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Full text of "The Canadian Nurse Volume 70"

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January 1974 



Nurse 




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T\» ^oiif't Response 
toTrauiM: Fractures 



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Recent releases 

for clinical 
competence 



® 














RESPIRATORY IMTENSIVE CARE 
NURSING 

Beth Israel Hospital, Boston 

... A comprehensive presentation of current inter- 
disciplinary practices in respiratory and nursing 
care. 
Little, Brown April 1973 $10.95 

COMMUNICATION IN NURSING 
PRACTICE 

Hein 

. . . Presents a simple, formal model of the com- 
munication process between nurse and patient, but 
emphasizes the need to use variety in meeting 
variety. 
Little, Brown July 1973 $6.25 

LEADERSHIP TECHNIQUE IN EXPECTANT 
PARENT EDUCATION 

2nd edition Clark 

. . . Designed to equip the nurse instructor to con- 
duct well planned educational sessions for pros- 
pective parents. 
Springer June 1973 $4.50 

MONITORING CENTRAL VENOUS 
PRESSURE: A Programmed Sequence 

Krueger 

... A programmed text on the aspects of central 

venous pressure of concern in nursing. 

Springer June 1973 $4.25 

EFFECTIVE APPROACHES TO PATIENT 
BEHAVIOR 

Lipkin and Cohen 

. . . How the nurse should approach an emotionally 
disturbed patient when giving direct nursing care. 
Springer June 1973 $5.50 



© 

1? 











THE BODY'S RESPONSE TO TRAUMA: 
Fractures 

Clissold 

... In this programmed text, fracture is used to 

demonstrate the responses of the cells of the body 

to trauma. 

Springer June 1973 $6.75 

WINTERS' PROTECTIVE BODY 
MECHANICS: A Manual for Nurses 

Bilger and Greene 

. . . Concentrates on the physical and physiological 

principles underlying the body movements that need 

to be initiated to achieve therapeutic objectives In 

patient care. 

Springer May 1973 $6.25 

ADMINISTERING NURSING SERVICE 

DiVincenti 

... A straight forward presentation of everyday 

approaches to the management of nursing services 

and the application of management theories to the 

care of patients. 

Little. Brown December 1972 $10.95 

MATERNAL-CHILD NURSING 

Broadribb and Corliss 

A family centered text for students being prepared 
to give direct care to mothers and children. 
Lippincott September 1973 about $11.00 

PERSPECTIVES IN HUMAN 
DEVELOPMENT: Nursing Throughout 
the Life Cycle 

Sutterley and Donnelly 

. . . Emphasizes a multi-disciplinary, holistic view of 
man. the promotion and maintenance of health as 
well as intervention in times of physical, emotional 
and social stress. 

Lippincott May 1973 $8.75 

THE PRACTICE OF MENTAL HEALTH 
NURSING: A Community Approach 
Morgan and Moreno 

. . . Reflects the dynamic quality of psychiatric care 
in a community setting and desirable colleague re- 
lationships required for successful treatment of the 
emotionally disturbed. 

Lippincott May 1973 flexible cover $5.95 

CRITICAL CARE NURSING 
Hudak, Gallo and Lohr 

... A comprehensive course in the area of critical 
care nursing unexcelled in depth and content. 
Lippincott August 1973 about $9.95 



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BE FIRST ON THE SCENE 

niiD ucMf ■ luc nc Ai*niiBi 



The 

Canadian 
Nurse 






A monthly journal for the nurses of Canada published 

in English and French editions by the Canadian Nurses' Association 

Volume 70, Numberl January 1974 

19 Guest Editorial M. Lalonde 



Editorial 



21 The Problem-Solving Technique: 
Is It Relevant to Practice? 



B.Geach 



23 Electrophrenic Respiration 

in Quadriplegia R.G. Vanderlinden, L. Gilpin, J. Harper, 

M. McClurkin, and D. Twilley 



27 When You Visit a Sick Friend 



28 I've Got a Wolf By the Ears B. Hartley 

32 Protecting Nonsmokers in Public Places S. Kessler 

The views cxpicsscJ in Ihc cilitiii iai and various ailiclcs arc Ihosc iit the authors and 
do not JK'Ccssarily rcpioscnl the policies or vieus of the Canadian Nurses' Association. 



4 Letters 

7 News 

37 Dates 

38 Names 

41 In A Capsule 



42 Research Abstracts 

44 Books 

49 AV Aids 

50 Accession List 
64 Official Directory 



txccutivc Director; IK-ltn K. Mussallcm • 
l-.ditor: Vit)>inia A. IJndabury • Assistant 
1 ditors: Liv-Klk-n l.ttckcbcrg, Dorothy S. 
Slarr • Iditorial Assistant: Carol A. Dwor- 
kin • Prcniuctiiin Assistant: Kliiabclh A. 
Stanlon • Circulation Manager: Beryl Dar- 
line • Advertising Manager: Georgina Clarke 

• Subscription Rates: ( anada: one year, 
S6.(K); two years. SI I .(H). loreign: one year, 
$6.50; two'years, $12.00. Single copies: 
$1.00 each. Make cheques or money orders 
payable to the Canadian Nurses .Association. 

• Change of .Address: .Six weeks' notice; the 
old address as well ;is the new are necessary. 
together with registration number in a pro- 
vincial nurses' association, where applicable. 
Not responsible Tor journals lost in mail due 
to errors in ;iddress. 



Manuscript Inl'ormation: ' I he Canadian 
Nurse" welcomes uns{ilieited articles. .-Ml 
manuscripts should be t\[vd. d luble-spuced. 
on one side ol unruled p;iper lea\ nig wide 
margins. M;inuscripls ;ire accepted lor res iew 
lor exclusive publication. I he editor reserves 
the right to nuike the usual editorial ehunges. 
I'hotographs (glossy prints) ;md graphs and 
diagrams (drawn in india ink on white paper) 
are welcomed with such articles. I he editor 
is not committed to publish ;ill articles sent, 
nor to indicate dellnite dates ol publication. 

Postage paid In cash at third class rate 
MCWTRI-Al.. P.O. Permit No. lO.OOI. 
50 The Driveway, CJitawa. Ontario. K2P 112 

C) ( iinadian Nurses' Assoeialion IW74. 



JANUARY 1974 



"Haveyou got thecps?" a colleague 
asked. 

"Gosh no," I replied emphatical- 
ly, darned glad I didn't have creep- 
ing pruritis systemicus. 

"You're wrong," she said, "you 
do have the cps." And with that she 
picked up the latest edition of the 
Compendium of Pharmaceuticals 
and Specialties from my desk and 
whisked it off to her office. 

That episode convinced me that 
I just don't "think in abbreviations." 
I need to have everything s-p-e-l-l- 

E-D O-U-T. 

I first noticed this weakness sev- 
eral years ago, while I was covering 
the annual meeting of the Turnip 
and Parsnip Society (taps). I kept 
forgetting what the acronym stood 
for, realizing only that it made me 
thirsty. Finally I gave up and went 
out and had a beer. 

I admire the person who, when 
reading a report, rhymes off a series 
of acronyms that would choke a 
HORSE (Honorary Officer in the 
Royal Society of Eggnogs). Even 
more, I admire the individual who 
really understands what the abbre- 
viation stands for. This is not easy. 
For example, who but a fruit or 
vegetable would know that garbage 
stands for "Group Against Ripe 
Bananas and Garlicky Endives?" 

Just when you believe you've 
cracked the code, you discover an 
anomaly. For example, C at the 
beginning of an acronym usually 
means Canadian; however, it can 
also stand for Council. As a rule, F 
stands for Federation; but the F may 
refer to another word, such as the F 
in the Canadian Fertilizer Associa- 
tion. You have to be careful. 

Anyhow, it's all very trying. I 

can't even gasp anymore. That 

word belongs to the Group Against 

Smokers' Pollution! — \/.A.L. 

THE CANADIAN NURSE 3 



letters { 



Letters to the editor are welcome. 

Only signed letters, which include the writer's complete address, 

will be considered for publication. 

Name will be withheld at the writer's request. 



Reader has questions 

It is good to see that a nurse has taken 
the initiative in suggesting some accept- 
able methods of dealing with physically 
aggressive behavior (Contmlling the 
Fight/Flight Patient. October 1973). 
As a staff development teacher in a 
provincial psychiatric hospital, I would 
like to comment on the following. 

The concept of a crisis team is gocxl. 
But what do the staff members do if 
there is no time to call the team and 
they have to intervene immediately 
for the safety of the patient and others? 
Another question is; What do you do 
with the patient who has backed into a 
corner and is using a chair or other ar- 
ticle as a weapon? 

Much emphasis has been put on the 
use of p.r.n. medication, which is 
another type of restraint. 1 would like 
to see more emphasis on recognizing 
the signs of impending aggression and 
methods of intervening before physical 
restraint is necessary. Many nursing 
staff miss behavioral cues that indicate 
agitation; are unaware of how effective 
talking, walking, or sitting are with the 
patient at this time; and are unaware 
that p.r.n. medications and physical 
restraint may be unnecessary. 

The staff on our unit, in conjunction 
with the psychology department, made 
a videotape of the signs and symptoms 
of impending aggressive behavior and 
three acceptable methods of restraint. 
This videotape has been shown to all 
the staff. It is now part of the orienta- 
tion program for all new nursing staff, 
and has been recommended for educat- 
ing staff in all Ontario psychiatric hos- 
pitals. 

In the discussion that follows the 
viewing of this videotape, nurses be- 
come aware that staff get the behavior 
they expect, there is a reason for it, and 
the choice of intervention depends on 
what is happening with the patient. — 
Charlannc Janson, Reg.N.. London. 
Ontario. 

Author replies 

1 here is no single right method that 
everyone can use in dealing with a pa- 
tient who is out of control. Guidelines 
that follow sound, theoretical know- 
ledge require modifications for those 
whose duty is to administer them. 

There is a common fallacy that more 
is better — more staff to control one 
4 THE CANADIAN NURSE 



patient. One to four well-trained staff 
members are more effective than any 
number (and I have seen the odds ten 
to one!) who are fearful and/or untrain- 
ed. The staff present who know and are 
known by the patient must intervene by 
verbal and nonverbal communication. 
A calm voice, even if the language is 
not understcmd, shows that someone is 
in control and goes a long way to alle- 
viate the patient's fears. Involving those 
present — be they other patients, 
professional or nonprofessional staff, 
and visitors — can sometimes be more 
effective than any "crisis team." 

The second query, regarding a 
patient with a weapon, is always fright- 
ening. However, taking a defensive 
posture is natural. Staff can dodge ar- 
ticles that are thrown, but they should 
make no attempt to overpower the 
patient. They should try to convey the 
need to help, and use all the negotiat- 
ing powers of communication available 
so that the patient is not stripped of his 
pride. Here is where time becomes 
everyone's greatest ally; time for the 
patient to listen and feel others' calm- 
ness and helpfulness, and time to gain 
control of himself; and time for the 
staff to be alert to cues presented by 
the patient, and to act on these for 
everyone's safety. — Jean A. Reid. 
Montreal, Quebec. 



Where was the humor? 

I will not say I was offended by the 
cartoon that appeared in the October 
1973 issue (page 48). Not impressed 
is a more accurate description. 

With the maternity ward as a setting, 
the cartoon depicted a rather hybrid 
combination of latter-day "longhair" 
clothed in tourist garb, carrying a pair 
of somewhat anachronistic bongo 
drums. In the caption, the nurse says 



RcgiNtcred nurses, 
your community needs 
[the benefit of youi 
skills and experience. 
Volunteer now to 
iciith St. John Ambulance home 
niusinp and child care courses. 

Contiicl your Provincial Headquarters, 
St. John Ambulance. 




to the father, "Congratulations — it's 
a person!" 

Of course, there is nothing wrong 
with seeing the humor in a situation, 
but was there any at all here? Subtle 
it was not. I hope nurses are worthy 
of better. — Erica C. Fonies. Van- 
couver, B.C. 



Student learns from article 

I was very interested in the article by 
Thora Kron, "How we communicate 
nonvcrbally with patients" (Niwcmber 
1972). It is true that bedside manners 
are important in communicating with 
patients. 

I was reminded of an unpleasant 
experience 1 had last year when I gave 
an injection to a patient for the first 
time. I was ready to give the injection, 
when the patient suddenly grabbed my 
other hand and said, "This is your first 
time giving an injection, and! do not 
want to be practiced upon." 

I was amiizcd and asked him why he 
said that. He replied, "Your looks re- 
veal it. You are trembling and perspir- 
ing profusely, and you look frightened." 
1 he instructor came and found us ar- 
guing; I was been able to convince the 
patient to receive the injection, under 
supervision. 

1 was so embarrassed. I did not 
know why I behaved the way I did, in 
spite of learning the right principles in 
the classroom. However, that experi- 
ence taught me a good lesson. It also 
showed the difference between know- 
ing something in theory and in practice. 

Now I am a junior nursing student 
and have given countless numbers of 
injections to patients. I am glad 1 have 
never experienced such embarrassment 
since. Ihe article in llie Canadian 
Nurse made mo more aware of my ges- 
tures and actions when I deal with pa- 
tients, and helped me avoid loss of 
confidence. 

I highly reconmiend that every stu- 
dent nurse read about the effects of 
nt)nverbalcomnuinication vvitJ! patients. 
I hope you will publish more articles 
of tliis type, as they are interesting and 
are applicable to the practice of nursing, 
especially for student nurses who are 
still learning the basic principles in 
nursing. — Melo Jean L. Manulo, 
School of Nursing. Philippine Union 
College, Manila. "^ 

JANUARY 1974 





Davol chained suction instruments 
just enough to make a big difference. 



There's only one difference 
between Davol instruments and 
metal ones. 

Davol made them disposable. 

So now nursing staffs save time 
because there's no recleaning. 

And most important, there's no 
risk of contamination. 

Everything else is the same. Your 
surgeons get the look, feel and action 
they're used to in metal Yankauers, 
Pooles, Fraziers and sigmoidoscopic 
instruments. 



Price? 

Davol suction instruments are 
priced to make disposability practical. 

Davol introduced disposable 
suction instruments. Since then 
over two thousand hospitals have 
already converted. 

Apparently, we made a big 
difference. 

Davol Canada Ltd., 1033 Range 
View Rd., Port Credit, Ont., 
L5E-1H2 (416)274-5252 



BUILDING ON A CENTURY OF QUALITY 
HEALTH CARE PRODUCTS 




1874-1974 



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6 THE CANADIAN NURSE JANUARY 1974 



news 



"Action Needed" Summarizes 
National Nursing Conference 

Ottawa — "The time for rhetoric and 
philosophizing is over. What we need 
now is action," is the way Alice Baum- 
gart summarized the tour-day National 
Conference on Nurses for Community 
Service, held in Ottawa November 
13-16. Ms. Baumgart, winner of the 
3M Nursing Fellowship for 1973, 
awarded by the International Council 
of Nurses, is a doctoral student at the 
University of Toronto. 

Ms. Baumgart said the most visible 
participants at the conference were 
the consumers and nurses from nursing 
practice, education, and administra- 
tion. She made special mention of the 
nursing assistants and psychiatric 
nurses, whose presence marked "a 
turning point to more open and cordial 
relations." 

The question "who should partici- 
pate" in community care is different 
from "who can participate," she noted. 
"The latter is where I would like to 
see the emphasis put." 

Taking up one idea raised during 
the panel discussion on November 14, 
Ms. Baumgart questioned the notion 
of the nurse as a ccxirdinator. "Is this 
role compatible with our interests in 
upgrading the clinical competencies 
of nurses?" she asked. "Does our affi- 
nity for this role relate to the fact that 
most nurses are women and we take to 
it as we accept the role of secretary or 
tea server?" 

Ms. Baumgart highlighted three 
points that were "mentioned in passing" 
during the conference; 

• Nursing students are not all young 
and all nurses are not female. 

• Nurses are increasingly turning to 
their own colleagues for consultation. 

• Nurses do not write enough about 
what they are doing. 

The conference was sponsored joint- 
ly by the department of national health 
and welfare and the Canadian Nurses" 
Association. The impetus for the meet- 
ing came from a resolution, accepted 
by delegates at the 1972 CNA annual 
meeting and convention in Edmonton, 
which asked, in part, that "the global 
objectives of nursing education be 
redefined in accord with the evolution 
in nursing." 

CNA directors decided at their 
meeting in September 1972 that it 
might be timely to review nursing edu- 

JANUARY1974 



cation trends across Canada and that 
a national conference including nurse 
educators from various kinds of pro- 
grams, together with "nurse practi- 
tioners," should be held. (See News. 
"CNA Directors at work," November 
1972 and March 1973.) 

Participants in the conference in- 
cluded nurses from all provinces and 
the Northwest Territories, student 
nurses, nursing assistants, and repre- 
sentatives of the Psychiatric Nurses' 
Association of Canada, Canadian Med- 
ical Association, Canadian Hospital 
Association, Canadian Public Health 
Association, department of national 
health and welfare, and provincial 
departments of education and health. 

Future Health Needs Demand 
Less Complex Structure 

Ottawa — "A crying need for the future 
will be a less complex bureaucracy, a 
health-care structure that consumers 
can understand." This comment was 
made by Helen Frayne, a member of a 
panel that discussed future health care 
needs, during a session at the national 
Conference on Nurses tor Community 
Service November 13-16, 1973. The 
conference was sponsored jointly by 
Health and Welfare Canada and the 
Canadian Nurses" Association. 

Ms. Frayne, an Ottawa writer and 
broadcaster, said the present system 
of providing care is top-heavy. "If 
the structure is simplified, perhaps even 
those who administer it will have some 
understanding of its workings," she 
suggested. 

Speaking about community health 
centers. Ms. Frayne mentioned the 
Hasting"s Report which, she said, 
skirted the issue of control and did 
not deal with the need for "govern- 
ment seed money"" so a center could 
become self-sufficient. "Control by 
the local community must be ensured 
at the outset through conditions attached 
to provision of public funds. "" she said. 

Consumers are taking an increased 
interest in health costs, while examin- 
ing the quality of care, Ms. Frayne said. 
"We won"t be content to pay high costs 
for indifferent care in the future." 

Another panelist, Yvonne Vanden- 
engel of Montreal, deplored the fact 
that physicians rarely make house calls, 
and suggested that RNs should fill this 
gap. The nurse should diagnose the 



ailment, referring patients with serious 
illness to the doctor, Ms. Vandenengel 
said. She had some advice for hospital- 
based nurses who don't like making 
home visits and prefer the hospital 
setting. "Stay there,"" she said. 

Nurses who make these home visits 
should have "peripheral vision."" Ms. 
Vandenengel explained. "Out of the 
corner of their eyes they observe, with- 
out being noticed. They see the type 
of home, the habits of the family — 
anything that will shed light on the 
health problems of the patient." 

The four-day national Conference 
on Nurses for Community Service was 
attended by more than 200 health 
professionals and their "clients." The 
theme of the conference was "the shift 
of nursing services from acute, curative 
care in institutions to the promotion 
of health in the community." 

Keynote speaker on the opening 
day of the conference was Marguerite 
Schumacher. CNA president. Her topic 
was "The Identity of Nursing in the 
Electronic Age." 



Panelists Set Forth Skills And 
Knowledge Of Nurse Of Tomorrow 

Ottawa — In reptirting to the plenary 
session on the second day of the 
national Conference on Nurses for 
Community Service, held in November, 
Denise Lalancctte, nurse clinician. 
University of Sherbnxike Clinic, said 
she was made uncomfortable by what 
she had heard the day before. 

She was disturbed by nurses' hesita- 
tion and reluctance to assume their 
responsibility to meet the needs of 
tomorrow; by the lack of nurses' ser- 
vices in homes and disadvantaged 
areas; by their apparent content with 
the "system" in that they do not ques- 
tion if users iwi'd their services as now 
offered; and by their lack of attention 
to the individual needs and comfort of 
patients, 

Ms. Lalancette felt reassured hi>w- 
ever, when she also heard: "There are 
health workers who are able to care 
for us at a price we can pay. They are 
the nurses." "We nurses must get going 
and use our skills." she concluded. 

Pamela Poole, research consultant. 
Health and Welfare Canada, was the 
first panelist to make projections on 
the knowledge and skills for future 
nursing practice. Hers was the general. 
THE CANADIAN NURSE 7 



news 



and personal, view: "Our mandate of 
physician's helper will change to that 
ot autonomous decision-maker. The 
nurse ot" the Future will have a greater 
sense of being independently respon- 
sible to the public he or she serves than 
to the agency." 

Ms. Poole further foresaw a health 
care system where the nurse in com- 
munity service will be able to care and 
will be concerned with health. "There 
will not be a separate individual for 
prevention and another for cure," she 
said, "and the needs of the people will 
take precedence over the needs of the 
providers [of care]." 

Projections were made for nursing 
in four areas: acute care nursing by 
Joyce Bailey, specialty nursing practice 
by Audrey Thompson, continuing 
nursing care by l.orine Besel. and pri- 
mary nursing care by Geneva Lewis. 

Ms. Lewis, director of public health 
nursing, Ottawa-Carleton health unit, 
envisioned the community nurse of the 
future as a skilled health educator 
capable of supervising and counseling 
the well individual from birth to death, 
constantly alert to signs of disease to 
permit early intervention. 

Ms. Besel, nursing director, Allan 
Memorial Institute. Montreal, stressed 
that long-term patients need someone 
to care ahoin them, not Just for them. 
"We must get away from the focus on 
illness, when a patient is an interesting 
case. We must foster an emotional 
curiosity and be able to tunc in to the 
patient's emotional experience as he 
goes through the various stages of adap- 
tation to his illness." 

Ms. Thompson, director of nursing. 
Red Deer Hospital, and vice-president 
of the Registered Nurses' Association 
of Alberta, said that no basic nursing 
education program can provide a prac- 
titioner with all that is needed for con- 
tinuing skilled practice and it is the 
individual nurse who must be motivated 
to constantly search for answers to 
problems that arise. 

In her opinion, the nurse of the 
future, even though a group member, 
will need to be self-directed, able to 
make autonomous prt)fessional deci- 
sions, and be accountable for his or her 
actions. This nurse will need to take a 
stand on issues, to speak out, and may 
have to learn to lobby, she added. 

"Does the nurse want to be more in- 
volved in direct patient care, or wish 
administrative responsibility or direc- 
tion over all those who deal with pa- 
tients?" she asked. Ms. Thompson bc- 
8 THE CANADIAN NURSE 



lieves nursing may become extinct un- 
less nurses have compassion for and 
involvement with patients. 

Ms. Bailey, director of nursing, 
Wellesley Hospital, Toronto, reminded 
the audience that care of the acutely 
ill will continue to be in an institution 
with sophisticated prcx:edures, ma- 
chines, and qualified staff". The nurse in 
this .setting must possess ""the ability to 
deal personally in a caring way with 
the critically ill and an understanding 
of the depersonalization that can occur 
in intensive care areas. Also important 
will be a tlexibility to learn new ap- 
proaches." 

Ms. Bailey warned nurses to be aware 
that, with the continuing explosion of 
specialties and subspecialties, their role 
is becoming more and more fragment- 
ed. "The point may be reached where 
there is very little left for nurses to do," 
she said. However, the future of nursing 
and acute care nursing as a specialty 
is "as bright and as exciting as we wish 
to make it,"" she added. 



Family Practice Nurse Role 
To Be Tested In Urban Setting 

Ottawa — "It is in the urban, fee-for- 
service. nuiltipractice setting that the 
acid test of feasibility of the attached 
nurse practitioner waits,'" Dr. Boyd 
Suttie told those attending the national 
Conference on Nurses for Community 
Service, on November 15, 1973. 

Dr. Suttie is president of the Cana- 
dian Public Health Association and 
professor o^ health care delivery at 
Memorial University, St. John's, Ntld. 
He was a member of a panel discussing 
the preparation of tomorrow's prac- 
titioners. 

Dr. Suttie outlined a demonstration 
project in Newfoundland to measure 
the impact on patient care, function 
transfers, and costs, of intrtxiucing a 
nurse to each of 10 urban general prac- 
tices. "For us io have chosen the rural 
or northern scene tor this project would 
have been a mistake," he said .... "To 
have devoted our efforts exclusively to 
the rural and northern areas could have 
led to the recognition of the expanded 
role nurse as a second-rate solution to 
the problem of provision of primary 
care in the absence or scarcity of phy- 
sicians, and the expanded role nurse 
has more to offer than that. 

"The time has come . . . for the for- 
malizing of the education and the utili- 
zation of the expanded role nurse, and 
for a sound, scientific evaluation of 
her impact .... We are not just chang- 
ing one role of the nurse. We are start- 
ing a chain of events that will change 
the role and relationship of the physi- 
cian and adjacent health professionals, 
particularly in primary care — a chain 
of events that will change the patterns 



of the practice of medicine," he said. 

"Nursing has long supported the 
need for continued learning but con- 
tinues to invest most of its time, energy, 
and money in basic and higher educa- 
tion for nurse," Margaret Neylan, a 
member of the panel, said. "Practicing 
nurses generally have limited, unsyste- 
matic access to fragmented learning 
resources. Thus, they are doomed to 
early obsolescence of knowledge and 
skills, and often become far from exem- 
plary role models for students." 

Ms. Neylan, associate professor and 
director of continuing education at the 
University of British Columbia school 
of nursing, told delegates at the confer- 
ence, "Our society pays for all the cost 
of elementary and secondary education, 
up to 90 percent or postsecondary edu- 
cation, but less than 5 percent of con- 
tinuing education instruction. This ap- 
proach constitutes educational suicide." 

She pointed out that even if contin- 
uing education was provided with un- 
limited resources, this would not ensure 
high standards of nursing practice. To 
make certain that the highest possible 
level of competence is maintained, 
specific clinical standards for measuring 
patient care will have to be developed. 
Once these standards are accepted, 
deficits can be assessed and programs 
for continued learning can be pre- 
scribed. 

Assessing the national scene in nurs- 
ing education, panelist Dr. Beverly 
Du Gas said, "We have not put enough 
stress, except in baccalaureate pro- 
grams, on the nurse's role in prevention 
and health maintenance; we have focus- 
sed our attention on the care of the sick 
in a hospital setting." 

Dr. Du Gas, director of the health 
manpower planning division of Health 
and Welfare Canada and first vice- 
president of the Canadian Nurses' As- 
sociation, said, "One of our biggest sins 
of omission in nursing education has 
been the failure to differentiate clearly 
between the responsibilities of differing 
levels of nursing practioner — the prac- 
tical nurse, the diploma RN, and bac- 
calaureate graduate. Great confusion 
exists in the minds of employers as to 
what to expect from graduates of these 
three different programs." 



ANPQ Approves Name Change 
And Reelects President 

Montreal, P.Q. — Delegates to the 
annual meeting of the Association of 
Nurses of the Province of Quebec 
(ANPQ) adopted a resolution to change 
the name of the organization to Order 
of Nurses of Quebec (ONQ), effective 
when the legislation has received royal 
assent. 

IContiniii'il on pane 10) 



JANUARY 1974 



\\T4 



t 



The Nurse^s 
Book Society 

Take any 3 important 
books on nursing 
for only 99(1: each 




.i^^viiaiii ii^w uyj^r^^ uii iiui^uig, wiiatcvci uicti apcvicutj. rvii ai auuaiaiitioj uia«^ouiiu». 



Why not join, and discover the advantages for yourself? 



(Retail prices shown) 

39681. COMMUNICATION IN NURSING 
PRACTICE. Eleanor C. Hein, R.N. Provides a 
variety of approaches to more effective com- 
munication in actual nursing situations. $5.95 

38480. THE CLINICAL NURSE SPECIALIST. 

Edited by Joan Riehl, R.N., and Joan Wilcox 
McVay, R.N. All about career trends and training 
programs including new jobs such as "physician's 
assistants" and "health associates." S12.00 

39691. COMMUNITY HEALTH NURSING. 

Kathleen Leahy, M. Marguerite Cobb, and Mary 
Jones. A wealth of practical information on the 
delivery of health care. Case histories show how 
to bring nursing care into the community. $8.50 

40131. CONCEPT FORMALIZATION IN 
NURSING. The Nursing Development Confer- 
ence Group. A repertoire of professional con- 
cepts for the nursing planner and developer. Ex- 
plores future nursing roles. $7.95 

64941. NURSING THE OPEN-HEART SUR- 
GERY PATIENT. Mary Jo Aspinall, R.N., M.N. 
Concise soft-bound handbook tells all about nurs- 
ing open-heart surgery patients: diet, drugs, and 
diagnostic tests. $9.95 



72990. PSYCHOSOCIAL ASPECTS OF TER- 
MINAL CARE. Edited by Bernard Schoenberg, 
M.D. and Others. The latest developments in 
terminal care: how to cope with your own anxie- 
ties, help the patient cope with his . . . new 
psychological skills to apply. $12J0 

73960. RESPIRATORY INTENSIVE CARE 
NURSING: From Beth Israel Hospital. Sharon 
S. Bushnell, R.N. What to do for respiratory 
crises and ways to prevent and deal with many 
respiratory complications such as pneumonia 
and atelectasis. Spiral bound. $9.95 

64991. NURSE'S GUIDE TO CARDIAC SUR- 
GERY AND NURSING CARE/THE NURSE'S 
GUIDE TO FLUID AND ELECTROLYTE 
BALANCE. Every aspect of caring for the pa- 
tient before, during, and after cardiac surgery. 
Plus guideUnes for handling electrolyte problems 
-diet, drugs, and emergency steps. Many charts. 
The 2 books count as one. $10JS 

67180. PARENTS AND CHILDREN IN THE 

HOSPITAL. Carol Hardgrove and Rosemary 
Dawson. Successful new programs where mothers 
live in and help care for their hospitalized chil- 
dren. $7.95 





56361. INTRODUCTION TO OPERATING- 
ROOM TECHNIQUE, Fourth Edillon. Edna 
Cornelia Berry and Mary L. Kohn. Details sterile 
technique, positioning and draping, your duties 
and procedures at every stage of surgery. $8.95 

60420. A MANUAL OF CARDIAC ARRHY- 
THMIAS. Michael Bililch, M.D. Up-to-date il- 
lustrated manual covering all the latest break- 
throughs in the detection and treatment of 
arrhythmias. $12.50 

60710. MATERNITY NURSING TODAY. Joy 

Princeton Clausen, Margaret Hemp Flook, Bon- 
nie Ford, Marilyn M. Green, and Elda Popiel. 
Forty contributors provide clearcut guidelines for 
maternity nursing. Practical nursing know-how 
and crisis-coping lips. $12.95 



61910. MEDICINE: Essentials of Olnicai Prac- 
tice. Chester Keejer, M.D.. and Robert IVIIklns, 
M.D. A complete guide to the art of making a 
sound diagnosis covering all the essentials for the 
detection and treatment of hundreds of clinical 
illnesses. $1230 

64930. NURSING CARE OF THE CHILD 
WITH LONG-TERM ILLNESS. Edited by Shir- 
ley Steele. A comprehensive guide to the latest 
thinking on the exacting science and art of nurs- 
ing chronically ill children. $9.95 

64940. NURSING MANAGEMENT FOR PA- 
TIENT CARE. Marjorie Beyers and Carole 
Phillips. Techniques and keys for getting more 
done and managing more efecflively. For nurses 
at every level. $9J0 



vJUBOOK 

•■ rmiic; 

RACIT- 




e any 3 books 

'Blues as high as $42.45) 

_ only 99c each 

(You simply join now and agree to 
buy 3 more books— at welcome discount- 
over the next 12 months.) 



37290. CARE AND MANAGEMENT OF 
EXCEPTIONAL CHILDREN. Juanita Fleming, 
R.N. Clarifies such questions as: How can re- 
tardation be prevented? How can you help the 
families of these children adjust? Where can you 
send people for help— what special agencies are 
there? $8.95 

67641. PEDIATRICS. Edited by Mohsen Ziai, 
M.D. A major, 1000-page medical guide on care 
of the child from prenatal stages through ado- 
lescence. Softbound. $11.50 

68570. PHAR.MACOLOGY: Drug Actions and 
Reactions. Ruih R. Levine. How drugs work and 
specific examples of hundreds of drugs you'll 
work with in your own nursing situations, in- 
cluding the important topics of drug interaction. 

$14.50 

72330. THE PSYCHODYNAMICS OF PA- 
TIENT CARE. Lawrence H. Schwartz and Jane 
Linker Schwartz. Focuses on people's reactions 
— lx)th normal and abnormal — to illness and 
hospitalization. Fascinating insights into the con- 
scious and unconscious mind. S10.95 

40590. CORONARY CARE/PATIENT CARE 
IN CARDIAC SURGERY. First, coronary care 
from the nurse's point of view: running the coro- 
nary care unit, therapeutic techniques, coping 
with emergencies. Plus the latest methods for 
nursing patients t>efore, during, and after cardiac 
surgery. The 2 books count as one. $13.45 

44460. EMERGENCY ROOM CARE, 2nd Edi- 
tion. Edited by Charles Ecker, M.D. The guide 
that will arm you to cope with the emergencies 
that crop up-from cardiac and obstetrical emer- 
gencies, wounds to orthopedic injuries. $14.00 

49360. FUNDAMENTALS OF CHEMOTHER- 
APY. William Brewster Pratt. M.D. Every chem- 
ical and clinical aspect of drug therapy: indis- 
pensable for today's nurse. $10.50 

52230. HANDBOOK OF DRUG INTERAC- 
TIONS. Gerald Swidler. Sets down the interac- 
tions of more than 1300 drugs, telling which 
other drugs must t>e avoided with a specific drug, 
preferred methods of administering, danger signs. 

$15.00 
36400. BLAKISTON'S COULD MEDICAL DIC- 
TIONARY, 3rd Edillon. A full 1828 pages of 
current information- generic and chemical names 
of the latest drugs, terms, diseases— from psychi- 
atry to biochemistry and genetics. Plus a wealth 
of tables and plates. Deluxe edition. Counts as 
2 of your 3 choices. $18.50 

If card is missing, simply write 

The Nurse's Book Society 

Dept.: 6 lOB. Riverside. N.J. 08075 

and indicate 3 books you want. 



news 



1 1'.''?>'':1I"'^'''^I '"''y •''-^'-'^'mc extinct un- of the practice of medicine," lie said. 



and personal, view: "Our m 
phiysician's helper will chan^ 
of autonomous decision-ma 
nurse of the future will have 
sense of being independenti 
sible to the public he or she s 
to the agency." 

Ms. Poole further foresaw 
care system where the nurse 
munity service will be able to 
will be concerned with healt 
will not be a separate indiv] 
prevention and another for 
said, "and the needs of the p. 
take precedence over the nee 
providers [of care]." 

Projections were made fo 
in four areas: acute care n 
Joyce Bailey, specialty nursin 
by Audrey Thompson, c 
nursing care by Lorine Besel, 
mary nursing care by Geneva 
Ms. Lewis, director of pub 

nursing, Ottawa-Carleton he; 

envisioned the community nurse of the 
future as a skilled health educator 
capable of supervising and counseling 
the well individual from birth to death, 
constantly alert to signs of disease to 
permit early intervention. 

Ms. Besel, nursing director. Allan 
Memorial Institute. Montreal, stressed 
that long-term patients need someone 
to care cihoni them, not just for them. 
"We must get away from the focus on 
illness, when a patient is an interesting 
ca.se. We must foster an emotional 
curiosity and be able to tune in to the 
patient's emotional experience as he 
goes through the various stages of adap- 
tation to his illness." 

Ms. Thompson, director of nursing. 
Red Deer Hospital, and vice-president 
of the Registered Nurses" Association 
of Alberta, said that no basic nursing 
education program can provide a prac- 
titioner with all that is needed for con- 
tinuing skilled practice and it is the 
individual nurse who must be motivated 
to ct)nstantly search for answers to 
problems that arise. 

In her opinion, the nurse of the 
future, even though a group member, 
will need to be self-directed, able to 
make autonomous professional deci- 
sions, and be accountable for his or her 
actions. This nurse will need to take a 
stand on issues, to speak out, and may 
have to learn to lobby, she added. 

"Does the nurse want to be more in- 
volved in direct patient care, or wish 
administrative responsibility or direc- 
tion over all those who deal with pa- 
tients?" she asked. Ms. Thompson be- 
8 THE CANADIAN NURSE 



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iMtawa — "It IS m the urban, fee-for- 
service. multipractice setting that the 
acid test of feasibility of the attached 
nurse practitioner waits," Dr. Boyd 
Suttie told those attending the national 
Conference on Nurses for Community 
Service, on November 15, 1973. 

Dr. Suttie is president of the Cana- 
dian Public Health Association and 
professor of health care delivery at 
Memorial University, St. John's, Ntld. 
He was a member of a panel discussing 
the preparation of tomorrow's prac- 
titioners. 

Dr. Suttie outlined a demonstration 
project in Newfoundland to measure 
the impact on patient care, function 
transfers, and costs, of intrtxlucing a 
nurse to each of 10 urban general prac- 
tices. "For us to have chosen the rural 
or northern scene for this project would 
have been a mistake," he said .... "To 
have devoted our efforts exclusively to 
the rural and northern areas could have 
led to the recognition of the expanded 
role nurse as a second-rate solution to 
the problem of provision of primary 
care in the absence or scarcity of phy- 
sicians, and the expanded role nurse 
has more to offer than that. 

"The time has come . . . for the for- 
malizing of the education and the utili- 
zation of the expanded role nurse, and 
for a sound, scientific evaluation of 
her impact .... We are not just chang- 
ing one role of the nurse. We are start- 
ing a chain o^ events that will change 
the role and relationship of the physi- 
cian and adjacent health professionals, 
particularly in primary care — a chain 
of events that will change the patterns 



HOW THE CLUB PLAN OPERATES 

• You begin by choosing any three of these 
exciting bool<s for only 99c each (a value of up 
to $43.50). 

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the reply form always enclosed with the News 
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patient care will have to be developed. 
Once these standards are accepted, 
deficits can be assessed and programs 
for continued learning can be pre- 
scribed. 

Assessing the national scene in nurs- 
ing education, panelist Dr. Beverly 
Du Gas said, "We have not put enough 
stress, except in baccalaureate pro- 
grams, on the nurse's role in prevention 
and health maintenance; we have focus- 
scd our attention on the care of the sick 
in a hospital setting." 

Dr. Du Gas, director of the health 
manpower planning division of Health 
and Welfare Canada and first vice- 
president of the Canadian Nurses' As- 
sociation, said, "One of our biggest sins 
ot omission in nursing education has 
been the failure to differentiate clearly 
between the responsibilities of differing 
levels of nursing practioner — the prac- 
tical nurse, the diploma RN, and bac- 
calaureate graduate. Great confusion 
exists in the minds of employers as to 
what to expect from graduates of these 
three different programs." 



ANPQ Approves Name Change 
And Reelects President 

Montreal, P.Q. — Delegates to the 
annual meeting of the Association of 
Nurses of the Province of Quebec 
(ANPQ) adopted a resolution to change 
the name of the organization to Order 
of Nurses of Quebec (ONQ), effective 
when the legislation has received royal 
assent. 

ICoiiliniifcl on ptif-e 10) 
JANUARY 1974 



Where can you turn when 
you need up-to-date answers 

to what's new- 




HANDBOOK 

OF DRl't 
INTERAC!" 



• in coronary and intensive care 

• in emergency room care? 

• in pharmacology? 

• in operating room technique? 

• in your pediatric and maternity care? 

The Nurse^s Book Society, a hepng hand for 

the nurse just starting out on station. A provident source of new techniques for the estab- 
lished professional. And a long-time friend of over 30.000 nurses who rely on it for the most 
important new books on nursing, whatever their specialty. All at substantial discounts. 
Why not join, and discover the advantages for yourself? 




(Retail prices shown) 

396«1. COMMUNICATION IN NURSING 
PRACTICE. Eleanor C. Hein, R.N. Provides a 
variety of approaches to more effective com- 
munication in actual nursing situations. $5.95 

384*0. THE CLINICAL NURSE SPECIALIST. 

Edited by Joan Riehl, R.N., and Joan yVilcox 
McVay, R.N . All about career trends and training 
programs including new jobs such as "physician's 
assistants" and "health associates " $12.00 

39«»I. COMMUNITY HEALTH NURSING. 

Kathleen Leahy, M. Marguerite Cobb, and Mary 
Jones. A wealth of practical information on the 
delivery of health care. Case histories show how 
to bring nursing care into the community. $830 

40131. CONCEPT FORMALIZATION IN 
NURSING. The Nursing Development Confer- 
ence Group. A repertoire of professional con- 
cepts for the nursing planner and developer. Ex- 
plores future nursing roles. $7.95 

64941. NURSING THE OPEN-HEART SUR- 
GERY PATIENT. Mary Jo Aspinall, R.N., M.N. 
Concise sofl-bound handbook tells all about nurs- 
ing open-heart surgery patients: diet, drugs, and 
diagnostic tests. $9.95 



72990. PSYCHOSOCIAL ASPECTS OF TER- 
MINAL CARE. Edited by Bernard Schoenberg, 
M.D. and Others. The latest developments in 
terminal care: how to cope with your own anxie- 
ties, help the patient cope with his . . . new 
psychological skills to apply. $12J0 

73960. RESPIRATORY INTENSIVE CARE 
NURSING: From Beth Israel Hospital. Sharon 
S. Bushnell, R.N. What to do for respiratory 
crises and ways to prevent and deal with many 
respiratory complications such as pneumonia 
and atelectasis. Spiral bound. $9.95 

64991. NURSE'S GUIDE TO CARDIAC SUR- 
GERY AND NURSING CARE/THE NURSE'S 
GUIDE TO FLUID AND ELECTROLYTE 
BALANCE. Every aspect of caring for the pa- 
tient before, during, and after cardiac surgery. 
Plus guidelines for handling electrolyte problems 
-diet, drugs, and emergency steps. Many charts. 
The 2 books count as one. $10.25 

67180. PARENTS AND CHILDREN IN THE 
HOSPITAL. Carol Hardgrove and Rosemary 
Dawson. Successful new programs where mothers 
live in and help care for their hospitalized chil- 
dren. $7.95 





56361. INTRODUCTION TO OPERATING- 
ROOM TECHNIQUE, Fourth Edllioo. Edna 
Cornelia Berry and Mary L. Kohn. Details sterile 
technique, positioning and draping, your duties 
and procedures at every stage of surgery. $8.95 

60420. A .MANUAL OF CARDIAC ARRHY- 
THMIAS. Michael Bilitch. M.D. Up-to-date il- 
lustrated manual covering all the latest break- 
throughs in the detection and treatment of 
arrhythmias. $12.50 

60710. MATERNITY NURSING TODAY. Joy 

Princeton Clausen, Margaret Hemp Flook, Bon- 
nie Ford, Marilyn M. Green, and Elda Popiet. 
Forty contributors provide clearcut guidelines for 
maternity nursing. Practical nursing know-how 
and crisis-coping tips. $12.95 



61910. MEDICINE: Essentials of ainlcal Prac- 
Uc*. Chester Keeler, M.D., and Robert Wilkins. 
M.D. A complete guide to the art of making a 
sound diagnosis covering all the essentials for the 
detection and treatment of hundreds of clinical 
illnesses. $12J0 

64930. NURSING CARE OF THE CHILD 
WITH LONG-TERM ILLNESS. Edited by Shir- 
ley Steele. A comprehensive guide to the latest 
thinking on the exacting science and art of nur^ 
ing chronically ill children. $9.95 

64940. NURSING MANAGEMENT FOR PA- 
TIE!VT CARE. Marjorie Beyers and Carole 
Phillips. Techniques and keys for getting more 
done and managing more efecftively. For nurses 
at every level. $9J0 




Take any 3 books 

(values as high as $42.45) 

for only 99c each 

(You simply join now and agree to 
buy 3 more books— at welcome discount- 
over the next 12 months.) 



37290. CARE AND MANAGEMENT OF 
EXCEPTIONAL CHILDREN. Juanita Fleming, 
R.N. Clarifies such questions as: How can re- 
tardation be prevented? How can you help the 
families of these children adjust? Where can you 
send people for help— what special agencies are 
Uiere? $8.95 

67641. PEDIATRICS. Edited by Mohsen Ziai. 
M.D. A major, 1000-page medical guide on care 
of the child from prenatal stages through ado- 
lescence. Softt>ound. $11.50 

68570. PHARMACOLOGY: Drug Actions and 
Reactions. Ruth R. Levine. How drugs work and 
specific examples of hundreds of drugs you'll 
work with in your own nursing situations, in- 
cluding the important topics of drug interaction. 

$14.50 

72330. THE PSYCHODYNAMICS OF PA- 
TIENT CARE. Lawrence H. Schwartz and Jane 
Linker Schwartz. Focuses on people's reactions 
— t>oih normal and abnormal — to illness and 
hospitalization. Fascinating insights into the con- 
scious and unconscious mind. $10,95 

40590. CORONARY CARE/PA'HENT CARE 
IN CARDIAC SURGERY. First, coronary care 
from the nurse's point of view: running the coro- 
nary care unit, therapeutic techniques, coping 
with emergencies. Plus the latest methods for 
nursing patients before, during, and after cardiac 
surgery. The 2 books count as one. $13.45 

44460. EMERGENCY ROOM CARE. 2nd Edi- 
tion. Edited by Charles Ecker, M.D. The guide 
that will arm you to cope with the emergencies 
that crop up— from cardiac and obstetrical emer- 
gencies, wounds to orthopedic injuries. $14.00 

49360. FUNDAMENTALS OF CHEMOTHER- 
APY. William Brewuer Pratt, M.D. Every chem- 
ical and clinical aspect of drug therapy: indis- 
pensable for today's nurse. $10.50 

52230. HANDBOOK OF DRUG INTERAC- 
TIONS. Gerald Swidler. Sets down the interac- 
tions of more than 1300 drugs, telling which 
other drugs must be avoided with a specJic drug, 
preferred methods of administering, danger signs. 

