y.  —  An  experimental 
program  to  prepare  school  nurse  prac- 
titioners was  started  by  the  University 
of  Colorado,  Denver,  Colorado,  re- 
ports the  November  1970  issue  of  the 
American  Journal  of  Nursing. 

The  experiment  began  with  four 
public  school  nurses  in  September. 
When  they  have  finished  the  course 
they  will  be  qualified  to  assume  the 
responsibility  for  identification  and 
management  of  many  child  health  prob- 
lems with  assistance  from  physicians 
as  needed.  The  nurses  will  assess  psy- 
chological, neurological,  nutritional, 
or  other  problems  affecting  normal 
development,  behavior  and  ability  to 
learn. 

They  will  take  medical  histories, 
do  physical  examinations,  and  super- 
vise screening  tests  to  detect  and  to 
evaluate  evidence  of  acute  or  chronic 
disorders  affecting  speech,  sight,  hear- 
ing, and  posture.  They  will  do  immu- 
nizations, give  direct  treatment  for  such 
common  illnesses  as  mild  upper  respir- 
atory infections  and  skin  rashes,  and 
give  emergency  care. 

The  course  was  developed  by  Henry 
K.  Silver,  professor  of  pediatrics  at 
the  University's  school  of  medicine. 
He  is  co-author  with  Loretta  P.  Ford, 
professor  of  community  health  nurs- 
ing in  the  CU  nursing  school,  of  the 
pediatric  nurse  program. 

A  second  class  of  selected  nurses 
began  the  course  in  January.  The  course 
is  open  to  experienced  school  nurses 
who  hold  a  bachelor's  degree.  Thirty 
nurses  are  expected  to  be  trained  during 
the  three-year  experiment. 

The  course  is  jointly  sponsored  by 
the  CU  schools  of  medicine  and  nurs- 
ing and  the  Denver  public  schools.  It 
is  funded  by  grants  of  $84,540  from 
the  Commonwealth  Fund,  New  York, 
and  $50,000  from  the  Bruner  Foun- 
dation, New  York. 


US  Nurses  Like 
Short  Work  Week 

New  York,  N.Y.  —  American  indus- 
try's latest  trend  is  the  shorter  week, 
longer  working  day  plan.  The  Novem- 
ber 1970  issue  of  the  American  Jour- 
nal of  Nursing,  describes  how  a  hos- 
pital in  Providence,  Rhode  Island, 
used  such  a  plan  in  setting  up  a  new 
shift  schedule  for  its  nurses. 

The  nurses  in  each  unit  are  divided 
into  two  teams,  with  one  tearn  working 


while  the  other  is  off.  Each  team  works 
seven  10-hour  days  every  two  weeks. 
The  first  week's  schedule  is  Sunday, 
Wednesday  and  Thursday.  The  second 
week  is  Monday,  Tuesday,  Friday, 
and  Saturday.  Each  24-hour  period 
is  divided  into  two  10-hour  shifts  and 
one  5-hour  shift:  7:00  A.M.  to  5:00 
P.M.;  5:00  P.M.  to  10:00  p.m.;  and 
9:00  P.M.  to  7:00  A.M. 

The  schedule  of  70  working  hours 
is  spread  over  seven  working  days 
each  two  weeks.  There  are  four  days 
of  work  one  week  and  three  the  alter- 
nate week  for  an  average  of  three  and 
one-half  working  days  a  week.  The 
nurses  are  paid  the  same  rate  they 
received  when  they  worked  40  hours 
over  the  traditional  five-day  week. 

This  plan  was  developed  as  a  way 
to  allocate  nursing  personnel  more 
evenly  over  the  24  hours  and  seven 
days  a  week  that  hospitals  have  to 
staff.  The  former  schedule  for  a  5 -day, 
40-hour  week,  combined  with  a  policy 
of  alternate  weekends  off  for  all  nurses, 
caused  inflexibility  in  scheduling,  too 
much  overstaffing,  and  too  high  a  ratio 
of  part-time  to  full-time  nurses,  said 
the  administration. 

The  hospital  was  having  difficulty 
getting  and  keeping  full-time  nurses, 
and  had  a  majority  of  part-time  nurses 
on  its  staff.  The  administration  was 
concerned  about  the  effect  this  situa- 
tion might  have  on  patient  care  as  the 
use  of  more  part-time  nurses  caused 
more  shift  changes  and  more  transfer- 
ring of  information  about  patients  from 
one  nurse  to  another. 

The  new  system  was  started  more 
than  a  year  ago  in  the  coronary  care 
unit  of  the  267-bed  general  teaching 
hospital.  It  was  enthusiastically  accept- 
ed by  the  nurses  and  was  offered  to 
other  nursing  units  on  a  voluntary  basis. 
At  present,  300  of  the  350  nurses  con- 
sidered eligible  for  the  schedule  are  on 
it.  Some  units,  such  as  the  operating 
room,  were  never  staffed  full-time 
seven  days  a  week. 

The  nurses  like  having  two  or  more 
days  off  consecutively,  alternating 
three-day  weekends,  and  less  time  spent 
per  year  traveling  to  and  from  work. 
The  administration  said  the  system 
decreased  overstaffing,  helped  recruit- 
ment, provided  more  efficient  patient 
care,  and  pleased  the  nurses. 


Manitoba  Board  Refuses 
To  Certify  Winnipeg  Group 

Winnipeg,  Man.  —  The  Winnipeg  Gen- 
eral Hospital  Registered  Nurses'  As- 
sociation's application  for  certifica- 
tion as  a  collective  bargaining  group 
was  turned  down  by  the  Manitoba 
labor    board.    The   dismissal    by   the 

(Continued  on  page  23) 
APRIL  1971 


NOWAY! 


There's  no  way  airborne  contaminants  can  accidentally  get  into 
viAFLEx  plastic  containers  unless  you  inject  them.  Unlike  glass 
bottles,  the  VIAFLEX  container  has  no  vent — room  air  is  kept  out. 
It's  the  only  completely  closed  I.V.  system;  airborne  contami- 
nants are  locked  out.  and  the  system  remains  sterile  throughout 
the  procedure.  Even  when  the  spike  of  the  set  is  inserted,  air 
cannot  get  in — because  the  spike  completely  occludes  the  port 


opening  before  it  punctures  the  Internal  safety  seal.  A  self- 
sealing  latex  cap  on  the  second  port  is  provided  for  adding 
supplemental  medication,  viaflex  is  the  first  and 
only  plastic  container  for  intravenous  solutions.  ^™  j(»- 
To  assure  your  patient  the  safety  of  a  completely 
closed  system,  it's  the  first  and  only  container 
you  should  consider. 


BAXTER  LABORATORIES  OF  CANADA 


DIVISION  OF  THAVENOL  LABORATORIES.  INC. 

6405  Northam  Drive.  Malton.  Ontario 


Viaflex 


Fleet 

ends  ordeal  by 

Enema 

for  you  and 
your  patient 


Now  in  3  disposable  forms: 

*  Adult  (green  protective  cap) 

*  Pediatric  (blue  protective  cap) 

*  Mineral  Oil  (orange  protective  cap) 

Fleet  —  the  40-second  Enema*  —  is  pre-lubricated,  pre-mixed, 
pre-measured,  individually-packed,  ready-to-use,  and  disposable. 
Ordeal  by  enema-can  is  over! 

Quick,  clean,  modern,  FLEET  ENEMA  will  save  you  an  average  of 
27  minutes  per  patient  —  and  a  world  of  trouble. 


WARNING:  Not  to  be  used  when  nausea, 
vomiting  or  abdominal  pain  is  present. 
Frequent  or  prolonged  use  may  result  in 
dependence. 

CAUTION:  DO  NOT  ADMINISTER 
TO  CHILDREN  UNDER  TWO  YEARS 
OF  AGE  EXCEPT  ON  THE  ADVICE 
OF  A  PHYSICIAN. 


In  dehydrated  or  debilitated 
patients,  the  volume  must  be  carefully 
determined  since  the  solution  is  hypertonic 
and  may  lead  to  further  dehydration.  Care 
should  also  be  taken  to  ensure  that  the 
contents  of  the  bowel  are  expelled  after 
administration.  Repeated  administration 
at  short  intervals  should  be  avoided. 


22     THE  CANADIAN   NURSE 


Full  information  on  request. 

■Kehlmann,  W.  H.:  Mod.  Hosp.  84:104,  1955 

FLEET  ENEMA®  —  single-dose  disposable  unit 


/  ^— ^^     QUALITY  PHARMACEUTICALS 

'  ft;^  CAanfedCJia^a  &Ca 

*^-^^         R«KL*NO  (MONTfltAli  CANADA         j 


APRIL  1971 


news 


(Coiiliniicd  from  pane  20l 


board  denies  the  group  the  right  to 
bargain  collectively. 

The  provincial  staff  nurses'  coun- 
cil of  the  Manitoba  Association  of 
Registered  Nurses  is  "appalled'"  at  the 
decision.  The  council  and  the  hospital 
group  are  meeting  to  decide  on  future 
courses  of  action. 

Six  bargaining  units  already  cer- 
tified by  the  labor  board  are  composed 
exclusively  of  registered  nurses.  These 
represent  nurses  at  Brandon  General 
Hospital,  Assiniboine  Hospital,  St. 
Boniface  General  Hospital,  Misericor- 
dia  General  Hospital,  Victoria  General 
Hospital,  and  the  Winnipeg  Civic 
Nurses'  Association. 


TV  Panelist  Named 
A  Medical  Watchdog 

Toronto,  Out.  —  Betty  Kennedy,  well- 
known  as  a  panelist  on  "Front  Page 
Challenge,"  a  CBC  weekly  TV  show, 
was  appointed  in  January  to  the  com- 
plaints committee  of  the  College  of 
Physicians  and  Surgeons  of  Ontario  by 
health  minister  Thomas  Wells. 

Mr.  Wells  said  this  was  the  first  time 
a  member  of  the  public,  except  for 
health  ministers  who  are  sometimes  not 
doctors,  will  participate  in  the  college's 
activities. 

Dr.  J.C.  Dawson,  the  college's  regis- 
trar, said  the  college  asked  that  a  non- 
medical person  be  appointed  to  its 
complaints  committee  after  some  just- 
ifiable dissatisfaction  had  been  express- 
ed about  the  way  patients'  complaints 
were  handled. 

During  a  six-month  period  ending 
October  31,  1970,  the  college  received 
104  complaints  in  writing  and  about 
300  by  telephone.  Most  complaints 
were  settled  by  the  college's  staff,  but 
12  were  sent  to  the  complaints  commit- 
tee. Of  these,  three  were  dismissed.  In 
five  cases,  the  doctors  involved  were 
cautioned,  and  charges  of  professional 
misconduct  against  four  doctors  were 
sent  to  the  college's  discipline  commit- 
tee. 

Dr  Dawson  said  the  appointment  of 
Mrs.  Kennedy  was  one  of  several  steps 
the  college  is  taking  to  "restore  public 
confidence  in  the  ability  and  intention 
of  the  college  to  deal  equitably  with 
complaints  against  doctors." 

In  addition  to  being  a  regular  panelist 
on  the  long-running  TV  show,  Mrs. 
Kennedy  is  public  affairs  editor  for  a 
Toronto  radio  station.  ^ 

APRIL  1971 


IF  YOU'RE  HAVING 
PROBLEMS  WITH  I.V.s 
TRY  THE  I  V  OMETER 

Varying  flow  rates,  bottles  emptying  too  fast  or  too  slow, 
infiltrations  and  stopped  needles  are  common  I.V.  prob- 
lems. 

The  IVOmeter,  a  disposable  metered  I.V.  set  has  been 
shown  to  reduce  the  severity  and  frequency  of  these  prob- 
lems. The  nurse  can  now  observe  an  indicator  which 
shows,  at  a  glance,  the  current  flow  rate  compared  to  the 
desired  flow  rate.  Because  of  the  Stay-Set  clamp  the  nurse 
can  be  assured  that  any  change  in  flow  is  patient  oriented. 

To  find  how  IVOmeter's  patented  meter  and  clamping 
technique  can  eliminate  drop  recounting  and  assist  in 
improving  patient  care,  just  complete  and  mail  the  coupon 
shown  below  to: 

I 'V- OMETER,  INC.    P.O.  B0XI219     Santa  Ouz,  Callf.  95O6O 


.Zip. 


Hospital  

Title/Position 


I  V- OMETER,  INC.    p  o  box  1219 

A  subsidiary  ol   Intermed  Corporation 


SantaCruz,  Calif.  95060 


THE  C/^ADIAN   NURSE     23 


names 


B  Betty  Sellers  (R.N., 
Regina  General 
Hospital  School  of 
Nursing,  B.Sc.N., 
U.  of  Saskatoon; 
M.N.,  U.  of  Wash- 
ington, Seattle)  has 
been  appointed  to 
the  newly  created 
position  of  nursing 
service  consultant  with  the  Alberta 
Association  of  Registered  Nurses.  She 
is  responsible  for  developing  and  con- 
ducting a  nursing  service  consultation 
program  aimed  at  assisting  health  agen- 
cies to  provide  and  maintain  a  high 
quality  of  nursing. 

Miss  Sellers  has  been  a  staff  nurse 
at  the  Regina  General  Hospital.  Start- 
ing as  supervisor,  she  became  assistant 
director,  and  then  director  of  nursing 
at  the  University  Hospital  in  Saskatoon. 
Later,  she  was  director  of  nursing  at  the 
Queen  Elizabeth  Hospital  in  Toronto. 
More  recently  Miss  Sellers  has  been 
an  assistant  professor  and  associate 
director  of  a  research  unit  at  the  Univer- 
sity of  Toronto  School  of  Nursing. 

Grace  Carter  (R.N., 
Wellesley  Hospital 
School  of  Nursing, 
Toronto)  became 
the  first  National 
Education  officer 
of  the  Canadian 
Cancer  Society  on 
February  1,  1971. 
To  quote  Miss 
Carter,  "I  share  the  belief  of  many 
dedicated  volunteers  that  cancer  can 
be  prevented  and  many  more  cures 
would  be  possible  if  people  would 
seek  early  treatment.  My  job  will 
be  to  sell  this  message  to  the  Cana- 
dian public  and  to  induce  them  to  act 
on  it." 

During  her  early  nursing  career, 
Miss  Carter  worked  in  Michigan  and 
California,  taking  time  to  study  jour- 
nalism at  the  University  of  California 
in  Berkeley.  On  her  return  to  Toronto, 
she  worked  as  neurosurgical  nurse  for 
a  private  practitioner. 

In  1953,  Miss  Carter  joined  the 
Canadian  Pacific  Railway  Company, 
where  her  most  recent  assignment  has 
been  convention  sales  manager  of  the 
Royal  York  Hotel  in  Toronto. 

Miss  Carter  has  many  extra-profes- 

24     THE  CANADIAN   NURSE 


sional  interests.  She  is  a  charter  member 
of  the  board  of  governors  of  Seneca 
College  of  Applied  Arts  and  Technolo- 
gy, a  member  of  Executives'  Secretaries 
Inc.,  the  Ontario  Hotel  Sales  Manage- 
ment Association,  and  is  on  the  advisory 
council  of  the  Arts  of  Management 
Conferences  sponsored  by  the  Toronto 
Business  and  Professional  Women's 
Club. 


Sharon       B.      Tiffin 

(R.N.,U.  of  Alberta 
Hospital  School  of 
Nursing,  Edmonton) 
is  serving  a  two- 
year  tour  of  duty 
with  MEDICO,  as 
one  of  a  team  of 
Canadians  working 
in  Surakarta  (Solo) 
in  the  province  of  Central  Java.  She  is 
involved  in  training  student  nurses  and 
upgrading  nursing  services  at  local 
hospitals. 

Miss  Tiffin  has  worked  at  St.  Paul's 
Hospital,  Vancouver,  and  with  the 
Canadian  Red  Cross  Blood  Trans- 
fusion Service.  She  has  also  been  em- 
ployed at  Lions  Gate  Hospital  in  North 
Vancouver.  Later,  she  studied  midwifery 
at  the  University  of  Alberta  and  then 
worked  at  Providence  Hospital,  Fort 
St.  John,  B.C. 


J. A.  McNab,  executive  director  of 
Toronto  General  Hospital,  has  an- 
nounced the  appointment  of  Eileen  D. 
Strike  as  director  of  nursing  service  for 
the  hospital,  effective  June  1,  1971. 
Miss  Strike  will  join  the  staff  on  May 
10  to  begin  orientation. 

Miss  Strike  (R.N., 
The  Montreal  Gen- 
eral Hospital  School 
of  Nursing;  B.Nurs., 
McGill  U.,  Mont- 
real; M.Sc,  Boston 
U.)  worked  at  the 
Royal  Edward  Chest 
Hospital  in  Mont- 
real as  associate 
director  of  nursing  from  1961  to  1963. 
She  was  special  assistant  to  the  director 
of  nursing  of  The  Montreal  General 
Hospital  from  1963  to  1965,  when 
she  was  named  associate  director  of 
nursing  service  at  that  hospital,  a  posi- 
tion she  has  filled  to  the  present  except 


/ 


for  a  period  of  leave  to  attend  Boston 
University  as  a  Canadian  Nurses'  Foun- 
dation Scholar. 

Miss  Strike  has  been  active  as  an 
execiftive  member  of  The  Montreal 
General  Hospital  school  of  nursing 
alumnae  association  and  was  chairman 
of  the  associate  membership  of  the 
United  Nurses  of  Montreal  in  1967-68. 
She  has  held  executive  positions  on 
both  district  and  provincial  committees 
of  the  Association  of  Nurses  of  the 
Province  of  Quebec,  including  among 
others,  the  committee  on  labor  rela- 
tions (1967-69)  and  the  committee  on 
nursing  service  (1969-70).  She  was  a 
member  of  the  legislation  committee 
( 1 966)  and  the  resource  committee  — 
Study  of  the  Nursing  Profession  in 
Quebec  (1970). 

Miss  Strike  is  currently  a  member 
of  the  CNA  standing  committee  on 
nursing  service. 


Ruth  K.  Schinbein  (R.N.,  Saskatoon 
City  H.),  obstetrical  supervisor  at  West 
Lincoln  Memorial  Hospital,  Grims- 
by, Ontario,  has  been  elected  chairman 
of  the  Ontario  section  of  the  nurses' 
association  of  The  American  College 
of  Obstetricians  and  Gynecologists. 

The  purpose  of  the  nurses'  associa- 
tion of  ACOG,  which  has  grown  to 
3,600  members  in  the  U.S.  and  Canada, 
is  to  promote,  in  conjunction  with  the 
College,  the  highest  standards  of  obstet- 
ric, gynecologic,  and  neonatal  nursing 
practice  and  education;  to  cooperate  at 
all  levels  with  qualified  physicians 
and  nurses;  and  to  stimulate  interest 
in  obstetric,  gynecologic,  and  neonatal 
nursing. 


Margaret  Cammaert  (B.Sc.N.,  U.  of 
Alberta;  M.P.H.,  Johns  Hopkins  U., 
Baltimore),  chief  nurse  with  the  Pan 
American  Health  Organization  in 
Washington,  D.C.,  paid  an  official  visit 
to  the  department  of  national  health 
and  welfare  in  February. 

She  met  with  the  principal  nursing 
officer,  Verna  Huffman,  and  other 
nursing  consultants  to  discuss  the  role 
of  the  nurse  in  the  delivery  of  health 
care.  Miss  Cammaert  visited  CNA 
House  on  February  1 1 ,  and  at  the 
opening  of  the  three-day  Nursing  Con- 

(Conliniied  on  page  26) 
APRIL  1971 


LA  CROSS  HAS 
BEAUTIFUL  IDEAS 


There's  more  to  La  Cross  than  pro- 
fessional good  looks.  Count  on  La 
Cross  for  comfort,  long  wear  and 
easy  care  fabrics.  La  Cross  .  .  .  the 
name  to  trust  for  value  in  quality 
nursing  fashions. 


^ 


Action  sleeve  gussets,  self  belt  and  front  zipper  on 
the  jacket.  Pants  are  sold  separately. 

80%  DACRON  —  20%  COTTON 

Style  5046  (Jacket)  Retails  about  $13.98 

Style  5034  (Pants)  Retails  about  $10.98 

SIZES  6-18 


This  and  other  styles  available  at  uniform  shops  and 
department  stores  across  Canada. 


« 


PROFESSIONAL  UNIFORMS 

For  a  copy  of  our  latest  catalogue  and 
for  the  store  nearest  you,  write : 

La  Cross  Uniform  Corp. 

4530  Clark  St., 

Montreal,  Quebec 

Tel :  845-5273 


•.  •.•■••.•.4 


LUCY 
0-1788 


THE  SECRET 
IS  IN  THE 

Buoh 

it  moulds  itself  to  the  shape  of  your 
foot  curve  for  curve,  giving  evenly 
distributed  buoyant  support  where  it 
is  needed. 


Conventional  Insoles 


Cradle  Arch  Insole 


But  that's  not  all: 

•  Until  now,  shoes  were  made  to  fit 
only  the  length  and  width  of  the 
foot.  Now  White  Cross  scientific 
3-WAY  FIT  ensures  perfect 
fit  around  the  girth  too. 

GIRTH 


•  All  White  Cross  Shoes  are 
HY-GE-NIC  for  added  comfort 
and  protection. 

•  Up  to  6  FITTINGS  are  avail- 
able on  most  styles. 


A  BEAUTIFUL  WAY  TO  BE  COMFORTABLE. 


JUDITH 
0-2431 


BRIGITTE 

0-1861 


At  better  shoe  stores  across  Canada. 


names 


26     THE  CANADIAN   NURSE 


(Conliniiedfri)iii  pajjc  24) 

ference  on  Research  in  Nursing  Prac- 
tice on  February  1 6.  extended  greetings 
on  behalf  of  her  organization  to  those 
present.  She  came  to  Canada  direct 
from  Venezuela  where  she  participated, 
in  a  seminar  on  nursing  systems. 

Miss  Cammaert,  a  Canadian,  has 
had  extensive  experience  in  Canada 
and  a  number  of  Latin  American  coun- 
tries. She  was  appointed  to  her  present 
position  in  1968  and  is  responsible  for 
all  program  planning  for  nurses 
throughout  the  region  of  the  .Americas. 


Betty  Mclnnes  (Reg.N.,  St.  Joseph's 
School  of  Nursing,  Hamilton;  B.Sc.N., 
U.  of  Toronto;  M.Sc.Ed.,  U.  of  Niag- 
ara, N.Y.)  has  written  a  95-page 
volume,  The  Vital  Signs,  and  is  the 
first  Canadian  to  have  a  book  on  nurs- 
ing published  by  the  C.V.  Mosby 
Company  of  the  United  States. 

Her  book  is  set  out  in  the  program- 
med manner  and  will  be  incorporated 
into  the  curriculum  next  year  at  St. 
Joseph's  school  of  nursing  where  Miss 
Mclnnes  has  been  on  the  teaching  staff. 

For  the  current  year,  Miss  Mclnnes 
has  been  relieved  of  teaching  duties 
in  order  to  be  the  school's  audiovisual 
coordinator. 

Maurice  Dignard  (R.N.,  Laval  U.,  Que- 
bec), formerly  of  Montreal,  has  been 
decorated  by  the  Government  of 
Jordan  for  his  work  with  an  emergency 
team  sent  to  Amman  by  MEDICO,  a 
service  of  CARE,  to  assist  in  treating 
casualties  of  the  recent  war. 

Mr.  Dignard  and  his  teammates 
were  awarded  gold  medals  inscribed 
in  gratitude  for  their  "round  the  clock" 
aid  to  victims  of  the  street  fighting. 

For  the  past  year,  Mr.  Dignard  has 
been  operating  room  nurse  with  a 
MEDICO  team  stationed  in  Tunis,  Tu- 
nisia. During  the  emergency  in  nearby 
Jordan,  he  and  his  teammates  were 
temporarily  transferred  to  the  Jordan- 
ian capital  of  Amman. 

Mr.  Dignard  specialized  for  a  year 
in  operating  room  nursing  at  Hotel 
Dieu  of  Quebec.  He  then  organized 
and  supervised  the  emergency  room  at 
Hotel  Dieu,  Levis,  and  later  headed 
the  emergency  clinic  at  the  Hydro- 
Quebec  Dam  Project.  He  has  also  been 
operating  room  supervisor  at  Charles 
LeMoyne  Hospital,  and  officer  in 
charge  of  purchasing  material  and  sup- 
plies for  the  operating  room  at  Hotel 
Dieu,  Montreal.  ^ 

APRIL  1971 


^ 


>^« 


kj 


Vr. 


t: 


"^ 


^ 


'^6 


"*i     ifi 


1^ 


^^'TH.Q. 


i 


A  Superb  Text ,, , 
Now  Better 

I  rfa/f  even  Extensively  revised  to  include  new 
nursing  and  medical  entities,  this  edition  offers  a  realistic, 
clinical  presentation  of  individualized  nursing  care,  firmly 
grounded  in  the  biologic,  social  and  behavioral  sciences. 

Dorothy  W.  Smith,  R.N..  Ed.D.;  Carol  P.  Hanley  Germain, 
R.N.,  B.S.N. ,  M.S.;  and  Claudia  D.  Gips,  R.N.,  Ed.D. 


About  11 60  Pages 

410  Illustrations 

Spring,  1971 

About  $13.95 


Philadelphia  •  Toronto 


new  products     { 


Descriptions  are  based  on  information 
supplied  by  the  manufacturer.  No 
endorsement  is  intended. 


Day-Timer's  Myfar 

Myfar  (my  financial  affairs  record)  is 
an  aid  to  iceeping  financial  affairs  in 
order.  Adapted  to  Canadian  tax  and 
estate  laws,  it  combines  in  one  book  all 
information  connected  with  one's  fi- 
nancial affairs,  investments,  purchase 
and  sale  of  securities,  real  estate  and 
other  property,  and  applicable  income 
and  expenses. 

This  book  has  many  uses.  For  ex- 
ample, in  the  event  of  loss  through 
fire,  theft,  or  other  casualty,  the  prep- 
aration of  a  proof  of  claim  can  be  sim- 
plified by  reason  of  the  inventory  and 
insurance  records  provided  in  Myfar's 
personal  property  inventory  and  insur- 
ance section. 

Further  information  may  be  obtained 
from  Day  Timers  of  Canada  Limited, 
109  Vanderhoof  Avenue,  Toronto, 
Ontario. 

Kynol  Flame  Resistant  Fiber 

Kynol  flame  resistant  fiber,  manufac- 
tured by  The  Carborundum  Company, 
is  now  available  in  13  different  fabric 
weaves  and  weights,  including  twill, 
herringbone,  and  basket  weaves. 

Kynol  phenolic  fiber,  orange-gold 
in  color,  is  an  organic  whole  fiber  that 
retains  its  identity  when  exposed  to  fire 
as  it  does  not  melt. 

28     THE  CANADIAN   NURSE 


Present  applications  of  Kynol  fiber 
include  protective  clothing,  gloves, 
face  masks,  and  helmet  liners.  Other 
uses  for  Kynol  fabric  now  under  consid- 
eration include  upholstery  fabrics  for 
hospitals,  hotels,  and  offices  where  fire 
may  be  a  grave  threat. 

For  further  information,  write  to 
the  Carborundum  Company,  Niagara 
Falls,  New  York  14302,  U.S.A. 

Crown  Industrial  Aerosols  Catalog 

This  illustrated  catalog  gives  a  complete 
listing  of  Crown  aerosol  products  — 
lubricants,  paints,  cleaners,  adhesives, 
to  name  a  few.  It  is  available  from 
Crown  Industrial  Products  (Canada) 
Limited,  1616  Charles  Street,  Whitby, 
Ontario. 


Disposable  Face  Mask 

Hal-Genie,  a  new  disposable  face  mask 
for  hospital  and  clinical  use,  has  been 
developed  by  Halbrand,  Inc. 

"Hal-Genie,"  with  a  filtration  pad  of 
non-woven  rayon  fiber  in  the  breathing 
area,  slips  over  the  ears  easily  and  fits 
securely  over  the  mouth  and  nose  area. 
It  has  a  contouring  clip  to  secure  it  over 
the  nose.  "Hal-Genie"  is  lightweight, 
non  irritating,  can  be  washed  for  reuse, 
and  can  be  autoclaved. 

The  product  comes  packaged  in  in- 
dividual protective  poly  bags  and  the 
face  masks  are  packaged  in  dispensing 
boxes. 

Information  on  Halbrand's  full  line 
of  disposable  products  is  available  by 
writing  to  Halbrand,  Inc.,  4413  In- 
dustrial Parkway,  Willoughby,  Ohio, 
44094,  U.S.A. 


Flotation  Pad  Brochure 

A  new  brochure.  The  Extra  Margin  of 
Safety,  shows  how  the  Stryker  Floatation 
Pad  adds  a  new  dimension  to  the  pre- 
vention and  treatment  of  decubitus 
ulcers.  The  cushion  contains  a  chemi- 
cally inert  silicone  gel,  making  it  an 
effective  measure  against  superficial 
tissue  breakdown. 

In  the  brochure,  an  anatomical  chart 
clearly  illustrates  the  usual  locations  of 
pressure  sores,  and  photos  of  sacral, 
throchantric,  and  ischial  sores  are  re- 
minders of  the  pain  and  discomfort 
accompanying  decubitus  ulcers. 

A  thin  latex  cover  over  the  gel  makes 


the  Stryker  Floatation  Pad  a  medium  of 
unrestricted  pressure  equalization  to 
absorb  critical  and  shearing  force  pres- 
sure. The  Pad  may  be  used  in  any  bed 
or  wheelchair  to  protect  pressure  points. 
Stryker  heel  and  knee  cushions  are  also 
available  for  patients  confined  to  bed. 

For  free  copies  of  the  brochure, 
write  to  the  Stryker  Corporation,  420 
Alcott  Street,  Kalamazoo,  Michigan 
49001,  U.S.A. 

Computer    Analyzed     ECGs 

Telemed  Corporation  offers  around- 
the-clock  computer  analysis  of  electro- 
cardiograms through  a  dual  configura- 
tion of  Xerox  Data  Systems  Sigma  5 
computers.  Multiple  telephone  lines 
connect  the  central  computer  facility  to 
remote  coupled  ECG  units  located  in 
hospitals,  diagnostic  and  industrial 
clinics,  medical  centers,  nursing  and 
convalescent  homes,  and  physicians" 
offices. 

The  computer  analyzes  pertinent 
ECG  amplitudes  and  durations,  wave 
forms  from  each  of  the  1 2  leads  of  the 
scalar  electrocardiogram,  rate,  and 
electrical  axis,  producing  an  interpreta- 
tion of  the  status  of  the  electrical  func- 
tion of  the  heart  based  upon  these  para- 
meters. The  analysis  is  then  transmitted 
by  telephone  to  a  teletype  unit  on  the 
subscriber's  premises,  ready  for  assess- 
ment by  the  physician.  The  analysis  is 
returned  within  10  minutes  after  taking 
the  ECG. 

A  12-page  brochure,  describing  this 
service,  is  available  by  writing  the  Tel- 
emed Corporation,  9950  West  Law- 
rence Ave.,  Schiller  Park,  111.  60176. 

B.M.D.  —  A  Real  "Un-Plugger" 

G.H.  Wood  make  a  new  product,  B.M. 
D.,  which  seems  to  be  the  answer  to 
plugging  problems  in  wash  basins, 
sinks,  toilets,  bathtubs,  drains,  and 
any  other  water  runways. 

B.M.D.  does  not  contain  caustic  and 
is  generally  safe  to  use.  Drain  odors 
and  poor  drainage  caused  by  accumu- 
lation of  grease,  organic  soil,  etc.,  can 
usually  be  eliminated  overnight.  The 
bacterial  action  of  B.M.D.  works 
fast  to  dissolve  grease  and  other  wastes. 

Full  details  are  obtainable  from 
G.H.  Wood,  the  "Sanitation  for  the 
Nation"  Company,  Queen  Elizabeth 
Way,  Box  34,  Toronto,  or  from  any 
of  its  50  sales  branches  in  Canada. 

APRIL  1971 


Synthetic  Absorbable  Surgical  Suture 

The  first  synthetic  absorbable  suture, 
Dexon,  has  been  introduced  in  Canada 
by  Davis  &  Geek,  Cyanamid  of  Canada 
Limited. 

Approved  by  the  Food  and  Drug 
Directorate  in  June  1970,  the  Dexon 
polyglycolic  acid  suture  combines  the 
flexibility  of  silk  with  superior  tensile 
strength,  fray  resistance,  and  consistent 
knot  security,  and  causes  little  or  no 
tissue  reaction.  It  is  the  first  absorbable 
suture  ever  made  from  a  laboratory- 
engineered  polymer  especially  designed 
to  meet  the  specific  requirements  of 
surgeons. 

A  special  sterile  package  for  Dexon 
to  save  time  in  preparing  sutures  in  the 
surgery  suite,  was  developed  to  aid 
operating  room  nurses.  Dexon,  ready 
to  use  as  it  emerges  from  an  easily- 
opened,  vacuum-sealed  envelope,  is 
available  in  a  full  range  of  suture  sizes 
needle  combinations  to  fit  most  surgical 
needs. 

Preclinical  investigations  are  present- 
ly being  conducted  to  extend  the  use  of 
Dexon  to  the  specialized  fields  of  car- 
diovascular, neural  and  ophthalmologi- 
cal  surgery. 

Further  information  may  be  obtained 
from  Davis  &  Geek  Products  Depart- 
ment, Cyanamid  of  Canada  Limited, 
P.O.  Box  1039,  Montreal  101,  Quebec. 

Drum-Cartridge  Catheter 

Abbott  Laboratories,  Limited,  has 
announced  the  availability  of  the  Drum- 
Cartridge  Catheter,  a  catheter-through- 
needle  unit.  This  new  catheter  has  been 
designed  especially  for  monitoring 
central  venous  pressure  and  may  be 
used  as  a  companion  to  Abbott's  CVP 


Single  Check  Value 


Manometer.  A  preassembled  cartridge 
contains  28  inches  of  catheter  tubing 
coiled  inside  a  drum. 

Aseptic  extension  of  the  radio-paque 
catheter  is  controlled  by  rotating  the 
drum  —  one  revolution  introduces 
approximately  five  inches  of  tubing 
into  the  patient's  vein.  The  Drum- 
Cartridge  Catheter  can  be  held  in  one 
hand  without  touching  the  sterile  cath- 
eter tubing  and,  after  catheter  place- 
ment, the  drum  cover  pops  off  with 
finger  pressure.  The  remaining  compo- 
nents disassemble  quickly  and  are 
ready  for  connection  to  an  intravenous 
administration  set. 

A  short-bevel,  14-gauge  thinwall 
needle  provides  ease  of  administra- 
tion and  reduces  tissue  and  vein  trauma. 
A  full  length  folding  needle  guard  pro- 
tects the  operator  and  patient  from 
possible  injury  by  folding  open  for 
venipuncture,  and  by  locking  in  place 
along  the  full  length  of  the  needle  after 
venipuncture. 

Further  information  may  be  obtained 
from  Abbott  Laboratories  Limited, 
P.O.  Box  6150,  Montreal,  P.Q. 

Pall  Single  Check  Valve 

The  Biomedical  Division  of  Pall  Cor- 
poration has  developed  a  disposable 
single  check  valve,  a  companion  to  the 
popular  disposable  Pall  dual  check 
valve. 

This  new  check  valve,  a  plastic  dis- 
posable device  with  no  moving  parts, 
insures  unidirectional  flow  of  liquids 
and  gases.  Available  with  tubing  or  luer 
connections,  and  able  to  withstand  80 


APRIL  1971 


psi  pressure,  the  new  Pall  Valve  can  be 
readily  attached  to  plastic  tubing  or  any 
apparatus  with  standard  luer  fittings. 
When  installed  in  each  of  several  branch 
lines  feeding  a  common  trunk,  back- 
flow  of  the  mixture  into  the  branch  line 
is  prevented,  and  cross  or  reverse  con- 
tamination of  products  is  avoided.  It 
may  be  used  as  a  vacuum  breaker  in 
closed  vessels  and  as  a  low  cost  diode 
in  fluidic  circuits. 

For  information  on  the  Pall  Single 
Check  Valve  and  the  complete  bio- 
medical line,  write  to  Biomedical  Pro- 
ducts Division,  Pall  Corporation,  30 
Sea  Cliff  Avenue,  Glen  Cove,  N.Y. 
11542,  U.S.A. 

Dual  Temp  Refrigerators 

Foster  Refrigerator  of  Canada  Ltd. 
recently  released  two  bulletins  illustrat- 
ing "Today"  line  dual  temp  refrigera- 
tors. 

All  these  dual  temps  have  two  separ- 
ate refrigeration  systems,  both  balanced 
Fostermatic.  The  Today  line,  includes 
four  self-contained  and  five  top-mount 
dual  temp  models  ranging  from  18  to 
92  cubic  foot  capacity. 

Of  welded  aluminum,  stainless  steel, 
or  a  combination  aluminum/stainless 
steel,  they  have  either  plate  coil  or 
electric  automatic  defrost  freezer  sec- 
tions. Accessories  include  five  types  of 
tray  slides,  insulated  glass  doors,  dial 
thermometers,  and  high-low  tempera- 
ture alarm  systems. 

Write  Foster  Refrigerator  of  Canada 
Ltd.,  Janelle  Street,  Drummondville, 
Quebec,  for  information.  ■§■ 

THE  CANADIAN   NURSE     29 


in  a  capsule 


Hold  that  smile 

In  the  House  of  Commons  recently, 
MP  Heath  Macquarrie  asked  some 
interesting  questions  about  the  effect 
of  certain  brands  of  toothpaste  on 
tooth  enamel. 

"Mr.  Speaker,"  he  said,  "whether 
we  all  have  clean  hands  and  a  pure 
heart  or  not,  Canadians  do  try  to  clean 
their  teeth  quite  often,  and  when  I 
asked  a  question  the  other  day  about 
abrasive  qualities  in  toothpaste  used 
by  Canadians,  I  was  not  being  facetious 
or  loose-lipped.  It  is  very  important, 
considering  the  dangers  inherent  in 
toothpaste  as  discovered  in  areas  of  the 
United  States,  that  we  in  Canada  know 
exactly  what  is  the  potential  for  injury 


in  the  toothpaste  which  is  used  by  mil- 
lions of  Canadians." 

Mr.  Macquarrie  said  the  findings 
of  three  organizations  in  the  US  —  the 
National  Academy  of  Sciences,  the 
US  food  and  drug  administration,  and 
the  American  Dental  Association  — 
were  quite  disturbing,  as  they  showed 
that  many  well-known  toothpastes  on 
the  market  have  qualities  that  are  in- 
jurious to  the  dental  health  of  their 
users. 

"One  news  item  indicates  there  is 
an  abundance  of  abrasive  material  in 
one  brand  which  is  injurious  to  tooth 
enamel  and,  therefore,  contributes 
to  early  decay,"  Mr.  Macquarrie  said. 
"Another  points  out  that  of  1 1  brands 


30     THE  CANADIAN   NURSE 


which  claim  to  prevent  or  retard  tooth 
decay,  only  two  have  any  right  to  that 
claim  whatsoever,  and  one  is  doubt- 
ful ..  .  " 

The  Honorable  Member  then  pleaded 
■  with  the  minister  of  national  health 
to  give  the  Canadian  people  reassur- 
ance, guidance,  and  suggestion.  "... 
the  mouths  of  Canadians  are  important, 
too,"  Mr.  Macquarrie  said. 

Do  nurses  see  MDs  as  a  good  "catch"? 

To  find  out  what  nurses  really  think 
of  doctors  in  terms  of  possible  mates, 
the  monthly  magazine  Canadian  Doctor 
sent  a  reporter  to  interview  several 
nurses.  The  results,  published  in  the 
January  issue  of  that  magazine,  may 
surprise  many  MDs. 

Most  nurses  interviewed  do  not  be- 
lieve a  physician  is  a  good  catch.  "Marry 
a  doctor?  Good  God,  no!"  said  one. 

Various  reasons  were  given  by  the 
nurses  as  to  why  they  have  a  different 
idea  of  the  MD  than  popular  doctor- 
nurse  paperbacks  would  indicate.  "The 
doctor  isn't  God  to  us  any  more,"  said 
one  nurse.  "We're  better  trained  than 
ever  before  and  I  think  this  is  attracting 
a  more  intelligent  and  independent- 
thinking  type  of  girl.  We're  more  co- 
workers than  subordinates  now,  and 
the  idea  of  the  nurse  kneeling  meekly 
in  obeisance  before  the  doctor  has 
become  ridiculous  ..." 

Most  nurses  interviewed  said  the 
time  a  physician  spends  away  from 
home  would  be  one  of  the  biggest  disad- 
vantages to  marrying  him. 

One  nurse  interviewed  said:  "It's 
more  to  the  doctor's  advantage  to  marry 
a  nurse  than  to  her  advantage.  He  gets 
a  woman  who  is  well  educated,  effi- 
cient, who  can  usually  talk  about  a  wide 
variety  of  subjects,  and  who  under- 
stands the  problems  of  being  a  doctor." 

The  article  reveals  that  there  are  still 
some  nurses  who  would  marry  a  doc- 
tor. One  said:  "I'd  marry  a  doctor 
because  I  think  it's  a  worthwhile  profes- 
sion, but  I'd  give  the  problem  serious 
thought  before  I  rushed  into  it.  As  for 
more  nurses  being  starstruck  by  the 
doctor,  I  think  it's  more  likely  to  be 
the  girl  who  is  not  a  nurse  who  is  eager 
to  rush  to  the  altar  with  the  intern  she 
met  last  Saturday  night." 

The  article  concludes:  "It  is  encour- 
aging to  remember  that  only  a  small 
fraction  of  womankind  is  drawn  to 
nursing."  § 

APRIL  1971 


for  use 
-on  the  ward 
-in  the  OR 


-in  training 


NEOSPORir 

IRRIGATING 

SOLUTION 

Available:  Sterile  Ice.  Ampoules, 
Boxes  of  10  and  100. 

INSTRUCTIONS  FOR  USE 

This  preparation  is  specitically  designed  foi  use  with  S  cc. 
"thiee-way    caiheteis  or  with  other  catheter  systems  p«fmit- 
ling  continuous  irrigation  of  the  uimary  tiitddet. 

1  PREPARE  SOLUTION 

Using  sterile  precautions,  one  (1 )  cc.  of  Noosponn  trtiga- 
ting  Solution  should  be  added  to  S  1,000  cc.  bORIe  of 

sterile  isotonic  saline  solution 

2  INSERT  INOWELUNG  CATHETER 

Catheleiiie  the  palieni  using  full  sterile  ptecaulions.  The 
use  of  an  antibacterial  lubricant  such  as  Lubaspofin*  Urethral 
Antibacterial  Lubricant  is  recornmended  during  Insertion  of 
the  catheter 

INFLATE  RETENTION  BALLOON 

Fill  a  Luei  type  syringe  with  1 0  cc.  of  sleiile  watei  or  saline 
(S  cc.  for  balloon,  the  remamcler  to  compensate  lor  the 
volume  required  by  the  inllalion  channel)    Insert  syringe 
o  valve  of  balloon  lumen,  inject  solution  and  remove 
^  syringe 

IPONNECT  COLLECTION  CONTAINER 

e  outflow  (drainage)  lumen  should  be  asepticatly  con- 
[Cled,  via  a  sienle  disposable  plastic  tube,  to  a  sterile 
jposable  plastic  collection  bag  (bottle). 

\tACH  rinse  SOLUTION 

)  inflow  lumen  of  the  5  cc   "three-way"  catheter  should 
n  be  connected  to  the  bottle  of  diluted  Neosporin 
jalion  Solution  using  sterile  technique. 

f  ADJUST  FLOW-RATE 

It  patients  inflow  rate  of  the  diluted  Neosporin 
Irrigating  Solution  should  be  adjusted  to  a  slow  drip  to 
deliver  about  1,000  cc  every  twenty-lour  hours  (about 
40  cc.  per  hour)  II  the  patient's  urine  output  exceeds  2 
liters  per  day  >i  is  recommended  that  the  inflow  'ale  be 
adjusted  to  deliver  2,000  cc.  of  the  solution  in  a  Iweniy- 
louf  hour  period  This  requires  the  addition  of  an  ampoule 
ol  Neosporin  IrriQatpng  Solution  to  each  of  two  1.000  cc 
bodies  of  sterile  saline  solution. 

•    KEEP  IRRIGATION  CONTINUOUS 

It  IS  important  thai  irrigation  olthe  bladder  be  continuous 
The  rinse  bottle  should  never  be  allowed  to  tun  dry.  or  the 
inflow  dfip  interrupted  for  more  than  a  few  minutes  The 
outflow  tube  should  always  be  inserted  into  a  sterile 


#    Convenient  product  idenlilying  labels  lor  use  on  bottles 

of  diluted  Neosporin  Irrigating  Solution  are  available  in  each 
ampoule  packing  or  from  your  'B.  W   &  Co.'  Hepresonlalive. 


1 

1 
1 

f= 

fe 


Burroughs  Wellcome  &  Co.  (Canada)  Ltd. 


Neosporin'  Irrigating  Solution 


INSTRUCTIONS  FOR  USE 


Designed  especially  for  the  nursing  pro- 
fession, this  Instruction  Sheet  shows 
clearly  and  precisely,  step  by  step,  the 
proper  preparation  of  a  catheter  system 
for  continuous  irrigation  of  the  urinary 
bladder.  The  Sheet  Is  punched  3  holes  to 
fit  any  standard  binder  or  can  be  affixed 
on  notice  boards,  or  in  stations. 

For  your  copy  (copies)  just  fill  in  the  cou- 
pon (please  print)  noting  your  function  or 
department  within  the  hospital. 


Dept.  S.P.E. 

Burroughs  Wellcome  &  Co.  (Canada)  Ltd. 

P.O.  Box  500,  Lachine,  P.O. 

Gentlemen : 

Please  send  me  1 1  copy  (copies)  of  the  N.I.S.  Instructions  for  Use.  My  department  or  function 


within  the  hospital  is_ 


NAME. 


ADDRESS. 


CITY  OR  TOWN. 


.PROV. 


I""""! 

"Trade  Maik 

APRIL  1971 


Burroughs  Wellcome  &  Co.  (Canada)  Ltd. 

THE  CANADIAN   NURSE 


31 


comfortable/economicai/tiinesaving/retelast 


® 


^■f  Available  in  9 

^9f  different  sizes. 

jf^S  The  original  tubular 

^^'f  elastic  mesh  bandage 

*^'^  §  allergy  free,  indispen 

*  for  hospital  care. 

New  stretch  weave  a 

^  maximum  ventilatioi 

',   .    .             ^  ^^                                   flexibility  for  patient 

/   i    I    ^  \  X  comfort  and  speedy  h 

/            /        \   »k  '      ^  ^'                              Demonstration  upon  r 


OPINION 


Research^  apple  juice^ 

and  daffodils  — 

a  good  combination  . 


The  editors  asked  the  author  to  give 
her  reactions  to  the  conference  on 
research  in  nursing,  held  in  Ottawa 
February  16  to  18,1971. 


The  first  national  conference  on  re- 
search in  nursing  practice  should  be 
heralded  as  a  historical  event  in  Cana- 
dian nursing,  whether  or  not  it  lived 
up  to  the  promise  of  its  title.  That 
judgment  is  the  prerogative  of  the 
individual  registrant. 

The  conference  brought  together, 
with  British  Columbia  apple  juice 
and  daffodils,  nurses  from  a  variety 
of  practice  settings,  nurses  with  many 
affiliations,  including  health  care  agen- 
cies and  institutions,  government,  and 
universities.  The  program  focused 
on  the  exploration  of  problems  —  prob- 
lems centered  around  research  in  pro- 
fessional practice  and  problems  of 
carrying  out  research  in  nursing. 

On  the  final  afternoon,  precious 
time  was  spent  on  the  problem  of  ap- 
proving resolutions  that  attempted 
to  represent  the  consensus  of  a  diverse 
group  that  had  had  little  time  to  explore 
the  basic  issues  underlying  the  resolu- 
tions. 

In  his  speech  that  initiated  the  con- 
ference. Dr.  Norman  Grace  suggested 
that  the  primary  objective  of  research 
is  to  add  to  our  store  of  knowledge. 
He  continued  by  distinguishing  bet- 
ween "s  e  a  r  c  h"  and  "research." 
"Search"  is  concerned  with  looking  up 
existing  information.  At  the  confer- 
ence the  resources  were  people  rather 
than  books,  and  the  three  days  were 
well  used  to  search  for  and  share  exist- 
ing information  on  how  to  proceed  if 
one  wanted  to  "do"  research  in  nurs- 
ing and  to  know  what  or  who  facilitated  ■ 
it. 

As  one  experienced  in  working  with 
nurse  researchers.  Dr.  Robert  Leonard 
pointed  out  that  most  nursing  research 
in  the  past  has  not  included  the  patient, 
confirming  that  the  basic  unit  of  clini- 

APRIL    1971 


Dorothy  J.  Kergin,  R.N.,  Ph.D. 

cal  nursing  research  is  the  nurse  and 
patient.  In  retrospect,  one  wonders 
whether  this  basic  unit  could  have 
received  more  serious  consideration 
during  the  conference.  For  instance, 
what  are  our  ethical  obligations  to  the 
patient  and  his  family  concerning  such 
matters  as  informed  consent? 

Dr.  Faye  Abdellah  provided  the 
conference  with  a  concise  view  of  the 
development  of  research  in  nursing  in 
the  United  States.  She  pointed  to  the 
changing  health  care  systems  of  the 
'70s  and  the  implications  of  these 
changes  for  nursing  research.  It  is 
unfortunate  that  her  expertise  was  not 
utilized  to  discuss  criterion  measures 
in  nursing. 

One  wonders,  too,  if  a  Canadian 
expert  on  methodology  in  nursing  re- 
search could  have  presented  a  scholarly 
paper  on  the  research  process  that 
would  have  equalled  Dr.  Loretta  Heid- 
gerken's  presentation  and  perhaps  been 
practically  related  to  the  "how"  of 
research.  Was  the  planning  committee 
too  modest  to  look  for  someone  among 
its  members?  Perhaps  in  the  future  we 
can  identify  such  an  expert  within  our 
own  boundaries. 

The  program  participants  were  all 
gentle,  supportive,  and  encouraging. 
Some  delegates  would  like  to  have 
heard  a  speaker  who  was  provocative 
and  challenging. 

Aside  from  Dr.  John  F.  McCreary's 
remarks  about  research  needed  in  the 
delivery  of  health  services,  the  impor- 
tance of  interdisciplinary  and  collabo- 
rative research  in  health  care  received 
little  attention.  Is  research  in  nursing 
generally  too  fragile  for  us  to  face  the 
fact  that  no  health  profession,  includ- 
ing nursing,  can  solve  its  problems  in 
isolation?  What  is  the  nature  of  profes- 
sional interdependence  now  and  in  the 
future?  How  can  nursing  capitalize  on 


Dr.  Kergin  is  Director.  School  of  Nurs- 
ing,    McMaster    University,     Hamilton 


the  interest  of  colleagues,  particularly 
physicians,  in  collaborative  studies? 

What  innovative  practices  have  been 
tried  successfully  by  nurses  in  educa- 
tional or  practice  settings?  It  would 
have  been  helpful  to  know  the  out- 
comes of  "search"  or  "research"  pro- 
jects, rather  than  just  project  titles  and 
objectives,  as  listed  in  three  papers 
presented  at  the  conference.  Is  nursing 
research  so  new  that  we  must  wait  for 
another  conference  to  find  out? 

Would  "brain-storming"  in  small 
groups  to  identify  problems  of  nurs- 
ing practice  have  resulted  in  proposed 
methodologies  or  application  of  the 
findings  from  other  studies  to  achieve 
solutions?  Could  innovative  practices 
have  been  discussed  that  might  have 
been  tested  in  small  trials  not  requiring 
the  financial  and  other  resources  that 
characterize  major,  funded  research? 
Will  a  major  outcome  of  the  conference 
be  a  fiood  of  research  grant  applications 
from  nurses  to  federal  and  provincial 
departments  of  health?  If  so,  a  number 
of  nurses  must  anticipate  rejection. 
There  is  a  limit  to  public  funds,  and 
we  are  all  taxpayers. 

Better  still,  can  we  look  for  reports 
in  professional  journals  of  the  creative 
application  in  new  settings  of  research 
findings  from  studies  that  were  listed 
for  the  conference  participants? 

Hindsight  is  a  temperamental  critic. 
The  Canadian  nursing  profession  owes 
its  thanks  to  the  University  of  British 
Columbia,  the  members  of  the  planning 
committee,  and  the  department  of 
national  health  and  welfare  for  focus- 
ing attention  on  the  needs  and  problems 
of  research  in  nursing  and  nursing 
practice,  and  for  providing  a  forum  to 
explore  these  areas. 

As  Verna  Huffman,  principal  nurs- 
ing officer,  office  of  the  deputy  minist- 
er, DNHW,  stated  in  her  opening  re- 
marks, the  conference  represented  the 
attainment  of  a  degree  of  maturity  for 
the  nursing  profession.  It  remams  for 
the  profession  to  provide  evidence  as  to 
the  extent  of  this  maturity.  § 

THE  CANADIAN  NURSE     33 


National  conference 
on  research  in  nursing  practice 


A  capsule  account  of  Canada's  first  national  conference  on  research 
in  nursing  practice,  held  in  Ottawa  February  16  to  18. 


"Our  emphasis  at  this  conference  has 
been  on  nursing  practice  —  and  this  is 
where  the  emphasis  should  remain," 
said  project  director  Dr.  Floris  E.  King, 
associate  professor  and  coordinator  of 
the  graduate  program  at  the  university 
of  British  Columbia's  school  of  nursing. 
34     THE  CANADIAN  NURSE 


"The  conference   was  a   terrific  first 
step  .  .  .  ■" 

This  comment,  made  by  one  of  the 
340  nurses  who  attended  Canada's 
first  national  conference  on  research 
in  nursing  practice,  describes  accurately 
the  general  reaction  to  the  conference. 
It  was,  indeed,  a  terrific  first  step;  in 
fact,  it  could  even  be  described  as  a 
giant  leap  that  may  well  get  nursing 
research  off  the  ground  and  over  some 
of  the  hurdles  that  have  stood  in  its 
way  in  the  past. 

Not  that  all  the  problems  were  solved 
at  this  conference  —  far  from  it.  But 
there  was  a  sense  of  enthusiasm,  an 
eagerness  to  become  involved  in  re- 
search or  at  least  to  learn  more  about 
it.  And  there  was  agreement  that  this 
was  only  the  beginning,  that  many 
other  conferences  on  research  will  be 
held  in  future. 

Further  evidence  of  nurses'  keen 
interest  in  research  to  improve  patient 
care  was  found  in  the  large  number 
of  registrants  (early  press  releases 
stated  registration  was  limited  to  200), 
and  the  diversity  of  the  registrants' 
occupation  and  educational  back- 
ground —  staff  nurses,  nurse  educators, 
supervisors,  directors  of  nursing,  public 
health  and  visiting  nurses,  head  nurses, 
graduate  students  —  all  were  represent- 
ed. 

The  conference,  sponsored  by  the 
University  of  British  Columbia  school 
of  nursing  with  the  support  of  the 
department  of  national  health  and  wel- 
fare, was  designed  to  stimulate  research 
in  nursing  practice.  Its  specific  objec- 
tives, as  outlined  by  the  project  director 
Dr.  Floris  E.  King,  associate  professor 


and  coordinator  of  the  graduate  program 
at  UBC's  school  of  nursing,  were  to 
identify  needs  for  research,  explore 
methodology,  and  improve  the  coordi- 
nation and  the  communication  of  re- 
search nationally. 

Problems  in  research 

Problems  inherent  in  research  were 
presented  by  several  speakers  at  the 
opening  session.  Dr.  Norman  S.  Grace, 
president  of  the  Association  of  Sci- 
entific Engineering  and  Technological 
Community  of  Canada  and  general 
manager  of  the  Dunlop  Research  Cen- 
tre, spoke  about  research  problems  in 
professional  practice.  He  began  by 
defining  his  basic  philosophy  on  re- 
search. 

"I  suggest  that  the  primary  objec- 
tive of  research  is  to  add  to  our  store 
of  knowledge,"  he  said.  "Increasingly, 
people  are  misusing  the  word  'research' 
when  they  really  mean  'search.'  ...  If 
you  go  to  look  up  existing  information 
in  the  library,  you  are  searching,  not 
researching." 

Dr.  Grace  said  the  good  researcher 
not  only  questions  the  unknown,  but 
also  questions  what  appears  to  be 
known.  This  takes  courage,  he  added, 
because  most  people  do  not  like  to 
question  established  concepts.  Crea- 
tive persons  are  needed  for  research, 
he  added,  and  it  is  not  always  easy 
to  recognize  them.  One  recently  pub- 
lished study  concluded  that  creativity, 
based  on  various  arbitrary  standards, 
did  not  correlate  with  intelligence  or 
class  standing.  "By  hiring  from  the  top 
of  the  class,  you  are  not  ensuring  that 
you  are  getting  the  most  creative  grad- 
uates," he  warned  the  audience. 

APRIL  1971 


Keynote  speakers  —  Dr.  Faye  Abdellah,  left,  who  presented  a  paper  on  the  devel- 
opment of  nursing  research,  and  Dr.  Loretta  E.  Heidgerken,  who  discussed  the 
research  process.  Their  papers  will  be  published  in  a  future  issue  of  The  Canadian 
Nurse. 


Creative  people  are  needed  for  research,  said  Dr.  N.  Grace,  center,  and  it  is  diffi- 
cult to  indentify  these  persons.  Dr.   W.  Brehaut,  left,  and  Dr.  B.  Quarrington, 
right,  spoke  about  research  in  other  disciplines. 
APRIL  1971 


Dr.  Grace  spoke  of  the  difficulties 
involved  in  selecting  a  problem  on 
which  to  do  research. 

"While  superficially  there  never 
appears  to  be  a  shortage  of  problems 
on  which  to  do  research,  in  actual 
practice  this  area  is  often  the  most 
difficult:  difficult  to  decide  on  what  is 
really  important,  difficult  to  clarify 
the  heart  of  the  problem,  and  difficult 
to  develop  a  meaningful  attack.  With 
the  best  planning  and  care,  there  are 
strong  elements  of  timing  and  luck. 
If  you  are  too  early,  some  of  the  mate- 
rials, facilities,  methods,  and  the  like, 
may  not  be  available.  If  you  are  too 
late,  then  someone  else  has  preempted 
the  field.  Luck  comes  in  many  ways, 
including  timing  and  importance,"  he 
said. 

"One  has  to  be  lucky,  too,  in  the 
way  in  which  one  develops  research 
personnel,  research  facilities,  and 
problems  or  research  projects.  If  too 
much  emphasis  is  placed  on  acquiring 
new  and  very  expensive  facilities  at 
too  early  a  stage,  there  is  a  temptation 
to  take  on  projects  without  regard  to 
their  importance,  just  to  keep  the  new 
facilities  busy.  The  same  situation  can 
arise  if  you  develop  too  big  a  research 
team  too  early.  There  is  a  tendency  to 
feel  you  must  keep  them  busy,  even  on 
trivia,  while  you  are  hopefully  search- 
ing for  the  right  problem  to  work  on. 
In  these  and  many  other  ways,  it  is 
easy  to  become  a  data  gatherer  rather 
than  a  problem  solver." 

Dr.  Grace's  advice  to  those  inter- 
ested in  research  was  to  concentrate 
on  important  ideas,  reduce  problems 
to  fundamentals,  get  the  best  advice, 

(ConliniucI  on  pane  3S) 


THE  CANADIAN   NURSE 

% 


35 


A. 

...  All  those  In  favor?   Hands  up,  please! 

B. 

.  .  .  almost  everyone  had  a  tape  recorder! 

C. 

Dr.  John  F.  McCreary,  dean  of  the  fac- 
ulty of  medicine  at  the  University  of 
British  Columbia,  spoke  about  research  in 
the  delivery  of  health  services.  He  is  seen 
with  M.  Thibaudeau,  left,  chairman  of 
one  of  the  sessions,  and  Joyce  Nevitt, 
director  of  the  school  of  nursing  at 
Memorial  University,  St.  John's,  New- 
foundland. 

D. 

Money  is  available  from  the  National 
Health  Grant  for  well-designed  projects, 
and  nurses  should  apply  for  these  grants, 
said  panelist  Pamela  E.  Poole,  right. 
Other  panelists  are,  from  left.  Dr.  Amy 
Griffin  and  Rose  Imai. 

E. 

Anna  Gupta,  left,  acting  director  of  the 
University  of  Windsor  school  of  nursing, 
chats  with  Dr.  Faye  Abdellah  and  Dr. 
Beverly  Du  Gas,  nursing  consultant, 
health  manpower  resources,  department 
of  national  health  and  welfare. 
F. 

Sister  Mary  Stella,  director  ot  nursing 
education  at  St.  Joseph's  Hospital,  Ham- 
ilton, and  Dr.  Helen  K.  Mussallem, 
executive  director  of  the  Canadian 
Nurses'  Association.  Dr.  Mussallem  sum- 
marized the  proceedings  on  the  final  day. 

G. 

.  .  .  some  even  worked  during  the  coffee 

break. 


and  look  ahead.  "Remember,"  he  said, 
"research  is  carried  out  to  influence 
the  future." 

Speakers  from  other  disciplines  told 
of  the  problems  their  professions  had 
encountered  in  conducting  research. 
Dr.  Bruce  Quarrington,  professor  of 
psychology  at  York  University,  Toron- 
to, said:  "If  you,  as  nurses,  feel  you 
have  lagged  behind  other  disciplines 
in  the  development  of  your  own  re- 
search resources,  then  I  would  say 
to  you,  as  a  researcher  in  applied  psy- 
chology, that  you  haven't  missed  much 
—  until  recently."  However,  Dr.  Quar- 
rington was  optimistic  about  the  future, 
and  indicated  that  nursing  research 
could  benefit  from  past  mistakes  of 
the  other  health  disciplines. 

Dr.  Willard  Brehaut  of  the  Ontario 
Institute  for  Studies  in  Education  spoke 
harshly  about  past  research  in  educa- 
tion. "...  much  of  the  educational  re- 
search that  has  been  conducted  has 
been  so  inadequate  as  to  be  little  more 
than  a  research  exercise,"  he  said.  "It 
is  no  wonder,  then,  that  it  has  been 
disregarded;  indeed,  it  is  probably 
fortunate  for  all  of  us  that  it  was  dis- 
regarded." 

Dr.  Brehaut  said  that  despite  the 
large  amount  of  research  that  has  been 
done  on  the  teaching-learning  process, 
little  is  known  about  what  goes  on 
between  teacher  and  child  in  the  class- 
room. "Because  man  is  a  poor  subject 
for  science,  do  not  be  surprised  or 
discouraged  if,  after  much  research 
in  nursing,  you  find  that  the  nurse- 
patient  relationship  is  among  the  last 
aspects  of  nursing  to  yield  its  secrets," 
he  said. 

38     THE  CANADIAN   NURSE 


Basing  his  comments  on  the  failures 
and  successes  in  educational  research. 
Dr.  Brehaut  gave  this  advice  to  nurses: 

•  Research  sould  be  seen  as  an  en- 
terprise in  which  the  practitioner  — 
in  this  instance,  the  staff  nurse  —  has 
an  important  part  to  play  from  begin- 
ning to  end,  from  the  initiation  of  the 
research  to  the  implementation  of  the 
results. 

•  If  research  is  to  be  done,  both  time 
and  money  must  be  made  available  — 
and  the  prime  requisite  is  time,  time 
away  from  other  duties. 

•  Nurses  must  focus  on  the  patient 
as  the  chief  beneficiary  of  their  labors, 
lest  they  lose  sight  of  the  primary  objec- 
tives of  their  research. 

•  Research  is  a  service  to  the  nurse, 
an  important  service,  but  no  substitute 
for  the  basic  activity  of  nursing. 

•  There  is  a  need  to  provide  a  sound 
theoretical  base  for  the  research  con- 
ducted. If  this  base  is  lacking,  the 
studies  undertaken  will  tend  to  be 
fragmented  bits  and  pieces  of  research 
that  add  little  or  nothing  to  the  sum 
total  of  professional  knowledge.  Even- 
tually this  will  lead  to  the  rejection  by 
practitioners  of  the  important  contribu- 
tion that  research  can  make  to  the  nurs- 
ing profession. 

Dr.  Robert  Leonard,  a  well-known 
American  sociologist  and  presently 
visiting  professor,  faculty  of  nursing, 
the  University  of  Western  Ontario, 
gave  his  views  on  clinical  research. 
Pointing  out  that  most  nursing  research 
has  not  included  patients,  he  said  there 
seems  to  be  more  concern  about  the 
practitioner  than  about  the  patient. 
As  examples  of  this  non-clinical   re- 


search, he  listed. studies  that  involved 
staffing,  manpower,  nursing  activities, 
and  nursing  attitudes.  "In  all  these  non- 
clinical kinds  of  research,  the  con- 
nection to  patient  care  remains  hypo- 
thetical," he  said,  "because  the  patient 
is  not  included." 

How  does  one  go  about  doing  clin- 
ical research?  "First,  by  clinical  ex- 
perience, by  nursing  patients,"  Dr. 
Leonard  said.  "Through  clinical  ex- 
perience the  nurse  identifies  prob- 
lems of  patient  care.  She  records  this 
experience  to  document  the  existence 
of  the  problem.  Then  she  compares 
notes  with  other  clinicians.  She  tries 
out  different  possible  solutions  to  the 
problem.  When  a  solution  has  been 
developed,  then  a  principle  of  practice 
has  emerged  or  a  familiar  principle  has 
found  a  new  application  ....  This  is 
the  point  where  systematic,  objectified 
research  methods  are  applied,"  he 
said. 

After  citing  several  clinical  studies 
that  have  been  carried  out.  Dr.  Leonard 
concluded  by  saying  that  studies  do  not 
get  repeated  as  much  as  they  should, 
that  they  tend  to  remain  isolated  ex- 
amples of  what  can  be  done.  "Con- 
sequently," he  said,  "we  do  not  yet 
see  examples  of  clinical  nursing  re- 
search that  have  compelled  some  widely 
adopted  improvement  in  patient  care." 

Research  activities  in  Canada 

On  the  second  day  of  the  confer- 
ence, delegates  were  given  a  bird's- 
eye  view  of  research  activities  in  nurs- 
ing in  Canada.  Pamela  E.  Poole,  nurs- 
ing consultant,  hospital  services  study 
unit,   department   of   national    health 

APRIL  1971 


Panelists  on  the, final  day  of  the  confer- 
ence discussed  the  climate  needed  for 
research,  communication,  the  project 
design,  and  other  topics.  Photo  at  far 
left  sliows  Dr.  Moyra  Allen,  associate 
professor.  School  For  Graduate  Nurses, 
McGill  University;  Jean-Yves  Rivard, 
professor  of  the  department  of  health 
administration.  University  of  Montreal; 
and  Dr.  Josephine  Flaherty,  assistant 
professor,  department  of  adult  edu- 
cation, Ontario  Institute  for  Studies 
in  Education.  Photo  at  left  shows 
M.  Geneva  Purcell,  director  of  nursing. 
University  of  Alberta  Hospital;  Kay  G. 
DeMarsh,  assistant  executive  director 
of  the  Winnipeg  General  Hospital  and 
first  vice-president  of  CNA;  and  Dr. 
Margaret  Cahoon,  professor  and  chair- 
man of  research.  University  of  Toronto 
School  of  Nursing. 


and  welfare,  gave  an  overview  of  re- 
search that  has  been  sponsored  or 
conducted  by  governments  and  service 
agencies;  Rose  Imai,  research  officer, 
Canadian  Nurses'  Association,  spoke 
about  the  role  of  professional  associa- 
tions in  nursing  research  in  Canada; 
and  Dr.  Amy  Griffin,  assistant  dean 
(academic)  and  coordinator  of  graduate 
programs  at  the  University  of  Western 
Ontario,  reported  on  research  com- 
pleted at  Canadian  university  schools 
of  nursing  within  the  past  10  years,  and 
projects  currently  being  conducted. 

Dr.  Griffin  based  her  paper  on  the 
results  of  a  questionnaire  she  sent  in 
December  1970  to  the  22  university 
schools  of  nursing.  Twenty  of  the 
schools  responded.  The  bulk  of  the 
research  reported  came  from  those 
schools  having  graduate  programs,  she 
said.  Research  completed  by  faculty 
totalled  20  projects,  as  contrasted  with 
a  total  of  1 12  completed  by  graduate 
students;  on  the  other  hand,  faculty 
research  in  progress  totals  36,  as  con- 
trasted with  25  in  progress  by  graduate 
students.  Most  of  the  projects  have 
been  confined  to  nursing  research 
alone.  Dr.  Griffin  said,  with  fewer 
projects  being  of  an  interdisciplinary 
nature.  However,  there  has  been  a  surge 
of  interdisciplinary  projects  recently, 
she  added,  particularly  in  the  area  of 
delivery  of  health  service. 

The  response  to  Dr.  Griffin's  ques- 
tionnaire revealed  a  dearth  of  publica- 
tion of  nursing  research.  Only  one 
graduate  student's  thesis  had  been 
published,  and  faculty  have  done  "a 
little  better."  The  picture  is  not  as 
gloomy  as  might  first  appear.  Dr.  Grif- 
APRIL  1971 


Resolutions  Approved 

The  following  resolutions  were  approved  by  the  delegates  on  the  final  day  of 
the  conference  on  research  in  nursing  practice. 

D  Resolved  that  this  conference  support  the  establishment  of  a  National  Coun- 
cil of  Health  and  that  this  Council  include  representation  from  the  nursing 
profession. 

D  Resolved  that  research  conferences  and  forums  both  at  national  and  regional 
levels  be  held  on  a  regular  basis  in  order  that  continued  ettort  be  made  to 
encourage  research  in  nursing  practice,  to  aid  in  the  stimulation  of  ideas 
and  dissemination  of  information  pertaining  to  research  in  nursing  practice, 
and  to  avoid  duplication. 

n  Resolved  that  presentations  on  research  developments  be  included  in  pro- 
grams of  national  and  provincial  nursing  association  meetings. 

D  Resolved  that  this  conference  suDOort  the  establishment  of  a  national  in- 
formation retrieval  centre  for  the  overall  development  of  the  health  sciences. 

D  Resolved  that  guidelines  be  developed  for  nursing  research  ethics. 

D  Resolved  that  research  courses  be  available  as  part  of  continuing  education 
programs  for  nurses. 

D  Resolved  that  employers  of  nurses  be  encouraged  to  establish  sabbatical 
leave  pwlicies  to  facilitate  advanced  study  and  research  projects. 

D  Resolved  that  university  schools  of  nursing  engage  in  systematic  programs 
to  develop  research  skills  of  faculty. 

D     Whereas  funds  for  research  training  grants  and  fellowships  and  nursing 
studies  are  available  through  the  National  Health  Grants,  and 
Whereas  these  funds  to  date  have  not  been  fully  utilized  by  nurses. 
Be  it  resolved  that  health  care  agencies,  educational  institutions,  individual 
nurses,  and  nursing  associations  increase  efforts  to  submit  applications. 

n  Resolved  that  the  planning  committee  of  this  conference  meet  in  order  to 
summarize  and  evaluate  the  Conference. 

D  Resolved  that  multidisciplinary  research  in  the  provision  and  evaluation  of 
health  care  be  increased. 

D  Resolved  that  the  Canadian  Nurses'  Association  begin  publication  of  mono- 
graphs of  research  studies  and  documents,  similar  to  those  published  by  the 
National  League  for  Nursing  as  League  Exchanges. 


fin  said,  as  copies  of  theses  are  usually 
placed  in  the  libraries  of  universities, 
and  are  available  on  inter-library  loan 
and  from  the  Canadian  Nurses'  Associa- 
tion. 

Concluding  her  paper,  Dr.  Griffin 
said  a  small  beginning  has  been  made 
and  that  there  is  a  serious  intent  to  push 
forward.  "  Whether  it  is  pxissible  to  do 
so  is  contingent  on  two  major  factors: 
provision  of  better  initial  and  ongoing 
preparation  in  research  for  faculty, 
and  sufficient  release  of  faculty  time 
to  engage  in  research." 

General  discussion 

Many  relevant  issues  and  questions 
were  raised  throughout  the  conference 
by  both  the  panelists  and  the  audience. 
Here  are  a  few  questions  and  answers, 
followed  by  several  interesting  com- 
ments: 

Q.  Can  we  get  help  to  design  a  research 
project? 

A.  Consultation  services  are  available 
from  the  department  of  national  health 
and  welfare  to  assist  in  the  design 


of  a  research  project,  to  assist  on  a 
continuing  basis  if  desired,  and  to 
help  analyze  the  data.  Also,  some 
university  faculties  provide  help. 

Q.  How  can  we  get  information  about 
research  studies  being  carried  out 
in  various  institutions? 

/I.  The  health  grants  directorate  of  the 
department  of  national  health  and 
welfare  publishes  annually  a  list  of 
projects  funded  by  the  federal  govern- 
ment. Also,  at  least  one  provincial 
nursing  association  (RNAO)  plans 
to  make  a  survey  of  research  being 
conducted  in  the  province. 

Q.  What  is  the  first  step  in  setting  up  a 
research  project? 

A.  Identify  and  define  your  objectives. 
All  too  often  a  researcher  gathers 
statistics  and  data  first,  without  defin- 
ing his  objectives.  There  is  no  logic 
to  this. 

Comment:  Only  a  small  percentage  of 

those  in  any  discipline  will  go  into 

research,  and  we  should  try  to  identify 

THE  CAi^DIAN  NURSE     39 


those  who  can  learn  research  meth- 
ods. However,  every  nurse  has  a  role 
that  has  research  implications. 

Comment:  We  have  to  create  a  climate 
in  which  research  can  be  done.  In 
a  profession  where  there  are  so  many 
sacred  cows,  you  have  to  know  which 
cow  you're  upsetting  so  as  not  to  cut 
off  the  supply  of  milk. 

Comment:  A  dichotomy  exists  between 
those  in  universities  and  those  in 
service  agencies.  As  long  as  this 
dichotomy  exists,  we  can  in  no  way 
do  good  research. 

Comment:  Researchers  must  involve 
practitioners  of  nursing,  otherwise 
the  research  will  be  scuttled. 

Comment:  We  need  a  nursing  research 
journal  in  Canada. 

Comment:  The  profession  is  ready  for 
the  full-time  nurse  researcher  who 
could  work  with  a  research  team  of 
nurses. 

Emphasis  should  remain  on  practice 

The  success  of  this  first  national 
conference  on  research  in  nursing 
practice  was  obviously  gratifying  to 
those  on  the  planning  committee  and 
especially  to  project  director  Dr.  Floris 
E.  King.  We  asked  Dr.  King  to  give  us 
her  reaction. 

"There  have  been  feelings  of  extreme 
optimism  expressed  throughout  the 
conference,"  she  said,  "and  a  feeling 
that  this  is  a  new  era,  that  it  is  the  start 
of  something  big.  There's  a  sense  of  new 
freedom  as  well,  freedom  to  grow,  to 
demonstrate  things,  to  try  things.  And 
this  is  the  crucial  factor  that  we  really 
need  in  the  nursing  profession  today 

—  this  spirit  of  development. 
"Many  things  can  happen  as  a  re- 
sult of  this  conference  —  what  they 
will  be,  I  really  don't  know.  But  I  can 
see  that  more  research  conferences  will 
be  held  ....  Our  emphasis  at  this  con- 
ference has  been  on  nursing  practice 

—  and  this  is  where  the  emphasis  should 
remain  .  .  .  .  "  ^ 


U 


WHAT  DID  NURSES 
THINK  OF  THE  CONFERENCE? 

—  here  are  a  few  comments 


33 


It's  about  time  we  had  a  conference  on  the  subject 

Nurse  Educator. 


"A  fantastic  conference! 
of  nursing  research  .  .  .  ." 

"An  excellent,  well-organized  conference.  It  has  been  part  of  my  professional 
enrichment.   A  follow-up  conference  should   be  held  in  a  year  or  two." 

Consultant. 

"\  really  enjoyed  this  conference,  and  hope  there  will  be  future  ones  on 
research  held  on  a  regional  as  well  as  national  basis.  At  the  next  conference 
I'd  like  to  see  someone  take  a  piece  of  research  and  dissect  it,  showing  how  it 
can  be  applied  in  the  nursing  service  areas 'back  home.'  "  Director  of  Nursing. 

"For  me,  the  highlight  of  this  conference  was  the  chance  to  see  and  hear 
many  of  the  well-known  leaders  in  nursing.  I  found  the  conference  very 
helpful,  as  we  are  presently  involved  in  a  project  to  establish  quality  patient 
care  in  our  hospital.  A  pre-conference  session  would  have  been  of  value,  as 
persons  of  various  levels  of  educational  preparation  were  represented  here." 

Assistant  Coordinator  of  /[Medical  Nursing. 

"Although  I  am  not  practicing  my  profession  at  present,  I  could  not  pass  up 
the  opportunity  to  attend  this  great  event.  I  really  feel  stimulated  by  this 
conference,  and  it  has  made  me  think  I  should  return  to  university  and 
learn  more  about  research  and  methodology." 

Homemal<er  and  Former  Nurse  Educator. 

"An  excellent  conference.  It  has  given  me  a  chance  to  meet  other  nurses  in 
Canada  who  are  interested  in  research,  find  out  what  they  are  doing,  and 
share  ideas  with  them.  Also,  several  of  the  studies  mentioned  by  the  panelists 
were  of  great  interest  to  me  as  I  had  not  heard  of  them  before.  I  plan  to 
read  these  studies  and  fxjssibly  make  use  of  their  findings." 

Director  of  Nursing. 

"I  was  very  disappointed.  There  was  too  much  presentation  of  information 
that  could  have  been  obtained  in  other  ways.  Everyone  got  the  same  'pack- 
age.'whether  they  needed  it  or  not.  There  should  have  been  two  groups  set 
up  for  the  discussion  period  —  one  group  composed  of  those  engaged  in 
research,  the  other  composed  of  those  interested  in  research,  but  who  have 
had  no  preparation  in  this  area.  Personally,  I  felt  uninvolved  for  three 
days."  Nurse  Educator. 

"A  very  stimulating  conference.  I  had  a  minimal  amount  of  training  in 
research  in  my  university  program  and  realize  now  that  I  have  much  to 
learn.  I  liked  the  emphasis  put  on  clinical  practice.  We  need  to  get  back  to  the 
clinical  setting,  look  at  some  of  the  problems  there,  and  then  think  of  what 
research  needs  to  be  done.  At  the  next  workshop  or  conference  on  research, 
I'd  like  to  have  more  time  for  group  discussion."  Nurse  Educator. 

"A  very  informative  conference,  but  I  don't  see  where  I  fit  in  to  research. 
One  thing  I  got  from  it  is  that  I  need  to  return  to  university  and  learn  more 
about  research  methodology.  In  a  way  I  feel  rather  frustrated  because  I 
realize  there  is  so  much  to  know  and  do.  We  need  future  conferences  to 
show  us  how  we  can  participate."  Director  of  Nursing. 

'This  conference  has'  opened  many  doors  to  me.  The  most  exciting  thing  has 
been  to  talk  to  others  and  find  out  what  they  are  doing  in  the  area  of 
research."  Nursing  Supervisor. 

"I  felt  that  the  conference  was  primarily  geared  to  the  faculty  of  universities, 
rather  than  to  hospital  staff.  Little  was  said  about  studying  problems  on  a 
nursing  unit  and  how  staff  nurses,  head  nurses,  and  clinical  instructors  could 
do  research.  I  found  parts  of  the  conference  stimulating,  but  did  not  under- 
stand all  that  panelists  and  speakers  were  saying."  i-lead  Nurse. 

"This  conference  is  a  terrific  first  step,  and  I'd  like  to  see  it  followed  up 
with  another  that  goes  a  step  beyond  this.  We  should  share  the  research  we're 
doing  with  others.  I'm  taking  part  in  a  workshop  in  my  community  next 
month,  and  plan  to  use  some  of  the  information  I've  obtained  here." 

Director  of  Nursing  Education. 


Management  of  Parkinson's 
disease  with  L-dopa  therapy 


The  effectiveness  of  L-dopa  against  the  symptoms  of  Parkinson's 
disease  has  been  confirmed  by  numerous  clinical  trials  involving 
several  hundred  patients. 


Eunice  Tyler 

James  Parkinson  (1755-1824),  a  gen- 
eral practitioner  in  London,  was  a  man 
of  many  talents.  He  not  only  made 
major  scientific  contributions  to  geol- 
ogy and  paleontology,  but  was  a  prom- 
inent political  reformer  as  well.  Par- 
kinson wrote  on  a  variety  of  medical 
subjects,  the  best  known  being  the  syn- 
drome that  now  bears  his  name.  His 
graphic  description  established  paral- 
ysis agitans  as  a  recognizable  entity 
in  1817.  ] 

Additional  clinical  features  have 
since  been  described,  including  a  dis- 
tinction between  the  rigidity  and  the 
akinesia  that  occur  in  the  syndrome. 
As  Parkinson  had  no  autopsy  material 
to  study,  he  erroneously  predicted 
that  the  lesions  of  paralysis  agitans 
would  be  found  in  the  cervical  spinal 
cord.  Later,  pathological  studies  of 
idiopathic  parkinsonism  showed  char- 
acteristic abnormalities  in  the  brain. 
In  some  cases  there  is  an  initiating 
cause,  such  as  encephalitis  lethargica, 
but  for  most,  the  etiology  remains 
unknown. 

Mrs.  Tyler,  a  graduate  of  Bristol  Ho- 
meopathic Hospital,  Bristol,  England,  is 
presently  Head  Nurse  of  Neurology, 
Toronto  General  Hospital.  Toronto,  On- 
tario. She  gave  this  speech  in  Toronto  at 
the  June  1970  meeting  of  the  Canadian 
Association  of  Neurological  and  Neuro- 
surgical Nurses. 


APRIL  1971 


Parkinson's  disease  is  a  chronic 
brain  condition  characterized  by  ri- 
gidity, slowness  of  movement,  tremor, 
a  mask-like  face,  shuffling  gait,  and 
emotional  depression.  Patients  com- 
plain of  weakness  of  their  muscles.  We 
have  seen  the  distressing  sight  of  the 
patient  who  cannot  turn  in  bed,  get 
out  of  a  chair,  walk  without  shuffling, 
tie  his  own  shoes,  eat  without  spilling, 
and  who  becomes  resigned  to  a  life  of 
invalidism. 

The  disease  is  more  prevalent  than 
most  people  realize.  In  Ontario,  for 
example,  there  are  an  estimated  40,000 
victims,  including  10,000  in  Metro 
Toronto. 

Medical  management 

James  Parkinson's  skeptical  attitude 
toward  the  medicinal  treatment  of  the 
disease  could  also  apply  to  the  anti- 
cholinergic compounds  —  of  limited 
value  —  which  became  the  mainstay 
of  medical  management.  Current  re- 
search, however,  gives  hope  of  pro- 
viding more  effective  drug  therapy. 

One  successful  approach  has  been 
the  treatment  of  parkinsonism  by 
stereotaxic  surgery.  In  many  cases, 
stereoencephalotomy  has  resulted  in 
stricking  amelioration  of  tremor  and 
rigidity.  2  This  technique  has  prompted 
an  interest  in  the  pathophysiology  of 
the  basal  ganglia,  and,  with  more 
knowledge  of  the  biochemistry  of  the 
THE  CA^NADIAN   NURSE     41 


basal  ganglia,  is  bringing  a  better  under- 
standing of  the  disorder. 

Doctor  Oleh  Hornykiewicz,  formerly 
of  Vienna  and  now  at  the  Clarke  Insti- 
tute of  Psychiatry  in  Toronto,  discov- 
ered that  the  brain  of  the  parkinsonian 
patient  was  deficient  in  a  chemical 
called  dopamine.  3|  A  similar  observa- 
tion was  made  at  the  same  time  by  a 
group  of  McGill  University  scientists, 
headed  by  biochemist  T.  L.  Sourkes.  * 

Unfortunately,  the  deficiency  could 
not  be  made  up  by  the  direct  use  of 
dopamine,  because  the  chemical  would 
not  pass  directly  from  the  blood  to  the 
brain.  This  problem  was  partially 
overcome  with  the  discovery  of  L-dopa 
by  Dr.  George  Cotzias  of  the  Brook- 
haven  National  Laboratory  in  Long 
Island,  New  York.  ^  The  solution  was 
only  partial,  because  the  blood-brain 
barrier  was  still  largely  impenetrable 
and  large  quantities  of  L-dopa  had  to 
be  used.  This  was  expensive  and  pro- 
duced intense  side  effects. 

The  discovery  of  a  new  drug,  known 
as  RO4-4602,  by  Dr.  Hornykiewicz, 
is  a  significant  advance  in  L-dopa  ther- 
apy. 6  If  taken  with  L-dopa,  it  allows 
more  of  the  L-dopa  to  get  through  to 
the  brain,  and  therefore  the  patient  can 
get  by  on  smaller  quantities  of  L-dopa. 
Dr.  Andre  Barbeau,  a  pioneer  in  the 
drug  treatment  of  Parkinson's  disease, 
has  been  carrying  on  clinical  tests  for 
some  years  at  Montreal's  Clinical 
Research  Institute,  and  he  is  opti- 
mistic about  developments  in  the  treat- 
ment of  Parkinson's  disease.  ^ 

Advantages  and  disadvantages. 

The  effectiveness  of  L-dopa  against 
the  symptoms  of  Parkinson's  disease 
has  now  been  confirmed  by  numerous 
clinical  trials  involving  several  hundred 
patients.  All  investigators  have  reported 
favorable  results  in  most  patients.  ^ 
Some  patients  have  been  on  the  drug 
for  18  months  or  more  with  continuing 
relief  of  bradykinesia,  rigidity,  and  the 
rnental  depression  associated  with  the 
disease.  Many  patients  have  reported 
an  increase  in  sexual  desire  and  potency, 
and  enhancement  of  smell  and  taste. 

The  most  serious  of  the  reported 
adverse  effects  are  orthostatic  hypo- 
tension and  cardiac  arrhythmias.  Treat- 
ment is  started  with  small  doses  (100 
to  250  mg.),  which  are  then  gradually 
increased  over  a  period  of  many  weeks. 
Careful  supervision  of  the  patient  with 
cutbacks  in  dosage  as  indicated  usually 
prevent  serious  hypotensive  episodes. 
Orthostatic  hypotension  tends  to  di- 
minish with  continued  treatment. 
42     THE  CANADIAN   NURSE 


Cerebrovascular  insufficiency  and 
stroke  have  also  been  reported,  but 
evaluation  of  the  significance  of  adverse 
cardiovascular  and  cerebrovascular 
disorders  occurring  in  patients  on  L- 
dopa  is  difficult,  as  the  drug  is  usu- 
ally given  to  patients  in  the  age  groups 
in  which  such  disorders  are  relatively 
common. 

Other  adverse  effects  of  L-dopa 
include  anorexia,  nausea,  vomiting, 
and  dyskinesia.  None  of  these  side 
effects  is  serious,  and  can  be  quickly 
reversed  or  controlled  by  reduction 
of  the  dose.  Nausea  and  vomiting  can 
often  be  prevented  if  the  patient  takes 
the  medication  with  food  and  in  more 
frequent,  but  smaller,  doses.  In  fact, 
the  most  common  adverse  effects  of 
L-dopa  can  be  minimized  by  slow  and 
gradual  increase  of  daily  dosage  over 
a  period  of  weeks  of  months. 

Dyskinesia  is  observed  only  in  pa- 
tients who  receive  large  doses  close  to 
the  maximum  therapeutic  dose.  This 
adverse  effect  consists  mainly  of  chorei- 
form movements  of  the  face,  tongue, 
neck,  and  extremities.  Slight  increase 
in  blood  urea  and  uric  acid  has  been 
observed  in  some  patients,  and  delirium 
and  hallucinations  occur  occasionally. 
These  effects  are  reversed  by  reducing 
the  dose  or  withdrawing  the  drug.  No 
persistent  hematological  disorders 
have  been  encountered.  Positive 
Coombs'  tests  in  some  patients  have 
been  noted. 

One  of  the  physicians  who  pioneered 
the  successful  use  of  L-dopa,  Dr.  Cot- 
zias, states,  "The  optimal  daily  dose  .  .  . 
has  averaged  5 .8  Gm.  per  day  (maximum 
8  Gm.  per  day)  and  maximal  improve- 
ment has  rarely  been  achieved  in  less 
than  six  weeks.  In  some  cases  we  and 
others  have  noted  further  improvement 
several  weeks  after  a  steady  dose  was 
established  ....  It  is  likely  that  the 
vomiting,  anorexia,  and  orthostatic 
hypotension  encountered  by  others 
starting  the  regimen  was  due  to  a  rapid 
rate  of  increasing  the  drug  ....  Dis- 
tribution of  the  daily  dose  among  at 
least  six  or  seven  portions  appeared  es- 
sential." 9 


Summary 

L-dopa  has  been  studied  experi- 
mentally in  several  hundred  patients  for 
about  two  years  and  has  proved  to  be 
an  effective  remedy  for  symptoms  of 
Parkinson's  disease.  With  proper  cau- 
tion in  dosage,  serious  or  irreversible 
adverse  effects  have  been  observed  in 
relatively  few  patients. 


As  with  all  new  drugs,  it  is  probable 
that  longer  use  will  disclose  new  ad- 
verse effects.  But  most  patients  with 
disabling  or  advancing  parkinsonism 
would  be  willing  to  take  that  risk  as 
an  alternative  to  hopeless  invalidism 
and  despair. 

References. 

l.Wilkins.  R.  H.  and  Brody.  1.  Parkin- 
son's syndrome.  Arch.  Neurol.  (Chi- 
cago) 20:  440-1,  Apr.  1969. 

2.  Cooper,  I.S.  Parkinsonism:  Its  Medi- 
cal and  Surgical  Therapy.  Springfield, 
III.,  Charles  C.Thomas,  1961. 

3.  Ehringer,  H.  and  Hornykiewicz.  O. 
[Distribution  of  noradrealine  and 
dopamine  (3-Hydroxytyramine  in  the 
human  brain  and  their  behaviour  in 
diseases  of  the  extrapyramidal  system  ] 
Klin.  W.uhr.  38:1236-1239.  Dec.  15, 
1960. 

4.  Sourkes,  T.L.  and  Poirier,  L.J.  Neuro- 
chemical bases  of  tremor  and  other 
disorders  of  movement.  Canad.  Med. 
Ass.  J.  94:53-60,  Jan.8.  1966. 

'5.  Cotzias,  G.C.  et  al.  Aromatic  amino 
acids  and  modifications  of  parkinsonism 
New  Eng.  J.  of  Med.  276:374-9,  Feb. 
16,  1967. 

6.  Hornykiewicz,  O.  Dopamine  (3-hy- 
droxytyramine)  and  brain  function. 
Pharmacol.  Rev.  18:925-64,  June  1966. 

7.  Barbeau,  A.  L-Dopa  therapy  on  Par- 
kinson's disease:  a  critical  review  of 
nine  years'  experience.  Canad.  Med. 
Ass.  J.    101:791-800,  Dec.  27.  1969. 

8.  A  second  report  on  levodopa.  Medical 
Letter  on  Drugs  and  Therapeutics,  vol. 
1 1,  no.  18,  issue  278.  Sep.5,  1969. 

9.  Cotzias,  G.C.  et  al.  L-Dopa  in  parkin- 
son's  syndrome.  New  Eng.  J.  Med.  28 1 : 
272,July31,  1969.  ■§■ 


APRIL  1971 


By  Wendy  Stockdale 


The  Cancer  Patient 


As  you  .  .  . 

My  fellow  being  lie  before  me. 

Weak  and  tired 

And  grasp  my  hand  in  pain 

With  eyes  that  plead  - 

"Don't  let  me  die," 

I  think  in  sadness  - 

Ah,  my  brother 

Tis  a  plea  beyond  my  realm 

or  power  to  grant. 

But  from  within  me 

comes  a  voice 

Too  clear  to  doubt  ^^ 

Too  real  to  shun 

That  says  -  my  friend, 

I  cannot  grant  you  life  .  .  . 

I  am  but  your  servant  here; 

But  I  can  gaze 

With  steadfast  faith 

Into  your  eyes 

and  silently  - 

Or  with  words  you  choose 

Can  help  you  find  that  strength  within 

To  fight  your  battle. 

I  cannot  fight  it  for  you. 

Nor  can  I  cause  its  end; 

But  I  can  try  to  ease  some  of  the  pain 

along  the  way. 

This  only  can  I  promise  - 

if,  though  in  pain. 

You  heed  your  soul. 

If  you  build  courage,  strength, 

endurance  - 

To  fight  that  mystic  foe 

Then,  if  you  win  your  life 

You've  won  its  essence,  too 

And  if  you  die  - 

You  die  in  well-earned  honor 

and  in  peace. 


Miss  Stockdale  is  a 

third-year  nursing  student  at  the 

University  of  Alberta  Hospital. 


Myo-electric  control 
—  one  more  aid 
for  the  amputee 

Recently,  myo-electric  control  has  been  applied  to  an  increasing  number  of 
amputees  In  Canada,  and  is  being  encountered  by  clinical  as  well  as  research 
staff.  This  article  explains  the  principles  of  myo-electric  control  and  describes  the 
operation  of  various  control  systems  that  are  of  clinical  significance. 


44     THE  CANADIAN   NURSE 


R.N.  Scott,  P.Eng. 

In  the  past  several  years  the  press  has 
carried  frequent  reports  of  myo-elec- 
tric control  systems,  often  with  a  head- 
line such  as  "artificial  arm  controlled 
by  nerves."  What  is  a  myo-electric 
control  system?  Let  us  start  with  a 
definition:  A  myo-electric  control  sys- 
tem uses  the  electric  signal  from  a 
muscle  to  control  the  flow  of  energy 
from  a  source  (battery)  to  an  actuator 
(motor).  Although  such  a  system  can  be 
used  for  many  purposes,  its  chief  use 
is  to  control  the,  artificial  limbs  of  per- 
sons with  upper-extremity  amputa- 
tions. It  is  this  application  that  is  de- 
scribed in  this  article. 

Historical  perspective 

Myo-electric  control  is  not  new.  The 
first  practical  myo-electrically  control- 
led prosthesis  was  demonstrated  at  th'" 
Exportmesse  in  Hanover  in  1948.^ 
This  excellent  work  by  Reinhold  Reiter, 
of  Munich,  was  not  followed  up,  per- 
haps due  to  the  unfavorable  postwar 
industrial  situation  in  Germany.  It  was 
not  until  1960  that  another  clinical- 
ly useful,  myo-electrically  controlled 
prosthesis  appeared,  this  time  in  Mos- 
cow. Unlike  Reiter's  earlier  system, 
this  development  by  Kobrinski^     at- 

Professor  Scott  is  Executive  Director 
of  the  Bio-Engineering  Institute  and 
Professor  of  Electrical  Engineering, 
University  of  New  Brunswick. 


tracted  great  attention.  Indeed,  it  is 
widely  cited  as  the  first  practical  myo- 
electric control  system. 

Although  considerable  research  ef- 
fort has  been  devoted  to  myo-electric 
control  in  the  U.S.A.,^''^^  England,' 
Denmark  and  Sweden,^  Japan,^  and 
Canada, '°  the  only  commercially- 
available  myo-electrically  controlled 
prostheses  (outside  the  U.S.S.R.)  are 
made  in  Duderstadt,  West  Germany 
(the  Myo-Bock  system)  and  Vienna, 
Austria,  (the  Myomot  system).  Both 
resemble  Kobrinski's  system  in  func- 
tion, with  significant  refinements  in 
design. 

The  myo-electric  signal 

The  origin  of  a  myo-electric  signal 
is  the  depolarization  of  the  cell  mem- 
brane of  individual  muscle  fibers  during 
contraction.  The  electric  currents 
associated  with  this  depolarization  and 
the  subsequent  repolarization  produce 
measurable  potential  differences  in 
tissues  some  distance  away.  It  is  these 
potentials,  rather  than  the  transcellular 
potentials,  which  are  used  in  myo- 
electric control. 

The  smallest  number  of  muscle  fi- 
bers that  can  contract,  under  normal 
circumstances,  is  the  group  that  has 
its  innervation  from  a  single  nerve 
axon.  This  functional  unit  (fibers, 
axon,  and  cell  body  of  neuron  in  the 
spinal  cord)  is  called  a  motor  unit. 
Conscious    voluntary    control    of   the 

APRIL  1971 


contraction  of  single  motor  units  in 
skeletal  muscle  is  possible,'^  but  re- 
quires a  high  degree  of  concentration. 
Consequently,  the  electric  potentials 
from  single  motor  units  have  not  been 
used  widely  for  myo-electric  control. 

When  a  large  number  of  motor  units 
are  active,  the  resulting  "gross  myo- 
electric potential"  has  a  waveform 
similar  to  that  shown  in  Figure  1.  If 
this  waveform  is  analyzed,  it  is  found 
that  most  of  the  energy  lies  in  the  fre- 
quency range  of  30  to  300  cycles  per 
second,  and  that  the  peak-to-peak 
amplitude  during  voluntary  contrac- 
tion may  range  from  a  few  microvolts 
to  several  millivolts.  (These  figures 
assume  measurement  with  electrodes 
on  the  skin  surface.) 

Certain  characteristics  of  the  gross 
myo-electric  potential  —  for  insta.ice 
the  "area  under  the  curve"  —  are 
roughly  proportional  to  the  force  ex- 
erted by  the  muscle  for  small  to  mod- 
erate isometric  contraction.  However, 
the  important  point  for  control  use  is 
that  the  "amount"  of  myo-electric  sig- 
nal is  subject  to  conscious  voluntary 
control.  This  is  true  of  muscles  atrophi- 
ed from  disuse,  of  partially  innervated 
muscles,  of  normally-inner\ated  muscle 
remnants  resulting  from  amputation. 

The  electrode  problem 

One  of  the  most  difficult  problems 
in  achieving  a  practical  myo-electric 
control  system  is  to  establish  good 
electrical  contact  between  the  signal 
source  (the  muscle)  and  the  electronic 


control  equipment.  The  skin  is  an  elec- 
trical insulator.  Also,  the  underlying 
tissues  are  conductive  and  permit  sig- 
nals from  many  muscles  to  be  measured 
at  any  one  location. 

Surgically-implanted  telemetry  sys- 
tems may  eventually  overcome  some 
of  these  problems,  and  there  is  a  possi- 
bility that  a  reliable  percutaneous  con- 
ductor may  be  developed.  At  present, 
however,  all  systems  in  clinical  use 
employ  surface  electrodes. 

The  resistance  between  the  surface 
electrode  and  the  highly  conductive 
tissues  under  the  skin  is  "in  series  with" 
the  signal  source.  If  the  input  resistance 
of  the  electronic  system  is  low  compar- 
ed to  this  electrode-to-tissue  resistance, 
serious  reduction  of  signal  occurs.  If 
the  input  resistance  of  the  electronic 
system  is  raised  to  avoid  this  problem, 
the  whole  system  becomes  more  sen- 
sitive to  electrical  interference  from 
the  environment. 

The  high  resistance  of  the  skin  is  a 
property  of  the  epidermis.  Although 
removal  of  this  outer  layer  of  skin  — 
for  example,  by  rubbing  it  with  an  abra- 
sive paste  —  will  solve  the  problem  for 
a  single  measurement,  it  cannot  be  pro- 
posed for  a  chronic  application.  A 
conductive  cream  or  paste,  or  even 
perspiration,  will  lower  the  skin  resis- 
tance greatly,  without  abrasion,  merely 
by  partially  penetrating  the  epidermis. 

Intermittent  contact  or  even  slight 
relative  movement  between  a  rigid 
electrode  and  the  skin  will  produce 
electrical  "noise"  that  may  be  greater 


Myo-electric 
Potential 


I:   Typical  Gross  Myo-electric  Signal 


APRIL  1971 


than  the  myo-electric  signal.  The  best 
electrodes  in  this  resjject  provide  some 
means  of  holding  the  metallic  part  of 
the  electrode  at  a  fixed  distance  from 
the  skin  (typically  2  to  3  mm.).  The 
space  between  is  filled  with  a  conduc- 
tive electrode  paste  that  provides  elec- 
trical contact  and  reduces  skin  resis- 
tance. 

At  any  contact  between  dissimilar 
materials,  including  an  electrode-to- 
tissue  contact,  a  "contact  potential" 
exists.  For  metallic  electrodes  in  con- 
tact with  biological  tissues,  this  poten- 
tial is  typically  several  hundred  milli- 
volts. Fluctuations  in  this  contact  px)- 
tential  constitute  electrical  "noise" 
that  may  exceed  the  myo-electric  sig- 
nal level.  To  achieve  a  stable  contact 
potential,  a  sintered  silver-silver  chlor- 
ide pellet  is  often  used  in  preference 
to  a  pure  metal  in  electrodes  for  bio- 
electric measurement. 

The  problem  of  measuring  potentials 
from  a  number  of  muscles  simulta- 
neously, when  the  signal  from  only 
one  muscle  is  desired,  is  not  solved 
easily.  The  potential  from  a  muscle 
fiber  decreases  very  rapidly  with 
distance  from  the  fiber.  Thus  it  is  im- 
portant that  the  electrode  be  placed 
close  to  the  muscle  whose  activity  is 
to  be  measured. 

If  other  active  muscles  are  relatively 
far  away,  the  interference  signal  from 
them,  referred  to  as  "crosstalk,"  will 
be  small.  Small  electrodes  permit  im- 
proved spatial  selectivity,  but  have  the 
disadvantage  of  increased  electrode- 
to-tissue  resistance.  As  long  as  surface 
electrodes  are  used,  this  selectivity 
problem  will  continue  to  place  serious 
limitations  on  the  selection  of  myo- 
electric control  sites. 

The  control  system 

A  myo-electric  control  system,  in 
its  simplest  form,  controls  the  flow  of 
current  to  an  electric  motor  in  accor- 
dance with  the  "amount"  of  myo-elec- 
tric signal.  In  practice,  at  least  three 
distinct  elements  exist  in  the  system: 
an  amplifier,  a  signal  processor,  and  a 
controller. 

The  amplifier  increases  the  ampli- 
tude of  the  myo-electric  signal  to  a 
convenient  level.  Amplifier  gain,  the 
ratio  of  output  to  input  signal,  may  be 
in  the  order  of  10,000,  and  is  usually 
adjustable  so  that  the  sensitivity  of  the 
system  can  be  matched  to  the  require- 
ments of  the  individual  patient. 

Differential  amplifiers  are  employed 

in  most  myo-electric  control  systems 

because  of  their  ability  to  discriminate 

THE  CANADIAN   NURSE     45 


I  btate  I 
-State  I  (off) — J     II     [• — State  III  (Openingl- 

(Closing) 


6  I 

Max. 
Noise 


J L 


Max.  Vol. 
Contraction 


Myoelectric 
Signal 


2:    "Three-State"  Control 


Motor 
Current 


Myoelectric 
Signal 


Opening 


3:    "Three-State  Variable"  Control 


against  external  electrical  interference 
and  to  permit  the  use  of  a  common 
power  supply  in  multichannel  systems. 
With  a  differential  amplifier,  a  "refe- 
rence" or  "common"  electrode  (some- 
times referred  to  incorrectly  as  a 
"ground"  electrode),  is  used,  together 
with  two  "active"  electrodes  for  each 
channel.  The  electric  potential  differ- 
ence between  the  two  active  electrodes 
is  amplified,  while  any  signal  (such  as 
external  interference)  that  exists  "in 
common"  between  the  active  electrodes 
and  the  reference  electrode  is  not  am- 
plified. 

The  instantaneous  value  of  the  myo- 
electric signal  is  not  useful  for  control 
purposes.  Rather,  some  characteristic 
that  represents  the  "average  activity" 
over  a  time  interval  must  be  used.  The 
selection  of  the  characteristic  that  is 
most  useful  has  been  the  object  of  much 
research,  thus  far  inconclusive.  In  the 
absence  of  any  clear  preference,  the 
choice  has  been  made  on  the  basis  of 
circuit  simplicity,  and  most  control 
systems  use  a  processor  that  approxi- 
mates, crudely,  the  "average  area  under 
the  curve." 

The  design  of  the  processor  involves 
a  difficult  compromise.  An  accurate 
determination  of  the  "amount  of  sig- 
nal," the  average  value  of  the  charac- 
teristic discussed  above,  requires  a 
certain  time,  with  the  accuracy  increas- 
ing as  the  sampling  time  is  increased. 
However,  rapid  response  to  voluntary 
changes  in  the  myo-electric  signal  re 
quires  that  the  processor  recognize 
46     THE  CANADIAN   NURSE 


these  changes  without  significant  time 
delay. 

It  is  customary  to  design  for  time 
delays  of  about  0.2  seconds,  which 
seem  to  be  reasonably  satisfactory  in 
terms  of  system  response,  and  to  accept 
the  resulting  degree  of  smoothing  as  the 
best  that  can  be  obtained.  One  signifi- 
cant technique  for  obtaining  a  smooth- 
er, though  not  more  accurate  output, 
is  described  by  Bottomley.  '•' 

Having  obtained,  at  the  output  of 
the  processor,  an  electric  signal  that 
represents  the  "amount"  of  the  myo- 
electric signal,  it  remains  to  use  this 
signal  to  control  an  actuator,  such  as 
the  motor  in  an  electric  hand.  The 
simplest  control  scheme,  used  in  what 
we  call  a  "two-state  on-off  system," 
requires  a  level  sensor  and  a  switch. 
When  the  processor  output  reaches  a 
preset  level,  the  switch  operates  to 
turn  on  the  motor.  Two  such  systems 
are  used  in  the  U.S.S.R.,  Otto  Bock, 
and  Viennatone  equipment,  one  to 
control  closing  and  one  to  control 
opening  of  an  electric  hand. 

As  long  as  the  myo-electric  signals 
:o  both  systems  are  less  than  the 
switching  level,  the  hand  remains  in 
a  fixed  position  (motor  off)-  Some  form 
of  protective  circuitry  is  used  to  prevent 
activating  both  the  closing  and  open- 
ing systems  simultaneously.  A  major 
disadvantage  of  this  scheme,  and  one 
that  becomes  particularly  critical  with 
high-level  amputees,  is  that  two  con- 
trol muscles  are  required  to  operate  a 
single    function.    For    some    patients 


this  scheme  permits  selection  of  control 
muscles  on  the  basis  of  their  original 
function. 

Another  application  of  the  two- 
state  on-off  system  has  been  useful 
with  young  patients.  Only  one  muscle 
is  used.  The  terminal  device  is  con- 
nected so  that  it  closes  unless  the  myo- 
electric signal  exceeds  a  certain  level, 
in  which  case  the  terminal  device 
opens.  This  results  in  a  normally- 
closed,  voluntarily-opened  mode  of 
operation  and  requires  only  a  single 
control  muscle.  A  limit  switch  is  re- 
quired to  disconnect  the  motor  when 
the  terminal  device  is  fully  closed  to 
prevent  wasting  electrical  energy.  As 
it  does  not  permit  less  than  full  closing 
force,  this  scheme  is  not  recommended 
for  terminal  devices  having  high  pinch 
force. 

A  better  control  scheme,  used  in 
what  we  call  a  "three -state  on-off  sys- 
tem,"i3  uses  only  one  control  muscle 
and  involves  a  controller  that  monitors 
the  processor  output  with  respect  to 
two  preset  levels.  If  the  output  is  less 
than  the  lowest  level,  the  hand  remains 
in  a  fixed  position  (motor  ofO-  If  the 
processor  output  exceeds  the  lower 
level  but  is  less  than  the  upper  level, 
the  hand  closes.  If  the  output  is  greater 
than  the  upper  level,  the  hand  opens. 
A  slight  time  delay  incorporated  into 
the  closing  circuit  permits  the  patient 
to  make  the  transition  from  "off"  to 
"opening"  without  any  closing  action. 

Operation  of  a  three-state  control 
system  and  the  designer's  problem  in 

APRIL  1971 


selecting  optimum  switching  levels 
are  illustrated  in  Figure  2.  In  this 
diagram,  "A"  represents  the  maximum 
expected  inadvertent  myo-electric  sig- 
nal, crosstalk,  and  other  "noise."  Clear- 
ly, the  first  switching  level,  "B",  must 
lie  well  above  "A"  to  avoid  accidental 
operation  of  the  prosthesis.  "D"  rep- 
resents the  maximum  voluntary  myo- 
electric signal  that  the  patient  can  a- 
chieve. 

Clearly,  the  second  switching  level, 
"C",  must  be  well  below  "'D"  to  avoid 
fatigue.  (At  the  University  of  New 
Brunswick  we  prefer  not  to  have  "C" 
higher  than  roughly  1/3  of  "D".)  But 
"C"  must  be  well  above  '"B"  to  make  it 
easy  for  the  patient  to  hold  the  system 
in  State  II.  Any  selection  is  a  compro- 
mise, as  these  are  conflicting  require- 
ments. It  should  be  noted  that  training 
of  the  patient  will  usually  increase  "D" 
and  lower  "A".  Also,  it  will  reduce  the 
fluctuations  in  voluntary  myo-electric 
signal,  making  a  narrower  second 
state  ("B"  to  "C")  acceptable.  Thus 
all  aspects  of  the  compromise  are  re- 
lieved by  training. 

Some  designers  have  experimented 
with  a  "four-state  on-off  control  sys- 
tem." This  differs  from  the  three -state 
in  providing  a  second  "off  state  be- 
tween the  two  active  states.  This  has 
not  generally  proven  to  be  a  signifi- 
cant improvement,  the  greater  tlexi- 
bility  being  obtained  at  the  cost  of 
increased  crowding  of  the  region  "A" 
to  "C". 

Some  powered  prosthetic  compo- 
nents move  so  slowly  (most  electric 
elbows)  or  have  so  little  pinch  force 
(the  Ontario  Crippled  Children's  Centre 
child's  size  electric  hook)  that  on-off 
control  is  adequate.  Others,  such  as 
the  Otto  Bock  Z-6  electric  hand,  devel- 
op their  high  pinch  force  very  slowly, 
so  that  good  control  of  force  is  easily 
achieved  with  on-off  control.  How- 
ever, this  is  not  true  of  all  devices. 
Where  it  is  necessary  to  control  motor 
torque  (and  hence  speed  or  force),  the 
motor  current  is  made  to  vary  as  a 
continuous  function  of  the  "amount" 
of  myo-electric  signal. 

Such  a  system  gives  "proportional 
control"  if  the  motor  current  is  a  linear 
function  of  myo-electric  signal.  Often 
a  non-linear  function  is  better.  The 
U.N.B.  "Three-State  Variable"  con- 
trol system  provides  continuous  con- 
trol of  closing  force  (or  speed)  and  on- 
off  control  of  opening,  as  shown  in 
Figure  3. 

The  major  limitations  of  myo-elec- 
tric cofitrol  (indeed  of  all  powered 
APRIL  1971 


Self-contained,  self-suspended  prosthesis  with  myo-electric 
control  of  an  electric  hand.  Patient  has  congenital  absence  of  left 
forearm.  (Cosmetic  "glove"  has  been  removed  to  show  removable 
battery  pack.)  Hand  is  made  by  Otto  Bock,  Duderstadt,  West 
Germany. 


Prosthesis  partly  disassembled  to  show  electronic  control  unit. 

THE  CANADIAN   NURSE     47 


Illustrative  bimanual  activities  for  which  a  functional  prosthesis  is  essential. 


prosthetics)  at  present  become  evident 
when  simultaneous  control  of  two  or 
more  functions  is  required.  An  ade- 
quate number  of  good  control  sites  is 
rarely  available,  and  the  patient,  de- 
pending almost  entirely  on  visual 
feedback  for  information  as  to  the 
action  of  his  prosthesis,  is  forced  to 
attend  to  one  function  at  a  time  rather 
than  attempt  smoothly  coordinated 
movements. 

We  hope  that  current  research  on 
telemetry  of  myo-electric  signals  from 
deep  muscles,  utilization  of  small  seg- 
ments of  muscles  as  control  sites,  re- 
cognition of  subtle  patterns  of  activity 
in  a  number  of  muscles,  and  particu- 
larly on  providing  supplementary 
feedback  from  the  prosthesis  to  the 
patient,  will  contribute  to  the  solution 
of  these  problems. 

References 

1 .  Reiter,  R.  Eine  neue  Eiektrokunsthand. 
Grenzgehiete  cler  Medizin,  1:4:133-5, 
Sept.  1948. 

2.  Kobrinski,  A.E.,  et  al.  Problems  of 
bioelectric  control:  in  automatic  and 
remote  control.  (Proc.  1st.  IFAC  Int'l. 
Congress,  Moscow,  1960.)  Butter- 
worths,  London,  vol.2,  pp  619-23 
1961. 

48     THE  CANADIAN   NURSE 


4. 


Reswick,  J.B.  Final  report,  biomedi- 
cal research  program  on  cybernetic 
systems  for  the  disabled.  Cleveland, 
Ohio,  Case  Western  Reserve  Univer- 
sity, Engineering  Design  Center, 
EDC  Report  4-70-29,  1970. 
Long,  Chas.  II.  Normal  and  abnormal 
motor  control  in  the  upper  extremi- 
ties. Cleveland.  Ohio,  Case  Western 
Reserve  University,  Ampersind 
Group,  Final  Report  on  SRS  RD- 
2377-M,  1970. 

Childress,  D.S.  Design  of  a  myo- 
electric signal  conditioner.  J.  Audio 
Eng.  Soc.  17:3:286-91,  June  1969. 
Antonelli,  D.J.  and  Waring,  W.  Myo- 
electric control  of  powered  devices. 
Archives  Phys.  Med.  Rehuh.  48  345- 
9,  July  1967. 

Bottomley,  A.H.  Myo-electric  control 
of  powered  prosthesis.  J.  Bone  Ji. 
Surg.  47B:3:4\\-]5  Aug.  1965. 
Herberts,  P.  Myo-electric  signals  in 
control  of  prostheses.  Acta  Ortho- 
paedica  Scandinavica,  Suppl.  no  124 
1969. 

Kato,  I.,  Okazaki,  E.,  and  Nakamura, 
H.  The  electrically  controlled  hand 
prothesis  using  command  disc  and/or 
EMG.  J.  Society  Imtrumeni  and 
Control  Engineers,  6:4:236-41,  Anril 
1967. 


10.  Scott.  R.N.  Myo-electric  control  sys- 
tems, in  Advances  in  Biomedical 
Engineering  and  Medical  Physics. 
S.N.  Levine,  Ed.  New  York,  Wiley- 
Interscience  Publishers,  2:45-72 
1968. 

1 1.  Basmajian,  J.V.,  and  Simard  T.G. 
Methods  in  training  the  conscious 
control  of  motor  units.  Arch.  Phvs. 
Med.  Rehah.  48:l2-\9.  Jan.  1967. 

12.  Bottomley,  loc.cit. 

13.  Dorcas,  D.S..  Dunfield.  V.A..  and 
Scott.  R.N.  Improved  myo-electric 
control  systems.  Medical  and  Biolog- 
ical Engineering,  8:333-4 1 ,  1 970.      ^ 


The  myo-electric  control  systems  re- 
search at  the  Bio-Engineering  Institute, 
University  of  New  Brunswick,  is  sup- 
ported in  part  by  the  Department  of 
National  Health  and  Welfare,  the  Nation- 
al Research  Council,  the  Workmen's 
Compensation  Board  (N.B.).  and  the 
Canadian  Rehabilitation  Council  for  the 
Disabled  (N.B.  Branch). 

APRIL  1971 


Basilar  aneurysms 


The  author  describes  aneurysms  of  the  basilar  artery,  aspects  of 
surgical  intervention,  and  the  nursing  care  involved. 


Marion  J.  Derdall 

Surgical  intervention  of  aneurysms  of 
the  vertebro-basilar  arterial  tree  has, 
until  recently,  presented  insurmount- 
able difficulties  and  serious  hazards. 
Consequently,  while  surgery  of  other 
intracranial  aneurysms  developed  apace, 
the  vertobro-basilar  system  remained 
forbidden  territory. 

In  the  last  few  years,  however,  neuro- 
surgeons have  been  able  to  harness  to 
this  particular  problem  the  skills  and 
experiences  accumulated  over  two  de- 
cades of  treating  aneurysms  in  other 
locations.  Refinements  in  anesthesia, 
with  careful  monitoring  of  hemo- 
dynamic and  ventilatory  aspects;  the 
use  of  mannitol  (an  osmotic  diuretic) 
and  steroids  to  reduce  brain  bulk; 
controlled  hypotension  during  surgery; 
and  the  increasing  use  of  the  operating 
microscope  are  some  factors  that  have 

Miss  Derdall.  a  graduate  of  Saskatoon 
City  Hospital.  Saskatoon.  Saskatchewan, 
was  Research  Assistant  to  Dr.  John 
Girvin,  Clinical  Neurosurgeon  and 
Neurophysiologist  at  the  University  of 
Western  Ontario,  when  she  wrote  this 
paper.  It  is  adapted  from  a  speech  she 
gave  in  Toronto  last  June  at  the  Canadian 
Association  of  Neurological  and  Neuro- 
surgical Nurses.  The  author  expresses 
her  thanks  to  Dr.  Charles  G.  Drake  and 
Dr.  Girvin  for  their  help  in  preparing 
this  manuscript. 


APRIL  1971 


made  posterior  fossa  aneurysm  surgery 
possible. ' 

Incidence  and  etiology 

Fortunately,  aneurysms  in  the  basilar 
system  are  uncommon.  According  to 
published  reports,  they  comprise  any- 
where between  4.5  percent  and  15  per- 
cent of  all  aneurysms  diagnosed,  ^  and 
they  seem  equally  distributed  between 
the  se.xes.  Studies  on  the  incidence  of  the 
more  unusual  forms,  such  as  mycotic, 
traumatic,  and  atherosclerotic  aneur- 
ysms of  this  region,  have  not  yet  found 
their  way  into  medical  literature. 

As  with  supratentorial  aneurysms, 
the  controversy  over  the  genesis  of 
these  lesions  has  not  been  resolved.  The 
traditional  theory  of  a  congenital  defect 
in  the  middle  coat  of  the  arterial  wall 
(the  media)  is  hotly  contested  by  the 
proponents  of  the  hypothesis  that  de- 
generative changes  in  the  media  or  in- 
ternal elastic  lamina,  aggravated  by 
hypertension  and  atheromatouschanges. 
are  responsible.  An  interesting  compro- 
mise is  the  theory  that  congenital  defects 
in  the  arterial  wall  predispose  to  early 
degenerative  changes  and  subsequent 
aneurysm  formation. 

Clinical  features 

An  acute  episode  of  subarachnoid 
hemorrhage    usually    draws    attention 
to   the   aneurysm.    Occasionally,    pre- 
monitory headache  or  wry  neck  precede 
THE  C/yiADIAN  NURSE     49 


a  major  rupture.  Sudden  entry  of  blood 
into  the  subarachnoid  space  is  herald- 
ed by  a  violent  headache,  nausea, 
vomiting,  and  changes  in  the  sensorium. 
Photophobia,  hemorrhages  in  the  fundi, 
and  a  stiff  neck  are  commonly  present. 
If  a  lumbar  puncture  is  performed, 
the  cerebrospinal  fluid  is  bloody  and 
xanthochromic.  Blood  pressure  is  fre- 
quently elevated  and  focal  neurological 
deficits  may  appear. 

Less  often,  aneurysms,  particularly 
in  the  posterior  circulation,  manifest 
as  cranial  nerve  palsies  or,  if  sufficient- 
ly large,  as  a  space-occupying  lesion, 
often  indistinguishable  from  a  posterior 
fossa  tumor.  Other  aneurysms  are  found 
incidentally  during  angiography  or  au- 
topsy. 

Ischemia  resulting  from  arterial 
spasm,  a  phenomenon  not  infrequently 
seen  with  a  ruptured  aneurysm,  can 
add  to  the  morbidity  and  confuse  the 
clinical  picture  by  producing  neurolog- 
ical deficits  in  areas  distant  from  the 
site  of  hemorrhage.  Blood  dissecting 
into  brain  substance  acts  essentially 
like  intracerebral  hematomas,  and  in- 
traventricular rupture  carries  a  grave 
prognosis. 

Blood  in  the  cisterns  around  the 
base  of  the  skull  causes  slowing  of 
cerebrospinal  fluid  circulation;  symp- 
toms of  acute  or  chronic  hydrocephalus 
may  develop. 

Although  spontaneous  rupture  can 
occur  even  in  sleep,  it  is  often  associat- 
ed with  straining,  as  in  lifting,  pushing, 
breath  holding,  and  during  coitus. 

Treatment 

The  words  of  one  authority  on  this 
subject,  Dr.  Charles  Drake,  probably 
indicate  the  views  held  by  most  neuro- 
surgeons about  basilar  aneurysm  sur- 
gery. 

"The  decision  to  operate  upon  a 
patient  with  a  ruptured  aneurysm  de- 
serves the  most  careful  consideration. 
50     THE  CANADIAN   NURSE 


Many  factors  are  to  be  considered,  but 
with  an  intimate  knowledge  of  the  case 
the  question  should  be  asked  whether, 
with  reasonable  surety,  this  aneurysm 
can  be  obliterated  without  hurting  the 
brain  further,  so  that  this  patient  will 
be  the  delight  of  his  family  and  useful 
to  the  community. 

"Many  cases  remain  unsuitable  for 
early  surgical  treatment  because  of 
serious  disorder  of  brain  function  from 
swelling,  infarction  and  disruption  by 
parenchymal  hemorrhage.  Too  often 
we  concern  ourselves  with  whether 
the  patient  lives  or  dies,  but  even  more 
tragic  than  death  is  the  specter  of  a 
person  rendered  demented,  or  mute 
and  hemiplegic. 

"Of  equal  importance  to  such  a  loss 
of  human  dignity  is  the  burden  for  the 
family.  A  judicious  waiting  period, 
days  or  even  weeks,  will  reveal  the 
degree  of  brain  function  of  which  the 
patient  will  be  capable,  and  a  worth- 
while life  can  then  be  preserved  by  op- 
eration .  .  .  ."^ 

Operative  Approach 

The  patient  is  placed  in  Sims'  posi- 
tion for  approach  under  the  right  tem- 
poral lobe.  This  approach  may  be 
altered  when  the  aneurysm  is  in  an 
unusual  location  or  when  there  is  sure 
knowledge  of  right  cerebral  dominance. 
Either  the  radial  or  brachial  artery  is 
cannulated  to  record  the  mean  arterial 
pressure. 

The  lateral  position  dllows  easy 
access  for  lumbar  puncture  and  drain- 
age of  all  cerebrospinal  fluid  after  the 
bone  flap  has  been  raised.  In  many 
instances  the  resulting  brain  slackness 
will  be  all  that  is  necessary  for  the  ex- 
posure. However,  deep,  firm  retraction 
of  the  temporal  lobe  may  be  required 
to  expose  the  basilar  bifurcation;  in 
these  cases,  mannitol  is  usually  given 
to  lessen  the  need  of  retractor  pressure, 
thereby  reducing  the  chance  of  bruising 
the    inferior   temporal   cortex.   When 


there  is  a  possibility  that  mannitol  will 
be  used,  an  indwelling  catheter  is  placed 
in  the  patient's  bladder  before  draping. 

Following  removal  of  the  bone  flap, 
exposure  is  performed  with  the  aid 
of  magnification,  and  profound  hypo- 
tension (approximately  40  to  50  mm 
Hg.)  is  artificially  induced.  Isolation  and 
obliteration  of  the  aneurysm  complete 
the  procedure.  Aneurysms  may  be 
clipped,  ligated,  wrapped,  or,  less 
often,  pilo-injected. 

Closure  of  the  craniotomy  deserves 
brief  comment.  When  the  operation 
has  been  delayed  for  a  week  and  has 
proceeded  uneventfully,  postoperative 
edema  is  unusual  and  the  dura  can  be 
closed  and  the  bone  flap  tied  in  place. 
However,  when  edema  is  expected  or 
when  the  brain  is  tight  or  swelling,  the 
dura  is  left  open  and  the  bone  flap 
placed  in  the  bone  bank  for  later  re- 
placement.'' 

Complications 

Basilar  eneurysm  surgery  is  subject 
to  all  the  complications  found  in  any 
craniotomy.  Clots  —  epidural,  sub- 
dural, and  intracerebral  —  can  occur 
at  any  time  in  the  postoperative  course; 
bone  flap  infections,  meningitis,  cere- 
bral edema,  and  systemic  complica- 
tions may  also  follow. 

Although  inadequate  vascular  per- 
fusion is  recognized  as  a  complication 
of  ruptured  aneurysm  without  surgery, 
it  is  also  a  condition  that  may  be  pre- 
cipitated by  intracranial  surgery.  Bot- 
terell  et  al  noted  that  ischemic  infarc- 
tion after  surgery  occurred  almost 
exclusively  in  those  persons  operated 
on  within  one  week  of  a  "bleed."  ^  They 
believe  arterial  spasm,  affected  by  two 
factors,  local  and  systemic,  is  implicat- 
ed. 

Local  factors  enhancing  spasm  in- 
clude trauma  to  the  vessel  wall,  exces- 
sive traction,  or  pinching  of  the  vessel 
if  the  clip  is  too  closely  applied.  Athero- 

APRIL  1971 


ANTERIOR  CEREBRAL 


INTERNAL  CAROTID 


ANEURYSM  AT 
BIFURCATION 


POSTERIOR  CEREBRAL  — 

ANEURYSM  ON  T 

TRUNK  OF 
BASILAR 
ARTERY 


ANTERIOR 
INFERIOR- 
CEREBELLAR 


POSTERIOR.'' 
INFERIOR  CEREBELLAR 


MIDDLE  CEREBRAL 


--POSTERIOR 
COMMUNICATING 


--^^ SUPERIOR 
CEREBELLAR 


BASILAR 


VERTEBRAL 


Diagram  showing  the  principal  arteries  at  the  base  of  the  brain  and  two  aneurysms-one  at  the 
bifurcation  and  one  on  the  trunl<  of  the  basilar  artery. 


sclerotic  plaques  provide  an  additional 
variable  that  may  contribute  to  local 
circulatory  changes. 

Systemic  variables  include  any 
changes  that  mav  reduce  blood  flow, 
such  as  hypovolemia;  reflex  hyperten- 
sion due  to  anesthesia;  drugs  such  as 
chlorpromazine,  and  mechanical 
changes  relating  to  gravity,  brought 
about  by  elevating  the  head. 

Allcock  and  Drake  also  consider 
arterial  spasm  to  be  the  main  cause  of 
mortality  and  morbidity  after  intracra- 
nial surgery  for  aneurysms  that  have 
bled.  6  In  addition,  they  believe  hypo- 
thermia, in  conjunction  with  excessive 
hyperventilation  and  perhaps  Fluothane 
anesthesia,  contribute  to  spasm. 

Complications  specific  to  the  clipping 
of  individual  arteries  also  occur.  The 
proximal  vertebral  ligation  may  be 
followed  by  transient  ischemic  signs, 
such  as  hemiparesis,  ataxia,  dysarthria, 
and  restriction  of  eye  movements. 

Nursing  care. 

The  nursing  care  of  patients  with 
basilar  aneurysms  varies  little  from 
care  given  to  patients  with  anterior 
circulation  aneurysms.  The  proximity 
of  vital  centers,  such  as  those  control- 
ling vasomotor  and  respiratory  function, 
to  the  site  of  the  lesion  and  surgery  must 
constantly  be  kept  in  mind.  Vigilance 
in  the  pre-  and  postof)erative  period  is 
the  rule. 

APRIL  1971 


On  admission  the  patient  is  placed 
on  a  subarachnoid  hemorrhage  regimen, 
which  is  by  no  means  rigid,  but  lays 
down  some  guidelines  that  are  modi- 
fied to  suit  the  individual  patient. 

Environmental  stresses  appear  to 
increase  the  chance  of  a  subarachnoid 
hemorrhage.  All  activities  that  increase 
the  patient's  blood  pressure  are  avoided. 
These  include  straining  at  defecation 
and  micturition,  lifting,  and  bending. 

Emotionally,  the  elimination  of 
undue  worry  is  a  prime  requisite  for 
both  the  patient  and  his  family.  Careful, 
concise  explanation  of  procedures  and 
treatments  prevents  anxiety  that  comes 
from  not  knowing  what  is  going  to 
happen. 

The  need  for  repeated  checks  of  the 
patient's  neurological  signs  is  vital, 
the  frequency  dictated  by  the  condi- 
tion of  the  patient. 


Regimen 

•The  patient  is  admitted  to  a  private 
room  when  possible,  and  is  put  on 
complete  bed  rest.  His  bed  is  kept 
flat,  but  he  is  allowed  a  small  pillow. 
Bedsides  are  used. 

•The  nurse  feeds  the  patient,  who  is 
on  a  low  residue  diet. 

•  No  enemas  or  suppositories  are  given; 
instead,  the  patient  takes  30  cc.  of 
Magnolax  and  30  cc.  of  mineral  oil 
daily.  A  fracture  pan  is  used,  and 


this,  or  a  urinal,   in  offered  to  the 
patient  every  four  hours. 

•  Male  patients  are  shaved  by  the  or- 
derly every  second  day. 

•  Television  is  not  allowed;  however, 
the  patient  can  listen  to  his  radio  at 
a  low  volume. 

•The  patient's  immediate  family  may 
visit  him  twice  daily  for  10  to  15 
minutes.  The  complete  regimen  and 
its  importance  are  explained  fully  to 
the  patient  and  his  family. 

•  A  complete  check  of  the  patient's 
neurological  status  is  made  by  the 
nurse  hourly  during  the  day  and  every 
two  hours  during  the  night. 

•  The  patient  is  discouraged  from  smok- 
ing, but  may  be  allowed  five  cigaret- 
tes daily. 

•A  sign  on  the  patient's  bed  indicates 
the  nursing  care  to  be  given. 

Medication 

Drugs  that  might  alter  the  neurolo- 
gical signs  are  avoided.  If  they  have  to 
be  given,  familiarity  with  their  effects 
is  important. 

The  choice  of  drugs  administered 
differs  from  center  to  center,  but  the 
desired  effect  rarely  varies.  Amobar- 
bital  60  mg.  per  os  in  given  q.  6  h.  as 
a  sedative;  codeine  60  mg.  per  os  or 
intramuscularly  is  the  analgesic  of 
choice.  Maintenance  of  the  patient's 
blood  pressure  seems  to  be  the  most 
difficult  to  control.  At  present,  An- 
solysen  (pentolinium  tartrate),  a  gan- 
glionic blocking  agent,  is  given.  Amicar 
(aminocaproic  acid),  a  fibrinolytic 
inhibitor,  is  given  to  reduce  the  chance 
of  further  bleeding.  These  drugs  are 
discontinued  the  day  prior  to  surgery. 

Preoperative  Preparation 

Barring  unforeseen  problems  arising 
from  routine  admission  tests,  carotid 
and  vertebral  angiography  are  per- 
formed shortly  after  admission  to  find 
the  cause  of  hemorrhage.  To  alleviate 
emotional  stress,  the  patient  is  frequently 
THE  CANADIAN   NURSE     51 


not  told  of  his  impending  surgery  until 
the  morning  of  surger>.  Naturally,  the 
family  is  forewarned  of  the  surger>  and 
its  implications.  As  all  hair  clipping  is 
done  after  induction,  a  pHisoHex  sham- 
poo is  all  that  is  required  in  the  phys- 
ical preoperative  preparation. 

Postoperative  Care 

The  first  24  hours  postoperatively 
are  the  most  crucial.  If  complications 
are  to  be  dealt  with  effectively,  time  is 
of  the  utmost  importance.  Because  of 
her  constant  contact  with  the  patient. 
the  nurse  can  detect  postof)erati\  e 
complications  immediately. 

Careful  monitoring  of  the  patient's 
neurological  status  is  basic  to  all  post- 
operative craniotomy  patients.  In 
addition,  it  is  wise  to  be  familiar  with 
the  patients  preoperative  status  so 
that  any  changes  in  his  condition  can 
be  interpreted  intelligently. 

Cerebral  edema  will  occur  to  some 
degree  in  all  craniotomies.  The  prob- 
lem is  to  ditTerentiate  between  signifi- 
cant and  insignitlcant  swelling.  Changes 
in  the  level  of  consciousness  are  the 
best  guidelines.  Initial  recoverv  from 
anesthesia  should  tlnd  the  patient 
alert,  oriented,  and  aware  of  his  envi- 
ronment. Gradual  drowsiness  and  con- 
fusion indicate  the  onset  of  cerebral 
edema.  With  other  signs  of  increased 
intracranial  pressure  registering,  ster- 
oid therapy,  mannitol,  and  other  wa\^ 
to  induce  dehydration  may  be  initiated. 

The  use  of  .-Xrtonad  to  lower  the 
blood  pressure  artificially,  may  result 
in  fixed-dilated  pupils  in  the  immediate 
postoperative  period.  As  the  effects  of 
this  drug  wear  off.  the  observation  of 
a  unilateral  paresis  of  the  third  cranial 
nerve,  temporarily  present  due  to  ma- 
nipulation during  surgerv.  may  cause 
the  nurse  to  "hit  the  panic  button" 
for  the  resident  unless  she  has  familiar- 
ized herself  with  the  operative  proce- 
dure. 

In  anerial  spasm.  level  of  conscious- 

52     THE  CANADIAN   NURSE 


ness  is  the  first  sign  to  alter.  Transient 
confusion  appears  to  be  the  forerunner, 
rapidly  followed  by  increasing  drows- 
iness and  focal  disturbance  of  brain 
function.  If  the  patient  has  had  recent 
bleeding  or  adverse  clinical  findings 
prior  to  surgerv,  the  nurse  should  be 
prepared  for  rapid  changes  in  his  neu- 
rological status.  Treatment  is  varied. 
Rheomacrodex  (a  plasma  volume 
expander),  alternated  with  mannitol 
and  steroid  therapy,  are  presently  used. 

The  future 

From  a  medical  viewpoint,  reduc- 
tion of  the  morbidity  and  mortality 
rates  associated  with  basilar  aneurysm 
surgerv  appears  to  rest  on  two  points: 
reducing  the  danger  of  a  second  or  a 
third  bleeding  episode  during  the 
waiting  period  prior  to  surgery,  or 
operating  immediately  on  admission 
and  eliminating  postoperative  arterial 
spasm.  Amicar,  pre\iously  mentioned, 
appears  to  have  potential  in  reducing 
the  danger  of  another  hemorrhage, 
but  arterial  spasm  continues  to  be  an 
unsolved  problem. 

From  the  nursing  standpoint,  moni- 
toring devices,  such  as  one  to  record 
intracranial  pressure,  will  surely  bring 
about  an  improvement  in  the  nursing 
care  given.  Finally,  continuing  educa- 
tion and  improved  communication 
among  those  concerned  with  neurolo- 
gical and  neurosurgical  nursing  will 
undoubtedly  enhaiKe  the  nursing  care 
of  patients  with  aneurv^ms  of  the  ver- 
tebro-basilar  system. 

References 

1 .  Drake.  C.G.  Further  experience  with 
surgical  treatment  of  aneurv'sms  of 
the  basilar  arterv'.  J.  \eurosurg.  29: 
372-391.  1968. 

2  Locksley.  H.B.  et  al.  Report  on  the 
cooperative  study  of  intracranial  aneur- 
N'sms  and  subarachnoid  hemorrhages. 
J.  Neurosurg.  25:6:  662-7(M.  1966. 


3.  Drake.  C.G.  On  surgical  treatment  of  | 
ruptured  intracranial  aneurjsms.  Clin. 
Seurosurg.  13:122-155,  1965. 

4.  Drake.  C.G.  The  surgical  treatment  of 
aneurvsms    of   the    basilar    arterv'.    J.  \ 
Seurosurg.  29:436-446.  1968. 

5.  Horwitz.  N.H..  Rizzoli.  H.\ .  Postoper- 
ative Complications  in  Neurosurgical  ' 
Practice.     Baltimore.     Williams     and 
WiikinsCc.  1967.  pp.  83-129. 

6.  Drake.  On  surgical  treatment  of  rup- 
tured intracranial  aneurvsms.  i^' 


APRIL  19n 


The 

Canadian 
Nurse 

50  The  Driveway,  Ottawa  4,  Canada 


^P 


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APRIL  1971 


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The  Canadian  Nurse 

OFFICIAL  JOURNAL  OF  THE  CA-NADIAN  NURSES'  ASSOCIATION 

THE  CANAOIAN   NURSE     53 


April  12-August  30, 1971 

Four  courses  on  coronary  care  nursing 
to  assist  registered  nurses  to  increase 
their  competency  as  staff  nurses  providing 
care  for  coronary  heart  disease  patients. 
Each  four-week  course  will  accommodate 
20  nurses.  Tuition  fee:  $200.00.  For  further 
information  and  application  forms  write: 
University  of  Toronto,  Continuing  Educa- 
tion Program  for  Nurses,  42  Queen's  Park 
Cres.  E.,  Toronto  5,  Ontario. 

April  15-16,1971 

University  of  British  Columbia,  Division  of 
Continuing  Education,  Course  on  Acute 
Illness  for  nurses  practicing  in  acute  wards 
of  general  hospitals.  Fee:  $23.00.  For  furth- 
er information  write:  Margaret  S.  Neylan, 
Associate  Professor  and  Director,  Univer- 
sity of  British  Columbia  School  of  Nursing, 
Division  of  Continuing  Education,  Van- 
couver 8,  B.C. 

April  17,1971 

Final  graduation  exercises.  Stratford  Gen- 
eral Hospital  School  of  Nursing,  to  be  held 
at  Stratford  Shakespearean  Festival  Thea- 
tre. All  alumnae  are  invited  to  return  tor  a 
homecoming  weekend. 

April  19-22, 1971 

Canadian  Public  Health  Association,  62nd 
annual  meeting.  King  Edward  Sheraton 
Hotel,  Toronto.  For  advance  registration, 
information,  and  accommodation,  write: 
CPHA  Annual  Meeting,  1255  Yonge  Street, 
Toronto  7,  Ontario. 

April  23-24, 1971 

Association  of  Operating  Room  Nurses 
National  Committee  on  Education  and 
the  Association  of  Operating  Room  Nurses 
of  St.  Louis,  Regional  Institute  on  Operat- 
ing Room  Nursing,  Stouffers  Riverfront 
Inn,  St.  Louis,  Missouri.  Program  theme: 
"Bridging  the  Gap."  For  further  information 
write:  Mrs.  Mary  Davern,  Registration 
Chairman,  Box  812,  Bridgeton,  Mo.  63044, 
U.S.A. 

April  29-May  1, 1971 

Annual  Meeting,  Registered  Nurses' 
Association  of  Ontario,  Royal  York  Hotel 
Toronto,  Ontario. 

May  3-14, 1971 

Intensive  course  on  "Analysis  of  the  Pro- 
cess of  Psychiatric  Nursing,"  to  be  con 
ducted  five  days  a  week  at  Sunnybrook 
Hospital,  Toronto,  Enrollment  is  limited 
to  10  nurses  working  in  the  field  of  psy- 
chiatric nursing.  Fee:  $125.00.  For  further 
information    and    application    forms   write: 

54     THE  CANADIAN   NURSE 


Continuing  Education  Program,  University 
of  Toronto,  47  Queen's  Park  Crescent 
East,  Toronto  5,  Ont. 

May  4-7, 1971 

Workshop  on  Test  Construction  for  Teachers 
in  Nursing  Education  to  be  conducted  by 
Professor  Vivian  Wood.  Tuition  fee,  includ- 
ing meals  and  accommodation:  $120.00. 
For  further  information  contact:  Summer 
School  and  Extension  Department,  The 
University  of  Western  Ontario,  London  72. 

May  9-12, 1971 

National  League  for  Nursing  and  National 
Student  Nurses'  Association,  annual  con- 
vention, Dallas  Memorial  Auditorium  and 
Convention  Hall,  Dallas,  Texas,  U.S.A. 

May  10-28, 1971 

Three-week  intensive  course  in  Developing 
Human  Resources  for  Improved  Nursing 
Care,  offered  for  nurses  who  take  respon- 
sibility for  the  work  of  others.  It  is  designed 
to  assist  the  nurse  to  improve  her  skills  in 
fostering  development  of  the  abilities  of 
individuals  and  work  groups  giving  nursing 
care.  For  further  information  write:  Continu- 
ing Education  Program  for  Nurses,  Univer- 
sity of  Toronto,  47  Queen's  Park  Crescent, 
Toronto  5,  Ont. 

May  11-14, 1971 

Alberta  Association  of  Registered  Nurses, 
annual  meeting,  Banff  Springs  Hotel,  Banff, 
Alberta. 

May  17-22, 1971 

Three  one  and  one-half  day  institutes, 
sponsored  by  Memorial  University  of  New- 
foundland School  of  Nursing  and  the  Asso- 
ciation of  Registered  Nurses  of  Newfound- 
land. Topic:  The  Expanded  Role  of  the 
Nurse.  Guest  speaker:  Martha  Rogers, 
Head,  Division  of  Nursing  Education  of 
New  York.  Obtain  registration  forms  from 
your  association  office. 

May  19, 1971 

Catholic  Hospital  Conference  of  Ontario, 
nursing  committee,  annual  meeting.  King 
Edward  Hotel,  Toronto,  Ontario 

May  19-20, 1971 

New  Brunswick  Association  of  Regis- 
tered Nurses,  annual  meeting.  Holiday  Inn, 
Saint  John,  N.B.  Convention  theme:  "Pat- 
terns of  Health  Care  in  N.B." 

May  26, 1971 

Registered  Nurses'  Association  of  British 
Columbia,  59th  annual  meeting,  Bayshore 
Inn,  Vancouver,  B.C. 


May  26, 1971 

Saskatchewan  Registered  Nurses'  Asso- 
ciation, annual  meeting,  Bessborough 
Hotel,  Saskatoon,  Saskatchewan. 

May  26-29, 1971 

Reunion  of  The  Montreal  General  Hospital 
School  of  Nursing  graduates  to  celebrate 
the  hospital's  150th  anniversary.  Graduates 
should  send  addresses  to:  Miss  Phyllis 
Walker,  The  Montreal  General  Hospital 
(Dept.  of  nursing),  Montreal  109,  P.Q. 

May  30-|une  1, 1971 

Manitoba  Association  of  Registered  nurses, 
annual  meeting,  Dauphin,  Manitoba. 

May30-June11,1971 

A  concentrated  two-week  course  to  provide 
basic  information  for  individuals  dealing 
with  problems  related  to  misuse  of  alcohol 
and  other  drugs,  sponsored  by  Addiction 
Research  Foundation,  to  be  held  at  the 
University  of  Guelph,  Guelph,  Ont.  Enroll- 
ment limited  to  100.  For  further  information 
write:  Director,  Summer  Courses,  Addic- 
tion Research  Foundation,  Education  Di- 
vision, 33  Russell  St.,  Toronto  4,  Ontario. 

June  2-5, 1971 

Reunion  of  Plummer  Memorial  Public 
Hospital  School  of  Nursing  graduates  to 
celebrate  the  school's  final  graduation. 
Those  interested  should  write:  Mrs.  Dor- 
othy Janstrom  (Williams),  49  Promenade 
Dr.,  Sault  Ste  Marie,  or  Mrs.  Dorothy  Sy- 
mes  (Rowe),  129  Princess  Cres.,  Sault 
Ste  Marie,  Ontario. 

June  10-11, 1971 

Symposium  on  Metabolism  and  Disease, 
sponsored  by  the  Food  and  Drug  Director- 
ate, Department  of  National  Health  and 
Welfare,  Talisman  Motor  Inn,  Ottawa. 

June  15-17, 1971 

Registered    Nurses'    Association    of    Nova  ^ 
Scotia,  annual  meeting.  Nova  Scotia  Agri- 
cultural College,  Truro,  Nova  Scotia. 

June  17-19, 1971 

Canadian  Association  of  Neurological 
and  Neurosurgical  Nurses,  second  annual 
meeting,  held  in  conjunction  with  the  Ca- 
nadian Congress  of  Neurological  Sciences, 
St.  John's,  Newfoundland.  For  further 
information  contact  the  Secretary:  Mrs. 
Jacqueline  LeBlanc,  5785  Cote  des  Nei- 
ges,  Montreal  290,  Quebec. 

May  13-19,1973 

International  Council  of  Nurses,  15th  Quad- 
rennial Congress,  Mexico  City,  Mexico.     ^ 

APRIL  19711 


research  abstracts 


Khairat,  Lara.  An  exploratory  study 
of  the  effectiveness  of  the  parent 
education  conference  method  on 
child  health.  Vancouver,  B.C.,  1970. 
Thesis  (M.Ed.)  U.  of  British  Colum- 
bia. 

In  the  study  that  examined  the  child 
health  conference  as  an  individual 
method  of  adult  education,  evaluations 
were  made  of  both  the  nurse  instructor 
and  parent-participant  relationships 
and  the  gains  made  by  parent  partici- 
pants in  their  knowledge  of  general 
health  information,  developmental 
milestones,  and  mother-infant  relation- 
ships during  their  period  of  attendance 
at  the  conferences.  It  was  hypothesized 
that  there  would  be  no  statistically 
significant  mean  equivalences  between 
the  first  and  final  test  scores  for  the  32 
parents  who  comprised  the  study  pop- 
ulation. The  hypotheses  were  rejected 
with  values  of  t  which  were  significant 
beyond  the  0.001  level. 

Despite  the  significant  gains  re- 
corded, it  would  appear  that  a  number 
of  major  factors  presently  limit  the 
conferences'  efficiency  in  providing 
optimal  conditions  under  which  learn- 
ing may  occur.  First,  an  assessment 
of  the  educational  needs  or  expectations 
of  each  parent  is  not  undertaken  at  the 
beginning  of  each  conference,  and 
learning  objectives  appropriate  to 
each  individual  participant  are  not 
set  up. 

Second,  the  conference  does  not 
presently  specify  educational  objectives 
in  terms  of  desired  behaviors  and,  there- 
fore, health  teaching  is  not  only  relegat- 
ed a  more  minor  role,  but  participants 
are  forced  to  become  mere  passive 
recipients  of  information.  Third,  the 
conference  may  not  always  reach  its 
present  broad  goals  because  appoint- 
ments made  by  the  nurse  for  the  parent- 
participant  to  return  for  further  dis- 
cussions may  be  broken. 

Although  it  was  felt  that  the  research 
instruments  used  in  this  study  met  to 
some  degree  the  requirements  for  which 
they  were  constructed,  they  could  un- 
doubtedly have  been  much  more  ef- 
fective measuring  devices  had  steps 
been  taken  to  increase  their  reliability, 
validity,  objectivity,  comprehensi- 
veness, and  differentiation.  Moreover, 
rating  scale  errors  could  have  been 
minimized  had  nurses  been  trained 
in  their  proper  use. 
APRIL  1971 


Smith,  Ethel  Margaret.  Concerns  of 
mothers  participating  in  the  care  of 
their  children  hospitalized  for  minor 
surgery  in  a  day  care  unit.  Vancou- 
ver, B.C.,  1970.  Thesis  (M.Sc.N.) 
U.  of  British  Columbia. 

At  present  very  little  is  known  of  the 
various  problems  mothers  experience 
when  their  children  are  admitted  to  a 
day  care  unit,  in  terms  of  the  increased 
responsibility  placed  upon  them  for  the 
preparation  of  their  children  and  their 
care  at  home  following  discharge.  The 
purpose  of  this  study  was  to  identify 
some  of  the  major  concerns  expressed 
by  mothers  who  participated  in  a  day 
care  unii  in  a  children's  hospital  in 
Vancouver. 

A  sample  of  20  mothers  was  selected. 
The  kinds  of  nursing  activities  in  which 
they  participated  in  the  unit  were  as- 
sessed and  rated  by  a  participation 
scale.  The  data  were  collected  by  the 


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researcher,  who  took  on  the  role  of 
participant  observer  in  the  day  care 
unit.  Field  notes  were  written  on  the 
mothers  while  they  were  in  the  unit, 
and  post-hospital  interviews  were 
recorded  approximately  one  week  to 
10  days  following  discharge. 

The  participation  scales,  field  notes, 
and  post-hospital  interviews  were  ana- 
lyzed, and  the  frequency  and  percent- 
ages of  the  expressed  concerns  deter- 
mined. Seventy  percent  of  the  mothers 
in  the  study  group  needed  help  to  assist 
with  the  care  of  their  children  in  the 
unit.  Concerns  expressed  by  the  mothers 
were  centered  on  the  notion  of  time 
and  a  desire  for  information  related 
to  the  child's  diagnosis,  the  anesthetic 
used,  and  the  operation  performed. 
Postoperatively,  they  expressed  con- 
cerns related  to  symptoms  caused  by 
the  anesthetic,  operation,  or  examina- 
tion. They  seemed  particularly  appre- 
hensive about  the  anesthetic  and  its 
possible  effects  on  the  children. 

Seventy-five  percent  of  the  mothers 
had  had  previous  experience  with  the 
hospitalization  of  their  children.  This 
factor  seemed  most  characteristic  of 
the  group  and  influenced  their  partici- 
pation in  the  day  care  activities.  Only 
two  mothers  had  prior  knowledge  of 
the  day  care  unit  and  they  participated 
independently,  requiring  little  assistance 
from  the  nurse. 

Ninety  percent  of  the  mothers  were 
satisfied  with  the  day  care  experience. 
Two  mothers  were  unhappy  about  the 
arrangements  and  would  have  preferred 
to  have  their  children  remain  in  hos- 
pital a  few  days  postoperatively.  These 
mothers  would  have  benefited  from  a 
home  visit  by  a  nurse.  The  remaining 
90  percent  stated  they  did  not  feel  they 
needed  a  visit  from  a  nurse  postopera- 
tively. All  mothers  appreciated  a  tele- 
phone call  from  the  hospital  following 
surgery.  The  mothers  contacted  their 
doctors  if  problems  arose  at  home.  They 
felt  the  instructions  they  received  by 
mail  prior  to  admission  were  adequate. 

The  success  of  surgical  day  care 
units  for  children  is  dependent  upon 
the  interest  and  support  of  parents. 
Mothers  can  prepare  their  children  for 
surgery  and  cope  with  post-hospital 
care,  if  they  receive  help  and  support 
from  the  nursing  staff.  Mothers  whose 
children  have  been  treated  in  a  day  care 
unit  are  most  enthusiastic  about  this 
type  of  hospital  care.  ^ 

THE  CANADIAN   NURSE     55 


Cassette  Recorderl Player 


Portable  Cassette  Recorder/Player 

The  first  Canadian-built  and  Canadian- 
designed  portable  classroom  cassette 
recorder/player  —  Model  CR5-C  — 
has  been  introduced  by  the  Rheem 
Califone  division  of  J.M.  Nelson  Elec- 
tronics (Rheem-Roberts  of  Canada). 
Its  main  advantage  is  convenience  and 
time  saved  usmg  mstant-loadmg  cas- 
settes. The  Califone  Model  CR5-C  is 
built  to  take  the  wear  and  tear  of  every- 
day classroom  use,  and  features  "Slide 
Pot"  controls  for  tone,  volume  and 
microphone  volume  setting,  automatic 
gain  control,  and  the  use  of  standard 
"1/4"  jacks  throughout. 

Further  information  may  be  obtain- 
ed by  writing  to  J.M.  Nelson  Electron- 
ics, 1305  Odium  Drive,  Vancouver  6, 
British  Columbia. 

Red  Cross  Society 

Medical  Langage  Communicator 

This  24-page  booklet  is  intended  to 
help  patients  unable  to  speak  English 
or  French  to  communicate  with  med- 
ical staff. 

The  left-hand  page  under  each  of 
the  10  languages  listed  is  for  the  phy- 
sician's use  when  asking  questions  of 

56     THE  CANADIAN   NURSE 


the  patient.  The  22  basic  questions 
have  opposite  them  the  pertinent  trans- 
lation. The  right-hand  page  contains 
26  useful  statements  and  requests,  with 
translation,  to  allow  the  patient  to 
communicate  with  the  doctor  or  nurse. 
The  foreign-language  material  in 
this  booklet  is  derived  from  the  doctor- 
patient  language  car^s  compiled  by  the 
British  Red  Cross  Society. 


^H 

Cheque  out  1 
a  crippled  child  1 

today.       ■ 

See  what  your  dollars  can  do.  H 

Support  Easter  Seals.  1 

In  response  to  a  felt  need,  the  book- 
let was  produced  in  English  and  in 
French  by  Parke-Davis  and  Company, 
through  the  cooperation  of  the  Cana- 
dian Red  Cross  Society. 

For  copies  of  the  Medical  Language 
Communicator  write  to  Parke-Davis 
and  Company,  5190  Cote  de  Liesse 
Road,  Montreal,  Quebec. 

Multicolor  Transparencies 
for  Overhead  Projection 

The  Patient  and  Circulatory  Disorders 
contains  54  transparencies  with  99 
overlays  and  includes  carrying  case  and 
comprehensive  instructor's  guide. 

Unit  1  —  Normal  anatomy  and  phys- 
iology ( 1 1  transparencies,  24  overlays) 

Unit  2  —  Special  tests  and  proce- 
dures (10  transparencies,  14  overlays) 

Unit  3  —  The  patient  and  coronary 
disease  (33  transparencies,  61  over- 
lays) 

A  detailed  brochure,  illustrating 
each  transparency  and  overlay  in  each 
unit  may  be  requested  from  the  J.B. 
Lippincott  Company  of  Canada  Ltd., 
60  Front  Street  West,  Toronto  1, 
Ontario. 

The  Patient  and  Fluid  Balance  contains 
64  transparencies  with  158  overlays 
with  carrying  case  and  instructor's 
guide. 

Unit  1  —  The  state  of  equilibrium: 
normal  physiology  ( 1 1  transparencies, 
26  overlays); 

Unit  2  —  Disequilibrium,  Part  A: 
Altered  physiology  (16  transparencies, 
48  overlays).  Part  B:  Clinical  applica- 
tion (17  transparencies,  35  overlays); 

Unit  3  —  Fluid  therapy  (20  trans- 
parencies, 35  overlays). 

A  detailed  brochure,  illustrating 
each  transparency  and  overlay  in  each 
unit  may  be  requested  from  J.B.  Lip- 
pincott Company  of  Canada  Ltd.,  60 
Front  Street  West,  Toronto  1 ,  Ontario. 

FILMS 

To  Inner  Space  (16  mm.  sound,  color, 
13  min.)  was  produced  by  Crawley 
Films  for  Hoffman-LaRoche,  Canada, 
with  Dr.  Edward  Atack  of  Ottawa  as 
consultant. 

This  is  the  case  history  of  a  young 
girl  suffering  from  a  neuromuscular 
disease.  The  film  portrays  the  complex- 
ity of  the  human  body  and  shows  what 
happens  when  it  malfunctions.  It  deals 

APRIL  1971 


with  the  role  played  by  drugs  and  the 
care  taken  In  producing  pharmaceutical 
agents,  including  laboratory  tests  on 
animals. 

The  distributor  of  this  film  is  Hoff- 
man-LaRoche,  1956  Bourdon  Street, 
Montreal  378,  Quebec. 

Films  available  on  loan  from  Abbott 
Laboratories  Limited,  P.O.  Box  6150, 
Montreal,  Quebec: 

Cell  Division  and  Growth  ( 1 3  minutes, 
sound)  shows,  in  a  few  minutes,  sev- 
eral days  of  cell  life.  The  activity  of 
living  tumor  cells  is  shown  under 
microscope  at  nearly  300  times  normal 
speed.  Cells  are  seen  moving  in  amoe- 
boid fashion,  developing  pseudopods, 
growing,  aligning  chromosomes,  and 
dividing  when  mature. 

That  They  May  Live  (27  minutes, 
sound)  instructs  the  layman  on  the 
safest  and  most  efficient  means  of 
mouth-to-mouth  artificial  respiration 
by  integrating  the  message  into  an  en- 
tertaining story.  Almost  all  areas  where 
accident  victims  might  need  on-the- 
spot  artificial  respiration  are  dealt  with. 


tion  and  heart  massage.  It  won  the 
San  Francisco  Film  Festival  Silver 
Award. 

The  Hospital  Pharmacy  Team  (20 
minutes,  sound),  of  interest  to  nursing 
groups  as  well  as  pharmacists,  is  essen- 
tially a  career  placement  film  on  the 
duties  of  hospital  pharmacists.  It  was 
directed  by  H.  Smythe,  director  of 
pharmaceutical  services,  Ottawa  Civic 
Hospital,  Ottawa. 

Films  available  on  loan  from  Canadian 
Film  Institute,  1762  Carling  Avenue, 
Ottawa  13,  Ontario: 
A  Half  Million  Teenagers  (1969, 
sound,  color,  16  minutes,  produced  by 
Churchill  Films,  USA.  Purchase  source 
in  Canada:  Educational  Film  Distrib- 
utors, Ltd.,  Toronto,  Ontario). 

Each  year  syphilis  and  gonorrhea 
claim  a  half  million  teenagers  as  vic- 
tims. The  film  shows  how  these  dis- 
eases are  contracted  and  their  prog- 
ress if  untreated.  It  also  stresses  that 
both  diseases  can  be  cured,  and  con- 
cludes with  a  series  of  questions  design- 
ed to  stimulate  discussion. 


Pulse  of  Life  (27  minutes,  sound),  of  Keep    Off  the    Grass   (1970,    sound, 

particular  interest  to  first-aid  groups  color,  12  minutes,  produced  by  More- 

and  teachers,  shows  the  most  recent  land-Latchford    Productions    Limited, 

methods  of  mouth-to-mouth  resuscita-  Toronto,  Ontario). 


This  film  shows  a  young  girl  in 
conflict  between  parental  values  and 
loyalty  to  fellow  teenagers.  She  has 
bought  grass  with  money  pooled  by 
her  teenage  friends  and  her  mother 
discovers  the  cigarettes.  The  mother 
has  the  girl  destroy  the  cigarettes  and 
permits  her  to  repay  her  friends  from 
iier  allowance.  The  friends  want  to  buy 
more  grass.  Open  ended,  the  film  pro- 
vides material  for  discussion. 

VD:  A  Call  to  Action  (1969,  sound, 
color,  27  minutes,  produced  by  John 
G.  Fuller  in  cooperation  with  the  Mas- 
sachussetts  Division  of  Communicable 
and  Veneral  Diseases,  Department  of 
Public  Health.  Underwritten  by  As- 
sociation Films,  New  York.  Purchase 
source  in  Canada  is  Association  In- 
dustrial Films,  Toronto,  Ontario). 

Diane  Champagne,  a  nurse  epidem- 
iologist of  Fall  River,  Mass.  and  26 
others  in  the  state  are  engaged  in  find- 
ing the  sources  of  VD  infection.  Pa- 
tients are  interviewed  to  trace  their 
sexual  contacts,  visits  are  made  to  a 
bar  to  locate  a  woman  who  may  have 
syphilis,  information  is  gathered  from 
a  private  physician,  and  current  cases 
are  discussed  with  her  supervisor. 
Stress  is  made  that  anyone  can  get  VD 
and  that  the  epidemic  is  a  real  one, 
needing  much  cooperation  in  every 
community.  ij" 


has  received 

URGENT 

requests  for 

NURSES 

to  work  in 

INDIA 

and 

COLOMBIA 


CUSO  health  department  has  high  priority  requests 
for  as  many  as  30  nurses  for  postings  in  India  and 
Colombia.  A  few  RNs  with  only  one  year's 
experience  can  be  placed,  but  the  real  need  is  for 
nurses  with  at  least  two  years'  experience.  Following 
are  typical  positions  available  for  BScNs,  BNs,  RNs 
with  post-basic  diplomas  and  RNs  with  experience: 

Public  Health  nursing  /  teaching  in  schools  for 
nursing  auxiliaries  /  teaching  at  both  diploma  and 
baccalaureate  level  /  ward  administration  and 
clinical  instruction  in  various  specialties  / 
operating-room  nursing  /  family  planning 

TERMS  OF  SERVICE:  In  addition  to  the 
professional  qualifications  a  CUSO  assignment  calls 
for  such  personal  qualities  as  maturity,  initiative, 
common  sense,  adaptability  and  sensitivity. 

All  assignments  are  for  two  years.  Most  salaries  are 
paid  at  approximately  local  rate  by  the  overseas 
employer.  CUSO  provides  training,  return 
transportation,  medical  and  life  insurance. 

Next  training  course  begins  early  August.  For  further 
information  write  NOW  to:  CUSO  Health 
Department,  151  Slater  Street,  Ottawa  4.  Ontario. 


APRIL  1971 


THE  CANKVDIAN   NURSE     57 


accession  list 


Publications  on  this  list  have  been 
received  recently  in  the  CNA  library 
and  are  listed  in  language  of  source. 

Material  on  this  list,  except  Reference 
items  may  be  borrowed  by  CNA  mem- 
bers, schools  of  nursing  and  other  in- 
stitutions. Reference  items  (theses, 
archive  books  and  directories,  almanacs 
and  similar  basic  books)  do  not  go  out 
on  loan. 

Requests  for  loans  should  be  made 
on  the  "Request  Form  for  Accession 
List"  and  should  be  addressed  to:  The 
Library,  Canadian  Nurses'  Association, 
50  The  Driveway.  Ottawa  4.  Ontario. 

No  more  than  three  titles  should  be 
requested  at  any  one  time. 


BOOKS  AND  DOCUMENTS 

1.  An  abstract  for  action.  Jerome  P.  Li- 
paught,  director.  Toronto,  McGraw-Hill 
for  National  Commission  for  the  Study  of 
Nursing  and  Nursing  Education,  1970.  I67p. 

2.  Administration  in  nursing.  2d.  ed.  by 
Mary  D.  Shanks  and  Dorothy  A.  Kennedy. 
Toronto,  McGraw-Hill,  1970.  324p. 

3.  Basic  concepts  in  anatomy  and  physiol- 


ogy; a  programmed  presentation.  2d.  ed. 
St.  Louis,  Mosby,  1970.  157p. 

4.  Canadian  almanac  and  directory.  Toronto. 
Copp  Clark,  1971.  91 2p.R 

5.  The  doctor's  shorthand  by  Frank  Cole. 
Toronto,  Saunders,  1970.  179p. 

6.  Essentials  for  the  technical  writer  by 
Hardy  Hoover.  Toronto,  Wiley,  1970.  216p. 

7.  Fifty  years  a  Canadian  nurse;  devotion, 
opportunities  and  duly  by  Rahno  M.  Bea- 
mish. New  York,  Vantage  Press,  1970.  344p. 

8.  Five  patients;  the  hospital  explained  by 
Michael  Crichton.  New  York,  Knopf,  1970. 
231  p. 

9.  Fundamentals  of  otolaryngology,  a  text- 
book of  ear,  nose  and  throat  diseases.  4th  ed. 
by  Lawrence  R.  Boies  et  al.  Philadelphia. 
Saunders,  1964.  553p. 

10.  Health  and  healing  by  D.  Naegele, 
compiled  and  edited  by  Elaine  Gumming. 
San  Francisco,  Jossey-Bass,  1970.  122p. 

11.  Helping  the  stroke  patient  to  speak  by 
Kingdon-Ward.  London,  Churchill,  1969. 
156p. 

12.  Interpersonal  processes  in  nursing  ease 
histories  by  Lois  Jean  Davitz.  New  York, 
Springer,  1970.  142p. 

13.  Life  with  the  mentally  sick  child;  the 
daily  care  of  mentally  sick  children  in  hos- 
pitals and  at  home  1st.  ed.  by  Phyllis  R. 
Lacey.  Toronto,  Pergamon  Press,  1969.  77p. 

14.  Medical  action  for  mental  health  prob- 
lems of  childhood  and  youth;  Proceedings 
of  a  conference  held  in  Ottawa,  Ont.  March 
11-13,1970.     Ottawa,     Canadian      Medicai 


Association,  Communications  and  Infor- 
mation Dept.,  1970.  196p. 

15.  Membership  directory.  Chicago,  Amer- 
ican Library  Association,  1970.  259p.  R 

16.  Monique  I'infirmiere;  photographies 
et  texte  par  Genevieve  Rouche-Gain.  Paris. 
Fernand  Nathan.  1970.  Iv.  (Les  femmes 
travaillent) 

17.  The  nursing  and  management  of  skin 
diseases;  a  guide  to  practical  dermatology 
for  doctors  and  nurses  3d.  ed.  by  D.S.  Wil- 
kinson. London,  Faber  and  Faber,  1969. 
403p. 

18.  Orientation  to  the  two-year  college;  a 
programmed  text  by  Richard  W.  Hostrop. 
Homewood.  111.  Learning  Systems:  Cana- 
dian distribution  through  Irwin  Dosey  Ltd., 
Georgetown,  Ont.,  1970.  205p.  (Irwin  pro- 
grammed learning  aid  series) 

19.  Orthopedic  nursing;  a  programmed 
approach  by  Nancy  A.  Brunner.  St.  Louis, 
Mosby,  1970.  173p. 

20.  Pediatric  surgery  for  nurses  1st  ed. 
edited  by  John  G.  Raffensperger  and  Ro- 
sellen  Bohlen  Primrose.  Boston,  Little  Brown, 
1968.  327p. 

2 1 .  Professional  organizations  in  the  Com- 
monwealth edited  by  James  Currie.  London, 
Published  for  the  Commonwealth  Foun- 
dation by  Hutchison,  1970.  5 11  p. 

22.  Les  recettes  de  maman;  collection  fem- 
me  dirigee  par  Nicole  Germain.  Montreal, 
Editions  de  IHomme,  1970.  168p. 

23.  The  roles  of  psychiatric  nurses  in  com- 
munity   mental    health   practice   edited    by 


MY  VERY  OWN 

STETHOSCOPE  ? 

—  but  of  course! 

ASSISTOSCOPE*  was 

designed  with  the 
nurse  in  mind. 

ASSISTOSCOPE*  gives 
you  the  acoustical 
perfection  of  the 
most  expensive 
stethoscopes. 

ASSISTOSCOPE ''^  is  available  with  black  or 
hospital-white  tubing  and  ear  pieces  with  the  slim-fit 
sonic  head  which  slips  easily  under  blood  pressure  cuffs 
or  clothing. 

Ord0r  fro/nf 
tCheck  with  your  Director  f 

::rrcrbur  w  winley-morrb  company  im 

USirrOSCOPE  It  AA    *UI><IC*L   INSTRUMENTt   DIVIIION 

special  group  prices,  ^A  iioiit«e«l  is  auEicc 

*TRAOE  MARK 


UNIVERSITY  OF  BRITISH  COLUMBIA 

SCHOOL  OF  NURSING 

DEGREE  PROGRAMMES 

Baccalaureate  —   basic  students 

—  registered  nurses 
This  course  for  both  groups  of  students  leads  to 
the  B.S.N,  degree,  and  prepares  the  graduate  for 
public  health  as  well  as  hospital  nursing  positions. 

Master's 

For  qualified  baccalaureate  nurses  leading  to  the 
degree  of  M.S.N.  This  course,  two  years  in  length, 
prepares  the  graduate  for  leadership  roles  in  nurs- 
ing with  emphasis  on  clinical  expertise. 

DIPLOMA  PROGRAMME  (Nursing  B) 

Community  Health  Nursing  —  for  registered 
nurses  —  psychiatric  nursing  required  prere- 
quisite. 

Early  applications  are  requested  — 
March    1    for   M.S.N.,  May    1    for  diploma, 

June  30  for  baccalaureate. 

For  information  write  to: 

The  Director 

SCHOOL  OF  NURSING,  UNIVERSITY  OF  B.C. 

Vancouver  8,  B.C. 


58     THE  CANADIAN   NURSE 


APRIL  1971 


Next  Month 
in 


The 

Canadian 
Nurse 


•  Young  Diabetics  Can 
Enjoy  Camp,  Too 

•  Nurses  in  Prison 

•  A  Community  Clinic 
Where  People  Count 


^^:p 


Photo  credits  for 
April  1971 

United  Nurses.  Inc., 
Montreal,  p.  12 

United  Press  International, 
Ottawa,  p.  14 

Crombie  McNeill  Photography, 
Ottawa,  pp.  34-38 

Dept.  National  Health  & 
Welfare.  Ottawa.  Photo 
of  Dr.  Heidgerken.  p.  35 

Miller  Photo  Services, 
Toronto,  p.  43 

University  of  New  Brunswick, 
Fredericton,  pp.  47,  48 


Gertrude  A.  Stokes.  New  York,  Maimonides 
Medical  Center,  Community  Mental  Health 
Center,  1969.  152p. 

24.  So.  you're  going  to  the  hospital;  what 
eveiy  patient  should  know  by  James  Gra- 
ham. St.  Louis.  Mo..  Warren  H.  Green. 
1968.  I63p. 

PAMPHLETS 

25.  Continuity  of  care — can  or  should  the 
nurse  innovate  change?  New  York,  National 
League  for  Nursing  for  Nursing  Advisory 
Service  of  NLN-NLTRDA,  1970.  20p. 

26.  Public  Affairs  Committee.  Pamphlets. 
New  York. 

no. 299  Personality  "plus"  through  diet 
by  Charles  Glen  King.  1960.  20p. 

27.  no.314  Check-ups:  safeguarding  your 
health  by  Michael  H.K.   Irwin.    1961.   18p. 

28.  no.315  You  and  your  hearing  by  Nor- 
ton Canfield.  1961.  20p. 

29.  no.318  Mental  aftercare;  assignment 
for  the  sixties  by  Emma  Harrison.  1961.  28p. 

30.  no. 333  Pathology  tests  look  into  your 
future  by  Thomas  M.  Petry  and  Alyce  Mo- 
ran  Goldsmith.  1962.  16p. 

3L  no. 339  Parents'  guide  to  children's 
vision  by  James  R.  Gregg.  1963.  20p. 

32.  no.345  Caring  for  your  feet  by  Herbert 
C.  Yahraes.  1963.  28p. 

33.  no.347  A  full  life  after  65  by  Edith  M. 
Stern.  1963.  28p. 

34.  no.350  Right  from  the  start;  the  im- 
portance of  early  immunization  by  Judy 
Graves.  1963.  27p. 

35.  no.352  Serioids  mental  illness  in  chil- 
dren by  Harry  Milt.  1963.  28p. 

36.  no. 353  Your  new  baby  by  Ruth  Carson. 
1963.  20p. 

37.  no.353S  Breastfeeding  by  Audrey  Palm 
Riker.  1964.  I6p. 

38.  no. 356  Family  therapy — help  for  trou- 
bled families  by  George  Thorman.  1964.  20p. 

39.  no.361  Smoking — the  great  dilemma 
by  Ruth  Brecher  and  Edward  Brecher.  1964 
28p. 

40.  no.364  Overweight — a  problem  foi 
millions  by  Michael  H.K.  Irwin.  1964.  20p. 

41.  no. 368  How  to  gel  good  medical  care 
by  Irwin  Block.  1965.  28p. 

42.  no.372  Your  health  is  your  business 
by  Harry  J.  Johnson.  1965.  20p. 

43.  no.375  What  you  should  know  about 
educational  testing  by  J.  McV.  Hunt.  1965. 
28p. 

44.  nQ.376  Nine  monlfis  to  get  ready;  the 
importance  of  prenatal  care  by  Ruth  Carson 
1965.  20p. 

45.  no. 379  X-ray — vanguard  of  modern 
medicine  by  Theodore  Berland.   1965.  28p. 

46.  no.439  Cigarettes —  America's  no.!  pub- 
lic health  problem  by  Maxwell  S.  Stewart. 
1969.  24p. 

47.  no.452  How  to  help  the  alcoholic  by 
Pauline  Cohen.  1970.  24p. 

48.  Standards  for  library  service  in  health 
care  institutions.  Chicago.  American  Library 
Association,  Hospital  Library  Standards 
Committee,  1970.  25p. 

49.  Submission  to  the  Study  Committee  on 
Nursing      Education.      Fredericton.      New 


i \ 

Busy,  busy 
little  fingers. 
Busily  spreading 
pinworms. 


Depend  upon 

m[M](Q)WDR{] 

(pyrvinium  pamoate  Frc 

to  eliminate 
pinworms  witti 
a  singie  dose 


Early  detection,  and  treatment  with 
Pamovin,  can  bring  the  usual  unpleasant 
course  of  pinworms  to  an  abrupt  halt. 

It  has  been  shown'  that  single-dose 
treatment  with  pyrvinium  pamoate 
achieves  an  overall  cure  rate  of 
96  per  cent. 

In  the  family  or  in  institutions,  pyrvinium 
pamoate  (PAMOVIN)  offers  the  advantages 
of  "low  cost,  ease  of  administration, 
and  effectiveness."' 

Dosage:  for  both  children  and  adults,  a  single 
dose  of  1  tablet  or  1  teaspoonful  for  every 
22  lbs.  of  body  weight. 

Cautions:  Occasionally,  nausea,  vomiting  or 
gastrointestinal  complaints  may  be  encoun- 
tered but  are  seldom  a  problem  on  such 
short-term  treatment.  Stools  may  be  coloured 
red.  Suspension  will  stain  clothing  and  fabrics. 

PAMOVIN  Tablets  of  50  mg.  (red,  film-coated), 
boxes  of  6,  and  bottles  of  24  and  100. 
Suspension  (red),  50  mg.  per  5  ml.  teaspoonful, 
bottles  of  30  ml.,  4  and  16  f1.  02. 

References:  1.  Beck,  J.  W.,Saavedra,  D., 
Antell,  G.  J.  and  Tejeiro,  B.:  Am.  J.  Trop.  Med. 
8:349,  1959.  2.  Sanders,  A.  I.  and  Hall,  W.  H.: 
J.  Lab.  &  Clin.  Med.  56:413,  1960. 

Full  intormalion  on  request. 


® 


3my^ 


CMAMLKS  K   rMOaST  «  CO.      KMKLJMD  IMONTmAU 


APRIL  1971 


THE  CAf^DIAN   NURSE     59 


accession  list 


Brunswick  Association  of  Registered  Nurses, 
1970.  37p. 


GOVERNMENT    DOCUMENTS 

Canada 

50.  Conseil  Economique.  Les  diverges  for- 
mes de  la  croissance.  Ottawa,  Imprimeur 
de  la  Reine,  1970.  119p.  (Its  septieme  ex- 
pose annuel) 

51.  Dept.  of  National  Health  and  Welfare. 
Income  security  for  Canadians.  Ottawa. 
Queen's  Printer,  1970.  60p. 

52.  Parliament.  Senate.  Special  Committee 
on  Mass  Media.  Report.  Ottawa,  Queen's 
Printer.  1970.  3v. 

53.  Public  Service  Commission.  Se.x  and 
the  public  .service  by  Kathleen  Archibald. 
Ottawa,  Queen's  Printer,  1970.  218p. 

54.  Royal  Commission  on  Bilingualism 
and  Biculturalism.  Canadian  history  text- 
hooks:  a  comparative  study  by  Marcel  Tru- 
del  and  Genevieve  Jain.  Ottawa,  Queen's 
Printer,  1970.  149p.  (Its  Study  no.  5) 

55.  Royal  Commission  on  the  Status  of 
Women.  Report.  Ottawa,  Queen's  Printer, 
1970.  488p. 

56.  Task    Force    on    Labour    Relations.    A 


study  of  the  effects  of  the  $1 .25  minimum 
wage  under  the  Canada  labour  (standards) 
code  by  Mahmood  A.  Zaidi.  Ottawa,  Queen's 
Printer,  1970.  163p.  (Its  Study  no.  16) 
United  States 

57.  National  Center  for  Chronic  Disease 
Control.  Heart  Disease  and  Stroke  Pro- 
gram. Guidelines  for  coronary  care  unit. 
Wash..  U.S.  Gov't  Print.  Off.,  1969.  23p. 
(Public  Health  Service  Publication  no.  1824) 

58.  National  Medical  Audio-visual  Centre. 
Videotapes  available  for  duplication.  At- 
lantic, Georgia,  1970.  53p. 

STUDIES  DEPOSITED   IN 

CNA   REPOSITORY   COLLECTION 

59.  Achieving  self-care:  a  shared  respon- 
sibility by  Marie  Holaday.  Montreal,  1970. 
106p.  (Thesis  (M.Sc.(App.))  -  McGill)  R 

60.  Le  comportenient  respectif  de  I'infir- 
miere,  des  mastectomisees  et  des  amputes 
d'un  membre  durant  les  changements  de 
pansements  par  Louise  Levesque.  Montreal. 
1970.  95p.  (Thesis  (M.Sc.(App.))  -  McGill)  R 

61.  A  descriptive  study:  permitting  choice 
in  nursing  the  aged  patient  is  inconsistent 
with  the  nurse's  goals  in  the  general  hos- 
pital by  T.  Rose  Murakami.  Montreal,  1970, 
60p.  (Thesis  (M.Sc.(App.))  -  McGill)  R 

62.  Etude  des  effets  de  I'intrevue  initiale 
entre  I'infirmiere  et  le  malade  mental  ad- 
mis  dans  un  service  de  psychiatric  par  Can- 
dide  Gravel.  Montreal,  1970,  163p,  (Thesis 
(MN)  -  Montreal)  R 


63.  A  follow-up  study  of  the  graduates  of  a 
selected  hospital  school  of  nursing,  1957- 
1962  by  Sister  St.  Cuthbert  Brownrigg. 
Washington.  1964.  60p.  (Thesis  (M.S.N.) - 
Catholic  University  of  America)  R 

64.  Nursing  in  fleeting  encounters  by  Mar- 
ion Kerr.  Montreal,  1970.  76p.  (Thesis 
(M.Sc.(App.))- McGill)  R 

65.  Nursing  papers  vol.  2,  no.2  Montreal, 
McGill  University  School  of  Graduate 
Nurses,  1970.  22p.  Contents.  -  Response 
to  the  Task  Force  reports.  -  Postpartal  inter- 
action. -  Looking  at  baccalaureate  education 
and  practice. 

66.  Selection  and  success  of  nursing  can- 
didates: a  critical  survey  by  Anne  Elizabeth 
Willett  et  al.  Toronto.  St.  Michael's  School 
of  Nursing,  1970.  92p.  R 

67.  A  study  of  the  characteristics  of  the 
nurse-aged  patient  interaction  process  by 
Anita  L.  Cabelli.  Montreal,  1970.  104p. 
(Thesis  (M.Sc.(App.))  -  McGill)  R 

68.  A  study  of  mother-nurse  interactions 
during  feeding  time  when  the  mother  is 
feeding  her  baby  by  Amelia  Pinsent.  Mont- 
real, 1970.  67p.  (Thesis  (M.Sc.(App.)) - 
McGill)  R 

69.  A  subjective  study  of  the  attitude  of 
public  health  nurses  employed  in  a  gener- 
alized public  health  agency  toward  providing 
service  to  patients  with  mental  or  emotional 
problems  by  Pauline  J.  Siddons.  Victoria, 
Health  Branch,  Dept  of  Health  Services  and 
Hospital  Insurance,  1970.  8Ip.  R  ^ 


Request  Form  for  "Accession  List" 
CANADIAN  NURSES'  ASSOCIATION  LIBRARY 

Send  this  coupon  or  facsimile  to: 

LIBRARIAN,  Canadian  Nurses'  Association,  50  The  Driveway,  Ottawa  4,  Ontario 

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No. 


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Reference  and  restricted  material  must  be  used  in  the  CNA  library. 

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Address    

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60     THE  CANADIAN   NURSE 


APRIL  1971 


DO  YOU 

WANT  TO  HELP 

YOUR  PROFESSION? 

Then  till  out  and  send  in  the  form  below 


REMITTANCE  FORM 
CANADIAN  NURSES'  FOUNDATION 

50  The  Driveway,  Ottawa  4,  Ontario 

A  contribution  of  $ payable  to 

the  Canadian  Nurses'  Foundation  is  enclosed 
and  is  to  be  applied  as  indicated  below: 

MEMBERSHIP  (payable  annually) 


Nurse  Member  — 

Regular             $     2.00 

Sustaining         $  50.00 

Patron               $500.00 

Public  Member  — 

Sustaining         $   50.00   

Patron                $500.00 

BURSARIES  $ 

RESEARCH  $ 

MEMORIAL  $ 

in  memory  of  

Name  and  address  of  person  to  be  notified  of 
this  gift  

REMIHER  

Address    

(Print  name  in  full) 

Position    

Employer    

N.B.:  CONTRIBUTIONS  TO  CNF 
ARE  DEDUCTIBLE  FOR  INCOME  TAX  PURPOSES 


Index 

to 

advertisers 

ApriM971 


Abbott  Laboratories  Ltd 8.  9 

Baxter  Laboratories  of  Canada 2 1 

Burroughs  Wellcome  &  Company 

(Canada)   Limited 31 

Clinic  Shoemakers 2 

Charles E.  Frosst&Co 22.59 

Hollister  Limited 18 

LV.  Ometer.  Inc 23 

Johnson  &  Johnson  Limited Cover  III 

LaCross  Uniform  Corp 25 

J.B.  Lippincott  Company 

of  Canada  Limited 19.27 

C.V.  Mosby  Company.  Ltd 10 

Nursing  Opportunities 15 

Octo  Laboratory  Ltd 32 

J.T.  Posey  Company 6 

Reeves  Company Cover  IV 

W.B.  Saunders  Company  Canada  Ltd I 

Julius  Schmid  of  Canada  Ltd 5 

Scholl  Mfg.  Co.  Limited 17 

Smith  &  Nephew  Limited 1 3 

White  Cross  Shoes 26 

White  Sister  Uniform,  Inc Cover  II 

Winley-Morris  Company  Ltd 58 

Advertising 

Manager 

Ruth  H.  Baumel, 

The  Canadian  Nurse 

50  The  Driveway 

Ottawa  4,  Ontario 

Advertising  Representatives 
Richard  P.  Wilson 
219  East  Lancaster  Avenue 
Ardmore,  Penna.  19003 

Vance  Publications, 
2  Tremont  Crescent 
Don  Mills,  Ontario 

Member  of  Canadian  

Circulations  Audit  Board  Inc. 


APRIL  1971 


THE  CANADIAN   NURSE     79 


PROVINCIAL  ASSOCIATIONS  OF  REGISTERED  NURSES 


Alberta 

Alberta  Association  of  Registered  Nurses, 
10256 —  1 12  Street,  Edmonton. 
Pres.:  M.G.  Purcell;  Pres.-Elect:  R.  Erick- 
son;  Vice-Pres.:  D.E.  Huffman,  A.J.  Prowse. 
Committees — Niirs.  Serv.:  G.  Clarke; 
Niirs.  Ediic:  G.  Bauer;  Staff  Ni4rses:  L.A. 
Meighen;  Superv.  Nurses:  L.  Bartlett;  Soc. 
&  Econ.  Welf.:  I.  Mossey.  Provincial  Office 
Staff — Pub.  Rel.:  D.J.  Labelle;  Employ. 
Rel.:  Y.  Chapman;  Committee  Advisor: 
H.  Cotter;  Registrar:  D.J.  Price;  Exec.  Sec: 
H.M.  Sabin;  Office  Manager:  M.  Garrick. 

British  Columbia 

Registered  Nurses'  Association  of  British 
Columbia,  2130  West  12th  Avenue,  Vancou- 
ver 9. 

Pres.:  M.D.G.  Angus;  Past  Pres.:  M.  Lunn; 
Vice-Pres.:  R.  Cunningham,  A.  Baumgart; 
Hon.  Treasurer:  T.J.  McKenna;  Hon.  Sec: 
Sr.  K.  Cyr.  Committees — Nurs.  Educ: 
E.  Moore;  Nurs.  Serv.:  J.M.  Dawes;  Soc. 
&  Econ.  Welf:  R.  Mcfadyen;  Finance: 
T.J.  McKenna;  Leg.  &  By-Laws:  Norman 
Roberts;  Pub.  Rel.:  H.  Niskala;  Exec  Di- 
rector: F.A.  Kennedy;  Registrar:  H.  Grice; 
Director  Communications  serv.:  C.  Marcus. 

Manitoba 

Manitoba  Association  of  Registered  Nurses, 
647  Broadway  Avenue,  Winnipeg  1 . 
Pres.:  M.E.  Nugent;  Past  Pres.:  D.  Dick; 
Vice-Pres.:  P.  McNaught,  Sr.  T.  Caston- 
guay.  Committees — Nurs.  Serv.:  i.  Robert- 
son; Nurs.  Educ:  S.J.  Winkler;  Soc.  &  Econ. 
Welf:  S.J.  Paine;  Legis.:  M.E.  Wilson;  Ac- 
crediting: M.E.Jackson;  Board  of  Examiners: 
E.  Cranna;  Educ.  Fund:  M.  Kullberg;  Fi- 
nance: B.  Cunnings;  Pub.  Rel.  Officer:  T.M. 
Miller;  Registrar:  M.  Caldwell;  Exec.  Di- 
rector: B.  Cunnings;  Coordinator  of  Contin. 
Educ:  H.  Sundstrom. 

New  Brunswick 

New  Brunswick  Association  of  Registered 
Nurses,  23 1  Saunders  Street,  Fredericton. 
Pres.:  H.  Hayes;  Past  Pres.:  I  Leckie;  Vice- 
Pres.:  A.  Robichaud,  L.  Mills;  Hon.  Sec: 
M.  MacLachlan.  Committees —  Soc.  &  Econ. 
Welf:  B.  Leblanc;  Nurs.  Educ:  Sr.  H.  Ri- 
chard; Nurs.  Serv.:  Sr.  M.L.  Gaffney;  Fi- 
nance: A.  Robichaud;  Legist.:  M.  MacLach- 
lan; Exec  Sec:  M.J.  Anderson;  Registrar: 
E.M.  O'Connor;  Adv.  Com.  to  Schools 
of  Nurs.:  Sr.  F.  Darrah;  Nurs.  Assl.  Comm.: 
A.  Dunbar;  Liaison  Officer:  N.  Rideout; 
Employ.  Rel.  Officer:  G.  Rowsell. 

Newfoundland 

Association  of  Nurses  of  Newfoundland, 
67  LeMarchand  Road,  St.  John's. 
Pres.:  P.  Barrett;  Past  Pres.:  E.  Summers; 
Pres.  Elect.:  E.  Wilton;  1st  Vice-Pres.:  J. 
Nevitt;  2nd  Vice-  Pres.:  E.  Hill;  Committees 
—  Nurs.  Educ:  L.  Caruk;  Nurs.  Serv.:  A. 
Finn;  Soc.  &  Econ.  Welf:  L.  Nicholas; 
80     THE  CANADIAN  NURSE 


Exec  Sec:  P.  Laracy;  A.Kst.  Exec.  Sec:  M. 
Cummings. 

Nova  Scotia 

Registered  Nurses'  Association  of  Nova 
Scotia,  6035  Coburg  Road,  Halifax. 
Pres.:  1.  Fox;  Past  Pres.:  J.  Church;  Vice- 
Pres.:  Sr.  C.  Marie,  M.  Bradley,  E.J.  Dob- 
son;  Advisor,  Nurs.  Educ:  Sr.  C.  Marie; 
Advisor,  Nurs.  Serv.:  J.  MacLean.  Com- 
mittees—  Nurs.  Educ:  Sr.  J.  Carr;  Nurs. 
Serv.:  G.  Smith;  Soc.  &  Econ.  Welf:  Roy 
Harding;  Exec.  Sec:  F.  Moss;  Pub.  Rel.  Of- 
ficer: G.  Shane;  Employ.  Rel.  Officer:  M. 
Bentley. 

Ontario 

Registered  Nurses'  Association  of  Ontario, 
33  Price  Street,  Toronto  289. 
Pres.:  L.E.  Butler;  Pres.  Elect:  M  J.  Flaherty. 
Committees — Socio.-Econ.  Welf:  M.E.B. 
Purdy;  Nursing:  E.  Valmaggia;  Educator: 
A.E.  GrifFm;  Administrator:  M.A.  Liddle; 
Exec.  Director:  L.  Barr;  A.'^st.  Exec:  Di- 
rector: D.  Gibney;  Employ.  Rel.  Director: 
A.S.  Gribben;  Coord..  Formal  Contin.  Educ 
Program:  L.C.  Peszat;  Director,  Prof.  Devel. 
Dept.:  CM.  Adams;  Pub.  Rel.  Officer:  I. 
LeBourdais;  Regional  Exec  Sec:  I.W. 
Lawson,  M.I.  Thomas,  F.  Winchester. 

Prince  Edward  Island 

Association  of  Nurses  of  Prince  Edward 
Island,  188  Prince  Street,  Charlottetown. 
Pres.:  C.  Corbett;  Past  Pres.:  B.  Rowland; 
Vice-Pres.:  B.  Robinson;  Pres.  Elect.:  E. 
MacLeod.  Committees — Nurs.  Educ: 
M.  Newson;  Nurs.  Serv:  S.  Griffin;  Pub; 
Rel.:  C.  Gordon;  Finance:  Sr.  M.  Cahill; 
Legis.  &  By-Laws:  H.L.  Bolger;  Soc.  & 
Econ.  Welf:  F.  Reese;  Exec.  Sec-  Registrar: 
H.L.  Bolger. 

Quebec 

Association  of  Nurses  of  the  Province  of 
Quebec,  4200  Dorchester  Boulevard,  West, 
Montreal. 

Pres.:  H.D.  Taylor;  Vice  Pres.:  (Eng.)  S. 
O'Neill,  R.  Atto;  (Fr.):  R.  Bureau,  M.  La- 
lande;  Hon.  Treas.:  J.  Cormier;  Hon.  Sec: 
R.  Marron.  Committees — Nurs.  Educ: 
M.  Callin,  D.  Lalancette;  Nurs.  Serv.:  E. 
Strike,  C.  Gauthier;  Labor  Rel.:  S.  O'Neill, 
G.  Hotte;  School  of  Nurs.:  M.  Barrett.  P. 
Proveni;al;  Legis.:  Sr.  M.  Bachand,  M.  Mas- 
ters; Sec-Registrar:  N.  Du  Mouchel. 
Mouchel. 

Saskatchewan 

Saskatchewan  Registered  Nurses  Association, 
2066  Retallack  Street.  Regina. 
Pres.:  M.  McKillop;  Past  Pres.:  A,  Gunn; 
l.<it  Vice-Pres.:  E.  Linnell;  2nd  Vice-Pres.: 
C.  Boyko.  Committees — Nurs.  Educ:  C. 
O'Shaughnessy;  Nurs.  Serv.:  J.  Belfry;  Chap- 
ters &  Pub.  Rel.:  M.  Harman;  Soc.  &  Econ. 
Welf:  E.  Fyffe;  Exec.  Sec:  A.  Mills;  Reg- 
istrar: E.  Dumas;  Employ.  Rel.  Officer:  A. 
M.  Sutherland;  Nurs.  Consult.:  E.  Hartig; 
A.'ist.  Registrar:!.  Passmore. 


YY  CANADIAN 

\^        NURSES- 


ASSOCIATION 


Board  of  Directors 

President  E.  Louise  Miner 

President-Elect 

Marguerite  E.  Schumacher 

1st  Vice-  President 

Kathleen  G.  DeMarsh 

2nd  Vice-President 

Huguette  Labelle 

Representative  Nursing  Sisterhoods 

...Sister  Cecile  Gauthier 
Chairman  of  Committee  on  Social  & 

Economic  Welfare  ..Marilyn   Brewer 
Chairman  of  Committee  on 

Nursing  Service  ...Irene  M.   Buchan 
Chairman  of  Committee  on  Nursing 
Education   Alice  J.  Baumgart 


Provincial  Presidents 

AARN  M.G.   Purcell 

RNABC  M.D.G.  Angus 

MARN   M.E.  Nugent 

NBARN   H.  Hayes 

ARNN   P.   Barrett 

RNANS  J.  Fox 

RNAO  L.E.  Butler 

ANPEI   C.  Corbett 

ANPQ  H.D.  Taylor 

SRNA    M.  McKillop 


National  Office 

Executive 

Director   Helen  K.  Mussallem 

Associate  Executive 

Director  Lillian  E.   Pettigrew 

General 

Manager  Ernest  Van  Raalte 


Research  and  Advisory  Services 

Nursing 
Coordinator  Harriett  J.T.  Sloan 

Research  Officer H.  Rose  Imai 

Library Margaret  L.  Parkin 

Information  Services 

Public  Relations  Doris  Crowe 

Editor.  The  Canadian 

Nurse Virginia  A.  Lindabury 

Editor.  L'infirmiere 
canadienne    Claire  Bigue 


APRIL  197  « 


May  1971 


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UNIVERSITY   OF  0Tt/,«. 
SCHOOL   OF   NUR<^?JJ^""^ 

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nurses  in  prison 

a  community  clinic 
where  people  count 

the  research  process 


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THIS  IS  THE  WAY  IT  IS 


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lAfHITE 
SISTER 


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8  TESTED  AND  PROVEN  TEXTS . . . 


FUNDAMENTALS    OF    NURSING:    The    Humanities    and 

Sciences  in  Nursing 

By  llinor  Y.  Fuerst,  R.N.,  M.A.,  and  LuVerne  Wolff.  UN.,  M.A. 

This  extensively  revised  and  expanded  edition  reflects  greatly  increased 
emphasis  upon  the  independent  functions  Implicit  in  the  nursing  role. 
Klighlighted  are  nursing  responsibilities  that  include  care  of  man  as  a 
human  being  as  well  as  a  biological  organism.  Nursing  measures, 
fundamental  to  the  core  of  all  patients,  have  been  added  and  others 
updated.  Stressed  are  the  physiologic,  pathologic  and  psychosocial 
bases  for  nursing  intervention. 
446    Pages  166    Illustrations  4th    Edition,    1969  $8.00 


BASIC  PHYSIOLOGY  AND  ANATOMY 

By  Ellen  E.  Chaffee,  R.N.,  M.N.,  M.  Litt.  and  Esther  M.  Greisheimer, 
Ph.D.,  M.D. 

This  skillful  blending  of  the  two  sciences  provides  the  student  with  a 
VIVID  picture  of  living  man.  Revised  and  updated  to  reflect  recent 
research  findings  in  bioscience,  this  edition  has  enhanced  value  as  a 
basic  text  for  students  of  nursing  and  allied  health  fields.  Chapter-end 
summories  and  review  questions  combine  to  stimulate  and  guide  the 
student. 

634    Pages  412    Illustrations,    45    in    Color,    plus    Videograf® 

2nd  Edition,  1969  $9.75 

BASIC  MICROBIOLOGY 

Margaret   F.    Wheeler,   R.N.,   A.B.,   A.M.;   Wesley   A.    Yolk.   Ph.D. 

A  foundation  text  particularly  designed  for  students  in  the  health 
fields.  The  Second  Edition  has  been  entirely  reset  and  features  an 
attractive,  highly  readable  format.  All  chopters  have  been  updated 
in  accordance  with  recent  developments  in  the  field,  with  many  areas 
treated  in  greater  depth.  Special  attention  has  been  given  to  the 
spectacular  advances  in  genetics,  with  emphasis  on  microbial  genetics, 
cell  structure,  and  immunology.  DNA,  RNA,  and  protein  synthesis  are 
presented  so  that  the  student  can  easily  grasp  the  fundamental  me- 
chanisms of  synthesis  and  control  of  macromolecules. 
410  Pages  182   Illustrations  Second   Edition,   1969  $9.00 

Cooper's  NUTRITION   IN   HEALTH  AND  DISEASE 

By  Helen  S.  Mitchell,  Ph.D.,  Sc.D.,  Hendeirka  J.  Rynbergen,  M.S., 
Linnea    Anderson,    M.P.H.,   and   Marjorie    Y.    Dibble,    M.S. 

A  comprehensive  survey  of  the  principles  of  nutrition  and  their  ap- 
plication to  normal  and  therapeutic  needs  is  presented  in  the  15th 
Edition  of  this  classic  text.  Additional  emphasis  is  given  to  the  under- 
lying biochemical  and  physiological  components  of  nutrition  as  they 
affect  the  maintenance  or  restoration  of  optimum  health. 
685   Pages  121    llustrotions  15th    Edition,   1968  $9.50 


PHARMACOLOGY  AND  DRUG  THERAPY  IN  NURSING 

By    Morton    J.    Rodman,    M.S.,    Ph.D.,    and    Dorothy    W.    Smith,    R.N., 
M.S.,  Ed.D. 

Thrs    text's    pharmacodynamic    approach    provides    the    student    with    a 

true  understanding  of  the  nature  of  drug  action  and  a  sound  rationale 

for    nursing    intervention.    Covers    sources,    dosage,    physiologic    action, 

untoward  effects,  contraindications  and  implications  for  nursing  action. 

". . .  the  text.  Pharmacology  and  Drug  Therapy  in  Nursing,  stands  head 

and  shoulders  above  all  other  pharmacology  books  written  for  nurses." 

— American   Journal   of  Pharmaceutical  Education 

"...  a    textbook    of    superb    quality . . ." — from    "Books    of    the    Year," 

American  Journal  of  Nursing 

738    Pages  lllustroted  1968  $10.25 

TEXTBOOK   OF  MEDICAL-SURGICAL   NURSING 

By   Lillian   S.   Brunner,   R.N.,   M.S.;   Charles   P.   Emerson,   Jr.,   M.D.;   L. 
Kraeer   Ferguson,   M.D.;   and   Doris   S.   Suddarth,   R.N.,   M.S.N. 

Massively  revised  and  enlarged  in  scope,  this  edition  is  designed  to 
develop  the  highest  degree  of  expertise  in  the  care  of  medical/surgical 
patients.  Exceptional  in  its  depth  of  pathophysiologic  content,  this  text 
ahso  emphasizes  the  psychosocial  factors  involved  in  patient  care. 
New  material  is  included  on  vascular/cardiac/respirotory  intensive 
care  nursing/neurologic  and  neurosurgical  problems/burns/genitourinary 
and  gynecologic  disorder/rehabilitative  measures. 
1031   Pages  387  Illustrations  2nd  Edition,  1970  $14.95 

NURSING  CARE  OF  CHILDREN 

By    Florence    G.    Blake,    R.N..    M.A..    F.    Howell    Wright.    M.D.,    and 
Eugenia   H.    Waechter,   R.N.,   Ph.D. 

Extensively  revised  and  exponded,  with  numerous  new  illustrations, 
this  superb  text  is  without  peer  as  a  comprehensive,  in-depth  study 
of  pediatric  nursing.  Recent  findings  in  all  areas  of  care  are  included 
— growth  and  development  (from  infancy  to  adolescence)  medical 
entities;  associated  nursing  therapies.  Consideration  is  given  to  prob- 
lems of  minority  groups  and  cultural  differences,  the  battered-child 
syndrome,  and  contemporory  problems  of  the  adolescent. 
588   Pages  254    Illustrations  8th    Edition,   1970  $9.50 

BASIC  PSYCHIATRIC  CONCEPTS  IN  NURSING 

By    Charles    K.    Hofling,    M.D.,    Madeleine    M.    Leininger,    R.N.,    Ph.D., 
and  Elizabeth   A.   Bregg,  R.N.,   B.S. 

By  presenting  basic  concepts  useful  in  all  areas  of  nursing,  the  authors 
provide  content  and  method  essential  to  the  practice  of  professional 
nursing  in  the  nonpsychiatric  as  well  as  the  psychiatric  setting. 
Emphasis  throughout  rs  on  nursing  care  and  the  nurse's  significant 
role,  OS  well  as  on  problem  solving,  process  recording  and  short  and 
long-term  nursing  goals. 
583    Pages  2nd    Edition,    1967  $7.25 


CONSIDER  THESE  OUTSTANDING 
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SERVING  THE  HEALTH  PROFESSIONS   IN  CANADA  SINCE   1897 


THE  CANADIAN   NURSE 


MAY  1971 


The 

Canadian 
Nurse 


^ 

^^7 


A  monthly  journal  for  the  nurses  of  Canada  published 

in  English  and  French  editions  by  the  Canadian  Nurses'  Association 


Volume    67,     Number    5 


May    1971 


33  Report:   CNA  Annual  Meeting 

37  Nurses  in  Prison G-  Norens 

40  The  Research  Process L.E.  Heidgerken 

44  Problems,  Issues,  Challenges 

of  Nursing  Research F.G.  Abdellah 

47  A  Community  Clinic  Where  People  Count L.E.  Lockeberg 

5 1  Young  Diabetics  Enjoy  Camp,  Too D.  Fitzgerald 

54  The  Subcutaneous  Injection M.  Pitel 


The  views  expressed  in  the  various  articles  are  the  views  of  the  authors  and  do  not 
necessarily  represent  the  policies  or  views  of  the  Canadian  Nurses'  Association. 


4  Letters 

24  New  Products 

29  Dates 

58  Books 


7  News 

26  Names 

30  In  a  Capsule 

60  Accession  List 


Executive  Director:  Helen  K.  Mussallem  • 
Editor:  Virginia  A.  Lindabury  •  Assistant 
Editor:  Liv-Ellen  Lockeberg  •  Editorial  As- 
sistant: Carol  A.  Kollarsky  •  Production 
Assistant:  ElizatKth  A.  Stanlon  •  Circula- 
tion Manager:  Berjl  Darling  •  Advertising 
Manager:  'Ruth  H.  Baumel  •  Subscrip- 
tion Rates:  Canada:  one  year,  $4.50;  two 
years,  $8.00.  Foreign:  one  year,  $5.00;  two 
years,  $9.00.  Single  copies:  50  cents  each. 
Make  cheques  or  money  orders  payable  to  the 
Canadian  Nurses'  Association.  •  Change  of 
Address:  Six  weeks'  notice;  the  old  address  as 
well  as  the  new  are  necessary,  together  with 
registration  number  in  a  provincial  nurses' 
association,  where  applicable.  Not  responsible 
for  journals  lost  in  mail  due  to  errors  in 
address. 


.Manuscript  Information:  "The  Canadian 
Nurse"  welcomes  unsolicited  articles.  All 
manuscripts  should  be  typed,  double-spaced, 
on  one  side  of  unruled  paper  leaving  wide 
margins.  Manuscripts  are  accepted  for  review 
for  exclusive  publication.  The  editor  reserves 
the  right  to  make  the  usual  editorial  changes. 
Photographs  (glossy  prints)  and  graphs  and 
diagrams  (drawn  in  india  ink  on  white  paper) 
are  welcomed  with  such  articles.  The  editor 
is  not  committed  to  publish  all  articles 
sent,  nor  to  indicate  definite  dates  of 
publication. 

Postage^  paid  in  cash  at  third  class  rale 
MONTREAL,  P.O.  Permit  No.  10,001. 
50  The  Driveway,  Ottawa,  Ontario.  K2P  1E2 
O  Canadian  Nurses'  Association  1971. 


Editorial 


MAY  1971 


A  few  months  ago,  the  Canadian  Psy- 
chiatric Association  took  a  stand  againsi 
the  Soviet  Union's  practice  of  commit 
ting  to  mental  hospitals  sane  person: 
who  disagree  with  aspects  of  Sovie 
society.  (News,  page  12.) 

Some  will  say  that  this  stand,  taker 
by  a  relatively  small  association  ( !,80C 
members),  will  have  little  effect  ir 
persuading  the  USSR  to  cease  thi; 
inhumane  practice.  Others  will  say  it  ii 
not  the  purpose  of  a  professional  organ 
ization  to  become  involved  in  the  inter 
nal  affairs  of  another  country. 

We  say  this  is  a  courageous  stanc 
taken  by  a  dynamic  organization  thai 
has  raised  its  sights  above  the  pedantic 
trivialities  that  sometimes  beset  pro 
fessional  associations.  We  believe  it  i) 
the  kind  of  stand  that  more  association; 
should  take.  Can  any  health  professior 
in  Canada  afford  to  sit  back  compla 
cently  and  discuss  'the  delivery  of  hcaltl 
care"  in  our  own  country  and  ignore 
what  is  going  on  in  the  world? 

We  are  not  implying  that  healtf 
professions  in  Canada,  including  the 
Canadian  Nurses"  Association,  shoulc 
cease  to  strive  for  the  best  possible 
health  services  for  the  country's  citi 
zens.  What  we  are  suggesting  is  tha 
we  must  go  beyond  this. 

Perhaps  we  will  even  have  to  gc 
beyond  what  our  own  governments  an 
saying  —  or  not  saying.  For  example 
what  government  in  the  Western  democ 
racies  has  taken  a  stand  against  the 
war  in  Vietnam?  What  governmcn 
has  condemned  the  slaughter  of  th< 
citizens  of  Vietnam,  as  evidenced  b) 
the  Mylai  atrocity? 

Politics,  you  say?  Another  country '< 
affairs  that  in  no  way  concern  the  healtl 
professions?  We  wonder. 

We  only  know  that  as  we  write  thii 
editorial  today,  Easter  Sunday,  we 
cannot  ignore  what  is  happening  arounc 
us.  We  cannot,  in  all  conscience,  avoic 
raising  these  questions  of  involvemem 
on  a  global  basis.  As  Robert  Jay  Liftor 
wrote  in  an  article  entitled  "Beyonc 
Atrocity"  {Saturday  Review,  March  27 
1 97 1 ),  "The  task  ...  is  to  confroni 
atrocity  in  order  to  move  beyond  it.' 

—  V.A.L 
THE  CANADIAN  NURSE       3 


letters 


Letters  to  the  editor  are  welcome. 

Only  signed  letters  will  be  considered  for  publication,  but 

name  will  be  withheld  at  the  writer's  request. 


Quebec's  Bill  64 

The  writer  of  this  letter  was  quoted  by 
The  Canadian  Nurse  (News,  March 
197] ,  pp.  10  and  12)  in  an  item  con- 
cerning Quebec's  Bill  64.  Here  are  her 
comments. 

In  February,  I  was  asked  by  the  jour- 
nals, in  a  telephone  interview,  to  give 
my  personal  opinion  on  Bill  64.  I  wish 
to  point  out  that  no  "loophole  in  the 
law"  was  mentioned  by  me  and  that  I 
did  not  speak  on  behalf  of  the  Associa- 
tion of  Nurses  of  the  Province  of  Que- 
bec as  indicated  on  page  12  of  the 
March  1971  issue.  —  Cecile  Gauvin, 
R.N.,  Assistant  Registrar,  ANPQ. 

Concerned  about  Bill  64 

As  an  English-speaking  immigrant  to 
Canada,  I  was  most  distressed  to  read 
the  news  item,  "Migrant  Nurses  to  At- 
tend French-Language  Classes,"  (News 
March  1971). 

I  assume  from  the  item  that  if  I  should 
move  to  Quebec,  then  1  would  have  to 
prove  a  working  knowledge  of  French 
before  I  could  join  the  professional 
nursing  association  and  gain  employ- 
ment as  a  registered  nurse  in  that  prov- 
ince. It  appears  that  English-speaking 
Canadian  nurses  do  not  have  to  prove  a 
working  knowledge  of  French,  nor  do 
French-speaking  Canadian  nurses  have 
to  prove  a  working  knowledge  of  Eng- 
lish to  join  this  same  professional  nurs- 
ing organization  and  to  gain  employ- 
ment as  a  registered  nurse  in  this  same 
province. 

Is  this  not  outright  discrimination 
against  the  immigrant  —  requiring 
her  to  meet  standards  that  any  other 
Canadian  nurse  does  not  have  to  meet? 

This  is  a  law  that  makes  some  nurses 
second-class  members  of  the  Quebec 
nurses'  organization.  What  is  the  Cana- 
dian Nurses'  Association  doing  to  bring 
about  the  removal  of  Bill  64  and  to 
prevent  further  such  legislation?  — 
Barbara  Kisilevsky,  R.N.,  M.N.,  Kings- 
ton, Ontario. 

Listening  to  the  layman 

Thank  you  for  your  March  editorial 
about  nurses"  attitudes  toward  relatives 
and  friends  of  patients.  I  was  particu- 
larly struck  by  your  question,  "...  do 
we  brush  aside  their  concerns,  believ- 
ing we  are  dealing  with  troublesome 
visitors  who  are  trying  to  interfere  with 
the  care  we  believe  is  best?"  How  often 
4       THE  CANADIAN   NURSE 


we  do  just  that!  I  particularly  remember 
my  three  years  in  an  intensive  care 
unit:  the  heavy  work  load,  the  extreme 
concern  and  fear  of  relatives,  and  the 
tension  caused  by  combining  these  two 
factors.  We  seldom  had  time  to  talk  to 
visitors,  much  less  listen  to  them. 

When  I  left  ICU  nursing  for  the  field 
of  chronic  hemodialysis,  I  found  myself 
in  an  entirely  different  situation.  We 
come  to  know  our  patients  extremely 
well,  since  they  spend  two  or  three  days 
a  week  under  our  care.  Occasionally 
a  close  relative  calls  us  to  describe  some 
problem  or  symptom  a  patient  has 
complained  of  at  home,  but  has  not 
mentioned  to  us.  These  comments  are 
invaluable  in  planning  the  long-term 
care  and  rehabilitation  of  our  patients. 

It  is  sometimes  difficult  for  a  skilled 
professional  person  to  admit  a  layman 
can  offer  useful  and  helpful  advice.  But 
perhaps  the  greatest  virtue  a  profession- 
al nurse  can  possess  is  humility  —  a 
genuine  awareness  of  how  little  she 
really  knows  about  life  and  a  constant 
willingness  to  learn  from  any  and  every 
available  source.  Such  willingness  cer- 
tainly includes  a  sincere  interest  in  her 
patients'  relatives  and  in  their  concerns, 
suggestions,  and  observations.  This  is 
an  integral  part  of  the  art  and  science  of 
professional  nursing! ' —  Christine  Frye 
Reg.  N.,  Ottawa. 


Abortion  and  the  Criminal  Code 

In  reference  to  the  stand  taken  by  the 
Canadian  Psychiatric  Association,  I 
was  surprised  to  read  that  "all  nurses 
who  were  interviewed  agreed  abortion 
should  be  removed  from  the  Criminal 
Code"  (News,  Feb.  1971). 

I  have  been  a  nurse  for  over  30  years 
and  have  intellectualized  about  abor- 
tions in  my  day.  I  have  seen  tragedies, 
such  as  the  death  of  four-year-old 
Ewan's  mother  who  died  of  septicemia 
after  a  self-procured  abortion. 

I  have  also  read  the  statistics  and 
heard  the  arguments  pro  and  con.  These 
arguments  are  not  new,  but  they  are 
more  vociferous  and  better  written 
than  ever.  The  grammar  is  good,  the 
style  is  polished,  the  logic  seems  irrefut- 
able. Is  it  any  wonder  that  young  people 
are  bewildered?  Instead  of  arguments, 
I  would  like  to  offer  an  anecdote  from 
my  own  experience. 

Recently  I  had  a  patient,  a  young 
married  woman,  who  had  had  a  dila- 


tion and  curettage  following  an  inevit- 
able abortion.  When  I  went  into  her 
room  to  tell  her  she  could  go  home 
and  offered  to  phone  her  husband  for 
her,  I  found  her  sobbing.  As  I  was  a 
bit  out  of  touch  with  this  branch  of 
nursing,  having  done  more  medical  and 
orthopedic  work  in  recent  years,  I  told 
the  head  nurse  that  the  patient  seemed 
acutely  depressed.  The  head  nurse 
said,  "Oh,  that's  O.K.  She'll  get  over 
that  faster  at  home.  Dr.  C.  (the  gyne- 
cologist) says  this  is  routine  following 
a  D.  &  C. 

Young  nurses  have  chosen  a  noble 
(excuse  the  old-fashioned  word)  profes- 
sion because  they  are  normal,  healthy 
young  women  and  nursing  is  something 
women  traditionally  have  done  well. 
These  girls  also  have  the  same  dreams 
and  aspirations  my  colleagues  and  I 
had  30  years  ago.  They  want  love  and 
motherhood,  not  empty  arms  and  an 
aching  heart.  But  they  are  bombarded 
with  articles  like  "Motherhood' — 
Who  Needs  It?"  in  a  popular  family 
magazine,  and  films  like  "Mash"  in 
which  the  men  they  most  admire  (young 
doctors,  who  else?)  perform  scientific 
miracles  in  the  operating  room  and 
behave  like  gangsters  outside  of  it. 

Let  us  think  twice  before  removing 
abortion  from  the  Criminal  Code.  How- 
ever, let  us  make  sure  our  magistrates 
who  enforce  the  laws  are  ethical  men 
and  also  men  who  believe  the  law  must 
be  enforced  non-punitively.  —  Mrs. 
Kay  Eliason,  R.N.,  Winnipeg,  Man. 


Head  nurse  problem 

I  wonder  whether  a  survey  has  ever 
been  made  of  a  nursing  problem  I  am 
sure  is  Canada-wide.  The  problem 
that  concerns  me  is  the  change  that 
takes  place  when  nurses  —  pleasant 
nurses  —  become  head  nurses  and 
almost  overnight  become  officious 
tyrants. 

Conscientious  staff  members,  some 
of  whom  may  have  worked  in  this  place 
for  years,  suddenly  cannot  do  anything 
right.  These  head  nurses  seem  to  stop 
liking  their  staff.  Why? 

Yet  other  head  nurses,  who  are  just 
as  efficient,  maintain  a  good  rapport 
with  their  staff.  The  patient  reaps  the 
benefits  of  this  rapport. 

Could  someone  write  an  article  on 
how  to  be  a  good  head  nurse?  —  R.N., 
Steinbach,  Manitoba.  ■§■ 

MAY  1971 


Personalized  CAP-TOTE  c^az 

Youf  caps  stay  crisp,  sharp  and  clean 
when  stored  or  carried  in  this  clever 
carry-all.  Clear,  non-creasing  flexible 
plastic  bag  with  white  trim,  has  zipper 
around  top,  carrying  strap  and  hang 
loop.  Squeezes  fiat  tor  easy  storage 
when  not  in  use.  Also  great  tor  wiglets,  _. 

curlers  or  whatever.  8Vi"  dia„  6"  high.  ^*^   "'^ 

No.  333  Tote  (no  Initials) . . .  2.50  ea.  ppd.      ^ 
SPECIAL !  6  or  more  totes,  only  2.2S  ea. 

INITIAIS  up  to  3  gold  embossed  on  top  . . .  ^ 

add  .50  per  Tote. ..,,^-^^ 

Personalized  MINI-SCISSORS 

Tiny,     useful,     precision-made     bandage 

scissors,  only  Vh"  long!  Slip  perfectly 

Only  ^X^'^'C!'^      '"*°  uniform  pocket  or  purse.  Two  year 

3V,"       y^'''^ r  guarantee  included-  Ctioose  jewelers  Gold 

lonfi^x^j%- — '^— ~^        or  gleaming  Chrome  plate  finish. 

P^^  No.  1 238  Scissors  (no  initials) . . .  2.25  ei.  ppd. 
SPECIAL!  1  doz.  scissors  for  just  S20.  ppd. 
ENGRAVING  up  to  3  initials,  add  .50  per  scissor. 

D«„«„,,!„H  BANDAGE  ^XjeJ)    "'^ 

Personalized    SHEARS  - 

6"  professional  precision  shears,  forged  long 

in  steel.  Guaranteed  to  stay  sharp  2  years. 

No.  1000  Shears  (no  initials) 250  ea.  ppd.  ^ -, 

SPECIAL!  1  Doz.  Shears $24. total       f 

Initials  (up  to  3)  etched add  50c  per  pair       ^-^^ 

T        All  Metal  CAP  TACS 

/l/V^^  Fine  selection  of  dainty,   jewelry-quality  Cap 
^*V^y  Tacs  to  hold  cap  bands  securely.  All  sculptured 
V    metal,  polished   gold  finish,  with  clutch  fas- 
n_j3?n  tenets,  approx.  H"  wide.  Two  Tacs  per  set,  grft- 

L5Lf\kJ  boxed.  Choose  Initial  Tacs  RN,  LPN,  LVN  . . .  or 

^    Plain  Caduceus  ,  .  ,  or  RN  Caduceus.  Specify 
'■  -      choice. 

i   No.  CT-1  Initial  Tacs         ) 
No.  CT-2  Plain  Caduceus    >  . . .  2.50  per  set,  ppd. 
No.  CT-3  RN  Caduceus       } 
SPECIAL!  12  or  more  sets  2.00  per  set  ppd. 


Immm^ 


Personalized 
CROSS  PEN 

with 
Caduceus 


famous  Cross  Writing 
Instrument  with  sculptured  cadu- 
ceus emblem.  Full  name  engraved  FREE 
barrel  (print  name  desired  on  LETTERING 
ne  in  coupon).  Refills  available  at  any  store. 
Lifetime  Guarantee. 

No.  3502  Chrome  Finish 8.00  ea. 

No.6602  12  Kt  Gold  Filled... 11.50ea. 


Nurses'  White  CAP  CLIPS 

Hold  caps  firmly  in  place!  Hard-to-find  wtiite 

bobbie  pins,  enamel  on  fine  spring  steel.  Eight 

2"  and  eight  3"  clips  included  in  plastic  snap 

box. 

No.  529  (  3  boxes  for  1.75, 6  for  3.25, 

Clips      S  7  or  more  49c  per  box.  all  ppd. 


Bzzz  MEMO-TIMER 

We  all  forget!  Time  hot  packs,  siti  baths, 
heat  lamps,  even  parking  meters . . .  remind 
yourself  to  check  vital  signs,  give  medica- 
tion, etc.  Tiny  (only  Wi"  dia.),  lightweight, 
sets  to  bull  at  from  5  to  60  minutes.  White 
plastic  case,  black  and  silver  dial.  Key  ring 
attached.  Swiss  made. 
No.  M-22  Timer . . .  3.98  ea.  ppd. 
SPECIAL!  3  for  9.75,6  or  more  3.00  ea. 


Deluxe  POCKET-SAVER 

No  more  tired  pockets!  Sturdy  pure  white  vinyl, 
with  three  compartments  for  pens,  scissors, 
etc.  Includes  change  pocket  with  snap  closure 
for  coffee  money,  and  key  chain.  4"  wide. 

No.  791  (6  for  2.98, 12  for  4.80, 

Pocket  Saver  \  25  or  more  35c  ea.,  all  ppd. 


NIGHTINGALE  LAMP 

An  authentic,  unique  favor,  gift  or  en- 
graved award!  Ceramic  off-white  can- 
dleholder  with  genuine  gold  leaf  trim. 
Recessed  candle  cup  at  front  (candle 
not  included),  7"  long. 
No.  F  lOOS  Lamp . . .  5.95  ea.  ppd. 
SPECIAL!  12  or  more,  3.95  ea. 
ENGRAVING  up  to  3  initials  and 
date  on  satin  gold  plaque  on  top,  add  1.00  per  lamp. 


Tri-Color  BALL  PEN 

Write  in  black,  red  and  blue  with  one  ball  point  pen. 

Flip  of  tfie  thumb  changes  point  (and  color).  Steno  fine 

point  (excellent  for  charts).  Polished  chrome  finish. 

No,  921  Ball  Pen...  1.50  ea.  ppd. 

SPECIAL!  3  for  3,75,  6  or  more  1.00  ea.  ppd. 

No.  292-R  3-color  Refills ...  50c  ea.  ppd. 


Caduceus  CUFF  LINKS 

Sim.  Molher.of'Pe3tl  set  into  gold  Tintsh  link, 
spring  arm.  Sculptured  gold  fin.  caduceus  with 
or  without  RN.  Gift-boxed. 

No.  403900  LINKS  (plain  caduceus))  3.95 pr. 
No.  403RN  LINKS  (R.N.  Caduceus)  (    ppd 


^ 


Sterling  HORSESHOE  KEY  RING 

Clever,  unusual  design:  one  knob  unscrews  for   in- 
serting  keys.   Fine  sterling   silver   throughout,   with 
sterling  sculptured  caduceus  charm. 
No.  96  Key  Ring 3.75  ea.  ppd. 


, 


EYEGLASS  CADDY  Pin 

Shp  eyeglass  bow  into  loop  tor  safe,  instant 

readiness . . .  avoid  scratching,  breakage.  Sturdy 

pinback.  safety  catch   Gold  or  Silver  plated, 

No.96ICaddy...1.50ea.ppl 

Ne.  961  ST  SterlinE  Silver  Caddy  ...  3.00  aa.  ppd. 


O 


Mrs.  R.  f.  JOHNSON 

SUPERVISOI 


dTJOHN  WILLIAMS 
RESIDENT 

^^^^COHN.L.PN. 

NURSES  CAP-TAGS 


Remove  and  refasten  cap  band  instantly 
for  laundering  and  replacement!  Tiny 
molded  plastic  tac,  dainty  caduceus. 
Choose  Black,  Blue,  White  or  Crystal 
with  Gold  Caduceus,  or  all  black  (plain).  '::,—• 
No.200Setof6Tacs..  1.00  per  set 
SPECIAL!  12  or  more  sets...  30  per  set 


Nurses  ENAMELED  PINS 

Beautifully  sculptured  status  insignia;  2-COlor  keyed, 
hard-fired  enamel  on  gold  plate.  Dime-sized;  pin-back. 
Specify  RN.  LPN,  PN.  LVN,  NA.  or  RPh.  on  coupon. 
No.  205  Enameled  Pin 1^0  ea.  ppd. 


Sel-Fix  NURSE  CAP  BAND 

Black  velvet  band  material.  Self-ad- 
hesive: presses  on.  pulls  off;  no  sewing 
or  pinning.  Reusable  several  times 
Each  band  20"  long,  pre-cut  to  pop- 
ular widths:  Vt"  (12  per  plastic  box), 
W"  (8  per  box).  H"  (6  per  box),  1" 
(6  per  box).  Specify  width  desired  in 
ITEM  column  on  coupon. 


No.  6343 

Cap  6and...l  box  1.50 
3  or  more  1.25  ea. 


Reeves  AUTO  MEDALLIONS 

Lend  professional  prestige.  Two  colors  baked  enamel  on 
gold   Dsckground    Resists   weather    Fused   Stud  and 
Adapter  provided  Specify  letters  desired   RN,  MD,  00. 
RPh.  DOS.  OMD  Of  Hosp.  Staff  (Plain) 
No.  210  Auto  Medallion 5.00  ea.  ppd. 


Professional  AUTO  DECALS 

Your    professional    insignia    on    window    decal. 
Tastefully  designed  in  4  colors,  iVt"  dia    Easy 
to  apply   Choose  RN,  LVN.  LPN  or  Hosp,  Staff. 
No. 621  Decal ...  1.00 ea., 

3  for  2.50,  6  or  more  .60  ea. 


Uniform  POCKET  PALS 

Protects  against  stains  and  wear.  Pliable  white 
plastic  with  gold  stamped  caduceus.  Two  com- 
partments for  pens,  shears,  etc.  Ideal  token  gifts 
or  favors. 

No.  210-E     (  6  for  1.50,  10  for  2.25 
Savers  j  25  or  more  .20  ea.,  all  ppd. 


RN/Caduceus  PIN  GUARD        .^^ 

Dainty  caduceus  tine-chained  to  your  professional    ^ 
letters,  each  with  pinback,  saf,  catct*.  Wear  as  is    2S    7 

or  replace  either  with  your  Class  Pin  for  safety, 
Gold  fin,,  gift-boxed.  Specify  RN,  LVN  or  LPN, 
No.  3240  Pin  Guard 2.95  ppd. 


Personalized  EXAMINING  PENLIGHT 


Deluxe  model  designed  for  Nurses,  with  caduceus 
imprinted  on  white  barrel:  aluminum  band  and 
pocket  clip  FREE  initials  hand-etched  on  band  to 
prevent  loss,  5"  long,  U.S.  made.  Batteries,  bulb 
included  (replacements  any  store).  Plastic  gift  box. 
No.  007  Penlight 3.9S  es.  ppd. 


-I"^' 


r- 


NURSES  CHARMS 

Finest  sculptured  Fistier  cliarms  in  Sterling  or 
Gold  Filled.  Ideal  addition  for  bracelet  or  hang 
on  pendant  chain. 

Choose  No.  263  Caduceus,  No.  164  Nurses 
Cap.  No.  68  Graduation  Hat  or  No.  8  Band- 
age Sfiears 2.75  ea.  ppd. 

Specify  Sterling  or  G.F,  under  COLOR  on  coupofl. 


"Endura"  Waterproof  NURSES  WATCH 

Swiss  made,  raised  silver  full  numerals,  lumin.  mark- 
ings. Red-tipped  sweep  second  hand,  chrome/stainless 
case.  Includes  genuine  black  leather  watch  strap  1 
year  guarantee. 

No.  1093 14.95  ea.  ppd. 


Scrjpto  PILL  LIGHTER 

Famous   Scrjpto   Vu-Lighter   with   crystal-clear   fuel 
chamber  containing  colorful  array  of  capsules,  pills 
and  tablets.  Novel,  unique,  for  yourself  or  for  unusual 
gifts  for  friends.  Guaranteed  by  ScriptO- 
No.  300-P  Pill  Ligtiter  4^5  ea.  ppd. 


fe 


REEVES  NAME  PINS 

Largest-selling  among  nurses!  Superb  lifetime 
quality  . . ,  smootli  rounded  edges .  .  .  feather- 
weight, lies  flat .  .  .  deeply  engraved,  and  lac- 
quered. Snow-white  plastic  will  not  yellow.  Satis- 
faction guaranteed.  GROUP  DISCOUNTS.  Choose 
lettering  in  Black,  Blue,  or  White  (No.  169  only). 

SAVE:  Order  2  identical       liijQ|K||9 

limii  \  1  Name  Pin  only 
l.nili  y  2  Pins  (sane  naniel 

1,75 

2.05      I 

2.60 

3.10      1 

PBjfk  1  Name  Pin  only 
■■Hf  2  Pins  (same  name) 

.85 

—    1 

1.35 

1.90      1 

GROUP  DISCOUNTS:            | 
25-99  pins,  5%;  100  or  more,  10%.     1 

Send  cash,  m.o.,  or  check.  No  billings  or  COD'S.    J 

Nurses'  Personalized 

ANEROID 
SPHYGMOMANOMETER 

A  superb  scientific  instrument  espe- 
cially designed  to  fill  the  needs  of 
today's  busy,  efficient  nurses!  This 
professional  unit  is  imported  from 
precision  craftsmen  in  W,  Germany. 
Easy-to-attach  Velcro  cuff,  light- 
weight,compact,  fits  into  soft  sim 
leather  zippered  case,  only 
2Vi"  X  4"  x  7".  Dial  calibrated 
to  320  mm.  lO-year  accuracy 
guaranteed  to  ±3  mm,  serviced 
and  adjusted  if  ever  required  by 
Reeves  Co,  Your  initials  engraved 
on  manometer  and  gold  stamped  on" 
case  FREE,  to  identify  permanently 
your  own  instrument  and  case  forever. 

No.  106  Sptiyg. . .  26.95  ppd.    6  or  more 


Personalized 

Littmanri 

NURSESCOPE® 


Product 
of  the 


■■coninuiT 


Famous  Litlmann  nurse's  dia- 
phragm stethoscope,  with  your 
initials  individually  engraved 
FREE!  A  fine,  precision  instru- 
ment, has  high  sensitivity  for 
blood  pressures,  general  auscu- 
lation.  Only  2  ois.,  fits  in  pocket 
Full  28"  vinyl  anti-collapse  tub- 
ing New  design  metal-rim  epoxy 
diaphragm  Non-rotating,  correct- 
ly-angled ear  tubes  U  S  made 
Choose  from  5  jewel-lihe  colors: 
Goldtone.  Silvertone.  Blue,  Green, 
Pink 


FREE  ENGRAVED   INITIALS! 

Up  Id  3  initials  permanently  engraved  into  chest  piece,  lends 

individual  distinction,  prevents  loss.  Specify  initials  on  coupon 

No.  216  Nursescope  . . .  13.80  ea.  ppd. 

6-11  ,. .  12.80  ea.  ppd.  12  or  more  ...  11.80  ea.  ppd. 

DUTYFREE 


TO:  REEVES  COMPANY,  Box  719,  Attleboro.  Mass.  02703 


ORDER  NO. 

ITEM 

COLOR 

OUANT. 

PRICE 

NAME  PINS:         D  One  Name  Pin       D  Two.  same  name 

LETT.  COLOR   

METAL  FINISH    

LETTERING  

2nd  line 

INITIALS  as  required 

I  enclose  $ (Sorry,  no  COD's  or  billing  terms) 

Please  add  25<  handling  charge  on  all  orders  under  K. 

Send  to 

Street  

City A> Zip 


♦  yV 


/ 


'    Jt -y 


comfortable/economicalMmesaving/retelast' 

Available  in  9 

different  sizes. 

The  original  tubular 

elastic  mesh  bandage 

allergy  free,  indispensab 

for  hospital  care. 

New  stretch  weave  allo\ 

^  maximum  ventilation  a. 

/   *    •  ^   \  flexibility  for  patient 

I   i    \  ^  \  \  .  comfort  and  speedy  heal 

-'    /  '    '  ^r»i.   '  '  •  -   \  ^  ^      -^ 

/      /      ,     7    '    \  V     '     ""   ^  Demonstration  upon  reqi, 


news 


CNA  Board  Issues  Statement 
On  Family  Planning 

Ottawa  —  Canadian  nurses  must  ac- 
cept more  responsibility  for  promoting 
family  planning  programs  across  the 
country.  This  belief  was  expressed  by 
the  Canadian  Nurses'  Association's 
board  of  directors  on  April  1 ,  the  last 
day  of  its  meeting  at  CNA  House.  The 
statement  on  family  planning,  as  ap- 
proved by  the  board,  reads: 

"The  CNA  believes  that  promotion 
of  health  is  one  of  the  primary  res- 
ponsibilities of  the  nurses  of  this  coun- 
try. Family  planning,  with  its  supportive 
educational  programmes,  is  one  of  the 
methods  that  can  be  used  to  maintain 
health  and  to  contribute  to  the  quality 
of  living  of  our  citizens.  Current  scien- 
tific knowledge  and  an  increasing 
understanding  of  the  whole  process  of 
life  makes  this  planning  feasible. 

"Canadian  nurses  must  accept  the 
responsibility  for  preparing  themselves 
to  participate  intelligently  in  such 
activities.  The  responsibility  for  iden- 
tifying the  need  and  the  urgency  for  ac- 
tion with  a  variety  of  approaches  is 
one  which  nurses  should  not  evade.  As 
citizens,  we  must  urge  the  establishment 
of  family  planning  programmes  across 
the  country." 

The  CNA  board  also  endorsed,  in 
principle,  a  statement  on  abortion.  This 
statement  will  be  sent  to  the  provincial 
nurses'  associations  for  their  reactions 
and  endorsement  by  June  20,  1971. 
If  endorsed  by  a  majority  of  the  pro- 
vincial nurses  associations,  the  state- 
ment will  then  become  the  official  stand 
of  the  CNA. 

CNA  Ad  Hoc  Committee  Gets 
Good  Response  From  Publishers 

Ottawa  —  The  program  of  action  by 
the  ad  hoc  committee  on  French-lan- 
guage textbooks  was  outlined  by  com- 
mittee chairman  Huguette  Labelle,  at 
both  the  Canadian  Nurses'  Association 
annual  meeting  on  March  31  and  the 
board  of  directors  meeting  on  April  1 . 

The  committee's  intention  is  to  pro- 
mote the  production  in  French  of  text- 
books on  nursing  care.  Also,  the  com- 
mittee plans  to  encourage  the  trans- 
lation or  adaptation  of  excellent  basic 
nursing  care  textbooks  which  could  be 
helpful  to  nurses  if  they  were  available 
in  the  French  language. 

Letters  have  been  sent  by  the  com- 
mittee to  publishers  of  English-lan- 
MAY  1971 


Sherry,  a  birthday  cake,  presents,  and  two  special  guests  helped  the  Canadian 
Nurses'  Association  celebrate  a  special  anniversary  April  1 :  Five  years  ago  to 
the  day  CNA  moved  into  its  new  headquarters  at  50  The  Driveway.  The  CNA 
board  of  directors  took  time  out  from  its  three-day  meeting  to  remember  the 
occasion,  and  invited  Evelyn  A.  Pepper,  who  was  vice-chairman  of  the  commit- 
tee that  pioneered  the  creation  of  CNA  House,  and  Dorothy  Percy,  the  build- 
ing's first  visitor,  to  participate  in  the  short  ceremony.  Left  to  right,  M.  Schuma- 
cher, CNA  president  elect;  E.L.  Miner,  president;  Miss  Pepper  and  Miss  Percy; 
Dr.  H.K.  Mussallem,  executive  director  of  the  Canadian  Nurses'  Association. 


guage  nursing  textbooks,  outlining  the 
need  for  textbooks  to  be  published  in 
French.  The  publishers  have  responded 
enthusiastically.  Two  publishers  are 
working  jointly  on  the  translation  and 
publication  of  Fundamentals  of  Patient 
Care:  A  Comprehensive  Approach  to 
Nursing  by  B.  Kozier  and  B.  Du  Gas. 
Six  other  texts  have  been  translated  into 
French  and  are  scheduled  for  publica- 
tion. 

Mrs.  Labelle  said  it  is  possible  the 
committee  will  eventually  act  as  liaison 
between  CNA  and  publishing  firms. 

The  committee  is  also  interested  that 
audiovisual  aids  be  available  in  French. 
It  intends  to  compile  a  listing  of  French- 
language  films  and  tapes  to  provide 
a  basic  source  for  use  in  teaching  by 
French-speaking  nurse  educators. 

CNA  Board  Votes  In  Favor 

Of  Commonwealth  Association 

Ottawa  —  The  Canadian  Nurses'  Asso- 
ciation is  in  favor  of  the  establishment 
of  a  Commonwealth  Nurses'  Federa- 


tion and  will  indicate  its  wish  to  become 
a  Founder  member.  This  decision  was 
made  by  the  CNA  board  of  directors 
at  its  meeting  March  29,  30,  and  April 
1,  1971. 

The  idea  of  establishing  this  Feder- 
ation originated  in  June  1969,  when 
representatives  of  33  Commonwealth 
countries  met  in  Montreal  during  the 
Congress  of  the  International  Council 
of  Nurses  to  decide  if  such  an  associa- 
tion was  needed.  An  ad  hoc  committee 
was  then  set  up  to  take  the  necessary 
action  to  establish  a  Commonwealth 
organization  for  nurses.  Dr.  Helen 
K.  Mussallem,  executive  director  of 
the  CNA,  is  one  of  the  seven  members 
of  this  ad  hoc  committee  and  represents 
the  Atlantic  region. 

A  number  of  Commonwealth  profes- 
sional ass(x:iations  are  already  in  ex- 
istence and  receive  financial  assistance 
from  the  Commonwealth  Foundation. 
A  basic  aim  of  the  Foundation  is  to 
promote  the  growth  of  Commonwealth 
associations,  and  it  has  shown  interest 
THE  CAt^DIAN   NURSE       7 


in  the  work  being  done  to  establish  a 
nurses'  association. 

The  decision  to  establish  a  Common- 
wealth Nurses'  Federation  will  be  made 
July  1,  1971,  when  the  ad  hoc  com- 
mittee, chaired  by  Catherine  M.  Hall  of 
the  United  Kingdom,  will  meet  in  Eng- 
land. By  then  all  nurses'  associations 
in  the  Commonwealth  will  have  maicat- 
ed  whether  or  not  their  associations 
would  support  the  setting  up  of  this 
Federation. 

Board  Grants  DBS 
Access  To  Address  Tapes 

Ottawa  —  At  its  April  1  meeting,  the 
Canadian  Nurses'  Association  board 
of  directors  agreed  to  a  request  from 
the  Dominion  Bureau  of  Statistics  for 
access  to  the  address  listings  of  The 
Canadian  Nurse  and  L'infirmiere  cana- 
dienne.  The  health  and  welfare  division 
of  DBS  is  undertaking  a  series  of  studies 
aimed  at  special  groups  of  nurses,  thus 
it  is  necessary  that  the  Bureau  undertake 
direct  mail  surveys  to  these  groups. 

Since  1970,  registration  torms  re- 
ceived from  the  provincial  nurse  reg- 
istrars have  been  edited  by  CNA  staff 
and  passed  to  DBS  for  processing. 
The  Bureau  has  keypunched,  edited, 
and  tabulated  data  by  computer  to 
produce  statistics  by  provinces  and 
these  data  will  be  published  in  DBS 
publications  for  public  information. 

In  making  the  request,  F.  Harris, 
director,  health  and  welfare  division, 
DBS,  said,  "The  importance  of  ade- 
quate accurate  statistics  on  Canada's 
health  manpower  resources  cannot  be 
overemphasized  tor  both  long-  an<; 
short-range  planning.  Data  are  required 
on  the  basic  counts  of  training  pro- 
fessionals working  both  in  and  out  of 
the  health  field. 

"The  work  of  your  association  in 
developing  model  national  registration 
data  has  been  most  important,  and  the 
system  we  are  proposing  is  based  upon 
your  association's  work  over  the  past 
few  years." 

Mr.  Harris  continued  by  discussing 
the  special  studies,  "We  can  see  the 
necessity  of  cohort  studies  on  the  ca- 
reers of  nurses  who  have  received  dif- 
ferent types  of  basic  training.  We  also 
see  surveys  aimed  at  finding  out  what 
would  be  required  to  bring  people  back 
into  the  health  field  including  those 
who  are  not  employed  or  those  employ- 
ed in  some  occupation  outside  the  health 
field." 

The  CNA  board  authorized  the  ex- 
ecutive director  or  her  designate  to 
8       THE  CANADIAN   NURSE 


Dr.  Helen  G.  McArthur  receives  a  gold  bracelet  from  E.  Louise  Mmer  on  behalf 
of  the  Canadian  Nurses'  Association. 


provide  the  address  tapes  to  DBS  for 
suitable  projects.  1  hese  will  be  provided 
at  no  cost  to  the  Bureau. 

At  the  Doard  meetmg,  Dr.  Helen  K. 
Mussallem,  CNA  executive  director, 
explained  that  provincial  associations 
have  access  to  the  statistical  compila- 
tions of  DBS  and  that  they  need  only 
make  a  request  for  the  information  to 
be  supplied. 

Helen  McArthur  Chalks  Up  A  first 

Ottawa  —  Dr.  Helen  G.  McArthur  is 
the  first  nurse  to  receive  an  Honorary 
Citation  from  the  Canadian  Nurses' 
Association.  The  ceremony  took  place 
at  the  CNA  annual  meeting  held  on 
March  3 1  at  the  Chateau  Laurier  Hotel. 

In  presenting  the  emblematic  cita- 
tion to  Dr.  McArthur,  Margaret  M. 
Hunter,  chief  nursing  officer  for  St. 
John  Ambulance  in  Canada,  outlined 
briefly  the  career  of  the  national  direc- 
tor of  nursing  service  of  the  Canadian 
Red  Cross  Society,  a  position  from 
which  Dr.  McArthur  is  retiring  in  a 
few  months. 

Helen  McArthur  was  among  the 
pioneers  in  public  health  nursing  in  rur- 
al Alberta  shortly  after  obtaining  her 
bachelor  of  science  degree  from  the 
University  of  Alberta  school  of  nurs- 
ing. Later,  she  became  acting  director 
of  the  same  school,  having  obtained  her 


master's  degree  in  supervision  and 
teaching  from  Columbia  University.  In 
1944  she  rejoined  the  Alberta  depart- 
ment of  public  health  as  superintendent 
of  the  public  health  nursing  branch. 

In  1946,  Dr.  McArthur  joined  the 
Canadian  Red  Cross  Society.  In  1954, 
at  the  personal  request  of  Syngman 
Rhee  and  under  the  auspices  of  the 
League  of  the  Red  Cross  Societies,  she 
began  an  1 8-month  assignment  in  Korea 
and  Japan.  In  Soeul,  the  nurses'  resi- 
dence of  the  Red  Cross  Hospital  has 
been  named  "McArthur  Hall"  as  a 
tribute  to  her  services  there. 

Dr.  McArthur,  always  active  in  nurs- 
ing organizations,  was  elected  pres- 
ident of  the  Canadian  Nurses'  Associa- 
tion in  1951  and  served  for  two  terms 
in  that  position.  She  has  served  as  presi- 
dent of  the  University  of  Alberta  Hospi- 
tal Alumnae  Association,  first  vice- 
president  of  the  Alberta  Association  of 
Registered  Nurses,  and  chairman  of 
the  nursing  section  of  the  Canadian 
Public  Health  Association. 

In  1957,  Dr.  McArthur  received  the 
highest  international  nursing  award, 
the  Florence  Nightingale  Medal,  from 
the  International  Committee  of  the 
Red  Cross.  In  1958,  she  received  the 
Coronation  Medal,  and  in  1964,  an 
honorary  degree  of~Doctor  of  Laws 
(Continued  on  page  10) 
MAY  1971 


Smoother,  Easier  Venipuncture:  Butterfly  "wings" 
give  you  a  built-in  needle  holder.  Fold  them  upward 
and  you  have  a  firm,  double  gripping  surface.  You 
can  manipulate  freely  and  accurately.  You  have 
excellent  control  over  entry  .  . .  smooth  positive 
penetration  on  good  veins  ...  far  less  trouble  with 
difficult  or  hard-to-find  veins.  The  super-sharp  needle 
slides  through  tissue  with  a  keenness  you  can  "feel ". 

Increased  Security:  Release  the  "wings"  after 
venipuncture  and  they  fold  back  flat  against  the 
patient's  skin.  Thus  you  have  a  ready-made  anchor 
surface.  Two  strips  of  tape  over  the  wings  usually 
suffice  for  complete  needle  immobilization  . .  . 
often  without  armboard  restraint. 

A  Size  For  Every  I.V.  Need:  There  are  two  Butterfly 
Infusion  Sets  for  general-purpose  fluids  administration, 
two  for  pediatric  and  geriatric  use,  one  expressly 
designed  for  O.R.  and  recovery  or  emergency  room 
requirements  .  . .  and  the  Butterlly-19,  INT  and 
Butterfly-21 ,  INT.  with  Reseal  Injection  Site,  for 
INTermittent  I.V.  therapy. 


luHTT  ■  ^^^  y*-"^''  Abbott  representative  to  show 
you  the  whole  collection 


Three  good  reasons 
for  starting  your  next 
.V.  procedure  with  a 

BUTTERFLY' 
Infusion  Set 


1^4.4.4.  4. 


i 


{i  i  i  i 


I PMAC I 


your  hospital  is 
safer,  operates  more 
efficiently  with  TIME 

NURSING 
LABELS 


news 


Safer  because  all  Time  Labels  relating 
to  patient  care  are  BACTERIOSTATIC 
to  assist  In  eliminating  contact  Infec- 
tion between  patient  and  nurse.  The 
self-stlcking  quality  of  Time  Nursing 
Labels  eliminates  the  need  for  hand 
to  mouth  contact  while  working  with 
patient  record. 

More  efficient  because  Time  Nursing 
Labels  provide  you  with  an  effective 
system  of  Identification  and  communi- 
cation within  and  between  departments. 

Time  Patient  Chart  Labels  color-code 
your  charts  and  records  in  any  of  17 
colors  with  space  for  all  pertinent  pa- 
tient Information. 

Time  Chart  Legend  Labels  alert  busy 
personnel  to  Important  patient  care 
divertlves  eliminating  the  possibility  of 
error  through  verbal  instructions. 

There  are  many  other  Time  Labels  to 
assist  you  In  speeding  your  work  and 
to  assure  accuracy  in  important  pa- 
tient procedures.  Write  today  for  a 
free  catalog  of  all  Time  Nursing  Labels. 
We  will  also  send  you  the  name  of 
your  nearest  dealer. 


^. 


PROFESSIONAL  TAPE  COMPANY,  INC. 
355  BURLINGTON  RD.,  RIVERSIDE,  ILL.  60546 


10     THE  CANADIAN   NURSE 


(Continued  from  page  8) 

trom  her  alma  mater,  the  University 
of  Alberta. 

E.  Louise  Miner,  president  of  CNA 
gave  Dr.  McArthur  a  gold  bracelet  as 
a  memento  of  her  contribution  to  nurs- 
ing in  Canada  and  abroad. 

In  thanking  the  association,  and  hint- 
mg  at  yet  another  career,  Dr.  McAr- 
thur's  remarks  "...  and  when  I'm 
tired  of  oatmeal  porridge  and  want  a 
filet  mignon,  I  shall  go  out  and  nurse 
the  aged,  for  they  need  the  kind  of  nurs- 
ing I  can  give  them  ..."  gave  way  to  a 
standing  ovation  from  the  general  meet- 
ing. 

Miss  Miner's  concluding  comment, 
"She  "is  a  person  whose  country  is  the 
world  and  whose  religion  is  to  do 
good,"  was  a  capsule  portrait  of  the 
nurse  who  was  given  yet  another  honoi 
that  was  her  due. 

Survey  To  Determine  Demand 
For  Tape  Cassette  Program 

Ottawa  —  At  its  March  meetmg,  the 
board  of  directors  of  the  Canadian 
Nurses'  Association  agreed  to  conduct 
a  bilingual  survey  of  nurse  educators 
and  administrators  to  determine  their 
interest  in  a  tape  cassette  program  that 
now  offers  doctors  medical  education 
and  information  through  audio  tapes. 

Dr.  A.  Peart,  former  general  sec- 
retary of  the  Canadian  Medical  Asso- 
ciation, ana  now  medical  director  of 
Medifacts  Ltd.,  a  company  formed  to 
set  up  and  administer  this  service  for 
general  practitioners,  told  the  board  his 
company  could  also  provide  CNA  with 
:he  technical  expertise  to  start  its  own 
program.  As  well,  Medifacts  would  pay 
half  the  cost  of  the  survey,  he  said.  The 
survey  will  cost  CNA  $600. 

This  new  Canadian  cassette  program, 
which  began  for  doctors  March  29, 
1971,  could  similarly  be  used  by  CNA 
to  provide  nurses  with  new  knowledge 
in  capsule  form  and  association  news. 
Or.  Peart  explained.  Although  the  tapes 
could  be  any  length,  he  suggested  30-  or 
60-minute  tapes  consisting  of  short  six- 
minute  items  and  three  to  five  minutes 
of  news. 

Based  on  1,000  subscribers,  the 
cost  of  one  cassette  would  be  $5,  though 
advertising  could  considerably  reduce 
the  cost.  Dr.  Peart  said  the  cassettes 
for  the  5,000  general  practitioner  sub- 
scribers, which  contain  six  one-minute 
advertising  slots,  cost  only  $1  each. 
These  doctors  receive  a  cassette  every 
two  weeks,  but  are  only  billed  twice 
yearly,  according  to  Dr.  Peart. 


Dr.  Peart  noted  that  a  medical  ad- 
visory committee  selects  topics  of  in- 
terest to  GPs,  sets  out  the  objective? 
ot  the  program,  and  commissions  each 
presentation  from  a  prominent  Can- 
adian doctor.  These  doctors  are  paid  for 
their  contributions  he  added.  There  is 
also  a  committee  that  screens  advertis- 
ing for  "good  taste." 

When  an  advertisement  for  a  drug 
is  on  a  tape,  a  full  account  of  the  drug 
is  included  with  the  cassette.  Illustra- 
tions may  be  included  with  some  cas- 
settes. Another  extra  teature  that  some- 
times accompany  the  tapes  are  35-mm 
slides. 

Medifacts  also  offers  its  subscribers 
cassette  players  for  $35  —  $15  less 
than  the  retail  price.  Dr.  Peart  said. 
Accessories,  such  as  a  foot  pedal  and 
telephone  hookup,  are  available,  too. 

"We  may  eventually  provide  this 
service  in  all  medical  sciences."  Ur. 
Peart  told  the  CNA  board.  He  also  said 
Medifacts  is  trying  to  set  up  a  French- 
speaking  program. 

Quebec's  Language  Legislation 
Explained  By  ANPQ 

Montreal,  Quebec  —  The  Association 
of  Nurses  of  the  Province  of  Quebec 
has  issued  an  explanation  of  the  provi- 
sions of  the  Professional  Matriculation 
Act  as  it  applies  to  professionals  im- 
migrating to  Quebec.  (News,  March 
1971,  p.  10) 

The  ANPQ  is  one  of  19  corporations 
covered  under  the  act,  which  stipulates 
that  the  association  "cannot  admit  any 
person  who  is  not  a  Canadian  citizen 
to  the  study  or  to  the  practice  of  the 
protession  it  such  person  does  not 
have  a  working  knowledge  of  the  French 
language  determined  in  accordance 
with  the  standards  established  by  regu- 
lation of  the  Lieutenant-Governor  in 
Council." 

The  ANPQ  received  regulations  as 
stipulated  by  an  order-in-council  (num- 
ber 936)  on  March  10,  1971.  The 
regulations  defined  the  meaning  of 
"immigrant"  as  "any  person  who  is  not 
a  Canadian  citizen  but  is  legally  admit- 
ted to  Canada  to  remain  there  perma- 
nently and  is  domiciled  in  Quebec." 

The  association  is  studying  the  arti- 
cles covered  in  the  legislation,  which 
might  eventually  affect  the  nursing 
staff  of  English-speaking  hospitals  iii 
the  province.  The  ANPQ  is  in  contact 
with  different  levels  of  the  departments 
of  social  affairs  and  immigration  to 
help  solve  problems  in  the  application 
of  the  new  law. 

*»ome  ''ifcerpts  from  the  law  are: 
the  candidates,  that  is.  the  immi- 
grants working  knowledge  of  French 
is  determined  by  evaluating  ability 
to  understand  written  texts,  phonetic 
(Continued  on  page  12 1 

MAY  1971 


the  shape  of  change: 


dlscworii 


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THE  C.V  MOSBY  COMPANY,  LTD    •   86  NORTHLINE  ROAD   •  TORONTO  374.  ONTARIO.  CANADA 


MAY  1971 


THE  CAI^ADIAN  NURSE     11 


I C out i maul  from  p<if!i'  10) 

perception,  ability  to  understand  spoken 
French,  oral  expression.  A  series  of 
standardized  and  normalized  tests  are 
used  for  the  evaluation. 

Another  article  states  that  every 
candidate  must  submit  an  application 
to  the  department  of  immigration  of 
Quebec.  A  candidate  may  be  exemp- 
ted from  the  examination  if  he  demon- 
strates to  the  examining  committee  that 
his  mastery  of  the  French  language  is 
obvious. 

The  examining  committee  studies 
candidates'  records.  It  keeps  an  up-to- 
date  register  in  which  the  name  of 
each  candidate  and  his  results  are 
recorded.  Examination  sessions  are 
held  once  a  month  in  the  Montreal  and 
Quebec  City  offices  of  the  department, 
and  at  any  other  time  and  place  deemed 
necessary  by  the  department. 

Candidates  who  pass  the  examina- 
tion are  awarded  a  certificate  by  the 
department.  A  copy  is  sent  to  the  can- 
didate's professional  corporation.  A 
candidate  who  tails  may  try  the  exami- 
nation again  after  a  three-month  period. 

Canadian  Psychiatrists 
Protest  Soviet  Misuse 
Of  Mental  Hospitals 

Toronto,  Ont.  —  The  Canadian  Psychi- 
atric Association  has  appealed  to  world 
medical  bodies  and  doctors  to  join 
them  in  their  protest  of  the  Soviet 
Union's  use  of  mental  institutions  for 
incarcerating  sane  people  who  disagree 
with  aspects  of  Soviet  society.  CPA  is 
the  first  medical  organization  m  the 
world  to  protest  this  practice  publicly. 

In  an  article  in  the  Toronto  Telegram 
February  17,  Peter  Worthington,  who 
has  worked  in  Moscow  as  Telegram 
correspondent,  said  the  Canadian  psy- 
chiatrists have  urged  that  the  World 
Health  Organization  Canadian  Medical 
Association,  the  World  Psychiatric 
Association,  and  other  international 
bodies  look  at  ways  of  taking  action 
against  the  Soviet  use  of  mental  institu- 
tions as  prisons  for  dissenters. 

Credit  for  providing  the  impetus  for 
the  CPA  stand  is  given  to  the  executive 
body  of  the  psychiatric  section  of  the 
British  Columbia  Medical  Association. 
Dr.  Norman  Hirt,  chairman  of  the  B.C. 
psychiatry  section,  compares  the  Soviet 
practice  with  the  Nazi  practice  of  ex- 
perimental surgery  and  killing  the 
"socially  undesirable." 

Dr.  Hirt  writes:  "Death  and  dying 
take  many  forms.  The  Nazis  killed 
corporeally  after  torture;  the  Russians 
12     THE  CANAUIAN   NURSE 


are  killing  the  delicate  and  individual- 
istic mind-structures  of  their  'mental' 
prisoners.  This  crime  is  no  less  evil  than 
actual  death." 

According  to  the  Telegram  story. 
Dr.  Hirt  is  particularly  upset  because 
up  to  now  no  world  medical  body  has 
reacted  directly  against  the  Soviet 
"mind-death  camps."  He  notes  in  a 
CPA  report  that  world  medical  opinion 
was  also  silent  when  the  Nazis  began 
their  medical  obscenities  in  the  1930's. 

The  report  compares  Nazi  and  Soviet 
atrocities:  "In  Germany,  the  advance 
of  killings  went  from  the  mentally 
retarded,  the  'chronic'  schizophrenic, 
the  'criminally  insane,'  to  the  'racially 
impure'  —  Jews,  Poles,  and  Russians. 

"With  the  convenience  of  cynical 
diagnostic  categories  it  is  now  easy 
for  the  Russians  to  move  from  "schizo- 
hetero-thinkers'  (political  dissenters)  to 
'schizo-religious-deviates'  —  namely 
orthodox  religious  believers,  particu- 
larly Jews  of  Russia  who  are  being 
politically  persecuted  today." 

The  report  also  points  out:  "Once 
you  can  kill  or  torture  or  destroy  men- 
tally one  human  being  and  find  that  you 
are  not  punished  or  isolated,  then  the 
sphere  of  behavior  .  .  .  becomes  enlarg- 
ed. There  is  no  doubt  that  we  are  seeing 
in  Russia  the  actual  beginnings  of  a 
future  holocaust.  .  .  . 

"As  we  know  from  actual  data,  some 
of  these  people  so  committed  to  men- 
tal hospitals  have  been  tortured  to 
death  by  the  advanced  medical  tech- 
nology available  to  psychiatry  today, 
including  drugs,  electrical  shock  and 
various  kings  of  physical  coercion." 

Dr.  Aldwyn  Stokes,  CPA  president, 
said  the  report  has  been  sent  to  the 
Canadian  Medical  Association,  which 
is  expected  to  endorse  the  report  and 
forward  it  to  the  United  States  and  the 
World  Health  Organization.  And  ac- 
cording to  the  Telegram.  Dr.  Stokes 
emphasizes  that  the  gesture  is  "com- 
pletely non-political"  and  based  only 
on  facts. 

Research  Officer  Attends 
ANA  National  Conference 

Ottawa  —  The  Canadian  Nurses'  Asso- 
ciation research  officer.  Rose  Imai, 
was  one  of  nearly  100  nurse  research- 
ers invited  to  attend  the  seventh  nursing 
research  conference  sponsored  by  the 
American  Nurses'  Association  in  Atlan- 
ta, Georgia,  from  March  10  to  12. 

The  conference,  funded  by  a  grant 
from  the  division  of  nursing,  bureau  of 
health  manpower  education,  provided 
a  forum  where  nurse  researchers  could 
engage  in  the  critical  analysis  of  select- 
ed research  studies.  The  program  focus- 
ed on  the  research  methods  and  mea- 
surement tools  applicable  to  the  study 
of  nursing  problems;  problem-areas 
encountered  in  research;  and  implica- 


tions of  the  findings  for  nursing  practice 
and  for  further  research. 

The  conference  was  part  of  the  con- 
tinuing efforts  of  ANA  and  the  division 
of  nursing  to  assist  in  the  further  devel- 
opment of  methodological  and  com- 
municative skills  of  nurse  researchers. 

Miss  Imai  found  the  conference 
both  "stimulating  and  exciting."  The 
conference  focused  on  critiques  of 
papers  given  to  the  delegates  in  ad- 
vance. "This  method  was  extremely 
valuable  because  it  provided  a  good 
basis  for  discussion,"  she  said. 


Committee  On  Clinical  Training 
For  Nurses  In  The  North 
Reports  To  Health  Minister 

Ottawa  —  If  the  recommendations 
made  in  a  report  submitted  last  Oc- 
tober to  the  federal  minister  of  health, 
John  Munro,  are  implemented,  nurses 
employed  in  northern  nursing  stations 
by  the  medical  services  branch  of  the 
department  of  national  health  and  wel- 
fare will  be  given  a  formal  training 
program  lasting  a  maximum  of  six 
months. 

This  program  would  begin  with  a 
two-  or  three-month  apprenticeship 
in  a  northern  nursing  station,  possibly 
combined  with  a  departmental  orienta- 
tion program,  to  orient  the  nurse  to 
life  in  a  northern  nursing  station  and 
help  her  identify  her  learning  needs. 

The  report  followed  visits  to  areas  in 
northern  Quebec  and  Manitoba  and  the 
Northwest  Territories  by  the  eight 
members  of  the  Committee  on  Clinical 
Training  of  Nurses  for  Medical  Services 
in  the  North.  Chairman  of  the  commit- 
tee was  Dr.  Dorothy  J.  Kergin,  director 
of  McMcMaster  University  s  school  of 
nursing. 

In  the  nursing  stations,  committee 
members  found  there  was  a  disparity  in 
educational  and  experiential  back- 
grounds among  nurses.  The  committee 
notes  in  its  report  that  because  of  such 
factors  as  isolation,  most  nurses  see 
their  work  lasting  approximately  two 
years  until  transfer,  promotion,  or 
resignation. 

In  the  committee's  view,  the  overall 
objective  of  a  training  program  for 
nurses  employed  by,  or  seeking  em- 
ployment with,  the  medical  services 
branch  in  the  North  is  to  increase  the 
skills  of  the  nurse  in  physical  assess- 
ment and  case  management.  It  recom- 
mends that  primary  emphasis  in  all 
areas  be  on  distinguishing  between 
normal  and  abnormal  findings,  des- 
cription of  signs  and  symptoms,  and 
on  management  of  simple  problems. 

On  completion  of  the  program,  the 
report  says,  the  nurse  should  possess 
skills  in  interviewing,  history  taking, 
and  carrying  out  a  basic  physical  exam- 

(Coiilimu'il  on  page  14) 
MAY  1971 


the  shape  of  change: 


Involvenem 


New  5th  Edition!  Shafer  et  al 

MEDICAL-SURGICAL 
NURSING 

This  was  the  first  text  to  combine  two  basic  areas  of 
clinical  nursing  in  one  patient-oriented  volume,  and  it 
remains  the  foremost  book  in  the  field!  Reflecting  your 
students'  unchanging  involvement  in  a  rapidly  changing 
profession,  this  modern  new  edition  retains  the  essential 
focus  on  individualized  nursing  care,  while  presenting 
recent  advances  in  procedures  and  treatment.  The  new 
author's  thoughtful  presentation  stresses  that  rapid  changes 
in  treatment  demand  alert,  flexible  nursing  care  based  on 
complete  understanding  of  the  rationale  for  treatment  of  a 
given  patient.  In  keeping  with  this  approach,  expanded  and 
reorganized  material  pinpoints  important  new  develop- 
ments in  medical  therapy  and  nursing  care. 

A  rewritten  and  enlarged  chapter  examines  nutrition 
as  a  dynamic  factor  in  nursing  care.  Extensively  revised 
chapters  reflect  progress  in  many  other  important  areas. 
Scientifically  accurate  discussions  update  information  on 
cancer  chemotherapy,  diagnostic  procedures  in  cardiovas- 
cular disease,  endotracheal  intubation  and  tracheostomy 
care,  and  many  other  clinically  relevant  topics.  The  chapter 
on  patients  with  personality  disorders  notes  the  intimate 
relationship  of  organic  and  functional  conditions,  and 
presents  facts  on  recently  developed  drugs  which  control 
behavior.  In  addition,  this  chapter  examines  conditions 
related  to  alcoholism,  drug  abuse,  and  narcotic  addiction. 
This  timely  material  outlines  symptoms  of  commonly 
abused  drugs,  and  current  treatment. 

Redesigned  in  a  modern  format,  with  larger  pages,  this 
attractive  presentation  also  features  more  than  75  new 
drawings  and  photographs.  A  helpful  Teacher's  Guide  is 
furnished  without  charge  to  instructors  adopting  this  book. 
The  effective  combination  of  text,  workbook  and  case 
studies  is  the  most  complete  approach  to  medical-surgical 
nursing  you  could  adopt  for  your  classes! 

By  WILMA  H.  PHIPPS,  R.N.,  A.M.,  Associate  Professor  and 
Chairman  of  Medical-Surgical  Nursing,  Frances  Payne  Bolton  School 
of  Nursing,  Case  Western  Reserve  University,  Cleveland,  O.;  with  the 
collaboration  of  Kathleen  Newton  Shafer,  R.N.,  M.A.;  Janet  R. 
Sawyer,  R.N.,  Ph.D.;  Audrey  M.  McCluskey,  R.N.,  M.A.,  Sc.M.Hyg.; 
and  Edna  Lifgren  Beck,  R.N.,  M.A.  June,  1971.  8th  edition,  approx. 
800  pages,  8"  x  10",  414  illustrations.  About  $13.15. 


A  New  Book!  Shafer  et  al 

PATIENT  CARE  STUDIES 
IN  MEDICAL- 
SURGICAL  NURSING 

Realistic  patient  care  problems  show  your  students 
how  to  establish  sound  nursing  objectives.  Valuable  rein- 
forcement for  their  clinical  experience,  these  carefully 
organized  studies  are  correlated  with  the  new  5th  edition  of 
Medical-Surgical  Nursing  (described  at  left). 

Each  perceptive  discussion  follows  a  logical  five-part 
format.  Beginning  with  a  statement  of  the  patient's  medical 
history,  the  authors  then  explain  his  relevant  social  back- 
ground, delineate  laboratory  findings,  and  describe  current 
medical  or  surgical  treatment  for  his  condition.  The  final 
section  then  demonstrates  how  the  nurse  can  draw  on  all 
this  information  to  formulate  sound  nursing  plans  which 
consider  the  patient  as  an  individual  as  well  as  his  disease. 
Consider  this  new  book  s  value  in  your  teaching  program! 

By  WILMA  H.  PHIPPS,  R.N.,  A.M.;  and  ROSEMARY  RICH,  R.N., 
Ph.D.,  Associate  Professor,  Frances  Payne  Bolton  School  of  Nursing, 
Case  Western  Reserve  University,  Cleveland,  O.  September,  1971. 
Approx.  150  pages,  7"  x  10",  illustrated. 


New  2nd  Edition!  Joel  et  al 

WORKBOOK  AND  STUDY 
GUIDE  FOR  MEDICAL- 
SURGICAL  NURSING 
A  Patient-Centered  Approach 

This  stimulating  workbook  vividly  demonstrates  appli- 
cation of  the  principles  of  medical-surgical  nursing  care.  Its 
23  patient-centered  case  studies  encourage  development  of 
problem-solving  techniques,  and  at  the  same  time  review 
basic  scientific  knowledge  and  nursing  skills.  A  Teacher's 
Guide  is  provided  without  charge  to  instructors  adopting 
this  flexible  book. 

By  Alma  L.  Joel,  R.N.,  B.S.N. :  Marjorie  Beyers,  R.N.,  B.S.,  M.S.; 
Lois  S.  Carter,  R.N.,  B.S.N. ;  Barbara  Puras,  R.N.,  B.S.N. ;  Mary  Ann 
Pugh  Randolph,  R.N.,  B.S.N. ;  and  Dorothy  Savich,  R.N.,  B.S.  1969, 
2nd  edition,  319  pages  plus  FM  l-X,  TA"  x  lO'/i".  13  illustrations. 
Price,  S5.25. 


MAY  1971 


MOSBY 

TIMES  MIRROR 

THE  C.V.  MOSBY  COMPANY.  LTD.  •  86  NORTHLINE  ROAD  •  TORONTO  374,  ONTARIO,  CANADA 

THE  CANADIAN   NURSE     13 


Just  as  you 

can't  call  any 

waterfall 

Niagara 


you  can't  call 

any  Conform 

Bandage  a 

KLING* 

BANDAGE. 

There's  really  only  one  KLING 
Conform  Bandage  —  by  Johnson 
&  Johnson. 

KLING  is  the  unique,  soft,  all  ab- 
sorbent cotton  bandage  that  is 
more  than  equal  to  the  bandaging 
requirements  of  areas  that  are  hard 
to  bandage  and  hard  to  keep  ban- 
daged. 

Because  KLING  is  self-adhering,  it 
clings  to  itself,  conforming  to  un- 
usual contours  and  resisting  flex- 
induced  slippage.  KLING  Conform 
Bandage's  elasticity  permits  it  to 
stretch  over  40%,  so  not  to  con- 
strict swelling  areas. 
KLING  Conform  Bandages  —  5 
yds.  when  stretched  are  supplied 
in  the  following  widths:  1"  —  2" 
—  3"  —  4"  —  6"  —  in  bulk  or  pre- 
wrap. 

KLING 

CONFORM  BANDAGE 
THE  BANDAGE  THAT 
REALLY  CONFORMS 

MONTREAL  4  TORONTO-  CANADA 

•Trademark  of  Johnson  &  Johnson 

Limited  or  afftftated  companies 

14     THE  CANADIAN   NURSE 


news 


(Conliniu'cl  from  ptifie  12) 

ination.  "In  particular  she  should  have 
the  opportunity  during  the  training 
program  to  make  a  systematic  assess- 
ment of  patients  presenting  problems 
that  are  commonly  encountered  in  iso- 
lated northern  communities.  These 
conditions  include  the  infant  with  fever; 
all  forms  of  respiratory  distress;  acute 
abdomen;  headache;  meningitis;  infant 
gastroenteritis  and  dehydration;  high 
risk  pregnancies  and  complications  of 
delivery;  and  venereal  disease." 

The  report  explains:  "Nurses  em- 
ployed in  the  North  require  a  highly 
developed  ability  to  relate  well  with 
others  and  to  understand  people  of  a 
different  culture.  Each  [nurse]  needs 
...  to  realize  how  people  are  motivated 
to  adopt  new  values,  particularly  those 
related  to  health.  ...  In  general,  nurses 
who  come  closest  to  this  ideal  are  .  .  . 
the  products  of  a  university  program 
in  nursing." 

Yet  the  report  notes  that  nurses  in  the 
North  require  abilities  beyond  those 
generally  acquired  in  Canadian  nursing 
educational  programs.  "The  answer  is 
not  to  recruit  nurses  from  other  coun- 
tries who  may  have  .  .  .  additional  prep- 
aration in  midwifery,  for  this  only  adds 
one  specific  area  of  expertise  to  a  rather 
traditional  nursing  educational  pro- 
gram." 

The  report  recommends  encouraging 
schools  of  nursing  to  provide  a  one- 
month  northern  experience  for  their 
students,  with  the  help  of  federal  funds. 
It  would  also  be  advisable  "to  establish 
one  program,  enrolling  10  nurses,  on 
a  trial  basis  in  one  institution  with 
subsequent  programs  developed  in  a 
year's  time."  A  suitable  institution  for 
this  type  of  program,  the  report  points 
out,  would  be  a  university  with  a  med- 
ical school  and  a  school  of  nursing, 
preferably  offering  the  program  through 
a  continuing  education  or  similar  de- 
partment. 

Entrance  requirements  to  this  pro- 
gram would  be  registration  as  a  nurse 
in  Canada  and  preferably  one  year's 
experience  in  nursing.  "Selection  of 
candidates  for  the  training  program 
should  be  made  by  a  committee  com- 
posed of  representatives  of  the  edu- 
cational institution  and  medical  serv- 
ices." the  report  adds. 

A  suggested  outline  of  course  content 
for  the  approximately  four-month  train- 
ing period  proposes:  obstetrics  and 
gynecology  (35%);  procedures  and 
techniques  (20% );  pediatrics  and  com- 
municable diseases  (15%);  ear,  nose 


and  throat  and  ophthalmology  (10%); 
pharmacology  and  community  habits  of 
Eskimos  and  Indians  (10%);  and  chest 
conditions  (10%). 

One  strong  recommendation  is  that 
nurses  who  complete  the  program  re- 
ceive a  diploma,  certificate,  or  credits 
from  the  university. 

The  committee  members  were  Dr. 
Dorothy  Kergin;  Dr.  W.D.  Dauphinee, 
Royal  Victoria  Hospital,  Montreal; 
Dr.  Fernand  Hould,  Laval  University, 
Quebec;  Huguette  Labelle,  Vanier 
School  of  Nursing,  Ottawa;  Pauline 
Laurin,  Ouebec  region,  and  Anne  Wid- 
er, Yukon  zone,  department  of  national 
health  and  welfare;  Dr.  James  Wiley, 
University  of  Ottawa;  and  Dr.  K.O. 
Wylie,  University  of  Manitoba,  Win- 
nipeg, Manitoba. 


National  Health  Conference 
Focuses  On  Physician's  Assistant 

Ottawa—  Although  the  National  Con- 
ference on  Assistance  to  the  Physician, 
called  by  the  department  of  national 
health  and  welfare  April  6-8,  may  not 
have  reached  the  final  answer  on  the 
question  of  the  need  for  a  physician's 
assistant,  it  did  challenge  the  status  quo 
of  the  health  care  system. 

Dr.  Gilles  Paquet  of  the  department 
of  economics  at  Carleton  University 
in  Ottawa,  said:  ".  .  .  the  whole  debate 
about  physician's  assistance  really 
[involves]...  a  restructuring  of  the 
health  care  system  and  of  power  within 
it.  We  cannot  have  change  without 
changing:  if  to  do  so  we  have  to  slaugh- 
ter some  sacred  cows,  let  the  slaughter 
begin." 

Participating  in  the  three  days  of 
group  workshops,  plenary  sessions, 
open  forum,  and  panel  discussions  were 
some  1 30  invited  participants:  uni- 
versity educators;  government  con- 
sultants; researchers;  representatives 
of  medical,  nursing,  labor,  and  con- 
sumer associations;  lawyers  and  econo- 
mists; hospital  directors;  and  a  sprinkl- 
ing of  practicing  nurses  and  physicians. 

Of  some  30  health  care  needs  indenti- 
fied  by  the  10  workshop  groups  on  the 
first  day  and  reported  at  a  plenary 
session  the  following  morning,  the 
most  basic  need  seen  was  for  more 
ready  access  to  the  health  care  system. 
Also  singled  out  were  needs  to:  integrate 
preventive  medicine  within  one  com- 
prehensive health  care  system;  include 
other  professions,  in  addition  to  nurses, 
as  possible  physicians'  assistants,  but 
prevent  these  assistants  from  being 
exploited  for  physicians'  profit;  re- 
distribute existing  professional  person- 
nel within  and  between  regions;  recog- 
(Conliniu'il  on  pn^-c  16) 
MAY  1971 


the  shape  of  change: 


ohalleise 


A  New  Book! 


Given-Simmons 


NURSING  CARE 

OF  THE  PATIENT  WITH 

GASTROINTESTINAL  DISORDERS 


A  New  Book!  Rodman  et  al 

THE  PHYSIOLOGIC 

AND  PHARMACOLOGIC  BASIS 

OF  CORONARY  CARE  NURSING 


The  first  text  in  this  specific  area,  this  compact  yet 
detailed  book  provides  a  solid  foundation  for  effective 
specialized  care.  Its  practical  discussions  stress  the  nurse's 
role  in  observation,  interpretation,  and  intervention,  clearly 
showing  how  to  evaluate  patient  needs  and  implement 
comprehensive  nursing  care  plans.  The  logical  systemic 
approach  clearly  outlines  disorders  of  the  gall  bladder, 
pancreas  and  liver  as  well  as  the  alimentary  tract  itself.  The 
focus  is  on  the  many  factors  underlying  nursing  actions: 
pathophysiologic  alterations,  clinical  symptoms,  require- 
ments of  diagnostic  tests,  medical  and  surgical  treatment. 

By  BARBARA  A.  GIVEN,  R.N.,  B.S.N. ,  M.S.,  Assistant  Professor  of 
Nursing,  Michigan  State  University,  East  Lansing:  and  SANDRA  J. 
SIMMONS,  R.N.,  B.S.N. ,  M.S.,  Assistant  Director,  Education  and 
Training,  The  Ohio  State  University  Hospitals,  Columbus.  January, 
1971.  271  pages  plus  FM  l-XII,  7"  x  10",  70  illustrations.  Price, 
$10.50. 


Specifically  written  for  the  nurse's  professional  orien- 
tation and  level  of  knowledge,  this  unusual  text  delineates 
the  special  information,  understanding,  and  skills  needed 
for  effective  coronary  care.  While  furnishing  the  necessary 
core  of  scientific  and  technical  knowledge,  it  emphasizes 
the  nurse's  role  rather  than  complex  instrumentation  and 
technology.  Correlating  clinical  information  with  nursing 
care,  this  challenging  book  presents  all  aspects  of  coronary 
disease,  from  basic  anatomy  of  the  heart  to  diagnosis  and 
therapy  of  specific  conditions.  It  carefully  examines  the 
nurse's  place  on  the  CCU  team.  Expand  your  students' 
ability  at  this  upgraded  level  ~  make  this  unconventional 
new  book  your  choice  next  semester! 

By  Theodore  Rodman,  M.D.,  Ralph  M.  Myerson,  M.D.;  L.  Theodore 
Lawrence,  M.D.;  Anne  P.  Gallagher,  R.N.,  B.S.N. ,  M.S.N. ;  and 
Albert  J.  Kasper,  M.D.  May,  1971.  Approx.  248  pages,  7"  x  10", 
103  illustrations.  About  $9.40. 


New  5th  Edition!  Anderson 

Newton's  GERIATRIC  NURSING 

Help  your  students  understand  the  special  needs  of  the 
elderly,  and  introduce  them  to  sound  nursing  principles  and 
practice!  A  major  revision,  the  new  5th  edition  of  this 
challenging  text  reflects  the  many  social,  economic,  and 
scientific  forces  which  have  profoundly  altered  the  lives  of 
all  aged  persons  in  recent  years.  Perceptive  discussions  stress 
health  maintenance,  preventive  care,  and  the  therapeutic 
importance  of  respect  and  consideration  for  the  aged  as 
responsible  individuals.  A  new  chapter  explains  the  often 
difficult  relationship  of  the  nurse  to  ill,  elderly  patients. 
The  expanded  material  on  psychiatric  care  now  focuses  on 
problems  caused  by  cerebral  functional  deficits,  rather  than 
on  specific  psychoses. 

By  HELEN  C.  ANDERSON,  R.N.,  M.N.,  Clinical  Nursing  Section 
Chief,  New  York  Medical  College  Center  for  Chronic  Disease,  Bird 
S.  Coler  Hospital,  New  York,  N.Y.  June,  1971.  5th  edition,  approx. 
384  pages,  7"  x  10",  59  illustrations.  About  $9.75. 


New  2nd  Edition!  lorio 

PRINCIPLES  OF  OBSTETRICS  AND 
GYNECOLOGY  FOR  NURSES 

The  only  text  to  combine  these  two  closely  related 
subjects,  this  careful  revision  features  a  new  principles- 
centered  approach.  Encouraging  your  students  to  develop  a 
thoughtful  problem-solving  attitude,  this  thoroughly  up- 
dated material  stresses  physiologic  and  psychologic  implica- 
tions of  the  reproductive  cycle.  It  follows  a  logical  sequence 
from  a  basic  outline  of  the  reproductive  process  through 
problems  of  the  menopause.  New  information  includes 
timely  discussions  of  phototherapy  for  jaundice  in  pre- 
mature infants,  Rh  sensitization,  abortion  by  saline  injec- 
tion, and  trends  in  family  planning.  Its  many  new  illustra- 
tions include  dramatic  photographs  of  actual  childbirth, 
showing  the  father  participating. 

By  JOSEPHINE  lORIO,  R.N.,  B.S.,  M.A.,  Associate  Professor  of 
Nursing,  Seton  Hall  University  School  of  Nursing,  South  Orange, 
N.J.  April,  1971.  2nd  edition,  approx.  396  pages,  6%"  x  9%",  171 
illustrations.  Price,  $9.75. 


MOSBY 


TIM 


MIRROR 


MAY  1971 


THE  C.V  MOSBY  COMPANY.  LTD    •   B6  NORTHLINE  ROAD  •  TORONTO  374.  ONTARIO.  CANADA 

THE  CAf^ADIAN   NURSE     15 


news 


A  Hug  For  Untario's  New  neaitn  /viinisier 


(Coiiliiuu'cl  from  pa^c  14) 

nize  that  the  fee  for  service  which  re- 
wards volume  can  be  an  obstacle  to  the 
delegation  of  tasks  by  the  medical  pro- 
fessions and  an  obstacle  to  their  accept- 
ance of  assistants;  get  all  practicmg 
health  professionals  working  together 
as  a  team  to  meet  community  needs; 
and  improve  continuity  of  care  for 
individuals  between  institutional  and 
community  services. 

But  the  groups  saw  no  need  for  a 
completely  new  health  professional, 
although  there  was  consensus  on  the 
need  to  extend  the  training  and  role 
of  existing  health  professionals.  The 
nurse  was  often  referred  to  throughout 
the  three  days  in  relation  to  such  an 
extended  role,  with  particular  recogni- 
tion paid  to  the  work  of  the  public  health 
nurse  and  nurses  in  the  north. 

Dr.  Maurice  LeClair,  deputy  mini- 
ster of  national  health,  told  the  con- 
ference: "The  primary  care  physician 
should  receive  top  priority  in  any  at- 
tempt to  make  increased  assistance 
available  to  the  physician.  The  reg- 
istered nurse  is  the  logical  person  to 
provide  this  assistance  but ...  the 
problem  lies  more  with  the  legal,  econ- 
omic and  professional  implications  of 
providing  this  assistance  than  it  does 
with  the  inadequate  or  inappropriate 
training  of  the  nurse." 

During  the  final  morning  open  fo- 
rum. Dr.  LeClair,  emphasizing  that  he 
was  presenting  a  personal  viewpoint, 
said  the  conference  did  not  provide  a 
final  answer  to  the  question  of  assistance 
to  the  physician.  He  added  that  the 
government  had  no  new  money  for 
training  another  health  professional.  If 
something  new  were  to  be  phased  into 
the  health  care  system,  he  said,  some- 
thing else  would  have  to  be  phased  out. 
In  reply  to  the  deputy  minister,  Dr. 
John  Evans,  dean  of  medicine  at  Mc- 
Master  University,  expressed  his  con- 
cern about  Dr.  LeClair's  "reticence 
about  moving  ahead."  Dr.  Evans  said  it 
would  be  disappointing  if  there  is  not  an 
opportunity  to  broaden  the  system  —  to 
move  into  team  practice  and  expand 
the  role  of  the  nurse.  Sometimes  ex- 
penditures are  required  to  get  a  pro- 
ject rolling,  but  eventually  they  pay 
off,  he  continued. 

The  conference  proceedings  and 
results  were  well  summed  up  by  Dr. 
George  Szasz  of  the  University  of  Brit- 
ish Columbia.  He  questioned  the  reality 
of  what  was  done  at  the  conference,  as 
few  practitioners  were  present.  And  he 
said  the  physician  has  come  to  realize 
16     THE  CANADIAN   NURSE 


Who  said  nurses  don't  embrace  politics?  If  it's  true,  this  nurse  is  certainly  an 
exception.  Maureen  Kearney,  Miss  Young  Progressive  Conservative  of  Ontario 
and  a  student  in  nursing  education  at  the  University  of  Ottawa,  made  the  most 
of  the  one-day  visit  to  Ottawa  March  1 8  of  Ontario's  minister  of  health,  A.B.R. 
Lawrence.  Maureen,  active  in  the  party  since  she  was  1 8,  is  also  second  vice- 
president  of  the  Ottawa  and  District  YPC  association  —  one  of  two  women  on 
this  executive.  She  finds  that  women  aren't  taken  seriously  enough  in  politics. 
Nor  do  many  nurses  become  actively  involved  in  political  parties,  she  says. 
But  she  is  doing  all  she  can  to  change  the  status  quo! 


that  "the  sun  doesn't  rise  and  set  on 
him." 

A  further  report  of  this  conference 
will  be  given  in  the  June  1971  issue 
of  The  Canadian  Nurse. 


RNABC  Wants  Change 
In  Abortion  Legislation 

Vancouver,  B.C.  —  The  Registered 
Nurses'  Association  of  British  Colum- 
bia supports  liberalization  of  abortion 
legislation  in  Canada  so  that  the  final 
decision  about  abortion  can  be  made 
by  a  woman  and  her  doctor.  In  a  posi- 
tion paper  on  abortion,  the  RNABC 
supports  a  nurse's  right  to  abstain  from 
participating  in  the  nursing  care  of 
patients  seeking,  having,  or  recovering 
from  a  therapeutic  abortion  except  in 
emergency  situations. 


The  association  is  urging  federally 
supported  research  programs  on  contra- 
ception and  dissemination  of  birth 
control  information,  because  it  believes 
that  abortion  should  not  replace  other 
methods  of  birth  control.  The  RNABC 
does  not  favor  taking  abortion  out  of 
the  Criminal  Code  entirely,  instead  it 
wants  section  237  of  the  Code  amended 
and  retained  to  protect  society  from  the 
illegal  abortionist. 

Provincially  the  association  will 
encourage  establishment  of  "pregnancy 
clinics"  in  public  health  units,  availa- 
bility of  birth  control  information  in 
hospital  maternity  units,  and  mandatory 
"sex  education-family  life"  courses  in 
the  public  school  system. 

The  RNABC  believes  that  the  pro- 
vision of  competent  nursing  care  for 
patients  having  therapeutic  abortions 
iCoiiliiiiii'cl  Dii  pa.vi'  18) 
MAY  1971 


the  shape  of  change: 


iHMvalioi 


A  New  Book!  Mclnnes 

THE  VITAL  SIGNS 

A  Programmed  Presentation 

Including  Material  on  the  Apical  Beat 

This  effective  introduction  explains  basic  concepts  and 
scientific  rationale  while  it  familiarizes  students  with  the 
use  of  common  equipment  through  actual  practice  in 
measuring  temperature,  pulse,  respiration,  and  blood  pres- 
sure. 

By  MARY  ELIZABETH  MclNNES,  R.N.,  B.Sc.N.,  M.Sc.(Ed.), 
Instructor  in  Nursing.  St.  Joseph's  School  of  Nursing.  Hamilton, 
Ontario.  Canada.  October.  1970.  95  pages  plus  FM  IXII.  7"  x  10", 
35  illustrations.  Price.  85.20. 


New  5th  Edition!  Price 

A  HANDBOOK  AND  CHARTING 
MANUAL  FOR  STUDENT  NURSES 

A  timesaving  tool  for  you  and  your  incoming  students, 
this  flexible  new  edition  concentrates  on  basic  study  skills 
and  rules  for  legible,  accurate  record-keeping.  A  radical 
departure  from  previous  editions,  the  lengthy  chapter  on 
charting  methods  points  out  significant  changes  in  the 
content  and  organization  of  nurses'  notes,  patient  records, 
and  other  clerical  procedures. 

By  ALICE  L.  PRICE,  R.N.,  M.A.  June,  1971.  5th  edition,  approx. 
232  pages,  S'/j"  x  11",  74  illustrations,  5  in  2color. 


New  Stti  Edition!  Jessee 

SELF-TEACHING  TESTS  IN 
ARITHMETIC  FOR  NURSES 

This  popular  manual  helps  your  students  develop  a 
strong  background  in  basic  applied  arithmetic,  in  class  or  by 
independent  study.  This  flexible  new  edition  places  the 
achievement  tests  and  their  answers  at  the  back  of  the 
book,  where  you  can  easily  remove  them  for  separate  use. 
A  free  answer  booklet  is  furnished  with  each  copy  of  this 
helpful  guide. 

By  RUTH  W.  JESSEE,  R.N.,  Ed.D.,  Chairman,  Department  of 
Nursing  Education,  Wilkes  College.  WilkesBarre,  Pa.  June,  1971. 
8th  edition,  212  pages  plus  FM  IXII,  7%"  x  lOVi",  21  illustrations. 
Price,  $5.00. 


A  New  Bool<!  Poland-Sanford 

ADJUSTMENT  PSYCHOLOGY 
A  Human  Value  Approach 

The  first  non-technical  introduction  to  interpersonal 
relationships  and  social  adjustment,  this  thoughtful  pro- 
grammed guide  can  help  your  students  develop  a  positive 
approach  to  personal  interaction  —  a  basic  nursing  skill! 

By  RONAL  G.  POLAND,  Ph.D.,  formerly  Lecturer  and  Consultant, 
Division  of  Continuing  Education,  University  of  Colorado.  Boulder; 
and  NANCY  D.  SANFORD.  R.N.,  M.S..  Instructor  of  Psychiatric 
Nursing,  St.  Luke's  Hospital  School  of  Nursing,  Denver,  Colo. 
February,  1971.  233  pages  plus  FM  l-X,  bV^"  x  B'/i".  Price,  $5.15. 


A  New  Bool<!  Sobol-Robischon 

FAMILY  NURSING:  A  Study  Guide 

Representing  a  wide  range  of  age  groups  and  social 
situations,  realistic  case  studies  of  14  families  provide  a 
dynamic  developmental  view  of  health  care  needs  and 
problems.  More  than  700  questions  guide  creative  study. 

By  EVELYN  G.  SOBOL,  R.N.,  A.M.,  Assistant  Professor,  Depart- 
ment of  Nursing,  Bronx  Community  College,  The  City  University  of 
New  York;  and  PAULETTE  ROBISCHON,  R.N.,  Ph.D..  Consultant 
in  Nursing  Education,  Department  of  Baccalaureate  and  Higher 
Degree  Programs,  National  League  for  Nursing.  November,  1970. 
148  pages  plus  FM  IXII,  7"  x  10".  Price,  $6.25. 


New  2nd  Edition!  YoungBarger 

LEARNING  MEDICAL  TERMINOLOGY 
STEP  BY  STEP 

Thoroughly  revised  and  updated,  this  highly  popular 
book  enables  your  beginning  students  to  build  a  workable 
medical  vocabulary  based  on  understanding  rather  than 
memorization.  The  new  2nd  edition  includes  23  new  terms 
and  their  definitions,  and  all-new  illustrations! 

By  CLARA  GENE  YOUNG.  Retired  Technical  Editor  and  Writer 
(Medical),  U.S.  Civil  Service;  and  JAMES  D.  BARGER.  M.D., 
F.C.A.P.,  Pathologist,  Sunrise  Hospital  Medical  Center.  Las  Vegas, 
Nev.  July,  1971.  2nd  edition.  325  pages  plus  FM  IXII,  7"  x  10".  39 
illustrations.  About  $9.35. 


M05BY 


TIMES  MIRROR 


MAY  1971 


THE  C.V  MOSBY  COMPANY.  LTD.  •  86  NORTHLINE  ROAD  •  TORONTO  374,  ONTARIO.  CANADA 

THE  CANyfDiAN  NURSE     17 


iContiniic'il  from  ptif^c  16) 

is  the  responsibility  of  the  nursing  pro- 
fession, but  it  also  recognizes  that  nur- 
ses, as  individuals,  hold  certain  moral, 
religious  or  ethical  beliefs  about  abor- 
tion and  may  in  good  conscience  be 
compelled  to  refuse  involvement.  The 
association  supports  the  right  of  a  nurse 
to  withdraw  from  this  situation  without 
being  subjected  to  censure,  coercion, 
termination  of  employment,  or  other 
forms  of  discipline.  Health  facilities 
should  make  plans  for  staffing  with 
personnel  who  are  willing  and  compe- 
tent to  care  for  therapeutic  abortion 
patients. 

In  emergency  situations,  the  patient's 
right  to  receive  the  necessary  nursing 
care  would  take  precedence  over  ex- 
ercise of  the  nurse's  individual  beliefs 
and  rights  until  other  personnel  could 
be  secured. 

Winnipeg  Nurses  Seek  Re-Hearing 
Of  Bargaining  Application 

Winnipeg,  Man.  —  Registered  nurses 
at  the  Winnipeg  General  Hospital  have 
applied  for  a  re-hearing  following  the 
denial  of  their  application  for  certifica- 
tion as  a  bargaining  unit  by  the  Manito- 
ba Labour  Board  in  February.  The 
board  dismissed  the  application  on 
the  basis  that  the  unit  applied  for  was 
inappropriate  for  collective  bargaining. 

The  hospital  management  had  claim- 
ed the  unit  applied  for  was  inappro- 
priate, wrongly  defined,  and  should 
include  licensed  practical  nurses,  regis- 
tered psychiatric  nurses,  and  nursing 
technicians.  At  a  meeting  of  the  Win- 
nipeg General  Hospital  Registered 
Nurses"  Association  it  was  unanimously 
agreed  that  the  initial  stand  be  continu- 
ed, that  only  registered  nurses  employ- 
ed by  the  hospital  comprise  the  bargain- 
ing unit. 

Prior  to  this  application  the  Man- 
itoba board  had  approved  certification 
for  six  collective  bargaining  units  com- 
prised of  registered  nurses  only.  At 
present  all  nurses'  bargaining  units 
in  Canada  contain  registered  nurses 
only. 

In  a  statement  the  Manitoba  Asso- 
ciation of  Registered  Nurses  said: 

"We  acknowledge  the  contribution 
made  by  other  members  of  the  nursing 
team,  but  we  believe  that  quality  nurs- 
ing care  can  best  be  provided  by  the 
registered  nurse.  The  registered  nurse 
and  the  licensed  practical  nurse  are 
two  distinct  categories  of  nursing  per- 
sonnel, prepared  for  different  levels 
of  practice. 

18     THE  CANADIAN   NURSE 


"The  MARN  is  in  agreement  that 
eventual  alliance  of  all  nurses  is  desir- 
able, but  believes  that  this  must  be 
accomplished  through  a  well  planned 
program.  A  study  of  this  proposal  is 
underway  between  the  groups  con- 
cerned. A  forced  togetherness  at  this 
time  might  well  be  detrimental  to  the 
long-range  goals  of  these  three  groups 
of  nurses." 

The  Manitoba  Hospital  Association 
resolved  at  its  annual  meeting  in  De- 
cember 1970,  to  request  that  the  as- 
sociation of  registered  nurses,  licensed 
practical  nurses,  and  psychiatric  nurses 
study  the  possibility  of  consolidating 
legislation  relating  to  nursing  personnel. 

CEGEP  Teachers  Attend 
ANPQ  Workshops 

Montreal,  P.Q.  —  The  Association  o1 
Nurses  of  the  Province  of  Quebec  has 
been  holding  a  series  of  workshops  for 
CEGEP  teachers.  Rita  Lussier,  ANPQ 
nursing  service  consultant,  arranged 
the  workshops,  which  are  completed 
by  a  week's  study  course. 

Some  workshop  themes  included 
maternal  care,  psychiatric  nursing  care, 
and  medical-surgical  nursing  care.  As 
well  as  objectives  the  workshops  dis- 
cussed program  1 80  of  the  nursing  tech- 
niques option. 

Beginning  in  February,  the  work- 
shops will  be  held  until  late  June  in 
Montreal,  Quebec  City,  and  Chicoutimi. 

NBARN  Interprets 
Brief  To  Members 

Fredericton,  N.B.  —  The  New  Bruns- 
wick Association  of  Registered  Nurses 
ad  hoc  committee  made  a  series  of 
chapter  visits  in  March  and  April  to 
explain  the  brief  prepared  by  the  com- 
mittee and  presented  to  the  provincial 
study  committee  on  nursing  education. 
This  brief  "could  determine  the  future 
of  nursing  in  the  province,"  said  an 
NBARN  release.  "One  vital  aspect 
will  be  the  study  committee's  recom- 
mendations regarding  NBARN's  legal 
authority." 

NBARN  felt  it  was  important  that 
members  understand  what  authority 
their  association  has  and  what  the 
implications  would  be  if  any  change 
in  this  authority  were  suggested.  The 
method  of  interpretation  used  during 
the  visits  included  a  review  of  the  prin- 
ciples behind  the  recommendations. 

Another  NBARN  activity  this  spring 
was  the  holding  of  a  second  series  of 
workshops  on  the  legal  aspects  of  nurs- 
ing. Again  sponsored  by  the  social  and 
economic  committee,  the  series  expand- 
ed on  material  covered  in  the  fall  of 
1 970.  Topics  covered  were:  malpractice 
insurance,  both  coverage  and  exclu- 
sions; review  of  practices  initiated  as  a 
result   of  the   statement  on   medical- 


nursing  procedures;  the  legal  responsi- 
bility of  nurses  working  in  intensive  care 
units  and  other  specialized  areas;  the 
nurse  as  a  witness;  and  privileged  com- 
munication. 

Head  nurses  attended  a  March  work- 
shop on  rituals  and  routines  at  the  Adult 
Education  Institute,  Memramcook, 
N.B.  Workshop  leader  was  Pamela 
Poole,  nursing  consultant,  department 
of  national  health  and  welfare.  The 
NBARN  nursing  service  committee 
planned  the  workshop  as  an  opportunity 
for  head  nurses  to  work  with  Miss  Poole 
in  a  critical  evaluation  of  nursing  rou- 
tines. 

in  group  discussions  the  nurses  were 
asked  what  they  would  change  about 
physical  care  routines,  food  service 
routines,  admission  and  discharge  of 
patients,  communication  to  patients, 
and  medication  routines.  They  continu- 
ed their  discussion  with  an  assessment 
of  the  need  for  change  and  the  develop- 
ment of  a  plan  for  the  implementation 
of  change. 

Ottawa  U.  Nursing  Students 
Polish  Debating  Skills 

Ottawa  —  Students  in  nursing  educa- 
tion at  the  University  of  Ottawa  hotly 
debated  two  resolutions  befofe.a  critical 
audience  of  fellow  students  March  17. 

The  auditorium  at  the  National  De- 
^■ence  Medical  Centre  resounded  with 
applause  throughout  the  two  debates. 
In  the  first,  six  students  argued  whether 
or  not  it  is  the  responsibility  of  the 
employing  agency  to  provide  inservice 
education  to  enable  the  graduate  of  a 
two-year  program  in  nursing  to  function 
as  a  staff  nurse.  The  six  speakers  in  the 
second  debate  questioned  whether  the 
graduate  of  a  two-year  program  should 
function  only  as  a  team  member  in  the 
public  health  agency. 

Arguing  for  the  affirmative  in  the 
first  debate.  Edith  Gange-Harris,  a 
nursing  counselor  on  leave  from  the 
department  of  national  health  and  wel- 
fare, said  it  is  nursing  service  admin- 
istration that  must  pattern  the  perform- 
ance of  nursing  personnel  for  efficiency, 
which  can  be  achieved  and  maintained 
only  by  inservice  education.  This  is  the 
most  productive,  simple,  and  cheap 
tool  for  an  agency,  she  added.  Any 
administration  that  recognizes  the  re- 
wards of  increased  productivity  and 
does  not  provide  inservice  education  for 
the  RN,  "is  not  fulfilling  its  responsi- 
bility to  the  patient,  staff,  and  com- 
munity." 

Lillian  Smith  of  the  negative  team 
argued  that  since  the  hospital  has  allow- 
ed nursing  education  to  use  its  facilities 
without  any  service  demands  on  nurses 
so  nurses  can  be  better  educated,  the 
hospital  has  the  right  to  expect  a  finish- 
ed product. 

(Continued  on  page  21) 
MAY  1971 


* 


Your  written  guarantee  of  quality 


Each  prescription  you  fill  is  an  exercise  of  your  professional 
judgment.  The  drug  you  dispense  is  vital  to  your  cus- 
tomers' health  and  well-being.  What  may  seem  to  be 
minor  differences  in  dosage  form,  particle  size,  solubility, 
and  rate  of  absorption  may  make  major  differences  in 
therapeutic  efficacy.  When  the  choice  is  yours,  you  want 
to  dispense  the  best. 

*  ILOSONE  250  mg.  (erythromycin  estolate) 


Eli  Lilly  and  Company  (Canada)  Limited,  Toronto,  Ontario 


This  mmft  take 
a  minute 

Nurses  themselves,  in  time-studies*,  established  FLEET  as 
"the  40-second  enema".  Compared  with  the  old-fashioned 
method,  FLEET  ENEMA*  saves  the  nurse  an  average  of  27 
minutes  per  patient  —  not  to  mention  all  the  drudgery. 
FLEET  disposables  are  pre-lubricated,  pre-mixed,  pre- 
measured  and  individually  packed.  Everything  moves 
better  with  FLEET. 

Three  disposable   forms:   Adult   (green   protective   cap). 
Pediatric  (blue  cap),  and  Mineral  Oil  (orange  cap). 


WARNING:  Not  to  be  used  when 
nausea,  vomiting  or  abdominal  pain 
is  present.  Frequent  or  prolonged 
use  may  result  in  dependence. 
CAUTION:  Do  not  administer  to  chil- 
dren under  two  years  of  age  except  on 
the  advice  of  a  physician.  In  dehy- 
drated or  debilitated  patients,  the 
volume  must  be  carefully  deter- 
mined since  the  solution  is  hyper- 
tonic and  may  lead  to  further  dehy- 
dration. Care  should  also  be  taken 
to  ensure  that  the  contents  of  the 
bowel  are  expelled  after  administra- 
tion. Repeated  administration  at 
short  intervals  should  be  avoided. 


Full  intormalion  on  request. 
•Kehlmann,  W.H.:  Mod.  Hasp. 
84:104,  1955 


FOUNDED  IN  CANADA  IN  1899 
CHARLES  E.  FROSST  &  CO. 
KIRKLAND  (MONTREAL)  CANADA 


news 


(Conliiuwclfrom  page  18) 

The  negative  team  then  proposed 
that  the  graduate  of  a  two-year  program 
serve  a  six-month  graduate  internship 
in  the  hospital  with  which  she  has  been 
affihated;  write  registration  examina- 
tions after  this  internship;  worl<  a  37 '/2  - 
hour  week;  and  be  paid  by,  and  receive 
the  benefits  of,  the  hospital  on  a  grad- 
uate nurse  level.  As  part  of  this  plan, 
the  nursing  school  would  supply  and 
pay  a  qualified  nurse  teacher  who  would 
rotate  the  various  services  and  shifts 
with  the  interns. 

The  three  judges  chose  the  affirm- 
ative as  the  winning  team  in  this  de- 
bate. 

In  the  second  debate,  Oksana  Mar- 
tyniuk,  a  speaker  for  the  negative  side, 
asked  whether  the  two-year  graduate 
should  be  stifled  and  not  allowed  to 
develop  to  her  fullest  potential.  The 
public  health  agency,  she  insisted, 
should  "harness  motivations  already 
there  and  not  just  confine  the  nurse  to 
team  member."  To  her  contention  that 
"a  nurse  is  a  nurse  is  a  nurse,"  the  af- 
firmative replied  that  a  nurse  is  a  nurse 
—  but  not  necessarily  a  leader.  It  was 
the  three  negative  speakers  who  con- 
vinced the  judges. 


Poor  Response  To  MARN  Survey 
Could  Mean  Little  Unemployment 

Winnipeg,  Man.  —  As  few  replies  have 
been  received  to  the  recent  survey  on 
unemployment  made  by  the  Manitoba 
Association  of  Registered  Nurses,  the 
association  is  assuming  there  is  no  lack 
of  employment  for  nurses  in  the  prov- 
ince. 

MARN  public  relations  officer,  T.M. 
Miller  said,  "On  the  other  hand  it  might 
be  just  a  matter  of  procrastination." 
MARN  is  anxious  to  have  a  picture  of 
the  employment  situation  in  the  prov- 
ince and  urges  registered  nurses  unable 
to  find  employment  to  contact  the 
association. 

Quebec  Nurses'  Union 
Conducts  Telephone  Survey 
Of  All  Quebec  Nurses 

Montreal,  P.Q.  —  The  United  Nurses, 
Inc.,  one  of  three  nurses'  unions  in 
Quebec,  began  conducting  a  telephone 
survey  of  all  30,000  nurses  in  the  prov- 
ince in  March.  Nurses  were  also  urged 
to  call  the  union. 

Union  president  Gloria  Blaker  said 
the  survey,  taken  because  of  the  serious 
implications  for  the  union's  membership 
in  the  recommendations  of  the  Caston- 

MAY  1971 


guay-Nepveu  Commission  Report, 
was  intended  to  obtain  information  to 
help  the  union  do  a  better  job  represent- 
ing nurses  at  the  bargaining  table. 
■■.  .  .  there  must  emerge  a  stronger 
representation  [  and  ] .  .  .  a  more  united 
voice  for  the  .  .  .  negotiations,"  she 
added. 

"The  present  collective  agreement 
covering  thousands  of  nurses  and  signed 
with  the  government  and  the  hospitals 
association  will  end  on  June  30.  From 
that  date  new  negotiations  will  be  taking 
place  and  the  government  wishes  them 
to  be  held  with  a  single  union,"  Mrs. 
Blaker  said. 

In  explaining  where  nurses  stand  on 
the  application  of  the  Castonguay  re- 
port, Mrs.  Blaker  says  most  nurses  are 
unhappy  about  the  lack  of  a  proper 
definition  of  their  work.  ".  .  .  one  of 
the  results  of  medicare  has  been  to 
throw  huge  additional  workloads  onto 
nurses;  yet  the  definition  of  that  work 
varies  from  one  hospital  to  the  next, 
there  is  inadequate  legal  definition  of 
nursing  acts  .  .  .  and  there  are  serious 
problems  in  terms  of  professional  re- 
sponsibility and  the  precise  role  we 
play  in  the  health  team." 

The  United  Nurses,  founded  in  De- 
cember 1966,  has  close  to  6,000  mem- 
bers in  40  hospitals  and  health  agencies 
in  the  greater  Montreal  area  and  the 
Eastern  Townships.  The  other  two 
unions  in  the  province  are  I'Alliance 
des  Infirmieres  of  the  Confederation  of 
National  Trade  Unions  (CNTU)  and 
SPIQ,  Federation  des  Syndicats  Pro- 
fessionnels  des  Infirmieres  du  Quebec. 

The  Eyes  Have  It  — 

With  Mobile  Care  in  Newfoundland 

Toronto,  Ont.  —  The  first  mobile  eye- 
care  unit  in  Canada  is  now  in  service 
in  Newfoundland,  said  the  Ontario 
Medical  Review  in  its  February  issue. 
The  unit  will  be  used  and  maintained 
by  the  Newfoundland  and  Labrador 
Division  of  the  Canadian  National 
Institute  for  the  Blind  to  serve  remote 
areas  where  proper  eye  care  has  not 
been  available. 

The  credit  for  this  project  goes  to 
Dr.  Ellis  Shenken,  a  Toronto  oph- 
thalmologist, the  Weston  Lions. Club, 
Weston,  Ont.,  and  the  CNIB.  Dr.  Shen- 
ken supervised  the  planning  and  tested 
the  unit  for  about  three  months  before 
it  was  shipped.  The  service  club  donated 
$20,000  to  provide  the  special  truck, 
and  CNIB  purchased  ophthalmic  equip- 
ment worth  $10,000. 

The  unit  is  fully  equipped  for  com- 
plete medical  eye  examinations,  minor 
eye  surgery,  glaucoma,  and  amblyopia 
surveys.  The  truck  has  heating  and  air- 
conditioning,  and  specially  constructed 
access  stairways,  said  the  article.  It  is 
staffed  by  a  driver-secretary,  a  register- 
ed nurse,  and  an  ophthalmologist. 


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THE  CANADIAN  NURSE     21 


For  nursing 
convenience... 

patient  ease 

TUCKS 

offer  an  aid  to  healing, 
an  aid  to  comfort 

Soothing,  cooling  TUCKS  provide 
greater  patient  comfort,  greater 
nursing  convenience.  TUCKS  mean  no 
fuss,  no  mess,  no  preparation,  no 
trundling  the  surgical  cart.  Ready- 
prepared  TUCKS  can  be  kept  by  the 
patient's  bedside  for  immediate  appli- 
cation whenever  their  soothing,  healing 
properties  are  indicated.  TUCKS  allay 
the  itch  and  pain  of  post-operative 
lesions,  post-partum  hemorrhoids, 
episiotomies,  and  many  dermatological 
conditions.  TUCKS  save  time.  Promote 
healing.  Offer  soothing,  cooling  relief 
in  both  pre-and  post-operative 
conditions.  TUCKS  are  soft 
flannel  pads  soaked  in  witch  hazel 
(50%)  and  glycerine  (10%). 


TUCKS  —  the  valuable  nur- 
sing aid.  the  valuable  patient 
comforter. 


w 


Specify  the  FULLER  SHIELD'*'  as  a  protective 
postsurgical  dressing.  Holds  anal,  perianal  or 
pilonidal  dressings  comfortably  in  place  with- 
out tape,  prevents  soiling  of  linen  or  cloth- 
ing. Ideal  for  hospital  or  ambulatory  patients. 


WINLEY-MORRIS  l% 

MONTREAL 


TUCKS  Is  a  trademark  of  the  Fuller  Laboratories  Inc. 
22     THE  CANADIAN   NURSE 


ICN  Prepares  Draft 
On  Status  Of  Nurses 

Geneva,  Switzerland — The  Interna- 
tional Council  of  Nurses'  professional 
services  committee  has  begun  a  draft 
on  what  it  believes  should  be  contained 
in  the  "special  international  instrument 
on  the  status  of  nursing  personnel,"  a 
document  to  be  prepared  in  final  form 
by  the  International  Labour  Organiza- 
tion, in  cooperation  with  the  World 
Health  Organization.  Work  on  the  out- 
line occupied  the  major  part  of  a  three- 
day  meeting  of  the  committee  on  Feb- 
ruary 10-12,  1971. 

ICN  member  organizations  were 
consulted  so  the  presentation  of  the 
draft  would  reflect  what  nurses  wish 
to  see  included  in  the  final  document, 
which  will  be  tabled  for  ratification  by 
various  governments. 

The  ICN  board  of  directors  referred 
to  the  committee  the  study  of  "auxiliary 
nursing  personnel  and  their  position  in 
relation  to  national  nurses'  associa- 
tions." Information  for  this  study  will 
bring  ICN  up-to-date  on  developments 
in  many  countries  and  possibly  indicate 
future,  trends  m  membership,  not  only 
of  national  nurses'  associations  but  of 
ICN.  The  committee  will  give  a  pro- 
gress report  at  the  Council  of  National 
Representatives  meeting  planned  for 
Dublin  in  July. 

The  committee  was  asked  by  the 
board  to  make  suggestions  for  revision 
of  the  ICN  code  ^ethics.  Three  com- 
mittee members,  chairman  Ingrid  Ham- 
elin  of  Finland,  Dr.  Rebecca  Bergman 
of  Israel,  and  Margery  Westbrook  of 
the  United  Kingdom,  met  as  a  subcom- 
mittee to  consider  code  revisions.  Their 
report  was  accepted  by  the  committee. 
The  final  document  will  be  voted  on  at 
the  CNR  meeting  in  1973. 

Also  at  the  request  of  the  board  the 
committee  is  considering  the  role  of 
ICN  in  nursing  research.  I  he  com- 
mittee agreed  that  ICN  has  a  role  m 
research  and  that  research  projects 
should  be  selected  on  a  priority  basis. 

At  its  1970  meeting  the  board  re- 
ferred to  the  committee  a  request  from 
a  member  association  to  study  the  role 
of  the  qualified  nurse  in  the  decision 
procedure  in  hospital  organization. 
The  committee  will  recommend  to  CNR 
that  ICN  reaffirm  the  relevant  state- 
ments contained  in  the  "statement  on 
nursing  education,  nursing  practice, 
and  service  and  the  social  and  economic 
welfare  of  nurses." 

These  are:  "Nursing  service  is  im- 
proved through  a  system  within  which 

(Continued  on  puf;e  24) 
MAY  1971 


NEW  EDITION  OF 


Edition 


Maintaining  the 

high  goals  set  by 

earlier  editions,  this 

family-focused  text  is 

^expanded  and  updated 

in  line  with  new  medical 

pxjncepts  and  concomitant 

irsing  practice.  All  content 

is  directed  toward  the  total 

health  and  well-being  of 

the  mother  and  infant. 

■     Elise  Fitzpatrick,  R.N.,  M.A.; 
SharonR.  Reeder.  R.N.,  M.S.;  and 
Luigi  Mastroianni,  Jr.,  M.D.,  F.A.C.S.,  F.A.C.O.G. 

700  Pages -320  Illustrations- April,  1971  •  $9.50 


J,  B.  Lippincott  Company  of  Canada  Ltd!^^  60  Front  Street,  West 


Toronto  1 ,  Ontario 


Next  Month 
in 

The 

Canadian 
Nurse 


•  Report  of  CNJ 
Readership  Survey 

•  Do  You  Have  a  Bad 

Trip  If  You  Go  to  hospital? 

•  Travel  Seminar 
to  the  North 


^ 

^^F 


Photo  credits  for 
May  1971 


Crombie  McNeill  Photography, 
Ottawa,  p. 7 

Photo  Features,  Ottawa,  pp.  8,  16 

RNABC  News,  Vancouver,  p.24 

Canada  Wide  Feature  Service 
Ltd.,  Montreal,  p. 48 

Armour  Landry,  Montreal, 
pp.49,  50 


It  Wasn't  Quite  The  Stanley  Cup! 


I II  iii«"jii" .  k 


It  might  not  have  been  the  same  as  Hockey  Night  in  Canada,  in  fact,  some  of 
the  players  wore  boots.  Still,  the  game  was  hotly  contested.  The  Registered 
Nurses'  Association  of  British  Columbia's  February  bulletin  gives  this  account 
of  "Schmocicey  Nite"  in  Powell  River,  B.C.  It  was  a  nurses  vs.  doctors  grudge 
match  following  the  doctors'  triumph  over  the  nurses  at  Softball  last  summer. 
The  nurses  were  out  to  get  the  doctors  from  the  start,  but  it  was  an  uphill  battle 
as  the  doctors  took  a  1-0  lead  early  in  the  game.  Then  a  strategic  time-out  was 
called.  The  nurses  passed  around  some  "refreshment"  in  an  intravenous  bottle. 
This  was  the  downfall  of  senior  medical  staff,  for  they  were  distracted  and  the 
wily  nurses  carried  off  the  doctors'  star  net  minder  on  a  stretcher.  Game  Over! 


24     THE  CANADIAN   NURSE 


(Continued  from  page  22) 

nursing  leadership,  is  exercised  and 
optimum  use  made  of  nursing  person- 
nel" and  "Nurses  should  participate  in 
the  planning  and  administration  of 
health  and  nursing  services  at  national 
and  local  levels." 

The  committee  reviewed  and  assem- 
bled material  related  to  the  emergence 
of  a  new  category  of  health  worker  — 
the  physician's  assistant.  The  issue  was 
raised  by  a  member  association  and 
referred  to  the  committee  by  the  board. 

The  committee  received  a  report 
from  headquarters  staff  on  the  success- 
ful international  seminar  on  nursing 
legislation  held  in  Warsaw,  Poland,  in 
July  1970.  The  committee  initiated 
the  project  and  will  recommend  to  the 
CNR  that  similar  seminars  be  held  in 
other  countries. 

Other  members  of  the  professional 
services  committee  are:  Laura  Barr, 
Canada;  Renee  de  Roulet,  Switzerland; 
and  Gertrude  Swaby,  Jamaica.  Also 
attending  the  meetings  were  Lily  Turn- 
bull,  chief  nursing  officer,  WHO; 
Yvonne  Hentsch,  director  of  the  nurs- 
ing bureau  of  the  league  of  Red  Cross 
Societies;  and  ICN  president,  M.  Kruse. 


ION  Post  Open 
In  Switzerland 

Geneva,  Switzerlarid  —  The  Interna- 
tional Council  of  Nurses  has  a  nurse 
advisor  position  open  on  the  execu- 
tive staff  of  the  council.  Applicants 
must  be:  registered  nurses  in  own  coun- 
try; members  of  an  ICN  member  as- 
sociation; willing  to  take  up  residence 
in  Geneva,  Switzerland;  able  to  travel 
extensively  on  behalf  of  the  organiza- 
tion; prepared  and  experienced  (post 
basic)  in  the  fields  of  nursing  service, 
education,  or  public  health;  fluent  in 
English  and  with  a  sound  knowledge 
of  a  second  Europen  language,  prefera- 
bly French  or  Spanish. 

Send  curriculum  vitae  (including 
experience  in  nursing  association  work) 
in  English  to:  Executive  Director, 
ICN  Headquarters,  Box  42,  1211 
Geneva  20,  Switzerland.  ■§> 


THE  RED  CROSS  IS 
PEOPLE  LIKE  YOU 
HELPING 
PEOPLE  LIKE  YOU 


MAY  1971 


for  use 
-on  the  ward 
-in  the  OR 


-in  training 


NEOSPORIN^ 
IRRIGATING 
SOLUTION 

Available;  Siefile  Ice,  Ampoules, 
Boxes  of  10  and  100 

INSTRUCTIONS  FOR  USE 


This  pfeparBiion  is  speciticolly  designed  for  use  with  5  cc. 
"three-way"  cattieTefs  o<  *"l*i  other  catheter  systems  permit- 
ting continuous  irriQsiion  of  the  unnsry  bladder. 

1  PREPARE  SOLUTION 

Usifig  siefile  piecaulions,  one  (1 )  cc.  of  Neospoim  Irriga- 
ting Solution  should  be  added  to  a  1 ,000  cc,  botile  of 
sterile  isoioH'C  saline  solution. 

2  INSERT  INDWELLING  CATHETER 

Catheierize  the  patient  using  full  sterile  precautions.  The 
use  of  sn  antibacterial  lubricant  sucli  as  Lubasponn*  Urethral 
Antibactenal  Lubficant  is  recommended  during  insertion  of 
the  catheter 

INFLATE  RETENTION  BALLOON 

Fill  a  Luer  type  syinge  with  1 0  cc.  of  sterile  water  or  saline 
(5  cc,  for  balloon,  the  remainder  to  compensate  for  the 
volume  required  by  the  inflation  channel)    Insert  symge 
tip  into  valve  ol  balloon  lumen,  in|ect  solution  and  remove 
syringe. 

IpONNECT  COLLECTION  CONTAINER 

outflov*  (drainage)  lumen  should  be  aseplicaliy  con- 
rcted.  via  a  sterile  disposable  plastic  tub«.  to  a  sterile 
losable  plastic  collection  bag  (bottle). 

ACH  RINSE  SOLUTION 

inflow  lumen  of  the  5  cc   "three-way"  catheter  should 
be  connected  to  the  bottle  ot  diluted  Neosporin 
ilion  Solution  using  sterile  technique, 

f  ADJUST  FLOW-RATE 

■or  most  patients  inflow  rate  of  the  diluted  Neosporin 
Irrigating  Solution  should  be  adjusted  to  a  slow  drip  to 
deliver  about  1.000  cc.  every  twenty-four  hours  (about 
40  CC   per  hour).  It  the  patient's  urine  output  exceeds  2 
liters  per  day  it  is  recommended  that  the  inflow  rate  be 
adjusted  to  deliver  2,000  cc   of  the  solution  m  a  twenty- 
four  hour  period  This  lequiies  the  addition  ot  an  ampoule 
ot  Neosporin  Irrigating  Solution  to  each  ot  two  1,000  cc, 
bottles  of  sterile  saline  solution 

KEEP  IRRIGATION  CONTINUOUS 

It  IS  important  that  irrigation  of'the  tiladder  be  continuous 
The  rinse  bottle  should  never  be  allowed  to  run  dry.  or  the 
inflow  d'lP  interrupted  lO'  more  than  a  few  minutes.  The 
outflow  tube  should  always  be  inserted  into  a  itenle 


Convenient  product  identifying  labels  for  use  on  bottles 

ot  diluted  Neosporin  Irrigating  Solution  are  available  in  each 
ampoule  packing  or  from  your  'B.  W    &  Co.'  Representative. 


Burroughs  Wellcome  &  Co.  (Canada)  Ltd. 


1 

i-o 

^Kt'-\f(i 

1 

1                                   i 

Jk>*-                     »  1 

^ 

I                                   1 

1 

;!GEEI 


Neosporirf  Irrigating  Solution 


INSTRUCTIONS  FOR  USE 


Designed  especially  for  the  nursing  pro- 
fession, this  Instruction  Sheet  shows 
clearly  and  precisely,  step  by  step,  the 
proper  preparation  of  a  catheter  system 
for  continuous  irrigation  of  the  urinary 
bladder.  The  Sheet  is  punched  3  holes  to 
fit  any  standard  binder  or  can  be  affixed 
on  notice  boards,  or  in  stations. 

For  your  copy  (copies)  just  fill  in  the  cou- 
pon (please  print)  noting  your  function  or 
department  within  the  hospital. 


Dept,  S,P,E. 

Burroughs  Wellcome  &  Co,  (Canada)  Ltd, 

P,0,  Box  500,  Lachine,  P,0, 

Gentlemen  : 

Please  send  me  I I  copy  (copies)  of  the  N.I.S.  Instructions  for  Use.  My  department  or  function 

within  the  hospital  is ■ — 


NAME. 


ADDRESS. 


CITYORTOWN_ 


.PROV. 


I   PIWIAC    I 

"Trade  Mark 

MAY   1971 


Burroughs  Wellcome  &  Co.  (Canada)  Ltd. 

THE  CAr^ADIAN   NURSE     25 


names 


Freda     Paltiel     has 

been  seconded  by 
the  Prime  Minister 
to  the  Privy  Coun- 
cil, the  cabinet  sec- 
retariat. As  coordi- 
nator of  the  federal 
government's  exam- 
ination of  the  status 
of  women,  she  works 
with  25  government  departments  and 
agencies  from  a  secluded  office  in  the 
East  Block  of  the  Parliament  buildings. 
Mrs.  Paltiel.  who  was  with  the  de- 
partment of  national  health  and  welfare 
doing  research  on  rehabilitation  and 
chronic  disease,  brings  to  her  task  a 
sound  education  in  sociology,  medical 
social  work,  and  public  health,  and 
recognized  experience  in  social  policy 
research. 


Eva  M.  O'Connor  (R.N.,  St  Mary's 
Hospital  School  of  Nursing,  Montreal; 
B.Sc,  University  of  Ottawa)  was  ap- 
pointed registrar  of  the  New  Brunswick 
Association  of  Registered  Nurses,  ef- 
fective March  1,  1971. 

Miss  O'Conner,  a  native  of  New 
Brunswick,  returned  to  her  home  prov- 
ince following  varied  experiences  in 
nursing  service  at  St.  Mary's  Hospital, 
Montreal;  in  Aukland,  New  Zealand; 
and,  most  recently,  in  Tampa,  Florida. 

Marie  T.  Germin  (R.N.,  Misericordia 
Hospital  School  of  Nursing,  Edmonton) 
is  currently  on  a  two-year  tour  of  duty 
with  MEDICO,  a  service  of  care,  work- 
ing with  a  10-member  team  of  doctors, 
nurses,  and  a  technologist  stationed  at 
Avicenna  Hospital,  Kabul,  Afghanis- 
tan's capital.  Her  role  is  that  of  teaching 
and  training  Afgahan  personnel  to 
eventually  carry  on  by  themselves  and 
train  others. 

Miss  Germin  has  worked  at  hospitals 
in  Tofield,  Wainwright  and  Red  Deer, 
Alberta,  and  at  Kelowna,  B.C.  She 
nursed  for  a  year  at  a  mission  center 
on  Dominica,  a  West  Indian  island. 

Jessie  Williamson  (R.N.,  St.  Boniface 
Hospital,  B.S.,  Columbia  University, 
New  York)  has  retired  as  director  of 
public  health  nursing  services  of  Man- 
itoba, a  position  she  has  held  for  16 
years.  She  believes  the  position  should 
be  filled  by  an  administrator  young 
enough  to  oversee  the  childhood  of  the 
"new  order."  For  her,  the  community 
26     THE  CANADIAN   NURSE 


health  center  concept  —  the  basis  of 
a  new  regional  health  service  system 
planned  by  the  provincial  government 
—  is  just  another  word  for  public 
health. 

Pamela  E.  Poole,  nursing  consultant, 
health  insurance  branch  of  the  depart- 
ment of  national  health  and  welfare, 
and  Rita  M.  Morin,  nursing  counsellor, 
public  service  health  division  of  the 
department  of  national  health  and  wel- 
fare in  Edmonton,  are  members  of  the 
1971  board  of  directors  of  the  Profes- 
sional Institute  of  the  Public  Service. 
They  represent  nursing  groups:  Miss 
Poole  for  the  Ottawa  area,  and  Mrs. 
Morin  for  the  prairies. 

Nelly  Garzon,  dean  of  the  faculty  of 
nursing  at  Universidad  Nacional  de 
Colombia,  and  LottI  Wiesner,  president 
ot  the  Colombian  Nurses'  Association 
and  chief  nurse  in  the  Ministry  of  Public 
Health,  both  of  Bogota,  Colombia, 
visited  CNA  House  March  16.  Leaders 


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Please  complete  appropriate  category: 

I     I     I  hold  active  membership  in  provincial 
nurses'  assoc. 


reg.  no. /perm,  cert./  lie.  no. 
I  I  I  am  a  Personal  Subscriber. 
MAIL  TO: 

The  Canadian  Nurse 

50  The  Driveway 

OnAWA,  Canada  K2P  1E2 


in  their  field,  they  are  interested  in  the 
comparative  aspects  of  Canadian  and 
Colombian  nursing  and  health  needs. 
They  were  in  Canada  as  guests  of  CUSO 
to  discuss  means  of  facilitating  the 
placement  of  CUSO  nurses  in  Colombia 
and  providing  relevant  in-country 
orientations  to  newly  arrived  Canadian 
nurses. 

Dr.  Muriel  Uprichard 

has  been  appointed 
head  of  the  school 
of  nursing  of  the 
University  of  Brit- 
ish Columbia,  ef- 
fective July  1 . 

Dr.  Uprichard 
brings  to  her  new 
position  a  distin- 
guished academic  background  (B.A., 
Queen's  University,  Kingston;  M.A., 
Smith  College,  Northampton,  Mass.; 
Ph.  D.  (educational  psychology)  Uni- 
versity of  London  Institute  of  Educa- 
tion; and  post-doctoral  studies  in  public 
health.  University  of  Michigan,  Ann 
Arbor)  as  well  as  a  rich  professional 
experience.  She  was  associate  professor 
at  the  school  of  nursing,  University  of 
Toronto  until  1965  when  she  joined  the 
faculty  of  the  University  of  California 
at  Los  Angeles  as  senior  lecturer  in 
nursing  and  associate  research  psy- 
chologist. 

In  1964-65,  as  consultant  to  the 
Royal  Commission  on  Health  Services 
in  Canada,  Dr.  Uprichard  was  respon- 
sible for  the  section  of  the  report  deal- 
ing with  the  improvement  of  patient 
care  through  more  effective  utilization 
of  nurses. 

In  1948,  Dr.  Uprichard  published 
Three  Little  Indians,  her  collection  of 
original  stories  for  children.  About 
to  be  published  (aided  by  funds  from 
The  American  Nurses'  Foundation) 
is  her  newest  work:  The  Making  of 
Modern  Nursing:  A  Study  of  Social 
Forces  Influencing  the  Development 
of  Professional  Nursing.  § 


RED  CROSS 

IS  ALWAYS  THERE 
WITH  YOUR  HELP 


+ 


MAY  1971 


DONT  DROPTHE  SUBJEQ 


Until  you  switch  to  VIAFLEX  plastic  con- 
tainers for  safer,  easier,  faster  l.V.  pro- 
cedures. Bottles  have  a  habit  of  falling. 
And  breaking.  Which  increases  costs — 
not  just  for  the  solutions,  but  also  for 
those  expensive  drugs  that  have  been 
added.  And  sometimes  people  get  cut  by 
the  broken  glass.  VIAFLEX  plastic  con- 


tainers can  fall,  but  they  can't  break. 
Chances  are,  though,  that  they  won't  fall 
— because  they're  lighter  and  easier  to 
handle.  No  metal  closures  or  caps  to 
fumble  with.  Set-ups  are  faster,  change- 
overs  are  easier.  And  the  whole  proce- 
dure is  safer.  Because  VIAFLEX  is  a  com- 
pletely closed  system.  No  vent;  no  room 


BAXTER  LABORATORIES  OF  CANADA 


DIVISION  OF  TRAVENOL  LABORATORIES.  INC. 

6405  Northam  Drive,  Malton,  Ontario 


air  enters  the  container;  no  airborne  con- 
taminants get  Inside  the  system.  VIAFLEX 
is  the  first  and  only  plastic  container  for 
l.V.  solutions.  For  safer,  easier,  faster 
procedures,  VIAFLEX  Is  Hf^^H| 
the  first  and  only  con-  ^HfASI^H 
tainer  you  should  con-  ^Bs^^| 
sider.  Easy  come.  Easy  go.     ^B^^H 

Viailex 


M/VY  1971 


THE  CANADIAN   NURSE     27 


HOSPITAL 
LIQUID  UNIT  DOSE 


...for  safety,  control,  convenience 


Each  unit  dose  is  protected  against 
contamination  in  amber  glass  with 
tamper-proof  seal,  clearly  labelled  as 
positive  safeguard  against  error  in 
administration. 


Each  unit  dose  is  precisely  measured, 
easily  identified  by  name,  quality- 
assured  from  our  production  line  to  your 
patient's  bedside. 


Each  unit  dose  is  ready  to  administer 
right  from  the  spill-proof  bottle,  saving 
you  valuable  time  in  preparation  and 
distribution. 


Each  unit  dose  is  packaged  to  provide 
the  maximum  safety,  control  and 
convenience. 


intra  medical  products 


TORONTO,  ONTARIO 


.•<:l»}:lBf:: 


May  11-14, 1971 

Alberta  Association  of  Registered  Nurses, 
annual  meeting,  Banff  Springs  Hotel,  Banff, 
Alberta. 

May  17, 1971 

Canadian  Nurses'  Foundation,  annual 
meeting,  CNA  House,  Ottawa,  Ontario. 


May  19-20, 1971 

New  Brunswick  Association  of  Regis- 
tered Nurses,  annual  meeting.  Holiday  Inn, 
Saint  John,  N.B.  Convention  theme:  "Pat- 
terns of  Health  Care  in  N.B." 


May  26, 1971 

Registered  Nurses'  Association  of  British 
Columbia,  59th  annual  meeting,  Bayshore 
Inn,  Vancouver,  B.C. 


May  21-24, 1971 

Halifax  Conference  in  Creative  Drama, 
sponsored  by  the  Canadian  Child  &  Youth 
Drama  Association,  Dalhousie  University. 
Halifax.  For  further  information  write:  Mrs. 
Susan  Loring,  Treasurer,  CCYDA,  56  Francis 
Street,  Halifax,  Nova  Scotia. 


May  22, 1971 

First  reunion  of  graduates  of  St.  Louis  de 
Montfort  Hospital  School  of  Nursing,  Vanier 
City,  Ontario.  Send  address  to:  C.  Larocque, 
School  of  Nursing,  St.  Louis  de  Montfort 
Hospital,  Vanier  City,  Ontario. 

May  24, 1971 

Final  graduation  and  grand  reunion,  St. 
Mary's  School  of  Nursing,  Sault  Ste.  Marie, 
Ontario.  Graduates  and  other  interested 
persons  should  write  for  further  details 
to:  Mrs.  A.  McPhee,  General  Hospital 
Nurses'  Alumnae,  941  Queen  St.  E.,  Sault 
Ste.  Marie.  Ontario. 

May  26, 1971 

Saskatchewan  Registered  Nurses'  Asso- 
ciation, annual  meeting,  Bessborough 
Hotel.  Saskatoon,  Saskatchewan. 

May  30-|une  1,1971 

Manitoba  Association  of  Registered  nurses, 
annual  meeting,  Dauphin,  Manitoba. 


May  31  to  June  2, 1971 

University  of  British  Columbia,  Division  of 
Continuing  Education,  Course  on  Nursing 
Service  Administration  for  directors  of 
nursing  service  in  all  health  care  agencies. 
Fee:  $55.00.  For  further  information  write: 

MAY  1971 


Margaret  S.  Neylan,  Associate  Professor 
and  Director,  University  of  British  Colum- 
bia School  of  Nursing,  Division  of  Continu- 
ing Education,  Vancouver  8,  B.C. 

June  2-4  1971 

Canadian  Hospital  Association,  National 
convention  and  assembly,  Queen  Elizabeth 
Hotel.  Montreal,  Quebec. 

June  6-10, 1971 

Ninth  Canadian  Cancer  Conference  under 
the  auspices  of  the  National  Cancer  Ins- 
titute of  Canada,  Honey  Harbour,  Ontario. 

June  7-11, 1971 

Canadian  Medical  Association,  104th  an- 
nual meeting.  Nova  Scotia.  For  further 
information:  Mr.  B.E.  Freamo,  Acting 
General  Secretary,  Canadian  Medical 
Association,  1867  Alta  Vista  Drive,  Ottawa 
8,  Ontario. 

June  9-11, 1971 

University  of  British  Columbia,  Department 
of  Continuing  Education,  course  on  nursing 
education  designed  f9r  educators  in  schools 
of  nursing  and  health  care  agencies.  Fee: 
$55.00.  For  further  information  write: 
Margaret  S.  Neylan,  Associate  Professor 
and  Director,  University  of  British  Columbia 
School  of  Nursing,  Division  of  Continuing 
Education,  Vancouver  8.  B.C. 

June  9-12, 1971 

Canadian  Psychiatric  Association,  21st 
annual  meeting,  Lord  Nelson  Hotel,  Halifax, 
ivf.S.  For  further  information  write:  Canadian 
Psychiatric  Association,  Suite  103,  225 
Lisgar  Street,  Ottawa  4,  Unt. 

June  10-11, 1971 

Symposium  on  Metabolism  and  Disease, 
sponsored  by  the  Food  and  Drug  Director- 
ate, Department  of  National  Health  and 
Welfare,  Talisman  Motor  Inn,  Ottawa. 

June  15-17, 1971 

Registered  Nurses'  Association  of  Nova 
Scotia,  annual  meeting.  Nova  Scotia  Agri- 
cultural College,  Truro.  Nova  Scotia. 

June  21-23, 1971 

Operating  Room  Nurses  of  Greater  To- 
ronto seventh  annual  conference.  Royal 
York  Hotel,  Toronto.  For  further  informa- 
tion contact:  Miss  Marilyn  Brown,  2178 
Queen  St.  E.,  Apt.  4,  Toronto  13,  Ontario. 

June  23-25, 1971 

Three-day  reunion,  Victoria  General  Hospi- 
tal. Registration:  Nurses'  Residence,  415 
River  Ave.,  Winnipeg.  For  further  informa- 
tion contact:  Mrs.  J.  Wakely,  426  Centen- 
nial St.,  Winnipeg  9,  Manitoba.  'S' 


This  hand 

was  bandaged 

in  just 

34  seconds 

with 

Tubegauz 

SEAMLESS 

TUBULAR 

GAUZE 


It  would  normally  take  over  2  minutes. 
But  the  Tubegauz  method  is  5  times 
faster— 10  times  faster  on  some 
bandaging  jobs.  And  it's  much  more 
economical. 

fv^any  hospitals,  schools  and  clinics 
are  saving  up  to  50%  on  bandaging 
costs  by  using  Tubegauz  instead  of 
ordinary  techniques.  Special  easy- 
to-use  applicators  simplify  ei^er/ type 
of  bandaging,  and  give  greater  patient 
comfort.  And  Tubegauz  can  be  auto- 
claved.  It  is  made  of  double-bleached, 
highest  quality  cotton.  Investigate 
for  yourself.  Send  today  for  our  free 
32-page  illustrated  booklet. 


Surgical  Supply  Division 

The  Scholl  Mfg.  Co.  Limited 

174  Bartley  Drive.  Toronto  16.  Ontario 

Please  send  me  "New  Techniques 
of  Bandaging  with  Tubegauz". 

NAME 

ADDRESS 


THE  SCHOLL  MFG.  CO.  LIMITED 

69H9 

THE  CANADIAN   NURSE     29 


in  a  capsule 


Convention-ilis 

We  are  passing  along  a  message,  which 
requires  no  comment,  from  the  editor 
ot7yas/;/7a/.v.  the  journal  of  the  American 
Hospital  Association.  This  editorial, 
by  James  Hague,  appeared  in  the  Feb- 
ruary 1 6  issue  of  the  journal. 

"...  Alexis  de  Tocqueville  has 
noted  the  American's  strange  affinity 
for  organizing  into  associations  to 
promote  one  worthy  cause  or  another 
The  years  have  not  changed  the  valid- 
ity of  the  Tocqueville's  observation. 

"One  of  the  first  things  an  associa- 
tion does  is  to  run  an  annual  meeting 
or  convention,  gathering  its  members 


from  near  and  far  to  conduct  all  sorts 
of  deliberations,  and  to  be  bombarded 
with  all  kinds  of  lofty  notions. 

"These  affairs  are  often  wearying 
beyond  endurance.  One  distinguished 
science  writer.  Doctor  Milton  Silver- 
man, was  exposed  to  more  than  what  he 
thought  was  his  proper  share  of  these 
extravaganzas,  it  led  him  to  comment 
that  the  last  day  of  a  convention  should 
be  eliminated,  and  this  process  should 
be  carried  to  its  logical  conclusion." 

In  Mr.  Hague's  closing  words,  "After 
just  finishing  one  of  these  affairs,  one 
is  inclined  to  suspect  that  Doctor  Sil- 
verman was  quite  right." 


30     THE  CANADIAN   NURSE 


"Phony"  words 

The  words  "Anglophone"  and  "Franco- 
phone" have  been  bandied  about  ad 
nauseam  since  the  B  and  B  Commission 
came  into  existence.  At  first  we  thought 
they  must  refer  to  some  new  gimmick 
put  out  by  Mother  Bell,  but  then  we 
learned  they  applied  to  those  who  speak 
English  and  those  who  speak  French. 

Nowhere  in  our  British  or  American 
dictionaries  could  we  find  these  words. 
However,  they  do  appear  in  Diclion- 
naire  Robert,  a  well-known  dictionary 
published  in  France. 

We  still  think  these  words  sound 
"phony."  And,  as  one  gentleman  said 
in  a  letter  to  the  editor  of  The  Ottawa 
Citizen,  if  people  insist  on  using  these 
words,  they  should  at  least  take  history 
into  account.  The  Saxons,  he  said, 
played  a  far  more  important  role  in 
history  than  did  the  Angles.  Therefore, 
he  suggested,  we  should  refer  to  those 
who  speak  English  as  "Saxophones." 


Art  brightens  medical  centre 

Three  cheers  for  McMaster  Univers- 
ity Medical  Centre!  it  has  reason  to  be 
proud  of  its  efforts  to  provide  its  visitors 
with  a  gallery  of  paintings  by  world 
renowned  artists. 

Chagall,  Dali,  and  Boulanger  are 
just  a  few  of  the  artists  whose  works 
have  adorned  the  walls  of  patient  wait- 
ing areas  in  the  completed  section  of 
the  medical  center.  In  March  the  Beck- 
ett Gallery  in  Hamilton  provided  a  dis- 
play, and  a  continuing  series  of  art 
exhibitions  are  planned. 

The  idea  is  to  make  the  center's 
atmosphere  as  human  and  stimulating 
as  possible.  Evidence  of  this  aim  can 
be  seen  in  the  colorful  treatment  of 
walls  and  the  use  of  pre-shaped  masonry 
materials  that  can  be  assembled  to 
produce  varying  wall  patterns. 

In  March  there  were  62  paintings 
and  etchings  on  show,  a  number  of 
lithographs,  serigraphs,  acrylics,  and 
Eskimo  stone  cuts.  And  for  those  who 
might  later  think  of  purchasing  a  piece 
of  art,  a  price  list  is  on  hand. 

McMaster  believes  this  is  the  first 
time  a  hospital  has  provided  this  kind 
of  interest  for  patients  and  visitors  — 
as  well  as  for  the  staff  who  work  there 
day  in  and  day  out.  Whether  it  is  a  first 
or  not,  McMaster  deserves  congratula- 
tions for  taking  this  imaginative  step 
forward.  ^ 

MAY  1971 


A  ward-winning 
combination 


With  Dermassage,  all  you  add  is  your  soft 
touch  to  win  the  praises  of  your  patients. 

Dermassage  forms  an  invisible, 
greaseless  film  to  cushion  patients 
against  linens,  helping  to  prevent 
sheet  bums  and  irritation.  It  protects 
with  an  antibacterial  and  antifungal 
action.  Refreshes  and  deodorizes 
without  leaving  a  scent.  And  it's 
hypo-allergenic. 

Dermassage  leaves  layers 
of  welcome  comfort  On 
tender,  sheet-scratched       ^  _ 
skin.  And  there's  another 
bonus  for  you:  While  , 

you're  soothing  patients 
with  Dermassage,  you're 
also  softening  and  ( 

smoothing  your  hands.    '^ 

Try  Dermassage.      ^ 
Let  your  fingers  a 

do  the  talking. 


,  I^itke.sUle  L.alx>ratories  (Canada)  Ltd. 
(14  ('olfiate  Avenue, Toronto  8,  Ontarw; 


*Trade  mark 


ijii^^^ 


i 


X 


no  OThKR  BflG  PfRFORfTU  UH£  fTlf 


My  safety  chamber 
really  slops  retro- 
grade infection. 
There's  simply  no  way 
for  the  bugs  to  back 
up  and  go  where  they 
don't  belong.  And  by 
tucking  the  BAC- 
STOP  chamber  in-~ 
side  the  bag,  it  can't 
be  kinked  acciden- 
tally to  stop  the  flow. 


Cystoflo 

Urinary  OnMMp  Sag 


My  hanger  is  the 
hanger  that  works 
well  all  the  time.  Hang 
it  on  a  bed  rail  or  a 
belt,  it  is  always  se- 
cure and  comfortable. 
I'm  always  on  the 
level  with  this  hanger, 
whether  my  patient  is 
lying,  sitting,  or  walk- 
ing around. 


I'm  clear-faced  and 
easy  to  read.  My  white 
back  makes  my  mark- 
ings stand  out  unique- 
ly, whether  you  look 
at  my  backbone  scale, 
or  tilt  me  diagonally 
to  read  small  amounts 
with  the  corner  cali- 
brations. 


I  hnvo  the  only  shortie 
drainage  tube  around, 
and  it's  miles  better 
than  any  other 
you've  ever  used.  It's 
easier  to  handle,  and  it 
won't  drag  on  the  floor, 
even  with  the  new  low 
beds.  So  out  goes  one 
more  path  to  possible 
contamination. 


I'm  the  unique  new  CYSTOFLO"  drainage  bag,  a 
true-blue  friend  to  nurses,  physicians  and  patients. 
Why  don't  we  get  acquainted? 


BAXTER  LABORATORIES  OF  CANADA 


OiViSHIN  (II    IHAVFNUl    IAH|] 
640S  Nnrlh.tn.  Or.vf    M. 


CNA  annual  meeting 


More  than  150  nurses  attended  the 
annual  meeting  of  the  Canadian  Nurses' 
Association,  held  in  the  Chateau  Lau- 
rier  Hotel,  Ottawa,  on  March  3  1 .  Of 
these,  93  were  voting  delegates  repres- 
enting the  1 0  provincial  nurses'  associa- 
tions. 

In  her  opening  remarks  to  the  as- 
sembly, CNA  President  E.  Louise  Mi- 
ner explained  the  reason  for  holding 
an  annual  meeting.*  She  then  spoke  of 
her  activities  on  behalf  of  the  associa- 
tion, remarking  that  she  was  "going 
steady  with  Air  Canada."  Miss  Miner 
said  she  will  spend  17  days  in  the  next 
two  months  on  association  business, 
and  expressed  regret  that  she  cannot 
accept  the  many  invitations  she  receives 
as  CNA  president. 

After  the  roll  call  had  been  taken  by 
Dr.  Helen  K.  Mussallem,  CNA  exec- 
utive director,  the  assembly  put  business 
aside  to  honor  Dr.  Helen  G.  McArthur, 
wl^  retires  this  summer  as  national 
director  of  nursing  services,  the  Cana- 
dian Red  Cross  Society.  The  CNA 
Honorary  Citation  was  presented  to 
Dr.  McArthur  for  her  outstanding 
contribution  to  nursing.  (See  News, 
page  8.) 

Delegates  were  asked  to  nominate 
and  elect  a  third  member  to  the  com- 


*Since  1922,  the  CNA  has  held  biennial 
meetings.  Now  that  the  association  comes 
under  the  Canada  Corporations  Act  Part 
2  and  has  been  issued  Letters  Patent,  an 
annual  meeting  is  required.  (See  August 
1970.  page  29.)  The  CNA  will  combine 
the  annual  meeting  with  a  convention 
program  in  1972  and  biennially  there- 
after. 
MAY  1971 


mittee  on  nominations.  (Present  mem- 
bers are  Florence  Gass,  Nova  Scotia, 
and  Marie  Rice,  Ontario.)  Sister  Mary 
Felicitas,  immediate  past  president  of 
CNA,  was  elected  unanimously  and  will 
serve  as  chairman  of  the  committee. 

In  her  report  to  the  annual  meeting. 
Dr.  Mussallem  outlined  the  action  taken 
by  the  board,  its  committees,  and  the 
CNA  staff  since  thfe  last  general  meet- 
ing in  Frederiction  nine  months  ago. 
"[We]  have  been  involved  in  carrying 
out  your  directives  and  mandate  'to 
lead,  to  coordinate,  and  to  advise' 
she  said.  (The  resolutions  of  the  last 
general  meeting  and  action  taken  by 
CNA  are  on  page  34.) 

Dr.  Mussallem  reported  that  CNA 
membership  for  1970  was  87,126  — 
an  increase  of  4,300  over  the  previous 
year.  After  speaking  briefly  about  the 
work  of  the  association  and  its  relation- 
ships with  other  agencies,  the  executive 
director  said  CNA  is  grossly  under- 
staffed and  is  not  fulfilling  its  role  to 
its  members  or  to  society. 

"In  1963  .  .  .  there  were  nine  nurses 
on  staff  in  national  office,"  Dr.  Mus- 
sallem said.  "Since  that  time  the  pro- 
gram has  mushroomed  and  the  number 
of  nurse  staff  decreased.  Today  there 
are  four  nurses  attempting  to  carry  a 
load  far  greater  in  every  aspect  than  in 
1963  ....  The  great  concern  is  not  so 
much  that  long  hours  of  work  are  re- 
quired, but  that  the  CNA  is  not  staffed 
to  respond  to  the  present  social  milieu," 
she  said. 

Dr.  Mussallem  then  pointed  out  that, 
excluding  the  cost  of  the  journals'  oper- 
ation, about  $4  per  member  remains 
—  the  same  as  it  was  in  1963.  "Anyone 
here  will  realize  the  difference  between 


purchasing  power  of  $4  in   1963  and 
1971,"  she  said. 

"This  is  not  an  appeal  for  increased 
fees,"  the  executive  director  told  the 
assembly.  "But  if  you  share  the  belief 
that  we  are  not  meeting  our  goals  in 
the  '70s,  some  very  hard  and  difficult 
decisions  will  have  to  be  made  on  how 
we  can  stretch  the  already  overstretched 
income  dollar  ....  If  this  association 
is  to  meet  its  potential  in  an  expanding 
role  in  today's  rapidly  changing  and 
accelerating  health  services,  it  cannot 
do  so  with  the  present  number  of  senior 
staff.  To  carry  out  these  responsibilities 
—  which  include  keeping  ahead  of 
crises  and  not  action  at  the  time  of  or 
after  a  crisis  —  a  new  and  dynamic 
approach  is  required  .  .  .  ." 


Reports  of  standing  committees 

Marilyn  Brewer,  chairman  of  CNA's 
standing  committee  on  social  and  econ- 
omic welfare,  read  a  progress  report 
to  the  delegates.  The  report  discussed 
issues  covered  by  the  committee  at  its 
meeting  in  November  1970  and  recom- 
mendations presented  to  the  CNA  board 
of  directors  at  its  meeting  March  29 
and  31,  1971.  (The  board  also  met 
April  1,  the  day  following  the  annual 
meeting.) 

A  directive  from  the  general  meet- 
ing in  Fredericton  last  June —  to  con- 
sider the  relationship  of  standards  of 
practice  and  employment  policies  — 
was  discussed  at  length  by  the  commit- 
tee. Members  saw  an  urgent  need  for 
the  nursing  profession,  through  CNA, 
to  develop  a  set  of  standards  defining 
the  acceptable  level  of  nursing  practice. 
(Ki'porl  lonliniicd  on  pane  35) 
THE  CAf^ADIAN  NURSE     33 


Action  on  Resolutions  from  CNA  35th  General  Meeting 

(For  full  text,  see  pp.  26-27,  August  issue  of  The  Canadian  Nurse) 


Resolved  that  the  Canadian  Nurses'  Association  press 
more  firmly  for  representation  on  the  Canadian  Council 
on  Hospital  Accreditation  .... 

Action:  As  CNA's  continued  efforts  to  gain  membership 
on  this  body  have  been  unsuccessful,  it  was  decided  at 
the  October  1970  board  meeting  to  postpone  further 
efforts  for  a  few  months. 

Resolved  that  the  CNA  request  the  department  of  na- 
tional health  and  welfare  to  call  a  national  confer- 
ence ...  to  study  health  matters.  .  .  . 
Action:  In  response  to  CNA's  request,  a  national  confer- 
ence on  assistance  to  the  physician:  the  complementary 
roles  of  the  physician  and  nurse,  was  held  in  Ottawa 
April  6-8.  (See  News,  page  14.) 

Resolved  that  the  CNA  prepare  a  position  paper  on  the 
introduction  of  the  new  categories  of  workers  into  the 
health  field,  namely  those  referred  to  as  the  physician's 
assistant  and  medical  practitioner's  associate. 
Action:  As  an  outcome  of  the  stand  taken  at  the  October 
1970  meeting  of  the  board  of  directors,  a  statement  on 
the  physician's  assistant  was  submitted  to  the  minister 
of  national  health  and  welfare.  This  stand  was  supported 
by  key  organizations  and  individuals. 


Resolved  that  the  CNA  urge  the  federal  government  to 
remove  the  sections  relating  to  abortion  from  the  crim- 
inal code. 

Action:  Initially  referred  by  the  general  membership  to 
the  board  of  directors  for  further  study  of  its  implica- 
tions, this  resolution  was  deferred  in  October  to  the 
March  board  meeting  to  give  provincial  nurses'  associa- 
tions an  opportunity  to  study  and  report  their  decisions 
on  both  its  criminal  code  aspects  and  the  implications 
involved.  A  statement,  based  on  British  Columbia's  sub- 
mission, was  endorsed  in  principle  by  the  board  and  sent 
to  the  provincial  associations  who  were  asked  to  report 
on  the  issue  by  June  20.  (See  News,  page  7.) 

Resolved  that  the  CNA  Board  of  Directors  consider  as 
a  priority  ways  and  means  of  encouraging  the  produc- 
tion of  textbooks  in  the  French  language. 
Action:  An  ad  hoc  committee  on  French  textbooks  met 
February  1-2  and  March  26.  (See  News,  page  7.) 

Resolved  that  the  CNA  make  a  presentation  to  the 
Federal  minister  of  finance  on  the  white  paper  on  taxa- 
tion. 

Action:  A  CNA  statement  was  submitted  to  the  minister 
of  fmance  in  July,  1970.  His  reply  gave  assurance  that 
the  CNA  would  be  notified  should  he  wish  to  discuss 
the  proposals  further. 

Resolved  that  a  sufficient  registration  fee  be  charged  to 
allow  each  registrant  to  receive  the  same  folio  of  infor- 
mation as  provided  for  voting  delegates;  and 
Resolved  that  all  nursing  students  enrolled  full  time  in 


diploma  or  university  programs  be  permitted  to  attend 
CNA  general  meetings  at  the  reduced  student  registra- 
tion fee. 