$15.00 

36400. BLAKISTON'S COULD MEDICAL DIC- 
TIONARY, 3rd Edition. A full 1828 pages of 
current information: generic and chemical names 
of the latest drugs, terms, diseases— from psychi- 
atry to biochemistry and genetics. Plus a wealth 
of tables and plates. Deluxe edition. Counts as 
2 of your 3 choices. $18,50 

If card is missing, simply write 

The Nurse's Book Society 

Dept.: 6-lOB. Riverside. N J. 08075 

and indicate 3 books you want. 



news 



(Ctintiiiiicil fioiii p<if>c S) 

The annual meeting was held in 
Montreal's Queen Elizabeth Hotel on 
November 5, 6. and 7, 1973. At the 
meeting, delegates reelected Rachel 
Bureau, Quebec City, as president for 
a third term. 

Under the new Quebec Nurses" Act 
(Bill 273), nurses had a choice of name: 
Professional Corporation of Nurses of 
Quebec or Qrdcr of Nurses of Quebec. 
Because the word "Qrder" applies 
specifically to professions with an ex- 
clusive right to practice, while "Corpo- 
ration" applies mainly to professional 
organizations with a reserved title only, 
the voting delegates chose ONQ. 

Delegates approved resolutions ask- 
ing the AN PQ to inform nurses on action 
to be taken and legal implications of 
their possible intervention on the scene 
of an accident, to exert pressure on the 
federal government to ensure that the 
Quebec Nurses" Act is respected when 
federally employed nurses work in 
Quebec, and to request the Quebec 
minister of social affairs to increase 
the number of specialized establish- 
ments for care of the chronically ill. 

ANPQ was asked, by resolution, to 
make enquiries on the ptitential role 
of the nurse in acupuncture and to 
participate in any Chinese-Canadian 
group formed to study this subject. 

1 he results ot a study of functions 
delegated to nursing personnel in health 
centers throughout Quebec were pres- 
ented to the annual meeting. More 
than .S.800 nurses participated in the 
study. 

The report says. "'32,000 nurses 
work illegally each day . . . for daily 
they perform acts for which they were 
trained but which the law docs not 
recognize as an integral part of the 
nursing role. . . . The present study 
concerns the problem posed by the 
"borderline act"" in demonstrating, with 
percentage for each procedure, the 
broad responsibilities accepted by the 
nurse."" 

The study is designed to obtain 
delegation of acts belonging to nursing, 
so nurses can work freely in their own 
field. The profession of nursing is 
defined in the Quebec Nurses" Act as 
"Every act the object of which is to 
identify the health needs of persons, 
contribute to methods of diagnosis, 
provide and control the nursing care 
required for the promotion of health, 
prevention of illness, treatment and 
rehabilitation, and to provide care 
according to a medical prescription.'" 
10 THE CANADIAN NURSE 



The Flowers That Bloom in The OR, Tra La 




Nurses and technicians in the ORs of the Health Sciences Centre, Winnipeg, 
compensate for the lack of haute couture in gowns by wearing light-weight 
cotton caps of their own design and manufacture. Helen Jakab. left, and Molly 
Brewster, right, are shown in their flowered headgear; they are nurses" aides in 
the operating rot>m at the Children's Centre in Winnipeg, Manitoba. 



According to the Act, a nurse may, 
in practicing her profession, inform 
the population on health problems. 
The Act also provides that no one ex- 
cept a nurse may do any of the acts 
described in the definition; this does 
not apply to health teaching. 

Early results of the questionnaire 
on delegation of functions were used 
to support ANPQ briefs to the parlia- 
mentary commission studying the Bills 
related to nursing. (News, June 1973, 
page 10). The completed ANPQ study 
will be used as a working document 
when the corporations of nursing and 
medicine discuss the delegation of 
functions that lie on the border between 
nursing and medical practice. 

The study report contains the gen- 
eral recommendation that the delega- 
tion of nursing acts is made to define 
the nurses" role without orienting it 
toward the medical domain for which 
she is not prepared, and that the limits 
of the nursing field take account of the 
scientific preparation of nurses. The 
report contains 65 specific recommen- 
dations, such as: the nurse receiving 
an order by telephone take the respon- 
sibility of carrying it out or of suspend- 
ing its application according to her 
judgment, since the professional pres- 



cribing cannot observe the patient; 
ordering an ECG, in the absence of a 
physician, is delegated to the nurse; 
and the nurse can modify the thera- 
peutic diet according to the patient's 
condition. 

Some of the recommendations re- 
late to the nurse working in an out- 
post or one who is the only health pro- 
fessional, such as. the outpost nurse 
may give oral medications without 
a doctor's order. 

In a report of ANI'Q priorities, 
work inherent in the two pieces of 
legislation, the Code of the Profes- 
sions and the Nurses" Act, were iden- 
tified. They are to develop ANPQ by- 
laws; set up a competency board to 
evaluate members" professional know- 
ledge; develop a code of ethics applying 
to the practice of nursing, a requirement 
of the Professional Code (Bill 250); 
and implement professional inspection 
programs to supervise the practice of 
nursing. 



Nurses Want Greater Voice 
In B.C. Health Corporation 

VaiKoiiver. B.C. — Directors of the 

Registered Nurses" Asstx'iation of 

British Columbia (RNABC ) have en- 

JANUARY 1974 



dorsed the establishment of an interim 
nursing advisory committee to advise 
the board ot the new B.C. crown corpo- 
ration on health, the B.C. Medical 
Centre. 

Matters on which the interim com- 
mittee could advise the B.C. Medical 
Centre Board include the nursing care 
of patients and the education of nursing 
personnel. The RNABC and the Univer- 
sity of B.C. school of nursing will ask 
J.V. Cristensen. chairman of the B.C. 
Medical Centre, to make the nursing 
advisory committee an official com- 
mittee of the complex. 

The bill creating the crown corpo- 
ration for health was given royal assent 
early in November 1973. It gives the 
health corporation the responsibility 
to establish and operate in Vancouver 
a provincial medical and health sci- 
ences center; to establish training 
schools and courses for medical, dental, 
and paramedical persons, for nurses, 
and for other persons in the health 
field: to provide public education in 
health: and to carry on medical and 
hospital research. 

T wo chief officers of the new corpo- 
ration were recruited from Vancouver 
General Hospital. The corporation's 
chairman. Mr. Lhristensen. was for- 
merly chairman of the VGH board: the 
corporation president, who is the chief 
administrative officer, is K.R. Weaver, 
former executive director of VGH. 

The B.C. Medical Centre's profes- 
sional advisory committee is made up 
of 15 doctors plus one appointee from 
RNABC. one appointee from each of 
two other professional groups, and a 
health sciences student elected by the 
student body. The RNABC board had 
supported a UBC proposal for a profes- 
sional advisory board to "permit all 
health professionals to have an equal 
voice in expressing their views through 
their chairman to the governing body."" 



RNs And LPNs Come Together 
In Three Manitoba Agreements 

IVinnipci;. Man. — The three most re- 
cent collective bargaining units to be 
certified in Manitoba include, for the 
first time, both registered nurses and 
licensed practical nurses. The Selkirk 
Nurses" Asscxiation was first, follow- 
ed by the Souris Registered Nurses" 
and Licensed Practical Nurses" Asso- 
ciation, and the Pine Falls Nurses" 
Associatiim. 

At the annual meeting ot the Mani- 
toba Association of Registered Nurses 
held in May. MARN members accept- 
ed a resolution to "'approve in princi- 
ple the amalgamation of the three 
nursing groups — registered nurses, 
licensal practical nurses, and registered 
psychiatric nurses — under one Act, in 
JANUARY 1974 



such a manner as may be deemed in the 
best interests of all groups and the 
health care of people of Manitoba."" 

The MARX News of September/Oc- 
tober 1973 said; "The movement that 
has taken place toward the unification 
of nurses over the past year and the 
resolutions passed at the MARN annual 
meeting influenced the decision"" to 
include LPNs in the Selkirk Nurses" 
Asstxiation. 

The Provincial Staff Nurses" Coun- 
cil, established in 1970 by bylaw of the 
MARN Act, is made up of nurses who 
are eligible for inclusion in collective 
bargaining units, elected by their peers: 
the president of M.ARN is not a mem- 
ber of the Council ex officio. 

The Council is responsible for as- 
sisting local staff nurses' asscxiations 
in collective bargaining. According 
to a recent Ci>uncil newsletter, separate 
negotiations have been held for 14 of 
18 collective bargaining units because 
employers refused to negotiate cen- 
tral Iv. 



Ont. Nurses' Association Formed 
For Province-Wide Bargaining 

Toronto. Ont. — Last October 1 3. a 
significant step toward province-wide 
collective bargaining by nurses was 
taken when the Ontario Nurses"Asso- 
ciation (ONA) was formed. 

Attending the founding meeting 
were more than 300 representatives 
from 85 independent nurses" associa- 
tions, which are certified as bargaining 
agents for nurses employed in health 
care institutions, public health units, 
visiting nurses" organizations, and in- 
dustry. These founding members adopt- 
ed a constitution and elected a board of 
directors who will hold office until the 
first annual meeting is held. 

It is expected that the 100 independ- 
ent nurses' associations in the provmce. 
representing more than 10.000 nurses, 
will merge with the ONA. Some 35.000 
to 40,000 nurses work in Ontario at 
present. 

At its 1973 annual meeting, the 
Registered Nurses' Association of 
Ontario passed a resolution endorsing 
the establishment of a separate central 
vehicle for collective bargaining by the 
Nurses' Central Security Fund (in 
which the 100 independent nurses" 
associations participate). 

Ontario labor legislation appears to 
prevent RNAO. as presently structured, 
from becoming certified as a trade 
union because its membership is not 
open to graduate non registered nurses 
who iire now included in bargaining 
units, and because some of its members 
are in management positions. 

Anne Gribben. director of RN.AO's 
employment relations department, 
explained, "By creating a central body. 




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THE CANADIAN NURSE 11 



news 



nurses will be ready to engage in pro- 
vincial, central, or regional bargaining 
when it becomes appropriate and the 
Ontario Government or employers 
agree to take the step." 

The ONA will have to be certified as 
an appropriate trade union by the 
Ontario labor relations board. To do 
this, one of the independent nurses' 
bargaining units will have to apply to 
the board to merge with the ONA; when 
this occurs, the other nurses' units will 
be able to become charter members of 
ONA. 

ONA president Jean Lowery said 
that "a central body, through the sheer 
strength of its numbers and resources, 
should exercise more impact at the 
bargaining table, both now and in the 
future." In addition to the president 
and secretary-treasurer, there are 1 3 
regional representatives of ONA. 



RNABC's Consulting Service 
Helps Smaller Hospitals 

Vancouver, B.C. — The Registered 
Nurses' Association of British Colum- 
bia has launched a Clinical Expert con- 
sulting service to help smaller hospitals 
solve problems in administration, plan- 
ning, and inservice education of staff 
in four clinical areas: intensive and 
coronary care, maternity and high risk 
newborns, operating room management 
and techniques, and intravenous ther- 
apy. 

Sixteen clinical experts from British 
Columbia hospitals attended a work- 
shop in October 1973 at RNABC head- 
quarters. Their services are offered 
through the cooperation of the nurses' 
association, large hospitals and their 
clinical experts, and smaller hospitals 
who request the consulting service. 

Therese Schnurr, director of nursing 
services for RNABC, said "the cost to 
the hospital receiving the service will 
be small in comparison to the big re- 
turn expected in better patient care." 



Government Council On Women 
Disapproves Award To Nurses 

Ottawa — The advisory council on the 
status of women has expressed to Trea- 
sury Board chairman CM. Drury their 
disapproval of the arbitration award 
made to federally employed nurses. 
(News, December 1973, page 7.) 

The advisory council, which met in 
Ottawa on November 1 3 and 1 4, asked 
Mr. Drury to reopen negotiations 
with the nurses immediately. The coun- 

12 THE CANADIAN NURSE 



cil said, "The regional wage application 
creates great discrepancies among 
nurses performing the same tasks in 
different parts of the country." 

The council was also critical of the 
study of nursing in the federal services, 
announced by Mr. Drury in the House 
of Commons on November 6, because 
it does not include an inquiry into the 
job evaluation of nurses. The Royal 
Commission on the Status of Women 
in Canada recommended that "the pay 
rates for nurses, dietitians, home econo- 
mists, librarians, and social workers 
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." 

Frank Howard, MP for Skeena, B.C., 
asked a question in the House of Com- 
mons on April 2, 1973, on what action 
has been taken on that recommenda- 
tion and others. Labor Minister John 
Munro answered, with respect to the 
question about pay rates, that "these 
groups bargain collectively for their 
terms and conditions of employment 
under the Public Service Staff Rela- 
tions Act, and are represented by the 
union of their choice." The advisory 
council on the status of women said 
they attach great importance to the 
study recommended by the Royal 
Commission. 

The report of the Royal Commission 
proposed a council directly responsible 
to Parliament, to advise on matters 
pertaining to women, and to propose 
legislation and policies to improve 
the status of women. On May 3 1, 1973, 
Mr. Munro, the minister responsible 
for the status of women, announced 



It's Winnipeg In '74 



^ 

^^P 



The Gateway to the West swings 
both ways — join nurses from across 
Canada at CNA's annual meeting and 
convention in Winnipeg, June 16 
to 21, 1974. There is murky water 
(Cree meaning of Winnipeg) at the 
juncture of the Assiniboine and Red 
Rivers, but if you can see your way 
clear to come, you'll have a "buffalo 
of a time!" (No whales in the Red 
River!) 



in the House of Commons the establish- 
ment of the advisory council. 

Its terms of reference are to advise 
the minister responsible, currently Mr. 
Munro, on matters relating to the status 
of women that the minister may refer 
to the council or that the council con- 
siders appropriate. Although the 
advisory council reports to the minister 
of labor, the group has the right to 
make its reports and recommendations 
public. 

Two nurses are among the 28 mem- 
bers of the advisory council; they are 
Maria Masson, Quebec City, who is 
vice-president of CEGEP Francois- 
Xavier Garneau, and Barbara Bromley, 
a public health nurse in Yellowknife, 
NWT. 



N.B. Court Finds RN Negligent 
Supreme Court Appeal Planned 

Fredericton, N.B. — Cheryl Wilcox, 
a Saint John registered nurse, has been 
ordered to pay $49,321.19 plus costs 
in a recent judgment handed down by 
the Appeal division of the New Bruns- 
wick Supreme Court. The decision, 
which reverses an earlier judgment by 
the Queen's Bench division, will be 
appealed to the Supreme Court of Can- 
ada. 

According to the newsletter of the 
New Brunswick Association of Regis- 
tered Nurses (NBARN), the trial in- 
volved a patient's claim for damages 
for personal injuries that he alleged 
resulted from negligence by Ms. Wilcox 
and a medical practitioner while they 
were treating him for an illness in Jan- 
uary 1971. 

After receiving an injection in his 
left arm by the nurse, the plaintiff 
developed gangrene that necessitated 
amputation of the fingers and thumb 
of the left hand. The patient based his 
claim on alleged negligence of the nurse 
in administering the injection and the 
doctor in failing to respond promptly 
to a phone call and failing to diagnose 
properly and treat the gangrene. 

The first court dismissed the nurse 
from any liability in the case; in both 
courts the doctor was acquitted. Ms. 
Wilcox, 33, was employed at the Saint 
John General Hospital at the time of 
the alleged negligence. 

The nurse injected two cc. of Bicillin 
intramuscularly into the deltoid muscle 
of the patient's left arm with a 1 1/2- 
inch needle. According to the evidence 
given at the trial, the patient did not 
wish to lower his pants for the IM. After 
the patient returned home from the out- 
patient department of the hospital 
where the injection was given, his 
left hand and arm became white and 
the fingers were clenched. The patient 
complained of extreme pain. 

JANUARY 1974 



During the trial, Ms. Wilcox de- 
scribed in detail the technique she used 
for giving an IM injection. Several 
expert witnesses testified that her met"h- 
od was proper. The nurse also testified 
she could not recall the routine details 
of giving that particular injection, but 
she knew she followed the described 
method because she always did it that 
way. 

Expert witnesses also testified that 
the deltoid muscle is a recommended 
and acceptable area for injection under 
certain circumstances; that aspiration 
is the only practical way to establish 
if the needle is in a blood vessel, but 
the technique is not foolproof; and that 
Bicillin is a suspension that could plug 
an artery and cut off the blood supply, 
which could result in symptoms similar 
to those described by the patient. Wit- 
nesses also said that, although there are 
several treatments suggested for gan- 
grene, they are not usually successful. 

The appeal judge upheld the trial 
judge's finding, supported by evidence, 
that Bicillin had somehow gotten into 
an artery and caused the damage suf- 
fered. In delivering the judgment 
against Ms. Wilcox, the appeal judge 
reasoned that the nurse's testimony 
as to what she did was not based on a 
recollection of events, but on her belief 
that she must have followed a particular 
technique because she always did. 

The judge concluded that the nurse 
failed to establish that the gangrene 
developed, or probably developed, from 
an unknown cause for which she cannot 
be held responsible. According to the 
judgment, the evidence is sufficient 
to support the conclusion "that the gan- 
grene would not have developed in the 
absence of fault in administering the 
injection. 

"NBARN is pleased that the case is 
going to be appealed," Nancy Rideout, 
N barn's liaison officer, told The 
Canadian Nurse. She said the Saint 
John General Hospital's insurance will 
cover the nearly $50,000 damages as- 
sessed against Ms. Wilcox. 



Nursing Concerns Clearly Heard 
At Ontario Hospital Convention 

Toronto, Ont. — During nursing ses- 
sions and panel discussions held at the 
annual convention of the Ontario Hos- 
pital Association October 29 to 31, 
1973, nurses from all parts of the prov- 
ince were vocal in sharing their con- 
cerns about the profession. 

Tom Carnaham, director of nursing 
at Ottawa's Montfort Hospital, spoke 
critically of nursing leadership. "We 
continue to elect traditional, staid, 
conservative, quiet-spoken, chicken- 
hearted leaders," he said. The orofes- 
sion is further "hamstrung," he added. 
JANUARY 1974 



by the lack of unity. "Nurses don't 
usually support each other profes- 
sionally," he explained, which relates 
to the tack of leadership. 

Mr. Carnaham also said it is time for 
nurses to make decisions for them- 
selves, instead of letting other groups 
make decisions (such as the new two- 
year college nursing programs) for 
them. The idea that nurses must ob- 
tain power was voiced repeatedly. 

One nurse from London, Ontario, 
was applauded by the large audience at 
the nursing session when she said, "I 
think our problem lies in 'being nice'. 
Nurses are educated not to rock the 
boat, and by the time they become 
administrators, they are so used to this 
. . . ." If a nurse challenges anything, 
she is threatened by her co-workers, she 
continued. 

A number of persons in the audience 
criticized the community colleges for 
making decisions about nursing, includ- 
ing program philosophy and the setting 
of standards, without involving nurses. 
Anger was also expressed over the 
colleges cutting clinical time for nurs- 
ing students and making them take 
subjects unrelated to nursing. 

"The Primary Contact Nurse" was 
the subject discussed by a panel at a 
general session on the final morning of 
the convention. Kathleen McPhee, past 
president of the Emergency Nurses' 
Association of Ontario, said these 
nurses are frustrated because they 
have a talent that is untapped. "We 
see the patient first. Then what can we 
do?" Nurses are the primary contact 
in the emergency department and they 
want to expand this role, she said. 

Nurses working in emergency have 
been a "yes, doctor" type of nurse. 
They are no longer content with this, 
explained Ms. McPhee. She said many 
patients in emergency can be effectively 
treated by a nurse. "Our assessment of 
each patient is very accurate." 

An enthusiastic account of two nurses 
working in small clinics in under- 
privileged areas was given by Dr. 
Richard T.G. Milne, who is engaged in 
family practice in Kingston. Hedescrib- 
ed the work being done by nurses in 
the clinics, which were set up to "give 
care to people who did not have it." 

Among the resolutions approved by 
OHA members was one that calls on 
OHA to "take the necessary steps to 
achieve policy changes which will 
enable qualified and experienced nurses 
from abroad to become registered in 
Ontario, based upon their nursing skills 
and training." 

Another resolution calls for studying 
the Hospitals of Ontario Pension Plan 
to establish the feasilibity of removing 
discrimination because: "...the 
clauses pertaining to benefits in the . . 
IContiniieil oil page 15) 



Next Month 
in 



The 

Canadian 
Nurse 



• A Diploma Is Not 
An Oil Painting 



• Ethics of Nursing Practice 



• Clinical Laboratory Procedures 



^ 

^^P 



Photo CTcdits for 
January 1974 



Health Sciences Centre, 
Winnipeg, Man., p. 10 



Toronto Western Hospital. 
Toronto, Ont., p. 25 



University of British Columbia, 
Vancouver, B.C., p. 49 



THE CANADIAN NURSE 13 



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Choose style you want, shown left. Print name (and 2nd 
line if desired) on doited lines below Checii other info in 
boxes on chart, clip this section and attach to coupon 



LETTERING: 2nd LINE: 

BACKSROUHO 



Plaitic I 
Lamiute | 169 
No. SS9 ■ 



ALL METAL, . . rich, trim and 
tailored. Lightweight, smooth 
edges, rounded corners. 



PLASTIC LAMINATE . slimmer, 

I broader: engraved thru surface to 
f contrasting core color Beveled 
' border matches ietlermg. 



.METAL FRAMED .Classic 

k design, snow labile plastic witi 
smoolh. polished beveled frarr 



L MOLDED PLASTIC. .Simple, smart, 

fceconomical. Will never discolor, 
' Smooth rounded corners and edges. 



KTAL 
COtM 



□ Gold 

□ Silver 



□ Gold 
a Silver 



KETAL 
FINISH 



n Duotone 
P Polished 
n Satin 



Polished 
frame 

only 



COLOR 

(FlMtic) 



apply 



n White 

□ Med. Green] 

□ Med Blue 

□ Cocoa 



e"ifl Li 



White 
only 



White 
only 



LETTEIIIM6 
COLOK 



□ Black 

□ Dk. Blue 
n White 



□ Black 

□ Dk. Blue 
,White 

Letters only 



□ Black 

□ Ok. eiu 



□ Slack 
D Dk, Blue 



Encnved I Ltii Eafravri 2 Liaet 



n 1 Pin 2.25 
G 2 Pins 3.75 

(same nanw) 



n I Pin .95 
n 2 Pins 1.65 

(sjme name) 



C 1 Pin 2.25 
n 2 Pins 3.75 



U 1 Pin .95 
□ 2 Pins 1.65 

(same namel 



C 1 Pin 1.55 
n 2 Pifis 2.60 

Isdme name) 



n I Pin 3.00 
r 2 Pins 4.95 



U 1 Pin 1.55 
n 2 Pins 2.60 



'Please add 25« per onter for 3 pins or lest. 



CROSS PEN ^ — J^TMT^WWn 

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 12kt. G.F. 



TO: RE£VtS COMPANY, Box C Attleboro, Mass 02703 



COLOR SIZE QUANT PRICE 



QUANTITY DISCOUNTS: 10-24 pins, deduct 10%; 
25-99 pins, 15%; 100 or more pins, 20?^. 



■■'■■■'■■■■■■■■■ 



MEDI-CARD SET Handiest reference 
ever! 6 smooth plastic cards (3Vi" x 5V^") 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 
locub. Periods, Adult Wgts. 
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! ^W stainless steet, 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 5Q« per forceps. 





Free Initials and Scope Sack 
with y!Qur own 

Littmann Nurmeope! 

Famous Littmann nurses' 
diaphragm stethoscope . . . 
a fine precision instrument, 
with high sensitivity for 
blood pressures, apical pulse 
rate. Only 2 ozs., fits in 
pocket, with gray vinyl anti- 
collapse tubing, non-chilling 
epoxy diaphragm. 28" over- 
all. Non-rotating angled ear 
tubes and chest piece beau- 
tifully styled in choice of'5 
jewel-like colors; Goldtone, 
Silvertone, Blue, Green, Pink. * 

FREE INITIALS AND SACK! 

Vour initials engraved FREE 
on chest piece; lend individ- 
ual distinction and help pre- 
vent loss. Also FREE SCOPE 
SACK included, worth $1. 
(Free sacks not personal- 
ized; add 50< if initials de- 
sired.) Note big savings on 
quantity orders. 

No. 216 Nursescope . . . 13.80 ea, ppd. 

6-11... 12.80 ea. 12 or more ...ll.SOea. 

Group Discounts include free Initials and Sack! 

'IMPORTANT; New "Medallion" styling includes tubing in 
colors to match metal parts. If desired, add $1. ea. to 
prices above; add "M" to Order (No. 216M) on coupon. 
No. 223 Scope Sack only . . . 1.00 ea. ppd. 
6 or more 75< ea. Gold stamped initials, add 50< 



■ ■ ■ ' 



''■'■■■'■■■■■■ 



KnRRlTTn Precision-made imported forged steel. 
«*3BB*JAB1 Professional quality. Guaranteed 2 years. 

3V2" LISTER MINI-SCISSORS 

Tiny, handy, slip into uniform pocket or 
purse Choose jewelers Gold o' gleammg 
^ -^ Chrome plate finish on coupon 
^^J=J No. 3500 Mini Scissors . . . 2 75 ea. 
4V2" or 5V2" LISTER SCISSORS 

As above, but larger lor bigger jobs Chrome finish only 
Mo 4500 {4'/i"l or No. 5500 (5'/i"l Scissors . . . 2.75 
5V2" OPERATING SCISSORS r-ppT^ 

Stainless steel, with sharp/tjiunt !!?^si^-^^^ /" A 

points. Beautifully polished finish. -i^g^— r — L._^ 

No. 705 OR Scissors . . . 2.75 ea. ^^^""^ 

All scissors above t doi. or more (any style) , . 2 00 ea. \^ 
Your initials engraved, add SOc per scissors ^ 




CLAYTON DUAL STETHOSCOPE Light 

weight imported dual scope; highest sensitivity for apica], 

pulse rate. Chromed head tubes and chest piece 

IVg" bell and !'/«" diaphragm, grey anti-collapse 

tubing, 4 02., 29" long. Extra ear plugs and # ((pt) 

diaphragm included- Two initials engraved free. * ^ 

No. 413 Dual Steth 1795 ea. 




<^ 



la^iUill NURSES CHARMS ^ 

finest sculptured Fisher charms, ^^i^ 
Sterling or Gold Filled (specify under COLOR on coupon). ^1' 
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. V/ 

jK^14K 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. cfiained 
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 Pin Guard 2.95 ea. 




ENAMELED PINS Beautifully sculptured status 
insignia, 2color 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 




Endura NURSE'S WATCH Fme Swiss made 

waterproof timepiece. Raised easy-to-read white numerals 
and hands on black dial, luminous markings. Red sweep- 
second hand. Chrome finish, stainless back. Includes 
black velvet strap. Gift-boxed, with 1 year guarantee. 
Very dependable. Includes 3 initials enfraved FREE! 
,No. 1093 Nurses Watcti 1995 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 more 20< ea. 

No. 791 (left) Deluxe Saver, 3 compt. 
change pocket & key chain . . . 
6 for 2.96. 25 or more 3S< ea. 

Nurses' POCKET PAL KIT 

Handiest for busy nurses Includes white Deluxe 
Pocket Saver, with 5" Bandage Shear (both shown 
opposite page). Tri-Color ballpoint pen. plus 
handsome little pen light ... all silver finished- 
Change compartment, key chain. 

No. 291 Pal Kit 4.95 ea. 

3 Initials entraveit on shears, add 50< per kit. 



BZZZ MEMO-TIMER rime hot packs, heat .,, 
lamps, park meters Remember to check vital signs ^« 
give medication, etc. Lightweight, compact KVh" dia), 
sets to buzz 5 to 60 min. Key xing. Swiss made. 

No. M-22 Timer 4.95 ea. 

3 or more 3.95 ea.; 6 or more 3.50 ea. 





EXAMINING PENLIGHT 

White barrel with caduceus imprint, aluminum 
l)and and clip- 5" long, U.S. made, batteries included (re- 
'placement batteries available any store). Your own light, gift boxed. 
No. 007 PenliKht . . . 3.96 ea. Your Inittals engraved, add 50f per lieht. 



wmmKBmmi 



H 



I Whittenton - . . 

Uniipm tcAlM^ 



f i V 



MISS five| 

Unique smock style with 3 little 
girl look. Generous patch pock- 
ets, inner surgical pocket 
Short sleeves 100% Dacror 
Double Knit 
STYLE No. 4632 

3/4-15/16. .21.95 



pREEVA 

Young fresh mulliluck Oib, 2- 
butlor cutf Gusset V4 sleeves 
100% Ddcron Double-Knit 
STYLE No. 4697 
6-20. 4 16 Petite . . . 22 95 
14V2-26V! . . 24.95 

75% Dacron,: 25% Cotton 
STYLE No. 4797 
6-20. 416 Petite . . 16.95 
14i/2-26Vi . . . 17.95 




\ ' 



/( 



IGIBSON GIRL 

Youthful high-rise waist, mini 

soft sitirred skirt, pleated 

blouse Inner surgical pocket 

100% Polyester Warp Knit % 

sleeves. 

STYLE No. 4624 

3/415/ 16... 18.95 

60% Dacron. 40% Nylon cord 
jersey, short sleeves. 
STYLE No. 4824 

3/4-15/16... 15.95 



Famous 

NXJRSE 

IMATES" 

New "Saucy" Bump Toe Moc 

Little fashion notches run around sole and 

heel; latest bumper-toe look with 

big bold eyelets; sturdy extra-light 

cushion ctepe sole and heel; finest 

long-wearing white glove leather 

... the ideal shoe to feet pretty 

in uniform. Fit guaranteed 

'""; -_ or return (unmarred) 

for size exchange 

No. 854 Saucy Shoe 
. . . 16.95 pr. 

New "ICork^lite^ Featherweight Style ^ 

Extremely lightweight . with the new 
"bottom" look. Smart comfortable lace 
up heel oxford. Thick sim cork sole 
with IVg" cork heel (very slip resistant 
outwears crepe) White washable 
soft glove upper leather, tricot 
lined, arch vents Fit guaran- 
teed or return (unmarred) 
for size exchange. 

No. 638 Kork Lite Shoe 
. ■ ■ 16.95 pr. 




^ 




A* or Ai S-M 
D or E: 5 tl 



All-Weather NURSES' CAPE 

Stay snug in cool weather, dry in the ram 
Traditional Navy with Bright Red lining. 
Finest tailoring of 65% Dacron polyester. ] 
35% combed cotton Zepel treated 100% 
Nylon Duralyn lining. Snap fasteners, arm 
openings Matching head scaif. SMAIL (up to 
34 bust), MEDIUM (3538,) or URGE (3942) 
specify size on coupon. 

No. 658 Cape 14.95 ea. 

3 Gold Initials on collar, add t.QO per cape 

<^A^ NURSES BAG A lifetime of service I 
for visiting nurses! Finest black W thick I 
genuine cowhide, beautifully crafted with I 
rugged stitched and rivet construction, I 
Water repellant. Roomy interior, with snap- 1 
in washable liner and compartments to I 
organize contents. Snap strap holds top I 
open during use Name card holder on zxiQ. I 
Two rugged carrying straps. 6" x 8" % 12". I 
Your initials gold embossed FREE on top. An I 




news 



(Continued from page 13) 

plan are discriminatory, in that the 
residual benefits in event of the death 
of the beneficiary are only paid to the 
surviving spq.use in the case of female 
beneficiary, if the widower is incapaci- 
tated and wholly supported by his wife. 

"Similarly, there is a difference in 
the treatment of the surviving children 
between a male and female beneficiary. 

"... Male and female employees 
are required to pay the same rate of 
premium and should be entitled to the 
same benefits." 



B.C. Labor Relations Act Gives 
Govt. RNs Bargaining Rights 

Vancouver, B.C. — Employees in the 
British Columbia government service 
are expected to begin collective bargain- 
ing early in 1974. The new Public Ser- 
vice Labour Relations Act allows these 
government employees — including 
about 750 registered nurses — to en- 
gage in collective bargaining for the 
first time in the province's history. 

The Registered Nurses' Association 
of British Columbia began prepara- 
tions for these new bargaining activities 
in the fall of 1973. Ann Sutherland, 
director of continuing education at 
Royal Inland Hospital in Kamloops, 
assisted the association for 10 weeks 
in the education and information pro- 
gram for nurses employed in the pub- 
lic service. 

Ms. Sutherland said, "I've been 
meeting with groups of registered 
nurses covered by the new legislation. 
In our discussions. I have explained 
the Act and the jpiethod of bargaining 
prescribed . , , , and also assisted with 
the gathering of items to be negotiat- 
ed." 

Registered nurses and registered 
psychiatric nurses — some 2,000 in 
total — form the nurses' bargaining 
unit, which is one of three units provid- 
ed for in the new legislation. The other 
two units are the licensed professional 
bargaining unit and a public service 
bargaining unit for all others employ- 
ed by the provincial government and 
covered by the legislation. 

Two collective agreements will 
apply to each bargaining unit. First 
there is to be a master agreement to 
include all the terms and conditions 
of employment that are common to all 
employees in the bargaining unit. 
Nurses will then split to negotiate two 
subsidiary agreements; one will be for 
RNs and registered psychiatric nurses 



^ Qut&landing value of superb quality. 
lilo1lS44>l Bag (with liner). . 37.95 ea. 
Extra liner No. 4415 6.95 ea. 



employed in institutions, and the other 
will cover employees, such as public 
health nurses, who do not work in insti- 
tutions. The subsidiary agreements will 
cover items specific to these groups. 

The nurses' bargaining committee, 
established from a joint organizing 
group of the RNABC and the Registered 
Psychiatric Nurses' Association of 
British Columbia, is preparing contract 
proposals. A smaller joint group has 
been elected to negotiate, with the help 
of professional staff from each nurses' 
association. 



McGill Offers Master's Program 
To Nurses And Nonnurses In '74 

Montreal, P.Q. — McGill University 
School of Nursing will offer a new 
master's degree program with two op- 
tions; nurse clinician and research, 
beginning in September 1 974. By taking 
a qualifying year, nonnurses with a 
B.A. or B.Sc. degree in either social or 
biological sciences may enter either 
option of the master's degree program 
m nursmg. 

The one-year qualifying program 
for non nurse baccalaureate graduates 
includes three nursing courses with 
concurrent field experience, a course 
on history ajid development in nursing, 
and one elective, which will be physiol- 
ogy in most cases. The qualifying year 
will also be offered in September 1974. 

The length of the master's program, 
minus the qualifying time, will be two 
academic years; part-time study may 
be arranged for both the master's pro- 
gram and the qualifying year. 

To be admitted to the nurse clinician 
option of the master's program, regis- 
tered nurses must have outstanding 
achievement at the baccalaureate level, 
baccalaureate preparation in nursing 
comparable to the B.N. or B.Sc. (Nurs- 
ing) program offered at McGill, and 
accomplishment and development as a 
nurse. 

For the research option, in addition 
to outstanding achievement at the 
baccalaureate level, and accomplish- 
ment and development as a nurse, the 
nurse needs baccalaureate preparation 
in nursing comparable to the B.Sc. 
(Nursing) program offered at McGill. 

The nurse clinician option is design- 
ed to prepare nurses foi the expanded 
function of nursing in any field, includ- 
ing health centers and family practice 
units. The research option fcKUses on 
reseiirch in clinical nursing or in health 
care provision and evaluation. 

Dr. Moyra Allen, professor of nurs- 
ing, is directing the development of 
McGill school of nursing's research 
unit. The nursing faculty plans to pro- 
vide demonstration projects in the 
expanded function of nursing. '^ 

THE CANADIAN NURSE 15 




VANGUARD 

OF CONTEMPORARY NURSING 



Trend-setting Mosby texts delineate 
modern nursing ideas and techniques. 



A New Book! Johns 

PHARMACODYNAMICS 
AND PATIENT CARE 

Proliferation of knowledge in pharmacology has 
created a veritable avalanche of information on the 
sources, structure, function, actions and interactions 
of drugs. To expect future nurses to store isolated 
bits of information on this ever-increasing multitude 
of drugs is impractical and even hazardous. This new 
text places the study of drugs within a meaningful 
framework of patient problems and relates informa- 
tion vital to the professional nurse's role in planning 
patient care. Unlike conventional approaches which 
group drugs by chemical structure or body system 
effect, this approach allows for single, in-depth 
presentation of drugs with known therapeutic effec- 
tiveness. It views each medication in relation to the 
biochemical or physiological effect it produces to 
control specific functional disorders and provides 
guidelines for nursing actions that contribute to the 
effectiveness of drug therapy. From this pharmaco- 
dynamic perspective, students learn to formulate 
nursing care plans that protect the patient's resources, 
support the action of medications administered and 
make optimum use of physiologic function restored 
by the drug. Chapters are arranged in units represent- 
ing commonalities of patient problems with each 
chapter designed as an independent module. Students 
can analyze and compare the effects of drugs used to 
control hemodynamics; activity and pain; anabolic- 
catabolic balance; reproduction and fertility; infec- 
tion and inflammation; and excretion of fluid, 
metabolic wastes, and toxicants. Each section thor- 
oughly discusses effector sites, the drugs predictable 
action in modifying physiologic action and its pos- 
sible adverse effects. Numerous line drawings lend 
added emphasis to the discussions. Although change 
is constant in pharmacology, this new text provides 
students with lasting guidelines for the study of any 
drugs with comparable pharmacodynamic effects. 

By MARJORIE P. JOHNS, R.N., B.S., M.S. January, 1974. 
Approx. 384 pages, 7" x 10", 62 illustrations in 49 figures. 
About $8.90. 



New 3rd Edition! 



Hart 



THE ARITHMETIC OF 
DOSAGES AND SOLUTIONS: 
A Programmed Presentation 

In this new 3rd edition, simplicity is definitely a 
virtue. Vital information on systems and procedures 
used in preparing drug dosages and solutions is 
presented in step-by-step, easy to digest pieces. 
Students are allowed to pace their own learning and 
to do it independent of instructor and classroom. 
Program frames proceed in logical order; each step 
builds on the one before; correct answers to each 
problem are revealed immediately at the end of the 
exercise offering maximum learning reinforcement. 
This innovative self-directed learning approach is 
designed for student nurses who possess the basic 
mathematical skills of addition, subtraction, multipli- 
cation and division. For those who need a refresher 
on fractions, decimals, percentages and ratios, a brief, 
but extremely helpful, review is provided. Convenient 
sections on abbreviations commonly used in medica- 
tion orders and formulas for calculating infant's and 
children's dosages are also included for reference and 
review purposes. In addition to these standard fea- 
tures, this new edition conveys a wealth of new 
information and has been totally reworked and 
reworded to insure clear and accurate explanations. 
Updated and expanded discussions precisely demon- 
strate how to calculate intravenous fluid flow and the 
use of the 10% rule for converting from one system 
of measurement to another. Seven new problems 
clarify an excellent presentation on insulin. All of the 
superb illustrations are also new to this edition. 

By LAURA K. HART, R.N., B.S.N. , M.Ed., M.A., Ph.D. 
April, 1973. 3rd edition, 76 pages plus FM l-VIII,7" x 10". 
Price, $4.15. 

INSTRUCTOR'S NOTE: To receive a complimentary 
copy for firsthand evaluation, write to the Textbook 
Department mentioning your position, course and 
enrollment. 



16 THE CANADIAN NURSE 



JANUARY 1974 



A New Book! 



Barber-Stokes-Billings A New Book.' 



ADULT AND CHILD CARE: 
A Client Approach to Nursing 

The first medical-surgical nursing text to integrate 
adult and child care according to basic human needs, 
this landmark work stresses common, recurring health 
care problems including those in home and non- 
hospital settings. Taking a unique client approach, the 
text's comprehensive coverage extends from neonatal 
pediatrics to the physiologic changes of aging. Dis- 
cussions consider 20th century phenomena not often 
included in medical-surgical texts: artificial insemina- 
tion; noise pollution; organ transplants; genetic coun- 
seling; to name only a fev*-. Students gain insight and 
instruction in: need promotion; the foundations of 
deprivation; learning disorders; crisis intervention; 
health hazard appraisal; and much more. 

By JANET MILLER BARBER, R.N., M.S.; LILLIAN 
GATLIN STOKES, R.N., M.S.; and DIANE McGOVERN 
BILLINGS, R.N., M.S. May, 1973. 814 pages plus FM l-XVI, 
8" X 10", 516 illustrations. Price, $16.30. 



New 3rd Edition.' Havener et al 

NURSING CARE IN EYE, 
EAR, NOSE, AND 
THROAT DISORDERS 

This new edition emphasizes the nurse's expanding 
role in the health care system. It offers vital assistance 
in the assessment role and in the development of 
nursing care plans based on thorough understanding 
of the pathophysiology, treatment and related prob- 
lems of patients with eye, ear, nose and throat 
disorders. Significantly revised, this edition places 
increased emphasis on patient teaching and nurse- 
patient communications. Highlights include: a new 
chapter on nursing care and assessment of patients 
with visual disabilities; more extensive coverage of the 
laryngeal examination and carcinoma of the larynx; 
and new material on the causes of hearing loss. 

By WILLIAM H. HAVENER, B.A., M.S.(Ophth.), M.D.; 
WILLIAM H. SAUNDERS, B.A., M.D.; CAROL FAIR 
KEITH, R.N., B.S.N., M.S.; and ANDRA W. PRESCOTT, 
R.N. February, 1974. 3rd edition, aoprox. 448 pages, 6'/4" x 
9%", 357 illustrations. About $12.35. 



FAMILY-CENIERED 
COMMUNITY NURSING: 
A Sociocultural Frame%voik 

This highly useful book of readings examines the 
cultural and psychosocial factors which determine 
whether families are likely to make constructive use 
of available health care services. Emphasizing the 
varied facets of family and community living which 
must be considered in planning and delivering health 
care programs, it illustrates the nature of new roles 
the nurse is expected to assume. The nurse-midwife, 
clinical associate, family nurse practitioner, nurse in 
independent practice and crisis intervention nurse — 
all receive close consideration. Moving from broad 
issues to specific community problems, the readings 
stress the importance of understanding cultural and 
social factors including appropriate methods of com- 
munication, data-gathering and analysis, and inter- 
personal relations. Salient factors concerning back- 
ground, customs and attitudes of minority groups are 
included in numerous articles. 

Edited by ADINA M. REINHARDT, Ph.D.; and MILDRED 
D. OUINN, R.N., M.S.; with 40 contributors. October, 1973. 
304 pages plus FM l-XVI, 6%" x 9%". Price, $6.60. 

INSTRUCTOR'S NOTE: To receive a complimentary 
copy for firsthand evaluation, write to the Textbook 
Department mentioning your position, course and 
enrollment. 



MOSBY 



TIMES MIRROR 

THE C. V MOSBY COMPANY. LTD 

86 NQRTHLINE ROAD 

TORONTO. ONTARIO 

M4B 3E5 



JANUARY 1974 



THE CANADIAN NURSE 17 




VANGUARD 

OF CONTEMPORARY NURSING 



Mosby references lead the way to career advancement. 



A New Book.' Roberts 

A REVIEW OF PEDIATRIC NURSING 

This concise, question-and-answer review of the entire 
spectrum of pediatric nursing places emphasis on 
family centered nursing care. With content structured 
around the wellness-illness continuum, it considers all 
aspects of a particular situation down to the critical 
details. Psycho-social, economic, pathogenic, diag- 
nostic, and nursing management considerations — all 
are detailed. Both the positive mental health of the 
sick child and the psychological needs of his family 
are stressed. A section on pediatric pharmacology is 
included. 

By FLORENCE BRIGHT ROBERTS, R.N., M.N. April, 
1974. Approx. 240 pages, SYi" x 8'//'. About $6.25. 

A New Book/ Lipkin 

PSYCHOSOCIAL ASPECTS OF 
MATERNAL/CHILD NURSING 

This new book considers behavioral and environ- 
mental conditions which affect the family unit and 
regards physical and emotional growth as inter- 
dependent factors. Discussions follow the family 
from premarital counseling through the child's adoles- 
cence and outline nursing assessment and care plans 
for each situation. Coverage of maternal deprivation 
and emotional impacts, the terminally ill child, and 
family reorganization at childbirth is especially en- 
lightening. 

By GLADYS B. LIPKIN, R.N., M.S. April, 1974. Approx. 
192 pages, 7" x 10", 31 illustrations. About $6.55. 



A New Book! 