Action:  Both  resolutions  will  be  taken  into  consideration 
by  the  board  of  directors  prior  to  the  1972  annual  meet- 
ing and  convention. 

Resolved  that  the  audited  financial  report  of  the  CNA 

be  printed  in    The  Canadian  Nurse  and  L'infirmiere 

canadienne. 

Action:  The  report  was  published  in  the  March  issue  of 

The  Canadian  Nurse  and  L'infirmiere  canadienne.  This 

practice  will  continue. 

Resolved  that  there  be  a  committee  on  legislation  of 
the  CNA. 

Action:  On  referral  of  this  resolution  by  the  general 
membership,  directors  voted  that  all  matters  relating  to 
legislation  be  referred  for  study  and  action  to  the  execu- 
tive committee,  and  that  it  be  empowered  to  request  con- 
sultation if  needed. 

Resolved  that  voting  delegates  De  granted  the  privilege 
of  voting  for  two  nominees  on  the  vice-presidential  bal- 
lot. 

Action:  This  resolution  has  been  incorporated  into  the 
"Rules  and  Procedures"  as  defined  in  the  Scrutineer's 
Manual. 


Resolved  that  the  board  of  directors  give  serious  consid- 
eration to  the  appointment  of  a  well-qualified  nurse  to 
assume  the  role  of  lobbyist  for  the  CNA. 
Action:  At  the  October  1970  meeting,  directors  ap- 
proved the  employment  of  the  legal  firm  of  Gowling  & 
Henderson  on  a  retainer-fee  basis.  This  contract  includes 
the  surveillance  of  federal  legsilation  to  provide  alertness 
to  impending  legislation  and  legal  advice  on  implications 
for  the  association. 

Resolved  that  at  future  general  meetings  of  the  CNA, 
program  time  and  facilities  be  provided  so  that  nurses 
interested  in  discussing  current  issues  can  meet  to  ex- 
plore them  in  open  forums  .  .  . 

Action:  This  has  been  referred  to  the  executive  commit- 
tee, which,  at  the  October  1970  board  of  directors'  meet- 
ing, was  appointed  the  program  committee  for  the  1 972 
annual  meeting  and  convention. 

Resolved  that  the  CNA  support  appropriate  measures 
proposed  for  the  control  of  threats  to  the  health  of  all 
Canadians  and  that  each  member  of  the  CNA  .  .  .  assist 
in  the  solution  of  these  grave  threats  to  life  in  the  world 
today. 

Action:  This  resolution  was  drawn  to  the  attention  of  all 
members  of  the  CNA  through  publication  in  the  August 
1970  issues  of  The  Canadian  Nurse  and  L'infirmiere 
canadienne.  At  the  board  of  directors'  meeting  April  I , 
it  was  decided  to  send  a  letter  on  the  subject  of  pollu- 
tion to  the  Hon.  Jack  Davis  at  the  appropriate  time. 


34     THE  CANADIAN   NURSE 


MAY  1971 


The  committee  recommended  that 
CNA  social  and  economic  welfare 
goals,  as  stated  in  On  Record,  remain 
unchanged,  with  the  exception  of  the 
salary  goal.  For  the  licensed  or  register- 
ed nurse,  the  national  salary  goal  for 
the  beginning  practitioner  was  set  at 
a  minimum  of  $7,920  a  year — a  10 
percent  increase  over  the  salary  goal 
approved  by  the  board  of  directors  for 
1970.  The  same  differential  as  in  pre- 
vious years  was  recommended  for  a 
beginning  practitioner  of  a  baccalaure- 
ate program,  bringing  the  national  goal 
to  $9,360  from  $8,640  per  annum. 

Also  considered  by  the  committee 
were  ways  of  giving  further  support  to 
concerns  stated  in  the  CNA  brief  on  the 
federal  government's  White  Paper  on 
Unemployment  Insurance  in  the  '70s 
to  protect  the  nurses'  position  as  legisla- 
tion is  developed.  The  CNA  brief  was 
submitted  last  September  to  the  House 
of  Commons  standing  committee  on 
labour,  manpower,  and  immigration. 
Because  of  changes  proposed  in  the 
government's  unemployment  insurance 
legislation,  the  committee  discussed  the 
needs  of  unemployed  professionals  for 
university  courses  for  retraining  and  the 
exclusion  of  such  courses  from  the 
Adult  Occupational  Training  Act 
(News,  April). 

On  the  last  day  of  the  board  meeting, 
Mrs.  Brewer  discussed  her  committee's 
report  on  the  federal  government's 
White  Paper  on  Income  Security  for 
Canadians.  The  report  agreed  with  the 
white  paper's  proposal  to  "revise  income 
security  policies  to  redirect  their  em- 
phasis" and  [agreed]  that  income  sec- 
urity programs  be  based  on  need,  and. 
outlined  four  priorities  for  CNA. 

These  priorities  are  that  CNA: 
•  Support  the  proposed  universal  flat 
rate  benefit  for  old  age  security  and 
endorse  an  increased  guaranteed  income 
supplement  for  low  income  persons  65 
years  and  over. 

•Agree  that  family  allowances  be  sel- 
ective, that  the  size  of  the  family  be 
MAY  1971 


considered,  and  that  a  proposed  ceil- 
ing be  examined  further. 

•  Encourage  the  proposal  to  improve, 
but  decrease  dependence  on,  social 
assistance. 

•  Support  the  basic  principle  of  includ- 
ing nurses  in  the  government's  unem- 
ployment insurance  plan. 

The  report  also  commended  the 
government's  recognition  that  "the 
effectiveness  of  income  security  will 
depend  in  part  on  the  effectiveness  of 
other  social  policies  in  meeting  their 
goals,"  for  example,  social  welfare 
services,  health  services,  housing,  and 
education. 

CNA's  board  of  directors  adopted 
this  report  as  the  basis  for  the  associa- 
tion's reaction  to  the  White  Paper  on 
Income  Security.  The  Canadian  Nurse 
will  report  on  CNA's  brief  when  it  is 
completed. 

In  her  progress  report  to  the  annual 
meeting,  Irene  Buchan,  chairman  of 
the  committee  on  nursing  service,  said 
the  CNA  board  of  directors  had  accept- 
ed the  recommendation  of  the  com- 
mittee that  the  CNA  cease  to  consider 
the  development  of  a  pamphlet  on  team 
nursing  because  there  is  a  large  volume 
of  literature  already  available  on  the 
subject. 

The  other  recommendation  accepted 
by  the  board  was  that  CNA  give  consi- 
deration to  the  appointment  of  a  nurs- 
ing consultant  with  special  prepara- 
tion in  adult  education  to  work  with 
CNA  membership  on  staff  development 
programs.  The  committee  noted  there 
is  a  great  awareness  of  the  impact  of 
staff  development  on  the  quality  of 
health  care  and  staff  satisfaction,  yet 
a  great  many  agencies  are  presently 
unable  to  fulfill  the  demand  on  their 
staff  for  continuing  education.  The 
committee  formed  the  resolution  as  a 
means  of  providing  some  interim  assis- 
tance until  more  educators  can  be  pre- 
pared in  adult  education  at  a  graduate 
level. 

Alice   Baumgart,   chairman   of  the 


committee  on  nursing  education,  pre- 
sented the  recommendations  of  the 
committee  acted  on  by  the  CNA  board 
of  directors.  The  board  approved  a 
resolution  that  CNA  give  urgent  atten- 
tion to  the  setting  up  of  regional  con- 
ferences for:  nursing  administrators 
involved  in  planning  the  transition 
from  hospital  sponsored  to  educationally 
oriented  institutions  to  familiarize 
them  with  appropriate  strategies  to  use 
in  the  process;  for  faculty  who  will  be 
teaching  in  educationally  oriented  nurs- 
ing programs  to  help  them  recognize 
and  adapt  to  the  different  learning  con- 
ditions which  prevail  in  educational 
institutions. 

The  committee's  resolution  that 
action  on  setting  up  accreditation  be 
deferred  at  this  time  was  carried  by 
the  board.  The  committee  noted  the 
concern  expressed  about  the  adequacy 
of  existing  controls  over  the  quality  of 
educational  programs  as  provided  by 
statute  and  association  approval  me- 
chanisms. It  also  noted  there  seems  to 
be  mounting  concern  about  the  merits 
of  accreditation  at  a  time  of  rapid 
change,  and  that  accreditation  is  a 
costly  procedure. 

Miss  Baumgart  said  the  committee 
felt  it  was  important  to  recognize  that 
nursing  is  entering  a  crucial  period  of 
transition,  and  innovative  approaches 
to  education  will  be  needed  to  prepare 
persons  for  changing  nurse  roles.  At  the 
same  time  continuing  emphasis  will 
have  to  be  given  to  restructuring  the 
institutions  and  curricula  that  serve 
nursing  education. 

Goals  and  priorities  listed  by  the 
committee  are:  promoting  the  orderly 
transition  in  basic  nursing  education 
from  hospital  sponsored  schools  to 
educational  institutions;  helping  intro- 
duce new  educational  products  into 
the  work  force;  promoting  the  devel- 
opment of  various  patterns  and  routes 
whereby  nurses  can  be  prepared  for 
specialist  and  extended  roles  or  for 
work  in  rural,  isolated  or  unusual  prac- 
THE  CANADIAN  NURSE     35 


tice  settings;  clearly  differentiating 
between  the  goals  of  diploma,  bacca- 
laureate, and  graduate  education  in 
nursing;  promoting  regional  planning 
for  development  of  nursing  education 
programs;  promoting  the  search  for 
more  efficient  and  economical  ways  of 
learning  how  to  nurse;  helping  to  ensure 
"that  systematic  attention  is  given  in 
basic  nursing  education  programs  to 
learning  to  be  a  continuing  learner  and 
to  developing  skills  in  collaborating 
with  health  team  members";  consider- 
ing ways  and  means  of  assisting  nursing 
personnel  to  upgrade  their  educational 
qualifications. 

An  armchair  conference  on  nursing 
practice  in  the  '70s  was  recommended 
in  the  report  of  the  joint  committee  on 
nursing  service  and  nursing  education 
presented  at  the  annual  meeting  by 
Irene  Buchan,  chairman  of  the  commit- 
tee on  nursing  service,  and  Alice  Baum- 
gart,  chairman  of  the  committee  on 
nursing  education. 

The  conference  was  conceived  as 
a  "brain-storming  session"  to  which 
will  be  invited  "innovative  thinkers 
about  nursing  including  young  active 
practitioners."  This  conference  will 
focus  on:  the  future  of  nursing  practice 
within  the  context  of  changing  health 
services;  long-term  goals  for  nursing 
in  Canada;  mechanisms  for  evolving 
long-term  goals  within  the  framework 
of  CNA.  The  joint  committee's  recom- 
mendation was  accepted  by  the  CNA 
board  at  its  sessions  prior  to  the  annual 
meeting. 

Also  accepted  by  the  board  was  the 
joint  committee's  resolution  that  the 
CNA  support  the  undertaking  by  pro- 
vincial nursing  associations  of  activi- 
ties with  allied  health  organizations 
to  determine  long-range  goals  for  health 
services  including  types  of  health  serv- 
ices required;  types  of  health  service 
practitioners  required;  the  education 
needs  of  present  and  future  health  prac- 
titioners. 

The  board  accepted  in  principle  the 
36     THE  CANADIAN  NURSE 


need  for  development  of  a  document 
which  would  contain:  a  philosophy  of 
staff  development;  a  definition  of  staff 
education,  and  its  relationship  to  other 
forms  of  continuing  education;  a  state- 
ment of  functions  of  a  staff  education 
department;  guidelines  concerning  how 
to  proceed  with  the  development  of  a 
staff  education  department;  a  state- 
ment concerning  qualifications  of  staff 
education  personnel;  job  description 
for  staff  education  personnel.  The  board 
decided  that  the  executive  director, 
in  consultation  with  the  president, 
would  approach  a  suitable  person  to 
develop  such  a  document. 

The  chairmen  of  the  three  standing 
committees  stressed,  at  both  the  annual 
meeting  and  the  board  meeting,  the 
shortcomings  of  the  present  standing 
committee  structure.  In  a  report.  Miss 
Baumgart,  Mrs.  Brewer,  and  Miss  Bu- 
chan said,  "No  longer  does  it  seem 
possible  for  most  issues  on  which  deci- 
sions are  needed  to  be  neatly  parceled 
into  either  education,  or  service,  or 
social  economic  welfare.  The  present 
committees  are  costly  in  terms  of  pro- 
ductiveness and  are  often  unable  to 
respond  expeditiously  to  matters  re- 
quiring the  attention  of  the  association." 

The  executive  of  CNA  had  asked 
the  committee  chairmen  to  prepare  a 
paper  on  changing  the  organizational 
framework  of  the  association.  At  two 
meetings  of  the  committee  chairmen, 
agreement  was  reached  that  a  need  to 
change  the  organizational  framework 
of  CNA  existed  and  that  this  involved 
much  more  than  simply  changing  the 
nature  of  the  committee  structure. 

The  paper  said,  "New  and  more  res- 
ponsive structures  seem  necessary  to: 
continuously  monitor  what  is  happen- 
ing in  relation  to  a  wide  range  of  social 
and  nursing  issues;  define  relevant  long- 
term  goals  and  set  appropriate  national 
priorities;  respond  quickly,  decisively 
and  knowledgeably  to  the  diversity  of 
public  issues  to  which  nursing  expertise 
has  relevance;  provide  for  greater  op- 


portunities for  member  participation 
in  association  affairs;  ensure  effective 
communications  both  within  the  pro- 
fession and  to  the  outside." 

Other  business 

Several  delegates  expressed  con- 
cern that  a  French-speaking  person 
had  not  yet  been  appointed  by  CNA 
to  its  senior  staff,  and  recommended 
that  a  selections  committee  be  set  up 
io  help  find  such  a  person.  The  execu- 
tive director  reported  she  had  approach- 
ed several  nurses  whose  mother  tongue 
was  French,  but  had  had  little  success 
in  finding  persons  interested  in  consul- 
tant positions.  She  announced,  however, 
that  as  of  September  1,  1971,  Sister 
Madeleine  Bachand,  whose  first  langua- 
ge is  French,  will  join  CNA  staff  as 
research  analyst. 

A  motion  to  set  up  an  advisory  panel 
on  selections,  to  be  called  at  the  discre- 
tion of  the  executive  director  when 
senior  positions  are  being  filled,  was 
approved  by  the  delegates.  It  was  agreed 
that  this  panel  would  serve  to  assist  the 
executive  director  and  would  in  no  way 
take  away  her  right  to  have  the  final 
decision  when  employing  staff. 

Before  adjourning  the  meeting,  the 
president  reminded  members  that  the 
next  annual  meeting  will  be  held  in 
Edmonton,  Alberta,  from  June  25  to 
28,  1972.  * 


MAY  1971 


Nurses  in  prison 

If  you  are  looking  for  a  challenging  and  rewarding  out-of-the-ordinary  job, 
you  might  try  signing  into  prison. 


Gwen  Norens 

At  least  one  warden  in  Canada  would 
like  to  see  more  nurses  in  prisons. 

He  is  Warden  Pierre  Jutras  of  the 
Drumheller  Medium  Security  Prison  in 
central  Alberta.  Mr.  Jutras  in  looking 
for  good,  qualified,  mature  nurses  to 
staff  his  prison  hospital  and  help  pro- 
vide health  care  for  the  400  prisoners  at 
his  federal  penitentiary. 

Drumheller  is  one  of  the  newer  Ca- 
nadian penitentiaries  and  takes  a  differ- 
ent approach  to  the  care  of  criminals. 
It  is  out  to  rehabilitate,  not  punish. 

"The  guiding  philosophy  of  the 
Drumheller  Penitentiary  focuses  on 
endorsing  a  sense  of  confidence,  self- 
respect,  and  dignity  for  the  prisoners," 
says  Warden  Jutras.  "It's  not  enough 
just  to  clamp  a  man  in  prison  to  punish 
him,  hold  him  in  custody  for  a  number 
of  years,  then  throw  him  out  again 
saying  'Now  function."  " 

One  of  the  warden's  major  reforms 
was  a  decision  to  send  prisoners  into 
the  community  on  temporary  leaves 
before  they  were  released  permanently 
or  paroled.  Under  the  Penitentiary  Act, 
a  warden  has  the  power  to  grant  leaves 
of  up  to  three  days  as  part  of  his  reha- 
bilitative program,  but  until  Warden 
Jutras  tried  it  at  Drumheller,  these 
passes  were  rare. 

Drumheller  began  granting  leaves, 
even  to  "hard-core"  prisoners,  for  a 
number  of  reasons  —  to  work  in  the 


Mrs.  Norens,  a  registered  nurse,  is  also 
a  freelance  writer. 


MAY   1971 


community,  to  visit  families,  to  give 
them  a  chance  to  look  for  work  and 
living  accommodations  before  they  are 
discharged. 

To  date,  Drumheller  has  given  more 
than  5,000  temporary  leaves  and  only 
once  has  a  prisoner  not  returned. 

But  the  leaves  are  only  one  part  of 
the  reforms  at  Drumheller.  It  was  even 
built  along  different  lines,  so  it  would 
look  less  like  a  fortress. 

It  includes  complete  academic,  vo- 
cational, and  trades  training  facilities 
where  prisoners  can  learn  skills  to  help 
them  fit  better  into  society  on  their 
release.  And  it  includes  a  17-bed  hos- 
pital and  outpatient  clinic  that  is  also 
a  part  of  the  rehabilitative  program. 

Mostly  outpatient  work 

John  Savrtka,  one  of  the  three  nurses 
on  staff  at  the  Drumheller  Penitentiary 
during  my  visit,  discussed  the  work 
being  done  by  the  hospital  staff.  He  and 
the  senior  hospital  officer,  Stanley 
Baird,  have  been  on  staff  since  the 
opening  of  the  prison  in  1967. 

"It's  not  really  just  a  hospital,"  said 
Mr.  Savrtka.  "It's  also  more  of  an  out- 
patient approach." 

To  him,  it's  like  a  community  health 
service  —  except  the  community  is 
bounded  by  a  seven-foot  fence  and  all 
the  patients  are  men. 

Drumheller  had  two  openings  for 
nurses  at  the  time  of  my  visit,  and  the 
warden  had  made  a  break  with  federal 
penitentiary  traditions  and  hired  a 
woman.  This  has  ^een  done  success- 
THE  CANADIAN  NURSE     37 


fully  in  provincial  all-male  prisons,  but 
it  was  a  pioneering  event  for  a  federal 
institution,  especially  at  the  medium 
security  level. 

Since  its  opening  in  1967,  Drum- 
heller  has  hired  women  to  work  in  the 
offices  inside  the  prison  block  and  was 
one  of  the  first  federal  prisons  to  do 
this. 

But  Warden  Jutras  is  particular 
about  the  staff  and  is  definite  that  he 
wants  the  best  —  the  best-prepared  and 
the  best  psychologically  able  to  work 
with  prisoners  in  what  can  be  a  tense 
situation. 

Also,  the  nurse  must  be  one  who 
agrees  with  the  philosophy  of  rehabil- 
itation, not  punishment. 

"We're  short  staffed  at  present  be- 
cause the  warden  refuses  to  lower  stand- 
ards," said  Mr.  Savrtka.  "He  could  hire 
non-nursing  staff  who  were  poorly 
prepared,  but  he  won't  —  and  we  agree 
because  we,  too,  want  the  best." 

Mr  Savrtka  is  a  registered  nurse 
a  graduate  of  Alberta  Hospital,  Ponoka 
with  an  affiliation  at  the  Calgary  Gen- 
eral Hospital.  After  graduation,  he 
worked  for  two  years  at  the  Calgary 
General,  then  moved  to  Drumheller 
his  hometown. 

"I  had  a  lot  of  responsibility  and 
enjoyed  working  at  the  General  —  I 

38     THE  CANADIAN   NURSE 


worked  mostly  nights  on  an  arthritic 
and  coronary  convalescent  ward.  Some 
patients  came  directly  from  the  intensive 
care  unit.  But  here,  we  have  a  greater 
responsibility  —  for  the  whole  person." 

The  hospital  area,  like  the  rest  of 
the  prison  buildings,  is  a  concrete  mo- 
dern block.  At  first  glance,  the  prison 
resembles  a  modern  school  building, 
but  it  isn't  hard  to  see  that  it  could  be 
turned  into  a  prison  fortress  within 
minutes  in  case  of  trouble. 

Inside,  the  clinic  area  looks  like 
a  modern  outpatient  area  in  some  large 
hospital.  There  is  a  17-bed  nursing 
unit  at  the  rear,  but  only  eight  or  ten 
patients  have  been  hospitalized  at  any 
one  time. 

The  hospital  is  self-contained  in 
many  respects.  The  front  part  contains 
offices,  treatment  rooms,  a  dispensary 
minor  surgery,  laboratory,  dental  office' 
ophthalmology  clinic,  x-ray  room,' 
examining  room,  and  two  doctors' 
offices. 

A  physician  from  the  city  of  Drum- 
heller visits  the  clinic  daily  (Monday 
to  Friday)  for  about  two  hours,  a  dentist 
comes  out  two  mornings  a  week,  an 
optometrist  visits  one  afternoon  a  week 
and  a  psychiatrist  from  Calgary  comes 
usually  once  every  two  or  three  weeks 
Consulting  specialists,  including  a  top 
ophthalmologist     and     dermatologist, 
come   occasionally    from   Calgary   on 
referrals  from  the  general  practitioners 
—  usually  about  once  a  month  when 
they  are  needed  and  if  the  patient  can't 
be  given  a  pass  to  visit  them  in  their 
offices  in  Calgary. 

There  is  a  full-time  psychologist  on 
the  prison  staff  who  works  closely  with 
the  nursing  staff.  As  well,  the  nurses 
work  in  close  cooperation  with  other 
prison  staff,  including  the  officers  in 
charge  of  the  dormitory  units,  the  teach- 
ing staff,  and  the  social  workers  who 
work  closely  with  the  individual  prison- 
ers at  Drumheller. 


Healthy,  but . . . 

Prisoners  are  given  a  routine  physical 
examination  as  part  of  the  prison  ad- 
mission routine.  At  that  time  a  list  of 


health  needs  that  should  be  attended 
to  is  drawn  up. 

"On  the  whole,  they're  a  pretty 
healthy  group,"  Mr.  Savrtka  said.  But 
many  prisoners  have  health  needs,  such 
as  dental  caries,  acne,  or  physical  de- 
fects, which  may  be  psychologically 
crippling  and  which  can  be  corrected 
while  they  are  in  prison  as  part  of  their 
overall  rehabilitative  treatment. 

"For  treatments  of  this  kind,  formal 
approval  from  the  warden  and  the  pa- 
tient are  needed,"  Mr.  Savrtka  said. 
For  example,  a  prisoner  may  benefit 
from  corrective  eye  surgery.  "Stra- 
bismus repairs  are  a  common  example." 
One  of  the  social  workers  said,  rather 
bitterly,  that  he  thought  physical  defects 
often  were  partly  responsible  for  forc- 
ing a  young  person  who  had  neither 
the  money  nor  the  knowledge  of  how 
to  get  health  services  into  criminal 
habits. 

Rehabilitative  surgery  also  includes 
such  things  as  removal  of  tatoos,  plastic 
surgery  to  remove  scars  or  correct  hare 
lips,  or  cosmetic  surgery  to  shorten  or 
repair  a  too  prominent  nose.  One  of 
the  most  common  cosmetic  repairs  is 
for  the  saddle  nose  deformity. 

In  these  latter  cases,  a  thorough 
psychiatric  assessment  is  done  first. 

Minor  surgery  is  performed  in  the 
prison  hospital;  major  surgery  is  carried  ' 
out  in  the  general  hospitals  in  Drum- 
heller or  Calgary.  Patients  return  to  the 
prison  for  convalescent  care.  If  neces- 
sary, physiotherapy  can  be  carried  out 
at  the  prison  hospital  or  a  patient  may 
get  leaves  to  visit  the  Drumheller  city 
hospital. 

Some  group  therapy  is  carried  on 
but  at  present  the  psychologist  prefers 
to  work  on  a  one-to-one  basis  with  the 
patients  and  to  have  the  staff  do  so  as 
well. 

"You  can  often  do  more  on  an  indi- 
vidual one-to-one  basis  in  a  situation 
like  this,"  said  Mr.  Savrtka.  "And  with 
such  a  relatively  small  number  of  pa- 
tients, you  can  get  to  know  them  well  " 

It  could  be,  too,  that  prison  peer 
groups  are  not  considered  the  best 
training  groups  for  someone  who  is 


MAY    1Q71 


trying  to  break  away  from  a  life  of 
crime. 

The  nurses  also  get  a  fair  amount  of 
minor  emergency  work  from  the  weld- 
ing and  woodworking  shops  and  the 
prison  laundry  and  kitchen,  all  staffed 
by  the  prisoners.  The  prisoners  have 
an  active  sports  program  and  there  are 
often  minor  treatments  for  football  and 
1j;j:    hockey  injuries. 

Only  a  small  number  of  prisoners 
are  on  medications,  and  they  must 
make  individual  visits  for  each  dose. 

"Maybe  five  percent  at  any  one  time 
]:};:  might  be  receiving  tranquilizers.  We 
look  for  other  ways  to  combat  depres- 
sion and  homesickness,  two  of  our 
most  common  problems." 

Training  programs 

The  hospital  unit  also  plays  a  part 
in  the  rehabilitative  job-training  pro- 
gram that  is  so  important  at  Drum- 
heller. 

One  of  the  prisoners  works  as  an 
orderly,  and  officials  are  corresponding 
with  Alberta's  orderly  training  program 
to  see  if  he  can  eventually  qualify  under 
that  program,  based  on  his  work  in  the 
prison. 

As  well,  because  Drumheller  ar- 
ranges for  work  passes  for  prisoners 
so  they  can  take  jobs  in  the  community 
even  before  they  are  released,  there 
is  a  possibility  a  trainee  might  be  able 
to  work  in  the  hospital  in  Drumheller. 

There  are  also  two  trainees  in  the 
dental  assistant  program.  They  get 
practical  experience  working  with  the 
dentist  at  the  prison  and  in  making  and 
fitting  dentures  in  the  completely  self- 
contained  dental  area.  All  plates  for 
prisoners  are  made  there. 

These  two  trainees  would  still  need 
to  take  part  of  the  course  in  one  of  the 
two  main  cities  before  they  qualified 
for  a  certificate,  but  it  may  be  possible 
that  this  could  be  done  during  their 
parole  period. 

Mr  Savrtka  praised  the  trainee  pro- 
gram with  its  greater  emphasis  on  edu- 
cation for  outside  living  and  would 
like  to  see  it  extended  even  further. 

"The  point  is  that  they  should  be 


better  individuals  when  they  are  released 
than  when  they  are  admitted." 

Good  working  conditions 

Mr.  Savrtka  said  he  would  recom- 
mend the  federal  penitentiary  service 
as  an  employer. 

"The  salaries  are  comparable  to 
those  in  the  cities,"  he  said.  But  he 
added  that  Drumheller,  a  small  city 
well  off  the  main  highway  between 
Calgary  and  Edmonton,  is  somewhat 
isolated. 

He  said  he  finds  it  rewarding  to 
perform  a  useful  job  for  society  as  part 
of  a  team  that  works  together  for  the 
good  of  everyone  —  prisoner  and 
society. 

"You  are  given  a  good  deal  of  per- 
sonal responsibility,  too,  and  there  is 
lots  of  room  for  initiative." 

Mr.  Savrtka  gives  the  warden  credit 
for  the  reforms,  as  did  all  the  other 
staff  I  interviewed.  But  the  staff  also 
know  that  the  warden's  methods  are 
working.  You  cannot  argue  with  sta- 
tistics —  and  these  show  that  about 
40  to  50  percent  of  prisoners  released 
from  Canadian  penitentiaries  end  up 
back  behind  bars.  But  at  Drumheller, 
the  average  is  about  1 5  to  17  percent. 

Mr.  Savrtka  said  there  has  never 
been  an  instance  when  a  prisoner  turned 
on  the  nurse  m  the  hospital  area. 

"That  doesn't  mean  I'd  do  something 
silly  and  tempt  a  patient  into  having  a 
go.  But  there  is  a  sense  of  trust  here." 

He  would  also  like  to  see  more  reg- 
istered nurses  knocking  on  the  prison 
doors  trying  to  get  in. 

"I  wouldn't  hesitate  to  have  my  wife, 
who  is  also  an  R.N.,  work  here."        § 


MAY  1971 


THE  CANADIAN   NURSE     39 


The  research  process 

The  author  describes  the  major  activities  inherent  in  the  research  process,  point- 
ing out  that  "researching"  is  interesting  and  challenging,  but  requires  infinite 
patience,  self-discipline,  and  persistence. 


Loretta  E.  Heidgerken,  R.N.,  Ed.D. 

Although  nursing  literature  stresses 
research  as  an  important  activity  for 
the  nursing  profession,  many  profes- 
sional nurses,  even  among  those  who 
have  pursued  graduate  study,  do  not 
give  it  high  priority.  In  a  recent  study 
on  work  values  in  nursing,  activities 
relating  to  research,  such  as  "Engage 
in  Research,"  "Direct  Research  Pro- 
jects," received  the  lowest  mean  value 
of  the  52  activities  listed.^ 

Moreover,  nurses  who  are  interested 
in  research  frequently  see  research 
as  being  a  desirable  activity  in  and  of 
itself,  with  little  regard  to  its  contribu- 
tion to  nursing.  Many  problems  in 
nursing  practice  are  being  ignored  by 
nurse  researchers  because  these  nurses 
are  so  far  removed  from  the  realities 
and  complexities  of  nursing.  This  is 
not  to  deny  the  nurse  researcher  the 
right  to  investigate  research  problems 
of  interest  to  her,  but  rather  to  stress  the 
need  for  nurse  researchers  to  place 
priority  on  research  on  problems  relat- 
ing to  nursing  practice. 


40     THE  CANADIAN   NURSE 


Dr.  Heidgerken,  known  internationally  as 
a  nurse  educator,  researcher,  and  author 
of  many  books  and  articles,  is  Professor 
of  Nursing  Education  at  The  Catholic 
University  of  America  School  of  Nursing, 
Washington,  D.C.  This  paper  is  adapted 
from  an  address  she  gave  at  the  first 
national  conference  on  research  in  nurs- 
ing practice,  held  at  the  .Skyline  Hotel  in 
Ottawa  Fcbriiury  lf>to  18.  1'>7I. 


Nursing,  a  newcomer  to  research, 
deals  with  complex  phenomena.  We 
might  well  learn  from  the  experience 
of  the  natural  sciences.  We  need  more 
and  better  descriptive  research  to 
provide  us  with  a  strong  and  broad 
factual  base  from  which  to  develop 
hypotheses  leading  to  theories  which 
can  be  tested  and  which  will  provide 
principles  for  practice.  Naturally,  the 
hypotheses  will  need  to  be  continually 
tested  and  modified. 

In  addition,  the  researcher  in  nurs- 
ing should  be  concerned  not  only  with 
the  study  of  nursing  problems,  but  also 
about  how  the  knowledge  can  be  ef- 
fectively used  in  practice.  It  is  possible 
to  have  nursing  knowledge  and  yet 
not  know  how  to  use  that  knowledge 
effectively  in  practice. 

Using  knowledge  in  practice  re- 
quires a  variety  of  judgments  on  the 
part  of  the  practitioner:  how  to  carry 
out  nursing  activities;  when  to  use 
them  or  not  to  use  them;  and  when 
to  modify  them  to  meet  the  needs  of 
the  patient  in  a  particular  situation. 
Practice  and  theory  building  are  in- 
dependent yet  interrelated;  theory  is 
used  in  practice  and  from  practice 
new  concepts  come  that  will  aid  in 
further  development  of  theory. 

The  process  of  research 

The  process  of  research  involves 
critical  thinking  of  a  high  order.  Al- 
though essential  elements  can  be  iden- 
tified,  the  process  is  neither  unified 

MAY  1971 


nor  sequential.  Rather,  it  includes 
innumerable  errors,  corrections,  di- 
gressions, laborious  trials,  and  the 
tedious  process  of  continual  evaluation 
and  validation. 

The  research  process  is  usually  des- 
cribed to  include  a  series  of  activities 
that  may  be  broadly  identified  as  fol- 
lows: 1.  exploring  the  problem  area; 
2.  selecting  the  focus  for  study  and 
stating  the  specific  purpose;  3.  esta- 
blishing the  importance  of  studying  the 
selected  focus;  4.  conceptualizing  the 
problem  and  deriving  hypothesis(es); 
5.  designing  the  study;  6.  collecting 
the  data;  7.  analyzing  and  interpreting 
the  data;  8.  arriving  at  conclusions  and 
making  recommendations;  and  9.  writ- 
ing and  publishing  the  report. 

These  activities  should  not  be  consi- 
dered as  necessarily  rigid  sequential 
steps  in  the  research  process.  They 
do  not  necessarily  occur  in  the  order 
presented  here,  nor  are  all  of  them 
explicitly  present  in  every  research 
project.  Some  of  these  activities  may 
be  carried  on  simultaneously,  some 
may  need  to  be  repeated  a  number  of 
times  in  various  phases  of  a  research 
project,  some  studies  may  not  be  test- 
ing a  hypothesis.  However,  knowing 
and  carefully  considering  each  of  these 
activities  will  enhance  the  accuracy 
of  the  research.  Neglecting  any  one  of 
them  may  result  in  introducing  a  po- 
tential and  hidden  pitfall  that  may 
cause  trouble  at  any  point  and,  in  fact, 
may  actually  endanger  the  soundness 
and  success  of  the  total  research  project. 

Exploring  the  problem 

The  first  step  in  the  research  process 
is  to  identify  and  explore  a  problem 
of  interest  to  the  researcher.  Many 
researchers  consider  this  to  be  the 
most  important  step  in  the  total  process. 
It  is  sometimes  said  that  a  problem 
"well-stated  is  a  problem  half-solved." 

The  researcher  may  start  the  re- 
search process  by  reflecting  on  a  per- 
sonally-experienced problem  that  has 
MAY  1971 


often  presented  questions  to  her.  For 
example,  a  nurse  may  have  noted  that 
many  post-cardiotomy  patients  ex- 
perience psychological  disturbances 
during  their  immediate  postoperative 
period.  She  may  ask  herself:  Why? 
What  are  the  causes?  What  can  a  nurse 
do  to  alleviate  such  disturbances?  When 
is  the  best  time  for  action?  Or,  the 
researcher  may  resort  to  authorities  in 
the  literature,  particularly  to  reported 
research  studies  in  the  general  area  of 
interest,  to  familiarize  herself  with 
previous  research  approaches  and 
results. 

After  the  problem  is  stated,  the 
researcher  attempts  to  identify  all  the 
elements  she  thinks  may  have  an  in- 
fluence on  the  problem.  What  elements 
make  up  the  total  situation?  What 
things,  persons,  institutions,  settings, 
and  so  on,  may  have  a  bearing  on  the 
problem?  I  call  this  phase  "armchair 
thinking."  I  have  my  students  diagram 
this  phase,  which  helps  them  to  visualize 
the  problem  area  and  also  to  become 
more  aware  of  the  complexity  of  the 
problem. 

Once  this  is  done  the  researcher  is 
ready  to  do  a  preliminary  search  of  the 
literature  to  determine  what  is  known 
and  unknown  about  the  problem.  This 
includes  the  locating  of  gaps  and/or 
inconclusive  areas  of  knowledge;  in- 
valid conclusions;  importance  and 
worthwhilenessof  the  proposed  problem 
for  research  relative  to  expenditure 
of  energy  and  money  needed  for  re- 
searching it;  "researchability"  of  the 
problem,  and  so  on.  The  researcher 
also  searches  the  literature  for  relevant 
theories  that  might  suggest  explanations 
that  could  serve  as  a  basis  for  con- 
ceptualizing the  problem,  deriving 
hypotheses,  and  selecting  a  research 
approach  and  techniques. 

During  this  phase  of  the  process, 
the  researcher  will  often  wonder  whe- 
ther she  should  include  this  or  that 
detail.  A  good  rule  to  follow  is  to  in- 
clude everything  that  seems  to  have 


direct  relevance  at  this  stage.  If  it  is 
not  needed,  it  can  be  discarded  later, 
but  if  it  is  needed,  it  will  be  available. 
This  saves  much  frustration  and  time 
in  the  long  run. 

Stating  and  justifying  purpose 

Having  identified  and  explored  the 
problem  area,  the  researcher  must  de- 
cide on  the  aspect  of  the  problem  she 
wishes  to  focus  on  for  study  and  state 
this  in  the  form  of  an  explicit  state- 
ment of  purpose,  sometimes  referred 
to  as  aim."  She  will  ask  herself:  What 
is  my  intent?  What  do  I  expect  to  derive 
from  this  project  —  a  description,  a 
prediction,  an  explanation,  or  all  of 
these?  In  other  words,  the  purpose  lays 
out  the  goal  that  is  to  be  attained. 

The  statement  of  the  purpose  of  the 
investigation  may  take  one  of  several 
forms:  a  hypothesis;  a  question;  or  a 
declarative  statement  that  begins,  "The 
purpose  of  this  research  is  to  describe 
(determine,  identify,  etc.)."  The  deci- 
sion as  to  which  form  to  use  depends 
on  the  type  of  study  and  the  approach 
used.  For  example,  in  my  recent  re- 
search project  I  chose  to  state  the  gener- 
al purpose  as  well  as  the  specific 
purpose:^ 

"The  general  purpose  of  this  study 
was  the  examination  of  the  vocational 
motivation  of  professional  nursing 
students  who  prefer  careers  in  teach- 
ing nursing  or  in  clinical  nursing.  More 
specifically,  the  study  tests  hypotheses 
regarding  differences  between  two 
groups,  in  respect  to  personality  char- 
acteristics, teacher  and  clinical  nurse 
practitioner  trait  characteristics,  self- 
concept,  and  work  values." 
Such  a  statement  of  purpose  should 
give  the  reader  a  clear  idea  of  the  in- 
vestigator's intent. 

Conceptualizing  the  problem 

Having  explicitly  stated  the  specific 

purpose  of  the  study,   the  researcher 

proceeds  to  state  the  problem.  To  do 

this  adequately  means  to  know  what 

THE  CANADIAN   NURSE     41 


constitutes  the  problem  and  the  kind 
of  answer  needed  (for  example,  "cause, 
effect,  relationship,  or  simply  systema- 
tic and  accurate  description  of  some 
aspect  of  the  empirical  world"^)  The 
problem  statement  must  conform  to 
the  stated  purpose  of  the  research. 

The  researcher  then  seeks  to  con- 
ceptualize further  his  research  prob- 
lem by  examining  theories  and  research 
studies  that  might  help  to  explain  the 
existence  of  the  problem  and  the  various 
elements  and  their  interrelationships 
that  comprise  it.  In  other  words,  she 
builds  a  theoretical  model  —  a  hypo- 
thesis —  that  sets  down  logically- 
derived,  interrelated  propositions 
that  assert  relations  among  the  pro- 
perties of  the  phenomena  under  study. 
On  the  basis  of  this  conceptualization, 
hypothetical  prediction(s)  may  be 
stated  which  are  to  be  tested  in  the 
study. 

She  also  specifies  the  assumptions 
and  limitations  of  the  research  study. 
Assumptions  are  statements  describing 
conditions  or  relationships  on  which 
the  study  is  based,  whose  correctness 
or  validity  is  not  tested  but  taken  for 
granted.  Assumptions  may  be  based  on: 
1 .  so-called  universally-accepted  truths, 
so  self-evident  that  they  require  no 
additional  testing;  2.  theories  that  are 
accepted  as  relevant  to  the  study;  and 
3.  findings  of  previous  research.  Those 
assumptions  that  have  a  significant 
bearing  on  the  study  should  be  expli- 
citly stated  as  the  research  design  rests 
on  them. 

A  hypothesis  is  a  proposition  that 
seems  to  explain  observed  facts  by 
ascribing  cause,  effect,  or  relation- 
ship to  them,  and  whose  truth  is  as- 
sumed tentatively  for  purposes  of 
investigation.  It  represents  a  temp- 
orary state  between  two  conditions  — 
acceptance  or  rejection.  No  hypothesis 
is  intended  to  remain  a  hypothesis 
forever. 

A  good  hypothesis  must  adequately 
explain  observed  facts;  offer  the  sim- 
plest explanation  under  the  circumstan- 
ces, yet  one  as  complex  as  necessary; 
42     THE  CANADIAN   NURSE 


offer  the  possibility  of  being  in  agree- 
ment or  disagreement  with  observa- 
tion; be  strong  enough  to  compel  in- 
quiry; and  extend  knowledge. 

The  hypothesis  being  tested  must 
be  carefully  examined  to  determine 
and  define  all  the  variables  and  con- 
cepts that  are  included  explicitly  or 
implicitly.  The  terms  must  be  defin- 
ed in  operational  terms  that  can  be 
observed  and  measured. 

Suppose  we  had  hypothesized  that 
the  attitude  of  the  nurse  was  related 
to  the  psychological  disturbances  man- 
ifested by  the  post-cardiotomy  patient 
in  the  immediate  postoperative  period. 
The  two  variables  are  the  nurse's  at- 
titude and  the  psychological  distur- 
bances. The  question  then  arises.  How 
can  we  measure  the  relationship  expres- 
sed in  the  hypothesis?"  We  have  to  ask 
and  define,  "What  do  we  mean  by 
nurse's  attitude?  What  do  we  mean 
by  psychological  disturbances?"  By 
the  time  we  get  through  asking  these 
questions,  we  will  have  a  seemingly 
unending  list  of  variables  that  would 
make  up  the  nurse's  attitude  and  in- 
dicate manifestations  of  psychological 
disturbances. 

We  will  also  find  that  many  of  these 
variables  are  not  measurable  by  tech- 
niques currently  available.  It  may  be 
that  a  whole  study  needs  to  be  '^one 
before  we  even  know  the  meaning  of 
one  of  the  variables  we  have  talked 
about. 

Designing  the  study 

The  design  of  a  research  plan  is 
primarily  concerned  with  determin- 
ing how  and  from  where  the  data  are  to 
be  collected.  It  is  concerned  with  plan- 
ning how  the  study  population  will  be 
brought  into  the  scope  of  the  research 
and  how  it  will  be  employed  within  the 
research  setting  to  yield  the  required 
data.  The  design  of  a  research  project 
details  the  overall  framework  for  con- 
ducting the  study. 

Designing  the  research  plan  usually 
takes  place  after  the  purpose  has  been 
stated,  the  problem  concretely  formu- 


lated, the  theoretical  framework  es- 
tablished, and  the  hypothesis  —  if 
any  —  stated.  However,  in  actuality, 
designing  the  research  plan  begins,  to 
some  extent,  when  the  researcher  starts 
to  explore  and  formulate  her  problem, 
as  the  design  of  any  particular  study 
is  directly  dependent  on  what  decisions 
have  been  made  throughout  the  research 
process. 

Selecting  the  appropriate  techniques, 
tools,  and  procedures  for  collecting 
data  is  an  important  activity  in  design- 
ing every  research  study.  When  possi- 
ble, instruments  previously  used  in 
other  studies  should  be  applied  if  they 
permit  collection  of  the  kind  of  data 
needed  for  the  study.  Instruments  may 
be  modified  for  the  purposes  of  a  spe- 
cific study.  However,  new  data-gather- 
ing tools  will  probably  have  to  be  de- 
veloped. 

Validity,  reliability,  and  expected 
error  sources  of  the  measures  used 
should  be  determined.  If  new  tools  are 
developed,  they  should  be  adequately 
tried  out  to  determine  if  they  will  col- 
lect the  needed  data  for  the  study.  One 
of  the  most  pressing  problems  in  doing 
experimental  research  in  nursing  is  the 
lack  of  adequate  criterion  measures 
that  can  be  used  to  evaluate  effective- 
ness of  nursing  care. 

Determining  the  number  and  kind 
of  subjects  and  the  sampling  techni- 
ques to  be  used  in  the  selection  of  sub- 
jects constitutes  another  part  of  the 
design.  And  if  the  study  is  designed 
to  test  hypotheses,  the  types  of  con- 
trol as  well  as  assignment  of  treatment 
to  groups  and/or  individuals  must  be 
determined. 

Finally,  determining  the  method  of 
data  analysis,  and,  if  the  study  tests 
hypotheses,  the  type  of  statistical  tests 
and  confidence  levels  that  will  be  ac- 
cepted for  significance,  are  important 
parts  of  the  design.  Waiting  until  after 
the  data  is  collected  to  determine  how 
it  will  be  analyzed  is  too  late.  Deter- 
mining how  the  data  will  be  analyzed 
is  an  integral  part  of  designing  all  re- 
search studies. 

MAY  1971 


In  addition  to  all  these  activities, 
the  researcher  should  have  alternative 
plans  built  into  her  design.  For  one 
reason  or  another,  research  plans  may 
have  to  be  modified  and  even  new  ones 
substituted. 

Collecting  the  data 

If  the  research  has  been  well  design- 
ed, collection  of  data  is  facilitated. 
However,  all  problems  that  may  be 
encountered  cannot  be  foreseen.  This 
is  particularly  true  in  nursing  research. 
Subjects  are  not  always  available,  nor 
is  access  to  subjects  always  possible. 

Three  factors  need  to  be  kept  in 
mind  when  collecting  data  and  when 
designing  the  study:  the  subject,  the 
experimenter,  and  possible  errors  in 
measurements.  Bias  in  data  can  result 
from  any  one  of  these  or  all  three  in 
any  one  study. 

Analyzing  and  Interpreting  data 

Many  different  methods  may  be  used 
to  organize  and  analyze  data.  Charts, 
graphs,  tables,  and  so  on  are  helpful  in 
organizing  and  analyzing  descriptive 
data.  Statistical  data  presents  its  own 
method  of  organizing  data  and  will 
vary  according  to  the  statistics  used. 
In  all  instances,  however,  the  investig- 
ator should  organize  her  data  so  she  will 
have  a  basis  for  generalizations  in  rela- 
tion to  her  purpose. 

As  the  researcher  organizes  her  data, 
she  will  at  the  same  time  be  trying  to 
interpret  it.  Organizing  the  data  refers 
to  the  organization  of  observable  phe- 
nomena collected,  and  interpreting 
refers  to  the  meaning  being  ascribed 
to  the  observed  phenomena.  The  ex- 
tent to  which  interpretations  can  be 
placed  on  data  depends  on  many  fac- 
tors, the  most  important  being  the  na- 
ture of  the  data,  the  selection  of  sample, 
the  way  the  data  were  collected,  and 
the  type  of  analysis.  Obviously,  if  only 
descriptive  data  were  collected,  the 
researcher  cannot  ascribe  cause  or  ef- 
fect. 

The  theoretical  framework  of  the 
study  and  review  of  relevant  findings 
MAY  1971 


from  other  research  studies  also  are 
of  help  to  the  researcher  in  the  inter- 
pretation of  her  findings.  The  process 
of  relating  findings  from  the  current 
study  to  those  of  earlier  studies  is  one 
of  determining  agreement  of  non- 
agreement  with  earlier  findings  and  of 
new  or  extended  meanings  that  can  be 
attached  to  both.  Valid  conclusions  can 
be  drawn  only  in  light  of  presented 
criteria.  It  is  not  fair  to  change  criterion 
measures  based  on  the  results  of  the 
study. 

Arriving  at  conclusions 

The  conclusions  of  a  research  study 
are  the  generalizations  that  are  drawn 
in  relation  to  the  purpose  of  the  study. 
They  should  be  clearly  stated,  free  from 
opinion,  never  go  beyond  the  facts 
established  by  the  study.  They  should 
answer  the  questions  raised  in  the  study. 

Researchers  are  sometimes  tempted 
to  broaden  the  basis  of  their  induc- 
tions by  including  personal  exper- 
iences chat  were  not  subject  to  the  con- 
trols under  which  the  data  of  the  study 
were  collected.  This  decreases  the  ob- 
jectivity of  the  study.  Equally  undesir- 
able is  the  practice  of  drawing  univers- 
al conclusions  from  a  limited  sample. 
The  careful  researcher  specifies  clearly 
and  concisely  the  conditions  under 
which  her  conclusions  apply  validly. 

If  the  study  has  been  a  careful  and 
thorough  one,  it  will  open  up  new  areas 
to  be  investigated,  and  recommenda- 
tions for  further  research  will  flow 
naturally.  Suggestions  may  be  made 
for  hypotheses  that  need  to  be  tested. 
Implications  and  recommendations 
for  the  use  of  the  knowledge  attained 
in  the  study  is  important  in  studies  on 
practice  disciplines. 

Writing  and  publishing 

A  research  study  has  not  been  com- 
pleted until  it  has  been  reported  and, 
if  possible,  published.  Publication  may 
take  place  in  a  variety  of  forms.  The 
following  are  most  generally  used  by 
researchers:  a  full-length  paper  publish- 
ed as  a  monograph;  an  article  published 


in  a  journal  that  specializes  in  the  area 
of  the  contribution;  and  a  short  sum- 
mary or  abstract. 

Research  findings  of  a  carefully  done 
research  study  should  be  disseminated 
as  widely  as  possible.  If  the  researcher 
has  been  successful  in  achieving  her 
purpose,  she  will  provide  a  generaliza- 
tion(s),  supported  by  facts,  to  be  used 
to  explain  specific  observations,  to 
guide  actions  in  specific  situations  and 
to  predict  outcomes  of  these  actions. 

Even  though  she  may  not  have  reach- 
ed her  goal,  she  will  still  have  made  a 
contribution  in  that  she  has  carefully 
researched  an  aspect  of  empirical 
reality.  By  describing  her  study  in 
detail,  other  investigators  can  replica- 
te her  study,  make  modifications  in  the 
approach  used,  or  use  a  different  ap- 
proach to  the  same  research  problem. 

To  summarize,  I  have  tried  to  present 
some  of  the  major  activities  inherent 
in  the  research  process.  The  one  thought 
I  would  leave  you  with  is  that  "research- 
ing" is  interesting,  challenging,  but 
long,  arduous  work  requiring  infinite 
patience,  self-discipline,  and  persist- 
ence. And  although  the  research  process 
can  be  analyzed  into  specific  activities, 
these  activities  are  usually  not  carried 
out  in  any  unified,  sequential  manner. 

References 

1 .  Heidgerken.  L.  Vocationul  Motivation 
for  Nursing  Careers  of  Tcaciiing  anil 
Clinical  Practice.  Washington,  D.C., 
The  Catholic  University  of  America 
Press,  1970.  pp.95-6. 

2.  ibid.,  p. 33. 

3.  Meyer.  B.  and  Heidgerken,  L.  Intro- 
duction to  Research  in  Nitrsinf;.  Phil- 
adelphia. J.B.  Lippincott.  1962,  pp. 
199-234.  ■§. 


THE  CANADIAN   NURSE     43 


Problems^  issues^  challenges 

of  nursing  research 


In  recent  years,  nurses  have  been  preoccupied  with  pressures  of  hospital 
expansion,  development  of  health  agencies,  and  increasing  demands  for 
nursing  services.  The  profession's  organized  efforts  have  been  directed 
toward  the  improvement  of  the  nurse  practitioner  and  the  nurse  educator, 
not  toward  the  preparation  of  the  nurse  scholar  nor  the  nurse  investigator 
in  research.  The  study  of  nursing  practice  and  the  art  and  science 
underlying  the  practice  of  nursing  are  only  beginning  to  be  recognized  as 
"musts"  for  the  profession. 


Faye  G.  Abdellah,  R.N.,  Ed.D.,  LL.D. 

Nursing  research  can  be  defined  as  a 
systematic,  detailed  attempt  to  discover 
or  confirm  the  facts  that  relate  to  a 
specific  problem  or  problems  in  nurs- 
ing. It  has  as  its  goal  the  provision  of 
scientific  knowledge  in  nursing. 

Descriptive  experimental  studies 
that  delineate  the  behavior  of  certain 
phenomena  may  not  have  immediate 
application  to  patient  care,  but  are 
indicative  of  the  kinds  of  highly-con- 
trolled, fundamental  observations  that 
must  be  made  before  possible  solutions 
to  problems  can  be  reduced.  The  very 
roots  of  nursing  practice  stem  from  the 
biological,  physical,  and  behavioral 
sciences. 

Descriptive  studies  are  concerned 
with  a  broad  range  of  phenomena.  The 
end  product  is  usually  a  lengthy  nar- 


Dr.  Abdellah  is  Assistant  Surgeon  Gener- 
al. Chief  Nurse  Officer,  U.S.  Public  Health 
Service.  Department  of  Health,  Educa- 
tion, and  Welfare.  This  paper  is  adapted 
from  an  address  she  presented  at  the 
first  National  Conference  on  Research  in 
Nursing  Practice,  held  in  Ottawa  February 
16  to  18,  1971.  The  information  in  this 
paper  is  based  on  material  presented  in 
Better  Patient  Care  Through  Nursing  Re- 
search by  Abdellah  and  l.evine  (Mac- 
millan  1965),  and  Dr.  Abdellah's  "Over- 
view of  Nursing  Research,  1955-1968," 
Parts  I.  il.  ill.  Nurs.  «o..  Jan.-June  1970. 


44     THE  CANADIAN   NURSE 


rative  statement  similar  to  the  case  study 
used  so  effectively  by  anthropologists. 

Explanatory  research  generally  re- 
quires experimentation  with  control 
over  the  phenomena  being  studied. 
This  control  factor  permits  the  investi- 
gator to  draw  valid  inferences  of  causal 
relationships  among  the  phenomena 
studied.  Explanatory  research  requiring 
experimentation  with  human  and  ani- 
mal subjects  needs  many  controls  that 
are  sometimes  difficult  to  maintain. 
Safeguards  for  subjects  must  be  worked 
out  in  detail  so  the  experimental  varia- 
ble is  not  harmful  to  the  subject  nor  too 
disruptive  to  his  care.  Highly-controlled 
settings  for  experimental  research  are 
hard  to  find. 

Both  descriptive  and  explanatory 
research  can  be  conducted  in  uncon- 
trolled settings,  although  explanatory 
research  is  less  likely  to  be  found  in 
these  settings.  Such  research  is  depen- 
dent on  nurse  scientists  who  have  main- 
tained a  depth  of  clinical  content  and 
who  seek  their  research  questions  from 
the  "real  world"  of  the  patient. 

The  limited  amount  of  clinical  re- 
search in  the  United  States  is  clearly 
due  to  the  enormous  problems  that 
have  yet  to  be  overcome:  the  lack  of 
precise  measuring  instruments;  the 
identification  of  criterion  measures  of 
quality  nursing  practice;  the  develop- 
ment of  models  and  theories  that  have 
relevance  for  nursing;  and  the  lack  of 

MAY  1971 


access  to  study  populations  and  to  ani- 
mal laboratories.  Until  these  obstacles 
are  overcome,  the  scientific  basis  of 
nursing  practices  cannot  be  studied  in 
depth. 

Major  shifts  in  the  '70s 

During  the  '70s,  major  breakthroughs 
that  will  result  in  the  improvement 
of  nursing  practice  will  come  from 
research  in  the  biological  and  behav- 
ioral sciences.  For  example,  nursing 
practices  will  undergo  many  changes  as 
research  moves  ahead  to  find  ways  of 
successfully  achieving  tissue  and  organ 
transplants  and  the  regeneration  of 
tissues. 

Studies  in  nursing  that  are  concerned 
with  the  gross  physical  and  physiologic- 
al signs  pertinent  to  nursing  practice 
need  to  be  undertaken.  Perhaps  the 
most  productive  approach  will  be  the 
collection  of  descriptive  data  of  patient 
behaviors  as  patients  react  to  or  interact 
with  physiological  and  environmental 
phenomena.  Thus,  the  major  focus 
should  be  on  inquiries  concerned  with 
the  discovery  and  the  application  of 
scientific  knowledge  to  improve  nurs- 
ing practice.  Evaluation  of  patient  care 
should  be  based  on  scientific  inquiry 
that  has  a  theoretical  basis. 

Another  major  shift  in  the  '70s  will 
be  toward  preventive  health  measures 
and  the  development  of  health  care 
delivery  systems.  Studies  might  include: 

1 .  The  physiological  and  psycholog- 
ical behaviors  of  individuals  with  dif- 
ferent types  of  diagnoses  in  different 
environments  to  predict  the  conse- 
quences of  actions.  The  use  of  video 
tapes  to  record  these  behaviors  would 
provide  documentary  evidence  and 
should  be  encouraged. 

2.  Establishment  of  the  scientific 
bases  for  nursing  practice.  This  will 
necessitate  free  access  of  qualified 
nurse  investigators  to  study  populations 
in  patient  care  research  centers  (usually 
18-  to  20-bed  units)  and  in  health  care 
research  centers.  Nurses  will  also  need 
to  develop  increased  sophistication  in 
the  use  of  animals  for  research. 

3.  Stimulation  of  additional  inter- 
disciplinary action  by  such  three-prong- 
ed approaches  as  utilization  of  nurses, 
physicians,  and  industrial  engineers  to 
study  patient  care  systems  and  health 
care  systems. 

4.  Study  of  such  problems  as  the 
operation  of  patient  monitoring  devices, 
medical  and  treatment  consoles. 

5.  Studies  of  interprofessional   and 
intraprofessional    communication    and 
its  effects  on  professional  practice. 
MAY  1971 


6.  Study  of  the  diagnostic  process 
initiation,  professional  actions  affect- 
ing it,  patient  involvement,  assessment 
of  the  patient's  total  problem. 

7.  Utilization  of  every  means  fxas- 
sible  to  communicate  scientific  findings 
into  nursing  practice,  for  example,  by 
such  means  as  multi-media  instructional 
systems  for  the  practicing  nurse,  cover- 
ing all  clinical  areas. 

Model  and  theory  development 

Model  and  theory  development 
should  be  undertaken  in  nursing,  but  it 
must  be  related  to  nursing  practice. 
Clearly  there  will  be  no  one  theory  of 
nursing,  but  multiple  theories  that 
eventually  will  comprise  a  nursing 
science. 

Nursing  science  can  deal  only  with 
those  models  and  theories  that  can  be 
set  right,  challenged,  and  corrected. 
Nursing  science  is  defined  as  a  body  of 
cumulative  scientific  knowledge  drawn 
from  the  physical,  biological,  and  be- 
havioral sciences,  which,  by  the  process 
of  synthetization,  becomes  uniquely 
nursing.  Nursing,  like  other  disciplines 
lacking  theories,  finds  some  of  its  in- 
vestigators embracing  seemingly  tested 
models  and  theories  from  other  disci- 
plines, without  checking  to  see  if  the 
model  or  theory  is  appropriate  for  use 
with  a  new  study  population  and  envir- 
onmental setting. 

Models  and  theories  adapted  from 
other  disciplines  must  be  continuously 
challenged  and  contested.  As  new  phe- 
nomena are  observed  and  new  events 
or  facts  added  or  rejected,  valid  and 
reliable  models  and  theories  can  be 
developed.  Research  can  help  to  clarify 
models  and  theories  related  to  nursing 
practice,  each  step  leading  toward  the 
development  of  a  nursing  science. 

Knowledge  is  needed  about  behavior 
of  patients  with  different  diagnoses, 
from  different  age  groups  and  environ- 
ments. Knowledge  is  also  needed  about 
patterns,  processes,  and  phenomena  in 
patient  situations.  Descriptive  research 
is  the  most  direct  line  of  attack  to  this 
problem.  Once  this  knowledge  is  avail- 
able, models  and  theories  can  be  devel- 
oped. 

Existing,  relevant  theories  that  will 
be  useful  in  building  a  scientific  base 
for  nursing  practice  need  to  be  located. 
These  theories  must  then  be  tested  and 
validated  to  see  if  they  will  hold  true  in 
the  new  setting  with  new  population 
groups.  Thus,  new  theories  are  not 
discovered,  but  are  invented.  Nursing 
theories  result  from  the  integration  of 
nursing  with  the  basic  sciences  and  are 


drawn  from  the  "real  world"  of  empir- 
ical reality. 

Major  gaps  in  research 

Criterion  measures  of  patient  care 
and  precise  instrumentation  to  measure 
the  effects  of  nursing  practice  on  pa- 
tient care  are  clearly  the  major  gaps  in 
nursing  research. 

The  failure  of  the  nursing  profession 
to  formulate  agreed  upon  goals  retlects 
one  of  the  key  problems  encountered  in 
trying  to  define  criterion  measures 
against  which  to  evaluate  performance. 
Nurses  themselves  cannot  agree  on 
measurable  criteria  of  effective  nursing 
care.  A  scientific  body  of  knowledge 
that  is  uniquely  nursing  has  yet  to  be 
identified  to  provide  a  theoretical  basis 
against  which  nursing  practice  can  be 
measured. 

Unlike  the  use  of  criterion  measures 
in  controlled  laboratory  research  —  in 
which  the  organism  being  studied  is  in 
a  controlled  environment,  such  as  a 
test  tube  or  a  cage  —  in  nursing  these 
measures  must  be  employed  in  the 
framework  of  the  patient's  complex 
environment.  Since  there  are  so  many 
extraneous  variables  in  the  situation, 
both  organismic  and  environmental,  it 
is  exceedingly  difficult  to  keep  the 
variables  under  sufficient  control. 

The  difficulties  in  identifying  criter- 
ion measures  in  nursing  have  directed 
much  of  the  research  in  nursing  into 
areas  that  are  more  easily  "research- 
able."  To  illustrate,  the  study  of  the 
nurse  —  what  she  does,  how  much  time 
she  spends  on  patient  care  —  can  prov- 
ide us  only  with  empirical  knowledge. 
This  knowledge  has  value  in  that  it 
helps  to  discern  problem  areas  that 
need  to  be  studied  in  more  depth. 

Ultimately,  however,  how  the  nurse 
functions  must  be  measured  against 
the  effects  (criterion  measures)  of  nurs- 
ing practice  on  the  patient.  Likewise, 
studies  of  the  role  of  the  nurse  have 
value  in  giving  direction  to  the  nursing 
profession.  These  studies  are  indeed 
important,  but  will  have  little  decisive 
impact  on  the  improvement  of  patient 
care  if  there  are  no  adequate  criterion 
measures  to  evaluate  effects  of  changed 
practice  on  patient  care. 

The  lack  of  criterion  measures  in 
nursing  places  a  partial  blindfold  on 
the  nurse  as  she  provides  nursing  care. 
Her  practice  thus  becomes  one  of  trial 
and  error  instead  of  one  based  on  tested 
practices,  proven  to  be  scientifically 
effective. 

Measurement  of  patient  care  in  terms 

of  valid  and  reliabjp  criterion  measures 

THE  CANADIAN   NURSE     45 


IS  a  crucial  part  of  research  in  nursing. 
The  fact  that  the  measurement  of  the 
effects  of  nursing  practice  on  patient 
care  continues  to  be  identified  as  the 
number  one  priority  area  for  nursing 
research,  reflects  the  difficulties  being 
encountered  in  finding  valid  and  reli- 
able measures.  Because  of  the  multi- 
dimensional nature  of  patient  care,  it 
is  difficult  but  not  impossible  to  meas- 
ure this  variable. 

Measurement  of  patient  care  can  be 
approached  by  evaluating  the  adequacy 
of  the  facilities  in  which  patient  care  is 
provided,  the  effectiveness  of  the  ad- 
ministrative and  organizational  struc- 
ture of  the  agency  providing  patient 
care,  the  professional  qualifications  and 
competency  of  personnel  employed  to 
provide  the  care,  and  the  evaluation  of 
the  effect  on  the  consumers  of  care  — 
the  patients. 

The  type  of  criterion  measure  used 
is  influenced  by  the  research  problem 
and  the  hypotheses  that  have  been  de- 
veloped to  explore  the  problem.  Once 
the  variables  have  been  defined,  the 
researcher  must  then  decide  how  the 
dependent  variable  —  the  criterion 
measure  —  will  be  calculated.  The 
decision  to  select  a  direct  or  indirect 
measure  will  be  influenced  by  the  ease 
with  which  the  variable  can  be  directly 
estimated. 

The  investigator  seeking  to  measure 
physiological  responses  has  available 
a  number  of  scientific  instruments, 
yielding  highly  refined  numerical  meas- 
urements, which  might  serve  as  criterion 
measures.  There  are  also  many  tests 
and  scales  available  to  measure  psy- 
chological or  sociological  phenomena. 

Because  of  the  lack  of  descriptive 
research  about  individual  and  patient 
behaviors,  judgments  of  quality  are 
often  incomplete  and  based  on  partial 
evidence.  Measurement  scales  need  to 
be  developed  that  discriminate  different 
levels  of  patient  response.  One  pro- 
blem in  scaling  that  must  be  solved  is 
the  way  in  which  difference  components 
on  the  measurement  scale  are  to  be 
weighted  in  the  process  of  arriving  at 
a  total. 

Systems  will  change 

Systems  for  the  delivery  of  health 
care  must  and  will  change  to  meet  pa- 
tients' needs. 

The  character  of  illness  is  also  chang- 
ing. As  ways  have  been  found  to  treat 
acute  infections,  chronic  illnesses  have 
increased  proportionately.  Long  periods 
of  hospitalization  for  psychiatric  disor- 
ders are  being  shortened.  More  attention 
46     THE  CANADIAN  NURSE 


can  now  be  given  to  the  emotional  com- 
ponents of  all  types  of  illness  and  to 
those  functional  symptoms  that  stem 
from  the  stresses  of  life.  Through  re- 
search, which  tends  to  average  out 
individual  variations  by  studying  groups 
of  individuals  in  health  and  illness, 
scientific  inquiry  provides  a  basis  for 
nursing  practice. 

As  the  nurse  assumes  more  respon- 
sibility for  the  patient,  she  must  acquire 
additional  preparation  as  a  clinical 
nurse  specialist.  However,  the  nurse 
specialist  must  move  out  into  the  com- 
munity where  she  can  have  an  impact  on 
the  delivery  of  health  services.  Organiz- 
ation of  the  physician-nurse  team  and 
the  broadening  of  its  base  of  operation 
for  the  delivery  of  health  services  to 
include  the  community  is  high  priority 
if  the  patient-centered  approach  to 
nursing  is  to  have  a  greater  impact. 

In  the  '70s,  substantial  changes  will 
occur  in  the  way  health  services  are 
provided,  and  nurses  will  play  an  im- 
portant role  in  determining  how  new 
health  delivery  systems  will  evolve. 
Nurses  need  to  undertake  an  aggressive 
role  both  in  the  professional  content  of 
health  care  and  in  the  leadership  of  new 
forms  of  health  care. 

The  major  changes  in  clinical  nurs- 
ing specialists  as  a  result  of  heart  sur- 
gery, renal  dialysis,  and  organ  trans- 
plants have  been  well  documented. 

The  changes  in  nursing  service,  based 
on  which  practices  and  techniques 
nursing  will  assume  responsibility  for, 
will  be  determined  by  situations  that 
lend  themselves  to  simple  change; 
situations  requiring  changes  that  may 
be  either  simple  or  complex,  but  require 
time  for  implementation;  situations  that 
are  basically  an  expression  of  the  atti- 
tudes, roles,  and  values  of  nurses  and 
physicians,  but  which  will  respond  to 
change  slowly. 

An  innovative  system  needed 

The  existing  delivery  systems  of 
health  care  with  the  acute  shortages  of 
manpower  and  facilities  are  inadequate. 
The  accepted  truth  that  medical  care 
is  a  right  of  every  individual  cannot 
become  a  reality  until  there  are  delivery 
systems  of  medical  care  capable  of 
providing  high  quality  medical  and 
nursing  services. 

A  rational  medical  and  nursing  care 
delivery  system  must  be  developed, 
tested,  and  implemented.  It  is  within 
such  systems  that  the  professional  nurse 
will  find  herself  funcfioning.  Therefore, 
any  consideration  of  patient-centered 
approaches  to  nursing  services  must  be 


considered  within  the  structure  of  a 
health  care  delivery  system.  The  physi- 
cian and  nurse  form  the  central  core  of 
this  system. 

The  concept  of  preventive  main- 
tenance services  has  emerged  as  an 
important  aspect  in  the  development 
of  any  delivery  system  of  health  care. 
Implementing  such  a  delivery  system 
will  demand  a  greatly  expanded  role 
for  the  professional  nurse  where  initial 
assessment  of  priority,  based  on  pa- 
tients' needs,  is  paramount.  The  ex- 
panded roles  of  the  nurse  require  ac- 
ceptance of  responsibilities  in  health 
care  systems  beyond  those  usually  ex- 
pected of  the  professional  nurse  who  has 
had  baccalaureate  degree  preparation 
in  education. 

An  unresolved  issue  is  whether  or 
not  the  expanding  roles  of  nurses  should 
include  the  diagnoses  and  treatment  of 
pathology  and  disease  as  a  responsibility 
delegated  by  a  physician  carried  on 
under  his  guidance.  The  National 
League  for  Nursing's  Committee  to 
Study  the  Nurse's  Role  in  the  Delivery 
of  Health  Services  has  recommended 
that  the  expanding  roles  of  nurses  should 
include  an  extension  of  responsibilities 
already  recognized  as  nursing  interven- 
tion and  nursing  decision-making, 
rather  than  the  technical  functions 
described  under  the  work  of  the  phys- 
ician's assistant. 

As  new  health  systems  for  care  de- 
velop, one  must  reappraise  training 
programs  for  nursing  practice.  One 
needs  to  ask  constantly,  "Training  for 
what?"  The  knowledge  and  skills  nec- 
essary to  perform  effectively  in  the 
delivery  of  health  services  must  be 
attuned  to  society's  health  services 
needs.  Thus,  nursing  researchers  in  the 
'70s  will  focus  on  both  nursing  service 
and  nursing  education  and  will  seek 
ways  to  develop  effective  delivery  sys- 
tems of  care  and  prepare  individuals  to 
function  in  these  systems.  § 


MAY  1971 


A  community  clinic 
where  people  count 

Initially  a  McGill  University  project,  the  Pointe  St.  Charles  Community 
Clinic,  now  financed  by  government  funds  and  run  by  its  clients,  is 
bursting  at  the  seams. 


Liv-Ellen  Lockeberg 

0654  Charlevoix  Street  is  just  another 
house  in  the  row,  but  its  front  window 
displays  a  handmade  sign:  "Pointe  St. 
Charles  Community  Clinic."  On  a 
bitterly  cold  Monday  morning  late  in 
January,  its  porch  steps  had  not  yet 
been  cleared  of  snow.  The  door  pushed 
open  without  needing  to  turn  the  brass 
knob. 

Among  the  few  in  the  front  waiting 
room  was  Maurice  Boivin,  a  young  de- 
partment store  delivery  man  who  was 
using  his  day  off  to  have  a  glucose 
tolerance  test.  One  of  the  luckier  resi- 
dents of  the  Point,  he  has  a  steady  job 
and  can  adequately  provide  for  his  wife 
and  two  small  children.  He  wears  strong 
glasses  for  marked  strabismus.  Would 
he  have  been  even  more  fortunate  had 
there  been  a  clinic  in  the  Point  when  he 
was  a  boy? 

In  the  small  office  across  the  hall,  a 
university  student  filled  out  forms  for 
the  clinic's  ongoing  research.  Friendly 
faces  appeared  at  the  door  to  leave  mes- 
sages for  the  nurses,  or  just  to  call  a 
greeting. 

The  hallway  is  wide  enough  for  a 
table  with  baby  scales,  a  coatrack,  a 
bench.  On  the  street  side,  three  doors 
announce  offices  for  doctors.  The  clinic 
workrooms  at  the  rear  occupy  what 
used  to  be  the  kitchen  and  pantry  of  this 

Miss  Lockeberg  is  Assistant  Editor  of 
1  lie  Caiuuliaii  Nurse.  Ottawa. 


MAY  1971 


ground-floor  flat.  Colorful  window 
drapes,  pale  walls,  a  few  plants  help  to 
cheer  the  place. 

Across  the  road,  at  0670  Charlevoix, 
a  similar  flat  offers  space  for  the  clinic's 
administrative  and  research  activities, 
a  place  for  its  teaching  and  training 
units,  and  for  its  members'  meetings. 

A  students'  clinic 

Three  years  ago,  the  Montreal  Stu- 
dent Health  Organization,  a  group  of 
students  of  medicine,  nursing,  and 
social  work  at  McGill  University,  were 
dissatisfied  with  their  opportunities  for 
clinical  and  research  experience.  To 
correct  this,  they  started  a  totally  in- 
tegrated clinic  staffed  by  themselves, 
with  guidance  from  their  professors  and 
voluntary  help  from  established  Mont- 
real practitioners.  Before  renting  an 
old  store  front  in  Pointe  St.  Charles  in 
July,  1968,  they  had  to  beg  and  borrow. 
Donations  came  from  such  diverse 
sources  as  the  McConnel  Foundation, 
the  John  and  Mary  Markle  Foundation, 
the  Koyai  Bank  of  Canada,  the  Bank 
of  Montreal,  and  private  foundations. 

To  improve  those  social  conditions 
that  could  contribute  to  many  organic 
and  psychiatric  illnesses,  they  added  an 
educational  program  embracing  a  learn- 
ing clinic,  a  tutorial  program,  and  a 
remedial  teaching  program. 

The  students  hired  Barbara  Stewart, 

a  McGill  gradual*  with  a  bachelor  of 

THE  CANADIAN   NURSE     47 


/);•.    Ficmi;ois    Lchnmnn   and    Burhuia 
Sli'wcirl  share  a  lighter  moment. 


Ken  li'atsoii  tells  Barbara  Stewart  a  "tall  one,"  while  his  mother  looks  on. 


nursing  degree  in  public  health,  to  lend 
continuity  to  the  project.  Barbara  is  still 
there.  Soon  afterwards,  they  hired 
Francois  Lehmann  on  a  half-day  basis. 
He,  too,  is  still  there,  now  full-time. 

As  the  citizens  of  Pointe  St.  Charles 
gradually  became  involved  in  the  affairs 
of  the  clinic,  the  students  withdrew 
their  control.  This  transfer  of  power, 
now  completed,  has  not  pleased  every- 
one, for  some  consider  the  clinic  only 
as  a  provider  of  medical  services  and 
not  as  a  focal  point  for  developing 
community  resources. 

Beyond  its  medical  function,  the 
clinic's  built-in  research  has  allowed 
it  to  merit  financial  support  from  feder- 
al and  provincial  governments.  Now 
that  the  Castonguay-Nepveu  Commis- 
sion recommendations  are  under  consi- 
deration, the  clinic  is  being  watched 
with  interest  and  has  received  much 
coverage  in  the  news  media  of  Quebec. 

Why  Pointe  St.  Charles? 

The  McGill  students  chose  to  locate 
their  clinic  in  Pointe  St.  Charles  be- 
cause it  has  many  low-income  fam- 
ilies and  is  well  defined.  To  the  west,  it 
borders  Verdun;  north,  the  railway  line 
and  the  Lachine  Canal;  east,  the  Bon- 
aventure  autoroute;  and  south,  the 
St.  Lawrence  River.  Isolated  and  in  an 
old  area  of  the  city  —  only  one  house 
in  seven  has  been  built  since  1920  — 
it  does  not  attract  the  well-to-do.  Rath- 
er, its  residents,  numbering  about 
48     THE  CANADIAN   NURSE 


23,000,  tend  to  be  those  with  low  in- 
comes, or  with  no  job,  or  those  who 
have  always  lived  there. 

Many  wage  earners  are  skilled  trades- 
men, production  workers,  or  laborers, 
and  the  present  wave  of  unemployment 
in  Montreal  has  hit  them  hard.  It  has 
become  a  day-to-day  struggle  to  make 
welfare  payments  stretch  between  in- 
tervals. Good  health  is  a  luxury. 

The  Point  has  no  general  hospital 
within  its  confines,  and  but  four  over- 
worked doctors  and  one  dentist  for  the 
whole  area.  They  welcomed  the  estab- 
lishment of  the  clinic. 

There  are  community  resources  in 
Pointe  St.  Charles,  but  how  adequately 
they  reach  the  community  remains  a 
question.  It  abounds  with  citizens" 
groups,  such  as  Le  Regroupement  des 
citoyens  de  Pointe  St-Charles  a:nd  its 
English  speaking  equivalent,  the  Citi- 
zens' Association  of  Pointe  St.  Charles, 
both  concerned  with  problems  on  hous- 
ing, consumer  affairs  and  education. 
Housed  near  the  clinic,  the  Community 
Legal  Services,  started  by  McGill  Uni- 
versity law  students  and  staffed  by 
lawyers  and  themselves,  help  persons 
on  low  incomes  with  their  legal  prob- 
lems. 

Facts  and  figures 

The  clinic  attempts  to  provide  com- 
prehensive diagnostic  and  therapeutic 
medical  care,  integrated  with  public 
health  concepts,  to  ambulatory  patients. 


The  team  —  the  family  practitioner, 
public  health  nurse,  and  Community 
health  worker  —  seeks  consultation 
with  medical  specialists,  psychologists, 
social  animators,  educators,  social 
workers,  sociologists,  and  others  when 
necessary. 

A  survey  during  a  seven-month  per- 
iod from  March  to  October,  1970, 
recorded  data  on  some  4,800  visits 
by  2,000  individuals  from  1,100  fam- 
ilies in  Pointe  St.  Charles.  Analysis  of 
the  data  showed  that  more  boys  than 
girls  visited  the  clinic,  and  that  four 
times  as  many  visits  were  made  by 
women  than  by  men. 

Among  the  numerous  sub-categories 
of  disease,  it  was  shown  that  almost 
half  the  visits  were  accounted  for  by 
the  following:  adult  depression  and 
anxiety,  9.1  percent;  infections  of  the 
upper  respiratory  system,  9.4  percent; 
accidents,  8.9  percent;  diseases  of  the 
skin  and  subcutaneous  tissue,  8.7  per- 
cent; special  conditions  and  examina- 
tions without  sickness,  13.5  percent. 

Findings  such  as  these  reflect  the 
problem  areas  of  the  community  and 
will  assist  in  forming  new  plans  for  the 
clinic,  organizing  available  resources, 
and  disseminating  public  health  infor- 
mation. 

Rather  than  going  on  to  a  detailed 
account  of  the  clinic's  complete  pro- 
gram (which  includes  teaching,  research 
and  social  and  educational  services) 
or  going  into  the  administrative  struc- 

MAY  1971 


ture  and  financial  priorities,  I  shall 
introduce  some  of  the  people  who  are 
helping  to  make  the  clinic  recognized 
as  an  asset  to  the  community-at-large. 

Clinic's  key  personnel 

The  very  nature  of  the  Point  demands 
that  all  personnel  employed  at  the 
clinic  be  bilingual,  be  interested  in 
practicing  medicine  in  a  community 
setting,  and  be  flexible  enough  to  meet 
situations  as  they  arise. 

The  clinic  doctor  is  expected  to 
function  as  a  member  of  a  team  besides 
filling  his  traditional  role  of  treating 
the  sick  and  seeing  them  in  hospital  as 
necessary.  He  supervises  nurses  when 
performing  certain  tasks  that  have  by 
custom  been  his  own,  though  not  ne- 
cessarily so.  He  sets  up  research  projects 
having  to  do  with  activities  of  the  clinic. 
He  teaches  medical  and  nursing  stu- 
dents. 

Dr.  Lehmann,  known  as  Francois 
to  staff  and  patients,  has  chosen  to  live 
in  the  Point  where  he  and  his  wife  take 
part  in  some  community  affairs.  He 
considers  that  the  climate  for  solo 
practice  is  not  good  in  this  type  of 


neighborhood,  and  that  being  on  sal- 
ary allows  him  the  freedom  needed  to 
practice  good  medicine. 

"Here  we  must  emphasize  preven- 
tion and  public  health  education.  Until 
recently,  Quebec  has  had  the  highest 
incidence  of  rickets  in  Canada,  and  in 
Pointe  St.  Charles  there  are  many  chil- 
dren who,  while  not  exactly  starving, 
do  not  get  enough  daily  protein,"  he 
said. 

Dr.  Lehmann  believes  in  the  team 
approach  and  encourages  the  nurses 
to  be  involved  in  nearly  every  diag- 
nosis. "While  the  final  responsibility 
for  decisions  rests  with  the  doctor,  the 
nurses  participate  to  an  important  de- 
gree in  the  decision-making  process.  It 
is  they  who  are  largely  responsible  for 
the  educational  aspect  of  helping  people 
to  understand  the  cause  and  treatment 
of  their  medical  problems  and  to  learn 
new  attitudes  toward  health." 

He  encourages  the  staff  to  attend 
clinics,  seminars,  and  short  courses  to 
keep  abreast  of  new  developments  to 
counteract  the  relative  isolation  of 
working  in  a  circumscribed  area  such 
as  the  Point. 


Dr.  Olav  Niilend,  who  attends  the 
clinic  five  mornings  a  week  and  his 
private  practice  in  Notre  Dame  de 
Grace  each  afternoon,  likes  the  mental 
stimulation  afforded  by  the  two  types 
of  work. 

The  three  staff  nurses  are  more  than 
medical  aides  to  the  doctor.  Relatively 
independent,  they  combine  the  role  of 
nurse  practitioner  with  the  preventive 
orientation  of  a  public  health  nurse. 
They  give  special  assistance  to  the 
family  practitioners  when  necessary 
and  are  expected  to  organize  and  co- 
ordinate the  community  health  worker 
program. 

Barbara  Stewart,  having  been  at  the 
clinic  from  its  beginning,  knows  the 
strengths  and  weaknesses  of  the  area. 
She  loves  her  work,  loves  the  people, 
and  her  enthusiasm  is  infectious.  Tri- 
lingual (fluent  Italian  plus  English 
and  French),  she  has  no  communica- 
tion problem.  Interested  in  teaching, 
she  has  trained  additional  staff,  and 
now  community  health  workers,  who 
will  be  expected  to  work  with  minimum 
guidance.  Unassuming,  she  can  get 
things   set   in   motion   with   apparent 


From  an  open  meeting  of  the  board  of  directors  of  the  Pointe  St.  Charles  Community  Clinic. 


0^^i 


V?-«R 


1 


MAY  1971 


THE  CANADIAN   NURSE     49 


ease.  Eloquent,  she  can  plead  the  case 
for  Pointe  St.  Charles,  as  she  did  at  last 
year's  hearings  of  the  Senate  committee 
on  poverty. 

Her  co-workers,  Suzanne  LeMay 
and  Bonnie  Weese,  are  cut  from  the 
same  mold. 

Andre  Cardinale,  the  executive  direc- 
tor, has  also  chosen  to  live  in  Pointe 
St.  Charles.  He  coordinates  all  clinic 
activities,  acts  as  liaison  for  the  board 
of  directors,  clinic  personnel,  the  pro- 
ject director,  and  McGill  University 
(under  whose  sponsorship  the  clinic 
exists  as  a  research  project).  It  is  Andre 
Cardinale  who  best  knows  that  the 
dollars  must  be  used  wisely  and  who 
prepares  grant  proposals  to  obtain 
government  funds  —  a  most  important 
requirement.  He  also  represents  the 
clinic  in  the  community  by  attending 
meetings  of  citizens'  groups  to  pub- 
licize the  clinic  and  to  encourage  great- 
er community  involvement. 

Community  health  workers  are  to 
be  the  center's  direct  liaison  with  the 
community  as  they  are  often  the  first 
members  of  the  health  team  to  make 
contact  with  a  family.  Being  citizens, 
they  can  exert  more  influence  than  a 
professional  "outsider"  in  breaking 
down  cultural  barriers  to  the  use  of 
health  services. 

Barbara  Stewart,  in  explaining  their 
role,  said  community  health  workers 
have  to  be  able  to  express  themselves 
well  in  French  and  English,  be  able 
to  relate  to  people,  and  be  independent 
thinkers. 

Madame  Therese  Dionne  and  the 
two  other  health  workers  are  highly 
regarded  and  resourceful  citizens  of  the 
Point.  Salaried,  they  find  families  with 
problems  through  their  own  contracts, 
or  have  them  referred  by  the  center. 
Depending  on  the  nature  of  problems 
found  in  the  home,  their  work  largely 
consists  of  history  taking,  assessment  of 
home  conditions,  and  referral  of  prob- 
lems to  the  appropriate  agency. 

Clinic's  board  of  directors 

Certain  aspects  of  the  clinic's 
work  in  the  neighborhood  are  tied  to- 
gether by  its  community  orientation. 
As  mentioned  earlier,  the  area  resi- 
dents who  use  the  clinic  now  control 
50     THE  CANADIAN  NURSE 


The  executive  director  of  the  clinic,  Andre  Cardinale,  (left),  and  the  chairman  of 
the  board  of  directors  discuss  the  agenda  prior  to  a  board  meeting. 


its  administration.  They  elect  annually 
a  board  of  directors  —  four  English 
speaking  and  four  French  speaking 
residents,  a  member  of  the  clinic  staff, 
and  an  associate  member  (non-resi- 
dent). The  executive  director  is  a  non- 
voting member. 

The  current  chairman  of  the  board 
of  directors,  Robert  Tremblay,  is  ob- 
viously interested  in  his  committee 
work.  Because  he  is  unemployed,  he 
has  sufficient  time  to  devote  to  matters 
relating  to  the  clinic's  administration. 
He  is  sincere,  bilingual,  well  read,  and 
au  courant  with  the  political  ramifica- 
tions of  welfare  legislation. 

He  said  that  the  board  meets  every 
two  weeks  with  almost  full  attendance 
and  that  the  Point,  having  more  needs 
than  resources,  is  awaiting  a  second 
clinic  with  interest.  He  mentioned  that 
one  of  the  citizens'  committees  in  the 
area  issues  a  monthly  bulletin  to  inform 
members  of  developments.  His  per- 
sonal wish  is  that  a  representative  of 
the  people  be  elected  and  paid  by  the 
government  to  inform  citizens  as  to 
what  their  rights  may  be,  and  to  explain 
to  them  the  legislation  that  concerns 
them  in  their  daily  lives. 


Madame  Jeannine  Roy  has  been  on 
the  board  of  the  clinic  for  two  years, 
prior  to  which  she  was  on  the  family 
planning  committee  of  Pointe  St. 
Charles. 

When  asked  about  the  clinic  expand- 
ing to  a  second  location,  she  said:  "We 
have  enough  trouble  to  get  doctors,  we 
need  another  one  at  this  clinic  first." 
Commenting  on  the  value  of  the  clinic, 
she  said  it  has  been  a  good  thing  for 
Pointe  St.  Charles.  "We  passed  a  ques- 
tionnaire last  year  and  the  response 
was  good.  People  feel  more  at  home 
here  and  they  don't  want  their  prob- 
lems to  go  outside  the  Point.  I've  lived 
here  20  years  and  my  husband  for  30, 
and  we  know  the  clinic  is  a  good  thing 
for  us." 


Conclusion 

The  clinic  cooperates  with  organiza- 
tions and  with  citizens'  groups  in  an 
attempt  to  correct  the  causal  factors 
of  disease,  such  as  inadequate  housing, 
poor  food,  and  the  strain  of  living  in 
poverty.  In  this  way,  the  level  of  well- 
being  of  the  population  is  bound  to 
improve.  'w' 

MAY  1971 


Young  diabetics  enjoy  camp,  too 

At  Camp  Banting,  diabetic  children  learn  things  that  will  help  them  long 
after  the  camp  season  is  over.  And  they  have  fun  at  the  same  time,  says  the 
author,  who  was  the  camp's  busy  senior  nurse  for  seven  seasons. 


Doris  Fitzgerald 

Most  children  would  love  to  go  to  Camp 
Banting.  With  its  135-acre  setting  on 
a  grassy,  tree-studded  bluff  overlooking 
the  Ottawa  River  20  miles  west  of  the 
capital,  it  offers  young  campers  scenic 
nature  trails,  plenty  of  shaded  areas 
ideal  for  quiet  activities,  and  an  always 
popular  waterfront. 

But  this  camp  is  only  for  certain 
children.  Its  two-week  summer  pro- 
gram is  designed  for  diabetic  boys  and 
girls,  eight  to  fifteen  years  old,  who 
require  special  medical  and  dietary 
attention. 

Although  there  are  now  12  camps 
for  these  children  in  Canada,*  Camp 
Banting,  sponsored  by  the  Kiwanis 
Club  of  Ottawa,  was  the  first.  This 
year  will  be  its  nineteenth  season. 

lack-of-all-trades 

To  survive  as  a  nurse  at  this  kind 
of  camp,  I  have  found  it  helps  to  be 
firm  and  understanding,  have  a  genuine 
liking  for  children  and  be  able  to  ac- 
cept them  as  they  are,  have  a  sense  of 


*  There  is  one  summer  camp  for  diabetic 
children  in  British  Columbia.  Saskatche- 
wan, Manitoba,  Quebec.  Nova  Scotia. 
Prince  Edward  Island,  and  Newfoundland; 
two  camps  in  Alberta;  and  three  in  On- 
tario. For  more  information,  nurses  can 
write  to  their  local  branch  of  the  Canadian 
Diabetic  Association  or  to  The  Canadian 
Diabetic  Association.  1491  Yonge  Street. 
Toronto  7.  Ontario. 


humor  and  common  sense.  One  es- 
sential ingredient  is  a  good  working 
knowledge  of  diabetes  mellitus. 

Then,  too,  the  camp  nurse  must 
keep  her  cool  in  emergencies,  be  able 
to  reassure  the  child,  and  let  him  know 
she  cares.  If  she  can  work  with  a  calm, 
sure  manner,  the  child  will  have  confi- 
dence in  her. 

As  one  member  of  a  group  that  looks 
after  the  many  needs  of  the  campers, 
the  nurse  assists  the  doctor  in  medical 
supervision  and  cooperates  with  the 
camp  director,  dietitian,  program  di- 
rectors, and  counselors,  entering  into 
the  varied  camp  activities  as  much  as 
her  time  allows. 

Before  the  season's  program  can 
begin,  the  staff  has  a  lot  of  organizing 
to  do.  For  the  nurse,  this  means  helping 
to  prepare  the  health  program.  First 
comes  the  thorough  cleaning  of  the 
health  cottage  and  insulin  station.  Then 
there's  an  inventory  to  make  of  the 
medical  supplies  on  hand.  Working 
with  the  doctor,  the  nurse  orders  any 
additional  items  needed  for  the  camp 
period. 


MAY  1971 


Mrs.  Fitzgerald  is  a  graduate  of  the  On- 
tario Hospital  in  Brockville.  She  has 
worked  at  the  Ottawa  Civic  Hospital  for 
the  past  16  years,  currently  on  staff  in  the 
hemodialysis  unit.  She  was  senior  nurse 
at  Camp  Banting  for  seven  years  between 
1 960  and  1970.      • 

THE  CANADIAN   NURSE     51 


-O 


Assembling  emergency  kits  contain- 
ing intravenous  glucose,  glucagon,  file, 
syringes,  needles,  and  a  tourniquet  is 
another  job  for  the  nurse,  who  keeps 
one  kit  in  the  health  cottage  and  gives 
the  others  to  each  doctor.  She  also 
distributes  first  aid  kits  and  corn  syrup 
to  vital  camp  areas,  such  as  the  main 
hall  and  waterfront,  and  checks  and 
replenishes  the  kits  after  each  use. 

Shortly  after  they  arrive  at  camp, 
the  children  are  examined  by  the  doc- 
tor, with  the  nurse's  assistance.  At  this 
time  any  minor  infections  or  illness 
can  be  detected  and  dealt  with  promptly 
to  prevent  their  spreading  throughout 
the  camp.  This  is  also  a  time  to  renew 
old  acquaintances  and  get  off  to  a 
friendly  relationship  with  newcomers. 

Once  the  routine  of  camp  sets  in,  the 
nurse's  duties  become  supervision, 
treatment,  and  teaching.  But  she  must 
still  find  time  for  periodic  inspection  of 
the  kitchen,  dining  area,  and  wash- 
rooms, and  for  collecting  water  samples 
each  week,  which  she  sends  for  testing. 

When  the  camp  program  is  in  full 
52     THE  CANADIAN   NURSE 


swing,  there  are  overnight  trips  —  one 
of  the  most  popular  activities  —  requir- 
ing the  nurse  to  make  temporary  charts 
for  recording  the  amount  of  insulin 
given  and  the  results  of  urine  tests. 
Insulin  dosages  have  to  be  made  out 
for  each  child,  and  each  insulin  bottle 
checked  to  make  sure  enough  has  been 
sent  for  every  camper.  The  nurse  also 
includes  emergency  kits  and  disposable 
syringes,  which  have  proved  most  help- 
ful at  camp  in  reducing  the  time  spent 
daily  sterilizing  needles  and  syringes. 

Insulin  injections 

At  Camp  Banting  the  insulin  station 
is  set  apart  from  the  health  cottage. 
First  thing  each  day  the  children  gather 
at  the  station  for  their  injections.  Most 
of  them  give  their  own,  although  the 
nurse  occasionally  gives  the  injections 
because  they  are  using  sites,  such  as  the 
buttocks,  inaccessible  for  administra- 
tion. This  helps  maintain  the  sites  they 
must  use  when  they  provide  their  own 
care  in  future  years. 

If  there  are  campers  who  have  never 
given  their  own  injections,  the  nurse 
begins  to  teach  them  within  the  first 
few  days.  With  patience,  encourage- 
ment, and  praise  from  the  nurse,  almost 
every  child  overcomes  this  hurdle  and 
gains  a  sense  of  independence  and  self- 
reliance  by  the  end  of  the  camp  period. 

I'll  always  remember  one  little  eight- 
year-old  girl  I  taught  to  give  her  own 
insulin.  At  home  her  mother  had  always 
given  her  the  two  doses  she  required 
daily.  After  a  few  days  of  watching  the 
other  children,  Liz  was  eager  to  try  it 
herself.  Starting  off  using  an  orange 
for  practice,  she  gradually  attempted 
the  injections  herself.  By  visiting  day, 
she  proudly  displayed  the  procedure 
for  her  parents. 

Record  of  each  child 

Each  morning  after  breakfast  is  the 
time  for  our  "sick  parade,"  when  the 
children   come   to   the   health  cottage 


with  their  various  complaints.  This  is 
an  opportunity  to  treat  any  immediate 
need  and,  as  often  happens,  discover 
more  obscure  conditions. 

Charts  for  each  camper  are  kept  in 
the  insulin  station.  On  these  are  record- 
ed information  such  as  the  child's  diet 
and  insulin  requirements,  weight,  his 
buddy  number,  tent  group,  and  coun- 
selor's name.  Both  camper  and  coun- 
selor must  accurately  and  regularly 
record  the  urine  tests.  From  these 
recordings  the  doctor  assesses  the  child's 
needs,  increasing  or  decreasing  his  diet 
or  insulin  to  maintain  good  control. 
Any  reactions  or  illnesses  are  also  chart- 
ed and  filed. 

A  separate  card  system  is  kept  as 
well.  This  card,  giving  a  detailed  ac- 
count ot  the  camper's  condition  and 
medication  or  treatment  received,  helps 
if  the  child  is  confined  to  the  health 
cottage. 

At  the  close  of  camp  there  is  a  readily 
available  picture  of  the  child's  control 
of  his  diabetes.  The  charts  can  then  be 
recopied  and  sent  with  a  letter  from  the 
camp  doctor  to  the  camper's  own  doc- 
tor, showing  him  the  progress,  treat- 
ment of  any  illness,  and  the  way  the 
child  adapted  to  camp  life. 

Teaching  program 

The  camp  doctor,  nurse,  and  diet- 
itian take  part  in  a  teaching  program 
that  consists  of  short,  informal  sessions. 
Each  one  takes  a  small  group  of  chil- 
dren and  sits  with  them  in  a  shady, 
grassy  area.  The  nurse  discusses  genera! 
hygiene;  prevention  and  care  of  infec- 
tions—  especially  of  the  feet;  precau- 
tions diabetics  need  to  take,  such  as 
keeping  sugar  available  for  reactions; 
and  any  problems  an  individual  might 
have.  By  joining  in  the  discussion, 
the  children  help  to  clear  up  or  prevent 
misunderstandings  about  diabetes. 

Although  most  of  the  children  are 
patient,  grateful  for  any  help  they  re- 
ceive, and  concerned  about  their  fellow 

MAY  1971 


campers,  I  have  known  a  few  excep- 
tions. By  talking  with  these  few  chil- 
dren, 1  learned  that  most  of  them  were 
either  overprotected  at  home  or  had 
some  misunderstanding  about  diabetes. 
This  shows  the  need  to  educate  parents 
and  children  in  managing  this  condi- 
tion. Great  strides  are  being  made, 
especially  in  the  larger  cities  where 
there  are  clinics  and  teaching  centers. 
But  I  see  the  need  to  encourage  parents 
from  smaller  communities  to  come  to 
the  larger  centers  periodically  with  their 
children  to  learn  more  about  the  ad- 
vances in  this  field. 

Medical  students  and  interns  are 
involved  in  our  program.  But  this  type 
of  camp  would  also  provide  an  excellent 
learning  experience  for  student  nurses. 
If  teaching  hospitals  participated  by 
including  nursing  students  in  this  pro- 
gram, these  students  would  learn  to 
recognize  the  continuing  needs  of  the 


diabetic  child  and,  as  registered  nurses, 
would  be  able  to  help  meet  them. 

Emergencies  involve  everyone 

Some  summers  are  more  hectic  than 
others.  Besides  the  usual  cuts,  bruises, 
sunburns  and  minor  insulin  reactions, 
we  have  had  one  influenza  epidemic 
and  one  Coxsackie  virus  visit  the  camp. 
When  such  illnesses  occur,  we  are  busy 
day  and  night.  However,  we  have  con- 
trolled these  situations  well  and  learned 
much  from  them. 

One  experience  with  the  flu  bug 
impressed  on  me  the  unpredictability 
of  a  child's  response  to  an  illness.  At 
that  time  five  children  in  the  health 
cottage  with  flu  kept  us  busy  long  into 
the  night  as  we  adjusted  their  diet  and 
insulin  requirements.  By  the  time  the 
doctor  had  made  his  final  check  for 
the  day,  I  was  satisfied  with  only  one 
child  who  had  been  drinking  well,  had 


stopped  vomiting,  and  seemed  to  have 
fair  control  of  her  diabetes.  But  during 
the  night,  while  the  other  children 
slept  soundly,  this  child  had  an  insulin 
reaction  with  convulsions. 

While  I  prepared  for  IV  glucose 
treatment,  the  dietitian  ran  for  the  doc- 
tor. By  the  time  we  began  working 
with  the  girl,  her  veins  had  collapsed. 
After  unsuccessful  attempts  to  enter  a 
vein  in  her  arm,  the  doctor  managed  to 
inject  the  glucose  in  a  vein  in  her  leg. 
We  rarely  have  to  use  glucose  for  insulin 
reactions  because  we  checR  the  chil- 
dren's testings  and  activity  daily,  and 
are  able  to  adjust  the  care  to  offset  any 
serious  reactions. 

At  the  peak  of  this  virus  episode  in 
camp,  about  75  percent  of  the  people 
were  ill.  Within  a  day  or  two  though, 
everyone  was  up  and  we  were  able  to 
relax.  One  of  the  things  I  appreciated 
most  during  this  time  was  the  way  the 
campers  and  staff  banded  together  to 
help  out. 

Some  continuity  of  staff  is  a  great 
advantage  to  any  camp,  but  especially 
to  a  diabetic  one.  New  people  bring 
fresh  ideas  and  new  approaches  to 
organizing  and  programming  camp 
activities.  But  the  return  of  some  of  the 
staff  gives  a  sense  of  security  and  sound 
direction  to  the  camp. 

There  is  a  need  for  more  camps  for 
diabetic  children.  Not  only  does  a  trip 
to  this  type  of  camp  help  the  child  gain 
independence  in  managing  his  disorder, 
but  it  also  frees  his  parents  from  the 
daily  care  of  the  child.  This  helps  par- 
ents take  a  more  objective  and  opti- 
mistic view  of  helping  their  child  man- 
age this  chronic  disorder.  § 


MAY  1971 


THE  CANADIAN   NURSE     53 


The 

subcutaneous 

injection 


Few  changes  in  the  technique  for  subcutaneous  injection  have  been  proposed 
since  the  first  one  was  given  over  a  hundred  years  ago.  This  nurse  has  reviewed 
the  literature  and  found  research  which  supports  abandoning  certain  standard 
practices,  such  as  cleansing  the  skin  prior  to  injection. 


Martha  Pitel 

Although  intravenous  medications  have 
been  administered  since  the  seventeenth 
century,  it  was  not  until  1855  that  Dr. 
Alexander  Wood  of  Edinburgh  publish- 
ed the  first  account  of  the  subcutaneous 
injection  of  solutions  of  drugs  for  ther- 
apeutic purposes  using  a  syringe  and 
needle. ' 

Interestingly  enough,  sherry  wine 
was  used  as  a  solvent  for  the  morphine 
injection  given  because  Dr.  Wood 
thought  "...  it  would  not  irritate  and 
smart  so  much  as  alcohol  and  it  would 
not  rust  the  instrument  as  a  water 
solution  of  opium  would  do."^  To 
Dr.  Charles  Hunter,  a  surgeon  in  Lon- 
don in  1859,  was  attributed  the  actual 
recognition  of  the  systemic  action  of  a 
drug  injected  subcutaneously  and  the 
introduction  of  medication  into  a  site 
distant  from  the  affected  part. 

The  discovery  of  the  syringe  and 
needle  and  the  administration  of  drugs 
subcutaneously  was  hailed  as  a  major 
medical  therapeutic  triumph,  but  not 

Dr.  Pitel.  a  graduate  of  Charles  S.  Wilson 
Memorial  School  of  Nursing,  Johnson 
City.  N.Y.,  received  both  her  B.S.  and  her 
M.S.  degrees  from  Western  Reserve  Uni- 
versity, Cleveland.  Ohio,  and  her  Ph.D. 
from  the  University  of  Minnesota,  Min- 
neapolis. Currently,  she  is  chairman  of  the 
department  of  nursing  education  at  the 
University  of  Kansas  School  of  Medicine, 
Kansas  City.  U.S.A. 


54     THE  CANADIAN   NURSE 


by  all.  These  words,  written  by  Dr. 
H.H.  Kane  in  1880,  have  a  familiar  ring 
of  today. 

There  is  no  proceeding  in  medicine 
that  has  become  so  rapidly  popular; 
no  method  of  allaying  pain  so  prompt 
in  its  action  and  permanent  in  its  ef- 
fect; no  plan  of  medication  that  has 
been  so  carelessly  used  and  thorough- 
ly abused;  and  no  therapeutic  dis- 
covery that  has  been  so  great  a  bless- 
ing and  so  great  a  curse  to  mankind, 
as  the  hypodermic  injection  of  mor- 
phia^ 

An  early  description  of  the  tech- 
nique of  hypodermic  injection  was 
given  in  1923  by  Mary  Wheeler  in 
Nursing  Technic.  Her  instructions 
were  to  "  .  .  .  insert  the  needle  quickly, 
almost  vertically,  and  in  the  direction 
of  the  heart."''  She  also  warned  that 
when  hypodermic  injections  are  given 
frequently,  the  injection  sites  should  be 
rotated  in  the  arms  and  legs.  In  1925, 
Annabella  McCrae  stated  that  "In 
giving  insulin,  the  needle  is  injected  at 
an  accentuated  45°  angle,  a  little  deep- 
er than  the  subcutaneous  tissue,  but 
not  into  the  muscle."^  Conflicting 
instructions  in  the  procedure  then, 
as    now.    needed    further    elucidation 


Copyright  Jan.  1  97  1 .  The  American  Jour- 
nal of  Nursing  Company.  Reprinted  from 
Ann'iicdii  Joiinial  of  Niii\iii^.  Jan.  1 97  1 . 

MAY  1971 


based   on   understanding   of  the   un- 
derlying scientific  principles. 

Nurses  administer  a  large  num- 
ber of  drugs,  vaccines,  and  hormones 
via  the  subcutaneous  route.  In  fact, 
subcutaneous  injection  is  one  of  the 
first  skills  learned  and  practiced  in 
the  clinical  area  which  provides  nursing 
with  a  symbol  of  action.  Not  only  are 
nurses  themselves  involved  in  the 
administration  of  the  subcutaneous 
medication,  but  they  also  teach  patients 
self-injection  techniques.  Thus,  it  is 
essential  for  the  nurse  to  analyze  crit- 
ically this  important  therapeutic  meas- 
ure in  order  to  improve  nursing  prac- 
tice. 

Histology  of  the  skin 

The  organ  of  the  skin  is  one  of  the 
largest  of  the  body.  For  our  purposes, 
description  of  the  skin  will  include 
only  those  details  of  this  structure 
pertinent  to  our  discussion. 

The  skin  constitutes  16  percent  of 
the  body  weight  and  ranges  in  thickness 
from  1-2  mm.  In  the  adult  male,  the 


surface  area  approximates  1.8  sq.  m., 
and  in  the  female,  1.6  sq.  m.  It  consists 
of  a  stratified  squamous  epithelial 
covering  called  the  epidermis,  which 
is  relatively  thin  throughout  the  body, 
usually  0.07  to  1 .2  mm.  The  only  places 
where  this  differs  are  the  soles  of  the 
feet,  where  it  is  1 .4  mm.  thick,  and  the 
palms  of  the  hand,  0.8  mm.6 

As  a  protective  mantle  of  the  in- 
ternal milieu,  the  skin  serves  as  a  selec- 
tive barrier  and  sensory  moderator  of 
the  external  environmental  forces  of 
both  micro  and  macro  magnitude.  The 
dermis  lies  under  the  epidermis  and  is 
dense  connective  tissue  containing  a 
network  of  thick  bundles  of  reticular 
and  elastic  fibers. 

The  hypodermis  or  subcutaneous 
layer  is  continuous  with  the  dermis 
and  consists  of  loose  areolar  connec- 
tive tissue  of  a  varying  amount  of  fat 
cells  which,  in  the  inferior  portion  of 
the  abdominal  wall,  can  become  more 
than  3  cm.  thick.  This  tela  subcutanea 
or  superficial  fascia  is  the  "between" 
layer  which  binds  the  skin  to  the  deeper 


1/2  INCH 
NEEDLE 


SUBPAPILLARY 
BLOOD  VESSELS 


y  EPIDERMIS 
I    DERMIS 


SUBCUTANEOUS 
1^    ADIPOSE 
TISSUE 


MAY  1971 


Structures  of  the  deep  fascia,  aponeur- 
osis, and  p)eriosteum.  An  extensive 
capillary  network  known  as  the  rete 
subpapillare  is  found  in  the  dermis 
between  the  papillary  and  reticular 
layers.  Another  network,  rete  cuta- 
neum,  exists  between  the  dermis  and  the 
subcutaneous  layer,  and  it  serves  as 
the  absorption  site  for  the  subcutaneous 
medication.^  6  Similar  lymphatic  net- 
works are  located  in  the  skin  but  do 
not  play  a  major  role  in  the  absorption 
of  medications. 

The  distensibility,  or  stretch  capaci- 
ty, of  the  skin  and  tela  subcutanea 
varies  considerably  in  different  areas 
of  the  body  as  is  evident  in  edematous 
extremities  and  in  the  abdominal  wall 
during  pregnancy.  In  measuring  dis- 
tensibility (millimeters  of  stretch  per 
centimeter  of  skin)  with  100  Gms.  of 
force,  Sodeman  and  Burch  found  the 
following:  abdomen,  2.07  mm.:  dorsum 
of  the  hand,  1.34  mm.:  dorsum  of  the 
foot,  0.59;  flexor  surface  of  the  fore- 
arm, 0.93  mm.'  When  the  skin  is 
stretched  beyond  limits,  tears  occur 
in  the  connective  tissue  and  appear 
as  white  lines  known  as  striae  gravida- 
rum in  the  postpartum  patient  and 
lineae  albicantes  with  other  causes  of 
stretch. 

Physiology  of  the  skin 

Diffusion  is  the  physiologic  pro- 
cess involved  in  subcutaneous  absorp- 
tion. Medications  deposited  in  the 
interstitial  fluid  are  absorbed  into  the 
circulating  blood  at  the  capillary  level. 
Transfer  of  fluid  and  other  substances, 
whether  crystalloid,  or  colloid,  from 
the  injection  site  into  the  circulatory 
system  depends  on  a  number  of  factors, 
such  as  injection  pressure,  hydrostatic 
pressure,  colloid,  osmotic  pressure, 
blood  flow,  capillary  permeability,  and 
so  forth. 

Whether  injection  pressure  influ- 
ences the  rate  of  absorption,  however, 
has  not  been  completely  clarified.  Using 
injection  pressures  of  one  to  two  atmos- 
pheres, Barke  showed  that  the  absorp- 
tion of  glucose  was  reduced  when  it 
was  injected  subcutaneously,  possibly 
due  to  traumatic  ischemia  and  hemor- 
rhages into  the  skin.*  Jet  syringes  have 
been  developed  which  employ  pres- 
sures from  2,300  to  3,900  lbs.  per 
sq.  inch  at  a  speed  of  600  miles  per 
hour.  Results  indicate  that  there  were 
not  any  significant  differences  in  the 
rate  of  absorption  between  the  jet  and 
regular  needle  injections.  However, 
histologic  findings  by  Coon  and  others 
did  indicate  greater  tissue  damage  — 
THE  CANADIAN   NURSE     55 


such  as  tissue  disruption,  necrosis,  and 
inflammatory  response  —  with  the 
jet  syringe  method  than  occurs  with 
the  needle  injection  technique.^  Weller 
and  Linder,  on  the  other  hand,  utilized 
the  jet  injection  method  in  1966  in 
administering  insulin  to  diabetic  pa- 
tients and  noted  that  the  jet  was  so 
fine  that  tissue  trauma  was  minimized; 
however,  no  histologic  findings  were 
included  in  their  report.  The  rate  of 
absorption  was  similar  to  that  of  the 
needle  injection  method. '°  Further 
controlled,  longitudinal  experiments 
are  needed  over  a  continuum  of  time 
with  a  larger  population  to  reveal  the 
extent  of  tissue  damage  and  absorption 
rate  with  the  jet  syringe  method. 

Another  vital  factor  influencing  the 
rate  of  absorption  is  the  connective 
tissue  ground  substance.  Hyaluronidase 
is  an  enzyme  which  depolymerizes 
hyaluronic  acid  and  has  been  shown  to 
enhance  the  absorption  of  drugs  by 
spreading  them  more  rapidly  over  a 
larger  area  in  the  more  fluid  connective 
tissue.^^  Histamine,  on  the  other  hand, 
which  is  released  as  a  result  of  injection 
trauma,  delays  subcutaneous  absorption 
by  its  self-depressing  effect  as  does 
serotonin.^  The  water  content  of  the 
connective  tissue  itself  seems  to  have 
no  influence  on  the  rate  of  subcutaneous 
absorption.^ 

The  rate  of  blood  flow  through  the 
capillary  network  of  the  skin  and  sub- 
cutaneous tissue  is  one  factor  which 
clearly  plays  an  important  role  in  the 
absorption  process.  This  flow  rate  is 
dependent  on  a  pressure  gradient 
between  the  arterial  and  venous  pres- 
sures across  the  vascular  bed.  A  rise 
in  arterial  pressure  will  increase  the 
blood  flow  in  the  bed,  whereas  a  rise 
in  venous  pressure  will  decrease  the 
blood  flow  through  the  bed  or  vice 
versa.  There  are  a  number  of  chemical 
substances  which  alter  blood  flow  — 
and  thereby  absorption  of  drugs  —  by 
either  vasoconstriction  or  vasodila- 
tion. 

Epinephrine  and  norepinephrine 
delay  absorption  by  vasoconstriction 
of  the  capillaries,  arterioles,  and  larger 
vessels,  thereby  decreasing  blood  flow. 
Vasodilation  is  produced  by  such 
substances  as  acetylcholine,  ATP,  and 
oxygen.  A  number  of  other  chemical 
substances,  either  endogenous  or  exo- 
genous, also  have  vasoactive  properties 
which  affect  the  blood  flow  and  subse- 
quently subcutaneous  absorption. 

The  role  of  capillary  permeability 
in  blood-tissue  exchange  has  been 
studied  extensively,  especially  the 
56     THE  CANADIAN   NURSE 


ultrastructure   of   the   capillary   wall, 
through  the  use  of  the  electron  mi- 


croscope. 


12,13 


Although    controversy 


still  reigns  concerning  the  role  of  the 
endothelial  cell  in  active  transport, 
the  evidence  in  support  of  such  a 
theory  is  becoming  more  favorable 
as  experimental  data  are  reported. 

Histopathologic  findings 

In  further  evaluating  the  subcu- 
taneous injection,  histopathologic 
changes  in  the  skin  and  subcutaneous 
tissue  have  been  observed  after  the 
administration  of  a  number  of  different 
agents.  The  various  skin  reactions 
which  have  been  found  include  in- 
flammation, fibrosis,  lipodystrophy, 
and  lipohypertrophy.  Several  investi- 
gators have  implicated  these  skin  lesions 
in  the  delay  or  prevention  of  absorption 
of  substances  from  the  injection  site.^'''^^ 
Thus,  the  pathology  of  the  skin  reac- 
tions and  its  relationship  to  subcutane- 
ous absorption  of  medications  should 
be  noted  and  evaluated  by  nurses.'^ 

In  reviewing  the  literature,  one  is 
struck  by  the  number  and  degree,  as 
well  as  the  variety,  of  skin  reactions  to 
substances  injected  sulxutaneously. 
Tobin  injected  30  ml.  of  air  into  the 
dorsal  subcutaneous  tissue  of  rats.'' 
A  localized,  circumscribed  pocket  was 
formed  with  early  infiltration  of  poly- 
morphonuclear leukocytes  into  the 
tissue.  Within  two  weeks,  fibroblasts 
formed  a  multilayered  wall  around 
the  air  pocket.  The  blood  supply  to 
the  pocket  consisted  of  enlarged  blood 
vessels,  which  were  predominantly 
veins  and  venous  arcades,  and  had 
increased  in  proportion  to  the  con- 
nective tissue  content.  A  similar  re- 
sponse of  connective  tissue  to  other 
gases  —  such  as  oxygen,  nitrogen,  and 
carbon  dioxide  —  was  demonstrated 
by  Wright.18 

Insulin  is  one  of  the  most  common 
substances  injected  under  the  skin. 
Since  injections  are  repeated  daily  or 
several  times  per  day,  the  likelihood 
of  skin  reactions  is  increased.  As  many 
as  60  to  80  percent  of  diabetic  patients 
do  exhibit  skin  reactions  to  insulin.'^ 
Furthermore,  these  reactions  are  corre- 
lated with  the  repeated  insulin  injections 
into  the  same  site.  Improper  techniques 
of  subcutaneous  injection  may  result 
in  (a)  leakage  of  insulin  from  the  site 
with  subsequent  increased  insulin 
requirements;  f/jj  introduction  of  insulin 
into  a  blood  vessel  with  more  rapid 
absorption  and/or  hemorrhage  into 
the  tissue;  (c)  excessive  pain  due  to 
high    injection    pressure,    overdisten- 


sion of  the  tissue,  and  the  inflammatory 
process;  (d)  disfigurement  related  to 
the  degree  of  lipodystrophy,  lipohyper-  i 
trophy,  or  fibrosis  in  the  injected  area;  j 
(e)  abscess  formation  following  the 
invasion  of  pathogenic  microorganisms; 
and  (f)  a  chronic  inflammatory  response 
with  induration  by  fibrosis  and  round 
cell  infiltration. 

Modification  of  the  traditional  tech- 
nique for  subcutaneous  injection  has 
been  proposed  by  several  investigators 
in  order  to  prevent  skin  reactions, 
particularly  in  diabetic  patients. 

Coates  and  Fabrykant  advocate 
stretching  the  skin  over  the  injection 
site  with  the  thumb  and  forefinger.'^ 
The  needle  is  then  plunged  into  the 
stretched  skin  at  a  right  angle  (90°) 
to  the  skin  surface  and  deep  into  the 
subcutaneous  tissue.  After  injectjon,  the 
needle  is  withdrawn  rapidly  and  firm 
pressure  and  massage  are  exerted  over 
the  injection  site. 

Another  variation  has  been  proposed 
by  Siebner  who  also  suggests  a  90° 
angle  between  the  needle  and  the 
surface  of  the  skin  but  with  the  insertion 
of  the  needle  to  the  depth  of  the  mus- 
cle fascia.^"  By  grasping  the  skin  bet- 
ween the  thumb  and  the  forefinger, 
one  forms  a  skin  fold.  Then  the  width 
of  the  skin  fold  is  measured  by  placing 
the  needle  parallel  to  the  surface  of  it 
to  determine  the  depth  of  the  injection. 
The  needle  is  then  thrust  into  the  skin 
one  half  the  width  of  the  skin  fold. 

Both  of  the  methods  described  at- 
tempt to  place  the  medication  deeper 
into  the  subcutaneous  tissue  and  more 
proximal  to  the  deep  fascia  covering 
the  muscle.  Both  investigators  also 
claim  that  their  method  successfully 
prevents  fat  atrophies,  painful  local 
lesions,  and  local  inflammatory 
changes. 

Skin  preparation 

In  looking  at  another  facet  of  the 
conventional  subcutaneous  injection 
technique,  Dann  raises  the  question, 
"Is  the  routine  skin  preparation  before 
injection  necessary?"^!  A  total  of  1,078 
injections  of  a  variety  of  medications 
were  administered  via  intradermal, 
subcutaneous,  intramuscular,  and  intra- 
venous routes.  Of  these,  713  were 
subcutaneous  injections.  No  infections 
were  observed  in  the  patients  receiving 
injections  without  pre-injection  skin 
preparation.  All  needles  and  syringes 
were  sterilized  by  boiling  them  for 
five  minutes.  The  rubber  cap  of  the 
bottle  containing  the  medication  was 
neither  cleansed  nor  disinfected  prior 

MAY  197' 


to  use.  This  practice  nas  been  found  to 
be  safe  for  nearly  three  years  and  still 
continues  to  be  used  at  the  Medical 
Centre  of  the  University  College  of 
Swansea,  Singleton  Park,  Great  Britain. 

In  support  of  Dann's  hypothesis, 
Lacey  has  performed  some  interesting 
experiments  regarding  the  antibacterial 
action  of  human  skin  lipid  and  the 
effect  of  treating  skin  with  defatting 
agents.^^  His  results  show  that  apply- 
ing 100  percent  acetone,  74  percent 
ethanol,  or  soap  to  the  skin  of  the 
forearm  causes  higher  numbers  of 
surface-inoculated  staphylococci  to  be 
recovered  five  hours  later  in  this  group 
than  can  be  found  in  the  control  group 
in  which  the  forearm  was  untreated.  His 
explanation  for  this  phenomenon  was 
that  the  normal  skin  lipids,  the  fatty 
acids,  present  in  the  sebaceous  secre- 
tions are  bactericidal  to  pathogens  on 
the  skin  and  constitute  the  natural 
antiseptic  property  of  the  skin.  There- 
fore, he  questions  the  practice  of  pre- 
operative skin  preparation  with  such 
organic  solvents.  He  further  suggests 
that  washing  can  enhance  bacterial 
growth  on  the  skin  surface  rather  than 
retard  pathogenic  invasion. 

Since  nursmg  is  involved  in  the 
cleansing  of  the  skin,  in  the  preparation 
of  the  skin  for  administration  of  medi- 
cations, and  in  treatment  after  the 
intact  skin  surface  has  been  opened 
by  a  needle  puncture  incision,  or  injury, 
these  findings  present  nursing  with 
challenging  research  problems  which 
should  be  pursued  critically  and  objec- 
tively in  controlled  experiments.  Rep- 
licating the  experiments  would  be  of 
value  to  nursing  practice. 

In  summary,  the  proper  technique 
of  administration  of  medications  via 
the  subcutaneous  injection  is  imperative 
to  allow  optimal  absorption  from  the 
injection  site  and  to  prevent  skin  reac- 
tions which  may  be  painful  and  lead 
to  disfigurement  of  the  body  part.  The 
following  method  is  suggested: 

A.  Aseptic  technique  should  be  fol- 
lowed until  further  research  indi- 
cates otherwise. 

1.  Cleanse  the  skin  surface  with 
an  antiseptic  allowing  thorough 
drying  of  the  area  to  prevent  local 
irritation. 

2.  The  syringe,  needle,  and  in- 
jected material  must  be  sterile  to 
avoid  introduction  of  pathogens 
under  the  skin. 

B.  The  injection  site  should  be  careful- 
ly selected. 

1.  Select  areas  in  the  upper  arms 
MAY   1971 


D 


and  anterior  and  lateral  aspects 
of  the  thighs  and  lower  ventral 
abdominal  wall. 

2.  Avoid  injecting  into  tender, 
painful  areas  and  those  characteriz- 
ed by  a  concavity,  scarring,  swel- 
ling, itching,  or  burning. 

3.  With  repeated  injections,  devise 
a  rotation  scheme  utilizing  the  five 
sites  and  post  it  at  the  patient's  bed- 
side or  wherever  injections  are 
administered.  Record  site,  dose, 
time  and  date  for  each  injection 
given  to  prevent  confusion  by 
changing  personnel. 

Inject  the  medication  deeply  into 
the  subcutaneous  tissue. 

1.  Allow  the  part  to  be  injected 
to  remain  in  its  natural  state.  Nei- 
ther stretch  nor  grasp  the  skin  to 
make  a  skin  fold. 

2.  If  a  half-inch  needle  is  used, 
plunge  the  needle  straight  into 
the  skin  at  a  90°  angle  to  the  skin 
surface. 

3.  If  the  needle  is  inserted  at  a 
45  angle  to  the  skin  surface,  use 
a  longer  needle  —  three-fourth  or 
five-eighths  inches  in  length. 

4.  Draw  back  on  the  plunger  of  the 
syringe.  If  blood  is  aspirated,  with- 
draw the  needle  a  short  distance 
and  redirect  it  into  another  area 
and  aspirate  again. 

Remove  the  needle  rapidly  from 
the  skin,  apply  firm  pressure,  and 
massage  over  the  injected  area. 


References 

1.  Howard-Jones.  N.  A  critical  study  Df 
the  origins  and  early  development  of 
hypodermic  medication.  J. Hint. Med. 
2:201-249,  1947. 

2.  Ibid.,  p.  23  \. 

3.  Kane.  H.H.  Drugs  That  En.sUivc. 
Philadelphia.  Presley  Blakiston.  1881, 
p.  30. 

4.  Wheeler.  Mary  G.  /Vi/i  s//i,i,'  Icclinic. 
2d  ed.  Philadelphia.  J.B.  Lippincott 
Co.,  1923.  p.  189. 

5.  McCrae,  Annabella.  Procedures  in 
Nursing.  Boston.  Barrow  and  Co.. 
1925,  p.  367. 

6.  Bloom.  William,  and  Fawcett.  D.W. 
Te.xtbook  of  Histology.  9th  ed.  Phila- 
delphia. W.B.  Saunders  Co..  1968. 

7.  Morris,  Sir  Henry.  Human  Anuiomy. 
12th  ed.  edited  by  Barry  J.  Anson. 
New  York,  McGraw-Hill  Book  Co., 
1966. 

8.  .Schou.  Jons.  Absorption  of  drugs  from 
subcutaneous  connective  tissue.  Phar- 
mticol.  Rev.  13:441-464.  Sept.  1961. 


9.  Coon.  W.W..  et  al.  Fundamental 
problems  in  jet  injection.  Amer.J.Med. 
Sci.  227:39-45.  Jan.  1954. 

10.  Weller.  C.  and  Linder,  M.  Jet  in- 
jection of  insulin  vs  the  syringe-and- 
needle  method.  JAMA  195:844-847. 
Mar.  1966. 

11.  Goodman.  L.S..  and  Oilman,  A. 
Plwrnuicological  Basis  of  Therapeu- 
tics. 3d  ed.  New  York.  Macmillan  Co., 
1969. 

12.  Zelickson.  A.S.  Ultra  Structure  of 
Normal  and  Abnormal  Skin.  Phi- 
ladelphia. Lea  and  Febiger,  1967. 

n.Orbison.  J.L..  and  Smith,  D.E.,  Eds. 
Peripheral  Blood  Ves.'icls.  Baltimore. 
Md..  Williams  and  Wilkins  Co., 
1963. 

14.  Fabrykant.  M..  and  Ashe.  B.I.  Preven- 
tion of  local  skin  reactions  to  insulin. 
New  York  J.  Med.  53:3019-3021, 
Dec.  15.  1953. 

15.Boulin,  R.,  et  al.  Etude  de  cas  de 
lipodystrophies  insuliniques.  Presse 
A/«/.  60:1024-1027.  July  9.  1952. 

16.  Kernicki,  J.  Needle  puncture:  health 
asset  or  menace.  Nurs.Ctin.N.Amer. 
1:269-274.  Jun.  1966. 

17.  Tobin.  C.E..  et  al.  Reaction  of  the 
subcutaneous  tissue  of  rats  to  in- 
jected air.  Proc-.  Soc-.  Exp.  Biol.  Med. 
109:122-126.  Jan.  1962. 

18.  Wright.  A.W.  The  local  effect  of  the 
injection  of  gases  into  the  subcuta- 
neous tissue.  Amer.J.Paih.  6:87-124. 
Mar.  1930. 

19.  Coates.  Florence  C,  and  Fabrykant. 
Maximilian.  Insulin  injection  techni- 
que for  preventing  skin  reactions. 
Amer.J.Nurs.  65:127-128.  Feb.  1965. 

20.  Siebner.  H.  Uber  eine  Technik  der 
Insulineinspritzung  zur  Verhutung 
von  Hautreaktionen.  Med.  Welt.  42: 
2305-2307.  Oct  19.  1968. 

21.  Dann.  T.C.  Routine  skin  preparation 
before  injection  —  is  it  necessary? 
Nurs.Times  62:1121-1122.  Aug.  26, 
1966. 

22.  Lacey,  R.W.  Antibacterial  action  of 
human  skin.  Brit.J.E.xp.Path.  49:209- 
215.  Apr.  1968.  ^ 


THE  CANADIAN   NURSE     57 


Your  Heart  and  How  to  Live  With  It 

by  Lawrence  E.  Lamb.  257  pages. 
Toronto,  W.B.  Saunders  Company, 
197L 

This  book  was  written  with  the  hope 
that  the  reader  will  gain  enough  know- 
ledge to  be  able  to  avoid  death  or  dis- 
ability from  cardiovascular  disorders. 
Consequently,  it  may  be  the  most  im- 
portant book  in  many  individual's  lives. 

The  author  presents  first  a  historical 
overview  of  progress  in  diagnosing  and 
treating  heart  disease.  The  latest  com- 
parative studies  of  incidence  are  in- 
cluded. He  then  explains  the  entire 
cardiovascular  system  and  its  ailments. 
The  physiological  effects  on  heart  func- 
tion of  bed  rest,  exercise,  prolonged 
standing,  personality,  smoking,  alcohol, 
stress,  heredity,  and  sexual  activity  are 
thoroughly  covered.  The  chapter  on 
proper  exercise  to  strengthen  the  heart 
is  one  of  exceptional  value. 

Dr.  Lamb  also  summarizes  such 
problems  as  high  blood  pressure,  angi- 
na pectoris,  valvular  diseases,  and  heart 
transplants  with  their  medical  or  surg- 
ical treatment. 

Maternity  Nursing  by  Constance  Lerch. 
360  pages.  Saint  Louis,  Mosby, 
1970. 

Reviewed  by  Tanna  Willis,  Perina- 
tal Unit,  Royal  Victoria  Hospital, 
Montreal,  Quebec. 

This  nursing  text  provides  good  ref- 
erence material  for  students.  It  contains 
valuable  tables,  such  as  the  one  for 
immunodiagnostic  tests;  its  diagrams 
are  simple  and  easy  to  understand, 
especially  the  development  of  the 
endometrial  cycle. 

The  psychological  preparation  for 
parenthood  not  only  tells  how  the 
reader  should  approach  parenthood, 
but  sets  the  atmosphere  for  the  whole 
textbook. 

The  term  "fetology"  heading  chap- 
ter 4  is  new  to  this  reviewer.  In  cover- 
ing the  period  before  birth,  the  author 
explains  clearly  the  "selective  power" 
of  the  fetal  capillaries  and  placenta, 
aptly  describes  the  development  of  the 
fetus,  and  deals  with  the  "emotional 
stress  phenomenon"  in  a  manner  that 
is  interesting  and  reassuring  to  students 
and  anxious  mothers  alike.  "Psycholog- 
ical adjustments"  (in  chapter  5)  are 
written  sympathetically  enough  to  be 
read  by  expectant  mothers. 

58     THfc  CANADIAN   NURSE 


Miss  Learch  emphasizes  the  impor- 
tance of  good  nutrition  during  pregnan- 
cy and  motherhood,  using  shaded 
boxes  for  describing  the  functions  and 
sources  of  food  elements.  Her  sugges- 
tions to  nurses  on  how  to  counsel  moth- 
ers in  nutrition  comprise  an  original, 
personal,  and  factual  approach  to  this 
difficult  area. 

The  simple,  concise  explanation  of 
the  minor  complications  of  pregnancy 
in  chapter  7  is  adequate  for  prelim- 
inary reading  by  students.  Later,  as 
they  observe  these  complications, 
study  of  the  selected  readings  becomes 
valuable. 

Appropriately,  all  three  chapters 
involving  "high  risk"  are  separated 
from  normal  pregnancy  and  mother- 
hood, as  obstetrics  does  not  generally 
concern  disease.  The  explanations, 
treatment,  and  nursing  care  of  "high 
risk  pregnancies"  are  complete  and 
up-to-date.  Complications  occur  often 
enough  for  students  to  see  at  least  some 
of  them.  The  later  chapters  on  "high- 


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risk  labor  and  delivery,"  including 
detailed  explanations  of  the  various 
ways  of  inducing  labor,  comprise  a 
clear  reference  for  nursing  students. 

Chapter  9  on  the  responsibilities 
of  nurses  in  prenatal  clinics  is  real- 
istic. It  mentions  the  flaws  in  many 
clinics.  Students,  as  "outsiders,"  are 
objective  observers,  and  will  quickly 
sense  them;  this  may  encourage  them 
to  promote  better  and  more  understand- 
ing patient  care. 

Chapter  1 1  contains  splendid  il- 
lustrations of  fetal  presentations  and 
fetal-maternal  anatomical  relation- 
ships, and  chapter  14  clearly  describes 
methods  to  alleviate  pain. 

The  author's  own  interest  and  under- 
standing is  apparent  in  the  entire  book. 
Her  introduction  to  Appendix  A  is 
particularly  fitting:  "Let  us  wander  back 
through  the  ages  and  read  the  story  of 
progress  in  obstetrics  —  of  woman's 
fortitude  in  bringing  forth  a  new  life." 

Scientific  Principles  in  Nursing,  6th  ed., 
by  Shirley  Hawke  Gragg  and  Olive 
M.  Rees.  462  pages.  Saint  Louis, 
C.V.  Mosby  Company,  1970. 
Reviewed  by  Sally  Tretiak,  Instruc- 
tor, Red  Deer  College,  Red  Deer, 
A  Iberta. 

This  book  is  directed  to  the  beginning 
nursing  student.  It  is  not  exhaustive 
in  coverage  but  should  provide  a  useful 
foundation  on  which  to  build  effective 
nursing  care. 

The  book  contains  seven  units,  with 
an  appendix  that  covers  common  abbre- 
viations, affixes,  symbols,  and  tables  of 
equivalents.  The  book  is  well  illustrated 
with  photographs.  Drawings  and  tables 
are  clear  and  complete. 

As  in  previous  editions,  basic  sci- 
ences are  identified  as  they  apply  to  the 
area  of  study.  At  the  end  of  each  chap- 
ter (there  are  33)  are  a  summary,  ques- 
tions for  discussion,  a  life  situation,  a 
suggested  performance  checklist  (where 
applicable),  and  suggested  readings. 

Rounding  out  the  scientific  prin- 
ciple-based procedures  approach  are 
several  areas  worthy  of  special  consider- 
ation. 

Unit  one,  an  introduction  to  nurs- 
ing embodies  an  interpretation  of  nurs- 
ing as  a  process.  A  whole  chapter  is 
devoted  to  the  problem-solving  ap- 
proach. 

Unit  two,  principles  related  to  meet- 

(Coiiliiiiicd  on  p(if;c  60) 
MAY  1971 


New 


this 
Spring 


ereier:  MATERNITY  NURSING  —  A  Textbook  for  Practical  Nurses  3rd  Edition 
By  Inge  J.  Bleier,  R.N.,  B.S.,  M.S.,  Michael  Reese  Hospital  and  Medical  Center. 

The  new  third  edition  of  this  well-i<nown  text  includes  new  material  on  family 
planning,  exercises  and  breathing  techniques  to  prepare  for  labor,  emergency 
delivery,  and  helping  the  unwed  mother  and  the  mother  faced  with  death  or 
malformation  of  the  newborn.  The  basic  information  on  anatomy  and  physiolo- 
gy and  the  full  coverage  of  nursing  responsibilities  from  antepartal  care  to  care 
of  the  newborn  have  been  brought  up  to  date. 
About  270  pages  with  about  135  illustrations.  About  $4.15.  Just  ready. 

Hymovich  &  Reed:  NURSING  AND  THE  CHILDBEARING  FAMILY  — A  Guide 

for  Study 

By  Debra  P.  Hymovich,  R.N.,  B.S.,  M.A.,  and  Suellen  B.  Reed,  R.N.,  B.S.N.,  M.S.N., 
both  of  the  University  of  Texas  Clinical  Nursing  School  at  San  Antonio. 
Following  the  highly  successful  pattern  of  Miss  Hymovich's  Nursing  of  Chil- 
dren, this  new  book  presents  a  series  of  18  study  guides  designed  to  teach  as 
well  as  to  evaluate  and  reinforce  learning.  The  authors  emphasize  the  nurse's 
role  as  a  teacher,  reminding  her  that  the  family  spends  most  of  the  childbear- 
ing  cycle  in  the  home.  This  guide  can  be  used  alone  or  with  any  standard  text- 
book. An  Instructor's  Manual  is  available. 
About  530  pages,  illustrated.  About  $5.15.  Just  ready. 

Keane:  STUDY  GUIDE  AND  WORKBOOK  IN  MEDICAL-SURGICAL  NURSING 
FOR  PRACTICAL  NURSES 

By  Claire  Brackman  Keane,  R.N.,  B.S.,  Athens  (Ga.)  General  Hospital  School  of  Prac- 
tical Nursing. 

This  new  study  guide  is  a  companion  to  Mrs.  Keane's  Essentials  of  Nursing.  It 
encourages  the  student  to  use  critical,  creative  thinking  in  solving  nursing 
problems  by  setting  up  specific  objectives  and  then  showing  the  student  how 
these  objectives  may  be  met.     About  160  pages.  About  $4.15.  Just  ready. 

Leake:  A  MANUAL  OF  SIMPLE  NURSING  PROCEDURES  5th  Edition 

By   Mary  J.   Leake,   M.S.,   R.N.,   formerly   Director,  Public   Health   Nursing  Assoc, 

Richmond,  Indiana. 

The  new  edition  of  this  thoroughly  practical  book  concentrates  on  how  and 
why  basic  nursing  procedures  are  carried  out.  The  procedures  are  arranged  in 
order  of  increasing  difficulty,  with  special  emphasis  on  medical  asepsis  and 
on  body  mechanics. 
About  240  pages  with  about  120  illustrations.  About  $4.40.  Just  ready. 

Reed  &  Sheppard:  REGULATION  OF  FLUID  AND  ELECTROLYTE  BALANCE:  A 
Programmed  Instruction  in  Physiology  for  Nurses. 

By  Gretchen  Mayo  Reed,  B.S.,  M.A.,  University  of  Tennessee,  and  Vincent  F. 
Sheppard,  Ph.D.,  Memphis  State  University. 

A  self-teaching  programmed  text  geared  to  the  needs  of  nursing  students,  this 
new  book  uses  a  physiological  approach  to  the  understanding  of  fluid  and 
electrolyte  balance  and  acid-base  balance.  The  final  section  relates  this  under- 
standing to  the  clinical  implications  for  patient  care. 
About  320  pages,  illustrated.  About  $5.70.  Ready  June. 


W.  B.  SAUNDERS  COMPANY  CANADA  Ltd.  1835  Yonge  Street,  Toronto  7. 

Please  send  on  approval  when  ready  and  bill  me: 

Author Book  Title 


MAY  1971 


Name 


Address. 
City 


Zone. 


.  Prov. 


CN  5-71 
THE  CANADIAN  NURSE     59 


(CoiitiiiiictI  fiDiii  pu^e  58) 

ing  the  patient's  needs  through  hospit- 
alization, deals  with  psychosocial  as- 
pects of  hospital  care.  Also  in  this  unit 
is  a  chapter  on  planning  nursing  care. 
It  contains  a  sample  plan  compiled  by 
a  student  —  the  patient  is  a  diabetic. 

Unit  seven  adapts  general  principles 
to  meet  the  needs  of  the  special  patient: 
the  surgical  patient,  the  patient  with  a 
wound,  the  patient  with  a  communi- 
cable disease,  the  long-term  illness 
patient,  and  the  dymg  patient. 

This  is  not  an  exciting  book,  but  it 
is  wholesome.  "Q 


accession  list 


Publications  on  this  list  have  been 
received  recently  in  the  CNA  library 
and  are  listed  in  language  of  source. 

Material  on  this  list,  except  Reference 
items  may  be  borrowed  by  CNA  mem- 
bers, schools  of  nursing  and  other  in- 
stitutions. Reference  items  (theses, 
archive  books  and  directories,  almanacs 
and  similar  basic  books)  do  not  go  out 
on  loan. 


a  boon 

to 

ileostomy 

and 

colostomy 

patients 

alike! 


Karaya  Seal,  a  Hollister  development,  makes  it 
possible  for  a  patient's  rehabilitation  to  begin  in 
the  hospital  soon  after  surgery  and  offers  him 
a  simple,  comfortable  method  of  self -care  after 
he  goes  home.  The  Karaya  Seal  Ring  combines 
the  protective  qualities  of  karaya  gum  powder 
and  the  adhesive  properties  of  cement— elimi- 
nating the  need  for  dressings.  Designed  to  fit 
securely  around  the  stoma,  Karaya  Seal  con- 
forms to  body  contours,  protects  the  skin  from 
intestinal  discharge,  thus  avoiding  painful  ex- 
coriation. Each  Hollister  ostomy  appliance  is  a 
lightweight,  disposable,  one-piece  unit,  with  no 
gasket  to  retrieve,  no  parts  to  clean.  Write  (on 
professional  letterhead)  for  free  samples  and 
information  on  Hollister  ostomy  products. 

OSTOMY  PRODUCTS  by  HOLLISTER 

60     THE  CANADIAN  NURSE      hollister  ltd.,  i60  bay  street.  Toronto  lie.  Ontario 


Requests  for  loans  should  be  made 
on  the  "Request  Form  for  Accession 
List"  and  should  be  addressed  to:  The 
Library,  Canadian  Nurses'  Association, 
50  rhc  Driveway.  Ottawa  4.  Ontario. 

No  more  than  three  titles  should  be 
requested  at  any  one  time. 


BOOKS  AND  DOCUMENTS 

1.  Anatomy  of  the  human  body  by  Henry 
Gray.  28th  ed.  edited  by  Charles  Mayo  Goss. 
Philadelphia,  Lea  &  Febiger,   1966.   I448p. 

2.  Les  Anglicismes  an  Quebec;  repertoire 
classifie  par  Gilles  Colpron.  Montreal,  Beau- 
chemin,  1970.  247p. 

3.  L'assistanle  dentaire  par  D.  Hervieu.  Paris, 
Masson,  1970.  115p. 

4.  Ce  combat  qui  m'en  finil  plus  .  .  .  par  A- 
lain  Stanke  et  Jean-Louis  Morgan.  Montreal, 
Editions  de  THomme,  1970.  269p. 

5.  Chirurgie  par  Claude  Bomet  avec  la  col- 
laboration de  M.  Th.  Bomet-Rouxel.  Paris, 
Maloine,  1966.  2v.  Contents. — t.l:  L'lnfec- 
tion  en  chirurgie;  traumatologie;  Maladies 
a  retentissement  social;  L'Intervention  chi- 
rurgicale;  Reanimation  chirurgicale;  Appa- 
reil  locomoteur. — 1.2:  Appareil  digestif; 
Urologie;  Gynecologie. 

6.  Coronary  care  by  Norman  L.  Goodland. 
Bristol,  John  Wright  &  Sons,  1970.  88p. 

7.  Definitive  dialing:  Nursing  Dial  Access; 
a  report  of  the  planning  year  and  the  first 
eighteen  months  in  operation,  Sep.  18,  1968- 
Mar.  15,  1970  by  Anne  G.  Niles.  Madison, 
Wise.,  University  Extension,  University  of 
Wisconsin,  Health  Sciences  Unit,  Dept.  of 
Nursing,  1970.  63p. 

8.  Development  of  an  instrument  for  use  in 
validating  effectiveness  of  nursing  action 
by  Margaret  Valerie  Moher.  New  Haven, 
Conn.  1965;  Ann  Arbor,  Mich.,  University 
Microfilms,  1970.  90p.  (Thesis  MSN  — 
Yale) 

9.  Dictionnaire  de  diagnostic  clinique  et 
topographique  par  Alain  Blacque-Belair  1. 
ed.  Paris,  Maloine,  1969.  1239p.  R 

10.  Dictionnaire  frangais-anglais  des  termes 
techniques  de  medecine  par  Jean  Delamare 
et  Therese  Delamare-Riche.  Paris,  Maloine, 
1970.  392p.  R 

\\.  Drugs  in  current  use  1971,  edited  by 
Walter  Modell.  New  York,  Springer.  173p. 

12.  Empirical  studies  in  health  economics. 
Proceedings  of  the  second  conference  on  the 
economics  of  health  edited  by  Herbert  E. 
Klarman  and  Helen  H.  Jaszi.  Baltimore, 
Hopkins,  1970.  433p. 

13.  English-French  dictionary  of  medical 
terms  by  Jean  Delamare  and  Therese  De- 
lamare-Riche. Paris,  Maloine,  1970.  357p.  R 

14.  Fiftieth  annual  report.  Ottawa,  Canadian 
Welfare  Council,  1970.  28p. 

15.  La  garderie  de  jour  au  service  de  la  fa- 
mille  moderne.  Documents  et  discussions 
d'un  colloque.  Edite  par  Rosyln  Burshtyn. 
Ottawa,  Institut  Vanier  de  la  Famille,  1970. 
65p. 

16.  General  urology  by  Donald  Ridgeway 
Smith.  6th  ed.  Los  Altos,  Calif.,  Lange, 
1969.  416p. 

MAY  1971 


17.  Health  care  services  for  the  aged;  prob- 
lems in  effective  delivery  and  use,  edited  by 
Carter  C.  Osterbind.  Gainesville,  Fla.,  Uni- 
versity of  Florida  Press,  published  for  the 
University  of  Florida  Institute  of  Gerontol- 
ogy, 1970.  149p. 

18.  Industrial  conversion  and  workers'  atti- 
tudes to  change  in  different  industries  by 
Jan  J.  Loubser  and  Michael  Fullan.  Ottawa, 
Queen's  Printer,  1969.  270p.  (Canada.  Task 
Force  on  Labour  Relations  Study  no.  12) 

19.  Introduction  a  V etude  du  travail.  Ge- 
neve, Bureau  International  du  Travail,  1970. 
380p. 

20.  Job  evaluation:  a  basis  for  sound  wage 
administration  by  Jay  L.  Otis  and  Richard 
H.  Leukart.  2d  ed.  Englewood  Cliffs,  N.J., 
Prentice-Hall,  1954.  532p.  R 

21.  iMhyrinth  of  silence  by  David  S.  Viscott. 
New  York.  Norton,  1970.  255p. 

22.  Legal  foundations  of  nursing  practice 
by  Irene  A.  Murchison  and  Thomas  S.  Ni- 
chols. Toronto,  Collier-Macmillan,  1970. 
529p. 

23.  List  of  members.  Ottawa,  Canadian 
Library  Association,  1970.  69p.  R 

24.  Medecine  par  J.   Guitton.   Paris,   Ma- 
loine,  1968.  405p. 

25.  Mosby's  review  of  practical  nursing.  5th 
ed.  Saint  Louis,  Mosby,  1970.  410p. 

26.  Neurologic  et  psychiatric  par  Jean  Ou- 
les.  Paris,  Maloine,  1967.  249p. 

27.  New  directions  for  nurses,  edited  by 
Bonnie  Bullough  and  Vern  Bullough.  New 
York,  Springer,  1971.  355p. 

28.  Nos  droits  sociaux,  par  Aurele  Saint- 
Yves.  Montreal,  Renouveau  Pedagogique, 
1970.  97p. 

29.  Nurses  come  lately;  the  first  five  years 
of  the  Quo  Vadis  School  of  Nursing  by  Ca- 
therine D.  McLean  and  Rex  A.  Lucas.  Eto- 
bicoke,  Ont.,  Quo  Vadis  School  of  Nurs- 
ing, 1970.  50p. 

30.  The  nurse's  guide  to  the  law  by  Sidney 
H.  Willig.  Toronto,  McGraw-Hill,  1970. 
264p. 

31.  Nursing  care  in  eye,  ear  nose  and  throat 
disorders  by  William  A.  Havener  et  al.  2d. 
ed.  Saint  Louis,  Mosby,  1968.  402p. 

32.  Nursing  in  the  coronary  care  unit,  by 
La  Vaughan  Sharp  and  Beatrice  Rabin. 
Philadelphia,  Lippincott.  1970.  213p. 

33.  Nursing  manpower  development:  a 
review  of  methods.  Geneva,  World  Health 
Organization.  Headquarters.  Nursing  Unit. 
1970.  52p. 

34.  Obstetrique  par  Bernard  Sequy  et  al.  2. 
ed.  Paris,  Maloine,  1969.  466p. 

35.  The  patient  in  surgery,  a  guide  for  nurses 
by  George  D.  LeMaitre  and  Janet  Finnegan. 
2d  ed.  Toronto,  Saunders,  1970.  457p. 

36.  Petit  dictionnuire  du  "joual"  en  franfais 
par  Augustin  Turenne.  Montreal  Editions 
delHomme,  1962.  92p. 

37.  The  professional  in  the  organization  by 
Mark  Abrahamson.  Chicago,  Rand  McNally, 
1967.  158p. 

38.  Quality  patient  care  scale  developed  by 
faculty  under  guidance  of  Mabel  A.  Wandelt 
and  Joel  Ager.  Detroit,  Wayne  State  Uni- 
versity. College  of  Nursing.  1970.  Iv. 

MAY  1971 


39.  Readings  in  development.  Ottawa,  Ca- 
nadian University  Service  Overseas,  1970. 
456p. 

40.  Report  submitted  to  the  Secretary  of 
State  for  Social  Services,  covering  the  per- 
iod April  1st,  1969  to  March  31  st  1970. 
London,  General  Nursing  Council  for  Eng- 
land and  Wales,  1970.  69p. 

41.  Report  of  Workshop  on  the  Expanding 
Role  of  Community  Nurses  London,  Ont.. 
May  27-29,  1970.  edited  by  Ethel  Horn. 
London,  Ont.,  University  of  Western  Ont., 
Faculty  of  Nursing,  Dept.  of  Summer  School 
and  Extension,  1970.  64p. 

42.  The  Slater  nursing  competencies  rating 
scale  by  Doris  Slater,  tested  and  refined  by 
students  and  faculty  of  the  College  of  Nurs- 
ing under  guidance  of  Mabel  A.  Wandelt. 
Detroit,  Mich.,  Wayne  State  University, 
Collece  of  Nursing.  1967.  42p. 

43.  /I  taxonomy  of  instructional  behaviors 
applicable  to  the  guidance  of  learning  ac- 
tivities in  the  clinical  setting  in  baccalau- 
reate nursing  education  by  Sister  Margaret 
Mannion.  Washington,  1968.  129p.  (Thesis 
—  Catholic  University  of  America. 

44.  L'urologie  par  Andre  Dufour.  Paris, 
Presses  Universitaires  de  France,  1970. 
128p.  (Que  sais-je?  no.  1405) 

45.  Le  vieillard  I'hospice  et  la  mort  par 
J.  Vignat.  Paris,  Masson,  1970.  146p.  (Col- 
lection de  medecine  legale  et  de  toxicologie 
medicale) 


NURSES 

HOSPITAL  OF  THE 
UNIVERSITY  OF 
PENNSYLVANIA 


Interesting  opportunities  await  Reg- 
istered Nurses.  Challenging  positions 
are  available  immediately  in  the 
950-bed  teaching  hospital  located  in 
the  heart  of  the  University  campus. 
Full  tuition  reimbursement  plan  in 
effect  for  all  full-time  staff  members. 
Other  benefits  include  retirement  pro- 
gram, full  paid  hospitalization  for 
employee  and  dependents,  irv-service 
education  and  modern,  furnished 
apartments  in  historic  Society  Hill. 
Excellent  storting  salaries  with  con- 
sideration given  for  previous  ex- 
perience. For  further  information,  call 
or    write: 

Director  of  Nursing  Service 

Department  S 

3400  Spruce   Street 

Philadelphia,   Pa.    19104,   U.S.A. 

(215)  M2-2607 

An    Equal   Opportunity   Employer 


PAMPHLETS 

46.  Bibliography  for  nursing  tapes.  Nursing 
Dial  Access  sponsored  by  University  Ex- 
tension, University  of  Wisconsin,  Health 
Sciences  Unit,  Dept.  of  Nursing  with  the 
Wisconsin  Regional  Medical  Program,  Inc. 
Madison,  Wise,  1970.  19p. 

47.  Extended  hospital  care:  a  nursing  con- 
cern. Vancouver,  Registered  Nurses"  Asso- 
ciation of  British  Columbia,  1970.  3  Ip.  R 

48.  Health  careers.  Don  Mills,  Ontario  Hos- 
pital Association.  1971.  35p. 

49.  Medical  reference  works,  1679-1966;  a 
selected  bibliography,  supplement  I.  Chica- 
go, Medical  Library  Association,  1970.  46p. 

50.  New  members  of  the  physician's  health 
union:  physician's  assistants.  Washington, 
National  Academy  of  Sciences.  Board  on 
Medicine.  Ad  Hoc  Panel  on  New  Members 
of  the  Physicians  Health  Team,  1970.  14p. 
5 \.  Report  1969.  Toronto.  Ontario  Cancer 
Treatment  and  Research  Foundation,  1970. 
202p. 

52.  Report,  1970.  Michigan,  W.K.  Kellogg 
Foundation,  1970.  41  p. 

53.  Some  continuities  and  discontinuities  in 
the  education  of  women  by  David  Riesman. 
Bennington,  Vermont,  Bennington  College, 
1956.  28p. 

54.  Suggested  personnel  policies,  salary 
ranges,  job  descriptions  and  staff  ratios  for 
registered  nurses  employed  in  homes  for  the 
aged  in  Ontario,  prepared  by  the  Working 
Committee  formed  at  the  general  assembly 
of  registered  nurses  at  the  1969  annual 
convention  of  the  Ontario  Association  of 
Homes  for   the   Aged.   Ottawa,    1970.   27p. 

GOVERNMENT  DOCUMENTS 
Canada 

55.  Bureau  of  Statistics.  Trusteed  pension 
plans,  financial  statistics  1969.  Ottawa, 
Queen's  Printer,  1970.  58p. 

56.  Dept.  of  Labour.  Economics  and  Re- 
search Branch.  Working  conditions  in  Ca- 
nadian industry.  255p. 

57.  Dept.  of  Manpower  and  Immigration. 
Career  outlook  community  college  1970-71. 
Ottawa,  Information  Canada,  1970.  60p. 

58. — .  Supply  and  demand:  new  university 
graduates  1970.  Ottawa.  Queen's  Printer, 
1970.  23p. 

59. — .  University  career  outlook  1970-1971. 
Ottawa,  Information  Canada.  1970.  72p. 

60.  Dept.  of  National  Health  and  Welfare. 
Canada's  northern  health  service.  Edmonton, 
1970.  47p. 

6 1 .  — .  Educating  mental  health  practitioners. 
Ottawa,  1970.  12p.  (CMH  suplement  no.  66) 

62.  — .  Health  and  welfare  services  in  Ca- 
nada 1970.  Ottawa,  Queen's  Printer,  1970. 
146p. 

63. —  .National  health  grant  manual,  1970 
7/.  Ottawa,  1970.  I4p. 

64.  — .  Report  on  health  conditions  in  the 
Northwest  Territories,  1969.  Ottawa,  1970. 
I4p. 

65.— .  Research  projects  and  investigations 
related  to  hospitals  1970.  Ottawa.  Queen's 
Printer,  1970.  196p. 

66.  Economic   Council   of  Canada.    Annual 
THE  CANADIAN  NURSE     61 


accession  list 


(Conliniietl  from  piifie  61 ) 

report  1969-70.  Ottawa,  Information  Canada. 
1970.  28p. 

67.  National  Library  of  Canada.  Report 
1970.  Ottawa,  Queen's   Printer,    1970.   55p. 

68.  Parliament.  House  of  Commons.  Li.\i 
of  members  with  their  respective  constituen- 
cies and  addresses.  Ottawa.  Queen's  Printer, 
1970.  89p. 

69.  — .  Senate.  Special  Committee  on  Science 
Policy.  Report.  Ottawa,  Queen's  Printer, 
1970.lv. 

70.  Secretariat  d'Etat.  Bureau  des  Traduc- 
tions. Centre  de  Terminalogie.  Bulletin. 
BT138:  Astronautique  133p.  BT141:  Lexi- 
que  d'art  at  d'archeologie  pt.l,  358p.;  pt.2, 
714p.;  pt.3,  1116p.  BT142:  Affaires  etran- 
geres  et  diplomatie.  189p.  BT144:  Repertoi- 
re alphabetique  codifie  des  lois  federales. 
62p.  R 

Ontario 

71.Dept.  of  Labour.  Research  Branch. 
Ontario  collective  agreement  expirations 
/ 977.  Toronto,  1970.  234p. 

72.  Minister  of  Health.   Guiding  principles 
for  the  regulation  and  the  education  of  the 
health  disciplines.  Toronto,  1971.  13p. 
Quebec 

73.  Ministere  de  la  Justice   Service  d'lnfor- 


mation.  Les  regimes  matrimoniaux.  Quebec, 
P.Q..  1971.  15p. 
Saskatchewan 

lA.  Dept.  of  Welfare.  Housing  and  Special 
Care  Homes  Branch.  Directory  of  housing 
and  special-care  homes  for  the  accommoda- 
tion and  care  of  the  aged,  needy,  infirm  and 
Hind.  Regina,  1970.  47p. 

United  States 

75.  National  Institutes  of  Health.  Bureau 
of  Health  Professions,  Education  and  Man- 
power Training.  Selected  training  programs 
for  physician  support  personnel.  Bethesda, 
Md.,  1970.  65p. 

76.  National  Library  of  Medicine.  Guide  to 
MEDLARS  service.  Bethesda,  Md.  U.S. 
Dept.  of  Health,  Education  and  Welfare. 
Public  Health  Service,  National  Institutes 
of  Health  1970.  20p.  (U.S.  Public  Health 
Service  Publication  no.  1694  rev.) 

77. — .List  of  journals  indexed  in  index 
medicus.  Washington,  U.S.  Gov't.  Print. 
Off.,  1970.  99p.  R 

STUDIES  DEPOSITED  IN  CNA  REPOSITORY 
COLLECTION 

78.  Collective  bargaining  and  the  nurse:  a 
study  of  selected  aspects  of  collective  bar- 
gaining by  graduate  nurses  in  the  public 
general  hospitals  of  the  province  of  Ontario 
by  Margaret  Inglis.  Toronto,  1969.  104p. 
(Thesis  (Dipl.  Hosp.  Admin.)  —  Toronto)  R 

79.  Concerns  of  mothers  participating  in  the 
care  of  their  children  hospitalized  for  minor 
surgery  in  a  day  care  unit  by  Ethel  Margar- 


et Smith.  Vancouver,  1970.  147p.  (Thesi 
(M.Sc.N.)— British  Columbia)  R 

80.  The  emergence  of  family  medicine  an,  \ 
its  influence  on  the  role  of  the  family  phys 
ician's  nurse  by  John  Victor  Rawlings.  To 
ronto,  1969.  Ann  Arbor,  University  Mien 
films,  1970.  123p.  (Thesis  (Dipl.  Hosi 
Admin.)  —  Toronto)  R 

81.  Etude  longitudinale  et  laterale  d'um 
experience  educative  d'etudiants  en  nurs 
ing  par  Therese  Perrault.  Montreal,  1970 
141p.  (These  (M.Nurs.) —  Montreal)  R 

82.  An  exploratory  study  to  determine  tht 
sex  education  of  young  unmarried  mother: 
by  Denise  Lalancette.  Boston,  1967  37p 
(Thesis  (M.Sc.N.) —  Boston)  R 

83.  Expressed  orientation  needs  of  nurse:, 
graduating  from  the  CGEP  in  the  province 
of  Quebec  by  Rita  J.  Lussier.  Boston,  1970 
89p.  (Thesis  (M.Sc.N.)—  Boston)  R 

84.  Interim  report  RNAO  project  for  team 
nursing  development  by  Registered  Nurses' 
Association  of  Ontario  with  the  co-operation 
of  Ontario  Dept.  of  Health,  Ontario  Hos- 
pital Services  Commission.  Toronto,  1970. 
53p.R 

85.  Report  of  regipnal  survey  of  training 
centres  for  nursing  assistants  in  Ontario. 
Toronto,  College  of  Nurses  of  Ontario.. 
1969.  51  p. 

86.  Le  "test  des  yeux  fermes":  instrument 
pour  mesurer  I'anxiete  situationnelle  chez 
les  clients  de  I'infirmiere  par  Janine  Dra- 
peau.  Montreal,  1969.  (Thesis  (M.Nurs.)  — 
Montreal)  R  ^ 


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62     THE  CANADIAN   NURSE 


MAY  1971 


|unel971 


UNIVERSITY  OF  OTTAWA 
SCHO  1L  OF  NURSING  LIBRARY 
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do  you  have  a  bad  trip 
if  you  go  to  hospital? 

what  readers  like 
—  and  don't  like  — 
in  The  Canadian  Nurse 


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2       THE  CANADIAN   NURSE  jUne  1971 


The 

Canadian 
Nurse 


& 

^^p 


A  monthly  journal  for  the  nurses  of  Canada  published 

in  English  and  French  editions  by  the  Canadian  Nurses'  Association 


Volume    67,    Number    6 


June    1971 


Editorial 


2y     What  Readers  Like  —  And  Want  Changed  — 

in  The  Canadian  Nurse H.  Shaw 

33     Relatives  Should  Be  Told  About  Intensive  Care 

—  But  How  Much  and  By  Whom?  P-  Wallace 

35  Deep-Freeze  Seminar  —  A  Warm  Experience S.  Rockburne 

39  Do  You  Have  a  Bad  Trip  It"  You  Go  To  Hospital? C.  Hacker 

45  Hey.  Nurse!  J-  Wilting 

46  Idea  Exchange 


The  views  expressed  in  the  various  articles  are  the  views  of  the  authors  and  do  not 
necessarily  represent  the  policies  or  views  of  the  Canadian  Nurses'  Association. 


4  Letters 

18  Names 

24  Dates 

48  Books 

52  Accession  List 


7  News 

21  New  Products 

26  In  a  Capsule 

50  AV  Aids 

72  Index  to  Advertisers 


Executive  Director:  Helen  K.  Mussallem  • 
Editor:  Virfiinia  A.  Lindabury  •  Assistant 
Editor:  Liv-Ellen  Lockeberg  •  Editorial  As- 
sistant: Carol  A.  Kotlarsky  •  Production 
Assistant:  Elizabeth  A.  Stanton  •  Circula- 
tion Manacer:  Beryl  Darling  •  Advertising 
Manager:  'Ruth  H.  Baumel  •  Subscrip- 
tion Rates:  Canada:  one  year,  $4.50;  two 
years,  $8.00.  Foreign:  one  year,  $5.00;  two 
years,  $9.00.  Single  copies;  50  cents  each. 
Make  cheques  or  money  orders  payable  to  the 
Canadian  Nurses'  Association.  •  Change  of 
Address:  Six  weeks'  notice;  the  old  address  as 
well  as  the  new  are  necessary,  together  with 
registration  number  in  a  provincial  nurses' 
association,  where  applicable.  Not  responsible 
for  journals  lost  in  mail  due  to  errors  in 
address. 


.Manuscript  Information:  The  Canadian 
Nurse"  welcomes  unsolicited  articles.  All 
manuscripts  should  be  typed,  double-spaced, 
on  one  side  of  unruled  paper  leaving  wide 
margins.  Manuscripts  are  accepted  for  review 
for  exclusive  publication.  The  editor  reserves 
the  right  to  make  the  usual  editorial  changes. 
Photo'araphs  (glossy  prints)  and  graphs  and 
diagrams  (drawn  in  India  ink  on  white  paper) 
are"  welcomed  with  such  articles.  The  editor 
is  not  committed  to  publish  all  articles 
sent,  nor  to  indicate  definite  dates  of 
publication. 

Postage  paid  in  cash  at  third  class  rate 
MONTREAL,  P.Q.  Permit  No.  10,001. 
50  The  Driveway,  Ottawa,  Ontario.  K2P  IE2 
©  Canadian  Nurses'  Association  1971. 


JUNE  1971 


Last  summer  the  Canadian  Nurses' 
Association  employed  a  research  organ- 
ization that  specializes  in  readership 
surveys  of  periodicals  to  find  out  what 
readers  like  —  and  do  not  like  —  about 
The  CaiHidian  Nurse.  The  results  of 
this  survey  are  favorable,  on  the  whole, 
and  give  the  editorial  staff  an  idea  of 
readers"  reactions  to  the  magazine's 
contents.  (See  "What  readers  like  — 
and  want  changed  —  in  The  Caiuulian 
Nurse."  page  29.) 

Although  pleased  with  the  findings 
of  this  survey,  we  look  on  them  merely 
as  guidelines  to  help  us  plan  future 
content  of  the  magazine.  In  doing  so. 
we  will  keep  in  mind  that  the  attitudes 
of  the  small  number  of  nurses  inter- 
viewed may  or  may  not  be  shared  by 
most  readers.  We  realize,  too.  that  one 
survey  is  insufficient,  and  that  others 
will  have  to  be  carried  out  if  we  are  to 
obtain  an  accurate  picture  of  readers" 
attitudes  toward  the  journal. 

One  thing  a  readership  survey  does 
not  tell  us  is  why  readers  like  or  dislike 
specific  content.  For  example,  although 
we  know  that  the  "audiovisual  aids"" 
department  was  rated  low  by  those 
interviewed,  we  do  not  know  why.  We 
can  only  guess.  Is  it  because  this  depart- 
ment is  of  interest  only  to  nurse  educ- 
ators, who  represented  1 .5  percent  of 
those  interviewed'.'  Is  it  because  the 
material  we  use  in  this  department  is 
circulated  to  most  readers  by  companies 
that  produce  films,  tapes,  and  other 
AV  aids?  Or  is  there  some  other  reason? 

Although  you  may  not  have  been 
one  of  the  203  persons  interviewed  for 
this  readership  survey,  you  can  still 
help  us  in  our  efforts  to  improve  the 
journal.  Write  to  the  editor.  The  Cci- 
luidiun  Nurse.  50  The  Driveway.  Otta- 
wa K2P  IE2.  and  give  your  opinions, 
suggestions,  and  criticisms  of  any  part 
of  the  journal.  Let  us  know  what  you 
like  and  don"t  like.  And  perhaps  youll 
be  able  to  tell  us  why  you  read  certain 
departments  or  articles  and  ignore 
others. 

Our  aim  is  to  publish  material  that 
is  of  use  and  interest  to  you.  You  can 
help  us  achieve  this  by  dropping  us 
a  line.  —  V.A.L. 

THE  CANADIAN   NURSE       3 


letters 


Letters  to  the  editor  are  welcome. 

Only  signed  letters  will  be  considered  for  publication,  but 

name  will  be  withheld  at  the  writer's  request. 


Comment  on  readership  survey 

Thank  you  for  giving  me  the  opportun- 
ity to  examine  the  Starch  report  of  the 
readership  survey  of  The  Canadian 
Nurse.  Having  observed  the  evolution 
of  this  publication  over  the  past  several 
years,  without  assuming  any  responsi- 
bility for  it.  I  was  naturally  interested 
in  reader  reaction  to  the  content  and 
the  format. 

My  colleague.  Hugh  Shaw,  who  has 
been  examining  and  interpreting  Starch 
reports  for  20  years,  was  most  impr^^^d 
by  the  favorable  response  of  the  readers 
interviewed  in  the  survey.  It  is  his  opin- 
ion that  such  surveys  cannot  be  pre- 
cisely accurate,  but  they  do  represent 
the  only  systematized  method  now 
available  for  assessing  reader  reaction 
to  a  publication. 

Although  the  survey  encompassed  a 
relatively  small  percentage  of  Canadian 
nurses,  those  interviewed  provided  a 
reasonably  good  geographical  and 
occupational  cross-section  of  your 
readership:  from  this  it  can  be  assumed 
that  the  opinion  reflected  in  the  repon 
is  representative  of  total  reader  opinion. 

Satisfying  the  diverse  interests  and 
tastes  of  80.000  people,  dispersed  as 
they  are  in  Canada,  is  at  best,  a  prohib- 
itive editorial  task.  It  is,  therefore, 
significant  that  the  level  of  readership 
indicated  by  the  survey  is  so  high  and 
that  nurses  depend  so  heavily  on  it  for 
information  in  this  field.  The  continued 
interest  of  your  members  in  such  ma- 
terial as  research  articles  and  anicles 
based  on  research  is  indicative  of  a 
lively  interest  in  the  profession  and  the 
ability  of  your  publication  to  satisfy 
this  interest. 

The  staff  of  The  Canadian  Nurse 
must  find  these  results  most  rewarding, 
and  I  think  some  applause  should  also 
be  directed  to  the  intellectual  vitality 
of  the  profession  that  generates  the  kind 
of  material  your  book  carries.  —  BJ. 
McGuire.  Forsier.  McGuire  <Sl  Co.. 
Limited,  Montreal. 

Replies  to  student's  letter 

The  problems  outlined  in  Elizabeth 
Jordan's  letter  (April  1971)  go  much 
deeper  than  they  appear  on  the  surface, 
when  we  consider  the  whole  spectrum 
of  society.  What  is  needed  is  a  new 
philosophy  for  living. 

In  the  meantime,  we  should  advocate 
a  revolution  in  nursing.  .After  all.  every- 
one is  calling  for  revolution.  Why  tK>t 

4       THE  CANADIAN   NURSE 


the  nursing  profession? 

Nurses  could  start  with  a  period  of 
internship  on  the  wards  with  the  pa- 
tients, emphasizing  behavioral  sciences 
to  understand  human  behavior.  How 
can  a  person  diagnose  a  patient's  needs 
without  a  sound  knowledge  of  these 
sciences? 

With  a  longer  internship  with  the 
medical  team,  the  nurse  could  easily 
learn  many  procedures  the  doctor  now 
carries  out.  How  frustrating  it  is  to  have 
to  wait  for  a  young  doctor  to  visit  the 
ward  to  order  an  antibiotic  or  other 
medication,  or  perform  a  procedure  to 
alleviate  a  patient's  suffering.  Many 
duties  of  a  sometimes  overtaxed  junior 
resident  do  not  have  to  be  performed  by 
a  doctor. 

Diagnosing  and  treating  patients  in 
their  homes  would  reduce  hospital 
admissions.  Follow-up  visits  could  also 
reduce  the  length  of  a  patient's  stay  in 
hospital  and  would  often  eliminate 
return  trips  to  overcrowded  outpatient 
clinics. 

These  nurses  would  staff  intensive 
care  units,  coronary  units,  and  recovery 
rooms.  They  would  be  a  mobile  group, 
perhaps  specializing  in  duties  particular 
to  one  hospital  service.  An  example 
could  be  a  group  covering  several  sur- 
gical wards. 

We  should  give  the  nursing  field 
to  nursing  assistants,  who  are  already 
proving  they  can  handle  this  work.  W  ard 
managers  could  control  the  nursing 
assistants. 

Let  us  meet  the  health  needs  of  our 
society  and  share  in  the  wealth  bestowed 
on  the  doctor.  And  let  us  stop  using  the 
name  "nurse."  For  as  long  as  we  are 
recognized  by  this  title,  we  will  be  sub- 
servient to  the  head  nurse,  supervisor, 
doctor,  and  administrator.  —  Jim  Car- 
roll. R.S.,  London,  Ontario. 

I  was  rather  annoyed,  to  say  the  least 
by  the  letter  from  the  liimed  off' 
student.  I  thought  it  a  particularly 
scathing  and  unfair  supposition  on  her 
part. 

For  every  negligent  and  poor  nurse. 


Letters  Welcome 
Letters  to  the  editor  are  welcome.  Be- 
cause of  space  limitation,  writers  are 
asked   to   restrict    their   leners   to  a 
maximum  of  350  words. 


there  are  100  excellent  and  compas- 
sionate ones.  Of  course  some  nurses 
"cop  out."  but  most  of  us  care  enough 
to  use  our  best  nursing  skills.  It  seems 
to  me  that  this  student  needs  to  open 
her  eyes  wider.  She  has  been  unfair  to 
our  profession  by  her  scathing  criticism. 
—  S.  Hannay,  R.S.,  Victoria.  B.C. 


I  read  Elizabeth  Jordan's  letter  (April 
1971)  with  interest.  Perhaps  she  i< 
perfectionist,  but  she  should  not  suggv 
that  all   nurses  are  sloppy   and   la^- 
compassion  and  responsibility. 

I  have  derived  great  pleasure  from 
my   many   years   of  nursing  and   a- 
proud  ot.my  profession.  As  a  stude- 
I   saw    myself  as   a   second   Flore r. 
Nightingale,    enriching    my    patier 
days  by  my  care  and  devotion.  Later 
realized  1  could  maintain  my  integr 
as  a  nurse  and  need  not  sacrifice  m> 
technique    to    accomplish    evervihing 
expected  of  me.  I  merely  matured  in 
viewing  my  responsibilities. 

.Most  of  the  nurses  1  work  with  are 
proud  of  their  appearance.  They  also 
carry  out  their  duties  conscientiously, 
doing  many  extras  to  help  and  cheer 
their  patients  whenever  fjossible.  They 
do  not  coddle  them  though,  as  this  is 
detrimental  to  their  surgical  progress. 
Laughter  is  frequent  and  appreciated,  j 
Moreover,  nurses  need  coffee  breaks 
as  w  ell  as  a  sense  of  humor. 

Nurses  aren't  saints  —  we  complain.  , 
We  get  tired  feet,  sore  backs,  and  gel  \ 
disenchanted  with  patients.  We  give 
the  sickest  patients  the  most  care  and, 
as  they  improve,  their  share  of  nursing 
time  lessens  until  they  get  minimal 
care.  This  isn't  a  lack  of  compassion, 
but  is  the  way  it  must  be. 

Miss  Jordan  says  we  rely  on  doc- 
tors to  assume  our  responsibility.  Yet 
few  doctors  accept  nurses  as  part  of  a 
team  that  makes  responsible  decisions; 
most  doctors  demand  that  all  decisions 
first  be  approved  by  them.  And  they 
ignore  many  suggestions. 

I  heartily  praise  the  work  of  reg- 
istered nursing  assistants.  If  they  some- 
times appear  to  give  more  conscientious 
bedside  care,  it  is  often  because  they 
have  more  uninterrupted  time  for  pa- 
tients than  nurses  have.  R.N.As  lack  the 
responsibilities  and  multiple  technical 
problems  that  often  beset  us.  We  strive 
for  the  best,  but  unfortunately  must  oc- 
casionally   settle    for    minimal    care 

JUNE  1971 


ncctiT  frequently  oa  an 


jrsafizednt' 

■iem  the  resah 

.  '.  shoct  a  time. 

nstm.  head  mmne. 

Si.  Caiharina. 


edty  leceived  naoy  reaolodoiH  shnbr 
L  These  wCTc  proinbiy 
I  oae  sadi  as  the  above, 
m  sooK  bytiri 


SpooMin  of  the  initiaJ  rootaioiB  were 


/7 


More  artidesMii 
I  r- .  .cc  -e  i-c'e  -Health  is  creiy- 
tx'«l".  i  r'_i_".csi  ?'.  Vugiua  Header- 
fiOB'(Maich  1971).'  b  ceitMlsr  has  a 
far  those  m  the  iKdkal  fno- 


teir  rcsolatioas  in  the  find  profXMaL 

It  was  thcrefofe  dtf&ak  lo  deiennae 
why  dK  lesiihiiiy  was  defieaied.  Was 
it  dae  to  the  aaphasis  on  "higb  pnon- 
tj.  a  lehwiarr  to  'distiapnA  be- 
tween levels  of  MBsiBgimciice.'^  or  fo 
dHtiapBdi  bctBcea  "apfmipreMe  levels 
of  nil  Mil  Mil  fOfaaaomT'  Or  were 
AeK  two  areas  coHideral  to  be  ■§- 
coHfolMe  with  the  facas  of  theoow- 
fefeaec!?  Wcie  we  ■*»&■«  lo 
ialoa< 
venal  area  at  dK  ead  of  i 


ck  to 


CCUSN  AaaiB  i«i>OMdewas 

Tbcs  letaer  is  dirgcTifi;?  co 


rily  in  the  dassroofn.  Some  vocational 
naniag  smdeats  are  confused  w  hen  they 
find  oat  they  se  osiiig  the  sane  lexis 
as-'R.N/'stadenls. 

Space  does  not  permit  further  ex- 
aa^iles.  Gladys  Jones' plea  in  the  Match 
issae  of  The  Cwuidkm  Syne  tm0A  be 
a  ifiiect  qrnipioni  of  the  oonnMion 
inherent  in  this  basic  problem. 

Natiooalhcaltfa  grants  »e  being  madr 
avabfble.  Does  die  solotion  of  the 
pfoHeni  of  dari^nag  kvds  of  practice 
aad  cdarjtioBai  pfcparauoa  wsiaat 
»?  Oar  answer  cooU 
this  poasMe!  —  Jean  Mackie, 
Dinctcr  efNanimg  Edacm'um.  Selkirk 
CoUete.C*ailegm,B.C. 

l-_f  Ji  -  I  iiy  f  ii||i'iiffi  I 
What  a  ifisappoiaoaeai  I  experieaced 
vitwiag  the  Caaadoa  ^tatscs'  Ascocia- 
tion'snew  fiha  The  La^ and  the  Lamp. 
After  fcadfa^  a  review  in  the  Mandtf 
Amil  l»r>40  Mrws,  I  anlici|Mled  a  fiat 

of  today's 


M0V1B6? 


•TarUnI 


Cami 


VEU   nAHEilt 


Ccf 


Zwe 


Zo 


a  ttm, 


The  oMiy 


doidK 
Do  we  not  also 

actinriei?  WIni 
al  those  Meetings 
this  wil  rcnnni  a 


feal  a  pracsic- 
■■aniyaf  dib 
dwhonly 
of  a  pro- 


After  viewine  <he  fiha  a  second 
to  see  if  1 

pf  If  tied  1  was  ao  i 

to  the  neceasicy  or  aK  of 
Le^aad  Oie  Lampt  What  kiad 
ofj     ^ 

of 


OP  IB 


\    F. Claris, ILS,.BJi^..T0rama.     * 


fom.  wn 


8  TESTED  AND  PROVEN  TEXTS . . . 


FUNDAMENTALS    OF    NURSING:    The    Humanities    and 

Sciences  in  Nursing 

By  llinor  V.  Fuerst,  R.N..  M.A.,  and  LuVerne  WolH.  R.N.,  M.A. 

This  extensively  revised  and  expanded  edition  reflects  greatly  increosed 
emphasis  upon  the  independent  functions  implicit  in  the  nursing  role. 
Highlighted  are  nursing  responsibilities  that  include  care  of  man  as  a 
human  being  as  well  as  o  biological  organism.  Nursing  measures, 
fundamental  to  the  core  of  all  patients,  have  been  added  and  others 
updated.  Stressed  ore  the  physiologic,  pathologic  and  psychosocial 
bases  for  nursing  intervention. 
446   Pages  166    Illustrations  4th    Edition,    1969  $8.00 


BASrC  PHYSIOLOGY  AND  ANATOMY 

By  lllen  f.  Chaffee,  R.N.,  M.N..  M.  Litt.  and  Esther  M.  Greisheimer, 
Ph.D.,  M.D. 

This  skillful  blending  of  the  two  sciences  provides  the  student  with  a 
VIVID  picture  of  living  man.  Revised  and  updated  to  reflect  recent 
research  findings  in  bioscience,  this  edition  has  enhanced  value  as  a 
basic  text  for  students  of  nursing  and  allied  health  fields.  Chapter-end 
summaries  and  review  questions  combine  to  stimulate  and  guide  the 
student. 

634    Pages  412    Illustrations,    45    in    Color,    plus    Videograf® 

2nd  Edition,  1969  $9.75 


BASIC  MICROBIOLOGY 

tAorgo'tt  f-  Wheeler,  R.N.,  A.B..  A.M.. 


Wesley   A.   Volk,   Ph.D. 


A  foundation  text  particularly  designed  for  students  in  the  heolth 
fields.  The  Second  Edition  has  been  entirely  reset  and  features  an 
attractive,  highly  readable  format.  All  chapters  have  been  updated 
in  accordance  with  recent  developments  in  the  field,  with  many  areas 
treated  In  greater  depth.  Special  attention  has  been  given  to  the 
spectacular  advances  in  genetics,  with  emphasis  on  microbial  genetics, 
cell  structure,  and  immunology.  DNA,  UNA,  and  protein  synthesis  are 
presented  so  that  the  student  can  easily  grasp  the  fundamental  me- 
chanisms of  synthesis  and  control  of  mocromolecules. 
410  Pages  182   Illustrations  Second   Edition,   1969  $9.00 

Cooper's  NOTRITION  IN  HEALTH  AND  DISEASE 

By    Helen    S.    Mitchell,    Ph.D.,    Sc.D.,    Hendeirka    J.    Rynbergen,    M.S., 
Linnea   Anderson,   M.P.H.,   and   Marjorie   Y.    Dibble,   M.S. 

A  comprehensive  survey  of  the  principles  of  nutrition  and  their  ap- 
plication to  normal  and  therapeutic  needs  is  presented  in  the  15th 
Edition  of  this  classic  text.  Additional  emphasis  is  given  to  the  under- 
lying biochemical  and  physiological  components  of  nutrition  as  they 
affect  the  maintenance  or  restoration  of  optimum  health. 
685  Pages  121    llustrations  15th   Edition,  1968  $9.50 


PHARMACOLOGY  AND  DRUG  THERAPY  IN  NURSING 

By    Morton    J.    Rodman,    M.S.,    Ph.D.,    and    Dorothy    W.    Smith,    R.N., 
M.S..  Ed.D. 

Thrs    text's    pharmacodynamic    approach    provides    the    student    with    a 

true  understanding  of  the  nature  of  drug  action  and  a  sound  rationale 

for    nursing    intervention.    Covers    sources,    dosage,    physiologic    action, 

untoward  effects,  contraindications  and  implications  for  nursing  action. 

".  . .  the  text.  Pharmacology  and  Drug  Therapy  in  Nursing,  stands  head 

and  shoulders  above  all  other  pharmacology  books  written  for  nurses." 

— American  Journal   of  Pharmaceutical  Education 

". .  .0    textbook    of    superb    quality  . .  ." — from    "Books    of    the    Year," 

American  Journol  of  Nursing 

738    Pages  Illustrated  1968  $10.25 

TEXTBOOK   OF  MEDICAL-SURGICAL   NURSING 

By   Lillian   S.   Brunner,   R.N.,   M.S.;   Charles   P.   Emerson,   Jr.,   M.D.;   L. 
Kraeer  Ferguson,   M.D.;   and   Doris   S.   Suddarth,   R.N.,   M.S.N. 

Massively  revised  and  enlarged  in  scope,  this  edition  is  designed  to 
develop  the  highest  degree  of  expertise  in  the  care  of  medical/surgical 
patients.  Exceptional  In  Its  depth  of  pathophysiologic  content,  this  text 
abo  emphasizes  the  psychosocial  factors  involved  in  patient  care. 
New  material  is  Included  on  vascular/cardioc/respiratory  intensive 
care  nursing/neurologic  and  neurosurgical  problems/burns/genitourinary 
and  gynecologic  disorder/rehabilitative  measures. 
1031   Pages  387  Illustrations  2nd  Edition,  1970  $14.95 

NURSING  CARE  OF  CHILDREN 

By    Florence    G.    Blake,    R.N.,    M.A.,    F.    Howell    Wright,    M.D.,    and 
Eugenia   H.   Waechter,   R.N.,   Ph.D. 

Extensively  revised  and  expanded,  with  numerous  new  illustrations, 
this  superb  text  is  without  peer  as  a  comprehensive,  in-depth  study 
of  pediatric  nursing.  Recent  findings  in  all  areas  of  care  are  included 
^■growth  and  development  (from  infancy  to  adolescence)  medical 
entities;  associated  nursing  therapies.  Consideration  is  given  to  prob- 
lems of  minority  groups  and  cultural  differences,  the  battered-child 
syndrome,  and  contemporary  problems  of  the  adolescent. 
588   Pages  254   Illustrations  8th   Edition,   1970  $9.50 

BASIC  PSYCHIATRIC  CONCEPTS  IN  NURSING 

By    Charles    K.    Hofling,    M.D.,    Madeleine    M.    Leininger,    R.N.,    Ph.D., 
and  Elizabeth   A.   Bregg,  R.N.,   B.S. 

By  presenting  basic  concepts  useful  in  all  areas  of  nursing,  the  authors 
provide  content  and  method  essential  to  the  practice  of  professional 
nursing  in  the  nonpsychiatric  as  well  as  the  psychiatric  setting. 
Emphasis  throughout  is  on  nursing  core  and  the  nurse's  significant 
role,  as  well  as  on  problem  solving,  process  recording  and  short  and 
long-term  nursing  goals. 
583    Pages  2nd    Edition,    1967  $7.25 


CONSIDER  THESE  OUTSTANDING 
TEXTS  FOR  UPCOMING  CLASSES 


J.  B.  LIPPINCOn  COMPANY  OF  CANADA  LTD. 

60  Front  Street  West 

Toronto    1 ,   Ont. 


SERVING  THE  HEALTH  PROFESSIONS  IN  CANADA  SINCE   1897 


THE  CANADIAN   NURSE 


JUNE  1971 


news 


RCAMC  Bursary  Announced 

Ottawa  —  The  Royal  Canadian  Army 
Medical  Corps  Fund  has  announced  an 
annual  bursary  of  $300  open  to  depend- 
ants of:  non-commissioned  members  of 
the  RCAMC,  Canadian  Forces,  who 
have  been  accepted  for  career  status; 
non-commissioned  members  or  former 
members  of  the  RCAMC,  Canadian 
Forces,  or  CA  (R),  who  have  served  a 
minimum  of  five  years  subsequent  to 
1950;  former  RCAMC  non-commis- 
sioned members  of  the  CASF  (Korea). 

The  bursary  will  be  awarded  to  a 
dependant  who  has  achieved  satisfactory 
scholastic  standing  in  the  entrance, 
first,  second,  or  third  year  of  a  recogniz- 
ed Canadian  university,  teachers'  col- 
lege, school  of  nursing,  or  institute  of 
technology  course  requiring  a  minimum 
of  2,400  hours  of  instruction. 

Further  details  may  be  obtained 
from  the  Secretary,  RCAMC  Bursary, 
Surgeon  General  Staff,  Canadian  Forces 
Headquarters,  Ottawa. 

Physician  Assistant's  Role 
Discussed  By  CPHA  Panel 

Toronto,  Ont.  —  The  nurse  is  the  per- 
son best  able  to  assume  the  role  of 
physician's  assistant,  according  to 
Walter  O.  Spitzer,  assistant  professor  of 
clinical  epidemiology  and  biostatistics 
at  McMaster  University,  Hamilton, 
Ontario.  He  was  a  member  of  a  panel 
discussing  "The  nurse  in  primary  care 
—  nurse  practitioner  or  physician 
assistant?"  at  the  annual  meeting  of  the 
Canadian  Public  Health  Association, 
held  in  Toronto  April  19  to  23. 

A  nurse  practitioner,  acting  as  phy- 
sician's assistant  or  associate,  would  be 
capable  of  handling  many  of  a  general 
practitioner's  primary  care  problems, 
he  said.  He  pointed  out  difficulties  a 
patient  often  encounters  in  finding  a 
general  practitioner,  and  suggested  that 
the  time  wasted  could  be  saved  by  using 
a  nurse  practitioner  in  the  primary  care 
field. 

Professor  Spitzeroutlined  a  Hamilton 
program  where  a  nurse  practitioner  sees 
a  patient  first,  decides  whether  she 
should  take  no  action,  intervene  herself, 
or  refer  the  patient  to  a  physician.  Addi- 
tional education  and  orientation  would 
be  necessary  if  the  nurse  is  to  take  on 
this  much  judgmental  responsibility, 
he  said,  but  added  he  believed  nurses 
were  competent  to  fill  the  role. 

Panelist  Dorothy  Kergin,  director, 
school  of  nursing  at  McMaster,  also 

JUNE  1971 


Checking  the  first  birthday  cake  of  the  York-Finch  General  Hospital,  Downs- 
view.  Ontario  are  nurses,  left  to  right,  Patricia  Hare,  Maureen  McAteer,  Donna 
Lagerquist,  Sherri  Watson,  Cathy  Sumner,  Irma  McLean,  and  Marie  Halladay. 
The  multi-layer  edifice,  under  examination  by  stethoscope,  was  concocted  by 
the  hospital's  baker.  Adding  to  the  festivities  was  the  announcement  that  the 
hospital  has  achieved  provisional  accreditation  from  the  Canadian  Council  on 
Hospital  Accreditation.  M.  Dowsett  is  director  of  nursing  at  York-Finch. 


noted  the  responsibility  that  physician's 
associates  would  be  asked  to  take.  In  a 
primary  health  care  unit,  her  duties  lie 
between  the  clerical  and  technical  duties 
of  a  physician's  assistant  and  the  larger 
responsibilities  of  a  physician's  substi- 
tute. "It  is  essential  that  the  nurse  and 
physician  work  together,  and  that  they 
mutually  agree  on  their  responsibili- 
ties," she  said. 

Physician  substitute  is  a  good  title  for 
the  nurse  in  the  north,  according  to  the 
third  panelist,  Anne  Wieler,  nursing 
officer  for  the  Yukon  Zone,  department 
of  national  health  and  welfare.  The 
nurse  is  often  the  only  person  in  a  com- 
munity with  the  necessary  health  know- 
ledge to  deal  with  health  problems, 
and  must  frequently  make  judgments 
beyond  usual  demands.  "The  nurse  is 
the  backbone  of  the  health  services  in 
the  north."  she  said,  "and  she  must  be 
capable  and  confident  enough  to  make 
such  decisions." 

Ciiairman  of  the  panel  was  Olivette 
Gareau.  coordinator  of  public  health 
services,  department  of  social  affairs, 
government  of  the  province  of  Quebec. 


RNABC  Supports  Munro's 
"Super  Nurses" 

Vancouver,  B.C.  —  The  Registered 
Nurses' Association  of  British  Columbia 
welcomed  statements  by  health  minister 
John  Munro  favoring  utilization  of 
nurses  to  meet  Canada's  shortage  of 
general  medical  practitioners.  In  a 
major  policy  speech  at  the  National 
Conference  on  Assistance  to  Physicians 
in  Ottawa,  April  7,  he  revealed  the  large 
role  reserved  for  doctors'  assistants  and 
referred  to  functions  that  could  be 
handled  by  these  "super  nurses." 

"We  are  gratified  to  learn  that  the 
health  minister  shares  our  view  that 
there  is  no  need  to  introduce  a  new 
category  of  health  worker  to  provide 
assistance  to  phvsicians,"  said  Monica 
Angus.  RNABC  president.  Last  fall, 
the  RNABC  supported  the  stand  of 
the  Canadian  Nurses'  Association  in 
opposing  the  introduction  of  such  a  new 
category  of  health  worker. 

"Nurses  constitute  a  large  and  ready 
pool  of  health  professionals  who.  with 
little  or  no  added  training,  could  move 
in  to  assume  greater  responsibilities," 

THE  CANADIAN   NURSE       7 


The  Third  Day  —  Summing  Up 
National  Conference  On  Assistance  To  The  Physician 


Mrs.  Angus  said.  "In  fact,  public  health 
nurses  already  carry  out  many  functions 
which  assist  the  physician,  as  do  many 
registered  nurses  employed  in  hospitals. 
We  certainly  favor  expanding  the  role 
of  the  registered  nurse  in  order  to  meet 
the  nation's  medical  problems  and  to 
curb  health  costs." 

CPHA  Agrees  To  CMA  Stand 
On  Smoking  And  Health 

Toronto,  Oni.  —  A  resolution  support- 
ing the  Canadian  Medical  Association's 
recommendations  on  smoking  and 
health  was  passed  without  debate  by  a 
general  meeting  of  members  of  the 
Canadian  Public  Health  Association. 
The  CPHA  annual  meeting  was  held  in 
Toronto,  April  19  to  23. 

These  recommendations,  submitted 
by  the  CMA  to  the  parliamentary  stand- 
ing committee  on  health,  welfare,  and 
social  affairs,  suggested  that  cigarette 
advertising  in  all  media  and  at  the  point 
of  sale  be  prohibited,  and  that  cigarette 
packages  carry  labels  indicating  that 
smoking  is  a  health  hazard.  The  label- 
ing, said  the  CMA,  should  indicate  the 
tar  and  nicotine  content  of  the  ciga- 
rettes. The  law  prohibiting  the  sale  of 
tobacco  to  minors  should  also  be  more 
strictly  enforced,  and  government  agen- 
cies encouraged  to  discontinue  any 
support  of  the  tobacco  industry. 

The  general  meeting  also  passed 
resolutions,  submitted  by  the  maternal 
and  child  health  section  of  the  CPHA, 
that  more  family  planning  programs 
be  established  by  departments  of  health, 
and  that  more  day-care  centers  be  set  up 
by  appropriate  agencies  for  the  children 
of  working  mothers. 

The  meeting  tabled  a  resolution  that 
children  between  the  age  of  one  year  and 
puberty  be  vaccinated  for  rubella,  that 
pregnant  women  not  be  vaccinated,  and 
that  women  of  childbearing  age  use 
acceptable  contraceptive  devices  for  two 
months  after  vaccination.  This  resolu- 
tion is  to  be  returned  to  the  laboratory 
division  of  the  CPHA  for  further  re- 
search on  the  effectiveness  of  immuniz- 
ing agents  and  the  safety  of  the  two- 
month  waiting  period  for  women. 

The  meeting  passed  a  resolution 
from  the  floor,  made  by  Donald  Kay, 
chairman  of  the  board  of  health  for 
Ottawa-Carleton  and  a  member  of  the 
board  of  directors  of  the  Ottawa  Com- 
munity Health  Foundation.  It  recom- 
mended that  the  incoming  executive 
of  the  CPHA  study  the  implications  of 
community  health  foundations  and 
make  recommendations  concerning  the 

8       THE  CANADIAN   NURSE 


Huguette  Labelle,  director  of  the  Vanier  School  of  Nursing,  Ottawa,  comments 
on  one  of  the  finer  points  discussed  at  the  national  conference  on  assistance  to 
the  physician,  sponsored  by  the  department  of  national  health  and  welfare  in 
April.  Jean  Jones,  a  consumer  of  health  services,  is  chairman,  with  Dr.  Alice 
Girard,  dean  of  the  faculty  of  nursing.  University  of  Montreal,  at  the  right. 
Beside  Mrs.  Labelle  is  Dr.  George  Szasz,  assistant  professor,  department  of 
health  care  and  epidemiology.  University  of  British  Columbia,  jotting  down 
notes  for  the  summary  he  gave  to  conclude  the  three-day  conference  in  Ottawa. 


financing  and  administration  of  such 
units  for  presentation  to  federal  and 
provincial  governments. 


Few  Manitoba  Nurses  Unemployed 

Winnipeg,  Man.  —  A  Manitoba  Asso- 
ciation of  Registered  Nurses'  survey  on 
unemployment  seems  to  indicate  few 
employment  problems  for  the  province's 
nurses.  Twenty-two  nurses  reported  they 
were  unemployed,  but  since  the  survey 
the  majority  of  them  have  found  em- 
ployment. 

MARN  believes  existing  unemploy- 
ment relates  to  geographical  factors 
and  selectivity  of  those  seeking  em- 
ployment. Vacancies  in  nursing  staffs 
still  exist  in  the  northern  areas  of  Man- 
itoba. 

A  study  of  342  graduates  of  Winni- 
peg hospital  schools  of  nursing  this 
year  reported  that  337  have  found  em- 
ployment. Most  new  graduates  located 
in  the  metropolitan  area. 

Family  Physicians  Want 
Nurses  As  Assistants 

Toronto,  Ont.  —  At  the  close  of  a  two- 
day  workshop  called  by  the  College  of 
Family  Physicians  of  Canada,  50  physi- 
cians and  nurses  went  on  record  as 
favoring  nurses  to  become  assistants  to 
family  physicians.  A  story  by  Leone 


Kirkwook,  in  the  Toronto  Globe  and 
Mail,  on  April  24,  said  the  delegates 
from  across  the  country  also  favored 
that  the  training  of  such  assistant  be  paid 
for  by  public  money  through  provincial 
departments  of  health. 

The  story  also  said  that  to  ensure 
the  report  is  not  pigeon-holed,  the 
responsibility  for  seeing  that  various 
groups  maintain  a  liaison  to  carry  out 
the  report  would  be  handed  over  to  the 
college's  provincial  chapters. 

On  the  first  day  of  the  workshop. 
Dr.  Harding  LeRiche,  school  of  hy- 
giene. University  of  Toronto,  warned 
that  patients  may  be  distrustful  of  a 
doctor's  assistant  unless  the  doctor 
introduces  the  assistant  with  care. 

Discussed  on  both  days  was  the  legal 
responsibility  of  nurses  taking  on  more 
duties.  Delegates  said  the  supervising 
doctor  would  still  be  responsible  but 
that  nurses  should  take  out  liability 
insurance. 


Immigrant  Nurses  Get 
Language  Reprieve 

Montreal,  P.Q.  —  An  amendment  to 
the  Quebec  Nurses  Act  grants  a  reprieve 
to  nurses  immigrating  to  the  province 
who  do  not  have  a  working  knowledge 
of  the  French  language.  This  amend- 
ment, passed  on  April  8,  allows  a  nurse 

JUNE  1971 


to  work  for  one  year  before  she  must 
meet  the  language  qualification  of  the 
Professional  Matriculation  Act.  (News, 
March,  page  10  and  May,  page  10.) 

The  revision  allows  any  person  who 
is  not  a  Canadian  citizen  and  who  does 
not  fulfill  all  the  conditions  of  the  act. 
but  who  lives  in  Quebec  and  is  other- 
wise qualified,  to  be  accepted  as  a  tem- 
porary member  by  the  Association  of 
Nurses  of  the  Province  of  Quebec.  The 
nurse  must  have  obtained  employment 
before  she  can  apply  for  a  temporary, 
non-renewable  permit  that  allows  her 
to  practice  her  profession  for  one  year 
only  and  at  the  specified  hospital. 

The  Quebec  department  of  immigra- 
tion must  be  informed  of  all  temporary 
permits  granted  and  their  expiration 
date.  The  year  can  be  used  by  the  nurse 
to  improve  her  French-language  profi- 
ciency by  taking  courses  offered  by  the 
provincial  government. 

The  ANPQ  has  been  in  continual 
contact  with  the  minister  of  social 
affairs  and  the  department  of  cultural 
affairs  and  immigration  concerning 
the  province's  much  debated  language 
legislation. 

Regional  Health  Care 
Advocated  For  Quebec 
By  Commission 

Quebec  City,  Quebec  —  The  fourth 
volume  of  the  province's  Castonguay- 
Nepveu  commission  of  inquiry  into 
health  and  social  welfare  services, 
entitled  Health,  recommends  a  re- 
structuring and  decentralization  of  the 
health  system.  The  commission,  which 
has  reported  since  1967,  released  its 
latest  volume  in  September. 

To  make  health  services  responsive 
to  the  needs  of  the  population,  the 
report  recommends  a  system  of  health 
care  distribution  making  every  com- 
ponent interdependent.  The  new  sys- 
tem would  be  open  to  the  community 
with  the  expectation  of  cooperation 
between  consumer  and  health  care  pro- 
fessionals to  provide  total  health  care. 

Quebec  would  be  divided  into  re- 
gions containing  five  levels  —  three 
levels  of  care  and  two  levels  of  ad- 
ministration. The  first  level  of  care 
would  be  the  local  health  center  giving 
primary  health  care  through  a  team  of 
health  professionals.  The  team  would 
include  general  practitioners,  nurses, 
social  workers,  dentists,  physiothera- 
pists, technicians,  etc.  Health  center 
meetings  would  be  open  to  the  public. 

At  the  next  level  is  the  community 
center  for  patients  referred  from  local 
units.  This  larger  unit  would  be  similar 
to  the  present  general  hospital,  but 
would  be  a  non-profit  institution.  Spe- 
cialists would  work  at  this  level,  either 
in  or  outside  the  hospital.  The  third- 
care  level  would  be  the  university  hospi- 

JUNE  1971 


POSEY  FOR  PATIENT  COMFORT 


The  new  Posey  products  shown 
here  are  but  a  few  included  in  the 
complete  Posey  Line.  Since  the 
introduction  of  the  original  Posey 
Safety  Beltjn  1937,  the  Posey 
Company  has  specialized  in 
hospital  and  nursing  products 
which  provide  maximum  patient 
protection  and  ease  of  care.  To 
insure  the  original  quality  product, 
always  specify  the  Posey  brand 
name  when  ordering. 

The  Posey  "Swiss  Cheese"  Heel 
Protector  has  new  hook  and  eye 
fasteners  for  easy  application  and 
sure  fit.  Available  in  convoluted 
porous  foam  or  synthetic  fur  lin- 
ing. #6727  (fur  lining),  #6722 
(foam),  $4.80  pr. 


The  Posey  Foot  Elevator  protects 
pressure  sensitive  feet  by  keeping 
them  completely  off  sheets.  A 
washable  flannel  liner  protects  the 
ankle.  Soft  polyurethane  foam  ring 
with  slick  plastic  shell  allows  pa- 
tient to  move  his  foot  freely. 
#6530   (4   inch  width  ),  $7.80. 


The  Posey  Foot-Guard  with  new 
"T"  bar  stabilizer  simultaneously 
keeps  weight  of  bedding  off  foot, 
helps  prevent  foot  drop  and  foot 
rotation.    #6472,   $21.00. 


The  Posey  Elbow  Protector  helps 
eliminate  pressure  sores  and  fric- 
tion burns.  Three  models  are  avail- 
able. #6220  (synthetic  fur  w/out 
plastic  lining),  $5.25  pair. 


The  Posey  Ventilated  Heel  Pro- 
tector helps  prevent  friction  and 
skin  breakdown  while  allowing 
free  movement.  The  newly  devel- 
oped closure  holds  heel  protector 
on  the  most  restless  patient.  #6770 
(wiplastic  shell),  $7.80  pr. 


Send  lor  the  free  all  new  POSEY  catalog-  supersedes  all  previous  editions. 
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THE  CANADIAN   NURSE 


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in 


The 

Canadian 
Nurse 


•  Midwives?  In  Canada? 
Let's  Hope  So! 

•  To  be  or  Not  to  be 

—  Disposable 

•  More  Hysterectomies 

—  Fact,  Fantasy,  or  Fad? 


Photo  Credits  for 
June  1971 


Canadian  Government  Photo 
Centre,  Dept.  Indian  Affairs 
&   Northern   Development, 
Ottawa,  cover  photo 

Roy  Nicholls  Photographer, 
Willowdale,  Ont.,  p.7 

Dept.  National  Health  & 
Welfare,    Information    Ser- 
vices, Ottawa,  p.8 

Julien  LeBourdais,  Toronto, 
pp.  II,  12,40,41 

The  Wellesley  Hospital, 
Toronto,  p.  1 8 

American  Journal  of  Nursing, 
New  York,  p.  19 

Photo  Features,  Ottawa,  p. 36 

Studio  Impact,  Ottawa,  p.38 

Armour  Landry,  Montreal, 
pp.  42,  43 

University  of  Cincinnati, 
Medical  Center,  Cincinnati, 
Ohio,  p.  46 


news 


tal  center,  which  would  be  assigned  the 
responsibility  for  research  and  educa- 
tion. This  hospital  would  give  highly 
specialized  and  general  care.  Leading 
specialists  in  their  field  would  work  at 
this  level. 

At  the  administrative  level,  the  pro- 
vincial governement  and  a  regional 
health  office  will  plan  health  care  ser- 
vices. The  regional  office  would  be 
responsible  for  the  optimum  production 
of  the  system.  Its  power  would  be  dele- 
gated by  the  province. 

The  provincial  department  of  health 
would  be  responsible  for  building  up 
a  health  record  service,  seeing  that  the 
public  health  service  advocated  becomes 
a  reality,  supervising  and  providing  ser- 
vices to  regional  administrative  organi- 
zations, and  planning  research  and 
education  programs.  The  actual  re- 
search and  education  programs  and  the 
funding  of  thpm  would  be  the  respons- 
ibility of  the  department  of  education. 

A  health  insurance  board  would 
function  to  protect  the  individual.  It 
would  set  standards  for  regulation  of 
the  professions.  The  board  would  pro- 
tect the  public  against  negligence  on  the 
part  of  the  administrative  services  with- 
in the  health  system. 

Claude  Castonguay  is  now  Quebec 
minister  of  social  affairs.  He  has  indi- 
cated legislation  will  be  put  forward 
during  the  current  session  of  the  legis- 
lature to  continue  the  regionalization 
process. 

Health  Of  City  Dwellers 
Discussed  At  CPHA  Session 

Toronto,  Ont.  —  The  health  problems 
of  Canadian  city  dwellers  received  the 
attention  of  three  speakers  at  a  session 
of  the  Canadian  Public  Health  Asso- 
ciation annual  meeting,  held  in  Toronto 
April  19  to  23.  The  session,  chaired  by 
G.H.  Bonham  of  the  Vancouver  Health 
Department,  heard  papers  on  the  effect 
of  high-rise  apartments  on  mental 
health,  the  difficulties  of  getting  to  a 
doctor,  and  the  particular  health  prob- 
lems of  metropolitan  Montreal. 

"The  higher  they  rise,  the  further 
they  fall,"  was  the  subtitle  of  the  paper 
on  high-rise  apartment  living  given  by 
Daniel  Cappon,  a  practicing  psychia- 
trist and  professor  of  urban  and  envi- 
ronmental studies  at  York  University, 
Toronto.  Although  there  is  not  yet  proof 
that  high-rise  living  impairs  mental 
health.  Dr.  Cappon  said,  "The  proper 
questions  have  not  been  asked  and  the 
fiinds  and  expertise  have  not  been  made 
available  for  a  study."  He  and  col- 
leagues at  York  University  are  consider- 
ing such  a  study. 


Dr.  Cappon  predicted  that  children 
will  be  shown  to  suffer  most,  since 
they  are  deprived  of  room  to  run  in  and 
cannot  make  the  normal  amount  of 
noise.  "Young  children  in  a  high-rise  are 
much  more  socially  deprived  of  neigh- 
borhood peers  and  activities  than  their 
single  family  dwelling  counterparts," 
he  said.  Adolescents  react  strongly  to 
what  Dr.  Cappon  called  the  "nothing- 
to-do  ennui,"  and  he  noted  that  "van- 
dalism rates  in  some  public  housing  is 
as  high  as  30  percent  of  total  mainte- 
nance costs." 

Donald  F.  Haythorne,  a  research 
assistant,  department  of  community 
medicine.  University  of  Alberta,  Ed- 
monton, outlined  the  results  of  a  study 
on  the  accessibility  of  doctors  to  pa- 
tients in  rural  and  urban  areas.  He  noted 
that  women,  the  less  well-educated,  the 
poor,  and  possibly  the  elderly,  had  most 
difficulty  in  seeing  a  doctor.  "The  im- 
portant point  is  that  certain  large  users 
of  physicians'  services  seem  to  have  the 
most  trouble  in  getting  to  a  doctor, 
especially  in  urban  areas,"  he  said. 
"Perhaps  one  might  conclude  from  this 
that  the  consumer  is  not  really  king 
when  the  product  is  health  services." 

Madeleine  Patry  of  the  Quebec  de- 
partment of  social  affairs  noted  the 
mflux  of  rural  people  into  the  center  of 
Montreal  and  the  exodus  of  the  well- 
to-do  to  the  suburban  areas.  The  stand- 
ards of  health  care  are  lower  in  poorer 
districts  than  in  the  wealthier  ones,  she 
said.  Infant  mortality  rates  in  poorer 
districts  are  as  high  as  30  per  1,000, 
while  in  wealthier  areas  they  are  as  low 
as  1 5  per  1,000,  noted  Miss  Patry.  "But 
the  poor  are  beginning  to  realize  that 
adequate  medical  care  is  a  right,  not  a 
privilege  for  the  rich,"  she  added.  "For 
example,  the  emergency  departments  of 
hospitals  are  being  used  by  the  poor  at  a 
rate  that  increases  by  about  1 0  percent 
annually." 


Results  Of  Ryerson  Study 
Disclosed  At  RNAO  Meeting 

Toronto,  Ont.  —  Graduates  of  the 
two-year  diploma  nursing  program  at 
Ryerson  Polytechnical  Institute  in 
Toronto  like  nursing  and  patients 
better,  are  more  willing  to  learn,  and 
are  more  ambitious  than  graduates  of 
hospital  schools  of  nursing. 

At  least  these  are  some  of  the  find- 
ings from  a  five-year  study  of  the  first 
Canadian  diploma  program  in  nurs- 
ing conducted  within  a  general  educa- 
tion system. 

Moyra  Allen,  associate  professor 
in  the  School  for  Graduate  Nurses  at 
McGill  University,  and  Mary  Reidy,  a 
lecturer  in  nursing  at  McGill  and  re- 
search associate  for  the  Ryerson  pro- 
ject, made  public  their  study  of  109 


10     THE  CANADIAN  NURSE 


JUNE  1971 


It  was  autograph  time  for  Mary  Reidy,  left,  and  Moyra  Allen,  right,  at  the  annual 
meeting  of  the  Registered  Nurses'  Association  of  Ontario  in  Toronto  April  29. 
Their  five-year  study  of  the  Ryerson  Nursing  Program,  Learning  to  Nurse,  is 
available  in  a  270-page  report  from  the  RNAO.  To  order  a  copy  of  this  study, 
complete  the  coupon  on  page  1 3  of  this  issue  of  The  Canadian  Nurse. 


Ryerson  graduates  at  the  annual  meet- 
ing of  the  Registered  Nurses'  Associa- 
tion of  Ontario  April  29.  RNAO  com- 
missioned the  $58,000  study,  which  was 
partly  financed  through  a  $20,000 
National  Health  Grant. 

This  study  compares  Ryerson  stu- 
dents with  students  of  two  large  hospit- 
al schools  and  one  autonomous  school. 
The  schools  all  differed  from  one  an- 
other and  had  the  reputation  of  being 
progressive,  the  report  says. 

The  interviewers  went  into  15  hos- 
pitals to  speak  to  head  nurses,  direc- 
tors of  nursing,  and  the  graduate  nurses. 
As  well.  Dr.  Allen  and  Mrs.  Reidy 
visited  hospital  wards  throughout  the 
five  years  to  observe  the  Ryerson  stu- 
dents. The  research  was  aimed  at  de- 
termining factors  that  appear  to  influ- 
ence students  as  they  learn  to  nurse; 
identifying  the  consequences  for  stu- 
dents with  respect  to  what  they  learn 
and  the  type  of  nurse  they  become; 
describing  and  assessing  the  major 
factors  that  support  or  interfere  with 
operation  of  the  nursing  education 
program;  and  studying  the  performance 
of  the  Ryerson  graduates  and  the  way 
they  fit  into  the  work  world. 

According  to  the  270-page  study, 
Ryerson  graduates  come  from  homes 
and  families  of  "diverse  ethnic  back- 
grounds, languages  and  customs."  They 
enter  Ryerson  with  little  family  or 
community  support,  and  see  them- 
selves as  lacking  self-confidence,  aver- 

JUNE  1971 


age  in  organizational  ability,  above 
average  in  self-discipline,  and  well 
above  average  in  independence. 

The  Ryerson  student  often  holds  a 
job  to  support  herself,  has  many  friends 
outside  Ryerson,  and  is  often  married. 
"Her  personality  development  results 
in  increased  intellectual  curiosity,  in- 
sight, and  ability  to  express  her  feelings 
and  desires  .  .  .  ." 

She  is  also  much  more  career-orient- 
ed than  students  from  the  hospital 
schools.  Although  similar  to  students 
in  the  hospital  schools  at  the  begin- 
ning of  the  program,  the  Ryerson  stu- 
dent becomes  increasingly  different 
from  them  as  she  moves  through  the 
program. 

Ryerson's  nursing  program  consists 
of  six  semesters,  including  summer 
semesters.  The  study  describes  Ryer- 
son as  a  "large,  active,  multi-disciplined 
institution,  housing  many  programs  and 
a  wide  diversity  of  staff  and  stu- 
dents .  .  .  .'  On  the  whole,  it  operates 
with  a  minimum  of  rules  and  regulations 
and  imposes  few  restrictions  on  stu- 
dents. Members  of  the  nursing  faculty 
tend  to  be  open-minded  and  receptive 
to  new  ideas.  They  interpret  nursing  in 
a  dynamic  way  and  give  the  student 
freedom  "to  reach  out  and  develop  her 
nursing  skills  .... 

"The  'richness  of  the  system"  .  .  . 
promotes  the  development  of  a  broad 
background,  varied  interests  and  an 
intellectual  and  cultural  outlook  .  .  .  ." 


This  hand 

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are  saving  up  to  50%  on  bandaging 
costs  by  using  Tubegauz  instead  of 
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THE  CANADIAN   NURSE     11 


news 


Summarizing  the  Ryerson  graduate, 
the  study  says;  "On  the  one  hand,  she  is 
flexible,  adaptive  and  independent. 
She  is  able  to  think  things  through,  ap- 
plies basic  principles  and  is  willmg  to 
learn.  She  is  articulate  and  uses  super- 
visory staff  for  support  and  reference. 
She  respects  herself  and  her  patient, 
is  [  interested  ]  in  them  and  is  able  to 
give  emotional  support  to  them.  She  is 
an  eager  young  woman  skilled  in  the 
communication  arts  who  fits  well  into 
the  work  world. 

"On  the  other  [hand],  she  lacks 
self-confidence,  is  initially  slower  in 
procedures,  needs  extra  help  in  taking 
charge,  and  in  the  eyes  of  the  directors 
of  nursing,  has  not  had  enough  exper- 
ience." 

"We  don't  need  any  more  studies 
like  this,"  Dr.  Allen  said.  Instead,  she 
pointed  to  the  need  for  ongoing  evalua- 
tion and  change  within  a  program,  and 
the  need  to  put  new  ideas  into  practice. 
She  considers  the  fact  that  Ryerson  was 
able  to  give  nursing  students  more 
community  experience  an  important 
advantage  of  this  type  of  program.  And 
until  nursing  moves  increasingly  into 
general  education.  Dr.  Allen  said, 
there  won't  be  much  change  in  nursing. 


Abortion  Debate  Miscarries 
At  RNAO  Annual  Meeting 

Toronto,  Onl.  —  Voting  delegates  at 
the  annual  meeting  of  the  Registered 
Nurses'  Association  of  Ontario  April 
28  to  May  1  supported  a  resolution  of 
their  board  of  directors  that  RNAO 
withhold  endorsement  of  the  Canadian 
Nurses'  Association  statement  on 
abortion.  An  amendment  to  this  res- 
olution adds  "because  the  association 
does  not  wish  to  make  a  statement 
on  abortion  at  this  time." 

The  CNA  statement  is  being  con- 
sidered by  all  provincial  associations, 
which  have  been  asked  for  their  reac- 
tions by  June  20. 

During  the  discussion  on  this  issue, 
one  nurse  asked  that  a  great  deal  of 
thought  be  given  to  a  provincial  family 
planning  council.  She  said  that  because 
this  was  a  legal,  medical,  social,  moral, 
and  religious  issue,  the  main  emphasis 
should  not  be  on  abortion  alone. 

A  number  of  nurses  said  they  favor- 
ed this  amendment  because  voting  on 
abortion  at  the  chapter  level  had  been 
divided.  One  nurse  said:  "As  wives, 
mothers,  and  nurses,  we  are  exposed  to 
a  greater  degree  than  most  women  to 
the  facts  of  life.  If  we  can't  make  a  deci- 
sion, who  can?" 

12     THE  CANADIAN   NURSE 


Bob  Henry  told  fellow  members  at  the 
annual  meeting  of  the  Registered 
Nurses'  Association  of  Ontario  April 
29,  that  their  resolution  on  abortion 
did  not  face  up  "to  the  realities  of  the 
situation."  Following  lively  debate  on 
an  RNAO  board  of  directors'  resolution 
that  withheld  endorsement  of  the  Ca- 
nadian Nurses'  Association's  state- 
ment on  abortion,  delegates  supported 
their  board's  stand,  adding  an  amend- 
ment that  they  do  "not  wish  to  make  a 
statement  on  abortion  at  this  time." 


A  different  point  of  view  was  ex- 
pressed by  a  nurse  who  said  it  takes 
courage  to  take  a  stand.  "RNAO  has 
failed  to  take  stands.  We  must  put 
aside  our  pettiness,  grow,  and  .  .  .  com- 
mit [ourselves] ,"  she  said. 

But  another  nurse  commented,  "No 
organization  can  support  a  moral  is- 
sue." 

"We  need  a  lot  more  discussion  and 
information  before  we  can  make  a 
statement,"  said  an  RNAO  member. 
Another  delegate  asked,  "What  facilities 
will  be  needed  if  abortion  on  demand  is 
granted?"  If  it  is  granted,  she  asked, 
what  guarantees  will  there  be  that  the 
criminal  abortion  rate  will  decrease? 
What  safeguards  on  the  performance 
of  abortion  will  there  be?  Could  abor- 
tion take  place  anywhere?  Will  women 
desiring  an  abortion  be  able  to  get  it 
in  time  if  facilities  are  overburdened? 

Before  the  discussion  began,  RNAO's 
legal  counsel,  Ross  Butters,  told  the 
nurses:  "If  you  make  a  stand,  you  must 
be  sure  it  could  not  become  a  divisive 
influence." 

Mr.  Butters  told  The  Canadian  nurse 
that  he  questions  whether  the  RNAO 
should  make  a  statement  on  an  issue 
such  as  abortion.  He  said  debate  is 
good,  but  the  association  shouldn't  get 


into  a  social  fight  over  the  issue. 

"No  matter  what  RNAO  says,  it 
would  be  wrong  to  many  segments  of 
society,"  Mr.  Butters  said.  He  pointed 
out  that  this  was  the  first  time  he 
thought  it  was  proper  to  give  general, 
as  opposed  to  technical,  legal  advice 
to  the  association.  A  suggestion  he  had 
was  that  nurses  hold  a  workshop  on 
abortion  and  open  it  to  the  news  media. 

Some  strong  criticism  was  raised 
during  the  discussion  on  abortion  by 
Bob  Henry,  a  delegate  from  Hamilton. 
He  called  the  amendment  to  the  RNAO 
board  resolution  a  "cop-out"  because 
it  did  not  face  up  "io  the  realities  of 
the  situation." 


Problems  Of  Pregnant  Teenager 
Discussed  At  Symposium 

Toronto,  Ont.  —  The  problems  of  the 
pregnant  teenager  were  illustrated 
by  a  survey  of  20  pregnant  girls  in- 
terviewed by  the  adolescent  unit,  Mon- 
treal Children's  Hospital.  Dr.  Peter 
Benjamin,  director  of  the  unit,  dis- 
cussed the  survey  at  a  March  sympos- 
ium on  adolescent  sexuality  attended 
by  doctors,  nurses,  social  workers, 
clergy,  and  teachers. 

Fourteen  of  the  girls  hoped  to  return 
to  school  after  their  babies  were  born; 
15  had  intercourse  with  only  one  boy; 
14  had  been  exposed  to  some  contra- 
ceptive information,  but  15  had  used 
no  contraceptive  at  all;  10  came  from 
intact  families  and  10  from  broken 
homes;  13  families  were  willing  to  al- 
low the  girl's  relationship  with  the  boy 
to  continue,  but  the  relationship  con- 
tinued in  only  four  cases,  and  only  one 
for  more  than  a  year. 

Dr.  Benjamin  said  his  unit  used 
to  see  about  three  or  four  pregnant 
teenagers  a  year.  "From  about  1968, 
our  clinic  has  become  increasingly 
known  and  we  have  allotted  a  special 
day  for  teenage  obstetrical  and  gyne- 
cological problems.  We  now  have  20 
to  25  pregnant  adolescents  at  a  time." 

Dr.  Marion  G.  Powell,  assistant 
medical  officer  of  health,  Scarborough 
department  of  health,  Toronto,  said 
pregnancy  is  the  leading  cause  of  school 
dropout  of  young  girls.  The  increase 
in  sexual  activity  among  adolescents 
can  be  gauged  by  the  number  of  preg- 
nancies and  cases  of  venereal  disease, 
she  said. 

"There  are  more  pregnant  girls  in 
our  schools,  the  illegitimacy  rate  is 
rising,  abortions  performed  on  girls 
under  the  age  of  1 8  are  increasing,  and 
young  girls  are  appearing  in  our  family 
planning  clinics  requesting  birth  con- 
trol," said  Dr.  Powell.  "The  consequen- 
ces of  teenage  pregnancy  are  far-reach- 
ing. Because  of  the  nature  of  the  phy- 
siological process  we  focus  on  the  girl 

(Coiiliniii'd  on  pafte  14) 
JUNE  1971 


Ann  OTarrell  dressed 
our  best  dressed  patient 
successfully. 

On  our  50th  anniversary. 

So  we  are  sending  a  five  hundred  dollar 
donation,  in  Ann's  name,  to  the  hospital  fund  she 
selected;  The  Royal  Jubilee  Hospital,  Department  of 
Coronary  Care,  in  Victoria,  B.C.  Ann's  was  the  first 
correct  entry  selected  from  the  many  sent  in  by 
nurses  from  all  over  Canada,  in  the  first  of  three 
"dress  our  best  dressed  patient"  contests  this  year. 
To  Ann  and  all  the  other  nurses,  we  say  a  big 
'thank  you'  for  entering  our  contest. 

SMITH  &  NEPHEW  LTD. 

21 00  -  52nd  Avenue,  Lachine,  Quebec,  Canada.  


Limited  edition  -  order  your  copy  NOW! 
LEARNING      TO     NURSE 

The  First  Five  Years  of  The  Ryerson  Nursing  Program 

by 

MOYRA  ALLEN  MARY  REIDY 

Associate  Professor  of  Nursing      &     Research  Associate 
McGill  University  Ryerson  Project 

As  described  in  the  article  on  page  10 of  this  issue,  LEARNING  TO  NURSE  is  of  particular 
interest  to  those  involved  in  nursing  education,  nurse  utilization,  nursing  administration, 
the  preparation  of  teachers  of  nursing,  and  nursing  research. 


LEARNING  TO  NURSE      RNAO      33  Price  Street,  Toronto,  Ont. 

Please  send copies  at  $5.75  ea.  (including  postage  &  handling)  to: 

Name     

Address      


My  cheque,  postal  or  money  order  for  $ is  enclosed. 


JUNE  1971 


THE  CANADIAN   NURSE     13 


Just  as  you 

can't  call  any 

waterfall 

Niagara 


you  can't  call 

any  Conform 

Bandage  a 

KLING* 

BANDAGE. 

There's  really  only  one  KLING 
Conform  Bandage  —  by  Johnson 
&  Johnson. 

KLING  Is  the  unique,  soft,  all  ab- 
sorbent cotton  bandage  that  is 
more  than  equal  to  the  bandaging 
requirements  of  areas  that  are  hard 
to  bandage  and  hard  to  keep  ban- 
daged. 

Because  KLING  is  self-adhering,  it 
clings  to  itself,  conforming  to  un- 
usual contours  and  resisting  flex- 
Induced  slippage.  KLING  Conform 
Bandage's  elasticity  permits  it  to 
stretch  over  40%,  so  not  to  con- 
strict swelling  areas. 
KLING  Conform  Bandages  —  5 
yds.  when  stretched  are  supplied 
in  the  following  widths:  1"  —  2" 
—  3"  —  4"  —  6"  —  in  bulk  or  pre- 
wrap. 

KLING 

CONFORM  BANDAGE 
THE  BANDAGE  THAT 
REALLY  CONFORMS 

MONTREAL  A  TORONTO-  CANADA 

"Trademark  of  Johnson  &  Johnson 
Limited  or  affiliated  companies 

14     THE  CANADIAN   NURSE 


(Continued  from  pane  12) 

and  her  problem.  I  frequently  see 
couples  where  guilt  and  concern  are 
more  evident  in  the  boy.  We  seldom 
consider  the  need  of  these  boys  as  we 
help  the  girls  work  out  a  satisfactory 
solution  to  their  pregnancy,"  said  Dr. 
Powell. 

Chairmen  of  the  program  were 
Dr.  Walter  J.  Hannah  and  Dr.  Donald 
C.  Moore,  both  of  the  department  of 
obstetrics  and  gynecology,  Women's 
College  Hospital,  Toronto.  Also  speak- 
ing were  Dr.  Beryle  Chernick  and  Dr. 
Avinoam  Chernick  of  London,  Ont., 
and  Betty  J.  Garbutt,  coordinator, 
women's  programs,  Calgary  school 
board,  Calgary,  Alberta. 

Master's  Program  Study 
Planned  By  CCUSN(AR) 
Fredehcton,  N.B.  —  A  study  of  facili- 
ties and  the  kind  of  master's  level  pro- 
gram suited  to  their  region  is  planned 
by  the  Canadian  Conference  of  Uni- 
versity Schools  of  Nursing,  Atlantic 
Region.  President  Carolyn  Pepler  of 
the  University  of  New  Brunswick  spoke 
about  the  plan  at  a  meeting  held  in 
Antigonish,  N.S.,  in  April. 

The  37  members  present  discussed 
the  results  of  a  follow-up  study  of  1 963- 
1970  graduates  of  baccalaureate  pro- 
grams in  the  Atlantic  provinces.  The 
study  of  72  graduates  who  responded 
from  across  Canada  and  the  United 
States  showed  that: 

•96  percent  believed  that  it  was  im- 
portant to  work  at  bedside  after  gradua- 
tion; 

•  40  percent,  who  are  now  teachers  and 
administrators,  had  worked  as  a  general 
staff  nurse  for  an  average  of  12.6 
months; 

•  28  percent  said  they  planned  to  go  on 
to  further  education,  teaching,  or  ad- 
ministration; 

•  87.5  percent  said  their  student  clinical 
experience  was  sufficient  to  allow  them 
to  give  satisfying  care  to  patients. 


Insulin  Discovered 
Fifty  Years  Ago 

Toronto,  Ont.  —  Canadian  Diabetic 
Association  president  Harold  H.  Alex- 
ander of  Toronto  has  announced  that  the 
association  plans  jubilee  year  recogni- 
tion of  the  discovery  of  insulin  by  the 
Canadian  research  team  of  Frederick 
Banting  and  Charles  H.  Best. 

Banting  and  Best  made  the  medical 
breakthrough  in  the  autumn  of  1921. 
Dr.  Best,  who  lives  in  Toronto  and  is 
the  honorary  president  of  the  Canadian 


Diabetic  Association,  will  figure  largely 
in  the  anniversary  celebrations  to  be 
climaxed  in  October  with  country-wide 
observances. 

The  two  Canadian  Medical  pioneers 
and  Nobel  prize  winners  who  made  the 
discovery  were  honored  by  govern- 
ments, universities,  and  societies  around 
the  world.  Dr.  Banting  was  killed  in  a 
plane  crash  in  1941. 

"The  significance  of  this  discovery 
can  hardly  be  computed,"  said  Mr. 
Alexander.  "It  is  estimated  that  25 
million  lives  have  been  saved  because 
of  the  discovery  of  insulin.  For  those 
who  have  diabetes,  it  becomes  a  daily 
miracle." 

Mr.  Alexander  said  further  research 
is  needed  if  medical  science  is  to  dis- 
cover why  people  get  diabetes  and  to 
find  a  cure.  "This  jubilee  year  is  a  fit- 
ting one  for  Canada  to  take  further 
strides  toward  the  final  conquest  of 
diabetes,"  he  added. 

Collective  Bargaining 

A  Charade,  B.C.  Nurses  Told 

Vancouver,  B.C.  —  Nurses  were  urged 
April  29  to  develop  mature  approaches 
to  changing  modes  of  collective  bar- 
gaining. 

Speaking  to  117  nurses  at  a  two- 
day  Registered  Nurses'  Association 
of  British  Columbia  staff  represent- 
atives' conference,  the  director  of 
management  services  at  The  Vancouver 
General  Hospital  predicted  the  demise 
of  collective  bargaining  as  it  operates 
now. 

Joseph  Roberts  said:  "Collective 
bargaining  is  going  to  become  more 
sophisticated.  I  firmy  believe  we  should 
dispense  with  collective  bargaining  as 
we've  known  it.  It's  had  it." 

Noting  that  British  Columbia  nurses 
were  the  first  to  bargain  with  hospitals 
on  a  provincial  basis,  and  that  "we 
learned  a  lot  from  each  other  over  the 
years,"  Mr.  Roberts  challenged  nursing 
to  show  professional  leadership  in  labor 
relations.  "Professional  groups  such  as 
yours  can  lead  the  way  in  getting  away 
from  what  I  call  charade  of  collective 
bargaining." 

Mr.  Roberts  is  a  member  of  the 
B.C.  Hospitals'  Association  Employee 
Relations  Council,  which  is  one  of 
four  councils  in  the  hospitals  associa- 
tion structure.  Outlining  the  BCHA's 
organizational  structure  for  labor  rela- 
tions, Mr.  Roberts  charged  that  the 
association's  bargaining  committee  is 
outweighed  by  hospital  administrators. 
"Due  to  the  imbalance,  administrators 
have  undue  weight  and  influence"  on  the 
committee  for  negotiations,  which 
"should  be  the  responsibility  of  the 
trustees." 

He  said  he  would  like  to  see  direc- 
tors of  nursing  on  the  bargaining  com- 

JUNE  1971 


mittee  for  BCHA  to  give  technical 
advice  on  nursing.  But  he  admitted 
that  since  they  were  RNABC  members, 
some  members  of  the  Employee  Rela- 
tions Council  were  not  ready  to  accept 
this  idea. 

Referring  to  the  negotiations  ahead, 
Mr.  Roberts  said  the  hospitals'  bargain- 
ing committee  would  de -emphasize  the 
academic  route  of  advancement  that 
"we  see  in  nursing  today."  He  advised 
his  audience  to  back  nursing  demands 
with  well  documented,  "irrefutable 
statistical  evidence."  And  he  predicted 
a  1 0-hour  work  day  and  four-day  week 
for  nurses. 

Another  speaker  said  that  a  study  of 
recent  decisions  by  the  B.C.  Labour 
Relations  Board  reflects  the  Board's 
desire  to  have  "all  employee  units" 
certified  for  bargaining.  Chris  Waddell, 
director  of  the  Women's  Bureau  in  the 
B.C.  department  of  labour,  said  the  ra- 
pidly expanding  field  of  white-collar 
employment  formed  the  major  new 
frontier  for  trade  unionism  and  collec- 
tive bargaining  in  Canada. 

"...  significant  characteristics  of 
this  new  unionism  are  the  complex 
problems  and  controversies  associated 
with  determining  the  appropriate  bar- 
gaining unit,"  she  explained. 

The  conference  ended  with  voting 
on  contract  proposals  for  negotiations 
on  major  hospital  contracts,  which  are 
to  begin  this  fall. 

RNAO  Wants  College  Of  Nurses 
To  Continue  Jurisdiction 
Over  Nursing  Assistants 

Toronto,  Ont.  —  Ontario's  minister 
of  health  reminded  registered  nurses 
May  1  of  one  of  the  government's 
"guiding  principles"  that  "no  [health] 
discipline  should  have  regulatory  pow- 
er over  another."  These  "guiding  prin- 
ciples," which  resulted  from  the  Report 
of  the  Committee  on  the  Healing  Arts, 
are  being  used  by  the  Ontario  govern- 
ment as  a  basis  for  new  legislation  on 
the  regulation  and  education  of  the 
health  disciplines. 

But  nurses  attending  the  annual 
meeting  of  the  Registered  Nurses'  Asso- 
ciation of  Ontario  passed  a  resolution 
that  RNAO  strongly  oppose  removing 
regulatory  responsibilities  for  register- 
ed nursing  assistants  from  the  College 
of  Nurses  of  Ontario.  The  college  is 
the  statutory  body  responsible  for  car- 
rying out  the  terms  of  the  Nurses'  Act 
of  1961-62. 

According  to  this  resolution,  the 
unity  of  nursing  within  the  College  of 
Nurses  is  endangered  by  the  supfwrt 
of  the  Ontario  Association  of  Register- 
ed Nursing  Assistants  (OARNA)  for  a 
proposal  to  transfer  responsibility  for 
certification  and  discipline  of  RNAs 
from  the  College  of  Nurses  to  the  gov- 
ernment's profxjsed  Health  Disciplines 

JUNE  1971 


Regulation  Board  (March  News,  page 
13). 

However,  the  nurses  defeated  a  resol- 
ution that  RNAO  support  the  prin- 
ciple that  RNAs  be  elected  to  the  Coun- 
cil of  the  College  of  Nurses  of  Ontario 
on  the  same  basis  as  RNs.  The  only 
RNA  on  the  Council,  which  carries  on 
the  College's  business,  is  appointed 
by  OARNA.  There  are  16  RNs  elect- 
ed to  the  Council  and  four  appointed 
by  the  RNAO. 

As  the  Nurses'  Act  1961-62  now 
stands,  membership  in  the  College  of 


Nurses  is  open  only  to  RNs,  although 
the  college  sets  minimums  standards  of 
education,  registration,  and  practice  of 
both  RNs  and  RNAs. 

Earlier  in  this  closing  session  of 
the  annual  meeting,  nurses  received  a 
position  paper  on  Registration  of 
Nursing  Personnel  in  the  '70s,  prepared 
by  the  College  of  Nurses.  The  paper 
included  a  resolution  that  "the  present 
designations  [of]  Registered  Nursing 
Assistant  'and  Registered  Nurse  be 
eliminated  and  all  licensed  nurse 
practitioners    be    called    Nurse;    that 


EMEMENCyi 


make  no  mistake  about  it! 

Another  patient  is  rushed  into  the  emergency  room,  but  even  before 
diagnosis  and  treatment  he  must  be  identified  or  assigned  a  number. 
The  reason  is  obvious  and  compelling:  the  right  treatment  must  be 
given  to  the  right  patient... even  if  he  is  unconscious,  confused,  or 
unable  to  speak. 

Hospitals  throughout  the  United  States  are  solving  this  real  problem 
with  a  proven  method  of  identification:  Emergency  Room  Ident-A- 
Band  by  Hollister.  Takes  only  seconds  to  apply  to  the  wrist  of  each 
emergency  patient.  Hospital  number  and  name  (if  known)  are  hand 
lettered  right  on  the  band.  No  insert  card  is  required.  Its  distinctive 
color  singles  out  the  emergency  patient  from  all  others. 


a 


HOLLISTER 


LTD..  332  CONSUMERS  ROAD.  WILLOWDALE.  ONTARIO 


THE  CANADIAN   NURSE     15 


Nurses  Attend  Military  Executive  Course 


(Coiitiniiecl  from  pai>e  15) 

licensing  be  at  the  primary  level;  that 
certification  be  given  for  defined  ad- 
ditional competency  levels;  and  that  up- 
ward and/or  lateral  mobility  be  facili- 
tated within  the  nursing  discipline." 

The  Council  of  the  College,  which 
passed  this  resolution  unanimously 
at  a  February  1971  meeting,  based  it 
on  the  concepts  that  nursing  is  one 
discipline,  provided  by  persons  edu- 
cated at  different  levels,  whose  prep- 
aration and  experience  enable  each  to 
contribute  to  the  overall  nursing  care 
within  the  health  care  delivery  system, 
and  that  the  current  registered  nursing 
assistant  functions  at  the  primary  level 
in  providing  safe  nursing  care. 

Elsbeth  Geiger,  president  of  the 
College  of  Nurses,  explained  to  the 
RNAO  members  how  the  College 
proposes  to  replace  registration  with 
licensure.  Nurses  would  be  placed  on 
one  of  three  registers  —  one  each  for 
RN,  RNA,  and  baccalaureate  levels  — 
and  would  be  given  a  license  to  practice 
at  that  level.  However,  upgrading 
through  education  would  be  actively 
encouraged.  The  masters  level  would 
be  considered  as  an  added  competency 
level,  rather  than  a  basic  one,  and  would 
be  recognized  through  certification. 
Miss  Geiger  said  that  persons  now 
registered  automatically  would  be 
placed  on  the  register. 

Asked  whether  the  profession  is 
ready  for  licensing.  Miss  Geiger  said: 
"We  are  much  more  ready  for  licensure 
today  than  we  were  five  years  ago." 

The  RNAO  members  were  asked  to 
think  over  the  College's  recommenda- 
tions, not  to  vote  on  them. 


iCN  Committee  To  Define 
"Active"  Membership  Term 

Geneva,  Switzerland  —  The  future 
structure  and  development  of  the  Inter- 
national Council  of  Nurses  in  the  mem- 
bership field  was  discussed  by  the 
membership  committee  at  a  meeting 
February  3-5,  1971.  Lyle  Creelman  of 
Canada  is  committee  chairman. 

ICN's  board  of  directors  asked  the 
committee  to  define  "active"  mem- 
bership of  an  association  as  used  in  the 
ICN  constitution.  The  interpretation 
of  these  words  varies  with  each  national 
nurses'  association,  said  the  board.  Ihe 
committee  believes  it  is  the  responsi- 
bility of  each  association  to  define  its 
own  categories  of  membership,  but 
that  ICN  has  a  responsibility  to  define 
the  term  as  used  in  ICN  regulations. 
The  committee  will  recommend  a  defi- 

16     THE  CANADIAN   NURSE 


Along  with  professional  expertise,  nurses  who  are  members  of  the  Canadian 
Armed  Forces  have  to  cope  with  the  military  aspects  of  their  careers.  They 
must  have  knowledge  of  service  procedures,  military  executive  skills,  and 
related  subjects.  Five  nurses  from  bases  across  Canada,  left  to  right,  Patricia 
Traynor,  Joan  Cashin,  M.P.  Lavoie.  D.  Proudler,  and  Edythe  Amiroult,  attend- 
ed a  10-week  course  for  captains  at  the  Canadian  Forces  Staff  School  in  To- 
ronto. They  were  the  only  female  officers  among  96  officers  from  land,  sea, 
and  air  elements  of  the  forces  taking  the  course  in  Toronto. 


nition,  for  ICN  purposes,  of  the  term 
"active"  member,  at  the  Council  of 
National  Representatives  meeting  in 
1973. 

The  committee  was  also  requested 
by  the  board  to  study  the  relationship  of 
ICN  with  regional  groups  of  nurses' 
associations.  Committee  members 
agreed  that  the  present  informal  and 
undefined  relationship  should  be  con- 


REMEMBER 

HELP  YOUR  RED  CROSS 

TO  HELP 


tinued.  There  was  also  agreement  that 
the  formation  and  development  of  such 
groups  can  be  of  benefit  and  should 
be  fostered  by  ICN 

The  board  also  referred  to  the  com- 
mittee the  question  that  some  form  of 
membership  be  offered  to  groups  of 
nurses  or  associations  unable  to  fulfill 
all  the  requirements  for  full  member- 
ship. The  committee  stressed  the  need 
for  ICN  to  encourage  and  to  maintain 
contacts  with  national  nurses'  associa- 
tions not  yet  members.  The  committee 
will  suggest  ways  this  could  be  done 
and  privileges  that  might  be  granted. 

Fifty  associations  or  goups  are  in 
contact  with  ICN.  The  committee  will 
follow  further  developments  and  pre- 
sent membership  recommendations  at 
the  1973  CNR  meeting. 

The  nurses  elected  to  the  member- 
ship committee  will  serve  until  1973. 
Members  attending  the  meeting  under 
Miss  Creelman's  chairmanship  were: 
Olive  Anstey,  Australia;  Phyllis  Friend, 
United  Kingdom;  Kofoworola  Pratt, 
Nigeria;  Beatrice  Salmon,  New  Zea- 
land; and  Julie  Symes,  Jamaica.         ^ 

JUNE  1971 


.n  LnUuu  nMu 

BEAUTIFUL  IDEAS 


There's  more  to  La  Cross  than  pro- 
fessional good  looks.  Count  on  La 
Cross  for  comfort,  long  wear  and 
easy  care  fabrics.  La  Cross  ...  the 
name  to  trust  for  value  in  quality 
nursing  fashions. 


« 


Action  sleeve  gussets  on  ttie  jacket.  Pants  have 
elasticized  waistband  and  a  permanently  stitched 
crease.  Pants  are  sold  separately. 

RIBBED  KNIT  JERSEY  TRICOT 

Style  2703  (Jacket)  Retails  about  $14.98 

Style  2734  (Pants)  Retails  about  $10.98 

SIZES  6  to  18 


This  and  other  styles  available  at  uniform  shops  and 
department  stores  across  Canada. 


PROFESSIONAL  UNIFORMS 


La  Cross  Uniform  Corp., 
4530  Clark  St.,  Montreal,  Que. 

Please  send  me  a  copy  of  your  latest  Catalogue. 
Also,  I  would  like  to  know  the  store  nearest  me 
where  I  can  purchase  La  Cross  Uniforms. 


NAME 


ADDRESS 
CITY 


PROVINCE 


names 


Lisette       A  r  c  a  n  d 

(R.N.,  St.  Joseph's 
Hospital  School  of 
Nursing,  Three  Riv- 
ers; PHN,  U.  of 
Montreal;  B.A., 
Centre  des  etudes 
universitaires  de 
Trois-Ri  vieres; 
B.Sc.N.,U.  of  Mont- 
real; M.N.,  U.  of  Montreal)  has  been 
appointed  to  the  directorate  of  planning 
and  research.  Social  Affairs  depart- 
ment of  the  province  of  Quebec. 

She  is  in  the  planning  division  of  the 
directorate,  where  she  studies  and  de- 
fines the  health  and  welfare  needs  of 
the  public,  recommends  programs  to  be 
initiated,  and  evaluates  their  effects. 

Her  previous  experience  includes 
hospital  service  in  Trois  Rivieres,  and 
public  health  service  with  the  Quebec 
government  as  staff  nurse  acting  as 
counselor  on  instruction  and  upgrading 
of  personnel.  She  has  been  a  visiting 
instructor  at  the  University  of  Montreal, 
Laval  University,  and  the  University  of 
Quebec;  a  CEGEP  instructor  in  inser- 
vice  education;  and  instructor  in  public 
health  at  the  Center  of  University  Stud- 
ies in  Three  Rivers. 

Rita  Dussault,  for- 
merly associate  pro- 
fessor and  vice-dean 
of  the  faculty  of 
nursing  at  the  Uni- 
versity of  Montreal, 
became  director  of 
the  school  of  nurs- 
ing sciences  at  La- 
val University  in 
Quebec  City  this  month.  She  replaces 
the  late  Claire  Gagnon-Mailhiot. 

Miss  Dussault  earned  a  B.Sc.N. 
degree  at  L'Institut  Marguerite  d'You- 
ville,  Montreal,  and  an  M.Sc.N.  degree 
at  the  Catholic  University  of  America, 
Washington. 

Prior  to  joining  the  faculty  of  the 
University  of  Montreal  in  1964,  Miss 
Dussault  taught  at  I'Hopital  St -Jean, 
St-Jean,  Quebec. 

Fay  Cook  of  Wakaw  has  been  elected 
by  the  Saskatchewan  Registered  Nurses' 
Association  Council  to  replace  Jean 
Belfry  of  Regina,  who  has  resigned  as 
chairman  of  the  nursing  service  com- 
mittee. Miss  Cook  is  the  director  of 
nursing  at  Wakaw  Union  Hospital. 

18     THE  CANADIAN  NURSE 


Building  Named  After  Wellesley's  Former  Nursing  Director 


In  appreciation  of  her  35  years  of  service,  Mrs.  C.A.  LaVenture,  the  former 
Elsie  K.  Jones,  was  honored  on  April  14  by  having  the  nurses'  residence  of  the 
Wellesley  Hospital,  Toronto,  officially  named  The  Elsie  K.  Jones  Building. 
Mrs.  LaVenture  points  to  the  room  she  had  when  she  was  director  of  nursing 
at  Wellesley.  Looking  on  with  "Jonesy"  are  nursing  students,  left  to  right,  Joan 
Fitzgerald,  Patricia  Sharp,  Sheryl  Fisher,  and  Phillipa  Tucker.  In  making  the 
presentation  of  the  architect's  sketch,  G.E.  Thornton,  executive  director,  told 
friends  and  colleagues  present  for  the  occasion,  "Miss  Jones  was  the  person 
who  held  the  Wellesley  hospital  together  through  many  crises  and  developed 
a  tremendous  spirit  among  the  staff." 


Audrey  (Jarvis)  Cro- 
teau  was  named  di- 
rector, nursing  ser- 
vice division,  Miser- 
icordia  General 
Hospital,  Winnipeg, 
last  November. 

Mrs.  Croteau 
(R.N.,  St.  Boniface 
General  Hospital 
School  of  Nursing;  cert,  nursing  educa- 
tion, supervision  and  teaching,  U.  of 
Manitoba)  has  just  completed  the  Ca- 
nadian Hospital  Association's  exten- 
sion course  in  hospital  organization 
and  management. 

Following  four  years  as  a  nursing 
sister  in  Canada  and  Western  Europe 
during  World  War  II,  Mrs.  Croteau's 
career  centered  around  operating  room 
nursing  and  nursing  education.  Prior 
to  her  present  appointment,  Mrs.  Cro- 


teau was  associate  director  of  nursing 
service  at  the  Misericordia  General 
Hospital. 

Active  in  the  Manitoba  Association 
of  Registered  Nurses  as  member-at- 
large,  board  of  directors,  and  chairman 
of  the  legislation  committee  of  District 
no.  1,  Mrs.  Croteau  is  also  president  of 
the  nursing  education  alumni  of  the 
University  of  Manitoba  and  president 
of  the  Winnipeg  Unit,  Nursing  Sisters' 
Association  of  Canada. 


Susan  Davies  (Reg.N.,  Lady  Minto 
Hospital  School  of  Nursing,  Cochrane, 
Ont.)  was  honored  by  more  than  300 
citizens  of  Smooth  Rock  Falls  on  the 
occasion  of  her  retirement  from  nursing 
this  spring. 

Early  in  her  nursing  career  in  Smooth 
Rock  Falls,  babies  were  born  at  home. 


JUNE  1971 


\ 


In  winter,  this  meant  walicing,  using  a 
dog  team,  or,  later,  a  make-shift  snow- 
mobile. 

When  the  present  Smooth  Rock  Falls 
hospital  was  opened  in  1949,  Miss 
Davies  became  its  director  of  nursing, 
a  post  she  held  at  the  time  of  her  retire- 
ment. 

Barbara  C.  Schutt,  editor  of  the  Amer- 
ican Journal  of  Nursing  since  1958, 
has  relinquished  the  reins  of  her  re- 
sponsible position  to  become  a  part-time 
contributing  editor.  Workmg  on  special 
assignments  for  the  journal,  she  will  be 
able  to  enjoy  her  home  in  Connecticut 
and  to  escape  the  hurly-burly  of  New 
York  City. 

Miss  Schutt  (R.N. ,  Jefferson  Medical 
College  Hospital  School  of  Nursing, 
Philadelphia;  B.A.,  Bethany  College, 
W.Va.;  M.A.,  U.  of  Pennsylvania)  had 
experience  in  general  duty  and  army 
nursing,  camp  and  college  health  nurs- 
ing, and  teaching.  She  was  for  several 
years  on  the  staff  of  the  Pennsylvania 
Nurses'  Association,  and  was  involved 
with  the  economic  security  program  of 
the  American  Nurses'  Association.  This 
wide  experience  enhanced  her  invalu- 
able contribution  to  her  position  of 
editor  of  the  Journal. 

In  another  staff  change,  Thelma 
Schorr  (Believue,  N.Y.,  B.S.,  Columbia 
U.,)  a  journal  staff  member  since  early 
1950,  has  been  named  executive  editor 
of  AJN  to  head  the  magazine  staff  until 
a  new  chief  editor  is  named.  A  search 
committee  has  been  appointed. 


Dr.  T.W.  Fyles  has  been  appx^inted 
vice-president  (health  sciences)  of  the 
University  of  Manitoba.  He  was  form- 
erly dean  of  the  faculty  of  medicine. 

Dr.  Fyles  assumes  respronsibility  at 
the  direction  of  the  president  for  the 
supervision  of  the  faculties  of  medicine 
and  dentistry,  the  school  of  nursing,  and 
the  faculty  of  pharmacy.  He  also  makes 
recommendations  to  the  president  on 
the  organization,  interrelation,  and 
development  of  the  health  science  fac- 
ulties. 


Emily    Melnyk    was 

app)ointed  director 
of  nursing,  Bloor- 
view  Children's 
Hospital,  Toronto, 
-—    -  '"  January,  having 

a*  '— -ix^^^M  been  assistant  direc- 
^m  .^^gjj^^B  tor  of  nursing  since 
|H^  ^^H  1968. 
I^H  wKKM  A  native  of  the 
Ukraine,  Mrs.  Melnyk  graduated  from 
the  University  School  of  Nursing,  Graz, 
Austria.   On   coming   to  Canada   she 

JUNE  1971 


Barbara  G.  Schutt,  who  resigned  as  editor  of  the  American  Journal  of  Nursing 
March  31,  was  honored  by  the  AJN  Company  board  of  directors  at  a  dinner  on 
April  15  at  the  St.  Regis-Sheraton  Hotel  in  New  York  City.  Above,  Miss  Schutt 
is  seen  with  Philip  E.  Day,  publishing  director  of  the  company.  The  190  persons 
attending  the  dinner  included  past  presidents  of  the  American  Nurses"  Associa- 
tion, executives  of  state  nurses'  associations,  and  other  national  figures.  Repre- 
senting the  Canadian  Nurses'  Association  and  its  two  journals  were  Virginia  A. 
Lindabury,  editor  of  The  Canadian  Nurse,  and  Claire  Bigue,  editor  of  L'infirmiere 
canadienne.  Miss  Lindabury  (left  in  photo  below)  and  Miss  Bigue  (right)  chat- 
with  ANA  and  AJN  personnel  after  the  dinner  at  the  St.  Re"i>- 


THE  CANADIAN   NURSE     19 


a  show  of  hands... 


proves  its  smoothness 


NEW  FORMULA  ALCOJEL,  with 
added  lubricant  and  emollient,  will 
not  dry  out  the  patient's  skin — 
or  yours! 

ALCOJEL  is  the  economical,  modern, 
jelly  form  of  rubbing  alcohol.  When 
applied  to  the  skin,  its  slow  flow 
ensures  that  it  will  not  run  off,  drip 
or  evaporate.  You  have  ample  time 
to  control  and  spread  it. 

ALCOJEL  cools  by  evaporation  .  .  . 
cleans,  disinfects  and  firms  the  skin. 

Your  patients  will  enjoy  the 
invigorating  effect  of  a  body  rub  with 
Alcojel  .  .  .  the  topical  tonic. 


ALCOJEL 

Send  for  a  free  sample 

through  your  hospital  pharmacist. 


IJellied 

RUBBING 

ALCOHOI- 


VWTH 

ADDED 

UJBRlCANTaml 


rBDH. 


BDH  PHARMACEUTICALS 

Barclay  Ave..  Toronto  550,  Ontario 


names 


enrolled  as  a  special  student  at  the 
Royal  Victoria  Hospital,  Montreal,  to 
obtain  registration  in  Canada.  Interested 
in  the  young,  her  nursing  career  has 
included  staff  nursing  at  the  Hospital 
for  Sick  Children  and  school  nursing 
at  Upper  Canada  College  in  Toronto. 
For  some  years  Mrs.  Melnyk  was  with 
the  Ontario  Department  of  Health 
as  clinical  instructor  in  pediatrics  at  the 
Nursing  Assistant  Centre. 

The  Mildred  I.  Walker  Bursary  Fund 
was  established  at  The  University  of 
Western  Ontario  Faculty  of  Nursing 
by  the  many  students  and  friends  of 
Miss  Walker.  This  year  awards  have 
been  given  to:  Nancy  E.  Evans,  Lynda 
.Johnston,  and  Shirley  McCracken. 

Voters  of  Langley,  B.C.,  elected  A.  Iris 
Mooney  as  alderman  for  1 97 1 .  As 
head  nurse  in  obstetrics  at  the  Lang- 
ley  Memorial  Hospital,  her  slogan 
was:  "Vote  for  Iris  —  she  delivers." 
Mrs.  Mooney  is  past  chairman  of  the 
committee  on  social  and  economic 
welfare  of  the  Registered  Nurses'  Asso- 
ciation of  British  Columbia. 


Mary  E.  (Christie)  Miller  (B.Sc.N.,  U. 
of  British  Columbia  School  of  Nursing) 
has  been  appointed  temporarily  by  the 
Registered  Nurses'  Association  of  Brit- 
ish Columbia  to  assist  in  the  depart- 
ment of  nursing  education  services.  She 
has  been  a  staff  nurse  in  pediatrics  at 
St.  Paul's  Hospital,  and,  as  a  member 
of  the  program  faculty  of  the  B.C. 
Institute  of  Technology,  has  taught 
pediatric  nursing.  ■g? 


20     THE  CANADIAN   NURSE 


JUNE  1971 


new  products     { 


Descriptions  are  based  on  information 
supplied  by  the  manufacturer.  No 
endorsement  is  intended. 


Monitoring 

General  Electric's  modularized  patient 
monitoring  equipment  makes  possible 
on-line,  continuous,  in  vivo  monitoring 
of  blood/gas  pC02  with  a  disposable 
sensor.  Although  designed  for  greater 
safety  in  anesthetic  management  and  in 
the  conduct  of  both  elective  and  emer- 
gency surgery  in  poor-risk  patients,  the 
system   is  also  useful   for   long-term, 

JUNE   1971 


Equipment 

continuous  monitoring  of  critically  ill 
patients  in  intensive,  coronary,  neo- 
natal, and  respiratory  care  units. 

This  pC02  monitor  eliminates  the 
need  for  discrete  blood  sampling  and 
extra-corporeal  shunts,  as  the  sensor 
is  inserted  directly  into  the  radial  ar- 
tery. A  standard  16-gauge  intra-arterial 
cannula  is  used  to  make  the  puncture 


and  position  the  sensor.  A  Seldinger 
"T"  adapter  with  a  3 -way  stopcock 
permits  monitoring  of  blood  pressure 
and  drawing  of  samples  through  the 
same  arterial  stick. 

The  system,  including  the  sensor, 
pCO  2  amplifier,  digital  pC02  readout, 
temperature  readout,  and  graph  record- 
er, provides  fast  reaction  to  changes 
in  pC02  partial  pressures. 

Blood/gas  pC02  information  is 
digitally  displayed  in  one  millimeter 
increments  over  the  full  scale  range. 
A  graph  module  continuously  and  ac- 
curately prints  out  a  permanent  record 
of  pC02. 

Each  sensor,  consisting  of  a  central 
insulated  electrode  circumscribed  by  a 
tubular  silver/silver  chloride  reference 
electrode,  is  packaged  in  its  own  sterile 
electrolyte-filled  plastic  straw.  After 
being  perfused  with  a  known  percent- 
age of  CO2  in  air  in  a  special  perfusion 
box  for  48  hours,  the  straw  contains  a 
known  partial  pressure  of  the  gas.  The 
sensor  is  then  inserted  in  the  amplifier's 
heater  block  where  it  is  brought  up  to 
37  degrees  C.  After  five  minutes,  the 
operator  merely  adjusts  the  calibrate 
control  until  the  digital  readout  matches 
the  known  concentration  in  the  sensor 
container.  Calibration  is  then  com- 
pleted. 

Close  temperature  measurement 
and  regulation  are  also  essential  for  ac- 
curate pC02  monitoring.  The  GE  blood 
gas  monitoring  system  employs  a  spe- 
cial module  to  provide  a  digital  dis- 
play of  the  patient's  temperature.  1  his 
information  is  duplicated  on  the  tem- 
perature compensation  control,  which 
adjusts  from  29  to  40  degrees  C,  imme- 
diately following  insertion. 

As  with  all  GE  monitoring  system 
components,  safety  is  designed  into 
the  blood  gas  monitor.  The  sterile, 
disposable  electrodes  are  non-toxic, 
non-thrombogenic,  and  bio-compatible. 
Since  there  is  no  need  to  clean  and 
resterilize  the  equipment,  cross-contam- 
ination is  eliminated.  The  simple  one 
step  calibration  procedure  can  be  ac- 
complished without  compromising 
sensor  sterility.  Electrical  safety  is  also 
assured.  The  system  will  provide  neither 
the  source  nor  the  path  for  leakage  cur- 
rents greater  than  10  microamperes. 

For  more  information,  write  Gen- 
eral Electric  Medical  Systems  Limited, 
3311  Bay  view  Avenue,  Toronto,  Ont. 

THE  CANADIAN   NURSE     21 


new  products 


Levobex-C  Tablets 

Levobex-C  by  Winley-Morris  is  a  spec- 
ific preparation  for  sufferers  of  Parkin- 
son's disease. 

Evidence  of  antagonism  between  the 
actions  of  pyridoxine  (Vitamin  B12) 
and  Levodopa  has  resulted  in  pyridox- 
ine being  contraindicated  when  Levo- 
dopa is  being  used  in  the  treatment  of 
paricinsonism. 

As  Pari<inson's  disease  is  a  condi- 
tion of  maturity  onset,  and  the  older 
patient  is  frequently  debilitated,  the 
hematinic  profile  of  such  patients  may 
be  most  important  to  the  clinician. 
Thus  Vitamin  B12  and  folic  acid  are 
deliberately  excluded  so  that  therapy 
with  water-soluble  fractions  of  B-Com- 
plex  can  be  given  without  interfering 
with  the  correct  diagnosis  of  the  hema- 
tological state  of  the  patient. 

In  recent  years,  more  credence  has 
been  afforded  to  the  use  of  large  doses 
of  ascorbic  acid  in  surgical  cases  to 
promote  wound  healing,  improve  iron 
absorption  and  the  blood  lipid  picture. 
It  may  also  decrease  capillary  fragility 
in  the  older  patient. 

Levobex-C  is,  therefore,  offered  as 
concomitant  therapy  with  Levodopa 
for  patients  with  Parkinson's  disease. 

Full  prescribing  information  and  file 
reference  card  are  available  from  Win- 
ley-Morris Co.  Ltd.,  675  Montee  de 
Liesse,  Montreal  377.  Quebec. 

Lasix  Tablets  Now  Colored  Yellow 

Hoechst  Pharmaceuticals,  division  of 
Canadian  Hoechst  Limited,  has  an- 
nounced that  the  color  of  Lasix  tablets 
is  now  yellow,  instead  of  the  traditional 
white. 

The  formula  and  the  coding  on  the 
tablets  remain  the  same.  Easier  ident- 
ification has  been  cited  as  the  prime 
reason  for  the  change.  Increasing  use 
of  the  diuretic/antihypertensive  was 
also  a  chief  factor  leading  to  the  change. 

All  trade  packages  will  be  especially 
marked  until  the  end  of  June,  and  all 
pharmacies  are  supplied  with  appropri- 
ate stickers  to  be  used  when  filling 
prescriptions. 

Stoxil  0.5%  Ophthalmic  Ointment 

Stoxil  0.5  percent  ophthalmic  ointment, 
a  new  companion  product  to  Stoxil 
0. 1  percent  ophthalmic  solution  widely 
used  in  the  treatment  of  herpes  simplex 
keratitis,  is  now  available  from  Smith 
Kline  &  French  Canada  Ltd. 

For  several  years  Stoxil  0.5  percent 
ophthalmic  ointment  has  been  available 
to  ophthalmologists  on  written  request. 
Now,  in  response  to  requests  from  many 

22     THE  CANADIAN   NURSE 


Kejlin  and  Keflex 


leading  Canadian  ophthalmologists, 
this  form  is  being  made  available  com- 
mercially. 

Stoxil  0.5  percent  ophthalmic  oint- 
ment is  easy  to  use,  does  not  require 
refrigeration,  and  remains  stable  for 
two  years  at  room  temperature. 

The  ointment  is  supplied  in  4  Gm. 
tubes,  and  the  solution  in  15  ml.  bottles 
with  dropper.  Both  forms  are  available 
on  prescription  only. 

Further  information  can  be  obtained 
from  Smith  Kline  &  French  Canada 
Ltd.,  Montreal  379,  Quebec. 

Keflex,  An  Oral  Cephalosporin 

Two  cephalosporin  antibiotics  have 
been  introduced  by  Eli  Lilly  and  Com- 
pany (Canada)  Limited.  The  world's 
first  oral  cephalosporin,  Keflex  (cepha- 
lexin monohydrate)  is  supplied  in 
250  mg.  green  and  white  opaque  cap- 
sules bearing  Identi-Code  No.  H69  for 
easy  identification.  Also  introduced  is 
Keflinl.V.(sodiumcephalothin)  suppli- 
ed in  I  Gm.,  10  ml.  rubber-stoppered 
ampoules,  Identi-Code  No.  N57. 

These  cephalosporin  antibiotics  are 
effective  against  a  wide  range  of  infec- 
Uons  and  are  unusually  safe. 

Further  information  may  be  obtained 
form  Eli  Lilly  and  Company  (Canada) 
Limited,  P.O.  Box  4037,  Terminal 
'A",  Toronto  I  16,  Ontario. 

Sheepskin  Heel  Booties 

Alconox  Duralamb  natural  sheepskin 
heel  booties  can  be  repeatedly  machine- 
or  hand-laundered,  yet  remain  resilient, 
absorbent,  and  supple.  Tanned  by  a 
method  devised  by  the  U.S.  Depart- 


ment of  Agriculture,  the  washable  med- 
ical shearling  has  long-life  economy, 
offering  superior  advantages  in  the 
relief  of  pressure-sensitive  skin  and  the 
prevention  of  decubitus  ulcers. 

The  natural  protein  of  these  sheep- 
skin heel  booties  is,  compatible  with 
human  skin.  The  medical  shearling 
can  absorb  up  to  20  percent  of  its  own 
weight  in  moisture  and  avoids  the 
"clamminess"  resulting  from  non-ab- 
sorbent synthetics  in  contact  with  the 
skin.  Because  the  soft  wool  fibers  of 
shearling  are  resilient  and  do  not  mat, 
they  form  a  comfortable  cushion  with 
adequate  air  circulation  and  minimal 
he&t  of  body  moisture  buildup.  Shear- 
ling does  not  contribute  to  air-borne 
lint,  as  each  fiber  is  naturally  embedded 
in  the  seude-like  skin  backing. 

The  heel  booties,  shaped  for  easy, 
comfortable  fit,  are  fastened  by  non- 
slip  laces.  The  company  also  offers 
sheepskin  bedpads,  elbow  pads,  and 
wheelchair  pads. 

For  additional  information  write 
to  Alconox,  Inc.,  215  Park  Ave.,  S., 
New  York.  N.Y.  10003. 


JUNE  1971 


LaBarge  Electronic  Thermometer 

An  electronic  thermometer  designed 
to  reduce  hospital  and  nursing  home 
costs,  eliminate  the  danger  of  cross 
infection,  and  speed  patient  service  has 
been  introduced  by  LaBarge,  Inc. 

It  has  been  estimated  that  each  time 
a  patient's  temperature  is  taken  by  a 
mercury  thermometer,  the  cost  per 
patient  ranges  from  four  cents  to  eight 
cents,  depending  on  such  factors  as  the 
cost  of  washing,  packaging,  cleaning 
equipment,  breakage,  and  the  initial 
investment  in  thermometers.  The  La- 
Baree  electronic  thermometer  reduces 
that  cost  to  less  than  1>^  cents  per 
patient,  including  the  cost  and  opera- 
tion of  the  instrument  and  the  dispos- 
able cover. 

The  LaBarge  electronic  thermometer 
takes  temperatures  in  approximately 
20  seconds,  compared  to  three  to  five 
minutes  for  a  merf^ury  glass  thermom- 
eter. It  uses  a  stei.le,  disposable  cover 
that  eliminates  cross  infection  and  re- 
infection. 

There  is  no  breakage  problem  of 
the  kind  associated  with  glass  ther- 
mometers, rendering  it  safe  for  ger- 
iatric and  pediatric  patients. 

The  LaBarge  electronic  thermom- 
eter, weighing  1 0  ounces,  may  be  carried 
in  a  pocket  or  suspended  from  the  wrist. 
Made  of  sturdy,  high-impact  plastic,  it 
contains  two  durable,  long-life,  9-volt 
transistor  batteries. 

In  addition,  the  operation  of  the 
LaBarge  electronic  thermometer  is 
simple.  Hospital  personnel  were  trained 
to  use  the  thermometer  in  about  15 
minutes.  During  the  hospital  evalua- 
tion, there  was  ready  acceptance  by  the 
nursing  staff,  and  there  were  no  com- 
plaints from  patients. 

The  LaBarge  electronic  thermom- 
eter is  marketed  by  the  Medical  Elec- 
tronics Group  of  the  LaBarge  Elec- 
tronics Division  through  hospital  supply 
dealers  and  distributors.  For  informa- 
tion write  to  Dede  Thompson  of  Ber- 
nard Swartz,  Ruder  &  Finn,  Inc.,  1 10 
East  59th  St.,  New  York,  N.Y.  10022 


Prepodyne  Scrub 

Prepodyne  Scrub,  a  microbicidal  skin 
cleaner  containing  a  "Tamed  Iodine" 
complex  in  a  lathering  base  especially 
compounded  for  hospital  use,  is  avail- 
able from  West  Chemical  Products  Inc. 

Prepodyne  is  highly  recommended 
for  use  as  a  pre-  and  postoperative 
scrub  and  as  a  handwashing  agent  in 
all  areas  of  the  hospital. 

Prepodyne  Scrub  destroys  a  broad 
range  of  microorganisms,  and  will  not 
irritate  or  sensitize  skin  tissue.  The 
"Tamed  Iodine"  complex  helps  reduce 
the  microbial  flora  of  the  skin,  and 
destroys  various  viruses,  bacteria,  fungi, 
and  yeasts. 


^'^i^^ 


Electronic  Thermometer 


For  additional  information  on  Pre- 
podyne Scrub,  now  available  in  gallons, 
but  soon  to  be  available  in  pints,  write 
Professional  Division,  West  Chemical 
Products,  Inc.,  42- 1 6  West  Street,  Long 
Island  City,  N.Y.  11101. 

Fractions  of  Human  Blood  Plasma 

With  the  addition  of  two  new  products. 
Armour  Pharmaceutical  Company  now 
markets  a  full  line  of  therapeutic  frac- 
tions of  human  blood  plasma. 

The  new  blood  products  are  normal 
serum  albumin  (human)  U.S. P.  5%  and 
Plasma-Plex  plasma  protein  fraction 
(human)  U.S.P.  5%  solution  heat-treat- 
ed. They  are  used  as  blood  volume 
expanders  for  shock,  burns,  and  in 
hypoproteinemia. 

Armour  Pharmaceutical's  three  other 
blood  components  are:  normal  serum 
albumin  (human)  U.S.P.  25%  salt  poor, 
important  in  fighting  shock;  immune 
serum  globulin  (human)  U.S.P.,  useful 
in  providing  passive  immunity  against 
viral  diseases  such  as  measles,  hepatitis, 
and  poliomyelitis;  and  tetanus  immune 
globulin  (human)  U.S.P.,  for  protection 
against  tetanus  infections. 

The  selective  use  of  blood  fractions 
Dffers  three  major  advantages  over  the 
use  of  whole  blood.  The  possibility  of 


JUNE  1971 


the  patient  contracting  serum  hepatitis 
is  reduced;  the  patient  is  given  only  the 
fraction  or  fractions  of  blood  that  he 
actually  needs;  and  human  blood,  as  a 
valuable  resource,  is  conserved  by 
permitting  it  to  fill  the  needs  of  several 
patients  instead  of  one  only. 

For  further  information  write  Ar- 
mour-Dial, Inc.,  Box  9222,  Chicago, 
Illinois  60690. 


Automatic  Chestfilmer  System 

An  eight-page,  three-color,  illustrated 
brochure  describes  Picker's  Automatic 
Chestfilmer  System:  from  exposure  to 
dry  diagnostic  film  takes  less  than  two 
minutes.  With  it,  approximately  one- 
third  of  an  x-ray  department's  case 
load  can  be  handled  in  a  single  small 
room. 

The  brochure  describes  the  design 
features  that  make  high-volume  radio- 
graphy possible  and  explains  the  eco- 
nomic benefits  that  can  result  from  tak- 
ing films  of  the  chest  with  this  system. 

To  request  a  copy  of  the  brochure 
write  Roger  Tinkham,  Picker  Corpora- 
tion, 595  Miner  Road,  Cleveland,  Ohio 
44143,  or  Picker  X-Ray  Engineering 
Ltd.,  100  Dresden  Ave.,  Montreal, 
Quebec.  '& 

THE  CANADIAN   NURSE     23 


June  11, 1971 

First  Quo  Vadis  Alumni  Reunion,  to  be 
held  at  the  Quo  Vadis  School  of  Nursing, 
Toronto.  For  further  information  contact: 
Mrs.  Bev  Lowther,  24  Shawford  Cres.,  Scar- 
borough, Ont. 


June  17-19, 1971 

Canadian  Association  of  Neurological 
and  Neurosurgical  Nurses,  second  annual 
meeting,  held  in  conjunction  with  the  Ca- 
nadian Congress  of  Neurological  Sciences, 
St.  John's,  Newfoundland.  For  further 
Information  contact  the  Secretary:  Mrs. 
Jacqueline  LeBlanc,  5785  Cote  des  Nei- 
ges,  Montreal  290,  Quebec. 


June  21-23, 1971 

Operating  Room  Nurses  of  Greater  To- 
ronto seventh  annual  conference,  Royal 
York  Hotel,  Toronto.  For  further  informa- 
tion contact:  Miss  Marilyn  Brown,  2178 
Queen  St.  E.,  Apt.  4,  Toronto  13,  Ontario. 


June  21-24, 1971 

Canadian  Society  of  Radiological  Techni- 
cians, 29th  annual  national  convention. 
Holiday  Inn,  St.  John's,  Newfoundland. 


July  3-4, 1971 

Reunion  of  Hotel-Dieu  de  L'Assomption  and 
the  Dr.  Georges  L.  Dumont  Hospital  School 
of  Nursing  graduates,  Moncton,  N.B.  For 
further  information  write:  Miss  Mabel  Deva- 
rennes,  343  Archibald  St.,  Moncton,  N.B. 


July  8-10, 1971 

Reunion  and  Saskatchewan  Homecoming, 
St.  Paul's  Hospital  Nurses'  Alumnae.  Send 
addresses  and  enquiries  to:  Mrs.  Rita 
Taylor,  433  Ottawa  Ave.  South,  Saskatoon, 
Saskatchewan. 


July  12-16, 1971 

Twenty-first  International  Tuberculosis 
Conference,  The  Palace  of  Congresses,  the 
Kremlin,  Moscow,  Russia.  Simultaneous 
translation  into  English,  French,  German, 
and  Russian  will  be  provided. 

24     THE  CANADIAN   NURSE 


July  13-19,1971 

International     Hospital     Federation 
gress,  Dublin,  Ireland. 


Con- 


July  24-25, 1971 

Alumnae  reunion  for  graduates  of  St. 
Joseph's  Hospital  School  of  Nursing, 
Saint  John,  N.B.,  in  conjunction  withclosing 
of  the  nursing  school.  Please  contact; 
Sister  A.M.  McGloan,  St.  Joseph's  Hospital, 
Saint  John,  N.B. 


August  2-6, 1971 

"Short  Course  on  Laser  Safety,"  Uni- 
versity of  Cincinnati,  Cincinnati,  Ohio. 
Tuition:  $325.  For  further  information 
write:  R.J.  Rockwell,  Laser  Laboratory, 
Children's  Hospital  Research  Foundation, 
Cincinnati,  Ohio  45229,  U.S.A. 


August  4-8, 1971 

Summer     Couchiching     Conference, 
planning  title:  "Privacy." 


P  re- 


August  22-28, 1971 

An  instrumental  one-week  course  to  pro- 
vide essential  information  for  those  indi- 
viduals dealing  with  problems  related  to 
misuse  of  alcohol  and  other  drugs, 
sponsored  by  Addiction  Research  Foun- 
dation, to  be  held  at  Lakehead  University, 
Thunder  Bay,  Ont.  Enrollment  limited  to 
80.  For  further  information  write:  Director, 
Summer  Courses,  Addiction  Research 
Foundation,  Education  Division,  33  Rus- 
sell St.,  Toronto  4,  Ontario 


August  23, 1971 

American  Academy  of  Medical  Admin- 
istrators, 14th  annual  convocation,  lunch- 
eon, and  reception.  Continental  Plaza 
Hotel,  Chicago,  Illinois,  U.S.A. 


August  23-27, 1971 

Sixth  International  Congress  of  School  and 
University  Health  and  Medicine,  Lisbon, 
Portugal. 


August  27-September  1, 1972 

Twelfth  World  Congress  of  Rehabilitation 
International,  Chevron  Hotel,  Kings  Cross, 
Sydney,  Australia.  .  Conference  Theme: 
Planning     Rehabilitation:     Environment  — 


Incentives  —  Self-Help.  For  further  in- 
formation write:  Twelfth  World  Rehabilita- 
tion Congress,  G.P.O.  Box  475,  Sydney, 
N.S.W.  2001,  Australia. 

September  16-17, 1971 

Conference  for  Industrial  Nurses,  Windsor 
Hotel,  Montreal,  P.O. 

September  23-26, 1971 

Canadian  Association  for  the  Mentally 
Retarded,  Nova  Scotian  Hotel,  Halifax,  N.S. 


October  2, 1971 

Golden  Anniversary  Homecoming  Cele- 
brations, Public  General  Hospital  School 
of  Nursing,  Chatham,  Ontario.  A  tea  and 
banquet  are  planned.  All  graduates  and 
former  faculty  are  invited.  For  further  in- 
formation write:  Miss  Jo-An  Dale,  190 
Thames  St.,  Chatham,  Ontario. 


October  4-7, 1971 

Nova  Scotia  Operating  Room  Nurses'  Asso- 
ciation. Lord  Nelson  Hotel,  Halifax.  N.S. 


October  5-7, 1971 

Nova  Scotia  Operating  Room  Nurses' 
Conference  (Maritime  Conference),  Lord 
Nelson  Hotel,  Halifax,  N.S. 


October  13-15, 1971 

Association  of  Registered  Nurses  of  New- 
foundland, annual  meeting,  St.  John's, 
Newfoundland. 


November  2-3, 1971 

Workshop,  sponsored  by  the  Manitoba 
Nursing  In-Service  Interest  Group.  Topic: 
"The  Teacher,  The  Learner,  The  Group 
Process."  Further  information  may  be 
obtained  from:  Miss  K.  Froese,  Chairman, 
Planning  Committee,  300  Booth  Dr.,  Win- 
nipeg 12,  Manitoba. 


November  28-December  4, 1971 

World  Psychiatric  Association,  Fifth  World 
Congress  of  Psychiatry,  Mexico  City.  For 
further  information,  write  Secretariado  Del 
"V"  Congresso,  Mundial  de  Psiquiatria, 
Apartado  Postal  20-123/24,  Mexico,  D.F.    ■§■ 


JUNE  1971 


Could  your  favourite  hospital 
fund  use  a  donation? 


on  our  50th  anniversary  in  Canada. 


Of  course!  And  because  it's  our 
50th  anniversary,  we're  giving  five 
hundred  dollar  donations  to  hos- 
pital funds.  So  you  could  be  the  one 
to  select  the  fund  by  entering  this 
little  contest.  A  simple  gesture  that 
could  help  someone.  But  that  is 
only  the  beginning.  Experience  and 
reliable  surgical  products  help.  too. 
At  Smith  &  Nephew  we've  got  both. 
Fifty  years  experience  in  quality 
products.  Below  are  just  four  of  the 
many  aimed  at  helping  you  and 
your  patient.  And  the  way  to  that 
donation. 

1.  Elastoplast  Elastic 
Adhesive  Bandages. 

The  unique  combination  of  overall 
porosity  plus  its  stretch  and  regain 
properties  makes  Elastoplast  band- 
ages suitable  for  many  types  of 
dressing  applications  —  ideal  for 
sprains  and  strains,  and  for  com- 
fortable retention  of  post-operative 
dressings. 


2.  Elastoplast  Skin 
Traction  Kits. 

Self-contained  skin  traction  kit 
adaptable  to  any  technique  of  skin 
traction;  ready  for  immediate  use 
to  save  nursing  time.  Complete  with 
soft  foam  lining,  spreader,  Elasto- 
crcpe  bandage  and  an  extension 
plaster  that  adheres  firmly  without 
wrinkling,  slipping  or  separation. 

3.  Elastocrepe. 

Elastocrepe  is  a  smooth  cotton  crepe 
bandage,  providing  greater  com- 
pression and  support  than  the  ordi- 
nary crepe  bandage.  Made  of  high 
quality  cotton  cloth  without  rubber 
threads,  Elastocrepe  is  well  suited 
for  treating  sprains  and  strains,  in 
the  after-treatment  of  below-knee 
fractures,  and  as  a  compression 
bandage  following  skin  grafts. 

4.  Elastoplast  "Anchor" 
Dressings. 

"H"-shaped  elastic  fabric  dressing 
spread  with  porous  adhesive  and 
tailed  to  give  firm  anchorage  on  mo- 


SMITH  &  NEPHEW  LTD. 

2lOO-52nd  Avenue.  Lachine,  Quebec 


Dress  our  best  dressed  padent. 


in  a  capsule 


Patients  Don't  Follow 
What  MDs  Order 

"Take  the  pink  pills  three  times  daily, 
the  orange  ones  four  times  daily,  and 
the  red  and  white  ones  every  six  hours," 
said  the  mythical  doctor  to  the  mythical 
patient.  If  all  this  mythology  seems 
Greek  to  you,  that's  what  doctors'  med- 
icine instructions  sound  like  to  the 
average  patient. 

A  study  of  23  discharged  patients 
from  an  Ottawa  hospital,  reported  in 
the  January  issue  of  the  Canadian  Fam- 
ily Physician,  indicated  that  less  than 
half  followed  instructions  given  by  their 
doctors.  In  their  study.  Dr.  W.W.  Ros- 
ser,  who  was  with  the  Ottawa  Civic 
Hospital's  family  practice  unit,  and 
D.E.  Flett,  a  registered  nurse  at  the 
University  of  Ottawa's  community 
medicine  and  epidemiology  department, 
said  one-fifth  of  the  patients  made 
errors  that  could  have  seriously  endan- 
gered their  health. 

The  doctor-nurse  research  team  also 
found  that  patients  were  less  likely  to 
neglect  post-hospital  treatment  if  in- 


structions are  written  down.  Nine  of 
fourteen  patients  in  the  group  who 
received  written  instructions  followed 
them.  But  only  one  of  nine  given  verbal 
instructions  complied. 

Travel  service  for  handicapped 

There's  no  reason  why  handicapped 
persons  can't  visit  the  Orient  or  take  an 
African  safari.  At  least  not  in  Philadel- 
phia, where  Moss  Rehabilitation  Hos- 
pital has  set  up  a  travel  information 
center  with  helpful  advice  from  all  over 
the  world  on  travel  attractions  suitable 
for  the  handicapped. 

Typical  questions  that  this  service 
answers  are:  Will  doorways  and  ramps 
admit  wheelchairs?  Are  there  only 
stairways  and  revolving  doors?  Does 
the  cruise  or  airline  help  the  disabled 
person?  Is  the  resort  safe  for  cardiac 
patients?  If  more  detailed  information 
is  needed,  other  travel  sources  are  pro- 
vided. 

Moss  Travel  Information  Center, 
although  mainly  a  service  available  to 
the  handicapped  individual,  will  pro- 


26     THE  CANADIAN   NURSE 


vide  free  information  to  agents  interest- 
ed in  serving  the  disabled  and  their 
families.  —  American  Journal  of  Nurs- 
ing, April  1971. 

Era  of  telecommunications 

After  reading  Hansard  of  April  7,  it 
occurs  to  us  that  a  whole  new  era  in 
communications,  complete  with  its 
own  jargon,  has  crept  up  on  us.  And 
we  still  haven't  caught  up  with  McLu- 
han! 

A  large  measure  of  thanks  for  this 
discovery  goes  to  the  former  minister  of 
communications,  Eric  Kierans,  who  ta- 
bled in  the  House  of  Commons  the  gen- 
eral report  of  the  Telecommission, 
which  was  launched  in  1969.  Titled 
Instant  World,  this  report  encompasses 
a  "vast  store  of  information"  collected 
by  43  study  groups.  And  from  this  re- 
port, which  represents  "almost  unprece- 
dented collaboration  of  hundreds  of 
individuals  .  .  .",  Mr.  Kierans  promised 
a  "white  paper  which  will  define  the 
government's  policy  on  telecommunica- 
tions." 

The  opposition  parties  were  quick 
to  recognize  possible  ramifications 
of  the  proposed  white  paper.  Mr.  Stan- 
field,  leader  of  the  opposition,  said: 
"I  shall  read  the  report  with  great  care 
in  the  hope  that  it  may  include  some 
method  of  getting  through  to  the  min- 
ister of  finance." 

Bracken  fern  dangerous? 

A  three-man  international  team  of 
physicians,  who  investigated  the  inci- 
dence of  bladder  tumors  in  various 
species  of  cattle,  warns  that  bracken 
fern,  used  as  greens  or  as  a  salad  in  the 
United  States,  New  Zealand,  and  espe- 
cially Japan,  may  cause  stomach  cancer. 

Both  men  and  animals  eat  this  fern 
in  many  parts  of  the  world.  Bracken 
grows  in  open,  sunny  places.  It  has 
black  underground  rootstock  filled 
with  starch,  which  can  be  used  in  place 
of  hops  in  making  beer. 

Experiments  on  cattle,  mice,  and 
guinea  pigs  led  to  the  discovery  that  the 
bracken  fern  contains  a  large  amount 
of  a  cancer-producing  chemical,  and 
that  the  disease  develops  rapidly  in 
animals  eating  the  substance.  A  drug 
called  phenothiazine  has  been  success- 
ful in  preventing  bladder  cancer  in 
bracken-fed  rats. 

In  the  United  States,  scientists  are 
concentrating  on  studies  with  rats  and 
guinea  pigs.  ■§■ 

JUNE  1971 


HYMOVICH  &  REED: 
Nursing  and  the 
Childbearing  Family 


Following  the  highly  successful  pat- 
tern of  Miss  Hymovich's  Nursing  of 
Children,  this  new  book  presents  a 
series  of  18  study  guides  that  offer  a 
new  approach  to  the  study  of  matern- 
ity nursing.  The  authors  stress  the 
nurse's  role  as  teacher,  emphasizing 
the  fact  that  the  larger  portion  of  the 
childbearing  cycle  takes  place  in  the 
home.  The  progression  of  normal 
pregnancy,  labor,  delivery  and  post- 
partum care  is  clearly  depicted. 
Problems  and  complications  that 
may  occur  are  considered  in  sepa- 
rate guides;  references  are  provided 
at  the  end  of  each  guide.  Information 
related  to  the  concept  of  the  family, 
cultural  patterns,  and  current  social 
problems  is  included. 

This  book  may  be  used  alone  or 
with  any  standard  text.  An  Instructor's 
Manual  is  available. 

By  Debra  P.  Hymovich,  R.N.,  B.S., 
M.A.,  and  Sueiien  B.  Reed,  R.N., 
B.S.N. ,  M.S.N. ,  both  of  the  Univ.  of 
Texas  Clinical  Nursing  School  at 
San  Antonio. 

About  350  pp.  Illustd.  About  $5.15. 
Just  Ready. 


Today's  books  for 
tomorrow's  challenges 

HOWE:  Basic  Nutrition  in  Health  and  Disease 

New  5th  Edition 

The  New  Fifth  Edition  of  this  book,  formerly  called  Nutrition  for  Practical  Nurses, 
devotes  special  attention  to  weight  control,  minerals,  and  vitamins  in  dietary 
situations.  Retaining  the  books  three  major  divisions  —  "Normal  Nutrition," 
'Diet  Therapy,"  and  "Selection  and  Care  of  Food  "  —  the  author  has  updated  all 
the  material.  She  has  expanded  the  appendix  to  include  a  glossary  and  a  list  of 
medical  prefixes  and  suffixes.  Many  new  references,  readings  and  practical  prob- 
lems are  suggested. 

By  Phyllis  Sullivan  Howe,  R.D.,  B.S.,  M.E.,  Contra  Costa  College. 
About  385  pp.  Illustd.  Soft  cover.  About  $4.90.  Ready  June. 


REED  &  SHEPPARD: 
Regulation  of  Fluid 
and  Electrolyte 
Balance 

A  self-teaching  programed  text  gear- 
ed to  the  needs  of  nursing  students, 
this  new  book  uses  a  physiological 
approach  to  the  understanding  of 
fluid  and  electrolyte  balance  and 
acid-base  balance. 

The  student  will  acquire  a  working 
knowledge  of  such  topics  as:  the 
role  of  the  kidney  and  endocrine 
system  in  maintaining  the  internal 
environment,  causes  of  fluid  shifts 
and  alteration  of  total  body  contents, 
and  physiological  processes  govern- 
ing solute  distribution. 

The  final  section  details  the  clinical 
Implications  of  fluid  and  electrolyte 
Imbalance.  Liver  disease,  infant 
diarrhea,  diabetes,  congestive  heart 
failure,  and  burns  are  among  the 
many  disorders  considered.  Case 
histories  are  Included.  An  Instructor's 
Guide  Is  available. 

By  Gretchen  Mayo  Reed,  B.S.,  M.A. 

Univ.  of  Tennessee,  and  Vincent  F. 

Sheppard,     Ph.D.,     Memphis     State 

Univ. 

About  320  pp.  Illustd.  About  $5.15. 

Ready  June. 


BEESON  & 
McDERMOTT: 
Textbook  of  Medicine 

New  13th  Edition 

The  New  13th  Edition  of  this  uni- 
versally acclaimed  reference  text 
presents  a  contemporary,  authori- 
tative and  precise  clinical  picture  of 
virtually  every  known  disease  entity. 
Each  of  800  diseases  is  discussed 
Individually,  from  Its  etiology  and 
symptoms  to  its  treatment  and  prog- 
nosis, by  an  author  expert  In  the 
field.  The  relevant  pathophysiology, 
biochemistry,  etc.  are  integrated  with 
pathologic  descriptions,  so  that  the 
need  to  look  for  symptoms  in  one 
place,  pathology  in  another,  and 
treatment  in  a  third  is  eliminated. 

Additions  have  been  made  to  the 
sections  on  nutrition,  respiratory 
diseases,  cardiovascular  and  renal 
diseases.  New  therapeutic  methods 
are  described  in  discussions  of:  the 
management  of  myocardial  Infarction, 
renal  substitution,  the  management  of 
pulmonary  Insufficiency,  and  many 
other  disorders. 

Edited  by  Paul  B.  Beeson,  M.D., 
Univ.  of  Oxford,  and  Walsh  McDer- 
mott,  M.D.,  Cornell  Univ.  Medical 
College.  169  contributors. 
About  1975  pp.  About  200  figs.  Single 
volume  about  $26.80.  2-Vol.  Set 
about  $30.90.  Just  Ready. 


W.B.  SAUNDERS  COMPANY  CANADA  LTD.         1335  Yonge  street,  Toronto  7 

Please  reserve  my  copy  to  be  sent  on  approval  when  ready 

n  Howe:  Basic  Nutrition  in  Health  and  Disease,  about  $4.90. 

n  Hymovich  &  Reed:  Nursing  and  the  Childbearing  Family,  about  $5.15. 

D  Reed  &  Sheppard:  Regulation  oi  i-iuio  and  biectrolyte  Balance,  about  $5.15. 

D  Beeson  &  McDermott:  Textbook  of  Medicine   DSingle  Vol.  about  $26.80.     D  2-Vol.  Set  about  $30.90. 


CN  6/71 


Name. 
Clty  _ 


Address  - 


-Zone 


■  Province 


JUNE  1971 


THE  CANADIAN   NURSE     27 


New 

Freshabyes 

Diapers 


Now  even  Superbaby 
won't  tear  them  apart. 


New  FRESHABYES  diapers  are  reinforced  with 
synthetic  threads,  to  eliminate  the  shredding  and  tearing 
that  were  annoying  characteristics  of  disposables.  Large 
active  babies  won't  be  able  to  pick  them  apart.  Nurses 
will  be  able  to  pull  FRESHABYES  diapers  snugly  and 
pin  them  tightly  without  tearing. 

But  strong  as  they  are,  FRESHABYES  diapers  are  still 
soft,  as  soft  as  the  facial  tissue  they're  covered  with— com- 
fortable enough  for  a  newborn.  FRESHABYES  diapers 
have  a  high  absorptive  capacity,  and  are  pre-folded  with 
a  special  pleat  to  better  fit  the  baby  and  provide  extra 
containment. 

FRESHABYES  diapers  are  used  only  once,  thus  elim- 


inating a  potential  source  of  cross-infection.  There  is 
also  no  possibility  of  irritation  from  harsh  laundry  resi- 
dues. In  all  ways,  FRESHABYES  diapers  are  invaluable 
in  isolation  units. 

The  new  strength  of  FRESHABYES  diapers  makes 
them  ideal  for  use  in  paediatrics  as  well  as  in  the  newborn 
nursery.  They  come  in  3  sizes,  newborn,  medium  and 
toddler. 

Consider  the  extra  advantages  of  FRESHABYES 
diapers. The  best  news  in  diapers  since  disposables  were 
born.  Your  FACELLE  Professional  Products  representative 
will  be  glad  to  give  you  further  details  and  show  you 
samples. 


il 

1  m 

P- 

I 

E 

3 

aneen 


SINGLE  USE  DIAPERS 

■FRESHABYES"  reg'd  T.M.  of 
Facelle  Company  Limited,  1350  Jane  Street,  Toronto  15,  Ontario. 

FACELLE  FacelleCompany  Limited,  Subsidiary  of  Canadian  International  Paper  Company  ct^ 


What  readers  like  — 
and  want  changed  — 
in  The  Canadian  Nurse 

In  the  not-so-distant  past,  editors  had  to  depend  on  readers'  brickbats  or  bouquets 
to  gauge  the  popularity  of  their  publications.  In  recent  years  more  scientific 
methods  have  achieved  acceptance.  Recently,  the  Canadian  Nurses'  Association 
engaged  a  research  organization  to  examine  the  status  of  The  Canadian  Nurse 
among  its  subscribers.  The  results  are  summarized  in  the  following  article. 


Hugh  Shaw 

Because  a  magazine  has  no  direct  sys- 
tem of  sensors  to  read  the  thoughts 
of  individual  readers,  publishers  and 
editors  have  to  develop  special  aptitudes 
and  sensitivities  to  let  them  know  how 
readers  are  responding  to  the  maga- 
zine's editorial  contents.  They  learn 
to  interpret  word-of-mouth  comment, 
to  evaluate  mail  from  readers,  and, 
perhaps  most  important,  to  develop 
their  editorial  judgment  —  to  be  able 
to  simulate  in  their  own  minds  the 
response  mechanisms  of  thousands  of 
individual  readers. 

All  these  devices  are  tools  of  the 
editor's  trade  and,  if  the  magazine  is  to 
be  a  success,  they  must  work.  But,  until 
recently,  there  was  no  easy  way  of 
measuring  with  any  scientific  preci- 
sion how  well  they  were  working. 

With  the  development  of  the  modern 
techniques  of  public  opinion  sampling, 
particularly  in  the  period  since  World 
War  II,  reactions  to  both  television  and 
magazine  audiences  can  now  be  tab- 
ulated on  the  basis  of  small  but  carefully 
selected  groups  of  viewers  and  readers. 

These  tested  methods  of  readership 
sampling  have  now  been  employed 
by   The  Canadian  Nurse  through  the 

Mr.  Shaw,  t'ornier  editor  of  H'cckciul. 
is  now  C'oniniunications  Consultant  with 
Forster.  McGuiie  &  Company  I  imiled. 
Montreal.  Quebec. 


JUNE   1971 


services  of  Daniel  Starch  (Canada) 
Limited,  one  of  the  major  research 
organizations  specializing  in  periodical 
readership  studies. 

On  the  strength  of  its  polling  of  The 
Canadian  Nurse  subscribers,  the  Starch 
organization  reports  that  you,  the  read- 
ers, generally  accept  the  magazine,  take 
a  serious  interest  in  its  contents,  depend 
on  it  for  professional  information  and, 
in  fact,  want  to  see  more  clinical  articles 
and  articles  about  the  nursing  profes- 
sion. 

And  although  this  was  primarily  a 
survey  of  readership  and  reader  inter- 
ests, it  showed  definitely  in  one  set  of 
responses  and  by  implication  in  several 
others,  that  readers  had  a  firm  belief  in 
the  significance  of  the  CN  A  as  a  profes- 
sional association  and  what  it  had 
achieved  through  its  enhancement  of 
the  goals  and  status  of  the  profession. 

The  issue  surveyed  for  page-by-page 
readership  was  The  Canadian  Nurse 
of  October.  1970. 

The  survey  was  based  on  a  selection 
of  readers  from  the  journal's  entire 
mailing  list,  which  was  turned  over  to 
the  Starch  organization. 

From  the  list,  names  were  selected 
in  the  following  areas: 
Nova  Scotia:  Halifax/Dartmouth. 
New    Brunswick:   St.   John/Lancaster, 

Moncton. 
Quebec:  Montreal. 

THE  CANADIAN   NURSE     29 


Ontario:  Ottawa,  Kingston,  Peterbor- 
ough, Toronto,  Hamilton,  Kitchener, 
London,  Sudbury.  Sault  Ste.  Marie, 
Thunder  Bay. 

Manitoba:  Winnipeg. 

Saskatchewan:  Saskatoon,  Regina, 
Moose  Jaw. 

Alberta:  Red  Deer,  Calgary,  Edmon- 
ton. 

British  Columbia:  Vancouver,  Pen- 
ticton,  Chiiiiwack. 

Within  these  areas.  Starch  inter- 
viewers selected  324  addresses  at  ran- 
dom, the  number  chosen  in  each  area 
being  related  to  the  number  of  subs- 
cribers in  the  region.  Of  the  324,  only 
38  were  unable  or  unwilling  for  various 
reasons  to  respond  to  the  questionnaire. 
Others  were  no  longer  at  the  addresses 
given.  In  all,  203  were  interviewed. 

Of  the  203  subscribers  interviewed, 
158  had  received  and  seen  the  October 
issue  and  were  quizzed  on  their  page- 
by-page  readership  of  that  issue.  The 
whole  group  of  203  was  asked  to  reply 
to  general  questions  about  the  maga- 
zine and  the  CNA. 

In  their  answers  to  the  question 
"About  how  long  have  you  been  sub- 
scribing to  The  Canadian  NurseT,  the 
subscribers  interviewed  indicated  that 
they  represented  a  wide  range  of  age 
groups  of  nurses  in  Canada.  Twelve 
percent  of  those  interviewed  said  they 
had  been  subscribers  for  less  than  one 
year,  15  percent  said  they  had  been 
subscribers  for  one  to  two  years,  14 
percent  said  four  to  five  years,  and 
16  percent  estimated  that  they  had 
been  subscribers  for  approximately 
1 0  years. 

Those  interviewed  were  asked  to  go 
through  the  entire  issue  of  the  maga- 
zine and  indicate  how  much  they  had 
observed  and  read  on  each  page.  Here 
are  some  of  the  things  their  responses 
revealed. 

It  was  learned  that  56  percent  of 
readers  had  noted  something  on  every 
page  and  4 1  percent  had  read  an  aver- 
age of  more  than  half  of  what  was  on 
every  page  containing  editorial  mate- 
rial, a  gratifying  show  of  interest  consi- 
dering the  fact  that  some  general  con- 
30     THE  CANADIAN  NURSE 


In   this   question,   subscribers    interviewed    in   the   survey   of    readership  o" 
The  Canadian  Nurse  were  confronted  with  five  statements  planted  in  the 
questionnaire  about  the  Canadian  Nurses'  Association  and  asked  to  indicate 
their  attitudes  toward  such  statements.  (Total   base  means  all  subscribe™ 
interviewed,  including  nurses  with  graduate  degrees).  \ 


Total 

Registered 

Canadian  Nurse  Study 

Base 

Nurses 

203 

190 

Percentage  Base 

100.0 

100.0 

Enhances  Goals/Status  Of  Profession 

Yes  —  Certainly 

63.1 

63.2 

Yes  —  Probably 

28.6 

29.5 

No  —  Probably  Not 

4.4 

4.2 

No  —  Certainly  Not 

1.5 

1.6 

No  Answer 

2.5 

1.6 

Membership  is  a  Prof.  Responsibility 

Yes  —  Certainly 

77.8 

79.5 

Yes  —  Probably 

14.3 

13.7 

No  —  Probably  Not 

4.4 

4.2 

No  —  Certainly  Not 

1.0 

1.1 

No  Answer 

2.5 

1.6 

Supplies  Valuable  Information 

Yes  —  Certainly 

66.5 

66.8 

Yes  —  Probably 

23.2 

23.7 

No  —  Probably  Not 

6.4 

6.3 

No  —  Certainly  Not 

1.5 

1.6 

No  Answer 

2.5 

1.6 

No  Real  Benefits  As  Member 

Yes  —  Certainly 

12.3 

13.2 

Yes  —  Probably 

12.3 

12.1 

No  —  Probably  Not 

14.3 

14.2 

No  —  Certainly  Not 

56.7 

56.8 

No  Answer 

4.4 

3.7 

Journal  Is  About  All  You  Get 

Yes  —  Certainly 

11.3 

12.1 

Yes  —  Probably 

17.2 

16.8 

No  —  Probably  Not 

15.8 

15.3 

No  —  Certainly  Not 

53.2 

54.2 

No  Answer 

2.5 

1.6 

lUNE  1971 

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sumer  magazines  have  to  be  resigned  to 
readers  spending  no  more  than  15  or 
20  minutes  with  an  entire  issue. 

In  general,  readers  of  The  Canadian 
Nurse  showed  a  decided  preference 
for  articles  on  clinical  and  professional 
subjects.  Eighty-seven  percent  of  the 
readers  who  were  interviewed  "noted" 
the  lead  article  of  the  October  issue 
"Active-care  hospital  nurse  expands 
her  role"  by  Coombs,  and  75  percent 
"read  most,"  that  is,  read  more  than 
half  of  the  article.  An  almost  equally 
striking  interest  was  shown  in  the  high- 
ly-specialized article  "Epidurals  are 
here  to  stay"  by  Dillabough  and  Rosen. 

Of  the  magazine's  regular  depart- 
ments. New  Products,  Names,  News, 
and  Letters  all  rated  high.  Other  de- 
partments obviously  and  predictably 
had  a  more  selective  readership. 

In  some  other  responses,  readers  gave 
the  editor  indications  of  their  preferen- 
ces and  priorities  of  interest: 

Readership  of  the  "back-of-the- 
book"  departments  was  considerably 
lower  than  the  average  for  the  mag- 
azine, the  best-read  of  these  depart- 
ments being  Books  and  Idea  Exchange 
with  the  lowest  readership  recorded 
by  AV  Aids  and  the  Accession  List. 

Information  for  Authors  obviously, 
and  no  doubt  predictably,  appeared  to 
attract  the  attention  only  of  CNA  mem- 
bers who  were  planning  to  write  for  the 
magazine. 

Fifty  percent  of  the  readers  inter- 
viewed were  sufficiently  stimulated  by 
one  or  more  articles  in  the  issue  to 
discuss  them  with  other  nurses.  Eighty 
percent  said  they  read  the  magazine 
at  home,  and  72  percent  said  they  kept 
the  magazine  for  a  substantial  length 
of  time  after  they  received  it  in  the 
mail. 

In  addition  to  indicating  what  they 
had  read  in  the  specific  (October)  issue 
of  The  Canadian  Nurse,  respondents 
were  asked  to  reply  to  a  general  ques- 
tionnaire and  thereby  reveal  some  of 

32     THE  CANADIAN   NURSE 


their  reading  habits  and  attitudes  to- 
ward The  Canadian  Nurse  and  the  Ca- 
nadian Nurses'  Association. 

Generally,  they  affirmed  that  The 
Canadian  Nurse  was  the  professional 
magazine  they  read  and  depended  on 
to  the  exclusion  (except  for  minimal 
awareness)  of  seven  other  professional 
and  profession-related  journals  about 
which  they  were  queried.  In  this  con- 
nection and  in  response  to  direct  ques- 
tioning, readers  interviewed  gave  their 
evaluation  of  the  CNA  as  a  source  of 
professional  leadership,  information, 
and  instruction.  (Table  A) 

Preference  indicated  on  replies  to 
this  "in-depth"  study  supported  the 
overall  demand  for  clinical  and  pro- 
fessional articles  shown  in  the  survey 
of  the  readership  of  the  October  issue 
and  gave  a  specific  order  of  preference 
for  various  categories  of  the  magazine's 
general  contents.  ( Table  B) 

Readers  found  a  number  of  aspects 
of  the  magazine  to  their  liking  as  they 
are.  Sixty-one  percent  of  those  inter- 
viewed said  the  coverage  of  association 
news  appeared  to  be  right  as  it  is.  How- 
ever, the  same  number  (61  percent) 
said  they  would  like  to  see  more  medical 
highlights,  and  a  significant  68  percent 
would  like  to  see  more  articles  based 
on  research. 


Nurses  interviewed  in  the  survey 
of  readers  of  The  Canadian  Nurse 
were  asked  a  number  of  questions 
about  themselves.  Their  answers 
give  a  composite  portrait  of  the 
nurse  in  Canada  as  represented  in 
the  Starch  Company's  cross-coun- 
try sampling. 

Ninety-three  percent  of  the 
readers  interviewed  reported  that 
they  were  registered  nurses.  Six 
and  a  half  percent  said  they  had 
bachelor's  degrees  in  nursing. 

Fifty-four  percent  were  found  to 
be  employed  full-time  in  nursing; 
31  percent  had  part-time  employ- 
ment. Nine  percent  were  not  em- 
ployed, four  percent  were  stu- 
dents, and  a  small  number  of  those 
interviewed  were  in  occupations 
other  than  nursing. 

Sixty-nine  percent  of  the  respon- 
dents were  employed  in  hospitals. 
The  rest  were  divided  in  some  nine 
other  nursing  occupations,  with 
nursing  homes  and  public  health 
services  each  named  by  slightly 
under  five  percent  as  their  present 
fields  of  employment. 

Fifty-four  percent  gave  their 
employment  situation  as  "general 
duty"  or  "staff,"  12  percent  were 
supervisors  or  assistants,  and  12 
percent,  head  nurses  or  assistants. 

Sixty-four  percent  said  they 
were  married. 

Largest  age  group  interviewed 
was  under  30  (33.5  percent  of  all 
respondents),  followed  by  the  40- 
49  group  (22  percent),  then  30-39 
(20.7  percent),  50-59  (18.2  per- 
cent), 60  and  over  (3.9  percent), 
and  1.5  percent  who  failed  to  an- 
swer this  particular  question.     ^ 


JUNE  1971 


OPINION 


Relatives  should  be  told  about  intensive  care  - 

but  how  much  and  by  whom? 


Pat  Wallace 

Michael  was  eighteen.  A  boating  acci- 
dent had  left  him  with  multiple  internal 
injuries.  After  admission  to  a  small 
rural  hospital,  he  developed  pulmonary 
edema  and  respiratory  failure.  Unable 
to  receive  the  specialized  care  he  need- 
ed, he  was  transferred  to  the  intensive 
care  unit  of  a  larger  hospital,  where  he 
could  receive  the  best  possible  treat- 
ment by  a  team  of  doctors  and  nurses. 

It  was  here  that  I  first  saw  Michael. 

On  admission  to  the  intensive  care 
unit,  he  was  intubated  by  an  endotra- 
cheal tube  connected  to  a  Bennett  MA 
I  respirator  —  an  apparatus  having 
many  dials  and  switches,  and  emitting 
unpleasant  sounds  while  doing  its  work 
of  breathing  for  Michael.  He  was  also 
hooked  up  to  the  electrocardiograph 
machine,  with  leads  placed  on  various 
parts  of  his  body.  An  intravenous  stand 
beside  his  bed  held  two  bottles  of  clear 
fluid  and  a  flask  of  blood,  with  a  tube 
leading  to  his  arm  to  give  him  drop-by- 
drop  sustenance.  Near  the  foot  of  the 
bed  a  Foley  catheter  was  draining 
bloody  urine  into  a  plastic  bag. 

As  Michael  had  lost  40  pounds  since 
his  accident  and  did  not  respond  to 
stimuli,  he  resembled  an  inert  skeleton 
covered  by  a  sheet.  His  bloodshot  eyes, 
half  closed,  without  focus,  enhanced  the 


Miss  Wallace  is  a  fourth-year  student  in 
the  basic  nursing  program  at  the  Uni- 
versity of  Toronto  School  of  Nursing. 


JUNE   1971 


moribund  aspect  of  his  appearance. 

I  was  there  when  Michael's  grand- 
mother came  to  visit.  She  walked  to- 
ward his  bed  with  the  confidence  and 
composure  of  her  mature  years.  On 
seeing  him  as  I  have  described  him,  her 
stunned  look  of  horror,  though  it  lasted 
but  seconds,  became  something  I  cannot 
easily  forget.  Her  tearful,  choking  sobs, 
as  she  hastened  out  of  the  room,  still 
ring  in  my  ears. 

Unanswered  questions  started  to  nag 
me  and  still  do. 

What  had  Michael's  grandmother 
expected  to  see  when  she  visited  him 
after  his  admission  to  our  intensive 
care  unit?  Could  someone  not  have  told 
her  about  all  the  equipment,  about  his 
semi-comatose  state,  about  his  appear- 
ance? But  who  should  have  told  her  — 
a  staff  nurse,  a  nurse  whose  specific 
function  it  is  to  prepare  families  psy- 
chologically, a  lay  person?  And  how 
much  should  she  have  been  told? 

Visitors  should  be  prepared 

I  am  convinced  that  there  is  a  need 
to  prepare  relatives  of  patients  in  the 
intensive  care  unit  beforehand  for  what 
they  will  encounter.  As  most  lay  people 
have  never  before  set  foot  in  such  a 
specialized  and  mechanized  area  of  the 
hospital,  the  equipment  alone  over- 
whelms them.  As  an  example,  it  is 
especially  valuable  for  relatives  of 
patients  to  have  a  good  psychological 
preparation  for  ventilators.  Anyone 
THE  CANADIAN   NURSE     33 


can  sense  the  significance  of  tliese 
strange  and  noisy  machines,  and  the 
natural  reaction  to  them  is  panic  or 
fear. 

Before  medical  or  nursing  students 
are  exposed  to  areas  such  as  the  inten- 
sive care  unit,  they  have  already  had 
experience  in  less  specialized  areas  of 
the  hospital  and  have  been  given  some 
physiological  and  psychological  prep- 
aration, at  least  in  theory.  Are  not  rela- 
tives of  patients  entitled  to  at  least  the 
psychological  preparation  accorded 
students?  I  am  not  suggesting  that  they 
receive  a  "minor"  medical  education  in 
half  an  hour  of  less,  but  they  deserve 
some  knowledge  of  what  to  expect  on 
entering  an  intensive  care  area.  They 
have  an  explicit  right  to  this  "pre-inten- 
sive  care  preparation"  and  it  should 
not  be  considered  a  privilege  to  be 
instructed  only  if  hospital  personnel 
have  the  time  for  it. 

My  first  day  of  work  in  the  inten- 
sive care  unit  had  a  tremendous  impact 
on  me.  I  was  frightened  and  became 
mentally  exhausted.  My  anxiety  did 
not  stem  from  responsibility,  as  a  grad- 
uate nurse  gave  actual  care  to  the  pa- 
tients. My  reaction  then  was  severe 
enough  while  working  with  complete 
strangers.  Imagine  my  depth  of  emo- 
tional feelings  had  I  been  related  to 
the  patients. 

As  visitors  to  these  patients  are 
usually  next-of-kin,  the  tense  environ- 
ment of  an  intensive  care  unit  is  sure 
to  have  a  shocking  impact  on  them. 
With  no  preparation  beforehand,  how 
can  they  control  their  feelings?  Little 
wonder  they  give  way  to  emotional 
outbursts  as  Michael's  grandmother  did. 

Pre-intensive  care  preparation  can 
serve  to  allay  certain  groundless  fears. 
For  example,  for  some  patients  in  inten- 
sive care  units,  ventilators  are  used  to 
permit  their  breathing  muscles  to  rest. 
As  the  respirator  takes  over  the  func- 
tion of  breathing,  all  a  patient's  bodily 
energies  can  be  directed  toward  correct- 
ing an  ailment,  where  the  strain  of 
breathing  would  prevent  healing.  Were 
this  explained  to  relatives,  they  would 
understand  that  the  use  of  a  respirator 
does  not  necessarily  mean  that  a  patient 
is  about  to  die. 

Preparation,  yes  —  but  how  much? 

First  of  all,  relatives  should  be  in- 
formed that  an  intensive  care  unit  is  a 
highly  specialized  area  where  all  staff 
members  are  specially  trained  to  per- 
form various  vital  functions,  and  that 
the  equipment  they  are  about  to  see 
around  their  loved  one  is  necessarily 

34     THE  CANADIAN   NURSE 


large  and  complex.  There  is  no  need 
for  an  elaborate  description  of  each 
item  in  the  room,  but  relatives  should 
understand  that  the  adequate  function- 
ing of  a  good  intensive  care  unit  de- 
pends on  advanced  technology.  For 
example,  if  a  respirator  is  needed,  the 
relatives  should  know  exactly  what  it 
does,  what  it  looks  like,  and  how  it 
sounds  when  in  use.  It  is  important  to 
describe  both  its  sound  and  its  appear- 
ance as  the  senses  of  both  vision  and 
hearing  may  be  stunned  on  first  enter- 
ing an  intensive  care  unit. 

It  is  also  essential  that  relatives  know 
how  this  apparatus  is  connected  to  the 
patient,  for  example,  by  endotracheal 
tube  or  by  tracheostomy.  In  Michael's 
case,  it  is  possible  that  seeing  the  metal 
tube  in  his  mouth  contributed  to  his 
grandmother's  panic.  Had  she  known 
the  purpose  of  this  tube  and  had  some 
idea  of  its  appearance,  her  emotional 
reaction  might  have  been  considerably 
less  upsetting. 

The  completeness  of  any  prepara- 
tory explanation  depends  not  only  on 
the  condition  of  the  patient,  but  on 
the  wishes  and  needs  of  the  relatives. 
If  the  patient  is  conscious  and  responds 
to  verbal  stimuli,  less  preparation  is 
needed.  However,  if  he  is  stuporous  or 
unconscious,  more  preparation  will 
help  relatives  through  their  first  visit. 

Who  prepares  the  visitor? 

The  doctor  is  responsible  for  explain- 
ing to  relatives  why  the  patient  is  in  an 
intensive  care  unit  and  should  at  least 
mention  the  complex  machinery  used 
in  caring  for  him.  However,  his  brief 
statement  on  the  nature  of  the  environ- 
ment is  not  enough,  and  further  prep- 
aration is  advisable.  It  would  be  almost 
impossible  for  the  staff  nurse  in  the 
unit,  who  must  give  her  entire  attention 
to  her  patient,  to  give  full  explanations 
to  visitors.  However,  while  she  may 
help  relatives  to  accept  the  intensive 
care  environment  once  they  are  in  the 
room,  some  advance  preparation  must 
be  accorded  them. 

The  charge  nurse  could  be  expected 
to  perform  this  task,  and  in  some  cir- 
cumstances this  would  work  out  quite 
well.  However,  the  nurse-in-charge  too 
often  becomes  involved  with  other 
urgent  matters,  and  any  extra  respons- 
ibility should  not  be  imposed  on  her. 

A  lay  person  should  not  assume  this 
responsibility,  mainly  because  of  lack 
of  medical  knowledge.  If  a  relative 
were  to  ask  a  question  he  could  not 
answer,  his  lack  of  information  could 


increase  anxiety.  Further,  a  lay  per- 
son may  not  possess  at  the  same  time 
both  empathy  and  sufficient  under- 
standing of  the  machines  nor  of  the 
intensive  care  environment. 

It  would  be  of  advantage  to  everyone 
to  engage  a  nurse  for  the  express  pur- 
pose of  tending  to  this  important  mat- 
ter. This  nurse  could  become  know- 
ledgeable about  equipment,  procedures, 
and  all  other  factors  that  make  up  the 
intensive  care  environment.  She  could 
become  acquainted  with  all  the  patients 
—  know  their  medical  history  and 
current  problems  —  and,  depending 
on  their  condition,  she  could  befriend 
them.  In  this  way,  when  she  meets  the 
patient's  relatives,  she  can  introduce 
a  personal  note  into  the  conversation  by 
referring  to  the  patient  himself  as  well 
as  by  talking  about  the  machinery  used 
for  his  care.  Such  a  nurse  could  also 
orient  new  staff  members  to  the  com- 
plexities of  the  intensive  care  unit,  in 
this  way  filling  a  dual  role. 

Conclusion 

It  is  my  opinion  that  the  shock 
Michael's  grandmother  experienced  in 
the  intensive  care  unit  on  seeing  her 
once  healthy  and  active  teenaged  grand- 
son was  more  intense  than  any  emo- 
tional reaction  most  of  us  have  had  to 
endure.  It  is  also  my  opinion  that  her 
reaction  need  not  have  been  the  trau- 
matic experience  that  it  was  had  she 
had  some  preparation  for  the  sight 
she  saw.  fy 


JUNE  1971 


Deep-freeze  seminar 
—  a  warm  experience 


JUNE  1971 


In  parkas  and  layers  of  slacks,  more  than  30  nurse  educators  traveled  North  this 
winter  in  a  series  of  three  seminars  sponsored  by  the  medical  services  branch 
of  the  department  of  national  health  and  welfare.  Although  "one  swallow  does 
not  a  summer  make"  or,  in  this  case,  a  winter,  nevertheless  four  travelers  inter- 
viewed said  their  short  stay  was  both  informative  and  exhilarating. 

Sheila  Rockburne 

E.  Louise  Miner,  president  of  the  Ca- 
nadian Nurses'  A  ssociation,  was  a  mem- 
ber of  the  first  seminar  that  visited 
the  Inuvik  area  in  mid-January.  Her 
seminar  originated  in  Edmonton,  where 
a  basic  orientation  program  was  given, 
then  moved  North  for  field  work.  Inu- 
vik is  a  town  planned  to  be  the  admin- 
istrative, educational,  and  medical 
center  for  the  Western  Arctic  and  was 
officially  opened  in  June,  1961.  It  is 
situated  in  the  Mackenzie  delta,  1 ,200 
miles  north  of  Edmonton,  125  miles 
north  of  the  A  rctic  circle,  and  60  miles 
south  of  the  Arctic  ocean.  At  the  Inuvik 
General  Hospital  the  visitors  received 
a  detailed  orientation  to  the  health 
program  and  problems  relevant  to  the 
Inuvik  zone.  Miss  Miner  wrote  for  The 
Canadian  Nurse  an  overview  of  one  of 
the  main  social  problems  in  the  North. 
The  trip  poignantly  underlined  the 
problem  to  her  and  she  links  it  to  the 
problem  of  providing  health  care  in 
the  North. 

Miss  Miner  said,  "Health  problems 
of  any  community  can  be  solved  only 
to  the  extent  that  social,  cultural,  econo- 
mic, and  other  related  factors  are  mod- 
ified to  support  health  services.  A 
visit  to  almost  any  isolated  community 
only  serves  to  accentuate  this  fact. 

"We  claim  we  want  the  'good  life' 
for  all  Canadians  wherever  they  live. 
Sometimes  I  think  we  really  do  not  know 

THE  CANADIAN  NURSE     35 


t.  L(.>iusc  Miner,  president  of  the  Cana- 
dian.Nurses'  Association. 


what  this  good  life  is.  Surely  it  is  not  a 
drunk  young  mother  lying  in  the  street 
at  50  degrees  belowizero.  Surely,  it  is 
not  watching  a  young  child  bring  her 
mother  to  an  efficiently  staffed,  well- 
equipped  nursing  station  for  treatment 
following  a  Saturday  night  brawl  — 
the  liquor  for  which  arrived  by  plane. 

"Drunkenness  became  a  major  prob- 
lem when  air  service  made  liquor  avail- 
able from  commercial  outlets.  We  may 
have  taught  these  people  to  buy  liquor, 
but  when  are  we  going  to  teach  them 
how  to  drink  it?"  Miss  Miner  asked. 

"One  sees  a  need  for  regular,  mean- 
ingful employment  to  help  create  an 
environment  conducive  to  the  promo- 
tion of  an  individual's  dignity.  Many 
natives  are  concerned.  Some  residents 
recognize  that  social  problems  will 
increase  if  pipe  lines  are  constructed 
through  the  territories  unless  specific 
preventive  measures  are  implemented. 

"What  responsibilities  do  Canadian 
nurses  have  to  ensure  a  better  life  for 
the  delightful  children  and  their  families 
in  our  vast  northland?  Certainly  our 
responsibility  is  to  provide  efficient, 
understanding  nursing  service  in  its 
broadest  potential,  and  to  help  imple- 
ment all  possible  programs  of  primary 
prevention  to  promote  high  level  well- 
ness. Involvement  in  improving  the 
total  environment  is  essential. 

"Nurses  comprise  the  largest  num- 
ber of  workers  in  the  provision  of  health 
services  and  must  understand  the  multi- 
plicity of  factors  that  interfere  with 
the  total  health  of  a  community.  A  will- 
ingness to  make  personal  sacrifice  will 
be  required  of  each  of  us  if  the  necessary 
change  is  to  be  effected.  The  time  was 
yesterday,"  concluded  Miss  Miner. 


Helan  Taylor,  president  of  the  Associa- 
tion of  Nurses,  Province  of  Quebec. 

We  had  a  baby!! 

Helen  Taylor,  president  of  the  Asso- 
ciation of  Nurses  of  the  Province  of 
Quebec,  represented  the  Canadian 
Nurses'  Association  at  the  second 
seminar,  which  left  Montreal  in  Feb- 
ruary. (The  third  seminar  originated 
in  Winnipeg  in  March.)  Miss  Taylor's 
field  assignment  was  to  the  station  at 
Povungnituk,  which  she  estimates  is 
1 ,000  miles  north  of  Montreal. 

"Povungnituk  is  called  POV  for 
short.  It  took  me  about  a  week  before 
I  learned  to  say  the  full  name.  It  also 
took  me  two  days  to  get  there,  the 
weather  was  so  bad.  Some  of  our  group 
took  as  long  as  four  or  five  days  to  get 
to  their  destination,  again,  because  of 
bad  weather. 

"So  I  think  the  first  impact  made 
on  all  of  us  was  the  difficulty  of  trans- 
portation and  communication  in  the 
North  and  the  great  problem  this  im- 
poses on  the  organizers  of  health  ser- 
vices branch  and  the  nurses  who  work 
there.  The  nurses  are  certainly  iso- 
lated, not  only  in  terms  of  where  they 


36     THE  CANADIAN   NURSE 


are  situated;  it  might  be  several  days 
before  they  can  talk  to  anyone  for  help 
or  have  any  opportunity  to  get  their 
patients  out  on  medical  emergency 
evacuation,"  said  Miss  Taylor. 

"Another  thing  that  had  great  im- 
pact on  me  was  the  emphasis  on  pub- 
lic health.  One  can  hardly  think  of 
nursing  there  without  becoming  in- 
volved in  the  total  health  care  aspect. 
We  were  able  to  see  first  hand  a  lot  of 
the  community,  and  so  we  saw  the 
vvhole  gamut  of  social  problems.  It's 
a  fantastic  adjustment  the  Indians  and 
Eskimos  are  attempting  to  make  from 
their  almost  stone  age  society  to  the 
white  man's  society. 

"A  visitor  can  see  the  social  implica- 
tions of  this  huge  change.  There  is  a 
big  gap  between  youth  and  the  so-called 
older  generation.  The  children  are  find- 
ing it  increasingly  difficult  to  com- 
municate with  their  parents  in  a  society 
where  they  had  lived  closely.  The  com- 
munity has  problems  of  alcoholism^ 
drugs,  law  and  order,  plus  emotional 
disorders.  I  would  ^escribe  this  as  truly 
a  public  health  fact  of  nursing." 

The  happening  of  Miss  Taylor's  visit 
was  the  confinement  of  an  Eskimo  wo- 
man. "I  think  we  were  the  only  ones 
on  our  seminar  'to  have  a  baby,'  "  said 
Miss  Taylor.  "It  was  the  most  normal, 
best  managed  delivery  1  ever  saw.  The 
woman  was  a  cooperative  patient,  it 
was  her  sixth  baby,  so  it  turned  out  to 
be  a  truly  good  experience." 

Miss  Taylor  assisted  with  the  de- 
livery of  the  seven-pound,  six-ounce 
girl.  "I  suppose  I  played  the  role  of  the 
nurse,  and  the  station  nurse  played  the 
traditional  role  of  the  doctor.  The  de- 
livery was  without  sedation  or  medica- 
tion and  it  was  perfect.  I  think  the  moth- 
er was  geared  to  have  a  more  normal 
delivery  than  perhaps  some  of  the  in- 
habitants of  the  south.  We  communicat- 
ed with  simple  words  or  gestures,  as 
the  woman  did  not  speak  English,  and 
the  interpreter  often  used  by  the  nurse 
was  not  available.  Really,  without  a 
word  spoken,  the  communication  was 

JUNE  1971 


very  close.  The  mother  thanked  us  by 
smiling  and  squeezing  our  arms. 

"This  delivery  took  place  in  a  well- 
equipped  nursing  station.  But  when 
we  got  back  to  Montreal  at  the  end  of 
the  seminar,  another  nurse  who  visited 
a  remote  area  said  a  confinement  there 
would  have  been  in  the  home." 

"Overall  I  think  we  were  all  impress- 
ed by  the  great  responsibility  the  nurses 
take,  not  only  in  midwifery.  They  are 
diagnosing,  treating,  and  doing  things 
that  in  our  hospitals  would  not  be  legally 
acceptable.  The  knowledge  of  drugs  they 
must  have  is  almost  frightening.  I  know 
nurses  with  public  health  experience 
who  would  like  to  go  North,  but  who 
can't  imagine  themselves  adequately 
prepared  for  the  responsibility,"  said 
Miss  Taylor. 

The  seminar  was  completed  by  a 
group  sharing  of  experiences  and  ideas 
back  at  home  base.  Northern  weather 
delayed  some  of  the  pick-up  planes  and 
those  nurses  had  extra  time  to  expjeri- 
ence  the  isolation  of  the  North.  Recom- 
mendations from  those  who  did  get 
back  on  schedule  were  divided  under 
the  two  objectives  of  the  seminars, 
which  were:  to  help  promote  recruit- 
ment of  nurses  to  small  Indian  and  Es- 
kimo communities  in  the  middle  and 
high  north  where  the  vacancy  rate  for 
registered  nurses  is  particularly  high; 
to  help  determine  whether  the  educa- 
tional level  of  Canadian  nurses  could 
be  expanded  to  include  depth  of  know- 
ledge and  skills  in  such  areas  as  man- 
agement of  medical,  dental,  and  obstet- 
rical cases. 

"We  discussed  whether  we  could  or 
should  alter  our  present  educational 
program  in  terms  of  teaching  to  pre- 
pare nurses  for  work  in  remote  areas," 
said  Miss  Taylor.  "As  there  would 
only  be  a  limited  number  of  persons 
interested  in  going  North,  I  don't  see 
this  being  placed  in  the  present  educa- 
tional structure.  But  I  certainly  see 
there  is  a  great  need  for  those  interested 
nurses  to  be  able  to  acquire  the  addi- 
tional training,"  she  said. 

)UNE  1971 


Margaret  Ross  of  Mount  Saint  Vincent 
University,  Halifax,  Nova  Scotia. 

Wolverine  fur  kept  face  frost-free 

Five  days  at  Fort  Norman,  south  of 
Inuvik,  meant  five  days  in  a  govern- 
ment-issue, double  parka  to  Margaret 
Ross,  lecturer  in  medical-surgical  nurs- 
ing at  Mount  Saint-Vincent  University's 
school  of  nursing,  Halifax,  Nova  Scotia. 

"The  parka  was  rimmed  around  the 
hood  with  wolverine  fur,  which  I  un- 
derstand is  the  best  fur  for  keeping  the 
breath  from  freezing  on  your  face.  Ev- 
ery inch  of  the  skin  had  to  be  covered 
because  the  temperature  hovered  around 
the  50  degree  below  zero  mark  all  the 
time  I  was  there.  The  rest  of  my  ward- 
robe consisted  of  slacks  —  indoors  one 
pair  and  outdoors  two  additional  pair," 
she  said  The  hours  of  daylight  were 
between  1 1:00  a.m.  and  2:00  p.m.  "It 
would  be  interesting  to  see  a  study  done 
on  the  affect  this  darkness  and  light 
might  have  on  individual  performance 
of  duties. 

"We  met  a  tremendous  number  of 
people  from  the  community,  including 
ministers,  RCMP  officers,  the  Hudson 
Bay  store  manager,  the  principal  of  the 


school.  We  arrived  on  the  weekend  and 
spent  a  lot  of  time  in  their  homes  talk- 
ing about  their  role  in  the  North.  Then 
it  was  three  days  of  following  the  nurse 
in  her  regular  routine  at  the  single  nurse 
station  that  is  set  up  for  the  popula- 
tion of  250  Indians." 

The  highlight  of  Miss  Ross's  vis- 
it came  at  a  meeting  of  the  Fort  Nor- 
man Women's  Institute.  "When  we  were 
going  about  with  the  nurse  we  saw 
signs  posted  about  the  meeting  which 
said,  'Come  and  meet  the  visiting 
nurses.'  It  was  a  terrible  night,  but  the 
turnout  was  the  largest  the  WI  ever  had. 
The  women  were  interested  in  hearing 
about  nursing  and  wanted  to  discuss 
the  problems  girls  from  the  North  have 
when  th\ey  go  'out'  to  take  a  course.  I 
also  think  the  large  turnout  shows  the 
respect  there  is  for  nurses  in  the  North." 

"The  nurse  at  our  station  was  a 
British  midwife  with  several  years 
experience  in  the  North.  She  was  just 
terrific.  I  would  like  to  see  more  Ca- 
nadian nurses  in  the  North  and  1  think 
our  degree  nurses  would  be  very  capable 
if  they  had  a  thorough  orientation  to 
northern  nursing.  The  nurse  in  the 
North  has  to  be  a  mature,  confident 
person  because  the  responsibility  on 
her  shoulders  is  quite  something.  She 
has  to  be  able  to  make  decisions  and 
take  responsibility  for  them.  It  was  cer- 
tainly clear  to  me  that  the  nurse  must 
have  tremendous  resources  as  a  per- 
son," said  Miss  Ross. 

(Conliiiticil  on  next  /JdjL'c./ 


THE  CANADIAN   NURSE     37 


Marcelle  Dumont,  of  the  University  of  Moncton,  New  Brunswick,  points  out 
the  place  she  visited  on  the  seminar. 


Last  stop  north  pole 

Marcelle  Dumont,  assistant  director  of 
the  school  of  nursing  sciences  at  the 
University  of  Moncton,  New  Bruns- 
wick, came  back  from  the  January  sem- 
inar a  member  of  the  Order  of  Adven- 
turers of  the  Artie,  Polar  Bear  Chap- 
ter. She  was  interviewed  by  Gertrude 
Lapointe,  associate  editor  ofL'infirmie- 
re  canadienne. 


Mrs.  Dumont's  membership  was 
earned  by  her  stay  at  the  nursing  sta- 
tion at  Tuktoyaictuk,  a  hamlet  of  600 
people  on  the  Beaufort  sea.  It's  tundra 
38     THE  CANADIAN   NURSE 


country,  but  it  reminded  her  of  a  child- 
hood in  the  Gaspe  region  of  Baie-des- 
Chaleurs,  Quebec.  "It  was  the  same 
cold  and  the  same  wind,  but  there  was 
improvement  over  my  time.  These 
people  have  electricity  in  their  homes 
and  electric  appliances,  which  we  did 
not  have.  Their  clothes  protect  them 
against  the  cold  much  better.  I  was 
told  that  vvhen  it  starts  to  thaw  in  Tuk, 
nature  is  beautiful.  There  are  flowers 
in  the  summer,  large  and  brilliant  flow- 
ers." 

Mrs.  Dumont  talked  with  emotion 
of  the  two  nurses  who  welcomed  her 
to  their  home  in  Tuk.  "They  know  so 


well  how  to  nurse  patients,"  she  said. 
"The  nurses  are  well-prepared  and  the 
station  is  so  well-equipped.  They  have 
all  the  drugs  they  need  and  they  know 
how  to  use  them.  They  suture  wounds, 
set  fractures,  and  even  pull  teeth.  The 
outpost  nurses  must  decide  if  a  patient 
should  be  sent  to  hospital,  so  they  are, 
in  effect,  diagnosing.  There  are  patients 
whom  they  treat  by  following  orders 
and  advice  radioed  to  them  by  a  doctor. 


"From  a  health  point  of  view  I  realiz- 
ed that  people  are  followed  more  closely 
than  in  the  South.  The  government  at- 
tempts to  stop  epidemics  and  to  practice 
preventive  health  through  education. 
Often  the  Indian  and  Eskimo  ignore 
the  instruction,"  she  said. 

In  her  teaching,  Mrs.  Dumont  always 
tries  to  interest  her  students  in  outpost 
nursing.  "I  talked  about  these  places, 
but  I  had  never  seen  them,"  she  said. 
"I  was  dreaming  about  this  trip  because 
I  believed  I  would  then  know  what  I 
was  talking  about  and  1  could  better 
prepare  my  students  for  this  kind  of 
nursing. 

"It  was  an  opportunity  to  witness 
the  work  of  nurses  stationed  in  the 
North  and  also  to  listen  and  to  talk  with 
Indians  and  Eskimos,"  Mrs.  Dumont 
said.  "By  this  gesture,  it  was  as  if  the 
federal  government  were  saying:  See 
what  we're  doing  for  Canadians.  Come 
and  help  us,  give  us  a  hand."  ^ 


JUNE  1971 


Do  you  have  a  bad  trip 
if  you  go  to  hospital? 

The  Canadian  Nurse  asked  the  author  to  visit  several  large  hospitals  to  find 
out  what  facilities  are  available  for  persons  on  "bad  trips,"  just  how  many 
come  to  hospital  for  treatment,  and  the  attitude  of  personnel  toward  those 
who  come.  Her  findings,  based  on  many  interviews,  are  surprising. 


"What,"  I  asked  Dr.  Lionel  Solursh  — 
trying  to  avoid  any  of  the  glib  phrases 
connected  with  drug  abuse  —  "What 
are  the  drug  patients  who  come  to  you 
generally  suffering  from?" 

"Discomfort,"  he  replied. 

That  set  the  scene  very  nicely  for 
what  was  obviously  going  to  be  an  "un- 
simple"  and  unstraightforward  piece  of 
research:  how  the  hospitals  are  dealing 
with  drug  abusers;  how  often  they  are 
doing  so;  and  how  nurses  are  reacting, 
feeling,  and  thinking  while  treating 
such  patients. 

Nothing  about  the  subject  is  clearcut 
because  you  can't  isolate  drug  abuse  as 
conveniently  as  if  it  were  a  new  virus. 
For  this  reason  I  didn't  tlnd  separate 
drug  units  in  the  hospitals;  it  seems 
mainly  to  be  laymen  who  consider 
them  desirable.  Dr.  Solursh,  who  is 
with  the  department  of  psychiatry  at 
Toronto  Western  Hospital,  doesn't 
want  to  start  one  at  TWH  because,  as 
he  explained,  he  is  treating  the  whole 
person  tor  ail  his  problems,  and  drugs 
are  often  only  a  reflection  of  these. 

Dr.  John  Unwin,  director  of  youth 
services  at  the  Allan  Memorial  Institute 
in  Montreal,  doesn't  see  drug  abuse  as  a 
separate  syndrome  either. 

"We  see  it  as  being  symptomatic  of 
other,  deeper  problems  among  the 
kids,"  he  said.  "As  we  handle  these, 
the  drug  abuse  thing  goes  into  the  back- 
ground. I  don't  think  there's  a  need 

JUNE  1971 


Carlotta  Hacker,  M.A. 

for  drug  abuse  centers,  except  at  the 
acute  intoxication  level." 

Dr.  Unwin  has  become  known  as  a 
drug  expert,  but  in  fact  he  is  a  youth 
psychiatrist.  The  one  led  to  the  other. 
And  this  is  what  happened  to  my  ques- 
tions —  only  they  led  from  drugs  to 
youth  and  from  there  to  all  directions. 

For  instance,  when  Dr.  V.M.  White- 
head of  The  Montreal  General  Hospital 
described  his  volunteer  work  at  the 
Youth  Clinic  (a  Montreal  street  agen- 
cy), the  drug  problems  faded  into  all 
the  others  —  malnutrition,  venereal 
disease,  pregnancies,  hopelessness, 
a  younger  generation  with  a  common 
philosophy  and  plenty  of  idealism, 
but  with  no  clear  incentive. 

"You  see  it's  not  so  much  a  drug 
problem,"  said  Dr.  Saul  Levine,  psy- 
chiatrist at  Toronto's  Hospital  for 
Sick  Children.  "There  is  a  drug  prob- 
lem, but  basically  it's  a  youth  problem. 
A  social  problem." 

Which,  of  course,  makes  it  much 
harder  to  tackle. 

The  author  is  a  freelance  writer  and  re- 
searcher, a  regular  contributer  to  Tlic 
Ctiiiacliaii  Niir\c.  aptt^iilfiTrjsDf  the  book 
.  .  .  And  C/;/■/.s7/^;<^y5(n■  on  Liixi^r  Island. 
She  spent  last  year  in^Maca,  asmting  her 
husband,  Hectir  J.  I^fflHix,  wittja  series 
of  educationalVilms  he  was  nwkWg  (here, 
and  she  is  curri^ifh'  wQip^  '\^^k  b|^ed 
on  their  expeditiOTv|[[^/.gi\e^,/         '      ^^ 


But  it  does  mean  that  when  a  patient 
is  admitted  to  a  hospital  because  of 
drugs,  he  isn't  segregated  or  treated  as 
a  hopeless  junky.  He  is  normally  placed 
in  a  psychiatric  ward  where  he  will  be 
given  individual  psychotherapy  or 
whatever  is  considered  necessary.  Or, 
if  he  is  admitted  for  serum  hepatitis,  he 
will  go  to  a  medical  ward,  though  a 
psychiatrist  will  be  called  in  for  advice 
and  the  patient  may  later  be  transferred 
to  a  psychiatric  unit. 

Naturally,  if  there  is  addiction,  cur- 
ing it  is  part  of  the  therapy;  Dr.  Solursh 
has  found  that  he  can  produce  adversive 
conditioning  to  speed  so  that  the  very 
process  of  injecting  it  becomes  highly 
unpalatable. 

Speed  was  mentioned  often,  so  of- 
ten that  1  was  ready  to  assume  it  was  the 
most  'commonly  treated  drug."  But  of 
course  the  answer  isn't  so  simple.  It 
depends  partly  on  what  drugs  are  on  the 
streets  at  any  time  —  although  even 
then  their  prevalence  may  not  be  re- 
flected in  the  hospitals.  For  example, 
marijuana,  even  LSD,  may  not  cause 
discomfort.  Neither  may  heroin  at 
first.  As  Dr.  Whitehead  pointed  out, 
few  of  the  2,000  or  so  herom  users  m 
Montreal  have  sought  treatment,  for 
heroin  kills  slowly  —  unlike  speed. 

"Speed  is  a  terrible  drug,"  said  Dr. 
Levine.  He  recently  finished  a  survey 
of  200  Canadian  speed  users,  and  be- 
lieves the  drug  has  been  badly  used 

THE  CANADIAN   NURSE     39 


medically  and  badly  used  by  the  kids. 
"It"s  self-destructive  and  self-defeating. 
It's  often  used  to  escape  from  a  terrible 
reality,  but  you  don't  escape:  you  get 
into  another  terrible  reality." 

So,  is  it  mainly  "speeders"  who  are 
being  treated  in  the  hospitals?  No,  it 
isn't.  Because,  as  Dr.  Levine  told  me 
and  as  I  was  told  again  and  again,  any 
drug  can  induce  psychotic  reactions.  It 
depends  so  much  on  who  is  using  it, 
why  he  is  doing  so  and  how.  Often  the 
user's  basic  social,  personal,  mental  or 
family  instability  is  as  important  a  con- 
tributing factor  to  a  crisis  as  the  drug 
itself. 

That  seemed  logical  enough,  but 
the  numbers  of  drug  cases  in  the  wards 
didn't.  Considering  how  much  we  hear 
about  '"drug-hurt  youth,"  I  was  surpris- 
ed to  find  that  so  few  of  them  had  been 
hurt  seriously  enough  to  be  hospitaliz- 
ed. 

At  St.  Michael's  Hospital  in  Toronto, 
the  director  of  social  work.  Leister 
White,  had  assembled  some  figures  for 
me;  in  1969,  of  the  four  or  five  thousand 
patients  who  passed  through  the  hos- 
pital, only  38  had  been  classified  as 
drug-abuse  cases.  From  July  to  October 
1970,  there  were  20.  As  Mr.  White 
pointed  out,  ^  drug  abuser  might  not 
always  be  classified  as  such.  Even  so, 
the  numbers  seemed  amazingly  small. 

The  four  other  hospitals  I  visited  had 
similarly  small  numbers:  perhaps  there 
would  have  been  one  patient  in  with 
hepatitis  during  the  past  three  months 
and,  in  each  psychiatric  ward,  there 
were  currently  only  a  handful  who  had 
been  admitted  principally  for  drug 
problems. 

Even  at  the  Allan  Memorial,  where 
Dr.  Unwin  has  12  psychiatric  beds 
especially  for  young  people,  only  2 
of  the  1 2  patients  on  average  have  been 
referred  there  primarily  because  of 
drugs. 

"Yet  at  any  given  time  there  are 
probably  eight  of  the  twelve  kids  who 
have  tried  drugs,"  Dr.  Unwin  told  me, 
"and  maybe  five  or  six  who  have  tried 
them  frequently.  But  this  is  not  the 
presenting  symptom  or  the  main  prob- 
lem." 

40     THE  CANADIAN   NURSE 


When  a  festival  is  on,  Dr.  Lionel  Solursh  encourages  the  nurses  oj  his  unit  to  go  to 
it,  partly  to  give  treatment,  but  principally  so  they  can  be  in  the  milieu  with  the 
kids  and  absorb  the  culture  through  their  pores,  instead  of  trying  to  understand 
it  at  a  distance  with  their  brains. 


I  wondered  if  it  was  more  often  the 
presenting  symptom  in  the  emergency 
departments.  Recently  I  had  read  in  the 
papers  how  drug  abusers  were  "Clutter- 
ing" the  emergency  wards,  and  it  did 
seem  likely  that  there  I  would  find 
a  more  appropriate  reflection  of  drug 
usage. 

Since  I  wished  to  see  for  myself  how 
the  kids  acted  and  were  treated  when 
they  arrived  at  a  hospital,  I  suggested 
that  1  spend  an  evening  at  St.  Michael's 
emergency  department.  But  the  super- 
visor. Sister  Mary  Gordon,  thought 
this  might  be  a  waste  of  my  time:  they 
didn't  have  drug  cases  every  night. 
Perhaps  if  she  phoned  me  when  one 
came  in  on  Saturday  or  Sunday,  the 
most  likely  nights? 

There  was  no  phone  call  from  her  on 
Saturday  night  and  I  was  still  listening 
for  one  on  Sunday  at  four  in  the  morn- 
ing. Nothing.  All  weekend  a  hospital 
in  downtown  Toronto  had  dealt  with 
nobody  on  a  bad  trip.  It  seemed  in- 


credible. The  following  Saturday  I 
transferred  my  attentions  to  the  Western 
Hospital,  but  I  called  it  off  toward 
midnight.  By  then  there  was  what  look- 
ed like  a  force-80  blizzard  in  Toronto. 
I  reckoned  that  if  no  kids  had  come  in 
on  a  bad  trip  yet,  they  wouldn't  be 
likely  to  in  such  weather  —  and  I 
wasn't  too  keen  on  braving  the  blizzard 
myself! 

But  what  did  all  this  waiting  and  non- 
tripping  mean?  Had  the  drug  scene 
been  wildly  exaggerated,  sensationaliz- 
ed out  of  all  proportion?  Why  had  no 
emergency  cases  come  to  St.  Michael's 
for  a  whole  weekend? 

"Well,  St.  Michael's  isn't  regarded 
as  a  very  receptive  hospital  to  people 
with  drug  problems,"  Mr.  White  told 
me.  "It's  considered  more  receptive  to 
the  alcoholic." 

Sister  Mary  Gordon  intimated  the 
same  thing  when  I  saw  her  in  emergen- 
cy, though  it  was  impossible  to  ima- 
gine her  being  unreceptive  to  anybody: 

JUNE  1971 


she  was  so  gentle  and  concerned.  And 
in  spite  of  the  empty  weekend,  she  did 
treat  bad  trips  regularly.  Her  records 
showed  that  there  had  been  eight  such 
cases  in  the  past  week.  By  comparison, 
there  had  been  eight  overdose  patients 
and  sixteen  alcoholics,  most  of  whom 
were  regulars. 

Did  that  tell  me  anything?  Not  really, 
for  Toronto  Western  —  which  is  said 
to  have  a  good  reputation  among  drug 
users  —  had  the  same  proportion, 
except  that  there  were  about  twice  the 
number  in  each  group.  At  The  Mont- 
real General,  the  same:  overdoses  and 
bad  trips  about  equal;  alcohol  figures 
were  double.  It  was  only  at  the  Hospital 
for  Sick  Children  (understandably,  be- 
cause of  the  age  factor)  and  at  the  Royal 
Victoria  Hospital  in  Montreal  that  the 
drug  misusers  exceeded  the  alcohol 
misusers. 

Yet  ail  the  drug  figures  seemed  in- 
congruously small,  even  allowing  for 
the  fact  that  the  psychistrists  were  seeing 
outpatients  who  didn't  necessarily  pass 
through  emergency.  What  was  the  ex- 
planation? 


It  was  Corinne  du  Tot,  supervisor 
of  the  Royal  Victoria's  emergency 
department,  who  spelled  it  out  for  me. 

"These  kids  really  don't  like  hos- 
pitals," she  said.  "I  think  they're  quite 
fearful  of  them  and  the  starch  that  goes 
with  them." 

She  said  if  you  are  having  a  bad 
trip,  first  you  go  to  your  friends  and, 
with  luck,  they  will  talk  you  down.  If 
they  fail,  then  there  are  youth  clinics 
and  street  agencies.  Montreal  is  well 
supplied  with  these —  the  Youth  Clin- 
ic, Drug  Aid,  The  Yellow  Door,  and 
many  more  —  places  where  doctors, 
nurses,  and  social  workers  are  on  duty, 
often  voluntarily,  to  deal  with  the  youth 
problems  near  their  source.  Even  the 
police  in  Montreal  generally  take  the 
kids  to  these  street  agencies,  and  it's 
only  the  extreme  cases  that  are  brought 
on  to  a  hospital,  generally  by  a  worker 
from  the  agency. 

In  Toronto,  where  there  are  fewer 
youth  clinics,  the  emergency  depart- 
ments receive  a  higher  percentage  of 
crisis  cases  who  come  in  directly,  but 
here,  too,  the  hospitals  are  suspect  as 


institutions,  as  "arms  of  the  establish- 
ment." Dr.  Levine  told  me  that  at  one 
time  The  Hospital  for  Sick  Children 
was  on  the  list  of  places  to  avoid  in  a 
crisis  —  not  because  you  were  unsym- 
pathetically  treated  there,  but  because 
there  was  too  much  involvement  and 
you  might  be  lectured,  persuaded. 

I  heard  a  great  deal  about  lecturing 
and  attitudes. 

"Yet  there's  no  particular  attitude 
necessary,"  said  Dr.  Unwin  of  the  Allan 
Memorial,  "except  to  see  them  as  sick 
people  needing  help.  But  this  has  been 
difficult  for  a  lot  of  the  staff,  both  doc- 
tors and  nurses." 

I  was  told  that  sometimes  there  had 
been  a  "serve-them-right"  attitude. 
Some  kids  had  been  treated  as  delin- 
quents; some  had  been  scared  away  by 
a  snappy  receptionist.  Others  had  come 
in  for  "Band-aid"  treatment  and  found 
they  were  into  a  whole  new  bag  of  prob- 
lems, with  lecturing  and  hectoring  and 
parents  getting  hysterical. 

And  what  did  the  kids  themselves 
say?  Quite  a  lot. 

"They  made  me  feel  like  a  convict," 
I  was  told.  "Like  .  .  .  sinful.  They  didn't 
understand.  They  just  didn't  under- 
stand." 

But  then  again,  I  heard  one  of  Dr. 
Solursh's  patients  saying  that  he  did 
understand. 

"He  didn't  treat  me  as  a  low  type  of 
being,"  she  said. 

And  Dr.  Levine  said  that  many  of  the 
200  speeders  he  interviewed  felt  they 
had  been  well  handled  by  doctors  and 
nurses  and  hadn't  been  criticized  un- 
necessarily. 


"Talking  down"  a  patient  on  a  had  trip 
might  prove  the  wisest  treatment  —  if 
//  will  work  —  Dr.  Saul  Levine  suggest- 
ed to  the  author,  because  Valium  merely 
enhances  the  drug  culture.  Up  you  go 
on  LSD,  down  you  come  on  Valium. 


JUNE   1971 


THE  CANADIAN   NURSE     41 


Bertha  Rady,  RN,  with  Dr.  Michael  Whitehead  at  Montreal  General  Hospital's 
department  of  hematology.  Both  do  volunteer  work  at  the  Youth  Clinic  —  a 
Montreal  street  agency. 


Obviously  there  has  been  unsympa- 
thetic handling  within  the  hospitals  — 
or  even  unsuitable  handling  because  of 
ignorance  —  and  as  a  result  the  kids 
have  been  driven  away.  But,  though 
many  people  feel  there  is  still  room  for 
improvement,  the  worst  shock  waves 
seem  to  have  past.  Certainly  the  emer- 
gency nurses  I  met  condemned  the  drugs 
rather  than  their  victims.  Their  attitudes 
ranged  from  a  slightly  puzzled,  but 
genuine  sympathy  to  a  real  positive 
understanding. 

The  actual  behavior  toward  a  crisis 
patient  varies  less  widely,  for  most  hos- 
pitals follow  much  the  same  routine 
when  dealing  with  a  kid  on  a  bad  trip. 
They  get  him  into  a  quiet  room  as  soon 
as  possible  and  have  him  seen  by  a 
doctor  who  usually  prescribes  Valium 
to  bring  him  down.  All  this  is  done 
before  any  attempt  is  made  to  find  out 
who  he  is  or  where  he  lives,  for  the 
clatter  of  a  typewriter,  insistent  ques- 
tioning, almost  anything  can  be  disturb- 
ing to  a  hallucinating  patient. 

42     THE  CANADIAN   NURSE 


The  quiet  room  can  present  a  prob- 
lem in  Toronto  where  the  patient  may 
not  be  accompanied  by  a  street  worker 
or  friend  who  will  stay  with  him.  As 
hallucinating  patients  must  be  watched, 
the  Western  Hospital  sometimes  has 
to  settle  them  in  the  hall  so  a  nurse 
can  keep  an  eye  on  them  without  having 
her  attention  monopolized  for  several 
hours. 

So  friends  are  very  welcome  and  most 
hospitals  encourage  them  to  stay  and 
exert  a  calming  influence.  Many  nurses 
mentioned  how  gentle  the  kids  are  with 
their  sick  friends  and  how  sometimes 
they  manage  to  talk  them  down.  Dr. 
Levine  feels  that  talking  down  may  be 
preferable,  if  it  will  work,  because 
Valium  merely  enhances  the  drug  cul- 
ture —  Up  you  go  on  LSD.  Down  you 
come  on  Valium.  But  talking  down 
generally  takes  longer  and  even  then 
Valium  may  be  required  as  well. 

Reassurance  is  also  important  be- 
cause a  kid  is  often  frightened  when  he 
comes  for  emergency  treatment:  fright- 


ened of  what  is  happening  to  his  mind, 
frightened  of  what  is  happening  to  his 
body  —  has  his  heart  stopped'.'  has  he 
stopped  breathing?  —  frightened  of 
the  hospital  set-up,  and  perhaps  fright- 
ened of  the  legal  implications.  There 
have  been  cases  where  the  kids  have 
left  before  treatment  because  a  police- 
man has  been  present  —  Is  he  after 
me?  Is  he  going  to  put  me  in  jail? 

It  is  easy  to  talk  about  calmness  and 
reassurance,  but  a  hallucinating  patient 
can  be  violent;  and  it  may  be  difficult 
for  a  young  nurse  to  realize  that  an 
alarming  and  possibly  abusive  young 
man  is  not  a  threat,  but  is  a  very  sick 
person  having  his  own  dreadful  night- 
mare. Sometimes  a  violent  patient  has 
to  be  strapped  in  his  bed  —  a  necessity 
that  doesn't  help  his  mental  recovery. 
And  here  The  Montreal  General  is  one 
up  on  the  other  hospitals.  By  placing 
mattresses  on  the  floors  of  the  rooms 
so  a  patient  can't  harm  himself  by  falling 
out  of  bed,  they  avoid  the  need  for  a 
restraining  strap  unless  a  patient  is  very 
wild. 

In  all  hospitals  a  psychiatrist  is  on 
call,  although  it  may  not  be  necessary 
to  call  him.  Before  the  patient  leaves 
—  he  may  be  in  for  four  or  five  hours, 
or  overnight  —  most  hospitals  see 
that  he  is  given  some  referral  (the  phone 
number  of  a  psychiatrist,  of  a  mental 
health  clinic  or  a  street  agency)  so  he 
can  call  for  continuing  therapy  if  he 
wants  to.  Unless  the  psychiatrist  consid- 
ers it  essential,  the  patient  is  not  pres- 
sured to  take  any  form  of  therapy  (and 
he  may  not  need  it). 

The  police  are  not  informed  and 
neither  are  his  family  unless  he  agrees 
or  particularly  requests  it.  Even  The 
Hospital  for  Sick  Children  doesn't 
automatically  notify  parents  any  longer. 
So,  in  most  cases,  it  is  a  first-aid  job 
without  strings  attached,  though  the 
strings  are  visible,  dangling  invitingly 
for  anyone  who  wants  to  use  them  as 
a  lifeline. 