Tobin at al 



THE PROCESS OF STAFF DEVELOPMENT: 
COMPONENTS FOR CHANGE 

Staff development is fast becoming an urgent issue 
with recent legislation requiring nursing license re- 
newal. This new book sets guidelines for establishing 
or altering staff education programs and provides 
information on teaching methods, aids and evalua- 
tion; organization and administration; adult learning; 
and more. 

By HELEN M. TOBIN, R.N., M.S.N.; PAT S. YODER, R.N., 
M.S.N.; PEGGY K. HULL, R.N., M.A.; and BARBARA J. 
CLARK, R.N., M.A.; with two contributing authors. April, 
1974. Approx. 224 pages, 7" x 10", 21 illustrations. About 
$9.50. 



A New Book.' Vitale-Schultz-Nugent 

A PROBLEM SOLVING APPROACH TO 
NURSING CARE PLANS: A Program 

A self-teaching tool, this new programmed approach 

aids in formulating relevant nursing care plans, it 

examines the purposes of the nursing care plan; data 

collection; deduction; nursing diagnosis; and more. 

Case studies reinforce the concepts demonstrated. 

By BARBARA ANN VITALE, R.N., M.A.; NANCY V. 
SCHULTZ, R.N., M.A.; and PATRICIA MARY NUGENT, 
R.N., M.S. April, 1974. Approx. 128 pages, 7" x 10", 28 
illustrations. About $5.25. 

A New Book! Treece-Treece 

ELEMENTS OF RESEARCH 
IN NURSING 

This new book offers concise explanations for each 
step of the research process. It treats the relationship 
between theory and method in depth and provides 
tips on writing, reporting and publishing research 
findings. 

By ELEANOR WALTERS TREECE, R.N., B.A., M.Ed., 
Ph.D.; and JAMES WILLIAM TREECE, Jr., B.R.E., B.A., 
M.A. June, 1973. 284 pages plus FM l-Xli, 7" x 10", 56 
illustrations. Price, $9.75. 

A New Book! Story 

CAREER MOBILITY: 

Implementing the Ladder Concept in 
Associate Degree and Practical Nursing 
Curricula 

This new book serves as an excellent model of the 
successful "ladder concept" program in nursing edu- 
cation. It presents guidelines for adapting curricula in 
institutions having both Associate Degree and 
LPN/LVN programs and completely outlines course 
structure, content, unit hours, and texts suited to the 
program. 

By DONNA KETCHUM STORY, R.N., B.S., M.A. March, 
1974. Approx. 200 pages, 6%" x 9%", 16 illustrations. About 
$6.25. 

MOSBV 

TIMES MIRROR 

THE C V MOSBY COMPANY, LTD 

86 NORTHLINE ROAD 

TORONTO. ONTARIO 

M4B 3E5 



18 THE CANADIAN NURSE 



JANUARY 1974 



Guest Editorial 



The Honorable Marc Lalonde 
Minister of National Health 
and Welfare 




1 am grateful for this opportunity to 
share some of my views with the reg- 
istered nurses of this country. As 
minister of National Health and Wel- 
fare, I have had occasion to appreciate 
the contribution of nurses to health 
care in Canada. 

Two of the key attributes 1 have 
noticed are your significant role in 
providing the essential element of 
continuity to the client's care, and the 
versatility of your services, which have 
facilitated the development of alter- 
native means of providing necessary 
client services. Also, because of your 
long history of dedication to preventive 
services, your impact will be felt even 
more, now that our government is 
striving to focus on a more positive 
approach of health promotion. This 
should result in a better balance between 
prevention and cure. 

Recently, my department studied the 
major causes of death and sickness in 
Canada to identify better our main 
health problems. From this evolved a 
conceptual framework that allows a 
more integrated approach to the study 
of the whole health field; at the same 
time, it provides us with potential for 
a broader spectrum of health-promoti(.)n 
activities. This framework, which we 
call the Health Field Concept, has four 
principle elements, human biology, en- 
vironment, life-style, and health-care 
organization. 



JANUARY 1974 



Human biology includes all those 
aspects of health that are endogenous 
to the individual, such as genetic inher- 
itances, the aging process, the health 
consequences of puberty, the metabolic 
processes, overall processes of matura- 
tion, and so on. 

The second element, identified as the 
environment, includes the conditions in 
the societal and physical environment 
of the individual that affect his health, 
yet over which he has little or no con- 
trol. In this case, unsafe or contaminat- 
ed foods; drugs, or cosmetics; noise 
and water pollution; crowded cities; 
and stresses of urban living arc part of 
the environment from which individuals 
cannot always protect them.selves. 

Life-style, the third element, relates 
to self-imposed risks that result from 
personal decisions and habits over which 
the individual has some degree of 
control. The individual decides whether 
to smoke, to overeat, to use alcohol 
excessively, or to lead a sedentary life. 
The life-style pursued by the individual 
will affect the requirements for using 
the health system, including its facilities 
and human resources. 

The health -care organization, or 
fourth element, is known to all of us as 
the health-care system and consists of 
the quantity, quality, arrangement, 
nature, and relationships of people 
and resources. It includes hospitals 
and extended-care institutions, public 
THE CANADIAN NURSE 19 



and community health care services, 
and ambulance services; both person- 
nel and facilities are part of this 
element. 

As we use this conceptual framework 
as a basis for assessing federal health 
policy, we are discovering that the 
causes of sickness and death in this 
country are found in the first three 
elements. Yet, until now, up to ninety- 
five cents of every dollar of our re- 
sources have been spent on the fourth 
element. It is this discrepancy we are 
striving to correct. 

As we reviewed the major causes of 
death in Canada in 1971, we found 
heart diseases to be the most significant 
after the age of 50. Motor-vehicle 
accidents and all other accidents ac- 
counted for more than one-half and 
even up to two-thirds of deaths in young 
men between the ages of 5-40. Suicide 
was a significant cause of death as early 
as 15 years of age. Respiratory dis- 
eases and lung cancer accounted for 
1 5 percent of deaths for men between 
the ages of 55-70. 

The morbidity in hospitalized pa- 
tients corresponds to the above causes, 
with the additional important fact that 
one-third of all hospital beds and hospi- 
tal days are for mentally ill patients. 
Indeed, in 1969, mental illness was 
responsible for some two million hos- 
pital days. We recognize that environ- 
mental and life-style factors, such as 
malnutrition, excessive smoking, lack of 
physical exercise, daily stresses, air 
and water pollution, and so on, have an 
important bearing on the major health 
problems noted. 

A shift from a cure orientation to 
health promotion does not negate the 
need and value of therapeutic services; 
however, we must recognize the need 
for, and the development of, programs 
20 THE CANADIAN NURSE 



that foster a safer environment and 
promote life-styles conducive to good 
health. Such programs should result in 
greater returns from our efforts and 
financial expenditures. 

Acceptance of this challenge has 
many implications for health profes- 
sionals, governments, health institu- 
tions, and individual citizens. It means 
better identification of those compo- 
nents of daily living that are conducive 
not only to longevity, but also to a 
happier and fuller life for Canadians. 

The search for these positive factors 
and their reinforcement should gradual- 
ly contribute to the lowering of the 
negative factors previously identified. 
Simultaneously, increased efforts 
should be made and resources allotted 
to augment research aimed at explor- 
ing the most effective ways of reaching 
people to persuade them to adopt 
life-styles conducive to good health. Of 
equal importance is the search for sen- 
sitive health indicators that will serve 
to diagnose the health status of our 
diverse communities and to measure 
effectiveness of new health programs. 

If we are to increase the individual's 
responsibility for his own health, we 
will require additional health education 
and better orientation to these prevent- 
ive resources. For nurses and other 
health professionals, role reevaluation 
will be needed more than ever; this, in 
turn, implies necessary role and curri- 
cular adjustments. 

The development of greater equil- 
ibrium between cure and prevention is 
the responsibility facing individuals, 
communities, nurses, physicians, other 
health workers, and governments, work- 
ing cooperatively at every level. We 
are all implicated as we strive to en- 
hance the quality of life for Canadians 
through a healthier state. 



As the largest single health profession 
in Canada, your manpower capacity is 
unparalleled in helping to make our 
health system more sensitive and 
responsive. W 



JANUARY 1974 



The problem-solving 

technique: 
is it relevant to practice? 



If problem-solving techniques are foreign to nursing practice, then teachers 
should realize this. And nurses in clinical practice are the persons to inform 
them. 



Barbara Geach, S.R.N., S.C.M., M.S.N, 



Now that the problem-solving technique 
is a well -entrenched part of the reper- 
toire of nurse educators, it seems 
reasonable to examine its influence on 
teaching and on nursing practice. 

The use of the term "problem-solv- 
ing technique" in nursing literature is 
fairly recent. In 1960, Abdellah et al 
wrote; "Nurses need training in the 
identification of both types of problems 
[ covert and overt ] , as well as exper- 
ience in total problem-solving."* 
Analysis of nursing problems and 
selection of the necessary course of 
action for the nurse to adopt is believ- 
ed by these authors to be a basic ele- 
ment of nursing practice. 

This idea is expanded by Abdellah 
and Levine, who state, "... the unique 
function of the professional nurse is 
conceived to be the identification or 
diagnosis of the nursing problem and 
deciding upon a course of nursing action 
to be followed for the solution of the 

* F.G. Abdellah ct al.. Pittieiit-Centerccl 
Approaclu's to Nursing. N .Y., Macmillan, 
1960, p. 10. 
JANUARY 1974 



problem ...."** 

There has been a steady progression 
from viewing the problem-solving 
technique as a basic tool to seeing it as 
a central professional activity, one 
that marks the user as professional. 

I have not found nearly as many 
clinical authors as educators writing 
with enthusiasm about the problem- 
solving technique, or explicitly referring 
to it as the basis of their practice. This 
may be because when one reads closely 
the literature that has appeared, one 
finds that it is sometimes nursing prob- 
lems that are to be solved, and some- 
times patient problems. I do not know 
whether these are two kinds of prob- 
lems, or one. 

It is not within my scope to clarify 
this issue; but the presence of this 
confusion suggests that, although the 
technique is well established — among 
educators, at least — it is not as clearly 
understood as we believe. Perhaps the 

•■'■' F.G. Abdellah, and E. Levine, Better 
Patient Care Through Nursing Research. 
N.Y.. Macmillan. 1965, p. 12. 



confusion accounts, in part, for the 
silence about it from clinicians. They 
may generally feel that nursing prob- 
lems are up to the teachers to clarify, 
and that their business concerns patient 
problems, which can be, and often are, 
expressed in terms of medical diagnosis 
or psychosocial adjustment, and dealt 
with in those terms, clinically and on 
paper. 

Whatever the reason, the small num- 
ber of contributions from clinicians is 
disturbing. Perhaps clinicians who use 
the problem-solving technique do not 
have time, energy, or talent to document 
its application. If so, this worries me. 

Too often, students regard the intel- 
lectual exercises set by their teachers 
as so much busywork. Students submit 
nursing care plans, nursing diagnostic 
interviews, and so on with remarkable 

The author is a graduate of the University 
College Hospital. London. England, and 
the Yale University School of Nursing. 
New Haven. Conn. She is Assistant Pro- 
fessor at the University of Connecticut 
School of Nursing. Wailingford. Conn. 

THE CANADIAN NURSE 21 



docility; yet 1 have the feeling they are 
bored doing these things and cannot 
wait to be out of school and function- 
ing in a context that demands none of 
these evidences of cerebral activity. 

Not being a clinician at present, I 
cannot right this situation by describ- 
ing nursing care I give using the prob- 
lem-solving technique. So I urge my 
fellow nurses in clinical practice to 
come out in print with lively documen- 
tations about the usefulness of the 
technique. Otherwise, how can I, in 
conscience, continue to exact labori- 
ously constructed exercises in problem - 
solving from my students, when I lack 
evidence from clinicians that it is mean- 
ingful and leads to better care? 

As I write, 1 have the fantasy that 
some clinicians reading this are smiling 
and saying to themselves: "I'm not 
going to turn out written documenta- 
tion of this process in action. The 
problem-solving technique is a good 
tool for students to use; however, once 
they know how to use it, problem-solv- 
ing will become second nature. I do it 
automatically. No longer is it conscious, 
any more than driving my car involves 
being conscious of all the steps involv- 
ed. I no longer need to categorize my 
thoughts and actions that way." 

So much for fantasy; if it is accurate, 
I would like to know. And it is this 
information 1 would like to see docu- 
mented by clinicians. I would especially 
like them to say how it became "second 
nature." Was it gradual? Or did it sud- 
denly "click," after they had carried 
the whole process through automatical- 
ly, that they had actually used the 
problem-solving technique? 

I can remember, as a junior, realiz- 
ing that a patient was having a grand 
mal seizure. I removed her dentures 
and turned her head to one side, and 
then pushed a nearby piece of furniture 
away from her thrashing limbs. I cer- 
tainly was not conscious of assessing 
her, planning, or implementing my plan. 
I guess when I thought about it after- 
ward, with some surprise at my speedy 
reactions, I was consciously evaluating 
the effectiveness of my action to pre- 
22 TH E CANADIAN NURSE 



serve her airway and prevent injury. 

But I had not thought this through 
conceptually as I worked. For me, the 
process suddenly "clicked." Before, 
it had to be thought through painfully 
and slowly; now this was no longer 
true. In retrospect, I can describe the 
components of the nursing process as 
I applied it — something I didn't do 
then and didn't find necessary at the 
time. Perhaps experienced clinicians 
would feel as artificial as I, if they were 
to relate their nursing care in terms of 
the problem-solving process. 

I have used this "grand mal seizure" 
experience in teaching students. When 
they seem bored with the chores of writ- 
ing nursing care plans, for example, I 
have tried to indicate how the problem- 
solving technique governs good practi- 
ce, even when it is carried out in a few 
seconds without writing down each step. 

"Eventually" I tell them, "problem 
solving becomes such a practiced skill 
that you can exercise it without all this 
thinking and writing. I am simply try- 
ing to help you be conscious of and 
articulate the steps in your practice. 
When you have to apply these steps 
quickly, you can do so with reasonable 
assurance that you are operating logi- 
cally and safely, because all the relevant 
data have been taken into account." 

I would find it helpful if I could 
point to examples other than the exper- 
ience I mentioned. Perhaps clinicians, 
remembering the painful process of 
their own learning, could help by 
making conscious once more their now 
unconscious skill in applying the tech- 
nique. 

But perhaps the students are right; 
maybe I am asking for an exercise that 
is only remotely, if at all, related to the 
real world of clinical practice. Just as a 
clinical phenomenon has to be stated in 
research terms to make it susceptible 
to scientific investigation, so a phrase 
which, in educational terms is full of 
meaning, may have to be rewritten 
carefully in clinical terms to make it 
meaningful to the clinician and the 
student. 

Clinical entities have to be concep- 



tualized carefully for teaching purposes. 
So it seems as if one might have to 
perform a kind of reverse conceptuali- 
zation with concepts that have become 
useful in teaching so as to make them 
useful in clinical practice. If this cannot 
be done, the value of a concept, even in 
teaching, may be rather restricted. For 
in nursing, what holds meaning in 
clinical practice must somehow be 
taught, and the two activities are too 
interdependent for each of them to 
develop jargon with limited value to 
the other. 

If, indeed, exercises in problem- 
solving techniques in nursing are foreign 
to real practice, then educators need 
to know this. And if the problem -solving 
technique is truly the basis for good 
practice, yet the means by which we 
seek to teach it is far removed from 
the way it is used in practice, then 
teachers must get together with clini- 
cians and evolve a common language, 
one that expresses the facts of practice 
authentically. 

The profession is not served by hav- 
ing its teachers and its practitioners 
running on parallel tracks that never 
meet. The student can only be confused 
if the teachers who grade and evaluate 
her competence do so on the basis of 
criteria that hold no meaning for clin- 
icians and that practitioners laugh at as 
"okay for those ivory-tower, clinically 
inexperienced teachers." 

Ultimately, patient care will suffer if 
new graduates — who form a large 
proportion of the staff of hospitals — 
have to spend the first few months of 
their careers in practice shedding the 
dead trappings of their schooling, and 
learning a different professional lan- 
guage. And surely educators and prac- 
titioners have good patient care as a 
common goal. ^ 



JANUARY 1974 



Electrophrenic respiration 
in quadriplegia 

How team members worked together to help a young quadriplegic regain 
some measure of independence. 



R.G. Vanderlinden, M.D., L. Gilpin, R.N., 
J. Harper, R.N., M. McClurkin, M.S.W., 
and D. Twilley, R.N. 



Acute respiratory failure is commonly 
encountered and successfully managed 
in the respiratory units of large teach- 
ing hospitals. These units, staffed by 
anesthetists, respirologists, and highly 
trained nurses, have significantly re- 
duced the mortality rate; they owe their 
success to the team approach to respir- 
atory problems. These patients, cared 
for by nurses on a one-to-one ratio, are 
ventilated by various types of mechan- 
ical respirators that tide them over the 
acute stages of illness until satisfactory 
gaseous exchange recurs or until death, 
resulting from cerebral or cardiac 
reasons, supervenes. 

Approximately 10 percent of cases 
of respiratory failure are on a neuro- 
logical basis. The pulmonary system is 
intact, but the central control or its 
peripheral outflow is deranged. Pa- 
tients in coma from head injury or 
increased intracranial pressure either 
recover with treatment or die. 

A patient who has a rare type of 
central nervous system viral infection, 
such as poliomyelitis, rhomboenceph- 
alitis, or Guillan-Barre syndrome, may 
survive with intact cerebral function 
but have impaired respiration due to 
involvement of the medullary respir- 
atory center, the anterior horn cells, or 
the ventral roots of the phrenic and 
intercostal nerves. Many of these pa- 
tients recover, but continue to suffer 
from a hypoventilation syndrome char- 
JANUARY 1974 



acterized by cyanosis, hypoxia, hyper- 
carbia, and respiratory acidosis, espe- 
cially during sleep when there may be 
prolonged periods of apnea (Ondine's 
curse*). 

The hypercarbia results in cerebral 
arterial dilatation and increased intra- 
cranial pressure, which cause matutinal 
headache, nausea, drowsiness, and 
confusion. These patients have been 
managed on a rocking bed or a cuirass- 
typc ventilator during sleep. This venti- 
latory assistance tends to maintain pOa 
and pCOj at the diurnal levels to which 
they have become accustomed. Obvi- 
ously these patients have little reserve, 
and even a mild respiratory infection 
is life threatening. 

A much rarer cause of acute respir- 



' According to Jablonski"s llliistruted 
Dictioiuiry of Eponyniic Syiulroines and 
Diseiisi's and their xynonyms (W.B. 
Saunders 1969). "Ondine's curse" is; 
"Failure of automatic respiratory func- 
tion with apnea, especially evident 
during sleep, and retained ability to 
breathe on command. Ondine's curse" 
is believed to have been coined by [ a 
Dr.] Severinghaus, who relates it to the 
legend of Ondine. a water nymph, who 
punished her mortal husband by depriv- 
ing him of the ability to breathe auto- 
matically. Thus, on falling asleep, he died, 
not being able to remember to breathe." 



atory failure is high cervical cord trau- 
ma. Although fractures and even dis- 
locations in the atlanto-axial (CI and 2) 
region are not uncommon, most of 
these injuries do not result in neurolog- 
ical deficit. If the spinal cord is signif- 
icantly traumatized above the origins 
of the phrenic nerves, which arise from 
the third, fourth, and fifth cervical 
segments, apnea results immediately 
and the patient is dead on arrival at the 
hospital. 

With increased public awareness and 
training in the use of mouth-to-mouth 
respiration, some of these victims will 
survive in a state of complete quadri- 
plegia and total dependency on me- 
chanical ventilation. This is a ne\\' prob- 
lem; fortunately, however, a new solu- 
tion to chronic respiratory insufficiency 
has recently been developed — electro- 
phrenic respiration. 

Historical development of EPR 

In 1937. Waud reported that rabbits 
could be maintained in a satisfactory 
respiratory condition for hours by 
rhythmic electrical stimulation of the 
phrenic nerves.^ Sarnoff ( 1948) exper- 
imented with several other species and 
noted that submaximal electric stimula- 



The authors are staff members at the 
Toronto Western Hospiial. I oronlo. 

THE CANADIAN NURSE 23 



23 ^^^ 



tion of a single phrenic nerve produced 
adequate gaseous exchange for at least 
22 hours. 2 He coined the term "elec- 
trophrenic respiration'" (EPR) and even 
stimulated phrenic nerves percutane- 
ously in man. The technology was crude 
and the technique limited by the devel- 
opment of infection around the nerve. 

Glenn (1959) developed the first 
cardiac pacemaker by inducing, trans- 
cutaneously, an electric current in a 
buried electrode, using an external 
radio wave frequency power source. ^ 
His success led to the development of 
suitable electrodes, radioreceivers, and 
a pacemaker for EPR. In 1968 he 
reported using EPR to obtain ventila- 
tory assistance in a case of hypoven- 
tilation syndrome.'' 5 

In November 1970, Dr. Glenn first 
implanted phrenic electrodes bilater- 
ally in a racing car driver who had 
sustained an odontoid fracture and a 
complete spinal cord lesion at the C2 
level. 6 He has now been totally main- 
tained by EPR for three years. Since 
then, Dr. Glenn has implanted bilateral 
electrodes in three patients with a high 
cervical cord lesion; our case is the 
first outside the United States. 

Case report 

A 17-year-old girl dived into the 
shallow end of a swimming pool on 
September 2, 1972, sustaining a frac- 
ture of CI and a fracture dislocation 
of the odontoid process of C2. She 
was rendered apneic and lay submerged 
and lifeless in the pool until one of her 
companions jumped in and administer- 
ed mouth-to-mouth respiration while 
they were rushed to the local hospital. 

An endotracheal tube was inserted 
and she was transferred to the neuro- 
surgical service of the Toronto West- 
ern Hospital; ventilation was main- 
tained by a Bird respirator. The patient 
had complete flaccid quadriplegia and 
an anesthesia level at the mandible. 
Although conscious and oriented, she 
was unable to breathe when the respir- 
ator was turned off briefly. A trache- 
ostomy was performed, skull tongs 
were applied, and constant urinary 
24 THE CANADIAN NURSE 



drainage was established. The girl was 
placed on a Stryker frame in the respir- 
atory unit. 

As the spinal cord lesion was com- 
plete from the onset, no hope of re- 
covery could be expected; we antici- 
pated that the patient would die of 
pneumonia. Her system adjusted to the 
quadriplegic state and after three 
months it was apparent she would sur- 
vive for an indefinite period. 

The prospect of an intelligent, 17- 
year-old girl spending the rest of her 
life in the respiratory unit of an acute 
general hospital seemed unacceptable 
on humanitarian and economic 
grounds. To improve this patient's 
quality of life, to give her a certain 
degree of mobility, and to permit trans- 
fer to a rehabilitation or chronic care 
institution, we decided to investigate 
the suitability of electrophrenic respir- 
ation. 

Our tlrst priority was to establish 
the electric excitability of the phrenic 
nerves and their ability to produce 
contraction of the diaphragm. This 
was done by inserting a transvenous 
pacemaker into the right atrium and by 
stimulating the right phrenic nerve 
through the wall of the heart. Diaph- 
ragmatic contraction was apparent 
on fluoroscopy, and clinically a hiccup 
was produced. 

Our second priority was to ensure 
that the phrenic nerve electrodes, the 
radioreceivers, and the pacemaker it- 
self were available. Dr. Glenn's electro- 
nic equipment had largely been custom- 
made by the Avery Laboratories, Fra- 
mingdale, N.Y., working in conjunc- 
tion with his electronic engineer. Avery 
assured us that the necessary equip- 
ment was available and that the com- 
pany's engineer. Marc Weinstein, 
would be present at the operation to 
monitor it during the various stages 
of the procedure. 

Our third priority, to learn the 
operative technique, culminated in a 
trip to Yale University, New Haven, 
Conn., to meet Dr. Glenn and observe 
him implanting a phrenic pacemaker. 

On May 1, 1973, the patient was 



anesthetized by endotracheal anes- 
thesia, the tracheostomy tube removed, 
and the tracheostomy stoma prepared 
with Betadine and occluded with sterile 
gauze and Vidrape. A horizontal in- 
cision was made about 3 cm. above the 
medial third of the left clavicle, and the 
scalenus anticus muscle was identified. 

The phrenic nerve running down- 
ward along the anterior surface of the 
muscle was stimulated to establish its 
identity and confirm diaphragmatic 
contraction. A bipolar platinum elec- 
trode, enclosed in a silastic cuff, was 
placed around the nerve and anchored 
firmly to the underlying muscle by su- 
tures. A subcutaneous pocket was devel- 
oped along the lateral chest wall, and 
the electrode wires were brought down 
subcutaneously into the pocket where 
they were connected to the radiore- 
ceiver. The wounds were then sprayed 
with Polybactrin and closed. 

A sterile antenna, attached to the 
phrenic pacemaker, was held over the 
radioreceiver; the left hemidiaphragm 
contracted rhythmically. A similar 
electrode and radioreceiver were im- 
planted on the opposite phrenic nerve 
so the right hemidiaphragm also res- 
ponded to radio frequency stimulation. 

Postoperatively, the patient was 
placed back on the Bird respirator until 
the wounds had healed. Pacing was 
begun two weeks later, but initially she 
could tolerate only six minutes on each 
side before becoming fatigued, as the 
diaphragm had not contracted for over 
eight months. Her tolerance improved 
rapidly and, by July i, total electro- 
phrenic respiration was established. 

Each side is stimulated for 12 hours 
alternatively and this is sufficient to 
maintain normal blood pH, pOg, and 
pCOg. The tidal volumes measured on 
each side are approximately 500 ml. 
and appear to be improving steadily. 

We removed the patient's tracheos- 
tomy tube, but kept the tracheostomy 
open with a small silastic stomal tube 
that permits periodic suctioning. The 
stomal tube is corked to allow normal 
speech. 

Prior to surgery, the patient learn- 
JANUARY 1974 



ed a breathing technique of contracting 
her platysma, sternomastoid, and trape- 
zius muscles, which are innervated by 
cranial nerves. She can maintain this 
"breathing" for 10 minutes before she 
tires; this would allow sufficient time 
for her to summon help in an emergen- 
cy. Her nurse has been instructed to 
attach an Ambu bag to the stomal tube 
and assist respirations until the prob- 
lem has been solved. 

An additional fail-safe mechanism 
is the fact that, unlike patients with 
hypoventilation syndrome, the chemo- 
; receptors in the medullary respiratory 
center of quadriplegics are normally 
sensitive to elevated pCOa. One night 
while our patient was sleeping, the 
pacing temporarily stopped and she 
began to "breathe" spontaneously. 
This awakened her, and the nurse who 
was in the room made necessary adjust- 
ments to the antenna to reestablish EPR. 

Respiratory nursing care 

Respiratory nursing care entails 
tracheotomy suctioning, changing the 
tracheotomy dressing, and checking 
the minute and tidal volumes to ensure 
adequate ventilation. 

The phrenic nerve pacer consists 
of four different parts. The two elec- 
trodes, as previously described, are 
wrapped around the phrenic nerves 
above the clavicles. Connected to each 
electrode is a receiver, situated sub- 
cutaneously under each axilla. A cir- 
cular antenna, placed externally over 
each receiver, transmits timed impulses 
from the pacer; these impulses initiate 
respiration {Figure 1 .) 

The current output of the pacer is 
measured in milliamperes and can be 
adjusted for each 12-hour period of 
pacing. The doctors initiJly set the 
current level and increased the dura- 
tion of pacing from 6 minutes to 20 
minutes on each side. The nurses then 
assumed the responsibility for pacing 
20 minutes on each side, 3 times daily, 
and progressed slowly over 6 weeks to 
continous phrenic nerve respiration. 

When the patient is in bed, the 
phrenic pacemaker is plugged into 
JANUARY 1974 




^ 



Figure 1 : The patient with radiofrequency phrenic nerve pacemaker, which is set 
at 2.0 milliamperes and powered by a transformer plugged into a wall outlet. The 
circular antenna taped to her chest induces a stimulating current in the subcutane- 
ous radio receiver attached to the electrode on the phrenic nerve. 



a wall outlet; when she is in a wheel 
chair, the unit is battery pxjwered. In 
the sitting position, more current is 
necessary to provide adequate tidal 
volumes. Initially, tidal and minute 
volumes were measured and recorded 
every five minutes; however, when 
total EPR was established, these re- 
cordings were taken every four hours. 
The speech therapist saw the patient 
while she was still on the Bird respi- 
rator and taught her a form of glottal 
speech that could be maintained for 
a long period but required little air. 
Her vocal cords were quite tight and 
only a monotone was produced. After 
EPR was established, she was able 
to speak in a normal voice, with moder- 
ate range in volume, when the trache- 
otomy tube was corked and the cuff 
deflated. She is being taught to cough 
up mucous so she will not require 
deep suaioning. 

Quadriplegic nursing care 

The usual problems of nursing the 
quadriplegic existed in this patient, 
but were complicated by the high level 
of cord injury. She was on a Stryker 
frame for six weeks with skull-tong 
traction, but tolerated the prone posi- 
tion poorly. Intensive skin care was 
required almost hourly. Once she was 
in a bed, sheepskins were used to pro- 
tect her skin and she was positioned 
with pillows and sandbags. 

As the sympathetic nervous supply 
to the body was destroyed, there was 
no perspiration and her skin had to 



be protected against dryness. An ex- 
cessive sebaceous secretion developed 
on her face, creating moderately severe 
acne that required frequent cleansing. 
The skin under the antenna needed 
extra care. 

The physiotherapist applied daily 
ice packs to the patient's legs and put 
her joints through a full range of passive 
exercises to prevent contracture deform- 
ities. These treatments reduced muscle 
spasms that developed after three 
months and at times were severe. Rolls 
of padding were used in the hands to 
prevent finger contractures. 

Placing the patient in the chair was 
also a difficult maneuver. A quadripleg- 
ic chair with horizontal leg support and 
head support was used; pillows support- 
ed her head and arms. Tensor bandages 
were applied from the toes to the groin 
to help maintain blood pressure, and an 
abdominal binder supported the abdo- 
men and back. Jobst panty hose provid- 
ed good support but were abandoned 
when she gained weight and they be- 
came too tight. 

The back of the wheelchair was 
first placed at a 45-degree angle and 
slowly raised to an upright position. 
We had to lift the patient every half 
hour to relieve pressure on her sacrum. 
The legs are lowered gradually to a 
45-degree angle. There has been some 
problem with spasms, causing her to 
hyperextend her back and slide down 
in the chair. 

Despite a good diet, profound mus- 
cle atrophy resulted in weight loss 
THE CANADIAN NURSE 25 



during the first three months, until 
the patient stabilized and started to 
regain weight as fat. Urinary drainage 
was accomplished by an indwelling 
Foley catheter with continuous bladder 
irrigation. If no spontaneous bowel 
movement occurred, a glycerin sup- 
pository was inserted every other day. 

Emotional support 

The social worker acted as a liaison 
because of the patient's complex family 
situation. Her parents had separated 
when she was four; an older brother 
and sister lived with the father, while 
she and a younger sister remained with 
the mother. Each parent subsequently 
remarried and had further children. 

The patient was heavily involved in 
domestic chores and the raising of four 
younger children. She had left school 
after completing Grade XI and was 
training as a hairdresser at the time of 
the accident. As the two families lived 
outside the city, much of the emotional 
support required by the patient had to 
be provided by the nursing staff and 
the social worker. 

The patient's condition naturally 
caused her a great deal of fear, anxiety, 
and hostility, which resulted in a reac- 
tive depression. Aided by a psychiatrist, 
the social worker attempted to unders- 
tand these emotions to help the patient 
use inner strengths and develop effect- 
ive coping mechanisms. For example, 
her usual method of handling anger and 
frustration had been withdrawal; in 
hospital, however, this method was not 
only ineffective but was also destruc- 
tive because it fed into the depression. 
Understanding this, she learned to 
handle her anger more directly. 

In discussions with the patient con- 
cerning her present condition and the 
future, emphasis was placed on the 
goals she would be able to attain. An 
honest "I do not know," or "There is 
no way anyone can promise you that," 
was the answer to many of her voiced 
hopes. 

Many times, however, she became 
depressed and withdrawn, sometimes 
for several days. We were eventually 
26 THE CANADIAN NURSE 



able to help her get rid of these periods 
of depression by being with her cons- 
tantly, showing an understanding of her 
behavior and, at the same time, setting 
limits for her demanding and attention- 
seeking actions. 

To strengthen personal relationships, 
the same two nurses attended the pa- 
tient during the day and evening shifts 
of the first eight months of her hospi- 
talization. They felt emotionally drain- 
ed after eight hours when the patient 
was depressed, but for the most part 
her natural vivacity and courage help- 
ed sustain them during the difficult 
times. They found it a humbling exper- 
ience to care for someone who was so 
completely and totally dependent on 
others. 

The patient is a pretty girl and her 
appearance is important to her. Her 
hair was washed and set frequently, 
nails were kept well manicured and 
polished, and makeup was applied 
daily. She was dressed in feminine 
gowns made by her stepmother, and 
wore jewelry most of the day. For 
diversion she had a television set and 
a stereo, which she used a great deal. 
The walls of her room were decorated 
with posters and with photographs of 
her family and friends. 

Since she first was helped into a 
chair, she has been out of her room as 
much as possible: up to the sun deck, 
out on the hospital grounds, and down 
to coffee with the nurses in the even- 
ings. She was even able to leave the 
hospital for six hours with her nurse to 
attend her girl friend's wedding recep- 
tion. 

Rehabilitation 

The occupational therapist provid- 
ed a wedge to prevent her from slipping 
down in the wheelchair, and a special 
tabic for use while sitting. The dental 
clinic designed a plastic mouthpiece 
to which a pen or paint brush could be 
attached; the patient is now learning to 
write and paint with her mouth. Ap- 
titude testing was done to provide a 
baseline from which the therapist and 
rehabilitation personnel could work 



toward a realistic vocational goal. 

This patient will always require the 
facilities of a chronic hospital that 
provides a high level of nursing care. 
The chief rehabilitative efforts have 
been directed toward obtaining an 
electric wheelchair that the patient 
can operate by blowing, or using her 
tongue and lips. 

Devices for remote control of light 
switches, television, doors, book pages, 
and even a typewriter can be attached 
to the wheelchair and allow the patient 
a far greater range of independence. 
Financial support for this apparatus 
has been secured and it is presently on 
order from the manufacturers. 

There will be more patients like ours 
in the future — aware, alert individuals 
who must not be showered with pity, 
but encouraged to achieve what is pos- 
sible. The challenge is great, but it can 
be met by a competent and dedicated 
team approach to the problem. 

References 

f Waud. R.A. Production of artificial 
respiration by rhythmic stimulation of 
the phrenic nerves. Nutitrc I40:35.'i0: 
849. Nov. 13. 1937. 

2. Sarnoff. S.J. et ai. Electrophrcnic 
respiration. Science 1()8:482. Oct. 29. 
1948. 

3. Glenn. W.W.I.. Remote stimulation of 
the heart by radiofrcquency transmis- 
sion: clinical application to a patient 
with Stokes-Adams syndrome. New 
Eiifi. J. Med. 261:19:948-51. Nov. .'i, 
1959. 

4. Judson. J. P. and Glenn. W.W.I.. Radio- 
frequency electrophrcnic respiration. 
Long-term application to a patient 
with primary hypoventilation. JAMA 
203:1033-37, Mar. 18. 1968. 

5. Glenn. W.W.I.. et al. Central hypoven- 
tilation: long-term ventilatory assist- 
ance by radiofrcquency clectrophrenic 
respiration. Ann. Siiif^. 172:755-73. 
Oct. 1970. 

6. Glenn. W.W.I., et al. Total ventilatory 
support in a quadriplegic patient with 
radiofrcquency electrophrcnic respira- 
tion. New Enfi. J. Med. 286:513-16. 
Mar. 9. 1972. '^^ 

JANUARY 1974 



r4^^- 




"DO BRING OR SEND YOUR 
FRIEND A FEW FLOWERS--' 



\ 




When you visit 
a sick friend.... 



Vanvouver cartoonist J. F.Dunnet 
illustrates some suggestions from the 
Catholic Hospital Association's pamphlet. 
Visiting Patients: Some Hints on 
What to Do and Say. 




"DO RESTRAIN YOURSELF 
FROM PRYING INTO WHY HE 
IS HOSPITALIZED" 



-DO MAKE YOUR VISIT SHORT- 



THE CANADIAN NURSfc 



I've got a wolf by the ears 



'I've got a wolf by the ears, as they say; I can't let go [and can't hold on] ." 

Terence, Phormio (Act III sc.2, 506-507) 



Bonnie Hartley 

I have systemic lupus erythematosus! 
1 am learning to live with it. but there 
is much to learn it" 1 am to keep the 
"wolf" subdued. 

When 1 first learned the diagnosis, 
I knew little about the disease. What 
did the future hold for me? Could I 
carry on at my job? What could I do 
tor recreation? Gradually, many of my 
questions have been answered. Adjust- 
ment to my disease has been greatly 
aided by my belief in a personal Christ 
and by realizing I can still be useful, 
even with lupus. 

What is systemic lupus erythema- 
tosus? An altered immune reaction 
that can affect a single organ or several. 
The course of the disease is usually 
marked by remissions and exacerba- 
tion.i 

Systemic lupus erythematosus (SLE) 
occurs 6 to S times more frequently in 
women than in men, and the peak 
incidence usually begins between 20 
and 40 years of age, although it may 



Ihc author was with the department of 
nursing education, Ihc Hospital for Sick 
Children, loronto. Ontario. She is pre- 
sently employed by Ryerson Polyteehnical 
Institute in Toronto. She acknowledges 
the a.ssistance of Dr. G. Davies, Sunny- 
brook Medical Centre, loronto. and the 
department of medical publications. Ihc 
Hospital for Sick Children, loronto. 



28 THE CANADIAN NURSE 



start as early as 2 years or as late as 97. 
Exact figures on the incidence are hard 
to find, but in 1972, in one 500-bed 
Canadian teaching hospital, 6 new cases 
were diagnosed. 

The patient with SLE manufactures 
a multitude of autoantibodies that 
attack his own tissues. Just how has yet 
to be discovered. Some researchers 
believe that tissue injury allows the 
release of potentially antigenic sub- 
stances to which the body then builds 
antibodies; but what causes the damage 
in the first place remains a mystery. The 
antibody most characteristic of SLE is 
the lupus erythematosus (LE) factor, 
which promotes phagocytosis of nuclco- 
protein. Many patients also have anti- 
nuclear factors (ANF), antibodies that 
react against the whole nucleus, nuclco- 
protein, DNA, and histone. 

How SLE begins 

There is nothing characteristic about 
how SLE begins. It can begin with 
fever, malaise, weight loss, and fatigue. 
Arthritis is common but rarely produces 
permanent deformity. The arthritis of 
SLE frequently mimics rheumatoid 
arthritis and may be so transitory that 
it is ignored. My initial joint pain and 
swelling lasted only 36 hours and oc- 
curred about 6 weeks before I had any 
other symptoms. 

Frequently, a "buttertly"" rash 

spreads over the bridge of the nose and 

flares out on the cheeks. A nineteenth 

JANUARY 1974 



century physician described the sicin 
lesions as looking like the bite of a 
wolf. The name literally means "red 
wolf disease. "2 

Ultraviolet light makes the rash 
worse. At first I had only a slight flush 
but, as summer progressed, the rash 
became deep red. Being a red-head 
and pale complexioned, I was very 
conscious of the strange appearance it 
gave me. Blemish stick, makeup, and 
powder did little to disguise it. To my 
great relief the rash faded after using 
steroid cream (Betnovate 0. 1 % ). 

The pleurisy and pleural effusions 
that accompany the condition produce 
chest pain and dyspnea. A slight hill 
between my apartment and the subway 
suddenly became a mountain. 1 had 
bilateral pleural effusions. 

The problems of diagnosis are com- 
pounded by symptoms related to the 
organs affected. If the onset is gastro- 
intestinal, the patient may experience 
abdominal pain, nausea, vomiting, 
diarrhea, or constipation, imitating 
acute appendicitis or renal colic. Epi- 
leptic-like seizures may be early 
evidence of SLE. although they are 
unusual. This and mental depression, 
excitability, headache, forgetfulness. 
or even a nervous breakdown can mark 
the onset. When lupus attacks the kid- 
neys, nephritis or protein-losing 
nephrosis results. Diagnosis is usually 
confirmed by a kidney biopsy. 

Several tests help to make a diag- 
nosis certain. Blotxi tests for the LE 
factor may occasionally be negative, 
even when the disease is present. If the 
antinuclear factor is present in the 
blood, it usually falls when a remission 
occurs. Most patients with .SLE also 
have low serum complement levels 
(normal 140 to 160), which are closely 
linked to renal disease. These slowly 
rise as the disease is brought under 
control. As well, most SLE patients have 
an elevated erythrocyte sedimentation 
rate, perhaps as high as 100 mm/hour, 
and normochromic anemia. 

Many factors, although not causes 
JANUARY 1974 






>J ^ 




.'■^ ^ 



"^f 



^J 



"Although I look very fashionable in my large-brimmed hat and seersucker jacket. 
I'd prefer to leave them at home when it is 100° in the shade!" 




of SLE, precipitate an exacerbation. 
These include; sunlight and ultraviolet 
radiation; local infections, such as a 
sore throat; the administration of a 
foreign protein, such as tetanus anti- 
toxin; certain drugs, such as sulfona- 
mides, penicillins, apresoline, mezan- 
toin, or hydantoin (Dilantin); and 
emotion. Just as at the time of diagno- 
sis, the exacerbation is ushered in by 
symptoms related to the organs affect- 
ed. 

Although the treatment of choice is 
the use of corticosteroids, the anti- 
malarial drugs, such as quinine or 
chloroquine (Aralen), are still used. 
Salicylates help to control Joint symp- 
toms, but none of these drugs except 
the steroids alter the course of the 
disease. The latest treatment involves 



the use of immunosuppressive agents, 
such as azathioprine (Imuran) or 
cyclophosphamide (Cytotoxan). Fre- 
quently, muchof the treatment is direct- 
ed at preventing further deterioration 
of renal function. 

Helping patient and family 

What special challenges does the 
patient with SLE present to the nurse? 
Symptomatic and supportive care are 
always necessary in the acute stage, 
but nurses should also prepare them- 
selves to answer the many questions 
the patient and his family will have. 
The family has to cope with the acute 
anxiety resulting from a serious illness 
and the mood changes characteristic of 
patients receiving steroid therapy, 
which may be intense and hard to live 
THE CANADIAN NURSE 29 



with. My doctor warned my tamily 
what to expect so that my emotional 
swings were no surprise. The fatigue, 
the increased dependence, the confine- 
ment, all accentuated these swings. 

In the past few years I have read 
much about the communication barrier 
erected by nurses between themselves 
and their seriously ill patients. I don't 
know if I intimidated nurses because I 
am a teacher o\' nursing or if the diagno- 
sis of my disease scared them. In any 
event, during my six weeks in hospital 
only two nurses ever acknowledged they 
knew what was wrong with me or had 
any understanding of the long-term 
nature of the disorder and what it might 
mean for me. Luckily, the doctors were 
willing to answer my many questions. 
Now that 1 am back at work, many 
people tell me of patients with lupus 
who are doing well. 

I have lived with lupus for 10 
months. I am not past the time tif great- 
est danger. The mortality rates are 
highest in the first year after diagnosis. 
Of the patients who survive this first 
year, 90 percent of the adults without 
renal disease and 80 percent of those 
with renal disease will survive five years 
or more. In children the prognosis is 
less favorable. Patients with lupus 
usually die of renal causes, central 
nervous system complications, or in- 
fections. ^ Generally, the easier it is to 
induce a remission and the longer the 
remission lasts, the better is the pro- 
gnosis. 

To reach her full potential, the nurse 
must be prepared tt) clarify informa- 
tion the diKtor gives and augment this 
with the appropriate patient teaching. 
She should know and make sure her 
patient knows that exposure to ultra- 
violet radiation can cause a sunburn 
and lead to an exacerbation. Outdoor 
activities, such as swimming, garden- 
ing, sailing, or water skiing, should be 
avt)ided between 9.00 A.M. and 4.00 
P.M. true sun time.2 The patient need 
not give up all sports, but should prac- 
tice them in the early morning or late 
30 THE CANADIAN NURSE 



afternoon to avoid the strong sun. 

Naturally, other forms of ultra- 
violet, such as sunlamps or "Disinfec- 
taires," should also be avoided, a spe- 
cial problem for me as I am a nurse in 
a pediatric surgical unit where Disin- 
fectaires hang in every baby's cubicle. I 
find it a nuisance to remember to turn 
off these lamps when I am caring for the 
baby and harder still to remember to 
turn them on again when 1 leave the 
room. 

When I walk to work, I cannot al- 
ways avoid the sunshine so I use an 
ultraviolet screening agent. Today's 
fashions — the big hats, the long 
sleeves, and the lightweight Jackets — 
favor the girl with SLE. Although I look 
very fashionable in my large -brimmed 
white hat and seersucker jacket, 1 
would prefer to leave them at home 
when it is 100° in the shade. Because 
a tan is fashionable, I stand out from 
my friends and co-workers. 

Haserick states, "A gradual return 
to full, normal activities after an IE 
flare [-up ) is best, usually over a period 
of several months."^ I will never forget 
the overwhelming fatigue st) frequently 
a part of lupus. Some days my fatigue 
was so great that even reading was too 
much effort. I beciime discouraged and 
depressed. 

At least eight hours sleep or more 
each night is essential: during the first 
few months after leaving hospital, a 
daytime nap is advisable. Patients 
need to be reminded that, if they feel 
tired after some activity, they should 
have done less and stopped sooner; at 
first, they should avoid heavy cleaning, 
lifting of children and baskets of wet 
wash, and long periods of ironing. 

After three months' off duty, I 
returned to work for two hours a day 
and was certainly glad to go home to 
bed at the end of this time. Gradually 
the hours increased and, within three 
weeks, I was back to work full time. 
Today, my energy level is just about 
normal. 

The nurse who cares for a patient 



with Sl.E needs not only special know- 
ledge, but also special frankness. 
Although the whole question of preg- 
nancy should be discussed thoroughly 
with the doctor, sometimes the patient 
turns to the nurse for further interpre- 
tation. According to Rook et al, preg- 
nancy does not affect the state of lupus 
in 50 percent of patients: in about 17 
percent of patients, the severity of the 
disease decreases; but in about ??! per- 
cent, it increases either during the preg- 
nancy or in the early postpartum 
period.'' Most physicians advise 
against pregnancy if the kidneys are 
severely affected. 

The wise nurse will try to make sure 
the patient understands that immuniza- 
tion and certain drugs, such as the sul- 
fas, should be avoided and that self- 
medication is dangerous. Any person 
on long-term drug therapy should be 
aware of the advantages of special 
identification, such as a "Medic -Alert" 
bracelet or necklace. 

If the doctor fails to explain that the 
Wassermann is falsely positive in about 
10 to 20 percent of .Sl.E patients, then 
the nurse should do so to decrease the 
possibility that the patient will be 
embarrassed by finding out later. 

A way of life 

Above all, the patient must under- 
stand that continuous drug therapy will 
become a way of life. He must never 
fail to take the drugs prescribed, and 
he must know the effects and side ef- 
fects of these drugs. Medical check-ups, 
drugs, and perhaps diet, too, become 
the new direction. 

I was pleasantly surprised at how 
quickly I adjusted to my high-protein, 
low sodium (1 gram per day) diet. At 
first all the food seemed tlat; but now, 
after 10 months, meals once again arc 
interesting and satisfying. I find it 
frustrating that quick foods that meet 
my diet restrictions are unavailable. 
Salt-free preparations of condiments, 
such as ketchup, pickles, mustard, and 
Worcester sauce, are not to be found in 
JANUARY 1974 



Eastern Canada, although they can be 
had in the United States. Health-food 
stores here stixrk a salt-free, crunchy- 
style peanut butter and mayonnaise. 
For me, the salt substitutes give food 
a peculiar taste that isn't at all salty. 

A high-protein diet demands milk. 
But the quest for low sodium milk was 
long and frustrating. The dietitian 
recommended one of the known prod- 
ucts as being better tasting than the 
other, and gave me a list of places 
where I could buy it. None of the pla- 
ces she listed carried the product or 
knew anyone who did. The manufactur- 
er was no better informed. Finally, a 
friend tackled the drug stores in the 
yellow pages and found one, miles from 
where I live, that sold low sodium milk. 
For the healthy, such deficiencies would 
be merely an irritation; for the patient 
with lupus, who must travel abroad 
and survive at home, they are crucial. 

Lupus patients on steroids are 
particularly prone to infection and 
must avoid people with colds or other 
infections. Pediatric nursing, my spe- 
cialty, is hazardous for me. Already an 
outbreak of chicken pox on one of my 
wards has put certain rooms out of 
bounds. A primary contact with a child 
with mumps meant I had to have a 
series of gamma globulin injections. 

Over the months the continued med- 
ical supervision can become onerous. 
Weekly, biweekly, or monthly visits 
to the doctor, the repeated and repeat- 
ed blood tests and urinalyses require 
much adjustment. So far I have been 
able to schedule my working hours 
around my appointments; but a per- 
son with less flexible hours would find 
all this supervision difficult to arrange, 
even though his survival depends on it. 

Drugs cost money. As well as the 
steroids (doses during the early part of 
the treatment may be 60 mg. or more 
per day), and immunosuppressives, 
there will also be antacids to prevent 
gastrointestinal upsets. 1 mix Amphojel 
and Maalox. It's hard to remember to 
take all these medicines regularly, as 
JANUARY 1974 







TABLE 1 




Frequency of Appearance of Clinical Symptoms 


Symptoms 




Frequency % Symptoms 


Frequency "A, 


Arthritis 




91 Pericarditis 


33 


Fever 




84 Murmurs 


24 


Skin 




76 EKG Changes 


18 


Renal 




54 Adenopathy 


46 


Gastrointestinal 




55 Splenomegaly 


10 


Pleurisy 




49 Hepatomegaly 


23 


Plural Effusion 




29 Central Nervous 
System 


30 


Pneumonia 




30 




Adapted from 


Cecil- Loeh Textbook of Medicine. 1 3ed.. Pli 


iladelphia. W.B 


Saunders. 1971 


/;. 818. 







the activities of the day crowd in to 
blot out such mundane matters. 

Yes, there is much for the patient 
with lupus erythematosus. The most 
important is that he can live a produc- 
tive, normal life. The "wolf can be 
held by the ears and subdued — al- 
though rarely tamed. 

References 

I.Tumuhy. P. A. .Systemic lupus erythe- 
matosus. //; Wintrobc, M.M. ei al cd. 
Harrison's principles of inlerndl med- 
icine. 6cd. New York. McGraw Hill, 

1970. p. 1962-7. 

2. Haserick. J.R. and Kellum. R.E. Primer 
lor patients with hipiis erytliemalosiis. 
Cleveland. Department of Dermatol- 
ogy. Cleveland Clinic Foundation, 
1 962. 

?■. .Schur. Peter H. Systemic lupus erythe- 
matosus. In Beeson. P.B. and McDer- 
niolt. VV. cd. Cecil-Loeh textbook of 
medicine. 1 .Vd. Toronto. .Saunders, 

1971. p. 816-22. 

4. Rowell. N.R. Lupus erythematosus, 
sclerodemia and dcrmatomyositis. The 
■■collagen"' or ■■conneciivc-tissue^' dis- 
ease. //; Rook Arthur and Wilkinson, 



D.S. cd. iexlhook of dermatoloi;y . 2cd. 
Oxford. Bhickwcll Scicniilie Publica- 
tions. 1972. p. 1061-1 1.^6. '^ 



THE CANADIAN NURSE 31 



Protecting nonsmokers 
in public places 



"I have asthma, so I can't sit in the auditorium because people are allowed 
to smoke," the caller stated. Complaints like this started the Southwest 
Florida Lung Association on a campaign for the rights of nonsmokers. 



Sandra Kessler 



The issue of the rights of the nonsmoi<er 
has grown strong in many a community, 
so much so in ours that the American 
Lung Association of Southeast Florida 
has jumped into the program with both 
feet. 

The Southeast Florida association 
was pushed into the program by citizens 
who phoned asking us to do something 
about smoking in public places. People 
would call and say, for example, 
"Smoking is still allowed in the public 
library. 1 have asthma, so I can't sit in 
a room where people are smoking 
without being extremely uncomfort- 
able." Or someone would say, "Do you 
know that in this day, there's no regula- 
tion against smoking in the municipal 
auditorium? Do you think that's right? 
Can you do something about it?" 

So many calls came in that the lung 
association decided it had better try to 
do something to start protecting the 
rights of nonsmokers. 

The program has been going for two 
years now. Let me tell you something 
about the methods we used, the results, 
and the mistakes we made — and we 
made quite a few. 

It's a health issue 

Before going into the program, the 
Southeast Florida association made a 
basic decision about the focus; From 
32 THE CANADIAN NURSE 



experience with other types of anti- 
smoking programs, the association had 
learned that you get nowhere if you 
say only that cigarette smoke is annoy- 
ing. Instead, you must back up your 
plea with the facts about the health 
hazards. 

It wasn't too difficult to draw up a 
fact sheet on the health hazards of 
cigarette smoking from the various 
sources available. 

Battleground: the library 

The first battleground was the public 
library. Many citizens — especially 
older people with respiratory diseases 
— had phoned the association com- 
plaining that they wanted to use the 
facility but couldn't because smoking 
was allowed on the main floor. Because 
I serve the association as program ad- 



.Sandra Kessler is program administrator 
of the American Lung Association of 
Southeast Florida. Following her gradua- 
tion from the University of Georgia, Ms. 
Kessler participated in the NTRDA career 
development program in Virginia and then 
worked as director of information for the 
Georgia Lung Association. This article 
is a condensation of Ms. Kessler's presen- 
tation at the ALA's annual meeting in 
New York City. N.Y.. U.S.A. 



ministrator in smoking deterrent pro- 
grams, I made an appointment to talk 
with the library's board of directors. To 
prepare for the meeting, I stuffed the 
fact sheet and several letters from phy- 
sicians in the briefcase. (It didn't occur 
to me that a physician should be on 
hand to present the scientific arguments 
against smoking.) Somebody from the 
cancer society and a library patron or 
two went with me for moral support. 

When our small group got to the 
library board meeting, the directors 
didn't bother to look at the fact sheet 
or the letters from physicians. They said 
we were a radical group and that they 
weren't in business to monitor public 
health. They voted not to ban smoking 
in the public library. 

That was super tlop number one. 

But even though the effort failed, 
the newspaper report about the request- 
ed smoking ban registered with a num- 
ber of the local citizens. Many people 
called the lung association saying, "I 
want to report that smoking is allowed 
in such-and-such building." Or "Are 
you aware that the bank tellers are 
smoking on the job?" Or "I want you to 



Reprinted with permission from the Sep- 
tember 1973 American Lung Association 
Bulletin. 

JANUARY 1974 



know that there's smoking in Dr. XYZ's 
office." 

When somebody phoned with this 
kind of information, I made a file card 
with the person's name and address. 
This was the start of our new nonsmok- 
er's rights constituency. Then I would 
write an authoritarian letter which 
started out like this: "It has been 
brought to our attention that smoking 
is being allowed in your office (or 
building) . . . ." Or the letter would 
begin, "The American Lung Associa- 
tion of Southeast Florida has been 
receiving reports from your patients 
that you are allowing smoking in your 
waiting room . . . . " The letter would 
end with a formal request to no longer 
permit tobacco smoking in the office 
or building. A copy of the fact sheet 
was enclosed with each letter. 

I don't really know whether the let- 
ters did any good, except that every 
person who received one at least started 
thinking about the rights of nonsmokers 
to a clean indoor environment. And the 
recipient learned that the lung associa- 
tion is concerned about the health 
hazards of cigarette smoking. I should 
add that the rights of the nonsmoker 
concept was very new at the time. 

The municipal auditorium 

The next assault was on cigarette 
smoking in the municipal auditorium. 
The city commissioners had the author- 
ity to say yes or no. 

This time we brought along not 
letters from physicians but a know- 
ledgeable physician to state the scientific 
evidence. When a doctor stands up at a 
meeting and talks about a health prob- 
lem, he's going to be listened to with 
respect. 

Then we got some students to write 
letters saying, for example, "Smoke 
is a problem to me because I have 
asthma. I want to go to a rock concert — 
or the skating rink, or wherever — in 
lANUARY 1974 



the Municipal Auditorium, but I can't 
because you allow smoking." These 
statements really packed a punch. Any- 
thing from kids has a definite appeal. 

Then the newspapers took up the 
cause. One ran an editorial, and another 
supported us with an editorial cartoon. 

Yet the city commissioners were 
reluctant to make a firm decision. So 
they said, "We're not going to support 
any ban on smoking, but we will consid- 
er separate seating sections." 

The lung association was still waiting 
to appear before the commissioners. 
We started a massive letter-writing 
attack. We were able to interest a 
number of students in the cause, and 
some of them even delivered letters 
about the health h;izards of smoking and 
consideration of the nonsmoker to the 
commissioners' homes. 

On the day of the presentation, the 
lung association brought along a group 
of junior high students who, with their 
teacher, were extremely interested in 
the proposed smoking ban in the audi- 
torium. The students put on a couple 
of skits in the city chambers. They also 
made signs, gave testimony, and helped 
pack the room. Testimony was also 
given by other municipal auditorium 
patrons, including emphysema patients. 

After hearing the people out, the 
commissioners voted 4 to 1 to ban 
smoking totally in the auditorium. That 
was our first real victory. It is signifi- 
cant that the vote was 4 to I because 
four of the commissioners were non- 
smokers and one was a smoker. Even 
though the commissioners are elected 
representatives of the people, in this 
matter they voted according to their 
own taste. 

We tactically made one important 
mistake in the municipal auditorium 
campaign; We asked the commissioners 
to ban smoking as a matter of policy. 
We did not ask for an ordinance against 
smoking. An ordinance is enforceable. 



A policy has much less weight; the 
patrons are simply asked not to smoke. 
In an effort to strengthen the ban, 
we stated to the commissioners that, if 
they did not enforce the no-smoking 
policy, we'd go back to them and ask for 
an ordinance. As a matter of record, 
we have not yet asked for that ordi- 
nance. People still smoke in the audito- 
rium, but there are fewer smokers 
now, and the number is decreasing. I 
think we have pretty much won the 
game in that arena. 

A smoking deterrence committee 

The next phase in the campaign was 
the organization of a smoking deter- 
rence committee from the lung associa- 
tion's board of directors. This new com- 
mittee decided to continue the associa- 
tion's rights of the nonsmoker efforts. 
Straight off, the committee decided to 
start an all-out public awareness cam- 
paign to help people stop and think 
when others are smoking in public 
places. 

Understandably, the committee 
couldn't come up with Madison Ave- 
nue-type slogans the first time around; 
they are not an advertising agency. 
But they did reprint, with permission, 
some of the posters dreamed up by 
GASP (Group Against Smokers' Pol- 
lution), a nonsmokers' organization 
located in Maryland. You may have 
seen the poster "Please don't smoke. 
People are breathing" done by GASP. 
We reproduced this poster plus two 
others; "In consideration of others, 
please don't smoke" and "Hnjoy clean 
air? Hide your ashtrays." Copies went 
to physicians, and citizen volunteers 
also distributed them in public places. 
An envelope accompanied each piece. 

Floods of requests for the posters 
came to the lung association. This was 
one activity that people are very much 
interested in giving money to because 
of its specific appeal. The posters paid 
THE CANADIAN NURSE 33 







Q \NH\LE > P-' 







for themselves within a short time. 

Out of the committee itself came 
an equally successful item: a smoker's 
etiquette card. It's a wallet-size piece 
that you can slip underhand to a smok- 
er. It says, "Please don't smoke . . . ," 
and the person giving away the card 
checks the next part: "while you are 
holding my baby," "in my home." "sit- 
ting next to me," "in this concert," "in 
the office," "in the restaurant," and so 
on. 

Not only does the card make a state- 
ment, but it has a second use: On the 
back there's a form saying, "I would 
like to report that indiscriminate smok- 
ing is being allowed at . . . ," and there's 
a blank to be filled in plus the lung 
association's address. The association 
follows up with a letter to the so-called 
offender, trying to make it sound as if 
the complaint were about a bonfire 
in the middle of the building. 

"A resolution for creature comfort" 
was the next item that the ALA-SEF 
smoking deterrence committee turned 
out. It was devised in response to an 
organization which asked the lung asso- 
ciation to write up a resolution saying 
that smoking will be prohibited at its 
upcoming convention. The group want- 
ed a resolution that would pass its board 
of directors. The wording did pass, so 
the lung association then sent copies 
ofthe standard "Resolution for Creature 
34 THE CANADIAN NURSE 



Comfort" to about a thousand organi- 
zations in southeast Florida. A whop- 
ping 35 wrote us back, saying their 
organization had voted to ban smoking, 
and about 20 reported they had voted 
not to ban smoking. 

A survey of smoking policies in 
hospitals was the next thing the com- 
mittee attacked. "I'm going to be in the 
hospital, and I'm scared to death to 
room with a smoking patient." We 
found that, out of 16 hospitals, only 
5 were separating smoking patients 
from nonsmokers. As a follow-up, we 
sent the report to the medical staff and 
the hospital directors, asking that they 
take up the matter of separating patients 
at their next board meeting. That move 
was made recently, and we don't have 
responses from all the hospitals as 
yet. 

Social awareness 

Behind the various facets ofthe rights 
of the nonsmoker program is one over- 
all objective — to create social aware- 
ness of how offensive smoking can be 
to nonsmokers. If the association hears 
of a theater that decided not to allow 
smoking, we phone the theater manager 
and congratulate him, adding that the 
lung association hopes the theater will 
continue that policy. We then inform 
the lung disease patients in the area that 
they can now go to that particular thea- 



ter without experiencing discomfort. 

A lot has been done behind the 
scenes to accomplish our objectives. 
There's a certain amount of sensation- 
alism in going before the city or county 
commissioners with a request to ban 
smoking in a big auditorium. But there 
are other ways to accomplish the same 
objective. For instance, we went direct- 
ly to the head of a local health depart- 
ment to let him know that his staff 
members were smoking in the clinics. 
The health commissioner responded 
by directing his employees not to smoke 
on the job. All that was necessary was a 
decision by the head of the department. 
You can usually engineer a change of 
policy by going to the right person. 

The lung association's current project 
is an effort to persuade physicians and 
dentists to prohibit smoking in their 
offices. The Michigan TB-RD Associa- 
tion wrote a strong letter to physicians 
that we adapted for use in Southeast 
Florida. Many replies have already 
come back from physicians in our area. 

We ultimately hope for city and 
countywide ordinances to ban smoking 
in public places. St. Petersburg, Florida, 
has such an ordinance, which is well 
written. 

Suggestions for a campaign 

I've written up a short summary of 
the things lung associations and other 
organizations should keep in mind in 
conducting a "rights ofthe nonsmoker" 
campaign. I've put down all the sugges- 
tions I can think of and some things you 
should watch out for. 

v' First of all, you should get a non- 
smoker to head up the campaign. 

V Second, you're going to have to 
convince your chief executive and your 
board of directors that a little contro- 
versy never hurt anybody and that 
you'll probably get some bad press. 
You need a board thaP will not die 
of embarrassment just because some 
JANUARY 1974 



newspaper editors may not agree that 
nonsmokers have rights. Some editors 
will come out and say that you're being 
radical. 

v' Next, be sure you compile a mail- 
ing list of everybody who's interested 
in what you're doing, so that you can 
involve them in your activities. 

v' Next, use a fact sheet. Always 
stress that smoking is a health issue. 
You can't get by with saying, "It 
bothers me," or "It's annoying," or "It 
makes me mad." Smoking is a public 
health hazard. It's indoor open burning. 

/ Become familiar with all your local 
ordinances — especially fire regula- 
tions because these are nebulous in 
that the fire chief can interpret them 
the way he wants. You may save your- 
self a lot of work by turning up the fact 
that there's a fire regulation that has to 
do with smoking. The fire chief may 
interpret it to mean that smoking is 
forbidden in a certain area. 

v' Attend city and county commis- 
sion meetings to learn how they func- 
tion. You can tell if you're going to get 
a negative response just by seeing how 
the commissioners react to other situa- 
tions. Learn who in these bodies smoke 
because that helps give you a good idea 
of how successful you're going to be. 

v' Use students because it's hard for 
the commissioners to say no to plead- 
ing, young, sweet, smiling voices — 
and by students I mean younger stu- 
dents. If you get college students, some- 
times the elected officials think that 
nonsmokers" rights is another radical 
issue. 

V Try to get smoking banned in your 
own association's offices and at meet- 
ings of your organization. If you live 
in smoky houses, it's hard to throw 
stones. 

v' Always precede your appearance 
at hearings with many letters. 

v' Tell the newspapers what you're 
going to do, because this is legitimate 
JANUARY 1974 



news for all their readers. 

v' Remember that nonsmokers are 
the majority. 

/ Expect increased contributions. A 
$5 Christmas Seal contributor wrote 
us to say,- "Because of what you're 
doing to get smoking prohibited, I'm 
increasing my contribution to $200." 
Also expect letters from smokers say- 
ing, "Go to — !" 

V Do expect a large demand for your 
materials. 

V One of your biggest problems will 
be getting people to stand up and speak 
for the rights of nonsmokers, because 
they don't want their neighbors to 
think they're fanatics. Some people will 
readily testify, but others will call you 
and say, "Do this, this, this and this." 
And you say, "Okay, fine, come down 
to the place and testify." And they say, 
"Oh, no, I'm not going to get involved." 

V You can expect strongly negative 
reactions from some governing bodies 
to the proposition that they ban smoking 
in their building or public facility. 
Because smoking has been socially 
acceptable for so long, it's hard for them 
to realize that nonsmokers, who are in 
the majority, no longer find it accept- 
able. 

v' When you approach the governing 
body of a community organization, 
always explain that you're carrying out 
the directives of your board of direc- 
tors — not a personal campaign. When 
people realize you're representing an 
organization interested in fighting res- 
piratory problems, that gives you a lot 
more clout. 

v' Finally, you can expect a lot of 
crank calls. One classic call I got was 
from a man who said that the municipal 
auditorium was a tax-supported institu- 
tion. I agreed with him. He said that, 
when the public let their money be 
used to build that building, they knew 
that smoking would be allowed, and, 
if they had known that smoking wouldn't 



be allowed, they would never have let 
it be built. 

I had one other classic call. The man 
said, "I wish you'd just bug off and 
leave us alone." He continued, "You 
are a very frustated old maid, and if 
you would get married, the smoke 
wouldn't bother you so much." 

So I responded, "Well, if my getting 
married would stop the smoke from be- 
ing a serious health hazard. I would 
do it tomorrow. I'd go out and find 
somebody." But I have a feeling that 
he didn't want to get involved either . . . 
if I had asked him to marry me, he 
would probably have said no! 

Working for clean air in public 
places can easily be carried out by any 
association in the country. This is one 
problem that is not endemic to only 
one particular part of the country or to 
a certain type of citizen. Wherever you 
have people, you have tobacco smok- 
ing; and wherever you have smoking, 
you have lungs. All you need is enough 
smoke, inadequate protection for non- 
smokers, and lots of angry breathers! ■§> 



THE CANADIAN NURSE 35 



The 

Canadian 
Nurse 

50 The Driveway, Ottawa, K2P 1E2, Ont. 



^ 

^^F 



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 ot mforma- 
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 
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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 
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Webster's 7th College Dictionary are used as spelling 
references. 

References, Footnotes, and 
Bibliography 

References, footnotes, and bibliography should be limited 



to a reasonable number as determined by the content of the 
article. References to published sources should be numbered 
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article. Information that cannot be presented in formal 
reference style should be worked into the text or referred to 
as a footnote. 

Bibliography listings should be unnumbered and placed 
in alphabetical order. Space sometimes prohibits publishing 
bibliography, especially a long one. In this event, a note is 
added at the end of the article stating the bibliography is 
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 pa»es 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 interest to an article. Black and white 
glossy prints are welcome. The size of the photographs is 
unimportant, provided the details are clear. Each photo 
should be accompagnied by a full description, including 
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may be used or CNA forms are available on request. 

Line drawings can be submitted in rough. If suitable, they 
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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 NURSES' ASSOCIATION 




February 6-8; February 13-15, 1974 
May 8-10; May 15-17, 1974 

Three-day pediatric nursing confer- 
ences for registered nurses. Registra- 
tion limited to 60 for each conference. 
Fee; $15. A minimunn of 40 registrants 
required for each conference. For 
further information, write to: Ms. E. 
Morrow, Continuing Nursing Educa- 
tion, Hospital for Sick Children, 555 
University Ave.. Toronto. Ontario, 
M5G 1X8. 

February 18-22, 1974 

Occupational health nursing program 
for registered nurses employed in 
the field of occupational health nurs- 
ing. Fee: $95. For further information, 
write to: Continuing Education Pro- 
gram for Nurses, Faculty of Nursing, 
University of Toronto, 50 St. George 
St., Toronto, Ontario. 

March 1-3, 1974 

Orthopedic Nurses' Association, first 
national congress, Atlanta, Georgia. 
For further information, write to: Clara 
A. Donahoo, Executive Director, Suite 
705, 1938 Peachtree Rd., N.W., Atlan- 
ta, Ga. 30309, U.S.A. 

April 5-6,1974 

Annual Stewart Research Conference 
and celebration of the 75th anniversary 
of the department of nursing education. 
Teachers College, Columbia Universi- 
ty, New York. Fee: $25. For information 
and reservations, write to: Dr. M. Louise 
Fitzpatrick, Chairman, Stewart Re- 
search Conference, Box 150, Dept. 
of Nursing Education, Teachers Col- 
lege, Columbia U., 525 W. 120th, New 
York, N.Y. 10027, USA. 



April 29-30, 1974 

Ambulatory Pediatric Association, 14th 
annual meeting, Sheraton-Park Hotel, 
Washington, D.C. Abstracts are invited 
to be considered for presentation at 
the scientific sessions. For further in- 
formation, write to: E.S. Hillman, M.D., 
Montreal Children's Hospital, 2300 
Tupper St., Montreal 108, Quebec. 
JANUARY 1974 



May 2-4, 1974 

Vancouver General Hospital 75th anni- 
versary, gala celebration and alumni 
banquet. Regency Hyatt Hotel, Van- 
couver, B.C. For further information, 
write to: Executive Secretary, VGH 
Alumni Association, 2851 Heather St., 
Vancouver 9, B.C. 

April 25-26,1974 

27th national conference on rural 
health, sponsored by the American 
Medical Association, The Detroit Hil- 
ton, Detroit, Mich. Theme: "Rural Health 
is a Community Affair." Registration 
fee: $25. For further information, write 
to: B.L. Bible, Ph.D., Dept. of Rural 
Health, American Medical Association, 
535 N. Dearborn St., Chicago, III. 
60610, USA. 



April 25-27, 1974 

British Columbia Operating Room 
Nurses Group, fourth biennial institute, 
Hotel Vancouver, Vancouver, B.C. For 
further information and advance regis- 
tration, write to: Ms. Jean Lowery, *1 - 
7151 CambieSt., Vancouver, B.C. 

May 5-10,1974 

Third Canadian Operating Room 
Nurses' convention. The Queen Eliza- 
beth Hotel, Montreal, Quebec. For 
additional information, write to: Ms. 
Peggy Iton, c/o Jewish General Hospi- 
tal, 3755 Cote St. Catherine Road, 
Montreal 249, Quebec. 



May 8-10, 1974 

Annual meeting. Registered Nurses' 
Association of British Columbia, Bay- 
shore Hotel, Vancouver, B.C. 



May 27-28, 1974 

Alumni committee, faculty of nursing. 
University of Western Ontario, third 
annual conference. Symposium enti- 
tled "Today's Youth — Problems, Cop- 
ing and Helping" will be led by Dr. 
Fritz Redl. For further information. 



write to: Ms. Dorothy Hart, Publicity 
Chairman, 895 Richmond Street, Lon- 
don, Ontario. 



June 7-8, 1974 

Third workshop on neurological edu- 
cation, Dalhousie Medical School, 
Halifax, Nova Scotia. For further infor- 
mation, write to: Chairman, Dr. T.J. 
Murray Dalhousie University, Halifax, 
Nova Scotia. 



lune 16-21, 1974 

Canadian Nurses' As- 
sociation annual 
meeting and conven- 
tion, to be held in the 
Manitoba Centennial 
Centre Concert Hall, 
Winnipeg, Manitoba. 



^ 

^^P 



June 17-19, 1974 

Emergency Nurses Association of 
Ontario, third annual conference. Royal 
Connaught Hotel, Hamilton, Ontario. 
For further information, write to: Ms. 
Jean Grote. 137 Duke St., Apt. 4. Ham- 
ilton, Ontario L8P 1X8. 



August 12-16, 1974 

Sixth international congress of the 
World Federation of Occupational 
Therapists, Vancouver, B.C. Theme: 
■'Occupational Therapy Health Care 
in the 70's." Registration from all 
health professions welcome. Direct 
enquiries to: World Federation of 
Occupational Therapists, Total Park 
Convention Centre, University of B.C., 
Vancouver 8, B.C. 

August 15-18, 1974 

Victoria Public Hospital, three-day 
homecoming reunion, coinciding with 
the final graduation exercises of the 
school of nursing. Former directors 
and graduates of the school should 
write to: Ms. Shirley Farrell. Publicity 
Chairman, VPH Alumnae, Apt. 20, 15B 
Waggoners Lane, Frederlcton, New 
Brunswick. W 

THE CANADIAN NURSE 37 



names 




Nancy Garrett has 

left her position at 
CNA House in Ot- 
tawa to work in a 
less frigid climate. 
She has accepted a 
two-year assignment 
with a team from 
Harvard University 
to work in Yaounde, 
the capital of Cameroun. 

Under the auspices of the Centre 
universitaire des sciences de la sante, 
the two physicians and two nurses will 
train nursing students who are aiming 
at what corresponds to our baccalaure- 
ate degree. The team will supply the 
maternal and child health component 
to the center. 



Ada McEwen, national director, has 
announced the appointment of Lorette 
Morel Sutton as an assistant director at 
the national office of the Victorian Or- 
der of Nurses for Canada in Ottawa. 

Ms. Sutton (B.Sc, 
public health nurs- 
ing, M.Ed., U. of 
Ottawa) was former- 
ly health education 
and nursing consult- 
ant for the Cana- 
dian Tuberculosis 
and Respiratory 
Diseases Associa- 
tion. Her new responsibilities include 
the identification of educational needs 
of VON staff and the development of 
programs to meet them. 



Dawna Sedun (Rcg.N., Hosp. for Sick 
Children, Toronto) has been appoint- 
ed infant nutrition/family planning 
specialist with Wyeth Ltd. 

Ms. Sedun was re- 
cently employed as 
a medical represent- 
ative with a major 
pharmaceutical 
company in the To- 
ronto area. In her 
» '. r» ■' new position she 

J will be responsible 

JhL ""iGtM.. for maintaining liai- 
son between Wyeth Ltd. and hospital 
and clinic personnel who deal with 
infant nutrition and birth control. She 
will be located at the company's execu- 
tive office in Toronto. 
38 THE CANADIAN NURSE 





At its annual meeting in Montreal in 
November, the Association of Nurses 
of the Province of Quebec gave a 
reception in honor of Alice Girard, at 
which time she was presented with a 
brooch. 

Dr. Girard. who recently retired as 
dean of the faculty of nursing at the 
University of Montreal, has accepted 
an appointment on the teaching staff 
of the school of nursing at the Univer- 
sity of Moncton, Moncton, N.B. 



Appointments and reinstatements to the 
nursing faculty of Mount Saint Vincent 
University, have been announced; 

M. Marguerite Muise, B.Sc.N., M.S., 
is coordinator of the nursing program. 
She had been on the faculty of the uni- 
versity for four years prior to working 
a year as staff nurse at St. Vincent's 
Hospital, Ottawa. 

Judith Arlene Allan, B.N.. is nursing 
instructor. She was formerly staff nurse 
at the Isaak W. Killam Hospital for 
Children, Halifax. 

Patricia Beattie Huggan, B.N., has 
been clinical instructor since 1972. Her 
previous experience includes public 
health nursing in Charlottetown, and 
hospital staff nursing in Eugene, Ore- 
gon, and Halifax. 

Marilyn Kelly, R.N., S.C.M., B.Sc.N , 
is chairman of the third-year basic 
degree program. She worked in Mel- 
bourne for several years, then was asso- 
ciate director of nursing education at 
Western Memorial Hospital, Corner- 
brook, Newfoundland, before joining 
the university faculty in 1972 as in- 
structor. 



Lillian Grady, who was made an 
honorary member of the Registered 
Nurses' Association of Nova Scotia at 
its annual meeting, retired as director 
of the department of nursing education 
at the Halifax Infirmary last August. 

Except for studies at St. Louis Uni- 
versity, St. Louis, Mo., to earn a 
B.Sc. (nursing education) and M.Sc. in 
nursing, Ms. Grady has devoted most 
of her long association with the Halifax 
Infirmary to furthering the education 
of nurses. 

Active in her profession, Ms. Grady 
has been president of the RNANS and 
president of the Atlantic Council of 
Catholic Nurses. 




Rachel Bureau of 

Quebec City accept- 
ed her third man- 
date as president of 
the Association of 
Nurses of the Prov- 
ince of Quebec at 
its annual meeting 
in November. It was 
during her terms of 
office that legislation affecting Quebec 
nurses was enacted. 

Other officers of ANPQ are: 1st vice- 
president (French), Pierrette Proulx, 
Montreal; 1st vice-president (English), 
Sheila O'Neill; 2nd vice-president 
(French). Yvan Lepage, Mont-Joli; 2nd 
vice-president (English), Judith Pink- 
ham, Montreal; honorary secretary. 
Pierrette Boucher. Montreal; honorary 
treasurer, Claire Royer, Sherbrooke. 



Nicole Du Mouchel, who was chosen 
by the Association of Nurses of the 
Province of Quebec to represent nurses 
on the interprofessional Council of 
Quebec, has been elected secretary to 
the council. Ms. Du Mouchel is the 
executive director and secretary-regis- 
trar of ANPQ. 



Bertha G. Lapointe 

has been appointed 
regional nursing su- 
pervisor in the Wey- 
burn-Estevan 
Health Region, 
Saskatchewan de- 
partment of public 
health. Ms. La- 
pointe (Reg.N., 
Regina Grey Nuns school of nursing. 
Regina; Dipl. Public Health Nursing, 
U. of Saskatchewan; B.N., McGill U., 
Montreal) has worked as a staff nurse 
in hospitals in Saskatchewan and Ottawa 
and as a public health nurse in Calgary 
and in Saskatchewan health regions. 

She was acting regional nursing su- 
pervisor for a year and assistant to the 
nursing supervisor in the North Battle- 
ford Health Region for two years prior 
to her present appointment. She suc- 
ceeds Muriel Niblett who retired in 
November. Ms. Niblett (Reg.N., Este- 
van General Hosp. School of Nursing; 
Dipl. Public Health Nursing, U. of 
Toronto) worked in Saskatchewan, in 
the Mayo Clinic, Rochester, Minn., and 
JANUARY 1974 




served in the Canadian Army overseas 
before joining liie staff ot the Weybiirn- 
Estevan Heahh Region as a public 
health nurse. 

She will Mve in \Ve\biirn and hopes 
to travel. 



C. Margaret Clark is the new director 
ot nursing at Joseph Brant .Memorial 
Hospital. Burlington. Ontario. The 
former director was Betty Davidson. 

Ms. Clark has been with the Royal 
Victoria Hospital in Montreal for sev- 
eral years, her most recent position 
there having been director of nursing 
and principal of the school of nursing. 



Barbara E. Burke, 

R.N., B.N.. M.Sc. 

(A), was recently 
appointed director 
of nursing at the 
Victoria General 
Hospital. Victoria. 
B.C. The former 
director of nursing 
at Doctors Hospital 
in Toronto. Ms. Burke had until 1972 
made Montreal and district her base. 
She has been on the nursing faculty of 
Dawson College. Westmount: assistant 
director of nurses, l^akeshore General 
Hospital in Pointe Claire; charge and 
seniitr staff nurse with the Victorian Or- 
der of Nurses in LaSalle and Montreal. 

On the occasion of the 40th anniver- 
sary of the school of nursing, celebrat- 
ed at its fall convocation, the University 
of Ottawa conferred honorary degrees 
on Sister Madeleine de Jesus (Corinne 
E. Latlamme) and Isabel Black. 






Sr. M. de Jesiis 



Isabel Black 



Sr. Madeleine de Jesus, professor 
emeritus, was recognized for her work 
as the first director of the school of 
nursing, a post she held from 1933 until 
her retirement in 1961. 

Ms. Black, principal nurse-consul- 
tant with the research and analysis 
division of the Ontario ministry of 
health, was given recognition for her 
work in nursing development in Can- 
ada. She is the author of several pub- 
lications dealing with the availability of 
clinical nurses and nursing education. 

JANUARY 1974 




Penelope Jessop, 

Reg.N.. B.Sc.N.. 
has been appointed 
nurse clinician, am- 
bulatory care de- 
partment. St. Jo- 
seph's Hospital. 
Hamilton. Her ex- 
perience as assistant 
director, staff edu- 
cation, at the Kmgston General Hos- 
pital and as clniical and classroom 
teacher ;.t St. Mary"s School o\ Nursing 
in Kitchener is being put to good use in 
her new position, which she finds 
"exciting and rewarding."" 

Ms. Jessop is co-author, with Fran- 
ces Howard, of "Problem -oriented 
charting — a nursing \ iewpoint"" 
{Caiuul. Mfrvc. August. 1973). 



C.N.A.M. Stokvis (S.R.N., S.C.M.) has 
been appointed director of the St. Boni- 
face General Hospital school of nurs- 
ing. Winnipeg. 

Ms. Stokvis, who was born in Hol- 
land, studied nursing in England. Her 
career there included work with the 
British Red Cross rehabilitation unit, 
research, and tutoring in midwifery. 

Since coming to Canada. Ms. Stokvis 
has been engaged in supervision and 
teaching, her most recent association 
being with the Metropolitan General 
Hospital in Windsor. Ontario, as clini- 
cal instructor of obstetrical nursing and 
assistant director of nursing education. 



Lucille E. Notter, Ed.D . R.N., has 

retired as editor of Niirsini^ Rcscanli. 
She has aisc) been editor of the /nicr- 
luitional Nursing Index. 

Concurrent with Dr. Notter's retire- 
ment is the release of her new book. 
Uiulcrstandini> Nnisini; Rcsciinh. 
published by the Springer Publishing 
Co.. New York City. Other published 
works include Professional Nursing. 



Elaine McClintock was appiiinted chair- 
man of the health sciences depailment 
of St. Lawrence College. Brockville. 
when the General Hi>spital school of 
nursing, of which she had been director, 
was t)fficially transferred tti the c\)llege. 
Ms. McClintock. 
B.Sc.N.. is a 1974 
c a n d i d a I e f o r a 
master's degree in 
educational admin- 
is t r a t i i> n I r o m 
Oueen"s University, 
Kingston. Prior ti) 
Joining the Brock- 
ville General Hos- 
pital school ot nursing in 1960. she had 
been a staff nurse with the Victorian 




Order of Nurses in BriKkville. Her 
present responsibilities, in addition to 
nmsing. include the allied health pro- 
grams of behavioral science and child- 
care worker. 



Several new appointments to the faculty 
ol nursing. Lakehead University. Thun- 
der Ba\ . Ontario, have been announced. 

Marjorie Wallington, R.N . B.Sc.N.. 
M.Sc.N.. assistant professor and acting 
chairman ol the faculty, has worked in 
Toronto for several years — as instruc- 
tor, then clinical nurse specialist, at the 
Toronto General Hospital, and as nurs- 
ing consultant with the minisir\ o\ 
health ol Ontario. 

Margaret Drummond Page, Reg.N., 
B.Sc.N., .M.P.H., assistant professor, 
has for the past two years been nursing 
consultant with the Ontario ministry of 
health. Toronto. Prior to this she wurk- 
ed in Thunder Bay (Port Arthur) in the 
areas of welfare and public health. 

Carolyn Wojtysiak Adams, B.A. 
Nurs.. M.Sc.N., special lecturer, com- 
pleted graduate studies in nursing at the 
University of Western Ontario durino 
the past y'ear. 




Catherine .Allan 




Lillian Hrudie 



Catherine Brewer Allan, Reg.N., 
B.Sc.N., M.S., lecturer, is returmiig to 
the faculty ot Lakehead L'niversiiy 
after completing her master's ilegree in 
public health nursing at the Universit\ 
ot Minnesota. Minneapi>lis. 

Lillian Callan Hrudie, Reg.N.. 
B.Sc.N., special lecturer, has been 
a teacher at Lakehead Regional School 
of Nursing tor the past two years. Prior 
to this she was on the leaching staff of 
St. Joseph's school ol nursing. Port 
Arthur. 

Elizabeth McNaught McCowatt, 
S.R.N.. S.C.M. . B.Sc.N.. special lectur- 
er, has taught at the Lakehead Regional 
School ol Nursing. For several years 
she worked at St. Joseph's General 
Hospital in Thunder Bay, first on staff, 
then as a teacher o^ obstetrics in the 
hospital's school of nursing. 

Elaine Peters Mullen, R.N., B.Sc.N.. 
special lectuier, has worked in Windsor 
and Detroit as a medical-surgical in- 
structor. She has more recentK been 
clinical assistant at the University ol 
Western Ontario school ot nursing in 
London, Ontario. 

THE CANADIAN NURSE 39 



names 



McMastcr University schodi of nurs- 
ing has anncHinccd new appointments 
to its t'aeuit\. 

Mariiyn Booth, B.Sc.N., lecturer, 
worked tor two years as a public 
health nurse in Etobicoke. t'ollowing 
graduation from McMastcr University. 

Oiga Darcovich, B.S.N., M.A., as- 
sistant pn^tessor. was recently clinical 



specialist in psychiatric nursing at 
McMastcr Univcrsitv Medical Centre. 

D. Joan Eagie, B.Sc.N., M.N.. as- 
sociate professor, school o\' nursing, 
and coordinator of pediatric care. 
Hamilton General Hospital, has been 
on the faculty of McMaster University 
school of nursing for several years. 

Mary Fawcett, B.Sc.N., lecturer. 
has. since 1961, been with the faculty, 
on an intermittent basis. 

Agnes Griffin, B.Sc.N., lecturer, 
has operated a group home in which 
the Children's Aid Society has placed 
young girls on a temporary basis. 




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40 THE CANADIAN NURSE 



Edith Murray, B.P.T., M.Sc., assistant 
professor, was previously assistant 
professor in the department of rehabili- 
tative medicine. University of Sas- 
katchewan. 

Cornelia P. Porter, B.S.N. , M.N.Ed., 
assistant professor, has worked in 
various capacities at the Pediatric 
Continuity Clinic of the University 
of Rochester. 

Mariiyn A. Ray, B.Sc, M.Sc, assis- 
tant professor, has held teaching posi- 
tions in medical-surgical nursing and 
maternal-child nursing at the University 
of California school of nursing, San 
Francisco. 

Marjorie E. Shaw, B.Sc.N., lecturer, 
has held various positions with the 
Montreal Children's Hospital, most 
recently serving as home-care coordi- 
nator. 

Ceciiy Margaret Smith, R.N., B.A., 
M.Ed., lecturer, has been a teacher 
at St. Joseph's Hospital school of nurs- 
ing in Hamilton. 

Grace E. Terry, B.Sc.N.. lecturer, 
has returned to the faculty after an 
absence o\' twx) years, during which she 
worked as staff nurse, then head nurse, 
at St. Joseph's Hospital in Hamilton. 



Helen Gary, R.N., B.S.N., a head 
nurse at St. Paul's Hospital, Vancouver, 
was the recipient ot the Innovative 
Nurse Award in recognition of her 
project on prnnary nursing care con- 
ducted at that hospital. This award was 
established to give recognition to 
Greater Vancouver District registered 
nurses who have implemented methcxls 
to facilitate patient care, and to offer 
financial support toward organizing 
and implementing such methods. 



Jean Laing of Toronto was elected pres- 
ident of the Ontario Occupational 
Health Nurses' Association at its an- 
nual meeting. She succeeds Patricia 
Ewan of Niagara falls. 

Dorothy Schwah of St. Catharines is 
first vice-president and Gail Pearson 
of Guelph. secretary. 

Roy Harding (R.N., St. Josephs Hos- 
pital school of nursing. Victoria; Dipl. 
Nursing Service Admin., Dalhousie 
U., Halifax), is earning his M.D. at 
Dalhousie University. 

Mr. Harding's professional exper- 
ience has included that of "medic" on 
an off-shore oil rig, where he looked 
after the general health of the rig's 
personnel and rendered emergency 
treatment when necessary. He was. tor 
two years, chairman ot the social and 
economic welfare committee of the 
Registered Nurses' Association of Nova 
Scotia. '■■^' 

JANUARY 1974 



in a capsule 



Hepatitis from clams 

A letter to the editor of the Joiinuil of 
The American Medical Association 
(Oct. 2y. 1973) tells how five of six 
persons who ate clams at a family reun- 
ion became ill with hepatitis. 

Apparently it is not enough merely 
to steam clams until they open, usually 
within the first minute of steaming. 
The two physicians who wrote the 
article advise that inadequately steam- 
ed clams may indeed transmit hepatitis, 
and that inadequate probably means 
failure to steam the clams "for at least 
4 to 6 minutes." 



Health, health, health 

A major new, prime time TV series 
on health, designed for an adult 
audience, is being developed by the 
Children's Television Workshop, 
creators of "'Sesame Street," and will 
premiere in the fall of 1974. 

A total of 26 original, hour-long 
programs will be created for the series" 
first experimental season, providing 
practical health information in an 
entertaining and instructional form. 

A primary target audience of the 
program will be the young parents who 
play major roles in the general health 
and nutritional well-being of their 
immediate families. The needs and 
problems of the poverty family will be 
of particular concern to the producers. 