And  are  the  nurses  also  inviting? 
Kindly,  rather  than  condemning?  1 
thought  so. 

I  was  particularly  impressed  by  the 
attitudes  of  the  nurses  in  Toronto  Wes- 
tern's   psychiatric    unit,    where    there 

JUNE  1971 


Montreal  is  well  supplied  y\ith  youth  clinics  and  street  agencies  —  places  where 
nurses,  doctors,  and  social  workers  are  on  duty,  often  voluntarily.  Photo  shows 
one  of  the  founders  of  Drogue  Secours,  Guy  Simard  (right)  and  Henry  Grey  (left), 
helping  calm  a  person  on  .   '  •  '  ■■  r 


A  Montreal  street  agency  —  Drogue  Secours  —  owns  a  smalt  truck  that  is  used 
to  pick  up  persons  "on  a  bad  trip"  or  to  take  them  to  hospital,  if  necessary. 
lUNE  1971 


seemed  to  be  a  caring,  yet  determined 
approach  to  each  patient.  For  instance, 
while  I  was  interviewing  Monica  Creen, 
she  was  called  to  the  phone.  An  inpa- 
tient, who  had  previously  been  on  LSD, 
had  left  the  hospital  to  go  to  his  music 
lesson  but  had  stayed  away  for  several 
days.  So  Monica  had  called  his  home 
to  say  that  the  unit  cared  about  him, 
that  she  wasn't  mad  at  him.  and  she 
hoped  he  would  come  back  and  continue 
his  therapy.  He  was  telephoning,  rather 
hesitantly,  to  say  he  would  return  that 
evening. 

It  is  natural  that  the  nurses  in  a  psy- 
chiatric ward  should  be  oriented  toward 
mental  problems  and  drug  problems, 
but  I  didn't  find  any  brickwall  attitudes 
in  the  medical  wards  either.  And  I  did 
try  very  hard  to  get  somebody  to  say  or 
even  think:  They're  a  bunch  of  dirty 
hippies  taking  up  space  in  good  hospital 
beds."  Nobody  even  implied  it.  The 
nearest  I  could  get  was  that  sometimes 
the  friends  were  a  nuisance:  they  might 
bring  in  drugs,  or  they  might  refuse  to 
submit  to  the  isolation  precautions 
connected  with  hepatitis.  But  the  pa- 
tients themselves'.'  Why,  they  were  just 
sick  people  who  needed  nursing. 

It  was  the  same  story  in  the  emer- 
gency wards,  where  sympathy  was 
the  predominant  attitude  —  sympathy 
mixed  with  an  understanding  of  how 
easily  kids  can  get  hooked  on  drugs. 
Helen  Readman  at  the  Toronto  West- 
ern Hospital  told  me  with  some  feeling 
that  she  was  glad  she  was  no  longer  a 
teenager. 

"Kids  are  curious,"  she  said,  "and 
your  friends  say  "Here,  try  some  of 
this.  .  .  .'" 

And  then  there  was  Corinne  du  Tot 
heading  the  Royal  Victoria  Hospital's 
emergency  staff,  well  informed  and 
talking  sound  common  sense.  She  had 
suggested  that  perhaps  hospital  starch- 
iness  scared  away  the  kids  and  it  may 
unintentionally  do  so  —  but  there 
isn't  a  crackle  of  it  in  her.  1  wondered  if 
this  was  why  the  street  agencies  often 
brought  their  extreme  cases  to  the 
Royal  Victoria.  Perhaps  also  why  the 
drug  abuse  figures  here  exceeded  the 
alcohol  abuse  figures? 

But   I   also  heard  that  the  Jewish 

THE  CANADIAN  NURSE     43 


General  Hospital  was  handling  large 
numbers  of  drug  cases  in  Montreal.  I 
had  to  bear  in  mind  that  I  was  basing 
my  opinions  on  a  handful  of  hospitals, 
chosen  at  random  and  not  especially 
for  their  drug  abuse  programs. 

Nevertheless,  1  thought  it  significant 
that  Miss  du  Tot  had  attended  the 
National  Symposium  on  Hospital 
Responsibility  Towards  Drug  Users, 
held  in  Montreal  in  February,  and  had 
then  called  iier  nurses  together  and 
relayed  to  them  what  had  been  discussed 
and  recommended  at  the  conference. 

The  symposium  spent  some  time 
considering  the  need  for  education 
about  drugs  and  drug  users  and,  as  a 
result  of  its  findings,  it  looks  as  if  more 
programs  will  be  started  for  hospital 
staff.  But  already  quite  a  lot  is  going  on. 
At  Toronto's  Hospital  for  Sick  Children 
there  is  an  inservice  training  program 
for  people  who  are  in  the  firing  line 
of  the  drug  scene  —  the  emergency 
department,  the  medical  clinic,  and  so 
on.  And  at  most  hospitals,  lectures  and 
talks  are  given,  though  not  always  in 
such  a  structured  way. 

There  is  also  plenty  of  serious  and 
considered  reading  matter  available. 
But  how  many  nurses  read  it?  Or  how 
often  does  it  come  their  way?  When  I 
saw  Sister  Mary  Gordon  at  St.  Mi- 
chael's, she  had  just  received  a  circular 
from  12  Madison  (a  Toronto  street 
agency)  and  was  both  pleased  and  re- 
lieved to  have  it.  For  it  helped  her  un- 
derstand what  the  kids  were  going 
through  and  consequently  how  to  see 
them  through  it. 

At  Toronto  Western  there  is  yet 
another  approach.  All  new  graduate 
nurses  are  given  an  explanatory  talk 
by  Ruta  Jansons,  the  drug  abuse  treat- 
ment coordinator,  and  by  D  i  a  n  n  e 
Hinchcliffe,  the  head  nurse  of  the  psy- 
chiatric unit.  And  when  there  is  a  festi- 
val on.  Dr.  Solursh  sends  his  nurses 
along,  partly  to  give  treatment  but 
principally  so  they  can  be  in  the  milieu 
with  the  kids  and  absorb  the  culture 
through  their  pores,  instead  of  trying 
to  understand  it  from  a  distance  with 
their  brains. 

Dr.  Whitehead,  too,  felt  that  exper- 
ience was  an  important  part  of  educa- 

44     THE  CANADIAN   NURSE 


tion,  either  second-hand  experience  by 
being  in  regular  contact  with  someone 
working  with  young  people,  or  in  a 
more  direct  form  by  working  at  a  street 
agency.  When  Bertha  Rady  told  him 
that  the  attitudes  toward  drug  patients 
had  not  been  moralistic  when  she  had 
been  a  nurse  on  a  medical  ward  at  The 
Montreal  General,  he  replied:  "Yes, 
but  how  much  did  you  contribute  to 
that?" 

The  question  was  left  hanging,  and  so 
answered  itself.  For  Bertha,  now  a  nurse 
at  Dawson  College,  has  for  some  time 
been  doing  voluntary  evening  work  at 
the  Youth  Clinic  and  has  worked  reg- 
ularly with  drug  users.  So  her  own 
attitude  would  almost  certainly  have 
influenced  her  fellow  nurses. 

There's  no  doubt  that  more  and  more 
formal  and  informal  education  about 
drug  misuse  and  the  whole  youth  scene 
is  permeating  the  hospitals,  and  that  the 
attitudes  are  less  moralistic  and  more 
medical  than  they  were,  say,  three  years 
ago.  But  when  considering  attitudes,  I 
began  to  realize  that,  like  so  much  else 
connected  with  the  drug  scene,  attitudes 
really  have  little  to  do  with  drugs. 

Ruta  Jandons  made  a  good  point 
when  she  said  you  can  also  arouse  hos- 
tility if  you  are  admitted  for  VD  or  for 
having  an  illegitimate  baby.  If  you  can 
speak  only  Polish  or  Italian,  that  can 
cause  antagonism  too:  it  can  be  any- 
thing that  might  create  difficulty,  cen- 
sure, or  discomfort.  It  can  simply  be 
that  you  have  long  hair. 

Even  so,  I  believe  hospitals  are  now 
bending  over  backwards  to  meet  the 
kids.  The  specialists  and  many  nurses 
are  undoubtedly  succeeding.  Dr.  White- 
head, for  instance,  feels  that  one  of  his 
more  important  functions  at  the  clinic 
is  simply  to  be  an  adult  whom  the  kids 
can  talk  to.  For  this  is  another  basic 
problem  at  the  heart  of  the  drug  scene: 
the  communications  barrier.  I  don't 
think  nurses  like  Bertha  Rady  would 
ever  have  any  great  difficulty  with  this 
barrier.  Neither  would  many  other 
young  nurses  —  particularly  someone 
like  Lydia  Ayles,  who  works  on  the 
youth  services  team  that  The  Montreal 
General  set  up  last  July. 

But,  as  I  visited  the  hospitals  I  met 


quite  a  number  of  nurses  —  kind,  car- 
ing people  —  whom  I  couldn't  imagine 
establishing  any  fundamental  rapport 
with  these  kinds,  whether  the  kids  were 
on  drugs  or  not.  It's  not  so  much  a 
generation  gap  as  a  type-of-person  gap, 
and  you  can't  close  that  simply  with  a 
course  of  lectures,  or  even  by  wanting 
to  close  it.  For  here  we  have  two  dif- 
ferent worlds,  another  pair  of  solitudes. 

Nevertheless,  as  the  nursing  profes- 
sion learns  more  about  the  new  youth, 
comes  to  understand  why  it  has  develop- 
ed as  it  has,  and  comes  to  appreciate 
its  virtues  and  idealism,  rather  than 
seeing  only  its  negative  qualities,  then 
the  gap  must  begin  to  close.  Similarly, 
as  more  is  learned  about  drugs;  as  there 
is  more  understanding  of  why  they  have 
become  such  a  cult  among  the  young; 
and  as  we  relate  them  to  socially-accept- 
ed drugs,  such  as  alcohol,  cigarettes, 
slimming  pills,  aspirin,  and  sleeping 
pills  that  the  "straight"  world  indulges 
in  —  so  their  prevalence  will  not  seem 
such  an  extraordinary  phenomenon. 

Already  in  the  hospitals  there  is  a 
positive  approach  to  understanding 
both  the  young  and  their  drugs.  This 
became  obvious  to  me  as  I  listened  to 
the  many  nurses  and  doctors  I  met  while 
preparing  this  article.  And  already  drug 
abuse  is  being  treated  with  compassion, 
seen  as  a  sickness,  rather  than  a  sin. 

For,  when  it  comes  down  to  it,  a 
nurse  doesn't  have  to  have  bridged  the 
gap;  she  is  not  required  to  do  what  so 
many  of  our  generation  can't  do  and 
what  the  kids  can't  do  either.  She  is 
simply  required  to  nurse  a  patient  who 
has  been  misusing  drugs  with  the  same 
expertise,  attention,  and  kindness  that 
she  extends  to  any  other  sick  person. 

And  this,  it  seems  to  me,  is  what  she 


is  generally  doing. 


* 


lUNE  1971 


"Hey,  Nurse! "is the 

brainchild  of  the  author, 

Jennie  Wilting,  (Nurse  Whozits), 

a  graduate  of  Blodgett 

Memorial  Hospital  School 

of  Nursing  in 

Grand  Rapids,  Michigan, 

and  the  University 

of  Minnesota,  Minneapolis. 

For  four  years  she 

was  head  nurse  on  a 

psychiatric  unit,  and 

for  10  years,  an  instructor 

in  psychiatric  nursing. 

At  present,  she  is 

a  lecturer  in  mental  health 

concepts  at  the 

University  of  Alberta 

School  of  Nursing 

in  Edmonton,  Alberta. 


by  Nurse  Whozits 

"Is  your  work  finished.  Miss  Tizzy?" 
asked  Mrs.  Squatter,  the  head  nurse. 

"Yes,  as  soon  as  I  make  a  notation 
on  Mrs.  Rusher's  Kardex  card." 

Miss  Tizzy  writes  neatly:  Very 
manipulative.  Do  not  let  yourself  be 
manipulated  by  this  patient. 

"There,"  sighs  Miss  Tizzy,  "my 
work  is  finished." 

Manipulative!  Manipulated!  Horri- 
ble words.  What  do  we  mean  by  them? 

We  use  these  words  frequently,  but 
when  we  try  to  pinpoint  what  they 
mean  we  usually  have  difficulty.  What 
is  clear,  however,  is  that  these  words 
have  a  negative  connotation  and  des- 
cribe undesirable  behavior. 

In  a  situation  that  involves  man- 
ipulation, one  person  uses  the  other 
person  to  obtain  his  own  goals  in  a  way 
that  is  unhealthy  for  both.  By  devious 
ways  one  person  influences  or  pres- 
sures the  second  person  to  behave  or 
act  in  a  manner  against  his  better  judg- 
ment. Manipulation  takes  two  — 
the  person  doing  the  manipulation 
and    the    person    being    manipulated. 

We  are  still  left  with  many  ques- 
tions. If  the  patient,  by  devious  or 
underhanded  ways,  gels  the  nurse  to 


JUNE   1971 


do  something  that  meets  a  physical 
or  emotional  need,  is  the  patient  being 
manipulative?  If  the  nurse  does  what 
the  patient,  in  a  subtle  way.  indicated 
he  wanted  her  to  do,  is  the  nurse  being 
manipulated? 

Is  it  possible  for  the  nurse  to  treat 
a  patient  in  a  way  that  makes  it  diffi- 
cult for  him  to  be  open  and  honest 
with  her?  If  the  patient  then  attempts 
to  express  his  needs  in  a  subtle  and 
unpleasant  way.  is  he  being  manipu- 
lative? Or,  perhaps,  is  he  being  man- 
ipulated by  a  manipulative  nurse  to 
behave  in  a  certain  manner? 

"The  patient  is  manipulative."  What 
a  derogatory  remark!  Before  using  it, 
let's  be  sure  we  know  what  we  mean 
by  "manipulative."  Then,  let  us  clarify 
for  ourselves  what  message  we  are 
trying  to  convey  to  the  other  staff 
members.  Finally,  how  is  this  informa- 
tion going  to  help  the  other  nurses  im- 
prove the  care  this  patient  is  receiving? 

There  is  one  final  question  we 
should  ask  ourselves:  Is  there  a  move 
effective  way  to  convey  this  informa- 
tion? If  there  isn't,  then  —  and  only 
then  —  should  we  use  the  word  "man- 
ipulative." '^ 

THE  CANADIAN   NURSE     45 


idea 
exchange 


46     THE  CANADIAN  NURSE 


JUNE  1971 


Plastic  Swaddlers  Keep  Newborns  Warm 


The  double-layered,  clear  plastic  mater- 
ial that  protects  fragile  china  or  glass  in 
shipping  can  be  used  with  advantage  to 
prevent  heat  loss  in  the  newborn. 
"Swaddlers,"  made  of  this  plastic,  keep 
babies  born  at  the  Cincinnati  General 
Hospital  safely  warm  during  that  criti- 
cal time  right  after  birth. 

Dr.  Sutherland,  director  of  the  divi- 
sion of  newborn  at  Cincinnati  General 
Hospital  and  professor  of  obstetrics  and 
gynecology  and  pediatrics  at  the  Uni- 
versity of  Cincinnati  College  of  Medi- 
cine, saw  in  the  plastic  packing  material 
its  insulating,  rather  than  its  cushion- 
ing, properties.  It  did  not  take  him 
long  to  envisage  a  baby  swaddler  made 
from  this  material. 

Designed  for  commercial  packaging, 
air  pockets  shaped  like  truncated  hemis- 
pheres sealed  between  two  layers 
of  polyvinylidene-coated  polyethylene 
form  a  pliable  cushion  to  protect  fragile 
objects  during  transport.  For  Dr.  Su- 
therland, the  air  pockets  spelled  insula- 
tion against  heat  loss;  to  be  precise, 
insulation  against  heat  loss  in  babies 
immediately  following  birth. 

Dr.  Sutherland  gathered  a  team  to 
test  his  innovation:  pediatricians  whose 
interest  paralleled  his  own  —  Drs. 
Nicholas  J.  Berch,  Paul  H.  Perlstein 
and  William  J.  Keenan;  an  electrical 
engineer,  Neil  K.  Edwards;  and  the 
supervisor  of  obstetrics  at  the  Cincin- 
nati General  Hospital,  Laurine  Coch- 
ran. 

They  all  recognized  the  importance 
of  the  conservation  of  heat  during  a 
baby's  first  few  hours  of  independent 
life.  A  warm,  content,  and  comfortable 
baby  expends  less  energy  than  a  cold 

JUNE  1971 


one  and  therefore  has  a  better  chance 
for  survival.  Should  a  cold  baby  need 
to  be  rewarmed,  there  is  the  added 
risk  of  apnea  that  often  develops  into  a 
difficult  problem.  The  team  points  out: 
"Birth  is  the  universal  cold  stress  for  an 
infant  in  a  civilized  society.  The  extra 
energy  demanded  of  a  small  or  sick 
infant  who  is  cold  may  create  enough 
added  stress  to  kill  him  —  like  forcing 
an  older  patient  with  heart  failure  and 
pulmonary  edema  to  run  a  mile." 

At  delivery,  a  baby's  temperature  is 
approximately  99  degrees  Fahrenheit. 
Suddenly,  unless  protected  at  once,  he 
faces  chilling  reality,  as  evaporation  of 
amniotic  fluid  from  his  wet  skin  can 
result  in  a  drop  in  body  temperature  of 
from  three  to  five  degrees  Fahrenheit 
within  half  an  hour.  Various  techniques 
in  general  use  prevent  this  initial  loss 
of  heat:  drying  the  infant  and  wrapping 
him  in  warm  blankets,  putting  him  in 
an  incubator  or  a  warmed  crib,  using 
radiant  warmers  and  opaque  swaddlers. 

The  plastic  swaddler  devised  by  Dr. 
Sutherland  has  been  tested  and  improv- 
ed over  a  two-year  period.  For  purposes 
of  comparison,  simultaneous  studies 
have  employed  one  or  more  techniques 
mentioned  above  for  keeping  the  babies 
warm.  Use  of  the  swaddler  has  been  the 
most  effective  means  of  conserving  an 
infant's  body  heat. 

Immediately  on  delivery,  a  baby  is 
slid,  feet  first,  into  the  plastic  swaddler. 
It  is  not  removed  during  delivery  room 
procedures,  during  transfer  of  the  baby 
to  the  nursery,  or,  when  necessary,  to 
another  hospital. 

Early  in  the  study  the  swaddler  was 
taped  over  the  baby's  shoulders,  leaving 


the  head  and  neck  exposed.  However, 
recalling  that  the  head  constitutes  be- 
tween 9  and  1 8  percent  of  a  newborn's 
body  surface,  the  bag  was  extended  to 
cover  the  ears  and  back  of  head.  This 
achieved  improved  retention  of  heat.  It 
was  conveniently  found  to  be  unneces- 
sary to  sterilize  the  bags  during  the 
study,  as  no  significant  bacteria  or 
fungi  could  be  found  on  the  material  of 
air  pockets  before  or  after  the  swaddlers 
were  made. 

The  clear  plastic  permits  close  ob- 
servation of  respiration,  color,  and 
activity  of  babies  and  does  not  hamper 
the  care  of  even  the  most  critically  ill 
infant.  Weighing,  eye  care,  and  removal 
of  mucus  from  a  baby's  nose  and  throat 
present  no  problem.  Other  routine 
measures,  such  as  clamping  the  in- 
fant's cord,  foot  printing,  applying 
identification  anklets  or  bracelets,  or 
determining  rectal  temperature,  are 
readily  managed  by  tearing  an  opening 
in  the  bag.  Such  openings  are  later 
effectively  closed  with  clear  plastic 
adhesive  tape. 

Special  techniques  can  also  be  done 
without  the  risk  of  cooling  the  baby. 
Again,  holes  are  made  in  the  swaddler 
to  facilitate  resuscitation,  umbilical 
catheterization,  and  collection  of  blood 
and  urine  samples. 

The  bag  is  easy  to  use,  inexpensive, 
disposable,  and  —  most  important  — 
safe.  The  developers  say:  "Two  years 
of  experience  have  produced  no  reason 
for  concern  about  accidental  asphyxia- 
tion using  these  plastic  bags,  as  they  are 
of  a  material  rigid  enough  to  preclude 
such  an  occurrence."  ^ 

THE  CANADIAN   NURSE     47 


strategies    For    Teaching    Nursing    by 

Rheba  de  Tornyay.  145  pages.  To- 
ronto, John  Wiley  and  Sons,  Inc., 
1971. 

Reviewed  by  Maureen  Cropper,  In- 
structor in  Basic  Nursing,  Holy 
Cross  Hospital  School  of  Nursing, 
Calgary,  Alberta. 

In  this  interesting,  easily-read  paper- 
back, nurse  educators  are  shown  how 
to  teach,  with  emphasis  on  allowing 
the  student  to  use  discovery.  The  book 
was  designed  to  assist  graduate  students 
and  nursing  instructors  to  analyze  teach- 
ing behavior. 

In  the  introduction  the  author  states 
that  the  underlying  assumption  for  the 
book  is  that  teaching  skills  can  be  learn- 
ed. An  attempt  has  been  made  to  bridge 
the  gap  between  theory  and  practice. 
Throughout,  emphasis  is  placed  on  the 
learner. 

The  first  six  chapters  deal  with  the 
components  of  instruction.  Excellent 
material  is  presented  regarding  positive 
and  negative  reinforcements,  use  of 
models  and  examples,  and  various 
methods  of  questioning.  A  chapter  on 
creating  set  indicates  the  importance 
of  stimulating  the  learner  and  allowing 
creativity.  The  chapter  on  using  closure 
as  a  teaching  technique  shows  that  it  is 
effective  in  allowing  the  student  to 
abstract  ideas  and  thus  transfer  know- 
lege  to  new  situations. 

The  last  six  chapters  deal  with  in- 
structional strategies.  The  advantages 
and  disadvantages  of  the  various  teach- 
ing methods  are  clearly  stated.  Brief 
summaries  of  research  done  on  the 
methods  are  included.  The  chapter  on 
individualized  instruction  emphasizes 
the  importance  of  finding  means  to 
allow  for  independent  study.  Teachers 
should  be  left  free  to  guide  elusive, 
complex  learning  processes.  An  em- 
phatic statement  closes  the  chapter, 
"Any  teacher  who  can  be  replaced  by  a 
machine,  should  beV 

The  epilogue  presents  briefly  the 
teaching  environment  in  2000  a.d.  when 
the  role  of  the  teacher  as  a  dispenser  of 
information  will  be  non-existent.  She 
will  instead  be  involved  deeply  in 
course  development  based  on  her  own 
nursing  experiences.  She  will  meet  the 
students  after  they  have  mastered  a 
specific  block  of  knowledge  to  assist 
them   in   higher-level   learning.  Using 

48     THE  CANADIAN   NURSE 


modern  technology,  nursing  students 
will  know  how  to  care  for  patients 
before  they  reach  the  clinical  situation. 
This  book  is  a  brief,  clear  reference 
for  those  presently  involved  in  nursing 
education  and  an  excellent  introduction 
for  those  learning  teaching  strategies. 
It  is  written  for  the  present,  and  gives 
good  indications  for  the  future.  Every 
nursing  student  would  benefit  if  her 
instructor  read  this  book. 


Basic  Pediatric  Nursing  by  Persis  Mary 
Hamilton.  487  pages.  Saint  Louis, 
Mosby,  1970. 

Reviewed  by  Carolyn  Vogt,  Director, 
Affiliate  Program,  School  of  Nurs- 
ing, The  Children's  Hospital  of  Win- 
nipeg, Winnipeg,  Manitoba. 

The  purpose  of  this  book,  as  stated  by 
the  author,  is  to  provide  a  basic  text  of 
pediatric  nursing  for  the  practical- 
vocational  nurse.  She  has  succeeded  in 
several  wavs. 

Throughout  the  book  she  uses  clear, 
direct  language  and  avoids  unnecessary 
medical  jargon.  The  necessary  termi- 
nology, fundamental  to  an  understand- 
ing of  the  content,  is  listed  at  the  begin- 
ning of  each  chapter,  and  each  word 
is  subsequently  used  in  the  content  of 
that  chapter. 

In  the  area  on  the  growing  and  devel- 
oping child,  the  author  reviews  briefly 


for  employment  or  bursaries  write: 

Director  in  Chief 

VICTORIAN  ORDER  OF  NURSES 

FOR  CANADA 

5  Blackburn  Avenue 

OKawa  2,  Ontario 


and  concisely  the  steps  through  which 
an  individual  must  pass  on  the  road  to 
maturity.  Here  she  clearly  points  out 
Erikson's  eight  stages  of  man  in  words 
and  in  a  clear,  eye-catching  illustration. 

A  highlight  of  the  chapter  on  "Ill- 
ness, the  Chikl  jind  His  Hospital  Care." 
is  the  table  devoted  to  common  child- 
hood signs  and  symptoms.  This  table 
enables  the  practical-vocational  nurse 
to  describe  in  an  effective  way  the  signs 
or  symptoms  that  a  child  may  exhibit 
and  helps  her  understand  the  possible 
physiological  cause.  Nursing  actions 
thus  can  be  based  on  knowledge,  rather 
than  on  rote  behavior  nursing  response 
to  the  child's  signs  and  symptoms. 

In  the  author's  discussion  of  dis- 
orders common  to  children  and  their 
care,  she  recognizes  that  a  basic  review 
of  the  structure  and  function  of  the 
pertinent  body  system  is  most  helpful 
in  assisting  the  practical-vocational 
nurse  to  understand  the  disease  process. 
For  example,  in  the  chapter  on  muscu- 
loskeletal conditions,  the  structure  and 
functions  of  the  bones  and  the  different 
types  of  muscle  tissue  are  reviewed.  In 
a  separate  chapter,  but  in  conjunction 
with  the  above,  the  author  clearly  out- 
lines the  nursing  care  related  to  ortho- 
pedic devices,  mainly  traction  and 
casts.  This  section  is  more  compre- 
hensive than  any  other  section  of  the 
book  in  that  the  many  principles  of 
care  pertinent  to  this  area  are  definitely 
included. 

Throughout  the  book  the  author 
both  directly  and  indirectly  points  out 
the  role  of  the  practical-vocational  nurse 
in  relation  to  other  personnel  involved 
in  health  care.  In  one  section,  a  schema- 
tic illustration  indicates  the  channels 
for  communication  in  team  nursing,  with 
the  practical-vocational  nurse  working 
under  the  supervision  of  a  registered 
nurse.  In  discussing  the  individual  plan 
of  care  as  opposed  to  team  nursing,  the 
author  states  that  "the  practical -voca- 
tional nurse  may  be  assigned  the  inoi- 
vidual  care  of  children  with  stable 
conditions  or  those  requiring  uncom- 
plicated care." 

Pervading  the  entire  book  are  ex- 
cellent pictures  illustrating  various 
aspects  of  nursing  care  and  different 
phases  of  growth  and  development.  The 
use  of  children  of  different  racial  back- 
grounds increases  the  effectiveness  of 
these  pictures. 

JUNE  1971 


It  would  be  desirable  in  this  book  to 
have  a  bibliographical  list  at  the  end  of 
each  chapter  or  section.  However,  the 
author  does  include  a  list  of  references 
for  further  study  at  the  end  of  the  book. 

The  author  has  achieved  her  objective 
as  outlined  in  the  preface  of  her  book. 
This  book  would  be  of  tremendous 
assistance  to  teachers  and  students  in 
practical  nurse  or  nursing  assistant 
programs. 


Community  College  Nursing  Education 

by  Virginia  O.  Alien.  173  pages. 
Toronto,  John  Wiley  and  Sons,  Inc., 
1971. 

Reviewed  by  Mona  Callin,  Nursing 
Instructor.  Dawson  College,  Mont- 
real, Quebec. 

This  text  is  one  of  the  six  volumes  in 
the  Wiley  Paperback  Nursing  Series 
edited  by  Mildred  Montag.  In  this 
volume  Virginia  Allen  describes  the 
development  and  growth  during  the 
six-year  demonstration  period  of  the 
associate  degree  nursing  program  at 
Newton  Junior  College. 

The  program  in  nursing  at  Newton 
Junior  College  was  the  first  associate 
degree  program  in  New  England  and 
served  as  a  prototype  to  demonstrate 
the  efficiency  of  two-year  college  level 
nursing  education  programs.  For  the 
first  six  years  the  program  was  consid- 
ered an  experimental  pilot  project. 
Virginia  Allen  was  its  chairman  from 
the  time  of  inception  and  throughout 
the  six-year  demonstration  period.  The 
author  hopes  that,  because  the  nursing 
program  at  Newton  Junior  College 
examplifies  the  essential  characteristics 
of  an  associate  degree  program  in  nurs- 
ing, this  volume  will  be  of  particular 
interest  and  value  to  individuals  who 
are  considering  establishing  nursing 
programs  and  to  those  presently  engaged 
in  their  development. 

The  book  presents  an  objective  and 
factual  account  of  the  planning,  imple- 
mentation, and  evaluation  stages  of  the 
program  and  concludes  with  some 
recommendations  for  the  development 
and  implementation  of  associate  degree 
programs  in  nursing.  Included  through- 
out the  text  are  examples  demonstrating 
the  application  of  ideas  and  concepts 
that  are  particularly  helpful  to  readers 
unfamiliar  with  associate  degree  nurs- 
ing education.  Although  the  author 
writes  about  her  experience  in  New 
England,  her  book  is  of  significance 
to  Canadian  nurses  concerned  about 
and  involved  in  the  transition  of  basic 
nursing  education  from  hospital -spon- 
sored schools  to  schools  within  the 
general  education  system. 

This  reviewer  was  impressed  by  the 
author's  obvious  commitment  to  asso- 

lUNE   1971 


ciate  degree  nursing  education,  her 
ability  to  present  the  essential  informa- 
tion clearly  and  concisely,  and  her 
willingness  to  share  openly  with  the 
reader  the  growing  pains  of  the  project. 
The  content  of  the  book  is  organized 
in  an  appropriate  chronological  se- 
quence, the  material  is  simply  present- 
ed, and  the  author's  style  is  easy  to  read. 
The  general  format  of  the  book  is  at- 
tractive, the  print  clear,  and  the  tables 
and  illustrations  suitably  placed. 

This  book  is  of  importance  to  all 
persons  interested  in  nursing  education 
and  it  could  prove  invaluable  to  indi- 
viduals called  on  to  set  up  college  level 
courses  at  very  short  notice. 


Health  and  the  Family:  A  Medical-So- 
ciological Analysis  edited  by  Charles 
O.  Crawford.  277  pages.  Toronto, 
Collier-Macmillan,  1971. 
Reviewed  by  Carol  Batra,  Assistant 
Professor,  School  of  Nursing,  Uni- 
versity of  Windsor.  Windsor.  Ont 

The  editor  undertakes  a  mammoth- 
sized  topic  in  a  few  pages.  His  purpose 
is  to  place  in  perspective  and  to  pin- 
point and  analyze  the  many  points  at 
which  family  and  health  intersect  and 
interact.  The  book  is  intended  as  a 
source  of  illustration  of  ways  in  which 
family  structure  and  function  relate 
to  societal  institutions. 

The  book  consists  of  six  well-de- 
fined and  well-organized  parts.  Part 
I  examines  the  general  features  of 
American  family  life  in  a  brief  over- 
view, family  life  among  elderly  per- 
sons, and  the  matrifocal  family  in  the 
black  ghetto.  All  these  areas  are  well 
substantiated  with  recent  statistics  and 
references.  Part  II  contains  a  brief  study 
of  health  problems  to  be  faced  and  a 
critique  of  the  existing  service  tradi- 
tion of  the  private  physician. 

Part  III  is  the  core  of  the  book.  It 
consists  of  a  paradigm  in  which  diseases 
and  their  relationships  to  family  life  can 
be  examined  in  conjunction  with  six 
stages  of  illness  and  the  organizational 
context  tor  dealing  with  illness.  This 
paradigm  seems  useful  for  testing  new 
patterns  of  health  care  in  Canada  and 
in  the  United  States. 

Parts  IV  and  V  present  essays  out- 
standing for  their  succinct  summaries 
of  recent  studies  and  for  their  contrast- 
ing approaches  —  the  effect  of  the 
family  on  health  and  the  way  health 
affects  the  family.  A  most  impressive 
and  lucid  exposition  is  written  on  the 
effects  of  the  family  on  schizophrenia, 
followed  by  health  problems  of  the 
aged  and  of  black  families.  Then  chronic 
illness,  alcoholism,  and  diabetes  are 
discussed,  giving  statistics  and  results 
of  recent  research  studies. 


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I  3  E  in  "2 
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3CV  O 
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THE  CANADIAN   NURSE     49 


In  Part  VI,  the  summary  and  conclu- 
sions, the  writer  is  to  be  commended 
for  stating  the  limitations  of  his  presen- 
tation: environmental  health,  health 
manpower,  and  family  planning  are 
intentionally  excluded.  He  ends  with 
some  suggestions  for  stimulating  future 
research:  the  application  of  the  para- 
digm, the  similarity  between  different 
families'  reactions  to  and  methods  of 
coping  with  chronic  disease,  and  so 
on. 

In  1971,  in  Canada,  nursing  is  feel- 
ing the  need  to  look  at  different  pat- 
terns of  health  care.  I  consider  this 
book  to  have  made  a  good  start  at  fer- 
reting out  the  problems  and  alterna- 
tives. People  working  with  families  in 
service  would  enjoy  this  fresh  approach. 
As  a  reference  source,  teachers,  re- 
searchers, or  students  in  all  health  fields 
would  find  in  this  book  a  wealth  of 
resource  materials  and  illustrations. 


The  Prevention  of  Perinatal  Mortality 
and  Morbidity:  Report  of  a  WHO 
Expert  Committee.  World  Health 
Organization  Technical  Report 
Series  1970,  No.  457.  60  pages. 
Available  through  Information  Can- 
ada (formerly  Queen's  Printer),  in 
Ottawa  at  17 1  Slater  Street. 

Improved  standards  of  health  and  ma- 
ternity care  in  recent  years  have  brought 
about  a  lowering  of  maternal  mortality. 
As  a  result,  greater  emphasis  is  now 
being  placed  on  the  survival  and  well- 
being  of  the  fetus  and  newborn  child. 
Factors  that  cause  perinatal  mortality 
and  immediate  and  long-term  morbid- 
ity, and  the  measures  required  to  reduce 
or  prevent  them  are  discussed  in  this 
report. 

Statistical  information  from  dif- 
ferent parts  of  the  world  is  reviewed, 
and  suggestions  are  made  for  improv- 
ing perinatal  definitions  and  reporting. 
In  considering  possible  preventive 
measures  and  in  formulating  criteria 
for  standards  of  normal  care,  known 
etiological  factors  are  discussed.  These 
include  biological,  socio-economic,  and 
nutritional  influences  that  arise  prior 
to  pregnancy  and  continue  throughout 
pregnancy  and  labor,  and  factors  aris- 
ing during  parturition  and  the  early 
neonatal  period. 

Because  growth  and  development 
form  a  continuous  process  from  birth 
through  childhood  and  adolescence  to 
adult  life,  the  successful  outcome  of  a 
pregnancy  depends  on  the  good  health 

50     THE  CANADIAN   NURSE 


of  the  mother  during  her  childhood  and 
the  preconceptional  and  childbearing 
periods.  For  this  reason,  emphasis  is 
>laced  in  the  report  on  the  planning 
and  organization  of  integrated  maternal 
and  child  health  services  to  provide  care 
on  a  continuous  basis.  Standards  of 
optimum  care  are  discussed,  as  well 
as  interim  standards  for  those  countries 
where  optimum  care  is  not  yet  feasible. 

A  section  of  the  report  is  devoted 
to  the  functions  of  the  midwife,  who 
has  an  essential  role  to  play  in  maternity 
and  neonatal  services,  especially  in 
developing  countries. 

Note:  French,  Spanish,  and  Russian 
editions  are  in  preparation. 


AV  aids 


National  AV  Center 

To  Educate  Health  Personnel? 

Ottawa  —  Dr.  Rae  Laurenson,  direc- 
tor of  audiovisual  education  at  the 
University  of  Alberta  Health  Sciences 
Centre,  visited  CNA  House  March  16 
where  he  discussed  the  audiovisual 
feasibility  study  he  has  been  conduct- 
ing for  the  department  of  national  health 
and  welfare. 

The  report  of  this  study,  which  was 
to  be  submitted  to  the  health  minister 
at  the  end  of  March,  followed  s  i  x 
months  of  visits  to  AV  centers  in  Can- 
ada and  the  United  States  to  consider 
the  possibility  of  establishing  a  national 
AV  center  to  help  educate  people  in  the 
health  professions. 

The  study,  which  was  announced  by 
Health  Minister  John  Munro  last  Oc- 
tober, called  for  Dr.  Laurenson  to  look 
at  present  production  and  distribution 
facilities;  report  on  the  availability  of 
audiovisual  aids  in  the  health  sciences 
in  Canada;  recommend  improvements; 
determine  future  needs;  gather  informa- 
tion on  the  availability  of  AV  aids  from 
other  countries;  and  designate  agencies 
to  meet  requirements. 

Dr.  Laurenson  told  The  Canadian 
Nurse  his  study  has  shown  there  is  an 
immediate  need  for  a  centralized  cata- 
logue of  AV  material.  With  production 
now  ahead  of  cataloguing,  a  central- 
ized collection  would  prevent  problems 
such  as  the  frequent  duplication  of 
AV  material,  he  explained.  The  logical 
location  for  this  type  of  service,  said 
Dr.  Laurenson,  is  in  a  health  sciences 
library,  as  library  services  across  the 
country  are  linked.  He  pointed  out  that 
the  National  Medical  AV  Center  in  the 
United  States  has  this  kind  of  catalogue. 

A  native  of  Scotland,  Dr.  Laurenson 
was  assistant  professor  of  anatomy  at 


Queen's  University  in  Kingston  before 
joining  the  anatomy  department  at  the 
University  of  Alberta  in  Edmonton  in 
1963.  He  is  the  author  of  the  text  An 
Introduction  to  Clinical  Anatomy  by 
Dissection.  In  1960  he  won  the  Aes- 
culapian  award  for  the  best  series  of 
lectures  to  medical  undergraduates, 
and  twice  won  the  Canadian  Medical 
Association  award  for  the  best  tele- 
vision production. 

Since  1 969  Dr.  Laurenson  has  been 
director  of  audiovisual  education  at 
the  University  of  Alberta  Health  Scien- 
ces Centre,  which  included  the  faculties 
of  dentistry,  medicine,  pharmacy,  and 
the  schools  of  nursing  and  rehabilita- 
tion medicine.  The  AV  division  works 
toward  promoting  the  exchange  of 
audiovisual  information  throughout 
the  Centre,  providing  facilities  to  in- 
corporate AV  techniques  into  educa- 
tional programs,  and  establishing  a 
health  sciences  library  of  AV  material. 


LITERATURE  AVAILABLE 

Plastic  Surgery  of  the  Nose 

A  brochure  that  gives  the  facts  about 
plastic  surgery  of  the  nose  is  the  latest 
in  a  series  of  patient-oriented  educa- 
tional publications  available  from  the 
American  Academy  of  Facial  Plastic 
and  Reconstructive  Surgery,  Inc. 

This  brochure  outlines  the  major 
steps  involved  in  this  surgery,  covering 
the  generalities  of  preoperative  surgical 
and  postoperative  procedures  funda- 
mental to  a  successful  patient-physician 
relationship.  The  importance  of- realis- 
tic attitudes  and  emotional  maturity  on 
the  part  of  the  patient  is  emphasized. 

Copies  of  the  brochure  are  available 
at  a  nominal  cost  from  Dr.  Carl  Patter- 
son, c/o  AAFPRS,  1110  W.  Main  St., 
Durham,  North  Carolina,  27701, 
U.S.A. 

First  Aid  First 

Smith  Lithograph  Co.  of  Richmond, 
British  Columbia,  is  offering  a  new 
first  aid  publication.  Illustrated  Injuries. 

This  functional  training  aid  contains 
a  series  of  photographs  of  common 
injuries  to  the  human  body,  compiled 
under  the  direction  of  the  divisions  of 
orthopedic  surgery  and  plastic  surgery 
in  the  faculty  of  medicine  at  the  Uni- 
versity of  British  Columbia. 

For  the  instructor,  there  are  28  full- 
color  reproductions  on  24  non-reflective 
pages  secured  to  an  easel.  Illustrations 
contain  additional  line  drawings  from 
x-rays  to  show  internal  damage.  An 
envelope  at  the  back  of  the  easel  con- 
tains brief  description  sheets  of  the 
signs  and  symptoms  of  each  injury, 
with  space  on  each  sheet  for  additional 
treatment  notes.  The  complete  instruc- 

(CoiiriiiiH'd  on  pane  52) 
JUNE  1971 


This  w(Hit  take 
aminutB 

Nurses  themselves,  in  time-studies*,  established  FLEET  as 
"the  40-second  enema".  Compared  with  the  old-fashioned 
method,  FLEET  ENEMA®  saves  the  nurse  an  average  of  27 
minutes  per  patient  —  not  to  mention  all  the  drudgery. 
FLEET  disposables  are  pre-lubricated,  pre-mixed,  pre- 
measured  and  individually  packed.  Everything  moves 
better  with  FLEET. 

Three  disposable   forms:   Adult   (green   protective   cap). 
Pediatric  (blue  cap),  and  Mineral  Oil  (orange  cap). 


WARNING:  Not  to  be  used  when 
nausea,  vomiting  or  abdominal  pain 
is  present.  Frequent  or  prolonged 
use  may  result  in  dependence. 
CAUTION:  Do  not  administer  to  chil- 
dren under  two  years  of  age  except  on 
the  advice  of  a  physician.  In  dehy- 
drated or  debilitated  patients,  the 
volume  must  be  carefully  deter- 
mined since  the  solution  is  hyper- 
tonic and  may  lead  to  further  dehy- 
dration. Care  should  also  be  taken 
to  ensure  that  the  contents  of  the 
bowel  are  expelled  after  administra- 
tion. Repeated  administration  at 
short  intervals  should  be  avoided. 


Full  inlormation  on  request. 
♦Kehlmann,  W.H.:  Mod.  Hosp. 
84:104,  1955 


FOUNDED  IN  CANADA  IN  1899 
CHARLES  E.  FROSST  &  CO. 
KIRK1.AND  (MONTREAL)  CANADA 


AV  aids 


(Cdiuiniii'd  from  pane  50) 

tor's  kit  is  available  in  a  special  light- 
weight container. 

The  material  has  been  condensed 
into  reference  booklet  size  for  trainees 
in  first  aid  and  emergency  care.  Pages 
beside  each  injury  illustration  provide  a 
description  and  ample  space  for  adding 
treatment  notes. 

This  graphic  teaching  aid,  designed 
to  help  the  instructor  bring  realism  to 
the  classroom,  can  be  purchased  from 
Graphic  Aids  Division,  Smith  Litho- 
graph Co.  Ltd.,  1250  Vulcan  Way, 
Richmond,  B.C. 

FILMS 
Child  health  and  welfare 

Poison  ( 16  mm.,  color,  sound,  14  min- 
utes) is  a  film  that  stresses  that  children 
are  unable  to  discriminate  between 
objects  which  might  appear  similar  to 
them,  such  as  pills  and  candy.  It  gives 
parents  advice  on  taking  precautions 
to  protect  the  child  and  what  to  do  in 
case  poisoning  is  suspected.  The  film 
was  produced  for  the  Alberta  Depart- 
ment of  Public  Health  in  consultation 
with  the  department  of  pediatrics  at 
the  University  of  Alberta  Hospital.  It 
can  be  purchased  for  $165  or  rented 
for  $  10  from  Educational  Film  Distrib- 
utors Ltd.,  191  Eglinton  Ave.,  E., 
Toronto  4 1 6,  Ontario. 

Also  available  from  this  distributor 
are:  Examining  the  Well  Child  (color, 
18  minutes);  Fears  of  Children  (black 
and  white,  29  minutes);  Health  on 
Wheels  (black  and  white,  14  minutes), 
about  chronic  disease  screening  taken 
to  communities  by  a  mobile  unit:  School 
Health  in  Action  (color,  23  minutes); 
and  Time  Out  For  Trouble  (color,  18 
minutes),  about  the  most  common  acci- 
dents in  the  home  and  the  mental  atti- 
tudes that  cause  them. 

Emergency  Treatment  of  Acute  Psy- 
chotic Reactions  Due  To  Psychoactive 
Drugs  (16  mm.,  black  and  white,  17 
minutes)  was  produced  by  the  Addic- 
tion Research  Foundation  of  Toronto 
in  cooperation  with  the  Ontario  Hos- 
pital Association  and  the  Ontario  Med- 
ical Association.  The  film  shows  the 
program  for  treatment  of  drug-related 
emergencies  at  Hotal  Dieu  Hospital 
in  St.  Catharines,  Ontario.  The  emer- 
gency department,  group  therapy  ses- 
sions, and  free  youth  clinic  of  this  gen- 
eral hospital  are  included  in  the  film. 

The  Quality  of  Life  (16  mm.,  color, 
14  minutes,  1970)  produced  by  West- 
minster Films  Ltd.,  looks  at  medical 
research  at  the  Hospital  for  Sick  Chil- 

52     THE  CANADIAN   NURSE 


uren  in  Toronto.  It  shows  a  nine-year- 
old  child  who  was  the  first  "blue-baby" 
operated  on  as  an  infant,  the  kidney 
dialysis  procedure,  and  research  studies 
in  progress. 

Did  You  Know? 

•The  International  Labour  Office,  CH 
1211,  Geneva  22,  has  published  a  world 
catalogue  of  occupational  safety  and 
health  films. 

•Groups  in  the  province  of  Quebec  can 
obtain,  free  of  charge,  250  different 
films  in  French  and  English  from  Mod- 
ern Talking  Picture  Service,  485  Mc- 
Gill  Street,  Montreal. 


accession  list 


Publications  on  this  list  have  been 
received  recently  in  the  CNA  library 
and  are  listed  in  language  of  source. 

Material  on  this  list,  except  Reference 
items  may  be  borrowed  by  CNA  mem- 
bers, schools  of  nursing  and  other  in- 
stitutions. Reference  items  (theses, 
archive  books  and  directories,  almanacs 
and  similar  basic  books)  do  not  go  out 
on  loan. 

Requests  for  loans  should  be  made 
on  the  "Request  Form  for  Accession 
List"  and  should  be  addressed  to:  The 
Library,  Canadian  Nurses'  Association, 
50  The  Driveway.  Ottawa  4.  Ontario. 

No  more  than  three  titles  should  be 
requested  at  any  one  time. 

BOOKS   AND  DOCUMENTS 

1.  Acta  final  Congreso  interamericano  de 
Enfermeria  9.  Caracas  22-27  de  Nov.  y  I-  de 
la  federaction  panamericana  de  enfermeras. 
Caracas,  Venezuela,  Colegio  de  Profesionals 
de  Enfermeria  de  Venezuela.  1970.  Iv. 

2.  Analysis  of  information  needs  of  nursing 
stations.  Sunnyvale,  Calif,  Lockheed  Missiles 
&  Space  Co..  Medical  Information  Systems, 
1969.  397p. 

3.  Atlas  d'anatomie  et  de  physiolo^ie  par 
Bernard  Sequy.  2.  ed.  Paris,  Maloine,  1969. 
3pts.  in  1. 

4.  Basic  pediatric  niasing  by  Persis  Mary 
Hamilton.  Toronto,  Mosby,  1970.  487p. 

5.  CCRE  surveys:  educational  research  in 
Canada  1970  by  Fred  E.  Whitworth  and  G.L. 
Joanls.  Ouawa,  CCRE,  1970.  I02p. 

6.  Canadian  government  programmes  and 
services;  government  organization  Jan.  197  I. 
Don  Mills,  Ont.,  CCH  Canadian  Ltd.,  1970. 
392p. 

7.  Collective  bargaining  hy  r^egistered  nin'ses 
by  William  Michael  Balrd.  Columbus,  Ohio. 
1968.  186p.  (Thesis  -  Ohio  State). 

8.  Communicating  nursing  research:  problem 
identification  and  the  research  design.  Edited 
by  Marjorie  V.  Batey.  Boulder,  Colorado, 
Western  Interstate  Commission  for  Higher 
Education.  1969.  175p. 


9.  Directory.  Chicago.  Medical  Library 
Association,  J uL  1,  1970.  8.^p.  R 

10.  L'evnlnalion  de  I'enseignenient  infir- 
mier;  rapport  d"un  Groupe  de  Travail  reu- 
nl  .  .  .  Copenhague  11  13  dec.  1968.  Co- 
penhague.  Organisation  Mondlale  de  la 
Sante,  Bureau  Regional  de  PEurope.  1970, 
106p. 

11.  Fluorides  and  human  health.  Geneva. 
World  Health  Organization,  1970.  364p. 
(Its  Monograph  series  no.  59) 

12.  The  fnnclions  of  the  executive  by  Chester 
I.  Barnard.  Thirtieth  anniversary  edition. 
Cambridge.  Mass..  Harvard  University 
Press,  1970.  334p. 

13.  Heritage;  history  of  the  nursing  profes- 
sion in  Quebec  from  the  Aiigiislinians  and 
Jeanne  Mance  to  Medicare  hy  Edouard 
Desjardins,  Eileen  C.  Flanagan  and  Suzanne 
Giroux.  Adaptation  from  French  by  Hugh 
Shaw,  Montreal.  Association  of  Nurses  of 
the  Province  of  Quebec,  1971.  247p. 

14.  Hospital  security  and  safety  journal 
articles;  a  collection  of  current  articles 
related  to  security  and  .safety  in  health  care 
institutions  edited  by  Russel  L.  Colling. 
Flushing,  N.Y..  Medical  Examination, 
1970.  158p. 

15.  Job  description  aiul  certification  for 
library  technical  assistcuits;  proceedings  of 
the  workshop  sponsored  by  Council  on 
Library  Technology  Central  Region  . .  .Jan. 
23-24,  1970.  Edited  by  Noel  R.  Grego  and 
Sister  Mary  Chrysantra  Rudnik.  Chicago. 
Council  on  Library  Technology.  1970. 
68p. 

16.  Keeping  on  course.  Report  of  the  1970 
regional  workshops  of  the  council  of  diploma 
programs.  New  York.  National  League  for 
Nursing.  Dept.  of  Diploma  Programs.  1971. 
44p. 

17.  Landon  and  Sider's  communicable 
diseases.  Ed.  9.  Revised  by  Shirley  T.  Mor- 
rison and  Carolyn  R.  Arnold.  Philadelphia. 
F.A.Davis.  1969.  559p. 

18.  Maniuil  for  nurses  in  faniily  and  com- 
munity health  by  Helen  Cohn  et  al.  Boston, 
Little  Brown,  1969.  77p. 

19.  The  manufacture  of  madness;  a  compar- 
ative study  of  the  Inquisition  and  the  mental 
health  movement  by  Thomas  Stephen  Szasz. 
New  York,  Harper  &  Row.  1970.  383p. 

20.  Medsirch:  a  computerized  system  for 
the  retrieval  of  multiple  choice  items  by 
C.B.  Hazlett.  Edmonton,  Division  of  Edu- 
cational Research  Services,  Faculty  of  Educa- 
tion, University  of  Alberta,  1970.  65p.  (Re- 
search and  information  report  DERS-3-70) 

21.  La  nevrose  institutionnelle  par  Russell 
Barton.  Adaptation  franijaise  de  Jean-Marie 
Mistouflet:  presentation  de  Roger  Gentis. 
Paris,  Editions  de  Scarabee,  1969.  97 p. 
(Bibliotheque  de  rinfirmier  psychiatrique) 

22.  New  h(trizons  in  health  care;  proceed- 
ings of  International  Congress  on  Group 
Medicine,  First,  Winnipeg,  Manitoba,  April 
26-30,  1970.  Winnipeg.  Man..  1970.  357p. 

23.  The  nurse-patient  relationship  in  psy- 
chiatric nursing;  workbook-guides  to  under- 
standing management  by  Janet  A.  Simmons. 

JUNE  1971 


Toronto.  Saunders.  1969.  I89p. 

24.   Tilt'  iinr.si'.','  f-iiUlc  to  jhiiil  and  cleclolyie 

hdliimc    by    Audrey    Burgess.    New    York. 

McGraw    Hill.    1970.    Il9p.   (Nurse's  guide 

series) 

2.^.  Oil  lianicwin^  R  &  D  lo  (itlvame  cdiicii- 

tioii  by  Fred  E.  Whitworth.  Ottawa.  CC RE. 

1970.  71  p. 

26.  On  oriidiiidiif;  R&D  in  Cuiuitla  by  Fred 
E.  Whitworth.  Ottawa.  CCRE.  1968.  136p. 

27.  I'cdiiinii  .siiiijUiil  care  by  Pedro  G.  La- 
vadia.  Quezon  City.  Univ.  of  the  Philip- 
pines Pr..  1970.  262p. 

28.  I'liilippiiw  niirsini;  law.  jurisprudence 
and  eiliics  by  Annie  Sand  and  Gonzalo  S. 
Robles.  5th  ed.  Manila.  Philippines.  Profes- 
sionals Publishing  Co..  1969.  533p. 

29.  Tlie  preveittioii  of  perinatal  mortality 
and  morbidity:  report  of  a  WHO  expert 
committee.  Geneva.  World  Health  Organiza- 
tion.   1970.   60p.   (Its  Technical   report   no. 

4.';7) 

30.  Principles  and  practice  of  intravenous 
therapy  by  Ada  Lawrence  Plumer.  1st  ed. 
Boston.  Little  Brown.  1970.  262p. 

3 1 .  Proceeding's  of  National  Seminar  on 
Accreditation  of  Baccalaureate  and  Diploma 
Profirains  in  Nursing.  Feb.  21  to  Mar.  15. 
1968.  Quezon  City.  Sponsored  by  the  Philip- 
pine government  and  the  World  Health 
Organization.  Quezon  City?  1968?  160p. 

32.  Proceedings  of  a  Symposium  on  Educa- 
tion and  tile  New  Technology.  Ottawa.  Nov. 
22.  23.  24.  1967.  Ottawa.  Canadian  Council 
for  Research  in  Education.  1971.  158p. 

33.  Professional  performance  committee 
manual.  San  Francisco.  Calif.,  California 
Nurses"  Association.  1970.  80p. 

34.  Psychology:  principles  and  applications 
by  Marian  East  Madigan  and  Jeannette  G. 
Nehren.  5th  ed.  St.  Louis.  Mosby.  1970. 
392p. 

35.  Science  news  comniiinication:  a  guide 
for  scientists,  physicians,  public  relations 
officers  and  inforniation  specialists.  Sea 
Cliff.  NY..  National  Association  of  Science 
Writers.  1968.  39p. 

36.  Special  libraries  and  information  cen- 
tres ill  Canada:  a  directory.  1970  revision. 
Compiled  by  Beryl  L.  Anderson.  Ottawa. 
Canadian  Library  Association.  1970.  168p. 

37.  A  textbook  for  midwives  by  Margaret 
F.  Myles.  6th  ed.  Edinburgh.  Livingstone. 
1968.  792p. 

38.  Textbook  of  obstetrics  and  obstetric 
nursing  by  Mae  M.  Bookmiller.  George  L. 
Bowen  and  Dolores  Carpenter.  5th  ed.  Phil- 
adelphia. Saunders,  1967.  574p. 

39.  Twenty  questions  on  conference  leader- 
sliip  by  Ernest  D.  Nathan.  Don  Mills.  Ad- 
dison-Wesley.  1969.  126p. 

40.  Writing  science  news  for  the  mass  media 
by  David  Warren  Burkett.  Houston.  Texas. 
Gulf.  1965.  183p. 

PAMPHLETS 

4  I .  Brief:  adopted  by  the  Board  of  Directors 
May.  1968.  Toronto,  Registered  Nurses' 
Association  of  Ontario.  Committee  to  Ex- 
plore Proposals  Set  Forth  by  the  Psychiatric 
Nurses"  Association  of  Ontario,  1968.  32p. 

lUNE   1971 


42.  Code  of  ethics.  Ottawa,  Canadian  Med- 
ical Association,  1971.  n. p. 

43.  L enfant  aiitiste  par  Milada  Havelkova 
et  ses  parents.  Montreal.  L'Association  Ca- 
nadienne  pour  la  Sante  Mentale.'  2 Ip. 

44.  Guidelines  on  short-term  continuing 
education  programs  for  pediatric  nurse 
as.sociates;  a  joint  statement  of  the  American 
Nurses"  Association.  Division  on  Maternal 
and  Child  Health  Nursing  Practice  and 
the  American  Academy  of  Pediatrics.  New 
York,  1971.  7p. 

45.  Health  services  research  bibliography  by 
John  W.  Williamson.  Baltimore.  Md..  Dept. 
of  Medical  Care  and  Hospitals,  School  of 
Hygiene  and  Public  Health.  Johns  Hopkins 
University.  1970.  27p. 

46.  Hospital  career  information.  Toronto. 
Ontario  Hospital  Association,  1971.  Iv. 

47.  Implications  of  the  behavioral  .\ciences 
for  management  by  Gordon  L.  Lippitt, 
Washington.  Society  for  Personnel  Adminis- 
tration. 1968.  12p.  (SPA  Booklet  no.3) 

48.  Job  design:  meeting  the  manpower 
challenge  by  George  H.  Hieronymus.  Wash- 
ington. Society  for  Personnel  Administration. 
1957.  42p.  (SPA  pamphlet  no.  1 5) 

49.  Medical  nursing  procedures  as  approved 
by  the  Registered  Nurses"  Association  of 
Nova  Scotia.  Provincial  Medical  Board.  No- 
va Scotia  Medical  Society  and  Nova  Scotia 
Hospital  Association.  Halifax.  1971. 

50.  Observations  relative  aii.x  recommenda- 
tions des  Comites  d'etiide  siir  le  coi'it  des 
services  sanitaires  an  Canada  presentees  au 
Ministere  de  la  Sante  et  du  Bien-etre  sociale. 
Ottawa.  Association  des  Infirmieres  cana- 
diennes,  1970.  lOp. 

51.  Organizational  development:  fantasy 
or  reality  by  Leslie  E.  This..  Washington. 
Society  for  Personnel  Administration.  1969. 
17p.  (SPA  booklet  no.7) 

52.  Philosophy  of  the  ANPQ  regarding 
two  levels  of  preparation  in  nursing  educa- 
tion, teamwork  and  inservice  education. 
Quebec.  P.Q..  Association  of  Nurses  of  the 
Province  of  Quebec.  1970. 

53.  The  photography  of  H.  Armstrong 
Roberts  vol.  15.  Philadelphia.  1971.  72p. 
Public  Affairs  Committee  Pamphlets.  New 
York. 

54.  no.454  Help  for  your  troubled  child  by 
Alicerose  Barman  and  Lisa  Cohen.  1970. 
24p. 

55.  no.455  Social  policy — improving  the 
human  condition  by  John  H.  McMahon. 
1970.  28p. 

56.  no.456  Marriage  and  love  in  the  middle 
years  by  James  A.  Peterson.  1970.  28p. 


Notice 

Frequently,  packages  o\'  books  sent 
from  the  CNA  library  to  persons  liv- 
ing in  apartments  are  returned  by  the 
po'st  office,  marked  ""not  picked  up." 
Borrowers  are  requested  to  tell  tjieir 
apartment  superintendent  in  advance 
that  they  arc  expecting  books  to  be 
delivered  from  the  CNA. 


57.  no. 457  Hunger  in  America  by  Maxwell 
S.  Stewart.  1970.  24p, 

58.  no.458  Unlocking  human  resources:  a 
career  in  .social  work  by  Patricia  W.  Soyka. 
1971.  24p. 

59.  no.459  Protecting  your  family  by  .Arthur 
S.  Freese.  1971.  28p. 

60.  Report  to  the  Minister  of  National 
Health  and  Welfare  on  the  Recommenda- 
tions of  the  Task  Forces  on  the  Cost  of 
Health  Services  in  Canada.  Ottawa.  Cana- 
dian Nurses"  Association.  1970.  lOp. 

61.  ,4  response  to:  The  Task  Force  Reports 
on  the  Cost  of  Health  Services  in  Canada. 
Vancouver,  B.C..  Canadian  Conference  of 
University  Schools  of  Nursing.  1971.  21  p. 

62.  Sabinission  to  the  Honourable  Harry 
E.  Strom.  Premier,  and  Miinbcrs  of  the 
Cabinet  and  Governineni  of  Alberta.  Ed- 
monton, Alberta  Association  of  Registered 
Nurses.  1971.  36p. 

63.  What  research  says  to  the  supervisor 
using  personnel  tests.  Washington,  Society 
for  Personnel  Administration,  1962.  72p. 
(SP,\  Leaflet  no.  II 


GOVtRNMENT   DOCUMENTS 
Canada 

64.  Bureau  of  Statistics.  Health  manpower 
in  hospitals.  1961-68.  Ottawa.  Queen's 
Printer.  1970.  12  pts.  in  I 

65.  Internal  migration  in  Canada:  demo- 
graphic analyses  by  M.V.  George.  Ottawa. 
Queens  Printer,  1970.  251  p. 

66.  Review  of  man-hours  and  hourly  earn- 
ings. 1967-69.  Ottawa.  Queen's  Printer, 
1971.  1  12p.  (DBS  catalogue  no.  72-202) 

67.  Canadian  Broadcasting  Corporation. 
Research  Department.  Public  opinion  in 
Canada  on  certain  aspects  of  the  law  nlaling 
to  abortion:  a  fact-finding  survey.  December. 
1970.  Ottawa.  1971.  25p. 

68.  Committee  on  Costs  of  Health  Services. 

Task  force  reports  on  the  cost  of  health 
services  in  Canada.  Ottawa.  Queen"s  Printer. 

1970.  3v. 

69.  Dept.  of  Indian  Affairs  and  Northern 
Development.  Northern  Science  Research 
Group.  Arctic  suburb:  a  look  at  the  North's 
newcmiiers  by  G.F.  Parsons.  Ottawa.  1970. 
94p.  (Mackenzie  Delta  Research  Project  8) 

70.  Dept.  of  Industry,  Trade  and  Cc  nmerce. 
A  statistical  &  economic  analysis  by  Ernst 
<)ic  Ernst.  Management  for  the  Department 
of  Industry,  Trade  and  Commerce.  Ottawa. 
Information  Canada,  1970.  172p. 

71.  Dept.  of  Manpower  and  Immigration. 
Employers  of  new  university  graduates: 
directory  1970-71.  Ottawa.  Information 
Canada!  1970.  146p. 

72.  Dept.  of  National  Health  and  Welfare. 
Earnings  of  physicians  in  Canada.  1958- 
1968.  Ottawa.  Q.P..  1970.  (Its  Health  care 
series  no.25) 

73. — .  Income  security  for  Canadians.  Otta- 
wa. Queens  Printer.  1970.  lOOp. 
74.  — .  Research  and  Statistics  Directorate. 
Comparison  of  social  security  expenditures 
in  Canada.  Australia.  New  Zealand.  United 
Kingdom    and    the    United    States.     Fiscal 

THE  CANADIAN   NURSE     53 


accession  list 


years  1961-62  to  1966-67.  inclusive.  Ottawa. 
1970.  35p. 

75.  Royal  Commission  on  Bilingualism  and 
Biculturalism.  Corporate  cidaptahiliiy  to 
hiliiigiuilism  ami  hicitltiiralism.  Study  of 
policies  imd  practices  in  large  Canadian 
manufacturing  firms  by  Robert  N.  Morrison. 
Ottawa.  Queens  Printer.  1970.  .389p.  (Its 
Commission  on  Bilingualism  and  Bicultural- 
ism Study  no. 5) 

76.  Science  Council  of  Canada.  Background 
to  invention.  Ottawa.  Queen's  Printer,  1970. 
77p.  (Its  Special  study  no.  II) 

Ontario 

11.  Commission  on  Post-Secondary  Educa- 
ion.  Guidelines  for  submitting  research  pro- 
posals. Toronto,  1 970.  1 9p. 

78.  Dept.  of  Health.  Public  Health  Division. 
Piihlic  health  nurses,  their  services  to  family, 
school  and  community.  Toronto.  1970. 
United  States 

79.  Congress.  Senate.  Committee  on  Govern- 
ment Operations.  Subcommittee  on  Execu- 
tive Reorganization  and  Government  Re- 
search. Federal  role  in  health.  Washington. 
U.S.  Gov-t  Print.  Off..  1970.  561p. 

80.  Dept.  of  Health.  Education  and  Welfare. 
Public  Health  Service.  Community  health 
nursing  for    working    people:    a    guide   for 


voluntary  and  official  health  agencies  to 
provide  part-time  occupational  health  nursing 
.services.  Cincinnati.  Ohio.  rev.  1970.  66p. 
(U.S.  Public  Health  Service  publication 
no.  1296) 

81.  National  Center  for  Health  Statistics. 
Health  resources  statistics:  Health  manpower 
and  health  facilities.  1969.  U.S.  Gov't.  Print. 
Off.,  1970.  286p.  (U.S.  Public  Health  Service 
publication  1509  rev.) 

82.  National  Library  of  Medicine.  The 
principles  of  mkdiak.s  Bethesda  Md. 
For  sale  by  the  Supt.  of  Docs.  U.S.  Gov't. 
Print.  Off.  Washington.  1970.  77p. 

83.  Office  of  Economic  Opportunity.  Office 
of  Health  Affairs.  Bibliography  on  the  com- 
prehensive health  service  program.  Washing- 
ton, U.S.  Gov't.  Print.  Off.,  1970.  42p. 

84.  Postal  Service.  Directory  of  post  offices: 
with  zip  code.  Washington.  U.S.  Gov't.  Print. 
Off..  1970.  488p.  (Its  publication  no.  26)  R 

STUDIES   DEPOSITED   IN 

CNA    REPOSITORY   COLLECTION 

85.  Acceptance  and  adaptation  in  chronic 
illness  or  disability  by  Susan  Martens.  San 
Francisco.  1969  48p.  (Study  in  partial  ful- 
fillment of  MN  course  requirements  Univer- 
sity of  California)  R 

86.  An  analysis  of  certain  factors  in  the 
diffusion  of  innovations  in  musing  practice 
in  the  public  general  hospitals  of  the  prov- 
ince of  British  Columbia  by  Beverly  Witter 
Du  Gas.  Vancouver.  1969.  361  p.  (Thesis  - 
British  Columbia)  R 


87.  Clinical  resources  and  nursing  educa- 
tion; report  of  area  study  Metropolitan, 
Toronto.  Newmarket  and  Richmond  Hill 
Toronto.  Ontario  Hospital  Services  Com- 
mission and  College  of  Nurses  of  Ontario, 
1969.  220p.  R 

88.  An  exploratory  study  of  the  effective- 
ness of  the  parent  education  conference 
method  on  child  health  by  Lara  Khairat. 
Vancouver,  1970.  77p.  (Thesis  (M.Ed.) 
British  Columi-sa)  R 

89.  An  investigation  of  the  characteristics 
of  change  in  affect,  activity  and  pain  in 
short-term  surgical  patients  by  Ma«y  Ellen 
Jeans.  Montreal,  1969.  73p.  (Thesis  (M.Sc. 
(App))-  McGilDR 

90.  Nursing  care  given  by  general  staff 
hospital  nurses  to  a  selected  group  of  pa- 
tients who  had  experienced  a  cerebrovas- 
cular accident  by  Geraldine  Grace  Louise 
Patrick.  Vancouver,  1970.  (Thesis  (M.Sc.N.) 

British  Columbia)  R 

9 1 .  Opionions  expressed  by  head  nurses 
about  their  involvement  in  the  clinical  ex- 
perience component  of  basic  nursing  educa- 
tion programs  in  the  province  of  Ontario, 
Canada  by  Sister  Mary  Irene  McDonald. 
Washington,  1970.  144p.  (Thesis  (M.Sc.N)  - 
Catholic  University  of  America)  R 

92.  A  study  of  the  renal  programme  in 
British  Columbia.  Victoria,  British  Colum- 
bia, Hospital  Insurance  Service,  1970.  2v. 
(Management  and  engineering  study  no. 
00-01-70)  R  ^ 


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54     THE  CANADIAN   NURSE 


JUNE  1971 


July  1971 


,oi 


UNIVERSITY  OF  OTTAWA 
SCHOOL  OF  NURSING  LIBRARY 
OTTAWA,  ONT. 
KIN  6N5 
I2-71-12-70-CN-PD 


The 


Canadian 
Nurse 


when  you  find  pollution 
you  find  disease 


midwives?  in  Canada 

—  let's  hope  so 

to  be  or  not  to  be 

—  disposable 


^^^^^  ^ 

■ 

^r  "^^1 

\^\m*« 

This  wont  take 
a  minute 

Nurses  themselves,  in  time-studies*,  established  FLEET  as 
"the  40-second  enema".  Compared  with  the  old-fashioned 
method,  FLEET  ENEMA®  saves  the  nurse  an  average  of  27 
minutes  per  patient  —  not  to  mention  all  the  drudgery. 
FLEET  disposables  are  pre-lubricated,  pre-mixed,  pre- 
measured  and  individually  packed.  Everything  moves 
better  with  FLEET. 

Three   disposable   forms:   Adult    (green   protective   cap), 
Pediatric  (blue  cap),  and  Mineral  Oil  (orange  cap). 


WARNING:  Not  to  be  used  when 
nausea,  vomiting  or  abdominal  pain 
is  present.  Frequent  or  prolonged 
use  may  result  in  dependence. 
CAUTION:  Do  not  administer  to  chil- 
dren under  two  years  of  age  except  on 
the  advice  of  a  physician.  In  dehy- 
drated or  debilitated  patients,  the 
volume  must  be  carefully  deter- 
mined since  the  solution  is  hyper- 
tonic and  may  lead  to  further  dehy- 
dration. Care  should  also  be  taken 
to  ensure  that  the  contents  of  the 
bowel  are  expelled  after  administra- 
tion. Repeated  administration  at 
short  intervals  should  be  avoided. 


Full  information  on  request. 
•Kehlmann,  W.H.:  Mod.  Hosp. 
84:104,  1955 


3ho^ 

FOUNDED  IN  CANADA  IN  1899 
CHARLES  E.  FROSST  &  CO. 
KIRKLAND  (MONTREAL)  CANADA 


Information  Indispensable 


Reed  &  Sheppard: 

REGULATION  OF  FLUID  AND  ELECTROLYTE  BALANCE: 

A  Programmed  Instruction  for  Nurses 
By    Gretchen    Mayo    Reed,    B.S.,    M.A.,    University    of 
Tennessee   Medical    Units,    and    Vincent   F.    Sheppard, 
Ph.D.,  Memphis  State  University. 

This  new  self-teaching  text  for  nursing  students  uses 
a  physiological  approach  to  build  an  understanding 
of  fluid  and  electrolyte  balance  and  acid-base  balance. 
The  only  previous  instruction  required  is  the  founda- 
tion that  student  nurses  normally  receive  in  their  first 
year  of  chemistry  and   physiology. 

The  student  w\\\  acquire  a  working  knowledge  of 
such  topics  OS:  the  role  of  the  kidney  and  endocrine 
system  in  maintaining  the  internal  environment, 
causes  of  fluid  shifts  and  alteration  of  total  body 
contents,  and  physiological  processes  governing  solute 
distribution.  The  final  section  details  the  clinical  im- 
plications of  electrolyte  imbalance.  Liver  disease,  infant 
diarrhea,  congestive  heart  failure,  and  burns  are 
among  the  many  disorders  considered.  An  Instructors 
Guide   is  available. 

About  320  pages,  illustrated.  About  $5.75.  Just  ready. 


THE  NURSING  CLINICS  OF  NORTH  AMERICA 


"Florence,  Where  Are  You?"  is  the  title  of  the  article 
by  Gertrude  Cherascavich  that  opens  the  current 
(June)  issue  of  the  famous  Nursing  Clinics.  It  is  one 
of  six  searching  evaluations  of  nursing  in  a  tech- 
nological environment  that  make  up  the  symposium 
"Nursing  Leaders  Look  at  Clinical  Nursing",  guest- 
edited  by  Lucy  D.  Germain.  In  the  second  symposium 
of  the  issue,  twelve  authors  under  the  guest  editor- 
ship of  Genrose  J.  Alfono  describe  administrative 
innovations  that  permit  the  professional  nurse  to 
spend  more  time  at  the  bedside.  The  twenty  articles 
in  this  issue  are  typical  of  the  high  professional  level 
of  the  Nursing  Clinics.  Sold  by  annual  subscription 
only,  four  issues  per  year  averaging  185  pages,  with 
no  advertising,  bound  between  hard  covers  for  per- 
manent   reference.    $13    per   year. 


Guyton:  BASIC  HUMAN  PHYSIOLOGY: 

Normal   Function   and  Mechanisms  of   Disease 

By  Arthur  C.   Guyton,  M.D.,   University  of  Mississippi 

Medical  School. 


Conn:   1971    CURRENT  THERAPY 

Edited  by  Hovy^ard  F.  Conn,  M.D.  with  331  authorities. 

This  annual  medical  volume  puts  at  your  fingertips 
information  on  the  treatment  of  more  than  300  con- 
ditions ranging  from  acne  to  zinc  fever.  Definitive 
articles  describe  currently  preferred  treatment,  give 
step-by-step  instructions,  and  point  out  potential 
hazards.  An  invaluable  reference  at  the  nursing 
station. 

836   pages.   $16.50.   Published   February    1971. 


A  careful  condensation  of  Guyton's  standard  medical 
text,  this  new  book  is  designed  for  students  in  the 
health  professions.  It  emphasizes  general  and  cellular 
physiology  and  biochemistry,  and  includes  material 
on  bone,  teeth,  and  oral  physiology.  All  the  facts 
are  there;  omitted  ore  discussions  of  alternative 
hypotheses  and  extensive  references.  The  authority, 
lucidity,  and  pertinence  for  which  the  big  Guyton 
is  famous  come  through  clearly  in  this  new,  more 
compact  book. 

721  pages  w'rth  431  illustrations.  $13.15.  March  1971. 


W.  B.  SAUNDERS  COMPANY  CANADA  LTD.,  1835  Yonge  Street,  Toronto  7 

Please  send  on  approval  and  bill  me: 

n     Reed  &  Sheppard:  FlUID  AND  EIECTROIYTE  BALANCE  (obout  $5.75) 

n     Conn:    1971    CURRENT    THERAPY   ($16.50)  D     Guyton:    BASIC    HUMAN    PHYSIOLOGY    ($13.50) 

□     Please  enter  my  subscription  to  the  NURSING  CLINICS  to  start  with  the  June  issue  ($13  per  yeor) 


Name 


Address 


City: 


JULY  1971 


Zone:    Prov:    

CN  7-71 

THE  CANADIAN   NURSE 


A  ward-winning 
combination 


With  Dermassage,  all  you  add  is  your  soft 
touch  to  win  the  praises  of  your  patients. 

Dermassage  forms  an  invisible, 
greaseless  film  to  cushion  patients 
against  linens,  helping  to  prevent 
sheet  burns  and  irritation.  It  protects 
with  an  antibacterial  and  antifungal 
action.  Refreshes  and  deodorizes 
without  leaving  a  scent.  And  it's 
hypo-allergenic. 

Dermassage  leaves  layers 
of  welcome  comfort  on 
tender,  sheet-scratched       f 
skin.  And  there's  another       ,  "^  "^ 
bonus  for  you:  While 
you're  soothing  patients 
with  Dermassage,  you're 
also  softening  and  \ 

smoothing  your  hands.     '      ' 

Try  Dermassage.      \ 
Let  your  fingers 
do  the  talking. 


JK^^^ 


/ 


The 

Canadian 
Nurse 


& 

^^p 


A  monthly  journal  for  the  nurses  of  Canada  published 

in  English  and  French  editions  by  the  Canadian  Nurses'  Association 


Volume    67,    Number    7  July    1971 

17     Midwives?  In  Canada?  Let's  Hope  So P.  Hayes 

20     Typhoid  In  Bouchette Gertrude  Lapointe 

24     Venereal  Disease  Problem 

In  Canada Dr.  S.E.  Acres  and  Dr.  J.W.  Davies 

28     The  Nurse  And  VD  Control H.  Ferrari 

3 1     To  Be,  Or  Not  To  Be  —  Disposable!  I.  Colvin 

33     More  Hysterectomies  —  Fact, 

Fantasy,  Or  Fad? Dr.  J.R.  Higgm 

36     Nursing  Care  of  Patients  having 

a  Hysterectomy L.A.  Holm 

The  views  expressed  in  the  various  articles  are  the  views  of  the  authors  and  do  not 
necessarily  represent  the  policies  or  views  of  the  Canadian  Nurses"  Association. 


Editorial 


4  Letters 

13  Names 

38  Dates 

40  Books 

41  Accession  List 


5  News 

1 5  New  Products 

39  In  a  Capsule 

41  AVAids 

56  Index  to  Advertisers 


Executive  Director:  Helen  K.  Mussallem  • 
Editor;  Virginia  A.  Lindabury  •  Assistant 
Editor;  Liv-Ellen  Lockeberg  •  Editorial  As- 
sistant; Carol  A.  Kotlarsky  •  Production 
Assistant:  Elizabeth  A.  Stanton  •  Circula- 
tion Manaccr:  Ber>l  Darling  •  Advertising 
Manager:  "Ruth  H.  Baumel  •  Subscrip- 
tion Rales:  Canada;  one  year,  $4.50;  two 
years,  $8.00.  Foreign;  one  year,  $5.00;  two 
years,  $9.00.  Single  copies;  50  cents  each. 
Make  cheques  or  money  orders  payable  to  the 
Canadian  Nurses'  Association.  •  Change  of 
Address:  Six  weeks'  notice;  the  old  address  as 
well  as  the  new  are  necessary,  together  with 
registration  number  in  a  provincial  nurses' 
association,  where  applicable.  Not  responsible 
for  journals  lost  in  mail  due  to  errors  in 
address. 


Manuscript  Inlormation:  "The  Canadian 
Nurse"  welcomes  unsolicited  articles.  All 
manuscripts  should  be  typed,  double-spaced, 
on  one  side  of  unruled  paper  leaving  wide 
margins.  Manuscripts  are  accepted  for  review 
for  exclusive  publication.  The  editor  reserves 
the  rieht  to  make  the  usual  editorial  changes. 
Photographs  (glossy  prints)  and  graphs  and 
Jiaerams  (drawn  in  india  ink  on  white  paper) 
arewelcomed  with  such  articles.  The  editor 
is  not  committed  to  publish  all  articles 
sent,  nor  to  indicate  definite  dates  of 
publication. 

Postage  paid  in  cash  at  third  class  rate 
MONTREAL,  P.O.  Permit  No.  10,001 
50  The  Driveway,  Ottawa,  Ontario.  K2P  1E2 
O  Canadian  Nurses'  Association  1971. 


lULY  1971 


Writing  about  typhoid  fever  in  1906, 
Dr.  William  Osier  had  this  to  say:  "Wide- 
ly distributed  throughout  all  parts  of  the 
world,  It  probably  represents  every- 
where the  same  essential  characteris- 
tics, and  is  everywhere  an  index  of  the 
sanitary  intelligence  of  a  community. 
Imperfect  sewage  and  contaminated 
water-supply  are  two  special  conditions 
favoring  the  distribution  of  the  bacilli  . . ." 

This  statement  is  as  true  today  as  it 
was  then:  Without  proper  methods  for 
disposal  of  excreta,  without  water  purifi- 
cation systems,  typhoid  fever  can  and 
will  occur  either  sporadically  or  in 
epidemics. 

The  citizens  of  Bouchette.  a  village 
in  Quebec,  have  been  aware  of  the 
consequences  of  faulty  sanitation  for 
some  years  and  have  tried  to  do  some- 
thing about  it  —  but  to  no  avail.  In  a 
small  community,  monies  to  finance 
sewage  disposal  plants  and  water  puri- 
fication systems  are  often  hard  to  come 
by. 

This  spring,  after  52  persons  in  Bou- 
chette contracted  typhoid  fever,  the 
problem  attracted  the  attention  ot  the 
whole  country.  No  doubt  something  will 
now  be  done  to  see  that  the  water  is 
no  longer  a  vehicle  for  transmitting 
disease  in  the  area. 

But  what  of  other  communities  across 
the  country?  For  Bouchette  is  not  alone 
in  its  problem  of  faulty  sanitation.  As 
Gertrude  Lapointe.  who  reported  on 
the  outbreak  of  typhoid  in  Bouchette 
for  the  journals,  points  out,  cases  ot 
this  serious  enteric  infection  are  occur- 
ring in  other  parts  of  Canada. 

True,  the  incidence  of  typhoid  in  this 
country  has  declined  since  1931.  when 
2,938  cases  of  typhoid  and  paratyphoid 
were  reported.  In  1968.  93  cases  were 
reported,  and  in  1969,  the  figure  was 
119. 

However,  this  impressive  decline  since 
the  '30s  allows  no  room  for  complacen- 
cy. There  is  nothing  to  assure  us  that 
typhoid  fever  cannot  become  the  scourge 
it  once  was.  —  V.A.L. 

THE  CANADIAN   NURSE       3 


letters 


Letters  to  the  editor  are  welcome. 

Only  signed  letters  will  be  considered  for  publication,  but 

name  will  be  withheld  at  the  writer's  request. 


Comment  on  head  nurses 

In  answer  to  the  letter  written  on  the 
head  nurse  problem  (May,  1971):  I 
believe  there  is  just  as  great  a  problem 
among  staff  nurses.  As  a  former  head 
nurse,  I  know  there  are  two  sides  to  this 
issue,  but  I  don't  think  it  is  quite  fair 
to  single  out  the  head  nurse.  The  whole 
thing  is  intermingled  with  staff  prob- 
lems. 

First,  stop  and  try  to  understand  why 
the  head  nurse  reacts  as  she  does.  Is  she 
frustrated  because  of  staff  shortcom- 
ings? Is  she  reacting  to  the  stresses  and 
strains  of  her  position?  It  is  fine  to  say 
that  if  she  cannot  cope  with  these  pres- 
sures she  should  give  up  her  position. 
But  don't  you  think  a  little  understand- 
ing on  the  part  of  her  staff  would  help 
the  situation  considerably? 

I  am  speaking  generally  when  I  say 
this,  not  basing  these  remarks  on  spe- 
cifics. But  I  really  don't  feel  an  article 
on  how  to  be  a  good  head  nurse  is  the 
answer  in  this  case.  —  R.N.,  Banff, 
Alberta. 

Health  system  must  be  changed 

Canadians  are  presently  voicing  con- 
siderable concern  about  the  quality 
of  health  care  that  is  currently  avail- 
able. Health  professionals  and  others 
share  this  concern.  Attention  has  been 
focused  on  enlarging  the  scope  of  nurs- 
ing practice  to  provide  improved  care 
and  to  give  greater  assistance  to  physi- 
cians in  meeting  health  needs  of  pa- 
tients. Now  that  health  is  being  accepted 
as  a  right  of  citizenship  in  Canada, 
greater  numbers  of  patients  are  seeking 
access  to  the  health  care  system. 

As  we  know,  nurses  stand  ready  to 
meet  this  challenge.  For  too  long  the 
nurse  has  been  restricted  to  a  narrowly 
conceived  role  that  does  not  make  suf- 
ficient use  of  her  professional  compet- 
ence. Nurses  need  to  be  free  to  give  a 
wider  range  of  care  to  patients,  especial- 
ly in  non-hospital  situations.  For  exam- 
ple, we  know  that  nurses  working  col- 
laboratively with  physicians  can  give 
health  supervision  to  both  normal  ex- 
pectant mothers  and  well  children  and 
to  selected  patients  with  chronic  ill- 
nesses. Many  nurses  seek  such  oppor- 
tunities. With  little  additional  specializ- 
ed preparation,  nurses  prepared  in  uni- 
versity schools  of  nursing  are  educated 
to  carry  out  these  kinds  of  services. 

However,  in  spite  of  physicians' 
acknowledged  need  for  assistance  and 
nurses'  statements  about  their  readiness 
4       THE  CANADIAN   NURSE 


to  give  a  broader  range  of  care,  some 
aspects  of  our  present  health  care  sys- 
tems block  attempts  to  put  coordinated 
efforts  of  physicians  and  nurses  into 
harness  to  improve  the  health  care  of 
our  people. 

The  present  payment  for  health  care 
through  provincial  health  insurance 
plans  does  not  make  it  economically 
worthwhile  for  physicians  to  have 
nurses  assume  these  additional  responsi- 
bilities for  which  nurses  are  prepared. 
Physicians  are  reluctant  to  delegate 
tasks  for  which  they  cannot  be  compen- 
sated through  insurance  claims.  The 
nurse  cannot  legitimately  carry  a  case 
load  in  a  physician's  practice,  working 
with  him  and  referring  ill  patients  or 
those  with  complex  problems  to  his 
specialized  care  unless  he  sees  the  pa- 
tient at  every  nurse-patient  visit. 

There  is  no  way  a  nurse's  service  can 
economically  be  compensated  in  a 
physician's  practice  for  a  hospital  or 
home  visit  through  provincial  insurance 
plans.  Otherwise  the  nurse  cannot  gen- 
erate sufficient  funds  in  a  physician's 
practice  to  warrant  her  services  on  an 
economic  basis. 

Further,  if  nurses  are  to  take  on 
additional  responsibilities,  they  must 
be  legally  accountable  for  their  own 
acts.  Physicians  are  understandably 
hesitant  to  extend  trust  to  others  for 
activities  delegated  unless  the  legal  stat- 
us of  the  nurse  practitioner  is  clarified. 

It  is  urgent  that  nurses  take  active 
steps  to  bring  the  present  systems  of 
health  care  under  review  so  that  the 
health  care  needs  of  the  Canadian 
people  may  be  better  met.  —  Ruth  C. 
Mac  Kay,  Associate  Professor  of  Nurs- 
ing, Queen's  University,  Kingston, 
Ontario. 

Unemployment  insurance  plan 

After  reading  the  heading  "CNA  Ac- 
cepts Federal  Unemployment  Insurance 
Plan"  and  the  accompanying  news  cap- 
tion (News,  page  12,  November  1970), 
I  began  to  wonder  if  I  had  correctlji 
interpreted  the  proposals  of  the  white 
paper  on  unemployment  insurance. 

I  thought  there  was  to  be  an  all- 
inclusive  plan,  that  is,  contributions 
would  be  made  by  both  employee  and 
employer  and  would  include  everyone 
in  the  labor  force.  Those  not  cover- 
ed now,  such  as  government  employees, 
persons  in  non-profit  organizations, 
and  those  earning  more  than  $7,800  a 


year  would  contribute  to  the  fund.  In 
other  words,  it  would  be  compulsory. 

What  is  CNA  accepting,  and  on 
whose  behalf?  There  are  hundreds  of 
registered  nurses  in  Canada  who  do 
not  work  in  hospitals,  and  by  virtue  of 
the  type  of  nursing  they  do,  have  paid 
unemployment  insurance  for  years. 
Because  of  a  long-time  shortage  of 
nurses,  they  have  put  little  or  no  strain 
on  the  fund. 

Faced  with  a  situation  reminiscent 
of  the  1930s,  and  with  unemployment 
in  nursing,  CNA  and  provincial  of- 
fices are  saying  they  are  going  to  accept, 
on  behalf  of  all  Canadian  nurses,  a 
compulsory  federal  unemployment 
insurance  plan. 

I  note  with  interest  Mr.  Weather- 
head's  statement  that  even  with  an 
oversupply  of  nurses,  they  would  not 
be  retrained  for  other  work.  But  nurses 
are  being  trained  for  other  work  now, 
some  by  choice,  others  out  of  necessity, 
with  and  without  the  aid  of  Manpower 
offices.  Due  to  rising  costs  of  health 
care,  restrictions  on  hospital  hiring, 
and  overtaxed  budgets,  there  is  a  high- 
er rate  of  nursing  unemployment  than 
most  people  realize. 

Provincial  offices  are  advising  nurses 
not  to  travel  from  one  province  to  an- 
other unless  they  already  have  a  job. 
Nurses  who  have  lost  their  positions 
because  of  illness  or  accident  are  on 
welfare  assistance.  Those  unable  to 
leave  the  urban  areas  also  find  that  no 
work  is  available. 

I  cannot  see  what  good  this  brief 
to  the  government  has  accomplished. 
Has  it  improved  our  image?  What  im- 
age! The  indifference  to  patient  care, 
the  sloppy  mod  uniform,  the  pant  suit. 
I  am  puzzled  why  time  and  effort  have 
been  spent  preparing  and  presenting 
this  brief  when  more  pressing  issues 
face  nursing  today.  —  Mrs.  Hazel 
Swenarton,  R.N.,  Edmonton,  Alberta. 


Summer  camps  for  diabetics 

In  the  article  "Young  diabetics  enjoy 
camp,  too"  (May  197 1), New  Brunswick 
was  omitted  in  the  footnote  that  listed 
the  number  of  these  camps  in  Canada. 

New  Brunswick  has  had  a  diabetic 
summer  camp  for  the  past  five  seasons, 
and  it  seems  a  pity  to  see  the  province 
omitted.  This  is  an  excellent  camp,  with 
very  capable  staff,  volunteer  workers, 
and  organizers.  —  W.  E.  Atcheson, 
Fredericton,  New  Brunswick.  ^ 


lULY  1971 


news 


CNA  Special  Committee 
Examines  Provincial  Research 

Ottawa  —  With  a  survey  of  provincial 
association  research  committees  in  front 
of  them,  members  of  the  Canadian 
Nurses'  Association  special  committee 
on  nursing  research  met  for  the  second 
time  on  May  5-6  at  CNA  House. 

The  survey,  which  focused  on  the 
structure  of  provincial  research  com- 
mittees, showed  that  five  provinces  — 
New  Brunswick,  Quebec,  Saskatche- 
wan, Ontario,  and  Newfoundland  — 
have  research  committees.  Alberta  is 
considering  its  research  responsibilities, 
and  Nova  Scotia  is  recommending  that 
a  committee  be  established. 

Consistent  with  its  terms  of  refer- 
ence, the  committee  is  identifying  needs 
and  priorities  in  the  research  field. 
(See  News,  April,  page  1 1).  CNA's  role 
in  research  will  probably  be  one  of 
coordination  and  identification  of 
trends. 

After  reviewing  a  wide  range  of 
references  on  ethics  and  statements  of 
ethics  of  several  professional  groups, 
the  committee  worked  on  a  draft  code 
of  ethics.  The  committee  discussed 
whether  nursing  research  ethics  should 
be  incorporated  into  a  revised  general 
code  of  nursing  ethics  or  whether  it 
should  be  separately  developed. 

The  committee,  chaired  by  Dr.  Shir- 
ley Stinson  of  Alberta,  discussed  the 
need  for  more  nursing  research  consult- 
ants. Although  some  services  are  avail- 
able through  the  federal  government 
and  universities,  the  committee  believes 
the  need  is  well  in  excess  of  current 
consultant  resources.  The  committee  is 
recommending  to  the  CNA  board  of 
directors  that  a  letter  be  sent  to  Health 
Minister  John  Munro  indicating  con- 
cern in  this  area  of  nursing  for  more 
well-prepared  research  consultants. 

The  development  of  liaison  mech- 
anisms with  other  CNA  standing  and 
special  committees  is  another  interest 
of  the  research  committee.  Also,  the 
editors  of  The  Catiaclian  Nurse  and 
L'infinniere  canadienne  were  invited  to 
a  committee  session  to  discuss  the 
possibilities  of  expanded  use  of  the 
journals  for  reporting  completed  nurs- 
ing research. 

The  next  meeting  of  the  special  com- 
mittee on  nursing  research  will  be  held 
September  30  and  October  1,  197 1 . 

JULY  1971 


CNF  Reaffirms  Principle 
Of  Permanent  Fund 

Ottawa  —  A  recommendation  that  the 
Canadian  Nurses'  Foundation  act  to  set 
up  a  permanent  endowment  fund  using 
interest  earned  as  a  basis  for  its  scholar- 
ships was  heard  by  members  at  the  CNF 
annual  meeting  held  May  17  at  CNA 
House.  The  recommendation  came 
from  a  study  of  the  foundation  done  as 
a  project  by  the  Okanagan-Similkameen 
district,  Registered  Nurses'  Association 
of  British  Columbia. 

The  special  presentation  was  made 
by  Edith  Engensperger  of  the  RNABC, 
who  co-authored  the  report  along  with 
Sharon  Shockey  of  the  same  district. 
Mrs.  Engensperger  urged  CNF  to  esta- 
blish a  trust  fund,  to  encourage  all  prov- 
inces to  participate  on  a  per  nurse 
basis,  and  to  invite  CNF  award  reci- 
pients to  make  "appreciative"  contribu- 
tions. She  also  believes  that  allied  firms 
and  organizations  could  be  encouraged 
to  donate  to  a  permanent  and  growing 
fund  for  CNF. 

The  repwrt  suggests  that  a  trust  fund 
be  established  by  an  investment  program 
that  would  enable  CNF  to  become 
independent  of  the  Canadian  Nurses' 
Association  for  administrative  purposes 


CNA  Convention  In  '72 
—Steer  For  Edmonton! 


TLkX 


At  the  Canadian  Nurses'  Asso- 
ciation annual  meeting  and 
convention  in  Edmonton,  Al- 
berta, June  25-29,  1972,  you 
can  bring  your  "beef"  to  the 
assembly  —  or  perhaps  the 
nearest  you'll  come  to  beef 
will  be  at  the  banquet  table. 
Either  way,  Edmonton  is  the 
place  in  '72! 


and  would  build  up  an  endowment  fund 
using  the  interest  earned  for  scholar- 
ship awards.  Mrs.  Engensperger  ac- 
knowledged that  monies  for  scholar- 
ships would  be  limited  during  the  build- 
up period. 

"In  view  of  the  perpetual  need  to 
provide  funds  for  scholarships,  the 
establishment  of  a  trust  fund  would 
assure  donors  that  their  contributions 
would  not  peter  out  quickly  but  would 
be  added  to  a  growing  fund.  As  the 
fund  matures  increasing  amounts  of 
interest  earned  would  permit  increasing 
numbers  of  scholarship  awards.  Donors' 
contributions  would  benefit  the  fund  on 
a  continuing  basis,"  said  Mrs.  Engen- 
sperger. 

The  report  was  accepted  in  principle 
and  referred  to  the  incoming  board  of 
directors  for  futher  study  and  action. 

Three  amendments  to  CNF  bylaws 
were  made  at  the  meeting.  One  amend- 
ment raised  membership  fees  to  five 
dollars,  another  made  CNF  member- 
ship compulsory  for  committee  mem- 
bers, and  the  third  reduced  the  number 
of  members  of  the  research  committee 
and  redefined  its  terms.  The  research 
committee  will  consist  of  five  mem- 
bers with  a  mandate  to  consider  applica- 
.tions  for  research  projects  and  to  for- 
ward recommendations  of  these  pro- 
jects to  the  CNF  board  of  directors. 

The  board  agreed  that  the  role  of 
CNF  in  relation  to  nursing  research  in 
Canada  should  be  to  provide  fellowships 
to  prepare  nurses  in  research  and  other 
areas  of  leadership,  and  to  receive  and 
dispense  funds  for  nursing  research 
projects.  A  draft  of  policies  and  criteria 
for  the  awarding  of  research  funds  has 
been  presented  to  the  board.  It  is  ex- 
pected the  new  board  will  appoint  a  re- 
search committee. 

President  Hester  Kernen  announced 
that  an  additional  fellowship  will  be 
available  to  nurses  through  CNF.  The 
Canadian  Red  Cross  Society's  $3,500 
annual  fellowship  will  be  administered 
by  CNF  along  with  four  other  fellow- 
ships and  its  own  scholarships. 

At  the  CNA  1972  annual  meeting 
and  convention  in  Edmonton,  one 
afternoon  could  be  called  CNF  after- 
noon. The  foundation  will  have  its  1 972 
annual  meeting,  and  Dr.  Shirley  Stinson 
of  Edmonton,  a  CNF  fellow,  will  coor- 
dinate a  special  program  to  commemo- 
THE  CANADIAN  NURSE       5 


rate  the  10th  anniversary  of  CNF. 

Elected  to  the  board  of  directors  were 
five  CNA  board  members:  Irene  Bu- 
chan,  Ottawa;  Dr.  Josephine  Flaherty, 
Toronto;  Margaret  Nugent,  Winnipeg; 
Helen  Taylor,  Montreal;  and  Geneva 
Purcell,  Edmonton.  Elected  from  the 
membership  at  large  were  Marilyn 
Riley,  Halifax;  Vera  Spencer,  Regina 
Constance  Swinton,  Ottawa;  and  Marie 
Thibaudeau,  Montreal. 

Citizenship  Ceremony  Also 
Honors  Florence  Nightingale 

Winnipeg,  Man.  —  In  a  distinctive 
ceremony  planned  by  the  Manitoba 
Association  of  Registered  Nurses,  20 
people  received  their  Canadian  citizen- 
ship in  Winnipeg,  May  12.  It  was  the 
first  citizenship  ceremony  held  for 
nurses,  and  the  occasion  also  marked 
the  birth  date  of  Florence  Nightingale. 

Through  special  arrangements  made 
with  the  Court  of  Canadian  Citizen- 
ship, the  ceremony  was  held  in  the 
newest  hospital  in  metropolitan  Win- 
nipeg. Victoria  General  Hospital  is 
named  for  Queen  Victoria,  who  gave 
support  to  Florence  Nightingale  in  her 
heroic  efforts. 

The  ceremony  included  nurses,  mem- 
bers of  their  families,  and  other  people 
who  fulfilled  citizenship  requirements 
They  originated  from  10  countries, 
Algeria,  Czechoslovakia,  Denmark, 
Finland,  Germany,  Hong  Kong,  the 
Netherlands,  the  Phillipines,  Poland, 
and  the  U.S.S.R. 

President  of  the  Manitoba  Associa- 
tion of  Registered  Nurses,  E.  Margaret 
Nugent,  said,  "It  was  impressive  to 
hear  Her  Majesty,  Queen  Elizabeth, 
in  speaking  to  those  receiving  citizen- 
ship in  Vancouver  recently,  emphasize 
that  those  becoming  Canadians  should 
not  forget  their  former  land.  As  the 
newest  group  of  Canadian  citizens,  you 
should  always  remember  your  origins, 
and  carry  your  traditions,  music,  and 
arts  into  the  national  fabric  of  Canadian 
life. 

"Not  only  do  our  good  wishes  go 
to  the  members  of  our  profession  who 
have  taken  this  important  step,  but 
also  to  those  of  you  not  in  nursing.  We 
welcome  you  as  new  citizens  of  this 
land  of  ours,  this  Canada  of  which  we 
are  all  a  part,  a  land  worthy  of  good 
citizens.  Canadian  citizenship  is  some- 
thing to  be  greatly  prized,"  said  Miss 
Nugent. 

NBARN  To  Hold 

Own  Armchair  Conference 

Saint  Jolvi.  N.B.  —  Members  of  the 
New  Brunswick  Association  of  Regis- 
tered Nurses  believe  that  nurses  must 
put  forward  their  ideas  about  health 
care  and  the  nursing  profession  in  the 
future.  At  the  NBARN  55th  annual 
6       THE  CANADIAN   NURSE 


To  celebrate  nurses  receiving  their  Canadian  citizenship  and  tne  birth  date  of 
Florence  Nightingale,  the  Manitoba  Association  of  Registered  Nurses  arranged  a 
special  citizenship  ceremony.  Left  to  right,  Mr.  Justice  Peter  Taraska  of  the  Court 
of  Canadian  Citizenship  who  presented  the  citizenship  papers,  Juliet  Manala 
Eckman,  teacher  of  obstetrics,  Winnipeg  General  Hospital,  who  received  her 
citizenship,  and  E.  Margaret  Nugent,  MARN  president. 


meeting  May  !  9-20,  delegates  voted  to 
set  up  an  armchair  conference  composed 
of  a  small  group  of  NBARN  members 
who  would  come  together  in  a  free- 
wheeling session  to  share  imaginative 
ideas  about  the  delivery  of  health  care, 
where  it  is  going,  what  it  needs,  and 
how  to  get  there. 

The  meeting  also  approved  a  recom- 
mendation that  NBARN  establish  a 
small  ad  hoc  committee  of  members 
closely  involved  in  the  practice  of  nurs- 
ing to  develop  specific  guidelines  for 
nursing's  position  on  all  aspects  of  the 
expanded  role  of  the  nurse. 

Another  resolution  noted  a  move- 
ment to  introduce  a  new  category  of 
worker,  the  physician's  assistant,  in  the 
health  team  and  said  the  association 
is  firmly  opposed  to  this  new  category 
of  worker  because  it  will  jeopardize 
the  future  of  nursing  and  cause  the  role 
of  the  nurse  to  deteriorate. 

Expressing  a  confident  belief  that 
expanding  the  present  role  of  the  nurse 


will  meet  the  need  for  assistance  to 
the  physician,  the  resolution  urged  a 
"core  committee  be  set  up  immediately 
to  deal  with  this  problem  and  to  take 
immediate  action  to  institute  a  program 
to  expand  the  role  of  the  nurse."  The 
committee  is  to  be  composed  of  nurses 
involved  in  all  phases  of  nursing  in  New 
Brunswick.  The  resolution  went  furthur 
and  said  necessary  steps  should  be  taken 
to  prevent  the  introduction  of  the  phy- 
sician's assistant  to  the  province. 

In  the  president's  address,  Harriet 
Hayes  visualized  areas  where  nurses 
should  expand  their  role.  "For  too  long, 
nurses  have  neglected  .  .  .  convalescent 
and  long  term  patients.  It  takes  a  great 
deal  of  knowledge  of  human  behavior 
and  physiology  to  understand  how  to 
help  people  to  help  themselves.  These 
patients  deserve  the  best  possible 
assistance." 

Miss  Hayes  would  like  to  see  nurses 
expand  their  role  in  "preventive  care 
to  preserve  health.  Nursing  has  been 

lULY  1971 


remiss  in  accepting  the  responsibility 
for  teaching  and  stressing  preventive 
care.  [We]  have  neglected  the  all  im- 
portant aspect  of  helping  the  patient 
understand  how  to  prevent  the  disease 
or  to  help  it  from  recurring." 

Nurses  should  expand  their  role  in 
the  care  of  patients  requiring  specialized 
services,  she  said.  "With  increasing 
knowledge  and  specialized  medical 
care  available  in  treating  patients,  it  is 
vital  that  nurses  become  prepared  to 
function  in  these  new  situations. 

"As  we  prepare  to  expand  our  role 
as  nurses,  let  us  have  a  firm  belief  of 
what  we  want  nursing  to  be,  what  the 
expanded  role  of  the  nurse  will  be, 
and  act  now  to  ensure  that  our  role  is 
expanded  to  our  expectations  and  not 
to  the  expectations  of  others,"  said 
Miss  Hayes. 

NBARN  is  sponsoring  a  nursing  re- 
search project  entitled  "comparative 
study  of  two  patterns  of  staffing  a  hos- 
pital unit."  The  purpose  of  the  study  is 
to  determine  whether  or  not  a  new  patt- 
ern of  staffing  a  hospital  nursing  unit 
is  superior  to  an  existing  one.  The  two 
patterns  will  be  compared  on  the  basis 
of  utilization  of  skills;  nursing  care 
provided;  and  costs  of  personnel,  ser- 
vices, and  supplies.  Helen  Beath  of 
Winnipeg  has  been  named  project 
director. 

Apolline  Robichaud  of  Fredericton 
was  elected  president,  with  Lorraine 
Mills  of  Edmundston,  first  vice-presi- 
dent; Claudette  Redstone  of  Camp- 
bellton,  second  vice-president;  and 
Margaret  MacLachlan  of  Fredericton, 
honorary  secretary. 

President  Tells  AARN 

It's  Time  For  Independence 

Banff,  Aha.  —  The  professional  nurse 
must  become  more  independent  in  her 
role  and  less  subservient  to  the  doctor, 
800  nurses  were  told  at  the  55th  annual 
meeting  of  the  Alberta  Association  of 
Registered  Nurses,  as  reported  in  a 
Calgary  Herald  story  by  Gordon  Legge. 

Delivering  the  president's  address 
at  the  May  1  1-14  meeting,  M.  Geneva 
Purcell  said,  "The  time  is  fast  ap- 
proaching for  the  nurse's  independent 
function  to  be  clearly  stated  and  the 
cooperative  team  approach  to  be  clarifi- 
ed. The  nurse's  function  has  been  a  job. 
ambiguous  at  times,  and  made  up  of 
diversified  tasks  delegated  to  her.  Her 
role  and  function  has  changed  at  the 
whim  of  anyone  in  the  bureaucratic 
organization." 

Nurses  must  stop  being  "all  things 
to  all  people,"  said  Miss  Purcell,  issu- 
ing a  call  for  nurses  to  become  "more 
resourceful,  motivated,  committed, 
creative,  imaginative,  and  progressive." 

Miss  Purcell  predicted  that  nursing 
education    programs    will    require    a 

JULY  1971 


broader  scientific  base  and  be  designed 
to  meet  the  needs  of  the  expanding  role 
of  the  nurse.  Before  the  role  of  the  nurse 
can  be  expanded,  the  needs  and  require- 
ments of  the  nurse  must  first  be  deter- 
mined, she  said. 

At  the  meeting,  concern  was  expres- 
sed by  a  group  of  nurses  over  their 
replacement  by  less  qualified  personnel 
in  various  hospitals  throughout  Alberta. 
They  complained  of  retiring  registered 
nurses  being  replaced  by  ward  aides 
and  nursing  aides,  in  an  effort  to  keep 
health  costs  down  by  hospital  adminis- 
tration. Others  said  retiring  nurses  were 
not  being  replaced  at  all,  thus  increasing 
workloads  on  general  duty  nurses. 

Alberta's  new  minister  of  health  and 
social  development,  Ray  Speaker,  told 
AARN  members  that  top  priority  will 
be  given  to  mental  health  programs 
during  the  coming  year.  He  said  the 
program  will  be  community  based  and 
extensively  decentralized. 

He  added  that  the  extent  of  the  pro- 
gram would  largely  depend  on  the  fi- 
nancial resources  available  and  the 
cooperation  of  local  health  authorities. 
The  decentralization  process  will  in- 
volve changing  admission  procedures, 
development  of  psychiatric  services  in 
active  treatment  hospitals,  and  a  greater 
number  of  auxiliary  hospitals  and 
nursine  homes. 

Also,  the  department  will  be  encour- 
aging  experimental    pilot   projects    in 


various  areas,  establishing  preventive 
programs,  and  setting  up  composite 
health  and  social  development  boards. 
Guidance  clinics  will  be  expanded  and 
facilities  improved  for  the  care  of  emo- 
tionally, intellectually,  and  neurologi- 
cally  disturbed  children. 

The  theme  tor  one  day  at  the  conven- 
tion was  "meeting  the  emotional  needs 
of  people."  Speakers  were  Dorothy 
Burwell,  director  of  nursing,  Clarke 
Institute  of  Psychiatry,  Toronto;  Helen 
Gemeroy,  assistant  director  of  nursing 
(psychiatry).  University  of  British 
Columbia;  and  Rev.  Kathryn  Hurlburt, 
counselling  director,  Lethbridge  Muni- 
cipal Hospital. 

The  message  that  came  through 
strong  and  clear  from  all  three  partici- 
pants was  the  importance  of  caring  for 
other  individuals  unconditionally. 
Whether  it  be  an  emotionally  disturbed 
child,  a  patient  in  hospital,  or  the  men- 
tally ill,  caring  is  the  key  that  opens  the 
door  to  health. 

A  panel  discussion  on  the  last  day 
of  the  convention  brought  open  disa- 
greement between  a  Calgary  child  psy- 
chiatrist and  a  Calgary  drug  expert. 
Dr.  D.O.C.  Rapier  said  marijuana 
should  be  legalized,  while  Ken  Low, 
coordinator  of  drug  education,  Calgary 
public  school  system,  differed. 

Dr.  Rapier  said  prohibiting  the  use 
of  marijuana  is  only  forcing  young 
people    to    become    acquainted    with 


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INTERNATIONAL.  We  have  not  been  able  to  fill  some  of  these  orders  due  to  the  limited 
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V-l  1972 


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NAME    I 

ADDRESS   I 

CITY    PROV I 


THE  CANADIAN  NURSE 


news 


ICoiiliiiiiid from  puiii'  7) 

Other  forms  of  drugs.  Because  the  law 
prevents  legal  use  of  the  drug,  young 
people  are  forced  to  obtain  the  sub- 
stance from  underground  street  sellers 
and  thereby  be  introduced  to  other 
forms  of  drugs. 


Mr.  Low  said  the  questions  of  why 
people  use  drugs,  such  as  alcohol  and 
marijuana,  and  how  to  prevent  their 
use  should  be  considered.  "We're  not 
going  to  make  a  dent  in  the  use  of  in- 
toxicants until  we  make  a  basic  change 
in  what  we  feel  are  the  important  things 
in  life." 

Offering  some  guidelines  for  dealing 
with  young  people,  Mr.  Low  said, 
"Make  sure  your  children  have  a  well- 
developed  set  of  living  skills.  Spend 
time  with  them  so  they  know  how  to 
survive  and  so  they  can  apply  different 


I  Hoiiisier's  complete 

U-BAG 


regular 

and  24-hour 

collectors 

in  newborn 

and 

pediatric 

sizes 


a 


get  any  infant  urine  specimen  when  you  want  it 

The  sure  way  to  collect  pediatric  urine  specimens 
easily  .  .  .  every  time  .  .  .  Hollister's  popular  UBag 
now  has  become  a  complete  system.  Now,  for  the 
first  time,  a  UBag  style  is  available  for  24hour  as 
well  as  regular  specimen  collection,  and  both  styles 
now  come  in  two  sizes  ...  the  familiar  pediatric  size 
and  a  new  smaller  size  designed  for  the  tiny  contours 
of  the  newborn  baby. 

Each  UBag  offers  these  unique  benefits:  ■  double- 
chamber  and  no-flowback  valves  ■  a  perfect  fit  on 
boy  or  girl,  newborn  or  pediatric  ■  protection  of  the 
specimen  against  fecal  contamination  ■  hypoaller- 
genie  adhesive  to  hold  the  UBag  firmly  and  comfort- 
ably in  place  without  tapes  ■  complete  disposability. 

Now  the  UBag  system  can  help  you  to  get  any  infant 
urine  specimen  when  you  want  it.  Write  on  hospital 
or  professional  letterhead  for  samples  and  informa- 
tion about  the  new  UBag  system. 


HOLLISTER  LIMITED  .  332  CONSUMERS  RD.,  WILLOWDALE.  ONT. 


8       THE  CANADIAN   NURSE 


skills  at  different  times.  For  if  they  can 
do  this,  they  won't  resort  to  drugs." 

Survey  Shows  Problems 
Of  Degree  Nurses 

Montreal,  Que.  —  Graduates  of  bacca- 
laureate nursing  programs  have  difficul- 
ty integrating  within  the  multidisciplin- 
ary  team,  indicated  a  survey  by  Nicole 
David,  professor  at  Laval  University's 
school  of  nursing.  Her  report  was  dis- 
cussed at  an  April  meeting  of  the  Que- 
bec branch,  the  Canadian  Conference 
of  University  Schools  of  Nursing,  held 
at  the  University  of  Montreal. 

Apparently  the  job  mobility  of  bac- 
calaureate nurses  is  high.  They  seem 
to  resent  their  integration  into  the  work- 
ing environment,  and  believe  they  do 
not  have  enough  opportunity  to  use 
their  knowledge. 

One  director  of  nursing  service  point- 
ed out  that  these  nurses  have  some  dif- 
ficulty in  adapting  themselves  to  the 
system  already  established  in  hospitals 
and  to  the  barriers  raised  by  other 
nurses. 

Also  participating  in  the  two-day 
event  were  clinical  specialists  who 
indicated  that  their  role  could  be  related 
to  the  suggested  expanded  role  of  the 
nurse.  They  believe  that  degree  nurses 
should  be  trained  to  act  as  agents  and 
to  help  others  adapt  to  changes  within 
the  profession.  It  was  noted  that  patients 
seem  to  accept  nurses  performing  tasks 
usually  reserved  for  doctors. 

The  meeting  passed  several  resolu- 
tions, including:  that  the  employment  of 
clinical  specialists  be  examined  in 
terms  of  practicability  within  the  eco- 
nomy of  the  system;  that  those  respon- 
sible for  nursing  education  at  the  bac- 
calaureate level  be  made  aware  of  the 
importance  of  establishing  supporting 
relationships  with  registered  nurses 
engaged  in  clinical  practice;  and  that 
graduate  nurses  be  encouraged  to  ac- 
quire practical  experience  for  one  or 
two  years  before  becoming  a  teacher 
at  the  CEGEP  level. 


Japanese  Nurse  Awarded 
3M  Fellowship 

Geneva,  Switzerland  —  A  Japanese 
nurse  has  been  awarded  the  3M  Inter- 
national Nursing  Fellowship  for  1971. 
The  announcement  of  the  award  to 
Junko  Kondo  was  made  following  the 
3M  selection  committee  meeting  at 
ICN  head -quarters  in  Geneva  in  March. 
Miss  Kondo  is  enrolled  in  a  doctoral 
program  at  Tokyo  University.  With 
the  3M  fellowship  she  will  study  ma- 
ternal behavior  and  its  relationship  to 
the  development  of  the  infant.  She 
believes  the  results  of  her  project  will 
assist  nurses  to  find  an  effective  ap- 
proach to  mother  and  child  care  in 

lULY  1971 


family  and  hospital  settings.  Miss 
Kondo  intends  to  teach  maternal  and 
child  health  nursing. 

The  $6,000  fellowship  is  granted  for 
postbasic  nursing  studies.  The  fellow- 
ship, administered  by  ICN,  is  sponsored 
by  the  Minnesota  Mining  and  Manufac- 
turing Co.  Nominations  came  from  17 
national  nurses'  associations:  Brazil, 
Canada,  Ceylon,  Egypt,  France,  Gree- 
ce, India,  Jamaica,  Japan,  Norway, 
Poland,  Sweden,  Taiwan,  United  States, 
Venezuela,  West  Germany,  and  Yugos- 
lavia. 

Members  of  the  selection  committee 
are  ICN  president  Margrethe  Kruse, 
Denmark,  and  three  vice-presidents, 
Dorothy  Cornelius,  United  States;  Alice 
Girard,  Canada;  and  Ruth  Elster,  Ger- 
many. Each  of  the  74  national  nurses' 
associations  who  are  ICN  members  is 
entitled  to  submit  one  candidate  for 
the  yearly  award. 

Nurses  Must  Participate 
In  Health  Care  Changes 

Vancouver,  B.C.  —  Nurses  must  be  in- 
cluded in  planning  at  the  provincial 
level  for  the  radical  changes  required 
in  the  health  care  delivery  system,  stat- 
ed the  board  of  directors  of  the  Regist- 
ered Nurses'  Association  of  British 
Columbia  prior  to  the  association's 
annual  meeting  May  26-28. 

The  present  fragmentation  of  health 
services  does  not  make  the  best  use  of 
the  tax  dollar,  the  RNABC  board  charg- 
ed. It  also  means  that  certain  segments 
of  the  population,  the  elderly  for  ins- 
tance, do  not  receive  the  quality  of 
health  care  to  which  they  are  entitled. 
Coordination  of  health  services  could 
provide  better  care  for  the  same  cost. 

The  RNABC  believes  that  a  unified 
approach  to  the  delivery  of  health  care 
should  begin  at  the  provincial  level  with 
integration  of  the  public  health,  mental 
health,  and  hospital  insurance  service 
branches  of  the  health  department. 

Nurses  need  to  be  included  in  plan- 
nmg  these  unified  services.  At  present 
the  nurse's  total  work  load,  and  there- 
fore the  quality  of  nursing  care,  is  all 
too  often  predetermined  by  factors  over 
which  the  nurse  has  no  control. 

A  year  ago.  Health  Minister  Ralph 
Loffmark  accepted  the  RNABC's  offer 
to  assist  in  planning,  but  to  date  the 
association  has  not  been  given  the  op- 
portunity to  participate.  This  situation 
is  unacceptable  to  the  nursing  profes- 
sion and  detrimental  to  sound  planning 
in  the  public  interest,  said  an  RNABC 
release. 

ANA  to  Move  Headquarters 
To  Kansas  City,  Missouri 

New  York,  N.  Y.  —  The  board  of  direc- 
tors of  the  American  Nurses'  Associa- 
tion voted  May  27  to  relocate  the  na- 

JULY  1971 


tional  headquarters  offices  of  the  asso- 
ciation in  Kansas  City,  Missouri. 
ANA's  headquarters  have  been  in  New 
York  City  since  the  founding  of  the 
association  in  1 896. 

Several  reasons  were  given  for  the 
decision  to  move.  For  maoy  years  ANA 
members  have  suggested  that  the  na- 
tional headquarters  should  be  in  the 
center  of  the  country  for  easier  acces- 
sibility to  constituents.  Among  the 
factors  considered  were  the  availability 
and  cost  of  suitable  headquarters  office 
space,  personnel,  and  services  required 
to  carry  out  the  work  of  the  association. 

The  board  of  directors,  in  announcing 
its  decision  to  relocate,  stated  that  there 


appears  to  be  a  markedly  progressive 
attitude  among  all  segments  of  Kansas 
City  —  private,  business,  academic,  and 
governmental.  The  city  also  has  a  mas- 
ter plan  for  redevelopment.  A  new  in- 
ternational airport  is  scheduled  to 
open  in  the  fall  of  1971. 

ANA  will  relocate  its  offices  at  the 
Crown  Center  Redevelopment  Corpora- 
tion, a  Kansas  City  urban  redevelop- 
ment project  wholly  financed  by  Hall- 
mark Cards,  Inc.  This  center  includes 
all  office  facilities  and  services  that  a 
national  headquarters  would  require. 
Target  date  for  the  move  is  September, 
1972. 

The  American  Journal  of  Nursing 


o 

SUGGESTION  TO  NU 

Wliynota 
portable  i 
every  nur 

RSING  SUPERVISORS: 

ispiratorat 

F^ 

sing  station! 

■            ^^MMMMMi- 

«      « 

It         /f 

O^l 

1  i 

1     * 

^^ 

^_.  ^ 

,           1    mm 

i            i 

jri^.1 

^^^mttgt0 

When  lime  is  more  important  than  anything  else 
in  providing  positive,  safe  aspiration  to  a  patient. 
this  proven  Gomco  Portable  Aspirator  is  a  friend 
indent!  lo  patient  and  nurse. 
Be  sure  you  have  it  when  you  need  it,  Keep  at 
least  one  on  hand  at  every  nursing  station.  Then 
you  can  get  a  replacement  from  Central  Supply 

GOMGO  SURGICAL  MANUFACTURING  CORP. 

828  E.  Ferry  Street.  Bultalo,  New  York  I42II    oept.  c-2 


for  the  next  emergency. 

The  Gomco  No.  789  "Portable  Aspirator"  weighs 
only  16  pounds,  is  easily  carried,  requires  less 
than  1  sq.  ft.  of  space,  provides  up  lo  20"  of  vacuum. 
Ask  your  nearby  Surgical  Supply  dealer  for  com- 
plete information  and  demonstration  or  write: 


THE  CANADIAN   NURSE 


Company,  a  publishing  company  wholly 
owned  by  ANA,  and  the  American 
Nurses'  Foundation,  the  research  arm 
of  ANA,  will  continue  to  be  located  in 
New  York.  Also  remaining  in  New 
York  is  the  National  Student  Nurses' 
Association. 

ANA  employs  approximately  85 
persons  on  its  headquarters  statt  at  pres- 
ent. It  is  unknown  at  this  time  how 
many  of  these  employees  will  move 
with  ANA  to  Kansas  City.  ANA  will 
continue  to  maintain  its  government 
relations  office  in  Washington,  D.C. 

Florence  Nightingale  Medal 
Minting  Announced 

Chicago,  III.  —  Minting  of  a  limited 
edition  bas  relief  medal,  honoring  the 
world's  most  famous  nurse  Florence 
Nightingale  on  the  151st  anniversary 
of  her  birth,  was  announced  recently 
by  the  Medical  Heritage  Society,  an 
organization  dedicated  to  honoring, 
in  medallic  and  other  art  forms,  great 
persons  and  achievements  in  health 
care  history. 

A  numbered  edition  of  only  3,000 
solid  sterling  silver  medals,  three  inches 
in  diameter  and  individually  hand- 
buffed  to  a  rich  antique  satin  finish,  will 
be  struck.  Of  these,  2,250  are  allocated 
to  the  United  States.  The  rest  will  go  to 
collectors  and  historians  in  other 
countries. 

The  sculpture  is  by  Barry  Stanton, 
leading  British  medallic  designer  and 
creator  of  the  official  United  Nations 
25th  anniversary  medal.  Mr.  Stanton 
sculpted  the  Florence  Nightingale 
medal  a  short  distance  from  the  Flor- 
ence Nightingale  School  of  Nursing  at 
St.  Thomas's  Hospital  in  London.  To 
assure  the  highest  minting  quality. 
Medical  Heritage  Society  retains  the 
consulting  services  of  Walter  Newman, 
M.V.O.,  chief  engraver  of  the  famed 
Royal  Mint  of  London. 

In  addition  to  the  sterling  silver 
medal,  unnumbered  pewter  and  solid 
bronze  editions  are  also  available. 

Each  medal  is  accompanied  by  the 
booklet.  The  Grace  of  the  Great  Lady, 
which  highlights  Miss  Nightingale's 
contribution  to  nursing  and  society. 
The  booklet  was  written  by  Professor 
Josephine  A.  Dolan,  author,  scholar, 
and  faculty  member  of  the  University 
of  Connecticut  School  of  Nursing. 

Further  information  on  how  to  obtain 
the  medals  is  available  by  writing  to 
the  Department  of  Nursing  History, 
Medical  Heritage  Society,  20  North 
Wacker  Drive,  Chicago,  Illinois  60606. 

10     THE  CANADIAN   NURSE 


Leading  British  medallic  sculptor  Barry  Stanton  puts  final  touches  on  the  plaster 
model  from  which  a  solid  sterling  silver  medal,  honoring  Florence  Nightingale 
on  the  151  st  anniversary  of  her  birth,  was  struck.  Looking  on  is  Walter  Newman, 
M.B.O.,  chief  engraver  for  the  famed  Royal  Mint  of  London  and  medallic  arts 
consultant  to  Medical  Heritage  Society,  Chicago,  which  issues  the  medals. 


CEGEPs  Limit  Registration 
In  Nursing  Course 

Quebec  City,  Quebec  —  The  General 
Directorate  of  College  Education,  Que- 
bec Department  of  Education,  has  pla- 
ced a  ceiling  on  the  number  of  students 
who  will  be  allowed  to  register  for 
CEGEP  nursing  courses  next  Septemb- 
er. The  move  was  made  necessary  when 
Quebec  hospitals  indicated  they  could 
not  train  a  greater  number  of  students 
in  the  fall. 

The  hospitals  had  been  surveyed  by 
the  department  in  cooperation  with  the 
department  of  social  affairs.  The  study 
was  based  on  the  assumption  that  stu- 
dents could  train  in  hospitals  for  a 
period  of  12  hours  daily  between  8:00 
A.M.  and  8:00  P.M.  The  department 
believes  there  is  not  enough  activity 
in  hospitals  at  night  to  enable  students 
to  benefit  from  training  at  that  time. 

The  department  would  not  want  to 
cut  down  on  the  amount  of  time  spent 
by  the  student  in  clinical  training 
periods  because  they  are  considered  an 
important  opportunity  for  the  student 


to  apply  her  knowledge  and  for  teachers 
to  assess  her  attitude  and  behavior 
within  the  working  environment. 

During  the  first  year,  nursing  students 
spend  three  hours  a  week  in  practical 
training  outside  the  college.  The  numb- 
er of  hours  increases  gradually  until, 
shortly  before  graduation,  the  student 
spends  1 8  hours  at  the  hospital  in  de- 
partments related  to  her  studies. 

According  to  the  survey,  in  order  to 
give  each  student  the  opportunity  to 
learn  techniques  through  clinical  train- 
ing and  thereby  keep  the  skill  of  regis- 
tered nurses  at  the  same  level,  the  num- 
ber of  registrations  cannot  be  increased 
in  September. 

Winnipeg  Nurses  Denied 
Re-Hearing  of  Application 

Winnipeg,  Man.  —  The  appeal  for  a 
re-hearing  of  the  initial  application  for 
certification  as  the  bargaining  unit  by 
the  Winnipeg  General  Hospital  Reg- 
istered Nurses'  Association  has  been 
denied.  No  reason  for  dismissal  of  the 
(Continiu'cl  on  pcific  12) 

JULY  1971 


Npw  that  SofrciTulle' 
jn  individual  packs 
is  here, 


ViJP^. 


.//    W^;!£ss^^fm 


mpfp^'^-'f 


creams  and 
ointments  covered 
with  dressings  are 
going  to  seem 

5ld-&hioned. 


It's  easy  to  see  why. 

Sofra-Tulle  Pieces  are  bactericidal 
dressings  which  are  individually  foil  sealed 
to  maintain  sterility.  Each  dressing 
stays  sterile  until  the  moment  of  use. 

Unlike  creams  and  ointments, 
Sofra-Tulle  provides  even  distribution  of 
the  antibiotic  and  excellent  mechanical 

MEMBER 

•Reg.  Can.  T.M.  OflP. 

For  full  prescribing  information,  please  see  page  00 


protection  for  conditions  such  as  burns, 
ulcers  and  infected  skin  lesions. 

Sheathed  in  parchment,  they  are  clean 
and  easy  to  handle,  cut  and  shape.  Moreover, 
there's  none  of  the  mess  and  waste  you  get 
from  squeezing  tubes  or  digging  into  jars. 

Old-fashioned  creams  and  ointments 
are  out.  New  Sofra-Tulle  Pieces  are  in. 


ROUSSEL 


Roussei  (Canada)  Ltd. 

153  Graveline 
Montreal  376,  Quebec 


SofraTulle* 

Badericidal 

Dnessing. 


COMPOSITION 

A  lightweight  lano-paraffin  gauze 

dressing  impregnated  with  1% 

Soframycin. 

INDICATIONS 

Traumatic:  Lacerations,  abrasions, 
grazes  (gravel  rash),  bites  (animal 
and  insect),  cuts,  puncture  wounds, 
crush  injuries,  surgical  wounds  and 
incisions,  traumatic  ulcers. 
Ulcerative:  Varicose  ulcers,  diabetic 
ulcers,  bedsores,  tropical  ulcers. 
Thermal:  Burns,  scalds. 
Elective:  Skin  grafts  (donor  and 
recipient  sites) ,  avulsion  of  finger  or 
toenails,  circumcision. 
Miscellaneous:  Secondarily  infected 
skin  conditions-e.g.,  eczema, 
dermatitis,  herpes  zoster;  colostomy, 
acute  paronychia,  incised  abscesses 
(packing),  ingrowing  toenails. 

CONTRA-INDICATIONS 

Allergy  to  lanolin  or  to  Soframycin. 
Organisms  resistant  to  Soframycin. 

APPLICATION 

If  required,  the  wound  may  first  be 
cleaned.  A  single  layer  of  Sofra-TuUe 
should  be  applied  directly  to  the  wound 
and  covered  with  an  appropriate 
dressing  such  as  gauze  linen  or  crepe 
bandage.  In  the  case  of  leg  ulcers,  it  is 
advisable  to  cut  the  dressing  exactly 
to  the  size  of  the  ulcer  in  order  to 
minimise  the  risk  of  sensitisation  and 
not  to  overlap  on  the  surrounding 
epidermis.  When  the  infective  phase 
has  cleared  the  dressing  may  be 
changed  to  a  non-impregnated  one. 
When  the  lesion  is  very  exudative  it  is 
advisable  to  change  the  dressing  at 
least  once  a  day. 

PRECAUTIONS 

In  most  cases  absorption  of  the 
antibiotic  is  so  slight  that  it  can  be 
discounted.  Where  very  large  body 
areas  are  involved  (e.g.  30%  or  more 
body  burn  I  the  possibility  of  oto- 
toxicity and/or  nephrotoxicity  being 
produced,  should  be  remembered. 

PACKINGS 

Cartons  of  10  units;  each  unit  pack 

contains  one  sterile  antibiotic  gauze 

dressing  10  cm  x  10  cm. 

Also  available : 

Tins  of  10  pieces :  4"  x  4". 

Tins  of  one  strip :  4"  x  40". 

Complete  information  available  on  request 

ROUSSEL  ■"- 


Roussel  (Canada)  Ltd. 

153  Graveline 
Montreal  376,  Quebec 

12     THE  CANADIAN   NURSE 


news 


(Continued  from  page  10) 

application  was  given  by  the  Manitoba 
Labor  Board,  said  a  release  from  the 
Manitoba  Association  of  Registered 
Nurses.  (News,  May  1971,  p.  18). 


Nurse  Will  Have  To  Prove 
Herself  In  New  Role 

Vancouver,  B.C.  —  Competence  in 
practice  will  broaden  the  nurse's  role 
and  set  the  limits  of  expansion,  Marga- 
ret Ann  Beswetherick,  assistant  profes- 
sor, University  of  Alberta  school  of 
nursing,  told  members  of  the  Registered 
Nurses' Association  of  British  Columbia 
at  their  annual  meeting  May  26-28. 

Miss  Beswetherick  said,  "It  will 
be  up  to  each  of  us  to  prove  we  are  able 
to  perform  these  extended  functions 
safely,  reliably,  and  with  professional 
discernment."  She  added  that  to  sur- 
vive in  a  changing  health  care  system 
the  nursing  profession  must  free  itself 
from  "crippling  adherence  to  outmoded 
traditions." 

The  goal  related  to  expansion  of 
any  role  was  to  more  adequately  meet 
health  needs  of  society.  "It  is  striving 
to  find  a  better  way  to  provide  care 
and,  at  the  same  time,  more  fully  utilize 
the  potential  of  the  nurse,"  she  said. 

Role  expansion  involves  a  broaden- 
ing or  enlarging  of  nursing  functions. 
This  process  allows  job  enrichment  and 
the  personal  development  of  the  nurse. 
It  would  allow  the  nurse  to  assess  or 
evaluate  patient  needs,  make  judg- 
ments, and  take  action  as  it  relates  to 
the  care  needs  of  the  patient.  "We  know 
that  with  additional  training  the  nurse 
can  function  at  a  higher  level  and  with 
a  greater  degree  of  certainty,  but  we 
have  denied  this  to  her,"  said  Miss 
Beswetherick. 

At  present  the  nurse's  success  of 
failure  is  measured  in  accordance  with 
tasks  accomplished  and  things  done. 
"She  is  well  aware  that  the  patient  is 
the  most  important  person  in  the  health 
care  system,  but  she  also  knows  her 
survival  is  dependent  upon  pleasing 
the  doctor  and  supervisors,"  she  said. 

Don  Knotts  Heads 
Attack  On  Pollution 

Minneapolis,  Mn.  —  TV  comedian  Don 
Knotts  has  joined  a  team  of  business, 
civic,  and  municipal  leaders  in  a  nation- 
wide attack  on  litter,  under  the  cam- 
paign theme,  "let's  keep  it  clean."  It  is 
the  first  massive  effort  to  clean  up  the 
environment  in  towns  and  cities  across 
the  United  States  on  a  voluntary  basis. 


"I'm  one  of  millions  of  Americans 
who  have  become  increasingly  alarmed 
in  recent  years  about  the  dirt,  filth,  and 
litter  covering  our  cities,  fouling  our 
air,  and  polluting  our  waters,"  said  Mr. 
Knotts.  "Now  I've  found  a  way  to  do 
something  about  it  personally." 

Sponsoring  the  campaign  are  com- 
panies in  the  cleanliness  business  with 
local  civic  organizations,  clubs,  and 
schools  as  co-sponsors.  "So  much  has 
been  said  about  pollution,  and  so  many 
guidelines  and  regulations  have  been 
written  to  combat  it,  but  little  attention 
has  been  directed  toward  providing  the 
tools,  motivation,  and  structure  for 
individual  citizens  to  do  their  part.  We 
hope  this  campaign  will  provide  such 
an  opportunity,"  said  Robert  J.  Pond, 
president  of  the  national  sponsoring 
company. 

Life  Style  Of  Homosexual 
Studied  by  Institute 

Toronto,  Ont.  —  The  sociological 
situation  of  homosexual  males  in  a 
heterosexual  society  is  under  study  by  a 
group  in  the  research  department  of  the 
Clarke  Institute  of  Psychiatry,  Toronto. 

The  study  of  the  complete  life  style 
of  the  male  homosexual  is  being  directed 
by  Ernest  Nagler,  LL.B.,  research 
scientist  at  the  institute.  "In  the  past 
few  years,"  Mr.  Nagler  said,  "homo- 
sexuality has  been  treated  with  more 
frankness.  Books,  plays,  and  movies 
portray  homosexual  life,  although  not 
always  with  accuracy,  and  homophile 
clubs  and  groups  have  sprung  up,  as 
homosexuals  discover  the  value  of 
being  what  they  honestly  are." 

He  said  a  recent  declaration  by  the 
American  National  Association  for 
Mental  Health  asserted  that  homosexual 
behavior  "does  not  constitute  a  specific 
mental  or  emotional  illness,"  and  that, 
whatever  its  cause  may  be,  "homo- 
sexuality appears  to  be  as  deeply  motiv- 
ated as  normal  heterosexual  behavior." 

In  the  current  study,  data  will  be 
collected  by  means  of  a  sociological 
questionnaire.  The  interviewer  will  seek 
answers  to  more  than  200  questions. 
Answers  to  15  questions  will  be  in  the 
form  of  an  open-ended,  tape-recorded 
conversation.  The  program  aims  to 
gather  data  from  250  non-patient  sub- 
jects. § 


I 


GOOD  THINGS      | 
HAPPEN  * 

I  WHEN  YOU  HELP  | 

I  RED  CROSS  I 


JULY  1971 


IWBW^U/KWM  Irene  Ross  McPhail, 
H^^^Sul  presently  president 
W^^^K^^mm  ofthe  Ottawa  Feder- 
al District  Nursing 
Divisions  of  St. 
John  Ambulance, 
has  been  made  a 
provincial  commis- 
sioner of  the  Ottawa 
Federal  District  for 
St.  John. 

This  is  the  first  time  in  the  world 
history  of  St.  John  Brigade  that  a  wom- 
an has  been  appointed  a  provincial 
commissioner  by  H.R.H.  the  Duke  of 
Gloucester,  Grand  Prior  of  the  Order. 

Born  in  British  Columbia,  Mrs.  Mc- 
Phail moved  to  Edmonton  before  com- 
ing to  Ottawa.  She  graduated  in  nursing 
from  the  University  of  Alberta  Hospital 
and  later  did  postgraduate  study  at 
Cornell  University  Medical  School, 
New  York. 

Mrs.  McPhail  has  been  active  in 
many  phases  of  St.  John  work  and  in 
various  jxjsitions  of  responsibility  since 
1964.  The  recommendation  for  the  new 
appointment  paid  tribute  to  her  extra- 
ordinary competence,  initiative,  and 
devotion,  and  to  the  respect,  confi- 
dence, and  affection  she  commands  from 
all  members  of  the  brigade  in  the  fed- 
eral district.  Because  she  is  the  first 
woman  to  be  so  recognized,  a  special 
headdress  must  be  designed  and  author- 
ized by  St.  John  Priory  in  England. 

Chancellor  L.H.  Nicholson  noted 
that  not  only  was  the  honor  to  be  shar- 
ed by  registered  nurses,  but  by  all  the 
women  in  Canada.  And  he  said  it  was  a 
signal  honor  for  Canada  to  lead  the 
world  in  this  kind  of  appointment. 


At  the  23rd  annual  meeting  of  the 
Nursing  Education  Alumni  Association 
of  Teachers  College,  Columbia  Uni- 
versity, held  in  May  in  Dallas,  Texas, 
Shirley  R.  Good,  director  of  the  school 
of  nursing  at  the  University  of  Calgary, 
Alberta,  was  reelected  for  a  second 
term  on  the  committee  on  nominations. 
Helen  K.  Mussallem,  executive  director 
of  the  Canadian  Nurses'  Association, 
continues  as  director  of  the  Alumni 
Association  for  1971-72.  Jean  M.  Hill, 
dean  of  the  school  of  nursing  at  Queen's 
University  in  Kingston,  Ontario,  con- 
tinues in  office  on  the  committee  on 
nominations. 


During  the  meeting,  three  nurses  who 
earned  their  doctorates  at  Teachers 
College,  Columbia,  were  honored  for 
distinguished  achievement: 

Eleanor  C.  Lambertsen,  dean  of  the 
Cornell  University-New  York  Hospital 
School  of  Nursing,  New  York,  was 
presented  with  the  R.  Louise  McManus 
Medal  by  Alumni  Association  President 
Faye  G.  Abdellah.  Dr.  Lambertsen, 
who  succeeded  Mrs.  McManus  as  chair- 
man of  the  Teachers  College  depart- 
ment of  nursing  education,  held  a  num- 
ber of  other  positions  in  research  and 
education  at  the  college  from  1950  to 
1970. 

Margaret  L.  Shetland,  dean  of  the 
college  of  nursing  at  Wayne  State  Uni- 
versity in  Detroit,  received  the  Alumni 
Achievement  Award  in  Nursing  Educa- 
tion. 

Lucille  E.  Notter,  the  first  full-time 
editor  of  Nursing  Research,  was  the 
recipient  of  the  Alumni  Achievement 
Award  in  Nursing  Research  and  Schol- 
arship. Dr.  Notter  was  influential  in 
launching  the  International  Nursing 
Index,  and  since  1965  has  been  project 
director  for  the  annual  nursing  research 
critique  conferences  of  the  American 
Nurses'  Association. 

Organized  in  1948,  the  Alumni  As- 
sociation has  1,100  members  in  the 
United  States,  Canada,  and  abroad. 

Dorothy  Colquhoun 

has  retired  from  her 
position  of  acting 
director  of  the  CNA 
Testing  Service. 

As  director  of  the 
RNAO  Testing 
Service  from  1961 
to  1970,  Dr.  Col- 
quhoun was  instru- 
mental in  establishing  standardized, 
objective-type  examinations  for  nurse 
and  nursing  assistant  registration  in 
Ontario.  When  this  service  was  purchas- 
ed by  the  Canadian  Nurses'  Association 
in  1970  to  form  the  nucleus  ofthe  pres- 
ent CNA  Testing  Service.  Dr.  Col- 
quhoun accepted  the  appointment  as 
acting  director  to  facilitate  the  transi- 
tion from  a  provincial  to  a  national 
service. 

A  graduate  of  the  Montreal  General 
Hospital  School  of  Nursing,  McGill 
University,  and  Columbia  University, 
Dr.  Colquhoun  has  had  wide  experience 


JULY  1971 


in  both  nursing  service  and  nursing 
education  in  many  parts  of  Canada. 
She  served  as  a  nursing  sister  in  the 
Royal  Canadian  Army  Medical  Corps 
in  Canada  and  overseas  from  1943  to 
1946. 


Mary  Berglund  received  an  honorary 
life  membership  in  the  Registered 
Nurses'  Association  of  Ontario  at 
RNAO's  annual  meeting  in  Toronto 
April  30. 

A  resident  of  Ignace,  Ontario,  Mrs. 
Berglund  has  served  people  in  a  225- 
mile  area  from  Thunder  Bay  to  Dryden. 
A  number  of  large  companies,  tourist 
camps,  and  the  citizens  of  Ignace  de- 
pended on  her  for  primary  health  care. 

In  1958,  when  she  received  the  Red 
Cross  Award  for  Service,  the  Fort 
William  Times  Journal  called  her  "the 
Florence  Nightingale  of  the  Bush."  She 
also  received  the  Governor  General's 
Medal  for  outstanding  service  to  the 
community  in  1966. 

Another  honor  given  at  the  RNAO 
meeting  went  to  Margaret  Street  of  the 
University  of  British  Columbia,  who 
received  an  honorary  membership  in 
RNAO. 

Miss  Street  (R.N.,  Royal  Victoria 
H.,  Montreal;  B.A.,  U.  of  Manitoba; 
M.S.,  Boston  U.;  cert,  in  teaching  and 
supervision,  McGill  U.)  has  been 
extremely  active  in  a  wide  variety  of 
nursing  positions;  instructor  in  the 
schools  of  nursing  at  St.  Joseph's  Hos- 
pital in  Victoria  and  Misericordia  Hos- 
pital, Winnipeg;  assistant  night  super- 
visor at  the  Vancouver  General  Hos- 
pital; clinical  supervisor  at  the  Royal 
Victoria  Hospital  in  Montreal;  associate 
director  of  nursing  at  the  Calgary  Gen- 
eral Hospital;  executive  secretary  ofthe 
Manitoba  Association  of  Registered 
Nurses;  president  of  the  Alberta  As- 
sociation of  Registered  Nurses;  and 
executive  secretary-registrar  of  the 
Association  of  Nurses  of  the  Province 
of  Quebec. 

Since  1962,  Miss  Street  has  been 
active  in  the  Registered  Nurses'  As- 
sociation of  British  Columbia  and  has 
been  an  assistant  and  associate  profes- 
sor in  the  school  of  nursing  at  the  Uni- 
versity of  British  Columbia.  She  is  now 
on  a  year's  sabbatical  to  work  on  a 
biography  of  Dr.  Ethel  Johns,  the  first 
full-time  editor  of  The  Canadian  Nurse. 

THE  CANADIAN   NURSE     13 


your  hospital  is 
safer,  operates  more 
efficiently  with  TIME 

NURSING 
LABELS 


t-^L-^-g 

scmm 

1  ALLERGIC 

->-— 

^3 

mil  Ml 

nnai 

macAvoM 

CHAMGCD, 

ENEMA 
RCOUWE 

n  ORDEII      HH 
N«RC0I1CS     ^^^ 

tummai 

4 

■ 

1' 

Safer  because  all  Time  Labels  relating 
to  patient  care  are  BACTERIOSTATIC 
to  assist  In  eliminating  contact  Infec- 
tion between  patient  and  nurse.  The 
self-sticking  quality  of  Time  Nursing 
Labels  eliminates  the  need  for  hand 
to  mouth  contact  while  worl<lng  with 
patient  record. 

More  efficient  because  Time  Nursing 
l-abels  provide  you  with  an  effective 
system  of  identification  and  communi- 
cation within  and  between  departments. 

Time  Patient  Chart  Labels  color-code 
your  charts  and  records  In  any  of  17 
colors  with  space  for  all  pertinent  pa- 
tient information. 

Time  Chart  Legend  Labels  alert  busy 
personnel  to  Important  patient  care 
divertlves  eliminating  the  possibility  of 
error  through  verbal  instructions. 

There  are  many  other  Time  Labels  to 
assist  you  In  speeding  your  work  and 
to  assure  accuracy  In  Important  pa- 
tient procedures.  Write  today  for  a 
free  catalog  of  all  Time  Nursing  Labels. 
We  will  also  send  you  the  name  of 
your  nearest  dealer. 


PROFESSIONAL  TAPE  COMPANY,  INC. 
355  BURLINGTON  RD.,  RIVERSIDE.  ILL.  60546 


14     THE  CANADIAN   NURSE 


names 


Constance  Swinton  (R.N.,  Royal  Alex- 
andra Hospital  School  of  Nursing, 
Edmonton;  B.N.,  McGill  University, 
Montreal;  M. P. H.,  University  of  Michi- 
gan, Ann  Arbor)  director  of  education 
and  projects  at  the  National  office  of 
the  Victorian  Order  of  Nurses  since 
1967,  has  been  granted  leave  to  be- 
come nursing  consultant,  public  health 
nursing,  child  and  adult  health  ser- 
vices directorate  of  the  department  of 
national  health  and  welfare,  Ottawa. 
j^Hj^^BHjH  Miss  Swinton's  du- 
^^^P^^^^H    ties  the 

^^^^^^^^H  planning  and  de- 
^^^^^  ^H  veiopment  of  a  na- 
H^V*<||  ^^m  tional  consultant 
I^^^L  ^  ^  ^H  and  advisory  pro- 
^^B^^^JH  gram  of  nursing 
I^^H^L  ^U  education,  service, 
^^Hpr^kS  and  research  in  sev- 
mlKr^^^m  eral  health  fields. 
These  include  maternal  and  child  health 
and  mental  health;  maintaining  com- 
munication with  provincial  health  de- 
partment branches  or  services,  schools 
of  nursing  and  agencies  providing 
health  services;  observing  and  assessing 
the  quality,  extent,  and  patterns  of  care 
and  services  for  the  family;  determining 
nursing  aspects  of  health  needs  and 
establishing  program  priorities;  and 
serving  on  committees  of  national  health 
or  welfare  organizations  as  a  represent- 
ative of  the  department. 

Miss  Swinton  has  been  with  the  Vic- 
torian Order  of  Nurses  since  1946,  in 
staff,  charge,  and  supervisory  posi- 
tions in  New  Brunswick,  British  Co- 
lumbia, Ontario,  and  Quebec. 


■HI 


Judith  Thrasher  Glenda  Carruthers 

Two  groups  of  nurses  graduated  dur- 
ing different  ceremonies  at  the  Uni- 
versity of  Saskatchewan's  60th  annual 
spring  convocation  in  Saskatoon  May 
13  and  14.  The  last  60  students  to 
complete  the  old  five-year  program  and 
the  first  58  students  to  complete  the 
new  four-year  program  received  bach- 
elor of  science  degrees  in  nursing. 

The  school  of  nursing  started  phas- 
ing out  the  five-year  program  following 


admission  of  the  final  first-year  class  in 
the  fall  of  1966,  and  introduced  the 
revised  four-year  program  in  the  fall 
of  1967. 

Two  top  graduates,  one  from  each 
program,  were  honored  at  the  convo- 
cation. Judith  Diane  Thrasher,  Rose- 
town,  received  the  Kathleen  Ellis  Prize 
for  the  most  distinguished  graduate  in 
the  five-year  course,  and  Glenda  Ko- 
rene  Carruthers,  Perdue,  received  the 
University  Prize  for  the  outstanding 
graduate  in  the  four-year  course.  Both 
prize  winners  graduated  with  great 
distinction.  As  well  as  their  high  aca- 
demic standing,  they  were  active  in 
numerous  university  activities. 


Shirley  Stinson,  associate  professor  in 
the  school  of  nursing  and  the  Division 
of  Health  Services  Administration  at 
the  University  of  Alberta,  Edmonton, 
recently  served  as  a  temporary  advisor 
to  the  Pan  American  Health  Organiza- 
tion of  the  World  Health  Organization 
in  Washington,  DC.  Dr.  Stinson  partic- 
ipated on  a  task  force  for  "Evolving  a 
Nursing  Systems  Model,"  which  will  be 
field-tested  in  South  America  in  the 
fall  of  1971.  ^ 


r" 


MOVING? 
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otherwise  you  will  likely  miss  copies. 


Attach  the  Label 
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Please  complete  appropriate  category: 

I     I     I  hold  active  membership  in  provincial 
nurses'  assoc. 


reg.  no. /perm,  cert./  lie.  no. 
I  I  I  am  a  Personal  Subscriber. 
MAILTO: 

The  Canadian  Nurse 

SO  The  Driveway 

OnAWA,  Canada  K2P  1E2 


JULY  1971 


new  products     { 


Descriptions  are  based  on  information 
supplied  by  the  manufacturer.  No 
endorsement  is  Intended. 


Pulse  Detector 

A  prototype  pulse  detector  system  to 
permit  remote  evaluation  and  patient 
evaluation  of  an  implanted  cardiac 
pacemaker  generator  has  been  announc- 
ed by  General  Electric's  Medical  Sys- 
tems Department. 

This  consists  of  two  separate  units: 
the  patient's  pacemaker  pulse  detector 
and  the  physician's  rate/interval  com- 
puter. The  pulse  detector,  the  size  of  a 
small  transistor  radio,  is  held  by  the 
patient  over  the  pacemaker  generator 
implant  site.  To  stimulate  the  heart,  the 
pacemaker  produces  a  small  electrical 
charge.  This  charge  is  detected  by  the 
unit  and  converted  to  an  audible  signal. 
The  patient  counts  the  "beeps"  for  a 
given  period  to  determine  if  the  pace- 
maker is  operating  properly. 

Ihe  physician  can  monitor  the  pa- 
tient's implanted  pacemaker  either 
in  his  office  or,  if  the  patient  is  else- 
where, by  telephone.  The  physician 
merely  attaches  a  small  electronic  pick- 
up to  his  telephone  receiver  and  the 
rate/interval  computer  determines  the 
pacemaker's  pacing  speed  to  within 
1/lOth  of  a  beat  per  minute.  The  rate 
and  the  interval  time  between  beats  are 
displayed  on  a  digital  readout. 

The  new  system  is  expected  to  re- 
duce the  need  for  elective  pacemaker 
changes,  thus  extending  pacemaker 
life.  Safety  would  not  be  compromised 
since  both  the  patient  and  physician 
can  check  the  pacemaker  as  often  as 
desired. 

For  more  information,  write  Gen- 
eral Electric  Medical  Systems  Limited, 
3311  Bayview  Avenue,  Toronto,  Ont. 


Pipe!  Tray 

A  Pipet  Tray  for  clinical  and  industrial 
laboratories  has  been  introduced  by 
Spectrum  Medical  Industries,  Inc.  It 
safely  holds  up  to  22  pipets  of  any  length 
or  bulb-size  conveniently  ready  for 
use  in  the  laboratory. 

This  tray  can  be  used  for  soaking, 
storing,  and  transporting  pipets.  It  fits 
in  drawers  or  on  the  bench,  and  its 
handles  make  it  easy  to  carry.  Made  of 
high  impact  polystyrene,  it  is  durable 
and  easy  to  clean. 

For  further  information,  write  Spec- 
trum   Medical    Industries,    Inc.,    P.O. 
Box  60916  Terminal  Annex,  Los  An- 
geles, California  90054. 
JULY  1971 


Electronic  Heart  Monitoring  System 

Hewlett-Packard  (Canada)  Ltd.  has 
announced  a  heart  monitoring  system 
that  allows  convalescing  patients  to 
move  about  freely  without  being  con- 
nected by  wires  to  alarm  devices. 

The  HP  58100  remote  heart  moni- 
toring system  uses  an  electrocardio- 
graph transmitter,  about  the  size  of  a 
pocket  transistor  radio,  connected 
to  the  patient  by  electrodes.  It  broad- 
casts information  to  monitoring  and 
alarm  units  and  allows  the  patient  to 
move  around  within  a  range  of  200 
feet.  Information  on  the  heart's  condi- 
tion and  action  is  transmitted  to  a  cen- 
tral station,  where  it  is  displayed  on  an 
oscilloscope  and  connected  to  an  alarm 
to  warn  of  any  abnormal  action. 

More  information  about  this  and 
other  electronic  heart  care  systems  may 
be  obtained  from  Hewlett-Packard 
(Canada)  Ltd.,  275  Hymus  Blvd., 
Pointe  Claire,  Quebec. 

Waterproof  Ink  Pen 
That  Won't  Dry  Out 

A  waterproof  ink  pen  guaranteed  not 
to  dry  out  has  been  developed  by  Pentel 
of  America,  Ltd. 

As  the  "Stiletto"  pen's  indelible  ink 
does  not  wash  out  nor  fade  in  sunlight, 
it  is  ideal  for  legal  documents  and  per- 
manent transcription.  The  pen's  cap 
can  be  left  off  for  as  long  as  30  days 
with  no  noticeable  loss  of  ink  supply. 

Unlike  the  broad  felt  tip  or  the  nar- 


row plastic  tip  of  "marker"  type  pens, 
the  Stiletto's  hard  acrylic  tip  does  not 
shred  or  soften  under  prolonged  use. 
It  accommodates  normal  handwriting, 
marking  on  cloth  or  fabric,  and  other 
uses  where  a  non-blotting  or  non- 
smudging  ink  is  needed. 

For  additional  information,  write 
to  Pentel  of  America,  Ltd.,  2715  Co- 
lumbia Street,  Torrance,  Calif.  90503. 


Automatic  Electrocardiograph 

The  Dallons  Instruments  Auto-Graph, 
an  electrocardiograph  with  automatic 
operation,  allows  the  doctor  or  nurse 
to  adjust  both  the  recording  interval 
and  the  recording  duration  of  an  elec- 
trocardiograph. The  Auto-Graph  also 
has  a  built-in  programming  device  that 
allows  it  to  make  a  recording  every  1 5, 
30,  or  45  minutes  —  or  at  1,  2,  or  4 
hour  intervals. 

Used  in  combination  with  a  heart 
rate  pulse  monitor,  the  solid  state  sys- 
tem will  interrupt  its  automatic  period 
to  make  an  instant  ECG  when  alerted 
by  an  alarm,  and  continue  recording 
until  manually  shut  off 

A  brochure  describes  the  specifica- 
tions of  the  system  and  a  number  of 
methods  for  using  it  in  coronary  care 
units. 

For  further  information,  or  a  copy 
of  the  brochure,  write  Dallons  Instru- 
ments, 120  Kansas  Street,  El  Segundo, 
Calif,  90245. 


Pipet  tray 


THE  CANADIAN   NURSE     15 


for  use 
-on  the  ward 
-in  the  OR 


-in  training 


NEOSPORIN^ 

IRRIGATING 

SOLUTION 

Available:  Slerile  1cc.  Ampoules, 
Boxes  of  10  and  100. 

INSTRUCTIONS  FOR  USE 

This  twepa'ation  is  spBCfically  designed  tor  use  wHti  5  cc. 
"thfee-way"  catheters  oi  wilh  other  calheler  syslems  p«rmit- 
Iing  commuous  itngaiion  ot  (he  uimary  Madder 

1  PREPARE  SOLUTION 

Using  Elenle  precautions,  one  (1)  cc.  ot  Neosporm  Irriga- 
iing  Solution  should  be  added  to  a  1.000  cc  bottle  of 

sterile  isoioriic  sslme  solution 

2  INSERT  INOWELUNG  CATHETER 

Caiheteiiie  the  patient  using  tuM  sterile  precautions.  The 
use  ot  an  antibacterial  lubficani  such  as  Lubasponn*  Urethral 
Antibacterial  Lubricant  is  recommended  during  insertioit  of 
the  catheter 

,   3    INFLATE  RETENTION  BALLOON 

Fill  a  Luer  type  syringe  with  1 0  cc.  of  sterile  water  or  ulirte 
(5  cc.  lot  balloon,  the  lemaindei  to  compensate  for  the 
volume  leQuired  by  the  inllation  channel).  Insert  syringe 

.   lip  into  valve  of  balloon  lumen,  inject  solution  and  remove 

^  synnge, 

pONNECT  COLLECTION  CONTAINER 

e  outflow  (drainage)  lumen  should  be  aseplically  con- 
bcted.  via  a  sienle  disposable  plastic  lube,  to  a  sterile 
^posable  plastic  collection  bag  (bottle) 


Ftach  rinse  solution 


fngalio 


three-way"  catheter  should 
:ia  of  diluted  Neotporin 
e  technique. 


r  ADJUST  flow-rate 

'  For  most  patients  inflow  rate  of  the  diluted  Neosporin 
ingating  Solution  should  be  adjusted  to  a  slow  drip  to 
deliver  about  1,000  cc.  every  iwenty-foui  hours  (about 
40  cc   per  hour).  If  the  patient's  urine  output  exceeds  2 
liters  per  day  il  is  recommended  that  the  inflow  rate  be 
adjusted  to  deliver  2.000  cc.  of  the  solution  m  a  twenty- 
four  hour  period.  This  requires  the  addrtion  of  an  ampoule 
of  Neosporin  Imgaling  Solution  to  each  of  two  1.000  cc. 
bottles  ot  stenle  saline  solution 

KEEP  irrigation  CONTINUOUS 

it  IS  important  thai  trrigstion  of  the  bladder  be  conimuout. 
The  rinse  bottle  should  never  be  allowed  to  run  dry.  o>  tfM 
inflow  d'lp  interrupted  for  more  than  a  tew  minutes.  The 
outflow  tube  should  always  be  inserted  into  a  sterile 


I    Convenient  product  identifying  labels  for  use  on  bottles 
ot  diluted  Neosponn  Irrigating  Solution  are  available  in  Mch 
ampoule  packing  or  from  your   B.  W   &  Co  '  ReprMentattva. 


& 


r^ 

B 

1 

( 

t 

^ 
^ 

) 

1 

%S 

JkJ-*-                           7          "»    1 

ex. 

k 

1                      1 

1 

Burroughs  Wellcome  &  Co.  (Canada)  Ltd. 


sCEEl 


Neosporirf  Irrigating  Solution 


INSTRUCTIONS  FOR  USE 


Designed  especially  for  the  nursing  pro- 
fession, this  Instruction  Sheet  shows 
clearly  and  precisely,  step  by  step,  the 
proper  preparation  of  a  catheter  system 
for  continuous  irrigation  of  the  urinary 
bladder.  The  Sheet  is  punched  3  holes  to 
fit  any  standard  binder  or  can  be  affixed 
on  notice  boards,  or  in  stations. 

For  your  copy  (copies)  just  fill  in  the  cou  - 
pon  (please  print)  noting  your  function  or 
department  Within  the  hospital. 


Dept.  S.P.E. 

Burroughs  Wellcome  &  Co.  (Canada)  Ltd. 

P.O.  Box  500.  Lachine.  P.O. 

Gentlemen ; 

Please  send  me  1 I  copy  (copies)  of  the  N.I.S.  Instructions  for  Use.  My  department  or  function 

within  the  hospital  is 


NAME. 


ADDRESS. 


CITY  OR  TOWN. 


.PROV. 


I'''^*'=l 

*Tfade  Mark 


16     THE  CANADIAN   NURSE 


Burroughs  Wellcome  &  Co.  (Canada)  Ltd. 


JULY  1971 


OPINION 


Midwives? 
In  Canada? 
Let's  hope  so! 


The  author  believes  midwives  should  give  care  to  the  "normal"  obstretical  patient 
and,  working  closely  with  general  practitioners,  perform  deliveries.  The  highly 
qualified  obstetrician  could  then  act  in  a  consultative  capacity. 


Pat  Hayes,  R.N.,  S.C.M.,  B.N. 

Does  Canada  need  midwives?  The  an- 
swer to  this  question  is  closely  related 
to  another.  Is  Canada  ready  to  accept 
midwives?  Needs  can  be  measured  ob- 
jectively, with  the  midwife's  role  being 
analyzed  and  evaluated  scientifically. 
Acceptance  is  subjective. 

A  basic  problem  seems  to  be,  is 
the  midwife  a  highly  qualified  nurse 
or  a  poorly  qualified  doctor?  This 
presupposes  knowledge  on  the  part  of 
the  evaluator  as  to  the  midwife's  level 
of  preparation.  Too  many  people  see 
her  as  an  ill-prepared  technician,  who 
is  a  potential  hazard  to  health  and  a 
return  to  the  dark  ages  of  medicine. 

Much  of  this  thinking  is  brought 
about  by  social  and  cultural  brain- 
washing. How  many  doctors,  who  ab- 
hor the  very  thought  of  midwives,  have 
ever  worked  with  them  in  a  colleague 
relationship?  How  many  nurses,  who 
feel  that  a  midwife  is  forsaking  the 
profession  of  nursing,  understand  the 

Miss  Hayes,  a  graduate  of  The  Royal 
Free  Hospital.  London,  England,  and 
McGill  University,  is  lecturer  in  Advan- 
ced Practical  Obstetrics  at  the  University 
of  Alberta  School  of  Nursing,  Edmon- 
ton, Alberta. 


JULY  1971 


midwifery  role?  How  many  lay  people 
have  been  given  the  facts,  rather  than 
the  biases? 

Are  we  biased? 

With  the  increasing  interest  in  the 
cost  of  health  care,  governments  are 
taking  a  closer  look  at  health  services. 
Ways  are  being  sought  to  bring  cheaper 
services  to  larger  numbers  of  people. 
The  midwife  could  give  care  to  the 
non-risk  obstetrical  patient  and,  work- 
ing in  close  liaison  with  the  general 
practitioner,  perform  normal  deliveries. 
This  would  allow  a  broader  coverage 
by  the  highly  qualified  obstetrician, 
who  could  then  act  in  a  consultative 
capacity. 

The  image  of  a  pseudodoctor  now 
becomes  apparent  and  the  physician's 
personal  economics  enter  the  picture. 
With  the  prospect  of  external  pressure, 
there  is  little  wonder  that  many  doctors 
are  resisting  the  entrance  of  a  new  group 
of  health  workers  into  what  is  consider- 
ed iheir  domain.  Like  any  professional 
group,  doctors  are  reluctant  to  accept 
changes  introduced  from  outside  their 
ranks. 

Nurses  have  essentially  viewed  them- 
selves as  giving  care  under  the  direction 
THE  CANADIAN  NURSE     17 


of  a  physician.  Only  recently  tiave  a  few 
begun  to  accept  the  idea  that  their 
contribution  to  health  care  is  unique. 
They  are  focusing  not  so  much  on  cur- 
ing as  on  caring. 

Some  nurses  with  high  levels  of 
clinical  expertise  and  the  necessary 
theoretical  background  are  already 
functioning  as  clinical  specialists  in 
medicine,  surgery,  and  pediatrics.  Un- 
fortunately, for  too  many  nurses  in 
obstetrics,  the  patient's  needs  are  relat- 
ed to  the  doctor's  perceptions  rather 
than  to  their  own.  The  midwife,  who  is 
an  obstetrical  nurse  clinician,  becomes 
a  threat  to  the  status  quo. 

Finally,  have  we  looked  at  what 
is  actually  happening  in  Canada?  It 
is  said  that  we  do  not  have  midwives 
in  this  country.  Yet  one  of  the  qualifica- 
tions a  nurse  usually  needs  to  practice 
in  the  North  is  experience  in  midwifery. 

Are  we  being  honest?  We  do  not 
employ  midwives  as  such,  but  our  nor- 
thern outpost  hospitals  and  many  ob- 
stetrical units  are  staffed  with  mid- 
wives  who  obtained  their  education  in 
Great  Britain,  Australia,  or  New  Zea- 
land. We  say  we  do  not  have  midwives 
in  Canada  because  we  have  no  midwif- 
ery schools.  But  if  we  call  them  pro- 
grams in  advanced  practical  obstetrics 
or  outpost  nursing,  they  are  acceptable. 

How  hypocritical  can  we  be?  Does 
this  mean  that  midwives,  classed  as 
inferior  beings  elsewhere  in  the  coun- 
try, can  be  used  as  replacements  for 
doctors  in  areas  considered  unsuitable 
for  physician  practice? 

The  social  climate 

There  is  growing  concern  among 
the  native  peoples  of  Canada  about 
their  identity  and  their  place  with- 
in the  social  structure.  They  are  becom- 
ing more  vocal  about  their  rights.  Our 
actions  indicate  we  believe  midwives  are 
adequately  qualified  to  give  these  peo- 
ple services  which,  for  the  rest  of  the 
population,  are  performed  by  doctors. 
Our  actions  also  indicate  we  believe 
midwives  are  not  qualified  to  render 
these  services  to  other  segments  of  the 
population. 

In  the  United  States,  nurse-mid- 
wifery schools  are  increasing  in  numb- 
er. Where  are  midwifes  practicing  in 
the  US?  Mainly  in  the  ghetto  areas  of 
the  inner  cities,  in  the  large  public 
hospitals,  or  in  the  economically-de- 
prived, rural  regions.  Few  are  practicing 
in  the  power  strongholds  of  the  middle- 
class.  As  in  Canada,  midwives  serve 
the  socially  underprivileged. 

Apparently   the   skills  of  midwives  | 
18     THE  CANADIAN   NURSE 


are  not  used  until  there  is  a  large,  eco- 
nomically-deprived group  that  demands 
services  which  physicians  are  unable 
or  unwilling  to  provide.  There  are  no 
monetary  gains  in  serving  the  poor. 
It  is  a  saddening  thought  that  nurses 
appear  to  have  more  of  a  social  con- 
science than  physicians. 

Now  that  Medicare  is  universal  in 
Canada,  we  do  not  have  these  large, 
medically-indigent  groups,  so  there  are 
fewer  economic  incentives  to  prepare 
midwives.  The  social  and  psychological 
needs  of  the  medically  deprived  are 
still  going  to  create  pressures  on  the 
health  professions  from  both  internal 
and  external  forces. 

Until  midwives  are  universally  ac- 
cepted to  practice  in  all  areas  of  the 
country  —  rural  and  urban,  suburb  and 
inner  city,  hospital  and  community  — 
we  are  going  to  meet  increasing  resis- 
tance from  our  native  peoples  in  using 
their  services. 

What  is  a  midwife? 

A  midwife  is  first  and  foremost  a 
nurse.  Her  initial  education  is  that  of 
a  nurse,  but  her  preference  is  to  ob- 
tain further  education  in  her  chosen 
clinical  specialty.  Using  modern  par- 
lance, therefore,  the  midwife  is  an 
obstetrical  nurse  clinician.  Because  of 
her  initial  orientation,  she  will  never 
wish  to  take  over  the  role  of  the  physi- 
cian, but  she  will  have  much  more  to 
give  to  the  obstetrical  patient  than  the 
nurse  with  minimal  basic  qualifications. 
The  doctor,  the  midwife,  and  the  reg- 
istered nurse  have  their  own  spheres 
of  practice.  Many  times  they  overlap, 
but  one  can  never  replace  the  other. 

A  midwife  identifies  with  the  total 
concept  of  family  life  —  not  just  with 
the  woman,  but  with  her  husband,  chil- 
dren and,  many  times,  the  extended 
family.  As  Vera  Keane  has  stated,  "A 
midwife  is  familyH;entered  rather  than 
pelvis-centered."*  With  our  ever-in- 
creasing interest  in  family-centered 
care,  it  is  obvious  that  the  place  for 
the  midwife  is  as  a  participating  mem- 
ber of  the  obstetrical  team.  She  has  the 
time  and  the  concern  to  listen  to  diffi- 
culties and  problems  that  many  women 
may  belive  are  too  minor  and  insig- 
nificant to  mention  to  the  doctor. 

It  is  said  that  the  nursing  role  is  both 
instrumental  and  expressive  in  its  func- 
tion. When  working  with  physicians, 

"Vera  Keane,  "Role  of  the  Midwife 
Today."  The  Midwife  in  the  United  StaU-fi. 
N.Y..  Josiah  Macy,  Jr.,  Foundation,  1968. 


the  midwife  maximizes  the  expressive 
role.  When  functioning  alone,  she  has 
the  knowledge  and  clinical  skills  that 
encompass  much  of  the  instrumental 
role,  but  she  never  allows  it  to  obliterate 
her  expressive  role. 

The  midwife  has  the  theoretical 
background  and  clinical  expertise  to 
become  a  primary  contact  for  obstet- 
rical care.  She  has  the  knowledge  to 
supervise  and  manage  normal  ante- 
partum care  and  is  aware  of  her  lim- 
itations relating  to  the  conduct  of  high 
risk  pregnancies  and  labors.  A  major 
area  of  her  expertise  is  in  teaching  and 
counseling.  She  is  the  professional  in- 
dividual who  can  best  assist  the  par- 
turient woman  to  attain  the  maternal 
role.  Because  of  her  knowledge  of  the 
family,  she  can  become  the  catalyst  in 
crises  that  evolve  during  pregnancy 
and  the  parturient  period. 

Use  of  midwifes 

At  present,  obstetrical  units  in  many 
Canadian  hospitals  are  staffed  by  nurses 
who  have  gained  their  knowledge  by 
informal  training  and  experience.  Con- 
siderable responsibility  is  therefore 
placed  on  the  individual  nurse's  ability 
to  recognize  her  own  inadequacies; 
those  with  greater  knowledge  have  not 
always  been  willing  to  accept  responsi- 
bility to  stimulate  learning.  The  mid- 
wife can  forge  links  between  these 
groups,  facilitating  communication 
and  cultivating  continuing  learning. 

The  system  of  health  services  under 
which  we  now  function  attempts  to 
integrate  semi -autonomous  hospitals, 
individual  doctors,  and  an  octupus 
of  social  and  community  health  agen- 
cies. Initially,  a  midwife  would  have  to 
limit  the  full  extent  of  her  functioning 
to  conform  to  the  social  and  economic 
pressures  of  self-interested  groups.  But 
her  role  would  change  as  the  working 
environment  altered  and  as  she  took 
her  place  as  part  of  the  total  health 
team. 

Midwives,  educated  in  other  coun- 
tries, are  already  working  in  labor  and 
delivery  rooms;  many  occupy  senior 
positions  in  obstetrical  units.  They 
hav^  knowledge  and  skills  that  are 
only  occasionally  recognized  and  used. 
Because  of  unfamiliarity  with  the  rigid 
hierarchical  and  autocratic  structure 
under  which  many  hospitals  function, 
these  midwives  "'step  on  corns,"  create 
"waves."  and  reinforce  the  physicians' 
negative  opinions.  In  spite  of  biases, 
however,  many  doctors  express  a  pref- 
erence for  midwives  to  function  in 
labor  and  delivery  rooms. 

JULY  1971 


Isolated  Areas  0 

Midwives  are  already  functioning  in 
isolated  areas,  giving  prenatal  care, 
assessing  high  risk  situations,  and  mak- 
ing judgments  about  the  time  and  place 
of  referrals.  Those  mothers  who  are  not 
termed  as  "risk"  patients  are  delivered 
by  the  midwife  who  has  to  have  the 
ability  to  cope  with  an  emergency  should 
it  arise. 

To  a  well  qualified  midwife,  few 
emergencies  occur,  because  critical 
situations  have  been  foreseen  and  ap- 
propriate action  taken.  These  midwives 
have  a  continuing  relationship  with  the 
mothers,  the  newborn,  and  the  extended 
family,  and  are  able  to  impart  informa- 
tion and  support  in  many  interrelated 
areas  at  a  time  when  there  is  maximum 
family  vulnerability. 

Rural  Areas 

In  Canada  we  have  many  rural  hos- 
pitals where  small  obstetrical  units  are 
staffed  on  a  part-time  basis  by  nurses 
who  also  work  on  a  surgical  or  medical 
unit,  or  perhaps  even  run  the  emergency 
department.  Rarely  is  the  obstetrical 
unit  large  enough  or  the  surrounding 
area  sufficiently  populated  to  support 
a  fully  qualified  obstetrician. 

General  practitioners,  of  necessity, 
give  the  "routine"  obstetrical  care;  many 
of  these  doctors  would  be  willing  to 
delegate  these  routines  to  another  per- 
son. Educated  in  a  system  where  pa- 
thology is  of  supreme  imjx)rtance,  it  is 
little  wonder  that  a  patient  with  a  frac- 
tured femur  or  angina  pectoris  would 
receive  more  attention  than  a  "normal" 
woman,  18  weeks  pregnant  with  her 
first  baby. 

Nurses  who  work  in  these  units, 
often  having  minimal  obstetrical  prep- 
aration, are  expected  to  function  at 
high  levels  of  technical  competence. 
They  are  oriented  to  "doctor's  routine 
orders"  and  find  themselves  "in  a  dou- 
ble bind"  between  responsiblity  to  the 
parturient  patient  and  the  other  "really 
sick"  patients.  In  this  situation  it  would 
be  possible  for  a  midwife  to  take  over 
areas  of  ongoing  responsibility  for 
obstetrical  care.  The  doctor,  with  his 
greater  depth  of  knowledge  of  psysiolo- 
gy  and  pathology,  could  then  use  his 
time  and  expertise  in  a  way  that  is  best 
for  all  patients. 

Urban  A  reas 

The  midwife  could  fill  many  roles 
within  our  large  cities. 

I.  In  the  hospital:  As  supervisor 
or  clinical  specialist  in  a  large  teach- 
ing hospital,  she  could  be  involved  in 
the  education  of  the  graduate  nursing 
JULY  1971 


staff,  nursing  students,  and  perhaps 
medical  students.  As  a  coordinator  of 
services  and  as  the  person  responsible 
for  continuity  of  care,  she  could  work 
in  close  liaison  with  the  multidisciplin- 
ary  group  of  people  associated  with 
the  obstetrical  patient.  The  midwife  is 
the  clinical  expert  and  takes  her  place 
alongside  those  other  nurse  clinicians 
functioning  in  intensive  care  cardiac 
units  and  renal  units. 

2.  In  the  community:  As  the  coordin- 
ator of  prenatal  classes,  she  could  ensure 
that  the  community  health  nurse,  who 
often  has  extremely  limited  obstetrical 
experience,  has  adequate  knowledge 
to  conduct  classes.  The  midwife  could 
also  be  instrumental  in  setting  up  and 
supervising  family  planning  clinics. 
She  would  become  the  consultant  for 
family  life  education  classes.  As  much 
of  the  community  care  revolves  around 
the  family  and  the  newborn,  the  mid- 
wife could  therefore  act  as  a  consultant 
on  many  fronts. 

3.  As  a  physician's  associate:  This 
term  has  many  connotations  that  create 
negative  reactions  among  nurses.  If 
we  can  forget  the  biases  brought  about 
by  semantics  and  examine  the  role  as 
being  fulfilled  by  a  nurse,  the  focus 
may  change.  A  midwife  working  with 
an  obstetrician  or  general  practitioner 
would  have  the  freedom  to  follow  the 
patients  from  the  doctor's  office  into 
the  hospital  and  back  to  their  homes. 

Patient  response 

Our  health  care  delivery  system  has 
made  patients  dependent  on  doctors 
because  they  have  never  been  exposed 
to  a  different  system. 

When  one  branch  of  medicine  prom- 
ulgates a  value  orientation  regard- 
ing skills  and  qualifications,  then  pro- 
motes it  to  an  elite  position  within  the 
nation's  socio-economic  structure,  the 
relative  merits  of  opposing  viewpoints 
become  obscured.  With  this  in  mind, 
the  reactions  of  patients  depend  on  the 
value  placed  on  the  midwife  by  the 
individual  who  introduces  her  into  the 
system  and  the  value  placed  by  patients 
on  the  individuals  who  do  the  intro- 
ducing. 

On  the  one  hand,  if  the  midwife  is 
given  value  only  as  a  poor  substitute 
for  the  doctor,  there  will  be  rejection 
and  poor  use  of  her  skills.  On  the  other 
hand,  if  she  is  introduced  as  a  clinical 
specialist  in  her  own  sphere  and  allow- 
ed to  function  in  a  way  that  expresses 
her  special  field  of  knowledge,  accep- 
tance and  utilization  would  be  assured. 

Immediate    responsibility    for    this 


introduction  rests  with  the  doctors. 
Governments  and  economists  cannot 
legislate  acceptance.  It  is  up  to  the  few 
midwives  we  have  in  Canada  to  de- 
monstrate a  level  of  skill,  knowledge 
and  unique  functioning  to  influence 
the  physicians.  Doctors,  fearful  of 
patients'  reactions,  may  be  willing  to 
act  en  masse,  but  do  not  wish  to  initiate 
the  change  individually.  Patients  are, 
after  all,  the  final  consumers. 

Conclusion 

I  believe  there  is  a  place  in  the  Cana- 
dian health  systems  for  midwives  —  not 
as  poorly  qualified  substitute  doctors, 
but  as  highly  qualified  nurse  practition- 
ers. We  must  stop  looking  at  the  past 
and  the  experiences  of  the  nineteenth 
century.  We  must  stop  looking  at  other 
countries  and  comparing  the  systems  of 
health  care  on  the  basis  of  economic 
and  social  differences.  We  must  look 
at  Canada. 

The  various  ways  in  which  midwives 
can  function  should  not  become  rigidly 
structured.  Nurses  must  move  into  these 
extended  roles.  They  must  be  willing 
to  accept  the  challenge  of  being  change 
agents  and  innovators.  a 


THE  CANADIAN  NURSE     19 


Typhoid  in  Bouchette 


As  a  result  of  its  experiences  this  spring,  the  Quebec  village  of  Bouchette  has 
become  a  warning  that  cannot  be  ignored.  Pollution  must  be  controlled  or 
mankind  will  pay  a  heavy  price. 


Until  May  of  this  year,  most  people  had 
not  heard  of  Bouchette,  a  village  65 
miles  north  of  Ottawa.  Almost  over- 
night the  name  of  the  town  became 
know,  as  many  of  its  citizens  came  down 
with  typhoid  fever. 

There  are  usually  two  or  three  cases 
of  typhoid  annually  in  Bouchette,  but 
deaths  are  practically  unknown.  One 
person  died  a  long  time  ago.  Life  in 
1971  is  a  far  cry  from  what  it  was  in 
1927,  when  Quebec  experienced  its 
worst  typhoid  epidemic.  Three  hundred 
people  died  before  the  carrier  —  the 
local  milkman!  —  was  found. 

This  spring  the  town  seemed  to  split 
in  two  —  the  sick  on  one  side,  the  sound 
and  healthy  on  the  other.  However, 
everybody  got  together  each  Sunday  at 
St.  Gabriel's  church,  which  is  situated 
on  the  bank  of  the  Gatineau  River. 

During  April,  the  Gatineau  River 
was  swollen  and  congested.  The  smell 
of  pulpwood  mingled  with  the  familiar, 
musty  odor  of  melting  snow  and  ice. 
Logically,  "after  church"  conversation 
centered  on  the  "bad  water,"  the  "good 
drinking  water,"  the  filth  of  the  river, 
the  good  quality  of  the  water  from  the 
artesian  wells,  the  activities  of  the 
municipal  council,  "which  was  doing 
its  best,"  and  the  prevalence  of  illness 
in  the  district. 

The  parish  priest.  Father  Antoine 
Garand,  pointed  out  one  of  the  charact- 
20     THE  CANADIAN   NURSE 


Gertrude  Lapointe 

eristics  of  his  congregation:  "They 
don't  come  to  the  rectory  to  complain." 
They  aren't  grumblers."  He  found  out 
about  the  epidemic  from  the  local  health 
unit.  "There  haven't  been  any  deaths 
as  yet,"  he  said.  "Last  year,  one  man 
almost  died,  but  he's  working  harder 
than  ever  this  year." 

Father  Garand  gets  his  water  supply 
from  the  river,  as  do  several  of  his 
parishioners.  "They  don't  all  depend 
on  the  river.  A  number  of  families 
have  artesian  wells." 

Out  of  a  population  of  970  in  Bou- 
chette, 30  to  40  are  farmers.  At  least 
25  men  are  employed  by  Maki  and 
Sogefors  in  Maniwaki.  However,  most 
of  the  working  force  is  centered  in 
Hull,  Ottawa,  and  their  surrounding 
districts. 

Looking  at  the  faces  of  the  towns- 
people, no  one  can  tell  who  is  or  who  is 
not  a  typhoid  carrier.  Everyone  is  well 
aware,  however,  that  Bouchette  is  no 
longer  a  forgotten  corner  of  the  earth. 
The  knowledge  that  typhoid  organisms 
are  traveling  regularly  to  Hull  and 
Ottawa  has  seen  to  that. 

"People  here  don't  need  their  priest 
at  their  heels  all  the  time,"  Father  Ga- 
rand said.  "Just  last  Sunday  I  congratu- 
lated them  on  getting  organized  to  peti- 

Mrs.  Lapointe  is  Associate  Editor  of 
Linfirmiere  camidienne. 


tion  for  a  town  reservoir.  They  have 
asked  for  it  several  times  already.  This 
isn't  a  rich  municipality  —  about 
$19,000  revenue  annually. 

"We  shouldn't  dramatize  this  Bou- 
chette situation  —  the  epidemic  —  too 
much.  To  begin  with,  the  illness  itself 
isn't  dramatic.  The  townsite  is  a  beau- 
tiful one,  and  the  people  really  have  a 
good  life.  They  get  together  and  take 
part  in  things.  They  are  united  in  their 
misfortune.  Are  you  going  to  blame 
them  for  being  patient.'" 

Bouchette  is  built  on  the  side  of  a  hill 
overlooking  the  river.  It  is  on  the  same 
winding  highway  that  leads  to  the  ski 
slopes  of  Camp  Fortune,  Vorlage, 
Edelweiss,  and  Lac  Ste  Marie,  as  well 
as  the  towns  of  Wakefield  and  Low.  As 
you  leave  Kazabazua,  the  road  signs 
point  to  Whitefish,  Cayamant,  and 
Blue  Sea  Lake.  Travelers  to  Maniwaki 
pass  through  Bouchette  en  route  — 
usually  without  a  stop  —  in  their  haste 
to  reach  greater  attractions. 

The  first  case 

The  first  typhoid  victim  this  year  in 
Bouchette  was  a  former  hockey  player 
with  the  Montreal  Canadiens,  Leo 
Gravelle.  Until  recently,  Leo  owned 
and  managed  an  inn.  Now  he  devotes 
his  time  to  the  sale  of  tickets  for  Loto- 
Quebec.  (A  lottery  sponsored  by  the 
province  of  Quebec.)  His  wife.  Yolan- 

lULY  1971 


Several  open  sewage  pipes,  such  as  this  one,  can  be  found  along  the  Gatineau  River. 


de,  is  a  registered  nurse.  She  blames 
herself  for  her  husband's  illness. 

"I  think  it's  my  fault  that  he  has 
been  sick.  I  gave  him  ice  cubes  that 
were  probably  contaminated." 

The  drinking  water  in  the  Gravelle 
home  comes  from  a  friend's  well.  How- 
ever, the  ice  cubes  were  made  from 
water  from  the  kitchen  tap.  That's 
enough  to  recall  other,  almost  forgotten, 
details.  Vegetables  and  fruit  are  washed 
in  water  from  that  same  source,  as  are 
the  dishes.  Tap  water  is  used  for  brush- 
ing teeth  as  well. 

Taking  everything  into  considera- 
tion, the  ice  cubes  probably  were  not 
the  offenders.  Leo  Gravelle  was  admitt- 
ed to  hospital  on  March  23  and  remain- 
ed there  15  days.  That  same  day.  five 
of  his  seven  children,  his  wife,  and  her 
parents  —  who  live  in  Ottawa  —  all 
received  their  first  vaccination.  Leo 
had  stayed  with  his  mother-  and  father- 
in-law  during  the  week  prior  to  his 
hospitalization.  Specimens  of  urine 
and  stool  from  all  family  members  were 
sent  to  the  provincial  laboratories  for 
examination  and  culture.  Fortunately, 
the  results  were  negative. 

Another  citizen  of  Bouchette  was 
admitted  to  hospital  on  March  28. 
Whole  families  now  began  to  be  affect- 
ed. The  men  seemed  to  have  greater 
immunity  and  were  not  as  ill.  In  the 
Gravelle  household,  the  telephone 
JULY  1971 


rang  constantly.  People  were  anxious 
about  the  condition  of  the  "first  pa- 
tient." They  asked  if  his  headache  was 
as  bad  as  they  had  been  told. 

Mrs.  Gravelle  never  again  wants  to  go 
through  the  anxiety  of  this  past  spring. 
She  watched  her  husband  suffering. 
'1  didn't  think  he  would  survive.  For 
one  whole  week  his  temperature  stayed 
between  104°F-105°F.  1  read  and  re- 
read every  medical  book  that  1  could 
put  my  hands  on  —  and  I  had  quite  a 
few." 

Something  about  the  illness 

As  well  as  knowing  the  symptoms  of 
typhoid,  the  nurse  must  observe  careful 
techniques  in  caring  for  these  patients. 
She  must  know  what  advice  to  give  them 
when  they  leave  hospital.  Leo  Gravelle 
was  supposed  to  rest  for  two  months. 
However,  one  of  his  business  colleagues 
died,  and  Leo  went  back  to  work.  As  a 
result  he  had  a  relapse. 

"People  have  big  families  here," 
Mrs.  Gravelle  said.  "They  raise  their 
children  sometimes  under  difficult 
circumstances,  and  accept  their  lot  in 
life.  To  use  their  words,  "they  have 
great  endurance.'  They  aren't  pessimis- 
tic —  the  contrary,  in  fact.  It  took  time 
to  get  them  to  accept  that  they  were 
suffering  from  typhoid.  They  thought 
it  was  tlu.  and  that  it  would  clear  up. 
They  made  their  children  go  to  school. 


even  when  they  weren't  feeling  well." 

As  she  was  speaking  to  me,  the  tele- 
phone rang  again.  "Go  next  door  and 
Tell  them  that  the  hospital  called.  There 
will  be  a  bed  for  the  daughter  at  4  00 
P.M.  today." 

Mrs.  Gravelle  picked  up  the  conver- 
sation again,  discussing  the  synipioiiis. 

"It  is  much  like  flu  at  the  beginning 
You  feel  sick  all  over:  sore  throat,  stiff 
neck.  The  abdomen  is  distended:  the 
liver  and  spleen  are  enlarged.  It's  a 
generalized  illness.  Some  patients  are 
constipated,  some  have  diarrhea.  Many 
vomit."  The  telephone  rang  again. 

This  time  the  call  was  about  an  18- 
month-old  baby.  The  nurse  advised 
the  parents  to  see  the  doctor  as  quickly 
as  possible. 

"I'm  really  working  full  time."  Mrs. 
Gravelle  said.  "The  chief  health  nurse 
lives  in  Maniwaki.  People  call  me  be- 
cause 1  am  right  on  the  spot." 

Mrs.  Gravelle  is  a  graduate  of  the 
Ottawa  General  Hospital.  She  studied 
hospital  administration  at  the  Universitc 
de  Montreal,  and  for  two  years  was  the 
director  of  nursing  at  Hopital  St-Joseph 
in  Maniwaki  —  a  100-bed  institution. 
At  present,  she  is  working  part  time. 
She  helped  with  the  work  of  the  three 
vaccination  clinics  set  up  recently  to 
care  for  the  people  of  Bouchette. 

"Typhoid    patients    are    exhausted: 

they  simply  collapse.  They  have  severe 

THE  CANADIAN   NURSE     21 


headaches  and  chills.  They  perspire 
profusely,  and  must  be  observed  care- 
fully for  complications  in  almost  any 
organ  of  the  body.  In  my  husband's 
case,  we  were  worried  about  endocar- 
ditis," Mrs.  Gravelle  said. 

"Until  the  presence  of  the  organism 
is  confirmed,  the  patients  receive  a 
liquid  diet  and  take  aspirin.  Once  the 
diagnosis  has  been  made,  antibiotic 
therapy  is  started,  using  such  prepara- 
tions as  chloramphenicol  or  ampicillin. 
After  two  or  three  days,  the  temperature 
starts  to  drop.  Antibiotics  may  have  to 
be  continued  after  hospitalization. 
Regular  checking  at  three-month  inter- 
vals is  necessary  to  determine  if  orga- 
nisms are  still  being  harbored." 

What  of  the  future? 

Typhoid  cases  in  Bouchette  have 
been  numerous.  However,  this  is  not 
the  only  town  to  be  affected.  An  adoles- 
cent in  Sault  Ste.  Marie  contracted  the 
disease  in  mid-May  and  was  put  under 
quarantine.  Several  instances  of  typhoid 
have  been  confirmed  in  Petit-Rocher. 
New  Brunswick. 

Polluted  water,  such  as  that  found  in 
the  Gatineau  River,  is  not  fit  to  drink. 
Citizens  of  Bouchette,  their  mayor, 
and  the  town  councillors  learned  this 
lesson  long  ago.  Six  years  ago,  they 
spoke  about  an  aqueduct  and  a  water 
treatment  plant.  Lack  of  finances  stood 
in  the  way,  they  said. 

A  typhoid  epidemic  in  1971  seems 
almost  inconceivable,  but  not  in  the 
judgment  of  those  concerned  with 
questions  of  ecology,  pollution  control, 
and  improvement  of  the  environment. 
Bouchette  is  a  warning.  The  responsi- 
bility does  not  fall  only  on  the  shoulders 
of  those  who  suffer  patiently.  A  nurse, 
in  Bouchette,  understands  this  all  too 
well. 
22     THE  CANADIAN   NURSE 


When  she  started  to  have  fever,  this 
woman  was  treated  for  influenza.  For 
a  whole  tnonth  her  temperature  remain- 
ed between  100^  and  104  f>F.  She  has 
three  children  —  six,  five,  and  four 
years  old — which  means  there  is 
plenty  to  do.  She  expected  to  move  into 
a  new  home  on  the  day  of  the  interview. 
Two  hours  later  she  was  informed  by 
the  hospital  that  a  bed  was  available. 


An  Interview  with  the  Quebec  Minister  of  Environment 

The  associate  editor  of  L'infirmiere  canadienne  spoke  to  the  minister  responsible 
for  environment  in  Quebec,  Dr.  Victor  Goldbloom.  Here  are  excerpts  from  their 
telephone  interview  on  Friday  May  21. 

Dr.  Goldbloom:  The  message  I  would  like  to  give  nurses  in  Quebec  is  this:  Wher- 
ever you  suspect  a  danger  for  the  health  of  the  population,  such  as  in  Bouchette, 
please  let  me  know.  We  want  to  make  a  quick  survey  of  all  the  localities  that 
are  grossly  contaminated.  I  have  requested  an  investigation,  and  I  believe  that 
public  health  nurses  have  just  as  much  of  a  role  to  play  as  medical  officers  of 
health. 

Question:  Sometimes  reports  from  public  health  nurses  receive  no  attention. 
What  do  you  suggest  can  be  done? 

Dr.  Goldbloom:  If  this  happens,  nurses  should  get  in  touch  with  me  directly  and 
I  will  send  inspectors  to  discuss  the  problem  with  the  medical  officer  of  health. 
Question:  You  probably  realize  that  in  doing  so  a  nurse  runs  the  risk  of  losing 
her  job  for  having  failed  to  go  through  the  usual  channel  of  communication. 
Dr.  Goldbloom:  Nurses  should  write  directly  to  the  Minister,  stating  that  the 
letter  should  be  kept  "confidential."  They  should  write  "Personal"  on  the 
envelope. 

Question:  When  can  the  people  of  Bouchette  anticipate  help?  These  people  are 
sick  and  certainly  cannot  wait  until  July. 

Dr.  Goldbloom:  We  are  doing  everything  we  can  to  find  a  solution  and  are  work- 
ing in  cooperation  with  the  minister  of  social  affairs.  We  shall  sink  a  well  as 
quickly  as  possible.  It  is  up  to  the  municipal  council  to  accept  its  responsibilities 
too.  The  investigation  being  conducted  should  reveal  whether  other  municipalities 
in  Quebec  are  in  the  same  position  as  Bouchette.  This  is  a  provincial  problem. 
Not  more  than  15  percent  of  the  municipalities  have  water  purification  systems. 
For  example,  all  the  sewage  from  the  city  of  Montreal  is  discharged  into  the  St. 
Lawrence  River.  This  is  a  problem  that  will  take  from  15  to  20  years  to  settle  and 
will  cost  about  $600  million. 

Question:  Would  you  say  that  Bouchette  is  a  warning  to  all? 
Dr.  Goldbloom:  This  is  exactly  what  I  said.  The  same  problem  exists  in  other 
parts  of  Canada,  and  we  have  a  lot  of  work  to  do! 


JULY  1971 


Vaccination  has  not  been  forced  on  the  population  ofBouchette,  but  many  persons 
availed  themselves  of  the  opportunity.  Others  did  not  believe  it  was  necessary 
for  themselves  or  their  children.  Little  Anne  Major  did  not  have  to  be  coaxed  by 
Nurse  Yolande  Grave  lie. 


The  old  dump  —  a  breeder  of  germs. 


lULY  1971 


While  their  friends  are  sick  in  hospital,  these  children  play  without  being  too 
concerned.  They  cannot  do  anything  to  solve  the  problem,  anyway.  But  will  they 
be  ready  to  assume  their  responsibilities  as  citizens  tomorrow?  ^ 

THE  CANADIAN   NURSE     23 


Venereal  disease 

problem 

in  Canada 

Although  syphilis  rates  have  been  relatively  constant  in  recent  years,  the  disease 
still  presents  a  national  problem.  The  incidence  of  gonorrhea  is  increasing 
sharply.  Because  these  diseases  are  tied  to  complex  social  and  behavioral  patterns, 
there  is  no  one  aspect  on  which  we  can  concentrate  resources  to  achieve  control. 
The  authors  believe  it  is  up  to  the  medical  and  nursi-^g  professions  and  society 
in  general  to  strengthen  preventive  measures. 


S.E.  Acres,  M.D.,  D.P.H.  and 

I.W.  Davies,  M.B.,  B.S.,  D.P.H.,  M.Sc, 

With  the  end  of  World  War  II  and  the 
advent  of  penicillin  therapy,  there  was 
a  dramatic  decline  in  the  incidence  of 
syphilis  (Figure  1  ).*  Eradication  of  the 
disease  was  anticipated  by  the  medical 
profession.  Surprisingly  —  and  regret- 
tably —  a  resurgence  of  infection  has 
occurred  during  the  past  decade. 

The  increase  may  be  attributed  to 
many  factors,  but  the  relative  impact 
of  each  is  im|X)ssible  to  measure.  Those 
mentioned  most  frequently  are: 

•  The  increase  in  population  with  a 
disproportionate  increase  in  the  young, 
sexually  active  age  groups.  Coincident 
with  this  is  the  longer  sexual  life  span 
due  to  earlier  maturity  because  of  the 
declining  age  of  menarche. 

•  Rapid  industrialization  and  increase 
in  urban  population.  Most  people  mov- 
ing to  urban  areas  are  young  people. 

•  Population  movement.  Besides  the 
vast  number  of  international  travel- 
ers, there  are  immigrants,  migrating 
labor  groups,  and  movements  of  armed 

Dr.  Davies  is  Chief  of  the  Epidemiology 
Division,  Department  of  National  Health 
and  Welfare.  Dr.  Acres  is  Medical  Con- 
sultant with  the  same  Division. 


24     THE  CANADIAN   NURSE 


forces,  often  with  associated  problems 
of  housing,  loneliness,  language  adjust- 
ment, and  race,  which  may  lead  to  more 
frequent  casual  or  promiscuous  sexual 
encounters. 

•A  possible  increase  in  promiscuity 
associated  with  changing  standards  of 
behavior  and  the  use  of  contraceptive 
pills  and  intra-uterine  devices. 

•  Ignorance.  It  is  frequently  dem- 
onstrated that  people  in  general  —  and 
especially  young  people  —  lack  even 
the  most  elementary  facts  about  the 
nature  of  the  venereal  diseases. 

•  More  patients  are  treated  by  private 
practitioners  than  by  venereal  disease 
clinics.  However,  private  practitioners 
frequently  neglect  to  follow  up  contacts 
or  to  request  the  help  of  the  local  health 
department  in  doing  so.  Treating  the 
case  and  neglecting  the  contacts  does 
nothing  to  break  the  chain  of  infection. 

Figure  2  clearly  demonstrates  the 
failure  to  control  gonorrhea.  In  addition 
to  the  reasons  for  rising  rates  listed 
above,    there    are    additional    factors 

*lt  should  be  noted  that  Figure  I  is  plotted 
on  semi-log  paper  to  encompass  the  range 
of  rates  included. 

JULY  1971 


i«-"l 


RATES 


FIGURE  1 


SYPHILIS  IN  CANADA 

Rates  per  100,000  population 

1945-1970 


V 


FIGURE  2 


GONORRHEA  CASES.  CANADA 

Rates  per  100,000  Population 

1940-1970 


1*40 


M4S 


MSO 


IfSS 


itte 


i«ts 


1*70 


that  complicate  gonorrhea  control. 
Most  infected  women  —  up  to  80  per- 
cent in  somes  studies  —  are  asymp- 
tomatic and  hence  unwittingly  continue 
to  disseminate  infection.  Furthermore, 
because  of  the  short  incubation  period 
(about  three  days),  it  is  impossible  for 
even  the  most  effective  contact  follow- 
up  team  to  locate  and  treat  all  infected 
persons  before  they  can  pass  on  the 
disease. 

Youth  and  venereal  disease 

Youth  is  frequently  blamed  for  many 
of  the  current  social  problems.  How- 
ever, firm  conclusions  regarding  trends 
are  impossible  to  draw,  as  venereal 
disease  is  so  vastly  under-reported  by 
physicians.  The  statistics  for  syphilis 
may  represent  one-third  to  one-half  of 
all  cases  actually  occurring,  but  it  is 
doubtful  if  more  than  one-tenth  of  all 
gonorrhea  cases  are  reported.  The 
proportion  of  cases  recorded  for  the 
15-  to  19-year  age  group  has  remained 
relatively  constant  over  the  past  several 
years.  Approximately  4  percent  of  all 
syphilis  cases  and  15  percent  pf  all 
gonorrhea  cases  reported  fall  within 
this  group. 

Tabic  I .  on  the  following  page,  shows 
that  the  incidence  of  syphilis  has  been 
stable  except  for  a  slight  rise  last  year. 
In  contrast,  gonorrhea  rates  have  risen 
markedly  during  the  past  two  years. 

Treatment  of  syphilis 

Penicillin  remains  the  drug  of  choice 
for  treatment  of  syphilis.  Therapy 
maintained  over  10  days  is  effective 
in  curing  syphilis  in  any  stage.  Various 
penicillin  preparations  may  be  used, 
but  care  should  be  taken  to  space  injec- 
tions properly  to  maintain  therapeutic 
blood  levels.  For  example,  the  treat- 
ment for  adults  may  be: 
•Aqueous  Procaine  Penicillin  G  — 
600,000  units  intramuscularly  daily. 
•  Procaine  Penicillin  G  with  2  per- 
cent Aluminum  Monostearatc  (P. A.M.) 
THE  CANADIAN   NURSE     25 


TABLE  1 

Cases  and 

Age-Specific  Venereal  Disease  Rates  per  100,000  population 

Age  Group  15-19  years,  Canada,  1966-1970 

Syphilis 

Gonorrhea 

Cases                           Rates 

Cases                       Rates 

1966 

80                               4.4 

3,249                       176.8 

1967 

102                             5.3 

3,267                        171.2 

1968 

89                             4.5 

3,386                       172.1 

1 969 

103                             4.4 

3,968                       196.9 

1970 

135                             6.5 

5.220                      252.4 

—  600.000  to  1,200,000  units  intra- 
muscularly every  three  days. 
•  Benzathine  Penicillin  G  —  2,400,000 
units  intramuscularly  given  at  a  single 
treatment  (1,200,000  units  in  each 
buttock)  will  maintain  adequate  levels 
for  at  least  10  days. 

Oral  medication  is  not  recommended 
because  of  variable  absorption  and  un- 
certainty of  patient  cooperation  in 
taking  the  pills.  However,  when  sensi- 
tivity precludes  penicillin,  tetracycline 
or  erythromycin  (total  dose  30-40  Gm.) 
should  be  given  orally  over  10  to  15 
days. 

A  follow-up  schedule  is  essential  to 
manage  syphilis  cases. 

Primary  and  Secondary  Syphilis: 
Clinical  inspection  and  quantitative 
serological  tests  for  syphilis  (STS)  at 
1,  3,  6.  and  12  months.  Successful  ther- 
apy will  be  evident  by  rapid  healing 
of  lesions  and  a  fall  of  serologic  reagin 
titers  to  non-reactive. 

Latent  Syphilis:  Quantitative  STS 
26     THE  CANADIAN   NURSE 


as  above,  then  every  six  months  for 
the  second  year.  Titer  may  decline 
slowly  or  remain  static  for  life.  At  least 
one  non-reactive  CSF  examination  — 
either  at  time  of  diagnosis  or  before 
discharge  —  is  essential. 

Neiirosypliilis:  Quantitative  serology 
every  three  months  and  CSF  examina- 
tion at  least  every  six  months  until 
cell  count  and  total  protein  return  to 
normal,  usually  within  six  months  to  a 
year.  Spinal  tluid  may  give  reactive 
serological  tests  for  syphilis  for  years, 
similar  to  blood  serum. 

Cardiovascular  and  Late  Benign 
Syphilis:  STS  every  three  months  for 
the  first  year,  then  every  six  months 
for  the  second  year.  In  cardiovascular 
syphilis,  clinical  improvement  may  not 
be  evident  if  vessels  and  valves  have 
been  scarred  or  damaged.  Late  benign 
lesions  heal  rapidly. 

Early  Congenital  Syphilis:  Follow-up 
is  the  same  as  for  primary  syphilis. 
Lesions  heal  quickly  and  serologic  titer 


declines  to  non-reactive.  (Infants  born 
to  seropositive  mothers  may  have 
reactive  tests  simply  due  to  transpla- 
cental transfer  of  antibodies.  If  there 
is  no  infection,  reagin  titers  decline 
below  detectable  levels  by  three  to  six 
months  of  age.) 

Late  Congenital  Syphilis:  If  CSF  is 
reactive,  follow  up  is  the  same  as  for 
neurosyphilis.  If  CSF  is  nonreactive, 
quantitative  serology  is  done  every 
six  months  for  two  years. 

Treatment  of  gonorrhea 

The  appearance  in  recent  years  of 
strains  of  gonococci  that  are  resistant 
to  penicillin  makes  it  advisable  to  use 
maximum,  rather  than  minimum,  dos- 
age. Most  cases  of  gonorrhea  are  still 
curable  with  penicillin,  and  uncompli- 
cated gonorrhea  in  men  is  usually  suc- 
cessfully treated  with  2,400,000  units 
of  Aqueous  Procaine  Penicillin  G  in 
one  treatment.  This  dosage  should  be 
doubled  for  uncomplicated  gonorrhea 
in  women. 

In  patients  sensitive  to  penicillin, 
treatment  may  be  carried  out  using 
tetracycline  or  erythromycin  in  a  single 
dose  of  1.5  Gm.,  or  0.5  Gm.  given 
orally  every  four  to  six  hours  until  2 
to  3  Gm.  have  been  given. 

The  combination  of  probenecid  and 
oral  penicillin  is  being  used  success- 
fully in  a  number  of  centers.  Others 
have  adopted  the  use  of  ampicillin  0.5 
Gm.  Stat,  repeated  in  eight  hours. 

In  males,  cure  is  evident  by  the 
disappearance  of  symptoms,  a  clear 
two  glass  urine  test  one  week  after 
treatment,  and  negative  cultures  of 
material  taken  from  prostatic  mas- 
sage of  urine  sediment. 

In  women,  repeated  cultures  or 
fluorescent  antibody  studies  should  be 
carried  out  on  specimens  obtained  from 
the  cervix,  Skene's  and  Bartholin's 
glands.  The  most  reliable  test  of  cure 

JULY  1971 


in  this  case  is  the  absence  of  reinfection 
of  the  male  sexual  partner. 

Control  programs 

Venereal  disease  control,  as  with 
most  health  matters,  is  primarily  the 
responsibility  of  provincial  health 
departments.  Traditionally,  their  pro- 
grams have  included:  the  operation  of 
cases  registries;  the  operation  of  free 
treatment  clinics:  the  provision  of  free 
laboratory  services:  the  provision  of 
free  drugs  to  physicians  and  reimburse- 
ment for  care  of  indigent  patients; 
location  and  treatment  of  contacts;  and 
production  and  distribution  of  educa- 
tional material. 

The  federal  role  has  been  largely 
one  of  financial  support  to  the  pro- 
vincial programs.  The  Department 
of  National  Health  and  Welfare  has 
also  supplemented  provincial  efforts 
through  the  production  of  educational 
material  for  both  professional  and  lay 
use.  In  addition,  the  Department's 
Communicable  Disease  Center  pro- 
vides standard  testing  reagents  to  the 
provincial  laboratories,  evaluates  their 
testing  pr(x;edures,  conducts  training 
for  laboratory  workers,  investigates 
new  methods  and  equipment,  and 
carries  out  research. 

With  the  availability  of  modern 
drugs,  venereal  diseases  are  rarely  life- 
threatening.  However,  they  do  consti- 
tute an  important  measure  of  illness  — 
preventable  illness  — that  requires  an 
outlay  of  several  million  dollars  in 
public  funds  each  year.  This  amount  is 
necessary  to  maintain  VD  control 
programs  and  to  pay  for  patients  requir- 
ing hospital  care. 

For  these  reasons,  DN  H  W's  Advisory 
Committee  on  Epidemiology  devoted 
a  day  to  the  venereal  disease  problem 
on  October  30,  1 970.  This  session  was 
attended  by  the  provincial  venereal 
disease  control  directors  and  by  rep- 

JULY  1971 


resentatives  from  the  Canadian  Nurses' 
Association,  the  Canadian  Medical 
Association,  the  College  of  Family 
Physicians  of  Canada,  and  the  Cana- 
dian Armed  Forces.  The  committee 
directed  its  attention  to  the  role  of 
specific  groups  involved  in  control  — 
doctors,  nurses,  health  departments  — 
and  tried  to  determine  where  improve- 
ments might  be  made. 

Role  of  Physicians 

Doctors  treat  patients  with  VD,  but 
frequently  neglect  to  arrange  for  an 
examination  of  sexual  contacts  or  to 
report  cases  to  the  appropriate  health 
departments,  which  could  then  follow 
up  contacts.  The  role  of  the  physician 
is  also  weakened  because  there  are  many 
young  physicians  now  in  practice  who 
have  received  little  instruction  on  vene- 
real disease  during  their  training  and 
who  may  not  have  seen  a  case. 

The  lack  of  a  sufficient  level  of 
awareness  of  VD  has  been  particulary 
evident  in  misdiagnosis  of  ano-rectal 
pathology  in  male  homosexuals.  With 
the  help  of  such  groups  as  the  College 
of  Family  Physicans,  public  health 
departments  are  striving  to  improve 
these  aspects  of  control. 
Role  of  Nurses 

The  role  of  the  nurse  is  discussed 
elsewhere  in  this  journal  and  will  not  be 
dealt  with  here. 
Role  of  the  Laboratory 

Many  physicians  are  not  familiar 
with  the  free  diagnostic  tests  provided 
by  provincial  department  ot  health 
laboratories.  The  constant  improve- 
ment and  refinement  of  tests  warrants 
an  ongoing  effort  on  the  part  of  health 
departments  to  inform  physicians  of 
their  interpretation. 
Role  of  Medical  Schools 

There  is  some  lack  of  coordination 
in  teaching  programs  in  medical 
schools.     The     Advisory     Committee 


recommended  that  evaluation  be  made 
of  VD  instruction  to  ensure  that  stu- 
dents have  sufficient  knowledge  when 
they  enter  practice  to  deal  with  patients. 

Conclusion 

Although  syphilis  rates  have  been 
relatively  constant  in  recent  years,  the 
disease  still  presents  a  national  prob- 
lem. The  incidence  of  gonorrhea  is 
increasing  sharply.  Because  these 
diseases  are  tied  to  complex  social  and 
behavioral  patterns,  there  is  no  one 
aspect  on  which  we  can  concentrate 
resources  to  achieve  control.  It  is  up  to 
the  medical  and  nursing  professions 
and  society  in  general  to  strengthen 
preventive  measures.  ^ 


THE  CANADIAN   NURSE     27 


The  nurse 
and  VD  control 


Every  nurse  should  know  the  facts  about  syphilis  and  gonorrhea  and  be  able  to 
communicate  her  knowledge  in  a  straightforward,  non-moralizing  manner. 


Harriet  E.  Ferrari 

Are  you  aware  that  untreated  syphilis 
still  causes  insanity,  heart  disease, 
and  neurological  degeneration?  And 
that  gonorrhea  is  the  number  one  in- 
fectious disease  in  some  countries? 
Perhaps  you  realize  that  in  Canada  the 
incidence  of  venereal  disease  increases 
every  year,  and  that  4.3  percent  of 
syphilis  cases  and  1 5  percent  of  gonor- 
rhea cases  are  in  the  !  5-  to  1 9-year  age 
group?! 

Could  you  answer  the  exacting  ques- 
tions your  teenagers  or  their  friends 
may  ask  about  VD?  Could  you  help  a 
patient  on  your  ward  who  suspects 
infection  and  seeks  information,  or 
a  housewife  you  meet  on  a  home  visit, 
who  is  worried  about  her  teenager,  her 
husband,  herself,  or  her  unborn  child? 
Perhaps  you  are  a  school  nurse  and 
encounter  situations  when  information 
and  advice  are  required  by  a  student. 
Or  maybe  you  work  in  a  family  planning 
clinic,  where  you,  the  nurse  counselor, 
discover  that  information  is  needed  by 
an  individual. 

Would  you  be  able  to  tell  these  people 
about  the  clinical  signs  of  VD^  and  why 


28     THE  CANADIAN   NURSE 


Mrs.  Ferrari,  a  graduate  of  Moose  Jaw 
General  Hospital,  is  presently  employed  as 
Officer  in  Charge  of  the  Social  Hygiene 
Unit.  Northern  Region.  Medical  Services. 
Department  of  National  Health  and 
Welfare.  Edmonton,  Alberta. 


treatment  and  contact  tracing  are  so 
necessary?^  Do  you  know  what  facilities 
are  available  in  your  community  for 
the  treatment  and  control  of  venereal 
disease? 

Know  the  facts 

Every  nurse  should  know  the  funda- 
mental facts  about  syphilis  and  gon- 
orrhea and  be  able  to  communicate 
her  knowledge  in  a  straightforward, 
non-moralizing  manner.  The  nurse  who 
responds  effectively  will  gain  the  confi- 
dence of  the  person  who  asked  the 
question,  and  may  render  a  valuable 
service.  After  the  person's  initial  en- 
quiry has  been  answered,  the  nurse  may 
refer  him  to  a  physician  or  a  clinic  for 
examination,  treatment,  or  further 
counseling. 

Some  nursing  positions  carry  a  spe- 
cial responsibility  for  public  education 
on  health  subjects.  Nurses  may  organize 
group  presentations  in  industrial  health 
settings,  or  be  brought  in  as  consultants, 
resource  persons,  or  speakers  to  teach 
VD  in  school  classrooms.  To  function 
effectively  in  these  areas,  the  nurse  must 
understand  the  fundamentals  of  learn- 
ing, the  various  teaching  techniques, 
the  use  of  audiovisual  aids,  and  have 
sound  knowledge  of  the  subject. 

Many  nurses  are  directly  involved 
in  VD  treatment  and  epidemiological 
services.    In   many  outpatient  depart- 

JULY  1971 


merits  in  hospitals,  a  nurse  may  ad- 
minister treatment,  conduct  the  con- 
tact interview,  and  counsel  the  patient 
after  the  doctor  has  diagnosed  the 
infection.  Public  health  nurses  often 
have  the  responsibility  of  tracing  the 
contacts  and  seeing  that  they  are 
brought  under  medical  care. 

In  isolated  areas,  many  nurses  under- 
take the  physical  examination  and 
collection  of  specimens,  make  the  diag- 
nosis, give  treatment  and  perform  the 
epidemiological  interview  and  tracing 
requirements. 

VD  control  programs 

Each  Canadian  province  has  a  div- 
ision of  venereal  disease  control,  which 
is  a  branch  of  the  department  of  health. 
Except  in  British  Columbia  and  Ontar- 
io, where  the  reports  of  VD  are  sent 
directly  to  the  local  medical  officer  of 
health,  notification  of  the  disease  must 
be  forwarded  by  the  physician  to  the 
provincial  divisions.  Most  provincial 
VD  control  divisions  assist  medical 
practitioners  by  providing  the  services 
of  an  experienced  worker  (usually  a 
nurse)  to  interview  the  patient,  obtain 
all  relevant  contacts,  and  arrange  for 
their  examination.'' 

The  divisions  of  VD  control  also 
run  public  clinics  in  most  cities.  These 
clinics  are  under  medical  direction,  but 
nurses  may  conduct  their  routine  func- 
tioning. 

In  these  specialized  programs  some 
nurses  have  had  special  instruction 
about  the  clinical  aspects  of  the  in- 
fections, the  epidemiological  aspects 
of  VD  control,  and  interviewing  and 
counseling  techniques.  Others  learn  on 
the  job.  These  nurses  function  in  an 
anonymous  role  in  their  communities 
to  preserve  the  confidential  nature  of 
their  work. 

Information  kept  confidential 

Nurses  must  have  full  knowledge  of, 
and  adhere  to,  the  "confidentiality 
code"  inherent  in  venereal  disease 
work.    This    includes    the    restriction 

JULY  1971 


about  divulging  medical  matters  and 
ensures  that  every  possible  measure  is 
taken  to  protect  the  patients  privacy. 

Information  is  given  only  when 
requested  by  a  physician,  clinic,  or 
nurse,  under  whose  care  the  patient 
is  currently  receiving  treatment.  Re- 
cords are  kept  under  lock  and  key.  Cor- 
respondence is  marked  "Medical  Con- 
fidential" on  the  envelope  and  on  the 
stationery  and  is  opened  only  by  the 
addressee.  In  VD  clinics  the  telephone 
lines  do  not  pass  through  a  switchboard, 
and  phones  are  answered  by  repeating 
the  number.  Numbers,  instead  of  names, 
are  used  on  case  files. 

During  contact  tracing,  the  personal 
approach  is  best  to  maintain  confident- 
iality. But  if  the  face-to-face  meeting  is 
not  possible,  contact  by  telephone  is  the 
best  alternative.  Party  lines  are  not  used 
and  calls  are  on  a  person-to-person 
basis  only. 

Communication  by  mail  is  avoided, 
because  someone  else  —  spouse  or 
parent  —  may  open  the  letter.  Also, 
even  a  partial  return  address,  which  is 
necessary  in  case  the  letter  is  undeliver- 
ed, may  arouse  suspicion. 

To  protect  the  patient's  privacy,  the 
contact  is  not  given  the  identity  of  the 
informant. 

Confidentiality  could  be  a  legal  as 
well  as  an  ethical  consideration,  as  any 
breach  of  confidence  would  be  contra- 
ry to  most  provincial  VD  division 
legislative  acts. 

In  addition  to  personal  adherence 
to  the  confidentiality  code,  the  nurse 
in  charge  of  any  unit  or  clinic  dealing 
with  VD  patients  or  contacts  makes" 
certain  that  the  lay  staff,  cl': 
raphers,  and  so  on,  ur 
maintain  the  code. 


Patient  counseling 

Every  person  with  ver 
must  be  interviewed  to  de 
source  and  contacts  of  the  infection, 
interview  takes  place  at  the  time  of 
diagnosis,  that  is.  at  the  b'iginning  of 
treatment.  Often,  a  second  interview  is 


useful,  particularly  in  syphilis  cases. 

The  basic  principles  and  techniques 
of  interviewing  and  counseling  apply 
to  venereal  disease  work.^ 

Privacy  is  imperative  for  the  sake  of 
confidentiality  and  for  the  patient's  com- 
fort and  ease.  Friendliness  and  res- 
pect for  the  patient  as  a  person,  not  as 
a  number  or  as  a  case,  are  essential 
attitudes  if  the  counseling  is  to  be  help- 
ful. 

The  interviewer  must  listen,  real- 
ly listen,  to  what  the  patient  is  saying 
or  trying  to  say.  The  conversation  should 
be  free,  without  stammering  or  embar- 
rassment, and  carried  out  in  terms  that 
the  patient  can  understand. 

Ouestions  should  be  open-ended. 
For  example,  "What  do  you  already 
know  about  gonorrhea  (or  syphilis)?" 
will  lead  to  a  discussion  of  the  clinical 
findings  and  the  transmission  of  disease. 
On  the  other  hand,  "Do  you  realize  that 
gonorrhea  can  be  a  serious  infection?" 
will  probably  produce  only  a  "Yes"  or 
a  "No".  With  some  patients  the  term 
"gonorrhea"  will  have  to  be  substituted 
by  "dose"  or  "clap." 

Patience,  honesty,  courage,  and 
openness  will  produce  dividends  in  ob- 
taining extra  information.  And  the 
confidence  of  the  patient  in  the  counsel- 
or will  be  enhanced. 

The  nurse  does  not  moralize.  Noth- 
ing will  turn  a  patient  off  faster  than 
even  a  hint  of  derision. 

A  suggested  format  for  the  epidem- 
iology interview  is  as  follows: 

General  Information:  The  interview- 
er obtains  the  person's  name,  aliases  if 
arty,  address,  date  of  birth,  occupation, 
and  marital  status.  If  kept  casual,  this 
eriod  puts  the  patient  at  ease. 
Medical  Information:  The  interview- 
makes  sure  that  the  patient  under-  i 
inds  the  diagnosis,  the  way  the  infec- 
ion  is  transmitted,  what  treatment  and 
follow-up  measures  are  necessary,  and 
the  importance  of  contact  tracing. 
Questions  are  encouraged. 

Sexual  Contact  Information:  The  pa- 
tient is  reassured  that  the  information 
THE  CANADIAN   NURSE     29 


he  gives  will  be  kept  in  confidence. 
Information  about  contacts  should  in- 
clude names;  nicknames;  aliases  if 
known;  addresses;  identification  data, 
such  as  age,  race,  appearance,  distin- 
guishing marks  or  scars;  marital  status; 
and  occupation. 

Interview  Summary:  The  main  points 
of  the  patient's  infection,  the  treatment 
necessary,  and  follow-up  essentials 
are  reviewed.  Also,  there  may  be  more 
discussion  on  how  to  avoid  reinfection. 
For  males,  the  use  of  condoms  is  often 
adv(x;ated.  Female  patients  who  need 
information  on  birth  control  may  be 
referred  to  a  family  planning  clinic 
or  to  a  physician. 

Motivating  the  patient 

Some  patients  may  require  extra 
encouragement  to  make  them  reveal 
source  and  contact  information.  The 
"help  yourself^'  approach  can  be  useful: 
"break  the  chain  of  infection  so  it  won't 
come  back  to  you." 

Using  the  reason  the  patient  came 
under  care  may  also  work.  For  exam- 
ple, if  the  person  was  named  as  a  con- 
tact, the  interviewer  might  say,  "You're 
lucky  we  could  get  in  touch  with  you, 
now  do  someone  else  a  good  turn." 

An  explanation  of  the  possible  com- 
plications of  untreated  infection  may 
help;  we  try  to  make  the  patient  feel 
responsible  for  getting  treatment  for  the 
contacts. 

The  interviewer  refers  to  the  con- 
tact in  the  same  way  as  the  patient  — 
"my  man,"  "boyfriend,"  "husband," 
and  so  on.  She  does  not  say  "your  hus- 
band" unless  the  patient  said  this,  as 
the  contact  may  not  be  her  husband. 
Similarly  the  interviewer  does  not  say 
"your  friend,"  if  the  patient  has  not 
referred  to  the  contact  as  such;  he  may 
not  really  like  her  or  may  want  to  avoid 
her  in  the  future. 

Marital  contacts 

A  married  person  often  avoids  men- 
tioning the  spouse,  even  if  other  con- 
tacts are  named  freely.  Therefore, 
specific  questions  must  be  asked  to 
determine  whether  the  marriage  partner 
has  been  in  contact  with  the  infection. 

The  handling  of  contacts  in  a  mar- 
ital exposure  (legal  or  common  law) 
requires  the  utmost  in  tact  and  under- 
30     THE  CANADIAN   NURSE 


standing.  Often  the  best  procedure  is 
to  allow  the  patient  to  explain  the  sit- 
uation to  the  spouse  and  to  be  res- 
ponsible for  bringing  her/him  for  ex- 
amination and  treatment.  If  the  patient 
fails  to  do  this  or  does  not  wish  to  do 
so,  the  health  worker  must  make  the 
approach. 

There  are  three  avenues  of  approach: 

1 .  Consider  the  patient  and  the  spouse 
as  separate  entities.  Simply  say,  "You 
have  been  named  as  a  contact  to  (infec- 
tion)." If  questions  or  accusations  about 
the  spouse  result,  the  health  worker  can 
honestly  and  ethically  reply,  "I'm  sorry, 
I  cannot  discuss  any  person's  findings 
with  another  person.  That  is  our  poli- 
cy." 

2.  If  the  patient  has  told  the  spouse 
about  the  infection,  it  can  be  discussed 
openly  if  the  contact  wishes.  The  con- 
tact who  has  been  infected  by  his  or  her 
marital  partner  may  be  shirked,  griev- 
ed, or  hostile;  the  infection  may  be  con- 
sidered the  last  straw  in  an  unhappy 
situation.  It  may  be  the  first  time  the 
contact  has  talked  to  anyone  about  the 
difficulties  at  home. 

The  interviewer  takes  time  to  listen, 
to  be  understanding,  and  to  care.  She 
casts  no  blame,  makes  no  judgments, 
and  is  careful  to  avoid  reinforcing  re- 
sentments, self-pity,  or  fear.  Often  an 
understanding,  objective,  and  support- 
ive role  by  the  nurse  can  lead  to  much 
needed  marriage  counseling. 

3.  Occasionally  the  spouse  can  be 
treated  without  arousing  suspicion. 
This  is  particularly  true  in  a  first  infec- 
tion and  when  only  gonorrhea  is  involv- 
ed. Inference  that  treatment  is  required 
because  of  the  partner's  urinary  infec- 
tion, trichomonas  or  other  non-specific 
urethritis,  may  save  the  couple  consi- 
derable anguish  by  lessening  the  effects 
of  a  once-in-a-marriage  indiscretion. 
The  pros  and  cons,  including  the  poten- 
tial consequences  of  each  alternative, 
must  be  weighed  diligently  when  this 
approach  is  considered. 

Lack  of  preparation 

At  the  annual  meeting  of  the  ad- 
visory committee  on  epidemiology  held 
in  Ottawa  last  October,  it  was  pointed 
out  that  many  nurses  and  other  health 
workers  lack  knowledge  of  VD,  are  not 
given  the  opportunity  to  acquire  the 


skills  of  interviewing  and  counseling 
and,  in  fact,  have  a  negative  attitude, 
including  fear,  about  involvement  with 
VD  services. 

The  committee  strongly  recommend- 
ed that  appropriate  courses  of  instruc- 
tion be  established  in  Canada  for  nur- 
ses, physicians,  and  other  workers  in 
VD  control,  and  that  such  courses  in- 
clude training  suitable  for  full-time 
or  part-time  epidemiological  field  staff. 

Better  preparation  of  personnel  is 
only  one  need  in  the  control  of  VD. 
New  and  improved  techniques  for 
fast,  accurate  diagnosis  are  needed  and 
are  being  developed.  Increased  and 
improved  facilities  are  required.  Pro- 
grams to  make  the  public  aware  of  these 
diseases  must  be  enriched  with  all  the 
modern  devices  available. 

The  rising  incidence  of  VD  chal- 
lenges all  health  workers.  Nurses  need 
to  be  equipped  with  the  knowledge, 
the  skill,  and  the  desire  to  play  a  part 
in  the  control  of  these  infections. 

References 

1.  Canada.  Dcpt.  of  National  Health  and 
Welfare,  Epidemiology  Division.  Vc- 
nerc'iil  Disease  in  Cuiuulci  Annual 
Report  1969.  Ottawa.  Queens  Printer. 
1970.  pp.  10-16. 

-■  —  •  —  •  SYpl)ili\  and  Gonarrlica. 
Ottawa,  Queen's  Printer.  1968,  pp.l8- 
29,  37-40. 

3.  Ibid.,  pp.  7-9.  p. 36 

4.  Ibid.,  p.  43. 

5.  Glenn  Educational  Films  Inc..  Syntex 
Family  Planning  Educational  Service. 
You  May  Be  The  Only  One.  Monsey, 
New  York,  1 969. 

Bibliography 

Onlario.  Department  of  Health.  Venereal 
Disease  Control  Section.  Venereal  Dis- 
eases and  Tlieir  Control,  A  Manual  for 
Nurses.  Toronto,  1 970. 

U.S.  Public  Health  Service.  Notes  on  Mo- 
dern M(UHif>enu'nt  of  VD.  Atlanta. 
Georgia,  Communicable  Disease  Cen- 
ter. 1968.  . 


JULY  1971 


To  be,  or  not  to  be 

—  disposable! 


Whether  or  not  they  create  more  problems  than  they  solve,  "disposables"  are 
a  fact  of  life,  especially  in  hospitals. 


Isabel  T.  Colvin,  B.N.,  M.Sc.  (A) 

Hospitals  have  always  been  concerned 
with  the  problem  of  supplying  equip- 
ment to  their  staff  so  they  can  provide 
optimum  patient  care  at  minimum  cost. 
One  of  the  more  recent  developments 
in  this  field  has  been  the  advent  of  the 
"disposable"  —  an  article  to  be  discard- 
ed after  one  use.  Hospitals  vary  greatly 
in  their  acceptance  of  disposables.  Some 
institutions,  notably  in  the  United 
States,  have  converted  almost  com- 
pletely to  one-use  articles  —  from 
dishes  to  operating  room  linen  —  while 
others  use  them  only  sparingly,  perhaps 
purchasing  but  one  or  two  items. 

Some  factors  retarding  the  wide- 
spread use  of  these  products  in  hos- 
pitals have  been  cost  considerations, 
traditional  approaches  to  equipment 
by  both  medical  and  nursing  staffs,  and 
supply  and  disposal  problems.  In  con- 
sidering the  introduction  of  disposables, 
all  these  factors  must  be  evaluated  and 
given  due  weight. 

When  disposable  products  were  first 
available,  hospitals  were  somewhat 
concerned  about  their  quality.  Experi- 
ence has  proven  that  these  fears  were 
not  justified.  Moreover,  many  hospitals 
lack  the  resources  to  ensure  that  re- 
usable products  attain  the  degree  of 

Miss  Colvin.  a  graduate  of  Regina  General 
Hospital  and  McGill  University,  Mont- 
real, is  Administrator  (patient  cure).  Regi- 
na  General  Hospital.  Regina.  Sasltatchewan. 


asepsis  found  in  disposable  items  pro- 
duced by  large  commercial  firms. 

In  selecting  disposable  items  for 
the  Regina  General  Hospital,  we  have 
applied  two  guiding  principles:  the 
impact  on  patient  care,  and  the  impact 
on  the  budget.  In  our  experience,  dis- 
posable items  cannot  be  justified  eco- 
nomically unless  the  services  of  a  spe- 
cific labor  group  can  be  dispensed  with. 
Again,  in  our  experience,  one-use 
items  contribute  materially  to  patient 
safety,  comfort,  and  peace  of  mind.  The 
types  of  disposable  equipment  we  chose 
were  selected  on  the  basis  of  these  two 
principles. 

Disposables  introduced 

The  first  items  brought  into  service 
in  1965-66  were  disposable  needles, 
syringes,  and  gloves.  These  had  previ- 
ously been  processed  through  our  cen- 
tral supply  room,  and  the  elimination 
of  labor  costs  from  this  area  made  the 
substitution  economically  feasible.  The 
contribution  of  one-use  needles  and 
syringes  to  patient  safety  is  today  dis- 
puted by  no  one,  and  this  constitutes  a 
major  weapon  in  the  battle  to  maintain 
safe  technique  for  every  patient.  The 
use  of  disposable  gloves  allows  a  stand- 
ardization more  difficult  to  achieve 
with  the  reusable  type,  a  desirable  by- 
product of  this  particular  change. 

Our  next  major  decision,  in    1968. 

was  made  in  conjunction  with  the  build- 

THE  CANADIAN   NURSE     31 


ing  of  a  new  central  supply  facility. 
This  is  a  separate  building,  prefabricat- 
ed, and  placed  on  a  full  basement.  It 
was  designed  by  our  central  supply 
room  supervisor  and  our  director  of 
building  management  to  make  the 
optimum  use  of  space  in  relation  to 
work  flow,  storage,  and  supply  to  units. 
We  decided  at  this  time  to  adopt  a 
system  of  delivering  supplies  to  units 
by  means  of  a  cart  to  be  exchanged 
daily.  Space  and  compactness  thus 
became  critical  factors.  Also,  due  to 
increasing  patient  load,  the  continued 
use  of  reusable  trays  would  have  ne- 
cessitated the  purchase  of  another  steam 
autoclave.  With  these  factors  in  mind, 
we  embarked  on  a  study  of  the  large 
scale  use  of  disposables. 

Study  done 

As  a  first  step  in  the  study,  we  invited 
representatives  of  various  companies 
to  display  their  products  and  to  tender 
prices.  A  cost  survey  was  instituted 
based  on  the  daily  average  use  of  trays, 
their  cleaning  and  sterilization,  their 
storage  and  supply  to  units.  We  also 
made  a  field  trip  to  Montreal  to  survey 
the  use  of  disposables  in  four  hospitals 
there.  When  all  the  data  had  been  gath- 
^  ered,  we  invited  several  suppliers  to 
demonstrate  their  complete  systems 
to  a  committee  that  had  representation 
from  the  administrative,  nursing,  and 
medical  staffs. 

A  decision  was  made  to  use  the  fol- 
kwing  disposable  items:  catheterization 
trays;  enema  buckets:  douche  trays; 
bladder  irrigation  trays;  skin  prepara- 
tion trays;  Foley  catheters;  bladder 
drainage  systems;  suction  tubing  and 
cannulas;  stomach  tubes  and  Cantor 
tubes;  and  feeding  tubes.  We  have  sub- 
sequently added  further  items  to  our 
disposables  list,  such  as  an  intermittent 
bladder  drainage  system,  hourly  output 
meters,  and  a  closed  irrigating  system 
for  the  cystoscopy  theatres.  We  also 
use  large  supplies  of  prepackaged  dres- 
sings. 

We  did  not  switch  to  disposable 
dressing  trays,  suture  removal  sets, 
spinal  puncture  or  myelogram  trays. 
Our  impression  was  that  these  items 
were  not  economically  feasible.  As  it 
is  not  easy  to  calculate  exact  labor 
costs,  it  is  therefore  difficult  to  justify 
replacement.  In  addition,  there  is  a 
much  larger  capital  investment  in  this 
32     THE  CANADIAN   NURSE 


type  of  equipment  than  in  an  enema 
tray  for  example.  With  the  use  of  the 
items  selected,  we  calculated  that  four 
service  aides  could  be  dispensed  with 
in  the  central  supply  room. 

In  January  1969,  we  instituted  a 
disposable  nurser  system  on  the  pedia- 
tric service,  including  the  nursery.  This 
also  reduced  our  labor  force  by  four 
people,  and  released  the  space  taken 
up  by  formula  preparation  for  addi- 
tional and  much  needed  locker  space 
for  employees. 

Our  policy  to  absorb  the  staff  who 
became  redundant  because  of  the  dis- 
posable program  into  normal  vacancies 
in  their  own  or  other  departments  was 
carried  out  successfully  with  the  coop- 
eration of  our  local  union. 

in  the  initial  stages  of  the  program 
we  encountered  some  resistance  to  the 
new  products,  mainly  from  members 
of  the  medical  staff  who  felt  the  change 
was  not  warranted.  This  opposition 
has  almost  completely  disappeared. 
On  the  whole,  nurses  were  very  recep- 
tive, and  required  only  initial  orienta- 
tion to  the  trays  to  become  "sold."" 

Disposal  of  equipment 

Disposal  must  be  planned  for  in 
implementing  the  change  to  dispos- 
ables. It  is  particularly  important  to 
educate  staff  in  the  proper  disposal  of 
needles  and  syringes,  both  from  the 
point  of  view  of  protecting  the  waste 
collection  staff,  and  of  ensuring  that 
the  items  cannot  become  available  in 
the  community  for  misuse. 

We  do  periodic  reviews  of  our  col- 
lection procedure,  and  have  developed 
a  close  liaison  with  the  hospital  safety 
committee  on  this  matter.  The  collec- 
tion men  are  trained  to  report  any 
violation  of  the  correct  procedure.  On 
the  introduction  of  catheterization, 
irrigation,  and  other  disposable  trays, 
it  became  necessary  to  increase  the 
collection  of  waste  by  one  round  per 
day.  This  was  accomplished,  without 
increasing  staff,  by  adjusting  schedules 
to  peak  load  times.  We  did  experience 
an  increase  in  cost  for  waste  removal 
from  the  property,  however. 

Costs  minimized 

Some  hospitals  have  hesitated  to 
introduce  disposables  for  fear  their 
use  will  induce  a  nonchalant  attitude 
by  the  nursing  staff  toward  costs.  Our 


orientation  program  stresses  unit  costs 
and  the  need  for  economy  in  the  use  of 
disposables.  Our  CSR  supervisor  main- 
tains a  close  check  on  deliveries  and 
monthly  costs,  and  thus  on  usage.  Var- 
iations must  be  accounted  for  by  in- 
creased patient  load  or  some  other 
reasonable  factor.  Head  nurses  on  our 
units  are  provided  with  their  monthly 
supply  costs. 

We  have  found  that  continuous  in- 
vestigation of  the  various  suppliers  is 
helpful.  Last  July,  after  a  committee  of 
the  nursing  staff  had  made  a  study  of 
the  offerings  from  four  companies, 
we  changed  our  supplier  for  the  bulk 
of  the  products.  We  were  thus  able  to 
lower  our  unit  cost  considerably,  and 
will  certainly  continue  this  periodic 
review. 

One  of  our  contract  requirements 
was  for  a  company  to  agree  to  ware- 
house in  the  city  and  to  make  regular 
deliveries  to  our  CSR  building.  This 
materially  reduces  the  storage  space 
required  in  the  hospital  itself  and  rend- 
ers most  unlikely  any  serious  disloca- 
tion of  supply. 

The  disposable  trays  are  extremely 
convenient  for  unit  supply.  They  are 
compact,  easily  identified,  light  to 
transport,  and  not  susceptible  to  such 
accidental  contamination  as  spillage 
of  liquid.  In  our  changeover  to  unit 
supply  carts  with  a  daily  standard,  the 
new  products  proved  to  be  superior  to 
the  bulky  reusable  trays. 

In  our  experience  the  introduction 
of  disposable  products  should  be  ap- 
proached as  a  system,  with  all  relevant 
factors  considered  beforehand  to  avoid 
potential  problems  rather  than  having 
to  deal  with  them  later.  A  haphazard  or 
piecemeal  approach  to  the  introduction 
of  these  products  could  lead  to  confu- 
sion and  to  loss  of  the  real  potential 
for  the  improved  patient  care  inherent 
in  the  "disposable." 

Bibliography 

Anderson.    M.H.   A   non-expendable  dis- 
posable. Hasp.  Manage.  95;2;58.  Feb. 
1963. 

Jones.  Earl  E.  Disposable  syringes  save 
time  in  central  supply.  Hosp.  Muiuii>i'. 
93;l;56,  Jan,  1962. 

Phelps,  J. A.,  Hiller.  A.J..  and  McHargue, 
A.M.  Disposable  nurser  system  for 
hospital  feeding.  Hosp.  Mdiuiiic.  93: 
1:30,  Jan.  1962.  ■§ 

JULY  1971 


More 

hysterectomies  — 
fact,  fantasy,  or  fad? 

Doctors  have  been  criticized  for  performing  hysterectomies  where  less  radical 
treatment  would  suffice.*  The  author  discusses  the  subject. 


|.R.  Higgin,  M.D. 

Hysterectomy  has  become  a  more  com- 
mon operative  procedure  in  the  past 
decade  due  to  many  factors  that  con- 
tribute to  the  relative  safety  of  this 
procedure:  more  physicians  are  specially 
trained  in  operative  gynecology,  anes- 
thetic services  have  improved,  anti- 
biotics are  increasingly  safe  and  effec- 
tive. Also,  symptoms  that  our  mothers 
and  grandmothers  would  have  tolerated 
are  no  longer  acceptable  in  our  present 
society. 

Unfortunately,  with  the  use  of  hor- 
mones for  perimenopausal  and  meno- 
pausal women  and  the  "feminine  for- 
ever" concept,  hormone-induced  bleed- 
ing in  the  fifties  and  sixties,  with  the 
attendant  worry  of  endometrial  malig- 
nancy, has  prompted  the  removal  of 
many  a  womb.  This,  so  that  the  hor- 
mones can  be  continued.  Whether  the 
continuous  use  of  hormones  does  in  fact 
provide  a  continuous  physiological  life, 
or  whether  some  of  the  response  is  due 
to  a  psychic  energization  is  open  to 
question.  In  any  event,  one  must  equate 
the  benefit  of  the  hormones  and  the 
risk  of  surgery. 

Indications  for  hysterectomy 

This  article  is  not  intended  to  outline 
in  detail  all  the  indications  or  contra- 
indications for  hysterectomy.  However, 

Dr.  Higgin  is  Director  of  the  Department 
of  Gynecology  and  Obstetrics  at  the  Cal- 
gary General  Hospital.  Calgary.  Alta. 


JULY  1971 


when  performed  via  the  abdominal 
route,  the  operation  is  usually  for  fi- 
broids (benign,  common,  smooth  muscle 
tumors  of  the  uterine  wall);  endome- 
triosis; chronic  pelvic  inflammatory 
disease;  persistent,  heavy,  prolonged 
vaginal  bleeding  that  is  not  readily 
controlled  by  dilatation  and  curettage 
or  by  hormones;  premalignant  or  malig- 
nant tumors  of  the  cervix,  uterine  body, 
or  ovaries. 

When  the  procedure  is  performed  via 
the  vaginal  route,  it  is  usually  done  in 
conjunction  with  the  repair  of  the  sup- 
ports under  the  bladder  and  over  the 
rectum.  The  terms  most  commonly  used 
to  designate  this  problem  are  symp- 
tomatic pelvic  relaxation,  or  "genital 

■For  example.  Norman  Cousins"  editorial 
in  the  August  22.  1970.  issue  of  Sniiirilay 
Review  mentioned  the  1962  Trussell- 
Van  Dyke  study  on  prepaid  insurance 
plans  serving  residents  of  New  York. 
Page  20  of  the  report  deals  with  those  60 
patients  in  the  sample  studies  who  had 
had  hysterectomies;  ".  .  .  one-third  were 
operated  on  unnecessarily  and  .  . .  some 
question  could  be  raised  about  the  ad- 
visability of  the  operation  in  another  10 
percent  of  the  cases.  Ai  the  very  least, 
these  women  should  have  had  a  dilata- 
tion and  curettage,  followed  by  a  period 
of  observation  prior  to  the  hysterectomy. 
In  many  instances,  the  dilatation  and 
curettage  alone  would  have  alleviated 
the  symptoms." 

THE  CANADIAN  NURSE     33 


prolapse."  These  terms  indicate  that 
there  has  been  sufficient  relaxation  of 
the  pelvic  supports  to  allow  the  mouth 
of  the  womb  or  cervix  to  descend  nearly 
to  or  through  the  vaginal  opening,  with 
downward  bulging  of  the  bladder  and 
rectum. 

Use  of  hormones 

Because  hysterectomy  is  major  sur- 
gery, a  woman  subjected  to  this  oper- 
ation cannot  expect  to  regain  her  energy 
and  sense  of  well-being  until  four  to  six 
months  after  the  operation.  The  pre- 
menopausal woman  almost  invariably 
will  require  adjunctive  hormone  therapy 
if  her  ovaries  have  been  removed  at  the 
time  of  hysterectomy.  Estrogen  can  and 
does  prevent  the  "hot  flushing,"  in- 
somnia, emotional  lability,  and  other 
symptoms  brought  on  by  a  surgically- 
induced  menopause.  We  must,  however, 
prescribe  estrogen  on  a  cyclic  basis  be- 
cause of  the  stimulation  of  breast  tissue, 
and  because  of  our  ignorance  of  the 
exact  cause  of  mammary  cancer. 

It  is  enough  to  say  that  development 
of  the  mammary  ducts  and  glandular 
tissue  at  the  time  of  puberty  is  depend- 
ent on  female  hormones,  and  that  some 
sort  of  continuing  relationship  exists 
during  a  woman's  menstrual  life.  A 
small  number  of  women  who  undergo 
hysterectomy,  but  whose  ovaries  are  not 
removed,  will  have  menopausal  symp- 
toms because  of  ovarian  atrophy.  This 
problem  is  related  to  interference  with 
ovarian  blood  supply,  and  replacement 
therapy  is  easily  instituted. 

In  the  last  10  years,  a  good  deal  has 
been  written  in  the  literature,  and  many 
studies  have  been  done  on  estrogen  in 
the  development  of  osteoporosis.  Osteo- 
porosis is  a  disease  of  protein  deficit  in 
bone,  and  estrogen  is  an  anabolic  (or 
34     THE  CANADIAN  NURSE 


building)  hormone  that  relates  to  the 
protein  matrix  in  bone.  If  the  matrix  is 
deficient,  then  there  is  an  insufficient 
framework  for  the  laying  down  of  cal- 
cium, and  vertebral  collapse  becomes 
a  distinct  possibility.  Treatment  with 
estrogen  at  an  early  stage  of  ovarian 
failure  may  well  prevent,  or  at  least 
slow  down,  the  development  of  this 
problem.  Once  advanced  osteoporosis 
has  been  established,  however,  estrogen 
therapy  has  been  disappointing  as  a 
stimulus  to  protein  formation. 

The  psychological  aspects  of  hys- 
terectomy are  many,  but  reassurance 
by  the  physician  and  an  explanation 
as  to  what  to  expect  can  prevent  many 
emotional  upsets.  The  result  can  be 
expected  to  be  directly  proportional  to 
the  severity  of  trouble  and  the  number 
of  symptoms  present  that  initially 
prompted  surgical  interference.  If  the 
uterus  only  is  removed,  then,  aside 
from  absence  of  menstruation  and  ina- 
bility to  bear  children,  the  patient  is  no 
less  female  than  prior  to  surgery.  Her 
sexual  activity  should  in  no  way  be  af- 
fected, unless  it  is  to  increase  because 
of  removal  of  the  threat  of  an  unwanted 
pregnancy,  or  cessation  of  prolonged 
episodes  of  bleeding,  or  because  coitus 
is  no  longer  painful. 

Case  history  I 

Mrs.  R.G.  was  a  46-year-old  patient, 
gravida  IV,  para  IV,  whose  last  normal 
menstrual  period  had  occurred  some 
three  years  prior  to  seeking  further 
medical  care.  Until  that  time,  the  pa- 
tient's periods  had  generally  occurred 
at  28-day  intervals.  The  duration  of  the 
flow  varied  between  four  and  six  days, 
usually  requiring   12  pads  per  period! 

She   than   noted   that   her   periods 

although    fairly    regular   on    a   cyclic 


basis  — lasted  longer,  that  her  flow 
had  increased  to  the  point  where  she 
used  1 8  to  20  pads  during  a  period,  and 
that  she  occasionally  passed  blood 
clots. 

She  had  previously  had  a  dilatation 
and  curettage.  For  8  to  1 0  months  after- 
wards, she  had  experienced  some  relief 
ot  her  symptoms  and  some  decrease  in 
menstrual    flow.   Then    the    increased 
flow,  which  she  endured  for  the  next 
four  to  six  months,  caused  her  to  be 
readmitted  to  hospital.  A  further  dilata- 
tion and  curettage  was  performed,  with 
some  relief  of  symptoms,  but  basically 
with  less  improvement  than  previously. 
During  the  four  months  prior  to  her 
present  consultation,  Mrs.  G.  had  ex- 
perienced increased  flow  with  clots,  and 
usually  had  to  spend  a  day  in  bed  during 
the  worst  part  of  her  menstrual  period. 
Past  history  revealed  that  Mrs.  G. 
had  had  four  uneventful  pregnancies, 
with  four  normal  children.  She  denied 
any  serious  medical  illnesses  or  other 
surgery.  Her  parents  were  both  alive 
and  well,  as  were  three  siblings.  There 
was  no  family  history  of  cancer,  dia- 
betes, or  congenital  problems.  During 
the  review  of  systems,  aside  from  her 
gynecological  complaints,  the  following 
were  reported:   The  patient's  general 
well-being  decreased  just  prior  to,  dur- 
ing, and  after  her  periods,  and  she  felt 
weak  eight  to  ten  days  after  cessation 
of  flow.  In  addition,  she  had  noted  a 
fullness  in  her  lower  abdomen;  some 
frequency,  which  she  explained  on  a 
pressure   basis,    without   any  dysuria; 
and    some    difficulty    in    moving    her 
bowels.  The  remainder  of  the  functional 
inquiry  was  negative. 

The  patient's  general  physical  exam- 
ination was  within  normal  limits.  The 
lower  abdomen  was  full,  with  an  irreg- 

JULY  1971 


ular  firm  mass  arising  out  of  the  pelvis. 
Speculum  examination  revealed  nothing 
abnormal.  A  routine  cytology  test  was 
taken,  later  reported  normal.  Manual 
examination  revealed  the  cervix  to  be 
fairly  moveable  and  of  normal  consist- 
ency. However,  arising  above  this  and 
replacing  the  uterine  fundus,  was  a 
large  firm  irregular  mass.  The  ovaries 
were  palpably  normal.  A  diagnosis  of 
uterine  fibroids  was  made. 

Suggested  management 

Because  this  patient  had  had  repeated 
dilation  and  curettage  for  menorrhagia 
and  was  continuously  slightly  anemic 
(hemoglobin  of  1  1  to  1 1 .5  grams),  and 
because  she  had  increasing  discomfort- 
and  fullness  in  the  lower  abdomen,  a 
total  abdominal  hysterectomy  was 
recommended. 

The  patient  was  admitted  to  a  gynec- 
ological unit  and  subjected  to  a  total 
abdominal  hysterectomy.  Because  she 
was  more  than  45  years  old,  her  ovaries 
and  tubes  were  also  removed.  The  ovar- 
ies were  removed  to  preclude  devel- 
opment of  an  ovarian  malignancy,  as 
treatment  of  this  disease  does  not  yet 
provide  a  means  to  a  suitable  five-year 
survival. 

From  the  second  postoperative  day, 
when  she  was  able  to  tolerate  oral 
intake,  Mrs.  G.  was  given  estrogen  1 .25 
milligrams  daily.  Postoperative  recov- 
ery in  hospital  was  unevenful. 

Mrs.  G.  was  seen  six  weeks  after  her 
surgery.  She  had  continued  her  estrogen 
until  then,  and  reported  that  she  had 
neither  hot  flushes  nor  insomnia,  and 
that  she  generally  felt  reasonably  well. 
Her  abdominal  wound  was  well  healed, 
as  was  the  vaginal  apex.  In  general, 
her  operative  site  did  not  demonstrate 
any  postoperative  complications.  The 
JULY  1971 


patient  was  then  placed  on  cyclic  hor- 
monal therapy  and  was  to  have  check- 
ups at  regular  intervals  during  the 
coming  years. 

Case  history  II 

Mrs.  T.W.  was  a  35-year-old  patient 
with  three  children,  the  youngest  of 
whom  was  seven.  She  had  not  sought 
medical  consultation  since  her  post- 
partum check  following  the  delivery 
of  her  last  child.  However,  she  had  read 
articles  about  the  "Pap  smear"  and 
thought  perhaps  she  should  have  one 
of  these  things.  The  history,  past  hist- 
ory, family  history,  and  functional 
inquiry,  as  well  as  the  physical  examina- 
tion, were  essentially  negative.  Pelvic 
examination  showed  that  the  external 
genitalia,  entroitus,  and  vaginal  walls 
were  normal.  The  cervix  was  parous 
but  had  no  obvious  lesions.  The  uterine 
fundus  was  antiverted.  antiflexed,  and 
of  normal  size,  shape,  and  consistency. 

The  report  on  the  cytology  test  was 
Class  IV,  indicating  abnormal  cells. 
Cytology  was  repeated,  and  again  re- 
ported as  Class  IV.  The  patient  was  then 
admitted  to  hospital  for  a  scalpel  con- 
ization of  the  cervix  and  a  D  and  C.  A 
histopathological  diagnosis  of  carcino- 
ma in  situ  of  the  uterine  cervix  was 
established  in  all  quadrants  of  the  cer- 
vix. Due  to  the  nature  of  the  illness, 
total  abdominal  hysterectomy  with  the 
removal  of  a  vaginal  cuff  was  recom- 
mended. The  operation  was  performed 
within  48  hours.  Because  of  the  pa- 
tient's age  and  the  absence  of  disease, 
the  ovaries  were  left  in  situ  in  the  pelvis. 
The  patient's  postoperative  course  was 
uneventful,  and  she  was  discharged  on 
her  fifth  postoperative  day. 

Mrs.  W.  was  seen  six  weeks  after 
surgery,  by  which  time  her  abdominal 


incision  and  the  vaginal  apex  had  heal- 
ed. The  patient  reported  she  had  suf- 
fered neither  hot  flushes  nor  insomnia. 
It  was  felt  that  her  ovaries  were  continu- 
ing to  function,  and  that  no  estrogen 
adjunctive  therapy  was  necessary.  She 
was  instructed  to  report  at  regular  inter- 
vals for  repeat  cytology  on  the  vaginal 
mucosa  and  for  adjunctive  hormone 
therapy  should  it  become  necessary. 

Comment 

The  two  cases  cited  represent  sound 
indications  for  abdominal  hysterec- 
tomy. At  some  centers,  squamous  car- 
cinoma in  situ  of  the  uterine  cervix  is 
being  definitively  treated  by  scalpel 
conization  of  the  cervix  only.  However, 
there  are  two  requirements  for  this  type 
of  management:  1.  that  the  surgical 
margin  of  the  conization  be  entirely  free 
of  any  abnormal  tissue;  2.  that  the 
patient  be  reliable  enough  to  report  for 
follow-up  examinations  and  cytology 
studies  at  no  less  than  three-month 
intervals  during  the  first  year,  six-month 
intervals  during  the  second  year,  and  at 
least  yearly  thereafter.  Should  the  cyto- 
logy return  to  an  abnormal  state,  then 
more  serious  intervention  becomes 
necessary. 

In  general,  then,  hysterectomy  is 
performed  in  our  hospital  for  sound 
reasons,  where  attempts  at  conservative 
management  have  failed.  Of  note  is  the 
fact  that  a  continuing  monthly  audit  is 
carried  out  on  all  cases  admitted  to  the 
gynecological  unit  to  ensure  optimal 
care  for  each  patient.  ^ 


THE  CANADIAN  NURSE     35 


Nursing  care  of  patients 
having  a  hysterectomy 

Hysterectomy  need  not  threaten  a  woman's  femininity  nor  sense  of  worth. 


Leslie  Anne  Holm,  R.N. 

Hysterectomy  is  feared  by  many  wom- 
en. Why?  They  may  still  believe  in 
superstitions  or  "old  wives'  tales."  They 
may  believe  this  type  of  surgery  threat- 
ens their  femininity  and  ability  to  re- 
main adequate  wives  and  mothers. 
Women  most  commonly  require  hyster- 
ectomies when  their  children  have 
grown  up  and  are  about  to  leave  home, 
when  their  husbands  have  reached  the 
peak  of  a  busy  career,  or  when  their 
own  financial  contribution  to  the  family 
as  working  wives  is  no  longer  pressing. 
It  therefore  becomes  a  major  respon- 
sibility of  the  nurse  to  see  that  such 
fears  are  brought  into  the  open  and 
carefully  explained.  Psychological 
preparation  for  surgery  is  just  as  im- 
portant as  any  physical  care  given  to 
women  undergoing  hysterectomy. 

Preoperative  care 

The  reasons  for  having  a  hyster- 
ectomy are  varied  and  the  doctor  usually 
discusses  them  with  his  patient  before 
she  enters  hospital.  However,  once  in 
hospital  the  patient  often  needs  further 
explanation  by  the  nurse  regarding  her 
condition  and  her  need  for  surgery.  She 
may  have  accepted  the  physical  need 
for  an  operation,  but  the  "old  wives' 
tales"  may  still  trouble  her. 


Mrs.  Holm  is  a  staff  nurse  in  the  gynecol- 
ogical department  of  the  Calgary  General 
Hospital.  Calgary,  Alberta. 


36     THE  CANADIAN   NURSE 


The  nurse  must  be  able  to  establish 
such  a  relationship  with  the  patient 
that  she  will  feel  free  to  ask  questions 
about  her  surgery  and  its  effect  on  her. 
The  nurse  can  then  reassure  the  patient 
that  the  only  effects  of  hysterectomy 
will  be  a  cessation  of  menstruation  and 
an  inability  to  become  pregnant.  She 
will  not  gain  weight;  nor  will  her  face, 
figure,  hair,  breasts,  or  voice  change. 
Her  appearance  may  even  improve 
because  she  will  feel  better  following 
surgery. 

The  nurse  is  also  able  to  reassure 
her  patient  in  another  area  of  great 
concern,  that  of  sexual  function  and 
pleasure.  The  patient's  interest  in  sex 
will  remain  essentially  the  same  as 
before  her  operation.  Intercourse  will 
be  possible,  and  sexual  pleasure  will 
not  in  any  way  be  affected  by  removal 
of  the  uterus. 

Should  the  patient  wonder  about 
hormone  therapy,  the  nurse  can  say 
that  it  is  the  doctor  who  prescribes 
hormones  and  that  the  matter  should 
be  discussed  with  him.  Hormones  are, 
however,  advocated  only  when  both 
ovaries  are  completely  removed,  for, 
if  even  a  small  portion  of  one  ovary 
remains,  sufficient  hormones  will  nor- 
mally be  secreted.  Generally,  the  nurse 
is  ready  to  answer  questions  according 
to  her  knowledge  of  the  subject  or  she 
can  call  on  the  doctor  to  answer  them. 

An  important  tool  in  securing  a 
patient's  cooperation  toward  a  quick 

JULY  1971 


recovery  is  teaching  what  is  expected 
of  her  postoperatively.  Why  procedures 
are  done  and  how  they  are  accomplished 
should  be  clearly  explained  to  the  pa- 
tient before  she  goes  to  the  operating 
theatre. 

She  will  then  understand  that  deep 
breathing  and  coughing  are  necessary 
to  avoid  accumulation  of  fluid  in  the 
chest.  This  exercise  should  be  practiced 
before  surgery  so  it  will  be  a  familiar 
procedure  when  the  patient  is  required 
to  do  it  postoperatively.  If  her  doctor 
calls  for  intermittent  positive  pressure 
breathing  (IPPB)  following  surgery,  she 
is  introduced  to  this  routine  preoper- 
atively. 

Leg  exercises  are  essential  to  main- 
tain good  circulation.  A  simple  one  is  to 
have  the  patient  point  her  toes  down 
toward  the  foot  of  the  bed,  then  up  and 
forward,  to  achieve  a  tightening  sensa- 
tion in  the  calf  and  behind  the  knee. 
This  exercise  is  effective,  easy  to  teach, 
and  easy  to  do  even  when  the  patient  is 
drowsy  from  postoperative  sedation. 

The  nurse  instructs  the  patient  on 
how  to  get  out  of  bed  without  straining 
her  abdominal  muscles.  She  should  roll 
on  her  side  toward  the  edge  of  the  bed, 
bring  her  knees  up  so  that  her  thighs 
are  at  right  angles  to  her  abdomen, 
then  move  her  feet  forward  until  her 
ankles  are  over  the  edge  of  the  bed. 
From  this  position  she  can  push  herself 
up  onto  her  lower  elbow  (with  or  with- 
out the  nurse"s  help)  and  swing  to  a 
sitting  position  on  the  edge  of  the  bed. 
Insertion  of  an  indwelling  catheter 
may  be  made  more  acceptable  to  the 
patient  if  the  nurse  explains  beforehand 
that  the  bladder  must  be  kept  out  of  the 
way  during  surgery,  and  that  pressure 
on  the  operative  site  due  to  a  full  blad- 
der must  be  prevented.  If  the  doctor 
catheterizes  the  patient  for  residual 
urine  following  removal  of  the  ind- 
welling catheter,  this  routine  is  also 
explained  prcoperatively. 

Preoperative  instruction  ought  to 
include  an  explanation  of  certain  proce- 
dures that  nurses  often  take  for  granted: 
intravenous  therapy,  blood  transfusions 
JULY  1971 


(sometimes  before,  during,  or  after 
surgery),  routine  blood  analyses,  urin- 
alysis, and  the  special  skin  preparation 
required.  Other  hospital  procedures  or 
doctor's  particular  routines  should 
likewise  be  explained. 

Above  all,  the  nurse's  words  and 
actions  must  reassure  the  patient  that 
every  staff  member  is  there  to  help  her 
recover  as  completely  and  as  quickly 
as  possible. 

Postoperative  care 

The  nurse  encourages  and  helps  the 
patient  to  deep  breathe  and  cough  as 
soon  as  she  is  returned  to  her  room 
following  surgery.  This  routine  is  re- 
peated every  two  hours.  If  IPPB  is 
used,  the  nurse  ensures  that  coughing 
follows  this  treatment  as  it  is  then  most 
effective.  A  patient  who  smokes  heav- 
ily, or  who  has  a  chronic  chest  condi- 
tion, may  need  to  follow  the  deep 
breathing  and  coughing  routine  more 
frequently  than  every  two  hours. 

The  nurse  helps  the  patient  do  her 
leg  exercises  until  she  is  fully  ambula- 
tory. 

Early  ambulation  should  be  stressed, 
but  not  without  the  doctor's  consent. 
The  patient  should  be  helped  out  of 
bed  and  encouraged  to  walk  at  least 
three  times  on  her  first  postoperative 
day.  Because  surgery  interrupts  pelvic 
circulation,  walking  for  even  a  short 
distance  is  preferable  to  sitting.  Sitting 
tends  to  slow  circulation  to  the  legs  and 
may  be  a  predisposing  factor  in  throm- 
bophlebitis. 

It  is  essential  to  observe  the  amount, 
color,  and  odor  of  vaginal  discharge 
when  assessing  the  patient's  progress. 
It  is  also  important  to  check  abdominal 
dressings  for  signs  of  hemorrhage  or 
other  discharge  and,  following  a  vaginal 
hysterectomy  associated  with  anterior 
and/or  posterior  vaginal  repair,  to  check 
the  perineum  for  swelling  or  bruising. 
All  observations  are  accurately  record- 
ed on  the  patient's  chart. 

The  perineum  is  kept  clean  following 
both  abdominal  and  vaginal  hysterec- 
tomy. The  nurse  gives  perineal  care  at 


least  every  four  hours,  more  frequently 
if  needed.  The  doctor  often  orders  sitz 
baths  once  the  packing  is  removed 
(usually  within  48  hours)  after  a  vaginal 
hysterectomy.  The  patient  is  encouraged 
to  take  sitz  baths  as  she  will  find  them 
soothing  and  helpful  in  maintaining 
perineal  cleanliness.  An  anesthetic 
spray  may  be  ordered  to  relieve  the 
pain  and  itching  of  a  healing  perineum. 

The  nurse  notes  the  patient's  vital 
signs  every  four  hours  for  48  hours,  or 
according  to  the  routine  of  the  doctor 
or  hospital.  Occasionally,  a  ureter  is 
tied  off  during  surgery,  making  it  es- 
sential to  note  carefully  and  to  record 
the  patient's  urinary  output  during  the 
postoperative  period.  Catheter  drainage 
is  usually  continued  for  a  longer  period 
following  a  vaginal  hysterectomy  than 
following  an  abdominal  hysterectomy. 

Both  the  type  of  surgery  and  the 
changing  situation  at  home  can  threaten 
a  woman's  sense  of  worth,  especially  if 
she  is  home  oriented.  This  is  why  the 
nurse,  with  the  assistance  of  other 
members  of  the  health  team  and  some- 
times community  agencies,  must,  during 
a  patient's  convalescence,  try  to  encour- 
age her  to  find  activities  outside  the 
home  to  engage  her  interest,  or  to  use 
her  talents  to  help  her  retain  her  feeling 
of  worth.  Such  activities  may  include 
volunteer  work,  formal  study  at  school, 
or  learning  a  new  and  useful  hobby. 

The  nurse's  goal,  when  caring  for 
a  patient  who  is  a  candidate  for  hyster- 
ectomy, is  to  help  her  to  retain  a  sense 
of  usefulness,  and,  through  understand- 
ing and  health  teaching,  to  remove  her 
fear  of  hysterectomy.  a 


THE  CANADIAN  NURSE     37 


Next  Month 
in 


The 

Canadian 
Nurse 


•  Pain  and  Suffering 
in  Cancer 

•  Rehabilitation 
of  Quadriplegics 

•  Nurse  at  Sea 


^ 

^^P 


Photo  Credits 
for  July  1971 


David  Portigal  &  Co.  Ltd., 
Winnipeg,  p. 6 

J.-R.  Gauvreau,  Maniwaki, 
pp.  21.22,  23 


August  2-6, 1971 

"Short  Course  on  Laser  Safety,"  Uni- 
versity of  Cincinnati,  Cincinnati,  Ohio. 
Tuition;  $325.  For  further  information 
write:  R.J.  Rockwell,  Laser  Laboratory, 
Children's  Hospital  Research  Foundation, 
Cincinnati,  Ohio  45229,  U.S.A. 


August  22-28, 1971 

An  instrumental  one-week  course  to  pro- 
vide essential  information  for  those  indi- 
viduals dealing  with  problems  related  to 
misuse  of  alcohol  and  other  drugs, 
sponsored  by  Addiction  Research  Foun- 
dation, to  be  held  at  Lakehead  University, 
Thunder  Bay,  Ont.  Enrollment  limited  to 
80.  For  further  information  write:  Director, 
Summer  Courses,  Addiction  Research 
Foundation,  Education  Division,  33  Rus- 
sell St.,  Toronto  4,  Ontario. 


August  23, 1971 

American  Academy  of  Medical  Admin- 
istrators, 14th  annual  convocation,  lunch- 
eon, and  reception.  Continental  Plaza 
Hotel,  Chicago,  Illinois,  U.S.A. 


August  23-27, 1971 

Sixth  International  Congress  of  School  and 
University  Health  and  Medicine,  Lisbon, 
Portugal. 


September  9-11, 1971 

Canadian  Society  of  Extra-Corporeal  Circul- 
ation Technicians,  annual  meeting,  Q4jeen 
Elizabeth  Hotel,  Montreal.  Nurses  in  fields 
of  hemodialysis  and  cardio-pulmonary 
bypass  welcome.  Program  includes  business 
meeting  (for  members  only),  scientific 
presentations,  exhibits,  and  social  activit- 
ies. Elective  exams  in  dialysis  theory  are 
planned.  For  further  information,  contact 
CanSECT,  Box  625,  Halifax,  N.S. 

September  30  and  Oct.  1, 1971 

Conference  for  Industrial  Nurses,  Windsor 
Hotel,  Montreal.  P.O. 

September  23-26, 1971 

Canadian  Association  for  the  Mentally 
Retarded.  Nova  Scotian  Hotel.  Halifax,  N.S. 

September  27-29, 1971 

Catholic  Hospital  Association  of  Canada, 
annual  assembly,  Ottawa. 

October  2, 1971 

Golden  Anniversary  Homecoming  Cele- 
brations,  Public   General   Hospital   School 


of  Nursing,  Chatham,  Ontario.  A  tea  and 
banquet  are  planned.  All  graduates  and 
former  faculty  are  invited.  For  further  in- 
formation write:  Miss  Jo-An  Dale,  190 
Thames  St.,  Chatham,  Ontario. 


October  5-7, 1971 

Nova  Scotia  Operating  Room  Nurses' 
Conference  (Maritime  Conference),  Lord 
Nelson  Hotel,  Halifax,  N.S. 


October  13-15, 1971 

Association  of  Registered  Nurses  of  New- 
foundland, annual  meeting,  St.  John's, 
Newfoundland. 


November  2-3, 1971 

Workshop,  sponsored  by  the  Manitoba 
Nursing  In-Service  Interest  Group.  Topic: 
"The  Teacher,  The  Learner,  The  Group 
Process."  Further  information  may  be 
obtained  from:  Miss  K.  Froese,  Chairman, 
Planning  Committee,  300  Booth  Dr.,  Win- 
nipeg 12,  Manitoba. 


November  12-13, 1971 

American  Heart  Association,  annual  meet- 
ing, nurses'  sessions,  Disneyland  Hotel, 
Anaheim,  California.  Further  information 
and  registration  forms  available  from: 
Katherine  A.  Lembright,  Dept.  Medical 
Education,  American  Heart  Association, 
44  East  23rd  Street,  New  York,  N.Y.  10010. 


November  28-December  4, 1971 

World  Psychiatric  Association,  Fifth  World 
Congress  of  Psychiatry,  Mexico  City.  For 
further  information,  write  Secretariado  Del 
"V"  Congresso,  Mundial  de  Psiquiatria, 
Apartado  Postal  20-123/24,  Mexico,  D.F. 

August  27-September  1, 1972 

Twelfth  World  Congress  of  Rehabilitation 
International.  Chevron  Hotel.  Kings  Cross, 
Sydney,  Australia.  Conference  Theme: 
Planning  Rehabilitation:  Environment  — 
Incentives  —  Self-Help.  For  further  in- 
formation write:  Twelfth  World  Rehabilita- 
tion Congress,  G.P.O.  Box  475,  Sydney, 
N.S.W.  2001,  Australia. 


June  25-29,  1972 

Canadian  Nurses'  As- 
sociation  annual 
meeting  and  conven- 
tion, to  be  held  in  the 
Northern  Alberta 
Jubilee  Auditorium, 
Edmonton,  Alberta. 


^ 

^^P 


38     THE  CANADIAN   NURSE 


JULY  1971 


in  a  capsule 


Hospital  wars 

Printing  errors  can  be  amusing,  as  this 
one  proves.  Our  thanks  for  bringing  it 
to  our  attention  go  to  Jacqueline  Brooic- 
es  of  Toronto. 

Under  "hospital  help  wanted"  in 
The  Globe  and  Mail,  came  this  ad: 
"Registered  Nurses  are  required  im- 
mediately for  full  time  duty  in  a  modern 
500  bed  hospital,  especially  in  medical, 
surgical,  and  gynecology  wars." 

But  who  knows?  Maybe  it  wasn't  a 
misprint. 

"Sorry"  party  for  patients 

One  hospital  has  certainly  gone  in  for 
patient  public  relations. 

According  to  a  news  item  in  The 
Vancouver  Sun  April  3,  patients  at  the 
242-bed  Burnaby  General  Hospital 
received  notes  and  pieces  of  cake  from 
hospital  officials  who  wanted  to  let 
them  know  about  the  beginning  of 
construction  of  a  new  extended  care 
unit  and  express  their  hope  that  the 
14-month  building  activity  would  not 
disturb  them. 

It  goes  to  show  that  you  sometimes 
can  have  your  cake  and  eat  it  too. 


Ban  the  butt 

Cigarette  manufacturers  are  not  gen- 
erally known  for  their  enthusiasm  to 
stop  advertising  their  products.  After 
all,  it's  profit  before  pollution. 

So  it  is  refreshing  to  read  that  the 
tobacco  industry  in  West  Germany  has 
volunteered  to  cut  television  advertising 
for  tobacco  products  by  half  by  July  1 
this  year,  and  completely  by  the  end  of 
1972. 

This  revelation  came  in  a  February 
issue  of  German  Features,  which  ex- 
plained that  this  move  was  a  result  of 
negotiations  with  the  Bonn  Health 
Ministry.  A  ban  on  tobacco  advertising 
had  not  been  included  in  the  Health 
Ministry's  new  draft  law  that  set  out 
reforms  in  regulations  on  food,  cos- 
metics, and  tobacco  marketing.  The 
draft  law  is  intended  to  revise  regula- 
tions to  protect  consumers  against  health 
hazards  and  misleading  advertising. 

One  of  the  proposed  new  measures 
would  limit  or  ban  the  sale  of  food  that 
had  been  subject  to  unusual  air,  water, 
or  soil  pollution,  such  as  vegetables 
grown  along  heavily  used  roads.  Pro- 
ducers of  food  products  and  cosmetics 
are  also  forbidden  to  advertise  their 
JULY  1971 


goods  as  being  "natural"  or  "naturally 
pure." 

The  ceremony  of  a  Royal  visit 

Canada's  supply  of  pomp  and  circum- 
stance is  dipped  into  on  the  occasion  of 
a  Royal  visit  like  no  other  display  of 
pageantry  in  the  life  of  the  nation.  Globe 
and  Mail  reporter  John  Slinger  covered 
the  recent  visit  of  the  Queen,  Prince 
Philip,  and  Princess  Anne  to  British 
Columbia. 

In  his  Victoria  despatch  he  described 
the  morning  ceremonial  firing  of  a  21- 
gun  salute.  "And  for  those  in  the  crowd 
not  quite  fully  awake,  the  battery  that 
fired  the  salute  from  the  quayside  came 
on  with  a  vengeance.  The  entire  group 
on  the  lawns  was  lifted  six  inches  into 
the  air  by  the  first  shot  and  the  only 
marvel  was  that  all  the  windows  for 
miles  around  weren't  shattered.  The 


Queen  was  apparently  leaving  the 
Royal  yacht  Britannia  by  the  gangway 
when  the  first  shot  rang  out  and  people 
nearby  said  she  visibly  flinched." 

Mr.  Slinger  continues  his  report 
with  a  description  of  the  Royal  party's 
tour  of  a  three-year-old  provincial 
museum.  "They  walked  around  the 
majestic,  bigger-than-life-size  sculpt- 
ure of  a  group  of  Nootka  Indians  in  a 
dugout  canoe  about  to  harpoon  a  whale. 
The  sculpture,  by  Lionel  Thomas,  was 
a  cause  celebre  —  in  fact  almost  a  cause 
for  open  warfare.  The  problem  was  that 
when  the  Nootka  Indians  went  whaling, 
they  went  whaling  naked.  And  the 
sculpture  was  authentic.  A  lot  of  ton- 
gues were  almost  sprained  clucking  at 
the  time,  but  the  Royal  Family  emerged 
from  the  museum  into  the  warm  sun- 
shine and  more  cheers,  looking  none 
the  worse  for  the  viewing."  ^ 


THE  CANADIAN   NURSE     39 


Toward  a  Theory  for  Nursing;  General 
Concepts    of    Human    Behavior    by 

Imogene  M.  King.  132  pages.  New 
York,  John  Wiley  and  Sons,  Inc., 
1971. 

Reviewed  by  Margo  Fahlman,  Assis- 
tant Director,  Regina  Grey  Nuns' 
School  of  Nursing,  Regina,  Sask. 

A  conceptual  framework  of  reference 
for  nursing  is  what  the  author  is  sug- 
gesting. With  advancement  in  science 
and  technology  influencing  rapid  change 
in  our  society  over  the  past  century, 
nursing  has  become  caught  within  that 
change.  Yet,  upon  close  observation, 
there  are  basic  components  in  nursing 
that  have  remained  constant  throughout 
the  years. 

As  more  nurses  are  looking  to  the 
challenge  of  research  in  the  nursing 
field,  there  have  been  numerous  at- 
temps  at  establishing  a  general  theory 
for  nursing.  The  author  has  used  this 
knowledge  and  has  drawn  an  effective 
and  exciting  framework  of  reference 
from  which  to  formulate  a  theory  for 
nursing. 

This  book  is  commendable  for  the 
manner  in  which  it  captivates  the  read- 
er. The  author  stresses  the  need  for 
concepts  as  building  blocks  to  theory, 
and  therefore  reviews  terminology  of 
concept,  theory,  and  sources  of  theory 
before  presenting  her  framework  of 
reference.  The  material  is  presented  in 
a  simple  yet  concise  way,  with  illustra- 
tions to  add  depth  to  one's  understand- 
ing of  the  book. 

The  framework  of  reference  develop- 
ed is  man,  health,  perception,  inter- 
personal relations,  and  social  systems. 
Each  symbol  is  developed  in  a  separate 
chapter.  Underlying  concepts  to  these 
symbols  are  presented.  These  are 
thought-provoking  and  make  one  look 
at  what  nursing  really  is,  and  to  ask 
questions:  Has  it  always  been  like  this? 
Is  there  really  a  common  element  in 
nursing?  What  is  the  specific  function 
of  nursing?  Is  nursing;  a  science? 

Following  each  chapter,  the  author 
draws  a  concluding  statement  to  help 
assist  the  reader  review  the  important 
ideas.  Also,  at  the  end  of  each  chapter 
are  selected  readings  for  those  wishing 
to  do  further  study. 

The  book  suggests  and  presents  ideas 
that  students,  nurses,  teachers,  and 
researchers  should  find  valuable  in 
studying  nursing  practice  as  it  relates 
to  man,  his  health,  and  life. 
40     THE  CANADIAN   NURSE 


Cardiovascular  Nursing  by  Jeanette 
Kernicki,  Barbara  Bullock,  and  Joan 
Matthews.  413  pages.  New  York, 
G.P.  Putnam's  Sons,  1970.  Canadian 
Agent:  Macmillan  Co.  of  Canada. 
Reviewed  by  Marjorie  Fussell,  Med- 
ical Nursing  Instructor,  Foothills 
Hospital,  Calgary,  Alberta. 

This  text,  a  first  edition,  attempts  to 
have  the  nurse  understand  her  col- 
laborative role  with  the  doctor.  The 
rationale  behind  symptomatology  and 
therapy  is  outlined  in  a  concise,  in- 
formative manner,  giving  a  current 
concept  of  the  nursing  role. 

Content  deals  with  the  heart  and 
blood  vessels,  starting  with  a  quick 
review  of  anatomy  and  physiology,  and 
then  a  bird's-eye  view  of  diagnostic 
procedures  used  to  evaluate  heart 
function.  It  deals  with  acquired  and 
congenital  diseases  of  the  heart,  surgery 
and  its  complications,  and  contains  a 
section  on  human  heart  transplants. 

The  book  is  set  out  in  chapters  hav- 
ing many  subheadings.  Material  is 
concise  and  pertinent,  with  no  chapter 
summary  necessary.  A  reference  list 
at  the  end  of  each  chapter  contains 
recent  journal  and  textbook  material 
for  further  research  that  would  be 
available  in  any  teaching  hospital  li- 
brary. It  is  a  readable  book  written  in 
easy  to  understand  terms. 

Each  chapter  deals  with  one  aspect 
of  heart  or  vessel  disease.  The  reader 
is  first  given  a  definition,  then  the 
physiology  related  to  signs  and  symp- 
toms. The  nursing  care  section  looks 
at  patient  needs,  rationale,  and  the 
nursing  approach. 

Most  of  the  illustration  are  dia- 
gramatic  and  help  to  explain  the  con- 
tent appropriately. 

The  material  is  up-to-date  with 
regard  to  new  trends  and  techniques. 
The  chapter  on  transplants  deals  with 
the  donor  and  recipient,  the  problems 
inherent  in  making  a  cross  match,  and 
the  legality  of  the  term  "death."  Read- 
ers should  bear  in  mind  that  this  is  an 
American  text  and  therefore  American 
laws  are  valid.  The  authors  look  to  the 
future  and  remind  the  readers  that 
techniques  are  changing  daily. 

In  the  preface,  the  authors  state  the 
text  is  designed  for  students,  nurse 
clinicians,  and  staff  nurses.  I  agree  that 
it  is  a  good  reference  text  for  cardio- 
vascular unit  staff  and  for  second-year 
nursing  students.  It  would  be  a  most 


useful  book  for  the  instructor  as  < . 
beginning  basis  for  her  lecture  material 

Birth  Control  and  the  Christian;  a  Protes- 
tant Symposium  on  the  Control  o4 
Human  Reproduction.  Edited  b'» 
Walter  O.  Spitzer  and  C.L.  Saylof 
590  pages.  Wheaton,  Illinois,  Tyn 
dale  House  Publishers,  1969.  Avail 
able  in  Canada  from  Home  Evange 
Books,  Toronto. 

Reviewed  by  Mabel  C.  Brown,  Direc 
tor  of  Library  Services,  Ottawc 
Civic  Hospital,  Ottawa,  Ontario. 

This  book,  on  a  topic  that  is  timely  foi 
nurses  and  members  of  the  medica 
profession,  is  the  outgrowth  of  a  symp- 
osium held  August  27  to  31,  1968,  in 
Portsmouth,  New  Hampshire.  Contrib- 
utors are  from  law,  genetics,  sociology 
and  theology. 

Scholarly  overviews  of  historic. 
Christian  and  non-Christian  position* 
are  presented  in  an  engaging  and  read- 
able form.  Such  majoi  divisions  as  bi- 
blical data  and  a  theological  basis, 
perspectives  from  the  health  sciences, 
medical  ethics,  societal  realities,  and 
legal  aspects  indicate  the  framework  of 
the  discussion.  The  excellent  bibliogra- 
phy in  itself  provides  a  wealth  of  re- 
sources for  further  study. 

Nurses'  reactions  to  broadened  abor- 
tion laws  range  from  acceptance  to 
reservation  to  outright  alarm.  The 
reader  will  find  this  book  richly  infor- 
mative and  helpful  in  clarifying  the 
many  questions  she  faces.  No  conclu- 
sions are  drawn  in  the  book.  The  reader 
in  simply  presented  with  many  view- 
points and  thus  given  a  parameter  in 
which  to  draw  her  own  conclusions. 

Health  Manpower  in  Hospitals  by  Carrie 
J.  Losee  and  Marion  E.  Altenderfer. 
82  pages.  Washington,  D.C.,  U.S. 
Government  Printing  Office,  1970. 

This  publication,  the  first  in  a  series  of 
division  of  manpower  intelligence  re- 
ports, reflects  progress  in  recruiting  and 
training  critically  needed  health  man- 
power. It  presents  national  and  regional 
estimates  of  professional  and  technical 
health  personnel  employed  in  hospitals 
in  the  United  States  on  March  28,  1969, 
and  gives  projected  estimates  of  the 
additional  full-time  personnel  needed 
to  provide  the  best  patient  care. 

Of  the   three   million   persons  em- 

lULY  1971 


books 


ployed,  two  thirds  were  in  professional 
and  technical  health  occupations. 

Nursing  personnel  accounted  for  7 
out  of  10  health  workers,  and  the  allied 
health  occupations,  for  about  23  per- 
cent of  the  personnel. 

The  report  showed  93,400  unfilled 
positions,  in  terms  of  current  health 
care  delivery  practice  in  the  reporting 
institutions,  for  professional  and  techn- 
ical personnel.  The  highest  number  of 
vacancies  was  for  registered  nurses 
(32,300),  followed  by  medical  interns 
and  residents  (4, 100).  Among  the  allied 
health  professions,  physical  therapists 
and  occupational  therapists  were  most 
needed. 

The  study's  estimates  on  hospital 
manpower,  together  with  an  earlier 
1966  survey,  make  it  possible  to  de- 
termine trends  in  hospital  manpower 
utilization  and  requirements.  The  1966 
survey  did  not  list  physicians,  dentists, 
administrators,  medical  secretaries, 
and  persons  in  training  —  all  of  whom 
were  included  in  the  1969  survey.  For 
categories  that  are  comparable,  em- 
ployment rose  from  1,332,000  to 
1,595,000  — an  increase  of  263.000 
(20  percent)  professional  and  technical 
health  employees.  Greatest  increases 
were  shown  for  cytotechnologic  tech- 
nicians (1,600  to  3,100),  electrocar- 
diographic technicians  (5,900  to  8,500), 
and  social  work  assistants  and  aides 
(1,500  to  3,700). 

The  1969  survey  was  conducted  by 
the  Bureau  of  Health  Manpower  Edu- 
cation in  collaboration  with  the  Amer- 
ican Hospital  Association.  The  Nation- 
al Center  for  Health  Statistics  of  the 
Public  Health  Service  was  the  collect- 
ing agent.  The  data  in  the  report  were 
derived  from  questionnaire  responses 
by  998  hospitals,  representing  97  per- 
cent of  the  1,031  hospitals  queried. 
This  probability  sample  was  selected 
from  the  nation's  8,200  hospitals.  The 
1966  survey,  conducted  for  the  Bureau 
by  the  American  Hospital  Association, 
was  based  on  all  AHA  registered  hos- 
pitals. 

The  Division  of  Manpower  Intellig- 
ence was  established  to  provide  a  na- 
tional and  federal  focus  for  analyzing, 
reporting,  and  interpreting  information 
on  health  manpower  supply  and  de- 
mand. Its  reports  are  designed  to  con- 
tribute to  better  understanding  of,  and 
planning  for,  health  manpower  needs. 

Single  copies  of  the  publication, 
Health  Manpower  in  Hospitals,  are 
available  from  the  Information  Office, 
Bureau  of  Health  Manpower  Educa- 
tion, National  Institutes  of  Health, 
Bethesda,  Maryland  20014,  U.S.A. 
JULY  1971 


AV  aids 


EVR  Cassette  Catalogue 

A  multi-subject,  broad-ranging  cata- 
logue of  EVR  cassette  film  titles,  total- 
ling over  600,  is  now  available. 

Varying  in  length,  about  half  mono- 
chrome and  half  color  subjects,  this 
collection  allows  individual  schools  to 
order  single  titles  or  packages.  With  the 
EVR  cassette  catalogue,  its  listed  films 
can  be  purchased  inexpensively  and 
acquired  permanently,  without  long 
waiting  periods. 

For  a  copy  of  the  catalogue,  write 
to:  Norman  Ober,  Director,  Press  & 
Public  Information,  CBS  Electronic 
Video  Recording  Division,  51  W.  52 
Street,  New  York,  N.Y.  10019. 

Two  films  have  been  produced  for  The 
Vancouver  General  Hospital  by  the 
CBC.  Cardiac  Monitoring  (16  mm, 
color,  28  minutes,  1970)  presents,  by 
flashback,  a  simulation  of  one  man's 
experience  with  a  heart  attack,  from 
his  arrival  in  hospital  to  consultation  at 
his  doctor's  office  after  discharge.  There 
are  scenes  that  demonstrate  the  special- 
ized cardiac  training  for  graduate 
nurses,  and  interviews  with  the  director 
of  cardiology  and  director  of  nursing  at 
the  hospital. 

Hospital  (16  mm,  black  and  white, 
28  minutes,  1970)  shows  the  doctors, 
nurses,  other  health  personnel,  and 
volunteers  involved  in  the  latest  devel- 
opments in  patient  care. 


accession  list 


Publications  on  this  list  have  been 
received  recently  in  the  CNA  library 
and  are  listed  in  language  of  source. 

Material  on  this  list,  except  Reference 
items  may  be  borrowed  by  CNA  mem- 
bers, schools  of  nursing  and  other  in- 
stitutions. Reference  items  (theses, 
archive  books  and  directories,  almanacs 
and  similar  basic  books)  do  not  go  out 
on  loan. 

Requests  for  loans  should  be  made 
on  the  "Request  Form  for  Accession 
List"  and  should  be  addressed  to:  The 
Library,  Canadian  Nurses"  Association, 
50  The  Driveway.  Ottawa  4.  Ontario. 

No  more  than  three  titles  should  be 
requested  at  any  one  time. 

BOOKS  AND  DOCUMENTS 

1.  Ahortioii  in  Ctiiuidci  by  Eleanor  Wright 
Pelrine.  Toronto.  New  press.  1971.  I. ^3 p. 
(New  woman  series  1) 

2.  The  anctl  ill:  copiiif;  nilli  prohlciii.s  in 
geriatric  care  by  Dorothea  Jaeger  and  Leo 


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THE  CANADIAN   NURSE     41 


W.  Simmons.  New  York.  Appleton-Century- 
Crofts.  1970.  377p. 

?•.  Basic  niir.\inf>  by  Eve  Rosemarie  Duffield 
Bendall  and  Elizabeth  Raybould.  3d.  ed. 
London.  Lewis.  1970.  226p. 

4.  Ccrtificots  tie  vaccination  exiges  dans  les 
voyages    internationaiix;    situation    an     ler 

Janvier  1970.  Geneve,  Organisation  mondiale 
de  la  Same.  1970.  59p. 

5.  Couple  el  sexualite;  itn  instrument  de 
reflexion  sur  la  vie  cortjiigale.  Ottawa,  Nova- 
lis.  1971.  6v. 

6.  Directory  of  health  sciences  lihraries  in 
the  United  Stales.  Edited  by  Frank  L.  Schick 
and  Susan  Crawford.  Chicago,  III.,  American 
Medical  Association,  1969.  197p. 

7.  Emergency  room  journal  articles;  a 
collection  of  current  articles  related  to 
hospital  emergency  rooms.  Edited  by  Abra- 
ham Gelperin  and  Eve  Arlin  Gelperin. 
Flushing,  N.Y.,  Medical  Examination  Pub- 
lishing Co.,  1970.  244p. 

8.  Escape  from  addiction  by  R.  Gordon 
Bell.  Toronto,  McGraw-HiM.  1970.  20lp. 

9.  Family  nursing:  a  study  guide  by  Evelyn 
G.  Sobol.  St.  Louis,  Mo.,  Mosby,  1970.  148p. 

10.  Infection  control  in  the  hospital. Ke\. 
ed.  Chicago,  ML,  American  Hospital  Asso- 
ciation. 1970.  154p. 

I  1 .  International  catalogue  of  occiipalionul 
health  and  safety  films.  6th  ed.  Geneva. 
International  Labour  Office,  1969.  557p. 

12.  An  introduction  to  the  theoretical  basis 
of  nursing  by  Martha  E.  Rogers.  Philadel- 
phia, Davis,  1970.  144p.  (Nursing  Science  1) 

13.  Length  of  stay  in  PAS  hospilids,  Canada. 

1969.  Ann  Arbor.  Mich.,  Commission  on 
Professional  and  Hospital  Activities,  1970. 
163p. 

14.  The  management  of  patient  care;  pulling 
leadership  skills  to  work  by  Thora  Kron 
3d  ed.  Toronto,  Saunders,  197 1 .  2  lOp. 

15.  Management's  views  of  union-nuinage- 
meni  relations  at  the  local  level  by  A.  Mika- 
lachki  et  al.  Ottawa,  Information  Canada, 
1968.  97p.  (Canada.  Task  Force  on  Labour 
Relations  Study  no.  17) 

16.  The  modern  practice  of  adult  educa- 
tion; andragogy  versis  pedagogy  by  Malcolm 
S.  Knowles.  New  York,  Association   Press, 

1970.  384p. 

17.  Nursing  and  anthropology:  two  worlds 
to  hlend  by  Madeleine  Leininger.  Toronto, 
Wiley.  1970.  181p. 

18.  Nursing  opportunities;  guide  to  pro- 
fessional hospital  employment.  Oeadell. 
N.J.  RN  magazine,  1971.  26op. 

19.  Nutrition  and  diet  therapy;  a  learning 
guide  for  sliulents  by  Sue  Rodwell  Williams. 
Saint  Louis,  Mo..  Mosby,  1970.  186p. 

20.  — .Teaching  guide.  Saint  Louis.  Mosby. 
1970.  87p. 

21.  Organisational  information.  1970-1971. 
Chicago,  III.,  American  Library  Association, 

1970.  152p. 

22.  Outpatient  services  Journal  articles;  a 
collection  of  current  published  articles  relat- 
ed to  outpatient  services  edited  by  Vivian 
Vreeland  Clark.  Flushing,  N.Y.,  Medical 
Examination  Publishing  Co.,  1970.  3  17p. 

23.  Paiycrs  presented  a  I  National  Conference 
42     THE  CANADIAN   NURSE 


on  Research  in  Nursing  Practice,  First,  Ot- 
tawa. Feb.  16.  17,  18,  1971.  Ottawa.  1971. 
Iv. 

24.  The  Pearson  report.  Ottawa,  Canadian 
Council  for  International  Cooperation,  1970. 

Iv.  (Its  Dossier  one) 

25.  Planning  for  innovation  through  dissem- 
ination and  utilization  of  knowledge  by 
Ronald  G.  Havelock.  Ann  Arbor,  Mich., 
Center  for  Research  on  Utilization  of  Scien- 
tific Knowledge,  Institute  for  Social  Re- 
search, University  of  Michigan,  1971.  Iv. 

26.  A  regional  nursing  body  for  the  Com- 
monwealth Caribbean;  report  of  a  meeting 
of  the  Commonwealth  Caribbean  Nurses, 
Barbados,  20th  -  28th  April,  1970.  Ottawa, 
Published  by  the  Canadian  Nurses"  Asso- 
ciation for  the  Commonwealth  Caribbean 
Nurses,  1970.  52p. 

27.  Serving  the  slate:  a  history  of  the  Pro- 
fessional Institute  of  the  Public  Service  of 
Canada  1920  -  1970  by  John  Sweetenham 
and  David  Kealy.  Ottawa,  Le  Droit,  1970. 
263p. 

28.  The  silent  dialogue:  a  study  in  the  social 
psychology  of  professional  .socialization 
by  Virginia  L.  Olesen  and  Evi  W.  Whitta- 
ker.  San  Francisco,  Jossey-Bass,  1968.  3  12p. 

29.  The  sociology  of  health:  an  introduction 
by  Robert  Neal  Wilson.  New  York,  Random 
House,  1970.  134p. 

30.  Teaching  psychiatric  musing;  a  report 
on  continuing  education  for  faculty  by  Annie 
Laurie  Crawford.  Atlanta,  Ga.,  Southern 
Regional  Education  Board,  1970.  47p. 

31.  Training  and  continuing  education:  a 
handbook  for  health  care  institutions.  Chi- 
cago, Hospital  Research  and  Educational 
Trust,  1970.  261  p. 

32.  Vaccination  certificate  requirements 
for    international    travel;    situations    as    on 

I  January  1970.  Geneva.  World  Health 
Organization.  1970.  59p. 

33.  Vascular  surgery  by  Christopher  R. 
Savage.  London,  Pitman  Medical  &  Scien- 
tific, 1970.  173p. 

34.  Where's  Hcuinah'.'  a  handbook  for  par- 
ents and  teachers  of  children  with  learning 
disorders  by  Jane  Hart  and  Beverly  Jones. 
New  York,  Hart,  1968.  272p. 

35.  The  Yorkville  subculture;  a  study  of  life 
styles  (Uitl  interactions  of  hippies  ami  non- 
hippies  prepared  from  the  field  notes  of 
Gopalci  Alanipur  by  Regina  G.  Smart  and 
David  Jackson.  Toronto,  Addiction  Research 
Foundation,  1969.  87p. 


PAMPHLETS 

36.  Briefing  of  internatioiud  coiisiiltcuits. 
New  York,  United  Nations.  1967.  34p. 

37.  La  constitution  ccuuulienne.  Une  elude 
de  noire  sysleme  tie  gouvernemeni  by  W.J. 
Lawson.  Ottawa,  Imprimeur  de  la  Reine. 
1963,  reimprime  1969.  31p. 

38.  Directory  1970.  A  directory  of  the 
schools  of  nursing  in  Latin  America.  Wash- 
ington. Pan  American  Sanitary  Bureau.  1970. 
3  3  p. 

39.  Education  peruninenle  et  formation  en 
coiirs  d'emploi.  Montreal,  Intermonde,  1970. 


2pts  in  1. 

40.  Medical  language  communicator.  Mont- 
real, Parke  Davis,  1971.  24p. 

41.  Report  1969-1970.  Ottawa,  Canadian 
Tuberculosis  and  Respiratory  Disease  Asso- 
ciation, 1970.  n.p. 

42.  Semi  annual  report,  Jan.  1971 .  Toronto, 
College  of  Physicians  and  Surgeons  of  Ontar- 
io, 1971.  20p. 

43.  Summary  record  of  Federal-Provincial 
Emergency  Health  Services  Conference,  Oct. 
6  to  8,  1970.  Ottawa,  Emergency  Health 
Services,  Dept.  of  National  Health  and 
Welfare,  1971.  25p. 

44.  iVard  rounds;  poems  by  K.D.  Beernink. 
Wallingford,  Penn.,  Washington  Square 
East,  1970.  36p. 

45.  Whats  in  it'.'  Study  guide  for  nation-wide 
circulation  and  di.scussion  based  on  the 
final  report  of  the  Royal  Commission  on  the 
Status  of  Women  in  Canada.  Ottawa,  Na- 
tional Council  of  Women  of  Canada  in  co- 
operation with  La  Federation  des  Femmes 
du  Quebec  and  the  assistance  of  the  Citi- 
zenship Branch  Department  of  the  Secretary 
of  State.  1970.  48p. 

46.  Wiunen's  two  roles:  home  and  work  by 
Alva  Myrdal  and  Viola  Klein.  2d  ed.  Lon- 
don. Routledge  &  Kegan  Paul,  1968.  21 3p. 


GOVERNMENT  DOCUMENTS 
Austr(dia 

47.  Dept.    of    Health,    Committee    of    En- 
quiry   into    Nursing.    Nursing    in    Victoria, 
Melbourne,  Australia,  1970.  139p. 
Catuida 

48.  Bureau  of  Statistics.  Hospital  morbidity 
1968.  Ottawa.  Information  Canada.  1971. 
143  p. 

49.  Review  of  employment  and  average 
weekly  wages  and  .salaries.  1967-69.  Ottawa, 
Information  Canada.  1971.  136p. 

50.  Commision  du  service  civil.  La  division 
de  Panalyse  de  la  gestion.  Mamiel  des  servi- 
ces de  classement.  Revue  et  reimprime.  Otta- 
wa. Imprimeur  de  la  Reine.  1964.  72p. 

51.  Dept.  of  Energy,  Mines  and  Resources, 
Surveys  and  Mapping  Branch.  Atlas  and 
gazetteer  of  Canada.  Ottawa,  Queen's  Print- 
er. 1969.  104p.R 

52.  Dept.  of  External  Affairs.  Canadian 
representatives  abroad  Sep.  1970.  Ottawa, 
Queen's  Printer.  Iv.  R 

53.  Dept.  of  Labour.  Catalogue  of  Training 
courses  in  occupational  safety  and  health 
available  in  Canada  and  the  United  States 
of  America.  Ottawa,  Information  Canada, 
1970.  37p. 

54.  Dept.  of  Manpower  and  Immigration. 
Adjusting  to  techiudogical  and  other  change. 
Ottawa.  Queen's  Printer,  1970.  28p. 

55.  Structural  unemployment  theory  and 
measuremem  by  G.  Peter  Penz.  Ottawa, 
Queen's  Printer.  1969.  91  p. 

56.  Dept.  of  National  Health  and  Welfare. 
How  to  plan  meals  for  your  family,  rev. 
Ottawa.  1962.  24p. 

57.  Plamiing  for  comprehensive  mental 
health  programs  by  Alfred  H.  Neufeldt. 
Ottawa,    Information    Canada,     1971.     12p. 

JULY  1971 


(Canada's  Mental  Health,  supplement  no. 67) 
.■^S.  Kcpiirt  t)J  Ct'iiiniilliv  on  Cliiikiil  Tniin- 
iiii;  ol  Niii.\i:\  fi>r  Mcilicdl  servkes  in  the 
\,>iili.  Ottawa.  1970.  28p. 
.^9.  Kconomic  Council  of  Canada.  Mcilinin- 
Icrni  iiipiiiil  in\f\ini('nl  sinvcy  1970  by  B.A. 
Keys  et  al.  Ottawa.  Information  Canada., 
1971.  .Sip. 

60.  Medical  Research  Council  of  Canada. 
Ad  Hoc  Committee  on  the  Implications  of 
Record  Linkage  for  Health  Relation  Re- 
search. Health  research  uses  of  record  link- 
aae  in  Canada.  A  report  to  the  Medical  Re- 
search Council  of  Canada.  Ottawa.  Medical 
Research  Council.  1968.  80p. 

61.  National  Science  Library.  Health  Scien- 
ces Resource  Centre.  Canadian  locations  of 
journals  indexed  in  index  mediciis.  1st  ed. 
Ottawa.  1970.  173p. 

62.  Conference  proceedings  in  the  he<dth 
sciences  held  hy  the  National  Science  Li- 
brary. 1st  ed.  Ottawa,  1969.  288p.  Iv 

63.  S(//)p/<'/)/('Hr.  Ottawa.  1970.  Iv. 

64.  Royal  Commision  on  the  Status  of  Wo- 
men. Studies  of  the  Royal  Commission  on  the 
Status  of  Women  in  Canada:  a  comparison 
of  men's  and  women's  salaries  and  employ- 
ment fringe  benefits  in  the  academic  pro- 
fession by  R.A.H.  Robson  and  Mireille  La- 
pointe.  Ottawa.  Information  Canada, 
1971.  39p. 

65.  Task  Force  on  Labour  Relations.  Interest 
arbitration  by  Donald  J.M.  Brown.  Ottawa. 
Information  Canada.  1968.  3IOp.  (Its  Study 
no.  18) 


Mitnlreal 

66.  Dept.  of  Health  Report  1968-69.  Mont- 
real. 1971.  266p. 

OiUtnio 

67.  Dept.  of  Labour.  Research  Branch.  The 
impact  of  the  Ontario  hospital  labour  dis- 
putes arbitration  act.  1965:  a  statistical 
analysis.  Prepared  by  Keith  McLeod.  Toron- 
to, 1970.  62p.  (Its  report  no.  4) 

68.  The  shorl-run  impact  of  the  thirty  cent 
revision  in  Ontario's  minimum  wage  on  five 
industries.  Prepared  by  Henry  FantI  and 
Frank  Whittingham.  Toronto.  1970.  42p.  (Its 
report  no.  3) 

Quebec 

69.  Conseil  superieur  de  lEducation.  Com- 
mission de  I'enseignement  technique  et  pro- 
fessionnel.  La  premiere  annee  du  developpe- 
/>ii?/i/  des  colleges  d'enseignement  general 
et  profcssionnel.  Quebec.  1969?  72p. 
United  Stales 

70.  Dept.  of  Health.  Education  and  Welfare. 
Public  Health  Service.  Annotated  biblio- 
graphy on  maternal  nutrition.  Washington, 
U.S.  Gov't.  Print.  Off..  1970.  I99p. 

7 1 .  Literature  relating  to  neurological  and 
neurosurgical  nursing.  Bethesda.  Md.,  1970. 
95p. 

72.  Tl/e  project  years  1961-1969.  Atlanta. 
Ga..  1969.  75p. 

73.  Scii-ntific  directory  and  annual  biblio- 
graphy /  959  Washington.  1970.  289p.  R 

74.  Selected  bibliography  on  death  cuul  ilying 
by  Joel  J.  Vernick.  Bethesda.  Md..  U.S. 
Govt  Print.  Off..  1970.  34p. 


75.  Dept.  of  Labor.  Child  care  services 
provided  hy  hospitals.  Washington,  U.S. 
Govt.  Print.  Off..  1970.  34p. 

STUDIES  DEPOSITED  IN  CNA 
REPOSITORY  COLLECTION 

76.  A  comparison  between  television  in- 
slriiclion  and  conventional  methods  in  leach- 
ing medical  isolation-given  procedure:  an 
experimental  sliuly  by  Dale  Edwin  Allen. 
Fredericton,  1969.  47p.  (Thesis  I  M.Ed)  - 
Dalhousie)  R 

77.  A  comparison  of  the  effectiveness  of 
two  nursing  approaches  in  the  relief  of 
post-operative  pain  by  Elizabeth  Mary 
Buzzell  and  Marie  Virginia  Roberto.  Boston. 
1967.  59p.  (Thesis  (M.Sc.N)  -  Boston)  R 

78.  Effets  d'un  entrainement  systenuilique 
sur  le  comportemem  d'independance  de 
deficients  meniaux  pen  evolues  par  Estelle 
Gelinas.  Montreal.  1969.  I25p.  (Thesis 
(M.Nurs.)  -  Montreal)  R 

79.  An  experiment  in  continuity  of  care  in 
maternity  by  May  Toth.  Boston,  1969.  66p. 
(Thesis  (M.Nurs.)-  Montreal)  R 

80.  A  family  study  by  Shron  Eaton.  San 
Francisco.  1969.  24p.  (Study  in  parital  fulfil- 
ment of  MN  course  requirements.  University 
of  California)  R 

81.  Investigation  du  processus  de  formation 
tie  I'eludiante  infirmiere  a  la  prise  de  decision 
ail  cours  d'experiences  d'apprentissage  de  la 
pratique  du  nursing  par  Marie-Paule  Gre- 
goire.  Montreal.  1970.  204p.  Thesis 
(M.Nurs.)- Montreal )R  ^ 


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JULY  1971 


THE  CANADIAN  NURSE     43 


classified  advertisements 


BRITISH  COLUMBIA 


BRITISH   COLUMBIA 


ONTARIO 


ASSISTANT  DIRECTOR  OF  NURSING  Required  for 
progressive  246-bed  acute  care  hospital  with  addition 
of  135  beds  scheduled  to  commence  in  September 
1971.  Position  becomes  vacant  August  1.  1971. 
Address  enquiries  stating  qualifications,  past  expe- 
rience and  salary  expected  to:  Director  of  Nursing 
Service,  Prince  George  Regional  Hospital,  Prince 
George,  B.C. 


NURSES  WITH    I.C.U.    TRAINING    AND   O.R.   TRAIN- 

ing  and  experience  HEAD  NURSE  for  30-bed 
Extended  Care  Unit  required  for  110-bed  hospital 
with  expansion  programme  to  be  completed  this 
summer.  Salary  $590  and  up  depending  on  experi- 
ence for  37V2  hour  week.  Apply,  Director  of  Nurs- 
ing, West  Cost  General  Hospital,  Port  Alberni, 
British  Columbia. 

PEDIATRIC  INSTRUCTOR  for  Maternal-Child  Health 
Program,  with  University  preparation  lor  a  Hospital 
School  of  Nursing  with  140  students.  Apply  As- 
sociate Director,  School  of  Nursing,  St.  Joseph's 
Hospital  School  of  Nursing,  Victoria,  British  Co- 
lumbia. 

dENERAL  DUTY  NURSES  for  modern  33-bed  hospital 
located  on  the  Alaska  Highway.  Salary  and  personnel 
policies  in  accordance  with  RNABC.  Accommodation 
available  in  residence.  Apply  to:  Director  of  Nursing, 
General  Hospital,  Fort  Nelson,  B.C. 

GENERAL  DUTY  NURSES  required  for  120-bed  Gen- 
eral Hospital  with  34  bed  Extended  Care  Unit 
attached.  Salary  as  per  RNABC  contract.  Nurses' 
residence  accommodation  available.  Apply  to:  Direct- 
or of  Nursing,  Powell  River  General  Hospital,  5871 
Arbutus  Street,  Powell  River,  British  Columbia, 


1 


ADVERTISING 
RATES 

FOR   ALL 

CLASSIFIED   ADVERTISING 

$15,00  for  6  lines  or  less 
$2.50  for  each  additional  line 

Roles  for  display 
advertisements   on   request 

Closing  dale  for  copy  and  cancellation  is 
6  weeks  prior  to  1st  day  of  publication 
month. 

The  Canodian  Nurses'  Association  does 
not  review  the  personnel  policies  of 
the  hospitals  and  agencies  advertising 
in  the  Journal,  For  authentic  information, 
prospective  applicants  should  apply  to 
the  Registered  Nurses'  Association  of  the 
Province  in  which  they  ore  interested 
in   working. 


Address  correspondence  to: 

The 

Canadian/L;j 
Nurse        - 

50  THE  DRIVEWAY 
OnAWA,  ONTARIO 
K2P    1E2 


OPERATING  ROOM  NURSES  for  modern  450-bed  hos- 
pital with  School  of  Nursing.  RNABC  policies  in  ef- 
fect. Credit  for  past  experience  and  postgraduate 
training.  British  Columbia  registration  is  required. 
For  particulars  write  to:  The  Associate  Director  of 
Nursing,  St.Joseph's  Hospital,  Victoria,  British  Co- 
lumbia. 


ONTARIO 


REGISTERED  NURSES  required  by  70-bed  General 
Hospital  situated  in  Northern  Ontario.  Salary  scale  — 
$560.00-5670.00,  allowance  for  experience.  Shift 
differential,  annual  increment,  40  hour  week.  O.H.A, 
Pension  and  Group  Life  Insurance,  OH  S.C.  and 
OHSIP  plans  in  effect.  Good  personnel  policies. 
For  particulars  apply:  Director  of  Nursing,  Lady 
Minto  Hospital  at  Cochrane,  Cochrane,  Ontario, 

REGISTERED  NURSES  for  34-bed  General  Hospital. 
Salary  $525.  per  month  to  $625  plus  experience  al- 
lowance. Residence  accommodation  available.  Ex- 
cellent personnel  policies.  Apply  to:  Superintendent. 
Englehart  &  District  Hospital  Inc.  Englehart,  Ontario. 


REGISTERED   NURSES   needed   for   81-bed   General 

Hospital  in  bilingual  community  of  Northern  Ontario- 
French  language  an  asset,  but  not  compulsory.  R.N. 
salary-$557  to  $662.  monthly  with  allowance  for 
past  experience,  4  weeks  vacation  after  1  year  and 
16  sick  leave  days.  Unused  sick  leave  days  paid  at 
100%  every  year.  Master  rotation  in  effect.  Rooming 
accommodation  available  in  town.  Excellent  per- 
sonnel policies.  Apply  to:  Personnel  Director, 
Notre-Dame  Hospital,  P.O.  Box  850.  Hearst.  Ont. 


REGISTERED  NURSES  required  for  a  12-bed  In- 
tensive Care-  Coronary  Care  combined  unit.  Post 
basic  preparation  and/or  suitable  experience  essen- 
tial. 1970  salary  range  $535  —  $645;  generous  fringe 
benefits.  Apply  to:  Director  of  Administrative  Serv- 
ices and  Personnel,  St.  Mary's  General  Hospital. 
911-B  Queen's  Blvd..  Kitchener.  Ontario. 


REGISTERED  NURSES  are  required  tor  our  pro- 
gressive, fully  accredited  166-bed  General  Hospital 
located  in  beautiful  northern  Ontario.  Our  personnel 
policies  are  constantly  up-dated  and  our  fringe 
benefit  package  is  excetlent.  Working  conditions 
are  good  and  you  will  enjoy  the  friendly  atmosphere 
which  prevails  in  our  well-equipped  hospital.  1971 
salary  range  is  $557.00  to  $667.00  per  month.  Good 
opportunity  for  advancement.  Contact:  Wayne  Hall. 
Personnel  Director.  St.  Mary's  Hospital.  Timmins. 
Ontario. 


REGISTERED  NURSES  AND  REGISTERED  NURSIrtQ 
ASSISTANTS.  Our  75-bed  modern,  progressive  Hos- 
pital invites  you  to  make  application.  Salaries  for 
Registered  Nurses  start  at  $549.00.  with  yearly 
increments  and  experience  benefits.  The  basic 
salary  for  R.N. A.  is  $382.00  with  yearly  increments. 
Room  is  available  in  our  modern  residence.  We  are 
located  in  the  Vacationland  of  the  North,  midway 
between  Winnipeg  and  Thunder  Bay.  Write  or  phone: 
The  Director  of  Nursing.  Dryden  District  General 
Hospital,  Dryden.  Ontario. 


REGISTERED  NURSES  AND  REGISTERED  NURSING 
ASSISTANTS  for  45-bed  hospital.  R.N.'s  salary  $560. 
to  $660.  with  experience  allowance  and  4  semi-annu- 
al increments.  Nurses'  residence  —  private  rooms 
with  bath  —  $30  per  month.  R.N.A.'s  salary  $380.  to 
"$460.  Apply  to:  The  Director  of  Nursing,  Geraldton 
District  Hospital,  Geraldton.  Ont. 


REGISTERED  NURSES  AND  REGISTEt^ED  NURSING 
ASSISTANTS,  looking  for  an  opportunity  wo  work  in 
a  patient  Centered  Nursing  Service,  are  required  by 
d  modern  well-equipped  hospital.  Situated  in  a  pro- 
gressive Community  in  South  Western  Ontario.  Ex- 
cellent employee  tSenefits  and  working  conditions. 
Write  for  further  information  to  Director  of  Nursing; 
Leamington  District  Memcirial  Hospital;  Leamington, 
Ontario. 

REGISTERED  NURSE  FOiR  OPERATING  ROOM  also 
GENERAL  DUTY  NURSES  for  80-bed  hospital;  recog- 
nition for  experience;  good  personnel  policies;  one 
month  vacation;  basic  salary  $567.50,  July  1st, 
$570.00.  Apply:  Director  of  Nursing.  Huntsville 
District  Memorial  Hospital,  Box  1150,  Huntsville, 
Ontario, 


REGISTERED  NURSING  ASSISTANTS  for  BO-bed 
hospital;  starting  salary  $375.00  with  increments  for 
past  experienre;  three  weeks  vacation;  18  days 
sick  leave;  residence  accommodation  available. 
Apply:  Director  of  Nursing.  Huntsville  District 
Memorial    Hospital.    Box    1150.    Huntsville.    Ontario. 

REGISTERED  NURSES,  for  GENERAL  DUTY  and 
I.C.U..    ind    REGISTERED    NURSING    ASSISTANTS 

iffuuired  for  160-bed  accredited  hospital.  Startiitg 
salary  $525.00  and  $365.00  respectively  with 
regular  annual  increments  for  both.  Excellent 
personnel  policies.  Temporary  residence  accommo- 
dation available.  Apply  to:  Director  of  Nursing. 
Kirkland  and  District  Hospital.  Kirkland  Lake. 
Ontario. 

REGISTERED  NURSES  AND  REGISTERED  NURSING 
ASSISTANTS    required    for    GENERAL    DUTY    in    a 

313-bed  fully  accredited  hospital.  Good  salary 
commensurate  with  experience,  excetlent  fringe 
benefits  and  gracious  living  in  the  Festival  City 
of  Canada,  Apply  in  writing  to  the:  Director  of 
Personnel,  Stratford  General  Hospital.  Stratford. 
Ontario. 

GENERAL  DUTY  REGISTERED  NURSES  required 
lor  175-bed  accredited  hospital.  Recognition  given 
for  experience  and  postgraduate  education.  Orienta- 
tion   and    In-Service    Educational    programmes    are 

provided.  Progressive  personnel  policies.  For  further 
information  write  to:  Personnel  Director.  Temiskaming 
General  Hospital.  Haileybury.  Ontario. 


GENERAL  DUTY  NURSES  for  95-bed  hospital 
equipped  with  all  electric  beds  throughout.  Starting 
salary  $550.00  per  month.  Excellent  personnel  poli- 
cies, and  residence  accommodation.  Only  10  minutes 
from  downtown  Buffalo.  Apply:  Director  of  Nursing. 
Douglas  Memorial  Hospital.  Fort  Erie.  Ont. 


EXPERIENCED  GENERAL  STAFF  NURSES  FOR 
OPERATING  ROOM  AND  INTENSIVE  CARE  AREA  — 

for  modern,  accredited  242-bed  General  Hospital. 
Good  personnel  policies,  recognition  tor  experience 
and  post-basic  preparation.  Apply:  Director  of 
Nursing,  Sudbury  Memorial  Hospital,  Regent  Street. 
S.,  Sudbury.  Ontario. 


PUBLIC  HEALTH  NURSES  required  by  International 
Grenfell  Association  for  areas  in  Northern  New- 
foundland and  Labrador.  Programme  based  on  New- 
foundland Department  of  Health  requirements. 
Vehicles  provided.  Residence  accommodation. 
Apply:  Mrs.  Ellen  E.  McDonald.  International  Grenfell 
Association,  Room  701,  88  Metcalfe  Street,  Ottawa 
4.  Ontario. 


PUBLIC  HEALTH  NURSES  (QUALIFIED)  for  generaliz- 
ed programme,  allowance  for  experience  and/or 
degree,  usual  fringe  benefits.  Direct  enquiries  to: 
Miss  Reta  Coyne.  Director,  Public  Health  Nurses. 
P  O.  Box  128.  Renfrew  County  and  District  Health 
Unit.  Pembroke.  Ontario. 


PUBLIC  HEALTH  NURSES  required  for  expanding 
health  unit  —  generalized  program  with  emphasis  on 
mental  health.  Excellent  personnel  policies  including 
car  mileage.  Starting  salary  for  B.Sc.N.  $7,800.00 
-$9  180.00.  Apply  to:  Dr.  G.B  Lane.  Medical  Officer 
of  Health.  Porcupine  Health  Unit.  70  Balsam  Street 
South.  Timmins.  Ontario. 


QUEBEC 


1 


REGISTERED  NURSES  for  30-bed  General  Hospital. 
Huntingdon  is  45  miles  south  west  of  Montreal. 
Salaries  as  approved  by  QH.I.S.  4  weeks  annual 
vacation.  Accumulated  sick  leave.  Blue  Cross  par- 
tially paid.  Full  maintenance  available  for  $43.50 
per  month.  Apply  to:  Mrs.  D.  Hawley.  R  N.,  Hunting- 
don County  Hospital.  Huntingdon.  Quebec. 


UNITED  STATES 


44     THE  CANADIAN   NURSE 


NURSES  for  new  171-Oed  General  Hospital.  Resort 
area.  Ideal  climate.  On  beautiful  PaciTIc  ocwn. 
Apply  to:  Director  of  Nurses.  South  Coast  Community 
Hospital,  South  Laguna,  California. 

JULY  1971 


August  1971 


Do      r.  ^.     . 


«A«r 


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SCHOOL  OF  NURSING  LIBRARY 
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vasectomy 


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Guyton:  BASIC  HUMAN  PHYSIOLOGY 

Normal  Function  &  Mechanisms  of  Disease 

In  clear,  easy-to-understand  language,  the  author 
shows  exactly  how  the  human  body  functions.  Spec- 
ifically designed  for  students  in  the  health  profes- 
sions, this  new  book  is  a  careful  condensation  of 
Guy  ton's  respected  Textbook  of  Medical  Physiology. 
The  emphasis  is  on  general  and  cellular  physiology 
and  biochemistry;  topics  include  material  on  bone, 
teeth  and  oral  physiology,  as  well  as  the  physiology 
of  sex.  Remarkably  clear  explanations  are  broken 
into  short  sections  and  coupled  with  diagrams.  The 
combination  insures  easy  reference  and  quick  com- 
prehension for  students. 

By  Arthur  C.  Guyton,  University  of  Mississippi  Medical  Center. 
721     pp.    431    figs.    $13.15.    March,     1971. 

Cole:  THE  DOCTOR'S  SHORTHAND 

This  new  manual  is  a  handy  guide  to  medical  ab- 
breviations, notations  and  symbols.  Nurses  will  find 
it  indispensable  in  reading  medical  records  and 
orders.  For  each  abbreviation,  the  author  provides 
a  simple  two  or  three  word  translation.  Where  an 
abbreviation  has  several  meanings,  the  most  com- 
monly used  is  listed  first.  Nearly  6,000  entries  have 
been  included,  ranging  from  AAA  (for  amalgam, 
abdominal  aortic  oneurism,  American  Academy  of 
Allergy,  or  androgenic  anabolic  agent)  to  Z  Z'  Z" 
(for  increasing  degrees  of  contraction).  A  special 
section  depicts  and  defines  medical  symbols. 

By  frank  Cole,  Editor,  Nebraska  State  Medical  Journal.  179  pp. 
$4.65.  October,   1970. 


Guyton:  New  4th  Edition 

TEXTBOOK  OF  MEDICAL  PHYSIOLOGY 

The  New  4th  Edition  of  this  classic  medical  refer- 
ence presents  the  body  as  a  single  functioning  or- 
ganism controlled  by  a  myriad  of  regulatory  systems. 
It  emphasizes  the  mechanisms  that  promote  home- 
ostasis, since  irregularities  in  these  systems  ore  the 
usual  manifestations  of  disease.  This  new  edition 
incorporates  the  latest  scientific  findings.  The  chap- 
ters on  general  and  cellular  physiology  have  been 
extensively  revised  and  the  chapter  on  circulation 
rewritten  to  stress  control  systems.  This  text  offers 
the  practicing  nurse  solid  help  in  strengthening  her 
understanding  of  physiology. 

By  Arthur  C.  Guyton,  University  of  Mississippi  Medical  Center. 
1032    pp.   757   figs.    $19.05.  January,    1971. 

MAYO  CLINIC  DIET  MANUAL 

New    4th    Edition 

Here  is  the  new  edition  of  the  most  popular  and 
respected  dietetic  guidebook  available  today.  This 
manual  presents  hundreds  of  diets  to  help  you  plan 
the  meals  the  doctors  orders.  Diets  are  classified 
by  disease  and  disorder.  In  this  edition,  the  Mayo 
Clinic  Food  Exchange  Lists  form  the  basis  for  plan- 
ning most  therapeutic  diets.  A  section  devoted  to 
diets  with  controlled  protein,  sodium  and  potassium 
for  the  management  of  renal  disease  has  been 
added.  New  diets  for  use  during  pregnancy  have 
been  devised,  and  diets  for  children  are  included. 

By  the  Committee  on  Dietetics  of  the  Mayo  Clinic.  166  pp. 
Soft  cover.  $6.15.  January,  1971, 


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AUGUST  1971 


THE  CANADIAN  NURSE     1 


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The 

Canadian 
Nurse 


^ 

^^7 


A  monthly  journal  for  the  nurses  of  Canada  published 

in  English  and  French  editions  by  the  Canadian  Nurses'  Association 

Volume  67,  Number  8  August     1971 

17     Nurse  at  Sea S.  Fraser 

20     Vasectomy lA.D.  Todd 

24     Specially  for  the  Newborn  —  Intensive 

Care  Nurseries , A.C.  Youngblut 

28     Pain  and  Suffering  in  Cancer F.  Turnbull 

32     Inservice  Education  Benefits 

All  Teachers - L-  Oatway 

35     Audio  Slides  Streamline  Interviews M.J.  Henricks 

37     Rehabilitation  of  a  Quadriplegic J.R.  Ford,  T.D.V.  Cooke 

39     Hey.  Nurse! 

The  views  expressed  in  the  various  articles  are  the  views  of  the  authors  and  do  not 
necessarily  represent  the  policies  or  views  of  the  Canadian  Nurses"  Association. 


4 

Letters 

7. 

News 

14 

Names 

15 

Dates 

40 

New  Products 

43 

In  a  Capsule 

44 

Research  Abstracts 

46 

Books 

49 

AV  Aids 

50 

Accession  List 

Executive  Director:  Helen  K.  Mussallem  • 
Editor:  Virgiilia  A.  Luidabiir>'  •  Assistant 
Editors:  Liv-EUen  Lockeberg,  Dorothy  S. 
Starr.  •  Editorial  Assistant:  Carol  A.  Kotlar- 
sky  •  Production  Assistant:  Elizabeth  A. 
Stanton  •  Circulation  Manager:  Beryl  Dar- 
ling •  Advertising  Manager:  Ruth  H.  Baumel 

•  Subscription  Rates:  ^Canada:  one  year. 
$4.50;  two  years,  $8.00.  Foreign:  one  year, 
$5.00;  two  years,  $9.00.  Single  copies;  50 
cents  each.  Make  cheques  or  money  orders 
payable  to  the  Canadian  Nurses'  Association. 

•  Change  of  Address:  Six  weeks'  notice;  the 
old  address  as  well  as  the  new  are  necessary, 
together  with  registration  number  in  a  pro- 
vincial nurses'  association,  where  applicable. 
Not  responsible  for  journals  lost  in  mail  due 
to  errors  in  address. 


Manuscript  Information:  "The  Canadian 
Nurse"  welcomes  unsolicited  articles.  All 
manuscripts  should  be  typed,  double-spaced, 
on  one  side  of  unruled  paper  leaving  wide 
margins.  Manuscripts  are  accepted  for  review 
for  exclusive  publication.  The  editor  reserves 
the  right  to  make  the  usual  editorial  changes. 
Photographs  (glossy  prints)  and  graphs  and 
diagrams  (drawn  in  India  ink  on  white  paper) 
are' welcomed  with  such  articles.  The  editor 
is  not  committed  to  publish  all  articles 
sent,  nor  to  indicate  definite  dates  of 
publication. 

Postage  paid  in  cash  at  third  class  rate 
MONTREAL,  P.Q.  Permit  No.  10,001. 
50  The  Driveway,  Ottawa,  Ontario.  K2P  1E2 
g   Canadian  Nurses'  Association  1971. 


AUGUST  1971 


THE  CANADIAN   NURSE 


letters    { 


Letters  to  the  editor  are  welcome. 

Only  signed  letters  will  be  considered  for  publication,  but 

name  will  be  withheld  at  the  writer's  request. 


Minister  acknowledges  CNA's  concern 
The  following  letter  was  received  by 
the  executive  director  of  the  Canadian 
Nurses'  Association,  Dr.  Helen  K. 
Mussallem,  in  response  to  a  letter  she 
sent  on  behalf  of  the  CNA  board  of 
directors  about  the  association's  "deep 
concern  for  the  problems  of  environ- 
mental pollution."  In  her  letter,  Dr. 
Mussallem  said  that  CNA  members 
can  be  "influential  proponents  for 
strong  citizen  support  for  the  swift, 
perhaps  drastic,  measures  neccessary  to 
reverse  the  pollution  process,"  and 
assured  the  minister  of  the  associa- 
tion's support  in  introducing  measures' 
"to  ensure  a  hospitable  environment  in 
which  to  live." 

I  was  most  gratified  to  receive  your 
letter  of  support  for  the  Department  of 
the  Environment  in  its  mission  of  creat- 
ing a  pleasant,  hospitable  environment 
in  which  Canadians  can  live.  The  tasks 
which  we  face  are  formidable,  both  in 
quality  and  quantity,  and  I  am  sure  you 
will  appreciate  that  it  is  not  possible  to 
rectify  ail  our  past  omissions  and  errors 
overnight.  I  believe  your  association  can 
help  us  very  materially  in  our  task  by 
encouraging  a  continuing  interest  on  the 
part  of  the  general  public  in  environ- 
mental concerns  during  the  months  and 
years  ahead. 

I  am  confident  that  the  future  will 
sec  many  and  extensive  improvements 
in  our  environment,  and  that  these 
improvements  will  provide  substantial 
benefits  to  human  health,  in  both 
physical  and  psychological  senses.  In 
this  regard  it  will,  of  course,  be  parti- 
cularly important  for  my  Department 
to  work  closely  with  the  proposed  Ur- 
ban Affairs  Secretariat,  because  of  the 
complex  interdependence  between  the 
two  fields. 

I  should  be  grateful  if  you  would 
convey  my  appreciation  of  the  support 
of  your  Association  to  the  Board  of 
Directors  and.  in  due  course,  to  your 
total  membership. — Jack  Davis,  Min- 
ister Environment  Canada.  House  of 
Commons.  Ottawa. 

"Hey,  Nurse!" 

"Hey.  Nurse!"  by  "Nurse  Whozits" 
(June  1971)  challenged  nurses  to  look 
at  the  way  in  which  they  assess  patients. 
Two  basic  principles  give  guidance  to 
the  nurse  in  these  situations.  Under- 
standing and  interpretation  are  the  first 

4     THE  CANADIAN   NURSE 


Steps,  and,  following  these,  the  nurse 
plans  her  method  of  dealing  with  patient 
behavior.  She  then  communicates  her 
method  to  others  and  assesses  the  re- 
sults. 

The  thoughtless  labelling  of  patients 
and  their  families  is  a  common  occur- 
rence in  nursing  units.  Why  do  so  many 
nurses  function  at  the  level  of  the  un- 
tutored in  the  area  of  human  behavior 
and  relationships?  It  would  be  interest- 
ing to  know  the  answers  to  this  ques- 
tion, and  I  look  forward  to  this  new 
series  by  "Nurse  Whozits". 

—  Madeline  Wilson,  assistant  director, 
nursing  education.  The  Montreal  Chil- 
dren's Hospital,  Montreal,  Quebec. 

Bag  and  baggage 

Table  B.  "Readers'  Preference:  Cate- 
gories of  Articles  in  The  Canadian 
Nurse"  ("What  readers  like  —  and 
want  changed  —  in  The  Canadian 
Nurse."  June,  1971)  summed  it  all  up 

—  "Because  of  lack  of  space,  the  12th 


Have  you  a  Christmas 
Story  Or  Message 
To  Share? 

The 

Canadian 
Nurse 


invites  readers  to  submit  original  ar- 
ticles about  Nursing  at  Christmas 
for  possible  publication  in  the  De- 
cember 1971    issue. 

Manuscripts  should  be  typed  double- 
space  on  one  side  of  unruled  paper, 
leaving  wide  margins.  The  usual  rate 
will  be  paid  for  accepted  material. 

Suggested  length:  1000-2500  words. 

Deadline  date:  October  1,  1971. 

Send  manuscript  to:  Editor,  The 
Canadian  Nurse,  50  The  Driveway, 
Ottawa,  Ontario,  K2P  1E2. 


and  13th  listings  have  been  omitted." 
Taking  up  this  space  is  a  marvellous 
table  dealing  with  "Attitudes  of  Readers 
About  the  Canadian  Nurses'  Associa- 
tion," which  is  based  on  questions  ad- 
mittedly planted,  changing  the  survey 
of  readership  of  The  Canadian  Nurse 
into  a  semi-slick,  approval-seeking 
gimmick  by  the  girls  down  at  head- 
quarters. What  you  want  is  obviously 
all  we  get. 

In  a  study  that  shows  readers  want 
clinical  articles,  opinion  pages,  edito- 
rials, etc.,  I  can  only  assume  that  the 
readership  wants  something  other  than 
The  Canadian  Nurse.  (Personally,  I  like 
the  letters).  —  Lef  Ann  R.  Siegal, 
R.N..  B.Sc.N.Ed.,  Montreal,  Quebec. 

The  Canadian  Nurse  has  improved  so 
much  during  the  last  10  years  that  I 
hardly  think  a  suggestion  for  more 
improvement  is  necessary.  However, 
you  asked  for  it  in  the  June  1971  issue! 
I  find  the  book  reviews  so  helpful 
that  I  was  wondering  if  such  comments 
would  be  possible  regarding  films, 
cassette  tapes,  and  other  visual  aids.  As 
the  students  arc  encouraged  to  do  more 
independent  study,  these  aids  will  be- 
come even  more  important  to  us.  — 
Jean  Mackic.  Selkirk  College,  Castle- 
gar.  B.C. 

This  is  an  excellent  idea.  Readers  who 
wis!)  !()  contribute  comments  or  reviews 
on  new  films  and  other  new  audiovisual 
aids  (ire  invited  to  do  so.  —  Editor. 

Thank  you  for  the  article  "The  Sub- 
cutaneous Injection"  (May,  1971)  and 
"Do  You  Have  a  Bad  Trip  If  You  Go 
To  Hospital?"  (June,  1971).  These  ar- 
ticles keep  us  up-to-date.  —  Reg.  N., 
Downsview.  Ontario. 

Wants  more  patient-care  studies 

As  a  Ibrmer  student  nurse  in  Montreal 
iMul  now  a  student  nurse  in  England. 
I  must  express  m\  dismay  at  the  current 
slaphapp>.  conceited  attitude  of  my 
graduate  colleagues  in  Canada. 

Because  I  am  now  looking  in  from 
(he  outside.  I  am  distressed  by  all  the 
talk  about  professionalism  and  adminis- 
tration. What  about  the  patients?  Why 
aren't  there  more  patient-care  studies 
in  The  Canadian  Nurse  that  are  helpful 
to  both  graduates  and  students? 

It  amuses  and  annoys  me  that  so 
much  emphasis  is  placed  on  the  posses- 
sion of  a  degree  in  nursing.  Ii  seems  lo 
be  simply  a  status  symbol." 

AUGUST  1971 


I  am  Ircquciitly  asked  b>  ni>  British 
issocialcs  about  nursing  in  Canada.  1 
o\c  to  talk  about  m_\  counti>  and  its' 
lospitals.  but  I'm  beginning  to  feci 
iuiltv  about  this,  because  nuising  in 
C^anada  is  not  the  mccea  I  imaginct!  it 
to  be. 

I  intend  to  return  to  Canada  in  a 
tew  years,  and  I  hope  that  by  that  time 
the  patient  will  be  the  center  of  nurs- 
ing, not  the  nurse  —  Susan  E.M.  Rcn- 
siiik.  London.  England. 

Curses  —  check  your  image 

I  must  speak  my  mind  about  the  way 
nurses  are  dressing.  They  should  either 
wear  a  uniform  properly  or  not  wear 
one  at  all. 

1  have  seen  a  fancy,  white  dress 
that  was  not  a  uniform;  long  hair  falling 
around  the  face  (a  small  cap  looks 
great  with  this!):  silver  bangles  on  both 
arms:  numerous  rings  with  big  stones: 
and  heavy  makeup. 

During  my  training,  we  had  to  use 
a  hair  net,  and  could  wear  only  a  plain 
band  because  patients  can  be  scratched 
by  other  rings.  Long  sleeves  were  re- 
quired and  makeup  was  forbidden.  Even 
white  shoes  today  can  hardly  be  recog- 
nized as  such. 

Today's  nurses  are  fashion  models 
who  spend  more  time  in  front  of  a 
mirror  than  they  spend  caring  for  their 
patients.  But  1  am  not  behind  the  times, 
because  I  think  a  pantsuit,  neat  hair, 
clean  shoes,  and  cap  look  fine. 

1  blame  much  of  this  on  some  cour- 
ses for  practical  nurses,  which  don't 
even  teach  students  how  to  dress.  Let's 
hope  someone  will  establish  a  set  of 
basic  rules  for  students.  —  E.  Ames, 
R.N. A.,  Port  Credit,  Ontario. 


Enjoyed  "The  Leaf  and  the  Lamp" 

1  strongly  disagree  with  Heather  F. 
Clarke's  letter  (June,  1971)  about  the 
Canadian  Nurses"  Association's  film. 
The  Leaf  and  the  Lamp.  As  a  young 
and  active  nurse,  I  found  the  film  color- 
ful, interesting,  and  all-encompassing. 
After  all,  you  cannot  do  the  impossible 
in  20  minutes! 

The  pace  was  rapid  —  in  fact  1 
viewed  the  film  four  times,  and  each 
time  I  found  something  new  that  1 
had  missed.  As  I  mentioned  before,  the 
film  was  colorful,  and  this  in  itself 
stimulated  interest.  The  music  was  very 
catchy. 

I  showed  this  film  to  my  senior 
(graduating)  nursing  students  and  they 
found  it  so  educational  and  informative 
that  they  asked  to  see  it  a  second  time. 
They  thought  that  The  Leaf  and  the 
Lamp  portrayed  the  professional  nurse 
in  all  the  phases  of  activity  in  which 
she  will  (or  should)  be  engaged  after 
registration. 

1  also  showed  this  film  to  my  fellow 

AUGUST  1971 


faculty  members  who  thought  it  was  an 
excellent  example  of  the  responsibili- 
ties of  every  professional  nurse.  (Since 
the  film  showing,  two  faculty  personnel 
have  joined  their  professional  organiza- 
tion.) 

IMiss Clarke  stated.  "The  only  indica- 
tion that  a  practicing  nurse  was  involv- 
ed ..  .  was  at  the  beginning,  and  this 
hardly  showed  the  responsibilities  of 
a  professional  nurse."  1  do  not  believe 
the  film  was  produced  to  show  the 
nursing  responsibilities  of  bedside 
nursing.  What  about  the  references 
in  the  film  to  nurses  in  other  fields 
of  nursing,  such  as  public  health,  in- 
dustrial nursing  and  northern  nursing' 
Do  we  still  need  a  uniform  to  hide  be- 
hind to  show  that  we  are  all  nurses? 

In  reference  to  "exchanging  dialogue 
across  large  tables,"  is  not  the  true 
basis  of  our  professional  organizations 
sound  communication?  Whether  we 
choose  large  conference  tables  or  small- 
er social  gatherings,  our  emphasis  is 
on  sharing  of  ideas,  aims,  and  purposes. 

Let's  give  the  CNA  a  break!  The 
Leaf  and  the  Lamp  is  a  film  well-done 
and  worth  every  cent  of  the  SI 3,373 
that  went  into  its  production.  — 
Shirley  E.  Smilli.  Rei;.N..  B.Si.N., 
Brockville,  Ontario. 

Red  Deer  College  survey 

We  have  just  completed  summarizing  a 
questionnaire  distributed  to  the  first 
three  classes  of  students  who  enrolled 
at  Red  Deer  College.  Perhaps  readers 
would  be  interested  to  know  something 
about  the  students  who  take  nursing 
programs  in  colleges. 

When  the  data  were  analyzed,  the 
profile  of  the  students  indicated  that 
the  majority  were  young  women  bet- 
ween the  ages  of  17  and  19  years.  A 
few  of  the  students  were  over  the  age 
of  25.  Some  were  married,  widowed, 
divorced,  or  separated:  however,  the 
majority  of  the  total  group  were  single. 
The  students  indicated  that  they  came 
from  the  city  of  Red  Deer  or  from  Al- 
berta towns.  Very  tew  came  frimi  out- 
side the  province.  The  occupation  of 

their  fathers  was  that  of  farmer. 

The  major  reasons  tor  choosing  to 
enroll  in  "the  college  program  were 
stated  as  being  in  relation  to  the  time 
and  the  length  of  the  program,  the 
convenience  of  the  kxration  of  the  col- 
lege, the  type  and  quality  of  the  pro- 


RED  CROSS 

IS  ALWAYS  THERE 
WITH  YOUR  HELP 


+ 


gram,  and  the  cost  of  the  program. 
Although  most  of  them  preferred  to 
come  into  a  two-year  college,  a  few 
would  have  preferred  to  go  into  a  four- 
year  university  program. 

The  high  school  education  of  most 
students  was  a  senior  matriculation 
standing  witli  an  average  between  60 
and  10  percent.  Most  students  had 
attended  high  school  in  Alberta  towns 
or  in  Red  Deer.  The  question  of  fi- 
nancial support  showed  that  most  stu- 
dents were  partly  responsible  for  their 
own  support  during  their  course,  but  a 
large  majority  also  had  assistance  from 
their  parents,  from  loans,  and  from 
relatives.  Three  quarters  of  the  group 
expected  to  be  working  after  gradua- 
tion, and  15  percent  of  them  were 
planning  to  continue  to  go  on  for  fur- 
ther education.  —  Mcnyiicriie  E.  Silui- 
macher.  Chairman,  Ninsini;  Depart- 
ment, Red  Deer  Collef^e,  Red  Deer. 
Alberta. 

Nurses  active  in  CPHA 

After  attending  the  62nd  annual  meet- 
ing of  the  Canadian  Public  Health 
Association  in  Toronto  recently,  and 
after  being  active  in  this  organization 
for  over  seven  years.  I  would  like  to 
emphasize  the  importance  of  the  pub- 
lic health  nurse's  role,  which  has  de- 
veloped within  the  association  in  the 
last  few  years. 

The  election  last  year  of  Geneva 
Lewis.  RN,  as  president  of  the  CPHA 
can  be  seen  as  official  recognition  of 
the  competence  of  the  Canadian  public 
health  nurse.  Members  were  unanimous 
in  praising  Mrs.  Lewis  for  the  way 
she  managed  the  association's  affairs 
in  the  past  year  and  for  her  exceptional 
qualities  as  a  public  health  administrat- 
or and  leader. 

The  election  of  Mrs.  Lewis  is  only 
one  example  .of  the  active  participa- 
tion of  nurses  in  the  association.  During 
the  last  10  years,  public  health  nurses 
have  been  active  in  all  areas  of  the 
association,  including  business  affairs, 
formation  of  policies  for  scientific  pro- 
grams, and  participation  in  standing 
committees. 

There  are  now  nurses  on  CPHA's 
executive  council  and  executive  com- 
mittee of  the  council,  on  all  four  stan- 
ding committees,  and  on  the  publica- 
tion committee  of  the  Canadian  Jour- 
nal of  PidUic  Health.  As  the  composi- 
tion of  all  the  committees  is  multi- 
disciplinary,  nursing  representation 
is  valuable. 

Nurses  have  gained  recognition 
through  their  qualifications  and  their 
active  participation  in  the  work  of  the 
nursing  division  and  within  various 
committees  such  as  research  and  labor. 
—  Olivette  Gareaii,  Pnhlie  Health 
Niirsinti  Service  Coordinator.  Prevent- 
ive Health  Division,  Quebec.  ^ 
THE  CANADIAN  NURSE     5 


y 


The  facts  about 
SpfraTulle* Pieces  compared 
vs^th  creams  and  ointments. 


Sofra-Tulle  Pieces  are  bactericidal  dressings 
which  are  individually  foil  sealed  to  maintain  ste- 
rility. They  are  ideally  suited  for  the  treatment  of 
conditions  such  as  burns,  ulcers  and  infected  skin 
lesions. 

We  thought  you'd  like  to  make  your  own  com- 
parison between  the  use  of  Sofra-Tulle  and  the  use 
of  creams  and  ointments  covered  with  a  protective 
dressing. 

Each  Sofra-Tulle  piece  stays  sterile  until  the  moment  of  use 
because  it's  sheathed  in  sterile  parchment. 

Creams  and  ointments,  normally  applied  with  fingers,  prevent 
effective  sterility. 

Sofra-Tulle  provides  even  distribution  of  the  antibiotic. 
Creams  and  ointments  cannot  be  applied  evenly. 
Each  Sofra-Tulle  piece  is  a  dressing  in  itself  that  is  clean  and 
easy  to  handle,  cut  and  shape. 

Creams  and  ointments  must  be  squeezed  out  of  tubes  or  dug 
out  of  jars.  They  are  messy  to  apply  and  wasteful. 

Old-fashioned  creams  and  ointments  are  out.  New  Sofra-Tulle 
Pieces  are  in. 

,^^  ROUSSEL 


•Reg.  Can.  T.M.  Off. 

For  full  prescribing  information,  please  see  page  41 


Roussel  (Canada)  Ltd. 

153  Graveline 
Montreal  376,  Quebec 


news 


Provincial  Associations  Veto 
CNA's  Abortion  Statement 

Ottawa  —  The  Canadian  Nurses'  Asso- 
ciation at  its  April  board  of  directors 
meeting  prepared  a  statement  asking 
for  an  amendment  to  the  Criminal 
Code  that  would  in  effect  allow  the 
decision  on  an  abortion  to  be  made  by 
the  physician  and  the  woman  request- 
ing the  abortion. 

The  proposed  statement  was  referred 
to  the  provincial  associations  and  if 
approved  by  a  majority  of  the  provinces 
would  have  been  released  in  late  June 
as  CNA"s  official  stand. 

The  abortion  issue  was  first  raised 
by  delegates  at  the  1 970  CNA  conven- 
tion in  Fredericton.  A  resolution  ask- 
ing for  removal  of  the  sections  relating 
to  abortion  from  the  Criminal  Code 
was  sent  to  the  CNA  board  for  further 
study. 

The  proposed  statement  was  similar 
to  that  developed  by  the  Registered 
Nurses"  Association  of  British  Colum- 
bia, which  said  legislation  relating  to 
abortion  should  be  made  sufficiently 
permissive  to  allow  the  final  decision 
to  be  decided  by  the  woman  who  re- 
quests an  abortion  and  the  doctor  who 
understands  the  circumstances  under 
which  the  procedure  can  be  safely 
performed. 

The  Criminal  Code  should  be  amend- 
ed so  that  its  sections  on  abortion  do  not 
apply  to  qualified  medical  practitioners 
said  the  RNABC.  The  association 
favored  the  retention  of  an  amended 
section  to  protect  society  against,  and 
to  punish,  the  illegal  abortionist. 

The  New  Brunswick  Association  of 
Registered  Nurses  decided  at  its  annual 
meeting  to  poll  each  member.  The 
proposed  statement,  some  background 
information,  and  ballot  were  sent  out 
to  3,425  NBARN  members.  Of  the 
1 , 1 80  ballots  returned,  74  percent  were 
in  favor  of  the  statement.  NBARN  plans 
to  issue  its  own  official  statement,  (see 
NBARN  story,  p.  10). 

The  Association  of  Nurses  of  Prince 
Edward  Island  also  polled  its  members 
and  the  statement  was  endorsed  by 
65  percent  of  the  183  questionnaires 
returned. 

The  Alberta  Association  of  Register- 
ed Nurses  circulated  the  statement  to 
district  executive  committees,  staff 
nurses"  associations  and  to  members 
at  the  AARN  annual  meeting.  A  con- 
sensus was  obtained  and  the  statement 

AUGUST  1971 


Toronto  Hospital's  Magazine  Wins  Award 


•  -^ 


\\  ia.Li>:sLi:\ 
^ORLD 


/ 


A  new  approach  to  the  Wcllesley  Hospitals  maga/inc  fiaiu  olTas  the  Wellesley 
World  won  first  prize  in  a  contesl  sptmsorcd  by  Hospital  Administration  in  j 
Canada.  Managing  editor  Dorothy  Sangstcr.  (left),  and  Wcllesley  graduate 
Alexandra  Hunter  look  over  the  changed" tbrmat.  which  includes  a  new  cover, 
printing  by  the  offset  priKCss.  a  pictorial  center  spread,  and  a  monthly  feature 
on  a  hospital  department  called  'Focus  on  ....""  The  magazine  is  published  i 
four  times  a  year  and  has  a  circulation  of  approximately  2,000. 


was  approved  by  the  AARN  provincial 
council. 

The  board  of  directors  of  the  Reg- 
istered Nurses"  Association  of  Ontario 
voted  34  to  18  against  approving  the 
statement.  The  resolution  of  the  board 
was  carried  at  the  RNAO  annual  meet- 
ing with  an  amendment  that  said, 
"because  the  association  does  not  wish 
to  make  a  statement  on  abortion  at 
this  time." 

The  Manitoba  Association  of  Regis- 
tered Nurses  could  not  reach  a  decision 
on  the  statement  at  its  annual  meeting. 
A  MARN  committee  had  studied  the 
issue  but  no  unified  position  could  be 
taken  because  of  conflicting  viewpoints. 
MARN  has  asked  its  members  to  sub- 
mit personal  views  on  the  issue  to  the 
federal  government. 

The  Registered  Nurses"  Asstx;iation 
of  Nova  Scotia  sent  the  statement  and 


a  ballot  to  its  4,500  members.  The 
CNA  statement  w  as  approved  by  969  of 
the  1,237  ballots  returned.  At  the 
RNANS  annual  meeting,  attended  by 
300  members,  the  statement  was  again 
discussed.  A  resolution,  passed  by 
46  to  41.  asked  CNA  to  refrain  from 
taking  a  stand  on  the  abortion  contro- 
versy. 

The  Association  of  Nurses  of  the 
Province  of  Quebec  referred  the  state- 
ment to  its  committee  of  management 
which  felt  it  could  not  take  a  stand  at 
this  time. 

The  Saskatchewan  Registered 
Nurses"  Association  sent  a  questionnaire 
to  its  membership  and  received  a  reply 
from  1,277  members  (approximately 
20  percent  of  membership).  There  was 
no  basis  for  a  position  from  these  res- 
ponses. At  the  SRNA  chapter  presi- 
dents" meeting  the  CNA  statement  was 
THE  CANADIAN  NURSE     7 


news 


supported  by  a  majority  of  two  votes, 
not  the  two-thirds  majority  SRNA  re- 
quired. Lacking  strong  support  for  the 
CNA  statement  SRNA  decided  not  to 
approve  it  at  this  time. 

The  council  of  the  Association  of 
Registered  Nurses  of  Newfoundland 
withheld  endorsement  of  the  statement 
because  it  did  not  wish  to  take  a  stand 
on  the  issue  of  abortion  at  this  time. 

Two  other  national  health  associa- 
tions, the  Canadian  Medical  Associa- 
tion and  the  Canadian  Psychiatric 
Association,  have  asked  for  change  in 
the  laws  dealing  with  abortion.  The 
CMA  wants  abortion  committees 
abolished  and  the  CPA  wants  abortion 
to  become  strictly  a  medical  procedure. 

CNF  Announces 

Two  MacLaggan  Fellows 

Ottawa  —  For  the  first  time,  the  Ca- 
nadian Nurses"  Foundation  has  awarded 
dual  Katharine  E.  MacLaggan  Fellow- 
ships. Jennine  Baudry,  Boucherville, 
Quebec,  and  Joan  Fowler  Shaver,  Cal- 
gary, Alberta,  will  each  receive  $4,500 
awards  for  graduate  studies  in  the 
1 97  I  -72  academic  year. 

Madame  Baudry  will  study  for  a 
doctorate  in  education  degree,  major- 
ing in  audiovisual  techniques  at  the 
University  of  Montreal.  Since  June 
1967,  she  has  worked  as  a  clinical  co- 
ordinator, basic  baccalaureate  program, 
faculty  of  nursing.  University  of  Mont- 
real. In  May  1970  she  obtained  her 
master  in  education  degree  from  the 
same  university. 

Mrs.  Shaver  will  study  for  a  doctor 
of  philosophy  degree,  majoring  in 
physiology  and  biophysics  at  the  Uni- 
versity of  Washington,  Seattle,  Wash- 
ington, U.S.A.  A  former  teacher  at 
Holy  Cross  Hospital  School  of  Nursing 
Calgary,  Aha.,  she  received  her  master 
of  nursing  degree  from  the  University 
of  Washington. 

CNF  awarded  $47,500  to  15  Ca- 
nadian nurses  to  pursue  graduate  studies 
during  the  coming  academic  year. 
Selection  is  based  on  leadership  po- 
tential and  scholastic  ability.  Recipients 
of  CNF  awards  are: 

•  Edith  V.  Benoit.  Winnipeg,  Man.,  a 
$3,000  fellowship  to  study  for  a  master 
of  science  in  nursing  degree  at  the 
Universityof  Western  Ontario,  London, 
Ontario. 

•  Fran(;oise  Bergeron,  Montreal,  Que., 
a  $3,000  award  to  study  for  a  master  of 
nursing  sciences  uegree,  majoring  in 
education,  at  the  University  of  Mont- 
real . 

8     THE  CANADIAN   NURSE 


•  Lesley  F.  Degner,  Winnipeg,  Man., 
a  $1,750  fellowship  to  study  for  a 
master  of  arts  degree,  majoring  in 
medical -surgical  nursing,  at  the  Uni- 
versity of  Washington,  Seattle,  Wash- 
ington, U.S.A. 

•  Sister  M.  Felicitas,  Montreal,  Que., 
two  awards:  the  $1,500  Dorothy  Mac- 
Rae  Warner  Fellowship  and  a  $1,500 
CNF  fellowship  to  study  for  a  master's 
degree  for  the  pastoral  studies,  major- 
ing in  pastoral  counseling,  at  St.  Paul 
University,  Ottawa. 

•  Judith  M.  Hibberd,  Toronto,  Ont., 
a  $3,000  fellowship  to  study  for  a  mas- 
ter in  health  services  administration 
degree,  majoring  in  nursing  service 
administration,  at  the  University  of 
Alberta,  Edmonton,  Alta. 

•  Janet  L  Leitch,  Winnipeg,  Man.,  a 
$  1 ,750  award  to  study  for  a  master  of 
arts  degree,  majoring  in  maternal  and 
child  teaching,  at  the  University 
of  Washington,  Seattle,  Washington, 
U.S.A. 

•  Jean  E.  Moneo,  Assiniboia,  Sask., 
a  $3,500  fellowship  to  study  for  a  mas- 
ter's degree,  majoring  in  medical-sur- 
gical nursing,  at  the  University  of 
Florida,  Gainesville,  Fla. 

•  M.T.  Mildred  Morris,  Sudbury,  Ont., 
a  $3,500  award  to  study  for  a  master 
of  science  in  nursing  degree,  majoring 
in  maternal  and  newborn  health,  includ- 
ing nurse-midwifery,  at  Yale  Universi- 
ty, New  Haven,  Conn. 

•  Edna  R.  McNeely,  Hamilton,  Ont., 
a  $3,000  fellowship  for  a  master  of 
science  in  nursing  degree,  majoring  in 
medical-surgical  nursing,  at  the  Uni- 
versity of  Toronto. 

•  Leola  A.  Robinson,  Winnipeg,  Man., 
a  $3,000  award  for  a  master  of  science 
(applied)  degree,  majoring  in  medical- 
surgical  nursing  in  the  community,  at 
McGill  University,  Montreal. 

•  Gail  M.  Ryde,  Richlea,  Sask.,  a 
$3,500  fellowship  to  study  for  a  mas- 
ter's degree,  majoring  in  maternal  and 
child  health,  at  the  University  of  Cali- 
fornia, San  Francisco,  Calif. 

•  Marilyn  M.  Steels,  Islington,  Ont., 
a  $3,500  award  to  study  for  a  master 
of  science  in  nursing  degree  at  Case 
Western  Reserve  University,  Cleveland, 
Ohio. 

•  Carol  Whiting,  Scarborough,  Ont., 
a  $3,000  fellowship  to  study  for  a 
master  of  science  in  nursing  degree, 
majoring  in  nursing  administration, 
at  the  University  of  Western  Ontario, 
London. 

Financial  assistance  has  been  given 
by  CNF  to  109  Canadian  nurses  since 
1 962.  The  foundation  was  incorporated 
to  receive  and  administer  funds  for 
fellowships  to  prepare  nurses  for  leader- 
ship positions.  CNF  is  dependent  upon 
gifts,  donations,  and  bequests  from 
individual  donors  and  organizations. 