The overall objective of the series 
is to get people to improve the level of 
their own health and that of their 
family. Health is closely related to life- 
style and the individual has much great- 
er ptiwer than most people realize to 
maintain his or her own health and 
to prevent illness. 



Have wheelchair, can travel 

The attractions of travel in Canada, 
the United States, Mexico, and Puerto 
Rico can be realized by the handi- 
capped. A guide is now available to help 
handicapped travelers decide on their 
destination. 

Hie Wheelchair Traveler, which is 
described in the September 1973 issue 
of C.A.R. Scope (published by the Ca- 
nadian Arthritis and Rheumatism 
Society), is the name of a guide that 
lists all the information available on 
facilities at each hotel ;ind motel, res- 
lANUARY 1974 



taurant, or resort. The listings were 
supplied by handicapped travelers and 
organizations for the handicapped. 
Douglas R. Annand. a paraplegic who 
has spent 20 years in a wheelchair, edit- 
ed the information. 

For information about this guide, 
write to The Wheelchair Traveler, 
Ball Hill Road. Milford, N.H. 03055. 



Progress for European women 

The first issue of Women at Work, 
published in October 1973 by the 
Women's Bureau, Canada Department 
of Labour, mentions some better deals 
for women in France and England. 

In France, the government is draft- 
ing new legislation that would give 
mothers retirement pensions. The 



legislation, which was expected to go 
before parliament by the end of 1973, 
would give pensions' to mothers, mar- 
ried or not. who have had no regular 
paid work and have devoted them- 
selves fully to their family duties. Ac- 
cording to information from the Minis- 
try of Labour, more French women 
between 20 and 55 years of age work 
outside than inside the home. 

in England, women in the public 
service receive three months' paid 
maternity leave and a further three 
months' leave without pay if necessary. 
Government departments have also 
been encouraged to arrange office 
hours to suit employees' needs; there 
are provisions for extra unpaid leave 
for men or women to cope with domes- 
tic duties. ^^ 




THE CANADIAN NURSE 41 



research abstracts 



The tbilowing arc abstracts of studies 
selected from the Canadian Nurses" 
Association Repository ("oliection ot 
Nursing Studies. Abstract manuscripts 
are prepared by the authors. 



Kezala, Wiiton S. The comfort of pci- 
licnts in traction: a descriptive study. 
Montreal. P.O., 1972. Thesis (M.Sc. 
(Appl.)) McGill U. 

This study describes the behaviors of 
patients who were immobilized in 
traction in a general hospital. Its pur- 
pose was to ascertain the relative de- 
grees of comfort or discomfort these 
patients had. Comfort was conceptual- 
ized as a state of being revealed through 
the patient's behaviors in two respects, 
the amount of physical restlessness he 
exhibited and the nature of ciincerns 
he expressed. 

The method used in investigating 
patients' behaviors was direct observa- 
tion. Data collection was carried out at 
various times of the day. and all pa- 
tients on one ward who were in tractii)n 
were i>bserved more than once during 
the investigative period. 

The findings revealed the following. 

1 , Some degree of physical restless- 
ness existed in all patients, and it ap- 
peared to have three main compo- 
nents, physical movement, change o\ 
focus of activity, and behaviors indica- 
tive of pain. 

2. Almost without exceptiiMi these 
three aspects t)f restlessness co-varied. 
That is. continuous physical movement 
was asstKiated with frequent change 
of activity and numerous pain behav- 
iors. Conversely, infrequent physical 
movement, infrequent activity change, 
and few pain behaviors oceured to- 
gether. 

.\ Patients exhibited varying degrees 
of physical restlessness, as described 
by behaviors related to the above 
three factors. What was probably some 
kind of continuum from a very high 
to a very low degree of restlessness 
was conceptualized in the three cate- 
gories of high, moderate, and low rest- 
lessness. An elevated bed and skeletal 
traction tended to be associated with 
a high degree of restlessness. 

4. Patients who were very restless 
and were therefore in pain gave speci- 
fic instructions to the nurses about how 
to handle their (patients'! injured limbs. 
42 THE CANADIAN NURSE 



Nurses usually responded to the pa- 
tients" instructions, and patients appear- 
ed relieved. 

.^. Very restless patients appeared 
to become less restless when they 
were with their relatives, but this did 
not seem to occur when they were with 
others. 

6. Patients sought advice from nurses 
and from fellow patients concerning 
pain and their treatment. When they 
received the advice, they used it to 
cope \v ith their pain and disctimfort. 

7. Very restless patients and younger 
patients appeared to be concerned w ith 
the immediate recovery in hospital, 
whereas the less restless patients and 
older patients, except those who were 
in skeletal traction, appeared to be 
concerned with the later (ultimate) 
recovery at home and about their home 
affairs. 

On the basis o\' these findings it was 
seen that patients in traction experience 
varying degrees of ph>sical. as well as 
psychological, comfort and discomfort. 
To reduce patients" discomfort would 
therefore require nurses to recognize 
the contributing factors outlined in this 
study. 



Macdonald, Myrtle I. Tlw circumstan- 
ces in wliicli postoperative patients 
and their nurses determine need for 
an anali>esic. Montreal. P.O., 1971. 

Thesis (M.Sc. (Appl.)) McGill U. 

This study was undertaken to discover. 
1 . the circumstances under which nurses 
perceive the possibility of patients 
having pain. 2. the factors nurses con- 
sider vshen determining the need for an 
analgesic. }. the factors patients con- 
sider when deciding to ask lor st)me- 
thing l(.)r pain, and 4. whether there is 
delay in carrying out requests of pa- 
tients lor analgesics. 

Data were collected by participant 
observation in three surgical units. 
All postoperative patients and nurses 
involved in decisions about analgesics 
during the observation periods were 
included in the sample. The sample 
consisted of 94 instances, 72 of giving 
and 22 of not giving analgesics to .^8 
patients. 

Findings sht)w that there were four 
ways that nurses perceived the possibil- 
ity of the patient needing an analgesic: 
1 . perceiving evidence of pain firsthand 



while the patient was moving or being 
moved. 2. receiving reports of pain or 
requests for an analgesic from the pa- 
tient. }. anticipating pain through 
knowledge gained firsthand in previous 
nursing interaction, or through formal 
and informal reports, and 4. anticipating 
need for an analgesic through theore- 
tical knowledge and routine practice. 

Decisions by patients" nurses to give 
or withhold analgesics were based 
largely on evidence gained while nurs- 
ing patients and fell into the first cate- 
gory, and "medication nurses"" made 
their decisions on the basis of the last 
three forms of evidence. 

Even when they were at the bedside, 
"medication nurses"" seldom noticed 
nonverbal signs of pain. The data sug- 
gest two reasons, they did not see the 
patient in movement, and their atten- 
tion was focused on the routines of 
giving medications. If they anticipated 
pain, they obtained further information 
by going to the patient or his nurse. If 
on the other hand, the patient"s nurse 
requested an analgesic, the "medica- 
tion nurse"" gave it without further 
assessment of pain and gave it imme- 
diately with no more than 10 minutes" 
delay. 

Patients cried out in surprise from 
pain when they were turned early 
after surgery, then learned to brace 
themselves, next to report pain, and 
later to ask for an analgesic. The call 
light was used only four times by pa- 
tients during the observation period 
and never before the fifth postopera- 
tive day. 

Decisions to ask for an analgesic 
were based on a number of the follow- 
ing factors, the previous advice of 
doctor or nurse, a desire for rest or 
sleep, the steadiness and/or severity 
of pain in comparison with other exper- 
iences of pain, the need to be brave, 
the fear of addiction, and the knowledge 
ol other ways to cope with pain. To 
weigh a number of these factors and 
then wait for a nurse to come into the 
room took as long as two hours. 

rhe use of analgesics to promote 
movement was not understood by pa- 
tients, for analgesics were considered 
to have a sedative effect, opposite 
to the objective of movement. 

There were 12 cases of unreported 

pain noticed by nurses, all occurring 

after the second postoperative day. 

Nurses" criteria for assessing pain 

JANUARY 1974 



after the second clay were vague. Thev 
missed and/or misinterpreted some 
nonverbal signs ot pain. They had 
dit't'iculty describing pain, and the words 
used implied assumptions as to 
etiology. 



Carleton, E. Gail. Relationships be- 
tween itniminied mothers and their 
newborn infants in hos/>ital. Mont- 
real.P.0..iy7I.Thesis(M.Sc.(Appl.)) 
McGill U. 

Using qualitative research methods, 
this descriptive study was designed to 
investigate interaction between un- 
married mothers and their infants as it 
occurred during the time each infant 
was being fed by his mother. Partici- 
pant observation was the approach used 
to collect data during the first feeding 
period on postpartum day one. and 
during one feeding periled on each of 
the four subsequent postpartum days 
for each dyad. 

The study was conducted on the 
.^5-bed obstetrical unit of a 266-bed 
general hospital. 

The sample included 9 unmarried 
mothers and their newborn infants. 
Both mothers who were planning to 
keep their infants in their own care and 
those who were placing their infants 
for adoption were included in the 
sample, the relevant criterion being 
that the mother was feeding her infant 
during the Hve-day hospitalization 
pericxi. 

Data analysis began early in the 
period of data collection. Through this 
joint process the specific research 
question was formulated, and. later, 
a classification system v\as evolved. 
Using this classification system, the data 
from 45 feeding periods ot 45 minutes 
were analyzed. 

Four patterns of mother-infant rela- 
tionships were identified in the daUi 
and described in detail. These patterns 
could be distinguished from one anoth- 
er in that two of the patterns were 
characterized by the diversified behav- 
iors of mothers and infants (changing 
from day to day), while the other two 
patterns were characterized by non- 
diversified behaviors of mothers and 
infants (much the same trom day to 
day). 

Of the two nondiversified patterns, 
one was remarkable for the physical 
closeness between mother and infant 
and the passivity of each over the five 
days {close-passive pattern): the second 
was remarkable for the physical dis- 
tance between mother and infant and 
the relative activity of each over the 
tlve days (distant-active pattern). 

7 he two diversitled patterns could 
be differentiated from each other by 
JANUARY 1974 



the progression of the behavioral 
changes observed. One o\ them was 
marked by the lluctuating nature of 
both mother and infant behaviors from 
day to tlay {H net nation pattern). In 
contrast, the other pattern had a rela- 
tively smooth progression of changes 
from day to ilay — gradually, a balance 
was achieved where the infant was 
alert and sucking well and the mother 
was anticipating his needs and respond- 
ing to them etfectively (developmental 
pattern). 

Within the limits of the small sample, 
the findings of this study indicate that 
patterns of nuuher-infant relationships 
cannot be differentiated on the basis of 
ethnicity of the mother, nor on the 
basis of whether she plans to rear the 
infant herself or relinquish him for 
adoption. There are. however, implica- 
tions that some features of the close- 
passive pattern and the fluctuation pat- 
tern may be specific to teenage moth- 
ers. For this reason, further research 
is indicated to study a large sample of 
both married and unmarried mothers 
to identity the existence of these and 
other patterns of mother-infant rela- 
tionships developing over the tlrst 
five days postpartum. 

This study also raises other ques- 



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tions for nursing research. I. Are there 
iilentifiable nursing care needs of 
molher-intant dyads displaying each of 
the four patterns of relationship'.' 2. Are 
there specific patterns of interaction 
between mothers and nurses, which 
coexist with specillc patterns of mother- 
intant relationships'.' 3. How are nurses' 
behaviors affecting the individual moth- 
er-infant dyads that display a particular 
pattern of relationship'.' 

Furnell, Margery D. Adolescent de- 
pression and interpersonal behavior. 
Vancouver.B.C.iy7.^.Thesis( M.S.N.) 
U. ol British Columbia. 

Adolescents may be particularly vul- 
nerable to depression. Yet public health 
nurses working with large groups of 
adolescents arc often unable to recog- 
nize depressed youths, due to the lack 
ol simple, reliable screening tools. This 
exploratory study was undertaken to 
gain information that could be used 
to develop such a tcxil. 

Specifically, the folknving question 
was posed. ""Are there modes of relat- 
ing interpersonally that can be used to 
distinguish the highly and moderately 
depressed adolescent from the non- 
depressed adolescent'.'"" The answer 
was sought trom information obtained 
from adolescent self-reports on Beck's 
Depression Inventory and an adapted 
and pretested tbrm of McNair and 
l.orrs Interpersonal Behavior Inven- 
tory. These inventories were adminis- 
tered to 25 adolescents who attended a 
treatment center for adolescents with 
emotional problems and 77 randomly 
selected adolescents w ho attended four 
Catholic high schools in Vancouver. 

Adolescents were classified as non- 
depressed, moderately depressed, and 
highly depressed on the basis of their 
scores on Beck's Depression Inventory. 
An analysis of variance was carried 
out to disciwer if there was a significant 
difference in interpersonal behavior 
scores of ncmdepressed. moderately 
depressed, and highly depressed ado- 
lescents. A simple regression analysis 
and a multiple stepw ise regression anal- 
ysis was done to see if there was a 
significant correlation between any 
interpersonal behavior categories that 
could distinguish between the non- 
depressed, moderately depressed, and 
highly tiepressed adolescent. 

The findings supported the overall 
conclusion, adolescents who exhibit 
mistrust, competition, and detachment 
most iif the time or all of the time and 
exhibit dominance only some of the 
time, iir not at all. may be nnxicralely 
or highly depressed adolescents. 

The findings did not support the 

generally held thesis that supressed 

hostility is an important factor in the 

depressed person. "u? 

THE CANADIAN NURSE 43 




Emergency Medical Guide, 3ed., by 

John Henderson. 651 pages. To- 
ronto, McGraw-Hill Rycrson, 1973. 
Reviewed hy Nicole Marchak. Direc- 
tor. National Department of Family 
Health, Canadian Red Cross Society , 
Toronto, Ontario. 

It is difficult to classify this book in any 
particular category and it is even more 
difficult to clearly understand for whom 
it is written. The author states that the 
book is neither a first aid book nor a 
medical textbook; it is rather "a view in 
depth ot many pressing medical prob- 
lems which could face a person at some 
time." 

The result is a unique product, not 
concise enough to serve the purpose of 
a text on first aid and not sophisticated 
enough to be used by medical or nursing 
students. It has been written according 
to a definite medical mcxlel (signs, 
symptoms, treatment) and I wonder if 
it were written for in-between groups 
such as medics or physicians' assistants. 

Ten chapters are dedicated to major 
first aid concerns such as resuscitation, 
hemorrhage, shock, fractures, poison- 
ing. In methods of artificial respiration, 
the author describes mouth-to-mouth 
resuscitation and also the modified 
Silvester method and the Holger Niel- 
son method. 

Experts have practically abandoned 
the teaching of the latter two (especially 
Holger Niclson) because, except in rare 
cases, mouth-to-mouth remains the 
simplest and most efficient technique of 
artificial respiration. 

The technique of external cardiac 
massage is described and. although this 
is a dangerous procedure, the author 
does not seem to be concerned with the 
possible serious damages to the body 
if this procedure is carried out by 
amateurs. 

Personally, I would not wish to have 
"a person" apply a downward pressure 
of 70 to 90 pounds on the lower third of 
my breastbone so that it moves one to 
two inches toward my spine — even 
though this "person" has been warned 
by the author not to pressure my ribs 
with his or her fingers and not to get 
excited, because the ribs could be 
broken or the heart muscle bruised. 

One chapter is dedicated to anatomy 
and physiology and this seems beyond 
the purpose of writing for emergencies. 
Discussion of drug abuse is a popular 
44 THE CANADIAN NURSE 



topic these days and is included in the 
bcxik, along with emergency child birth. 

The author seems to think that pain- 
ful menstruation is a medical emergency 
and has listed a series of exercises to 
improve posture and develop pelvic 
structure for the young woman. Also 
thrown in as a bonus are basic home 
nursing techniques, a schedule for ac- 
tive immunization of infants, and an 
immunization record. 

It is deplorable that the author has 
tried to cover too much with one pub- 
lication; his objective remains obscure. 
It does not seem to contain inaccurate 
facts and could be interesting for an 
individual who feels quite nostalgic 
about not having trained as a medical 
doctor. 

Ihis book would not be convenient 
for a true first -aider nor for professional 
workers in hospital emergency wards. 



Psychiatric Nursing, 9ed., by Margue- 
rite Lucy Manfreda. 557 pages. 
Philadelphia, F.A. Davis Company, 
1973. Canadian Agent: McGraw- 
Hill Ryerson, Scarborough, Ontario. 
Reviewed liy Jean Forrest, Asso- 
ciate Professor, Faculty of Nursint;, 
The University of IVestern Ontario, 
London. Ontario. 

The ninth edition of this book reviews 
the current field of mental illness and 
psychiatry as an introduction to psy- 
chiatric nursing. Psychiatric care today 
indicates intervention by a variety of 
health professionals. This book includes 
a rather limited description of a team 
approach tor the individual's care. 

Ihe needs of each individual requir- 
ing psychiatric care are indicated in 
Unit 5, but are not followed through 
in Unit S to a sufficient degree. The 
medical model, used by this author, is 
increasingly under consideration and 
question as a method of practice for 
other members of the health team. 

As members of the team, nurses 
must assess the behaviors, thoughts, 
and feelings that have brought the 
individual for professional help, either 
voluntarily or involuntarily. By care- 
ful assessment, the nurse can establish 
therapeutic nursing in collaboration 
with other members of the psychiatric 
health team. 

Unit 8 is focused on the behavior 
and nursing care of patients. By using 



the medical model as the basis for 
discussion of nursing care, there is 
limited reference to the current nurs- 
ing modalities now being described in 
the literature. 

Nurses are practicing in one-to-one 
therapeutic relationships, as leaders or 
co-leaders in therapeutic groups, as 
nurse family therapists, as behavior 
therapists, as milieu therapists — what- 
ever the method of treatment, the 
nurse by therapeutic use of self and 
a variety of techniques permits the 
individual to move to more acceptable 
behavicH". 

Several chapters are worthy of men- 
tion, chapters 10, II, 12, 13, and 14 
have a succinct review of behaviors, 
patterns, and symptoms that require 
assessment. Chapter 29 has a good 
review of the current drugs and their 
side effects. 

This reviewer believes that a book 
with a title of Psychiatric Nursing 
should include a broader base and 
clearer discussion of current nursing 
practice related to the modalities now 
being described in the nursing liter- 
ature. 

Foundations of Pediatric Nursing, 2ed., 
by Violet Broadribb. 500 pages. 
Toronto. Lippincott. 1973. 
Reviewed hy Carolyn Roberts, As- 
sistant Professor, Faculty of Nurs- 
ing. University of IVestern Ontario, 
London. Ontario. 

Often the second edition of a textbook 
differs little from the first. However, 
the author of Foundations of Pediatric 
Nursing has revised and expanded the 
first edition considerably. 

Ms. Broadribb purports to have pre- 
pared a book on pediatric nursing that 
provides a basis from which a student 
"... can build to the depth and breadth 
she needs and desires. The emphasis is 
on getting started .... The student 
needs practical help as well as broad 
guidelines." Thus, the intent is a basic, 
practical text. As such, the emphasis is 
on the what and the how, rather than the 
why of pediatric nursing. 

The book has much to recommend it. 
The text is supplemented by illustra- 
tions, tables, and case studies that 
facilitate acquisition of the material. 
On the whole, the material is current 

(Ci'iiliiiiu'il oil piiiic 46) 
JANUARY 1974 



Pampas 




ives 



you both 

abeak 



Ceeps WM 7-7 ^ Saves 

him drier ■ /^ ^ fl you time 

Instead of holding ^^V JI^K^^^ ^^ Pampers construction 

moisture, Pampers ^^^ ^^^^Bl^ J helps prevent moisture 

hydrophobic top sheet ■ ^^^^B f from soaking through 

aUows it to pass fc-^^^fc^ ^^HFW k and soiling linens. As a 

through and get M-^^J^^ g" '^W^'^Lw^ ' result of this superior 

ba^'sSom^t^ ^m^ 1\ ^V as they would with 

drier than it would in tKT iA ' *■ ^ ^^ conventional cloth 

cloth diapers. ^^' "^^ JMI|tJ %*.-. diapers. And when less 



time is spent changing 
linens, those who take 
care of babies have 
more time to spend on 
other tasks. 



ritOCTEK i GAMBLE 




(Conliiuicd from /)(',i,'i' 44) 
and reflects areas of increased concern 
in pediatrics, such as drug abuse, neo- 
natal intensive care units, the stages of 
grief, and the concept of prcspeech 
training for infants with cleft palates. 
The text is most explicit in what to do 
and how, over a broad range of skills 
from Apgar scoring to the use of a uri- 
nometer. 

The author states "" . . . no attempt 
is made in this book to delve deeply 
into the psychological aspects of child 
behavior." It is this aspect of pediatric 
nursing that this reviewer found to be 
most uneven. For example, the psycho- 
logy of the family and the child with a 
chronic or terminal illness is discussed 
adequately, but for those concerned 
with the battered or burned child, the 
author alludes cursorily to some of the 
salient psychodynamics without clinical 
application. 

The role of the nurse in counseling 
parents of retarded children is a cogent 
and succinct presentation, but the dis- 
cussion of the eneuretic child is incon- 
sistent with the research of the last 
decade in terms of both etiology and 
treatment. 

As this is an American text, infor- 
mation on such matters as immunization 
schedules and legalities specific to 
pediatric nursing do not apply to the 
Canadian practitioner. 

This reviewer regrets some of the 
deletions from the first edition, includ- 
ing the sample PKU menu and the 
homemade play materials. 

As a technical, how-to book on 
pediatric nursing, this is a dandy that 
should have a place in the library of 
everyone interested in pediatric nursing. 



Introductory Maternity Nursing, 2ed., 
by Doris C. Bethea. 276 pages. To- 
ronto, Lippincott, 1973. 
Reviewed by Mary Ellen Driscoll, 
Staff Nurse, St. Joseph's Hospital, 
Saint John, New Brunswick. 

In the preface the author states, "the 
purpose of this second edition is to 
present the latest information and 
trend of thinking in the area of mater- 
nity nursing." With the exception of 
her discussion of certain aspects of 
neonatal care, such as oxygen admin- 
istration, indications for phototherapy, 
congenital heart disease, and temper- 
ature control, the author has certainly 
fulfilled her purptise. 

In the chapter, "The Family and 
Pregnancy," she has given necessary 

46 THE CANADIAN NURSE 



attention to the possible effects a preg- 
nancy can have on the entire family. 

The author has included the high 
risk mother in this edition. The medical 
conditions that may cause an expectant 
mother to be classified as high risk are 
well presented; however, the author 
expresses some questionable views, 
in this day and age, in relation to the 
social conditions that may cause an 
expectant mother to be considered high 
risk. 

The title of this book is misleading. 
It is not an introduction to maternity 
nursing per se, but rather is a pertinent, 
up-to-date summary of the highlights of 
reproductive physiology — an excellent 
and necessary companion to a maternity 
nursing care text. 



Problem Pregnancy and Abortion Coun- 
seling, edited by Robert R. Wilson. 
120 pages. Saluda, North Carolina, 
Family Life Publications, 1973. 
Reviewed by M.T. Mildred Morris, 
Assistant Professor. Scluxtl of Nurs- 
ing, University of Ottawa, Ottawa. 
Ontario. 

This book is designed for anyone who 
counsels those who have a problem 
pregnancy. It may be used as a training 
manual or as a resource. Several authors 
have contributed to this excellent work. 
The specific techniques the counselor 
needs to be nondircctive and nonjudg- 
mental are presented in detail. 

The first chapter covers the coun- 
selor's primary role in helping the 
woman decide upon a course of action. 
The author emphasizes that the coun- 
selor's goals must be focused on the 
examination of alternatives and on the 
decision-making process, rather than 
on attempting behavioralchange and/or 
tension reduction. By accepting and 
understanding the client's situation, by 
providing information, and by enabling 
her to face the decision-making pro- 
cess and come up with an alternative 
she can live with, the woman is helped 
to make a decision. Whenever possible 
and appropriate, the male is included 
in decision making. 

The following chapters deal with 
the alternatives in continuing the preg- 
nancy and the abortion alternative. 
However, the decision is not treated 
as absolutely final. 

In the second chapter, the role of the 
male partner is further emphasized. In 
counseling for keeping the pregnancy, 
the areas deserving concentration are; 
the future of the child, and using the 
pregnancy experience as an opportu- 
nity for learning and growth. The prob- 
lems that may emerge during an un- 
planned pregnancy and their possible 
solutions are treated at length. The 
alternatives of keeping the child or 



placing him for adoption are fully ex- 
plored. No pressure for either alterna- 
tive, but as free a choice as possible, 
is the main objective in counseling. 

The abortion alternative is presented 
in great detail in the third chapter. The 
three sections making up this chapter 
discuss abortion counseling, medical 
aspects of abortion, and the changing 
abortion laws. Abortion counseling 
means working with a woman who has 
made a responsible decision to seek an 
aboition. These sections provide more 
than adequate information for the 
counselor. 

To insure that a problem pregnancy 
will not recur, the woman requires 
help to establish a pattern of responsible 
sexual behavior, and instruction in the 
most reliable form of contraception that 
is acceptable to her. The concluding 
chapters contain information that will 
guide the counselor in helping his 
clients to avoid future problem preg- 
nancies. 

This book is highly recommended 
for anyone who counsels persons who 
have a problem pregnancy. It should 
enable counselors to cope in an intelli- 
gent, effective way with the problems 
presented by their clients. It would be 
a valuable addition to any nurse's 
library. 



The Teaching Function of the Nursing 
Practitioner, 2ed.. by Margaret I.. 
Pohl. 129 pages. Dubuque. Iowa. 
Wm. C. Brown Company. 1 973. Ca- 
nadian Agent. Burns& MacEachern, 
Don Mills. Ontario. 
Reviewed by E. Mary Buz.zell. As- 
sociate Professor, School of Nursing, 
McMaster University, Hamilton, 
Ontario. 

This book, which is an outgrowth of 
the author's research for her doctoral 
degree, is intended to assist nursing 
practitioners who desire to improve 
their teaching ability. In this new edi- 
tion, references at the conclusion of each 
chapter have been updated beyond 
1960. A new chapter on evaluating 
teaching and learning, plus added em- 
phasis on the period of convalescence, 
is indeed valuable. 

The objective of the book is achiev- 
ed. Content is built around the examina- 
tion of principles of learning and teach- 
ing with emphasis on teaching as the art 
of helping people learn. Factors affect- 
ing teaching and learning are described. 

Chapters dealing with subject matter, 
methods of teaching, and teaching 
materials are up-to-date and explicit. 
The information on planning for teach- 
ing and evaluation provide good exam- 
pies for the reader. 

(Ciiiiliiiiifil on inii;c 4Hi 

JANUARY 1974 



HOW do you handle 
a patient who wants to die? 

Or, how do you resolve a professional disagreement with a doctor. . .or deal with a 
tyrannical supervisor? Most nursing textbooks don't face up to these situations. 
Critical Incidents in Nursing does. 

Editors Loretta Sue Bermosk and Raymond CorsinI provide you with a collection of 
everyday human relations problems that confront today's nurse along, with accomp- 
anying commentary from a panel of specialists on how to approach each incident with 
regard to ethics and professionalism. 




A variety of ideas and a wide range of attitudes rise out of each situation. Some 
consultants may mirror your feelings; others may present opposing views. The 
editors point out that there are many ways to approach any interpersonal situation, 
and that these multiple approaches emphasize the complexity of the problems facing 
the nurse and the diversity of possible solutions. 

This unique book is patterned after "critical incident" volumes in other specialties. 
Selected incidents have been grouped into six areas of nursing interaction: with the 
patient, with other nurses, with doctors, with the family, with supervisors, and with 
the system. Editors' overviews precede each section, offering useful reading suggest- 
ions derived from experience with prior "critical incident" volumes. It provides a bene- 
.oial learning experience for any nurse. 

Ideally suited for classroom use or self-study. 

By Loretta Sue Bermosk, R.N., M.Litt., Professor, School of Nursing, University of 
Hawaii, Honolulu; and Raymond J. Corslnl, Ph.D., Research Affiliate, School of Pub- 
lic Health, University of Hawaii, Honolulu. 

369 pages. $11.85. Published June 1973. 



M 



W. B. SAUNDERS COMPANY CANADA, LTD. 

833 Oxford Street, Toronto, Ontario M8Z 5T9 

Please send me for; 

G my personal library 1[ for classroom adoption 

School 



Position. 



Name 



1696 Bermosk & Corsini : Critical Incidents In Nursing $11 .85. 
Address 



Prov. 



l_. 



CN 1 



74J 



JANUARY 1974 



THE CANADIAN NURSE 47 




(Coiiliniicil from piii,'i' 4fy) 

One of the strong points of the book 
is its organization. Each chapter con- 
tains a summary, excellent references, 
and is organized clearly, systematically, 
and concisely. The application to vari- 
ous nursing settings lends itself to use 
as a quick reference. 

In summary, this book is an excellent 
resource text for both nursing students 
and for graduates who are interested in 
improving their teaching. This revised 
book is a valuable addition to the other 
eight books in the Foundations of 
Nursing series. 



International Directory of Nurses with 
Doctoral Degrees. 106 pages. New 
York. American Nurses" Foundation, 
1973. 

The American Nurses" Foundation pub- 
lished its first Directory of Nurses 
with Eanu'd Doctoral Degrees in 1969. 
This was a follow-up to the list com- 
piled by Amy Frances Brown for an 
appendix to her Research in Nursing 
(Philadelphia. Saunders, I95S). Both 
these lists, and the 1970 and 1971 
supplements to the ANF Directory, 
were national compilations for the 
United States. 

C"anadians will be particularly 
pleased that the ANK has made this 
197.'^ edition international. Canada 
is next to the United States in havir.g 
employed within her borders the most 
nurses with earned dtKtoral degrees, 
that is. of the 55 nurses with earned 
doctoral degrees working outside the 
United States. 28 are in Canada. We 
must admit, of course, that Canada. 
as a neighbor of the United States with 
ready access to the many American 
institutions offering doctoral degrees 
in fields of interest to nursing, is in "a 
most favored country"" position in this 
regard. 

The nursing profession began to kx>k 
seriously at research in the 1950s. 
Nursing associations in many coun- 
tries agitated for more personnel and 
resources for this important aspect of 
the development of the profession. The 
Directories are an excellent indication 
that progress in both is being made. 

Dr. Brown listed 109 American 
nurses, and the 197.^ Directory"s inter- 
national total is 1,019 nurses with earn- 
ed doctoral degrees. (Somewhere the 
"Earned"" has been omitted from the 
handsome gold-on-blue cover of the 
1973 edition. This is surely a bindery 
oversight since the Preface and "A Word 

48 THE CANADIAN NURSE 



About the Entries'" on page ix makes 
the intent to cover only earned degrees 
quite clear.) 

The entries in the Directory include 
more information than in previous 
Directories. The data on clinical inter- 
est areas, working experience, and 
current employment status and field 
extend its usefulness for employers and 
research departments seeking personnel 
with special qualifications. For exam- 
ple, an individual whose doctoral 
studies 10 years ago were in a specific 
clinical area may have proceeded in 
administration or teaching and the 
clinical expertise is no longer current. 

The value of the emphasis on minori- 
ty groups and the indication of race 
appears less obvious. What constitutes 
a minority group varies from country 
to country. 

Cooperation from nurses eligible 
for this Directory must generally have 
been gocxl. Of the two Canadians who 
are missing from the listing, one is no 
longer actively in the nursing profes- 
sion and the other was on sabbatical 
leave out of the country at the time of 
the survey. To balance this loss, two 
others shown as employed in Canada 
are not, we suspect, Canadian citizens! 

Three indexes that are new features 
of the 1973 Directory extend its use- 
fulness. The figure quoted earlier of 
nurses with earned dcx;toral degrees 
employed beyond the United Sates 
were from the Index by Geographical 
Location of Employment. This partic- 
ular index might be more useful by 
country of citizenship and the optimum 
would be, of course, to have both. 
The other Indexes, by Subject of Doc- 
toral Dissertation, and by Field of 
Doctoral Study are indicators of areas 
of research helpful for research workers 
and prospective doctoral candidates 
looking for new channels of investiga- 
tion, and for historical and trend 
studies. 

The American Nurses" Foundation 
has made a splendid contribution to 
the ttxjis of nursing research with this 
collection of all health science and 
research libraries serving nurses. 



A Very Private Matter: The Ostomy 
Handbook by Edith S. Lenneberg 
and Miriam Weiner. 28 pages. Los 
Angeles, Calif., United Ostomy As- 
sociation, 1973. 

Reviewed by Genevieve Thonipson, 
Enterostomal Therapist. St. Joseph's 
General Hospital. Thunder Bay. 



This book was written with not only 
the nursing profession in mind but the 
general public, who would have reason 
to be interested in the subject of stomas. 
Its purpose is to acquaint the reader 



with generalities and provide under- 
standing of the various types of "sto- 
mas"" and problems that may effect the 
patient after this type of surgery. 

One ot the prime objecuves is to pre- 
sent the subject to the reader so he may 
understand the extent of the problems 
involved and the need for specialized 
services for complete rehabilitation. 
The authors also explain that these ser- 
vices are not only necessary for the 
patient with recent surgery, but also for 
patients who have had this handicap 
for many years. This type of rehabili- 
tation is an ongoing process. 

The book is easy to read and has 
continuity of subject matter. Descrip- 
tion of anatomy is concise and explicit, 
with the exception of the illustration of 
the ileal conduit, which all readers may 
not tlnd clear. 1 found the sense of 
humor, in which "the nature of the 
handicap"" was described, delightful. 
The purpose may not have been to pro- 
duce entertainment, but to convey the 
sense of humor that must be maintained 
to avoid projecting the feeling of com- 
plete hopelessness. 

Good management of a stoma is a 
complex matter — medically, surgi- 
cally, and technically. All these aspects 
are well explained, further stressing 
the involvement of several agencies and 
personnel to provide complete service 
to the patient. The importance of stoma 
location is stressed. This information is 
seldom mentioned to any extent in most 
texts and is an imperative surgical 
decision. 

The discussion of emotional adjust- 
ment is well expressed. I feel nursing 
personnel, patients, and involved 
families, have difficulty in accepting 
the fact that it is "normal" to express 
hostilities and anxieties during the 
stages of acceptance. If these thoughts 
were not suppressed, long-term man- 
agement would come more easily. 

The pictorial glossary of stoma sites 
and appliances definitely highlight 
the book. It was good to see a variety 
of manufacturers" products illustrated. 
The stoma sites would have been more 
effective in color. 

In summary, the authors have offered 
a unique basic book related to ostomy 
care. It offers a complete understanding 
of the word "stoma"" and all the com- 
plications and problems involved in 
returning such patients to an active, 
productive role in the community. A 
stoma is not a disease; instead, it res- 
tores the patient to health — the point 
brought out by the text. The book would 
definitely be useful in teaching those 
who are involved in managing the pa- 
tient and the patient, who must be 
given tools to help himself. 

As a reference book for any individ- 
ual who may be in need of information 
or seeking assistance, it is excellent. ■§■ 
JANUARY 1974 



AV aids 



n A series of taped television pro- 
grams on "The Canadian Woman," 
produced in 1972 by some 75 Montreal 
women and telecast on a Montreal 
cable station, are now available at no 
cost tor showing on cable stations 
across Canada and to women's groups. 
There are two sets of these color, half- 
hour, half-inch tapes; one is available 
from any regional office of the citizen 
section of the secretary of state depart- 
ment and the other from the Women's 
Centre of the YWCA. I .^55 Dorchester 
Blvd. W„ Montreal. Deposits of $10 
per tape, plus shipping charges, are 
required for the Montreal source. 

These 25 taped programs can be 
viewed on any but Portopak projectors. 
Included in the program series are the 
subjects; women in the family; cons- 
ciousness raising; feminism; sexuality 
of women, in two parts; women: the 
Native experience; women as artists; 
the prostitution of women; women at 
work, in two parts — in the labor force 
and returning to work; women in revo- 
lution; the feminine consciousness in 
contemporary literature; women from 
the viewpoint of the law. in two parts; 
communal living, the psychology of 
women, m three parts; women from 
the viewpoint of the church; and wo- 
men from the viewptiint of politics. 

n "Learning to Nurse," a series of 
videotapes for use in the teaching of 
nursing, is available from Videotape 
Research Program, School of Nursing, 
McGill University. 3506 University 
Street. Montreal I 12. Quebec. The aim 
of each tape is "to demonstrate every- 
day, ordinary behavior and perform- 
ance of people." These tapes, made 
for demonstration purposes in a re- 
search project, arc for sale only. 

The tapes available are: Admission 
to Discharge of a Little Girl with T and 
A (.34.5 min.) and the Admission of an 
Infant to Hospital (12 min.); An Infant 
with Cleft Palate and Harelip ( 1 min.), 
and Suctioning an Infant in Respiratory 
Distress (7 min.); A Child with Dia- 
betes; A Comparative Study in Three 
Families (28 min.); Diabetes. Socializ- 
ing the Child and Family (26 min.); 
Diabetes in the Child — A Late Find 
(14 min.); Ageing and Diabetes (23.5 
min.); A Comparative Study. Aging 
and Illness — Part A (27.5 min.), Part 
B (31.5 min.). Part C (19.5 min.); and 
The Aged in Hospital (40 min.). 
JANUARY 1974 



This AV Resource Center Travels 




*"-««aiii| 




British Columbia hospitals located in communities with few doctors can call on 
the Mobile Instructional Resources Centre — a fancy name for a continuing 
education program set up in a bus. The University of British Columbia's 
division of continuing education in the health sciences bought the bus. which 
has been converted into an audiovisual library and classroom. The software 
on one side includes 1,000 audio- and 30 videotapes, 15 movie cartridges, 
and 30 slide-tape programs. Three cubicles on the other side contain three tape 
recorders, three slide projectors, two TV sets, an autotutor, and a cartridge 
movie projector. Six persons can use headsets at one time to listen to or watch 
six different programs. So far. nurses have made most use of the programs. 
The Registered Nurses' Association of British Columbia has donated S8.000 
toward purchasing and producing AV materials and has allocated S5.000 to 
the end of 1974 for developing instructional packages. The AV material used 
in this continuing education program is being constantly updated. 




THE CANADIAN NURSE 49 



AWARD OF MERIT 

D On October 25, 1973, the First 
Canadian Festival of Institutionally 
Produced Instructional Media and 
Canadian Education Showplace pre- 
sented The University of Western 
Ontario in London with an Award of 
Merit for the entry Examination of a 
Newborn. 

Dr. N. Jaco made this cassette at 
the request of Carol Anonsen, nurse 
coordinator, for use in the clinical 
training course offered at U.W.O. for 
nurses in the north. C; 



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 ins- 
titutions. Reference (R) items (Archive 
books and directories, almanacs and 
similar basic books) do not go out on 



loan. These are on Reserve and may 
go out on Interlibrary loan only. 

Request for loans should be made on 
the "Request Form for Accession List" 
and should be addressed to. The Libra- 
ry, Canadian Nurses" Association, .50 
The Driveway, Ottawa, Ont. K2P 1E2. 

No more than three titles should be 
requested at any one time. 

BOOKS AND DOCUMENTS 

1. Ailiill (iiiil cliilil Idle: ti (lien/ tii>i>nHich to 
luirsiiii;. by Janet Miller Barber el al. St. 
I oiiis. Mosby. 197.'?. 8l4p. 

2. AllciiHitivc to iii.siiliitioiitil care for ohicr 
Aiiii'riciins: praclicc ami plaiiiiiiii>. A coiifcr- 
I'lKc report, edited by Eric Pfeiffer. Dur- 
ham, N.C., Center for the Study of Aging 
and Human Development. Duke Univ.. 197.^. 

I97p. 

3. Les (issemhiees {leliheraiite.s lilan.s le.s coo- 
peratives), par Claude Beland. Ville Mont- 
Royal. P.Q., Editions Robel. 1969. 208p. 

4. Behavior iiiodificalioii ami the iiiirsiiii; 
process, by Rosemarian Berni and Wilbert E. 
Fordyce. St. Louis. Mosby. 197.3. I3.'ip. 

^, Canadian Hospital Association office ami 
association directory. 197.^. Toronto, Cana- 
dian Hospital Association. 197.3. 6Sp. R 

6. Canadian Nurses' Association statements. 
Ottawa. Canadian Nurses' Association. 1973. 
1 vol. 

7. //)(' clinical approach to the patient, by 
William L. Morgan and George 1.. Engel. 



Toronto. Saunders. 1969. 3l4p. 

H. Clinical iieiiroloi;y. by Francis Michael 

Forster. 3ed. St. Louis, Mosby. 1973. 20Sp. 

9, Continiiiiity health - ^trnlei^ies for ihaiii;e. 
Papers presented at the 19/2 rvj>ionul meet- 
i litis of the Count il of Home Health Aficn- 
cies and Coiiiiiianily Health Services held 
ill Atlantic City. N.J.. Novendur 17-1 H, and 
Dallas. 'Ie.\a\. Deceiiiher 11-12. New York. 
National League for Nursing. Depl. of Home 
Health Agencies and Community Health 
Services. 1973. 76p. 

10, Conlrollinti the spread of infection: a 
pro\iraiiiiiH'd presentation, by Betty Mclnnes. 
St. Louis. Mosby. 1973. lllp. 

I I. The day care hook, by Barb Cameron et 
al. Toronto, Canadian Women's Educa- 
tional Press. 1972. 48p. 

12. l)e\elopiiienls in the ctnrectioiis field in 
Canada. Ottawa. Canadian Criminology and 
Corrections Association, 1973, 54p. 
1 3. Directory of career inohility opportuni- 
ties in niirsiiit;. Prepared by Carrie B. l.en- 
burg. Waller L. Johnson and Jo Ann T. 
Vahey. New York. National League for 
Nursing. Division of Research. 1973. 218p. 
14. Driifis. demons, iloctors and ilisease. by 
Perry A. Sperber. St. Louis. Warren H. 
Green. 1973. 294p. 

1.^. Elements of research in niirsiiif;. by 
Eleanor Walters Treece and James Wil- 
liam Treece. St. Louis, Mosby, 1973. 284p. 
1 6. Evaluation of :jr<uliiates of associate 
dcfiree nursing proi;raiiis. by Mildred L. 



Tropical 
Diseases 
and 
Parasitology 



Take our special course in tropical diseases 
and related subjects. Thia equips you to function 
intellig«ntly as a nurse In an environment where 
such diseases pose a health problem. 

Open to graduate nurses currently registered in 
their own province or state. Comprehensive 16 
week course commences in September and 
February. Train In modern, equipped centre with 
attractive accommodation for living in located 
in Metropolitan Toronto 

For Information write to: 

Co-ordinator. 

international 
health institute 

4000 Leslie Street, VUUowdale, 
Ontafio, Canada. 



Nursing Program 
Faculty Position 

Applicant must be prepared to teach basic nursing 
concepts and skills at the diploma level. Masters 
Degree preferred. 

Mount Royal College is an old established institu- 
tion with a completely new campus designed for 
independent study and individualized instruction. 
This opening is for the 1974-75 school year. Earlier 
appointment is possible. 
Personnel policies are excellent. 
Salary up to $14,725 commensurate with educa- 
tional preparation and teaching experience. 

Apply to: 

Vice-President. Instruction 
Mount Royal College 
4825 Richard Road S.W. 
Calgary, Alberta 



MOUNT ROYAL 
COLLEGE 

LINCOLN PARK CAMPUS, CALGARY, ALBERTA 
TELEPHONE 246-6111 



50 THE CANADIAN NL'RSt 



JANUARY 1974 



Montag. New York, published for Ihe Dept. 
of Nursing Education by Teachers College 
Press. Teachers College. Columbia Univer- 
sity. 1972. lOOp. (Nursing education mono- 
graphs no. 13) 

\7. Foiiiuliilioiis i)J pi'ilidtrh ninsiiit'. by 
Violet Broadribb. 2ed. Toronto, Lippincott. 
197.3. .<iOOp. 

18. Gitints (iiul uniinls iniitlc. 1^73. Ottawa. 
Medical Research Council. 1973. 63p. 

19. The i;ri>iify appromli in iiiiiwiiif; pniclUc, 
by Gwen D. Marram. St. Louis. Mosby. 
1973. 220p. 

20. Hiiiulhixik for niirsiiii; iiidcs. lOed. re- 
vised. Melbourne. Hospitals and Charities 
Commission for Nursing Aide Training 
Schools in Victoria. 1973. 3 lOp. 

2\ . Iiifc'cliii/i: picvcnlion unci ciniirol. by 
HIaine C. Dubay and Reba D. Grubb. St. 
Louis. Mosby. 1973. 160p. 

22. Inlcnialiiiniil dircnnry i/J nurses nilli 
iloclonil dcfirc'cs. New York. American 
Nurses' Foundation, 1973. 106p. 

23. hunivenous medications; a handbook for 
nurses and other allied health personnel, by 
Betty L. Gahart, St. Louis, Mosby, 1973. 
I76p. 

24. Inlrodinlion to clinical niirsinii. by 
Myra Esirin Levine. 2ed. Philadelphia, Da- 
vis, 1973. .SlSp. 

2.S. Introductory iiiatcniiiy niu\in;^. by Do- 
ris C. Bethea. 2ed. Toronto, Lippincott. 
1973. 276p. 
26. Meinoirc sur Ic projcl dc ri\i;lcincnl nio- 



difiant le realeiiicnt en vertu de la loi siir 
Ics services de same el les services socitiu.y. 
Montreal. Federation des Adminislrateurs 
des Services de Sante et des Services sociaux 
du Quebec, 1973. .'i4p. 

27. Microbiology: laboratory maiuuil and 
workbook, by Alice Lorraine Smith. 3ed. 
St. Louis, Mosby, 1973. 172 p. 

28. Nursiiif,' in the seveiuies; selected read- 
iiiiis that present both the old and Ihe new 
trends to help create heller luirsini,' care for 
patients. Compiled by Anne K. Roe and 
Mary Sherwood. Toronto, Wiley, 1973. 
32lp. 

29. People ami ideas. Nursiiii; at Western. 
1920-1970. by Hendrick Overduin. London, 
Ont., Faculty of Nursing, University of 
Western Ontario, 1970. l.'iOp. 

30. Perspectives in human development: 
ninsint; throuiihoiil the life cycle, by Doris 
Cook Sutterly and Gloria Ferraro Don- 
nelly. Toronto, Lippincott, 1973. 331p. 

31. The practice of mental health nursinf;: 
a conununily approach, by Arthur James 
Morgan and Judith Wilson Moreno. Toron- 
to. Lippincott, 1973. 2 lip. 

32. Precision joiiriuilisin: a reporter's intro- 
duction lo social science nielhoils. by Phi- 
lip Meyer. Bloomington, Ind.. Indiana Univ. 
Pr., 1973. 342p. 

33. Principles of intensive care, by E.R.J. 
Emery et al. London. English Universities 
Pr., 1973. 168p. 

34. Principles of microbiolofiy. by Alice Lor- 



raine Smith. 7ed. .St. Louis, Mosby, 1973. 
681 p. 

3-'i. Problem prci^niuicy ami abortion cinin- 
selint;. Edited by Robert R. Wilson. Salud. 
N.C., Family Life Publications, 1973. 120p. 

36. Re(ulini-s in ;jcrontoloi;y. edited by Virgi- 
nia M. BrantI and Sister Marie Raymond 
Brown. St. Louis. Mosby. 1973. 1 I 7p. 

37. Report 1973. Ottawa. Canadian Crimi- 
nology and Corrections Association, 1973. 
I vol. 

38. Report 1972-73. Ottawa. International 
Development Reseaich Centre, 1973. I04p. 

39. The teachin.s- function of the niirsin;j 
practitioner, by Margaret L. Pohl. 2ed. 
Dubuque, Iowa, Brown, 1973. 129p, 

40. Textbook of pediatric niirsiiif;. by Doro- 
thy R. Marlow. 4ed. Toronto, Saunders, 
1973. 776p. 

PAMPHLETS 

41. Aid to the humanities and social scien- 
ces. Ottawa, Canada Council, 1973. 17p. 

42. The c(U-e of your colostomy, by John 
Cedric Goligher and Muriel Pollard. 2ed. 
London, Bailliere. Tindall. 1973. 3lp. 

43. Maiaial of continitini; nursiu'j ediucition. 
Vancouver, B.C.. University of British Co- 
lumbia, 1973. 8p. 

44. Nuisin.v educatitui and rcnisiratiou: 
.statistical repmt. 1972. Toronto. College 
of Nurses of Ontario. 1973. 38p. 

4.S. Report 1972. Loronlo. Canadian Men- 
tal Health Association. 1973. 



Request Form 
for "Accession List" 

CANADIAN NURSES' 
ASSOCIATION LIBRARY 

Send this coupon or facsimile to: 
LIBRARIAN, Canadian Nurses' Association, 
50 The Driveway, Ottawa K2P 1 E2, 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, 

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 

Date of request 



In decubitus 
ulcers 




Nursing Care is 
what it's all about. 



A comprehensive film on the role of the nurse 
in the treatment and prevention of decubitus ulcers 
plus a unique concept in skin care, is available 
upon request from the Education Department, 
Westwood Pharmaceuticals, 120NorthQueenStreet, 
Toronto, Ontario M8Z 2E3. 

Suppliers of Alpha-Keri*, therapeutic bath 
oil, and Keri* Lotion, all over body lotion. 

•T.M. Auth. User 




□ YES, please contact me to schedule a viewing of 
Westwood's in-service film on decubitus ulcers. 



Westwood Pharmaceuticals Toronto. Ontario M8Z 2E3 



Name. 



Title. 



_ Telephone No. . 



Institution. 
Address 



Cily- 



. Postal Code _ 



JANUARY 1974 



THE CANADIAN NURSE 51 



Coricidin'D' 



DESCRIPTION: 

Coricidin 'D'l Each white, coated 
tablet contains; 

2 mg chlorpheniramine maleate U.S. P.. 
390 mg acetylsalicylic acid, 
30 mg caffeine and 
10 mg phenylephrine. 
Available in blisters of 12 
and 24. and bottles of 100 tablets. 

Coricidin *D* Medilets: Each orange- 
pineapple-flavored multicolored tablet contains: 
0,5 mg chlorpheniramine maleate U.S. P., 
80 mg acetylsalicylic acid and 
2,5 mg phenylephrine HCl. 
Available in boxes of 24 Medilets in a 
child's protective package. 
INDICATIONS: 

Symptomatic relief of nasal congestion and 
other discomforts associated with sinusitis, 
colds and allergic or vasomotor rhinitis. 
CONTRAINDICATIONS: 

Sensitivity to any of the components, 
patients receiving MAO inhibitors. 

PRECAUTIONS: 

Administer with caretopatients with hyper- 
tension, cardiac disorders, hyperthyroidism, 
diabetes mellitus and patients hypersensitive 
to sympathomimetic compounds. 

Patients should be cautioned not to oper- 
ate vehicles or hazardous machinery until 
their response to the drug has been deter- 
mined. Since the depressant effects of anti- 
histamines are additive to those of other 
drugs affecting the central nervous system, 
patients should be cautioned against drink- 
ing alcoholic beverages or taking hypnotics, 
sedatives, psychotherapeutic agents or other 
drugs with CNS depressant effects during 
antihistaminic therapy. 

Rarely, prolonged therapy with antihista- 
mine-containing preparations can produce 
blood dyscrasias. 

ADVERSE EFFECTS: 

Drowsiness, dizziness, nausea, increased 
irritability or excitement may be 
encountered. 
DOSAGE: 

Coricidin 'D': Adults: 1 tablet every 4 
hours, not to exceed 4 tablets in 24 hours. 
Children 10 to 14 years: 1/2 adult dose: 
under 1 years: at discretion of physician. 
Coricidin 'D' Medilets: 2 to 6 years: 
1/4 to 1 Medilets: 7 to 12 years: 1 to 2 
Medilets. Each dose may be repeated every 
3 to 4 hours, but not more than 4 Medilets 
should be given in one day to children 2 to 
6 years, and 6 Medilets to children 7 to 12 
years. Lirnit treattrient to 3 days. The recom- 
mended dosage should not be exceeded 
except on a physician's advise. 



Detailed information is available on 

request. 

SCHERING CORPORATION LIMITED 

Pointe Claire, Quebec H9R 1B4 



accession list 



46. ()( ciipaliomil firsl aid. by St. John Am- 
bulance Association and Brigade. London. 
Macmillan Journals, 1973. 4.3p. 

47. Shitcim'iil of hflicf: coiiliniiiiifi cclina- 
lioii for icfiixicrctl iKiiwci. Edmonton. 
Alberta Association of Registered Nurses. 

GOVERNMENT DOCUMENTS 
CdlKuUl 

48. Dept. of Industry. Trade and Commerce. 
Rc/xiil 1970 of rlif Minister of . . . iiiulcr 
llic Corportilions iinil Lalxmr Unions Rclnrns 
Act. Ottawa. 1973. 2 vols. 

49. Dept. of the Solicitor General. The gene- 
nil itro^rnni for the developntenl of psy- 
(liinlric services in fetlernl correelionnl ser- 
vices in Ciuuulii. Ottawa. Information Cana- 
da. 1973, 60p. 

."^O. Labour Canada. Uitunir orf>ani:alions 
in Canaild. 1972. Ottawa. Information Ca- 
nada. 1973. I47p. 

.5 I. Statistics Canada. Advance siaiisiics of 
edncotion 1973174. Ottawa, Information 
Canada. 1973. 39p. 

.'>2. Statistics Canada. Annual report of no- 
tijiahlc diseases. 1972. Ottawa. Information 
Canada. 1973. 44p. 

53. — .Canadian universities and C(illei;es. 
1973. Ottawa, published jointly by . . . and 
AUCC. 1973. .SLSp. R 

-'^4. — .Fall enrolment in iiniversilies anil 
tolle.ves. I97II72. Ottawa, Information Ca- 
nada. 1973. 1.52p. 

.''-'^. — .Hospital statistics 1971: vol. 7. Hos- 
pital indicnlors. Ottawa. Information Cana- 
da. 1973. I. SI p. 

.56. — .Instrnclions and definitions for the 
anniiiil return of hospitals, by . . . and Dept. 
of National Health and Welfare. Ottawa. 
57. Statistique Canada. Directives de defini- 
tions pour le rapport d'activite des liopilaii.x. 



par . . . et Ministere de la Sante et du Bien- 
etre social. Ottawa. I 972. 2 vols. 
.58. — . Statistique de lenseignenient-estima- 
tions. 197.1174. Ottawa. Information Cana- 
da, 1973. 39p. 
United States 

59. National Institutes of Health. A hihlio- 
(.'rapliy of Chinese sources on medicine and 
piihlic health in the People's Repiihlic of 
China: 1960-1970. Washington, U.S. Govt. 
Print. Off., 1973. 486p. (U.S. DHEW Pub- 
lication no. (NIH) 73-439) 

60. National Library of Medicine. Bihlio- 
i;rtipliy of the history of medicine, no. 6. 
1970. Bethesda. Md.. 1973. 295p. 

STUDIES DEPOSITED IN CNA REPOSITORY 
COLLECTION 

61. Evaluation de ieffet siir I'anxiete pre- 
hronclioscopie. d'lin mode d'informalion re- 
pondanl aiix questions de clients hospitali- 
ses, par Maria Da Encarnacao Serralheiro. 
Montreal. 1970. I4lp. (These (M.Nurs.)- 
Montreal) R 

62. Health care in Canada: a comnientaiy, 
by H. Rocke Robertson. Ottawa, Informa- 
tion Canada, 1973. I73p. (Science Council 
of Canada. Special study no. 29) 

63. Is red for dan.aer: a stiitly of the somatic 
reactions of red haired children to illness. 
by Elinor Bridget Leslie Peer. Gainesville. 
Fla., 1973. 30p. (Thesis (M.Sc.N.)- Florida)R 

64. Nurse aide similarity to patient and feel - 
iiifis of helplessness, by Charlotte Tramblay. 
Cleveland. Ohio. 1971. 38p.(Thesis(M.Sc.N.) 
-Case Western Reserve)R 

65. Nin-ses perceptiinis of their ho.spilal's 
orfitini-ational characteristics, by Audry 
De Block. Milwaukee. Wise. 1969. 70p. 
(Thesis (M.Sc.N.)- Marquette) R 

66. A survey of Canadian schools of iiiirsinf; 
to determine the instruction and clinical 
experience provided in menial retardation. 
by Elsie I.E. Pearen. Vancouver, B.C.. 1973. 
87p. (Thesis (M.Sc.N.)- British Columbia) R 



Library Photocopies 



The CNA library has a large collec- 
tion of journals. Many of them, for 
example the foreign nursing journals, 
are not readily available elsewhere in 
Canada. The library has never loaned 
journals, either single issues or bound 
volumes. However, to make them 
available to those who cannot come 
to the library to use them, photocopies 
of articles have been supplied at a 
charge of ten cents a page for all 
pages over five. 

The volume of requests for this 
service has increased considerably. 
Library staff spend an appreciable 
time searching the articles, which are 
frequently poorly cited, and processing 
them for, and after, photocopying. 

CNA has decided, therefore, to in- 
crease the charge for photocopying 
to come closer to the actual cost of 



the service. This increase will bring 
the CNA photocopying policy in line 
with that of other libraries, notably 
the National Science Library. Be- 
ginning 1 January 1974, the charges 
for photocopying periodical iirticles 
will be; 

1 cents per page 

Minimum charge per article $ 1 
i.e., the charge for a request for 
3 pages from one article and 2 
pages from another will be $2. 

This will still be "a token charge." 
Even this increase in charging will 
not fully cover the cost of the service. 

In line with the practice followed 
by the CNA Publications Order De- 
partment, charges under $5. must be 
prepaid. 

Photocopying of books and docu- 
ments will not be done. 



52 THE CANADIAN NURSE 



JANUARY 1974 



classified advertisements 



ALBERTA 



BRITISH COLUMBIA 



BRITISH COLUMBIA 



DIRECTOR OF NURSING required for modern 25-bed 
Hospital on Highway 12. East Central Alberta. Please 
apply to: Administrator. CORONATION MUNICIPAL 
HOSPITAL. CORONATION. ALBERTA. TOC ICO. Tele- 
phone: 578-3691. 



HEAD NURSE required for Obstetrical-Gynecological 

Nursing Unit (including nursery) in 230-bed active 
treatment hospital in Okanagan Valley of British 
Columbia. RNABC contract in ettect. Apply to: Direct- 
or of Nursing. Penticton Regional Hospital. Penticton. 
British Columbia. 



EXPERIENCED GENERAL DUTY NURSES for modern 
lO-bed hospital with doctors offices in hospital. 
Situated beautiful west coast of Vancouver Island: 
Accommodation $50.00 a month. Apply Administra- 
tor. Tahsis Hospital. Box 399. Tahsis. British 
Columbia 



REGISTERED NURSES required immediately for 72- 
bed accredited, active treatment fK)spital. Also 1 RH.- 
for 50-bed Nursing Home. AARN-AHA contract in 
force Refund of fare after one year of service Apply: 
Director of Nursing, Providence Hospital. High Prai- 
rie. Alberta TOG 1E0. 



BRITISH COLUMBIA 



REGISTERED NURSES AND LICENSED PRACTICAL 
NURSES WANTED FOR FULLY ACCREDITED HOS- 
PITAL EXPANDING TO 190 BEDS IN JANUARY 1974 
GENERAL DUTY POSITIONS IN MEDICAL-SURGICAL 
PSYCHIATRIC AND ICU-CCU AREAS. MUST BE 
ELIGIBLE FOR BC REGISTRATION. BASIC SALARY 
1973 — S672 00 (NEW CONTRACT BEING NEGOTIAT- 
ED) APPLY DIRECTOR OF NURSING. ST JOSEPH S 
GENERAL HOSPITAL. COIVlOX, BRITISH COLUMBIA 
V9N 4B1. 



ADVERTISING 
RATES 

FOR ALL 
CLASSIFIED ADVERTISING 

$15.00 for 6 lin«s or less 
$2.50 for each additional line 

Rotes for display 
advertisements on request 

Closing dole for copy and cancellation is 
6 weeks prior to Ist day of publication 
month. 

The Conodion Nurses' Association does 
not review the personnel policies of 
the hospitals and agencies advertising 
in the Journal. For authentic informotion, 
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 
OTTAWA. ONTARIO 
K2P 1E2 




WANTED HEAD NURSE for 5-bed Intensive Care 
Unit in Okanagan. Duties to commence February 1st, 
1974. Eligible for B.C registration. Preparation and/ 
or previous experience in l.C U. and Administration. 
Salary and benefits tn accordance with RNABC 
Contract. Please apply to: Director of Nursing, 
Vernon Jubilee Hospital. Vernon. British Columbia. 



OPERATING ROOM NURSE wanted for active mo- 
dern acute hospital. Four Certified Surgeons on 
attending staff. Experience of training desirable. 
Must be eligible for B.C. Registration. Nurses 
residence available. Salary $687 per month starting. 
Apply to Director of Nursing, f^/tills Memorial Hospi- 
tal. 271 1 Tetrault St.. Terrace. British Columbia. 



EXPERIENCED NURSES required in 409-bed acute 
Hospital with School of Nursing, Vacancies m 
medical, surgical, obstelrlc, operatir>g room, pediat- 
ric and Intensive Care areas. Basic salary $672. — 
$842. B.C. Registration required. Apply: Director 
of Nursing. Royal Columbian Hospital, New West- 
mtnster. British Columbia. 



GRADUATE NURSES for 21-bed hospital preferably 
with obstetrical experience. Salary in accordance 
with RNABC. Nurses residence. Apply to: Matron, 
Tofino General Hospital. Toftno, Vancouver Island. 
British Columbia. 



NURSES REQUIRED FOR GENERAL DUTY AND 
INTENSIVE CARE UNIT. IN EIGHTY-FOUR BED 
MODERN ACUTE GENERAL ACCREDITED HOSPITAL 
IN CENTRAL BRITISH COLUMBIA RNABC CON- 
TRACT WAGES RESIDENCE ACCOMMODATION 
AVAILABLE, PLEASE APPLY IN WRITING TO: DI- 
RECTOR OF NURSING. CARIBOO MEMORIAL HOS- 
PITAL. 517 NORTH SIXTH AVENUE. WILLIAMS 
LAKE, BRITISH COLUMBIA. 



GENERAL DUTY NURSES for modern 4l-bed 
hospital, located on the Alaska Highway. Salary and 
personnel policies tn accordance with RNABC 
Accommodation available in residence. Apply: 
Director of Nursing, Fort Nelson General Hospital, 
Fort Nelson, British Columbia. 



GENERAL DUTY NURSES REQUIRED FOR 21-BED 
HOSPITAL 120 MILES NORTH OF PRINCE GEORGE, 
BC RNABC POLICIES IN EFFECT APPLY TO 
DIRECTOR OF NURSING, MacKENZlE HOSPITAL, 
BOX 249. MacKENZlE, BRITISH COLUMBIA 



EXPERIENCED GENERAL DUTY NURSES required for 
151-bed Hospital, Basic Salary $672 — $842 per 
month. Policies in accordance with RNABC Contract. 
Residence accommodation available. Apply to: 
Director of Nursing. Powell River General Hospital 
5871 Arbutus Avenue. Powell River. 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) m residence. Apply The Director 
of Nursing. St. Mary s Hospital. P.O Box 678. Se- 
chelt. British Columbia. 



GENERAL DUTY NURSE wanted for 87-bed modern 
hospital. Nurses Residence Salary $646,00 per 
month for BC Registered Apply Director of Nursing, 
Mills Memorial Hospital, Terrace, British Columbia. 



GENERAL DUTY NURSES required immediately for 
hospital in central B C This is a new hospital opened 
in May or ihis year. Residence accommodations 
available. RNABC policies m effect. Apply to. 
Director of Nurses. St. John Hospital, Vanderhoof, 
British Columbia. 



MANITOBA 



D.O.N, required tor 68-bed Personal Care Home. 
a new facility Excellent salary and fringe benefits. 
Will credit for past experience Must be bilingual 
and have experience m geriatrics For further in- 
formation write to Administrator Foyer Notre Dame 
Inc - Notre Dame de Lourdes Manitoba, ROG IMO 



TWO REGISTERED NURSES are required by Baldur 
District Hospital for general duty Duties to commence 
in early 1974. Attractive residence m 16-bed hospital 
Salary based on Governmeni scale with consideration 
for experience. For further information contact Mrs 
K Gordon. Director of Nursing, telephone 535-2373. 
Baldur District Hospital. Baldur. Manitoba. 



Required immediately — 3REGISTERED NURSES and 
3 LICENSED PRACTICAL NURSES for a new 60-bed 

Personal Care Home Salary m accordance with the 
recommendations of the MARN Apply Director of 
Nursing, Swan River Valley Personal Care Home 
inc. SWAN RIVER. Manitoba ROL 120. 



NOVA SCOTIA 



REGISTERED NURSES (3) for general duty and (1) 
with operating Room experience required for 22bed 
hospital in Sheet Harbour Nova Scotia (situated on 
the scenic Eastern Shore) Apply to Administrator, 
Eastern Shore Memorial Hospital, Sheet Harbour. 
Nova Scotia 



ONTARIO 



lANUARY 1974 



Applications lor the position of NURSING ADMINIS- 
TRATIVE SUPERVISOR and HEAD NURSE for the 

Paediatnc Department of a 14^ bed General Hospital 
are now being accepted Preference will be given to 
applicants wilh formal preparation in Nursing Service 
Administration, bul those with administrative exper- 
ience Will be considered Completely furnished apart- 
ments with balcony and swimmmg pool adjacent to 
hospital and lake are available, arxj the location is 
within easy driving distance of American and Cana- 
dian metropolitan centres Apply Director of Nursing. 
General Hospital, Port Cofborne Ontario 



SUPERVISOR OF PUBLIC HEALTH NURSING: for 

progressive Health Unit wilh generalized program. 
Nursing degree essential supervision and adminis- 
tration preferred Excellent personnel policies Apply 
Dr V Soudek, Medical Officer of Health, Leeds, 
Grenville & Lanark District Health Unit. Box 130. 
Brockville, Ontario 

THE CANADIAN NURSE 53 



ONTARIO 



SASKATCHEWAN 



REGISTERED NURSES for 34-bed General Hospital. 
Salary $646. per month to $756. plus experience al- 
lowance. Excellent personnel policies. Apply to: 
Director ol Nursing Englehart & District Hospital 
Inc.. Englehart. Ontario. 



REGISTERED NURSES required for a new 79-bed 
General Hospital in bilingual comnnunity of North- 
ern Ontario. French language an asset, but not 
compulsory. Salary is $645. to $758. monthly with 
allowance for past experience. 4 weeks vacation 
after 1 year and 18 sick leave days per year. Unused 
sick leave days paid at 100% every year. Master 
rotation in effect. Rooming accommodations available 
in town. Excellent personnel policies. Apply to: Per- 
sonnel Director, Notre-Dame Hospital, P.O. Box 850, 
Hearst. Ont. 



REGISTERED NURSES required immediately lor 30- 
bed general hospital Salary range $650 — $760 with 
allowance for experience. Residence accommodation 
available. Apply Mrs. M Simmonds. R N. Director 
of Nursing Bingham Memorial Hospital, Matheson, 
Ontario. Phone (705) 273-2424 



REGISTERED NURSES are required by a 228-bed 
regional hospital located close to numerous resort 
areas. Salary and benefits according to SRNA con- 
tract. For further information contact: Personnel 
Director. Victoria Union Hospital, Prince Albert, 
Saskatchewan. 



UNITED STATES 



R.N.s — SOUTHERNCALIFORNIA — Immediate need 
exists for medical-surgical units. Orientation and in- 
service program. Excellent salary, full paid benefits 
We will assist you with your H-1 visa for immigration 
An interim permit may be obtained from the Califor- 
nia Board of Nursing Education and Registration to 
practice nursing in California prior to licensing. Con- 
tact Personnel Director. The Hospital of the Good 
Samaritan. 1212 Shatto Street. Los Angeles. Califor- 
nia 90017. (213) 482-8111 ex 287. 



THE CAPTAIN WILLIAM JACKMAN 
MEMORIAL HOSPITAL 

LABRADOR CITY 



require the following nursing personnel to 
meet extension of services commencing early 
January 1974. 

Day supervisor — Nurse II 

Head Nurse — Nurse II 

Staff Nurse — Nurse I 

Certified nursing assistants {male and 

female) 

Ward clerk 

Applicants stiould apply in own hantiwriting tO: 

Director of Nursing 

Captain Wm. Jackman Memorial 

Hospital 

410 Booth Avenue 

Labrador City, Newfoundland 



REGISTERED NURSES AND REGISTERED NURSING 
ASSISTANTS for 45-bed Hospital Salary ranges 
include generous experience allowances R.N. s 
salary $645 to $745. and R.N As salary $445. to $530. 
Nurses residence -private rooms with bath-- $40. 
per month. Apply to The Director of Nursing. Gerald- 
ton District Hospital. Geraldton. Ontario. 



REGISTERED NURSES and REGISTERED NURSING 
ASSISTANTS for field hospital in Northern Post of 
James Bay. Fort Albany and Altawapiskal Salary 
scale according to previous experience plus North- 
ern Allowance. 4 weeks vacation alter one year and 
18 sick leave days per year. Traveling expenses paid 
to a maximum of $90 00 for Fort Albany and $115.00 
tor AtlawapisKat upon employment, vacation and 
termination. Rooming available in nurses residence 
with meals, accommodations at the hospital. French 
language an asset, out not compuisary. Apply to 
James Bay General Hospital. PO Box 370. Mooso 
nee. Ontario P01 lYO. 



REGISTERED NURSES for General Duty and I.CU, 
— ecu. Unit required for 162-bed accredited 
hospital. Starting salary $645.00 with regular annual 
increments. Excellent personnel policies. Temporary 
residence accommodation available. Apply to: The 
Director of Nursing. Kirkland and District Hospital. 
Kirkland Lake. Ontario. 



MONTREAL 

NEUROLOGICAL 

HOSPITAL 

A Teaching Hospital 
of McGill University 

requires 

Registered Nurses 

for 

General Duty 

Previous experience in neurological nursing not 
required. Active inservice education programme. 

Apply to: 

The Director of Nursing, 

Montreal Neurological Hospital 

3801 University Street, 

Montreal 112, P.Q. 



REGISTERED NURSES 
GENERAL DUTY 



Required for modern, fully equipped 28'bed 
hospital, with two Medical and one Dental 
staff. Salary per S,R.N,A.-S.H,A, schedule. 
Excellent personnel policies. Accommodation 
available in residence. Kipling is located 
near the summer resorts of the Qu'Appelle 
Valley Lake System and also the Moose 
Mountain Provincial Park, 



Apply to: 

Administrator 

KIPLING MEMORIAL UNION 

HOSPITAL 

Box 420 

KIPLING, Saskatchewan 

SOG 2S0 



OPERATING ROOM TECHNICIAN required for fully 
accredited 75-bed Hospital. You will be in the 
Vacationland of the North, midway between Thunder 
Bay. Ontario and Winnipeg, Manitoba. Basic wage is 
$4/1.50 with consideration tor experience. Write or 
phone the Director of Nursing. Dryden District 
General Hospital. Dryden, Ontario. 



PUBLIC HEALTH NURSES (QUALIFIED) FOR GEN- 
ERALIZED PROGRAMME ALLOWANCE FOR EXPER- 
IENCE AND/OR DEGREE USUAL FRINGE BENE- 
FITS DIRECT ENQUIRES TO: MRS. RETA McBEAN, 
DIRECTOR, PUBLIC HEALTH NURSING, RENFREW 
COUNTY AND DISTRICT HEALTH UNIT, PO BOX 
128, PEMBROKE, ONTARIO. 



QUEBEC 



D 



RESEARCHERS |Ph d preferred) in the health field 
To study development ol the expanded function of 
nursing in new types of health services descrip 
tion, evaluation To study problems of family health 
and health practices relevant to nursing and fiealth 
services Apply Director, School of Nursing. McGilt 
University Montreal Quebec H:iA 2A9, 

54 THE CANADIAN NURSE 



NORTH NEWFOUNDLAND & LABRADOR 

requires 

REGISTERED NURSES 
PUBLIC HEALTH NURSES 

International Grenfell Association provides 
medical services for Nortfiern Newfoundland 
and Labrador, We staff four hospitals, eleven 
nursing stations, eleven Public Health units. 
Our mam 180-bed accredited hospital is 
situated at St, Anthony, Newfoundland, Active 
treatment is carried on in Surgery, Medicine, 
Paediatrics, Obstetrics, Psychiatry, Also, 
Intensive Care Unit, Orientation and In-Service 
programs, 40-hour week, rotating shifts. Living 
accomodations supplied at low cost, PUBLIC 
HEALTH has challenge of large remote areas. 
Excellent personnel benefits include liberal 
vacation and sick leave. Salary based on 
Government scales. 
Apply to: 

INTERNATIONAL GRENFELL ASSOCIATION 
Assistant Administrator of 

Nursing Services, 
St. Anthony, Newfoundland. 



GENERAL DUTY 
NURSES 



— for 360-bed acute general hospital 

— clinical areas include; — Medicine, Surgery, 
Obstetrics, Paediatrics, Psychiatry, Rehabili- 
tation, Extended Care and Coronary Care 

— B,C. Registration preferred but not manditory 
during initial employment 

— Personnel policies in accordance with 
RNABC Contract. 

Please contact the: 

Director of Nursing 

Nanaimo Regional General 

Hospital 

Nanaimo, British Columbia 



JANUARY 1974 



GENERAL DUTY NURSES 

Required Immediately 

« for 270-bed acute care general hospital 
expanding to 370 beds 

• clinical areas include; Medicine Surgery 
Obstetrics Paediatrics Psychiatry Rehabilita- 
tion Extended Care and Intensive and 
Coronary Care 

• Must be eligible for B.C. registration 

• Personnel policies in accordance with 
RNABC Contract 

• 1973 Salary $672 - $842.00 per month 

Please contact: 

Director of Nursing 

Prince George Regional Hospital 

Prince George, B.C. 



REGISTERED NURSES 



Required for 110-bed hospital for 
chest diseases. 



Situated in Laurentian Ski Resort 
area 55 miles north of Montreal. 
Residence accommodation avail- 
able. 



Apply to: 

Director of Nursing 

P.O. Box 1000 

Ste. Agathe des Monts, Quebec 

J8C 3A4 



RIVERVIEW UNIT 

WINDSOR WESTERN HOSPITAL 

CENTRE 

Invites applications from 

REGISTERED NURSES 

starting Salary $655 
Increments for Contemporary Experience 
REGISTERED NURSING ASSISTANTS 
Starting Salary December 1st $493 
TOP FRINGE BENEFITS 
All Shifts 
Permanent positions available 
Afternoons and Nights 
Orientation and Staff Development Program 
Windsor offers cultural and educational oppor- 
tunities including University and Community 
College 

WE ARE PEOPLE HELPING PEOPLE 
in the rapidly progressing specialty of chronic 
care and rehabilitation. We offer 

— a challenge 

— job satisfaction 

— a happy environment 
Apply tO: 

Director of Nursing 
3177 Riverside Drive E., 
Windsor, Ontario 
N8Y 4S2 



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, Paediatrics, Obste- 
trics and Gynaecology, General Surgerv and 
Medicine. 

Basic 2 week Orientation Program and con- 
tinuing Active Inservice Program for all levels 
of Staff. 

Salary is commensurate with preparation and 
experience. 

Benefits include Canada Pension Plan, Hospital 
Pension Plan, Unemployment Insurance. — 
Group Life Insurance and O.H.I .P. (66-2/3% 
Basic Rate paid by Hospital). — Extended 
Health Care Plan — Supplementary Blue Cross. 
After 3 months, cumulative sick time. 
Rotating periods of duty — 40 hour week — 
10 Statutory holidays — 3 weeks annual vaca- 
tion afte'r completion of one years service. 

APPLY: 

ASSOCIATE DIRECTOR 
OF NURSING SERVICE 

ST. JOSEPH'S HOSPITAL 

30 The Queensway 
TORONTO 3, ONTARIO. 



CITY OF VANCOUVER 

CARE FACILITIES 
CONSULTANT II 



THE POSITION: Considerable past 
involvement in community care facilities 
will permit the successful applicant to 
develop new consultative services. The 
aim is to assist in the operation of resi- 
dential rest homes, personal care home 
facilities, and supervisory and educa- 
tional facilities for children up to ]^ 
years of age. The position will involve 
the co-ordination and motivation of a 
small staff conducting initial, continuing 
and annual visitations. 

THE APPLICANT: Will have a uni- 
versity degree in the social sciences and 
may have taken relevant post graduate 
training. Considerable experience in 
institutions and facilities listed above, 
preferably in an administrative, consult- 
ative or supervisory capacity is required. 

THE SALARY: S986 to SI 185 per 
month. 

THE APPLICATIONS: Must be ob- 
tained from and returned along with a 
detailed resume of education and exper- 
ience to the Director of Personnel Ser- 
vices. 4.'<.^ West 12th Avenue. Vancouver 
10. B.C.. as soon as possible. Please 
quote competition P-8988. 



HUMBER MEMORIAL 
HOSPITAL 

Telephone 249-8111 (Toronto) 

200 Church Street, 

Weston, M9N-1M8,Ont. 

Registered Nurses and Registered Nursing Assistants seeking 
employment In an active treatment hospital in NORTH WEST 
METROPOLITAN TORONTO, are requested to write to ttie Di- 
rector of Nursing concerning employment opportunities. 

Orientation and Staff Development Programmes are provided. 

Competitive salaries offered to qualified personnel. Registered 
Nurses are urgently required for temporary employment July, 
August and September. 



JANUARY 1974 



THE CANADIAN NURSE 55 



MISERICORDIA HOSPITAL 
EDMONTON, ALBEKTA 

has vacancies for 

GENERAL DUTY 
REGISTERED NURSES 

Edmonton is a fast growing Met- 
ropolitan area of 500,000 people. 
Our modern 555 bed active treat- 
ment hospital offers an orientation 
program combined with an active 
inservice education program. 

Please apply to: 

Misericordia Hospital 

16940 - 87th Ave. 

Edmonton, Alberta 

T5R 4H5 




VANCOUVER 
GENERAL HOSPITAL 

requires 

REGISTERED NURSES 

FOR REGULAR AND 
VACATION RELIEF POSITIONS 

For details and application 
please write tO: 

PERSONNEL SERVICES 

VANCOUVER GENERAL HOSPITAL 

855 West 12th Ave. 
Vancouver 9, B.C. 

Registration in British Columbia required. 
Contact; 

Registered Nurses' Association of B.C. 
21 30 West -12th Ave., 
Vancouver 9, B.C. 
for details. 



CLINICAL NURSE 
SPECIALIST 

FOR 

MED-SURG 
NURSING 

REQUIRED IN 254BED 

ACTIVE CARE 

GENERAL HOSPITAL 

APPLY TO: 
Director of Nursing 
Moose Jaw Union Hospital 
Moose Jaw, Sask. 
692-1841 



McMASTER 

UNIVERSITY 

School 

of Nursing 



Nurse faculty members, including an Asso- 
ciate Director, required for July. 1974 by a 
progressive School of Nursing. Thie School is 
an integral part of a newly developed Health 
Sciences Centre where collaborative relation- 
ships are fostered among the various health 
professions. 

Requirements: master s or doctoral degree 
preferred, with clinical specialist preparation 
or experience and/or preparation in teaching. 

Salaries: commensurate with education and 
experience. 

Application, with copy of 

curriculum vitae and two 

references to 

Dr. D.J. Kergin, Director, 
School of Nursing, 

McMaster University, 

Health Sciences Centre, 

1200 Main Street West, 

HAMILTON, Ontario, 

L8S 4J9. 



THE MONTREAL 
CHILDREN'S HOSPITAL 

REGISTERED NURSES 
NURSING ASSISTANTS 

Our patient population consists of 
ttie baby of less tfian an hiour old 
to the adolescent wtio tias just 
turned seventeen. We see them in 
Intensive Care, In one of the Med- 
ical or Surgical General Wards, or 
in some of the Pediatric Specialty 
areas. 

They abound in our clinics and 
their numbers increase daily in our 
Emergency. 

If you do not like v/orking with 
children and with their families, 
you would not like it here. 

If you do like children and their 
families, we would like you on our 
staff. 

Interested qualified applicants 
should apply to the: 

DIRECTOR OF fJURSING 
Montreal Children's Hospital 
2300 Tupper Street 
Montreal 108, Quebec 



DOUGLAS HOSPITAL 

IN METROPOLITAIN MONTREAL 

A multl-dlsciplinary psychiatric hospital with 
1,100 adult and 100 cftlldren's beds; 

requires 

NURSING STAFF ON ALL LEVELS 

We Invite enquiries from registered nurses with 
experience In psychiatric nursing or new 
graduates for our medical, geriatric or 
children's services. 

Nursing assistants with experience or newly 
graduated. Psychiatric nursing background Is 
preferable but not essential. 

Language requirement for licensing In Quebec 
not applicable to Canadian citizens. 

Applications and enquiries should be sent tO: 

DIRECTOR OF NURSING 
6875 LaSalle boulevard 
Verdun 204, Quebec. 



REGISTERED NURSES 

AND 

REGISTERED NURSING ASSISTANTS 

required for a 104-bed active treatment plus 
72-bed chronic care unit located at Halleybury. 
The Tri-Town area consisting of New Liskeard, 
Haileybury, Cobalt all within 5 miles of each 
other Is located 90 miles from North Bay 
with dally plane, train and bus service to and 
from Toronto etc. Beautiful recreational facil- 
ities including curling, skating, skiing, swim- 
ming, boating, hunting, fishing. 

Salary fully appropriate to the responsibility of 
the position; personnel policies In line with 
Industry and hospital practice. Orientation 
and In-Service Educational programmes are 
provided. 

Apply In writing to: 

PERSONNEL DIRECTOR, 
Temiskaming Hospitals, 
Haileybury, Ontario. 



THE LADY MINTO HOSPITAL 
AT COCHRANE 

invite applications from 

REGISTERED NURSES 

54-bed accredited general hospi- 
tal. Northeastern Ontario. Compe- 
titive salaries and generous bene- 
fits. Send inquires and applications 
to; 

MISS E. LOCKE 

Director of Nursing 

The Lady Minto Hospital at 

Cochrane 

P.O. Box 1660 

Cochrane, Ontario 

POL ICO 



56 THE CANADIAN NURSE 



JANUARY 1974 



EXCITEMENT IN NURSING 

plus 

THE MAGIC OF ARIZONA 

jfessionalism m a perfect setting, join 
im in a new. modern, fully accredited 
I with services focused on care of adult 
s. Openings all stiifts for RNs and LPNs. 
opportunities also for interested or 
need ICU-CCU Nurses. 

our nursing units are in-tfie-round 
ting our giving individualized patient 
Located in a delightful retirement 
nity near Phoenix. Arizona. This is the 
t. safest, resort area in the US You 
joy the advantages of a large metro- 
area with none of its problems. 

ke the opportunity to give you all the 



Welch 

tant Director of Nursing 
ER 0. BOSWELL HOSPITAL 
Box 10 
lity, Arizona. 
An Equal Opportunity Employer. 



GENERAL DUTY and 
NSIVE CARE UNIT NURSES 

I or 1 39 Acute, 30 Extended Care 
Bed Modern Accredited Hospital 
on Vancouver Island. Excellent 
recreational facilities and within 
easy reach of Victoria and Vancou- 
ver. 

Personnel Policies as per RNABC 
Contract. 

Apply: 

Director of Nursing. 
West Coast General Hospital, 
814 - 8th Avenue, North, 
Port Alberni, B.C. 



COLLEGE OF 
NEW CALEDONIA 

FACULTY POSITION 
DIRECTOR OF NURSE TRAINING 

REQUIRED A qualified person to develop and 
co-ordinate a two year registered nurse 
diploma programme, this is a new programme 
planned to start in the fall of 1974 in a 
growing community college. 

QUALIFICATIONS: fi^asters degree in nursing 
or equivalent experience in nursing educa- 
tion knowledge of current nursing practices 
administrative experience helpful 

Salary commensurate with education prepara- 
tion and experience, attractive fringe benefits 
and relocation allowance 

Apply in writing immediately stating qualifica- 
tions, experience, references and date avail- 
able to 

Or. F.J.SPECKEEN. PRINCIPAL. 
COLLEGE OF NEW CALEDONIA. 
2001 CENTRAL STREET. 
PRINCE GEORGE. B.C. 



CH9 



Everyone Knows 
Where We Are! 



Where Are You? 



Come and nurse in exciting Montreal at — 



The Montreal General Hospital 

a teaching hospital of McGill University 






^. 



■"^w*'' 



^ 



The Montreal General Hospital 

1650 Cedar Avanu*, Monlraol 109, Quebec 



Please tell me about hospital nuraing under Quebec's new concept of Social and 
Preventive Medicine. 



Name_ 



Address 



Quebec language requirements do not apply to Canadian oppiiconts. 

i I 



JANUARY 1974 



THE CANADIAN NURSE 57 



MISERICORDIA HOSPITAL 
EDMONTON, ALBEKTA 

has vacancies for 

GENERAL DUTY 
REGISTERED NURSES 

Edmonton is a fast growing Mei- 
ropolitan area of 500,000 people. 
Our modern 555 bed active treat- 
ment hospital offers an orientation 
program combined with an active 
inservice education program. 

Please apply to: 

MJsericordia Hospital 

16940 - 87th Ave. 

Edmonton, Alberta 

T5R 4H5 




VANCOUVER 
GENERAL HOSPITAL 

requires 

REGISTERED NURSES 

FOR REGULAR AND 
VACATION RELIEF POSITIONS 

For details and application 
please write tO: 

PERSONNEL SERVICES 

VANCOUVER GENERAL HOSPITAL 

855 West 12th Ave. 
Vancouver 9, B.C. 

Registration in British Columbia required. 
Contact: 

Registered Nurses' Association of B.C. 
21 30 West- 12th Ave., 
Vancouver 9, B.C. 
for details. 



CLINICAL NURSE 
SPECIALIST 

FOR 

IVIED-SURG 
NURSING 

REQUIRED IN 254-BED 

ACTIVE CARE 

GENERAL HOSPITAL 

APPLY TO: 
Director of Nursing 
Moose Jaw Union Hospital 
Moose Jaw, Sasl:. 
692-1841 



McMASTER 

UNIVERSITY 

School 

of Nursing 

Nurse faculty members, including an Asso- 
ciate Director, required for July, 1974 by a 
progressive Scfiool of Nursing. Tfie School is 
an integral part of a newly developed Healtfi 
Sciences Centre where collaborative relation- 
sfiips are fostered among the various fiealtti 
professions. 

Requirements: master s or doctoral degree 
preferred, with clinical specialist preparation 
or experience and/or preparation in teaching. 

Salaries; commensurate with education and 
experience. 

Application, with copy of 

curriculum vitae and two 

references to 

Dr. D.J. Kergin, Director, 
School of Nursing, 

McMaster University, 

Health Sciences Centre, 

1200 Main Street West, 

HAMILTON, Ontario, 

L8S 4J9. 



THE MONTREAL 
CHILDREN'S HOSPITAL 

REGISTERED NURSES 
NURSING ASSISTANTS 

Our patient population consists of 
the baby of less than an hour old 
to the adolescent who has just 
turned seventeen. We see them in 
Intensive Care, In one of the Med- 
ical or Surgical General Wards, or 
in some of the Pediatric Specialty 
areas. 

They abound in our clinics and 
their numbers increase daily in our 
Emergency. 

If you do not like w/orking with 
children and with their families, 
you would not like it here. 

If you do like children and their 
families, we would like you on our 
staff. 

Interested qualified applicants 
stiould apply to the: 

DIRECTOR OF NURSING 
Montreal Children's Hospital 
2300 Tupper Street 
Montreal 108, Quebec 



DOUGLAS HOSPITAL 

IN METROPOLITAIN MONTREAL 

A multi-disciplinary psychiatric hospital 
1,100 adult and 100 children's beds; 

requires 

NURSING STAFF ON ALL LEVEL! 

We invite enquiries from registered nurse 
experience in psychiatric nursing oi 
graduates for our medical, geriatr 
children's services. 

Nursing assistants with experience or 
graduated. Psychiatric nursing bachgro 
preferable but not essential. 

Language requirement for licensing in ( 
not applicable to Canadian citizens. 

Applications and enquiries should be sent 

DIRECTOR OF NURSING 
6875LaSalle boulevard 
Verdun 204, Quebec. 



REGISTERED NURSES 

AND 

REGISTERED NURSING ASSISTAf 

required for a 104-bed active treatmei., ^,-- 
72-bed chronic care unit located at Haileybury, 
The Tri-Town area consisting of New Liskeard, 
Haileybury, Cobalt all within 5 miles of each 
other is located 90 miles from North Bay 
with daily plane, train and bus service to and 
from Toronto etc. Beautiful recreational facil- 
ities including curling, skating, skiing, swim- 
ming, boating, hunting, fishing. 

Salary fully appropriate to the responsibility of 
the position-, personnel policies in line with 
industry and hospital practice. Orientation 
and In-Service Educational programmes are 
provided. 

Apply In writing tO: 

PERSONNEL DIRECTOR, 
Temiskaming Hospitals, 
Haileybury, Ontario. 



THE LADY MINTO HOSPITAL 
AT COCHRANE 

invite applications from 

REGISTERED NURSES 

54-bed accredited general hospi- 
tal. Northeastern Ontario. Compe- 
titive salaries and generous bene- 
fits. Send inquires and applications 
to: 

MISS E.LOCKE 

Director of Nursing 

The Lady MInto Hospital at 

Cochrane 

P.O. Box 1660 

Cochrane, Ontario 

POL ICO 



56 THE CANADIAN NURSE 



JANUARY 1974 



EXCITEMENT IN NURSING 
THE MAGIC OF ARIZONA 

For professionalism m a perfect setting, join 
our team in a new, modem, fully accredited 
tiospital witfi services focused on care of adult 
patients. Openings all stiifts for RNs and LPNs, 
Great opportunities also for interested or 
experienced ICU-CCU Nurses. 