Conciliation  Board  Award 
Accepted  In  Alberta 

EdmontDii.  Alta.  —  The  Alberta  Hos- 
pital Association  and  the  Alberta  Asso- 
ciation of  Registered  Nurses  have 
accepted  a  conciliation  board  award 
to  settle  contract  negotiations.  The 
award  was  accepted  unanimously  by  39 
hospital  boards  throughout  the  province 
and  by  38  of  39  staff  nurses'  associa- 
tions. 

The  agreement,  which  affects  more 
than  3,300  Alberta  nurses,  is  retro- 
active to  January  I,  197!  and  will 
remain  in  effect  until  March  31,  1973. 
The  award  gives  a  staff  nurse  a  basic 
starting  salary  of  $520  per  month  with 
an  increase  to  $550  on  January  1,  1972. 
The  increase  amounts  to  6. 1  percent 
in  1971,  and  a  further  5.8  percent  in 
1972. 

Head  nurses  will  receive  an  8.1 
percent  increase  in  1971,  rising  from 
a  basic  $444  per  month  to  $600  per 
month  on  January  1,  and  further 
5.8  percent  in  January,  1972,  to  $635 
per  month. 

Also  introduced  is  a  special  rate  of 
payment  for  the  new  graduate  in  her 
first  employment.  The  new  graduate 
may  receive  a  reduced  rate  for  a  maxi- 
mum six  months.  During  this  time 
she  may  be  raised  to  the  basic  level 
of  the  salary  scale  after  a  period  of  one 
or  three  months  dependent  on  evalua- 
tion of  her  performance.  The  proposed 
rate  for  the  new  graduate  is  five  percent 
below  the  basic  wage. 

The  board  recommended  that  hos- 
pitals be  allowed  to  develop  a  period  of 
internship  that  would  recognize  the 
element  of  individual  differences, 
provided: 

•  it  apply  to  the  nurse's  initial  employ- 
ment period  at  the  time  she  seeks  her 
first  job  as  a  nurse; 

•  it  not  exceed  a  six-month  period; 

•  it  apply  equally  to  all  new  nurses 
regardless  of  the  type  of  training  pro- 
gram followed  (for  example,  no  distinc- 
tion between  the  two-  or  three-year 
nursing  programs); 

•  the  nurse  is  evaluated  at  the  end  of 
the  first  and  third  month  of  this  intern- 
ship period,  and,  if  either  one  of  these 
evaluations  is  satisfactory,  that  her  in- 
ternship period  be  concluded  and  she 
be  assigned  to  the  full  duties  as  a  staff 
nurse  at  the  rates  shown  on  the  salary 
scale. 

Responsibility  allowance  was  raised 
from  the  existing  75  cents  per  day  or 
$  1 5  per  month  to  $  1 .00  per  day  or 
$20  per  month. 

Change  in  hiealth  System 
Forecast  by  N.B.  Minister 

Saint  John,  N.B.  —  Alternatives  to 
hospitalization  as  the  primary  method 
of  servicing  health  needs  must  be  found 

AUGUST  1971 


if  the  health  cost  spiral  is  to  be  control- 
led, said  New  Brunswick  health  minis- 
ter Paul  Creaghan.  keynote  speaker  at 
the  New  Brunswick  Association  of 
Registered  Nurses"  annual  meeting 
May  19  and  20. 

NBARN's  55th  annual  meeting  had. 
as  its  theme,  "'patterns  in  health  care." 
and  Mr.  Creaghan  indicated  some 
trends  that  might  take  shape  in  New 
Brunswick.  "Health  problems  are  not 
necessarily  solved  by  building  more 
hospital  beds  and  in  fact  can  be  com- 
pounded by  doing  so,"  he  said.  ""It  is 
necessary  to  understand  that  health 
needs  do  not  always  require  active 
treatment  hospital  facilities  or  treat- 
ment from  a  highly  trained  specialist. 
This  will  take  time  because  it  involves 
a  change  in  attitudes.  I  am  convinced 
that  such  a  change  in  attitude  is  essen- 
tial if  we  are  to  provide  quality  health 
services." 

"'Doctors,  nurses,  and  other  profes- 
sional health  workers  must  perform 
a  function  related  to  the  degree  of  train- 
ing and  expertise  which  they  possess. 
They  must  not  perform  functions  which 
could  equally  well  be  carried  out  by 
less  highly  trained  professionals."  he 
said. 

"'In  the  important  field  of  nursing 
education,  the  establishment  of  the 
ad  hoc  committee  on  nursing  education 
by  the  former  administration  was  a 
sound  move."  (See  News.  March,  p.  14 
and  April,  p.  1 6. )"'...  1  have  no  doubt 
it  will  have  a  major  influence  on  nurs- 
ing education  and  its  relationship  to 
educational  institutions  and  the  hospi- 
tals. 

""I  will  be  particularly  interested  to 
see  whether  the  committee  will  make 
any  observations  or  recommendations 
concerning  the  composition  of  the  li- 
censing and  standard  setting  body  for 
nurses.  I  have  been  most  impressed  by 
the  Ontario  Committee  on  the  Healing 
Arts  Report  that  recommended  that 
licensing  bodies  include  lay  representa- 
tion on  their  boards."  he  said. 

Mr.  Creaghan  outlined  the  composi- 
tion of  the  province's  new  health  serv- 
ices advisory  council.  The  government 
will  name  a  chairman  and  appoint  a 
committee  consisting  of  a  hospital 
trustee,  three  physicians,  a  nurse,  a 
dentist,  a  hospital  administrator,  a 
representative  from  the  universities  of 
New  Brunswick,  and  four  members  of 
the  public.  The  deputy  minister  of 
health  and  one  other  senior  official 
from  the  department  will  be  non- 
voting members. 

He  expects  members  of  the  council 
to    be    sufficiently    knowledgeable    to 

AUGUST  1971 


"Not  many  Canadians  have  had  the  sombre  experience  of  visiting  and  working  in 
underdeveloped  countries  —  especially  in  the  rural  areas,"  says  Dr.  C.W.L.  Jea- 
nes,  medical  director  of  the  Canadian  Tuberculosis  and  Respiratory  Disease  Asso- 
ciation, who  took  this  photograph  in  the  Canadian-built  anti-tuberculosis  clinic 
in  Quang  Ngai  province  in  South  Viet  Nam.  The  central  clinic  is  part  of  a  prov- 
ince-wide demonstration  program.  "Our  object,"  Dr.  Jeanes  says,  "is  to  leave  a 
tangible,  practical,  comprehensive  public  health  and  tuberculosis  program  to 
serve  the  province." 


have  an  overview  of  all  aspects  of 
health  services.  He  intends  to  refer  to 
the  council  all  "matters  of  conse- 
quence" and  intends  to  spend  "suffi- 
cient time  with  the  council,  particu- 
larly the  chairman. 

International  Medical  Expert 
Shows  Our  Role  Is  Vital 
In  "The  Other  World" 

Ottawa —  In  the  underdeveloped  parts 
of  the  world,  such  as  West  Africa  and 
Asia,  there  has  been  little  progress  in 
the  past  10  years  in  the  crucial  matters 
of  economic  standards,  poverty,  disease, 
and  exploding  birth  rate. 

This  was  the  dark  side  of  the  picture 
painted  by  Dr.  C.W.L.  Jeanes.  medical 
director  of  the  Canadian  Tuberculosis 
and  Respiratory  Disease  Association, 
who  gave  a  vivid  slide-talk  presentation 
at  the  University  of  Ottawa  June  10. 
Although  he  clearly  showed  the  exten- 
siveness  of  the  depressed  living  stand- 
ards in  underdeveloped  countries,  he 
also  expressed  hope.  "For  the  first  time 
in  world  history,  the  developed  coun- 
tries have  sufficient  wealth  and  expertise 
to  eradicate  poverty  and  disease  in  the 
next  20  years,"  he  said. 

Canada  has  accepted  this  challenge. 
Dr.  Jeanes  said.  He  pointed  out  the 
important  work  being  done  by  the 
Government's  Canadian  international 
Development  Agency  (CIDA)  and  the 
Commission  on  International  Develop- 


ment, headed  by  Lester  Pearson,  with 
its  research  center  in  Ottawa. 

Dr.  Jeanes  explained  it  does  not 
help  a  developing,  disorganized  coun- 
try to  superimpose  a  Canadian  program 
geared  for  our  kind  of  economy.  In- 
stead, he  said  it  is  necessary  to  plan  a 
program  that  can  be  integrated  into  the 
country's  society  without  causing 
regional  disparity. 

"The  piecemeal  approach  has  been 
the  greatest  weakness  of  aid  in  the 
past,"  he  said.  However,  he  noted  a  new 
approach:  "CIDA  looks  at  aid  as 
a  whole  and  trains  men  and  women  to 
carry  on  a  project  after  Canadians  have 
left."  This  principle  of  educating  per- 
sons in  developing  countries  to  stand 
on  their  own  feet  was  stressed  through- 
out his  talk. 

Dr.  Jeanes  said  that  medical  pro- 
grams in  disease-ridden  countries, 
where  the  doctor-patient  ratio  can  be 
as  high  as  one  to  100,000  must  be 
public  health  community-oriented  to 
provide  a  horizontal  program  (as  op- 
posed to  Canada's  vertical  program) 
that  encompasses  as  high  a  proportion 
of  the  population  as  fxissible. 

The  colored  slides  showed  Canada's 
successful  anti-tuberculosis  program 
operating  in  South  Viet  Nam.  In  a 
country  where  TB  is  a  major  health 
problem,  there  is  only  one  anti-TB 
clinic  outside  Saigon.  Since  this  clinic 
was  built  by  Canada  five  years  ago  in 

THE  CANADIAN  NURSE     9 


Fely  Durana  dressed 
our  best  dressed  patient 
successfully. 

On  our  50th  anniversary. 

So  we  are  sending  a  five  hundred  dollar  dona- 
tion, in  Fely's  name,  to  the  hospital  fund  she  selected; 
The  Gilbert  Plains  Hospital  Fund,  Manitoba.  Fely's 
was  the  first  correct  entry  selected  from  the  many 
sent  in  by  nurses  from  all  over  Canada,  in  the  second 
of  three  "dress  our  best  dressed  patient"  contests 
this  year.  To  Fely  and  all  the  other  nurses,  we  say  a 
big  'thank  you'  for  entering  our  contest. 

SMITH  &  NEPHEW  LTD. 


2100  -  52nd  Avenue,  Lachine,  Quebec,  Canada. 


Quang  Ngai  province,  a  five-member 
Canadian  team,  including  two  nurses, 
has  been  training  Vietnamese  techni- 
cians to  run  the  busy  clinic  on  their 
own. 

Some  300  persons  —  1 0  percent  with 
infectious  TB — come  to  this  clinic 
daily.  The  vaccination  program  is 
conducted  exclusively  by  the  Vietnam- 
ese who  give  70,000  BCG  vaccinations 
here  each  year.  Sputum-testing  is  done, 
as  x-rays  are  too  expensive.  Chemo- 
therapy treatment  is  also  a  vital  part  of 
the  program.  According  to  Dr.  Jeanes, 
the  young  people  who  learn  to  become 
village  health  technicians,  are  efficient 
and  "remarkably  trainable."'  Most  of 
them  are  girls,  as  almost  all  the  men  are 
involved  in  the  war. 

A  year  from  now,  the  Canadians 
will  hand  over  the  clinic's  TB  program 
to  the  Vietnamese  to  run  at  the  tech- 
nician level.  Until  then,  Maureen 
Brown,  a  public  health  nurse  from 
Corner  Brook,  Newfoundland,  is  in 
charge  of  the  program. 


NBARN  To  Issue 
Statement  On  Abortion 

Fredericton,  N.B. — The  New  Bruns- 
wick Association  of  Registered  Nurses 
was  one  of  four  provincial  associations 
supporting  the  proposed  Canadian 
Nurses'  Association  statement  calling 

10     THE  CANADIAN  NURSE 


for  changes  in  Canada's  abortion  laws. 
Since  a  majority  of  the  provincial 
associations  did  not  approve  the  state- 
ment, the  NBARN  plans  to  issue  its 
own  statement. 

A  NBARN  release  said  the  decision 
to  approve  the  statement  followed 
months  of  emotional  debate  at  chapter 
meetings,  the  annual  meeting,  and 
finally  a  poll  of  all  active  members. 

The  NBARN  poll  emphasized  that 
the  vote  was  not  for  or  against  abortion, 
but  for  or  against  removing  the  abortion 
committee  from  the  Criminal  Code. 
"Probably  no-one  is  in  favor  of  abor- 
tion per  se,"  the  poll  said.  "The  real 
question  is:  how  do  we  best  deal  with 
a  social  and  health  problem  that  will 
continue  to  exist  with  or  without  protec- 
tive legislation?" 

Of  the  1,180  responses  to  the  poll, 
members  voted  74  percent  in  favor  of 
amending  section  237  of  the  Criminal 
Code,  implying  that  the  decision  re- 
garding abortion  would  be  reached  by 
the  doctor  and  the  woman  involved 
without  an  abortion  committee  and 
without  endangering  the  physician's 
legal  position.  The  back-room  abor- 
tionist would  still  be  punished. 

Support  for  a  statement  calling  for 
the  nurse's  right  to  withdraw  from 
nursing  an  abortion  patient  was  given 
by  77  percent  of  the  respondents.  This 
statement    included    the   qualification 


that  the  patient's  right  to  receive  neces- 
sary nursing  care  would  take  precedence 
over  the  nurse's  right  in  emergency 
situations. 

NBARN  members  voted  to  support 
CNA's  proposed  statements  and  there- 
fore accept  in  principle  the  concepts  of 
these  statements  said  the  release.  Before 
an  official  NBARN  statement  is  issued, 
changes  could  be  made  to  the  original 
statements  based  on  comments  express- 
ed by  the  voters.  A  final  wording  will  be 
considered  by  the  NBARN  council  at  its 
next  meeting. 


MARN  Wants  RNs  Only 
In  Bargaining  Units 

Dauphin,  Man.  —  At  its  annual  meeting 
May  30-June  I,  the  Manitoba  Associa- 
tion of  Registered  Nurses  reiterated 
opposition  to  the  inclusion,  at  this  time, 
of  other  categories  of  health  workers  in 
registered  nurses'  collective  bargaining 
units. 

This  follows  the  denial  by  the  Mani- 
toba Labour  Board  of  a  re-hearing  of 
the  application  for  certification  of  a 
registered  nurses"  bargaining  unit  at 
the  Winnipeg  General  Hospital.  The 
application  was  originally  turned  down 
by  the  board  on  the  basis  that  the  unit 
applied  for  was  "inappropriate."  At  the 
initial  hearing,  hospital  management 
AUGUST  1971 


news 


L 


had  suggested  that  such  a  bargaining 
unit  should  include  licensed  practical 
nurses,  registered  psychiatric  nurses, 
and  nursing  technicians. 

Another  resolution  called  for  MARN 
to  recommend  to  the  Manitoba  Health 
Services  Commission,  the  Manitoba 
Hospital  Association,  hospital  admin- 
istrators, and  directors  of  nursing,  the 
employment  of  a  higher  ratio  of  regis- 
tered nurses  to  licensed  practical  nurses 
and/or  other  health  workers. 

The  delegates  approved  other  resolu- 
tions that  will  lead  to  the  establishment 
by  the  boards  of  directors  of  a  commit- 
tee to  stimulate,  support,  and  coordinate 
nursing  research  in  the  province.  The 
research  committee  will  cooperate  with 
any  similar  committee  of  the  Manitoba 
Hospital  Association.  MARN  will  also 
set  up  a  fund  to  "encourage,  promote, 
and  support"  nursing  research. 

MARN  was  also  directed  to  appoint 
committees  to  study  and  recommend  the 
functions  that  the  nurse  in  an  "'expanded 
role"  should  be  prepared  to  perform 
and  the  program  necessary  to  prepare 
this  category  of  nurse  practitioner.  The 
resolution  emphasized  there  was  ""great 
urgency"  in  this  matter. 

On  the  same  theme.  MARN  will 
request  from  the  Manitoba  Medical 
Association  a  written  statement  as  to 
what  functions  the  '"assistant  to  the 
physician""  would  be  expected  to  per- 
form. Also,  MARN  will  indicate  to  the 
MMA  its  belief  that  registered  nurses 
are  the  best  suited  health  workers  to  fill 
this  gap  in  medical  care. 

Members  whould  like  MARN  to  take 
a  good  hard  look  at  itself  to  see  if  the 
stated  objectives  of  the  association  have 
been  met  and  if  these  objectives  are 
relevant  to  today's  situation.  The  resolu- 
tion continued  by  asking  that  a  report  on 
the  findings  of  such  an  assessment  be 
presented  at  the  1972  annual  meeting. 
Another  resolution  reaffirmed 
MARN's  belief  that  it  should  continue 
being  responsible  for  the  standards  of 
nursing  education  programs  and  should 
retain  the  licensing  power  of  registered 
nurses  in  the  province.  MARN  also 
supported  the  Canadian  Nurses"  Asso- 
ciation recommendation  on  the  develop- 
ment of  legislation  to  bring  into  the 
collective  bargaining  process  nurses  in 
middle  managerial  positions. 

CCUSN  Changes 
Names  To  CAUSN 

5/.  John's.  Njld.  —  The  Canadian 
Conference  of  University  Schools  of 
Nursing  emerged  from  its  annual  meet- 
ing, held  in  St.  John"s.  May  3  1  to  June 

AUGUST  1971 


2,  as  the  Canadian  Asscxiation  of  Uni- 
versity Schcxils  of  Nursing. 

CCUSN  became  CAUSN  to  make  its 
name  more  readily  translatable  into 
French  as  ""Association  canadienne  des 
ecoles  universitaires  de  nursing.""  Presi- 
dent of  the  retitled  association,  Eliza- 
beth McCann.  said,  ""We"ve  been  ccusn" 
long  enough  now  its  time  to  begin 
causn."  "■ 

On  behalf  of  Dr.  Jean  Hill.  Dr.  Amy 
Griffin  and  Dr.  Margaret  Phillips  dis- 
cussed the  Ontario  region's  working 
paper,  ""guidelines  for  baccalaureate 
programs  in  nursing  in  Ontario."  The 
paper  was  developed  to  give  guidance 
to  new  and  existing  schools,  to  express 
attainable  goals,  and  to  assist  in  inter- 
preting baccalaureate  education  in 
nursing. 

The  Quebec  region  gave  an  account 
of  the  Castonguay  commission's  philo- 
sophy of  delivery  of  health  care  and 
implications  for  the  education  of  nurses. 
Two  clinical  research  projects  were  also 
presented. 

The  Western  region  reported  that 
the  University  of  British  Columbia 
compiled  a  list  of  all  research  being 
undertaken  by  members  of  university 
schools  of  nursing  within  the  region. 
This  list  will  be  updated  in  November, 
1971.  The  University  of  Calgary  is 
compiling  a  list  of  all  audiovisual  hold- 
ings with  information  on  their  availa- 
bility to  other  schools  and  their  cost. 
This  list  will  be  updated  annually  by  the 
region. 

Special  programs  included  a  paper, 
"the  effect  of  cooperative  schemes  of 
education  on  the  student,  employer, 
and  faculty,"  by  Professor  George 
Soulis,  associate  dean  of  undergraduate 
studies,  faculty  of  engineering.  Univer- 
sity of  Waterloo.  At  present,  he  is  visit- 
ing professor  at  Memorial  University. 

He  said,  "if  professional  education 
is  only  an  academic  experience  without 
practical  experience,  then  it  is  an  ego 
trip  for  the  faculty." 

Ontario  Job  Market 
Tightens  For  Nurses 

Toronto,  Ont.  —  Graduating  nurses  are 
finding  it  more  difficult  this  year  to 
obtain  jobs  in  the  province,  said  Laura 
Barr,  executive  director  of  the  Re- 
gistered Nurses"  Association  of  Ontario 
in  a  Canadian  Press  story  on  June  1. 

Miss  Barr  said  the  association  would 
not  have  exact  employment  figures 
until  a  province-wide  check  this  month. 
She  said  nurses  have  traditionally 
taken  positions  at  the  hospital  in  which 
they  were  trained  or  nearby  ones. 

She  suggested  that  nursing  directors 
might  be  taking  more  time  this  year  in 
selecting  graduates.  "They're  taking 
him  to  select  staffs  balanced  between 
experienced  and  inexperienced  nurses. 


They  may  not  be  willing  to  take  on  a 
lot  of  new,  inexperienced  graduates  if 
they  can  get  people  with  five  or  eight 
years  experience. 

"Now  new  graduates  will  have  to 
get  out  on  the  hustings,"  said  Miss  Barr. 

Her  comments  were  seconded  by  a 
story  in  the  London  Free  Press  in  which 
a  health  department  spokesman  said 
that  Ontario  has  a  surplus  of  nurses  in 
large  urban  centers.  The  situation  will 
be  examined  over  the  summer  to  see  if 
there  is  any  need  to  curtail  enrollment 
in  nursing  schools,  the  spokesman  said. 

There  is  no  official  estimate  on  the 
surplus,  but  approximately  4,000  nurses 
are  to  graduate  this  year.  The  health 
department  official  said  there  are  still 
jobs  in  smaller  centers,  but  in  cities  like 
Windsor,  London,  and  Toronto,  some 
hospitals  must  reject  graduates  of  their 
own  nursing  schools. 


TGH  Alumnae  Association 
Spans  Ninety  Years 

Toronto.  Ont.  —  Bridging  the  genera- 
tions is  a  difficult  chore,  but  symboli- 
cally, the  unveiling  ceremony  held 
May  28  at  the  Toronto  General  Hospi- 
tal school  of  nursing  illustrated  a  score 
of  ties  that  bind  together  generations  of 
the  schools  nursing  students  from  1 88 1 
to  1971. 

The  ceremony  was  the  unveiling  of 
a  plaque  commemorating  the  assistance 
provided  by  the  alumnae  association 
of  the  school  in  furnishing  and  equip- 
ping the  library  of  the  new  school.  As 
a  centennial  project,  the  alumnae  raised 
$15,000  to  provide  money  for  the  use 
of  the  library  in  filling  needs  not  met 
by  funds  from  government  sources. 
Personal  letters  of  appeal  to  almost 
3,000  graduates  raised  $10,000.  Chap- 
ters in  such  areas  as  Ottawa,  Vancou- 
ver, and  London  gave  joint  donations. 

The  original  TGH  alumnae  associa- 
tion, organized  in  1894,  was  the  fore- 
runner of  various  national  and  inter- 
national nursing  asstx:iations  that  today 
have  evolved  into  the  Registered 
Nurses"  Association  of  Ontario,  the 
Canadian  Nurses"  Association,  and  the 
International  Council  of  Nurses. 

The  first  material  for  The  Canadian 
Nurse  was  gathered  by  Mary  Agnes 
Snively,  superintendent  of  nurses  at 
TGH.  She  persuaded  the  alumnae  asso- 
ciation to  sponsor  a  magazine  for  the 
nurses  of  Canada,  in  March  1905,  the 
magazine  appeared  for  the  first  time, 
starting  as  a  quarterly  publication. 

It  was  the  hope  of  the  founders  that 
'"this  magazine  may  aid  in  uniting  and 
uplifting  the  profession  and  in  keeping 
alive  that  esi>rii  de  corps  and  desire  to 
grow  better  and  wiser  in  work  and  life, 
which  should  always  remain  to  us  a 
daily  ideal." 

THE  CANADIAN  NURSE     11 


ANPQ  Responds 

To  Castonguay  Report 

Moiurccil,  (Jiichci  — The  position  of 
ihc  Association  of  Nurses  of  the  Prov- 
ince of  Quebec  on  the  role  and  function 
of  the  nurse,  nursing  education,  nursing 
personnel,  research  in  nursing  care,  and 
participation  of  nurses  in  planning  and 
administration  was  presented  in  a  brief 
to  the  minister  of  st)cial  affairs  Claude 
Castonguay  on  .June  ?>.  The  brief  was 
developed  in  response  to  volume  IV  of 
the  Castonguay  report,  which  outlines 
a  restructured  health  care  system  for 
the  province. 

Discussing  the  role  of  the  nurse,  the 
ANPQ  supports  the  compt)sition  and 
responsibilities  of  the  health  team  as 
recommended  in  the  report.  The  asso- 
ciation advocates  that  research  be  con- 
ducted on  health  care  teams  in  the  local 
health  centers  to  determine  the  number 
and  types  of  professional  workers  re- 
quired. 

The  ANPQ  brief  notes  the  reference 
made  in  the  report  to  a  new  category 
of  health  worker,  the  medical  assistant. 
The  ANPQ  mentions  its  part  in  the 
preparation  of  the  Canadian  Nurses' 
Association  statement  on  the  physi- 
cian's assistant.  It  also  supports  the 
brief  of  the  Canadian  Association  of 
University  Schot)ls  of  Nursing.  Quebec 
region  (formerly  CCUSN)  that  "a  new 
category  of  health  worker  (medical 
assistant)  not  be  created,  but  that  a 
study  of  the  enlarged  role  of  the  univer- 
sity nurse  and  her  preparation  be  under- 
taken jointly  by  the  university  schools 
of  nursing  and  the  faculties  of  medicine, 
and  the  professional  corporations,  that 
is,  the  ANPQ  and  the  College  of  Physi- 
cians and  Surgeons." 

"Representatives  of  the  nursing  pro- 
fession must  be  members  of  all  commit- 
tees redefining  Job  descriptions  of  the 
categories  of  nursing  personnel,  and 
these  representatives  should  be  appoint- 
ed after  consultation  with  the  ANPQ," 
said  the  association. 

Under  preparation  of  nursing  per- 
sonnel, the  ANPQ  reaffirms  its  continu- 
ing responsibility  for  the  basic  education 
of  the  nurse.  It  recommends  that  "the 
teaching  of  nursing  continue  to  be  the 
Joint  responsibility  of  the  CEGEPs.  t)f 
the  health  science  faculties  of  the  uni- 
versities, of  the  department  of  educa- 
tion andof  the  ANPQ." 

Also,  aware  that  the  need  tor  nurses 
prepared  at  university  for  teaching, 
supervision,  and  administration,  con- 
tinues to  be  acute  and  will  become  cri- 
tical when  clinical  nurses  are  required 
on  the  health  team  at  the  local  health 

12     THE  CANADIAN   NURSE 


centers,  the  ANPQ  recommends,  'that 
nurses  be  encouraged,  by  leave  of 
absence  and  bursary  assistance,  to  con- 
tinue their  education  at  the  baccalaure- 
ate, master's  and  doctoral  levels." 

The  ANPQ  agrees  there  is  need  for 
research  in  health  care.  Research  is 
needed  in  the  practice  ot  nursing,  espe- 
cially in  the  identification  of  criteria 
of  quality  in  nursing  care,  lor  this 
reason  the  association  recommends 
that  "qualified  nurses  who  wish  to 
undertake  research  in  nursing  be  en- 
couraged and  supported  financially  by 
grants  from  the  research  council  on 
health. " 

To  assure  the  participation  of  nurses 
in  the  development  of  the  new  health 
care  system,  the  ANPQ  recommends 
that  "pilot  projects  be  carried  out  in 
the  distribution  of  health  care  at  the 
local  health  level,  taking  into  account 
the  needs  of  the  population  served. 
This  research  should  be  conducted  by 
a  multi-disciplinary  team  which  in- 
cludes nurses." 

l-or  nurses  to  contribute  effectively 
to  the  total  health  care  scheme,  they 
must  participate  on  all  levels  of  plan- 
ning and  in  the  administration  of  health 
services,  said  the  brief.  Nurse  represent- 
atives should  be  appointed  to  the  ad- 
ministration council  of  the  local  health 
center,  the  community  health  center, 
and  the  university  health  center. 

The  ANPQ  advocates  that  on  the 
consultative  bodies  which  are  proposed 
at  the  three  levels  of  health  care,  no 
professional  group  should  hold  a  major- 
ity over  other  professional  members  of 
the  group.  The  ANPQ  requests  that  a 
nurse  representative  be  appointed  to  the 
research  council  on  health. 

The  association  assured  the  minister 
of  its  willingness  to  undertake  other 
studies  according  to  the  needs  of  the 
department  and  the  implementatit)n  of 
the  new  health  scheme  in  the  province. 

Contract  Dispute  Of  Nurses 
In  Federal  Public  Service 
Taken  To  Arbitration 

Ottawa  —  A  national  pay  scale  for  all 
nurses  working  in  the  federal  public 
service  was  one  demand  taken  by  the 
nurses'  group  to  a  government  arbitra- 
tion tribunal,  which  began  its  three-day 
public  hearing  August  3.  An  award  is 
expected  to  be  handed  down  by  mid- 
October. 

The  Professional  institute  of  the 
Public  Service  of  Canada,  the  bargain- 
ing agent  for  the  2,200  nurses,  asked 
for  arbitration  May  21.  five  months 
after  the  nurses"  contract  expired  and 
negotiations  with  the  government 
remained  deadlocked.  When  the  new 
contract  is  signed,  it  will  be  the  second 
one  for  nurses  since  collective  bargain- 
ing began  in  the  public  service  in  1967. 


According  to  Hugh  Larsen  of  the 
Professional  institute,  "This  is  the 
tlrst  time  the  nurses  had  a  real  oppor- 
tunity of  seeking  a  third  party  to  settle 
the  dispute." 

Mr.  Larsen,  chief  spokesman  for 
the  nursing  group,  told  Tlw  Cuiutdian 
Nurse  June  30  that  "the  biggest  prob- 
lem is  the  real  desperate  state  of  many 
of  the  general  duty  nurses."  who  make 
up  72.5  percent  of  the  nurses'  group. 
He  said  government  salaries  are  ap- 
proximately six  percent  behind  those 
in  the  private  sector. 

Figures  provided  by  the  Professional 
institute  show  that  federally-employed 
general  duty  nurses  in  Saskatchewan. 
Manitoba,  and  the  Maritimes  start 
at  $5,523,  compared  with  S6. 135  in 
Ontario,  Quebec,  the  North  West 
Territories,  and  the  Yukon,  and  S6.345 
in  British  Columbia.  Mr.  Larsen  said 
nurses  are  demanding  a  uniform  pay 
scale  because  the  cost  of  living  in 
Halifax,  for  example,  is  as  high  as  it 
is  anywhere  else  in  Canada. 

The  comparison  of  nurses'  salaries 
with  those  of  other  workers  is  alst>  a 
contentious  issue.  The  Professional 
institute  reports  that  "many  laboratory 
technicians,  x-ray  technicians,  dental 
hygienists  and  others,  whose  salaries  are 
under  review  at  the  present  time,  are 
earning  more  than  the  nurse  I.  and  in 
many  cases  more  than  the  nurse  2. 
who  are  the  head  nurses  in  hospitals, 
charge  nurses  in  nursing  stations  in 
the  Northern  Territories,  or  nursing 
counselors  in  the  various  federal  build- 
ings." 

Stressing  the  difficulties  faced  by 
nurses  responsible  for  raising  a  family. 
Mr.  Larsen  noted  that  one  nurse  resign- 
ed because  she  could  get  more  money 
on  welfare.  The  Professional  institute 
claims  that  the  take-home  pay  of  some 
nurses  is  barely  above  the  $4,000  pov- 
erty level  set  by  the  Economic  Council 
of  Canada,  it  also  maintains  that  the 
low  salaries  have  led  nurses  to  seek 
additional  employment  in  off  duty 
hours,  which  reduces  the  standard  of 
nursing  care  in  federal  hospitals  and 
nursing  homes. 

Another  argument  raised  by  the 
institute  is  that  the  salaries  of  nursing 
consultants  "do  not  reflect  their  value 
to  the  community,  especially  when 
consultants  in  other  disciplines  in  the 
same  department  are  paid  nearly  $3,000 
more  for  providing  a  similar  service." 

The  nurses'  group  is  also  asking  for 
four  weeks'  vacation  instead  of  three; 
an  increase  in  shift  premium  and  stand- 
by remuneration;  a  properly  defined 
37 '/2 -hour  week  with  the  meal  break 
taken  away  from  the  ward;  and  im- 
provements in  working  conditions  for 
nurses  in  isolated  areas. 

As  an  exampleof  the  problems  nurses 

face  in  remote  areas,  Mr.  Larsen  point- 

AUCUST  1971 


ed  out  that  nurses  working  on  an  Indian 
Reserve  in  North  Battleford,  Sasicat- 
chewan,  have  no  means  of  communica- 
tion in  their  cars.  It  could  be  dangerous 
if  they  get  caught  in  a  blizzard  or  have 
a  blowout,  he  noted.  "It  is  deplorable 
that  we  .  .  .  have  had  to  raise  this  in  a 
collective  agreement". 

A  June  newsletter  to  members  of  the 
nursing  group  quoted  the  acting  exec- 
utive director  of  the  federally-run 
Charles  Camsell  Hospital  in  Edmon- 
ton: "Nobody  argues  that  the  salaries  of 
our  nurses  are  now  lower,  but  the 
hospital's  unique  atmosphere  and  role 
compensates  adequately." 

The  newsletter,  signed  by  Ruth 
Millar,  chairman  of  the  nursing  group, 
called  on  the  nurses  to  highlight  public- 
ly that  "for  too  long  we  have  suffer- 
ed the  indignity  of  near  poverty  because 
we  have  chosen  to  work  in  the  nursing 
profession  .  .  .  ." 

NBARN  Nursing  Study 
Receives  Federal  Grant 

Oiuiwa  —  A  $16,682  federal  health 
grant  has  been  approved  for  the  New 
Brunswick  Association  of  Registered 
Nurses  to  assist  in  a  comparative  study 
of  staffing  hospital  nursing  units.  (See 
News.  July  pp.  6-7  and  Names,  August 
p.  14).  The  grant  was  announced  by 
Jean-Eudes  Dube.  minister  of  veterans 
affairs  and  MP  for  Restigouche,  on 
behalf  of  national  health  and  welfare 
minister  John  Munro. 

The  NBARN  study  will  compare 
nursing  units  staffed  by  nurses  only 
with  units  staffed  by  a  mix  of  nurses  and 
auxiliary  nurses.  The  demonstration 
project  will  be  carried  out  at  the  Monc- 
ton  Hospital,  Moncton,  N.B. 

Physician's  Assistant 
Does  Not  Nurse 

St.  John's,  Nfld.  —  If  a  nurse  chooses 
to  be  a  physician's  assistant  she  changes 
her  profession.  Dr.  Martha  Rogers, 
head  of  the  nursing  education  division, 
New  York  University,  told  nurses  at 
three  institutes  on  the  expanded  role  of 
the  nurse  held  at  Memorial  University. 
They  were  sponsored  by  the  university's 
school  of  nursing  and  the  Association 
of  Registered  Nurses  of  Newfoundland. 

"Physician's  assistants  do  not  nurse," 
said  Dr.  Rogers.  "A  technical  nurse 
does  not  undergo  the  same  rigorous 
program  of  study  as  does  the  profession- 
al nurse. 

"One  should  not  ask,  'what  does  the 
professional  nurse  do  that  is  different 
from  the  technical  nurse'  but  'what  does 

AUGUST  1971 


she  know  that  is  different.'  All  kinds  of 
people  can  give  injections,  do  dressings, 
but  the  nurse  brings  certain  kinds  of 
knowledge  to  the  task  which  makes 
the  difference  between  whether  or  not 
what  was  done  was  nursing."  she  said. 

"If  nurses  wish  to  expand  their  role, 
they  will  need  to  develop  greater  self- 
awareness,  greater  understanding  of 
human  growth  and  development,  and 
to  increase  their  knowledge  and  under- 
standing of  social,  cultural,  and  scientif- 
ic developments."  Dr.  Rogers  said 
nurses  need  to  recognize  their  own 
social  significance,  and  to  be  more  vocal 
in  professional  and  civic  affairs. 

"An  increasingly  knowlegeable  pub- 
lic is  becoming  critical  of  the  delivery 
of  health  care,  and  since  nurses  provide 
a  large  part  of  health  care,  often  in 
outdated  systems,  they  must  be  prepar- 
ed to  initiate  changes  where  necessary. 

"Too  often  the  system  handicaps 
the  creative,  imaginative  nurse.  Nurses 
themselves  must  be  united  in  their 
efforts  to  bring  about  changes  which 
will  facilitate  their  ability  to  expand 
their  role,"  said  Dr.  Rogers. 

Post-Diploma  Programs 
Expanded  At  Ryerson 

Toronto,  Ont.  —  The  nursing  depart- 
ment, Ryerson  Polytechnical  Institute, 
is  expanding  its  present  post-diploma 
programs  for  Ontario  registered  nurses. 
The  expanded  program  is  due  to  in- 
creasing demand  from  applicants  and 
prospective  employers  of  graduates  of 
these  programs. 

A  1 5 -week  (one  semester)  program 
in  pediatric  nursing  will  start  in  Sep- 
tember, 1971  and  January,  1972  with 
a  maximum  of  25  students  per  session. 
The  course  offers  pediatric  nursing 
theory,  concepts,  and  practice.  Along 
with  classroom  work,  three  days  each 
week  are  spent  gaining  experience  at 
Toronto's  Hospital  for  Sick  Children 
under  the  supervision  of  a  Ryerson 
nursing  instructor. 

Also  to  start  in  September,  1 97 1 
and  January,  1972  is  a  15-week  (one 
semester)  program  in  adult  intensive 
care  nursing,  again  with  a  maximum  of 
25  students.  Courses  are  taught  by 
clinical  experts  and  specialists  in  sub- 
ject areas  from  the  Ryerson  faculty. 
Two  days  each  week  are  spent  obtain- 
ing clinical  experience  at  selected 
general  hospitals  in  the  Toronto  area. 
Preference  will  be  given  to  applicants 
who  have  had  a  minimum  of  one  year's 
nursing  experience,  especially  in  an 
active-treatment  unit. 

Advanced  psychiatric  nursing  is  the 
third  course  in  the  expanded  program. 
It  is  a  two-semester  (30  week)  course 
for  a  maximum  of  25  students.  It  will 
start  in  September,  1971  and  finish 
in  April.  The  curriculum  includes 
psychiatric  nursing  theory  and  practice. 


psychopathology,  social  sciences,  and 
a  choice  of  related  elective  courses. 
Clinical  experience  is  provided  in 
Toronto  psychiatric  hospitals.  Appli- 
cants must  have  diploma  level  psychia- 
tric nursing  theory  and  experience. 

For  information  write  to  the  Regis- 
trar, Ryerson  Polytechnical  Institute, 
50  Gould  Street.  Toronto. 


N.S.  Nurses  Want 

To  Bargain  With  Province 

Halifax.  N.S.  -  More  than  S.^^  percent 
of  registered  nurses  in  Nova  Scotia 
liospitals  are  organized  into  units  for 
collective  bargaining,  and  these  nurses 
want  to  negotiate  contracts  directly 
with  the  provincial  governmenl. 

A  briet  prepared  by  statf  nurses 
associations  at  the  request  of  provincial 
minister  of  health  D.  Scott  MacNutt 
stated  that  bargaining  sessions  with 
various  hospital  biiards  have  been  "an 
exercise  in  futility. '  The  brief  notes 
that  hospital  boards  have  little  economic 
pi)wer  and  must  refer  to  the  hospital 
insurance  commission  before  making 
tlecisions  involving  the  expenditure  of 
hospital  funds. 

"Moreover,  points  gained  at  one 
negotiation  had  to  be  argued  out  in  full 
at  almost  every  other  hospital,  wasting 
valuable  time  and  patience,"  said  the 
brief.  "Many  boards  display  both  total 
ignorance  t)f  collective  bargaining  pro- 
cedures and  an  unwillingness  either  to 
learn  or  to  hire  the  necessary  expertise. 

"As  volunteer  bodies,  the  boards 
have  found  it  difficult  to  devote  to  col- 
lective bargaining  the  time  required  ft)r 
study  of  proposals,  drafting  of  counter 
proposals,  or  actual  negotiations.  The 
result  has  been  unwarranted  delay  in 
negotiating  most  collective  agreements, 
complaints  to  the  labor  relations  board 
of  failure  to  negotiate,  and  much  un- 
necessary ill-feeling,"  continues  the 
brief. 

rhe  outcome,  in  every  case  so  far 
decided,  has  been  identical  in  wages 
and  major  fringe  benefits.  "All  staff 
nurses'  associations  and  hospitals, 
therefore,  have  struggled  through 
months  of  trying  negotiations  only  to 
produce  at  the  end  a  result  which  pre- 
sumably could  have  been  predicted  at 
the  outset."  slates  the  brief. 

The  associations  are  recommending 
that  immediate  steps  be  taken  so  that 
wages  and  fringe  benefits  can  be  nego- 
tiated by  representatives  of  the  provin- 
cial government  with  representatives 
of  nurses  in  all  independent  hospitals 
in  the  province.  The  brief  also  recom- 
mends a  two-tier  system  of  negotiation 
with  the  second  level  bargaining  for 
non-economic  issues  between  the  nurses 
and  local  hospital  boards.  This  could 
be  modeled  after  the  Saskatchewan 
system,  said  the  brief.  "& 

THE  CANADIAN  NURSE     13 


names 


Dorothy  S.  Starr  (B.A.,  Simpson  Col- 
lege, Iowa;  M.N.,  Yale  U.  School  of 
Nursing.  New  Haven.  Conn.)  Joined 
the  staff  of  Tlw  Canadian  Nurse  in 
July  as  an  assistant  editor. 

For  the  past  two 
years,  Mrs.  Starr 
was  an  assistant 
professor  at  the 
University  of  Otta- 
wa School  of  Nurs- 
ing,  where  she 
taught  courses  in 
.clinical  teaching 
and  administration 
of  schools  of  nursing  in  the  certificate 
program  for  registercd'nurses.  As  assist- 
ant director,  program  development,  she 
carried  a  major  responsibility  for  the 
development  of  the  B.Sc.N.  program 
for  registered  nurses,  which  will  enroll 
students  in  September  1971. 

Mrs.  Starr  was  previously  employed 
at  the  Ottawa  Civic  Hospital  School 
of  Nursing,  first  as  senior  instructor, 
then  as  assistant  director  of  nursing 
education,  and  for  five  years  as  prin- 
cipal of  the  school.  Prior  to  coming  to 
Ottawa,  her  experience  included  psy- 
chiatric nursing,  multi-faceted  work  as 
a  member  of  a  Quaker-sponsored  mo- 
bile medical  relief  team  in  Pakistan,  and 
staff  nurse  at  Lord  Dufferin  Hospital 
in  Orangeville,  Ontario. 

She  is  the  mother  of  four  children. 
Her  hobbies  are  skin-  and  scuba  diving, 
underwater  photography,  and  listen- 
ing to  folk  music.  In  the  past  three 
years,  articles  written  by  Mrs.  Starr 
on  scuba  diving,  the  Ottawa  Distress 
Centre,  and  the  educational  value  of 
student  errors,  have  appeared  in  The 
Canadian  Nurse. 

Helen  Beath  (R.N.,  Misericordia  Gen- 
eral H.  School  of  Nursing.  Winnipeg, 
Man.,  B.N.,  LI.  of  Manitoba)  has  been 
appointed  director  of  a  nursing  research 
project  sponsored  by  the  New  Bruns- 
wick Association  of  Registered  Nurses, 
entitled  "comparative  study  of  two 
patterns  of  staffing  a  hospital  unit." 

Miss  Beath  brings  valuable  exper- 
ience to  her  new  position  as  project 
director.  She  was  director  of  nursing 
research  and  guidance  at  the  Victoria 
General  Hospital  in  Winnipeg  from 
1 967  to  1 970  and  has  been  general  duty 
nurse  at  the  Portage  la  Prairie  General 
Hospital  in  Manitoba,  The  Montreal 
General    Hospital,   and   the   Nanaimo 

14     THE  CANADIAN  NURSE 


General  Hospital  in  British  Columbia. 
Other  positions  include  assistant  head 
nurse  and  assistant  director  of  nursing 
services  at  the  Misericordia  General 
Hospital  in  Winnipeg,  and  instructor 
at  the  Misericordia  General  Hospital 
School  of  Nursing. 

Miss  Beath  has  also  been  involved 
in  experimental  projects  at  the  Victoria 
General  Hospital  in  Winnipeg. 

She  was  a  member  of  the  nursing 
service  committee  of  the  Canadian 
Nurses'  Association  from  1966-68. 


M.  Josephine  Flaherty  (B.Sc.N.,  B.A., 
M.A.,  Ph.D.,  U.  of  Toronto)  began  her 
two-year  term  of  office  as  president  of 
the  Registered  Nurses'  Association  of 
Ontario  in  May. 

Dr.  Flaherty  succeeds  Laura  Butler, 
president  of  RNAO  from  1 969-7  1 .  The 
new  president  has  been  involved  in  staff 
nursing,  nursing  research,  and  teaching 
at  the  university  level.  She  was  nurse 
in  charge  of  the  Red  Cross  Outpost 
Hospital  in  Matachewan,  Ontario,  and 
later  became  research  assistant  and  staff 
nurse  at  St.  Michael's  Hospital  in  To- 
ronto. Dr.  Flaherty  was  an  instructor  at 
the  Nightingale  School  of  Nursing  in 
Toronto  and  at  the  University  of  Toron- 
to. School  of  Nursing.  She  was  also  a 
research  assistant  in  the  department  of 
measurement  and  evaluation  at  the 
Ontario  Institute  for  Studies  in  Educa- 
tion, and  later,  an  assistant  professor 
atOlSE. 

Dr.  Flaherty's  involvement  in  the 
RNAO  includes  two  years  as  a  member 
of  the  RNAO  Committee  on  personnel 
policies;  member  of  the  RNAO  resolu- 
tions committee;  member  of  the  com- 
mittee for  the  establishment  of  nursing 

Clarification 

An  item  on  page  26  of  the  May  issue 
of  The  Canadian  Nurse  suggests  that 
Pamela  E.  Poole  and  Rita  M.  Morin 
represent  only  nurses  on  the  board  of 
directors  of  the  Professional  Institute  of 
the  Public  Service.  In  fact,  they  were 
elected  to  their  respective  offices  by 
all  the  voting  delegates — nationally, 
in  the  case  of  Miss  Poole,  and  region- 
ally, in  the  case  of  Mrs.  Morin.  This 
means  that  nurses  have  reached  the 
directorship  level  of  the  Professional 
Institute  of  the  Public  Service  and  that 
they  represent  the  membership  at  large, 
not  merely  the  nursing  sector. 


programs  in  colleges  of  applied  arts  and 
technology;  and  member  of  the  RNAO 
committee  on  nursing  research. 

RANO's  president-elect,  Wendy  J. 
Gerhard  is  an  assistant  professor  at  the 
faculty  of  nursing.  University  of  West- 
ern Ontario,  and  chairman  of  RNAOs 
working  party  to  prepare  the  brief  to 
the  commission  on  post -secondary 
education. 

Mrs.  Gerhard 
(Reg.N.,  Victoria 
H.  School  of  Nurs- 
ing, London,  Ont.; 
B.Sc.N.,  M.Sc.N.  in 
Administration  and 
Education,  U.  of 
Western  Ontario) 
has  a  varied  profes- 
sional background. 
She  was  a  staff  nurse  at  Alexandra  Ma- 
rine and  General  Hospital,  Goderich, 
Ontario,  and  at  St.  Joseph's  Hospital 
in  Toronto;  a  supervisor  at  Victoria 
Hospital  in  London;  a  lecturer  on  the 
faculty  of  nursing.  University  of  West- 
ern Ontario;  and  a  teacher  with 
RNAO's  refresher  program  in  London. 


Iris  Mossey  (R.N.,  Gait  H.  School  of 
Nursing.  Lcthbridge,  Alberta;  dipl. 
Public  Health  Nursing.  B.Sc.N.,  U.  of 
Alberta  School  of  Nursing)  was  named 
Alberta's  Nurse  of  the  Year  by  the 
Alberta  Association  of  Registered 
Nurses  in  May. 

Mrs.  Mossey  has  been  employed 
with  the  Lcthbridge  health  unit  in  Leth- 
bridge.  Alberta,  and  is  presently  direc- 
tor of  health  services  at  St.  Michael's 
General  Hospital  in  Lcthbridge. 

She  has  held  offices  in  the  AARN 
at  the  local,  district,  and  provincial 
levels,  and  has  represented  it  on  the 
National  committee  of  socio-economic 
welfare. 


Shirley  J.  Paine,  Brandon,  Manitoba, 
was  named  winner  of  the  District  II 
Centennial  Bursary  at  the  districts 
annual  meeting  April  28th,  1971. 

The  $1,500  bursary  will  help  Mrs. 
Paine  obtain  her  master's  degree  from 
the  University  of  Western  Ontario  in 
London.  Her  specialty  will  be  teaching. 

Mrs.  Paine  is  chairman  of  the  social 
and  economic  welfare  committee  in  the 
Manitoba  Association  of  Registered 
Nurses.  ^ 

AUGUST  1971 


August  15-19, 1971 

Canadian  Pharmaceutical  Association, 
annual  convention,  Winnipeg,  Manitoba. 
For  further  information  write  to  the  Can- 
adian Pharmaceutical  Association,  175 
College  St.,  Toronto  2B,  Ontario. 

August  22-28,  1971 

11th  residential  summer  course  on  alcohol 
and  other  drugs  of  dependence,  Lakehead 
University,  Thunder  Bay,  Ontario.  Sponsored 
by  the  Addiction  Research  Foundation  of 
Ontario,  with  the  cooperation  of  Lakehead 
University.  Basic  information  and  findings 
of  current  research  relating  to  the  use  and 
misuse  of  alcohol  and  other  drugs  will  be 
presented,  and  provision  made  for  discus- 
sion of  prevention  and  treatment  aspects 
of  dependency  problems.  Enrollment  limited 
to  80,  Write  to  Director.  Summer  Courses, 
Addiction  Research  Foundation,  Communi- 
cation Programs  Division,  33  Russell  St., 
Toronto  4,  Ont. 

September  9-11, 1971 

Canadian  Society  of  Extra-Corporeal  Circul- 
ation Technicians,  annual  meeting.  Queen 
Elizabeth  Hotel,  Montreal.  Nurses  in  fields 
of  hemodialysis  and  cardio-pulmonary 
bypass  welcome.  Program  includes  business 
meeting  (for  members  only),  scientific 
presentations,  exhibits,  and  social  activit- 
ies. Elective  exams  in  dialysis  theory  are 
planned.  For  further  information,  contact 
CanSECT,  Box  625,  Halifax,  N.S. 

September  13-16, 1971 

Workshops  on  infection  control  to  be  con- 
ducted by  Helen  Palmer,  assistant  director 
of  medical  nursing.  The  Hospital  for  Sick 
Children,  Toronto.  The  two-day  workshops 
will  be  held  in  Red  Deer  on  September  13 
and  14,  and  in  Medicine  Hat  on  September 
15  and  16,  with  a  $10  registration  fee.  For 
more  information  write:  Mrs.  Joseline  Pear- 
ce,  129-12  St.  N.W.,  Medicine  Hat,  Alberta, 
or  Mrs.  Gertrude  Clarke,  Box  129,  5013-52 
St.,  Olds,  Alberta. 

September  22-25, 1971 

Annual  conference  of  the  Canadian  Asso- 
ciation for  the  Mentally  Retarded,  Hotel 
Nova  Scotian,  Halifax,  N.S.  A  pre-conference 
professional  session  on  the  report  of  the 
Commission  on  Emotional  and  Learning 
Disorders  in  Children  is  planned  for  the 
24th,  and  a  concurrent  youth  conference 
will  take  place  on  the  last  two  days.  For 
further  information  write  to  the  CAMR, 
Kinsmen  NIMR  Building,  York  University, 
4700  Keele  Street,  Downsview,  Toronto. 
AUGUST  1971 


September  30  and  Oct.  1, 1971 

Conference  for  Industrial  Nurses,  Windsor 
Hotel,  Montreal,  P.O. 

September  30-October  2, 1971 

Postgraduate  course  on  Pediatric  Cardio- 
respiratory Care,  Houston,  Texas.  Developed 
by  the  American  College  of  Chest  Physi- 
cians, the  Cystic  Fibrosis  Foundation,  and 
the  Texas  Institute  for  Rehabilitation  and 
Research,  the  program  is  geared  to  the 
physician,  although  nurses  with  a  special 
interest  in  pediatric  care  are  invited  to 
participate  actively.  Lectures  and  panel 
discussions  will  deal  with  operative  lesions, 
inoperative  cardiopulmonary  diseases, 
infectious  and  noninfectious  pneumonitis, 
asthma,  upper  airway  obstruction,  and 
cystic  fibrosis.  Registration  fee  for  nurses 
is  $30.  For  more  details  write  to:  Depart- 
ment of  Continuing  Education,  American 
College  of  Chest  Physicians,  112  East 
Chestnut  Street,  Chicago,  Illinois  60611, 
U.S.A. 

October  5-8, 1971 

Institute  on  mental  retardation  sponsored 
by  the  schools  of  nursing  and  social  work, 
University  of  Toronto.  Designed  for  public 
health  nurses  and  social  workers  working 
with  young,  mentally  retarded  children  and 
their  families.  For  further  information  write 
to  Mrs.  Marion  I.  Barter,  Continuing  Educa- 
tion Program  for  Nurses,  University  of  To- 


CNA  Convention  In  '72 
—Steer  For  Edmonton! 


At  the  Canadian  Nurses'  Asso- 
ciation annual  meeting  and 
convention  in  Edmonton,  Al- 
berta, June  25-29,  1972,  you 
can  bring  your  "beef"  to  the 
assembly  —  or  perhaps  the 
nearest  you'll  come  to  beef 
will  be  at  the  banquet  table. 
Either  way,  Edmonton  is  the 
place  in  '72! 


ronto,  47  Queen's  Park  Crescent,  Toronto 
5,  Ontario. 

October  6-8, 1971 

Canadian  Society  of  Respiratory  Tech- 
nologists, 6th  annual  convention  and  educa- 
tional seminar,  Winnipeg  Inn.  Winnipeg. 
For  information  write  to  Charles  Frew, 
R.R.T.,  Inhalation  Therapy  Dept..  Victoria 
General  Hospital,  2340  Pembina  Highway, 
Winnipeg  19,  Manitoba. 

October  13-15, 1971 

Association  of  Registered  Nurses  of  New- 
foundland, annual  meeting,  St.  John's, 
Newfoundland. 

October  18-22, 1971 

National  Conference  On  Continuing  Educa- 
tion In  Nursing,  The  University  of  Wiscon- 
sin, Madison.  Designed  for  nurses  on  the 
faculty  of  a  college  or  university,  on  the 
inservice  education  staff  of  a  medical  center 
associated  with  an  institution  of  higher 
learning,  or  on  the  staff  of  a  regional  medi- 
cal program.  General  sessions  will  consider 
philosophies  of  continuing  education, 
implications  for  professional  licensure, 
competencies  of  faculty,  and  national  and 
regional  planning  for  continuing  education. 
For  further  details  write  to  Department  of 
Nursing,  Health  Science  Unit.  University 
Extension,  The  University  of  Wisconsin, 
610  Langdon  St,  Madison.  Wisconsin 
53706,  U.S.A. 

November  3-5, 1971 

Alberta  Hospital  Association,  annual  meet- 
ing, Jubilee  Auditorium,  Edmonton,  Alberta. 


November  15-16, 1971 

Clinical  evaluation  in  nursing,  sponsored 
by  the  University  of  Toronto  School  of 
Nursing.  A  study  of  the  principles  of  clinical 
evaluation  and  their  application  in  the 
development  and  use  of  specific  evaluative 
methods  in  nursing.  Planned  primarily  for 
teachers  in  schools  of  nursing.  For  further 
information  write  to  Continuing  Education 
Program  for  Nurses,  University  of  Toronto, 
47  Queen's  Park  Crescent,  Toronto  5,  Ont.    • 

August  27-September  1, 1972 

Twelfth  World  Congress  of  Rehabilitation 
International.  Chevron  Hotel.  Kings  Cross, 
Sydney,  Australia.  Conference  Theme: 
Planning  Rehabilitation:  Environment  — 
Incentives  —  Self-Help.  For  further  in- 
formation write:  Twelfth  World  Rehabilita- 
tion Congress,  G.P.O.  Box  475.  Sydney, 
N.S.W.  2001,  Australia. 

THE  CANADIAN   NURSE      15 


CONSIDER  THESE  OUTSTANDING 
TEXTS  FOR  FALL  CLASSES 


FUNDAMENTALS    OF    NURSING:    The    Humanities    and 

Sciences  in  Nursing 

By  Elinor  V.  Fuerst,  R.N.,  M.A.,  and  LuYerne  Wolff,  R.N.,  M.A. 

This  extensively  revised  and  expanded  edition  reflects  greotly  increased 
emphasis  upon  the  independent  functions  implicit  in  the  nursing  role. 
Highlighted  ore  nursing  responsibilities  that  include  care  of  man  as  a 
human  being  as  well  as  a  biological  organism.  Nursing  measures, 
fundamental  to  the  care  of  all  patients,  have  been  added  and  others 
updated.  Stressed  are  the  physiologic,  pathologic  and  psychosocial 
bases  for  nursing  intervention. 
446   Pages  166    lllustrotions  4th    Edition,    1969  $8.00 

DUNCAN'S  DICTIONARY  FOR  NURSES  Just  Published: 
Helen  A.  Duncan,  R.N.,  M.A. 

Duncan's  Dictionary  for  Nurses  covers  all  the  terms  the  modern  nurse 
needs  to  know  in  the  areas  of  nursing,  medicine,  psychiatry,  and  the 
social  and  biological  sciences.  It  includes  many  terms  not  found  in 
medical  dictionaries,  and  presents  those  medical  terms  the  nurse  must 
use  in  her  work  from  /ler  point  of  view.  Truly  new,  from  cover  to  cover, 
Duncan's  Dictionary  will  be  equolly  useful  as  a  ready  reference  book  for 
the  busy  professional  nurse  and  supervisor,  and  as  a  practical  aid  to 
learning  for  student  nurses,  nurses'  aides,  and  paramedical  personnel. 
Nursing  instructors,  in  particular,  will  welcome  the  volume  for  the  time 
it  will  save  them  in  classroom  explanations. 

400  pp.,  $5.25;  hardbound,  $7.95 

NURSING  CARE  OF  THE  LONG-TERM  PATIENT 

Second  Edition 

Jeanne  E.  Blumberg,  R.N.,  P.H.N.,  M.S.;  and 

Eleanor  E.  Drummond,  R.N.,  P.H.N.,  Ed.D. 

This  successful  book  is  now  brought  up  to  date  in  a  second  edition  that 
takes  into  account  the  new  nursing,  medical,  technical,  and  societal 
discoveries  and  innovations  in  the  care  of  patients  with  long-term  ill- 
nesses. For  each  of  eight  key  concepts  in  the  management  of  such 
patients,  the  book  discusses  in  detail  the  relevant  techniques  and  pro- 
cedures. Contents:  A  model  for  nursing  care.  Observations.  Physical 
care.  Emotional  support.  Treatment.  Teaching.  Counseling.  Economics. 
Death,  the  inevitable — an  approach.  A  case  study — a  model  for  nursing 
care. 

156  pp.,  illus.,  flexible  cover,  $4.25 

Cooper's  NUTRITION  IN  HEALTH  AND  DISEASE 

By  Helen  S.  Mitchell.  Ph.D.,  Sc.D.,  Hendeirka  J.  Rynbergen,  M.S., 
Linnea   Anderson,   M.P.H.,   and   Morjorie    V.    Dibble,    M.S. 

A  comprehensive  survey  of  the  principles  of  nutrition  and  their  ap- 
plication to  normal  and  therapeutic  needs  is  presented  in  the  15th 
Edition  of  this  classic  text.  Additional  emphasis  is  given  to  the  under- 
lying biochemical  and  physiological  components  of  nutrition  as  they 
affect  the  maintenance  or  restoration  of  optimum  health. 
685  Pages  121    llustrations  ISth   Edition,   1968  $9.50 


PHARMACOLOGY  AND  DRUG  THERAPY  IN  NURSING 

By    Morton    J.    Rodman,    M.S.,    Ph.D.,    and    Dorothy    W.    Smith,    R.N., 
M.S.,  Ed.D. 

This  text's  pharmacodynamic  approach  provides  the  student  with  a 
true  understanding  of  the  nature  of  drug  action  and  a  sound  rationale 
for  nursing  intervention.  Covers  sources,  dosage,  physiologic  action, 
untoward  effects,  contraindications  and  implications  for  nursing  action. 
". . .  the  text.  Pharmacology  and  Drug  Therapy  in  Nursing,  stands  head 
and  shoulders  above  all  other  pharmacology  books  written  for  nurses." 
— American  Journal  of  Pharmaceutical  Education 
"...  a  textbook  of  superb  quality . . ." — from  "Books  of  the  Year," 
American  Journal  of  Nursing 

738    Pages  Illustrated  1968  $10.25 


TEXTBOOK    OF   MEDICAL-SURGICAL    NURSING 

By   Li7/;on   S.   Brunner,   R.N.,   M.S.;   Charles   P.    Emerson,   Jr.,   M.D.;    L: 
Kraeer   Ferguson,   M.D.;    and   Doris   S.    Suddarth,   R.N.,   M.S.N. 

Massively  revised  and  enlarged  in  scope,  this  edition  Is  designed  to 
develop  the  highest  degree  of  expertise  in  the  care  of  medical/surgical 
patients.  Exceptional  In  its  depth  of  pathophysiologic  content,  this  text 
also  emphasizes  the  psychosocial  factors  involved  in  patient  care. 
New  material  is  included  on  vascular/cardlac/resplratory  intensive 
care  nursing/neurologic  and  neurosurgical  problems/burns/genltourinary 
and  gynecologic  disorder/rehabilitative  measures. 
1031   Pages  387  Illustrations  2nd  Edition,  1970  $14.95 


F.    Howell    Wright,    M.D.,    and 


NURSING  CARE  OF  CHILDREN 

By    Florence    G.    Blake,    R.N.,    M.A., 
Eugenia  H.   Waechter,   R.N.,   Ph.D. 

Extensively  revised  and  expanded,  with  numerous  new  Illustrations, 
this  superb  text  is  without  peer  as  a  comprehensive.  In-depth  study 
of  pediatric  nursing.  Recent  findings  in  all  areas  of  care  are  Included 
— growth  and  development  (from  infancy  to  adolescence)  medical 
entities;  associated  nursing  therapies.  Consideration  Is  given  to  prob- 
lems of  minority  groups  and  cultural  differences,  the  battered-child 
syndrome,  and  contemporary  problems  of  the  adolescent. 
588   Pages  254   Illustrations  8th    Edition,   1970  $9.50 


BASIC  PSYCHIATRIC  CONCEPTS  IN  NURSING 

By    Charles    K.    Hofling,    M.D.,    Madeleine   M.    Leininger,    R.N.,    Ph.D., 
and  Elizabeth   A.   Bregg,   R.N.,   B.S. 

By  presenting  basic  concepts  usefull  in  all  areas  of  nursing,  the  authors 
provide  content  and  method  essential  to  the  practice  of  professional 
nursing  In  the  nonpsychiatric  as  well  as  the  psychiatric  setting. 
Emphasis  throughout  is  on  nursing  care  and  the  nurse's  significant 
role,  as  well  as  on  problem  solving,  process  recording  and  short  and 
long-term  nursing  goals. 
583    Pages  2nd    Edition,    1967  $7.25 


Lippincott 


J.  B.  LIPPINCOTT  COMPANY  OF  CANADA  LTD. 

60  Front  Street  West 

Toronto    1,   Ont. 


SERVING  THE  HEALTH   PROFESSIONS   IN  CANADA  SINCE   1897 


t6     THE  CANADIAN   NURSE 


AUGUST  1971 


Nurse  at  sea 


Around  the  world  in  a  ship.  Sound  like  fun?  It  is,  according  to  this  nurse,  even 
though  your  patients  may  suffer  from  seasickness,  fractures,  or  even  measles. 


Shirley  Fraser 

As  I  left  the  taxi  that  had  brought  me  to 
the  quayside,  I  looked  up  at  the  towering 
white  hull  of  the  ship  —  my  ship,  even 
though  she  was  Italian  and  I,  English 
—  and  thought  how  nice  it  was  to  be 
coming  back  to  her.  Then,  as  I  started 
up  the  crew  gangway.  I  chuckled  to 
myself.  How  silly  to  feel  like  this  when 
it  was  only  yesterday  morning  that  I  had 
left  her  to  go  on  a  36-hour  leave  between 
voyages. 

I  felt  even  more  satisfied  when  I 
found  that  my  two  colleagues,  also 
registered  nurses,  were  already  on 
board.  We  greeted  each  other  and 
exchanged  news  as  if  we  had  all  been 
away  on  vacation.  Still,  two  days  was  a 
long  separation  for  us. 

The  ship  and  her  hospital 

Our  voyage  around  the  world,  taking 
British  migrants  to  Australia  by  way  of 
South  Africa  and  bringing  fare-paying 
passengers  back  through  the  Panama 
Canal,  took  us  nine  weeks.  Members  of 
the  ship's  company  rarely  had  a  full  day 
ashore.  Those  of  us  in  the  ship's  hospi- 
tal usually  put  in  an  hour  or  two  of 
work  before  leaving  the  ship,  and  a 

Miss  I  raser,  a  graduate  of  the  Royal 
Berkshire  Hospital  in  Reading.  England, 
has  had  a  varied  nursing  career.  She  has 
worked  in  hospitals  in  Pakistan,  the 
U.S.A..  Bermuda,  and  Canada:  spent  over 
seven  years  at  sea:  and  has  been  a  hotel 
nurse  and  a  nurse  at  a  boys"  school. 


AUGUST  1971 


few  more  after  returning.  No  40-hour 
week  for  us!  However,  to  compensate, 
we  were  well  paid. 

We  were  a  happy  medical  unit,  and 
everyone  had  been  together  on  several 
trips.  There  were  eight  permanent 
members  of  the  staff:  two  surgeons,  as 
ship's  doctors  are  always  called;  a  dis- 
penser; a  male  nurse;  a  long-suffering 
and  hard-working  Chinese  steward;  and 
Margaret,  Anne,  and  myself  —  register- 
ed nurses. 

On  the  outward-bound  voyage  from 
Southampton  to  Sydney,  the  ship  had  to 
carry  a  British  or  Australian  doctor 
for  the  children  and  a  British  or  Aus- 
tralian night  nurse  —  a  requirement  of 
the  Australian  immigration  authorities. 
These  were  always  persons  who  "work- 
ed their  passage." 

Occasionally,  but  only  occasionally, 
we  had  the  same  good  fortune  home- 
ward-bound. If  there  was  no  night 
nurse,  the  five  of  us  who  were  RNs 
(the  dispenser  was  officially  a  nurse) 
took  our  turn  on  duty  until  midnight, 
then  went  on  call  from  midnight  to 
7:00  A.M.  When  we  had  a  seriously 
ill  patient  or  a  young  child  in  the  ship's 
hospital,  the  nurse  who  was  directly 
responsible  for  that  patient  slept  in 
the  same  ward. 

The  first  week  was  usually  the  most 
relaxed  part  of  the  voyage  for  the  medi- 
cal staff.  Passengers  had  not  yet  become 
ill,  and  we  were  not  yet  losing  an  hour's 
sleep  nightly  because  of  time  changes. 
THE  CANADIAN  NURSE     17 


We  were  given  officer  privileges, 
allowed  to  attend  the  gala  dances  and 
the  passenger  cinema  shows,  and  use 
the  music  room.  We  often  disregarded 
our  social  opportunities,  however.  On 
a  busy  trip  we  usually  preferred  our 
bunks  to  anything  that  interfered  with 
sleep. 

The  voyage  begins 

After  the  usual  wearying  first  day, 
with  passengers  arriving  out  of  clinic 
hours  to  see  the  doctors  and  making 
mistakes  about  the  times  we  dispensed 
bottles  and  baby  foods  to  infants  under 
a  year  old,  we  decided  to  go  to  the 
lounge  to  view  the  people  on  board. 

We  had  not  been  there  long  when  a 
steward  requested  Margaret  to  take  a 
telephone  call. 

"A  very  ill  lady  has  been  admitted, 
no  doubt,""  said  Margaret,  who  was 
responsible  for  the  adult  passenger 
clinic  and  the  female  ward,  "and  Anto- 
nio wants  me  to  help  the  new  night 
nurse."" 

She  came  back  a  moment  or  two 
later.  "Quite  right,  a  patient  with  a 
rather  bad  cardiac,"'  she  said,  and  left 
immediately. 

Anne  and  I  decided  to  go  down  to 
the  hospital  and  see  if  we  could  help. 

We  could.  On  the  way  we  heard 
familiar,  terrified  yells  coming  up  a 
stairway.  We  both  knew  what  this 
meant.  Some  youngster  had  had  a  finger 
crushed  in  one  of  the  ship's  heavy 
doors.  We  were  right.  We  escorted  the 
child  and  his  mother  to  the  hospital 
and,  as  we  entered  it,  the  mother  nearly 
fainted.  While  Anne  saw  to  her,  I  went 
into  the  operating  room  and,  with  the 
struggling  little  boy  tucked  under  an 
arm,  tried  to  prepare  for  a  suturing. 

The  children's  doctor  arrived  as  if 
by  magic.  In  three  quarters  of  an  hour 
he,  Anne,  and  I  had  transformed  one 
terrified  little  lad  into  one  who  was 
still  shuddering  with  sobs,  but  who  was 
18     THE  CANADIAN  NURSE 


proud  that  he  had  been  x-rayed  and  had 
his  arm  in  a  sling — "Just  like  Daddy 
when  he  broke  his  wrist,"  said  a  restored 
mother. 

Anne  and  I  then  tidied  the  OR  and 
peeped  into  the  women's  ward.  The 
cardiac  patient  was  dozing  peacefully 
in  an  oxygen  tent.  Then  we  went  into 
the  kitchen,  where  most  of  the  medical 
staff  had  gathered  and  were  drinking 
strong,  black,  Italian  coffee. 

"Well,"  said  Margaret  as  we  entered, 
"the  trip  seems  to  have  started  with  a 
bang  this  time!  Marjory  (the  night 
nurse)  has  admitted  a  patient  to  my 
ward,  and  one  to  your  department,  too, 
Shirley.  A  seven-year-old  with /M^'fli/e-.v." 

I  took  care  of  the  isolation  hospital 
and,  when  not  busy  there,  helped  where 
necessary.  Anne  dispensed  bottles  of 
milk  and  baby  foods  five  times  a  day 
to  infants,  ran  the  children's  clinic, 
and  looked  after  non-infectious  children 
who  were  admitted  to  the  hospital.  The 
dispenser,  of  course,  dispensed  med- 
icines, and  ran  the  clinic  for  the  crew. 
The  junior  male  nurse  helped  with  this 
and  was  responsible  for  the  men's 
wards. 

Bay  of  Biscay  to  Cape  Town 

As  it  turned  out,  the  first  part  of  the 
voyage  was  not  busy.  The  Bay  of  Biscay 
did  not  live  up  to  its  rough  reputation, 
and  our  cardiac  patient  progressed 
satisfactorily. 

Las  Palmas  is  a  good  shopping  port, 
and  all  the  members  of  the  medical 
department  who  wanted  to  get  ashore 
were  able  to  do  so.  Life  continued 
smoothly  on  the  long  haul  from  there 
to  Cape  Town.  The  weather  was  pleas- 
ant, but  on  the  cool  side.  Patients  admit- 
ted to  the  hospital  all  had  upper  respira- 
tory infections,  except  for  a  few  more 
cases  of  measles. 

The  day  before  we  reached  Cape 
Town,  a  girl  with  a  threatened  abortion 
was   admitted   to   hospital.   She   bled 


heavily  and  had  an  incomplete  abortion 
during  the  night.  She  went  ashore  to 
Groote  Schuur  Hospital,  had  a  dilation 
and  curettage  and  a  blood  transfusion, 
and  returned  to  the  ship  before  we 
sailed. 

As  we  crossed  the  southern  Indian 
ocean,  accompanied  at  times  by  that 
magnificent  sea-bird,  the  albatross, 
the  hospital  became  busier.  The  male 
nurse  had,  in  his  ward,  an  unconscious 
patient  who  had  had  a  cerebrovascular 
accident,  and  Margaret  had  an  asth- 
matic patient  in  hers.  Diarrhea  and 
vomiting,  common  complaints  aboard 
ships,  swept  through  the  passengers, 
and  the  clinics  were  busy.  Fortunately, 
it  was  the  adults,  not  the  children,  who 
were  principally  affected. 

The  number  of  measles  cases  slowly 
increased.  Three  days  before  we  "hit 
the  Australian  coast,"  (as  seamen  al- 
ways say),  three-year-old  twins  were 
admitted  to  the  hospital  with  this  dis- 
ease. Their  parents  were  unhappy,  to 
say  the  least,  that  they  could  not  visit 
the  children  in  the  ward. 

AUGUST  1971 


I  explained  the  Hague  Convention, 
which  decrees  that  patients  aboard 
ship  who  have  communicable  diseases 
must  be  isolated.  Anne  repeated  this 
information,  and  so  did  two  of  the  doc- 
tors. Finally,  the  staff  captain  had  to  do 
so.  The  couple  must  have  been  fed  up 
with  thewords  "the  HagueConvention." 

Around  the  Australian  coast 

The  parents  of  the  twins  could  hardly 
wait  to  get  to  Fremantle,  the  chief  port 
of  Western  Australia,  where  they  were 
disembarking.  However,  when  they 
were  interviewed  by  the  port  health 
doctor,  they  were  told  the  twins  would 
have  to  be  transferred  to  a  shore-side 
infectious  disease  hospital. 

The  patient  with  the  cerebral  hem- 
orrhage and  the  asthmatic  patient  were 
also  hospitalized  in  Fremantle,  and 
other  patients  disembarked,  so  there 
were  few  persons  left  in  our  hospital. 
We  had  a  busy  morning,  however,  and 
there  was  no  time  to  go  ashore,  except 
to  the  port's  fine  Ocean  Terminal.  Here 
I  bought  newspapers,  magazines,  and 
a  bark  picture,  made  by  the  aborigines. 

Like  the  Bay  of  Biscay,  the  Great 
Australian  Bight  has  a  reputation  for 
being  choppy;  but  it  did  not  live  up  to 
expectations  this  voyage.  We  had  a 
smooth  and  uneventful  crossing  to 
Melbourne,  where  the  ship  remained 
in  port  for  24  hours. 

A  full  day  at  sea  separates  Melbourne 
and  Sydney,  On  this  day,  a  child  who 
had  been  unwell  for  several  days  was 
brought  to  the  morningclinic,  diagnosed 
as  having  acute  appendicitis,  and  oper- 
ated on  in  the  late  evening.  1  had  been 
at  sea  for  seven  years  and  had  seen  only 
three  appendectomies  performed  aboard 
ship. 

Although  we  had  all  worked  until 
the  early  hours  of  that  morning,  Anne 
and  I  were  up  to  watch  the  ship  enter 
Sydney  Harbour.  Before  going  on 
duty,  I  got  several  snapshots  of  the 
AUGUST  1971 


bridge  and  the  fantastic  opera  house. 

To  my  delight,  we  docked  in  Circular 
Quay.  This  is  a  fascinating  dock,  a 
stone's  throw  from  the  opera  house  and 
within  walking  distance  of  the  bridge. 
It  is  the  terminal  for  the  ferries  that 
cross  the  harbor  to  a  dozen  different 
points,  and  there  are  umpteen  little 
shops  in  the  area  to  tempt  passengers 
while  they  wait  for  the  ferries.  My  time 
ashore  in  Sydney  was  spent  around 
Circular  Quay  with  my  camera. 

When  1  returned  to  the  ship,  welcome 
news  awaited  me:  we  were  having  a 
night  nurse  homeward  bound.  There 
was  no  doctor  working  his  passage  to 
England,  though,  so  the  Junior  surgeon 
would  have  to  take  over  the  children's 
clinic. 

Measles  again 

The  only  noteworthy  thing  that 
happened  between  Sydney  and  Tahiti 
was  that  two  children  who  had  embark- 
ed at  Fremantle  developed  measles. 
Alas,  these  homeward-bound  children 
had  caught  the  disease  from  the  out- 
ward-bound ones!  Fortunately,  fewer 
children  were  on  the  return  voyage,  so 
with  a  bit  of  luck  these  two  might  be 
the  only  victims. 

Marjorie,  Margaret,  and  I  went  for 
a  drive  around  Tahiti.  When  wc  got 
back  on  board,  we  found  that  another 


child  with  measles  had  been  admitted 
to  the  isolation  unit.  The  following  day, 
two  more  were  admitted;  numbers 
slowly  increased. 

Unfortunately,  most  were  toddlers, 
and  toddlers  require  far  more  attention 
than  children  who  can  use  the  toilet 
and  feed  themselves.  I  found  myself 
extremely  busy.  Anne  gave  me  a  lot 
of  help,  but  finally  we  found  ourselves 
giving  up  our  off-duty  hours  and  falling 
into  bed  as  soon  as  the  night  nurse  took 
over.  Luckily,  none  of  our  patients 
developed  any  complications. 

The  last  lap 

There  was  a  lull  between  batches  of 
children  the  day  we  went  through  the 
Panama  Canal.  That  afternoon  I  man- 
aged to  get  on  deck  as  we  passed  through 
the  Gatun  Locks  shortly  before  docking 
in  Cristobal,  on  the  eastern  end  of  the 
Canal.  As  a  rule  we  stopped  on  the 
Pacific  side  of  it,  so  this  was  a  pleasant 
change,  particularly  as  Cristobal  is 
better  for  shopping  than  Panama. 

Hard  work  was  the  hospital  staffs 
lot  across  the  Atlantic.  Because  so  many 
patients,  including  two  adults,  were 
admitted  with  measles,  everybody  had 
to  help  look  after  them.  The  weather 
was  somewhat  rough,  so  there  was  a  lot 
of  seasickness.  One  person  ended  up 
with  a  fractured  clavicle,  another,  a 
Pott's  fracture.  1  did  not  get  ashore  at 
either  Cura(;ao,  in  the  West  Indies,  nor 
at  Lisbon,  and  was  worn  out  when  we 
reached  Southampton. 

Anne,  to  her  relief,  was  having  a 
voyage  off.  Margaret  had  decided  to 
leave  the  sea.  They  urged  me  to  go 
ashore  as  soon  as  we  d(x:ked.  and  said 
they  would  stay,  see  the  patients  off. 
and  spring-clean  the  wards.  1  then  went 
to  London  to  stay  with  my  sister. 

1  returned  in  48  hours,  much  refresh- 
ed and  ready  to  begin  another  trip; 
ready  for  another  nine  weeks  of  — 
what.'  ^ 

IHE  CANADIAN  NURSE     19 


Vasectomy 


Most  men  who  request  a  vasectomy  as  a  permanent  method  of  sterilization  are 
reasonably  intelligent,  require  little  counseling,  and  ask  few  questions.  Usually 
their  family  relationship  is  sound. 


lain  A.  D.  Todd,  M.  Chir.,  F.R.C.S.  (C) 

Ten  years  ago  in  most  parts  of  Canada, 
it  was  impossible  to  find  a  physician 
who  openly  performed  vasectomies  for 
male  sterilization.  The  most  significant 
reason  for  this  was  the  reluctance  of 
most  physicians  to  put  themselves  in  a 
position  where  they  were  possibly  at 
risk  legally,  and  many  physicians  men- 
tally associated  the  performance  of 
vasectomy  with  the  performance  of 
abortion. 

It  is  quite  incredible  how,  in  10  short 
years,  the  attitude  of  the  medical  profes- 
sion has  changed.  The  general  liberali- 
zation of  thought  regarding  sex,  sterili- 
zation, and  abortion,  along  with  the 
published  support  of  many  dedicated 
and  thoroughly  respectable  organiza- 
tions, has  made  the  physician  more 
willing  to  risk  a  law  suit  although,  to  my 
knowledge,  no  test  of  the  legality  of  the 
procedure  has  yet  occurred  in  the  Ca- 
nadian courts.  Each  physician  has  to 
make  up  his  own  mind  whether  he 
believes  it  to  be  morally  correct  to 
perform  a  surgical  operation  on  a 
healthy  person  for  what  can  only  be 
called  social  convenience. 

Reasons  for  seeking  vasectomy 

Methods  of  birth  control  can  be 
grouped   into  the  temporary  and  the 


Dr.  Todd,  a  graduate  of  Cambridge  Uni- 
versity, is  Chief  of  Urology  at  Scarbo- 
rough Centenary  Hospital.  West  Hill, 
Ontario. 


20     THE  CANADIAN  NURSE 


permanent.  The  latter  consists  of  vasec- 
tomy and  tubal  ligation.  Since  perma- 
nent sterilization  has  a  direct  relation- 
ship to  the  family  structure,  the  spouse 
must  be  consulted  and  accept  respon- 
sibility. 

In  my  experience,  the  reasons  for  a 
couple  seeking  permanent  sterilization 
are  almost  always  female  originated. 
They  may  be  medical  (danger  of  further 
pregnancy),  psychological  (fear  of  furth- 
er pregnancy),  or  complications  from 
other  forms  of  birth  control,  notably  the 
use  of  the  pill.  In  less  than  10  percent 
of  the  couples  I  have  seen,  the  initial 
move  came  from  the  male;  in  these 
instances,  the  two  most  common  factors 
were  age  and  economics.  With  this 
predominance  of  female-originated 
wish  for  permanent  sterilization,  the 
males  who  offer  to  have  the  operation 
are  generally  considerate,  and  usually 
the  family  relationship  is  a  sound  one. 

Occasionally  motives  for  requesting 
sterilization  are  devious.  One  man  I 
operated  on  was  impotent  beforehand, 
and  he  felt  that  part  of  his  problem  was 
the  family's  concern  about  a  possible 
addition.  Naturally,  he  was  still  impo- 
tent later,  when  I  learned  more  of  the 
facts.  One  other  situation,  which  I 
fortunately  discovered  in  my  initial 
interview,  involved  a  bad  marriage 
with  little  respect  between  the  couple. 
The  man  felt  that  his  wife's  apparent 
lack  of  sexual  eagerness  was  due  to  a 
fear  of  pregnancy  when,  in  fact,  it  was 
due  to  a  candid  dislike  of  her  husband. 
AUGUST  1971 


This  is  one  of  the  tew  patients  1  have 
refused  to  consider  for  a  vasectomy. 

Most  patients  who  request  a  vasec- 
tomy are  reasonably  intelligent,  have 
spoken  to  friends  about  it,  and  have 
read  a  fair  amount  about  the  subject 
before  they  are  seen.  They  require 
little  counseling  and  ask  few  questions. 
If  they  are  above  the  age  of  35,  I  have 
no  trouble  in  acceding  to  their  wishes; 
if  they  are  between  30  and  35,  I  ask 
a  few  more  penetrating  questions  about 
the  marital  stability.  When  they  are 
under  30,  I  spend  a  great  deal  of  time 
trying  to  dissuade  them  from  having 
permanent  sterilization,  in  this  last 
group  I  generally  send  the  couple  away 
to  cogitate  for  a  three-month  period. 
If,  at  the  end  of  that  time,  they  are  still 
adamant  and  my  first  impression  at 
interview  was  one  of  stability,  then 
a  vasectomy  will  be  done. 

Two  patients  who  had  vasectomies 
performed  for  unusual  indications  are 
worthy  of  mention.  The  first  was  a 
hiighly  intelligent  young  man  of  24 
about  to  be  married,  who  had  a  strong 
family  history  of  a  dominant  genetic 
disorder.  He  and  his  fiancee  had  con- 
sulted a  geneticist.  As  a  result  of  this 
consultation  they  felt  that  the  risk  of 
bringing  an  abnormal  child  into  the 
world  was  unacceptable  and  a  vasecto- 
my was  done.  The  other  unusual  prob- 
lem arose  when  a  father  of  40  brought 
his  1 7-year-old  son  into  the  office  with 
him.  The  lad  had  an  lO  of  just  over  60, 
and  was  unable  to  look  after  himself, 

AUGUST  1971 


although  he  was  a  fully  mature  male 
physically.  Father  and  son  had  side-by- 
side  vasectomies. 

Routine  involved 

Vasectomy  is  a  simple  operation  with 
few  complications.  It  can  be  performed 
by  most  medically  qualified  people,  and 
perhaps  the  most  suitable  person  is  the 
family  doctor.  He  is  the  one  most  likely 
to  know  the  family  members,  their 
socio-economic  situation,  and  their 
stability. 

As  a  urologist,  I  see  patients  on  a 
referred  basis  only,  and  I  feel  I  have 
to  get  to  know  them  before  performing 
any  operation.  1  therefore  take  a  brief 
history  and  do  a  physical  examination 
on  the  husband,  talk  to  the  wife  and 
then  to  both  together  before  having  them 
sign  the  forms.  This  visit  takes  an  aver- 
age of  1 5  to  20  minutes. 

Initially,  the  procedure  was  carried 
out  under  a  general  anesthetic.  During 
this  time  my  colleague  and  I  worked 
out  our  own  techniques,  as  this  was  not 
incorporated  in  our  medical  training. 
As  we  became  more  proficient,  we 
started  to  use  1  percent  Xylocaine 
without  adrenalin,  and  now  use  a  gen- 
eral anesthetic  only  if  we  anticipate 
trouble  because  of  local  anatomic 
variances.  For  example,  one  patient 
to  whom  I  gave  a  general  anesthetic 
for  a  vasectomy  had  virtually  no  scrotum 
and  his  testes  were  buried  in  a  large, 
infrapubic  fat  pad. 

Having  started  with  general  anesthe- 


sia and  having  a  cooperative,  liberal- 
minded  hospital  administration,  we 
were  fortunate  to  be  permitted  to  con- 
tinue doing  vasectomies  in  the  hospital 
cystoscopy  suite.  The  sterile  surround- 
ings and  instruments,  along  with  highly 
trained  help,  make  the  procedure  much 
more  efficient  than  I  could  make  it  in 
the  office.  My  colleague  and  1  are 
fortunate,  but  1  have  no  personal  axe 
to  grind  with  the  concept  of  office 
vasectomy. 

Surgical  technique 

The  instruments  used  during  the 
procedure  are  shown  in  the  photograph. 
The  needle  driver  is  used  only  if  skin 
suture  is  required.  The  Allis  forceps 
should  have  deep,  sharp  teeth,  but  the 
variety  of  "snap"'  is  immaterial.  I  prefer 
toothed  Adson  forceps  and  very  sharp, 
pointed,  curved  scissors  during  the 
dissection.  The  second  pair  of  scissors 
is  used  to  cut  sutures. 

Following  suitable  preparation  and 
draping,  my  technique  is  to  stretch  the 
skin  of  the  median  scrotal  raphe  over 
one  of  the  testicles  to  find  a  one  cm. 
length  of  the  midline  that  is  free  of 
blood  vessels.  Local  anesthetic  is  then 
infiltrated  in  this  area,  and  a  vertical 
one  cm.  incision  made.  The  left  vas  is 
grasped  between  finger  and  thumb  and 
maneuvered  beneath  the  skin  incision. 

The  vas  and  its  surrounding  tissues 
are  then  further  infiltrated  with  the 
local,  and  the  sharp  scissors  are  used 
in  a  spreading  fashion  parallel  to  the 
vas  to  separate  it  from  its  surroundings. 
The  vas  is  then  picked  up  with  the 
Allis  forceps  and  further  dissected  to 
clear  away  all  adventitia.  This  usually 
enables  one-half  inch  of  vas  to  be 
delivered  for  excision.  It  is  sent  for 
pathological  confirmation. 

The  cut  ends  are  tied  with  silk  no.  1, 

and  these  silks  are  tied  to  each  other. 

The  latter  move  helps  to  control  oozing, 

usually  turns  the  cut  ends  of  vas  so  that 

THE  CANADIAN   NURSE     21 


they  point  away  from  each  other,  and 
also  gives  a  permanent  landmari<  should 
the  unlikely  situation  occur  that  reversal 
is  requested. 

The  same  prcx:edure  is  done  on  the 
right  side  and.  if  the  incision  has  indeed 
avoided  blood  vessels,  then  no  skin 
suture  is  necessary.  The  patients  are 
advised  to  wear  Jockey-type  shorts  when 
they  come  for  a  vasectomy,  and  these 


satisfactorily  hold  in  a  small  gauze 
dressing  that  prevents  embarrassing 
oozing. 

Aftercare  and  results 

There  is  usually  some  discomfort 
tor  24  to  72  hours,  and  an  awareness 
that  something  has  been  done  for  a 
week  or  two,  but  most  patients  need  no 
more  than  a  couple  of  A  PC  tablets 
postoperatively. 


Approximately  I  patient  in  every  20 
will  develop  undue  discomfort  on  one 
side  or  the  t)thcr.  This  appears  to  be 
a  chemical  rather  than  a  bacterial 
intlammation,  either  due  to  spilled 
spermatozoa  or  the  suture  material. 
This  responds  quickly  and  easily  to 
oxyphenbutazone  100  mg.  t.i.d.  for  10 
days. 

One  patient  in  fifty  will  develop  a 
hard,  marble-sized  lump  at  the  site  of 
"igation,  which  1  believe  to  be  a  similar 
chemical  type  of  intlammation.  These 
persist  for  many  months  and  are  inter- 


Instruments  used  to  perform  a  vasectomy 


22     THE  CANADIAN   NURSE 


AUGUST  1971 


mittently  painful.  Out  of  over  600 
personal  cases,  three  patients  have  gone 
on  to  extrude  the  silk  suture  from  one 
or  other  side. 

Three  patients  have  developed  severe 
epididymitis  and  required  hospitaliza- 
tion, and  one  patient,  a  severe  diabetic, 
developed  a  scrotal  abscess  and  had  to 
be  admitted. 

Following  the  operation,  showers 
only  are  allowed  for  the  first  week;  no 
dressings  are  required  after  the  first  24 
hours.  Despite  this  apparently  cavalier 
disregard  for  aseptic  techniques,  no 
bacterial  infections  have  been  reported 
except  for  the  diabetic  mentioned 
above. 

As  the  vas  is  severed  in  the  scrotum, 
a  length  of  vas  with  its  ampulla  and 
the  seminal  vesicle  on  each  side  are 
not  affected  by  the  operation.  These 
areas  contain  live  spermatozoa  that 
remain  viable  for  many  months. 

Following  a  vasectomy,  therefore, 
patients  are  encouraged  to  be  sexually 
active,  but  continue  to  take  birth  control 
precautions  for  two  months.  At  the  end 
of  that  time  a  seminal  fluid  specimen 
is  examined  in  the  office.  Ninety-five 
percent  of  the  time  this  shows  no  live 
or  dead  spermatozoa,  and  the  patient 
is  advised  that  he  can  stop  using  birth 
control.  The  further  five  percent  usually 
show  few  poor  quality  spermatozoa, 
but  they  are  advised  to  continue  with 
birth  control  methods  for  a  further  six 
weeks,  at  which  time  they  have  another 
seminal  fluid  analysis. 

Six  patients  (one  percent)  have  had 
to  have  the  procedure  repeated  because 
of  persistent  spermatozoa;  all  were 
successful  on  the  second  occasion. 
These  occurred  in  the  first  two  years, 
when  I  like  to  think  i  was  a  little  less 
skilled  than  I  am  now.  The  reason  for 
failure  is  probably  removal  of  throm- 
bosed veins  instead  of  a  segment  of  vas 
(this  is  why  we  now  send  segments  to 
pathology)  or  removal  of  two  segments 
AUGUST  1971 


of  the  same  vas.  I  doubt  the  oft-claimed 
excuse  of  a  double  vas  on  one  side,  and 
believe  failure  to  be  surgical  error. 

To  my  knowledge,  only  one  true 
■'failure'"  occurred.  This  patient's  wife 
became  pregnant  despite  an  absence 
of  spermatozoa  from  the  specimen 
both  before  and  after  the  event! 

Comments 

Vasectomy  as  a  means  of  permanent 
sterilization  is  definitely  becoming 
increasingly  popular.  More  physicians 
are  performing  the  procedure  than 
ever  before,  yet  waiting  lists  continue 
to  increase  —  mine  is  now  over  four 
months.  There  is  no  scientific  evidence 
in  the  human  that  re -canalization  after 
this  type  of  technique  ever  occurs,  so 
that  as  far  as  one  can  say,  the  method  is 
"foolproof." 

Vasectomy  does  not  create  any  hor- 
monal imbalance,  and  therefore  sexual 
drive  and  performance  should  not  be 
altered  in  any  way.  Seminal  fluid  comes 
mostly  from  the  prostate,  and  ejacula- 
tion occurs  just  as  before. 

I  have  been  surprised  to  find  so 
few  psychological  effects  occurring 
following  this  procedure.  The  only  one 
I  have  personally  encountered  was  a 
patient  referred  by  another  urologist 
for  a  re-anastomosis  only  one  month 
after  the  vasectomy.  This  patient  had  a 
long  history  of  mental  illness  even 
before  his  operation,  and  has  since 
spent  a  great  deal  of  time  in  hospital. 

If  the  patient  changes  his  mind  at 
a  later  date,  reversal  can  be  accomplish- 
ed quite  easily.  However,  the  proof  of 
adequate  reversal  is  a  subsequent  preg- 
nancy, and  this  depends  on  the  quality 
of  sperm  produced  after  obstruction  of 
the  vas  for  some  time.  Since  this  is  an 
unknown  quantity,  I  always  advise 
patients  to  think  of  a  vasectomy  as  a 
permanent,  irreversible  proposition. 
I  have  performed  two  reversals  that 
were    technically    easy,    but    am    still 


awaiting  the  reappearance  of  spermato- 
zoa and  pregnancy. 

Conclusion 

The  photograph  of  the  four  mon- 
keys shows  a  marble  statue  that  I  ob- 
tained in  India  last  year.  The  added 
monkey  is  "do  no  evil,"  and  my  guide 
attributed  his  presence  to  the  enormous 
need  for  family  planning  in  his  country. 
Unfortunately  there,  as  here  in  Canada, 
the  uneducated  are  suspicious  of  and 
the  uninformed  diffident  to  vasectomy 
and,  in  fact,  to  any  method  of  birth 
control.  If  one  carries  that  thought 
to  its  ultimate  conclusion,  the  possibili- 
ty of  creating  an  imbalance  between  the 
productive  and  the  dependent  members 
of  society  becomes  very  real  and  tant- 
amount to  voluntary  genocide. 

Quite  apart  from  that  consideration, 
it  is  obvious  that  those  in  the  lower 
income  brackets  are  not  able  to  afford 
to  care  for  large  families  in  our  society. 
At  present,  the  political  solution  seems 
to  be  to  subsidize  and  encourage  the 
larger  families.  I  believe  that  the  time 
has  come  to  take  a  long  hard  look  at 
this  policy  and  wonder  if  society  at 
large  should  not  have  a  word  to  say  in 
the  "right"  of  the  individual  to  pro- 
create. 'iS' 


THE  CANADIAN  NURSE     23 


( 


Specially  for  the  newborn  - 
intensive  care  in  the  nursery 


Where  hospitals  have  fully  equipped  and  well-staffed  special  care  units, 

the  survival  rate  for  high  risk  babies  has  improved.  The  treatment  couples 

new  techniques  with  intensive  aggressive  care  from  the  moment  of  birth. 

The  author  describes  such  a  unit  in  Grace  General  Hospital,  Winnipeg,  Manitoba. 


Ann  Carrol  Youngblut 


Like  "Topsy,"  our  newborn  special  care 
nursery  "just  growed."  In  1967  we  had 
1,267  deliveries.  By  1970  there  were 
1,500  deliveries,  and  it  was  predicted 
we  would  have  2,000  deliveries  in 
1971.  Before  a  move  in  1967  to  the 
suburb  of  St.  James-Assiniboia,  we  had 
a  "premie"  nursery,  but  all  sick  babies 
were  transferred  to  a  central  neonatal 
intensive  care  unit. 

Supported  by  our  chief  of  pediatrics, 
the  staff  used  the  move  as  an  opportu- 
nity to  prove  our  contention  that  a 
special  care  nursery  would  fill  a  need 
in  our  community  hospital.  We  now 
care  for  all  our  newborns  with  the 
exception  of  those  requiring  respirators 
or  immediate,  specialized  surgery. 

A  community  hospital  can  care  for 
many  infants  who  do  not  require  trans- 
fer to  save  their  lives  or  who  could 
never  tolerate  a  transfer.  Our  goal  goes 
beyond  the  reduction  of  infant  mortality 
and  encompasses  the  concept  of  intact 
survival  through  excellence  of  care. 

Mrs.  Youngblut,  a  graduate  of  the  Univer- 
sity of  Alberta  Hospital  School  of  Nurs- 
ing, Edmonton,  is  in  charge  of  the  New- 
born Special  Care  Unit,  Grace  General 
Hospital.  Winnipeg,  Manitoba.  The  author 
thanks  E.  Parker,  Supervisor  of  Obstetrics 
and  Gynecology,  and  Velma  Johnston, 
Head  Nurse,  for  their  encouragement 
and  assistance  in  writing  this  article. 


24     THE  CANADIAN  NURSE 


Family-centered  care 

In  keeping  with  the  policy  of  the 
obstetrical  department  to  practice 
"family-centered  maternity  care,"  we 
have  changed  the  strict  isolation  and 
the  "hands  off'  approach  used  in  the 
past  to  care  for  the  newborn,  sick  or 
well.  Much  interesting  study  and  in- 
vestigation is  being  done  into  our  long- 
held  North  American  practice  of  sepa- 
rating mother  and  child  after  delivery. 
The  most  famous  of  the  early  neonatal- 
ogists,  Pierre  Buden,  recognized  as 
early  as  1895  that  "Mothers  separated 
from  their  young  soon  lost  all  interest 
in  those  whom  they  were  unable  to 
nurse  or  cherish. "^ 

Mothers  and  fathers  are  invited  to 
come  to  the  nursery.  Observing  hand 
washing  techniques  described  later  in 
this  article,  they  may  gown  and  reach 
into  the  isolette  to  touch  their  child  and 
gradually  perform  simple  tasks  of  care. 
Even  if  the  child  is  seriously  ill,  parents 
are  comforted  by  visiting  and  by  an 
explanation  of  treatment  and  equipment 
used.  An  attitude  of  cautious  optimism 
is  maintained  by  staff.  As  the  child 
progresses,  the  mother  is  allowed  to 
hold  and  to  feed  her  baby.  After  her 
hospital  discharge,  she  is  encouraged  to 
visit  often  and  to  learn  how  to  care  for 
her  baby. 

Babies  are  taken  out  of  the  isolette 

as  soon  as  safety  permits  for  "cuddling" 

AUGUST  1971 


and  feeding  in  our  nursery  rocking 
chairs.  They  are  nursed  in  cribs  when 
their  weight  reaches  2,040  Gm.  Bottle 
feedings  replace  gavage  gradually,  and 
intervals  between  feedings  are  lengthen- 
ed from  three  to  four  hours  by  discharge 
time. 

Parents  are  asked  to  bring  brightly 
colored  toys  and  mobiles  to  hang  on 
isolette  or  crib.  Music  boxes  are  a 
wonderful  aid  to  provide  sensory  stimu- 
lation. Nurses  have  observed  small 
babies  listening  attentively  to  "Brahms 
Lullaby."  As  the  babies  grow  older, 
cuddle  seats  are  used  in  isolette  or 
crib  to  offer  a  change  in  position.  We 
talk  to  the  babies,  using  their  first 
names.  They  like  it  and  their  parents 
love  it. 

We  suggest  that  units  such  as  ours 
be  provided  with  a  parents'  room  ad- 
jacent to  the  nursery.  This  gives  a  pri- 
vate place  for  parents  to  talk  with  the 

AUGUST  1971 


nurse,  physician,  or  clergy  and  to  hold 
and  feed  their  infant. 

At  discharge,  referral  is  made  to  the 
public  health  department  to  ensure 
some  continuity  of  care.  Much  improv- 
ement is  needed  in  this  area.  A  home 
visit  by  an  obstetrical  nurse  who  is 
familiar  with  both  mother  and  child 
would  be  beneficial  if  carried  out  w  ithin 
1 0  days  of  discharge. 


The  rewards 

We  have  many  success  stories.  One 
of  the  most  exciting  began  on  September 
24,  1969,  when  Mrs.  Sandra  G.,  moth- 
er of  two  girls  aged  five  and  two,  was 
delivered  at  32  weeks'  gestation  of 
triplet  boys.  A,  B  and  C,  later  named 
Andrew,  Bruce,  and  Colin.  They  weigh- 
ed 1,200,  1,270,  and  1,245  Gm.  All 
suffered  severe  respiratory  distress 
and  numerous  setbacks,  including 
spontaneous  pneumothorax.  We  were 
provided  with  two  extra  cardiac  moni- 
tors. With  many  overtime  nursing  hours 
and  the  guidance  and  encouragement 
of  the  attending  pediatrician  and  our 
staff  physicians,  we  discharged  three 
healthy  boys  November  25,  1969. 
They  will  soon  be  two  years  old  and 
are  progressing  normally. 

Donna  Marie  K.  was  born  at  28 
weeks' gestation,  on  September  1,  1967, 
weighing  1,077  Gm.  Looking  back 
over  her  history,  we  find  severe,  pro- 
longed apnea  from  admission  until  one 
month  of  age.  She  received  intermittent 
oxygen  for  36  days.  She  required  endo- 
tracheal intubation  on  several  occa- 
sions, and  on  September  20  spontane- 
ous respirations  were  not  reestablished 
for  approximately  20  minutes.  On  Sep- 
tember 23,  she  was  given  30  cc.  of 
packed  cells  when  her  hemoglobin  fell 
to  8.5  Gm.  At  this  time  she  weighed 
1.050  Gm.  Today,  Donna  Marie  is  a 
happy,  healthy,  intelligent,  well-formed 
child.  Her  progress  encourages  us  to  do 
everything  possible  to  help  premature 


infants  fight  seemingly  impossible  odds. 
Lisa  S.,  gestation  26  weeks,  weighed 
in  at  822  Gm.  on  October  16,  1970, 
and  amazed  everyone  by  progressing 
with  few  problems  other  than  the  in- 
evitable apnea.  She  was  discharged  a 
healthy  baby,  weighing  2,425  Gm.,  on 
January  15, 1971. 


Facilities  and  equipment 

Elaborate  facilities  and  equipment 
are  not  a  requisite  for  a  special  care 
nursery.  We  have  a  large  room  with 
a  desk,  wall  storage,  and  scrub-up  area 
divided  from  the  patient  area  by  a  glass 
partition.  Within  the  patient  area  are 
two  sinks  with  foot-operated  taps  and 
soap  dispensers.  Large  viewing  windows 
allow  mothers  to  see  their  infants  from 
the  patient  corridors.  The  blinds  are 
left  open  in  all  nurseries  unless  a  proce- 
dure is  taking  place  that  might  distress 
onlookers.  There  are  eight  wall-mount- 
ed oxygen  and  suction  outlets  that 
have  proved  more  than  adequate. 

We  have  eight  isolettes  and  are  grad- 
ually replacing  our  older  models  with 
Air  Shields  Model  C-86  with  Servo 
Thermal  Control  Unit.  Recent  studies 
have  shown  the  importance  of  keeping 
the  newborn's  temperature  at  thermo- 
neutrality.  This  unit  maintains  exposed 
abdominal  skin  temperature  at  36.5 
degrees  centigrade.  ^  Routine  delivery 
room  care,  which  often  results  in  excess- 
ive chilling  of  the  low-birth-weight 
baby,  is  minimized  by  the  use  of  infra- 
red warmers  and  preheated  incubators 
until  transfer  to  the  nursery. 

Apart  from  the  isolette,  our  most 
valuable  equipment  has  proved  to  be 
the  Harco  Cardiac  Monitor,  Model  Har 
14.  This  comparatively  inexpensive 
device  is  invaluable  in  the  early  detec- 
tion of  apnea.  An  apneic  episode  is 
followed  in  less  than  30  seconds  by  a 
decrease  in  heart  rate.  ^  An  alarm  warns 
the  nurse  to  stimulate  the  child  before 
damaging  anoxia  occurs. 

THE  CANADIAN  NURSE     25 


The  Sage  infusion  pump  helps  to 
keep  intravenous  infusions  open  and 
running  at  accurate  rates  as  low  as  one 
to  two  cc.  per  hour.  ''  Phototherapy 
units,  used  interchangeably  with  the 
main  nursery,  have  greatly  reduced  the 
incidence  of  severe  hyperbilirubinemia 
and  resulting  exchange  transfusions.  ^ 
A  portable  x-ray  machine  is  available 
for  those  patients  unable  to  be  moved 
to  our  radiology  department.  A  necess- 
ary adjunct  to  our  nursery  is  a  labora- 
tory available  on  a  24-hour  basis  to 
monitor  blood  gases,  electrolytes,  serum 
glucose,  calcium,  and  bilirubin  by  micro 
method  and  to  do  routine  hematology, 
urinalysis,  and  bacteriology. 

When  any  amount  of  oxygen  is  added 
to  inspired  air,  the  use  of  an  accurate, 
regularly  calibrated  oxygen  analyzer 
is  a  must.  In  our  unit,  oxygen  is  given 
in  sufficient  concentration  to  keep  the 
infant  a  good  color.  Once  this  is  achiev- 
ed, regular  attempts  are  made  to  lower 
and  discontinue  oxygen.  Even  low 
concentrations  over  a  long  period,  when 
not  required,  may  cause  retrolental 
fibroplasia. 

Our  unit  depends  on: 

Nursing  Staff:  Nothing  is  more  im- 
portant to  the  survival  and  progress  of 
our  patients  than  the  quality  of  nursing 
they  receive.  The  nurse  is  the  key  per- 
son in  the  nursery  24  hours  a  days.  We 
train  staff  through  a  regular  ongoing 
inservice  education  program.  We  en- 
courage attendance  at  courses  and  con- 
ferences on  special  care  for  the  new- 
born. 

Depending  on  types  of  infants  pre- 
sent, a  ratio  of  one  registered  nurse  for 
every  three  to  five  babies  is  necessary. 
All  nursery  nurses  rotate  through  the 
unit  to  assure  adequate  number  of  train- 
ed personnel.  Student  nurses  who 
choose  this  area  for  their  senior  ex- 
perience also  rotate  through  the  unit. 
Our  experience  shows  that  carefully 
selected,  unit-trained  licensed  practical 
nurses  and  aides  can  give  care,  working 
under  the  direction  of  a  registered 
nurse. 

26     THE  CANADIAN  NURSE 


Physician's  program:  A  qualified 
pediatrician  is  in  charge  of  the  nur- 
series, with  seven  staff  pediatricians 
providing  coverage  on  a  rotating  basis. 
We  have  a  full-time  pediatric  resident, 
and  an  intern  education  program, 
which  includes  participation  in  infant 
care. 

Infant  transportation:  A  program  is 
necessary  to  transport  infants  to  the 
closest  intensive  care  unit  and  to  arrange 
for  their  return  to  the  community  hos- 
pital for  convalescence.  The  infants  are 
transported  in  their  isolettes  by  heated 
ambulance  equipped  with  oxygen  and 
suction. 

Development  of  specialized  skills  by 
staff:  This  includes  establishing  intra- 
venous therapy  and  the  addition  of 
drugs  to  same;  nasogastric  feeding  tech- 
niques; use  of  resuscitation  equipment 
and  oxygen;  routine  passage  of  cathe- 
ters on  admission  through  mouth  and 
nostrils  into  the  stomach  to  rule  out 
possible  congenital  defects  and  prevent 
aspiration  of  stomach  contents;  tech- 
niques of  heart  monitoring  and  use  of 
infusion  pump. 

Program  of  self-evaluation:  Infection 
surveillance  includes  routine  cultures 
on  admission  and  once  weekly  there- 
after. Appropriate  cultures  must  be 
taken  before  starting  antibiotics.  Reg- 
ular perinatal  mortality  and  morbidity 
conferences  are  held  with  represent- 
atives from  pediatrics,  nursing,  obste- 
trics, pathology,  and  anesthesiology. 
The  purpose  of  the  meetings  is  to  alter 
or  correct  procedures  and  adopt  new 
policies. 

Accurate  records  and  compiling  of 
statistics:  For  example; 
1970 
Total  admissions  263 

Number  of  deaths  15 

Mortality  Rate  |.17c 

Transfers  to  the  Children's 

Hospital  of  Winnipeg  12 

Admissions 

Any  infant  who  requires  special  care 
is  admitted,  irrespective  of  gestational 
age  or  weight.  The  presence  or  possibi- 


lity of  bacterial  infections  is  not  consid- 
ered a  deterrent  to  admission.  Simple 
techniques  of  daily  Phisohex  bathing 
of  infants  and  careful  hand  washing 
before  handling  each  infant  prevent 
the  spread  of  infection.^  We  believe 
that  almost  all  infections  are  spread 
by  contaminated  hands.  Separate  gowns 
are  not  required  unless  the  nurse  actu- 
ally holds  the  baby  or  the  doctor  per- 
forms a  physical  examination.  Admis- 
sions include:  all  low  birth  weight  in- 
fants (under  2,500  Gm.);  those  who 
have  suffered  asphyxia  and  required 
resuscitation  at  delivery;  severe  mal- 
formations; those  born  through  difficult 
delivery  or  by  cesaerean  section;  those 
born  of  mothers  considered  to  be  "high- 
risk";  and  infants  in  respiratory  dis- 
tress. 

The  small-for-dates  infant 

It  is  now  estimated  that  30  percent 
of  all  infants  weighing  2,500  Gm.  or 
less  are  full-term.  Various  terms  used 
to  describe  such  infants  include  in- 
trauterine growth  failures  and  placental 
insufficiencies.  These  fetuses  do  not 
grow  to  normal  size  in  utero  and  mani- 
fest signs  of  chronic  malnutrition  and 
long-term  asphyxia  at  birth.  They  have 
a  high  rate  of  fetal  distress  and  still- 
birth as  well  as  neonatal  hypoglycemia 
and  congenital  abnormalities.  Follow- 
up  studies  show  increased  incidence 
of  mental  and  neurological  handicaps. 

The  nurse  should  familiarize  her- 
self with  the  criteria  for  identifying 
these  babies.  As  they  show  poor  ability 
to  conserve  body  heat,  chilling  in  the 
delivery  room  and  nursery  must  be 
avoided.  Cold  stress  may  lead  to  slower 
recovery  from  birth  asphyxia,  exhaus- 
tion of  limited  fat  and  glycogen  stores, 
and  increased  risk  of  hypoglycemia. 
Early  feeding  at  three  hours  of  age, 
along  with  carefully  monitored  blood 
glucose  levels  every  12  hours  for  48 
to  72  hours,  are  carried  out  in  our  nur- 
sery. Those  infants  with  blood  glucose 
levels  below  40  mg.  per  100  ml.  are 
given  IV  therapy,  usually  using  10  per- 
cent dextrose  in  water,  until  milk  feed- 
AUGUST  1971 


ings  are  well  established  and  the  blood- 
glucose  level  is  stabilized. 

The  premature  infant 

The  care  of  "premies""  requires  skill 
and  intelligent  observation  by  nurses. 
Isolette  care  with  temperature  and 
humidity  control,  oxygen  therapy,  car- 
diac monitoring,  accurate  IV  therapy, 
initial  minimal  handling,  and  skillful 
gavage  feeding  all  play  their  part  in 
helping  the  "•smallest""  in  their  struggle 
to  survive.  We  use  size  3.5  indwelling 
feeding  tubes  changed  at  least  every  72 
hours.  Judicious,  regular  increases  in 
amount  of  formula  fed  assures  an  ade- 
quate fluid  and  caloric  intake,  reducing 
the  need  for  prolonged  IV  therapy.  The 
need  for  constant  observation,  record- 
ing of  vital  signs  and  oxygen  concentre- 
tion,  and  the  importance  of  report- 
ing immediately  any  change  in  condi- 
tion cannot  be  overemphasized. 

As  the  infant  progresses  through  the 
period  of  apneic  episodes,  the  nurse 
plays  an  important  role  in  preventing 
anoxia.  Emergency  resuscitation  is 
usually  performed  by  our  anesthetic 
staff  and  requires  size  2.5  to  3.0  endo- 
tracheal tubes,  suction  catheters,  and 
positive  pressure  breathing  bag. 

The  ever  present  danger  of  infection 
must  be  guarded  against.  Other  than  an 
outbreak  of  pseudomonas  in  1969. 
traced  to  oxygen  and  suction  tubing 
and  vapojets,  we  have  had  no  serious 
infections.  This  equipment  is  now 
changed  every  24  hours  when  in  use. 

In  the  future 

Our  goals  call  for  the  development 
of  our  special  care  nursery  so  that  all 
infants  up  to  six  weeks  of  age  who 
present  this  hospital  with  a  medical  or 
surgical  problem  will  be  admitted. 
Included  would  be  babies  born  in  or 
out  of  this  hospital,  or  those  who  have 
gone  home  and  are  returning  with  a 
problem;  newborns  would  have  admis- 
sion priority,  but  we  feel  such  a  policy 
would  provide  better  use  of  trained 
staff  and  specialized  equipment,  and 
improved  cost  effectiveness.  The  mix- 
AUCUST  1971 


ing  of  all  types  of  infants  may  present 
problems. 

Those  nations  with  better  perinatal 
statistics,  such  as  Sweden,  the  Nether- 
lands, and  New  Zealand,  all  have  highly 
organized  programs  for  the  delivery  of 
maternal  and  child  health  care.  Can- 
ada's statistics  will  improve  only  when 
we  recognize  the  importance  of  expand- 
ing our  programs  in  public  education, 
interconceptional  care:  family  planning 
and  genetic  counseling;  and  prenatal, 
perinatal,  and  postnatal  care  for  mother 
and  child. 

Summary 

Measures  that  prevent  death  may 
also  prevent  brain  damage,  for  example, 
in  the  prompt  correction  and  treatment 
of  neonatal  asphyxia,  jaundice,  and 
hypoglycemia.  There  are  some  advo- 
cates of  a  centralized  unit,  which,  with 
its  limited  capacity,  can  and  should 
care  for  only  the  most  seriously  ill 
newborn  babies.  We  believe  the  resp- 
onsibility for  providing  quality  care  for 
the  vast  majority  of  infants  must  con- 
tinue to  rest  with  the  community  hos- 
pital. 

It  is  our  hope  that  newborn  special 
care  units  may  play  their  part,  not  only 
in  lowering  mortality,  but  in  helping 
to  achieve  a  better  qualily  of  human 
being. 


References 

1.  Budin,  P.  The  Nursling.  199  p.  London. 

Caxton,  1907. 
Z.Oliver.   T.K.   Temperature    regulation 

and  heat  production  in  the  newborn. 

PccliarrU    Clinics   of  Norlli    America. 

12:765.  1965. 
3.(  hernick,  V..  Haldrich,  K..  and  Avery, 

H.E.  Periodic  breathing  of  premature 

infants.  J.  Pcdiai.  64:330,  1964. 
4.  .Slrominger.    D.B.    James    D.H..    and 

Uoldring.  D.  C  onstant  infusion  pump 

for  limiting  fluids.  J.   Pediai.   51:310, 

1957. 

5.  l.ucey.  J..  Kerreiro.  \l..  and  Hewitt,  J. 
Prevention  of  hyperbilirubinemia  by 
phototherapy.  Fcdiairics  4:  \041.  1968. 

6.  Gluck  L.  and  Wood.  H.F.  Effect  of  an 
antiseptic  skin-care  regimen  in  reduc- 
ing staphylococcal  colonization  in  new- 
born infants.  New  Eng.  J.  Med.  265: 
1177.  1961. 

Bibliography 

Bchrman.  Richard  E..  editor.  The  new- 
born. Pediatric  Clinics  oj  North  Amer- 
ica. 17:4:759-1092.  Nov.  1970. 

Sinclair.  J.C".  Heat  production  and  ther- 
moregulation in  the  small-for-date  in- 
fant. Pediatric  Clinics  of  North  Amer- 
ica. 17:1:147-58.  Feb.  1970. 

Symposium  on  Maternity  Nursing.  Nurs- 
ing Clinics  of  North  America.  3:2:275- 
365,  June  1968.  ■& 


THE  CANADIAN   NURSE     27 


Pain  and  suffering  in  cancer 

The  subject  of  pain  in  association  with  cancer  is  simple  or  complex,  depending  on 
how  you  regard  it.  If  you  ask  the  patient  no  questions  and  use  plenty  of  morphine, 
the  problems  may  seem  easy  to  resolve.  But  sooner  or  later  a  patient  appears  whose 
problems  do  not  fit  the  simple  rules.  Then  you  need  an  understanding  of  the  broad 
aspects  of  cancer  and  a  philosophy  of  pain. 


Frank  Turnbull,  M.D. 

Cancer  is  not  always  lethal,  and  when 
it  does  cause  death,  it  is  not  always 
painful.  But  every  intelligent  adult 
knows  that  some  cases  of  cancer  are 
associated  with  pain  and  suffering. 
What  the  lay  person  does  not  know, 
but  doctors  do  know,  is  that  pain  is 
more  prevalent  in  certain  types  of  cancer 
than  in  others.  It  occurs  most  frequently 
with  cancer  of  the  cervix,  the  lung,  the 
rectum,  and  the  prostate.  Pain  may 
develop  in  association  with  other  types 
of  cancer,  but  less  commonly. 

When  pain  begins  to  trouble  an 
individual  who  has  cancer,  the  disease 
is  usually  far  advanced.  Quite  often 
the  pain  commences  after  all  possible 
forms  of  treatment  have  been  used  to 
their  limit.  The  pain  may  be  easy  to 
manage  with  encouragement  and  simple 
medication.  Even  if  it  is  severe,  it  may 
occur  only  in  the  last  few  weeks  of  life, 
when  all  that  is  called  for  is  the  medical 
equivalent  of  extreme  unction  —  opi- 
ates and  comfortable  words.  But  some- 


( 


28     THE  CANADIAN  NURSE 


Dr.  Turnbull,  a  graduate  of  the  University 
of  Toronto  Medical  School,  is  Consultant 
in  Neurosurgery  at  the  British  Columbia 
Cancer  Institute.  Vancouver.  B.C.  He 
presented  this  paper  at  a  Symposium  on 
the  Management  of  Pain,  sponsored  by 
the  University  of  British  C^olumbia. 


times  it  becomes  severe  and  chronic 
several  months  or  a  year  before  the 
patient  dies. 

Word  "cancer"  Is  avoided 

Certain  features  of  cancer  make 
it  a  unique  disease.  It  is  the  most  feared 
of  all  diseases.  Both  patient  and  doctor 
tend  to  avoid  the  word  "cancer,"  and  to 
employ  words  like  "lump"  or  "growth." 
Some  patients  may  not  use  the  word  at 
all,  but  what  they  say  usually  indicates 
they  know  what  they  have. 

The  patient  soon  comes  to  under- 
stand that  he  has  no  control  over  his 
disease.  This  is  unlike  many  other 
serious  conditions.  For  example,  the 
patient  with  heart  disease  may  slow 
down  the  development  of  his  disease 
and  gain  a  measure  of  control  by  rest 
and  medication.  The  diabetic  patient 
knows  that  diet  and  insulin  will  help 
keep  his  disease  at  a  standstill.  But  the 
patient  with  cancer  cannot  alter  the 
progress  of  his  disease.  This  feature  be- 
comes increasingly  apparent  to  him  as 
the  disease  advances. 

In  the  early  stages,  the  patient  is 
optimistic.  He  wants  to  talk  about  his 
trouble,  particularly  about  how  it  be- 
gan. He  tells  his  doctor  he  wants  to 
know  the  truth.  Sometimes  a  patient  will 
indicate  he  wants  to  hear  only  a  partial 
truth.  Often,  there  is  no  reason  to  tell 
AUGUST  1971 


the  patient  the  whole  truth.  Whatever 
one  does  say  must  be  truthful. 

After  the  initial  treatment  of  his 
cancer,  the  patient  is  usually  told  to 
return  periodically  to  a  doctor  or  a 
clinic  for  reexamination.  During  this 
period  there  is  a  tendency  for  him  to 
retreat  from  the  truth.  He  does  not  seek 
much  conversation  about  his  disease. 

When  it  becomes  evident  some  time 
later  that  the  initial  disease  was  not 
eradicated  or  is  recurring,  serious 
problems  develop  for  the  patient,  his 
doctors,  and  his  family.  Further  treat- 
ment may  be  started.  Patients  know 
why  they  are  being  treated  again  and 
are  anxious. 

At  this  stage  they  will  discuss  a  new 
symptom,  but  they  tend  to  avoid  ques- 
tions about  their  basic  disease.  They 
want  to  talk  about  their  bodily  distress 

—  pain,  shortness  of  breath,  fatigue  — 
but  on  a  superficial  level.  They  may 
appear  to  have  put  the  early  details  out 
of  mind.  They  become  passive  and 
dependent  and  do  not  object  to  being 
referred  from  one  doctor  to  another. 
They  want  to  be  reassured  that  the 
doctor  —  any  doctor  —  will  see  them. 

The  terminal  stage  is  a  time  of  gen- 
uine crisis.  The  patient  is  starting  to  die. 
He  may  know  he  is  dying  and  may 
want  to  talk  about  it,  or  at  least  discuss 
some  aspect  of  death.  He  does  not  fear 
death  as  much  as  the  process  of  dying. 
This  fear  includes  a  fear  of  pain,  of 
not  being  able  to  cope  with  it,  or  of  not 
obtaining  sufficient  relief  from  pain. 

Patients  fear  their  courage  may  fail. 
They  are  afraid  of  becoming  a  nuisance. 
Fear  of  abandonment  becomes  intense. 
Because  they  face  the  loss  of  every- 
thing—  life,  status,  family,  and  friends 

—  they  are  depressed.  They  may  ex- 
press anger  about  a  delay  in  the  early 
diagnosis.  Fear,  depression,  and  anger 
may  evoke  a  defense  mechanism  of 
withdrawal  or  even  euphoria. 

"Terminal  care"  is  a  legitimate 
phrase,  but  it  should  never  mean  that 
nothing  more  can  be  done.  There  is 
often  a  good  deal  to  be  done  —  not 

AUGUST  1971 


officious  meddling  to  prolong  life  at 
any  cost,  but  a  positive  effort  to  control 
symptoms  such  as  pain,  nausea,  dysp- 
nea, and  confusion. 

UBC  study  of  pain 

The  course  of  painful  experience 
of  many  patients  has  been  studied  in 
detail  at  the  British  Columbia  Can- 
cer Institute.  We  have  observed  that 
in  some  forms  of  cancer,  such  as  cancer 
of  the  jaw,  there  is  not  much  difference 
in  the  character  of  pain  experienced 
by  patients,  but  there  is  a  difference  in 
the  severity  of  the  pain. 

in  other  forms  of  cancer,  partic- 
ularly in  cancer  of  the  cervix  and  the 
lung,  there  is  wide  variation  in  the 
patterns  of  pain  that  may  develop. 
These  patterns  or  syndromes  of  pain  can 
be  identified  by  the  patient's  story  and 
can  help  to  establish  a  prognosis  and 
make  a  more  effective  plan  for  manage- 
ment. 

Our  earliest  intensive  studies  of 
pain  concerned  cancer  of  the  cervix. 
At  that  time  (1950),  this  type  of  cancer 
seemed  to  give  rise  to  the  worst  pain. 
Our  first  survey  of  the  records  provided 
a  surprising  glimpse  of  the  disease  as 
one  might  encounter  it  in  a  primitive 
land. 

The  early  case  records  of  the  In- 
stitute included  the  histories  of  1 1 
women  who  had  entered  the  clinic 
with  cancer  of  the  cervix  in  such  an  ad- 
vanced stage  that  no  treatment,  sur- 
gical or  radiogical,  was  indicated. 
Today,  we  never  see  this  type  of  case. 
All  1 1  died  within  a  few  weeks  of 
cachexia  and  hemorrhage.  The  strik- 
ing feature  was  that  only  2  of  the  1 1 
suffered  pain,  which  was  of  moderate 
severity  and  had  been  present  only  for 
a  short  period. 

We  were  forced  to  speculate  whether 
this  should  be  classified  as  the  "natural" 
terminal  history  of  cancer,  equivalent 
to  malignant  growths  in  animals.  The 
quite  different  stories  of  those  who  died 
after  modern  treatment  might  be  class- 
ified as  the  "unnatural"  terminal  hist- 


ory. Surgical  and/or  radiological  treat- 
ments may  cure  the  primary  disease 
that  might  have  led  to  a  painless  death, 
but  these  treatments  also  allow  the  pa- 
tient to  survive  and  develop  secon- 
dary disease,  which  is  often  painful. 
The  price  of  cure  may  be  greater  than 
we  acknowledge. 

The  pain  of  cancer  does  not  arise 
in  the  cancer  itself,  but  in  the  injured 
or  degenerated  tissues  adjacent  to  it. 
Unfortunately,  autopsy  findings  have 
contributed  little  to  our  understand- 
ing of  pain  in  association  with  cancer. 
The  same  postmortem  appearances, 
gross  and  microscopic,  are  consistent 
with  a  history  of  pain  or  a  history  of 
no  pain.  The  physio-patho-psychologi- 
cal  phenomena  that  are  the  basic  causes 
of  pain  are  not  demonstrable  after 
death. 

We  decided  to  follow  a  group  of 
patients  with  cancer  of  the  cervix  from 
the  beginning  to  the  end  of  their  dis- 
ease. One  hundred  consecutive  patients 
were  followed  intensively  for  seven 
years.  We  knew  that  the  five-year  cure 
rate  for  cancer  of  the  cervix  was  50 
percent,  which  meant  that  50  of  the 
group  would  be  dead  in  five  years. 
Actually,  49  died  within  the  5  years 
and  the  50th,  a  few  months  later. 

At  the  end  of  the  study,  one  feature 
of  the  records  that  worried  us  became 
clear:  if  one  were  blindfolded  and  had 
the  100  histories  on  a  table,  he  could 
shuffle  them  into  the  two  categories  — 
those  patients  who  had  died  and  those 
who  had  recovered  —  merely  by  noting 
the  crude  weight  of  their  records.  There 
was  never  much  to  say  on  the  return 
visit  of  the  fortunate  50  percent.  But 
the  unlucky  50  percent  kept  on  having 
troubles  and  numerous  investigations 
all  the  way  through.  In  addition  to 
their  regular  clinical  notes,  we  made 
detailed  notes  about  their  pain:  38  per- 
cent of  the  fatal  cases  suffered  from 
considerable  pain  for  an  average  of 
seven  months  before  death. 

The  volume  and  variety  of  suffering 

that   the   study   revealed  was  greater 

THE  CANADIAN  NURSE     29 


than  we  had  anticipated.  A  somewhat 
altered  viewpoint  about  the  choice 
of  patients  who  might  benefit  from 
pain-relieving  surgery  emerged.  We 
learned  that  the  prime  requirement  was 
not  a  study  of  the  heterogeneous  com- 
plications of  the  disease,  but  an  identifi- 
cation of  the  syndromes  of  pain. 

Syndromes  identified 

Nine  syndromes  became  apparent. 
A  few  basic  physical  observations  and 
tests  were  made,  but  the  key  to  the 
syndromes  rested  in  the  patient's  story. 
A  given  patient  might  suffer  various 
syndromes  in  succession.  Sometimes 
two  or  more  occurred  simultaneously. 
The  time  of  their  appearance,  the 
combination,  and  the  order  of  their 
development  were  significant. 

The  syndromes  do  not  all  call  for 
radical  treatment,  such  as  cordotomy. 
The  syndrome  of  painful  cutaneous 
reaction  or  the  syndrome  of  dysuria 
may  be  self-limited  or  may  respond  to 
simple  treatment.  The  painful  rectal 
reaction  can  be  severe,  but  is  usually 
of  limited  duration.  The  painful  syn- 
dromes of  hydronephrosis  and  of 
swollen  leg  usually  cause  only  mild  and 
transient  pains,  but  they  are  significant 
because  in  combination  they  provide 
infallible  evidence  that  disease  in  the 
pelvic  side-wall  is  present. 

The  syndrome  of  pain  from  recur- 
rent local  ulceration  is  usually  mild 
and  may  respond  to  symptomatic  treat- 
ment. It  is  chiefly  important  because 
it  provides  a  clear  indication  that  the 
disease  is  out  of  control.  Metastases  to 
bone  usually  cause  a  pattern  of  pain 
that  is  characteristic.  This  is  one  type 
of  truly  intractable  pain  that  may  res- 
pond well  to  radiotherapy,  albeit  usual- 
ly temporarily. 

The  most  alarming  and  severe  syn- 
drome of  pain  occurs  in  patients  whose 
disease  appears  to  affect  the  lumbosa- 
cral plexus.  This  is  the  group  with  the 
greatest  need  for  cordotomy.  We  added 
the  history  of  previous  lumbago  andjor 
sciatica  as  a  ninth  syndrome,  because 
30     THE  CANADIAN  NURSE 


that  story  was  common  and  could  lead 
to  much  confusion. 

Cancer  of  the  lung  provides  just 
about  as  wide  an  array  of  painful  com- 
plications as  cancer  of  the  cervix. 
Deaths  from  cancer  of  the  lung  in 
British  Columbia  are  six  times  as  com- 
mon as  deaths  from  cancer  of  the  cer- 
vix. In  contrast  to  the  stituation  20 
years  ago,  we  now  find  that  cancer  of 
the  lung,  rather  than  cancer  of  the 
cervix,  is  the  source  of  more  patients 
with  serious  problems  of  pain.  Patients 
with  cancer  of  the  lung  who  come  to 
the  B.C.  Cancer  Institute  have  either 
developed  recurrence  of  the  disease 
some  time  after  lobectomy  or  pneumec- 
tomy,  have  been  recognized  as  incur- 
able at  operation,  or  are  considered  to 
be  unsuitable  for  surgery.  Their  average 
life  expectancy  is  two  years. 

In  our  initial  clinical  study  of  100 
consecutive  cases  of  cancer  of  the  lung, 
we  found  5  distinct  patterns  of  pain. 
Two  of  these  syndromes  —  deep  uni- 
lateral ache  in  the  chest  and  substernal 
ache  —  are  usually  mild  and  are  easily 
managed.  The  three  other  syndromes 
may  be  the  source  of  intense  suffering. 
These  are  the  syndrome  of  cancerous 
involvement  of  the  chest  wall;  the  syn- 
drome of  distant  metastases  to  bone, 
particularly  of  the  lumbar  spine;  and  the 
syndrome  of  the  brachial  plexus.  A 
sixth  pattern  of  pain  that  appeared 
occasionally  was  persistent  discomfort, 
sometimes  severe,  in  the  thoracotomy 
scar. 

Cancers  other  than  cancer  of  the 
cervix  and  the  lung  may  be  complicat- 
ed by  burdensome  pain,  but  without  a 
variety  of  syndromes.  In  other  cancers, 
such  as  cancer  of  the  rectum,  prostate, 
or  kidney,  pain  of  great  severity  may 
accompany  recurrent  disease.  The  pat- 
tern of  pain  is  fairly  constant  from  case 
to  case. 

Some  years  ago  an  elderly  gentleman 
arrived  at  the  Pain  Clinic  with  a  large, 
recurrent,  incurable  cancer  of  the  cent- 
er of  his  lower  jaw.  He  had  been  ad- 
mitted as  an  outpatient  to  the  Institute 


six  weeks  earlier.  The  records  were 
exemplary.  Typewritten  notes  of  five 
or  six  doctors  who  had  seen  him  on 
successive  visits  provided  a  clear  word- 
picture:  the  texture  and  mobility  of  the 
tissues,  the  x-ray  appearance  of  the 
jaw,  the  biopsy  report.  All  these  were 
in  the  record.  It  was  clearly  not  a  case 
that  could  be  treated  by  surgery  or 
radiation.  And  nowhere  in  the  story 
was  there  any  mention  of  pain. 

I  asked  him,  "Sir,  do  you  have  any 
pain?"  He  answered,  "God,  doctor, 
that's  my  problem."  He  had  no  false 
hopes  about  ridding  himself  of  cancer. 
What  he  wanted  was  to  discuss  this 
new  and  all-pervading  feature  of  his 
life  —  constant  pain.  And  having  talk- 
ed about  the  pain,  he  needed  help  to 
revive  an  interest  in  his  lost  identity. 

Bibliography 

Abrams.  R.D.  Ihc  patient  with  cancer  — 

his  changing  pattern  of  communication. 

New  Eng.  J.  Mccl.  274:6:317-322.  F-eb. 

10.  1966. 
C'ramond.    W.A.    Psychotherapy    of   the 

dying  patient.  Brit.  Mccl.  J.  3:389-393. 

Aug.  15.  1970. 
Saunders.  CM.  The  care  of  the  terminal 

stages  of  cancer.  Ann.  Roy.  Coll.  Surg. 

Eng.  41:162-169.  Supplementary  issue. 

Summer  1967. 
lurnbull.   h.  The  nature  of  pain   in  the 

late    stages    of   cancer.    Surg.    Gynci. 

Obstet.  1  10:665-668.  June  1960.         ■§" 


AUGUST  1971 


The  following  note  was  written  by  a  patient  who  had  malignant  melano- 
ma. At  the  time,  she  was  in  hospital  receiving  her  first  chemotherapy 
treatment,  which  consisted  of  10  daily  injections  at  monthly  intervals. 
This  was  about  one  year  after  her  operation  for  malignant  melanoma 
and  subsequent  Cobalt  therapy,  and  approximately  one  year  before  her 
deathon  June  26,  1970. 


I  have  malignant  melanoma  . . . 

I  have  malignant  melanoma.  It  took  time  for  the 
fact  that  I  had  an  incurable  cancer  "to  sink  in." 
After  the  operation  to  remove  the  lump  from 
under  my  arm,  I  went  to  England  for  Cobalt 
treatment,  hoping  I  would  be  among  that  small 
percentage  of  people  whose  disease  goes  into 
remission.  I  came  back  and  dived  into  my  normal 
life  of  teaching  children  with  learning  difficulties 
and  running  a  home  with  a  husband  and  three 
teenagers.  1  now  accepted  the  fact  that  it  was 
unlikely  I  would  live  to  see  my  grandchildren. 

Strangely  enough  1  didn't  mind  the  thought  of 
dying,  so  long  as  it  came  quickly  and  did  not 
become  a  long,  drawn-out,  and  painful  process. 
In  the  past,  I  had  always  been  intrigued  by  stories 
of  people  who  had  been  given  six  months  to  live, 
and  my  imagination  had  played  with  the  thought 
of  what  I  would  do  in  such  circumstances.  But 
it's  not  that  simple.  We  find  we  are  not  free  to  do 
what  we  will.  We  are  tied  to  others  in  relation- 
ships and,  in  fact,  do  not  want  to  be  free  of  these 
relationships  —  they  are  the  essence  of  living. 

Because  we  have  a  shorter  time  to  live  does 
not  alter  the  fact  that  we  are  an  intricate  part  of 
a  design,  and  the  threads  emanating  from  us  are 
the  threads  of  life  —  unalterable.  I  felt  that  for 
me  there  was  not  more  that  I  could  get  out  of 
life.  I  might  be  useful  in  putting  something  into 
other  lives,  but  I  realized  I  was  not  indispensable 
—  something  or  somebody  would  compensate 
my  departure.  The  big  question  was,  would  I 
have  another  six  months,  six  years,  sixteen  years? 
This  bothered  me  most.  The  uncertainty  of  it. 

Last  month,  signs  appeared  that  the  disease 
was  still  active.  I  am  now  undergoing  chemo- 
therapy to  put  it  into  recession  again.  I  woke  up 
one  morning  with  the  feeling  that  I  djd  care  to  go 


on  living —  I  wanted  to  make  a  fight  for  it,  not 
because  I  felt  indispensable,  but  because  my 
spirit  was  quickened  by  thoughts  of  life  to  be 
enjoyed. 

Where  does  Cod  come  into  all  this?  For  a  long 
time  I  have  longed  for  a  simplicity  of  religion. 
I  believe  in  a  God  and  a  Christian  way  of  life. 
Man  has  complicated  life  with  thousands  of  rules, 
customs,  prejudices,  and  all  the  other  parapher- 
nalia that  people  spend  so  much  time  fighting 
for  and  arguing  about.  For  me.  Cod  is  in  our 
minds  and  in  our  beings. 

Whither  now?  For  how  long?  I  don't  know  — 
I  must  ask.  Meantime  I  have  a  husband  and  three 
children.  I  would  like  to  give  them  the  psycholog- 
ical ability  to  cope  with  life:  to  take  the  knocks 
as  they  come,  to  have  them  know  that  one  can 
only  feel  those  rare  moments  of  tremendous 
joy  if  one  has  the  opposite.  We  were  not  meant 
to  just  exist,  knowing  neither  extreme  pain  nor 
joy.  It  is  these  feelings  that  assure  us  we  are  alive. 
Perhaps  we  have  deprived  our  young  of  suffering. 
We  have  sheltered  them  so  much.  We  see  that 
their  bodies  are  comfortable,  and  we  have  tried 
to  see  that  their  minds  and  spirits  are  too,  by 
protecting  them  from  frustrations.  But,  instead, 
we  have  deprived  them  of  the  essence  of  life. 
No  wonder  some  take  drugs  —  they  have  never 
felt  anything  strongly  enough. 

Last  night  the  need  to  get  my  thoughts  down 
on  paper  was  so  strong!  I  know  my  ability  to  put 
down  all  the  thoughts  is  very  limited. 

If  I  were  asked  what  the  most  important  thing 
in  life  was,  I  would  say  "relationships"  —  relation- 
ships with  others.  ^ 


AUGUST  1971 


THE  CANADIAN  NURSE     31 


Inservice  education  benefits  all  teachers 

The  Hamilton  and  District  School  of  Nursing  launched  an  inservice  educa- 
tion program  for  teachers  of  nursing  in  September  1969.  All  teachers, 
whether  new  to  the  school  or  not,  contributed  their  time  and  imagination  to 
the  program.  This  article  tells  how  everyone  benefited  from  inservice  sharing. 


32     THE  CANADIAN  NURSE 


Lillian  Oatway,  R.N.,  B.E.d. 

There  were  a  number  of  reasons  why 
the  Hamilton  and  District  School  of 
Nursing  launched  an  inservice  educa- 
tion program  for  its  teachers  of  nurs- 
ing. 

First,  administrative  staff  at  the 
school  wanted  to  assist  teachers  more 
with  their  teaching  responsibilities 
after  the  existing  orientation  program. 
Second,  teachers  wondered  if  they  were 
on  the  right  track.  Although  this  school 
hires  the  baccalaureate  prepared  nurse, 
only  a  few  of  the  baccalaureate  pro- 
grams represented  gave  the  teacher  a 
background  in  principles  and  methods 
of  teaching.  As  well,  some  new  teachers 
had  no  experience  in  teaching  or  staff 
nursing.  Third,  faculty  members  were 
interested  in  working  toward  some 
form  of  periodic  and  final  overall 
evaluation  for  teachers. 

Consequently,  an  inservice  educa- 
tion program  for  1 8  teachers  of  nurs- 
ing was  planned  and  put  into  action. 


Lillian  Oatway,  a  graduate  of  the  Univer- 
sity of  Saskatchewan,  has  had  10  years" 
experience  working  with  student  teachers 
in  Saskatchewan.  As  Associate  Director 
(Education)  at  the  Hamilton  and  District 
School  of  Nursing,  her  responsibilities 
include  the  implementation  of  the  inser- 
vice education  program. 


The  program  consists  of  two  main 
areas  —  orientation  and  staff  develop- 
ment. 

Why  an  inservice  program? 

Two  things  concern  the  teacher:  the 
depth  of  knowledge  she  possesses  in  her 
area  of  responsibility,  and  her  ability 
to  challenge  and  direct  students  so  that 
effective  learning  takes  place. 

Our  program  has  three  objectives: 
to  provide  students  with  an  educational 
program  of  the  highest  caliber  possible; 
to  encourage  and  assist  the  teacher  to 
develop  her  potential  as  a  professional 
instructor  of  nursing  students;  and  to 
develop  further  an  interest  in  continuing 
education. 

These  objectives  are  based  on  the 
following  concepts:  a  teacher's  per- 
formance in  the  classroom  and  in  the 
clinical  area  has  a  direct  influence  on 
how  well  students  understand,  learn, 
and  apply  themselves;  there  exist  skills 
of  teaching  that  can  be  learned,  evaluat- 
ed, and  taught'  and  these  should  act  as 
a  framework  within  which  a  teacher's 
creative  traits  are  allowed  to  develop; 
observing  the  teacher  in  the  classroom 
and  clinical  situation  throws  some  light 
on  her  effectiveness  or  inadequacies 
in  handling  the  teaching-learning  situa- 
tion; learning  can  be  facilitated  on  the 
job  by  inservice  education  programs 
AUGUST  1971 


and  by  experience^;  it  is  just  as  impor- 
tant to  acicnowledge  the  effective  teach- 
er as  to  offer  assistance  to  the  ineffective 
teacher;  and  continuing  education  is 
a  right  and  an  obligation. 

Orientation  from  beginning 

The  orientation  program  begins 
with  the  first  letter  or  the  first  inter- 
view. At  this  time  we  attempt  to  ac- 
quaint the  new  teacher  with  the  philo- 
sophy and  objectives  of  the  school  and 
to  give  an  overview  of  our  two-year 
program.  Three  to  four  weeks  of  formal 
orientation  are  given  once  the  teacher 
is  on  staff.  The  first  week  consists  of 
'"school  orientation,"  which  includes 
getting  settled  in  an  office  and  introduc- 
tion to  staff,  students,  curriculum, 
schedules,  committees,  library,  man- 
uals, and  team  teaching.  The  teacher 
gets  some  time  each  day  to  familiarize 
herself  with  her  environment. 

It  has  been  said  that  "a  good  teach- 
er is  first  and  foremost  a  person  and 
this  fact  is  the  most  important  thing 
about  him.'"^  We  attempt  to  individual- 
ize the  orientation  program  and  encour- 
age the  new  teacher  to  talk  about  her 
past  experiences  and  aspirations.  Part- 
icular attention  is  directed  toward  both 
the  curriculum  and  the  clinical  area 
in  which  she  will  be  working.  As  well 
as  being  provided  with  a  big  sister, 
she  gets  a  chance  to  meet  her  teaching 
team  as  soon  as  possible. 

New  teachers  are  given  a  list  of 
references  on  writing  objectives,  plan- 
ning conferences,  and  creative  teaching, 
which  are  set  aside  in  the  library  sec- 
tion reserved  for  material  on  faculty 
education.  These  teachers  also  receive 
copies  of  the  teachers'  school  manual, 
sample  forms,  curriculum  guide,  course 
outlines,  and  a  teaching  guide. 

During  the  second  week  of  formal 
orientation,  introduction  to  the  hospi- 
tal and  particular  ward  areas  begins. 
Nursing  office  is  notified  and  contact 
is  made  with  the  director  of  inservice 
AUGUST  1971 


education,  the  ward  supervisor,  or  the 
head  nurse.  The  orientation  program, 
which  is  planned  according  to  the  indi- 
vidual teacher's  needs,  may  include 
working  with  the  ward  team  for  a  day 
or  two.  When  possible,  the  new  teacher 
spends  some  time  with  another  teacher 
who  works  in  the  same  hospital.  We 
stress  lines  of  communication  within 
the  school  and  hospital,  and  expect  the 
teacher  and  the  nurse-in-charge  to 
work  out  plans  for  student  experience 
and  solve  problems  together. 

Last  spring  new  faculty  members 
were  asked  to  evaluate  the  orientation 
program,  using  a  previously  prepared 
questionnaire.  Since  then,  unneccessary 
detail  has  been  deleted,  certain  issues 
clarified,  and  suggestions  of  staff  mem- 
bers incorporated  into  the  program. 
For  example,  some  thought  that  certain 
material  was  provided  prematurely. 
Others  believed  there  should  be  more 
clearly  defined  guidelines  about  roles 
in  the  teaching  teams.  The  manuals 
were  found  to  be  helpful  and  reference 
readings  were  well  used.  But  perhaps 
what  was  most  appreciated  was  the 
time  spent  in  the  clinical  situation  and 
at  conferences  with  other  teachers. 

Staff  development  follows 

The  staff  development  program 
provides  assistance  with  teaching 
responsibilities  after  orientation,  and 
opportunities  to  attend  educational 
conferences,  workshops,  and  seminars. 

Teachers  receive  encouragement 
and  assistance  in  areas  such  as  plan- 
ning, classroom  presentations,  laborato- 
ry techniques,  clinical  organization, 
conferences,  and  student  evaluations. 
The  associate  director  (education) 
tries  to  visit  each  teacher  twice  during 
the  school  year  in  both  the  classroom 
and  clinical  situations,  and  gives  extra 
attention  to  teachers  who  are  new  on 
staff  or  who  need  additional  assistance. 

Following  each  visit,  time  is  set  aside 
for  discussion  and  planning.  Sometimes 


\ 


the  teacher  is  asked  to  begin  by  relat- 
ing her  own  feelings  about  her  perform- 
ance. To  comply  with  teachers'  re- 
quests, observations  and  comments 
about  a  performance  are  recorded  in 
duplicate  so  the  teacher  may  have  a 
copy  for  future  reference.  Each  report 
is  written  according  to  a  predetermined 
format  and  ends  with:  "points  to  be 
improved"  and  "points  to  be  encourag- 
ed." 

Because  it  was  decided  early  in  the 
program  that  a  readily  available  refer- 
ence of  various  teaching-learning  ap- 
proaches would  be  helpful,  a  teaching 
guide  was  compiled.  It  contains  general 
information  for  handling  classroom  and 
conference  material,  along  with  outlines 
of  common  techniques.  We  hope  this 
framework  will  stimulate  teacher  in- 
genuity and  creativity. 

This  year,  before  new  teachers 
became  fully  involved  with  teaching 
responsibilities,  they  were  asked  to 
attend  a  pre-arranged  classroom  pres- 
entation. During  the  discussion  that 
followed,  they  gave  their  impressions 
about  the  teaching  method  used,  student 
participation,  and  the  use  of  the  visual 
aids. 

All  teachers  are  encouraged  to  talk 
over  new  approaches  or  verify  proced- 
ure. Requests,  such  as  the  following, 
are  sometimes  heard:  "Could  you  please 
attend  my  next  class?  I  have  planned 
an  approach  I  have  never  used  before." 
"Will  you  sit  in  on  my  post-conference? 
I  seem  to  have  difficulty  keeping  the 
students  on  topic."  "Will  you  go  over 
this  progress  report  and  tell  me  how 
it  sounds  to  you?" 

The  teaching  team  contributes  a 
great  deal  toward  orientation  and  staff 
development.  The  new  teacher  may 
take  an  assisting  role  before  assuming 
full  responsibility  as  a  team  member. 
During  the  early  part  of  the  current 
year,  the  associate  director  (education) 
tried  to  attend  each  team  meeting,  be- 
lieving that  certain  contributions  might 
THE  CANADIAN  NURSE     33 


be  most  helpful  if  made  at  the  planning 
stage.  Again,  background  informa- 
tion obtained  here  might  be  useful 
when  a  teacher  asks  for  individual  as- 
sistance at  a  later  date. 

Faculty  committee 

The  faculty  education  committee 
continues  to  sort  and  post  notices  of 
conferences,  workshops,  and  other 
meetings  on  a  bulletin  board  reserved 
for  that  purpose.  Any  teacher  may 
submit  an  application  to  attend  a  func- 
tion, or  she  may  be  appointed  to  attend 
as  a  group  representative. 

Once  each  month  this  committee 
plans  an  educational  hour  for  all  faculty 
members,  who  are  encouraged  to  sub- 
mit ideas  for  topics.  This  year,  instead 
of  choosing  one  theme,  such  as  student 
evaluations,  objective  tests,  or  group 
sensitivity  sessions,  a  different  topic 
is  discussed  each  month.  Time  is  also 
set  aside  during  these  hours  for  reports 
from  workshops  and  other  groups. 

A  three-day  faculty  workshop  is  held 
after  the  summer  vacation  and  before 
students  return.  Last  September,  the 
professor  of  the  department  of  anatomy 
at  McMaster  University  helped  us 
develop  a  problem-solving  technique 
to  use  in  the  teaching-learning  process. 
During  Christmas  break,  we  hold  a 
staff  development  day;  however,  teach- 
ers who  have  wanted  to  visit  other 
educational  centers  at  this  time  have 
found  this  day  inconvenient,  although 
they  have  indicated  they  like  the  idea. 

A  successful  staff  education  program 
must  have  its  own  source  of  finance. 
The  school  budgets  for  inservice  edu- 
cation to  allow  for  partial  or  full  pay- 
ment for  the  cost  of  staff  education. 
At  times,  a  teacher  attends  an  event  at 
her  own  expense. 

Evaluating  staff  development 

Fifteen  teachers  evaluated  the  staff 
development  program  at  the  end  of  the 
school  year  in  July  1 970.  They  said  they 
found  the  written  evaluations  and  dis- 
cussions about  their  performance  help- 
ful. They  wanted  more  regular  visits 
to  the  classroom  and  clinical  areas 
whenever  improvement  of  a  teacher's 
performance  was  necessary.  Several 
teachers  said  they  would  like  to  be 
notified  of  an  impending  visit.  Eleven 
found  the  teaching  guide  helpful,  and 
four  rarely,  or  never,  used  it;  two 
teachers  were  concerned  that  such 
a  guide  might  restrict  the  instructor  at 
the  expense  of  creativity. 

One  suggestion  was  that  the  effective 
teacher  might  try  new  approaches,  de- 
34     THE  CANADIAN  NURSE 


velop  her  creativity,  or  use  her  abilities 
to  assist  other  teachers.  Some  consider- 
ed the  program  most  helpful  because 
it  offered  consultation  opportunities. 
Others  were  concerned  about  motiva- 
tion, team  dynamics,  and  the  effective 
use  of  time  at  team  meetings.  But  all 
teachers  agreed  there  had  been  suffi- 
cient follow-through  to  help  the  new 
teacher  become  a  contributing  member 
of  the  team  and  assume  the  responsibili- 
ties required  of  her.  The  general  tone 
of  the  evaluation  was  "more  of  the 
same!" 

As  with  any  new  undertaking,  ques- 
tions and  problems  have  arisen.  Or- 
ientation to  the  clinical  situation  some- 
times occurs  at  an  awkward  time  in 
relation  to  teacher  and  student  needs. 
Observing  the  teacher  while  she  super- 
vises a  student  carrying  out  a  procedure 
has  not  yet  been  attempted,  as  the  pre- 
sence of  a  "second  supervisor"  seems  to 
be  undesirable. 

Organization  of  time  has  occasion- 
ally been  a  problem.  The  associate 
director  (education)  limited  her  attend- 
ance at  team  meetings  when  it  was  found 
that  the  objectives  met  by  going  to  these 
meetings  did  not  warrant  the  time  in- 
volved. Extra  administrative  duties  pop 
up  unexpectedly.  These  cannot  take 
priority  over  inservice  activities  if  the 
inservice  education  program  is  to  be 
assured  some  success. 

Are  we  meeting  our  objectives? 

The  teachers'  evaluation  of  the  staff 
development  program  last  year  indicat- 
ed that  various  needs  and  requests  of 
the  individual  teacher  were  fulfilled. 
Team  membership  provided  the  teach- 
er with  an  opportunity  to  develop  her 
leadership  potential.  Because  the  pro- 
gram was  of  value  to  teachers,  it  must 
ultimately  benefit  the  student.  How- 
ever, there  are  still  areas  in  which  staff 
needs  have  not  been  met. 

Teachers  have  shown  interest  in 
conferences,  workshops,  and  courses 
that  contribute  to  a  greater  depth  of 
knowledge  and  understanding  of  nurs- 
ing education.  At  this  time,  however, 
it  is  difficult  to  estimate  how  much  the 
inservice  education  program  has  con- 
tributed toward  a  growing  interest 
in  ongoing  education. 

The  plan  for  periodic  or  final  overall 
evaluation  for  teachers  has  not  yet  fully 
materialized.  Each  faculty  member  has 
submitted  her  ideas  and  feelings  about 
teacher  evaluation,  and  schools  of 
nursing  in  this  area  have  met  to  discuss 
the  topic.  The  overall  feeling  is  that 
an  inservice  education  program  should 


make    a    worthwhile    contribution    to 
the  teacher's  performance  record. 

Planning  continues 

Future  plans  for  our  inservice  educa- 
tion program  are  varied.  Tapes  and 
films  could  be  used  in  the  classroom, 
laboratory,  or  conference  room  to 
facilitate  follow-up  discussion  about 
the  teacher's  performance.  Group  or 
team  evaluation  of  the  individual  teach- 
er's performance  might  also  include 
pointers  related  to  the  dynamics  of 
team  membership.  Each  teacher  could 
evaluate  her  own  performance,  bring- 
ing her  written  evaluation  to  the  fol- 
low-up interview;  students  could  also 
evaluate  the  teacher.  Of  special  interest 
here  would  be  ways  in  which  a  teacher 
best  contributes  to  the  student's  growth 
and  development. 

We  foresee  development  of  a  proce- 
dure to  help  evaluate  changes  in  teach- 
er knowledge,  attitudes,  and  effecfive- 
ness.  We  also  hope  there  will  be  further 
study  of  an  evaluation  for  teachers, 
increased  involvement  of  nursing  ser- 
vice in  our  inservice  education  pro- 
gram, and  a  change  in  the  use  of  the 
staff  development  day. 

Inservice  education  for  teachers 
of  nursing  is  an  exciting  challenge.  Some 
form  of  staff  development  for  the  bac- 
calaureate nurse  who  has  not  been 
prepared  to  teach  is  a  must.  Continu- 
ing education  for  teachers  of  nursing 
holds  priority  in  an  age  of  technologi- 
cal advances  and  changes  in  the  health 
science  approach  to  patient  care. 

Perhaps  Henry  Brooks  Adams  gave 
us  our  greatest  reason  for  inservice, 
when  he  wrote  approximately  one  cen- 
tury ago:  "The  teacher  affects  eternity; 
he  can  never  tell  where  his  influence 
stops. '"' 

References 

1.  Laurits,  J.  Thoughts  on  the  evaluation 
of  teaching.  Eiliiccitional  Horizons. 
^^■.y.95.  Spring  1967. 

2.  Alexander.  Mary  (Joseph).  Effective- 
ness oj  clinical  inslniclors  us  perceived 
by  nursinfi  stndents.  London,  Ontario. 
Thesis  (IVI.Sc.N.).  University  of  West- 
ern Ontario,  1968.  p.  125. 

i.  tombs,  A.W.  ■//(('  Frofessional  Ediica- 
ilon  of  1  eacJiers.  Boston.  Allyn  and 
Bacon,  1965,  p.  9. 

4.  Adams,  Henry  B.  The  Ediicution  of 
Henry  Adams.  Boston,  Houghton- 
Miftlin.  1918,  p.  300.  ^ 


AUGUST  1971 


idea 
exchange 


Audio  slides  streamline  interviews 

Presented  before  an  interview,  audio  slides  can  put  prospective  students  and 
interviewer  at  ease. 


Margaret  J.  Henricks,  B.Sc,  M.S. 

During  peak  periods  of  admission  of 
students  to  the  school  for  nursing  assis- 
tants at  the  Ottawa  Civic  Hospital,  it  is 
not  unusual  to  interview  up  to  eight 
applicants  a  day  to  ascertain  their 
suitability  for  admission  to  the  school. 
The  facility  and  quality  of  communica- 
tion during  such  interviews  can  influ- 
ence a  candidate's  opinions  and  con- 
cepts to  a  great  degree.  Under  ordinary 
circumstances,  the  enthusiasm  and 
interest  of  interviewers  cannot  remain 
at  a  high  level  after  four  or  five  pre- 
admission interviews.  Further,  there 
may  be  a  tendency  to  omit  some  perti- 
nent information  or  to  overlook  some 
details  important  to  the  applicant. 

We  found  that  too  much  interview 
time  was  devoted  to  presenting  fact- 
ual information  concerning  the  course 
of  study.  This  meant  that  the  warm 
human  interaction  between  the  inter- 
viewer and  the  candidate  during  the 
interview  was  in  danger  of  giving  way 
to  a  stereotyped  repetition  of  factual 
material. 

The  first  and  major  step  to  improve 
the  quality  of  communication  was  to 
free  the  interviewer  from  having  to 
present  routine  information. 

Our  faculty  accomplished  this  by 
setting  up  an  automatic  system  of  com- 
munication. This  is  a  synchro-recorder 
suitable  tor  synchronized  audiovisual 


AUGUST  1971 


Miss  Henricks  is  principal  of  the  Ottawa 
Civic  Hospital  School  for  Nursing  Assis- 
tants. Ottawa. 

1 


projection  by  coupling  it  with  a  slide 
projector. 

For  our  purpose,  we  have  assembled 
2.'^  color  slides  in  logical  sequence  to 
depict  the  classroom  and  clinical  ex- 
periences of  a  student  nursing  assistant. 
A  recorded  audio  message  verbally 
explains  specific  details  relating  to 
each  slide. 

The  audio  tape  is  in  a  factorv-scalcd 
cartridge  to  render  it  self-threading  and 
to  allow  it  to  be  played  on  a  continuous 
loop.  For  our  current  recorded  pro- 
gram, we  use  a  15-minute  cartridge. 
The  system  is  designed  so  that  when 
the  message  relating  to  one  slide  ends, 
the  next  slide  advances  automatically 
to  allow  the  audio  message  to  continue 
without  interruption. 

This  communication  system  pro- 
vides each  prospective  student  with 
visual  and  auditory  stimuli,  and  allows 
his  whole  attention  to  fcKUS  on  the 
activities  that  represent  the  curriculum 
of  the  nursing  assistant. 

When  the  receptionist  escorts  the 
applicant  to  the  audiovisual  room  before 
his  preadmission  interview,  she  shows 
him  how  to  operate  the  synchronized 
unit  by  using  an  ON  and  OFF  switch. 
The  study  carrel  is  large  enough  to 
allow  three  people  to  view  the  program 
simultaneously. 

A  printed  sheet  outlines  the  pur- 
pose of  the  audio  slide  series.  The 
applicant  is  invited  to  write  any  ques- 
tions he  may  wish  to  have  answered 
during  the  ensuing  personal  interview. 
Throughout  the  interview,  provision 
THE  CANADIAN  NURSE     35 


IS  macic  tor  feedback  to  allow  clarifica- 
tion of  nevvl y-fornied  concepts  concern- 
ing the  school  curriculum. 

We  have  found  this  type  of  pre- 
interview  presentation  of  curriculum 
mtormation  to  have  the  following 
advantages:  (a)  identical  information 
regarding  the  proposed  course  of  study 
IS  accorded  every  prospective  student: 
(b)  interview  time  can  be  focused  on  the 
individual's  specific  qualities  and  needs; 
and  (c)  as  the  slides  and  message  re- 
flect the  philosophy  of  our  school,  each 
applicant  is  made  aware  of  the  nursing 
assistant's  role  as  defined  by  the  College 
ot  Nurses  of  Ontario. 

Although  positive  resulting  attitudes 
are  good,  negative  ones  are  also  valu- 
able. Two  prospective  candidates  were 
able  to  indicate  at  the  beginnine  of  their 
interview  that  the  course  of  study  offer- 
ed would  be  of  little  interest  to  them. 
This  also  saved  time  and  possible  frus- 
tration for  the  interviewer. 

The  synchronized  recorder,  coupled 
with  a  slide  projector,  has  potentialities 
beyond  disseminating  information 
prior  to  an  interview.  It  is  already  bcinc 
developed  as  an  inservice  orientation 
tool  for  nursing  staff  in  the  operating 
room.  It  can  be  used  for  self-instruction 
on  many  topics  in  the  school  curricu- 
lum. As  students  are  being  encour- 
aged to  spend  more  time  working  in- 
dependently, a  synchronized  system  of 
this  kind  holds  many  exciting  possi- 
bilities, rt 


/)  mil  sin 


g  ussistaiu  applicant  watches  a  slide  as  she  listens  to  the  tape. 


36     THE  CANADIAN  NURSE 


Mothers  soinetunes  come  with  their  daughters  to  see  "what  it's  all  about."  Here 
a  mother  and  daiiy  '■  "-r  view  the  slides  and  listen  to  an  accompanying  tape. 

AUGUST  1971 


Rehabilitation  of  a  quadriplegic 

A  unique  method  of  bed-wheelchair  transfer  was  developed  to  allow  a  young 
quadriplegic  to  achieve  complete  independence. 


J.R.  Ford,  R.G.,  and  T.D.V.  Cooke,  M.D. 

The  goals  of  rehabilitation  may  seem 
unattainable  to  patients  with  quadri- 
picgia  because  their  limitations  are 
so  great  that  even  simple  tasks,  such 
as  sitting  up.  are  initially  impossible. 

The  "G.  F.  Strong  Rehabilitation 
Centre  has  initiated  an  intensive  pro- 
gram for  these  patients.  It  is  designed  to 
strengthen  and  readapt  residual  active 
musculature,  and  to  teach  and  counsel 
patients  on  ways  of  acci>mplishing 
tasks  that  will  enable  them  to  achieve 
the  goals  of  rehabilitation. 

All  too  often,  failure  or  delay  in 
progress  is  encountered,  for  these  pa- 
tients can  retreat  into  a  resentfully 
dependent,  apathetic  state  and  view 
their  program  and  therapists  with  con- 
tempt and  suspicion.  Counseling  and 
hectoring,  even  bribing,  are  then  o\' 
little  help. 

Motivation  is  the  key  to  success  in  the 
rehabilitation  of  such  patients.  Use 
of  the  bed-wheelchair  transfer  method 
described  in  this  article  helped  to  start 
one  young  quadriplegic  patient,  who 
had  lost  all  hope,  on  a  course  that  led 

Mr.  lord  is  chief  remedial  gymnast  at  ihe 
Ch.  Strong  Rehabilitation  (  entre.  Van- 
couver, and  Dr.  C  ooke  was  surgical  resi- 
dent there  for  the  first  six  months  of  l'»67. 
Ihe  authors  acknowledge  Mr.  .1.  Borth- 
wiek  as  the  originator  o\'  the  I  ranster 
Method  described,  and  thank  Miss  C  . 
Brown  for  her  secretarial  assistance. 


AUGUST  1971 


to  his  complete  independence.  This 
method  has  subsequently  proved  valu- 
able in  our  program  with  other  quad- 
riplegics. 

Clinical  summary  and  progress 

Murray  N..  a  1  d  year-oltl  student, 
had  been  involved  in  a  motor  vehicle 
accident  where  he  suffered  a  fracture 
dislocation  of  his  cervical  spine  that 
resulted  in  a  complete  neuroli>gical 
deficit  below  and  involving  the  seventh 
cervical  vertebra.  He  had  useful  vol- 
untary elbow  flexion  and  wrist  exten- 
sion (radial  extensors).  He  had  no  abili- 
ty in  the  elbow  extensors  tior  in  the 
other  voluntary  nuncments  of  wrists 
or  hands.  A  latiiinectomy  with  fusion 
of  the  unstable  vertebrae  was  dime  soon 
after  the  injury.  He  had  been  in  an 
acute  care  hospital  for  about  seven 
months,  but  in  a  wheelchair  for  about 
four  months  o\'  that  lime,  when  trans 
ferred  to  the  Rehabilitation  Centre. 

His  initial  program  at  the  Centre 
consisted  o\'  self-care  training,  group 
activities,  physiotherapy,  occupational 
therapy,  schooling,  and  counselitig. 
Every  eflbrt  was  made  to  stimulate  and 
encourage  hitii  in  all  aspects  o\'  this 
program. 

During  the  eight  months  following 
admission.  Murray's  functional  abil- 
ities improved  little,  and  no  success 
had  been  achieved  with  any  of  the 
known  transfer  techniques.  He  did. 
THE  CANADIAN   NURSE     37 


however,  complete  grade  12  by  cor- 
respondence. After  much  discussion, 
the  decision  tor  nursing  home  place- 
ment was  reluctantly  made.  Happily, 
subsequent  events  made  this  unneces- 
sary. 

Because  Murray  was  heavy,  passive 
transfer  from  bed  to  chair  was  difficult 
for  the  nursing  staff.  A  technique  to 
eliminate  lifting  was  then  investigated 
and  tried.  This  required  some  help 
from  the  patient. 

We  suddenly  realized  that  Murray 
derived  stimulation  and  satisfaction 
from  his  small  achievement  of  helping. 
The  technique  was  quickly  adapted  to 
give  him  an  opportunity  to  increase 
his  sense  of  contribution  and  achieve- 
ment. 

What  followed  our  chance  discovery 
was  dramatic  this  young  man  attempt- 
ed any  reasonable  task  offered  him.  and 
after  some  five  weeks,  he  achieved  a 
lateral  bed-wheelchair  transfer. 

At  the  time  of  discharge  18  months 
alter  his  admission,  Murray's  new 
accomplishments  were:  wheelchair 
transfer  to  and  from  bed,  toilet,  and 
car;  washing,  shaving,  cleaning  teeth, 
dressing,  and  eating;  excellent  wheel- 
chair mobility:  independence  of  bowel 
management,  application  and  mainten- 
ance of  urine-collecting  apparatus; 
admission  to  university;  and  driving 
a  car. 

Murray  has  since  become  completely 
independent  in  the  activities  of  daily 
living.  He  is  completing  a  four-year 
course  in  commerce  at  the  University 
ot  British  Columbia.  He  drives  his  car 
and  enjoys  physical  and  mental  well- 
being. 

Method  of  transfer 

Eqiiipinciu    (see    illustration).    The 
method  of  transfer  requires  overhead 
bars,  one  attached  at  the  head  and  two 
at  the  foot  of  the  bed  ( I  and  2).  A  spe- 
cial   "end"    (3)    incorporates   the    two 
overhead  bars  as  shown.  A  box-frame 
bridge  (4).  padded  with  one-inch  foam 
rubber    and    upholstered    with    nylon, 
fills  the  gap  between  the  mattress  and 
the    wheelchair   seat,    making   a    level 
entrance  through  the  zippered  back  of 
the  wheelchair.  Two  eye-bolts  (5)  are 
fastened  to  the  uprights  of  the  over- 
head   bar.    level    with   the   wheelchair 
arms.   Hooks,   made  of   1/4'"  rod,  are 
attached  to  the  eye-bolts,  and  the  hook 
ends  are  dropped  into  holes  drilled  in 
the  back  of  the  wheelchair  arms  (6). 
These  lock  the  chair  to  the  bed. 

Horizontal  rope  ladders  (7)  are 
fastened  to  the  foot  and  head  on  each 
38     THE  CANADIAN  NURSE 


This  method  of  hccMweldunr  iransjer  helps  the  patient  to  achieve  indepemtenc 


side  of  the  bed.  The  lower  ropes  of  these 
ladders  are  approximately  4""  above 
the  mattress  to  allow  the  patient  to 
maneuver  his  wrists  beneath  and  around 
them.  The  rungs  are  about  7"  apart. 

Straps  (8)  are  suspended  from  the 
overhead  bars  to  provide  wrist  holds 
where  required.  The  bed  is  covered  with 
a  nylon  contour  sheet  (9).  The  leg 
strap  ( 10)  provides  a  means  of  elevat*^ 
ing  the  knees,  as  the  feet  can  be  placed 
on  it. 

Transfer  to  the  IhhI  from  chair:  The 
patient  locks  the  wheelchair  in  po- 
sition and  lifts  his  feet  onto  the  leg  strap 
(10).  He  opens  the  zippered  back  by 
slipping  his  thumb  through  a  leather 
loop  attached  to  the  zipper  toggle  and 
by  pushing  it  down,  keeping  his  balance 
with  the  wrists  through  a  strap  on  the 
llrst  overhead  bar.  He  then  lowers  him- 
self to  the  bed,  using  one  wrist  in  the 
strap  and  the  other  arm  around  the 
wheelchair  back's  upright. 

Sliding  his  wrists  under  the  rope 
ladders,  he  reaches  up  the  bed  and 
hooks  each  wrist  behind  a  rung.  Ad- 
ducting  the  shoulders  and  Hexing  the 
elbows  pulls  him  up  the  bed.  He  repeats 
this  maneuver  until  he  reaches  the 
desired  position.  The  straps  on  the  head 
end  bar  help  the  patient  in  sitting  and 
rolling  over,  etcetera. 

Transfer  from  Iwd  to  chair:  The 
patient  reverses  the  procedure  above. 
First,  he  brings  his  feet  together  by 
rolling  from  side  to  side.  He  then  reach- 
es down  the  bed  and  inserts  each  wrist 
behind  a  rung,  but  now  from  the  inside 


of  the  ladders.  Adducting  the  shoulders 
and  flexing  the  elbows  pulls  him  down 
the  bed.  The  procedure  is  repeated 
until  his  feet  are  on  the  footrests  of  the 
wheelchair.  He  regains  a  sitting  posi- 
tion by  pulling  up  on  the  overhead 
foot-end  straps  and  finally  on  the  wheel- 
chair back  uprights. 

Murray  was  unable  to  re -zip  the  back 
of  his  chair,  but  a  mechanism  to  do  this 
was  never  needed  for  him.  as  he  quickly 
progressed  to  another  method  of  trans- 
fer.- 

Discussion 

For  the  quadriplegic,  some  small 
achievement  on  his  part  is  the  key  that 
liberates  the  sudden  expression  of  drive 
or  motivation  to  allow  further  rehabil- 
itation. The  solution  to  the  problem  in 
Murray's  case  was  in  essence  simple, 
yet  it  took  many  months  to  uncover. 
Our  later  experience  with  quadriple- 
gics has  provided  increasing  evidence 
of  this  simple  truth  and  of  its  many 
applications.  This  technique,  which 
was  first  used  with  Murray  as  a  con- 
venience, has  since  been  applied  many 
times. 

It  would  appear  that  our  role  in  the 
rehabilitation  of  quadriplegic  patients 
is  to  give  them  the  opportunity  they 
seek  to  experience  the  satisfaction  of 
accomplishing  by  themselves  a  mean- 
ingful task,  however  small.  "^ 

A  chair  back  that  has  a  shaped,  full- 
length  metal  clamp,  clipping  the  back  of 
ihc  upright  on  one  side,  has  been  used 
successfully  by  other  patients. 

AUGUST  1971 


"Hey,  Nurse! "is the 

brainchild  of  the  author, 

Jennie  Wilting,  (Nurse  Whozits), 

a  graduate  of  Blodgett 

Memorial  Hospital  School 

of  Nursing  in 

Grand  Rapids,  Michigan, 

and  the  University 

of  Minnesota,  Minneapolis. 

For  four  years  she 

was  head  nurse  on  a 

psychiatric  unit,  and 

for  10  years,  an  instructor 

in  psychiatric  nursing. 

At  present,  she  is 

a  lecturer  in  mental  health 

concepts  at  the 

University  of  Alberta 

School  of  Nursing 

in  Edmonton,  Alberta. 


by  Nurse  Whozits 

"The  doctor  says  Mr.  Bending's  prog- 
nosis is  nil,"  reported  Miss  Tizzy. 
"There's  nothing  to  be  done  for  him." 


"Prognosis  is  nil,  there's  nothing  to 
be  done  for  him."  How  often  we  hear 
these  words!  They  describe  the  young 
man  injured  in  an  accident  who  will 
never  walk  again;  the  aged,  infirm  lady 
whose  arteries  are  slowly  hardening; 
the  schizophrenic  girl  who  spends  much 
of  the  day  in  her  own  world;  the  middle- 
aged  man  with  extensive  cancer. 

As  the  word  is  passed  along,  a  sense 
of  hopelessness  and  gloom  settles  on  the 
nursing  staff.  Frequently,  these  mes- 
sages of  hopelessness  and  gloom  are 
passed  on  to  the  patient  in  subtle  ways. 

Is  it  true  there  is  nothing  we  can  do 
for  these  patients?  "Prognosis  is  nil" 
refers  to  the  medical  prognosis.  It  means 
the  patient's  health  or  state  of  wholeness 
cannot  be  completely  restored.  It  means 
the  patient  must  live  with  his  condition, 
or  that  his  condition  will  worsen  and 
he  will  eventually  die. 

If  we  believe  nursing  involves  not 
only  preventing  illness  and  promoting 
health,  but  also  alleviating  pain  and 
suffering  and  helping  the  patient  live 
and  die  in  a  dignified  manner,  then  the 
nursing  prognosis  is  not  nil.  This  prog- 
nosis doesn't  depend  on  whether  the 


AUGUST  1971 


patient  will  get  well,  remain  ill,  live, 
or  die.  It  depends  on  whether  there  is 
something  wc  can  do  to  ease  the  pain 
and  suffering  and  help  the  patient  work 
through  the  problems  created  by  his 
condition. 

A  feeling  of  hopelessness  lessens  the 
nurse's  ability  to  recognize  the  many 
opportunities  to  give  care.  The  patient 
provides  the  opportunity  to  use  a  count- 
less number  of  nursing  skills;  for  exam- 
ple, providing  physical  comfort,  dispel- 
ling loneliness,  and  con\e\ing  under- 
standing. 

This  is  the  challenging,  day-by-day 
and  moment-by-moment  care  a  nurse 
can  give  her  patients.  The  rewards  are 
small  but  important:  some  pain-free 
moments  for  the  patient,  a  few  words 
of  appreciation  from  him,  and  the 
knowledge  that  the  best  possible  was 
done  to  ease  his  burdens. 

The  medical  prognosis  is  nil.  Ihe 
future  of  the  patient  is  known  —  death, 
or  a  life  of  chronic  illness.  Wc  have  the 
opportunity  and  responsibility  to  help 
make  this  time  meaningful  and  perhaps 
even  rewarding  for  the  patient. 

As  for  ourselves,  we  have  the  op- 
portunity to  take  small  parts  of  the 
patient's  personality  and  experience 
into  our  lives,  enabling  us  to  become 
more  understanding  and  a  credit  to  the 
patients  under  our  care.  ■$■ 

THE  CANADIAN  NURSE     39 


new  products     { 


Descriptions  are  based  on  information 
supplied  by  the  manufacturer.  No 
endorsement  is  intended. 


Trainer  Torso 

A  computerized  training  torso  designed 
to  assist  in  the  teaching  of  arrhythmia 
pattern  recognition  and  to  facilitate 
practice  sessions  in  the  electrical  treat- 
ment of  cardiac  arrhythmias  has  been 
developed  by  Hewlett-Packard  (Can- 
ada) Limited. 

Model  4654A  trainer  torso  and  as- 
sociated 465 3A  arrhythmia  trainer  also 
teach  countershock  and  pacing  tech- 
niques, using  a  pacemaker  and  defib- 
rillator. 

Reinforced  learning  occurs  because 
the  torso's  response  is  similar  to  that 

40     THE  CANADIAN   NURSE 


of  the  human  cardiac  system.  If  the 
student  applies  pacing  or  countershock 
correctly,  the  arrhythmia  reverts  to  a 
normal  sinus  rhythm.  However,  if  an 
incorrect  response  is  given,  the  pattern 
will  remain  unchanged  or  revert  to  a 
more  serious  arrhythmia. 

The  system  eliminates  the  need  for 
dogs  when  training  hospital  staff  in 
defibrillation. 

When  the  torso  is  connected  to  the 
arrhythmia  trainer,  a  magnetic  tape 
device  that  permits  a  library  of  record- 
ed arrhythmias  to  be  shown  on  a  moni- 
tor scope  or  recorder  can  be  sequentially 


programmed  into  the  torso  to  simulate 
emergency  situations.  They  include  such 
patterns  as  normal  sinus  rhythm, 
ventricular  fibrillation,  atrial  flutter, 
and  paced  rhythm. 

For  further  information  write  to 
Hewlett-Packard  (Canada)  Limited, 
275  Hymus  Boulevard,  Pointe  Claire, 
Quebec. 


Spray  Room  Deodorant 
With  Chemical  Action 

H  &  L  Spray  Room  Deodorant,  devel- 
oped by  Alconox  Inc..  safely  and  effec- 
tively eliminates  odors  encountered  in 
sick  rooms,  laboratories,  kitchens, 
bathrooms,  lounges  and  other  odor- 
prone  areas.  Itself  unscented,  the  spray 
contains  the  patented  agent  Metazene 
that  chemically  destroys  vapor  odors 
of  ammonia,  formaldehyde,  sulphur 
and  nitrogen  compounds,  and  such 
odors  as  produced  by  smoke  or  organic 
decomposition. 

The  chemical  neutralization  process 
leaves  no  unpleasant  after-odor  or 
perfume-masking  scent.  To  meet  health- 
care institution  specifications,  the 
spray  is  non-allergenic  and  non-stain- 
ing. 

For  information  on  local  supply 
sources  and  special  bulk  prices,  write 
Alconox,  Inc..  215  Park  Ave.  South. 
New  York,  N.Y.  10003. 


Betadine  Vaginal  Suppositories 

1  he  Purdue  Frederick  Company  (Can- 
ada) Limited  has  dcvck)ped  Betadine 
vaginal  suppositories  to  make  elemental 
iodine  available  in  a  form  that  essential- 
ly maintains  the  microbicidal  activity 
o\'  iodine  without  irritation  or  toxicit) 
and  without  staining  skin  and  natural 
fabrics. 

It  is  indicated  for  trichomonas  vag- 
inalis vaginitis,  monilial  vaginitis,  and 
nonspecific  vaginitis  —  infections 
manifested  by  leukorrhea,  malodour, 
pruritis,  and  burning  sensation  of  vulva 
and  vagina. 

Each  Betadine  vaginal  suppository 
ct)ntains  200  mg.  of  ptwidinc-iodine 
N.F.  to  provide  20  mg.  of  available 
iodine  in  a  water-soluble  base.  It  is 
supplied  in  boxes  of  14  suppositories 
with  applicator. 

For  further  information  write  to  Dr. 
R.T.  Towson,  The  Purdue  Frederick 
Company  (Canada)  Limited.  123  Sun- 
rise Avenue.  Toronto.  Ontario. 

AUGUST  1971 


Key  Pharmaceutical  Syllables 


The  March  1971  issue  of  the  World  Health  Organization's  Chronicle 
contained  information  conveyed  by  Latin,  English,  and  French  pharma- 
ceutical and  chemical  syllables.  Below,  suffixes  and  prefixes  are  in- 
dicated    by    hyphens    appropriately    placed. 


Meaning 

synthetic     polypeptides    with     a 
corticotrophin-like  action 

steroids,  androgenic 

anticoagulants  of  the  coumarin 
type 

tranquillizers  of  the  propanediol 
and  pentonediol  series 
barbituric  acids,  hypnotic  activity 
anabolic  steroids 
local  anesthetics 

antibiotics     with     cefalosporanic 
acid    nucleus 
penicillins:  derivative  of 
6-amino-penicillanic  acid 
steroids,      glucocorticoids     and 
mineralocorticoids,     other     than 
prednisolone  derivatives 
ocridine   derivatives 
curare-like  drugs 
antibiotics,  tetracycline  deriva- 
tives 

estrogenic  drugs 
guanidine  oral  antidiabetics 
steroids,  progestotive 
sulfonamide  oral  antidiabetics 
iodine-containing  contrast  media 
mercury-containing  drugs,  anti- 
microbial or  diuretic 
monoamine  oxidase  inhibitors 
antimicrobial  antibiotics,  pro- 
duced by  Streptomyces   strains 
5-nitrofuran  derivatives 
onorexigenic  agents 
dibenzozepine,  compounds  of 
the  imipramine  type 
quinoline  derivatives 
derivatives  of   Rauwolfia  alka- 
loids 

sulfonamides,  used  as  antimi- 
crobials 

diuretics  which  are  thiazide 
derivatives 

antiepileptics  which  ore  hydon- 
toin  derivatives 

spasmolytics  with  a  papaverine- 
like  action 

alkaloids  and  organic  bases 
ketones 

quaternary  ammonium  com- 
pounds 


Latin 

English 

French 

-actidum 

-octide 

-octide 

•andr- 
or  -stan- 
or  -ster- 

■andr- 
or  -stan- 
or  -ster- 

-ondr- 
or  -ston- 
or  -ster- 

-orolum 

-arol 

-arol 

-bamotum 

■bamate 

-bomote 

barb 
bol 

barb 
bol 

barb 
bol 

-coinum 
cef- 

-caine 

cef- 

<aTne 
cef- 

-cillinum 

-cillin 

-cilline 

cort 

cort 

cort 

-crinum 

-crine 

-crine 

-curium 
-cyclinum 

-curium 
-cycline 

-curium 
-cycline 

-estr- 

-forminum 

gest 

gli- 

io- 

-estr- 

-formin 

gest 

gii- 

io- 

-estr- 

-formine 

gest 

gli- 

io- 

-mer- 

-mer- 

-mer- 

-moxinum 

-moxin 

-moxine 

■mycinum 

■mycin 

-mycine 

nifur- 

nifur- 

nifur- 

-orexum 

-orex 

-orex 

■prominum 

-pramine 

-pramine 

-quinum 
-serpinum 

-quine 
-serpine 

-quine 
-serpine 

sulfa- 

sulfo- 

sulfa- 

-tizidum 

-tizide 

-tizide 

-toinum 

-toin 

-toVne 

-verinum 

-verine 

-verine 

-inum 

-ine 

-ine 

-onum 

-one 

-one 

-ium 

-ium 

-ium 

SofraTulle* 

Bactericidal 

Dressing. 


AUGUST  1971 


COMPOSITION 

A  lightweight  lano-paraffin  gauze 
dressing  impregnated  with  1% 
Soframycin. 

INDICATIONS 

Traumatic:  Lacerations,  abrasions, 
grazes  (gravel  rash),  bites  (.animal 
and  insect),  cuts,  puncture  wounds, 
crush  injuries,  surgical  wounds  and 
incisions,  traumatic  ulcers. 
Ulcerative :  Varicose  ulcers,  diabetic 
ulcers,  bedsores,  tropical  ulcers. 
Thermal:  Burns,  scalds. 
Elective:  Skin  grafts  (donor  and 
recipient  sites) ,  avulsion  of  finger  or 
toenails,  circumcision. 
Miscellaneous:  Secondarily  infected 
skin  conditions— e.g.,  eczema, 
dermatitis,  herpes  zoster;  colostomy, 
acute  paronychia,  incised  abscesses 
(packing),  ingrowing  toenails. 

CONTRA-INDICATIONS 

Allergy  to  lanolin  or  to  Soframycin. 
Organisms  resistant  to  Soframycin. 

APPLICATION 

If  required,  the  wound  may  first  be 
cleaned.  A  single  layer  of  Sofra-TuUe 
should  be  applied  directly  to  the  wound 
and  covered  with  an  appropriate 
dressing  such  as  gauze  linen  or  crepe 
bandage.  In  the  case  of  leg  ulcers,  it  is 
advisable  to  cut  the  dressing  exactly 
to  the  size  of  the  ulcer  in  order  to 
minimise  the  risk  of  sensitisation  and 
not  to  overlap  on  the  surrounding 
epidermis.  When  the  infective  phase 
has  cleared  the  dressing  may  be 
changed  to  a  non-impregnated  one. 
When  the  lesion  is  very  exudative  it  ia 
advisable  to  change  the  dressing  at 
least  once  a  day. 

PRECAUTIONS 

In  most  cases  absorption  of  the 
antibiotic  is  so  slight  that  it  can  be 
discounted.  Where  very  large  body 
areas  are  involved  (e.g.  30%  or  more 
body  burn )  the  possibility  of  oto- 
toxicity and/or  nephrotoxicity  being 
produced,  should  be  remembered. 

PACKINGS 

Cartons  of  10  units ;  each  unit  pack 

contains  one  sterile  antibiotic  gauze 

dressing  10  cm  x  10  cm. 

Also  available: 

Tins  of  10  pieces :  4"  x  4". 

Tins  of  one  .strip :  4"  x  40". 

Complete  information  available  on  request 

ROUSSEL  ■-- 


Roussel  (Canada)  Ltd. 

153  Graveline 
Montreal  376,  Quebec 


Next  Month 
in 


The 

Canadian 
Nurse 


•  The  Expanding  Role: 
Where  Do  We  Go  From  Here? 

•  Why  is  Hypothermia 
Overlooked? 

•  A  Woman's  Right  to  Nag  — 
Inalienable  and  Essential 

•  Acting  Up  or  Acting  Out? 


& 

^^P 


Photos  Credits  for 
August  1971 

Wellesley  Hospital.  Toronto, 
p.  7 

Canadian  Tuberculosis  and 
Respiratory    Disease   Asso- 
ciation, Ottawa,  p.  9 

Scarborough   Centenary   Hos- 
pital, West  Hill,  Ontario, 
p.  21,22 

Ottawa  Civic  Hospital, 
Ottawa,  p.  36 

G.  F.  Strong  Rehabilitation 
Centre,  Vancouver,  B.C., 
p.  38 


42     THE  CANADIAN  NURSE 


new  products 


Ultrasonic  Nebulizer 

Canadian  Liquid  Air  Ltd.  of  Montreal 
is  Canadian  distributor  for  the  Bendix 
ultrasonic  nebulizer,  a  self-contained 
portable  unit  used  to  treat  respiratory 
ailments  such  as  emphysema  and  cystic 
fibrosis. 

The  nebulizer  takes  up  little  space, 
and  generates  high  frequency  sound 
energy  that  produces  fog  or  aerosol 
from  liquid  medication.  The  aerosol  is 
administered  to  the  patient  at  a  control- 
led rate  through  a  mask  or  oxygen  tent. 

Cross  contamination  is  prevented  by 
using  an  inexpensive,  disposable,  poly- 
ethylene container  in  which  liquid 
medicament  is  stored  and  nebulized. 

For  further  information  write  to 
Canadian  Liquid  Air,  Ltd.,  1210  Sher- 
brooke  St.,  West,  Montreal  1 10,  Que- 
bec. 


Minocin 

Minocin  (minocycline  hydrochloride), 
a  broad  spectrum  antibiotic,  has  been 
introduced  by  Lederle  Laboratories  of 
Cyanamid  of  Canada  Limited.  This 
new,  semi-synthetic  antibiotic  has  been 
shown  to  possess  greater  activity  than 
previously  available  tetracyclines 
against  many  strains  of  tetracycline- 
resistant  staphylococci  and  against 
other  organisms  known  to  be  sensitive 


to  tetracyclines,  such  as  certain  pen- 
icillin/ampicillin  resistant  strains. 

Minocin  is  indicated  in  the  treat- 
ment of  a  wide  variety  of  infections, 
mcludmg  infections  of  the  respiratory 
and  genitourinary  tracts,  and  skin  and 
sott  tissue  infections.  Its  side  effects  are 
minimal.  For  example,  it  is  among  the 
less  photosensitizing  tetracyclines 
However,  the  absorption  of  Minocin 
IS  influenced  by  foods  and  dairy  prod- 
ucts, and  should  be  given  at  least  one 
hour  before  or  after  ingestion  of  such 
substances. 

Minocin    is   available    in    100    me 
capsules. 

For  further  information  write  to 
Lederle  Products  Department,  Cyana- 
mid of  Canada  Limited,  P.O  Box 
1039,   Montreal  101,  Quebec. 


J 


/S! 


Med-Ad  Metered  Volumetric  IV  Set 

IV  Ometcr,  Inc.,  manufacturer  of  me- 
tered intravenous  infusion  sets,  has  in- 
troduced a  new  disposable  Med-Ad  set. 
Itcombinescfficientvolumetricdelivery 
with  visible  flow  indication  and  sensi- 
tive, stable,  tlow  control.  In  addition, 
the  Med-Ad  pliable  volumetric  chamber 
serves  as  a  positive  pressure  unit  when 
rapid  introduction  of  a  solution  is  re- 
quired in  emergencies. 

The  Med-Ad  set  incorporates  two 
IV  Omcter  "Y"  injection  sites  and  a 
"flashback"'  indicator  at  the  needle 
adapter.  It  is  adaptable  to  all  solution 
containers  and  is  available  in  both  mi- 
crodrop  and  standard-drop  configura- 
tions. 

For    further    information    write    to 

IV  Ometer  Inc.,  P.O.  Box  1219,  Santa 

Cruz,  California,  95060.  § 

AUGUST  1971 


in  a  capsule 


Dig  this! 

Women's  liberation  adherents  may  be 
fighting  for  their  cause  all  the  way  to 
the  grave.  According  to  an  announce- 
ment from  Fiberglas  Canada  Ltd.,  a 
boat -building  company  in  Victoria- 
ville,  Quebec  has  started  making  "Fi- 
berglas-reinforced  plastic  caskets  de- 
signed specifically  for  the  burial  of 
women.""  A  writer  for  The  Financial 
Post  quipped  "...  for  clients  who  don't 
dig  the  first  model,  in  white,  the  manu- 
facturer is  coming  up  with  a  second, 
more  feminine  version  —  in  pale  pur- 
ple."" 

Underarm  sprays  dangerous? 

You  never  know  what  you're  going  to 
find  when  you  read  Hansard.  Looking 
under  the  heading  "health""  of  the  May 
26  issue,  we  discovered  that  aerosol 
underarm  sprays  might  be  dangerous. 

P.B.  Rynard,  Simcoe  North,  asked 
Health  Minister  John  Munro:  "In  view 
of  the  statement  recently  made  at  a 
meeting  of  the  American  Thoracic 
Society  that  the  use  of  aerosol-type 
sprays  as  underarm  deodorants  may 
cause  lung  lesions  and  may  be  potential- 
ly dangerous  to  patients  with  cardiac  or 
respiratory  diseases,  what  step  is  the 
government  taking  to  ban  the  two  com- 
mercial brands  that  have  been  identified 
by  researchers?" 

Mr.  Munro  replied  that  the  Food 
and  Drug  Directorate  of  his  department 
is  looking  into  the  matter. 

It's  probably  only  a  matter  of  time 
before  we  pick  up  a  newspaper  and 
read:  "A  group.  Action  Aerosol,  march- 
ed on  Parliament  Hill  yesterday  to 
protest  that  underarm  spray  deodorants 
have  not  been  banned.  Waving  their 
aerosol  spray  cans,  they  chanted:  Deo- 
dorants can  be  deadly.  Sprays  spread 
disease.  Ban  underarm  pollutants 
NOW!" 


"Peoplepower,"  not  manpower! 

In  a  House  of  Commons  debate  in  June, 
M.P.  Grace  Maclnnis  gave  examples  of 
the  discrimination  against  women  in 
the  manpower  training  program.  "First 
of  all,  and  most  obviously"  she  pointed 
out.  "it  is  the  name  of  the  program  — 
manpower  training.  It  is  just  as  though 
it  were  reserved  exclusively  for  humans 
ol  the  male  gender,  it  completely  ig- 
nores the  tact  ihat  one-third  of  the  labor 
force  is  composed  of  women." 
AUGUST  1971 


The  report  of  the  Royal  Commission 
on  the  Status  of  Women  calls  for  an 
amendment  to  the  occupational  training 
act  to  permit  full-lime  house-hold  re- 
sponsibility to  be  equivalent  lo  partici- 
pation in  the  labor  force  insofar  as 
eligibility  for  training  allowance  is  con- 
cerned. 

Perhaps  an  alternative  title  tor  the 
training  program  would  be  "people- 
power,"  to  avoid  discrimination  against 
either  manpower  or  womanpower. 


Taste  expansion 

If  beef  stew  isn't  exactly  your  idea  of 
company  cuisine,  perhaps  okra  stew  or 
ground  nut  stew  (a  Nigerian  chicken 
and  peanut  recipe)  is  more  like  it.  If 
stew  still  doesn't  tempt  you,  why  not 
experiment  with  mango  fool  (English 
pudding,  African  style),  tom  yam  kung 
(lemon  soup  with  shrimp),  or  Satay 
(a  Sarawak  meat  dish  that  can  be  spic- 
ed, skewered,  and  grilled)?  Just  the 
names  alone  are  a  start  in  the  right 
direction. 

These  are  a  few  of  the  overseas  reci- 
pes that  Elizabeth  Posgate  brought 
back  with  her  from  a  two-year  posting 
in  India. 

Writing  about  her  "taste  expansion" 
experience  in  The  Globe  and  Mail  May 
20,  she  included  these  interesting  culi- 
nary observations: 


■Traditionally,  meat,  vegetable, 
soup  and  pickles  are  eaten  as  one 
course;  water  is  the  beverage  and  sweets 
rarely  follow  the  meal,  but  are  taken  at 
tea  time.  In  the  Western  world,  beer  is 
generally  accepted  as  the  most  suitable 
liquid  accompaniment  for  curry.  How- 
ever, less  filling  and  equally  refreshing, 
is  rose  or  medium  dry  white  wine.  Fresh 
fruit  or  sherbet  solve  the  dessert  prob- 
lem without  overburdening  the  diner."' 

Travel  certainly  can  add  a  refreshing 
—  as  well  as  sensible  —  perspective  to 
dining!  And,  at  the  same  time,  it  can 
leave  us  with  savory  memories  long 
after  other  thoughts  of  a  trip  have  de- 
serted us. 

Wanted:  one  Indian  chief 

An  advertisement  in  the  Globe  and 
Mail  in  April  tickled  our  sense  of  the 
unusual.  The  ad  in  question  read: 

Township  of  Chinguacousy  requires 
an  INDIAN  CHIEF  to  participate  m  the 
1 50th  anniversary  celebrations. 

•  Knowledge  of  Indian  history,  folklore 
&  crafts  an  asset. 

•  Should  have  own  regalia. 

•  Mostly  weekend  work. 

•  With  own  transportation  a  perfect 
position  for  Outgoing  Personality." 

It  could  be  that  there  is  a  bright 
future  for  unemployedchiefs.  Especially 
if  it's  true,  as  many  often  grumble, 
that  there  are  too  many  chiefs  and  not 
enough  Indians. 


CARDIAC  COMMENTS: 

By  Patricia  Orr,  R.N., 

New  Brunswick 


"I  ran  into  the  edge  of  the  screen! 


THE  CANADIAN   NURSE     43 


The  following  are  abstracts  of  studies 
selected  from  the  Canadian  Nurses' 
Association  Repository  Collection  of 
Nursing  Studies.  Abstract  manuscripts 
are  prepared  by  the  authors. 

Holaday,  Marie.  Achieving  self  care: 
a  shared  responsibility.  Montreal, 
Quebec,  1970.  Thesis  (M.Sc.(App.)) 
McGill  University. 

A  descriptive,  qualitative  research 
study  was  done  to  ascertain  the  nature 
of  interactions  between  nurses  and 
patients  when  the  expectations  of  each 
partner  in  the  interaction  situation,  in 
relation  to  the  role  of  self  and  the  other 
when  carrying  out  required  physical 
care,  are  congruent  or  when  they  are 
incongruent;  and  to  identify  thereby 
those  nursing  behaviors  having  a  pos- 
itive effect  on  the  patient's  resump- 
tion of  self-care  activities. 

The  sample  under  study  consisted  of 
verbal  interactions  that  occurred  bet- 
ween 50  post-surgical  patients  and  10 
nursing  personnel.  The  research  setting 
was  a  surgical  ward  of  a  265 -bed  gener- 
al hospital. 

Data  on  more  than  100  observations 
of  nurse-patient  interactions,  in  the 
form  of  verbatim,  post  observational 
recording,  were  collected,  coded,  and 
analyzed  to  isolate  variables. 

Two  main  categories  of  interaction 
emerged  from  the  data:  1 .  interactions 
wherein  the  nurse  and  patient  expecta- 
tions for  the  resumption  of  self-care 
activities  by  the  patient  were  congruent; 
and  2.  interactions  wherein  the  nurse 
and  patient  expectations  were  incon- 
gruent; either  the  nurse  expected  the 
patient  to  assume  responsibility  for 
more  self-care  activities  than  he  was 
willing  to  assume,  or  the  patient  was 
willing  to  assume  more  responsibility 
than  the  nurse  expected  him  to  assume. 

In  each  type  of  interaction,  nurse 
behaviors  having  a  direct  effect  on  the 
patient's  resumption  of  self-care  activi- 
ties were  identified. 

In  congruent  interactions  the  nurse 
behaviors  found  to  have  a  positive 
influence  were:  the  encouragement, 
acceptance  and  collaborative  imple- 
mentation of  patient-made  plans;  the 
making  of  complementary  nursing 
plans;  the  creation  of  nurse-patient 
partnerships;  and  verbal  rewards  in  the 
form  of  praise,  approval,  joking,  cajol- 
ing, and  bargaining.  Such  nurse  be- 
44     THE  CANADIAN   NURSE 


haviors  as  overprotection,  deprivation 
of  opportunities,  focusing  on  nurse's 
needs  or  "gettrng  the  work  done"  foster- 
ed patient  dependency. 

In  incongruent  interactions,  those 
nurse  behaviors  found  to  have  a  pos- 
itive influence  on  the  unwilling  pa- 
tient were:  increasing  patient  part- 
icipation; giving  decision-making 
responsibilities;  holding  up  subsequent 
rewards  as  bribes;  and  using  mild 
threats  tempered  with  teasing,  bargain- 
ing, praise,  and  confidence.  The  imposi- 
tion of  ready-made  plans;  the  use  of 
orders,  commands  and  belittling  com- 
ments; and  the  threat  of  sanctions  tended 
to  increase  the  patient's  unwillingness. 
Understanding,  explanation,  and  sug- 
gestion helped  the  overwilling  patient; 
commands,  reprimands,  appeals, 
threats,  and  "it's  up  to  you"  tended  to 
create  negative  influences. 

The  findings  suggest  that  nurse- 
patient  expectations  and  nurse  behav- 
iors are  components  of  the  nurse-patient 
interaction  having  significant  effects 
on  the  patient  and  holding  important 
consequences  for  the  outcome  of  the 
interaction.  A  need  for  extensive  study 
of  these  two  components,  using  a  large 
sample  drawn  from  all  areas  in  which 
nursing  is  practiced,  is  implied. 


Murakami,  Rose.  A  descriptive  study: 
permitting  choice  in  nursing  the 
aged  patient  is  inconsistent  with  the 
nurse's  goals  in  the  general  hospital. 
Montreal,  Quebec,  1970.  Thesis 
(M.Sc(App.))  McGill  University. 

A  descriptive  study  on  how  aged  pa- 
tients are  nursed  in  a  general  hospi- 
tal was  carried  out  on  an  acute  medical 
ward  of  a  265 -bed  hospital.  The  sample 
included  16  nurses  and  12  aged  pa- 
tients who  needed  assistance  and/or 
supervision  with  the  activities  of  daily 
living.  Participant  observation  was  the 
method  used  to  collect  data.  Fifty 
observations  were  made  over  a  period 
of  four  months,  the  mean  length  of 
each  observation  being  60  minutes. 

The  hypothesis  was:  the  idea  of 
permitting  choice  for  the  aged  patient 
is  not  consistent  with  the  nurse's  prim- 
ary goal  of  keeping  the  patient  alive. 

Given  that  the  goal  of  the  nurse 
in  the  general  hospital  is  "cure"  and 
that  the  maintenance  of  physiological 
well-being  is  of  primary  concern,  per- 


mitting the  aged  patient,  who  is  in  the 
process  of  slowing  down,  to  make 
choices  may  mean  that  he  will  choose 
to  slow  down.  This  is  inconsistent  with 
the  nurse's  primary  goal.  Analysis  of 
the  data  showed  three  ways  in  which 
the  nurse  limits  the  patient's  choice: 
1 .  the  patient  is  "non-existent,"  render- 
ing a  choice  irrelevant.  2.  the  patient  is 
given  no  choice.  3.  the  patient  is  given 
a  choice,  yet  no  choice. 

Examples  reflecting  each  way  of 
nursing  to  limit  the  patient's  choice  are 
described  in  detail.  The  data  support 
the  hypothesis. 

Lalancette,  Denise.  An  E.\ploratory 
study  to  deternune  the  se.x  educa- 
tion of  voting  unmarried  mothers. 
Boston,  1967.  Thesis  (M.Sc.N.) 
Boston  U. 

This  exploratory  study  is  to  determine 
the  specific  kinds  of  knowledge  that 
16  adolescent,  unmarried  pregnant 
girls  received  concerning  sex  educa- 
tion prior  to  pregnancy.  These  unmar- 
ried pregnant  girls  were  in  the  last  tri- 
mester ot  their  pregnancy  at  the  time 
of  the  interview,  and  were  confined  in 
a  maternity  home. 

It  was  assumed  that  young  unmarried 
pregnant  girls  had  had  a  limited  sex 
education  prior  to  their  pregnancy. 
Pregnancy  might  have  resulted  because 
much  of  their  knowledge  was  derived 
from  sources  other  than  parents  and 
educators,  who  were  best  suited  to  help 
adolescents  find  their  sexual  identity. 

The  criteria  for  the  study  were  that 
the  girls  be:  unwed,  from  1 3  to  17  years 
old.  and  primagravida. 

The  findings  invalidated  the  stated 
assumptions.  However,  information 
received  from  parents  provoked  fear, 
confusion,  curiosity,  shock,  embar- 
rassment, fear  of  pregnancy,  disgust, 
anxiety  to  start  menstruating  in  order 
"to  be  normal."  or  the  inability  to  be- 
lieve information  on  intercourse.  These 
feelings  are  not  those  expected  to  aid 
in  the  development  of  ego  identity, 
nor  could  they  assist  the  girl  in  becom- 
ing a  sexually  well-balanced  human 
being,  accepting  her  sex  and  her  role 
as  a  woman.  This  confirms  that  the 
failure  to  find  sexual  identity  is  a  factor 
in  the  pregnancy  of  the  subjects  studied. 
This  characteristic  is  consistently  found 
in  the  data  obtained  from  each  of  the 
1 6  interviews. 

AUGUST  1971 


Buzzell,  Elizabeth  Mary,  and  Roberto, 
Marie  Virginia.  A  comparison  of  the 
effectiveness  of  two  nursing  ap- 
proaches in  the  rehef  of  post -opera- 
tive pain.  Boston.  Mass.,  1967.  The- 
sis (M.Sc.N.)  U.  of  Boston. 

The  purpose  of  this  study  was  to  de- 
termine which  nursing  intervention  — 
a  combination  of  analgesic  and  back- 
rub  or  a  combination  of  analgesic 
and  purposeful  communication  —  was 
more  effective  m  relieving  pain  in  the 
surgical  patient  on  his  first  postopera- 
tive day.  The  study  was  designed  to 
utilize  the  patients'  perceptions  of  the 
actual  effectiveness  of  these  interven- 
tions. The  hypothesis  was:  the  patient 
will  experience  more  effective  relief 
of  postoperative  pain  when  the  combi- 
nation of  analgesic  and  backrub  is 
administered  than  when  the  combina- 
tion of  analgesic  and  purposeful  com- 
munication is  administered. 

Three  first-day  postoperative  adult 
patients,  who  had  undergone  abdominal 
surgery,  participated  in  the  study  con- 
ducted in  a  376-bed  teaching  hospital 
in  the  Boston  area.  A  non-random 
sample  was  used.  Eight  criteria  gov- 
erned selection.  Each  patient  selected 
was  interviewed  preoperatively. 

The  instruments  used  to  collect  the 
data  were  a  check  list  and  a  structured 
question.  The  check  list  consisted  of 
five  phrases  descriptive  of  painful 
sensations  ranging  from  no  pain,  as- 
signed a  value  of  zero,  to  very  severe 
pain,  assigned  a  value  of  plus  three. 
Provision  was  also  made  for  the  patient 
to  indicate  an  increase  in  pain.  Values 
were  not  shown  on  the  check  list.  The 
structured  question  was  designed  to 
elicit  which  nursing  intervention,  if 
any,  the  patient  felt  was  meaningful 
for  him. 

Patients  were  randomly  assigned  to 
one  of  three  groups  that  differed  in  the 
experimental  variable,  the  nursing 
intervention.  The  patient  in  Group  I 
was  given  a  combination  of  Demerol 
and  a  backrub;  in  Group  II,  a  combina- 
tion of  Demerol  and  purposeful  com- 
munication; and  in  Group  III,  Demerol 
only.  Data  collection  began  when  the 
patient  verbalized  pain.  Prior  to  the 
administration  of  the  analgesic,  and  at 
15,  30,  and  60  minutes  after  adminis- 
tration of  the  drug,  the  patient  was 
requested  to  complete  the  check  list. 
Times  selected  were  based  on  the  initial 
and  peak  action  of  the  drug.  After  one 
hour,  the  following  question  was  asked: 
"Was  there  anything  that  a  nurse  or 
anyone  else  did,  during  the  past  hour, 
that  you  feel  helped  to  relieve  your 
pain?" 

A  descriptive  analysis  of  the  data  did 
not  lend  support  to  the  hypothesis. 

Conclusions:  1.  Patients  perceived 
analgesia  to  be  a  more  therapeutically 
AUGUST  1971 


effective  nursing  measure  in  the  relief 
of  their  pain  than  combinations  of  a 
nursing  intervention  and  analgesia. 
2.  Nurses  and  patients  have  differing 
perceptions  as  to  the  effectiveness  of 
particular  nursing  interventions  to 
relieve  pain. 

Phillips,  Frances  Patricia.  A  study  to 
develop  an  instrument  to  assist  muses 
to  assess  the  abilities  of  patients  with 
chronic  conditions  to  feed  them- 
,sW\rs. Vancouver. B.C..  i97 1  .Thesis 
(M.Sc.N.)  L).  of  British  Columbia. 

Construction  of  a  tool  to  assist  nurses 
to  assess  the  abilities  of  patients  with 
chronic  conditions  to  feed  themselves 
was  based  on  21  identified  feeding 
behaviors  derived  from  observations 
of  a  random  sample  of  50  such  patients 
from  two  urban  hospitals.  Observa- 
tions were  also  made  of  the  nurses  who 
cared  for  these  patients.  Identifying 
specific  behavior  items  was  concurrent 
with  defining  five  categories  along  the 
dependence-independence  continuum 
during  analysis  of  the  data. 

A  3:1:1  ratio  for  weighting  behav- 
ioral components  was  established  ar- 
bitrarily. The  Kenny  self-care  five- 
point  numerical  rating  scale  was  adapt- 
ed to  provide  a  method  of  determining 
the  amount  of  help  a  patient  would 
require  to  feed  himself.  Experts  in  the 
field  agreed,  with  minor  modifications, 
that  the  tool  could  determine  a  measure 
of  independent  feeding. 

A  reliability  test,  using  8  pairs  of 
registered  nurses  to  assess  32  patients, 
produced  a  reliability  coefficient  oi 
.849.  evidence  that  this  tool  is  depend- 
able and  consistent  in  measuring  the 
relative  state  of  feeding  dependence- 
independence  of  patients  with  chronic 
conditions.  Rating  behaviors  provides 
written  evidence  of  the  degree  to  which 
the  patient  is  able  to  feed  himself.  The 
difference  between  what  a  patient  can 
do  and  the  criteria  tor  independent 
feeding  provides  a  measure  of  the  help 
a  patient  will  require  to  feed  himself. 

Further  research  is  indicated  in 
the  areas  of:  usefulness  of  the  tool  for 
registered  nurses,  identifying  psycho- 
social behaviors  more  precisely,  testing 
the  tool  in  different  feeding  situations, 
and  expanding  the  tool  to  include  the 
other  activities  of  daily  living. 

Mrazek,  Margaret  Loretta.  Hospital 
clinical  facilities  utilized  by  Ed- 
nuinton  niirsiiif;  programs:  a  descrip- 
tive siiuly.  1971.  Thesis  (M.H.A.) 
U.  of  Alberta. 

This  study  undertook  to  describe  and 
compare  selected  aspects  of  current 
processes  of  alkx'ating  clinical  re- 
sources in  Edmonton  hospitals.  The 
investigation   was    limited    to   nursing 


programs  in  the  Edmonton  area  and  the 
hospitals  that  presently  pnnidc  learn- 
ers w  iih  clinical  experience. 

Eleven  hospitals  (live  acute  and  six 
other)  and  10  schools  of  nursing  partic- 
ipated in  the  study.  The  nursing  educa- 
tion programs  that  participated  includ- 
ed: master  of  health  services  administra- 
tion, nursing  service  administration 
major;  basic  and  postbasic  bachelor 
degree:  certified  nursing  aide:  certified 
nursing  orderly:  2  year  psychiatric 
nursing  diploma:  2-year  RN  diploma: 
and  3-ycar  RN  diploma.  The  subjects 
included  1  I  administrators.  1  1  direc- 
tors of  nursing  service.  3  directors  of 
nursing  from  3  of  the  hospitals,  and  the 
10  directors  of  nursing  programs. 

The  data  collecting  technique  uti- 
lized was  the  questionnaire.  The  in- 
vestigator developed  one  series  con- 
sisting of  five  questionnaires  that  con- 
tained items  designed  to  collect  basic 
information:  data  regarding  past,  pres- 
ent, and  future  allocation  of  clinical 
resources:  and  identification  of  areas  of 
concern  to  the  hospitals  and  nursing 
programs. 

The  questionnaires  were  pretested  in 
one  hospital  in  Southern  Alberta.  All 
questionnaires  were  returned.  On  the 
basis  of  the  completed  questionnaire 
from  the  only  graduate  nursing  program 
in  the  study,  it  was  decided  that  data 
obtained  was  not  relevant  to  this  partic- 
ular study,  as  the  type  of  field  experi- 
ence needed  by  the  learners  in  this 
program  differed  from  the  terms  of 
reference  regarding  clinical  experience 
defined  in  the  stud> . 

Data  were  treated  in  both  a  descrip- 
tive and  inferential  manner.  Niinpa- 
rametric  statistical  tests,  especially  the 
Kruskal-Wallis  one-way  analysis  of 
variance  by  ranks  for  K  independent 
samples  and  the  Kolmogorov-Smirnov 
two  independent  sample  test,  were 
applied. 

The  major  conclusions  are:  I.  ad- 
missions are  being  limited  in  one-third 
of  the  Edmonton  nursing  programs  in 
the  study  because  of  lack  of  availa- 
bility of  clinical  resources;  2.  there 
is  a  seeming  incapacity  of  the  majority 
of  acute  hospitals  to  accept  more  nurs- 
ing learners:  and  3.  mechanisms  for 
assessing  the  needs  and  alkxrating 
resources  arc  inadequate. 

Two  primary  recommendations  aris- 
ing from  this  stud\  are:  First,  a  volun- 
tary joint  committee,  comprised  of 
representatives  from  all  health  per- 
sonnel educational  programs  and  all 
health  agencies  should  be  formed  to 
assess  the  needs  of  the  programs  and 
to  work  toward  maximizing  the  utili- 
zation of  resources.  Second,  there  is  a 
need  for  a  survey  similar  in  design  to  the 
present  study,  but  broader  in  scope, 
including  all  health  personnel  educa- 
tional programs  and  health  agencies.  ^ 
THE  CANADIAN  NURSE     45 


For  The  Bereaved,  edited  by  Austin 
H.  Kutscher  and  Lillian  G.  Kutscher. 
157  pages.  Toronto.  George  J.  Mc- 
Leod,  Ltd..  1971. 

Reviewed  hy  Sisler  Peler  Claver. 
Lecliirer  in  Rehahilitation  Nurs- 
ing. Si.  Martha's  Hospital  School 
of  Nursing,  Antigonish,  N.S. 

Death  is  the  ultimate  loss,  yet  it  is  as 
intrinsie  a  human  experience  as  life. 
Rabbi,  priest,  minister,  educator,  doc- 
tor, nurse,  lawyer,  and  others  have 
contributed  to  this  compilation  ot'essays 
on  loss  and  grief.  Notwithstanding  the 
brevity  of  some  of  the  individual  con- 
tributions, the  authors  have  managed 
lo  present  a  thoughtful,  inspiring,  and 
comprehensive  treatment  of  a  much 
discussed  and  difficult  problem  of 
today. 

Here  are  some  subtitles  selected  at 
random:  should  a  patient  be  told  the 
truth;  the  right  to  die  in  dignity;  under- 
standing your  mourning;  the  nurses 
education  for  death;  and  medical  needs 
ot  the  bereaved  family. 

The  theme  of  this  book  is  under- 
standing grief  and  death.  In  this  country 
we  have  difficulty  talking  about  death, 
and  often  fail  to  realize  that  a  patient 
wants  to  share  this  ultimate  experience 
witii  others.  Professional  experts  and 
consultants  in  diverse  fields  of  human 
care  have  contributed  their  views  on 
the  concepts  of  death  relating  to  grief 
and  loss.  Fur  The  Bereaved  suggests 
practical  guidelines  for  accepting  loss 
and  making  use  of  adversity  so  that 
one's  spirit  is  renewed,  not  quenched. 
It  should  be  a  helpful  guide  not  only 
for  the  bereaved  but  for  others  who 
seek  direction  in  confronting  the  is- 
sues of  death  and  grief. 

Most  of  nurses'  time  is  spent  in  ef- 
forts to  preserve  life  and  ward  off 
death's  approach.  Presumably  they 
must  develop  some  expertise  in  helping 
dymg  people  and  in  accepting  the 
patient's  and  family's  response  to  death. 
What  then  is  the  nurse's  own  philoso- 
phy of  death?  To  read  this  little  book 
IS  to  ask  oneself  this  question.  Mean- 
ingful insights  into  life  and  death  values 
provide  a  basis  for  a  realistic  and 
practical  approach  to  coping  with  a 
loss,  and  at  the  same  time  transmitting 
genuine  concern. 

This  readable  volume  lends  itself 
to  personal  study,  discussion,  or  refer- 
ence. 

46     THE  CANADIAN  NURSE 


Medical  Handbook,  edited  by  Dr.  R.L. 
Kleinman.  I  I  I  pages.  London.  Eng- 
land. International  Planned  Parent- 
hood Federation.  1971. 
Reviewed  hy  Constance  Swinton. 
Nursing  Consultant,  Child  and  Adult 
Health  Services,  De/>t.  National 
Health  and  Welfare,  Ottawa. 

This  medical  handbook  has  been  writ- 
ten for  physicians  with  up-to-date 
information  on  the  various  forms  of 
contraception  with  an  emphasis  on 
two  modern  forms:  hormonal  methods 
and  intrauterine  devices.  Additional 
chapters  on  abortion  and  sub-fertility 
widen  the  scope  of  the  handbook  to 
cover  family  planning  more  broadly 
than  for  contraception  alone. 

The  Bulletin  "Dispatch"'  No.  9. 
1970.  prepared  by  the  Educational 
Services.  Food  and  Drug  Directorate. 
Department  of  National  Health  and 
Welfare,  should  be  read  in  conjunction 
with  chapter  2  on  oral  contraceptives 
in  the  Medical  Handbook.  This  bulle- 
tin contains  excerpts  from  the  report 
on  "All  Aspects  of  the  Safety  and  Ef- 
ficacy of  Oral  Contraceptives  Market- 
ed in  Canada,"'  which  was  prepared  by 
a  committee  of  the  Food  &  Drug  Direc- 
torate. 

Nurses  working  in  obstetrical  ser- 
vices in  hospitals  and  in  community 
family  health  care  programs  should 
tlnd  this  publication  a  useful  clinical 
reference  book  with  excellent  illustra- 
tions and  information.  It  will  be  of 
particular  value  as  supplementary  read- 
ing in  conjunction  with  the  Handbook 
on  Family  Planning  for  nurses  prepar- 
ed by  Miriam  Manisoff. 

The  Medical  Handbook  is  available 
in  both  French  and  English  editions 
free  of  charge  by  writting  to  Family 


Family  Planning  Information 

A  listing  of  sources  for  educational 
information  materials  has  been  com- 
piled by  the  Health  Education  Unit 
of  the  Health  Services  Branch  of  the 
Department  of  National  Health  and 
Welfare  for  the  use  of  health  and 
.social  workers  actively  engaged  in 
family  planning  education. 

This  list,  together  with  a  bibliog- 
raphy on  family  planning  recently 
prepared  by  the  Canadian  Nurses'  As- 
sociation librarian,  is  now  available 
from  theCNA  library. 


Planning  Program.  Department  of 
National  Health  &  Welfare.  Brooke 
(  laxton  Building.  Ottawa  KIA()K9. 

Family   Planning  — A   Teaching   Guide 

for  Nurses  by  Miriam  Manisoff.  ,SS 
pages.  New  York.  Planned  Parent- 
hood Federation  of  America.   Inc 
1969. 

Reviewed  by  Constance  Swinton, 
Niu-sing  Consultant,  Child  and  Adult 
Health  Services,  Depi.  National 
Health  and  Welfare,  Ottawa. 

This  handbook  was  written  as  a  teach- 
ing aid  to  assist  nurses  in  gainina  know- 
ledge of  the  major  aspects  of"  family 
planning.  It  has  been  prepared  in  unit 
torm  with  curriculum  materials,  nuide- 
lines.  and  suggestions  for  further  study. 
I  his  book  is  directed  lo  leacheis  in 
schools  of  nursing,  nurses  responsible 
tor  staff  education  programs  in  hospitals 
or  public  health  agencies,  and  for 
mdividual  nurses  interested  in  this 
important  area  of  family  health  care. 
A  selective  bibliography  and  a  price 
list  (in  U.S.  funds)  for  films  and  other 
publications  related  to  family  planning 
are  contained  in  the  final  section  of  the 
book . 

Although  the  content  is  American, 
developments  in  family  planning  in 
Canada  have  been  quite  similaV  to 
those  in  the  United  Stales.  The  ra- 
tionale for  family  planning  as  an  im- 
portant factor  in  the  protection  of 
family  health  is  presented  clearly  and 
effecticely.  The  social  and  psychologi- 
cal aspects  of  birth  control  are  identiTi- 
ed  in  relation  to  the  patient's  ability 
to  make  use  of  family  planning  services. 

The  role  of  the  nurse  as  a  member  of 
the  health  care  team  has  been  defined 
and  extends  to  three  main  areas:  case 
finding,  case  holding  and  followup. 
and  education.  Nurses  have  contact 
with  many  women  ol  child-bearing  age. 
and  it  was  suggested  that  these  were 
opportunities  for  nurses  to  initiate  dis- 
cussion t)ii  family  planning  and  to  make 
lelerrals  to  an  appropriate  agency. 

A  general  review  of  the  physiology 
of  reproduction  is  presented  as  a  pre- 
liminary to  the  understanding  of  current 
contraceptive  methods.  These  methods 
of  birth  control,  their  effectiveness, 
and  possible  side  effects  are  summariz- 
ed in  the  concluding  unit. 

This    handbook    is    a    useful    guide 

for  nurses  generally.  The  subject  matter 

has  been  presented  simply  and  briefly, 

AUGUST  1971 


providing  a  ready  reference  manual 
suitable  for  registered  nurses  working 
with  patients  and  families.  It  is  avail- 
able from  Planned  Parenthood  — 
World  Population,  515  Madison  Ave.. 
New  York.  N.Y.  10022  at  SI. 50  (U.S. 
funds)  per  copy. 


Abortion  in  Canada  by  Eleanor  Wright 
Pclrinc.  1.^.^  pages.  Toronio.  New 
Press.  1971. 

This  book,  the  tirsl  in  a  scries  called 
New  Wonmn.  treats  the  emotional 
subject  of  abortion  rationally  ani.1 
factually,  and  gives  a  quick  briefing  on 
its  medical,  moral,  and  current  legal 
aspects. 

Ihe  author's  style  is  such  that  the 
general  reader  will  ha\c  no  problem  in 
understanding  what  abortion  is  all 
about.  She  describes  actual  priKctlures 
and  indicates  where  to  get  help  in  ob- 
taining a  legal  abortion. 

In  appendices.  Mrs.  Pclrine  records 
the  results  of  her  questionnaires  on 
abortion.  One.  containing  questions 
relating  to  a  therapeutic  abt>rtion  com- 
mittee, was  sent  to  Canadian  hospitals 
ha\ing  nmrc  than  100  beds.  The  other 
was  sent  to  a  group  ot  Canadian  pro- 
fessional women  regarding  their  per- 
sonal experience,  il  any.  with  abortion. 
Her  findings  reveal  how  little  has  been 
done  to  meet  what  may  be  considered 
a  wide  demanti  for  abortion. 

The  author's  personal  view  that  more 
freedom  of  choice  should  be  available 
for  pregnant  women  wanting  abortion 
pervades  the  book.  In  her  closing  lines, 
she  presents  the  two  sides  of  the  moral 
issue:  ""  Those  who  do  not  believe  in 
abortion  —  who  believe  it  is  murder  - 
need  not  avail  themselves  of  il.  On  the 
other  hand,  their  belief  should  not  limit 
the  rights  of  those  not  bound  by  identi- 
cal religious  or  moral  convictions." 

Although  directed  to  a  lav  audience, 
there  is  much  in  this  book  for  profes- 
sionals, including  nursing  practitioners 
and  educators,  and  nursiim  stutlents. 


Nursing  and  Anthropology:  Two  Worlds 
To  Blend  by  Madeleine  M.  Leininger. 
ISl  pages.  Toronto,  John  Wiley  and 
Sons,  Inc.,  1970. 

Reviewed  hy  Muii;aiel  /:'.  Ihiri,  Direc- 
tor, School  oj  Niirsini;,  I  he  Universily 
of  Marti toini,  Wiitnipef^. 

For  five  years  prior  to  the  publication 
of  this  book.  Dr.  Leininger  worked 
closely  with  nurses  and  students  in 
service  and  educational  settings.  For 
example,  in  undergraduate  and  graduate 
programs  she  introduced  perspectives 
on  the  interrelationships  between 
anthropology  and  nursing.  She  also  had 
many  consultation  and  group  discus- 
AUCUST  1971 


/2 


POSEY  LAP  ROBE 


The  Posey  Lap  Robe  is  one 
of  the  many  products  included 
in  the  complete  Posey  Line.  Since 
the  introduction  ol  the  original 
Posey  Safety  Belt  in  1937,  the  Posey 
Company  has  specialized  in  hos- 
pital and  nursing  products  which 
provide  maximum  patient  protec- 
tion and  ease  ol  care.  To  insure  the 
original  quality  product  always 
specify  the  Posey  brand  name  when 
ordering. 

The  Posey  Safety  Lap  Robe  provides 
the  patient  warmth  while  preventing 
him  from  sliding  forward  or  slumping 
over.  This  is  one  of  eleven  wheelchair 
safety  products  providing  patient  se- 
curity. #5763-4532,  $21.00. 


The  Posey  Foot-Guard  is  designed 
with  a  rigid  plastic  shell  providing 
support  and  synthetic  wool  liner  to 
prevent  pressure  sores  on  heels  and 
ankles.  The  Posey  Line  includes 
twenty-three  rehabilitation  products. 
#5163-6410,  $15.00  ea. 


The  Posey  "V"  Safety  Roll  Belt  se- 
cures under  the  bed  out  of  the  pa- 
tient's reach,  yet  offers  maximum  free- 
dom to  roll  from  side  to  side  and  sit 
up.  This  belt  is  one  of  seventeen 
Posey  safety  belts  which  insure  pa- 
tient comfort  and  security.  #5163- 
7137  (with  tie  ends),  $9.90. 


The  Posey  Body  Holder  may  be  used 
in  either  a  wheelchair  or  a  bed  to 
secure  chest,  waist  or  legs.  There  are 
sixteen  other  safety  belts  in  the  com- 
plete Posey  Line.  #5763-7737  (with 
ties),  $5.10. 


The  Posey  Houdini  Security  Suit, 

constructed  of  cool  breezeline  mate- 
rial, is  virtually  impossible  for  patient 
to  remove  yet  provides  security  with 
comfort.  There  are  eight  safety  vests 
in  the  complete  Posey  Line.  #5163- 
3472, 175.00. 


Send  lor  the  free  all  new  1970  POSEY  catalog  -  supersedes  all  previous  editions. 
Please  insist  on  Posey  Quality  -  speciiy  the  Posey  Brand  name. 


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THE  CANADIAN   NURSE      47 


sion  experiences  in  health  and  university 
settings  across  the  United  States,  which 
helped  her  develop  insight  into  the 
usefulness  of  anthropological  concepts 
in  the  health  field. 

The  author  states  that  the  purpose 
of  her  book  is  to  bring  nursing  and 
anthropology  together  so  that  each 
field  will  benefit  from  the  contribution 
of  the  other,  with  the  ultimate  purpose 
of  encouraging  nurses  to  blend  their 
own  knowledge  with  relevant  anthropo- 
logical concepts.  She  anticipates  that 
current  academic  preparation  of  nurs- 
ing leaders  in  the  social  sciences  will 
influence  the  design  of  nursing  practices 
to  meet  the  cultural  and  social  health 
needs  of  people. 

To  emphasize  the  interdependence 
of  nursing  and  anthropology,  she  out- 
lines potential  contributions  that  each 
could  make  to  the  other.  The  contribu- 
tions from  anthropology  are  seen  to 
influence  theory,  practice,  and  research 
in  nursing.  The  contributions  from 
nursing  emanate  from  the  close  relation- 
ship between  nurses  and  the  patients 
and  families  they  serve.  The  author 
also  sees  possibilities  for  collaborative 
research,  with  the  nurse  and  the  anthro- 
pologist each  making  a  special  contribu- 
tion. In  one  of  her  concluding  chapters, 
the  author  considers  the  theories  that 
have  developed  with  respect  to  health 
institutions  as  cultural  and  social  sys- 
tems, and  the  influence  of  exposing 
health  professionals  to  such  systems. 
Finally,  she  puts  forward  the  merits  of 
the  systematic  study  of  the  way  of  life 
of  a  cultural  group  in  developing  com- 
patible nursing  practices. 

This  book  will  serve  as  a  useful  refer- 
ence in  both  educational  and  service 
settings  in  nursing.  Furthermore, 
nurses  and  anthropologists  should 
find  value  in  the  ideas  the  book  provides 
for  collaboration  in  research. 


Training  Nonprofessional  Community 
Project  Leaders  by  Janice  R.  Neleigh, 
Frederick  L.  Newman,  C.  Elizabeth 
Madore,  and  William  F.  Sears.  59 
pages.  New  York,  Behavioral  Public- 
afions.  Inc.,  1971. 

This  Monograph  Series  No.  6  of 
the  Community  Mental  Health  Journal 
reports  the  major  research  findings  of 
a  five-year  training  project.  The  non- 
professionals trained  to  provide  mental 
health  services  were  second-career 
people  who  had  some  skills  related  to 
the  jobs,  but  were  not  qualified  mental 
health  workers.  The  nonprofessional 
project  leader  was  given  the  complex 
48     THE  CANADIAN  NURSE 


role  of  cooperating  with  the  community 
in  planning,  promoting,  and  develop- 
ing service  projects,  such  as  schools 
for  retarded  children,  and  crisis  center 
services. 

Dona  Ana  Mental  Health  Services, 
the  parent  for  the  project,  was  directed 
by  a  full-time  nurse  mental  health 
consultant  and  a  part-time  psychiatrist. 
These  professionals  had  the  primary 
job  of  training,  supervising,  and  sup- 
porting the  nonprofessionals. 

Although  many  questions  remain  un- 
answered following  the  demonstration 
study  described,  the  monograph  con- 
tains much  useful  information. 


Handbook  of  Child  Nursing  Care  by 

Margaret  Ann  Jaeger  Wallace.  138 
pages.  New  York,  John  Wiley  and 
Sons,  Inc.,  1971. 

Reviewed  by  Madeline  Wilson,  As- 
sistant Director  of  Nursing  Educa- 
tion, The  Montreal  Children's  Hos- 
pital, Montreal,  P.Q. 

This  volume  in  the  Wiley  paperback 
series  is  written  by  an  author  who  has 
contributed  to  the  literature  of  nursing 
education  and  who  is  interested  in 
integrating  child  development  with 
nursing  care.  Her  aim  as  stated  in  the 
preface  is  to:  "Complete  into  a  read- 
able and  convenient  form,  those  nursing 
procedures  and  situations  most  fre- 
quently encountered  by  the  pediatric 
nurse." 

1  he  author  has  selected  and  organ- 
ized her  content  into  two  groups  of 
procedures  and  situations:  I .  the  most 
common  disturbance  in  physiological 
functions  encountered  in  the  nursing 
care  of  children,  and  2.  the  most  com- 
mon emotional  reactions  of  children 
to  hospitalization. 

The  discussion  of  the  problems  of 
physiological  functions  include:  a 
simple  review  of  the  central  points  in 
normal  physiology,  a  discussion  of  the 
important  reactions  to  be  expected  from 
children  to  nursing  treatments,  and 
methods  of  assisting  the  child  in  the 
situations. 

The  emotional  needs  and  responses 
of  the  child  to  hospitalization  are 
presented  clearly  by  defining  the  emo- 
tions and  describing  the  influence  that 
development  and  experience  have  on 
the  feelings  and  needs  of  the  child. 
Details  of  the  essentials  of  nursing  care 
follow  in  the  discussion  of  each  topic. 

There  is  no  mention  of  diseases,  and 
principles  only  are  used  in  the  discus- 
sion of  nursing  care  measures.  The 
statements  and  facts  are  accurate  and 
sound. 

This  handbook  would  be  useful  for 
undergraduate  students  in  conjunction 
with  the  larger,  fuller  texts.  It  would 


be  useful,  also,  in  orienting  groups  of 
nurses  or  nursing  assistants  to  the  es- 
sentials of  child-centered  nursing  care. 

The  Drug,  The  Nurse,  The  Patient,  4ed., 
by  Mary  W.  Falconer,  Mabelclaire 
Ralston  Norman,  H.  Robert  Patter- 
son, and  Edward  A.  Gustafson.  566 
pages  plus  250-page  Current  Drug 
Handbook  1970-72.  Toronto,  W.B. 
Saunders  Company,  1970. 
Reviewed  by  Mrs.  Judith  MacLeod, 
Instructor,  Pharmacology ,  The  Vic- 
toria General  Hospital  School  of 
Nursing,  Halifax,  Nova  Scotia. 

This  latest  edition  has  basically  the 
same  format  as  previous  editions,  but 
its  material  is  presented  in  greater 
depth.  There  are  many  changes  in 
chapter  sequence,  and  several  chapters 
have  been  combined  to  render  the 
approach  more  inclusive.  Of  particular 
interest  is  a  chapter  dealing  with  fluid 
and  electrolyte  imbalance  and  contain- 
ing a  table  of  IV  solutions  with  the 
rationale  for  their  use.  Emphasis  is 
placed  on  the  clinical  situation,  and 
drugs  are  arranged  according  to  clinical 
usage,  rather  than  according  to  system. 

The  text  is  divided  into  three  main 
sections.  The  first  deals  with  a  basic 
general  introduction  to  drugs,  starting 
with  a  history  of  pharmacology  and 
progressing  to  standardization  and  legal 
control  of  drugs  today.  The  second 
part  concentrates  on  the  responsibilities 
for  the  administration  of  medications 
and  on  posology.  A  basic  arithmetic 
review  is  provided,  followed  by  tables 
of  weights  and  measures  and  practice 
questions  using  them.  The  last  chapter 
in  this  section  deals  with  posology,  and 
provides  a  number  of  calculations  and 
problems. 

The  final  section,  "Clinical  Phar- 
macology," is  the  text's  area  of  main 
concern,  and  is  where  the  greatest 
number  of  changes  can  be  seen.  The 
emphasis,  as  always,  is  patient-cen- 
tered. Each  chapter  follows  the  same 
general  format:  correlation  with  other 
sciences,  general  summary  of  related 
disease  entities,  and  drug  therapy  re- 
quired for  these  conditions. 

The  index  is  excellent,  with  many 
references  for  each  topic.  The  pages 
containing  detailed  information  are 
shown  in  bold  type. 

The  250-page  Current  Drug  Hand- 
hook  at  the  end  of  the  text  is  probably 
the  strongest  section  of  the  book.  It 
provides  a  rapid  and  concise  reference 
of  drug  information  in  summary  form, 
and  deals  with  all  aspects  of  pharma- 
cology. 

This  text  is  easy  to  read,  its  informa- 
tion is  readily  accessible,  and  it  would 
be  an  excellent  reference  book  for 
both  the  nursing  student  and  the  gradu- 
ate nurse.  §■ 
AUGUST  1971 


AV  aids 


LITERATURE  AVAILABLE 

DA  ncv\  Can;Kli;in-bascd  maga/inc. 
Newstiitenu'ius,  deals  with  interna- 
tional problems  such  as  chronic  unem- 
ployment, overfragmentation  of  arable 
land,  and  poverty,  and  has  correspond- 
ing editors  from  all  over  the  world.  The 
magazine  contains  articles  in  English, 
French,  and  Spanish. 

Although  not  a  mouth-piece  for  Ca 
nadian  University  Services  Overseas, 
any  profits  from  the  sale  of  Ncwsiatc- 
lucnts  will  ao  to  CUSO.  Subscription 
rates  are  S2  per  issue  or  S6  per  year. 
For  further  information  write  to  New- 
skilcmcnis.  Suite  1000.  LSI  Slater 
Street.  Ottawa.  Ontario  K  1  P  .^H5. 

D  Portex  Division  of  Smith  Industries 
North  America  ltd.  has  introduced  a 
new  publication  entitled  Handbook 
on  rrachcosioiiiy  Care.  This  manual  is 
supplied  free  of  charge  to  any  hospital 
intensive  care  unit. 

The  handbook  contains  general  in- 
formation on  the  history  of  tracheosto- 
my. It  is  available  from  Portex  Division 
of  Smith  Indsutries  North  America 
Ltd..  lO.S  Scarsdale  Road.  Don  Mills. 
Ontario. 


FILMS 

Films  available  from  the  Davis  &  C}eck 
Film  librarv.  Cyanamid  of  Canada 
Limited,  P.O'  Box  1039,  Montreal  101, 
Ouebec: 

Ccire  of  the  Ncnrosuriiical  Palieni 
{ 16  mm.,  sound,  color.  24  min.)  stress- 
es the  psychological  and  physical  prep- 
aration of  the  patient.  It  also  deals 
with  the  instrumentation,  operative 
functions,  and  postoperative  care  of 
the  neurosurgical  patient,  including 
rehabilitation. 


Di'xon  Niirsini>  Film  (16  mm.,  sound, 
color)  provides  information  on  the  de- 
velopment ol  the  Dexon  polyglycolic 
acid  suture,  the  first  absorbable  sur- 
gical suture  (New  Products,  April. 
1971).  Data  concerning  its  physical 
characteristics  and  handling  are  in- 
cluded. Methods  of  dispensing  by  the 
circulating  nurse  and  handling  by  the 
scrub  nurse  are  described,  including 
the  dry  packaging  of  the  sutures. 

AUGUST  1971 


C'ii\scnc  DiipUmtor 


FILM 

A  Royal  Disease  (color.  32  min.)  has 
been  produced  for  Warner-Chilcott 
Diagnostics,  a  division  of  Warner- 
Lambert  Canada  Ltd..  primarily  as  a 
training  film  for  second-year  medical 
technology  students. 

Filmed  over  a  two-week  period  at 
The  Hospital  for  Sick  Children  in  To- 
ronto and  at  the  Warner-Lambert  Re- 
search Institute,  A  Royal  Disease  pres- 
ents clinical  symptoms,  laboratory 
testing,  and  treatment  for  bleeding  dis- 
orders. It  was  produced  with  the  help 
of  Dr.  Peter  McClure,  director  of  hema- 


REMEMBER 

HELP  YOUR  RED  CROSS 

TO  HELP 


tology  at  The  Hospital  for  Sick  Chil- 
dren, and  Dr.  Martin  Inwood.  St.  .Jo- 
seph's Hospital  in  London. 

This  film  graphicalK  presents  the 
diagnostic  procedures  that  begin  with 
the  admittance  of  a  hemophilic  child 
to  the  hospital  emergency  room.  View- 
ers are  presented  with  symptoms  of  a 
bleeding  disorder  —  nasal  bleeding 
for  two  days  before  the  child's  arrival 
for  diagnostic  procedures  and  the 
appearance  of  bruises  on  the  child's 
arm.  Blood  samples  arc  sent  ti>  the 
laboratory,  and  various  tests  are  per- 
formed and  explained  b\  a  medical 
laboratory  technoloi^is;  Emphasis  is 
placed  on  theory,  quality  control,  and 
proper  techniques  required  in  perform- 
ing blood  coagulation  procedures. 

More  information  about  this  new 
film,  which  updates  and  succeeds  War- 
ner-Lambert's medical  training  tilm 
IL/n-  Joliiinv  Bleeds,  is  available  from 
PPS  Publicity.  Suite  704.  69  Yonge 
Street.  Toronto  1,  Ontario. 

Cassette  duplicator 

Recordcx  Corporation  has  introduced 
a  new,  inexpensive  cassette  duplicating 
unit  for  use  in  the  medical  and  hospital 
field.  The  CS-200  is  a  high-speed,  dual 
THE  CANADIAN  NURSE     49 


track  cassette  duplicator  that  produces 
copies  every  !-%  minutes  from  either 
reel  or  cassette  masters. 

The  cassette  duplicator  copies  up 
to  32  C-30  cassettes  every  hour.  Ad- 
ditional units  are  available  to  produce 
extra  tape  cassette  duplications,  and 
the  CS-200  also  incorporates  auto- 
matic rewinding  of  master  tapes,  and 
simultaneous  duplication  of  all  chan- 
nels. 

For  further  information  write  to  the 
Recordex  Corporation,  3227  Cains  Hill 
Place  N.W.,  Atlanta,  Georgia  30305.  ■§> 


accession  list 


Publications  on  this  list  have  been  received 
recently  in  the  C  NA  library  and  are  listed 
in  language  of  source. 

Material  on  this  list,  except  /icjciciicc 
iicius  may  be  borrowed  by  CNA  members, 
schools  of  nursing  and  other  institutions. 
Rcjc-rciuc  items  (theses,  archive  books  and 
directories,  almanacs  and  similar  basic 
books)  do  iKit  go  out  on  loan. 

Requests  for  loans  should  be  made  on  the 
■Request  I  orm  for  Accession  List'  and 
should  be  addressed  to:  The  Library.  (  ana- 
dian  Nurses'  Association.  .SO.  The  Driveway 
Ottawa.  Ont.  K2P  IE:. 

No  more  than  three  titles  should  be  re- 
quested at  any  one  time. 


SOOKS  AND  DOCUMENTS 

I.  Analysis  iiiul  interpretation  of  A  HE  e.\- 
penence  in  tlie  inner  city:  lowani  a  theory 
of  practice  in  tile  public  schools:  annual 
report.  .May  1969-.lune  1970.  New  York. 
Columbia  University.  Teachers  College. 
Center  for  Adult  Education.  1970.  I  vol. 
2.  A  hih(ioi;raphy  f>r  the  coiilinifinii  >lia- 
lofiiie;  convocation  honoring  Dr.  Ernst  Web- 
er compiled  by  James  A.  Cioldman.  Brook- 
lyn, N.Y..  Polytechnic  Institute  of  Brooklyn 
and  Society  of  Sigma  XI,  Polytechnic  Chap- 
ter, 1970.  48p.  (Stacks  no.  28.  May  8.  1970) 
.^.  A  C()inpara!i\e  e.xaniinalion  of  two  coiii- 
piitcrizetl  patient  care  iiifonnalion  systems 
by  Nancy  (  .  Norton.  New  Haven.  Conn.. 
1970.  95p.  (Thesis  (MPH)  -  Yale.) 

4.  Coniiniiin)-  eilncalion  in  niirsiiii'.  Bould- 
er. C  olorado.  Western  Interstate  C  ommission 
for  Higher  Education.  1969.  I08p. 

5.  Dinest  of  the  ^;/^^,■</<"n  of  the  Netherlands: 
social  aspects.  4th  ed.  The  Hague.  Govt. 
Print.  Off.  for  Govt.  Information  Service 
1968.  I  lip. 

6.  Essentials  of  psychiatric  niirsinf!  by  Do- 
rothy Mereness.  8th  ed.  St.  Louis.  (Mo..) 
Mosby.  1970.  .13  I  p. 

7.  Fiinilamentals  of  research  in  nursinf;  by 
J.  David.  2d  ed.  New  York.  Appleton-C  entu- 
ry-C  rofts.  1970.  .323P. 

8.  Generation  in  the  middle.  Chicago,  III., 
Blue  C  ross  Association.  1970.  96p.  (Its  Blue- 
print for  health,  v. 2.3.  no.  I ) 

50     THE  CANADIAN  NURSE 


9.  Health  economics:  report  on  a  seminar 
convened  hy  World  Health  Organization. 
Regional  Office  for  Europe.  Moscow.  2,S 
June-5July  1968.  Copenhagen.  1969.  6lp. 

10.  Heritaf;e  for  tomorrow;  proceedings  of 
SCITEC.  Core  Conference.  1st.  Halifa.x. 
N.S..  Attf!.  1970.  Ottawa,  1970.  lOOp. 

11.  Instructional  systems  in  medical  educa- 
tion: proceedings  of  Rochester  Conference 
on  Self  Instruction  in  Medical  Eilncalion, 
4th  ed.  1968.  Rochester,  N.Y..  Rochestei^ 
Clearinghouse  on  Self-Instructional  Materials 
for  Healthcare  Facilities,  1970.  270p. 

12.  Israel's  nursing  educators  in  the  diploma 
.schools  of  nursing:  selected  demographic 
and    professional    characteristics.    1966    and 

1968.  Tel-Aviv.  Tel-Aviv  University.  Laculty 
of  C  ontinuing  Medical  Education.  Depl.  of 
Nursing,  1970.  66p. 

13.  LPN's  1967;  an  inventory  of  licen.sed 
practical  nurses  prepared  by  Eleanor  D. 
Marshall  and  Evelyn  B.  Moses.  American 
Nurses"  Association.  Research  and  Statistics 
Department.  Bethesda.  Md.,  U.S.  Public 
Health  Service.  1971.  10.*ip. 

14.  J  manual  of  dermatology  by  Donald  .M. 

Pillsbury.  Toronto.  Saunders.  1971.  299p. 

I.'i.  Nursing  care  in  tuherciilosi.s;  a  program- 
med course  of  instruction.  New  York.  Na- 
tional League  for  Nursing.  1970.  97p. 

16.    The   older   patient,    an    introduction    to 

geriatrics  by  Robin  Eliot  Irvine  et  al.  (1st 
ed.)  London.  English  Universities  Press. 
1968.  2  12p.  (Modern  nursing  series) 


r- 
I 


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otherwise  you  will  likely  miss  copies.  | 


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OR 
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nurses  assoc. 


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MAILTO: 

The  Canadian  Nurse 

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OHAWA,  Canada  K2P  1E2 


17.  Planning  of  surgical  centers:  basic  .stiul- 
ies  by  Ervin  Putsep.  Stockholm.  Natur  och 
Kultur,  1969.  (Distributed  outside  Scandina- 
via by  Lloyd-Iuke  (.Medical  Books)  London  ) 

124p. 

18.  Proceedings      of     Annual      Conference, 
Hamilton,   Ontario.  20-25  June   1970.   Otta- 
wa.   Canadian    Library    Association.     1971 
85p. 

19.  Proceedings  of  National  Confere/ice  on 
Continuing  Education  for  Nurses.  Nov.  10- 
14,  1969,  Williamsburg,  Va.  Richmond,  Va.. 
School  of  Nursing  of  the  Medical  C  ollege  of 

Virginia.  Health  Sciences  Division  of  Virginia 
(  ommonwealth  University.  1970.  220p. 

20.  Proceedings  of  Nursing  Theory  Con- 
ference, 2d,  University  of  Kan.sas  Medical 
center,  Dept.  Nursing  Education,  October 
9-10,  1969.  Edited  by  C  atherine  M.  Norris. 
Kansas  City.  Kansas,  1970.  I63p. 

21.  Proceedings  of  Nursing  Theory  Cmi- 
lerence,  3d,  University  of  Kan.ws  Medical 
Center,  Dept.  of  Nursing  Education,  January 
29-30,  1970.  Edited  by  Catherine  M.  Norris. 
Kansas  City.  Kansas.  1970.  l9.Sp. 

22.  Reminiscences      of      Linda       Richards: 
America's  first   trained  niir.se  by   Linda    Ri- 
chards. Boston.  Whitcomb  &  Barrows.  1911. 
Reprinted.      Montreal.      Lippincott       1948 
12lp.R 

23.  SU.\t  (service  unit  management):  an 
orgam' national  approach  to  improved  patient 
care  by  Richard  C.  Jelinek,  et  al.  Battle 
Creek.    Mich..    W.K.    Kellogg    Foundation. 

1971.  Il4p. 

24.  Le  sein.  Montreal.  Editions  de  I'homme 
1970.  I7.'^p. 

2.S.  .S7//(/v  of  health  facilities  in  the  province 
oj  New  Brunswick  —  summary  of  report  on 
the  study  undertaken  for  the  Dept.  of  Health 
and  Welfare.  Ottawa,  Llewelyn-Davies 
Weeks  Forestier-Walker  and  Bor.  1970.  27p. 

26.  Te.ytbook  of  medical  physiology  by 
Arthur  Clifton  Ciuyton.  4th  ed.  Philadelphia. 
.Saunders.  1971.  I032p. 

PAMPHLETS 

27.  Arctic  bibliography  compiled  by  E.M. 
Smith.  Ottawa.  C  anadian  Library  Associa- 
tion. 1970.  15p. 

28.  A  conceptual  model  for  measuring  the 
quality  of  medical  care  in  hospitals  by  C  har- 
les  Joseph  Pearson.  Berkely.  Calif..  1970. 
34p. 

29.  Evaluation  of  the  hostel  unit.  Jan.  5  to 
N.iv.  30.  1970  by  T.  Dagnone.  Saskatoon. 
Sask..  1970.  lOp. 

30.  Interim  report  on  nursing  service  lUid 
social  and  economic  welfare  with  respect 
to  nurses  in  the  province  of  Miiniiohu.  Ma- 
nitoba Association  of  Registered  Nurses. 
Winnipeg.  1970.  8p. 

3  I .  /J  proposed  plan  for  the  orderly  develop- 
ment of  nursing  education  in  British  Colum- 
bia. Part  two:  post-hasic  nursing  education. 
Vancouver.  Registered  Nurses"  Association 
of  British  Columbia.  1971.  I8p. 

32.  Report.  Toronto,  (anadian  Public 
Health  Association.  Public  Health  Practices 
Committee.  1971.  24p. 

33.  Resecuch    and    studies    on     luirsing    in 

AUGUST  1971 


hrai'l.  compiled  by  Ihe  Interdisciplinary 
Korum  for  the  Protection  of  Nursing  Re- 
search in  Israel:  ed.  by  Olga  M.  Wiess. 
Tel-Aviv.  Tel-Aviv  University.  Faculty  of 
Continuing  Medical  Education.  Dept.  of 
Nursing.  1970.  I9p. 

34.  Sitilistical  rcpiiit  on  niirsiuf;  ctliicdiioii 
and  rc'siislriiiion.  Toronto.  (  ollege  of  Nurses 
of  Ontario,  1970.  .36p. 

3.^.  )'on  (//■('  Binhani  Jordan:  an  in-haskcl 
exercise  on  narsini;  scrvive  adniiniMrtilion: 
participant's  kit.  (  hicago.  Hospital  Re- 
search and  Educational  Trust.  1970.  24p. 

GOVERNMENT  DOCUMENTS 
Alhcrla 

36.  Dept.  of  Health.  Medical  Services  Divi- 
sion. Hcallh  careers.  Edmonton.  Alberta 
1971.  I  vol. 

Canada 

37.  Bureau  of  Statistics.  Annual  report  of 
llie  Minister  oj  Indaslry,  Trade  and  Coni- 
nterte  nnder  llie  anporations  and  lalionr 
anions  returns  act:  pi. I .  Corporations.  1968. 
Ottawa.  1970.  1  vol. 

38.  Bureau  of  Statistics.  Mental  health 
stcitislies:  the  e.xpeetation  of  admission  to  a 
Canadian  psychiatric  iiistitation:  joint 
expectancy  measure.  Ottawa.  Queen's  Print- 
er. 1968.  37p. 

39.  (  ivil  Service  (  ommission.  Management 
Analysis  Division.  Manned  on  filini;  services. 
Revised.  Ottawa.  Queen's  Printer  1960.  64p. 

40.  Dept.  of  Industry.  Trade  and  (  ommerce. 
Directory  of  scientific  research  and  develop- 


meiit  establishments  in  Canada.  Ottawa. 
Queen's  Printer.  1969.  105p. 

41.  Dept.  of  Indian  Affairs  and  Northern 
Development.  Library.  Acqnisition  list.  vol. 
5.  no.  4.  Ottawa.  1971. 

42.  National  Library  of  {  anada.  An  inteitrat- 
ed  information  system  for  the  \iitional 
Library  oJ  Canada:  a  summary  of  the  re- 
port of  the  Systems  Development  Project. 
Ottawa.  1970.  76p. 

43.  National  Research  (  ouncil  of  C  anada. 
Division  of  Building  Research.  Canadian 
baildinf-  di.vest.  Ottawa.  1960-1967.  (various 
issues) 

44.  Public     Service     (  ommission.      Report 
1969.  Ottawa.  Queen's  Printer.  1970.  8."ip. 
Quebec 

45.  Bureau  de  la  Statistique  du  Quebec.  Di- 
vision du  Travail.  Ttia.y  tie  salaire  el  henres 
de  travail,  ler  Octohre.  1969.  Quebec.  1969. 
143p. 

S<rskinche»iin 

46.  Saskatchewan  Registered  Nurses'  .Xsst)- 
ciation.  Annual  report.  1971. 

United  Slates 

47.  Dept.  of  Housing  and  Urban  Develop- 
ment. Survey  of  I II A-assisted  niirsint;  ho- 
mes. Washington.  U.S.  Ciovt.  Print.  Off.. 
1969.  47p. 

48.  Dept.  of  Labor.  U.S.  manpower  in  the 
I970's:  opptnianity  &  challeiifie.  Washington. 
U.S.  Govt.  Print.  Off..  1970.  1  vol. 

49.  National  institutes  of  Health.  Division 
of  Manpower  Intelligence.  Health  manpow- 
er in  hospitals  by  (iarrie  .1     Losee  and   Ma- 


rion E.  Allenderfer.  Washington.  U.S.  Govt. 
Print.  Off..  197  1.82p. 

STUDIES  DEPOSITED  IN  CNA  REPOSITORY 
COLLECTION 

.''O.  A  comparative  stndy  of  the  interests  of 
ninsiiif;  itroiips  as  measured  by  the  slroii)' 
vocational  interest  blank  by  Esther  R  tiro- 
gin.  Saskatoon.  Sask..  School  of  Nursing. 
University  of  Saskatchewan.  1970.  78p.  R 
.''I.  Continuity  of  care:  outline  of  loni;  term 
tuid  immediate  studies  on  the  subject  by 
Nicole  DuMouchel.  Toronto.  Canadian 
(ouncil  on  Hospital  Accreditation.  1967. 
lip.  R 

.'>2.  Etude  des  normes  de  ienseii;nemenl 
infirmiere  dans  le  conte.xte  de  lenseii-nemenl 
colU'nial.  Montreal.  Quebec.  Direction  gene- 
rale  de  I'Enseignement  collegial.  (  omite 
ad  hiK.  1969.  39p.  R 

.^3.  ihe  relitdiility  and  validity  tesliiif;  of  a 
subjective  patient  classification  system  by 
.I.W  Mainguy  et  al.  \  ancouver.  \  ancouver 
General  Hospital.  1970.  81p.  R 
.^4.  Report  R\,-i()  project  tor  team  nursint; 
development.  Toronto.  Registered  Nurses' 
Association  of  Ontario.  1970.  189p.  R 
55.  A  stiuly  of  patient  proi;res\.  \  ictoria. 
British  (  olumbia.  Dept.  of  Health  .Services 
and  Hospital  Insurance.  Health  Branch. 
Division  of  Public  Health  Nursing.  1966. 
88p.  R 

-^6.  A  stiuly  oj  the  trainiui-  and  utilization 
oj  the  posti;rtuliHite  prepared  nurse  by  I  loris 
E  king.  \  ancouver.  University  of  British 
(olumbia.  1971    6'«p.  R  ^ 


Request  Form 
for  "Accession  List" 

CANADIAN  NURSES' 
ASSOCIATION  LIBRARY 

Send  this  coupon  or  facsimile  to: 
LIBRARIAN,  Canadian  Nurses'  Association, 
SO  The  Driveway,  Ottawa  K2P  1E2,  Oniario. 

Please  lend  me  the  following  publications,  listed  in  the 
issue  of  The  Canadian  Nurse, 
or  add  my  name  to  the  waiting  list  to  receive  them  when 
available. 


Item 
No. 


Author        Short  title  (for  identification) 


Request  for  loans  will  be  filled  in  order  of  receipt. 
Reference  and  restricted  material  must  be  used  in  the 
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Dote  of  request 


In  future,  use  only 


Chi 


Absorbents 


CHIX  Absorbents  offer  so  much  more  than  mere 
tissues  that  they're  like  having  a  bit  of  the  future 
today. 

Made  from  soft  w/hite  surgical  rayon.  CHIX  Ab- 
sorbents are  more  absorbent  than  paper,  are  lint 
tree,  have  high  wet  strength  and  can  be  aulo- 
claved. 

CHIX  Absorbents  are  good  tor  all  kinds  of 
uses  —  as  cleaners  in  dressing  packs,  diaper 
liner,  heavy-duty  mouth  wipes,  instrument  wipes, 
lint-free  glass  cleaners,  etc. 

Chix* 

Absorbents  by  ^xAvuonciJ^cluiiron 

MONTREALiTORONTO  -  CANADA 

A        'Trademark  of  Johnson  i  Johnson  or  aflilialed  companies 


AUGUST  1971 


THE  CANADIAN  NURSE     51 


classified  advertisements 


ALBERTA 


BRITISH    COLUMBIA 


ONTARIO 


DIRECTOR  OF  NURSING  This  position  carnes 
responsibility  tor  the  coordination  of  all  facets  of 
nursing  services  within  a  75-bed.  Accredited  hospital- 
Preference  given  to  applicants  with  University 
preparation  in  Nursing  Administrator  or  successful 
supervisory  and  Nursing  Administration  experience. 
Apply  in  writing,  stating  experience,  qualifications. 
references  and  date  available  to  Administrator. 
St    Therese  Hospital,  St    Paul,  Alberta. 


BRITISH  COLUMBIA 


REGISTERED  NURSES  with  supervisory,  intensive 
care  or  operating  room  experience  required  tor 
126-bed  active  treatment  hospital  expanding  to 
?l?-beds  Residence  accommodation.  Apply  to:  Direc- 
tor of  Nursing.  Penticton  Regional  Hospital.  Hentic- 
ton.  British  Columbia. 


GENERAL  DUTY  NURSES  AND  LICENSED  PRAC- 
TICAL NURSES  for  modern  lUU-bed  accredited 
hospital  on  Vancouver  Island,  BC  Resort  area  - 
home  of  the  tyee  salmon  Four  hours  travelling  time 
to  City  of  Vancouver.  Collective  agreements  with 
Provincial  Nursing  Associations  and  Hospital  Em- 
ployee Union  in  effect  Residence  accommodation 
available.  Direct  enquiries  to  Director  of  Nursing 
Services,  Campbell  River  Hospital,  Campbell  River. 
British  Columbia 

GENERAL  DUTY  NURSES  for  modern  33-bed  hospital 
located  on  the  Alaska  Highway.  Salary  and  personnel 
policies  in  accordance  with  RNABC.  Accommodation 
available  in  residence.  Apply  to:  Director  of  Nursing. 
General  Hospital,  Fort  Nelson.  B.C. 


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$2.50  for  each  additional  line 

Rotes  for  display 
advertisements   on   request 

Closing  dole  for  copy  and  concellotion  is 
6  weel<s  prior  to  1st  day  of  publicotion 
month. 

The  Conodian  Nurses'  Association  does 
not  review  the  personnel  policies  of 
the  hospitals  and  agencies  advertising 
in  the  Journal.  For  authentic  information, 
prospective  applicants  should  apply  to 
the  Registered  Nurses'  Association  of  the 
Province  in  which  they  ore  interested 
in   working. 


Address  correspondence  to 

The 

Canadian 
Nurse 

50  THE  DRIVEWAY 
OHAWA,  ONTARIO 
K2P    1E2 


WANTED:  GENERAL  DUTY  NURSES  lor  modern  70- 
bed  hospital.  (48  acute  beds — 22  Extended  Care) 
located  on  the  Sunshine  Coast,  2  hrs.  from  Vancou- 
ver Salaries  and  Personnel  Policies  in  accordance 
with  RNABC  Agreement  Accommodation  available 
(female  nurses)  in  residence  Apply  The  Director 
of  Nursing,  St  Mary  s  Hospital,  P  O  Box  678.  Se- 
chelt,  British  Columbia 


EXPERIENCED  NURSES  required  for  GENERAL 
DUTY.  OPERATING  ROOM,  OBSTETRICS.  PEDIAT- 
RICS and  INTENSIVE  CARE  in  a  409-bed  hospital 
with  a  School  of  Nursing,  basic  salary  $590  -  $740, 
BC  Redistration  is  required.  Apply:  Director  of 
Nursing,  Royal  Columbian  Hospital,  New  Westminster. 
British  Columbia, 

OPERATING  ROOM  NURSES  for  modern  4S0-bed  hos- 
pital with  School  of  Nursing,  RNABC  policies  in  ef- 
fect. Credit  for  past  experience  and  postgraduate 
training,  British  Columbia  registration  is  required. 
For  particulars  write  to:  The  Associate  Director  of 
Nursing,  St,Josephs  Hospital,  Victoria,  British  Co- 
lumbia. 


MANITOBA 


HEAD  NURSE  -  (IVIEDICAL/SURGICAL  WARD)  requir- 
ed for  40-bed  General  Hospital  in  Northern  f^anitoba. 
Good  personnel  policies  and  excellent  salary.  Apply 
giving  details  of  experience  and  qualifications  to 
The  Director  of  Nursing,  Fort  Churchill  General 
Hospital,  Fort  Churchill,  Manitoba, 


ONTARIO 


DIRECTOR  OF  NURSING  required  by  30-bed  Northern 
Hospital.  Mature  person  preferred  with  experience 
in  nursing  administration.  Salary  negotiable,  good 
fringe  benefits  and  working  conditions.  Apply  in 
writing  to  Administrator,  Bingham  Memorial  Hospital, 
Matheson.  Ontario, 


OPERATING  ROOM  TECHNICIANS  —  Support  your 
Association,  Write  for  further  information  Box  212, 
Postal  Station   'F   ,  Toronto,  Ontario, 


REGISTERED  NURSES  required  by  70-bed  General 
Hospital  situated  in  Northern  Ontario,  Salary  scale  — 
$560,00-$670,00.  allowance  lor  experience.  Shift 
differential,  annual  increment,  40  hour  week,  OH, A, 
Pension  and  Group  Life  Insurance,  0,H,S,C  and 
OHSIP  plans  in  effect  Good  personnel  policies. 
For  particulars  apply  Director  of  Nursing,  Lady 
Minto  Hospital  at  Cochrane.  Cochrane.  Ontario. 


REGISTERED  NURSES  for  34-bed  General  Hospital. 
Salary  $525.  per  month  to  $625  plus  experience  al- 
lowance. Residence  accommodation  available.  Ex- 
cellent personnel  policies.  Apply  to:  Superintendent, 
Englehart  &  District  Hospital  Inc.,  Englehart,  Ontario. 


REGISTERED  NURSES  needed  tor  81-bed  General 
Hospital  in  bilingual  community  of  Northern  Ontario. 
French  language  an  asset,  but  not  compulsory.  R,N, 
salary-$557  to  $662,  monthly  with  allowance  for 
past  experience,  4  weeks  vacation  after  1  year  and 
18  sick  leave  days,  Unused  sick  leave  days  paid  at 
100%  every  year.  Master  rotation  in  effect.  Rooming 
accommodation  available  in  town.  Excellent  per- 
sonnel policies.  Apply  to:  Personnel  Director, 
Notre-Dame  Hospital,  P.O   Box  850,  Hearst,  Ont. 


REGISTERED  NURSES  AND  REGISTERED  NURSING 
ASSISTANTS  for  45-bed  hospital,  R  N,s  salary  $560, 
to  $660,  with  experience  allowance  and  4  semi-annu- 
al increments.  Nurses'  residence  —  private  rooms 
with  bath  —  $30  per  month.  R,N,A,s  salary  $380,  to 
■$4C0,  Apply  to:  The  Director  ot  Nursing,  Geraldton 
District  Hospital.  Geraldton,  Ont, 


REGISTERED  NURSES  AND  REGISTERED  NURSING 
ASSISTANTS,  looking  for  an  opportunity  to  work  in 
a  patient  centered  Nursing  service,  are  required  by 
a  modern  well-equipped  hospital.  Situated  in  a  pro- 


gressive Community  m  South  Western  Ontario,  Ex- 
cellent employee  benefits  and  working  conditions. 
Write  for  further  information  to  Director  of  Nursing 
Leamington  District  Memorial  Hospital:  Leamington 
Ontario. 

REGISTERED  NURSE  FOR  OPERATING  ROOM  also 
GENERAL  DUTY  NURSES  for  80-bed  hospital;  recog- 
nition for  experience:  good  personnel  policies:  one 
month  vacation:  basic  salary  $567,50,  July  1st, 
$570,00,  Apply  Director  of  Nursing,  Huntsville 
District  Memorial  Hospital,  Box  1150,  Huntsville, 
Ontario, 


REGISTERED  NURSING  ASSISTANTS  for  BO-bed 
hospital:  starting  salary  $375,00  with  increments  for 
past  experience;  tnree  weeks  vacation;  18  days 
sick  leave;  residence  accommodation  available. 
Apply:  Director  of  Nursing,  Huntsville  District 
Memorial    Hospital,    Box    1150,    Huntsville,    Ontario, 

REGISTERED  NURSES,  for  GENERAL  DUTY  and 
I.C.U..    and    REGISTERED    NURSING    ASSISTANTS 

loquired  for  160-bed  accredited  hospital.  Starting 
salary  $525.00  and  $365.00  respectively  with 
regular  annual  increments  for  both.  Excellent 
personnel  policies.  Temporary  residence  accommo- 
dation available.  Apply  to:  Director  of  Nursing. 
Kirkland  and  District  Hospital,  Kirkland  Lake, 
Ontario. 


REGISTERED  NURSES  AND  REGISTERED  NURSING 
ASSISTANTS  required  for  GENERAL  DUTY  in  a 
313-bed  fully  accredited  hospital.  Good  salary 
commensurate  with  experience,  excellent  iringe 
benefits  and  gracious  living  in  the  Festival  City 
of  Canada.  Apply  in  writing  to  the:  Director  of 
Personnel,  Stratford  General  Hospital,  Stratford, 
Ontario. 

GENERAL  DUTY  REGISTERED  NURSES  with  at  least 
one  year  s  experience  required  for  175-bed  accredit- 
ed hospital  Recognition  given  for  experience  and 
postgraduate  education.  Orientation  and  In- 
Service  Educational  programmes  are  provided 
Progressive  personnel  policies.  For  further  informa- 
tion write  to:  Personnel  Director.  Temiskammg 
General  Hospital.  Haileybury,  Ontario, 


REGISTERED  NURSES  FOR  GENERAL  DUTY  AND 
OPERATING  ROOM:  for  104-bed  accredited  Gen- 
eral Hospital,  Basic  salary  —  $570 — $670/m,  with 
remuneration  for  past  experience.  Shift  differential 
$1,00  per  evening  or  night,  shift  Yearly  increments 
A  modern,  well-equipped  hospital,  amidst  the  lakes 
and  streams  of  Northwestern  Ontario,  Apply  to:  Mrs 
L  DeGagne,  Director  ol  Nursing.  La  Verendrye  Hos- 
pital. Fort  Frances,  Ontario, 


EXPERIENCED  GENERAL  STAFF  NURSES  FOR 
OPERATING  ROOM  AND  INTENSIVE  CARE  AREA  — 

for  modern,  accredited  242-bed  General  Hospital. 
Good  personnel  policies,  recognition  tor  experience 
and  post-basic  preparation.  Apply:  Director  of 
Nursing,  Sudbury  Memorial  Hospital,  Regent  Street, 
S.,  Sudbury,  Ontario, 

PUBLIC  HEALTH  NURSES.  Northern  Newloundland 
and  Labrador  Programme  based  on  Newfoundland 
Department  of  Health  requirements.  Vehicles  provid- 
ed. Resident  accommodation.  Apply  Mrs,  Ellen  E. 
McDonald,  International  Grentell  Association,  Room 
701  88  Metcalfe  Street.  Ottawa.  Ontario.  KIP  5L7 


PUBLIC  HEALTH  NURSES  (QUALIFIED)  for  generaliz- 
ed programme,  allowance  lor  experience  and/or 
degree,  usual  Iringe  benefits.  Direct  enquiries  to 
Miss  Reta  Coyne,  Director,  Public  Health  Nurses, 
P  O  Box  128.  Renfrew  County  and  District  Health 
Unit,  Pembroke,  Ontario. 


Walter  Safety  says, 
"Think,  don't  sink! 
Be  water  wise!  Learn 
ajid  practise  water 
safety  every  day." 


52     THE  CANADIAN   NURSE 


AUGUST   1971 


September  1971 


The 


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Canadian 
Nurse 


cycling  for 
fitness  and  fun 

the  expanding  role  — 
where  do  we  go  from  here? 

a  woman's  right  to  nag 

—  inalienable  and  essential 


why  is  hypothermia  overloo 


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nursing  and  medical  entities,  this  edition  offers  a  realistic, 
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The 

Canadian 
Nurse 


^ 

^^p 


A  monthly  journal  for  the  nurses  of  Canada  published 

In  English  and  French  editions  by  the  Canadian  Nurses'  Association 


Volume  67,  Number  9 


September  1971 


3 1      The  Expanding  Role:  Where  Do  We  Go  . 

From  Here? H.K.  Mussallem) 

35     Why  Is  Hypothermia  Overlooked? K.G.  Tolman 

38     A  Woman's  Right  to  Nag  —  Inalienable 

and  Essential Sister  M.T.  More 

41  What  is  Outpost  Nursing? C.W.  Keith 

45  Acting  Out  or  Acting  Up? V.  Crossley 

49  Taking  Rehabilitation  to  the  Patient E.A.  Halverson 

52  Cycling  for  Fitness  and  Fun 

The  views  expressed  in  the  various  articles  are  the  views  of  the  authors  and  do  not 
necessarily  represent  the  policies  or  views  of  the  Canadian  Nurses"  Association. 


Editorial 


4 

Letters 

9 

News 

24 

Names 

29 

Dates 

54 

New  Products 

56 

In  a  Capsule 

57 

Research  Abstracts 

58 

Books 

64 

AV  Aids 

65 

Accession  List 

79 

Index  to  Advertisers 

80 

Official  Directory 

Executive  Director:  Helen  K.  Mussallem  • 
Editor:  Virgiiiia  A.  Lindabun  •  Assistant 
Editors:  LIv-EUen  Lockebei^,  Dorothy  S. 
Starr.  •  Editorial  Assistant:  Carol  A.  Kotlar- 
sky  •  Production  Assistant:  Elizabeth  A. 
Stanton  •  Circulation  Manager:  Beryl  Dar- 
Ung  •  Advertising  Manager:  Ruth  H.  Baumel 

•  Subscription  Rates:  Canada:  one  year, 
$4.50;  two  years.  $8.00.  Foreign:  one  year, 
$5.00;  two  years,  $9.00.  Single  copies:  50 
cents  each.  Make  cheques  or  money  orders 
payable  to  the  Canadian  Nurses'  Association. 

•  Change  ol  Address:  Six  weeks'  notice;  the 
old  address  as  well  as  the  new  are  necessary, 
together  with  registration  number  in  a  pro- 
vincial nurses'  association,  where  applicable. 
Not  responsible  for  journals  lost  in  mail  due 
to  errors  in  address. 


Manuscript  information:  "The  Canadian 
Nurse"  welcomes  unsolicited  articles.  All 
manuscripts  should  be  typed,  double-spaced, 
on  one  side  of  unruled  paper  leaving  wide 
margins.  Manuscripts  are  accepted  for  review 
for  exclusive  publication.  The  editor  reserves 
the  right  to  make  the  usual  editorial  changes. 
Photographs  (glossy  prints)  and  graphs  and 
diagrams  (drawn  in  India  ink  on  white  paper) 
are  welcomed  with  such  articles.  The  editor 
is  not  committed  to  publish  all  articles 
sent,  nor  to  indicate  definite  dates  of 
publication. 

Postage  paid  in  cash  at  third  class  rate 
MONTREAL,  P.Q.  Permit  No.  10,001. 
50  The  Driveway,  Ottawa,  Ontario.  K2P  1E2 
©   Canadian  Nurses'  Association  1971. 


SEPTEMBER  1971 


The  Walls  Are  Tumbling  Down 

We  are  hearing  increasing  demands  for 
a  broader  based,  coordinated  health 
service.  This  is  as  it  should  be  because 
the  search  for  excellence  in  health  care 
must  continue. 

In  this  connection  nurses  might  prof- 
itably examine  the  evolution  of  health 
care  and  ask:  "Are  we  missing  oppor- 
tunities?" It  is  my  conviction  that  we 
are  doing  just  that  —  missing  oppor- 
tunities to  improve  health  care  and,  as 
a  result,  missing  opportunities  to  spend 
our  health  dollar  more  usefully. 

In  1969.  81.1  percent  of  all  registered 
nurses  were  devoting  their  time  and 
skills  to  the  care  of  patients  in  hospitals 
or  other  institutions.  At  the  same  time, 
less  than  7  percent  of  RNs  were  employ- 
ed in  community  and  school  health  pro- 
grams; only  1.7  percent  were  employed 
in  occupational  health  services. 

This  means  a  disproportionately 
small  percentage  of  nursing  skill  is 
devoted  to  the  prevention  of  illness  and 
to  community  services.  The  fault  lies 
not  with  nurses:  limited  budgets  provid- 
ed for  this  purpose  frustrate  many  who 
attempt  to  provide  health  services  in 
the  community:  a  further  limitation  is 
the  small  percentage  of  nurses  whose 
educational  programs  took  them  beyond 
the  hospital  walls. 

Economists  and  governments  are 
recognizing  the  fulilify  of  pouring  such 
a  high  proportion  of  health  services 
into  "golden  beds"  and  related  cost 
items.  They  see  that  many  major  health 
problems  are  rooted  well  beyond  the 
walls  of  health  care  institutions.  Further, 
a  realization  is  developing  that  many  ill 
persons,  particularly  children,  recuper- 
ate most  rapidly  in  their  own  homes. 

Many  persons  not  working  directly 
in  the  field  of  health  are  giving  leader- 
ship in  several  areas  affecting  health 
—  such  as  highway  safety,  industrial 
safety,  pollution  control,  and  so  on.  If 
health  is  our  raison  d'etre,  why  are  not 
more  nurses  "out  there"  giving  support 
to  such  efforts  rather  than  working 
behind  hospital  walls? 

Changes  in  the  health  care  delivery 
system  are  necessary.  And  such 
changes  require  the  support  and  lead- 
ership of  nurses.  To  nurses  who  have 
not  practiced  beyond  hospital  walls 
we  say,  "Come  on  in  —  the  water's 
fine." — E.  Louise  Miner,  CNA  Presi- 
dent. 

THE  CANADIAN   NURSE       3 


letters    { 


Letters  to  the  editor  are  welcome. 

Only  signed  letters  will  be  considered  for  publication,  but 

name  will  be  withheld  at  the  writer's  request. 


Disposing  of  disposables 

This  will  seem  like  a  simple  question  to 
the  author  of  the  article  "To  be,  or  not 
to  be  —  disposable!"  (July  1971)  and 
perhaps  to  the  editors  ot  The  Camulian 
Nurse,  but  where  are  we  disposing  of 
all  these  disposables?  Why  we' re  burn- 
ing them  you'll  say,  or  we're  giving 
them  to  the  garbagemen. 

Right  now,  Montreal  hospitals  stand 
accused  of  being  the  biggest  polluters  in 
this  city.  Last  month  1  called  City  Hall 
and  reported  one  large  metropolitan 
hospital  that  spewed  foul  black  smoke 
over  a  large  area  of  the  city  for  over  half 
an  hour. 

It  is  inconceivable  that  in  1971  an 
article  that  gives  as  its  two  guiding 
principles  "the  impact  on  patient  care 
and  the  impact  on  the  budget"  can  be 
written  and  published.  Nowhere  in  this 
irresponsible  article  was  there'  one 
word  about  the  impact  on  the  environ- 
ment. After  only  a  few  attempts  to 
educate  and  interest  the  public  about 
the  crisis  we  all  face,  one  learns  that 
the  public  knows  but  is  generally  un- 
willing to  sacrifice  their  conveniences 
to  save  this  earth.  One  becomes  much 
more  discouraged  when  those  who 
profess  to  be  interested  in  public  health 
live  by  the  old  American  premise:  get  it 
cheap,  use  it  quick,  throw  it  away. 

1  would  like  to  comment  on  several 
specific  points  in  this  article.  "Some 
institutions,  notably  in  the  United 
States,  have  converted  almost  com- 
pletely to  one-use  articles  .  .  ."  To  any- 
one looking  at  the  United  States  with 
more  in  mind  than  their  gross  national 
product  this  is  not  surprising  and  hardly 
admirable. 

"In  our  experience,  disposable  items 
cannot  be  justified  economically  unless 
the  services  of  a  specific  group  can  be 
dispensed  with"  At  a  time  when  the 
two  major  problems  in  this  country  are 
pollution  and  unemployment,  can  this 
statement  be  justified? 

"The  use  of  disposable  gloves  allows 
a  standardization  more  difficult  to 
achieve  with  the  reusable  type,  a  desir- 
able by-product  of  this  particular 
change."  It's  probable  that  manufactur- 
ers of  disposable  bottles  are  saying  these 
very  words,  whatever  significance  they 
may  have  .... 

There  is  no  reason  for  hospitals  to 
have  disposable  enema  buckets,  douche 
trays,  skin  preparation  trays,  suction 
tubing  and  cannulas,   stomach   tubes, 

4     THE  CANADIAN  NURSE 


Cantor  tubes,  and  feeding  tubes  .... 

Let's  be  honest.  If  we're  worried 
about  money,  let's  come  right  out  and 
say  so.  U's  a  legitimate  complaint 
sometimes,  but  let's  not  hide  behind 
this  supposed  concern  for  "our  pa- 
tients." 

How  can  we  spend  so  much  nursing 
time  and  energy  worrying  about  opti- 
mum patient  care  when  we  are  prepar- 
ing to  send  these  same  people  into  a 
world  we  are  helping  to  destroy?  — 
Sharon  Johnston  Fraser,  R.N.,  Mont- 
real, Quebec. 

Educational  issue 

1  enjoyed  the  July  1971  issue  of  The 
Canadian  Nurse.  Even  my  husband, 
who  has  never  even  noticed  the  maga- 
zine before,  picked  it  up  and  read  it 
for  half  an  hour. 

All  of  the  articles  were  excellent  and 
very  appropriate,  especially  the  typhoid 
epidemic  article.  I  was  also  hoping 
someone  would  write  an  account  of 
the  cholera  epidemic  in  Pakistan.  1 
wonder  how  many  nurses  really  know 
what  cholera  is  and  how  it  is  treated? 

I  was  very  happy  to  see  the  case  his- 
tories in  Dr.  J.R.  Higgin's  article  on 
hysterectomies.  Mrs  Holm's  article 
"Nursing  care  of  patients  having  a 
hysterectomy"  was  of  great  educational 
value  to  all  of  us,  especially  those  who 
are  not  currently  practising  in  the  nurs- 
ing profession. 

I  hope  there  will  be  more  articles 
like  these  in  the  future  because  to  nurses 
The  Canadian  Nurse  is  not  only  a  source 
of  information  on  current  events  and 
meetings,  but  also  a  source  of  continu- 
ing education.  —  R.N.,  Surrey,  B.C. 

Nursing  in  prison 

I  enjoyed  the  article  "Nurses  in  Prison," 
by  Gwen  Norens  (May  1 97 1 ),  who  told 
of  her  work  in  a  penitentiary  in  Alberta. 
In  1962-63  I  was  the  hospital  officer 
at  William  Head  minimum  security 
institution  —  a  federal  prison  with 
125  men,  about  20  winding  miles  from 
Victoria,  British  Columbia.  An  orderly 
and  I  were  the  only  staff  in  the  five-bed 
hospital,  although  there  was  a  visiting 
doctor  and  dentist.  Minor  surgery  and 
routine  office  calls  were  handled  in  the 
prison  hospital,  but  major  surgery, 
seriously  ill  patients,  and  patients  re- 
quiring x-rays  were  treated  in  the  Vet- 
erans Hospital  in  Victoria  and  in  a 
government  clinic. 


The  psychological  aspect  of  incar- 
ceration played  a  large  part  in  many 
of  the  health  problems.  Inmate  reac- 
tions ranged  from  obsession  to  get  out 
of  prison  to  refusal  to  leave  the  grounds 
for  any  purpose  until  the  sentence  was 
completed. 

In  addition  to  applying  routine  dres- 
sings, performing  mmor  surgery,  and 
looking  after  headaches  and  colds, 
I  spent  a  great  deal  of  time  working 
closely  with  clinical  instructors,  padres, 
prison  officers,  and  parole  officers. 
Inmates  sometimes  showed  another 
side  of  their  personalities  when  they 
discussed  their  problems  with  a  woman 
who  was  not  considered  a  disciplinar-  J 
ian.  ' 

I  found  it  challenging  to  work  on 
my  own  most  of  the  time.  Ten  years 
ago  it  was  a  privilege  to  be  allowed  to 
suture  wounds.  Sometimes  1  had  to  give 
emergency  treatment  first  and  ask  per- 
mission afterward,  because  1  did  not 
have  an  outside  telephone  in  the  hos- 
pital. 

The  inmates  had  frequent  visiting 
privileges;  their  families  came  with 
picnic  lunches,  which  they  ate  on  the 
grounds.  They  also  took  part  in  sports, 
such  a  baseball  and  soccer  games,  fish- 
ing, and  golf  Other  activities  included 
public  speaking  courses,  religious  in- 
struction, woodworking  and  other  trades 
courses,  as  well  as  academic  education. 
I  taught  first  aid  to  large  classes. 

Each  day  some  of  the  inmates  went 
by  truck  to  work  on  road  construction, 
where  they  mixed  freely  with  people 
outside  the  institution.  Inmates  also 
did  most  of  the  local  maintenance  work, 
cooked  all  the  meals,  and  grew  most  of 
the  vegetables  that  were  used  at  Wil- 
liam Head. 

As  for  the  immates'  living  accommo- 
dation, there  were  dormitories  and  pri- 
vate rooms.  And  there  were  no  locks  on 
the  doors,  with  the  exception  of  the 
pharmacy  door,  although  this  was  easily 
picked  by  the  "experts."  —  Margaret 
Fletcher.  Victoria.  B.C. 

Nursing  audits 

There  is  a  strong  case  for  developing 
and  carrying  out  a  nursing  audit.  It 
is  used  increasingly  in  Canadian  hos- 
pitals as  a  method  ot  evaluation  and 
control  by  the  nursing  service  admin- 
istration. Theissen's  article  in  The 
Canadian  Nurse  ("A  Nursing  Service 
(Continued  on  page  6) 

SEPTEMBER  1971 


/Vcce^  /icMf^d4^  /lmfed...^0(^  ^eei^ 


Our  best-selling  items,  carefully  selected  for  today's 
nurse.  Many  available  with  up  to  3  gold-stamped  or 
engraved  initials  for  identification,  protection,  and 
distinction.  All  shipped  ppd. 

Complete  Satisfacfion  Guaranteed! 


^       REEVES  NAME  PINS 

America's  largest  selling ...  by  far!  Jewelry  like 
quality,  smooth,  featherlight,  lie  flat  on  uniform. 
Names  deeply  engraved  and  lacquered.  Pin- 
backs    permanently   swaged   in    (not   glued). 
Choose  lettering  in  Black  or  Blue  (also  White  on 

SAVE:  Order  2  identical       HmI  Wmm 
Pins  as  precaution  against  MPMIWifli 
loss,  less  changing.           |y||pj  mHpj 

LnLjjl  1  Kane  Pin  inly 
nnllilT 2  Pins  (same  njme! 

1.85* 

2.35* 

2.85* 

3.35* 

Ijm^l  Kame  Pin  t*i 
rniniT2  Pin  (salt  uael 

.95* 

1.45* 

1.65* 

2.30* 

•IMPOFITANI:  Please  add  25«  per  order  handling  charge 
on  all  ciders  of  3  pins  Of  less 
CROUP  DISCOUKTS:   10-24  pins,  deduct   10%;  2S  99 
pins.  15%,  100  or  more  pins,  20%. 
.   Send  cash,  m.o.,  or  checli.  No  biilints  or  COD's. 

Mrs.  R.  F.  JOHNSON 
SUPERVISOR 


CHARLENE  HAYNES 
TTNrCOHN.LPN. 


BANDAGE  SCISSORS 


Personalized,  precision-made  forged 
Lister  scissors.  Guaranteed  2  years 


3V2 "  MINI  SCISSORS 

Tiny,  handy,  slip  into  uniform  pocket  or 
purse.  Choose  jewelers  Gold  or  gleaming 
Chrome  plate  finish  on  coupon. 

Ay%"  or  SVa"  SCISSORS 

As  above,  but  larger  tor  bigger  jobs.  Chrome  finish  only. 
Choose  No.  3500  O'/j").  No.  4500  (4Vi"l  or  No.  5500  (5'/,") ...  2.50  ei. 
1  Doi.  or  more  . . .  $2.00  ea.  Your  initials  eneraved,  add  50(  per  scissors. 


JEWELRY 


y  ■ 


NURSES  CHARMS  ^ 

Finest  sculptured  Fisher  charms." 
I  Sterling  or  Gold  Filled  (specify  under  COLOR  on  coupon). 

For  bracelet  or  pendant  chain.  Add  to  your  collection! 

No.  263  Caduceus;  No.  164  Cap;  No.  68 
I  Grad.  Hat;  No.  &  Band.  Scissors  .  ■  3.49  ea. 

14K  PIERCED   EARRINGS 

"  Dainty,  detailed  14K  Gold  caduceus,  for  on  or  oft  duty 
wear.  Shown  actual  size.  Gift  boxed  for  fnends,  too. 
No.  13/297  Earrings 5.95  per  pair. 

PIN  GUARD  Sculptured  caduceus,  chained 
to  your  professional  letters,  each  with  pinback/ 
safety  catch.  Or  replace  either  witti  class  pin  for 
safety.  Gold  finish,  gift  boxed  Choose  RN.  LPN 
Of  LVN  No.  3420  Pin  Guard 2.95  ea. 


POCKET  SAVERS 


ENAMELED   PINS  Beautifully   sculptured   status 
insignia.  2-color  keyed,  hard-fired  enamel  on  gold   plate. 
Dime-sized,   pin-back    Specify  RN.  LPN.  PN.   LVN.   NA.  or 
RPh.  on  coupon. 
No.  205  Enam.  Pin  1.95  ea.,  12  or  more  1.50  ea. 


Prevent   stains   and  wear! 

Smooth,  pliable  pure  white  vinyl.  Ideal 
low-cost  group  gifts  or  favors. 
No.  210-E  (right),  two  compartments 
with  flap,  gold  stamped  caduceus  . .  ■ 
6  for  1.50.  25  or  iioro  20«  ea. 

No.  791  (left)  Deluxe  Saver,  3  compt. 
change  pocket  4  key  chain  .  .  . 
6  for  2.9S.  25  or  more  35«  u. 


NIGHTINGALE  LAMP 

An  authentic,  unique  favor,  gift  or  engraved 
award!  Ceramic  oft-white  candleholder  with 
genuine  gold  leaf  tnm  Recessed  candle 
cup  (candle  not  included'    7"  long 


No.  FIDOS  Lamp    .  6.95  ea..  12  or  more  4,95  ea. 

Initials  and  date  engraved  on  gold  plaque  .  . 
add  1-00  per  lamp. 


NURSES  WATCHES 


Hamilton  17  Jewel 

"Buren  '  Calendar  Watch,  17  jewels,  sweep- 
second  hand  Oate  changes  at  midnight  Water, 
shock  resis..  antimag,  unbreak  mainspring. 
Chrome  finish,  expan  bracelet,  1  yr.  guarantee 
No.  BL53  Ham.  Watch  .  .  .  34.95  ea. 


Endura  Waterproof  swiss  made  raised  silver  fuii 

numerals,   lumin    markings    ReO-tipped   sweep   second- 
hand, chrome  ■  stainless  case.  Includes  genuine  black 
leather  watch  strap.  I  year  guarantee.  Very  dependable 
No.  1093  Endura  Watch 19.95  ea. 


BZZZ   MEMO-TIMER    nme  not  packs,  heat   ^ 

lamps,  park  meters    Remember  to  check  vital  signs.    $^ 
give  medication,  etc   Lightweight,  compact  KXW  dial, 
sets  to  Buzz  ^  to  60  mm   Key  rmg  Swiss  made 

No.  M-22  Timer 3.98  ea. 

3  for  9.75  ea..  6  or  more  3.00  ea. 


EXAMINING  PENLIGHT 


White  barrel  ""itfi  caduceus  impnnl,  aluminum 
^  band  and  clip.  5"  long.  U  S  made,  batteries  included  (te- 

'"placement  batteries  available  any  store)  Your  own  light,  gift  boxed 
No.  007  Penlight . .  .  3.98  ea.  Tour  Initials  engraved,  add  50c  per  tlglt 


MEDI-CARD  SET  Handiest  reference 
ever!  6  smooth  plastic  cards  (S^-ii"  x  ST'i  cram- 
med with  information,  including  Equivalencies  of 
Apothecary  to  Metric  to  Household  Meas.,  Temp. 
"C  to  °F,  Prescrip,  Abbr,,  Urinalysis,  Body  Chem,, 
Blood  Chem..  Liver  Tests,  Bone  Marrow,  Disease 
Incub  Periods.  Adult  Wgts  ,  Child's  Dosages,  etc 
All  in  white  vinyl  holder  with  gold  stamped 
caduceus  No.  289  Card  Set  .  .  .1.50  ea. 
6  or  more  1.25  ea.     12  or  more  1.10  ea. 

Your  initials  gold-stamped   on   holder, 

add  50€  per  set. 


KELLY   FORCEPS  So  handyfor 

every    nurse!    5^"    stainless    steel,    fully 
guaranteed  Ideal  for  clamping  off  tubing.  Your 
own  initials  help  prevent  loss. 
(§A^)  No,  25-72  Forceps . . .  2-75  ea.     6  or  more  2,50  ea, 
/  Your  initials  engraved,  add  50<  per  forceps. 


PULSOMETER  simplify    pulsetsking'    Min^ 

iature  hourglass  times  15  seconds  very  accurately. 

Pocket  clip,  or  pins  on  with  9"  removable  chain. 

Chrome  plated,  plastic  box.  Handy,  efficient. 

No  K  15  E  Pulsoaetor  2.95  ea.       3  r  iTore  2.50  la 

12  or  mori  2,00  ea. 

Engraved  initials,  add  50c  per  item. 


/. 


ENT  INSTRUMENT  SET 

A  superb  quality  set  for  nurses!  Includes  med. 
handle  with  resistance  regulation,  otoscope 
head,  nose  speculum,  ilium,  tongue  blade 
holder,  5  assort  ear  reflectors.  Precision 

crafted,  fitted  into  handsome  velvet-^ __ 

lined  case  Powered  by  2  "C"  (^AK, 

batteries.  Your  initials  engraved  on 
handle  and  gold-stamped  on  case  FREE- 
lOyear  guarantee.  Outstanding  value! 
No.  33     ENT  Set  .  .  only  49.95  ea. 


NURSES  BAG  A  lifetime  of  service 
for  visiting  nurses!  Finest  black  W  thick 
genuine  cowhide,  beautifully  crafted  with 
rugged  stitched  and  rivet  construction 
Water  repellant  Roomy  interior,  with  snap- 
in  washable  liner  and  compartments  to 
organize  contents.  Snap  strap  holds  top 
open  during  use.  Name  card  holder  on  end 
Two  rugged  carrying  straps,  6"  x  8"  x  12". 
Your  initials  gold  embossed  FREE  on  top.  An 
outstanding  value  of  superb  quality 

no.  1544-1  Bag  [with  liner).  .  42.50  ea. 

Extra  liner  No.  4415 8.50 


^-,^SHOE  TOTE    Keep    or    carry 
oC  L^  shoes  in  this  fine  stitched  white  vinyl 
bag!  Opens  wide,  separate  scuffproof 
compartment    for    each    shoe     Zips 
weather-tight,  carrying  strap.  4"  x  5"  x  12" 
No.  444  Tote  .  5.49  ea.     6  or  more  4.50  ea. 
Your  initials  gold-stamped,  add  50c  per  Tote. 


(four 

ms 

aim... 


|csZ§5 


Per%ona\\ze6 

Littmann  300! 

NURSESCOPF 

Famous  Littmann  nurses  diaphragm 
stethoscope,  with  your  initials  indi- 
vidually engraved  FREE!  A  fine,  pre- 
cision instrument,  has  high  sensi- 
tivity for  blood  pressures,  general 
ausculatton.  Only  IW  ozs..  fits  m 
pocket,  23"  vinyl  anti^ollapse  tub- 
ing, non-chilling  snap-on  diaphragm, 
non-rotat ing.  correctly  ■  angled  ear 
tubes.  U  S.  made  Choose  from  5 
jewel-tike  colors  Goldtone.  Sttver- 
tone,   Blue,   Green,   Pink. 

FREE  INITIALS! 

engraved  on  chest  piece,  lends  indi- 
vidual   distinction,    prevents    loss. 
Specify  on  coupon  below 
No.  216  Nursecope  13.80  ea. 

6-11 12.80  ea. 

12  or  more 11.80  ea. 

SCOPE  SACK  neatly  carries  and  pro- 
tects Nursescope  or  any  scope.  Double-thick 
■osted  flexible  plastic,  white  vinyl  binding.  4Vi" 
'  9"^".  Your  own  initials  help  prevent  loss 
No.  223  Sack. .  .  1.00  ea.  6  or  more  7Sc  u. 
Your  initials  gold-stamped,  aild  50c  per  sack. 


NURSES  PERSONALIZED 
ANEROID  SPHYG. 

A  superb  instrument  especially 
designed  for  nurses!  Imported  from  pre- 
cision craftsmen  m  W,  Germany    Easy- 
to-attach  Velcro  cuff,  lightweight,  com- 
pact, fits  into  soft  Sim,  leather  zippe 
case  IVi"  X  4"  i  7",  Dial  calibra 
ted  to  320  mm,  lO-year  accurac. 
guaranteed  to  r3  mm.  Serviced  by 
Reeves  if  ever  required.  Your  ini- 
tials engraved  on  manometer  and 
gold  stamped  on  case  FREE,  for 
permanent    identification    and 
distinction.  A  wise  investment  for 
a  lifetime  of  dependable  service! 
No.  106  Sphye.  .  .  .  26.95  ea. 


CAP  ACCESSORIES 


CROSS  PEN  '-•.^^^^^^^"'"'"■■i^'X""-"' I 

World-famous  ballpoint. ' 

sculptured  caduceus  emblem  Full  name 

FREE  engraved  on  barrel  (include  name  with  coupon] 

Refills  avail  everywhere  Lifetime  guarantee 


CAP  TOTE    keeps   your   caps   crisp  and   clean    _  ^ 

while  stored  or  carried.  Flexible  clear  plastic,  white         ■■  . 

trim,  zipper,  carrying  strap,  hang  loop  Stores  flat.  Also       _  — -~ 
for  wiglets.  curlers,  etc.  %W  dia..  6"  high.  ' 

No.  333  Tote  . .  2.65  ea.,  6  or  more  .  .  2.35  ea. 
Your  initials  gold-stamped,  add  50<  per  Tote. 

WHITE  CAP  CLIPS      Holds    caps 
firmly  in  place!  Hard-to-find  white  bobbie  pms, 
enamel  on  fine  spring  steel.  Eight  2"  and  eight 
3"  clips  included  in  plastic  snap  box. 
No.  529  Clips  .  .  3  boies  for  1.95. 
6  for  3.25.  12  for  49<  ea. 

MOLDED  CAP  TAGS 

Replace  cap  band  instantly.  Tiny  plastic  tac. 
dainty  caduceus, -Choose  Black,  Blue,  White 
or  Crystal  with  Gold  CaduceuS;  or  all  Black  ; 
(plain).  The  neater  way  to  fasten  bands. 
No.  200  Set  Of  6  Tacs  . . .  1.25  per  sat. 
12  or  more  sets  1.00  per  set 

f-TP«       .^dHp    METAL   CAP  TACS     Pair   of   dainty 

\m^\  ^f       jewelry^juality   Tacs   with    grippers,    holds   cap 

_  ~lL^  1        bands  securely    Sculptured  metal,   gold   finish, 

nRUl  appfOJt    H"   wide.   Choose   RN,   LPfJ,   LVN,   RN 

I— i^W  .,-;^^^  Caduceus  or  Plain  Caduceus    Gift  boxed 

n  WifX"!  ^^  No.  CTl  (Specify  Initials).  No.  CT-2  (Plain 

UAAM  b^^Cad.)  or  No.  CT-3  (RN  Cad.)  .  .  .  2.95  pr 

SEL-FIX  CAP   BAND    Blackvetvet 

band  material  Self-adhesive,  presses  on. 
pulls  off;  no  sewmg  or  pinning  Reusable 
several  times  Each  band  20"  long,  pre-cut  to 
popular  widths:  W  112  per  plastic  box)  V^" 
(8  per  box)  ^■'  (6  per  box)  I"  (5  per  bbx). 
Specify  width  under  ITEM  column  on  coupon. 
No.  6343  Band.  .  .  1.75  per  box         3  or  more 


BABY  SCALE  weigh  infants  on  home  visits. 
Precis  ion-made  bronze  cyclinder,  nickel  handle  and 
hook  Weight  to  15  lbs  or  7  kg.  White  vinyl  cloth 
sling  holds  infant  securely  for  weighing,  then  folds 
to  form  compact  carry  case.  Useful  ano  accurate' 

No.  IN-15  Scale 14.95  ea. 

Your  initials  engraved,  add  50<  per  scale. 


t 


AUTO  INSIGNIA  Full-color  enam 

elled  RN  insignia  (left)  on  bronze-plated 
medallion  Easy  to  attach  to  registra- 
tion plate  Weather-proof,  distinctive 
No.  210  Medallion  ....  5.95  ta. 
4-color  decai  with  RN  emblem,  transfers 
easily  to  instde  car  window.  4"^'  dia. 
No.  621  Oecal 1.25  ea. 


TRI-COLOR  BALL  PEN 

Write  in  black,  red  and  blue  with  one  ball  point  pen 
Flip  of  the  thumb  changes  point  tand  color)  Steno  fine  point  (excellent 
for  charts)   Polished  chrome  finish.  Ahandy  accessory  for  every  nurse' 

No.  921  Ball  Pen 1.95  ea. 

No.  292-R  3-color  Refills 50c  ea. 


SCRIPTO  PILL  LIGHTER  Famous  Sc.pto 
Vu-Lighter  with  crystal-cleat  fuel  chamber  containing  color- 
ful array  of  capsules,  pills  and  tablets  Novel,  unique,  for 
yourself  or  for  unusual  gifts  for  friends  Guaranteed  by 
Scripto.  A  real  conversation  piece! 


^mk 


^ 


ORDER  NO. 


B" 


LLUMl!!^ 


COLOR    QUANT. 


arom 


NAME  PINS:  3  One  Name  Pin       D  Two,  same  nam* 

LETT.  COLOR METAL  FIM. , 

LETTERING  

2nd  line 


INITIALS  as  required 


I  enclose  $_ 


.  (Mass  residents  add  3%  S.  T.) 


Sorry,  no  COD'S  or  billini  terms  available 


Send  to  . 
Street  .. 


i \ 

Busy,  busy 
little  fingers. 
Busily  spreading 
pinworms. 


Depend  upon 


^[M](Q)M][]^ 

(pyrvinium  pamoate  Frosst) 

to  eliminate 
pinworms  witii 
a  single  dose 


Early  detection,  and  treatment  with 
Pamovin,  can  bring  tiie  usual  unpleasant 
course  of  pinworms  to  an  abrupt  halt. 

It  has  been  shown'  that  single-dose 
treatment  with  pyrvinium  pamoate 
achieves  an  overall  cure  rate  of 
96  per  cent. 

In  the  family  or  in  institutions,  pyrvinium 
pamoate  (PAMOVIN)  offers  the  advantages 
of  "low  cost,  ease  of  administration, 
and  effectiveness."^ 

Dosage:  for  both  children  and  adults,  a  single 
dose  of  1  tablet  or  1  teaspoonful  for  every 
22  lbs.  of  body  weight. 

Cautions:  Occasionally,  nausea,  vomiting  or 
gastrointestinal  complaints  may  be  encoun- 
tered but  are  seldom  a  problem  on  such 
short-term  treatment.  Stools  may  be  coloured 
red.  Suspension  will  stain  clothing  and  fabrics. 

PAMOVIN  Tablets  of  50  mg.  (red,  film-coated), 
boxes  of  6,  and  bottles  of  24  and  100. 
Suspension  (red),  50  mg.  per  5  ml.  teaspoonful, 
bottles  of  30  ml.,  4  and  16  fl.  oz. 

References:  1,  Beck,  J.  W.,Saavedra,  D., 
Antell,  G.  J.  and  Tejeiro,  B.:  Am.  J.  Trop.  Med. 
8:349,  1959.  2.  Sanders,  A.  I.  and  Hall,  W  H.- 
J.  Lab.  &  Clin.  Med.  56:413,  1960. 

Full  Inlormation  on  request. 


® 


3ho<yM 


6     THE  CANADIAN  NURSE 


(Continued  from  page  4} 

Audit,"  February  1966)  gives  a  repre- 
sentative view  of  how  a  nursing  audit 
is  conducted,  describing  its  mechanics 
and  its  benefits.  Since  then,  the  nursing 
audit  has  been  recommended  by  the 
Canadian  Council  for  Hospital  Accred- 
itation. 

An  audit  usually  involves  the  eval- 
uation of  selected  discharge  charts  by 
a  group  of  senior  nurses  using  establish- 
ed criteria.  Inservice  and  administrative 
personnel  often  comprise  the  auditing 
body.  This  is  a  speedy  and  efficient 
process  because  the  small  group  of 
auditors  becomes  skilled  in  evaluating 
charts  and  formulating  recommenda- 
tions. 

As  a  nurse  at  the  Ottawa  Civic  Hos- 
pital. I  was  involved  in  monthly  audit- 
ing. The  monthly  audit  of  each  group 
of  units  was  coordinated  by  the  area 
supervisor,  but  it  was  actually  carried 
out  by  the  staff  members  of  each  unit. 
All  nurses  were  instructed  in  the  me- 
chanics of  the  audit  and  in  the  use  of 
the  forms.  When  an  audit  session  was 
scheduled  for  a  certain  group  of  units, 
each  unit   in   that  group  would  send 
any  staff  member  who  could  be  spared. 
This  meant  that  each  audit  committee 
was  a  changing  group,  and  that  no  one 
participated  often  enough  to  become 
highly  skilled  at  auditing.  There  were 
several  advantages  to  this  system,  how- 
ever. The  auditors  were  critically  eval- 
uating,   against    standardized   criteria, 
the  written  record  of  their  own  nursing 
practice.  During  audit  sessions,  nurses 
also   had   the   opportunity   to   discuss 
their  practice  and  to  share  approaches 
to  complex  care  problems. 

As  recommendations  for  change  were 
generated  by  unit  staff  representatives, 
these  recommendationsbecame  virtually 
self-implementing.  Each  auditor  was 
conscious  of  her  participation  in  deci- 
sion-making in  a  direct  and  practical 
way.  Staff  nurses  who  participated  in 
auditing  had  the  opportunity  to  suggest 
creative,  novel  approaches  to  solving 
the  problems  of  maintaining  a  high 
standard  of  nursing  care.  Ultimately, 
this  led  to  the  greater  welfare  of  the 
patient.  —  Roberta  E.  Rivett,  London, 
Ontario. 


Topics  for  journal 

I  would  like  to  comment  on  the  content 
of  The  Canadian  Nurse.  As  a  person 
who  is  concerned  about  the  nursing 
profession  in  a  society  where  education 
and  health  services  are  changing  at  a 
revolutionary  rate,  I  think  there  should 


be  more  about  the  profession  in  the 
journal. 

I  suggest  the  following  topics  be 
used:  administration  of  nursing  units, 
team  nursing,  interpretation  of  cliches 
such  as  "support  the  patient,"  union- 
ization of  professionals,  the  attitude  ot 
servitude  to  the  medical  profession, 
the  clarification  of  overall  purposes  and 
specific  objectives  within  nursing  de- 
partments and  nursing  units,  planning, 
discussion,  and  communication  at  a 
professional  level. 

I  often  wonder  if  nursing  can  survive 
without  speeding  up  change  within  the 
ranks,  and  developing  a  common  under- 
standing of  our  vocabulary,  the  activi- 
ties in  which  we  are  involved,  and  of 
our  responsibilities  in  a  period  of  rapid 
change. 

Is  the  lack  of  such  content  an  indica- 
tion of  the  level  at  which  the  majority 
of  nurses  are  functioning  or  of  simple 
lethargy? —  Madeline  WiLton.  assistant 
director,  nursing  education,  The  Mont- 
real Children's  Hospital,  Montreal, 
Quebec. 

I  am  a  registered  nurse  working  part- 
time  in  public  health.  1  read  and  enjoy 
most  ot  The  Canadian  Nurse.  1  partic- 
ularly enjoy  human  interest  articles  and 
case  histories.  Items  written  by  nurses 
are  usually  of  the  most  interest  to  me. 

As  for  new  products  and  book  re- 
views, 1  only  glance  at  these,  but  1  read 
every  word  ot  the  news. 

1  would  like  to  see  more  articles  on 
such  things  as  counseling  high  school 
students  and  drug  abuse.  —  Patricia 
Bull,  RN,  Glovertown,  Newfoundland. 

Concerned  about  unemployed  nurses 

I  am  distressed  that  less  and  less  nurs- 
ing is  done  by  registered  nurses,  and 
that  unemployment  among  nurses  is 
increasing. 

1  am  pleased  that  so  many  people 
believe  we  should  give  additional  train- 
ing to  nurses  rather  than  create  a  new 
category  of  worker  to  assist  the  doctor. 
—  Violet  Keller,  Medlev,  Alberta. 


Book  wanted 

I  am  anxious  to  obtain  a  copy  of  Esther 
A.  Werminghaus'  book,  entitled  Annie 
W.  Goodrich  —  Her  Journey  to  Yale, 
published  in  New  York  around  1950 
by  The  Macmillan  Company. 

As  this  book  is  out  of  print  and  no 
longer  available,  1  wonder  whether 
any  readers  of  The  Canadian  Nurse 
have  a  copy  that  they  would  be  prepared 
to  sell  or  donate  to  our  health  sciences 
library.  We  will  be  grateful  for  any  help 
in  finding  this  book.  —  R.  Catherine 
Aikin.  Dean.  Faculty  of  Nursing,  The 
University  of  Western  Ontario,  London 
72,  Ontario.  Q 

SEPTEMBER  1971 


Three  good  reasons 
for  starting  your  next 
I.V.  procedure  with  a 

BUTTERFLY" 

Infusion  Set 


i  4 


Smoother,  Easier  Venipuncture:  Butterfly  "wings" 
give  you  a  built-in  needle  holder.  Fold  them  upward 
and  you  have  a  firm,  double  gripping  surface.  You 
can  manipulate  freely  and  accurately.  You  have 
excellent  control  over  entry  .  . .  smooth  positive 
penetration  on  good  veins  ...  far  less  trouble  with 
difficult  or  hard-to-find  veins.  The  super-sharp  needle 
slides  through  tissue  with  a  keenness  you  can  "feel". 

Increased  Security:  Release  the  "wings"  after 
venipuncture  and  they  fold  back  flat  against  the 
patient's  skin.  Thus  you  have  a  ready-made  anchor 
surface.  Two  strips  of  tape  over  the  wings  usually 
suffice  for  complete  needle  immobilization  . .  . 
often  without  armboard  restraint. 

A  Size  For  Every  I.V.  Need:  There  are  two  Butterfly 
Infusion  Sets  for  general-purpose  fluids  administration, 
two  for  pediatric  and  geriatric  use,  one  expressly 
designed  for  O.R.  and  recovery  or  emergency  room 
requirements  .  . .  and  the  Buttertly-19,  INT  and 
Butterfly-21 ,  INT,  with  Reseal  Injection  Site,  for 
INTermittent  I.V.  therapy. 


Ask  your  Abbott  representative  to  show 
you  the  whole  collection 


uaoTT 


901109 


i  <  M  I 


I PMAC I 

•RD.  T.M. 


We  want  a  special  kind  of 
nurse.  To  nurse  the  men  of  the 
Canadian  Armed  Forces  and  ac- 
cept the  responsibilities  of  an  offi- 
cer. Which  makes  it  a  challenging 
job,  but  an  interesting  one,  too.  You 
could  be  travelling  to  bases  all  over 
Canada  and  working  in  one  of  sev- 
eral different  hospitals.  You'd  never 
find  yourself  in  a  dull  routine.  And 
you'd  have  the  added  prestige  of 
being  a  commissioned  officer  when 
you  join  us.  If  the  idea  interests  you, 
you're  probably  the  kind  of  special 
person  we're  looking  for. 

So  write  our  Director  of  Re- 
cruiting and  Selection,  Canadian 
Forces  Headquarters,  Ottawa, 
Ontario,  K1A  0K2.  Soon. 


We  want 
a  nurse 

who  can  handle  ^ 
two  Jobs. 


The  Canadian 
Armed  Forces 

You've  got  to  be  good  to  get  in. 


a  special  service 
for  special 
people 


.  .  .  and  nurses  are  some  of  our  most  special  people. 
You're  doing  a  terribly  difficult  -  and  all  too  often 
unappreciated  -  job. 

To  help  make  your  vital  task  a  little  less  diffi- 
cult and  a  little  more  rewarding,  we  at  Mosby  seek  the 
finest  material  to  offer  you  .  .  .  books  ranging  over 
every  facet  of  your  field. 

Beginning  in  November.  Nancy  Manning,  our 
special  nursing  customer  service  consultant,  will  bring 
you  a  special  message  about  what's  just  off  the  press 
at  Mosby;  what's  coming  up  in  the  next  few  months,  and 
what  your  colleagues  are  saying  about  recently  pubUshed 
titles.  Keep  an  eye  open  for  the  information-packed 
"Nancy's  Notes"  in  the  November  issue. 

From  time  to  time,  Nancy  also  will  send  you 
advance  previews  of  special  forthcoming  nursing  books, 
so  you  can  reserve  your  copies  early  .  .  .  and  you  can 
start  putting  the  latest  information  to  work  as  soon  as 
possible  to  help  yourself  and  your  patients.  Watch 
for  "Nancy's  Notes"  in  your  mail! 

Any  or  all  of  the  1 8  books  listed  on  the  back  of 
the  page  can  be  yours  to  read  and  use  for  30  days  at 
no  cost  or  obligation  .  .  .  each  one  is  backed  by  the 
Mosby  Guarantee  of  Satisfaction.  Shouldn't  you  invest 
a  few  minutes  of  your  time  to  take  a  look? 


yraZUU  -^**<^  y^yyioxJi^  ^  %^^.<^  Tl^yfU^  / 


PLACE 
STAMP 
HERE 


The  C.  V.  MOSBY  Company  Ltd. 

86  Northline  Road 
Toronto  374,  Ontario,  Canada 


(2So^^''^^<=^^^^^^^ 


Vthe   physiologic   and   pharmacologic   basis   of   coronary  care 

NURSING,  New:  By  Theodore  Rodman,  M.D.:  Ralph  M.  Myerson.  M.D.:  L.  Theodore 
Lawrence,  M.D.;  Anne  P.  Gallagher.  R.N..  B.S.N. ,  M.S.N.;  and  Albert  J.  Kasper,  M.D.  The 
whole  ecu  story  from  YOUR  point  of  view.  Clinical  procedures,  instrumentation,  interper- 
sonal relationships,  much  more.  July,  1971.  228  pp.,  103  illus.  $9.20. 

O  CURRENT  concepts  IN  CLINICAL  NURSING,  New  Volume  HI:  Edited  by  Margery 
Duffey,  R.N..  Ph.D.:  Edith  H.  Anderson.  R.N..  Ph.D.:  Betty  S.  Bergersen,  R.N.,  Ed.D.:  Mary 
Lohr,  R.N.,  Ed.D.:  and  Marion  H.  Rose,  R.N.,  M.A.  New  volume  in  widely  renowned  series 
brings  you  most  up-to-date  procedures  from  specialists  in  every  nursing  field.  September,  1971. 
Approx.  384  pp.,  24  illus.  About  $15.25. 

O  COMPREHENSIVE  CARDIAC  CARE,  A  Handbook  for  Nurses  and  Other  Paramedical 
Personnel,  New  2nd  Edition:  By  Kathleen  G.  Andreoli,  R.N..  B.S.N. .  M.S.N. :  Virginia  K.  Hunn, 
R.N.,  B.S.N. ;  Douglas  P.  Zipes,  M.D.;  and  Andrew  G.  Wallace,  M.D.  Best-selling  handbook 
offers  specifics  on  cardiac  function,  cardiac  failure  and  patient  rehabilitation.  New  emphasis  on 
hemodynamic  deterioration:  new  material  on  pacemakers  and  drug  therapy.  August,  1971. 
Approx.  216  pp.,  164  illus.  About  $6.05. 

O  TEXTBOOK  OF  ANATOMY  &  PHYSIOLOGY,  New  8th  Edition:  By  Catherine  Parker 
Anthony,  R.N.,  B.A.,  M.S.  With  the  collaboration  of  Norma  Jane  Kolthoff,  R.N.,  B.S.,  Ph.D. 
Revised  classic  features  new  chapter  on  stress,  fresh  facts  on  the  cell,  the  circulatory  and 
nervous  systems,  new  illustrations,  larger  pages,  full-color  Trans-Vision  •  insert.  April,  1971. 
592  pp.,  320  fig.,  137  in  color,  15-plate  Trans-Vision  ®  insert.  $10.80. 

0>^EDICAL-SURGICAL  NURSING,  New  5th  Edition:  By  Kathleen  N.  Shafer,  R.N.,  M.A.; 
Janet  R.  Sawyer,  R.N.,  Ph.D.:  Audrey  M.  McCluskey,  R.N.,  M.A.,  Sc.M.Hyg.:  Edna  Lifgren 
Beck,  R.N.,  M.A.:  and  Wilma  H.  Phipps,  R.N.,  A.M.  The  preferred  book  on  total  patient  care, 
thoroughly  revised.  New  information  on  nutrition,  preoperative  preparation,  cancer  chemo- 
therapy, cardiac  disease,  drug  abuse,  much  more.  July,  1971.  Approx.  800  pp.,  414  illus. 
$13.40. 


0Mosbv's  COMPREHENSIVE    REVIEW  OF  NURSING,^ 

7th  Edition:  Edited  by  Dorothy  F.  Johnston,  R.N.,  B.S., 
M.Ed.:  with  II  collaborators.  Most  comprehensive,  up-to- 
date,  easy-to-use  review  book  available.  Offers  concise  resume 
of  every  subject  in  basic  program  for  professional  nurses.  Use 
it  to  prepare  for  class  or  board  examinations,  or  as  a 
"refresher  course"  for  a  particular  subject.  Latest  procedures 
in:  Biological  and  Physical  Sciences;  Social  Sciences;  Para- 
clinical  Nursing:  Maternal  and  Child  Health  Nursing;  Mental 
Health  Nursing.  Rewritten  chapters  on  chemistry,  communi- 
cable disease,  psychiatric  nursing:  integrated  OB-GYN  infor- 
mation; medical-surgical  chapter  largely  new.  Updated  answer 
book  free  with  each  copy.  1969.  602  pp.,  24  illus.  $10.45. 


O  REVIEW    OF    HEMODIALYSIS     FOR 
NURSES     AND     DIALYSIS     PERSONNEL, 

New:  By  C.  F.  Gutch,  M.D.:  and  Martha  H. 
Stoner,  R.N.,  M.S.  Timely  discussions  in 
handy  question-and-answer  format.  Brings 
new  information  on:  use  of  hollow  fiber 
artificial  kidney;  dialysis  theory:  delivery 
system;  nursing  problems:  home  dialysis, 
much  more.  August,  1971.  Approx.  208  pp., 
35  illus.  About  $7.90. 

O  LEARNING  MEDICAL  TERMIN- 
OLOGY STEP  BY  STEP,  New  2nd  Edition: 
By  Clara  Gene  Young:  and  James  D.  Barger, 
M.D,,  F.C.A.P.  Best-selling  handbook  revised 
throughout.  All  illustrations  redrawn.  Unique 
3-step  method  teaches  more  than  4000  terms, 
abbreviations,  symbols.  July,  1971.  339  pp. 
39  illus.  $9.35. 


WAN  ATLAS  OF  NURSING  TECH- 
NIQUES, New  2nd  Edition:  By  Norma 
Greenler  Dison,  R.N.,  B.A.  Nurse 's-eye-view 
of  the  most  current  techniques  in  use  of 
Hand-E-Vent  and  Retec  N-30  units,  Teledyne 
oxygen  analyzer,  much  more.  All  illustrations 
new  or  redrawn.  August.  1971.  Approx.  280 
pp.,  593  illus.  About  $9.45. 

®  PRINCIPLES  OF  OBSTETRICS  & 
GYNECOLOGY     FOR    NURSES,    New    2nd 

Edition:  By  Josephine  lorio,  R.N.,  B.S..  M.A. 
Essentials  for  nurse  on  ob-gyn  service.  Discus- 
ses fetal  development,  delivery,  gynecologic 
complications,  pathology.  Fresh  facts  on 
phototherapy  for  jaundice:  Rh  sensitivity 
treatment:  saline-induced  abortion.  May, 
1971.425  pp.,  171  illus.  $9.75. 


©THE  NURSE'S  ROLE  IN  COMMUNITY 
MENTAL  HEALTH  CENTERS.  Out  of  Uni- 
form and  Into  Trouble,  New:  By  Carol  D. 
De Young,  R.N.,  M.S.;  and  Margene  Tower, 
R.N.,  M.S.  Frank,  provocative  look  at  how 
other  disciplines  view  the  psychiatric  nurse. 
February,  1971.  135  pp.  $5.15. 

®  NURSING  CARE  OF  THE  PATIENT 
WITH   GASTROINTESTINAL  DISORDERS, 

New:  By  Barbara  A.  Given,  R.N.,  B.S.N. , 
M.S.:  and  Sandra  J.  Simmons,  R.N.,  B.S.N. , 
M.S.  Today's  only  specialized  presentation  of 
gastrointestinal  nursing  helps  you  provide 
comprehensive  care  for  G.l.  patient.  January, 
1971 .  283  pp.,  70  illus.  $10.50. 


(Di 


NEUROLOGICAL  AND  NEURO- 
SURGICAL NURSING,  5th  Edition:  By  Esta 
Carini,  R.N.,  Ph.D.:  and  Guy  Owens,  M.D. 
Consistently  popular  text  provides  updated 
material  on  blood-brain  barrier,  brain  scan, 
stereotaxic  surgery.  1970.  398  pp.,  122  illus,, 
2  in  color.  $10.80. 

©THE  VITAL  SIGNS,  A  Programmed 
Presentation  Including  Material  on  the  Apical 
Beat:  By  Mary  Elizabeth  Mclnnes,  R.N., 
B.Sc.N.,  M.Sc.fEd.)  Review  important  basics 
and  perfect  your  skills  in  immediate  bedside 
assessment  of  vital  signs.  1970.  107  pp.  $5.20. 

©ORTHOPEDIC  NURSING,  A  Pro- 
grammed Approach:  By  Nancy  A.  Brunner, 
R.N.,  B.S.N,  Review  fundamentals,  refresh 
your  knowledge  of  kinesiologic  and  ortho- 
pedic terminology:  enhance  your  skills  in 
patient  care,  recognition  and  prevention  of 
complications.  1970.  183  pp.,  126  illus. 
$6.05. 


© 


TEAM  LEADERSHIP  IN  ACTION, 
Principles  and  Application  to  Staff  Nursing 
Situations:  By  Laura  Mae  Douglass,  R.N., 
B.A.,  M,S.:  and  Em  Olivia  Bevis,  R,N.,  B.S., 
M.A.  Develop  your  leadership  potential:  mas- 
ter administrative  principles  and  how  to  apply 
them.  Explore  group  dynamics,  delegation  of 
authority,  conferences.  1970.  151  pp.  $5.55. 


© 


INTRODUCTION  TO  MEDICAL 
SCIENCE:  By  Clara  Gene  Young:  and  James 
D.  Barger.  M.D.,  F.C.A.P.  Learn  more  about 
how  and  why  diseases  occur  .  .  .  how  they 
affect  the  body  in  part  or  as  a  whole.  New 
insight  into  neoplasia,  infections,  congenital 
anomalies.  1969.  307  pp.,  11  illus.  $9.40. 


©. 


'CARE  OF  THE  PATIENT  IN  SUR- 
GERY INCLUDING  TECHNIQUES,  4th  edi- 
tion: By  Edythe  L.  Alexander,  B.S.,  M.A., 
R.N.:  Wanda  Burley,  B.S.,  M.A.,  R.N,;  Doro- 
thy Ellison,  B.A.,  M.A.,  R.N.;  and  Rosalind 
Vallari,  B.S.,  M.A.,  R.N.  Explicit,  up-to-date 
information  for  O.R.  nurse,  or  R.N.  aspiring 
to  become  one.  1 967.  91 6  pp.,  621  illus.,  5  in 
color.  $20.25. 


THE 

MOSBY 

GUARANTEE  OF 

SATISFACTION 


Complete,  detach  and  mail  today 

Only  YOU  can  determine,  after  careful 
examination,  whether  a  particular  book 
can  help  you  in  your  career.  Therefore, 
each  book  may  be  ordered  on  30-dav 
approval.  If  any  book  does  not  meet 
your  expectations,  merely  return  it  for 
full  credit  or  refund  withm  30  days  after 
date  of  shipment. 


Please  send  me  on  30-day  approval  the  book(s)  whose  number(s) 
I  have  circled  at  right. 

Name 


Address  . 


City  _ 
Zone  . 


1  4144  THE  PHYSIOLOeiC  AND 

PHARMACOLOaiC  lASIS  OF 
CORONARY  CARE  NURSING,  itX 

1  1411  CURRENT  CONCEPTS  IN  CLINICAL 
NURSING,  Vol.  Ill,  abMtS1S.2S 

]  0249  COMPREHENSIVE  CARDIAC  CARE,  2iHl 
tdilion,  ilKWt  KJIi 

4  02S3  TEXTBOOK  OF  ANATOMY  t 
PHYSIOLOGY.  IthMtition.SIO.IO 

9  4SI5  MEDICAL  SURGICAL  NURSING,  Stil 
edition,  $13.40 

I  3K7  Mosbv's  COMPREHENSIVE  REVIEW  OF 
NURSING.  7tli  aditien,  $10.4S 

7  tM2  REVIEW  OF  HEMODIALYSIS  FOR 

NURSES  AND  DIALYSIS  PERSONNEL, 
abwit  S7.90 

I  StSt  LEARNING  MEDICAL  TERMINOLOGY 
STEP  BY  STEP.  2nd  •dititn.  SUS 

I  1306  AN  ATLAS  OF  NURSING  TECHNIQUES, 
2iriidiliM,ikMtii.4i 


10  233C  PRINCIPLES  OF  OBSTHRICS  t, 

GYNECOLOGY  FOR  NURSES, 
2nd  edition,  (9.75 

11  1277  THE  NURSE'S  ROLE  IN  COMMUNITY 

MENTAL  HEALTH  CENTERS,  ».19 

12  1147  NURSING  CARE  OF  THE  PATIENT 

WITH  GASTROINTESTINAL 
DISORDERS,  ilO.» 

13  0949  NEUROLOGICAL  A  NEUROSURGICAL 

NURSING,  StliaditiM,SIO.«l 

14  3339  THE  VITAL  SIGNS,  S9J0 

19  0137  ORTHOPEDIC  NURSING:  A 

PROGRAMMED  APPROACH.  itM 

It  1439  TEAM  LEADERSHIP  IN  ACTION,  S9J9 

17  9099  INTRODUCTION  TO  MEDICAL 
SCIENCE,  U.40 

II  0102  CARE  OF  THE  PATIENT  IN  SURGERY 
INCLUDING  TECHNIQUES.  4tli  i 


-Province  . 


news 


"Old  Hands"  Group 
To  Meet  In  Fall 

Ottawa  —  A  meeting  of  retiring  Cana- 
dian Nurses'  Association  board  mem- 
bers, the  chairmen  of  CNA's  three 
standing  committees,  and  the  chairman 
of  the  CNA  special  committee  on  nurs- 
ing research,  is  planned  for  September 
27-28  at  CNA  House. 

The  meeting  grew  out  of  discussion 
at  the  spring  CNA  board  of  directors' 
meeting  as  a  method  of  utilizing  the 
expertise  board  members  gained  during 
their  two-year  term  of  office.  At  that 
time  the  board  thought  such  a  group 
could  meet  simultaneously  with  the 
armchair  conference  for  "innovative 
thinkers."  (See  CNA  annual  meeting 
report,  April,  p. 36.) 

CNA  president  E.  Louise  Miner 
thought  some  of  the  ideas  emerging 
from  the  "old  hands"  group  would 
provide  valuable  reference  for  the  arm- 
chair conference.  Thus,  the  president 
directed  their  meeting  to  be  held  before 
the  conference  so  the  views  of  these 
experienced  board  members  could  be 
the  base  from  which  projections  for  the 
future  might  be  considered. 

Invited  to  attend  the  meeting  are 
past  presidents;  Monica  Angus,  Reg- 
istered Nurses'  Association  of  British 
Columbia;  Geneva  Purcell,  Alberta 
Association  of  Registered  Nurses;  Mad- 
ge McKillop,  Saskatchewan  Registered 
Nurses'  Association;  Laura  Butler, 
Registered  Nurses'  Association  of  On- 
tario; and  Helen  Taylor,  retiring  presi- 
dent of  the  Association  of  Nurses  of  the 
Province  of  Quebec. 

Committee  chairmen  invited  to  attend 
are:  Marilyn  Brewer,  social  and  eco- 
nomic welfare  committee;  Irene  Bu- 
chan,  nursing  service  committee;  Alice 
Baumgart,  nursing  education  commit- 
tee; and  Dr.  Shirley  Stinson,  nursing 
research  committee. 


Nova  Scotia  Nurses  Ratify 
Four  Collective  Agreements 

Halifax.  N.S. — Four  more  contracts 
have  been  settled  recently  by  nurses' 
staff  associations  in  Nova  Scotia.  This 
makes  12  agreements  currently  in  effect 
in  the  province. 

At  Colchester  Hospital,  Truro,  nurses 
formed  a  staff  association  in  1969  and 
became  certified  in  April.  1970.  In 
September,  1970,  the  association  began 
negotiations  with  their  hospital  board 

SEPTEMBER  1971 


There's  Toronto  Sick  Kids  And  Then  There's  . . . 


Muffet  Frost,  who  loves  animals  and  whose  husband  is  allergic  to  both  cats  and 
dogs,  raises  goats,  said  a  photo-story  in  the  June  bulletin  of  the  Toronto  Hos- 
pital For  Sick  Children.  Her  tiny  pet  is  a  tremendous  hit  when  he  visits  the 
hospital.  Children  aren't  the  only  ones  who  get  a  chuckle  from  the  goat.  Mrs. 
Frost  said,  "My  baby  goat  Rocquefort  came  to  visit  the  children  in  the  play- 
room. On  the  way  up  in  the  elevator  a  visiting  father  looked  speculatively  at  us 
for  a  moment.  'Well,'  he  said,  "I've  heard  of  Sick  Kids  but  1  never  thought  I'd 
see  one.  What  ward  is  he  going  to?'  " 


that  continued  all  winter.  Conciliation 
services  were  requested  and  received 
from  the  provincial  department  of  la- 
bor. 

Agreement  was  reached  on  June  1, 
1971,  with  more  than  70  nurses  at  Col- 
chester Hospital  covered  by  the  agree- 
ment. The  highlights  are  the  provision 
of  a  grievance  and  arbitration  proce- 
dure, the  establishment  of  a  committee 
to  improve  communications,  premiums 
for  on  call,  call  back,  overtime,  educa- 
tion, and  an  additional  week's  vacation 
after  five  years  service.  The  contract 
will  terminate  in  December  1972  with 
salaries  for  1972  to  be  negotiated  at  the 
end  of  this  year.  Present  salaries  arc 
comparable  to  other  signed  agreements 
in  the  province. 

More  than  150  nurses  belong  to  the 
staff  association  formed  in  early  1970 
and  certified  in  June.  1 970,  at  Aberdeen 


Hospital,  New  Glasgow.  The  agreement 
is  similar  to  the  Colchester  one  but  the 
additional  week's  vacation  applies  after 
nine  and  one-half  years'  service.  The 
contract  terminates  in  December,  1971. 

At  Payzant  Memorial  Hospital, 
Windsor,  the  nurses'  staff  association 
ratified  a  proposed  collective  agreement 
on  June  30,  1971,  to  be  signed  at  a 
later  date.  More  than  38  full-time  and 
part-time  nurses  work  at  this  hospital. 
They  organized  early  in  1970  and  were 
certified  in  July. 

Negotiations  at  Payzant  were  carried 
on  for  almost  a  year  and  were  concluded 
with  the  assistance  of  a  department  of 
labour  conciliator.  The  association 
agreed  to  a  two-year  contract.  Salaries 
will  be  negotiated  yearly.  The  salary 
and  contract  is  similar  to  other  signed 
agreements  in  Nova  Scotia. 

The  nurses'  staff  association  at  Cape 

THE  CANADIAN  NURSE     9 


news 


Breton  Hospital,  Sydney  River,  has 
ratified  a  collective  agreement  with  the 
hospital  board  after  short  but  productive 
negotiations.  The  agreement  covering 
more  than  30  nurses  will  be  for  1971. 
The  contract  is  similar  to  ones  negotiat- 
ed by  other  Nova  Scotia  nurses'  staff 
associations. 

Two  other  staff  associations,  at 
Halifax  County  Hospital,  Cole  Har- 
bour, and  at  Glace  Bay  General  Hos- 
pital, Glace  Bay,  have  been  certified 
and  have  served  notice  to  negotiate. 
Six  other  nurses'  staff  associations  are 
at  the  organizational  stage  and  will 
make  a  total  of  20  nurses'  staff  associa- 
tions certified  in  the  province. 

ICN  Supports  Family  Planning 
As  Basic  Human  Right 

Dublin,  Ireland  —  Parents  have  a  basic 
human  right  to  determine  freely  and 
responsibily  the  number  and  spacing  of 
their  children.  Part  of  the  nurse's  role 
is  to  assist  whenever  possible  in  the 
implementation  of  this  right.  This  reso- 
lution was  approved  by  the  Council  of 
National  Representatives  of  the  Inter- 
national Council  of  Nurses,  meeting 
from  July  26  to  30,  1971. 

Over  90  nurses  attended  the  meeting, 
representing  53  of  the  74  national 
nurses'  associations  belonging  to  the 
ICN.  E.  Louise  Miner,  president  of  the 
Canadian  Nurses'  Association,  and 
Helen  K.  Mussallem,  executive  direc- 
tor, represented  the  CNA. 

The  CNR  also  adopted  a  resolution 
that  the  ICN  endorse  the  Universal 
Declaration  of  Human  Rights,  and  re- 
quest its  member  associations  to  take 
steps  to  support  and  implement  the 
objectives  of  the  United  Nations'  Dec- 
laration of  Human  Rights. 

In  an  interview  with  The  Irish  Times, 
Margrethe  Kruse,  president  of  the  ICN, 
said  that  passing  of  the  two  resolutions 
on  human  rights  were  by  far  the  most 
important  actions  taken  by  the  CNR  at 
the  Dublin  meeting. 

During  the  first  three  days  of  the 
meeting,  the  CNR  considered  the  report 
of  a  study  of  ICN  objectives,  structure 
and  function,  prepared  by  the  inter- 
national management  firm  of  Cresap, 
McCormick  and  Paget.  The  report, 
which  advocates  major  changes  in  ICN 
objectives,  membership  base,  and  struc- 
ture, provoked  lively  debate  among 
delegates. 

The  consultants'  report  was  referred 
to  member  associations  for  study  and 
comment  as  a  matter  of  urgency.  It  is 
anticipated  that  the  report  will  be  dis- 
10     THE  CANADIAN  NURSE 


Enjoying  some  informal  discussion  at  a  reception  and  banquet  held  in  Dublin  at 
the  end  of  a  four-day  meeting  in  July,  are  three  delegates  of  the  Council  of  Nation- 
al Representatives  of  the  International  Council  of  Nurses:  E.  Louise  Miner, 
center,  president  of  the  Canadian  Nurses'  Association;  Jacqueline  Lightbourne, 
left,  president  of  the  Bermuda  Nurses'  Association;  and  Sister  M.  Eucharia,  right, 
of  the  Irish  Guild  of  Catholic  Nurses  in  Dublin. 


cussed  at  the  next  meeting  of  the  CNA 
board  of  directors. 

Immediate  merger  of  two  ICN  publi- 
cations. International  Nursing  Review 
and  ICN  Calling,  into  a  bi-monthly 
magazine  was  approved  by  the  CNR. 

The  next  meefing  of  the  CNR  will 
be  held  during  the  ICN  quadrennial 
in  Mexico  City,  May  13-19,  1973. 

Nurses'  Function 
Should  Develop 

Truro,  N.S.  —  Caring,  as  used  in  the 
theme  "Caring  —  the  Challenge  and 
the  Reward"  at  the  62nd  annual  meeting 
of  the  Registered  Nurses'  Association 
of  Nova  Scotia,  refers  to  the  unique 
function  of  nursing,  Jean  MacLean, 
RNANS  advisor  in  nursing  service, 
told  delegates  attending  the  June  meet- 
ing. 

"The  term,  and  therefore  the  unique 
function,  must  change  and  adjust  since 
society  needs  change  and  since  a  pro- 
fession develops  and  exists  to  meet  a 
need  in  society." 

Miss  MacLean  said,  "as  hospitals 
developed  in  complexity,  the  need  for 
compassion  increased,  as  well  as  the 
need  for  a  great  deal  of  knowledge  and 
skill  in  applying  this  compassion.  The 
knowledge  explosion  makes  caring  more 
complex." 

The  new  curricula  in  both  diploma 


and  degree  programs  are  planned  for 
a  broader  interpretation  of  caring  than 
would  have  been  possible  even  a  few 
years  ago  she  said. 

Asking  delegates  to  consider  whether 
there  is  imminent  need  of  further  broad- 
ening and  clarification  of  the  term  car- 
ing Miss  MacLean  said,  "is  a  respon- 
sible profession  not  entitled  to  some 
autonomy  and  some  consultation  about 
policies  which  affect  it  and  its  role? 

"In  Nova  Scotia  a  health  council 
was  set  up  in  1970  by  the  previous 
government  and  included  a  represent- 
ative from  our  provincial  association. 
The  change  in  government  came  about 
before  there  was  an  opportunity  for 
this  council  to  meet. 

"The  new  council,  as  amended  by 
the  new  minister,  does  not  specify  a 
representative  from  RNANS.  .  .  .  There 
is  no  guarantee  that  we  will  be  included 
even  though  we  are  the  largest  in  num- 
ber. 

"Do  we  care  enough  to  fight  for  such 
a  seat?  Are  we  united  enough,  strong 
enough,  courageous  enough?  Are  we 
using  the  support  which  could  be  ob- 
tained from  one  another  as  members 
of  this  large  association? 

"Our  association  has  always  assumed 
a  protective  role  for  the  consumer  of 
nursing  by  setting  minimum  standards 

(Continued  on  pone  13) 

SEPTEMBER  1971 


PACK  UP 

YOUR  TROUBLES 

WITH 


Ensemble 
de  Champs 


^c(m«m.*flo|m*on 


The  big  advantage  of 
BARRIER"  Drape  Packs  is  that 
they  do  a  better  job  —  they  eliminate 
moisture  penetration  and  bacteria!  migration, 
because  BARRIER*  Drape  Packs  are  moisture  proof. 

But  another  important  advantage  of  BARRIER  *  Drape 
Packs  is  that  they  are  disposable.  You  eliminate  laundry 
inspection,  folding,  sorting,  mending,  wrapping  and 
autociaving.  The  savings  in  cost,  time  and  space  can 
be  immense. 

With  performance,  convenience,  disposability  and 
economy,  BARRIER  *  Drape  Packs  are  a  great  way  to 
pack  up  your  draping  troubles. 


MONTREAL*  TORONTO -CANADA 

Trademark  of  Johnson  ft  Johnson  or  affiliated  companiea. 


^M' 


Npw  that  SofraTulle' 
jn  individual  packs 
ishere^ 


creams  and 
ointments  covered 
with  dressings  are 
going  to  seem 

old-fdshioned. 


It's  easy  to  see  why. 

Sof  ra-Tulle  Pieces  are  bactericidal 
dressings  which  are  individually  foil  sealed 
to  maintain  sterility.  Each  dressing 
stays  sterile  until  the  moment  of  use. 

Unlike  creams  and  ointments, 
Sof  ra-Tulle  provides  even  distribution  of 
the  antibiotic  and  excellent  mechanical 

MEMBEn 

I PMAC I 

♦Reg.  Can.  T.M.  Off. 
For  full  prescribing  information,  please  see  page  13 


protection  for  conditions  such  as  burns, 
ulcers  and  infected  skin  lesions. 

Sheathed  in  parchment,  they  are  clean 
and  easy  to  handle,  cut  and  shape.  Moreover, 
there's  none  of  the  mess  and  waste  you  get 
from  squeezing  tubes  or  digging  into  jars. 

Old-fashioned  creams  and  ointments 
are  out.  New  Sof  ra-Tulle  Pieces  are  in. 


ROUSSEL 


Roussel  (Canada)  Ltd. 

153  Graveline 
Montreal  376,  Quebec 


SofraTulle* 

Bactericidal 

Dressing. 


COMPOSITION 

A  lightweight  lano-paratRn  gauze 
dressing  impregnated  with  1% 
Soframycin. 

INDICATIONS 

Traumatic:  Lacerations,  abrasions, 
grazes  (gravel  rash),  bites  (.animal 
and  insect ),  cuts,  puncture  wounds, 
crush  injuries,  surgical  wounds  and 
incisions,  traumatic  ulcers. 
Ulcerative:  Varicose  ulcers,  diabetic 
ulcers,  bedsores,  tropical  ulcers. 
Thermal:  Burns,  scalds. 
Elective:  Skin  grafts  (donor  and 
recipient  sites),  avulsion  of  finger  or 
toenails,  circumcision. 
Miscellaneous:  Secondarily  infected 
skin  conditions-e.g.,  eczema, 
dermatitis,  herpes  zoster ;  colostomy, 
acute  paronychia,  incised  abscesses 
(packing),  ingrowing  toenails. 

CONTRA-INDICATIONS 

Allergy  to  lanolin  or  to  Soframycin. 
Organisms  resistant  to  Soframycin. 

APPLICATION 

If  required,  the  wound  may  first  be 
cleaned.  A  single  layer  of  Sof  ra-TuUe 
should  be  applied  directly  to  the  wound 
and  covered  with  an  appropriate 
dressing  such  as  gauze  linen  or  crepe 
bandage.  In  the  case  of  leg  ulcers,  it  is 
advisable  to  cut  the  dressing  exactly 
to  the  size  of  the  ulcer  in  order  to 
minimise  the  risk  of  sensitisation  and 
not  to  overlap  on  the  surrounding 
epidermis.  When  the  infective  phase 
has  cleared  the  dressing  may  be 
changed  to  a  non-impregnated  one. 
When  the  lesion  is  very  exudative  it  is 
advisable  to  change  the  dressing  at 
least  once  a  day. 

PRECAUTIONS 

In  most  cases  absorption  of  the 
antibiotic  is  so  slight  that  it  can  be 
discounted.  Where  very  large  body 
areas  are  involved  (e.g.  SO'/c  or  more 
body  burn )  the  possibility  of  oto- 
toxicity and  or  nephrotoxicity  being 
produced,  should  be  remembered. 

PACKINGS 

Cartons  of  10  units ;  each  unit  pack 

contains  one  sterile  antibiotic  gauze 

dressing  10  cm  x  10  cm. 

Also  available : 

Tins  of  10  pieces :  4"  x  4". 

Tins  of  one  strip :  4"  x  40". 

Complete  information  available  on  request 

•Reg.  Can. 
T.M.  Off. 


news 


ROUSSEL 


Roussel  (Canada)  Ltd. 

153  Graveline 
Montreal  376,  Quebec 


tContiniivd  from  paf>e  lOl 

for  education  and  practice.  Perhaps 
the  public  has  a  right  to  expect  more 
than  this  kind  of  rather  passive  protec- 
tion from  a  professional  association,"" 
said  Miss  MacLean. 

RNANS  president  Joan  Fox  said  the 
first  classes  of  the  new  two-year  diploma 
program  will  graduate  this  year.  She 
hoped  that,  "for  the  solidarity  of  our 
profession  and  the  delivery  of  proper 
health  care  you  will  accept  them  and 
help  them. 

■"One  of  the  benefits  of  nursing  exper- 
ience is  that  we  have  learned  that  help 
is  a  two-way  street,""  she  said.  "In  our 
tradition  as  nurses  we  expect  to  help 
our  new  graduates,  but  we  also  expect 
that  they  will  help  us  ...  as  they  bring 
their  youthful  enthusiasm  and  their 
background  of  a  new  type  of  nursing 
education,  we  can  learn  from  them.  In 
this  way,  our  whole  profession  will  be 
strengthened,"'  said  Mrs.  Fox. 

SRNA  Staff  Tried 
Four-day  Work  Week 

Regiiui.  Sask.  — The  1 1  member  staff 
of  the  Saskatchewan  Registered  Nurses" 
Association  experimented  with  a  four- 
day  work  week  during  the  summer.  The 
experiment  continued  until  Labor  Day 
and  results  will  be  reported  to  the  asso- 
ciation"s  governing  council. 

From  the  beginning  of  June,  the  five 
registered  nurses  and  six  secretarial 
staff  at  the  association  office  worked 
their  usual  36  1/4  hours  per  week  in 
four  days.  The  experimental  working 
day  was  from  7:25  a.m.  to  noon  with  a 
halfhour  off  for  lunch  and  then  continu- 
ed to  5  p.m.  Before  the  trial  the  day  ran 
from  8:30  a.m.  to  noon  and  from  1:15 
p.m.  to  5  p.m. 

Days  off  were  staggered  with  most 
of  the  staff  off  Saturday  and  Sunday 
one  week  and  off  Friday,  Saturday, 
Sunday.  Monday  the  following  week. 
Two  nurses  and  a  secretary  were  on  a 
different  rotation  taking  Friday,  Satur- 
day, and  Sunday  off  each  week. 

The  office  was  open  five  days  a  week 
with  longer  continuous  hours  because  of 
the  nevy  schedule.  Prior  to  the  experi- 
ment the  office  closed  at  noon  hour. 
There  were  no  complaints  from  SRNA 
members. 

Alice  Mills,  executive  secretary  of 
the  association,  said  there  seems  to  be 
a  trend  toward  the  shorter  work  week. 
In  the  United  States  where  it  has  been 
tried  there  are  indications  that  it  in- 
creased morale  and  productivity,  said 
Miss  Mills. 

Ann  Sutherland,  employment  rela- 


tions officer,  in  a  July  Regina  Leader- 
Post  article,  was  quite  definite  about 
the  advantages  of  the  four-day  week. 
She  can  see  this  work  week  being  ap- 
plied for  nurses  in  hospitals. 

Mrs.  Sutherland  thought  it  was  a 
good  idea  for  the  small  nursing  associa- 
tion office  to  try  the  system.  "Nurses 
are  always  tarred  with  the  conservative 
brush  so  this  was  a  major  step  on  the 
part  of  the  governing  body  to  try  it  for 
three  months."" 

A  plus  point  to  her  was  the  fellow- 
ship that  grew  between  the  secretarial 
and  professional  staff.  There  were 
fewer  people  in  the  office  at  any  one 
time  and  both  groups  had  coffee  breaks 
and  lunch  together. 

SRNA  registrar  Edna  Dumas  thought 
she  would  be  one  of  the  least  optimistic 
voices  when  the  future  of  the  system 
is  discussed  at  a  council  meeting.  She 
admits  her  opinion  is  influenced  by  the 
changes  she  has  seen  in  nursing  condi- 
tions over  the  years. 

When  she  graduated  as  a  registered 
nurses  in  1939,  a  nurse  had  one  day 
off  a  week  and  a  student  nurse  half  a 
day.  "And  we  just  accepted  it.  I  think 
being  tired  is  a  relative  thing,""  said 
Mrs.  Dumas  predicting  that  when  the 
work  week  is  reduced  to  30  hours  peo- 
ple will  still  feel  tired. 

She  said  maybe  she  was  less  enthusi- 
astic about  the  system  because  she  is 
older  than  most  of  the  staff,  "i  find  it 
awfully  early  when  the  alarm  clock 
rings."" 

Secretary  Freda  Weare  said  she 
appreciated  the  extra  day  off.  "During 
the  first  week  I  was  rather  tired  from 
the  longer  day  but  I  have  adjusted  now 
and  I  don"t  feel  tired  at  all.""  The  tryout 
system  required  teamwork  said  Mrs. 
Weare,  "I  had  to  absorb  the  work  of 
other  secretaries  and  they  did  the  same 
for  me."" 

Another  working  mother,  book- 
keeper Irene  Dahl,  said  she  had  more 
time  to  spend  with  her  three  small  chil- 
dren. Veronica  Jacobsen,  a  secretary, 
said  the  summertime  arrangement  gave 
her  more  time  to  spend  outdoors.  "I'm 
all  for  it,"'  said  Irene  Kajewski,  a  typist, 
for  it  gave  her  more  time  to  spend  with 
her  family  and  she  had  no  problem 
keeping  up  with  her  work. 

Neuro  Nurses  Meet 
In  Newfoundland 

Sr.  John's.  Nfld.  —  Slides,  films,  tapes, 
and  a  display  of  neuro  aids  were  part  of 
the  scientific  program  of  the  second 
annual  meeting  of  the  Canadian  Asso- 
ciation of  Neurological  and  Neuro- 
surgical Nurses  held  in  conjunction  with 
the  sixth  annual  meeting  of  the  Cana- 
dian Congress  of  Neurological  Sciences. 
President  Maila  Maki,  Toronto, 
discussed  the  philosophy  of  the  neuro 
THE  CANADIAN  NURSE     13 


news 


nurse  and  the  objectives  of  the  asso- 
ciation. Papers  were  presented  by  mem- 
bers during  the  June  16-19  meeting. 

Jessie  Young,  Toronto,  assisted  by 
Marilyn  Reid,  Toronto,  outlined  neuro- 
surgical nursing  care  in  intracranial 
aneurysms.  A  movie  showed  the  intri- 
cate aneurysm  exposed  during  surgery. 

Gem  Killikelly,  Toronto,  discussed 
the  abstract  problem  of  pain  in  a  paper 
entitled,  "nursing  care  of  patients  with 
intractable  pain."  She  noted  that  proce- 
dures to  alleviate  pain  are  increasing  in 
the  neurosurgical  field. 

Ferelith  Taylor,  Toronto,  used  slides 
to  illustrate  the  progressive  deteriora- 
tion of  a  patient  with  Jakob-Creutzfeldt 
disease.  Sue  Goode,  New  Westminster, 
B.C.,  gave  the  case  history  of  a  patient 
recovering  from  spontaneous  brain 
hemorrhage. 

Guillain-Barre  syndrome  was  de- 
scribed by  Geraldine  Hart,  Lucy  Dali- 
candro,  and  Judy  Harkness,  all  of  the 
Montreal  Neurological  Hospital.  In  a 
patient  study  they  recorded  interviews 
with  the  patient  and  his  family  describ- 
ing their  reactions  to  the  disease. 

Papers  were  also  presented  by  Bonita 
Marshall,  St.  John's,  Nfld.,  Catherine 
MacDonald,  Halifax,  N.S.,  Lesley  Mc- 
Donald, Winnipeg,  Man.,  and  Leslie 
Lewis,  Kingston,  Ont.  Displays  were 
presented  by  Mary  Allen,  Toronto, 
and  Gayle  VanderZee,  Toronto. 

Elected  to  the  board  of  directors  were 
Jacqueline  LeBlanc,  Montreal,  presi- 
dent ;  Sue  Goode,  president-elect ;  Geral- 
dine Hart,  Montreal,  secretary;  Alice 
Walborn,  Toronto,  treasurer.  The  third 
annual  meeting  will  be  held  in  Banff, 
Aha.,  in  June  1972. 

Three  Sudbury  Nurses 
Win  Hospital  Settlement 
After  13  Months' Fight 

Ottawa  —  Three  registered  nurses, 
dismissed  last  year  from  St.  Joseph's 
Hospital  in  Sudbury,  Ontario,  for  alleg- 
ed insubordination,  were  reinstated  in 
July  1971,  13  months  after  their  dis- 
missal. The  settlement  awarded  the 
nurses  $20,000,  amounting  to  75  per- 
cent of  their  lost  salary,  and  reinstated 
them  with  a  record  of  unbroken  service. 
It  was  only  after  taking  their  case 
to  a  member  of  the  Ontario  Legislature, 
to  the  Ontario  Hospital  Services  Com- 
mission, and  to  the  Registered  Nurses' 
Association  of  Ontario  that  the  settle- 
ment was  reached  between  Hamilton 
labor  consultant  William  Walsh  — 
representative  for  the  three  nurses  — 
and  the  hospital's  lawyers. 

14     THE  CANADIAN  NURSE 


Labor  consultant  William  Walsh  won  a  voluntary  settlement  for  these  three  Sud- 
bury nurses  dismissed  from  St.  Joseph's  Hospital  in  June  1970.  From  left  to  right 
they  are  Vane  Shanahan,  the  acting  head  nurse  on  the  ward  at  the  time  of  the 
incident  that  led  to  the  dismissal;  Mr.  Walsh,  the  nurses'  representative  chosen  by 
the  RNAO;  Elizabeth  Storie,  a  registered  nurse  who  had  graduated  first  in  hei 
class  at  Jt.  Joseph's  school  of  nursing  the  year  before  her  dismissal;  and  Lillian 
Appleby,  an  RN  at  the  hospital  for  the  past  15  years. 


RNAO  recruited  a  tough  bargainer 
in  Mr.  Walsh,  a  well-known  Canadian 
trade  union  consultant  and  the  man  who 
was  instrumental  in  settling  last  year's 
postal  strike.  And  it  looks  as  though 
his  days  of  negotiating  for  nurses  are 
just  beginning. 

In  an  interview  with  The  Canadian 
Nurse,  Mr.  Walsh  said  that  from  his 
limited  experience  with  nurses,  "the 
problem  is  their  own  traditions  of  dedi- 
cation. They  have  been  misused  and 
taken  advantage  of.  They  have  shared 
with  many  other  professional  groups 
the  idea  that  because  they  are  profes- 
sional, they  owe  allegiance  beyond  the 
call  of  duty." 

Mr.  Walsh  also  sees  discrimination 
against  women  as  an  important  element 
in  nurses'  low  salaries.  "They  are  only 
beginning  to  realize  they  have  a  lot  of 
ground  to  catch  up  on."  Not  surprising- 
ly, he  strongly  believes  that  this  can 
happen  only  through  organizing.  But 
he  adds,  "Collective  bargaining  is  still 
a  new  concept  for  nurses." 

Mr.  Walsh  calls  the  Sudbury  settle- 
ment a  landmark  case  that  illustrated 
what  can  happen  when  hospital  nurses 
have  no  internal  organization  to  help 
them.  A  nurses'  association  has  since 
been  formed  at  the  hospital. 