All of our nursing units are in-the-round 
facilitating our giving individualized patient 
care. Located in a delightful retirement 
community near Phoenix, Arizona. This is the 
sunniest, safest, resort area in the U.S. You 
will enjoy the advantages of a large metro- 
politan area with none of its problems. 

We'd like the opportunity to give you all the 
details! 

Write tO: 
Mary Welch 

Assistant Director of Nursing 
WALTER 0. BOSWELL HOSPITAL 
P.O. Box 10 
Sun City, Arizona. 

An Equal Opportunity Employer. 



GENERAL DUTY and 
INTENSIVE CARE UNIT NURSES 

for 139 Acute, 30 Extended Care 
Bed Modern Accredited Hospital 
on Vancouver Island. Excellent 
recreational facilities and within 
easy reach of Victoria and Vancou- 
ver. 

Personnel Policies as per RNABC 
Contract. 

Apply: 

Director of Nursing, 
West Coast General Hospital, 
814 - 8th Avenue, North, 
Port Alberni, B.C. 



COLLEGE OF 
NEW CALEDONIA 

FACULTY POSITION 
DIRECTOR OF NURSE TRAINING 

REQUIRED A qualified person to develop and 
co-ordmate a two year registered nurse 
diploma programme, this is a new programme 
planned to start in the fall of 1974 in a 
growing community college. 

QUALIFICATIONS: Masters degree in nursing 
or equivalent experience in nursing educa- 
tion knowledge of current nursing practices 
administrative experience helpful 

Salary commensurate with education prepara- 
tion and experience, attractive fringe benefits 
and relocation allowance. 
Apply in writing immediately stating qualifica- 
tions, experience, references and date avail- 
able tc 

Or. F,J,SPECKEEN. PRINCIPAL, 
COLLEGE OF NEW CALEDONIA, 
2001 CENTRAL STREET, 
PRINCE GEORGE, EC 



CH9 



Everyone Knows 
Where We Are! 



Where Are You? 



Come and nurse in exciting Montreal at — 



The Montreal General Hospital 

a teaching hospital of McGill University 






\' 



'^'i«i«*'' 



The Montreal General Hospital 

1650 Ctdar Avanua, Atontreal 109, Quebec 



Please tell me about hospllol nursing under Quebec's new concept of Social and 
Preventive Medicine. 



Nanie_ 



Address. 



Quebec language requirements do not apply to Canadian applicants. 



I I 



JANUARY 1974 



THE CANADIAN NURSE 57 



UNIVERSITY OF 
ALBERTA HOSPITAL 

EDMONTON, ALBERTA 
invites applications from general duty nurses 



Opportunities for Professional development in 
general and specialty areas of Medical and Sur- 
gical Nursing, Paediatrics, Obstetrics, Psychiatry, 
Operating Room, Renal Dialysis Unit, and Extend- 
ed Care. 

Planned Orientation Program, 
In-service Education Program. 

Salary commensurate with education and expe- 
rience. 

For further information write to: 

EMPLOYMENT SUPERVISOR — NURSING 
UNIVERSITY OF ALBERTA HOSPITAL 
84 Avenue & 112 Street 
Edmonton, Alberta 



BRISBANE, AUSTRALIA 

REGISTERED NURSES 



Applications are invited from Registered Nurses to fill 
vacancies on tfie staff of the Royal Brisbane Hospital, 
Brisbane, Queensland. Australia Its associate, ttie Royal 
Women's Hospital, invites applications from Registered 
General Nurses desirous of undertaking 12 monttis' mid- 
wifery training course. 

Wages and conditions are in accordance witfi Nurses 
Award (Queensland). Uniforms are provided and laundered 
free of cfiarge; nurses' swimming pool and tennis courts 
are available. Accommodation at a reasonable cfiarge is 
available for applicants wistiing to 'live in'. 

Royal Brisbane Hospital and Royal Women's Hospital, 
Brisbane togethier witfi Royal Children's Hospital, Brisbane 
form a major teaching hospital complex of approximately 
1 700 beds, in a city of approximately 800,000 people. 

Enjoying a sub-tropical climate, Brisbane is within easy 
access to popular surfing beaches and tourist resorts with 
the Great Barrier Reef a little further away. (No work permit 
is necessary on entry to Australia). 

For further information, contact the General Matron, 
the North Brisbane Hospitals Board, Base Hospitals 
Post Office, Brisbane, Queensland 4029, Australia. 



REGISTERED NURSES 

SOUTHERN CALIFORNIA 

An exciting and rewarding career awaits the Canadian educated registered nurse at Saint John's 
recently expanded 611 bed acute-care hospital in sunny Southern California. Challenging positions 
are offered to those who wish to utilize their knowledge and nursing skills in the following areas: 
Coronary and Post Coronary Care; Medical-Surgical; Intensive Care; Orthopedic; Psychiatry; 
Hemodialysis; Emergency Room; Operating Room Nursing; Obstetrics; Pediatrics and Extended Care. 

Located within sight of the beautiful Santa Monica beaches. Saint John's Hospital is at the center of 
Southern California's many diverse recreational, educational and cultural areas. Such activities as 
skiing, boating, swimming, golf and tennis are excellent year around. This together with the numerous 
colleges and universities located within minutes of Saint John's enhances the already attractive 
employment opportunities. You may even meet "Marcus Welby" as our hospital is often used as the 
set for the T.V. series. 

An outstanding fringe benefit package is supported by an equally impressive salary schedule. General 
starting salary guidelines are as follows: 

R.N.'s one year experience $845/mo. USA 

R.N.'s B.S. degree $845/mo. USA 

R.N.'s B.S. degree & one year's experience $888/mo. USA 

A ten-percent shift differential is paid for evening or night shift work. 

Please don't hesitate! Write today for information regarding California Licensure and 
work visa requirements. 

Employment Office 

Saint John's Hospital — 1328 22nd Street, 

Santa Monica, California 90404 



58 THE CANADIAN NURSE 



JANUARY 1974 




CARIBOO COLLEGE 

KAMLOOPS 
BRITISH COLUMBIA 

Situated north of the Okanagan Valley in a city of 
55,000. 

Applications are invited for teaching positions in an 
established, approved two-year diploma nursing 
program. Positions will be available from the spring 
of 1974. 

Applicants with a Master's degree are preferred. 
Minimum requirements are a baccalaureate degree 
with experience in nursing and teaching and eligibili- 
ty for registration in B.C. 

Attractive salaries commensurate with preparation 
and experience. 

Apply in writing stating experience, qualifications 
and references to: 

Chairman of Nursing 

Cariboo College 

Box 860 

Kamloops. B.C. V2C 5N3 




COILEGE 

Invites applications for the position of 

DEAN OF NURSING 
EDUCATION 

This position has direct responsibility for the administra- 
tion, co-ordination and development of nursing education 
programs throughout the College. These at present consist 
of about 700 students enrolled in R.N and R N.A. pro- 
grams. The College has also been developing post diploma 
courses in various nursing fields. In addition to responsi- 
bility for nursing education, the person appointed will be 
expected to assist the senior management team of the 
College and to contribute to the development of overall 
College policies in this area. 

Candidates should be nurses registered (or eligible for 
registration) in the Province of Ontario with advanced prep- 
aration in either administration or education and prefer- 
ably with considerable experience in nursing education and 
related fields 

Applications, giving full details of education, qualifications, 
experience, and the names of two referees, should be sent 
to: 

The Personnel Officer. 

Fanshawe College, 

P.O.Box 4005, 

Terminal C. 

London. Ontario NSW 5H1 

Closing date for applications: 31st January, 1974 




Jewish General Hospital 

Montreal, Quebec ■ 

A modem 700 bed non-sectarian hospital which has general and special services. 
Active In-Service Education Programme, including Planned Orientation Programme. 
Excellent personnel policies. Bursaries for post-basic University courses in Nursing 
Supen/ision and Administration. 
Applications invited from Registered Nurses and Nursing Assistants. 

For further information, please write: 

Director, Nursing Service JEWISH GENERAL HOSPITAL 
3755 Cote St. Catherine Road Montreal 249, Quebec 



JANUARY 1974 



THE CANADIAN NURSE 59 



ROYAL VICTORIA 
HOSPITAL 

MONTREAL, QUEBEC 
invites applications from 

REGISTERED NURSES 

for 

GENERAL DUTY 

Inservlce Education program, progressive Personnel 
Policies. Inquiries from nurses with special clinical or 
educational preparation are welcome, including cardiac 
and other intensive care areas. 

Language requirement for licensing in Quebec not 
applicable to Canadian citizens. 

For further information apply to: 

The Director of Nursing 

ROYALVICTORIA HOSPITAL 

Montreal 112. P.Q. 



TORONTO 
GENERAL HOSPITAL 

Invites applications from 

REGISTERED NURSES 
REGISTERED NURSING 

ASSISTANTS 
FOR GENERAL DUTY 

— Superior opportunities for Professional Grov^'th 
and Development. 

— Progressive Personnel Policies. 

— Excellent opportunities for advancement in 
atmosphere of medical excellence. 

Please apply to: — 

Personnel Office 

TORONTO GENERAL HOSPITAL 

101, College SL, 

Toronto, Ontario, 

M5G 1L7. 



OTTAWA CIVIC 
HOSPITAL 

REQUIRES 

HEAD NURSES FOR 
MEDICAL UNITS 

AND 

SUPERVISOR OF 
ORDERLIES 



Apply in writing to: 

Miss Marjorie Mills, Reg.N. B.Sc.N. 

Assistant Director Nursing Service 

Ottawa Civic Hospital 

1053 Carling Ave. 

Ottawa, Ontario 

K1Y4E9 




ORTHOPAEDIC tC ARTHRITIC 
HOSRITAL- 



\«/|\^ 



43 WELLESLEY STREET, EAST, 

TORONTO, ONTARIO 

M4Y1H1 



Enlarging Specialty Hospital offers a unique op- 
portunity to nurses and nursing assistants interested 
in the care of patients with bone and joint disorders 

Must be registered in the Province of Ontario. 

Preparation by post-graduate education or exper- 
ience required for Senior positions. 






60 THE CANADIAN NURSE 



JANUARY 1974 




DALHOUSIE UNIVERSITY 

SCHOOL OF NURSING 

FACULTY POSITIONS AVAILABLE 

July, 1973 

1) Medical Surgical Nursing 

2) Psychiatric Nursing 

3) Community Health Nursing 

4) Maternal-Child Nursing 

Masters degree required. 
Apply to: 

Dr. Floris E. King 

Director 

SCHOOL OF NURSING 

DALHOUSIE UNIVERSITY 

Halifax, Nova Scotia 



WE CARE 




HOSPITAL: 

Accredited modern general - 260 beds. Expansion 
to 420 beds in progress. 

LOCATION: 

Immediately north of Toronto. 
APARTMENTS: 
Furnished - shared. 

Swimming Pool, Tennis Court, Recreation Room, 
Free Parking. 

BENEFITS: 

Competitive salaries and excellent fringe benefits. 
Planned staff development programs. 

Please address all enquiries to: 
Assistant Administrator (Nursing) 
York County Hospital, 
NEWMARKET, Ontario. 
L3Y 2R1 




NURSING 
ADMINISTRATOR 



AVAILABLE 

A challenge in the Community Nursing Education 
Programme 

WHEN 

Begins July 1, 1974 



WHERE 

Evening Division 
Loyola of Montreal 
Health Education 

HOW 

As Assistant to the Coordinator of Community 
Health Nursing 

WHO 

Holds a Master's Degree in Nursing and has the 
ability to work with people in a challenging multi- 
discipline programme, preferably bilingual 

SALARY 

According to University scale 

INFORMATION FROM 

G. Lennox 

Programme Coordinator for Health Education 

Loyola of Montreal 

Evening Division 

7270 Sherbrooke Street West 

Montreal, Quebec 

H4B 1R6 

Tel. 514-482-0320 (loc. 427) 




THE SCARBOROUGH 
GENERAL HOSPITAL 

invites applications from: 

Registered Nurses and Registered Nursing Assist- 
ants to work in our 650-bed progressive, accredit- 
ed, community-centered, active treatment hospital. 

We offer opportunities in Medical, Surgical, Paediatric, and Obstetrical 

nursing. 

Our specialties include a Burns and Plastic Unit, Coronary Care, Intensive 

Care and Neurosurgery Units and an active Emergency Department. 

• Obstetrical Department — participation In "Family centered" teach- 
ing program. 

• Paediatric Department — participation in Play Therapy Program. 

• Orientation and on-going staff education. 

• Progressive personnel policies. 

The hospital is located in Eastern Metropolitan Toronto. 
For further information, write to: 

The Director of Nursing, 

SCARBOROUGH GENERAL HOSPITAL, 
3050 Lawrence Avenue, East, Scarborough, Ontario. 



lANIIARY iq7d 



THi TANADIAN NURSE fil 



PROVINCE OF BRITISH COLUMBIA 

requires 

REGISTERED NURSE - 
HOSPITAL CONSULTANT 

(INSPECTOR-HOSPITALS AND 
CONSULTANT) 
VICTORIA 
B.C. Hospital Insurance Service. To carry out consul- 
tation and on-site inspection work related to acute, 
rehabilitation, extended care and private hospitals 
(nursing homes), requiring some travelling; to advise 
on standards and quality of care; to prepare and 
make recommendations; to conduct special surveys; 
to co-operate with other Consultants in the review 
of hospital operating estimates and construction 
plans; to perform research duties and recommend 
methods of increasing efficiency and improving 
nursing administration; to stimulate the development 
of new programs. Requires Registration, or eligibility 
for Registration, with the Registered Nurses' Associa- 
tion of British Columbia; preferably, a University 
degree in Nursing; OR, a diploma in teaching, admin- 
istration, clinical supervision, or equivalent, plus 
considerable experience, including work at a senior 
administrative level. Starting salary up to $1,011, 
depending on qualifications and experience, rising 
to $1,133. Obtain applications from the CIVIL SER- 
VICE COMMISSION OF BRITISH COLUMBIA, 544 
Michigan Street, VICTORIA, and return IMMEDIATE- 
LY COMPETITION NO. 73:1656. 



BORED? 
RESTLESS? 



R 



— Stimulating General Duty activities in 
a 675 bed hospital — on a unit of your 
choice 

— Leisure time activitiesthat are interest- 
ing and exciting 



Apply to: 

Director of Nursing 
Reglna General Hospital 
Regina, Saskatchewan 




THE RELIGIOUS 
HOSPITALLERS 
OF SAINT JOSEPH 



INVITE YOU to share their 300 year heritage of service to the 
Church in health, education and welfare services in 
the United States, Canada and France 

to share their availability to reach out to those in 
need in Africa. Peru and the Dominican Republic 
proclaiming Christ's love by care and prevention, 
teaching and development programs 

to share their common life of prayer and v»orK in a 
spirit of openness to God and the needs of others 



R.S.V.P. FORMATION CENTER 
4381/2 College St. 
Burlington, Vermont 
05401 

FORMATION CENTER 
4 Toronto Street, 
Ottawa, Ontario. 
K1S0N2 




62 THE CANADIAN NURSE 



JANUARY 1974 



Index 

to 

Advertisers 

January 1974 



Davol Canadii. Ltd 5 

Hollistcr Limited 40 

International Health Institute 50 

J.B. Lippincott Co. ol Canada Ltd 1 

Mont Sutton. Inc 1 1 

C.V. Mosby Company. Ltd 16. 17. IS 

The Nurses" Book StKiety 9 

Perry Rubber Company 6 

Procter & Gamble 45 

Reeves Company |4. ]5 

W.B. Saunders Company Canada. Ltd 47 

Schcring Corporation Limited 52. Cover IV 

Westwood Pharmaceuticals 5 | 

White Sister Uniform. Inc 2. Cover II. Cover III 



.^ cJyi-riisinf' Manai^er 
Cjeorgina Clarke 
The Canadian Nurse 
50 The Driveway 
Ottawa K2P 1E2 (Ontario) 

A (Ivertisinfi Representaiives 
Richard P. Wilson 
219 East Lancaster Avenue 
Ardmore, Penna. 19003 

1 elcphone. (21.^) Mid\\a\ M-I4M7 

Gordon Tit'tin 

2 Tremont Crescent 
Don Mills. Ontario 
lelephone. (416)444-47.^1 

Member of Canadian 
Circulations Audit Board Inc. 



BS3 



Serve Canada's 
native people 




in 

a well 
equipped 
hospital. 



1^ 



Health and Welfare Sant6 « Bien-feire social 
Canada Canada 



Medical Services Branch 

Department of National Health and Welfare 

Ottawa, Ontario K1A0K9 



Please sand- me information on hospital 
nursing with this service. 



Name: 

Address: 

City: 



Prov: 



JANUARY 1974 



THE CANADIAN NURSE 63 



PROVINCIAL ASSOCIATIONS OF REGISTERED NURSES 



Alberta 

Alberta Association of Registered Nurses. 
10256 — 112 Street. Edmonton. T5K 1M6. 
Pres.: A.J. Prowse; Prcs.-Elccl: D.E. Huff- 
man; Vki'-Prcs.: A. Thompson, I. Walker. 
Coiiiniitwes — Staff Niir.\i:\: C. Asp: Nsf;. 
Elm.: W. Mills: /V.vj,-. Practkc: A. Clark: 
Siiperv. Nurses: J. Smith; Project Direc. Nsf>. 
ElIiic: M. Moncrieff. Prov. Office Staff— 
Pith. Rcl. Officer: A. Shaw; Employ. Rel.: 
Y. Chapman: A.wl. Employ. Rel. Officer: 
R.R. Donahue: N.v^'. Serv. Consult.: B. Sel- 
lers: Comiii. Advisor: H. Cotter: Refii.stmr: 
A.R. McKinnon: E.xec. Sec: H.M. Sabin; 
Office Mamifier: M. Garrick. 

British Columbia 

Registered Nurses" Association of British 
Columbia. 21.^0 West 12th Avenue. Van- 
couver. Pies.: G. LaPointe: l^ice-Pres.: T. 
Duck. R. Macfadyen. Committees — Ns/;. 
Eiliic: J.K. Griffith; Nsa. Practice: E.H. 
Dancer; Soc. & Econ. Welf.: B. Archer. Staff 
— £v«-. Direc: P. A. Kennedy: Rcf-istrar: 
H. Grice; As.sl. Ref-i.strar: J. Small: Direc. 
Eiliic Serv.: C. Kermacks: As.sl. Direc Ecliic. 
Serv.: J. McCullagh: Direc. N.i/;. Serv.: T. 
Schnurr; Direc. Personnel Ser\\: N. Paton: 
As.st. Direc. Personnel Serv.: (Placement 
Serv.): F. MacDonald. (Uihor Rel.): G. 
Smale: Direc. Comm. Serv.: C. Marcus; 
Lihniricin: J. Molson; Atlmiii. As.\i.: D. St. 
Germain. 

Manitoba 

Manitoba Association of Registered Nurses, 
647 Broadway Avenue. Winnipeg. R3C 0X2, 
Pies.: F. McNaught: Pa.u Pres.: E.M. Nu- 
gent; Vice-Pres.: R.G. Black. L. McClure. 
Committees — Nsa.: A. Croteau, M. Swe- 
dish: Soc. <$ Econ. Welf.: A. Daniels; Le/iisl.: 
O. McDermott; Bid. of E.xam.: O. McDer- 
mott; Finance: K. DeJong: Profess. Staff — 
Employ. Rel. Advis.: J. Gleason: Piih. Rel. 
Officer: M. Pay men Renistrar: M. Caldwell: 
Contin. Educ. Advis.: H. Sundstrom. 

New Brunswick 

New Brunswick Association of Registered 
Nurses, 231 Saunders Street. Fredericton. 
Pres.: B. LeBlanc: Past Pres.: A. Robichaud; 
Vice-Pres.: S. Cormier, R. Dennison; Hon. 
Sec: S. Robichaud. Committees — Nsf>.: 
Z. Hawkes. S. MacLeod; Nsj;. Asst. Comm.: 
J. Sherwood; Lenisl.: K. Wright: Exec Sec: 
MJ. Anderson: Liaison Officer: N. Rideout: 
Consult. Soc. & Econ. Welf: G. Rowsell: 
Refiistrar: E. O'Connor: A.s.\t. Exec. Sec. & 
Ref;istrar: M. Russell; Eiliic Consult: A. 
Christie. 

Newfoundland 

Association of Registered Nurses of New- 
foundland, 67 Le Marchand Road. St. John's. 
Pres.: E. Wilton: Past Pres.: P. Barrett: Pres. 
Elect: F. Bouzan: Vice-Pres.: E. Summers. 
J. Nevitt. Committees — Nst;. Eiliic: E. 
fid THF TANAniAN NURSE 



Gardner; A'.vj;. Serv.: }. Pawlett: Soc & Econ. 
Welf: W. Williams; E.xec Sec: P. Barrett. 

Nova Scotia 

Registered Nurses' Association of Nova 
Scotia. 60.t.'5 Coburg Road. Halifax. 
Pres.: M. Bradley; Past Pres.: J. Fox: Vice- 
Pres.: Sr. M. Barbara. G. Smith. C. Butler. 
Record. Sec: Sr. M. Gillis; Exec Sec: F. 
Moss. Committees — Nsf;. Educ: J. Blaikie: 
Ns!-. Serv.: S. MacDonald; Soc & Econ. 
Welf: G. Murphy: Advis. N.sf-. Educ: Sr. C. 
Marie; Advis. Nsf;. Serv.:}. MacLean: Em- 
ploy. Rel. Officer: M. Bentley; Piih. Rcl. Offi- 
cer: D. Miller: Admin. Asst.: E. MacDonald. 

Ontario 

Registered Nurses' Association of Ontario. 
.3? Price Street. Toronto. M4W 1Z2. 
Pres.: W.J. Gerhard; Pres. Elect: N.M. Ma- 
rossi. Committees — Socio-Econ. Welf: C.i. 
Seppala; /Vvv.; G.L. Schmidt; Educator: C.J. 
Faulkner: Admin.: M.L. Peart; Exec. Direc: 
L. Barr; As.st. E.xec. Direc: D. Gibney; 
Direc. Employ. Rel.: A.S. Gribben; Direc 
Profe.\s. Devel.: CM. Adams; Re/;. Exec 
Sec: M.I.Thomas, F. Winchester. 

Prince Edward Island 

Association of Nurses of Prince Edward 
Island. 188 Prince St.. Charlottetown. 
Pres.: E. MacLeod: A/a' Pres.: C. Carruthers: 
Pres. Elect: B. Robinson; Vice Pres.: S. 
Mulligan; E.xec. Sec-Ref;.: L. Eraser. C<mi- 
miltees— N.tf!. Educ: D. Sawler; Nsf>. 
Seiv.: J. Peters; Piih. Rel.: H. Wood; Finan- 
ce: C. Carruthers: Lef^isl. & By-Ltnvs: Sr. 
M. Cahill; Soc & Econ. Welf: M. Babineau. 

Quebec 

Association of Nurses of the Province of 
Quebec. 4200 Dorchester Blvd.. W.. Mont- 
real. H.3A 1V2. 

Pie.\.: R. Bureau: Vice-Pres.: S. O'Neill, 
J. Pinkham. (Eng.). P. Proulx. Y. LePage, 
(Fr.); H<ni. Treas.: C. Royer: Hon. Sec: P. 
Boucher. Committees — N.s/;. Ediic:G. Al- 
len. D. Lalancette. Nsf;. Sen-.: J. Hackwell. 
R. Dionne: Profess. Serv.: S. O'Neill. P. Mur- 
phy; School of Nsf;.: R. Atto. C. de Villiers 
Sauve: Lef;isl.: .M. Masters. C. Belanger: 
Sec Re)>.: N. Du Mouchel; Piih. Rel. Officer: 
M. Jean. 



Saskatchewan 

Saskatchewan Registered Nurses' Associa- 
tion. 2066 Retallack St.. Regina. S4T 2K2. 
Pres.: DJ. Pipher; Past Pres.: E. Linnell; 
Pre.s. Elect: J. MacKay; Vice-Pres.: Sr. B. 
Bezaire, S. Rhoden. Committees — Ns);.: 
I. Watson: Chapters & Piih. Rel.: R. Leding- 
ham; Soc. & Econ. Welf: G. Hutchinson; 
Exec. Sec: A. Mills; Re^tisirar: E. Dumas; 
Puh. Inform. Officer: B. Schill; Nsg. Consult.: 
R. Mireau: A.sst. Registrar: i. Passmore. 



JV"^ ^J Canadian 
kLAsS Nurses' 
v\v Association 



Directors 



President 



Marguerite E. Schumacher 



President-Elect Huguette Labelle 



1st Vice-President .. Beverly Du Gas 



M em ber-at- Large Glenna Rowsell 



Member -at-Large .. K. Marion Smith 



Member-at-Large 



, Denise Lalancette 



Member-at-Large Roberta Coutts 



A.J. Prowse AARN 



G. LaPointe RNABC 



F. McNaught MARN 



B. LeBlanc NBARN 



E. Wilton ARNN 



M. Bradley RNANS 



W. Gerhard RNAO 



E. MacLeod ANPEI 



R, Bureau ANPQ 



DJ. Pipher SRNA 



Executive Director 



Helen K. Mussallem 



JANUARY 1974 




DYALE RIB" 
jutifully detailed 
ss for a 
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es3-15 
ite only 
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The soft and fluid 
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Pink, Blue 
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Tunnel waist 
pantsuit for action 
packed days 



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Sizes 3-15 
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Price 
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1254 BAY ST. 

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SCHERIIMGi 



Howto1cateh"a cold 




Surprise a cold right at its onset with 
Coricidin 'D' for adults and Coricidin 'D' 
Medilets" for children. You can recom- 
mend these products knowing they will 
provide relief from aches, pains and 
fever plus decongestant action. 
Coricidin 'D" and Coricidin 'D' 
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one of the world's most widely used 
antihistamines; phenylephrine, a 
highly effective decongestant and acetyl- 
salicylic acid for aches, pains and fever. 
The adult form contains caffeine as a mild 
stimulant to keep your patients on the go. 



CoricidinD' 



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ror rnmn 



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Nurse 



February 1974 I 



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OTTAWA KIN 5H9 00056886 




WHITE SISTER DESIGNS FOR THE 
BUSY LIFE ^Ki-^vYOU LEAD 




Style #42445 

Royale corded tricot 

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Pale Blue, Navy .. about $27.00 



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Royale oxford tricot 
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White about $20.00 

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r^ADCiTD ADDADCl AT PIMP QTnRF.q AP-RO.^S r.ANADA 




NURSING 




© 



© 



CRITICAL CARE NURSING , 

Hudak. Gallo and Lohr 

This book's holistic approach is based on the 
interrelation of the major body systems — res- 
piratory, cardiovascular, renal and nervous — 
with mans' needs as a framework. Holism is 
explained in terms of physiological consider- 
ations for crisis nursing and emotional response 
to illness. Anatomy, physiology and pathophysi- 
o'ogy, management modalities and assessment 
skills are discussed in relation to the major 
body systems. Nursing practice in the critical 
care unit is examined, including staff training 
and development and legal responsibilities. 



© 



Lippincott 



500 pages 



1973 



© 



STUDENT WORK MANUAL IN 
CRITICAL CARE NURSING 

Lippincott 1973 90 pages 



$9.95 



$3.75 



© 



© 




GUIDELINES FOR COMPREHENSIVE 
NURSING CARE IN CANCER 

Memorial Sloan-Kettering Cancer Center 
Report of a series of seminars directed by 
Beatrice Chase and Guy Robbins, M.D., bring- 
ing together today's expert knowledge about 
caring for patients with various types of cancer. 
Springer 1973 399 pages $7.95 

CARE OF THE OLDER ADULT 

Birchenall and Streight 

A valuable text in an increasingly important 
area of health care for the practical/vocational 
nurse. Content includes the older person in the 
family and society, developmental tasks; com- 
munity aspects; housing, health, nutrition, 
recreation: normal aging; nursing in long-term 
facilities. Restorative nursing is emphasized. 
Lippincott 1973 250 pages paperbound $4.75 

ESSENTIALS OF NURSING RESEARCH 

Wo»er 

This eminently knowledgeable book, by the 
recent editor of Nursing Research, explains the 
techniques of preparing and using research re- 
ports. Specifically designed for nurses and stu- 



THE GERIATRIC AIDE 

Stolten 

Techniques and procedures in such specific 
geriatric areas as physical therapy, food and 
fluid intake, skin care, and bowel and bladder 
control are included. Important chapters deal 
with common geriatric conditions requiring 
special care, such as stroke, arthritis, mental 
disorders, and diabetes. A handy study guide 
of questions at the beginning of each chapter, 
a helpful glossary of terms, and a student work 
record are just a few of the useful items in- 
cluded. 

Little Brown 1974 375 pages, illustrated 

paperbound $7.95 



© 



dents of nursing, the volume is in three main 
parts: Introduction. The Research Process. 
Reporting and Evaluating Research. 
Springer 1974 160 pages $8.95 

DYNAMIC PSYCHIATRY IN SIMPLE 
TERMS 

Mezer 

Revised and expanded 5th Edition of this pop- 
ular introduction to psychiatry. Provides in 
clear English, a basic understanding of psy- 
chiatric concepts and classifications of mental 
illness, as well as the methods of treatment. 
Springer 1974 200 pages $4.95 




Serving the health professions in 

Canada since 1897 

J. B. Lippincott Co. of Canada Ltd. 

75 Horner Ave. 

Toronto, Ontario M8Z 4X7 

Representing in Canada: 

Little Brown and Company 

Blackwell Scientific Publications Ltd. 

Springer Publishing Company, Inc. 



Please send me the book(s) whose numbersCs) I have circled 

1 5 

2 6 

3 7 



Name 

Address 

City 



Province 



n Payment enclosed (send postpaid) 
Books may be returned within 15 days 



Position 

Postal Code 

Q Use my Chargex number 
n Charge and bill me 



CN-2-74 



FEBRUARY 1974 



THE CANADIAN NURSE 1 




SOME STYLES ALSO AVAILABLE IN COLORS . . . SOME STYLES 3y2-12 AAAA-E, about 23.95 to 29.95. 

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. CM 2, 7912 Bonhomme Ave. • St. Louis, Mo. 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 70, Number 2 



February 1974 



19 A Diploma is Not an Oil Painting! M. MacDougai 



22 Ethics of Nursing Practice M. Allen 



24 When You Visit a Sick Friend 



25 Clinical Laboratory Procedures E.M. Watson. A.H. Neut'cld 



I he views cxprCNsal in ihc cdilorial unci various articles are those of the authors and 
do not necessarily represent the policies or views ofthc Canadian Nurses' Association. 



4 Letters 

7 News 

45 In a Capsule 

46 Dates 

47 Names 

49 New Products 



5 1 Research Abstracts 

54 Books 

60 AvAids 

61 Accession List 

79 Index to Advertisers 

80 Official Directory 



F-.xcculivc Direclcir: lli'ltn K. Mussallvm • 
I dilor; Virginia A. Lindabury • Assist, ml 
I ililiirs: l.iv-Klli-n I, ockebvr);, Dorothy S. 
Starr • rditorial Assistant: Carol A. I)««r- 
kin • l'i(nUicliim Assistant: Klizabi'tli A. 
Slanlon • ( iiculiition Manager: Btryl Dar- 
lin{> • AdvL-rtising ManagL-r: (k'or)>ina Clarke 

• Subscription Ratt-s: Canada: (mk- \L',ir. 
S6.(l(l; l\\(i years. SI I .(K>. I iircign. one uar. 
$6.50; two years, $12.00. Single copies: 
$1.00 eactt. Make cheques or money orders 
payable to the Canadian Nurses Assoeiali<iii. 

• Chan)>i' of .\ddrt'ss: Six weeks' notice; the 
okl iidtiress as v,\-\\ ;is the new ;ire neeessaiA. 
together with registr;ition luiniher in a pro- 
vincial nurses' ;issoeiation. where applicable. 
Not responsible lor iournals lost in mail due 
to errors in address. 



IVIanuscripl Information: 11k C ,inailian 
Nurse" uelconies unsolicited ;irticles. All 
maiHiseripIs should be t\ped. ilouble-spaeed. 
on one side ol unruled paper leaving wide 
margins, Vhinuseripts are accepted lor review 
tor exclusive publication, I he editor reserves 
the right to make the usual etlitori.il eli,inges, 
Photographs (glossv prints) ;ind graph- ,ind 
diagr;ims (drawn in iiuIki ink on while p.iperl 
are welcomed with such articles. I he editor 
is not committed to publish all ;irlicles sent, 
nor to indicite delinite dales of publication. 

Postage paid in cash at third class rate 
MONIKIAl, l',0. Permit No, ID.Odl. 
50 the f:)rivewav. Ottawa. Ontario, K^P 112 



I ( an,itli,in Nurses' \s 



l»74. 



FEBRUARY 1974 



I'm presently reading Margaret M. 
Street's book "Watch-fires on the 
mountains: the life and writings of 
Ethel Johns'" This is a fascinating 
biography of the late Ethel Johns, 
who was editor of The Canadian 
Nurse from 1 933 to 1 944. 

Ms. Johns had a lively sense of 
humor, which frequently found its 
way into her monthly column "Off 
Duty.' In her August 1943 column, 
she wrote about her lack of "math- 
ematical sense, " which presented 
problems when she tried to com- 
plete her income tax return. Her 
unique method of calculating this 
tax is inspirational at this time of 
year. 

"First, we bought a book that 
claimed to tell all about it in six easy 
lessons. Then we wrapped a wet 
towel round our aching brow, prop- 
ped the book open in front of us, 
and filled in the form to the best of 
our ability. 

"The next morning we took it to 
the Income Tax office and proudly 
offered it to a bored official. He 
didn't seem to share our high opin- 
ion of it and ran a disdainful pencil 
through our carefully computed 
percentages .... You have not 
indicated whether the total of com- 
pulsory savings portion isthe lesser 
of either (a) one-half of item J or (b) 
is greater than the total of voluntary 
savings (if any) as compared with 
the refundable portion of tax, less 
item K.' 

"We feebly muttered that we 
hadn't gone that far at school and 
that it wasn't in the Income Tax 
book either. 

" 'We can't help that, madam,' 
said he. 'False information or omis- 
sion incurs a fine of ten thousand 
dollars or six months imprisonment 
or both.' 

"Since we evidently have to go to 
jail anyway, we arrived at the requi- 
red estimates by adding our tele- 
phone number to item J and then 
subtracting the total from item K. 

"It seemed wise to refrain from 
submitting this final revision per- 
sonally, so we just sent it by regis- 
tered mail to the Receiver General 
of Canada. We will let you know 
later how he reacted to it. They let 
you write letters even in jail. — E.J. ' 

— V.A.L. 

*A review of this book will appear in a 
future issue of The Canadian Nurse 

THE CANADIAN NURSE 3 



letters | 



Letters to the editor are welcome. 

Only signed letters, which include the writer's complete address, 

will be considered for publication. 

Name will be withheld at the writer's request. 



Readers recall influenza 

I was interested in the article in the 
December issue by Gladys Mortem. 
"The pandemic influenza of 19 hS." I 
do not imagine many nurses practicing 
today will recall those times. I was only 
a child of 10, but I can vividly remem- 
ber the horrors of that epidemic. 

1 was the eldest of three children 
living on a farm in central Saskatch- 
ewan. My father, a road construction 
contractor who used to come home on 
weekends to instruct my mother in 
farm operations, suddenly arrived home 
very ill and reported having to close 
down his work because 70 to SO percent 
of his men were ill. 

Within a week our two hired men 
and the family, except my mother and 
myself, were ill. Outside chores, cook- 
ing, caring for the sick, and so on were 
left to us. Within another week, 1 sud- 
denly became ill; although not acutely 
sick, ! spent nearly three months recov- 
ering. Mother worked outside, cooked, 
and cared for the sick without help. 
Every houschokl in the community 
and village was stricken and deaths 
occurred daily. My father and brother 
were very ill with pneumonia, but re- 
covered as did my young sister. 

Our one village doctor, who had a 
chauffeur, slept in his car only between 
calls. Being on the road day and night, 
he visited at all hours. How he survived 
only God knows. He was concerned 
about my mother, who never seemed to 
rest. He finally organized a makeshift 
hospital and moved our two hired hands 
there. 

When my father began to improve 
and felt he should relieve my mother of 
the outdoor chores, my mother — usu- 
ally a placid soul — locked him in the 
house while she carried on with the 
chores. 1 can still recall his ranting over 
the fact that mother had defied him. 

My father said his frequent hot 
whiskey tt)ddies saved his life. How- 
ever my mother, who was a teetotaler, 
did not altogether agree with him. She 
simply maintained that she never had 
time to become ill. — E. Sanders. 
Maiclsioiw, Saskatchewan. 

I was particularly interested in the 
article concerning the influenza epi- 
demic of 191 S. I was a 12-year-old 
living in Massachusetts at that time. 
My brother was due to enter the army 
in October, presumably to be sent to 
4 THE CANADIAN NURSE 



France. He went to visit friends in 
another city and came back to report the 
death of one from "flu and the illness 
of another. A few days later my brother 
was in bed with the 'flu and soon con- 
tracted pneumonia. 

I also had a mild case of the "flu. so 
was confined to bed. I was ttxi young 
to realize how ill my brother was. My 
chief thought was that his entry into 
the army had been postponed. 

This article brought back memories 
of my parents" days of worry, and made 
me realize how serious the family situa- 
tion might have become. Because of the 
illness, my brother's induction was 
postponed to November 1 1, and his en- 
tire four months of army service were 
spent in Boston harbor, instead of in 
France! — Edna Frye, Vermont. 

Second-class nurse 

I am getting tiied of being considered 
a second-class nurse because 1 work in 
a home for the aged, i think it is time 
to do something about this. 

Registered nurses in Canada who 
work with the aged are not giving them- 
selves a chance. They have allowed 
themselves to be pushed into a corner 
of the nursing world and forgotten — 
the way some people forget their old 
folk. 

Is it fair that we should be paid less 
because we choose to work with the 
aged'.' Does working with the aged 
mean we can take life easy, not have 
to care about the job, and not work as 
hard as we would in a hospital? Some 
persons apparently think so. 

Let anyone take over, for just one 
day, the duties of an RN caring for 50 
or more agitated, noisy, confused, 
demanding, and senile aged persons. 
One day should be enough to convince 
them of the RN"s value and make them 
ask why she is being paid less than her 
hospital sisters. 



Registered nurses, 
your community needs 
|the benefit of youi 
skills and experience. 
Volunteer now to 
leach Si. John Ambulance home 
niusinp and child care courses. 

Contact your Provincial Headquarters, 
St. John Ambulance. 



There is another facet to this argu- 
ment — our patients, themselves. Are 
they not the ones who struggled through 
a depression and helped win a war? 
To many of these old folks, whose rela- 
tives are either gone or do not have 
time for them now that they are old, 
the RN who cares for them is a queen, 
a reason for living, one of the few links 
with an outside world that seems other- 
wise to have forgotten their existence. 

Should we punish them because they 
have dared to grow old? Of course not! 
But they arc being deprived because 
good nurses, who are particularly suit- 
ed to caring for the aged, are being 
lured into better-paid jobs in hospitals 
— jobs that any RN could do. 

Only the truly dedicated nurse will 
deliberately choose to work for a lower 
salary, and with the lower status that 
implies, however much she might be 
drawn toward the elderly. Dedication 
is fast becoming a luxury in this topsy- 
turvy world. 

By not standing up for our rights, 
we are not just letting ourselves down. 
We are letting our patients down, too, 
because we are implying they arc not 
important enough to fight for, or to care 
for. They deserve the best we can give 
them. -^ Patricia M. Brings, SRN. SCM. 
Reg.N., London. Ontario. 

Letter must be answered 

The letter "Nurses should not retire" 
(December 197 3, page 4) must be 
answered. 

I was out of nursing for 20 years and 
have been back for two. I must admit 
that at first it was grim. You need a 
brave director of nursing and a long 
suffering head nurse. Medicines are 
all new. Intensive care units did not 
exist, but it is amazing what tloes come 
back. 

About five or seven years ago, one of 
the hospitals in my city had a refresher 
course, but I was unable to attend. This 
winter, St. Lawrence College is giving 
a l.'i-week refresher course. 

I certainly resent being told to step 
down to a registered nursing assistant 
position. I was a good nurse and still 
am, although in a limited capacity. 
Since I graduated, I have never given 
up reading Tlie Canadian Nnrse. There 
arc also many good nursing texts, which 
nurses can fxirrow from their hospital 
to answer their many questions. — J. 
Nciinian. Kingston, Ontario. '^ 

FEBRUARY 1974 



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6 THE CANADIAN NURSE 




Xylocaine® 100 mg 

{lidocaine hydrochloride injection U S P ) 

INDICATIONS-Xylocaine administered intra- 
venously is specifically indicated in the acute 
management of ( I) ventricular arrhythmias occur- 
ring during cardiac manipulation, such as cardiac 
surgery; and(2) life-threatening arrhythmias, par- 
ticularly those which are ventricular in origin, such 
as occur during acute myocardial infarction. 

CONTRAINDICATIONS-Xylocaine is contra- 
indicated (I) m patients with a known history of 
hypersensitivity to local anesthetics of the amide 
type; and (2) in patients with Adams-Stokes syn- 
drome or with severe degrees of sinoatrial, atrio- 
ventricular or intraventricular block, 

WARNINGS -Constant monitoring with an elec- 
trocardiograph is essential in the proper adminis- 
tration of Xylocaine intravenously. Signs of exces- 
sive depression of cardiac conductivity, such as 
prolongation of PR interval and QRS complex 
and the appearance or aggravation of arrhythmias, 
should be followed by prompt cessation of the 
intravenous infusion of this agent. It is mandatory 
to have emergency resuscilative equipment and 
drugs immediately available to manage possible 
adverse reactions involving the cardiovascular, 
respiratory or central nervous systems. 

Evidence for properusage in children is limited. 

PRECAUTIONS -Caution should be employed 
in the repeated use of Xylocaine in patients with 
severe liver or renal disease because accumulation 
may occur and may lead to toxic phenomena, since 
Xylocaine is metabolized mainly in the liver and 
excreted by the kidney. The drug should also be 
used with caution in patients with hypovolemia 
and shock, and all formsof heart block (see CON- 
TRAINDICATIONS AND WARNINGS), 

In patients with sinus bradycardia the adminis- 
tration of Xvlocaine intravenously for the elimina- 
tion of ventricular ectopic beats without prior 
acceleration in heart rate (e.g. by isoproterenol 
or by electric pacing) may provoke more frequent 
and serious ventricular arrhythmias. 

ADVERSE REACTIONS-Systemic reactions of 
the following types have been reported. 

(1) Central Nervous System: lightheadedness, 
drowsiness; dizziness; apprehension; euphoria; 
tinnitus; blurred or double vision; vomiting; sen- 
sations of heat, cold or numbness; twitching; 
tremors; convulsions: unconsciousness; and respi- 
ratory depression and arrest. 

(2) Cardiovascular System: hypotension; car- 
diovascular collapse: and bradycardia which may 
lead to cardiac arrest. 

There have been no reports of cross sensitivity 
between Xylocaine and procainamide or between 
Xylocaine and quinidine. 

DOSAGE AND ADMINISTRATION Single 

Injection: The usual dose is 50 mg to 100 mg 
administered intravenously under ECG monitor- 
ing. This dose may be administered at the rate 
of approximately 25 mg to 50 mg per minute. 
Sufficient time should be allowed to enable a slow 
circulation to carry ihe drug to the site of action. 
If the initial injection of 50 mg to 100 mg does 
not produce a desired response, a second dose may 
be repeated after 10-20 minutes. 

NO MORE THAN 200 MG TO 300 MG OF 
XYLOCAINE SHOULD BE ADMINISTERED 
DURING A ONE HOUR PERIOD. 

In children experience with the drug is limited. 

Continuous Infusion: Following a single injection 
in those patients in whom the arrhythmia lends 
to recur and who are incapable of receiving oral 
antiarrhythmic therapy, intravenous infusions of 
Xvlocaine may be administered at the rate of 1 
mg to 2 mg per minute (20 to 25 ug/kg per minute 
in the average 70 kg man). Intravenous infusions 
of Xylocaine must be administered under constant 
ECG monitoring to avoid potential overdosage 
and toxicity. Intravenous infusion should be ter- 
minated as soon as the patient's basic rhythm 
appears to be stable or at the earliest signs of 
toxicity. It should rarely be necessary to continue 
intravenous infusions beyond 24 hours. As soon 
as possible, and when indicated, patients should 
be changed to an oral antiarrhythmic agent for 
maintenance therapy. 

Solutions for intravenous infusion should be 
prepared by the addition of one 50 ml single dose 
vial of Xylocaine 2% or one 5 ml Xylocaine One 
Gram Disposable Transfer Syringe to I liter of 
appropriate solution. This will provide a 0.1^. 
solution; that is, each ml will contain I mg of 
Xylocaine HCI. Thus I ml to 2 ml per mmule 
will provide I mg to 2 mg of Xylocaine HC! per 
minute. 



FEBRUARY 1974 



news 



Nursing And Health Is Theme 
Of 1974 CNA Convention 

Ottawa — The theme ot the 1 974 c NA 
annual meeting and convention will 
be "Nursing and Health."" It will be 
held in Winnipeg at the Manitoba 
centennial center. June 16 to 21. 1974. 