At  the  time  of  the  dismissal,  Mr. 


Walsh  said  the  three  nurses  were  trying 
to  look  after  an  unusually  large  number 
of  postoperative  patients.  After  several 
days  of  working  overtime  and  not  get- 
ting the  relief  help  they  asked  for,  the 
acting  head  nurse  told  the  nursing  office 
that  the  three  nurses  would  quit  at  10:00 
A.M.  if  they  did  not  get  extra  help. 
Although  they  did  not  get  help,  they 
finished  their  shift  and  again  worked 
overtime.  Shortly  after,  they  were  dis- 
missed for  "insubordination." 

The  nurses  were  refused  a  hearing, 
but  continued  to  fight.  Other  nurses  at 
the  hospital  voluntarily  signed  a  petition 
protesting  the  dismissal,  which  they 
presented  to  the  hospital.  And  10 
months  after  the  dismissal  a  march 
was  held  in  support  of  the  nurses. 

Finally,  the  chairman  of  the  OHSC 
persuaded  the  hospital  administration 
to  agree  to  an  impartial  arbitrator.  In 
March  1971,  the  hospital  selected  an 
arbitrator  and  Mr.  Walsh  was  asked  to 
represent  the  nurses.  He  explains  that 
a  voluntary  hearing  is  a  new  concept 
in  labor. 

In  Sudbury,  Mr.  Walsh  interviewed 
some  30  persons:  the  regular  head  nurse 
who  had  been  away  at  the  time  of  the 
dismissal,  a  nursing  supervisor,  staff 
nurses  on  the  shifts  before  and  after  the 

{Continued  on  page  16) 
SEPTEMBER  1971 


We'll  make  a  donation  to  the 
hospital  fund  of  your  choice, 


on  our  50th  anniversary  in  Canada 


Simply  enter  this  little  contest. 
The  first  correct  entry  drawn,  wins. 
And  a  five  hundred  dollar  donation 
will  be  sent  in  the  winner's  name  to 
the  hospital  fund  selected.  A  small 
gesture  that  could  help  someone. 
But  that  is  only  the  beginning.  Expe- 
rience and  reliable  surgical  products 
help  too.  At  Smith  &  Nephew 
we've  got  both  —  fifty  years  expe- 
rience in  quality  products.  Below 
are  just  four  of  the  many  aimed  at 
helping  you  and  your  patient.  And 
the  way  to  that  donation. 

1.  Plastazote: 

Plastazote  is  a  strong,  resilient, 
thermoplastic  material  for  making 
and  fitting  splints  and  supports 
by  direct  moulding.  It  can  be  cut  to 
shape  or  when  warm  moulded  to 
fit  any  body  contour.  And  it  sets 
within  minutes  to  form  a  semi-rigid 
shell  that  cushions,  pads  and  protects. 
Soft  and  comfortable  for  the  pa- 
tient, Plastazote  is  excellent  for  a 
wide  range  of  orthopaedic  con- 
ditions. 

2.  Elastoplast  Airstrip 
Patchettes: 

After  injections,  blood  samplings 


and  in  the  treatment  of  small  cuts, 
wounds  and  abrasions,  Elastoplast 
Airstrip  Patchettes  are  the  effective 
waterproof  plastic  dressings  to 
aid  healing  and  reduce  the  risk  of 
infection.  While  allowing  the  skin  to 
'breathe',  the  small  pores  prevent 
water  penetration  and  act  as  a  bac- 
terial filter,  giving  maximum 
protection. 

3.  Elastoplast  Dressing 
Strip: 

A  versatile  porous  elastic  adhesive 
dressing  permitting  strips  to  be  cut 
according  to  the  size  of  the  wound 
- —  ideal  for  small  or  large  abrasions, 
wounds  and  incisions.  A  unique 
plastic  net  film  separates  the  med- 
icated pad  from  the  surface  of 
the  wound  to  prevent  adherence  and 
promote  natural  healing.  Available 
in  1  yd.  and  5  yd.  lengths,  in  1  Vi", 
2'/2"  and  3"  widths. 

4.  Elastoplast  'Airstrip' 
Wound  Dressing: 

The  Elastoplast  'Airstrip'  Water- 
proof Microporous  Plastic  Wound 
Dressing,  size  3'/2"  x  IVz".  is  ideal 
for  the  less  extensive  injuries  treated 


by  the  score  in  emergency  depart- 
ments such  as  punctures,  deep  cuts 
or  small  lacerations.  May  be  left 
undisturbed  for  long  periods  without 
severe  maceration  to  the  skin. 


Apply  the  four  dressings  listed 
to  our  patient  by  entering  the  appro- 
priate dressing  number  (1.2,3 
and  4)  in  the  circles  provided.  Fill 
in  your  name  and  mail  the  page 
to  Smith  &  Nephew  Ltd.  First  cor- 
rect entry  selected  wins.  Entries 
must  be  postmarked  no  later  than 
September  30th,  1971. 


(Registered  Nurses) 
Address: 

Hospital  Fund  Selected: 


SMITH  &  NEPHEW  LTD. 

2100-52na  Avenue.  Lachine. Quebec 


Dress  our  best  dressed  patient. 


(Continued from  page  14) 

three  nurses,  doctors,  patients,  nursing 
consultants,  and  nursing  teachers  at  the 
university.  He  found  it  necessary  to 
subpoena  1 5  witnesses  to  appear  at  the 
hearing  called  for  July  13,  1971. 

Shortly  before  the  hearing,  Mr.  Walsh 
was  told  the  hospital  would  not  proceed 
with  it.  Instead  of  telling  the  nurses 
about  the  hospital's  decision,  he  arrang- 


ed a  press  conference  and  prepared 
literature  to  send  to  unions  across  the 
country.  "Once  the  hospital  lawyers 
realized  we  were  going  to  blast  this 
thing,  they  wanted  to  negotiate,"  he 
explained.  Then  he  made  it  clear  there 
would  be  no  settlement  without  the 
complete  clearing  of  the  nurses,  their 
reinstatement,  and  financial  payment. 

"The  hospital  was  compelled  to  rec- 
ognize that  the  nurses  did  have  a  re- 
sponsibility to  their  patients  that  was 
greater  than  any  remark  a  nurse  made," 
Mr.  Walsh  said.  Thus  the  employer 
recognized  the  nurse's  right  to  question 
what  she  considers  unsafe  staffing. 


instant 
prints 
witiinnt 


HOLLISIER 


disposable  FOOIPRINIER 


Now  you  can  get  perfect  footprints  of  the  newborn 
more  easily  then  ever  before.  Hollister's  Disposable 
FootPrinter  contains  just  the  right  amount  of  Ready- 
Rolled*  Ink  for  two  baby  footprints  and  a  correlating 
printof  the  mother's  thumb  or  finger.  To  use,  lift  from 
dispenser  box,  apply  to  skin,  make  your  print,  and  dis- 
pose of  the  FootPrinter.  You  get  good  prints  fast-with- 
out the  mess  of  old-fashioned  ink-and-roller  methods. 


B 


Write,  using  hospital  or 
professional  letterhead,  and  ask  for 
free  samples  of  Hollister's  Disposable  FootPrinter 
to  try  in  your  delivery  room 


HOLLISTER 

HOLLISTER  INC..  211  EAST  CHICAGO  AVE.,  CHICAGO,  ILL.  60611 
IN  n.s.».  IN  CANADA,  HOLLISTER  LIMITED 


16     THE  CANADIAN  NURSE 


Quebec  Nurses  Won't  Pay 
For  Unemployment  Insurance 

Quebec  City,  Quebec  —  An  amend 
ment  to  the  Quebec  public  service  law 
recently  passed  in  the  provincial  legis 
lature  exempts  hospital  employees 
including  nurses,  and  teachers  from  thf 
new  provisions  of  the  federal  govern- 
ment's unemployment  insurance  act. 

The  Quebec  Minister  of  Labour  anc 
Manpower  Jean  Cournoyer  presented 
the  legislation  because  federal  Minister 
of  Labour  Bryce  Mackasey  refused  to 
exclude  these  semi-public  employees 
from  the  revamped  act.  Using  powers 
granted  under  the  Canadian  constitu- 
tion, the  Quebec  government  opted  out 
of  the  scheme. 

Quebec  considers  that  since  the  sala- 
ries of  these  two  groups  are  subsidized 
by  the  province,  then  they  are  not  af- 
fected by  the  federal  act.  The  exempt- 
ing of  these  employees  from  the  act  by 
the  province  will  cost  the  federal  fund 
$20  million  in  premiums. 

M.  Cournoyer  said,  "the  government 
of  Quebec  has  no  intention  of  allowing 
these  employees  to  be  subject  to  the 
federal  law  because  their  job  security 
is  a  matter  for  inclusion  in  collective 
bargaining  agreements." 

Nurses  And  Their  Associations 
Will  Provide  More  Leadership 

Saskatoon,  Sask.  —  Nurses  and  nursing 
associations  will  provide  more  leader- 
ship in  the  future  predicted  Madge 
McKillop  in  her  presidential  report  to 
400  delegates  at  the  54th  annual  meet- 
ing of  the  Saskatchewan  Registered 
Nurses'  Association  in  Saskatoon  in 
May. 

"I  see  nurses  more  involved  in  policy- 
making decisions  in  their  own  working 
situations  and  as  members  of  boards  of 
health  agencies,"  said  Miss  McKillop. 
"It  means  that  nurses  will  have  to  exert 
extra  effort  and  to  take  the  responsibili- 
ty involved  in  this  decision-making. 

"Because  of  our  special  prepare- 
tion,  we  should  have  an  understanding 
of  community  needs.  This  understand- 
ing could  be  an  invaluable  asset  in 
government  if  put  to  use  for  the  benefit 
of  the  community  either  locally,  prov- 
incially,  or  nationally. 

"The  de-emphasis  which  should 
occur  in  relation  to  acute  care  and  the 
growing  emphasis  on  the  prevention  of 
illness  and  the  promotion  of  health 
should  mean  that  about  30  percent  of 
the  nursing  force  will  be  employed  in 
the  community  rather  than  in  the  hos- 
pital," said  Miss  McKillop. 

SRNA  appointed  an  ad  hoc  commit- 
tee to  do  preparatory  work  resulting 
from  a  resolution  that  asked  the  prov- 
incial council  to  convene  a  meeting  of 
representatives  of  agencies  concerned 
with  the  delivery  of  health  care  and 

SEPTEMBER  1971 


those  concerned  with  preparation  of 
health  care  personnel.  The  meeting 
would  explore  long-  and  short-range 
goals  for  the  delivery  of  health  care 
services  including  nursing.  Members  of 
the  committee  are  Miss  McKillop, 
Saskatoon;  Angela  Din  Bin  and  Cathe- 
rine O'Shaughnessy,  both  of  Regina. 

Delegates  instructed  SRNA  to  sup- 
port publicly  a  resolution  that  said 
personnel  employed  in  health  care  insti- 
tutions for  direct  patient  care  should 
be  prepared  in  educational  programs 
rather  than  trained  on  the  job. 

The  delegates  also  approved  a  resolu- 
tion that  noted  there  is  no  provision 
for  staff  nurses'  associations  in  the 
present  SRNA  structure,  and  that  SRNA 
give  consideration  to  the  relationship  of 
staff  nurses'  associations  within  the 
provincial  association. 

Ontario  Plans  To  Legalize 
Human  Organ  Transplants 

Toronto,  Ont.  —  Major  health  legisla- 
tion that  would  permit  organ  trans- 
plants between  living  persons  were 
introduced  in  the  Ontario  legislature 
by  Health  Minister  Bert  Lawrence  said 
a  June  Canadian  Press  story. 

A  health  department  spokesman 
said  there  currently  was  no  law  govern- 
ing kidney  transplants  that  are  made 
between  living  persons.  The  new  bill 
makes  such  transplants  legal. 

The  bill,  the  Human  Tissue  Gift 
Act,  would  also  prohibit  a  relative  of  a 
deceased  person  from  countermanding 
consent  given  by  the  deceased  for  a 
hospital  to  use  his  organs  or  tissues  for 
transplants. 

Another  provision  permits  a  hospital 
administrator  to  consent  to  the  removal 
of  a  deceased  person's  organs  for  trans- 
plant if  the  person  died  in  hospital  and 
if  the  administrator  is  unable  to  get  in 
touch  with  relatives  who  have  attained 
the  age  of  majority  or  a  person  lawfully 
in  possession  of  the  body. 

Consent  may  also  be  given  orally 
after  death  by  the  person's  spouse, 
relative,  or  other  person  in  the  presence 
of  at  least  two  witnesses.  It  may  also  be 
given  by  telegraph,  "recorded  telephon- 
ic or  other  recorded  message"  of  the 
spouse,  relative,  or  other  person  such 
as  the  hospital  administrator. 

The  bill  provides  that  the  organs  or 
other  body  parts  may  be  used  for  med- 
ical education  or  scientific  research  in 
addition  to  therapeutic  purposes.  Any 
person  over  the  age  of  majority  in 
Ontario  may  make  postmortem  gifts 
for  transplants. 

The  identities  of  donors  or  recipients 
must  not  be  disclosed  other  than  by  the 
donors  or  recipients  themselves.  The 
bill  provides  for  a  $1,000  fine  for  il- 
legal disclosure. 

Mr.  Lawrence  said  in  an  interview 

SEPTEMBER  1971 


A  Tree  To  Remember  —  Someday  A  Forest 


In  what  has  become  an  annual  event  the  graduating  class  of  the  school  of  nurs- 
ing, Memorial  University,  St.  John's,  Newfoundland,  presented  the  university 
with  a  Norewegian  maple.  The  tree  planting  ceremony  took  place  in  May  near 
the  Arts-Education  building.  Ann  Collingwood  shovels  in  the  first  soil  while 
university  president  Lord  Taylor,  director  of  nursing  Joyce  Nevitt,  staff  mem- 
bers, and  graduates  watch  the  Class  of  '71  tree  installed. 


that  the  disclosure  of  the  identities  of 
persons  involved  in  transplant  opera- 
tions has  been  known  to  have  adverse 
psychological  effects.  "This  could  have 
an  extreme  impact  on  people  who  are 
walking  around  with  bits  and  pieces  of 
you  and  me  in  them,"  he  said. 

He  said  the  legislation  was  drafted 
by  a  committee  of  doctors  and  lawyers 
to  provide  a  balance  between  "legal 
rights  and  medical  necessity." 

Board  Finds  No  Bias 
In  Abortion  Demotion 

Hamilton,  Ont.  —  The  Ontario  Human 
Rights  Commission  has  rejected  a  com- 
plaint by  a  Hamilton  nurse  who  charged 
she  had  been  discriminated  against  by 
the  Henderson  General  Hospital  for 
refusing  to  assist  with  an  abortion  sand  a 
Globe  and  Mail  story,  July  9. 

Frances  Jean  Martin  filed  the  com- 
plaint after  being  demoted  from  head 
nurse  in  the  labor  delivery  unit  to  regu- 
lar duty  nurse  in  the  surgical  ward,  with 
a  pay  cut  of  $80  to  $100  a  month. 

The  commission  ruled  on  July  8, 
after  a  four-month  investigation,  that 
Miss    Martin    was    not    discriminated 


against  because  of  her  Roman  Catholic 
faith.  It  said  the  demotion  was  because 
of  Miss  Martin's  inability  to  carry  out, 
as  an  employee,  lawful  hospital  policy. 

"It  is  the  rightful  expectation  of  hos- 
pital authorities  that  a  nurse  who  is  an 
employee  should  carry  out  those  duties 
to  which  she  is  assigned,"  the  commis- 
sion ruled. 

Last  February,  almost  a  year  after 
the  hospital  started  doing  therapeutic 
abortions.  Miss  Martin  was  scheduled 
to  assist  at  one.  She  refused  and  said 
she  was  transferred  and  demoted  two 
days  later. 

The  commission  said  it  would  ask 
the  hospital  to  readjust  Miss  Martin's 
salary  to  her  former  level  and  to  find 
her  a  position  equivalent  to  the  one  she 
held  before  the  dispute.  But  it  added 
that  such  a  post  should  be  "dependent 
on  her  willingness  to  perform  the  work 
and  provided  she  has  the  qualifica- 
tions." 

Ken  Dickson,  director  of  personnel 
for  Hamilton  city  hospitals,  said  the 
hospital  would  comply  with  the  recom- 
mendations "in  good  faith."  He  said 
the  commission's  decision  was  "reassur- 
ing to  the  board  of  governors  and  man- 

THE  CANADIAN  NURSE     17 


agement.  We  did  not  feel  guilty  of 
discrimination. 

"We  certainly  feel  Miss  Martin  had 
the  right  to  complain  to  the  commission 
if  she  felt  discriminated  against."  Mr. 
Dickson  hopes  this  will  close  the  matter 
and  that  Miss  Martin  is  satisfied. 

This  is  the  first  case  in  Ontario  where 
a  nurse  complained  of  discrimination 
because  of  an  antiabortion  stand.  Miss 
Martin  said  in  her  complaint  she  is 
morally  opposed  to  abortions  and  has 
never  assisted  at  one. 

RNABC  Guidelines  On 
Medical-Nursing  Procedures 

Vancouver,  B.C.  —  Highly  specialized 
patient  care  units  prompted  a  joint 
committee  of  the  Registered  Nurses' 
Association  of  British  Columbia  and 
the  British  Columbia  Hospital  Associa- 
tion to  review  their  guidelines  on  med- 
ical-nursing procedures. 

The  1971  guidelines,  distributed 
with  the  June/July,  1971,  issue  of  the 
RNABC  News,  approve  a  number  of 
new  procedures  for  registered  nurses. 
The  prior  guidelines  were  published 
in  1965. 

In  the  absence  of  a  physician,  life- 
saving  measures  for  the  patient  who 
has  a  cardiac  arrest  are  within  nursing 
practice  when  the  registered  nurse  has 


received  preparation  to  recognize  car- 
diac arrest.  The  nurse  must  also  receive 
training  and  supervised  practice  in  the 
closed  method  of  cardiopulmonary 
resuscitation,  in  the  use  of  monitoring, 
defibrillating  and  resuscitating  equip- 
ment and  in  techniques  of  intubation. 

The  guidelines  recommend  that  a 
committee  ot  representatives  from  a 
hospital's  medical  staff,  nursing  depart- 
ment and  hospital  administration  devel- 
op a  written  statement  of  policy,  deter- 
mine a  criteria  for  safe  practice,  and 
develop  a  training  program  when  a 
hospital  has  decided  that  a  registered 
nurse  may  perform  the  techniques. 

"The  practice  of  nurse  midwifery 
has  not  been  accepted  in  British  Colum- 
bia except  in  isolated  areas  or  in  emer- 
gency situations  when  no  doctor  is 
available,"  states  the  1971  guidelines; 
midwifery  is  not  mentioned  in  the  1965 
guidelines. 

Providing  the  nurse  has  had  special 
training  and  adequate  supervision,  and 
there  is  a  specific  and  written  order 
from  the  physician,  the  1971  RNABC 
guidelines  approve  the  nurse's  perform- 
ance of  vaginal  examinations  during 
labor. 

In  case  of  the  serious  illness  or  death 
of  a  patient,  a  physician  may  delegate 
to  the  nurse  in  charge  the  responsibility 
to  notify  the  patient's  next  of  kin  and, 
in  certain  instances,  to  obtain  written 
permission  for  an  autopsy. 

The  new  guidelines  state  that  "in 
the  labor  and  delivery  room  the  nurse 
may  direct  the  self-administration  of 


Host  AAKN  Is  Busy 


With  Hospitality  Plans 


^^Z 


Edmonton,  Alta.  —  The  Alberta  Asso- 
ciation of  Registered  Nurses  promises 
a  large  sample  of  Alberta  hospitality 
to  delegates  attending  the  Canadian 
Nurses'  Association  1972  convention, 
June  25-29. 

It's  easy  to  book  accommodation 
now  with  space  available  at  two  down- 
town hotels,  the  MacDonald  (CN)  and 
the  Chateau  Lacombe  (CP)  or  in  the 
modern  high-rise  buildings  on  the 
University  of  Alberta  campus  next  to 
the  convention  site. 

All  convention  sessions  will  be  held 
in  the  university's  Jubilee  Auditorium 
which  has  a  seating  capacity  of  2,700. 
Lunch  will  be  served  next  door  in  Lister 
Hall,  the  university's  food  services 
building. 

18     THE  CANADIAN  NURSE 


Social  functions  are  being  planned 
for  the  two  downtown  hotels  with  a 
chartered  bus  service  available  to  carry 
delegates  to  and  from  the  convention 
meetings. 

Plan  to  travel  West  next  summer 
with  your  family  because  the  AARN  is 
arranging  activities  for  husbands/wives 
and  children.  The  convention  can  be 
part  of  a  holiday  trip  for  everyone. 

You  can  sign  up  for  postconvention 
tours:  one  will  take  you  through  the 
Rockies  with  arrival  in  Calgary  for  the 
opening  of  the  world  famous  Calgary 
Stampede;  another  tour  will  take  you 
through  the  Alberta  badlands  where 
prehistoric  animals  once  roamed.  All 
tours  will  be  moderately  priced  and 
rates  based  on  groups  of  25  or  more. 


penthrane  inhalor  and/or  trilene  by 
the  mother  or  administer  the  penthrane 
inhalor  and  the  trilene.  Both  procedures 
are  performed  under  the  direction  of 
the  physician  in  charge  of  the  case." 

Providing  the  registered  nurse  is 
adequately  prepared  and  there  is  a 
written  order  from  the  physician,  the 
guidelines  indicate  that  it  is  proper 
practice  for  a  registered  nurse  to  remove 
retention  or  stay  sutures,  change  burn 
dressings,  and  remove  sutures  and/or 
drains  for  plastic  and  eye  surgery. 

It  is  also  proper  practice  for  a  regis- 
tered nurse  to  insert  a  gastric  tube  for 
lavage  or  gavage  upon  written  order 
from  the  physician,  except  following 
thoracic  or  gastric  surgery,  or  where 
the  danger  of  perforation  is  increased. 

The  guidelines  point  out  that  "no 
statement  of  policy  by  professional 
organizations  or  by  employing  agencies 
can  relieve  the  individual  nurse  of  resp- 
onsibility for  her  own  acts.  A  statement 
of  policy  will  not  provide  immunity 
from  legal  action  if  the  nurse  is  negli- 
gent. A  policy  statement  will  give  the 
nurse  support  by  setting  forth  recom- 
mended pwlicy  which  responsible  pro- 
fessional groups  suggest  for  appropriate 
practice  and  sound  procedures." 

Guidelines  on  Medical-Nursing  Pro- 
cedures are  designed  to  assist  hospitals 
and  other  health  agencies  in  B.C.  to 
establish  policies  and  procedures  for 
safe  nursing  care. 

Special  Emergency  Units 
Needed  For  Drug-Users 

Montreal,  Quebec  —  Hospitals  are 
going  to  have  to  set  up  separate  emer- 
gency units  to  deal  with  drug-users 
seeking  treatment.  Dr.  B.L.P.  Bros- 
seau,  executive  director  of  the  Canadian 
Hospital  Association,  said  in  a  Mont- 
real Star  interview  in  June. 

"Stuffing  them  into  regular  emer- 
gency sections  —  particularly  when 
they  are  in  a  bad  condition  —  is  inhu- 
man. It's  worse  than  ignoring  them," 
said  the  doctor  discussing  recommenda- 
tions made  at  a  national  symposium 
on  hospital  responsibility  toward  drug 
users  held  in  Montreal  in  February. 
(See  News,  April,  p.  16.) 

Dr.  Brosseau  told  delegates  to  the 
fourth  annual  convention  of  the  Cana- 
dian Hospital  Association  that  the 
means  to  implement  the  recommenda- 
tions of  this  symposium  must  be  found 
"if  we  are  not  to  lose  faith  with  the  many 
individuals,  hospitals,  and  agencies  who 
attended  the  symposium." 

Although  little  has  been  done  so 
far,  Dr.  Brosseau  said  the  wheels  are 
in  motion  to  effect  many  of  the  propos- 
als. Recently  his  association  was  guar- 
anteed federal  funds  to  further  its  study 
into  means  of  bringing  about  change. 

He  said  there  was  no  doubt  in  his 
SEPTEMBER  1971 


mind  this  will  involve  a  different  ad- 
missions policy  for  hospitals,  as  well 
as  a  different  attitude  on  the  part  of 
receiving  staff.  "Attitudes  are  attitudes 
and  they  are  hard  to  change  so  it  may 
involve  hiring  staff  specially  trained  to 
relate  to  drug  users." 

Initially,  kindness  and  understanding 
are  the  most  important  treatment,  Dr. 
Brosseau  said.  Hospitals  and  doctors 
alike  have  to  realize  that  drug-users 
are  sick,  but  sick  people  who  need 
special  treatment  in  special  quarters. 
"They  have  to  appreciate  the  fact  that 
a  freak  out  is  an  episode  and  that  the 
rehabilitation  process  is  a  lengthy  one." 

Lawrence  Sidesteps 
Abortion  Issue 

Toronto,  Ont.  —  Ontario  Health  Min- 
ister Bert  Lawrence  will  not  become 
involved  in  allegations  that  some  hos- 
pital nurses  have  been  threatened  with 
dismissal  because  they  will  not  partici- 
pate in  therapeutic  abortions,  said  a 
Canadian  Press  story  in  June. 

Asked  in  the  legislature  whether  he 
knew  if  some  nurses  in  the  Oshawa- 
Toronto-Ajax  area  hospitals  were  liv- 
ing under  constant  fear  of  dismissal 
over  their  stand  on  the  matter,  Mr. 
Lawrence  said  he  was  unaware  of  the 
situation. 

He  said  he  knew  there  was  a  stand 
against  abortion  by  some  hospitals 
"controlled  or  oriented  by  particular 
religious  groups  —  those  which  have 
an  historic  or  Roman  Catholic  back- 
ground. On  the  other  side  of  the  ques- 
tion, generally  speaking,  our  facilities 
for  performing  therapeutic  abortions 
are  adequate,"  he  said. 

Pursued  further  on  the  question 
whether  the  government  would  assure 
protection  against  dismissal  for  nurses 
who  do  not  cooperate  with  the  hospitals 
that  perform  abortion,  Mr.  Lawrence 
said,  "That  is  up  to  the  hospital  boards 
involved." 


New  Association  Holds 
Tuberculosis  Seminar 

Ottawa  —  The  fledgling  Infection 
Control  Nurses'  Association  held  its 
first  annual  meeting  on  June  10-11, 
with  a  tuberculosis  seminar  for  hospital 
staff  nurses  on  the  first  day  and  business 
sessions  the  second  day.  The  program 
was  presented  by  the  association's  Ot- 
tawa-Hull chapter  and  sponsored  by  the 
Ottawa-Carleton  tuberculosis  and  resp- 
iratory disease  association. 

Dorothy  Pequegnat,  infection  con- 
trol officer,  Ottawa  Civic  Hospital, 
said  hospital  staff  fear  the  undiagnosed 
case  of  tuberculosis.  "The  undiagnosed 
case,  not  on  chemotherapy,  can  transmit 
tubercle  bacilli  to  his  or  her  contacts," 
she  said. 

SEPTEMBER  1971 


"With  the  closing  of  sanatoriums 
there  is  an  inclination  towards  apathy 
to  TB,  but  it  is  my  belief  that  all  staff 
working  with  patients  should  have  a 
high  index  of  suspicion  with  regard 
to  tuberculosis  in  their  patients. 

"The  undiagnosed  case  quite  often 
is  that  elderly  man  or  woman  who  came 
into  hospital  for  possible  carcinoma 
of  the  lung  or  some  lung  complication. 
Be  suspicious  of  these  patients  and 
remember  that  tuberculosis  can  also 
occur  in  conjunction  with  other  diseases 
such  as  emphysema  and  chronic  bron- 
chitis," said  Mrs.  Pequegnat. 

"When  diagnostic  tests  are  being 
carried  out  on  these  patients  ...  a  spe- 
cimen should  also  go  for  acid  fast  bacil- 
li. The  smear  positive  patient  is  your 
greatest  threat  to  the  community  and 
the  hospital.  These  are  your  infectious 
reservoirs —  the  source  of  the  spread 
of  the  tubercle  bacilli." 

Tuberculosis  is  considered  as  having 
low  communicability.  "It  takes  pro- 
longed exposure  to  the  disease  or  a 
high  concentration  of  organisms  in  the 
air  to  contract  tuberculosis,"  said  Mrs. 
Pequegnat. 

The  association  got  its  start  a  year  ago 
when  nurses  working  in  this  new  field  — 
infection  control  in  the  hospital  —  saw 
the  value  In  an  organization  that  would 
arrange  workshops  and  seminars  relat- 
ing to  their  specialty.  In  June  1970, 
the  first  meeting  was  held  with  the 
graduating  class  of  the  hospital  infec- 
tion control  course  at  the  University 
of  Ottawa. 

Continuing  on  the  executive  for  the 
second  year  are  Sue  Legace,  Ottawa, 
president;  Connie  Perkin,  Niagara 
Falls,  Ont.,  vice-president;  Raymonde 
Garon,  Hull,  Que.,  secretary;  and  Lise 
Archambault,  Hull,  treasurer. 

New  UBC  Program 

in  Continuing  Education 

Vancouver,  B.C.  —  The  University  of 
British  Columbia  has  recently  started 
a  program  of  professional  education, 
which  aims  to  prepare  specialists  in 
continuing  education  in  the  health 
sciences.  These  specialists  will  in  turn 
help  health  professionals  continue 
educating  themselves. 

The  program  is  the  first  of  its  kind  in 
the  world  and  is  open  to  health  profes- 
sionals in  medicine,  nursing,  dentistry, 
pharmacy,  and  related  health  fields.  It 
is  being  supported  by  a  five-year  grant 
for  $335,000  from  the  W.K.  Kellogg 
Foundation,  Battle  Creek,  Michigan. 
Dr.  Coolie  Verner,  professor  of  adult 
education,  will  head  the  program,  assist- 
ed by  the  directors  of  the  various  sec- 
tions within  the  division  of  continuing 
education  in  the  health  sciences. 

"As  the  demand  for  further  education 
in  the  health  sciences  has  increased,  so 


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news 


has  the  need  for  specially  trained  indi- 
viduals who  are  competent  both  in 
professional  health  sciences  and  in  adult 
education,"  said  Dr.  Verner.  The  exist- 
ing curriculum  in  adult  education  at  the 
university  will  provide  the  core  academ- 
ic program  for  the  would-be  specialists. 
Applicants  may  seek  admission  to 
either  of  two  master  level  degree  pro- 
grams or  for  a  doctorate.  The  Master  of 
Arts  degree  will  require  a  full  year  of 
academic  work  in  residence,  and  the 
Master  of  Education  may  be  achieved 
through  part-time  study.  A  doctorate 
requires  two  years  in  residence.  A 
diploma  program  will  also  be  offered. 
Special  students  could  also  be  accepted 
for  directed  study  in  terms  of  their  own 
needs  and  interests. 

MGH  Celebrates 
150th  Birthday 

Montreal,  Quebec  — The  150th  anni- 
versary of  The  Montreal  General  Hos- 
pital was  celebrated  with  a  four-day 
birthday  party  from  May  26  to  May  30. 
It  was  not  just  a  party,  because  organiz- 
ers of  the  festivities  took  advantage  of 
the  fact  that  leaders  in  the  medical  and 
nursing  professions  would  be  attending, 
and  planned  scientific  symposia  and 
panel  discussions. 

As  part  of  a  two-day  panorama  of 
nursing,  a  symposium  on  changes  in 
nursing  education  was  held.  Florence 
MacKenzie.  MGH  associate  director 
of  nursing  (education),  told  alumnae 
that  -'the  time  for  change  has  come 
and  in  1972  the  last  class  will  graduate 
from  the  MGH  school  of  nursing. 

"The  change  was  advocated  because 
educational  principles  governing  the 
preparation  of  nurses  do  not  differ 
fundamentally  from  those  principles 
governing  other  fields  of  education. 
It  is  an  established  fact  that  service 
needs  of  the  hospital  must  take  prece- 
dence over  the  education  of  students," 
said  Miss  MacKenzie.  "In  an  educa- 
tional setting,  the  education  of  nursing 
students  would  come  first." 

Montreal  General  has  direct  links 
to  the  early  days  of  this  country.  In 
1 8 1 5,  a  European  economic  slump  sent 
a  flood  of  immigrants  to  the  colony. 
The  Female  Benevolent  Society  of 
Montreal  organized  soup  kitchens  to 
help  feed  the  destitute  settlers  disem- 
barking from  sailing  ships.  Two  years 
later  the  society  started  a  House  of 
Recovery  in  the  Recollect  suburb,  said 
a  story  by  David  Oancia  in  the  May  17 
issue  of  Montreal  Star. 

When    this    facility    proved    inade- 
20     THE  CANADIAN  NURSE 


The  Montreal  General  Hospital  in  1822 


quate,  the  citizens  of  the  city  dug  into 
their  own  pockets  and  financed  the 
rental  of  a  larger  house  on  Craig  Street, 
two  doors  east  of  Bleury,  to  provide 
more  treatment  for  the  sick  and  desti- 
tute. They  called  the  institution  they 
opened  on  May  1 ,  1819,  The  Montreal 
General  Hospital. 

The  rented  house  on  Craig  Street 
also  proved  too  small.  And  before  1 820 
was  out,  three  prominent  Montrealers 
bought  and  donated  the  land  on  Dor- 
chester Street,  which  was  to  be  the  site 
of  the  MGH  for  more  than  120  years. 
These  three  were  John  Richardson,  fur 
trader  and  financier;  William  McGilli- 
vray  of  Northwest  Company  fame, 
founder  of  Fort  William;  and  Samuel 
Gerrard,  then  president  of  the  Bank  of 
Montreal. 

Other  prominent  Montrealers 
through  the  years  emulated  this  first 
trio,  and  their  gifts  and  endowments  are 
largely  responsible  for  making  the  hos- 
pital the  important  center  it  is  today. 

CNA  President  Tells  SRNA 
Revision  Of  Health  Systems 
Will  Require  Collaboration 

Saskatoon,  Sask. — The  revision  of 
our  systems  of  delivering  health  care 
will  require  collaboration  of  all  those 
providing  service  and  of  those  receiving 
care,  at  all  levels,  the  Canadian  Nurses' 
Association  president  E.  Louise  Miner 
told  400  delegates  at  the  May  annual 
meeting  of  the  Saskatchewan  Registered 
Nurses'  Association  in  Saskatoon. 

"The  extent  to  which  nurses  assume 
a  strong  leadership  role  in  this  planning 


process  will  directly  influence  not  only 
the  kind  and  quality  of  health  care 
provided  but  will  determine  the  future 
of  nursing,"  said  Miss  Miner.  "Nurses 
are  too  often  conspicuous  by  their 
absence  when  plans  are  developed  for 
hospitals,  clinics,  community  health 
centers,  and  other  service  agencies  in 
which  nursing  care  is  one  of  the  most 
critical  components." 

Two  choices  are  open  to  nurses  Miss 
Miner  said.  "Passive  acceptance  of 
decitions  made  by  others  is  one  alter- 
native. Willingness  to  see,  understand, 
assess,  predict,  and  put  into  operation 
the  demands  and  opportunities  for  nurs- 
ing to  achieve  a  new  place  in  the  health 
care  system  is  the  second  choice.  This 
requires  leadership  of  the  highest  lev- 
el." She  noted  that  nurses  who  take  on 
an  activist,  leadership  role  can  find  the 
professional  world  a  harsh  and  lonely 
place  for,  "this  is  no  popularity  con- 
test." 

The  CNA  president  believes  that 
collaboration  for  comprehensive  health 
care  requires  critical  examination  of 
the  health  sciences  educational  systems. 
"I  am  encouraged  by  some  of  the 
changes  being  made  but  discouraged 
by  the  delay  and  opposition. 

"Our  rigidity  comes  through  so' loud 
and  clear  as  I  continue  to  hear  unin- 
formed debate  on  the  preparation  of  a 
nurse  in  any  program  of  less  than  three 
years'  duration.  Just  when  I  think  I 
surely  won't  have  to  sit  through  another 
that  again,  up  it  pops  —  usually  without 
warning,  and  I  require  another  period 
(Continued  on  page  22) 
SEPTEMBER  1971 


no  OTHER  BflG  reRFORfTV  UK£  fTlf 


My  safety  chamber 
really  stops  retro- 
grade infection. 
There's  simply  no  way 
for  the  bugs  to  back 
up  and  go  where  they 
don't  belong.  And  by 
tucking  the  BAC- 
STOP  chamber  in- 
side the  bag,  it  can't 
be  kinked  acciden- 
tally to  stop  the  flow. 


Cystoflo 

Uraunr  BntHp  Rm 


My  hanger  is  the 
hanger  that  works 
well  all  the  time.  Hang 
it  on  a  bed  rail  or  a 
belt,  it  is  always  se- 
cure and  comfortable. 
I'm  always  on  the 
level  with  this  hanger, 
whether  my  patient  is 
lying,  silting,  or  walk- 
ing around. 


I'm  clear-faced  and 
easy  to  read.  My  white 
back  makes  my  mark- 
ings stand  out  unique- 
ly, whether  you  look 
at  my  backbone  scale, 
or  tilt  me  diagonally  \ 
to  read  small  amounts 
with  the  corner  cali- 
brations. 


I  have  the  only  shortie 
drainage  lube  around, 
and  it's  miles  better 
than  any  other 
you've  ever  used.  It's 
easier  to  handle,  and  it 
won't  drag  on  the  floor, 
even  with  the  new  low 
beds.  So  out  goes  one 
more  path  to  possible 
contamination. 


I'm  the  unique  new  CYSTOFLO  dramage  bag.  a 
true-blue  friend  to  nurses,  physicians  and  patients. 
Why  don't  we  get  acquainted? 


BAXTER  LABORATORIES  OF  CANADA 


6406  Noriham  D-ive   Vjitu"  0" 


news 


(Continued from  page  20) 

of  recovery  before  I  am  able  to  listen 
with  reasonable  attentiveness  to  the 
discussion,"  she  said. 

Collaboration  may  prove  difficult 
for  many  providers  of  care  indicated 
Miss  Miner  for,  "we  all  suffer  from 
'hardening  of  the  categories'."  She 
discussed  the  April  national  conference 
on  assistance  to  the  physician  at  which 
three  main  categories  of  assistance  to 
the  physician  were  defined: 
•the  physician  substitute  —  to  serve 
in  place  of  the  physician  where  the 
physician  is  inaccessible,  for  example, 
in  outpost  nursing  programs;  or  unavail- 
able on  a  usual  basis,  for  exemple,  in 
intensive  care  units  or  coronary  moni- 
toring units.  This  is  clearly  a  profes- 
sional role  with  major  independent 
judgmental  responsibilities  and  may 
require  special  preparation  in  training 
for  the  role. 

•the  physician  associate  —  to  comple- 
ment and  supplement  the  physician, 
serving  in  a  partnership  with  a  physi- 
cian. Again  the  role  is  professional 
but  the  emphasis  on  training  for  inde- 
pendent judgemental  responsibilities 
in  the  field  of  medical  care  is  not  as 
strong  as  in  the  previous  category. 
•the  physician  assistant  —  a  subordi- 
nate to  the  physician  to  carry  out  spe- 
cific instruction  in  a  relatively  narrow 
field  discharging  predetermined  techni- 
cal or  repetitive  tasks.  Professional 
training  would  be  over-training  for  such 
a  role.  The  operating  room  assistant, 
the  orthopedic  assistant,  or  the  medical 
information-medical  history  taking 
assistant  are  possibilities  in  the  hospital 
setting. 

"The  national  conference  felt  that 
primary  attention  should  be  focused 
on  the  categories  of  substitute  and  asso- 
ciate personnel  rather  than  assistant 
personnel.  The  urgent  need  is  for  per- 
sonnel who  would  serve  in  the  commun- 
ity setting  as  opposed  to  the  hospital 
setting.  It  was  felt  implementation  of 
changes  in  professional  role  in  the 
community  could  be  accelerated  by  an 
organizational  base  such  as  a  commun- 
ity health  center,"  said  Miss  Miner. 

Nursing  Degree  Program  Updated 

Saskatoon.  Sask.  —  A  new  degree  pro 
gram  for  registered  nurses  will  be  in 
troduced  at  the  Universitv  of  Saskat- 
chewan, Saskatoon,  this  fall.  Designed 
to  meet  the  needs  of  nurses  in  con- 
temporary society,  the  new  program 
replaces  one  that  has  been  provided 
since  the  t950s. 

Dr.    Lucy    Willis,    director    of    the 

22     THE  CANADIAN  NURSE 


Don  Brown,  lecturer  in  nursing  at  the  University  of  Saskatchewan.  Saskatoon, 
uses  a  mechanical  respirator  to  demonstrate  artificial  ventilation  during  a  new 
clinical  course.  The  course,  which  centers  on  the  basic  principles  of  caring  for  the 
acutely  ill,  will  be  offered  as  part  of  a  new  degree  program  for  registered  nurses 
at  the  University  of  Saskatchewan.  Saskatoon,  this  fall. 


school  of  nursing,  said  the  new  program 
fully  recognizes  the  student's  previous 
learning  and  experience.  Using  these  as 
a  basis,  she  said,  we  have  designed 
courses  that  we  believe  will  provide  the 
registered  nurses  with  what  they  need 
and  what  they  are  looking  for  when 
they  come  to  university  to  improve  their 
qualifications. 

The  new  program  provides  a  wider 
range  of  nursing  classes  than  the  old. 
Other  features  include  a  compulsory 
course  in  community  health  nursing, 
a  class  in  the  area  of  teaching,  adminis- 
tration, or  beginning  research,  and  a 
class  in  clinical  nursing. 

Enrollment  in  the  program  at  the 
university  has  been  fairly  constant, 
numbering  between  35  and  40  full-time 
students  annually,  along  with  many 
part-time  students. 

Hospital  Costs  Spiral 

Toronto,  Ont.  —  In  conjunction  with 

Canada  Hospital  Day  on  May  12,  the 

Canadian   Hospital   Association   used 

statistics    to    underline    the    problems 

faced  by  hospitals  in  their  attempt  to 

control  spiraling  costs: 

•A   half  million  more  patients  were 

hospitalized  in   1970  as  compared  to 

I960. 

•  More  than  three  million  Canadians 

were   treated   in   hospital   in   Canada 

last  year. 

•Hospital  construction  costs  rose  by 

nearly  400  percent  in  the  last  decade. 

In  1960,  it  cost  $10,000  to  $12,000  to 

put  one   bed   into  treatment  service; 


today  it  costs  $30,000  to  $35,000  per 

hospital  bed. 

•Since  1900,  the  daily  cost  per  hospital 

patient  has  risen  by  about  500  percent. 

At  the  turn  of  the  century,  the  average 

cost  was  SI;  by  1945,  it  had  risen  to 

$5.82;  today,  the  figure  runs  between 

$40  to  $50  per  day. 

•  In    1964,   the   patient   hospital   bill 

totaled  $983  million.  By  1969  the  bill 

had  reached  $2.5  billion. 

Quebec  Postpones 
Nurses'  Refresher  Course 

Montreal.  Quebec  —  The  Quebec  de- 
partment of  education  will  not  offer  a 
refresher  course  for  nurses  during  the 
coming  year.  The  department  has  post- 
poned the  course  because  it  believes 
there  is  a  surplus  of  nurses  in  the  pro- 
vince. 

Also,  a  large  number  of  nursing  assis- 
tants will  become  registered  nurses 
after  completing  the  training  course 
offered  for  the  first  time  this  year  by 
the  department. 

A  special  ad  hoc  committee  of  the 
Association  of  Nurses  of  the  Province 
of  Quebec  is  now  preparing  a  refresher 
course  program  for  nurses.  This  com- 
mittee, chaired  by  Rita  Lussier,  will 
submit  this  program  to  the  department 
of  social  affairs  with  the  suggestion 
that  it  be  offered  solely  or  jointly  with 
the  department  of  education. 

The  ANPQ  and  the  department  of 
social  affairs  have  asked  Laval  Univer- 
sity, Quebec  City,  to  offer  a  program  on 
social  medicine  open  to  nurse  enroll- 
ment. ^ 
SEPTEMBER  1971 


this  is  our  bouncina  bab 


VIAFLEX1V  soumoN  SySTEW 


\ 


this  baby^  future  is  the  future  of  fluid  therapy 


VIAFLEX  is  the  lightweight,  flexible  plastic  I.V.  system 
that  gave  birth  to  a  revolution  in  the  world  of  fluid 
therapy. 

VIAFLEX  is  the  closed  I.V.  system  that  requires  no  air 
venting.  Outside  air  does  not  enter,  so  air-borne  con- 
tamination from  venting  of  sterile  solutions  does  not 
occur  and  the  danger  of  air  embolism  is  dramatically 
reduced. 

*A8  with  all  parenterals,  compatibilities  should  be  checl<ed  when  additives  are  used. 


VIAFLEX  has  the  unique  set  entry  port  that  is  designed 
to  prevent  inadvertent  "touch"  contamination  during 
set  insertion,  while  the  medication  port  guards  sterility 
during  addition  of  drugs*.  It's  a  closed 
sterile  system. 

Put  our  baby  to  work  for  you.  He'll  revolu- 
tionize the  safety  of  fluid  therapy  proce- 
dures in  your  hospital. 


BAXTER  LABORATORIES  OF  CANADA 

DIVISION  OF  TRAVENOL  LABORATORIES.  INC. 

6405  Northam  Drive,  Malton,  Ontario 


Viaflex 

THE  ONLY  NON-AIR-DEPENDENT  SYSTEM 


names 


Madge  McKillop,  right,  past  president  of  the  SRNA,  accepts  an  honor  roll  from 
Vera  Spencer,  provincial  department  of  public  health,  at  the  SRNA  annual  meet- 
ing in  Saskatoon. 


Sister  Madeleine 
Bachand  has  been 
appointed  nursing 
ct)nsultant  (research 
analyst)  to  the  Ca- 
nadian Nurses"  As- 
sociation in  Ottawa, 
effective  Septem- 
ber, 1971. 

Sister  Bachand 
brings  a  wide  variety  of  education  and 
experience  to  her  new  post.  She  is  a 
graduate  of  Hotcl-Dieu  in  Montreal. 
and  holds  a  bachelor  of  nursing  degree 
from  the  University  of  Montreal  and 
a  master  of  science  degree  from  McGill 
University  in  Montreal.  Sister  Bachand 
also  has  a  licence  in  pedagogy  from  the 
University  of  Montreal. 

She  is  a  tornicr  director  of  the  school 
of  nursing  at  Hotel-Dieu.  Mt)ntrcal. 
Sister  Bachand  has  served  as  co-chair- 
man of  the  Association  of  Nurses  of  the 
Province  of  Quebec  committee  on  legis- 
lation, and  as  co-chairman  of  the  com- 
mittee on  nursing  education.  Her  posi- 
tion as  Mother  Provincial  of  the  Ordrc 
des  Hospitalieres  de  St.  Joseph  termi- 
nated on  July  1,  1971. 

Lyie  M.  Creelman  (B.Sc.N.,  U.  of  Brit- 
ish Columbia:  M.A.,  Columbia  U., 
New  York;  LL.D.,  U.  of  New  Bruns- 
wick) has  been  awarded  the  medal  of 

24     THE  CANADIAN  NURSE 


service  of  the  Order 
of  Canada.  The 
medal  was  given  to 
Dr.  Creelman  in  rec- 
ognition of  her  dis- 
tinguished career  in 
nursing  on  the  na- 
tional and  interna- 
tional levels.  Dr. 
Creelman"s  latest 
honor  highlights  a  long  and  interesting 
career.  She  began  as  supervisor  of 
school  nursing  and  director  of  public 
health  nursing  for  the  Metropolitan 
Health  Committee  in  Vancouver.  On 
the  international  level.  Dr.  Creelman 
was  chief  nurse  for  the  United  Nations 
Relief  and  Rehabilitation  Administra- 
tion shortly  after  the  second  world 
war.  She  was  also  field  director  of  a 
study  of  public  health  services  in  Can- 
ada conducted  by  the  Canadian  Public 
Health  Association.  Dr.  Creelman  retir- 
ed in  August  1968  after  14  years  as 
chief  nursing  officer  of  the  World 
Health  Organization. 

At  the  spring  convocation  at  Queen's 
University  in  Kingston,  four  awards 
were  presented  to  nursing  students. 
Patricia  Susan  Carter,  Richmond  Hill, 
Ont.,  received  the  medal  in  nursing; 
Barbara  Lorraine  Ready,  Kingston,  re- 
ceived the  professor's  prize  in  nursing 


education;  Penelope  Jane  Smith,  Vine- 
land  Station,  Ont.,  received  the  profes- 
sor's prize  in  public  health  nursing; 
and  Patricia  Susan  Carter,  Richmond 
Hill,  received  the  professor's  prize  in 
nursing  sciences. 

The  names  of  seven  nurses  were  on  an 
honor  roll  presented  to  Madge  McKillop 
at  the  Saskatchewan  Registered  Nurses' 
Association's  annual  meeting  in  Saska- 
toon in  May.  These  Saskatchewan-born 
nurses  have  received  recognition  of 
their  contributions  to  nursing  on  nation- 
al and  international  levels. 

Caroline  S.N.  Dauk  is  with\he  United 
Nations  Development  Program  in  Bagh- 
dad, Iraq. 

Lois  M.A.  Howat  is  a  missionary  at 
the  Door  of  Life  Hospital  in  Ambo, 
Ethiopia. 

Ardice  E.  Ziolkowski  is  a  missionary 
nurse  in  West  Cameroon,  Africa. 

A^nes  Dorothy  Potts  is  the  regional 
nursmg  adviser  with  the  WHO  in  Braz- 
zaville, Republic  of  the  Congo. 

Lillian  E.  Pettigrew  is  associate  execu- 
tive director  of  the  Canadian  Nurses' 
Association,  Ottawa. 

Lily  Mary  Turnbull  is  chief  nursing 
officer  with  WHO  in  Geneva,  Swit- 
zerland. 

Sister  Mary  Felicitas  was  director  of 
St.  Mary's  Hospital  School  of  Nursing  in 
Montreal,  and  is  a  past  president  of  the 
Canadian  Nurses'  Association. 


Eleanor  Bland  retir- 
ed in  June,  197  1,  as 
head  nurse  at  the 
Foothills  Hospital, 
Calgary,  Alberta. 
She  is  a  graduate  of 
the  Brandon  Gener- 
al Hospital  School 
Nursing,  Brandon. 
Manitoba,  and  the 
University  ot  Manitoba. 

Mrs.  Bland  has  served  in  various 
positions  in  several  Alberta  and  Mani- 
toba hospitals  as  general  duty  nurse, 
head  nurse,  instructt)r.  assistant  director 
of  nursing,  and  assistant  director  of, 
nursing  education.  She  also  contributed 
to  the  presentation  of  the  Alberta  Asso- 
ciation of  Registered  Nurses"  brief  on 
nursing  education  to  the  Scarlett  Com- 
mittee. 

(Continued  on  page  26) 

SEPTEMBER  1971 


* 


l^s^^f^-  ■ 


Your  written  guarantee  of  quality 


Each  prescription  you  fill  is  an  exercise  of  your  professional 
judgment.  The  drug  you  dispense  is  vital  to  your  cus- 
tomers' health  and  well-being.  What  may  seem  to  be 
minor  differences  in  dosage  form,  particle  size,  solubility, 
and  rate  of  absorption  may  make  major  differences  in 
therapeutic  efficacy.  When  the  choice  is  yours,  you  want 
to  dispense  the  best. 

*ILOSONE  250  mg.  (erythromycin  estolate) 


S^ 


Eli  Lilly  and  Company  (Canada)  Limited,  Toronto,  Ontario 


names 


Frances  M.  Howard  (R.N.,  Saint  John 
General  H..  Saint  John,  N.B.;  B.N., 
School  For  Graduate  Nurses,  McGiil 
U.,  Montreal;  M.Sc.N.,  U,  of  Western 
Ontario.  London)  was  appointed  in 
August  to  the  position  of  director  of 
staff  development,  department  of  nurs- 
ing services,  Kingston  General  Hospi- 
tal, with  added  teaching  responsibilities 
at  Queen's  University  School  of  Nurs- 
ing, Kingston,  Ontario. 

A  Canadian  Nurses'  Foundation  fel- 
low. Miss  Howard  brings  a  wide  variety 
of  experience  to  her  new  duties.  She 
served  as  assistant  secretary  of  nursing, 
secretary  of  nursing  education,  and 
consultant  in  nursing  service  with  the 
Canadian  Nurses'  Association.  She  was 
also  an  obstetrical  supervisor  and  ins- 
tructor at  the  Oshawa  General  Hospi- 
tal, Oshawa,  Ontario;  assistant  super- 
visor of  the  delivery  room  at  Boston 
Lying-in  Hospital,  Boston,  Mass.;  and 
general  duty  nurse  at  Saint  John  Gen- 
eral Hospital.  Saint  John.  N.B. 

Roseanne   Erickson, 

director  of  nursing 
for  admitting,  emer- 
gency, central  sup- 
ply room,  and  the 
medical-surgical 
day  care  center  at 
the  Foothills  Gen- 
eral Hospital  in 
Calgary,  was  instal- 
led as  president  of  the  Alberta  Associa- 
tion of  Registered  Nurses  during 
AARN's  annual  convention  in  Banff 
May  11-14. 

Mrs.  Erickson  (R.N.,  Calgary  Gen- 
eral H.)  succeeded  M.  Geneva  Purcell, 
director  of  nursing  at  the  University 
Hospital  in  Edmonton.  Before  she  join- 
ed the  staff  of  the  Foothills  Hospital  in 
1966,  Mrs.  Erickson  worked  at  the 
Calgary  General  Hospital.  As  an  active 
AARN  member,  she  has  been  a  com- 
mittee chairman,  vice  president,  and 
president  of  the  South  Central  District, 
and  a  vice-president  on  the  provincial 
executive  before  becoming  president- 
elect. 

Judith  Prowse,  supervisor  of  the 
department  of  surgery  at  Royal  Alexan- 
dra Hcfspital  in  Edmonton,  was  elect- 
ed president-elect -of  AARN  to  succeed 
Mrs.  Erickson  in  1973. 

Miss  Prowse  (B.Sc.N..  U.  of  Alberta) 
worked  as  an  instructor  at  the  Medicine 
Hat  General  Hospital  School  of  Nurs- 
ing from  IM6.^  to  1967.  when  she  be- 
came evening  supervisor  in  pediatrics 
at  the  Royal  Alexandra  Hospital.  For 

26     THE  CANADIAN  NURSE 


the  past  two  years  she  has  been  presi- 
dent of  the  North  Central  District  of 
AARN. 

Two  AARN  vice-presidents  were 
elected  to  one-year  terms  during  the 
annual  convention:  Margaret  Besweth- 
erick  (R.N.,  The  Vancouver  General 
H.;  B.Sc.  and  M.S.,  McGill),  assistant 
professor  in  the  school  of  nursing  at  the 
University  of  Alberta  in  Edmonton,  and 
Edythe  Huffman  (B.Sc.N.,  U.  of  Toronto 
School  of  Nursing),  an  instructor  in  the 
school  of  nursing  at  the  University  of 
Calgary. 

Iris  Mossey  was  named  "Nurse  of  the 
Year"  for  197  I  at  the  convention.  Mrs. 
Mossey  (R.N.,  Gait  School  of  Nursing. 
Lethbridge;  Dipl.  in  P.H.  and  B.Sc, 
U.  of  Alberta)  is  director  of  health 
services  at  St.  Michael's  General  Hospi- 
tal in  Lethbridge. 

A  former  vice- 
president  and  sec- 
retary of  the  Leth- 
bridge chapter  and 
chairman  of  the 
nursing  education 
committee  for  the 
South  District,  Mrs. 
Mossey  has  also 
been  involved  in 
staff  nurses'  associations  since  1 964  and 
has  been  chairman  of  the  AARN  pro- 
vincial committee  for  staff  nurses'  asso- 
ciations. 


Anne  Isobel  MacLeod  was  honored  at  a 
special  convocation  at  McGill  Univer- 
sity May  28  with  an  honorary  Doctor 
of  Law  degree. 

Mrs.  MacLeod  (B.Sc.N,  U.  of  Al- 
berta; M.A.,  Teachers  College,  Colum- 
bia U.)  has  been  director  of  nursing  at 
The  Montreal  General  Hospital  since 
1953. 

As  a  prominent  public  health  nurse, 
Mrs.  MacLeod  was  assistant  super- 
visor of  the  Victorian  Order  of  Nurses 
in  Victoria,  British  Columbia;  a  health 
teacher  at  the  Winnipeg  General  Hos- 
pital; instructor  of  public  hea.'th  nurs- 
ing at  the  school  of  nursing,  the  Uni- 
versity of  Manitoba;  assistant  super- 
intendent of  the  VON  for  Canada  from 
1 947  to  1 949 ;  and  director  of  Montreal 
branch  of  the  VON  from  1949  to  1953. 

In  presenting  the  honorary  LL.D. 
degree  to  Mrs.  MacLeod,  the  executive 
director  of  The  Montreal  General  Hos- 
pital said: 

"During  the  almost  two  decades  in 
which  Mrs.  MacLeod  has  directed  the 
nursing  affairs  of  The  Montreal  General 
Hospital,  she  has  been  responsible  for 
the  education  of  approximately  1.700 
student  nurses  ....  With  her  great 
knowledge  of  the  art  and  the  science  of 
nursing,  her  understanding  of  the  care 
of  the  sick,  and  her  wise  counsel  and 


sense  of  responsibility,  she  has  made  a 
contribution  to  Canadian  Nursing  rarely 
achieved  in  the  past  and  which  in  our 
changing  times  may  not  be  possible  in 
the  future. 

"Mrs.  MacLeod  is  known,  not  only 
in  our  McGill  University  teaching  hos- 
pital orbit,  but  as  a  past  president  of 
the  Canadian  Nurses'  Association 
[  1964-1966]  during  some  of  the  dif- 
ficult years  in  the  sixties  when  new 
approaches  in  nursing  were  being  for- 
mulated, and  her  advice  continues  to 
be  sought  by  governments  at  all  levels 
in  this  country  and  abroad." 


Margaret  S.  Neylan, 

associate  professor 
at  the  school  of 
nursing  and  direc- 
tor of  continuing 
nursing  education. 
University  of  Brit- 
ish Columbia,  has 
been  elected  presi- 
dent ot  the  Register- 
ed Nurses'  Association  ol  British  Co- 
lumbia. Her  election,  by  mail  ballot  of 
the  membership,  was  announced  May 
28  in  Vancouver.  She  succeeds  Monica 
D.  Angus  for  a  two-year  term. 

Mrs.  Neylan  (R.N.,  Brandon  General 
H,.  Brandon.  Man.;  B.Sc.N.,  McGill  U., 
Montreal:  M.A.,  U.  of  British  Colum- 
bia; Dipl.  Supervision  in  Pyschiatric 
Nursing.  McGill  U.)  has  a  wide  range 
of  nursing  experience.  She  has  been 
staff  nurse  and  head  nurse  at  the  Pro- 
vincial Mental  Hospital  in  Ponoka, 
Alberta;  head  nurse  and  supervisor  at 
The  Montreal  General  Hospital,  psy- 
chiatric division;  and  a  psychiatric  nurse 
at  a  private  hospital  in  New  York  City, 
and  at  St.  Anne  de  Bellcvue.  Quebec. 

RNABCs  new  president  has  been 
active  on  the  RNABC  committee  on 
nursing  education,  the  task  committee 
on  learning  rest)urces.  the  task  planning 
committee  on  n'rsing  education,  and 
a  task  committee  to  establish  criteria  for 
courses  in  intensive  care  nursing.  Mrs. 
Neylan  was  also  a  joint  director  of  the 
RNABC  funded  research  project  to 
study  the  perceived  learning  needs  of 
graduate  students  working  fulltime  in 
giving  direct  care  to  patients  in  acute 
medical-surgical  units.  As  well,  she 
served  as  a  consultant  in  continuing 
nursing  education  to  RNABC  districts 
and  chapters. 

Other  new  officers  are  Geraldine 
Lapointe,  first  vice-president,  who  is 
director  of  nursing  education.  Royal 
Inland  Hospital  School  of  Nursing. 
Kamloops,  B.C.,  Donald  C.  Ransom, 
second  vice-president,  infection  control 
coordinator.  St.  Paul's  Hospital.  Van- 
couver; Marion  Macdonell,  honorary 
treasurer,  health  unit  supervisor.  Metro- 
politan Health  Services.  Vancouver: 
SEPTEMBER  1971 


Marilyn  J.  McSporran,  honorary 
tarv.  Kootenay  Lake  District  He 
Nelson.  B.C. 


secre- 

lospital. 


fivy  H.  Dunn  (R.N.. 
The  Montreal  Gen- 
eral H.;Dipl.  Psych. 
Nurse.,  McGill  U., 
Montreal:  M.Sc.N.. 
Nursing  Adminis- 
tration. Boston  U.) 
was  appointed  di- 
rector of  nursing  at 
the  Royal  Ottawa 
Hi'spitai  in  August  IS>70. 

Miss  Dunn's  nursing  experience  in- 
cludes head  nurse,  nursing  supervisor, 
and  director  of  nursing  —  all  at  the 
Douglas  Hospital  in  Montreal. 

She  was  secretary  of  the  Psychiatric 
Nurses'  Interest  Group  in  Montreal, 
as  well  as  a  co-trainer  at  the  Registered 
Nurses"  Association  of  Ontario's  annual 
conference  on  personal  growth  and 
group  achievement.  Miss  Dunn  was 
aiso  treasurer  of  the  asstx;iate  members. 
United  Nurses  of  Montreal,  and  a  chair- 
man of  the  committee  for  nursing, 
district  XI,  English  Chapter  of  the 
Association  of  Nurses  of  the  Province 
of  Quebec. 

Sarah  Persis  Darrach 

(R.N.,  The  Brandon 
General  H.  School 
of  Nursing,  Bran- 
don, Man .)  was 
awarded  an  honor- 
ary doctor  of  laws 
degree  from  Bran- 
don University  at  its 
spring  convocation. 
Dr.  Darrach  was  superintendent  of 
nurses  at  the  Brandon  General  Hospi- 
tal, and  dean  of  women  at  Brandon 
College  until  she  retired  in  1953.  She 
is  the  first  woman  to  receive  an  honor- 
ary doctor  of  laws  degree  from  Brandon 
University. 


Dorothy  M.Wylie(Reg.N.,  St.  Michael's 

H.,  Toronto;  B.N.,  New  York  U;  M.A.. 
Teachers  College,  Columbia  U.)  has 
been  appointed  director  of  nursing  at 
Sunnybrook  Hospital,  University  of 
Toronto. 

^^^  Miss     Wylie     was 

/M/^B^L.         asscxiate  director  of 

4|^^HiH||A     clinical    nursing   at 

1^      ^%P     the        Scarborough 

^^^F^  ^.W      Centenary  Hospital 

im^  ♦f      in  West  Hill,  Onta- 

^  ^^9r^  rio,  from  1969  until 

^PB^t  her  recent  appoint- 

'  '^■1^  ment.  She  has  held 

wHIA  a  number  of  senior 

clinical     and     nursing    administrative 

positions  in  the  United  States. 

SEPTEMBER   1971 


E.  Marie  Rice  (Reg.  N.,  Wellesley  Hos- 
pital School  of  Nursing,  Toronto:  B.N., 
School  for  Graduate  Nurses,  McGill  U., 
Montreal)  has  been  appointed  assistant 
administrator  of  nursing  at  the  New 
Mount  Sinai  Hospital  in  Toronto. 

Mrs.  Rice  has  a  varied  background 
in  nursing.  She  was  general  duty  nurse, 
assistant  head  nurse, 
head  nurse,  and 
educational  super- 
visor at  the  Welles- 
ley  Hospital  in  To- 
ronto, lecturer  in 
surgical  nursing  at 
the  University  of 
Toronto,  assistant 
director  of  nursing 
education  and  director  of  nursing  at  the 
New  Mount  Sinai  Hospital. 

The  new  assistant  administrator  is  a 
past  president  of  the  Registered  Nurses" 
Association  of  Ontario,  and  was  a  mem- 
ber of  the  provisional  council  of  the 
College  of  nurses.  Mrs.  Rice  was  also  a 
member  of  the  manpower  committee 
for  the  Ontario  Council  of  Health,  and 
she  served  on  the  ad  hoc  committees  on 
legislation  and  on  the  function,  structure 
and  relationships  of  the  Canadian 
Nurses'  Association.  She  was  a  short- 


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term  consultant  to  South  East  Asia  for 
the  World  Health  Organization,  and  a 
CNA  observer  to  the  Canadian  Council 
on  Hospital  Accreditation.  At  present 
Mrs.  Rice  is  a  member  of  the  CNA 
nominating  committee. 

Lois  L  Gladney  received  a  lite  mem- 
bership in  the  New  Brunswick  Asso- 
ciation of  Registered  Nurses  at  the 
association's  annual  banquet  May  17. 
Sister  BerniceLeBlanc  of  ValleeLourdes 
presented  the  citation,  which  described 
Mrs.  Gladney's  contributions  to  the 
nursing  profession  at  the  national  and 
provincial  levels.  Sister  LeBlanc  is  also 
a  life  member  of  NBARN. 

Mrs.  Gladney  is  a  graduate  of  the 
Royal  Victoria  Hospital  School  of 
Nursing  in  Montreal.  Her  nursing 
experience  has  included  the  positions 
of  staff  nurse,  head  nurse,  night  super- 
visor, and  private  duty  nursing.  She 
joined  NBARN  staff  in  1957,  and  in 
1959  was  appointed  the  association's 
first  registrar,  a  position  she  held  until 
her  retirement  last  December. 

Life  membership  is  granted  to  mem- 
bers or  former  members  of  NBARN  in 
recognition  of  long  or  outstanding  ser- 
vice to  the  association.  NBARN  now 
has  15  life  members. 


£Jean  Woods  Smith 
(R.N.,  Manchester. 
England:  Diploma. 
Occupational 
Health  Nursing, 
Royal  College  of 
Nursing,  London) 
has  been  appointed 
cKcupational  health 
nursing  consultant 
in  the  Department  of  Public  Health, 
Halifax,  Nova  Scotia. 

Mrs.  Smith  has  had  extensive  expe- 
rience in  occupational  health,  both  in 
Great  Britain  and  in  Canada.  Before 
her  present  appointment  she  was  an 
occupational  health  nursing  consultant 
with  the  Department  of  Public  Health 
in  Regina.  Saskatchewan. 

Jessie  M.  Wilson  retired  as  director  of 
nursing  at  the  Runnymedc  Hospital 
in  Toronto,  after  25  years  of  service. 

OA  graduate  of  the 
Toronto       General 
Hospital   School   of 
Nursing.  Miss  \V  il- 
/  son  received  her  di- 

ploma in  advanced 
nursing  education 
from  the  University 
of  Toronto  School 
l«."l  of  Nursing,  and  a 
bachelor  iif  arts  in  psychology  l'ri>m  the 
University  of  Toronto.  She  has  been 
with  the  Runnymedc  Hospital  since  it 
llrst  opened  in  1945.  ^'' 

THE  CANADIAN  NURSE     27 


HOSPITAL 
LIQUID  UNIT  DOSE 


...for  safety,  control,  convenience 


Each  unit  dose  is  protected  against 
contamination  in  amber  glass  with 
tamper-proof  seal,  clearly  labelled  as 
positive  safeguard  against  error  in 
administration. 


Each  unit  dose  is  precisely  measured, 
easily  identified  by  name,  quality- 
assured  from  our  production  line  to  your 
patient's  bedside. 


Each  unit  dose  is  ready  to  administer 
right  from  the  spill-proof  bottle,  saving 
you  valuable  time  in  preparation  and 
distribution. 


Each  unit  dose  is  packaged  to  provide 
the  maximum  safety,  control  and 
convenience. 


intra  medical  products 


TORONTO,  ONTARIO 


September  22-25, 1971 

Annual  conference  of  the  Canadian  Asso- 
ciation for  the  Mentally  Retarded,  Hotel 
Nova  Scotian,  Halifax,  N.S.  A  pre-conference 
professional  session  on  the  report  of  the 
Commission  on  Emotional  and  Learning 
Disorders  in  Children  is  planned  for  the 
24th,  and  a  concurrent  youth  conference 
will  take  place  on  the  last  two  days.  For 
further  information  write  to  the  CAMR, 
Kinsmen  NIMR  Building,  York  University, 
4700  Keele  Street,  Downsview,  Toronto. 

September  29-October  1, 1971 

14th  annual  convention  of  the  Alberta  Certi- 
fied Nursing  Aide  Association  in  Calgary. 
For  more  information  write  to  A.C.N. A. A. 
Office,  no.  4,  10830-107  Avenue,  Edmonton, 
Alberta. 

September  30  and  Oct.  1, 1971 

Conference  for  Industrial  Nurses,  Windsor 
Hotel,  Montreal,  P.O. 

October  3-6, 1971 

National  Conference  of  the  Community 
Planning  Association  of  Canada,  Halifax, 
Nova  Scotia.  For  further  information  write 
Mr.  R.G.  Elliot,  Conference  Coordinator, 
CPAC,  Nova  Scotia  Division,  P.O.  Box  211, 
Halifax,  Nova  Scotia,  or  CPAC  National 
Office,  425  Gloucester  St.,  Ottawa,  Ontario, 
K1R5E9. 

October  5-8, 1971 

Institute  on  mental  retardation  sponsored 
by  the  schools  of  nursing  and  social  work. 
University  of  Toronto.  Designed  for  public 
health  nurses  and  social  workers  working 
with  young,  mentally  retarded  children  and 
their  families.  For  further  information  write 
to  Mrs.  Marion  I.  Barter,  Continuing  Educa- 
tion Program  for  Nurses,  University  of  To- 
ronto, 47  Queen's  Park  Crescent,  Toronto 
5,  Ontario. 

October  6-8, 1971 

Canadian  Society  of  Respiratory  Tech- 
nologists, 6th  annual  convention  and  educa- 
tional seminar,  Winnipeg  Inn,  Winnipeg. 
For  information  write  to  Charles  Frew, 
R.R.T.,  Inhalation  Therapy  Dept.,  Victoria 
General  Hospital,  2340  Pembina  Highway, 
Winnipeg  19,  Manitoba. 

October  13-15, 1971 

Association  of  Registered  Nurses  of  New- 
foundland, annual  meeting,  St.  John's, 
Newfoundland. 

October  18-22, 1971 

National  Conference  On  Continuing  Educa- 
tion In  Nursing,  The  University  of  Wiscon- 

SEPTEMBER  1971 


sin,  Madison.  Designed  for  nurses  on  the 
faculty  of  a  college  or  university,  on  the 
inservice  education  staff  of  a  medical  center 
associated  with  an  institution  of  higher 
learning,  or  on  the  staff  of  a  regional  medi- 
cal program.  General  sessions  will  consider 
philosophies  of  continuing  education, 
implications  for  professional  licensure, 
competencies  of  faculty,  and  national  and 
regional  planning  for  continuing  education. 
For  further  details  write  to:  Department  of 
Nursing,  Health  Science  Unit,  University 
Extension,  The  University  of  Wisconsin, 
610  Langdon  St.,  Madison,  Wisconsin 
53706,  U.S.A. 

November  15-16,  1971 

Clinical  evaluation  in  nursing,  sponsored 
by  the  University  of  Toronto  School  of 
Nursing.  A  study  of  the  principles  of  clinical 
evaluation  and  their  application  in  the 
development  and  use  of  specific  evaluative 
methods  in  nursing.  Planned  primarily  for 
teachers  in  schools  of  nursing.  For  further 
information  write  to  Continuing  Education 
Program  for  Nurses,  University  of  Toronto, 
47  Queen's  Park  Crescent,  Toronto  5,  Ont. 

October  21-23, 1971 

Second  Symposium  of  the  Institute  of 
Community  and  Family  Psychiatry,  Jewish 
General  Hospital,  Montreal,  Quebec.  Papers 
on  techniques  in  family  therapy  and  on  the 
future  of  the  family  will  be  presented  with 
simultaneous  translation  into  French.  For 
further  information  write  Mrs.  F.  Silver- 
stone,  Registrar,  Institute  of  Community 
and  Family  Psychiatry,  4333  Cote  St.  Cathe- 
rine Road,  Montreal  249,  Quebec. 

October  28-30, 1971 

Annual  meeting,  Association  of  Nurses  of 
the  Province  of  Quebec,  Queen  Elizabeth 
Hotel,  Montreal,  Quebec. 

May  25-27, 1972 

The  75th  anniversary  of  the  Sherbrooke 
Hospital  School  on  Nursing  will  be  celebrat- 
ed by  a  reunion  for  all  former  graduates 
and  faculty  members.  For  more  informa- 
tion write  Mrs.  Ruth  Atto,  Sherbrooke  Hos- 
pital, 375  Argyle  Street,  Sherbrooke,  P.O. 

August  27-September  1, 1972 

Twelfth  World  Congress  of  Rehabilitation 
International,  Chevron  Hotel,  Kings  Cross. 
Sydney,  Australia.  Conference  Theme: 
Planning  Rehabilitation:  Environment  — 
Incentives  —  Self-Help.  For  further  in- 
formation write:  Twelfth  World  Rehabilita- 
tion Congress,  G.P.O.  Box  475,  Sydney, 
NSW.  2001,  Australia.  ^ 


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THE  CANADIAN  NURSE     29 


^f' 


omfortable/economical/yitfesaving/retelast' 


Available  in  9 
different  sizes. 
The  original  tubular 
elastic  mesh  bandage 
allergy  free,  indispensable 
for  hospital  care. 
New  stretch  weave  allows 
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The  expanding  role: 
where  do  we  go  from  here? 


The  Canadian  Nurses'  Association  and  the  provincial  nurses'  associations  have 
issued  firm,  unequivocal  statements  about  the  proposal  to  create  a  new  health 
worker,  and  nursing  leaders  have  had  considerable  success  in  presenting  the 
profession's  case  to  other  professional  groups,  to  various  levels  of  government, 
and  to  the  public.  What  happens  next  will  depend  to  a  large  extent  on  the 
attitudes  and  actions  of  the  individual  nurse. 


Helen  K.  Mussallem,  S.M.,  R.N.,  Ed.D. 


Future  historians  of  nursing  will  sec 
this  decade  as  one  of  tremendous  en- 
largement in  the  scope  and  service  of 
our  profession.  In  the  past  years  we 
have  emerged  from  uncertainty  and 
self-doubt  about  our  role  into  an  almost 
unprecedented  degree  of  awareness  and 
self-determination.  At  the  same  time, 
we  have  within  our  grasp  an  opportunity 
to  participate  in  crucial  decisions  that 
could  shape  a  whole  new  future  for 
health  care  in  Canada. 

As  members  of  a  self-determining 
profession,  we  cannot  afford  to  be 
passive  observers.  And  no  nurse  who 
is  aware  of  her  own  roots  and  who  ac- 
cepts her  role  as  the  pivotal  element 
on  the  health  team  needs  to  feel  threat- 
ened by  change.  The  whole  history  of 
nursing  is  based  on  adaptation  to  social 
crisis  and  challenge. 

When  the  Augustinian  Hospitallers, 
the  Ursuline  sisters,  and  Jeanne  Mance 
arrived  in  Canada  over  three  centuries 
ago,  they  were  the  front  line  health 
professionals  committed  to  serve  the 
inhabitants  of  the  New  World.  Since 
then,  nurses  have  been  and  still  are  on 
the  front  line  of  health  services  and, 
although  the  practice  of  nursing  has 
changed  dramatically,  the  traditional 
commitment  remains. 

Our  nursing  ancestors  had  to  deal 
with  scarcity,  primitive  conditions, 
physical  hardships,  and  danger.  We 
have  to  deal  with  problems  created 
by  great  technological  riches  and 
SEPTEMBER  1971 


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Dr.  Mussallem  is  Executive  director  of 
the  Canadian  Nurses"  Association. 

radically  altered  attitudes,  in  a  sense, 
we  are  victims  of  our  own  technology 
and  affluence,  and  the  challenge  today 
is  to  create  a  system  that  will  guarantee 
health  care  to  every  citizen. 

If  I  may  be  permitted  to  make  a 
nursing  diagnosis,  what  we  suffer  from 
is  fragmentation  —  fragmentation  that\ 
could  lead  to  depersonalization  of  care. 
What  can  we  as  nurses  do  to  foster 
the  ancient  art  of  "caring"  within  to- 1 


day's  complicated  and  sophisticated 
scheme  of  health  care?  We  can  begin 
by  resisting,  individually  and  collective- 
ly, the  impetus  to  further  complicate 
and  fragment  health  care  by  introduc- 
ing new  categories  of  workers. 

I  am  referring,  of  course,  to  proposals 
for  the  creation  of  a  new  category  of 
health  worker,  popularly  called  a 
"physician's  assistant."  A  MEDLARS 
search  on  the  "physician's  assistant" 
topic  reveals  through  print-outs  that 
the  literature  on  the  subject  is  increas- 
ing almost  hourly.  Conspicuously 
absent  from  this  documentation  is  the 
one  category  that  needs  an  assistant  — 
the  patient,  whom  we  purport  to  serve. 

Obstacles  to  overcome 

In  addition  to  the  fragmentation  and 
depersonalization  of  service  to  the 
individual,  other  obstacles  block  our 
efforts  to  give  effective  care  to  all 
citizens.  These  are: 

•  Separation  of  preventive  (public 
health)  and  "curative"  (hospital)  ser- 
vices. 

•  Discrepancy  between  the  resources 
—  human  and  financial  —  made  avail- 
able to  the  preventive  and  "curative" 

A  bibliography  on  the  topic  of  the  physi- 
cian's assistant  and  the  expanded  role  of 
the  nurse  is  available  on  request.  Write 
to  the  [  ibrarian.  Canadian  Nurses'  Asso- 
ciation. 50  I  he  Driveway.  Ottawa  K2I' 
I E2,  Ontario,  Canada. 

THE  CANADIAN  NURSE     31 


programs.  Why  are  less  than  seven 
percent  of  nurses  in  Canada  engaged 
in  public  health  practice?  Can  we 
justify  devoting  only  five  percent  of 
the  health  dollar  to  preventive  services? 

•  Uneven  geographical  distribution 
of  health  personnel,  and  a  late  start  on 
efforts  to  coordinate  the  overall  supply 
and  work  of  all  health  professionals. 

•  Uneven  distribution  and  use  of  health 
facilities.  Although  Canada  has  gone 
far  in  reducing  the  economic  barriers 
to  health  care,  there  are  still  serious 
gaps  in  home  nursing,  dental  care, 
drug  therapy,  and  so  on. 

The  general  public  and  some  health 
professionals  believe  these  obstacles 
are  caused  by  an  undersupply  of  per- 
sonnel, particularly  physicians.  There 
is  undoubtedly  justification  for  this 
belief.  Many  in  the  low  income  group 
do  not  have  family  doctors  and  are 
experiencing  increasing  difficulty  in 
making  contact  with  a  physician.  The 
same  complaint  is  also  heard  from  the 
more  affluent. 

Today,  when  patients  seek  or  are 
directed  to  a  physician,  they  are  usually 
confronted  by  overcrowded  offices  or 
clinics  and  long  waiting  periods;  or, 
even  worse,  they  are  unable  to  get  an 
appointment.  Too  often  they  receive 
only  a  few  minutes  of  expert  medical 
advice  from  a  busy  practitioner  who 
has  little  time  to  give  the  necessary 
technical  instruction,  to  say  nothing  of 
health  teaching  and  preventive  counsel- 
ing. 

It  is  easy  to  assume  that  this  situation 
calls  for  an  enlarged  supply  of  doctors. 
Closer  inspection,  however,  suggests 
that  both  the  physician  and  the  patient 
need  assistance. 

To  a  degree,  this  aid  is  now  being 
provided  in  two  different  ways.  First, 
highly  specialized  technical  functions 
are  performed  by  technicians  or  as- 
sistants who  are  trained  to  perform 
one  task,  such  as  testing  for  skin  aller- 
gies, doing  electrocardiograms,  or  ap- 
32     THE  CANADIAN  NURSE 


plying  plaster  casts.  Second,  in  remote 
settings,  as  in  the  Canadian  North, 
nurses  diagnose  and  treat  a  wide  variety 
of  medical  conditions  and  supervise  the 
general  health  of  the  community.  Access 
to  medical  consultation  and  specialized 
care  is  by  way  of  telephone,  radio,  and 
airplane. 

These  two  —  the  specialized  tech- 
nician and  the  nurse  practitioner  — 
are  quite  different.  The  first  is  a  tech- 
nician whose  competence  does  not 
depend  on  a  comprehensive,  sound, 
scientific  background.  The  second  is  a 
general ist  whose  concern  is  for  the 
welfare  of  the  whole  individual  with 
sensitivity  to  the  needs  of  the  family 
and  community.  For  competent  prac- 
tice, she  requires  a  scientific  back- 
ground to  enable  her  to  recognize  the 
significance  of  health  problems  encoun- 
tered. The  depth  of  her  knowledge  and 
the  extent  of  her  skills  should  match  the 
nature  of  the  task  to  be  undertaken. 
This,  in  turn,  rests  on  the  needs  and 
resources  of  the  setting  in  which  she 
serves. 

Physician's  assistant  not  needed 

The  critical  question  is  whether  the. 
urban  community,  or  indeed  every 
community,  needs  the  services  of  a 
new  kind  of  generalist.  If  so,  should 
that  service  be  provided  by  enlarging  the 
role  of  the  nurse  or,  as  proposed  in  the 
United  States,  by  creatii)g  a  new  catego- 
ry of  health  professional —  the  physi- 
cian's assistant? 

This  topic  has  consumed  countless 
hours  in  the  conclaves  of  professional 
organizations  and  departments  of 
government.  Too  frequently,  however, 
the  issue  has  been  Confused  by  failure 
to  distinguish  between  two  different 
needs  and  the  roles  just  described. 

Discussion  became  less  theoretical 
with  the  publication  in  November  1969 
of  the  Task  Force  Reports  on  the 
Cost  of  Health  Services  in  Canada, 
which    had    far-reaching    implications 


for  nursing.'  This  report  recommended 
more  rational  and  economic  use  of 
health  care  resources,  including  more 
efficient  use  of  nursing  personnel; 
the  upgrading  of  managerial  skills; 
an  examination  of  alternative  systems 
of  care;  and  the  setting  up  of  a  pilot 
project  to  train  (and  later  evaluate)  a 
class  of  physician's  assistants.  Concur- 
rently, announcement  of  courses  to 
train  the  new  category  aroused  specula- 
tion and  some  anxiety. 

The  role  of  nursing  and  the  propos- 
ed development  of  a  new  and  separate 
category  of  health  professional  were 
major  topics  at  the  Canadian  Nurses' 
Association  general  meeting  in  1970. 
Resolutions  were  adopted  directing 
CNA  to  develop  a  statement  on  the 
physician's  assistant,  and  to  urge  the 
federal  government  to  convene  a  nation- 
al conference  of  health  purveyors  and 
consumers  to  discuss  "more  effective 
utilization  of  medical  and  nursing  man- 
power to  fill  the  unmet  needs  of  Cana- 
dians .  .  .  with  special  emphasis  on  the 
development  of  complementary  roles 
for  nurses  and  physicians. "'^ 

Nurses  across  Canada  —  and  partic- 
ularly the  CNA  board  of  directors  — 
studied  these  questions  in  depth.  In 
October  1970,  the  CNA  board  issued 
an  official  statement  on  the  proposed 
creation  of  a  new  catagory  of  health 
worker,  and  asserted  that  health  needs 
could  be  met  more  effectively  and 
economically  by  expanding  the  role  of  ^ 
the  nurse. 

CNA's  pronouncement  stated  that 
nurses  constitute  a  large  and  ready  pool 
of  health  professionals  who,  with  little 
or  no  added  training,  could  assume 
greater  responsibilities.  Public  health 
nurses,  in  particular,  already  carry 
out  many  functions  suggested  for  the 
proposed  physician's  assistant,  and 
many  other  university-prepared  nurses 
do  not  now  realize  their  full  potential. 

Nurses    seeking    employment    in    a 

number  of  Canadian  cities  would  be 

SEPTEMBER  1971 


readily  available  if  new  roles  existed, 
and  it  would  be  less  costly  to  provide 
short  courses  for  nurses  than  to  fund 
programs  to  prepare  a  totally  new 
category.  CNA  urged  that  immediate 
action  be  taken  to  use  nursing  potential 
to  its  fullest  capacity  in  relation  to 
primary,  continuing,  preventive,  and 
specialized  care.  The  association  also 
recommended  that  research  and  dem- 
onstration projects  be  undertaken  to 
assess  the  feasibility  of  an  expanding 
role  for  nurses. 

This  statement  was  addressed  to 
the  minister  of  national  health  and 
welfare  and  circulated  widely  to  gov- 
ernment agencies  at  all  levels,  to  other 
professional  groups,  to  consumer 
representatives,  and  to  key  individuals. 

Last  April,  a  conference  on  "Assist- 
ance to  the  physician:  the  complemen- 
tary role  of  the  physician  and  nurse," 
was  convened  in  Ottawa  by  the  depart- 
ment of  national  health  and  welfare 
with  the  cooperation  of  the  CNA,  the 
Canadian  Medical  Association,  and 
the  Canadian  Association  of  Consum- 
ers. Most  participants  invited  to  the 
conference  were  doctors,  nurses,  and 
consumers. 

Nurses  from  all  regions  of  Canada 
played  a  major  role  in  this  conference 
both  as  planners  and  participants.  They 
were  confident,  informed,  and  able 
contributors  in  formal  presentations 
at  plenary  sessions  and  in  discussions 
with  fellow  professionals  and  consum- 
ers. 

By  the  end  of  the  conference  it  was 
clear  that  the  nurse  was,  for  many 
reasons,  the  logical  health  professional 
to  work  in  partnership  with  the  physi- 
cian in  providing  health  care.  Further, 
the  consensus  was  that  a  new  category 
of  worker  —  the  physician's  assistant 
—  was  neither  required  nor  acceptable. 

Conferences  were  held  in  other  cities, 
and  nurses  met  on  a  basis  of  mutual 
partnership  with  physicians  and  receiv- 
ed professional  and  public  acceptance 
SEPTEMBER  1971 


as  the  persons  most  suitable  to  be 
prepared  for  this  role.  At  a  meeting 
organized  by  the  College  of  Family 
Physicians  of  Canada,  one  doctor 
commended  nurses  for  their  emphasis 
,  on  "health,"  as  opposed  to  "disease," 
identifying  them  as  truly  modern  exem- 
plars of  an  expanded  vision  of  medical 
care. 

Thus,  the  task  of  solving  the  prob- 
lem of  improving  the  quality  of  care 
and  making  it  available  to  all  obviously 
rests  on  the  shoulders  of  both  physicians 
and  nurses.  Nurses  are  now  challenged 
to  develop  ways  in  which  they  can 
extend  their  role  to  work  effectively 
in  a  complementary  relationship  with 
the  physician  in  primary  health  care. 

The  immediate  task  is  to  demonstrate 
the  nurse's  capacity  to  accept  respon- 
sibility for  the  broader  role  required  by; 
society.  Nurses  must  be  prepared  to 
conduct  the  best  possible  program  of 
research,  demonstration,  and  assess- 
ment. They  must  not  only  identify  and 
communicate  what  they  are  capable  of 
providing  in  the  way  of  extended  ser- 
vices, but  they  must  also  tell  their  story 
loudly  and  clearly  about  the  compre- 
hensive, innovative  roles  they  are  now 
playing.  When  the  story  is  told,  nurses, 
other  health  professionals,  and  the  pub- 
lic will  be  surprised. 

Nurse's  role  has  expanded 

A  year  ago  I  was  invited  by  The 
Medical  Post  to  contribute  an  article 
on  the  expanding  role  of  the  nurse.*  I 
decided  to  undertake  my  own  informal 
survey  of  nursing  potential  and  re- 
sources. Although  we  have  discussed 
and  speculated  about  the  extent  to 
which  some  nurses  have  expanded 
i  their  roles,  there  is  no  organized  survey 

*  Reprints  of  The  Medical  Post  article  can 
be  obtained  by  writing  to  the  Public 
Relations  Offi(;er,  the  Canadian  Nurses" 
Association,  50  The  Driveway,  Ottawa 
K2P  1E2,  Canada. 


or  investigation  to  indicate  the  nature 
and  extent  of  this  trend. 

As  a  purely  personal  venture,  I  wrote 
to  about  50  nurses  on  CNA  national 
committees,  outlining  the  problem  and 
asking  them  to  comment  on  the  expand- 
ed role  they  had  assumed  or  one  in 
which  they  were  intimately  involved. 
The  response  was  astonishing,  both  in 
scope  and  volume.  Lucid,  fascinating 
documents  arrived  daily  describing 
nurses  with  little  advanced  preparation 
who  were  enlarging  their  responsibili- 
ties mainly  through  inservice  training. 
Others,  with  more  advanced  prepara- 
tion, were  making  sophisticated  diag- 
nostic judgments,  using  complicated 
monitoring  devices  in  highly  complex 
patient  situations,  and  assuming  greatly 
enlarged  duties  in  patient  teaching, 
counseling,  and  coordination  of  care. 
Moreover,  they  established  continuity 
of  health  supervision  of  individuals  and 
their  families  from  hospital  to  home. 
I  discovered  a  whole  new  dimension 
of  nursing  practice  in  Canada. 

I  found  that  nurses  are  providing  a 
surprisingly  varied  and  expanded 
service  in  every  area  of  patient  care  — 
from  coronary  and  intensive  care  units 
in  the  most  modern  hospitals  to  com- 
munities where  the  nurse  is  the  sole 
health  professional.  These  are  highly 
skilled  professionals  known  over  the 
centuries  by  the  name  "nurse."  All  see 
their  patients  as  a  whole  person,  as 
part  of  a  family  and  a  community.  They 
see  their  unique  contribution  in  return- 
ing the  individual  to  his  fullest  capacity 
for  living  the  "good  life."  They  are 
devising  new  methods  of  care  and  are 
still  retaining  the  nurse's  historic 
attributes  of  compassion  and  service 
within  a  contemporary  technological 
framework. 

These  changes  have  not  taken  place 
in  a  vacuum.  We  need  constantly  to 
remind  ourselves  of  the  rapidly  chang- 
ing social  climate  that  provides  the 
impetus  and  setting  for  new  approaches: 
THE  CANADIAN  NURSE     33 


•  Rising  consumer  expectations  and 
spiraling  health  costs  have  made  gov- 
ernment and  public  alike  increasingly 
open  to  change  and  reform,  not  only  in 
the  delivery  of  health  care,  but  also  in 
its  accessibility. 

•  Nurses  are  gaining  recognition  as  a 
responsible  body  of  professionals  and 
citizens.  Also,  nurses'  organizations  are 
losing  some  of  their  timidity  in  com- 
municating with  other  professions  and 
the  public  at  large.  This  has  been 
reflected  in  a  greatly  enhanced  climate 
of  interprofessional  respect  and  accept- 
ance. 

•  Rapid  change  and  reforms  in  nurs- 
ing education  are  reflected  in  attitudes 
and  approaches  to  health  care.  With 
22  university  schools  of  nursing,  an 
accelerating  shift  of  diploma  programs 
into  educational  settings,  and  increas- 
ed emphasis  on  continuing  education, 
nurses  are  engaged  in  a  process  of  self- 
examination,  reappraisal,  upgrading, 
and  improvement  that  will  provide  a 
growing  body  of  well-equipped  prac- 
titioners. Implementation  of  a  core 
curriculum  in  health  science  education 
will  give  an  increasing  number  of  nurses 
and  physicians  a  better  understanding 
of  the  other's  role. 

•  Nurses  now  have  equal  opportunity 
with  other  health  professionals  to  obtain 
federal  health  grants  for  research  and 
innovative  programs. 

How  should  nurses  react? 

Prospects  for  the  individual  health 
professional  in  meeting  the  health  needs 
of  both  sick  and  well  in  a  complex 
society  can  be  stimulating.  It  can  also 
be  uncomfortable.  The  nurse  has  new 
realities  to  face  and  new  concepts  of 
health  care.  How  should  she  react? 
First  —  and  this  is  essential  —  she 
must  reexamine  and  assess  her  own 
role  and  functions.  Then  she  can  ana- 
lyze, in  her  own  situation,  all  the  activi- 
ties that  someone  "above"  her  is  per- 
forming and  that  she,  with  her  prepara- 
tion, can  do  better.  She  can  then  make  a 
34     THE  CANADIAN  NURSE 


plan  to  integrate  these  activities  grad- 
ually into  her  role.  Concurrently,  she 
should  assess  present  activities  to  de- 
termine which  could  be  delegated  to  a 
less  well-prepared  person.  This  is  not 
a  simple  process.  But  it  has  been  done 
by  a  few  nurses  who  had  the  courage 
to  become  "change  agents"  because  they 
wished  to  serve  better  and  knew  they 
could. 

Many  nurses  reject  an  expanding 
role  when  it  is  presented  in  terms  of 
"an  extra  pair  of  hands  for  the  busy 
physician."  Nurses  see  themselves  as 
front-line  troops,  as  primary  contacts, 
and  coordinators  of  health  care.  And 
it  is  in  these  terms  that  new  roles  must 
be  developed. 

In  addition,  nurses  must  be  fullj 
aware  of  the  changing  shape  of  health 
care  into  which  their  services  will  be 
integrated.  In  collaboration  with 
physicians  and  consumers,  nurses  have 
a  responsibility  to  study,  develop, 
experiment  with,  and  expand  the  health 
team  concept.  This  concept  should 
bring  to  bear,  on  behalf  of  the  patient, 
all  available  skills  necessary  for  quality 
care  and  maintenance  of  health. 

The  "pyramid"  view  of  health  pro- 
fessionals is  yielding  to  the  "pie"  con- 
cept, where  each  member  of  the  team 
is  a  wedge  of  different  size  according 
to  the  problem  of  the  patient  or  the 
community.  In  some  situations  a  mem- 
ber of  the  team  may  have  no  part  of  the 
"pie."  However,  the  patient  and  his 
family  always  have  a  wedge. 

Summary 

Nurses  will  be  called  on  to  expand 
their  roles.  The  attitude  of  the  entire 
profession  is  vital  to  the  success  of  the 
pioneering  minority  and  to  the  very 
future  of  nursing.  Difficult  decisions 
will  have  to  be  made  about  education, 
legal  aspects,  and  even  nomenclature. 
Each  nurse  has  a  responsibility  to  be 
informed  and  to  be  involved  —  and 
involvement  will  be  based  on  confi- 
dence. 


These  are  not  matters  that  others  can 
arrange  for  the  nurse.  Each  nurse, 
wherever  she  works,  can  be  a  catalyst 
for  change,  rather  tjian  a  passive  recip- 
ient. This  is  not  easy,  but  it  can  make 
the  difference. 

And  we  must  work  together  to  shape 
the  future.  A  profession  of  nearly 
140,000  registered  nurses  cannot  ab- 
rogate the  responsibility  of  working 
with  others  to  develop  long-range, 
comprehensive  plans  to  improve  health 
care  for  the  entire  population.  And  his- 
tory will  not  deal  lightly  with  a  profes- 
sion which,  because  of  expediency  or 
timidity,  tolerates  a  patchwork  effort 
to  remedy  a  system  that  has  now  become 
outmoded. 

If  it  is  possible  to  generalize  about 
the  innovative  roles  created  by  nurses 
in  a  wide  variety  of  hospitals,  commu- 
nities, and  small  villages,  one  can 
conclude  that  in  almost  every  case  it 
was  the  individual  nurse  who  recogniz- 
ed a  specific  need  and  her  own  ability 
to  contribute. 

A  West  Coast  university  has  as  its 
motto  two  words  that  sum  up  the  chal- 
lenges and  opportunities  of  this  situa- 
tion: Tuum  est  —  "It's  up  to  you." 
And  so  it  is. 

References 

1 .  Canada.  Committee  on  Costs  of  Health 
Services.  Task  force  reports  on  the 
costs  of  health  services  in  Canada. 
Ottawa.  Queen's  Printer,  1970.  3v. 

2.  Resolutions  passed  at  CNA  35th  Gen- 
eral Meeting.  Ciinad.  Niir.w  66:8:26, 
Aug.  1970.  ■§> 


SEPTEMBER  1971 


Why  is  hypothermia 
overlooked? 

Hypothermia  may  be  a  hidden  cause  of  death,  especially  in  elderly  or  debilitated 
persons.  Every  effort  must  be  made  to  recognize  high-risk  patients  and  prevent 
them  from  becoming  cold. 


Keith  G.  Tolman,  M.D. 

In  health,  the  body  temperature  of  man 
is  maintained  within  a  remarl<ably 
narrow  range  in  spite  of  wide  extremes 
of  environmental  temperatures.'  Claude 
Bernard,  in  "Lemons  sur  les  Phenome- 
nes  de  la  Vie,"^  his  lectures  given  at  the 
College  of  France  and  published  post- 
humously in  1878,  said,  "La  fixite  du 
milieu  interieur  est  la  condition  de  la 
vie  libre,  et  independante." 

Most  of  us  are  familiar  with  the 
constancy  of  the  "milieu  interieur," 
but  in  spite  of  Bernard's  remarkable 
discoveries  of  nearly  1 00  years  ago,  wc 
still  fail  to  recognize  the  importance  of 
low  body  temperature.  Yet  we  are 
familiar  with  the  importance  of  high 
body  temperature.  Indeed,  the  search 
for  fever  has  made  thermometry  the 
most  common  clinical  procedure  in 
medicine.  Unfortunately,  we  arc  using 
only  one  end  of  the  scale. 

Interest  in  hypothermia  is  gradually 
increasing  in  both  this  country  and  the 
United  States,  with  gradual  recognition 
that  low  body  temperature  is  just  as 
significant  as  high  body  temperature. 
Here  I  wish  to  emphasize,  as  Bernard 
did,  that  when  the  body  temperature  is 
either  abnormally  high  or  low,  some- 
thing is  disrupting  the  constancy  of  the 
internal  environment. 

Definition 

Normal  body  temperature  is  difficult 
to  define  when  measured  in  a  refined 
manner.  This  is  because  of  the  normal 


SEPTEMBER  1971 


Dr.  I  ohnan,  u  Canadian.  Is  instructor  in 
medicine  at  ihc  college  of  medicine,  gas- 
Irocnicrology  division,  dcparlmeni  of 
internal  medicine.  University  of  Utah 
Medical  C  enter.  Salt  I  ake  C  ity.  Utah. 
I  he  author  thanks  Kathleen  Borick  and 
.Claudia  McNair  for  assistance  in  the 
preparation  of  this  manuscript. 

diurnal  variation  in  body  temperature. 
Usually  the  temperature  is  highest  in 
the  early  evening,  when  it  may  reach 
99.2° F.  Conversely,  it  may  fall  as  low 
as  97.4° K.  between  2  00  A.M  and 
4:00  A.M  These  variations  are  inde- 
pendent of  body  activity  and  do  not 
change  in  people  u  ho  work  at  night  and 
sleep  during  the  da\ . 

THE  CANADIAN  NURSE     35 


For  practical  purposes,  any  tem- 
perature that  falls  beyond  one  degree 
above  or  below  98.4°F.  during  waking 
hours  may  be  considered  abnormal. 

Causes 

Let  us  turn  directly  to  low  body 
temperature.  Out  of  a  maze  of  mis- 
understanding has  come  the  gradual 
acceptance  that  hypothermia  may  be 
more  common  than  previously  suspect- 
ed, and  that  it  may  be  a  clue  to  impor- 
tant diseases.  There  are  three  principal 
types  of  human  hypothermia:  1 .  acci- 
dental, 2.  spontaneous  or  pathologic, 
and  3.  therapeutic  or  induced.  (See 
Table.) 


Ill 


Human  Hypothermia 

Accidental 
Spontaneous 

1.  Central     Nervous    System 
Diseases 

a.  Hypothalamic  tumors 

b.  Vascular  accidents 

2.  Drug-Induced  Conditions 

a.  Sedatives  —  especially 
barbiturates 

b.  Tranquilizers  —  espe- 
cially phenothiazines 

c.  Some  analgesics 

3.  Metabolic  Diseases 

a.  Myxedema 

b.  Hypopituitarism 

c.  Hypoad  renal  ism 

d.  Hypoglycemia 

4.  Liver  Failure 

5.  Cardiovascular  Shock 
Therapeutic 


Accidental  hypothermia  is  usually 
seen  in  people  who  are  both  debilitated 
(by  old  age,  alcoholism,  or  diabetes) 
and  exposed  to  low  environmental  tem- 
peratures. It  is  distinguished  from  other 
forms  of  hypothermia  by  very  low  body 
temperatures,  often  in  the  seventies 
and  eighties,  and  by  absence  of  recog- 
36     THE  CANADIAN  NURSE 


nized  causes  of  hypothermia.  It  rarely, 
if  ever,  occurs  in  normal  individuals. 

Accidental  hypothermia  is  a  partic- 
ular problem  among  the  elderly  in 
Great  Britain  ^  but  has  also  been  report- 
ed in  the  southern  United  States.?  It 
may  be  more  common  in  Canada  than 
previously  suspected,  but  is  missed 
because  of  failure  to  diagnose. 

Spontaneous  or  pathologic  hypo- 
thermia, like  fever,  is  a  manifestation 
of  a  disease  state.  Unlike  fever,  hypo- 
thermia is  a  sign  of  poor  prognosis 
when  associated  with  other  diseases.  It 
is  most  commonly  seen  in  metabolic 
disorders  5  8  (myxedema  and  hypo- 
glycemia), drug  overdosage,  central 
nervous  system  disorders^  (brain  tu- 
mor), liver  failure^o  and  cardiovascular 
shock.  It  is  important  that  nurses  recog- 
nize the  significance  and  importance 
of  hypothermia  because  they  have  an 
unparalleled  opportunity  to  make  the 
initial  observation.  All  too  often  the 
observation  is  simply  not  made  or  is 
passed  over  as  a  technical  failure  of  the 
thermometer.  A  crucial  observation  is 
then  lost. 

Therapeutic  or  induced  hypothermia 
is  low  body  temperature  created  in  the 
patient  for  a  therapeutic  purpose.  It  is 
used  primarily  in  cerebral  vascular  and 
cardiovascular  surgery  because  of  its 
depressing  effect  on  tissue  metabolism. 
The  lessened  demand  for  oxygen  allows 
longer  periods  of  ischemia  during  sur- 
gery. It  has  also  been  tried  experimen- 
tally in  the  treatment  of  pancreatitis 
and  catatonic  schizophrenia. 

Diagnosis 

The  major  problem  has  been  recog- 
nition. Hypothermia  may  be  present 
without  anyone  realizing  it,  largely 
because  the  usual  glass  clinical  ther- 
mometer does  not  measure  in  both  up 
and  down  directions.  It  is  generally 
"shaken  down"  to  only  96°  or  97°F. 
and   therefore  cannot  record  temper- 


atures lower  than  that.  The  problem 
can  be  partially  avoided  by  consistently 
shaking  the  thermometer  down  to,  or 
below,  94°F.  Thermocouple  probe 
thermometers  do  not  present  this  prob- 
lem and  are  therefore  more  reliable.  If 
a  thermocouple  thermometer  (below)  is 
not  available,  a  pediatric  incubator  ther- 
mometer may  be  used  rectally. 


Because  it  is  so  easy  to  miss  hypo- 
thermia in  the  hospital  routine,  it  is 
important  to  recognize  the  settings 
where  hypothermia  may  occur. 

Accidental  hypothermia  should  be 
suspected  in  any  comatose,  hypoten- 
sive patient,  and  the  temperature  should 
be  determined  accurately  and  promptly 
with  an  incubator  thermometer  or  a 
thermocouple  probe.  Suspicion  of 
hypothermia  should  be  raised  by  the 
presence  of  old  age,  alcoholism,  or 
diabetes  mellitus. 

Spontaneous  hypothermia  should 
be  suspected  in  hospitalized  patients 
having  the  conditions  listed  in  the  table. 
Conversely,  the  unexpected  finding  of 
hypothermia  may  offer  a  clue  to  the 
same  conditions. 

Patients   with    suspected   endocrine 

abnormalities,  central  nervous  system 

SEPTEMBER  1971 


E-S 

Meailcs  ind 

! ; 

z~~ 

PouiUc  i 
Pciks 

Mumtis  and 

=—3 

innuenia 

Glandular  fever  —^ 

z — ^ 

Common  cold ^ 

- — c 

(in  infants  and 

;       "" 

,  young  children) 

2 ^ 

Fever      maximum  m 

-     e 

late  afternoon 
or  early 
evening  (99*) 

? 

AveraM 

■Normal- 

Normal  range 

i! 

I 

Minimum 

\ 

7 

3-5  a.m. 
(96.7-) 

Sc 

verc  shock  or  collapse 

Subnormal 

Lowe 

t  survival  level 

< 

disease,  and  liver  disease,  as  well  as 
those  particularly  susceptible  to  cardio- 
vascular shock,  should  have  regular, 
accurate,  temperature  recordings.  Final- 
ly, any  patient  who  subjectively  or 
objectively  feels  cold  should  have 
accurate  temperature  recordings. 

Prognosis 

The  recognition  of  hypothermia 
may  be  important  from  a  prognostic 
point  of  view.  In  cirrhosis,  for  example, 
the  development  of  hypothermia  is 
invariably  fatal.  Furthermore,  hypo- 
thermia is  one  of  the  most  serious 
prognostic  signs  in  septic  shock  and 
myxedema.  On  the  other  hand,  hypo- 
thermia occurring  in  hypoglycemia 
is  totally  reversible  and  has  no  prognos- 
tic significance.  The  prognosis  of  acci- 
dental hypothermia  is  variable,  depend- 

SEPTEMBER  1971 


ing  on  the  occurrence  of  complicating 
factors,  such  as  infection  and  intra- 
vascular thrombosis. 

Treatment 

Treatment  depends  on  the  type  of 
hypothermia.  Spontaneous  hypothermia 
is  best  treated  by  proper  management 
of  the  underlying  condition,  without 
regard  for  the  hypothermia  per  se.  The 
treatment  of  accidental  hypothermia 
is  primarily  supportive,  with  careful 
monitoring.  One  must  resist  the  tempta- 
tion to  warm  these  patients  actively. 
External  rewarming  may  result  in  what 
has  been  called  "rewarming  shock,"'! 
a  decrease  in  endogenous  heat  produc- 
tion, and  a  redistribution  of  blood  flow 
away  from  the  vital  organs  in  response 
to  the  application  of  external  heat.  The 
result  is  frequently  cardiovascular 
collapse  and  death. 

Because  of  the  high  frequency  of 
cardiac  arrythmias  in  accidental  hypo- 
thermia, continuous  electrocardio- 
graphic monitoring  should  be  employ- 
ed. However,  primary  attention  must 
be  directed  toward  good  respiratory 
care.  Most  patients  will  have  depressed 
respiration,  and  many  of  them  will  die 
of  respiratory  infection.  Assisted  respi- 
ration, with  meticulous  endotracheal 
suction,  is  the  hallmark  of  good  man- 
agement. 

Finally,  it  should  be  remembered 
that  accidental  hypothermia  is  a  pre- 
ventable condition  and  that  old  age, 
alcoholism,  and  diabetes  mellitus  are 
the  predisposing  factors.  Every  effort 
must  be  made  to  ensure  that  high  risk 
patients  have  appropriate  shelter  and 
warmth. 

References 

1,  Pickering.  G.  Regulation  of  body  tem- 
perature in  health  and  disease.  Lan- 
cet 1:1-9.  Jan.  4,  1958. 

2.  Bernard,  C.  Li\on.\  sur  les  phenomenes 
de  la  vie.  Paris,  Baiiliere.  1878. 


3.  British  Medical  Association,  Special 
Committee  on  accidental  hypothermia 
in  the  elderly.  Brit.  Med.  J.  2:5419: 
1255-58.  Nov.  14,  1964. 

4.  Tolman,  K.G.  and  Cohen,  A.  Accident- 
al hypothermia.  Canad.  Med.  Assoc.  J. 
103:13:1357-61,  Dec.  19.  1970. 

5.  Verbov,  J.L.  Modern  treatment  of  myx- 
edema coma  associated  with  hypo- 
thermia. Lancet  1:194-6,  1964. 

6.  Sheehan.  H.L.  and  Summers,  V.K. 
Treatment  of  hypopituitary  coma. 
Brit.  Med.  J.,  1:1214-5,  1952. 

7.  Cooper,  K.E..  Hunter,  A.R.  and  Keat- 
inge,  W.R.  Accidental  hypothermia. 
Int.  Anesth.  Clin..  2:999-1013.  1964. 

8.  Kedes.  L.H.  and  Field,  J.B.  Hypother- 
mia. A  clue  to  hypoglycemia.  New 
Eng.  J.  Med.  271:785-7,  1964. 

9.  Wechsler.  I.S.  Hypothalamic  syndro- 
mes. Brii.  Med.  J..  2:375-8.  1956. 

10.  Tolman,  K.G.,  Harman.  C.G.,  and 
Englert,  E.  Hypothermia  in  cirrhosis: 
a  cause  of  renal  failure?  Gastroen- 
terology 56:6: 1201,  June  1969. 

1 1.  Duguid,  H.,  Simpson,  R.G.  and  Stow- 
ers,  J.N.  Accidental  hypothermia. 
Lancet.  2:1213-9.  1961.  ^ 


THE  CANADIAN  NURSE     37 


A  woman's  right  to  nag- 
inalienable  and  essential 


The  author's  comments  on  women  and  their  organizations  are  outspol<en, 
sometimes  irreverant  and  sometimes  outrageous.  Yet  her  nagging  is  contagious! 


Sister  M.  Thomas  More,  OSF 

A  woman's  right  to  nag  —  it  is  inalien- 
able and  essential.  Perhaps  it  would  be 
an  idea  to  define  what  I  mean  by  the 
term  "nag."  One  definition  in  my  dic- 
tionary is:  "nag;  an  inferior,  aged,  or 
unsound  horse."  This  is  not  exactly 
what  I  have  in  mind. 

This  next  definition  will  do  nicely: 
"nag:  to  affect  with  recurrent  aware- 
ness, to  make  recurrently  conscious  of 
something  (as  a  problem,  issue,  or  con- 
cern)." 

How  does  one  make  another  "recur- 
rently aware  or  conscious"  of  some- 
thing? There  are  all  sorts  of  ways  and 
means.  We  could  list  the  many  ways, 
but  there  is  no  need.  Women  are  the 
all-time  pros  in  this  department. 

Naggers  we  can  be  and  naggers  we 
are.  We  have  the  name  and  the  game. 
What  should  concern  us,  however,  is 
not  our  reputation  nor  our  methodol- 
ogy. What  should  command  our  atten- 
tion is  the  answer  to  the  question:  what 
are  fit  subjects  for  nagging? 

I  am  going  to  backtrack  before  an- 
swering that  question.  Anthropologist 
Margaret   Mead  has  complained  that 

Sister  More  is  a  member  of  the  Franciscan 
Sisters  of  Christian  Charity,  a  teaching 
and  nursing  order,  based  in  Manitowoc, 
Wisconsin.  She  holds  her  M.A.  and 
Ph.D.  degrees  from  the  Catholic  Uni- 
versity of  America.  Washington.  D.C., 
where  she  majored  in  history.  This  article 
was  adapted  from  her  speech  at  the  annual 
convention  of  the  Alberta  Association  of 
Registered  Nurses  held  in  Banff,  Alberta, 
from  May  11  to  14,  1971. 


38     THE  CANADIAN   NURSE 


women  have  developed  a  "cave -woman 
mentality."  Their  principal  interest  is 
the  cave  —  better  homes  and  gardens, 
interior  decoraUon,  their  own  kids,  their 
own  husband,  or  their  job,  their  boss. 
The  whole  world  begins  and  ends  with 
the  fence  around  the  yard  or  the  office 
walls.  They  seem  unconcerned  about 
the  needs  of  others,  except  as  these 
needs  have  some  relationship  to  the 
cave.  Mead  considers  this  tragic. 

So  does  Betty  Friedan,  author  of 
The  Feminine  Mystique.  I  heard  her 
speak  some  time  ago  during  a  seminar 
on  the  urban  crisis  held  in  New  York. 
Friedan  said,  "There  must  be  something 
more  important  in  the  world  than  get- 
ting the  kitchen  sink  whiter  than  white." 
Too  few  women  have  interests  that  are 
really  significant  for  the  rest  of  human- 
ity. 

Our  social  machinery  needs  renew- 
ing. I  don't  think  this  is  even  debatable. 
But  where  does  this  renewing  process 
start?  We  begin  by  accepting  two  facts: 
each  of  us,  as  an  individual,  must  as- 
sume responsibility  for  action,  and  each 
of  us,  as  an  individual,  is  powerless 
alone.  We  must  belong  to  effective 
organizations.  Renewed  individuals 
and  renewed  organizations  would  give 
us  a  chance  to  move  ahead  in  the  proc- 
ess of  changing  society. 

Individual  renewal 

The  first  step  in  the  renewal  of  an 
individual  is  the  restoration  of  mean- 
ing in  her  life.  For  the  last  several 
months  1  have  been  probing  this  idea 
of  vocation.  I  have  been  forced  to  do 
SEPTEMBER  1971 


this  because  of  the  crisis  facing  most 
religious  orders  these  days.  (Girls  are 
going  over  the  walls  like  flies.)  I  have 
come  to  the  notion  that  we  must  stop 
restricting  use  of  the  concept  of  "voca- 
tion" or  of  "calling"  to  nunneries  and 
seminaries.  I  believe  every  one  of  us 
is  called.  (Since  I'm  wearing  this  little 
thing  on  the  back  of  my  head,  you  know 
who  called  me.)  We  are  all  called  by 
the  spirit,  and  our  calling  consists  of 
three  levels 

First  level:  we  are  called  to  a  state  in 
life.  It  is  not  by  chance  that  one  individ- 
ual marries,  another  chooses  to  remain 
single,  still  another  enters  religion  as  a 
celibate. 

Second  level:  we  are  called  to  a  way 
of  making  a  living.  It  is  not  by  chance 
that  one  of  us  works  as  a  nurse,  another 
as  a  teacher,  or  an  executive,  or  a  musi- 
cian. There  is  a  reason  for  our  being  in 
one  occupation  rather  than  another. 

Third  level:  we  are  called  to  specific 
service  to  the  common  good.  All  of  us 
are  called  to  serve  those  outside  our 
immediate  families  or  outside  our  spe- 
cific occupational  group.  There  are  a 
million  possibilities. 

A  woman  becomes  a  girl  guide  or  cub 
leader,  an  individual  starts  an  anti- 
pollution campaign,  people  work  for  a 
candidate  running  for  political  office, 
individuals  serve  as  officers  or  on  com- 
mittees in  their  organizations.  I  could 
go  on  listing  the  ways  in  which  a  person 
can  render  specific  service  to  the  com- 
mon good.  Some  of  these  ways  are  spec- 
tacular and  rate  headlines.  Most  are 
quiet,  known  only  to  those  close  to  the 
service  rendered. 

It  is  not  a  matter  of  mere  ability  of 
which  we  speak.  It  is  a  matter  of  who 
can  best  perform  a  particular  service. 
I  must  assess  my  assets  and  liabilities. 
I  must  figure  out  what  society  needs. 
I  must  serve  the  need  in  my  best  way, 
bringing  my  assets  to  society's  needs. 

This  level  of  calling  may  be  tem- 
porary. One  need  not  be  a  den  mother 
for  life;  nor  should  one  be  chairman  of 
an  organization  for  life.  We  should  give 
our  best  during  the  time  that  we  can 
give  our  best.  We  should  then  move 
over  to  permit  new  talent  to  replace  us. 

The  third  level  is  closely  associated 
with  the  other  levels.  The  first  two 
levels  give  us  the  leverage  we  need  to 
SEPTEMBER  1971 


accomplish  the  demands  of  the  third 
level.  For  example,  I  am  a  nun  by  state 
and  a  teacher  by  trade.  My  third  thing 
is  preaching  unity  to  farm  groups. 
Because  I  am  a  nun  and  a  teacher,  I 
have  the  time,  the  freedom,  and  the 
education  to  do  the  work  of  preaching 
unity.  I  can  get  the  idea  across  to  an 
audience  that  might  not  find  it  accept- 
able coming  from  somebody  else.  If 
a  farmer  was  to  get  up  on  the  stage  and 
say  some  of  the  things  I  do,  he'd  be 
lynched  before  he  left  the  hall. 

And  that  isn't  half  of  it.  When  we 
are  exercising  our  third  level  of  calling, 
we  are  really  in  the  act  of  guiding 
change.  It  is  on  this  level  that  I  can  be 
completely  me.  It  is  here  that  I  can  do 
my  own  thing. 

Third  level  ignored 

We're  not  doing  our  bit  at  the  third 

level.  We  don't  think  we're  called  to 
•this.  It's  nice  if  you've  got  the  time,  we 
say. 

This  is  one  phrase  I  absolutely  abhor: 
"I  have  no  time."  It  is  the  most  despic- 
able statement  in  a  world  that  needs 
each  of  us.  Nobody  has  time  —  you 
take  it.  And  if  your  organization  needs 
something,  you  take  time;  it  needs  help 
now,  not  when  you've  got  time. 

Somebody  calls  you  up  and  asks  you 
to  be  chairman  of  a  committee.  You 
say  you  don't  have  the  time.  Somebody 
asks  you  to  put  your  name  on  the  ballot 
for  president.  No  time  again.  I  can't 
wait  for  the  day  of  video-phones  —  I 
want  the  caller  to  see  you  lie. 

Who  is  going  to  put  the  finger  on  you 
at  the  third  level  of  calling?  Who  knows 
what  you  can  do?  Only  you\  On  this 
third  level  you  can  cop  out  so  easily. 

You  have  particular  responsibilities 
to  the  common  good  because  you  are 
in  a  particular  profession.  There  are 
certain  things  you  know  about,  things 
you  can  take  stands  on,  positions  you 
know  better  than  anybody  else.  What 
are  you  doing? 

Many  of  you  are  here  as  delegates 
to  the  AARJ>J  convention.  When  you 
go  home,  are  you  going  to  report  on  the 
golfing  or  some  such  thn; 
how  much  fun  you  ha^-^c 
going  to  be  changed ' 
What  difference  wii 
society  you  are  return^ 


have  been  here?  If  no  difference,  then 
this  whole  thing  was  a  waste  of  time. 

Organization  renewal 

We  have  organized  our  work,  our 
worship,  and  our  play.  Oddly  enough, 
once  we  are  together  we  run  out  of 
ideas  on  what  to  do.  There  are  three 
steps  in  the  process  of  figuring  out  what 
to  do:  learn  what  an  organization  is; 
develop  viable  leadership  and  support 
it;  and  decide  if  you  should  tackle  gut 
issues. 

Everyone  knows  what  an  organiza- 
tion is.  It  is  a  machine  to  be  used  to 
accomplish  big  objectives.  When  a 
woman  cannot  accomplish  a  task  alone, 
she  joins  with  others  to  do  so.  An  organ- 
ization, or  a  structure,  cannot  do  any- 
thing by  itself.  Like  a  lawn  mower  or  a 
truck,  a  machine  can  do  nothing  until 
a  person  gets  into  the  driver's  seat, 
turns  on  the  motor  and  steers  to  the 
goal. 

As  a  speaker  I  attend  hundreds  of 
business  meetings  that  precede  my  part 
of  the  program.  Believe  me,  attending 
these  meetings  is  about  as  exciting  as  a 
visit  to  a  petrified  forest.  What  a  horri- 
ble waste  of  woman  power  they  repre- 
sent! As  somebody  said,  they  keep 
minutes  and  waste  hours. 

Now  if  I  were  to  judge  the  purpose 
of  most  women's  organizations,  I  would 
say  they  exist  to  collect  old  clothes 
and  to  eat.  Take  away  the  rummage 
sale  and  most  churches  would  fall  apart 
tomorrow.  And  men's  organizations 
exist  to  wear  old  clothes  and  to  drink. 
That  is  one  huge  generalization  —  but 
check  the  purpose  of  your  organization. 

Why  was  it  born?  To  provide  a  room 
for  you  to  play  cards  or  make  quilts? 
To  serve  you  one  good  feed  on  the  day 
of  the  annual  meeting?  Why  do  people 
join  your  organization?  Are  they  sold 
on  the  purposes  for  which  the  group 
was  created?  What  is  the  human  need 
to  which  this  organization  can  address 
itself?  Does  the  machinery  of  this  organ- 
ization help  or  hinder  the  accomplish- 
ment of  your  objectives? 

Developing  leadership 

Leadership  is  constituted  by  three 

things;    challenging    ideas    or    vision, 

competence  to  execute  an  idea,  and 

courage  to  see  it  through  to  completion. 

THE  CANADIAN  NURSE     39 


People  are  not  bom  with  these  charac- 
teristics, they  must  be  developed.  The 
key  is  the  challenging  idea.  Without  it, 
who  needs  competence  and  courage? 
The  element  of  vision  is  often  killed. 
How  many  times  have  we  labeled  the 
visionary  or  the  idea  woman  as  im- 
practical, too  idealistic? 

When  we  use  these  terms  "too  im- 
practical and  too  idealistic,"  we  are 
implying  that  a  visionary  has  got  to  be 
a  nut.  Sometime  ago  I  was  watching  a 
TV  documentary  called  the  "New 
American  Catholic."  In  an  interview, 
an  elderly  monsignor  was  asked,  "What 
do  you  think  of  all  the  changes  in  the 
Catholic  Church?"  The  monsignor 
said,  "When  Pope  John  opened  the 
window  to  let  in  fresh  air,  an  awful  lot 
of  queer  birds  came  in  also."  Who  is 
an  ecclesiastical  queer  bird?  He's  the 
guy  who  is  considered  a  nut  today,  but 
10  years  from  now  I'll  be  required  to 
believe  what  he  says  as  dogma  or  be 
torn  from  the  bosom  of  Holy  Mother 
Church. 

We  are  so  fearful  of  new  ideas,  espe- 
cially challenging  ones,  that  we  have 
developed  very  effective  cerebral  con- 
traceptive devices  to  prevent,  or  at 
least  space,  the  birth  of  brain  children. 
Officers  of  organizations  cling  to  the 
device  called  the  agenda  which,  if  used 
judiciously,  will  prevent  one's  getting 
caught  by  a  brain  child. 

Members  prefer  that  grand  old  pro- 
cess called  "informality."  This  is  the 
means  by  which  nothing  happens,  at 
great  length.  There  is  nothing  wrong 
with  an  agenda  or  informality.  It  is 
good  and  proper  to  use  both,  but  not  as 
a  defense  against  the  challenge  of  new 
ideas. 

The  development  of  leaders  is  stymi- 
ed in  other  ways.  The  tiniest  suggestion 
of  a  new  idea  is  removed  by  the  dedicat- 
ed VSNA,  (the  Vision  Smashers  of 
North  America),  who  come  in  several 
species.  You  get  a  bright  action  idea, 
present  it  to  your  membership,  only 
to  be  met  with  the  immortal  line,  "We 
didn't  do  it  that  way  last  year."  This 
species  is  known  as  the  Unswitchables. 
Another  variety  is  the  Infallibles. 
They  greet  an  idea  with  their  slogan, 
"It  won't  work."  They  never  try  any- 
thing, yet  they  know  what  won't  work. 
(I  thought  the  Pope  had  a  corner  on 
40     THE  CANADIAN  NURSE 


infallibility;  I  swear  he  doesn't  even 
know  his  opposition.) 

And  then  we  come  to  the  pick  of 
the  crop  —  the  Untouchables.  Your 
members  accept  the  new  idea,  you  try 
it,  and  it  flops.  Now  theydeny  you  like 
Peter.  Or,  if  they  admit  to  having  voted 
in  favor  of  your  idea,  they  intone  sol- 
emnly, "Now,  if  you  had  done  it  our 
way  .  .  ."  or  "Well,  we  told  you  so!" 
These  people  are  willing  to  take  the 
credit,  but  never  the  blame.  They  seldom 
work  to  make  a  project  succeed;  they 
only  pontificate  at  the  last  rites. 

These  Vision  Smashers  are  a  bad 
lot,  but  they  aren't  the  biggest  problem. 
Where  is  the  rest  of  the  membership 
while  the  Vision  Smashers  are  crucify- 
ing the  Visionaries?  Well,  they  are  not 
developing  leadership.  They  are  there 
developing  callouses  on  that  part  of  the 
anatomy  for  which  Dr.  Scholl  still  does 
not  have  a  pad.  They  sit  by  quietly  and 
take  sides  secretly.  They  will  not  openly 
support  a  side,  nor  will  they  arbitrate 
to  prevent  polarization  of  thought. 
Some  would  call  them  the  silent  major- 
ity, but  there  is  no  such  thing.  They 
are  talking  all  the  time,  but  not  where 
it  does  any  good. 

Functions  of  an  officer 

It  is  no  wonder  that  so  many  organ- 
izations have  a  difficult  time  finding 
officers.  The  function  of  an  officer  can 
be  characterized  under  three  headings: 
janitorial,  managerial,  and  dietetic. 
•Janitorial:  a  good  officer  selects  a 
comfortable  place  for  the  session,  sees 
that  the  chairs  are  set  up  before  the 
meeting,  turns  on  the  heat  if  it's  cold 
and  the  air  conditioning  if  it's  hot,  and 
cleans  up  after. 

•  Managerial:  a  good  officer  assigns  the 
unwilling  to  committees  to  collect  tick- 
ets, decorate  tables,  solicit  ads  for  pro- 
grams, find  donors  for  door  prizes.  A 
good  officer  sees  that  the  program  has 
something  besides  long-winded  speak- 
ers, as  women  will  be  interested  in 
sightseeing  tours,  fashion  shows,  etc. 

•  Dietetic:  a  good  officer  knows  the 
successful  program  will  include  the 
following  ingredients — just  enough 
baking  powder  to  get  a  rise  out  of  the 
timid,  plenty  of  shortening  to  butter  up 
the  sensitive,  a  dash  of  spice  to  give 
zip  to  the  proceedings,  plenty  of  vanilla 


to  flavor  the  whole  batch  so  everyone 
goes  home  with  a  good  taste  in  her 
mouth.  You  call  that  viable  leadership? 
I  call  it  light  housekeeping. 

Gut  issues 

Many  people  come  to  a  meeting  be- 
lieving you  shouldn't  handle  anything 
controversial.  If  it's  controversial,  leave 
it  alone.  Actually,  it's  here  we  should 
make  our  weight  felt.  Everyone  belongs 
to  several  organizations.  How  many  of 
them  provide  you  with  an  opportunity 
to  look  at  all  sides  of  an  important  issue 
or  the  opportunity  to  pick  the  best 
course  of  action? 

Important  issues  are  decided  by  you 
at  your  annual  meetings,  or  at  your 
regular  weekly  or  monthly  meetings. 
So  we  come  to  you.  How  much  digging 
do  you  do  on  your  own?  Facts  are  the 
raw  materials  of  decisions.  When  is  a 
fact  not  a  fact?  Do  you  know?  Do  you 
know  how  to  find  out? 

We  are  in  the  midst  of  a  knowledge 
revolution.  We  cannot  get  all  the  facts 
by  ourselves.  We  need  help  to  interpret 
facts  and  to  marshal  1  them  in  a  way 
that  reveals  the  truth.  Is  it  too  much 
to  ask  that  the  organizations  to  which 
you  belong  be  turned  into  study  clubs 
where  you  can  really  focus  on  important 
issues,  plan  a  policy,  and  plot  a  strategy? 

In  short,  get  the  ingredients  necessary 
to  launch  a  great  campaign.  I  suggest 
you  communicate  by  restoring  the  fine 
old  art  of  nagging.  Nagging  is  a  function 
of  women;  it  is  not  just  a  nasty  habit. 
Someone  must  be  responsible  for  the 
task  of  keeping  people  constantly  aware 
of  what  needs  to  be  done.  Forward, 
fellow  naggers,  forward!  ^ 


SEPTEMBER  1971 


What  is  outpost  nursing? 

Nursing  in  a  small  northern  community  requires  more  than  hard  work  and 
dedication.  This  article  describes  outpost  nursing  and  asks  whether  there 
is  a  place  for  outpost  nursing  in  our  cities. 


Catherine  W.  Keith,  M.S.,  C.N.M. 

Outpost  nursing  is  caring  —  in  the 
widest  sense  of  the  word  —  about 
people  in  settlements  beyond  the  fron- 
tier. 

It  is  putting  nursing  knowledge  and 
technical  skills  to  work  when  that 
elusive  disorder  "Something"  is  going 
around  and  many  in  the  community 
are  ill;  it  means  teaching  parents  the 
"why"  of  many  of  the  things  they  are 
asked  to  do  and  getting  their  help  in 
adapting  these  things  to  what  is  possible 
for  them. 

It  means  promoting  community  ef- 
forts to  develop  healthy  outlets  for 
everyone's  energies. 

Caring  involves  coordinating  the 
efforts  of  many  visiting  health  pro- 
fessionals who  bring  their  special  skills 
to  the  people  for  a  limited  time  only. 
It  means  doing  many  non-nursing  duties 
—  medical,  dental,  social  welfare, 
x-ray,  and  laboratory  procedures  — 
when  there  is  no  one  else  in  the  area 

Miss  Keith  is  a  graduate  of  Soldiers"  Me- 
morial Hospital  in  Campbellton,  New 
Brunswick.  She  has  a  diploma  in  teach- 
ing and  supervision,  a  diploma  in  public 
health  nursing,  and  a  bachelor  of  nursing 
degree  from  McGill  University;  and  a 
master  of  science  in  nursing  degree  and 
a  certificate  in  nurse-midwifery  from 
Columbia  University.  She  is  presently 
Adviser.  Nursing  Development,  in  the 
Medical  Services  Branch  of  the  Depart- 
ment of  National  Health  and  Welfare. 
Ottawa,  Ontario,  Canada. 


SEPTEMBER  1971 


THE  CANADIAN  NURSE     41 


who  knows  how  to  do  them.  And  it's 
being  able  to  let  go  of  these  responsi- 
bilities gracefully  when  someone  comes 
on  the  scene  who  can  do  them  as  well  or 
even  better. 

Caring  means  that  the  outpost  nurse 
uses  head,  heart,  hands,  and  feet  in 
well-balanced  proportions  to  help 
people  help  themselves. 

Now  it  also  means  helping  the  health 
professions  of  urban  Canada  to  under- 
stand the  meaning  of  "the  nurse  work- 
ing in  an  expanded  role." 


Outpost  nursing  in  Canada? 

Where  in  Canada  are  nurses  working 
in  outposts?  Surely  it  must  be  just  in 
the  "far  north."  But  have  you  looked 
at  a  map  lately?  Look  for  Obedjiwan, 
not  very  far  north  of  Montreal;  Lans- 
downe  House,  not  far  north  of  Thunder 
Bay,  Ontario.  Look  for  Pelican  Nar- 
rows, not  too  distant  from  Prince  Al- 
bert, Saskatchewan;  Saddle  Lake,  not 
far  northeast  of  Edmonton;  and  Teslin, 
a  few  miles  south  of  Whitehorse  in  the 
Yukon  Territory.  Yes,  it  is  also  found 
in  Port  Burwell  at  the  northern  tip  of 
Labrador,  and  in  Resolute,  on  Corn- 
wallis  Island  in  the  Arctic. 

The  outpost  may  be  a  semi-isolated 
health  center,  where  the  resident  public 
health  nurse  carries  a  full,  generalized, 
preventive  program;  provides  emergen- 
cy care  for  the  sick  or  injured  and 
arranges  for  their  transfer  to  a  nearby 
hospital:  and  participates  in  community 
programs  for  the  promotion  of  health. 
Or  it  may  be  an  isolated  nursing  station 
that  provides  for  limited  inpatient  nurs- 
ing care,  preventive  programs,  and 
emergency  care  of  the  sick  and  injured 
who  will  need  nursing  care  until  their 
transfer  is  possible. 

Outpost  stations  are  generally  located 
in  settlements  of  200  or  more  persons 
who  are  remote  from  hospital  and 
medical  services  for  at  least  part  of  the 
year  because  weather  or  seasonal 
42     THE  CANADIAN  NURSE 


In  an  outpost  nursing  station,  the  nurse  teaches  a  mother  one  technique  of  cur  in  t; 
for  her  baby.  Teaching  by  demonstration  is  an  important  part  of  the  comprehen- 
sive nursing  service  provided  in  the  north. 


conditions  cut  off  the  community  from 
the  general  population.  This  does  not 
mean  that  services  are  not  provided 
for  settlements  of  less  than  200.  These, 
too,  are  considered  individually,  and 
provision  is  made  for  meeting  their 
needs  in  other  ways. 


What  does  this  work  involve? 

Outpost  nursing  in  Canada  may  be 
sponsored  by  federal  or  provincial 
governments,  by  religious  organiza- 
tions, or  by  voluntary  agencies  such  as 
the  Red  Cross.  Regardless  of  sponsor- 


ship, outpost  nurses  are  special  and 
important  persons  —  .special  because 
the  combination  of  personality,  academ- 
ic preparation,  and  experience  necessary 
to  succeed  sets  them  apart  from  others, 
and  important  because  in  many  in- 
stances they  are  the  only  persons  in 
small  settlements  who  have  the  know- 
ledge and  skills  to  supervise  the  health 
care  of  the  population. 

The  agency  that  employs  the  nurse 
is  responsible  for  making  available 
total  health  services  to  the  people  with- 
in a  defined  area.  As  part  of  this  pro- 
gram, the  outpost  nurse  conducts 
SEPTEMBER  1971 


clinics.  These  might  be  two-hour  med- 
ical screening  clinics  to  give  advice  and 
medication  for  simple  disorders,  mixed 
clinics  to  treat  some  illness  and  provide 
prenatal  care,  or  well-baby  counseling, 
depending  on  the  size  of  the  community 
and  what  allows  for  the  best  use  of 
her  time. 

The  nurse  might  have  one  or  two 
inpatients  to  care  for  —  perhaps  a 
mother  and  newborn  delivered  within 
the  past  few  days.  She  makes  home 
visits  for  post-sanatorium  follow-up 
on  treatment  or  welfare,  school  visits, 
and  follow-up  on  any  school  health 
problems.  Her  day  can  also  include  a 
planning  meeting  with  a  community 
organization  or  a  committee  develop- 
ing some  health  activity  program  — 
recreation,  sanitation  project,  or  health 
teaching  course.  In  addition,  the  nurse 
sometimes  arranges  accommodations 
for  professional  or  administrative 
personnel  who  are  coming  to  provide 
expert  service  for  two  or  three  days,  or 
plans  meaningful  activities  for  students 
in  the  health  professions  who  are  with 
her  for  field  experience. 

No  matter  how  you  look  at  it,  the 
outpost  nurse  is  employed  full-time. 
Whether  there  are  one,  two,  or  three 
nurses  in  the  station,  there  is  enough 
work  to  keep  them  all  busy  in  any  one 
or  all  aspects  of  nursing  and  in  some 
areas  that  are  considered  non-nursing 
in  urban  areas.  It  is  not  unusual  for 
persons  with  toothaches,  respiratory 
problems,  or  broken  bones  to  show  up 
at  the  station  door  the  day  after  the 
dentist's  biannual  visit  or  the  visiting 
medical  officer's  regular  or  irregular 
clinic. 


her  personality  that  bear  scrutiny  if 
she  is  to  be  considered  for  a  relatively 
long-term  assignment  of  one  or  two 
years. 

iVhat  motivates  her?  A  nurse  may 
be  highly  motivated  to  help  others,  but 
be  so  busy  satisfying  this  personal  need 
that  she  is  unable  to  help  others  to 
help  themselves.  This  defeats  a  basic 
objective  of  the  outpost  program,  which 
is  to  help  individuals  and  communities 
accept  responsibility  for  solving  their 
own  health  problems.  This  nurse  will 
soon  find  herself  overworked  and  the 
people  more  and  more  dependent  on 
her.  She  must  therefore  be  able  to  re- 
adjust her  satisfaction  needs  to  the 
slower  pace  of  leader,  rather  than  the 
faster  pace  of  doer. 

To  what  degree  is  she  self-sufficient? 
A  nurse  with  the  maturity  to  succeed  on 
the  job  in  a  remote  station  knows  the 
limits  of  her  capability  and  responsibili- 
ty and  is  not  afraid  to  seek  help  from 
her  superior  officer  at  base  hospital. 
On  the  other  hand,  she  must  be  confi- 
dent enough  to  make  decisions  within 
the  limits  expected  of  her  and  learn  to 
live  with  the  consequences,  whatever 
they  may  be. 

Will  she  be  bored?  There  is  also  the 
social  side  to  consider.  The  nurse  must 
adjust  to  a  community  where  organized 
entertainment  is  limited  or  nil.  She 
must  see  this  as  a  need  for  health 
promotion  in  the  community  and  partic- 
ipate in  establishing  healthy  outlets  for 
community  energy.  This  is  perhaps  one 
of  the  least  rewarding  areas  of  her 
experiences  because  a  one-  or  two-year 
assignment  does  not  always  give  her 
the  time  to  see  tangible  results. 


How  is  the  nurse  selected? 

We  cannot  stereotype  the  personality 
of  the  outpost  nurse  in  such  a  way  as 
to  say:  "this  one  will  fail"  or  "this  one 
will  succeed"  because  of  certain  attri- 
butes. However,  there  are  some  areas  of 

SEPTEMBER   1971 


To  the  nurse  working  in  a  northern  out- 
post station,  fashion  means  an  eskimo- 
style  parka  with  a  fur-lined  hood. 


THE  CANADIAN  NURSE     43 


Can  we  count  on  her  for  a  fair  re- 
turn of  service  in  exchange  for  the 
tremendous  cost  of  getting  her  into 
and  out  of  an  isolated  post?  In  recruit- 
ing staff  for  these  areas,  it  is  important 
to  study  the  applicant's  employment 
patterns  and  seek  professional  refer- 
ences from  employers  experienced  in 
appraisal.  Evaluating  these  references 
is  important  because  statements  made 
in  one  frame  of  reference  might  not 
apply  in  the  outpost  situation.  Ability 
to  work  well  with  others  and  a  stable 
employment  pattern  are  essential  if  the 
nurse  is  to  give  the  service  needed  and 
get  satisfaction  from  work  well  done. 

Academic  preparation  vital 

Nowhere  in  Canada  is  the  academic 
preparation  of  the  nurse  more  impor- 
tant than  in  outpost  nursing.  In  a  hos- 
pital, quality  care  can  be  maintained 
and  promoted  with  continuous  inservice 
education  programs  and  close  super- 
vision which  contributes  to  continuing 
professional  growth  of  the  staff.  The 
outpost  nurse  is  on  her  own  more  often 
than  not.  The  factors  that  lead  to  the 
establishment  of  the  outpost  also  make 
close  supervision  impractical. 

Inservice  education  projects  are 
costly  and  limited,  and  upgrading 
opportunities  at  the  moment  are  non- 
existent. It  is  therefore  essential  that 
selection  of  staff  for  such  locations 
follow  more  rigid  standards  than  else- 
where, and  that  assignments  be  limited 
in  length  until  these  difficulties  are 
overcome. 

Postgraduate  education  in  midwifery 
and  public  health  nursing  is  preferred, 
but  a  minimum  of  four  years  of  satis- 
factory experience  after  graduation  in  a 
field  of  nursing  related  to  maternal  and 
child  care  is  also  considered  for  some 
positions. 

For  these  outpost  nurses,  the  weak- 
est point  in  Canadian  nursing  educa- 
tion is  in  maternal  and  child  care.  Until 
nurses  and  mothers  examine  this  weak- 
44     THE  CANADIAN  NURSE 


ness  objectively  and  scientifically  and 
explore  ways  for  nurses  to  receive 
greater  knowledge  and  skills  in  man- 
agement of  mothers  and  infants  in 
hospital  and  field  situations,  we  shall 
have  to: 

•  continue  to  look  to  nurses  from  other 
countries  to  help  us  in  outpost  nursing. 

•  supplement  basic  nursing  education 
with  extra  preparation  in  public  health 
and  midwifery. 

•  make  up  other  deficiencies  by  ori- 
entation and  continuing  education  pro- 
grams. It  requires  a  greater  degree  of 
knowledge,  skill,  and  experience  than 
our  basic  nursing  education  provides 
to  screen  mothers  and  take  care  of 
medical  and  pediatric  problems. 


Is  extra  support  needed? 

Once  the  nurse  is  selected,  has  passed 
a  health  examination  as  physically  fit, 
has  been  documented  for  pay  purposes, 
has  been  oriented  to  the  agency's  pol- 
icies and  programs  and  given  the  op- 
portunity to  acquire  extra  skills,  she 
may  or  may  not  be  accompanied  by  her 
supervisor  to  the  outpost.  Most  nursing 
supervisors  believe  that  a  short  period 
on  her  own  gives  the  nurse  time  to 
gather  questions;  a  visit  is  more  valu- 
able after  a  month  when  the  nurse  has 
a  feeling  of  what  the  job  entails  but 
before  she  has  established  poor  work 
habits. 

The  outpost  nurse  needs  nursing 
support  at  her  headquarters.  Regardless 
of  the  amount  of  confidence  or  self- 
reliance  she  may  have,  she  wants  the 
opportunity  to  ask  once  in  awhile: 
"How  am  I  doing?"  Or  she  might  want 
to  share  a  successful  project  with  others. 
It  is  important  for  morale  that  senior 
nursing  personnel  visit  the  outpost 
nurse  regularly;  their  greatest  contribu- 
tion may  be  just  listening  to  the  nurse 
and  interpreting  needs  for  her  back  at 
base. 

There  is  also  a  need  to  find  ways 
to  make  up  for  the  lack  of  opportunity 


for  continuous  inservice  education 
and  resulting  professional  growth. 
Nurses  who  are  far  from  base  and  from 
each  other  —  which  makes  it  uneco- 
nomical to  plan  for  more  than  one 
conference  a  year  —  must  receive  the 
latest  knowledge  by  the  most  practical 
means  available:  e.g.,  current  pro- 
fessional literature,  tapes,  and  films. 

Length  of  assignments  must  be  limit- 
ed unless  the  nurse  can  attend  courses, 
seminars,  or  workshops.  Regular  super- 
visory visits  must  be  made  to  assess 
the  nurse's  continuing  grasp  of  commu- 
nity problems,  her  own  health  and 
general  well-being,  and  her  needs  for 
continuing  professional  growth  and 
maintenance  of  a  high  standard  of 
service  to  the  people. 


Summary 

What  happens  to  the  outpost  nurse 
after  her  northern  assignment?  Is  there 
a  place  for  her  in  the  health  services 
delivery  system  in  our  urban  communi- 
ties? 

Every  city  in  Canada  has  people  for 
whom  health  care  is  unavailable. 
Couldn't  this  nurse  reach  them?  If  she 
can  extend  the  arms  and  legs  of  many 
scarce  health  service  professionals  in 
the  outpost,  could  she  not  do  the  same 
in  urban  areas  that  are  under-serviced? 

Nurses  who  have  served  in  outposts 
since  nursing  began  in  Canada  have 
indeed  been  "physician's  associates" 
working  in  an  expanded  role,  usually 
without  benefit  of  extra  preparation, 
always  without  extra  financial  recogni- 
tion, and  always  being  "cut  back  to 
size"  when  they  return  to  "civiliza- 
tion." Do  our  nurses  know  there  are 
unique  opportunities  to  use  their  own 
initiative  in  their  own  country?  And 
do  the  other  health  service  professions 
recognize  the  help  they  have  so  close 
at  hand?  ^ 


SEPTEMBER  1971 


Acting  out  or  acting  up? 


Managing  the  behavior  of  pediatric  patients 


Vicki  Crossley 

Four-year-old  Stuart  bounds  out  of  his 
room  and  propels  himself  toward  the 
drinking  fountain,  where  he  comes  to  a 
sliding  halt.  He  turns  on  the  tap  and 
emits  a  jubilant  screech  as  the  water 
spurts  onto  the  floor.  His  laughter 
increases  as  he  splashes  it  on  the  wall, 
the  floor,  and  himself.  Seeing  you  com- 
ing, he  darts  into  a  room,  slipping  on 
the  water  and  knocking  over  the  block 
tower  of  a  toddler.  It's  3:00  P.M.  and 
Stuart  has  been  at  it  since  6:00  A.M. 
—  he  never  naps. 


SEPTEMBER  1971 


Lorie  is  six,  and  says  "no"  to  every- 
thing. She  screams  and  fights  over  each 
x-ray.  She  refuses  to  remain  in  bed. 
Giving  medication  to  Lorie  is  a  constant 
battle,  because  she  is  tight-lipped  and 
struggling;  her  nurse  is  tense  and  frus- 
trated. 

Michael  is  a  handsome,  cooperative 
nine-year-old  with  a  septal  defect  and 
recent  history  of  severe  headaches.  He 
is  booked  for  a  carotid  arteriogram 
under  general  anesthetic.  On  the  morn- 
ing of  the  test,  Michael's  nurse  explains 
the  procedure  and  tells  him  why  he 
cannot  eat.  After  she  leaves.  Michael 
hops  out  of  bed  and  runs  around  in  his 
bare  feet,  acting  silly.  He  tells  his  room- 
mate he  doesn't  care  about  the  "dumb 
old  test,"  and  begins  to  throw  paper 
darts  at  passers-by.  When  his  nurse 
returns  a  little  later,  Michael  announces 
with  a  grin  that  he  can't  have  the  test 
now,  because  he  just  ate  his  room- 
mate's cereal. 

Michael  was  anxious  about  his  ar- 
teriogram because  he  did  not  understand 
its  purpose.  He  thought  it  was  somehow 
linked  with  his  heart  defect,  which 
alarmed  him  since  he  had  previously 
been  assured  that  his  heart  did  not  re- 
Mrs.  Crossley  is  a  graduate  of  The  Hos- 
pital for  Sick  Children,  loronlo.  When 
she  wrote  this  article,  she  was  working 
as  a  psychiatric  nurse  with  the  Depart- 
ment of  Medical  Nursing  at  the  same 
hospital  in  Toronto,  Ontario. 

THE  CANADIAN  NURSE     45 


quire  treatment.  His  increased  activity, 
silliness,  and  hostility  were  signs  of 
his  anxiety.  When  he  received  no  expla- 
nation or  reassurance,  he  sabotaged  the 
test  by  eating. 

Eileen  is  eight  and  recovering  from 
a  bladder  infection.  She  feels  well  and 
is  bored  and  lonely.  She  wanders  into 
the  nursing  station  and  fiddles  with 
the  phone.  She  upsets  her  juice  all  over 
her  bed  when  her  nurse  enters  the  room. 
She  always  seems  to  be  asking  for  things 
she  doesn't  really  want  or  could  get 
herself.  When  reprimanded  for  her 
incessant  requests,  she  retorts  that 
although  she  could  get  her  own  things, 
she  likes  someone  to  come  and  see  her. 
She  is  referred  to  as  "our  shadow." 


problems.  They  note  with  chagrin  that 
behavior  which  was  "cute"  or  "funny" 
to  them  during  a  brief  affiliate  exper- 
ience is  now  irritating  when  they  are 
faced  with  it  day  after  day. 

In  this  article  we  shall  examine  the 
origins  of  such  behavior  and  the  atti- 
tudes and  feelings  of  nurses  who  en- 
counter it,  and  offer  suggestions  for 
managing  hyperactivity,  negativism, 
anxiety,  and  attention-seeking  within 
the  general  pediatric  ward. 

Acting  out  or  acting  up? 

To  handle  behavior  skillfully,  we 
require  some  knowledge  of  its  origin. 
First  we  must  determine  whether  the 
child  is  acting  out  or  acting  up.  Acting 


If  you  are  a  pediatric  nurse,  all  these 
situations  will  be  familiar.  Hyperactiv- 
ity, negativism,  anxiety,  and  attention- 
seeking  occur  daily  on  pediatric  wards. 
Nurses  new  to  pediatrics  do  not  expect 
to  encounter  them  so  often  on  a  ward  of 
"emotionally  well"  children,  and  soon 
realize  they  lack  the  skill  and  insight 
to  handle  the  behavior  appropriately. 
They  find  they  must  cope  with  several 
children  at  once,  and  others  frequently 
turn  to  them  for  help  with  management 

46     THE  CANADIAN  NURSE 


out  has  been  defined  as  "aggressive 
behavior  which  expresses  an  uncons- 
cious wish."*  The  person  who  acts 
out  does  not  understand  what  his  be- 
havior means.  When  Lisa,  a  12-year- 
old,  was  told  of  her  discharge,  she  acted 
out  her  anger  at  us  for  sending  her  back 
to  a  chaotic  home;  she  became  bellig- 

*H.S.  Lippman.  Treainwiii  of  the  Child 
ill  Emotional  CoiifTici,  led..  Toronto. 
McGraw-Hill.  1962,  p.  233. 


erent  and  destroyed  hospital  equipment. 

Acting  up  is  also  aggressive  behavior, 
but  does  not  arise  from  an  unconscious 
fantasy.  On  pediatric  wards,  acting  up 
is  often  born  of  boredom,  inadequate 
outlets  for  activity,  or  a  desire  for  atten- 
tion from  an  adult.  It  can  also  be  a 
direct  expression  of  anger.  Often  child- 
ren do  know  why  they  act  up. 

Deciding  whether  a  child  is  acting 
out  or  acting  up  will  help  you  under- 
stand his  behavior.  Then  you  can  help 
him  find  better  ways  to  express  his 
feelings  so  that  he  no  longer  needs  to 
act  them  out. 

It  takes  two  to  tangle 

In  discussing  the  problems  they  have 
had  with  a  child,  nursing  staff  often 
forget  their  role.  They  forget  what  they 
said  and  did  to  the  child.  As  nurses  we 
often  naively  believe  we  have  controlled 
ourselves  well  in  front  of  our  patients; 
however,  we  are  unaware  how  much 
our  feelings  and  attitudes  have  shown 
through.  And  just  as  often  we  are  un- 
aware of  why  we  respond  the  way  we 
do. 

Our  society  teaches  that  good  beha- 
vior is  rewarded  and  bad  behavior  is 
punished;  thus,  we  respond  automati- 
cally countless  times  each  day.  A  col- 
league smiles  a  "hello"  and  you  smile 
back.  A  saleslady  is  rude  and  abrupt, 
and  you  glare  at  her  and  take  your 
package  without  a  thank-you. 

Similarly,  the  child  who  is  affec- 
tionate and  cuddly  gets  picked  up  and 
cuddled  when  he  wanders  into  the  nurs- 
ing station.  However,  the  bold  or 
defiant  child  is  likely  to  be  directed  out 
with,  "You  shouldn't  be  in  here,  young 
man."  This  child  needs  firm  limits,  but 
more  than  firm  limits  are  implicated 
in  the  staffs  eagerness  to  send  him  out. 

Not  only  do  we  unwittingly  punish 

or  reward  a  child  for  his  behavior,  but 

we  also  allow  the  child  and  his  behavior 

to  become  one  in  our  eyes.  "She's  a 

SEPTEMBER  1971 


brat"  and  "he's  a  monster"  are  state- 
ments that  well  illustrate  this  point.  The 
behavior  may  be  atrocious,  but  the 
child  is  not  a  bad  person,  nor  are  his 
feelings  bad.  If  we  strive  to  make  this 
message  clear  to  him,  he  will  know  his 
behavior  is  out  of  line,  but  his  self- 
esteem  will  not  be  threatened. 

The  problem  with  putting  this  ap- 
proach into  practice  is  that  the  behavior 
may  have  made  the  nurse  so  uncom- 
fortable or  angry  that  she  responds  with 
her  own  feelings.  She  fails  to  see  the 
child's  point  of  view  until  well  after  the 
incident  is  over. 

Allen,  a  10-year-old  boy,  refused  to 
get  on  the  stretcher  to  be  taken  to  the 
operating  room  for  a  cystoscopy.  His 
nurse  persists  in  telling  him  that  if  he 
doesn't  comply,  she'll  get  help  to  put 
him  on  the  stretcher.  Allen  begins  to 
shout  and  swear,  and  shoves  the  stret- 
cher so  that  it  hits  the  nurse's  ankle. 
The  situation  deteriorates  until  other 
nurses  are  called  in,  Allen  is  given 
sedation  and  taken  to  the  operating 
room. 

In  discussing  the  situation,  Allen's 
nurse  insists  angrily  that  she  "didn't 
know  why  he  had  to  act  that  way.  I 
explained  it  to  him  before  and  he's  old 
enough  to  understand."  She  realizes 
she  had  been  angered  by  his  refusal  to 
cooperate,  despite  her  explanation.  She 
was  keenly  aware  that  the  OR  was  wait- 
ing. She  now  sees  that  her  veiled  threat 
to  get  help  to  put  him  forcibly  on  the 
stretcher  was  an  expression  of  her 
anger. 

She  wishes,  instead,  that  she  had 
explained  why  the  stretcher  was  ne- 
cessary and  enlisted  his  cooperation. 
She  remembers  that  he  had  remained 
silent  during  her  explanation  of  the 
procedure,  and  she  assumed  that,  since 
he  had  not  asked  questions,  he  under- 
stood. She  recalls  he  is  a  child  who 
needs  time  to  accept  medications  and 
procedures. 
SEPTEMBER  1971 


Allen's  nurse  saw  that  in  her  anger 
she  had  responded  to  him  punitively 
for  being  belligerent  and  unreasonable. 
She  had  failed  to  see  and  deal  with  his 
fear  and  his  need  for  time  to  accept  the 
situation.  She  was  now  aware  of  the 
part  she  had  played  in  the  way  Allen 
behaved. 

Many  other  factors  may  influence 
the  nurse's  response  to  her  patient's 
behavior.  The  patient  may  consciously 
or  unconsciously  remind  her  of  another 
child  she  particularly  liked  or  disliked. 
The  nurse  may  be  tired,  worried,  or 
angered  by  an  event  unrelated  to  the 
child.  She  may  vicariously  enjoy  his 
acting  up  or  acting  out;  conversely,  her 
punitive  approach  may  reflect  her  own 
resentment  toward  behavior  that  she 
herself  was  never  permitted.  It  is  im- 
portant not  only  to  ask  yourself  "Why 
is  this  child  acting  that  way?"  but  also, 
"Why  am  I  responding  this  way  to 
him?" 

The  hyperactive  child 

Whether  diagnosed  as  being  hyper- 
kinetic, or  as  being  a  very  active  child 
in  a  restricted  environment,  a  hyper- 
active child  is  an  exhausting  patient  to 
look  after.  It  helps  to  organize  at  the 
outset.  Your  two  greatest  allies  can  be 
a  structured  day  and  a  calm  approach. 

Outline  an  enforceable  daily  routine 
and  stick  to  it.  If  the  child  is  old 
enough,  you  can  make  him  his  own  co- 
lorful book  outlining  his  day.  Make  the 
best  use  of  the  time  you  spend  with 
him  by  anticipating  when  he  will  need 
you  most.  A  quiet  story  and  a  cuddle 
prior  to  nap  time  will  help  to  settle  him 
down.  Enlist  the  help  of  others  when 
possible;  a  volunteer  might  be  glad  to 
provide  a  period  of  activity  in  the  play- 
room. 

Hyperactive  children  are  into  every- 
thing and  need  consistent  limits.  It's  no 
use  telling  the  child  repeatedly  to  stop 
playing  with  the  taps.  If  you  have  told 


him  and  he  does  it  again,  remove  him 
from  the  situation,  if  possible,  and 
provide  alternate  activity.  Above  all, 
keep  cool. 

Four-year-old  Stuart,  a  hyperkinetic 
child,  was  a  patient  for  many  weeks 
awaiting  admission  to  a  specialized  day- 
care program.  A  picture  of  perpetual 
motion,  Stuart  required  constant  super- 
vision or  restraint.  Many  of  the  nursing 
staff  commented  that  he  was  so  much 
easier  to  manage  when  they  remained 
calm.  By  sharing  his  care,  everyone 
was  able  to  maintain  patience  and  a 
sense  of  humor. 

The  child  who  says  no 

In  caring  for  the  negativistic  child,  a 
nurse  must  examine  his  unique  circum- 
stances and  not  rely  on  methods  that 
succeeded  with  other  patients.  The  child 
tries  to  please  those  he  loves  and  trusts. 
When  he  comes  to  hospital,  he  sees  us 
as  strangers  and  neither  loves  nor 
trusts  us.  We  make  demands  on  him  to 
cooperate  with  unpleasant  procedures. 

In  a  strange  environment,  tilled 
with  strange  people,  his  whole  life 
routine  is  disrupted.  Understandably 
he  balks  when  asked  to  cooperate  brave- 
ly with  an  unpleasant  or  painful  exper- 
ience. Don't  offer  children  the  opportu- 
nity to  say  no  when  vou  do  not  mean  it. 

If,  for  instance,  you  say  to  Lorie, 
"It's  time  for  your  bath  now,  okay?" 
Lorie  may  well  shout,  "No!"  If  her 
nurse  then  scoops  her  up  and  places 
her  in  the  tub,  Lorie  may  wonder  why 
the  nurse  bothered  to  ask  if  it  was 
"okay."  When  a  child  says  "no,"  ask 
yourself  how  important  your  request  is. 
Could  it  as  easily  be  left,  or  must  it  be 
pursued  now?  If  it  must  be  pursued, 
ask  yourself  the  following  questions: 

•  How  old  is  the  child?  A  "chronically 

negative"  two-year-old? 

•  What  does  his  facial  expression  re- 

veal —  anger?  fear'.' 

•  What  happened  Just  prior  to  my  re- 

THE  CANADIAN  NURSE     47 


quest?  A  needle?  A  scolding?  Just 
awakened?  Mother  left? 
•How  long  has  he  been  here  and  how 
much  has  he  endured? 

•  What  else  do  I  know  about  the  child 

and  his  family  that  might  help  me? 

•  How  adequate,  really,  is  my  expla- 

nation for  the  procedure?  It  is  sur-^ 
prising,  in  this  day  of  audiovisual 
aids,  how  seldom  nurses  use  colorful 
and  simple  pictures,  felt  boards,  and 
models  to  augment  their  explanations 
to  patients. 

The  answers  to  these  questions  and 
others  you  might  formulate  should  lead 
to  a  helpful  approach.  Avoid  a  power 
struggle  in  which  the  issue  is  lost  and 
the  struggle  becomes  a  matter  of  win- 
ning over  the  child.  An  attempt  to 
maintain  emotional  neutrality  by  saying 
"It's  important  for  you  to  do  such  and 
such"  is  often  more  successful  than, 
"Because  I  say  so"  or,  "The  doctor 
says  so." 

The  anxious  child 

Anxiety  in  pediatric  patients  often 
goes  unrecognized.  Children  show  and 
deal  with  their  anxiety  in  many  differ- 
ent ways.  The  more  obvious  include 
the  anxious  mannerisms  of  hair  pulling, 
nail  biting,  and  regression  to  thumb 
sucking;  disturbed  sleep  patterns  with 
nightmares  or  enuresis:  fears  that  are 
excessive  in  number  or  degree;  physical 
complaints,  such  as  stomach  aches  or 
headaches;  and  withdrawn  behavior. 
The  child  who  becomes  hyperactive, 
negativistic,  or  hostile  may  also  be 
anxious. 

Excessive  sleeping,  "model"  behav- 
ior, or  false  bravado  are  also  ways 
children  use  to  cope  with  their  anxiety. 
If  you  sense  that  a  child  is  anxious, 
look  for  reasons  and  try  to  alleviate 
them.  How  often  we  could  avoid  expos- 
ing our  pediatric  patients  to  unnesessary 
anxiety  if  we  would  remember  little 
things,  such  as  closing  the  door  to  a 

48     THE  CANADIAN  NURSE 


room  where  a  child  is  screaming,  or 
asking  the  medical  staff  not  to  discuss 
the  child  in  his  presence. 

The  attention-seeker 

If  you  have  worked  in  pediatrics, 
you  will  be  aware  of  an  endless  variety 
of  attention-seeking  behavior.  Your  aim 
in  management  is  two-fold:  first,  to  let 
the  child  know  that  this  behavior  is  not 
necessary  to  receive  your  attention; 
second,  to  make  the  attention-seeking 
device  fail.  Thus  you  give  the  attention 
at  other  times,  but  not  when  the  child 
acts  up.  Of  course  you  cannot  always 
completely  ignore  a  child's  behavior, 
especially  if  he  is  running  off  the  ward. 
But  deal  with  it  swiftly  and  matter-of- 
factly,  let  him  know  when  you  will  be 
free  to  be  with  him,  and  in  the  mean- 
time provide  an  alternative. 

Certain  behaviors,  such  as  swearing, 
must  be  limited.  Saying,  "Don't  ever 
say  that  again,"  is  bait  to  which  the 
child  may  rise  with  an  even  more  color- 
ful expletive.  But  you  can  say,  "No 
swearing  in  the  halls  or  playroom," 
and  remove  him  if  it  happens  again. 

Include  the  parents 

Parents  may  be  distressed  by  their 
child's  behavior,  yet  often  avoid  dealing 
with  it,  preferring  the  nurse  to  proceed 
without  their  interference.  If  you  dis- 
cuss their  child's  behavior  with  them 
alone,  they  may  contribute  to  the  "why" 
of  the  behavior  and  tell  how  they  have 
handled  it  at  home.  They  may  look  to 
you  for  guidance,  or  seek  an  explana- 
tion for  your  approach.  Make  it  clear 
who  is  to  control  the  behavioral  prob- 
lem should  it  occur  when  they  visit,  so 
that  both  you  and  the  parents  are  nei- 
ther holding  back  nor  jumping  in. 

Let's  be  realistic 

Even  the  most  thoughtful  approaches 
to  acting  out  and  acting  up  will  some- 
times fail  or  backfire.  On  the  days  when 


nothing  seems  to  work  and  you  feel 
totally  inadequate  to  deal  with  your 
patients,  it  is  time  to  realize  the  limita- 
tions to  what  you  can  do.  A  totally 
undisciplined  child  may  not  accept 
limits  during  his  entire  hospitalization. 
The  child  who  is  hopelessly  overindulg- 
ed may  be  demanding  from  first  day 
until  last.  The  hyperactive  child  may 
require  weeks  or  months  to  settle  into 
a  routine. 

It  is  also  time  to  preserve  your  sense 
of  humor.  (It  was  rather  funny  when 
Steven  threw  his  mashed  potatoes  at  the 
kid  in  the  next  bed  who  called  him  a 
chicken.) 

Children's  behavior  shows  us  far 
more  than  they  can  tell  us  about  what 
they  are  feeling  and  how  they  are  ex- 
periencing the  hospital  world.  How 
sensitively  we  tune  in  to  their  behavior 
and  how  we  deal  with  it  are  two  unique 
challenges  of  pediatric  nursing. 

Bibliography 

Ginott.    H.B.  Between  Piireni  unci  Child. 

New  Solidions  to  Old  Frohleins.  New 

York,  Macmillan.  1969. 
Redl,  F.    When   We  Deal  with  Children. 

Selected  Writings.  New  York.  Collier 

Macmillan.  1966.  'g? 


SEPTEMBER  1971 


Taking  rehabilitation 
to  the  patient 


The  Calgary  General  Hospital  has  successfully  brought  Its  rehabilitation  services 
to  seven  outlying  communities,  showing  that  rural  hospitals  need  not  transfer  pa- 
tients to  city  hospitals  for  specialized  care  or  treatment. 


The  rural  rehabilitation  service  at  the 
Calgary  General  Hospital  is  designed 
to  bring  physical  medicine  treatment 
and  rehabilitation  techniques  to  rural 
communities  that  are  unable  to  obtain 
qualified  personnel. 

This  service,  a  division  of  the  hospi- 
tal's department  of  physical  medicine 
and  rehabilitation,  is  an  outcome  of  a 
study  done  in  1 966  by  the  Alberta  Med- 
ical Association. 

Following  this  study  the  AMA  made 
recommendations  to  the  department  of 
health  of  the  province  of  Alberta  on 
the  optimal  use  of  existing  physical 
medicine  and  rehabilitation  services 
in  the  province.  Among  its  recommen- 
dations was  the  establishment  of  a  rural 
rehabilitation  service  as  a  pilot  project. 

In  September  1967,  three  hospitals 
in  the  Calgary  area  were  chosen  to 
participate  in  such  a  pilot  project,  with 
the  Calgary  General  Hospital  as  the 
"parent"  hospital.  In  October  1969, 
this  project  was  extended  to  include 
four  additional  area  hospitals. 

The  University  of  Alberta  Hospital 
in  Edmonton  organized  a  program  to 
meet  the  needs  of  hospitals  in  north- 
ern Alberta  and,  in  the  summer  of 
1970,  Lethbridge  initiated  a  similar 
service  to  cover  five  hospitals  in  the 
southern  part  of  the  province.  These 
SEPTEMBER  1971 


Elizabeth  Ann  Halverson 

programs  are  independent  of  that  of  the 
Calgary  General  Hospital. 

The  program 

Our  rual  rehabilitation  service  has 
two  aims:  one,  to  make  all  staff  mem- 
bers of  the  outlying  hospitals  more 
aware  of  rehabilitation  and  of  their 
role  in  relation  to  it;  the  other,  to  es- 
tablish physiotherapy  services  and  to 
assure  quality  of  treatments  performed. 

The  Calgary  General  Hospital  is  the 
nucleus  for  seven  centers  within  a  90 
mile  radius  of  Calgary:  Drumheller, 
Didsbury,  Olds,  Sundre,  High  River, 
Vulcan,  and  Claresholm.  Their  12  gen- 
eral hospitals,  auxiliary  hospitals,  and 
nursing  home  have  a  total  of  55 1  beds. 
Their  distance  from  Calgary,  their 
size,  and  their  need  and  desire  for  ser- 
vice were  considerations  in  including 
these  hospitals  in  the  program. 

At  present,  two  teams,  each  consist- 
ing of  a  nurse  and  a  physiotherapist  from 
our  hospital  staff,  provide  rehabilitation 

Mrs.  Halverson  is  a  graduate  of  the  C'al- 
gary  General  Hospital  School  of  Nursing 
and  has  been  involved  in  rehabilitation 
nursing  for  nine  years.  For  the  past  three 
years,  she  has  been  with  the  rural  rehabili- 
tation service  of  the  Calgary  General 
Hospital,  Calgary,  Alberta. 


services  to  the  participating  rural 
hospitals.  They  live  in  Calgary  and 
make  regular  weekly  visits  to  each  rural 
community,  driving  to  and  from  the 
area  within  the  same  working  day.  They 
travel  four  days  a  week,  and  spend  the 
fifth  day  at  the  Calgary  General  Hospi- 
tal. Here  they  plan,  organize,  and  re- 
view plans  and  problems  with  the  med- 
ical director  in  charge  of  the  program. 

In  every  hospital  included  in  the 
program,  the  physical  medicine  depart- 
ment functions  autonomously,  being 
directly  responsible  to  the  hospital 
administrator.  In  each  hospital  a  local 
doctor  is.designated  as  medical  director 
of  physical  medicine  to  allow  him  to 
deal  with  difficulties  encountered  with 
patients  and  to  act  as  liaison  between 
the  rehabilitation  department  and  other 
doctors.  A  registered  nurse  is  respon- 
sible for  the  continuous  functioning  of 
the  department,  and,  depending  on  the 
needs  of  the  area,  up  to  four  nursing 
aides  work  under  her/his  supervision. 

Rehabilitation  nurse 

The  team's  rehabilitation  nurse  is 
very  important  to  our  program.  In  the 
rural  hospital  complexes  she  instructs 
all  levels  of  staff  for  the  improvement 
of  patient  care  and  demonstrates  reha- 
bilitation nursing  techniques  on  the 
THE  CANADIAN  NURSE     49 


nursing  units  and  in  the  classroom.  She 
stresses  those  principles  of  medical 
rehabilitation  related  to  the  prevention 
of  disabilities  and  to  the  simpler  meth- 
ods of  physical  restoration  where 
disabilities  have  occurred.  It  is  impor- 
tant to  demonstrate  these  techniques 
on  the  nursing  units,  as  they  involve 
such  matters  as  transfers,  self-care  ac- 
tivities, positioning,  and  bowel  and 
bladder  training. 

If  the  outlying  hospital  already  has 
an  inservice  education  program,  she 
incorporates   her   teaching   into   it.    If 


not,  she  sets  one  up,  giving  most  em- 
phasis to  rehabilitation. 

She  includes  in  her  teaching  program 
certain  resource  personnel  —  speech 
therapists,  occupational  therapists,  psy- 
chologists, inhalation  therapists,  social 
service  workers,  nursing  service  and 
nursing  education  personnel  —  who  are 
brought  from  the  Calgary  General  Hos- 
pital to  lecture  in  their  specialized 
fields. 

The  total  team  approach  is  stressed 
by  both  the  rehabilitation  nurse  and 
the  physiotherapist.  The  local  nursing 


Physiotherapist  demonstrates  crutch  walking  to  nursing  staff. 


and  physiotherapy  staff  and  the  travel- 
ing team  attend  weekly  patient  assess- 
ment rounds  and  total  team  confer- 
ences. The  rehabilitation  nurse  plays  a 
large  role  in  coordinating  physiotherapy 
with  nursing. 

Physiotherapist 

As  in  all  physiotherapy  departments, 
treatments  are  carried  out  only  on 
doctor's  orders.  For  our  program, 
specially  designed  requisitions  offer 
only  those  modalities  that  the  local 
staff  is  prepared  to  carry  out.  The  phys- 
iotherapist assesses  all  referred  patients 
and  plans  the  treatment  program  for  the 
local  department  staff  to  follow. 

The  physiotherapist  is  responsible 
for  training  staff  members  to  do  the 
physiotherapy  treatments  in  her  ab- 
sence. Once  a  week  she  holds  formal 
half-hour  classes  in  each  department, 
where  she  teaches  practical  techniques 
as  well  as  some  theory.  She  also  gives 
clinical  instruction  to  the  staff  for  each 
patient  as  she  assesses  him  and  pro- 
grams his  treatment.  She  allows  staff 
members  to  do  only  what  she  knows 
they  arc  capable  of  doing. 

Assessment  records  and  progress 
notes  are  kept  for  each  patient  to  in- 
form the  dtKtor  on  his  patient's  activi- 
ties in  the  physical  medicine  depart- 
ment. 

The  physiotherapist  takes  an  active 
part  in  the  inservice  education  pro- 
gram organized  by  the  rehabilitation 
nurse.  She  teaches  all  the  hospital  staff 
the  general  principles  of  rehabilitation. 
Her  classes  include  such  topics  as 
crutch  walking,  breathing  exercises, 
positioning,  and  passive  movements. 

Speech  therapist 

Twice  a  month  a  speech  therapist 
from  the  Calgary  General  Hospital 
travels  with  the  team  to  five  of  the 
seven  hospital  complexes.  The  patients 
whom  she  assesses  and  treats  are  con- 
sidered to  be  outpatients  of  the  depart- 

SEPTEMBER  1971 


Nursing  staff  use  the  rehabilitation  technique  of  transferring  a  patient. 


nient  t)f  physical  medicine  and  rehabili- 
tation of  the  Calgary  General  Hospital. 

Courses  in  rehabilitation 

The  Calgary  General  Hospital  has 

cstabli^hed  an  educational  program  in 
conjunction  with  its  rural  rehabilitation 
service.  As  sufficient  teaching  could 
not  be  accomplisiicd  during  the  team's 
weekly  visits  to  the  complexes,  sup- 
plementary rehabilitation  courses  were 
introduced. 

A  tuo-and-one-half  week  course  is 
entitled  "Organization  and  Techniques 
o\'  Rehabilitation  Medicine. '"  Its  first 
three  days,  covering  principles  and 
i>rganizational  aspects  of  rehabilitation 
services,  is  offered  to  hospital  board 
members,  administrators,  and  register- 
ed nurses.  The  remainder  of  the  course 
is  for  nurses  only,  and  covers  theory 
SEPTEMBER  1971 


as  well  as  practical  techniques  of  re- 
habilitation. This  course  has  been  held 
for  the  past  three  years. 

A  one-week  course  "Practical  Re- 
habilitation Techniques,"  is  designed 
to  leach  nursing  aides,  hospital  assis- 
tants, and  orderlies  the  modern  techni- 
ques of  rehabilitation  nursing.  This 
course  has  been  held  t\)r  the  past  two 
years. 

In  addition,  a  series  of  seven  month- 
ly workshops  have  been  prepared  to 
acquaint  nursing  personnel  with  the 
principles  and  techniques  necessary 
for  the  practice  of  rehabilitation  nurs- 
ing. 

Summary 

The  primary  aim  of  this  prciject  is 
to  make  the  personnel  of  rural  hospitals 
more  conscious  of  rehabilitation.  The 


rehabilitation  nurse  achieves  this  by 
her  inservice  education  program,  total 
team  conferences,  rounds,  and  courses. 

The  second  aim  is  to  provide  safe, 
supervised  physiotherapy  services  to 
these  hospitals.  This  has  been  accom- 
plished by  setting  up  physical  medicine 
departments  and  providing  part-time 
supervision  of  the  local  department 
staff  by  the  physiotherapist.  The  team 
is  present  in  each  outlying  hospital  at 
least  one-half  day  per  week,  and  up 
to  four  half  days  a  week,  depending  on 
the  size  of  hospital  complex  and  need. 

The  functions  of  physiotherapy  as- 
sistants or  aides  are  of  utmost  impor- 
tance in  this  project.  The  quality  of 
treatment  performed  by  them  does  not 
reach  that  of  a  qualified  physiotherapist 
but  it  is  certainly  better  than  no  treat- 
ment at  all. 

This  program  provides  a  workable 
means  of  supplying  basic  rehabilitation 
services  to  many  individuals  in  Alberta 
who  might  otherwise  be  unable  to  bene- 
fit from  rehabilitation.  In  many  in- 
stances the  services  provided  allow 
patients  to  be  treated  in  their  local 
hospital,  rather  than  requiring  transfer 
to  a  city  hospital. 

Hospital  beds  are  used  more  advan- 
tageously, particularly  in  the  chronic 
care  areas,  as  the  concept  of  progres- 
sive patient  care  is  practiced  more 
readily.  The  rate  of  admissions  and 
discharges  has  increased  as  more  con- 
centrated treatment  is  being  offered. 
Patients  fri>m  larger  hospitals  can  be 
transferred  to  their  local  hospital  for 
follow-up  physical  medicine  treat- 
ments. 

The  Calgary  General  Hospital  pro- 
ject has  shown  that  continuous  phys- 
ical medicine  services  can  be  establish- 
ed and  maintained  in  rural  commu- 
nities, and  that  a  program  of  ongoing 
education  in  rehabilitation  medicine 
can  be  instituted  in  outlying  hospitals. 
Thus,  a  person  need  not  be  deprived 
of  rehabilitation  services  because  he 
lives  in  a  small  rural  community.  ^ 
THE  CANADIAN  NURSE     51 


Cycling 
for 

fitness 
and  fun 


■  Outdoor  recreational  activi- 
ties are  booming.  In  1971  the 
development  of  cycling  as  a 
"fun  thing"  has  been  phenom- 
enal, encouraged  in  part  by  the 
establishment  of  special  cycle 
trails  in  many  Canadian  cen- 
ters. 


■  Occasionally,  women  hesi- 
tate. They  don't  want  leg  devel- 
opment that  would  give  them 
muscles  like  those  below 
(which,  incidentally,  belong  to 
Paul-Andre  Cadieux,  a  former 
member  of  Canada's  national 
hockey  team).  Apparently  they 
see  extended  muscular  activity 
as  a  visible  threat  to  their  fem- 
ininity. 


52     THE  CANADIAN  NURSE 


■  But  that's  not  so.  A  look  at 
the  attributes  of  this  limb, 
which  belongs  to  Diane  Ralph, 
a  recent  nursing  graduate  of 
the  University  of  Ottawa, 
proves  otherwise.  Diane  is  an 
eager  cyclist,  and  has  toured 
with  friends  through  Ontario 
and  the  New  England  states. 

SEPTEMBER  1971 


■  Fat  mobilization  takes  time, 
even  with  extensive  exercise 
and  diet  control.  To  gain  ob- 
vious cardiovascular  benefits 
and  to  maintain  a  figure  that 
continues  to  be  complimented 
by  current  fashion  trends,  the 
School  of  Physical  Education 
and  Recreation  at  the  Univers- 
ity of  Ottawa  suggests  a  daily 
or  every-second-day  program 
of  leisure  activities  throughout 
the  year.  Go  ahead!  Cycle  in 
spring,  summer,  and  fall  — 
it's  more  fun  than  it  is  work. 
And  when  winterarrives, sports 
such  as  swimming,  skiing, 
skating,  or  volleyball  provide 
alternate  activities  that  will 
keep  you  in  shape  for  a  new 
season  of  cycling. 

TECHNICAL  COMMENTS 

Dr.  James  S.  Thoden,  Department 

of   Kinanthropology,    University   of 

Ottawa. 
PHOTOGRAPHY 

Don     Gilimore.     Communications 

and    Instructional    Media    Centre, 

University  of  Ottawa. 
TANDEM  BICYCLE 

V.F.  Clost  Bicycles,  Ltd.,  Ottawa. 

SEPTEMBER  1971 


THE  CANADIAN  NURSE     53 


new  products     j 


Descriptions  are  based  on  information 
supplied  by  the  manufacturer.  No 
endorsement  is  intended. 


Audiometric  booth 

The  Eckoustic  Audiometric  Booth, 
developed  by  Eckel  Industries  Inc., 
provides  the  proper  acoustic  environ- 
ment for  conducting  hearing  tests. 

Model  ASB  200  is  completely  assem- 
bled and  ready  to  use  when  delivered. 
The  compact  booth  measures  32'"  wide 
X  40"  deep  x  62"  high,  and  it  weighs 
500  lbs.  It  has  a  large  built-in  window, 
a  magnet-sealed  door,  and  a  spacious 
interior.  The  booth's  built-in  standard 
jack  panel  can  be  used  with  any  audio- 
meter. 

For  more  information  write  to  Eckel 
Industries  of  Canada  Ltd,  Allison 
Avenue,  Morrisburg,  Ontario. 

Lasan 

Anthralin  as  a  treatment  for  psoriasis 
presents  greater  precision  in  therapeutic 
action  than  compounds  such  as  tar 
mixtures  and  chrysarobin. 

The  occlusive  dressing  is  one  of  the 
most  effective  means  of  treating  psoria- 
sis. Lasan  achieves  this  by  incorporat- 
ing Anthralin  N.F.  into  a  vehicle  of 
Lassar's  Paste.  To  complement  Lasan, 
a  pomade  is  also  presented  for  use  on 
the  scalp  where  Lasan  may  be  undesir- 
able. 

Lasan  is  available  in  two  strengths, 
Lasan  2  with  0.2%  Anthralin  N.F.  in 
a  base  of  Lassar's  Paste  (Zinc  oxide 
24.9%,  White  Petroleum). 

Lasan  Pomade  contains  0.4%  An- 
thralin N.F.  in  a  suitable  washable 
ointment  base.  File  card  and  prescrib- 
ing information  may  be  requested  from 
Winley-Morris  Co.  Ltd.,  675  Montee 
de  Liesse,  Montreal  377,  Quebec. 

Audibell 

C.  &  M.  Products  Ltd.  has  produced  a 
heavy  duty  bell  called  the  Audibell.  It  is 
available  in  10  inch.  6  inch  and  4  inch 
sizes  with  a  choice  of  single  stroke  or 
vibrating  design  and  operates  on  alter- 
nating or  direct  current. 

The  tone  is  clear  and  free  of  any 
mechanical  noises.  This  unit  also  fea- 
tures die-cast  housings  that  are  shock- 
proof,  a  stainless  steel  striker,  a  low 
friction  motor  with  Teflon  lifetime 
bearings,  a  mounting  screw,  and  low 
current  draw. 

For  more  information  write  to  C.  & 
M.  Products  Ltd,  189  Bullock  Drive, 
Markham,  Ontario. 

54     THE  CANADIAN  NURSJ 


I 


1 


Audiometric  Booth 


Mingograf-34 

The  Mingograf-34  is  a  new  direct- 
writing  recorder  that  produces  electro- 
and  phonocardiograms.  It  can  also  be 
adapted  for  recordings  of  pulse  waves 
and  other  biophysical  phenomena. 

Multiple  recordings  are  possible 
because  the  Mingograf-34  can  be  equip- 
ped with  up  to  four  recording  channels. 
Special  buffer  circuitry  gives  high  input 
and  ensures  error-free  ECG  results. 
The  unit  uses  inexpensive  chart  paper, 
and  ink  is  available  m  disposable  car- 
tridges. 

For  more  information  write  to  Sie- 
mens Medical  Canada  Ltd.  7 300  Trans- 
Canada  Highway.  P.O.  Box  7300. 
Pointe  Claire  730,  Quebec. 

Vaseline  lotion 

Vaseline  Intensive  Care  lotion,  an  all- 
purpose  lotion  for  use  in  hospital  pa- 
tient care,  has  been  introduced  by 
Chesebrough -Pond's  (Canada)  Ltd. 

The  lotion  spreads  easily  on  the  skm 
and  dries  rapidly,  leaving  a  nongreasy 


light  emollient  residual  film  that  helps 
prevent  loss  of  skin  moisture. 

Vaseline  lotion  can  be  used  when 
massaging  patients.  It  is  easily  rinsed 
off  with  water.  The  lotion  is  available  in 
7  oz.  and  14  oz.  squeeze  bottles. 

For  more  information  write  toChese- 
brough-Pond's  (Canada)  Ltd.,  Hospital 
Products  Division,  150  Bullock  Drive. 
Markham.  Ontario. 

Electronic  keyboard 

Varifab  Inc.  has  introduced  a  low -cost 
portable  electronic  keypunch.  The  15- 
pound  Vari-Punch  is  designed  for  use 
in  nursing  stations  and  other  hospital 
locations  where  data  originates. 

Using  the  12-key  input  keyboard 
the  operator  can  produce  three  card  or 
form  sets  a  minute  that  include  all  the 
data  normally  accommodated  by  an  80- 
column  punch  card.  No  training  is  nec- 
essary for  the  keypunch  operator. 

For  further  information  write  to 
Varifab  Inc.,  1700  E.  Putnam  Ave., 
Old  Greenwich  Conn.  06870.  U.S.A. 

SEPTEMBER  1971 


Control  for  IV  flow  rates 

The  McGaw  Meter  provides  an  accurate 
IV  flow  rate  reading  in  milliliters  per 
hour.  It  is  designed  to  save  time,  reduce 
chance  of  error,  and  to  improve  control 
of  solution  administration.  After  setup, 
the  McGaw  Meter  does  not  require 
time-consuming  drop  counting.  Nurses 
need  only  observe  the  rate  on  the  scale. 

The  buoyant  ball  in  the  fluid  channel 
indicates  the  rate  of  flow  on  a  scale  of 
60  ml.  to  500  ml.  per  hour.  Control 
clamp  permits  easy  regulation  of  flow. 

Further  information  may  be  obtained 
from  McGaw  Laboratories,  Division 
of  American  Hospital  Supply  Corpora- 
tion (Canada)  Ltd..  1076  Lakeshore 
Rd.  E.,  Port  Credit,  Ontario. 


Unit-Pak 

A  new,  compact,  inexpensive  machine 
that  packages  and  identifies  unit  doses 
of  tablets  and  capsules  is  available 
from  Packaging  Machinery  Associates, 
Cherry  Hill,  New  Jersey.  The  Unit- 
Pak,  for  use  in  hospital  pharmacies, 
accepts  most  sizes  and  shapes  of  solid 
oral  medication,  including  oversized 
gelatin  capsules.  It  automatically  pack- 
ages and  labels  a  minimum  of  45  her- 
metically-sealed pouches  a  minute.  A 
V-type  knife  separates  dosages  into 
individual  packets  or  perforated  strips 
with  a  simple  knob  adjustment. 

The  Unit-Pak  uses  anv  standard 
heat-sealable  supported  film  roll  stock. 
The  operator  places  the  medication  into 
an  automatically-timed  multiple  pocket 
feeder.  No  adjustments  are  required  for 
a  normal  packaging  operation.  A  de- 


Practi-Cath  Units 

Top:  thin-walled  needle  infusion  set 

Left:  over-the-needle  intravenous  catheter  unit 

Right:  through-the-needle  intravenous  catheter  unit 


Control  flow  for  IV  rates 
SEPTEMBER  1971 


mand  feeder  is  available  as  an  option 
for  completely  automatic  operation. 

This  machine  is  constructed  of  alumi- 
num, stainless  and  plated  steel.  1  he 
multiple  pocket  feeder  lifts  out  for  easy 
cleaning.  It  measures  36"  wide,  18"" 
high  and  20"  deep,  and  standard  pack- 
age size  is  2  ■  x  2"  the  length  may  be 
increased  to  4"  if  desired. 

For  more  information  write  to  Pack- 
aging Machinery  Associates,  1800  Lark 
Lane,  Cherry  Hill,  New  Jersey  08034. 

Literature  available 

Common  insect  pests  from  cockroach 
to  centipede,  bedbug  to  housefly  are 
illustrated  in  a  four-color  "Insect  Iden- 
tification Chart"  available  from  West 
Chemical  products  Inc. 

The  chart  includes  life-sized  photos 
of  pests  in  adult  or  immature  stages. 

For  a  copy  of  this  chart  write  to  the 
Canadian  office  of  West  Chemical 
Products  Inc.,  5623  Casgrain  Avenue, 
Montreal,  Quebec. 

Practi-Cath  units 

Cenco  Medical/Health  Corporation  of 
Chicago  has  introduced  five  new  intra- 
venous catheters  and  winged  infusion 
sets. 

The  thin-walled  needle  infusion  set 
includes  a  stainless  steel  needle  with  a 
needle  guard.  It  has  two  wings,  one 
fixed  behind  the  needle,  and  one  adjust- 
able and  detachable  security  wing.  The 


clear  vinyl  tubing  is  soft  and  flexible 
and  it  will  not  kink.  A  color-coded  luer 
connector  and  a  luer  plug  are  added 
features  of  the  infusion  set. 

The  over-the-needle  intravenous 
catheter  unit  is  available  in  Practi-Cath 
3  with  a  luer  plug,  and  Practi-Cath  4 
with  a  disposable  syringe.  Both  units 
include  a  Teflon  catheter  with  color- 
coded  catheter  hub.  The  release  ring  on 
the  catheter  hub  facilitates  separation  of 
catheter  and  needle  after  entering  the 
vessel.  A  stainless  steel  needle  with  a 
needle  guard  is  standard  on  both  units. 
The  attached  needle  hub  has  a  bevel 
position  indicator  to  help  align  the 
needle  properly  prior  to  venipuncture. 
A  transparent  chamber  shows  flash- 
back immediately  upon  entry.  Flexible 
inert  plastic  obturators  with  positive 
male  luer  locks  are  available  for  each 
size. 

The  through-the-needle  intravenous 
catheter  unit  is  available  in  Teflon  and 
in  vinyl  material.  Both  units.  Practi- 
Cath  1  and  Practi-Cath  2,  include  a 
needle  guard,  split  needle,  color-coded 
needle  bixly,  stop  button,  sack  body, 
protective  sack,  and  a  color-coded  luer 
connector. 

These  sterile  units  are  fully  assembled 
and  ready  to  use  when  delivered. 

For  more  information  write  to  Cenco 

Medical/Health    Supply    Corporation, 

440 1  West  26th  Street,  Chicago,  Illinois 

60623,  U.S.A.  * 

THE  CANADIAN  NURSE     55 


in  a  capsule 


Some  only  half-counted 

June  1  was  the  day  that  Canadians, 
in  the  terms  of  the  Dominion  Bureau 
of  Statistics'  census  planners,  were 
to  "stand  up  and  be  counted."  But 
some  of  us  had  the  feeling  we  counted 
less  than  others. 

The  CBC  started  the  day  off  by 
announcing  this  was  census  day  —  "the 
day  that  Canadians,  their  wives,  their 
children"  get  counted.  A  women's  libber 
would  call  that  a  typical  example  of 
male  thinking. 

Then  there  was  the  form  itself.  We 
should  have  been  given  two  copies: 
one  to  send  in  and  one  suitable  for 
framing  as  a  document  designed  not  to 
reflect  the  social  and  economic  reali- 
ties of  Canada,  1971. 

For  instance,  there  was  the  manda- 


tory designation  of  the  man  as  the  head 
of  the  household  and  the  woman  as  the 
wife  of  the  head.  Hardly  a  picture  of 
today's  many  "partnership  marriages" 
or  the  woman  who  works  to  support 
an  invalid  husband  or  the  sole-support 
mother  whose  husband  happened  to 
turn  up  on  census  day. 

In  the  House  of  Commons,  Grace 
Maclnnis,  MP,  asked  the  minister 
responsible  for  DBS,  "In  view  of  the 
fact  that  the  declaration  that  the  head  of 
the  household  is  the  husband  rather 
than  the  wife  is  inaccurate,  misleading, 
and  undemocratic  to  the  point  of  insult- 
ing large  numbers  of  people  .  .  .  would 
the  minister  say  whether  such  an  ante- 
diluvian description  was  made  with 
his  approval?"  The  minister  of  indus- 
try, trade  and  commerce  Jean-Luc  Pe- 


Hlustrated  by  Fran  Kuc 


"Hmmm,  the  mists  of  time  are  parting.  Madame  Zelda  zees  you 
sitting  in  the  front  row,  voting,  talking,  braless,  at  the  CNA 
biennial  convention  in  Edmonton,  June  25-29.  While  there 
you  will  meet  a  tall,  dark  stranger —  a  nurse!" 


56     THE  CANADIAN  NURSE 


pin,  replied,  "The  bureau  of  statist! 
has  to  go  by  appearances  most  of  the 
time  and  this  is  one  such  occasion." 

A  letter  in  the  Globe  and  Mail  on 
June  4  said,  "As  a  young  mother  and 
housewife  my  frustration  arising  from 
a  lack  of  socio-economic  autonomy  was 
reinforced  by  the  1971  census  omission 
of  questions  pertaining  to  my  status  .  .  . 
I  find  my  role  being  defined  in  terms 
of  my  husband's  salary  and  the  number 
of  flush-toilets  per  dwelling  ....  Ac- 
cording to  the  Canadian  Government, 
I  am  unemployed,  unremunerated, 
uneducated,  and  unimportant.  Can 
women  exist  outside  a  political,  social, 
and  economic  framework  and  retain 
their  integrity,  humaneness,  and  san- 
ity?" 

Eliminate  extension  cord  heists 

This  informative  item  may  not  be  useful 
right  now,  as  it  comes  under  the  heading 
of  "foiling  extension  cord  thieves"  — 
a  specie  that  hibernates  during  the 
summer  but  becomes  active  in  winter 
as  temperatures  drop. 

So,  next  wmter  if  you  are  bothered 
by  these  car-nivorous  pests,  remember 
this  suggestion:  stop  your  vehicle  ap- 
proximately two  feet  from  plug-in, 
attach  cord,  place  some  of  excess  cord 
before  a  front  wheel,  return  to  car,  move 
it  forward  and  run  over  the  cord,  there- 
by abolishing  one  of  winter's  abomina- 
tions. 

The  nurses'  dragon 

In  the  past,  some  British  nurses  referred 
to  their  ward  sister  as  the  "old  dragon," 
a  somewhat  exaggerated  description  of 
the  matron  who  had  to  maintain  order 
and  discipline  among  staff  nurses. 

"Nursing  used  to  depend  on  a  sort 
of  rule  of  terror"  said  one  British  nurse 
who  was  quoted  in  a  London  news- 
paper. Change  is  coming,  however,  and 
Northwick  Park  hospital  in  the  London 
area  has  started  its  nursing  revolution. 

The  new  matron  is  young  in  years  as 
well  as  young  in  spirit,  and  she  is  no 
longer  concerned  with  giving  nurses 
jobs  that  aren't  strictly  nursing  duties. 

British  nurses  are  beginning  to  have 
more  freedom  and  time  to  concentrate 
on  nursing,  and,  as  one  writer  for  a  Lon- 
don newspaper  observed,  "Northwick 
Park  isn't  perfect.  But  what  it  is  doing 
is  bringing  nursing  out  of  the  last  cen- 
tury —  before  the  last  British  nurse 
either  disappears  to  America  or  be- 
comes an  air  hostess  instead."  ^ 
SEPTEMBER  1971 


research  abstracts 


The  following  are  abstracts  of  studies 
selected  from  the  Canadian  Nurses' 
Association  Repository  Collection  of 
Nursing  Studies.  Abstract  manuscripts 
are  prepared  by  the  authors. 


Nordwich,  Irene  Erika.  Concerns  of 
cardiac  patients  regarding  their  abil- 
ity to  implement  the  prescribed  drug 
therapy.  London,  Ont.,  1970.  Thesis 
(M.Sc.N.)  U.  of  Western  Ontario. 

The  purpose  of  this  study  was  to  deter- 
mine the  kinds  of  concerns  expressed  by 
selected  patients  with  chronic  cardiac 
disability  about  their  capability  to  im- 
plement an  ongoing,  prescribed  regimen 
of  drug  therapy  during  the  posthopitali- 
zation  phase  of  their  illness. 

The  sample  consisted  of  13  patients, 
four  men  and  nine  women,  discharged 
from  three  general  hospitals  following 
an  episode  of  acute  cardiac  insufficien- 
cy. 

The  data  were  collected  in  two  tape- 
recorded,  unstructured  interviews  con- 
ducted with  each  subject  at  two  and 
four  week  intervals  following  discharge 
from  the  hospital.  Personal  and  medical 
data  were  obtained  from  the  subjects' 
hospital  charts. 

Almost  all  patients  expressed  limited 
and  vague  understanding  of  fundamen- 
tal aspects  of  their  heart  condition  and 
its  implications  for  continued  self-care. 
All  patients  lacked  information  about 
the  name,  therapeutic  or  nontherapeutic 
effects  of  at  least  two-thirds  of  their 
prescribed  medications. 

In  a  total  of  75  drug  errors  related  by 
1 1  patients,  omission  of  medication 
was  the  most  frequent  type  of  error 
made.  This  involved  many  drugs  that 
played  a  vital  part  in  the  patients'  treat- 
ment. 

Patients  perceived  a  notable  dearth 
of  communication  among  themselves, 
their  physicians,  the  hospital  nursing 
staff,  and  community  agencies  regarding 
their  understanding  of  their  own  illness, 
the  instituted  therapy  and  the  prepara- 
tion for  self-care  at  home.  On  infre- 
quent occasions  when  patients  sought 
information  from  the  nursing  staff  they 
felt  dissatisfied  with  the  answers  receiv- 
ed. 

The  subjects  repeatedly  gave  ex- 
pression to  a  variety  of  concerns  arising 

SEPTEMBER  1971 


out  of  their  illness  and  its  prescribed 
therapeutic  plan  of  care. 

The  patients  perceived  the  hospital 
staff  nurses  with  whom  they  had  contact 
as  health  workers  carrying  out  technical 
activities  arising  from  the  demands  of 
physical  care  and  in  compliance  with 
physicians'  orders.  They  did  not  view 
the  nurses  as  independent  practitioners, 
health  teachers,  and  counselors. 

Given,  |anice.  A  study  of  anticipatory 
socialization  in  prospective  nursing 
students.  Toronto,  Ontario,  1970. 
Thesis  (M.A),  U.  of  Toronto. 

Do  the  prospective  student  nurse's 
attitudes  and  preconceptions  about 
nursing  influence  her  success  or  failure 
in  her  desired  career.'  Can  such  pre- 
conceptions be  as  important  in  assessing 
her  success  in  nursing  as  aptitude  and 
personality  testing?  This  study  examines 
the  preconceptions  about  nursing  and 
nurses  formed  by  prospective  nursing 
students  and  the  sources  used  to  collect 
information  about  this  career. 

A  group  of  125  high  school  girls 
who  anticipated  entry  into  schools  of 
nursing  in  Ontario  in  September,  1970. 
responded  to  a  questionnaire  designed 
to  explore  commitment  to  nursing,  the 
types  of  extrapersonal  influences  acting 
upon  the  aspirants,  the  sources  and 
kinds  of  information  used  in  learning 
about  nursing  roles,  and  the  preconcep- 
tions of  these  future  nurses  about  nurs- 
ing and  nurses. 

Particular  emphasis  was  placed  upon 
an  investigation  of  the  effect  of  age  at 
the  time  of  occupational  decision-mak- 
ing on  these  anticipatory  activities.  The 
decision  to  study  nursing  is  often  made 
at  an  early  age  and  may  be  fantasy- 
based,  according  to  reported  occupa- 
tional research.  It  was  felt  that  the 
applicant's  age  at  the  time  of  her  deci- 
sion to  become  a  nurse  might  produce 
differing  preconceptions  about  nursing, 
e.g.,  aspirants  who  chose  a  nursing 
career  before  age  1 3  might  have  a  less 
realistic  picture  of  contemporary  nurs- 
ing than  those  deciding  to  become  a 
nurse  after  age  1 6. 

A  five  percent  sample  ( 1 85)  of  3,700 
nursing  aspirants  who  had  applied  to 
study  in  Ontario  schools  of  nursing  by 
March  1 ,  1 970,  produced  a  final  sample 
of  125,  or  67 .5  percent. 

It  was  found  that  prospective  nursing 


students  do  engage  in  many  anticipatory 
activities  and  that  an  important  link  in 
them  is  friendship  with  a  student  attend- 
ing a  nursing  school.  Most  nursing 
aspirants  have  a  preconceived  picture 
of  nursing  based  on  the  traditional  role 
of  the  nurse  at  the  patient's  bedside. 
They  seem  unaware  of  the  organiza- 
tional and  technical  aspects  of  modern 
nursing  and  of  the  division  of  labor  of 
the  health  team. 

The  importance  of  mothers  in  the 
career  activities  of  future  nurses  became 
evident.  Most  aspirants  reported  sup- 
port from  a  mother  who  was  a  nurse  or 
who  had  always  wanted  to  pursue  this 
career.  It  was  also  found  that  when 
paking  a  career  decision,  age  does 
mfluence  pre -career  thinking.  Those 
who  had  made  nursing  their  career 
choice  by  age  13  were  more  committed 
to  nursing  and  expressed  more  positive 
feelings  about  their  career  choice  than 
those  of  16  or  older.  In  addition,  the 
younger  age  group  had  been  more 
influenced  by  adult  role  models  and 
had  a  more  traditional  picture  of  nurs- 
ing activities  than  the  older  group. 
Those  choosing  nursing  after  age  16 
seemed  more  aware  of  the  diversity  of 
the  nurse's  role  and  of  the  varied  oppor- 
tunities to  pursue  nursing  in  roles  other 
than  bedside  nursing. 

Finally,  many  new  values  were  re- 
vealed concerning  the  commitment  to 
work  of  these  young  women.  Most  ex- 
pected to  combine  work  and  marriage 
and  expressed  loyalty  and  commitment 
to  nursing  as  a  career  and  did  not  view 
nursing  as  a  job  to  do  until  marriage. 

This  study  points  out  that  the  period 
between  a  future  nurse's  decision  to 
become  a  nurse  and  her  actual  enroll- 
ment in  a  nursing  school  may  be  a  cru- 
cial and  important  time  for  her  success- 
ful socialization  into  nursing.  The  pre- 
conceptions formed  during  this  period 
will  influence  the  aspirant's  abilit>  to 
find  the  satisfactions  in  nursing  that  she 
seeks,  and  although  she  may  possess  the 
aptitude  and  personality  for  nursing 
success,  she  may  still  find  disappoint- 
ment and  drop  out.  Although  many 
recommendations  are  made  in  the  con- 
clusion of  this  study,  the  dominant  one 
is  that  an  examination  of  the  informa- 
tion on  modern  nursing  be  made  in 
order  that  pictures  of  contemporary 
nursing  may  be  available  for  prospective 
nurses.  § 

THE  CANADIAN  NURSE     57 


Basic  Chemistry,  a  programmed  pres- 
entation, 2ed.,  by  Stewart  M.  Brooks. 
1 1 8  pages.  Saint  Louis,  C.V.  Mosby 
Company,  1971. 

The  author's  programmed  presentation 
of  Basic  Chemistry  is  intended  to  intro- 
duce the  subject  to  students  who  will 
not  study  chemistry  at  a  complex  level. 

The  format  is  similar  to  other  pro- 
grammed texts.  As  the  problem  of  the 
student  who  has  the  wrong  answer  and 
doesn't  know  why  he  is  wrong  is  not 
solved  by  a  text  of  this  type,  the  student 
must  turn  to  other  resource  reading 
for  more  detailed  explanation  of  the 
problem  area.  In  this  book  the  suggested 
references  are  all  works  by  Mr.  Brooks. 

Basic  Chemistry  is  divided  into  1 1 
brief  and  compacted  sections,  from  an 
introduction  concerned  with  the  basics 
of  matter  and  energy  to  nuclear  and 
organic  chemistry  and  biochemistry. 

The  text  could  be  used  as  an  adjunct 
to  a  basic  course  in  nursing;  as  an  addi- 
tional help  for  selected  students  in  diffi- 
culty; as  a  self-study  guide  or  review 
guide  for  a  nurse  wishing  to  update  her 
knowledge  of  chemistry.  The  success 
of  the  text  will  be  directly  related  to 
the  user's  ability  to  comprehend  mate- 
rial pared  to  the  bone. 

The  One-Parent  Family  in  Canada  by 

Doris  E.  Guyatt.  141  pages.  Ottawa, 
The  Vanier  Institute  of  the  Family, 
1971. 

There  is  growing  public  interest  in 
the  problems  of  the  one-parent  family 
since  so  many  of  them  require  public 
assistance  of  many  kinds.  This  explor- 
atory study  provides  background  know- 
ledge of  one-parent  families  in  Canada. 

Mrs.  Guyatt  examines  the  socio- 
economic characteristics  of  one-parent 
families  in  Canada,  the  Canadian  litera- 
ture and  research  available  on  the 
subject,  and  the  organizations  and 
services  available  to  help  single  parents. 

She  notes  that  in  1966  there  were 
over  370,000  single-parent  families 
in  Canada  (8.2  percent  of  all  families) 
and  the  one-parent  families  had  577,207 
children  under  25  years  of  age.  A  wo- 
man was  the  parent  in  80  percent  of  the 
single-parent  families. 

Response  to  a  questionnaire  sent  to 
a  sampling  of  single  parents  listed  lone- 
liness as  the  most  difficult  problem 
facing  them,  but  more  income  was  their 

58     THE   CANADIAN  NURSE 


greatest  need,  followed  by  their  need 
to  be  included  in  community  life. 

The  style  of  writing  in  the  study  is 
readable  and  the  numerous  tables  are 
clear.  This  report  can  assist  student  and 
graduate  nurses  to  understand  better  the 
life  situation  of  adults  and  children  who 
are  members  of  a  one-parent  family. 

Heritage:  History  of  the  Nursing  Pro- 
fession in  the  Province  of  Quebec 

by  Edouard  Desjardins  with  Eileen 
C.  Flanagan  and  Suzanne  Giroux. 
Adaptation  from  French  by  Hugh 
Shaw.  Montreal,  Association  of 
Nurses  of  the  Province  of  Quebec, 
1971. 

Reviewed  by  Sister  Mary  Felicitas, 
director,  School  of  Nursing,  St. 
Mary's  Hospital  Montreal,  past 
president  of  the  Canadian  Nurses' 
Association,  and  an  active  member 
of  the  Association  of  Nurses  of  the 
Province  of  Quebec. 

The  English  edition  contains  96  pages 
of  appendixes  (Appendix  A  to  K)  and 
a  bibliography  of  three  pages  as  well 
as  an  index.  The  French  edition  con- 
tains 82  pages  of  appendixes  and  an 
index.  The  book  proper,  of  156  pages, 
is  divided  into  24  chapters.. Although 
the  title  announces  it  as  a  history  of 
nursing  in  the  province  of  Quebec,  it 
begins  with  a  general  history  of  nursing 
from  prehistoric  times. 

Part  1,  The  Origins,  contains  10 
chapters,  only  4  of  which  are  directly 
concerned  with  nursing  in  the  province 
of  Quebec.  Part  II  devotes  one  chapter 
to  the  International  Council  of  Nurses 
and  one  to  the  Canadian  Nurses'  Asso- 
ciation, leaving  the  other  four  for  nurs- 
ing in  Quebec.  Part  111  includes  some 
history  of  Quebec  nursing  in  two  of 
its  five  chapters.  These  deal  especially 
with  the  graduate  schools  and  profes- 
sional education.  The  other  three  chap- 
ters of  this  section  include  the  Nightin- 
gale School,  professional  training,  and 
the  Weir  report.  In  Part  IV  the  chapter 
dealing  with  military  nursing  is  general 
in  content  but  gives  some  references  to 
Quebec  province.  The  other  two  chap- 
ters on  "Nursing  Assistants"  and  "Ad- 
ministration in  a  New  Era"  are  more 
specific. 

The  numerous  appendixes  contain  a 
chronological  synopsis  of  the  Associa- 
tion of  Nurses  of  the  Province  of  Que- 
bec, biographical  notes  of  its  presidents, 


secretary-registrars,  and  leaders  of  the 
profession  in  the  province,  as  well  as 
other  pertinent,  though  brief,  informa- 
tion concerning  this  nursing  associa- 
tion. The  final  appendix  is  a  complete 
copy  of  the  Nurses  Act  of  the  Province 
of  Quebec. 

This  is  a  book  in  which  each  chapter 
is  a  complete  entity.  One  can  open  it  at 
random  without  feeling  a  need  to  look 
backward  or  forward  to  effect  continui- 
ty. However,  in  reading  it  from  cover 
to  cover  this  becomes  a  handicap,  as 
one  frequently  loses  oneself  at  the  be- 
ginning of  a  new  chapter  in  the  need  to 
return  to  a  different  era  or  to  another 
part  of  the  world. 

With  the  number  of  books  already 
published  on  the  history  of  nursing, 
one  questions  the  need  for  the  inclusion 
of  so  much  extraneous  material  in  a 
book  purporting  to  be  a  history  of  the 
nursing  profession  in  the  province  of 
Quebec.  It  is  impossible  to  do  justice 
to  so  many  varied  topics  in  such  a 
condensed  form. 

Most  of  the  vital  information  con- 
cerning the  specific  topic  is  contained  in 
the  appendix.  One  could  desire  that  the 
authors  had  enlarged  on  this  consider- 
ably more,  as  it  outlines  the  develop- 
ment of  nursing  in  Quebec.  This  excel- 
lent material  consists  of  abbreviated 
chronological  data  and  biographical 
sketches.  If  expanded,  it  would  have 
made  fascinating  reading  as  a  true 
history  of  the  profession  in  this  prov- 
ince. In  doing  so,  much  of  the  other 
material  not  directly  related  to  it  could 
have  been  omitted,  as  it  is  so  readily 
available  elsewhere. 

The  inclusion  of  the  "Nurses  Act" 
consumes  considerable  space.  One 
wonders  whether  such  a  document  will 
capture  the  interest  of  readers.  Finally, 
an  auditor's  statement  seems  out  of 
place  in  a  book  such  as  this. 

One  recognizes  the  amount  of  time 
spent  in  researching  the  contents.  Some- 
how it  seems  as  though  an  opportunity 
has  been  missed  to  present  a  thorough 
and  consecutive  history  of  a  topic  so 
relevant  and  interesting  to  many  nurses. 
However,  this  book  could  rouse  curios- 
ity concerning  other  historical  nursing 
events  and  entice  someone  to  further 
reading  of  these  elsewhere.  Perhaps 
someone  would  use  the  chronological 
data  as  an  outline  for  another  book  on 
this  topic. 

{Continued  on  page  60) 

SEPTEMBER  1971 


A  ward-winning 
combination 


With  Dermassage,  all  you  add  is  your  soft 
touch  to  win  the  praises  of  your  patients. 

Dermassage  forms  an  invisible, 
greaseless  film  to  cushion  patients 
against  linens,  helping  to  prevent 
sheet  bums  and  irritation.  It  protects 
with  an  antibacterial  and  antifvingal 
action.  Refreshes  and  deodorizes 
without  leaving  a  scent.  And  it's 
hypo-allergenic. 

Dermassage  leaves  layers 
of  welcome  comfort  on 
tender,  sheet-scratched       ^  _ 
skin.  And  there's  another       , 
bonus  for  you:  While 
you're  soothing  patients 
with  Dermassage,  you're 
also  softening  and  \ 

smoothing  your  hands.    \,     ■ 

V 

Try  Dermassage.      ^ 
Let  your  fingers 
do  the  talking. 


JK. 


/ 


,  I..akesi<l6  Laboratories  (Canada)  Ltd. 
*>4  Colgate  Avenue.  Toronto  8,  Onlari< 


*Tra(!e  mark 


\ 


1/ 


(Continued from  page  58) 

Adjustment  Psychology:  A  Human  Value 
Approach  by  Ronal  G.  Poland  and 
Nancy  D.  Sanford.  233  pages.  St. 
Louis.  C.V.  MosbyCo.,  1971. 

The  authors  wrote  this  book  about  hu- 
man behavior  for  the  undergraduate 
who  may  or  may  not  have  taken  an 
introductory  psychology  course.  How- 
ever, a  student  who  already  has  a  uni- 
versity psychology  course  would  not 
likely  find  much  that  is  new  in  this 
book. 

For  the  beginning  nursing  student, 
this  book  would  provide  a  simplified 
means  of  looking  at  herself  and  her 
relationships  with  others.  Beginning 
with  a  section  on  infancy,  childhood 
and  adolescence,  and  adulthood,  the 
book  proceeds  to  look  at  basic  social, 
sexual,  and  self  relationships;  the  fami- 
ly, school,  formal  organization,  and 
concludes  with  a  section  on  defense 
mechanisms  and  anxiety. 

The  writing  style  is  unusual  for  this 
type  of  book.  Each  chapter  begins  with 
a  series  of  fictional  anecdotes  that  read 
like  excerpts  from  a  novel.  They  cer- 
tainly capture  the  reader's  attention  and 
colorfully  introduce  the  lesson  that  is 
to  follow.  Also  different  are  statements 
in  each  chapter  that  are  either  true  or 
false,  where  the  reader  is  told  to  turn 
to  a  certain  page  if  he  chooses  the 
"true,"  and  to  another  page  if  he  chooses 
"false."  This  novelty,  however,  quickly 
wears  off  as  you  have  to  go  five  pages 
forward  to  read  a  few  lines,  then  go  back 
to  where  you  left  off.  It  also  wastes 
many  pages,  for  if  the  book  were  written 
in  the  usual  way,  it  would  be  only  about 
half  as  long. 

This  book,  with  its  direct  language 
and  easily  understood  explanations  of 
biological  and  psychological  develop- 
ment and  behavioral  conflicts,  should 
make  a  welcome  supplement  to  a  begin- 
ning psychology  course. 


Introduction  to  Physical  Science  for 
Students  of  Nursing  by  J.S.  Peel. 
91  pages.  Christchurch,  N.Z.,  N.  M. 
Peryer  Limited,  1971. 

Written  by  a  pharmacist  and  teacher 
of  nurses,  whose  previous  publication 
Materia  Meclica  and  Pharinucology 
for  Nurses  is  used  extensively  in  New 
Zealand  schools  of  nursing,  this  book 
is  designed  for  use  in  conjunction  with 
teaching  of  students  in  that  country. 

Rn      THF    rANAniAN    MIIDCF 


Its  subject  matter,  as  the  title  indi- 
cates, ranges  from  the  chemistry  of  life 
itself  to  radioactivity  and  electrolytes. 
The  style  is  simple,  the  drawings  and 
charts  are  clear. 

Throughout  are  applications  to  nurs- 
ing and  medicine.  For  example,  in  deal- 
ing with  force  and  gravity,  the  author 
explains  and  illustrates  how  three  forces 
acting  in  different  directions  are  the 
basis  of  Russell's  traction  for  an  injured 
knee.  In  dealing  with  fluids,  a  simple 
diagram  of  an  artificial  kidney  demon- 
strates the  principle  of  dialysis. 

Perhaps  the  book  loses  something  by 
over-simplification.  However,  for  Ca- 
nadian students  of  nursing  it  would 
provide  a  brief  and  clearly  stated  over- 
view of  a  large  subject  and  a  ready  and 
compressed  source  of  information. 


Advanced  Concepts  in  Clinical  Nursing, 

edited  by  Kay  Corman  Kintzel.  427 
pages.  Toronto,  J.B.  Lippincott 
Company,  1971. 

Reviewed  by  E.  Bride,  Inservice 
Education  Supervisor,  Prince  George 
Regional  Hospital,  Prince  George, 
British  Columbia. 

The  editor  has  designed  this  book  to 
assist  professional  nurses  and  students 
in  those  complex  and  challenging  as- 
pects that  require  in-depth  knowledge 
for  patient  care  today.  Twenty  contribu- 
tors have  dealt  with  many  health  areas 
of  concern  to  nursing,  including:  main- 
tenance of  health;  family  planning;  the 
life  cycle;  intensive  care  nursing;  med- 
ical genetics;  nursing  intervention  for 
diabetic  patients,  to  name  a  few. 

The  authors  present  newer  concepts 
and  assessments  of  the  patients'  needs 
in  formulating  appropriate  nursing 
goals,  nursing  care  plans  and  nursing 
histories.  They  emphasize  nursing 
intervention  appropriate  for  the  patient 
and  his  particular  situation,  and  preven- 
tion, continuity  of  care,  and  the  nurse's 
role  in  relation  to  the  patient's  family 
and  the  community;  also  the  nurse's 
responsibility  for  patient  teaching  and 
rehabilitation  is  stressed. 

This  textbook  will  be  of  great  value 
for  meeting  the  needs  and  demands  of 
the  patient  of  today,  and  should  help 
nurses  to  recognize  the  variety  of  factors 
relevant  to  each  patient's  care.  Repeti- 
tion in  some  chapters  is  noticeable  but 
not  boring;  the  first  chapter  is  lengthy 
but  nevertheless  interesting  and  chal- 
lenging. 

Illustrations  are  clear  and  detailed. 
A  summary  appears  at  the  end  of  each 
chapter,  and  a  reference  and  biblio- 
graphical list  at  the  end  of  each  section. 

The  book  provides  a  realistic  presen- 
tation of  nursing  care,  with  emphasis 
on  the  approach  to  patients'  needs  by  a 
number  of  individuals  who  have  special 


competence  in  their  fields.  The  editor 
has  achieved  her  objective  outlined  in 
the  preface. 

This  text  is  interesting,  easy  to  read, 
and  will  be  of  great  value  to  all  concern- 
ed with  the  return  of  the  ill  one  to  health 
and  well-being. 


The  Care  of  the  Aged:  A  Guide  for 
the    Licensed    Practical    Nurse    by 

Maureen    J.    O'Brien.    144    pages. 
St.  Louis,  C.V.  Mosby,  1971. 
Reviewed   by   Phyllis  B.   Philippe, 
Teacher,  School  for  Nursing  Assis- 
tants, Ottawa  Civic  Hospital,  Ottawa. 

The  book  was  written  to  help  practical 
nurses  consider  the  dynamics  of  aging. 
It  is  the  author's  intent  to  focus  on  the 
potential  of  the  aged  and  the  important 
role  of  the  practical  nurse  in  planning 
personalized  care. 

Rather  than  handling  in  detail  dis- 
eases associated  with  aging,  Miss  O' 
Brien  is  concerned  with  basic  care  relat- 
ed to  normal  aging  and  pertinent  infor- 
mation associated  with  common  chronic 
illnesses. 

The  book  begins  by  focusing  on  the 
psychosocial  problems  of  the  aged.  A 
brief  history  of  practical  nursing  is  given 
and  the  author  relates  how  care  for 
the  aged  has  been  borne  largely  by  this 
group  of  nurses.  She  also  states  that 
the  problems  of  care  of  the  elderly  can- 
not be  resolved  without  professional 
assistance.  Later  in  the  book  the  person- 
al development  of  the  nursing  practi- 
tioner as  well  as  laws  and  ethics  related 
to  her  work  are  discussed. 

Miss  O'Brien  deals  with  the  positive 
outcomes  of  the  aging  process.  She 
discusses  physical  and  emotional  health 
problems  and  gives  advice  on  appro- 
priate nursing  action.  The  use  of  a 
"patient  situation"  to  highlight  her 
suggestions  is  most  effective.  The  au- 
thor's warmth  an^  compassion  for  the 
elderly,  and  her  emphasis  on  respecting 
their  dignity  are  attitudes  that  prevail 
throughout  the  book.  The  "personal 
element"  is  frequently  brought  into 
focus. 

Nursing  with  "a  plan"  that  centers 
on  the  potential  of  the  patient  is  discus- 
sed. Miss  O'Brien  states  that  one  method 
that  may  be  used  to  personalize  care  is 
the  concept  of  assessment  which  she 
explains  in  three  phases.  She  discusses 
problem  solving,  the  team  conference, 
and  recording. 

Death  is  referred  to  as  a  "personal 
venture."  The  reader  is  given  insight 
that  will  aid  her  in  supporting  her  pa- 
tient on  this  topic.  Miss  O'Brien  stresses 
the  importance  of  effective  communica- 
tion and  collaboration  in  several  areas 
—  with  the  patient,  the  patient's  family, 
the  co-workers,  and  the  community. 
The  results  of  studies  made  to  determine 
SEPTEMBER  1971 


the  reactions  of  practical  nurses  to  the 
care  of  the  aged,  and  of  the  problems 
and  advantages  of  aging  further  adds  to 
the  value  of  the  book.  In  her  summary, 
Miss  O'Brien  challenges  practical 
nurses  to  continue  to  assist  the  aged, 
and  emphasizes  their  importance  on  the 
health  team. 

In  writing  this  book.  Miss  O'Brien 
has  given  the  reader  a  deeper  under- 
standing and  appreciation  for  the  elder- 
ly. Although  written  primarily  for  pract- 
ical nurses,  this  book  should  be  a  valu- 
able reference  for  anyone  involved  with 
elderly  persons. 


Back  to  Nursing:  A  Guide  to  Current 
Practice  for  Active  and  Inactive 
Nurses  by  Ruth  Perin  Stryker.  371 
pages.  Toronto,  W.B.  Saunders 
Company,  1971. 

Reviewed  by  Jean  Passmore,  Assis- 
tant Registrar,  Saskatchewan  Reg- 
istered Nurses'  Association,  Regina, 
Saskatchewan. 

It  became  evident  to  the  author  that 
the  first  edition  of  Back  to  Nursing 
was  being  used  by  practicing  nurses 
who  wished  to  increase  their  knowledge 
and  skills.  The  present  edition  has  been 
written  so  that  it  may  be  used  with 
equal  benefit  by  inactive  nurses  re- 
entering the  profession  and  active 
nurses  who  have  not  been  exposed  to 
newer  trends  in  nursing. 

The  aim  of  this  book  is  "to  gather 
facts  which  will  help  the  nurse  refresh 
herself." 

In  the  first  unit  of  this  book,  empha- 
sis is  placed  on  learning  changing  roles 
and  new  goals,  upon  current  knowledge 
in  the  clinical  areas.  While  new  proce- 
dures are  of  prime  importance  to  the 
older  procedure -centered  nurse,  they 
are  only  a  part  of  the  knowledge  neces- 
sary for  the  practicing  nurse  of  today. 
The  mature  experienced  nurse  and  the 
young  well-educated  nurse  have  much 
to  gain  from  each  other  for  the  mutual 
benefit  of  their  patients. 

The  second  unit  of  this  book  offers  a 
description  of  the  changes  in  society, 
knowledge  and  health  delivery  which 
affect  nursing.  The  role  of  the  nurse  of 
today  is  described,  as  are  the  changes 
that  have  occurred  in  nursing  education. 

The  third  unit  comprises  the  largest 
part  of  the  book.  It  includes  innova- 
tions and  changes  that  have  influenced 
the  care  of  the  patient.  Changing  meth- 
ods of  patient  assignment,  charting, 
patient  teaching,  and  communications 
are  considered.  A  section  of  this  unit 
explains  the  responsibility  of  the  nurse 
in  regard  to  laboratory  and  x-ray  tests, 
as  well  as  to  dietary  services  that  may 
cause  concern  to  a  nurse  returning  for 
reorientation  to  nursing.  New  supplies 

SEPTEMBER  1971 


and  equipment  are  well  described  and 
illustrated.  This  should  give  the  nurse 
more  self  confidence  when  she  is  called 
upon  to  use  them. 

The  chapter  on  administration  of 
drugs  is  clearly  written  and  well  illus- 
trated. There  are  sample  problems 
throughout  the  chapter.  Equally  well 
done  is  the  chapter  concerning  fluid 
and  electrolyte  balance.  It  is  simply 
stated,  and  understandable  at  a  basic 
level.  The  responsibility  of  the  nurse  in 
these  areas  is  stressed.  The  remainder 
of  this  unit  is  focused  on  the  basic  needs 
of  the  patient  in  relation  to  his  care. 

Unit  four  gives  a  resume  of  the  new 
approaches  to  nursing  in  the  fields  of 
maternal  and  child  health,  psychiatry, 
and  geriatric  nursing. 

In  her  conclusion  the  author  imparts 
practical  advice  on  licensure  and  legal 
aspects  of  nursing.  Ongoing  education, 
whether  in  an  institution  or  in  the  home, 
is  urged  for  professional  self  develop- 
ment. 

Although  this  book  is  written  for 
American  nurses,  it  can  be  used  with 
discrimination  by  Canadian  nurses 
who  wish  to  upgrade  their  present 
knowledge. 

Sociology:  Nurses  and  Their  Patients 
in  a  Modern  Society,  8ed.,  by  Jessie 
Bernard  and  Lida  F.  Thompson. 
313  pages.  St.  Louis.  C.V.  Mosby 
Co.,  1970. 

Reviewed  by  Shirley  Campbell,  Lec- 
turer, School  of  Nursing,  Memorial 
University  of  Newfoundland,  St. 
John's,  Newfoundland. 

This  book  should  be  valuable  to  begin- 
ning nursing  students  as  it  stresses  the 
fact  that  nursing  is  not  done  at  the 
bedside  alone,  but  involves  many  facets. 

It  begins  by  introducing  the  read- 
er to  the  many  different  cultures  she 
will  encounter  in  her  profession,  as 
well  as  the  social  structure  of  the  com- 
munity. The  nurse  is  made  aware  of  her 
role  in  ministering  to  people  with  vary- 
ing backgrounds. 

The  authors  give  an  interesting  over- 
view of  population  and  its  significance 
to  health  caic.  Difteieiiccs  in  age,  sex, 
race,  and  between  people  in  rural  and 
urban  centers  are  stressed  as  factors  to 
consider  in  community  health.  The 
nurse's  contribution  in  this  area  is  of 
utmost  importance. 

The  role  of  groups  in  society  is 
discussed. 

The  first  part  of  the  book  looks  at 
people.  The  next  section  begins  the 
study  of  institutions,  or  rules  and  pat- 
terns of  behavior.  These  institutions 
are  designed  to  meet  a  goal  or  func- 
tion. The  authors  refer  to  the  inflexibil- 
ity of  many  of  these  institutions  and  the 
current  trend  of  revolt  against  formal- 
ism. 


Next  Month 
in 

The 

Canadian 
Nurse 


•  Banting  and  Best 

—  the  Men  who 
Tamed  Diabetes 

•  Adolescent  Sexual  Response 

•  Dying  with  Dignity 

•  Florence  Emory 

—  a  Pioneer  in  Nursing 


^ 

^^^ 


Photo  Credits  for 
September  1971 

Miller  Photo  Services  Ltd., 

Toronto,  Cover  I 
The  Hospital  for  Sick 

Children,  Toronto,  p. 9 
PRFotoservice,  Dublin, 

Ireland,  p.  10 
ETV  Centre,  Memorial 

University,  St.  John's, 

Nfld.,  p.l7 
University  of  Saskatchewan, 

Saskatoon,  Sask.,  p. 22 
Gibson  Photos,  Ltd., 

Saskatoon,  Sask.,  p. 24 
University  of  Utah,  Medical 

Center,  Salt  Lake  City, 

Utah,  p.35 
Dept.  of  Indian  Affairs  and 

Northern  Development, 

Ottawa,  pp.  41,  42 
Dept.  of  National  Health  and 

Welfare,  Information 

Services,  Ottawa,  p. 43 
Foothills  Hospital,  Calgary, 

pp.50,  51 


TME  CANADIAN  NURSE     61 


Your  Hospital  is 
More  Efficient  with 

TIME  TAPE 
SYSTEMS 


Color  Coding  Systems  developed 
with  BACTERIOSTATIC  TIME  Tape 
are  assisting  hospitals  throughout 
the  .world  to  cut  costs,  increase  effi- 
ciency, simplify  communications  and 
provide  patient  and  nurse  with  a 
safer  environment.  By  providing  in- 
stant visual  identification,  these  sys- 
tems are  used  in  every  department 
of  the  hospital  for  a  variety  of  func- 
tions ranging  from  patient-doctor 
identification  to  procedural  control. 
The  BACTERIOSTATIC  qualities  of 
TIME  Tape  make  it  the  ONLY  safe 
tape  system  for  use  within  the  hos- 
pital where  the  chance  of  contact 
infection  is  so  great. 
Your  hospital  should  be  employing 
TIME  Color  Coding  Systems  now. 
These  systems  are  the  least  expen- 
sive, most  versatile  way  to  save  valu- 
able staff  time.  Think  of  the  many 
ways  they  can  be  employed  In  your 
hospital  to  speed  up  procedures 
while  cutting  down  on  errors.  Write 
today  for  free  samples  and  litera- 
ture, we  will  also  send  the  name  of 
your  nearest  TIME  Products  distrib- 
utor. 

NOTE:  NEW  ADDRESS.  We  have  re- 
cently moved  into  new  facilities;  en- 
larged and  automated  to  serve  you 
better. 


PROFESSIONAL  TAPE  COMPANY,  INC. 

DEPARTMENT    16 
144   TOWER    Dfl      BURR    RIDGE    (HINSDALE),    ILL     60521 


Although  the  institution  of  the  family 
has  changed,  it  is  destined  to  change 
even  more  in  the  future.  Variations 
within  different  cultural  patterns  are 
cited,  and  comparisons  arc  made  be- 
tween the  nineteeth  century  family 
and  today's  family  in  urban  areas.  The 
role  of  woman  shows  perhaps  the  most 
dramatic  change  of  all.  The  book  also 
shows  an  awareness  of  educational  and 
governmental  institutions  in  today's 
society  and  how  they  influence  the 
children  in  today's  world. 

Finally,  the  problems  and  failures 
in  development  and  socialization  are 
learned.  Behavior  disorders  as  related 
to  "normals"  are  discussed.  The  au- 
thors show  these  as  problems  that  must 
be  dealt  with  accordingly. 

The  book  gives  a  good  introduction 
to  social  problems,  ll  covers  a  broad 
area  of  topics,  but  does  not  deal  with 
any  one  of  them  in  depth.  This  should 
be  a  good  overview  for  beginning  nurs- 
ing students. 

Learning  to  Nurse:  The  First  Five 
Years  of  the  Ryerson  Nursing  Pro- 
gram by  Moyra  Allen  and  Mary 
Reidy.  270  pages.  Toronto,  The  Reg- 
istered Nurses'  Association  of  Onta- 
rio, 1971. 

The  study  of  the  Ryerson  nursing  pro- 
gram, the  first  diploma  program  in 
nursing  in  Canada  to  be  established 
within  the  general  education  setting, 
was  first  presented  at  the  1971  annual 
meeting  of  the  Registered  Nurses'  Asso- 
ciation of  Ontario.  An  account  of  the 
initial  presentation  appeared  on  page 
10  of  the  June,  197  1,  issue  of  The  Cci- 
nculian  Nurse. 

The  study.  Learning  to  Nurse,  is 
evaluative  research  using  a  systems 
approach  and  includes  some  compara- 
tive data  related  to  three  other  diploma 
schools  of  nursing,  as  well  as  to  the 
Ryerson  nursing  program.  An  interest- 
ing component  of  the  study  is  following 
the  process  of  learning  to  nurse  as  the 
student  moves  into  and  through  the 
system.  The  performance  of  the  gradu- 
ate and  her  "fit"  into  the  work  world  is 
highlighted  also,  with  some  interesting 
differences  between  general  opinions 
expressed  by  registered  nurses  in  super- 
visory positions  and  the  realities  of  their 
experience  with  Ryerson  graduates. 
Interest  has  been  generated,  loo,  in  the 
variation  in  the  teaching  of  nursing 
among  the  four  school  faculties. 

The  report  is  of  interest  to  all  persons 
concerned  with  the  education  of  profes- 


62     THE  CANADIAN  NURSE 


sionals  for  the  health  field,  in  particular 
for  those  involved  in:  education  of 
nurses  at  the  community  college  level; 
utilization  of  diploma  nurses  in  health 
services;  provision  of  clinical  facilities 
for  students  in  community  college  pro- 
grams, such  as  nursing  service  person- 
nel, hospital  administrators  and  physi- 
cians; preparation  of  teachers  of  nursing 
in  university  schools;  and  educational 
research  and  research  programs. 

An  appendix  to  Learning  to  Nurse 
which  reproduces  the  forms,  question- 
naires and  scales  used  in  the  study, 
together  with  information  on  the  devel- 
opment and  validation  of  the  instru- 
ments, is  published  separately. 

The  report  is  available  from  the 
Registered  Nurses'  Association  of  On- 
tario, 33  Price  Street,  Toronto  5,  Onta- 
rio, at  a  cost  of  $5.00  per  copy,  plus 
75t  to  cover  handling  and  postage 
(Canadian  funds).  The  appendix  is 
included  upon  request  at  an  additional 
cost  of  $2.00 


A  Manual  of  Dermatology  by  Donald  M . 
Pillsbury.  290  pages.  Toronto,  W.B. 
Saunders  Company,  1 97  1 . 
Reviewed  by  M.  Whitney,  Assistant 
Director.  School  of  Nursing,  St. 
Paul's  Hospital,  Vancouver  5,  B.C. 

This  reference  text  attempts  to  provide 
clear,  concise,  up-to-date  material  on 
dermatological  conditions  for  physi- 
cians, nursing  personnel  (both  public 
health  and  hospital  oriented),  and  para- 
medical personnel.  It  will  be  helpful 
for  initial  assessment,  for  determining 
the  need  for  further  study,  and  for 
deciding  on  a  course  of  treatment.  The 
author  states  that  the  methods  of  treat- 
ment outlined  have  been  greatly  simpli- 
fied, primarily  due  to  the  Drug  Efficien- 
cy Study  of  the  National  Research 
Council  —  National  Academy  of  Sci- 
ence, conducted  on  behalf  of  the  Food 
and  Drug  Administration  of  the  United 
States. 

Following  the  excellent  introductory 
chapter  on  the  anatomy  and  physiology 
of  the  skin  and  skin  diseases,  the  author 
devotes  a  brief  chapter  to  basic  patho- 
physiology, then  clearly  outlines  major 
dermatological  conditions.  With  the 
aid  of  263  color  figures,  even  a  person 
not  familiar  with  dermatology  is  able 
to  see  what  the  conditions  look  like. 

In  our  era  of  increased  specializa- 
tion, as  the  author  states,  "there  seems 
to  be  a  need  for  specialty  texts  that  are 
as  simple  as  possible." 

This  text  allows  people  of  differing 
backgrounds  to  become  familiar  with 
a  subject  that  is  of  occasional  concern 
in  some  fields,  and  of  major  concern  in 
others.  It  should  be  considered  as  a 
reference  book  for  medical  or  nursing 
students.  ■§ 

SEPTEMBER  1971 


Pillsbury: 

A  MANUAL  OF 

DERMATOLOGY 

Simple  and  easy  to  use, 
this  new  medical  atlas  will 
broaden  your  knowledge 
of  skin  diseases.  Organized 
by  regions  of  the  body, 
causal  agents,  and  specific 
diseases,  the  book  contains 
263  full-color  illustrations 
complemented  by  lucid  cli- 
nical descriptions.  Each 
chapter  covers  one  or  more 
diseases,  defines  the  new- 
est methods  of  diagnosis, 
and  indicates  appropriate 
treatment,  while  cautioning 
against  obsolete  or  harm- 
ful remedies. 

By  Donald  M.  Pillsbury,  M.D., 
Uniyenity  of  Pennsylvania  School 
of  Medicine.  299  pages.  290  figs 
$15.45.  February   1971. 


WIDE-RANGING  TOPICS  FOR 
THE  WELL-INFORMED  NURSE 


Creighton: 

LAW  EVERY  NURSE 

SHOULD  KNOW 

New  2nd  Edition 

Here  are  the  legal  facts  every  nurse 
must  know  —  her  responsibilities  as  well 
as  her  rights.  Written  by  a  nurse  and 
nursing  educator  who  is  also  a  lawyer, 
this  book  sets  forth  the  legal  facts  that 
no  practising  nurse  can  afford  to  ignore. 
The  first  edition  became  the  standard  re- 
ference that  helped  thousands  of  nurses 
avoid  legal  entanglements.  This  new, 
substantially  larger  edition  includes  cov- 
erage of  such  topics  as  "good  Samaritan" 
laws,  child  abuse,  telephone  orders,  ster- 
ilization, and  organ  transplantation.  Dr. 
Creighton  explains  these  topics  and  many 
more,  but  she  has  not  neglected  the  fun- 
damentals of  law.  Here  you  will  find 
information  on  contracts,  licensure,  mal- 
practice, torts,  crimes,  and  wills.  The  au- 
thor has  included  a  full  chapter  on  Cana- 
dian law;  she  also  cites  the  latest  court 
decisions  and  explains  their  significance. 

By  Helen  Creighton.  R.N..  B.S.N. ,  A.B.,  A.M., 
M.S.N. ,  J.D,  Professor  of  Nursing,  University  of 
Wisconsin-Milwaukee.  246  pages    S7.75.  June  1970. 


Cuyton : 

BASIC  HUMAN 
PHYSIOLOGY 

Normal  Function  and  Mechanisms  of 
Disease 


Carefully  condensed  from  Guyton's  re- 
spected Textbook  of  Medical  Physiology, 

this  new  book  is  designed  both  for  stu- 
dents and  for  practising  nurses.  In  clear, 
easy-to-understand  language,  the  author 
demonstrates  exactly  how  the  human 
body  functions.  He  emphasizes  cellular 
physiology  and  biochemistry,-  topics  in- 
clude material  on  bone,  teeth,  and  oral 
physiology  as  well  as  on  i.ie  physiology 
of  sex.  All  the  facts  contained  in  the 
standard  text  are  there;  however,  lengthy 
qualifying  statements,  comparative  theo- 
ries, and  extensive  references  are  omit- 
ted. Remarkably  clear  explanations  are 
broken  down  into  short  sections  and 
coupled  with  diagrams.  Lucid,  author- 
itative, and  pertinent,  this  new  and 
compact  book  insures  easy  reference  and 
quick  comprehension  for  students. 

By  Arthur  C.  Guyton,  M.D.,  University  of  Mississippi 
Medical  School.  72/  pages.  431  illustrations.  $13.15. 
March  1971 


Hymovich  and  Reed: 

NURSING  AND  THE  CHILDBEARING  FAMILY 

A  Guide  for  Study 

Emphasizing  the  nurse's  role  in  assisting  the  childbearing  family,  this  new  collec- 
tion of  18  study  guides  evaluates  and  reinforces  the  student's  learning  process. 
The  authors  accentuate  the  progression  of  a  typical  family  through  a  normal  child- 
bearing  experience,  including  pregnancy,  labor,  delivery,  and  postpartum  care  of 
the  mother  and  the  neonate.  Also  covered  are  family  planning,  high-risk  preg- 
nancies, and  the  nursing  care  of  the  newborn  infant.  An  Instructor's  manual  is 
available. 

By  Debro  P.  Hymovich,  R.N.,  B.S.,  M.A.,  and  Suellen  B.  Reed,  R.N.,  B.5N..  M.S.N.,  both  of  the  University 
of   Texas    Clinical    Nursing    School   at    San    Antonio.  334  pages.  $5.15.  May  1971. 


W.  B.  SAUNDERS  COMPANY  CANADA  LTD.    1 835  Yonge  Street,  Toronto  7,  Ontario 


Please    send    on    approval    and    bill    me: 
D   Creighton:  LAW  EVERY  NURSE  SHOULD 

KNOW  -  $7.75  (2nd  Edition) 
D   Guyton:   BASIC  HUMAN  PHYSIOLOGY 

$13.15 

Name 


n   Hymovich  &  Reed:  NURSING  AND  THE 

CHILDBEARING  FAMILY      $5.15 
D   Pillsbury:  A  MANUAL  OF  DERMATOLOGY  - 

$15.45 


Address 


CN-9-71 

SEPTEMBER  1971 


City 


Zone 


Province 
THE  CANADIAN  NURSE     63 


Just  as  you 

can't  call  any 

waterfall 

Niagara 


you  can't  call 

any  Conform 

Bandage  a 

KLING* 

BANDAGE. 

There's  really  only  one  KLING 
Conform  Bandage  —  by  Johnson 
&  Johnson. 

KLING  is  the  unique,  soft,  all  ab- 
sorbent cotton  bandage  that  is 
more  than  equal  to  the  bandaging 
requirements  of  areas  that  are  hard 
to  bandage  and  hard  to  keep  ban- 
daged. 

Because  KLING  is  self-adhering,  it 
clings  to  itself,  conforming  to  un- 
usual contours  and  resisting  flex- 
induced  slippage.  KLING  Conform 
Bandage's  elasticity  permits  it  to 
stretch  over  40%,  so  not  to  con- 
strict swelling  areas. 
KLING  Conform  Bandages  —  5 
yds.  when  stretched  are  supplied 
in  the  following  widths:  1"  —  2" 
—  3"  —  4"  —  6"  —  in  bulk  or  pre- 
wrap. 

KLING 

CONFORM  BANDAGE 
THE  BANDAGE  THAT 
REALLY  CONFORMS 

MONTREAL  &  TORONTO  —  CANADA 

'Trademark  of  Johnson  &  Johnson 

Limited  or  affiliated  companies 

64     THE  CANADIAN  NURSE 


AV  aids 


I  Films 
n  On  Becoming  a  Nurse-Psychother- 
apist (16mm  sound,  black  and  white, 
42  min.)  a  study  of  a  young  nursing 
student's  first  psychiatric  case,  is  dis- 
tributed by  the  University  of  California 
Extension  Media  Center,  Berkeley, 
California  94720,  on  a  purchase,  pre- 
view-before-purchase,  or  rental  basis. 

The  film  follows  the  case  from  initial 
interview  to  termination,  showing  the 
development  of  two  parallel  relation- 
ships: nurse  with  patient  and  nurse 
with  instructor.  It  emphasizes  the  ther- 
apeutic tools  developed  by  the  nurse, 
showing  her  failures  of  intervention  as 
well  as  her  successes,  her  difficulties  in 
accepting  her  role,  and  her  growing 
awareness  of  herself  as  a  psychother- 
apist. 

D  Films  about  Indian  people  of  Canada 
are  available  through  local  municipal 
libraries  and  from  the  National  Film 
Board  Library  in  different  cities.  Some 
of  the  films  are  available  in  both  French 
and  English. 

For  a  list  of  the  films  available  from 
the  Roche  Medical  Library  write  to 
Roche  Film  Library,  Hoffman-LaRo- 
che  Limited,  1 956  Bourdon  Street,  Ville 
Saint-Laurent,  Montreal  378,  P.O. 
These  films  are  available  free  of  charge 
to  professional  societies  and  cover  a 
wide  range  of  topics  from  Valium  Phar- 
macology to  Controlled  Hypotension  in 
Surgery  and  Suicide  Prevention 

Films  available  for  purchase  or  on  loan 
from  the  National  Film  Board  of  Can- 
ada Distribution  Branch,  P.O.  Box 
6100,  Montreal  101,  Quebec,  are: 

Citizens'  Medicine  (16mm  sound,  black 
&  white,  30  minutes  18  seconds)  is  the 
story  of  a  community  health  clinic  set 
up  by  the  St.  Jacques  Citizens'  Commit- 
tee in  Montreal.  The  film  shows  discus- 
sion, planning,  and  the  clinic  in  opera- 
tion. It  presents  the  clinic's  problems 
and  advantages  as  seen  by  both  vol- 
unteer medical  workers  and  local  resi- 
dents. 

Members  of  the  Citizens'  Committee 
participated  in  the  making  of  the  film, 
from  original  planning  through  filming, 
selecting,  and  editing. 

Mother-to-he  (16mm.  sound,  black  & 
white,  75  minutes  18  seconds)  ques- 
tions whether  or  not  a  woman  can  ful- 
fill her  own  potential  while  giving  her- 
self to  the  role  of  wife  and  mother. 
The  film  delves  into  the  emotions  of 


joy,  anticipation,  and  anxiety  experi- 
enced by  a  young  pregnant  mother 
several  weeks  before  the  birth  of  her 
second  child.  There  is  some  footage 
from  Czechoslavakia  showing  natural 
childbith  in  a  hospital  delivery  room 
and  a  state  nursery  for  children  of 
working  mothers. 


Videotape  production 

Hospitals  interested  in  producing  video- 
tapes for  use  in  staff  inservice  training 
and  patient  education  programs  can 
rent  the  facilities  of  the  Acklands  Vi- 
deotape Productions'  studio  in  Don 
Mills,  Ontario. 

The  studio  is  equipped  with  camera, 
microphone,  and  lighting.  A  sync  pulse 
generator  can  tie  up  to  10  cameras,  to 
the  studio  electronics,  and  the  videotape 
recorders.  There  are  zoom  lenses  tor 
all  cameras. 

During  production,  A.V.P.  provides 
editing,  effects,  titles,  electronic  magni- 
fication, and  animation.  The  studio 
is  available  on  a  per-day  rental  basis. 

For  more  information  write  to  Ack- 
lands Videotape  Productions,  230 
Lesmill  Road,  Don  Mills,  Ontario. 


Body  Talk 

This  game  is  an  exercise  in  learning  the 
language  of  the  body,  in  other  words, 
how  to  communicate  nonverbally.  The 
playing  cards  require  players  to  express 
feelings  by  using  only  certain  parts  of 
the  body  that  are  illustrated  on  the  face 
of  the  card.  Body  Talk  allows  players 
to  share  their  feelings  of  joy,  sorrow, 
hope,  frustration,  love,  hate,  loneliness; 
their  indifference,  admiration,  fear, 
anger,  shyness,  and  contentment  non- 
verbally. The  game  was  created  by  three 
psychologists  for  Communication/Re- 
search/Machines Inc.,  Carmel  Valley 
Road,  Del  Mar,  California  92014. 


Audio  tape 

Venereal  Disease  is  a  one-hour  audio 
tape,  catalogue  no.  484L,  available  on 
either  tape  cassette  or  tape  reel  from 
CBC  Learning  Systems,  Box  500,  Ter- 
minal A,  Toronto  1 1 6,  Ontario. 

The  tape  on  venereal  disease  focuses 
on  the  situation  in  a  number  of  centers 
across  the  country.  It  also  poses  many 
questions:  Is  the  medical  profession 
doing  all  it  can  to  solve  the  problem'.' 
Is  there  enough  information  being 
given  to  the  public  about  symptoms 
and  treatment'.'  What  about  the  conten- 
tion that  there  is  a  VD  epidemic'.'        i. 

SEPTEMBER  1971 


4 


accession  list 


Publications  on  this  list  have  been  received 
recently  in  the  CNA  library  and  are  listed 
in  language  of  source. 

Material  on  this  list,  e.xccpl  Reference 
items,  may  be  borrowed  by  CNA  members, 
schools  of  nursing  and  other  institutions. 
Reference  items  (theses,  archive  books  and 
directories,  almanacs,  and  similar  basic 
books)  do  not  go  out  on  loan. 

Requests  for  loans  should  be  made  on  the 
"Request  Form  for  Accession  List"  and 
should  be  addressed  to:  The  Library.  Cana- 
dian Nurses"  Association.  50  The  Driveway. 
Ottawa.  Onl.  k:P  IE:. 

No  more  than  three  titles  should  be  re- 
quested at  any  one  time. 


BOOKS  AND  DOCUMENTS 

1.  AV  instruction  ntcdiii  tinil  methods  by 
James  W.  Brown  et  al.  3d  ed.  New  York. 
McGraw-Hill.  1969.  62lp. 

2.  Acute  myocanlitil  infarction  tmil  coro- 
nary care  units,  edited  by  Charles  K.  Fried- 
berg,  with  29  contributors.  New  York.  Grune 
&  Stratton.  1969.  288p. 

3.  American  Nurses'  Association  clinical 


conferences.  1969.  Minneapolis!  Atlanta. 
New  York.  Appleton-Century-Crofts.  1970. 
342p. 

4.  The  audio-tutorial  approach  to  learn- 
ing through  independent  study  and  integrat- 
ed experience.  2d  ed.  by  S.N.  Postlethwait 
et  al.  Minneapolis.  Minn..  Burgess.  1969. 
149p. 

5.  Basic  human  physiology:  normal  func- 
tion and  mechanisms  of  disease  by  Arthur 
Clifton  Guyton.  Philadelphia.  W  B  Saun- 
ders. 1971.  72  I  p. 

6.  Bottin.  Toronto.  Association  canadien- 
ne  de  sante  publique,  1970.  104p.  R 

7.  Cardiovascular  nursing:  rationale  for 
therapy  and  nursing  approach  by  Jeanette 
Kernicki  et  al.  New  York.  Putnam.  1970. 
431  p. 

8.  The  clinical  nurse  specialist  compiled 
by  Edith  P.  Lewis.  New  York.  American 
Journal  of  Nursing  Co..  1970.  350p.  (Con- 
temporary nursing  series) 

9.  Commioxicaling  nursing  research: 
methodological  issues.  Edited  by  Marjorie 
V.  Batey.  Boulder.  Colorado.  Western  Inter- 
state Commission  for  Higher  Education. 
1970.  166p. 

10.  Communications  sampler  by  David 
Abbey.  Ottawa.  Communications  Studies 
Group  of  the  Northern  Electric  Laboratories, 
1970.  1  lip.  (the  issue  no.6) 

1  1.  Community  college  nursing  education 
by  Virginia  O.  Allen.  Toronto.  Wiley.  1971. 
I73p.  (Wiley  nursing  paperback  series) 


12.  Compte-rendu  de  V Atelier  siir  la  Dis- 
tribution et  Usage  des  Appareils  eleclroni- 
ques  en  Education,  now  23-25.  1970.  St 
Donat.  P.Q.  Ottawa.  Conseil  canadienne 
pour  la  recherche  en  education.  1971.  47p. 

13.  The  creative  writer  by  Earle  Birney. 
Toronto.  Canadian  Broadcasting  Corp.. 
1966.  85p. 

14.  Directory.  Toronto.  Canadian  Public 
Health  Association.  1970.  104p.  R 

15.  Educational  measurement.  2d  ed. 
Edited  by  Robert  L.  Thorndike.  Washing- 
ton. American  Council  on  Education  1971. 
768p. 

16.  Executive  compensation  in  Canada 
May  1971.  Ottawa.  H.V.  Chapman.  1971. 
1vol.  R 

17.  Family-centered  nursing  in  communi- 
ty psychiatry:  treatment  in  the  home  by 
Claire  Mintzer  Fagin.  Philadelphia.  F.A.  Da- 
vis. 1970.  190p. 

18.  Guide  de  discussion  et  resume  dii 
rapport  de  la  Commission  rayale  d'enqiii-ie 
stir  la  sitimlion  de  la  femine  au  Canada. 
Montreal.  Federation  des  Femmes  du  Que- 
bec. 1971.  46p. 

19.  Handbook  of  child  nursing  care  by 
Margaret  Ann  Jaeger  Wallace.  Toronto. 
Wiley.  1971.  138p.  (Wiley  nursing  paper- 
back, series) 

20.  Health  and  the  family:  a  medical- 
sociological  anidysis.  Edited  by  Charles  O. 
Crawford.  Toronto.  Collier-Macmillan. 
1971.  277p. 


Is  learning 
French 
as  difficult 
they  say 
or  is  it  just  a 
lot  of  talli? 


Learning  French  isn't  difficult,  but  it  does  take  a  lot  of  talk. 
That's  why  Intext  developed  "Franpais". 

It's  the  easiest,  most  effective  and  least  costly  way  to  learn  French.  Talking.  Listening. 
And  correcting  your  own  pronunciation.  "Franpais"  starts  you  right  off  in  French. 
You  are  exposed  to  French  (and  only  French)  from  the  very  beginning.  Intext  calls  it 
the  "exclusive  exposure"  method.  So  go  ahead  and  talk.  Only,  do  it  all  in  French. 
The  complete  course  consists  of: 

■  Solid  state.  4  track  cassette  recorder/player  by  Sanyo...  specially  modified  for  use 
as  a  teaching  machine. 

■  Microphone  and  earphones. 

•  Instructional  guide. 

•  Five,  fully  illustrated  text  books  which  follow  lessons  on  cassette  tapes. 
■Ten  professionally  prerecorded  cassette  tapes. 

Listen  to  pre  recorded  professional  voices  while  following  along  in  illustrated  texts. 
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SEPTEMBFR    iq71 


THE  CANADIAN  NURSE     65 


accession  list 


21.  The  health  manpower  dilemma. 
Papers  presented  at  the  fourth  annual  meet- 
ing. Council  of  Hospital  and  Related  Insti- 
tutional Nursing  Services.  Oct.  22-23.  1970, 
Chicago,  III.  New  York,  National  League 
for  Nursing,  1971.  64p. 

22.  Meaninf>  and  the  stnntiire  of  lan- 
guage by  Wallace  L.  Chafe.  Chicago,  Uni- 
veristy  of  Chicago  Press,  1970.  360p. 

23.  Modern  systems  research  for  the 
behavior  scientist:  a  sourcebook.  Edited  by 
Walter  Buckley.  Chicago,  Aldine,  1968. 
525p. 

24.  !\liirse.s'  guide  to  cardiac  surgery  and 
nursing  care  by  Elizabeth  Ford  Pitorak  et 
al.New  York,  McGraw-Hill,  1969.  156?. 

25.  Nurse's  guide  to  diagnostic  procedures 
by  Ruth  M.  French.  2d  ed.  New  York,  Mc- 
Graw-Hill, 1967.  3  13p. 

26.  Nursing  care  of  the  patient  with 
medical-surgical  disorders.  Edited  by  Harriet 
Coston  Moidel  et  al.  New  York,  McGraw- 
Hill,  1971.  1252p. 

27.  Nursing  in  the  north  1867-1967  by 
Rie  Munoz.  Juneau,  Alaska  Nurses"  Associa- 
tion, 1967.  50p. 

28.  Prevention  de  la  mortal ite  et  de  la 
morbidite  perinatales.  Rapport.  Geneve, 
Organisation  Mondiale  de  la  Sante.  Comite 
d'experts.  1970.  69p.  (OMS.  Serie  de  rap- 
ports techniques  no.  457) 

29.  Proceedings  of  the  midwinter  meet- 
ing, Chicago,  Jan.  18-24.  1970  and  the  89th 
annual  conference,  Detroit,  Jim.  28-Jul.  4, 
1970.  Chicago,  American  Library  Associa- 
tion. 1970.  I60p. 

30.  Proceedings  of  3rd  InlenuilioiKil  Con- 
gress of  NuKses,  Buffalo,  Sep.  18-21,  1901. 
Edited  by  Isabel  Hampton  Robb,  and  Maud 
Banfield  Dock.  London,  International  Coun- 
cil of  Nurses,  1902.  487p.  R 

31.  Proceedings  of  Workshop  on  Curri- 
cidum  and  Instruction  in  Medical-surgical 
and  Psychiatric  Nursing  -  Baccalaureate 
Programs,  June  12  to  June  20,  1969.  Edited 
by  Virginia  C.  Conley.  Washington,  Catholic 
University  of  America,  1970.  173p. 

32.  Proceedings  of  Workshop  on  the 
Distribution  and  Use  of  Electronic  Aids 
in  Education,  Nov.  23-25.  1970,  St.  Donat. 
P.Q.  Ottawa,  Canadian  Council  for  Re- 
search in  Education,  1971.  47p. 

33.  RAP;  research  awareness  publica- 
tion for  family  medicine  in  Canada.  Don 
Mills,  College  of  Family  Physicians  of 
Canada.  1971.  12p. 

34.  Report  of  Nursing  Research  Confer- 
ence. 5lh.  Mar.  3-5.  1969,  New  Orleans. 
Louisiana.  New  York,  American  Nurses' 
Association,  1970.  376p. 

35.  Strategies  for  teaching  nursing  by 
Rheba  de  Tornyay.  Toronto,  Wiley,  1971. 
145p.  (Wiley  nursing  paperback  series) 

36.  A  task  analysis  method  for  improved 
66     THE  CANADIAN   NURSE 


manpower  utilization  in  the  health  sciences. 
California,  Health  Manpower  Council  of 
California,  1970.  64p. 

37.  Toward  a  theory  for  nursing;  general 
concepts  of  human  behavior  by  Imogene  M. 
King.  Toronto,  Wiley,  1971.  132p.  (Wiley 
nursing  paperback  series) 

38.  Training  nonprofessional  community 
project  leaders  by  Janice  R.  Neleigh  et  al. 
New  York.  Behavior  Publications,  1971. 
59p.  (Community  Mental  Health  Journal 
Monograph  series  no.  6) 

■39.  Trends  in  health  and  hospital  care 
clHijt  book  1969  by  Canadian  Hospital 
Association  and  Dominion  Bureau  of  Sta- 
tistics. Toronto,  1969-70.  2vols. 

40.  Tiiberculose  par  D.-F.  Raguet.  Paris, 
Maloine,  1961.  252p. 

41.  The  vital  signs  by  Mary  Elizabeth 
Mclnnes.  St.  Louis,  Mosby,  1970.  95p. 

42.  Whde  rivers  flow:  stories  of  early 
Alberta  by  Kate  Brighty  Colley.  Drawings  by 
Margaret  Manuel  Elwell.  Saskatoon,  Sask.. 
Prairie  Books,  1970.  148p.  R 

PAMPHLETS 

43.  Annual   report,    1970-1971.  Toronto, 
Canadian   Public  Health  Association,    1971 
27p. 

44.  Assignment  report  nursing  education 
in  Philippines,  July  to  September  1970  by 
Helen  K.  Mussallem.  Manila.  World  Health 
Organization.  Regional  Office  for  the  West- 
ern Pacific.  1970.  20p. 

45.  California  invitational;  malpractice 
prevention  w<>rkshops:  a  progress  report. 
Reprinted  from  Cidifornia  Medicine.  San 
Francisco.  Published  by  California  Medical 
Association  and  California  Hospital  Associa- 
tion. 1970.  9p. 

46.  Duties  and  responsibilities  of  directors 
in  Canada  by  J.M.  Wainberg.  Don  Mills. 
Ont..CCH  Canada.  1967.  32p. 

47.  Florence  Nightingale  rebel  with  a 
cause  by  the  editors  of  RN  magazine.  Ora- 
dell,  N.J.,  Medical  Economics  Book  Divi- 
sion, 1970.  23p. 

48.  Guide  for  the  development  of  libra- 
ries for  schools  of  nursing.  3d  ed.  New  York, 
National  League  for  Nursing,  1971.  23p. 

49.  Guidelines  tor  (Uidiovisual  nuiterials  & 
services  for  public  libraries.  Chicago,  Amer- 
ican Library  Association.  Public  Library 
Association.  Audiovisual  Committee,  1970. 
33p. 

50.  Handbook  on  tracheostomy  care  by 
Gary  C.  Hudson.  Don  M  ills,  Portex  Division, 
Smiths  Industries,  1971.  32p. 

51.  Nursing    manpower    development;    a 


RED  CROSS 

IS  ALWAYS  THERE 
WITH  YOUR  HELP 


+ 


review  of  methods  prepared  for  the  Scien- 
tific Group  on  the  Development  of  Studies 
in  Health  Manpower  held  in  Geneva,  2-10 
Nov.,  1970.  Geneva,  World  Health  Organ- 
ization. Nursing  Unit.  1970.  35p. 

52.  The  pursuit  of  excellence  in  nursing. 
Report  of  Conference  of  the  Western  Council 
on  Higher  Education  for  Nursing,  5th, 
Denver,  Col.,  Mar.  22-23,  1962.  Boulder, 
Col.,  Western  Interstate  Commission  for 
Higher  Education,  1962.  40p. 

53.  Recent  trends  in  illicit  drug  use 
among  adolescents  by  R.G.  Smart  and 
Diane  Fejer.  Ottawa.  Information  Canada. 
1971.  13p.  (Canada's  Mental  Health  supple- 
ment no.  68) 

54.  Requirements  for  approval  of  schools 
of  nursing  in  Saskatchewan  for  admission  of 
graduate  nurses  to  the  Saskatchewan  Reg- 
istered Nurses'  Association.  Rev.  Regina. 
Saskatchewan  Registered  Nurses'  Associa- 
tion. 1970,  18p. 

55.  Public  Affairs  Committee.  Pamphlets. 
New  York. 

no.  453  The  responsible  consumer  by  Sidney 
Margolius.  1970.  20p. 

56.  no.  460  Sihizophrenia:  current  ap- 
proaches to  a  baffling  problem  by  Arthur 
Henley.  1971.  24p. 

57.  Selected  list  of  reliable  nutrition 
books.  Rev.  Toronto.  Toronto  Nutrition 
Committee.  1970.  13p. 

58.  Toward  excellence  in  nursing  educa- 
tion; a  guide  for  diploma  school  improve- 
ment. 2d  ed.  New  York.  National  League 
for  Nursing.  Dept.  of  Diploma  Programs. 
1971.  44p. 

GOVERNMENT  DOCUMENTS  J 

Canada  H 

59.  Bureau  Federal  de  la  Statistique.  Di- 
vision de  I'education.  Enquete  sur  la  popula- 
tion etudiante  du  post  secondaire  1968-1969. 
Ottawa.  Imprimeur  de  la  Reine.  1970.  145p. 

60. — .Bureau  of  Statistics.  Canadian 
community  colleges  and  related  institutions, 
1969-70.  Ottawa.  Queen's  Printer,  1970.  60p. 

61. — .Hospital  morbidity,  1968.  Ottawa, 
Queen's  Printer.  1971.  143p. 

62.  Dept.  of  Labour.  Women's  Bureau. 
Women's  bureau  '70.  Ottawa,  Information 
Canada.  1971.  26p. 

63.  Dept.  of  Manpower  and  Immigra- 
tion. Manpower  Information  and  Analysis 
Branch.  Program  Development  Service. 
University  and  community  college  guide 
70-71.  Ottawa.   Information  Canada.    1971. 

64. — .Reserach  Branch.  Program  Develop- 
ment Service.  Canada's  highly  qualified 
manpower  resources  by  A.  G.  Atkinson  et 
al.  Ottawa,  Queen's  Printer.  1970.  304p. 

65. — . — . — .The  migration  of  Canadian- 
born  between  Canada  and  United  States  of 
America  1955  to  1968  by  T.J.  Samuel.  Ot- 
tawa. Queen's  Printer.  1969.  46p. 

66.  Dept.  of  National  Health  and  Welfare. 
Food  and  Drug  Directorate.  Health  protec- 
tion and  food  laws.  Ottawa.  1970.  48p. 

67. — .Medical  Services  Branch.  History, 
objectives  and  philo.sophy  of  the  Medical 
Services    Branch.    Compiled    by    Alice    K. 

SEPTEMBER  1971 


Smith  for  Special   Project,  Nursing  Travel 
Seminars  1971.  Ottawa,  1971.  19p. 

68. — .Research  and  Statistics  Directorate. 
Health  care  price  movements  in  Canada, 
April  1961  to  April  1970.  Ottawa,  1970. 
16p. 

69.  Parliament.  House  of  Commons. 
Standing  Committee  on  Labour,  Manpwwer 
and  Immigration.  Minutes  and  proceedings 
of  evidence,  no.  18,  Wednesday,  Sep.  30, 
1970,  respecting  White  Paper  on  Unemploy- 
ment Insurance.  Ottawa.  Queen's  Printer, 
1970.  106p. 

70.  Royal  Commission  on  the  Status  of 
Women  in  Canada.  Manpower  utilization  in 
Canadian  chartered  banks  by  Marianne 
Bossen.  Ottawa,  Information  Canada,  1971. 
60p.  (Its  Study  no.  4) 

71. — .Patterns  of  manpower  utilization 
in  Canadian  department  stores  by  Marianne 
Bossen.  Ottawa.  Information  Canada,  1971. 
105p.  (Its  Study  no.  3) 

72. — .5('.ir  role  imagery  in  children:  social 
origins  of  mind  by  Robert  Lambert.  Ottawa, 
Information  Canada.  1971.  156p.  (Its  Study 
no.  6) 

73. — .Taxation  of  the  incomes  of  married 
women  by  Douglas  G.  Hartle.  Ottawa,  In- 
formation Canada,  1971.  88p.  (Its  Study 
no.  5) 

74. — .Women  at  home:  the  cost  to  the 
Canadian  economy  of  the  withdrawal  from 
the  labour  force  of  a  major  proportion  of  the 
female  populiitioii  by  Frangois  D.  Lacasse. 
Ottawa.    Information    Canada.     1970.    28p. 


(Its  Study  no.  2) 
Scotland 

75.  North-Eastern  Regional  Hospital 
Board.  Nursing  workload  per  patient  as  a 
ba.'iis  for  staffing.  Report  by  the  Work  Study 
Dept...on  the  development  of  a  formula 
for  calculating  the  day  duty  nurse  staffing 
requirements  of  a  hospital  ward.  Edinburgh, 
Scottish  Home  and  Health  Dept.,  1969. 
73p.  (Scottish  Health  Service  studies  no.  9) 

United  States 

76.  Dept.  of  Health,  Education  and  Wel- 
fare. Nursing  home  research  study;  quantita- 
tive measurement  of  nursing  services  by  Elea- 
nor M.  McKnight.  Washington.  U.S.  Govt. 
Print.  Off..  1970.  54p. 

77.  Educational  Resources  Information 
Centre.  ERIC  products  1 967- J  968  compiled 
by  The  ERIC  Clearinghouse  for  Library 
and  Information  Sciences,  University  of 
Minnesota.  Washington.  U.S.  Govt.  Print. 
Off.,  1969.  18p. 

78.  National  Institutes  of  Health.  Clinical 
Center.  Nursing  clinical  conference:  nursing 
care  of  patients  with  cerebral  seizures.  Be- 
thesda,  Md.,  1971.  I6p. 

79. — .Division  of  Nursing.  Feet  first; 
for  older  people  and  people  who  have  dia- 
betes. Washington,  U.S.  Govt.  Print.  Off., 
1970.  45p. 

80.  Public  Health  Service.  Health  Services 
and  Mental  Health  Administration.  Com- 
munity Health  Service.  Division  of  Health 
Resources.  Nursing  Home  Branch.  Long 
term  care  facility  administration  case  .study 


manual.  Edited  by  Lois  A.  Crooks.  Washing- 
ton, U.S.  Govt.  Print.  Off.,  1970-  I  vol. 

STUDIES  DEPOSTIED  IN  CNA  REPOSITORY 
COLLECTION 

8 1 .  Hospital  clinical  facilities  utilized  by 
Edmonton  nursing  programs:  a  descriptive 
study  by  Margaret  Loretta  Mrazek.  Edmon- 
ton, 1971.  181p.(Thesis(M.H.S.A.)-Alberta)R 

82.  Learning  to  nurse;  the  first  five  years 
of  the  Ryerson  nursing  program  by  Moyra 
Allen  and  Mary  Reidy.  Toronto,  Registered 
Nurses'  Association  of  Ontario,  197 1 .  270p.  R 

83.  Report  of  study  of  the  need  for  short 
term  courses  in  p.sychiatric  nursing  for 
registered  nurses  in  Canada  by  Elizabeth 
D.  McCue  and  Beverly  DuGas.  Ottawa.  Dept. 
of  National  Health  and  Welfare,  1970.  R 

84.  Report  of  National  Conference  on 
Research  in  Nursing  Practice,  Ottawa.  Feb. 
16,  17,  18,  1971.  Vancouver,  School  of  Nurs- 
ing, University  of  British  Columbia,  1971. 
187p. 

85.  Research  completed  or  in  progress 
as  reported  by  Canadian  university  schools  of 
nursing,  December  1970  prepared  for 
National  Conference  on  Research  in  Nurs- 
ing Practice,  Ottawa,  Feb.  16,  17,  18,  1971. 
Ivol.R 

86.  To  develop  a  case  study  which  will  be 
presented  through  the  medium  of  color 
slides,  to  illustrate  problems  of  communica- 
tion that  arc  encountered  by  a  patient  in  a 
hospital  by  Julie  Patenaude  and  Jeannine 
Girard.  Ottawa,  1962.  24p.R  ^ 


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SEPTEMBER   1971 


THE   CANADIAN   NURSE     67 


classified  advertisements 


ALBERTA 


BRITISH   COLUMBIA 


ONTARIO 


DIRECTOR  OF  NURSING  This  position  carries 
responsibility  lor  the  coordination  of  all  facets  of 
nursing  services  within  a  75-bed  Accredited  hospital. 
Preference  given  to  applicants  with  University 
preparation  in  Nursing  Administrator  or  successful 
supervisory  and  Nursing  Administration  experience. 
Apply  in  writing,  staling  experience,  qualifications, 
references  and  date  available  to:  Administrator, 
St.  Therese  Hospital,  St,  Paul,  Alberta. 


BRITISH  COLUMBIA 


Modern  700-bed  hospital  offers  positions  for:  HEAD 
NURSES:  for  Pediatric  Department,  for  our  combined 
Ophthalmology  and  Ear,  Nose  and  Throat  Depart- 
ment and  for  our  Operating  Room.  B.S  N  preferred. 
Experience  essential  REGISTERED  NURSES:  (or 
GENERAL  DUTY  in  specialty  areas —  O.R  ,  Emergen- 
cy, Recovery  Room,  Psychiatry.  BC  Registration 
required  RNABC  policies  in  effect.  Apply  Director 
of  Nursing,  Royal  Jubilee  Hospital.  1900  Fort  Street, 
Victoria,  British  Columbia 

WANTED:  GENERAL  DUTY  NURSES  for  modern  70- 
bed  hospital,  (48  acute  beds — 22  Extended  Care) 
located  on  the  Sunshine  Coast,  2  hrs,  from  Vancou- 
ver Salaries  and  Personnel  Policies  in  accordance 
with  RNABC  Agreement,  Accommodation  available 
(female  nurses)  in  residence.  Apply:  The  Director 
of  Nursing,  St  Mary's  Hospital,  PC,  Box  678,  Se- 
chelt,  British  Columbia, 


EXPERIENCED  NURSES  required  for  GENERAL 
DUTY,  OPFRATINR  ROOM.  OBSTETRICS  PFDIAT- 
RICS   and   INTENSIVE  CARE   in   a   409-bed   hospital 


ADVERTISING 
RATES 

FOR  ALL 
CLASSIFIED   ADVERTISING 

$15.00   for   6   lines   or   less 
$2.50  for  each  odditiorwl   line. 

Rotes   for   display 
odvertisements   on   request 

Closing  date  for  copy  and  cancellation  is 
6  weeks  prior  to  1st  day  of  publicotion 
month. 

The  Conodian  Nurses'  Association  does 
not  review  the  personnel  policies  of 
the  hospitals  and  agencies  advertising 
in  the  Journal.  For  authentic  infornnation, 
prospective  applicants  should  apply  to 
the  Registered  Nurses'  Association  of  the 
Province  in  which  they  are  interested 
in   working. 


Address   correspondence   tO: 

The 

Canadian 
Nurse 

50  THE  DRIVEWAY 
OnAWA,  ONTARIO 
K2P    1E2 


with  a  School  ol  Nursing,  Basic  salary  $590  -  $740, 
BC,  Reaistration  is  required.  Apply:  Director  of 
Nursing,  Royal  Columbian  Hospital.  New  Westminster. 
British  Columbia. 


OPERATING  ROOM  NURSES  for  modern  450-bed  hos- 
pital with  School  of  Nursing.  RNABC  policies  in  ef- 
fect. Credit  for  past  experience  and  postgraduate 
training.  British  Columbia  registration  is  required. 
For  particulars  write  to:  The  Associate  Director  of 
Nursing.  St.Joseph's  Hospital.  Victoria.  British  Co- 
lumbia. 

OPERATING  ROOM  NURSE  wanted  for  active  modern 
acute  hospital.  Three  certified  surgeons  on  attending 
staff  PG  in  OR.,  required.  Ivtust  be  eligible  for 
B.C.  Registration.  Salary  $615.00  per  month  starting- 
Nurses'  residence  available.  Apply  to:  Director  of 
Nursing,  Mills  Memorial  Hospital.  2711  Tetraull  St., 
Terrace,  British  Columbia, 


MANITOBA 


HEAD  NURSE  -  (MEDICAL/SURGICAL  WARD)  requir- 
ed for  40-bed  General  Hospital  in  Northern  Manitoba 
Good  personnel  policies  and  excellent  salary.  Apply 
giving  details  of  experience  and  qualifications  to 
The  Director  of  Nursing,  Fort  Churchill  General 
Hospital.  Fort  Churchill.  Manitoba, 

INTENSIVE  CARE  NURSE  required  for  active  88-bed 
hospital  —  to  help  set  up  a  programme  to  train  staff 
in  the  use  of  Portable  Equipment  and  to  work  actively 
with  this  type  of  patient.  Salary  will  be  commensurate 
with  qualifications  and  experience.  Position  available 
immediately.  Must  be  in  good  standing  with  MARN 
and  have  a  recognized  course  in  intensive  care. 
Apply  to  Director  ol  Nursing,  Swan  River  Valley 
Hospital,  Swan  River,  Manitoba. 


NOVA   SCOTIA 


REGISTERED  NURSES,  PSYCHIATRIC  NURSES  AND 
CERTIFIED  NURSING  ASSISTANTS.  General  Staff 
positions  available  in  this  modern  270-bed  Psychiatric 
Hospital  located  in  the  Annapolis  Valley.  Orientation 
and  In-Service  Program  provided.  Excellent  personnel 
policies.  Salary  commensurate  with  qualifications 
and  experience.  For  further  information  direct  en- 
quiries to:  The  Director  of  Nursing.  Kings  County 
Hospital.  Waterville,  Nova  Scotia. 


ONTARIO 


REGISTERED  NURSES  needed  for  81 -bed  General 
Hospital  in  bilingual  community  of  Northern  Ontario. 
French  language  an  asset,  but  not  compulsory.  R.N. 
salary-$557  to  $662.  monthly  with  allowance  for 
past  experience,  4  weeks  vacation  after  1  year  and 
18  sick  leave  days.  Unused  sick  leave  days  paid  at 
100%  every  year.  Master  rotation  in  effect.  Rooming 
accommodation  available  in  town.  Excellent  per- 
sonnel policies.  Apply  to;  Personnel  Director. 
Notre-Dame  Hospital.  P.O.  Box  850.  Hearst,  Ont. 


REGISTERED  NURSES  required  by  70-bed  General 
Hospital  situated  in  Northern  Ontario.  Salary  scale  — 
$560  00-$670,00,  allowance  for  experience.  Shift 
differential,  annual  increment,  40  hour  week,  OH, A. 
Pension  and  Group  Life  Insurance,  OH.S.C.  and 
OHSIP  plans  in  effect.  Good  personnel  policies 
For  particulars  apply:  Director  of  Nursing,  Lady 
Minto  Hospital  at  Cochrane.  Cochrane.  Ontario. 


UNIVERSITY  OF  TORONTO.  DIRECTOR.  SCHOOL  OF 
NURSING  Nominations  or  applications  for  this 
position  should  be  sent  with  curriculum  vitae  and 
references  to  Dr.  John  Hamilton.  Vice  President, 
Health  Sciences,  University  of  Toronto,  Toronto  181, 
Ontario,  Canada. 


REGISTERED  NURSES  for  34-bed  General  Hospital. 
Salary  $525.  per  month  to  $625  plus  experience  al- 
lowance. Residence  accommodation  available.  Ex- 
cellent personnel  policies.  Apply  to:  Superintendent. 
Englehart  &  District  Hospital  Inc..  Englehart.  Ontario. 


REGISTERED  NURSES  AND  REGISTERED  NURSIl^ 
ASSISTANTS.  Our  75-bed  modern,  progressive  Hos- 
pital   invites   you    to    make   application.   Salaries   for 


Registered  Nurses  start  at  $549.00.  with  yearly 
increments  and  experience  benefits.  The  basic 
salary  for  R.NA.  is  $382.00  with  yearly  increments. 
Room  is  available  in  our  modern  residence.  We  are 
located  in  the  Vacationland  of  the  North,  midway 
between  Winnipeg  and  Thunder  Bay.  Write  or  phone; 
The  Director  of  Nursing,  Dryden  District  General 
Hospital,  Dryden,  Ontario. 


REGISTERED  NURSES  AND  REGISTERED  NURSING 
ASSISTANTS  for  45-bed  hospital.  R.N.'s  salary  $560. 
to  $660.  with  experience  allowance  and  4  semi-annu- 
al increments.  Nurses'  residence  —  private  rooms 
with  bath  —  $30  per  month.  R.N.A.'s  salary  $380.  to 
■$460.  Apply  to:  The  Director  of  Nursing,  Geraldton 
District  Hospital,  Geraldton,  Ont. 

REGISTERED  NURSES  AND  REGISTERED  NURSIN6 

ASSISTANTS,  looking  for  an  opportunity  to  work  in 
a  patient  centereo  Nursing  service,  are  required  oy 
a  modern  well-equipped  hospital.  Situated  in  a  pro- 
gressive Community  in  South  Western  Ontario.  Ex- 
cellent employee  benefits  and  working  conditions. 
Write  for  further  information  to:  Director  of  Nursing; 
Leamington  District  Memorial  Hospital;  Leamington, 
Ontario. 


REGISTERED  NURSE  FOR  OPERATING  ROOM  also 
GENERAL  DUTY  NURSES  for  80-bed  hospital;  recog- 
nition for  experience;  good  personnel  policies;  one 
month  vacation;  basic  salary  $567.50,  July  1st. 
$570.00.  Apply.  Director  of  Nursing.  Huntsville 
District  Memorial  Hospital,  Box  1150.  Huntsville, 
Ontario. 

REGISTERED  NURSING  ASSISTANTS  lor  80-bed 
hospital;  starting  salary  $375.00  with  increments  lor 
past  experience;  three  weeks  vacation;  18  days 
sick  leave;  residence  accommodation  available. 
Apply:  Director  of  Nursing.  Huntsville  District 
Memorial    Hospital.    Box    1150.    Huntsville,    Ontario. 


REGISTERED  NURSES,  lor  GENERAL  DUTY  and 
I.C.U..    and    REGISTERED    NURSING    ASSISTANTS 

.ouuired  for  160-bed  accredited  hospital.  Starting 
salary  $525.00  and  $365.00  respectively  with 
regular  annual  increments  for  both.  Excellent 
personnel  policies.  Temporary  residence  accommo- 
dation available.  Apply  to:  Director  of  Nursing, 
Kirkland  and  District  Hospital,  Kirkland  Lake, 
Ontario. 


REGISTERED  NURSES  AND  REGISTERED  NURSING 
ASSISTANTS    required    for    GENERAL    DUTY    in    a 

313-bed  fully  accredited  hospital.  Good  salary 
commensurate  with  experience,  excellent  fringe 
benefits  and  gracious  living  in  the  Festival  City 
of  Canada.  Apply  in  writing  to  the:  Director  of 
Personnel.  Stratford  General  Hospital.  Stratford. 
Ontario. 

GENERAL  DUTY  REGISTERED  NURSES  with  at  least 
one  year's  experience  required  for  175-bed  accredit- 
ed hospital.  Recognition  given  for  experience  and 
postgraduate  education.  Orientation  and  In- 
Service  Educational  programmes  are  provided. 
Progressive  personnel  policies.  For  further  informa- 
tion write  to;  Personnel  Director,  Temiskaming 
General  Hospital,  Haileybury,  Ontario. 


GENERAL  DUTY  NUHSES  for  95-bed  hospital 
equipped  with  all  electric  beds  throughout.  Starting 
salary  $550,00  per  month.  Excellent  personnel  poli- 
cies, and  residence  accommodation.  Only  10  minutes 
from  downtown  Buffalo.  Apply;  Director  of  Nursing. 
Douglas  Memorial  Hospital.  Fort  Erie.  Ont. 


EXPERIENCED  GENERAL  STAFF  NURSES  FOR 
OPERATING  ROOM  AND  INTENSIVE  CARE  AREA  — 

for  modern,  accredited  242-bed  General  Hospital. 
Good  personnel  policies,  recognition  for  experience 
and  post-basic  preparation.  Apply;  Director  of 
Nursing,  Sudbury  Memorial  Hospital.  Regent  Street, 
S.,  Sudbury,  Ontario. 


TO  HBLP 


68     THE  CANADIAN  NURSE 


SEPTEMBER  1971 


October  1971 


^tlA     Vt-rtiOX    ii     X  vy< 


SCHOOL  OF  NURSING  LIBRARY 

OTTAWA,    ONT. 

KIN    6N5 
12-7L-12-70-CN-PD 


The 


Canadian 

Nurse 


Banting  and  Best: 

the  men  who  tamed  diabetes 

dying  with  dignity 


adolescent  sexual  behavior 


electrical  hazards  in  OR 


WHITE 
SISTER 


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NEW  1971 

NURSING  OF  PEOPLE  WITH 

CARDIOVASCULAR  PROBLEMS 

By  Sister  Catherine  Armirtgton,  D.C.,  R.N.,  B.S.N.E.,  and 
Helen  Creighton,  R.N.,  AM.,  M.S.N.,  J.D. 

This  new  book  provides  the  nurse  with  what  amounts 
to  a  post-graduate  course  in  the  care  of  patients  with 
cardiovascular  problems.  Prepared  with  the  needs  of 
both  patient  and  nurse  in  mind,  this  volume  has  been 
enriched  by  the  advice  and  suggestions  of  various 
cardiologists,  cardiac  surgeons,  and  nurse  educators. 
Approx.   350   pp.,   illustrated.  About  $9.95. 

NEW  1971 

NURSING  IN  THE  INTENSIVE 

RESPIRATORY  CARE  UNIT 
A  MANUAL  FOR  NURSES 

By  Hannelore  M.  Sweetwood,  R.N.,  Inservice  Director, 
Jersey  Shore  Medical  Center. 

Here  is  the  specific  information  needed  to  equip  the 
nurse  to  function  effectively  in  an  intensive  respiratory 
care  unit.  Much  of  the  material,  which  has  been  tested 
in  the  actual  teaching  of  nurses  in  this  new  specialty, 
is  available  in  no  other  manual.  The  equipment  and 
procedures  discussed  are  suitable  for  the  average 
community  hospital  and  can  be  adapted  to  the  smaller 
hospital  as  well. 

224  pages  23  illust.  $5.25. 


Carol   P.   Hanley 
Gips,  R.N.,  Ed.D. 


NEW  1971 

CARE  OF  THE  ADULT  PATIENT: 

Medical-Surgical  Nursing 

By   Dorothy  W.   Smith,   R.N.,   Ed.D.; 
Germain,  R.N.,  M.S.;  and  Claudia  D. 

Reorganized,  expanded  and  updated  in  line  with 
changes  in  nursing  practice,  the  great  strength  of  this 
superb  text  continues  to  lie  in  its  focus  on  nursing. 
Particular  consideration  is  given  to  the  individualized 
care  required  at  various  stages  in  adult  life  along 
the  health-illness  continuum.  Both  pathophysiologic 
and  psychosocial  factors  are  explored  and  applied 
to   nursing   problems. 

1197   Pages     410  Illustrations      3rd   Edition      $13.95 


NEW  1971 

ADVANCED  CONCEPTS  IN 

CLINICAL  NURSING 

By  Kay  Corman  Kintzel,  R.N.,  M.S.N.,  Editor.  With  20 
Contributors. 

The  first  book  of  its  kind!  Written  to  foster  expertise 
in  the  more  complex  and  little-explored  aspects  of 
clinical  nursing,  this  text  offers  intensive  studies  of 
sixteen  areas  requiring  a  greater  depth  of  knowledge. 
Emphasis  is  on  prevention,  continuity  of  care,  the 
relation  of  the  nurse  to  patients'  families  and  the 
community,  and  her  responsibilities  in  teaching  and 
rehabilitation. 
427  Pages  100  Illustrations  $13.50 


NEW  1971 
EMERGENCY-ROOM  CARE 

By  26  authors.  Edited  by  Charles  Eckert,  M.D. 

The  tremendous  increase  in  public  demand  for  em- 
ergency-room services  and  facilities  prompted  im- 
portant revisions  in  this  basic  reference  for  interns, 
residents,  general  surgeons,  and  nurses  in  dealing 
with  emergency-room  situations  from  severe  accident 
cases  to  psychiatric  crises. 

2nd  Edition  Approx.  450  pages,  illustrated. 
Paperback  about  $9.95,  clothbound  about  $14.75. 


SERVING  THE  HEALTH  PROFESSIONS  IN  CANADA  SINCE  1897 


PLEASE  SEND  ME  THE  FOLLOWING  BOOKS 

D     CARE    OF  THE    ADULT  PATIENT 

D     ADVANCED     CONCEPTS     IN     CLINICAL     NURSING 

D     NURSING  OF  PEOPLE  WITH  CARDIOVASCULAR  PROBLEMS 

D     NURSING   IN   THE   INTENSIVE   RESPIRATORY  CARE   UNIT 

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OCTOBER      1971 


THE     CANADfAN     NURSE     1 


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If  your  nurses  have  been  practicing  pharmacy  at  the  nursing 
station  .  .  .  compounding  a  IVIilk  of  Magnesia/Cascara  Sagrada 
suspension,  take  heart!  Now,  you  can  provide  them  with  this 
combination  in  a  tamper  proof,  positively  identified,  30  ml.  unit 
dose  bottle  which  is  not  opened  until  it  reaches  the  patient's 
bedside.  Check  with  your  nursing  staff— this  could  be  just  what 
they  are  looking  for! 


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Division  of  Penick  Canada  Ltd.,  Toronto,  Canada 


2    THE     CANADIAN     NURSE 


OCTOBER      1971 


The 

Canadian 
Nurse 


^ 

^^p 


A  monthly  journal  for  the  nurses  of  Canada  published 

in  English  and  French  editions  by  the  Canadian  Nurses'  Association 


Volume    67,    Number    10 


October    1971 


27     Banting  and  Best  —  the  Men 

Who  Tamed  Diabetes D.M.  Grant 

3 1      Dying  With  Dignity Elisabeth  Kiibier-Ross 

36     Behavior  Therapy  Approach  to 

Psychiatric  Disorder J.  Raeburn  and  J.  Soler 

39     Adolescent  Sexual  Activity George  Szasz 

44     Gel  Pillow  Helps  Prevent  Pressure  Sores C.E.  Robertson 

47     Electricity:  A  hospital  Hazard 


The  views  expressed  in  the  various  articles  are  the  vievN,s  of  the  aiilhois  and  do  not 
necessarily  represent  the  policies  or  views  of  the  Canadian  Nurses'  AssiKiation. 


4  Letters 

22  Names 

52  Dates 

58  Accession  List 


7  News 

51  New  Products 

54  Books 

72  Index  to  Advertisers 


Executive  Director:  Helen  K.  Mussallem  • 
Editor:  Virgliila  A.  Llndaborj  •  Assistant 
Editors:  Liv-EUen  Lockeberg,  Dorothy  S. 
StaiT.  •  Editorial  Assistant:  Carol  A.  Kotlar- 
sky  •  Production  Assistant:  Elizabeth  A. 
Stanton  •  Circulation  Manager:  Beryl  Dar- 
ling •  Advertising  Manager:  Ruth  H.  Baumel 

•  Subscription  Rates:  Canada:  one  year, 
$4.50;  two  years.  $8.00.  Foreign:  one  year, 
$5.00;  two  years,  $9.00.  Single  copies:  50 
cents  each.  Make  cheques  or  money  orders 
payable  to  the  Canadian  Nurses'  Association. 

•  Change  of  Address:  Six  weeks'  notice;  the 
old  address  as  well  as  the  new  are  necessary, 
together  with  registration  number  in  a  pro- 
vincial nurses'  association,  where  applicable. 
Not  responsible  for  journals  lost  in  mail  due 
to  errors  in  address. 


Manuscript  InformatioD:  "The  Canadian 
Nurse"  welcomes  unsolicited  articles.  All 
manuscripts  should  be  typed,  double-spaced, 
on  one  side  of  unruled  paper  leaving  wide 
margins.  Manuscripts  are  accepted  for  review 
for  exclusive  publication.  The  editor  reserves 
the  right  to  make  the  usual  editorial  changes 
Photoeraphs  (glossy  prints)  and  graphs  and 
diaerams  (drawn  in  India  ink  on  white  paper) 
are~welcomed  with  such  articles  The  editor 
Is  not  committed  to  publish  all  articles 
sent,  nor  to  indicate  definite  dates  of 
publication. 

Postage  paid  in  cash  at  third  class  rate 
MONTREAL,  P.Q.  Permit  No.  10,001. 
50  The  Driveway,  Ottawa,  Ontario.  K2P  IE2 
©   Canadian  Nurses'  Association  1971. 


OCTOBER      1971 


Dear  Mr.  Prime  Minister 

We  realize  how  concerned  you  and  your 
colleagues  on  Parliament  Hill  are  about 
President  Nixon's  decision  to  Impose 
a  10  percent  surcharge  on  imports.  Not 
being  ones  to  sit  idly  by  In  this  partic- 
ipatory" democracy,  leaving  you  to 
worry  about  all  the  "contingency 
plans.  "  we  put  our  heads  together  to 
produce  a  solution  of  our  own.  Here  it 
is: 

For  some  time  we  have  been  aware 
of  an  ailment  that  affects  all  Canadians, 
particularly  those  who  belong  to  the 
health  professions.  This  ailment,  which 
we  shall  label  the  "general-adaptation- 
to-U.S. -utterance"  syndrome  (GAS.  for 
short)  —  or,  if  you  prefer,  the  "Yankee- 
Doodle-itis"  syndrome,  "overabsorp- 
tion  "  syndrome,  etc.  —  could  be  put  to 
profitable  use.  But  we  will  explain  how 
in  a  moment.  First,  more  about  the  ail- 
ment itself. 

GAS  can  be  defined  as  an  insidious, 
chronic  condition  characterized  by  an 
uncontrollable  urge  to  grab  all  U.S. 
terminology  and  ideas — good  or  bad 
—  and  put  them  into  immediate  use  in 
Canada.  The  main  symptom  is  Licht- 
heim's  aphasia  —  a  form  of  aphasia, 
according  to  Dorland's  Medical  Dic- 
tionary, in  which  spontaneous  speech 
IS  lost,  but  the  ability  to  repeat  words 
IS  retained. 

A  high  incidence  of  GAS  has  been 
found  among  nurses  and  doctors.  It  is 
an  extremely  contagious  ailment,  and  is 
frequently  contracted  by  politicians 
and.  indeed,  even  by  writers.  Generally 
the  persons  afflicted  experience  no 
nausea:  however,  nausea  is  a  definite 
symptom  in  those  who  do  not  have  the 
disease. 

Perhaps  a  few  examples  of  GAS  are 
in  order.  The  most  recent,  of  course,  is 
evidenced  by  a  few  persons  who  ad- 
vocate the  physician's  assistant'  — 
an  idea  imported  directly  from  south  of 
the  border  without  any  interference 
from  Customs.  Another  example  is  "the 
unit  manager"  —  an  ideaquickly  adapt- 
ed by  many  Canadian  hospitals,  and  now 
being  questioned  by  critics  in  the  USA. 
from  whence  the  title  and  role  emerged. 

And  the  expression  "delivery  of 
health  care'  '  Whatever  did  we  say 
before  that  pompous  phrase  was  export- 
ed (no  doubt  with  some  relief)  by  our 
U.S.  colleagues? 

Is  the  message  coming  across.  Mr. 
Prime  Minister''  Now  if  you  were  to  put 
a  15  percent  surcharge  on  all  this  GAS 
business,  it  would  help  solve  our  finan- 
cial problems.  Moreover,  it  might  even 
result  m  more  original  thinking  on  this 
side  of  the  border,  and  send  expres- 
sions such  as  "delivery  of  health  care" 
back  where  they  belong  —  in  this  case, 
to  the  grocery  boy  or  milkman. 
Yours  in  the  Service,  V.A.L. 

THE  CANADIAN   NURSE       3 


letters    { 


Letters  to  the  editor  are  welcome. 

Only  signed  letters  will  be  considered  for  publication,  but 

name  will  be  withheld  at  the  writer's  request. 


Family  participation  stimulated 

After  digesting  the  August  issue  of 
The  Canadian  Nurse,  I  became  intrigued 
with  the  idea  exchange  on  "Audio  slides 
streamline  interviews."  It  seems  to  be 
an  ultramodern  way  of  pre-interview 
orientation  for  nursing  or  for  any  of  its 
related  fields.  Miss  M.  Henricks  is  to 
be  congratulated  on  its  possibilities  for 
the  present  and  for  future  space-age 
advancements. 

One  thing  that  caught  my  interest  was 
the  fact  that  mothers  sometimes  partici- 
pate with  their  daughters  to  see  "what 
it's  all  about."  Isn't  this  where  our 
"team"  begins — in  the  home  where 
encouragement,  sympathy,  and  under- 
standing can  be  given  objectively  by 
family  members  or  close  friends  who 
have  some  idea  as  to  what  "it's  all 
about"?  They  can  stimulate  the  student 
and  guide  her  back  into  perspective 
after  an  "off  day  with  a  difficult  pa- 
tient, or  when  test  results  are  lower 
than  anticipated. 

I  do  not  intend  to  take  any  responsi- 
bility from  teachers  or  counselors,  and 
I  am  sure  there  are  many  young  students 
who  want  to  do  their  "thing"  on  their 
own.  However,  more  of  this  type  of 
family  interview  and  participation  could 
snowball  by  word  of  mouth  and  it  could 
educate  our  society  more  accurately  in 
the  finer  arts  of  nursing  and  its  related 
fields.  —  Vera  Temple,  R.N.,  Ottawa. 

CUSO  nurse  on  abortion 

I  must  repliy  to  some  of  the  nurses  who 
have  written  about  the  stand  on  abortion 
taken  in  the  November  1970  editorial 
of  The  Canadian  Nurse. 

I  am  a  Canadian  nurse  working  in 
India  (this  explains  the  lateness  of  my 
letter)  with  the  Christian  Medical  Asso- 
ciation of  India,  Family  Planning  Pro- 
ject. I  came  to  India  with  Canadian 
University  Service  Overseas,  and  this 
will  be  my  second  year  here. 

1  am  interested  in  Canadian  develop- 
ments in  maternal-child  health  and 
family  planning  because  1  am  involved 
in  an  educational  program  where  we 
teach  all  hospital  personnel  the  "why" 
and  the  "how"  of  family  planning. 
They,  in  turn,  are  expected  to  teach 
everyone  they  come  in  contact  with.  We 
also  talk  to  villagers  who  have  many 
questions  about  the  family  planning 
program  here  in  India. 

Here,  perhaps  more  than  at  home, 

4     THE     CANADIAN     NURSE 


the  plight  of  an  unplanned  for  and 
unwanted  child  is  more  dramatic  be- 
cause of  the  many  other  factors  that 
impinge  on  the  Indian  family  —  ane- 
mia and  poor  health  of  the  mother  at 
the  time  of  delivery,  the  number  of 
already  existing  children,  the  low  or 
subsistence  level  of  income  for  the 
family,  and  the  hard  labor  that  both 
parents  must  do  to  bring  in  even  this 
small  income.  Still,  whether  in  India 
or  in  Canada,  an  unplanned  for  baby 
will  place  a  burden  on  the  family's 
income.  The  baby  itself  may  suffer 
emotionally  from  a  lack  of  the  mother's 
attention  and  care  (so  important  to  its 
growth)  and  perhaps  physically  from 
malnutrition,  as  is  the  case  in  India. 

The  editorial  in  the  November  1970 
issue  of  The  Canadian  Nurse  states  that 
"prevention  of  conception  is  preferable 


r' 


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to  the  termination  of  an  unwanted 
pregnancy."  Contraception  is  being 
talked  about,  clinics  and  all  the  family 
planning  methods  are  available  freely  in 
India,  but  still  there  are  unwanted 
pregnancies. 

We  are  taught  that  a  nurse  should 
have  a  non -judgmental  attitude  toward 
her  patient.  She  should  see  her  patient 
as  part  of  the  family  unit,  not  isolated 
from  it.  When  a  woman  has  reached 
the  decision  that  for  herself  and  her 
family  another  child  is  not  advisable, 
who  are  we  to  impose  our  own  personal 
views  on  her?  As  nurses  we  must  sup- 
port her  through  this  period,  so  she  can 
return  to  her  family  and  function  fully 
as  a  wife  and  mother.  We  must  minimize 
the  feelings  of  guilt  that  she  will  have, 
no  matter  how  much  understanding  she 
has  received  at  this  time. 

,The  matter  of  abortion  is  one  between 
a  woman  and  her  doctor.  Are  nurses 
going  to  be  an  imf)ediment  to  the  pa- 
tient who  comes  to  the  hospital  for  an 
abortion?  I  hope  not.  —  Carol  Rogers, 
B.Sc.N.,  Bangalore,  India. 


Nurse  reflects  on  her  career 

I  am  a  nurse  from  the  Philippines  work- 
ing in  a  general  hospital  in  Ontario. 
After  three  years  of  nursing,  I  have 
given  serious  thought  to  my  profession 
and  what  it  means  to  me. 

My  chosen  profession  is  not  as  easy 
as  I  thought  it  would  be  before  I  entered 
it.  It  requires  sacrifices,  patience,  un- 
derstanding, and  especially  responsibil- 
ity. One  mistake  can  mean  the  differ- 
ence between  life  and  death  for  a  pa- 
tient. 

Nurses  must  deal  with  people  from 
all  walks  of  life  —  young  and  old,  rich 
and  poor.  I  try  to  give  each  one  the 
best  care  I  can. 

Because  of  their  illness,  most  patients 
become  irritable  and  •  impatient.  Yet, 
in  spite  of  this,  I  try  to  alleviate  a  little 
of  their  suffering. 

As  I  look  back,  I  don't  know  why 
I  chose  this  profession  of  serving  others, 
which  sometimes  means  I  have  to 
forego  social  activities  and  work  long 
hours.  But  I  know  that  seeing  a  person 
who  is  extremely  ill  and  near  death 
regain  his  health  makes  me  happy  to 
be  a  nurse  in  a  hospital.  —  Benjamita 
Ocompo,  Reg.N.,  Port  Colborne,  Onta- 
rio. ^ 

OCTOBER      1971 


"^,NG  SOIAV 


Leadership  is  a  lonely 

I  /^  r^      when  you  have  the  ultimate  responsibility  for 
J  v^  k^  •   quality  nursing  care,  there  is  often  no  one  else  at  hand 
qualified  to  help  you  solve  the  "prickly"  problems  with 
which  you  must  deal.   Now,  thanks  to  our  distinguished 
editorial  advisors,  The  journal  of  Nursing  Administration 
has  become  the  helpful  counsellor  you  need.   Its  articles  offer 
a  judicious  mixture  of  practical  and  theoretical 
\       advice;  some  which  you  can  use  now,  some  to  be  filed 
away  for  later,  all  of  which  gives  you  perspective  on 
what  others  are  doing  and  thinking.    In  the  immediate 
future,  jONA  will  announce  the  appointment  of 
special  consultants  on  law,  architecture,  research, 
accounting,  finance,  recruiting,  and  systems  development. 
Don't  miss  all  this  good  advice;  subscribe  now!   If  you  send  a  check  with 
your  order,  we'll  send  you  two  back  issues  as  a  bonus— as  long  as  the  supply  lasts. 


^S^^^^^"" 


Editorial  Board 

Luther  Christman,  R.N.,  Ph.D. 
Lucy  Germain,  R.N.,  M.A. 
Evelyn  Zetter  Jones,  R.N., 

M.   Lift. 
Doris  I.  Miller,  R.N.,  M.Ed. 
K.  Mary  Straub,  R.N.,  Ed.D. 

Contributing  Editors 

Ruth  Anderson,  R.N.,  Ph.D. 
Lyndall  Birkbeck,  R.N.,  M.A. 
Gertrude  Cherescavich,  R.N. 

M.S. 
Annie  Laurie  Crawford,  R.N. 

M.Ed. 
Barbara  A.  Davis,  R.N.,  M.S. 
Eva  H.  Erickson,  R.N.,  M.S. 
Marie  DiVincenti,  R.N.,  Ed.D. 
Helen  W.  Dunn,  R.N.,  M.S.N.E. 
Ruth  Freeman,  R.N.,  Ed.D. 
Clifford  Jordan,  R.N  ,  M.Sc.Ed 
Eleanor  Lambertsen,  R.N., 

Ed.D. 
Dulcy  Miller,  B  A. 
Sylvia  R.  Peabody,  R.N.,  M.S. 
John  L.  Ryan,  M.H.A. 
Sr.  M.  Loyola  Schwab,  O.S.B., 

R.N. 
Mary  Shaughnessy,  R.N.,  Ed.D. 
Helen  Weber,  R.N  ,  A.M. 
Lucie  Young,  R.N.,  Ph.D. 


In  the  Next  Issue 

A  Month  of  Result  Producing  Ideas         Ernest  W.  Fair 
Team  Nursing — How  Viable  is  it  Today         Thora  Kron 
Setting  the  Stage  for  Teaching  Ancillary  Personnel         Joan  C.  Murphy 
Clincal  Specialization:   Conflict  Between  Reality  and  Theory 

Mary  Woodrow  and  Judith  Bell 
Finding  Clinical  Problems  for  Study         Donna  Diers 

Psycho-Social  Implications  of  the  Elderly  Psychiatric  Patient       Cherie  Harrison 
Appropriate  Utilization  of  Health  Professionals         Virginia  Cleland  and 

Dawn  Zagornik 
Cyclical  Staffing  With  a  Ten  Hour  Day— Four  Day  Week         Jeannine  Bauer 
A  Rose  by  Any  Other  Name  ...  A  Satire         Margaret  Olendzki 

Articles  in  Preparation 

Performance  Appraisal  Systems         Susan  Albrecht 

The  California  Nurse  Practice  Act— Radical  Change         Rachel  Ayers 

Maternity  Leave         Virginia  Cleland 

Working  With  an  Architect         Maxine  Mann 

Accountability  for  Nursing  Practice         Marion  McKenna 

Centralized  Staffing  Procedures         Mary  Ellen  Warstler 

A  Computerized  Nursing  History         Elizabeth  Wesseling 


Mail  this  coupon  or  a  facsimile  to  ' 

THE  JOURNAL  OF  NURSING  ADMINISTRATION 
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n  6    Teacher 

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CLINICAL  SPECIALTY   (please   indicate 
primary,  secondary,  and  tertiary 
interests  by  placing  numerals 
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Intensive  Care 
Medical-Surgical 
Obstetrics 
Pediatrics 
Operating  Room 
Geriatrics 
Psychiatry 
Rehabilitation 
Outpatient  Clinic 
Central   Supply 
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Other 


Number  of  beds?  . 


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OCTOBER      1971 


THE     CANADIAN     NURSE     5 


8CHERING 


For  effective  relief 

of  cold  symptoms 

take  the  clear-headed 

family  approach. 

Recommend  Coricidin. 


4 


Coricidin*  is  a  whole  family  of  cold  fighters.  Each  form  is 
formulated  for  maximum  effectiveness  in  controlling 
cold  symptoms. 

Coricidin  'D',  for  instance,  has  five  ingredients 
to  combat  every  head  cold  symptom:  a  top-rated  anti- 
histamine to  stop  running  noses,  two  pain  relievers  and 
fever  fighters,  caffeine  to  brighten  spirits  and  a  decon- 
gestant to  shrink  swollen  membranes. 

For  the  junior  cold  sufferer,  Coricidin 'D'  Medilets" 
offer  the  same  relief  in  a  dosage  suitable  for  the  young 


patient,  in  a  pleasant-tasting  chewable  tablet. 

For  everyone  in  the  family,  there  is  a  member  of  the 
Coricidin  family  to  bring  real  relief:  Adult  tablet  forms 
packaged  in  the  new,  easy-to-use  pop-out  blister  packs, 
spray,  lozenges  and  a  pleasant-tasting  cough  mixture. 

Recommend  Coricidin.  Your  charges  will  be  glad 
you  did.  For  further  information,  consult  your  physician 
or  write  Schering  Corporation  Limited,  Pointe  Claire 
730,  P.Q. 

•  Reg.  T.M. 


Coricidin 


THROAT  i 


soothing  HONEY  MEN 


auQi 


Coricidin 


24  TABLETS 
fof  r«iMf  o4  cold 
■vmpiom*  and 
jccofnpmving  achM. 
pain*.  tcvOT  and  ttrnptt 
hMdMh* 


for  fail  r*lt«t  of 
childran's  ttuffv  >nd 
runny  no»M  du«  lo 
1h«  common  co(d 


Coricidin 


COUGH  MIXTURE 


1 


8&;sisr££ 


24  TABLETS 
<or  ttttml  ot  COM 

•nd  •ceompaovir>g 

od  tinua 
congattKifi 


gj 


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A  Family  of  cold  products. 


news 


Status  Of  Women  Report 
"Got  Things  Going" 


Ottawa  —  The  Report  of  the  Royal 
Commission  on  the  Status  of  Women  in 
Canada  was  made  public  almost  a  year 
ago.  Nurses  have  had  time  to  study  it, 
react  to  it,  ignore  it,  or  forget  it.  To  find 
out  if  the  Report  meant  anything  to 
nurses  or  was  just  another  dust-gather- 
ing royal  commission  product.  The 
Canadian  Nurse  polled  a  small  sample 
of  nurses  across  Canada. 

Twelve  nurses  were  called  to  give 
their  opinions.  Results  from  this  ran- 
domly-selected group  showed:  three 
had  read  the  report;  three  had  read 
parts  of  it;  one  had  read  What's  In  It, 
a  study  guide  published  by  the  National 
Council  of  Women;  and  five  had  been 
informed  by  television,  magazines,  and 
press  reports. 

All  the  nurses  were  interested  in  the 
Report.  None  felt  it  was  a  waste  of  the 
taxpayers'  (their!)  money  or  time.  Delcie 
Hill,  a  mental  health  nurse  with  the 
Okanagan  Mental  Health  Unit,  Kelow- 
na,  B.C.,  said,  "I  was  impressed  with 
the  fact  the  subject  had  been  studied.  I 
think  the  Report  got  things  going  for 
women  in  Canada. 

"I  am  glad  many  things  have  come 
out  in  definite  facts,  that  there  are  num- 
bers given,  and  percentages  compiled. 
There  are  the  statistics  that  say  women 
haven't  had  an  equal  opportunity  —  in 
jobs,  education,  credit,  and  so  on,"  she 
said. 

Mrs.  Hill  chuckled  about  one  con- 
tradiction in  the  Report.  "The  chairman 
was  referred  to  as  Florence  Bird  in  two 
places  and  in  one  place  as  Mrs.  John 
Bird."  And  most  people  know  her  better 
as  Anne  Francis.  The  Report  said, 
"The  fact  that  a  woman  at  marriage 
loses  her  name  and  assumes  that  of  her 
husband  is  an  example  of  a  custom  that 
is  to  a  greater  or  lesser  degree  harmful 
to  a  woman's  self-development  .... 
The  change  of  name  upon  marriage 

OCTOBER      1971 


may  create,  as  well,  a  source  of  some 
confusion." 

In  Edmonton,  Alta.,  Judith  Prowse, 
supervisor  of  surgical  nursing  at  the 
Royal  Alexandra  Hospital,  said  she 
wasn't  really  surprised  by  anything 
in  the  Report,  but  she  too  was  interested 
in  seeing  some  of  these  things  in  print. 
"Sometimes  you  hear  things  and  think 
it's  one  circumstance,  one  individual. 
But  the  Report  proved  that  many  of 
these  conditions  are  widespread. 

"I  was  pleased  to  see  recognition 
given  to  the  housewife,  not  as  a  sup- 
portive member  of  our  society,  but  as 
a  contributing  member.  Maybe  I  was 
being  discriminatory  in  my  own  mind, 
but  I  didn't  think  there  would  be  a  great 
impact  for  the  woman  at  home.  I  had 
assumed  this  wouldn't  be  covered  and 
I'm  glad  it  was,"  said  Miss  Prowse. 

Sister  Moira  Gillis,  director  of  nurs- 
ing at  Halifax  Civic  Hospital,  Halifax, 
N.S.,  believes  the  commission  was 
worthwhile.  "As  in  other  countries,  we 
had  a  need  for  this  in  Canada.  I  thought 
the  Report  covered  the  subject  fairly 
well.  Although  there  were  some  areas 
that  need  more  work. 

"This  is  where  women  and  nurses' 
associations  fell  down.  I  don't  think  we 
did  enough  in  supplying  the  commission 
with  information.  Nurses  are  very  lack- 
adaisical about  public  affairs,"  she  said. 
Sister  Gillis  belongs  to  an  informal 
study  group  that  is  reviewing  the  Report 
clause  by  clause. 

Miss  Prowse  disagreed  with  the  fourth 
principle  adopted  by  the  Commission 
that  "in  certain  areas  women  will  for 
an  interim  period  require  special  treat- 
ment to  overcome  the  adverse  effects 
of  discriminatory  practices." 

"I  don't  think  this  is  a  good  idea," 
she  said.  "If  women  have  equality  of 
opportunity,  they  don't  need  special 
treatment.  If  we're  given  special  treat- 


ment, it's  human  nature  to  misuse  it. 
And  once  it's  started  you  can't  have  it 
for  an  interim  period;  it  would  be  hard 
to  eliminate.  In  the  past,  women  have 
lived  by  special  treatment  and  now 
we're  asking  for  it.  I  think  we'd  be 
damaging  ourselves." 

Lise  Eichler,  head  nurse  of  the  out- 
patient department  at  The  Montreal 
Children's  Hospital,  Montreal,  wished 
the  commissioners  had  made  a  distinc- 
tion between  the  woman  who  has  to 
work  and  the  woman  who  works  because 
she  wants  to  continue  a  career. 

Six  nurses  said  they  would  like  to  see 
action  taken  on  the  Report's  recom- 
mendations about  day-care  centers. 
June  Scott,  president  of  the  staff  nurses' 
association.  Royal  Alexandra  Hospital, 
Edmonton,  said,  "Governments  must 
go  ahead  with  day-care  centers.  They 
have  to  be  available  before  women  are 
really  free  to  work.  This  is  part  of 
equality  of  opportunity.  Women  have 
to  be  free  to  look  for  a  job." 

Bemadette  LeBlanc,  a  field  worker 
with  the  Canadian  Association  for  the 
Mentally  Retarded  in  Moncton,  N.B., 
said  day-care  centers  are  important 
to  nurses.  She  noted  that  in  parts  of  her 
province  there  is  a  shortage  of  nurses 
and  that  pressure  has  been  put  on  nurses 
with  families  to  come  back  to  work. 
"It's  difficult  for  them  to  find  a  good 
housekeeper  who  will  give  the  children 
the  kind  of  care  they  should  have," 
she  said. 

Mrs.  LeBlanc,  chairman  of  the  New 
Brunswick  Association  of  Registered 
Nurses'  committee  that  studied  the 
Report,  believes  such  centers  should 
be  community  sponsored.  "Financing 
should  be  provided  by  the  government, 
with  autonomy  of  operation  left  to  the 
community,"  she  said. 

On  proposals  for  private  sponsor- 
ship of  day-care  centers,  the  Report 
said,  "these  might  include  provision 
made  by  businesses,  hospitals,  and 
universities  for  children  of  staff  and 
students."  Elizabeth  Ireton,  instructor 
in  the  inservice  education  department 
of  the  Montreal  Children's  Hospital, 
said,  "at  a  pediatric  center  like  ours  a 
day-care  center  supplied  by  the  em- 
ployer could  serve  many  purposes.  It 
could  be  an  area  of  observation  for 
people  who  want  to  study  normal  child- 
ren's growth  and  behavior." 

Director  of  nurses  at  the  same  hos- 

THE     CANADIAN     NURSE     7 


news 


pital,  Roselyn  Smith,  said  the  idea  of  a 
day-care  center  at  the  hospital  had  been 
discussed  for  over  three  years.  "We 
haven't  established  one  because  we 
don't  have  the  space,  funds,  or  admini- 
strative staff.  A  center  would  be  an  asset 
not  only  for  mothers  and  children,  but 
for  students  as  a  learning  lab.  It  needn't 
be  an  institutional  responsibility,  but 
could  be  located  nearby  in  the  com- 
munity," she  said. 

A  general  duty  staff  nurse  at  St. 
John's  General  Hospital,  Newfound- 
land, who  has  three  children  ages  13, 
1 1,  and  10,  feels  that  as  a  sole-support 
parent  she  could  use  some  help  from 
society.  She  would  like  to  have  avail- 
able an  agency  that  would  provide 
activities  for  her  children  while  she  is 
at  work.  The  Commission  stated  that 
supplementary  programs  should  be 
provided  for  school-age  children,  and 
that  such  programs  should  be  included 
by  the  provincial  governments  in  their 
administration  of  child-care  facilities. 

In  the  Report's  chapter  on  taxation 
and  child-care  allowances,  the  Com- 
mission's approach  was  to  look  for  "a 
system  which  would  be  neutral  in  the 
sense  it  would  preserve  a  married  wo- 
man's freedom  either  to  stay  at  home  or 
to  enter  the  labor  force  ....  Other 
aspects  of  neutrality  should  be  respect- 
ed ...  .  We  wanted  to  avoid  creating 
an  undue  advantage  in  favor  of  married 
women  compared  with  men  or  single 
women." 

The  taxation  system  was  the  next 
most-mentioned  topic.  Miss  Ireton 
believes  tax  exemptions  allowed  for 
children  should  be  increased,  particul- 
arly for  women  raising  families  alone 
or  both  parents  working  to  provide  an 
adequate  income. 

Judy  White,  a  staff  nurse  at  St.  John's 
General  Hospital,  Newfoundland,  and 
mother  of  five  children,  would  like 
costs  for  child-care,  transportation, 
and  uniforms  deductible  as  business 
expenses.  Another  Newfoundland  nurse 
would  like  tax  benefits  increased,  par- 
ticularly for  child-care  expenses.  "An 
employed  mother  should  be  able  to 
deduct  the  full  amount  she  pays  to  have 
her  child  looked  after  during  working 
hours,"  she  said. 

Feme  Trout,  assistant  administrator, 
department  of  nursing,  Lion's  Gate 
Hospital,  Vancouver,  B.C.,  said, 
"Change  is  necessary  in  the  taxation 
structure  to  create  parity  and  to  permit 
women  to  combine  their  motherhood 
and  career  roles  with  hope  of  success  in 
both." 

Other  topics  discussed  in  the  Report 
received  about  equal  mention  from  the 

8     THE     CANADIAN      NURSE 


nurses.  Miss  Trout  said,  "In  my  opin- 
ion the  key  point  is  the  section  pertain- 
ing to  equal  opportunity  and  equal  pay. 
It  will  have  significance  for  a  great 
number  of  women.  The  recognition 
functionally  and  economically  of  wo- 
men as  individuals  will  spur  them  to 
develop  their  innate  abilities  and  to 
contribute  more.  These  are  the  factors 
that  in  the  long  run  will  lead  women 
into  a  more  active  political  and  econo- 
mic role  in  the  affairs  of  the  country. 

"The  Report  shows  that  women  are 
in  the  lower  salary  range.  This  is  un- 
doubtedly so  in  both  low  and  high  pay- 
ing jobs.  Women  are  often  doing  the 
spade  work  for  top  management.  This 
can  require  decision  and  policy-making 
ability,  but  they  receive  little  recogni- 
tion for  it.  A  woman  may  have  a  lion's 
title,  but  she  frequently  gets  paid  less 
than  a  man  in  the  same  position,"  said 
Miss  Trout. 

Sister  Gillis  feels  strongly  about 
equality  of  salary  for  equal  education 
and  experience  in  a  position.  "In  our 
profession,  men  and  women  with  the 
same  qualifications  and  with  the  same 
experience  should  be  entitled  to  the 
same  salaries." 

A  head  nurse  at  University  Hospital, 
Saskatoon,  Sask.,  also  believes  in  equal- 
ity on  the  job  and  equality  of  pay.  "The 
question  is,  do  women  get  the  positions 
in  the  first  place  to  get  the  equal  pay, 
especially  if  there  are  men  applying  for 
the  same  job?"  she  asked. 

Miss  Ireton  also  talked  about  the 
scarcity  of  women  in  senior  positions. 
"This  is  a  problem  in  professions  or 
situations  that  men  have  dominated  in 
the  past.  I  think  women  are  usually 
kept  from  possibilities  of  getting  into 
these  positions  at  lower  levels." 

Miss  Prowse  agreed  with  the  Report's 
recommendations  on  employment. 
"Speaking  as  a  working  woman,  I  think 
we  should  push  for  change  in  these 
areas.  There  should  be  equality  of  op- 
portunity in  employment  conditions. 
There  are  discrepancies  in  credit  op- 
portunities, banking  privileges,  insur- 
ance options,  and  so  on,"  she  said. 

"For  instance,  I  didn't  know  that 
a  woman  who  is  married  and  in  the 
same  employment  circumstances  as 
me,  a  single  person,  is  persuaded  not  to 
maintain  an  adequate  pension.  She 
can  get  as  much  insurance  as  I  can  but 
neither  of  us  can  get  as  much  as  a  man." 

Mrs.  Hill  said,  "Women  must  take 
the  initiative  if  they  want  some  of  these 
things.  No  amount  of  legislation  will 
give  us  equal  status  unless  we  respect- 
fully earn  it.  If  women  are  to  receive 
equal  pay,  then  I  insist  they  must  per- 
form at  the  same  level,  with  none  of  the 
other  fringes  and  frills  they've  been 
given. 

"Why  should  men  do  certain  things 


for  us  in  our  job  situation  just  because 
we're  women?  Why  should  we  have  our 
coffee  first?  Or  have  doors  opened  for 
us? 

"There  are  still  women  who  do  not 
put  as  much  into  their  jobs  as  men  do. 
Men  think  of  their  work  position  as 
their  life  position,  while  a  lot  of  women 
don't  think  this  way,"  said  Mrs.  Hill. 

In  its  examination  of  the  participa- 
tion of  women  in  public  life,  the  Re- 
port said:  "The  last  50  years,  since  wo- 
men suffrage  was  introduced,  have 
seen  no  appreciable  change  in  the  poli- 
tical activities  of  women  beyond  the 
exercise  of  the  right  to  vote.  In  the 
decision-making  positions,  most  con- 
spicuously in  the  government  and  the 
Parliament  of  Canada,  the  presence  of 
a  mere  handful  of  women  is  not  more 
than  a  token  acknowledgement  of  their 
right  to  be  there.  The  voice  of  govern- 
ment is  still  a  man's  voice  .... 

"Nowhere  else  in  Canadian  life  is 
the  persistent  distinction  between  male 
and  female  roles  of  more  consequence. 
No  country  can  make  a  claim  to  having 
equal  status  for  its  women  as  long  as  its 
government  lies  entirely  in  the  hands 
of  men." 

The  University  Hospital  head  nurse 
said,  "It  takes  quite  an  exceptional  wo- 
man to  be  in  politics.  First,  a  woman 
has  to  convince  men  she  has  the  quali- 
ties necessary  for  public  office.  She  has 
to  prove  herself  to  get  men  to  even  lis- 
ten to  her." 

Mrs.  Eichler  is  very  much  interested 
in  politics,  but  only  on  the  sidelines 
as  she  is  "always  busy  at  work  and  at 
home.  I  don't  do  any  political  work,  but 
I  have  a  sister  who  is  really  involved  in 
politics.  We  discuss  politics  often." 

When  asked  if  women's  organizations 
—  for  example,  local  chapters  of  a 
nurses'  association  —  should  support 
women  candidates  for  office.  Miss 
Trout  said,  "I  don't  think  women's 
organizations  should  direct  their  mem- 
bership to  support  a  woman  candidate 
on  the  grounds  of  her  sex  alone.  I  am 
not  implying  that  women  should  not 
think  more  politically  than  they  do,  not 
that  women  in  various  professions 
should  not  prepare  themselves  to  voice 
their  beliefs  more  clearly  and  logically 
than  they  do. 

"I  believe  nursing  organizations 
should  be  more  vocal,  particularly  in 
health  care  matters  so  they  can  influence 
more  segments  of  the  population,"  she 
said. 

On  the  future  of  the  Report,  Sister 
Gillis  said:  "I  hope  this  is  not  going 
to  be  one  more  thing  they  spend  a  lot 
of  money  on,  only  to  file  it  in  a  cabinet. 
I  think  something  should  be  done  within 
the  year.  At  the  next  session  of  Parlia- 
ment I  would  expect  to  see  some  legisla- 
tion stemming  from  the  recommenda- 
tions." (Continued  on  page  10) 

OCTOBER      1971 


PACK  UP 

YOUR  TROUBLES 

WITH 


The  big  advantage  of 
BARRIER*  Drape  Packs  is  that 
they  do  a  better  job  —  they  eliminate 
moisture  penetration  and  bacterial  migration, 
because  BARRIER*  Drape  Packs  are  moisture  proof. 

But  another  important  advantage  of  BARRIER*  Drape 
Packs  is  that  they  are  disposable.  You  eliminate  laundry, 
inspection,  folding,  sorting,  mending,  wrapping  and 
autoclaving.  The  savings  in  cost,  time  and  space  can 
be  immense. 

With  performance,  convenience,  disposability  and 
economy,  BARRIER*  Drape  Packs  are  a  great  way  to 
pack  up  your  draping  troubles. 


MONTREAL4TORONTO- CANADA 
'Trademark  of  Johnson  &  Johnson  or  affiliated  companiei. 


M' 


news 


(Continued  from  page  8) 

Mrs.  LeBlanc  said,  "We  will  continue 
our  interest  in  the  Report  and  specifi- 
cally any  recommendations  that  are  act- 
ed upon.  We  are  not  going  to  forget  it!" 


Alberta's  Lieut-Govemor  Is 
Speaker  At  CNA  Biennial 

Edmonton,  A  Ita.  —  The  Honorable  Dr. 
J.  W.  Grant  MacEwan,  Lieutenant- 
Governor  of  Alberta,  will  be  the  main 
speaker  at  the  banquet  of  the  Canadian 
Nurses'  Association  biennial  meeting. 
The  banquet  is  scheduled  for  Tuesday, 
June  27, 1972. 

Planning  for  the  1 972  CNA  biennial, 
to  be  held  in  Edmonton  from  June  25 
to  29,  is  now  moving  into  high  gear. 

The  Alberta  Association  of  Register- 
ed Nurses,  hostess  for  the  meeting, 
has  appointed  a  10-member  committee 
to  plan  the  social  events  for  the  five 
days. 

Dr.  MacEwan  is  a  regular  contrib- 
utor to  farm  magazines  and  newspapers, 
and  has  had  18  books  published.  Of 
these  four  were  technical  and  the  re- 
mainder concerned  the  history  and 
development  of  western  Canada,  biog- 
raphy of  people  living  in  the  West,  and 
conservation. 

Alberta's  Lieutenant-Governor  was 
bom  to  pioneer  parents  who  farmed  in 
Manitoba  and  later  in  Saskatchewan. 
His  university  education  was  in  the 
field  of  agricultural  science.  He  taught 
at  the  University  of  Saskatchewan  be- 
fore he  became  Dean  of  Agriculture  at 
the  University  of  Manitoba. 

After  23  years  of  university  teach- 
ing and  administration.  Dr.  MacEwan 
moved  to  Calgary  where  he  became  in- 
volved in  politics  at  the  community 
level,  and  later  as  a  member  of  the 
provincial  legislature  and  leader  of  the 
opfX)sition. 

He  took  office  as  Lieutenant-Gov- 
ernor of  Alberta  on  January  6,  1966. 
He  has  received  honorary  degrees  from 
three  universities,  Alberta,  Calgary  and 
Brandon. 

Educational  Goals,  Deterrents 
Identified  In  CNA  Study  Of  RNs 

Ottawa —  The  majority  of  nurses  who 
have  some  educational  preparation 
in  a  university  want  additional  uni- 
versity work  within  the  next  five  years, 
according  to  questionnaire  replies  from 
6,493  nurses  actively  registered  in 
Canada. 

A  large  proportion  of  nurses  in  all 
categories  studied  indicated  that  a  need 
for  financial  assistance  was  delaying 
10     THE     CANADIAN     NURSE 


the  pursuit  of  their  educational  goals. 

In  1966,  the  Canadian  Nurses'  Asso- 
ciation proposed  a  study  to  identify 
some  of  the  factors  that  have  prevented 
registered  nurses  from  achieving  their 
goals  for  higher  education.  In  April 
1970,  a  National  Health  Grant  was 
awarded  to  conduct  the  study;  the  study 
has  just  been  completed. 

For  the  study  a  questionnaire  was 
mailed  to  all  nurses  actively  registered 
in  Canada  in  1970  who  had  some 
credits  toward  a  bachelor's  degree  or 
who  had  obtained  an  academic  degree. 
Seventy-five  percent  of  the  nurses 
replied  to  the  questions. 

The  nurses  with  less  than  a  bachelor's 
degree  expressed  relatively  more  inter- 
est in  continuing  their  education  than 
those  who  have  already  obtained  an 
academic  degree. 

One-third  of  all  nurses  responding 
in  the  study  said  that  they  plan  to  enroll 
in  a  university  "next  year"  as  a  full-  or 
part-time  student.  One-half  of  the 
group  state  that  they  can  obtain  their 
degree  within  one  academic  year  of 
full-time  study. 

However,  there  is  a  discrepancy 
between  the  intentions  of  the  nurses  to 
take  additional  university  education 
and  their  enrollment  in  university, 
according  to  the  CNA  study.  The  differ- 
ence is  most  pronounced  at  the  post- 
graduate level. 

The  study  indicates  that  as  the  nurse 
moves  up  the  degree  ladder  "home 
and  family  responsibilities"  decrease 
from  being  the  primary  delaying  factor 
and  "insufficient  funds  or  inability  to 
forego  salary,"  a  relatively  stable  factor, 
takes  precedence. 

Comments  written  on  the  question- 
naire illustrate  the  interdependence  of 
the  factors  delaying  further  education. 

Comments  also  brought  to  light 
another  factor:  many  nurses  indicated 
that  if  part-time,  extension  or  corre- 
spondence courses  in  nursing  and 
portability  of  acquired  academic  cred- 
its were  available,  they  could  pursue 
their  studies  despite  family  responsibil- 
ities and  financial  problems. 

Rose  Imai,  CNA  research  officer, 
sees  in  the  study  these  implications: 

•  More  readily  available  extension 
programs  would  lessen  the  amount  of 
funds  required  by  the  individual  nurse. 

Miss  Imai  recommends  a  study  to 
determine  whether  the  cost  of  providing 
an  extension  program  for  the  bachelor's 
degree  in  nursing  would  be  less  than 
the  cost  of  providing  an  equal  increase 
in  the  full-time  degree  program  capacity 
of  the  university. 

•  Career  and  academic  counseling 
could  make  nurses  aware  of  the  oppor- 
tunities available  jn  continuing  pro- 
fessional education.  Counseling  might 
help  to  relieve  the  fear  and  insecurity 


concerning  education  that  some  nurses 
are  currently  experiencing,  according 
to  study  responses. 

•  The  provision  of  day  care  facilities, 
together  with  more  flexible  employ- 
rnent  policies  regarding  leave  for  educa- 
tion, might  enable  many  more  nurses  to 
achieve  their  educational  goals.  Nurses 
should  be  in  the  forefront  of  initiating 
and  supporting  day  care  demonstration 
projects,  according  to  Miss  Imai. 

A  copy  of  the  study  will  be  available 
on  loan  from  CNA  Library. 


WHO  Seminar  For  Chief  Nurses 
Called  An  "Excellent  First" 

Ottawa —  "An  excellent  first"  was  the 
description,  given  by  Vema  Hyffman 
Splane,  of  the  international  seminar  for 
nurse  administrators  held  in  Washing- 
ton, D.C.,  on  August  9-14. 

Mrs.  Splane,  principal  nursing  officer 
of  the  department  of  national  health 
and  welfare,  represented  Canada  at  the 
meeting  sponsored  by  the  World  Health 
Organization. 

"One  goal  of  the  seminar  was  to  help 
principal  nursing  officers  look  at  the 
provision  of  health  care  and  its  nursing 
component.  The  seminar  did  this  to  a 
marked  degree,"  said  Mrs.  Splane. 

The  chief  nurse  in  the  government 
of  each  of  1 8  countries,  three  from  each 
of  WHO'S  six  regions,  was  invited  to 
meet  with  her  counterparts  to  talk 
about  the  work  of  the  principal  nursing 
officer  in  providing  health  care  in  her 
country. 

"The  idea  really  started  in  Canada," 
Mrs.  Splane  told  The  Canadian  Nurse. 
The  Canadian  minister  of  health  invit- 
ed national  nursing  officers  to  visit 
Ottawa  following  the  International 
Congress  of  Nurses  in  Montreal  in 
1969.  Fifty-five  nurses  from  43  coun- 
tries accepted  the  invitation  to  spend 
two  days  in  Ottawa,  learning  about  the 
DNHW  and  the  structure  of  nursing  in 
Canada,  and  seeing  the  sights  of  the 
capital. 

During  the  1 969  visit  to  Ottawa,  the 
chief  nurses  informally  discussed  their 
work  and  its  problems,  and  expressed  a 
need  to  continue  the  discussion.  The 
recent  seminar  was  held  to  meet  that 
need  in  part. 

Canadians  took  an  active  part  in  the 
Washington  seminar.  Mrs.  Splane  chair- 
ed two  plenary  sessions  and  led  a  small 
group  discussion.  Lily  Tumbull,  chief 
of  nursing  for  WHO;  Margaret  C.E. 
Cammaert,  chief  nurse  of  the  Pan 
American  Health  Organization;  and 
Dorothy  Hall,  nursing  advisor  for  the 
southeast  Asia  region  of  WHO,  are 
Canadians  who  were  resource  persons 
for  the  international  seminar. 

"I  was  impressed  with  the  leader- 
ship quality  apparent  in  young  nurses, 
OCTOBER     1971 


some  from  developing  countries,"  said 
Mrs.  Splane. 

The  principal  nursing  officer  from 
each  of  the  following  attended  the 
seminar:  Denmark,  United  Kingdom, 
and  Poland  (European  region  of  WHO); 
Uganda,  Ghana,  Botswana,  and  Ethio- 
pia (African  region);  Cyprus,  Iran,  and 
Israel  (Mediterranean  region);  India, 
Thailand,  and  Indonesia  (Asian  region); 
Australia,  and  Malaysia  (Pacific  re- 
gion); Ecuador,  Peru,  and  Canada 
(American  region).  South  Korea  was 
represented  at  the  seminar  by  a  doctor. 

The  principal  nursing  officers  from 
Scotland,  Colombia,  and  the  United 
States  served  as  advisers  to  the  seminar. 

Seminar  participants  felt  the  need 
for  further  seminars  to  permit  nurses 
who  work  at  national  level  to  explore 
some  of  the  approaches  that  make  their 
jobs  more  effective  in  delivering  health 
care. 

It  was  felt  that  nurses  who  assist  at 
the  policy-making  level  in  planning  for 
national  health  care  require  special 
preparation  in  planning  and  adminis- 
trative skills. 

Mrs.  Splane  gave  The  Canadian 
Nurse  two  examples  of  such  advanced 
programs  —  the  multidiscipline  courses 
in  health  planning  offered  by  the  Amer- 
ican region  of  WHO,  and  the  program 
to  prepare  large  numbers  of  nurses  for 
junior,  middle,  and  senior  management 
positions  under  the  Salmon  scheme  in 
England. 

iCN  Essay  Competition 
For  Irish  Student  Nurses 

Geneva,  Switzerland  —  Irish  student 
nurses  participated  in  the  first  student 
essay  competition  organized  by  the 
International  Council  of  Nurses,  in 
conjunction  with  the  ICN  Council  of 
National  Representatives  meeting  in 
Dublin  in  July. 

The  ICN  wanted  to  seek  the  students' 
ideas  about  ways  in  which  the  ICN  and 
student  groups  might  develop  a  closer 
and  more  meaningful  relationship. 
Students  were  given  the  topic  "ICN: 
Past,  Present,  and  Future"  and  were 
asked  to  write  about  what  the  ICN  has 
done  and  is  doing  to  advance  the  nurs- 
ing profession.  They  also  had  to  outline 
their  ideas  on  what  the  student  nurse, 
the  professional  nurse,  ajid  the  national 
nurses'  association  can  expect  of  the 
ICN  and  what  they  in  turn  can  contrib- 
ute to  the  ICN. 

Three  prizes  for  the  competition 
were  announced.  The  first  was  a  $125 
prize  donated  by  Alice  Girard  of  Can- 
ada, ICN  second  vicepresident.  The 
second  prize  of  $100  was  donated  by 
ICN  president  Margrethe  Kruse  of 
Denmark.  The  third  prize  was  $75, 
donated  by  Christiane  Reimann,  ICN 
executive  secretary  from  1922  to  1934. 

lOCTOBER      1971 


In  This  Case  She's  A  Body  Cast  Painter 


For  a  while,  body  painting  was  a  fad.  Now  a  new  one  is  getting  underway.  It 
requires  not  only  a  body,  but  some  part  of  it  encased  in  plaster  and  the  talents  of 
Mona  Currie  of  the  WA  Recreation  Service,  The  Hospital  for  Sick  Children, 
Toronto.  When  her  daughter  broke  her  leg,  Mrs.  Currie,  who  describes  herself 
as  a  "Sunday  painter,"  began  to  decorate.  She  does  all  kinds  of  casts  —  body, 
leg,  arm  —  with  brightly-colored  drawings.  Most  requests  are  for  Snoopy  and 
Peanuts  characters,  followed  by  flowers  and  other  animals. 


Although  this  first  ICN  essay  com- 
petition was  open  only  to  Irish  student 
nurses,  the  ICN  hopes  the  significance 
of  the  event  for  nurses  and  their  organi- 
zations will  be  international  in  scope. 
It  also  hopes  this  will  be  the  first  of  a 
series  of  student  competitions. 

ANPQ  Protests  To  Government 
On  Behalf  Of  Nursing  Assistants 

Montreal,  Que.  —  The  Association  of 
Nurses  of  the  Province  of  Quebec  has 
protested  to  the  Quebec  government 
about  the  reduction  in  the  number  of 
nursing  assistants  allowed  to  take  the 
province's  18-month  upgrading  course. 
ANPQ  is  against  this  decision  because 
it  was  made  after  the  nursing  assistants 
had  been  officially  accepted  into  the 
course  that  enables  them  to  become 
registered  nurses. 

Nicole  Du  Mouchel,  registrar  of 
ANPQ,  told  The  Canadian  Nurse  that 
many  of  the  60  nurses  who  are  now 


unable  to  take  this  course  had  left  their 
jobs  and  moved  to  Montreal.  The 
course  was  first  offered  a  year  ago  for 
some  160  nursing  assistants  who  must 
have  two  years  of  experience  and  a 
grade  1 1  high  school  education. 

Seven  colleges  offer  this  course,  which 
is  sponsored  by  the  departments  of 
education  and  manpower.  There  is 
no  legislation  in  Quebec  covering  nurs- 
ing assistants,  although  ANPQ  volun- 
tarily looks  after  their  interests. 
Through  its  school  of  nursing  com- 
mittee, ANPQ  has  approved  the  up- 
grading course  for  nursing  assistants. 

In  an  August  press  release,  ANPQ 
said  it  learned  July  30  that  it  had  been 
blamed  for  this  reduction  because  it 
supposedly  said  there  were  registered 
nurses  unable  to  find  work.  ANPQ 
denies  that  there  are  too  many  nurses 
in  the  province. 

With  a  shortage  of  highly  qualified 

(Conlinued  on  page  14) 
THE     CANADIAN     NURSE     11 


Presenting 
the  nn-lmen 

nureera.. 


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losses  and  over-use,  laundry  and  replacement 
costs  and  help  reduce  the  possibility  of  cross- 
infection. 

Details  on  a  complete  cost/usage  control  pro- 
gram with  this  modern  nursery  system  are 
available  from  your  FACELLE  Professional 
Products  Representative. 


I 


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NURSERY  Pi=IODUCTS 


The  Saneen  neuiborn  nursery  products 


Saneen 
neuiborn  diapers 

...for  babies  5Vj  to  12  pounds.  New 
FRESHABYES  single-use  diapers  for  new- 
borns are  made  of  facial  tissue  reinforced 
witfi  synthetic  tfireads  to  provide  a  unique 
combination  of  both  strength  and  softness. 
They  are  pre-folded  with  a  special  pleat,  de- 
signed to  prevent  seepage  around  the  legs. 


Saneen 
premature  diapers 

.  .  the  first  single-use  diaper  specifically  de- 
signed for  low  birth  weight  infants  of  less 
than  SVz  pounds.  Proportioned  fit  eliminates 
excess  bulk,  and  facial  tissue  softness  helps 
prevent  irritation  of  the  premature's  delicate 
skin.  Also  its  pure  cellulose  fluff  interior  has 
a  high  absorptive  capacity. 


Saneen 
nursery  underpad 

.  .  .  specially  sized  for  nursery  use.  New  10" 
X  17"  size  provides  extra  length  to  tuck-in 
edges  under  bassinet  mattress,  thereby  se- 
curing underpad  in  desired  position.  The  top 
cover  is  soft  facial  tissue  reinforced  with 
synthetic  threads,  and  the  underpad  is 
backed  with  polyethylene  for  complete  linen 
protection.  No  plastic  touches  the  baby's 
skin  and  all  four  edges  are  sealed  to  com- 
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Saneen 
infant  uiipes 

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Saneen 
medical  touiels 

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provide  for  rapid  absorbency,  softness  and  a 
high  degree  of  strength  when  wet.  The  12" 
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as  a  feeding  bib  or  burp  cloth. 


Saneen 
medical  touiels 

...  for  scale  liners  .  .  .  These  3-ply  towels 
provide  a  strong  yet  soft  scale  liner.  And  the 
towels  come  in  two  large  sizes  (12"  x  24" 
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Saneen 
bassinet  sheets 

These  single-use  sheets  are  made  of  two 
layers  of  cellulose  tissue,  reinforced  with 
synthetic  threads  to  stand  up  to  the  most 
active  babies.  Yet  their  facial  tissue  con- 
struction is  soft  to  a  baby's  skin.  Also  a  full 
28"  X  35"  size  allows  for  good  tuck-in  under 
the  mattress. 


Saneen 
cellulose  uiipes 


...  an  all-purpose  nursery  wipe,  and  suitable 
for  use  in  applying  the  weighing  technique 
suggested  in  "Recommended  Standards  for 
Maternity  and  Newborn  Care,"  Department 
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CLIP  AND  SAVE  THIS  AD  FOR  REFERENCE 


Hneen 


NURSERY  PROCXXITS 


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(Continued  from  page  11) 

nursing  personnel  in  certain  regions  and 
in  certain  categories  of  health  centers, 
the  allegation  of  an  overcrowed  labor 
force  cannot  be  justified,  ANPQ  says. 
Overcrowding  "might  originate  more 
from  limited  budgets,  poor  utilization 
of  nursing  personnel,  hospital-centered 
orientation,  and  the  minimum  level 
accepted  for  hours  of  care  for  certain 
categories  of  patients. 

"Without  being  against  control, 
ANPQ  believes  that  this  reduction  of 
the  student  population  must  be  done  in 
terms  of  future  admissions,  but  not 
after  candidates  have  been  accept- 
ed. ... " 

A  study  was  undertaken  this  year  by 
the  Quebec  departments  of  education 
and  social  affairs  to  reduce  the  number 
of  nursing  students.  Although  the 
ANPQ  has  been  unable  to  obtain  a 
copy  of  the  study  report,  it  says  the 
reason  implied  for  this  reduction  is  a 
limitation  of  clinical  fields,  the  number 
of  qualified  instructors,  and  overcrowd- 
ing of  the  labor  force. 


NBARN's  Research  Project 
Will  Start  In  Fall 

Fredericton,  N.B.  —  New  Brunswick 
Association  of  Registered  Nurses' 
$16,682  research  project  comparing 
two  patterns  of  staffing  a  hospital  unit 
will  get  underway  early  this  fall.  The 
project  will  take  approximately  three 
years  to  complete  and  will  be  directed 
by  Helen  Beath. 

Two  units  at  Moncton  Hospital, 
Moncton,  N.B.,  will  be  used  in  the 
project.  The  study  will  attempt  to  deter- 
mine whether  or  not  a  new  staffing 
pattern  is  superior  to  the  existing  pat- 
tern. 

One  of  NBARN's  objectives  is  to 
assure  qualified  nursing  care  for  the 
people  of  New  Brunswick  by  improv- 
ing and  maintaining  standards  for  nurs- 
ing service  and  education.  "Over  the 
years  the  needs  of  the  patients  have 
greatly  changed,"  said  a  NBARN  re- 
lease. "The  patient  is  more  knowledge- 
able. The  nurse  is  emerging  with  a 
different  viewpwint  and  a  different 
framework  of  knowledge,  especially 
the  baccalaureate  graduate.  The  hos- 
pital administrative  structure,  how- 
ever, has  remained  traditional." 

The  association  believes  research  is 
needed  to  demonstrate  that  a  staffing 
pattern  comprising  two  categories  of 
nurses,  the  baccalaureate  nurse  and 
the  diploma  nurse,  with  two  supporting 
health  workers,  health  unit  secretary 

14     THE     CANADIAN      NURSE 


and  wardkeeper,  will  result  in  improved 
patient  care  when  compared  with  the 
existing  staffing  pattern. 

The  utilization  of  all  nursing  skills 
can  be  improved  by  reorganizing  the 
staffing  pattern,  delegating  non-nursing 
duties  to  those  persons  properly  prepal  - 
ed  to  carry  them  out,  and  reducing  the 
number  of  supervisory  personnel,  said 
NBARN.  "We  feel  that  when  health 
workers  are  educated  to  a  role  and 
given  opportunity  to  carry  out  that 
role  there  will  be  increased  job  satisfac- 
tion. We  believe  that  the  nursing  needs 
of  society  can  best  be  met  by  two  groups 
in  nursing,  the  baccalaureate  nurse, 
prepared  in  the  university,  and  the 
diploma  nurse,  prepared  in  a  two-year 
program  within  the  general  education 
system." 

As  principal  investigator,  NBARN 
is  responsible  for  receiving  and  admin- 
istering the  project  funds.  NBARN's 
research  committee,  which  has  develop- 
ed the  project,  will  be  responsible  for 
its  supervision.  Members  of  the  commit- 
tee are:  chairman  Margaret  McPhed- 
ran,  Ruth  Dennison,  Jean  Anderson, 
Anna  Christie,  all  of  Fredericton;  Ka- 
therine  Wright  and  Sister  Huberte 
Richard,  both  of  Moncton. 

Change  To  Part-time  Hours 
Causes  Problems  For  Nurses 

Toronto,  Ont.  —  The  employment  rela- 
tions department  of  the  Registered 
Nurses'  Association  of  Ontario  in  a 
July  newsletter  said  there  have  been 
difficulties  for  nurses  changing  from 
full-time  to  part-time  status. 

Many  nurses  think  they  have  to  resign 
before  they  can  change  their  status  said 
the  department.  "Some  nurses  have 
done  so  on  the  expectation  they  would 
be  offered  part-time  employment,  only 
to  find  themselves  out  in  the  cold." 

These  nurses  could  not  lodge  a  griev- 
ance because  they  had  terminated  their 
employment  relationship.  The  depart- 
ment advises  that  the  best  way  to  avoid 
this  problem  is  to  state  clearly  a  trans- 
fer of  employment  status  from  full-time 
to  part-time.  It  adds,  "never  resign  if 
you  wish  to  retain  any  claim  against 
your  employer." 

Enclosed  in  the  newsletter  were 
copies  of  guidelines  to  be  followed  by 
nurses   filing   a   grievance.   A   simple 


St.  John  Ambulance  urgently  needs 
the  support  of  registered  nurses  to 
teach  home  nursing  and  child  care 
courses.  Nurses  who  would  like  to 
contribute  their  knowledge  and  skill 
to  this  worth  while  community  project 
should  write  to  their  provincial  St. 
John  headquarters.  The  headquarters 
for  each  province  is  located  in  the 
provincial  capital. 


statement  of  facts  and  redress  requested 
is  sufficient  on  the  grievance  form  itself, 
but  the  association  executive  requires 
more  detailed  information.  The  guide- 
lines were  designed  to  establish  all  the 
facts  in  the  case  and  are  to  be  used  in 
conjunction  with  other  grievance 
material. 

"Some  of  the  items  may  appear  to 
be  irrelevant,  but  grievances  are  fre- 
quently argued  on  the  interpretation  of 
a  subtle  point  in  a  collective  agreement, 
and  success  or  failure  may  hinge  on  an 
unexpected  twist  or  technicality,"  said 
the  guidelines. 

The  association  representative  should 
receive  a  separate  sheet  with  detailed 
answers  to  these  questions:  who  is  in- 
volved? what  happened?  when?  where 
did  the  incident  take  place?  why  is  this 
a  grievance?  what  redress  do  you  want? 

The  guidelines  continue,  "Redress 
should  always  be  requested  in  full. 
Because  of  delays  involved  in  the  griev- 
ance procedure  one  should  not  only  ask 
that  the  problem  be  eliminated  for  the 
present  and  future  but  retroactively 
back  to  its  commencement." 

By  May,  1971,  the  RNAO  employ- 
ment relations  department  was  servicing 
a  total  of  76  nurses'  associations  cover- 
ing more  than  5,000  nurses  in  the  prov- 
ince. A  breakdown  of  the  associations 
show  31  in  public  health,  39  in  hospi- 
tals, 1  in  a  school  board,  1  in  occupa- 
tional health,  4  in  independent  schools. 

ANPQ  Forms  Committee 
To  Study  Bill  65 

Montreal,  Quebec — The  Association 
of  Nurses  of  the  Province  of  Quebec 
has  formed  a  committee  to  study  the 
implications  of  bill  65,  which  was  pre- 
sented to  the  provincial  legislature  in 
July.  Minister  of  social  affairs,  Claude 
Castonguay,  developed  this  bill  to- re- 
organize health  and  social  services  in 
Quebec. 

The  comments  of  the  ANPQ  commit- 
tee will  be  presented  in  the  fall  to  the 
parliamentary  committee  on  social 
affairs.  The  ANPQ  has  also  invited 
members  of  other  paramedical  profes- 
sions to  join  in  presenting  a  common 
front  before  the  committee. 

Bill  65  details  funding  arrangements, 
licensing,  and  administrative  powers 
for  hospitals  and  social  service  agencies 
that  come  under  the  authority  of  the 
province.  First  to  be  affected  will  be 
community  centers  and  second,  social 
service  centers  such  as  children's 
homes,  and  family  service  centers,  now 
to  be  called  receiving  centers. 

As  the  department  of  social  affairs 
will  assume  the  initial  costs  of  the 
changeover,  the  bill  indicates  that 
private  institutions  cannot  continue  to 
function  unless  they  receive  a  permit 

(Continued  on  paf>c  16) 
OCTOBER     1971 


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OCTOBER      1971 


THE   CANADIAN   NURSE     15 


(Continued  from  page  14) 

from  the  minister.  Old  permits  will  he 
renewed  on  a  two-year  basis.  Moreover, 
the  department  will  not  pay  private 
institutions  a  daily  rate  higher  than  the 
public  ones  receive.  Private  institutions 
will  have  to  make  up  the  difference 
themselves. 

The  bill  also  provides  for  an  adminis- 
trative council  for  public  institutions  as 
a  method  of  bringing  together  the  de- 


partment and  the  citizens.  At  least  once 
a  year  the  council  would  hold  public 
rneetings  and  invite  the  local  popula- 
tion to  participate. 

For  administrative  purposes,  there 
will  be  committees  of  various  propor- 
tions appointed  to  watch  over  the  man- 
agement of  the  institutions.  At  commu- 
nity and  social  service  centers  the 
committee  will  have  14  members,  with 
seven  members  chosen  from  the  centers. 
Local  receiving  centers  will  have  a 
committee  of  eight,  again  with  half  of 
the  membership  chosen  from  the  cen- 
ters. 

The  bill  creates  local  community 
service   centers    to   supplant   existing 


your 
waiting  room 

^^%iH  I    1^^^  a  quieter  place 


A  sound  that  echoes  around  all  the  doctors*  waiting  rooms 

from  September  until  Spring  is  the  sound  of  coughing. 
Now  Parke-Davis  introduces  an  additional  formula  for  your 

coughing  patients:  BENYLIN®  DM  cough  syrup. 

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Dextromethorphan  together  with  the  antihistamine 

BENADRYL®  which  also  has  antispasmodic  action 


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are  drowsiness,  dizziness,  dryness  of  the 
mouth,  nausea  and  nervousness.  Palpita- 
tion and  blurring  of  vision  have  been  re- 
ported. Aa  with  any  drug,  allergic  reactions 
may  occur. 

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16     THE     CANADIAN     NURSE 


emergency  services  and  local  health 
units.  These  centers  will  be  under  the 
direction  of  a  nucleus  of  10  people, 
five  to  be  elected  for  a  term  of  four 
years  by  the  population  served  by  the 
center. 

To  act  as  a  liaison  mechanism  be- 
tween the  department  and  the  people, 
there  will  be  administrative  councils  for 
regional  medical  offices.  The  depart- 
ment will  nominate  half  the  members  of 
these  councils. 

The  first  attack  on  bill  65  came  from 
the  Pointe  St.  Charles  Community 
Clinic.  It  believes  that  citizens  should 
form  a  majority  on  the  local  community 
center  councils.  Dr.  Fran9ois  Leham, 
the  employees'  representative  on  the 
clinic's  present  administrative  council, 
and  Andre  Cardinal,  former  director 
of  the  clinic,  said  health  reform  would 
not  be  effective  without  participation 
of  consumers  in  the  centers'  manage- 
ment. 

According  to  them,  50  percent  repre- 
sentation by  the  population  will  not  put 
effective  control  in  the  hands  of  the 
consumers.  Control  would  still  be  in 
the  hands  of  health  professionals  as 
they  have  an  advantage  in  these  mat- 
ters over  the  ordinary  citizen,  said 
M.  Cardinal. 


NBARN  Fears  Future  Challenged 
By  Nursing  Education  Report 

St.  John,  M.B.  —  A  news  bulletin  issued 
in  August  by  the  New  Brunswick  Asso- 
ciation of  Registered  Nurses  says  the 
association's  future  has  been  challenged 
by  the  government-commissioned  re- 
port of  the  Study  Committee  on  Nursing 
Education. 

The  233-page  report,  made  public 
August  5  after  almost  a  year  of  study 
by  the  10-member  committee,  makes  30 
recommendations  about  nursing  educa- 
tion in  the  province  and  the  Registered 
Nurses'  Act  of  New  Brunswick. 

NBARN  is  particularly  concerned 
about  the  recommendation  to  replace 
the  .Registered  Nurses  Act  with  two 
boards,  one  to  look  after  regulation  of 
the  profession  and  one  to  look  after 
nursing  education. 

This  two-board  setup  calls  for  a 
Registered  Nurse  Regulation  Board 
responsible  to  the  minister  of  health 
for  registration  and  discipline  of  nurses 
and  participation  in  the  development 
of  national  exams,  and  a  Committee 
on  Education  of  RNs  to  "provide  advice 
and  recommendations  to  the  minister  of 
education  on  all  policies  and  standards 
relative  to  diploma  nursing  education." 

According  to  the  Study  Committee 
report,  "The  present  degree  of  control 
of  the  Association  over  all  matters 
relating  to  the  education  and  registration 

OCTOBER      1971 


of  nurses,  approval  of  schools,  and  so 
on,  leads  to  an  uneasiness  on  the  part 
of  the  public  who  feel  that  their  interests 
are  not  properly  safeguarded.  .  .  .  The 
Association  in  effect  acts  as  a  regulatory 
body,  an  educational  authority,  and  a 
professional  association.  These  multiple 
roles  raise  the  question  of  potential 
conflicts  of  interest." 

The  report  also  disapproves  of 
NBARN's  authority  over  the  education 
and  registration  of  nursing  assistants 
because  it  "involves  control  over  an- 
other group  who  are  not  represented 
on  the  governing  body."  For  this  reason 
it  recommends  setting  up  a  Registered 
Nursing  Assistant  Regulation  Board. 

NBARN  says  the  report  attacks  the 
association's  present  legislation  by 
completely  eliminating  the  profession's 
responsibility  for  nurses'  registration 
and  schools  of  nursing.  And  the  associa- 
tion considers  nurse  registration  under 
the  minister  of  health  undesirable  be- 
cause "under  such  a  system  nurses 
would  have  no  professional  voice  in 
matters  affecting  standards  of  patient 
care." 

Although  NBARN  has  favored  the 
phasing  out  of  hospital-based  diploma 
nursing  programs  (news,  March  1971, 
page  16),  it  is  critical  of  the  report's 
recommendation  that  "after  1971,  no 
further  students  should  be  enrolled  in 
hospital-based  schools."  The  report 
proposed  that  these  schools  be  replaced 
by  a  two-year  nursing  education  pro- 
gram to  be  given  in  four  independent 
regional  diploma  schools  of  Nursing. 
NBARN's  reservations  about  this  rec- 
ommendation are  "in  relation  to  the 
effects  on  patient  care  of  mass  with- 
drawal of  nursing  students  from  hos- 
pital schools  at  the  same  time,  and  the 
extremely  short  time  span  for  establish- 
ing three  new  schools  by  September 
1972."  There  is  already  one  independ- 
ent school  of  nursing  in  the  province. 

In  its  August  news  bulletin,  NBARN 
also  points  out  potential  dangers  that 
it  believes  could  arise  if  the  recommen- 
dations are  enforced.  Some  of  the  ques- 
tions it  asks  are:  "Would  standards 
for  registration  ...  be  lowered  under 
government  control?  Would  registration 
of  N.B.  nurses  be  recognized  by  other 
provincial  associations?  With  the  two 
separate  Boards  and  Ministers  control- 
ling nursing  education  and  registration, 
is  there  any  guarantee  of  coordination? 
Will  there  be  any  professional  unified 
voice  to  speak  on  behalf  of  nurses  to 
Government,  CNA  and  other  groups, 
or  to  stand  behind  the  individual 
nurse?" 

To  help  counter  what  it  terms  "a 
very  serious  threat ...  to  the  concept 
of  professionalism,"  NBARN  planned 
to  hold  a  meeting  of  its  ad  hoc  commit- 
tee and  a  meeting  with  Health  Minister 
Paul  Creaghan.  The  association  believ- 

OCTOBER      1971 


ed  this  meeting  would  "determine 
whether  'negotiations'  can  be  carried 
out  quietly  between  Government  and 
NBARN  officials,  or  whether  every 
NBARN  member  will  have  to  come  to 
her/his  association's  defence.  A  plan 
for  individual  nurse  and  group  action 
will  be  developed  on  the  basis  of  this 
meeting.  .  .  ." 

Other  plans  call  for  developing  a 
position  paper  based  on  its  reaction 
to  the  total  report;  keeping  its  members 
informed  through  study  sessions  and 
other  means;  and  meeting  with  mem- 
bers of  the  provincial  legislature,  with 
representatives  of  the  Association  of 
New  Brunswick  Nursing  Assistants, 
and  with  other  professional  associa- 
tions. 


Union  Survey  Gives 
Composite  of  Quebec  Nurses 

Montreal,  Quebec —  To  take  the  pulse 
of  the  Quebec  nursing  profession,  the 
United  Nurses  union  did  an  extensive 
survey  of  the  province's  nurses  this 
spring. 

Specialists  prepared  the  questionnai- 
re, space  was  rented,  and  up  to  90  tele- 
phones were  installed.  Results  were 
compiled  by  computers.  Survey  excerpts 
show: 

•  43  percent  of  the  nurses  registered 
in  Quebec  are  between  24  and  34  years 
of  age. 

•  55  percent  are  married. 

•  2  percent  belong  to  religious  orders. 

•  90  percent  have  a  basic  nursing 
diploma. 

•  3  percent  have  had  additional  training 
since  graduation. 

•  5  percent  hold  a  bachelor's  degree 
in  nursing  or  credits  toward  a  degree. 

•  34  percent  have  over  12  years'  expe- 
rience. 

•  86  percent  work  in  hospitals. 

•  14  percent  are  employed  in  public 
health  services,  private  duty,  nursing 
schools,  industrial,  and  school  hygiene. 

•  70  percent  of  the  nurses  work  in  the 
Montreal  region,  and  1 1  percent  in 
Quebec  City. 

•  75  percent  of  hospital  nurses  are 
full-time  employees. 

•  72  percent  work  on  a  regular  time 
schedule,  28  percent  are  on  rotation; 
at  the  supervisory  level,  1 3  percent  work 
on  a  rotation  basis. 

•  24  percent  of  the  nurses  work  in  a 
department  assigned  by  the  employer. 

•  42  percent  are  confident  that  their 
association  can  ensure  the  proper  eval- 
uation of  the  nursing  profession  in 
Quebec;  3 1  percent  believe  that  a  union 
can  do  more;  27  percent  don't  know, 
did  not  say,  or  counted  on  other  means 
to  protect  their  interests. 

•  3  percent  of  nurses  in  Quebec  are 
unemployed;  23  percent  of  this  number 


are  English-speaking  and  77  percent 
are  French-speaking.  The  largest  num- 
ber of  unemployed  nurses  are  concen- 
trated in  Montreal. 


Flexible  Program  Prepares 
Researchers  At  U.  Of  Alberta 

Edmonton,  Alta. —  Virtually  any 
selection  of  classes  from  the  Division 
of  Health  Services  Administration,  as 
well  as  classes  from  elsewhere  on  the 
campus,  can  be  put  together  for  a  year 
or  a  half-year  of  research  training, 
according  to  Dr.  Carl  A.  Meilicke, 
director  of  University  of  Alberta's  new 
program. 

Preparation  for  research  and  nursing 
service  administration  is  offered  by  the 
University  of  Alberta  in  a  two-year 
program  leading  to  the  degree  Master 
of  Health  Services  Administration 
under  the  direction  of  the  Faculty  of 
Graduate  Studies. 

The  first  year  of  the  MHSA  program 
can  be  taken  on  a  part-time  basis,  or 
taken  as  a  year  of  full-time  study  follow- 
ed by  a  gap  in  time  before  the  full-time 
second  year.  It  is  also  feasible  for  a 
student  to  attend  the  University  of 
Alberta  for  a  year  of  specialized  re- 
search training  that  does  not  necessarily 
conform  to  the  first  year  requirement. 

The  details  of  a  student's  course 
requirements  can  be  substantially  tailor- 
ed to  his  background  and  career  inter- 
ests. 

In  the  MHSA  program,  the  student 
who  chooses  nursing  service  adminis- 
tration as  an  area  of  concentration  has 
the  choice  of  a  thesis  or  non-thesis 
option. 

Selection  of  the  thesis  option  is 
recommended  for  students  who  have  a 
primary  interest  in  learning  research 
skills.  The  non-thesis  option  is  more 
suitable  for  students  choosing  to  em- 
phasize skills  related  to  administration 
and  management.  In  addition  to  an 
area  of  concentration  and  the 
thesis/non-thesis  options,  the  program 
permits  enough  flexibility  for  subjects 
of  special  interest  to  be  pursued  in  con- 
siderable depth. 

Dr.  Shirley  Stinson,  director  of  the 
University  of  Alberta  School  of  Nurs- 
ing, is  a  faculty  member  of  the  MHSA 
program. 

Requirements  for  admission  to  the 
MHSA  program  are  a  baccalaureate  de- 
gree wiii  an  average  of  at  least  65  per- 
cent in  the  work  of  the  final  two  years, 
submission  of  the  results  of  a  Miller 
Analogies  Test,  and  a  statement  from 
the  director  of  the  Division  of  Health 
Services  Administration  that  the  appli- 
cant is,  in  all  respects,  acceptable  to  the 
program. 

For  further  information  about  the 

(Conliniied  on  page  20) 
THE     CANADIAN     NURSE     17 


0 


^ 


«     Easy 
Splashdown! 


The  major  use  for  irrigating  soiutions  is 
in  pour  procedures.  Throughout  the 
hospital!  Now,  with  the  Urogate*  system 
you  have  all  the  advantages  of  a  container 
specially  designed  for  use  in  pouring. 


You  can  empty  this  3,000  ml.  Urogate 
bottle  in  seconds  flat! 


There's  a  generous  38  mm.  opening  on 
the  3,000  ml.  Urogate  bottle.  It  lets  you 
pour  irrigating  solution  quickly . .  , 
smoothly . . .  copiously. 

With  a  single  easy  twist  of  the  cap,  you 
unseal  the  container.  A  special  slip-disc 
assures  easy  opening.  The  "business" 
end  of  this  Urogate  container  features 
a  pair  of  lifting  lugs  or  "ears".  With 
these,  you  can  lift  and  transport  the 
bottle  conveniently  and  safely. 

At  the  base  of  the  container,  there's  the 
unique  Nauta*  bail.  When  you  want  to 
suspend  the  Urogate  solution,  the  Nauta 
bail  snaps  upright.  (And  stays  there ! ) 
Both  your  hands  are  free  to  position 


the  inverted  bottle  on  its  hanger. 

In  addition  to  the  3,000  ml.  Urogate, 
Abbott  also  provides  a  1,500  ml.  con- 
tainer where  smaller  quantities  of  fluid 
are  required.  You  control  the  quantity 
and  direction  of  pour  naturally.  With 
just  one  hand.  On  either  side  of  the 
bottle,  deep  indentations  give  you  a  firm, 
comfortable  grip. 

Whatever  your  irrigating  needs,  see 
your  Abbott  representative.  He  can 
help  you  choose  the  right  size  Urogate 
container  to  meet  your  needs,  be  it  a 
3,000  ml.,  1,500  ml.,  or  the  new  smaller 
sizes ;  1,000  ml.,  and  500  ml. 


001171 


Urogate 


Most  widely  used  of  all 
irrigating  solution  systems 


UROGATE  EQUIPMENT 

4689  Urogate  Cystoscopy  Set 

4687  Urogate  Irrigation  Set 
4692  Urogate  Secondary  Urologic 

Irrigation  Set 
4694  Urogate  "Y"  Connector 

4688  Urogate  T-U-R  Irrigation  Set, "  Y"  Type 

And  the  netv 
4777  Urogate  Catheter  Irrigation  Set 
4759  Urogate  Urinary  Drainage  System  "DrainboxTW" 


Now  available  with  38  mm.  openings: 

1,500  ml.  and  3,000  ml.,  and  the  new  500  and  1,i 

Wide-mouth  1,000  ml.  bottle  empties 

In  Just  7  seconds . . .  one-third  the  time 

It  took  with  the  28  mm.  opening  formerly  used! 

•RD.  T.M. 

I PMAC I 

TM  —  Trademarks 


UROGATE  SOLUTIONS 

6205  Sodium  Chloride  Solutions,  U.S.P. 

6209  Water  for  Irrigation 

6218  Glycine  Solution,  1.5 f^r 

6937  Urologic  Solution,  Suby's  Solution  G 

6429  Glycine  for  Dilution 


500  ml.    1,000  ml.   1,500  ml.   3,000  ml. 


(Continued  from  page  17) 

program  and  about  available  financial 
assistance,  write  to:  Division  of  Health 
Services  Administration,  Faculty  of 
Medicine,  University  of  Alberta,  Ed- 
monton 7,  Alberta. 


DNHW  Study  Confirms  Need, 
Proposes  Psychiatric  Courses 

Ottawa —  Short  courses  ofnot  less  than 
six  months  to  prepare  registered  nurses 
in  psychiatric  nursing  are  recommended 
in  the  report  of  a  study  carried  out  by 
two  Department  of  National  Health  and 
Welfare  nurse  consultants. 

The  courses  should  be  held  in  each 
of  Canada's  five  regions:  British  Colum- 
bia, the  prairies,  Ontario,  Quebec,  and 
atlantic,  according  to  the  study. 

The  report  further  recommends  that 
two  pilot  projects,  one  in  French  and 
the  other  in  English,  be  established  to 
test  and  evaluate  the  course  guidelines 
suggested  in  the  study. 

Mental  health  nurses,  meeting  in 
Fredericton,  N.B.,  at  the  time  of  the 
Canadian  Nurses'  Association  biennial 
in  June,  1970,  discussed  the  need  for 
more  registered  nurses  with  current 
mental  health  and  psychiatric  nursing 
knowledge  and  experience. 

Following  the  June,  1970,  meeting, 
the  two  consultants,  Elizabeth  D.  Mc- 
Cue  of  Mental  Health  Division,  and 
Beverly  M.  DuGas  of  Manpower  Plan- 
ning Division,  conducted  a  survey  of  the 
provinces  to  secure  data  on  the  need 
for  nurses  with  this  additional  back- 
ground. 

A  working  party  of  six  mental  health 
and  psychiatric  nursing  experts  from 
Canada's  five  regions  met,  following 
the  tabulation  of  survey  data,  to  develop 
guidelines  for  a  short  course  for  regis- 
tered nurses  in  mental  health  and 
psychiatric  nursing.  They  recommended 
that  each  short  course  be  established 
in  a  teaching  center  affiliated  with  a 
center  for  higher  education. 

Guidelines  for  administrative  and 
financial  policy,  selection  of  candidates 
and  faculty,  and  course  content  were 
worked  out  by  the  group  that  included 
Helen  Gemeroy  of  Vancouver,  M.C. 
Schreder  of  Regina,  Dorothy  Burwell 
of  Toronto,  Lorine  Besel  and  Victorine 
LeClair  of  Montreal,  and  Ryllys  Cutler 
of  Fredericton.  Mrs.  McCue  was  chair- 
man of  the  working  party  and  Dr.  Du- 
Gas, assistant  chairman. 

Survey  data  and  short  course  guide- 
lines are  published  in  Report  of  study 
of  the  need  for  short  term  courses  in 
20     THE     CANADIAN     NURSE 


psychiatric  nursing  for  registered  nurses 
in  Canada,  available  on  loan  fromCNA 
library. 

The  CNA  has  complimented  the 
DNHW,  through  a  letter  to  Dr.  Mau- 
rice LeClair,  deputy  minister  of  health, 
for  having  undertaken  the  study,  for 
convening  the  working  party,  and  for 
proposing  recommendations  to  amelio- 
rate the  present  situation.  In  the  letter 
the  CNA  urged  that  the  proposals  in 
the  report  be  given  the  full  support  of 
the  department  of  national  health  and 
welfare. 

Mrs.  McCue  told  The  Canadian 
Nurse  that  finances  have  so  far  prevent- 
ed initiation  of  the  pilot  projects  to 
test  the  short  course  guidelines. 

In  the  survey  of  need  for  additional 
preparation,  conducted  by  Mrs.  McCue 
and  Dr.  DuGas,  figures  for  1968  and 
1969  indicate  that  the  greatest  number 
of  registered  nurses  employed  in  Cana- 
dian mental  hospitals  in  all  categories, 
including  those  positions  with  admin- 
istrative responsibility,  had  no  addition- 
al preparation  beyond  the  basic  course. 

Six  provinces  (British  Columbia, 
Saskatchewan,  Manitoba,  Ontario,  Nova 
Scotia,  and  Newfoundland)  replied  to 
the  questionnaire  sent  out  by  the  nurse 
consultants;  all  expressed  a  need  for 
considerable  numbers  of  registered 
nurses  with  additional  psychiatric 
preparation,  or,  conversely,  registered 
psychiatric  nurses  with  registered  nurse 
preparation.  The  number  required  vari- 
ed from  50  in  one  province  to  88  in 
another.  In  five  years,  it  is  anticipated 
that  the  need  will  be  doubled  in  one 
province  and  increased  substantially 
in  the  others. 

The  total  registered  nurse  staff  in 
mental  retardation  facilities  in  all  prov- 
inces, except  Nova  Scotia  and  New- 
foundland who  did  not  supply  data  in 
this  area  of  the  survey,  amount  to  only 
7.24  percent  of  a  total  staff  of  6,419. 

Qualifications  indicate  thata  majority 
of  nursing  personnel  employed  in  Cana- 
dian institutions  for  mental  retardates 
are  registered  psychiatric  nurses  in  the 
western  provinces,  and  nursing  assis- 
tants in  the  east.  "Other  nursing  per- 
sonnel" also  form  a  very  large  group  in 
mental  retardation  facilities  in  four 
provinces,  according  to  1968  DBS 
figures. 


First  Nursing  Intersession 
Chosen  by  RNs  at  Windsor  U. 

Windsor,  Ont.  — For  the  first  time  this 
year,  students  in  the  school  of  nursing 
at  the  University  of  Windsor  were  offer- 
ed the  choice  of  taking  the  course  in 
community  health  nursing  and  commu- 
nity health  services  during  the  regular 
school  year  or  during  the  six-week 
intersession  in  June  and  July,  1971. 
Twenty  students,  all  RNs,  elected  to 


take  the  course  during  the  intersession. 

The  course  in  community  health 
nursing  is  part  of  both  the  four-year 
program  for  high  school  graduates  and 
the  two-year  program  for  RNs,  leading 
to  a  baccalaureate  degree  in  nursing. 

Students  attended  lectures  and  had 
clinical  practice  in  the  public  health 
units  and  with  the  Victorian  Order  of 
Nurses  in  Chatham  and  St.  Thomas, 
Ontario,  under  the  guidance  of  three 
experienced  public  health  nurses  who 
were  employed  as  part-time  clinical 
teachers  for  the  six-week  period.  The 
community  health  nursing  course  is 
under  the  direction  of  Mrs.  Margaret 
Wilson. 

The  classes  and  experiences  were 
the  same  as  those  planned  for  the  course 
given  in  the  winter,  but  Anna  Gupta, 
director  of  the  University  of  Windsor 
School  of  Nursing,  admits  that  the  inter- 
session is  intensive. 

Mrs.  Gupta  told  The  Canadian  Nurse 
that  students  and  faculty  of  the  school 
of  nursing  are  pleased  with  the  experi- 
ence of  the  first  intersession  course, 
and,  if  demand  warrants,  the  course 
will  be  repeated  as  an  intersession 
elective. 


250  RNs  Enter  Montreal 

Community  Health  Course 

Montreal — A  certificate  program  in 
community  nursing,  offered  by  the 
continuing  education  service  of  the 
University  of  Montreal  in  collaboration 
with  the  Faculty  of  Nursing,  has  attract- 
ed 250  students  to  its  first  course,  which 
started  this  fall. 

The  program  will  prepare  registered 
nurses  to  work  in  the  community  health 
centers  that  are  a  part  of  the  new  health 
care  system  of  the  Quebec  ministry  of 
social  affairs. 

The  certificate  course  may  be  taken 
in  one  year  of  full-time  study  or  up  to 
three  years  of  part-time  study.  Courses 
for  the  full-time  students  are  given  in 
the  day  and  evening,  those  for  part-time 
students  in  the  evening  only. 

To  be  eligible  for  admission  to  the 
certificate  program,  a  registered  nurse 
must  have  at  least  one  year's  work 
experience  in  the  past  five  years.  The 
language  of  instruction  at  the  University 
of  Montreal  is  French. 

For  information  about  the  program, 
write  to  the  secretary.  Continuing  Edu- 
cation Service,  University  of  Montreal, 
3333  Chemin  de  la  Reine-Marie,  C.P. 
6128,  Montreal  101,  Quebec. 

Nurse  Researches  Portable 
Human  Waste  Disposal  Systems 

London,  England — A  nurse,  Miss 
Pamela  J.  Rogers,  is  a  member  of  a 
team  of  four  scientists  making  a  com- 
prehensive study  of  the  problem  of  the 
OCTOBER     1971 


disposal  of  human  wastes  from  patients 
at  home  and  in  hospital.  The  National 
Research  Development  Corporation 
of  U.K.  has  commissioned  the  study, 
which  is  supported  in  part  by  the  De- 
partment of  Health  and  Social  Security 
of  the  U.K. 

Miss  Rogers  recently  became  the 
first  nurse  to  receive  the  degree  of 
Master  of  Design,  Royal  College  of  Art, 
London.  She  is  a  State  Registered  Nurse 
and  a  State  Certified  Midwife. 

Patients  and  nursing  staff  in  hos- 
pitals and  nursing  homes,  and  relatives 
in  home  situations  are  faced  by  nu- 
merous and  sometimes  unpleasant  prob- 
lems in  the  use  of  portable  toilet  equip- 
ment, such  as  commodes,  bedpans, 
sani-chairs  and  urinals.  The  improve- 
ment of  these  items  is  the  subject  of  the 
study.  The  work  is  expected  to  produce 
a  number  of  prototypes  for  manu- 
facture. 

The  provisions  of  adequate  toilet 
facilities  for  patients  in  hospital  and  in 
the  home  is  a  problem  that  is  steadily 
increasing  in  step  with  the  rising  average 
age  of  patients. 

Formerly  Miss  Rogers  was  concern- 
ed with  the  development  of  a  Depart- 
ment of  Geriatric  Medicine  as  part  of 
the  new  Charing  Cross  Hospital  at 
Fulham,  England. 


NWT  Ski  Training  Program 
An  Experiment  in  Motivation 

Ottawa  —  The  government  of  the 
North-west  Territories  has  received  a 
$25,000  federal  sports  grant  for  the 
1971-72  Territorial  Experimental  Ski 
Training  program.  The  TEST  is  a  re- 
search program  using  cross-country 
skiing  to  motivate  Indian,  Eskimo, 
and  Metis  people  of  the  north. 

In  1964  Rev.  J.  Mouchet,  a  Roman 
Catholic  priest,  introduced  cross-coun- 
try skiing  as  a  recreation  for  teenagers 
living  in  hostels  while  attending  school 
in  Inuvik,  1,200  miles  north  of  Edmon- 
ton. The  youngsters  responded  enthu- 
siastically and  in  1967  Bjorger  Petter- 
sen,  a  Norweigian  ski  instructor  who 
had  conducted  spring  courses  in  Inuvik 
in  1965  and  1966,  was  hired  as  a  full- 
time  coach. 

Sixty  percent  of  Canada's  cross- 
country ski  team  are  TEST  products, 
and  these  include  two  of  the  world's 
best  junior  cross-country  skiers,  Sharon 
and  Shirley  Firth,  the  17-year-old 
Inuvik  twins.  More  than  250  Indian, 
Eskimo,  and  Metis  youngsters  are 
training  up  to  six  days  a  week  under 
the  program. 

The  grant  will  help  the  Northwest 
Territories  defray  the  cost  of  continuing 
the  present  experimental  ski  training 
program  in  the  1971-72  fiscal  year.  ■§ 

OCTOBER      1971 


NEW  POSEY  DEVELOPMENTS 


The  new  Posey  products  shown 
here  are  but  a  lew  included  in  the 
complete  Posey  Line.  Since  the 
introduction  ol  the  original  Posey 
Safety  Belt  in  1937,  the  Posey 
Company  has  specialized  in 
hospital  and  nursing  products 
which  provide  maximum  patient 
protection  and  ease  ol  care.  To 
insure  the  original  quality  product, 
always  specify  the  Posey  brand 
name  when  ordering. 

The  Posey  Pelvic  Seat  effectively 
prevents  sliding  forward  and  fall- 
ing from  chair.  This  device  is  se- 
cured from  behind  on  any  type  of 
chair  and  is  comfortable  for  the 
patient.     #4432  (cotton),  $7.50. 


The  Posey  "Swiss  Cheese"  Heel 
Protector  has  new  hook  and  eye 
fasteners  for  easy  application  and 
sure  fit.  Available  in  convoluted 
porous  foam  or  synthetic  fur  lin- 
ing. #6727  (fur  lining),  #6722 
(foam),  $4.80  pr. 


The  Posey  Body  Stop  Kit  with 
soft  padded  bar  provides  a  quick, 
simple,  and  effective  method  of 
preventing  a  patient  from  "scoot- 
ing" forward  in  any  standard 
wheelchair.     #8755,  J24.95. 


The  Posey  Houdini  Security 
Suit  is  for  the  patient  that  will  not 
stay  in  bed  or  wheelchair.  Vest  and 
lower  portion  interlock  with  waist 
belt  making  it  virtually  escape- 
proof    #3472,  575.00  complete. 


The  Posey  Foot-Guard  with  new 
"T"  bar  stabilizer  simultaneously 
keeps  weight  of  bedding  off  foot, 
helps  prevent  foot  drop  and  foot 
rotation.    #6472,   $27.00. 


Send  for  the  free  all  new  POSEY  catalog  -  supersedes  all  previous  editions. 
Please  insist  on  Posey  Quality  -  specify  the  Posey  Brand  ryame. 


0aa4^ 


POSEY  PRODUCTS 
Stocked  in  Canada 

ENNS  &  GILMORE  LIMITED 

1033  Rangeview  Rood 
Port  Credit,  Ontario,  Canada 


names 


Rachel  Lamothe 


Nancy  Garrett 


Rachel  Lamothe  and  Nancy  Garrett  have 
been  appointed  nursing  consultants/ 
research  analysts  to  the  Canadian 
Nurses'  Association.  Miss  Lamothe 
and  Miss  Garrett  join  two  other  nursing 
consultants  on  the  staff  at  CNA  House, 
Rose  Imai  (Names  Nov.  '70)  and  Sister 
Bachand  (Names  Sept.  '71). 

Miss  Lamothe  received  a  bachelor  of 
nursing  degree  from  the  University  of 
Montreal,  and  a  master  of  nursing  de- 
gree from  the  University  of  California, 
Los  Angeles.  She  has  worked  in  the 
obstetrical  units  of  the  Royal  Victoria 
Hospital,  the  Fleury  Hospital,  and  the 
Bellechasse  Hospital,  all  in  Montreal. 

Miss  Garrett  is  a  graduate  of  the  St. 
Paul's  Hospital  School  of  Nursing  in 
Vancouver.  She  obtained  a  bachelor  of 
science  degree  from  Columbia  Univer- 
sity in  New  York,  as  well  as  a  master 
of  public  health  degree  from  the  Univer- 
sity of  Michigan  School  of  Public 
Health,  Ann  Arbor,  Michigan. 

Miss  Garrett  served  as  a  joint  med- 
ical director  for  Canadian  University 
Service  Overseas  in  Delhi,  India,  a 
public  health  instructor  in  India,  a  car- 
diac monitor  nurse  at  the  Columbia 
Presbyterian  Hospital  in  New  York, 
and  as  an  operating  room  nurse  with 
the  New  York  Hospital  for  Special 
Surgery. 


Eleanor  MacDougall 

(Reg.N.,  Ottawa 
Civic  Hosp.  School 
of  Nursing)  has 
been  appointed  dis- 
trict director  of  the 
Greater  Montreal 
branch  of  the  Vic- 
torian Order  of 
Nurses.  Miss  Mac- 
Dougall was  previously  regional  direc- 
tor of  the  VON  for  Alberta  and  Sas- 
katchewan. She  has  been  a  member  of 
VON  since  1954. 

22     THE     CANADIAN     NURSE 


Eleanor  Linnell  (R.N.,  Regina  General 
H.  School  of  Nursing,  Regina,  Sask.; 
B.Sc.N.,  U.  of  Western  Ontario,  Lon- 
don; B.Ed.,  U.  of  Saskatchewan,  Sas- 
katoon) succeeded  Madge  McKlllop  as 
president  of  the  Saskatchewan  Regis- 
tered Nurses'  Association  at  its  annual 
meeting  in  Saskatoon  in  May.  Miss 
Linnell  is  director  of  nursing  educa- 
tion at  the  Regina  General  Hospital 
School  of  Nursing. 

The  new  president 
has  a  wide  variety  of 
nursing  exjjerience. 
She    was     a    staff 


^,  •  —  nurse,  operating 
— ^  '  room  mstructor,  and 
nursing  instructor 
all  at  the  Regina 
General  Hospital, 
and  head  operating 
room  nurse  at  the  Ottawa  Civic  Hospi- 
tal in  Ottawa.  Miss  Linnell  also  served 
as  a  general  duty  nurse  in  psychiatric 
nursing  at  Westminster  Hospital  in 
London,  Ontario,  and  as  an  operating 
room  nurse  at  Toronto  Western  Hospi- 
tal in  Toronto. 

Evelyn  Pepper  was 

selected  by  the  In- 
ternational Com- 
mittee of  the  Red 
Cross  as  one  of  35 
nurses  from  1  8 
countries  to  be  a- 
warded  the  Flor- 
ence Nightingale 
Medal.  The  award, 
considered  the  highest  in  nursing,  is  only 
one  of  many  honors  received  by  Miss 
Pepper  in  her  long  and  distinguished 
nursing  career. 

She  is  the  first  civil  servant  and  the 
eleventh  Canadian  to  receive  the  award 
since  1927.  Until  her  retirement  in 
1970,  Miss  Pepper  had  been  nursing 
consultant  in  the  emergency  health  ser- 
vices division  of  the  department  of 
national  health  and  welfare. 

Geraldine  R.  Clements  (R.N.,  Saint 
John  General  H.,  N.B.;  B.N.,  Dalhousie 
U.,  Halifax,  N.S.)  has  been  appointed 
director  of  nursing  at  the  Oromocto 
Public  Hospital,  Oromocto,  New 
Brunswick.  Mrs.  Clements  is  the  form- 
er director  of  nursing  at  the  Sackville 
Memorial  Hospital  in  Sackville,  N.B. 
She  has  also  served  as  an  office  nurse 
with  the  Fredericton  Medical  Clinic  in 
Fredericton,  N.B.,  general  duty  nurse 


and  night  supervisor  at  the  Victoria 
Public  Hospital  in  Fredericton,  and  as 
an  obstetrical  supervisor  at  the  Sackville 
Memorial  Hospital. 

The  new  director  of  nursing  at  Oro- 
mocto Hospital  is  an  active  member  of 
the  New  Brunswick  Association  of 
Registered  Nurses  and  is  chairman  of 
the  NBARN  Committee  on  Evalua- 
tion of  Schools  for  Nursing  Assistants. 

Thelma    M.    Schorr 

(R.N.,  Bellevue  H. 
School  of  Nursing, 
New  York;  B.A., 
Teachers  College, 
Columbia  U.,  New 
York.)  was  appoint- 
ed editor  of  the 
American  Journal 
of  Nursing  on  Au- 
gust 1,  1971. 
Mrs.  Schorr  has  been  a  member  of 
tne  journal's  staff  since  1 950,  when  she 
was  a  part-time  assistant  editor.  Most 
recently  she  has  been  executive  editor 
for  three  months  following  the  resigna- 
tion of  Barbara  G.  Schutt  as  editor  in 
April  (Names  June  1971).  Before  that 
she  was  senior  editor  in  charge  of  AJN's 
clinical  content,  and  associate  editor. 

Helen  McArthur 

retired  in  July  after 
25  years  as  national 
director  of  nursing 
with  the  Canadian 
Red  Cross  Society. 
Dr.  McArthur  is  the 
first  nurse  to  have 
received  an  Honor- 
ary Citation  from 
the  Canadian  Nurses'  Association 
(News,  May  1971).  She  is  a  recognized 
leader  in  nursing  on  the  national  and 
international  levels. 

Apolllne  Robichaud  (R.N.,  St.  Mary's 
H.,  Montreal;  B.Sc.  N.,  M.A.,  Colum- 
bia U.,  New  York)  was  elected  pres- 
ident of  the  New  Brunswick  Associa- 
tion of  Registered  Nurses  at  their  55th 
annual  meeting  in  May  in  Saint  John, 
New  Brunswick. 

Miss  Robichaud  is  director  of  public 
health  nursing  for  New  Brunswick.  Her 
professional  experience  also  includes 
public  health  nursing  in  Bathurst  and 
Newcastle,  New  Brunswick,  and  lectur- 
ing at  Teachers'  College,  Fredericton, 
New  Brunswick - 

(Cont'd  on  page  24) 

OCTOBER      1971 


These  features  are  what  makes 

dermicel 

Surgical  Tape 

the  tape  of  things  to  come 

—  for  its  hypo-reactivity  —  making  it  especially  well  tolerated  by  patients  with  a  history 
of  tape  sensitivity  —  and  of  course  '■'■'jv-^^  .^'''■"'  not  counting  Dermicel's  special 
ability  to  peel  off  the  skin  —  especially  hair-bearing  surfaces  —  pain- 

I 
ji 

lessly  and  with  an  absolute  minimum  of  skin  reaction  —  and  if  you    ''s'.'',y>/l',ij!]! 
disre^^T^  gard  Dermicel's  single  ingredient  adhesive  mass,  something  of  an 
ES^S3^!^i/ innovation  in  the  evolution  of  surgical  tape  —  and  finally  of  course,  pro- 
vided you  overlook  the  ultimate  difference  about  Dermicel  —  the  fact  that  it  looks 

different  and  feels  different  and  is  better  to  work  with  than  traditional  surgical  tape 

I* 


dermicel 

Surgical  Tape 

another  improvement  from 

/I  (J  LIMITED 


®  J&J  'Trademark  of  Johnson  &  Johnson  or  Affiliated  Companies. 


names 


(Continued  from  page  22) 

Kay  Sjoberg,  project  director  of  a  major 
nursing  study  at  the  University  of 
Saskatchewan,  died  on  August  15,  1971 
in  Saskatoon. 

Mrs.  Sjoberg  was  a 
graduate  of  the 
University  of  Sas- 
katchewan School 
of  Nursing.  Since 
1967  she  has  been 
on  the  staff  of  the 
Hospital  Systems 
Study  Group  of  the 
University  of  Sas- 
katchewan. An  article  she  wrote  de- 
scribing her  research,  called  "Unit 
Assignment  —  A  New  Concept"  ap- 
peared in  the  July  1969  issue  of  The 
Canadian  Nurse.  Phase  III  of  the  study 
that  Mrs.  Sjoberg  was  working  on  before 
her  death  involved  the  implementation 
and  assessment  of  the  unit  assignment 
on  a  multiple  ward  basis. 

The  effect  of  Mrs.  Sjoberg's  work 
will  be  felt  in  nursing  for  many  years 
to  come.  Her  main  objective  was  to 
find  methods  to  provide  for  personaliz- 
ed care  by  professional  nurses. 

Claire  Tissington 

(B.Sc.N.,  U.  of  Al- 
berta, Edmonton; 
M.Sc.  (A),  McGill 
U.,  Montreal)  has 
been  appointed  di- 
rector of  education 
services  of  the  Reg- 
istered Nurses'  As- 
sociation of  British 
Columbia.  For  the  past  two  years  Miss 
Tissington  has  been  associate  director 
of  the  Hamilton  and  District  School 
of  Nursing,  Hamilton,  Ontario. 

She  was  a  general  duty  nurse  at  the 
Edmonton  General  Hospital  in  Ed- 
monton, and  instructor  at  the  Miser- 
icordia  Hospital  in  Edmonton  and  also 
at  the  Hotel  Dieu  Hospital  in  Kingston, 
Ontario. 

Miss  Tissington  was  a  Canadian 
Nurses'  Foundation  fellow  in  1968. 

lessie  MacCarthy  (R.N.,  Vancouver 
General  H.,  Vancouver,  B.C.;  B.S.N. , 
U.  of  British  Columbia)  is  the  first 
woman  to  be  elected  to  the  management 
committee  of  the  Canadian  Tuberculo- 
sis and  Respiratory  Disease  Associa- 
tion. Miss  MacCarthy  is  a  nurse  epide- 
miologist and  an  assistant  professor  at 
the  University  of  British  Columbia. 

Before  being  appointed  to  this  com- 
mittee she  was  chairman  of  the  British 
Columbia  branch  of  the  CTRDA. 

24     THE     CANADIAN     NURSE 


Doris  I.  Small  retir- 
ed from  the  Vic- 
torian Order  of 
Nurses  at  the  end  of 
April  after  27  years 
service  with  VON. 
From  1953  until 
her  retirement,  she 
was  district  director 
ofthe  Greater  Mont- 
real branch  of  the  Victorian  Order. 

A  native  of  Western  Canada,  Mrs. 
Small  graduated  from  The  Winnipeg 
General  Hospital  and  took  prostgradu- 
ate  courses  in  public  health  nursing  at 
the  universities  of  Toronto  and  McGill. 
Before  she  joined  the  VON  in  Mont- 
real, Mrs.  Small  worked  for  the  VON 
in  Trenton,  Ontario,  as  nurse-in-charge 
and  in  Owen  Sound,  Ontario.  She  was 
then  transferred  to  Lincoln  County  as 
nurse-in-charge  of  the  organization 
of  the  first  county  VON  branch,  and 
was  later  appointed  to  the  national 
organization  as  junior  assistantdirector- 
in-chief,  responsible  for  the  supervision 
of  the  branches  in  the  Ottawa  valley. 
During  her  stay  at  national  office,  she 
completed  the  organization  of  the  first 
branch  in  Newfoundland,  at  St.  John's, 
and  began  the  organization  of  a  branch 
in  Comer  Brook. 


M.  Ruth  Thompson  Hal  Chalmers 

M.  Ruth  Thompson  (R.N.,  B.Sc.N.,  U. 
of  Alberta;  M.A.,  Columbia  U.,  New 
York)  retired  in  June  1971  as  director 
ofthe  school  of  nursing  at  the  University 
of  Alberta  Hospital  after  41  years  of 
service. 

Miss  Thompson  has  had  an  interest- 
ing and  varied  nursing  career.  She  was 
instructor  at  Lamont  General  Hospital, 
Lamont,  Alberta;  the  first  clinical  in- 
structor at  the  University  of  Alberta 
Hospital  (at  that  time  Miss  Thompson 
was  the  only  clinical  instructor  in  the 
hospital);  matron  at  the  Belleville  Gen- 
eral Hospital  in  Ontario;  nurse  on  the 
hospital  ships  Lady  Nelson,  and  the 
Letita,  as  a  member  of  the  Royal  Cana- 
dian Army  Medical  Corps;  administra- 
tive supervisor  ofthe  Colonel  Mewburn 
Pavilion,  a  wing  of  the  University  of 
Alberta  Hospital;  director  of  nursing 
at  the  Victoria  General  Hospital,  Lon- 
don, Ontario;  and  associate  director  of 


nursing  education  at  the  University  of 
Alberta  Hospital. 

Succeeding  Miss  Thompson  as  direc- 
tor of  the  school  of  nursing  is  Hal  Chal- 
mers (B.  Ed.,  U.  of  Victoria,  Victoria, 
B.C.:  M.Ed.,  U.  of  Alberta).  Mr.  Chal- 
mers is  one  of  the  few  non-nurses 
to  be  appointed  director  of  a  school  of 
nursing. 

Marianne  Schwarz  (Dipl.  Nursing,  Ecole 
Valaisanne  d'Inf.,  Sion,  Switzerland; 
B.Sc.N.,  U.  of  Toronto  School  of  Nurs- 
ing, Toronto,  Ont.)  has  been  appointed 
director  of  nursing  service  at  the  Cha- 
leur  Regional  Hospital  in  Bathurst, 
New  Brunswick. 

Miss  Schwarz  is  a 
native    of   Switzer- 
land and  she  served 
in    several   nursing 
positions     in     that 
4        ^  B     country  before  com- 
■^f    .        H     ing  to  Canada.  She 
is    a    former    staff 
'  >w^     nurse,  assistant 

J  ^Ht  head  nurse,  inser- 
vice  instructor,  part-time  supervisor, 
and  staff  education  coordinator,  all  at 
the  Women's  College  Hospital  in  To- 
ronto. She  also  worked  as  a  staff  nurse 
at  the  Anson  General  Hospital  in  Iro- 
quois Falls,  Ontario. 


Mary  Murphy  (Reg. 
N.,  St.  Joseph's  H. 
School  of  Nursing, 
London,  Ont.; 
B.Sc.N.,  U.  of  Wind- 
sor: M.H.A.,  U.  of 
Ottawa)  has  been 
appointed  director 
of  nursing  at  North 
York  General  Hos- 
pital, Willowdale,  Ontario. 

Miss  Murphy's  previous  experience 
includes  general  staff  nurse,  nursing 
supervisor,  administrative  assistant, 
assistant  administrator,  and  adminis- 
trator in  hospitals  in  Sarnia,  London, 
and  Hamilton. 


Shirley  A.  Lockridge  (Reg.N.,  St.  Jo- 
seph's School  of  Nursing,  London,  Ont.; 
B.Sc.N.,  U.  of  Windsor,  Ont.)  has 
been  appointed  director  of  nursing 
services  at  The  Hospital  for  Sick  Chil- 
dren in  Toronto. 

Before  becoming  director  of  nursing 
services  at  the  Toronto  Sick  Children's 
Hospital,  she  was  director  of  the  Hotel 
Dieu  Hospital  School  of  Nursing  in 
Windsor.  Miss  Lockridge  was  director 
of  nursing  and  supervisor  of  obstetric 
nursing  at  St.  Joseph's  Hospital  in  Sar- 
nia, and  also  clinical  teacher,  general 
duty,  and  head  nurse,  and  supervisor  of 
obstetric  nursing,  all  at  the  St.  Joseph's 
Hospital  in  London,  Ontario.  ^ 

OCTOBER      1971 


First  sign? 

Don't  save  Selsun 
for  difficult  cases. 
Use  it  to  avoid  them. 


Selsun 


Why  save  best  for  last  when 
you  can  count  on  Selsun 
effectiveness?  As  for  safety, 
Selsun  has  shown  itself 
impressively  free  of  serious 
side  effects. 


(Selenium  sulfide  detergent  suspension,  U.S. P.) 

Indications:  For  treatment  of  common 
dandruff  and  mild  to  moderately  severe 
seborrheic  dermatitis  of  the  scalp. 
Precautions  and  side  effects:  Keep  out  of 
the  eyes;  burning  or  irritation  may  result. 
Avoid  application  to  inflamed  scalp  or  open 
lesions.  Occasional  sensitization  may  occur. 


(PMAC I 


Abbott  Laboratories,  Limited, 
Montreal,  Quebec 


1). 


An  unconventional  new  role  For 
nurses  In  cordioc  core... 

Unconventional  new  books  to  prepare 
your  odvonced  students! 

A  New  Book  I 

THE  PHYSIOLOGIC  AND  PHARMACOLOGIC  BASIS  OF 
CORONARY  CARE  NURSING 


Coronary  care  nursing  requires  an  unconventional  perspec- 
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care,  this  challenging  new  book  presents  all  aspects  of 
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examines  the  nurse's  place  on  the  CCU  team,  and  stresses 
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By  Theodore  Rodman,  M.D.;  Ralph  M.  Myerson,  M.D.;  L.  Theodore 
Lawrence,  M.D.;  Anne  P.  Gallagher,  R.N.,  B.S.N.,  M.S.N. ;  and 
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early  rehabilitation  of  the  patient.  Substantially  increased 
emphasis  falls  on  prevention  of  circulatory  failure.  A  new 


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By  Kathleen  G.  Andreoli,  R.N.,  B.S.N..  M.S.N.;  Virginia  K.  Hunn, 
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MOSBV 

TIMES  MIRROR 


THE  C.V.  MOSBY  COMPANY.  LTD.  •  86  NORTHLINE  ROAD  •  TORONTO  374,  ONTARIO,  CANADA 


Banting  and  Best —  the  men 
who  tamed  diabetes 


Dorothy  Metie  Grant 

"Ligate  the  pancreatic  ducts  of  dogs. 
Wait  six  to  eight  weeks  tor  degenera- 
tion. Remove  the  residue  and  extract." ^ 

Three  short  sentences  written  by 
Frederick  Banting  during  a  sleepless 
night  in  October.  1920.  Who  could 
know  then  that  this  sudden  idea  would 
e\entually  lead  to  the  discovery  of 
insulin,  the  life-saving  hormone  that 
was  destined  to  provide  Benting  and  his 
co-researcher.  Charles  Best,  with  a 
permanent  place  in  medical  history. 

This  \ear  marks  the  50th  anniversary 
of  their  great  achievement  which, 
through  the  years,  has  become  a  price- 
less legacy  of  life  to  millions  of  persons 
with  diabetes  mellitus. 

Banting:  the  man  with  an  idea 

Frederick  Grant  Banting  was  born 
in  Alliston.  Ontario,  in  1891.  In  1916. 
he  graduated  from  the  University  of 
Toronto's  Medical  School,  and  almost 
immediately  joined  the  Canadian  Army 
Medical  Corps.  Three  years  later  he 
was  back  in  Canada,  bringing  w ith  him 
the  Military  Cross,  awarded  for  out- 
standing bravery  displayed  on  the 
battlefields  in  France. 

After  completing  a  residency  in 
orthopedics  at  Toronto's  Hospital  for 
Sick  Children,  he  decided  to  set  up 
practice  in  London.  Ontario.  But  after 
a  month,  with  one  patient  and  four 
dollars  to  his  credit,  he  was  painfully 
aw  are  of  the  need  to  augment  his  meagre 
income. 2 


Mrs.  Grant,  a  graduate  of  Halifax  Infir- 
mary School  of  Nursing,  lives  in  Halifax. 
Nova  Scotia.  She  is  a  freelance  writer. 


OCTOBER      1971 


Dr.  Banting  was  already  lecturing  in 
orthopedics  at  the  University  of  Western 
Ontario,  but  he  eagerly  accepted  a 
lecturers  position  in  UWO"s  depart- 
ment of  physiology.  His  reading  prior 
to  a  lecture  on  the  pancreas  tlrst  aroused 
his  detective  instincts. 

For  many  years  some  researchers 
had  suggested  that  the  islets  of  Langer- 
hans.  a  small  group  of  cells  within  the 
pancreas,  probably  contained  an  un- 
known hormone  that  controlled  carbo- 
hydrate metabolism.  To  Banting,  the 
mysterious  substance  represented  a 
tentaliKing  mystery;  but  it  was  a  medical 
article  that  led  his  interest  into  active 
research. 

The  author  of  the  article  w  rote  alxiut 
an  intriguing  condition  he  had  discover- 
ed during  a  postmortem  examination: 
gallstones  had  obstructed  the  pancreatic 
duct  and.  although  the  pancreas  itself 
had  atrophied,  the  islets  of  Langerhans 
had  remained  healthy. 

To  Banting  it  was  an  important  clue. 
Perhaps  by  ligating  the  pancreatic 
duct  in  dogs  he  could  surgically  produce 
an  atrophied  pancreas.  With  the  pan- 
creas's natural  digestive  enzymes  elim- 
inated, he  believed  he  could  isolate  the 
islets'  secret  hormone.^ 

His  colleagues  at  the  University  of 
Western  Ontario  agreed  that  his  theory 
had  merit,  but  suggested  he  seek  better 
research  facilities  at  the  University  of 
Toronto. 

Dr.  John  Rickard  Macleod.  head  of 
the  University  of  Toronto's  depart- 
ment of  physiology,  had  an  outstanding 
background  in  both  the  academic  and 
research  fields,  and  was  a  noted  author- 
ity on  carbohydrate  metabolism.  How- 
THE     CANADIAN     NURSE     27 


ever,  he  belonged  to  the  school  of 
thought  that  seriously  doubted  the 
existence  of  any  internal  pancreatic 
secretion/  Only  on  his  third  visit  to  Dr. 
Macleod's  office  was  Banting  able  to 
win  a  concession  from  the  professor. 

Dr.  Macleod  was  planning  to  visit 
his  native  Scotland  during  the  summer, 
and  he  agreed  to  allow  Banting  to  have 
the  use  of  a  small  laboratory  for  eight 
weeks.  When  Banting  candidly  admit- 
ted he  was  uneasy  about  the  inherent 
problems  of  complicated  laboratory 
procedures,  the  Scottish  doctor  con- 
tributed the  important  element  that  may 
well  have  sealed  the  success  of  the  re- 
search project:  He  approached  two  top 
students  in  the  University's  graduating 
class  in  physiology  and  asked  if  one  of 
them  would  be  interested.  Charles 
Best  volunteered  and  became  the  other 
half  of  the  team.  He  had  been  doing 
part-time  research  work  on  a  problem 
in  diabetes  during  the  past  year,  and 
had  decided  to  work  during  the  summer 
on  his  master's  thesis. 

Charles  Herbert  Best  was  born  in 
West  Pembroke,  Maine,  in  1899.  His 
parents  were  Canadian.  He  has  always 
been  proud  of  his  ancestors,  who  arrived 
in  Canada  in  1749  with  Edward  Corn- 
wallis.  the  founder  of  Halifax.^ 

In  May  1921  the  22-year-old  "Char- 
ley" Best  had  just  received  his  degree  in 
physiology  and  bio-chemistry.  Ban- 
ting's theory  deeply  interested  him  and, 
although  no  money  was  available,  he 
decided  it  was  a  research  project  he 
could  not  afford  to  miss. 

The  history  of  diabetes 

Neither  Banting  nor  Best  were  stran- 
gers to  the  horrors  of  diabetes  mellitus. 
As  a  youngster.  Banting  had  seen  the 
rapid  deterioration  and  death  of  a  young 
diabetic  friend.  In  Best's  case,  the  dis- 
ease had  a  greater  personal  impact: 
his  aunt,  Anna  Best,  a  young  graduate 
nurse,  had  developed  diabetes  and  had 
died  at  his  parent's  home. 

Diabetes  mellitus  has  a  lengthy  his- 
tory that  can  be  traced  to  the  Ebers 
Papyrus.  1550  B.C.^  It  was  the  Greeks 
who  named  it  "diabetes."  meaning  "a 

28     THE     CANADIAN      NURSE 


passing  through"  —  an  accurate  des- 
cri  ption  of  the  copious  amounts  of  urine 
passed  by  those  afflicted  with  the  dis- 
ease.' The  Romans  were  fascinated  by 
diabetes  and  attached  "mellitus"  to  its 
name,  a  word  meaning  "sweet  as  hon- 
ey."* They  noticed  that  bees  were  at- 
tracted to  diabetics'  urine  and  that  it 
had  a  sweet  taste.  But  hundreds  of  years 
were  to  pass  before  doctors  began  to 
understand  something  about  the  cause 
of  the  disease. 

In  1869,  Paul  Langerhans  discovered 
that  microscopic  examination  of  the 
pancreas  revealed  a  small  group  of 
cells  uniquely  different  from  the  rest  of 
the  organ. ^  Undisputable  proof  of  the 
relation  of  the  pancreas  and  diabetes 
came  when  von  Mering  and  Minkowski 
showed  that  removal  of  this  organ 
from  dogs  produced  diabetes. '° 

Early  in  the  twentieth  century,  sev- 
eral researchers  attempted  to  use  pan- 
creatic extracts  in  the  treatment  of 
diabetes,  but  in  all  cases  experimenta- 
tion ceased  when  some  patients  devel- 
oped severe  toxic  reactions. '^ 

Both  Banting  and  Best  were  convinc- 
ed that  these  experiments  had  failed 
because  of  the  presence  of  pancreatic 
enzymes.  They  hoped  to  eliminate  this 
problem  by  using  an  extract  from  com- 
pletely atrophied  pancreas. 

Research  begins 

On  May  16th,  1921,  Banting  and 
Best  began  their  work.  The  pancreatic 
duct  was  tied  in  several  dogs:  in  others, 
pancreatectomies  were  performed  so 
the  researchers  could  familiarize  them- 
selves with  the  postoperative  clinical 
findings.  ^^ 

A  serious  delay  occurred  early  in 
July,  when  ligatures  had  to  be  reapplied 
in  several  animals.  Finally,  on  July  27, 
a  dog  whose  duct  had  been  tied  was 
selected,  and  the  atrophied  residue  of 
its  pancreas  was  removed.  The  gland 
was  then  chopped  into  small  pieces  in 
a  chilled  mortar  and  frozen  in  brine. 
The  resulting  mass  was  ground  up  and 
100  cc.  of  saline  were  added. 

Five  cc.  of  the  extract  were  then 
administered   intravenously   to  a  dog 


that  had  had  its  pancreas  removed. 
Samples  of  blood  taken  at  half-hour 
intervals  clearly  demonstrated  a  marked 
decline  in  the  animal'^s  blood  sugar.  '-^ 

This  evidence  left  little  doubt  in  the 
minds  of  the  researchers:  they  had  dis- 
covered the  islets'  secret  hormone, 
which  they  named  "isletin." 

But  excitement  had  to  be  tempered 
with  scientific  responsibility.  Repeated 
tests  had  to  be  made  and  carefully 
documented  so  no  one  could  label  their 
discovery  a  mere  fluke. 

Most  important  was  the  need  to  find 
a  constant,  reliable  source  of  isletin. 
The  answer  seemed  to  lie  in  using 
pancreas  from  larger  animals,  such  as 
beef  cattle.  With  this  in  mind,  they 
turned  to  the  University's  Connaught 
Laboratories.  For  some  time  isletin  was 
extracted  from  fetal  pancreas;  later. 
Banting  and  Best  modified  their  proce- 
dure and,  instead,  used  glands  taken 
from  adult  animals.''' 

During  the  course  of  their  summer's 
work,  many  of  the  dogs  used  for  re- 
search died,  and  the  researchers  had 
to  look  for  animals  they  could  buy 
from  disinterested  owners.  Critics  later 
accused  them  of  cruelty  to  the  dogs, 
but  nothing  could  have  been  further 
from  the  truth. 

Both  men  made  sure  the  animals 
received  the  best  of  care,  and  were 
always  deeply  disturbed  when  a  dog 
died  or  had  to  be  sacrified  during  exper- 
iments. The  animals  were,  in  fact,  per- 
fect "guinea  pigs. "  They  were  so  well 
trained  that  they  willingly  offered  their 
paws  so  samples  of  blood  could  be 
taken.'^ 

But  other  problems  faced  Banting 
and  Best.  For  example:  When  was  the 
best  time  to  administer  isletin.'  How- 
could  they  determine  the  amount  neces- 
sary to  maintain  blood  sugar  within 
normal  levels?  How  would  they  recog- 
nize early  hypoglycemia,  the  condition 
produced  by  overdoses  of  the  drug?'^ 

Dr.  Macleod  returns 

Returning  to  Toronto  after  his  vaca- 
tion   in    Scotland.    Dr.    Macleod    was 
amazed    to    discover    that    two    inex- 
OCTOBER     1971 


penenced  researchers  had  isolated 
the  hormone  previously  missed  by  many 
of  the  greatest  scientists.  When  he  was 
at  last  convinced  that  there  was  no 
doubt  of  isletin's  therapeutic  effect  on 
diabetes,  he  reassigned  his  staff  and 
labs  to  help  with  the  discovery.  He 
also  insisted  that  Banting  and  Best 
rename  their  discovery  "insulin,"  a 
term  used  by  Sharpey-Schaefer  in  ear- 
lier research.  ^^ 

By  the  end  of  1 92 1 ,  Banting  and  Best 
were  anxious  to  test  insulin  on  a  human 
diabetic.  The  chance  came  early  in 
1922,  when  it  was  decided  to  allow  two 
doctors  at  Toronto  General  Hospital 
to  test  insulin  on  a  diabetic  child. 
OCTOBER     1971 


The  14-year-old  boy,  Leonard 
Thompson,  was  obviously  near  death. 
He  was  suffering  from  all  the  classic 
signs  and  symptoms  associated  with 
diabetes.  Down  to  65  pounds,  his  hair 
falling  out,  suffering  from  extreme 
hunger  and  thirst,  he  displayed  the  signs 
of  impending  diabetic  coma. 

Doctors  had  prescribed  the  usual 
"undernutrition"  diet,  in  this  case  a 
total  daily  intake  of  450  calories.  But 
glycosuria  persisted,  the  boy's  blood 
sugar  remained  extremely  high,  and 
there  was  a  strong  odor  of  acetone  on 
his  breath.  Obviously  only  a  miracle 
could  save  his  life. 

In  Leonard  Thompsons  case,  insulin 


Dr.  Banting  (right)  and  Charles  Best 
with  one  of  the  first  diabetic  dogs  to 
have  its  life  saved  by  Insulin.  This 
photo  was  taken  in  August.  ] 92],  Just 
after  the  men  were  convinced  that  their 
discovery  was  effective.  They  stand  on 
the  roof  of  the  medical  building  of  the 
University  of  Toronto. 


therapy  provided  the  miracle.  He  began 
to  gain  weight,  his  blood  sugar  dropped 
to  normal,  his  urine  was  free  of  sugar, 
and  for  the  first  time  in  months,  hope 
was  written  on  his  face.'' 

Problems  develop 

News  of  the  discovery  brought  im- 
mediate reaction.  Thousands  of  diabet- 
ics wrote  to  the  University  of  Toronto, 
begging  to  be  given  the  life-saving  drug. 
Newspapers  demanded  that  insulin  be 
made  available  immediately  to  all 
diabetics. 

But  few  people  knew  that  problems 
had  developed  in  devising  methods  of 
large-scale  production.^"  Charles  Best 
was  given  the  task  of  solving  the  dilem- 
ma, and  for  two  months  a  total  insulin 
famine  existed  while  he  and  a  colleague 
searched  for  the  answer.  Later,  after 
the  problem  was  solved,  Connaught 
Labs  and  the  Eli  Lilly  Company  assum- 
ed responsibility  for  producing  insulin. 

Neither  Banting  nor  Best  would 
accept  money  from  the  sale  of  insulin. 
It  was  agreed  patent  rights  would  be 
taken  out  by  the  University  of  Toronto. 
Like  the  co-discoverers,  the  university 
had  no  interest  in  making  money,  but 
it  was  apparent  that  stringent  controls 
had  to  be  placed  on  the  production  of 
insulin.  An  insulin  committee  was 
created  and  had  the  duty  of  assaying  all 
manufactured  insulin,  with  the  right 
to  control  the  purity  and  standardization 
of  the  drug.^' 

A  new  way  of  life 

But  what  of  the  world's  diabetics? 
How  did  the  discovery  change  their 
lives?  Perhaps  the  most  significant 
change  came  in  their  life  expectancy: 
before  insulin,  an  adult  diabetic  might 
THE     CANADIAN     NURSE     29 


live  five  or  six  years;  a  child,  seldom 
longer  than  a  year. 

The  starvation  diet  of  a  few  hundred 
calories  was  replaced  by  well-balanced 
meals  that  encouraged  rapid  weight 
gain.  No  longer  did  diabetics  suffer  the 
agonies  of  polydipsia,  polyuria,  and 
polyphagia.  Now  they  could  even  have 
surgery,  knowing  it  was  no  longer  an 
extremely  high  risk. 

Certainly  there  were  new  problems 
to  face,  but  most  were  soon  overcome. 
Adults  and  children  learned  to  give 
themselves  insulin  and  to  recognize 
and  treat  the  symptoms  of  hypoglyce- 
mia. Diabetics  had  entered  the  age  of 
insulin,  an  age  that  brought  hope  where 
once  there  had  been  only  despair. 

The  years  after 

During  the  next  few  years.  Best  was 
busy  completing  his  medical  degree, 
while  continuing  his  work  at  Connaught 
Laboratories.  Later,  following  post- 
graduate study  in  England,  he  became 
head  of  the  University  of  Toronto's 
newly  formed  department  of  physiolog- 
ical hygiene.  He  also  became  associate 
director  of  the  Connaught  Labs  and, 
on  Dr.  Macleod's  retirement,  replaced 
him  as  head  of  the  University's  physi- 
ology department.  In  1924,  Charles 
Best  married  Margaret  Mahon  from  St. 
Andrews,  New  Brunswick. 

Banting  never  became  a  clinician. 
He  remained  a  researcher,  and  led  a 
group  of  young  scientists  in  several 
important  investigations  relating  to 
problems  of  aviation  and  military  med- 
icine. He  was  kept  busy  lecturing  at 
medical  meetings. 

Many  honors  came  to  both  men 
during  the  next  few  years.  In  1923,  Dr. 
Banting  learned  he  had  won  the  Nobel 
Prize  for  medicine.  It  was  to  be  shared 
with  Dr.  John  Macleod,  not  with  Char- 
les Best.  He  immediately  announced 
that  one-half  of  his  $20,000  would  be 
given  to  his  co-researcher.  Best.  Soon 
after.  Dr.  Macleod  announced  that  his 
prize  money  would  be  split  with  Dr. 
James  Collip,  who  had  done  important 
work  in  establishing  the  standard  unit 
of  insulin. 
30     THE     CANADIAN     NURSE 


This  would  not  be  the  only  time 
that  Best's  part  in  the  discovery  was 
underplayed.  During  the  rest  of  his  life, 
Banting  never  missed  the  opportunity 
to  emphasize  Best's  important  work  in 
the  early  research  on  diabetes.  He  would 
never  forget  that  it  was  Best  who  had 
worked  at  his  side  during  the  hot,  ex- 
hausting summer  of  1 92 1 . 

But  life  was  never  easy  for  Fred 
Banting.  He  found  public  speaking 
terrifying,  and  resented  the  invasion  of 
his  privacy  by  newsmen  who  seemed 
to  think  it  was  his  duty  to  make  frequent 
discoveries  comparable  to  insulin.  His 
one  great  joy  lay  in  oil  painting,  and 
some  of  his  most  pleasant  memories 
came  during  painting  trips  to  Quebec 
and  to  the  North  with  his  close  friend 
A.Y.  Jackson. 

In  1941,  Dr.  Banting  was  killed  in 
a  plane  crash  in  Newfoundland.  Death 
came  at  a  time  when  life  had  held  great 
promise.  A  second  marriage  and  some 
gratifying  research  had  made  him  feel 
he  was  entering  a  new  phase  in  his  life. 
Many  people  have  suggested  that  the 
crash  was  caused  by  sabotage.  Whatever 
the  cause,  the  crash  resulted  in  the  death 
of  a  truly  great  Canadian. 

Today,  the  Canadian  Diabetic  Asso- 
ciation reports  there  are  200,000  known 
diabetics  in  this  country,  and  probably 
200,000  people  who  are  undetected 
victims  of  the  disease. ^^  Many  thou- 
sands of  diabetics  now  rely  on  insulin 
discovered  only  50  years  ago  by  Banting 
and  Best.  But  it  was  a  discovery  that 
came  only  because  two  men  attempted 
what  many  had  termed  impossible.  The 
many  million  lives  insulin  has  saved  is 
the  greatest  memorial  of  all  to  their 
remarkable  achievement. 

Neither  Banting  nor  Best  ever  asked 
for  more! 

References. 

1.  Harris.  Scale.  Bantiiifi's  Miracle:  ilic 
Siory  of  ilic  DIm  ovcry  of  Insulin.  To- 
ronto. Dent.  1946.  p.  50. 

2.  Ibid.  p.  40. 

}.  Barron.  O.  Moses.  The  relation  of  the 
islets  of  l.angcrhans  to  diabetes  with 
special  reference  to  cases  of  pancreatic 


lithiasis.  Siirf>cr\,  fiynecolof-y  anil  obs- 
tetrics i  1 :437-48,  Nov.  1920. 

4.  Fcasby,  W.R.  Thediscovery  of  insulin. 
/  Hist.  Mcil.  13:68-84,  Jan.  1958. 

5.  Best,  Charles  H.  Selected  Papers  of 
Cluirles  H.  Best  Toronto,  University 
of  Toronto  Press.  1963,  p.  4. 

6.  Dolger.  Henry,  and  Secmcn.  Bernard. 
How  to  Live  with  Diabetes.  New 
York.  Norton,  1958.  p.  14. 

7.  Harris,  Scale,  op.  cit.  p.  62. 

8.  Ibid. 

9.  Joslin,  Elliott  Procter.  A  Diabetic 
Manual  for  the  Mutual  Use  of  Doctor 
and  Patient.  4cd.  Philadelphia,  Lea  & 
Febiger,  1929,  p.  27. 

10.  Banting.  Frederick  G.  ct  al.  Pancreatic 
extracts  in  the  treatment  of  diabetes 
mellitus.  Canad.  Med.  Ass.  J.  12:141- 
6.  Mar.  1922. 

1  1.  Banting.  Frederick  G.  Diabetes  and 
insulin  (Nobel  lecture).  Canad.  Med. 
Ass.  J.  16:221-32,  Mar.  1926. 

12.  Banting.  Frederick  G.  The  history  of 
insulin.  Edinburgh  Med.  J.  36:1-18. 
Jan.  1929. 

13.  Ibid. 

14.  Fcasby.  W.R.  op.  cit.  p.  73. 

15.  Best.  Charles  H.  Reminiscences  of  the 
researches  which  led  to  the  discovery 
of  insulin.  Canad.  Med.  Ass.  J.  47: 
398-400.  Nov.  1942. 

16.  Harris.  Scale,  op.  cit.  p.  76-7. 

17.  Banting.  Frederick  G.  The  history  of 
insulin.  Edinburgh  Med.  J.  36:8.  Jan. 
1929. 

18.  Joslin,  E.P.  The  diabetic.  Canad.  Med. 
/J.vv.  /  48:488-97.  Jun.  1943. 

19.  Banting.  Frederick  G.  et  al.  Pancreatic 
extracts  in  the  treatment  of  diabetes 
mellitus.  Canad.  Med.  A.ss.  J.  12:141- 
6.  Mar.  1922. 

20.  Best.  Charles  H.  Selected  Papers  of 
Charles  H.  Best.  Toronto.  University 
of  Toronto  Press.  1963.  p.  90. 

2 1 .  Stevenson.  Lloyd  G.  5/)-  Frederick 
Banting.  Toronto.  Ryerson  Press. 
1946.  p.  105-7. 

22.  Personal  communication.  Halifax 
Branch,  Canadian  Diabetic  Assoc. 

The  author  expresses  her  appreciation  to 
Lady  Banting  and  Dr.  Best  for  checking 
the  accuracy  of  all  statements.  ig> 

OCTOBER      1971 


Dying  with  dignity 


We  must  allow  the  dying,  who  are  about  to  lose  everyone  and  everything  they 
know,  to  reach  the  acceptance  of  their  own  death  with  dignity,  and  in  peace. 


Elisabeth  Kiibler-Ross 


When  I  joined  the  University  of  Chicago 
about  six  years  ago,  we  became  involved 
in  a  research  project  on  dying  quite  by 
chance.  Four  theology  students  came  to 
me  for  help  in  writing  a  paper.  Having 
been  asked  to  write  a  paper  on  "crisis 
in  human  life,"  four  in  the  class  chose 
dying  as  the  biggest  crisis  man  has  to 
face.  Then  they  were  stuck,  for  they 
didn't  know  quite  how  to  do  research  in 
an  area  where  you  can't  really  verify 
the  data,  where  you  can't  ask  those  who 
have  experienced  death,  and  where  you 
can't  experience  it  yourself.  But  they 
wanted  to  write  on  what  it  is  really  like 
to  be  dying. 

I  want  to  share  what  my  students  and 
I  learned  from  interviewing  some  500 
dying  patients.  You  probably  wonder 
how  people  can  get  involved  in  such  a 
morbid,  depressing  specialty.  I  want  to 
assure  you  that  this  is  not  depressing 
work,  but  probably  one  of  the  most 
beautiful,  gratifying  things  that  I  have 
ever  done. 

How  can  we,  as  members  of  the  help- 
ing profession,  help  patients  who  are 
dying?  We  must  first  admit  that  we 
don't  know  much,  and  allow  the  patients 
themselves  to  teach  us.  I  asked  the 
students  if  they  would  be  willing  to 
listen  to  some  interviews  with  dying 
patients,  then  made  a  big  mistake  by 
volunteering  to  find  a  dying  patient. 

After  a  week  of  searching,  I  seemed 
unable  to  find  a  single  dying  patient  in 
our  600-bed  hospital.  1  had  gone  from 

OCTOBER      1971 


Dr.  Kiibler-Ross  is  the  author  of  On  Death 
and  Dying,  published  in  Toronto  by  Collier- 
Macmillan,  copyright  1969.  Currently  Med- 
ical Director,  Family  Services  of  South  Cook 
County,  Chicago  Heights,  Dr.  K.  Ross  makes 
her  home  in  Flossmoor,  Illinois. 

ward  to  ward,  asking  politely  to  talk  to 
a  dying  patient,  always  receiving  the 
answer:  "Nobody  is  dying  on  our  ward." 
Yet,  there  were  many  patients  who 
looked  very  sick,  many  whom  I  knew 
were  critically  ill.  So  I  went  around 
again.  The  second  time,  the  staff  asked, 
"What  do  you  want  to  talk  to  them 
about?"  When  I  said,  "about  dying," 


they  looked  at  me  as  if  I  needed  a  psy- 
chiatrist. I  realized  much  later  that  this 
is  what  is  called  "denial."  The  staff 
really  did  not  like  to  be  reminded  that 
patients  were  dying  in  their  hospital. 

When  I  didn't  give  up,  when  I  pointed 
out  names  on  the  critically-ill  list,  the 
staff  was  quick  to  rationalize:  the  pa- 
tient was  too  depressed,  or  too  weak, 
or  too  sick,  to  talk  —  some  might  even 
jump  out  the  window!  When  I  still 
didn't  give  up,  the  staff  became  very 
angry,  very  hostile,  very  nasty;  one 
nurse  even  asked  me  if  1  enjoyed  play- 
ing God! 

I  became  curious  about  this  phenom- 
enon. I  began  to  wonder  what  it  must 
be  like  to  die  in  hospital,  if,  perhaps, 
you  have  some  unfinished  business  or 
questions  to  ask,  when  all  the  people 
around  you  are  so  leery  about  accepting 
the  fact  that  you  are  dying. 

When  I  finally  got  permission  to  see 
one  patient,  I  made  another  big  mis- 
take. 

IVly  first  patient  was  an  old  man 
obviously  ready  to  talk,  who  needed  to 
talk,  but  who  was  avoided,  like  many 
of  our  dying  patients.  When  I  approach- 
ed him,  he  put  his  arms  out  and,  with 
pleading  eyes,  said,  "Please  sit  down 
now,"  —  with  the  emphasis  on  now.  I 
replied  matter-of-factly,  "No,  not  now, 
tomorrow  at  1 :00  P.M." 

When  my  students  and  I  returned  to 
this  patient  the  nextday,  he  was  elevated 
on  pillows,  in  an  oxygen  tent,  and  hardly 

THE     CANADIAN     NURSE     31 


\ 


breathing.  He  looked  at  me  with  the 
same  pitiful  look  and  said,  "Thank  you 
for  trying,  anyway."  He  died  half  an 
hour  later. 

We  returned  to  my  office  to  talk  over 
what  this  patient  had  done  to  us.  I 
shared  with  them  my  shame,  guilt, 
grief,  and  also  my  anger  and  frustra- 
tion over  what  had  happened. 

We  learned  quickly  that  working  with 
dying  patients  is  a  two-way  street  —  to 
really  minister  to  these  patients  we 
must  admit  that  we,  too,  are  afraid  of 
death  and  learn  to  overcome  our  own 
fears.  Only  then  can  we  truly  help  our 
dying  patients  —  and  the  best  teacher 
is  the  dying  patient  himself. 

Soon  we  moved  from  the  bedside 
for  interviews  to  a  screened-window 
interviewing  room  to  accommodate 
others  who  wanted  to  join  us  —  nurses, 
social  workers,  various  members  of  the 
clergy,  and  so  on.  Eventually  these 
sessions  were  incorporated  into  an 
accredited  course  for  the  medical  school 
and  the  theological  seminaries.  We 
formed  an  interdisciplinary  seminar  on 
death  and  dying,  and  each  week  inter- 
viewed a  dying  patient,  whom  we  had 
asked  to  be  our  teacher. 

Our  patients  knew  that  we  used  a  tape 
recorder,  that  we  had  an  audience,  and 
that  they  were  volunteering  for  this  kind 
of  work.  Our  patients,  ranging  in  age 
from  1 6  to  96,  were  chosen  at  random 
from  among  those  who  had  been  told 
and  those  who  had  not  been  told  of  the 
seriousness  of  their  condition.  We  did 
not  use  children  for  teaching  purposes. 

Patients  know,  but  — 

Patients  who  are  aware  of  their 
impending  death  and  who  need  to  talk 
about  it  will  tell  you,  but  only  if  you 
are  comfortable  listening  to  them  and 
if  you  understand  their  language. 

Basically,  they  use  three  kinds  of 
language  to  talk  about  dying.  One  of 
them  is  plain  English,  which  is  not 
always  as  plain  as  you  think.  Children 
use  play  acting  and  drawings.  The  third 
language  is  symbolic,  the  most  difficult 
to  understand,  and  something  you  have 
to  teach  to  members  of  the  helping 
profession  so  that  they  can  respond 
appropriately  to  dying  patients.  Pa- 
tients who  are  most  frightened,  or  who 

32     THE     CANADIAN     NURSE 


have  little  time  between  the  onset  of 
their  terminal  illness  and  their  actual 
death  will  use  the  most  difficult  lan- 
guage. 

We  asked  our  patients  if  they  would 
like  to  have  been  told,  and,  if  so,  by 
whom  and  when.  Most  wanted  to  be 
informed  of  the  seriousness  of  their 
illness  early  —  not  by  telephone,  but 
in  the  privacy  of  the  physician's  room. 
Wives  wanted  to  be  told  in  the  presence 
of  their  husbands.  However,  only  two 
conditions  really  mattered  to  the  patient 
when  told  about  the  seriousness  of  his 
illness  —  that  he  be  allowed  some  hope 
'and  be  given  assurance  that  he  will  not 
be  deserted.  If  these  two  conditions  can 
be  met,  patients  are  able  to  go  through 
the  five  stages  of  dying  very  quickly. 
Most  of  our  patients  have  been  able 
to  reach  the  stage  of  acceptance  without 
great  turmoil. 

I  shall  dwell  for  a  moment  on  hope. 
Many  physicians  say,  "How  can  I  give 
this  patient  hope  when  he  has  come  to 
me  in  a  hopeless  condition?"  that  is, 
when  he  is  full  of  metastases. 

It  is  important  to  understand  that  the 
hopes  of  the  active  and  relatively  well 
person  are  different  from  the  hopes  of 
the  dying.  We  know  the  hopes  of  the 
living  —  cure,  good  treatment,  and 
prolongation  of  life.  When  these  are  no 
longer  realistic,  our  patients  will  switch 
their  hopes  to  something  no  longer 
associated  with  these  three.  The  nurse 
or  physician  must  never  project  his  or 
her  own  hopes,  but,  rather,  strengthen 
those  of  the  patient. 

To  be  deserted  is  another  tragedy. 
And  many  of  our  dying  patients  are 
indeed  deserted  —  they  are  lonely  and 
isolated.  Many  even  feel  they  are  treated 
as  if  they  have  a  contagious  disease! 

When  a  patient  asks  not  to  be  desert- 
ed, he  does  not  always  want  daily  or 
weekly  rounds.  What  he  asks  for  was  , 
expressed  beautifully  by  one  of  my 
elderly  patients  in  a  nursing  home:  "If 
the  doctor  would  only  have  called  up 
once  to  say:  'Hi,  Josephine,  how  are 
you  doing?'  "  This  shows  that  patients 
don't  expect  much,  but  they  are  asking 
us  to  consider  them  important  persons, 
not  only  as  long  as  we  can  cure,  or  treat, 
or  prolong  life  to  gratify  our  own  needs, 
.  but  to  show  that  they  still  count  and  are 


still  cared  for  even  after  they  are  beyond 
medical  help.  And  this  may  take  only 
a  two-minute  telephone  call. 

Fear  of  death 

To  understand  the  real,  devastating, 
repressed  fear  of  death,  we  have  to 
study  ancient  cultures,  ancient  rituals, 
patients  undergoing  psychoanalytic 
treatment,  and,  most  important,  chil- 
dren. When  we  listen  to  children  and 
look  at  their  drawings,  especially  those 
made  by  dying  children,  we  begin  to 
appreciate  what  the  fear  of  death  really 
is. 

Fear  of  death  is  the  fear  of  a  cata- 
strophic, destructive  force  that  hits  us 
from  outside.  We  feel  totally  quelled  in 
the  face  of  it.  In  terms  of  my  uncon- 
scious, I  have  a  hard  time  to  conceive 
my  own  death.  I  can  imagine  that  100 
years  from  now  all  of  you  are  a  handful 
of  dust,  but  I  am  not  among  you  —  and 
you  feel  the  same  way.  This  is  what 
gives  the  soldier  on  the  battlefield  the 
courage  to  go  ahead,  for  he  believes: 
"death  will  come  to  thee  and  to  thee, 
but  not  to  me." 

If  I  am  forced  to  conceive  of  my 
own  death,  I  can  only  conceive  of  it 
as  a  malignant  intervention  from  the 
outside.  I  can  only  be  killed.  This  is 
important  to  understand  when  caring 
for  dying  patients.  Death  is  always  a 
question  of  kill  or  be  killed. 

Cancer,  of  all  illnesses,  is  the  best 
means  for  the  average  person  to  con- 
ceive of  death,  and  patients  for  a  long 
time  to  come  will  associate  cancer  with 
the  destructive  catastrophic  death.  So, 
if  you  want  to  ensure  that  people  go  to 
cancer  detection  clinics,  that  they 
change  their  conceptual  fear  of  cancer 
as  death  and  seek  early  help,  you  will 
have  to  help  them  overcome  their  fear 
of  death  first.  Then  they  will  be  able 
to  face  cancer  as  an  illness  that  can  be 
treated  and  that  can  be  cured. 

We  asked  an  eight-year-old  boy 
with  an  inoperable  brain  tumor  to  draw 
us  a  picture.  It  became  a  big  tank,  a 
pretty  little  house  behind  it,  with  a  tree 
and  sunshine.  In  front  of  the  barrel 
where  the  bullet  comes  out  was  a  tiny 
boy  with  a  stop  sign  in  his  hand. 

This  is  a  typical  picture  expressing 

the  unconscious  part  of  the  fear  of 

OCTOBER      1971 


death  —  death  as  this  catastrophic 
destructive  force  bearing  down  on  you, 
without  you  being  able  to  do  a  thing 
about  it.  That's  the  impotence,  tininess, 
rage,  and  anger  you  feel  when  facing 
death.  How  would  you  help  this  boy 
were  he  to  draw  this  picture  for  you? 
Would  you  be  able  to  talk  with  him 
about  what  he  was,  in  fact,  saying? 

When  this  boy  had  been  helped,  he 
drew  another  picture.  On  being  asked 
what  it  was,  he  said,  'This  is  the  peace 
bird  flying  up  into  the  sky,  with  a  little 
bit  of  sunshine  on  my  wing."  The  upper 
part  was  painted  gold.  This  was  the  last 
picture  he  drew  before  he  died. 

Do  you  see  the  difference  between 
the  two  pictures?  They  represent  to  me 
what  it  means  to  minister  to  dying  pa- 
tients—  to  help  them  from  the  concept 
of  a  catastrophic  destructive  force  to 
that  of  a  peace  bird  flying  up  into  the 
sky  with  a  little  bit  of  sunshine  on  "my" 
wing. 

Each  patient  we  saw  recharged  our 
batteries  enough  to  go  on  with  this 
work.  We  were  impressed  with  how 
needy  these  patients  were,  how  much 
they  welcomed  us,  and  how  quickly 
they  were  able  to  talk  about  theii  needs, 
their  hopes,  and  their  unfinished  busi- 
ness, which  had  to  be  done  if  they  were 
to  be  able  to  die  with  peace  and  dignity. 

Denial 

Many  patients  appeared  at  first  to 
say,  "No,  not  me."  On  the  surface,  they 
seemed  to  use  denial,  but  they  often  just 
tested  us.  On  entering  one  patient's 
room  we  asked  him,  "How  sick  are 
you?"  To  his  solemn  counter-question, 
OCTOBER      1971 


"Do  you  really  want  to  know?"  I  voiced 
a  simple  "Yes,"  and  meant  it.  He  then 
said,  "I  am  full  of  cancer."  He  knew 
without  being  told,  and  at  this  point  the 
strange  conspiracy  of  silence  between 
family  and  hospital  staff  could  be  bro- 
ken. Several  patients  revealed  that  it 
was  only  after  they  had  faced  their 
own  death  and  were  able  to  talk  about 
■  it  that  they  truly  began  to  feel  free  and 
to  really  live  again. 

Few  patients  needed  denial  for  them- 
selves. Most  of  them  who  looked  as  if 
they  needed  denial  resorted  to  it  because 
of  our  need.  When  we  conveyed  to  them 
that  we  had  no  need  for  denial,  they 
soon  opened  up  and  shared  with  us  what 
they  had  known  all  along. 

We  had  only  one  patient,  a  28-year- 
old  mother  of  three,  who  had  to  main- 
tain denial  because  the  tragedy  of  her 
life  was  too  difficult  to  face.  Needless 
to  say,  we  helped  her  to  maintain  denial 
and  let  her  know  that  we  would  not 
desert  her  under  any  circumstance.  We 
simply  sat  with  her  and  held  her  hands. 
She  said  during  one  of  my  last  visits, 
"I  hope  when  my  hands  get  colder  and 
colder  that  I  have  warm  hands  like 
yours  holding  mine."  Was  she  really 
saying,  "When  I  am  dying,  I  hope 
somebody  with  a  little  compassion, 
with  warm  hands  .  .  ."?  This  is  what 
most  of  our  patients  need  and  what 
anyone  can  give. 

Anger  at  God 

Most  patients  after  the  "No,  not  me" 
stage  quickly  become  nasty,  difficult, 
horrible,  obnoxious  patients.  They  are 
then  saying,  "Why  me?"  One  of  my 


favorite  patients  said  one  day,  "Why 
couldn't  it  have  been  poor  old  George? 
That  bum,  he  never  worked  a  day  in  his 
life!"  This  is  normal  and  healthy  anger. 
Try  to  understand  the  anger  that  makes 
patients  nasty  and  ungrateful. 

The  problem  is  that  we  react  to  these 
patients  by  being  angry  at  them!  We 
stick  the  needle  in  a  bit  harder;  we  wait 
twice  as  long  before  responding  to 
them;  we,  too,  are  nasty  and  obnoxious. 
'We  must  teach  student  nurses,  especial- 
ly, that  it  is  not  only  a  blessing  to  have 
a  patient  behave  like  that,  but  that  it 
is  a  compliment  to  them.  For  it  is  the 
person  who  is  full  of  life  and  energy 
and  who  is  functioning  who  receives 
most  of  the  patient's  anger.  The  patients 
are  not  angry  at  you  as  a  person,  but 
are  angry  because  you  represent  the 
zest  for  living  that  they  are  in  the  pro- 
cess of  losing.  You  would  be  angry  too 
if,  a  few  weeks  ago,  you  had  been  able 
to  take  care  of  your  children,  had  been 
able  to  cook,  take  a  shower,  and  do 
everything  yourself,  and  now,  a  few 
weeks  later,  someone  has  to  bathe  and 
feed  you.  You  would  sooner  or  later 
ask,  "Why  is  this  happening  to  me?" 

Let  patients  express  their  anger.  They 
need  not  scream  and  disrupt  the  hos- 
pital routine.  Simply  invite  them  to 
"pour  it  out."  They  will  then  be  able  to 
cry  on  your  shoulder.  They  will  question 
God,  the  whole  world.  No  need  to  give 
»  them  an  answer.  Just  let  them  be  them- 
selves and,  in  no  time  —  sometimes 
within  five  minutes  —  they  will  be  more 
comfortable.  The  staff  will  be  more 
comfortable  too,  as  the  patients  won't 
ring  for  the  nurse  all  the  time.  Their 
families  will  also  be  more  comfortable. 

Bargaining 

When  the  "Why,  me?"  stage  is  over, 
the  patient  usually  says,  "Yes,  it's  me, 
but .  .  ."  This  is  the  bargaining  stage, 
a  peculiar  stage  that  usually  only  the 
minister,  priest,  or  rabbi  hear.  On  the 
surface,  bargaining  is  like  peace,  but 
it  is  only  a  temporary  truce.  The  patient 
usually  bargains  with  God:  "If  You  give 
me  one  year  to  live,  I'll  be  a  good  Chris- 
tian," or  "I'll  go  to  the  synagogue  every 
day,"  or  "I'll  donate  my  eyes  or  kid- 
neys." This  is  an  attempt  to  buy  a  pro- 
longation of  life. 

THE     CANADIAN     NURSE     33 


When  the  bargaining  is  over  (the 
promises  are  hardly  ever  kept,  in  any 
event),  the  patient  will  drop  the  "but" 
and  will  say,  "Yes,  me."  This  is  when 
our  patients  become  very  depressed. 

Depression 

The  depressive  stage  has  two  phases. 
First,  the  patient  mourns  for  what  is 
already  lost  —  part  of  the  bowel,  a 
breast,  perhaps  a  job  or  income,  or 
even  just  being  able  to  be  at  home  with 
family  and  children.  We  can  understand 
this  kind  of  reactive  depression  because 
we  can  picture  our  own  reaction  should 
something  similar  happen  to  us.  But 
then  the  patient  goes  through  a  prepara- 
tory grief,  a  silent  depression  that  is 
harder  for  men  then  for  women.  Harder 
for  the  health  worker  too. 

How  do  you  feel  when  a  man  silently 
cries  into  his  pillow?  What  is  your 
own  need  and  what  is  your  gut  reac- 
tion? You  feel  like  avoiding  him,  but 
what  you  do  is  much  worse  —  you 
suddenly  get  busy  and  want  him  to  do 
something.  You  might  even  say,  "Cheer 
up,  it's  not  so  bad."  Not  so  bad  for 
whom?  You  do  this  because  you  can- 
not tolerate  it. 

This  is  the  paradox.  Should  you  lose 
a  loved  one,  you  will  be  allowed  to 
mourn  and  to  cry.  But  if  a  man  has  the 
courage  to  face  the  fact  of  dying,  he 
has  the  courage  to  face  the  loss  of  all 
those  whom  he  has  ever  loved.  Isn't 
this  much  more  sad?  Should  he  not  be 
allowed  to  mourn  and  grieve,  to  know 
that  it  takes  a  man  to  cry,  without 
shame,  and  that  there  is  no  need  to  hide 
his  sadness?  Then  he  can  go  through 
the  mourning  and  preparatory  grief 
more  quickly  and  easily. 

This  is  when  patients  begin  to  with- 
draw from  people.  They  will  ask  ac- 
quaintances to  come  once  more,  then 
their  children  once  more,  and  at  the 
end  they  need  only  one  beloved  person 
to  sit  nearby,  silently  and  comfortably, 
when  a  touch  becomes  more  important 
than  a  word. 

Remember,  the  family  is  going 
through  the  same  stages  of  denial, 
anger,  bargaining —  but  they  often  lag 
behind  the  patient.  This  is  when  they 
try  to  turn  back  the  clock,  begging  the 
physician    for    extraordinary    means, 

34     THE     CANADIAN      NURSE 


for  new  procedures.  Then  they  run  to 
the  nursing  station  to  try  to  get  some 
action. 

Acceptance 

In  one  instance,  a  patient  who  had 
reached  the  stage  of  acceptance  was 
lying  comfortably  and  quietly  without 
speaking  to  the  relatives  who  had  gath- 
ered by  his  bedside.  His  wife  could  not 
understand  why  he  could  not  be  sociable 
when  they  had  come  from  such  a  dis- 
tance just  to  see  him,  and  why  he  could 
not  act  as  the  host  as  he  had  always 
done.  She  could  not  even  then  conceive 
of  herself  soon  having  to  take  on  that 
role.  She  was  still  limping  behind  in 
the  stage  of  partial  denial  while  her 
husband  had  already  reached  accept- 
ance. If  you  try  to  help  the  ones  who 
limp  behind,  they  may,  but  not  always, 
reach  the  stage  of  acceptance  before  the 
patient  dies. 

The  last  stage,  acceptance,  is  hard  to 
.define.  It  is  not  resignation,  and  it  is 
not  giving  up.  It  is  a  time  when  your 
work  is  done,  when  you  have  no  more 
unfinished  business,  when  you  have  no 
more  fears  or  anxieties,  and  little  or  no 
physical  pain.  This  is  when  you  can 
truly  say,  as  one  of  my  patients  did, 
"My  time  is  very  close  now  and  it's 
alright.  It'^not  happy,  but  it's  okay." 

Sometimes  it  is  difficult  to  know 
whether  the  patient  has  reached  the 
stage  of  acceptance  or  is  just  resigned 
to  his  circumstances. 

Last  summer  I  frequently  visited 
an  83-year-old  man.  At  some  point  dur- 
ing each  visit  he  said,  "Doctor,  there 
isn't  a  thing  you  can  do  for  me  except 
pray  to  the  Lord  that  he  will  take  me 
soon."  So,  naturally,  1  shared  this  hope 
with  him,  and  1  presumed  that  he  was 
in  the  stage  of  acceptance.  Some  weeks 
later,  to  my  great  dismay,  he  greeted 
me  with  a  sense  of  urgency.  He  was 
no  longer  a  quiet  man.  He  said,  "Dr. 
Ross,  did  you  pray?"  He  didn't  even 
say  hello!  1  had  hardly  answered,  "No," 
before  he  said,  "Thank  the  Lord,  I  was 
so  afraid  he  might  hear  you!"  When 
I  asked  what  had  happened,  he  replied, 
"You  remember  the  73-year-old  lady 
across  the  hall?"  He  had  fallen  in  love 
and  wanted  to  live  again. 

His  had  not  been  the  stage  of  accept- 


ance; it  had  been  a  beautiful  example 
of  resignation.  Had  1  asked  him  why 
he  had  been  in  such  a  hurry  to  have 
the  Lord  take  him,  1  would  have  been 
told  that  there  was  no  love,  no  meaning, 
and  no  purpose  in  this  life  of  his,  and 
that  he  might  as  well  die.  This  is  the 
resignation  so  often  found  in  nursing 
homes. 

Prolongation  of  life 

1  should  like  to  touch  on  the  area  of 
the  prolongation  of  life.  We  often  have 
fewer  problems  in  helping  a  terminally 
ill  patient  work  through  the  stages  of 
dying  than  we  have  with  the  staff,  as 
they  have  a  harder  time  facing  the  real- 
ity of  death.  We  train  members  of  the 
health  professions  to  cure,  to  treat,  and 
to  prolong  life,  but  we  do  not  train  them 
to  cope  with  a  patient  who  is  beyond 
medical  help  or  to  accept  the  patient's 
right  to  die  in  peace  and  with  dignity. 

1  am  talking  about  euthanasia,  but 
not  in  its  sense  of  mercy  killing.  1  am 
very  much  in  favor  nf  euthanasia  as  the 
work  itself  implies —  a  good  death  — 
and  1  think  we  should  all  work  toward 
that  goal. 

Robert  died  alone 

Let  me  tell  you  about  Robert,  a  hand- 
some 21 -year-old  student,  full  of  life 
and  energy.  He  came  to  our  hospital 
nearly  two  years  ago.  He  had  leukemia. 
He  faced  squarely  the  fact  that  he  had 
the  disease,  and  he  knew  that  all  the 
odds  were  against  him.  When  asked, 
he  was  pleased  to  take  part  in  our  semi- 
nar. 

During  our  interview,  Robert  shared 
with  us  his  greatest  hopes:  that  he  would 
get  well  enough  to  graduate  from  uni- 
versity in  the  spring,  that  he  would 
trave'  to  Europe  soon  thereafter,  and, 
bargaii.'ng,  that  he  would  not  continue 
his  studies  for  at  least  three  years.  Then 
he  could  go  on  to  his  doctorate  of  phi- 
losophy and  a  career  in  teaching.  That 
would  be  his  real  sacrifice,  for  in  three 
years  he  would  surely  be  cured,  and 
then  he  could  really  begin  to  live  again. 
That,  summarized,  is  what  he  shared 
in  our  seminar. 

Robert  left  our  hospital  soon  after- 
wards, and  asked  to  be  left  alone  as  long 
as  he  was  at  home,  for  he  wanted  to 
OCTOBER     1971 


live  with  a  new  intensity  and  together- 
ness with  his  family.  We  respected  his 
needs,  and  we  did  not  try  to  get  in  touch 
with  him. 

On  New  Years  Eve  something  hap- 
pened that  I  must  share  with  you.  Ex- 
pecting about  25  dinner  guests  to  arrive 
at  7:30  P.M.,  1  was  busy  popping  hors 
d'oeuvres  in  the  oven  and  doing  other 
last-minute  cooking.  When  the  tele- 
phone rang  at  7:00,  it  was  the  hospital 
chaplain  who  wanted  me  to  know  that 
Robert  was  back  in  hospital  in  a  very 
critical  condition,  and  was  not  expected 
to  live  through  the  night. 

You  can  appreciate  my  conflict  — 
1  was  supposed  to  have  guests,  and  all 
1  wanted  to  do  was  to  hop  in  the  car 
and  drive  to  Chicago,  an  hour  away, 
to  be  with  Robert! 

Then  I  did  something  silly:  I  called 
the  hospital  to  ask,  "How  is  he  doing?" 
Do  you  know  why  I  did  that?  Magical 
thinking —  if  I  wished  long  and  hard 
enough,  maybe  he  would  be  alright,  at 
least  until  the  next  day  when  it  would 
be  convenient  for  me  to  see  him.  Of 
course,  the  hospital  assured  me  that  I 
was  not  really  wanted,  nor  needed.  But 
that  didn't  help:  I  wanted  to  be  with 
Robert! 

At  that  point  I  did  what  only  a  wo- 
man can  do  —  1  let  my  hors  d'oeuvres 
bum.  Not  because  1  was  consciously 
acting  out,  but  because  I  wasn't  "with 
it."  Then  my  husband  came  into  the 
kitchen,  sniffing,  and  asked  who  had 
called.  When  told,  he  said,  "If  you 
don't  drive  to  Chicago,  1  will  drive  you 
there  myself!"  That  gave  me  the  free- 
dom to  go  to  the  hospital. 

At  the  hospital  I  witnessed  the  most 
painful  part  of  this  work  with  dying 
patients.  Robert's  parents  sat  in  the 
waiting  room.  I  had  never  seen  them 
before.  His  father  was  numb  with  pain, 
he  couldn't  talk,  and  he  obviously  should 
not  have  to  be  bothered  or  disturbed. 
When  family  members  feel  this  way, 
do  not  go  and  disturb  them;  be  a  re- 
spectful distance  away,  but  available 
when  they  are  ready  to  open  up.  1  then 
talked  with  Robert's  mother,  who  shared 
an  anecdote  with  me  that  shows  what  I 
meant  earlier  by  symbolic  language. 

She  said,  "When  we  came  to  Chica- 
go, acquaintances  offered  us  a  room 
OCTOBER      1971 


near  the  hospital.  We  had  our  car  parked 
downstairs  outside  the  church.  When 
the  phone  call  came,  we  wanted  to 
rush  to  the  hospital.  We  went  down  to 
the  car  only  to  see  that  someone  had 
stolen  the  battery  out  of  it!"  I  wondered 
why  she  talked  about  stolen  car  batteries 
when  this  happens  in  Chicago  all  the 
time. 

There  can  be  a  hundred  interpreta- 
tions for  what  this  mother  meant.  1  tried 
to  think  of  several.  I  looked  at  her  sud- 
denly and  said,  "People  are  very  cruel." 
Then  the  father  looked  up  and  started 
to  cry,  and  the  mother  pointed  to  the 
intensive  care  unit,  crying.  They  were 
then  expressing  what  they  had  wanted 
to  say  but  had  found  too  difficult.  I  then 
went  quietly  into  the  intensive  treatment 
room. 

There  before  me  lay  this  handsome 
young  man,  Robert  —  blown  up,  tubes 
hanging  out  of  his  mouth,  lips  cut, 
infusion  bottles  running,  the  trache- 
otomy, the  respirator  —  the  whole 
works.  But  what  first  bothered  me  was 
that  he  was  naked  from  head  to  toe! 
"Why?"  —  I  took  a  bedsheet  to  cover 
him  up,  only  to  be  told,  "Don't  bother, 
he's  going  to  push  it  off  again,  anyway." 
Angered  by  this  I  said,  "Give  me  two 
safety  pins." 

When  I  walked  over  to  him,  he  took 
my  hand  and  looked  up  to  the  ceiling. 
My  first  thought  was  that  he  was  telling 
me  that  he  was  ready  to  die.  But  then 
I  noticed  a  strong  light  shining  into  his 
eyes.  When  I  asked  if  these  lights  could 
be  dimmed  or  switched  off,  I  was  instead 
lectured  about  the  rules  and  regulations 
of  the  intensive  care  unit  (and  I  know 
the  rules  and  regulations).  Naturally  I 
became  more  angry  and  more  disap- 
pointed. 

I  also  asked  for  two  chairs  to  allow 
Robert's  parents  to  sit  down.  I  could 
not  understand  why  a  young  person 
had  to  die  alone  while  his  parents  sat 
outside  in  the  waiting  room,  allowed 
to  come  in  for  only  five  minutes  out  of 
every  hour.  I  was  told  that  they  could 
not  give  the  mother  a  chair  to  sit  on 
because  she  had  stayed  more  than  five 
minutes  the  last  time! 

Well,  Robert  died  at  3:30  a.m..  New 
Year's  morning —  alone,  with  tubes  in 
his  mouth,  with  infusion  and  respirator 


gomg,  the  light  shining  in  his  eyes  — 
and  with  his  parents  sitting  outside  in 
the  waiting  room. 

The  question  is:  What  do  you  do  to 
change  this?  You  cannot  change  it  by 
breaking  the  lightbulb.  You  cannot 
change  it  by  revolution,  only  by  evolu- 
tion. 

The  physicians  had  taken  excellent 
care  of  Robert.  He  had  had  the  best 
possible  medical  care.  They  acknow- 
ledged at  7:00  p.m.  New  Year's  Eve 
that  he  was  dying,  they  conveyed  the 
message  beautiftilly  and  tactfully  to  the 
parents,  and  then  they  left.  If  they  had 
really  felt  deep  down  inside  that  they 
had  been  marvellous,  wonderful  physi- 
cians, that  they  had  done  everything 
good  physicians  could  do,  that  it  was 
alright  to  die,  they  would  have  taken 
Robert  out  of  the  intensive  care  unit 
at  7:00  P.M.  and  put  him  in  a  small 
room  —  a  private  room  with  a  dim 
light,  and  two  chairs  for  his  parents  to 
sit  on.  And  he  would  have  died  in  the 
presence  of  his  parents,  in  peace  and 
with  dignity. 

Death  is  the  most  difficult  thing  to 
teach.  I  believe  the  only  way  you  can 
teach  it  is  to  include  it  in  the  curricula 
of  medical  schools,  nursing  schools, 
social  work  schools,  and  theological 
seminaries.  And  I  hope  that  each  of 
you  will  try  to  light  one  little  candle, 
rather  than  curse  the  darkness. 


This  article  is  adapted  from  a  paper  Dr. 
Kubler-Ross  presented  at  a  conference 
sponsored  by  the  University  of  Western 
Ontario  I  acuity  of  Nursing  and  Summer 
School  and  Extension  Department,  in 
conjunction  with  the  Canadian  Cancer 
Society  (Ontario  Division).  a 


THE     CANADIAN     NURSE     35 


Behavior  therapy  approach 
to  psychiatric  disorder 

The  authors  explain  how  behavior  therapy  differs  from  traditional 
psychotherapies  in  treating  psychiatric  patients.  They  present  this  therapy  from 
a  nursing  point  of  view  and  illustrate  some  techniques  through  a  case  history. 


A  radically  new  approach  to  the  treat- 
ment of  psychiatric  patients  is  beginning 
to  find  its  way  into  Canadian  hospitals. 
Called  behavior  therapy  or  behavior 
modification,  it  represents  a  breakaway 
from  the  medical  tradition  of  psychiatry 
and  draws  upon  the  expanding  field 
of  scientific  psychology  for  its  know- 
ledge. Results  to  date  indicate  that 
behavior  therapy  is  effective  for  a  wide 
variety  of  disorders.  It  might  assist 
patients  where  other  methods  have 
failed. 

New  kind  of  psychotherapy 

Much  of  today's  psychiatry  regards 
mental  illness  as  a  disease  process  that 
can  be  alleviated  or  cured  by  medical 
methods,  such  as  drugs  or  electro- 
convulsive therapy.  To  get  rid  of  the 
symptoms  some  supposed  underlying, 
although  invisible,  disorder  must  first 
be  cured.  Many  of  the  symptoms  are 
thought  to  originate  in  the  unconscious, 
coming  to  the  surface  through  the  com- 
plex interplay  of  various  mental  mech- 
anisms. 

For  example,  to  treat  a  patient  with 
a  nervous  tic,  the  psychiatrist  might 
spend  considerable  time  studying  the 
patient's  history  to  determine  the 
conflicts  and  anxieties  thought  to  under- 
lie his  symptom.  By  gaining  insight 
into  his  conflicts,  the  patient  would 
be  expected  to  lose  his  symptom. 

These  views  of  mental  illness  have 
grown  out  of  traditional  medicine  and 

36     THE     CANADIAN      NURSE 


John  Raeburn,  Ph.D.,  and  Joan  Soler,  R.N. 

have  been  influenced  by  Freudian  and 
other  "depth"  views  of  human  person- 
ality. 

In  contrast,  behavior  therapy  is  not 
concerned  with  underlying  and  invisible 
processes  as  much  as  the  everyday, 
observable  functioning  of  the  patient. 
It  may  be  the  symptom  rather  than  the 
underlying  process  that  is  of  interest. 
For  example,  the  patient  suffering  from 
a  nervous  tic  would  simply  be  put  on  a 
schedule  of  "massed  practice,"  requir- 
ing him  to  keep  moving  the  muscles 
involved  in  the  tic  until  he  could  no 
longer  do  so.  After  practicing  this  a  few 
times,  the  tic  usually  disappears  com- 
pletely. This  treatment  may  require 
only  one  session  with  the  therapist;  in 
fact,  we  have  cured  this  type  of  tic  by 
giving  instructions  by  mail. 

Persons  who  hear  about  behavior 
therapy  treatment  are  often  concerned 
about  the  possibility  of  symptom 
substitution.  This  means  that,  if  symp- 


When  they  wrote  this  article.  Dr.  Raeburn 
was  assistant  director  of  the  Behavior  Ther- 
apy Unit  at  the  Douglas  Hospital  in  Mont- 
real, and  Mrs.  Soler  was  head  nurse  in  the 
unit.  Dr.  Raeburn.  a  graudate  of  Queen's 
University,  Kingston,  Ontario,  left  the 
Douglas  Hospital  in  June  1971  to  travel 
abroad.  Mrs.  Soler,  who  was  head  nurse 
in  this  unit  for  three  and  a  half  years  until 
her  resignation  in  April  1971,  is  a  graduate 
of  the  Toronto  East  General  and  Orthopedic 
Hospital,  Toronto,  Ontario. 


toms  are  removed  without  paying 
enough  attention  to  what  lies  beneath, 
new  symptoms  will  emerge  to  replace 
the  old.  This  notion  has  been  thoroughly 
researched,  and  to  date  there  is  no 
evidence  that  it  occurs.  In  fact,  when 
the  patient  sees  his  symptoms  improve, 
his  confidence  and  well-being  usually 
increase  remarkably,  with  any  under- 
lying problems  disappearing  of  their 
own  accord. 

What  problems  can  be  treated? 

The  term  "behavior  therapy"  covers 
at  least  20  techniques  applicable  to 
numerous  disorders.  These  techniques 
are  divided  into  the  following  three 
broad  areas,  according  to  the  kinds  of 
problems  they  are  designed  to  treat: 
Disorders  associated  with  anxiety: 
phobias,  obsessions  and  compulsions, 
hysteria,  complex  anxiety  states,  bed- 
wetting,  interpersonal  difficulties,  and 
sexual  impotence. 

Behaviors  unacceptable  to  tlie  patient 
or  to  society:  alcoholism,  drug  addic- 
tion, over-eating,  excessive  smoking, 
homosexuality,  exhibitionism,  and 
other  sexual  deviations. 
Behaviors  associated  with  schizophrenia 
and  deficits  due  to  organic  brain  damage 
or  mental  deficiency:  In  these  cases, 
behavior  therapists  might  conclude 
there  are  underlying  processes  that 
will  not  be  changed  by  their  methods. 
Nevertheless,  behavioral  techniques 
can  often  greatly  improve  the  daily 
OCTOBER     1971 


functioning    of    patients    with     these 
disorders. 

Mood  disorders  found  in  manic- 
depressive  psychosis  are  not  yet  ac- 
cessible to  behavior  therapy  methods. 
In  addition,  no  methods  are  available 
for  patients  who  do  not  want  to  be 
treated;  this  applies  especially  to 
"unacceptable"  behaviors,  such  as 
addictions.  As  with  any  form  of  psycho- 
therapy, motivation  is  an  important 
factor. 

All  nurses  are  involved 

Traditional  psychotherapeutic  meth- 
ods have  been  the  specialty  of  a  limited 
number  of  highly  trained  psychiatrists 
who  may  spend  large  blocks  of  time 
with  individual  patients.  This  has 
meant  that  nursing  staff  in  hospitals 
has  played  mainly  a  supportive  and 
caretaking  role,  with  minimal  involve- 
ment in  active  therapy.  However,  in 
our  Behavior  Therapy  Unit  (B.T.U.) 
at  Douglas  Hospital,  every  member  of 
the  nursing  staff  participates  in  therapy. 
Each  patient  has  a  supervising  thera- 
pist, a  psychologist,  and  two  or  three  co- 
therapists,  nursing  staff  or  other  help- 
ers. Many  of  the  basic  behavior  therapy 
techniques  can  be  learned  by  a  nurse 
after  a  relatively  short  on-the-job 
training  period.  At  service  conferences, 
nurses  are  encouraged  to  express  their 
ideas,  and  treatment  plans  can  be 
changed  in  accordance  with  them. 

Nurses  are  responsible  for  much  of 
the  observation  of  patients,  both  before 
and  during  treatment.  This  observa- 
tion is  conducted  systematically,  per- 
mitting them  to  draw  up  graphs  and 
other  statistical  records  of  behavioral 
changes  due  to  treatment.  Such  records 
provide  encouragement  for  both  staff 
and  patients.  Being  actively  involved 
in  treatment  and  being  able  to  see  the 
results  of  her  efforts,  make  work  in 
behavior  therapy  a  fulfilling  and  excit- 
ing experience  for  the  nurse. 

Debbie's  treatment 

An  example  of  this  therapy  at  work 
can  be  seen  in  Debbie,  an  aggressive 
and  retarded  schizophrenic  girl  treated 
in  the  B.T.U.  The  behavior  therapy 
OCTOBER      1971 


technique  used  with  her  is  called  oper- 
ant conditioning,  a  treatment  for  be- 
havior associated  with  schizophrenia 
and  deficits  due  to  organic  brain  dam- 
age or  mental  deficiency.  This  technique 
involved  a  number  of  nursing  staff  in 
her  treatment. 

When  Debbie  came  to  the  B.T.U. in 
1968,  she  was  12  years  old.  Her  ab- 
normality had  first  become  evident 
in  kindergarten,  where  she  was  des- 
cribed as  being  cruel  toward  the  other 
children.  She  became  increasingly 
unmanageable  at  home  and  was  admit- 
ted to  the  children's  services  at  Douglas 
Hospital  in  1964.  There  she  displayed 
fiercely  aggressive  behavior  directed 
primarily  toward  females.  Typically, 
she  would  lunge  at  her  victim,  seize 
her  by  the  hair,  throw  her  to  the  ground, 
and  tear  at  her  clothes  and  face.  She 
showed  such  strength  in  these  activities 
that  it  often  took  several  men  to  res- 
train her. 

Increasing  amounts  of  medication 
of  all  kinds  were  given  to  Debbie.  When 
she  came  to  the  B.T.U.,  she  was  on 
phenothiazines,  barbiturates,  psycho- 
sedatives,  and  muscle  relaxants  in  near 
lethal  doses.  But  no  amount  of  medi- 
cation seemed  able  to  control  her.  and 
if  not  restrained,  her  attacks  would 
average  about  20  a  day.  It  thus  became 
necessary  to  confine  her  to  a  single 
room  to  protect  others  and  herself;  at 
the  time  of  her  referral  to  B.T.U.,  she 
had  spent  the  better  part  of  three  years 
alone  in  her  room. 

Apart  from  her  aggressive  behavior, 
Debbie  was  incapacitated  in  virtually 
every  other  sphere  of  her  life.  She  had 
no  control  over  bladder  or  bowel  func- 
tions, and  made  almost  no  positive 
response  to  those  around  her.  Although 
able  to  play  simple  games  under  super- 
vision, she  could  concentrate  on  a  task 
no  longer  than  three  minutes.  Her 
speech  was  restricted  to  one-word 
answers  to  questions. 

Eliminating  negative  behavior 

It  was  evident  that  two  main  treat- 
ment approaches  to  Debbie  were  re- 
quired: one  to  eliminate  her  undesir- 
able aggressive  behavior,  and  the  other 


to  build  up  desirable  behaviors  that 
she  lacked.  According  to  psychological 
principles,  behavior  is  largely  controll- 
ed by  its  immediate  consequences.  A 
positive  event  or  reward  immediately 
following  the  behavior  strengthens  it, 
but  if  this  reward  is  lacking  or  if  there 
are  negative  consequences,  the  behav- 
ior will  be  weakened  and  will  tend 
to  disappear.  Psychologists  describe 
these  effects  as  reinforcement:  the 
strengthening  of  behavior  by  reward  is 
"positive"  and  the  weakening  of  beha- 
vior by  unpleasant  consequences  is 
"negative."  When  this  concept  of 
reinforcement  is  used  systematically, 
it  is  a  powerful  method  of  changing 
behavior.  It  is  the  reinforcement  imme- 
diately following  the  behavior  that  has 
the  most  effect. 

Whenever  possible,  the  therapist 
uses  positive  reinforcement.  What  is 
rewarding  depends  on  what  an  individ- 
ual will  work  for.  Food,  candy,  ciga- 
rettes, and  praise, are  commonly  used 
positive  reinforcers.  Psychiatric  pa- 
tients, who  are  usually  looked  after 
by  a  relatively  small  number  of  people, 
can  find  the  attention  of  staff  reward- 
ing. 

For  Debbie,  such  attention  was  prob- 
ably the  positive  reinforcement  that 
maintained  her  aggressive  behavior,  as 
it  always  brought  staff  running  to  deal 
with  her.  The  nurses,  who  ran  to  control 
Debbie  by  putting  her  in  a  room  by 
herself  (which  might  be  regarded  as 
negative  reinforcement),  gave  her  a  lot 
of  rewarding  attention  before  she  got 
into  the  room. 

Negative  reinforcement  is  used  only 
if  it  is  necessary  to  treat  grossly  undesir- 
able behavior.  Sometimes  all  that  is 
required  is  the  temporary  withholding 
of  positive  reinforcement,  which  results 
in  a  process  called  extinction.  This 
means  that  a  behavior,  which  is  main- 
tained by  rewards,  will  eventually  dis- 
appear or  be  extinguished  if  these 
rewards  are  not  given.  However,  be- 
haviors sometimes  become  so  well 
entrenched,  they  do  not  respond  to  this. 
In  extreme  cases,  a  mild  electric  shock 
may  be  used  as  a  negative  reinforcer. 
Again,  it  is  crucial  that  the  reinforcer 

THE     CANADIAN     NURSE     37 


be  given  as  soon  as  the  behavior  is 
observed.  Usually  few  shocks  are 
required  to  halt  the  behavior,  and 
advantage  can  be  taken  to  begin  de- 
veloping constructive  behaviors  by 
using  positive  reinforcement. 

An  attempt  was  first  made  to  deal 
with  Debbie's  aggressive  behavior  by 
an  extinction  procedure.  A  young  male 
therapist  entered  her  room  wearing  a 
fencing  mask  to  prevent  communicating 
any  "rewarding"  expressions  of  distress 
to  Debbie.  As  predicted,  Debbie  attack- 
ed him,  but  he  stood  his  ground  and 
the  attacks  gradually  became  fewer 
until  they  disappeared.  He  was  event- 
ually able  to  remove  the  mask  with 
the  same  results. 

Unfortunately,  the  extinction  was 
not  permanent  and  the  aggressive  be- 
havior reappeared  after  a  time.  Electric 
shock  was  then  introduced  as  a  negative 
reinforcer.  Each  time  Debbie  began  to 
lunge  at  someone,  a  mild  shock  was 
delivered  from  a  rod  held  by  a  staff 
member.  Only  four  such  schocks  were 
required  to  bring  her  attacks  to  a 
manageable  level.  Although  her  attacks 
were  never  completely  eliminated,* 
they  dropped  from  20  a  day  to  less 
than  one  per  week. 

Building  positive  behavior 

It  was  then  possible  to  concentrate 
on  building  positive  behaviors.  Much 
of  this  training  was  done  by  nursing 
staff.  The  first  step  was  to  define  pre- 
cisely the  areas  of  behavior  needing 
work.  Programs  were  set  up  so  that 
each  area  was  graded  into  a  series  of 
gradual  steps  from  the  simplest  level 
to  the  most  complex.  Each  approxima- 
tion to  the  behaviors  specified  by  a  step 
in  the  program  brought  immediate 
positive  reinforcement.  At  first,  food 
and  candies  were  the  reinforcers;  later, 
praise  and  affection  became  more 
important. 


*There  may  have  been  some  organic  basis 
to  Debbie's  aggressive  behavior.  This  did 
not  contraindicate  the  shock  approach,  but 
it  did  mean  the  attacks  would  probably  never 
go  away  completely. 

38     THE     CANADIAN      NURSE 


The  following  areas  of  behavior  were 
approached  in  this  manner:  personal 
habits,  including  cleanliness,  grooming, 
dressing,  politeness,  and  table  manners; 
language,  beginning  with  single  words 
and  building  up  to  sentences  and  con- 
versation; schooling,  which  progressed 
from  playing  constructive  games  to 
reading,  elementary  arithmetic,  and 
other  scholastic  skills;  and  socializa- 
tion, which  improved  to  the  extent  that 
she  was  able  to  build  strong  positive 
relationships  with  staff,  and  would 
work  hard  for  a  kind  word  or  a  smile 
from  them. 

In  the  relatively  brief  span  of  four 
months,  Debbie  responded  so  well  to 
her  program  that  it  was  possible  to  with- 
draw her  from  all  medication.  There 
were  longer  periods  during  which  she 
displayed  no  aggressive  behavior;  one 
such  period  lasted  19  weeks.  The  nurs- 
ing staff,  who  had  their  positive  rein- 
forcement from  this  progress,  became 
very  fond  of  her.  Treatment  lasted  more 
than  a  year,  when  it  appeared  she  had 
reached  the  limit  of  her  capacities. 
Among  other  things,  she  was  able  to 
eat  in  the  public  cafeteria,  choose  what 
to  wear,  dress  herself,  do  schoolwork, 
enjoy  sports,  do  light  domestic  chores, 
express  herself,  and  smile  and  laugh 
appropriately.  Most  important,  she 
could  give  and  receive  affection,  there- 
by finding  some  happiness  in  what  must 
always  remain  a  relatively  limited 
existence. 

Conclusion 

It  should  be  emphasized  that  the 
operant  conditioning  technique  used 
with  Debbie  is  only  one  of  many  kinds 
of  behavior  therapy  treatment.  Also, 
Debbie's  treatment  was  unusual  in  that 
it  involved  a  considerable  length  of 
time,  which  reflected  the  gravity  of 
her  deficits. 

Most  people  treated  in  B.T.U.  are 
discharged  in  less  than  six  months.  Al- 
though many  patients  have  already 
had  years  of  various  therapies  with 
little  success,  over  80  percent  of  our 
patients  leave  "improved"  or  "greatly 
improved."  However,  we  have  not 
yet  been  able  to  assess  systematically 


the  permanence  of  these  effects.  The 
unit  hums  with  activity,  and  though 
this  puts  demands  on  all  concerned,  we 
believe  we  are  engaged  in  a  worthwhile 
and  vital  enterprise.  Learning  and 
experimentation  never  stop,  and  we 
are  constantly  adding  new  methods  to 
our  repertoire. 

Although  behavior  therapy  is  still 
new,  there  is  growing  research  evidence 
that  it  has  the  potential  to  be  one  of 
the  most  effective  approaches  yet 
devised  to  deal  with  psychiatric  dis- 
orders. Behavior  therapy  will  be  heard 
of  more  and  more  in  the  future  and  it 
will  offer  the  psychiatric  nurse  increas- 
ing challenge  and  satisfaction.  ^ 


OCTOBER      1971 


Adolescent  sexual  activity 

Many  factors  complicate  adolescent  sexual  relations.  Because  these  relations  are 
not  sanctioned  socially,  they  tend  to  be  furtive,  ill-prepared,  and  hasty  affairs. 
Often  the  sexual  partners  are  unable  to  communicate  with  each  other  or  with 
health  workers  about  sexual  problems  because  they  fear  censure  or  loss  of  face. 


George  Szasz,  M.D. 

Sexuality  is  a  term  used  to  describe  all 
those  manifestations  of  behavior  that 
reflect  a  person's  maleness  or  female- 
ness  in  the  social  milieu.  Adolescent 
sexuality  differs  from  adult  sexuality 
in  that  adults  try  to  demonstrate  that 
they  are  men  or  women,  whereas 
adolescents  try  to  prove  that  they  are 
rapidly  becoming  men  or  women. 

The  term  sexuality  includes,  but  is 
not  synonymous  with,  sexual  behavior; 
the  latter  denotes  specifically  those 
activities  that  lead  to  social  pair  for- 
mation and  mating  activities.  Sexual 
activity  is  the  term  normally  reserved 
to  describe  a  portion  of  sexual  behavior 
which  leads  to  the  unfolding  of  a  specif- 
ic chain  of  physiological  events:  the 
sexual  response  of  men  and  women. 

The  sexual  activities  of  adolescents 
are  not  any  different  from  those  of 
adults.  These  may  be:  1 .  solitary  sexual 
activities,  such  as  masturbation;  2. 
heterosexual  activities,  such  as  various 
forms  of  petting  and  intercourse;  3. 
homosexual  activities,  usually  in  the 
form  of  petting  and  anal  intercourse; 
and  4.  sexual  activities  involving 
animals.  In  addition,  nocturnal  orgasms 
(wet  dreams,  nocturnal  emission  of 
semen)  may  occur  frequently  in  ado- 

Dr.  Szasz  is  Associate  Professor.  Director 
of  the  Office  of  Interprofessional  Educa- 
tion. Health  .Sciences  Centre.  The  Univer- 
sity of  British  Columbia,  Vancouver,  B.C. 


lescent  boys, 
generation  of 
not  understood. 


The   exact 
this  sexual 


method   of 
response  is 


OCTOBER      1971 


Sexual  stimuli  and  response 

The  physiology  of  human  sexual 
response  is  characterized  by  the  build- 
ing up  of  neuro-muscular  tensions  to 
a  peak,  followed  by  a  sudden  spas- 
modic discharge  of  that  tension  and  a 
return  of  the  body's  functioning  to  its 
normal  physiological  state.  The  physical 
equipment  that  allows  the  body  to 
respond  to  various  sorts  of  stimuli  are 
present  from  birth,  but  the  capacity  of 
the  body  to  respond  in  a  way  that  is 
specifically  sexual  seems  to  increase 
as  a  child  develops  physically.  In  many 
children  it  does  not  appear  until  near 
the  age  of  adolescence. 

The  chain  of  physiological  events 
occurring  in  the  course  of  sexual  stim- 
ulation is  virtually  the  same  in  young 
and  old.  The  intensity  of  feelings  and 
the  significance  to  the  individual  may 
be  different. 

The  stimuli  that  produce  the  sexual 
response  cycle  consist  of  certain  cul- 
turally-determined thoughts  and  certain 
activities,  in  general,  adolescent  boys 
are  stimulated  by  the  thoughts  of  sexual 
organs  and  mental  pictures  of  sexual 
activity;  girls  appear  to  be  more  stim- 
ulated by  thoughts  of  romantic  relation- 
ships with  handsome  suitors. 

THE     CANADIAN     NURSE     39 


Although  thoughts  can  initiate  the 
sexual  response  cycle,  usually  the  touch 
activities  only  are  productive  of  orgasm. 

Orgasm 

Stimulation  of  the  erogenous  areas 
of  the  body  (nape  of  the  neck,  lips, 
chest,  breasts,  skin  of  the  abdomen, 
inside  of  the  thighs,  and  the  genitalia) 
results  in  a  dilation  of  blood  vessels 
under  the  skin.  A  slight  blush  appears 
on  the  face,  neck,  and  chest,  accompani- 
ed by  tingling  sensations. 

As  the  volume  of  blood  increases  in 
the  region  of  the  breasts  in  the  female, 
the  breast  tissues  become  swollen  and 
the  nipples  become  erect.  When  the 
blood  rushes  into  the  pelvic  area  in 
boys,  the  male  organ  becomes  distended 
and  erect:  in  girls,  the  clitoris,  the  lips 
of  the  vagina,  and  the  barrel  of  the 
vagina  become  somewhat  swollen,  and 
a  mucous  lubrication  appears. 

With  further  stimulation,  the  adoles- 
cent experiences  acute  feelings  of 
pleasure  localized  in  the  genital  area. 
Gradually,  both  boys  and  girls  become 
aware  of  gentle  waves  of  muscular 
spasms  in  the  skeletal  muscles,  occa- 
sionnally  even  in  the  intestines  and  the 
anus. 

As  the  muscular  tension  increases, 
a  desire  overwhelms  the  adolescent 
to  carry  on  with  this  stimulation.  Ra- 
tional concerns  are  often  brushed  aside, 
and  perceptions  of  the  realities  of  the 
world  become  distant.  Soon  all  sensa- 
tions reach  a  peak.  There  seems  to  be 
no  fuller  sensation  possible  in  the 
genital  area,  and  suddenly  the  orgasm, 
in  the  form  of  a  spasmodic  release  of 
tension,  occurs. 

Boys  report  that  this  release  is  usually 
preceded  by  a  feeling  of  the  inevitability 
that  something  will  be  ejected  from 
their  male  organ.  This  feeling  gives 
way  to  four  or  five  contractions,  which 
start  at  the  base  of  the  male  organ  and 
move,  like  waves,  toward  the  tip.  Each 
contraction  results  in  the  ejection  of 
semen.  The  early  adolescent  does  not 

40     THE     CANADIAN     NURSE 


yet  ejaculate,  but  feels  the  contractions. 
The  relatively  minor  anatomical  struc- 
ture needed  for  ejaculation  does  not 
develop  until  a  later  stage. 

Girls  report  that  the  acute  sensation 
of  fullness  is  usually  focused  in,  or 
around,  the  clitoral  area.  Waves  of 
muscular  spasms  occur  in  the  barrel  of 
the  vagina  at  rhythmic  intervals,  often 
radiating  into  the  area  occupied  by 
the  uterus,  and  sometimes  even  into 
the  abdomen. 

During  orgasm,  the  adolescent's  face 
may  become  tense  due  to  spasms 
occurring  in  the  muscles  of  the  jaw; 
sometimes  swallowing  and  breathing 
stop  for  a  few  seconds,  but  resume  as 
the  gradual  convulsive  movements  of 
the  body,  legs,  and  arms  occur.  During 
orgasm,  the  adolescent  is  oblivious 
to  the  discomforts  of  positioning  and 
the  pains  inflicted  by  the  tight  squeez- 
ing, biting,  or  scratching  of  the  partner. 

The  actual  time  period  of  orgasm  is 
usually  quite  brief  for  both  sexes. 
Following  5  to  10  seconds  of  contrac- 
tions, the  body  quite  rapidly  returns 
to  its  normal  state.  As  the  blood  flow 
is  redirected  from  the  pelvic  areas, 
the  high  pulse  rate,  the  elevated  blood 
pressure,  and  the  rapid  respiratory 
rate  all  return  to  the  level  normal  for 
that  individual. 

Young  boys  and  girls  often  do  not 
recognize  that  they  have  just  experi- 
enced an  orgasm.  Boys  tend  to  puzzle 
over  the  sudden  loss  of  erection  of  their 
male  organ.  Both  might  wonder  about 
the  tiredness  that  may  overwhelm  them 
after  the  orgasm. 


Sexual  functioning  unique 

The  sexual  functioning  of  the  body 
at  any  age  is  a  natural,  physiological 
process.  Sexual  responsivity  possesses, 
however,  a  unique  facility  that  no  other 
natural  physiological  process  can 
imitate:  it  can  be  delayed  indefinitely, 
or  functionally  denied  for  a  lifetime. 

Guidelines  exist  in  most  societies  to 


indicate  the  extent  to  which  a  person 
should  channel  his  sexual  activities.  The 
ability  to  conform  to  these  guidelines 
has  become,  in  many  cultures,  the 
yardstick  of  measurement  of  that 
individual's  honor,  fidelity,  honesty, 
self-control,  and  trustworthiness.  Thus, 
sexual  functioning  can  be,  and  has 
been,  easily  removed  from  its  natural 
context  as  a  basic,  physiological  re- 
sponse. Sexual  activities  are  being  used 
now  for  procreation,  exploration  of 
each  other's  body,  search  for  tranquil- 
ity, commercial  gains,  relief  from 
boredom,  and  other  purposes. 

Adolescent  sexual  problems 

Sexuality  —  the  becoming  and  being 
of  a  man  or  a  woman  —  has  thus  be- 
come a  complex  and  relative  concept 
that  does  not  lend  itself  easily  to  simpli- 
fication. The  young  person  wants  to 
be  a  man  or  a  woman,  and  wants  to  use 
his  or  her  sexual  apparatus.  The  search 
for  sexual  response  stirs  up  irrational 
and  unconscious  resistances,  and  mobil- 
izes a  great  deal  of  anxiety. 

Apart  from  moral  issues,  fears  of 
the  consequences  of  sexual  activity  are 
probably  uppermost  in  young  people's 
minds. 

The  most  common  fear  relates  to 
masturbation.  The  erroneous  notion 
that  masturbation  will  harm  the  indi- 
vidual physically,  or  interfere  with  his 
subsequent  responses  to  a  partner,  is 
widespread.  Many  individuals  still 
believe  that  masturbation  will  lead  to 
illnesses  such  as  heart  disease  or 
tuberculosis,  and  that  it  is  a  factor  in 
causing  mental  illness,  and  may  even 
lead  to  suicide. 

Fears  also  relate  to  petting:  adoles- 
cents are  uncertain  whether  premarital 
petting  experiences  may  harm  future 
marital  adjustment.  They  are  anxious 
to  know  what  effect  intercourse  before 
marriage  might  have  on  their  subse- 
quent social  and  marital  adjustments. 
Many  adolescents  are  worried  about 
venereal  diseases  and  pregnancy  as 
OCTOBER     1971 


consequences  of  their  sexual  activities. 

Interestingly,  however,  when  the 
adolescent  turns  to  a  health  professional 
for  help,  he  or  she  does  so  not  because 
of  fear,  but  because  of  the  appearance 
of  these  consequences. 

Inadequacy  in  performance  is  an- 
other source  of  adolescent  sexual  prob- 
lems. Premature  ejaculation  is  one  of 
the  more  common  inadequacies  occur- 
ring in  sexually  active  boys.  The  defi- 
nition of  this  condition  is  somewhat 
difficult,  as  there  are  individual  varia- 
tions. Some  boys  reach  orgasm  when 
a  girl  touches  their  male  organ;  some 
reach  orgasm  upon  insertion  of  their 
male  organ  into  the  female  organ;  and 
some  reach  orgasm  within  the  first  few 
moves  during  intercourse. 

The  cause  of  premature  ejaculation 
is  not  fully  understood.  One  factor  may 
be  the  socio-cultural  pressure  to  com- 
plete the  sexual  act  quickly;  another 
may  relate  to  petting  activity  in  which 
only  male  release  is  sought.  Both  these 
factors  relate  to  inexperience,  anxiety 
about  the  sexual  act,  and  the  lack  of 
privacy  and  an  appropriate  place  to 
perform  such  an  act. 

Impotence,  the  inability  to  achieve 
or  maintain  an  erection  sufficient  to 
perform  intercourse,  is  not  uncommon 
among  male  adolescents.  The  causes  of 
this  condition  are  many.  In  fact,  this 
condition  is  related  to  anything  that 
might  throw  a  shadow  of  doubt  on  the 
young  male's  ability  to  perform,  or  on 
his  state  of  masculinity.  Repeated  oc- 
casions of  premature  ejaculation,  fears 
related  to  the  size  of  the  penis  or  its 
shape,  guilt  feelings  about  sexual 
activities,  pressure  of  time  or  place, 
uncooperative  or  upset  female  partners, 
and  the  use  of  drugs  or  alcohol  might 
all  be  partial  causes  of  impotence. 

In  the  adolescent  girl,  failure  to 
reach  orgasm  is  perhaps  the  most 
common  problem.  Sometimes  this  dys- 
function in  the  result  of  deep-seated 
psychological,  social,  or  physiological 
problems. 

OCTOBER      1971 


Much  more  common,  however,  is  the 
so-called  "situational  orgasmic  dys- 
function." The  young  girl  suffering 
from  this  condition  has  experienced 
orgasm  through  masturbation,  petting, 
or  perhaps  through  intercourse,  but 
orgasm  does  not  materialize  at  all  times. 
Usually  the  cause  of  this  problem  is 
related  to  the  value  she  places  on  her 
male  partner.  If  he  does  not  meet  her 
requirements  of  character,  drive,  ap- 
pearance, size,  smell  and  personality, 
she  may  be  unable  to  complete  her 
sexual  response. 

Related  to  orgasmic  dysfunction  are 
fears  about  losing  one's  virginity  and 
fears  of  the  pain  that  might  occur  dur- 
ing the  first  intercourse.  As  a  result  of 
anxiety  or  actual  injury  and  pain,  the 
muscles  of  the  vagina  may  constrict  at 
the  vaginal  opening,  causing  further 
serious  discomfort  when  the  male  at- 
tempts to  enter  the  vaginal  passage. 

Parents'  worries 

Many  complaints  about  adolescent's 
sexual  activities  come  from  parents 
who  are  worried  about  the  social  con- 
sequences of  their  children's  behavior. 
Homosexual  activities  are  perhaps  the 
greatest  worry  to  parents. 

The  extent  of  homosexual  behavior 
in  teenagers  is  unknown,  primarily  be- 
cause of  the  reluctance  of  boys  and  girls 
to  seek  medical  attention.  When  teen- 
age homosexuals  come  for  help,  it  is 
generally  due  to  their  worry  over  the 
possibility  of  venereal  disease,  or  the 
discomfort  caused  by  injured  anal 
tissues.  At  the  same  time,  adolescents 
are  very  curious  about  homosexuality, 
and  this  subject  comes  up  invariably 
in  group  discussions  about  sexual 
behavior. 

Another  problem  that  worries  par- 
ents is  promiscuity.  Sometimes  the  nurse 
or  doctor  may  see  a  teenage  girl  who 
has  had  intercourse  with  several  boys 
in  succession  and  who  has  become 
worried  about  becoming  "promiscu- 
ous." Current  views  of  sexual  behavior 


suggest  that  persons  involved  in  fre- 
quent, unselective  sexual  practices  are 
experimenters  (albeit  fickle  or  unwise) 
or,  perhaps,  suffer  deep-seated  anxiety. 

Teenage  pregnancy  used  to  be  a  great 
source  of  parental  worry.  Concern 
about  this  seems  to  have  lessened  with 
the  wider  availability  of  contraceptives 
and  the  more  liberal  attitudes  and  laws 
of  abortion. 

Sexual  relations  between  family 
members  is  not  an  entirely  uncommon 
occurrence.  The  emotional  implications 
and  the  development  of  such  a  relation- 
ship are  beyond  the  scope  of  this  paper. 
Because  of  the  difficulty  in  separating 
the  facts  from  the  emotions  surround- 
ing the  situation,  and  because  of  the 
usual  need  for  psychiatric  help  and  sup- 
port from  social  and  legal  agencies, 
no  health  professional  is  equipped  to 
handle  this  complicated  problem  alone. 

Implications  for  health  workers 

Many  factors  complicate  adolescent 
sexual  relations,  and  because  these  rela- 
tions are  not  sanctioned  socially,  they 
tend  to  be  furtive,  ill-prepared,  awk- 
ward, and  hasty  affairs.  The  sexual 
partners  are  often  unable  to  communi- 
cate with  each  other  or  with  a  physician 
or  nurse  about  sexual  problems  because 
they  fear  censure  or  loss  of  face.  Conse- 
quently, they  depend  on  hearsay  and 
folklore,  and  often  turn  to  popular 
books  or  outmoded  encyclopedias  for 
information. 

It  is  not  usual  for  adolescents  to  men- 
tion specific  sexual  problems  to  nurses 
or  doctors.  In  fact,  questions  about 
sexual  activities  are  unlikely  to  arise 
in  conversation  unless  they  are  in- 
troduced by  the  health  professional. 

In  many  instances,  however,  convert- 
ed symptoms  give  the  teenager  an 
opportunity  to  visit  the  nurse  or  doc- 
tor. Complaints  of  headaches,  abdom- 
inal pain,  chronic  tiredness,  and  de- 
layed menstrual  periods  often  give  clues 
to  underlying  sexual  problems. 

A  few  minutes  spent  with  the  teen- 
THE     CANADIAN     NURSE     41 


ager  may  expose  a  problem  related  to  a 
lack  of  sexual  responsiveness,  an  emo- 
tional conflict  about  the  moral  aspects 
of  premarital  sexual  relations,  worry 
about  being  over-sexed,  or  anxiety 
related  to  the  possible  presence  of 
venereal  disease  or  pregnancy.  The 
ability  of  the  nurse  or  doctor  to  discuss 
sexual  matters  with  an  adolescent 
depends  on  an  understanding  of  the 
patient  and  the  extent  to  which  the 
practitioner  understands  his  or  her  own 
sexual  impulses. 

Most  nurses  and  doctors  have  re- 
ceived little  if  any  information  about 
the  physiology  and  psychology  of  sex- 
ual behavior  during  their  professional 
training.  Both  are  guided  primarily  by 
their  own  sexual  experiences,  expanded 
by  whatever  they  have  read,  heard, 
or  observed  about  the  sexual  practices 
of  patients. 

In  addition,  many  practitioners 
believe  that  interest  in  sexuality  is 
shameful  and  has  perhaps  some  hidden 
meaning  that  reveals  an  innate,  in- 
appropriate set  of  desires.  Conse- 
quently, many  nurses  and  physicians 
are  concerned  about  the  reaction  of 
their  patients  and  colleagues  who  may 
overhear  or  learn  about  their  interest 
in  sexual  matters. 

Some  supervisors  and  educators 
may  feel  that  sexually-oriented  assess- 
ment of  patients  has  little  or  no  place 
in  patient  management. 

What  must  be  realized  is  this:  Any 
form  of  interpersonal  or  interfamily 
relationship  with  patients  already  in- 
cludes some  kind  of  subtle,  explicit,  or 
overzealous  sexuality  assessment. 

A  knowledge  of  the  adolescent's 
sexual  attitudes  and  behavior  offers 
deep  and  rapid  insight  into  his  or  her 
personal  identification,  concept  of  the 
male  or  female  roles,  and  estimation  of 
personal  worth.  Such  information  may 
direct  the  nurse  practitioner  or  the  med- 
ical practitioner  to  areas  of  personal 
difficulties  that  require  therapy,  educa- 
tion, or  reassurance  for  the  adolescent. 

42     THE     CANADIAN     NURSE 


The  information-gathering  proce- 
dure itself  may  serve  as  therapy,  as  it 
provides  an  opportunity  for  the  adoles- 
cent to  ventilate  accumulated  fears. 
Reassurance  may  arise  even  out  of 
brief  discussions,  for  the  adolescent 
may  come  to  understand  the  "normal" 
sexual  behavior  patterns.  A  satisfactory 
interview  may  become  an  educational 
session,  and  the  knowledge  and  the 
assurance  obtained  at  an  early  date  can 
prevent  future  problems. 

The  nurse's  role 

The  nurse's  assessment  methods  and 
approach  to  relationship  problems  will 
vary,  depending  on  the  role  she  attempts 
to  fulfill. 

First,  she  may  be  performing  nurs- 
ing tasks  that  have  specific  sexual  con- 
notations. These  include  daily  bed 
baths;  back  massages;  changes  of  dress- 
ings; and  the  management  of  toilet  func- 
tions, including  catheterization  proce- 
dures. 

Second,  she  may  act  as  a  counselor 
of  individuals:  patients  in  hospital,  or  at 
home;  students;  couples  to  be  married; 
pregnant  women  or  new  mothers;  par- 
ents of  growing  children;  aging  couples; 
widows  and  widowers.  As  an  adminis- 
trator or  supervisor,  she  may  become 
a  counselor  to  her  staff  members  as 
well. 

Third,  she  may  be  a  health  educator 
and,  as  such,  be  expected  from  time  to 
time  to  share  her  biological  knowledge 
with  school  classes,  teachers,  and 
groups  of  interested  people. 

Fourth,  the  nurse  may  be  asked  to 
offer  her  advice,  as  a  consultant,  to 
schoolboards,  church  organizations, 
service  clubs,  and  other  official  or 
voluntary  agencies  of  the  community, 
in  planning  community  educational 
programs  that  touch  on  various  aspects 
of  human  behavior. 

In  whatever  role  the  nurse  finds 
herself,  she  should  keep  in  mind  three 
basic  principles.  First,  she  should 
avoid  being  caught  up  in  the  emotions 


of  a  person  or  a  group.  Individuals  or 
groups  deeply  disturbed  over  their 
own  or  others'  misfortunes  often  fail 
to  see  the  implications  of  certain  prob- 
lems and  become  enthusiastic  support- 
ers of  activities  they  believe  will  cure 
the  problem.  Second,  she  should  at- 
tempt to  clarify  the  various  aspects  of 
problems  presented  to  her.  In  particu- 
lar, she  should  try  to  discover  whose 
problem  she  is  being  asked  to  deal  with; 
the  parents';  the  schoolboard's,  or 
the  adolescent's.  Third,  she  should 
recognize  her  own  limitations  and  ac- 
knowledge and  utilize  the  knowledge 
of  others. 

Knowledge  and  skills  needed 

The  state  of  scientific  knowledge 
about  human  sexual  behavior  is  rather 
elementary.  The  research  results  of 
Kinsey,  Ford  and  Beach,  Masters  and 
Johnson,  Vincent,  Schofield  and  others 
are  milestones  in  this  field,  but  even 
they  are  at  a  tentative  stage.  It  does  ap- 
pear, however,  that  human  sexuality 
should  be  studied  through  an  examina- 
tion of  human  evolutionary  history,  a 
comparison  of  the  sexual  behavior  of 
people  in  many  cultures,  and  an  exam- 
ination of  the  psychosocial-physiolog- 
ical  functioning  of  the  individual. 

Nurses  and  doctors  need  to  recognize 
teachable  moments  for  sexually-orient- 
ed subjects  and  to  develop  ability  to 
"hear"  sexually-oriented  questions. 
They  may  also  have  to  develop  courage 
and  confidence  to  use  their  knowledge 
and  skills  when  interviewing  adoles- 
cents. 

Guides  to  interviewing 

In  a  conversation  with  the  adoles- 
cent, the  chief  objective  of  the  inter- 
viewer must  be  to  avoid  any  artificiali- 
ty. This  requires  the  creation  of  a  milieu 
free  from  feelings  of  guilt,  of  shame, 
and  of  being  watched. 

The  key  to  success  often  rests  on  the 
type  of  language  used  during  the  inter- 
view. Clinical  words,  such  as  "penetra- 

OCTOBER     1971 


tion,"  "emission  of  semen,"  "homo- 
sexual practice,"  and  so  on,  mean  little 
to  the  young  person.  Similarly,  the 
connotation  of  words  like  "immoral," 
"philanderer,""promiscuous,""chaste," 
and  others,  quite  often  interfere  with 
the  open  discussion  of  issues. 

The  responsibility  to  find  out  what 
level  of  vocabulary  the  young  person 
can  use  or  wishes  to  use  rests  with  the 
interviewer. 

The  adolescent's  thoughts  about 
sexual  matters  are  usually  in  a  state  of 
flux,  often  because  of  the  conflicting 
information  he  obtains  through  tele- 
vision, the  news  media,  books,  and,  of 
course,  observation  of  adult  behavior. 
Also,  while  general  social  attitudes  are 
less  restricted  now  than  in  the  past,  the 
adolescent's  family  may  still  hold  on  to 
old  traditions.  Furthermore,  the  young 
person's  thoughts  and  expectations 
might  be  colored  by  his  religious  train- 
ing, his  parents'  social  customs  and  cul- 
tural beliefs. 

The  adolescent  usually  has  precon- 
ceived notions  about  the  members  of 
the  treatment  team.  He  often  thinks  of 
them  as  trustworthy  and  wise,  inform- 
ed, understanding,  and  non-judgmental. 
He  almost  always  thinks  of  the  nurse 
and  the  doctor  as  unqualified  experts 
in  sexual  matters. 

At  the  same  time,  however,  the 
adolescent  may  supply  answers  purely 
to  impress  the  nurse  or  the  doctor.  A 
popular  young  girl  may  not  admit  to 
orgasmic  dysfunction;  a  football  hero 
might  not  wish  to  reveal  that  he  is 
suffering  from  premature  ejaculation. 

Nurses  and  doctors  often  attempt 
to  fulfill  the  stereotype  held  by  the 
adolescent:  they  try  to  satisfy  the 
adolescent's  image  of  a  nurse  or  a  doctor 
and  to  appear  knowledgeable  about 
issues  of  sexuality,  about  the  changing 
world,  and  about  themselves.  But  their 
activities  are  also  colored  by  their  own 
religion,  social  background,  experiences 
as  a  health  worker,  domestic  situation, 
and  their  own  preconceived  notions 
OCTOBER     1971 


obtained  through  their  life  experiences. 

Thus,  in  their  view  of  sexual  activi- 
ties, the  nurse  or  the  doctor  may  have  a 
host  of  biases:  they  unwittingly  may 
attach  unfavorable  labels  to  people  who 
show  behavior  different  from  their 
own,  and  they  may  react  with  anxiety 
to  descriptions  of  sexual  activities. 

The  loss  of  objectivity  will  cause 
the  interviewer  to  err  by  becoming 
authoritarian  and  judgmental,  thus 
reinforcing  the  patient's  own  inappro- 
priate defence  mechanisms.  It  may  be 
necessary  to  admit  to  some  anxiety,  or 
to  define  the  anxiety  for  the  patient. 
The  latter  can  be  done  with  such  ques- 
tions as,  "Do  you  feel  guilty  about 
this?"  "Does  it  concern  you  that  we 
are  discussing  this  now?"  "If  this  were 
true  in  your  history,  could  you  tell  me 
so?" 

It  is  also  important  to  listen  to  the 
adolescent's  phrasing  of  his  feelings. 
Statements  such  as,  "When  I  have  the 
curse,"  or  "When  we  copulate,"  and 
so  on,  may  indicate  certain  attitudes. 

In  general,  it  is  wise  to  progress  from 
topics  that  are  easy  to  discuss  to  those 
that  are  more  difficult.  For  instance,  it 
is  easier  to  discuss  what  a  female  patient 
feels  during  her  menstrual  period  before 
discussing  the  feelings  she  experiences 
during  orgasm,  although  eventually 
the  latter  has  to  be  discussed  too.  Just 
what  the  order  of  questions  should  be 
depends  on  the  reason  for  the  interview 
and  the  degree  of  willingness  on  the 
part  of  both  the  patient  and  the  inter- 
viewer to  proceed  to  emotionally- 
charged  areas  of  personal  experience. 

Sometimes  it  is  necessary  to  talk  to 
both  the  boy  and  the  girl  who  are 
mutually  involved  in  sexual  activities. 
This  is  particularly  true  when  contra- 
ception is  being  discussed,  or  when 
sexual  inadequacy  of  the  boy  or  girl  is 
the  main  problem.  In  these  discussions 
the  counselor  may  need  assistance  from 
a  counselor  of  the  opposite  sex.  It  is 
sometimes  as  difficult  for  a  woman 
practitioner    to    understand    a    young 


male's  sexual  feelings,  needs,  and 
desires  as  it  is  for  a  male  practitioner 
to  fathom  the  depths  of  female  emo- 
tions. 


Conclusion 

Problems  related  to  sexuality  will 
not  be  resolved  in  our  society  for  a 
long  time.  However,  the  various 
professionals  can  help  to  create  an 
atmosphere  within  which  members  of 
the  community  may  reexamine  their 
value  systems  and  come  to  some  reason- 
able conclusions  about  the  accepted 
limits  of  their  various  forms  of  beha- 
vior —  including  the  sexual  one. 


Bibliography 

Beach.  Frank  A.,  ed.  Sex  and  Behavior. 
New  York.  Wiley.  1965.  p.  494. 

Juhasz-McCreary,  Anne,  and  Szasz,  Geor- 
ge. Adolescents  in  Society.  Toronto, 
McClelland  and  Stewart,  1969. 

Kinsey,  Alfred  C.  et  al.  Sexual  behavior 
in  the  Human  Mate.  Philadelphia, 
Saunders,  1948. 

Kinsey,  Alfred  C.  et  al.  Sexual  behavior 
in  the  Human  Female.  Philadelphia, 
Saunders,  1953. 

Masters.  William  Howell  and  Johnson, 
Virginia  E.  Human  sexiuil  response. 
Boston,  Little,  Brown,  1966. 

Masters,  William  Howell  and  Johnson, 
Virginia  E.  Human  Sexual  Inadequacy, 
led.  Boston,  Little,  Brown,  1970. 

Schofield,  Michael  George.  The  Sexual 
Behaviour  of  Young  People.  Boston, 
Little,  Brown,  1965. 

Wahl,  Charles  W..  ed.  Sexual  Problems; 
Diagnosis  and  Treatment  in  Medical 
Practice.  New  York,  Free  Press,  1967. 


THE     CANADIAN     NURSE     43 


Gel  pillow  helps  prevent  pressure  sores 

In  1970,  nurses  at  the  Montreal  Neurological  Hospital  completed  a  two-year 
study,  using  the  Stryker  gel  pillow  for  30  selected  neurological  patients.  Here  the 
author  explains  why  the  pillow  has  been  added  to  the  nursing  arsenal  in  the 
battle  against  pressure  sores. 


Caroline  E.  Robertson,  R.N.,  B.N. 

One  of  the  constant  battles  in  neurologi- 
cal nursing  is  waged  to  prevent  decub- 
itus ulcers.  Good  skin  care  is  the  essence 
of  good  nursing,  as  the  discouraging 
sight  and  smell  of  pressure  sores  is 
traumatic  to  everyone  —  patients, 
relatives,  and  hospital  staff. 

Most  hospitals  have  developed  a 
routine  method  of  skin  care,  followed 
religiously  as  an  aid  in  preventing 
pressure  sores.  It  may  be  difficult  to 
break  this  routine  if  there  is  no  guaran- 
tee that  a  change  will  be  an  improve- 
ment. However,  any  opportunity  that 
might  improve  this  nursing  care  must 
be  taken. 

The  extent  of  this  problem  is  great, 
considering  that  80  percent  of  all  pa- 
tients with  spinal  injuries  and  up  to  15 
percent  of  other  bedridden  patients  are 
said  to  acquire  pressure  decubiti.  With 
an  estimated  cost  in  caring  for  each 
patient  of  between  $2,000  and 
$10,000,1  there  is  no  doubt  that  pre- 
vention pays  financially,  to  say  nothing 
of  preventing  trauma  to  the  patients. 


Miss  Robertson  is  a  graduate  of  the  koyal 
\  ictoria  Hospital,  Montreal,  and  McCiill 
Lniversity.  When  she  wrote  this  article, 
she  was  supervisor,  department  of  nurs- 
ing, at  the  Montreal  Neurological  Hospi- 
tal. Ihe  author  wishes  to  thank  Elizabeth 
Roll  and  Helena  Zatylny  tor  their  help 
with  the  study  conducted  at  R.V.H. 


44     THE     CANADIAN      NURSE 


Bertrand  recommends  turning  every 
hour  for  patients  with  recent  spinal 
injuries.2  Cosgrove  suggests  turning 
chronically  paralyzed  patients  every 
two  hours  and  ideally  every  hour.^ 

Neurological  patients  should  be  turn- 
ed hourly  if  they  are  paralyzed  or  if 
their  conscious  level  is  inadequate, 
that  is,  if  they  are  drowsy  and  disorient- 
ed. This  is  to  prevent  pressure  sores 
resulting  from  the  continuous  down- 
ward push  of  bony  prominences  on  the 
skin  that  is  in  contact  with  a  firm  sur- 
face; assist  drainage  of  mucus  so  that 
congestion  does  not  build  up  in  the 
lung;  avoid  renal  calculi  that  may  form 
when  urine  remains  stationary  in  the 
bladder;  stimulate  circulation;  provide 
anopportunity  to  exercise  the  limbs;  and 
make  the  patient  more  comfortable 
physically  and  mentally." 

Carrying  out  the  project 

The  objectives  of  the  project  were 
to  determine  whether  the  Stryker  pillow 
is  a  satisfactory  nursing  measure  in 
preventing  pressure  sores;  whether  its 
regular  use  can  save  nursing  time,  turn- 
ing the  patient  every  two  to  three  hours 
instead  of  hourly;  and  which  groups  of 
neurological  patients  would  find  the 
pillow  useful. 

Inservice  sessions  were  carried  out 

to  familiarize  personnel  with  the  pillow 

and  the  project  methtxls.  A  series  of 

slides,    which    depicted    experimental 

OCTOBER      1971 


research  on  dogs  when  the  pillow  was 
used  in  comparison  with  other  equip- 
ment, were  shown  and  commented 
upon.  Everyone  had  a  chance  to  sit  on 
the  pillow  to  see  how  the  coccyx  sinks 
into  the  pillow  gel.  An  egg  was  used  to 
show  how  the  pressure  of  a  person's 
weight  can  be  applied  over  it  without 
breaking  the  egg  because  of  the  resilien- 
cy of  the  gel  it  displaces  when  the  pres- 
sure is  applied.  Finally,  nursing  check- 
lists for  the  collection  of  data  were 
discussed. 


Choosing  patients  for  this  study  was 
an  initial  and  continuing  problem.  Pa- 
tients who  had,  or  might  develop,  skin 
problems  from  pressure  fitted  into  the 
project.  The  pillow  could  not  be  tested 
with  patients  who  had  respiratory  dif- 
ficulties, severe  bladder  complications, 
or  circulation  problems,  as  we  believe 
these  patients  must  be  turned  hourly. 

Patients  who  were  known  to  need 
special  skin  care  were  selected.  All 
paraplegic  patients  and  those  with  a 
greatly  lowered  level  of  consciousness 


'^—i"  Gel  pillow  with  firm  mat- 
tress. 

/iGel  pillow   removed    to 
V  show      construction      of 
mattress. 


OCTOBER      1971 


were  chosen  because  they  could  not 
provide  total  care  for  themselves.  Thus 
all  patients  who  could  not  move  them- 
selves or  attend  to  their  own  total  basic 
needs  formed  the  basis  of  our  selection. 

Mattress  combined  with  pillow 

During  the  study,  it  was  found  that 
nursing  was  difficult  with  the  patient 
lyingon  the  foam  mattress  supplied  with 
the  gel  pillow.  The  foam  bunched  when 
the  patient  was  turned,  or  it  shifted  and 
the  sheets  wrinkled.  The  mattress  was 
also  difficult  to  clean.  Furthermore, 
alignment  of  the  spinal  column  did  not 
seem  as  satisfactory  as  on  a  firm  mat- 
tress. 

Therefore  a  firm  Simmons  mattress 
was  designed  with  a  center  hole  for 
the  pillow.  It  is  covered  by  waterproof 
material  that  makes  cleaning  and  up- 
keep easy.  Its  firmness  solves  the  prob- 
lem of  spinal  alignment  (see  photo- 
graphs), and  it  provides  a  much  more 
satisfactory  base  for  smdying  the  effec- 
tiveness of  the  gel  pillow.  From  the 
analysis  of  the  study  and  from  the 
satisfaction  expressed  by  patients  and 
nurses,  the  combination  of  the  gel  pillow 
and  the  firm  mattress  seems  to  be  an 
adjunct  to  patient  care. 

In  29  patients,  skin  care  was  promot- 
ed by  using  the  pillow;  that  is,  at  least 
one  problem  was  solved  or  a  difficult 
aspect  of  skin  care  was  improved.  In 
three  patients,  the  pillow  made  the 
problems  of  skin  care  worse,  and  in 
another  four  patients  the  benefit  was 
undecided.  One  patient  had  both  good 
and  poor  results. 

With  13  patients,  it  was  possible 
to  decrease  the  turnings  from  every 
hour  to  every  two  hours.  No  patient 
could  tolerate  turnings  every  three 
hours  for  more  than  48  hours,  mainly 
because  of  respiratory  or  morale  prob- 
lems. Thus  the  pillow  maintained  the 
skin  care  during  two-hour  peritxls. 

Hourly  turnings  had  to  be  continued 
THE     CANADIAN      NURSE     45 


FACTORS  RELATING  TO  SELECTION  OF  PATIENTS  FOR  STUDY 

Positioning: 

Spasticity  of  decerebrate  rigidity,  weight 

loss   causing    bony    protuberances,    pain. 

difficulty   in   maintaining  postural  align- 

ment, and  a  body  cast. 

Turning: 

Unusually  heavy  patients,  those  who  refuse 

to  turn,  those  with  respiratory  problems. 

and  those  with  a  wound. 

Cleanliness: 

Radiation  therapy  or  presence  of  infection 

or  high  temperature  requiring  extra  bathing 

to  reduce  fever. 

Elimination: 

Excessive  Perspiration,  e.g.,  in  quadriple- 

gia  above  the  level  of  injury;  incontinence 

not  aided  by  a  propped  urinal,  condome,  or 

drainage  system;drainagefromdecubiti;or 

excessive  diarrhea. 

Nutrition: 

inadequate  food  intake,  especially  protein- 

rich  food. 

Hydration: 

Inadequate  fluid  intake,  i.e.,  below  2000 cc. 

per  day. 

Level  or  consciousness: 

Restlessness  leading  to  a  greater  chance  of 

rubbing,  or  lower  level  of  consciousness 

with  inadequate  movement. 

Motor  Ability: 

inability  to  move  well,  or  sensory  loss. 

Condition  of  Skin: 

Presence  or  absence  of  lesions. 

Morale: 

Improvement  related  to  longer  sleep  per- 

iods at  night,  to  early  ability  to  sit  in  a 

wheelchair,  and  to  feelings  of  comfort  or 

discomfort. 

for  16  patients,  essentially  because  of 
respiratory  problems  such  as  chest 
congestion.  This  was  not  decisive  in 
seven  patients,  either  because  the  pillow 
was  used  for  an  inadequate  length  of 
time  or  because  it  was  used  incorrectly. 
For  the  six  children  tested,  the  pillow 
proved  especially  useful  in  skin  care 
around  the  ears  and  around  bony 
protuberances  of  the  skull. 

Conclusions  and  recommendations 

The  nursing  staff  involved  in  this 
study  believe  that  the  gel  pillow  helps 
considerably  in  the  skin  care  of  patients 
with  decubitus  ulcers,  or  in  preventing 
46     THE     CANADIAN     NURSE 


them.  However,  it  is  not  a  substitute 
forturning,  debridement  and  washing  of 
the  ulcers,  and  warm,  continuous  tub 
baths  to  stimulate  circulation. 

Certain  selected  patients  with  no 
respiratory  difficulty,  no  circulation 
problems,  and  little  bladder  involve- 
ment were  turned  every  two  hours,  in- 
stead of  hourly,  with  no  detriment  to  the 
skin  or  to  the  patient's  morale.  Turnings 
every  three  hours  were  found  to  be 
detrimental  to  the  patient's  chest  condi- 
tion when  kept  up  over  the  24-hour 
period,  and  the  patients  found  them 
uncomfortable. 

The   actual    patient  diagnosis    is   a 


much  less  accurate  guide  for  success  of 
the  pillow  than  the  patient's  symptoms, 
signs,  and  expressed  feelings. 

The  author  and  the  nursing  staff  who 
helped  with  the  observations  and  care 
of  the  patients  believe  that  a  routine 
of  hourly  turnings  for  paralyzed  and 
unconscious  patients  has  a  great  part 
to  play  in  their  final  rehabilitation,  it 
is  much  simpler  to  maintain  this  routine 
than  to  disrupt  it.  Much  time  and  com- 
munication with  all  staff  members  is 
involved  in  breaking  the  routine  for 
the  few  patients  who  could  benefit  by 
trying  fewer  turnings.  And  it  requires 
considerable  time  and  learning  for 
nurses  to  decide  which  patients  can 
benefit  from  a  different  turning  routine. 

However,  if  the  time  saved  by  turn- 
ing each  patient  half  as  often  (IVi 
minutes  for  four  staff  members  multipli- 
ed by  12  times  a  day  equals  120  min- 
utes, or  two  hours  a  day  instead  of  four 
hours)  is  planned  and  well  spent  on 
other  items  of  nursing  care  for  the  pa- 
tient, it  is  extremely  worthwhile  to  take 
the  time  to  decide  if  a  new  routine  is 
possible. 

References 

1.  S pence.  W.R.  et  al.Gel  support  for  preven- 
tion of  decubitus  ulcers.  Arch.  Pliys.  Med. 
48:283, -lune  1967. 

2.  Bertrand,  Gilles.  Management  of  spinal 
injuries  with  associated  cord  damage. 
I'osianid.  Med.  37:3:251.  March.  1965. 

3.C'are  of  the  chronically  paralyzed  patient. 

(ieridiric  Instil..  7:3: 15-17,  Summer  1964. 
4.C  ormier,    Ivan   and   Derm   Dunwoody.   I 

came  back  from  the  dead.  Maclean's  73: 

15:75,  Oct.  8,  I960. 

Bibliography 

Grabenstetter,    Joan,    Synthetic    fat     helps 

prevent    pressure   sores.    Amer.  J.    Niirs. 

68:7:l52l-l522,July  1968. 
Pfaudler,   Marjorie.  Flotation  displacement, 

and    decubitus    ulcers,    Amer.    J.    Nnrs. 

68:11:2351-2355, Nov.  1968. 

OCTOBER      1971 


Electricity: 

a  hospital  hazard 

As  electronic  technology  advances  and  becomes  more  and  more  an  adjunct  to 
hospital  procedures,  many  lives  are  saved.  But  precautions  must  be  taken 
against  the  minute  undetected  electric  current  that  can  prove  to  be  lethal. 


Twenty  years  ago,  the  hazard  of  electric 
shock  in  the  operating  room  was  sec- 
ondary to  that  of  ignition  or  explosion 
of  flammable  anesthetic  agents.  Then 
safety  standards  were  oriented  around 
the  risk  of  combustion:  humidity  was 
controlled  at  a  high  level  to  reduce  the 
generation  of  static  charges;  garments 
and  patient  drapes  that  were  prone 
to  develop  electrostatic  charges  were 
banned;  conductive  footwear  and  floors 
were  specified  in  the  operating  area 
to  ensure  the  dissipation  of  whatever 
static  charges  remained.  Electric  protec- 
tion was  directed  against  gross  shock 
or  sparks  above  the  ignition  level. 

However,  two  developments  have 
changed  the  operating  room  environ- 
ment of  that  era.  The  trend  is  now  away 
from  the  flammable  to  the  non-flam- 
mable anesthetic  agent,  thus  reducing 
the  incidence  of  combustion.  At  the 
same  time,  modern  technology  has 
produced  a  multiplicity  of  instrumenta- 
tion for  effective  diagnosis  or  treatment 
of  patient  disorders.  The  development 
of  this  equipment  has  supported  new 
surgical  or  medical  techniques.  As  a 
result,  the  operating  room  has  become 
crowded  with  items  such  as  heat  ex- 
changers, bypass  pump  oxygenators, 
cardiac  resuscitators,  electrosurgery 
units,  pressure  transducers,  patient 
monitors,  to  name  a  few.  Used  alone, 


OCTOBER      1971 


any  one  of  these  instruments  is  inherent- 
ly safe.  Used  in  combination,  they  can 
cause  disaster. 

Hazard  hard  to  identify 

The  combination  of  new  medical 
techniques  and  instruments  has  led  to 
a  peculiar  electric  shock  hazard  that  is 
hard  to  identify  and  control.  Since  the 
development  of  cardiac  stimulation 
and  heart  catheterization  procedures, 
electric  currents  are  no  longer  limited 
to  skin  contact  on  the  patient's  body. 
These  currents  now  invade  tissues 
inside  the  body  where  the  critical  shock 
levels  are  some  two  thousand  times 
lower  than  on  the  body  surface.  The 
vulnerability  of  patients  with  internal 
current  paths  is  greatly  increased,  and 
the  number  of  incidences  of  shock  has 
risen  steadily  during  the  past  five  years. 

For  20  years,  scientists  and  engineers 
in  the  Radio  and  Electrical  Engineering 
Division  of  the  National  Research 
Council  of  Canada  have  collaborated 

This  article  is  adapted  from  "Electricity: 
A  Subtle  Menace  in  Hospitals"  Science 
Dimensions,  Vol.  3,  No.  1,  February  1971, 
The  Canadian  Nurse  thanks  the  National 
Research  Council  of  Canada  for  permission 
to  bring  this  material  before  its  readers, 
and  Mr.  John  Hopps,  the  research  source, 
for  simplifying  difficult  technical  phrases. 

THE     CANADIAN     NURSE     47 


in  medical  research.  As  this  group  did 
its  early  work  in  cardiovascular  instru- 
mentation, it  was  inevitable  that  it 
should  come  to  grips  with  the  risk 
of  electric  shock.  Since  this  critical 
hazard  involves  electrical  parameters 
of  the  heart,  an  area  in  which  the  group 
had  already  contributed  a  substantial 
background  of  research,  it  become 
logical  to  investigate  electrical  safety. 
Bioengineers  combined  forces  with 
those  engineers  in  other  divisions  who 
had  been  active  in  the  design  and  spec- 
ification aspects  of  hospital  safety,  to 
carry  out  a  program  of  evaluation  of 
equipment  and  hospital  procedures. 

John  Hopps,  a  research  officer  in 
the  Engineering  Division's  Engineering 
Section,  and  chairman  of  the  Canadian 
Standards  Association  Hospital  Code 
Subcommittee  on  Electronics,  admits 
that  there  has  always  been  a  hazard  in 
hospitals,  particularly  with  regard  to 
flammable  and  explosive  anesthetic 
agents.  He  adds,  however,  that  as  elec- 
tronics has  become  more  sophisticated 
and  has  been  more  generally  used  in 
hospitals,  the  shock  problem  has  taken 
over  as  the  dominant  factor  in  electrical 
hazards. 

Divisional  staff  members  have  in- 
vestigated innumerable  hospital  instal- 
lations, procedures,  and  incidences  of 
hazards,  and  have  served  on  the  hospital 
safety  committees  of  organizations  in 
Canada  and  in  the  United  States.  The 
results  of  these  investigations  and 
studies  have  been  incorporated  into  a 
revised  Canadian  Standards  Associa- 
tion Operating  Room  Code,  which 
became  effective  in  June,  1970. 

According  to  Mr.  Hopps,  the  use  of 
electronic  equipment  causes  the  patient 
to  become  a  conductor  between  differ- 
ent pieces  of  equipment.  He  says,  "We 
must  re-design  equipment,  such  as 
pacemakers  and  cathode  implants,  to 
protect  the  patient  against  very  minute 
{Conlimied  on  page  SO) 

48 


Experimental  surgery  in  National  Re- 
search Council's  bioengineering  labo- 
ratories. The  operating  room  complies 
with  the  requirements  of  the  Canadian 
hospital  code  and  provides  a  facility 
for  assessment  of  electrical  hazards. 


During  electroangiography ,  the  fluid  content  of  the  catheter  can  provide  a  conduc- 
tive path  to  the  heart.  If  either  the  monitor  or  the  'dye'  injector  is  not  grounded,  a 
leakage  current  may  kill  the  patient. 


A  ventricular  defibrillator  with  one  patient  electrode  grounded 
permits  multiple  current  paths  during  the  resuscitation  shock, 
reducing  the  efficacy  of  the  shock  treatment  and  endangering 
both  patient  and  operator. 

49 


shocks.  As  they  are  inserted  near  the 
heart,  these  instruments  can  cause  a 
heart  attack  when  current  is  so  small 
that  it  evokes  no  physical  sensation." 

There  are  two  ways  of  combatting 
the  problem:  isolating  the  patient  from 
all  extraneous  electric  currents,  or 
interrupting  the  electrical  supply  when 
a  fault  occurs.  Mr.  Hopps  maintains 
that  there  is,  in  actual  fact,  no  one 
way  to  use  electricity  with  complete 
safety,  as  the  approach  taken  to  elimi- 
nate any  danger  depends  on  the  indi- 
vidual situation. 

The  approximate  threshold  of  sen- 
sation for  electric  shock  on  the  body 
surface  is  about  one  to  two  milliamperes 
(0.001  —  0.002,  or  one-  to  two-thou- 
sandths of  an  ampere).  The  sensation 
of  pain  becomes  objectionable  between 
one  and  10  milliamperes.  The  "cannot- 
let-go"  point  occurs  between  9  and  20 
milliamperes.  This  is  when  it  becomes 
impossible  to  release  a  hand-held 
electric  contact.  Heart  fibrillation 
occurs  when  levels  of  current  are  be- 
tween 70  and  100  milliamperes  on  the 
surface  of  the  body.  However,  the 
threshold  of  danger  for  internal  organs 
can  be  as  low  as  20  microamperes 
(millionths  of  an  ampere). 

Special  protection  required 

The  internal  shock  hazard  is  not 
limited  to  the  operating  room  but  exists 
in  intensive  or  coronary  care  units, 
catheterization  laboratories,  dialysis 
rooms,  and  other  locations  where  in- 
ternal probes  may  be  used.  Such  areas 
are  now  considered  to  be  electric  shock 
locations  that  require  special  protec- 
tion, and  a  new  standard  is  being  pre- 
pared by  the  Canadian  Standards  Asso- 
ciation to  cover  the  required  safety 
specifications. 

In  a  coronary  care  unit  it  is  possible 
for  several  patients  to  be  undergoing 
simultaneous  treatment,  or  to  be  mon- 
itored in  a  complex  system  of  instru- 
50     THE     CANADIAN     NURSE 


The  isolation  of  a  battery-powered  cardiac  stimulator  may  be  invalidated  by  con- 
nection of  a  monitor  oscilloscope  with  grounded  input  circuitry.  If  it  is  necessary 
to  monitor  pacer  performance  while  it  is  connected  to  the  heart,  the  monitoring 
leads  must  be  isolated  from  ground. 


mentation.  In  such  a  situation  it  is 
essential  that  the  failure  of  one  piece 
of  equipment  is  not  allowed  to  transfer 
a  fault  current  to  a  patient  through  a 
monitoring  or  grounding  lead.  This 
limits  the  potential  gradient  between 
individual  instruments  under  fault 
conditions  to  a  maximum  of  five  milli- 
volts. 

To  monitor  such  a  system,  the  Na- 
tional Research  Council  developed  the 
dynamic  ground  fault  detector.  This 
detector  was  patented  by  Canadian 
Patents  and  Development  Limited,  a 
subsidiary  of  NRC,  and  has  been  in  use 
for  12  years.  It  is  manufactured  by 
Federal  Pacific  Pioneer  Electric  Limit- 
ed, Toronto,  and  Measurement  Engi- 
neering Limited,  Amprior,  Ontario. 

"We  know,"  says  Mr.  Hopps,  "that 
systems  can  be  installed  ...  to  monitor 
ground  fault  currents  as  low  as  one 
milliampere  —  in  fact,  we  can  detect 
currents  as  low  as  10  microamperes, 
and  have  had  experience  with  a  hospital 
installation  operating  at  the  60  micro- 
ampere level.  We  also  feel  that  the 
Canadian  dynamic  detector  offers 
better  protection  than  the  static  type 
still  used  in  most  American  hospitals." 

There  is  now  reasonable  agreement 
that,  in  areas  where  internal  body 
probes  are  normally  applied,  isolated 
power  service  provides  greatest  pro- 
tection. For  other  areas,  which  may 


become  electric  shock  locations  for 
specific  procedures,  portable  load 
centers  can  provide  protection.  A  pack- 
age incorporating  an  isolation  trans- 
former, ground  hazard  indicator, 
receptacles,  and  perhaps  a  continuity 
monitor,  could  be  connected  to  the 
conventional  service  in  a  hospital  bed- 
room or  ward. 

The  new  Patient  Care  Shock  Code 
being  prepared  will  specify  safe  cur- 
rent limits  for  equipment  associated 
with  internal  patient  probes  and  for 
other  medical  equipment  used  in  critical 
environments. 

In  addition,  the  design  engineer, 
manufacturer,  and  medical  staff  need 
to  develop  an  increased  awareness  of 
hazards  in  order  to  bring  about  a  reduc- 
tion in  the  alarming  incidence  of  fatal- 
ities from  electric  shock. 

Bibliography 

Hopps,  J.A.  The  electric  shock  hazard  in 
hospitals.  CMAJ  98:1002-1007,  May  25, 
1968. 

—  .,  J.A.  Shock  hazards  in  operating  rooms 
and  patient-care  areas.  Anesthesiology. 
31:2:142-55,  Aug.  1969. 

— .,  J.A.  Electrical  hazards  in  hospitals. 
Bulletin  of  Radio  and  Electrical  Engineer- 
ing Division  National  Research  Council. 
20:2:1,  1970.  ^ 


OCTOBER     1971 


new  products     { 


Descriptions  are  based  on  information 
supplied  by  the  manufacturer.  No 
endorsement  is  intended. 


SlOoo 


***">L, 


ING   ^ir 


"i:-^" 


AtAcsf 


"C« 


Arterial  blood  sampling  kit 

Macbick,  a  subsidiary  of  C.R.  Bard 
Inc.,  has  introduced  a  compact,  sterile 
kit  that  contains  all  the  necessary 
equipment  for  taking  a  sample  of 
arterial  blood  to  test  for  blood  gases. 
The  kit  includes  a  CSR  over-wrap, 
10  cc  glass  syringe -Luer  Lock,  1  cc 
Sodium  Heparin  (1000  USP  units), 
two  20g  X  iVz"  needles,  short  bevel, 
clear  hub,  5"  x  11"  resealable  plastic 
ice  bag,  two  alcohol  prep  pads,  two 
3"  X  3"  gauze  sponges,  rubber  stopper. 
Sodium  Heparin  circular,  and  a  patient 
label. 

Testing  for  blood  gas  can  be  stand- 
ardized throughout  the  hospital  by 
using  the  kit,  and  this  sterile,  single-use 
equipment  offers  protection  for  patients 
and  personnel. 

For  more  information  write  to  Mac- 
bick, Billerica,  Massachusetts  01821, 
or  to  C.R.  Bard  Inc.,  22  Torlake 
Crescent,  Toronto  530,  Ontario. 

Literature  available 

A  four-page,  illustrated,  color  brochure 
describing  the  Picker-Kermath  position- 
ing chair  for  neuroradiology  is  available 
from  the  Picker  X-Ray  Engineering 
Ltd.  in  Montreal. 

Used  in  conjunction  with  a  standard 
ceiling  x-ray  mount,  the  chair  enables 
the  user  to  do  pneumoencephalographic 
and  auto  tomographic  studies. 
OCTOBER     1971 


Blood  Sampling  Kit 

The  brochure  explains  the  chair's 
design  features  that  include  patient 
securement,  tumbling  and  rotation, 
cassette  positioning,  controls,  and 
optional  features. 

For  more  information  write  to  Picker 
X-Ray  Engineering  Ltd.,  100  Dresden 
Avenue,  Montreal,  Quebec. 


A  16-page  illustrated  guidebook  on 
the  use  of  plastic  surgical  drapes  is 
available  from  the  3M  Company. 

The  guidebook,  entitled  The  Wall 
of  Protection,  uses  pictures  and  dia- 
grams to  explain  how  to  apply  the 
impermeable  drapes.  These  Steri- 
Drapes  prevent  skin  bacteria  from 
reaching  the  incision.  Various  sizes 
of  mcise,  towel,  and  aperture  drapes 
are  described. 

Special  sections  of  the  guidebook 
cover  plastic  drape  applications  for 
orthopedic,  neurological,  opthalmo- 
logical,  gynecological,  abdominal,  and 
thoracic  surgery. 

Copies  of  the  drape  guide  are  avail- 
able from  Medical  Products  Group, 
3M  Company,  London  12,  Ontario. 

Suction  catheter  tray 

The  suction  catheter  tray  contains  in 
sterile  packages  all  the  necessary  equip- 
ment for  one  patient.  An  adapter  ena- 
bles a  wide  entrance  in  the  side  arm  of 
the  catheter  to  equalize  air  pressure 
inside  and  outside  the  suction  catheter. 
It  also  provides  minimum  level  of  suc- 
tion during  introduction  and  removal 
of  the  catheter. 

For  more  information  write  to  C.R. 
Bard  Inc.,  Murray  Hill,  New  Jersey 
07974,  U.S.A.  ^ 


Suction  Catheter  Tray 

THE     CANAD^N     NURSE     51 


Just  as  you 

can't  call  any 

waterfall 

Niagara 


you  can't  call 

any  Conform 

Bandage  a 

KLING* 

BANDAGE. 


There's  really  only  one  KLING 
Conform  Bandage  —  by  Johnson 
&  Johnson. 

KLING  is  the  unique,  soft,  all  ab- 
sorbent cotton  bandage  that  is 
more  than  equal  to  the  bandaging 
requirements  of  areas  that  are  hard 
to  bandage  and  hard  to  keep  ban- 
daged. 

Because  KLING  is  self-adhering.  It 
clings  to  itself,  conforming  to  un- 
usual contours  and  resisting  flex- 
induced  slippage.  KLING  Conform 
Bandage's  elasticity  permits  it  to 
stretch  over  40%,  so  not  to  con- 
strict swelling  areas. 
KLING  Conform  Bandages  —  5 
yds.  when  stretched  are  supplied 
in  the  following  widths:  1"  —  2" 
—  3"  —  4"  —  6"  —  in  bulk  or  pre- 
wrap. 

KLING 

CONFORM  BANDAGE 
THE  BANDAGE  THAT 
REALLY  CONFORMS 

MONTREAL*  TORONTO-  CANADA 

•Trademark  of  Johnson  &  Johnson 
Limited  or  affiMaled  companies 

52     THE     CANADIAN     NURSE 


October  18-20, 1971 

International  Association  of  Hospital 
Central  Se-'vices  Management,  Mount 
Royal  Hotel,  Montreal,  Quebec. 

October  19-21, 1971 

International  Disposables  Exposition 
and  Assembly  at  Philadelphia  Civic 
Center,  Philadelphia,  Pennsylvania, 
sponsored  by  the  Disposables  Associa- 
tion. For  more  information  write  to  the 
Disposables  Association,  10  E.  40th 
Street,  New  York,  N.Y.  10016. 

October  22, 1971 

Workshop  for  nurses  in  administration 
sponsored  by  the  Registered  Nurses' 
Association  of  Ontario's  joint  adminis- 
trator and  educator  committees,  region 
2.  For  more  information  write  to  the 
Regional  Office,  RNAO,  316  Queens 
Avenue,  London  14,  Ontario. 

October  25-27, 1971 

Ontario  Hospital  Association,  annual 
convention.  Royal  York  Hotel,  Toronto, 
Ontario. 

October  27-29, 1971 

Workshop  on  test  construction,  Dal- 
housie  University  School  of  Nursing. 
The  workshop  is  planned  for  teachers 
in  schools  of  nursing.  For  more  informa- 
tion write  to  Prof.  Gordon  B.  Jeffrey, 
Dept.  of  Education,  Dalhousie  Universi- 
ty, Halifax,  Nova  Scotia. 

November  1 -December  25, 1971 

Basic  course  in  psychiatric  nursing, 
also  being  offered  January  3-February 
27, 1972  and  March  6-April  30, 1972.  For 
more  information  write  to  the  assistant 
director  of  nursing  education,  Clarke 
Institute  of  Psychiatry,  250  College  St., 
Toronto. 

November  13, 1971 

Fifteenth  annual  rehabilitation  sym- 
posium co-sponsored  by  the  Ontario 
Society  for  Crippled  Children  and  the 
Rehabilitation  Foundation  for  the  Dis- 
abled at  the  Ontario  Institute  forStudies 
In  Education,  252  Bloor  Street  W., 
Toronto.  For  more  information  write  to 
Dr.  John  E.  Hall,  The  Hospital  for  Sick 
Children,  555  University  Ave.,  Toronto 
2,  Ontario. 

March  13-15,1972 

American  College  of  Surgeons  19th 
combined  sectional  meeting  in  Phila- 
delphia for  nurses  and  doctors.  For 
more  information  write  to  Mr.  T.E.  Mc- 
Ginnin,  American  College  of  Surgeons, 
55  East  Erie  Street,  Chicago,  Illinois.  ■& 


Next  Month 
in 

The 

Canadian 
Nurse 


•  The  Colonel  is  a  Lady 
—  and  a  Nurse 

•  Hospital  Diet  Line 

•  How  to  make  a  Film 
in  Your  Spare  Time 

•  Wanted:  a  Nursing  Theory 


Photo  credits  for 
October  1971 


The  Hospital  for  Sick 
Children,  p.  1  1 

University  of  Toronto, 
Banting  and  Best  Dept.  of 
Medical  Research,  p.  29 

University  of  British 

Columbia,  Vancouver,  p.  39 

Montreal  Neurological 
Hospital,  p.  45 

National  Research  Council, 
Ottawa,  pp.  48,  49 


OCTOBER     1971 


museum  piece 

FLEET  ENEMA®  —  the  disposables  —  puts  the  enema-can  right  where  it  belongs  —  in  the 
Chamber  of  Costly  Horrors.  Nurses  themselves,  in  time-studies*,  established  FLEET  as 
"the  40-second  enema".  Compared  with  the  old-fashioned  method,  FLEET  ENEMA® 
saves  the  nurse  an  average  of  27  minutes  per  patient  —  not  to  mention  all  the  drudgery. 
FLEET  disposables  are  pre-lubricated,  pre-mixed,  pre-measured  and  individually  packed. 
Everything  moves  better  with  FLEET.  Three  disposable  forms:  Adult  (green  protective 
cap),  Pediatric  (blue  cap),  and  Mineral  Oil  (orange  cap). 


WARNING:  Not  to  be  used  when 
nausea,  vomiting  or  abdominal  pain 
is  present.  Frequent  or  prolonged 
use  may  result  in  dependence. 
CAUTION:  Do  not  administer  to  chil- 
dren under  two  years  of  age  except  on 
the  advice  of  a  physician.  In  dehy- 
drated or  debilitated  patients,  the 
volume  must  be  carefully  deter- 
mined since  the  solution  is  hyper- 
tonic and  may  lead  to  further  dehy- 
dration. Care  should  also  be  taken 
to  ensure  that  the  contents  of  the 
bowel  are  expelled  after  administra- 
tion. Repeated  administration  at 
short  intervals  should  be  avoided. 


Full  information  on  request. 
•Kehlmann,  W.H.:  Mod.  Hosp. 
84:104,  1955 


FOUNDED  IN  CANADA  IN  1899 
CHARLES  E.  FROSST  &  CO. 
KtRKLANO  (MONTREAL)  CANADA 


The  Riddle  of  Cruelty  hy  G.  Rothman. 

210  paces.  New  York,  Philosophical 
Library.  1971. 

Reviewed  hy  J.  A.  McDonald.  Direc- 
tor of  Nursing  Service,  Alhertci  Hos- 
pital. Claresliolm.  Alherta. 

This  is  a  well  written  book  which  can 
be  easily  understood  by  the  layman. 

The  author  describes  sadism  and 
masochism  as  being  two  manifestations 
of  the  same  drive.  The  subject  is  dealt 
with  in  the  context  of  philosophy,  psy- 
chology, sociology,  religion,  law,  med- 
icine, and  education.  The  existence  of 
cruelty  in  many  spheres  of  life,  from 
early  history  to  the  present  time,  is 
described  in  detail  in  the  many  exam- 
ples of  sado-masochism  which  are  quot- 
ed throughout  the  book.  Dr.  Rothman 
produces  much  evidence  of  the  close 
link  between  cruelty  and  sex. 

In  describing  some  of  the  customs 
of  the  present  time.  Dr.  Rothman  ob- 
serves that  though  cruelty  towards 
individuals  may  have  diminished,  mass 
cruelty  has  grown  beyond  all  propor- 
tions. He  expresses  the  hope  that  a- 
wareness  of  the  existence  of  the  drive 
for  cruelty  as  a  basic  factor  of  all -per- 
sonalities, and  a  better  understanding 
of  its  manifestations,  may  enable  cruelty 
to  be  more  effectively  controlled. 

This  book  would  be  more  valuable 
if  fewer  detailed  examples  of  sado- 
masochism had  been  quoted. 

Crises  of  Family  Disorganization:  Pro- 
grams to  Soften  Their  Impact 

edited  by  Eleanor  Pavenstedt  and 
Viola  W.  Bernard.  103  pages.  New 
York,  Behavioral  Publications, 
Inc.,  1971. 

When  any  member  of  a  family  displays 
overt  mental  illness,  it  is  a  crisis  not 
only  for  the  sick  person  but  for  the 
whole  family.  If  the  sick  person  is  the 
parent  of  young  children,  the  children 
feel  the  stress  of  separation  when  the 
parent  is  hospitalized.  If  the  parent  is 
enabled  to  remain  at  home,  the  children 
are  also  under  stress,  especially  if  the 
parent-patient's  delusions  in  some  way 
include  the  child. 

Mental  health  workers  need  to  ident- 
ify, as  the  book  indicates,  "those  po- 
tential hazards  for  young  children  that 
might  be  on  the  increase,  as  a  side 
effect  of  profoundly  important  advances 
in   chemotherapy   and    in   community 

54     THE     CANADIAN     NURSE 


psychiatry,  whereby  increasing  numbers 
of  psychiatrically  sick  or  vulnerable 
parent-patients  (are)  remaining  in  the 
community." 

The  papers  collected  in  the  book  are 
divided  into  three  categories:  parents 
with  mental  illness,  parents  under  un- 
manageable stress,  and  programs  to 
assist  parents. 

One  paper  discusses  the  role  of  the 
public  health  nurse  in  providing  sup- 
portive care  for  the  mentally  ill  parent 
and  preventive  care  for  the  children. 

This  book  offers  valuable  refer- 
ence material  to  community  health 
workers. 


Fluids  and  Electrolytes  with  Clinical 
Applications  by  Joyce  LeFever  Kee. 
494  pages.  New  York,  John  Wiley 
&Sons,  Inc.,  1971. 
Reviewed  by  Donna  Dempsey,  In- 
structor, Holy  Cross  Hospital  School 
of  Nursing,  Calgary,  Alberta. 

The  purpose  of  this  text  is  to  help  the 
reader  understand  the  effects  of  fluid 
and  electrolyte  balance  and  imbalance 
on  the  body  in  many  conditions  and 
clinical  situations.  It  will  enable  the 
nurse  to  be  cognizant  of  the  rationale 
of  medical  treatment. 

Fluids  and  Electrolytes  is  unique  in 
both  scope  and  method  of  presentation. 

The  book  is  organized  on  a  program- 
med learning  approach,  its  most  unique 
and  valuable  point.  The  programmed 
learning  approach  is  well  used  and 
designed  for  optimum  self-activity 
on  the  part  of  the  learner,  allowing  her 
to  progress  at  her  own  rate. 

Each  chapter  begins  with  behavioral 
objectives  permitting  the  learner  to 
understand  what  is  expected  of  her.  A 
glossary  of  words  used  throughout  the 
text  is  included  at  the  end. 

The  programmed  chapters  deal  with 
a  large  number  of  small  steps;  the  learn- 
er actively  responds  to  these  steps  by 
answering  questions  on  preceding  data 
and  receives  immediate  confirmation 
to  her  answers  in  information  following 
the  question. 

There  are  60  diagrams  and  tables; 
reviews  throughout  the  chapters  help 
to  reinforce  learning. 

The  initial  chapters  give  general  and 
basic  information  on  fluid  and  electro- 
lyte balance  and  imbalance,  needed  to 
understand  clinical  application. 


A  chapter  on  parenteral  therapy, 
containing  clinical  considerations  and 
nursing  interventions  and  rationale,  is 
followed  by  a  chapter  on  four  main 
clinical  conditions:  dehydration,  water 
intoxication,  edema  and  shock  that  are 
programmed  in  detail  to  enable  the 
learner  to  be  aware  of  these  conditions 
when  they  confront  her.  The  final 
chapter  deals  with  clinical  situations 
that  can  cause  severe  fluid  and  electro- 
lyte imbalance,  for  example,  burns  and 
renal  failure. 

The  clinical  situations  are  realistic 
and  the  method  of  treatment  given  is 
complete  and  accurate. 

Mrs.  LeFever  Kee  has  accomplished 
the  purpose  for  which  the  text  is  design- 
ed. The  diligent  learner  will  have  know- 
ledge of  fluid  and  electrolyte  balance 
and  imbalance  on  completion  of  study- 
ing this  book. 

The  material  in  this  text  is  geared 
to  three  levels  within  the  nursing  pro- 
fession: the  beginning  students  who 
have  had  some  background  in  biological 
sciences  or  an  anatomy  and  physiology 
course,  students  who  have  sufficient 
background  but  need  assistance  with 
clinical  application  of  basic  knowledge, 
and  the  graduate  nurse  who  needs  help 
to  review  and  increase  her  knowledge. 

Winds  of  Change  —  Report  of  a  Confer- 
ence on  Activity  Programs  for  Long- 
Term  Care  Institutions.  40  pages. 
Chicago,  III.  American  Hospital 
Association,  1971. 

In  the  foreword  to  this  report  of  a  two 
and  one-half  day  conference  on  activity 
programs  for  long-term  care  institu- 
tions, Ruth  Knee  of  the  U.S.  National 
Institute  of  Mental  Health  writes:  "The 
quality  of  life  in  long-term  care  institu- 
tions has  become  the  concern  of  many 
groups,  including  health  professionals, 
private  citizens,  community  groups, 
legislatures,  and  institutional  residents 
themselves.  The  consensus  among  these 
groups  is  that  action  must  be  taken  to 
make  sure  that  the  billions  of  tax  and 
personal  dollars  spent  each  year  on 
long-term  care  are  used  for  the  benefit 
of  the  individual,  not  just  for  'ware- 
housing' him." 

The  35  conference  participants  agre- 
ed that  an  activity  program  in  a  long- 
term  care  institution  is  "the  conscious 
management  of  daily  life  through  creat- 
(Continiied  on  pofic  56) 
OCTOBER      1971 


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Personalized,  precision-made  forged 
Lister  scissors.  Guaranteed  2  years 

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purse.  Choose  jewelers  Gold  or  gleaming 
Chrome  plate  finish  on  coupon. 

AVi"  or  SVi'*  SCISSORS 

As  above,  but  larger  for  bigger  jobs.  Chrome  finish  only. 

ChoKC  No.  3S0Q  13'/^"),  No.  4500  (AVi")  or  No.  5500  (SVi") ...  2.50  ea. 

:.  or  more  . . .  $2.00  ea.  Yoar  initials  enpiwd,  add  S0<  per  scissors. 


NURSES  CHARMS  t;t» 

Finest  sculptured  Fisher  charms. "^S^ 
I  Sterling  or  Gold  Filled  (specify  under  COLOR  on  coupon),    ^ 

For  bracelet  or  pendant  chain.  Add  to  your  collection! 

No.  263  Caduceus:  No.  164  Cap;  No.  68 
I  Grad.  Hat;  No.  8.  Band.  Scissors  .  .  3.49  ea. 

PIERCED   EARRINGS 

Dainty,  detailed  14K  Gold  caduceus.  for  on  or  off  duty 
wear.  Shown  actual  size.  Gift  boxed  for  friends,  too. 
No.  13/297  Earrings 5.95  per  pair. 

PIN  GUARD  Sculptured  caduceus,  chained 
to  your  professional  letters,  each  with  pinback/ 
safety  catch.  Or  replace  either  with  class  pin  for 
safety.  Gold  finish,  gift  boxed.  Choose  RN,  LPN 
or  LVN.  No   3420  pjn  Guard 2.95  ea. 


POCKET  SAVERS 


ENAMELED    PINS  Beautifully   sculptured   status 
insignia,  2-color   keyed,   hard-fired  enamel  on  gold  plate. 
Dime-sized,   pin-back    Specify   RN,   LFH,   PN.   LVN,   NA.  or 
RPh.  on  coupon. 
No.  205  Enam.  Pin  1.95  ea.,  12  or  more  1.50  ea. 


Prevent  stains  and  wear! 
Smooth,  pliable  pure  wtiite  vinyl.  Ideal 
low-cost  group  gifts  or  favors. 
No.  210-E  (right),  two  compartments 
with  flap,  gold  stamped  caduceus  .  .  . 
6  for  1.50.  25  or  aiore  20<  ta. 

No.  791  {left)  Deluxe  Saver.  3  compt.. 
change  pocket  &  key  chain  .  .  . 
6  for  2.96.  25  or  more  35<  ea. 


NIGHTINGALE  LAMP 

An  authentic,  unique  favor,  gift  or  engraved 
award!  Ceramic  off-white  candleholder  with 
genuine  gold  leaf  trim.  Recessed  candle 
cup  (candle  not  Included).  7"  long. 

No.  n00SLan)p..S.9Sea.,  12  or  more  4.95  ea. 
Initials  and  date  engraved  on  gold  plaque  . .  . 
add  1.00  per  lamp. 


NURSES  WATCHES 


Hamilton  17  Jewel 

"Buren"  Calendar  Watch,  17  jewels,  sweep- 
second  hand.  Date  changes  at  midnight.  Water, 
shock  resls.,  anti-mag.,  unbreak.  mainspring. 
Chrome  finish,  expan.  bracelet.  1  yr,  guarantee. 
No.  BLS3  Ham.  Watch  .  .  .  34.95  ea., 

Endura  Waterproof  Swiss  made,  raised  silver  full 
numerals,  lumin.  markings.  Red-tipped  sweep  second- 
hand, chrome  /  stainless  case.  Includes  genuine  black 
leather  watch  strap.  1  year  guarantee.  Very  dependable. 
No.  1093  Endura  Watch 19.95  ea. 


BZ2Z  MEMO-TIMER  rime  hot  packs,  heat 
lamps,  park  meters.  Remember  to  check  vital  signs. 
give  medication,  etc.  Lightweight,  compact  ilVi"  dia.). 
sets  to  buzz  5  to  60  mm.  Key  ring.  Swiss  made. 

No,  M-22  Timer 3.98  ea. 

3  for  9.75  ea.,  6  or  more  3.00  es. 


EXAMINING  PENLIGHT 

White  barrel  with  caduceus  Imprint,  aluminum 
trend  and  clip.  5"  long.  U.S.  made,  batteries  included  (re- 
placement batteries  available  any  store).  Your  own  light,  gift  boxed. 
No,  007  Penligtit ...  3.98  ea.  Your  Inltioli  eniraved.  add  5Q<  per  light 


MEDI-CARD  SET  Handiest  reference 
ever'  6  smooth  plastic  cards  (3W"  x  bVz")  cram- 
med with  information,  including  Equivalencies  of 
Apothecary  to  Metric  to  Household  Meas.,  Temp. 
'C  to  "f.  Prescnp  Abbr,,  Urinalysis,  Body  Chem.. 
Blood  Chem.,  Liver  Tests,  Bone  Marrow.  Disease 
Incub.  Periods,  Adult  Wgts.,  Child's  Dosages,  etc. 
All  in  white  vinyl  holder  with  gold  stamped 
caduceus  No.  289  Card  Set  .  .  .1.50  ea. 
6  or  more  1.25  ea.     12  or  more  1.10  ea. 

Your  initials  gold-stamped   on   holder, 

add  50*  per  set. 


KELLY  FORCEPS  So  handyfor 

every   nurse!    bVi"    stainless   steel,    fully 
guaranteed  Ideal  for  clamping  off  tubing.  Your 
own  initials  help  prevent  loss. 

C2-^-^  No.  25-72  Forceps . . .  2.75  ea.     6  or  more  2.50  ea. 
Your  initials  engraved,  add  50<  per  forceps. 


PULSOMETER  simplify  pulse-taking!  Min- 
iature hourglass  times  15  seconds  very  accurately. 
Pocket  clip,  or  pins  on  with  9"  removable  chain. 
Chrome  plated,  plastic  box.  Handy,  efficient. 
No.  K-15-E  Pulsometer  2.95  ea.  3  or  rfore  2.50  «a. 
12  or  mora  2.00  ea. 
Engraved  initials,  add  SQ<  per  item.     Duty    Free 


ENT  INSTRUMENT  SET 

A  superb  quality  set  for  nurses!  Includes  med. 
handle  with  resistance  regulation,  otoscope 
head,  nose  speculum,  Ilium,  tongue  blade 
holder.  5  assort,  ear  reflectors.  Precision 
crafted,  fitted  into  handsome  velvet-  ^ 

lined  case.  Powered  by  2  "C"  C^AJi, 

batteries.  Your  initials  engraved  on 
handle  and  gold-stamped  on  case  FREE. 
10  year  guarantee.  Outstanding  value! 
No.  33     ENT  Set  .  .  only  49.95  ea.  Duw 


NURSES  BAG  A  lifetime  of  service 
for  visiting  nurses!  Finest  black  H"  thick 
genuine  cowhide,  beautifully  crafted  with 
rugged  stitched  and  rivet  construction. 
Water  repellant.  Roomy  interior,  with  snap- 
in  washable  liner  and  compartments  to 
organize  contents.  Snap  strap  holds  top 
open  during  use.  Name  card  holder  on  end. 
Two  fugged  carrying  straps.  6"  x  8"  x  12". 
Your  Initials  gold  embossed  FREE  on  top.  An 
outstanding  value  of  superb  quality. 
1544-1  Bag  (with  liner).  .  42.50  ea. 


Extra  liner  No.  4415 8.50 


SHOE  TOTE    Keep    or    carry 
shoes  in  this  tine  stitched  white  vmyt 
bag!  Opens  wide,  separate  scuff-proot 
compartment    for    each    shoe.    Zips 
weather-tight,  carrying  strap,  4"  x  6"  x  12", 
No.  444  Tote  .  5.49  ea.     6  or  more  4.50  ea. 
Your  initials  gold-stamped,  add  50*  per  Tote. 


BABY  SUALE  weigh  infants  on  home  visits. 
Precision-made  bronze  cyclinder.  nickel  handle  and 
hook.  Weight  to  15  lbs.  or  7  kg.  White  vinyl/cloth 
sling  holds  infant  securely  for  weighing,  then  folds 
to  form  compact  carry  case.  Useful  and  accurate! 

No.  IN-15  Scale 14.95  ea. 

Your  initials  engraved,  add  50*  per  scale. 


f 


AUTO  INSIGNIA  Full-color  enam 

elled  RN  insignia  (left)  on  bronze-plated 
medallion.  Easy  to  attach  to  registra- 
tion plate.  Weather-proof,  distinctive. 
No.  210  Medallion  ....  5.95  ea. 
4-colDr  decal  with  RN  emblem,  transfers 
easily  to  inside  car  window.  AVi"  dia, 
Mo.  621  Decal 1.25  ea. 


CROSS  PEN 

World-famous  ballpoint,  with 
sculptured  caduceus  emblem.  Full  name 
FREE  engraved  on  barrel  (Include  name  with  coupon). 
Refills  avail,  everywhere.  Lifetime  guarantee. 
No    3502  Chrome  8.00  ea.       No.  6602  12l(t.  6.F. 


TRI-COLOR  BALL  PEN 

Write  In  black,  red  and  blue  with  one  ball  point  pen. 
Flip  of  the  thumb  changes  point  (and  color).  Steno  fine  point  (excellent 
for  charts)   Polished  chrome  finish.  A  handy  accessory  for  every  nurse! 

No.  921  Ball  Pen 1.95  ea. 

No.  292-R  3-color  Refills 50«  ea. 


SCRIPTO  PILL  LIGHTER  Famous  Scnpto 
Vu-Lighter  with  crystal-clear  fuel  chamber  containing  color- 
ful array  of  capsules,  pills  and  tablets.  Novel,  unique,  tor 
yourself  or  for  unusual  gifts  for  friends.  Guaranteed  by 
Scripto.  A  real  conversation  piece! 
No.  300-P  Pill  Lighter 5.95  ea. 


ms 
o(d-- 


Personalized 

Littmanii  3ID 

NURSESCOPE' 

Famous  Litlmann  nurses  diaphragm 
stethoscope,  with  vour  Initials  Indi- 
vidually engraved  FREE!  A  fine,  pre- 
cision Instrument,  has  high  sensi- 
tivity for  blood  pressures,  general 
ausculatton.  Only  IV^  ozs.,  fits  In 
pocket.  23"  vinyl  anti-collapse  tub- 
mg.  non-chilling  snap-on  diaphragm. 
non-rotating,  correctly -angled  ear 
tubes.  U.  S.  made.  Choose  from  5 
jewel-like  colors.  Goldtone,  Silver- 
tone,  Blue.  Green,  Pink. 

FREE  INITIALS! 

engraved  on  chest  piece,  lends  indi- 
vidual   distinction,    prevents    loss. 
Specify  on  coupon  below. 
No.  216  Nursecope  13.80  ea. 
6-11  ........  12.80  ea. 

Duty    Free 

SCOPE  SACK  neatly  carries  and  pro- 
tects Nursescope  or  any  scope.  Double-thick 
frosted  flexible  plastic,  white  vinyl  binding.  AVi" 
I  9Vi",  Your  own  initials  help  prevent  loss. 
No.  223  Sack.  .  ■  1.00  ea.  6  or  more  7S<  ei. 
Your  initials  gold-stampod,  add  50<  per  sack. 


NURSES  PERSONALIZED 
ANEROID  SPHYG. 

A  superb  instrument  especially 
designed  for  nurses!  Imported  from  pre- 
cision craftsmen  In  W.  Germany.  Easy- 
to-attach  Velcro  cuff,  lightweight,  com- 
pact, fits  into  soft  sim.  feather  zippered 
case  2V2"  X  4"  x  7".  Dial  calibra- 
ted to  320  mm.,  lO-year  accuracy 
guaranteed  to  i3  mm.  Serviced  by 
Reeves  if  ever  required.  Your  ini- 
tials engraved  on  manometer  and 
gold  stamped  on  case  FREE,  for 
permanent    Identification    and 
distinction.  A  wise  investment  for 
a  lifetime  of  dependable  service! 
No.  106  Sphys 26.95  ea. 


CAP  ACCESSORIES 


Duty 
Free 


CAP  TOTE  keeps  your  caps  crisp  and  clean  ^  ^ 

while  stored  or  carried.  Flexible  clear  plastic,  white        '■■" 

trim,  zipper,  carrying  strap,  hang  loop.  Stores  flat.  Also      ^-— *- 

for  wiglets,  curlers,  etc,  SV;"  dia,,  6"  high.  ' 

No.  333  Tote  . .  2.65  ea.,  6  or  more  . .  2.35  ea. 

Your  initials  gold-stamped,  add  50«  per  Tote.  '~^ 

WHITE  CAP  CLIPS      Holds    caps 

firmly  In  place!  Hard-to-find  white  bobbie  pins, 
enamel  on  fine  spring  steel.  Eight  2"  and  eight 
3"  clips  Included  In  plastic  snap  box. 
No.  529  Clips  .  .  3  boxes  for  1.95, 
6  for  3.25,  12  for  49*  ea. 

MOLDED  CAP  TACS 

Replace  cap  band  Instantly.  Tiny  plastic  tac, 
dainty  caduceus.  "Choose  Black.  Blue.  White 
or  Crystal  with  Gold  Caduceus:  or  all  Black  ; 
(plain).  The  neater  way  to  fasten  bands.        : 
No.  200  Set  of  6  Tacs ...  1.25  par  set. 
12  or  more  sets  1.00  per  set 

f^r^       -^SF    METAL  CAP  TACS     Pair    of    dainty 

im^l  ^       jewelry-quality   Tacs   with    grippers.   holds   cap 

_  — ^-^-,  1        bands  securely.   Sculptured  metal,   gold  finish, 

njaJJl  approx,    %"   wide.   Choose   RN.   LPlf,  LVN,   RN 

\S^F^M  .^^p' Caduceus  or  Plain  Caduceus.  Gift  boxed. 

flfyVXI  ^SklNo.  CT-l  (Specify  Initials),  No.  CT-2  (Plain 

UwUJ  l?Y^Cad.)  or  No.  CT-3  (RN  Cad.)  .  .  .  2.95  pr. 

SEL-FIX  CAP  BAND  Blackvelvet 
band  material.  Self-adhesive,  presses  on, 
pulls  off;  no  sewing  or  pinning.  Reusable 
several  times.  Each  band  20"  long,  pre-cut  to 
popular  widths:  V4"  (12  per  plastic  box)  Vi" 
(8  per  box)  %"  (6  per  box)  1"  (6  per  bbx). 
Specify  width  under  ITEM  column  on  coupon. 
No.  6343  Band.  .  .1.75  per  box         3  or  more 


TO:  REEVES  COMPANY,  Box  719,  Attleboro.  Mass  02703 


ORDER  NO. 


ITEM 


COLOR    QUANT.      PRICE 


NAME   PINS:  D   One  Name  Pin       D   Tao,  same  name 

LETT.  COLOR METAl  FIN 

LETTERING  


2nd  line  . 


INITIALS  as  required 


I  enclose  $_ 


.(Mass.  residents  add  3%  S.  T.) 


Sorry,  no  COO's  or  billing  terms  available 


Send  to  . 
Street  .. 
City 


.Zip 


You  can  breathe  easy 

withVentfoam 

Traction  Band. 

The  Scholl's  Double  Seal] 
Ventfoam  Traction  Band  has 
everything  you  want  and  your 
patients  need  for  comfort  and 
healing. 

The  perforations  allow 
skin  to  breathe,  inducing  more 
rapid  healing  of  lesions. 

The  Ventfoam  Traction 
Band  is  the  strongest  in  its 
field.  Made  of  super  soft  foam 
rubber,  laminated  to  a  fine 
rayon  twill  backing,  it  has  a 
tensile  strength  of  over  100 
pounds. 

It's  hypoaliergenic.  It 
comes  in  3  and  4  inch  widths, 
in  handy  64  inch  packages. 

Let  us  demonstrate  the 
Ventfoam  Traction  Band  for 
you. 

Surgical  Supply  Division, 
TheSchollMfg.  Co.Ltd., 
174  Bartley  Drive, 
Toronto  16,  Ontario. 


(Continued  from  page  54) 

ing,  supporting,  developing,  and  restor- 
ing the  appropriate  life-style  of  the 
resident  in  the  direction  of  personal  and 
social  autonomy." 

The  report  contains  the  results  of 
participants'  discussions  about  require- 
ments for  implementing  an  activity 
program,  staff  participation  in  the  pro- 
gram, helping  the  patient  and  his  family 
to  adjust  to  a  new  role  when  an  activity 
program  is  started,  and  the  community's 
role  in  activity  programs. 

Included  in  the  appendixes  are  a 
patient's  account  of  her  own  activity 
program  at  Goldwater  Memorial  Hos- 
pital, New  York,  and  a  suggested  read- 
ing list. 

Winds  of  Change  is  available  from 
the  American  Hospital  Association, 
840  North  Lake  Shore  Drive,  Chicago, 
Illinois  606 11,  for  $1.00  (U.S.). 


Mental   Health  and  Mental   Illness  by 

Mabel  K.  Johnston.  307  pages.  To- 
ronto, J.B.  Lippincott  Co.,  197 L 
Reviewed  by  Marjorie  V.  Bhusari, 
Lecturer  in  Nursing,  School  for 
Graduate  Nurses,  McGill  University, 
Montreal. 

This  book  is  intended  for  practical 
nurses,  aides  and  technicians  who  care 
for  patients  with  psychiatric  illness. 

Early  chapters  deal  very  briefly 
with  such  subjects  as  normal  growth 
and  development,  learning,  physiolog- 
ical and  psychosocial  needs  and  com- 
munication. Theories  of  personality 
development  from  the  perspectives  of 
Freud  and  Erikson  are  described  brief- 
ly, but  in  an  easily  understood  style. 

The  third  section  addresses  itself  to 
"Mental  Health  and  Mental  Illness." 
Several  chapters  are  limited  in  scope 
and  are  not  well  organized.  A  chapter 
dealing  with  "Human  Behavior  and 
Mental  Health"  consists  only  of  an 
assortment  of  categorical  statements 
and  definitions  of  normal,  neurotic  and 
psychotic  behavior,  mental  health  and 
illness,  and  anxiety.  A  discussion  of 
deviant  patterns  of  behavior  is  repeti- 
tious of  subject  matter  introduced  in  a 
previous  chapter. 

The  latter  part  of  this  section  and  the 
subsequent  two  sections  emphasize 
symptoms  associated  with  various  types 
of  mental  illness,  mental  retardation  and 
epilepsy.  The  author  finely  reduces 
these  to  many  separate  diagnostic  cate- 
gories. 

The  last  section,  "Psychiatric  Nursing 
Considerations,"   is   a   "how-to-do-it" 


56     THE     CANADIAN     NURSE 


approach  to  nursing  patients.  With 
emphasis  on  acceptance,  warmth  and 
reassurance,  material  is  organized  into 
prescriptive  guidelines  for  nursing, 
depending  on  the  patient's  diagnosis. 
Discussions  on  nursing  the  young  child 
and  adolescent  and  nursing  the  geriatric 
patient  have  been  treated  similarly. 

The  author  also  deals  with  the  nurse's 
responsibilities  in  various  forms  of 
treatment,  for  example,  wet  sheet  packs, 
hydrotherapy,  lobotomy,  insulin  shock, 
several  of  which  have  been  little  used 
for  some  time.  While  this  selection  of 
material  may  reflect  an  orientation  and 
patterns  of  care  still  existent  in  some 
mental  hospitals,  it  is  not  representative 
of  contemporary  psychiatric  thought 
and  practice.  This  section  of  the  book 
is  somewhat  redeemed  by  the  inclusion 
of  descriptions  of  the  nurse's  role  in 
group  therapy  and  in  community  serv- 
ices. 

The  author's  approach  to  the  subject 
as  a  whole  is  oversimplified  and  in 
relation  to  nursing,  perpetuates  the 
assumption  that  a  great  deal  is  known 
about  the  relationship  between  certain 
nursing  behavior  and  subsequent  pa- 
tient behavioral  outcomes. 

In  content  or  style,  this  book  is  not 
an  improvement  over  several  psychiat- 
ric nursing  texts  that  have  been  publish- 
ed in  recent  years.  I  would  hesitate  to 
recommend  this  book  except  to  the 
reader  audience  for  whom  it  was  intend- 
ed. 


Clinical    Guide   to    Undesirable    Drug 
Interactions    and    Interferences    by 

Soloman    Garb.    497    pages.    New 
York,  Springer  Publishing  Co.,  1 97 1. 

The  content  of  this  book,  designed  for 
use  by  physicians,  is  presented  entirely 
in  tables  that  list  a  drug  by  its  generic 
name  opposite  the  drug,  food  or  diag- 
nostic test  with  which  it  interacts  un- 
desirably. Common  brand  names  of 
drugs  are  included  in  the  alphabetic 
listing  of  generic  drug  names  and  cross- 
indexed  to  the  generic  name. 

The  form  of  the  interaction  or  inter- 
ference is  indicated  by  a  code  letter; 
the  meaning  of  the  code  is  printed  in  the 
text  and  also  in  a  detachable  section  at 
the  back  of  the  book. 

The  source  of  the  information  is 
indicated  by  a  number  referring  to 
the  bibliography.  Over  980  biblio- 
graphic entries  are  drawn  from  medical 
and  pharmacology  books  and  journals. 

Dr.  Garb,  in  his  short  introduction, 
urges  the  reader  to  seek  the  original 
source  to  determine  how  much  weight 
should  be  placed  on  the  reported  inter- 
action of  one  drug,  food  or  diagnostic 
test  with  another. 

The  book  is  an  index  to  sources  of 

(Continued  on  page  58) 

OCTOBER      1971 


Community  nursing  in  Canada 

and  other  timely  topics  you'll  not  want  to  miss 


The  Nursing  Clinics 
of  North  America 

In  the  current  (September)  issue  of  this  respected  and 
informative  periodical,  Guest  Editor  Dorothy  J.  Kergin 
of  AAcAAoster  University  chairs  a  symposium  on  com- 
munity nursing  in  Canada.  Twelve  Canadian  authors 
describe  unusual  programs  that  pioneer  innovations 
in  the  structure  of  health  care.  Explored  are  such 
topics  as  nursing  in  the  far  North,  geriatric  community 
nursing,  and  the  role  of  the  Student  Health  Organiza- 
tion, University  of  Toronto  (SHOUT)  in  helping  the 
disadvantaged.  A  second  symposium  discusses  the 
systems  approach  to  nursing,  examining  nursing  as  a 
sub-system  in  the  total  health-care  system.  Both  sym- 
posia reflect  the  high  professional  level  of  informa- 
tion presented  by  this  unique  hardbound  periodical. 

Sold  by  onnuol  subscription  only:  four  issues  a  year  averaging  185 
pages    with    no  advertising;    hard   cover;    $13    per    year. 


Mathieu: 

Hospital  and  Nursing 

Home  Management 

A  valuable  new  instructional  manual  for  training 
administrators  and  supervisory  personnel  and  a  useful 
reference  for  the  practicing  administrator.  Covers  such 
topics  as  business  procedures;  physical  plant  and  en- 
vironment; nursing  service;  dietary  service;  clinical 
records;  physical  and  occupational  therapy;  and 
personnel. 

By  Robert  P.  Mathieu,  M.S.,  F.A.C.H.A.,  F.A.P.H.A.,  Division  of 
Hospitols,  State  of  Rhode  Island.  About  255  pp.  and  60  illust. 
About  $10.30.  Just  reody. 


Brown  and  Fowler: 
Psychodynamic  Nursing 
A  Biosocial  Orientation 

New/  Fourth   Edition 

Offers  both  the  student  and  the  graduate  nurse 
explicit  guidance  on  the  use  of  psychology  in  nursing 
.  .  .  especially  in  psychiatric  service.  Helps  the  nurse 
to  better  understand  interpersonal  relationships  be- 
tween herself  and  her  co-workers  and  patients.  Aids 
the  student  in  developing  insight  into  the  special 
needs  and  feelings  of  the  psychiatric  patient.  This 
new  edition  includes  a  chapter  on  mental  health 
nursing  in  community  settings  and  places  more  em- 
phasis on  nursing  in  the  deprived  environment. 

By  Martha  Montgomery  Brow/n,  R.N.,  Ph.D.,  Univ.  of  Nebraska 
School  of  Nursing;  and  Grace  R.  Fowler,  R.N.,  M.A.,  Univ.  of 
Missouri  School  of  Nursing.  About  385  pp.,  illustd.  About  $7.75. 
Ready  October. 

Howe: 

Basic  Nutrition  in 

Health  and  Disease 

New  Fifth  Edition 

A  completely  up-dated  edition  of  the  text,  formerly 
called  Nutrition  for  Practical  Nurses.  Presents  the 
basic  principles  of  nutrition,  diet  therapy,  and  food 
handling  in  clear  and  simple  form.  Gives  special 
attention  to  weight  control,  and  to  minerals  and 
vitamins  in  the  diet.  Explains  diet  therapy  in  detail  .  .  . 
text,  tables,  and  charts  give  steb-by-step  guides  for 
preparing  diets  for  gastrointestinal,  metabolic,  car- 
diovascular or  urinary  disorders.  Includes  o  new 
glossary  and  list  of  medical  suffixes  and  prefixes. 
Suggests  many  new  references  and  readings. 

By  Phyllis  S.  Howe,  R.D.,  B.S.,  M.E.,  Contra  Costa  Community 
College.  About  450  pp.,   71    illust.   and  74  tables.  $5.40.   July   1971. 


W.  B.  Saunders  Company  Canada  Ltd.  1835  Yonge  Street,  Toronto  7 

Please  send  and  bill  me  for:  □     Brown  &  Fowler:  Psychodynamic  Nursing  —  About  $7.75 

n     Howe:  Basic  Nutrition  —  $5.40 

□     Mathieu:  Hospital  and  Nursing  Home  Monagement  —  About  $10.30 
n     Pleose   enter    my    subscription   to  the    Nursing    Clinics   beginning    with    the    September   issue    —    $13    per    year 


Name 
Address 
City  

CN-lO-71 


Zone 


Prov. 


OCTOBER      1971 


THE     CANADIAN     NURSE     57 

% 


{Continued  from  page  56) 
information,   rather  than   information 
about  undesirable  interactions.  It  has 
liirJted  use  for  the  individual  nurse  or 
nursing  unit  in  a  health  agency. 


Publications  on  thiis  list  have  been  received 
recently  in  the  CNA  library  and  are  listed 
in  language  of  source. 

Material    on    this    list,    except    Reference 
items, may  be  borrowed  by  CNA  members. 


schools  of  nursing  and  other  institutions. 
Reference  items  (theses,  archive  books  and 
directories,  almanacs,  and  similar  basic 
books)  do  not  go  out  on  loan. 

Requests  for  loans  should  be  made  on  the 
"Request  Form  for  Accession  List"  and 
should  be  addressed  to:  The  Library,  Cana- 
dian Nurses'  Association,  50  The  Driveway, 
Ottawa,  Ont.  K2P  1E2. 

No  more  than  tliree  titles  should  be  re- 
quested at  any  one  time. 


BOOKS  AND  DOCUMENTS 

1.   At>stracting  scientific  and  tecltnical  liter- 
ature, by  Robert  E.  Maizell  et  al.  Toronto, 


a  boon 

to 

ileostomy 

and 

colostomy 

patients 

alike! 


Karaya  Seal,  a  Hollister  development,  makes  it 
possible  for  a  patient's  rehabilitation  to  begin  in 
the  hospital  soon  after  surgery  and  oflFers  him 
a  simple,  comfortable  method  of  self -care  after 
he  goes  home.  The  Karaya  Seal  Ring  combines 
the  protective  qualities  of  karaya  gum  powder 
and  the  adhesive  properties  of  cement— elimi- 
nating the  need  for  dressings.  Designed  to  fit 
securely  around  the  stoma,  Karaya  Seal  con- 
forms to  body  contours,  protects  the  skin  from 
intestinal  discharge,  thus  avoiding  painful  ex- 
coriation. Each  Hollister  ostomy  appliance  is  a 
lightweight,  disposable,  one-piece  unit,  with  no 
gasket  to  retrieve,  no  parts  to  clean.  Write  (on 
professional  letterhead)  for  free  samples  and 
information  on  Hollister  ostomy  products. 

TM 

OSTOMY  PRODUCTS  by  HOLLISTER 


HOLLISTER  LTD.,  160  BAY  STREET.  TORONTO  116,  ONTARIO 


58     THE     CANADIAN     NURSE 


Wiley-lnterscience,  cl97l.  297 p. 

2.  Abstracts  of  Symposium  on  Biomathe- 
matics  and  Computer  Science  in  the  Life 
Sciences,  9tli  annual,  Houston,  Texas,  March 
22-24,  1971.  Houston,  Texas,  University  of 
Texas,  Graduate  School  of  Biomedical 
Sciences,  Division  of  Continuing  Education, 
1971.  Il5p. 

3.  Advanced  concepts  in  clinical  nursing,  by 
Kay  Corman  Kintzel,  ed.,  Toronto,  Lippin- 
cott,  cl971.427p. 

4.  Annuaire.  Ottawa,  Association  des  tra- 
ducteurs  et  interpretes  de  I'Ontario,  1970. 
80p. 

5.  Canadian  women  and  the  law,  by  Marvin 
A.  Zuker  and  June  Callwood.  Toronto,  Copp 
Clark,  1971.  lOOp. 

6.  Catalogue.  Toronto,  Visual  Education 
Centre,  1971.  82p. 

7.  Challenge  to  nursing  education;  prepara- 
tion of  the  professional  nurse  for  future 
roles.  Papers  presented  at  the  seventh  confer- 
ence of  the  Council  of  Baccalaureate  and 
Higher  Degree  Programs  held  at  Miami 
Beach,  Florida,  November  11-13,  1970.  New 
York,  National  League  for  Nursing.  Dept. 
of  Baccalaureate  and  Higher  Degree  Pro- 
grams, 197  1.  65p. 

8.  Changing  patterns  of  nursing  practice: 
new  needs,  new  roles.  Compiled  by  Edith 
Patton  Lewis.  New  York,  American  Journal 
of  Nursing  Co.,  cl971.  332p.  (Contemporary 
nursing  series) 

9.  Clinical  guide  to  undesirable  drug  inter- 
actions and  interferences,  by  Solomon  Garb. 
New  York,  Springer,  c  1971.  49  Ip. 

10.  Colostomy,  ileostomy  and  ureterostomy 
care:  a  guide  of  practical  information  for 
nurses,  rev.  Cleveland,  Cuyahoga  Unit,  Ohio 
Division,  American  Cancer  Society,  1970. 
58p. 

11.  Community  information  centres;  a  pro- 
posal for  Canada  in  the  70' s.  A  study  prepar- 
ed for  the  government  of  Canada.  Ottawa, 
The  Public  Policy  Concern,  1971.  68p. 

12.  Design  for  ETV;  planning  for  schools 
with  television,  by  Dave  Chapman.  New 
York,  Educational  Facilities  Laboratories. 
1960.  96p. 

13.  Directory.  Ottawa,  Association  of  Trans- 
ators  and  Interpreters  of  Ontario,  1970.  80p. 

14.  Dynamics  of  adaptation  in  the  federal 
public  service,  by  Michel  Chevalier  and 
James  R.  Taylor.  Ottawa,  Information  Can- 
ada, 1971.  89p.  (Canada.  Roval  Commission 
on  Bilingualism  and  Biculturalism,  study 
no.9) 

15.  The  dynamics  of  change,  by  Don  Fabun. 
Toronto,  Prentice-Hall,  cl967.  Iv. 

16.  The  elimination  of  architectural  barriers 
to  the  disabled:  a  selected  bibliography  and 
report  on  the  literature  in  the  field.  Compiled 
by  Susan  Klement.  Toronto,  Canadian 
Rehabilitation  Council  for  the  Disabled, 
1969.  36p. 

17.  Ethical  issues  in  health  services;  a  report 
and  annotated  bibliography,  by  James  Car- 
mody.  Rockville.  Md.,  U.S.  Public  Health 
Service,  1970.  43p.  (Report  HSRD  70:32) 

18.  Evaluative  research:  principles  and 
practice  in  public  service  and  social  action 

OCTOBER      1971 


programs,  by  Edward  A.  Suchman.  New 
York.  Russell  Sage  Foundation,  1967.  186p. 

19.  Family  planning:  a  reaching  guide  for 
nurses,  by  Miriam  T.  Manisoff.  New  York, 
Planned  Parenthood-World  Population, 
C1969.  I04p. 

20.  The  geriatric  day  hospital;  a  report  of 
three  studies  of  geriatric  day  hospitals  in 
Great  Britain  and  Northern  Ireland,  by 
John  C.  Brocklehurst.  London,  King  Ed- 
ward's Hospital  Fund  for  London,  1970. 
lOOp. 

21.  Guide  for  the  beginning  researcher,  by 
Mabel  A.  Wandelt.  New  York.  Appleton- 
Century-Crofts.  Education  Division/Meredith 
Corporation.  1970.  322p. 

22.  Guide  to  programmes  of  work,  study 
and  travel  opportunities,  in  Canada  and 
abroad.  Ottawa,  Canadian  Bureau  for  Inter- 
national Education.  1971.  76p. 

23.  Healthier  living  highlights:  a  college 
text  in  personal  and  environmental  health, 
by  Jusus  J.  Schiflferes.  Toronto,  Wiley,  cl97L 
276p. 

24.  Lhopital  general  de  Quebec  1692-1764, 
par  Micheline  d'Allaire.  Montreal,  P.Q., 
Fides.  1971.  251p. 

25.  Human  anatomy  and  physiology,  by 
James  E.  Crouch  and  J.  Robert  McClintic. 
Toronto,  Wiley,  c  1971.  646p. 

26.  Learning  activities  of  the  retarded  pre- 
schooler: a  manual  for  parents,  by  Margaret 
Anne  Johnson.  Montreal,  Quebec  Associa- 
tion for  the  Mentally  Retarded.  1971.  109p. 

27.  The  management  quiz  kit:  a  training  aid 
packet  designed  to  encourage  individual 
discussion  and  participation  in  training  pro- 
grams. Washington,  D.C.,  Leadership  Re- 
sources, 1971.  Iv. 

28.  Maternity  nursing,  by  Elise  Fitzpatrick 
et  al.  12th  ed.  Toronto.  Lippincott.  1971. 
63  8p. 

29.  Medical  computing:  progress  and  prob- 
lems: the  proceedings  of  a  conference  held 
at  the  University  of  Birmingham,  6-10 
January  1969,  Edited  by  M.E.  Abrams.  New 
York.  Elsevier,  1970.  396p. 

30.  Medical  handbook,  by  R.L.  Kleinman. 
3d  ed.  Reprinted  with  some  amendments. 
London,  International  Planned  Parenthood 
Federation,  Central  Medical  Committee. 
1971.  nip. 

3 1 .  Medecine  preventive  et  hygiene  publi- 
que.  par  Paul  Claveau.  Quebec,  les  presses 
de  rUniversite  Laval,  1966.  199p. 

32.  Mental  health  &  mental  illness,  by  Mabyl 
K.  Johnston.  Toronto,  Lippincott,  cl971. 
307p. 

33.  Multicultural  societies  and  federalism, 
by  Ronald  L.  Watts.  Ottawa,  Information 
Canada,  1971.  I87p.  (Canada.  Royal  Com- 
mission on  Bilingualism  and  Biculturalism, 
study  no.  8) 

34.  Nursing  care  of  the  long-term  patient, 
by  Jeanne  E.  Blumberg  and  Eleanor  E. 
Drummond.  2d  ed.  New  York,  Springer, 
C1971.  144p. 

35.  Nursing  education  in  Iowa:  a  study  of 
students  and  f acidly;  Report  prepared  by 
Orpha  J.  Glick  et  al  Iowa  City,  Iowa,  Iowa 
Nurses"  Association  and  Iowa  League  for 
OCTOBER      1971 


Nurses.  Available  from  College  of  Nursing, 
University  of  Iowa,  1 97 1.  I36p. 

36.  On  becoming  an  educated  person:  the 
university  and  college,  by  Virginia  Voeks. 
3d  ed.  Toronto.  Saunders,  1970.  278p. 

37.  On  being  a  woman.  The  modern  wom- 
an's guide  to  gynecology,  by  W.  Gifford- 
Jones.  Toronto,  McClelland  and  Stewart, 
C1969.  218p. 

38.  The  one-parent  family  in  Canada,  by 
Doris  E.  Guyatt.  Ottawa,  The  Vanier  Institute 
of  the  Family,  1971.  148p. 

39.  The  pill  on  trial,  by  Paul  Vaughan. 
London,  Weidenfeld  and  Nicolson.  cI970 
232p. 

40.  Proceedings  of  the  national  consultation 
on  rehabilitation,  Toronto,  Dec.  1-3,  1969. 
Toronto,  Canadian  Rehabilitation  Council 
for  the  Disabled,  1970.  153p. 

41.  Psychiatric  nursing,  by  Ruth  V.  Mathe- 
ney  and  Mary  Topalis.  5th  ed.  St.  Louis, 
Mosby,  1970.  346p. 

42.  Les  relations  humaines  a  I'hopital,  par 
Elizabeth  Barnes.  Traduction  de  Genevieve 
Durand.    Toulouse,    France,    Privat,    1968. 

136p. 

43.  Report  on  Inter-country  Workshop  on 
the  Control  and  Management  of  the  Nurs- 
ing Component  of  Health  Services,  New 
Delhi,  Nov.  3-14,  1969.  New  Delhi,  World 
Health  Organization,  Regional  Office  for 
South-East  Asia,  1971.  Iv. 

44.  Scientific  principles  in  nursing,  by 
Shirley  Hawke  Gragg  and  Olive  M.  Rees. 
6th  ed.  St.  Louis,  Mosby,  1970.  462p. 

45.  Signs  and  symptoms;  applied  pathologic 
physiology  and  clinical  interpretation.  Edited 
by  Cyril  Mitchell  MacBryde  and  Robert 
Stanley  Blacklow.  5th  ed.  Toronto,  Lippin- 
cott, c  1970.  I025p. 

46.  State-approved  schools  of  nursing- 
L.P.N.IL.V.N.;  meeting  minimum  require- 
ments set  by  law  and  board  rules  in  the 
various  Jurisdictions,  1971.  New  York,  Na- 
tional League  for  Nursing.  Division  of 
Research,  1971.  76p. 

47.  Textbook  of  anatomy  and  physiology, 
by  Catherine  Parker  Anthony.  8th  ed.  St. 
Louis,  Mosby,  1971.  580p. 

48.  Textbook  of  anatomy  and  physiology, 
laboratory  manual,  by  Catherine  Parker 
Anthony.  8th  ed.  St.  Louis,  Mosby,  1971. 
213p. 

49.  Teaching  in  the  community  junior  col- 
lege, by  Win  Kelley  and  Leslie  Wilbur.  New 
York,  Appleton-Century-Crotts,  cI970.  295p. 

50.  Today's  child:  a  modern  guide  to  baby 
care  and  child  training,  by  Elizabeth  Chant 
Robertson  and  Margaret  I.  Wood.  Toronto, 
Pagurian  Press;  distributed  by  Bums  &  Mac- 
Eachern,  1971.  230p. 

51.  L'Universite  et  le  developpement  socio- 
economique,  par  Alphonse  Riverin.  Ottawa, 
Publications  les  Affaires,  1971.  162p. 

52.  Visiting  homemaker  services  in  Can- 
ada; report  of  a  survey  with  recommenda- 
tions. Ottawa,  Canadian  Council  on  Social 
Development.  Advisory  Committee  on 
Visiting  Homemaker  Services.  1971.  157p. 

53.  Working  with  the  mentally  ill,  by  Alice 


THE     CANAC^AN     NURSE     59 


i ^ 

Busy,  busy 
little  fingers. 
Busily  spreading 
pinworms. 


Depend  upon 

(pyrvinium  pamoate  Frosst) 

to  eliminate 
pinworms  witii 
a  singie  dose 


Early  detection,  and  treatment  with 
Pamovin,  can  bring  tlie  usual  unpleasant 
course  of  pinworms  to  an  abrupt  halt. 

It  has  been  shown'  that  single-dose 
treatment  with  pyrvinium  pamoate 
achieves  an  overall  cure  rate  of 
96  per  cent. 

In  the  family  or  in  institutions,  pyrvinium 
pamoate  (PAMOVIN)  offers  the  advantages 
of  "low  cost,  ease  of  administration, 
and  effectiveness."^ 

Dosage:  for  both  children  and  adults,  a  single 
dose  of  1  tablet  or  1  teaspoonful  for  every 
22  lbs.  of  body  weight. 

Cautions:  Occasionally,  nausea,  vomiting  or 
gastrointestinal  complaints  may  be  encoun- 
tered but  are  seldom  a  problem  on  such 
short-term  treatment.  Stools  may  be  coloured 
red.  Suspension  will  stain  clothing  and  fabrics. 

PAMOVIN  Tablets  of  50  mg.  (red,  film-coated), 
boxes  of  6,  and  bottles  of  24  and  100. 
Suspension  (red),  50  mg.  per  5  ml.  teaspoonful, 
bottles  of  30  ml.,  4  and  16  fl.  oz. 

References:  1.  Beck,  J.  W.,Saavedra,  D., 
Antell,  G.  J.  and  Tejeiro,  B.:  Am.  J.  Trop.  Med. 
8:349,  1959.  2.  Sanders,  A.  I.  and  Hall,  W.  H.: 
J.  Lab.  &  Clin.  Med.  56:413,  1960. 

Full  inlormalion  on  request. 


® 


3no^y^ 


CMAm.lS  C.   PAOSST  *  CO.       KIRKI.ANO  (MONTHEAI.)  CANADA 


60     THE     CANADIAN     NURSE 


accession  list 


M.  Robinson.  4th  ed.  Toronto,  l.ippincott. 
CI97I.  249p. 

54.  Yon,  your  child  and  dni)^s.  New  York, 
Child  Study  Press.  cl97 1.  73p. 

PAMPHLETS 

55.  Brief  to  the  Minister  of  Social  Affairs, 
Government  of  Quebec  concerninf;  the  report 
of  the  commission  of  inquiry  on  health  and 
social  nelfare,  volume  IV  "Health".  Mont- 
real. Association  of  Nurses  of  the  Province 
of  Quebec,  1971.  14p. 

56.  Brief  to  the  New  Brunswick  Hif>her 
Education  Commission.  Fredericton,  New 
Brunswick  Association  of  Registered  Nurses, 
1971.  15p. 

57.  The  doctor  talks  about  birth  control; 
a  teen-ane  fact  book,  by  Alan  F.  Guttmacher. 
New  York,  Planned  Parenthood  Federation 
of  A  merica,  c  1 969.  5p. 

58.  Health  care  for  the  adolescent,  by  June 
V.  Schwartz.  New  York.  Public  Affairs 
Committee,  1971.  28p.  (Public  affairs  pam- 
phlet no.  463) 

59.  Money  for  our  cities:  is  revenue  sharing 
the  an.swer'.'  by  Maxwell  S.  Stewart.  New 
York.  Public  Affairs  Committee,  cI971. 
24p.  (Public  affairs  pamphlet  no.  461) 

60.  Nursing- 1 980  (national  survey)  Oradel, 
N.J..  RN.  1970.  43p. 

61.  Nursing  education  programs  in  British 
Columbia;  information  for  counsellors. 
Rev.  Vancouver.  B.C.,  Registered  Nurses" 
Association  of  British  Columbia.  1971.  26p. 

62.  Nursing  papers.  May  1971.  Montreal, 
P.Q..  McGill  University.  School  for  Graduate 
Nurses,  1971.  28p.Contents:-QuebecCCUSN 
responds  to  the  Castonguay  report. -Adapting 
social  measurement  for  special  population 
groups.  Perceived  role  differences  and  dis- 
crepancies among  nursing  supervisors. 

63.  Our  troubled  waters:  the  fight  against 
water  pollution,  by  Gladwin  Hill.  New  York, 
Public  Affairs  Committee,  1971.  24p.  (Public 
affairs  pamphlet  no. 462) 

64.  Report  of  Conference  on  Continuing 
education  in  the  Professions,  Toronto,  Nov. 
17-20,  1970.  Toronto,  Ontario  Institute  for 
Studies  in  Education.  1971.  40p. 

65.  Report  of  Metropolitan  Toronto  Hospital 
Planning  Council  1970.  Toronto,  1971.  31  p. 

66.  Report  of  Registered  Nurse.'i'  Association 
of  British  Columbia,  Committee  to  Review 
tile  Report  of  the  Royal  Commission  on  the 
Status  of  Women.  Vancouver,  B.C.,  1971. 
lOp. 

67.  The  right  way  to  birth  control  Chapel 
Hill.  N.C..  Carolina  Population  Center, 
n.d.  12p 

68.  Sex  and  marriage,  by  Robert  E.  Hall. 
New  York,  Planned  Parenthood-World 
Population,  cl965.  16p. 

69.  5;  Florence  revenait  au  Quebec.  Mont- 
real, Alliances  des  infirmieres  de  Montreal. 
1971.  36p 


70.  The  state  of  collective  bargaining  between 
hospitals  in  Nova  Scotia  and  members  of  the 
Nurse.'i'  Staff  Associations.  Presentation  to  the 
Honourable  D.  Scott  MacNutt,  May  14, 
1971.  Halifax.  Registered  Nurses"  Associa- 
tion of  Nova  Scotia.  1971.  12p. 
7  1 .  Winds  of  change.  Report  of  a  confer- 
ence on  activity  programs  in  long-term 
care  institutions.  Chicago,  American  Hos- 
pital Association,  c  1971.  38p. 

GOVERNMENT  DOCUMENTS 
Canada 

72.  Bureau  of  Statistics.  Census  Division. 
Census  of  Canada.  1966.  Volume  2;  house- 
holds and  families.  Ottawa.  Information 
Canada,  1970.  29p. 

73.  Bureau  of  Statistics.  Married  female 
labour  force  participation:  a  micro  study,  by 
Byron  G.  Spencer  and  Dennis  C.  Feather- 
stone.  Ottawa,  Queen"s  Printer,  1970.  102p. 
(Its  Special  labour  force  studies.  Series  B. 
no. 4) 

74.  Bureau  of  Statistics.  Surgical  procedures 
and  treatments,  1968.  Ottawa,  Information 
Canada,  1971.  163p. 

75.  Dept.  of  National  Health  and  Welfare. 
Research  and  Statistics  Directorate.  Legisla- 
tion, organization  and  administration  of 
rehabilitation  services  for  the  disabled  in 
Canada,  1970,  by  .  .  .  and  Dept.  of  Manpower 
&  Immigration.  Ottawa,  Queen"s  Printer, 
1971.  104p.  (Its  Health  care  series  no.27) 

76.  Dept.  of  Supply  and  Services.  Report  of 
the  Dept.  of  Public  Printing  &  Stationery 
(April  1.  1968  to  March  31,  1969)  and  of  the 
Canadian  Government  Printing  Bureau 
(January  1,  1968  to  March  31,  1969)  Ottawa, 
Queens  Printer,  1970.  32p. 

77.  Public  Service  Commission.  Report, 
1970.  Ottawa,  Information  Canada.  1971. 
97  p. 

78.  Secretary  of  State.  Our  history.  Ottawa, 
Information  Canada,  1970.  86p. 

79.  Treasury    Board.    Occupational    health 
and  safely  policies.  Public  Service  of  Canada. 
Ottawa,  Information  Canada,  1971.  I4p. 
Great  Britain 

80.  Dept.  of  Employment  and  Productivity. 
Health  and  safety  at  work:  organisation  of 
industrial  health  services.  London,  H.M. 
Stationery  Off..  1970.  24p.  (Safety,  health  and 
welfare  new  series  no.21.  amended) 

New  Zealand 

81.  Dept.  of  Health.  A  review  of  hospital 
and  related  services  in  New  Zealand.  Wel- 
lington, 1969.  187p. 

Quebec 

82.  Commission  of  Inquiry  on  Health  and 
Social  Welfare.  Report.  Quebec,  P.Q.,  Gov- 
ernment of  Quebec,  1970.  7  volumes. 
Saskatchewan 

83.  Dept.  of  Education.  Health  Sciences 
Section.  Guidelines  for  curriculum  develop- 
ment in  programs  of  diploma  nurse  education 
in  Saskatchewan.  Regina.  1971.  18p. 

84.  Dept.  of  Education.  Health  Sciences 
Section.  Survey  of  performance  characteris- 
tics related  to  program  objectives  for  diploma 

(Continued  on  page  62) 
OCTOBER     1971 


L^ 


no  OTHER  BfIG  PERFORfn;  UH€  m£ 


My  safety  chamber 
really  slops  retro- 
grade Infection. 
There's  simply  no  way 
for  the  bugs  to  back 
up  and  go  where  they 
don't  belong.  And  by 
tucking  the  BAC- 
STOP  chamber  in- 
side the  bag,  it  can't 
be  kinked  acciden- 
tally to  stop  the  flow. 


I'm  clear-faced  and 
easy  to  read.  My  white 
back  makes  my  mark- 
ings stand  out  unique- 
ly, whether  you  look 
at  my  backbone  scale, 
or  tilt  me  diagonally  \ 
to  read  small  amounts 
with  the  corner  cali- 
brations. 


<    X 


Cystono' 


My  hanger  is  the 
hanger  that  works 
well  all  the  time.  Hang 
it  on  a  bed  rail  or  a 
belt,  it  is  always  se- 
cure and  comfortable. 
I'm  always  on  the 
level  with  this  hanger, 
whether  my  patient  is 
lying,  sitting,  or  walk- 
ing around. 


I  have  the  only  shortle 
drainage  tube  around, 
and  it's  miles  better 
than  any  other 
you've  ever  used.  It's 
easier  to  handle,  and  it 
won'tdragonlhelloor. 
even  with  the  new  low 
beds.  So  out  goes  one 
more  path  to  possible 
contamination. 


I'm  the  unique  new  CYSTOFLO'  drainage  bag,  a 
true-blue  friend  to  nurses,  physicians  and  patients. 
Why  don't  we  get  acquainted? 


BAXTER  LABORATORIES  OF  CANADA 

UiV'b'ON  U»    IHAVfNOl  lABOHAIOHKS   'N(. 

6406  Noriham  Dnve  Malion  Ontario 


accession  list 


{Continued  from  page  60) 

nursing;,   Sciskcilchewan   institute  of  Applied 
Arts  and  Sciences,  Saskatoon.  Regina,  1971. 
:0p,  R 
United  Stales 

85.  Health  Services  and  Mental  Health  Ad- 
ministration. Training  the  auxiliary  liealth 
worker;  an  aiuilysis  of  functions,  training 
content,  training  costs,  and  facilities.  Wash- 
ington. D.C..  U.S.  Govt.  Print.  Off..  1968. 
38p.  (U.S.  Public  Health  Service  publication 
no.  1817) 

STUDIES  DEPOSITED  IN  CNA  REPOSITORY 
COLLECTION 

86.  Analyse  comparative  des  resultats 
nioyens  ohieniis  a  des  tests  verifumt  I'acqiii- 
siiion  dun  conlenu  en  soins  infiriniers  et  le 
temps  moxen  consacre  a  cette  acquisition  par 
deu.x  groupes  d'etudiantes-infirmieres  soiiinis 
a  des  methodes  differentes  d'enscigneinent 
\ur  cjuelques  principes  de  base  relatifs  a  la 
prise  de  la  temperature  luimaine.  par  Jeanni- 
ne  Baudry.  Montreal.  1970.  94p.  (Thesis 
(M.Ed.l-Montreal)  R 

87.  Appendix  to  learning  to  nurse:  the  first 
five  years  of  the  Ryerson  nursing  program, 
by  Moyra  Allen  and  Mary  Reidy.  Toronto, 


Registered  Nurses'  Association  of  Ontario. 
1971.  135p.  R 

88.  Canadian  Hospital  Association  two 
year-three  year  employer  opinion  survey, 
by  Woods,  Gordon  &  Co.  Toronto,  Canadian 
Hospital  Association,  1971.  46p.  R 

89.  Clinical  resources  for  nursing  education; 
report  of  area  study  Essex  County,  Ont. 
Toronto,  Ontario  Hospital  Services  Commis- 
sion and  College  of  Nurses  of  Ontario,  1969. 
56p.  R 

90.  Clinical  resources  for  nursing  education; 
report  of  area  study  Kingston,  Ont.  Toronto, 
Ontario  Hospital  Services  Commission  and 
College  of  Nurses  of  Ontario,  1968.  30p.  R 

91.  Clinical  resources  for  nursing  education; 
report  of  area  study  London,  Ont.  and  St. 
Joseph's  Hospital,  Chatham.  Toronto,  Ontario 
Hospital  Services  Commission  and  College 
of  Nurses  of  Ontario,  1969.  78p.  R 

92.  Participation  verbale  du  personnel  in- 
firmier  au  coiirs  de  la  reunion  malades- 
personnel  a  I'hopital  psychiatrique  etfacteurs 
qui  influencent  cette  participation,  par  Deny- 
se  Latourelle.  Montreal,  P.Q.,  1970.  103p. 
(Thesis  (M.  Nurs.)- Mont  real)  R 

93.  People  look  at  doctors  and  other  rele- 
venat  matters.  The  Siinnyhrook  health 
attitude  survey,  by  W.  Harding  LeRiche  at 
al.  Toronto.  Sunnybrook  Hospital.  cl971. 
204p.  R 

94.  Some  factors  related  to  the  mobility  of 
teachers  in  diploma  schools  of  nursing  in  the 
province  of  Ontario,  by  Muriel  A.  Ward.  To- 
ronto, 1970.  48p.  (Thesis  (M.  Ed.)-Toronto)  R 


95.  A  study  of  anticipatory  socialization  in 
prospective  nursing  students,  by  Janice 
Given.  Toronto,  cl970.  1 17p.  (Thesis  (M.  A.) 
-Toronto)  R 

96.  A  study  to  develop  an  instrument  to 
assist  nurses  to  assess  the  abilities  of  patients 
with  chronic  conditions  to  feed  themselves, 
by  Frances  Patricia  Phillips.  Vancouver. 
B.C..  1971.  83p.  (Thesis  (M.  Sc.  N.)-British 
Columbia)  R 

97.  A  survey  of  the  development  of  bacca- 
laureate and  diploma  schools  of  nursing  in 
Ontario  since  1965.  Toronto.  College  of 
Nurses  of  Ontario,  1971.  61  p.  R 

98.  A  survey  of  the  development  of  training 
centres  for  nursing  assistants  in  Ontario 
since  1946.  Toronto,  College  of  Nurses  of 
Ontario,  1971.  33p.  R 

99.  5(/r\'f_v  public  health  activities.  Appraisal 
made  by  the  consultants  for  the  survey,  the 
Committee  on  Administrative  Practice  of  the 
American  Public  Health  Association.  Mont- 
real, P.Q.,  Montreal  Health  Survey  Commit- 
tee. Published  by  the  Metropolitan  Life 
Insurance  Company,  1928.  149p.  R 

100.  Team  nursing  in  a  generalized  public 
health  nursing  program  (not  including  bed- 
side care),  by  Rosella  Cunningham.  Toronto, 
University  of  Toronto,  School  of  Nursing, 
1970.  I2.'ip.  R 

101.  Treiuls  for  diploma  programs  in  nursing 
in  Ontario  as  reflected  by  the  nursing  litera- 
ture and  the  opinions  of  selected  nurse  educ- 
ators, by  Dorothy  Syposz.  Toronto,  cl97l. 
203p.  (Thesis  (M.A.)-TorontojR  a 


Request  Form  for  "Accession  List" 
CANADIAN  NURSES'  ASSOCIATION  LIBRARY 

Sentj  this  coupon  or  facsimile  to: 

LIBRARIAN,  Canadian  Nurses'  Association,  50  The  Driveway,  Ottawa,  Ontario.  K2P  1E2. 

Please  lend  me  the  following  publications,  listed  in  the  issue  of  The 

Canadian  Nurse,  or  add  my  name  to  the  waiting  list  to  receive  them  when  available: 

Item  Author  Short  title  (for  identification) 

No. 


Requests  for  loans  will  be  filled  in  order  of  receipt. 

Reference  and  restricted  material  must  be  used  in  the  CNA  library. 

Borrower Registration  No. 

Position    


Address    

Date  of  request 


62     THE     CANADIAN     NURSE 


OCTOBER     1971 


IStdvember  1971 


ou 


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The 


=.«■;;.::„"'■■■ 

OTTAWA.    ONT. 
KIN   6N5 

l2-73-10-71-CN-i,v.    3037 


Canadian 
Nurse 


the  Colonel  is  a  lady 
—  and  a  nurse 

wanted:  a  nursing  theory 

how  to  make  a  film 
in  your  spare  time 


'A^ 


■  >■» 


^ :-:!,«»: 


pn    int    I  uu  I  nruL  teiiic 


WHITE 
SISTER 


WHITE  SISTER 

BRINGS  IMPORTANT  FASHION  NEWS 

TO  THE  JUNIOR  FIGURE 


fl^  » 


#40989  — In  "Super  Supreme"  Plain  Tricot  Knit 
White,  Lilac,  Navy,  Red  at  $19.98 
Sizes:   3-15 


#40992  —  "Super  Supreme"  Plain  Tricot  with  Knitted 
Tucked  Tricot  White  Only  at  $15.98 
Sizes:  3-15  Junior  Length 


White  Sister  Uniform    Inc.  -  Montreal,  Toronto,  Vancouver. 


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Each  30  ml.  contains  5  ml.  Aro- 
matic Cascara  Sagrada  in  the  equiv- 
alent of  30  ml.  of  Milk  of  Magnesia 


If  your  nurses  have  been  practicing  pharmacy  at  the  nursing 
station  .  .  .  compounding  a  Milk  of  Magnesia/Cascara  Sagrada 
suspension,  take  heart!  Now,  you  can  provide  them  with  this 
combination  in  a  tamper  proof,  positively  identified,  30  ml.  unit 
dose  bottle  which  is  not  opened  until  it  reaches  the  patient's 
bedside.  Check  with  your  nursing  staff— this  could  be  just  what 
they  are  looking  for! 


tLIST  NO. 
70140 

Intra 


Milk  of  Magnesia 
Cascara  Sagrada  Suspension 


MEDICAL  PRODUCTS 

Division  of  Penick  Canada  Ltd.,  Toronto,  Canada 


NOVEMBER   1971 


THE  CAN/y)IAN  NURSE     1 


Lippincott 


EXPAND 
YOUR 
PERSONAL 
LIBRARY 


NURSING  rN  THE  INTENSIVE 

RESPIRATORY  CARE  UNIT 

By  Hannelore  M.  Sweetwood,  R.N.,  Inseryice  Director, 
Jersey  Shore  Medical  Center. 

Here  is  the  specific  information  needed  to  equip  the 
nurse  to  function  effectively  in  an  intensive  respiratory 
care  unit.  Much  of  the  material,  v^^hich  has  been  tested 
in  the  actual  teaching  of  nurses  in  this  new  specialty, 
is  available  in  no  other  manual.  The  equipment  and 
procedures  discussed  are  suitable  for  the  average 
community  hospital  and  can  be  adapted  to  the  smaller 
hospital  as  well.   224  pages     23  illust.     1971.     $5.25. 

Dennis  and  Doyle 

THE  COMPLETE  HANDBOOK  FOR 

MEDICAL  SECRETARIES  AND  ASSISTANTS 

By  Robert  L.  Dennis,  M.D.,  and  Jean  Monty  Doyle,  R.R.L. 

The  most  complete  book  of  its  kind,  this  is  a  com- 
prehensive, straightforward  reference  for  medical  as- 
sistants and  medical  secretaries.  The  authors  have 
compiled  and  organized  medical  definitions,  anatomic- 
al terms,  and  case  reports  according  to  medical  spe- 
cialty. Studying  the  section  on  a  particular  specialty 
will  enable  the  assistant  to  understand  the  doctor's 
terminology  and  type  reports  accurately.  An  up-to- 
date  list  of  surgical  instruments,  dressings,  materials, 
drugs,  anesthetics,  and  laboratory  procedures  is  also 
included,  as  is  an  excellent  section  on  electrocardio- 
grams. Indispensable  in  every  doctor's  office,  this 
manual  provides  the  assistant  with  basic  knowledge 
and  suggests  further  reading;  it  is  also  recommended 
for  instructors.  538  pages.  1971.  $10.00 

SERVING  THE  HEALTH  PROFESS 


NURSING  OF  PEOPLE  WITH 

CARDIOVASCULAR  PROBLEMS 

By  Sister  Catherine  Armington,  D.C.,  R.N.,  B.S.N.E.,  and 
Helen  Creighton,  R.N.,  A.M.,  M.S.N.,  J.D. 

This  new  book  provides  the  nurse  with  what  amounts 
to  a  post-graduate  course  in  the  care  of  patients  with 
cardiovascular  problems.  Prepared  with  the  needs  of 
both  patient  and  nurse  in  mind,  this  volume  has  been 
enriched  by  the  advice  and  suggestions  of  various 
cardiologists,  cardiac  surgeons,  and  nurse  educators. 
Approx.  350  pages,  illustrated.      1971.     About  $9.95. 


CARE  OF  THE  ADULT  PATIENT: 
Medical-Surgical  Nursing 

By   Dorothy  W.   Smith,   R.N.,   Ed.D.;   Carol   P.    Hanley 
Germain,  R.N.,  M.S.;  and  Claudia  D.  Gips,  R.N.,  Ed.D. 

Reorganized,  expanded  and  updated  in  line  with 
changes  in  nursing  practice,  the  great  strength  of  this 
superb  text  continues  to  lie  in  its  focus  on  nursing. 
Particular  consideration  is  given  to  the  individualized 
care  required  at  various  stages  in  adult  life  along 
the  health-illness  continuum.  Both  pathophysiologic 
and  psychosocial  factors  are  explored  and  applied 
to  nursing  problems. 
1197  pages.     410  Illust.     3rd  Edition     1971.     $13.95. 


ADVANCED  CONCEPTS  IN 
CLINICAL  NURSING 

By  Kay  Carman  Kintzel,  R.N.,  M.S.N.,  Editor.  With  20 
Contributors. 

The  first  book  of  its  kind!  Written  to  foster  expertise 
in  the  more  complex  and  little-explored  aspects  of 
clinical  nursing,  this  text  offers  intensive  studies  of 
sixteen  areas  requiring  a  greater  depth  of  knowledge. 
Emphasis  is  on  prevention,  continuity  of  care,  the 
relation  of  the  nurse  to  patients'  families  and  the 
community,  and  her  responsibilities  in  teaching  and 
rehabilitation.    427  pages.     100  Illust.    1971.    $13.50 


DUNCAN'S  DICTIONARY  FOR  NURSES 

Helen  A.  Duncan,  R.N. 

All   the  terms  a   modern   professional   nurse   needs   to 
know  in  nursing,  medicine,  psychiatry,  the  social  and 
biological  sciences  —  more  than  10,000  entries,  com- 
piled for  nurses,  by  a  nurse. 
1971.     408  pages.      Illust.     $5.25;  hardcover  $7.95. 

ONS  IN  CANADA  SINCE  1897 


PLEASE  SEND  ME  THE   FOLLOWING  BOOKS 

n     CARE    OF  THE    ADUIT  PATIENT 

G     ADVANCED     CONCEPTS     IN     CLINICAL     NURSING 

D     NURSING  OF  PEOPLE  WITH  CARDIOVASCULAR  PROBLEMS 

D      NURSING    IN    THE    INTENSIVE    RESPIRATORY   CARE    UNIT 

n     DUNCAN'S  DICTIONARY  FOR  NURSES  □ 

□      Hardcover 
D     THE  COMPIHE  HANDBOOK  FOR 

MEDICAL    SECRETARIES    AND    ASSISTANTS 


$13.95 
$13.50 
about  $  9.95 
$  5.25 
$  5.25 
$  7.95 


$10.00 


PAYMENT    ENCLOSED    D 
CHARGEX    n 

Lippincott  bool(s  may  be  returned  in  30  days  if  you  are  not  satisfied 


J.  B.  LIPPINCOTT  CO.  OF  CANADA  LTD. 
60  FRONT  ST.  W.,  TORONTO  1,  ONT. 

NAME    

ADDRESS     

CITY  

CHARGE    AND    BILL    ME    D 


CN-Il-71 


2     THE  CANADIAN  NURSE 


NOVEMBER   1971 


The 

Canadian 
Nurse 


^ 

"^^ 


A  monthly  journal  for  the  nurses  of  Canada  published 

in  English  and  French  editions  by  the  Canadian  Nurses'  Association 


Volume  67,  Number  11 


November  1971 


23     The  Colonel  Is  a  Lady  —  And  a  Nurse L.-E.  Lockeberg 

26  Cut  1,  Scene  2  —  Or  How  to  Make  a  Film  in 

Your  Spare  Time L.  Brydges 

28     Wanted:  A  Theory  of  Nursing J-  Foley 

33     A  Pioneer  in  Nursing  Education C.  Kotlarsky 

36  idea  Exchange E.  Hughes 

37  The  Patient  Who  Needed  a  Friend C.  Hornby 

40     Hey,  Nurse!  J-  Wilting 


The  views  expressed  in  the  various  articles  are  the  views  of  the  authors  and  do  not 
necessarily  represent  the  policies  or  views  of  the  Canadian  Nurses'  Association. 


5  News 

4 1  Research  Abstracts 

44  In  a  Capsule 

48  AV  Aids 


16  New  Products 
20  Dates 
42  Names 
46  Books 


Executive  Director;  Helen  K.  Mussallem  • 
Editor:  Virginia  A.  Lindabury  •  Assistant 
Editors:    Liv-EUen    LoclsebeiB.    Dorothy    S. 

SJarr  •  Editorial  Assistant:  Carol  A.  Kotlar- 
sky •  Production  Assistant:  Eli^abeth  A. 
Stanton  •  Circulation  Manager:  Beryl  Dar- 
ling •  Advertising  Manager:  Georgina  Clarke 

•  Subscription  Rales:  Canada:  one  year. 
$6.00;  two  years,  $11.00.  Foreign:  one  year, 
$6.50;  two  years,  $12.00.  Single  copies:  7.*! 
cents  each.  Make  cheques  or  money  orders 
payable  to  the  Canadian  Nurses"  Association 

•  Change  of  Address:  Six  weeks"  notice;  the 
old  address  as  well  as  the  new  arc  necessary, 
together  with  registration  number  in  a  pro- 
vincial nurses'  association,  where  applicable. 
Not  responsible  for  journals  lost  in  mail  due 
to  errors  in  address. 


Manuscript  Information:  the  Canadian 
Nurse "  welcomes  unsolicited  articles.  All 
manuscripts  should  be  typed,  doublespaced. 
on  one  side  of  unruled  paper  Icavinp  wide 
margins.  Manuscripts  arc  accepted  for  rc\iew. 
for  exclusive  publication.  The  editor  reserves 
ihc  right  to  make  the  usual  cditori.il  changes 
Photographs  (glossy  prints)  and  graphs  and 
di.icrams  (drawn  in  India  ink  on  white  paper! 
.irc~ welcomed  with  such  article.  The  editor 
is  not  committed  to  publish  all  .irlicles 
sent,  nor  to  indicate  definite  dates  of 
publication 

Postage  paid  in  cash  at  third  class  rate 
MONTRKAI  .  PO  Permit  No.  10.001 
SO  The  Driveway,  Ottawa.  Ontario.  K2P  1  E2 
©    Canadian  Nurses'  Association   1971. 


NOVEMBER   1971 


Editorial 

In  an  editorial  published  after  the  34th 
CNA  general  meeting,  we  comment- 
ed on  the  delegates'  decision  to  re- 
examine the  association's  goals,  func- 
tions, and  structure.  We  ended  the  edi- 
torial by  saying:  "No  association  in  a 
democratic  society  can  escape  a  pe- 
riodic self-examination  if  it  is  to  survive 
and  be  successful.  " 

Now,  three  years  later,  that  state- 
ment IS  outdated.  Perhaps  it  was  out- 
dated even  then.  For  the  truth  is,  as 
Alvin  Toffler  writes  in  Future  Shock, 
with  so  much  change  about  us,  "reor- 
ganization is,  and  must  be,  an  on-going 
process."  Tofflersays  tfiat  when  change 
is  accelerated  "more  and  more  novel 
first-time  problems  arise,  and  tradition- 
al forms  of  organization  prove  inade- 
quate to  the  new  conditions.  They  can 
no  longer  cope.  " 

Well,  right  now  CNA  is  being  bom- 
barded with  more  and  more  "novel 
first-time  problems.  "  And  whether  the 
problem  concerns  community  health 
centers,  pollution,  proliferation  of  health 
workers,  or  whatever,  itisnoexaggera- 
tion  to  say  that  CNA  members,  other 
associations,  and  government  bodies 
alike  are  demanding  CNAs  response 
yesterday.  In  effect.  CNA  can  hardly 
keep  up  with,  let  alone  be  ahead  of, 
these  issues.  In  other  words,  the  tradi- 
tional forms  of  organization  are,  indeed, 
proving  inadequate  to  cope  with  new 
conditions. 

The  CNA  directors  have  been  study- 
ing this  problem  since  their  meeting 
last  March,  when  the  chairmen  of  the 
association's  three  standing  committees 
reported  that  ""  .  ,  ,  a  need  to  change 
the  organizational  framework  of  CNA 
existed  and  that  this  involved  much 
more  than  simply  changing  the  nature 
of  the  committee  structure," 

The  directors  discussed  alternative 
approaches  at  their  meeting  last  month, 
and  undoubtedly  will  present  a  propos- 
al to  delegates  at  the  next  annual  meet- 
ing. Their  proposal  will  take  into  ac- 
count the  fact  that  CNA  now  has  four 
research  officers  on  staff,  whose  res- 
ponsibilities are  to  collect,  analyze, 
and  synthesize  data  on  crucial  issues, 
identifying  them  before  they  become 
crises;  and  to  prepare  working  papers 
on  various  issues  and  make  recom- 
mendations. 

As  we  see  it.  CNA  will  continue  to 
call  on  persons  or  groups,  on  an  ad 
hoc  basis,  to  respond  to  issues  within 
their  area  of  expertise.  Also,  some 
of  the  work  traditionally  done  by  the 
standing  committees  will  be  under- 
taken by  staff,  who  will  present  alter- 
native courses  of  action  —  and  their 
ramifications — to  the  CNA  directors 
for  decision-making.  And  here  we 
raise  an  important  question:  Is  there 
time  for  the  directors  to  refer  issues 
back  to  the  provinces,  except  at  a  CNA 
general  meeting?  —  V.A.L. 

THE  CANADIAN  NURSE      3 


SCHERINQ 


For  effective  relief 
of  cold  symptoms 

take  the  clear-headed 
family  approach. 

Recommend  Coricidin. 


Coricidin*  is  a  whole  family  of  cold  fighters.  Each  form  is 
formulated  for  maximum  effectiveness  in  controlling 
cold  symptoms. 

Coricidin  'D',  for  instance,  has  five  ingredients 
to  combat  every  head  cold  symptom:  a  top-rated  anti- 
histamine to  stop  running  noses,  two  pain  relievers  and 
fever  fighters,  caffeine  to  brighten  spirits  and  a  decon- 
gestant to  shrink  swollen  membranes. 

For  the  junior  cold  sufferer,  Coricidin  'D'  Medilets  * 
offer  the  same  relief  in  a  dosage  suitable  for  the  young 


patient,  in  a  pleasant-tasting  chewable  tablet. 

For  everyone  In  the  family,  there  is  a  member  of  the 
Coricidin  family  to  bring  real  relief:  Adult  tablet  forms 
packaged  in  the  new,  easy-to-use  pop-out  blister  packs, 
spray,  lozenges  and  a  pleasant-tasting  cough  mixture. 

Recommend  Coricidin.  Your  charges  will  be  glad 
you  did.  For  further  information,  consult  your  physician 
or  write  Schering  Corporation  Limited,  Pointe  Claire 
730,  P.Q. 

•  Res.  T.M. 


Coricidin 


PEDIATRH 


r 


<r^fe 


Coricidin 


THR0A1 
iOZI 

soothing  HONEY  MEN 


Coricidin 


COUGH  MIXTURE 


^fiJi'"  OUNCES 


Coricidin 


COLO 


^^^fSHI 


24  TABLETS 
'or  ttli»i  ot  COkl 
■yniptofna  end 
KCDmpanying  «chM. 
lM>f>«.  f«v«r  end  wmpl* 
hMdAch*  ^B 


N»wl  Chird'i  Pfot»ctiv«  P«c* 


CorlcidinD' 


lEDitrrs' 


24  CHEWABLE  TABLETS 

For  (Mt  rsiief  of 
c^ildfan'i  ituffy  and 
runny  notes  du«  to 
th«  common  cold 


Coricldin'D' 


gRBTAillTf-Wtf* 

weattsTWT  tcnm 


24  TABLETS 

fw  f«li«f  ot  cofd  symptoms 

•od  •ccompaoymg 

*ch«a,  paint,  l*v«i 

•rtd  tinus 


Coricidin 


MEDILETS 
xiiiriHni.tMMi 


® 


A  family  oF  cold  products. 


news 


CNA  Board  Rescinds 

All  Statements  On  Abortion 

Ottawa  —  The  Canadian  Nurses"  As- 
sociation now  has  no  statements  on 
abortion.  A  motion  approved  unani- 
mously by  the  CNA  directors  on  the 
tlnal  day  ot  their  meeting  October  6-8 
rescinded  "the  previous  action  ot"  the 
directors  in  relation  to  statements  on 
abortion." 

This  action  means  that  the  resolu- 
tion on  abortion  approved  by  the  board 
a  year  ago  ("News,"  November,  1970, 
page  7)  has  been  withdrawn.  This  res- 
olution stated,  in  part.  "...  that  when 
questions  concerning  the  stand  of  the 
CNA  on  the  issue  of  abortion  are  rais- 
ed, the  CNA  takes  the  opportunity  to 
reiterate  its  belief  that  every  Canadian 
woman  who  has  decided  to  secure  an 
abortion  has  the  opportunity  of  availing 
herself  of  the  best  healthcare  possible. "" 

One  reason  given  by  the  directors 
for  deleting  this  resolution  was  that 
most  member  associations  have  stated 
they  do  not  wish  to  comment  on  abor- 
tion ("News,"  August  1971,  page  7) 
and  that  their  decision  overrules  any 
previous  action  taken  by  the  board. 

The  abortion  issue  was  first  raised 
by  delegates  at  the  June  1970  CNA 
convention  in  Fredericton.  At  that 
time  a  resolution  asking  for  removal 
from  the  Criminal  Ccxie  of  sections 
relating  to  abortion  was  referred  to  the 
CNA  directors  for  further  study.  In  Oc- 
tober 1970  the  board  issued  the  state- 
ment quoted  above,  and  in  the  spring 
of  1971  prepared  a  more  specific  state- 
ment, saying,  in  effect,  that  the  final 
decision  for  an  abortion  should  be 
made  by  the  woman  and  her  doctor. 
This  last  statement  was  to  be  adopted 
by  CNA  if  a  majority  of  member  asso- 
ciations approved  it.  Only  4  of  the  10 
provinces  endorsed  the  statement, 
hence  it  was  defeated. 

Community  Health  Centers  First 
Of  CNA  Priorities  For  1970-72 

Ottawa — On  the  final  day  of  its  Oc- 
tober 6  to  8  meeting  at  CNA  House, 
the  directors  of  the  Canadian  Nurses" 
Association  changed  the  order  of  pri- 
orities for  the  1970-72  biennium. 

Two  considerations  were  taken  into 
account,  when  changing  the  order  of 
these  priorities:  the  budget,  and  the 
fact  that  action  has  already  been  taken 
on  some  of  these  priorities.  The  pri- 

NOVEMBER   1971 


orities,  as  originally  listed  for  the  bien- 
nium, were  published  in  the  November 
1970  issue  of  the  CNJ  ("News.""  page 
8).  {  NA"s  goal,  however,  remains  the 
same:  "to  influence  nursing  practice 
in  a  changing  health  care  delivery  sys- 
tem through  an  informed  membership 
and  relevant  policy  statements."" 

Heading  the  list  of  seven  priorities 
is  community  health  centers.  CNA  is 
preparing  a  written  submission  for 
the  Community  Health  Centre  Project 
in  Toronto,  headed  by  Dr.  John  Has- 
tings. Dr.  Hastings  has  received  a  fed- 
eral government  grant  to  direct,  togeth- 
er with  an  expert  committee,  a  project 
that  will  study  the  development  of  vari- 
ous types  of  community  health  centers 
for  Canada.  In  December,  The  Cana- 
dian Nurse  will  carry  a  news  story 
giving  further  details  of  this  project 
and  CNA's  participation  with  other 
groups  who  will  be  meeting  in  the 
coming  months  to  discuss  the  commu- 
nity health  center  concept. 

Second  on  the  list  of  priorities  is  the 
expanded  role  of  the  nurse.  According 
to  the  CNA  directors,  excellent  pf)lit- 
ical  awareness  of  this  idea  was  created 
during  the  past  year  through  CNA's 
position  statement  approved  in  Octo- 
ber 1970;  through  the  federal  govern- 
ment's conference  on  assistance  to  the 
physician  in  April,  1971;  and  through 
articles  written  by  the  CNA  executive 
director. 

Specialization  in  nursing  is  the  third 
priority.  A  small  task  force  will  pre- 
pare a  working  paper  on  the  basis  for 
specialization  in  nursing,  which  will 
be  submitted  to  the  directors,  to  mem- 
bers of  CNA's  three  standing  commit- 
tees, and  to  selected  nurses  in  educa- 
tion and  service  for  response  before 
the  March  meetingof  the  directors. 

The  fourth  priority — position  pa- 
pers on  social  issues — will  involve 
CNA's  research  officers  in  reviewing 
certain  social  issues  to  decide  whether 
they  have  relevance  for  nursing.  If  they 
are  relevant,  the  research  officers  could 
then  define  areas  of  interest  to  nurses 
or  prepare  a  working  paper,  with  reac- 
tion sought  from  various  persons.  Fol- 
lowing such  reaction,  a  task  force  or 
working  party  could  be  set  up,  if  fur- 
ther work  is  necessary.  The  research 
officers  have  been  asked  to  prepare 
material  on  family  planning,  the  status 
of  women,  care  for  the  aged,  and  pre- 
paration   of  nurses   for  dealing   with 


drug  abuse  problems.  These  are  issues 
on  which  (  NA  believes  it  must  be 
prepared  to  respond. 

Action  has  already  been  taken  on 
three  priorities:  the  publication  of 
French  books  for  educational  purposes, 
tlie  proliferation  of  health  workers, 
and  nursing  research. 

The  next  meeting  of  the  CNA  exec- 
utive committee  is  scheduled  for  Jan- 
uary 27-28,  and  the  next  directors" 
meeting  for  March  8-10,  1972. 


Registrants  At  CNA  Meeting 
Will  Receive  All  Documents 

Ottawa — All  full-time  registrants, 
and  as  many  part-time  registrants  as 
possible,  will  receive  a  complete  set 
of  the  documents  provided  to  voting 
delegates  at  the  CNA  annual  general 
meeting  and  convention  to  be  held  in 
Edmonton  on  June  25-29,  1972. 

Information  about  the  documents 
and  the  registration  fee  for  the  meet- 
ing were  announced  at  the  CNA  board 
meeting  on  October  6. 

Registration  fees  for  the  Edmonton 
meeting  will  be: 

•  $25. —  full  registration  for  regis- 
tered nurses 

•  $  7.  — daily  rate 

•  $12. —  full  registration  for  all 
students,  both  graduate  and  under- 
graduate 

•  $  3.  —  daily  rate  for  students 
The  provision  of  complete  sets  of 

documents  and  the  inclusion  of  gradu- 
ate students  in  the  student  fee  were 
requested  at  the  1970  meeting  in  Fre- 
dericton, New  Brunswick. 


Retiring  Presidents  And 

CNA  Standing  Committee  Chairmen 

Recommend  Changes  To  Directors 

Ottawa — Approaches  other  than  the 
customary  one  of  holding  standing 
committee  meetings  should  be  consid- 
ered by  the  CNA  directors.  This  rec- 
ommendation was  made  by  the  retir- 
ing provincial  association  presidents 
and  the  standing  committee  chairmen 
in  their  report  at  the  directors'  meet- 
ing held  at  CNA  House  October  6-8, 
1971. 

Committee    meetings    alone    are    a 

slow  and  expensive  means  of  carrying 

out  the  work  of  CNA,  especially  as 

there  no  longer  seems  to  be  a  clear 

THE  CANADIAN  NURSE     5 


delineation  between  what  constitutes 
education,  service,  and  social  and 
economic  welfare,  the  group  reported. 

Would  task-oriented  ad  hoc  commit- 
tees better  serve  the  CNA?  Would 
telephone  conferences  speed  up  deci- 
sions? Would  an  ongoing  interoffice 
communications  system,  such  as  Telex, 
improve  communication  between  and 
among  national  office  and  all  provin- 
cial associations?  These  were  some 
of  the  questions  raised  by  the  "old 
hands""  when  they  met  at  CNA  House 
September  27  and  28.  ("News,""  Sep- 
tember 1971,  page  9.) 

At  that  time  they  also  discussed 
other  issues:  the  need  for  a  strong 
national  nursing  association  to  keep 
pace  with  the  strengthening  of  provin- 
cial associations;  the  need  to  add  fur- 
ther means,  beyond  the  two  journals, 
to  make  more  meaningful  to  the  indi- 
vidual member  the  role  of  the  CNA; 
the  need  for  position  papers  on  the 
expanding  role  of  the  nurse  and  her 
preparation  for  it.  and  on  the  commu- 
nity health  center  concept  and  speciali- 
zation in  nursing. 

They  suggested  ways  the  directors 
could  facilitate  their  meetings.  They 
agreed  that  policy  was  the  responsi- 
bility of  the  directors  and  that  imple- 
mentation of  policy  and  administrative 
details  were  that  of  permanent  staff. 

Recognizing  that  the  CNA  has  two 
working  languages,  the  "old  hands"" 
group  asked  Helen  Taylor,  retiring 
president  of  the  Association  of  Nurses 
of  the  Province  of  Quebec,  to  develop 
a  statement  on  bilingualism  to  be  in- 
cluded in  their  report  to  the  directors. 
In  essence,  she  said. 

"...  the  average  French-speaking 
nurse  is  as  interested  in  identifying 
with  the  CNA  as  the  average  English- 
speaking  nurse,  but  .  .  .  this  relation- 
ship and  communication  must  be  mean- 
ingful and  .  .  .  worthwhile  to  both  par- 
ties. Otherwise,  it  will  ...  not  be  a 
true  national  organization.  .  .  .  What 
is  our  interpretation  of  a  Canadian 
Nurses'  Association?  Should  we  be 
committed  to  nursing  throughout  Can- 
ada or  will  language  be  too  great  a 
handicap  for  us  to  function  in  this  more 
difficult  and  more  costly  approach? 

"If  we  believe  it  is  desirable  to  in- 
clude French-speaking  nurses  in  the 
Association  .  .  .  there  are  at  least  two 
immediate  considerations —  the  trans- 
lation of  documents  and  the  total  ac- 
ceptance of  the  nurse  to  communicate 
in  French.  We  should  not  expect  this 
process  to  be  easy.  .  . 

6     THE  CANADIAN  NURSE 


"...  hopefully,  ways  and  means 
will  be  found  for  the  future  boards  to 
base  their  conclusions  and  decisions 
on  specific  issues  .  .  .  without  imme- 
diately relating  them  to  a  language 
situation.  .  .  ."" 

The  report  presented  to  the  directors 
represented  the  thinkmg  ot  Monica 
Angus  (British  Columbia),  Laura  But- 
ler (Ontario),  Madge  McKillop  (Sas- 
katchewan), Geneva  Purcell  (Alberta), 
Helen  Taylor  (Quebec),  and  the  chair- 
men of  four  CNA  committees:  Alice 
Baumgart,  Marilyn  Brewer,  Irene  Bu- 
chan,  and  Shirley  Stinson.  E.  Louise 
Miner,  CNA  president,  was  chairman 
and  Helen  K.  Mussallem,  executive 
director  of  CNA,  acted  as  secretary 
for  the  group. 


Subscription  Rates  Up 
For  Non-Members  Of  CNA 

Ottawa —  Non-member  subscribers 
will  pay  more  for  the  Canadian  Nurses' 
Association  journals.  The  Canadian 
Nurse  and  L'infirmiere  canadienne. 

Effective  January  1972,  the  one-year 
subscription  rate  will  be  $6.00  to  non- 
members  living  in  Canada  and  $6.50  to 
non-members  living  outside  Canada. 

The  rates  were  last  increased  five 
years  ago.  The  increase  was  made 
necessary  by  rising  production  costs 
and  postal  rate  changes. 


CNF  Board  Elects  President  And 
Vice-President  For  2-Year  Term 

Ottawa  —  Two  members  of  the  Cana- 
dian Nurses'  Foundation  board  of  di- 
rectors were  elected  president  and 
vice-president  for  two-year  terms  at 
a  CNF  board  meeting  September  24. 
There  are  nine  members  on  the  board. 

M.  Geneva  Purcell  is  the  new  pres- 
ident and  Helen  D.  Taylor  the  new 
vice-president.  Miss  Purcell,  who  is 
director  of  nursing  education  at  the 
University  of  Alberta  Hospital  in  Ed- 
monton, is  past  president  and  a  past 
vice-president  of  the  Alberta  Associa- 
tion of  Registered  Nurses.  She  has 
been  a  member  of  the  Canadian  Nurses' 
Association  board  of  directors  since 
1968. 

Miss  Taylor,  director  of  nursing  at 
the  Jewish  General  Hospital  in  Mont- 
real, was  president  of  the  Association 
of  Nurses  of  the  Province  of  Quebec 
from  1969  to  1971,  and  prior  to  that 
served  as  a  vice-president  of  the  asso- 
ciation. She  was  a  member  of  the  CNA 
board  of  directors  from  1968  to  1971. 

At  its  September  meeting,  the  CNF 
board  also  chose  its  five-member  nom- 
inating committee,  five-member  re- 
search committee,  and  seven-member 


selections  committee.  The  selections 
committee  will  meet  early  in  May  1972 
to  recommend  candidates  from  among 
the  applicants  for  CNF  fellowships; 
the  final  selection  and  awards  will  be 
made  later  that  month  by  the  CNF 
board. 

The  CNF  annual  meeting  will  be 
held  in  conjunction  with  the  CNA  an- 
nual general  meeting  and  convention 
in  Edmonton  in  June  1972. 

169  Nursing  Studies  Received 
In  CNA  Library  In  1971 

Ottawa  —  The  1971  addendum  to  the 
Index  to  Canadian  Studies,  prepared  by 
the  CNA  Library  staff  under  the  direc- 
tion of  Margaret  Parkin,  has  recently 
been  released. 

The  1971  addition  to  the  Index  lists 
169  studies;  the  majority  of  the  reports 
and  theses  are  on  file  in  the  CNA  Li- 
brary. 

Listed  in  the  addendum  are  such 
items  as  the  report  of  the  New  Bruns- 
wick Study  Committee  on  Nursing 
Education  (see  News,  October),  the 
statistical  report  on  nursing  education 
and  registration  from  the  College  of 
Nurses  of  Ontario,  a  master's  thesis 
entitled  A  Study  of  the  Characteristics 
of  the  Nurse-Aged  Patient  Interac- 
tion Process,  and  a  study  published  by 
the  Alberta  Association  of  Registered 
Nurses,  called  A  Woman's  Profession; 
a  Man's  Research. 

The  CNA  Library  now  has  a  record 
of  about  632  studies,  of  which  about 
500  have  been  deposited  in  the  CNA 
Repository  Collection  of  Studies. 

Anyone  who  has  not  received  the 
197 1  addendum  may  write  to  the  CNA 
Library  for  a  copy. 

More  Money  For  Manitoba  Nurses 
In  New  Collective  Agreement 

Winnipeg,  Man. —  A  10  to  17  percent 
salary  increase  for  registered  nurses  is 
part  of  a  collective  bargaining  agree- 
ment signed  by  the  Manitoba  Hospital 
Association  and  the  Provincial  Staff 
Nurses"  Council  of  the  Registered 
Nurses'  Association  of  Manitoba. 

This  agreement,  announced  early 
in  September  after  almost  eight  months 
of  deliberation,  gives  a  26-month  con- 
tract, effective  January  I,  1 971,  to  more 
than  900  full-  and_  part-time  nurses 
m  the  Assiniboine,  Brandon  General, 
Misericordia  General,  St.  Boniface 
General,  and  Victoria  General  Hospi- 
tals. The  hospitals  and  their  staff 
associations  had  to  ratify  the  agreement. 

The  first  salary  increase  is  retro- 
active to  March  1,  1971,  with  further 
increases  effective  March  I,  1972.  A 
nurse  I  will  go  from  $500  per  month 
at  present  to  $515  in  1971  and  $550 
in  1972;  a  nurse  II  from  $515  to  $550 
(ContiiKiecl  on  pa^'c  8) 

NOVEMBER   1971 


The  Hows  and  Whys 
of  Pediatric  Nursing 


Leifer  New  2nd  Edition 

Principles  and  Techniques 

in  Pediatric  Nursing 

This  new  clinical  textbook  is  designed 
to  bridge  the  gap  between  theoretico' 
knowledge  and  practical  skill.  The 
book  deals  with  nursing  principles 
and  the  responsibilities  and 
techniques  that  are  essential  to  the 
practicing  pediatric  nurse.  Detailed 
discussions  are  included  on-,  use  of 
new  and  complex  equipment, 
development  of  observation 
techniques,  nursing  activities  and 
judgments,  assessing  the  newborn   / 
and  intensive  care  of  the 
the  neonate. 

The  unique  format  and  numerous 
clear  illustrations  bring  all  the 
information  into  focus  for 
fingertip  reference. 


By   Glorio    Leifer,    R.N.,    AA.A.,   formerly 
Dept.  of  Nursing  Education,  Coiifornio 
State  College,   Los   Angeles.  About 
250  pp.,  145  illust.  About  $7.25. 
Ready  January    1972. 


Hymovich  &  Reed: 

Nursing  and  the 

Childbearing  Family 

Evaluating  the  student's  learning, 

this  new  collection  of  18  study  guides 

places  emphasis  on  the  nurse's  role 

in  assisting  the  childbearing  family. 

The  authors  accentuate  the  progress 

of  a  typical  family  through  a 

normal  childbearing  experience, 

including  pregnancy,  labor, 

delivery,  and  postpartum  care 

of  the  mother  and  the 

neonate. 

Special  attention  is  given  to 

family  planning,  high-risk 

pregnancies  and  the  nursing 

care  of  the  newborn.  An 

Instructors  AAanuol  is  available. 

By  Debro  P.  HymovicH,  R.N.,  B.S.,  MA. 

and  Suellen  B.  Reed,  R.N.,  B.S.N.,  M.S.N., 

both  of  the  Univ.  of  Texas  Clinicol 

Nursing   School,   Son  Antonio. 

334  pp.   $5.15.   May    1971. 


Talbot,  Eisenberg  &  Kagan:     Behavioral  Science  in  Pediatric  Medicine 


Here's  a  timely  new  volume  that  deals  with  per- 
sonality abnormality  as  well  as  normal  devel- 
opment. The  authors  show  you  how  psycho- 
logical, familial,  and  social  factors  can  determine 
the  child's  response  to  illness  and  offer  useful 
instruction  in  handling  emotional  disturbances 
in  infants,  children,  and  adolescents.  Particular 
emphasis   is  placed  on  discussions  of  perception 


and  learning  processes  —  developmental  be- 
havioral genetics,  psychological  assessment,  and 
the   development  of   personality. 

By  Nathan  B.  Talbot,  M.D.,  Harvard  Medicol  School,.  Jerome 
Kagan,  Ph.D.,  Dept.  of  Social  Relations,  Harvard  University; 
and  Leon  Eisenberg,  M.D.,  Harvard  Medical  School.  432  pp. 
Illustd.  About  $18.05.  Just  ready. 


W.B.  SAUNDERS  COMPANY  CANADA  LTD.  iSSSVonge  street,  Toro-no  7 


please  send  on  approval; 

D  Leifer:  Principles  and  Techniques  in  Pediatric  Nursing;  about  $7.25 

n  Hymovich  &  Reed:  Nursing  and  Childbearing  Family;  $5.15. 

n  Talbot,  Eisenberg  &  Kagan:  Behavior  Science  in  Pediatric  Medicine;  about  $18.05. 

n  Bill  me  n     Check  enclosed  {postage  paid) 


CN-1I.71 


Name- 
City  _ 


Address  - 


-Zone 


.  Province 


NOVEMBER   1971 


THE  CANADIAN   NURSE      7 


Your  Hospital  is 
More  Efficient  witfi 

TIME  INSTROMARK* 
INSTRUMENT  COLOR 
CODE  SYSTEM 


Easy   to   use   Time®    Instromark   Tape 

marks  instruments  for  identification  at 
a  glance.  Pliable,  tougticoat  plastic 
tape  attaches  securely  to  any  surface, 
withstands  repeated  autoclaving  and  is 
unaffected  by  solutions.  Stays  in  place 
for  months.  Won't  change  weight  or 
"feel"  of  instrument.  Instromark  Tape 
System  uses  9  vivid  colors,  rolls  sup- 
plied on  a  unique  dispenser  that  allows 
neat,   swift  application   of  tape. 

TIME  '  FLO-METER 
LABEL  SYSTEM 


The  Time^  Flo  Meter  Label  System  al- 
lows easy  visual  checking  and  accurate 
recording  of  all  intravenous  infusions. 
Exclusive  standard  designs  are  avail- 
able for  all  makes  of  solution  bottles. 
With  just  a  touch  of  the  fingers  the 
pressure-sensitive  label  is  applied,  im- 
mediately assuring  an  accurate  record- 
ing of  rate-of-flow  and  volume.  The 
compact  label  has  space  for  patient 
data,  time,  medication,  etc.  After  in- 
fusion, the  label  is  removed  from  the 
bottle  and  transferred  to  the  patient's 
permanent  record.  No  rewriting  or 
transcribing  is  necessary.  Write  for 
samples  and  literature  of  these  and 
other  Time   Products  for  the  hospital. 


NOTE:  NEW  ADDRESS. 

We  tiave  recently  moved  into 
new  facilities;  enlarged  and 
automated  to  serve  you  better. 


PROFESSIONAL  TAPE  COMPANY,  INC. 

DEPARTMENT   ie 
144    TOWER    DR  ,    BURR    RIDGE    (HINSDALE)     ILL     60521 


news 


iCiniliiiiicil  from  pcifif  6) 

and  $589;  a  nurse  ill  from  $530  to 
$562  and  $601 ;  a  nurse  IV  from  $560 
to  $594  and  $636;  and  a  nurse  V  to 
$651  and  $697.  it  is  expected  that 
these  rates  will  apply  across  the  pro- 
vince, where  there  are  some  3,000 
registered  nurses. 

Also  included  in  the  agreement  is 
a  bi-weekly  work  period  of  a  maximum 
of  77  1/2  hours,  excluding  meal  per- 
iods but  including  rest  periods;  paid 
sick  leave  benefits  increased  from  90 
to  102  working  days  in  1971  and  to 
1  14  working  days  in  1972;  and  a  $1 
shift  allowance  for  nurses  temporarily 
assigned  to  responsibilities  of  a  more 
senior  position,  after  15  working  days 
in  such  a  position  in  a  calendar  year. 

Quebec  Village  Of  Bouchette 
To  Get  Water  Filtration  System 

Qitchi'c,  Que.  —  An  outbreak  of  ty- 
phoid in  the  western  Quebec  village  of 
Bouchette  in  May  1971  put  this  village 
and  the  unhappy  story  of  its  polluted 
water  on  the  front  pages  of  the  country's 
newspapers.  The  Canadian  Nurse 
published  an  article  on  "Typhoid  in 
Bouchette"  in  its  July  issue. 

Now  the  village  is  getting  a  water 
filtration  system.  The  Quebec  govern- 
ment has  promised  a  $192,000  pro- 
vincial grant  for  the  construction,  which 
began  in  October.  An  engineering  firm 
in  Hull,  Sanscartier  L.P.  &  Associes. 
is  installing  the  filtration  system. 

Canadian  Nursing  Book  Revised, 
French  Edition  Out  In  1972 

Ottawa  —  The  second,  completely  re- 
vised edition  of  a  popular  Canadian 
nursing  text  will  be  published  by  W.B. 
Saunders  in  the  spring,  and  a  French 
version  in  the  fall  of  1972.  The  new 
book  is  Kozier  and  Du  Gas'  Introduc- 
tion to  Patient  Care  by  Beverly  Witter 
Du  Gas. 

The  first  edition,  published  in  1967 
by  Saunders,  was  titled  Fundamentals 
of  Patient  Care:  a  Comprehensive 
Approach;  its  co-authors  were  Barbara 
Kozier  and  Dr.  Du  Gas. 

Much  of  the  book  has  been  complete- 
ly rewritten  to  give  more- emphasis  to 
the  care  function  of  nursing,  including 
nursing  process.  Dr.  Du  Gas  told  The 
Canadian  Nurse  that  the  care  aspects 
are  the  unique  function  and  major  role 
of  the  nurse,  although  the  cure  and 
expressive  functions  are  also  important. 

The  new  book  draws  on  research  to 
document  the  contribution  nursing 
makes   to   patients'   smooth   recovery 


8     THE  CANADIAN  NURSE 


from  surgery;  as  an  example.  Dr.  Du 
Gas  points  out  that  anxiety  is  now 
recognized  as  a  major  factor  in  pain. 
Research  has  also  indicated  that  the 
manner  in  which  patients  are  oriented 
to  hospital  bears  a  relation  to  recovery 
rates.  These  and  other  research  find- 
ings have  important  implications  for 
nursing  care  functions,  Dr.  Du  Gas 
feels. 

The  French  version  of  Introduction 
to  Patient  Care  will  be  published  by 
Holt,  Rinehart  and  Winston;  it  will  be 
ready  for  use  by  nursing  schools  in  the 
fall  of  1972. 

Dr.  Du  Gas,  nursing  consultant  in 
the  health  insurance  and  resources 
branch,  department  of  national  health 
and  welfare,  says,  "Revision  of  the  book 
has  taken  up  all  of  my  spare  time  for 
the  past  year." 

The  first  edition  of  the  book  took  two 
years  to  write.  Miss  Kozier  wrote 
sections  dealing  with  nursing  techniques 
and  Dr.  Du  Gas  wrote  about  common 
nursing  problems,  such  as  fever  and 
pain,  psychological  aspects  of  nursing, 
legal  implications,  and  historical  back- 
ground. 


Coronary  And  ICU  Refresher 
Taken  To  All  Parts  Of  BC 

Vancouver,  BC — Nurses  throughout 
British  Columbia  will  be  given  an  op- 
portunity to  refresh  their  coronary  and 
intensive  care  nursing  skills  by  partici- 
pating in  a  unique  continuing  nursing 
education  program  being  given  in 
every  major  community  throughout 
British  Columbia. 

A  preliminary  two-day  course  in 
coronary  and  intensive  care  has  already 
been  offered  in  approximately  12  BC 
communities  and  will  be  offered  in 
almost  every  community  of  medium 
size  in  the  province  throughout  the 
coming  year. 

A  more  intensive  three-week  course 
is  to  be  offered  in  1 1  other  major  British 
Columbia  regions.  The  course  will  be 
tailored  to  suit  the  conditions  and  the 
equipment  available  in  each  of  the 
regions  in  which  it  is  offered. 

Highly  sophisticated  health  care 
equipment  and  a  special  multimedia 
teaching  system  will  be  used  to  help 
nurses  review  their  knowledge  and 
skills  in  coping  with  respiratory  and 
cardiac  emergencies. 

Most  interesting  item  among  the 
teaching  equipment  being  used  in  the 
course  is  "Anne,"  a  life-size  plastic 
model  capable  of  showing  the  symptoms 
of  acute  cardiac  or  respiratory  arrest 
and  of  responding  to  treatment  in  the 
same  way  as  a  human  patient.  "Anne," 
who  gets  her  nickname  from  the  tech- 
nical term  —  arrhythmia  resuscianne 
—  used  to  describe  the  sophisticated 
electric  monitoring  cardiac  care  equip- 
NOVEMBER  1971 


—  ■=-'»«.  S„„„  ,»3„,„„, 


This  month  I'd  nj,-  .«  t  , 
figurative  hat  of f  *  ^^^  "^ 
critical  care  n,     ^°  ^^^ 

1962.  more  than  ?^nn^-   ^^"''^ 
care  units  hav^*°'""^°^l 

themselves  as  vitar^'''""^^ 
ents  in  the  nJ+     mgredi- 

--•    And'\\e"\'j°?  ,\,^-lth 

nurse  has  proven  hi        f^    ^^''e 

°neof  the^rsrv';SY/°'^ 
bers  of  the  h„„o     '^■^"able  mem- 

staff  these  IntT  '^""'^  '^^^ 

o"""rorT aire's  Tf  ^°^^^^ 

nurses     with    1.k^^"^^=    these 

"-'-y  '■esiSLibUitTe''^^'^- 
Pioneering  journii  f^'  ^''^^ 
publication    in     I     '     *°    ^'egin 

ognizes  the  crft""'''^'  '■^=- 
""i-se's  special  ^^^  °^'-« 
unique  trffnV  "^^^^  for 
the-minute    in"^    ^"'^    "P-to- 

*ill  serve  as  °th?'%°?-  ^^ 
publication  of  th  o  °fficial 
ber  American  ,^^  ^-°°0  "e""- 
CardiovaSart?sV3'.^^°"     °^ 


paced  world  of  ^    ■. 
-ore   than  40  dedfc^'^f   '^'^■ 
and  doctors   from  an    '^  ""^^^^ 
country    share     th  "^^'^  t^e 

enoe    With    you    »    ^^"^    experi- 
the  journaJ^r  members    of 

torial   boaJd      °°"^"lting  edi- 


l^ho  would  know  the<,fi  \, 
needs  of  the  r^  f  special 
nurse  better  .^"^""^^  ^^re 
Andreoli      R  »   ^^f"    Kathleen 

cV^h^^-S-  '^°^"-"-^ 

Editors,    Alfred  sorr''-^"""" 
and  Sylvan  ri^     ^^®''-    M.D. 

Offer  their  srH'"'"^'  "•°- 
knowledge     to  %?^  ^  =  ^  ^  ^a  t  ed 

torxal    nucleus    ortH*'"     ""^i- 

--"s"u-roA-"-  -^-"-^ 

^-est    advfn^s'^-^   t^Vst 


Emphasizing  the   "t^ 

^aques    Col       i  0^'^'=^^°"'"     by 

Lee  Weinberg"-  mVd'^V^^^'" 
tique  on  Teachine  Vn  n^'''-- 
nary  Care  UnU  "  k  ^  '^°''°- 
Wilier.     R  N        v.    ^^     *'axine 

Of  Transvenous  P?.  '"^^^  ^°^^ 
Myocardial  inff'"^  ^"  Acute 
Suzanne    B      KnnlZ^\°''-"    ^y 


planned  for  fut,,,-,.  • 
problems  of  snadZT''^^-   ^^e 
goals    and    limult^.  '^^^*^'    *''« 
coronary     care     un\°"'    °'    *'^« 
anticoagulants     andSh  °^ 

^ytic    agents      a„rf    *'""°'"bo- 
Pacemakers    and    th«       "^''^^^o 

°nly  a   few  of  the   f«?"^"    ^'"^ 
topics     you'll     fii^5^°^"ating 

nurse-oriented   tex?        '"      ^^^ 

*ord  to  the  first  ?.'^  ''°"^- 
^°  figuratively  ""r;  "^'^^ 
silently,    I   li=    ^'     ''"*    not 

the  future  Vital,?,  ^^^"^  ^o 
""rse,  not  onil  .°^®  °f  the 
the  cardiac  p"a[i^"'^%--'-e  of 
education  of  the  „i,''"t  m  the 

that   surrounds  her   -''"'  ^*^" 

to^?r."^  folTlt  r'^  -- 
scription  to  this  h7''  ^"^- 
furnal.  Remember— 'f~T'''^ 
a  member  of  the  aL  ^°"   re 

oiation  o  f  cLh  f  "°^"  ^^^°- 
Nurses,  you '11  f  V^  =  ^"l  a  r 
receive  the  ^^^.^^"/"'"^tically 

your  membersCbenent's '•*  °' 

page— all    are    h     ?*"    °-^    this 

Jfl-y      Gtara^^tee'"';?    's'at^'^^ 
faction.  Satis- 


faction. 
Nancy  Manning 


^Ay9t>ri'*n'\^ 


Nancy  Manning 
Consu\"fan'r*°'"^'-  ^-^^- 


A  new  journal  on  critical  care  nursing  is  coming  . . . 
sign  up  today  for  HEART  AND  LUNG:  The  Journal  of  Total  Care! 


PLACE 
STAMP 
HERE 


The  C.  V.  MOSBY  Company  Ltd. 

86  Northiine  Road 
Toronto  374,  Ontario,  Canada 


di^U^o^^'""'^^ 


Ir  AN  ATLAS  OF  NURSING  TECHNIQUES,  New  2ncl  Edition:  By  Norma  Greenler  Dison, 
R.N.,  B.A.  Nurse 's-eye-view  of  the  most  current  techniques  in  use  of  Hand-E-Vent  and  Retec 
N-30  units,  Teledyne  oxygen  analyzer,  sump  type  gastric  tube,  Greer  colostomy  irrigating  tip, 
much  more.  All  illustrations  new  or  redrawn.  August.  1971 .  326  pp.,  593  iilus.$9.75, 

O  COMPREHENSIVE  CARDIAC  CARE,  A  Handbook  for  Nurses  and  Other  Paramedical 
Personnel,  New  2nd  Edition:  By  Kathleen  G.  Andreoli.  R.N.,  B.S.N. ,  M.S.N. :  Virginia  K.  Hiinn, 
R.N..  B.S.N. :  Douglas  P.  Zipes,  M.D.:  and  Andrew  G.  Wallace,  M.D.  Best-selling  handbook 
offers  specifics  on  cardiac  function,  cardiac  failure  and  patient  rehabilitation.  New  emphasis  on 
hemodynamic  deterioration;  new  material  on  pacemakers  and  drug  therapy.  August  1971 
219  pp.,  164  illus.  $6.05. 

O     THE  PHYSIOLOGIC  &  PHARMACOLOGIC  BASIS  OF  CORONARY  CARE  NURSING, 

New:  By  Theodore  Rodman,  M.D.:  Ralph  M.  Myerson,  M.D.:  L.  Theodore  Lawrence,  M.D.: 
Anne  P.  Gallagher.  R.N.,  B.S.N. ,  M.S.N. :  and  Albert  J.  Kaspar.  M.D.  The  whole  CCU  story  from 
YOUR  point  of  view.  Clinical  procedures,  instrumentation,  interpersonal  relationships,  much 
more.  August,  1971.  228  pp.,  103  illus.  $9.20. 

O  Mosby's  COMPREHENSIVE  REVIEW  OF  NURSING,  7th  Edition:  Edited  by  Dorothy  F. 
Johnston,  R.N.,  B.S.,  M.Ed.:  with  II  collaborators.  Most  comprehensive,  up-to-date,  easy-to-use 
review  book  available.  Offers  concise  resume  of  every  subject  in  basic  program  for  professional 
nurses.  Use  it  to  prepare  for  class  or  board  examinations,  or  as  a  "refresher  course"  for  a 
particular  subject.  Latest  procedures  in:  Biological  and  Physical  Sciences;  Social  Sciences; 
Paraclinieal  Nursing;  Maternal  and  Child  Health  Nursing;  Mental  Health  Nursing.  Rewritten 
chapters  on  chemistry,  communicable  disease,  psychiatric  nursing;  integrated  OB-GYN 
information;  medical-surgical  chapter  largely  new.  Updated  answer  book  free  with  each  copy 
1969.  602  pp.,  24  illus.  $10.45. 


O  MEDICAL-SURGICAL  NURSING,  New  Sth  Edition: 
By  Kathleen  N.  Shafer,  R.N.,  M.A.:  Janet  R.  Sawyer,  R.N., 
Ph.D.:  Audrey  M.  McCluskey,  R.N..  M.A.,  Sc.M.Hyg.:  Edna 
Lifgren  Beck,  R.N.,  M.A.:  and  Wilma  J.  Phipps,  R.N.,  A.M. 
The  preferred  book  on  total  patient  care,  throughly  revised. 
New  information  on  nutrition,  preoperative  preparation, 
cancer  chemotherapy,  cardiac  disease,  drug  abuse,  much 
more.  August,  1971.  927  pp.,  414  illus. $13.40. 


REVIEW    OF    HEMODIALYSIS    FOR 
NURSES    AND    DIALYSIS    PERSONNEL, 

New:  By  C.  F.  Gutch.  M.D.:  and  Martha  H. 
Stoner,  R.N.,  M.S.  Question-and-an.swer  for- 
mat offers  detailed  overview  of  hemodialysis 
and  its  applications.  Includes  recent  ad- 
vances in  use  of  hollow  fiber  artificial 
kidney,  diet  and  fluid  management,  much 
more.  August,  1971.  237  pp.,  33  illus. 
S7.90. 

O  MANAGEMENT  OF  HIGH-RISK 
PREGNANCY  &  INTENSIVE  CARE  OF 
THE  NEONATE,  New  2nd  Edition:  By  S. 
Gorham  Babson.  M.D.:  and  Ralph  C.  Ben- 
son. M.D.  Revised  material  details  nurse's 
responsibility  in  fetal  nursing,  resuscitation 
of  the  apneic  neonate,  oxygen  administra- 
tion, feeding  methods.  Efficient  outline 
format.  October,  1971.  Approx.  304  pp.,  73 
illus.  About  $16.25. 

O  A  GUIDE  TO  HEALTH  FACILITIES, 
Personnel  &  Management,  New:  By  Robert 
M.  Sloane,  A.B.,  M.S.:  and  Beverly  LeBov 
Sloane.  A.B.  Presents  entire  how,  who,  and 
what  of  health  facilities.  Explores  nursing's 
changing  responsibilities,  effects  on  other 
team  members,  November,  1971.  Approx. 
416  pp.,  63  illus.  About  $6.25. 


H  UNDERSTANDING  LABORATORY 
MEDICINE,  New:  By  Camillo  V.  Bologna, 
M.D.  Helps  you  understand  laboratory  tests 
without  endless  detail.  Unique  biologic  ori- 
entation emphasizes  cellular  basis  of  medi- 
cine; relates  evolutionary  past  to  today's 
concepts  of  human  disease.  November, 
1971.  Approx.  352  pp.,  23  illus.  About 
$11.05. 

(D     TEXTBOOK      OF      ANATOMY      & 

PHYSIOLOGY,  New  Sth  Edition:  By 
Catherine  Parker  Anthony,  R.N.,  B.A., 
M.S.:  with  the  collaboration  of  Norma  Jane 
Kolthoff.  R.N.,  B.S.,  Ph.D.  Revised  classic 
features  new  chapter  on  stress,  fresh  facts 
on  the  cell,  the  circulatory  and  nervous 
systems,  new  illustrations,  larger  pages,  full- 
color  Trans-Vision  ®  insert.  April,  1971.592 
pp.,  320  fig.,  137  in  color,  15-page  Trans- 
Vislon®insert.  $10.80, 

O  LEARNING  MEDICAL  TERMI- 
NOLOGY STEP  BY  STEP,  New  2nd  Edi- 
tion: By  Clara  Gene  y'oung,  and  James  D. 
Barger.  M.D.,  F.C.A.P.  Popular  guide  revised 
throughout;  illustrations  redrawn.  Unique 
-l-step  method  teaches  more  than  4000 
terms,  abbreviations,  svmbols.  July,  1971, 
339  pp.,  39  Illus.  $9.35. 


®     Newton's     GERIATRIC      NURSING, 

New  Sth  Edition:  By  Helen  C.  Anderson, 
R.N.,  M.N.  Explores  current  social,  eco- 
nomic and  cultural  situations  of  elderly. 
Offers  innovative  approaches  for  continuity 
of  care  and  prevention  of  illness;  discusses 
new  federal  programs  for  aged.  June,  1971. 
372  pp„  54  illus,  $9.45. 

®  PSYCHOLOGY,  Principles  and  Appli- 
cations, New  Sth  Edition:  By  Marian  East 
Madigan,  Ph.D.,  with  a  chapter  by  Jeanette 
G.  Nehren,  R.N.,  M.S.  Sharpen  your  percep- 
tion of  your  patients  and  yourself;  apply 
psychology  to  nursing  situations.  1970.402 
pp.,  129  illus.  $9.75. 

©  ORTHOPEDIC  NURSING,  7th  Edi- 
tion: By  Carroll  B,  Larson,  M.D.,  F.A.C.S.: 
and  Marjorie  Gould,  R.N.,  B.S.,  M.S.  Sound, 
practical  help  in  day-to-day  orthopedic  nur- 
sing. Increased  emphasis  on  prevention  and 
rehabilitation,  especially  in  stroke  and  spinal 
cord  injuries.  New  illustrations;  updated 
bibliography.  1970.  500  pp.,  377  illus. 
$10.45. 

©  NEUROLOGICAL  &  NEUROSUR- 
GICAL NURSING,  Sth  Edition:  By  Esta 
Carini,  R.N..  Ph.D.:  and  Guy  Owens,  M.D. 
Revised  classic  gives  you  vital  basics  for  care 
of  patients  with  neurological  disorders.  New 
material  on  blood-brain  barrier,  brain  scan, 
botulism,  rabies  and  tetanus.  1970.  398  pp 
122  illus.,  2  in  color.  $10.80. 

©  CARE  OF  THE  PATIENT  IN  SUR- 
GERY, Including  Techniques,  4th  Edition: 
By  Edythe  L.  Alexander,  B.S.,  M.A.,  R.N.: 
Wanda  Burley,  B.S.,  M.A.,  R.N.:  Dorothy 
Ellison.  B.A.,  M.A.,  R.N.;  and  Rosalind 
Vallari,  B.S..  M.A.,  R.N.  Explicit,  up-to-date 
information  for  O.R.  nurse  or  RN  aspiring 
to  become  one.  1967.  916  pp.,  621  illus.,  5 
in  color.  $20.25. 


I 


© 


PROGRAMMED     INSTRUCTION     IN 
ARITHMETIC,  DOSAGES  &  SOLUTIONS, 

2nd  Edition:  By  Dolores  F.  Saxton,  R.N., 
B.S.,  M.A.:  and  John  F.  Walter,  Sc.B..  M.A., 
Ph.D.  Explains  basic  concepts  in  terms  of 
both  old  and  new  math;  immediate  self-help 
for  RN  or  student,  1970.  68  pp.  $3.95. 


© 


Mosby's  REVIEW  OF  PRACTICAL 
NURSING,  Sth  Edition:  By  an  Editorial 
Panel  of  S  authorities.  Concise  resume  of 
basic  practical  nursing,  revised  throughout. 
Ideal  refresher  or  review.  Eree  answer  book. 
1970.  426  pp.,  6  illus.  $6.25. 


»^.  _«^_-v" 


B.lJt  x>  S 


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1  ISM  Dison,  AN  ATLAS  OF  NURSING 

TECHNIQUES,  2nd  edition,  S9.75 

2  024S  Andreoli  el  al..  COMPREHENSIVE  CARDIAC 

CARE.  2nd  edition,  SS.05 

3  4131  Rodman  etal.,  THE  PHYSIOLOGIC  t 

PHARMACOLOGIC  BASIS  OF  CORONARY 
CARE  NURSING, S9.20 

4  3B7  Mosby's  COMPREHENSIVE  REVIEW  OF 

NURSING.  S10.4J 

5  45IS  Shafer  et  aL.  MEDICAL-SURGICAL 

NURSING.  Sth  edition,  S13.40 

6  1992  Gutch  Stoner.  REVIEW  OF 

HEMODIALYSIS  FOR  NURSES  I 
DIALYSIS  PERSONNEL,  S7.90 

7  0413  Babson  Benson.  MANAGEMENT  OF  HIGH- 

RISK  PREGNANCY  i,  INTENSIVE  CARE 
OF  THE  NEONATE.  2nd  edition,  about  Sie.2S 
I  4(52  Sloane  Sloane.  A  GUIDE  TO  HEALTH 
FACILITIES,  about  SS.2S 

9  0701  Boloina.  UNDERSTANDING  LABORATORY 
MEDICINE,  about  in.OS 


10  02J3  Anthony,  TEXTBOOK  OF  ANATOMY  t 

PHYSIOLOGY.  Sth  edition,  5I0.M 

)l  5651  Youni  Barter,  LEARNING  MEDICAL 
TERMINOLOGY  STEP  BY  STEP, 
2nd  edition,  S9.35 

12  0211  Anderson,  Newton's  GERIATRIC  NURSING 

Sth  edition,  {9.45 

13  3064  Madiian.  PSYCHOLOGY,  5tb  edition,  S9.75 

14  2164  Larson-Gould,  ORTHOPEDIC  NURSING, 

7lh  edition,  SI0.45 

15  0944  Carini-Owens,  NEUROLOGICAL  t 

NEUROSURGICAL  NURSING,  Sth  edititn, 
S10.M 
le  0102  Aleiander  etal.,  CARE  OF  THE  PATIENT 
IN  SURGERY.  4lh  edition.  S20.25 

17  4332  Sailon  Walter,  PROGRAMMED 

INSTRUCTION  IN  ARITHMETIC,  DOSAGES, 
li  SOLUTIONS,  2nd  edition,  J3.9S 

11  3534  Mosby's  REVIEW  OF  PRACTICAL 

NURSING,  Sth  edition,  SE.2S 


30  dav  aooroval  offer  Qood  onlv  in  Canada  and  continental  U.S. 


merit  of  which  she  is  a  part,  is  also  used 
during  the  shorter  two-day  course. 

Two  qualified  instructors  —  Sue 
Rothwell,  visiting  instructor  and  con- 
sultant in  continuing  nursing  education 
for  the  L!BC'  School  of  Nursing,  and 
Audrie  Sands,  head  nurse.  Royal  Inland 
Hospital.  Kamloops —  will  travel  to 
the  1  1  regions  to  teach  the  course. 

The  plan  for  the  coronary  care 
project  was  developed  by  the  Register- 
ed Nurses"  Association  of  BC.  The 
regional  courses  are  being  sponsored 
by  the  DEC  Division  of  Continuing 
Nursing  Education.  The  course  has 
been  made  possible  by  a  $25,000  grant 
from  the  British  Columbia  Medical 
Services  Foundation. 


Physician  Assistant  Sparks 
Debate  But  No  Answers  At 
World  Medical  Assembly 

Ottawa  —  Against  a  background  of  the 
flags  of  many  nations,  five  short  papers 
on  the  use  of  physician  assistants  in 
primary  health  care  were  given  to  a 
standing-room-only  audience  on  the 
morning  of  September  15,  1971.  Dele- 
gates representing  the  national  medical 
associations  of  61  countries  were  gath- 
ered for  the  25th  meeting  of  the  World 
Medical  Association. 

Ora  Babcock,  zone  nursing  officer 
for  the  Quebec  region.  Medical  Ser- 
vices branch,  department  of  national 
health  and  welfare,  was  the  only  nurse 
on  the  panel. 

Drawing  on  her  experience  of  the 
health  care  given  by  nurses  in  isolated 
afeas  of  Canada's  north.  Miss  Babcock 
said,  "To  meet  the  needs  of  the  numer- 
ous, small,  isolated  communities  (150 
to  800  persons  in  a  community  usually), 
a  nurse  carries  out  a  program  of  out- 
patient care,  inpatient  care,  and  preven- 
tive medicine  which  complements  the 
services  provided  by  visiting  physi- 
cians. 

"With  a  relatively  small  population, 
the  nurse  soon  knows  the  people  as 
individuals  and  as  families." 

Speaking  of  how  a  nurse  could  func- 
tion similarly  in  an  urban  setting,  Miss 
Babcock  said,  "Her  role  could  be  en- 
larged but  with  a  smaller  population 
than  she  now  generally  is  responsible 
for.  The  public  health  nurse  with  a 
smaller  area  to  cover  more  completely 
would  know  the  family  in  both  sickness 
and  health,  as  well  as  teach  prevention. 

"As  a  public  health  nurse  she  would 
not  just  hear  from  the  patient  that  he 
is  under  the  care  of  a  physician,  but  she 
would  know  why  he  is  ill  and  the  treat- 
ment prescribed,  and  wOold  help  in  his 
follow-up  both  in  the  clinic  and  at 
home.  She  would  actually  work  with  the 
doctor  in  meeting  the  needs  of  the  fami- 
lies concerned,  including  prenatal,  well 
baby,  and  outpatient  clinics." 

NOVEMBER    1971 


On  the  platform  of  the  World  Medical  Association  meeting  on  September  15  were 
(left  to  right)  Dr.  J.D.  Wallace,  Canada,  (chairman  of  the  session);  Dr  A  Z  Ro- 
mualdez,  Philippmes,  (secretary-general  of  the  WMA);  and  panelists  on  the  use 
ot  physician  assistants  in  primary  health  care:  Dr.  A.G.  Boohene,  Ghana-  Miss 
Ora  Babcock,  Canada;  Dr.  R.O.  Cannon,  USA;  Dr.  F.N.  Romashov,  USSr'. 


R.O.  Cannon  described  programs  in 
the  USA  to  prepare  paramedical  per- 
sonnel. "These  new  assistants  differ 
from  other  health  related  personnel  in 
that  they  are  solicited  by  physicians, 
trained  by  physicians,  and  report  ad- 
ministratively directly  to  physicians. 
They  serve  to  extend  the  arms,  legs, 
and  brains  of  the  physician.  They  are 
capable,  under  the  direction  of  the 
physician,  of  performing  functions  now 
usually  performed  by  the  physician." 

Dr.  Cannon  said  that  approximately 
47  programs  are  or  will  soon  be  in 
operation  in  the  USA  for  training  new 
occupational  groups  to  assist  physi- 
cians. Of  these  programs,  2 1  are  design- 
ed to  prepare  new  types  of  workers 
to  assist  primary  care  physicians. 

In  Ghana,  said  A.G.  Boohene,  only 
candidates  recruited  from  experienced 
members  of  the  nursing  profession  are 
trained  to  become  health  center  super- 
intendents. 

Dr.  Boohene  said  that  in  the  rural 
health  center,  the  health  center  super- 
intendent is  the  leader  of  the  health 
team,  which  usually  consists  of  a  public 
health  nurse/midwife,  a  sanitarian,  a 
midwife,  and  community  health  nurses. 

Until  1970,  only  male  nurses  were 
considered  for  training  as  health  center 
superintendents,  but  now  both  sexes 
are  eligible,  Dr.  Boohene  said.  "Per- 
haps the  more  glamorous  aspect  of  the 
health  center  superintendent's  work  is 


the  diagnosis  and  treatment  of  minor 
ailments  seen  at  the  center.  His  diag- 
noses are  symptomatic  and  his  treat- 
ment stereotype.  He  is  capable  of  using 
IV  fluids,  based  on  a  simple  regime,  for 
the  correction  of  dehydration,  especially 
in  children. 

"In  this  curative  exercise,  the  health 
center  superintendent  is  constantly 
conscious  of  his  limitations  and  refers 
nonminor  cases  to  the  district  hospital 
where  the  medical  officer  who  super- 
vises his  work  is  based. 

"He  works  under  the  supervision  of 
a  medical  officer.  Such  supervision  is 
usually  remote  in  the  rural  health  cen- 
ters but  quite  close  in  the  urban  setting. 
He  is  forbidden  from  undertaking 
private  practice,"  Dr.  Boohene  said. 

F.N.  Romashov  of  the  USSR,  speak- 
ing in  English,  told  of  the  system  of 
health  care  in  his  country.  More  than 
650,000  doctors  and  over  2  million 
secondary  medical  workers  are  employ- 
ed in  the  USSR,  he  said. 

The  feldsher,  a  specialist  with  a  se- 
condary medical  education,  plays  "a 
great  role  in  providing  people  with  med- 
ical and  preventive  care."  About  three- 
quarters  of  the  over  400,000  feldshers 
are  employed  in  cities  and  towns,  with 
about  one-quarter  working  in  villages 
in  rural  areas.  This  can  be  explained, 
said  Dr.  Romashov,  by  the  fact  that 
large  numbers  of  feldshers  staff  the 
medical  stations  at  "enterprises."  The 
THE  CAI^ADIAN   NURSE     9 


word  "enterprise"  is  used  to  mean  in- 
dustry, collective  farm,  school — any 
place  where  a  large  number  of  people 
are  employed. 

A  motion  to  establish  a  committee  to 
define  the  roles  and  training  of  various 
categories  of  physician  assistants  was 


referred  by  the  assembly  of  the  World 
Medical  Association  to  its  board  for 
consideration. 

Who  Does,  Who  Does  Not 
Use  Health  Services? 

London.  Ont.  —  Thelma  I.  Potter, 
assistant  professor  in  the  faculty  of 
nursing.  University  of  Western  Ontario, 
is  directing  a  study  to  find  out  the  extent 
to  which  available  health  care  services 
are  used  by  persons  of  higher  and  lower 
income  groups. 


EMERGENCY! 


make  no  mistake  about  it! 

Another  patient  is  rushed  into  the  emergency  room,  but  even  before 
diagnosis  and  treatment  he  must  be  identified  or  assigned  a  number. 
The  reason  is  obvious  and  compelling:  the  right  treatment  must  be 
given  to  the  right  patient... even  if  he  is  unconscious,  confused,  or 
unable  to  speak. 

Hospitals  throughout  the  United  States  are  solving  this  real  problem 
with  a  proven  method  of  identification:  Emergency  Room  Ident-A- 
Band  by  Hollister.  Takes  only  seconds  to  apply  to  the  wrist  of  each 
emergency  patient.  Hospital  number  and  name  (if  known)  are  hand 
lettered  right  on  the  band.  No  insert  card  is  required.  Its  distinctive 
color  singles  out  the  emergency  patient  from  all  others. 


a 


HOLLISTER 


LTD.,  332  CONSUMERS  ROAD,  WILLOWDALE,  ONTARIO 


10     THE  CANADIAN  NURSE 


Professor  Potter  hopes  to  identify 
factors  indicating  the  differences  be- 
tween persons  who  do  use  the  available 
services  and  those  who  do  not. 

The  study  is  funded  by  a  $1,000 
grant  from  the  Richard  G.  Ivey  Foun- 
dation. 

During  the  study,  direct  interviews 
will  be  held  with  75  occupants  of  homes 
in  the  same  city.  Twenty-five  people 
will  be  interviewed  in  each  of  three 
subdivisions  that  are  designated  as 
high  income,  middle  income,  and  low 
income  areas. 

The  plan  for  the  study  indicates  that 
the  housewife  will  be  considered  the 
spokesman  for  the  household  on  matters 
of  health.  The  interviews  will  be  direct- 
ed to  three  broad  areas:  family  status 
(education,  occupation,  residence), 
health  status,  and  health  knowledge. 

Professor  Potter  hopes  that  the  study 
will  provide  data  that  will  focus  on  the 
need  for  consideration  of  new  and  dif- 
ferent kinds  of  health  care  delivery. 


Use  Of  Sask.  Health  Services 
Studied  By  University  Team 

Ottawa  —  The  federal  health  depart- 
ment has  approved  a  $37,250  health 
grant  to  the  department  of  economics 
and  political  science  of  the  University 
of  Saskatchewan,  Saskatoon,  Saskat- 
chewan, to  support  a  research  study  on 
the  utilization  of  health  services  in  that 
province. 

The  project  is  a  multi-phase  pro- 
gram of  research  on  various  aspects  of 
utilization  of  health  services,  including 
a  detailed  study  of  utilization  by  income 
class,  the  effects  of  utilization  fees,  and 
the  compilation  of  a  source  book  of 
statistics  on  health  care  use  in  Saskat- 
chewan. 

The  project  will  provide  more  infor- 
mation on  the  workings  of  the  health 
care  delivery  system  under  medical  care 
insurance. 


Shortage  Of  Nurses  Critical 

In  Quebec's  "English"  Hospitals 

Montreal — An  article  in  the  Mont- 
real Gazette  recently  referred  to  the 
lack  of  nursing  personnel  in  the  "Eng- 
lish" hospitals  of  Quebec. 

Commenting  on  this  article,  Nicole 
Du  Mouchel,  secretary-registrar  of  the 
Association  of  Nurses  of  the  Province 
of  Quebec,  claimed  that  this  situation 
is  temporary,  perhaps  because  English- 
speaking  students  at  CEGEP  will  not 
know  their  examination  results  until 
November.  She  added  that  there  are  no 
refresher  program,;  in  Quebec's  "Eng- 
lish" hospitals. 

"It  is  a  fact,"  added  Miss  Du  Mou- 
chel   "that  English-speaking   students 

NOVEMBER  1971 


in  the  CFGEPs  have  decreased  in  num- 
ber, but  that  French-speaking  students 
have  increased." 

In  hospitals  under  "Enghsh"  man- 
agement, nursing  personnel  are  not 
required  to  be  Enghsh  speaking  but 
are  only  asked  to  be  able  to  express 
themselves  in  that  language. 

Miss  Du  Mouchel  believes  that  the 
adoption  of  Bill  64 — requiring  pro- 
fessional immigrants  to  Quebec  to 
work  in  the  French  language — has 
perhaps  added  to  this  situation,  but 
she  stated  that  this  law  applies  only 
to  professionals  coming  from  outside 
Canada. 

The  English-speaking  directors  of 
nursing  service  are  currently  study- 
ing this  question  in  collaboration 
with  the  ANPQ. 

Claude  Castonguay  has  also  given 
assurance  that  the  Quebec  government 
will  give  further  study  to  this  problem. 

P.H.  Nurses  Volunteer  Help 
To  Summer  Hostel  Infirmary 

Siulhury.  Out.  —  Twenty  public  health 
nurses  volunteered,  along  with  reg- 
istered nursing  assistants,  to  staff  an 
infirmary  in  hostel  facilities  provided 
during  the  summer  for  transient  young 
people. 

Before  the  young  travelers  began  to 
arrive  in  Sudbury,  the  Sudbury  and  dis- 
trict health  unit  arranged  with  local 
youth  workers  to  provide  medical 
facilities  and  assistance  at  the  hostel. 
An  infirmary,  with  limited  necessary 
medications  and  first  aid  supplies,  was 
staffed  by  a  public  health  nurse  and  a 
registered  nursing  assistant  for  an  hour 
each  night  of  the  week. 

The  chief  purpose  of  the  project  was 
to  help  care  for  unmet  health  needs 
and  to  provide  health  education.  Two 
hundred  and  ninety-seven  hitchhikers 
with  a  variety  of  problems  came  to  the 
infirmary. 

In  the  early  part  of  the  summer,  black 
fly  bites  were  the  chief  complaint; 
with  changing  weather,  the  common 
cold  was  more  evident.  Many  cases  of 
sunburn,  blisters,  and  aching  muscles 
were  treated. 

The  nurses  reported  frequent  cases 
of  infected  cuts,  earaches,  and  tooth- 
aches. Several  diabetics  were  seen,  and 
one  who  had  exhausted  his  supply  of 
insulin  received  help. 

Of  the  5,000  transient  young  people 
who  used  the  Sudbury  hostel,  the  infir- 
mary reported  only  two  cases  of  venere- 
al disease.  One  male  hitchhiker  was 
treated  as  a  result  of  a  bad  trip  on 
mescaline;  he  was  taken  to  a  hospital 
emergency  ward.  One  young  mother, 
traveling  with  her  two-year-old  child, 
was  referred  to  the  infirmary  because 
she  had  exhausted  her  supply  of  tuber- 
culosis medication. 

NOVEMBER   1971 


For  nursing 
convenience... 

patient  ease 

TUCKS 

offer  an  aid  to  healing, 
an  aid  to  comfort 

Soothing,  cooling  TUCKS  provide 
greater  patient  comfort,  greater 
nursing  convenience.  TUCKS  mean  no 
fuss,  no  mess,  no  preparation,  no 
trundling  the  surgical  cart.  Ready- 
prepared  TUCKS  can  be  kept  by  the 
patient's  bedside  for  Immediate  appli- 
cation whenever  their  soothing,  healing 
properties  are  Indicated.  TUCKS  allay 
the  Itch  and  pain  of  post-operative 
lesions,  post-partum  hemorrhoids, 
epislotomles,  and  many  dermatologlcal 
conditions.  TUCKS  save  time.  Promote 
healing.  Offer  soothing,  cooling  relief 
in  both  pre-and  post-operative 
conditions.  TUCKS  are  soft 
flannel  pads  soaked  In  witch  hazel 
(50%)  and  glycerine  (10%). 


TUCKS  —  the  valuable  nur- 
sing aid,  the  valuable  patient 
comforter. 


w 


Specify  the  FULLER  SHIELD*  as  a  protective 
postsurgical  dressing.  Holds  anal,  perianal  or 
pilonidal  dressings  comfortably  in  piace  with- 
out tape,  prevents  soiling  of  linen  or  cloth- 
ing. Ideal  for  hospital  or  ambulatory  patients. 


WINLEY-MORRIS  LS^ii 


TUCKS  Is  a  trademark  of  the  Fuller  Laboratories  Inc. 

THE  CANi^DIAN   NURSE     11 


Many  times,  quite  apart  from  med- 
ical needs,  these  transient  youth  sought 
out  the  nurse  just  to  talk.  They  seemed 
desperately  lonely,  the  report  says.  As 
one  hosteler  phrased  it,  "You  listened 
and  isn't  that  what  a  nurse  is  for?" 

Indian  Majority  On  Council 
To  Operate  New  Health  Center 

Ottawa  — The  $125,000  health  center 
to  be  built  on  the  Stoney  Indian  Re- 
serve at  Morley,  Alberta,  will  be  one 
of  the  first  in  Canada  to  be  operated 
by  a  health  council  with  a  majority  of 
Indian  band  representatives. 

Other  council  members  will  come 
from  the  University  of  Calgary  and 
Medical  Services  branch  of  the  Depart- 
ment of  National  Health  and  Welfare. 

The  Faculty  of  Medicine  of  the  Uni- 
versity of  Calgary  will  provide  medical 
staff  and  consultants  for  the  center 
and  will  cooperate  with  Medical  Ser- 
vices in  public  health  and  health  educa- 
tion programs  in  the  community  of 
Morley,  which  consists  of  1 ,545  Indians 
and  about  100  non-Indians. 

The  health  center,  which  will  re- 
place the  existing  health  clinic  operat- 
ed by  Medical  Services  branch  of 
DNHW,  will  train  and  employ  native 
people  as  medical  workers.  The  center 
is  designed  to  serve  as  a  model  for  other 
Indian  and  non-Indian  rural  com- 
munities. 

UBC  Studies  Marijuana 
Effect  On  Short-term  Memory 

Vancouver,  B.C.  —  Members  of  the 
Faculty  of  Medicine  at  the  University 
of  British  Columbia,  in  a  study  funded 
by  the  federal  government,  will  try  to 
find  out  if  the  use  of  marijuana  dis- 
rupts short-term  memory  and  if  it  does, 
whether  impairment  is  limited  to  verbal 
processes  or  includes  nonverbal  memory 
patterns  as  well. 

Volunteers  between  18  and  30,  men 
and  women,  are  carefully  screened 
before  acceptance  into  the  program  and 
their  identity  is  being  kept  strictly 
confidential.  Volunteers  and  UBC 
officials  will  be  immune  to  prosecution 
from  provincial  or  federal  legal  author- 
ities. 

Investigators  do  not  expect  to  find 
any  difference  between  the  effects  on 
men  and  women  but  have  included 
women  to  make  the  study  more  scientif- 
ically and  socially  relevant  since  both 
sexes  use  marijuana  in  society.  Many 
marijuana  studies  in  the  past  have  used 
men  only. 

All  volunteers  must  have  previously 

12     THE  CANADIAN  NURSE 


used  marijuana  or  hashish.  They  must 
not  have  been  on  medication  of  any 
kind  for  two  months  preceding  the 
study,  and  they  are  asked  to  abstain 
from  any  drugs  for  a  week  before  the 
testing  begins  and  between  sessions. 

After  preliminary  psychiatric  and 
psychological  screening  each  volunteer 
is  tested  in  three  experimental  sessions. 
At  each  of  these  sessions  the  volunteer 
is  given  either  marijuana  (supplied  by 
the  Federal  Food  and  Drug  D  irectorate) 
or  a  placebo  that  resembles  marijuana 
in  appearance. 

During  the  first  two  sessions  the 
volunteers  are  given  short-term  memory 
and  other  batteries  of  neuropsychologi- 
cal tests. 

The  volunteers  remain  in  hospital 
until  the  effects  of  the  drug  have  worn 
off.  They  are  then  sent  home  by  taxi 
and  are  telephoned  the  next  day  to  make 
sure  they  are  all  right. 

In  the  third  session,  investigators 
make  EEC  recordings  of  the  volunteers 
before  and  after  administration  of  either 
marijuana  or  the  placebo. 

Examine  Teacher  Evaluation 
By  Nursing  Students  In  England 

London,  Ont.  —  The  report  of  a  pilot 
study  into  student  evaluation  of  tutors 
in  four  selected  hospital  schools  of 
nursing  in  England  has  recently  been 
published.  Vivian  Wood,  associate 
professor  in  the  Faculty  of  Nursing, 
University  of  Western  Ontario,  con- 
ducted the  research  in  1970  under  a 
grant  from  the  British  Department  of 
Health  and  Social  Security. 

Iwo  articles  concernmg  the  tmdmgs 
of  the  study  were  published  in  Nursing 
Times  in  June  and  July,  1971 . 

The  grant  of  approximately  $  1 ,800 
for  the  research  project  was  administer- 
ed through  the  research  division  of  the 
General  Nursing  Council  in  England 
and  Wales. 

During  Professor  Wood's  stay  in 
England,  she  visited  several  hospital 
schools  of  nursing  as  well  as  schools 
engaged  in  the  preparation  of  teachers 
of  nursing.  Mrs.  Wood  utilized  the 
grart  while  she  was  on  study  leave  in 
Lo  idon,  England,  from  January  until 
June,  1970. 

In  April,  1970,  Professor  Wood  was 
invited  to  participate  in  the  third  Inter- 
national Congress  on  Counselling  held 
in  the  Hague,  Netherlands. 

Hepatitis  Associated  Antigen 
Detected  In  New  Blood  Test 

Ottawa  —  A  blood  test  has  been  devel- 
oped recently  that  identifies  an  antigen 
associated  with  serum  hepatitis.  Within 
the  past  few  months  Canadian  Red 
Cross  blood  banks  have  begun  to  use 
the  test  routinely  on  all  blood  donated 
for  transfusion. 


The  antigen  was  first  found  in  the 
blood  of  an  Australian  aborigine,  giving 
the  name  "Australian  antigen."  The 
Canadian  Red  Cross  does  the  test  for 
the  hepatitis  associated  antigen  (HAA) 
by  cross  electrophoresis  m  conjunction 
with  other  tests  made  on  donated  blood. 

If  the  Red  Cross  laboratory  finds 
HAA  in  a  blood  sample,  the  blood  is 
discarded.  The  donor  is  notified  that 
the  Australian  antigen  has  been  found 
and  is  advised  to  contact  his  physician. 

HAA  may  be  found  in  blood  from  a 
donor  who  is  unaware  that  he  has  serum 
hepatitis.  The  test  is  also  being  used  by 
some  doctors  to  verify  a  diagnosis  of 
serum  hepatitis. 

Canadian  blood  banks  are  maintained 
by  volunteer  donors.  A  laboratory  tech- 
nician from  a  Red  Cross  blood  bank 
told  The  Canadian  Nurse  that,  although 
the  percentage  of  positive  blood  tests 
varies  from  center  to  center  in  Canada, 
HAA  is  found  in  less  than  one  percent 
of  Canadian  donors. 

Serum  hepatitis  is  prevalent  among 
drug  users  who  contract  the  disease 
through  used  or  unsterilized  needles. 
Blood  transfusion  services  in  the  U.S. 
pay  blood  donors;  an  increase  in  hepa- 
titis that  can  be  attributed  to  blood 
transfusions  hasocurred  in  the  U.S. 

Two  New  Specialties 
Offer  Careers  To  Nurses 

Loma  Linda,  Calif.  —  Midwives  are 
coming  back  into  medical  fashion. 
Hospital  and  private  obstetricians  are 
on  waiting  lists  to  hire  them  fresh  out 
of  the  training  program  developed  at 
Loma  Linda  University  school  of  nurs- 
ing. 

Unlike  the  midwife  of  the  past,  the 
modem  version  is  a  highly-skilled  nurse 
with  special  training  in  obstetrics,  local 
anesthesia,  and  comprehensive  advanced 
methods  of  pre-  and  postnatal  care.  She 
is  capable  of  handling  normal  deliveries 
in  a  hospital  as  a  physician's  health  care 
associate. 

Midwifery,  as  a  specialty,  is  one  of 
two  new  certificate  programs  being 
developed  by  nursing  schools  in  re- 
sponse to  requests  from  American 
health  authorities  and  doctor's  associa- 
tions. The  second  and  newer  career 
program  is  that  of  pediatric  nurse  asso- 
ciate. It  is  a  job  that  takes  the  nurse 
with  specialized  postgraduate  prepara- 
tion out  of  the  hospital  and  into  the 
community  to  provide  health  and  pre- 
ventive care  to  well  children  and  those 
with  minor  illness. 

Ruth  White,  chairman  of  community 
health  at  the  university,  said,  "Some 
people  think  this  will  be  second  class 
care.  It  won't  be.  It  will  enhance  and 
increase  mother  and  child  care  for  all, 
because  it  calls  for  the  nurse-practition- 

CiiiiliiiKi'il  (III  ptii;c  14) 
NOVEMBER   1971 


First  sign? 

Don't  save  Selsun 
for  difficult  cases. 
Use  it  to  avoid  them. 


Why  save  best  for  last  when 
you  can  count  on  Selsun 
effectiveness?  As  for  safety, 
Selsun  has  shown  itself 
impressively  free  of  serious 
side  effects. 


Selsun 


(Selenium  sulfide  detergent  suspension.  U.S. P.) 

Indications:  For  treatment  of  common 
dandruff  and  mild  to  moderately  severe 
seborrheic  dermatitis  of  the  scalp. 
Precautions  and  side  effects:  Keep  out  of 
the  eyes:  burning  or  irritation  may  result. 
Avoid  application  to  inflamed  scalp  or  open 
lesions.  Occasional  sensitization  may  occur. 


I PMAC I 


Abbott  Laboratories,  Limited, 
Montreal,  Quebec 


^1 

'  M 


(Coiiliiuu'J  from  pti^i'  12) 

er  to  work  in  collaboration  with  the 
physician  and  enables  the  physician  to 
give  priority  to  those  who  have  severe 
health  problems." 

Much  more  than  nurses  now  working 
in  obstetrical  or  pediatric  wards  of 
hospitals,  a  nurse  in  either  of  the  two 
specialties  will  become  a  physician's 
"extra  arm."  She  will  be  more  percep- 
tive of  physical  deviations  from  the 
normal,  for  example:  irregularities  in 
heart  sounds,  abnormal  breathing  pat- 
terns, skin  lesions,  and  would  call  them 
to  the  physician's  attention.  She  will  be 
qualified  to  accept  more  responsibility 
for  the  management  of  normal  or  rou- 
tine examinations,  baby  deliveries,  and 
preventive  health  care. 

A  physician  would  examine  the 
expectant  mother  on  the  initial  prenatal 
visit.  If  everything  seems  normal,  and 
if  the  mother  has  signed  up  for  mid- 
wifery service,  the  nurse-midwife  would 
take  care  of  the  patient.  If,  during  the 
pregnancy  or  delivery  there  was  a  prob- 
lem, she  would  call  in  the  obstetrician 
member  of  the  team. 

The  nurse-midwife  is  trained  in  the 
administration  of  local  anesthesia  and 
in  doing  the  episiotomy.  She  is  also 
skilled  in  working  with  women  who 
want  to  have  their  babies  by  natural 
childbirth. 

International  Meeting 
Of  School  Health  Nurses 
Focuses  On  Emotional  Health 

Ottawa — Emotional  health  problems 
in  students  of  all  ages  must  be  rec- 
ognized early,  and  the  school  health 
team  needs  the  collaborative  member- 
ship of  psychologists  and  psychiatrists. 
These  were  conclusions  of  over  200 
nurses  who  met  in  a  discussion  group 
during  the  sixth  international  congress 
of  school  and  university  health  and 
medicine  held  in  Lisbon,  Portugal,  in 
August  1971. 

Marie  Loyer,  a  faculty  member  of 
the  University  of  Ottawa  school  of 
nursing,  told  The  Canadian  Nurse 
that  the  school  health  nurses  felt  that 
inclusion  of  psychiatric  nursing  in 
basic  nursing  programs  in  all  countries 
is  important. 

The  school  health  nurse,  because  of 
her  ability  to  enter  into  a  helping  rela- 
tionship with  families,  can  help  to 
bridge  the  communication  gaps  be- 
tween the  school  and  the  community,  the 
student  and  the  school,  and  the  student's 
family  and  the  school. 

The  nurses  at  the  congress  held 
conflicting    opinions    as    to    whether 

14     THE  CANADIAN  NURSE 


MariedesAngesLoyer,  Ottawa,  attend- 
ed the  6th  International  Congress  on 
School  and  University  Health  and 
Medicine,  held  in  Portugal  in  August. 


the  school  nurse  should  be  a  member  of 
the  teaching  staff  or  of  the  health  team. 
Kirsten  Webber  of  the  University  of 
British  Columbia  school  of  nursing  was 
a  panelist  at  one  of  the  congress's  plen- 
ary sessions. 


Bill  To  Define  Nursing 
Vetoed  By  N.Y.  Governor 

A Ibany,  N.Y.  —  A  bill  intended  to 
provide  a  new  definition  of  nursing  and 
amend  the  New  York  State  nurse 
practice  act  was  vetoed  by  Governor 
Nelson  Rockfeller  July  6  after  it  had 
received  the  approval  of  the  state 
legislature. 

The  bill,  sponsored  by  the  New 
York  State  Nurses'  Association,  defines 
the  practice  of  a  registered  professional 
nu  rse  as  "d  iagnosing  and  treating  human 
responses  to  actual  or  potential  health 
problems  through  such  services  as  case 
finding,  health  teaching,  health  counsel- 
ing, and  provision  of  care  supportive 
to  or  restorative  of  life  and  well-being 
and  executing  medical  regimens  as 
prescribed  by  a  .  .  .  legally  authorized 
physician  or  dentist." 

A  letter  to  the  governor,  signed  by 
NYSNA  president  Evelyn  Peck,  called 
the  veto  a  "shocking  and  resounding 
rejection  of  the  essential  social  services 
rendered  by  nursing  practitioners."  The 


letter  also  criticized  what  it  called  the 
governor's  failure  to  recognize  the 
independent  functions  of  nursing  prac- 
tice, and  his  statement  that  nurses  "are 
capable  of  helping  to  meet  this  physi- 
cian shortage  by  undertaking  increas- 
ing responsibility." 

According  to  the  NYSNA  letter,  the 
nursing  profession  exists  to  serve  the 
patient,  not  to  meet  the  physician  short- 
age. 

Although  the  governor  agreed  in 
his  veto  message  that  the  present  defini- 
tion of  nursing  is  "both  outmoded  and 
unnecessarily  restrictive  and  that  [it] 
fails  ...  to  reflect  the  actual  state  of 
the  profession,"  he  said  a  new  defini- 
tion must  "maintain  a  responsible 
distinction  between  the  professions 
of  medicine  and  nursing  commensurate 
with  the  respective  training  and  exper- 
ience of  both  .professions." 

The  summer  issue  of  The  Journal 
of  the  New  York  State  Nurses'  Asso- 
ciation declared  that  "the  flight  of 
independence  of  the  nursing  profes- 
sion has  begun."  Also,  the  theme  of  the 
NYSNA  biennial  convention  October 
18-22,  "declaration  of  independence," 
illustrated  by  a  white  bird  in  flight,  is 
meant  to  dramatize  "the  basic  compo- 
nents of  independence:  skill,  self- 
discipline,  freedom,  creativity  and 
authority." 

Student  Volunteer  Project 
Receives  $100,000  Contract 

Bethesda,  Md.  —  A  project  in  which 
student  nurse  volunteers  have  been 
helping  members  of  minorities  in  the 
United  States  become  registered  nurses 
has  received  a  $100,000  contract  from 
the  U.S.  department  of  health,  educa- 
tion and  welfare. 

The  activities  with  blacks,  Spanish- 
Americans,  and  Indian  Americans  in 
1 7  separate  target  areas  will  be  expand- 
ed by  the  National  Student  Nurses' 
Association.  The  project  has  strong 
emphasis  on  the  recruitment  of  men 
mto  nursing. 

The  student  volunteers  enlist  the 
aid  of  communications  media  in  the 
various  target  areas  to  publicize  op- 
portunities for  registered  nurses;  work 
with  minority  communities  to  identify 
potential  candidates  for  nursing  school; 
and  persuade  the  schools  to  accept 
applicants  with  language  limitations 
and  other  evidences  of  minority  status. 
The  volunteers  also  tutor  the  minority 
students  and  acquaint  prospective  stu- 
dents with  financial  aid  sources.  ■§> 


RED  CROSS 

IS  ALWAYS  THERE 
WITH  YOUR  HELP 


+ 


NOVEMBER  1971 


musetun  piece 

FLEET  ENEMA®  —  the  disposables  —  puts  the  enema-can  right  where  it  belongs  —  in  the 
Chamber  of  Costly  Horrors.  Nurses  themselves,  in  time-studies*,  established  FLEET  as 
"the  40-second  enema".  Compared  with  the  old-fashioned  method,  FLEET  ENEMA® 
saves  the  nurse  an  average  of  27  minutes  per  patient  —  not  to  mention  all  the  drudgery. 
FLEET  disposables  are  pre-lubricated,  pre-mixed,  pre-measured  and  individually  packed. 
Everything  moves  better  with  FLEET.  Three  disposable  forms:  Adult  (green  protective 
cap),  Pediatric  (blue  cap),  and  Mineral  Oil  (orange  cap). 


WARNING:  Not  to  be  used  when 
nausea,  vomiting  or  abdominal  pain 
is  present.  Frequent  or  prolonged 
use  may  result  in  dependence. 
CAUTION:  Do  not  administer  to  chil- 
dren under  two  years  of  age  except  on 
the  advice  of  a  physician.  In  dehy- 
drated or  debilitated  patients,  the 
volume  must  be  carefully  deter- 
mined since  the  solution  is  hyper- 
tonic and  may  lead  to  further  dehy- 
dration. Care  should  also  be  taken 
to  ensure  that  the  contents  of  the 
bowel  are  expelled  after  administra- 
tion. Repeated  administration  at 
short  intervals  should  be  avoided. 


Full  information  on  request. 
•Kehlmann,  W.H.:  Mod.  Hasp. 
84:104,  1955 


FOUNDED  IN  CANADA  IN  1899 
CHARLES  E.  FROSST  &  CO. 
KIRKLAND  (MONTREAL)  CANADA 


new  products     { 


Descriptions  are  based  on  information 
supplied  by  the  manufacturer.  No 
endorsement  is  intended. 


Mattress  for  Premature  Infants 


Mattress  for  premature  infants 

A  mattress-alarm  system  marketed  for 
the  first  time  in  Canada  by  Arbrooi< 
Limited,  ensures  that  infants  suscep- 
tible to  apnea  can  be  monitored  simply, 
reliably,  and  inexpensively. 

Designed  by  the  British  National 
Institute  for  Medical  Research,  the 
Codman  Apnea  Alarm  eliminates  the 
need  for  attachment  of  electrodes  to  the 
infant's  body.  Thus  there  is  nothing  to 
interfere  with  the  nursing  routine, 
nothing  to  come  loose,  and  nothing  to 
irritate  the  baby's  skin. 

The  baby  is  placed  on  the  air-filled 
mattress;  movement  as  slight  as  breath- 
ing is  detected  by  the  mattress-alarm, 
if  breathing  stops,  the  control  unit 
sounds  an  alarm  and  flashes  a  light. 
Fail-safe  features,  such  as  an  audible 
alarm  if  the  unit  is  inadvertently  turned 
off,  assure  a  high  degree  of  reliability. 

Key  to  the  operation  of  the  alarm 
is  a  heat-sensitive  device  that  detects 
air  movement  from  one  mattress  com- 
partment to  another  as  the  baby 
breathes.  Absence  of  movement  triggers 
audible  and  visual  alarms  after  a  pre- 
selected interval.  If  the  baby  resumes 
breathing  spontaneously,  the  audible 
alarm  stops,  but  the  light  continues 
flashing,  confirming  that  an  attack  did 
occur. 
16     THE  CANADIAN  NURSE 


Because  it  is  battery-powered,  the 
Codman  alarm  is  completely  portable, 
requires  no  connection  to  an  electrical 
outlet,  and  runs  entirely  on  low  voltage. 
The  alarm  sounds  automatically  if  the 
batteries  run  low,  if  the  sensing  connec- 
tion is  pulled  out,  or  if  the  mattress  is 
deflated.  The  price  is  $329. 

Further  information  is  available 
from:  Mr.  W.A.  Clarke,  Product  Man- 
ager, Arbrook  Limited,  Peterborough. 


Disposable  line  heat  exchanger 

The  first  disposable  venous  line  heat 
exchanger  for  maintaining  normal  body 
temperature  during  heart-lung  bypass 
procedures  has  been  introduced  by  the 
Artificial    Organ    Division    of  Baxter. 

Earlier,  permanent-style  heat  ex- 
changers had  to  be  cleaned,  sterilized, 
and  reassembled  before  each  use.  They 
were  also  mounted  on  the  arterial  line 
for  bypass  procedures,  necessitating 
the  use  of  a  bubble  trap  and  added 
blood  prime. 

The  Miniprime  disposable  venous 
line  heat  exchanger  can  be  mounted 
quickly  and  has  a  low  priming  volume. 
Its  venous  line  position  eliminates  the 
need  for  a  bubble  trap  since  the  entire 
Miniprime  oxygenator  acts  in  that 
capacity.  The  heat  exchanger  design 
features  silicone  rubber  manifolds 
bonded  to  a  multifolded  core  of  sili- 
cone-coated  stainless  steel.  Fluid  and 
blood  entry  and  exit  ports  are  molded 
into  the  manifold.  All  fluid  paths  are 
sterile  and  nonpyrogenic. 

Because  all  seams  of  the  new  Mini- 
prime  unit  have  an  air  interface,  there 
is  no  risk  of  water  to  blood  leakage. 
Venous  tlow  in  the  unit  is  unimpeded 
due  to  a  low  resistance  in  the  heat 
exchanger.  Resistance  in  the  blood 
path  of  the  heat  exchanger  is  less  than 
that  in  a  3/8  inch  I.D.  tubing  of  the 
same  length. 

For  further  information,  write  to: 
Baxter  Laboratories  of  Canada,  1405 
Northam  Drive,  Malton,  Ontario. 

IC  iiiiliiiiu'il  on  i'(ii:c  IS) 


Disposable   Line  Heat  Lxclumger 


NOVEMBER   1971 


Victor  Stephen  Saunders 
dressed  our  best  dressed 
patient  successfully. 


On  our  50th  anniversary. 

So  we  are  sending  a  five  hundred  dollar 
donation,  in  Victor's  name,  to  the  hospital  fund  he 
selected;  The  Maple  Ridge  Hospital,  Haney,  B.C. 
Victor's  was  the  first  correct  entry  selected  from  the 
many  sent  in  by  nurses  from  all  over  Canada,  in 
the  third  "dress  our  best  dressed  patient"  contest 
this  year.  To  Victor  and  all  the  others  who  entered 
our  contest,  we  say  a  big  "thank  you". 


SMITH  &  NEPHEW  LTD. 

2100  -  52ncl  Avenue,  Lachine,  Quebec,  Canada. 


SCHOLARSHIPS  IN  FAMILY  PLANNING 

In  1969  G.  D.  Searle  of  Canada,  Limited,  established  the  Searle  Scholarship  Program  for  Canadian  nurses. 
This  Program  is  being  continued,  and  during  1972  up  to  8  scholarships  in  family  planning  will  be  offered 
under  the  following  conditions: 

1.  Applications  will   be  considered   from   any  graduate  nurse  employed  full-time  in  Canada,  regard- 
less  of   citizenship   or   training    school    attended. 

2.  Awards   will    be  made  on   the   basis   of   expressed   interest  in  family  planning  education  and  the 
applicant's   present  and   future  prospects  for  making   use  of  family   planning  clinic  training. 

Successful  applicants  will,  at  Searle  expense,  travel  from  any  point  in  Canada  to  Chicago,  be  provided 
with  accommodation  in  that  city,  attend  a  2  week  course  at  the  Chicago  Planned  Parenthood  Clinic,  and 
receive   $150   for   meals   end   incidental   expense.    Instruction   is  available  in  English  only. 

Applications  for  the  first    1972  course   must  be  received  no  later  than  December  31,   1971. 

This  program  should  be  of  special  interest  to  nurses  engaged  in  Public  Health  work,  or  in  School  or 
College  Health  Programs,  but  is  not  restricted  to  these  groups.  Awards  are  made  entirely  at  the  dis- 
cretion of  the  Scholarship  Selection  Committee.  Names  of  the  16  previous  scholarship  winners  ore 
available  on  request. 

Application  forms  may  be  obtained  from: 
Reference  and  Resource  Program, 

C.  D.  SEARLE  &  CO.  OF  CANADA,  LIMITED 

400  Iroquois  Shore  Rd., 
Oakville,  Ontario 


NOVEMBER   1971  THE  CAN/^JIAN  NURSE     17 


new  products 


Insulin  Injection  Device 

A  new  device  that  facilitates  self-injec- 
tion of  insulin  has  been  introduced 
by  Ditek  Corp.  Ltd.  The  Ditek  Mound 
Forming  Clamp  is  a  simple,  metal  and 
elastic  device  that  fits  around  the 
diabetic's  arm  or   leg.   It  raises  and 


holds  a  mound  of  flesh  for  easier  injec- 
tion, and  it  is  also  adjustable. 

For  more  information  write  to 
N.M.  Kully,  vice-president  of  Profes- 
sional &  Engineered  Patents  Ltd., 
1255  Queensway,  Toronto  1 8,  Ontario. 


Urine  collection  device 

Abbott  Laboratories  Ltd.  has  announc- 
ed a  new  urine  collection  device.  The 
"Drainbox"  urogate  urinary  drainage 
system  departs  from  the  usual  design 
of  urine  collection  bags  by  offering 
several  unique  features. 

"Drainbox"  provides  a  vented  cath- 
eter connector  that  admits  filtered  air 
into  the  drainage  tube  from  the  Foley 
catheter  and  eliminates  negative  pres- 
sure. This  feature  and  a  large  rigid 
container  space  permit  urine  to  flow 
freely,  and  avoid  the  possibility  of 
bladder  mucosa  lesions.  Since  urine 
will  not  collect  in  the  line  above  the 
level  of  the  inlet  port,  the  risk  of  retro- 
grade bacterial  migration  is  minimized. 

Drainbox  is  its  own  self-storing 
package  and  offers  good  stacking  qual- 
ities, together  with  positive  end  identifi- 
cation. The  unit  may  be  aseptical-ly 
opened  by  peeling  back  the  water- 
repellent  cover  and  "popping  up"  the 
top  of  the  clear  vinyl  container.  The 
walls  of  the  drainbox  do  not  stick  to- 
gether and  impede  urine  flow.  Accurate 
visualization  of  urine  is  assured  by  a 
rigid  base  and  plastic  clarity. 

The  Drainbox  may  be  quickly  and 
easily  emptied  through  a  large  bore 
rubber  tube,  which  has  a  twist-over 
closure  that  eliminates  bothersome 
clamps.  It  may  be  securely  attached  to 
any  type  of  bed  by  the  two  sturdy  metal 
hangers  provided  in  the  package.  The 
unit  will  not  touch  the  floor  because  of 
its  long  horizontal  axis  and  shorter 
hanging  length.  Since  the  drainage  tub- 
ing need  not  be  coiled  back  over  the 
top  of  the  drainbox,  there  is  less  chance 
of  kinking  or  shutdown  in  urine  flow. 

For  more  details,  write  to:  Abbott 
Laboratories  Limited,  P.O.  Box  6150, 
Montreal,  Quebec. 


Urine  Collection  Device 


18     THE  CANADIAN  NURSE 


Steri-Flex  tubing 

Sterile,  disposable,  flexible  tubing  for 
use  in  inhalation  therapy  has  been 
introduced  by  Air  Products  and  Chem- 
icals Inc.  The  new  Steri-Flex  line  is  the 
first  tubing  of  its  type  available  to  hos- 
pitals in  individual  sterile  packages 
for  single  patient  use. 

The  tubing  is  made  of  lightweight, 
low-compliance,  translucent  polyethyl- 
ene. It  is  7/8  inch  in  diameter  and  fits 
most  IPPB  and  aerosol  equipment. 

For  more  information  write  to  Air 
Products  and  Chemicals  Inc.,  Allen- 
town,  Pennsylvania. 

r 

New  disposable  gloves 

A  new  concept  in  disposable  gloves 
has  been  announced  by  Safety  Supply 
Company.  The  "pretectal"  glove  is 
made  of  "silken  touch  polyethylene," 
a  material  that  is  tough  and  durable, 
but  allows  the  glove  to  slip  easily  on 
and  off. 

The  pretectal  disposable  glove  fits 
either  hand  and  comes  in  a  single  size 
that  fits  all  hands.  It  is  available  in 
packages  of  50  single  gloves  from  Safety 
Supply  Company,  214  King  Street 
East,  Toronto,  Ontario,  and  from 
branches  across  Canada. 

Antidiabetic  agent 

Hoechst  Pharmaceuticals  has  marked  its 
60th  anniversary  in  the  field  of  diabetes 
research  with  the  introduction  of  Diabe- 
ta  (glyburide  Hoechst). 

According  to  the  company,  Diabeta, 
a  low-dosage  antidiabetic  agent,  is  being 
referred  to  as  a  "second  generation" 
sulfonylurea. 

Primarily  for  the  treatment  of  ma- 
turity-onset diabetics  who  cannot  be 
controlled  on  diet  alone,  Diabeta's 
principal  feature  is  the  more  physio- 
logical release  of  insulin  from  the  B- 
cells  of  the  pancreas  than  with  standard 
oral  agents. 

The  product  is  now  available  in 
"Unit-pack"  boxes  of  30  and  300  from 
Hoechst  Pharmaceuticals,  3400  Jean 
Talon  St.  W.,  Montreal  301,  Quebec. 

Alcotabs 

Alcotabs,  effervescentdetergent  tablets, 
specifically  formulated  for  cleaning 
reusable  pipettes  and  test  tubes  in 
syphon  washers,  have  been  introduced 
by  Alcanox,  Inc. 

The  Alcotab  detergent  is  biodegrad- 
able and  completely  soluble  in  cold 
or  warm  water.  It  produces  a  cleaning 
action  through  and  around  pipette  bores 
and  on  outside  and  inside  surfaces  of 
test  tubes.  After  rinsing,  Alcotabs  leave 
no  film  residue  and,  because  they 
contain  neither  acids  nor  caustic  agents, 
will  not  etch  glass  or  cloud  pipettes  and 
test  tubes. 

For  more  information  write  to  Alca- 
nox Inc.,  215  Park  Avenue,  South, 
New  York,  N.Y.,  10003.  * 

NOVEMBER  1971 


'j&si 


Successful  ELASE  treatment  often  depends  on  proper  application. 
These  four  steps  will  help  prevent  an  unsatisfactory  or  delayed 
response: 

1.  Clean  wound  with  water,  peroxide,  or  normal  saline  ...  and  dry 
area  gently. 

2.  Apply  a  thin  layer  of  ELASE  Ointment. 

3.  Cover  with  petrolatum  gauze  or  other  nonadhering  dressing. 

4.  Change  dressing  and  repeat  the  above  procedure  at  least  once 
a  day  . . .  preferably  twice  a  day. 


Enzymatic  debridement  with  ELASE  facilitates  healing  in  topical 
ulcers,  burns,  infected  wounds  and  other  fibro-purulent  lesions. 
By  helping  remove  necrotic  debris  and  purulent  exudates,  ELASE 
Ointment  creates  a  better  environment  for  healing. 

ELASE-CHLOROMYCETIN®  Ointment  provides  effective  enzymatic 
debridement  plus  direct  antibacterial  action  to  assist  healing  of 
seriously  infected  surface  lesions  when  the  organisms  are  suscep- 
tible to  chloramphenicol. 


This  enzyme  combination  is  supplied  in  three  forms:  ELASE  (a  lyophilized  powder),  ELASE  Ointment,  and  ELASE-CHLOROIVIYCETIN  Ointment.  Each  gram  of  ointment 
contains  1  unit  (Loomis)  of  fibrinolysin  and  666  units  of  desoxyribonuclease.  Each  vial  of  ELASE  for  solution  contains  25  units  (Loomis)  of  fibrinolysin  and  15,000  units  of 
desoxyribonuclease.  ELASE-CHLOROMYCETIN  Ointment  contains  1%  Chloromycetin  (chloramphenicol,  Parke-Davis)  in  combination  with  ELASE  Oinlment. 


Elase- 


[fibrinolysin  and  desoxyribonuclease,  combined  (bovine),  Parke-DavisJ 


ELASE  (powder  for  solution)    ELASE  Ointment 
ELASE-CHLOROMYCETIN  Ointment 


INDICATIONS:  ELASE  is  indicated  for  topical 
use  as  a  debriding  agent  in  a  variety  of  inflamma- 
tory and  infected  lesions.  These  include  general 
surgical  wounds;  ulcerative  lesions,  abscesses, 
fistulae,  sinus  tracts;  second-  and  third-degree 
burns;  hematoma;  cervicitis;  vaginitis;  circum- 
cision and  episiotomy;  otorhinolaryngologic 
wounds.  ELASE-CHLOROMYCETIN  Ointment 
may  be  useful  in  the  topical  treatment  of  seriously 
infected  burns,  ulcers,  wounds,  cervicitis  and 
vaginitis  when  the  organisms  are  susceptible  to 
chloramphenicol  and  utilize  a  process  of  fibrin 
deposition  as  a  protective  device.  APPLICATION: 
General  Topical  Use— repeat  local  application  of 
ointment  or  solution  as  indicated  as  long  as 
enzymatic  action  is  desired,  since  enzymatic 
activity  becomes  progressively  less  after  applica- 


tion, and  is  probably  exhausted  for  practical  pur- 
poses at  the  end  of  24  hours.  Remove  necrotic 
debris  between  applications.  Intra-vaginal  Use- 
In  mild  to  moderate  vaginitis  and  cervicitis,  5  cc. 
of  ELASE  Ointment  should  be  deposited  deep  in 
the  vagina  once  nightly  at  bedtime  for  approx- 
imately 5  applications;  reexamine  to  determine 
possible  need  for  further  therapy.  PRECAU- 
TIONS: Observe  usual  precautions  against  aller- 
gic reactions,  particularly  in  persons  sensitive  to 
materials  of  bovine  origin,  antibiotics  or  thime- 
rosal  (a  preservative).  ELASE-CHLOROMYCETIN 
Ointment  should  be  used  only  for  serious  infec- 
tions caused  by  organisms  which  are  susceptible 
to  the  antibacterial  action  of  chloramphenicol. 
WARNINGS:  ELASE  should  not  be  used  paren- 
terally.  ELASE-CHLOROMYCETIN  Ointment 


should  not  be  used  as  a  prophylactic  agent  Chlor- 
amphenicol when  absorbed  systemically  from 
topical  application  may  have  toxic  effects  on  the 
hemopoietic  system.  Prolonged  use  may  lead  to 
an  overgrowth  of  non-susceptible  organisms  in- 
cluding fungi.  ADVERSE  REACTIONS:  Although 
deleterious  side  effects  have  not  been  a  problem, 
local  hyperemia  has  been  observed.  IF  ELASE- 
CHLOROMYCETIN  Ointment  is  used,  allergy  to 
the  chloramphenicol  portion  of  the  preparation 
may  show  itself  as  angioneurotic  edema  or  vesicu- 
lar and  maculopapular  types  of  dermatitis. 
SUPPLY:  ELASE  Ointment  in  30-gram  and  10- 
gram  tubes;  ELASE-CHLOROMYCETIN  Ointment 
in  30-gram  tubes;  V-Applicators  (disposable 
vaginal  applicators),  in  packages  of  6,  for  use  with 
rO-gram  tubes;  ELASE  is  supplied  dried  in 
Subber-diaphragm-capped  vials  of  30  cc. 

Detailed  information  available  on  request. 


PARKE-DAVIS 


PARKE,  DAVIS  (  COMPANY,  LTD.,  MONTREAL  379 


Next  Month 
in 

The 

Canadian 
Nurse 


•  Federal  Nursing  Consultants 
Revisited 

•  Rock  Festivals:  New  Problems 
and  New  Solutions 

•  Headaches  —  and 
Their  Management 


<^ 


Photo  Credit  for 
November  1971 


Miller  Photo  Services,  Toronto, 
cover  photo 

John  Evans  Photography  Ltd., 
Ottawa,  p.  9 

Mario  Lcitao,  Lisbon, 
Portugal,  p.  14 

Crombie  McNeill  Photography, 
Ottawa,  pp.  23,  24 

Toll  Studio,  Toronto,  p.  33 

Misericordia  Hospital,  Edmonton 
p.  36 


November  9-11, 1971 

Quebec  Operating  Room  Nurses  12th 
annual  convention,  Skyline  Hotel,  Mont- 
real, Quebec. 


November  15-16, 1971 

Clinical  evaluation  in  nursing,  sponsor- 
ed by  the  University  of  Toronto  School  of 
Nursing.  A  study  of  the  principles  of 
.clinical  evaluation  and  their  applica- 
tion in  the  development  and  use  of 
specific  evaluative  methods  in  nursing. 
Planned  primarily  for  teachers  in 
schools  of  nursing.  For  further  informa- 
tion write  to  Continuing  Education 
Program  for  Nurses,  University  of  To- 
ronto, 47  Queen's  Park  Crescent,  To- 
ronto 5,  Ontario. 

November  18-19, 1971 

Northwest  Territories  Hospital  Associa- 
tion, seventh  annual  meeting,  Fort 
Smith,  NWT. 

November  24-26, 1971 

Saskatchewan  Hospital  Association, 
annual  convention,  Saskatoon,  Sask. 

November  29-December  1, 1971 

Conference  for  senior  nurse  adminis- 
trators, sponsored  by  the  Registered 
Nurses'  Association  of  Ontario,  West- 
bury  Hotel.  Toronto.  For  further  infor- 
mation contact:  Professional  Develop- 
ment Department.  RNAO,  33  Price 
Street,  Toronto. 

November  29-December  3, 1971 

Nurse  educators'  course,  Canadian 
Emergency  Measures  College,  Arn- 
prior,  Ontario.  For  more  information 
write  to  the  provincial  director  of  emer- 
gency health  services,  department  of 
public  health,  in  your  province. 

December  1-3, 1971 

Annual  Manitoba  Health  Conference, 
Manitoba  Centennial  Centre,  Winnipeg, 
Manitoba.  Sponsored  by  the  Manitoba 
Hospital  Association,  Inc.  Twenty-five 
affiliated  organizations  are  participat- 
ing, including  the  Manitoba  Associa- 
tion of  Registered  Nurses. 

December  6-10, 1971 

Conference  for  head  nurses:  "Setting 
the  Pace,"  sponsored  by  the  Registered 
Nurses'  Association  of  Ontario,  Gene- 
va Park,  Ontario.  For  further  informa- 
tion contact:  Professional  Develop- 
ment Department,  RNAO,  33  Price 
Street,  Toronto. 


20     THE  CANADIAN   NURSE 


January  11-12, 1972 

Two-day  course  in  Gerontological 
Nursing  Practice,  presented  by  Dr.  Vir- 
ginia Stone,  Professor  of  Nursing, 
Duke  University,  Durham,  N.C..  Em- 
bassy Room,  Statler  Hilton  Hotel.  Buf- 
falo, N.Y.  Address  inquiries  to:  Con- 
tinuing Nursing  Education,  State  Uni- 
versity of  New  York  at  Buffalo,  Buffalo 
New  York.  U.S.A. 

January  24-28  &  March  20-24, 1972 

Two-week  course  for  Occupational 
Health  Nurses,  co-sponsored  by  the 
Occupational  Safety  and  Health  Train- 
ing Branch,  U.S.  Dept.  of  Health.  Edu- 
cation &  Welfare.  Address  inquiries  to: 
Continuing  Nursing  Education,  State 
University  of  New  York  at  Buffalo,  Buf- 
falo, N.Y. 


March  6-8, 1972 

Second  conference  on  the  use  of  audio- 
visual aids  sponsored  by  the  Registered 
Nurses'  Association  of  Ontario  and  the 
Nursing  Educational  Media  Association. 
The  program  is  open  to  teachers  of 
nursing  in  university,  diploma,  nursing 
assistant,  and  staff  development  pro- 
grams, public  health  and  other  register- 
ed nurses  in  health  teaching,  and  AV 
technicians  on  the  staff  of  schools  of 
nursing. 

April  19-21, 1972 

Regional  Workshop  on  Nursing  Re- 
search &  Nursing  Practice  presented 
by  the  School  of  Nursing,  University  of 
Calgary.  For  further  information  write 
to  Dr.  Shirley  R.  Good,  Director  and 
Professor,  School  of  Nursing,  Univer- 
sity of  Calgary,  Calgary,  Alberta. 

May  21-26, 1972 

Fourth  international  congress  of  social 
psychiatry  in  Jerusalem,  Israel.  Theme 
of  the  Congress  is  "Social  Change  and 
Social  Psychiatry."  For  more  informa- 
tion write  to  Ruth  Broza,  Organizing 
Committee,  Fourth  Congress  of  Social 
Psychiatry,  Ministry  of  Health,  King 
David  Street  20,  Jerusalem,  Israel. 

Summer  1972 

Carleton  Memorial  Hospital  School  of 
Nursing,  Woodstock,  New  Brunswick, 
established  in  1903,  will  graduate  its 
last  class  in  1972.  A  school  reunion  is 
planned.  Interested  graduates  may 
write  to:  Miss  Marjorie  M.  McLean, 
Alumnae  Planning  Committee,  Carle- 
ton  Memorial  Hospital,  Woodstock.      '& 

NOVEMBER   1971 


A  ward-winning 
combination 


With  Dermassage,  all  you  add  is  your  soft 
touch  to  win  the  praises  of  your  patients. 

Dermassage  foiins  an  invisible, 
greaseless  film  to  cushion  patients 
against  linens,  helping  to  prevent 
sheet  bums  and  irritation.  It  protects 
with  an  antibacterial  and  antifungal 
action.  Refreshes  and  deodorizes 
without  leaving  a  scent.  And  it's 
hypo-allergenic. 

Dermassage  leaves  layers 
of  welcome  comfort  on 
tender,  sheet-scratched       <  _ 
skin.  And  there's  another 
bonus  for  you:  While  ^ 

you're  soothing  patients 
with  Dermassage,  you're 
also  softening  and  ^ 

smoothing  your  hands. 

Try  Dermassage. 
Let  your  fingers 
do  the  talking. 


MEDICATED 


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lakeside  Laboratories  (CaL._ 

(>4  Colgate  Avenue/Ibronto  8.  Ontaric; 


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omfortable/economical/tiHie  saving/retelast 


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Available  in  9 

diflferent  sizes. 

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Demonstration  upon  reques 


The  Colonel 
is  a  lady 


and  a  nurse 


As  director  of  nursing  for  the  Canadian  Armed  Forces  Medical  Service, 
Lieutenant-Colonel  Mary  Joan  Fitzgerald  assumes  her  role  with  dignity,  good 
humor,  and  quiet  efficiency. 


Informal  hospitality  and  graciousness 
from  the  time  you  meet  her  until  you 
wave  a  cheery  "'see  you,"  after  a  leisure- 
ly lunch,  are  what  epitomize  Mary 
Joan  Fitzgerald  —  Lieutenant-Colonel 
M.J.  Fitzgerald. 

After  being  welcomed  by  the  deputy 
surgeon  general,  Brigadier  -  General 
W.G.  Leach,  to  whom  Colonel  Fitzger- 
ald reports,  you  realize  that  their  smooth 
working  relations  are  based  on  trust  and 
mutual  esteem,  laced  with  good  humor. 
A  little  banter,  a  few  direct  questions, 
and  the  General  leaves  you  to  a  morn- 
ing of  sheer  pleasure — an  interview 
with  the  director  of  nursing  for  Can- 
ada's armed  services. 

Colonel  Fitzgerald's  office  seems 
almost  aseptic,  with  its  white  walls, 
functional  and  austere  oak  furniture. 
A  few  green  plants  on  the  bookcase, 
and  a  colorful  semi-abstract  painted 
by  a  friend  add  a  personal  touch.  How- 
ever, dominating  the  room  is  a  portrait 
of  a  nursing  sister  painted  by  Lauren 
Harris  during  World  War  IL  In  nursing 
NOVEMBER  1971 


Liv-Ellen  Lockeberg 

uniform,  with  veil,  this  painting  lends 
quiet,  slightly  stern,  authority  to  the 
office  —  a  reminder  that  it  is  the  armed 
forces  that  Joan  Fitzgerald  serves. 

Officers  are  now  required  to  wear 
uniforms  only  once  a  week,  and  as  this 
is  not  the  day  for  her  directorate,  Colo- 
nel Fitzgerald  wears  a  beautifully  cut, 
softly  feminine  rose  dress. 

We  talk  of  work.  We  talk  of  vaca- 
tions. We  talk  of  personal  ambitions. 
And  we  drink  coffee. 

When  discussing  her  work,  Colonel 
Fitzgerald  is  enthusiastic,  and  to  explain 
her  own  functions  she  hands  me  her 
terms  of  reference,  an  imposing  and 
formidable  catalogue  of  two  typewritten 
pages. 

She  advises 

In  her  capacity  as  nursing  consultant, 
the  director  of  nursing  advises  on  mat- 
ters pertaining  to  nursing  care  and 
nursing  personnel  in  the  Canadian 
forces  medical  service.  This  includes 
advising  on  the  number  and  categories 


of  nursing  care  personnel  needed  for 
efficient  functioning  of  the  Canadian 
forces  medical  services  establishments. 
There  are  58  of  them,  in  large  centers 
and  small,  from  Massett  in  the  Queen 
Charlotte  Islands  off  the  coast  of  Brit- 
ish Columbia,  to  Lahr  in  Germany. 

Colonel  Fitzgerald  advises  on  public 
health  nursing  programs.  What  has 
public  health  to  do  with  the  armed 
services?  On  some  stations,  particularly 
the  overseas  ones,  families  of  forces 
personnel  are  looked  after  too,  and  as 
service  personnel  retire  at  an  early  age, 
the  people  served  are  relatively  young. 
A  population  that  includes  children  of 
all  ages  who  travel  a  great  deal,  or  who 
live  outside  Canada,  need  all  the  public 
health  measures  in  the  book. 

She  advises  on  nursing  care  of  mass 
casualties  and  on  the  procurement  of 


Miss  Lockeberg  is  an  Assistant  Kditor  of  The 
Caiuicliiin  Nurse.  Ottawa,  Ontario. 

THE  CANApiAN  NURSE     23 


nursing  personnel  in  an  emergency. 
Tiiis  requires  practical  imagination  in 
an  area  where  predictions  are  less  than 
certain. 

In  addition,  she  must  be  a  super 
public  relations  officer  who  advises  on 
publicity  for  the  nursing  branch  of  the 
Canadian  forces  medical  service.  This 
includes  exhibits,  news  releases,  radio 
and  television  interviews,  and  recruiting 
brochures  seeking  "that  special  kind  of 
nurse"  who  is  expected  to  be  a  nurse 
and  an  officer  at  the  same  time. 

She  recommends 

Colonel  Fitzgerald  recommends 
career  policies,  recruitment  policies 
and  procedures.  This  includes  assisting 
with  placement  programs  for  nursing 
officers. 

She  proposes  policies  and  action 
to  improve  nursing  care  practices. 
Where  there  are  implications  for  nurs- 
ing care,  she  makes  recommendations 
on  medical  treatment  policies  and 
practices. 

She  suggests  textbooks  on  nursing 
care  and  relevant  literature  for  units 
of  the  Canadian  forces  medical  service. 

Uniforms  and  dress  regulations  for 
nursing  personnel  come  within  her 
sphere  of  influence.  Indeed,  at  the  time 
of  integration  of  the  forces,  Lieutenant- 
Colonel  Fitzgerald  and  her  predeces- 
sor. Lieutenant -Colonel  H.J.T.  Sloan 
(known  affectionately  as  Hallie  Sloan 
at  CNA  House,  where  she  has  worked 
as  nursing  coordinator  since  retirement 
from  the  forces)  had  already  made 
headway  in  achieving  a  more  feminine 
and  attractive  uniform  for  female  nurs- 
ing officers.  No  longer  does  the  jacket 
have  sharply  squared  mannish  should- 
ers, nor  does  the  shirt  require  the 
starched  collar  with  knotted  tie.  "The 
becoming  new  shade  of  green  may 
have  lent  itself  to  these  and  other  subtle 
changes,"  says  Colonel  litzgcrald. 

She  does  other  things  too 

The  chief  nursing  officer  evaluates 
equipment  used  for  nursing  care.  Her 
recommendations  for  its  retention  or 
replacement  with  newer,  more  efficient, 
equipment  are  reflected  in  the  constantly 
updated  supply  catalogue. 

She  interprets  policy  for  nursing 
personnel.  She  inspects,  supervises, 
and  advises  on  nursing  care  procedures 
and  nursing  services  management.  She 
interviews  nursing  personnel.  Colonel 
Fitzgerald's  comment,  "traveling  to 
accomplish  this  takes  about  50  percent 
of  my  time,"  is  credible  when  you 
24     THE  CANADIAN  NURSE 


realize  that  she  visits  all  the  58  Cana- 
dian forces  medical  service  installations 
where  nurses  work. 

Further,  she  lectures  on  military 
nursing  procedures  and  nursing  admin- 
istration in  the  Canadian  forces  med- 
ical service,  and  she  takes  time  to  inter- 
view all  newly-enrolled  nursing  officers 
during  their  orientation  training. 

As  her  own  liaison  officer,  she  is  in 
close  touch  with  nursing  consultants 
in  the  department  of  national  health 
and  welfare,  the  chief  nursing  officer  of 


St.  John  Ambulance,  the  Canadian 
Nurses"  Association,  and  other  nurs- 
ing organizations. 

All  this  sounds  like  "thinking"  and 
"acting"  work,  and  that  may  explain 
why  Colonel  Fitzgerald's  desk  is  almost 
clear  of  paper  —  or  perhaps  it's  just 
her  many  years  in  the  services  that  have 
taught  her  to  eliminate  what  is  extra- 
neous. However,  she  does  make  reports 
on  what  she  observes,  and  these  form 
the  basis  for  her  recommendations  on 
policy  and  for  action  to  improve  nurs- 


Colonel  Fitzgerald's  office  seems  almost  aseptic,  with  its  white  walls,  functional 
and  austere  oak  furniture.  However,  mi4ch  of  her  time  is  spent  away  from  the 
office  as  she  visits  the  58  medical  service  stations  where  nurses  work. 

NOVEMBER   1971 


ing  care  practices.  She  also  conducts 
the  correspondence  necessary  for  a 
smooth  flowing  operation. 

She  assists  the  senior  women  officers 
of  the  Canadian  forces  with  planning 
for  administrative  arrangements  and 
welfare  of  women  personnel. 

All  this  packed  into  a  petite  lady 
colonel  whose  voice  is  all  music  and 
whose  eyes  still  have  that  look  of  won- 
derment. 

Personal  development 

But  how  has  this  charming  lady 
become  director  of  nursing  in  Canada's 
armed  forces? 

Joan  Fitzgerald  was  a  nursing  student 
at  the  Halifax  Infirmary  early  in  World 
War  11.  What.  then,  could  be  more  fit- 
ting than  to  join  the  army  as  a  nurse? 
She  stayed  with  the  Royal  Canadian 
Army  Medical  Corps  from  1942  until 
war's  end,  serving  in  the  United  King- 
dom, Italy,  and  Belgium. 

On  discharge,  she  attended  the  Uni- 
versity of  Ottawa.  "I  was  in  a  class  of 
13,"  she  said,  "where  I  received  an 
excellent  grounding  in  public  health 
nursing.  By  the  time  I  had  graduated  in 
the  spring  of  1 948,  the  A  ir  Force  needed 
public  health  nurses  to  train  medical 
assistants."  She  then  joined  the  RCAF, 
becoming  an  instructor  in  Ottawa. 

This  led  to  a  "sabbatical"  year  of 
high  and  dangerous  adventure  during 
the  worst  days  of  the  Korean  war.  Nurs- 
ing Sister  Fitzgerald  became  the  first 
of  10  Canadian  nurses  to  be  engaged  in 
ferry  duty  for  patients  from  Korea. 
Attached  to  the  United  States  Air  Force 
and  based  in  Hawaii,  her  tour  of  duty 
was  from  Japan  to  Hawaii  and  on  to 
San  Francisco,  working  with  American 
evacuation  crews. 

In  1954,  it  was  back  to  school  once 
more  for  Joan  Fitzgerald,  to  study  nurs- 
ing administration  at  the  University  of 
Toronto  School  of  Nursing.  "Again, 
there  were  13  in  my  class,"  she  said. 
"As  I  was  on  salaried  educational  leave 
from  the  Department  of  National  De- 
fence, I  was  required  to  serve  a  further 
five  years  with  the  forces  —  no  problem 
there  though,  as  I  had  long  ago  decided 
to  make  military  nursing  my  career." 

So,  after  a  few  years  as  nursing  serv- 
ice staff  officer  in  Ottawa,  promotions 
followed  in  rapid  succession.  First, 
regional  matron  in  St.  Hubert,  Quebec, 
then  director  ofnursing  of  the  Canadian 
Forces  Hospital  at  Kingston  before 
returning  to  Ottawa  as  nursing  service 
staff  officer  in  the  Surgeon  General's 
office.  On  the  retirement  of  Lieutenant- 
Colonel  Sloan  in  January,  1968,  Joan 
NOVEMBER   1971 


Fitzgerald  was  appointed  matron-in- 
chief  of  the  Canadian  Forces  Medical 
Service  at  headquarters  in  Ottawa, 
with  the  rank  of  Lieutenant-Colonel. 
Her  title  has  been  changed  to  director 
of  nursing,  although  she  still  refers  to 
herself  as  Nursing  Sister  Fitzgerald. 

Military  nursing 

Generally,  nurses  with  two  years' 
experience  are  invited  to  apply  as 
nurses  for  the  armed  forces.  Beginning 
as  lieutenants,  with  lieutenant's  pay, 
they  progress  to  the  rank  of  captain 
in  four  years.  At  present  13  of  the  400 
nursing  officers  are  ranked  above  cap- 
tain. Twelve  of  them  are  majors,  with 
administrative  responsibilities  as  hos- 
pital or  command  matron.  One  excep- 
tion is  Major  Jessie  Urquhart  who,  as 
nursing  career  manager,  is  based  in 
Ottawa. 

Since  1967,  men  have  also  been 
recruited  as  nursing  officers. 

The  nursing  service  offers  several 
specialties:  public  health  and  nursing 
education,  both  with  inherent  teaching 
elements;  nursing  administration;  psy- 
chiatric nursing;  intensive  care;  operat- 
ing room  nursing;  flight  nursing;  and 
field  nursing. 

After  five  weeks  at  Camp  Borden 
to  learn  military  organization  and  the 
difference  between  military  and  civilian 
nursing,  nursing  officers  are  ready  for 
posting.  However,  education  is  an  on- 
going fact  in  the  forces.  As  many  nurs- 
ing officers  as  possible  are  given  courses 
in  air  medical  evacuation  nursing,  a 
three-week  course  at  Trenton  designed 
to  care  for  patients  in  preparation  for, 
during,  and  after  flights.  Many  nurses 
are  granted  leave  to  continue  university 
education,  but  this  is  contingent  on 
continuing  with  the  military  service 
for  a  further  five  years. 

There  is  a  large  turnover  in  the  first 
two  years,  usually  due  to  marriage  — 
often  to  personnel  at  the  military  estab- 
lishment. Colonel  Fitzgerald  says,  "The 
short  working  life  of  many  young  nurs- 
ing officers  is  not  disturbing.  They  make 
good  servicemen's  wives  and  form  a 
ready  pool  of  nursing  skills,  as  civilian 
nurses  are  in  demand  in  many  military 
hospitals.  Because  of  this  high  attrition 
rate,  nursing  officers  tend  to  be  young 
—  half  are  under  25  years  of  age,  and 
only  one-third  arc  over  30." 

Officers  are  posted  where  they  are 
needed,  although,  in  some  cases,  a 
nurse's  preference  may  be  granted. 
They  have  an  unparalleled  opportunity 
to  get  to  know  Canada,  and  to  know 
those  areas  that  are  off  the  usual  tourist 


lanes.  Colonel  Fitzgerald  says,  "I  revel 
in  my  own  opportunity  for  travel  and 
encourage  new  recruits  to  get  to  know 
the  areas  surrounding  bases  or  posts  at 
which  they  are  stationed.  I  have  found 
this  to  be  a  most  rewarding  bonus  during 
my  own  career." 

As  mentioned  earlier,  there  are  about 
400  nursing  officers.  In  addition,  about 
150  civilian  nurses  are  on  staff  as  civil 
servants,  and  paid  salaries  as  such. 
Also,  about  1,500  medical  assistants 
(men)  and  nursing  assistants  (women) 
are  attached  to  the  services,  all  trained 
after  joining  the  service  by  the  nursing 
officers.  Colonel  Fitzgerald  regrets  that 
although  their  training  and  experience 
is  second  to  none  in  the  land,  their  lack 
of  formal  preparation  in  obstetrics, 
geriatrics,  and  pediatrics  does  not  allow 
them  to  qual  ify  as  equivalent  employees 
on  "civvy  street"  without  further  train- 
ing. 

Colonel  Fitzgerald,  private  citizen 

Finally,  we  talk  of  personal  things 

—  vacations,  preferences,  small  talk. 
Although  Lieutenant-Colonel  Fitz- 
gerald always  travels  in  uniform,  she 
sheds  her  official  self  once  she  is  on 
vacation.  Then  she  finds  the  time  to 
pursue  her  hobbies. 

She  is  an  ardent  gardener.  She  plays 
a  good  hand  of  bridge.  A  quiet  evening 

—  of  which  there  are  too  few  —  may 
find  her  reading  for  pleasure. 

Swimming  is  something  else  again. 
It  is  part  of  her  life  style,  for  she 
swims  almost  daily  —  even  throughout 
the  winter,  when  Ottawa's  sub-zero 
weather  could  afford  an  excuse  to  stay 
home. 

When  the  time  arrives  for  Mary  Joan 
Fitzgerald  to  become  a  civilian  once 
again,  she  will  bring  many  personal 
gifts  beyond  work  experience  to  her 
next  career,  geriatric  nursing.  Patients 
will  benefit  richly  from  her  quiet  effi- 
cient manner,  her  warm  kindliness, 
and  her  becoming  modesty.  w 


THE  CANM)IAN   NURSE     25 


)   HOW  TO    ) 

MAKE 

A  FILM 


~% 


,   \NVOUR 
^     SPARt   M 


With  a  little  help  from  your  friends,  a  lot  of  ingenuity,  and  a  sense  of  humor, 
you  can  join  the  growing  number  of  film-making  enthusiasts.  So  say  Doris 
McDonald  and  Lyse  de  Varennes,  two  young  Montreal  nurses  who  made  two 
films,  one  of  which  has  won  international  acclaim. 


Low-budget,  independent  film-making 
is  attracting  a  variety  of  people  who 
share  a  sense  of  adventure  and  a  willing- 
ness to  experiment  and  to  improvise. 

Lyse  de  Varennes  and  Doris  Mc- 
Donald, neurosurgical  nurses  at  the 
Charles-Lemoyne  Hospital  in  Green- 
field Park,  a  suburb  of  Montreal,  are 
two  such  people.  During  the  past  year 
and  a  half,  they  combined  their  talents 
and  their  ideas  to  make  two  films  on 
neurosurgical  nursing. 

The  idea  of  making  a  film  first  came 
to  them  when  they  were  asked  to  pre- 
pare a  paper  for  the  April  1971  Con- 
gress of  the  American  Association  of 
Neurosurgical  Nurses  in  Houston, 
Texas.  They  hoped  that  a  film  would 
communicate  some  of  their  ideas  on 
neurosurgical  nursing  in  an  interesting 
and  effective  manner.  The  fact  that 
neither  of  them  had  any  previous  expe- 
rience in  film-making  did  not  deter 
them  from  jumping  in  feet  first.  They 
both  laughingly  admit  that  they  really 
didn't  know  what  they  were  getting 
into  when  they  first  started  the  project 
in  September  1970. 

Help  from  different  sources 

Lyse  and  Doris  are  quick  to  point 
out  that  their  12-minute,  16mm  color 
film  could  not  have  been  produced  with- 

Mrs.  Brydges,  an  editorial  assistant  at 
The  Canadian  Nurse  for  the  past  two 
summers,  is  a  fourth-year  arts  student  at 
Carleton  University  in  Ottawa. 


out  the  help  and  cooperation  of  the 
staff  at  the  Charles-Lemoyne  Hospital. 
They  used  a  16mm  Bell-Howell  movie 
camera  borrowed  from  a  doctor.  Light- 
ing equipment  consisted  of  12  spot- 
lights; 6  belonged  to  Doris  and  the 
others  were  donated  by  a  nurse  in  the 
recovery  room. 

The  actual  shooting  of  the  film  was 
done  by  a  professional  photographer, 
and  the  cost  of  hiring  this  man  and 
paying  for  the  film  he  used  were  the 
greatest  expenses  they  encountered. 

The  two  nurses  were  also  fortunate 
to  find  a  patient  willing  to  cooperate 
in  their  film-making  venture.  This 
woman  was  being  operated  on  for  liga- 
tion of  an  intracerebral  angioma.  They 
decided  to  focus  their  film  on  the  post- 
operative care  of  this  patient,  and  they 
called  it  The  postoperative  care  of  an 
intracerebral  angioma. 

I 
Learning  by  doing 

As  in  any  "learning  by  doing"  situa- 
tion, Lyse  and  Doris  experienced  many 
problems  and  frustrations.  For  example, 
they  had  to  reshoot  several  scenes,  and 
this  often  meant  calling  the  patient  back 
and  having  her  repeat  a  certain  phase  of 
her  rehabilitation  in  physiotherapy, 
inhalation  therapy,  or  ergotherapy. 
Once  they  even  had  to  ask  the  patient 
to  return  to  the  hospital  so  they  could 
shoot  a  scene  again. 

The  reasons  for  these  delays  were 
varied.  They  had  to  make  the  film  on 
their  own  free  time  and  on  a  limited 


budget.  The  cameraman,  who  was  inex- 
perienced in  using  1 6mm  cameras,  used 
the  wrong  lens  in  some  scenes  or  siiot 
them  from  the  wrong  angle.  This  meant 
wasting  much  of  the  film.  Out  of  1 ,000 
feet  of  film  they  could  use  only  450  feet. 

The  many  problems  encountered  in 
making  the  film  were  outweighed  by 
the  spirit  of  adventure  and  coopera- 
tion of  everyone  involved  in  the  project 
—  doctors,  nurses,  and  therapists.  The 
patient  had  a  cheerful  and  optimistic 
attitude  that  made  delays  and  frustra- 
tions easier  to  accept.  She  inspired  the 
theme  song  of  the  film,  "Que  cest  beau 
la  vie,"  which  seemed  to  capture  the 
mood  of  the  film  and  of  the  people 
making  it. 

The  two  nurses  narrated  their  film 
in  English  and  in  French  when  it  was 
shown  in  Houston.  Since  they  could 
not  afford  to  have  the  sound  synchro- 
nized —  a  costly  process —  they  simply 
taped  their  comments  and  then  played 
them  at  the  appropriate  moments.  The 
music  was  done  in  the  same  manner. 
This  method  proved  to  be  a  difficult 
one  and  the  results  were  less  than  satis- 
factory. Now  this  film  has  sound  syn- 
chronization in  French. 

Next  stop  Prague 

Despite  their  numerous  difficulties, 
both  nurses  were  pleased,  and  a  little 
surprised,  at  the  excellent  results  of 
their  first  film.  Consequently,  they  had 
little  hesitation  when  Doris,  secretary 
of  the   World   Federation  of  Neuro- 


surgical Nurses,  was  asked  to  present 
a  paper  at  the  IV  European  Congress 
of  Neurosurgery  in  Prague,  Czechos- 
lovakia, in  July  1971.  Another  film 
was  definitely  in  order. 

The  subject  of  the  second  film  was 
the  pre-  and  postoperative  care  of  a 
patient  with  an  anterior  cervical  graft 
(C-1,  C-2  Cloward).  Produced  and 
directed  by  Doris,  the  film  demonstrated 
the  medical  procedures  involved  in  this 
operation  and  it  showed  the  nursing 
care  of  the  patient  during  his  stay  L' 
the  hospital. 

Their  first  film-making  venture 
taught  the  two  nurses  several  valuable 
lessons.  The  second  film  had  sound 
synchronization.  This  was  possible  only 
because  of  financial  assistance  from 
a  friend. 

Because  of  the  cost  of  making  a 
film,  both  Lyse  and  Doris  agree  that 
their  next  film  will  have  financial  back- 
ing, possibly  from  a  drug  company 
whose  products  are  mentioned  as  part 
of  a  patient's  treatment.  Their  first 
film  cost  close  to  S600,  and  they  think 
this  expense  may  be  a  prohibitive  factor 
in  a  nurse's  decision  to  make  a  film. 

But  the  enthusiastic  reactions  to 
their  film  in  Houston  and  to  Doris's 
film  in  Prague  made  up  for  prob- 
lems and  high  costs  involved  in  making 
them.  A  third  film  is  already  in  the 
planning  stages,  and  it  is  safe  to  assume 
that  it  will  be  even  more  successful 
than  the  first  two.  ^ 


27 


Wanted:  ATHEORY  OF  NURSING 


Joan  Foley,  Dip.  N.  Admin.,  F.C.N.A. 


If  the  title  of  this  paper  were  posted  as 
an  advertisement,  I  am  afraid  a  common 
response  would  be:  "Wanted  by  whom? 
I'm  a  practical  person  —  /  don't  want 
any  theories!"  Theory,  in  many  circles, 
is  a  nasty  word,  usually  associated  with 
terms  like  "woolly-minded"  and 
"impractical."  In  fact,  there  is  a  wide- 
spread tendency  to  set  theory  and  prac- 
tice against  each  other,  implying  that 
a  theorist  is  not  practical  and  a  practi- 
tioner does  not  bother  her  head  with 
theory.  This  is  not  exclusive  to  nursing, 
but  it  is  widely  evident.  In  her  analysis 
of  the  myths  underlying  the  nursing 
profession  in  Britain,  ^  Reinkemeyer 
quotes  the  following  as  two  of  the 
commonest: 

"Nursing    is    practical.    Nursing    must    be 

practical,  not  theoretical" 

and 

"Nursing  can   be   taught   and    learned   only 

on  thejob. " 

Myths  like  these  are  held  at  least  as 
widely  in  Australia  as  they  are  in  Brit- 
ain; and  that,  so  long  as  they  are  held, 
theory  will  be  viewed  at  best  with  sus- 
picion, and  more  probably  with  outright 
hostility. 

There  are  also,  of  course,  widespread 
myths  about  theory.  For  people  who 
claim  to  have  little  time  for  theory,  our 
acquaintances  are  curiously  fond  of 
beginning  statements  with  "I  have  a 
28     THE  CANADIAN  NURSE 


theory  that .  .  .",  when  they  really  mean 
"I  guess  that  .  .  .■",  or  "I  have  a  hunch 
that .  .  .",  or  even  "I  wish  that ..."  A 
guess,  or  a  hunch,  or  a  wishful  day- 
dream, is  not  a  theory.  To  say  that 
world  conflict  would  cease  if  all  men 
spoke  the  same  language  is  not  to  state 
a  theory;  it  is  to  express  a  pious  hope. 
It  might  be  true;  but  there  is  no  evidence 
even  to  suggest  the  possibility  that  it 
might. 

What  is  a  theory? 

A  theory  is  not  a  set  of  rules  for  doing 
something.  You  may  know  from  trial 
and  error  that  a  sharp  kick  will  set  your 
television  set  working;  but  this  is  not  a 
theory  that  effective  television  is  related 
to  the  kicking  power  of  the  viewer.  You 
may  be  a  fine  gardener  without  develop- 
ing any  theory  of  growth  or  soil  man- 
agement. 

And  to  return  to  my  opening,  a  theory 
is  not  a  substitute  for  reality,  an  escape 


Miss  Foley,  Assistant  to  the  Advisor  in 
Nursing.  Department  of  Health.  Queens- 
land, Australia,  presented  this  paper  at 
the  twenty-first  annual  meeting  of  the 
College  of  Nursing,  Australia,  in  1970. 
1  his  article  is  reprinted,  with  permission, 
from  the  lincnicilioniil  \iii:siiii;  Review. 
vol.  18.  no.  2.  1971. 


from  the  hard  facts  of  "the  real  world 
out  there."  A  real  theorist  is  intensely 
and  effectively  involved  in  practical 
life.  In  the  world  of  discovery  and 
change  in  which  we  are  living,  the 
discoveries  which  touch  our  lives  most 
closely  and  make  the  most  difference 
to  its  quality  are  not  those  which  have 
come  from  random  trial  and  error  work- 
ing, but  those  which  have  been  predicted 
by  theorists  and  verified  in  practice. 
Progress,  in  fact,  comes  mainly  from 
developing  a  theory  and  then  finding 
ways  of  making  it  work;  and  as  Kurt 
Lewin  once  said,  there  is  nothing  so 
practical  as  a  good  theory. 

There  are  many  things  a  theory  is 
not.  We  must,  however,  look  rather  at 
what  a  theory  is.  Both  sides  are  well 
discussed  by  Daniel  H.  Griffiths,^  and 
he  gives  one  of  the  best  short  definitions 
of  what  a  theory  is: 

"...  essentially  a  set  of  assumptions 
from  which  a  set  of  empirical  laws 
(principles)  may  be  derived."  ^ 

Griffiths  also  outlines  the  value  of  a 
theory  to  the  practitioner  by  listing  the 
uses  of  theory^: 

1 .  A  theory  is  a  guide  to  action  as  it 
enables  a  practitioner  to  determine  the 
consequences  of  action  and  so  to  predict 
results. 

2.  A  theory  guides  the  collection  of 
facts  by  providing  a  framework  to  help 

NOVEMBER  1971 


the  practitioner  assemble,  from  the 
great  body  of  facts  available,  those 
which  are  relevant  to  the  task  in  hand. 

3.  Theory  is  a  guide  to  new  know- 
ledge; it  shows  the  seeker  where  to  di- 
rect his  search  and  lifts  his  thinking 
above  the  level  of  trial  and  error. 

4.  Finally,  theory  helps  to  explain, 
not  only  the  processes,  but  the  very 
nature  of  the  activity  with  which  it  is 
connected. 

If  we  accept  theory  as  a  guide  to 
action,  and  so  admit  its  practical  value, 
it  is  then  necessary  to  consider  what  is 
involved  in  developing  a  theory.  The 
process  may  be  described  as  a  series  of 
steps: 

\.  Available  data  are  collected,  as- 
sembled, and  examined. 
_  2.  Assumptions  are  made  about  the 
data,  to  explain  why  they  are  as  they 
are. 

3.  The  assumptions  are  tested  by 
application  in  practical  situations  de- 
signed as  experiments;  that  is,  the 
assumptions  are  verified  empirically. 

4.  When  the  assumptions  have  been 
verified  as  fully  as  possible,  they  are 
then  used  to  derive  laws  or  principles, 
and  from  these  are  developed  practical 
applications. 

Physicists,  for  example,  seek  to  ex- 
plain the  nature  and  behaviour  of 
matter.  They  assume  that  matter  is  made 
up  of  particles  and  sub-particles,  which 
behave  in  certain  observable  ways.  They 
must  assume  this,  since  no  one  has  ever 
seen  an  atom,  much  less  an  electron, 
a  neutron,  or  a  quark.  And,  having  as- 
sumed the  existence  of  these  particles 
and  sub-particles,  they  devise  sophisti- 
cated pieces  of  equipment  in  which 
the  behaviour  of  particles  can  be  ob- 
served. They  note  that  the  behaviour 
can  be  explained  by  the  assumptions 
they  have  made.  Maybe  the  explana- 
tions are  not  complete,  and  then  the 
investigators  make  further  assumptions, 
taking  in  more  facts  until  they  are  sure 
beyond  all  reasonable  doubt  of  their 
findings.  These  findings  are  then  incor- 
porated in  a  theory  of  matter. 

The  process  does  not,  of  course, 
NOVEMBER   1971 


always  yield  a  valid  theory.  If  the  data 
reveal  that  the  consumption  of  whisky 
and  soda,  gin  and  soda,  or  brandy  and 
soda  in  large  quantities  leads  to  intoxi- 
cation, it  would  be  very  poor  theorizing 
to  make  the  assumption  that  soda  water 
is  responsible  for  intoxication.  A  more 
serious  example  is  the  famous  "phlogis- 
ton theory"  of  combustion  which  was 
put  forward  in  the  seventeenth  century. 
Finding  that  the  collected  products  of 
combustion  always  weighed  more  than 
the  original  matter  burnt,  two  chemists 
assumed  that  combustible  matter  con- 
tained a  part,  which  they  called  phlo- 
giston, which  weighed  less  than  nothing, 
so  that  when  it  was  released  the  matter 
gained  weight.  It  was  not  till  Lavoisier 
discovered  oxygen  and  its  share  in 
combustion  that  the  phlogiston  theory 
was  discredited. 

Does  this  mean  that  theory-building 
which  leads  to  theories  which  can  be 
discredited  is  useless?  Not,  I  think,  if 
it  is  done  with  a  serious  intent  to  make 
the  best  use,  at  the  time,  of  the  data 
available.  The  phlogiston  theory  con- 
tained a  rank  improbability  which  acted 
as  a  challenge  to  other  chemists  until, 
by  inventing  better  tools  and  methods 
of  research,  they  were  able  to  eliminate 
it  from  the  theory  underlying  the  pro- 
cess of  combustion. 

Theory  and  nursing 

Having  examined  briefly  the  nature 
and  uses  of  theory,  let  us  look  again  at 
the  title  of  the  paper.  It  has  two  mean- 
ings, both  of  which  are  valid.  First,  it 
can  mean  that  a  theory  is  wanted  where 
none  exists.  This  is  the  meaning  which 
would  apply  when  dealing  with  "pract- 
icalists" — people  who  claim  to  be 
indifferent  or  hostile  to  theory.  At  least 
it  would  seem  so,  except  for  one  thing: 
these  "practicalists,"  if  they  are  success- 
ful practitioners,  rarely  if  ever  work 
without  some  theory,  whether  they  know 
it  or  not,  and  however  violently  they 
deny  it.  Any  successful  human  practice 
where  skill  and  knowledge  are  involved 
is  based  on  at  least  an  implicit  theory. 

The  second   meaning  of  my   title, 


and  the  one  I  wish  to  use,  is  that  an 
adequate  theory  is  needed  to  replace 
present  inadequate  attempts  at  theory. 
I  should  like  therefore  to  examine  some 
of  the  attempts  at  a  nursing  theory 
which  have  been  made. 

Some  of  these  are  briefly  but  power- 
fully discussed  by  Muriel  Uprichard, 
who  calls  them  "images  of  the  nurse" 
and  regards  them  as  "the  first  deterrents 
to  development  of  a  modern  image  of 
the  nurse  as  professional  woman. "^The 
three  images  she  identifies  are  the 
mother,  or  folk,  image;  the  saint,  or 
religious,  image;  and  the  servant  image. 
I  see  each  of  these  as  founded  on  as- 
sumptions about  nursing,  and  therefore 
attempts  at  theory  building. 

The  folk  image  is  the  image  of  the 
nurse  as  a  substitute  mother,  giving  her 
patients  the  same  care  and  consideration 
as  a  mother  gives  her  children.  What 
theoretical  assumptions  seem  to  underlie 
this? 

F  irst  would  seem  to  be  the  assumption 
that  nursing  care  and  mother  love  are 
the  same  or  very  similar  phenomena. 
This  leads  to  the  further  assumption 
that  success  in  nursing  will  come  from 
either  recruiting  motherly  nurses  or 
teaching  recruits  to  be  as  motherly  as 
possible. 

These  assumptions  should  be  tested. 
First,  is  there  a  relation  between  moth- 
erliness  and  nursing  which  differs  from 
the  relation  between  motherliness  and 
other  situations  where  a  woman  is 
responsible  for  the  care  of  the  weak, 
the  helpless,  or  the  unfortunate?  I  doubt 
whether  such  a  special  relation  could  be 
shown  to  exist.  Second,  has  it  ever  been 
shown  by  any  form  of  research  that 
nursing  calls  for  such  a  special  relation? 
And  has  such  a  relation,  if  it  has  been 
shown  (which  I  doubt)  been  used  as 
the  basis  for  either  recruitment  or  train- 
ing of  nurses?  The  truth,  1  suspect,  is 
that  this  assumption  is  based  on  no 
more  than  a  vague  feeling  that  the 
quality  of  motherliness  should  be  a 
characteristic  of  a  good  nurse.  This,  I 
submit,  is  an  inadequate  basis  on  which 
to  erect  a  theory. 

THE  CANADIAN  NURSE     29 


Uprichard's  second  image,  the 
"saint"  or  "religious"  image,  I  should 
prefer  to  call  the  image  of  dedication. 
Its  origin  in  the  religious  life  of  past 
centuries  justifies  her  term;  but  today, 
with  the  growth  of  secular  nursing,  1 
suggest  that  one  can  see  an  attitude  of 
dedication  among  nurses  whose  pro- 
fessional life  has  little  to  do  with  any 
religious  institution.  But  whetherservice 
is  dedicated  to  the  greater  glory  of  God 
or  to  the  service  of  humanity,  the  image 
is  recognizable.  This  leads  to  an  as- 
sumption that  the  success  of  the  true 
nurse  is  related  to  the  degree  of  dedica- 
tion she  brings  to  her  profession.  In  a 
sense  this  is  profoundly  true.  However, 
it  is  accompanied  by  other  assumptions 
which  cry  out  for  testing.  One  such 
assumption  is  that  the  dedicated  nurse 
brings  to  her  profession  a  special  kind 
of  dedication.  It  differs,  for  example, 
from  a  teacher's  dedication,  or  that 
of  a  librarian,  a  secretary,  a  sales- 
woman, or  even  a  religious  whose  pro- 
fession is  not  nursing.  Another  assump- 
tion is  that,  even  if  the  kind  of  dedica- 
tion is  not  different,  nursing  requires 
it  in  a  special  quantity.  And  a  third  is 
that  dedication  is  a  substitute  for  the 
other  satisfactions  which  may  be  gained 
from  the  practice  of  a  profession. 

I  suggest  that  none  of  these  assump- 
tions would  stand  rigorous  testing,  espe- 
cially the  first  two,  which  do  not  seem 
capable  of  testing.  The  third  is  more 
subtle.  It  is  true  that  dedication  to  one's 
profession  is  a  powerful  source  of  satis- 
faction, and  a  completely  valid  one.  But 
it  is  unwise  to  assume  further,  as  is 
often  done,  that  other  satisfactions  are 
either  less  important  or  less  worthy,  or 
even  that  it  is  normal  human  behaviour 
to  close  one's  life  entirely  to  other  satis- 
factions, such  as  the  approval  of  one's 
professional  colleagues,  self-fulfilment 
outside  the  profession,  or  adequate 
material  recompense.  Indeed,  there  is 
more  evidence  that  true  dedication  to  a 
profession  is  accompanied  by  a  rich, 
full,  and  varied  life  surrounding  it. 
When  professional  dedication  is  played 
up  at  the  expense  of  other  legitimate 
satisfactions,  this  theory  becomes  dan- 
30     THE  CANADIAN  NURSE 


gerously  close  to  a  theory  based  on 
exploitation  of  the  individual. 

Uprichard's  final  image,  the  servant 
image,  is  probably  the  most  widely  held 
in  many  parts  of  the  world,  and  is  not 
unfamiliar  in  our  own.  This  image 
depicts  the  nurse  as  docile,  unquestion- 
ing, and  hard-working.  The  underlying 
assumption  seems  to  be  that  successful 
nursing  depends  on  finding  docile 
recruits,  educating  them  under  strict 
discipline,  and  insisting  on  unquestion- 
ing obedience  to  predetermined  rou- 
tines. Or,  in  the  words  once  offered  to 
men  in  search  of  wives:  '"Catch  "em 
young,  treat  'em  rough,  and  tell  "em 
nothing!"" 

Do  I  hear  someone  asking  what's 
wrong  with  that  theory? 

What  is  wrong  with  it?  In  the  first 
place,  it  is  based  on  a  theory  of  social 
class  which  is  almost  extinct.  In  the 
second,  it  is  violently  contradicted  by  all 
recent  study  of  human  behaviour.  It 
arose  in  days  when  nursing  recruits 
came  from  a  social  class  accustomed  to 
■'keep  its  place"  and  obey  its  ■'betters.""8 
And  it  makes  certain  assumptions  about 
human  behaviour  which  are  being 
discredited  more  and  more.  The  as- 
sumptions underlying  it  have  never 
been  tested  or  even  examined.  In  fact, 
the  real  assumption  seems  to  me  to  be 
related  not  to  nursing  success,  but  to 
administrative  convenience;  it  is  easier 
to  run  an  organization  with  a  docile 
staff  than  with  a  lively  and  critical  one. 

In  all  the  theories  based  on  Upri- 
chard's "images,"  something  vitally 
important  has  been  omitted;  they  look 
at  only  half  the  question.  This  is  under- 
standable, because  the  other  half  has 
only  recently  come  under  scrutiny.  But, 
if  we  are  to  develop  a  theory  of  nursing 
which  will  lead  to  better  nursing,  nurs- 
ing education,  or  nursing  administra- 
tion, we  shall  neglect  it  at  our  peril.  It 
has  been  called  by  McGregor  "the 
human  side  of  enterprise."" 

Nursing,  in  most  cases,  takes  place 
in  organizations.  In  order  to  under- 
stand the  effects  of  organizational  life 
on  the  people  involved,  it  is  necessary 
to  know  the  purposes  of  organizations. 


These  have  been  described  in  many 
ways3  but  can  be  reduced  to  two:  goal 
achievement  and  group  maintenance. 
Putting  it  simply,  an  organization  must 
do  two  things:  achieve  a  goal,  such  as 
healing  the  sick,  making  a  profit,  or 
winning  football  matches;  and  keep 
itself  in  existence,  since  an  organization 
which  ceases  to  exist  cannot  achieve 
its  goals — you  can't  win  football 
matches  without  players. 

Until  comparatively  recently,  almost 
all  the  attention  was  given  to  the  first 
purpose,  goal  achievement.  Organiza- 
tions were  managed  with  this  purpose 
firmly  in  mind;  individuals  were  condi- 
tioned by  all  possible  means  —  indoc- 
trination, reward,  punishment,  appeals 
to  loyalty  —  to  place  the  welfare  of  the 
organization  above  their  own.  The 
organization  was  structured  so  that  the 
individual  became,  in  fact,  a  cog  in  a 
machine,  and  was  conditioned  to  think 
of  himself  as  one.  And,  let  us  be  quite 
clear,  this  is  by  no  means  a  dead  atti- 
tude. 

More  recently,  study  has  moved  from 
seeking  more  effective  ways  of  achiev- 
ing goals  to  the  effects  of  organizational 
life  on  the  individuals  making  up  the 
organization.  Probably  this  movement 
began  with  Mary  Parker  FoUett,  who 
was  concerned  to  correct  the  lack  of 
human  consideration  displayed  by  the 
"scientific  management"  movement 
of  the  early  twentieth  century. 5  Since 
then  a  whole  literature  has  been  produc- 
ed documenting  the  dysfunctional  ef- 
fects of  organizational  life  on  individ- 
uals.' This  literature  has  in  turn  led  to 
attempts  to  reconcile  the  two  great 
organizational  purposes.  McGregor, 
for  example,  puts  forward  alternative 
theories  of  human  behaviour."  Theory 
X  holds  that  work  is  repugnant  to 
individuals,  that  they  avoid  it  as  far  as 
possible,  and  have  to  be  firmly  directed 
and  closely  supervised  to  ensure  that 
any  effective  work  is  done.  Theory  Y 
holds  that  work  is  as  natural  a  form  of 
human  activity  as  any  other,  that  it 
has  intrinsic  satisfactions  for  workers, 
and  that  their  apparent  dislike  for  work 
is  not  for  work  as  such,  so  much  as 
NOVEMBER  1971 


for  the  conditions  under  which  they  are 
required  to  work. 

In  most  occupations  at  present  Theo- 
ry X  is  predominant,  and  conditions 
are  maintained  as  if  it  were.  Theory  X 
concerns  itself  only  with  the  first  or- 
ganizational purpose,  goal  achievement. 
It  regards  individuals  as  instruments 
for  goal  attainment,  not  as  individuals 
in  their  own  right.  Theory  Y  concerns 
itself  mainly  with  group  maintenance: 
if  individuals  are  regarded  as  respon- 
sible, if  they  can  participate  actively  in 
the  management  of  their  task,  and  if 
they  can  obtain  personal  satisfaction 
from  it,  this  is  what  should  be  aimed 
at.  However,  there  is  a  growing  body  of 
evidence  that,  if  the  conditions  of  Theo- 
ry Y  are  met,  not  only  group  mainte- 
nance but  also  goal  achievement  will  be 
improved. 

The  Uprichard  "images,"  then,  are 
inadequate  theoretically  because  in 
each  case  the  image  is  concerned  with 
only  one  of  the  two  organizational 
purposes;  goal  achievement  is  central, 
but  group  maintenance  is  not  consider- 
ed. In  the  complex  modern  world  in 
which  nursing  is  now  carried  on,  the 
dysfunctional  effects  of  this  lack  are 
being  increasingly  noted.  For  this  rea- 
son —  and  I  maintain  that  it  is  an 
intensely  practical  one  —  the  develop- 
ment of  an  adequate  theory  of  nursing 
seems  to  be  urgently  required. 

The  urgency  is  increased  by  the 
changes  in  organization  caused  by  the 
complexity  1  have  just  mentioned.  One 
aspect  of  this  complexity  has  been  the 
tendency  for  organizations  to  grow 
very  large.  Because  of  this,  control  has 
tended  to  become  more  impersonal  and 
to  be  a  matter  of  the  observation  of 
formal  rules  rather  than  one  of  personal 
interaction.  And  because  of  this,  indi- 
viduals have  more  and  more  come  to 
be  regarded  as  interchangeable,  and  to 
be  used  as  means  rather  than  ends.  Even 
in  smaller  organizations  this  has  tended 
to  develop,  perhaps  because  superiors 
in  smaller  organizations  such  as  country 
hospitals  have  come  from  positions  in 
large  ones. 

Now  this  kind  of  organization  has 
NOVEMBER   1971 


considerable  advantages  for  the  attain- 
ment of  goals;  but,  as  Argyris  and 
Presthus  have  very  forcibly  pointed  out, 
it  tends  to  develop  dysfunctions  in  the 
individuals  involved,  and  these  dys- 
fiinctions  tend  to  increase  as  the  individ- 
uals become  more  mature,  more  inde- 
pendent, and  more  aware  of  themselves 
as  individuals.  And  there  is  no  doubt 
that  this  kind  of  self-awareness  is  a 
necessary  accompaniment  of  better 
education  and  more  sophisticated  social 
living.  It  is  with  us,  and  we  neglect  it 
at  our  peril.  For  this  reason,  an  adequate 
theory  of  nursing  is  urgently  required 
so  that  the  members  of  the  profession, 
from  every  level  of  skill  and  responsi- 
bility, know  both  what  they  are  doing 
and  why. 

Where  must  we  look  for  help  in 
developing  such  a  theory?  The  trend  of 
this  paper  will  have  suggested  that  the 
teYm  "theory  of  nursing"  is  perhaps 
inappropriate.  A  theory  of  nursing  as 
nursing  is  perhaps  incapable  of  devel- 
opment. What  is  perfectly  capable  of 
achievement,  however,  is  the  explicit 
linking  of  nursing  as  a  profession  to 
theories  of  behaviour,  of  organization, 
of  administration,  and  of  education, 
and  the  application  to  nursing  of  re- 
search which  is  at  present  shaping  these 
theories.  This  linking  has  in  fact  been 
commenced;  its  extension  would  place 
at  the  disposal  of  the  profession  a  grow- 
ing body  of  research  findings  and  theo- 
retical developments  which  are  perfectly 
applicable  to  the  nursing  situation. 

The  study  of  nursing 

Basically,  the  approach  to  the  study 
of  nursing  needs  to  be  widened  from  a 
mainly  technical  one,  with  some  ethical 
aspects,  to  an  approach  which  deals 
with  people  nursing,  not  merely  the 
process  of  nursing.  This  approach  can 
call  on  many  disciplines  of  study.  It  can 
draw  from  the  study  of  human  behav- 
iour both  in  individuals  and  among 
groups;  that  is,  from  individual  psychol- 
ogy, from  group  psychology,  and  from 
sociology.  It  can  draw  from  the  study  of 
organizations,  which  again  depends 
heavily  on  psychology  but  also  involves 


economics  and  political  science.  It  can, 
in  fact,  draw  from  almost  every  aspect 
of  what  have  come  to  be  known  as  the 
behavioural  sciences,  in  which  recently 
there  have  been  many  new  and  exciting 
developments. 

It  is  not  enough,  of  course,  that  a 
few  members  of  the  profession  should 
become  involved  in  these  apparently 
esoteric  studies.  Even  if  their  findings 
were  communicated  to  those  responsible 
for  providing  nursing  services,  and  those 
responsible  attempted  to  give  these 
findings  expression  in  providing  these 
services,  it  would  still  be  insufficient 
to  reduce  dysfunctions  and  change 
organizational  climates.  Change  from 
the  top  is  often  ineffective  because  it  is 
change  which  does  not  involve  the  field 
workers.  What  is  necessary  is  not  only 
the  application  of  a  more  adequate 
theory  of  nursing  by  the  controllers  of 
institutions,  but  the  involvement  of  the 
field  workers,  the  nurses  themselves, 
in  developing  the  theory.  There  is  ample 
evidence  that  change  is  more  effective 
when  those,  to  whom  the  change  is 
going  to  make  a  difference,  are  them- 
selves involved  in  bringing  it  about. 
Helplessness  in  the  face  of  change  is 
one  of  the  most  strongly  dysfunctional 
aspects  of  organizational  life. 

Assuming,  then,  that  the  profession 
sets  itself  to  develop,  and  does  develop, 
a  theory  of  nursing  as  an  organic  devel- 
opment within  the  profession,  what 
desirable  outcomes  may  be  expected?  I 
suggest  that  they  may  be  expected  in 
three  areas. 

1 .  Nurses  who  have  come  to  examine 
theories  of  themselves  and  their  pro- 
fession will  see  themselves  differently. 
Their  self-image,  their  role  perception, 
and  their  aspirations  will  be  different. 
The  resulting  enlargement  of  the  nurs- 
ing role  may  reasonably  be  expected  to 
increase  occupational  satisfaction  and 
so  to  make  group  maintenance  more 
effective. 

2.  Nursing  education  based  on  an 
adequate  theory  of  nursing,  and  incor- 
porating this  theory  as  part  of  what  is 
studied,  may  be  expected  to  increase 
technical    effectiveness    in    nurses    by 

THE  CAN4DIAN  NURSE     31 


changing  attitudes  both  to  the  profes- 
sion as  a  general  concept  and  to  the 
reasons  underlying  the  need  for  tech- 
niques. Theory,  as  1  pointed  out  earlier, 
will  provide  a  guide  to  action. 

3.  Similarly,  the  development  of 
adequate  theory  will  change  attitudes 
between  nurses  and  nursing  administra- 
tors. The  enlargement  of  the  nursing 
role  will  make  nursing  a  truly  coopera- 
tive activity  between  nurses  and  admin- 
istrators, increasing  the  levels  of  both 
goal  attainment  and  group  maintenance. 

It  will  not,  however,  be  quite  as  easy 
as  might  appear.  The  development  of 
nursing  theory  along  the  line  1  have 
suggested  is  likely  to  engender  strong 
resistance,  and  we  should  consider 
where  this  resistance  is  most  likely  to 
be  found. 

Resistance  will  come  first  from  the 
" practical ists"  —  those  who  see  theory 
as  irrelevant  to  practice.  1  have  already 
suggested  that  m  fact  the  practicalist 
is  not  really  as  free  from  theory  as  she 
would  insist  she  is — but  she  thinks 
she  is,  and  acts  accordingly.  She  may 
be  perfectly  genuine  in  her  attitude, 
and  very  hard  to  convince  that  change 
is  necessary.  By  training  and  exper- 
ience, she  finds  the  kind  of  idea  we  are 
considering  here  foreign  and  unwel- 
come. 

Resistance  will  also  come  on  eco- 
nomic grounds.  While  greater  material 
gain  is  not  the  only  satisfaction  from 
greater  professional  development,  it  is 
a  satisfaction  and  a  completely  valid 
one.  This  means  that  it  must  be  made 
worthwhile  for  nurses  to  develop  more 
professional  attitudes  and  accept  greater 
professional  responsibility.  We  may 
expect  therefore  the  argument  that  the 
nursing  services  cannot  afford  the  costs 
of  professionalization.  This  is  a  strong 
argument  in  a  society  where  so  much 
of  the  nursing  service  is  provided  at 
public  expense.  It  may  be  necessary  to 
develop  public  attitudes  towards  the 
problem.  For  example,  will  the  absolute 
cost  of  nursing  increase  so  very  much? 
Or  will  it  be  possible  to  effect  substan- 
tial economies  by  transferring  non- 
professional activities  from  nurses  and 

32     THE  CANADIAN  NURSE 


leaving  fewer  nurses  free  to  develop  an 
adequate  nursing  role?  Or  is  truly  ade- 
quate nursing  capable  of  being  presented 
as  something  worth  paying  more  for? 

My  third  focus  of  resistance  is  per- 
haps even  more  serious  than  either  of 
the  foregoing.  Organizational  life  is 
very  largely  coloured  by  the  role  per- 
ceptions of  the  participants.  An  organi- 
zation, in  fact,  ftinctions  largely  because 
the  participants  develop  perceptions  of 
their  own  roles  and  expectations  of  the 
roles  others  will  play;  and  the  resulting 
interactions  produce  effective  goal 
achievement  and  group  maintenance. 
Any  reorganization  of  the  nursing 
profession  such  as  1  have  suggested  will 
inevitably  bring  about  changes  in  these 
role  perceptions  and  expectations.  This 
will  in  turn  raise  questions  about  power 
in  the  organization.  Power  has  been 
variously  defined,  but  it  may  be  consid- 
ered as  the  ability  to  move  others  to 
action.  Now  those  who  hold  power  will 
often  be  remarkably  acceptant  of 
changes  which  involve  the  comfort, 
the  welfare,  or  the  financial  remunera- 
tion of  their  subordinates,  but  will 
jealously  guard  their  own  power  and 
fiercely  resist  any  attempt  to  limit  or 
reduce  it.  It  is  here  that  the  strongest 
resistance  to  changes  in  the  nursing  role 
may  be  expected. 

This  resistance,  to  a  large  extent, 
comes  from  a  mistaken  concept  of 
power.  It  is  widely  held  that  power  in 
an  organization  is  a  fixed  sum;  that  the 
enlargement  of  one  individual's  power 
can  come  only  from  the  diminution  of 
someone  else's.  Augmentation  of  the 
nursing  role  will  obviously  increase  the 
power  of  the  individual  nurse  in  the 
sense  that  she  will  be  able  to  make  more 
decisions  without  reference  upward.  If 
the  concept  of  power  I  have  just  outlined 
is  valid,  this  will  obviously  be  seen  as 
a  threat  to  the  power  of  superiors,  and 
can  be  expected  to  inspire  resistance. 

Is  it,  however,  a  valid  concept?  There 
is  increasing  evidence  that  it  is  not; 
that  the  concept  of  power  is  not  nearly 
as  simple  as  it  seems  to  be,  and  that 
the  total  amount  of  power  in  an  organi- 
zation is  not  a  fixed  sum.  FoUett  saw 


this  some  time  ago  when  she  put  forward 
the  concepts  of  "power  over"  and 
"power  with."s  "Power  over"  is  in 
line  with  the  conventional  idea  that 
power  is  what  enables  one  person  to 
move  others.  "Power  with"  is  a  much 
more  sophisticated  concept,  which  is 
probably  why  it  is  not  yet  widely 
known.  It  arises  from  the  fact,  as  Follett 
points  out,  that  interaction  between 
individuals  or  groups  actually  increases 
their  power  in  joint  action.  Recent 
research  in  fields  as  widely  separated 
as  industrial  relations  and  classroom 
education  suggests  that  "power  with" 
is  a  real  thing  and,  in  Shakespeare's 
words,  "a  consummation  devoutly  to 
be  wished." 

Nevertheless,  it  is  not  widely  known 
as  yet,  which  is  another  reason  for  the 
development  of  a  theory  of  nursing 
which  takes  it  into  consideration.  If  we 
within  the  profession  are  only  dimly 
aware  of  it,  we  are  in  no  position  to 
make  it  widely  known,  or  win  accept- 
ance for  it  either  inside  or  outside  the 
profession. 

References 

l.Argyris.  C.  Personality  unci  organization. 
Harper.  New  York,  1957. 

2.  Griffiths,  D.E.  Administrative  theory, 
pp.  13-19,  24-27,  28,  28-29.  New  York, 
Appleton-Century-Crofts,  1959. 

3.  Lonsdale,  R.C.  Maintaining  the  organiza- 
tion in  dynamic  equilibrium;  in  Griffiths 
Behavioural  Science.  Chicago,  University 
of  Chicago  Press  for  National  Society  for 
the  Study  of  Education. 

4.  McGregor,  D.M.  The  human  side  of  enter- 
prise. New  York,  McGraw-Hill.  1960. 

5.  Metcalf  H.C.  and  Urwick,  L.  Dynamic 
administration — the  collected  papers  of 
Mary  Parker  Follett.  London,  Pitman, 
1941. 

6.  Metcalf,  H.C.  and  Urwick,  L.  Dynamic 
administration — the  collected  papers  of 
Mary  Parker  Follett.  Chap.  IV.  London. 
Pitman,  1941. 

7.  Reinkemeyer,  A.M.  The  myths  by  which 
we  live.  /"/.  Niirs.  Rev.,  vol.  16.  no.  I, 
1969. 

8.  Uprichard,  M.  Ferment  in  nursing.  Int. 
Ni4rs.  Rev.,  vol.  16,  no.  3,  1969.  * 


NOVEMBER   1971 


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paclcage  will  remain  sterile  until  opened. 

Before  we  make  this  guarantee,  we  had  to  develop 
a  totally  new  paper,  special  packaging  techniques, 
and  unique  autoclaving  methods.  We  also  had  to 
develop  methods  for  constantly  checking  and  review- 
ing our  own  techniques. 

We  developed  a  special  low-porosity  paper  that 
has  pores  of  such  size  that  bacteria  cannot  penetrate 
through  to  the  contents  of  the  PATIENT-READY 
package. 

We  developed  a  thermoplastic  seal  for  the 
PATIENT-READY  package  that  creates  a  strong, 


bacteria-proof  seam.  When  you  open  a  PATIENT- 
READY  package  you  actually  tear  paper  fibres  away 
from  one  side  of  the  paper  with  this  special  thermo- 
plastic seal.  In  addition  to  assuring  a  positive  seal, 
this  prevents  accidental  resealing  if  a  package  is  open- 
ed inadvertently. 

Because  of  a  large  predictable  volume,  we  utilize 
reproducible  load  geometry  in  the  sterilization  cycles 
of  our  PATIENT-READY  products.  This  means 
that  the  same  product  is  sterilized  in  the  same  quan- 
tities in  the  same  way  to  ensure  uniform  sterilization 
conditions.  Precise  and  delicate  thermocouples  con- 
stantly record  temperatures  in  the  very  centre  of  the 
PATIENT-READY  package  itself  throughout  the 
autoclave  cycle. 


economical 


Even  apart  from  purely  automatic  mechanical  con- 
trols, no  less  than  20  persons  test  each  PATIENT- 
READY  product  before,  during,  and  after  sterili- 
zation. 

Thus  ...  we  can  state  "Guaranteed  Sterile"  on 
each  PATIENT-READY  package  —  and  mean  it! 

We  are  certain  PATIENT-READY  dressings  will 
save  your  hospital  money. 

We  are  certain  because  of  the  numerous  labor  costs 
the  PATIENT-READY  concept  avoids.  The  count- 
ing, the  packing,  the  piling,  the  storing,  the  auto- 
claving  and  the  possible  re-autoclaving.  This  makes 
sense  when  you  consider  that  labour  amounts  to  70% 
of  the  average  hospital's  costs,  when  you  consider  the 


cost  of  tape  and  wrapping  materials,  when  you  con- 
sider the  true  cost  in  use  of  the  hospital  autoclave. 

Portion  control  is  another  money  saving  concept 
you  can  take  advantage  of  with  PATIENT-READY 
packages.  Portion  control  simply  involves  avoiding 
waste  by  designing  package  units  that  come  as  close 
as  possible  to  what  is  likely  to  be  required.  This  of 
course  is  not  always  possible  with  bulk  dressings.  The 
proof  that  portion  control  is  important  can  be  seen 
in  one  instance  where  1200  Johnson  &  Johnson 
PATIENT-READY  dressings  did  the  job  of  2000 
bulk  sponges  previously  used! 

This  is  why  PATIENT-READY  dressings  give 
you  guaranteed  economy. 


Have  you  ever  considered 
what  a  dressing  study 
could  do  for  your  hospital? 


The  object  of  a  dressing  study  is  to  find  ways  and  means 
of  reducing  the  total  annual  cost  to  you  of  surgical  dressings. 

A  dressing  study  seeks  to  standardize  items  and  dressing 
procedures  where  possible,  and  to  simplify  procedures  in  the 
different  departments  in  your  hospital. 

Cost-in-use  is  the  major  consideration  in  determining 
the  true  price  of  an  item.  A  Johnson  &  Johnson  dressing 
study  means  a  thorough  value  analysis  of  all  of  your  surgical 
dressing  needs. 

Naturally,  your  foremost  interest  is  the  welfare  of  the 
patient.  In  its  conduct  of  a  dressing  study,  Johnson  & 
Johnson  ensures  that  this  factor  is  afforded  paramount 
consideration. 

A  dressing  study  costs  you  nothing  —  it  is  free  advice. 
Yet,  it  is  informed  advice  —  it  can  afford  your  hospital 
very  significant  efficiencies  and  economies. 

Your  Johnson  &  Johnson  representative  would  be  pleased 
to  arange  and  carry  out  such  a  study  at  your  hospital. 


MONTREAL  ATORONTO  -  CANADA 


•Trademark  of  Johnson  &  Johnson  or  afHUated  companies. 


A  pioneer  in  nursing  education 


As  a  public  health  nurse  and  teacher,  author,  and  leader  in  the  organized 
profession,  Florence  H.M.  Emory  plunged  into  everything  she  did  "imbued  with 
enthusiasm."  There  is  a  spirit  of  excitement  underlying  her  reminiscences, 
recounted  here  after  an  afternoon's  talk  in  her  Toronto  home.  At  82,  she  still 
maintains  an  active  interest  in  nursing  affairs  and  continues  to  look  forward  to 
new  experiences. 


Carol  Kotlarsky,  B.J. 

"There  is  an  excitement  about  a  pioneer 
period  you  don't  get  when  things  be- 
come accepted."  For  Florence  Emory, 
that  excitement  symbolized  the  years 
1915  to  1954  —  years  of  change  that 
were  to  make  nursing  in  Canada  what 
it  is  today. 

Between  1915,  when  she  left  the 
former  Grace  Hospital  School  of  Nurs- 
ing in  Toronto  as  a  registered  nurse, 
and  1954,  when  she  retired  as  professor 
and  associate  director  of  the  University 
of  Toronto  School  of  Nursing  after 
devoting  30  years  to  its  early  develop- 
ment, Florence  Emory  put  her  whole 
life  into  nursing. 

As  she  looks  back  at  that  adventurous 
period,  she  says  she  and  her  colleagues 
were  "enveloped"  in  nursing.  "It  seem- 
ed to  satisfy  us  completely.  We  were 
married  to  it.  It  was  our  life's  work." 

That  enthusiasm  still  bubbles  over 
when  you  ask  this  remarkable  woman 
to  share  her  rich  memories.  Although 
she  enjoys  reminiscing,  she  stresses 
that  she  does  not  live  in  the  past.  As 


Miss  Kotlarsky,  a  graduate  of  the  School 
of  Journalism.  Carleton  University, 
Ottawa,  iseditorial  assistant,  TheCanadiaii 
Nurse.  Ottawa.  Ontario. 


NOVEMBER   1971 


Florence  H.M.  Emory 

she  puts  it:  "If  pioneering  means  the 
development  of  new  thoughts  and 
ideas,  it  continues." 

Interest  in  preventive  nursing 

The  increasing  emphasis  on  preven- 
tive medicine  at  the  turn  of  the  century 
convinced   Florence  Emory   that   she 
wanted  to  work  in  this  field.  In  1915, 
THE  CArs^DIAN  NURSE     33 


after  three  years  in  the  Grace  Hospital 
School  of  Nursing — now  part  of  the 
Toronto  Western  Hospital  —  the 
young  registered  nurse  headed  for  the 
new  but  dynamic  public  health  nursing 
division  of  the  Toronto  department  of 
health. 

This  department,  she  explains,  had 
an  excellent  reputation  in  the  adminis- 
tration of  public  health  nursing.  After 
eight  years  as  staff  nurse  and  super- 
visor there,  she  received  a  scholarship 
from  the  American  Child  Health  Asso- 
ciation to  study  at  the  Massachusetts 
Institute  of  Technology  in  Boston. 
When  she  returned  to  Toronto  the 
following  year,  it  was  to  begin  work  in 
a  new  direction  —  new  for  her  and  for 
public  health  nursing  in  Canada. 

Teaching  adventure 

Public  health  nursing  was  still  a 
new  field  in  1924  when  Florence  Emory 
went  to  work  with  Kathleen  Russell, 
director  of  the  newly  formed  depart- 
ment of  public  health  nursing  at  the 
University  of  Toronto.  As  well  as  being 
assistant  director  of  the  school,  Miss 
Emory  taught  public  health  nursing. 

From  the  outset,  "our  school,"  as 
Miss  Emory  calls  it,  experimented  in 
different  types  of  nursing  preparation. 
She  recalls  that  at  first  one  year  in 
public  health  nursing  was  given  at  the 
university  following  a  three-year  nurs- 
ing program  in  a  hospital  school.  Be- 
cause a  preventive  outlook  came  after 
three  years  of  curative  work,  it  was 
difficult  for  these  nurses  to  understand 
the  importance  of  prevention,  she 
explains. 

It  was  the  baccalaureate  program, 
begun  in  1942,  with  its  integration  of 
general  and  professional  education  and 
of  the  preventive  and  curative  aspects 
of  nursing,  which  made  the  school 
"distinctive."  Miss  Emory  calls  Kath- 
leen Russell  the  leader  in  Canada  in 
connection  with  this. 

"The  thing  that  claimed  my  interest 
34     THE  CANADIAN  NURSE 


most  was  teaching.  I  loved  the  seminar 
method  but  was  not  so  fond  of  the 
formal  lectures."  What  Florence  Emory 
enjoyed  most  was  a  small  group  of 
students,  learning  with  them  and  sitting 
with  them — never  standing  before 
them. 

There  are  many  aspects  of  the  school 
of  nursing  Miss  Emory  points  to  proud- 
ly. "There  was  flexibility  in  our  school. 
We  felt  strongly  that  the  discipline  in 
hospital  schools  of  nursing  was  not  the 
kind  we  wanted.  Our  students  did  not 
have  to  make  up  lost  time  —  a  tradi- 
tion inherited  largely  from  the  military 
aspect  of  nursing  training." 

She  also  speaks  of  flexibility  in  the 
administration  of  the  school:  "The  few 
rules  adopted  were  often  broken." 
Rules  must  be  used  intelligently,  she 
says,  adding  that  things  have  greatly 
changed  for  the  better.  "Young  people 
today  would  not  accept  what  we  did 
in  the  old  training  schools." 

Miss  Emory  notes  that  another 
important  feature  of  the  school  was  a 
spirit  of  research.  "We  were  always 
trying  to  find  better  ways  of  preparing 
a  gocxi  nurse.  When  you  think  of  this 
school,  you  have  to  think  of  experimen- 
tation, culminating  in  the  method  of 
integration." 

Pioneer  work  and  dedication 

Throughout  her  professional  career. 
Miss  Emory  was  associated  with 
pioneer  effort  in  administration  and 
education.  "There  was  a  dedication  that 
went  with  that.  Miss  Russell  spent  a 
great  deal  of  time  making  a  place  for 
nursing  within  the  university,  and  I 
spent  a  lot  of  my  time  in  the  communi- 
ty, interpreting  to  the  public  what  we 
were  doing."  She  explains  that  in  the 
early  days  they  were  trying  to  get  the 
profession  and  the  community  to  accept 
changes,  such  as  requiring  nurses  to  pay 
for  their  preparation. 

The  pioneer  period  never  ended  for 
her,  she  says,  stressing  the  "never."  It 


continued  after  degree  work  was  estab- 
lished and  when  the  University  of  To- 
ronto, which  she  says  was  ""very  con- 
servative," accepted  the  bachelor  of 
science  in  nursing  program. 

Miss  Emory  says  she  and  her  col- 
leagues were  trying  to  "make  bricks 
without  straw  —  taking  what  we  had 
and  adding  to  it."*  There  were  few 
people  with  degrees  in  her  day.  But 
"we  had  many  fine  people  who  believ- 
ed in  nursing  and  put  their  whole  life 
into  it.  We  did  not  stop  to  count  the 
cost." 

Although  she  emphasizes  she  had 
very  little  academic  preparation,  she 
supplemented  it  in  as  many  ways  as  she 
could.  "It  was  all  exciting,"  she  chuck- 
les. But  she  thinks  young  people  today 
"are  so  privileged  to  be  able  to  enroll 
in  our  ready-made  schools.  They  have 
the  advantage  of  teachers  well-prepar- 
ed for  their  work." 

Leader  in  organized  profession 

Florence  Emory's  contributions  to 
the  organized  profession  were  as  much 
a  part  of  her  life  as  her  work  at  the  uni- 
versity. She  says  her  organization  work 
was  "enriching  for  the  students,"  and 
she  notes,  "you  grow  as  you  take  part 
and  you  learn  by  doing." 

After  being  chairman  of  the  public 
health  nursing  section  of  the  Canadian 
Public  Health  Association  in  1925, 
Miss  Emory  went  on  to  become  the 
first  president  of  the  Registered  Nurses' 


*Miss  Emory's  textbook.  Public  Hciillh 
Nursing  in  Canada,  was  published  by  the 
Macmillan  Company  in  1945  and  revised 
In  1953.  It  is  still  a  basic  text  on  this 
subject,  although  Miss  Emory  would  like 
to  see  a  young  Canadian  nurse  write  a 
new  public  health  nursing  text.  "From 
certain  points  of  view,  principles  don't 
change,  but  practice  and  methods  of 
practice  must  have  changed  mightily." 
she  told  the  author  of  this  article. 

NOVEMBER   1971 


Association  of  Ontario  from  1927  to 
1930.  and  president  of  the  Canadian 
Nurses'  Association  from  1 930  to  1 934. 
Also  active  in  the  Canadian  Red  Cross 
Society  as  a  nursing  consultant,  she 
was  gratified  when  the  Society  estab- 
lished a  fellowship  for  nurses  in  gradu- 
ate work. 

Her  many  active  years  in  the  Inter- 
national Council  of  Nurses  took  her  to 
a  number  of  countries,  where  she  made 
"rich  contacts.'"  She  still  visits  London 
and  sees  a  long-time  ICN  colleague, 
Daisy  Bridges,  who  was  general  secre- 
tary of  the  council  from  1948  to  1961 . 
"The  ICN  is  a  mighty  force  for  peace," 
Miss  Emory  says,  although  she  points 
out  that  it  is  especially  meaningful  to 
developing  nations. 

These  thoughts  come  from  first-hand 
observation.  Her  first  ICN  meeting  was 
in  Montreal  in  1929,  and  many  meet- 
ings abroad  followed.  In  Paris  in  1933 
she  was  made  chairman  of  the  member- 
ship committee,  and  when  she  went  to 
the  Stockholm  conference  in  1949,  it 
was  still  as  membership  chairman. 
Following  the  war  years,  she  attended 
a  conference  in  Atlantic  City  "to  gather 
up  the  threads  of  the  ICN."  She  gives 
credit  to  Effie  Taylor  of  the  United 
States,  ICN  president  from  1937  to 
1947,  forkeeping  the  ICN  together  dur- 
ing a  most  difficult  period.  A  year  after 
the  war  Miss  Emory  went  to  London 
for  a  joint  meeting  of  the  ICN  and  the 
Florence  Nightingale  Foundation. 

It  was  not  surprising  that  in  1953  she 
received  the  highest  international  honor 
for  nurses —  the  Florence  Nightingale 
Medal,  awarded  by  the  International 
Committee  of  the  Red  Cross. 

Concluding  thoughts 

One  of  Florence  Emory's  basic 
beliefs  is  that  if  you  have  faith  in  what 
you  do  and  imagination  about  the  pos- 
sibilities for  growth,  adventure  follows. 
"People  who  have  a  real  faith  are 
never  satisfied  with  the  present."  She 
NOVEMBER   1971 


adds  that  she  and  Miss  Russell  were 
profoundly  dissatisfied  with  the  status 
quo  in  nursing  education. 

She  is  critical  of  persons  who  do  not 
move  to  effect  change.  One  reason  she 
was  "caught  up  in  the  organized  pro- 
fession" was  because  she  saw  this  as 
the  best  avenue  for  change.  By  this  she 
also  means  social  change  associated  with 
new  trends  in  nursing.  "We  should  try 
to  keep  away  from  a  narrow  profes- 
sionalism," she  says. 

"My  very  happy,  rewarding  pro- 
fessional life  was  possible  largely  be- 
cause of  the  people  with  whom  I  have 
been  associated.  Throughout  the  years, 
nursing  has  drawn  to  itself  many 
women  of  outstanding  caliber." 

In  1970,  Florence  Emory  was  award- 
ed an  honorary  Doctor  of  Laws  degree 
at  the  convocation  that  marked  the 
50th  anniversary  of  the  founding  of 
the  school  at  the  University  of  Toronto. 
"I  felt  this  honor  deeply,  not  for  my- 
self as  much  as  for  nursing  and  the 
school,"  she  says,  adding  that  she  was 
greatly  impressed  that  the  director  of 
the  school  presented  her  for  the  honor. 
"I  have  never  known  a  nurse  to  present 
a  candidate  for  that  degree." 

The  ending  of  her  convocation  ad- 
dress aptly  describes  her  keen  out- 
look on  life:  "These  are  a  few  thoughts 
of  an  octogenarian  who,  looking  back- 
ward, is  grateful  for  having  had  the 
opportunity  to  serve  and  who,  looking 
forward,  has  zest  for  new  experiences 
which  life  may  still  offer."  'i' 


THE  CANADIAN   NURSE     35 


idea  exchange 


Hospital  Diet  Line      by  Eduh Hughes 


After  discovering  I  could  not  lose 
weight  by  a  magic  formula,  but  only 
through  counting  calories  and  exercis- 
ing some  self-denial,  I  became  particu- 
larly sensitive  to  the  problems  fellow 
staff  members  were  facing  in  their  diets. 
I  noticed  that  many  persons  who  were 
trying  to  lose  weight  found  it  necessary 
to  bring  their  lunch  to  work.  This  seem- 
ed like  bringing  coals  to  Newcastle! 

It  occurred  to  me  that  the  poorly-used 
express  line  in  our  hospital  cafeteria 
could  be  converted  into  a  "diet  line." 
Here  was  an  opportunity  for  the  dieti- 
tians to  apply  their  knowledge  to  benefit 
the  staff  of  the  Misericordia  Hospital, 
Edmonton.  As  members  of  the  para- 
medical team,  the  dietitians  recognized 


the  need  for  an  effective  diet  program 
—  one  that  provides  food  that  is  nutri- 
tious but  not  monotonous,  and  one 
that  corrects  faulty  food  habits. 

As  part  of  an  overall  weight  reduc- 
tion program,  the  dietitians  set  up  a 
cafeteria  counter  for  low-calorie  foods 
to  assist  and  encourage  staff  who  were 
either  trying  to  lose  weight  or  trying  to 
maintain  their  weight.  Since  the  hospital 
was  already  preparing  restricted  caloric 
foods,  it  was  easy  enough  to  include  a 
meal  pattern  for  calorie-conscious 
staff. 

Mrs.  Edith  Hughes  is  Director,  Food 
Services,  at  the  Misericordia  Hospital  in 
Edmonton,  Alberta. 


36     THE  CANADIAN   NURSE 


A  large  chart  giving  "ideal"  height 
and  weight  figures  beckons  weight 
watchers  to  the  diet  line.  After  seeing 
the  number  of  pounds  they  should  lose, 
they  are  greeted  by  a  variety  of  attrac- 
tively-arranged foods,  with  the  number 
of  calories  displayed  on  each  item. 

Menus  are  certainly  varied.  A  typical 
menu  offers  a  choice  of  french  onion 
soup;  open-faced  cheese  and  tomato 
sandwiches;  tossed  salads;  chefs  salad 
with  ham,  turkey  and  low-calorie  dres- 
sing; lean  broiled  steaks  and  roast 
meats;  an  interesting  choice  of  vegeta- 
bles —  french -cut  green  beans,  julienne 
turnips,  cauliflower,  frozen  peas,  and 
mushrooms;  desserts  of  fresh  fruit, 
sherbet,  or  jello;  and  skim  milk,  tea, 
coffee,  or  artificially  sweetened  bever- 
ages. 

But  making  food  appetizing  for  a 
reducing  diet  is  only  part  of  the  pro- 
gram. Short  noon-hour  meetings,  held 
when  the  program  first  got  underway, 
gave  staff  members  the  opportunity 
to  ask  the  dietitians  about  food,  exer- 
cise, and  other  aspects  of  weight  con- 
trol. Now  the  staff  are  generally  more 
aware  that  an  appetizing  and  nutritional 
meal  pattern  can  become  a  normal 
family  routine  that  will  result  in  success- 
ful weight  reduction. 

Our  nursing  staff  has  applauded 
this  program,  not  only  for  the  personal 
benefits  each  one  has  received,  but  also 
for  the  positive  attitude  that  has  devel- 
oped toward  the  role  of  diet  in  the  total 
care  of  patients.  One  shy  person  told 
me:  "This  is  the  best  thing  you  have 
done  in  the  hospital." 

Thanks  to  the  new  cafeteria  line, 
weight-worrying  staff  members  have 
learned  that  counting  calories  along 
the  diet  line  cuts  down  the  inches  around 
the  waistline.  It's  no  wonder  that  this 
project  has  promoted  good  public  rela- 
tions for  our  Food  Services  Depart- 
ment. ■& 

i 

Staff  who  are  trying  to  lose  weight  or 
to  maintain  their  present  weight  have 
a  choice  of  these  attractively-arranged 
foods.  The  number  of  calories  is  dis- 
played on  each  item. 

NOVEMBER  1971 


The  patient  who  needed 
a  friend 


"My  assignment  was  a  patient  who  was  considered  by  the  hospital  staff  to  be 
'cantankerous.'  His  experience  impressed  me,  mainly  because  I  don't  feel  it 
should  have  ended  as  it  did.  Perhaps  it  is  a  common  story,  but  my  question  is: 
should  it  be  common?" 


Celia  Hornby 

How  and  where  did  we  fail  him?  Was 
it  in  medical  treatment,  nursing  care 
—  or  did  we  just  forget  that  in  room 
720,  bed  4,  lay  a  person?  Did  we 
remember  only  his  body,  and  not  his 
spirit? 

1  first  heard  of  Mr.  Michalson  during 
a  morning  report  in  early  September. 
My  fellow  students  and  I  were  new  to 
the  ward,  and  the  nursing  staff  was  tak- 
ing pains  to  explain  the  intricacies  of 
caring  for  our  assigned  patients:  those 
things  that  did  not  appear  on  the  Kar- 
dex. 

Mr.  Michalson,  they  explained,  had 
been  in  the  hospital  since  June.  Origi- 
nally he  had  been  admitted  for  a  com- 
plication of  his  diabetes:  gangrene  of 
two  right  toes  that  had  subsequently 
been  amputated.  "But  he  won't  listen  to 
us,"  they  continued.  "We  tell  him  not 
to  walk  around,  and  to  keep  his  feet 
up  in  bed;  but  he  continues  to  walk  in 
the  halls  and,  as  a  result,  his  foot  is 
infected.  He  has  had  one  skin  graft  and 
is  now  scheduled  for  another." 


Miss  Hornby  was  a  second-year  student 
in  the  baccalaureate  program.  School  of 
Nursing,  University  of  Ottawa,  when  she 
wrote  this  article.  .She  expresses  apprecia- 
tion for  the  help  and  encouragement  given 
by  her  instructor,  Mrs.  Basanti  Majumdar. 
who  was  then  on  the  faculty  of  the  Ottawa 
University  School  of  Nursing. 


NOVEMBER   1971 


"I  find  him  most  uncooperative  and 
hostile,"  said  another  member  of  the 
team.  "He  just  won't  take  a  bath.  I 
think  he  likes  to  stay  dirty.  You  had 
better  make  him  wash  right  away,"  she 
cautioned  me.  "That  way,  you  may  get 
him  washed  by  lunch  time.  And  try  to 
get  him  into  some  clean  pyjamas." 

1  mentally  filed  Mr.  Michalson  under 
the  "cantankerous  old  man"  section 
and  went  into  room  720  to  meet  him. 

"Good  morning  Mr.  Michalson,"  I 
chirped,  "How  are  you  feeling  this 
morning?" 

"Tired,  my  dear,  very  tired.  They 
were  polishing  the  floor  all  last  night 
and  1  couldn't  sleep." 

"That's  too  bad,"  I  sympathized.  "It 
certainly  isn't  very  considerate  to  polish 
floors  at  night.  By  the  way,  my  name  is 
Miss  Hornby  and  I'm  a  student  nurse 
from  the  university.  I'll  be  looking  after 
you  for  the  next  little  while." 

"Nice  to  meet  you,"  he  replied  and 
closed  his  eyes. 

"Would  you  like  to  sleep  now?"  was 
my  next  question.  I  received  no  answer 
and.  feeling  rebuffed,  left  the  room. 

When  I  returned  to  room  720  after 
he  had  eaten,  I  was  determined  that  he 
should  have  his  bath. 

"Would  you  like  your  bath  water 
now,  Mr.  Michalson'"  I  inquired,  while 
deliberately  getting  out  his  wash  basin 
and  towel. 

"Not  now,  my  dear.  I  always  like  to 

listen  to  the  news  first.  I  like  to  keep 

THE  CANADIAN   NURSE     37 


up  with  world  affairs,  even  though  I  am 
in  the  hospital.  Did  you  know,  I  have 
been  in  since  June?  Three  months!  I 
missed  the  summer."  I  murmured  some- 
thing to  the  effect  that  it  was  a  shame  to 
miss  the  best  season  of  the  year,  as  he 
mused  about  his  roof-top  garden.  "Quite 
unusual  in  the  city,  you  know  my  dear," 
and  his  eyes  took  on  a  different  quality 
as  he  described  his  garden,  each  shrub 
and  flower  bed.  "I  think  I  miss  my 
garden  most  of  all  here,"  he  exclaimed, 
looking  at  the  drab  hospital  walls. 

I  had  my  duty  to  do,  however,  and 
with  a  determination  that  I  was  sure 
would  delight  my  instructor,  I  persisted. 
"If  you  have  your  wash  now,  you'll 
have  the  rest  of  the  day  free  to  do  what- 
ever you  like  .  .  .  ." 

"All  right,  my  dear.  And  could  you 


get  me  a  clean  pair  of  pyjamas?  They 
never  seem  to  bring  mc  any.  ...  1  do 
wish  I  could  see  my  garden,  though." 

Listening  helps 

With  my  mission  almost  accomplish- 
ed, I  relented  and  talked  to  him  for 
several  minutes  about  his  home  and  his 
garden.  "Thank  you  for  listening,  no 
one  ever  seems  to  have  the  time,"  he 
concluded,  and  attacked  the  basin  of 
water. 

I  was  touched  by  Mr.  Michalson's 
last  statement.  1  wondered  how  he  had 
first  been  labeled  "hostile"  and  "unco- 
operative"; he  seemed  to  me  just  a 
lonely  old  man. 

Later,  when  I  returned  to  room  720, 
I  was  just  in  time  to  hear  a  nurse  exclaim 
sharply:  "Mr.  Michalson,  you  know 
you  shouldn't  walk  in  the  hall.  Stay  in 
bed.  I'm  going  to  get  cross  with 
you  .  .  . ,"  she  warned. 


The  object  of  the  rebuke,  his  face 
crestfallen,  hobbled  back  to  bed  and  sat 
down .  Perhaps  he  thought  mine  a  friend- 
ly face,  for  he  muttered  bitterly:  "1  don't 
like  being  in  bed  all  the  time.  I  like  to 
get  a  bit  of  exercise.  It's  almost  off,  you 
know,"  he  added  guiltily,  pointing  to 
the  bedraggled  dressing  on  his  foot. 

"Well,"  I  said  cheerily,  "it's  time  to 
change  your  dressing  now,  anyway.  I'll 
go  and  get  the  tray." 

"Can  I  get  up  then?"  he  asked  pit- 
ifully. 

"1  don't  know.  We'll  try  to  think  up 
something  so  you  can.  The  trouble  is, 
when  you  walk  on  your  foot  with  just 
the  dressing  on  it,  dirt  might  get  into 
your  foot  and  it  could  become  infect- 
ed." 

"And  it  won't  get  better,  you  mean?" 
he  asked. 

"That's  right,  it  will  heal  much  more 
slowly." 

"Alright,  my  dear,  I'll  get  into  bed." 

I  hurried  off  to  my  instructor  and 
asked  if  there  were  something  I  could 
do  to  allow  him  out  of  bed.  She  said  that 


if  I  could  construct  some  sort  of  boot  breeds  friendliness.  1  thought, 
to  put  over  his  dressing,  he  could  be         Each  day  when  I  left  him,  he  would 

allowed    out    o\'   bed  ....     "But    why  ask  me  to  say  a  prayer  for  him  —  as 

wasn't  something  devised  months  ago?"  if  he  knew  something  that  we  did  not. 


Explanation  breeds  cooperation 

Ten  minutes  later,  1  hurried  into  Mr. 
Michalson's  room.  I  applied  the  order- 
ed wet  dressing,  secured  it,  and  then 
added  my  inspiration;  the  stockinette 
used  when  applying  plaster  casts.  I 
informed  him  that  with  this  covering 
on  his  foot  he  could  walk  in  the  hall. 
"Could  you  try  to  keep  your  legs  up 
when  you  are  in  bed,  and  not  let  them 
dangle  over  the  edge?"  1  asked. 

"They  always  tell  me  that,  my  dear. 
But  1  don't  see  why:  my  foot  isn't  on 
the  floor." 

"Mr.  Michalson,  didn't  anyone  tell 
you  that  if  you  keep  your  feet  up,  they 
won't  become  swollen?" 
"1  don't  think  they  did." 
Why,  I  pondered  after  he  had  gone, 
hadn't  they  explained  things  to  him? 
No  wonder  Mr.  Michalson  was  labeled 
"uncooperative,"  if  he  didn't  under- 
stand why  he  was  required  to  undergo 
certain  measures.  Because  a  person 
enters  hospital,  he  does  not  necessarily 
lose  his  natural  curiosity. 

Where  d id  commun ication  first  break 
down  with  this  patient?  His  problems 
were  so  small  and  so  easily  solved.  I 
wondered  many  things  as  I  left  Mr. 
Michalson,  who  was  hobbling  happily 
down  the  hall. 

During  the  days  that  followed,  I  grew 
to  know  a  Mr.  Michalson  who  did  not 
appear  on  the  Kardex  or  the  chart.  He 
spoke  to  me  of  his  world  travels:  Eng- 
land, India,  South  America,  Australia. 
He  had  known  them  all  in  his  travels 
as  a  Canadian  Pacific  Railway  clerk. 
His  hospital  room  became  alive  with 
his  recollections  of  humorous  incidents 
on  six  continents.  Yet,  world  traveler 
that  he  was,  it  was  the  quiet  village 
chapels  and  majestic  cathedrals  that 
he  seemed  to  love  best,  and  his  voice 
would  grow  soft  as  he  described  them. 

He  told  me  of  his  crippled  younger 
sister,  whom  he  had  cared  for  in  his 
city  apartment  and  beloved  roof  garden, 
until  at  last  he  had  laid  her  in  her  grave. 
"But  she  was  always  happy,  my  dear, 
always  a  happy  little  thing." 

September  became  October  ...  He 
talked  about  world  politics  and  his 
favorite  books,  which  included  some 
of  the  best  literature  ever  written.  His 
life  was  rich  in  experience  and  know- 
ledge. The  nurses  noticed  how  friendly 
he  had  become,  and  they  talked  and 
laughed  with  him.  Maybe  friendliness 


Downward  slide 

One  morning  when  I  arrived  at  the 
hospital,  1  was  shocked  to  learn  that 
he  had  developed  shortness  of  breath 
the  evening  before.  He  was  being  treat- 
ed with  intravenous  medication. 

He  had  long  ago  ceased  to  be  "my" 
patient,  but  1  still  visited  him  and  fussed 
over  him.  So.  that  morning,  as  soon  as 
1  was  free,  I  popped  in  to  see  him.  I 
was  appalled  by  his  appearance.  He  sat 
huddled  in  his  chair,  staring  fearfully 
around  him.  He  had  no  protective 
covering  on  his  foot,  so  I  got  a  length  of 
stockinette  for  his  boot  and  encourag- 
ed him  to  go  for  a  walk. 

"Not  with  this,"  he  quavered,  eye- 
ing the  intravenous  suspiciously. 

"Do  you  know  why  you  have  the 
intravenous?"  1  inquired. 
"No  ...  I  ...  " 

1  tried  to  explain  that  the  IV  was 
just  to  administer  a  drug  more  easily  — 
to  avoid  the  use  of  many  injections.  But 
1  could  see  that  he  was  unconvinced. 
The  thread  of  communication  is  so  fine, 
so  easily  severed.  A  nurse  passing  the 
room  called  in,  "Mr.  Michalson,  how 
about  getting  into  bed,  with  your  feet 
up?"  Obediently,  he  climbed  into  bed 
and  pulled  the  blankets  up.  I  watched 
him  mutely,  not  knowing  what  to  say. 
I  think  I  would  have  preferred  to  see 
him  stubbornly  keep  his  feet  down  at 
that  moment.  He  seemed  so  small  and 
lonely  perched  on  his  bed.  I  tried  to 
draw  him  into  conversation,  waiting 
for  the  old  familiar  light  to  come  into 
his  eyes. 

"My  parents  enjoyed  the  book  you 
loaned  them,"  I  began. 
He  closed  his  eyes. 
Somewhere   his   newly   found   trust 
had  been  lost.  The  pendulum  had  swung 
its  full  arc. 

October  became  November  .  .  .  Mr. 
Michalson  stayed  in  bed.  I  was  ill  for 
two  weeks,  and  when  I  returned  he  was 
still  in  bed.  He  remembered  me  when  1 
went  to  see  him;  but  his  mind  was 
wandering.  And  he  wouldn't  eat;  he 
wouldn't  get  up;  he  wouldn't  even  move 
in  bed.  The  intravenous  had  been 
removed,  but  its  shadow  seemed  to 
loom  over  him. 

New  tactics,  too  late 

The  staff,  led  by  a  newly  graduated 
registered  nurse,  sought  to  improve  Mr. 
Michalson's  condition.  They  borrowed 


the  patient  care  plans  1  had  completed 
for  my  instructor  and  we  held  a  con- 
ference, trying  to  determine  the  cause 
for  and  solution  to  Mr.  Michalson's 
static  existence.  We  were  all  working 
together,  proposing  and  evaluating;  all 
striving  to  one  end. 

It  was  wonderful  that  we  were  a 
team  working  together,  analyzing  the 
care  of  Mr.  Michalson.  But  it  was  too 
late.  For  so  long,  interest  in  Mr.  Mi- 
chalson had  been  confined  to  "Here 
are  your  pills,"  or  "Let  me  change  your 
dressing." 

Daily  Mr.  Michalson  slipf)ed  further 
from  our  grasp.  His  lucid  periods  grew 
fewer  —  the  days  of  the  roof  garden 
and  church  bells  seemed  far  away 
indeed.  He  lost  weight,  his  skin  broke 
down,  he  had  periods  of  incontinence. 

Outside  the  hospital,  with  fall  over, 
winter  was  coming  —  windy  and  cold. 
Inside  the  hospital  it  was  grey  and 
drab. 

It  was  then  that  Mr.  Michalson's 
condition  required  him  to  be  moved  to 
a  private  room.  As  if  he  had  not  suffer- 
ed enough  loneliness,  he  was  now  cut 
off,  alone  in  a  small  grey  room.  And  so 
he  drew  his  last  breath  alone. 

Here  my  story  of  Mr.  Michalson 
ends.  Yet  it  stretches  on.  Every  day  in 
the  hospital  we  are  confronted  with 
"cantankerous  old  men"  and  "shrill 
complaining  women."  Daily,  we  are 
given  the  chance  to  help  our  patients: 
to  understand  the  problems  and  emo- 
tions underlying  their  overt  behavior, 
to  be  kind.  Surely  if  we  work  together, 
each  one  giving  a  few  moments,  a  smile, 
or  a  kindly  greeting  to  our  patients, 
their  long  hospital  days  would  become 
much  brighter. 

Can  we  spare  five  minutes  out  of  a 
crammed  day  to  help  a  fellow  human 
renew  his  grip  on  life?  The  answer  lies 
with  us. 


39 


by  Nurse  Whozits 


"Hey,  Nurse! "is the 

brainchild  of  the  author, 

Jennie  Wilting,  (Nurse  Whozits), 

a  graduate  of  Blodgett 

Memorial  Hospital  School 

of  Nursing  in 

Grand  Rapids,  Michigan, 

and  the  University 

of  Minnesota,  Minneapolis. 

For  four  years  she 

was  head  nurse  on  a 

psychiatric  unit,  and 

for  10  years,  an  instructor 

in  psychiatric  nursing. 

At  present,  she  is 

a  lecturer  in  mental  health 

concepts  at  the 

University  of  Alberta 

School  of  Nursing 

in  Edmonton,  Alberta. 


Miss  Tizzy  placed  the  chart  back  in 
the  rack,  her  hand  trembling  slightly. 
"Mrs.  Ogler.  the  supervisor,  wants  to 
see  me  in  the  nursing  otTice,"  she  said. 
"Td  better  go  right  now." 

Let's  take  a  look  at  Mrs.  Ogler  for 
a  moment.  We  don't  know  whether 
she  is  short  or  tall,  thin  or  Fat.  But  she 
wears  a  white  uniform  and  cap,  and  on 
her  uniform,  a  gold  pin  with  white  and 
blue  lettering.  She  earned  this  pin  by 
sitting  long  hours  in  a  classroom,  writ- 
ing endless  numbers  of  papers,  and 
studying  the  material  in  a  huge  pile  of 
books.  She  earned  it  by  walking  rapidly 
up  and  down  hospital  corridors.  She 
earned  it  by  carrying  the  heavy  respon- 
sibility of  caring  for  people  who  were 
ill. 

Let's  look  closer.  What  is  Mrs.  Ogler 
like  as  a  person?  She  has  a  need  to  be 
accepted  and  loved,  a  need  to  feel  her 
work  is  worthwhile  and  well  done.  At 
times  she  becomes  discouraged  by  the 
many  little  irritating  problems  that  crop 
up  during  the  day. 

Occasionally,  worries  and  concerns 
in  Mrs.  Ogler's  personal  life  reflect 
on  her  work  in  the  hospital.  When  she 
feels  good  and  things  are  going  smooth- 
ly, she  usually  smiles  and  is  kind  and 
considerate.  But  when  she  is  frightened, 
unhappy,  or  angry,  she  may  speak 
harshly  or  abruptly,  covering  up  her 


feelings  by  snapping  at  people.  On 
occasion  she  has  even  been  known  to 
shout  at  a  staff  member.  When  a  situa- 
tion strikes  her  as  funny,  she  chuckles 
or  laughs. 

Often  Mrs.  Ogler  finds  there  aren't 
enough  hours  in  the  day  for  her  to 
carry  out  her  responsibilities  as  thor- 
oughly as  she  would  like.  Each  day 
she  has  to  decide  which  duties  are  most 
pressing  and  how  she  can  use  her  time 
wisely. 

We  could  say  much  more  about  Mrs. 
Ogler.  But  already  she  sounds  strikingly 
familiar.  In  fact,  she  is  much  like  the 
rest  of  us.  Mrs.  Ogler.  Miss  Tizzy,  and 
you  and  1  have  much  in  common.  I 
wonder  why  Miss  Tizzy  is  afraid  of  her. 


40     THE  CANADIAN   NURSE 


NOVEMBER   1971 


research  abstracts 


The  following  are  abstracts  of"  studies 
selected  from  the  Canadian  Nurses" 
Assix-'iation  Rcpositor)  Collection  of 
Nursing  Studies.  Abstract  manuscripts 
are  prepared  by  the  authors. 


Loyer,  Marie  A.  and  Morris,  M.T.  Mil- 
dred. Survey  of  library  rcsDiirccs  in 
Canadian  schools  of  nursing.  Ottawa. 
University  of  Ottawa,  1971. 

A  survey  of  a  selected  sample  of  librar- 
ies of  schools  of  nursing  was  undertaken 
to  collect  data  to  be  used  for  compara- 
tive purposes  in  support  of  a  request  for 
additional  budgetary  allowances,  as  well 
as  to  serve  as  a  base  for  an  expanding 
study  of  library  facilities. 

The  review  of  the  pertinent  literature 
indicates  that  little  research  has  been 
done  in  the  area  of  nursing  libraries. 
The  two  most  valid  sources  are  the 
Mussallem  pilot  study  and,  by  infer- 
ence, the  Simon  report.  In  the  absence 
of  sufficient  information,  it  was  decid- 
ed to  carry  out  a  survey  of  the  facilities 
and  resources  of  the  libraries  of  schools 
of  nursing. 

The  sample  included  libraries  of  the 
22  university,  16  hospital  and  17  re- 
gional schools  of  nursing.  Responses 
were  received  from  the  libraries  of  9 
university,  13  hospital,  and  3  regional 
schools  of  nursing. 

The  data  submitted  only  partially 
sustains  the  hypothesis  that  the  library 
of  a  university  school  of  nursing  con- 
tains an  up-to-date  collection  of  books 
and  periodicals  in  nursing.  The  libraries 
of  university  schools  of  nursing  contain 
more  than  half  the  basic  requirements 
listed  on  the  questionnaire,  which  is 
considered  to  contain  the  essential 
reference  sources  for  nursing,  and  their 
collections  exceed  those  of  the  other 
types  of  schools  of  nursing  that  report- 
ed. There  was  insufficient  evidence  to 
sustain  the  existence  of  a  withdrawal 
policy  for  the  scientific  collection. 

The  hypothesis  that  the  library  com- 
mittee has  a  decision-making  role  was 
only  partially  sustained.  The  criterion 
of  adequate  holdings  to  meet  the  needs 
of  students  and  staff  was  not  met. 
Though  libraries  offered  liberal  ser- 
vices, the  majority  were  not  served  by 
a  qualified  librarian.  There  was  also 
a  great  need  to  incorporate  modern 
trends  in  education  into  the  planning 
and  implementing  of  library  services. 

This   survey    indicates    that   efforts 

NOVEMBER   1971 


should  be  made  to  improve  libraries 
in  schools  of  nursing  by  the  consistent 
employment  of  qualified  library  staff, 
and  the  organization  of  a  representative 
library  committee  having  a  decision 
makmg  role  in  the  governance  or  tne 
library.  Specialized  nursing  libraries 
must  consider  modern  trends  in  educa- 
tion and  plan  to  become  resource  cen- 
ters containing  materials  that  are  cur- 
rent and  helpful  in  the  pursuit  of  re- 
search. A  study  of  this  nature  should 
be  extended  and  expanded  to  include  a 
larger  number  of  schools  of  nursing, 
and  be  specifically  directed  at  the 
quantity  and  quality  of  the  scientific 
holdings  in  their  libraries. 

Patrick,  GeraldineGrace  Louise.  A^///'.v/>!i' 

care  i^iven  by  general  staff  hospital 
nurses  to  a  selected  group  of  patients 
who  had  experienced  a  cerebro- 
vascular accident.  Vancouver,  B.C., 
1970.  Thesis  (M.Sc.N.)  University  of 
British  Columbia. 

Thepurposeof  this  study  was  to  identify 
the  nature  of  nursing  care  given  by 
general  staff  hospital  nurses  to  a  select- 
ed group  of  patients  who  had  experienc- 
ed a  cerebrovascular  accident. 

Six  hemiplegic  patients  who  had 
experienced  a  cerebrovascular  acci- 
dent one  to  three  weeks  before  the 
period  of  observation  were  selected  for 
the  study.  The  data  were  compiled 
from  direct  observations  and  from  a 
nursing  history  that  included  an  inter- 
view with  the  patient  and/or  his  near- 
est relative,  and  data  from  his  chart. 
The  observed  behavior  of  29  general 


Use  Christmas  Seals 


CANADA 


FIGHT  TUBERCULOSIS 
EMPHYSEMA  AND  OTHER 
RESPIRATORY  DISEASES 


staff  hospital  nurses,  6  patients,  and 
other  members  of  the  rehabilitation 
team  was  recorded  in  the  form  of 
anecdotal  notes  by  the  non -participat- 
ing nurse-researcher.  Each  patient  was 
observed  for  two  days,  the  mean  length 
of  observation  time  per  day  was  6 
hours,  49.4  minutes. 

The  data  were  categorized  into  10 
basic  nursing  care  activities.  Basic 
nursing  care,  as  defined  by  Henderson, 
meant  helping  the  patient  with  activities 
related  to  his  basic  needs  or  providing 
conditions  under  which  he  could  per- 
form them  unaided.  The  data  were 
further  organized  into  desirable  activi- 
ties, as  outlined  in  the  literature,  and 
undesirable  activities  that  were  observ- 
ed. 

1 1  was  demonstrated  that  many  nurses 
in  the  study  helped  patients  with  most 
of  the  10  activities.  However,  few 
nurses  provided  conditions  under  which 
they  could  perform  them  unaided. 
Food  and  fluids  were  fed  to  patients 
who  could  have  fed  themselves,  with  a 
little  encouragement.  Bowel  and  blad- 
der training  was  not  seen  as  an  impor- 
tant factor  in  the  care  of  the  patient  who 
had  experienced  a  cerebrovascular 
accident. 

Nurses  seldom  included  exercise 
during  the  bath  and  frequently  left 
the  patient  in  the  chair  for  prolonged 
periods.  Nurses  demonstrated  that 
they  did  not  understand  the  importance 
of  communication  with  patients  who 
had  experienced  a  cerebrovascular 
accident,  nor  did  they  appear  to  be 
aware  of  the  concept  of  a  rehabilitation 
team. 

The  recommendations  were: 

1 .  that  an  orientation  to  the  total 
picture  of  rehabilitation  of  the  patient 
who  had  experienced  a  cerebrovascular 
accident,  in  the  acute  hospital,  specializ- 
ed unit,  and  in  the  home,  be  provided 
for  graduate  general  hospital  nurses. 

2.  that  existing  knowledge  in  rela- 
tion to  the  nurse's  role  in  the  rehabilita- 
tion of  the  patient  who  had  experienc- 
ed a  cerebrovascular  accident  be  com- 
piled and  made  accessible  to  general 
staff  hospital  nurses.  It  now  primarily 
appears  in  journals  that  these  nurses  do 
not  normally  see. 

3.  that  general  staff  hospital  nurses 
learn  to  communicate  more  effectively 
with  patients  who  have  experienced 
a  cerebrovascular  accident,  with  their 
families,  and  with  other  members  of  the 
rehabilitation  team.  v 

THE  CANADIAN   NURSE     41 


names 


We  regret  that  the  photographs  of  Iris 
Mossey  and  Margaret  S.  Neylan  were 
interchanged  in  our  September 
"Names."  Because  of  this  error,  we 
are  again  publishing  the  information 
about  these  two  nurses. 

Iris  Mossey  was  named  "Nurse  of  the 
Year"  for  1971  at  the  convention.  Mrs. 
Mossey  (R.N.,  Gait  School  of  Nursing, 
Lethbridge;  Dipl.  in  P.H.  and  B.Sc. 
U.  of  Alberta)  is  director  of  health 
services  at  St.  Michael's  General  Hospi- 
tal in  Lethbridge. 

A  former  vice- 
president  and  sec- 
retary of  the  Leth- 
bridge chapter  and 
chairman  of  the 
nursing  education 
committee  for  the 
South  District,  Mrs. 
Mossey  has  also 
been  involved  in 
staff  nurses"  associations  since  1 964  and 
has  been  chairman  of  the  AARN  pro- 
vincial committee  for  staff  nurses'  asso- 
ciations. 

Margaret  S.  Neylan, 

associate  professor 
at  the  school  of 
nursing  and  direc- 
tor of  continuing 
nursing  education. 
University  of  Brit- 
ish Columbia,  has 
been  elected  presi- 
dent of  the  Register- 
ed Nurses'  Association  of  British  Co- 
lumbia. Her  election,  by  mail  ballot  of 
the  membership,  was  announced  May 
28  in  Vancouver.  She  succeeds  Monica 
D.  Angus  for  a  two-year  term. 

Mrs.  Neylan  (R.N.,  Brandon  General 
H.,  Brandon.  Man.;  B.Sc.N.,  McGill  U.. 
Montreal:  M.A.,  U.  of  British  Colum- 
bia; Dipl.  Supervision  in  Pyschiatric 
Nursing,  McGil!  U.)  has  a  wide  range 
of  nursing  experience.  She  has  been 
staff  nurse  and  head  nurse  at  the  Pro- 
vincial Mental  Hospital  in  Ponoka, 
Alberta:  head  nurse  and  supervisor  at 
The  Montreal  General  Hospital,  psy- 
chiatric division:  and  a  psychiatric  nurse 
at  a  private  hospital  in  New  York  City, 
and  at  St.  Anne  de  Beilevue,  Quebec. 

RNABC's  new  president  has  been 
active  on  the  RNABC  committee  on 
nursing  education,  the  task  committee 
on  learning  resources,  the  task  planning 
committee  on  nursing  education,  and 

42     THE  CANADIAN  NURSE 


a  task  committee  lo  establish  criteria  for 
courses  in  intensive  care  nursing.  Mrs. 
Neylan  was  also  a  joint  director^ of  the 
RNABC  funded  research  project  to 
study  the  perceived  learning  needs  of 
graduate  students  working  fulltime  in 
giving  direct  care  to  patients  in  acute 
medical-surgical  units.  As  well,  she 
served  as  a  consultant  in  continuing 
nursing  education  to  RNABC  districts 
and  chapters. 

Other  new  officers  are  Geraldine 
Lapointe,  first  vice-president,  who  is 
director  of  nursing  education.  Royal 
Inland  Hospital  School  of  Nursing. 
Kamloops,  B.C.,  Donald  C.  Ransom, 
second  vice-president,  infection  control 
coordinator.  St.  Paul's  Hospital.  Van- 
couver; Marion  Macdonell,  honorary 
treasurer,  health  unit  supervisor.  Metro- 
politan Health  Services.  Vancouver: 
Marilyn  J.  McSporran,  honorary  secre- 
tary. Kootenay  Lake  District  Hospital, 
Nelson.  B.C. 

Eileen  Hodgson  was  appointed  member 
of  the  Nova  Scotia  Council  of  Health, 
established  July  1,  1971.  As  a  mem- 
ber of  the  new  Health  Council,  Mrs. 
Hodgson  will  be  advising  and  assisting 
Nova  Scotia  Health  Minister  Scott  Mac- 
Nutt  on  matters  relating  to  health  ser- 
vices, facilities,  and  resources. 

Dorothy  Chisholm  (R.N.,  Royal  Victo- 
ria H.,  Montreal;  Dipl.  P.H.N.,  and 
B.N.,  McGill  U.)  is  the  new  regional 
consultant,  public  health  nursing,  in 
the  Local  Health  Services  Branch, 
Eastern  Region  of  the  Ontario  Depart- 
ment of  Health. 

Miss  Chisholm  has  had  considerable 
experience  in  public  health  nursing, 
most  recently  as  supervisor  for  three 
years  in  the  Thunder  Bay  District 
Health  Unit,  Thunder  Bay,  Ontario. 
She  has  also  been  on  the  staff  of  the 
Sudbury  and  District  Health  Unit  in 
Sudbury,  Ontario;  the  City  Health 
Department  in  Belleville,  Ontario;  the 
Child  Health  Association  in  Montreal; 
and  the  U.S.  Department  of  Health. 

Barbara  Racine  (R.N.,  Saskatoon  City 
H.;  Dipl.  Teaching  and  Superv.,  U.  of 
Saskatchewan;  B.Sc.N.  and  MHSA,  U. 
of  Alberta)  has  been  appointed  to  a  new 
position  at  the  University  of  Alberta  in 
Edmonton.  After  a  year  as  part-time 
director,  continuing  education  for 
nurses,  at  the  University  of  Alberta 
School  of  Nursing,  she  has  become  as- 


sistant professor,  division  of  health 
services  and  the  school  of  nursing.  This 
position  involves  planning  continuing 
education  programs  for  health  services 
administrators  and  nurses. 

Miss  Racine  has 
held  the  positions 
of  director,  inser- 
vice  education,  at 
Hollywood  Presby- 
terian Hospital  in 
Los  Angeles,  Calif.; 
general  duty  nurse 
at  St.  Joseph  Hos- 
pital in  Burbank, 
Calif.;  and  general  duty  nurse  and  in- 
structor at  Saskatoon  City  Hospital, 
Saskatoon,  Saskatchewan.  She  has  been 
active  in  the  Saskatchewan  Registered 
Nurses'  Association  and  is  involved  in 
various  activities  with  the  Alberta  Asso- 
ciation of  Registered  Nurses. 

After  two  years  as  coordinator  of  the 
Formal  Continuing  Education  Pro- 
gram for  the  Registered  Nurses'  Asso- 
ciation of  Ontario,  Lucille  Peszat  has 
left  RNAO  to  chair  the  new  division 
of  health  sciences  at  Humber  College 
of  Applied  Arts  and  Technology  in 
Rexdale,  Ontario.  The  hub  of  this  divi- 
sion is  the  college's  two-year-old  pro- 
gram for  registered  nurses  —  the  first 
of  its  kind  in  Ontario. 

MissPeszat(Reg.N., 
St.  Joseph's  School 
of  Nursing,  Chat- 
ham, Ont.;  B.ScN., 
U.  of  Western  On- 
tario, London; 
M.Ed.,  Ontario  In- 
stitute for  Studies  in 
Education,  Toron- 
to) has  worked  in 
man}  areas  o1  adult  education  in  Can- 
ada and  abroad.  As  a  nursing  adviser  in 
Canada's  external  aid  program  to  the 
government  of  Trinidad  and  Tobago, 
she  spent  14  months  teaching  and  help- 
ing reorganize  basic  nursing  programs. 
She  has  held  the  positions  of  lecturer 
at  the  University  of  Ottawa  School  of 
Nursing  and  curriculum  consultant  at 
the  Quo  Vadis  School  of  Nursing  in 
Toronto,  Ontario. 

Constance    Slaughter   has  joined    the 
University  of  Calgary  School  of  Nurs- 
ing as  assistant  professor,  community 
health. 
Mrs.  Slaughter  comes  from  Montana, 

NOVEMBER   1971 


where  she  studied  nursing  (R.N.,  Car- 
roll College;  B.Sc.N.,  and  M.N..  Mon- 
tana State  U.),  worked  as  a  staff  nurse 
in  two  hospitals,  and  as  a  public  health 
nurse.  She  was  an  active  member  of  the 
American  Nurses'  Association. 

Teresa  Davis  has  also  joined  the  staff 
of  the  University  of  Calgary  School  of 
Nursing.  A  native  of  Edmonton,  Mrs. 
Davis  (R.N.,  Edmonton  General  H.; 
B.N.,  McGill  U.;  M.Ed.,  U.  of  Alberta, 
Edmonton)  has  had  varied  nursing 
experience.  During  the  past  1 0  years  she 
has  been  a  general  duty  nurse  at  the 
Edmonton  General  Hospital,  at  the 
University  of  Alberta  Hospital  in  Ed- 
monton, and  at  the  Royal  Victoria 
Hospital  in  Montreal;  psychiatric  nurs- 
ing instructor  and  associate  director  of 
nursing  education  at  the  Alberta  Hos- 
pital in  Edmonton;  and  supervisor, 
department  of  psychiatry,  at  the  Uni- 
versity Hospital  in  Edmonton. 

Mrs.  Davis  has  won  several  awards, 
including  a  Canadian  Nurses'  Founda- 
tion fellowship. 

Glen  Smale  has  joined  the  staff  of  the 
St.  Boniface  School  of  Nursing,  St. 
Boniface,  Manitoba,  as  a  teacher  in 
psychiatric  nursing. 

■|^H||^BHMB|    A  graduate  of  The 
^^BBH^^^I    Winnipeg    General 
M  1  *     Hospital  School  of 

W  0^y        Nursing  and  the 

'^  University  of  Mani- 

toba (B.N.),  Mr. 
Smale  has  worked 
as  a  team  leader 
^  ^_  v~^V'  ^^^  ^^  ^  teacher  in 
f  ^^■■i^r  A  psychiatric  nursing 
at  The  Winnipeg  General  Hospital, 
Winnipeg,  Manitoba. 

As  an  active  member  of  the  Manitoba 
Association  of  Registered  Nurses,  he 
has  served  as  a  member  of  the  Social 
Economic  Committee  of  MARN  and 
is  now  in  his  second  term  as  chairman 
of  the  provincial  staff  nurses'  council. 
He  is  also  a  past  president  of  The  Win- 
nipeg General  Hospital  Registered 
Nurses'  Association. 

The  following  faculty  appointments 
have  been  announced  at  the  School  of 
Nursing,  Queen's  University,  Kingston. 
Elaine  Carty,  Lorene  Bard,  and  Pa- 
tricia Layton  have  joined  the  faculty  as 
lecturers  in  nursing.  Mrs.  Carty  (R.N., 
B.S.N. ,  M.Sc.N.,  Yale;  C.N.M.)  was  a 
lecturer  at  the  University  of  New  Bruns- 
wick from  1968  to  1970  and  has  been 
a  member  of  the  staff  at  the  Kingston 
General  Hospital  in  Kingston,  Ontario. 
Miss  Bard  (R.N.,  Grey  Nun's  H.,  Regi- 
na;  B.N.,  M.Sc.  (Appl.),  McGill  U., 
Montreal)  worked  as  a  hospital  staff 
nurse  in  New  Mexico  while  she  was 
studying  at  the  university  there.  Miss 
Layton  (R.N.,  B.S.N. ,  U.  of  Western 
Ontario,  London)  has  held  a  number 

NOVEMBER   1971 


of  positions  in  official  public  health 
agencies  and  the  Victorian  Order  of 
Nurses.  She  has  also  worked  as  a  staff 
nurse  with  the  Visiting  Nurses'  Asso- 
ciation of  Chicago  and  as  a  staff  nurse 
in  rehabilitation  in  the  Cantonal  Hos- 
pital in  Geneva,  Switzerland. 

Janet  Wray  (R.N.,  B.S.N. ,  U.  of 
Kansas;  M.N.,  U.  of  Washington, 
Seattle)  has  joined  the  faculty  as  an 
assistant  professor  of  nursing.  Before 
her  appointment  at  Queen's,  Miss  Wray 
was  responsible  for  the  teaching  of  first- 
year  nursing  courses  at  Olympia  College 
in  Washington.  Other  positions  she 
has  held  in  the  United  States  are  staff 
nurse  and  nurse  supervisor  in  public 
health  nursing  in  Washington  state,  and 
staff  and  head  nurse  at  Bellevue  Hos- 
pital in  New  York  City. 
Thelma  A.  Blaikie  (R.N.,  Nova  Scotia 
H.  School  of  Nursing.  Dartmouth,  N.S.; 
B.N.,  Dalhousie  U.,  Halifax,  N.S.) 
was  appointed  director  of  nursing  edu- 
cation at  the  Nova  Scotia  Hospital  in 
June,  1971. 

Mrs.  Blaikie  has  held  several  posi- 
tions at  the  Nova  Scotia  Hospital.  She 
was  instructor,  science  instructor,  and 
assistant  supervisor  of  nursing.  The  new 
director  of  nursing  education  is  record- 
ing secretary  for  the  Registered  Nurses' 
Association  of  Nova  Scotia. 


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Lise     Latreille    has 

been  appointed  as- 
sistant director, 
Children's  and  Ado- 
lescent  Services, 
Douglas  Hospital, 
Montreal.  For  the 
past  year.  Miss  La- 
treille (B.  A. .College 
Jesus-Marie,  Mon- 
treal; B.Sc,  U.  of  Montreal;  M.  Admin. 
Hygiene,  School  of  Public  Health,  U. 
of  Montreal)  has  been  executive  assis- 
tant. Children's  Services,  at  Douglas 
Hospital. 

Recent  appointments  to  the  University 
of  Saskatchewan  School  of  Nursing  in 
Saskatoon  include: 


I'iolci  Sfhifk 


Holler  Schiiinan 


Violet  Schick  (R.N.,  B.S.N. ,  U.  of  Sas- 
katchewan), as  an  instructor  in  obstet- 
rical nursing.  Prior  to  her  appointment 
as  instructor,  Mrs.  Schick  was  a  member 
of  the  summer  relief  staff  at  the  Uni- 
versity Hospital  in  Saskatoon. 
Holley  Schuman  (R.N.,  Calgary  H. 
School  of  Nursing;  B.S.N.,  U.  of  Sas- 
katchewan), as  an  instructor  in  pedia- 
tric nursing.  Miss  Schuman  was  a  staff 
nurse  at  the  University  Hospital  in 
Saskatoon  before  becoming  pediatric 
nursing  instructor. 


Siisiin  Wdgiicr 


Noniiii  Joy  I-  iilton 


Susan  Wagner  (B.S.N.,  B.A.,  U.  of 
Saskatchewan),  as  an  instructor  in  nurs- 
ing fundamentals.  Mrs.  Wagner's  pre- 
vious experience  includes  working  as 
a  summer  relief  nurse  at  the  Moose 
Jaw  Union  Hospital. 
Norma  Joy  Fulton  (R.N.,  B.S.N., 
M.C.Ed.;  U.  of  Saskatchewan,  Saska- 
toon) as  an  assistant  professor  in  con- 
tinuing education.  Mrs.  Fulton  will 
work  in  cooperation  with  the  School  of 
Nursing,  the  Continuing  Medical  Edu- 
cation and  Extension  Division,  and  with 
the  Saskatchewan  Registered  Nurses' 
Association  and  its  chapters. 

THE  CANADIAN  NURSE     43 


in  a  capsule 


Medicare  for  cows,  pigs,  sheep  . . . 

Following  the  success  of  medicare  for 
humans,  Quebec  instituted  a  similar 
scheme  July  1  for  cows,  pigs,  sheep, 
poultry,  fur-yielding  animals,  and 
estrogen-yielding  mares. 

This  plan,  reported  in  The  Financial 
Post  August  14,  pays  veterinarians  by 
visit,  by  hour,  or  by  act,  and  provides 
bonuses  for  work  done  on  holidays  and 
for  travel.  The  Quebec  government  will 
generally  pay  half  the  costs,  and  the 
farmers  the  other  half. 

Another  feature  of  this  medicare  calls 
for  the  setting  up  of  a  central  drug 
store  by  the  government.  Drugs,  which 
are  expected  to  cost  less  than  in  the 


past,  will  be  distributed  by  the  veteri- 
narians, who  also  have  the  right  to  opt 
out  the  whole  scheme. 

Non-smokers  unite! 

Researchers  at  the  University  of  Cin- 
cinnati MedicalCenter  have  discovered 
that  no  one  is  exempt  from  the  iia/ards 
of  smoking,  even  those  who  don't 
smoke.  Cadmium,  a  metal  poisiinous  to 
man.  is  present  in  the  smoke  drifting 
from  the  burning  end  of  cigarets,  cigars, 
and  pipes,  and  can  be  harmful  to  any- 
one reached  by  the  smoke.  Smaller 
amounts  of  the  metal  are  in  the  main- 
stream snmke  inhaled  by  the  smoker. 
The   non-smoker,   therefore,   is  inhai- 


44     THE  CANADIAN  NURSE 


ing  greater  amounts  of  this  toxic  metal 
than  the  person  who  is  smoking. 

Ihe  research  team  estimated  tiiat 
in  a  room  approximately  10  \  12  teel. 
a  pack  of  cigarets  smoked  in  an  eigiu- 
hour  period,  with  no  ventilation,  re 
leases  12  to  14  micrograms  of  cadmium 
into  the  atmosphere,  f-.ven  if  only  10 
percent  of  this  amount  remains,  the  room 
has  a  uniform  distribution  of  cadmiLmi 
particles  that  is  10  times  greater  than 
tiial  usually  found  in  the  outside  air. 

Ha\ e  you  ever  suffereti  from  watering 
and  stinging  eyes,  or  felt  the  dismay  of 
having  clean  and  shining  hair  turn  dull, 
or  had  to  air  the  drapes  on  the  line  be- 
cause of  cigaret.  pipe,  or  cigar  smoke'.' 
If  so.  you  arc  probably  a  imn-smoker 
who  is  affected  both  direetiv  and  in- 
directly by  tiie  hazards  of  smoking.. 

Women  prone  to  whiplash  injuries 

When  a  car  is  struck  from  the  rear, 
women  passengers  are  twice  as  likely 
as  men  to  suffer  whiplash  neck  injuries, 
no  matter  where  the  person  is  sitting 
in  the  car  that  is  struck. 

The  July  issue  of  Ontario  Traffic 
Safety  reported  that  researchers  believe 
women  suffer  this  type  of  injury  more 
often  than  men  because  their  neck 
muscles  are  weaker.  And  if  the  woman 
is  a  front-seat  passenger  without  a  head 
restraint,  her  chances  of  sustaining  a 
whiplash  are  50  percent  greater  than  if 
she  is  sitting  in  the  rear  seat. 

Also  pointed  out  is  the  fact  that  tall 
persons  suffer  whiplash  more  often 
than  short  persons,  and  front-seat 
passengers  are  hurt  more  often  than 
drivers.  The  chance  of  whiplash  is 
greater  in  slower-speed  impacts  be- 
cause in  more  severe  crashes  the  seat 
bends  backward  or  breaks  loose  entirely 
allowing  the  upper  body  to  move  back 
with  the  head. 

Hospital  not  for  pet  goat 

After  showing  off  Rocquefort,  the  pet 
goat  at  The  Hospital  for  Sick  Children 
in  Toronto,  in  our  August  news,  we  were 
saddened  to  read  that  the  kid  died.  This 
must  have  been  a  big  disappointment 
to  the  children  at  the  hospital  who  were 
entertained  by  this  friendly  visitor. 

According  to  the  hospital  publication 
What's  New,  the  vet  attributed  the  kid's 
death  to  meningitis.  But  Muffet  I'rost, 
who  raised  the  goat  and  brought  him 
to  the  hospital  to  cheer  up  the  children, 
thinks  it  more  likely  that  he  ate  a  poi- 
sonous plant.  i? 

NOVEMBER   1971 


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NURSES  CHARMS  ^ 

Finest  sculptured  Fisher  charms. "^S^  *^n^^i 
I  Sterling  or  Gold  Filled  Ispecify  under  COLOR  on  coupon).    ^  ^r 

For  bracelet  or  pendant  chain.  Add  to  your  collection! 
I  No.  263  Caduceus:  No.   164  Cap:  No.  68 


I  Grad.  Hat;  No.  8.  Band.  Scissors  .  .  3.49  oa. 

,14K  PIERCED  EARRINGS 

Dainty,  detailed  I4K  Gold  caduceus.  for  on  or  oft  duty 


^-r 


V  W      wear.  Shown  actual  size.  Gift  twxed  for  friends,  too 

"       No.  13/297  Earring's 5.95  per  pair. 

PIN    GUARD    Sculptured  caduceus.  chained  ■ 
to  your  professional  letters,  each  with  pinback,^ 
safety  catch.  Or  repixe  either  with  class  pin  tor 
safety.  Gold  finish,  gift  boxed.  Choose  RN,  IPN 
»'  LVN  No.  3420  Pin  Guard  ....  2.95  ea. 


® 


ENAMELED    PINS  eeautitully   sculptured   status 
insignia,  2-color  keyed,   hard-fired  enamel  on  gold  plate. 
Dime-sized,   pin-back    Specify  RN.   LPN.   PN,   LVN,   NA.  or 
RPh   on  coupon 
No.  205  Enam.  Pin  1.95  ea.,  12  or  more  1.50  ea. 


POCKET  SAVERS 


Prevent  stains  and  wear! 
Smooth,  pliable  pure  white  vinyl.  Ideal 
low-cost  group  gifts  or  favors. 
No.  210-E  (right),  two  compartments 
wtth  flap,  gold  stamped  caduceus  .  .  . 
6  for  1.50.  25  or  more  20«  ea.        j 

No.  791  (left)  Deluxe  Saver.  3  comot.. 
chance  pocket  &  key  chain  .  .  . 
6  for  2.98,  25  or  more  3Sf  ea. 


MEDI-CARD   SET    Hand.est  reference 

ever'  6  smooth  plastic  cards  13H"  x  S"^")  cram- 
med with  infofmation.  including  Equivalencies  of 
Apothecary  to  Metric  to  Household  Meas.,  Temp 
"C  to  "F,  Prescrip,  Abbr,,  Urinalysis.  Body  Chem,, 
Blood  Chem.,  Liver  Tests,  Bone  Marrow,  Disease 
Incub  Periods.  Adult  Wgts ,  Child's  Dosages,  etc 
All  in  white  vinyl  holder  with  gold  stamped 
caduceus  No.  289  Card  Set  .  .  .1.50  ea. 
6  or  more  1.25  ea.     12  or  more  1.10  ea. 

Your   initials  gold-stamped   on   holder, 

add  50f  per  set. 


KELLY   FORCEPS  so  haniy  for 

every    nurse!    bVj"    stainless   steel,    fully 
guaranteed.  Ideal  for  clamping  off  tubing.  Your 
own  initials  help  prevent  loss. 

No.  25-72  Forceps . . .  2,75  ea.     6  or  more  2.50  ea. 
Your  initials  engraved,  add  50*  per  forceps. 


PULSOMETER  simplify  pulse-takingi  Min- 
iature hourglass  times  IS  seconds  very  accurately. 
Pochet  clip,  or  pins  on  with  9"  removable  chain. 
Chrome  plated,  plastic  box.  Handy,  efficient. 
No.  K-15-E  Pulsometer  2.95  ea.  3  or  rfore  2.50  ea. 
12  or  more  2.00  ea. 
Engraved  initials,  add  50*  per  item.      Duty    Free 


ENT  INSTRUMENT  SET 

A  superb  quality  set  for  nurses!  Includes  med. 
handle  with  resistance  regulation,  otoscope 
head,  nose  speculum,  ilium,  tongue  blade 
holder,  5  assort  ear  reflectors.  Precision 
crafted,  fitted  into  handsome  velvet-^—      ^ 
lined  case.  Powered  by  2  "C"  (^AJi^ 

batteries.  Your  initials  engraved  on  ^ 

handle  and  gold-stamped  on  case  FREE 
10  year  guarantee.  Outstanding  value! 
No.  33     ENT  Set  .  .  only  49.95  ea.  o^i 


NIGHTINGALE  UMP 

An  authentic,  unique  favor,  gift  or  engraved 
award!  Ceramic  oft-white  candleholder  with 
genuine  gold  leaf  tnm.  Recessed  candle 
cup  (candle  not  included).  7"  long. 


No.  FIDOS  Lamp  . .  6,95  ea.,  12  or  more  4,95  ea. 
Initials  and  date  engraved  on  gold  plaque  .  .  . 
add  1.00  per  lamp. 


X_. 


NURSES  WATCHES 


Hamilton  17  Jewel 

"Buren"  Calendar  Watch,  17  lewels,  sweep- 
second  hand.  Date  changes  at  midnight.  Water, 
shock  rests,  anti-mag,  unbreak  mainspring. 
Chrome  finish,  eipan.  bracelet,  1  yr  guarantee. 
No.  8L53  Ham.  Watch  .  .  .  34.95  ea. 


EndUfa  Waterproof  Swiss  made,  raised  silver  full 
numerals,  lumin.  markings.  Red-tipped  sweep  second- 
hand, chrome  /  stainless  case.  Includes  genuine  black 
leather  watch  strap.  1  year  guarantee.  Very  dependable. 
No.  1093  Endura  Watch 19.95  ea. 


BZZZ  MEMO-TIMER  Jme  hot  packs,  heat 
lamps,  park  meters.  Remember  to  check  vital  signs, 
give  medication,  etc  Lightweight,  compact  il^"  dia.). 
sets  to  buzz  ^  to  60  mm    Key  ring   Swiss  made 

No.  M-22  Timer 3.98  ea. 

3  for  9.75  ea.,  6  or  more  3.00  ea. 


■t} 


(^M>      -^<p    EXAMINING  PENLIGHT 

L    -""""^.J^^^^       White  barrel  with  caduceus  imprint,  aluminum 
I      SJ^V—-"'^"^       tJflfid  and  clip.  5"  long.  US.  made,  batteries  included  (re- 
'-       placement  batteries  available  any  store).  Your  own  light,  gift  boxed. 
No.  007  Penlight . .  .  3,98  ea.  Your  Initials  engraved,  add  50<  per  Itght 


CROSS  PEN 

Wofld-famous  ballpoint,  with 

sculptured  caduceus  emblem.  Full  name 

FREE  engraved  on  barrel  (include  name  with  coupon). 

Refills  avail  everywhere  Lifetime  guarantee. 

Ma     7<;n7   rhrnma   A  rV)   ea  Nn     KAO?    1  9kt     R  f . 


NURSES  BAG  A  lifetime  of  service 
for  visiting  nurses!  Finest  black  W  thick 
genuine  cowhide,  beautifully  crafted  with 
rugged  stitched  and  rivet  construction. 
Water  repetlant.  Roomy  interior,  with  snap- 
in  washable  liner  and  compartments  to 
organize  contents.  Snap  strap  holds  top 
open  during  use.  Name  card  holder  on  end. 
Two  rugged  carrying  straps  6"  x  8"  x  12". 
Your  initials  gold  embossed  FREE  on  top.  An 
outstanding  value  of  superb  quality, 
.  1544-1  Bag  (with  liner) .  .  42.50  ea. 
Extra  liner  No.  4415 8.50 


->^^^^SHOE  TOTE    Keep    or    carry 
^^  ^  shoes  in  this  fine  stitched  white  vinyl 
bag!  Opens  wide,  separate  scuft-proof 
compartment    for    each    shoe.    Zips 
weather-tight,  carrying  strap,  4"  x  6"  x  12". 
No.  444  Tote  .  5.49  ea.     6  or  more  4.50  ea. 
Your  initials  gold-stamped,  add  50<  per  Tote. 


DAdY  dUALE  Weigh  infants  on  home  visits. 
Precision-made  bronze  cyclmder,  nickel  handle  and 
hook.  Weight  to  15  lbs.  or  7  kg.  White  vinyLcloth 
sling  holds  infant  securely  for  weighing,  then  folds 
to  form  compact  carry  case.  Useful  and  accurate! 

No.  IN-15  Scale 14.95  ea. 

Your  initials  engraved,  add  50*  per  scale. 


^ 


AUTO  INSIGNIA  Full-color  enam 

elled  RN  insignia  (left)  on  bronze-plated 
medallion  Easy  to  attach  to  registra- 
tion plate.  Weather-proof,  distinctive. 
No.  210  Medallion  ....  5.95  ea. 
4-color  decal  with  RN  emblem,  transfers 
easily  to  instde  car  window  4Vi"  dia. 
No.  621  Decal 1.25  ea. 


TRICOLOR  BALL  PEN 

Write  in  black,  red  and  blue  with  one  ball  point  pen. 
Flip  of  the  thumb  changes  point  (and  color).  Steno  fine  point  (excellent 
for  charts]   Polished  chrome  finish.  Ahandy  accessory  for  every  nurse! 

No.  921  Ball  Pen 1.95  ea. 

No.  292-R  3-color  Refills 50«  ea. 


SCRIPTO  PILL  LIGHTER  Famous  Scripto 
Vu-Lighter  with  crystal-clear  fuel  chamber  containing  color- 
ful array  of  capsules,  pills  and  tablets.  Novel,  unique,  for 
yourself  or  for  unusual  gifts  tor  friends.  Guaranteed  by 
Scripto  A  real  conversation  piece! 
No.  300-P  Pill  Liehler 5.95  ea. 


^^^^ 


em 
ohm... 


|(g^g5 


Personalized 

Littmann  3D0I 

NURSESCOPE* 

Famous  Littmann  nurses  diaphragm 
stethoscope,  with  your  initials  indi- 
vidually engraved  FREE!  A  fine,  pre- 
cision instrument,  has  high  sensi- 
tivity for  blood  pressures,  general 
ausculation.  Only  IVz  ozs.,  fits  in 
pocket,  23"  vinyl  anti-collapse  tub- 
ing, non-chilling  snap-on  diaphragm, 
non-rotating,  correctly -angled  ear 
tubes  U  S-  made.  Choose  from  5 
jewel-like  colors.  Goldtone,  Silver- 
tone,  Blue.  Green,  Pink. 

FREE  INITIALS! 

engraved  on  chest  piece,  lends  indi- 
vidual   distinction,    prevents    loss 
Specify  on  coupon  below. 
No.  216  Nursecope  13.80  ea. 

6-11 12.80  ea. 

Duty    Free 

SCOPE   SACK    neatly  carries  and  pro- 
tects   Nursescope    or   any   scope.    Double-thick 
'rested  flexible  plastic,  white  vinyl  binding  4^^" 
'  9'-2",  Your  own  initials  help  prevent  loss. 
No.  223  Sack.  .  .  1.00  ea.         6  or  more  75<  ea.    : 
Your  initials  gold-stamped,  add  S0<  per  sack. 


NURSES  PERSONALIZED 
ANEROID  SPHYG. 

A  superb  instrument  especially 
designed  for  nurses'  Imported  from  pre- 
cision craftsmen  in  W.  Germany.  Easy- 
lo-attach  Velcro  cuff,  lightweight,  com- 
pact, fits  into  soft  sim.  leather  zippered 
case  2W"  x  4"  x  7".  Dial  calibra- 
ted to  320  mm..  10-year  accuracy 
guaranteed  to  ±3  mm.  Serviced  by 
Reeves  if  ever  required.  Your  ini- 
tials engraved  on  manometer  and 
gold  stamped  on  case  FREE,  for 
permanent    identification    and 
distinction.  A  wise  investment  for 
a  lifetime  of  dependable  service! 
No.  106  Sphyg.  .  .  .  26.95  ea 


CAP  ACCESSORIES 


Duty 
Free 


cSZ3>^ 

CAP  TOTE    keeps   your   caps   crisp   and   clean    ^^  ^ 

while  stored  or  carried.  Flexible  clear  plastic,  white    ^*  _ 

trim,  zipper,  carrying  strap,  hang  loop.  Stores  flat.  Also       ,  -  — 

for  wiglets.  curlers,  etc.  8Vi"  dia.,  6"  high.  ' 

No.  333  Tote  . .  2.65  ea.,  6  or  more  .  .  2.35  ea. 

Your  initials  gold-stamped,  add  50c  per  Tote.  " 

"^       WHITE  CAP  CLIPS      Holds    caps 

firmly  in  place!  Hard-to-find  white  bobbie  pins, 
enamel  on  fine  sp'ing  steel.  Eight  2"  and  eight 
3"  clips  included  in  plastic  snap  box. 
No.  529  Clips  .  .  3  boxes  for  1.95. 
6  for  3.25,  12  for  49<  ea. 

MOLDED  CAP  TACS 

Replace  cap  band  instantly.  Tiny  plastic  tac. 
dainty  caduceus, -Choose  Black.  Blue.  White 
or  Crystal  with  Gold  CaduceuS;  or  all  Black  ;' 
(plain).  The  neater  way  to  fasten  bands. 
No.  200  Set  of  6  Tacs  . . .  1.25  per  set. 
12  or  more  sets  1.00  per  set 

METAL  CAP  TACS     Pai,   of   dainty 
jewelry^iualify  Tacs  with  grippers.  holds  cap 
„  r-^fyf^        -3       bands  securely.  Sculptured  metal,  gold  finish, 
lUZji^l  approi    V,"   mde.   Choose   RN.   LPN.   tVN,   RN 

^-*'^'^'   -ijii©' Caduceus  or  Plain  Caduceus.  Gift  boxed. 
n  Wfyi       ^59   No.  CT-l  (Specify  Initials),  No.  07-2  (Plain 
U«/lM       !^^-Cad.)  or  No.  CT-S  (RN  Cad.)  .  .  .  2.95  pr. 

SEL-FIX  CAP  BAND  Black.el.et 
band  material.  Selfadhesive,  presses  on, 
pulls  off;  no  sewing  or  pinning  Reusable 
several  times.  Each  band  20"  long,  pre^cut  to 
popular  widths:  V."  (12  per  plastic  box)  ^" 
(8  per  box)  %"  16  per  box)  1"  (6  per  bbx). 
Specify  width  under  ITEW  column  on  coupon 
No.  6343  Band.  .  .  1.75  per  box         3  or  more 


COLOR    OUANT.      PRICE 


NAME  PINS:  Zl   One  Name  Pin        D   Two,  same  name 

LETT.  COIOR METAL  FIN 

LETTERING  

2nd  line 


INITIALS  as  required 


.  (hflass.  residents  add  3%  S.  T.) 


Sorry,  no  COD'S  or  billing  terms  availatile 


Send  to  . 
Street  .. 
Citv  . 


.St«t» ZJD  . 


Injectable  Solutions  and  Additives: 
Compatibilities,  Incompatibilities, 
Routes  of  Administration  Dy  Thomas 
J.  Fowler,  32  pages  and  chart.  New 
York,  Springer  Publishing  Company, 
1971. 

Mr.  Fowler  uses  tabular  form  exclusi- 
vely to  present  information  regarding 
which  drugs  are  or  are  not  compatible 
in  injectable  forms.  The  first  table 
presents  frequently  used  intravenous 
solutions  and  additives;  the  second, 
multiple  additives;  and  the  third,  routes 
of  administration  for  injectable  medica- 
tions. 

The  first  section  of  the  book  is 
reproduced  in  a  large  chart  suitable 
for  posting  on  the  wall  in  an  area  where 
intravenous  solutions  are  mixed;  it  is 
coded  in  three  colors  to  indicate  com- 
patible, incompatible,  and  undetermin- 
ed combinations. 

The  information  presented  in  this 
concise  and  usable  form  is  collected 
from  published  sources;  the  factual 
information  is  complete,  but  no  at- 
tempt is  made  to  provide  explanations. 

The  format  of  the  book  and  the  wall 
chart  makes  the  information  readily 
accessible  and  useful  to  a  hospital  nurs- 
ing unit. 

Working  with  the  Mentally  III.,  4ed.,  by 
Alice  M.  Robinson.  249  pages.  To- 
ronto, J. B.  Lippincott,  1971. 
Reviewed  by  Rita  E.  Jennings,  Psy- 
chiatric Nurse-Teacher,  Western 
Memorial  Hospital  School  of  Nurs- 
ing, Cornerbrook,  Newfoundland. 

The  fourth  edition  of  Alice  M.  Robin- 
son's book  The  Psychiatric  Aide  has 
recently  appeared  in  an  expanded  form 
with  a  new  title  Working  with  the  Men- 
tally III. 

The  change  of  title  is  a  splendid 
departure  as  it  clearly  indicates  to  the 
reader  that  the  mental  health  worker 
and  the  patient  work  together  in  find- 
ing constructive  modes  of  behavior 
for  the  patient.  In  the  past  we  may  have 
been  remiss  in  using  the  term  "to  nurse" 
in  reference  to  our  responsibilities  to  the 
so  called  "mentally  ill."  "To  mother," 
"to  nurture,"  "to  care  for,"  have  been 
designates  that  have  not  always  convey- 
ed to  mental  health  workers  the  correct 
approaches  for  the  incapacitated  who 
have  fallen  within  the  confines  of  psy- 
chiatric terminology. 

46     THE  CANADIAN  NURSE 


Despite  the  new  title,  the  content  of 
the  book  has  changed  very  little.  Chap- 
ters have  been  added  on  the  current 
problems  of  drug  abuse,  adolescents, 
and  geriatrics.  Miss  Robinson  has  also 
devoted  a  section  to  the  Community 
Mental  Health  Center  and  enlarged  on 
the  career  opportunities  awaiting  the 
ambitious  psychiatric  aide.  The  reading 
list  has  been  brought  up-to-date  and 
the  American  Psychiatric  Association 
classification  that  appeared  in  the  pre- 
vious edition  has  been  deleted. 

Miss  Robinson's  concepts  have  al- 
ways been  dynamic  and  she  has  been 
able  to  express  these  concepts  in  very 
readable  and  reassuring  ways.  This 
book  can  be  recommended  for  psychia- 
tric aides  and  lay  people,  but  it  lacks 
the  depth  of  material  required  for 
professional  psychiatric  groups.  How- 
ever, this  new  edition  of  Miss  Robin- 
son's book  could  be  helpful  to  a  student 
nurse  who  might  find  her  initial  contact 
with  psychiatric  nursing  a  particularly 
trying  experience. 


Care  of  the  Adult  Patient,  3ed.  by  Doro- 
thy W.  Smith,  Carol  P.  Hanley  Ger- 
main, and  Claudia  D.  Gips.  1197 
pages.  Toronto,  Lippincott,  1971. 
Reviewed  by  Shirley  Anderson,  Cur- 
riculum Coordinator,  Royal  Jubilee 
Hospital  School  of  Nursing,  Victo- 
ria. B.C. 

The  authors  have  accomplished  their 
objective  in  presenting  an  excellent 
text  for  nursing  students  that  contains 
a  comprehensive  approach  to  medical- 
surgical  nursing  problems  in  the  adult. 
The  text  also  lends  itself  to  use  by  a 
graduate  nurse  who  wishes  to  review 
her  basic  medical-surgical  knowledge. 

The  reorganization  and  revision  of 
the  units  and  chapters  has  developed 
a  more  inclusive  approach,  including 
the  role  of  the  nurse  in  patient  care, 
and  the  psychosocial  implications  of 
illness  and  rehabilitation.  The  unit  on 
neurosurgery  still  requires  some  updat- 
ing of  the  nursing  content. 

New  headings  such  as  "Disturbances 
of  Body  Supportive  Structure  and  Lo- 
comotion" and  "Insults  to  Cardiovas- 
cular Integrity"  excite  the  interest  of 
the  reader  and  indicate  a  broad  ap- 
proach to  a  specific  nursing  problem. 
The  expanded  chapter  on  "Dependence 
on  and  Abuse  of  Tobacco,  Alcohol  and 
Drugs"  and  "The  Patient  in  Pain"  in- 


clude more  about  the  physiologic  effect 
on  the  individual,  and  are  timely  and 
of  value. 

There  are  excellent  case  studies 
within  chapters.  It  is  unfortunate  that 
newer  pictorial  illustrations  were  not 
used.  Students  frequently  comment  on 
outdated  illustrations  and  some  go  so 
far  as  to  judge  the  book  content  from 
the  pictures. 

The  authors,  no  doubt,  intended  the 
chapters  dealing  with  "Life  Threatening 
Physiologic  Crises"  to  be  considered 
material  of  greater  depth  and  therefore 
separated  them  from  the  more  basic 
concepts  of  care  for  the  particular 
system  involved.  This  well-presented 
content  might  have  been  integrated 
with  the  previous  chapters  to  produce 
a  greater  impact. 

Teachers  and  students  who  are  fam- 
iliar with  previous  editions  of  this 
text  will  be  pleased  to  see  that  the 
authors,  in  addition  to  providing  a 
very  readable  and  realistic  approach 
to  nursing  problems,  have  added  suf- 
ficient content  to  create  an  appetite  for 
further  knowledge. 

In  summary,  the  text  provides  nurs- 
ing teachers  and  students  with  a  com- 
prehensive basis  for  medical-surgical 
nursing  at  a  beginning  level. 

I  Have  Feelings  by  Terry  Berger,  pho- 
tographed by  I.  Howard  Spivak. 
35  pages.  New  York,  Behavioral 
Publications,  Inc.,  1971. 

/  Have  Feelings  is  an  illustrated  book 
for  children,  the  fourth  in  a  series  of 
books  on  psychologically  relevg^nt 
themes. 

The  book  covers  17  different  feel- 
ings, both  good  and  bad,  and  the  sit- 
uations that  precipitated  each  one.  Each 
feeling  is  presented  by  a  situation,  the 
feeling  that  results,  and  finally  by  an 
explanation  of  that  feeling. 

The  treatment  of  the  feelings  is  gear- 
ed for  a  young  audience  (4-9  years) 
and  the  material  is  presented  for  the 
child  himself  to  read  and  comprehend. 
Explanations  of  feelings  are  approach- 
ed in  a  rational,  therapeutic  manner. 

For  example,  one  picture  shows  the 
child,  the  same  little  boy  in  each  pic- 
ture, with  a  cherubic  toddler  in  a  pram. 
The  text  above  the  picture  is:  "The 
lady  next  door  asks  me  to  watch  her 
baby.  She  needs  something  from  the 
store."  Under  the  picture,  "I  feel  im- 
portant." On   the  opposite  page,  the 

NOVEMBER   1971 


explanation:  "Rocking  the  baby  to 
sleep  I  keep  on  thinking — It's  nice 
to  know  I  can  do  the  job." 

Photographs  enable  easy  identifica- 
tion while  maintaining  the  tone  of  reali- 
ty that  is  inherent  in  each  encounter. 

The  series  of  books  could  be  valuable 
to  nurses  as  parents,  aunts  or  uncles, 
siblings,  and  as  practitioners. 


Nursing  and  the  Childbearing  Family: 
ACuideforStudyby  DebraP.  Hymo- 
vich  and  Suellen  B.  Reed.  334  pages. 
Toronto,  W.B.  Saunders  Co.,  1 97 1 . 

The  18  study  guides  which  make  up 
Nursing  and  the  Childbearing  Family 
provide  a  framework  within  which 
students  can  discover  how  nursing  can 
assist  families  during  childbearing  and 
in  the  first  year  of  childrcaring.  As  the 
preface  to  the  book  states,  "the  guides 
are  designed  to  involve  the  nursing 
student  in  her  own  learning  by  having 
her  select  information  needed  to  pro- 
pose solutions  to  nursing  problems." 

Some  of  the  human  situations  in- 
cluded in  the  guides  are  a  family  with  a 
first  baby,  teen-aged  parents,  an  un- 
married mother,  the  family  of  a  still- 
born baby,  and  adoptive  parents  of  a 
newborn  baby. 

The  guides  are  useful  for  either 
diploma     or     baccalaureate     nursing 


students  and  can  suggest  to  teachers 
imaginative  approaches  to  content 
organization. 


Helping  Unmarried  Mothers  by  Rose 

Bernstein.  186  pages.  New  York, 
Association  Press,  1 97 1 . 
Reviewed  by  Margaret  Keogh,  Pub- 
lic Health  Staff  Nurse,  Ottawa- 
Carle  ton  Regional  Area  Health  Unit, 
Ottawa,  Ontario. 

The  introduction  to  this  book  is  a 
particularly  good  summary  of  the  dif- 
ferent attitudes  and  expectations  so- 
ciety holds  regarding  married  and  un- 
married mothers.  Mrs.  Bernstein  be- 
lieves that  attitudes  toward  unmarried 
mothers  downgrade  their  maternal 
image  and  can  do  serious  injury  to 
maternal  function  with  subsequent 
children.  The  author's  theory  is  that 
crisis  intervention  is  most  effective 
because  it  reaches  mothers  at  a  time  of 
receptivity  and  may  prevent  or  reduce 
maternal  functioning  damage. 

She  quotes  several  sources  who 
consider  pregnancy  itself,  even  in 
marriage,  as  a  potentially  critical  exper- 
ience—  perhaps  a  time  of  crisis  in 
which  old  problems  arc  revived  and 
there  is  a  breakdown  in  the  person's 
customary  way  of  managing.  At  this 
time  a  person  is  often  more  susceptible 


to  change  and  to  accept  the  intervention 
of  others.  For  the  unmarried  mother 
the  crisis  is  compounded  and  may  be 
precipitated  by  many  factors. 

Mrs.  Bernstein's  theory  is  that  help 
should  be  available  as  close  as  possible 
to  the  precipitating  event  and  should 
deal  with  events  that  the  mother  her- 
self finds  most  distressing.  Help  accept- 
ed at  this  time  is  likely  to  be  more 
effective  than  help  given  through  sched- 
uled interviews  in  which  the  interviewer 
attempts  to  have  the  mother  foresee 
problems.  However,  crisis  intervention 
should  not  serve  merely  to  carry  the 
mother  from  one  crisis  to  another  but 
should  help  her  to  see  underlying 
problems  that  may  be  preventing  ade- 
quate problem  solving  now. 

Mrs.  Bernstein  goes  on  to  discuss  her 
theory  in  terms  of  the  mother's  request 
for  help,  planning  for  the  baby,  the 
postnatal  period,  the  adolescent  un- 
married mother  and  the  unmarried 
father.  She  uses  many  cases  to  illustrate 
a  practical  approach. 

Although  this  book  is  primarily 
oriented  to  social  workers  in  the  United 
States,  it  has  value  for  anyone  working 
with  unmarried  mothers.  It  outlines  the 
potential  psychological  and  social 
hazards  of  having  a  child  out  of  wed- 
lock and  the  factors  that  determine 
whether  the  mother  will  receive  the 
services  she  needs.  o 


THE  MONTREAL 
GENERAL  HOSPITAL 

Invites  applications  from 

REGISTERED  NURSES 
FOR  GENERAL  DUTY 

ACTIVE  INSERVICE  EDUCATION  PROGRAM. 
PROGRESSIVE  PERSONNEL  POLICIES. 

for  further  information. 
Apply  to: 

The  Director  of  Nursing 

THE  MONTREAL 
GENERAL  HOSPITAL 

1650  Cedar  Avenue 
Montreal  109,  Quebec 


IDRC 
RESEARCH  ASSOCIATE  GRANTS 


As  part  of  its  Human  Resources  Development  Program, 
the  International  Development  Research  Centre  is  offer' 
ing  ten  one-year  research  grants  to  professional  practition- 
ers wishing  to  enter  the  field  of  international  development 
or  improve  skills  they  are  already  applying  in  this  field. 

Each  grant  provides  for  a  stipend  of  up  to  $15,000 
(depending  upon  other  sources  of  income),  plus  allow- 
ances for  travel,  research  or  training  costs. 

Candidates  must  be  Canadian  citizens  or  landed  immi- 
grants with  a  minimum  of  three  years'  residence  in 
Canada.  They  should  have  good  professional  standing, 
approximately  ten  years  of  experience  and  possess  de- 
monstrated expertise  applicable  to  the  problems  of 
developing  countries. 

Fields  of  interest,  though  not  limited,  can  be  in  such 
areas  as  agriculture,  food  and  nutrition  sciences,  inform- 
ation and  communications,  population  and  health 
sciences,  rural-urban  dynamics,  social  sciences,  technology 
transfer,  education,  engineering. 

Inquiries  should  be  addressed  to: 


Research  Associate  Grants, 
International  Development 

Research  Centre, 
P.O.  Box  8500, 
Ottawa,  Ontario,  Canada 
K1G  3H9 


NOVEMBER   1971 


THE  CAf>J<^DiAN  NURSE     47 


AV  aids 


Films 

□  Films  on  world  health  and  environ- 
mental control  are  available  from 
Shell  film  libraries  across  Canada.  The 
films  are  loaned  free  of  charge,  and 
they  may  be  borrowed  by  any  charitable 
group,  organization,  or  school,  but  not 
by  private  persons. 

For  more  information  write:   in  the 


Atlantic  Provinces  and  Quebec,  Shell 
Film  Library,  Box  430,  Station  B, 
Montreal,  Quebec;  in  Ontario,  Shell 
Film  Library,  Box  400,  Terminal  A, 
Toronto;  in  the  Western  Provinces, 
Shell  Film  Library,  Box  6700,  Winni- 
peg, Manitoba,  Shell  Film  Library, 
Box  100,  Calgary,  Alberta,  and  Shell 
Film  Library,  Box  221  I.  Vancouver  3. 

□  Challenge  For  the  Health  Team 
(16mm.,  sound,  color,  10  minutes) 
illustrates  some  of  the  skills  and  func- 
tions of  the  nurse  in  an  expanded  role. 
The  film  includes  brief  scenes  of  nurses 


Who  Prefers 

explosion-proof  suction 
units?    "We  do," 
say  most  0.  R.  nurses. 

Here's  why;  Gomco  Explosion-Proof 
Suction   Pumps  are  ready  for  life- 
protecting  service  because  of  their 
dependable,  quiet  operating  pump, 
precision   regulating  valve  and  gauge, 
explosion-proof,  heavy-duty  motor 
and  sealed-in  su'itch.  Cabinet, 

portable,  and  stand-mounted  units. 

Are  your  operating  rooms  prop- 
erly equipped  with  Gomco?  For 
latest  catalog,  see  your  dealer 
or  write:  GOMCO  SURGICAL 
MANUFACTURING  CORP.,  828 
E.  Ferry  St^^uffalo,  N.Y.  14211 


No    929 

ixplosion- 
proof  major 
suction  unit. 


No.  901  explosion-proof 
stand-mounted  unit. 


No.  9U  explosion-proof 
porlal)!e  suction  unit. 


48     THE  CANADIAN   NURSE 


in  different  settings:  in  the  community 
visiting  a  home,  in  the  doctor's  office 
as  a  doctor's  associate,  teaching  a  small 
group,  suturing  a  superficial  wound, 
and  initiating  and  maintaining  referrals. 
It  attempts  to  interpret  the  present  and 
the  potential  role  of  the  nurse  with  a 
degree  in  nursing. 

The  film  can  be  purchased  or  rented 
from  the  University  of  Saskatchewan 
Film  Library  Audio  Visual  Services 
Division,  Saskatoon,  Saskatchewan. 

U  Bamet  (1971,  48  minutes,  color) 
presents  a  complete  account  of  the 
conception,  gestation,  and  birth  of 
a  child,  including  the  delivery  of  the 
baby. 

This  film,  the  story  of  a  young  couple 
having  a  first  baby,  uses  animation  to 
explain  conceptioh  and  actual  photo- 
graphs to  trace  the  development  of  the 
fetus.  When  the  young  woman  goes  into 
labor,  her  husband  takes  her  to  the 
hospital,  and  he  assists  throughout  the 
delivery,  which  is  shown  in  detail.  The 
film  concludes  with  an  account  of 
postnatal  hospital  care. 

The  film  is  available  on  loan  or  for 
purchase  from  Educational  Film  Dis- 
tributors Ltd.,  191  Eglinton  Ave.  E., 
Toronto  3  15,  Ontario. 

Auditorium  Slide  Projector 

A  new  1000-watt  slide  projector  has 
been  introduced  by  General  Audio- 
visual Co.  The  Slide  King  1  1  is  compact 
and  measures  8'/2"  wide  x  13"  high  x 
18"  long.  Additional  features  include 
a  wide  selection  of  interchangeable 
lenses,  instant-change  condenser  chests, 
and  slide  carriers. 

The  projector's  cooling  system  uses 
two  centrifugal  blowers,  one  to  circu- 
late forced  air  through  the  projector 
housing,  and  the  other  to  cool  both 
sides  of  the  slide. 

For  more  information  write  to  the 
General  Audio-Visual  Co.,  1 350  Birch- 
mount  Rd.,  Scarborough  733,  Ontario. 

Terminology  aid 

The  correct  spelling,  pronunciation, 
and  dctmition  ot  over  700  basic  ana- 
tomical terms  has  been  presented  in  a 
series  of  13  programs  that  incorporate 
12  cassette  tapes,  an  illustrated  booklet 
and  instructor's  guide  by  Au-Vid  Corp, 
Garden  Grove,  California.  The  series 
covers  the  anatomical  terminology  of 
dermatology,  endocrinology,  gastroen- 
terology, gynecology,  neurology,  obstet- 
rics, ophthalmology,  urology,  orthope- 
dics, otorhinolaryngology,  pathology, 
the  respiratory  system  and  the  cardio- 
vascular system.  A  standard  cassette 
player  is  required  to  listen  to  the  pro- 
gram. For  more  information  write  to 
Au-Vid  Corp,  P.O.  Box  964,  Garden 
Grove,  California  92643.  U.S.A. 

NOVEMBER   1971 


Literature  Available 

Parents'  Guide  to  Hyperactivity  in 
Children  discusses  the  difficulties  of 
coping  with  hyperactive  children  and 
suggests  methods  of  dealing  with  this 
problem  for  both  parents  and  teachers. 
The  guide  is  written  by  Dr.  K.  Minde, 
assistant  professor  in  psychiatry  at  Mc- 
Gill  University  in  Montreal. 

Individual  copies  of  the  guide  are 
available  for  one  dollar  and  there  are 
discounts  on  orders  of  25  or  more.  For 
more  information  write  to  the  Quebec 
Association  for  Children  with  Learning 
Disabilities,  Suite  11,  6338  Victoria 
Avenue.  Montreal  252.  Quebec.  'iS' 


accession  list 


Publications  on  this  list  have  been 
received  recently  in  the  CNA  library 
and  are  listed  in  language  of  source. 

Material  on  this  list,  except  Reference 
items  may  be  borrowed  by  CNA  mem- 
bers, schools  of  nursing,  and  other 
institutions.  Reference  items  (Theses, 
archive  books  and  directories,  almanacs 
and  similar  basic  books)  do  not  go  out 
on  loan. 

Requests  for  loans  should  be  made 
on  the  "Request  Form  for  Accession 
List"  and  should  be  addressed  to:  The 
Library,  Canadian  Nurses'  Association, 
50  The  Driveway,  Ottawa,  Ont.  K2P 
1E2. 

Not  more  than  three  titles  should 
be  requested  at  any  one  time. 

BOOKS  AND  DOCUMENTS 

1.  Ahorlion  lows:  a  survey  of  current  world 
legislation.  Geneva,  World  Health  Organiza- 
tion. 1971.  78p. 

2.  Aclivite  dc  lOMS  en  1970.  Rapport 
annuel  du  Directeiir  general  a  t'Asseinhlee 
mondiate  de  la  Stinle  et  uu.x  Nations  Unies. 
Geneve,  Organisation  mondiale  de  la  Sante, 
1971.  305p.  (ItsActesofficielsno.  188) 

3.  Adjustment  psychology:  a  human  value 
approach,  by  Ronald  G.  Poland  and  Nancy 
D.  Sanford.  St.  Louis.  Mo..  Mosby,  1971. 
223p. 

4.  The  adolescent  in  the  modern  world. 
Toronto,  Ontario  Federation  of  Home  and 
School  Associations,  c  1967.  ll.'^p. 

5.  The  anatomy  and  physiology  of  obstetrics: 
a  short  textbook  for  students  and  midwives. 
5th  ed.  by  Clifford  William  Furneaux  Bur- 
nett. London,  Faberand  Faber,  1969.  215p. 

6.  A  ustralasian  hospital  directory  and  nurses' 
yearbook  1970-1971 .  Compiled  and  annotat- 
ed by  A.L.  Hart.  Sydney.  NSW..  New  South 
Wales  Nurses"  Assoc.  1970.  180p.  R 

7.  Birth  control  handbook.  Edited  by  Donna 
Cherniak  and  Allan  Feingold.  5th  ed..  rev. 
Montreal.  P.Q  .  1969.  c  1970.  47p. 

NOVEMBER   1971 


8.  Canadian  labour  in  transition.  Edited  by 
Richard  Ulric  Miller  and  Eraser  Isbester. 
Scarborough.  Ont..  Prentice-Hall,  cl971. 
266p. 

9.  Care  of  the  adult  patient:  medical-surgical 
nursing,  by  Dorothy  W.  Smith,  Carol  P. 
Hanley  Germain  and  Claudia  D.  Gips.  3d  ed. 
Philadelphia,  Lippincott,  cl971.  1 197p. 

10.  Care  of  experimental  animals:  a  guide 
for  Canada.  Ottawa,  Canadian  Council  on 
Animal  Care,  1969?  1  vol. 

11.  The  centenary  the  Sisters  of  Chatham, 
.\'.B.  1869-1969.  Chatham,  N.B.,  1969. 
1  vol.R 

12.  Connaissance  de  la  drogue,  par  Andre 
Boudreau.  Montreal.  P.Q-.  Editions  du  jour, 

1970.  204p. 

13.  Developing  multi-media  libraries,  by 
Warren  B.  Hicks  and  Alma  M.  Tillin.  New 
York,  Bowker,  cl970.  199p. 

14.  Eduquer  les  enfants  deficients?  by  Pa- 
querette  Villeneuve.  Paris,  Unesco,  cl969. 
80p. 

15.  Emergency  care  of  the  sick  and  injured: 
a  maniud  for  law-enforcement  officers,  fire- 
fighters, ambulance  personnel,  rescue  squads 
and  nurses.  Edited  by  Robert  H.  Kennedy 
for  American  College  of  Surgeons.  Com- 
mittee on  Trauma.  Philadelphia,  Saunders, 
1969.  130p. 

16.  Tlie  family  and  its  future.  Edited  by 
Katherine  Elliott.  London.  J.  and  A.  Chur- 
chill. 1970.  230p.  (Ciba  Foundation  Blue- 
print) 

17.  Fluids  and  electrolytes  with  clinical 
applications:  a  programmed  approach,  by 
Joyce  Lefever  Kee.  Toronto,  Wiley,  cl971. 
494p.  (Wiley  nursing  paperback  series) 

18.  Fringe  benefits:  wages  or  social  obliga- 
tion.' An  analysis  with  historical  perspectives 
from  paid  vacations,  by  Donna  Allen.  Rev. 
ed,  Ithaca,  N.Y.,  Cornell  University,  1969. 
272p. 

19.  Future  shock,  by  Alvin  Toffler.  New 
York.  Random  House,  cl970.  505p. 

20.  General  and  organic  chemistry,  by 
Garth  L.  Lee  et  al.  Toronto,  Saunders,  1971. 
868p.  (Saunders  golden  series) 

21.  Guide  for  expectant  parents.  New  York, 
Grosset  &  Dunlap  for  Maternity  Center 
Association,  1971.  182p. 

22.  Histoire  du  nursing,  par  Fran^oise  Sa- 
vard  et  Jean-Marc  Gagnon.  Montreal,  P.Q. 
Editions  du  Renouveau  Pedagogique.  cl970. 
142p. 

23.  L'homme  au  travail,  format  du  temps'.' 
par  Pierrette  Sartin.  Belgium,  Gamma, 
C1970.  266p. 

24.  Livres  et  auteurs  quebecois;  revue  criti- 
que de  I'annee  litteraire,  1970.  Montreal, 
P.O.,  EiditionsJumonville,  1971.  3l2p. 

25.  A  manual  of  simple  nursing  procedures, 
by  Mary  J.  Leake.  5th  ed.  Toronto,  Saunders, 

1971.  233p. 

26.  Mealtime  manual  for  the  aged  and 
handicapped.  Richmond  Hill,  Ont.,  Simon 
&  Schuster  for  Institute  of  Rehabilitation 
Medicine,  University  Medical  Center,  cl970. 
242p. 

27.  Medicine  and  stamps.  Edited   by  R.A. 


You  can  breathe  easy 

withVentfoam 

Traction  Band. 

,  The  Scholl's  Double  Seal' 
Ventfoam  Traction  Band  has 
everything  you  want  and  your 
patients  need  for  comfort  and 
healing. 

The  perforations  allow 
skin  to  breathe,  inducing  more 
rapid  healing  of  lesions. 

The  Ventfoam  Traction 
Band  is  the  strongest  in  its 
field.  Made  of  super  soft  foam 
rubber,  laminated  to  a  fine 
rayon  twill  backing,  it  has  a 
tensile  strength  of  over  100 
pounds,  . 

It's  hypoallergenic.  It 
comes  in  3  and  4  inch  widths, 
in  handy  64  inch  packages. 

Let  us  demonstrate  the 
Ventfoam  Traction  Band  for 
you. 

Surgical  Supply  Division, 
TheSchollMfg.  Co.Ltd,, 
174  Bartley  Drive, 
Toronto  16,  Ontario, 


THE  CAN/y)IAN   NURSE     49 


accession  list 


Kyle  and  M.A.  Shampo.  Chicago.  American 
Medical  Association.  cl970.  216p. 

28.  The  incnml  health  leant  hi  the  schools. 
by  Margaret  Morgan  Lawrence.  New  York. 
Behavioral  Publications,  c  197  1 .  I69p. 

29.  The  nurse's  role  in  community  mental 
health  centers:  out  of  uniform  and  into  trou- 
ble, by  Carol  D.  De  Young  and  Margene 
Tower.  St.  Louis,  Mo.,  Mosby,  1971.  1 17p. 

30.  Orthopaedic  problems  in  the  newer 
world:  report  on  a  Commonwealth  Founda- 
tion lecture  tour.  Mar. -Sep.  1970.  by  R.L. 
Huckstep,  London,  Commonwealth  Founda- 
tion, 1970.  80p.  (Commonwealth  Founda- 
tion. Occasional  paper  no.  10) 

.3  1.  Pain  relief  in  labour:  a  handbook  for 
midwives.  by  Donald  D.  Moir.  Edinburgh. 
Churchill  Livingstone.  1971.  140p. 

32.  Parents'  answer  book:  what  your  child 
ought  to  know  about  sex,  by  Charlotte  del 
Solar.  New  York,  Grosset  &  Dunlap,  1969. 
89p. 

33.  Pharnuicologie  pratique:  medecine  - 
.wins  infirmiers  -  pharmacie.  par  Gilles 
Girard.  Arthabaska,  P.Q..  Hotel-Dieu 
d'A  rthabaska.  1970.  I50p, 

34.  Pharmacology  for  practical  nur.ses.  by 
Mary  Kaye  Asperheim.  3d  ed.  Philadelphia. 
Saunders,  1971.  18  Ip. 

35.  The  physician's  a.'i.tistant:  an  annotated 
bibliography.  Minneapolis,  Minn.,  American 
Rehabilitation  Foundation.  Institute  for 
Interdisciplinary  Studies  Educational  and 
Occupational  Research  Division,  1970.  47p. 

36.  Population  challenging  world  crisis. 
Edited  by  Bernard  Berelson.  Washington. 
Voice  of  America,  1969.  335p.  (Voice  of 
America  Forum  Lectures) 

37.  Pour  un  controle  des  naissances.  Redac- 
teurs:  Donna  Cherniak  et  Allan  Feingold. 
5ed.  rev.  Montreal,  P.Q..  I97L47p. 

38.  Premiers  secours  dans  les  detresses  res- 
pi  ratoi  res,  des  accidents  du  trafic.  des  into.xi- 
calions  et  des  maladies  aigues,  par  M.  Cara 
et  M.  Poisvert,  3.  ed.  Paris.  Masson,  1971. 
151p. 

39.  President's  review  and  annual  report 
1970.  New  York.  Rockfeller  Foundation. 
I97I.229p. 

40.  Simplified  psychiatry,  by  Jane  Pape. 
Bordentown,  N.J..  Stuart  James,  cl968. 
108p. 

41.  RN  survey  on  inservice  education.  Ora- 
dell.N.J..  RN  Research  Dept.,  1970.  99p. 

42.  Rapport.  Publication  complementaire 
au  rapport  CELDIC:  un  million  d'enfants. 
Montreal,  P.Q..  Commission  sur  I'etude  des 
troubles  de  Paffectivite  et  de  I'apprentissage 
chezl'enfant.Comitequebecois,  1970.  113p. 

43.  /.<'  rapport  Castonguay-Nepveu  et  I'in- 
firmier(e).  Montreal.  P.Q..  Infirmieres  et 
Infirmiers  Unis  Inc.,  1971.  94p. 

44.  Report  of  the  Study  Committee,  Cana- 
dian University  Service  Overseas.  Ottawa, 
1970.  1  vol. 

i:n       TI-IP    /~AMArtlAM    kji  idcf 


45.   Serials  on  microfilm  1971.  Ann  Arbor. 
Mich.,  University  Microfilms.  197  I.  450p. 
46:  Si  voire  enfant  se  drogiiait,  par  Ralph 
E,  Wendeborn  et  al.  Ottawa.  Novalis,  1971. 
23  Op. 

47.  Toward  a  public  policy  on  mental  health 
care  of  the  elderly.  New  York.  Group  for 
the  Advancement  of  Psychiatry.  C  ommittee 
on  Aging,  cl970.  50p.  (GAP  publication. 
vol.  7,  report  no.  79) 

48.  Tracheostomy  for  the  nurse,  by  Frank 
Wilson.  London.  Edward  Arnold  Ltd.. 
C1970.  104p. 

49.  True  to  you  in  my  fashion:  a  woman 
talks  to  men  about  marriage,  by  Adrienne 
Clarkson.  Toronto,  New  Press,  1971.  173p. 

50.  Urban  America:  the  expert  looks  al  the 
city.  Edited  by  Daniel  P.  Moynihan.  Was- 
hington,   Voice    of  America,     1970.    376p. 
(Voice  of  America  Forum  Lectures) 

51.  Urological  nursing  procedures,  by 
John  Whelan.  New  York,  Institute  of  Reha- 
bilitation Medicine,  New  York  University 
Medical  Center.  1970.  42p.  (Rehabilitation 
monograph  no.  43) 

52.  Welfare:  hidden  backlash,  by  Morris 
C.  Shumiatcher.  Toronto,  McClelland  and 
Stewart,  c  1 97 1.21 5p. 

53.  The  work  of  WHO.  1970.  Annual  report 
of  the  director-general  to  the  World  Health 
Assembly  and  to  the  United  Nations.  Gene- 
va. World  Health  Organization,  1971.  305p. 
(Its Official  records  no.  188) 


PAMPHLETS 

54.  Analyse  du  rapport  de  I'etude  C.R.O.P. 
(Centre  de  Recherche  sur  I'Opionion  Pu- 
blique)  Inc.  Quebec.  P.Q.  Association  des 
Infirmieres  et  Infirmiers  de  la  Province 
de  Quebec.  District  no.9.  197 1 .  40p. 

55.  Annual  meeting.  Committee  reports. 
1971.  Toronto.  Canadian  Hospital  Associa- 
tion, 1971.  35p, 

56.  Ciuidelines  on  medical-nursing  proce- 
dures 1971,  by  Registered  Nurses"  Associa- 
tion of  British  Columbia  and  British  Colum- 
bia Hospitals'  Association.  Vancouver. 
B.C..  1971.  12p. 

57.  How  to  cope  with  crises,  by  Theodore 
Irwin.  New  York.  Public  Affairs  Committee. 
1971.  28p.  (Public  affairs  pamphlet  no.  464) 

58.  Managing  your  colostomy  .  .  .  so  a  nor- 
mal life  is  yours  again.  Willowdale.  Ont.. 
Hollister,  CI971.  20p. 

59.  Managing  your  ileostomy  .  .  .  .vo  it 
doesn't  manage  you.  Willowdale.  Ont.. 
Hollister.  cl971.  20p. 

60.  A  method  for  rating  the  proficiency  of 
the  hospital  general  staff  nurse:  manual  of 
directions.  New  York,  National  League  for 
Nursing,  Research  and  Studies  Service, 
C1964.  28p. 

61.  Modern  methods  of  hrith  control,  rev. 
New  York.  Planned  Parenthood  Federation 
of  America,  1970.  pam. 

62.  Nursing  and  the  childbearing  family:  a 
guide  for  study,  by  Debra  P.  Hymovich 
and  Suellen  B.  Reed.  Toronto,  Saunders, 
I97I.334p. 

63.  Psychiatric  nursing,  by  Donna  C.  Agui- 


lera  and  Janice  M.  Messick.  Bordentown. 
N.J..  Stuart  James,  c  1968.  32p. 

64.  Recommended  health  manpower  policy 
.for  Minnesota.  St.  Paul.  Minnesota  State 
Planning  Agency,  Comprehansive  Health 
Planning  Program,  1970.  9p. 

65.  Reports  of  Workshops  held  at  Vellore, 
South  India,  Jan. -Feb..  1969  on  speech 
and  hearing  problems  in  .South  East  Asia. 
London.  Commonwealth  Foundation.  1970. 
34p.  (Commonwealth  Foundation.  Occasion- 
al paper  no.  6) 

66.  Second  chances  for  mature  women: 
report  of  a  talk-in  with  the  Quo  Vadis  School 
of  Nursing.  March  3,  1971.  Toronto,  Onta- 
rio Institute  for  Studies  in  Education,  Dept. 
of  Adult  Education,  1971.  29p. 

67.  Some  statistics  on  baccalaureate  and 
higher  degree  programs  in  nursing.  New 
York,  National  League  for  Nursing.  Dept. 
of  Baccalaureate  and  Higher  Degree  Pro- 
grams, 1971.  12p. 

68.  Utilization  review  guidelines  for  home 
health  agencies,  by  Associated  Hospital 
Service  of  New  York.  Home  Health  Agency 
Medicare  Liaison  Committee.  New  York. 
National  League  for  Nursing,  1971.  26p. 

69.  \'olunteers  in  education  and  health:  a 
discussion  of  the  work  being  done  by  vo- 
lunteer teachers  and  health  specialists  in 
developing  countries  and  of  the  new  possi- 
bilities for  voluntary  .service  in  the  1970s. 
Paris,  Unesco.  Coordinating  Committee  for 
International  Voluntary  Service.  1971. 
3  5  p. 

70.  What  kind  of  manpower  planning'.' 
Address  at  opening  of  Seminar  on  Man- 
power Planning  in  the  South  Pacific,  Fiji, 
July  1970,  by  Walter  Elkan.  London,  Com- 
monwealth Foundation.  1971.  I8p.  (Com- 
monwealth Foundation.  Occasional  paper 
no.l  1) 

71.  Work  study  practice;  report  of  Regional 
commonwealth  Work  Study  Seminar,  Sin- 
gapore, May  1970.  London.  Commonwealth 
Foundation,  1970.  32p.  (Commonwealth 
Foundation.  Occasional  paper  no.9) 

GOVERNMENT  DOCUMENTS 

Canada 

72.  Bureau  of  Statistics.  Annual  salaries 
of  public  health  nur.ws  1969.  Ottawa.  Queen's 
Printer.  1970.  46p. 

73.  Bureau  of  Statistics.  Illness  and  health 
care  in  Canada:  Canadian  sickness  survey 
1950-51.  Prepared  jointly  by  .  .  .  and  Dept. 
of  National  Health  and  Welfare.  Ottawa, 
Queen's  Printer,  I960.  217p. 

74.  Bureau  of  Statistics.  Survey  of  vocation- 
al education  and  training  1968-69.  Ottawa, 
Information  Canada,  1971.  I39p. 

75.  Canadian  Permanent  Committee  on 
Geographic  Names.  Gazetteer  of  Canada, 
supplement  /6.  Ottawa.  Information  Canada, 
1971.  54p. 

76.  Commission  royale  d'enquete  sur  le 
bilinguisme  et  le  biculturalisme.  Analyse 
des  nouvelles  televisees,  par  Monique  Mous- 
seau.  Ottawa,  Information  Canada,  1970. 
26lp.  (Its  Documents  no. 8) 

77.  Dept.   of  External   Affairs.    Diplomatic 

MnVFMRFR    iq71 


I 


corps  ami  consular  iinil  other  representatives 
in  Canada,  February  1971 .  Ottawa,  Informa- 
tion Canada,  1971.  74p.  R 

78.  Dept.  of  Finance.  Esliinates  for  the  fiscal 
year  ending  March  31.  1972.  Ottawa,  Infor- 
mation Canada,  1971.  I  vol. 

79.  Dept.  of  Labour.  Labour  organizations 
in  Canada.  59th  ed.  Ottawa,  Information 
Canada,  1971.  132p. 

80.  Dept.  of  National  Health  and  Welfare. 
Hospital  morbidity  statistics.  Based  on  the 
experience  of  provincial  hospital  insurance 
plans  in  Canada.  1967.  Ottawa,  197  1 .  286p. 
81. —  .How  to  get  your  guaranteed  income 
supplement:  a  program  of  the  government 
of  Canada.  Ottawa,  Information  Canada, 
1971.  16p. 

82. —  .Report  of  the  National  Conference  on 
Assistance  to  the  Physician,  Ottawa,  Apr. 
6-8,  / 97/.  Ottawa,  1971.  1  vol. 
83. —  .Research  projects  and  investigations 
into  economic  and  social  aspects  of  health 
care  in  Canada,  1970.  Ottawa.  1971.  183p. 
84. —  .Economic  Council  of  Canada.  Canadi- 
an hospital  costs  and  efficiency,  by  R.D. 
Fraser.  Ottawa,  1971.  159p.  (Its  Special 
study  no.  13) 

85. —  .Performance  and  potential:  mid- 
1950' s  to  mid-1970' s.  Ottawa,  Information 
Canada.  1970.  95p. 

86.  Ministere  de  la  Sante  nationale  et  du 
Bien-etre  social.  Les  services  de  sante  el  de 
hien-etre  au  Caruida,  1969.  Ottawa,  1971. 
146p. 


87.  National  Research  Council  of  Canada. 
Report.  1970-1971.  Ottawa,  Information 
Canada,  1970.  94p. 

88.  Northwest  Territories.  Laws  and  Statu- 
tes. Ordinances.  1970  -first  session.  Ottawa, 
Information  Canada,  1970.  54p. 

89.  Northwest  Territories.  Commissioner; 
Report  1970.  Ottawa,  Information  Canada, 
1971.  128p. 

90.  Royal  Commission  on  Bilingualism  and 
Biculturalism.  Acadian  education  in  Nova 
Scotia:  an  historical  survey  to  1965,  by 
George  A.  Rawlyk  and  Ruth  Hafter.  Ottawa, 
Information  Canada,  1970.  66p.  (Its  Study 
no.  I  1 ) 

91.  Education  and  economic  achievement, 
by  Donald  E.  Armstrong.  Ottawa,  Informa- 
tion Canada,  1970.  lOlp.  (Its  Documents 
no.7) 

Ontario 

92.  Council  of  Health.  Report.  Supplement 

1970.  Toronto.  Dept.  of  Health,  1970.  9 
volumes. 

93.  Dept.  of  Labour.  Research  Branch. 
Summer  employment  of  Ontario  secondary 
school  students,  1969.  Prepared  by  H.  Ri- 
chard Hird  and  Michel  D.  Lagace.  Toronto, 

1971.  56p.  (Its  Report  no.5) 
United  States 

94.  Dept.  of  Health.  Education  and  Welfare. 
Cooperative  planning  for  a  school  of  nursing 
within  a  health  science  complex,  by  Elizabeth 
.1.  Worthy  and  Dorothy  M.  Crowley.  Bethes- 
da,  Md.,  1970.  26p. 


95.  National  Institutes  of  Health.  Clinical 
Center.  Nursing  Care  of  patients  with  intern- 
al or  exteriuil  pacemakers.  Bethesda,  Md., 
1971.  20p. 

96.  . — .Nursing  care  of  patients  with  midline 
granuloma.  Bethesda.  Md.,  1971.  16p. 

STUDIES  DEPOSITED  IN  CNA  REPOSITORY 
COLLECTION 

97.  The  activities  of  nursing  personnel:  a 
study  of  the  activities  of  nursing  personnel 
in  selected  wards  and  clinics  of  12  hospitals 
and  one  district  of  the  V'.O.N.  in  the  Mont- 
real area,  by  Joan  M.  Gilchrist.  Montreal, 
P.Q.,  Research  Committee,  School  for 
Graduate  Nurses,  McGill  University, 
1971.  145p.  R 

98.  CUSO  nursing  programme:  a  descriptive 
study,  by  Sheila  Ward.  Ottawa,  CUSO,  1971. 
76p.  R 

99.  Concerns  of  cardiac  patients  regarding 
their  ability  to  implement  the  prescribed 
drug  therapy,  by  Irene  Erika  Nordwich. 
London.  Ont..  1970.  157p.  (Thesis  (M.Sc.N.) 
—  Western  Ontario.  R 

100.  The  perceived  learning  needs  of  gradu- 
ates of  a  two  year  diploma  program  in  nurs- 
ing, by  Frances  Margaret  Howard.  London, 
Ont.,  1971.  (Thesis  (M.Sc.N.)— Western 
Ontario.  R 

101.  A  pilot  study  into  student  evaluations 
of  tutors  in  four  selected  hospital  schools 
of  nursing,  by  Vivian  Wood.  London,  Dept. 
of  Health  and  Social  Security  (Nursing  Re- 
search) c  1971.  60p.R  ^- 


Request  Form 
for  "Accession  List" 

CANADIAN  NURSES' 
ASSOCIATION  LIBRARY 

Send  this  coupon  or  facsimile  to: 
LIBRARIAN,  Canadian  Nurses'  Association, 
50  The  Driveway,  Ottawa  K2P  1E2,  Ontario. 

Please  lend  me  the  following  publications,  listed  in  the 
issue  of  The  Canadian  Nurse, 
or  add  my  name  to  the  waiting  list  to  receive  them  when 
available. 


Item 
No. 


Author        Short  title  (for  Identification) 


Request  for  loans  will  be  filled  in  order  of  receipt. 
Reference  and  restricted  material  must  be  used  in  the 
CNA  library. 
Borrower 


Registration  No. 
Position 


Address  

Dote  of  request 


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Sen(d  in  tine  coupon,  we'll  se<c\6  you  back 
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NOVEMBER   1971 


THE     CANADIAN     NURSE     51 


classified  advertisements 


ALBERTA 


BRITISH    COLUMBIA 


ONTARIO 


ASSISTANT  DIRECTOR  OF  PUBLIC  HEALTH  NURS- 
ING: To  assist  Director  in  Administration  and  Super- 
vision of  a  Generalized  Public  Health  Nursing 
program  and  to  be  responsbile  for  continuing  Staff 
education  Qualifications:  Degree  in  Public  Health 
Nursing  with  Field  and  Administration  experience. 
Preference  will  be  given  to  those  at  the  Masters 
level.  Excellent  personnel  policies.  Salary  accord- 
ing to  experience.  Apply  to:  Dr.  G,  Ball.  Local  Board 
of  Health,  787  C.N.  Tower,  EDMONTON,  Alberta. 


REGISTERED  NURSES  and  CERTIFIED  NURSES 
ASSISTANTS  required  for  modern  60-bed  hospital 
located  in  the  Peace  River  Country,  AARN  salaries 
and  policies  in  effect.  Apply  to;  The  Director  of 
Nursing,  McLennan  General  Hospital.  P.O.  Box  390, 
McLENNAN,  Alberta. 


BRITISH  COLUMBIA 


HEAD  NURSE  and  TEAM  LEADER  positions  available 
days,  evenings  or  nights.  50-bed  Acute  Care  Hospital 
60  miles  west  of  Prince  George.  Challenging  nurs- 
ing and  administrative  experience;  a  chance  to 
develop  your  leadership  skills.  New  hospital  under 
construction,  good  recreational  area.  Wages  accord- 
ing to  RNABC  contract.  Apply:  Director  of  Nursing, 
St.  John  Hospital.  Vanderhoof.  British  Columbia. 


ADVERTISING 
RATES 

FOR   ALL 
CLASSIFIED   ADVERTISING 

$15.00  for  6  lines  or  less 
$2.50  for  each  additional  line 

Rates  for   display 
advertisements   on   request 

Closing  dote  for  copy  and  cancellation  is 
6  weeks  prior  to  1st  day  of  publication 
month. 

The  Canadian  Nurses'  Association  does 
not  review  the  personnel  policies  of 
the  hospitals  and  agencies  advertising 
in  the  Journal.  For  authentic  information, 
prospective  applicants  should  opply  to 
the  Registered  Nurses'  Association  of  the 
Province  in  which  they  are  interested 
in   working. 


Address  correspondence  to: 

The 

Canadian  ^ 
Nurse        ^ 

1  50  THE  DRIVEWAY 
■  OTTAWA,  ONTARIO 
i        K2P    IE2 

52     THE  CANADIAN  NURSE 


Modern  700-bed  tiospital  otters  positions  for  HEA^^ 
NURSES:  lor  Pediatric  Department,  lor  our  combined 
Optittialmology  and  Ear.  Nose  and  Ttiroat  Depart- 
ment and  lor  our  Operating  Room.  B  S  N  prelerred 
Experience  essential  REGISTERED  NURSES:  for 
GENERAL  DUTY  m  specialty  areas  —  OR.  Emergen- 
cy. Recovery  Room.  Psyctiiatry.  BC  Registration 
required.  RNABC  policies  m  etiecl.  Apply  Director 
ol  Nursing.  Royal  Jubilee  Hospital.  1900  Fort  Street 
Victoria.  Britisti  Columbia 


WANTED:  GENERAL  DUTY  NUR6ES  lor  modern  70 
bed  hospital.  (48  acute  beds — 22  Extended  Care) 
located  on  ttie  Sunstiine  Coast.  2  tirs  from  Vancou- 
ver Salaries  and  Personnel  Policies  in  accordance 
with  RNABC  Agreement  Accommodation  available 
(female  nurses)  in  residence.  Apply;  The  Director 
of  Nursing,  St.  Mary's  Hospital.  P  O.  Box  678.  Se- 
chelt,  British  Columbia. 


OPERATING  ROOM  NURSES  lor  modern  450-bed  hos- 
pital with  School  of  Nursing.  RNABC  policies  in  el- 
lect.  Credit  lor  past  experience  and  postgraduate 
training.  British  Columbia  registration  is  required. 
For  particulars  write  to  The  Associate  Director  of 
Nursing.  St. Joseph's  Hospital.  Victoria.  British  Co- 
lumbia. 


MANITOBA 


EXPERIENCED  REGISTERED  NURSE  required  lor 
OBSTETRICAL  and  General  Wards  in  40-bed  General 
Hospital  in  Fort  Churchill,  Manitoba.  Starting  salary 
in  excess  of  $650.00  per  month,  paid  fare  from 
Winnipeg  refunded  after  6  months  service.  For  partic- 
ulars apply  to:  Director  of  Nursing.  Fort  Churchill 
General  Hospital.  Fort  Churchill,  Manitoba. 


NOVA   SCOTIA 


REGISTERED  NURSES  AND  C.N. AS,  preferably  with 
psychiatric  experience,  required  lor  new  200-bed 
psychiatric  hospital  recently  opened  in  Halifax.  Active 
programs  for  in-patients  and  day  centre  patients. 
4  weeks  annual  vacation.  Blue  Cross,  pension  plan 
and  group  insurance.  Apply:  Director  of  Nursing. 
Abbie  J.  Lane  Memorial  Hospital,  5909  Jubilee 
Road.  Halifax.  Nova  Scotia. 


ONTARIO 


DIRECTOR  OF  NURSING  required  immediately  for 
105-bed  hospital  tor  severely  mentally  and  physically 
handicapped  children.  Reply  to:  Attention:  Dr.  W, 
Rygiel,  Board  of  Directors,  Dr.  Rygiel's  Home  for 
Children,  430  Whitney  Avenue,  Hamilton  15,  Ontario. 


DIRECTOR  OF  NURSING  SERVICES:  To  be  respons- 
ible for  the  Administration  of  the  nursing  depart- 
ment ol  the  International  Grenfell  Association  in 
Northern  Newfoundland  and  Labrador.  This  includes 
five  hospitals,  thirteen  nursing  stations  and  Public 
Health  Services.  Please  direct  applications  stating 
qualifications  and  experience  to:  Mrs.  Ellen  t. 
McDonald,  International  Grenfell  Association,  Room 
701,  88  Metcalfe  Street,  Ottawa,  Ontario.  KIP  5L7 


NURSING  PROGRAMME  CO-ORDINATOR  to  assist 
with  implementation,  co-ordination  and  interpretation 
of  Nursing  Programme,  and  evaluate  and  supervise 
Nursing  staff.  Public  Health  degree  and  Supervision 
required.  Good  personnel  policies.  Apply  to:  Dr. 
A.E.  Thoms,  Medical  Officer  of  Health,  Leeds, 
Grenville,  and  Lanark  District  Health  Unit.  70  Charles 
Street,  P.O.  Box  130.  Brockville,  Ontario. 


HOME  CARE  ADMINISTRATOR,  diploma  or  preferably 
degree  PUBLIC  HEALTH  NURSE  with  qualifications 
equivalent  to  that  of  SUPERVISOR,  required  to 
administer  and  co-ordinate  the  services  ol  a  Home 
Care  Programme.  Apply  in  writing  giving  background 
inlormation  to:  Dr.  A.E,  Thoms,  Medical  Officer  of 
Health,  Post  Ollice  Box  130   Brockville,  Ontario 

REGISTERED  NURSES  required  by  70bed  General 
Hospital  situated  in  Northern  Ontario,  Salary  scale  — 
$660  00-$670  00.  allowance  lor  experience  Shilt 
dillerential  annual  increment  40  hour  week  OH  A 
Pension  and  Group  Lite  Insurance  OHSC  and 
OHSIP  plans  in  etiect  Good  personnel  policies 
For  particulars  apply  Director  ol  Nursing,  Lady 
Minto  Hospital  at  Cochrane,  Cochrane.  Ontario. 


REGISTERED  NURSES  lor  34-bed  General  Hospital. 
Salary  $525.  per  month  to  $625  plus  experience  al- 
lowance. Residence  accommodation  available.  Ex- 
cellent personnel  policies.  Apply  to:  Superintendent 
Engleharl  &  District  Hospital  Inc..  Englehart,  Ontario 


REGISTERED  NURSES  needed  tor  81 -bed  General 
Hospital  in  bilingual  community  of  Northern  Ontario- 
French  language  an  asset,  but  not  compulsory.  R.N, 
salary-$557  to  $662.  monthly  with  allowance  for 
past  experience.  4  weeks  vacation  alter  1  year  and 
18  sick  leave  days,  Unused  sick  leave  days  paid  at 
100%  every  year.  Master  rotation  in  ellect.  Rooming 
accommodation  available  in  town.  Excellent  per- 
sonnel policies.  Apply  to:  Personnel  Director, 
Notre-Dame  Hospital,  P.O.  Box  850.  Hearst,  Ont. 


REGISTERED  NURSES  required  lor  a  12-bed  Intensive 
Care-Coronary  Care  combined  unit.  Post  basic 
preparation  and/or  suitable  experience  essential. 
1971  salary  range  $570-$680;  generous  Iringe  bene- 
tits.  Apply  to:  Director  ol  Administrative  Services 
and  Personnel,  St,  Mary's  General  Hospital.  911-B 
Queen's  Blvd.,  Kitchener,  Ontario. 

REGISTERED  NURSES  AND  REGISTERED  NURSIiv 
ASSISTANTS.  Our  75-bed  modern,  progressive  Hos- 
pital invites  you  to  make  application.  Salaries  for 
Registered  Nurses  start  at  $549.00,  with  yearly 
increments  and  experience  benefits  The  basic 
salary  lor  R  N  A  is  $382.00  with  yearly  increments. 
Room  IS  available  in  our  modern  residence.  We  are 
located  in  the  Vacalionland  ol  the  North,  midway 
between  Winnipeg  and  Thunder  Bay.  Write  or  phone: 
The  Director  ol  Nursing.  Dryden  District  General 
Hospital.  Dryden.  Ontario. 

REGISTERED  NURSES  AND  REGISTERED  NURSING 
ASSISTANTS  for  45-bed  hospital  R  N  s  salary  $560. 
to  S660  with  experience  allowance  and  4  semi-annu- 
al increments  Nurses  residence  —  private  rooms 
with  bath  -  S30  per  month  R  N  A.  s  salary  $380.  to 
^4c0.  Apply  to  The  Director  ol  Nursing.  Geraldton 
District  Hospital.  Geraldton,  Ont. 


REGISTERED  NURSES  AND  REGISTERED  NURSING 
ASSISTANTS,  looking  tor  an  opportunity  to  work  in 
a  patient  ueniereo  Nursing  bervice.  are  required  by 
~a  modern  well-equipped  hospital.  Situated  in  a  J) re- 
gressive Community  in  South  Western  Ontario.  Ex- 
cellent employee  benelits  and  working  conditions 
Write  for  further  information  to:  Director  of  Nursing; 
Leamington  District  Memorial  Hospital:  Leamington, 
Ontario. 

REGISTERED  NURSES  are  required  immediately  for 
GENERAL  DUTY  in  48-bed  General  Hospital.  Salary 
commensurate  with  experience.  Excellent  Iringe 
benefits  and  liberal  personnel  policies.  Good  modern 
accommodation  available  at  reasonable  rates.  Appli- 
cations and  enquiries  are  invited.  Apply  to:  Director 
of  Nursing,  Lady  Minto  Hospital  Chapleau,  Ontario. 


REGISTERED  NURSE  FOR  OPERATING  ROOM  also 
GENERAL  DUTY  NURSES  lor  80-bed  hospital;  recog- 
nition for  experience;  good  personnel  policies,  one 
month  vacation;  basic  salary  $567.50.  July  1st, 
$570.00.  Apply,  Director  ol  Nursing,  Huntsvillo 
District  Memorial  Hospital,  Box  1151),  Huntsville, 
Ontario. 

REGISTERED     NURSING     ASSISTANTS     lor    80-bed 

hospital,  starting  salary  $375.00  with  increments  tor 
past  experience;  three  weeks  vacation;  18  days 
sick  leave;  residence  accommodation  available. 
Apply:  Director  of  Nursing.  Huntsville  District 
Memorial    Hospital,    Box    1150,    Huntsville,    Ontario. 


NOVEMBER     1971 


^^ 


Oetember  1971 


^' 


«w^  ® 


ft\6 


The 

Can 
Nurse 


OTTAWA.    ONT. 
KIN    6N5 


and  a  Merry  Christmas 
to  all! 

rock  festivals:  new  problems 
and  new  solutions 

when  you  need  a  consultant . . 


Lippincott 


...FOR 

MATERNAL 

CHILD 

NURSING 


PRACTICAL    NEONATAL    PAEDIATRICS 

R.  J.  K.  Brown,  M.B.  FRCP.  D.C.H.;  H.  B  Valman 
M.B.  M.R.C.P.  D.C.H.  D.R.C.O.G. 

Written  for  all  personnel  on  the  neonotal  health 
unit;  this  new  book  provides  well-indexed  informa- 
tion on  monagement  of  the  new-born.  Chapters  are 
arranged  according  to  gross  presenting  features  to 
help   with    common   clinical    problems. 

47'f,.      96  pages,  3   illustrations.      $4.50 


1971. 


7'/4 


PEDIATRIC   SURGERY   FOR   NURSES 

Edited  by  John  G.  Raffensperger,  M.D.,  and  Rosellen  B. 
Primrose,  R.N.,  B.S. 

Students  and  pediatric  nurses  will  find  this  text 
straightforward,  easy-to  use,  and  essential  as  a  guide- 
book for  handling  pediatric  surgical  patients.  Detailed 
descriptions  of  patient  conditions  and  discussions  of 
preoperative  and  postoperative  care  appear  through- 
out the  book.  Included  also  are  many  useful  photo- 
graphs illustrating  surgical  procedures  and  patient 
syndromes.  Authoritative  advice  on  the  many  psycho- 
logical considerations  in  dealing  with  a  sick  child  and 
his  parents  adds  to  the  depth  of  this  recommended 
text. 


Illustrated.      327 


pp. 


1968.       $11.00        Paper    $4,50 


MATERNITY  NURSING 

Elise   Fitzpatrick,   R.N.,   M.A.,  Sharon 
M.S.,     and     Luigi     Mastroianni,     Jr 
F.A.C.O.G. 


R.    Reader,   R.N., 
M.D.,    F.A.C.S., 


Maintaining  the  same  high  goals  of  earlier  editions, 
this  family-focussed  textbook  is  directed  toward  the 
total  heahh  and  well-being  of  the  mother  and  infant. 
Expanded  and  updated  in  line  with  new  medical  con- 
cepts and  concomitant  nursing  practice,  this  is  com- 
prehensive maternity  nursing  at  its  best. 
The  importance  of  psychosocial  factors  is  reflected  in 
the  authors'  decision  to  integrate  psychological  prin- 
ciples throughout  the  text  and  add  an  entirely  new 
chapter  on  Social  Factors.  New  chapters  also  include 
Patient  Teaching  and  Fetal  Diagnosis  and  Treatment, 
A  number  of  illustrations  and  diagrams  have  been 
added  to  aid  student  comprehension.  A  new  author 
joins  the  book  with  this  edition.  Dr.  Mastroianni  has  a 
distinguished  background  in  teaching  research  and 
clinical  practice. 

12th    Edition.   700   pp.    320    Illustrations.    1971     $9.75. 

NURSING  CARE  OF  CHILDREN 

By  Florence  G.  Blake,  R.N.,  M.A.,  F.  Howell  Wright, 
M.D.,  and  Eugenia  H.  Waechter,  R.N.,  Ph.D. 

Extensively  revised  and  expanded,  with  numerous 
new  illustrations,  this  superb  text  is  without  peer  as  a 
comprehensive,  in-depth,  study  of  pediatric  nursing. 
Recent  findings  in  all  areas  of  care  are  included  — 
growth  and  development  (from  infancy  to  adoles- 
cence) medical  entities,-  associated  nursing  therapies. 
Consideration  is  given  to  problems  of  minority  groups 
and  cultural  differences,  the  battered-child  syndrome, 
and  contemporary  problems  of  the  adolescent, 

588  Pages    254  Illustrations    Bih   Edition,    1970    $9,50 

THE  FIRST  DAY  OF  LIFE 
Principles  of  Neonatal  Nursing. 

By  Helen  R.  McKilligin,  M.D.,  Chief  of  Neonatology, 
Grace   General  Hospital,   St.   John's,  Newfoundland. 

Briefly,  but  convincingly.  Dr.  McKilligin  makes  it  clear 
why  the  needs  of  an  infant,  during  the  first  hours  of 
life,  demand  special  knowledge  on  the  part  of  the 
nurse.  Her  book  is  a  distillate  of  neonatology,  the 
specialty  (hat  has  emerged  between  obstetrics  and 
pediatrics,  bringing  with  it  new  facts,  new  insights, 
new   challenges   and    satisfactions. 


1970. 


Flexible    cover,    128    pp. 


$3.95 


SERVING  THE  HEALTH  PROFESSIONS  IN  CANADA  SINCE  1897 


PLEASE   SEND   ME   THE   FOLLOWING   BOOKS 

J.  B.  LIPPINCOTT  CO.  OF  CANADA  LTD. 

1            n      MATERNITY    NURSING                                                                         $  9  75 

75    HORNER   AVE.,   TORONTO    18,   ONT. 

1            n      NURSING    CARE    OF    CHILDREN                                                       $  9  SO 

NAME 

1            n      PEDIATRIC    SURGERY    FOR    NURSES                                                $11.00 

D      PAPER                     $  4.50 

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D      FIRST    DAY    OF    LIFE                                                                           $  3.95 

CITY 

□      PRACTICAL    NEONATAL    PAEDIATRICS                                          $  4.50 

These    books    may    be    ordered    through    your    medical    bookstore. 

PAYMENT    ENCLOSED    D             CHARGE    AND    BILL    ME    Q 
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30   days 

if   you   are   not  satisfied                                                         CN-12-71 

SCHERINQ 


For  effective  relief 

of  cold  symptoms 

take  the  clear-heddecl 

family  approach. 

Recommend  Coricidin. 


Coricidin*  is  a  whole  family  of  cold  fighters.  Each  form  is 
formulated  for  maximum  effectiveness  in  controlling 
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Coricidin  'D',  for  instance,  has  five  ingredients 
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histamine to  stop  running  noses,  two  pain  relievers  and 
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gestant to  shrink  swollen  membranes. 

For  the  junior  cold  sufferer,  Coricidin  'D'  Medilets  * 
offer  the  same  relief  in  a  dosage  suitable  for  the  young 


patient,  in  a  pleasant-tasting  chewable  tablet. 

For  everyone  in  the  family,  there  is  a  member  of  the 
Coricidin  family  to  bring  real  relief:  Adult  tablet  forms 
packaged  in  the  new,  easy-to-use  pop-out  blister  packs, 
spray,  lozenges  and  a  pleasant-tasting  cough  mixture. 

Recommend  Coricidin.  Your  charges  will  be  glad 
you  did.  For  further  information,  consult  your  physician 
or  write  Schering  Corporation  Limited,  Pointe  Claire 
730,  P.Q. 

•  Reg.  T.M. 


Coricidin 


Coricidin 


m^juuM-auaaaM 


Coricidin 


PED 


soothing  HONEY  MEN 


COLO  TABLETS; 

24  TABtETS 
for  r«<t«f  of  cotd 

sympiomi  arvl 
Accompanying  aches. 
p«inft.  t«vw  and  atmpla 


N«wt  Child*  ^TofcXivm  P*ck 


24  CHEWABLE  TABLETS 

For  fMt  t9\M  of 
chtklr«n'«  stuffy  and 
runny  nose*  du«  lo 
th«  common  cold 


^.1^^ 


n 


Coricidin 


COUGH  MIXTURE 


^ciMir.  (IMNCES 


Coricidin'D' 


com  TA(UTS~ftW 

.mamiim  tarn 


24  TASLtIS 

(Of  r*li«f  of  cold  *ymptom» 

■nd  ac  company  I  rvg 

•chM.  paini,  favw 

•nd  unut  ^ — ^ 

COn^MtMn  ffflJ 


Coricidin 


ME0(L6TS 


% 


A  Family  of  cold  products. 


greetings  to  you  who 
give  patience  ami 
UHderstamiiHg 
a  a  gear  'roimiJ 


THE 


OLIIIO 

TRADEMARKS  REQ.  US    PAT    Off.   »  CANADA.  MADE   IN  USA, 

SHOE 


THE  CLINIC  SHOEMAKERS   •    7912  Bonhommo  Ave.  ■    ;.t  loms.  Mo  03iOb 


The 

Canadian 
Nurse 


A  monthly  journal  for  the  nurses  of  Canada  published 

in  English  and  French  editions  by  the  Canadian  Nurses'  Association 


Volume  67,  Number  12 


December  1971 


21     The  Old  Rights  Remain Sister  C.  Labonte 

24     A  Painter,  A  Pilot,  A  Rock  Hound,  and  Some  Cooks: 

The  Federal  Nursing  Consultants  Revisited D.  S.  Starr 

32     Rock  Festivals  —  New  Problems, 

New  Solutions B.  Zimmerman,  R.  Jansons 

36     Headache  —  Diagnosis  and  Management R.M.  Gladstone 

39     Hey,  Nurse!  J-  Wilting 

I-XIX   1971  Index 

The  views  expressed  in  the  various  articles  are  the  views  of  the  authors  and  do  not 
necessarily  represent  the  policies  or  views  ot'the  Canadian  Nurses'  Association. 


4     Letters 
17     New  Products 
40     In  a  Capsule 


7     News 
19     Dates 

42     Names 


45      Research  Abstracts       47     Books 

50     Acession  List  62     Official  Directory 


Executive  Director:  Helen  K.  Mussallem  • 
Editor:  Virginia  A.  Lindabury  •  Assistant 
Editors:  Liv-Ellen  Lockeberg.  Dorothy  S. 
Starr  •  Editorial  Assistant;  Carol  A.  Kollar- 
sky  •  Production  Assistant:  Elizabeth  A. 
Stanton  •  Circulation  Manager:  Beryl  Dar- 
ling •  Advertising  Manager:  Gcorgina  Clarke 

•  Subscription  Rales:  Canada:  one  year. 
$6.n0;  two  years,  $11.00.  Foreign:  one  year. 
$6,50;  two  years,  $12.00.  Single  copies:  75 
cents  each.  Make  cheques  or  money  orders 
payable  to  the  Canadian  Nurses'  Association. 

•  Change  of  Address:  Six  weeks'  notice;  the 
old  address  as  well  as  the  new  are  necessary, 
together  with  registration  number  in  a  pro- 
vincial nurses'  association,  where  applicable 
Not  responsible  for  journals  lost  in  nKiil  due 
to  errors  in  address. 


Manuscript  Information:  '1  he  Canadian 
Nurse "  welcomes  unsohcited  articles.  All 
manuscripts  should  be  typed,  double-spaced, 
on  one  side  of  unruled  paper  leaving  wide 
marcins.  Manuscripts  arc  accepted  for  review 
for  exclusive  publication.  The  editor  reserves 
the  richt  to  make  the  usual  editorial  changes 
Photographs  (glossy  prints)  and  graphs  and 
diagrams  (drawn  in  india  ink  on  white  paperl 
;irc^ welcomed  with  such  articles.  The  editor 
is  not  committed  to  publish  all  articles 
sent,  nor  to  indicate  definite  dates  of 
publication. 

Postage  paid  in  cash  at  third  class  rate 
MONTREAL.  PO  Permit  No.  10.001. 
50  The  Driveway,  Ottawa.  Ontario.  K2P  IE2 
©    Canadian  Nurses'  Association   1971. 


DECEMBER      1971 


THE     CANADIAN     NURSE     3 


letters    { 


Letters  to  the  editor  are  welcome. 

Only  signed  letters  will  be  considered  for  publication,  but 

name  will  be  withheld  at  the  writer's  request. 


Editorial  relieves  GAS 

Thank  you  for  relieving  my  mind  and 
my  typewriter  of  GAS. 

Having  only  recently  entered  the 
world  of  health  professionals,  I  found 
myself  trying  to  take  on  protective 
colouring  by  using  the  "proper"  terms 
such  as:  the  delivery  of  health  care,  the 
service  component  and,  my  pet  hate, 
ongoing  education.  Now,  having  had 
the  word  from  someone  like  you  that 
this  is  jargon,  and  imported  at  that,  I 
can  carry  on  as  if  I  had  never  been 
exposed  to  the  disease,  although  traces 
may  linger. 

Your  editorial  (Oct.  1971,  page  3) 
was  received  here  with  much  appre- 
ciative comment.  The  chairman  of  the 
nursing  service  committee  read  it  aloud 
at  a  recent  meeting — so  already  the 
ripples  are  widening. 

The  enclosed  I  send  you  —  with 
apologies  to  the  late  Ogden  Nash.  — 
Mrs.  Dorothy  G.  Miller,  Public  Rela- 
tions Officer,  The  Registered  Nurses' 
Association  of  Nova  Scotia. 

An  Open  Letter  To  Miss  Lindabury 
In  appreciation  of  an  editorial  which, 
in  our  opinion,  was  fun  to  read  and, 
not  incidentally,  extremely  necess-ury. 

Yes,  Virginia,  for  this  service  we  would 
like  to  show  you  our  appreciation. 
Perhaps  the  best  way  to  do  so  would  be 
to  work  for  the  nation-wide  alleviation 
of  the  ailment  you  labelled  general- 
adaptation-to-U.S. -utterance  syndrome 
(GAS,  for  short). 

So  we  now  propose  an  expedition  to 
hunt  down  and  search  out  all  sufferers 
(you  might  call  this  a  new  form  of 
sport). 

The  slogan  on  our  high-held,  far-flung 

banner   will   be   -help   stamp   OUT 

GAS,"  and  though  we  will  hunt  in  all 

parts  of  the   forest,  our  aim  will  be 

directed  mainly  to  Media  in  the  Mass. 

But,  all  publications,  public  utterances 

and    most    particularly    a   Committee 

Report, 

Indeed  all  communications  having  to  do 

with  any  subject  whatsoever,  but  most 

particularly  of  the  health  sort, 

If,  when  discovered,  do  not  pass  our 

rigid  inspection. 

Will  be  instantly  labelled  for  outright 

rejection. 

In   fact,   without   mercy,   we'll   stamp 

them  "recommended  for  euthanasia,  as 

it  is  our  considered  opinion  that  this 

4     THE     CANADIAN      NURSE 


communication  is  suffering  from  an 
insidious  chronic  disease,  the  main 
symptom  of  which  is  Lichtheim's 
aphasia." 

However,  if  by  chance,  your  letter  to 
the  Prime  Minister  gets  the  message 
across. 

And  a  15%  surcharge  on  all  such  im- 
ports will  be  levied  —  as  decided  by  the 
Boss, 

To  help  settle  our  financial  problems 
we'll  be  happy  to  cooperate  in  any  way 
we  can 

By  delivering  health  care  to  the  grocery 
boy,  the  paper  boy,  and,  of  course,  the 
milk  man. 

And  we'll  do  it  good. 
Like  a  physician's  assistant  should! 

But,  not  so  secretly,  we  hope  that  your 
delightful  editorial  will  really  result  in 
more  original  thinking  on  this  side  of 
the  border. 

So  that  those  who  have  communicated 
heretofore  by  the  use  of  imported  "non- 
words"  and  "pompous  phrases"  will 
not  find  it  necessary  to  re -order. 

Dr.  Best  Replies 

1  have  just  returned  from  a  diabetes 
symposium  in  Indianapolis  to  find  your 
two  copies  of  the  October  issue  of  The 
Canadian  Nurse  awaiting  me.  My  wife 
and  I  are  delighted  to  have  them. 

The  article  by  Mrs.  Grant,  "Bant- 
ing and  Best  —  the  men  who  tamed 
diabetes,"  is  very  well  written  and 
should  be  of  particular  interest  to  all 
who  are  concerned  with  diabetes.  It  is 
timely  to  print  this  during  the  fiftieth 
anniversary  year  of  insulin.  1  do  not 
know  who  was  responsible  for  the  cover 
illustration,  but  we  think  it  excellent. 

I  feel  sure  that  this  journal  must  have 
a  wide  distribution  and  compliment 
you  warmly  on  its  general  excellence. 
—  Charles  H.  Best,  Charles  H.  Best 
Institute,  University  of  Toronto. 

Article  fills  gap 

"Dying  with  dignity,"  the  article  by 
Dr.  Elisabeth  Kiibler-Rosf  in  your 
October  issue,  fills  a  psychological  gap 
in  our  education,  which  has  been  ignor- 
ed or  poorly  handled  in  the  past.  The 
author's  findings  should  prove  invalu- 
able in  our  professional  and  private 
lives. 

Thank  you  for  making  her  report 
available  to  your  readers.  —  Mrs. 
Gwen  Kavanagh,  R.N.,  Vancouver. 


Teaching  nursing  in  college 

In  1967  a  new  era  began  for  nursing 
education  in  Quebec  with  the  establish- 
ment of  regionally  dispersed  colleges, 
or  CEGEPs.  These  colleges  offer  pre- 
university  programs  leading  to  a 
bachelor's  degree,  and  technological 
programs  such  as  nursing,  requiring  two 
or  three  years  of  study  at  a  college. 

In  September  1970  all  English- 
language  nursing  education  at  the 
diploma  level  was  transplanted  from 
hospital  schools  of  nursing  into  the 
colleges.  As  a  teacher  at  a  college  from 
the  birth  of  its  nursing  program,  I  would 
like  to  share  my  impressions  and  feel- 
ings about  teaching  nursing  in  a  college 
setting. 

Each  student  who  was  enrolled  in 
nursing  at  the  college  took  courses  in 
English,  humanities,  biology,  psy- 
chology, nutrition,  microbiology,  and 
chemistry  with  students  from  other 
programs.  The  nursing  course  was 
given  six  hours  a  week  in  classroom  and 
laboratory  sessions. 

Although  time  was  at  a  premium, 
this  was  not  the  liability  that  it  might 
appear.  The  teachers  were  forced  to 
give  students  only  meaningful  behavior- 
al objectives  and  experiences.  Each  of 
these  had  to  be  justified  on  the  grounds: 
"Is  this  something  a  nurse  must  know 
or  be  able  to  do?"  And  "Is  this  some- 
thing the  student  can  learn  on  her  own 
in  independent  study?"  As  teachers  tend 
to  "give"  too  much  knowledge,  the 
time  premium  helped  discourage  this. 

The  most  important  thing  1  learned 
is  that  nurses  teach  nursing,  biologists 
teach  biology,  and  chemists  teach 
chemistry.  I  had  not  known  this  so 
vividly  before.  1  had  to  teach  the 
students  how  to  use  knowledge  from  the 
social  and  biological  sciences  to  under- 
stand themselves  and  their  patients, 
and  to  intervene  to  meet  patient  needs 
when  necessary.  I  had  to  frequently 
remind  myself  that  this  is  nursing. 

In  a  college  setting,  I  found  I  could 
concentrate  on  teaching  nursing,  with- 
out trying  to  assume  the  impossible  task 
of  becoming  an  expert  in  every  field 
from  which  a  nurse  draws  knowledge. 
With  nursing  programs  in  this  setting, 
new  challenges  arise.  The  greatest 
seems  to  be  the  need  to  develop  further 
a  unique  body  of  knowledge.  Nurses 
can  no  longer  teach  biology  and  psy- 
chology and  microbiology;  they  must 
teach  nursing.  Learning  to  work  with 

DECEMBER      1971 


people  of  vastly  different  backgrounds 
and  preparations  is  also  a  new  chal- 
lenge for  a  teacher  of  nursing.  —  Bon- 
nie Lee  Smith,  Reg.N.,  B.Sc.N.,  Vanier 
College  CEGEP,  Montreal,  Quebec. 

Criticizes  two-year  RN  course 

Slowly  the  two-year  course  for  register- 
ed nurses  is  creeping  into  the  picture. 
At  first  it  was  a  mere  suggestion  that 
the  plus-one  year  of  the  two-plus-one 
course  be  dropped.  Now  there  is  con- 
stant mention  of  a  two-year  RN  course. 
Doesn't  anybody  object? 

The  two-plus-one  nursing  course 
was  a  great  improvement  over  the 
disorganized  three-year  course.  In  the 
former,  the  first  two  years  covered  all 
the  theory,  with  a  little  practical  work 
to  coordinate  with  the  classes;  for  ins- 
tance, obstetrical  training  given  at  the 
same  time  as  obstetrical  classes.  Great! 
But  these  students  were  not  depended 
on  as  hospital  staff;  when  it  was  class 
time,  off  they  went.  In  the  third  year  the 
students  were  expected  to  use  their 
training  and  earn  the  title  "RN."  They 
were  not  expected  to  be  as  efficient  or 
speedy  as  an  RN,  but  as  the  year  went 
by,  they  were  expected  to  improve  and 
gain  skill  and  confidence. 

Would  anybody  approve  if  the  med- 
ical college  abandoned  the  intern  year? 
The  dental  college  is  considering  adding 
an  intern  year  to  its  four  years  of  train- 
ing; in  fact,  the  college  has  added  a 
"dexterity"  test  to  determine  what 
students  to  accept  or  reject.  That  means 
a  test  to  determine  how  well  the  student 
can  work  with  his  hands. 

Nursing  is  not  all  book  work  and 
theory.  A  good  nurse  has  to  move  fast 
and  act  efficiently.  Is  she  ready  for  this 
after  two  years  of  mainly  theory?  Dur- 
ing the  nurse  intern  year,  she  is  building 
up  her  self-confidence  and  is  learning 
to  be  an  RN.  She  is  earning  money  and 
frequently  lives  out  of  residence.  She  is 
learning  responsibility  slowly — she 
is  not  being  thrown  headfirst  into  it. 

The  two-year  RN  is  barely  a  jump 
ahead  of  the  registered  nursing  assis- 
tant; in  fact,  she  is  at  a  disadvantage. 
The  RNA  gets  more  practical  exper- 
ience in  her  one  year,  and  less  theory; 
she  is  not  expected  to  know  or  do  as 
much  as  the  RN.  The  old  three-year 
nursing  course  may  have  been  badly 
disorganized,  but  it  contained  plenty 
of  practical  experience.  It  wasn't  ideal: 
students  did  too  much  menial  work; 
they  had  too  much  responsibility  right 
from  the  first  year,  but  they  got  their 
practical  experience  along  with  their 
classes. 

The  two-plus-one  course  seemed  a 

DECEMBER      1971 


vast  improvement.  But  why  are  we  go- 
ing back?  How  can  nursing  be  a  profes- 
sion if  it  is  jammed  into  two  years? 
The  only  advantage  I  can  see  for  the 
nurse  would  be  if  the  two-year  course 
were  given  university  credits.  Then 
the  two-year  RN  could  go  on  to  uni- 
versity and  get  her  degree  in  another 
two  years.  This  would  be  comparable 
to  the  four-year  university  nursing 
course  that  leads  to  an  RN  and  a 
BScN  degree. 

Shouldn't  RNs  be  striving  to  make 
the  world  believe  they  are  a  profes- 
sion?—  Mrs.  Betty  Kowalchuk,  RN, 
Scarborough,  Ontario. 

Patienf  s  children  send  thanks 

Today  we  seldom  hear  "thanks"  from 
people,  especially  from  patients.  Thus 
I  was  indeed  gratified  when  I  received 
this  letter  from  the  children  of  one  of  my 
patients  who  had  died.  I  would  like  to 
share  this  letter  with  your  readers.  — 
/.  Sen,  Head  Nurse,  Montreal. 

"Dear  Nurses, 

"During  these  days  of  retrospection,  our 
thoughts  so  often  turn  to  all  of  you.  We 
did  not  know  that  in  one  profession 
there  existed  so  many  highly  skilled, 
compassionate,  professional  individu- 
als. While  our  mother  was  ill,  our  eyes 
were  opened  to  a  new  world  of  pain  and 
suffering. 

"In  this  world,  the  heroines  are  the 
ladies  in  white.  You  see  people  at  their 
worst  and  you  care  for  them  as  lovingly 
as  if  they  were  a  close  relation.  As 
mother  became  more  ill,  it  seemed  thai 
you  became  more  thoughtful,  if  that 
is  possible. 

"As  mother  once  said,  'They're  all 
my  friends.  Even  the  ones  who  don't 
know  me  come  in  to  say  they're  going 
for  a  break  but  they'll  be  back.' 

"Our  sense  of  values  in  this  world 
is  truly  upside  down.  If  things  were  as 
they  should  be,  you  would  each  make 
$100,000  a  year.  Yet  you  are  paid  in  a 
more  intangible  way  by  the  love  and 
respect  of  people  like  our  mother. 

"Thank  you  all  from  the  bottom  of 
our  hearts.  Thank  you  for  helping  the 
dearest  person  in  the  world  when  we 
were  no  longer  able  to.  Please  always 
remember  how  important  you  are  and 
always  maintain  your  high  standards. 
You  will  probably  always  be  overwork- 
ed and  underpaid.  Nevertheless,  yours 
is  one  of  the  most  important  jobs  in 
this  society." 

Why  not  "health  care?" 

Even  I,  who  do  not  like  to  write  letters, 
must  send  you  a  note  in  connection 
with  your  editorial  in  the  October  issue 
of  The  Canadian  Nurse.  From  the  first 
word  of  "Yours  in  Service"  to  your 
signature,  I  could  not  agree  more  with 
your  description  of  our  present  syn- 
drome. 


Speaking  from  personal  experience, 
anything  that  is  transplanted  without 
modification  usually  grows  like  a  wild 
weed.  That  is  exactly  what  we  are  get- 
ting now  with  the  fashionable  vocabul- 
ary, delivery,  and  so  on.  Why  not  simply 
state  "health  care?" 

In  the  September  issue,  Dr.  Mussal- 
lem  answered  the  problem  of  creating 
a  new  category  of  physician  assistant. 
Yet  we  are  still  having  discussions  and 
debates  on  that  subject.  Who  really 
needs  a  new  bird?  Let  them  stay  in  the 
sunshine  in  Florida!  —  Emily  Melnik, 
Toronto,  Ontario. 

Expanding  role  of  the  nurse 

1  wish  to  say  how  much  1  appreciated 
Dr.  Helen  IVlussaliem's  comprehensive 
review  of  a  highly  debated  topic  (Sep- 
tember 1 97 1 ).  My  reaction  on  rereading 
her  article,  "The  expanding  role:  where 
do  wc  go  from  here?",  was  gratitude 
that  Canadian  nurses  are  fortunate 
enough  to  have  a  person  of  Dr.  Mussal- 
lem's  caliber  as  executive  director  of 
the  Canadian  Nurses'  Association.  But 
I  also  reacted  with  a  twinge  of  cynicism 
as  I  wondered  what  percentage  of  read- 
ers would  share  my  enthusiasm.  How  I 
wish  I  could  be  proven  to  be  just  a 
miserable  cynic! 

Dr.  Mussallem  is  the  first  writer  I 
have  encountered  who  has  raised  the 
question  of  why  we  devote  only  five 
percent  of  the  health  dollar  to  public 
health  services. 

Nearly  two  years  ago  1  initiated  a 
combined  fact  and  opinion  survey  of 
my  island  community  and  the  47  local 
physicians.  IVIy  basic  premise  was  that 
wc  use  costly  hospital  facilities  where 
expansion  of  public  health  facilities 
through  an  increased  share  of  the  tax 
dollar  would  be  a  more  sensible  use 
of  taxpayers'  money.  The  medical 
director  of  the  public  health  unit,  to 
whom  I  gave  the  survey  results,  was 
reassured  that  minor  tokens  of  support 
were  better  than  apathy,  but  his  frustra- 
tion at  this  situation  was  ill-disguised. 

Recently  I  raised  this  alternative 
approach  for  cutting  costs  and  improv- 
ing care  at  a  local  chapter  meeting, 
where  the  speaker  was  a  representative 
of  the  local  medical  fraternity.  He  ad- 
mitted honestly  that  he  had  not  given 
this  question  much  thought,  since  it  is 
not  his  particular  area  of  interest.  Des- 
pite my  frustration  with  his  reply,  I  am 
tenacious  enough  to  keep  raising  the 
question. 

As  a  taxpayer,  general  duty  nurse, 
wife,  mother  of  two  young  children, 
and  a  concerned  citizen.  1  would  like 
to  appeal  to  all  nurses  to  take  the  time 
to  see  their  role  in  our  complex  society 
as  a  multi-faceted  one  that  must  cons- 
tantly be  reexamined  in  broad  and  spe- 
cific terms. —  N.  Pamela  Fairchild, 
R.N.,  Gahriolu  Island.  B.C.  .^ 

THE     CANADIAN     NURSE     5 


mmr 


Black  &  W\m(B  Cocktail 


0«»' 


Each  30  ml.  contains  5  ml.  Aro- 
matic Cascara  Sagrada  in  the  equiv- 
alent of  30  ml.  of  Milk  of  Magnesia 


If  your  nurses  have  been  practicing  pharmacy  at  the  nursing 
station  .  .  .  connpounding  a  Milk  of  Magnesia/Cascara  Sagrada 
suspension,  take  heart!  Now,  you  can  provide  them  with  this 
combination  in  a  tamper  proof,  positively  identified,  30  ml.  unit 
dose  bottle  which  is  not  opened  until  it  reaches  the  patient's 
bedside.  Check  with  your  nursing  staff— this  could  be  just  what 
they  are  looking  for! 


LIST  NO. 
70140 


c 


intra 


Milk  of  Magnesia 
Cascara  Sagrada  Suspension 


MEDICAL  PRODUCTS 

Division  of  Penick  Canada  Ltd.,  Toronto,  Canada 


news 


CNA  Research  Officers  Provide 
Information  For  Decisions 

Ottawa — Canadian  Nurses"  Associa- 
tion's four  research  officers  will  provide 
information  the  CNA  directors  can  use 
in  decision-making.  Helen  K.  Mussal- 
lem  told  The  Caiuulian  Nurse. 

A  change  in  title  from  nursing 
consultant/research  analyst  to  research 
officer  was  announced  at  the  CNA 
directors"  meeting  on  October  6. 

Dr.  Mussallem,  execut  ve  director  of 
the  CNA.  described  the  functions  of 
the  research  officers:  to  collect,  analyse, 
synthesize,  and  interpret  relevant  data; 
and  to  formulate  conclusions  and 
recommendations,  and  report  on  the 
results  of  studies. 

The  research  officers  are  drafting 
position  papers  in  areas  identified  as 
priorities  by  the  CNA  directors  in  their 
October  meeting  (News.  November 
1971,  page  5).  Rose  Imai  is  working 
on  a  proposed  position  paper  on  health 
care  centers,  as  well  as  continuing 
work  on  a  survey  of  job  opportunities 
for  nurses  in  Canada. 

Rachel  Lamothe  is  gathering  infor- 
mation for  a  draft  position  paper, 
giving  increased  detail,  on  the  expand- 
ing role  of  the  nurse.  A  study  of  Cana- 
dian legislation,  current  or  pending, 
effecting  nursing  is  one  of  Sister  Ba- 
chand"s  assignments. 

Nancy  Garrett  is  drafting  a  position 
paper  on  family  planning.  Miss  Garrett 
has  also  been  appointed  to  an  editorial 
committee  to  review  a  manual  for 
nurses  in  family  planning  that  is  being 
prepared  by  Eileen  Healey  Mountain 
for  the  child  and  adult  health  service 
of  the  department  of  national  health 
and  welfare. 

CNA  has  also  agreed  to  provide 
professional  consultation  for  the  French 
language  translation  of  the  manuscript 
for  the  family  planning  manual. 


CNA  Directors  Approve  Dual 
Structure  For  Testing  Service 

Ottawa — Canadian  Nurses"  Associa- 
tion directors  ratified  two  appoint- 
ments to  the  CNA  Testing  Service: 
Henry  P.  Cousens,  as  director  of  ad- 
ministration, and  Eric  P.  Parrott,  as 
director  of  test  development.  (Names, 
December  1 97 1 ,  page  42). 

Jean  Dalziel,  chairman  of  the  testing 
service  board,  told  the  CNA  directors 


that  the  work  of  the  Testing  Service 
seems  to  divide  logically  into  two 
major  functions:  one  involving  the 
development  and  production  of  new 
examinations,  the  other  involving  test 
delivery  and  administration.  She  ex- 
plained that  Mr.  Cousens  and  Mr. 
Parrott  would  have  equal  responsibility 
and  each  would  be  responsible  to  the 
testing  service  board. 

The  testing  service  board,  a  special 
committee  of  CNA,  is  made  up  of 
nominees  from  registering  and  licen- 
sing bodies,  appointed  by  CNA.  CNA 
directors  have  the  ultimate  respon- 
sibility for  making  policy  for  the  test- 
ing service. 

Mrs.  Dalziel  told  The  Catiadian 
Nurse  that  there  is  nursing  input  at 
all  levels  of  test  development  and 
construction.  A  committee  of  nursing 
experts  makes  the  blueprint  for  the 
overall  examination  content,  and  six 
subject  matter  committees  (five  subjects 
in  RN  examinations,  one  for  nursing 
assistants)  plan  the  blueprint  for  subject 
examinations,  e.g.,  medical  nursing  or 
pediatric  nursing.  The  writers  of  the 
individual  test  items  for  all  examina- 
tions are  nurses. 

Testing  Service  staff  includes  three 
professional  nurses. 


CNA  Convention  In  '72 
—Steer  For  Edmonton! 

sso- 

and 

Al- 

you 

the 

the 

beef 

ible. 

the 

At  the  Canadian  Nurses'  A 
elation    annual    meeting 
convention    In   Edmonton, 
berta,   June  25-29,   1972, 
can  bring  your  "beef"  to 
assembly  —  or    perhaps 
nearest   you'll   come   to 
will  be  at  the  banquet  tc 
Either  way,  Edmonton   Is 
place  in  '72! 

DECEMBER      1971 


"By  having  nursing  expertise  com- 
ing in  through  the  committees,  current- 
ness  is  maintained,"  Mrs.  Dalziel  said. 

Mrs.  Dalziel  reported  to  the  CNA 
directors  at  the  October  6  meeting  that 
representatives  from  CNA  Testing 
Service  board  and  staff  went  to  Mon- 
treal in  October  to  start  some  "ex- 
ploratory discussion  with  the  Asso- 
ciation of  Nurses  of  the  Province  of 
Quebec  in  terms  of  the  test  develop- 
ment program  of  French-language  ex- 
aminations. 

"We  are  anxious  to  pursue  this  and 
it  has  been  given  priority,""  she  said. 


CNA  Believes  Proposals  Would 
Turn  ICN  Into  Conglomerate 

Ottawa —  The  Canadian  Nurses' Asso- 
ciation believes  admission  of  national 
associations  with  non-nurse  members  or 
associations  strongly  related  to  trad? 
unions  or  governments  would  change 
the  International  Council  of  Nurses  into 
a  new  organization  of  many  needs  and 
interests,  an  international  conglomer- 
ate. 

ICN  has  been  a  federation  of  na- 
tional associations  of  one  type  of  nurse 
practitioner:  the  nurse  who  is  qualified 
and  authorized  in  her  country  to  supply 
the  tnost  responsible  service  of  a  nurs- 
ing nature. 

CNA  officers  stated  that  if  ICN 
changes  its  basis  of  membership,  the 
purposes  and  functions  of  ICN  must 
change  to  serve  a  multipractitioner 
membership.  CNA  said,  "Redefined 
objects  and  functions  may  or  may  not 
be  acceptable  to  present  member  as- 
sociations, each  ot  whom  has  the  right 
to  remain  or  to  withdraw  its  member- 
ship because  of  the  changed  nature  of 
ICN." 

CNA  officers  expressed  apprehen- 
sion about  some  of  the  recommenda- 
tions in  the  report  of  a  European 
management  consultant  firm  that 
studied  the  purposes,  structure,  mem- 
bership, and  finances  of  the  ICN.  Some 
of  the  recommendations,  according 
to  CNA,  disregard  some  basic  socio- 
logical and  philosophical  aspects  of  a 
professional  organization. 

The  management  consultants'  report 
recommends:  "In  some  countries, 
strong  associations  representing  pro- 
fessional nurses  also  represent  other 
nursing  personnel;  in  these  countries, 

THE      CANADIAN      NURSE     7 


news 


ICN  should  be  willing  to  accept  such 
associations. 

"Similarly,  the  most  effective  repre- 
sentation for  professional  nurses  in 
other  countries  is  provided  by  groups 
that  are  strongly  related  to  trade  unions 
or  government,  and  ICN  should  recog- 
nize such  groups." 

This  proposal  prompted  CNA  to  say, 
"an  autonomous  view  and  voice  for 
nursing  is  dependent  upon  its  homo- 
geneity, its  freedom  of  expression  and 
its  freedom  from  domination  by  govern- 
ment or  others  with  which  it  is  associat- 
ed." CNA  asks:  "Can  associations  that 
are  government  or  union  dominated  .  .  . 
be  self-governing?" 

ICN  to  date  has  been  a  federation 
of  national  associations  that  are  free  to 
advocate,  promote,  and  direct  efforts 
toward  improvement  of  nursing  prac- 
tice. 

CNA's  comments,  sent  in  a  letter  on 
November  2,  1971,  support  views 
expressed  in  answer  to  the  management 
consultants'  questionnaire  in  the  spring 
ofl971.  ^     ^ 

The  management  consultants'  report 
was  discussed  at  a  meeting  of  the  ICN 
Council  of  National  Representatives 
in  July  and  referred  to  member  asso- 
ciations for  comment  (News,  Septem- 
ber, 1971,  page  10).  CNA  directors 
studied  the  report  and  the  officers 
were  asked  to  reply. 

ICN  has  set  up  a  three-member  spe- 
cial study  committee  to  prepare  a 
composite  report  from  the  replies,  and 
make  recommendations  for  distribu- 
tion to  member  associations. 

This  report  will  include  an  indication 
of  the  amendments  to  the  ICN  constitu- 
tion required  to  implement  the  propos- 
ed action.  Amendments  to  the  consti- 
tution will  be  debated  and  voted  upon 
by  Representatives  of  the  national  nurs- 
ing associations  at  the  ICN  Congress  in 
Mexico  City  in  1973. 

Chairman  of  the  special  study  com- 
mittee is  Hildegard  Peplau,  president 
of  the  American  Nurses'  Association; 
committee  members  are  Elouise  Dun- 
can, president  of  the  Liberian  Nurses' 
Association;  Hermosinda  de  Campos, 
president  of  the  Nurses'  Federation  of 
Argentina;  and  Margrethe  Kruse,  ICN 
president  (ex  officio). 

E.  Louise  Miner,  president  of  the 
CNA,  reported  to  the  directors  at  their 
October  meeting  that  the  ICN  is  now 
making  a  study  of  auxiliary  nursing 
personnel  and  their  position  in  rela- 
tion to  national  nurses'  associations. 

The  Royal  College  of  Nursing  and 
National  Council  of  Nurses  of  the 
United    Kingdom    admitted    enrolled 

8     THE     CANADIAN      NURSE 


Halifax  Infirmary  Newsletter  Wins  First  Prize 


Two  Halifax  Infirmary  graduates,  J.  Kerr  and  J.  O'Donnell,  admire  the  metal 
plaque  received  by  the  hospital  in  recognition  of  first  prize  in  the  1970  hospital 
newsletter  contest,  sponsored  by  Hospital  Administration  in  Canada.  The 
Nova  Scotia  hospital's  newsletter,  "H.I.  Lites,"  won  first  prize  in  the  category 
for  monthly  newsletters  published  by  hospitals  of  200-500  beds. 


nurses  (auxiliary  nurses)  to  membership 
October  1,  1970,  and  are  requesting 
that  these  nurses  be  granted  member- 
ship in  ICN.  Hong  Kong  Nurses'  Asso- 
ciation has  notified  ICN  that  they 
intend  to  accept  psychiatric  trained 
nurses  into  membership. 

The  continued  eligibility  of  the  Brit- 
ish Nurses'  Association  for  member- 
ship in  ICN  was  confirmed  at  the  July 
meeting  of  CNR,  provided  that  the 
results  of  the  study  on  auxiliary  nursing 
personnel  support  this  decision. 


CNA  Directors  Discuss  Possibility 
Of  Making  Statement  On  Legislation 
That  Affects  Nurses  And  Nursing 

Ottawa —  Should  the  Canadian  Nurses" 
Association  be  prepared  to  respond 
to  the  many  legislative  problems  now 
being  encountered  by  provincial  as- 
sociations? This  question  was  raised 
by  the  CNA  directors  at  their  meeting 
October  6-8,  1971,  and  the  consensus 
was  that  both  the  provinces  and  the 
national  association  would  benefit  if 
CNA  could  respond  to  some  of  these 
problems. 

Some  issues  CNA  might  study  were 
outlined: 

•  Should  there  be  lay  representation 
on  governing  boardsof  statutory  bodies? 
If  so,  how  much? 

•  If  the  use  of  drugs,  such  as  marijuana. 


is  legalized,  how  would  the  association 
feel  about  the  nursing  practitioner  who 
uses  them? 

•  How  does  CNA  feel  about  interdis- 
ciplinary activity  with  relation  to  nurs- 
ing legislation  and  other  legislation? 

•  What  levels  of  workers  should  be 
represented  or  included  in  nursing 
legislation?  Should  nursing  legislation 
cover  all  people  who  contribute  to 
nursing? 

•  How  does  CNA  feel  about  represent- 
ation on  councils  that  administer  legis- 
lation? Should  all  groups  affected  by 
legislation  be  represented  on  such 
councils? 

•  How  does  CNA  feel  about  the  ques- 
tion of  registration  vs.  licensing? 

•  If  nursing  education  is  administered 
under  the  framework  of  general  educa- 
tion in  the  province,  who  should  be  the 
licensing  or  registering  body  for  nurses? 
Who  would  approve  educational  pro- 
grams? 

Although  the  CNA  directors  realiz- 
ed that  issues  such  as  licensing  and 
registration  are  under  provincial  juris- 
diction, they  agreed  that  national  guide- 
lines would  be  supportive  to  the  pro- 
vincial associations.  One  director  said, 
■"This  is  a  complex  issue,  and  right  now 
the  provincial  governments  are  trying 
to  grab  other  provinces'  ideas.  There 
should  be  some  place  where  the  prov- 
inces can  come  for  support."  Directors 

DECEMBER      1971 


emphasized  that  solid  evidence  is  need- 
ed to  show  that  nursing  care  is  better 
when  nurses  are  licensed  as  they  are  in 
the  Canadian  provinces. 

Further  information  on  nursing 
legislation  will  be  prepared  by  a  CNA 
research  officer  and  presented  to  the 
directors  before  their  meeting  in  March 
1972.  They  will  then  decide  what  state- 
ment, if  any,  they  wish  to  make. 


ANPQ  Raises  Fees,  Approves 
Abortion  Removal  from  Code 

Montreal,  Quebec — Delegates  to  the 
annual  meeting  of  the  Association  of 
Nurses  of  the  Province  of  Quebec 
approved  an  increase  in  the  associa- 
tion's annual  membership  fee  to  $40  in 
1972  and  $50  in  1973;  the  1971  fee 
was  $25.  Voting  on  the  fee  increase 
was  by  secret  ballot,  the  only  such  ballot 
of  the  convention. 

The  ANPQ  meeting  was  held  Octo- 
ber 29,  30,  and  3 1 ,  1 97 1 ,  at  the  Queen 
Elizabeth  hotel. 

A  resolution,  that  the  ANPQ  recom- 
mend to  the  Canadian  government 
amendment  of  the  Criminal  Code  so 
that  abortion  becomes  a  medical  pro- 
cedure, was  approved  by  more  than 
two-thirds  of  the  287  voting  delegates. 

Another  resolution  requesting  the 
ANPQ  to  study  seriously  the  possibility 
of  withdrawing  from  the  Canadian 
Nurses'  Association  was  defeated. 

Voting  delegates  adopted  a  resolu- 
tion calling  for  an  efficient  method  of 
investigation  and  control  mechanisms 
necessary  for  the  ANPQ  to  carry  out  its 
legislative  responsibilities  with  regard  to 
discipline. 

Figures  reported  to  the  meeting 
showed  that  in  1970,  for  the  first  time, 
practicing  membership  in  the  ANPQ 
exceeded  30,000  nurses. 

Rachel  Bureau  was  chosen  president 
of  the  ANPQ  by  the  committee  of 
management.  Other  officers  selected 
are  Juliette  Bruneau  { 1  st  vice-president, 
French)  and  Sheila  O'Neill  {1st  vice- 
president,  English);  Madeleine  Lalande 
(2nd  vice-president,  French)  and  Helen 
D.  Taylor  (2nd  vice-president,  English); 
Jeannine  Tellier-Cormier  (honorary 
treasurer);  and  Roberta  Coutts  (honor- 
ary secretary). 

The  next  meeting  of  the  ANPQ  will 
be  held  in  Quebec  City,  at  the  Chateau 
Frontenac,  October  18,  19,20,  1972. 

OHA  President  Urges 

More  Community  Involvement 

Toronto,  Ont. —  Hospitals  should  get 
out  and  involve  more  people  from 
their  communities,  Hugo  T.  Ewart, 
president  of  the  Ontario  Hospital  Asso- 
ciation, told  delegates  at  OHA's  47th 
annual  convention  October  25-27. 
DECEMBER     1971 


1971.  In  his  president's  report.  Dr. 
Ewart  stressed  the  importance  of  bring- 
ing health  care  into  the  community 
through  satellite  community  clinics, 
and  trying  to  involve  a  larger  segment 
of  the  population  through  hospital 
community  advisory  councils. 

Dr.  Ewart,  former  administrator 
of  the  Hamilton  Health  Association 
and  a  past  president  of  the  Ontario 
Medical  Association,  said  that  through 
such  councils,  hospitals  could  draw 
on  many  more  socially-conscious  people 
who  may  not  have  the  time  to  serve  on 
a  hospital's  board,  but  nevertheless 
have  a  great  deal  to  contribute.  "There 
must  be  many  people  in  business,  un- 
ions, service  clubs,  ratepayer  associa- 
tions, citizens'  groups  and  other  com- 
munity organizations  who  could  serve 
a  valuable  purpose,"  he  said.  "I  am 
proposing  that  hospitals  deliberately 
seek  out  these  people  from  a  wide 
variety  of  sources  and  invite  them  to 
form  a  hospital-community  advisory 
council." 

Dr.  Ewart  said  he  hoped  an  advisory 
council  would  act  as  an  active,  inquir- 
ing, and  critical  forum  to  which  the 
hospital  representatives  must  come 
fully  prepared  to  listen  and  to  explain. 
Listing  the  potential  benefits  of  such 
a  council,  he  said,  "The  hospital  board 
would  gain  from  the  deeper  knowledge 
of  public  attitudes  which  its  own  council 
representatives  would  report  back.  It 
would  gain  from  the  opportunity  to 
explain  the  hospital's  activities,  its 
problems  and  plans,  to  a  broadly-based 
group  of  influential  community  leaders. 
Almost  certainly  it  would  gain,  too, 
from  public  recognition  of  the  fact 
that  the  hospital  really  does  want  to 
know  what  people  think.  The  commu- 
nity would  gain  from  a  better  under- 
standing of  what  makes  their  hospital 
tick  and  from  the  opportunity  to  offer 
new  ideas  and  suggestions." 

Some  8,000  persons  attended  the 
OHA  convention  this  year.  The  theme 
was  "Hospitals — moving  into  the 
community." 


Coordination  Of  Education 
Theme  Of  Second  National 
Health  Manpower  Conference 

Ottawa — Formation  of  the  proposed 
Canada  health  council,  a  move  toward 
making  the  educational  resources  of 
the  health  sciences  into  national  assets, 
and  support  in  establishing  a  series  of 
community  health  centers  as  demon- 
stration models  were  priorities  cited  by 
Dr.  John  F.  McCreary,  dean  of  the 
faculty  of  medicine.  University  of  Brit- 
ish Columbia,  when  summing  up  the 
deliberations  of  the  second  national 
conference  on   health  manpower  held 


Uniform  Spells  Chic  Comfort 
For  NS  Public  Health  Nurses 


The  new  uniform  chosen  by  the  public 
health  nurses  of  Nova  Scotia's  eight 
health  units  is  made  by  Bonda  Tex- 
tiles, Yarmouth.  It  is  navy  blue  crim- 
plene piped  in  white,  with  an  optional 
belt.  It  is  easy  to  see  that  staff  nurse, 
Mrs.  Helen  Purly,  who  lives  in  Am- 
herst, N.,  S.,  likes  her  uniform. 


October  19-22,  1971,  in  Ottawa. 

The  conference,  sponsored  jointly 
by  the  department  of  national  health 
and  welfare,  the  Association  of  Uni- 
versities and  Colleges  of  Canada,  and 
the  Association  of  Canadian  Commu- 
nity Colleges,  had  more  than  150  par- 
ticipants from  acrossCanada,  represent- 
ing universities,  community  colleges, 
and  hospitals,  professional  associations, 
and  governments. 

Dr.  Josephine  Flaherty,  president  of 

the  Registered  Nurses'  Association  of 

Ontario,  on  opening  the  meeting,  said: 

"The  conference   is  to  review   health 

THE      CAN/^DIAN      NURSE     9 


news 


manpower  educational  programs  tor 
the  purpose  of  promoting  flexibility, 
adaptability  and  coordination." 

Dr.  Helen  K.  Mussallem  spoke  for 
the  professional  associations,  but 
particularly  for  the  CNA,  on  a  panel 
including  representatives  of  a  universi- 
ty, community  college,  and  provincial 
government.  Her  note  of  alarm:  "How 
much  longer  can  we  be  part  of  a  system 
where  approximately  five  cents  of  the 
health  dollar  is  devoted  to  preventive 
services?"  was  followed  by  a  hope  that 
those  at  the  conference  could  find  "com- 
mon denominators  on  which  to  build 
a  health  service  that  progressively 
channels  a  greater  portion  of  the  health 
dollar  into  prevention  .  .  ." 

The  deputy  minister  of  national 
health  and  welfare,  Dr.  Maurice  Le- 
clair,  challenged  health  educators  to  be 
"responsive  to  the  needs  of  the  public 
and  to  produce  appropriately  trained 
health  professionals  in  the  right  num- 
bers and  at  the  right  time."  He  had  al- 
ready mentioned  that  professional 
training  should  be  oriented  toward 
social  aspects  of  health  care  and  the 
psychological  basis  of  illness,  in  addi- 
tion to  the  scientific  training  required 
for  primary  care. 

Most  speakers  and  many  in  the  group 
sessions  that  formed  the  basis  of  the 
conference  sought  flexibility  to  allow 
and  to  encourage  both  horizontal  and 
vertical  mobility  within  the  health 
industry. 

As  examples  of  areas  of  rigidity. 
Professor  Thomas  J.  Boudreau,  direc- 
tor of  the  division  of  social  medicine, 
faculty  of  medicine.  University  of 
Sherbrooke,  mentioned  the  present 
formal  system  of  education,  with  its 
proliferation  of  categories  of  health 
worker;  the  non-global  budgeting  sys- 
tem in  many  hospitals;  the  collective 
agreements  aimed  at  providing  job 
security  to  each  worker  in  a  category 
without  introducing  incentives  for  mo- 
bility and  upgrading  of  that  worker; 
and  the  professional  corporations,  12 
in  Quebec  alone,  that  no  longer  have 
as  their  main  objective  a  need  to  protect 
the  public. 

It  was  felt  that  the  cost  of  health 
services  could  go  no  higher  and  that 
some  of  the  costs  of  education  could 
be  contained  by  offering  core  curricula 
to  the  various  health  disciplines,  thus 
sharing  expensive  libraries  and  other 
facilities,  benefiting  from  the  best  teach- 
ers of  whom  there  is  a  felt  lack,  and 
receiving  cross-pollenation  from  other 
disciplines. 

Stanley  T.  Richards,  director,  divi- 
sion of  health  technology  at  the  British 

10     THE     CANADIAN      NURSE 


Columbia  Institute  of  Technology, 
suggested  that  the  role  of  licensing  and 
accrediting  bodies  is  "to  advise  on  what 
they  expect  of  the  graduate,"  and  that 
the  college  undertake  "to  produce  grad- 
uates who,  hopefully,  will  meet  these 
standards."  He  predicted  that  the  com- 
munity college  will  soon  make  a  signi- 
ficant contribution  in  terms  of  numbers 
trained  and  excellence  of  graduates. 
He  noted  also  that  the  cost  per  student 
year  is  currently  $  1 ,500  in  a  community 
college,  substantially  less  than  in  a  uni- 
versity. 

Dr.  H.  Rocke  Robertson,  currently 
making  a  study  of  Canada's  health 
services  for  the  Science  Council,  went 
a  step  further  by  saying,  "Without  a 
well-planned  system  of  follow-up  edu- 
cation, the  abilities  and  the  enthusiasm 
of  the  recent  graduate  are  bound  to 
wane."  He  questioned  the  general 
movement  away  from  the  laboratory 
and  the  hospital;  "Is  not  the  hospital 
work  too  underplayed  and  the  experi- 
ence that  can  be  gained  only  there  going 
to  be  too  restricted?" 

On  the  emergence  of  a  new  person 
into  the  primary  health  care  field,  he 
considered  nurses  to  be  at  present  those 
whose  training  most  nearly  fits  the 
new  role,  but  then  raised  questions  as 
to  their  payment  and  protection. 

Dr.  Grainger  W.  Reid,  director  of 
the  research  and  planning  branch  of 
the  Ontario  department  of  health,  said 
it  was  "important  and  urgent  to  define 
the  health  care  that  we  feel  we  can 
afford."  He  recommended  the  integra- 
tion of  the  three  aspects  of  health  care 
—  health  maintainance,  curative  care, 
and  rehabilitation —  with  de-emphasis 
on  acute  hospital  care  facilities,  the 
establishment  of  community  health 
centers,  and  a  concentration  on  chronic 
hospitals. 

Dr.  McCreary's  final  suggestions  on 
behalf  of  the  assembly  were  that  the 
postgraduate  student  in  any  health 
professional  school  should  be  considered 
as  a  national  asset  and  be  supported 
from  federal  sources  of  funds;  and 
that  some  support  should  be  granted 
for  continuing  education  within  the 
health  sciences  to  allow  nurses,  phar- 
macists, rehabilitation  therapists,  and 
others  the  opportunity  to  keep  them- 
selves up-to-date. 

First  Nurse  Appointed 

To  Medical  Research  Council 

Ottawa — Dorothy  J.  Kergin,  director 
of  the  school  of  nursing,  McMaster 
University,  has  been  appointed  for  a 
three-year  term  to  the  Medical  Research 
Council.  This  is  the  first  time  that  a 
member  of  the  nursing  profession  has 
been  named  to  the  council. 

The  Medical  Research  Council  is 
the  main  federal  agency  with  respon- 


sibility for  the  support  of  research  in  the 
health  sciences  in  Canadian  universities 
other  than  in  the  field  of  public  health. 
It  consists  of  a  president  and  21  mem- 
bers. 

Terms  of  the  eight  new  members  of 
the  Council  were  equally  divided  be- 
tween three  and  two  years.  Dr.  Kergin 
becomes  the  third  woman  on  the  coun- 
cil, joining  a  Montreal  pediatrician  and 
a  biochemist  from  the  University  of 
Ottawa. 

Underutilization  Of  Skills 
Leads  To  Lack  Of  Commitment 

Toronto.  Out.  —  Nursing  directors 
have  been  criticized  for  lacking  man- 
agerial skills,  but  frequently  they  are 
not  given  the  opportunity  to  use  these 
skills,  said  Jacqueline  Brown,  director 
of  nursing  at  the  Ottawa  General  Hos- 
pital. 

Mrs.  Brown,  who  chaired  a  nursing 
session  at  the  annual  meeting  of  the 
Ontario  Hospital  Association  October 
26,  said  the  scope  of  nursing  directors" 
function  is  broad,  but  in  practice  they 
often  have  little  to  say  about  decisions 
that  are  made.  "Yet  they  have  to  cope 
with  the  mess  that  ensues  .  .  .  and  have 
to  make  ends  meet,"  she  said. 

A  good  example  of  this,  according 
to  Mrs.  Brown,  can  be  found  in  budget 
planning:  The  nursing  director  works 
closely  with  her  head  nurses  to  prepare 
a  budget,  basing  requests  tor  an  increase 
of  staff  on  such  things  as  extra  patient 
loads,  more  acutely  ill  patients  in  the 
units,  and  so  on.  The  director  then 
goes  to  a  budget  meeting  only  to  be  told, 
"A  union  contract  has  been  settled  with 
another  group  of  hospital  personnel, 
and  they  got  an  increase,  therefore  you 
can't  have  an  increase." 

In  this  case,  Mrs.  Brown  said,  the 
nursing  director  should  make  it  clear 
that  her  staff  is  unable  to  provide  the 
necessary  level  of  patient  care,  and 
therefore  the  number  of  patients  admit- 
ted must  be  reduced.  Unfortunately 
few  directors  are  willing  to  do  this, 
she  said,  because  they  are  afraid  to  face 
the  doctors  who  would  be  forced  to 
admit  fewer  patients. 

Following  Mrs.  Brown's  discussion 
of  the  many  problems  facing  nurses  in 
hospitals,  Huguettc  Labelle,  director 
of  the  Vanier  School  of  Nursing,  Ot- 
tawa, spoke  of  possible  solutions.  Pre- 
facing her  remarks,  she  said  that  many 
nurses  in  the  future  will  be  attracted 
to  the  community  clinics — "which 
will  mushroom  in  the  next  few  years" 
—  and  that  hospitals  should  act  now 
to  provide  more  job  satisfaction  for  the 
nurse. 

"The  nurse  in  the  community  clinic 

will  have  an  exciting  role,  maybe  too 

exciting,"  she  said,  "and  this  may  en- 

iCoiiliiiiictl  on  pii^'c  12) 

DECEMBER      1971 


A  useful  guide  to 

rehabilitation  of  the 

disabled  and 

chronically  ill 

Krusen,  Kottke  &  Ellwood: 

Handbook  of  Physical  Medicine 
and  Rehabilitation    New  2nd  Edition 

Thoutoughly  revised  and  expanded  the  New  2nd 
Edition  of  this  medical  text  and  reference  brings 
you  the  most  recent  concepts  in  the  rehabilitation 
of  seriously  disabled  and  chronically  ill  patients. 

New  and  timely  topics  include  the  psychiatric 
aspects  of  rehabilitation,  the  fastgrowing  role  of 
engineering  technology,  and  the  rehabilitation  of 
the  mentally  retarded,  the  deaf,  and  the  blind. 

Discussions  on  cryotherapy,  management  of  neu- 
rogenic bladder  and  bowel  dysfunction,  and 
contraindications  to  diathermy  for  patients  with 
implanted  cardiac  pacemakers  are  among  those 
provided  by  the  38  contributing  authors.  The 
chapter  on  care  of  the  amputee  has  been  ex- 
tensively  revised   and    updated. 

Edited  by  Frank  H.  Krusen,  M.D  ,  Frederic  J.  Kottke,  M.D  , 
Ph.D.,  both  of  Ihe  Univ.  of  Minnesota;  and  Pool  M.  Ellwood, 
Jr.,     M.D,,     American     Rehabilitation     Foundation. 


38    contributors. 

920    pp.  447     figs. 


August     1971. 


$23.20 


Instruction  for 


the  patient  -- 
help  for  the  nurse 


Nursing  Clinics  of 
North  America 

The  December  Issue  of  Nursing  Clinics  is  devoted 
to  the  important  topics  of  "Patient  Teaching"  and 
"Use  of  the  Self  in  Clinical   Practice." 

The  first  symposium,  edited  by  Kathleen  Smyth, 
University  of  Illinois,  stresses  the  role  the  nurse 
plays  in  teaching  her  patient  what  he  needs  to 
know  about  his  disease,  his  future  prognosis  and 
especially  the  procedures  required  for  his  own 
self-core.  Articles  include:  counseling  unwed 
pregnant  adolescents,  effects  of  aging  on  the 
patient's  ability  to  learn,  and  teaching  the  young 
[iotienf  with  spinal  cord  injury  to  help  in  his  own 
rehabilitation. 

Margaret  Colliton,  Yale  Psychiatric  Institute,  edits 
the  second  symposium,  which  describes  how  the 
nurse  can  use  her  self,  her  own  strengths,  in  the 
therapeutic   nurse-patient    relationship. 

This  issue  is  typical  of  the  high  professional  level 
you  will  find  in  each  issue  of  the  Nursing  Clinics. 

Sold  by  annuol  subscription  only.  Four  issues  a  ycor  averaging 
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DECEMBER      1971 


THE      CANADIAN      NURSE      11 


news 


iCoiitiiiiicil  from  i)tifn'  10) 
hance  the  problems  that  appear  to  be 
in  hospitals.  So  we  may  be  wise  to  move 
rapidly  and  look  at  these  problems  in 
our  institutions.  Otherwise  we  may  be 
faced  with  an  exodus  of  nurses  from 
hospitals  to  community  health  agen- 
cies." 

Present  staffing  patterns  may  lead 
to  a  lack  of  commitment  on  the  part  of 
the  staff  nurse,  Mrs.  Labelle  said. 
"If  the  nurse  is  not  given  full  responsi- 
bility for  the  care  of  the  individual,  from 
his  admission  to  his  discharge  from  the 
unit,  she  cannot  develop  sufficient 
interest  and  knowledge  about  him  to 
fulfill  her  role  adequately.  She  does  not 
have  the  opportunity  to  do  other  than 
'caretaker  nursing,"  and  is  in  a  poor 
position  to  plan  any  program  of  care  for 
her  patient.  As  nurses  rotate  from  one 
unit  to  another,  from  one  patient  to 
another,  and  from  one  shift  to  another 
.  .  .  the  patient  is  left  to  cope  with  a 
procession  of  nameless  and  faceless 
nurses,"  she  said,  "and  the  nurse  be- 
comes merely  an  assemblyline  worker." 

Mrs.  Labelle  deplored  the  lack  of 
experimentation  with  new  staffing 
patterns.  After  mentioning  a  few  hos- 
pitals that  are  trying  new  patterns, 
she  said,  "Maybe  we  should  look  at 
the  set-up  at  The  Winnipeg  General 
Hospital,  where  nurses  on  one  unit  work 
7  out  of  14  days,  on  a  12-hour  shift." 

A  nurse's  lack  of  commitment  may 
also  be  caused  by  lack  of  involvement, 
Mrs.  Labelle  said.  "Too  often  decisions 


are  made  at  the  top  and  the  nurses  at 
the  bottom  have  to  live  with  this.  I 
believe  they  should  be  involved  in  all 
decisions  that  are  related  to  their  work. 
If  there  were  more  direct  input  from 
the  nurse  who  gives  patient  care,  deci- 
sions at  the  top  might  be  more  relevant 
to  needs." 

Plan  Carefully,  Set  Goals 
Before  Establishing  Clinic 

Toronto,  Ont. —  If  you're  thinking  of 
setting  up  a  community  health  clinic 
as  a  satellite  to  your  hospital,  don't 
rush  in  without  careful  planning.  This 
advice  came  from  J.D.  Snedden,  execu- 
tive director  of  Toronto's  Hospital  for 
Sick  Children,  who  addressed  delegates 
at  the  Ontario  Hospital  Association's 
annual  meeting  October  25-27,  1 97  1 . 

Careful  planning  involves  setting 
goals,  forecasting  costs  for  a  least  five 
years,  and  knowing  where  the  money 
will  come  from.  Dr.  Snedden  said.  In 
any  new  model,  such  as  the  community 
clinic,  certain  goals  must  be  achieved: 
the  service  must  be  easily  accessible 
to  the  consumer  in  both  geographical 
location  and  cost;  it  must  be  given  in 
a  personalized  way,  responsive  to  the 
wishes  of  the  consumer;  and  it  must 
be  equal  to  that  given  in  institutions. 

Dr.  Snedden  had  another  word  of 
advice:  "Don't  make  your  neighbor- 
hood clinic  a  matter  of  competition 
with  other  hospitals  in  the  community. 
Regional  planning  is  necessary  and 
should  even  be  mandatory." 

The  Hospital  for  Sick  Children  oper- 
ates two  community  clinics,  which 
Dr.  Snedden  described  as  "demonstra- 
tion models." 


12     THE     CANADIAN      NURSE 


CAUSN  Considers  Expanding 
Role,  Status  Of  Women 

Ottawa — The  Canadian  Asscx;iation 
of  University  Schools  of  Nursing  plans 
to  collect  descriptions  of  the  bacca- 
laureate nurse  in  practice,  showing 
differences  between  her  way  of  nursing 
and  that  of  the  diploma  nurse.  Decision 
to  collect  descriptive  data  was  made 
by  representatives  of  ail  but  one  of 
Canada's  university  schools  of  nursing 
at  a  meeting  held  at  the  Chateau  Laurier 
on  November  1  and  2,  197  1 . 

Forty  members  of  nursing  faculties, 
including  the  dean  or  her  representative 
from  2 1  universities,  all  of  theCanadian 
faculties  except  Montreal  University, 
and  the  presidents  of  the  four  C'ausN 
regions — Atlantic,  Quebec,  Ontario, 
and  the  West — attended  the  two-day 
meeting. 

Vema  Huffman  Splane,  principal 
nursing  officer  of  the  department  of 
national  health  and  welfare,  reported 
to  the  group  on  activity  following  the 
Status  of  Women  report.  Mrs.  Splane 
suggested  that  nurses  should  look  at  the 
Report  in  terms  of  basic  human  rights 
for  everyone,  not  Just  for  women.  Wo- 
men have  to  respect  not  only  themselves 
but  their  sex;  women  need  to  support 
women. 

Mrs.  Paltiel,  coordinator  of  the  fed- 
eral government's  examination  of  the 
status  of  women,  is  setting  up  a  bank 
of  names  of  Canadian  women  in  busi- 
ness and  the  professions  who  would 
be  appropriate  for  appointment  to 
committees.  Nursing  school  deans 
agreed  to  send  Mrs.  Paltiel  a  list  of 
names  of  women  who  might  serve 
Canada  in  this  way. 

The  executive  secretary  of  CAUSN 
is  Eileen  Healey  Mountain;  the  office 
is  located  at:  151  Slater  St.,  Room 
1200,  Ottawa,  Ont.,  K1P5N1. 


CCHA  Chairman  Says 
CNA  Should  Be  On  Council 

Toronto,  Ont. —  Membership  on  the 
Canadian  Council  of  Hospital  Accred- 
itation should  be  extended  to  include 
the  Canadian  Nurses'  Association.  This 
statement  was  made  by  CCHA  chairman 
W.M.  Goldberg,  who  addressed  dele- 
gates on  the  final  day  of  the  Ontario 
Hospital  Association's  annual  meeting 
October  25-27,  1971. 

Speaking  of  ways  the  present  system 
of  hospital  accreditation  could  be  im- 
proved. Dr.  Goldberg  said,  "the  CCHA 
represents  the  major  health  care  bodies 
in  this  country,  and  should  be  extended 
to  include  the  CNA  as  well  as  a  broader 
representation  from  other  bodies,  in- 
cluding the  consumers." 

Dr.  Goldberg  proposed  an  in-depth 
type  of  survey  that  would  go  beyond 
the  present  type  of  assessment.  Hos- 
pitals are  now  accredited  on  the  basis 

DECEMBER      1971 


of  whether  or  not  they  have  the  admin- 
istrative mechanisms  and  organizational 
patterns  that  create  an  environment  in 
which  good  health  care  can  be  carried 
out.  Generally  these  surveys  are  con- 
ducted by  one  person,  usually  someone 
who  has  had  experience  in  administra- 
tion, and,  according  to  Dr.  Goldberg, 
"are  rather  superficial  by  their  very 
nature." 

In  future,  he  said,  "it  is  planned  that 
the  survey  team  will  consist  of  an  ad- 
ministrator to  study  in  depth  the  admin- 
istration of  the  institution,  a  nursing 
representative  to  study  her  area  of  con- 
cern as  related  to  the  standards,  and  a 
doctor,  who  is  a  clinician,  to  study  the 
quality  of  care  aspect  of  the  institu- 
tion." 

Dr.Goldbergemphasizedthatgovern- 
mental  agencies  should  noi  be  respon- 
sible for  this  type  of  accrediting  be- 
cause it  would  become  an  inspection, 
rather  than  an  in-depth  survey.  "We 
are  constantly  barraged  by  the  fact 
that  since  government  pays  all  the 
money,  they  should  have  the  total  say 
as  to  how  it  is  spent,"  he  said.  "This  is 
a  fallacy,  because  the  government 
really  only  acts  as  an  agent  of  the  people 
from  whom  it  takes  the  money  and  then 
dispenses  it.  While  I  realize  they  have 
a  right  to  see  that  it  is  utilized  appro- 
priately, this  will  ...  be  best  accom- 
plished by  having  some  voluntary  out- 
side organization,  which  represents 
those  individuals  intimately  involved 
with  providing  and  receiving  the  ser- 
vice, carry  out  the  ultimate  assessment 
of  the  end  product,  that  is,  the  quality 
of  care  and  its  economic  utilization." 


Drug  Use  Only  Tip  Of  Iceberg 
Doctor  Tells  Industrial  Nurses 

Montreal,  Quebec —  When  it  comes  to 
drug  misuse,  the  generation  gap  has 
been  bridged.  This  was  the  message 
nurses  received  October  I  at  a  con- 
ference for  industrial  nurses,  sponsored 
by  the  Association  of  Nurses  of  the 
Province  of  Quebec. 

Dr.  John  R.  Unwin,  director  of  youth 
services  at  Allan  Memorial  institute 
of  Psychiatry  in  Montreal  and  associate 
professor  of  psychiatry  in  the  faculty 
of  medicine  at  McGill  University,  told 
his  audience:  "The  non-medical  (but 
too  often  medically-initiated)  use  and 
misuse  of  drugs  is  so  prevalent  in  our 
society  that  every  nurse  in  contact  with 
the  populations  t>f  workers  you  serve 
will  want  to  be  thoroughly  familiar  with 
the  appearance,  modes  of  use,  effects 
and  management  of  the  various  popular 
drugs  of  nonmedical  use. 

DECEMBER      1971 


"Industrial  nurses  must  also  become 
involved  in  preventive  programs  of 
detection  and  education,  both  within 
factories,  etc.,  and  within  the  local 
communities  where  the  basic  causes  of 
drug  misuse  lie."  He  specifically 
recommended:  "Presume  that  you  have 
a  drug  misuse  problem  in  your  industry, 
and  set  up  programs,  after  appropriate 
consultation,  for  detection,  prevention, 
rehabilitation  and  education  —  with- 
out undertaking  a  witch-hunt." 

The  speaker  also  quoted  recommen- 
dations of  drug  experts:  "It  is  clear 
that  much  adolescent  drug  use  or  abuse 
cannot  be  reduced  without  a  parallel 
reduction  in  parental  drug  use.  .  .  . 
Perhaps  family  therapy  rather  than 
individual  or  group  therapy  is  requir- 
ed. It  also  seems  evident  that  the  target 
population  for  drug  education  should 
not  be  students  but  entire  families." 

Looking  at  the  use  of  marijuana 
by  students.  Dr.  Unwin  singled  out 
medical  students.  "In  one  McGill  survey 
in  1 969,  40  percent  of  medical  students 
admitted  marijuana  use  at  least  once 
in  the  past  six  months."  He  added  that 
another  study  of  student  drug  use 
"found  that  amphetamine  use  was 
widest  among  students  of  the  schools 
of  medicine  and  nursing." 

Dr.  Unwin  noted  that  the  "current 
barbarous  Canadian  drug  laws,"  which 
he  said  are  often  more  destructive  than 
the  drugs  they  are  unsuccessfully  trying 
to  control,  "continue  to  impinge  mainly 
on  the  young  —  the  great  majority  of 
marijuana  convictions  involve  people 
under  the  age  of  25.  .  .  ." 

Case  Western  Reserve  To  Offer 
Ph.D.  Program  In  Nursing 

Cleveland.  Ohio  —  Case  Western  Re- 
serve University  will  open  a  Ph.D. 
program  in  nursing  in  September  1972. 
Approval  by  the  university's  graduate 
council  came  after  almost  two  years  of 
study  conducted  by  a  school  of  nursing 
task  force  appointed  by  Dr.  Rozella 
Schlotfeldt,  dean  of  the  school  of  nurs- 
ing. Selected  members  of  the  school  of 
nursing  faculty,  holding  earned  doctoral 
degrees  in  a  variety  of  disciplines,  have 
responsibility  for  the  new  program. 

At  Case  Western  Reserve  University 
the  degree  of  master  of  science  in  nurs- 
ing represents  preparation  for  beginning 
practice  as  a  nurse  specialist;  the  mas- 
ter's degree  also  includes  preparation 
for  research.  The  focus  of  the  Ph.D. 
program  will  be  clinical  nursing,  and 
the  traditional  expectation  for  the  Ph.D. 
as  a  research  degree  will  be  fulfilled 
by  those  completing  the  program. 

Enrollments  are  expected  to  grow 
gradually  as  the  school  is  able  to  aug- 
ment the  faculty  with  those  who  hold 
earned  doctoral  degrees  and  to  obtain 
fellowship  support  for  students. 


CAMOS, 


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THE      CANAI|IAN      NURSE      13 


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14     THE     CANADIAN     NURSE 


Men  Kicking  Cigarette  Habit 
But  More  Teenage  Girls  Hooked 

Ottawa — Preliminary  results  of  an 
analysis  of  Canadian  smoking  habits 
indicate  a  steady  reduction  in  cigarette 
smoking  among  adult  males.  However, 
the  proportion  of  regular  smokers 
among  teenage  girls  has  increased  subs- 
tantially, while  the  proportions  among 
adult  women  and  teenage  boys  have 
remained  about  the  same. 

The  study  is  based  on  annual  surveys 
carried  out  for  the  department  of  na- 
tional health  and  welfare  by  Statistics 
Canada  in  conjunction  with  the  labor 
force  survey  between  1964  and  1970. 

From  a  peak  of  58  percent  in  1965, 
the  proportion  of  regular  cigarette 
smokers  among  men  20  and  over  drop- 
ped to  51  percent  in  1970.  Regular 
smoking  among  females  has  not  de- 
creased correspondingly.  In  fact,  the 
proportion  rose  slightly  during  the  same 
period  and  appears  to  have  levelled 
off  at  approximately  34  percent. 

The  extent  of  discontinuation  of 
cigarette  smoking  among  adult  males 
is  indicated  from  the  estimate  that 
there  were  400,000  fewer  regular 
cigarette  smokers  in  1970  than  there 
would  have  been  if  1965  percentages 
had  continued. 

However,  population  growth  and 
the  increase  or  levelling  off  of  smoking 
among  females  and  teenage  boys  result- 
ed in  a  half-million  more  regular  cig- 
arette smokers  in  Canada  in  1 970  than 
in  1965  (almost  six  million  in  1970, 
compared  to  about  five  and  one-half 
million  in  1965). 

Contrary  to  commonly  held  opinion, 
a  minority  —  only  two  out  of  five 
Canadian  adults — are  habitual  cig- 
arette smokers. 

Most  men  seem  to  stop  smoking 
entirely  when  they  discontinue  cig- 
arettes. The  findings  suggest  no  subs- 
tantial switch  to  pipes  or  cigars.  There 
has  been  little  change  in  the  proportion 
of  men  who  smoke  only  pipes  or  cigars 
except  among  those  65  and  over  where 
it  decreased  from  21  percent  in  1965 
to  17  percent  in  1970. 

The  prevalence  of  occasional  cig- 
arette smoking  has  remained  essentially 
unchanged  over  the  past  seven  years 
—  about  three  percent  of  persons  smok- 
ing cigarettes  once  in  awhile.  The  small 
percentage  of  occasional  cigarette 
smokers  reflects  the  habit-forming 
properties  of  cigarette  smoking. 

From  a  low  of  19  percent  in  1965 
the  proportion  of  regular  smokers  re- 
ported among  girls  15  to  19  increased 
to  25  percent  in  1970. 

DECEMBER      1971 


The  latter  finding  may  be  partly  due 
to  an  increased  willingness  in  1970  for 
teenage  girls  or  their  mothers  to  admit 
their  smoking.  In  any  case,  the  data 
for  adult  as  well  as  teenage  females 
indicate  that  the  evidence  regarding 
the  dangers  of  smoking  has  not  had  the 
impact  on  women  that  it  has  had  on 
men. 

Venereal  Disease  Hotline  Gives 
Round-The-Clock  Information 

Toronto,  Ont.  —  A  telephone  hotline 
set  up  by  the  Ontario  department  of 
health  gives  callers  recorded  infor- 
mation about  the  locations  of  Toronto's 
seven  venereal  disease  clinics  and  the 
hours  they  are  open.  This  information, 
available  24  hours  a  day  each  day  of 
the  week,  is  updated  twice  daily. 

Health  Minister  Bert  Lawrence  ex- 
plained that  the  hotline  was  needed 
because  of  confusion  over  the  location 
of  the  VD  clinics  and  the  hours  they 
are  open.  As  part  of  an  overall  VD 
education  campaign,  the  hotline  was 
also  a  response  to  the  significant  in- 
crease in  VD  in  Ontario.  Gonorrhea 
cases  reported  in  the  province  from 
January  to  June  1971  increased  10 
percent  compared  with  the  same  period 
in  1970. 

As  well  as  the  hotline,  the  depart- 
ment's VD  campaign  features  displays 
at  major  fairs,  including  the  Canadian 
National  Exhibition;  radio  and  tele- 
vision public  service  announcements; 
transit  cards;  and  a  series  of  pamphlets. 

Two  additional  VD  clinics  have  been 
approved  by  the  health  department: 
one  outside  Toronto  at  Hotel  Dieu 
Hospital  in  St.  Catharines,  and  one  at 
the  Wellesley  Hospital.  The  other 
clinics  in  metropolitan  Toronto  are 
located  at  Women's  College  Hospital; 
The  Toronto  General,  Toronto  West- 
em,  and  St.  Michael's  Hospital;  The 
Hospital  for  Sick  Children;  and  the 
Scarborough  health  department. 

Federal  Nurses  Far  From  Satisfied 
With  Arbitration  Tribunal  Award 

Ottawa —  Nurses  in  the  federal  govern- 
ment saw  little  reason  to  rejoice  over 
the  provisions  of  the  5 1  -page  award 
handed  down  in  October  by  the  Arbi- 
tration Tribunal  headed  by  Mr.  Justice 
Andre  Montpetit  (News,  August,  page 
12).  The  nurses'  bargaining  agent  is  the 
Professional  Institute  of  the  Public 
Service  of  Canada. 

In  a  newsletter  sent  to  the  2,200 
members  of  the  nursing  group,  Ruth 
Millar,  the  group's  chairman,  explain- 
ed: "We  cannot  dance  for  joy  when 
the  Award  does  not  grant  our  most 
DECEMBER      1971 


important  need,  namely  a  National 
Rate  for  Nurse  I,  and  in  addition  is 
silent  or  unfavorable  in  respect  of  other 
items  which  we  thought  were  important 
enough  issues  to  place  before  the  Tri- 
bunal." 

But  a  news  release  from  the  Profes- 
sional Institute  said,  "The  Tribunal 
recognized  the  Institute's  conten- 
tion that  salary  scales  for  nurses  have 
been  completely  unrealistic  by  granting 
substantial  increases."  Increases  at  the 
Nurse  I  level  averaged  from 7.9  percent 
in  the  Maritimes  to  1 2.8  percent  in  Brit- 
ish Columbia.  These  increases,  retro- 
active to  January  4,  1971,  will  be  fol- 
lowed by  an  across-the-board  increase 
ofsixpercenteffective  January  3,  1972. 

Nurses  in  Saskatchewan  and  the 
Maritimes,  who  receive  the  same  rates 
of  pay,  will  now  get  $6, 100  at  the  mini- 
mum of  level  I ,  increasing  to  $6,466  in 
January  1972.  Nurses  in  British  Colum- 
bia at  this  salary  level  will  now  receive 
$7,340  and  $7,780  in  1972.  The  new 
1971  and  1972  rates  in  the  other  prov- 
inces are:  Alberta — $6,540  and 
$6,932;  Manitoba— $6,500  and 
$6,890;  and  Quebec,  Ontario,  the 
Northwest  Territories,  and  the  Yukon 
—  $6,950  and  $7,367. 

As  the  Professional  Institute  ex- 
plains, these  new  salary  rates  widened 
"the  disparity  in  pay  across  the  country, 
so  that  the  salary  differential  between 
a  nurse  in  Vancouver  at  the  maximum 
of  level  I  and  a  nurse  at  the  same  classi- 
fication level  in  the  Maritimes  has  been 
increased  by  over  $400." 

There  was  also  disappointment  about 
the  return  of  the  special  rate  for  Mani- 
toba, which  was  eliminated  in  the  pre- 
vious round  of  bargaining.  According 
to  the  nursing  group  executive,  "The 
Tribunal  has  given  Manitoba  nurses 
fair  treatment,  but  looking  ahead  .  .  . 
the  more  regional  rates  that  exist,  the 
harder  it  will  be  to  achieve  a  National 
Rate  for  Nurses  I  in  the  next  round  of 
bargaining." 

Other  benefits  requested,  but  not 
granted,  included  relief  for  commuting 
between  midnight  and  7:00  A.M..  addi- 
tional pay  for  adverse  weather  condi- 
tions, radio-telephones  in  vehicles  used 
by  nurses,  and  increased  vacation  leave 
for  all  nurses.  However,  nurses  with 
30  years  of  service  will  now  receive 
five  weeks  of  vacation  leave. 

The  nurses'  executive  did  find  some 
good  news  in  the  award.  "We  have  .  .  . 
been  granted  salary  increases  that  will 
at  least  establish  nurses  as  a  profes- 
sional group  and  the  Tribunal  has  gone 
a  considerable  way  toward  eliminating 
the  similarity  in  salary  between  the 
hospital  orderlies  and  ourselves.  ..." 

Other  benefits  of  the  award  include 
an  increase  in  shift  premiums,  effective 
November  1,  1971,  to  $2  for  the  even- 
ing shift  and   to  $1.50  for  the  night 


shift.  Non-shift  worKcrs  will  receive 
compensation  for  overtime  at  the  rate 
of  time  and  a  half  for  hours  worked  in 
excess  of  37'/2  hours  per  week.  Also 
fi-om  November  1 ,  overtime  compensa- 
tion for  extra  professional  services  can, 
at  the  employer's  discretion,  be  taken 
in  cash  or  in  leave.  Educational  and 
supervisory  allowances  for  Nurses  I 
and  2  have  been  increased  by  $  100. 

Hugh  Larsen,  of  the  Professional 
Institute,  who  was  one  of  three  repre- 
senting the  nurses  at  the  arbitration 
tribunal  hearing,  says  that  the  nurses 
in  the  Maritimes  got  "the  dirty  end 
of  the  stick"  in  comparison  with  nurses 
in  the  rest  of  the  country.  After  visiting 
the  Maritimes  to  discuss  the  outcome  of 
the  award,  he  promises  another  long 
fight  to  improve  the  "ludicrously  low" 
salary.  "We  will  go  back  and  back  and 
back  until  we  achieve  a  national  rate." 
He  notes  that  the  cost  of  living  on  the 
east  coast  is  as  high  as  it  is  in  Van- 
couver. 

This  sentiment  was  also  expressed 
in  the  newsletter  to  the  nurses:  "We 
must  continue  to  fight  until  we  achieve 
true  recognition  of  our  worth  to  the 
community." 

Committee  Of  Experts  Studies 
Various  Types  Of  Health  Centers 

Ottawa — Since  June  1971,  a  commit- 
tee of  1 9  specialists  from  across  Canada 
has  been  studying  ways  to  provide  or- 
ganized approaches  to  primary  and 
continuing  care  for  ambulatory  patients 
in  the  community. 

Financed  by  a  $400,000  federal 
government  grant,  the  committee  is 
collecting  and  analyzing  papers,  briefs, 
and  studies  from  a  wide  variety  of  pro- 
fessional and  consumer  groups.  The 
committee's  final  report,  which  will  be 
forwarded  to  a  conference  of  health 
ministers  in  June  1972,  will  make  spe- 
cific recommendations  on  the  forms  of 
health  centers  that  the  committee  be- 
lieves should  be  developed  in  Canada. 

In  a  November  interview  with  The 
Canadian  Nurse,  committee  chairman 


St.  John  Ambulance  Bursaries 

One  or  more  $1,000  bursaries  award- 
ed annually  from  the  Margaret  Mac- 
Laren  Memorial  Fund  arc  available  to 
experienced  registered  nurses  for  study 
at  the  master's  level.  This  fund  may  also 
be  used  for  student  nurse  applicants, 
with  preference  given  to  those  having 
St.  John  Ambulance  affiliation. 

Applications  for  these  bursaries, 
which  must  reach  the  national  head- 
quarters of  St.  John  Ambulance  no 
later  than  May  1,  1972,  should  be 
addressed  to  the  Chairman  of  Bursary 
Funds,  321  Chapel  Street,  Ottawa 
Ontario,  KIN  7Z2. 

THE      CAN>^IAN      NURSE      15 


POSEY  FOR  PATIENT  COMFORT 


The  new  Posey  products  shown 
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hospital  and  nursing  products 
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protection  and  ease  of  care.   To 
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The  Posey  "Swiss  Cheese"  Heel 
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The  Posey  Foot  Elevator  protects 
pressure  sensitive  feet  by  keeping 
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The  Posey  Elbow  Protector  helps 
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The  Posey  Ventilated  Heel  Pro- 
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16     THE     CANADIAN      NURSE 


Dr.  John  Hastings,  professor  and  head 
of  medical  care  in  the  school  of  hygiene 
at  the  University  of  Toronto,  explained 
that  the  committee  "must  deal  with 
some  of  the  prickly  pear  issues."  But 
it  is  not  trying  to  get  new  information. 
Rather,  it  is  pulling  together  available 
knowledge  and  experience. 

Committee  members,  who  represent 
different  ideas,  approaches,  and  geo- 
graphical areas,  were  chosen  from 
nursing,  medicine,  labor,  universities, 
law,  social  welfare  and  voluntary  health 
and  welfare  associations,  the  depart- 
ment of  national  health  and  welfare, 
and  provincial  health  departments. 
Nursing's  representative  on  the  commit- 
tee is  Olivette  Gareau,  director,  public 
health  nursing  department  of  social 
affairs,  Quebec. 

As  well  as  requesting  some  60  papers 
for  the  study,  the  committee  has  written 
to  several  hundred  organizations 
throughout  the  country,  including  the 
Canadian  Nurses'  Association,  for 
their  views  on  community  health  cen- 
ters. Case  studies  from  individuals 
with  experience  that  might  be  helpful 
to  the  committee  are  also  being  request- 
ed. Dr.  Hastings  says  "It  is  very  hard 
for  us  to  identify  beyond  key  groups. 
We  don't  want  to  leave  out  any  input 
that  may  be  relevant." 

In  the  spring  of  1972,  the  commit- 
tee will  hold  a  series  of  special  semi- 
nars, including  one  for  nurses,  to  look 
at  the  role  of  the  various  professions 
in  this  type  of  health  center.  Legal  and 
architectural  implications  will  also  be 
dealt  with  in  these  seminars.  To  get 
information  not  otherwise  available. 
Dr.  Hastings  will  visit  each  province.  He 
may  also  make  selective  visits  to  the 
United  States,  Britain,  and  Western 
Europe  to  study  experiences  that  could 
be  relevant  to  Canada. 

Health  centers  sponsored  by  govern- 
ment, consumers,  and  the  medical  pro- 
fession are  being  examined,  as  well  as 
the  relationship  of  such  centers  to  social 
services,  hospitals,  and  other  services 
within  the  whole  context  of  health  care. 

Dr.  Hastings  would  like  to  hear  from 
nurses  who  have  had  experience  work- 
ing in  an  ambulatory  care  setting.  All 
information,  which  must  reach  him  by 
January  15,  1972,  should  be  addressed 
to  Dr.  John  E.F.  Hastings,  Project 
Director,  Community  Health  Centre 
Project,  55  St.  Clair  Avenue  East, 
Suite  623,  Toronto  7,  Ontario.  Q 

RED  CROSS 

IS  ALWAYS  THERE  | 
WITH  YOUR  HELP 

DECEMBER      1971 


+ 


new  products     { 


Descriptions  are  based  on  information 
supplied  by  the  manufacturer.  No 
endorsement  is  intended. 


Proctosedyl  Ointment 

Proctosedyl  ointment  is  now  available 
in  30G  tubes,  giving  the  patient  suf- 
ficient medication  to  relieve  pain, 
inflammation,  pruritus,  and  bleeding 
—  symptoms  associated  with  hemor- 
rhoids and  fissure-in-ano. 

For  more  information  write  to  Rous- 
sel  (Canada)  Ltd.,  153  Graveline, 
Montreal  376,  Quebec. 


FDD  approves  lithium  carbonate 

The  federal  government  Food  and  Drug 
Directorate  has  approved  lithium  car- 
bonate, a  drug  used  for  treating  the 
manic  phase  of  manic  depressive  psy- 
chosis, for  sale  in  Canada. 

Both  Winley-Morris  Co.  Ltd.,  Mon- 
treal, and  Pfizer  Company  Ltd.,  Mon- 
treal, have  announced  the  introduction 
of  this  controversial  chemical  sub- 
stance. 

Winley-Morris  is  producing  the  drug, 
which  it  calls  "Carbolith,"  in  300  mg. 
capsules.  According  to  the  company, 
the  action  of  lithium  in  manic  disease 
is  not  yet  fully  understood,  although 
the  results  observed  have  been  frequent- 
ly dramatic  in  the  treatment  of  manic 
depressive  disease.  More  information 
is  available  from  Peter  J.  Wilson, 
Winley-Morris  Co.  Ltd.,  675  Montee 
de  Liesse,  Montreal  377,  Quebec. 

Pfizer  Pharmaceutical  Division,  50 
Place  Cremazie,  Montreal  II,  has 
introduced  the  drug  as  Lithane  tablets. 
"The  ability  of  lithium  carbonate  to 
quiet  manic  elation  without  sedation 
or  impairment  of  mental  processes 
makes  it  unique  in  the  drug  therapy  of 
this  illness,"  the  company  says.  It  also 
explains  that  the  side  effects  of  Lithane 
can  be  divided  into  two  categories: 
"milder  ones  seen  at  low  serum  con- 
centrations and  considered  merely 
inconvenient,  and  the  more  severe 
ones  resulting  from  higher  serum 
concentrations.  Such  side  effects  may 
be  relieved  by  reducing  the  dosage. 
During  therapy,  the  patient,  as  well  as 
his  family,  must  be  instructed  regard- 
ing the  clinical  signs  and  symptoms  of 
excess  lithium  carbonate." 


Aspirite  unit 

The  new  "Aspirite"  unit,  introduced 
by  Bristol  Laboratories  of  Canada,  is  a 
plastic  container  designed  to  replace  the 

DECEMBER      1971 


glass  bottle  used  in  hospitals  for  collect- 
ing aspirated  fluids.  This  disposable 
collection  unit  is  intended  to  reduce 
the  risk  of  cross  contamination,  save 
labor,  and  eliminate  clean-up  problems. 

Double  inner-seal  rings  in  the  snap- 
on  lid  create  a  vacuum  to  give  optimum 
suction  from  the  existing  equipment. 
Aspirite  fits  most  existing  hospital 
suction  systems,  and  easily  adapts  to 
others.  Foaming  is  reduced  by  the 
flexible  antisplash  sleeve  built  into  the 
lid.  Fluid  entering  the  canister  is  forced 
to  the  bottom  to  fill  from  a  submerged 
position.  Fluid  levels  are  easy  to  read 
against  the  clear  calibrations. 

Lid  apertures  are  clearly  marked. The 
funnel-shaped  ports  accommodate  all 
standard  sizes  of  tubing,  and  there  is 
no  complex  valve  apparatus  or  assem- 
bly. This  unit  is  made  of  clear  plastic, 
specially  coated  to  eliminate  static 
electricity.  Qnce  it  is  used,  it  can  be 
crushed  to  a  powder  or  incinerated. 
Aspirite  is  available  in  1400  and  2400 
cc.  sizes,  and  may  be  used  interchange- 
ably or  in  tandem. 

For  more  information,  write  to: 
Bristol  Laboratories  of  Canada  Limit- 
ed, 100  Industrial  Blvd.,  Candiac, 
Quebec. 


Extended  life  pacemaker 

An  asynchronous  pacemaker,  featuring 


an  implanted  life  of  up  to  five  years, 
has  been  introduced  by  the  General 
Electric  Company. 

The  pacemaker's  increased  life 
expectancy,  doubling  that  of  most 
present-day  pacing  units,  is  provided 
by  a  unique  dual  power  source.  While 
two  battery  cells  are  used  to  pace  the 
heart  initially,  two  additional  cells  are 
held  in  reserve.  When  the  energy  in 
the  first  two  pacing  cells  is  almost 
depleted,  the  pulse  generator  automatic- 
ally switches  to  the  reserve  power 
source,  and  pacing  continues.  This 
change  is  signaled  by  a  two  ppm  drop 
in  the  pacing  rate.  Approximately  60 
percent  of  the  generator's  life  is  expend- 
ed when  this  change  occurs. 

This  pacemaker  offers  the  choice  of 
two  energy  outputs  and  either  bipolar 
or  unipolar  pacing.  The  high  energy 
output  may  easily  be  selected  for  pa- 
tients exhibiting  high  threshhold  during 
or  after  implant.  However,  this  mode 
reduces  maximum  pacemaker  life  to 
about  four  years. 

The  pacemaker  system  is  especially 
designee  for  patients  with  permanent 
heart  block  or  bradycardia,  in  cases 
where  competitive  pacing  is  not  an- 
ticipated. 

For  additional  information,  write 
to  General  Electric  Medical  Systems 
Limited,  3311  Bayview  Avenue, 
Toronto,  Ontario. 


THE     CANADIAN     NURSE     17 


new  products 


Simpler  stoma  and  ileostomy  bags 

Hollister  Limited  has  introduced  an 
adhesive,  drainable  ileostomy  bag  and 
a  disposable  urostomy  bag. 

The  adhesive  ileostomy  bag  is  con- 
structed in  a  beltless,  gasketless  appli- 
ance for  users  who  prefer  a  stick-on 
appliance  requiring  no  supporting 
belt.  It  can  also  be  used  for  the  hospital 
patient  who  has  a  draining  fistula  or 
wound.  To  give  a  more  natural  fit,  the 
hypoallergenic  adhesive  is  applied  to 
butterfly-like  wings,  rather  than  to  the 
surface  of  the  bag. 

This  bag  is  16  inches  long,  and  is 
made  with  a  special  odor-barrier  film. 
With  a  reusable  plastic  clamp  sealing 
its  lower  end,  it  can  be  emptied  and 
drained  several  times  without  disturb- 
ing the  stoma  area.  Seven  stoma  sizes, 
ranging  from  I-Va  inches  to  3  inches, 
are  available. 

The  disposable  urostomy  bag,  well 
suited  for  the  ileal  conduit  stoma,  is  a 
lightweight,  valve-drained  collector 
with  a  comfortable  adhesive-plus-belt 
mounting.  A  five-foot  detachable  drain 
tube  replaces  the  daytime  valve  stopper 
for  convenient  overnight  drainage  and 
uninterrupted  sleep. 

This  bag  is  available  in  five  stoma 
openings,  ranging  from  one  to  two 
inches.  The  Karaya  Seal  urostomy  bag 
has  a  built-in  karaya  cushion  for  extra 
skin  protection  during  postoperative 
healing. 

All  urostomy  bags  are  constructed 
with  odor-barrier  film  and  a  slender 
drain  valve  for  easy  operation  into  a 
urinal,  toilet,  or  bedpan.  Hospital  or 
nursing  home  officers  may  order  a 
small  trial  supply  free  by  writing  to: 
Hollister  Limited,  332  Consumers 
Road,  Willowdale,  Ontario. 

Literature  available 

A  booklet  entitled  Parenteral  Admin- 
istration is  available  free  of  charge  to 
registered  nurses  from  Abbott  Labo- 
ratories Limited. 

This  60-page  booklet  describes  Ab- 
bott intravenous  equipment  and  in- 
cludes a  number  of  drawings  to  illustrate 
the  points  made,  the  techniques  describ- 
ed, and  the  equipment  used.  Other 
features  include  a  well-presented  table 
of  contents  section,  references,  and  a 
generally  easy-to-read  text. 

For  a  copy  of  this  1970  publication, 
write  to  Abbott  Laboratories  Limited, 
Montreal. 

A  new  booklet.  Nutrition —  Your 
Guide  to  the  Tropics,  has  resulted  from 
a  study  made  in  the  clinic  for  tropical 

18     THE     CANADIAN      NURSE 


and  parasitic  diseases  at  the  Toronto 
General  Hospital. 

This  booklet  offers  information  on 
factors  that  influence  nutrition  in  the 
tropical  climate.  Advice  on  other  adjust- 
ments includes  the  need  to  provide 
protection  against  parasitic  and  gastro- 
intestinal infestations. 

Canada's  Food  Guide,  with  good  eat- 
ing habits,  menu  planning,  and  tips  on 
safe  eating  and  drinking,  is  also  contain- 
ed in  the  booklet.  There  are  sugges- 
tions about  vegetables  and  salads,  left- 
overs, milk,  and  water. 

For  a  copy  of  this  booklet,  send  40 
cents  to  the  department  of  nutrition, 
Toronto  General  Hospital,  101  College 
Street,  Toronto  2,  Ontario. 

Motorized  x-ray  unit 

The  optima  200-M  mobile  x-ray 
unit  features  two  forward  and  one 
reverse  speeds  with  automatic  braking. 

The  battery-operated  drive  unit  can 
be  recharged  at  any  standard  100  volt 
or  240  a.c.  outlet. 

For  more  information  write  to  Cenco 
Medical/Health  Supply  Corp.  4401. 
West  26th.  Street,  Chicago,  Illinois 
60623. 


Survival  stretcher  system 

Baxter  Laboratories  of  Canada  has  add- 


ed a  survival  stretcher  system  to  its 
line  of  medical  electronics  and  emer- 
gency cardiopulmonary  resuscitation 
equipment. 

Designed  for  use  in  industrial  plants, 
large  office  buildings,  and  hospital 
emergency  rooms,  the  survival  stretch- 
er incorporates  equipment  that  allows 
medical  and  paramedical  personnel  to 
institute  immediate  basic  resuscitation 
techniques,  especially  where  shock  or 
cardiac  arrest  is  a  threat. 

The  system  is  completely  self-con- 
tained and  needs  no  external  power 
source  when  in  use.  It  incorporates  as 
standard  equipment  an  oxygen -p>ower- 
ed  heart-lung  resuscitator,  battery- 
powered  monopulse  defibrillator,  elec- 
trocardioscope,  pacemaker,  and  syn- 
chronizer. 

The  specialized  services,  previously 
available  only  in  hospital,  can  reach 
the  patient  as  fast  as  the  emergency 
team  with  the  stretcher  and  can  be  put 
into  operation  within  seconds.  It  can 
be  easily  loaded  into  the  ambulance. 
The  stretcher  and  its  built-in  compo- 
nents fold  for  compact  storage  when 
not  in  use. 

For  further  information,  write  to 
the  Director  of  Marketing,  Baxter 
Laboratories  of  Canada,  Division  of 
Travenol  Laboratories,  Inc.,  6405 
Northam  Drive,  Malton,  Ontario.       <^: 


Survival  Stretcher  System 


DECEMBER      1971 


January  n -12, 1972 

Two-day  course  in  Gerontological 
Nursing  Practice,  presented  by  Dr.  Vir- 
ginia Stone.  Professor  of  Nursing, 
Duke  University,  Durham,  N.C.,  Em- 
bassy Room,  Statler  Hilton  Hotel,  Buf- 
falo, NY.  Address  inquiries  to:  Con- 
tinuing Nursing  Education,  State  Uni- 
versity of  New  York  at  Buffalo,  Buffalo, 
New  York,  U.S.A. 

January  17-21,1972 

Conference  for  teachers  of  nursing: 
"The  Dynamics  of  Being  a  Faculty  Mem- 
ber." Sponsored  by  the  Registered 
Nurses'  Association  of  Ontario.  For 
further  information  contact:  Profession- 
al Development  Department,  RNAO,  33 
Price  Street,  Toronto,  Ontario. 

January  24-28  &  March  20-24, 1972 

Two-week  course  for  Occupational 
Health  Nurses,  co-sponsored  by  the 
Occupational  Safety  and  Health  Train- 
ing Branch,  U.S.  Dept.  of  Health,  Edu- 
cation &  Welfare.  Address  inquiries  to: 
Continuing  Nursing  Education,  State 
University  of  New  York  at  Buffalo,  Buf- 
falo, NY. 


January  31  -February  3, 1 972 

Association  of  Operating  Room  Nurses, 
19th  annual  congress,  Albert  Thomas 
Convention  Center,  Houston,  Texas.  For 
further  information  write:  Congress 
Dept.,  8085  E.  Prentice  Ave.,  Engle- 
wood,  Colo.  80110,  U.S,A. 

Febmary  14-18, 1972 

Five-day  course  for  registered  nurses 
with  five  years  or  less  experience  in 
occupational  health  nursing.  Focus  will 
be  on  the  role  and  responsibility  of  the 
nurse  as  a  member  of  the  occupational 
health  team.  For  information  write  to: 
Continuing  Education  Program  for 
Nurses,  University  of  Toronto,  47 
Queen's  Park  Crescent  East,  Toronto  5, 
Ontario. 


February  15-17, 1972 

Two-day  Institute  on  the  Dying  Patient, 
Statler  Hilton  Hotel,  Buffalo,  N.Y.  Ad- 
dress inquiries  to:  Continuing  Nursing 
Education,  State  University  of  New  York 
atBuffalo,  Buffalo,  N.Y. 

DECEMBER      1971 


Febmary  22-29, 1972 

Sixth  World  Civil  Defence  Conference, 
t^aison  des  Cong  res,  Geneva,  Switzer- 
land. General  Theme:  Disaster — Pre- 
planned Mutual  Aid.  For  information 
contact:  International  Civil  Defence 
Organisation,  P.O.  Box  124, 1211  Gene- 
va 6.  Switzerland. 


March  6-8, 1972 

Second  conference  on  the  use  of  audio- 
visual aids.  Sponsored  by  the  Register- 
ed Nurses'  Association  of  Ontario,  Ge- 
neva Park  Conference  Centre.  For  fur- 
her  information  contact:  RNAO,  33  Price 
Street,  Toronto,  Ontario. 

March  13-15,1972 

American  College  of  Surgeons  19th 
combined  sectional  meeting  in  Phila- 
delphia for  nurses  and  doctors.  For 
more  information  write  to  Mr.  T.E.  Mc- 
Ginnin,  American  College  of  Surgeons, 
55  East  Erie  Street,  Chicago,  Illinois. 

April  4-7, 1972 

Four-day  course  for  registered  nurses 
with  supervisory  responsibilities  for  a 
minimum  of  two  occupational  health 
nurses.  For  information  write  to:  Con- 
tinuing Education  Program  for  Nurses, 
University  of  Toronto,  47  Queen's  Park 
Cres.  E.,  Toronto  5,  Ontario. 

April  19-21, 1972 

Regional  Workshop  on  Nursing  Re- 
search &  Nursing  Practice  presented 
by  the  School  of  Nursing,  University  of 
Calgary.  For  further  information  write 
to  Dr.  Shirley  R.  Good,  Director  and 
Professor,  School  of  Nursing,  Univer- 
sity of  Calgary,  Calgary,  Alberta. 


May  15-17, 1972 

Operating  Room  Nurses  of  Greater  To- 
ronto, eighth  conference  Skyline  Hotel, 
Toronto,  Ontario.  For  information  write 
to:  Jean  Watson,  3  DuMaurier  Blvd., 
Apt.  11,  Toronto  319,  Ont. 

May  21-26, 1972 

Fourth  international  congress  of  social 
psychiatry  in  Jerusalem,  Israel.  Theme 
of  the  Congress  is  'Social  Change  and 
Social  Psychiatry."  For  more  informa- 
tion write  to  Ruth  Broza,  Organizing 


Committee,  Fourth  Congress  of  Social 
Psychiatry,  Ministry  of  Health,  King 
David  Street  20,  Jerusalem,  Israel. 


May  24-25, 1972 

Two-day  Institute  on  the  Role  of  the 
Nurse  in  the  Rehabilitation  Process, 
Mount  View  Hospital,  Lockport,  N.Y. 
Address  inquiries  to:  Continuing  Nurs- 
ing Education,  State  University  of  New 
York  at  Buffalo,  Buffalo,  N,Y. 


May  25-27, 1972 

The  75th  anniversary  of  the  Sherbrooke 
Hospital  School  of  Nursing  will  be  cele- 
brated by  a  reunion  for  all  former  grad- 
uates and  faculty  members,  For  more 
information  write  Mrs.  Ruth  Atto,  Sher- 
brooke Hospital,  375  Argyle  Street, 
Sherbrooke,  Quebec. 

Summer  1972 

Carleton  Memorial  Hospital  School  of 
Nursing,  Woodstock,  New  Brunswick, 
established  in  1903,  will  graduate  its 
last  class  in  1972.  A  school  reunion  is 
planned.  Interested  graduates  may 
write  to:  Miss  Marjorie  M.  McLean, 
Alumnae  Planning  Committee,  Carle- 
ton  Memorial  Hospital,  Woodstock,  N.B. 


June  1-3, 1972 

Three-day  symposium  for  the  profes- 
sional nurse  working  in  a  college  health 
service  setting,  co-sponsored  by  the 
New  York  State  College  Health  Associa- 
tion, Executive  Motor  Inn,  Buffalo,  NY. 
Address  inquiries  to:  Continuing  Nurs- 
ing Education,  State  University  of  New 
YorkatBuffalo,  Buffalo,  N.Y. 

June  7-9, 1972 

Canadian  Public  Health  Association, 
63rd  annual  meeting,  Centennial  Aud- 
itorium and  Bessborough  Hotel,  Saska- 
toon, Saskatchewan.  Theme:  Personal 
Responsibility  for  Health.  For  informa- 
tion write  to:  CPHA,  1255  Yonge  St., 
Toronto  7,  Ontario 

June  7-10, 1972 

Canadian  Psychiatric  Association  an- 
nual meeting,  held  jointly  with  the  Royal 
College  of  Psychiatrists  and  the  Quebec 
Psychiatric  Association,  Queen  Eliza- 
beth Hotel,  Montreal,  P.O.  V 

THE     CANADIAN     NURSE     19 


L«) 


no  OMR  BflG  PERFORm;  UK€  m 


My  safety  chamber 
really  slops  retro- 
grade infection. 
There's  simply  no  way 
for  the  bugs  to  back 
up  and  go  where  they 
don't  belong.  And  by 
tucking  the  BAC- 
STOP  chamber  in-' 
side  the  bag,  it  can't 
be  kinked  acciden- 
tally to  stop  the  flow. 


I'm  clear-faced  and 
easy  to  read.  My  white 
back  makes  my  mark- 
ings stand  out  unique- 
ly, whether  you  look 
at  my  backbone  scale, 
or  tilt  me  diagonally  \ 
to  read  small  amounts 
with  the  corner  cali- 
brations. 


Cystoflo' 

Urtaanr  Dra)iiat<     «<< 


My  hanger  is  the 
hanger  that  works 
well  all  the  time.  Hang 
it  on  a  bed  rail  or  a 
belt,  it  is  always  se- 
cure and  comfortable. 
I'm  always  on  the 
level  with  this  hanger, 
whether  my  patient  is 
lying,  sitting,  or  walk- 
ing around. 


I  have  the  only  shortie 
drainage  tube  around, 
and  it's  miles  better 
than  any  other 
you've  ever  used.  It's 
easier  to  handle,  and  it 
won't  drag  on  the  floor, 
even  with  the  new  low 
beds.  So  out  goes  one 
more  path  to  possible 
contamination. 


I'm  the  unique  new  CYSTOFLO'  drainage  bag,  a 
true-blue  friend  to  nurses,  physicians  and  patients. 
Why  don't  we  get  acquainted? 


BAXTER  LABORATORIES  OF  CANADA 

DIVISION  OP  TflAVE^OL  LABORATOfliES    iNC 

6405  Northam  Drive   Malton   Ontano 


The  old  rights  remain 

Administration  of  the  Quebec  Nurses'  Act  must  change  in  some  respects  to 
conform  to  the  province's  new  educational  pattern.  However,  the  professional 
association  will  continue  to  oversee  nursing  education  programs  and  to  monitor 
their  quality. 


Cecile  Labonte,  s.g.m. 

•  '■  What  ohji'ctivcs  does  the  Association  of  Nurses  of  the  Province  of  Quebec 
hope  to  achieve  under  the  CHGEP*  system?" 

•  "M.v  chief  authority  is  the  department  of  education.  Does  the  ANPQ  stand 
between  it  and  me?" 

•  "  Why  do  students  wlio  have  completed  CEGEP  programs  have  to  write  pro- 
vincial examinations?  Collei;e  examinations  and  a  diploma  should  be  enough!" 

•  "  IVill  the  Quebec  Nurses'  Act  he  abolished?" 

m"  If  the  government  takes  over,  what  will  happen  to  the  ANPQ?" 


These,  and  similar  questions,  are  aslced 
frequently  by  nurses  in  the  province 
of  Quebec.  Undoubtedly  they  reflect 
a  deep  concern  about  the  role  of  the 
ANPO  within  the  new  educational  pat- 
tern, and  a  feeling  of  uncertainty  about 
the  transfer  of  nursing  education  from 
the  department  of  health  to  the  depart- 
ment of  education. 

The  way  it  was 

In  the  past,  nurse  educators  in  Que- 
bec dealt  with  two  different  authorities 
in  the  performance  of  their  duties.  Qn 
the  one  hand  they  depended  on  hospi- 
tal administration  —  and  ultimately  the 
department  of  health  —  for  financial 
backing  (and  even  for  a  certain  degree 
of  organization  of  the  teaching  pro- 
gram); on  the  other  hand,  they  expected 
their  professional  association,  the 
ANPQ,  to  approve  schools  of  nursing, 
set  admission  standards  for  students, 
visit  schools,  and  establish  professional 
educational  standards. 

*C'EGtP  (C  olleges  dcnscigncmcnt  gene- 
ral et  professionnci)  arc  community  colle- 
gt-s  in  Quebec  that  arc  under  the  provin- 
cial department  of  education. 
DECEMBER      1971 


The  ANPQ  sponsored  study  sessions 
for  educators  and,  through  its  various 
committees,  carried  out  the  functions 
that  unquestionably  fostered  progress 
and  quality  of  nursing  education  in  the 
hospital  schools. 


Advent  of  change 

Recommendations  of  the  1964  Royal 
Commission  on  Education  report  (Pa- 
rent report),  which  examined  the  Que- 
bec educational  system,  resulted  in  far- 
reaching  changes  that  have  had  an  ef- 
fect on  the  preparation  of  the  bedside 
nurse.  The  opening  of  three  nursing 
schools  in  September  1967  marked  the 
beginning  of  the  transformation.  Three 
years  later,  hospital  schools  came  under 
the  authority  of  the  department  of  edu- 

Sistcr  l^abonte  is  a  graduate  of  the  School 
of  Nursing.  Hopital  Notrc-Dame.  Mont- 
real. She  obtained  her  baccalaureate 
degree  from  I'lnstitut  Marguerite  d'You- 
ville.  and  her  master's  degree  from  the 
Catholic  University  of  America.  Washing- 
ton. [3.C  .  She  is  presently  consultant  in 
nursing  education  at  the  Association  of 
Nurses  of  the  Province  of  Quebec. 


cation.  Now.  technical  nursing  options 
are  available  in  38  CEGEP  institu- 
tions. 12 

As  early  as  1962.  while  the  Parent 
study  was  still  in  progress,  the  ANPQ 
presented  a  brief  to  the  Commissioners 
in  which  it  questioned  the  place  of  nurs- 
ing education  within  the  general  educa- 
tional structure.  It  even  recommended 
the  establishment  of  two  financially 
independent  schools  to  be  controlled  by 
a  joint  committee  on  which  the  depart- 
ment of  public  instruction  (now  called 
the  department  of  education)  would 
have  representation!^  In  1965  a  second 
brief  was  submitted  to  the  department 
offcducation.  It  explicitly  recommended 
that  the  basic  nursing  course  be  at 
the  collegiate  level  and  three  years  in 
length." 

Under  the  present  system,  the  ANPQ 
works  closely  with  the  department 
of  education,  and  study  committees 
have  been  formed.  In  1966.  a  full-time 
nursing  consultant  to  the  department 
was  appointed.  The  steps  necessary 
for  the  transfer  of  hospital  schools  into 
general  and  professional  institutions  of 
learning  were  taken  in  a  spirit  of  under- 
standing and  cooperation  between  the 
groups  involved. 

Loss  of  rights  —  yes  or  no? 

Has  professional  nursing  in  Quebec 
lost  the  rights  granted  to  it  by  law  in 
1920  and  1947?  Has  there  been  a  fun- 
damental change  in  the  role  of  the 
ANPO  since  the  establishment  of  tech- 
nical nursingoptions  within  the  CEGEP 
system  in  the  province  of  Quebec? 

THE     CAN/^IAN     NURSE     21 


Any  reply  to  these  questions  must 
tiike  into  account  four  different  aspects: 
1 .  the  rights  and  privileges  granted  by 
law  to  the  ANPO;  2.  the  reciprocity 
clause  dealing  with  the  professional 
practice  of  immigrant  and  emigrant 
nurses;  3.  the  apolitical  nature  of  the 
body;  and  4.  the  Nurses'  Act  and  the 
act  encompassing  the  professions  pro- 
posed by  the  Castonguay-Nepveu 
report. 

Rights  and  privileges 

In  1920  the  Quebec  legislature  sanc- 
tioned the  formation  of  a  nurses'  asso- 
ciation. In  1946,  a  new  act  was  passed, 
granting  to  this  body  the  right  and  duty 
to  regulate  the  practice  of  the  profession 
and  the  education  of  its  members.^  ® 

Transfer  of  schools  of  nursing  from 
the  jurisdiction  of  the  department  of 
health  (now  called  the  department  of 
social  affairs)  to  that  of  the  department 
of  education  in  no  way  affected  the 
privileges  of  the  ANPQ.  The  Act  was 
not  abolished;  the  right  to  control  nurs- 
ing education  did  not  suddenly  come  to 
an  end.  Only  ihe  way  in  which  the  Act 
is  administered  has  changed.  The 
ANPO's  established  functions  of  con- 
sultation, counseling,  and  development 
of  educational  standards  in  keeping 
with  present  and  future  needs  of  society 
are  exercised  within  the  CEGEP  sys- 
tem. 

The  department  of  education  is,  of 
course,  the  ultimate  authority  for  the 
CEGEP  institutions.  Organization  and 
financing  of  the  colleges,  as  well  as 
preparation  of  the  course  outlines  for 
the  various  options,  come  under  its 
control.  However,  it  is  recognized  that 
the  head  of  a  faculty  and  the  teachers 
are  the  most  competent  persons  to 
administer  a  program  of  professional 
study.  Thus,  with  specific  reference 
to  the  technical  nursing  options,  nurses 

—  heads  of  departments  and  teachers 

—  have  the  responsibility  of  adminis- 
tering and  evaluating  their  own  pro- 
grams. These  nurses,  incidentally,  are 
all  members  of  the  ANPQ. 

Naturally,  the  Act  is  not  administer- 
ed by  individual  nurses;  however,  each 
nurse  does  have  the  right  to  elect 
members  from  her  district  who  will 
act  on  her  behalf.  Also,  any  nurse  may 
be  called  on  to  participate  in  programs, 
committee  work,  study  days,  research, 
and  any  other  activity  that  is  directed 
toward  nursing  education. 

The  committee  on  schools  of  nurs- 
ing, in  particular,  continues  to  carry 
out  evaluation  and  consultation  ser- 
22     THE     CANADIAN     NURSE 


vices  in  the  technical  nursing  options. 
Its  membership  is  comprised  of  nurses 
who  are  the  heads  of  technical  nursing 
options. 

Reciprocity 

A  recurring  question  from  all  sides 
is  why  a  student  must  pass  provincial 
examinations  in  order  to  practice  as 
a  professional  nurse.  Undoubtedly  the 
preceding  remarks  have  indicated  part 
of  the  answer.  Two  other  aspects  re- 
main. 

The  first  relates  to  the  question  of 
reciprocity.  What  does  the  term  mean'.' 
How  docs  the  nurse  qualify  for  the  pri- 
vilege? 

Reciprocity  is  the  end  result  of  an 
understanding  between  the  various 
provincial  associations,  the  Canadian 
Nurses'  Association,  and  the  Interna- 
tional Council  of  Nurses.  Under  the 
terms  of  this  agreement,  a  nurse  is  al- 
lowed to  practice  her  profession  in 
another  province,  state,  or  country, 
after  study  of  her  record  has  shown 
she  has  met  the  requirements  for  regis- 
tration in  the  area  concerned. 

Since  this  evaluation  of  her  record 
is  in  the  hands  of  professional  groups, 
it  is  obvious  that  the  nurse  who  has 
nothing  to  show  except  a  diploma  re- 
cognized by  a  provincial  department  of 
education  is  bound  to  encounter  diffi- 
culties outside  her  own  province  or 
country.  For  example,  France  and 
Belgium  recognize  a  state  diploma  for 
certain  nursing  categories.  These  nurses 
encounter  many  obstacles  when  they 
seek  the  right  to  practice  in  Canada. 
One  reason  is  that  their  state  diplomas 
lack  uniformity  from  one  area  to  an- 
other, even  within  their  own  countries. 

Reciprocity  is  established  by  the 
professional  association  of  the  province 
or  country  where  the  nurse  wishes 
to  practice,  after  evaluation  of  the 
following: 

a)  Conditions  for  admission  to  pro- 
fessional study —  in  particular, 
the  required  level  of  learning. 

b)  Content  of  the  nursing  courses 
followed,  the  applicant's  personal 
record,  and  the  established  stan- 
dards of  nursing  practice  in  the 
province  or  country  of  origin. 

c)  Applicant's  standing  as  a  profes- 
sional nurse  within  the  professional 
association  of  her  own  province  or 
country. 

d)  Recognition  of  her  professional 
association  by  the  ICN. 

e)  Continual  review  of  the  socioecon- 
omic conditions  of  the  particular 


country  (hospitals,  population, 
health  organizations,  and  so  on). 
When  the  applicant's  record  meets 
the  requirements  for  admission  to  the 
province  or  country  concerned,  permis- 
sion to  practice  is  granted.  The  nurse 
should  then  request  non-resident  mem- 
bership in  her  own  provincial  or  natio- 
nal association. 

There  is  another  point  to  be  consi- 
dered in  justifying  the  need  for  quali- 
fying examinations.  Testing  at  the  pro- 
vincial level  encourages  uniformity  in 
the  basic  nursing  programs  offered  by 
different  colleges.  Nevertheless,  each 
program  retains  certain  individual 
characteristics  appropriate  to  its  spe- 
cific milieu.  This  permits  the  nurse  to 
prepare  herself  to  meet  the  needs  of 
a  particular  environment  in  terms  of 
preventive,  curative,  and  rehabilitative 
care. 

Apolitical  nature  of  ANPQ 

The  ANPQ  is  conscious  of  its  res- 
ponsibility to  ensure  continued  progress 
in  nursing  science  and  in  nursing  care. 
Its  strictly  professional  nature,  oriented 
toward  improvement  of  present  and 
fijture  membership,  is  a  pledge  of 
security  for  the  public.  It  places  the 
association  above  the  political  intlu- 
cnces  common  to  all  governmental 
agencies. 

A  question  of  survival 

Since  the  appearance  of  that  part 
of  the  Castonguay-Nepveu  report 
which  deals  with  the  professions,  there 
have  been  innumerable  comments  about 
the  survival  of  professional  associa- 
tions. It  was  even  asserted  by  some 
nursing  groups  that  the  ANPQ  would 
shortly  disappear.  However,  the  report 
was  only  a  report  —  nothing  more. 

The  members  of  the  commission 
made  no  mention  of  the  abolition  of 
associations.  Rather,  they  discussed  the 
possibility  of  a  code  encompassing  cer- 
tain basic  clauses  that  would  be  appli- 
cable to  all  professions.  Concerning 
the  subject  of  professional  obligations, 
one  recommendation  suggests  that  the 
structure  of  the  regulating  and  super- 
visory body  of  a  profession  should  be 
such  that  it  is  enabled  to  protect  the 
public  effectively.  This  would  be  ac- 
complished through  regulation  of  the 
rights  and  duties  of  the  professional 
membership,  and  supervision  of  the 
quality  of  activity.' 

The  ANPQ  presented  its  comments 

on  each  of  the  recommendations  in  the 

Report.  8     In   addition,   the  executive 

committee  of  the  association  met  with 

DECEMBER      1971 


the  minister  of  social  affairs,  Claude 
Castonguay.  to  acquaint  him  with  the 
stand  taken  by  the  association  relative 
to  these  same  proposals.  The  committee 
was  assured  that  the  vested  rights  of 
the  association  would  not  be  withdrawn. 
There  is  no  question  of  the  abolition  of 
the  Act  or  acts  governing  public  bodies. 
The  intention  is  only  to  modify  certain 
clauses  to  ensure  greater  public  pro- 
tection. 

What  of  the  future? 

Everyone  is  conscious  of  the  speed 
with  which  traditional  patterns  of  nurs- 
ing education  have  given  way  to  the 
new.  As  a  result  we  lack  scientific  stu- 
dies to  help  us  evaluate  the  "final  pro- 


with  the  department  of  education;  a 
consultation  service  for  the  colleges; 
and  the  development  of  standards  to 
evaluate  nursing  programs.  The  ultimate 
goal  is  accreditation  of  programs  that 
meet  required  standards. 

Summary 

Within  a  period  of  four  years,  nurs- 
ing education  in  Quebec  has  rrioved 
from  hospital  to  CEGEP  schools.  It 
has  passed  from  the  jurisdiction  of  the 
department  of  health  to  that  of  the 
department  of  education.  However,  the 
role  of  the  ANPO  remains  the  same.  It 
is  recognized  that  certain  changes  in  the 
method  of  administration  of  the  Act  will 


4.  Assockillon  clc'\  injirniu'n's  dc  la  pro- 
vince (tc  Oiiehcc.  Projct  de  reformc  dc 
i"cnscigncmcnt  infirmicr  dans  la  pro- 
vince dc  Quebec;  memoirc  prescnte 
au  ministcrc  dc  {'Education.  Montreal. 
1965.  p.55. 

5.  Association  dcs  injirnii'crvs  ct  infir- 
niicrs  dc  la  province  dc  Quebec.  Me- 
moirc au  ministcrc  dcs  Affaires  sociales 
sur  Ic  volume  W  "La  .Sante"  de  la 
C  ommission  dcnquctc  sur  la  .Sanie  ct  Ic 
Bien-ctrc  social  du  gouvcrncmcnt  du 
Quebec.  Montreal.  1971.  p.  10-11. 

6.  Dcsjardins.  Edouard.  Heritage:  history 
of  the  nnrsinf>  profession  in  Quebec  .  .  . 
by  Suzanne  Giroux  and  Eileen  C  .  I  lan- 
agan.  Montreal.  Association  of  Nurses 


be  necessary  to  conform  to  rapid  chan-         of  the  Province  of  Quebec,  1970. 


duct"  that  emerges  from  the  present 
educational  programs.  Those  entrusted 
with  the  administration  of  the  new 
courses  of  study  have  done  their  best 
with  the  means  at  their  disposal.  Eva- 
luation of  the  present  program  and  fu- 
ture improvements  will  be  based  on  the 
performance  of  graduates  of  the  new 
schools  who  will  join  the  labor  market 
this  year. 

During  the  academic  year  1970-71, 
various  specialists  from  the  ANPQ 
provided  welcome  assistance  to  the 
CEGEP  teachers.  Visits  to  more  than 
one-half  of  the  colleges  that  offer  tech- 
nical nursing  options  disclosed  certain 
resources  and  certain  deficiencies.  Fu- 
ture plans  call  for  closer  cooperation 
DECEMBER     1971 


ges  occurring  within  the  general  educa- 
tional system.  Nevertheless,  in  the  final 
analysis  the  professional  body  has  the 
legal  responsibility  for  educating  its 
members  and  supervising  the  quality 
of  that  education. 

References 

1.  .Special ites  offertes  dans  les  CEGEP 
en  1971/72.  Ednc.  Quebec  1:16:16-17, 
mai  12,  1971. 

2.  Association  d' institutions  d'enseigne- 
nient  secondaire.  Annuairc  1970/71. 
Montreal,  1970. 

3.  Association  dcs  iiifirinieies  de  la  pro- 
viiue  de  Quebec.  Memoire  a  la  C  om- 
mission royale  d'Enquetc  sur  I'Ensci- 
gnemcnt.  Montreal.  1962.  p. v. 


7.  The  Professions  and  Society.  Report  ol 
the  Commission  of  Inquiry  on  Health 
and  Social  Welfare.  Vol.  7.  No.  1. 
part  5.  Quebec.  Government  of  Que- 
bec. 1970.  p.  77. 

8.  Association  des  infinnieres  et  infiriniers 
de  la  province  cle  Quebec.  (  ommcn- 
taircs  sur  chacunc  dcs  recommanda- 
tions  ""Rapport  C  astonguav ."  Montreal. 
1971.  * 


THE     CANADIAN     NURSE     23 


A  painter^  a  pilot  ^  I'ock  hound^ 

and  some  cooks: 

the  federal  nursing  consultants  revisited 


In  response  to  readers'  requests  to  update  the  October  1968  article,  "A  Foot  in 
the  Door,"  the  12  federal  nursing  consultants  were  visited.  From  the  interviews 
emerged  a  mosaic  of  personalities  with  individual  interests  and  separate 
contributions  to  the  goal  of  providing  health  care  to  Canadians  within  the 
framework  of  the  responsibilities  of  the  department  of  national  health  and 
welfare. 

Dorothy  S.  Starr 


Organizationally,  each  federal  nursing 
consultant  is  ultimately  responsible  to 
the  head  of  the  branch  in  which  she 
works.  The  senior  nurse  in  the  depart- 
ment of  national  health  and  welfare  is 
Vema  Huffman  Splane,  principal  nurs- 
ing officer;  she  reports  directly  to  the 
deputy  minister  of  health. 

Three  consultants  are  in  the  health 
services  branch:  Constance  Swinton 
(child  and  adult  health  services),  Eli- 
zabeth McCue  (mental  health),  and 
Lorraine  Davies  (emergency  health 
services). 

In  the  health  insurance  and  resources 
branch  are  Margaret  McLean  (senior 
consultant,  hospital  nursing),  Irene 
Buchan  (consultant,  hospital  nursing), 
Louise  Tod  (consultant,  hospital  nurs- 
ing), Pamela  Poole  (hospital  services 
study  unit),  and  Beverly  Du  Gas  (health 
resources). 

Advisers  in  the  medical  services 
branch  are  Alice  Smith  (nursing  ser- 
vices). Heather  McDonald  (nursing 
operations),  and  Catherine  Keith  (nurs- 
ing development.) 

Principal  nursing  officer 

Vema  Huffman  Splane  focuses  on 
nursing  in  general,  because  her  job  is 
"to  be  an  adviser  to  the  deputy  minister 
of  health  on  all  matters  related  to  nurs- 

Mrs.    Starr    is    an    assistant   editor   of   The 
Canadian  Nurse,  Ottawa.  Canada. 


24     THE     CANADIAN      NURSE 


ing."  Any  current  issue  involving  nurs- 
ing or  those  with  implications  for  long- 
range  health  care  planning  are  referred 
to  the  principal  nursing  officer  for 
comment  and  a  recommended  course 
of  action. 

Mrs.  Splane  provides  nursing  with 
a  voice  at  the  policy-making  level  of 
the  department  of  national  health. 
"It  is  important  that  1  keep  abreast  of 
nursing  trends  and  developments,  both 
nationally  and  internationally;  the 
department  of  health  must  have  access 
to  as  many  points  of  view  as  possible 
in  planning  health  care  programs," 
said  Mrs.  Splane. 

The  principal  nursing  officer  main- 
tains strong  channels  of  communica- 
tion with  nursing  and  the  related  health 
fields  in  Canada  and  abroad. 

This  is  accomplished  nationally 
through  regular  contact  with  the  Cana- 
dian Nurses'  Association  and  through 
participation  on  advisory  committees 
for  national  organizations  and  govern- 
ment departments.  A  current  involve- 
ment of  particular  interest  to  nurses 
is  Mrs.  Splane's  membership  on  a  spe- 
cial interdepartmental  committee  set 
up  by  the  Privy  Council  office  to  study 
the  Report  of  the  Royal  Commission  on 
the  Status  of  Women. 

Internationally,  Mrs.  Splane  main- 
tains an  active  working  relationship 
with  the  World  Health  Organization 
as  well  as  with  the  Canadian  Interna- 
DECEMBER      1971 


tional  Development  Agency. 

In  August  of  this  year  she  represent- 
ed Canada  on  the  First  Advisory  Com- 
mittee on  Health  and  Social  Welfare 
convened  by  the  Pan  American  Health 
Organization  in  Washington,  D.C. 
More  recently,  she  has  been  appointed 
to  the  International  Social  Service  Com- 
mittee, which  concerns  itself  with  family 
problems  that  transcend  national 
boundaries. 

On  October  1,  1971,  Jane  Murphy, 
who  is  not  a  nurse,  was  appointed  ad- 
ministrative assistant  to  Mrs.  Splane. 
Mrs.  Murphy  is  responsible  for  the 
nontechnical  operations  of  Mrs.  Spla- 
ne's  office  and  will  act  in  her  absence. 

A  current  aspect  of  Mrs.  Splane"s 
work  is  consideration  of  the  structure 
of  nursing  within  the  DNHW  in  terms 
of  leadership  that  nursing  consul- 
tants give  to  the  country.  "We  hope 
for  an  exchange  system  to  bring  nurses 
from  universities,  agencies,  and  organi- 
zations into  the  government  to  do  short- 
term  assignments  and,  conversely,  to 
permit  government  nurses  to  contribute 
increasingly  in  these  areas.  This  ex- 
change will  help  us  develop  and  main- 
tain the  horizontal  point  of  view  so 
essential  to  the  creation  of  balanced 
programs." 

When  asked  about  her  personal  life, 
Mrs.  Splane  referred  to  her  husband 
of  less  than  a  year,  and  said  they  share 
many  interests  both  in  their  private 
and  professional  lives.  Their  work  is 
closely  interrelated  since  Dr.  Splane  is 
engaged  in  social  welfare  administra- 
tion in  the  federal  government. 

She  recalled  with  amusement  that 
one  week  before  she  and  Dr.  Splane 
were  married  a  provincial  minister  of 
health  gave  the  groom  a  copy  of  Future 
Stiock . 

The  Splanes  like  to  swim,  ski  cross- 
country, attend  concerts  and  the  theater, 
and  entertain.  She  likes  to  cook,  and 
coq  au  vin  is  one  of  her  specialties. 

Mrs.  Splane's  hometown  is  Peter- 
borough, Ontario. 

Child  and  adult  health 

Constance  Swinton  began  her  work 
as  public  health  nursing  consultant  to 
the  director  of  child  and  adult  health 
DECEMBER      1971 


services  on  April  1,  1971.  Her  position 
is  a  new  one;  the  divisions  relating  to 
family  and  community  health  have  been 
grouped  together. 

Miss  Swinton,  a  generalist  in  public 
health  nursing,  is  responsible  for  iden- 
tifying the  nursing  component  and  as- 
sisting with  the  development  of  com- 
tpunity  nursing  programs  within  the 
directorate  of  child  and  adult  health 
services. 

As  the  directorate  is  still  in  the 
early  stages  of  development,  the  thrust 
of  Miss  Swinton's  program  is  along  the 
lines  of  priorities  already  established. 
Family  planning  gets  top  priority. 
(News.  April  1971,  p. 17) 

Twelve  one-day  workshops  on  the 
role  of  health  professionals  in  family 
planning  were  part  of  Miss  Swinton's 
fall  schedule;  the  workshops  were  held 
in  Nova  Scotia,  New  Brunswick,  Prince 
Edward  Island,  and  Newfoundland. 

"Nurses  are  concerned  with  the  use 
of  public  health  services,  and  with  the 
fact  that,  in  some  areas,  family  planning 
services  are  underused  and  families  do 
not  derive  full  benefit  from  the  services 
provided,"  Miss  Swinton  said.  Special 
studies  of  utilization  are  necessary  in 
certain  segments  of  the  community  and 
in  certain  geographical  areas.  It  is  also 
recognized  that  the  nature  of  the  pro- 
gram is  such  that  care  must  be  taken 
not  to  offend  personal  beliefs. 

"Nurses  on  the  federal  consultative 
staff  must  be  innovative  so  they  do  not 
repeat  what  public  health  nurses  with 
clinical  specialties  are  doing  within  the 
provincial  departments  of  health.  I 
work  with  the  provincial  services  to 
bring  to  them  the  needs  of  the  rest  of 
Canada,  and  to  facilitate  sharing  infor- 
mation on  programs  and  trends,  help- 
ing them  to  keep  a  broad  perspective." 

Miss  Swinton  explained  that  the 
federal  government  nursing  consultants 
depend  on  input  from  field  trips  to  the 
provinces.  Her  visits  are  made  in 
cooperation  with  provincial  depart- 
ments of  health,  giving  her  an  oppor- 
tunity to  talk  with  nurses  and  visit 
programs  in  university  schools  of  nurs- 
ing and  official  and  voluntary  commun- 
ity health  agencies. 

In  looking  to  the  future,  Miss  Swin- 


ton sees  an  expanded  role  for  the  com- 
munity health  nurse".  This  work  will 
likely  include  such  independent  func- 
tions as  physical  appraisal  and  assess- 
ment, postoperative  care  procedures  in 
home  care,  and  additional  responsibility 
for  obstetrical  care  possibly  leading  to 
midwifery  in  rural  and  sparsely  settled 
areas. 

She  also  foresees  a  change  in  the 
normal  working  hours  of  generalized 
community  nursing  service  from  day- 
time to  24-hour  service  to  provide  home 
nursing  care  for  acutely  ill  people,  and 
the  establishment  of  evening  or  shift 
programs  to  accommodate  working  par- 
ents in  community  clinics,  as  well  as 
clients  in  street  clinics,  drop-in  centers, 
and  youth  hostels. 

In  her  free  time  Miss  Swinton  likes 
to  golf  and  play  tennis  in  the  summer, 
curl  and  snowshoe  in  the  winter.  "There 
are  beautiful  trails  to  walk  on  snow- 
shoes  in  the  Ottawa  area;  the  Ottawa 
winter  is  ideal."  She  also  enjoys  garden- 
ing and  a  game  of  bridge. 

Her  family  home  was  in  Edmonton, 
Alberta,  but  she  considers  Ottawa  her 
home  now. 

Miss  Swinton  is  a  member  of  the 
board  of  directors  of  the  Canadian 
Nurses'  Foundation,  and  a  member  of 
the  Canadian  Public  Health  Associa- 
tion; she  serves  on  the  nominating  com- 
mittee of  the  American  PHA. 

Mental  health 

Elizabeth  McCue  is  consultant  to 
nurses  within  the  mental  health  service 
of  each  province.  Only  British  Colum- 
bia, Nova  Scotia,  and  Saskatchewan 
have  provincial  nursing  consultants  in 
mental  health;  in  the  other  provinces, 
mental  health  is  part  of  the  work  of 
generalized  nursing  consultants. 

Mrs.  McCue  aims  to  get  an  overall 
picture  of  mental  health  programs  in 
her  visits  to  provincial  departments 
of  health,  hospitals,  and  schools  of 
nursing. 

One  of  her  recent  achievements  is 
a  position  paper  on  the  need  for  prepa- 
ration in  psychiatric  nursing  (News. 
October  1971,  p.20).  Mrs.  McCue 
feels  that  integration  of  mental  health 
concepts  into  community  health  care 
THE     CANADIAN     NURSE     25 


is  coming.  "Finally,  the  lip  service 
begins  to  have  meaning." 

Looking  to  the  future,  she  sees  an 
increasing  awareness  of  dependence 
and  sharing  with  other  members  of 
the  health  team.  She  is  pleased  to  see 
the  decentralization  of  facilities  for  the 
mentally  retarded,  and  welcomes  the 
National  Institute  for  Mental  Retarda- 
tion, a  research  facility  on  the  grounds 
of  York  University  near  Toronto. 

Mrs.  McCue  enjoys  doing  needle- 
point in  her  free  time,  and  keeps  three 
different  pieces  going.  She  likes  to  cook 
and  entertain. 

Ottawa  is  home  to  Mrs.  McCue. 
This  year  she  had  a  holiday  abroad  for 
the  first  time,  visiting  the  five  Low 
Countries,  England,  and  Scotland. 
She  had  "a  glorious  time." 

The  National  Arts  Centre,  with  its 
ballet  and  orchestral  music,  is  a  source 
of  pleasure  to  Mrs.  McCue,  and  she 
listens  to  her  hi-fi  at  home. 

Emergency  health  services 

Lorraine  Davies  began  her  work  as 
nursing  adviser,  emergency  health  ser- 
vices, on  December  1,  1970.  She  works 
half-time. 

"In  an  area  that  has  experienced 
a  disaster  situation,  our  program  goes 
ahead  more  quickly.  Nurses  realize 
that  disasters  happen  in  other  countries, 
but  don't  equate  the  need  for  the  pro- 
gram with  Canada,"  said  Mrs.  Davies. 

The  major  thrust  of  her  work  is 
revision  of  the  course  in  disaster  nurs- 
ing for  nurse  educators  from  bacca- 
laureate and  diploma  nursing  schools. 
The  revised  course,  which  began  No- 
vember 1 97 1 ,  emphasizes  preparation 
for  work  in  peacetime  disasters  such  as 
earthquake,  hurricane,  tornado,  or 
explosiorf. 

Recently  Mrs.  Davies  updated  a 
bibliography  on  disaster  health  care, 
and  helped  other  members  of  the  ser- 
vice make  a  film  on  roadside  first-aid 
for  car  accidents.  She  also  acted  in  the 
film:  "I'm  the  one  who  goes  to  phone 
for  help  —  1  may  end  up  on  the  cut- 
ting-room floor,  "  she  said.  The  film 
is  intended  to  motivate  people  to  take 
an  up-to-date  first-aid  course. 

26     THE     CANADIAN      NURSE 


Mrs.  Davies  is  also  reassessing  the 
use  made  of  disaster  nursing  in  nursing 
school  programs,  in  the  light  of  changes 
in  nursing  education.  She  became  in- 
terested in  disaster  nursing  through 
serving  as  a  member  of  the  Nova  Scotia 
militia  while  she  was  working  in  operat- 
ing room  and  emergency  department 
nursing.  Prior  to  coming  to  Ottawa  at 
the  time  of  her  marriage  to  Dr.  John 
Davies,  chief  of  the  federal  government 
division  of  epidemiology,  she  was  nurs- 
ing consultant  for  the  Nova  Scotia 
emergency  health  services. 

As  federal  nursing  consultant,  she 
works  with  the  nursing  consultants  on 
emergency  health  services  in  the  three 
provinces  that  have  such  positions,  and 
with  generalized  nursing  consultants 
in  the  other  provinces.  She  provides 
liaison  with  voluntary  agencies  such  as 
St.  John  Ambulance  and  the  Red  Cross. 

She  still  considers  Sydney,  Nova 
Scotia,  her  home  town.  One  of  the 
things  she  enjoys  is  sewing  her  own 
clothes.  "Right  now  I'm  making  a  suit 
of  Welsh  wool  from  Swansea,  my  hus- 
band's home  town,"  she  said. 

She  likes  to  golf  and  swim,  and  to 
cook  "when  I  have  lots  of  time."  She 
also  enjoys  preserving  fruit  and  making 
jam.  She  and  her  husband  like  winter 
holidays;  they  went  to  Spain  and  Por- 
tugal last  year  and  plan  to  visit  Mexico 
this  winter. 

Health  insurance,  diagnostic  services 

Margaret  McLean  is  senior  nursing 
consultant  of  the  health  insurance  and 
diagnostic  serv  ices  d  ivision  of  the  health 
insurance  and  resources  branch. 

Miss  McLean  has  been  active  in 
CNA  in  many  capacities  and  is  chair- 
man of  the  ad  hoc  committee  on  stand- 
ards for  nursing  care.  She  sees  a  connec- 
tion between  her  work  with  the  DNHW 
and  the  objectives  of  the  committee. 
"In  studying  management  services  of 
the  nursing  department  of  a  hospital, 
we  look  at  what  the  consumer  receives. 
Anything  the  committee  produces  will 
be  useful  to  us  in  this  work  since,  at 
the  moment,  there  are  no  objective 
standards  accepted  by  all." 

The   major   thrust  of  her  work   at 


present,  according  to  Miss  McLean,  is 
toward  helping  those  responsible  for 
supervision  and  direction  to  become 
nursing  care  oriented.  She  believes 
that  thedirector  of  nursing  is  not  neces- 
sarily an  expert  in  clinical  nursing  but 
must  be  nursing  care  oriented. 

What  is  meant  by  nursing  care  orien- 
tation? "There  are  many  techniques  of 
management  that  we  can  use  and  adapt 
to  better  nursing  service.  If  we  are  not 
thinking  of  what  happens  to  the  con- 
sumer, we  may  have  an  efficient  organi- 
zation, running  at  reasonable  cost,  but 
there  may  be  ways  in  which  the  care 
needs  to  be  improved.  Our  emphasis 
needs  to  be  away  from  routinization 
and  toward  individual,  planned  care  to 
the  patient." 

Changes  in  Miss  McLean's  work 
since  1968  include  membership  in  a 
multidiscipline  group  within  the  direct- 
orate that  is  working  to  implement  the 
recommendations  of  the  task  force  on 
costs  of  health  care;  working  with  the 
director  of  planning  and  development 
in  the  provincial  departments  of  health; 
and  becoming  more  involved  in  continu- 
ing education  both  at  the  university  and 
the  nursing  association  level. 

The  near  future  will  see  continuation 
of  present  activities.  Miss  McLean 
feels,  but  also  changes  in  the  direction 
of  assistance  in  the  development  of  out- 
patient services  in  active  treatment 
hospitals,  such  as  day  care  for  medical 
and  surgical  patients,  and  satellite 
health  centers. 

"1  am  interested  in  keeping  people 
out  of  hospital  beds,  so  I  see  the  need 
to  be  more  creative  in  our  use  of  out- 
patient services." 

Outside  of  work,  Miss  McLean  en- 
joys oil  painting,  especially  landscapes. 
She  hopes  to  take  a  holiday  to  paint 
along  the  Newfoundland  coast.  She  likes 
to  cook. 

As  Miss  McLean  has  not  had  a  ciga- 
rette since  July  5,  1971,  she  is  "knit- 
ting and  crocheting  like  mad.  It  didn't 
bother  me  as  much  as  I  thought.  I  dis- 
covered that  I  used  a  cigarette  as  a  time 
spacer  and  now  1  have  to  find  something 
else." 

Bom  in  southwestern  Ontario,  Otta- 

DECEMBER      1971 


Verna  Huffman  Splane 
Principal  Nursing  Officer 


Constance  Swinton 


^  i 


Elizabeth  McCue 


Lorraine  Davies 


Margaret  McLean 


Irene  Buchan 


Louise  Tod 


Pamela  Poole 


Alice  Smith 


Heather  McDonald 


*»         / 


Catherine  Keith 


wa  is  now  Miss  McLean's  home. 

Irene  Buchan  joined  the  DNHW 
five  years  ago  and  finds  her  woric  as  a 
consultant  on  hospital  nursing  "a  tre- 
mendous challenge."  She  feels  her 
work  is  fundamentally  unchanged  in 
the  past  few  years;  she  still  works  with 
a  multidiscipline  team  in  doing  hos- 
pital surveys,  but  she  points  out  that  as 
evaluation  tools  such  as  the  assessment 
of  levels  of  care  are  developed,  she 
uses  them  in  her  work. 

Miss  Buchan  disseminates  informa- 
tion to  her  provincial  nursing  counter- 
parts and  to  hospital  nurses  through 
workshops,  seminars,  and  demonstra- 
tions. The  federal  nursing  consultants 
provide  assistance  with  nursing  service 
and  care  to  individual  hospitals  as  re- 
quested by  the  provincial  authority  and 
the  hospital  administration. 

Most  of  her  work  is  in  hospitals  of 
less  than  500  beds.  Miss  Buchan  said, 
and  her  hope  is  to  help  nursing  staff 
find  ways  to  increase  efficiency  within 
the  nursing  department  so  there  is  more 
time  to  give  to  patient  service.  "I'm 
sold  on  the  team  approach,"  she  said. 
"Nursing  can  go  only  so  far  alone  be- 
cause we  are  so  integrated  with  other 
departments,  such  as  supply  systems." 

In  the  future  she  sees  more  nurse 
involvement  in  evaluation  of  quality 
of  nursing  care,  and  in  pressing  for 
standards  of  nursing  care. 

Miss  Buchan  gives  much  time  to  the 
work  of  the  national  nurses'  associa- 
tion as  chairman  of  the  CNA  committee 
on  nursing  service  and  a  member  of  the 
executive.  She  is  also  a  member  of  the 
CNA  ad  hoc  committee  on  standards 
for  nursing  care,  and  a  member  of  the 
board  of  the  Canadian  Nurses'  Foun- 
dation for  1971-73. 

She  believes  her  federal  position  and 
her  work  for  CNA  are  closely  related, 
as  she  develops  a  national  outlook  on 
nursing  in  her  job,  and  the  CNA  com- 
mittees recommend  national  policy  and 
identify  national  problems. 

Miss  Buchan  considers  Calgary  to 
be  her  home.  Photography  had  been 
one  of  her  major  interests  for  some 
time;  most  of  her  colored  slides  are 
28     THE     CANADIAN     NURSE 


taken  when  she  is  on  holiday.  When 
she  visits  a  place  like  the  Canary 
Islands,  she  tries  to  make  a  complete 
photographic  description  of  the  flora, 
fauna,  people,  and  scenery. 

She  also  likes  growing  things:  a  two- 
foot  tall  grapefruit  tree,  three  Japanese 
orange  trees,  and  a  peach  tree  are  po- 
tential ceiling-lifters  in  her  garden 
home.  Collecting  stamps  and  coins, 
doing  petit  point,  and  snowshoeing  in 
winter  are  other  activities  she  enjoys. 

Louise  Tod,  a  former  chairman  of 
the  CNA  committee  on  social  and 
economic  welfare  (1968-70),  became 
a  nursing  consultant  in  the  health 
insurance  and  diagnostic  services  divi- 
sion on  July  12,  1971. 

Her  previous  experience  on  the  col- 
lective bargaining  staff  of  the  Alberta 
Association  of  Registered  Nurses  gives 
her  an  insight  into  the.  problems  of 
providing  nursing  care  within  a  nursing 
service  department. 

"Often  nurses  first  sought  assistance 
from  their  professional  association 
because  of  their  concern  about  the 
quality  of  care  provided  to  patients," 
she  said.  Nurses  were  also  upset  by 
inadequate  staffing,  excessive  overtime, 
poor  use  of  nursing  personnel,  and  lack 
of  opportunity  to  grow  and  develop 
professionally  within  the  service  or- 
ganization. 

Miss  Tod  considers  Edmonton  her 
home.  She  likes  to  curl,  and  developed 
an  interest  in  hiking  while  attenting 
graduate  school  at  the  University  of 
Colorado.  Around  Denver  there  are  or- 
ganized hikes  in  the  mountains,  design- 
ed to  meet  the  requirements  of  hikers 
in  various  states  of  physical  fitness,  she 
said. 

Last  summer  Miss  Tod  went  for  a 
nine-day  raft  trip  down  the  Colorado 
River,  "rushing  the  wild  river"  through 
the  Grand  Canyon  on  rubber  pontoon 
rafts  by  day  and  camping  along  the 
river  at  night.  She  called  the  28  other 
rafters  "the  most  congenial  group  I  have 
ever  met." 

Trail  hikes  through  the  Canadian 
Rockies  are  on  her  list  for  a  vacation 
"one  of  these  years,"  she  says. 


•  Miss  Tod  enjoys  snowshoeing,  and 
going  to  concerts  and  the  theater.  Since 
her  arrival  in  Ottawa  she  is  learning  to 
play  bridge. 

Hospital  services  study 

Pamela  Poole  joined  the  DNHW  in 
June,  1965.  In  her  role  as  "encourager 
of  research,"  she  talked  about  areas  of 
nursing  research  developed  in  the  last 
three  years.  There  have  been  three 
studies  on  patient  classification  accord- 
ing to  nursing  care  needs,  in  which  she 
has  had  varying  degrees  of  involvement. 

Just  finished  is  a  study  comparing 
parents  from  two  maternity  services 
—  one  traditional,  the  other,  a  family- 
centered  service. 

The  most  recent  thrust  is  research 
into  the  expanded  role  of  the  nurse. 
Two  such  studies  are  being  completed: 
one  concerns  the  functions  of  a  bac- 
calaureate degree  nurse  seconded  to  a 
pediatrician  working  in  a  family  prac- 
tice unit,  and  the  other  is  on  the  work 
of  a  basic  baccalaureate  graduate  as  a 
nurse  practitioner  in  a  family  practice 
unit.  There  are  several  projects  going 
on  and  in  the  planning  stage  at  various 
centers. 

Miss  Poole  said  her  three  functions 
are  to  encourage  applied  research  in 
hospitals  and  related  health  services, 
to  assist  people  to  conduct  research, 
and  to  do  research.  About  her  advisory 
role  to  a  group  planning  research,  she 
said,  "All  1  do  is  some  seeding  and 
some  weeding." 

When  a  group  of  nurses  has  defined 
a  problem,  they  may  consuUMiss  Poole 
on  the  feasibility  of  doing  research  to 
answer  the  problem.  The  group  decides 
whether  or  not  to  do  the  research,  finds 
a  researcher,  and  may  use  Miss  Poole 
for  further  consultation  on  methodology 
during  the  study.  Miss  Poole's  services, 
and  that  of  all  other  federal  nursing 
consultants,  are  given  without  charge. 

Elected  on  a  national  ballot  to  the 
board  of  directors  of  the  professional 
institute  of  the  public  service  alliance. 
Miss  Poole  said  she  is  "let  off  being 
a  committee  chairman  because  of  my 
constant  travel";  but  she  is  a  member 
of  the  committee  on  institute  organiza- 

DECEMBER      1971 


tion  and  last  year  was  a  member  of 
the  finance  committee. 

"The  closest  I  have  to  a  home  is  a 
cottage  in  Arundel,  Quebec."  One 
advantage  of  her  frequent  travel  is  that 
she  has  been  able  to  visit  friends  from 
coast  to  coast.  "Tm  not  a  stranger  in 
most  of  the  major  cities  of  Canada." 

Miss  Poole  likes  to  read  and  to  listen 
to  folk  music.  Her  favorite  singers  are 
Pete  Seeger,  Gordon  Lightfoot,  the 
Irish  Rovers,  Harry  Belafonte,  Johnny 
Mathis  and  Mireille  Mathieu.  "T'd  go 
anywhere  to  see  a  Katherine  Hepburn 
movie,"  she  added. 

Miss  Poole  likes  to  garden  and  has 
found  some  recipes  for  protecting  her 
tlowers  from  the  wildlife  around  her 
cottage.  "Porcupines  don't  like  mari- 
golds, so  1  plant  marigolds  around  the 
roses.  To  keep  the  groundhogs  out  of 
the  phlox,  I  put  mothballs  in  the  flower 
beds."  She  has  a  passion  for  fishing. 

Health  resources 

Beverly  M.  Du  Gas  began  her  work 
with  theDNHW  in  August.  1969. 

She  is  one  of  four  members  of  a 
group  that  includes  an  economist,  a 
statistician,  and  a  medical  doctor,  who 
are  concerned  with  setting  up  the  me- 
chanics to  gather  information  on  pre- 
sent health  workers  in  Canada.  One 
problem  for  the  group  is  getting  com- 
patible data  from  provinces  and  profes- 
sional associations.  "We  are  further 
ahead  in  nursing  because  there  is  an 
agreement  among  the  provincial  nursing 
associations  to  use  a  standard  registra- 
tion form.  Nursing  is  the  only  health 
profession  that  has  such  a  form,  so  the 
nursing  form  is  being  used  as  a  model." 

A  20-year,  longitudinal  study  of  all 
nurses  who  graduated  in  1970,  divided 
into  diploma  and  baccalaureate  gradu- 
ates, is  in  process. 

Dr  Du  Gas  said  one  of  her  functions 
is  to  coordinate  efforts  of  provincial 
governments  in  their  planning  for  health 
manpower.  She  stressed  that  health 
manpower  planning  must  be  integrated; 
it  is  not  possible  to  consider  nurses, 
doctors,  pharmacists,  or  nursing  assis- 
tants in  isolation. 

Dr.  Du  Gas  is  also  interested  in 
DECEMBER      1971 


studying  the  effective  use  of  health  man- 
power. "In  the  future,  the  whole  matter 
of  manpower  planning  will  be  more 
important;  it  will  come  into  its  own 
as  a  science.  It  will  never  be  an  exact 
science  since  needs  change;  at  present 
we  have  an  increase  in  population  at 
both  ends  of  the  age  spectrum;  in  the 
future  there  will  be  a  shift  to  the  older 
age  group.  Technology  also  produces 
shifts  in  the  numbers  and  types  of  peo- 
ple needed  for  health  care,  with  result- 
ing changes  in  educational  programs." 

A  question  about  her  hobbies  elicit- 
ed the  information  that  her  free  time  for 
the  past  year  has  been  spent  revising  her 
nursing  textbook.  (News,  November 
1971,  pages.) 

Dr.  Du  Gas  thinks  of  Vancouver  as 
her  home  town;  she  has  four  children, 
aged  19  to  25,  all  living  in  Vancouver 
at  present.  "Suddenly  they've  all  grown 
up  and  left  home,"  she  said. 

Medical  services 

Alice  Smith  joined  the  DNHW  on 
May  16,  1950.  The  date  is  fixed  in 
her  mind  because  on  her  first  day  as 
regional  nursing  supervisor  of  the 
central  region  (comprising  Manitoba 
and  northwest  Ontario  at  that  time), 
she  drove  her  car  full  of  Eskimo  pa- 
tients from  Winnipeg  to  Sioux  Lookout 
to  escape  the  Winnipeg  flood. 

Her  present  position  was  created  in 
1952,  and  she  was  the  first  incumbent. 

There  is  progress  toward  the  goal, 
stated  in  The  Canadian  Nurse  article 
in  October  1968,  of  having  provincial 
and  local  health  services  provide  health 
care  to  Indians  and  Eskimos  as  they 
do  for  other  citizens.  "We  will  continue 
to  act  as  the  health  department  for  the 
Yukon  and  Northwest  Territories  until 
they  are  able  to  provide  for  their  own 
services  and  gain  provincial  status." 

Looking  ahead  to  1975,  Miss  Smith 
believes  there  will  be  greater  participa- 
tion by  provincial  and  local  authorities 
in  the  health  care  of  native  peoples. 

Recent  changes  in  the  medical  ser- 
vices branch  provide  for  decentralized 
administration  of  all  activities  within 
each  region;  activities  include  quaran- 
tine, immigration  health,  occupational 


health  for  public  servants,  and  Indian 
health  and  northern  health.  The  region- 
al nursing  supervisor  is  responsible  to 
the  regional  director,  medical. 

Changes  in  health  care  provided  to 
public  servants  in  the  near  future  will 
include  more  extensive  physical  exami- 
nation for  certain  groups  of  healthy 
people,  with  an  expanded  responsibility 
for  the  nurse.  Workshops  and  seminars 
are  planned  to  prepare  public  health 
nurses  working  in  the  federal  occupa- 
tional health  service  for  this  expanded 
role. 

Nurses  in  the  occupational  health 
service  are  also  being  informed  about 
family  planning  so  they  can  make  avail- 
able to  public  servants  information  as 
requested,  and  make  appropriate  re- 
ferrals. "Up  to  now  drugs  have  not 
been  as  great  a  problem  as  alcoholism; 
we  have  a  drug  problem,  however,  and 
more  information  on  drugs  will  be 
included  in  the  inservice  programs." 

She  thinks  of  Vancouver  as  her 
home,  although  she  said  she.  enjoys 
living  in  Ottawa.  Miss  Smith  grows 
tuberous  begonias  and  red  geraniums. 
"In  the  summer  my  apartment  balcony 
is  so  full  of  flowers  there  is  little  room 
for  a  chair." 

She  "has  to  steal  time  to  read,"  but 
likes  books  ranging  from  The  Games 
People  Play  to  modern  verse.  She  is 
an  enthusiastic  concert-goer  and  espe- 
cially enjoys  violin  and  vocal  music. 

Nursing  operations 

Heather  McDonald  joined  the 
DNHW  in  1955  as  nursing  officer  of 
the  eastern  region,  which  included  On- 
tario to  the  eastern  seaboard  and  up  to 
the  Arctic.  In  September  1968,  she 
became  adviser  on  nursing  operations, 
medical  services  branch. 

Miss  McDonald  gives  advice  and 
information  on  the  scope  of  nursing 
service,  according  to  the  policies  and 
statutes  of  the  medical  services  branch, 
and  on  the  preparation  required  for 
nurses  to  perform. 

One  way  she  does  this  is  by  auditing 

nursing  performance.  This  occupied  a 

great  deal  of  her  time  in  1970.  Nurses 

employed    by    the    medical    services 

THE     CANADIAN     NURSE     29 


branch  wrote  descriptions  of  their  jobs; 
Miss  McDonald  amalgamated  the  900 
or  so  resulting  descriptions  into  groups 
of  similar  kind  and,  from  these,  des- 
cribed models  of  the  nurse  positions 
in  medical  services. 

Miss  McDonald  serves  as  a  repre- 
sentative of  management  in  collective 
bargaining  with  nurses  in  the  profes- 
sional institute.  "We  have  a  service 
to  provide  so  we  must  ensure  good 
personnel  policies  and  collective  agree- 
ments to  permit  recruitment  and  selec- 
tion of  the  nurses  best  prepared  to  give 
quality  care  in  our  many  areas,"  she 
said. 

The  900  nurses  employed  by  medi- 
cal services  branch  are  scattered  across 
Canada;  the  largest  number,  about  200, 
work  in  the  Charles  Camsell  Hospital 
in  Edmonton.  About  165  positions  are 
in  isolated  and  truly  remote  nursing 
stations;  in  these  stations  nurses  live 
in  small  communities  and  are  subject 
to  call  at  all  times. 

This  year,  specially-adapted  TV 
sets  were  installed  in  the  isolated  nurs- 
ing stations.  Audiovideo  tapes  of  cur- 
rent entertainment  and  inservice  educa- 
tion topics  are  circulated,  each  set  of 
five  tapes  staying  one  week  in  a  sta- 
tion. Sometimes,  depending  on  the 
weather,  regular  TV  programs  can  be 
received,  relayed  by  satellite. 

In  the  future.  Miss  McDonald  sees 
continuation  of  a  present  trend;  "The 
Indians  are  beginning  to  express  their 
feelings  and  needs  for  health  care,  as 
well  as  in  other  aspects  of  life.  We  wel- 
come the  challenge  to  work  with  them 
in  meeting  their  health  needs.  Mixing 
with  people  from  southern  Canada  is 
bringing  health  problems  associated 
with  stress  and  strain  to  the  native 
people  of  the  north." 

Miss  McDonald  sees  another  grow- 
ing trend — the  involvement  of  uni- 
versity medical  and  nursing  schools 
in  health  service  to  the  north.  Already 
specialists  from  university  medical 
faculties  rotate  through  the  northern 
nursing  stations. 

She  was  born  and  brought  up  in 
Ottawa.  Her  favorite  hobbies  are  sports 
—  curling  in  the  winter,  golf  in  the 
30     THE     CANADIAN     NURSE 


summer,  and  flying  anytime. 

"This  past  summer  I  reactivated  my 
instructor's  rating  to  teach  tlying."  Miss 
McDonald  likes  tlying  because  she 
meets  a  different  group  of  people. 

"Flying  is  a  terrific  help  in  the  north; 
I  can  understand  the  problems  of  trans- 
portation by  plane." 

Nursing  development 

Catherine  Keith  joined  the  DNHW 
in  1950,  and  her  last  position  before 
coming  to  Ottawa  as  adviser,  nursing 
development,  was  as  regional  nursing 
officer  for  the  Northwest  Territories  and 
the  Yukon. 

Miss  Keith  is  glad  her  title  has  been 
changed  to  adviser,  nursing  develop- 
ment. "People  often  equate  education 
with  academic  pursuits.  Development  of 
the  potential  in  employees  requires 
experience  as  well  as  academic  activity. 
Working  in  this  broader  concept  I  have 
the  need  and  the  opportunity  to  keep  in 
touch  with  nurses  who  are  actually 
giving  care  to  people,  and  to  help  more 
people  understand  that  practice  is  every 
bit  as  important  as  classroom  work  in 
acquiring  knowledge,  skills,  and  good 
judgment." 

Courses  to  prepare  nurses  for  work 
in  the  north,  in  addition  to  the  course 
at  Dalhousie  University,  are  still  in  the 
negotiating  stage,  but  Miss  Keith  hopes 
to  have  a  program  off  the  ground  early 
in  1972. 

Miss  Keith  said:  "We're  in  the  mar- 
ket for  offering  clinical  experience  to 
schools  of  nursing.  1  foresee  baccalau- 
reate and  diploma  nursing  students 
having  an  opportunity  to  become  in- 
volved in  a  nursing  experience  in  the 
north;  urban  facilities  are  overused 
while  we  have  well-prepared  nurses  in 
areas  of  Canada's  north  and  midnorth, 
in  both  hospital  and  field  positions,  who 
lack  the  opportunity  to  contribute  to 
the  experience  of  the  oncoming  genera- 
tion of  nurses. 

"My  work  has  not  changed;  it  is 
still  that  of  keeping  the  quality  compo- 
nent in  the  care  given  to  our  clients  by 
nursing  personnel.  The  adviser's  acti- 
vities have  changed  direction  to  some 
degree,    with   greater    involvement   of 


faculties  of  medicine  and  schools  of 
nursing  in  providing  services.  The 
percentage  of  time  spent  this  year  on 
the  northern  seminars  and  on  preparing 
courses  in  clinical  training  for  outpost 
nurses  has  been  high." 

When  asked  about  her  home  town. 
Miss  Keith  said,  "I  still  haven't  got 
used  to  having  a  home,  although  I  have 
bought  a  condominium  house  in  Otta- 
wa. My  doctor  is  in  Ottawa,  my  dentist 
in  Regina,  and  my  hairdresser  in  Win- 
nipeg." 

Miss  Keith  is  a  rock  hound  who  de- 
lights in  polishing  stones  collected  in 
her  work  across  Canada.  She  has  col- 
lected dinosaur  bones  in  the  badlands 
of  Alberta — "they  polish  very  well" 
—  and  woolly  mammoth  tusks  and 
jade  in  the  Yukon.  "In  the  Arctic  I 
used  to  hitchhike  with  oil  and  mineral 
geologists  who  helped  me  find  rocks. 
The  fellows  had  cause  to  regret  offering 
to  carry  my  luggage;  they  didn't  know 
how  many  rocks  were  tucked  into  my 
bedroll!" 

At  the  moment  Miss  Keith  is  rejoic- 
ing over  a  gift  from  a  friend,  a  pair  of 
bookends  made  of  petrified  dinosaur 
dung. 

She  is  also  an  enthusiastic  flower 
gardener.  ^.^ 


DECEMBER      1971 


The 

Canadian 
Nurse 

50  The  Driveway,  Ottawa  4,  Canada 


& 

^i^ 


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DECEMBER      1971 


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OFFICIAL  JOURNAL  OF  THE  CANADIAN  NLIRSES'  ASSOCIATION 

THE     CAN/|DIAN     NURSE     31 


Rock  festivals  —  new 
problems^  new  solutions 

As  rock  concerts  and  festivals,  with  the  free  and  easy  use  of  drugs  associated 
with  them,  continue  to  court  young  people,  health  care  workers  are  realistically 
facing  up  to  the  music. 


Bob  Zimmerman,  M.A.,  and  Ruta  lansons,  R.N. 


Celebration  of  Life.  Beggers'  Banquet. 
Festival  Express.  Strawberry  Fields. 
Rock  Hill.  Woodstock.  The  names  of 
rock  festivals  are  part  of  the  lingua 
franca  of  youth,  sustaining  the  myth 
that  is  so  important  a  part  of  the  youth 
culture.  The  names  of  the  performers 
are  mentioned  with  something  approch- 
ing  awe:  Sly  and  the  Family  Stone,  The 
Band,  The  Guess  Who,  Sha-Na-Na, 
The  Rolling  Stones. 

In  the  last  five  or  six  years,  concerts 
and  festivals  built  around  rock  music 
have  become  events  of  importance  for 
the  young  people  who  attend  them  and 
of  controversy  and  challenge  for  the 
communities  that  host  them  and  the 
health  professionals  who  service  them. 
Few  of  the  challenges  the  medical  pro- 
fession has  had  to  meet  in  the  last  few 
years  have  been  as  vivid  as  those  pre- 
sented by  youth,  particularly  at  such 
gatherings  where  drug  use  seems  to 
have  become  expected.  The  manner  in 
which  medical  care  at  rock  festivals 
has  evolved  has  been  influenced  by 
the  special  needs  of  the  people  attending 
and  by  the  nature  of  the  event  itself. 

Variations  in  conventional  organiza- 
tion of  medical  service,  as  developed  in 
response  to  these  needs,  involve  doc- 
tors, nurses,  and  other  professionals 
in  new  ways  of  working  with  each 
32     THE     CANADIAN     NURSE 


other,     with     non-professionals,     and 
with  patients. 

The  why  and  how  of  festivals 

The  ostensible  purpose  of  all  rock 
festivals  is  the  gathering  together  of 
large  numbers  of  people  to  listen  to 
rock  music.  Rock  co/icerfs generally  last 
five  hours  to  one  day,  whereas  rock 
festivals  can  run  anywhere  from  twenty- 
Mr.  Zimmerman  has  a  master  of  arts  de- 
gree in  sociology  from  the  University  of 
California  and  has  spent  two  additional 
years  studying  human  communication  at 
Michigan  State  University.  He  has  taught 
sociology  and  communication  courses  at 
university  and  has  worked  with  youth  in 
drug  education,  recreation,  individual, 
group  and  family  therapy.  At  present  he 
is  a  youth  worker  at  Toronto's  Rochdale 
Free  Clinic.  During  the  past  summer  he 
worked  at  five  rock  festivals.  Miss  Jan- 
sons  is  a  graduate  of  the  Toronto  Western 
Hospital.  For  the  past  year  she  has  been 
coordinator  of  drug  abuse  treatment  at 
the  Toronto  Western,  where  she  works 
with  personnel  in  all  parts  of  the  hospital 
and  with  street  agencies  on  projects  to 
help  troubled  youth.  She  worked  at  seven 
rock  festivals  this  past  summer.  Her  pre- 
vious experience  includes  psychiatric 
nursing  in  Montreal  and  Toronto. 


four  hours  to  five  days.  The  former  are 
commonly  held  in  an  urban  area,  using 
some  large  center  such  as  an  arena  or 
stadium;  the  latter  are  located  away 
from  the  city,  usually  on  farm  land 
leased  for  the  purpose.  The  focal  point 
is  an  elevated  stage  filled  with  elaborate 
sound  equipment  and  surrounded  by 
the  audience  sitting  on  the  ground. 

To  obtain  his  permit,  the  promoter 
has  to  meet  certain  minimal  standards 
of  service  and  public  health,  so  some 
provision  is  made  in  advance  for  toilet 
facilities  and  for  water.  Food,  of  the 
snack  variety,  is  usually  sold,  but  parti- 
cipants are  expected  to  provide  their 
own  shelter.  Care  of  the  area  and  dis- 
posal of  garbage  are  also  minimal  or 
non-existent. 

Into  this  setting  comes  an  audience 
of  anywhere  from  3,000  at  a  short  con- 
cert to  perhaps  50,000  at  a  long  festival; 
in  the  famous  event  at  Woodstock,  half 
a  million  people  attended.  For  the  most 
part  they  are  young —  14  to  25  —  and 
have  usually  paid  an  admission  charge 
that  may  run  up  to  $  1 5  a  ticket,  although 
free  festivals  are  not  unknown. 

They  come  to  the  larger  events  from 
all  over  the  country,  some  by  car  or 
public  transport,  many  hitchhiking 
for  days.  Some  have  tents,  extra  food, 
and  other  camping  equipment;  most 
DECEMBER     1971 


have  no  food,  little  money,  and  no  more 
than  the  clothes  on  their  backs.  They 
bring  their  children,  their  pets,  and 
whatever  they  perceive  as  necessary 
for  survival  and  enjoyment:  alcohol  and 
other  drugs,  sports  equipment,  musical 
instruments,  toys.  They  come  to  hear 
music  and  also  to  see  and  be  seen,  to 
meet  people,  to  find  a  guy  or  a  girl, 
to  have  fun,  to  be  part  of  an  experience 
in  which  they  can  define  themselves 
and  "do  their  thing." 

A  rock  festival  is  not  just  a  musical 
event.  It  is  a  large-scale,  complex  social 
event  for  which  the  music  may  be  mere- 
ly a  justification  for  gathering. 

Special  health  team  needed 

Such  is  the  population  and  the  setting 
that  the  health  team  encounters  when 
it  comes  to  a  rock  festival.  Health  care 
must  generally  be  provided  on  a  conti- 
nuing basis  during  the  event,  and  staf- 
fing is  planned  accordingly.  The  team 
may  range  in  size  from  one  doctor,  two 
nurses,  and  two  youth  workers,  to  three 
or  four  teams  of  several  times  that 
number  of  personnel  covering  three 
or  four  shifts  per  day. 

A  word  must  be  said  about  the  youth 
workers.  These  essential  team  members 
are  usually  young  people  themselves, 
knowledgeable  about  the  youth  scene, 
its  norms,  its  jargon,  and  especially  its 
DECEMBER      1971 


drugs.  They  have  a  twofold  role  on  the 
health  team:  they  have  special  compe- 
tence in  treating  drug-related  problems 
(bad  trips,  freak-outs)  and  other  psy- 
chological problems  special  to  the  set- 
ting of  rock  festivals;  and  they  are  able 
to  interpret  to  the  other  team  members 
the  needs,  vocabulary,  and  problems 
of  the  young  people  who  present  them- 
selves for  help.  In  this  way  they  serve 
as  a  communication  link  between  the 
youth  culture  and  the  health  profession- 
als themselves. 

The  health  team  is  paid  either  out 
of  public  funds  or  by  the  promoter, 
whose  prime  objective  in  the  event  is 
profit.  Promoters  accept  the  necessity 
of  providing  medical  coverage,  either 
because  their  insurance  requires  it,  or 
because  they  are  offered  the  service 
at  no  cost  to  themselves. 

The  police  on  duty  like  to  have  an 
adequate  medical  facility  as  part  of  the 
general  control  mechanism  to  look  after 
problems  that  would  otherwise  fall 
to  them  and  which  they  are  unable  to 
handle.  Drug-related  problems  in  par- 
ticular fall  into  this  category. 

Team  members  are  usually  people 
who  have  had  or  who  wish  to  gain  ex- 
perience working  with  young  people 
in  this  type  of  setting;  but  it  is  unlikely 
they  would  attend  a  festival  if  they  were 
not  working  there.  They  are  not  part 


of  the  festival  population,  are  billeted 
away  from  the  site —  if  they  sleep  in 
the  area  at  all  —  and  come  on  the  site 
only  to  work  a  shift.  They  spend  their 
time  in  the  medical  facility,  socializing 
mostly  with  one  another.  As  they  have 
little  or  no  influence  on  facilities  or 
conduct  of  the  audience  in  the  planning 
stages  or  during  the  festival,  they  can 
do  nothing  in  the  way  of  preventive 
medicine. 

The  health  personnel  may  or  may 
not  have  been  acquainted  with  each 
other  before  the  event,  and  usually 
function  as  a  team  only  for  its  duration. 
In  many  cases  they  are  not  native  to 
the  immediate  area  and  are  unfamiliar 
with  local  resources.  So  they  must  rely 
on  local  first  aid  and  ambulance  per- 
sonnel to  fill  the  information  lack.  Their 
total  experience  is  confined  to  the  med- 
ical facility. 

Prepared  for  all  problems 

The  medical  facility  is  generally 
located  in  a  tent  or  building  in  an  area 
that  is  a  compromise  between  the  need 
tor  relative  quiet  and  the  need  to  be 
easily  visible  and  accessible  to  the  peo- 
ple it  is  meant  to  serve.  Usually  this 
results  in  some  degree  of  physical  iso- 
lation from  both  the  stage  and  the  great- 
est concentration  of  the  audience. 

Within  the  tent  there  is  provision  for 
THE     CAN/|DIAN      NURSE     33 


reception  and  screening,  immediate 
first-aid  care,  talking  and  counseling, 
bed  rest  and  basic  nursing  care,  admi- 
nistration of  drugs,  and  minor  surgical 
procedures  such  as  suturing.  Medical 
teams  at  the  longer  festivals  live  in  hope 
and  trepidation  that  someone  might 
decide  to  deliver  a  baby  during  the 
festival! 

Whatever  problems  appear,  the  team 
must  deal  with  them.  The  average 
"casualty  load"  at  a  rock  festival  has 
been  estimated  at  one  per  five  hundred 
persons  each  day  of  the  event.  About 
15  percent  of  the  problems  are  related 
to  drug  use;  the  others  are  medical  or 
first-aid  in  nature. 

The  health  problems  encountered 
change,  depending  on  the  number  of 
people  present,  the  length  of  the  event, 
the  type  of  music  being  played,  the 
weather,  and  other  elements  affecting 
the  atmosphere  of  the  festival. 

Early  in  the  festival,  physical  pro- 
blems are  presented  by  persons  who 
have  traveled  a  long  way  with  poor 
facilities,  climbed  fences,  stumbled 
around  unfamiliar  terrain,  or  tried  a 
new  drug  in  an  unfamiliar  setting  with 
people  they  do  not  yet  trust. 

As  the  festival  progresses,  the  physi- 
cal problems  become  more  complex. 
They  result  from  a  steady  diet  of  hot 
dogs  and  raw  corn  for  three  days,  from 
walking  barefoot  through  trash  and 
garbage,  from  sleeping  under  the  stars 
on  cold  nights.  Both  the  resistance 
to  hurt  and  the  individual's  ability  to 
cope  with  it  decrease  under  adverse 
physical  and  psychological  conditions. 

The  drug-related  problems  are  also 
affected  by  the  course  of  the  festival. 
The  most  common  problem  is  that  of 
panic  from  the  use  of  a  new  drug  or  an 
unexpected  reaction  from  a  drug 
thought  to  be  familiar.  These  are  the 
bad  trips  and,  in  severe  cases,  the  freak- 
outs. 

Many  drugs  sold  are  passed  on  as 
something  other  than  what  they  are, 
many  are  of  poor  quality,  and  many 
have  been  mixed  with  injurious  sub- 
stances. The  reactions  are  unpredict- 
34     THE     CANADIAN     NURSE 


able  and  often  terrifying  to  the  user. 

There  are  also  bad  trips  and  freak- 
outs  due  to  the  setting,  rather  than  to 
pharmacological  effects.  Certain  kinds 
of  music,  bad  weather,  fights  in  the 
crowd,  the  appearance  of  large  numbers 
of  policemen,  and  anxiety  generated 
by  the  rumor  of  bad  drugs  being  sold 
can  "bum  somebody  out." 

Another  type  of  drug  problem  in- 
volves the  actual  overdose  of  some 
depressant  or  stimulant  drug;  the  pa- 
tient may  be  unconscious  or  severely 
stimulated  to  the  point  of  convulsion. 
Along  with  these  are  side  effects  from 
contaminated  drugs  or  poorly  synthe- 
sized preparations.  For  example,  a 
person  may  develop  cramps  from  in- 
gesting strychnine  or  ergot  derivatives 
in  LSD. 

Finally,  although  a  simple  bad  trip 
on  one  dose  of  some  psychoactive  drug 
is  relatively  easy  for  an  experienced 
person  to  handle,  it  is  a  different  matter 
when  this  occurs  after  16  to  60  hours 
at  a  festival  in  a  person  who  is  both 
physically  and  mentally  fatigued,  who 
may  have  taken  a  number  of  different 
drugs,  and  who  may  have  been  "trip- 
ping" for  the  entire  time.  This  is  the 
most  complex  drug  problem. 

As  people  come  to  the  medical  tent, 
the  team  must  assess  them  as  they  ap- 
pear, decide  who  requires  what  type 
of  treatment,  if  any,  and  who  will  give 
that  treatment,  deal  with  the  person's 
friends,  and  maintain  good  relations 
with  those  who  are  running  the  festival, 
the  security  forces,  and  the  general 
audience.  This  process  tests  the  quality 
of  the  medical  team's  planning  and  its 
ability  to  adapt. 

The  team  in  action 

What  differentiates  the  medical 
team  of  a  rock  festival  from  other  types 
of  health  teams?  An  example  of  how  it 
functions  will  illustrate  this. 

It  is  8:00  P.M.  The  team  has  been 
on  duty  since 4:00  P.M.;  the  rock  groups 
have  been  playing  nearly  continuously 
for  six  hours.  It  is  the  second  evening 
of  the  festival,  and  some  of  the  young 


people  have  been  on  the  site  for  three 
days. 

In  the  medical  tent  a  number  of 
people  are  moving  about.  At  first  glance 
none  seem  to  be  workers  —  ah  yes, 
the  people  with  the  blue  arm  bands  or 
the  white  crosses  taped  on  various 
parts  of  their  anatomy  seem  to  be  the 
staff.  Someone  is  having  a  foot  soaked; 
someone  is  having  a  gash  on  his  head 
sutured.  A  number  of  persons  are  curl- 
ed up  on  cots,  some  asleep,  some  with 
several  people  in  attendance.  One  or 
two  are  alternating  between  tears  and 
laughter.  Worried  friends  pop  into  the 
tent  looking  for  someone.  Other  people 
approach  a  worker  to  ask  for  a  "down- 
er" (tranquilizer)  for  a  tripping  friend. 

An  ambulance  drives  up  to  take  a 
young  man  to  hospital.  He  has  suffered 
from  low  abdominal  pain  ever  since 
he  came  to  the  festival,  but  he  leaves 
reluctantly.  The  place  is  noisy,  but 
quiets  down  when  a  worker  points  out 
that  there  are  people  tripping  in  here; 
we  say  "worker"  because  you  have  to 
watch  for  some  time  to  decide  who  is 
the  doctor,  who  is  the  nurse,  and  who 
is  the  youth  worker. 

Young  people  have  definite  expec- 
tations of  those  who  deliver  health 
care,  and  they  make  these  known  ver- 
bally and  by  refusing  service  if  their 
expectations  are  not  met.  Their  label 
for  irrelevence  is  "uncool" — some- 
thing those  who  work  with  them  cannot 
afford  to  be. 

The  young  judge  the  person  giving 
the  care  on  the  basis  of  the  type  of  care 
they  get  and  on  the  style  of  the  worker; 
they  do  not  respect  a  nurse  simply  be- 
cause she  is  a  nurse,  or  obey  a  doctor 
simply  because  he  is  a  doctor.  They  ask 
themselves:  "Does  this  person  seem  to 
know  what  he's  doing?  Does  he  or  she 
see  me  as  a  real  and  important  person?" 
They  require  honesty  more  than  liking. 
Their  concern  is  not  at  all  with  the  mys- 
tique of  medicine  or  the  formal  profes- 
sional qualifications  of  the  individual. 
They  want  to  feel  better  as  soon  as 
possible,  to  be  treated  as  a  human 
being.  And  that  is  all. 

DECEMBER      1971 


The  rock  festival  is  a  short-lived 
social  event,  with  little  or  no  past  and 
probably  no  future  after  it  ends.  Health 
care  must  be  given  in  this  context  and 
must  be  oriented  to  the  present.  There 
is  almost  no  room  for  scheduling  or 
deferring  treatment,  or  for  referring 
the  person  to  other  facilities.  Record- 
keeping is  minimal,  as  there  is  no 
opportunity  for  follow-up  care. 

To  work  effectively  in  this  type  of 
situation,  the  team  must  make  full  use 
of  all  its  human  resources.  Each  team 
member  must  work  to  his  fullest  capac- 
ity, referring  to  other  members  only 
those  problems  he  feels  unequipped  to 
handle.  A  relationship  of  trust  and 
equality  is  necessary  for  this  to  be  ef- 
fective, with  recognition  of  each  team 
member's  abilities  and  limitations, 
defined  in  terms  of  the  person,  rather 
than  in  terms  of  rigidly  defined  roles. 

For  instance,  a  youth  worker  may 
assist  the  doctor  in  suturing,  or  give 
first  aid  for  minor  injuries;  a  nurse,  on 
the  other  hand,  may  spend  her  whole 
shift  talking  to  a  person  on  a  bad  trip. 
Often  team  members  can  act  as  consul- 
tants to  one  another,  thus  helping  to 
broaden  their  skills  and  maintain  con- 
tinuity of  care.  And  team  members 
must  be  flexible,  as  they  may  not  have 
anticipated  what  will  happen  and  will 
need  to  adapt  rapidly  without  the  luxury 
of  long  planning  meetings. 

Lessons  learned 

The  lessons  we  have  learned  about 
the  organization  and  style  of  care  at 
rock  festivals  could  apply  in  other 
contexts. 

•  We  believe  that  in  terms  of  the  human 
needs  of  patients  —  their  need  for 
immediate  help,  for  a  feeling  of  having 
been  helped,  and  for  ensuring  that  they 
come  for  help  —  conventional  emer- 
gency services  could  draw  on  the  lessons 
learned  at  rock  festivals.  Both  the  type 
of  problems  presented  and  the  type  of 
care  required  are  similar;  thus  emer- 
gency service  could  be  improved  by 
drawing  lessons  from  sources  other 
than  conventional  medical  care. 
DECEMBER      1971 


•  Rock  festival  care  is  hightly  integrat- 
ed with  the  needs  and  expectations  of 
the  specific  population  served.  Consid- 
eration of  how  decisions  about  organiz- 
ing that  care  were  reached  and  what 
variables  were  considered  with  what 
weight  may  be  of  use  in  organizing  any 
community  service,  although  the  even- 
tual style  of  care  may  be  quite  different. 
Even  when  the  purely  medical  consid- 
erations are  identical,  service  to  dif- 
ferent communities  may  have  to  be 
organized  differently  for  maximum 
effectiveness. 

•  One  special  case  of  community  ser- 
vice is  particularly  close  to  rock  festival 
care  in  terms  of  the  kind  of  patient 
needs  involved:  service  on  a  large  scale 
to  a  welfare  clientele.  As  large  urban 
hospitals  and  neighborhood  clinics  in 
poverty-stricken  areas  face  many  of  the 
same  problems,  they  may  well  use  some 
of  the  organizational  and  stylistic  ele- 
ments found  suitable  for  festival  med- 
ical teams. 

In  conventional  medical  organiza- 
tions, patients  are  too  often  forced  to 
adapt  themselves  to  meet  the  needs  of 
the  system.  Much  of  what  we  have  dis- 
cussed about  rock  festival  care  came 
about  when  this  conventional  approach 
proved  impossible  or  at  least  counter- 
productive. As  a  result,  rock  festival 
care  has  developed  as  a  model  of  flexi- 
ble, adaptive,  efficient  organization 
created  to  serve  patient  needs.  This  care 
is  highly  responsive  to  those  needs  and 
to  the  changing  health  picture  in  the 
context  it  serves.  In  other  words,  health 
services  at  rock  festivals  have  shown 
it  is  possible  to  create  a  system  that 
recognizes  the  needs  of  the  community 
and  adapts  to  them. 

We  hope  this  model  may  be  drawn 
on  by  those  who  believe  that  medical 
treatment  can  be  made  more  pleasant, 
fulfilling,  and  comprehensible  for  the 
patient  than  the  usual  hospital  exper- 
ience, which  too  often  treats  the  pro- 
blem well  but  fails  the  human  being 
who  has  the  problem.  Q 


THE      CArN|^CIAN      NURSE     35 


Headache —  diagnosis 
and  management 


Both  nurse  and  physician  must  regard  a  patient's  complaint  of  headache  as 
significant  and  indicative  of  a  plea  for  help. 


Richard  M.  Gladstone,  M.D.,  F.R.C.P.(C) 


Headache  is  probably  the  most  com- 
mon complaint  of  both  men  and  wo- 
men. In  one  form  or  another  it  affects 
an  estimated  90  percent  of  the  popula- 
tion* Fortunately,  headache  is  in- 
frequently a  sign  of  organic  intracranial 
or  extracranial  disease.  Even  so,  it  can 
cause  extreme  pain  and  be  a  source 
of  anxiety  for  the  person  afflicted. 

In  this  brief  review  the  following 
will  be  discussed:  tension  headache; 
migraine  and  its  sub-varieties;  and 
headache  of  organic  intracranial  dis- 
ease. 

Tension  headache 

Headaches  caused  by  tension  are 
extremely  common  and  are  probably 
the  most  frequent  reason  for  a  patient's 

*Fred  Plume,  "Headache,"  Cecil-Loeb 
Textbook  of  Medicine,  13cd.,  eds.  F'. 
Beeson  and  W.  McDermott,  Toronto, 
W.B.Saunders,  1971,  p.  154. 

Dr.  Gladstone,  a  graduate  of  the  Univer- 
sity of  Toronto  Medical  School,  is  on 
the  staff  of  North  York  General  Hospital, 
Willowdale.  Ontario.  He  is  a  clinical 
teacher  at  the  University  of  Toronto  and 
Sunnybrook  Hospital,  and  consultant  in 
neurology  at  York-Finch  General  Hos- 
pital, Toronto,  Ontario. 


36     THE     CANADIAN     NURSE 


referral  to  a  neurologist  who  has  a 
suburban  office  practice.  Tension 
headaches  can  be  due  to  two  causes 
—  nervous  tension  and  muscle  tension. 

There  are  three  different  types  of 
headache  caused  by  nervous  tension. 
In  the  commonest  type,  the  patient 
complains  of  a  squeezing,  constricting 
type  of  head  pain,  mainly  in  the  frontal 
and  temporal  areas,  and  says  he  feels 
as  if  his  head  were  in  a  vice.  In  the 
second  type  there  is  frontal-occipital 
discomfort,  often  accompanied  by 
muscular  stiffness  in  the  neck.  In  the 
third  type,  pain  is  located  in  the  vertex 
or  crown  of  the  head  and  may  be  des- 
cribed as  an  expanding  feeling — as 
if  the  top  of  the  head  had  been  blown 
off. 

The  usual  type  of  tension  headache 
spreads  from  its  point  of  origin  to  be- 
come a  holo-cranial  headache.  It  gen- 
erally builds  up  slowly,  and  may  last 
from  several  hours  to  several  weeks. 
Patients  usually  complain  that  even 
the  strongest  analgesics  do  not  relieve 
their  discomfort.  There  are  no  ocular, 
visual,  nasal,  or  gastrointestinal  symp- 
toms present. 

Anxiety  usually  causes  this  type  of 
headache,  and  there  is  a  definite  rela- 
tionship between  the  headache  attack 
and  a  preceding  distressful  situation. 
DECEMBER     1971 


Often  the  attack  occurs  in  the  "let 
down"  phase  that  follows  a  stressful 
situation;  consequently,  the  relation- 
ship between  the  preceding  stressful 
event  may  be  overlooked. 

Fatigue  may  promote  this  type  of 
headache.  A  perfectionist  type  of 
personality  and  those  who  lack  the 
capacity  to  adapt  to  changing  situations 
are  also  prone. 

Prolonged  nervous  tension  leads  to  a 
stale  of  hypertonicity  in  the  nervous  and 
vascular  systems.  Consequently,  when 
the  tension  is  relieved  the  blood  vessels 
dilate  with  resultant  stimulation  of  pain- 
sensitive  fibers  and  the  production  of 
headache  pain. 

In  muscle  tension  headaches,  dis- 
comfort occurs  because  of  sustained 
contraction  of  the  scalp,  face,  neck, 
and  shoulder  muscles.  In  addition  to 
an  emotional  etiology,  this  type  of 
headache  can  also  be  triggered  by  fati- 
gue and  faulty  posture.  At  times,  local 
tenderness  of  the  muscles  and  the  spasm 
can  be  palpated. 

The  appearance  of  tension  head- 
aches may  indicate  that  nature  is  giving 
the  body  a  biological  reprimand.  For 
effective  treatment  one  must  get  to 
know  the  patient,  his  social,  personal, 
and  domestic  situation,  and  his  life 
profile. 

Continued  dispensing  of  analgesics 
only  is  usually  unsuccessful,  although 
sedation  and/or  antidepressant  therapy 
is  sometimes  indicated.  Wet  or  dry  heat 
may  also  help  to  produce  symptomatic 
relief.  Psychotherapy,  too,  plays  an 
important  role.  The  patient  should  be 
taught  how  to  relax;  I  have  often  pres- 
cribed recreational  swimming,  yoga, 
and  other  d iversional  hobbies  and  sports 
as  part  of  medical  therapy.  At  all  times 
one  must  be  aware  that  tension  head- 
aches can  coexist  with  structural  le- 
sions. 

Migraine 

Migraine  is  a  vascular  type  of  head- 
ache in  which  there  is  an  initial  vaso- 
constriction of  the  cranial  vessels.  Dur- 
ing this  phase  the  prodromal  neurol- 
DECEMBER      1971 


ogical  symptoms  occur,  such  as  scintil- 
lating scotoma,  hemianopia,  paresthe- 
sia, and  so  on.  It  is  not  yet  certain  what 
causes  the  initial  vasoconstriction,  but 
many  chemical  substances  are  being 
studied. 

Following  thisphase,  the  vasodilation 
phase  occurs,  and  the  headache  is  prom- 
inent. Either  phase  may  be  dominant, 
and  it  is  even  possible  to  have  the  is- 
chemic symptoms  only,  without  any 
headache  at  all,  and  still  suffer  mi- 
graine! 

Common  Migraine 

In  common  migraine  the  aura  usual- 
ly is  absent.  The  attacks  may  be  holo- 
cranial,  and  are  sometimes  called  bi- 
lious headache,  or  sick  headache.  Mi- 
graine also  can  produce  systemic  symp- 
toms with  chills,  nausea,  vomiting, 
polyuria,  diarrhea,  pallor,  malaise,  and 
soon. 

Classical  Migraine. 

In  classical  migraine  there  is  an  aura 
with  scintillating  scotoma,  usually  last- 
ing 5  to  10  minutes.  The  headache  is 
hemicranial,  and  usually  there  is  some 
relief  with  vomiting.  Episodes  may  be 
accentuated  by  menses,  oral  contra- 
ceptives, and  drugs  such  as  reserpine, 
hydralazine,  and  Parnate. 

For  effective  relief,  one  of  the  ergo- 
tamine  compounds  is  given  every  20  to 
30  minutes  from  the  earliest  onset  of  the 
headache  until  it  has  been  relieved  or 
until  a  maximum  of  six  tablets  has  been 
taken.  If  nausea  occurs,  ergotamine 
suppositories  or  a  combination  of  ergo- 
tamine and  an  antinauseant  may  be 
prescribed.  In  addition,  self-administer- 
ed subcutaneous  injections  of  ergo- 
tamine or  an  ergotamine  Medihaler  are 
available,  but  only  on  the  advice  of  a 
physician.  When  migraine  headaches 
become  frequent  and  severe,  prophy- 
lactic medication,  such  as  daily  ergo- 
tamine combined  with  sedation,  is  help- 
ftil. 

Methysergide  helps  about  70  percent 
of  patients  with  severe,  frequent  vas- 
cular headaches;  they  benefit  from  its 


antiserotonin,  anti-inflammatory,  and 
vasoconstrictive  effects.  However,  this 
drug  has  significant  gastrointestinal, 
neurological,  and  cardiopulmonary 
side  effects  and  a  tendency  to  cause 
weight  gain  and  edema.  As  with  any 
ergot  preparation,  it  is  contraindicated 
in  pregnancy  and  in  vascular,  renal, 
hepatic,  or  collagen  disease;  main- 
tenance ergot  therapy  must  be  interrupt- 
ed periodically  to  avoid  vascular  com- 
plications. 

A  new  medication,  called  B.C.  105 
—  an  antiserotonin  plus  an  antihistam- 
inic  compound  —  is  now  under  inves- 
tigational use  for  patients  with  mi- 
graine. 

Cluster  Migraine 

With  cluster  migraine  the  patient 
has  a  specific  type  of  pain  that  is  des- 
cribed as  deep  and  boring;  the  head- 
ache is  usually  short,  lasting  10  to  45 
minutes.  There  are  prominent  autono- 
mic symptoms  with  conjunctival  injec- 
tion, photophobia,  tearing,  nasal  stuf- 
finess and,  at  times,  drooping  of  the 
involved  eyelid  and  narrowing  of  the 
ipsilateral  pupil. 

These  headaches  often  occur  at  n  ight, 
and  may  reoccur  several  times  during 
the  day.  They  tend  to  cluster,  lasting 
for  several  weeks  with  a  remission,  and 
are  more  prevalent  in  the  spring  and 
fall.  At  times  they  occur  with  clock- 
like regularity  each  day.  Their  duration 
is  so  brief  that  at  times  it  is  almost  im- 
possible for  the  medication  to  take  ef- 
fect before  the  end  of  the  headache. 
Therefore,  prophylactic  doses  of  ergot, 
given  as  tablets  or  suppositories  h.s., 
may  abort  the  headaches  or  modify 
them  so  that  patients  are  more  respon- 
sive to  subsequent  medication  taken 
immediately  at  the  onset  of  the  head- 
ache. 

In  cluster  migraine,  section  of  the 
superficial  temporal  artery,  or  cryo- 
surgery, is  being  advocated;  although 
the  results  of  this  type  of  therapy  are 
encouraging,  adequate  long-term  fol- 
low-up is  not  yet  available.  Patients 
should  not  be  referred  for  surgical 
THE     CAISI^DIAN     NURSE     37 


consideration  until  all  conservative 
measures  have  been  exhausted. 

With  intractable  migraine,  the  vessel 
wall  may  become  edematous  following 
prolonged  vasodilatation.  To  decrease 
this  edema,  ergotamine  can  be  adminis- 
tered on  a  regular  basis,  b.i.d.  or  t.i.d., 
for  several  days,  or  a  course  of  steroids 
in  reducing  dosage  may  be  tried. 

It  is  important  to  remove  any  source 
of  precipitating  or  triggering  factor, 
particularly  in  this  type  of  migraine. 
Patients  with  a  high  intake  of  coffee, 
tea,  and  cigarettes  are  likely  to  have 
precipitation  of  migraine  on  withdrawal 
of  these  vasoconstrictive  chemicals. 
Similarly,  vasodilators,  such  as  alcohol 
and  oral  contraceptives,  may  increase 
the  frequency  of  migraine. 

A  llergy  is  not  considered  a  predispos- 
ing factor  to  migraine  per  se,  but  some 
people  are  sensitive  to  dietary  subst- 
ances containing  tyramine,  a  vaso- 
pressor. These  people  are  usually  aware 
of  headache  brought  on  by  old  wine, 
old  cheese,  chicken  livers,  chocolate, 
cocoa,  nuts,  avocado,  broad  beans,  and 
so  on. 

Rare  Forms  Of  Migraine 

Ophthalmoplegic  and  hemiplegic  mi- 
graine are  rare  and  tend  to  be  familial. 
In  the  ophthalmoplegic  type,  the  third 
and  sixth  cranial  nerves  usually  are 
involved.  Hemiplegic  migraine  may 
be  accompanied  by  both  motor  and 
sensory  defects.  These  patients  should 
be  referred  to  a  specialist  for  evalua- 
tion. 

Basilar  artery  migraine  is  uncom- 
mon, and  occurs  mainly  in  young  wo- 
men who  usually  have  a  strong  family 
history  of  migraine.  The  attacks  are 
severe  and  frightening,  usually  begin- 
ning with  visual  blurring  or  loss,  either 
partial  or  total,  which  is  then  followed 
by  vertigo,  tinnitus,  ataxia,  dysarthria, 
paresthesia,  or  even  loss  of  conscious- 
ness. Usually  a  severe,  throbbing  occi- 
pital headache  and  vomiting  follow. 
Between  attacks  the  patients  are  well, 
and  no  abnormalities  are  found  on 
neurological  examination. 

In  the  ophthalmoplegic,  hemiplegic, 
38     THE     CANADIAN     NURSE 


and  basilar  artery  types  of  migraine, 
the  vasoconstrictive  phenomena  are 
often  severe.  Ergotamine  therapy  is 
not  recommended.  The  mainstay  of 
therapy  in  this  type  is  prophylactic, 
with  analgesics  as  required  at  the  time 
of  the  headache. 

Organic  intracranial  cause 

Headache  of  brain  tumor  or  of  an 
expanding  lesion  inside  the  cranium 
arises  from  stimulation  of  the  pain- 
sensitive  structures  inside  the  skull, 
either  by  traction,  inflammation,  dis- 
tension, or  by  direct  pressure. 

Pain-sensitive  structures  include 
the  venous  sinuses,  the  dural  arteries 
(for  example,  the  middle  meningeal 
arteries),  the  arteries  at  the  base  of  the 
brain  in  their  proximal  portions  only, 
the  cranial  nerves  carrying  pain  fibers 
(5,  9,  10),  and  the  dura  adjacent  to  the 
venous  sinuses. 

Most  of  the  dura,  arachnoid,  epen- 
dyma  and  choroid  plexuses,  the  cranial 
bone  (except  the  periosteum),  and  the 
parenchyma  of  the  brain  are  insensitive. 

Usually  headaches  caused  by  brain 
tumor  are  localized  at  the  onset,  but 
later  become  more  generalized.  These 
headaches  increase  in  frequency  and 
severity  with  time.  They  are  worsened 
by  maneuvers  that  alter  the  relation- 
ship of  intracranial  structures,  such  as 
lying  down,  bending  forward,  jolting 
the  head,  and  are  increased  by  maneu- 
vers that  increase  intracranial  pressure, 
such  as  coughing,  sneezing,  or  straining. 
Because  of  the  increased  volume  of 
blood  found  inside  the  head  during 
recumbency,  these  headaches  are  often 
worse  on  awakening  in  the  morning. 
On  neurological  examination,  physical 
signs  are  usually  prominent. 

Conclusion 

Both  nurse  and  physician  must  al- 
ways regard  the  patient's  complaint  of 
headache  as  significant  and  indicative 
of  a  plea  for  help.  Only  by  careful  dis- 
cussion, enquiry,  and  thorough  exami- 
nation can  one  be  satisfied  of  the 
significance  of  the  general  complaint 
of  headache  in  a  particular  patient.     V 


DECEMBER      1971 


by  Nurse  Whozits 


"Hey,  IMurse! "  is  the 

brainchild  of  the  author, 

Jennie  Wilting,  (IMurse  Whozits), 

a  graduate  of  Blodgett 

Memorial  Hospital  School 

of  Nursing  in 

Grand  Rapids,  Michigan, 

and  the  University 

of  Minnesota,  Minneapolis. 

For  four  years  she 

was  head  nurse  on  a 

psychiatric  unit,  and 

for  10  years,  an  instructor 

in  psychiatric  nursing. 

At  present,  she  is 

a  lecturer  in  mental  health 

concepts  at  the 

University  of  Alberta 

School  of  Nursing 

in  Edmonton,  Alberta. 


•"Oh,  no!  Not  Mrs.  Bussfudget  again."" 
groaned  Miss  Tizzy,  as  she  looked  at 
her  morning  assignment.  "Tve  had  her 
three  mornings  in  a  row.  She  makes  me 
feel  stupid  with  her  step-by-step  direc- 
tions for  her  care.  To  hear  her.  you'd 
think  I  didn't  know  what  1  was  doing!" 
■■|  know  how  you  feel."  said  Miss 
DECEMBER     1971 


Dealer,  the  team  leader.  "Mrs.  Buss- 
fudget can  be  trying.  But  don't  take  it 
personally  and  try  to  understand.  She 
is  completely  paralyzed  and  can't  do 
anything  for  herself.  Because  this  is 
terribly  threatening  to  her,  she  tries  to 
control  her  nurse  by  constantly  giving 
directions." 

So  that  explains  it!  Yet  I  wonder  .  .  . 
Perhaps,  but  perhaps  not.  There  arc 
many  other  possible  explanations  for 
Mrs.  Bussfudget's  behavior.  Maybe  she 
wants  to  receive  good  physical  care 
and  feels  responsible  for  getting  it. 
Therefore,  she  gives  specific  directions 
each  day  as  to  how  this  care  should  be 
given.  Perhaps  she  has  learned  during 
her  hospital  stay  that  a  small  wrinkle 
in  the  sheet  or  a  poorly  aligned  limb 
results  in  an  uncomfortable  day  for 
her.  Thus,  it's  important  that  her  care 
be  given  in  a  specific  way. 

Or  it  could  be  that  she's  embarrassed 
by  the  intimate  care  she  receives  and 
keeps  up  constant  chatter  to  cover  this 
embarrassment.  Mrs.  Bussfudget  may 
have  concluded  from  her  experiences 
that  nurses  give  inadequate  care  unless 
she  carefully  supervises  and  directs 
them.  Perhaps  she  enjoys  talking,  but 
because  of  her  limited  environment 
is  somewhat  at  a  loss  for  words. 

These  are  enough  "perhapses"'  to 
make  the  point  that  there  are  many 
possible  explanations  for  Mrs.   Buss- 


fudget's behavior.  But  what  does  Mrs. 
Bussfudget  say?  What  reason  or  ex- 
planation does  she  give  for  her  be- 
havior? 

No  matter  how  learned  or  impressive 
our  explanations  for  a  particular  pa- 
tient's behavior  sound,  unless  confirm- 
ed by  the  patient,  they  are  merely 
guesses.  Possibly  an  accurate  guess. 
but  a  guess  nonetheless. 

There  is  danger  in  planning  nursing 
care  using  a  guess  as  a  fact.  The  nurse 
receives  false  assurance  that  her  nurs- 
ing care  is  satisfactory  and  assumes  an 
attitude  of  resignation.  The  patient  is 
then  left  with  unmet  needs  and  a  feel- 
ing of  confusion.  Our  patients  are  too 
important  to  base  our  nursing  care  on 
guesses! 

If  Miss  Tizzy  and  Miss  Dealer  want 
to  understand  Mrs.  Bussfudget's  be- 
havior, they  must  talk  to  her.  Most 
likely  she  can  explain  her  behavior. 
But  if  she  can't,  she  at  least  gets  the 
opportunity  to  express  her  feelings 
about  the  care  she  is  receiving.  Through 
a  clearer  understanding  between 
nurse  and  patient,  and  possibly  a  few 
changes  in  nursing  care  and  the  pa- 
tient's behavior.  Mrs.  Bussfudget  may 
no  longer  be  an  undesirable  patient. 

As  nurses,  do  we  think  of  consult- 
ing our  patients  when  we  are  irritated, 
annoyed,  puzzled,  or  confused  by  their 
behavior?  ~" 

THE     CAN>|DIAN     NURSE     39 


in  a  capsule 


Save  us  from  affluence 

Nationalism  is  a  dirty  word  to  some 
Canadians;  to  others  it  represents  a 
desperate  attempt  to  keep  Canada  Ca- 
nadian. The  way  you  look  at  it  depends 
on  many  things:  where  you  live,  who 
you  work  tor,  and  how  aware  you  are 
of  the  effects  of  American  economic 
control  on  our  institutions  and  culture. 

Some  of  the  everyday  effects  of 
American  influence  on  a  Canadian 
city  were  given  down-to-earth  treatment 
in  The  Financial  Post  July  17.  The 
front-page  story,  about  "Gait,  U.S.A." 
was  written  by  Robert  Perry  after  he 
visited  Gait,  a  city  of  38,000  people  in 
the  heart  of  industrial  Ontario. 

"By  my  count.  Gait  has  a  greater 
proportion  of  its  industrial  heart  tissue 
under  American  control  than  Canada 
as  a  whole,"  Mr.  Perry  writes.  Yet  his 
interviews  with  people  from  all  walks 
of  life  show  that  most  are  indifferent 


about  American  control  or  keep  quiet 
about  their  feelings.  "His  pay  cheque: 
that's  what  the  working  man  is  concern- 
ed about,"  he  was  told. 

Gait  is  described  as  a  juxtaposition 
of  "old  stone  houses  mingled  with  wood 
and  stucco  in  the  quiet,  treed  east-side 
residential  streets"  and  "the  trappings 
of  A  mericanization." 

"It  has  a  long  way  to  go  to  catch  up 
with  the  blatant,  overpowering,  almost 
hilarious  ugliness  of  Strips  in  central 
New  Jersey,  Long  Island  and  Califor- 
nia. But  give  it  time." 


Consumer  fraud? 

We  hear  so  much  about  the  virtues  of 
organically-grown  food  that  it  comes 
as  somewhat  of  a  jolt  to  be  told  that 
"'organically  grown'  looks  like  the 
biggest  consumer  fraud  yet  perpetrat- 
ed on  the  American  public." 


momn 


Illustrated  bv  Fran  Kiic 


Going  my  way? 


40     THE     CANADIAN      NURSE 


This  accusation  was  made  in  the 
New  England  Journal  of  Medicine 
August  12  by  Donald  W.  Holsten, 
Pharm.  D.,  State  of  California,  Bu- 
reau of  Food  and  Drug.  In  a  letter  to 
the  editor,  he  explained  that  all  food 
is  organically  grown.  Referring  to 
"organic"  food  as  being  advertised  to 
mean  food  grown  without  added  pesti- 
cides or  chemicals,  he  said:  "We  know 
that  pesticides  and  chemical  soil  addi- 
tions have  had  worldwide  distribution 
and  that  such  substances  remain  in  the 
soil  for  many  years  at  least.  At  this 
point  in  time  one  can  question  whether 
such  pure  growing  soil  exists.  We  may 
find  that  people  are  paying  a  lot  more 
money  for  an  inferior  food  because  we 
have  no  standards  for  the  term  'organic- 
ally grown.'  " 

New  words,  old  habit 

The  mother  who  used  to  remind  her 
children  to  pick  up  the  wrappings  after 
a  picnic  was  a  compulsive  nag.  Now 
her  offspring  consider  her  to  be  attun- 
ed to  the  times,  aware  of  the  perils  of 
pollution. 

What  a  pleasure  to  earn  brownie 
points  for  a  lifetime  practice! 


Disposable  executives 

"European  nonwoven  disposables  exec- 
utives to  attend  Idea  7 1  exposition 
in  United  States"  was  the  heading  of  a 
news  release  that  came  to  our  attention. 
We  agreed  that  it  would  be  reasonable 
for  an  executive  classified  as  nonwoven 
and  disposable,  to  have  fewer  fears  in  a 
gathering  of  peers. 

This  same  news  (was  it  released  or 
did  it  escape?)  told  us  that  "hospitals 
and  nursing  homes  are  the  biggest  non- 
consumer  users  of  nonwoven  dispos- 
ables." And  of  executives  to  match? 


Smile,  or  your  money  back 

Since  everyone  does  not  get  a  chance 
to  read  Bay  Views,  a  bimonthly  pub- 
lished by  Western  Memorial  Hospital 
in  Comer  Brook,  Newfoundland,  we'd 
like  to  pass  along  a  few  of  the  lighter 
lines.  They're  guaranteed  to  produce 
a  chuckle. 

Attention  nursing  staff.  To  those 
who  have  asked,  those  who  have  been 
wondering,  and  those  who  figure  they 
dare  not  —  yes,  nursing  staff  may  wear 
uniform  hot  pants  on  duty. —  Your 
Director. 

DECEMBER      1971 


ffW  fKCHOd^o^^  /lmfed...^m  ^eci^ 


Our  best-selling  items,  carefully  selected  for  today's 
nurse.  Many  available  with  up  to  3  gold-stamped  or 
engraved  initials  for  identification,  protection,  and 
distinction.  All  shipped  ppd. 

Comp/ete  Satisfaction  GaaianXwA'. 


REEVES  NAME  PINS 

America's  largest  selling ...  by  far !  jeweiry-likt 
quality,  smooth,  featherlight,  lie  flat  on  uniform 
Names  deeply  engraved  and  lacquered.  Pin 
backs    permanently    swaged    in    (not   glued: 
Choose  lettering  in  Black  or  Blue  (also  White  or 

N°'«9  ""'>"•                ■MHUBBMHiM 
SAVE:  Order  2  identical       l|filHPI| 
Pins  as  precaution  against  MpMlllljf  M 
loss,  less  changing.           V|||pU  1^  p 

^|Mjl  1  Name  Pin  only 
rnniiyz  Plns  (sane  name) 

1.85* 

2.35* 

2.85* 

3.35* 

rQt  ^1  Name  Pin  enljf 
HQE  ^2  Pins  (samt  name) 

.95* 

1.45* 

1.65* 

2.30* 

•IMPOIIUNI;  Please  add  lit  per  order  handiing  charge 
on  all  orders  of  3  pins  or  less. 
6R0UP  DISCOUNTS:  10-24  pins,  deduct  10%;  25-99 
pins.  15%.  100  or  more  pins,  20%. 

^  Send  cash.  m.o..  or  check.  No  billings  or  COD'S 

i 

Mrs.  r.  f.  johwson 

SUPERVISOR 

CHARLENE  HAYNES 


BANDAGE  SCISSORS 


Personalized,  precision-made  forged 
Lister  scissors.  Guaranteed  2  years. 


3V2"  MINI  SCISSORS 

Tiny,  tiandy.  slip  into  uniform  pocket  or 
purse.  Choose  jewelers  Gold  or  gleaming 
Ctirome  plate  finish  on  coupon. 

41/2"  or  5V2''  SCISSORS 

As  above,  but  larger  for  bigger  jobs.  Chrome  finish  only 
Ctioose  No  3500  \^W).  No.  4500  (4yi")  or  No.  5500  \Vh"\ . . .  2.50  ea. 
1  Ooz.  or  more  . . .  $2.00  ea.  Your  initials  engraveil.  add  50<  per  scissors. 


JEWELRY 


kt 


NURSES  CHARMS  ^        .-v 

Finest  sculptured  Fisher  charms,  ^^Sfi?*  ^r^^fe^ 
I  Sterling  or  Gold  Filled  {specify  under  COLOR  on  coupon).    ^  ^9 

For  bracelet  or  pendant  chain.  Add  to  your  collection! 

No.  263  Caduceus:  No.  164  Cap;  No.  68 
I  Grad.  Hat;  No.  &  Band.  Scissors  .  .  3.49  ea. 

14K  PIERCED   EARRINGS 

'  Dainty,  detailed  I4K  Gold  caduceus,  for  on  or  oft  duty 
wear.  Shown  actual  size.  Gift  boxed  for  friends,  too. 
No.  13/297  Earring's 5.95  per  pair. 

PIN    GUARD    Sculptured  caduceus,  chained  ■ 

to  your  professional  letters,  each  with  pinback/ 
safety  catch.  Or  replace  either  with  class  pin  for 
safety.  Gold  finish,  gift  boxed.  Choose  RN.  LPN 
Of  LVN  No.  3420  Pin  Guard 2.95  ea. 


® 


ENAMELED   PINS  Beautifully   sculptured   status 
insignia,  2-color  keyed,   hard-fired   enamel  on  gold  plate. 
Dime-sized,   pin-back.   Specify  RN,   LPN,   PN.  LVN,   NA,  or 
RPh    on  coupon 
No.  205  Enam.  Pin  1.95  ea.,  12  or  more  1.50  ea. 


POCKET  SAVERS 


Prevent  stains  and  wear! 
Smooth,  pliable  pure  white  vinyl.  Ideal 
low-cost  group  gifts  or  favors. 
No.  210-E  (right),  two  compartments 
with  flap,  gold  stamped  caduceus  . . . 
6  for  1.50,  25  or  more  20(  ea. 

No.  791  (left)  Deluxe  Saver,  3  compt., 
change  pocket  i  key  chain  .  .  . 
6  for  2.96,  25  or  more  35*  ea. 


NIGHTINGALE  LAMP 

An  authentic,  unique  favor,  gift  or  engraved 
award!  Ceramic  otf-wfiite  candleholder  with 
genuine  gold  leaf  tnm.  Recessed  candie 
cup  'candle  not  included).  7"  long. 

No  F100S  Lamp  . .  6.95  ea.,  12  or  more  4.95  ea. 
Initials  and  date  engraved  on  gold  plaque  . .  . 
add  1.00  per  lamp. 


NURSES  WATCHES 


Hamilton  17  Jewel 

"Buren"   Calendar   Watch,    17   jewels,   sweep- 
second  hand.  Date  changes  at  midnight  Water,  i 
shock   resis.,   anti-mag.,   unbreak.   mainspring.' 
^  Chrome  fmish.  expan.  bracelet,  1  yr.  guarantee. 
No.  BL53  Ham.  Watch  .  .  .  34.95  ea.. ' 

^^    Endura  Waterproof  Swiss  made,  raised  silver  full 

^^^ft    numerals,   lumin.   markings.   Red-tipped  sweep  second- 

^^*   hand,  chrome  ,■  stainless  case.   Includes  genuine  black 

leather  watch  strap.  1  year  guarantee.  Very  dependable. 

No.  1093  Endura  Watch 19.95  ea. 


BZZZ   MEMO-TIMER    rime  hot  packs,  heat  ^^ 

lamps,  park  meters    Remember  to  check  vital  signs,  S!*-- 

give  medication,  etc.  Lightweight,  compact  i\W  dia.),  iX^ 

set5  to  buzz  5  to  60  min.  Key  ring.  Swiss  made.  \m0'... 

No.  M'22  Timer 3.98  ea. 

3  for  9.75  ea..  6  or  more  3.00  ea. 


EXAMINING  PENLIGHT 

White  barrel  with  caduceus  imprint,  aluminum 
band  and  clip,  5"  long,  U.S.  made,  batteries  included  (re- 
'placement  batteries  available  any  store).  Your  own  light,  gift  boxed. 
No.  007  Penlight  .  .  .  3.96  ea.  Your  Initials  engraved,  add  50<  per  light 


CROSS  PEN 

World-famous  ballpoint,  with 

sculptured  caduceus  emblem.  Full  name 

FREE  engraved  on  barrel  (include  name  with  coupon). 

Refills  avail,  evervwhere.  Lifetime  guarantee. 


MEDI-CARD  SET  Handiest  reference 
ever!  6  smooth  plastic  cards  I3W"  x  5Vz")  cram- 
med with  information,  including  Equivalencies  of 
Apothecary  to  Metric  to  Household  Meas-,  Temp. 
•^C  to  "f.  Prescrip.  Abbr..  Urinalysis,  Body  Chem  , 
Blood  Chem,,  Liver  Tests,  Bone  Marrow,  Disease 
Incub,  Periods,  Adult  Wgts.,  Child's  Dosages,  etc. 
All  in  white  vinyl  holder  with  gold  stamped 
caduceus  No.  289  Card  Set  .  .  .1.50  ea. 
6  or  more  1.25  ea.     12  or  more  1.10  ea. 

Your   initials  gold-stamped   on   holder, 

add  50f  per  set. 


KELLY   FORCEPS  So  teniy  for 

every   nurse!    5^"   stainless   steel,    fully 
guaranteed.  Ideal  for  clamping  off  tubing.  Your 
own  initials  help  prevent  loss. 
C©-4  J£)  No.  25-72  Forceps  . . .  2.75  ea.     6  or  more  2.50  ea. 
Your  initials  engraved,  add  50«  per  forceps. 


PULSOMETER  simplify  pulse-taking!  Min- 
iature hourglass  times  15  seconds  very  accurately. 
Pocket  clip,  or  pins  on  with  9"  removable  chain. 
Chrome  plated,  plastic  box.  Handy,  efficient. 
No.  K-15-E  Pulsometer  2.9S  ea.  3  or  tSort  2.50  ea. 
12  or  more  2.00  ea. 
Engraved  initials,  add  50<  per  Item.      Duty    Free 


i:      :' 


I 


ENT INSTRUMENT  SET 

A  superb  quality  set  for  nurses!  Includes  med, 
handle  with  resistance  regulation,  otoscope 
head,  nose  speculum,  ilium,  tongue  blade 
holder,  5  assort,  ear  reflectors.  Precision 

crafted,  fitted  mto  handsome  velvet- _, 

lined  case.  Powered  by  2  "X"  (^AJi, 

batteries.  Your  initials  engraved  on 
handle  and  gold-stamped  on  case  FREE. 

10  year  guarantee.  Outstanding  value!  

No.  33     ENT  Set  .  .  only  49.95  ea.  Duty   Tre? 


NURSES  BAG  A  lifetime  of  service 
for  visiting  nurses!  Finest  black  Va"  thick 
genuine  cowhide,  beautifully  crafted  with 
rugged  stitched  and  rivet  construction. 
Water  repellant.  Roomy  interior,  with  snap- 
in  washable  liner  and  compartments  to 
organize  contents.  Snap  strap  holds  top 
open  during  use.  Name  card  holder  on  end. 
Two  rugged  carrying  straps,  6"  x  8"  x  12", 
Your  initials  gold  embossed  FREE  on  top.  An 
outstanding  value  of  superb  quality- 
No.  1544-1  Bag  (with  liner) .  .  42.50  ea. 
Extra  liner  No.  4415 8.50 


^       ^SHOE  TOTE    Keep    or    carry 

pL  LJ  shoes  in  this  fine  stitched  white  vinyl 

bag!  Opens  wide,  separate  scuff-proof 

compartment    for    each    shoe.    Zips 

weather-tight,  carrying  strap.  4"  x  6"  x  12". 

No.  444  Tote  .  5.49  ea.     6  or  more  4.50  ea. 

Your  initials  gold-stamped,  add  50c  per  Tote. 


BABY  SCALE  weigh  infants  on  home  visits. 
Precision-made  bronze  cyclinder,  nickel  handle  and 
hook.  Weight  to  15  lbs,  or  7  kg.  White  vinyl./cloth 
sling  holds  infant  securely  for  weighing,  then  folds 
to  form  compact  carry  case.  Useful  and  accurate! 

No.  IN-15  Scale 14.95  ea. 

Your  initials  engraved,  add  50*  per  scale. 


AUTO  INSIGNIA  Full-color  enam 

eiled  RN  insigma  (left)  on  bronze-plated 
medallion.  Easy  to  attach  to  registra- 
tion plate.  Weather-proof,  distinctive. 
No.  210  Medallion  ....  5.95  ea. 
4-color  decal  with  RN  emblem,  transfers 
easily  to  inside  car  window.  AW  dia. 
No.  621  Decal 1.25  ea. 


TRI-COLOR  BALL  PEN 

Write  in  black,  red  and  blue  with  one  ball  point  pen. 
Flip  of  the  thumb  changes  point  (and  color),  Steno  fine  point  (excellent 
for  charts)   Polished  chrome  finish.  A  handy  accessory  for  every  nurse! 

No.  921  Ball  Pen 1.95  ea. 

No.  292-R  3-color  Refills 50<  ea. 


SCRIPTO     PILL     LIGHTER    famous  Scnpto 

Vu-Lighter  with  crystal-clear  fuel  chamber  containing  color- 
lul  array  of  capsules,  pills  and  tablets.  Novel,  unique,  for 
yourself  or  for  unusual  gifts  for  friends.  Guaranteed  by 
Scriplo.  A  real  conversation  piece! 


ms 
dm... 


Personalized 

Littmann  310 

NURSESCOPE® 

Famous  Littmann  nurses  diaphragm 
stethoscope,  with  your  initials  indi' 
vidually  engraved  FREE!  A  fine,  pre- 
cision instrument,  has  high  sensi- 
tivity for  blood  pressures,  general 
ausculation.  Only  IVi  ozs,,  fits  in 
pocket,  23"  vinyl  anti-collapse  tub- 
ing, non-chilling  snap-on  diaphragm, 
non-rotating,  correctly  -  angled  ear 
tubes.  U,  S.  made.  Choose  from  5 
jewel-like  colors.  Goldtone,  Silver- 
tone,   Blue,   Green,   Pink. 

FREE  INITIALS! 

engraved  on  chest  piece,  lends  indi- 
vidual   distinction,    prevents    loss, 
Specify  on  coupon  below. 
No.  216  Nursecope  13.80  ea. 
6-11  ......  ..  12.80  ea. 

Duty    Free 

SCOPE  SACK  neatly  carries  and  pro- 
tects Nursescope  or  any  scope.  Double-thick 
frosted  flexible  plastic,  white  vinyl  binding.  AW 
X  9V2".  Your  own  initials  help  prevent  loss. 
No.  223  Sack.  . .  1,00  ea.  6  or  more  75c  ea. 
Your  initials  go  Ill-stamped,  add  50*  per  sack. 


NURSES  PERSONALIZED 
ANEROID  SPHYG. 

A  superb  instrument  especially 
designed  for  nurses!  Imported  from  pre- 
cision craftsmen  in  W,  Germany.   Easy- 
to-attach  Velcro  cuff,  lightweight,  com- 
pact, fits  into  soft  Sim.  leather  zippered 
case  2V^"  x  4"  x  7".  Dial  calibra- 
ted to  320  mm.,  lO-year  accuracy 
guaranteed  to  :^3  mm.  Serviced  by 
Reeves  if  ever  required.  Your  ini- 
tials engraved  on  manometer  and 
gold  stamped  on  case  FREE,   for 
permanent    identification    and 
distinction.  A  wise  investment  for 
a  lifetime  of  dependable  service! 
No.  106  Sphyg 26.95  ea. 


CAP  ACCESSORIES 


Duty 
Free 


c^3>^ 

CAP  TOTE    keeps   your   caps   crisp   and   clean    .,^ 

while  stored  or  carried.  Flexible  clear  plastic,  white  *-    " 

trim,  zipper,  carrying  strap,  hang  loop.  Stores  flat  Also 

for  wiglets.  curlers,  etc.  8Vi"  dia.,  6"  high.  ' 

No.  333  Tote  . .  2.65  ea..  6  or  more  . .  2.35  ea. 

Your  initials  gold-stamped,  add  50c  per  Tote.  -^" 

WHITE  CAP  CLIPS     hms   caps 

firmly  in  place!  Hard-to-find  white  bobbie  pins. 
enamel  on  fine  spring  steel.  Eight  2"  and  eight 
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names 


Two  new  appointments  have  been  made 
to  the  CNA  Testing  Service:  Henry 
P.  Cousens  as  director  of  administration 
and  Eric  G.  Parrott  as  director  of  test 
development. 


Henry  Cousens 


Eric  ParrotI 


Mr.  Cousens  (B.A.,  Carieton  U., 
Ottawa)  joined  the  Testing  Service  in 
Ottawa  after  23  years  with  the  Canadian 
Armed  Forces.  As  paymaster,  finance 
officer,  comptroller,  and  staff  officer, 
he  was  stationed  in  various  parts  of 
Canada.  He  also  served  one  year  with 
the  United  Nations  Emergency  Force 
in  Egypt  as  assistant  field  cashier.  Dur- 
ing his  military  service  he  received  the 
Canadian  Forces'  Decoration  with 
Clasp. 

A  native  of  Newfoundland,  Mr.  Par- 
rott (B.A.,  Dalhousie  U.,  Halifax; 
M.Ed.,  U.  of  Toronto)  worked  for  the 
past  two  years  in  Toronto's  Boys  Village 
—  a  treatment  center  for  emotionally 
disturbed  children.  At  the  same  time  he 
did  casework  with  boys  and  their  par- 
ents in  the  Child  Guidance  Clinic.  He 
also  worked  for  two  years  on  test  con- 
struction in  the  department  of  measure- 
ment and  evaluation  at  the  Ontario 
Institute  for  Studies  in  Education,  where 
he  is  working  on  a  Ph.D. 

Mr.  Parrott  left  Newfoundland, 
wher?  he  taught  in  elementary  and  high 
schools  for  four  years,  to  join  a  Toronto 
insurance  company.  While  he  was  work- 
ing in  group  insurance  and  computer 
programming  in  the  company,  he 
was  awarded  a  fellowship  in  the  Life 
Management  Institute. 

Marion  Robertson  (R.N.,  Grace  General 
H.,  Winnipeg)  is  the  new  director  of 
nursing  at  the  Elizabeth  M.  Crowe 
Memorial  Hospital  in  Eriksdale,  Mani- 
toba. 

Miss  Robertson  has  had  general  duty 
experience  at  the  Grace  General  Hos- 
pital in  Winnipeg;  the  Fisher  River 
Indian  Hospital  in  Hodgson,  Manitoba; 
the  Wrinch  Memorial  Hospital  in 
Hazelton,  British  Columbia;  the  E.M. 

42     THE     CANADIAN     NURSE 


Crowe  Memorial  Hospital  in  Eriksdale; 
and  the  Brandon  General  Hospital, 
Brandon,  Manitoba. 

■■■■kjl^^  Lan  Gien  has  been 
■j^^^^^^^  appointed  instructor 
^^KHRJIIH  in  medical  -  surgical 
wK^m  ^^k    nursing  at  the  Me- 

^^m  -r^  i^l  morial  University  of 
^H  ^*i^    Newfoundland 

^B  L2iki  School  of  Nursing. 
\S^  A  native  of  Viet 
^•^Ij--^  Nam,  Mrs.  Gien  re- 

*  ceived  a  bachelor  of 

science  in  nursing  degree  at  Loretto 
Heights  College  in  Denver,  Colorado. 
She  has  also  studied  at  the  University 
of  Tunis  in  Tunisia  and  has  done  work 
toward  a  master's  degree  in  medical- 
surgical  nursing  at  New  York  Universi- 
ty- 

Her  work  experience  includes  being 
a  staff  nurse  at  De  Paul's  Hospital  in 
Cheyenne,  Wyoming,  and  at  Geoffrey 
St.  Hilaire  Hospital  in  Paris,  France, 
and  an  instructor  at  St.  John's  General 
Hospital  School  of  Nursing,  St.  John's, 
Newfoundland. 

Mrs.  Gien  is  a  member  of  the  medi- 
cal-surgical nursing  bluepiuit  commit- 
tee for  the  CNA  Testing  Service. 

Louise  Tod  has  been 
apfxjinted  nursing 
consultant  for  hos- 
pital insurance  and 
diagnostic  services 
of  the  health  insur- 
ance and  resources 
branch,  department 
of  national  health 
and  welfare. 
Since  she  graduated  from  the  Royal 
Alexandra  Hospital  in  Edmonton,  Al- 
berta, Miss  Tod  has  taken  a  postgrad- 
uate course  in  neurosurgical  and  neuro- 
logical nursing  at  the  Montreal  Neuro- 
logical Institute,  has  received  a  diploma 
in  administration  hospital  nursing  ser- 
vice from  the  University  of  Saskatche- 
wan, a  bachelor  of  nursing  degree  from 
McGill  University,  and  recently  a  mas- 
ter of  science  degree  from  the  University 
of  Colorado. 

As  a  general  staff  nurse,  Miss  Tod 
has  worked  at  the  Lacombe  Municipal 
Hospital  in  Lacombe,  Alberta;  at  The 
Vancouver  General  Hospital;  at  the 
Royal  Victoria  Hospital  in  Montreal 
and  at  the  University  of  Alberta  Hos- 
pital in  Edmonton.  She  was  also  a  head 


nurse,  clinical  instructor,  and  super- 
visor at  the  University  of  Alberta  Hos- 
pital. The  variety  of  positions  she  has 
held  also  includes  those  of  committee 
coordinator  and  employment  relations 
officer  for  the  Alberta  Association  of 
Registered  Nurses. 

From  1968  to  1970,  Miss  Tod  served 
the  Canadian  Nurses'  Association  as 
chairman  of  the  socioeconomic  commit- 
tee, as  a  member  of  the  executive  com- 
mittee, and  as  a  member  of  the  board 
of  directors. 

Mary     E.     Maclnnis 

(Reg.N.,  Kingston 
General  H.  School 
of  Nursing,  Kings- 
ton. Ont.;  B.Sc.N., 
U.  of  Western  On- 
tario, London)  has 
been  appointed  as- 

Wsociate   director   of 
nursing,  Victoria 
Hospital,  L  ciidon,  Ontario. 

Miss  Maclnnis  has  had  a  wide  variety 
of  experience  in  both  nursing  service 
and  nursing  education.  Before  becoming 
associate  director  of  nursing  she  was  the 
clinical  nurse  coordinator  of  medicine 
at  Victoria  Hospital. 

Roberta  Wallter  has 

been  named  nursing 
consultant  for  the 
Saskatchewan  Reg- 
istered Nurses'  As- 
sociation. Born  in 
Regina,  Miss  Walk- 
er (R.N.,  Regina 
.  GeneralH.;B.Sc.N., 
«»Vi  181.*^    U.  of  Toronto)  was 

a  clinical  instructor  in  pediatric  nurs- 
ing at  the  Regina  General  Hospital  at 
the  time  of  her  appointment  to  SRNA. 
She  has  also  worked  as  a  nursing  super- 
visor at  New  Mount  Sinai  Hospital  in 
Toronto. 

Margaret  Mackling,  district  director  of 
the  Victorian  Order  of  Nurses  for 
Canada,  has  been  appointed  second 
vice-president  of  the  Manitoba  Asso- 
ciation of  Registered  Nurses.  She 
replaces  Sister  T.  Castonguay  who 
has  moved  to  Edmonton,  Alberta. 

Sister  M.  Carignan,  director  of  nurs- 
ing at  St.  Anthony's  Hospital  in  The 
Pas,  Manitoba,  has  been  named  to 
represent  the  nursing  sisterhoods  on  the 
MARN  board  of  directors.  She  replaces 
Sister  I.  Pepin. 

DECEMBER     1971 


names 


The  Registered 
Nurses'  Association 
of  Nova  Scotia  has 
appointed  Dorothy 
Cray  Miller  to  the 
position  of  public 
relations  officer. 

Born  in  Nova 
Scotia,  Mrs.  Miller 
(B.A.,  London)  re- 
cently returned  to 
the  province  from  Kingston,  Jamaica, 
where  she  was  managing  director  of 
Gray-Miller,  advertising  and  public 
relations  consultants.  She  was  also 
editor  and  publisher  of  The  Jamaican 
Magazine. 

Before  working  in  Jamaica,  Mrs. 
Miller  was  publications  officer  at  the 
United  Nations  Information  Office 
in  New  York  and  was  a  member  of  the 
U.N.  Secretariat  in  the  department  of 
public  information. 


Edith  Patten  Lewis  is  the  recently 
appointed  editor  of  Nursing  Outlook, 
the  official  organ  of  the  National  League 
for  Nursing  in  the  United  States. 

During  her  25  years  with  The  Amer- 
ican  Journal  of 
Nursing  Company, 
M  rs.  Lewis  has 
worked  on  all  three 
of  the  company's 
publications.  She  is 
a  former  editor  of 
the  American  Jour- 
nal of  Nursing,  and 
was  the  first  manag- 
ing editor  of  Nurs- 
ing Research  from  1953  to  1958.  Since 
she  was  appointed  editorial  consultant 
for  the  company's  educational  services 
division  in  1971,  Mrs.  Lewis  has  com- 
piled and  edited  The  Clinical  Nurse 
Specialist,  Changing  Patterns  of  Nurs- 
ing Practice,  and  Nursing  in  Cardio- 
vascular Diseases.  She  is  also  author  of 
Nurse:  Careers  Within  a  Career,  pu- 
blished by  the  Macmillan  Company. 

Mrs.  Lewis  is  a  graduate  of  Smith 
College  and  the  Frances  Payne  Bolton 
School  of  Nursing  at  Case  Western  Re- 
serve University  in  Cleveland,  where 
she  earned  a  master's  degree  in  nursing. 

George  H.  Pettifer,  Frobisher  Bay, 
Northwest  Territories;  Ardythe  C. 
Wildsmith,  Halifax,  Nova  Scotia;  Muriel 
Leilh,  Kingston,  Ontario;  and  Beverley 
Andrews,  St.  John's,  Newfoundland, 
were  winners  of  the  spring  1 97 1  Searle- 
Canada  scholarships. 

These  scholarships,  introduced  in 
1969,  cover  tuition  in  family  planning 

DECEMBER      1971 


at  the  United  States  Planned  Parent- 
hood's  International  Clinic  in  Chicago. 
For  the  first  time,  this  year's  winners, 
who  were  chosen  from  66  candidates, 
included  students  from  educational 
health  centers,  as  well  as  public  health 
nurses. 

Mr.  Pettifer  is  responsible  for  super- 
vising 26  public  health  and  staff  nurses 
in  12  nursing  stations  and  health  cent- 
ers in  the  north.  He  expects  to  introduce 
a  family  planning  program  through  the 
public  health  nurses  he  advises. 

Mrs.  Wildsmith  (Reg.  N.,  Nightin- 
gale School  of  Nursing,  Toronto;  Dipl. 
in  P.H.,  and  B.Sc.N.,  U.  of  Toronto) 
is  a  community  health  instructor  at 
the  Victoria  General  Hospital  School 
of  Nursing  in  Halifax. 

Mrs.  Leith,  who  graduated  in  nurs- 
ing in  Melbourne,  Australia,  is  the 
nurse  in  charge  of  health  services  at 
St.  Lawrence  College  of  Applied  Arts 
and  Technology  in  Kingston,  Ontario. 
The  college's  health  service  provides 
daily  health  care  and  counseling  for 
1,400  students  and  staff.  Mrs.  Leith 
is  also  chairman  of  a  newly-formed 
Planned  Parenthood  Association  in 
Kingston. 

Mrs.  Andrews,  the  first  Searle  Schol- 
arship winner  from  Newfoundland, 
is  an  instructor  in  the  General  Hospital 
School  of  Nursing  in  St.  John's.  At 
present,  Newfoundland  has  only  one 
family  planning  clinic,  although  Mrs. 
Andrews  hopes  to  improve  this  situation 
in  the  near  future. 

The  Saskatchewan  Registered  Nurses' 
Association  has  awarded  $10,000  in 
bursaries  to  seven  nurses  studying  for 
baccalaureate  degrees.  SRNA  makes 
bursaries  available  annually  for  post- 
graduate studies  in  baccalaureate, 
master's,  and  doctorate  programs. 

Five  of  these  bursaries  went  to 
nurses  studying  at  the  University  of 
Saskatchewan.  Nora  Sullivan  (R.N., 
Grey  Nuns  H.,  Regina)  received  $  1 ,500 
for  studies  toward  a  bachelor  of  science 
in  nursing  degree.  Ceorgia  Piechotta 
(R.N.,  Moose  Jaw  Union  H.)  and  Patri- 
cia Barkman  {R.N.,  Grey  Nuns  H.)  each 
received  $  1 ,000  to  complete  studies 
for  a  baccalaureate  degree.  Beverley 
Carter  (R.N.,  Regina  General  H.)  was 
awarded  $1,500  toward  a  bachelor  of 
education  degree.  Stella  Pankratz  (B.Sc. 
N.,  U.  of  Sask.),  awarded  $2,000,  is 
continuing  studies  for  a  master's  degree 
in  continuing  education. 

Eunice  Brataschuk  (B.Sc.N.,  U.  of 
Sask.)  and  Eileen  Bourret  (R.N.,  Grey 
Nuns  H.)  received  bursaries  for  their 
studies  at  the  University  of  Western 
Ontario  in  London.  Miss  Brataschuk 
received  $2,000  for  her  work  on  a 
master's  degree  and  Miss  Bourret  re- 
ceived $1,000. 


The  Victorian  Order  of  Nurses  for 
Canada  has  announced  the  following 
appointments  to  senior  positions. 

Dorothea  Atkinson  (R.N.,  The  Mon- 
treal General  H.;  B.N.,  M.N.,  McGill 
U.,  Montreal)  has  been  appointed  an 
assistant  director  of  the  VON  for  Can- 
ada. She  was  previously  districtdirector 
of  the  London-St.  Thomas,  Ontario, 
branch.  Before  working  in  London, 
she  was  assistant  director  of  public 
health  nursing  for  the  Nova  Scotia 
Department  of  Health.  Miss  Atkinson 
has  also  worked  in  staff,  nurse-in- 
charge,  and  assistant  supervisor  posi- 
tions. 

CatherineCannon  (R.N. ,  St.  Boniface 
H.,  St.  Boniface,  Manitoba;  Cert,  in 
P.H.N. .  U.  of  Manitoba;  B.N.,  Colum- 
bia U.,^New  York;  M.N.,U.  of  North 
Carolina)  has  been  named  regional 
director  for  New  Brunswick.  Before 
this  appointment  she  was  assistant 
director  of  the  Vancouver  branch.  Her 
VON  work  has  also  taken  her  to  New- 
foundland, Ontario,  Manitoba,  and 
Alberta. 

Margaret  Standerwick  (R.N.,  The 
Vancouver  General  H.;Cert.  in  P.H.N., 
U.  of  Toronto;  B.N.,  McGill  U.,  Mon- 
treal) is  the  new  VON  regional  director 
for  Alberta  and  Saskatchewan.  For  the 
past  nine  years,  Miss  Standerwick  was 
district  director  of  the  VON  branch  in 
Bumaby,  British  Columbia.  She  has 
been  nurse  in  charge  in  branches  in 
Ontario  and  Alberta. 

Eileen  Healey  Mountain  (Reg.N.,  St.  Jo- 
seph's School  of  Nursing,  London,  Ont.; 
B.  Sc.  N.,  U.  of  Western  Ontario,  Lon- 
don; M.A.,  U.  of  London,  England)  has 
been  appointed  executive  secretary  of 
the  Canadian  Association  of  University 
Schools  of  Nursing.  In  1970,  Mrs. 
Mountain  was  elected  president  of  the 
Ontario  region  of  the  Canadian  Confer- 
ence of  University  Schools  of  Nursing 
—  now  called  CAUSN. 

Previously  an  associate  professor  in 
the  faculty  of  nursing  at  the  University 
of  Western  Ontario,  Mrs.  Mountain 
has  also  been  a  teacher  at  the  Ottawa 
Civic  Hospital,  St.  Joseph's  School  of 
Nursing  in  London,  Ontario,  and  the 
Beal  Secondary  School  in  London. 

Birgit  Tauber,  a  Danish  nurse,  joined 
the  staff  of  the  International  Council 
of  Nurses  in  July  as  nurse  adviser. 

Miss  Tauber  came  to  the  ICN  from 
the  national  health  service  of  Denmark, 
where  she  was  a  nursing  officer*  since 
1961.  In  this  post  she  was  responsible 
for  registration  of  Danish  nurses  follow- 
ing completion  of  their  basic  nursing 
education.  She  also  assisted  Danish 
nurses  applying  for  registration  in 
foreign   countries  and   foreign   nurses 

THE     CANADIAN     NURSE     43 


Next  Month 
in 

The 

Canadian 
Nurse 


•  Directional  Signals  for 
Nursing's  Expanding  Role 

•  What  You  Can  Do  About 
Pollution 

The  Seven-Day  Fortnight 

•  Setting  up  a  Free  Clinic 
for  Transient  Youth 

•  What's  Different  About 
Community  College  Teaching? 


^ 

^^P 


Photo  credits  for 
December  1971 


Halifax  Infirmary,  Halifax, 

N.S.,  p.8 

Dept.  Public  Health,  Halifax, 
N.S.,  p.9 

Dept.  National  Health  & 
Welfare,  Ottawa,  p.27 


names 


seeking  registration  in  Denmark;  plan- 
ned study  programs  for  nurse  visitors  to 
her  country;  did  administrative  and 
advisory  work  in  relation  to  the  train- 
ing of  auxiliary  nurses  and  other  cate- 
gories of  health  personnel;  and  examin- 
ed plans  for  nursing  homes  and  homes 
for  the  aged. 

She  took  her  basic  nursing  educa- 
tion at  Sundby  Hospital,  Copenhagen, 
received  a  nursing  administration  diplo- 
ma from  the  Advanced  School  of  Nurs- 
ing Education  at  Aarhus  University, 
and  studying  under  a  WHO  fellowship, 
obtained  a  certificate  in  nursing  ad- 
ministration from  the  University  of 
Edinburgh,  Scotland. 

Active  in  the  Danish  Nurses'  Organ- 
ization, Miss  Tauber  has  been  a  mem- 
ber of  its  professional  services  com- 
mittee since  1961.  She  is  a  member  of 
the  board  of  directors  of  the  School  for 
Occupational  Therapists  in  Copenha- 
gen and  of  the  Florence  Nightingale 
International  Nurses'  Association. 

The  education  board  of  the  Danish 
health  service  appointed  Miss  Tauber 
secretary,  from  1967  to  1970,  of  a 
working  party  that  prepared  guidelines 
on  the  functions  and  training  of  a  new 
category  of  nursing  personnel  trained  in 
a  two-year  program  to  work  in  geriat- 
rics. 

lean  Isabel  Masten,  director  of  nursing 
at  the  Hospital  for  Sick  Children  in 
Toronto  for  22  years  until  her  retire- 
ment in  1961,  died  suddenly  in  July. 

Educated  in  Canada  and  England, 
Miss  Masten  took  a  course  in  physio- 
therapy at  Guy's  Hospital,  London,  and 
a  course  in  teaching  and  administration 
at  Bedford  College,  University  of  Lon- 
don. Before  she  decided  to  go  into  nurs- 
ing at  the  Hospital  for  Sick  Children, 
she  was  chief  physiotherapist  at  the 
Toronto  General  Hospital. 

Miss  Masten,  a  well-known  Cana- 
dian nurse,  was  president  of  the  Regis- 
tered Nurses'  Association  of  Ontario 
from  1944  to  1945. 

The  Ontario  Division  of  the  Canadian 
Red  Cross  Society  has  announced  that 
Janice  Given,  a  native  of  Port  Colborne, 
has  been  awarded  the  Volunteer  Nurs- 
ing Committee's  $  1 ,000  bursary  for 
1971.  This  award  is  given  to  enable  an 
Ontario  nurse  to  continue  studies  in 
nursing  at  the  degree  level.  Selection 
of  the  successful  candidate  is  made  on 
the  basis  of  training,  nursing  experi- 
ence, and  leadership  qualities. 

Miss  Given  (Reg.N.,  The  Greater 
Niagara   General    H.,    Niagara    Falls, 


Ont.;  Dipl.  N.Ed,  and  B.Sc.N.,  U.  of 
Western  Ontario,  London;  M.A.,  U.  of 
Toronto)  is  a  Ph.D.  candidate  and  plans 
to  return  to  teaching  nursing  after  she 
completes  her  Ph.D.  at  the  University 
of  Toronto.  She  has  had  general  nursing 
experience  as  well  as  experience  teach- 
ing in  two  schools  of  nursing. 

The  University  of  Calgary  School  of 
Nursing  has  announced  the  appoint- 
ment of  four  faculty  members.  Colleen 
Stain  ton,  Fannie  L.  Sparks,  and  Ronald 
S.  Reighley  are  assistant  professors, 
and  Dorothy  Edythe  Huffman  is  an 
instructor. 

Bom  in  Kamloops,  British  Columbia, 
Colleen  Stainton  (R.N.,  The  Vancouver 
General  H.;  B.Sc.N.,  U.  of  British 
Columbia;  M.S.,U.  of  California,  San 
Francisco)  has  worked  as  a  staff  nurse 
at  St.  Vincent's  Hopital  in  Vancouver 
and  in  Sydney,  Australia;  as  an  instruc- 
tor at  Holy  Cross  Hospital,  Foothills 
Hospital,  and  Mount  Royal  College  in 
Calgary,  Alberta.  An  active  member  of 
the  Alberta  Association  of  Registered 
Nurses,  Miss  Stainton  received  a  World 
Health  fellowship  for  1970-7 1 . 

Fannie  Sparks  (R.N.,  Calgary  General 
H.;  B.S.  and  M.S.,  U.  of  California, 
San  Francisco)  was  a  staff  nurse  for  one 
year  at  the  Calgary  General  Hospital 
and  from  1959  to  1968  was  a  staff 
nurse,  assistant  head  nurse,  and  charge 
nurse  in  hospitals  in  Long  Beach  and 
San  Francisco,  California. 

Ronald  Reighley,  assistant  professor 
of  psychiatric  nursing,  has  worked  as 
a  staff  nurse  at  Red  Deer  General 
Hospital,  Red  Deer,  Alberta,  and  as  a 
nursing  instructor  for  two  years  at  the 
Alberta  Hospital  in  Ponoka.  Mr.  Reigh- 
ley (Cert.  Psychiatric  Nursing  and  R.N. , 
Alberta  H.,  Ponoka;  Dipl.  Teaching 
&  Superv.,  B.N.,  M.Sc.(A),  McGill 
U.,  Montreal)  was  awarded  a  Canadian 
Nurses'  Foundation  fellowship  for 
1969-70. 

Dorothy  Huffman  (B.Sc.N.,  U.  of 
Toronto)  has  experience  as  a  staff  nurse 
with  the  Manitoba  Department  of 
Health,  the  Flin  Flon,  Manitoba,  De- 
partment of  Health,  and  the  Calgary 
General  Hospital,  and  was  a  teacher  at 
the  Calgary  General  from  1966  to 
1970.  Mrs.  Huffman  has  been  an 
active  member  of  the  Manitoba  Public 
Health  Association  and  is  currently  a 
vice-president  of  the  Alberta  Associa- 
tion of  Registered  Nurses  and  a  presi- 
dent at  the  district  level.  She  is  also  on 
the  AARN  provincial  council.  sr 


RED  CROSS 

IS  ALWAYS  THERE 
WITH  YOUR  HELP 


+ 


44     THE     CANADIAN      NURSE 


DECEMBER      1971 


research  abstracts 


The  following  are  abstracts  of  studies 
selected  from  the  Canadian  Nurses' 
Association  Repository  Collection  of 
Nursing  Studies.  Abstract  manuscripts 
are  prepared  by  the  authors. 


Lambeth,  Dorothy  M.  (Syposz).  Trends 
for  diploma  programs  in  nursing  in 
Ontario  as  reflected  in  the  nursing 
literature  and  the  opinions  of  select- 
ed nurse  educators. 
Toronto,  1971.  Thesis  (M.A.)  Uni- 
versity of  Toronto. 

Those  who  work  in  a  profession  can 
best  translate  proposals  for  change 
into  reality.  Therefore,  it  seems  that 
changes  in  nursing  education  can  be 
effected  by  members  of  the  nursing 
profession  who  work  in  this  area.  The 
extent  of  their  agreement  may  influence 
trends  in  nursing  education. 

This  study  attempted  to  identify  in 
the  literature  the  major  trends  for  di- 
ploma programs  in  nursing,  to  deter- 
mine to  what  extent  selected  nurse 
educators  were  in  agreement  with 
these  trends,  and  to  what  degree  situa- 
tions in  schools  of  nursing  as  reported 
by  nurse  educators  were  congruent 
with  the  trends. 

Administration  and  organization, 
faculty  qualifications  and  development, 
curriculum,  and  responsibility  for 
students  were  the  four  areas  in  diploma 
programs  in  nursing  for  which  major 
trends  were  identified. 

An  instrument  was  developed  which 
consisted  of  9  questions  on  background 
information  and  60  questions,  in  pairs, 
on  major  trends  in  diploma  schools  of 
nursing.  Each  pair  had  one  question 
on  what  was  believed  "should  be"  the 
trend  for  a  diploma  school  of  nursing, 
and  one  regarding  the  situation  prevail- 
ing in  the  school  of  nursing  where  the 
nurse  educator  was  employed.  Reasons 
were  requested  for  four  of  the  answers 
on  beliefs. 

The  sample  included  all  the  full-time 
nurse  educators  in  six  hospital-based 
diploma  schools  of  nursing  in  Eastern 
Ontario.  Three  of  the  schools  conduct- 
ed two-plus-one  programs,  the  others, 
two-year  programs.  The  responses  of 
140  nurse  educators,  or  93.3  percent 
of  the  sample,  provided  the  data  for  the 
study. 

Studies  of  professions  have  given 
some    indications   that  differences   of 

DECEMBER      1971 


opinion  exist  within  individual  pro- 
fessions, even  within  groups  with 
common  interests,  such  as  nurse  edu- 
cators. This  study  indicated  significant 
differences  among  nurse  educators, 
classified  according  to  certain  charac- 
teristics, in  relation  to  trends  for  diplo- 
ma programs  in  nursing. 

it  was  found  that  the  nurse  educator 
with  a  higher  level  of  education  was 
more  likely  to  agree  with  the  trends  to 
move  diploma  schools  of  nursing  into 
colleges  of  applied  arts  and  technology, 
to  require  a  master's  degree  for  the 
position  of  d  irector,  and  a  baccalaureate 
for  the  position  of  teacher  of  nursing. 
The  nurse  educators  employed  in  two- 
year  programs  were  more  in  favor  of  the 
trend  to  discontinue  the  intern  year 
than  were  those  employed  in  two-plus- 
one  programs.  The  nurse  educator  with 


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the  longer  period  of  experience  in  nurs- 
ing and  nursing  education  was  more 
likely  to  agree  with  the  trend  to  require 
some  experience  in  nursing  for  the  posi- 
tions of  director  and  teacher. 

The  study  revealed  an  apparent  lack 
of  congruence  in  several  areas  of  the 
diploma  programs  between  the  trends 
identified  in  the  literature  and  the 
opinions  of  the  nurse  educators.  The 
actual  trends  in  schools  of  nursing 
need  to  be  investigated.  Change  is 
inevitable  for  diploma  programs  in 
nursing. 

Consensus  within  the  nursing  pro- 
fession, and  particularly  among  the 
nurse  educators  employed  in  the  schools 
who  are  responsible  for  implementing 
change,  may  be  a  force  to  expedite 
innovation.  However,  it  is  apparent 
from  this  study  that  agreement  with  the 
trends  may  vary  according  to  certain 
characteristics  of  individuals. 

Studies  are  needed  to  determine 
what  factors,  both  internal  and  external 
to  diploma  schools  of  nursing,  have  an 
influence  on  the  implementation  of 
change. 


Buder,  Ada  Madeleine.  A  study  of  the 
self  perceptions  of  a  selected  group 
of  recently  widowed  older  people 
concerning  physical  health  ana  use 
of  community  health  resources,  Van- 
couver, B.C.  Thesis  (M.Sc.N.)  U.  of 
British  Columbia. 

Two  questions  were  asked  by  this  ex- 
ploratory-descriptive study.  Does  the 
older  person's  perception  of  his  physi- 
cal health  status  change  following  wi- 
dowhood? Does  the  older  person's  pat- 
tern of  contact  with  community  health 
resources  change  following  widowhood? 
In  order  to  answer  these  questions,  the 
study  surveyed  the  self  perceptions  of 
a  selected  group  of  50  recently  widowed 
older  persons  to  gather  information 
concerning  present  physical  health 
status  and  present  use  of  community 
health  resources,  and  information 
eliciting  whether  or  not  change  in  either 
was  perceived  to  have  occurred  follow- 
ing widowhood. 

A  semi-structured  research  inter- 
view schedule  was  developed  and  used 
to  obtain  the  information  pertinent 
to  the  research  problem.  Fifty  widow- 
ed persons  were  interviewed  in  their 
usual  place  of  residence.  All  were  over 

THE     CANADIAN     NURSE     45 


research  abstracts 


60  years  of  age.  All  had  been  widowed 
more  than  9  but  less  than  12  months 
at  the  time  of  interview. 

An  assumption  made  on  the  basis 
of  experiences  during  the  interviewing 
phase  of  the  study  was  that  the  widowed 
persons  participating  in  the  study,  when 
visited  in  their  own  environment,  show- 
ed a  desire  for  conversation  about  the 
loss  of  the  spouse,  the  details  of  the 
loss,  and  the  aspects  of  widowhood 
which  were  significant  to  them. 

TheWilcoxon-Matched  Pairs  Signed- 
Ranks  Test  was  used  to  test  the  first 
hypothesis  of  the  study.  It  was  conclud- 
ed that  there  was  significant  statistical 
evidence  of  a  difference  in  the  older 
person's  perception  of  his  physical 
health  status  following  widowhood.  A 
majority,  or  78  percent  of  the  study 
group,  reported  an  increase  of  physical 
complaints  and  health  problems  in  the 
year  following  widowhood.  Although 
most  respondents  had  a  positive  attitude 
toward  health,  28  percent  of  the  study 
population  reported  a  decline  in  func- 
tioning ability  over  the  past  year. 

Descriptive  analysis  was  carried 
out  in  relation  to  the  second  hypothesis 
of  the  study.  The  study  found  no  reason 
to  believe  that,  for  the  majority  of  older 
people  who  were  able  to  remain  in  the 
community  following  widowhood, 
increase  in  health  complaints  and  health 
problems  was  accompanied  by  increase 
in  contact  with  community  health 
workers.  Fifteen  persons,  or  30  percent 
of  the  study  group,  reported  such  change 
and  said  they  had  no  contact  with  any 
health  worker  over  the  year.  Fifty 
percentofthe  study  population  reported 
contact  with  health  workers  unchanged 
as  compared  to  a  year  ago.  Of  these 
25  persons,  15  reported  increase  in 
health  complaints  over  the  year.  It  was 
concluded  that,  for  most  of  the  older 
persons  in  the  study  group,  widow- 
hood was  not  accompanied  by  change 
in  pattern  of  contact  with  community 
health  resources. 


Howard,  Frances./l  study  of  the  per- 
ceived learning  needs  of  graduates 
of  a  two  year  diploma  program  in 
nursing  during  the  first  three  months 
of  employment.  London,  Ont.,  197 1 . 
Thesis  (M.Sc.N.)  U.  of  Western 
Ontario. 

This  study  was  conducted  in  the  belief 
that  during  the  initial  months  of  em- 
ployment the  learning  needs  of  the 
graduates  of  two-year  diploma  pro- 
grams differ  from  those  of  graduates 
of  other  types  of  nursing  programs. 
46      THE      CANAniANi      MIIRSF 


Specifically,  the  study  identified:  the 
perceived  learning  needs  that  were  met; 
the  perceived  learning  needs  that  were 
not  met;  by  whom  and  in  what  way  the 
perceived  learning  needs  were  met;  and 
the  graduates' perceptions  of  satisfaction 
with  the  outcome. 

The  sample  for  the  study  included 
graduates  of  a  selected  school  of  nursing 
in  the  province  of  Ontario  who  were 
employed  in  general  hospitals  in  med- 
ical, surgical,  medical/surgical,  pediat- 
ric, obstetric  and  psychiatric  areas. 

Data  were  collected  through  a  ques- 
tionnaire administered  to  respondents 
both  prior  to  and  after  three  months 
of  employment,  and  weekly  diary  en- 
tries during  the  three-month  period. 
Through  the  questionnaire  respondents 
indicated  their  perceived  need  for 
guidance  in  carrying  out  activities 
required  of  general  staff  nurses.  Learn- 
ing needs  perceived  by  the  respondents 
during  the  three-month  period  were 
recorded  in  the  weekly  diary  entries. 
These  learning  needs  were  defined  for 
purposes  of  the  study  as  "a  need  for 
increased  knowledge  and  skills  perceiv- 
ed by  the  nurse  as  necessary  in  the 
performance  of  her  role  as  a  general 
staff  nurse." 

Prior  to  employment  the  majority  of 
the  respondants  perceived  little  or  no 
need  for  guidance  in  providing  patient 
care  and  assisting  in  the  coordination 
of  care,  and  no  need  for  guidance  in 
the  utilization  of  management  skills 
related  to  the  provision  of  patient  care. 

Generally  the  learning  needs  were 
met  to  the  satisfaction  of  the  respond- 
ents. Satisfaction  with  the  outcome 
appeared  to  depend  on  the  manner  in 
which  needs  were  met  rather  than  on 


SAY 
MERRY    CHRISTMAS 

WITH 
CHRISTMAS  SEALS 

IT'S  A  MATTER  OF 
LIFE  AND  BREATH 

FIGHT 

•  EMPHYSEMA 

•  TUBERCULOSIS 

•  OTHER  RESPIRATORY 

DISEASES 


the  category  of  personnel  or  the  method 
used  in  meeting  the  needs.  There  was 
evidence  that  respondents  experienced 
anxiety,  confusion  and  apprehension 
when  meeting  their  learning  needs 
without  additional  assistance.  It  was 
observed  that  the  majority  of  these 
needs  related  to  direct  care  of  individual 
patients  or  groups  of  patients  and  situa- 
tions involving  the  art  of  communica- 
tion. 

The  findings  of  this  study  showed 
that  respondents  were  desirous  of  and 
motivated  to  increase  their  expertise 
in  providing  patient  care.  The  findings 
also  showed  that  the  respondents  wished 
to  develop  their  leadership  skills.  It 
appeared,  however,  that  the  respondents 
perceived  a  need  to  perfect  their  skills 
in  providing  nursing  care  before  they 
could  begin  to  concentrate  on  the  devel- 
opment of  leadership  skills. 

Eleven  recommendations  are  made 
for  improvement  of  hospital  orienta- 
tion and  nursing  education  programs. 
A  need  for  either  'average'  or  'more 
than  average  guidance'  was  perceived 
by  one-third  to  more  than  half  of  the 
respondents  in  assuming  charge  respon- 
sibilities and  in  performing  some  of 
the  activities  required  of  team  leaders. 

The  learning  needs  identified  by 
respondents  in  the  weekly  diary  entries 
indicated  that  their  perceptions  of  need 
for  guidance  prior  to  employment 
were,  to  some  extent,  misconceived. 

The  majority  of  learning  needs,  re- 
ported by  30  of  the  31  respondents, 
involved  activities  related  to  patient 
care. 

Learning  needs  related  to  orientation 
to  the  hospital,  nursing  department  and/ 
or  nursing  unit  were  reported  by  27 
respondents.  These  needs  were  perceiv- 
ed by  respondents  irrespective  of  pre- 
service  clinical  experience  in  the  em- 
ploying hospital;  differences  in  the 
nature  of  these  learning  needs  were  also 
observed.  Respondents  employed  in 
hospitals  where  preservice  clinical 
experience  had  been  obtained  reported 
more  learning  needs  related  to  direct 
patient  care;  those  in  hospitals  where  no 
preservice  clinical  experience  had  been 
obtained  placed  emphasis  on  technical 
care. 

Less  than  1 5  percent  of  the  reported 
learning  needs  involved  management 
and  communication  skills.  These  learn- 
ing needs  were  reported  by  45.2  percent 
of  the  respondents. 

No  appreciable  change  in  respon- 
dents' perceptions  of  need  for  guidance 
after  three  months  employment  was 
observed.  The  majority  of  the  respond- 
ents continued  to  feel  a  need  for  'aver- 
age guidance'  in  assuming  charge  re- 
sponsibilities and  in  performing  some 
of  the  activities  required  of  team  lead- 
ers. 

HFrFMRFR       1971 


Nursing:  Concepls  of  Practice  by  Doro- 
thea E.  Orem.  237  pages.  Scarbo- 
rough, Ont.,  McGraw-Hill,  1971. 
Reviewed  by  Irene  Leckie,  Profes- 
sor, Faculty  of  Nursing.  University 
of  New  Brunswick,  Fredericton, 
New  Brunswick. 

Essentially  the  author  writes  about  a 
design  for  nursing  care  and  the  term, 
practice,  in  the  title  can  be  so  inter- 
preted. In  the  first  chapter  it  is  noted 
"...  that  the  nurse's  role  in  society 
focuses  on  the  maintainance  of  self- 
care  activities  individuals  continuously 
need  to  sustain  life  and  health,  recover 
from  disease  and  injury  and  cope  with 
their  effects."  The  means  by  which 
self-care  activities  are  attained  and 
maintained  is  the  thesis  of  the  book. 

Three  nursing  systems  and  the  de- 
sign for  each  are  described,  ranging 
from  the  first  one  in  which  the  patient 
has  no  acting  role  in  self-care  to  the 
third  in  which  both  the  patient  and 
nurse  take  responsibility  for  the  per- 
formance of  specific  health  care  mea- 
sures. 

There  is  identification  of  factors  that 
interfere  with  self-care  activities  and 
discussion  of  the  means  by  which  the 
nurse  establishes  what  these  are.  A 
classification  of  nursing  situations  is 
suggested  based  upon  the  state  of  the 
individual's  health  and  the  change  in 
focus  required  by  deviations  from  a 
state  of  wellness. 

The  chapter  dealing  with  the  nursing 
process  is  excellent.  The  author  states 
there  are  three  steps  in  its  development, 
and  that  it  is  in  this  process  that  the 
design  of  a  system  evolves.  This  system 
is  in  essence  a  plan  of  care,  the  ultirnate 
goal  being  self-care  to  the  extent  that 
it  is  possible  for  the  patient. 

The  overall  impression  obtained  is 
that  nursing  care  should  continuously 
have  as  its  focus  assisting  and  directing 
each  patient  toward  that  degree  of 
self-care  that  is  feasible  and  reasonable 
for  him.  For  many  this  will  be  a  new 
approach.  It  is  one  that  is  well  worth 
considering. 

Certain  areas  in  the  text  pertain 
specifically  to  nursing  in  the  United 
States,  such  as  the  legal  qualifications 
for  nursing,  and  nursing  organizations 
that  exist  in  that  country.  In  the  final 
chapter  "Nursing  and   the  Law""  one 

DECEMBER      1971 


should  note  that  there  are  differences 
in  the  court  systems  in  Canada  and 
differences  in  provincial  and  state  laws. 
This  book  is  worthy  of  the  thoughtful 
consideration  of  practitioners  of  nurs- 
ing, students  or  graduates. 

Renewal  for  Nursing  by  Myra  E.  Le- 
vine.  204  pages.  Philadelphia,  F.A. 
Davis  Company,  1971.  Canadian 
Agent:  McGraw-Hill,  Scarborough, 
Ontario. 

Reviewed  by  B.  Burton,  Teacher, 
Refresher  Courses  for  Nurses,  Brit- 
ish Columbia  Institute  of  Technol- 
ogy, Vancouver,  B.C. 

Myra  Levine,  an  associate  professor  of 
nursing,  commences  her  paperback 
with  an  introduction  to  nurses,  nursing, 
and  the  changing  community.  The 
stress  is  on  "the  individual  who  must 
enter  upon  patienthood  in  the  modern 
hospital  and  is  increasingly  unable  to 
discover  individualization  in  his  care." 
A  brief  mention  is  also  made  of  the 
hyperbaric  unit,  intensive  care  units, 
and  postanesthetic  rooms. 

The  nursing  concepts  of  the  central 
nervous  system  integration  stresses  the 
four  survival  needs.  Factors  such  as 
pain,  disease,  and  drugs  interfere  with 
this  integration.  Under  the  nursing 
concepts  of  hormonal  integration, 
concentration  is  on  management  of  the 
diabetic. 

Disturbances  of  homeostasis  empha- 
size the  importance  of  respiratory, 
and  fluid  and  electrolyte  balance.  Other 
chapters  cover  problems  encountered 
with  the  cancer  patient  and  the  moral, 
legal,  and  social  issues  of  transplants. 

The  last  chapter  covers  the  new 
field  of  nursing  research.  The  import- 
ance of  sleeping,  the  activity  of  the 
sleep-wakefulness  cycle,  and  problems 
that  arise  when  the  patient  is  confined 
to  the  hospital  are  mentioned. 

Throughout  the  book,  the  key  points 
are  emphasized  in  cartoons,  and  each 
chapter  ends  with  a  list  of  practical 
suggestions  for  implementing  content. 
At  the  end  of  the  book  is  a  bibliography 
of  paperbacks. 

This  easily  read  book  gives  the  in- 
active nurse  a  good  preview  of  the 
new  changes  in  nursing  care;  it  would 
be  beneficial  for  her  to  read  it  before 
taking  a  refresher  course. 


Newton's  Geriatric  Nursing,  5ed.,  by 
Helen  C.  Anderson.  362  pages.  Saint 
Louis,  C.V.  Mosby  Company,  1971. 
Reviewed  by  D.  Ross,  Instructor  in 
Medical-Surgical  Nursing,  School 
of  Nursing,  Regina  General  Hospital, 
Regina,  Saskatchewan. 

This  book  provides  instruction  to  nurses 
who  are  to  evaluate  the  individual's 
needs  and  care  for  the  increasing  num- 
bers of  elderly  persons  in  the  popula- 
tion. 

Consideration  is  given  to  past  and 
present  social  and  economic  forces  af- 
fecting the  elderly.  The  nursing  care 
described  is  based  on  updated  scientific 
principles  and  practices.  The  author 
describes  the  elderly  person  as  "one 
in  which  the  spirit  is  ageless,  even 
though  it  must  look  out  from  slowing, 
altering  and  aging  physical  features." 
This  refreshing  image  highlights  the 
four  well-organized  parts  of  the  book; 
throughout  we  view  the  elderly  person, 
not  as  a  remnant  of  a  life  style  gone  by, 
but  as  an  interesting  individual  grown 
old,  retaining  immeasurable  individual 
worth  and  a  wish  to  remain  indepen- 
dent, to  think  and  to  make  decisions  for 
himself  in  a  changing  society. 

Part  I  focuses  on  various  practical 
perspectives  of  the  aged  population, 
comparing  statistics  of  1900  with  the 
present  and  predicting  for  the  future 
that  "dependent  old  age  as  we  perceive 
it,  is  no  longer  the  next  generation  past 
middle  age.  It  is  two  generations  be- 
yond." 

Systematic  consideration  is  given  to 
the  problem  areas  of  income,  housing, 
transportation,  occupation  and  attitudes 
of  the  older  and  younger  individuals  of 
society.  The  author  points  out  that  older 
individuals  rarely  think  of  themselves 
as  old;  others  are  just  getting  younger. 
Yet  most  retirees  at  65  years  of  age 
must  cope  with  physiological  changes 
plus  such  variables  as  a  reduced  income 
of  75  percent,  thus  often  a  move  from 
the  familiar  environment  to  dwelling 
with  less  conveniences.  The  problem 
defined,  the  author  challenges  the  read- 
er with  possible  solutions. 

Part  II  focuses  on  the  maintenance 
of  health  for  the  elderly,  primarily 
through  prevention  of  illness  and  next 
by  minimizing  secondary  complica- 
tions of  trauma  or  disease.  If  the  elderly 

THE     CANADIAN     NURSE     47 


measure  health  as  the  absence  of  pain 
and  in  retained  functional  ability,  as 
the  author  suggests,  how  are  they  to  be 
stimulated  to  seek  frequent  check-ups 
at  already  strained  facilities?  (It  is  no 
longer  compulsory  through  employ- 
ment.) Well  aged  clinics,  styled  after 
well  baby  clinics,  might  identify  and 
follow  up  special  health  needs  of  these 
individuals. 

Part  III  focuses  on  clinical  practice 
in  geriatric  nursing.  Economic,  cultural, 
and  educational  components,  the  com- 
mon physiological  changes  plus  the 
decrease  of  energy  and  motivation  are 
incorporated  in  planning,  implement- 
ing, and  evaluating  care.  Problems  of 
the  elderly,  nursing  measures,  and  res- 
ponsibilities are  discussed  in  areas  of 
nutrition,  general  physical  and  mental 
hygiene,  rehabilitation,  and  operative 
care.  Maintaining  the  patient's  sense 
of  personal  worth  is  emphasized. 

Part  IV  relates  to  nursing  older 
persons  with  selected  diseases,  focusing 
on  the  need  for  early  diagnosis  and 
comprehensive  follow-up.  Normal 
physiologic  changes  are  related  to  com- 
mon conditions  affecting  each  system. 
Due  coverage  is  also  given  to  meta- 
bolic disorders  and  cancer. 

Because  of  its  wide  scope  of  cover- 
age of  the  aged  population  and  easily 
understood  terminology,  this  book  lends 
itself  well  to  use  by  students  and  teach- 
ers of  nursing  and  the  social  sciences. 

Principles  ofObstetrics  and  Gynecology 
for  Nurses,  2ed.  by  Josephine  lorio. 
413  pages.  Saint  Louis,  C.V.  Mosby 
Co.,  1971.  Reviewed  by  Barbara 
Bellhouse,  Instructor,  The  Royal 
Columbian  Hospital  School  of  Nurs- 
ing, New  Westminster,  B.C. 

Many  gynecologic  problems  are  directly 
and  closely  related  to  obstetrics,  and 
the  author  skillfully  combines  obstetric 
and  gynecologic  nursing  in  this  text. 

The  current  concept  of  family-center 
ed  nursing  is  the  theme  throughout  this 
book  and  should  stimulate  the  reader  to 
think  about  and  plan  for  the  care  of 
families  during  the  reproductive  years. 

The  book  is  set  out  in  five  units  deal- 
ing with  reproduction,  maternity  cycle, 
deviations  from  the  normal,  and  the 
interpregnancy  period. 

Each  chapter  ends  with  a  list  of  se- 
lected references  and  questions,  most 
of  which  are  situational  and  test  ability 
to  think  through  the  problem  and  arrive 
at  a  suitable  solution.  Illustrations  are 
numerous  and  help  to  explain  the 
content  appropriately. 

48     THE     CANADIAN      NURSE 


The  chapter  "Unmarried  Parents" 
is  informative,  well  written,  and  reflects 
the  concern  shown  for  youth  today. 
A  well-worded  philosophy  about  the 
care  of  unmarried  parents  sums  up  this 
chapter.  "They  (unmarried  mothers) 
need  something  as  simple  and  wonder- 
ful as  human  interest.  They  need  some- 
one strong  enough  to  share  the  responsi- 
bility they  cannot  carry,  to  give  the 
direction  they  lack,  and  to  provide  the 
structure  which  can  put  controls  on 
their  destructive  behavior  and  encour- 
age what  strengths  they  do  have.  In 
other  words,  they  need  protective 
authority  that  will  keep  them  out  of 
trouble  instead  of  punishment  after 
they  are  already  in  it." 

This  book  presents  ideas  that  stu- 
dents, staff  members,  and  instructors 
should  find  valuable  in  relation  to  the 
field  of  obstetric  and  gynecologic  nurs- 
ing. 

Maternity  Nursing,  12ed.,  by  E.  Fitz- 
patrick  et  al.  638  pages.  Toronto, 
J.B.  Lippincott Company,  1971. 
Reviewed  by  Maybelle  M.  Owen, 
formerly  of  the  University  of  Sas- 
katchewan School  of  Nursing,  Sas- 
katoon, Saskatchewan. 

Three  new  chapters  have  been  added  to 
the  twelfth  edition  of  this  familiar 
obstetrical  text:  social  factors  in  ma- 
ternal care;  patient  teaching;  and  fetal 
diagnosis  and  treatment. 

The  chapter  on  social  factors  ex- 
amines some  interesting  concepts:  the 
social  and  cultural  meaning  of  preg- 
nancy; sociocultural  patterns  in  an- 
tenatal care;  poverty;  and  the  sick 
role,  illness,  and  pregnancy. 

The  chapter  on  patient  teaching 
highlights  a  few  major  principles  of 
teaching  but  focuses  mainly  on  group 
teaching  of  patients  in  preparation  for 
childbirth.  Other  aspects  of  teaching 
are  integrated  throughout  the  text. 

The  unique  and  well  written  chapter 
on  fetal  diagnosis  and  treatment  is  a 
valuable  addition  since  it  examines 
some  specific  fetal  problems  and  re- 
views the  present  status  of  fetal  medi- 
cine. Some  of  the  topics  discussed  are 
fetal  electrocardiography,  amniocent- 
esis, fetal  blood  studies,  estriol  studies, 
and  acute  and  chronic  fetal  distress. 

Another  major  change  is  reflected 
in  the  deletion  of  the  chapter  on  mental 
hygiene  of  pregnancy  and  the  inclusion 
of  mental  health  concepts  as  an  inte- 
gral part  of  maternity  care.  Various 
other  revisions  have  been  made  to 
update  the  contents  and  incorporate 
new  developments  and  approaches. 
The  chapter  on  the  care  of  the  pre- 
mature infant  has  been  rewritten  to 
include  recent  knowledge  of  the  diagno- 
sis and  classification  of  low  birth-weight 


infants,  as  well  as  the  medical  and 
nursing  management  of  such  infants. 

It  is  unfortunate  that  a  book  of  this 
caliber  does  not  publish  a  Canadian 
edition  so  that  Canadian  nurses,  like 
American  ones,  can  have  available  an 
up-to-date,  readable  introduction  to 
obstetrics,  which  is  firmly  embedded  in 
a  familiar  domestic  context. 

Nursing  Care  of  the  Patient  with  Gastro- 
intestinal Disorders  by  Barbara  A. 
Given  and  Sandra  J.  Simmons.  271 
pages.  Saint  Louis,  C.V.  Mosby 
Company,  1971. 

Reviewed  by  Jane  C.  Haliburtpn, 
Director  of  Education,  Yarmouth 
Regional  Hospital,  Yarmouth,  N.S. 

The  authors'  intent  as  stated  in  the 
preface  is  "to  provide  the  nurse  prac- 
titioner and  student  with  a  practical 
guide  for  care  of  the  patient  with  com- 
mon gastrointestinal  disorders." 

This  is  a  reference  book  for  a  special- 
ty area. 

In  clear  language  the  authors  indicate 
the  scientific  background  for  the  nurs- 
ing activities  discussed.  A  distinction  is 
made  between  activities  that  support 
the  physician  in  his  diagnosis  and  deci- 
sion making  and  activities  that  involve 
independent  nursing  judgment  and 
responsibility.  The  concept  that  the 
nurse  must  know  herself  and  be  sensitive 
to  the  patient  in  order  to  understand 
reactions  and  behavior  and  make  accu- 
rate nursing  diagnosis  and  interventions 
is  a  strand  throughout  the  book. 

There  is  mention  of  the  importance 
of  patient  and  family  teaching;  how- 
ever, my  overall  criticism  is  that  this 
aspect  should  have  received  more  atten- 
tion. 

Focusing  on  institutional  care,  this 
book  is  a  significant  contribution  to  the 
current  effort  to  develop  inservice  edu- 
cation programs.  It  should  prove  use- 
ful to  any  student  interested  in  nursing 
patients  with  gastrointestinal  disorders. 

Textbook  of  Anatomy  and  Physiology 

3ed.,  by  Catherine  Parker  Anthony 

and  Norma  Jane  Kolthoff.  580  pages. 

St.   Louis,  C.V.   Mosby  Company, 

1971. 

Reviewed  by  Larraine  Smith,  Head 

Nurse,  Moose  Jaw  Union  Hospital, 

Moose  Jaw,  Saskatchewan. 

In  the  preface  of  this  edition,  the  author 
states  as  her  purpose  "to  improve  upon 
the  second  edition."  To  this  end.  revi- 
sions in  both  organization  and  content 
have  been  made. 

Organizational  revisions  are  seen 
mainly  in  the  third  unit,  where  the 
chapter  on  the  nervous  system  has  been 
reorganized,  and  a  chapter  on  the  endo- 
crine system  has  been  included. 

DECEMBER      1971 


Extensive  revisions  in  content  occur 
in  the  introductory  chapter,  and  to  a 
lesser  extent  in  the  chapters  on  cells 
and  the  circulatory  system.  Review 
questions  have  been  revised.  Reference 
readings  have  been  updated.  Also, 
throughout  the  text  are  more  inclusions 
of  changes  in  body  structure  and  func- 
tion resulting  from  age. 

An  entirely  new  unit  entitled  "Stress" 
has  been  written,  which  discusses  phy- 
siological stress,  psychological  stress, 
and  their  relationship  to  disease. 

The  revisions  in  this  edition  warrant 
its  continued  use  as  a  favored  choice 
of  nurse  educators  of  both  students  and 
graduates. 

Infant  Feeding  &  Feeding  Difficulties, 

4cd.,  by  Ronald  McKeith  and  Chris- 
topher Wood.  260  pages.  London, 
J.  &  A.  Churchill,  1971.  Canadian 
Agent:  Longmans,  Don  Mills,  On- 
tario. 

Reviewed  by  E.  Hornby,  Clinical 
Instructor,  Halifax  Infirmary,  School 
of  Nursing,  Halifax  N.S. 

Doctors  Ronald  MacKeith  and  Christo- 
pher Wood  state  in  the  preface  to  the 
fourth  edition,  "The  physiology  and 
practice  of  infant  feeding  is  a  very 
actively  advancing  part  of  medical 
knowledge.  It  is  the  responsibility  of 
doctors  to  bring  these  advances  into 
everyday  practice." 

Since  the  last  edition  of  this  book, 
published  in  1958,  marked  changes 
and  new  knowledge  have  necessitated 
much  revision  and  rearrangement.  The 
product  of  this  revision  contains  much 
of  value  to  all  those  who  are  involved 
in  any  way  with  infant  feeding. 

The  authors"  belief  that:  ".  .  .  .  the 
child  is  laying  the  foundation  of  the 
bodily  and  mental  health  of  his  adult 
life.  This  will  thus  be  influenced  bv  the 
feeding  he  has  in  this  first  year.  .  .  ." 
stands  out  in  this  work.  Emphasis  is 
placed  on  the  importance  of  common- 
sense  advice  on  nutrition  in  pregnancy 
and  practical  training  in  "parentcraft" 
(a  term  commonly  used  in  British 
publications).  The  value  of  group 
discussions  is  pointed  out,  and  there 
are  helpful  suggestions  for  those  inter- 
ested in  setting  up  or  conducting  classes 
for  parents. 

The  authors  deal  specifically  with 
breast  and  bottle  feeding,  feeding 
patterns  and  schedules,  and  the  care  of 
the  breasts  and  nutrition  during  lac- 
tation. Because  of  the  prevalence  of 
bottle  feeding,  this  topic  is  discussed 
at  length.  However,  emphasis  on  the 
advantages  of  breast  feeding  seems  to 
crop  up  under  practically  every  topic 
covered  in  the  book. 

The  section  dealing  with  the  more 
common  feeding  problems  is  excellent 
in  content  and  clarity.  The  same  may 

DECEMBER      1971 


be  said  of  those  dealing  with  anomalies 
and  diseases  of  each  area  of  the  gastro- 
intestinal tract,  from  mouth  to  anus. 
Other  more  complex  causes  of  feeding 
disorders  are  adequately  presented: 
food  intolerances  and  deficiency  syn- 
dromes (vitamin,  mineral,  protein, 
calorie  deficiency).  Emphasis  is  plac- 
ed on  the  preventive  aspects  of  these 
disorders,  but  the  general  principles  of 
treatment  and  the  more  common  com- 
plications are  also  considered. 

The  more  common  metabolic  disor- 
ders are  dealt  with  briefly  and  simply. 
Admittedly,  discussion  of  all  problems 
of  faulty  metabolism  is  beyond  the 
scope  of  this  work. 

Practical  procedures  are  presented 
in  the  final  chapter  and  include  those 
procedures  most  commonly  used  in  the 
treatment  of  infants  with  feeding  disor- 
ders. The  illustrations  are  very  good. 

Ihe  35  pages  that  make  up  the 
appendixes  are  rich  in  graphs  and 
tables  with  helpful  directives  for  correct 
interpretation. 

Infant  Feeding  and  Feeding  Diffi- 
culties may  be  somewhat  complex  for 
the  lay  reader,  but  I  would  consider  it 
excellent  reference  material,  providing 
an  immense  amount  of  accurate  infor- 
mation presented  in  a  manner  enjoy- 
able to  read. 

The    Yearbook    of   Nursing    VIII.    213 

pages.  Helsinki,  Finland,  The  Foun- 
dation for  Nursing  Education,  1 97 1 . 

The  Yearbook  of  Nursing  VIII  (written 
in  Finnish  and  Swedish,  with  compre- 
hensive summaries  in  English)  contains 
reports  on  research  of  current  interest, 
together  with  articles  on  public  health 
care,  on  nursing  education  and  experi- 
ments concerned  with  the  development 
of  nursing,  the  hospital  in  history,  and 
the  activities  of  the  international  organ- 
ization of  nurses. 

Mari  Airio  has  conducted  a  survey, 
sponsored  by  The  Association  of  Public 
Health  Nurses,  of  morbidity  among 
public  health  nurses  and  their  use  of 
medical  services.  The  investigation 
compares  the  morbidity  of  public  health 
nurses  with  that  of  women  in  four  other 
occupational  groups.  It  also  provides 
information  on  whether  public  health 
nurses  make  greater  use  of  medical 
services  as  a  result  of  their  public 
involvement  in  the  health  care  field. 

What  are  the  strongest  sales  points 
of  health?  How  should  the  product  of 
health  care  —  health  —  be  marketed 
to  compete  most  effectively  with  other 
demands  for  society's  resources?  In 
addition  to  these  problems,  Hannu 
Vuori  discusses  investigations  showing 
the  economic  significance  of  health 
care.  The  article  motivates  the  planning 
and  implementation  of  health  education 
to  achieve  fixed  goals. 


Katie  Eriksson  analyzes  problems 
concerned  with  nursing  education  in 
a  report  on  her  empirical  investigation 
"An  analysis  of  the  education  of  nurses 
on  the  basis  of  a  theoretical  model 
from  educational  science."  The  investi- 
gation gives  many  suggestions  and  ideas 
suitable  for  implementation.  A  full 
definition  of  the  aims  of  nursing  educa- 
tion also  requires  a  description  of  the 
function  and  character  of  a  nurse's 
work. 

How  are  nurses  selected  for  profes- 
sional training?  What  part  does  infor- 
mation gained  from  aptitude  tests  play 
in  the  opinion  of  the  psychologist?  Is 
it  true  that  aptitude  tests  favor  passive 
individuals  and  exclude  more  active 
applicants?  These  questions  form  the 
subject  of  Matti  Tuukkanen's  article 
"Aptitude  tests  in  colleges  of  nursing." 

Achievement  of  patient-oriented 
nursing  is  a  crucial  problem  in  the 
development  of  nursing.  How  can  we 
ensure  a  high  level  of  nursing  care  to 
hospital  and  outpatient  departments? 
Does  the  systematic  planning  of  nurs- 
ing care  offer  a  solution,  and  what  ex- 
perience do  we  derive  from  experiments 
with  nursing  care  plans?  Ritva  Virtanen 
suggests  a  solution  in  her  article  "Fac- 
tors affecting  the  nursing-care  plan." 

Leena  Kakkola  reports  on  the  ex- 
perimental use  of  discussion  groups 
in  a  general  hospital.  The  experience 
gained  should  encourage  further  ex- 
periments and  a  development  of  this 
activity.  Marjatta  Eskola  comments  on 
the  experiment:  "In  group  work,  it  is 
the  group  process  that  must  be  empha- 
sized. Even  a  group  which  meets  only 
once  provides  a  valuable  opportunity 
for  communication." 

Arja  Kallanranta  writes  on  the  use 
of  family  therapy  in  mental  health  care. 
The  author  describes  the  theoretical 
background  and  technique  of  various 
forms  of  family  therapy.  This  article 
provides  objective  information  on  how 
consideration  of  the  family  unit  as  a 
whole  can  be  of  decisive  importance 
in  the  treatment  of  mental  disturbances. 

Hertta  Tirranen  has  contributed  a 
historical  essay  on  "Institutional  life 
around  the  year  1800,"  describing  the 
attitudes  of  people  at  that  time  to 
quarantine  regulations,  "lunatic  asy- 
lums," and  prison  life. 

Margarethe  Kruse  gives  a  compre- 
hensive "close-up"  of  the  International 
Counc  il  of  N  u  rses.  The  fu  11  range  of  the 
ICN's  activities  is  presented  to  the 
reader,  who  receives  not  only  a  descrip- 
tion of  the  present  situation  but  also  an 
interesting  view  of  the  future  with  its 
many  challenges. 

In  another  article  in  the  international 
nursing  scene,  Ingrid  Hamelin  asks 
every  nurse  to  consider  her  own  person- 
al attitude  to  the  international  collabo- 
THE     CAN/^IAN     NURSE     49 


ration  which  exists  among  professional 
bodies  of  nurses.  The  importance  of 
international  collaboration  is  emphasiz- 
ed. 

BabySurgery:  Nursing Managementand 

Care  by  Daniel  G.  Young  and  Barbara 
F.  Weller.  183  pages.  Aylesbury, 
England,  Harvey  Miller  and  Medcalf 
Ltd.,  1971. 

Reviewed  by  Gwen  Comthwaite, 
Teacher,  First  Year  Program,  Grace 
General  Hospital,  School  of  Nursing, 
Winnipeg,  Manitoba, 

This  book  is  concerned  with  the  sur- 
gery and  nursing  care  of  infants  under 
one  year  of  age.  It  has  been  clearly 
divided  into  systems,  giving  an  outline 
of  the  conditions  of  each  system  requir- 
ing surgery.  The  book  contains  excel- 
lent illustrations,  131  diagrams  and 
photographs  of  the  various  conditions 
and  operative  procedures. 

The  book  contains  an  introductory 
section  that  is  concise  and  offers  a  quick 
reference  to  the  immediate  care  of  the 
infant  requiring  surgery.  This  is  pres- 
ented as  a  review,  pointing  out  the 
differences  between  the  older  patient 
and  the  infant. 

A  brief  introduction  to  the  psycho- 
logical trauma  of  the  family  of  an  infant 
requiring  surgery  is  presented.  The 
final  section  of  the  introduction  deals 
with  resuscitation  of  the  infant. 

This  book  is  an  adequate  reference 
book  for  students,  in  conjunction  with 
their  textbook  material.  It  could  also 
be  used  by  pediatric  nurses  as  a  quick 
reference  to  nursing  problems  of  the 
infant  surgical  patient. 

The  book  has  been  written  in  a  con- 
cise and  understandable  manner  by  a 
doctor  and  nurse-teacher,  both  con- 
cerned with  the  care  of  the  pediatric 
patient.  There  are  few  books  written 
on  this  topic  and  1  feel  this  book  offers 
the  material  needed  for  quick  reference. 


Library  Loan  Service 

As  usual,  mailing  of  material  on  loan 
for  the  library  will  be  curtailed  over 
the  holiday  mailing  season.  Loans  will 
not  be  mailed  out,  therefore,  between 
December  1,  1971  and  January  5, 
1972. 


accession  list 


Publications  on  this  list  have  been 
received  recently  in  the  CNA  library 
and  are  listed  in  language  of  source. 

Material  on  this  list,  except  reference 
items  may  be  borrowed  by  CNA  mem- 
bers, schools  of  nursing  and  other 
institutions.  Reference  items  (theses, 
archive  books  and  directories,  almanacs 
and  similar  basic  books)  do  not  go  out 
on  loan. 

50     THE     CANADIAN     NURSE 


BOOKS  AND  DOCUMENTS 

1.  Action  communications:  the  creation 
of  multimedia,  multi-screen  presentations 
by  community  groups.  OUawa,  Canadian 
Council     for     International     Co-operation, 

I    1970.  1  vol. 

2.  Associate  degree  education  for  nurs- 
ing—  current  issues,  1971.  Papers  presented 
at  tlie  fourth  conference  of  the  Council  of 
A.ssociate  Degree  Programs  held  at  Washing- 
ton. D.C..  March  3-5.  1971.  New  York, 
National  League  for  Nursing,  Dept.  of 
Associate  Degree  Programs.  1971.  69p. 

3.  Basic  chemistry;  a  programmed  pre- 
sentation, by  Stewart  M.  Brooks.  2d  ed.  St. 
Louis,  Mo.,  Mosby,  1971.  1 18p. 

4.  Biologic  humaine  et  hygiene.  Quebec. 
Universite  Laval,  Extension  de  Penseigne- 
ment  cours  d'infirmieres,  1966.  67p. 

5.  Canadian  government  programmes 
and  services;  government  organization,  1971 . 
Don  Mills,  Ont.,  CCH  Canadian  Limited. 
1971, 419p. 

6.  Classification  medicate  de  la  "National 
Library  of  Medicine".  Version  fran^aise 
etablie  d'apres  la  3.  ed.  rev.,  par  Genevieve 
Nicole  et  Manuel  Nicole.  Paris,  Gauthier- 
Villars,  1970.  301p.  R 

7.  Developing  attitude  toward  learning,  by 
Kobert  L.  Mager.  Palo  Alto,  Calif..  Kearon. 
C1968.  I04p. 

8.  Directory  1971.  Toronto,  Professional 
Photographers  of  Canada,  Inc..  1971.  46p. 

9.  Directory  of  Canadian  non-government- 
al organizations  engaged  in  international 
development  assistance.  Ottawa,  Canadian 
Council  for  International  Cooperation.  1970. 
28  5  p. 

10.  Duncan's  dictionary  for  nurses,  by 
Helen  A.  Duncan.  New  York.  Springer. 
cl971.386p. 

11.  hconomic  consultative  bodies:  their 
origins  and  institutional  characteristics, 
by  Paul  Malles.  Ottawa,  Information  Canada, 
1971.  239p. 

12.  Educalioiuil  tools  for  liealth  personnel, 
by  Muriel  Bliss  Wilbur.  New  York,  Mac- 
mi  llan.  c  1968.  274p. 

13.  Health  care  in  transition:  directions 
for  the  future,  by  Anne  R.  Somers.  C  hicago. 
ML.  Hospital  Research  and  Educational 
Trust,cl97I.  176p. 

14.  Man:  a  holistic  conception  for  nurs- 
ing, by  Laye  E,  Spring.  Cleveland.  Case 
Western  Reserve  University,  Frances  Payne 
Bolton  School  of  Nursing,  1969.  76p. 

15.  Manitoba  authors.  Ottawa.  National 
Library.  1970.  1  vol. 

16.  Maternity  nursing;  a  textbook  for 
practical  nurses,  by   Inge  J.   Bleier.   3d  ed. 


Toronto,  Saunders,  1971.  298p. 

17.  New  buildings  on  campus;  six  designs 
for  a  college  comtnunicalions  center.  New 
York,  Educational  Facilities  Laboratories, 
C1963.  1vol. 

18.  Newton's  geriatric  nursing,  by  Helen 
C.  Anderson.  5th  ed.  St.  Louis,  Mo.,  Mosby. 

1971.  362p. 

19.  Practical  nursing:  study  guide  and 
review,  by  Zella  von  Gremp  and  Lucille 
Broadwell.  3d  ed.  Toronto,  Lippincott, 
cl971.443p. 

20.  Precautions  in  the  management  of 
patients  who  have  received  therapeutic 
amounts  of  radionuclides;  recommenda- 
tions. Washington,  National  Council  on 
Radiation  Protection  and  Measurements, 
1970.  61  p. 

21.  Repertoire  des  organ ismes  non-gou- 
vernementaux  canadiens  engages  dans  des 
programmes  d'aide  au  developpement  in- 
ternational. Ottawa,  Conseil  canadien  pour 
la  cooperation  internationale,  1970.  285p. 

22.  Reprints.  Washington.  Association 
Management.  1969-70.  1  vol. 

23.  Soins  infirm iers  en  medecine  et  chi- 
rurgie.  2.ed.  Quebec,  Universite  Laval, 
Extension  de  I'enseignement  cours  d'infir- 
mieres, 1968.  127p. 

24.  Soins  infirmiers  en  obstetrique.  2.  ed. 
Quebec,  Universite  Laval,  Extension  de 
Penseignement  cours  d'infirmieres.  1969. 
5lp. 

25.  Soins  infirmiers  en  psychiatric.  2.  ed. 
Quebec,  Universite  Laval.  Extension  de 
I'enseignement  cours  d'infirmieres.  1969. 
56p. 

26.  Soins  infirmiers  en  puericulture  et 
pediatric.  2.  ed.  Quebec,  Universite  Laval, 
Extension  de  I'enseignement  cours  d'infir- 
mieres, 1969.  92p. 

27.  The  teaching  of  social  and  behavioural 
.•sciences  in  Canadian  medical  schools  in 
1970;  working  papers  of  Conference  on 
Social  Science  and  Medicine  in  Canada, 
2iul,  Winnipeg.  Man..  May  31  and  June  1, 
/970.  Winnipeg.  1970.  I38p. 

28.  Textbook  for  psychiatric  technicians, 
by  Lucille  Hudlin  McClelland.  2d  ed.  St. 
Louis.  Mo..  Mosby.  1971.  269p. 

29.  T/iree  reports  of  World  Food  Con- 
gress Second,  June  1970.  The  Hague.  Ottawa. 
Canadian  Council  for  International  Co- 
operation, 1970.  1  vol. 

PAMPHLETS 

30.  /t  brief  to  the  task  force  on  the  cost 
of  health  services  in  Canada.  Toronto,  Oper- 
ating Room  Nurses  of  Greater  Toronto. 
1971.  13p. 

31.  Health  education  review  '70.  Edited 
by:  Amy  Elliott  Zelmer.  Ottawa,  Canadian 
Health  Education  Specialists  Society,  1970. 
23  p. 

32.  The  hospital  in  a  changing  society: 
auiuial  report  1969.  Chicago,  III,.  American 
Hospital  Association.  1970.  20p. 

33.  Memoir e  au  Minister e  des  Affaires 
sociales  stir  le  volume  IV  "La  Same"  de  la 
Commission  d'Enquete  siir  la  Sante  et  le 
Bien-etre  social  du  Gouverncmcnl  dii  Que- 

DECEMBER      1971 


accession  list 


/'('(.  par  Association  des  Infirmieres  et  In- 
firmiers  de  la  Province  de  Quebec.  Montreal. 
P.Q..  1971.  14p. 

34.  Papers  for  conference  for  directors 
of  schools  of  niirsini;,  Niagara  Falls.  Ont.. 
Nov.  10-14.  1964.  Toronto,  Registered 
Nurses"  Association  of  Ontario,  1964.  1  vol. 

35.  Practical  techniques  for  nurses  in 
trainini>,  by  Winifred  Hector.  London,  Bri- 
tish Broadcasting  Corporation,  1970.  3lp. 

GOVERNMENT  DOCUMENTS 

Canada 

36.  Conseil  economique  du  Canada. 
Depenses  personnelles  de  consontination  an 
Canada.  1926-1975.  Partie  2:  Meuhles  el 
aiitres  articles  d'aineiihlement.  appareils  et 
entretien  menaf>ers.  soins  medicaiix  et  servi- 
ces de  .same,  transport  et  communications, 
by  Thomas  T.  Schweitzer.  Ottawa.  Inform- 
ation Canada,  1971.  65p.  (its  Etude  no. 26) 

37.  Dept.  of  Indian  Affairs  and  Northern 
Development.  Indian  nffairs  facts  and  fif;iires. 
Ottawa,  Queen's  Printer,  1970.  49p. 

38.  Dept.  of  Industry.  Trade  and  Commer- 
ce. Office  of  Design.  The  office;  environ- 
mental plannint;.  by  Gordon  Forrest.  C  om- 
missioned  for  the  National  Design  Council. 
Ottawa,  Information  Canada.  1970.  113p. 

39.  Dept.  of  Labour.  International  Labour 


Affairs  Branch.  Eqnal  remuneration  for  wcnk 
ofeqnal  value.  Ottawa,  1970.  1  vol. 

40.  Dept.  of  Manpower  and  Immigration. 
Report  1969-70.  Ottawa.  Information 
Canada,  1971.  20p. 

41.  Dept.  of  National  Health  and  Welfare. 
//(('  Canada  pension  plan.  Ottawa.  Informa- 
tion Canada,  c  1970.  46p. 

42.  Dept.  of  National  Health  and  Welfare. 
Food  and  Drug  Directorate.  Guide  for 
preparation  of  snhmissions  on  food  addi- 
tives.  Ottawa.    Information   Canada.    1970 

43.  Dept.  of  Regional  Economic  Expan- 
sion. DREE.  Ottawa.  Information  Canada. 
1971.  pam. 

44.  Treasury  Board.  How  yonr  ta.x  dollar 
is  spent.  Oliav.a.  Information  Canada,  1971 
3  2  p. 

Ontario 

45.  Dept.  of  Labour.  Research  Branch. 
Nef>otiated  waf;e  rales  in  Ontario  hospitals. 
Toronto,  1971.  179p. 

Qaehec 

46.  Ministere  des  Affaires  sociales.  .\-1e- 
decins  hyi>ienisies  des  unites  sanitaires. 
Quebec.  P.Q..  1971.  12p.  R 

United  States 

47.  Dept.  of  Health,  Education  and  Wel- 
fare. Public  Health  Service.  Hnntinaion's 
disease  (Hnntinf>ton's  chorea)  hope  through 
research.  Washington.  U.S.  Govt.  Print. 
Off.,  1971.  25p. 

48.  National  C  enter  for  Health  Services 


Research  and  Development.  Reprint  series 
71-1.  February  1971.  Rockville,  Md.,  U.S. 
Public  Health  Services  and  Mental  Health 
Administration.  1971.  1488-1496p. 

STUDIES  DEPOSITED  IN  CNA  REPOSITORY 
COLLECTION 

49.  Effets  dun  programme  de  reeduca- 
tion .snr  les  comporlements  d'independance 
des  personnes  dgees  hemiplegiques  relatifs 
a  lenrs  soins  personnels,  by  Yvette  Roy. 
Montreal.  1970.  57p.  (Thesis  (M.  Nurs.)  — 
Montreal.)  R 

50.  Four  dimensional  view  of  the  sick  role 
as  seen  hy  the  citronically  ill  patient,  the 
primary  care-giver,  and  the  public  health 
nurse,  by  Margaret  Mono  Mackling.  Min- 
neapolis. Minn..  1971.  .'^3p.  (Thesis  (MP. H.) 
—  Minnesota.  )R 

51.  The  nature  of  phantom  phenomenon, 
by  Patricia  A.  O'Dwyer.  Boston.  1969.  59p. 
(Thesis  (M.Sc.N.) — Boston.)  R 

52.  Opinions  of  graduate  nurses  about 
orientation  programs  in  selected  hospitals 
in  Montreal,  by  Mary  Elaine  Jacob.  Wash- 
ington, 1967.  70p.  (Thesis  (M.Sc.N,)  — 
Catholic  University  of  America.)  Rm 

53.  Regards  siir  les  bachelieres  de  base 
en  nursing,  by  Nicole  David.  Quebec,  P.Q.. 
1971.  39p.  R 

54.  Survey  of  library  resoinces  in  Caiui- 
dian  schools  of  nursing  by  Marie  A.  Loyer 
and  M.T.  Mildred  Morris.  Ottawa,  Library 
Committee,  School  of  Nursing,  University 
of  Ottawa,  1971.80p.  R  w 


SECRETARY 

COMMONWEALTH  NURSES  FEDERATION 

Based  on  London,  a  qualified  and  experienced  nurse  with  administrative  experience  required 
for  post  of  chief  executive  and  professional  nursing  adviser  to  newly  established  Common- 
wealth Nurses  Federation.  To  represent  it  at  governmental  and  international  level.  Some 
overseas  travel    involved.    Knowledge   of   Commonwealth    countries    an    advantage. 

Salary  in  region  of  ;£^3,000  -  ;£?3,500  sterling,   contributory  pension   scheme. 

Secondment  for  two  to  three  years  would   be  considered. 

Requests  for  application  form  and  job  specification,  should  be  received  by  1st  January, 
1972,    obtainable    from    the: 

COMMONWEALTH  NURSES  FEDERATION 

c/o  Ren 
Henrietta  Place 
London,  W1M  OAB 


DECEMBER      1971 


THE     CANy^lAN     NURSE     51 


classified  advertisements 


BRITISH  COLUMBIA 


BRITISH    COLUMBIA 


ONTARIO 


Modern  700-bed  hospital  offers  positions  for:  HEAL> 
NURSES:  for  Pediatric  Department,  for  our  combined 
Ophthalmology  and  Ear.  Nose  and  Throat  Depart- 
ment and  for  our  Operating  Room  B  S  N  preferred 
Experience  essential  REGISTEKED  NURSES:  lor 
GENERAL  DUTY  in  specialty  areas  —  OR.  Emergen- 
cy. Recovery  Room.  Psychiatry,  B  C  Registration 
required.  RNABC  policies  m  effect.  Apply  Director 
of  Nursing,  Royal  Jubilee  Hospital,  1900  Fort  Street. 
Victoria.  British  Columbia 


HEAD  NURSES— OBSTETRICS  AND  EMERGENCY. 
CHILD  MATERNAL  HEALTH  SUPERVISOR.  EVENING 
AND  NIGHT  SUPERVISORS  for  modern  430-bed 
hospital  with  School  o(  Nursing.  RNABC  policies 
in  effect,  credit  for  past  experience  and  post- 
graduate training,  BC  registration  required.  For 
particulars  write  to  Associate  Director  of  Nursing. 
St.  Joseph  s  Hospital.  Victoria,  British  Columbia. 


GENERAL  DUTY  NURSE  wanted  lor  87-bed  modern 
Hospital.  Nurses  Residence,  Salary  $605,00  per 
month  lor  BC  Registered,  Apply:  Director  of  Nurs- 
ing, Mills  Memorial  Hospital,  Terrace,  British  Co- 
lumbia, 


WANTED:  GENERAL  DUTY  NURSES  for  modern  70- 
bed  hospital.  (48  acute  beds — 22  Extended  Care) 
located  on  the  Sunshine  Coast,  2  hrs.  from  Vancou- 
ver Salaries  and  Personnel  Policies  in  accordance 
with  RNABC  Agreement  Accommodation  available 
(female  nurses)  in  residence.  Apply:  The  Director 
of  Nursing.  St,  Mary's  Hospital,  P.O,  Box  678,  Se- 
chelt,  British  Columbia, 


ADVERTISING 
RATES 

FOR   ALL 

CLASSIFIED    ADVERTISING 

$15.00   for   6   lines   or   less 
$2.50  for  each  additional   line 

Rates   for   display 

odvertisements   on   request 

Closing  dole  for  copy  and  cancellation  is 
6  weeks  prior  to  1st  day  of  publication 
month. 

The  Canadian  Nurses'  Association  does 
not  review  the  personnel  policies  of 
the  hospitals  and  agencies  advertising 
in  the  Journal.  For  authentic  information, 
prospective  applicants  should  apply  to 
the  Registered  Nurses'  Association  of  the 
Province  in  which  they  ore  interested 
in    working. 


Address   correspondence   tO: 

The 

Canadian  ^A 
urse 


50  THE  DRIVEWAY 
OnAWA,  ONTARIO 
K2P    1E2 


OPERATING  ROOM  NURSES  for  modern  450-bed  hos- 
pital with  School  of  Nursing.  RNABC  policies  in  ef- 
fect- Credit  lor  past  experience  and  postgraduate 
training.  British  Columbia  registration  is  required. 
For  particulars  write  to:  The  Associate  Director  of 
Nursing,  St, Joseph's  Hospital.  Victoria,  British  Co- 
lumbia, 


GRADUATE  NURSE  lor  modern  21-bed  active  hos- 
pital. Friendly  atmosphere — near  famous  Long 
Beach.  Salary  in  accordance  with  RNABC  agree- 
ments. Contact:  Matron,  Tolino  Hospital,  Tofino,  BC, 


MANITOBA 


DIRECTOR  OF  NURSING.  A  valued  employee  is 
retiring  shortly  and  we  need  a  capable  NURSING 
DIRECTOR  to  take  her  place.  Applications  are  invit- 
ed for  the  above  position  in  the  17-bed  V^ilson 
Memorial  Hospital,  Melita,  Man,  The  incumbent  will 
be  directly  responsible  to  the  administration  for 
the  co-ordination  of  all  facets  of  activity  within  the 
nursing  department  including  accreditation.  Please 
direct  inquiries  or  applications  stating  age.  exper- 
ience, qualifications,  date  available  and  references 
to  Administrator,  Wilson  Memorial  Hospital,  Melita, 
Manitoba,  Canada, 


REGISTERED  NURSES  required  lor  Pediatrics 
Medicine  &  Surgery  in  a  68-bed,  modern  hospital 
Salary  $560.  March  1,  1972-$599,  Must  have  MARN 
registration.  Apply  Administrator,  Ste,  Rose  General 
Hospital,  Ste.  Rose,  Manitoba. 

REGISTERED  NURSE  required  for  general  dury  in 
17-bed  general  hospital  two  doctors.  Rotating 
shifts-40  hour  week.  Basic  salary  $560.00  plus 
increments.  Hospital  is  situated  near  Riding  Moun- 
tain and  Agassiz  Ski  resorts.  Residence  accom- 
modation IS  available.  Apply  Mrs.  D.  Hrymack 
DO  N  .  McCreary  District  Hospital,  McCreary, 
Manitoba  or  phone  McCreary  46  (collect). 


ONTARIO 


NURSING  SUPERVISOR  required  Feb,  1st.  1972  for 
45-bed  General  Hospital,  Contact:  Director  of  Nurs- 
ing. Geraldton  District  Hospital.  Geraldton.  Ontario. 


NURSING  PROGRAMME  CO-ORDINATOR  to  assist 
with  implementation,  co-ordination  and  interpretation 
of  Nursing  Programme,  and  evaluate  and  supervise 
Nursing  staff.  Public  Health  degree  and  Supervision 
required.  Good  personnel  policies.  Apply  to:  Dr, 
AE  Thorns,  Medical  Officer  of  Health,  Leeds, 
Grenville,  and  Lanark  District  Health  Unit,  70  Charles 
Street,  PC.  Box  130,  Brockville.  Ontario, 


HOME  CARE  ADMINISTRATOR,  diploma  or  preferably 
degree  PUBLIC  HEALTH  NURSE  with  qualifications 
equivalent  to  that  of  SUPERVISOR,  required  to 
administer  and  co-ordinate  the  services  of  a  Home 
Care  Programme,  Apply  in  writing  giving  background 
information  to:  Dr,  A.E  Thorns,  Medical  Officer  of 
Health,  Post  Office  Box  130,  Brockville,  Ontario, 


REGISTERED  NURSES  required  by  70-bed  General 
Hospital  situated  in  Northern  Ontario  Salary  scale  — 
$560.00-$670  00.  allowance  for  experience  Shift 
differential,  annual  increment.  40  hour  week.  O  HA. 
Pension  and  Group  Life  Insurance.  O  H  S  C.  and 
OHSIP  plans  in  effect  Good  personnel  policies. 
For  particulars  apply  Director  of  Nursing.  Lady 
Minto  Hospital  at  Cochrane.  Cochrane,  Ontario, 


REGIbTERED  NURSES  for  o4-bed  General  Hospital, 
Salary  $525.  per  month  tc  $625  plus  experience  al- 
lowance. Residence  accommodation  available.  Ex- 
cellent personnel  pol'.cies.  Apply  to:  Superintendent, 
Englehart  &  District  Hospital  Inc,  Englehart,  Ontario 


REGISTERED  NURSES  needed  for  81 -bed  General 
Hospital  in  bilingual  community  of  Northern  Ontario, 
French  language  an  asset,  but  not  compulsory,  R  N 
salary-$557  to  $662,  monthly  with  allowance  for 
past  experience,  4  weeks  vacation  after  1  year  and 
18  sick  leave  days.  Unused  sick  leave  days  paid  at 
100%  every  year.  Master  rotation  in  effect.  Rooming 
accommodation  available  in  town.  Excellent  per- 
sonnel policies.  Apply  to:  Personnel  Director 
Notre-Dame  Hospital,  P.O.  Box  850.  Hearst.  Ont 


REGISTERED  NURSES  required  for  a  12-bed  Intensive 
Care-Coronary  Care  combined  unit.  Post  basic 
preparation  and/or  suitable  experience  essential, 
1971  salary  range  $570-$680;  generous  fringe  bene- 
fits. Apply  to:  Director  of  Administrative  Services 
and  Personnel,  St,  Mary's  General  Hospital,  911-B 
Queen's  Blvd,.  Kitchener.  Ontario, 


REGISTERED  NURSES  AND  REGISTERED  NURSING 
ASSISTANTS  for  45-bed  hospital.  R  N  s  salary  $560. 
to  $660  with  experience  allowance  and  4  semi-annu- 
al increments.  Nurses  residence  —  private  rooms 
with  bath  -  S30  per  month.  R  N  A  s  salary  $380.  to 
$460.  Apply  to  The  Director  of  Nursing,  Geraldton 
District  Hospital  Geraldton.  Ont, 


REGISTERED  NURSES  AND  REGISTEKED  NURSING 

ASSISTANTS,  looking  for  an  opportunity  to  work  in 
a  patient  centered  Nursing  bervice.  are  required  oy 
a  modern  well-equipped  hospital.  Situatnd  in  a  pro- 
gressive Community  in  South  Western  Ontario,  Ex- 
cellent employee  benefits  and  working  conditions. 
Write  for  further  information  to:  Director  of  Nursing; 
Leamington  District  Memorial  Hospital;  Leamington, 
Ontario, 


REGISTERED  NURSES  FOR  GENERAL  DUTY  AND 
OPERATING  ROOM:  lor  104-bed  accredited  Gen- 
eral Hospital.  Basic  salary  —  $570 — $670/m,  with 
remuneration  for  past  experience  Shift  differential 
$1.00  per  evening  or  night,  shift  Yearly  increments, 
A  modern,  well-equipped  hospital,  amidst  the  lakes 
and  streams  of  Northwestern  Ontario  Apply  to  Mrs 
L  DeGagne,  Director  of  Nursing,  La  Verendrye  Hos- 
pital. Fort  Frances,  Ontario, 


REGISTERED  NURSE  FOR  OPERATING  ROOM  also 
GENERAL  DUTY  NURSES  for  80-bed  hospital:  recog- 
nition for  experience;  good  personnel  policies;  one 
month  vacation;  basic  salary  $567,50,  July  1st 
$570.00.  Apply:  Director  of  Nursing,  Huntsville 
District  Memorial  Hospital,  Box  1150,  Huntsville 
Ontario. 


REGISTERED  NURSING  ASSISTANTS  for  80-bed 
hospital,  starting  salary  $375.00  with  increments  for 
past  experience;  three  weeks  vacation;  18  days 
sick  leave;  residence  accommodation  available. 
Apply:  Director  of  Nursing.  Huntsville  District 
Memorial  Hospital.  Box  1150.  Huntsville.  Ontario, 


REGISTERED  NURSES,  for  GENERAL  DUTY  and 
I.C.U..    and    REGISTERED    NURSING    ASSISTANTS 

•  enquired  for  160-bed  accredited  hospital.  Starting 
salary  $525.00  and  $365  00  respectively  with 
regular  annual  increments  for  bolh.  Excellent 
personnel  policies.  Temporary  residence  accommo- 
dation available.  Apply  to:  Director  of  Nursing, 
Kirkland  and  District  Hospital,  Kirkland  Lake, 
Ontario. 


REGISTERED  NURSES  AND  REGISTERED  NURSING 
ASSISTANTS     required     for     GENERAL     DUTY     in     a 

313-bed  fully  accredited  hospital.  Good  salary 
commensurate  with  experience,  excellent  fringe 
benefits  and  gracious  living  in  the  Festival  City 
of  Canada.  Apply  in  writing  to  the:  Director  of 
Personnel.  Stratford  General  Hospital,  Stratford, 
Ontario 


GENERAL  DUTY  REGISTERED  NURSES  with  at  least 
one  year  s  experience  required  for  175-bed  accedit- 
ed  hospital.  Recognition  given  for  experience  and 
postgraduate  education.  Orientation  and  In- 
Service  Educational  programmes  are  provided 
Progressive  personnel  policies.  For  further  informa- 
tion write  to  Personnel  Director,  Temiskaming 
General  Hospital,  Haileybury,  Ontario 


52     THE     CANADIAN     NURSE 


DECEMBER      1971 


ONTARIO 


UNITED  STATES 


UNITED  STATES 


EXPERIENCED  GENERAL  STAFF  NURSES  FOR 
OPERATING  ROOM  AND  INTENSIVE  CARE  AREA  — 

for  modern,  accredited  242-bed  General  Hospilal. 
Good  personnel  policies,  recognition  tor  experience 
and  post-basic  preparation.  Apply:  Director  of 
Nursing,  Sudbury  Memorial  Hospital,  Regent  Street, 
S.,  Sudbury.  Ontario. 


PUBLIC    HEALTH    NURSE    (2)    required    innnnediatety 

by  Huron  County  HeallH  Unit--  progressive  general- 
ized program  —  allowance  for  experience  —  excel- 
lent personnel  policies.  Apply  to  Dr  G  F  Mills.  Act- 
ing Medical  Officer  of  Health,  Huron  County  Healtfi 
Unit,  Goriericfi.  Ontario. 


PUBLIC  HEALTH  NURSES.  Northern  Newfoundland 
and  Labrador  Programme  based  on  Newfoundland 
Department  of  Health  requirements  Vehicles  provid 
ed  Resident  accommodation.  Apply  Mrs  Ellen  E 
McDonald,  International  Grenfell  Association,  Room 
701  88  Metcalfe  Street    Ottawa    Ontario    KIP  5L7. 


PRINCE  EDWARD  ISLAND 


EXECUTIVE  SECRETARY  and  SCHOOL  OF  NURSING 
ADVISER  for  the  ANPEl  Qualifications  -  (1)  at  least 
5  years  experience  in  nursing  (2)  at  least  a  bacca- 
laureate degree  m  nursing  (3)  experience  m  direct- 
ing programmes  m  nursing  education  (4)  facility 
in  maintaining  congenial  relationships  (5)  ability 
to  adjust  to  change  (6)  current  registration  as  a  nurse 
in  Prince  Edward  island  Salary  —  open  Send 
correspondence  to:  President.  Association  of  Nurses 
of  Prmce  Edward  >sland.  188  Prince  Street.  Charlot- 
tetown.  Pnnce  Edward  island 


QUEBEC 


REGISTERED  NURSES  for  30-bed  General  Hospital 
Huntingdon  is  45  mrles  south  west  of  Montreal. 
Salaries  as  approved  by  Q  H  i  S  4  weeks  annual 
vacation  Accumulated  sick  leave  Blue  Cross  par- 
tially paid  Full  maintenance  available  for  S43  50 
per  month  Apply  to  Mrs  D  Hawley,  R  N  ,  Hunting- 
don County  HosDilal    Huntingdon   Quebec 


REGISTERED  NURSES—  Invitation  extended  to 
qualified  nurses  to  submit  applications  for  work 
in  Bakersfield:  a  friendly,  modern  community  locat- 
ed in  Central  California.  Summer  and  winter  recrea- 
tional facilities  nearby.  Must  have  or  be  eligible  to 
obtain  California  registration.  General  Duly  Staff 
nursing  positions  available  on  most  shifts  of  all  nurs- 
ing units.  Operating  Room  also  has  open  positions 
for  qualified  nurses  and  interested  nurses  can  be 
trained  or  retrained  to  this  important  service.  Salaries 
to  $950.00  a  month.  For  applications  and  additional 
information,  write:  The  Personnel  Director.  Mercy 
Hospital.  P  O   Box  119.  Bakersfield  California  93302. 


REGISTERED  NURSES  —  410-bed  acute  General 
Hospital  offers  you  the  opportunity  to  put  your  total 
professional  skills  to  use.  Why  not  |Oin  our  delightful 
suburban  community  just  20  minutes  from  San 
Francisco  in  sunny  California  Eligibility  for  California 
licensure  required  Write  Mrs  Sue  Love.  Peninsula 
Hospital  and  Medical  Center.  1783  El  Camino  Real, 
Burhngame,  California  94010 


STANFORD  UNIVERSITY  HOSPITAL:  extends  an 
invitation  to  join  our  professional  staff  A  600-bed 
teaching  hospital  offering  all  speciality  services 
Salary  geared  to  education  and  experience;  liberal 
differential  and  outstanding  benefits:  internal 
promotional  system;  continuing  Inservice  Education 
Palo  Alto,  the  home  of  Stanford  University,  is  a 
beautifully  planned  residential  area  located  38 
miles  south  of  San  Francisco.  We  can  assist  in 
visa  procedures  We  will  only  consider  RNs  with 
California  licensure.  Apply  to  Mrs.  Sue  Power. 
Employment  Manager.  Stanford  University  Hospital. 
Stanford   Calif   94305 


STAFF  NURSES:  To  work  in  Extended  Care  or 
Tuberculosis  Unit.  Live  in  lovely  suburban  Cleveland 
in  2-bedrooni  house  for  $55  a  month  including  all 
utilities.  Modern  salary  and  excellent  fringe  benefits. 
Write  Director  of  Nursing  Service.  4310  Richmond 
Road,  Cleveland.  Ohio 


REGISTERED  NURSES  —  immediate  openings  in 
all  services,  medical,  surgical,  ICU'CCU,  pediatrics, 
maternity,  psychiatry  JCAH  Hospital  halfway 
between  San  Francisco  and  Lake  Tahoe.  $700.00  for 
beginning  salary  for  RNs  m  our  hospital,  with 
shift  differentials  Apply  Director  of  Nursing  Serv- 
ices. Woodland  Memorial  Hospital,  1325  Cottonwood 
Street.  Woodland,  California  95695 


STAFF  NURSES — Here  is  the  opportunity  to  further 
develop  your  professional  skills  and  knowledge  in 
our  1,000-bed  medical  center  We  have  liberal 
personnel  policies  with  premiums  for  evening  and 
night  tou.'S  Our  nurses  residence  located  in  the 
midst  of  33  cultural  and  educational  institutions, 
offers  low-cost  housing  adjacent  to  the  Hospitals. 
Write  for  our  booklet  on  nursing  opportunities. 
Feel  free  to  tell  us  what  type  position  you  are 
seeking.  Write:  Mrs.  Dorothy  P  Lepley,  R.N,  Manager 
of  Nurse  Recruitement,  Room  C-12.  University  Hos- 
pital<:  of  Cleveland.  Cleveland.  Ohio  44106. 


TEXAS  wants  you!   If  you  are  an  RN    experience  or 

a  recent  graduate,  come  to  Corpus  Chnsti.  Spar- 
kling City  by  !he  Sea  a  city  building  for  a  better 
future  where  your  opportunities  tor  recreation  ao'' 
studies  are  limitless  Memorial  Meaicai  Center, 
500*bed  general  teaching  hospital  encourages 
career  advancement  and  provides  mservice  orienta- 
tion Salary  from  $630  00  to  S802  00  per  month, 
commensurate  with  education  and  experience 
Differential  for  evening  shifts  available  Benefits 
include  holidays,  sick  leave,  vacations,  paid  hospita 
i/ation  health  life  insurance,  pension  program 
Become  a  vital  part  ot  a  modern  up  to  date  hospital 
write  John  W  Gover  Jr  Director  of  Personnel 
Memorial  Medical  Center  PO  Box  5280  Corpus 
Christi,  Texas 


STAFF  NURSE,  CHARGE  NURSE,  RN  ANESTHETIST 
and  PHYSIOTHERAPIST  req  d  immediately  by 
hospitals  in  Washington,  Oregon,  Calif,  and  Arizona, 
USA  Salary  $600  -  $1,000  per  mo.  Will  assist  on 
visa  and  moving.  PHILCAN  PERSONNEL  CONSULT- 
ANTS LTD  (Medical  Placement  Specialists).  5022 
Victoria  Drive,  Vancouver  16,  Britisri  Columbia, 
Canada.  Ph:  327-9631,  Eves.  325-7619. 


MAIMONIDES  HOSPITAL 

and 

HOME  FOR  THE  AGED 

a  247  bed  geriatric  centre 

requires 

GENERAL  DUTY  NURSES 

eligible  to  practice 
in  the  Province  of  Quebec 

Will  work  closely  with  social  service,  physical 
therapy,  and  occupational  therapy  depart- 
ments to  provide  comprehensive  nursing  care. 

Ongoing  orientation  and  in-service  education 
program. 

Apply:  DIRECTOR  OF  NURSING 
5795  Caldwell  Avenue 
Montreal  269,  Quebec 
Telephone  (514)  488-2301 


THE  SCARBOROUGH 
GENERAL  HOSPITAL 


accredited     hospital,     located 


Eastern 


A     650bed     progressive, 
Metropolitan   Toronto. 

Challenging  opportunities  in  Mcdicol  and  Surgical  nursing,  including 
specialties  such  os  Cardiology,  Intensive  Care,  Burns,  Plastic 
Surgery,  Opihalmology,  Paediatrics,  Infection  Control,  and 
Emergency. 

Modern    Training    Programs    to    assist    all    staff    members    to    under- 
stand the  principles  of   management: 
I.   Assists    the    administrative    nurse 


the    management    of    the 


2.   Assists   the   staff   nurse   to   develop   skills   for   rendering   patient- 
centred   nursing   care. 
Staff   Development   Program    includes   Videotape   Telecasts,   Lectures, 
Films,    Demonstrations,    ond    Workshops    vi'hich    make    use    of    role 
playing    and    group    problem-solving   methods. 

For  further  information  write  to: 
Director  of  Nursing 

SCARBOROUGH  GENERAL  HOSPITAL 

Scarborough,  Ontario 


DECEMBER      1971 


THE     CANADIAN     NURSE     53 


DIRECTOR  OF  NURSING 


Applications  are  invited  for  the  position 
of  DIRECTOR  OF  NURSING  of  the  Fernie 
Memorial  Hospital.  This  thriving  com- 
munity located  in  the  East  Kootenay, 
has  been  granted  approval  for  a  new 
66-bed  hospital  to  replace  the  existing 
43-bed  unit.  Construction  is  scheduled 
to   begin    in  the    Summer    of    1972. 

In  addition  to  the  nursing  administra- 
tion functions  normally  associated  with 
such  a  position,  the  successful  applicant 
will  be  directly  involved  in  the  planning 
of    the    new    facilities. 

This  is  on  exciting  and  chollengir>g  posi- 
tion for  a  well-qualified  individual  with 
previous    experience. 

StancJord  fringe  benefits  for  the  field 
apply,  and  salary  will  be  commensurate 
with   qualifications   and   experience. 


Submit  complete  resume  in 
confidence  to: 

Mr.  R.  C.  Williams 
Administrator 

FERNIE  MEMORIAL  HOSPITAL 

P.O.  Box  670 
Fernie,  B.C. 


SAINT 

JOHN 

GENERAL 


^Miii     HOSPITAL 


710-bed,  accredited,  modern,  well-equipped.  General  Hospital  which 
is  rapidly  expanding  — 

Needs  YOU! 

GENERAL  STAFF  NURSES  AND  REGISTERED  NURSING  ASSISTANTS. 

To  meet  needs  of  Patients  in  the  following  units:  Medical,  Surgical, 
Coronary  Core,  S.I.C.U.,  Neurosurgery,  Chronic  and  Convales- 
cent,  Rehabilitation,   Burn,   Plastic  Surgery  and  others. 

Active,  progressive  In-Service  Education  Program  —  Special  at- 
tention to  orientation. 

STAFF  NURSE  SALARIES 

$500  to  $580 
allowance  for  experience  and  post  basic  preparation. 
Easy  access  to  beaches,  golf  courses,  and  ski  hills. 
Come  to  the  beautiful  Maritimes  where  hospitality  is  outstanding. 

For  further  information,  write  to: 

Director  of  Nursing 

SAINT  JOHN  GENERAL  HOSPITAL 

Saint  John,  N.B. 


+ 


ONCE   A   NURSE... 
ALWAYS   A   NURSE 


Whether  you're  a  practicing  R.N.  or  just  taking  time 
out  to  raise  a  family,  you  can  serve  your  community 
by  teaching  lay  persons  the  simple  nursing  skills 
needed  to  care  for  a  sick  member  of  the  family  at 
home. 

Red  Cross  Branches  need  VOLUNTEER  INSTRUCTORS 
to  teach  Red  Cross  Care  in  the  Home  courses. 

VOLUNTEER  NOW  AS  A  RED  CROSS  INSTRUCTOR 
IN  YOUR  COMMUNITY 

For  further  information,  contact: 

National  Director,  Nursing  Services 

THE  CANADIAN  RED  CROSS  SOCIETY 

95  Wellesley  Street  East 
Toronto  5,  Ontario 


THE  MONTREAL 
GENERAL  HOSPITAL 

Invites  applications  from 

REGISTERED  NURSES 
FOR  GENERAL  DUTY 

ACTIVE  INSERVICE  EDUCATION  PROGRAM. 
PROGRESSIVE  PERSONNEL  POLICIES. 

For  further  information. 
Apply  to: 

The  Director  of  Nursing 

THE  MONTREAL 
GENERAL  HOSPITAL 

1650  Cedar  Avenue 
Montreal  109,  Quebec 


54     THE     CANADIAN      NURSE 


DECEMBER      1971 


POST  GRADUATE  COURSES 


The  following  courses  in  this  modern  1200  bed 
teaching  hospital  will  be  of  interest  to  registered 
nurses  who  seek  advancement,  specialization  and 
professional  growth. 

—  Cardiovascular  Nursing.  This  is  a  six  month 
clinical  course  with  classes  commencing  in 
October  and  February. 

—  Operating  Room  Techniques  and  AAanagement. 
This  six  month  course  commences  September 
and  AAarch. 

For  further  information  and  details  contact: 

Employment  Supervisor  —  Nursing 

UNIVERSITY  OF  ALBERTA  HOSPITAL 

Edmonton,  Alberta. 


DOUGLAS  HOSPITAL 

MONTREAL,  QUEBEC 
Invites  Applications  from: 

CERTIFIED  NURSING  AST'S 

GENERAL  DUTY  REGISTERED  NURSES 

ASSISTANT  HEAD  NURSES 

SUPERVISORS 

This  Is  a  large  dynamic  psychiatric  hospital  which 
offers  services  to  the  Anglophone  population  of 
Quebec;  as  well  as  the  Francophone  population  of 
the  immediate  surroundings  areas. 

Unilingual  and  bilingual  candidates  will  be  con- 
sidered. 

Apply  to 

DIRECTOR  OF  NURSING 

ADULT  SERVICES 

6875  LaSalle  Blvd.,  Verdun  204,  Quebec 

and 

DIRECTOR  OF  NURSING 

CHILDREN'S  SERVICES 

6600  Champlain  Blvd.,  Verdun  204,  Quebec 


UNIVERSITY  OF  BRITISH  COLUMBIA 

SCHOOL  OF  NURSING 

DEGREE  PROGRAMMES 

Baccalaureate  —  basic  students 

—  registered  nurses 
This  course  for   both  groups  of  students   leads  to 
the  B.S.N,  degree,  and  prepares  the  graduate  for 
public  health  as  well  as  hospital  nursing  positions. 

Master's 

For  qualified  baccalaureate  nurses  leading  to  the 
degree  of  M.S.N.  This  course,  two  years  in  length, 
prepares  the  graduate  for  leadership  roles  in  nurs- 
ing with  emphasis  on  clinical  expertise. 

DIPLOMA  PROGRAMME  (Nursing  B) 

Community  Health  Nursing  —  for  registered 
nurses  —  psychiatric  nursing  required  prere- 
quisite. 

Early  applications  ore  requested  — 
March    1    for    M.S.N. ,  May    1    for   diploma, 

June  30  for  baccalaureate. 

For  information  write  to: 

The  Director 

SCHOOL  OF  NURSING,  UNIVERSITY  OF  B.C. 

Vancouver  8,  B.C. 


For  the  progressive,  patient  oriented  Head  Nurse, 
there  are  often  obstacles  of  standard  practise  and 
traditional  methods  which  prevent  the  development 
of  a  sophisticated  programme  dedicated  to  expand- 
ing an  interdisciplinary  approach  to  patient  care  and 
interpersonal    staff   relations. 

HEAD  NURSES 

in  the  McMoste'r  University  Medical  Centre  will  find 
an  environment  highly  conducive  to  this  type  of 
programme.  The  successful  applicants  will  work  with 
the  Physician  Directors  and  School  of  Nursing  Fa- 
culty in  the  development  and  implementation  of 
programmes,  both  at  the  clinical  and  teaching  levels, 
ensuring  that  these  programmes  achieve  maximum 
success. 

Applications  are  invited  from  nurses  presently  em- 
ployed OS  "Heads"  or  "Assistant  Heads"  who  feel 
they  are  ready  to  accept  the  type  of  challenge  our 
418-bed   University   Hospital   has  to  offer. 

Positions  are  available  in  all  clinical  areas.  Prefer- 
ence will  be  given  those  possessing  a  B.Sc.  and/or 
possessing  considerable  experience  in  their  speciality. 

Please  send  a  complete  resume  in  confidence  to: 

Employment  Supervisor 

McMASTER  UNIVERSITY  MEDKAL  CENTRE 

1400  Main  Street  West 
Hamilton  16,  Ontario 


DECEMBER      1971 


THE     CAN/W3IAN      NURSE     55 


THE  MONTREAL  CHILDREN'S 
HOSPITAL 

Attention:  Registered  Nurses! 

Certified  Nursing  Assistants! 

At  our  Hospital  we  really  care  about  each  of  our 
children.  We  ail  want  the  best  for  them. 

Our  nurses  say  that  our  Hospital  is  a  happy  place 
and  they  like  it  here.  Would  you  like  to  join  our 
staff?  We  might  just  have  the  job  you  have  been 
looking  for.  Our  personnel  policies  are  good.  Our 
In-Service  programme  is  good,  and  we  think  that 
the  care  our  children  get  is  good.  Maybe  you  can 
help  us  moke  it  better.  Applications  for  part-time 
during  the  summer  months  will  also  be  considered. 

Enquiries  should  be  directed  to: 
The  Director  of  Nursing 

MONTREAL  CHILDREN'S  HOSPITAL 

2300   Tupper    Street 
Montreal    108,   Quebec 


LATIN  AMERICA 


Are  you   interested   in   Latin  America? 

Canadian  University  Service  Overseas  urgently 
needs  20  experienced  nurses  to  work  in  Peru,  Ecua- 
dor and  Columbia, 

—  in  public  health 

—  as  teachers   in   Nursing   Auxiliary  Schools 

—  as    head    nurses    in   hospitals. 

The  contract  lasts  2  years.  Salaries  vary  according 
to   the   scales   of   the   host   country. 

The  CUSO  Latin  America  Programme  pays  the  ex- 
penses for  language  training  in  Spanish  at  a  special 
language   centre   in   Mexico. 

In  addition,  CUSO  pays  the  costs  of  transportation, 
life  and  health  insurance  and  gives  you  a  settling-in 
allowance  and  reintegration  allowance  at  the  end 
of  your  contract. 

For  more  information,  please  go  to  your  nearest 
CUSO  office  or  write  to: 

CUSO 

Latin  America  Desl< 
151  Slater  Street 
Ottawa 
KIP  5H5. 


there    are   over 

200,000    more 

who  need  your  help! 


REGISTERED  NURSES    #     PUBLIC  HEALTH  NURSES 
CERTIFIED  NURSING  ASSISTANTS 

Have    you    considered    a    Career    with    the... 

Indian    Health    Services    of   MEDICAL    SERVICES 
DEPARTMENT   OF    NATIONAL    HEALTH    AND    WELFARE 

for   further    information   write   to:   MEDICAl   SERVICES,   DEPARTMENT   OF    NATIONAL    HEALTH    AND    WELFARE,    OTTAWA,    CANADA 


56     THE     CANADIAN      NURSE 


DECEMBER      1971 


ST.  JOSEPH'S  HOSPITAL 
TORONTO,  ONTARIO 

Registered  Nurses 

630-bed  fully  accredited  hospital  provides 
experience  in  Emergency,  Operating  Room, 
Post  Anaesthesia  Room,  Intensive  Care 
Unit,  Orthopaedics,  Psychiatry,  Pediatrics, 
Obstetrics  and  Gynaecology,  General 
Surgery    and    Medicine. 

Basic  2  week  Orientation  Program  and 
continuing  Active  Inservice  Program  for 
all    levels   of    staff. 

Salary  is  commensurate  with  preparation 
and  experience.  Benefits  include  Canada 
Pension  Plan,  Hospital  Pension  Plan. 
After  3  months,  cumulative  sick  leave 
—  O.H.S.C.  —  O.H.S.I.P.,  Group  Life 
Insurance  —  66%%  payment  by  hos- 
pital.. 

Rotating  Periods  of  duty  —  40  hour 
week  —  10  Statutory  holidays  —  3 
weeks  annual  vacation  after  completion 
of   one    years    service. 

Apply: 

Associate  Director  of 
Nursing  Service 

ST.  JOSEPH'S  HOSPITAL 

30  The  Queensway 
Toronto  3,  Ontario 


Applications  are  invited 
for  the  position  of 

HEAD  NURSE  FOR 
OBSTETRICAL 
DEPARTMENT 

Applicant  would  be  required  to 
hove  a  Baccalaureate  degree, 
postgraduate  course,  or  exten- 
sive experience  in  obstetrics  with 
proven  adnninistrative  skills. 

Generous  salary  allowance  with 
full  fringe  benefits  in  a  163-bed 
fully  accredited   hospital. 

For  further  information  and 
details,  apply  to: 

Director  of  Nursing 

KIRKLAND  AND  DISTRICT 
HOSPITAL 

Kirldand    Lake,    Ontario. 


NUMBER  MEMORIAL  HOSPITAL 

(North  West  Metropolitan  Toronto) 

200  Church  Street,  Weston,  Ontario. 

Telephone  249-8111    (Toronto) 

Positions  are  available  to  Registered  Nurses  and  Registered 
Nursing  Assistants  in  ail  Nursing  Units  in  an  active  treat- 
ment 350-bed  hospital. 

•  •  • 

High  quality  patient  care  is  given  by  a  staff  of  well  qual- 
ified nnedical  and  nursing  staff. 

•  •  • 

Orientation  and  on-going  inservice  educational  pro- 
grammes are  provided. 

•  •  • 

Monetary    recognition    is   considered    for    past   experience 

(Registered  Nurses.) 

•  •  • 

Furnished  apartments  are  available  temporarily,  at  sud- 

sidized  rates. 

•  •  • 

Write  to:  Director  of  Nursing  for  information  concerning 
employment  opportunities. 


PROVINCE  OF  BRITISH  COLUMBIA 

has  openings  for 

TEACHING  POSITIONS 

Dept.  of  Nursing  Education 
ESSONDALiE 


Starting  salary  $8,244  to  $9,588  per  annum,  depending  on  qual- 
ifications, rising  to  $10,740  per  annum. 

Junior  and  Senior  teaching  positions  in  an  autonomous  educational 
facility  responsible  to  the  Mental  Health  Branch  Headquarters  in 
Victoria,  B.C.  A  faculty  of  twenty-four  provides  a  two-year  training 
course  graduating  nurses  eligible  for  licensure  as  Psychiatric  Nurses. 
The  correlated  curriculum  uses  the  facilities  of  three  hospitals  for 
clinical  experience  in  psychiatric  and  geriatric  nursing  and  care  of 
the  retardate. 

Applicants  must  be  Canadian  citizens  or  British  subjects  with  a 
university  degree  in  nursing  and  membership  or  eligible  in  the 
RNABC;   nursing   and   teaching   experience   desirable. 

Obtain  applications  from  the 

CIVIL   SERVICE   COMMISSION  OF   BRITISH   COLUMBIA, 
Valleyview    Lodge,    Essondale,    and    return    IMMEDIATELY. 
COMPETITION  NO.  71:1095. 


DECEMBER      1971 


THE     CANAQIAN     NURSE     57 


MONTREAL  NEUROLOGICAL 
HOSPITAL 

A  TEACHING   HOSPITAL 
OF   McGILL   UNIVERSITY 

requires 

REGISTERED  NURSES 

for 

OPERATING  ROOM 

and 

CLINICAL  AREA 

For  further  ir)formation  write  to: 

Director  of  Nursing 

MONTREAL  NEUROLOGICAL 

HOSPITAL 

3801  University  Street 

Montreal  112,  Quebec 


Applications  for  the  position   of: 

NURSING  ADMINISTRATIVE 
SUPERVISOR 

HEAD  NURSE  for  the 
OBSTETRICAL  DEPARTMENT 

of  a  152-bed  General  Hospital  ore  now 
being  accepted.  Preference  will  be  given 
to  applicants  with  formal  preparation  in 
Nursing  Service  Administration,  but  those 
with  administrative  experience  will  be 
considered. 

Completely  furnished  apartments  with 
balcony  and  swimming  pool  adjacent  to 
hospital  and  lake  ore  available,  and  the 
location  is  within  easy  driving  distance 
of  American  and  Canadian  metropolitan 
centres. 

Apply: 

Director  of  Nursing 

GENERAL  HOSPITAL 

Port  Colborne,  Ontario 


ASSISTANT  DIRECTOR  OF 
NURSING  SERVICE 

Applications  are  invited  for  the  above 
position  in  167-bed  General  Hospital 
located  in  a  progressive  town,  (10,000 
population)    in    South    Western    Ontario. 

Candidates  should  possess  ability  to  ap- 
ply Nursing  and  Administrative  Principles 
within  a  philosophy  of  patient  centered 
care. 

For  information  write  to: 

Director  of  Nursing 

LEAMINGTON   DISTRICT 

MEMORIAL  HOSPITAL 

Leamington,  Ontario 


ST.  MARY'S  SCHOOL  OF  NURSING 
KITCHENER,  ONTARIO 

requires  teachers 

for 
2  Year  Programme 

Affiliated  with  a  modern,  pro- 
gressive 400-bed  fully-accredited 
hopital.  Student  enrolment,  120. 
Salary  commensurate  with  pre- 
paration and  experience. 

For  further  information   apply 

Director 

ST.    MARY'S    SCHOOL 

OF  NURSING 

Kitchener,  Ontario 


INTERNATIONAL   GRENFELL 

ASSOCIATION 

requires 

REGISTERED  NURSES 

for 

NORTHERN   NEWFOUNDLAND 

AND   LABRADOR 

The  Grenfell  Association  provides  medical 
services  In  Northern  Newfoundland  and 
Lobrador.  We  staff  five  hospitals,  fourteen 
nursing  stations  and  five  '  Public  Health 
Units.  Our  main  hospital  is  a  180-bed  oc- 
credited  hospital  situated  in  St.  Anthony, 
Newfoundland.  Active  Treatment  is  carried 
on  in  Surgery,  Medicine,  Pediatrics,  Obste- 
trics and  Intensive  Care  Un't.  Orientation  and 
Active  Inservice  Program  for  staff.  Salary 
based  on  Government  scoles.  40  hour  week, 
rotating  shifts.  Excellent  personnel  benefits 
include    liberal    vacation    and    sick    leave. 

Apply    to: 
Mrs.    Ell«n    E.    McDonald 

International  Grenfell  Association 

Room   701,   88   Metcalfe  Street 
Ottawa  KIP  517,   Ontario 


DIRECTOR  OF  NURSING 

Renfrew  Victoria  Hospital 

Aplications  are  invited  for  the 
position  of  Director  of  Nursing 
at  this  100-bed  Active  Treatment 
hospital. 

Preference  will  be  given  to  ap- 
plicants having  a  Baccalaureate 
Degree  in  Nursing  and  admin- 
istrative experience. 

Apply  in  writing,  stating  exper- 
ience, qualifications,  references 
and  available  date  tO: 

R.  W.  Mackenzie 

Administrator 

RENFREW  VICTORIA  HOSPITAL 

Renfrew,  Ontario 


WILSON  MEMORIAL 
GENERAL  HOSPITAL 

requires 

REGISTERED  NURSES 
FOR  GENERAL  DUTY 

25-bed,  new/,  modern  well  equipped  hos- 
pital. Located  in  Northwestern  Ontario 
community.  Usual  fringe  benefits.  Resi- 
dence accommodation  available  at  nom- 
inal rate.  Solary  commensurate  with 
qualifications    and    experience. 

Applications    and    enquiries    should    be 
sent    to: 

The    Director  of  Nursing 

WILSON  MEMORIAL 

GENERAL  HOSPITAL 

Marathon,  Ontario 


58     THE     CANADIAN     NURSE 


DECEMBER      1971 


NORTHERN  ONTARIO 

REGIONAL  SCHOOL  OF 

NURSING 

requires 

CURRICULUM 
COORDINATOR 

and 

TEACHERS 

Two   year   program  with  on   an- 
nual  enrollment  of  30  students. 

QUALIFICATIONS: 

University   preparation. 

Apply 
Director 

NORTHERN  ONTARIO  REGIONAL 
SCHOOL  OF  NURSING 

Box  366 
Kirkland  Lake,  Ontario 


A6BIE  J.  LANE 
MEMORIAL  HOSPITAL 

HALIFAX,  N.S. 
requires 

NURSING  SUPERVISORS 

This  200-bed  Mental  Hospital  is 
developing  active  programs  to 
provide  a  comprehensive  service 
for  the  City  of  Halifax  in  ac- 
cordance with  modern  psychia- 
tric  philosophy. 

Halifax  is  the  Medical,  Educa- 
tional and  Cultural  centre  of  the 
Maritimes  —  a  good  place  to 
work  in  Canada's  Ocean  Play- 
ground,   Salaries    Negotiable. 

Nurses  with  3  to  5  years  psy- 
chiatric experience  should  write 
giving  full  particulars  and  salary 
expected  to: 

Director  of  Nursing 

Abbie  J.  Lane  Memorial  Hospital 

5909  Jubilee  Road 
Halifax,  N.S. 


THE  HOSPITAL 

FOR 

SICK  CHILDREN 


S^P^^R 


OFFERS: 


1.  Satisfying    experience. 

2.  Stimulating   and   friendly   en- 
vironment. 

3.  Orientation      and      In-Service 
Education    Program. 

4.  Sound   Personnel    Policies. 

5.  Liberal    vacation. 

APPLICATIONS  FOR  REGISTERED 
NURSING  ASSISTANTS  INVITED. 

for  detailed  information 
please  write  to: 

The  Assistant  Director 

of  Nursing 

AUXILIARY  STAFF 

555   University  Avenue 
Toronto  101,  Ontario,  Canada 


NURSE 

ADMINISTRATORS 

UNITED  STATES 

Top  level  nursing  administrative  posi- 
tions are  immediately  available  at 
leading  medical  centres  throughout 
the  United  States.  These  unique  pro* 
fessional    opportunities    offer: 

•  Outstanding     salaries 

•  Comprehensive    benefits 

•  Full    administrative    support 

•  Choice    of    locale 

Absolutely  no  placement  fees.  Send 
resume     in     confidence    to: 

Mr.  Lewis  Jaffe 

MICHAEL  STARR 
INTERNATIONAL,  LTD. 

730   Fifth   Avenue, 
New  York,   N.Y.    10019 


NURSE 
TEACHERS 

For   2   year  diploma   program. 

Annual    enrollment    80    students. 

Social  Sciences  and  English 
taught  by  St.  Lawrence  College 
of  Applied  Arts  and  Technology. 

QUALIFICATIONS: 

Registered   Nurse   in  Ontario. 

Baccalaureate    Degree     in 
Nursing. 

Please  apply  in  writing  to: 

Director 

REGIONAL    SCHOOL   OF 

NURSING 

BROCKVILLE  GENERAL  HOSPITAL 

Brockville,    Ontario 


DECEMBER      1971 


THE     CANADI/IN     NURSE     59 


the  word  is 


OPPORTUNITY 

for  Registered  Nurses  in  tlie  medical 
centre  of  Atlantic  Canada 


Opportunity  for  professional  growth 
Opportunity  for  advancement 
Opportunity  for  specialization 

If  you  are  a  registered  nurse  looking  for  new 
horizons  where  you  can  fulfill  the  aspirations  of 
your  nursing  profession  in  the  challenging 
atmosphere  of  a  large,  progressive,  teaching  hospital 
. . .  join  us  at  the  Victoria  General.  Our  need 
is  your  opportunity.  There  are  excellent  general 
staff  openings  in  Medicine,  Neuro-surgery,  Surgery, 
Recovery  Room,  Emergency  and  Operating  Room 
and  Intensive  Care  Units.  Excellent  salary  and 
benefits  with  additional  credit  for  experience  and 
skills  learned  in  special  units.  You  will  enjoy 
living  in  Nova  Scotia  with  its  almost  unlimited 
recreational  opportunities  and  temperate  climate. 
We'll  be  glad  to  send  you  more  information. 

Write:  D.R.  Miller 

Personnel  Officer 

VICTORIA  GENERAL  HOSPITAL 

Halifax,  Nova  Scotia 


FIT  YOURSELF  INTO 
THIS  PICTURE 


and  be  part  of  the  Team  at 

SUNNYBROOK  HOSPITAL 

This  1,200  bed  University  owned  teaching  hospital 
offers  challenging  opportunities  in  medical,  surgical 
and  modern  specialty  units. 

•  Medical    &    Coronary    Intensive    Care    Unit 

•  Surgical     Intensive    Care    Unit 

•  Renal    Dialysis 

•  Rehabilitation   Medicine 

•  Neurosurgery 

•  Psychiatry 

Residence  accommodation  is  available  with  park- 
land setting  and  excellent  transportation  to  down- 
town Toronto. 

Comprehensive  range  of  fringe  benefits  and  com- 
petitive salaries  are  offered. 

For  further  information 
write  to: 

Selection  Officer 
Personnel  Department 

SUNNYBROOK  HOSPITAL 

2075  Bayview  Avenue 
Toronto  315,  Ontario 


60     THE     CANADIAN     NURSE 


DECEMBER      1971 


DO  YOU 

WANT  TO  HELP 

YOUR  PROFESSION? 

Then  fill  out  and  send  in  the  form  below 

REMIHANCE  FORM 
CANADIAN  NURSES'  FOUNDATION 

50  The  Driveway,  Ottawa  K2P  1 E2,  Ontario 

A  contribution  of  $  payable  to 

the  Canadian  Nurses'  Foundation  is  enclosed 
and  is  to  be  applied  as  indicated  below: 

MEMBERSHIP  (payable  annually) 

Nurse  Member  —  Regular  $     5.00   

Sustaining         $  50.00  

Patron 


$500.00 

Public  Member  —    Sustaining         $  50.00 
Patron  $500.00 

BURSARIES  $ RESEARCH  $ 

MEMORIAL  $ in  memory  of 


Name  and  address  of  person  to  be  notified  of 
this  gift   


REMITTER 

Address 
Position    . 
Employer 


(Print  name  in  full) 


N.B.:  CONTRIBUTIONS  TO  CNF 
ARE  DEDUCTIBLE  FOR  INCOME  TAX  PURPOSES 


Index 

to 

advertisers 

December  1971 

Baxter  Laboratories  of  Canada 

20 

Clinic  Shoemakers 

2 

Charles  E.  Frosst  &  Company 

..Cover  III 

The  Journal  of  Nursing  Administration  .. 

...Cover  IV 

Intra  Medical  Products 6 

J.B.  Lippincott  Company  of  Canada  Ltd Cover  II 

J.T.  Posey  Company 16 

Reeves  Company 41 

W.B.  Saunders  Company H 

Shering  Corporation  (Canada)  Limited 1 

Winley-Morris  Co.  Ltd 14 


Advertising 

Manager 

Georgina  Clarke 

The  Canadian  Nurse 

50  The  Driveway 

Ottawa  K2P  1E2  (Ontario 

Advertising  Representatives 
Richard  P.  Wilson 
219  East  Lancaster  Avenue 
Ardmore,  Penna.  19003 

Vanco  Publications, 
2  Tremont  Crescent 
Don  Mills,  Ontario 

Member  of  Canadian 
Circulations  Audit  Board  Inc. 


DECEMBER      1971 


THE     CANADIAN     NURSE     61 


INDEX  TO  VOLUME  SIXTY-SEVEN 


JANUARY-DECEMBER  1971 


ABDELLAH,FayeG. 

Problems,  issues,  challenges  of  nursing 
research.  44  (May) 

Speakers  and  panelists  announced  for  re- 
search conference.  10,  14  (.Ian) 

ABORTION 

ANPy  raises  fees,  approves  abortion 
removal  from  Code,  9  (Dec) 

C'NA  Board  rescinds  all  statements  on 
abortion,  5  (Nov) 

NBARN  to  issue  statement  on  abortion. 
10  (Aug) 

RNs  react  to  abortion  issue:  agree  CNA 
should  take  stand.  7.  12  (Feb) 

RNABC  wants  change  in  abortion  legis- 
lation. 16  (May) 

Abortion  debate  miscarries  at  RNAO 
annual  meeting.  12  (Jun) 

Board  finds  no  bias  in  abortion  demotion. 
17 (Sep) 

Lawrence  sidesteps  abortion  issue.  19  (Sep) 

Provincial  associations  veto  CNA's  abor- 
tion statement.  7  (Aug) 

ACCIDEIVTS 

Hlectricity:    a    hospital    hazard,    47    (Oct) 
Women    prone    to   whiplash    injuries,   44 
(Nov) 

ACCREDITATION 

Manitoba  seeks  to  accredit  all  health  fa- 
cilities, 15  (Apr) 

ACHIEVEMENT 

Selection  and  success  of  students  in  a  hos- 
pital school  of  nursing.  (Willett  et  al), 
41  (Jan) 

ACRES,  S.E. 

Venereal  disease  problem  in  Canada, 
(Davies),  24  (Jul) 

ADMINISTRATION 

WHO  seminar  for  chief  nurses  called  an 

"excellent  first",  10  (Oct) 
Underutilization    of  skills    leads   to    lack 

of  commitment,  10  (Dec) 

ADOLESCENCE 

Adolescent  sexual  activity,  (Szasz),  39 
(Oct) 

Course  on  adolescence  discusses  sex,  par- 
ents, epilepsy,  acne  .  .  .,  16  (Jan) 

Problems  of  pregnant  teenager  discussed 
at  symposium,  12  (Jun) 

ALBERT,  Yolande 

Mission  with  hospital  ship  Hope,  (port), 
20  (Mar) 

ALBERTA  ASSOCIATION  OF 
REGISTERED  NURSES 

AARN  brief  presented  to  Premier  and 
cabinet,  13.  14  (Mar) 

AARN  warns  nurses  of  job  shortage.  10 
(Jan) 

Betty  Sellers  appointed  nursing  service 
consultant,  (port).  24  (Apr) 

Conciliation  board  award  accepted  in  Al- 
berta, 8  (Aug) 


Edythe  Huffman  elected  vice-president. 
26  (Sep) 

Host  AARN  is  busy  with  hospitality  plans 
18  (Sep) 

Iris  Mossey  named  "nurse  of  the  year", 
(port),  26  (Sep) 

Judith  Prowse  elected  president-elect,  26 
(Sep) 

Margaret  Beswetherick  elected  vice-pres- 
ident. 26  (Sep) 

President  tells  AARN  it's  for  independ- 
ence. 7  (Jul) 

Roseanne    Hrickson    president.    26    (Sep) 

ALLAN,  Beth  (Bullis) 

Appointed  coordinator  of  patient  relations 
at  York-Finch  General  Hospital.  Downs- 
view,  Ontario,  (port).  19  (Mar) 

ALLEN,  Moyra 

Results  of  Ryerson  study  disclosed  at 
RNAO  meeting.  10  (Jun) 

AMERICAN  COLLEGE  OF 
OBSTETRICIANS  AND 
GYNECOLOGISTS 

Ruth  K.  Schinbein  elected  chairman  of 
Ontario  section  of  ACOG.  24  (Apr) 

AMERICAN  NURSES'  ASSOCIATION 

ANA    to    move    headquarters    to   Kansas 

City,  Missouri,  9  (Jul) 
Constance  A.  Holleran  appointed  director 

of  the  government  relations  department. 

18  (Mar) 
Research    officer   attends   ANA    national 

conference,  12  (May) 

ANDERSON,  Shirley 

Bk.  rev..  46  (Nov) 

ANDREWS,  Beverley 

Winner  of  spring  1971  Searle-Canada 
scholarship.  43  (Dec) 

ARC  AND,  Lisette 

Appointed  to  Directorate  of  Planning  and 
Research,  Social  Affairs  Department 
Quebec,  (port),  18  (Jun) 

ARTHRITIS 

The   smoothest  joints   in   town,   23   (Jan) 

ASSOCIATION  OF  NURSES  OF  THE 
PROVINCE  OF  QUEBEC 

ANPQ  honors  past  president  Caroline  V. 
Barrett,  (port),  8  (Jan) 

ANPQ  president  says  nurses  must  decide 
own  future,  8  (Jan) 

ANPQ  resolutions — forty  of  them!  8  (Jan) 

CEGEP  teachers  attend  ANPQ  workshops, 
18  (May) 

A  book  is  born  in  French,  10  (Jan) 

Forms  committee  to  study  Bill  65,  14 
(Oct) 

Helena  Reimer,  Secretary-Registrar, 
retires,  (port),  19  (Jan) 

Nicole  DuMouchel  appointed  Secretary- 
Registrar  of  ANPQ,  (port),  19  (Jan) 

The  old  rights  remain,  (Labonte),  21  (Dec) 

Protests  to  government  on  behalf  of  nurs- 
ing assistants,  1 1  (Oct) 


Quebec  postpones  nurses'  refresher  course, 
22  (Sep) 

Raises  fees,  approves  abortion  removal 
from  Code,  9  (Dec) 

Responds  to  Castonguay  report,  12  (Aug) 

Rita  Lussier  appointed  program  coordi- 
nator with  the  ANPQ,  (port),   19  (Jan) 

Quebec's  language  legislation  explained 
by  ANPQ,  10  (May) 

ASSOCIATION  OF  REGISTERED 
NURSES  OF  NEWFOUNDLAND 

ARNN  and  government  meet  on  wage 
demands,  12  (Apr) 

ASSOCIATION  OF  OPERATING 
ROOM  NURSES 

AORN  members  tly  to  Italy  on  seminar, 
17  (Jan) 

ATTO,  Ruth 

Bk.rev..  47  (Feb) 

ATTITUDES 

Comparison  of  social  attitudes  between 
freshmen  and  seniors  in  a  collegiate 
school  of  nursing,  (abst),  (Gorrow),  44 
(Feb) 

ASSOCIATION  OF  REGISTERED 
NURSES  OF  NEWFOUNDLAND 

Officers  for  1971,  15  (Feb) 

ATKINSON,  Dorothea 

Appointed    assistant    director    VON,    43 
(Dec) 
AUDIO  VISUAL  AIDS 

AV   aids,   50  (Feb).   53  (Mar),  56  (Apr), 

50  (Jun).  41   (Jul).  49  (Aug),  64  (Sep), 
48  (Nov),  (Dec) 

CBC    learning    systems    catalog,    (tapes), 

51  (Feb) 

CNA  film  available  through  local  chap- 
ters, 7  (Jan) 

EVR  cassette  catalogue,  41  (Jul) 

IV  additives:  steps  to  safety,  50  (Feb) 

LEGS  (Learning  experience  guides  for 
nursing  education),  51  (Feb) 

VD:  a  call  to  action,  57  (Apr) 

The  art  of  heart  auscultation,  (record), 
50  (Feb) 

Audio  slides  streamline  interviews,  (Hen- 
ricks),  35  (Aug) 

Audio  tape,  64  (Sep) 

Auditorium  slide  projector,  48  (Nov) 

Barnet,  48  (Nov) 

Body  talk,  64  (Sep) 

Canadian  film  catalog,  54  (Mar) 

Care  of  the  neurosurgical  patient,  49  (Aug) 

Cassette  duplicator,  49  (Aug) 

Challenge  for  the  health  team,  48  (Nov) 

Citizens'  medicine,  64  (Sep) 

Cut  1,  scene  2  or  .  .  .  how  to  make  a  film 
in  your  spare  time.  (Brydges),  26  (Nov) 

Dexon  nursing  film,  49  (Aug) 

Emergency  treatment  of  acute  psychotic 
reactions    due    to    psychoactive   drugs, 

52  (Jun) 

Examining  the  well  child,  52  (Jun) 

Faces  and   phases  of  O.R.   management, 

50  (Feb) 
Fears  of  children,  52  (Jun) 
Film  rejuvenation,  54  (Mar) 

•  II 


Films   about    Indian   people   of  Canada, 

64  (Sep) 
Films  available  from  Roche  Medical  Li- 
brary, 64  (Sep) 
Films  on  world  health  and  environmental 

control.  48  (Nov) 
A  half  million  teenagers,  57  (Apr) 
Health  on  wheels,  52  (Jun) 
I'm   not  a  small  adult — nursing  care  of 

the  pediatric  patient  in  surgery,  50  (Feb) 
L'infirmiere  au  Canada,  53  (Mar) 
Keep  off  the  grass,  57  (Apr) 
The  leaf  and  the  lamp,  53  (Mar) 
Literature  available,  49  (Aug) 
Modern   hospital   pharmacy  practice,   50 

(Feb) 
Mother-to-be,  64  (Sep) 
Multicolor    transparencies    for    overhead 

projection,  56  (Apr) 
National    AV    center    to    educate    health 

personnel?  50  (Jun) 
On    becoming    a    nurse-psychotherapist, 

64 (Sep) 
Poison,  52  (Jun) 

Portable  cassette  recorder/player,  56  (Apr) 
The  quality  of  life,  52  (Jun) 
A  royal  disease,  49  (Aug) 
School  health  in  action,  52  (Jun) 
Sony  videotape  splicing  kit,  5 1  (Feb) 
The  spark  of  life,  54  (Mar) 
Survey    to   determine    demand    for    tape 

cassette  program,  10  (May) 
Terminology  aid,  48  (Nov) 
Time  out  for  trouble,  52  (Jun) 
U.S.     medical    videotapes    available    for 

duplication,  54  (Mar) 
Videotape  production,  64  (Sep) 

AWARDS 

CNA  Board  nominates  candidate  for  ICN 

3-M  award,  8  (Feb) 
CNF  announces  two  MacLaggan  fellows, 

8  (Aug) 
NBARN    nursing    study    receives   federal 

grant,  13  (Aug) 
RCAMC  bursary  announced,  7  (Jun) 
SRNA  bursaries,  43  (Dec) 
Alice  J.    Baumgart   awarded    a    Milbank 

Faculty  Associate  Fellowship,   19  (Jan) 
^nne  Isobel  MacLeod  received  honorary 

Doctor   of  Law    degree    from    McGill 

University,  26  (Sep) 
Canadian    Red    Cross    Society,    Ontario 

Division,  44  (Dec) 

Citizenship  ceremony  also  honors  Flor- 
ence Nightingale,  6  (Jul) 

Evelyn  Pepper  awarded  Florence  Night- 
ingale Medal,  (port),  22  (Oct) 

Fellowships,  research  projects  funded  by 
National  Health  Grant,  8  (Mar) 

Florence  Nightingale  medal  minting  an- 
nounced, 10  (Jul) 

Four  awards  to  nursing  students  at  spring 
convocation  at  Queens',  24  (Sep) 

Friesen  sponsors  two  awards  to  be  given 
annually  by  CHA,  18  (Jan) 

Grant  helps  to  finance  special  course  for 
BC  nurses,  1 1  (Feb) 

Information  seminar  held  on  National 
Health  Grant,  10  (Jan) 

III 


Japanese  nurse  awarded  3M  fellowship, 
8  (Jul) 

Lyle  M.  Creelman  awarded  medal  of 
service  of  Order  of  Canada,  (port),  24 
(Sep) 

Mildred  I.  Walker  Bursary  Fund  establish- 
ed, 20  (Jun) 

National  Health  Grant  for  U.  of  T.  School 
of  Nursing,  I  I  (Feb) 

St.  John  Ambulance  bursaries.  15  (Dec) 
Searie-Canada  scholarships,  43  (Dec) 


B 


BACHAND,  Madeleine,  Sister 

Appointed  nursing  consultant  CNA,  (port), 
24  (Sep) 

BAETZ.Joan 

Serving    in   Afghanistan   with    MEDICO, 
(port).  15  (Feb) 

BANTING,  Frederick  Grant 

Banting  and  Best — the  men  who  tamed 
diabetes,  (Grant),  27  (Oct) 

BARD,  Lorene 

Lecturer  in  nursing  at  School  of  Nursing, 
Queen's  University,  43  (Nov) 

BARKMAN,  Patricia 

Awarded  SRNA  bursary,  43  (Dec) 

BARR,  Laura 

Ontario  job   market   tightens   for   nurses, 
II  (Aug) 

BARRETT,  Caroline  V. 

ANPQ    honors   past    president,    (port),    8 
(Jan) 

BARRETT,  Phyllis 

Elected   president   of  ARNN,   (port),    15 
(Feb) 

BATRA,  Carol 

Bk.  rev..  49  (Jun) 

BAUMGART,  Alice  J. 

Awarded    a    Milbank    Faculty   Associate 

Fellowship,  19  (Jan) 
Bk.  rev.,  48  (Feb) 

BEATH,  Helen 

Appointed   director   of  NBARN    nursing 
research  project,  14  (Aug) 

BEHAVIOUR 

Behavior    therapy    approach    to    psychi- 
atric disorder,  (Raeburn,  Soler),  36  (Oct) 

BELLHOUSE,  Barbara 

Bk.rev.,  48  (Dec) 

BERGLUND,  Mary 

Received    honorary    life    membership    in 
RNAO.  13  (Jul) 

BEST,  Charles 

Banting  and  Best — the  men  who  tamed 
diabetes,  (Grant),  27  (Oct) 

BESWETHERICK,  Margaret  Ann 

Elected  vice-president  of  AARN,  26  (Sep) 


Nurse  will  have  to  prove  herself  in  new 
role,  12  (Jul) 

BHUSARI,  Maijorie  V. 

Bk,  rev.,  56  (Oct) 

BIRTH  CONTROL 

CNA    board    issues  statement   on   family 

planning,  7  (May) 
ICN    supports   family   planning   as    basic 

human  right,  10  (Sep) 
Family     planning     conference     discusses 

federal  program,  17  (Apr) 
Family  planning  information.  46  (Aug) 
Vasectomy,  (Todd),  20  (Aug) 

BLAIKIE.ThelmaA. 

Director   of  nursing   education   at   Nova 
Scotia  Hospital,  43  (Nov) 

BLAND,  Eleanor 

Retired  as  head  nurse  at  Foothills  Hos- 
pital, Calgary,  (port),  24  (Sep) 

BLOOD  AND  BLOOD  DISEASES 

Hepatitis   associated   antigen   detected    in 
new  blood  test,  12  (Nov) 

BODY  TEMPERATURE 

Why    is    hypothermia    overlooked?    (Tol- 
man),  (port),  35  (Sep) 

BOOK  REVIEWS 

Allen.    Moyra,    Learning    to    nurse:    the 

first  five  years  of  the  Ryerson  nursing 

program,  (Reidy),  62  (Sep) 
Allen,    Virginia   O..   Community   college 

nursing  education,  49  (Jun) 
Altenderfer.  Marion  E..  Health  manpower 

in  hospitals.  (Losee).  40  (Jul) 
American  Academy  of  Facial  Plastic  and 

Reconstructive  Surgery.  Plastic  surgery 

of  the  nose.  50  (Jun) 
American  Hospital  Association.  Winds  of 

change.  54  (Oct) 

Anderson.    Helen  C.   Newton's  geriatric 

nursing.  47  (Dec) 
Anthony.  Catherine  Parker,  Textbook  of 

anatomy    and    physiology.    (KolthofO. 

48  (Dec) 

Beamish,  Rahno  M..  Fifty  years  a  Cana- 
dian nurse.  47  (Feb) 

Bernard.  Jessie,  Sociology:  nurses  and 
their  patients  in  a  modern  society. 
(Thompson),  61  (Sep) 

Bernard,  Viola  W.  (ed.).  Crises  of  family 
disorganization:  programs  to  soften 
their  impact,  (Pavenstedt).  54  (Oct) 

Bernstein,  Rose,  Helping  unmarried 
mothers,  47  (Nov) 

Brooks,  Stewart  M..  Basic  chemistry,  a 
programmed  presentation.  56sep) 

Brown,  Esther  Lucille,  Nursing  recon- 
sidered; a  study  of  change  part  1.  48 
(Feb) 

Crawford,  Charles  O.  (ed.).  Health  and 
the  family:  a  medical-sociological  anal- 
ysis, 49  (Jun) 

Craytor,  Josephine  K..  The  nurse  and  the 
cancer  patient:  a  programmed  text- 
book, (Fass),  52  (Mar) 

Desjardins,  Edouard,  Histoire  de  la  pro- 
fession  infirmiere  dans  la  province  de 


Quebec,  (etal),  10  (Jan) 
Desjardins.  Edouard,  Heritage:  history  of 
the  nursing  profession  in  the  province 
of  Quebec,  (el  al).  58  (Sep) 
Du  Gas.  Beverly  Witter,  Kozier  and  Du 
Gas"    introduction    to    patient    care.    8 
(Nov) 
Eng.  Evelyn.  Disaster  handbook,  (Garb) 

48  (Feb) 
Falconer.  Mary  W..  The  drug,  the  nurse, 

thepatient.  (etal),  48  (Aug) 
Fass,  Margot  L„  The  nurse  and  the  can- 
cer   patient;    a    programmed    textbook, 
(Craytor),  52  (Mar) 
Fitzpatrick,  E..  Maternity  nursing,  (et  al), 

48  (Dec) 
Foundation  for  Nursing  Education.  The 

yearbook  of  nursing  VIII,  49  (Dec) 
Fowler,   Thomas  J.,    Injectable   solutions 
and  additives:  compatibilities,  incompa- 
tibilities,   routes  of  administration,   46 
(Nov) 
Garb,  Soloman,  Clinical   guide  to   unde- 
sirable drug   interactions  and   interfer- 
ences, 56  (Oct) 
Garb,      Solomon,      Disaster      handbook, 

(Eng),  48  (Feb) 
Germain,  Carol   P.   Hanley,  Care  of  the 

adult  patient,  (et  al),  46  (Nov) 
Gips,  Claudia  D:.  Care  of  the  adult  pa- 
tient, (et  al),  46  (Nov) 
Given,  Barbara  A.,  Nursing  care  of  the 
patient  with  gastrointestinal  disorders, 
(Simmons),  48  (Dec) 

Gragg,  Shirley  Hawke,  Scientific  prin- 
ciples in  nursing,  (Rees),  58  (May) 

Guyatt,  Doris  E.,  The  one-parent  family 
in  Canada,  58  (Sep) 

Hamilton,  Persis  Mary,  Basic  pediatric 
nursing,  48  (Jun) 

Hymovich,  Debra  P.,  Nursing  and  the 
childbearing  family;  a  guide  for  study, 
(Reed),  47  (Nov) 

lorio,  Josephine,  Principles  of  obstetrics 
and  gynecology  for  nurses,  48  (Dec) 

Johnston,  Mabel  K.,  Mental  health  and 
mental  illness,  56  (Oct) 

Kee,  Joyce  LeFever,  Fluids  and  electro- 
lytes with  clinical  applications,  54  (Oct) 

Kernicki,  Jeanette,  Cardiovascular  nurs- 
ing, (et  al),  40  (Jul) 

King,  Imogene  M.,  Toward  a  theory  for 
nursing;  general  concepts  of  human 
behavior,  40  (Jul) 

Kintzel,  Kay  Corman,  (ed.).  Advanced 
concepts   in   clinical   nursing,   60  (Sep) 

Kleinman,  R.L.,  (ed.).  Medical  handbook, 
46  (Aug) 

Kolthoff,  Norma  Jane,  Textbook  of  anat- 
omy and  physiology,  (Anthony),  48 
(Dec) 

Kutscher,  Austin  H.,  (ed.).  For  the  be- 
reaved, (Kutscher),  46  (Aug) 

Lamb,  Lawrence  E.,  Your  heart  and  how 
to  live  with  it,  58  (May) 

Leininger,  Madeleine  M.,  Nursing  and 
anthropology:  two  worlds  to  blend,  47 
(Aug) 

Lerch,  Constance,  Maternity  nursing,  58 
(May) 


Levine,    Myra   E.,    Renewal    for   nursing 
47  (Dec) 

Losee,    Carrie   J..    Health    manpower    in 
hospitals,  (Altenderfer),  40  (Jul) 

McKeith,  Ronald,  Infant  feeding  &  feed- 
ing difficulties,  (Wood),  49  (Dec) 

Madigan,  Marian  East,  Psychology  prin- 
ciples and  applications,  48  (Feb) 

Manisoff,  Miriam,  Family  planning — a 
teaching  guide  for  nurses,  46  (Aug) 

Matheney,  Ruth  V.,  Psychiatric  nursing, 
(Topalis),  52  (Mar) 

Memmler,  Ruth  Lundeen,  The  human 
body  in  health  and  disease,  (Rada),  47 
(Feb) 

Mendels,  Joseph,  Concepts  of  depression, 

47  (Feb) 

Neleigh,  Janice  R.,  Training  nonprofes- 
sional community  project  leaders,  (et  al), 

48  (Aug) 

Notter,  Lucille  E..  Professional  nursing: 
foundations,  perspectives  and  relation- 
ships, (Spalding),  47  (Feb) 

O'Brien,  Maureen  J.,  The  care  of  the  aged: 
a  guide  for  the  licensed  practical  nurse, 
60  (Sep) 

Orem,  Dorothea  E.,  Nursing;  concepts  of 
practice,  47  (Dec) 

Pavenstedt,  Eleanor  (ed.).  Crises  of  family 
disorganization:  programs  to  soften 
their  impact,  (Bernard),  54  (Oct) 

Peel,  J.S.,  Introduction  to  physical  science 
for  students  of  nursing,  60  (Sep) 

Pelrine,  Eleanor  Wright,  Abortion  in  Can- 
ada, 47  (Aug) 

Pillsbury,  Donald  M„  A  manual  of  der- 
matology, 62  (Sep) 

Plummer,  Ada  Lawrence,  Principles  and 
practice  of  intravenous  therapy,  52 
(Mar) 

Poland,  Ronal  G.,  Adjustment  psychology: 
a  human  value  approach,  (Sanford),  60 
(Sep) 

Rabin,  Beatrice,  Nursing  in  the  coronary 
care  unit,  (Sharp),  52  (Mar) 

Rada,  Ruth  Byers,  The  human  body  in 
health  and  disease,  (Memmler),  47  (Feb) 

Red  Cross  Society,  Medical  language 
communicator,  56  (Apr) 

Reed,  Suellen  B.,  Nursing  and  the  child- 
bearing  family:  a  guide  for  study,  (Hy- 
movich), 47  (Nov) 

Rees,  Olive  M.,  Scientific  principles  in 
nursing,  (Gragg),  58  (May) 

Reidy,  Mary,  Learning  to  nurse;  the  first 
five  years  of  the  Ryerson  nursing  pro- 
gram, (Allen),  62  (Sep) 

Robinson,  Alice  M.,  Working  with  the 
mentally  ill,  46  (Nov) 

Rothman,  G.,  The  riddle  of  cruelty,  54 
(Oct) 

Sanford,  Nancy  D.,  Adjustment  psychol- 
ogy; a  human  value  approach,  (Poland), 
60  (Sep) 

Saylor,  C.L.,  (ed.).  Birth  control  and  the 
Christian;  a  Protestant  symposium  on 
the  control  of  human  reproduction, 
(Spitzer),  40(Jul) 

Sharp,  LaVaughn,  Nursing  in  the  coro- 
nary care  unit,  (Rabin),  52  (Mar) 


Simmons,  Sandra  J.,  Nursing  care  of  the 
patient  with  gastrointestinal  disorders, 
(Given).  48  (Dec) 

Smith,  Dorothy  W.,  Care  of  the  adult 
patient,  (etal),  46  (Nov) 

Smith  Lithograph  Co.,  First  aid  first,  50 
(Jun) 

Spalding,  Eugenia  Kennedy,  Professional 
nursing:  foundations,  perspectives  and 
relationships.  (Notter),  47  (Feb) 

Spitzer,  Walter  O.,  (ed.).  Birth  control 
and  the  Christian;  a  Protestant  sympo- 
sium on  the  control  of  human  reproduc- 
tion, (Saylor),  40  (Jul) 

Spivak,  1.  Howard,  1  have  feelings,  46 
(Nov) 

Stryker,  Ruth  Perin,  Back  to  nursing:  a 
guide  to  current  practice  for  active  and 
inactive  nurses,  61  (Sep) 

Thompson,  Lida  F.,  Sociology:  nurses 
and  their  patients  in  a  modern  society, 
(Bernard),  61  (Sep) 

Topalis,  Mary,  Psychiatric  nursing,  (Ma- 
theney), 52  (Mar) 

Tornyay,  Rheba  de.  Strategies  for  teach- 
ing nursing,  48  (Jun) 

Vanier  Institute  of  the  Family,  "Day 
care  —  a  resource  for  the  contempora- 
ry family",  51  (Feb) 

Wallace,  Margaret  Ann  Jaeger,  Hand- 
book of  child   nursing  care,  48  (Aug) 

Weller,  Barbara  F.,  Baby  surgery:  nurs- 
ing management  and  care,  (Young), 
50  (Dec) 

Wood,  Christopher,  Infant  feeding  &  feed- 
ing difficulties,  (McKeith),  49  (Dec) 

World  Health  Organization.  The  preven- 
tion of  perinatal  mortality  and  morbid- 
ity; report  of  a  WHO  expert  committee, 
50  (Jun) 

Young,  Daniel  G.,  Baby  surgery;  nursing 
management  and  care,  (Weller),  50 
(Dec) 

BOOKS 

47  (Feb),  52  (Mar),  58  (May),  48  (Jun), 
40  (Jul),  46  (Aug),  58  (Sep),  54  (Oct), 
46  (Nov),  47  (Dec) 

BOURRET,  Eileen 

Awarded  SRNA  bursary,  43  (Dec) 


BOYLE,  Peter 

Bk.  rev.,  52  (Mar) 

BRANDON  UNIVERSITY 

Sarah   Persis  Darrach  awarded  honorary 
doctor  of  laws  degree,  (port),  27  (Sep) 

BRATASCHUK,  Eunice 

Awarded  SRNA  bursary,  43  (Dec) 

BREEN,  Lawrence  J. 

Selection  and  success  of  students  in  a  hos- 
pital school  of  nursing,  (et  al),  41  (Jan) 

BRENCHLEY,  Maureen 

The    child   with    Hurler's    syndrome,    38 
(Feb) 

BRIDE,  E. 

Bk.  rev,.  60  (Sep) 

%  iV 


BRISCOE,  John  V. 

Appointed  assistant  administrator  (nurs- 
ing) at  Trenton  Memorial  Hospital. 
Trenton,  Ontario,  (port).  20  (Mar) 

BROUGH,  Sylvia 

Relationship  of  the  faculty  members 
perception  of  participation  in  policy 
making  to  their  perception  of  the  usa- 
bility of  the  policy,  (abst),  46  (Feb) 

BROWN,  Mabel  C. 

Bk.  rev.,  40  (Jul) 

BROWN,  Margaret  Joan 

Preadmission  orientation  for  children  and 
parents,  29  (Feb) 

BRYDGES,  Lynn 

Cut  I,  scene  2  or  .  .  .  how  to  make  a  film 
in  your  spare  time,  26  (Nov) 

BUCHAN,  D.J. 

Mind-body  relationships  in  gastrointesti- 
nal disease,  35  (Mar) 

BUCHAN,  Irene 

A  painter,  a  pilot,  a  rock  hound,  and  some 
cooks:  the  federal  nursing  consultants 
revisited,  (Starr),  24  (Dec) 

BURGESS,  Phyllis 

Bk.  rev.,52  (Mar) 

BURTON,  B. 

Bk.  rev.,47  (Dec) 

BUTLER,  Ada  Madeleine 

A  study  of  the  self  perceptions  of  a  select- 
ed group  of  recently  widowed  older 
people  concerning  physical  health  and 
use  of  community  health  resources, 
(abst),  45  (Dec) 


BUZZELL,  Elizabeth  Mary 

A  comparison  of  the  effectiveness  of  two 
nursing  approaches  in  the  relief  of  post- 
operative pain,  (Roberto),  (abst),  45 
(Aug) 


CARE/MEDICO 

Marie  T.  Germin  with  MEDICO  at  Avi- 
cenna  Hospital,  Kabul,  Afghanistan, 
26  (May) 

CEGEP 

CEGEP  teachers  attend  ANPQ  work- 
shops, 18  (May) 

Limit  registration  in  nursing  course,  10 
(Jul) 

CUSO 

Nelly  Garzon  and  Lotti  Wiesner  in  Can- 
ada as  guests  of  CUSO.  26  (May) 

CALLIN,  Mona 

Bk.  rev.,  49(Jun) 

CAMMAERT,  Margaret 

Chief  nurse  with  PA  HO  paid  official  visit 
to  Dept.  of  National  Health  &  Welfare, 
24  (Apr) 

V 


CAMPBELL,  M. 

Bk.  rev.,  52  (Mar) 

CAMPBELL,  Shirley 

Bk.rev.,  61  (Sep) 

CANADIAN  ASSOCIATION  OF 
NEUROLOGICAL  AND 
NEUROSURGICAL  NURSES 

Neuro  nurses  meet  in  Newfoundland,  13 
(Sep) 

CANADIAN  ASSOCIATION  OF 

UNIVERSITY  SCHOOLS  OF  NURSING 

CCUSN  changes  names  to  CAUSN.  1 1 
(Aug) 

Considers  expanding  role,  status  of  wom- 
en, 12  (Dec) 

Eileen  Healey  Mountain  appointed 
executive  secretary,  43  (Dec) 

CANADIAN  CANCER  SOCIETY 

Grace  Carter  became  national  education 
officer,  (port),  24  (Apr) 

CANADIAN  CONFERENCE  OF 
UNIVERSITY  SCHOOLS  OF 
NURSING 

CCUSN    changes   names   to  CAUSN.    11 

(Aug) 
Elizabeth  K.   MoCann  new   president.    16 

(Feb) 
Task  force  discussion  by  Quebec  chapter. 

13  (Mar) 
Master's     program     study     planned     by 

CCUSN  (AR),  14(Jun) 

CANADIAN  COUNCIL  OF  HOSPITAL 
ACCREDITATION 

Chairman  saysCNA  should  be  on  council, 
12  (Dec) 

CANADIAN  DLVBETIC 
ASSOC  L\TION 

Insulin  discovered  fifty  years  ago,  14  (Jun) 

CANADIAN  HOSPITAL 
ASSOCUTION 

Friesen  sponsors  two  awards  to  be  given 
annually  by  CHA.  18  (Jan) 

CANADIAN  MEDICAL  ASSOCLVTION 

CPHA  agrees  to  CMA  stand  on  smoking 
and  health,  8  (Jun) 

CANADL\N  NURSE 

Information     for    authors,     31  (Jan),    42 

(Feb),  46  (Mar) 
Readershipsurvey,(Lindabury),  (editorial), 

3  (Jun) 
Subscription    rates    up   for   non-members 

ofCNA,  6  (Nov) 
What  readers  like —  and  want  changed  — 

in  the  Canadian  Nurse,  (Shaw),  29  (Jun) 

CANADIAN  NURSES'  ASSOCIATION 

CCHA  chairman  says  CNA  should  be  on 
council,  12  (Dec) 

CNA   annual   meeting;   report,   33   (May) 

CNA  executive  director  appointed  to 
Economic  Council  of  Canada,  II  (Apr) 

CNA  film  available  through  local  chap- 
ter, 7  (Jan) 

CNA    holds    annual    meeting    in   Ottawa 


next  month.  8  (Feb) 

CNA  president  tells  SRNA  revision  of 
health  systems  will  require  collabora- 
tion, 20  (Sep) 

CNA's  goals,  functions,  and  structure, 
(l-indabury),  (editorial).  3  (Nov) 

RNs  react  to  abortion  issue:  agree  CNA 
should  take  stand.  7.  12  (Feb) 

Action  on  resolutions  from  CNA  35th 
general  meeting,  34  (May) 

And  here's  a  toast  ....  7  (May) 

Auditors"  report,  42  (Mar) 

Believes  proposals  would  turn  ICN  into 
conglomerate,  7  (Dec) 

Community  health  centers  first  of  CNA 
priorities  for  1970-72,  5  (Nov) 

Educational  goals,  deterrents  identified  in 
CNA  study  of  RNs,  10  (Oct) 

Helen  McArthur  chalks  up  a  first.  8  (May) 

Official  directory,  72  (Feb),  72  (Mar), 
80 (Sep) 

Official  notice  of  CNA  annual  meeting, 
8  (Feb) 

Provincial  associations  veto  CNA's  abor- 
tion statement,  7  (Aug) 

Rachel  l.amothe  and  Nancy  Garrett  ap- 
pointed research  analysts,  (port),  22 
(Oct) 

Registrants  at  C  NA  meeting  will  receive 
all  documents.  5  (Nov) 

Report  to  the  Minister  of  National  Health 
and  Welfare  on  the  recommendations 
of  the  Task  Forces  on  the  Cost  of 
Health  Services  in  Canada,  27  (Jan) 

Research  officers  provide  information 
for  decisions,  7  (Dec) 

Retiring  presidents  and  CNA  standing 
committee  chairmen  recommend 
changes  to  directors,  5  (Nov) 

Sister  Madeleine  Bachand  appointed  nurs- 
consultant,  (port),  24  (Sep) 

CANADIAN  NURSES'  ASSOCIATION. 
AD  HOC  COMMITTEE  ON  FRENCH 
LANGUAGE  TEXTBOOKS 

CNA  board  sets  up  committee  to  study 
French-language  texts,  7  (Jan) 

Enthusiasm  evident  as  committee  begins 
work,  8  (Mar) 

Gets  good  response  from  publishers,  7 
(May) 

CANADIAN  NURSES'  ASSOCIATION. 
AD  HOC  COMMITTEE  ON  NURSING 
RESEARCH 

Examines  provincial  research,  5  (Jul) 

CANADIAN  NURSES'  ASSOCIATION. 
BOARD  OF  DIRECTORS 

Approve  dual  structure  for  testing  Service, 

7(Dec) 
Board  rescinds  all  statements  on  abortion, 

5  (Nov) 
Discuss   possibility   of  making   statement 
on   legislation   that   affects   nurses  and 
nursing,  8  (Dec) 
Grants  DBS   access   to   address   tapes,   8 

(May) 
Issues   statement   on   family   planning.    7 

(May) 
Nominates  candidate  for  ICN  3-M  award, 
8  (Feb) 


"Old  hands"  group  to  meet  in  tall.  9  (Sep) 

Sets  up  committee  to  study  French-lang- 
uage texts.  7  (Jan) 

Survey  to  determine  demand  tor  tape 
cassette  program.  10  (May) 

Votes     in     favor     of    commonwealth 
association.  7  (May) 
CANADIAN  NLIRSES-  ASSOCIATION 

COMMITTEE  ON  SOCIAL  AND 

ECONOMIC  WELFARE 

Meets  at  C'NA  house,  7  (.Ian) 

CANADUN  NLIRSES-  ASSOCIATION. 
CONVENTION  1972 

Alberta's    lieut. -Governor    is    speaker   at 

CNA  biennial.  10  (Oct) 
Host  AARN  is  busy  with  hospitality  plans 

18 (Sep) 

CANADIAN  NURSES' ASSOC L\TION. 
LIBRARY 

Accession  list.  52  (Feb).  54  (Mar).  58 
(Apr).  60  (May).  52  (Jun).  41  (Jul).  50 
(Aug).  65  (Sep).  58  (Oct).  49  (Nov). 
50  (Dec) 

169  nursing  studies  received  in  CNA 
library  in  1971.  6  (Nov) 

CANADUN  NURSES'  ASSOCIATION. 
NURSING  EDUCATION  COMMITTEE 

Two  C  NA  standing  committees  meet.  7 
(Mar) 

CANADLVN  NURSES'  ASSOCIATION. 
NURSING  SERVICE  COMMITTEE 

Two  CNA  standing  committees  meet 
7.  8  (Mar) 

CANADIAN  NURSES' ASSOCUTION. 
SPECLVL  COMMITTEE  ON  NURSING 
RESEARCH 

Nursing  research  committee  to  develop 
code  of  ethics,  1  1  (Apr) 

CANADIAN  NURSES'  ASSOCIATION 
TESTING  SERVICE 

CNA  directors  approve  dual  structure. 
7  (Dec) 

Dorothy  Colquhoun  retired  as  acting 
director,  (port).  13  (Jul) 

Eric  G.  Parrott  director  of  test  develop- 
ment, (port).  42  (Dec) 

Henry  P.  Cousens  director  of  administra- 
tion, (port).  42  (Dec) 

Large  number  of  candidates  write  CNATS 
examinations.  8  (Mar) 

CANADIAN  NURSES' FOUNDATION 

Announces    two    MacLaggan    fellows.    8 

(Aug) 
Board  elects  president  and  vice-president 

for  2-year  term.  6  (Nov) 
Board  of  Directors  hears  membership  up. 

7  (Jan) 
Reaffirms    principle    of  permanent    fund. 

5  (Jul) 

CANADIAN  PUBLIC  HEALTH 
ASSOC  L\TION 

CPHA  agrees  to  CMA  stand  on  smoking 

and  health,  8  (Jun) 
Health  of  city  dwellers  discissed  at  CPHA 

session.  10  (Jun) 
Joyce   Nevitt   elected    president   of  New- 


foundland branch.  15  (Feb) 
Physician    assistant's    role    discussed     by 
CPHA  panel.  7  (Jun) 

CANADLVN  PUBLIC  RELATIONS 
SOCIETY 

T.M.  Miller  presented  with  life  member- 
ship, (port).  20  (Mar) 

CANADIAN  PSYCHL\TRIC 
ASSOCIATION 

Canadian  psychiatrists  protest  Soviet 
misuse  of  mental  hospitals.  12  (May) 

CANADIAN  RED  CROSS  SOCIETY 

Helen  M.  Carpenter  awarded  honorary 
membership.  16  (Feb) 

Helen  McArthur  retired  as  national  direc- 
tor of  nursing,  (port).  22  (Oct) 

Janice  Given  awarded  Volunteer  Nursing 
Committee  bursary.  44  (Dec) 

Medical  language  communicator,  (bk. 
rev.).  56  (Apr) 

CANADIAN  TUBERCILOSIS  AND 
RESPIRATORY  DISEASE 
ASSOCLVTION 

International  medical  expert  shows  our 
role  is  vital  in  "the  other  world".  9 
(Aug) 

CANCER 

Bracken  fern  dangerous'.'  26  (Jun) 
The  cancer  patient.  (Stockdale).  43  (Apr) 
Pain  and  suffering  in  cancer,  (lurnbulll. 
28  (Aug) 

CARPENTER,  Helen  M. 

Honorary  membership  in  Canadian  Red 
Cross  Society.  16  (Feb) 

CARRUTHERS,  Glenda  Korene 

Received  University  Prize,  (port),  14 
(Jul) 

CARTER,  Beverley 

Awarded  SRNA  bursary.  43  (Dec) 

CARTER,  Grace 

National  education  officer  of  Canadian 
Cancer  Society,  (port),  24  (Apr) 

CARTER.  Patricia  Susan 

Awarded  medal  in  nursing  and  pro- 
fessor's prize  in  nursing  sciences  at' 
Queens"  University  spring  convocation, 
24  (Sep) 

CARTY,  Elaine 

Lecturer  in  nursing  at  School  of  Nursing, 
Queen's  University.  43  (Nov) 

CASE  WESTERN  RESERVE  UNIVERSITY 

To  offer  Ph.D.  program  in  nursing.  13 
(Dec) 

CASTONGUAY  REPORT 

ANPQ  responds.  12  (.Aug) 

CEREBROVASCULAR  ACCIDENT 

Nursing  care  given  by  general  staff  hos- 
pital nurses  to  a  selected  group  of  pa- 
tients who  had  experienced  a  cerebro- 
vascular accident,  (Patrick),  (abst),  41 
(Nov) 


CHALMERS,  Hal 

Director  of  school  of  nursing  at  Univer- 
sity of  Alberta  Hospital,  (port).  24  (Oct) 

CHILDREN 

C  anadian  soldiers  in  Cyprus  help  crip- 
pled children,  14  (Feb) 

CHISHOLM,  Dorothy 

Regional  consultant,  public  health  nurs- 
ing, in  Local  Health  Services  Branch, 
Eastern  Region,  of  ODH.  42  (Nov) 

CHRONIC  ILLNESS 

A  study  to  develop  an  instrument  to  assist 
nurses  to  assess  the  abilities  of  patients 
with  chronic  conditions  to  feed  them- 
selves. (Phillips),  (abst),  45  (Aug) 

CLARE  MARIE,  Sister 

Advisor  in  nursing  education  of  RNANS, 
19  (Jan) 

CLARK,  Linda 

Working  in  Family  Health  C  are  Centre 
at  McMaster  University  Medical  Cen- 
tre, (port).  16  (Feb) 

CLARKE  INSTITUTE  OF  PSYCHIATRY 

Life  style  of  homosexual  studied.   12  (Jul) 

CLAVER,  Peter,  Sister 

Bk.  rev..  46  (Aug) 

CLEMENTS,  Geraldine  R. 

Appointed  director  of  nursing  at  Oromoc- 
to  Public  Hospital.  22  (Oct) 

COLLECTIVE  BARGAINING 

ARNN    and    government    meet   on    wage 

demands.  12  (Apr) 
MARN    wants    RNs   only    in    bargaining 

units.  10  (Aug) 
RNAO  accepts  concept  of  group  bargain- 
ing, 17  (Jan) 
RNAO  removes  greylisting  of  Scarborough 

Health  Department,  8  (Feb) 
Collective    bargaining    a    charade,    B.C. 

nurses  told,  14  (Jun) 
Conciliation    board    award    accepted    in 

Alberta,  8  (Aug) 
Contract    dispute    of    nurses    in    federal 
public  service  taken  to  arbitration,    12 
(Aug) 
Federal    nurses    far    from    satisfied    with 

arbitration  tribunal  award,  15  (Dec) 
Manitoba  board  refuses  to  certify  Winni- 
peg group,  20  (Apr) 
Manitoba   nurses   now   accept   bargaining 

concept,  12  (Mar) 
More  money  for  Manitoba  nurses  in  new 

collective  agreement.  6  (Nov) 
Nova  Scotia  nurses  ratify  four  collective 

agreements.  9  (Sep) 
Nova  Scotia  nurses  sign    197  1   contracts. 

12  (Mar) 
Nova  Scotia  nurses  want  to  bargain  with 

province,  13  (Aug) 
Nurses'    needs   and   wants   turn    them   to 

group  action.  10  (Feb) 
Public    hospital    nurses   sign    new    agree- 
ment. 16  (Mar) 
Three  Sudbury   nurses  win   hospital   set- 

•  VI 


tlement  after  13  months"  fight,  14  (Sep)      CORNTHWAITE,  Gwen 


Winnipeg  nurses  denied  re-hearing  of 
application,  10  (Jul) 

Winnipeg  nurses  seek  re-hearing  of  bar- 
gaining application,  18  (May) 

COLLEGE  OF  NURSES  OF  ONTARIO 

RNAO  wants  College  of  Nurses  to  con- 
tinue jurisdiction  over  nursing  assis- 
tants, 15  (Jun) 

COLLEGE  OF  PHYSICIANS  AND 
SURGEONS  OF  ONTARIO 

TV  panelist  named  a  medical  watchdog, 
23  (Apr) 

COLQUHOUN,  Dorothy 

Retired  as  acting  director  of  CNA  Test- 
ing Service,  (port).  13  (Jul) 


COLVIN,  Isabel T. 

To  be.  or  not  to  be- 


disposable!  31  (Jul) 


COMMITTEE  ON  CLINICAL  TRAINING 
OF  NURSES  FOR  MEDICAL 
SERVICES  IN  THE  NORTH 

Committee  on  clinical  trammg  for  nurses 
in  the  north  reports  to  health  min- 
ister, 12  (May) 

COMMONWEALTH  NURSES' 
FEDERATION 

CNA  board  votes  in  favor  of  common- 
wealth association,  7  (May) 

COMMUNICATION 

"Nursing  Communication  Act"  is  the 
core  of  nursing,  (Schumacher),  40  (Feb) 

Relatives  and  friends,  (Lindabury),  (edi- 
torial), 3  (Mar) 

COMMUNITY  SERVICES 

See  Health  Facilities 

CONFERENCES  AND  INSTITUTES 

ANPO  Conference  for  industrial  nurses, 
13  (Dec) 

AORN  members  fly  to  Italy  on  seminar, 
17  (Jan) 

Convention-itis,  30  (May) 

National  conference  called  on  assistance 
to  physicians,  7  (Mar) 

National  conference  on  research  in  nurs- 
ing practice,  (report),  34  (Apr) 

Physicians,  administrators  join  nurses  in 
Hamilton  seminar,  14,  16  (Jan) 

Research,  apple  juice,  and  daffodils — a 
good  combination  .  .  ..  (Kergin),  33 
(Apr) 

Second  National  Health  Manpower 
Conference,  9  (Dec) 

Sending  someone  to  a  conference?  (Mc- 
Kone),  36  (Feb) 

Speakers  and  panelists  announced  for  re- 
search conference,  10,  14  (Jan) 

University  nursing  students  hold  cons- 
titutional conference,  14  (Apr) 

CONROY,  Mary  M. 

Catchbasins,  debentures,  subsidies  and 
garbage  cans,  27  (Feb) 

COOKE,  T  J)  .V. 

Rehabilitation  of  a  quadriplegic,  (Ford' 
37  (Aug) 

VM 


Bk.  rev..  50  (Dec) 

COSMETICS 

Underarm  sprays  dangerous?  43  (Aug) 

COUSENS.  Henry  P. 

Director  of  administration  CNA  Testing 
Service,  (port),  42  (Dec) 

CREELMAN,  LyIeM. 

Awarded  medal  of  service  of  Order  of 
Canada,  (port),  24  (Sep) 

CROPPER,  Maureen 

Bk.  rev..  48  (Jun) 

CROSSLEY,  Vicki 

Acting  out  or  acting  up?  45  (Sep) 

CROTEAU,  Audrey  (Jarvis) 

Named  director  nursing  service  division, 
Misericordia  General  Hospital,  Winni- 
peg, (port),  18  (Jun) 

CROZIER,  Shirley.  Sister 

Appointed  administrator  of  the  General 
Hospital,  Sault  Ste.  Marie,  Ontario, 
15 (Feb) 

CURRIE,  Mona 

In  this  case  she's  a  body  cast  painter.  1 1 
(Oct) 


D 


DARRACH,  Sarah  Persis 

Honorary  doctor  of  laws  degree  from 
Brandon  University,  (port).  27  (Sep) 

DIABETES 

Young  diabetics  enjoy  camp,  too,  (Fitz- 
gerald), 51  (May) 

DALHOUSIE  UNIVERSITY.  SCHOOL 
OF  NURSING 

Nova  Scotia  lacks  nurses  with  degrees, 
17  (Mar) 

DATES 

22  (Jan).  54  (Feb).  26  (Mar),  54  (Apr), 
29  (May).  24  (Jun),  38  (Jul),  15  (Aug), 
29  (Sept),  52  (Oct),  20  (Nov).  19  (Dec) 

DAUK,  Caroline  S.N. 

SRNA  honor  role,  24  (Sep) 

DAVIDSON,  Muriel  H. 

First  director  of  health  services  for 
George  Brown  College  of  Applied 
Arts  and  Technology,  Toronto,  (port). 
16  (Feb) 

DAVIES,J.W. 

Venereal  disease  problem  in  Canada, 
(Acres).  24  (Jul) 

DAVIES.  Lorraine 

A  painter,  a  pilot,  a  rock  hound,  and  some 
cooks:  the  federal  nursing  consultants 
revisited,  (Starr),  24  (Dec) 

DAVIES,  Susan 

Honored  on  retirement,  18  (Jun) 


DEATH 

Dying    with    dignity,    (Kubler-Ross),    31 

(Oct) 
Nationalism  goes  funereally,  23  (Jan) 

DEMPSEY.  Donna 

Bk.rev.,  54  (Oct) 

DENTISTRY 

Hold  that  smile,  30  (Apr) 

DEPT.  OF  NATIONAL  HEALTH  & 
WELFARE 

DNHW    study    confirms    need,    proposes 

psychiatric  courses,  20  (Oct) 
Information    seminar    held    on    National 

Health  Grant,  10  (Jan) 
Louise  Tod  appointed  nursing  consultant 

for   hospital    insurance   and    diagnostic 

services,  (port),  42  (Dec) 
A  painter,  a  pilot,  a  rock  hound,  and  some 

cooks:    the  federal   nursing  consultants 

revisited,  (Starr),  24  (Dec) 
Travel    seminars    to    be    held    for    nurse 

educators,  7  (Jan) 

DERDALL,  MARION  J. 

Basilar  aneurysms,  49  (Apr) 

DIABETES 

Banting  and  Best —  the  men  who  tamed 

diabetes.  (Grant),  27  (Oct) 
Insulin  discovered  fifty  years  ago,  14  (Jun) 

DIBLASIO,  Elsie  K. 

Appointed  curriculum  coordinator  at 
Lakehead  Regional  School  of  Nursing, 
(port),  15  (Feb) 

DICKSON.  Elinor .1..  Sister 

Selection  and  success  of  students  in  a  hos- 
pital school  of  nursing,  (ct  al ),  41  (Jan) 

DIETETICS 

Its  a  new  game,  23  (Jan) 

DIGNARD,  Maurice 

Decorated  by  Government  of  Jordan,  26 
(Apr) 

DOEPKER,  Kenneth  B. 

Awarded  SRNA  bursary,  20  (Jan) 

DOMINION  BUREAU  OF  STATISTICS 

Board  grants  DBS  access  to  address  tapes, 
8  (May) 

DRUGS 

UBC  studies  marijuana  effect  on  short- 
term  memory.  12  (Nov) 

Days  of  pill-pushing  nurse  are  numbered, 
12  (Feb) 

Do  you  have  a  bad  trip  if  you  go  to  hos- 
pital? (Hacker).  39  (Jun) 

Drug  symposium  recommends  commu- 
nity clinics.  16  (Apr) 

Drug  use  only  tip  of  iceberg  —  doctor  tells 
industrial  nurses.  13  (Dec) 

key    pharmaceutical    syllables.    41    (Aug) 

Rock  festivals —  new  problems,  new 
solutions,  (Zimmerman.  Jansons).  32 
(Dec) 


Special  emergency  units  needed  for  drug- 
users,  18  <Sep) 

DRURY,  Betty 

Appointed  director  of  nursing  of  Sturgeon 
General  Hospital,  20  (Mar) 

DU  GAS.  Beverly 

A  painter,  a  pilot,  a  rock  hound,  and  some 
cooks:  the  federal  nursing  consultants 
revisited,  (Starr),  24  (Dec) 

DUMONT.  Mareelle 

Deep-freeze  seminar — a  warm  experi- 
ence, (Rockburne),  35  (Jun) 

DUMOUCHEL,  Nicole 

Appointed  Secretary-Registrar  of  ANPQ 
(port),  19  (Jan) 

DUNN.  Ivy  H. 

Appointed   director  of  nursing  at  Royal 
Ottawa  Hospital,  (port).  27  (Sep) 
DUSSAULT,  Rita 

Director  of  school  of  nursing  sciences  at 
Laval  U  niversity,  (port),  18  (Jun) 

E 
ECONOMIC  COUNCIL  OF  CANADA 

CNA  executive  director  appointed  to 
Economic  Council  of  Canada,  II  (Apr) 

EDUCATION 

NBARN  fears  future  challenged  by  nurs- 
ing education  report,  16  (Oct) 
NBARN  gives  brief  to  study  committee 
10  (Feb) 

Comparison  of  social  attitudes  between 
freshmen  and  seniors  in  a  collegiate 
school  nursing,  (abst),  (Gorrow),  44 
(Feb) 

Educational  goals,  deterrents  identified  in 
CNA  study  of  RNs,  10  (Oct) 

Examine  teacher  evaluation  by  nursing 
students  in  England,  12  (Nov) 

Flexible  program  prepares  researchers  at 
atU.  of  Alberta,  17  (Oct) 

Hospital  clinical  facilities  utilized  by  Edr 
monton  nursing  programs:  a  descriptive 
study,  (Mrazek),  (abst),  45  (Aug) 

Nurse  educators  travel  to  north  on  semi- 
nars. 8  (Mar) 

"Nursing  Communication  Act"  is  the  core 
of  nursing,  (Schumacher).  40  (Feb) 

Nursing  student  enrollment  increases  in 
province  of  Quebec,  1 1  (Feb) 

The  old  rights  remain,  (Labonte),  21  (Dec) 

A  pioneer  in  nursing  education.  (Kotlars- 
ky).  33  (Nov) 

Relationship  of  the  faculty  members' 
perception  of  participation  in  policy 
making  to  their  perception  of  the  usa- 
bility of  the  policy,  (Brough).  (abst), 
46  (Feb) 

Travel  seminars  to  be  held  for  nurse  edu- 
cators, 7  (Jan) 

EDUCATION,  BACCALAUREATE 

CCUSN    changes  names  to  CAUSN,    II 

(Aug) 
First  nursing  intersession  chosen  by  RNs 

at  Windsor  U.,  20  (Oct) 


Nursing  degree  program  updated.  22  (Sep) 

Ottawa  U.  nursing  students  polish  debat- 
ing skills.  18  (May) 

A  study  of  literature  selection  in  bacca- 
laureate students  in  nursing,  (Munro), 
(abst),  51  (Mar) 

Survey  shows  problems  of  degree  nurses 
8  (Jul) 

EDUCATION,  CONTINUING 

DNHW  study  confirms  need,  proposes 
psychiatric  courses,  20  (Oct) 

RNAO,  OHA,  OMA  sponsor  courses  in 
coronary  nursing,  12.  14  (Feb) 

Course  on  adolescence  discusses  sex.  par- 
ents, epilepsy,  acne  . .  .,  16  (Jan) 

Grant  helps  to  finance  special  course  for 
BC  nurses,  1 1  (Feb) 

New  UBC  program  in  continuing  educa- 
tion, 19 (Sep) 

Post-diploma  programs  expanded  at  Ryer- 
son,  13  (Aug) 

RNANS  sponsors  three  courses.  13  (Mar) 

EDUCATION,  DIPLOMA  PROGRAMS 

CEGEP  teachers  attend  ANPQ  workshops, 
18  (May) 

CEGEPs  limit  registration  in  nursing 
course,  10  (Jul) 

NBARN  wants  end  of  hospital  schools, 
16  (Mar) 

New  method  used  to  develop  curriculum, 
11  (Feb) 

Nursing  education  committee  hearings 
turn  controversial,  14  (Apr) 

Selection  and  success  of  students  in  a  hos- 
pital school  of  nursing,  (Willet  et  al), 
41  (Jan) 

A  study  of  the  perceived  learning  needs 
of  graduates  of  a  two  year  diploma 
program  in  nursing  during  the  first 
three  months  of  employment,  (Howard), 
(abst),  46  (Dec) 

Trends  for  diploma  programs  in  nursing 
in  Ontario  as  reflected  in  the  nursing 
literature  and  the  opinions  of  selected 
nurse  educators,  (Lambeth),  (abst),  45 
(Dec) 

EDUCATION,  GRADUATE 

Case  Western  Reserve  to  offer  PhD. 
program  in  nursing,  13  (Dec) 

Master's  program  study  planned  by 
CCUSN  (AR),  14  (Jun) 

EDUCATION,  INSERVICE 

See  Inservice  Education 

EMERGENCIES 

Emergency  department  nurses  form  asso- 
ciation in  Edmonton,  16  (Jan) 

EMERGENCY  DEPARTMENT  NURSES 
ASSOC  LVT  ION 

Emergency  department  nurses  form  asso- 
ciation in  Edmonton.  16  (Jan) 

EMORY,  Florence  H.M. 

A  pioneer  in  nursing  education,  (Kotlars- 
ky).  33  (Nov) 


EMPLOYMENT  CONDITIONS 

SRNA  staff  tried  four-day  work  week    13 

(Sep) 
US  nurses  like  short  work  week.  20  (Apr) 

EQUIPMENT  AND  SUPPLIES 

To  be.  or  not  to  be — disposable!  (Col- 
vin).  31  (Jul) 

ERICKSON,  Roseanne 

President  of  AARN.  (port).  26  (Sep) 

EVALUATION 

Examine   teacher   evaluation   by   nursing 
students  in  England,  12  (Nov) 

EXAMINATIONS 

See  Tests  and  Measurements 


FAHLMAN,  Marge 

Bk.  rev.,  40  (Jul) 

FEES 

ANPQ  raises  fees,  9  (Dec) 


FELICITAS,  Mary,  Sister 

SRNA  honor  role.  24  (Sep) 
Bk.  rev..  58  (Sep) 

FERRARI,  Harriet  E. 

The  nurse  and  VD  control,  28  (Jul) 

FILMS 

See  Audio  Visual  A  ids 

FITZGERALD,  Doris 

Young  diabetics  enjoy  camp,  too,  5 1  (May) 

FITZGERALD,  Mary  Jean 

The  Colonel  is  a  lady — and  a  nurse, 
(Lockeberg),  23  (Nov) 

FLAHERTY,  M.Josephine 

President  of  RNAO.  14  (Aug) 

FLANAGAN,  Eileen 

Autographs  the  first  copy  of  "Histoire  de 
la  profession  infirmiere  dans  la  provin- 
ce de  Quebec",  (port).  10  (Jan) 

FLETT,  Dariene  E. 

Patients  don't  follow  what  MDs  order, 
26  (Jun) 

FOLEY,  Joan 

Wanted:  a  theory  of  nursing,  28  (Nov) 

FORD,  J.R. 

Rehabilitation  of  a  quadriplegic,  (Cooke), 

37  (Aug) 

FORD,  LorettaC. 

Nursing — evolution  or  revolution?  32 
(Jan) 

FRANCIS,  Anne  (Bird) 

A  look  at  the  Francis  Report  on  the  status 
of  women  in  Canada.  25  (Feb) 

ERASER,  Shirley 

Nurse  at  sea,  17  (Aug) 

FRENCH    LANGUAGE 

Enthusiasm  evident  as  committee  begins 
work.  8  (Mar) 

VIII 


Immigrant  nurses  get  language  reprieve. 

8(Jun) 
Migrant  nurses  to  attend  French-language 

classes.  10  (Mar) 

FULTON,  Norma  Joy 

Assistant  professor  in  continuing  educa- 
tion at  University  of  Saskatchewan 
School  of  Nursing,  (port),  43  (Nov) 

FUSSELL,  Marjorie 

Bk.  Rev..  40  (Jul) 

FYLES,  T.W. 

Appointed  vice-president  (health  sciences) 
of  University  of  Manitoba.  19(Jun) 


GANNON,  Catherine 

Appointed  regional  director  New  Bruns- 
wick VON.  43  (Dec) 

GARRETT,  Nancy 

Appointed  research  analyst  to  CNA. 
(port).  12  (Oct) 

GARZON,  Nelly 

In  Canada  as  guest  of  CUSO.  26  (May) 

GASTROINTESTINAL  DISEASE 

Care  of  patients  with  G.l.  diseases  that 
have  a  psychological  component.  (Mow- 
chenko),  38(Mar) 

Mind-body  relationships  in  gastrointes- 
tinal disease,  (Buchan).  35  (Mar) 

GERHARD,  Wendy  J. 

President-elect  of  RNAO,  port,   14  (Aug) 

GERL\TRICS 

A  descriptive  study:  permitting  choice  in 
nursing  the  aged  patient  is  inconsistent 
with  the  nurse's  goals  in  the  general 
hospital,  (Murakami),  (abst).  44  (Aug) 

A  study  of  the  self  perceptions  of  a  select-' 
ed  group  of  recently  widowed  older 
people  concerning  physical  health  and 
use  of  community  health  resources. 
(Butler),  (abst).  45  (Dec) 
GERIMIN,  Marie  T. 

With  MEDICO  at  Avicenna  Hospital. 
Kabul.  Afghanistan,  26  (May) 

GIEN,  Lan 

Appointed  instructor  in  medical-surgical 
nursing.  Memorial  University  of  New- 
foundland School  of  Nursing,  (port), 
42  (Dec) 

GIVEN.  Janice 

Awarded  Volunteer  Nursing  Committee 
bursary,  44  (Dec) 

A  study  of  anticipatory  socialization  in 
prospective  nursing  students,  (abst).  57 
(Sep) 

GLADNEY,  LoisL. 

Received  life  membership  in  NBARN,  27 

(Sep) 
Retired   as   registrar   of  NBARN,   (port). 

18  (Mar) 

iX 


GLADSTONE,  Richard  M. 

Headache — diagnosis  and  management. 
36  (Dec) 

GLEASON,  Joyce  E. 

Appointed  employment  relations  officer 
of  MARN.  (port).  19  (Mar) 

GOOD.  Shirley  R. 

Reelected  on  committee  on  nominations 
of  Nursing  Education  Alumni  Asso- 
ciation of  Teachers  College.  13  (Jul) 

GORDON,  Ethel  M. 

Honored  by  Professional  Institute  of  the 
Public  Service  of  Canada,  (port).  20 
(Mar) 

GORROW.  Mary  Wranesh 

Comparison  of  social  attitudes  between 
freshmen  and  seniors  in  a  collegiate 
school  of  nursing,  (abst),  44  (Feb) 

GRANT,  Dorothy  Metie 

Banting  and  Best — the  men  who  tamed 

diabetes.  27  (Oct) 

GYNECOLOGY 

More  hysterectomies —  fact,  fantasy,  or 
fad'(Higgin).  33(Jul) 

Nursing  care  of  patients  having  a  hyster- 
ectomy. (Holm).  36  (Jul) 


H 


HACKER.  Cariotta 

Do  you  have  a  bad  trip  if  you  go  to  hos- 
pital? 39(Jun) 

HALIBURTON.  JaneC. 

Bk.  rev..  48  (Dec) 

HALIFAX  INFIRMARY 

Newsletter  wins  first  prize.  8  (Dec) 

HALVERSON,  Elizabeth  Ann 

Taking  rehabilitation  to  the  patient,  49 
(Sep) 

HANDICAPPED 

Canadian  soldiers  in  Cyprus  held  crippled 

children.  14  (Feb) 
Travel  service  for  handicapped,  26  (Jun) 

HART,  Margaret  E. 

Bk.  rev..  47  (Aug) 

HAYES,  Pat 

Midwives?  In  Canada?  Let's  hope  so!   17 

(Jul) 
Travelling  maternity  workshops.  48  (Jan) 

HEALTH  CARE 

P.H.  nurses  volunteer  help  to  summer 
hostel  infirmary,  1 1  (Nov) 

Change  in  health  system  forecast  by  N.B. 
minister.  8  (Aug) 

Health  is  everybody's  business.  (Hender- 
son). 31  (Mar) 

Indian  majority  on  council  to  operate 
new  health  center,  12  (Nov) 

A  painter,  a  pilot,  a  rock  hound,  and  some 
cooks:  the  federal  nursing  consultants 
revisited,  (Starr).  24  (Dec) 


Purpose  of  a  professional  organization, 
(Lindabury),  (editorial),  3  (May) 

Rock  festivals — new  problems,  new 
solutions.  (Zimmerman,  Jansons).  32 
(Dec) 

A  study  of  the  self  perceptions  of  a  select- 
ed group  of  recently  widowed  older 
people  concerning  physical  health  and 
use  of  community  health  resources, 
(Butler),  (abst),  45  (Dec) 

Use  of  Sask.  health  services  studied  by 
university  team.  10  (Nov) 

The  walls  are  (rumbling  down.  (Miner), 
(guest  edit.).  3  (Sep) 

Who  does,  who  does  not  use  health  ser- 
vices? 10  (Nov) 


HEALTH  FACILITIES 

ANPQ  forms  committee  to  study  Bill  65, 

14  (Oct) 
Committee    of    experts    studies    various 
^      typesof  health  centers.  15  (Dec) 
A  community  clinic  where  people  count, 

(Lockeberg).  47  (May) 
Community  health  centers  first  of  CNA 

priorities  for  1970-72.  5  (Nov) 
Manitoba    seeks    to    accredit    all    health 

facilities,  15  (Apr) 

Plan  carefully,  set  goals  before  establish- 
ing clinic,  12  (Dec) 

Provincial    monies    support    intermediate 

care  program,  17  (Apr) 
A  study  of  the  self  perceptions  of  a  select- 
ed   group   of   recently   widowed    older 
people  concerning  physical  health  and 
use    of    community    health    resources, 
(Butler),  (abst).  45  (Dec) 
Unions    sponsor    health    center    for    the 
capital  area,  14  (Feb) 

I 
HEALTH  MANPOWER 

RNABC  supports  Munro's  "super  nurses", 

7  (Jun) 
Coordination     of    education     theme     ot 

second      national      health      manpower 

conference,  9  (Dec) 
Dear   Mr.   Prime   Minister,   (Lindabury), 

(edit.).  3  (Oct) 
Family  physicians  want  nurses  as  assist- 
ants. 8  (Jun) 
National  conference  called  on  assistance 

to  physicians.  7  (Mar) 
National    health    conference    focuses    on 

physician's  assistant.  14  (May) 
Ontario  government  proposes  change   in 

structure  of  health  disciplines,  13  (Mar) 
Physician  assistant  sparks  debate  but  no 

answers   at  World    Medical  Assembly, 

9  (Nov) 
Physician    assistant's    role    discussed    by 

CPHA  panel.  7  (Jun) 
Physician's  assistant   does  not   nurse,    13 

(Aug) 
Task  force  discussion  by  Quebec  chapter, 

13  (Mar) 

HEALTH  SERVICES 

OHA  speaker  says  traditions  will  change. 


16  (Jan) 
Report  to  the  Minister  of  National  Health 
and  Welfare  on  the  recommendations 
of  the  Task  Forces  on  the  Cost  of 
Health  Services  in  Canada  from  the 
CNA.  27  (Jan) 

HEART  AND  HEART  DISEASES 

Concerns  of  cardiac  patients  regarding 
their  ability  to  implement  the  prescribed 
drug  therapy,  (Nordwich),  (abst),  57 
(Sep) 

Coronary  and  ICU  refresher  taken  to  all 
parts  of  BC.  8  (Nov) 

HEIDGERKEN,  Loretta  E. 

The  research  process,  40  (May) 
Speakers  and  panelists  announced  for  re- 
search conference,  10.  14  (Jan) 

HENDERSON.  Virginia  A. 

Health  is  everybody's  business,  31  (Mar) 

HENRICKS.  Margaret  J. 

Audio  slides  streamline  interviews,  35 
(Aug) 

HEPATITIS 

Hepatitis  associated  antigen  detected  in 
new  blood  test,  12  (Nov) 

HERWITZ,  Adele 

Appointed  executive  director  of  ICN,  20 
(Jan) 

HIGGEV,  J.R. 

More  hysterectomies — fact,  fantasy,  or 
fad?  33  (Jul) 

HILL,  Jean  M. 

On  committee  on  nominations  of  Nurs- 
ing Education  Alumni  Association  of 
Teachers  College,  13  (Jul) 

HODGSON,  Eileen 

Member  ofN  ova  Scotia  Council  of  Health, 

42  (Nov) 

HOLADAY,  Marie 

Achieving  self  care:  a  shared  responsibi- 
lity, (abst),  44  (Aug) 

HOLLERAN,  Constance  A. 

Appointed  director  of  the  government 
relations  department  of  ANA,  18  (Mar) 

HOLM,  Leslie  Anne 

Nursing  care  of  patients  having  a  hyster- 
ectomy, 36  (Jul) 

HOMOSEXUALITY 

Life  style  of  homosexual  studied  by  insti- 
tute, 12  (Jul) 

HOPE  PROJECT 

Yolande  Albert  begun  mission  with  hos- 
pital ship  Hope,  (port),  20  (Mar) 

HORNBY,  Celia 

The  patient  who  needed  a  friend,  37  (Nov) 

HORNBY,  E. 

Bk.  rev..  49  (Dec) 

HOSPITAL  FOR  SICK  CHILDREN, 
TORONTO 

Hospital  not  for  pet  goat.  44  (Nov) 


In  this  case  she's  a  body  cast  painter,  1 1 

(Oct) 
There's  Toronto  Sick  kids  and  then  there's 

....  9  (Sep) 

HOSPITALS 

Hospital  costs  spiral.  22  (Sep) 
Emergency  department  nurses  form  asso- 
ciation in  Edmonton,  16  (Jan) 

HOWARD,  Frances  M. 

Appointed  director  of  staff  development, 
dept.  of  nursing  services,  Kingston 
General  Hospital,  26  (Sep) 

A  study  of  the  perceived  learning  needs 
of  graduates  of  a  two  year  diploma 
program  in  nursing  during  the  first 
three  months  of  employment,  (abst), 
46  (Dec) 

HOWAT,LoisMA. 

SRNA  honor  role,  24  (Sep) 

HOWE,  Delia  M. 

Awarded  SRNA  bursary.  20  (Jan) 

HUFFMAN,  Dorothy  Edythe 

Elected  vice-president  of  AARN,  26  (Sep) 
Instructor  University  of  Calgary  School 
of  Nursing,  44  (Dec) 

HUMAN  RELATIONS 

Achieving  self  care:  a  shared  responsibility. 
(Holaday).  (abst).  44  (Aug) 

Nursing  in  fleeting  encounters,  (Kerr), 
"(abst).  46  (Feb) 

Relatives  should  be  told  about  intensive 
care  —  but  how  much  and  by  whom? 
(Wallace),  33  (Jun) 

A  study  of  mother-nurse  interaction  dur- 
ing feeding  time  when  the  mother  is 
feeding  her  baby.  (Pinsent),  (abst).  51 
(Mar) 


IDEA  EXCHANGE 

48  (Jan),  36  (Nov), 

IMAI,  Rose 

Research  officer  attends  ANA  national 
conference,  12  (May) 

IMMUNIZATION 

Congenital  rubella — one  approach  to 
prevention,  (Reid).  38  (Jan) 

IN  A  CAPSULE 

23  (Jan).  22  (Feb),  28  (Mar),  30  (Apr), 
30  (May),  26  (Jun),  39  (Jul),  43  (Aug), 
56  (Sept),  44  (Nov).  40  (Dec) 

INDEX  TO  ADVERTISERS 

64  (Jan),  71  (Feb),  71  (Mar),  80  (Apr), 
72  (Jun),  56  (Jul),  79  (Sep),  72  (Oct), 
64  (Nov),  61  (Dec) 

INDEXES 

MEDLARS  and  you,  (Nevill,  Parkin),  46 
(Jan) 

INDIANS  AND  ESKIMOS 

NWT  ski  training  program  an  experi- 
ment in  motivation,  21  (Oct) 


Indian    majority   on    council    to   operate 

new  health  center,  12  (Nov) 
Wanted:  one  Indian  chief,  43  (Aug) 

INFANTS,  NEWBORN 

Plastic   swaddlers   keep   newborns  warm, 

47  (Jun) 
Specially    for     the     newborn — intensive 

care    in    the   nursery,   (Youngblut),   24 

(Aug) 

INFECTION  CONTROL  NURSES' 
ASSOCIATION 

New  association  holds  tuberculosis  sem- 
inar, 19  (Sep) 

INFECTIONS 

Wash  (?)  those  cuffs!  22  (Feb) 

L'INFIRMIERE  CANADIENNE 

Subscription  rates  up  for  non-members 
of  CNA,  6  (Nov) 

INJECTIONS 

The  subcutaneous  injection,  (Pitel),  54 
(May) 

INSERVICE  EDUCATION 

Inservice  education  benefits  all  teachers, 
(Oatway),  32  (Aug) 

INSURANCE,  UNEMPLOYMENT 

Federal  government  answers  unemploy- 
ment insurance  concerns,  1 1  (Apr) 

INSULIN 

Banting  and  Best — the  men  who  tamed 
diabetes,  (Grant),  27  (Oct) 

INSURANCE,  HEALTH 

Medicare  for  cows,  pigs,  sheep ...  44 
(Nov) 

Quebec  nurses  won't  pay  for  unemploy- 
ment insurance,  16  (Sep) 

INTENSIVE  CARE 

Coronary  and  ICU  refresher  taken  to  all 

parts  of  BC,  8  (Nov) 
Relatives  should  be  told  about  intensive 

care — but  how  much  and  by  whom? 

(Wallace),  33  (Jun) 
Specially    for    the    newborn — intensive 

care    in   the  nursery,   (Voungblut),   24 

(Aug) 

INTERNATIONAL  COUNCIL  OF 
NURSES 

CNA  believes  proposals  would  turn  ICN 
into  conglomerate,  7  (D^) 

CNA  Board  nominates  candidate  for 
ICN  3-M  award,  8  (Feb) 

Adele  Herwitz  appointed  executive  di- 
rector, 20  (Jan) 

Birgit  Tauber  nurse-adviser,  43  (Dec) 

Committee   to   define   "active"   member- 
ship term,  16  (Jun) 
Essay  competition  for  Irish  student  nurses, 

1 1  (Oct) 
Japanese   nurse  awarded   3M   fellowship, 

8  (Jul) 
Post  open  in  Switzerland,  24  (May) 
Prepares  draft  on  status  of  nurses,  22  (May) 
Supports  family  planning  as  basic  human 
right,  10  (Sep) 


INTERNATIONAL  LABOUR 
ORGANIZATION 

ICN   prepares  draft  on  status  of  nurses, 
22  (May) 

ISBESTER,  F. 

Nurses"   needs  and  wants  turn   them   to 
group  action,  10  (Feb) 


JANSONS,  Ruta 

Rock  festivals —  new  problems,  new  solu- 
tions, (Zimmerman),  32  (Dec) 

JEANES,  C.W.L. 

International  medical  expert  shows  our 
role  is  vital  in  "the  other  world",  9 
(Aug) 

JENNINGS,  Rita  E. 

Bk.  rev.,  46  (Nov) 

JONES,  Elsie  K. 

Building  named  after  Wellesley's  former 
nursing  director,  18(Jun) 


K 


KEARNEY,  Maureen 

A  hug  for  Ontario's  new  health  minister, 
16  (May) 

KEITH,  Catherine  W. 

A  painter,  a  pilot,  a  rock  hound,  and  some 
cooks:  the  federal  nursing  consultants 
revisited,  (Starr),  24  flDec) 

What  is  outpost  nursing?  4 1  (Sep) 

KENNEDY,  Betty 

TV  panelist  named  a  medical  watchdog, 
23  (Apr) 

KENNEDY,  Fanny  Annette  (Nan) 

Appointed  executive  director  of  RNABC, 

15  (Feb) 

KEOGH,  Margaret 

Bk.  rev.,  47  (Nov) 

KERGIN,  Dorothy  J. 

First  nurse  appointed  to  Medical  Research 

Council,  10  (Dec) 
Research,  apple  juice,  and  daffodils — a 

good  combination  .  . .,  33  (Apr) 

KERR,  Marion 

Nursing  in  fleeting  encounters,  (abst),  46 
(Feb) 

KHAIRAT,  Lara 

An  exploratory  study  of  the  effectiveness 
of  the  parent  education  conference 
method  on  child  health,  (abst),  55  (Apr) 

KONDO,  Junl(o 

Japanese  nurse  awarded  3M  fellowship, 
8  (Jul) 

KOTLARSKY,  Carol 

A  pioneer  in  nursing  education,  33  (Nov) 

KUBLER-ROSS,  Elisabeth 

Dying  with  dignity,  31  (Oct) 

XI 


LABONTE,  Ceciie 

The  old  rights  remain,  21  (Dec) 

LABOUR  UNK)NS 

United  nurses  of  Montreal  begin  unique 

trainmg  program,  12  (Apr) 
Unions    sponsor    health    center    for    the 

capital  area,  14  (Feb) 

LAKEHEAD  REGIONAL  SCHOOL  OF 
NURSING 

Elsie  K.  Di  Blasio  appointed  curriculum 
coordinator,  (port),  15  (Feb) 

LALANCETTE,  Denise 

An  exploratory  study  to  determine  the 
sex  education  of  young  unmarried 
mothers,  (abst),  44  (Aug) 

LAMBERTSEN,  EleanorC. 

Presented  with  R.  Louise  McManus  Med- 
al, 13  (Jul) 

LAMBETH,  Dorothy  M.  (Syposz) 

Trends  for  diploma  programs  in  nursing 
in  Ontario  as  reflected  in  the  nursing 
literature  and  the  opinions  of  selected 
nurse  educators,  (abst),  45  (Dec) 

LA  MOTHE,  Rachel 

Appointed  research  analyst  to  CNA, 
(port),  22  (Oct) 

LANG,  Judith  A. 

Awarded  SRNA  bursary,  20  (Jan) 

LAPOINTE,  Geraldine 

Vice-president  RNABC,  26  (Sep) 

LAPOINTE,  Gertrude 

Typhoid  in  Bouchette,  20  (Jul) 

LATREILLE,  Lise 

Assistant  director  Children's  and  Adoles- 
cent Services,  Douglas  Hospital,  Mont- 
real, (port),  43  (Nov) 

LAW  AND  LEGISLATION 

CNA  directors  discuss  possibility  of  mak- 
ing statement  on  legislation  that  affects 
nurses  and  nursing,  8  (Dec) 

RNABC  guidelines  on  medical-nursing 
procedures,  18  (Sep) 

LAWRENCE,  A.BJt. 

A  hug  for  Ontario's  new  health  minister, 
16  (May) 

LA'VTON,  Patricia 

Lecturer  in  nursing  at  School  of  Nursing, 
Queen's  University,  43  (Nov) 

LEADERSHIP 

Nurses  and  their  associations  will  provide 

more  leadership,  16  (Sep) 
A    woman's    right    to    nag — inalienable 

and  essential,  (More),  (port),  38  (Sep) 

LECKIE,  Irene 

Bk.  rev.,  47  (Dec) 


LECKIE,  Nessa 
Bk.  rev.,  47  (Feb) 

LEITH,  Muriel 

Winner  of  spring  1971  Searle-Canada 
scholarship,  43  (Dec) 

LETTERS 

4  (Jan),  4  (Feb),  4  (Mar),  4  (Apr),  4  (May), 
4  (Jun),  4  (Jul),  4  (Aug),  4  (Sep),  4  (Oct), 
4  (Dec) 

LEWIS,  Edith  Patton 

Editor  of  N  ursing  Outlook,  (port),  43  (Dec) 

LIBRARIES 

CNA  library  see  Canadian  Nurses'  Asso- 
ciation. Library 

Library  service  widens  horizons  for  "shut- 
ins",  (Millen),  41  (Mar) 

Survey  of  library  resources  in  Canadian 
schools  of  nursing,  (Loyer,  Morris), 
(abst),  41  (Nov)  J 

LICENSURE  " 

NBARN  fears  ftiture  challenged  by  nurs- 
ing education  report,  16  (Oct) 

LINDABURY,  Virginia  A. 

CNA's  goals,  functions,  and  structure, 
(editorial),  3  (Nov) 

Canadian  Nurse  readership  survey,  (edit.), 
3  (Jun) 

Dear  Mr.  Prime  Minister,  (edit.),  3  (Oct) 

Dissemination  of  research  reports,  (edit.), 
3  (Apr) 

Purpose  of  a  professional  organization, 
(edit.),  3  (May) 

Relatives  and  friends,  (edit.),  3  (Mar) 

Royal  Commission  on  the  Status  of  Wom- 
en, (edit.),  3  (Feb) 

Typhoid  fever,  (edit.),  3  (Jul) 

LINNELL,  Eleanor 

President  of  SRNA,  (port),  22  (Oct) 

LOCKEBERG,  Liv-Ellen 

The  Colonel    is   a   lady — and   a   nurse, 

23  (Nov) 
A  community  clinic  where  people  count, 

47  (May) 

LOCKRIDGE,  Shiriey  A. 

Director  of  nursing  services  at  Hospital 
for  Sick  Children,  Toronto,  24  (Oct) 

LOUGHLIN,  Anna 

Working  in  Family  Health  Care  Centre 
at  McMaster  U  niversity  Medical  Centre, 
(port),  16  (Feb) 

LOWRY,  Muriel  Violet 

Obit,  19  (Jan) 

LOYER,  Marie  A. 

Survey  of  library  resources  in  Canadian 
schools  of  nursing,  (Morris),  (abst),  41 
(Nov) 

LUSSIER,  Rita 

Appointed  program  coordinator  with  the 
ANPQ,  (port),  19  (Jan) 


M 


MEDICO 

Maurice  Dignard  decorated  by  Govern- 
ment of  Jordan,  26  (Apr) 

Sharon  B.  Tiffin  serving  with  MEDICO  in 
Surakarta,  Central  Java,  (port),  24 
•Apr) 

IVfEDLARS 

MEDLARS  and  you,  (Nevill,  Parkin),  46 
(Jan) 

McARTHLR,  Helen  G. 

Helen  McArthur  chalks  up  a  first,  8  (May) 
Retired    as   national   director   of  nursing 

with    Canadian     Red    Cross    Society, 

(port),  22  (Oct) 

McCANN,  Elizabeth  K. 

President  of  Canadian  Conference  of 
University  Schools  of  Nursing,  16  (Feb) 

MacCarthy,  Jessie 

First  woman  to  be  elected  to  management 
committee  of  Canadian  Tuberculosis 
and  Respiratory  Disease  Association, 
24  (Oct) 

IMcCUE,  Elizabeth 

A  painter,  a  pilot,  a  rock  hound,  and  some 
cooks:  the  federal  nursing  consultants 
revisited,  (Starr)  24  (Dec) 

McDonald,  Doris 

Cut  I,  scene  2  or  .  .  .  how  to  make  a  film 
in  your  spare  time,  (Brydges),  26  (Nov) 

Mcdonald,  Heather 

A  painter,  a  pilot,  a  rock  hound,  and  some 
cooks:  the  federal  nursing  consultants 
revisited,  (Starr),  24  (Dec) 

Mcdonald,  ja. 

Bk.  rev.,  54  (Oct) 

MacDONELL,  Marion 

Honorarv  treasurer  RNABC,  26  (Sep) 

MacDOUGALL,  Eleanor 

Appointed  director  of  Greater  Montreal 
branch  of  VON,  (port),  22  (Oct) 

MacEWAN,  J.W.  Grant 

Alberta's  Lieut. -Governor  is  speaker  at 
CNA  biennial,  10  (Oct) 

McGILL  UNIVERSITY 

Anne  Isobel  MacLeod  received  honorary 
Doctor  of  Law  degree,  26  (Sep) 

McBNNES,  Betty 

First  Canadian  to  have  a  book  on  nursing 
published  byC.V.  Mosby,  26  (Apr) 

MacCMNIS,  Grace 

Report  of  the  Royal  Commission  on  the 
Status  of  Women,  (guest  edit.),  3  (Jan) 

MacINNIS,  Mary  E. 

Appointed  associate  director  of  nursing, 
Victoria  Hospital,  London,  Ont.,  (port), 
42  (Dec) 

McKILLOP,  Madge 

Honor  roll  presented,  24  (Sep) 


MACKLING,  Margaret 

Appointed  second  vice-president  of 
MARN,42(Dec) 

McKONE,  Alma 

Sending  someone  to  a  conference''  36 
(Feb) 

MacLAREN,  Alice 

Bk.  rev.,  52  (Mar) 

MacLEAN,  Jean 

Advisor   in   nursing   service   of  RNANS. 

19  (Jan) 
Nurses"  function  should  develop,  10  (Sep) 

McLEAN,  Margaret 

A  painter,  a  pilot,  a  rock  hound,  and 
some  cooks:  the  federal  nursing  con- 
sultants revisited,  (Starr),  24  (Dec) 

MacLEOD,  Anne  Isobel 

OHA  speaker  says  traditions  will  change, 

16  (Jan) 
Received  honorary  Doctor  of  Law  degree 

from  McGill  University,  26  (Sep) 

MacLEOD,  Judith 

Bk.  rev.,  48  (Aug) 

McMASTER  UNIVERSITY 

Federal    grant    approved    for    McMaster 

project,  14  (Feb) 
McMaster   school    studies   role   of  "GP's 

nurse",  18  (Apr) 

McMASTER  UNIVERSITY.  MEDICAL 
CENTRE 

Appointments    in    Family    Health    Care 

Centre,  (port),  16  (Feb) 
Art  brightens  medical  centre,  30  (May) 

McPHAIL,  Irene  Ross 

Provincial  commissioner  of  St.  John  Am- 
bulance, (port),  13  (Jul) 

McSPORRAN,  Marilyn  J. 

Honorary  secretary  RNABC.  27  (Sep) 

MANITOBA  ASSOCIATION  OF 
REGISTERED  NURSES 

Citizenship  ceremony  also  honors  Flor- 
ence Nightingale,  6  (Jul) 

Joyce  E.  Gleason  appointed  employment 
relations  officer  of  MARN,  (port),  19 
(Mar) 

Margaret  Mackling  appointed  second 
vice-president,  42  (Dec) 

More  money  for  Manitoba  nurses  in  new 

collective  agreement,  6  (Nov) 
Plans  citizenship  ceremony,  17  (Apr) 
Poor   response    to    MARN    survey   could 

mean  little  unemployment,  21  (May) 
Surveys  employment  scene,  17  (Apr) 
Three  TV   programs  tell  nurses"  role,   17 

(Jan) 
Wants  RNs  only  in  bargaining  units,   10 

(Aug) 

MANPOWER 

"Peoplepower,""  not  manpower!  43  (Aug) 


MASTEN,  Jean  Isabel 

Died,  44  (Dec) 

MEDICAL  RESEARCH  COUNCIL 

First  nurse  appointed,  10  (Dec) 

MEDICATION 

Patients  don"t  follow  what  MDs  order, 
26(Jun) 

MELNYK,  Emily 

Appointed  director  of  nursing,  Bloorview 
Children's  Hospital,  Toronto,  (port), 
19(Jun) 

MEMORLiL  UNIVERSITY.  SCHOOL  OF 
NURSING 

Lan  Gien  appointed  instructor  in  medical- 
surgical  nursing,  (port).  42  (Dec) 

A  tree  to  remember — someday  a  forest, 
17  (Sep) 

MENTAL  HEALTH 

Health  of  city  dwellers  discussed  at  CPHA 
session,  10  (Jun) 

MIDWIFERY 

Midwives?    In    Canada?    Let"s    hope    so! 

(Hayes),  17  (Jul) 
Two  new  specialties  offer  careers  to  nurses, 

12  (Nov) 

MILITARY  NURSING 

The   Colonel    is   a    lady — and   a   nurse, 

(Lockeberg),  23(Nov) 
Nurses  attend  military  executive  course, 

16  (Jun) 

MILLEN,  Vivian 

Library  service  widens  horizons  for  "shut- 
ins"',  41  (Mar) 

MILLER,  Dorothy  Gray 

Public  relations  officer  RNANS,  (port), 
43  (Dec) 

MILLER,  Mary  E.  (Christie) 

Appointed  by  RNABC  to  department  of 
nursing  education  services,  20  (Jun) 

MILLER,  T.M. 

Presented  with  life  membership  in  Cana- 
dian Public  Relations  Society,  (port), 
20  (Mar) 

MILLS,  Dorothy-Anne 

Working  in  Family  Health  Care  Centre 
at  McMaster  University  Medical 
Centre,  (port),  16  (Feb) 

MILNE,  Barbara 

Working  in  Family  Health  Care  Centre 
at  McMaster  University  Medical  Centre, 
(port),  16  (Feb) 

MINER,  E.  Louise 

CNA  president  tells  SRNA  revision  of 
health  systems  will  require  collabora- 
tion, 20  (Sep) 

Deep-freeze  seminar —  a  warm  experience, 
(Rockburne),  35  (Jun) 

The  walls  are  trumbling  down,  (guest 
edit.),  3  (Sep) 

XII 


MOFFETT,  Moira  B. 

Australian  educator  on  study  tour,  (port), 
7  (Mar) 

MONTREAL  GENERAL  HOSPITAL 

MGH  celebrates  150th  birthday,  20  (Sep) 

MONTREAL  STUDENT  HEALTH 
ORGANIZATION 

A  community  clinic  where  people  count, 
(Lockeberg),  47  (May) 

MOONEY,  A.  Iris 

Elected  as  alderman  of  Langley,  B.C.,  20 
(Jun) 

MORE,  M.  Thomas,  Sister 

A  woman's  right  to  nag — inalienable 
and  essential,  (port),  38  (Sep) 

MORIN.RitaM. 

Member  of  board  of  directors  of  Profes- 
sional Institute  of  the  Public  Service, 
26  (May) 

MORRIS,  M.T.  Mildred 

Survey  of  library  resources  in  Canadian 
schools  of  nursing,  (Loyer),  (abst),  41 
(Nov) 

MOSSEY,  Iris 

Named  "nurse  of  the  year",  (port),  14 
(Aug),  26  (Sep),  42  (Nov) 

MOTIVATION 

NWT  ski  training  program  an  experiment 
in  motivation,  21  (Oct) 
MOUNTAIN,  Eileen  Healey 

Appointed  executive  secretary  of  CAUSN, 
43  (Dec) 

MOWCHENKO,  Gloria 

Care  of  patients  with  G.l.  diseases  that 
have  a  psychological  component.  38 
(Mar) 

MRAZEK,  Margaret  Loretta 

Hospital  clinical  facilities  utilized  by 
Edmonton  nursing  programs:  a  descrip- 
tive study,  (abst),  45  (Aug) 

MUNRO,John 

RNABC  supports  Munro's  "super  nurses", 
7  (Jun) 

MUNRO,  Margaret  F. 

A  study  of  literature  selection  in  bacca- 
laureate students  in  nursing,  (abst),  51 
(Mar) 

MURAKAMLRose 

A  descriptive  study:  permitting  choice 
in  nursing  the  aged  patient  is  incon- 
sistent with  the  nurse's  goals  in  the 
general  hospital,  (abst),  44  (Aug) 

MURPHY.  Mary 

Director  of  nursing  at  North  York  Gen- 
eral Hospital,  Willowdale,  Ont.,  (port), 
24  (Oct) 

MURRAY,  V.V. 

Nurses'  needs  and  wants  turn  them  to 
group  action,  10  (Feb) 

MUSSALLEM,  Helen  K. 

CNA     executive    director    appointed     to 
XIII 


Economic  Council  of  Canada,  II  (Apr) 
Directors  of  Nursing  Education  Alumni 

Association    of  Teachers    College,     13 

(Jul) 
The  expanding  role:  where  do  we  go  from 

here?  3  I  (Sep) 


N 


NAMES 

17  (Jan),  15  (Feb),  18  (Ma'r)  24  (Apr),  25 
(May),  18  (Jun),  13  (Jul).  14  (Aug),  24 
(Sep),  22  (Oct),  42  (Nov),  42  (Dec) 

NATIONAL  CONFERENCE  ON 

ASSISTANCE  TO  THE  PHYSICUN 

National  health  conference  focuses  on 
physician's  assistant,  14  (May) 

The   third   day — summing   up   National 
Conference  on  Assistance  to  the  Physiciar 
8  (Jun) 

NATIONAL  HEALTH  GRANT 

Fellowships,  research  projects  funded  by 
National  Health  Grant,  8  (Mar) 

NATIONAL  SCIENCE  LIBRARY 

MEDLARS  and  you,  (Nevill,  Parkin),  46 
(Jan) 

NATIONAL  STUDENT  NURSES' 
ASSOCIATION 

Student  volunteer  project  receives 
$  100.000  contract.  14  (Nov) 

NEUROLOGY 

Basilar  aneurysms.  (Derdall).  49  (Apr) 
Gel   pillow   helps  prevent  pressure  sores. 

(Robertson).  44  (Oct) 
Headache — diagnosis   and    management. 

(Gladstone).  36  (Dec) 
Management  of  Parkinson's  disease  with 

L-dopa  therapy.  (Tyler),  41  (Apr) 
Occult  hydrocephalus  in   adults,  (Schick, 

Yallowega).  47  (Mar) 

NEUROSURGERY 

Carotid  artery  stenosis  with  transient 
ischemic  attacks,  (VanderZee),  32  (Feb) 

NEVILL,  Ann  D. 

MEDLARS  and  you,  (Parkin).  46  (Jan) 

NEV  ITT,  Joyce 

Elected  president  of  Newfoundland  branch 
of  Canadian  Public  Health  Association. 
15  (Feb) 

NEW  BRUNSWICK  ASSOCIATION  OF 
REGISTERED  NURSES 

Apolline     Robichaud     elected     president, 

22  (Oct) 
Change  in  health  system  forecast  by  N.B. 

minister,  8  (Aug) 
Eva  M.  OConnor  appointed  registrar,  26 

(May) 

Fears  future  challenged  by  nursing  educa- 
tion report,  16  (Oct) 
Gives  brief  to  study  committee,   10  (Feb) 
Helen  Beath  appointed  director  of  nursing 

research  project,  14  (Aug) 
Interprets  brief  to  members,  18  (May) 
Leaders   meet   at    presidents'   conference. 
16  (Apr) 


Lois  L.   Gladney   received   life   member- 
ship, 27  (Sep) 
Mary  Russell   named   acting   registrar  of 

NBARN,  18  (Mar) 
Nursing    education    committee    hearings 

turn  controversial.  14  (Apr) 
Nursing  study  receives  federal  grant.    13 

(Aug) 

Research  project  will  start  in  fall.  14  (Oct) 

To  hold  own  armchair  conference.  6  (Jul) 

To  issue  statement  on  abortion.  10  (Aug) 

Wants  end  of  hospital  schools.   16  (Mar) 

NEW  PRODUCTS 

18  (Feb).  22  (Mar),  28  (Apr),  24  (May), 
21  (Jun),  15  (Jul),  40  (Aug).  54  (Sep). 
51  (Oct).  16  (Nov),  17  (Dec) 

NEW  YORK  STATE  NURSES' 
ASSOCUTION 

American  nurses  march  to  support  nurs- 
ing bill,  18  (Apr) 

NEWS 

7  (Jan).  7  (Feb).  7  (Mar).  1 1  (Apr).  7  (May), 
7  (Jun),  5  (Jul),  7  (Aug),  9  (Sep),  7  (Oct). 
5  (Nov),  7  (Dec) 

NEYLAN,  Margaret  S. 

Elected  president  RNABC,  (port),  26  (Sep), 

42  (Nov) 

NIGHTINGALE,  Florence 

Citizenship  ceremony  also  honors  Flor- 
ence N  ightingale,  6  (Jul) 

Florence  Nightingale  medal  minting 
announced.  10  (Jul) 

NORDWICH,  Irene  Erika 

Concerns  of  cardiac  patients  regarding 
their  ability  to  implement  the  prescrib- 
ed drug  therapy,  (abst),  57  (Sep) 

NORENS,  Gwen 

Nurses  in  prison.  37  (May) 

NORTHERN  HEALTH  SERVICES 

Committee  on  clinical  training  for  nurses 
in  the  north  reports  to  health  minister. 

12  (May) 
Deep-freeze    seminar — a    warm    experi- 
ence. (Rockburne),  35  (Jun) 

Nurse  educators  travel  to  north  on  semi 

nars,  8  (Mar) 
What  is  outpost  nursing?  (Keith),  41  (Sep) 

NORTHWEST  TERRITORIES 

NWT  ski  training  program  an  experiment 
in  motivation,  21  (Oct) 

NOTTER,  Lucille  E. 

Received  Alumni  Achievement  Award 
in  Nursing  Research  and  Scholarship, 

13  (Jul) 

NURSING 

American  nurses  march  to  support  nurs- 
ing bill,  18  (Apr) 
Bill    to   define    nursing    vetoed    by   N.Y. 

Governor.  14  (Nov) 
Nurse  at  sea,  (Eraser).  17  (Aug) 
The  nurses'  dragon,  56  (Sep) 
Those  days  are  gone  forever,  22  (Feb) 
Three  TV   programs  tell  nurses'  role.   17 
(Jan) 


Wanted: 

(Nov) 


a  theory  of  nursing,  (Foley).  28 


NURSING  CARE 

Basilar  aneurysms,  (Derdall),  49  (Apr) 

Care  of  patients  with  G.I.  diseases  that 
have  a  psychological  component,  (Mow- 
chenko),  38(Mar) 

Gel  pillow  helps  prevent  pressure  sores, 
(Robertson),  44  (Oct) 

Nursing  care  given  by  general  staff  hos- 
pital nurses  to  a  selected  group  of  pa- 
tients who  had  experienced  a  cerebro- 
vascular accident.  (Patrick),  (abst),  41 
(Nov) 

Nursing  care  of  patients  having  a  hyster- 
ectomy. (Holm),  36  (Jul) 

Nursing  in  fleeting  encounters,  (Kerr), 
(abst),  46  (Feb) 

The  patient  who  needed  a  friend.  (Horn- 
by). 37  (Nov) 

Relatives  and  friends,  (Lindabury),  (edit.), 
3  (Mar) 

NURSING  EDUCATION 

See  Education 

NURSING  EDUCATION  ALUMNI 

ASSOCIATION  OF  TEACHERS  COLLEGE 

Three  nurses  honored,  13  (Jul) 

NURSING  MANPOWER 

See  also  Health  Manpower 

AARN  warns  nurses  of  job  shortage,   10 

(Jan) 
MARN    surveys    employment    scene,    17 

(Apr) 
Few  Manitoba  nurses  unemployed,  8  (Jun) 
Nova  Scotia  lacks  nurses  with  degrees,  17 

(Mar) 
Ontario  job  market  tightens  for  nurses,  1 1 

(Aug) 
Shortage   of  nurses   critical    in   Quebec's 

"English"  hospitals,  10  (Nov) 

NURSING  TRAVEL  SEMINAR 

Deep-freeze  seminar — a  warm  experi- 
ence, (Rockburne),  35  (Jun) 

NURSING  TRENDS 

ANPQ  president  says  nurses  must  decide 

own  future,  8  (Jan) 
NBARN  to  hold  own  armchair  conference, 

6  (Jul) 
The  expanding  role:  where  do  we  go  from 

here?  (Mussallem).  3  1  (Sep) 
Family  physicians  want  nurses  as  assist- 
ants, 8  (Jun) 
McMaster   school    studies   role   of  "GP's 

nurse",  18  (Apr) 
Nurse  will  have  to  prove  herself  in  new 

role,  12  (Jul) 
Nurses"  function  should  develop,  10  (Sep) 
Nurses   must    participate    in    health   care 

changes,  9  (Jul) 
Nursing —  evolution  or  revolution?  (Ford). 

32  (Jan) 
Physicians,  administrators  join  nurses  in 

Hamilton  seminar,  14  (Jan) 
The   walls   are   tumbling   down,   (Miner), 

(guest  edit.).  3  (Sep) 

NUTRITION 

Hospital  diet  line,  36  (Nov) 


O 


OATWAY,  Lillian 

Inservice  education  benefits  all  teachers, 
32  (Aug) 

OBSTETRICS 

Hand  and  arfn  motor  behavior  in  labor- 
ing patients,  (Walton),  (abst),  44  (Feb) 

Midwives?  In  Canada?  Let's  hope  so! 
(Hayes),  17  (Jul) 

Problems  of  pregnant  teenager  discussed 
at  symposium,  12  (Jun) 

A  study  of  mother-nurse  interaction  dur- 
ing feeding  time  when  the  mother  is 
feeding  her  baby,  (Pinsent),  (abst),  51 
(Mar) 

Traveling  maternity  workshops,  (Hayes), 
48  (Jan) 

OCONNOR,  Eva  M. 

Appointed  registrar  of  the  New  Brunswick 
Association  of  Registered  Nurses,  26 
(May) 

OCCUPATIONAL  HEALTH  NURSING 

Drug   use   only   tip   of   iceberg — doctor 

tells  industrial  nurses,  13  (Dec) 
Nurses  in  prison,  (Norens),  37  (May) 

ONTARIO  HOSPITAL  ASSOC LVTION 

OHA  speaker  says  traditions  will  change, 

16  (Jan) 
RNAO.  OHA.  OMA   sponsor  courses  in 

coronary  nursing,  12,  14  (Feb) 

ONTARIO  HOSPITAL  ASSOCIATION. 
ANNUAL  MEETING 

CC HA  chairman  says  CNA  should  be  on 
council,  12  (Dec) 

President  urges  more  community  involve- 
ment, 9  (Dec) 

Underutilization  of  skills  leads  to  lack  of 
commitment,  10  (Dec) 

ONTARIO  MEDICAL  ASSOC  LVTION 

RNAO,  OHA,  OMA  sponsor  courses  in 
coronary  nursing,  12,  14  (Feb) 

OPERATING  ROOM 

Electricity:  a  hospital  hazard,  47  (Oct) 

OPTHALMOLOGY 

The  eyes  have  it — with  mobile  care  in 
Newfoundland,  21  (May) 

ORIENTATION 

Preadmission  orientation  for  children  and 
parents,  (Brown),  29  (Feb) 

OWEN,  Maybelle  M. 

Bk.  rev.,  48  (Dec) 


PAIN 

Pain  and  suffering  in  cancer,  (TurnbuU), 
28  (Aug) 

PAINE,  Shirley  J. 

Winner  of  District  II,  MARN,  centennial 
bursary,  14  (Aug) 


PAKRATZ,  Stella 

Awarded  SRNA  bursary,  43  (Dec) 

PALTIEL,  Freda 

Coordinator  of  the  federal  government's 
examination  of  the  status  of  women, 
(port),  26  (May) 

PAN  AMERICAN  HEALTH 
ORGANIZATION 

Shirley  Stinson  temporary  advisor,  14 
(Jul) 

PARALYSIS 

Rehabilitation  of  a  quadriplegic,  (Ford, 
Cooke),  37  (Aug) 

PARKIN,  Margaret  L. 

MEDLARS  and  you,  (Nevill),  46  (Jan) 

PARKINSON'S  DISEASE 

Management  of  Parkinson's  disease  with 
L-dopa  therapy,  (Tyler),  41  (Apr) 

PARROTT,  EricG. 

Director  of  test  development  CNA  Test- 
ing Service,  (port),  42  (Dec) 

PASSMORE,  Jean 

Bk.  rev.,61  (Sep) 

PATRICK,  Geraldine Grace  Louise 

Nursing  care  given  by  general  staff  hos- 
pital nurses  to  a  selected  group  of  pa- 
tients who  had  experienced  a  cerebro- 
vascular accident,  (abst),  4 1  (Nov) 

PEARSON,  Sally  A. 

Appointed  director  of  patient  care  services 
of  Kootenay  Lake  General  Hospital, 
(port).  15  (Feb) 

PEART,  A. 

Survey  to  determine  demand  for  tape 
cassette  program,  10  (May) 

PEDIATRICS 

Acting  out  or  acting  up?  (Crossley),  45 
(Sep) 

The  child  with  Hurler's  syndrome,  (Bren- 
chley),  38  (Feb) 

Concerns  of  mothers  participating  in  the 
care  of  their  children  hospitalized  for 
minor  surgery  in  a  day  care  unit, 
(Smith),  (abst),  55  (Apr) 

An  exploratory  study  of  the  effectiveness 
of  the  parent  education  conference 
method  on  child  health,  (Khairat), 
(abst),  55  (Apr) 

Preadmission  orientation  for  children 
and  parents,  (Brown),  29  (Feb) 

Young  diabetics  enjoy  camp,  too,  (Fitz- 
gerald). 51  (May) 

PEPPER,  Evelyn  A. 

Awarded    Florence    Nightingale     Medal, 

(port),  22  (Oct) 
Bk.  rev..  48  (Feb) 

PESZAT,  Lucille 

To  chair  the  new  division  of  health 
sciences  at  Humber  College  of  Applied 
Arts  and  Technology  in  Rexdale,  Ont., 

42  (Nov) 

XIV 


PETTIFER,  George  H. 

Winner  of  spring  1971  Searle-Canada 
scholarship,  43  (Dec) 

PETTIGREW,  Lillian  E. 

SRNA  honor  role,  24  (Sep) 

PHILIPPE,  Phyllis  B. 

Bk.  rev..  60  (Sep) 

PHILLIPS,  Frances  Patricia 

A  study  to  develop  an  instrument  to  as- 
sist nurses  to  assess  the  abilities  of  pa- 
tients with  chronic  conditions  to  feed 
themselves,  (abst),  45  (Aug) 

PHYSICUN'S  ASSISTANTS 

See   Health    Manpower;   Nursing   Trends 

PHYSICIANS 

Do  nurses  see  MDs  as  a  good  "catch"? 
30  (Apr) 

PIECHOTTA,  Georgia 

Awarded  SRNA  bursary,  43  (Dec) 

PINSENT,  Amelia 

A  study  of  mother-nurse  interaction  dur- 
ing feeding  time  when  the  mother  is 
feeding  her  baby,  (abst),  5 1  (Mar) 

PITEL,  Martha 

The  subcutaneous  injection,  54  (May) 

POLLUTION 

Don   Knotts    heads   attack    on    pollution, 

12  (Jul) 
Typhoid  in  Bouchette,  (Lapointe),  20  (Jul) 

POOLE,  Pamela  E. 

Member  of  board  of  directors  of  Profes- 
sional Institute  of  the  Public  Service, 
26  (May) 

A  painter,  a  pilot,  a  rock  hound,  and  some 
cooks:  the  federal  nursing  consultants 
revisited,  (Starr),  24  (Dec) 

POTTER,  ThelmaL 

Who  does,  who  does  not  use  health  ser- 
vices? 10  (Nov) 

POTTS,  Agnes  Dorothy 

SRNA  honor  role,  24  (Sep) 

PRACTICAL  NURSING 

ANPQ  protests  to  government  on  behalf 
of  nursing  assistants,  II  (Oct) 

NBARN  fears  future  challenged  by  nurs- 
ing education  report.  16  (Oct) 

RNAO  wants  College  of  Nurses  to  con- 
tinue jurisdiction  over  nursing  assist- 
ants, 15  (Jun) 

PROFESSIONAL  INSTITUTE  OF  THE 
PUBLIC  SERVICE 

Ethel  M.  Gordon  honored,  (port),  20  (Mar) 
Pamela  E.  Poole  and  Rita  M.  Morin  mem- 
bers of  board  of  directors,  26  (May) 

PRO  WSE,  Judith 

Elected  president-elect  of  AARN,  26  (Sep) 

PSYCHIATRIC  NURSING 

DNHW    study    confirms    need,    proposes 

XV 


psychiatric  courses,  20  (Oct) 
Hey,  nurse!  by  Nurse  Whozits,  (Wilting), 

45  (Jun),  39  (Aug),  40  (Nov),  39  (Dec) 
Nurses    study    remotivation    therapy,    20 

(Apr) 

PSYCHIATRY 

Behavior  therapy  approach  to  psychiatric 
disorder,  (Raeburn,  Soler),  36  (Oct) 

Canadian  psychiatrists  protest  Soviet  mis- 
use of  mental  hospitals,  12  (May) 

PSYCHOLOGY 

Care  of  patients  with  G.i.  diseases  that 
have  a  psychological  component,  (Mow- 
chenko),  38  (Mar) 

Mind-body  relationships  in  gastronintesti- 
nal  disease,  (Buchan),  35  (Mar) 

PUBLIC  HEALTH 

P.H.    nurses   volunteer    help    to   summer 

hostel  infirmary,  1 1  (Nov) 
A  community  clinic  where  people  count, 

(Lockeberg),  47  (May) 
An  interview  with  the  Quebec  Minister  of 

Environment,  22  (Jul) 
250  RNs  enter  Montreal  community  health 

course,  20  (Oct) 
Typhoid  in  Bouchette,  (Lapointe).  20  (Jul) 
A  pioneer  in  nursing  education,  (Kotlars- 

ky).  33  (Nov) 
Public  hospital  nurses  sign  new  agreement, 

16  (Mar) 
Uniform  spells  chic  comfort  for  NS  public 

health  nurses,  9  (Dec) 
PURCELL,  M.  Geneva 

President  tells  AARN  it's  time  for  inde- 
pendence, 7  (Jul) 


QUEBEC.  COMMISSION  OF  INQUIRY 
ON  HEALTH  AND  SOCLVL  WELFARE 

Regional  health  care  advocated  for  Que- 
bec by  commission,  9  (Jun) 

QUEBEC.  DEPT.  OF  EDUCATION 

Quebec  postpones  nurses'  refresher  course, 
22  (Sep) 

QUEBEC.  MINISTER  OF  ENVIRONMENT 

An  interview,  22  (Jul) 

QUEENS'  UNIVERSITY 

Barbara  Lorraine  Ready  awarded  profes- 
sor's prize  in  nursing  education  at  spring 
convocation,  24  (Sep) 

Lecturers  in  nursing  at  School  of  Nursing, 
43  (Nov) 

Patricia  Susan  Carter  awarded  medal  in 
nursing  and  professor's  prize  in  nursing 
sciences  at  spring  convocation,  24  (Sep) 

Penelope  Jane  Smith  awarded  professor's 
prize  in  public  health  nursing  at  spring 
convocation,  24  (Sep) 


vices  at  University  of  Alberta  School  of 
Nursing,  42  (Nov) 

RANSOM,  Donald  G. 

Second  vice-president  RNABC,   26  (Sep) 

READY,  Barbara  Lorraine 

Awarded  professors  prize  in  nursing  edu- 
cation at  Queen's  University  spring 
convocation,  24  (Sep) 

RECREATION 

In  this  case  she's  a  body  cast  painter.  1 1 
(Oct) 

RED  DEER  COLLEGE 

"Nursing  Communication  Act"  is  the  core 
of  nursing,  (Schumacher),  40  (Feb) 

REFRESHER  COURSES 

Coronary  and  ICU  refresher  taken  to  all 

parts  of  BC.  8  (Nov) 
Quebec  postpones  nurses'  refresher  course, 

22  (Sep) 

REGISTERED  NURSES' ASSOCL\TION 
OF  BRITISH  COLUMBLV 

Claire   Tissington    appointed    director   of 

education  services,  (port),  24  (Oct) 
Collective    bargaining    a    charade,    B.C. 

nurses  told,  14  (Jun) 
Cost  is  minimal  to  improve  street  safety 

after  dark,  8,  10  (Feb) 
Donald  G.  Ransom  second  vice-president, 

26  (Sep) 
Fanny  Annette  Kennedy  appointed  exec- 
utive director,  15  (Feb) 
Geraldine    Lapointe    first    vice-president, 

26  (Sep) 
Guidelines  on  medical-nursing  procedures, 

18 (Sep) 
It  wasn't  quite  the  Stanley  Cup!  24  (May) 
Margaret    S.    Neylan    elected    president, 

(port).  26  (Sep) 
Marilyn  J.  McSporran  honorary  secretary, 

27 (Sep) 
Marion     Macdonell    honorary    treasurer, 

26  (Sep) 
Nurses    must    participate    in    health    care 

changes,  9  (Jul) 
President  and  new  officers,  42  (Nov) 
Supports  Munro's  "super  nurses",  7  (Jun) 
Wants  change  in  abortion  legislation,   16 

(May) 


RAEBURN,  John 

Behavior  therapy  approach  to  psychiatric 
disorder,  (Soler),  36  (Oct) 

RACINE,  Barbara 

Assistant  professor,  division  of  health  ser- 


REGISTERED  NURSES' ASSOC UTION 
OF   NOVASCOTLV 

Announces    two    new    appointments,     19 

(Jan) 
Dorothy   Gray    Miller    appointed    public 

relations  officer,  (port),  43  (Dec) 
Nurses'  function  should  develop,  10  (Sep) 
Sponsors  three  courses,  13  (Mar) 

REGISTERED  NURSES' ASSOCIATION  OF 
ONTARIO 

Abortion    debate    miscarries    at    RNAO 

annual  meeting,  12  (Jun) 
Accepts  concept  of  group  bargaining,   17 

(Jan) 
M.  Josephine  Flaherty  president  of  RNAO, 

14  (Aug) 
Margaret  Street  received  honorary  mem- 


i 


bership.  13  (Jul) 
Mary    Berglund    received    honorary    life 

membership,  13  (Jul) 
Ontario  job  market  tightens  for  nurses,  1 1 

(Aug) 
Removes  greylisting  of  Scarborough  Health 

Department,  8  (Feb) 
Results    of   Ryerson    study    disclosed    at 

RNAO  meeting,  10  (Jun) 
Sponsors  courses  in  coronary  nursing,  12 

(Feb) 
Three  Sudbury  nurses  win  hospital  settle- 
ment after  13  months'  fight,  14  (Sep) 
Wants    College    of   Nurses    to    continue 

jurisdiction  over  nursing  assistants,    15 

(Jun) 
Wendy  J.  Gerhard  president-elect  RNAO, 

(port),  14  (Aug) 

REHABILITATION 

Myo-electric  control  —  one  more  aid  for 

the  amputee,  (Scott).  44  (Apr) 
Nurses    study    remotivation    therapy,    20 

(Apr) 
Rehabilitation   of  a   quadriplegic,   (Ford, 

Cooke),  37  (Aug) 
Taking  rehabilitation  to  the  patient,  (Hal- 

verson),  49  (Sep) 

REID,  Winifred  M. 

Congenital  rubella — one  approach  to 
prevention,  38  (Jan) 

RE  ID  Y,  Mary 

Results  of  Ryerson  study  disclosed  at 
RNAO  meeting,  10  (Jun) 

RE IGHLEY,  Ronalds. 

Assistant  professor  University  of  Calgary 
School  of  Nursing.  44  (Dec) 

REIMER.  Helena 

Secretary-Registrar  of  ANPQ  retires, 
(port),  19  (Jan) 

RESEARCH 

CNA  research  officers  provide  informa- 
tion for  decisions,  7  (Dec) 

CNA  special  committee  examines  pro- 
vincial research,  5  (Jul) 

NBARN's  research  project  will  start  in 
fall,  14  (Oct) 

Dissemination  of  research  reports,  (Linda- 
bury),  (edit.),  3  (Apr) 

Educational  goals,  deterrents  identified  in 
CNA  study  of  RNs,  10  (Oct) 

Fellowships,  research  projects  funded  by 
National  Health  Grant.  8  (Mar) 

Flexible  program  prepares  researchers  at 
U.  of  Alberta,  17  (Oct) 

National  conference  on  research  in  nurs- 
ing practice,  (report),  34  (Apr) 

Nurse  researches  portable  human  waste 
disposal  systems,  20  (Oct) 

Nursing  research  committee  to  develop 
code  of  ethics,  II  (Apr) 

169  nursing  studies  received  in  CNA  li- 
brary in  1971,  6  (Nov) 

Problems,  issues,  challenges  of  nursing 
research.  (Abdellah).  44  (May) 

Research,   apple  juice,   and  daffodils —  a 


good  combination ....  (Kergin),  33 
(Apr) 

The  research  process,  (Heidgerken),  4C 
(May) 

Speakers  and  panelists  announced  for  re- 
search conference,  10,  14  (Jan) 

RESEARCH  ABSTRACTS 

44  (Feb),  51  (Mar),  55  (Apr),  44  (Aug), 
57  (Sep).  41  (Nov),  45  (Dec) 

RICE,  E.  Marie 

Appointed  assistant  administrator  of  nurs- 
ing at  New  Mount  Sinai  Hospital  in 
Toronto,  (port),  27  (Sep) 

RIFFEL,  PiusA. 

Selection  and  success  of  students  in  a  hos- 
pital school  of  nursing,  (etal).  41  (Jan) 

RITCHIE,  Roberta  M. 

Bk.  rev..  47  (Feb) 

ROACH,  Marie  Simone,  Sister 

Appointed  acting  chairman  of  the  nursing 
department  of  St.  Francis  Xavier  Uni- 
versity. Antigonish.  (port),  19  (Mar) 

ROBERTO,  Marie  Virginia 

A  comparison  of  the  effectiveness  of  two 
nursing  approaches  in  the  relief  of  post- 
operative pain.  (Buzzell),  (abst),  45 
(Aug) 

ROBERTSON,  Caroline  E. 

Gel  pillow  helps  prevent  pressure  sores, 
44  (Oct) 

ROBERTSON,  Marion 

Director  of  nursing  at  Elizabeth  M.  Crowe 
Memorial  Hospital,  Ericksdale,  Mani- 
toba, 42  (Dec) 

ROBICHAUD,  Apoliine 

President  of  N  BARN,  22  (Oct) 

ROCKBURNE,  Sheila 

Deep-freeze  seminar — a  warm  experi- 
ence, 35  (Jun) 

ROGERS,  Caroline 

AORN  members  fly  to  Italy  on  seminar, 
17  (Jan) 

ROGERS,  Pamela  J. 

Nurse  researches  portable  human  waste 
disposal  systems,  20  (Oct) 

ROSS,  D. 

Bk.  rev..  47  (Dec) 

ROSS,  Margaret 

Deep-freeze  seminar — a  warm  experi- 
ence. (Rockburne),  35  (Jun) 

ROSSER,  W.W. 

Patients  don't  follow  what  MDs  order.  26 
(Jun) 

ROWNEY,  Julie 

Bk.  rev..  48  (Feb) 

ROYAL  CANADIAN  ARMY  MEDICAL 
CORPS 

RCAMC  bursary  announced.  7  (Jun) 


ROYAL  COMMISSION  ON  THE 
STATUS  OF  WOMEN 

AARN   brief  supports  Status  of  Women 

Report.  14  (Mar) 
Editorial,  (Lindabury),  3  (Feb) 
A  look  at  the  Francis  Report  on  the  status 

of  women  in  Canada,  25  (Feb) 
Report   tabled,   (Maclnnis),   (guest   edit.). 

3  (Jan) 
Science  has  priority  over  people.  22  (Feb) 
Status  of  women  report  "got  things  going", 

7  (Oct) 
Congenital     rubella — one    approach    to 

prevention,  (Reid),  38  (Jan) 

RUSSELL,  Mary 

Acting    registrar   of  NBARN,    18    (Mar) 

RYERSON  POLYTECHNICAL  INSTITUTE 

Post-diploma  programs  expanded  at  Ryer- 
son, 13  (Aug) 

Results  of  Ryerson  study  disclosed  at 
RNAO  meeting,  10  (Jun) 


ST.  FRANCIS  XAVIER  UNIVERSITY 

Sister  Marie  Simone  Roach  appointed 
acting  chairman  of  nursing  department, 
(port),  19  (Mar) 


ST.  JOHN  AMBULANCE 

Bursaries,  15  (Dec) 

SAFETY 

Cost  is  minimal  to  improve  street  safety 
after  dark,  8,  10  (Feb) 

SALARIES 

ARNN    and   government   meet   on   wage 

demands,  12  (Apr) 
More  money  for  Manitoba  nurses  in  new 

collective  agreement,  6  (Nov) 

SASKATCHEWAN  REGISTERED  NURSES" 
ASSOCIATION 

CNA  president  tells  SRNA  revision  of 
health  systems  will  require  collabora- 
tion. 20  (Sep) 

Awarded  bursaries  to  three  nurses.  20  (Jan) 

Bursaries  awarded,  43  (Dec) 

Eleanor  Linnell  president,  (port).  22  (Oct) 

Honor  roll  presented  to  Madge  McKillop. 
24  (Sep) 

Nurses  and  their  associations  will  provide 
more  leadership.  16  (Sep) 

Roberta  Walker  named  nursing  consultant, 
(port).  42  (Dec) 

Staff  tried  four-day  work  week.   13  (Sep) 

SCHICK,  Carol 

Occult  hydrocephalus  in  adults.  (Yallow- 
ega).  47  (Mar) 

SCHICK,  Violet 

Instructor  at  University  of  Saskatchewan 
School  of  Nursing,  (port).  43  (Nov) 

SCHINBEIN,  RuthK. 

Elected  chairman  of  Ontario  section  of 
ACOG.  24  (Apr) 

SCHOOL  NURSING 

International    meeting    of   school    health 

•  XVI 


nurses  on   emotional   health.    14  (Nov) 
School    nurses    take    practitioner   course. 
20  (Apr) 

SCHORR.  ThelmaM. 

Editor  of  American  Journal  of  Nursing, 
(port).  19  (Jan).  22  (Oct) 

SCHUMACHER.  Marguerite  E. 

"Nursing  C  ommunication  Act"  is  the  core 
of  nursing,  40  (Feb) 

SCHUTT.  Barbara  G. 

Retired  as  editor  of  American  Journal  of 
Nursing,  (port).  19(Jun) 

SCHWARZ.  Marianne 

Director  of  nursing  service  at  Chaleur 
Regional  Hospital  in  Bathurst,  N.S., 
(port),  24  (Oct) 

SCHUMAN,  Holley 

Instructor  at  University  of  Saskatchewan 
School  of  Nursing,  (port).  43  (Nov) 

SCOTT,  R.N. 

Myo-electric  control  —  one  more  aid  for 
the  amputee.  44  (Apr) 

SELLERS.  Betty 

Appointed  nursing  service  consultant 
with  AARN.  (port),  24  (Apr) 

SEX 

Adolescent  sexual  activity.  (Szasz).  39 
(Oct) 

An  exploratory  study  to  determine  the 
sex  education  of  young  unmarried 
mothers.  (Lalancette).  (abst).  44  (Aug) 

SHAW.  Hugh 

What  readers  like —  and  want  changed  — 
in  the  Canadian  Nurse.  29  (Jun) 

SHETLAND.  Margaret  L. 

Received  Alumni  Achievement  Award. 
13  (Jul) 

SJOBERG.  Kay 

Died.  (port).  24  (Oct) 

SKIN 

The  subcutaneous  injection.  (Pitel),  54 
(May) 

SLAUGHTER.  Constance 

Assistant  professor,  community  health, 
at  University  of  Calgary  School  of 
Nursing,  42  (Nov) 

SMALE,  Glen 

Teacher  in  psychiatric  nursing  at  St.  Bon- 
iface School  of  Nursing,  St.  Boniface, 
Man.,  43  (Nov) 

SMALL.  Doris  L 

Retired  from  VON.  (port),  24  (Oct) 

SMITH,  Alice 

A  painter,  a  pilot,  a  rock  hound,  and  some 
cooks:  the  federal  nursing  consultants 
revisited,  (Starr),  24  (Dec) 

SMITH,  Ethel  Margaret 

Concerns  of  mothers  participating  in  the 
care  of  their  children  hospitalized  for 

XVII 


minor  surgery  in  a  day  care  unit,  (abst), 
55  (Apr) 

SMITH,  Jean  Woods 

Appointed  occupational  health  nursing 
consultant  in  Dept.  Public  Health,  N.S.. 
(port).  27  (Sep) 

SMITH,  Larraine 

Bk.  rev.,  48  (Dec) 

SMITH,  Penelope  Jane 

Awarded  professors  prize  in  public  health 
nursing  at  Queens"  University  spring 
convocation,  24  (Sep) 

SMOKING 

CPHA  agrees  to  C  MA  stand  on  smoking 

and  health,  8  (Jun) 
Ban  the  butt,  38  (Jul) 

Men  kicking  cigarette  habit  but  more 
teenage  girls  hooked,  14  (Dec) 

Non-smokers  unite!  44  (Nov) 

SOCIETIES 

A  woman's  right  to  nag — inalienable 
and  essential,  (More),  (port).   38  (Sep) 

SOLER,  Joan 

Behavior  therapy  approach  to  psychiatric 
disorder.  (Raeburn).  36  (Oct) 

SPARKS,  Fannie  L. 

Assistant  professor  University  of  Calgary 
School  of  Nursing.  44  (Dec) 

SPECIALISM 

Two  new  specialties  offer  careers  to  nurses. 
12  (Nov) 

SPLANE,  Verna  Huffman 

WHO  seminar  for  chief  nurses  called  an 
"excellent  first",  10  (Oct) 

A  painter,  a  pilot,  a  rock  hound,  and  some 
cooks:  the  federal  nursing  consultants 
revisited,  (Starr),  24  (Dec) 

SPORTS 

Cycling    for    fitness    and    fun.    52    (Sep) 

STAFFING 

NBARN's  research  project  will  start  in 
fall.  14  (Oct) 

Change  to  part-time  hours  causes  problems 
for  nurses.  14  (Oct) 

Three  Sudbury  nurses  win  hospital  settle- 
ment after    13   months'  fight.    14  (Sep) 

STAINTON,  Colleen 

Assistant  professor  University  of  Calgary 
School  of  Nursing.  44  (Dec) 

STANDERWICK,  Margaret 

VON  regional  director  for  Alberta  and 
Saskatchewan,  43  (Dec) 

STANOJEVIC,  Patricia  S.B. 

Director  of  the  Hospital  for  Sick  Children 
School  of  Nursing,  (port).  18  (Mar) 

STARR,  Dorothy  S. 

Assistant  editor  of  The  Canadian  Nurse, 
(port),  14  (Aug) 


A  painter,  a  pilot,  a  rock  hound,  and  some 
cooks:  the  federal  nursing  consultants 
revisited.  24  (Dec) 

STATISTICS 

Some  only  half-counted,  56  (Sep) 

STATISTICS  CANADA 

See  Dominion  Bureau  of  Statistics 

STEED,  Margaret 

Bk.rev..  47  (Feb) 

STLNSON,  Shirley 

Temporary  advisor  WHO/PAHO.  14  (Jul) 

STOCKDALE,  Wendy 

The  cancer  patient.  43  (Apr) 

STREET,  Margaret 

Received  honorary  membership  in  RNAO. 
13  (Jul) 

STRIKE.  Eileen  D. 

Appointed  director  of  nursing  service  for 
Toronto  General  Hospital,  (port).  24 
(Apr) 

STUDENTS 

ICN  essay  competition  for  Irish  student 
nurses,  1  1  (Oct) 

Audio  slides  streamline  interviews,  (Hen- 
ricks),  35  (Aug) 

Selection  and  success  of  students  in  a  hos- 
pital school  of  nursing,  (Willett  et  al), 
41  (Jan) 

Student  volunteer  project  receives  $100,000 
contract.  14  (Nov) 

A  study  of  anticipatory  socialization  in 
prospective  nursing  students.  (Given), 
(abst),  57  (Sep) 

University  nursing  students  hold  consti- 
tutional conference,  14  (Apr) 

SUICIDE 

Persons  contemplating  suicide  can  often 
be  identified  social  worker  tells  audi- 
ence, 10  (Feb) 

SULLIVAN,  Nora 

Awarded  SRNA  bursary,  43  (Dec) 

SURGERY 

Basilar  aneurysms,  (Derdall),  49  (Apr) 
A  comparison  of  the  effectiveness  of  two 
nursing  approaches  in  the  relief  of  post- 
operative    pain,     (Buzzell,     Roberto), 
(abst),  45  (Aug) 
Vasectomy,  (Todd),  20  (Aug) 

SWINTON,ConsUnce 

Bk.  rev,.  46  (Aug) 

Nursing  consultant  of  Dept,  of  National 

Health  and  Welfare,  (port).  14  (Jul) 
A  painter,  a  pilot,  a  rock  hound,  and  some 

cooks:    the  federal   nursing  consultants 

revisited.  (Starr).  24  (Dec) 

SZASZ,  George 

Adolescent  sexual  activity,  (port).  39  (Oct) 


TASK  FORCES  ON  THE  COST  OF 
HEALTH  SERVICES  IN  CANADA 


Report  to  the  Minister  of  National  Health 
and  Welfare  from  theCNA.  27  (Jan) 

TAUBER,  Birgit 

Nurse-adviser  of  ICN,  43  (Dec) 
TAXATION 

Social  and  Economic  Welfare  Committee 
meets  at  CN A  house.  7  (Jan) 

TAYLOR,  Elsie  Mary 

Director  of  nursing  at  Kitimat  General 
Hospital.  15  (Feb) 

TAYLOR,  Helen  D. 

ANPQ  president  says  nurses  must  decide 
own  future.  8  (Jan) 

Deep-freeze  seminar —  a  warm  experi- 
ence. (Rockburne).  35  (Jun) 

TEACHERS  AND  TEACHING 

Inservice  education  benefits  all  teachers, 
(Oatway).  32  (Aug) 

Relationship  of  the  faculty  members" 
perception  of  participation  in  policy 
making  to  their  perception  of  the  usa- 
bility of  the  policy,  (abst).  (Brough). 
46  (Feb) 

TELEVISION 

TV    drama    not    for   everyone.    23    (Jan) 
TV   panelist  named  a  medical  watchdog. 

23  (Apr) 

Three  TV  programs  tell  nurses"  role.  17 
(Jan) 

TERMINOLOGY 

"Phony""  words,  30  (May) 

TESTS  AND  MEASUREMENTS 

Large  number  of  candidates  write  CNATS 
examinations.  8  (Mar) 

THOMAS.  Jane 

"'Fifty  years  a-nursing",  (port),    18  (Mar) 

THOMPSON.  M.  Ruth 

Retired  as  director  of  school  of  nursing  at 
University  of  Alberta  Hospital,  (port). 

24  (Oct) 

THRASHER,  Judith  Diane 

Received  Kathleen  Ellis  Prize,  (port).  14 
(Jul) 

TIFFIN,  Sharon  B. 

Serving  with  MEDICO  in  Surakarta.  Cen- 
tral Java.  (port).  24  (Apr) 

TISSINGTON,  Claire 

Director  of  education  services  RNABC. 
(port).  24  (Oct) 

TOD,  Louise 

Appointed  nursing  consultant  for  hospital 

insurance  and  diagnostic  services.  Dept. 

National     Health    &     Welfare,    (port). 

42  (Dec) 
A  painter,  a  pilot,  a  rock  hound,  and  some 

cooks;   the  federal   nursing  consultants 

revisited.  (Starr).  24  (Dec) 

TODD,  lainAX). 

Vasectomy.  20  (Aug) 

TOLMAN,  Keith  G. 

Why  is  hypothermia  overlooked?  (port). 
35 (Sep) 


TORONTO  GENERAL  HOSPITAL 

Alumnae  association  spans  ninety  years, 
1 1  (Aug) 

TRANSPLANTATION 

Ontario  plans  to  legalize  human  organ 
transplants.  17  (Sep) 

TRETIAK.  Sally 

Bk.  rev.,  58  (May) 

TUBERCULOSIS 

International  medical  expert  shows  our 
role  is  vital  in  "the  other  world"",  9 
(Aug) 

New  association  holds  tuberculosis  semi- 
nar, 19  (Sep) 

TURNBULL,  Frank 

Pain   and   suffering   in   cancer,    18   (Aug) 

TURNBULL,  Lily  Mary 

SRNA  honor  role,  24  (Sep) 

TYLER,  Eunice 

Management  of  Parkinson's  disease  with 
L-dopa  therapy,  41  (Apr) 

TYPHOID  FEVER 

Quebec  village  of  Bouchette  to  get  water 

filtration  system.  8  (Nov) 
Typhoid  fever.  (Lindabury).  (edit.),  3  (Jul) 
Typhoid  in  Bouchette,  (Lapointe),  20  (Jul) 


U 


UNEMPLOYMENT 

Few     Manitoba    nurses    unemployed,    8 

(Jun) 
Poor   response    to    MARN    survey   could 

mean  little  unemployment.  21  (May) 
Union  survey  gives  composite  of  Quebec 

nurses,  17  (Oct) 

UNIFORMS 

There"s  one  difference,  22  (Feb) 

Uniform  spells  chic  comfort  for  NS  public 
health  nurses,  9  (Dec) 

UNITED  NURSES  INC. 

Quebec  nurses"  union  conducts  telephone 
survey  of  all  Quebec  nurses,  21  (May) 

Union  survey  gives  composite  of  Quebec 
nurses,  17  (Oct) 

United  Nurses  of  Montreal  begin  unique 
training  program,  12  (Apr) 

UNIVERSITY  OF  ALBERTA 

Flexible  program  prepares  researchers  at 
U.  of  Alberta,  17  (Oct) 

UNIVERSITY  OF  BRITISH  COLUMBIA 

New  UBC  program  in  continuing  educa- 
tion, 19  (Sep) 

Muriel  Uprichard  appointed  as  head  of 
the  school  of  nursing,  (port).  26  (May) 

UNIVERSITY  OF  CALGARY.  SCHOOL 
OF  NURSING 

Appointments,  44  (Dec) 

UNIVERSITY  OF  SASKATCHEWAN 

Nursing  degree  program  updated,  22  (Sep) 

Recent  appointments,  43  (Nov) 

Use  of  Sask.   health   services  studied   by 


university  team,  10  (Nov) 

UNIVERSITY  OF  TORONTO 

National  Health  Grant  for  U.  of  T.  School 
of  Nursing,  11  (Feb) 

UNIVERSITY  OF  WINDSOR 

First  nursing  intersession  chosen  by  RNs 
at  Windsor U.,  20  (Oct) 

UPRICHARD,  Muriel 

Appointed  head  of  school  of  nursing  of 
University  of  British  Columbia,  (port), 
26  (May) 


VANDERZEE,  Gelske 

Carotid  artery  stenosis  with  transient 
ischemic  attacks,  32  (Feb) 

VARENNES,  Lyse  de 

Cut  1,  scene  2  or  .  .  .  how  to  make  a  film 
in  your  spare  time,  (Brydges),  26  (Nov) 

VENEREAL  DISEASE 

The  nurse  and  VD  control,  (Ferrari),  28 
(Jul) 

Venereal  disease  hotline  gives  round-the- 
clock  information,  15  (Dec) 

Venereal  disease  problem  in  Canada, 
(Acres,  Davies),  24  (Jul) 

VOGT,  Carolyn 

Bk.  rev.,  48  (Jun) 

VICTORLVN  ORDER  OF  NURSES 

Appointments  announced,  43  (Dec) 
Doris   I.   Small   retired,   (port),   24   (Oct) 
Eleanor  MacDougall  appointed  director  of 

Greater    Montreal    branch,    (port),    22 

(Oct) 


W 


WAGNER,  Susan 

Instructor  at  University  of  Saskatchewan 
School  of  Nursing,  (port),  43  (Nov) 

WALKER,  Mildred  L 

Bursary  fund  established,  20  (Jun) 

WALKER,  Roberta 

Nursing  consultant  for  SRNA,  (port),  42 
(Dec) 
WALLACE,  Pat 

Relatives  should  be  told  about  intensive 
care — but  how  much  and  by  whom? 
33  (Jun) 

WALTON,  Elizabeth  Ann 

Hand  and  arm  motor  behavior  in  labor- 
ing patients,  (abst),  44  (Feb) 

WELLESLEY  HOSPITAL 

Building  named  after  Wellesley"s  former 

nursing  director,  18  (Jun) 
Toronto  HospitaPs  magazine  wins  award, 

7  (Aug) 

WBESNER,  Lotti 

In  Canada  as  guest  of  CUSO  26  (May) 
WILDSMITH,  Ardythe  G. 

Winner  of  spring  1971  Searie-Canada 
scholarship,  43  (Dec) 

«  XVIII 


WILLETT,  Elizabeth  A. 

Selection  and  success  of  students  in  a  hos- 
pital school  of  nursing,  (et  al),  41  (Jan) 

WILLIAMSON,  Jessie 

Retired  as  director  of  public  health  nurs- 
ing services  of  Manitoba,  26  (May) 

WILLIS,  Tanna 

Bk.  rev.,  58  (May) 

WILSON,  Jessie  M. 

Retired  as  director  of  nursing  at  Runny- 
mede  Hospital,  Toronto,  (port),  27  (Sep) 

WILSON,  Madeline 

Bk.rev..  48  (Aug) 

WILTING,  Jennie 

Hey,  nurse!  by  Nurse  Whozits,  45  (Jun), 
39  (Aug),  40  (Nov),  39  (Dec) 

WINNIPEG  GENERAL  HOSPITAL 

REGISTERED  NURSES' ASSOCIATION 

Denied  re-hearing  of  application,  10  (Jul) 

WOMEN 

CAUSN  considers  expanding  role,  status 

of  women,  12  (Dec) 
Freda   Paltiel   coordinator  of  the  federal 

government's  examination  of  the  status 

of  women,  (port),  26  (May) 
Catchbasins,    debentures,    subsidies    and 

garbage  cans,  (Conroy),  27  (Feb) 
Report  of  the  Royal  Commission  on  the 

Status   of  Women,    (Maclnnis),    (guest 

edit.),  3  (Jan) 
Status  of  women  report  "got  things  going", 

7  (Oct) 
A    woman's    right    to    nag — inalienable 

and  essential,  (More),  (port),  38  (Sep) 
Women    prone    to   whiplash    injuries,   44 

(Nov) 

WORLD  HEALTH  ORGANIZATION 

ICN  prepares  draft  on  status  of  nurses, 
22  (May) 

Seminar  for  chief  nurses  called  an  "excel- 
lent first",  10  (Oct) 

WORLD  MEDICAL  ASSOCIATION 

Physician  assistant  sparks  debate  but  no 
answers  at  World  Medical  Assembly, 
9  (Nov) 

WYL  IE,  Dorothy  M. 

Appointed  director  of  nursing  at  Sunny- 
brook  Hospital,  (port),  27  (Sep) 


YOUNGBLLIT,  Ann  Carrol 

Specially     for     the     newborn — intensive 
care  in  the  nursery,  24  (Aug) 


ZIMMERMAN,  Bob 

Rock     festivals — new     problems, 
solutions,  (Jansons),  32  (Dec) 

ZIOLKOWSKI.  Ardice  E. 

SRNA  honor  role,  24  (Sep) 


YALLOWEGA,  Elizabeth 

Occult  hydrocephalus  in  adults,  (Schick), 
47  (Mar) 

YARMOUTH  REGIONAL  HOSPITAL 
SCHOOL 

New  method  used  to  develop  curriculum, 
1 1  (Feb) 

YORK-FINCH  GENERAL  HOSPITAL 

Yes,    indeed,    this   hospital    is   alive   and 
well,  7  (Jun) 

XIX 


museum  piece 

FLEET  ENEMA®  —  the  disposables  —  puts  the  enema-can  right  where  it  belongs  —  in  the 
Chamber  of  Costly  Horrors.  Nurses  themselves,  in  time-studies*,  established  FLEET  as 
"the  40-second  enema".  Compared  with  the  old-fashioned  method,  FLEET  ENEMA® 
saves  the  nurse  an  average  of  17  minutes  per  patient  —  not  to  mention  all  the  drudgery. 
FLEET  disposables  are  pre-lubricated,  pre-mixed,  pre-measured  and  individually  packed. 
Everything  moves  better  with  FLEET.  Three  disposable  forms;  Adult  (green  protective 
cap),  Pediatric  (blue  cap),  and  Mineral  Oil  (orange  cap). 


WARNING:  Not  to  be  used  when 
nausea,  vomiting  or  abdominal  pain 
is  present.  Frequent  or  prolonged 
use  may  result  in  dependence. 
CAUTION:  Do  not  administer  to  chil- 
dren under  two  years  of  age  except  on 
the  advice  of  a  physician.  In  dehy- 
drated or  debilitated  patients,  the 
volume  must  be  carefully  deter- 
mined since  the  solution  is  hyper- 
tonic and  may  lead  to  further  dehy- 
dration. Care  should  also  be  taken 
to  ensure  that  the  contents  of  the 
bowel  are  expelled  after  administra- 
tion. Repeated  administration  ^t 
short  intervals  should  be  avoided. 


1  BBii 

1  [enema] 

1    ■■    ■     liNEMA-]    1 

fuW  information  on  request. 
'Kehlmann,  W.H.:  Mod.  Hosp. 
84:104,  1955 


3m^ 

FOUNDED  IN  CANADA  IN  1899 
CHARLES  e.  FROSST  &  CO. 
KIRKL.AND  (MONTREAL)  CANADA 


The  faster  things  move 


in  your  ever-changing  world  of  nursing  leadership, 
the  more  important  it  is  to  keep  yourself  informed 
about  new  techniques  and  new  technology.  The 
distinguished  RN's  who  are  the  contributing  editors 
of  THE  JOURNAL  OF  NURSING  ADMINISTRATION 
want  to  help  you  keep  up  (and  ahead)  no  matter 
how  fast  things  change.  And  they  go  beyond  the 
world  of  nursing  supervision  to  draw  on  the 
insights  of  specialized  consultants  in  such 
related  fields  as  law,  architecture,  systems 
development,  recruiting,  and  accounting. 
For  only  $15.00  a  year  they  report  it  all 
back  to  you  every  other  month  in  a  veritable 
harvest  of  ideas  and  information.  THE  JOURNAL 
OF  NURSING  ADMINISTRATION  —  an  exceptional  investment 
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ditorial  Board 

.uther  Christman,  R.N.,  Ph  D 
ucy  Germain,   R.N.,   MA. 
Ivelyn  Zetler  |ones,  R.N., 

M.    I.itt. 
)oris  I.  Miller,  R.N.,  M  Ed. 
;.  Mary  SIraub,  R.N.,  Ed.D. 

lontributing  Editors 

!uth  Anderson,  R.N  ,  Ph.D. 
yndall  Birkbeck,   R  N  ,  M.A. 
jertrude  Cherescavich,  R.N. 

M.S. 
^nnie  Laurie  Crawford,  R.N. 

M.Ed. 
tarbara  A.  Davis,  R.N.,  M.S 
;va  H.  Erickson,  R  N.,  MS. 
klarie  DIVIncenti,   R.N.,   Ed.D. 
lelen  W.  Dunn,  R.N.,  M.S.N. E. 
tulh  Freeman,  R.N.,  Ed.D. 
:lifford  Jordan,  R.N.,  M.Sc.Ed 
ileanor  lamberlsen,  R.N., 

Ed.D. 
)ulcy   Miller,   B  A. 
iylvia  R.  Peabody,  R.N.,  M.S. 
ohn  L.  Ryan,  M.H  A. 
r.  M.  Loyola  Schwab,  O.S.B., 

R.N 
Aary  Shaughnessy,  R.N.,  Ed.D. 
lelen  Weber,  R  N.,  A.M. 
ucie  Young,  R  N.,  Ph.D. 


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Putting  the  Health  in  the  Health  Institution  ...  by  Eugenia  Lee 

Unit  Management  Systems  ...  by  Eileen  Hilger 

The  Clinical  Specialist  in  a  Community  Hospital  ...  by  Ruth  Kirkman  and  Marian  Miller 

Nurses'  Travel ...  by  Stanley  Lippert 

The  Question  Behind  the  Question  ...  by  Marlene  Kramer  and  Margaret  Treat 

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The  California  Nurse  Practice  Act — Radical  Change  ...by Rachel  Ayers 

Maternity  Leave  . . .  by  Virginia  Cleland 

Working  With  an  Architect  . . .  by  Maxine  Mann 

Accountability  for  Nursing  Practice  ...  by  Marion  McKenna 

Centralized  Staffing  Procedures  ...  by  Mary  Ellen  Warstler 

A  Computerized  Nursing  History  ...  by  Elizabeth  Wesseling 


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