Registration will begin on Sunday. 
June 16. at noon. An intertaith church 
service will be held at 1600 hours, and 
the opening ceremony at 19.^0 hours, 
followed by a reception. 

Monday. June 17. will be a business 
session with reports from the executive 
director, special committees on the 
testing service and on research, tlnan- 
cial reports, and the report of the com- 
mittee on nominations. At the Monday 
night dinner, there will be a presenta- 
tion to nurses to be honored. 

Two panels on nursing and health 
will be presented on Tuesday. June I S. 
In the morning, a panel will discuss 
New Work Relationships; the afternoon 
panel will focus on New Structures in 
Health Care Delivery. An open forum 
will follow the second panel presenta- 
tion. 

Wednesday morning, June 19, the 
Canadian Nurses" Foundation will hold 
its annual meeting. Also on Wednesday 
morning, CNA voting delegates will 
ch(X)se CNA officers for the biennium. 
Wednesday afterncH>n is tree time. 

Thursday. June 20. is the second day 
devoted to the topic of Nursing and 
Health. In the morning, a panel on 
Personal Attitudes and Professional 
Image is scheduled, to be followed by 
an open forum. Multiple sessions are 
on the program for Thursday afternoon, 
including clinical topics, current re- 
search in nursing practice, relicensing 
and continuing education, specializa- 
tion in nursing, and experiments in use 
of hospital nursing manpower. 

A general business session is sched- 
uled for the morning of the tlnal day of 
the annual meeting and convention. 
Friday. June 21. 

The newly-elected t)fficers will be 
installed at 1400 hours: the president"s 
reception follows. 



NBARN Requests Govt. Attention 
To Pension Plan Discrimination 

h'n'dcricion. N.B. — Last December, 
the New Brunswick Association of Reg- 
istered Nurses sent telegrams to the 
FEBRUARY 1974 



federal government requesting that it 
give priority to the remov;il of discrim- 
inatory aspects of the Canada Pension 
Plan (CPP). 

Bcrnadette LeBlanc. nbarn presi- 
dent, explained that nurses in the prov- 
ince are deeply concerned about the 
unfairness of the CPP's benefit paid on 
the death of a female contributor. 

"Although male and female contrib- 
utors are treated alike as far as pay- 
ments arc concerned, the spt)use and 
family of the female contributor receive 
less benefit from the plan than the 
spouse and family of the male contrib- 
utor,"" the president said, nbarn's 
membership is 99.7 percent female; 
64.4 percent of these members are mar- 
ried contributors. 

The association "s action followed a 
meeting of its executive committee. 
According to Ms. LeBlanc, further 
study on the CPP as it affects nurses 
is being undertaken by a special nbarn 
task committee. 



MARN Studies RNs' Need 
For Refresher Programs 

Winnipeg, Man. — The Manitoba As- 
sociation of Registered Nurses (marn) 
is conducting a province-wide survey 
to determine the number of nurses who 
would return to active practice if re- 
fresher programs were available in 
centers throughout Manitoba. 

The need for such a survey arose 
because many Manitoba hospitals, 
especially in rural areas, are having 
difficulty in obtaining sufficient nursing 
staff. MARN believes there are a num- 
ber of registered nurses who have been 
out of nursing for several years and 
who would return to active nursing if 
refresher programs were available. 

MARN is distributing a questionnaire 
across the province via its members, as 
well as through community newspapers. 
The questionnaire asks formerly active 
registered nurses to indicate their pref- 
erence of 100 centers at which relresher 
programs could be held, the preferred 
time of year for a course, and whether 
the RNs would be prepared to work 
full- or part-time after a^mpleting the 
program. 

Marlene Caldwell. MARN registrar, 
said, "Refresher programs thus far 
have not been available m rural cen- 
ters. This has meant that some former 



nurses, particularly in rural Manitoba, 
because of family responsibilities, have 
been unable to take advantage of the 
chance to update their professional 
knowledge. 

"By offering refresher programs in 
different centers we are hoping to 
encourage these nurses to consider 
returning to active practice."" 



Nursing Committees Set Up 
By EC Health Corporation 

Vancoiner. B.C. — A nursing advisory 
committee, recommended by the direc- 
tors of the Registered Nurses" Asso- 
ciation of British Columbia (rnabc), 
has been established for the new pro- 
vincial crown corporation on health, 
called the B.C. Medical Centre. (News, 
January 1974, page 10). 

Patricia Wadsworth. director of pa- 
tient services at Vancouver General 
Hospital, was named chairman of the 
committee by the Centre's administra- 
tion. The RNABC named Audrey Mur- 
ray, director of nursing at St. Paul's 
Hospital. Vancouver, to be vice-chair- 
man. 

The RNABC has been given the op- 
portunity to appoint two more repre- 
sentatives to the Centre"s professional 
advisory committee; it already has one 
appointee. rnaBC president Geraldinc 
LaPointe. The other two named to the 
committee are Thurley Duck, RNABC 
first vice-president, and Kirsten Web- 
ber, assistant professor at UBC school 
of nursing. The professional advisory 
committee at the B.C. Medical Centre 
takes the place of the medical advisory 
committee that is usual in hospitals. 

The B.C. Medical Centre has also 
established a nursing task committee 
to act in an advisory capacity to the 
planning and building committee, one 
ol the Centre's six major committees. 

SRNA Recommendations Concern 
Nursing Role In Health Centers 

Rc'i>ina. .Sa\k. — The nursing role in 
Saskatchewan's community iiealth and 
social centers should be developed in 
consultation with the Saskatchewan 
Registered Nurses' Association, and 
the department of public health should 
make consultation services on nursing 
matters available to nurses employed in 
these centers. 

THE CANADIAN NURSE 7 



news 



(Conliniicd from pii.i;c 7) 

These two recommendations, ap- 
proved at a meeting held November 
1-3. 1973, by the SRNA council, will 
be communicated to Health Minister 
W.F, Smishek. 

SRNA supports in principle the 
concept of these health and social 
centers, providing they incorporate 
a significant preventive health com- 
ponent in their services. Some of the 
association's concerns regarding the 
community centers are: 

• Nurses employed in these centers 
receive no orientation on the concept 
of the centers, on the preventive care 
role of the nurse, or on community 
nursing.' 

• There are no written policies per- 
taining to nursing practice in the cen- 
ters. 

• No mechanism has been established 
to allow nurses, physicians, and board 
members at the centers to meet annually 
or semiannually for educational pur- 
poses and program planning. 

• Advisory boards, as suggested by the 
department of public health, have not 
been established. 

• No criteria have been developed to 
cover the on-call function of nurses in 
the centers. 

SRNA will also urge that standards 
officers with the Saskatchewan Hospi- 
tal Services Plan make the same visits 
to community health centers as they 
make to hospitals. 

The association's nursing consultant 
has visited five of the existing centers 
to obtain information about the com- 
munities' plans for their centers and the 
role and functions of the nurses em- 
ployed there. 

At the November meeting, the SRNA 
council approved two recommendations 
from the board of examiners concern- 
ing refresher courses for nurses. 

Nurses taking a refresher course 
will be required to reregister imme- 
diately after completing the course, 
and will have to work 30 days within 
the following year. They will also have 
to complete the clinical portion of the 
course within one and one-half years 
from the date they began the theory 
part of the course. 

Nurses who have not been active 
in nursing for five years or more will 
have to take a refresher course approv- 
ed by SRNA before they are eligible 
to practice. At present, a correspond- 
ence refresher course is available 
through the extension department of 
the U. of Saskatchewan. Regina. 

SRNA's standing committee on nurs- 
8 THE CANADIAN NURSE 



ing requested the council to appoint a 
consumer to the committee. It was 
agreed that the Saskatchewan branch 
of the Consumers" Association of 
Canada be asked to name a person to 
serve on this committee. 

A motion to disallow smoking dur- 
ing SRNA council meetings was also 
approved. 



LeDain Report Explains Reasons 
Behind Nonmedical Drug Use 

Ottawa — The crucial factor in using 
an opiate narcotic, such as heroin, for 
the first time is access to the drug. "It 
is a combination of a person being 
psychologically or socially vulnerable 
to heroin use. and receiving encourage- 
ment or persuasion from another per- 
son on whom one feels somewhat de- 
pendent . . .," says the final report uf 
the Commission of Inquiry Into the 
Non-Medical Use of Drugs. 

This I 148-page report was released 
to the public last December, four and a 
half years after the five-member com- 
mission was appointed by the federal 
government. Gerald LeDain, dean of 
Osgoode Hall Law School in Toronto, 
was the chairman. 

In its introduction, it notes the im- 
portance of preventing contact with 
drug users, "especially when persons 
are young, inexperienced, and perhaps 
less able to make prudent choices." 



Official Notice 

of 

Annual Meeting and Convention 

of 

Canadian Nurses' Association 

The 1974 annual meeting and con- 
vention of the Canadian Nurses' 
Association will be held June 16- 
21, 1974, in the Concert Hall of the 
Manitoba Centennial Centre. Win- 
nipeg, Manitoba. The opening 
ceremony will be held on Sunday 
evening, June 16, at I9.M) hours, 
followed by a reception for the 
members, students, and guests 
registered for the meeting. An inter- 
faith church service will be held on 
Sunday afternoon at 1600 hours. 
Business and special interest sessions 
will commence at 0900 hours, Mon- 
day June 17, continuing daily and 
concluding on Friday afternoon, 
J une 2 1 . Students enrolled in schools 
of nursing in Canada may register as 
observers at the annual meeting and 
can participate in special interest 
sessions ana social events. — Helen 
K. Mussallem. Executive Director. 
Canadian Nurses' Association. 



However, many other factors that 
contribute to nonmedical drug use arc 
mentioned. For example, "The drugs 
themselves, as a means of relieving 
discomfort and affording pleasure, exer- 
cise a powerful attraction for people 
who have been conditioned more and 
more to seek comfort and pleasure. 
Modern advertising encourages the 
notion that there is no reason to put up 
with discomfort." 

Although the report says that some 
forms of nonmedical drug use seem to 
have levelled off and even decreased in 
certain eases, as a whole it has conti- 
nued to increase. Other findings are 
that; 

• Alcohol and tobacco remain the ma- 
jor sources of drug-related public 
health problems; 

• The dominant pattern is one of mul- 
tiple drug use, with a hard core of 
indiscriminate, chronic multidrug users 
who encourage the spread of harmful 
drug use; 

• A marked increase has occurred in 
experimental and dependent use of 
the opiate narcotics; and 

• Hallucinogen users have become 
more sophisticated in the ability to 
avoid acute adverse reactions. 

As for treatment of drug dependence, 
the commission considers the outlook 
discouraging. "Efforts to promote 
abstinence in drug-dependent individ- 
uals by long periods of confinement 
in prison or hospital settings have yield- 
ed poor results in the long run." Al- 
though the commission released its 
report on treatment earlier, it devotes 
one section in the final report to opiate 
maintenance and a shorter section to 
the therapeutic community. 

The adverse effects of imprison- 
ment of drug offenders are described 
and suggestions made. "Prison is in 
many ways a finishing schcxil for crim- 
inals. ... It is difficult to think of a 
better way to train people for crime 
than to bring all the criminal types 
together in one long live-in seminar 
on crime. There would be, on the con- 
trary, every interest in trying to keep 
them away from one another .... 

"These adverse effects . . . arc par- 
ticularly reflected in the treatment of 
drug offenders. . . . There is consider- 
able circulation of drugs within penal 
institutions,. . . offenders are reinforced 
in their attachment to the drug culture, 
and ... in many cases they are intro- 
duced to certain kinds of drug use by 
prison contacts." says the report of the 
LeDain Commission. 

In its conclusions and recommenda- 
tions for control of the drug user, the 
commission strongly recommends 
against extending the offence of sim- 
ple possession. "We believe that we 
should gradually withdraw from the 

iCoiiliniiftl.in />(/,;'<■ 10) 
FEBRUARY 1974 



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Next Month 
in 



The 

Canadian 
Nurse 



• Cholera Epidemiology 
and Control 



• Poor Baby: The Nurse 
and Feminism 



Adjusting to imminent Death 



• A Volunteer Nurse 
in Israel 




^ZP 



Photo credit for 
February 1974 



Public Relations Dept.. City Hall 
Montreal, Quebec, cover photo 



news 



( Colli illlK'll flDIII pClfii' fi) 

use of the criminal law against the non- 
medical user of drugs .... There is 
virtually no limit to the number of 
drugs to which it would have to be 
applied if it were to be pursued to its 
logical conclusions." However, this 
recommendation does not apply to the 
strong hallucinogens, such as LSD and 
MDA. 

If there is a serious effort to use the 
criminal law process for diversion to 
treatment or management of opiate 
dependence, the report warns "there 
will have to be not only an increase in 
treatment facilities of all kinds . . . , 
including specialized methadone units 
and therapeutic communities, but a 
considerable increase in the number 
of probation officers and others cap- 
able of assisting with the task of social 
rehabilitation." 



MARN Approves $40 Daily Fee 
For Private Duty Nurses 

Winnipeg. Man. — The directors of 
the Manitoba Association of Registered 
Nurses (MARN) recently approved a 
fee increase to .S40 for S hours' nursing 
care by RNs in private practice. 

The new rate was effective January 
1. 1^74. It replaces a fee of S31 for >S 
hours, which has been in effect for 2 
years. The new hourly rate will be 
.S7.50 for periods of less than 4 hours. 

The increase brings salaries of the 
self-employed nurses into closer align- 
ment with nurses employed by health 
care institutions, MARN says. 



New Labor legislation In Nfld. 
Limits Right To Strike 

St. John's. Nfld. — With the recent 
passing of a controversial bill in the 
Newfoundland House of Assembly, 
strikes by public service employees 
who are classified as "essential" are 
illegal. 

The draft legislation, which was 
passed in October 1973 after much 
debate and amendment, governs collec- 
tive bargaining with respect to certain 
employees in the province's public ser- 
vice. The labor movement has objected 
strongly to three sections of the bill. 

One of these sections states in part: 
"Upon certification of a bargaining 
agent, the [labor relations] board shall 
request the employer of employees in 
the unit to . . . provide the board and 
the bargaining agent with a statement 



10 THE CANADIAN NURSE 



in writing of the employees or classes 
of employees in the unit . . . considered 
by the employer to be essential em- 
ployees . . . . " By "essential," the bill 
defines employees whose duties "may 
be necessary for the health, safety, or 
security of the public or otherwise in 
the public interest." 

David Sparkes, employment relations 
officer for the Association of Reg- 
istered Nurses of Newfoundland, told 
The Canadian Nurse that the main ob- 
jection to this section "is that to pro- 
hibit essential employees from striking 
is to limit the effectiveness of the strike 
weapon. For example, if 50 to 75 per- 
cent of the employees were declared 
essential, then a strike would be com- 
pletely ineffective and meaningless." 

Another objectionable feature of this 
legislation, Mr. Sparkes noted, was 
that compulsory arbitration can be 
imposed under specific circumstances. 
This is "totally unacceptable to prac- 
tically all unions," he said. 



Western Nurse-Midwives 
Form Regional Association 

luhnoiiron. .Aim. — Nurse-midwives in 
Western Canada have formed an asso- 
ciation to include members from Al- 
berta, British Columbia. Saskatchewan, 
the Yukon, and the Northwest Terri- 
tories. 

President of the Western Nurse- 
Midwives Association is Pat Hayes, 
Edmonton; other officers are Sarla 
Sethi, Calgary, vice-president; Peggy- 
Anne Field, Edmonton, secretary- 
treasurer; and members-at-Iarge Jose- 
phine Bertrand. St. Walburg. Sask.. 
and Miriam Roberts. Drayton Valley, 
Alta. 

The association adopted the state- 
ment of the role and functions of nurse- 
midwives delineated by the Registered 
Nurses' Association of Ontario (News, 
July 1973, p. 12) and supported by the 
Canadian Nurses' Association (News, 
December 1973, p. 7). Two ad hoc 
committees were named by the new 
association; the constitution committee 
is chaired by Judith Friend, Edmon- 
ton, and the continuing education com- 
mittee is headed by Mary McL,ees. 
Calgary. 

(3ne objective of the western mid- 
wives association is to promote up- 
grading of nursing care in all areas 
of the maternity cycle in Canada by 
working toward continuing education 
for nurse-midwives and by acting as 
a resource for nurses in obstetrical or 
public health nursing. 

The group is aiming tor a national 
organization of nurse-midwives, a pre- 
requisite for admission to the Inter- 
national Congress of Midwives. 

iCciltiilii'cl nil i>iii;v 12) 
FEBRUARY 1974 



luf actured in Canada for immediate delivei 



^^ggjgg^ 



electable 



pong 



specialty 
Also custom- 



: •.' :>■-.•«»'? *\-TCsVS- -ri^/tt -'_►•. i«I»7aiar"(i tJiS"; J5ya5i3tcl 



ypes 
oyour specifications 




FEBRUARY 1974 



THE CANADIAN NURSE 11 



news 



iCi'iiliiiiird Jniiii fxis^c 10) 

You don't Have To Be A Communist 
To Love Your Brother, OHA Told 

Toronto. Out. — After a recent trip 
to China as leader of a Canadian med- 
ical delegation. Dr. Gustave Gingras 
told members of the Ontario Hospital 
Association October 29, "You don't 



have to be a communist to love your 
brother. It comes from the Bible." 

Speaking at the opening of the OHA 
convention, held October 29 to 31, 
1973, the executive director of the 
Rehabilitation Institute of Montreal 
left the impression that Canadians 
could learn from the Chinese people's 
"acknowledgement of the inadequacies 
of health care there, the modesty . . . 
concerning major advances, the zeal 
of pursuing plans for further improve- 
ment, and the complete subordination 
of individual goals to the success of 
group effort . . . ." 



in geriatric atonic constipation. . . 

Glysennid' tonight- 
action tonnorrow! 



Glysennid ... for predictable action. Taken at bedtime, it 
acts in the morning! Ideal for geriatric atonic constipation. 
Glysennid . . . supplied in easy-to-take tablets. 
Glysennid . . . clinically proven, constant potency. 
Glysennid . . . acts systemically to help re-establish nor- 
mal bowel evacuation patterns . . . ideal for nursing 
homes, institutions. 



Composition: Each tablet contains 1 2 mg sennosides A and B 
Average dosage: 2 tablets at bedtime until normal routine is estab- 
lished. Then 1 tablet at bedtime. Dosage may be increased to a maximum 
of 5 daily if required 

Contraindications: Appendicitis, intestinal hemorrhage, ulcerative 
colitis. 

Supply: Bottles of 1 00 and 500 tablets. 
Full product information available upon request. @ 

SANDOZ 

DOHVAL. QUEBEC 



Sandoz Pharmaceuticals Division of Sandoz (Canada) Ltd , Dorvai Quebec 



^^^^ ml , lll2 i 




12 THE CANADIAN NURSE 



Dr. Gingras pointed out that once 
a year in China, each general hospital 
sends a medical team to visit the coun- 
tryside to treat patients, consult, and 
teach for a few months to a year. Even 
if it is only for a few weeks, "why can't 
we do the same in this country'.'" he 
asked. 

Referring to the rising costs of hos- 
pital care in this country. Dr. Gingras 
said he remembers the abysmal salaries 
paid to dedicated hospital workers, in- 
cluding nurses, a few years ago. "Many 
of the millions and percentage increases 
in hospital costs have simply corrected 
one of the greatest social injustices of 
our time." 

He said he has no obiections to grown 
men being paid $40,000 or $50,000 
per year to play a boy's game on ice or 
on a football field. "But as long as we 
tolerate . . . that standard, by compari- 
son the nursing supervisor in a cardiac 
intensive care unit is grossly under- 
paid." 

So far, the general public has not 
become aware or started to criticize 
hospitals for generally having the most 
junior, inexperienced staff instead of the 
most capable in emergency departments 
on evenings and weekends when the 
most critically ill patients are brought 
in, said Dr. Gingras. 

Nor is the public aware that 25 per- 
cent of patients with spinal cord in- 
juries who are referred by university 
teaching hospitals to rehabilitation cen- 
ters have one or more large decubi- 
tus ulcers. 

Dr. Gingras asked why it is that 
hospitals, "where open heart surgery 
and organ transplantations are per- 
formed, cannot prevent . . . pressure 
sores," which jeopardize the rehabil- 
itation program of so many patients. 
"Do they realize that each decubitus 
ulcer costs the tax payer $10,000 to 
$15,000?" 

As an authority on rehabilitation. 
Dr. Gingras emphasized that the needs 
of the many Canadians who arc over 
65 "far exceed those of our young popu- 
lation." The health profession, he said, 
has to "combat the deplorable aversion 
to the problems of advanced age." 
Although "geriatrics has not presented 
the most promising career," he predict- 
ed this has to change soon. 



Help Dying Patient Feel Useful 
U.S. Nurse Tells Conference 

Ottawa — A nurse consultant with the 
American Cancer Society cautioned 
nurses October 13 to avoid acting in 
ways that could make a patient near 
death feel he is no longer useful. 

Instead of referring to death by 

euphemisms, if it is mentioned at all, 

(CoDlimicit 1)11 !>iii,'f 15) 

FEBRUARY 1974 



Pampefs 




you both 
abieak 



feeps 
lini drier 



Instead of holding 
moisture, Pampers 
hydrophobic top sheet 
allows it to pass 
through and get 
"trapped" in the 
absorbent wadding 
underneath. The inner 
sheet stays drier, and 
baby's bottom stays 
drier than it would in 
cloth diapers. 




SavCvS 
you time 

Pampers construction 
helps prevent moisture 
from soaking through 
and soiling linens. As a 
result of this superior 
containment, shirts, 
sheets, blankets and 
bed pads don't have to 
be changed as often 
as they would with 
conventional cloth 
diapers. And when less 
time is spent changing 
linens, those who take 
care of babies have 
more time to spend on 
other tasks. 



rROCTER * GAMBLE 



/«^^U*^%* 



*^<W! 



l/^liA 



Reeves Name Pins . . . finest 
quality, smartest styltng, 
with safety ctasps. New 
optional Ouotone Hnisti with 
contrasting satin background 
and polished edges for a 
distinctive flair. 



/wimtrfu 



iH^'Hf 



^ 



Mrs. R.F.JOHNSON 
SUPERVISOR 



H^ 



NURSES PERSONALIZED 
ANEROID SPHYG. 

A superb Instrument especially 
designed for nurses! Impofted from pre- 
cision craftsrpen in W. Germany. Easy- 
to-attach Velcro cuff, lightweight, com- /, 
pact, fits into soft sim. leather zippered /j 
case IW t 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. . . . 37.95 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 fiat. Also , -— «- > . 

for wiglets, curlers, etc. ZVi" 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 CUPS 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 2.25, 
6 for 65< ea., 12 for 60< ea. 

MOLDED CAP TACS 

Replace cap band instantly. Tiny plastic tac, 
dainty caduceus. -Choose Black. Blue. White 
or Crystal witti 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 Pair of dainty 
jewelry-quality Tacs with grippers. holds cap 
bands securely. Sculptured metal, gold finish. 
approx. ^" wide. Choose RN. LPN, LVN, RN 
Caduceus or Plain Caduceus. Gift boxed. 
.^^ No. CT-1 (Specify Initials), No. CT-2 (Plain 
"^ Cad.) or No. CT-3 (RN Cad.) . . . 2.95 pr. 

SEL-FIX CAP BAND Black velvet 

band material. Self-adhesive, presses on, 
pulls off, no sewing- or pinning. Reusable 
several times. Each band 20" long, pre-cut to 
popular widths: %" (12 per plastic box) Vi" 
(8 per box) %" (6 per box) 1" (6 per bbx). 
Specify width under ITEM column on coupon. 
f^o. 6:^3 Band. . . ].7g per box 3 or more 






. 1.50 ea. 




COLOfl SIZE QUANT. PRICE 



Use extra sheet for additional items or orders. 

INITIALS as desired: 

(Good idea ... for distinctive identification) 



TO ORDER NAME PINS, fill out all information in box top 
right, clip out and attach to this coupon. 



I enclose $_ 



.(Mass, residents add 3% S. T,) 



Sorry, no COD's or billing terms available 



Send to . 
Street .. 



City State . 



.Zip . 



IT'S EASY TO ORDER REEVES NAME PINS FOR YOURSELF OR FRIENDS ! 

Choose style you want, shown left, Prmt name (and 2nd 
line if desired! on dotted lines below. Check other mfo m 
boxes on chart, clip this section and attach to coupon 



bottom left Attach extra sheet for additional pins. 
NOTE SAVINGS ON 2 IDENTICAL PINS . . . more convenient, 
spare in case of loss. 



LETTERING: 2nd LINE:. 



I STYLE i 
NO. 



Plastic I 
Umiute I 169 
Ho. 559 I 



ALL METAL. . . rich, tr.m and 
tailored. Ligtitweight, smooth 
edges, rounded corners. 



PLASTIC LAMINATE slimmer, 
k broader; engraved thru surtace to 
I contrasting core color. Beveled 

border matches lettering. 



.METAL FRAMED Classic 

\ design, snow-white plastic with 
Tiooth, polished beveled frame 



k MOLDED PLASTIC Simple. smart, 
^leconomical. Will never discolor, 
' Smooth rounded comers and edges. 



METAL 
COLOR 



□ Gold 

□ Silver 



D Gold 
D Sliver 



METAL 
FINISH 



Q Duolone 
□ Polished 
n Satin 



Polished 
frame 
only 



BACKGROUND 
COLOR 
(Plastic) 



apply 



D White 
O Med. Green] 
pMed. Blue 
□ Cocoa 






White 
only 



White 
only 



LETTEDINC 
COLOR 



□ Black 
a Ok. Blue 
G White 



□ Black 
Q Dk. Blue 
.White 
Letters only 



□ Black 

□ Dh. Blue 



n Black 
n Dk. Blue 



PRICES' 
Eitcraveil t Line ERetavcd 1 lines 



n 1 Pin 2.25 
C 2 Pins 3.75 



n 1 Pin .95 

r 2 Pins 1.65 

(same name] 



G 1 Pin 2.25 
D 2 Pins 3.75 



C 1 Pin .95 
Q 2 Pins 1.65 



n 1 Pin 3.00 



C 1 Pin 1.55 
n 2 Pins 2.60 



C 1 Pin 3.00 

□ 2 Pins 4.95 



n 1 Pin 1.55 
□ 2 Pir>s 2.60 



CROSS PEN ^ ^. \a/a/,€.^.'H}i 

World-famous ballpoint, with 
sculptured caduceus emblem. Full name 
FREE engraved on barrel (include name with coupon). 
Refills avail- everywhere. Lifetime guarantee. 
No. 3502 Cfirome 8.00 ea. No. 6602 12kt. G.F. 11.50 ea. 



TO: REEVES COMPANY. Box C Attleboro. Mass 02703 



•Please add 25c per order for 3 pins or less. 



QUANTITY DISCOUNTS: 10-24 pins, deduct 10%; 
25-99 pins, 15%; 100 or more pins, 20%. 



■»■''■'■■'■'■■■■■ 



MEDI-CARD SET Handiest reference 
ever! 6 smooth plastic cards (3V^" x SVj") 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. 
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. 




WM. 



KELLY FORCEPS so hand, for 

every nurse! bW stainless steel, fully 
guaranteed. Ideal for clamping off tutiing, Youi 
own initials help prevent loss. 
CG-4 JO No. 25-72 Foraeps . . . 2.75 ea. 6 or more 2.50 ea. 
Your initials engraved, add S0< per forceps. 





hVHlVi 



Free Initials and Scope Sack 
with your own 

Littmann Nurse^cope! 

Famous L ittmann nurses' 
diaphragm stethoscope . . . 
a fine precision instrument, 
with high sensitivity for 
blood pressures, apical pulse 
rate. Only 2 ozs., fits in 
pocket, with gray vinyl anti- 
collapse tubing, non-chilling 
epoxy diaphragm. 28" over- 
all. Non-rotating angled ear 
tubes and chest piece beau- 
tifully styled in choice of*5 
jewel-like colors: Goldtone. 
Silvertone, Blue, Green, Pink." 

FREE INITIALS AND SACK! 

Your initials engraved FREE 
on chest piece; lend individ- 
ual distinction and help pre- 
vent loss. Also FREE SCOPE 
SACK included, worth $1. 
(Free sacks not personal- 
ized; add 50^ if initials de- 
sired.) Note big savings on 
quantity orders. 
No. 216 Nursescope . . . 13.80 ea. ppd. 
6-11... 12.80 ea. 12 or more ... 11.80 ea. % 

Group Discounts include free Initials and Sack!.t 
■IMPORTANT: New "Medallion" styling includes tubing in > 
colors to match metal parts. If desired, add $1. ea. to ^ 
prices above; add "M" to Order (No. 216M) on coupon. D 
No. 223 Scope Sack only . . . 1.00 ea. ppd. 
6 or more 75« ea. Gold stamped initials, add 50< 




'■■■■■■■■■■■'■■■■■■' 



''|T<Tjl Precision-made imported forged steel. 
h^ABl Professional quality. Guaranteed 2 years. 

3V2" LISTER MINI-SCISSORS 

Tiny, handy, slip into unifofm pocket or 
purse Choose jewelefs Gold or gleaming 
Ti o r^^ Chrome plate fmish on coupon 
B^J^ No 3500 Mini-Scissors . . . 2.75 ea. 
4V2" or 5V2" LISTER SCISSORS 

As above, but larger tor bigger )obs Chrome finish only 
No. 4500 (4V7") or No. 5500 (5Vi") Scissors . . . 2.75 
5V2" OPERATING SCISSORS 

Stainless steel, wtlh sharp.-blunt 
points Beautifully polished finish. 
No. 705 OR Scissors . . . 2.75 ea. 
All scissors above: 1 doz. or more (any style) . . . 2.00 
Your initials engraved, add 50c per scissors 





CLAYTON DUAL STETHOSCOPE tight 

weight imported dual scope; highest sensitivity for apicaL. 

pulse rate. Chromed head tubes and chest piece with j 

I'/s" bell and Vk" diaphragm, grey anti-collapse 

tubing, 4 02,, 29" long. Extra ear plugs and f (P fT) 

diaphragm included. Two initials engraved free. I ^- — -^ O'tity j 

No. 413 Dual Steth 17.95 ea. ^^ .^ree 




NURSES CHARMS ^ -v 

Finest sculptured Fisher charms,-^^^ "r^^b" 
Sterling or Gold Filled (specify under COLOR on coupon). ^ ^9 

For bracelet or pendant chain. Add to your collection! n, r\ 

No. 263 Caduceus; No. 164 Cap; No. 68 A« "ii. 

Gnd. Hat; No. 8. Band. Scissors . . 3.49 ea. (// 

J^,... 14K PIERCED EARRINGS^ 

Dainty, detailed 14K Gold caduceus. for on or off 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 
0' 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 



nnmiDi tens s&TiRPAf^TinM aiiARAMreEO! ad oricem Dostaaid. Plaasa allow sufrtclent time for delivarv 




Endura NURSE'S WATCH nne swissmade 

waterproof timepiece. Raised easy-to-read white numerals 
and hands on black dial, luminous markings. Red sweep- 
second hand. Chrome finish, stainless back. Includes 
black velvet strap. Gift-boxed, with 1 year guarantee. 
Very dependat)le. Includes 3 initials engraved FREE! 
.No. 1093 Nurses Watch 19.95 ea. 




Prevent stains and wear! 

Smootfi. pliable pure white vinyl. Ideal 
low-cost group gifts or favors. 
No. 210-E (right), two compartments 
with flap, gold stamped caduceus . . . 
6 tor 1.50, 25 or more 20< ea. 

No. 791 (left) Deluxe Saver. 3 compt. 
change pocket & key ctiain . . . 
6 (ir 2.98. 25 or more 35f ea. 

Nurses' POCKET PAL KIT 

Handiest for busy nurses. Includes white Deluxe 
Pocket Saver, with 5" Bandage Shear (both shown 
opposite page), Tri-Color ball-point pen, plus 
handsome little pen light ... all silver finished. 
Change compartment, key chain. 

No. 291 Pal Kit 4.95 ea. 

3 Initials engraved on shears, add 50< per kit. 



BZZZ MEMO-TIMER rime hot packs, heat ^^, 
lamps, park meters. Remember to check vital st^ns §?■ 
give medication, etc. Lightweight, compact dV^" dia,). 
sets to bull 5 to 60 mm. Key ling. Swiss made. 

No. M-22 Timer 4.95 ea. 

3 or more 3.95 ea.; 6 or more 3.50 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 . . . 3.98 ea. Your Initials engraved, add 50f per tight. 




I Whittenton -, . 

7mm 



V 



i 



pREEVA 

Young fresh multi-tuck bitj. 2- 
button cuff Gusset ^4 sleeves 
100% Dacron OouljieKnit. 
STYLE No. 4697 
6-20, 416 Petite ... 22.95 
14'/2-26yi . . . 24.95 

75% Dacron/ 25% Cotton 
STYLE No. 4797 
6-20, 4-16 Petite . . . 16.95 
lt'/2-26V2 . . . 17.95 




MISS FIVEf 

Unique smocK style with a little 
girl look Generous patch poc^ 
ets. inner surgical pockp* 
Short sleeves. 100% Dacr.-- 
Double Knit. 
STYLE No. 4632 

3/4-15/16... 21. 95 






GIBSON GIRL 

Youthful high-rise waist, mini 

soft shirred skirt, pleated 

blouse. Inner surgical pocket 

100% Polyester Warp Knit V. 

sleeves. 

STYLE No. 4624 

3/4-15/16... 18.95 

60% Dacron, 40% Nylon cord 
jersey, short sleeves 
STYLE No. 4824 

3/4-15/16... 15.95 



Famous 
IVEATES" 

New "Saucy" Bump Toe Moc 

Little fashion notcties run around sole and 

heel; latest bumpertoe look with 

big bold eyelets; sturdy extra-light 

cushion crepe sole and heel; finest 

long-wearing white glove leather 

... the ideal shoe to feel pretty 

in uniform. Fit guaranteed 

Of return (unmarred) 

for size exchange 

No. 854 Saucy Shoe 
. . . 16.95 pr. 

New TCork-'lJtes Featherweight Style 

Eitfemely lightweight , . with the new 
"bottom" look Smart comfortable lace- 
up heel oxford. Thick sim. cork sole 
with li/B"cofk heel (very slip resistant 
outwears crepe) White washable 
soft glove upper leattier, tricot 
lined, arch vents fit guaran- 
teed or return (unmarred) , - 
for size exchange f 

No. 638 Kork-Lite Shoe 
■ ■ - 16.95 pr. 



All-Weather NURSES' CAPE 

Stay snug in cool weather, dry in the ram 
Traditional Navy with Bright Red lining 
Finest tailoring of 65% Dacron polyester, 
35% combed cotton. Zepel treated !00% 
Nylon Ouralyn lining. Snap fasteners, arm ; 
openings. Matching head scarf, SMALL (up to I 
34 bust), MEDIUM (35-38,) or LARGE (39-42) | 
. . . specify size on coupon. 

No. 658 Cape 14.95 ea. | 

3 Gold Initials on c ottar, add 1,00 per cape, 

C^AX) NURSES bag Alifetimeofservicel 

for visiting nurses! Finest black Vi" thick | 
genuine cowhide, beautifully crafted 
rugged stitched and rivet construction I 
Water repellant Roomy interior, with snap- 1 
in washable liner and compartments to I 
organize contents. Snap strap holds top I 
open during use. Name card holder on end, [ 
Two rugged carrying straps. 6" i 8" x 12". I 
Your initials gold embossed FREE on top. An | 
outstanding value of superb quality. 

No. 1544-1 Bag (with liner). . 37.95 ea. 

Extra liner No. 4415 6.95 ea. 





news 



K'oiiliiiiictl fniiii pcii:c 12) 
nurses should "prolong the vitality of 
life and show by example that members 
of the patient's family should act like- 
wise," Virginia Barckley told 125 par- 
ticipants in a health team conference 
at the University of Ottawa. The con- 
ference was sponsored by the universi- 
ty's school of nursing and the Canadian 
Cancer Society. 

Patients have "a curious way of meet- 
ing our expectations," she said. "If we 
expect them to be depressed or un- 
stable, they will be, and if we expect 
them to cope, we will be amazed at 
their depth and resources." 

Ms. Barckley told her audience that 
one of the bonuses of nursing is seeing 
"the heights of nobility that our fellow 
human beings, under the greatest ima- 
ginable stress, can and do reach." 

In the cancer situation, there are 
many ways to help patients. For exam- 
ple, she said, "We can help them main- 
tain their personalities. Too often we 
speak impersonally of 'the dying." Too 
often we treat them by rote, deperson- 
alizing them . . . ." 

She suggested that nurses "can en- 
courage families to turn to patients for 
advice. Unable to serve those they love, 
the patients then have a sense of still 
being needed and wanted. Through 
preserving the role for the patient that 
was always important to him, we make 
it possible for him to die with dignity." 
In Ms. Barckley"s opinion, what 
nurses say to patients is never as im- 
portant as what they let patients tell 
them. She also places more importance 
on the feeling with which communica- 
tion is made than on the words. 

In her conclusion, the speaker point- 
ed out that one of the chief tasks in 
nursing "is to help patients, threatened 
by physical suffering and inner tur- 
moil, to maintain their individuality." 
She said nurses should remember that 
many patients meet death with a digni- 
ty that enriches the lives of everyone 
around them. 



Hospital Launches Campaign 
To Help Victims Of Child Abuse 

Toronto . Oni. — A new campaign to 
save victims of child abuse and help 
their families has been launched by The 
Hospital for Sick Children, in cooper- 
ation with the Cathi>lic and Metropol- 
itan Children's Aid Societies. 

Any nurse or doctor who sees a case 
of suspected abuse is to report to a 



special child-abuse team immediately. 
This team consists of Dr. Robert Bates, 
a pediatrician; Ruth Koch-Schulte, a 
coordinator; and Dawn Blackler, a 
social worker who was recently ap- 
pointed by the hospital. 

Team members will give patients a 
thorough physical examination, includ- 
ing x-rays, to detect any Injuries (new 
and old) and will meet informally with 
the families involved. Instead of making 
accusations, they will show concern and 
offer the family help. 

The hospital believes that parents 
who bring a child for treatment are 
asking for help, and intervention at 
this point might prevent further abuse. 
Close affiliation with Children's Aid 
will facilitate the referral of families 
to many of its services, which include 
day-care centers and visiting home- 
makers. 

In 1972, the hospital treated 1(X) 
abused children, five of whom died; 
the Children's Aid Society investigated 
15,000 possible cases of neglect or 
abuse. 

Douglas Snedden, executive director 
of The Hospital for Sick Children, 
explains it is no longer sufficient to 
report child abuse. He says the hospital 
must become involved with the families, 
advise them, refer them to agencies in 
the community, and do everything in 
its power to "break this vicious cycle." 



U.S. Nurses Will Show Muscle 
When ANA Forms Political Arm 

Kansas City. Missouri — The Ameri- 
can Nurses" Association is establishing 
a nonpartisan, political arm that will 
enable nurses to exercise more political 
influence nationally. 

The purpose of this new unit is to 
educate nurses and other persons on 
political issues, help nurses and others 
organize for effective political action 
and tor carrying out civic responsibili- 
ties, and raise funds for political can- 



Have an idea you'd like to 
share with your colleagues? 

The Canadian Nurse will pay 
up to $15 for each Idea ac- 
cepted for its "idea exchange" 
page. 

Put your ideas on paper now! 

Forfurther information write: 
Editor, The Canadian Nurse, 
50 The Driveway, 
Ottawa, K2P1E2. 



THE CANADIAN NURSE 

% 



15 




news 



MONT SUTTON commands the highest peak 
within a radius of 100 miles of Montreal. 
20 miles of trails and slopes, 6 modern, 
lifts, ski school, ski shop and full range 
of facilities, great snow and superior 
grooming! 

Mid-Week Special 

SUTTON 5 

Lift tickets and SIci Lessons $43.00 

a) 5 consecutive days (Monday to Friday) 
with 4 hours of ski lessons per day. 

b) 5 days to be enjoyed at will over a 
period of your choice, with 2 hours of ski 
lessons per day. 

Lift tickets only $24.00 

a) 5 consecutive days (Monday to Friday). 

b) 5 days of skiing to be enjoyed at will 
over a period of your choice. 

Also ... a special BONUS. 

Buy your regular mid-week day ticket any- 
time after 12:00 noon and you automa- 
tically receive another full-day mid-week 
ticket . , . FREE, usable anytime, except on 
holidays and week-ends. 

We invite you to ski with us this season. 
MONT SUTTON INC. Sutton, Quebec 
Tel.: (snow reports) . . . (514)866-7639 

(514 866-7718 

Accommodation (514) 538-2646 

Office (514 866-5156 

(514) 538-2545 



didates who have supported issues im- 
portant to nurses. These arc areas not 
open to ANA. 

The unit will not lobby or take its 
own position on issues, but will be 
guided in its actions by .ANA policies. 
Although ANA will provide someot'the 
financial support, contributions are 
also expected from interested individ- 
uals. The organizational details have 
not been announced yet. but some 
ANA board members arc expected to 
be on the unit's board of directors. 

For some time, legally separate. 
political action arms have been working 
with state nurses" associations in Cali- 
fornia. Colorado, and Washington. 



St. John Ambulance Offers 
Bursaries For Master's Study 

Ottawa — St. John Ambulance offers 
one or more bursaries of Sl.OOO from 
the Margaret MacLaren Memorial 
Fund, awarded annually, to experienced 
registered nurses for study at the mas- 
ter's level. This fund also serves student 
nurses; preference is given to those with 
St. John Ambulance affiliation. 

Applications must reach national 
headquarters not later than May 1st, 
addressed to the Chairman of Bursary 
Funds, 321 Chapel Street, Ottawa. 
Ontario, KIN 7Z2. 



New Nurse Practitioner Program 
Begins At U. Of Sasiiatchewan 

Regiiui, Susk. — A new nurse practi- 
tioner program begins March 1. 1974 
at the University of Saskatchewan's 
college of nursing in Saskatoon. The 
program will prepare experienced 
nurses to give primary medical care 
in rural communities that are without 
resident doctors. 

To begin, only four nurses will be 
admitted to the program, which con- 
sists of a six-month training course and 
two years of service in one t)f tour com- 
munities. The training program is 
designed to prepare the nurses to as- 
sume an extended and independent 
role as members of the health care 
team. 

When the nurse practitioners com- 
plete the two-year employment period, 
the program will be evaluated and a 
decision made about whether to expand 
it. The Saskatchewan government is 
financing the training course and the 
employment program. A committee 



responsible for the program consists of 
representatives from the Saskatchewan 
Registered Nurses" Asscx;iation, Sas- 
katchewan Medical Association, col- 
leges of nursing and medicine at the 
Saskatoon campus, and provincial 
department of public health. 

The four rural commimities chosen 
as demonstration areas — Maryfield. 
Leroy, Fox Valley, and Meadow Lake 
— are representative of communities 
that have difficulty obtaining primary 
medical care. Ctmimunity health and 
social centers are operated by the Mary- 
field and Leroy communities. 

All four nurse practitioners will be 
employed by local boards in the com- 
munities and will work closely with 
doctors in nearby centers. The nurse 
who serves the Meadow Lake area will 
also serve four other areas on a visiting 
basis. These nurses will be the health 
workers cif first contact, providing 
initial assessment and screening pa- 
tients, giving immediate treatment for 
minor conditions and emergency treat- 
ment when necessary, and referring pa- 
tients to doctors for further treatment. 

The colleges iif nursing and medicine 
at the University of Saskatchewan are 
cooperating to give the training pro- 
gram. Four major courses make up the 
curriculum; they include theory and 
practice, as well as a period of supervis- 
ed experience with a physician. The 
courses relate to iliagnosis. management 
and treatment of disease, counseling 
and teaching health maintenance, and 
ethics, roles, and relationships. 

Nurses interested in receiving further 
information or in applying to the pro- 
gram should write to Ms. M.E. Craw- 
ford, Associate Professor of Nursing, 
College of Nursing, University of 
Saskatchewan, Saskatoon S7N OWO. 
Preference in selecting candidates will 
be given to nurses with experience in 
a rural setting and in public health. '■■;* 



Going 

on 
Vacation 




YOU'LL ENJOY IT 
MORE IF YOU 
GIVE BLOOD 
BEFORE YOU GO 



+ 



16 THE CANADIAN NURSE 



FEBRUARY 1974 




Your patients will 

appreciate knowing about new 




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.® 



a therapeutic bath oil for dry skin care that: 

• Gives relief from itching 

• Supplements natural skin oils 

• Helps to retain moisture 

• Is economical 



[»; 



iW] 



Division of William H. Rorer, (Canada) Ltd., Bramalea, Ontario 



FEBRUARY 1974 



THE CANADIAN NURSE 17 

% 




The Davol story on suction catheters 

begins at the end* 

At the end of our catheters, you'll keep exudate from contaminating 

find an exclusive anti-traumatic tip fingers. . -,. • i n 

that's extra gentle to sensitive And all are packaged mdividually 

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It's a big difference, and one that's are also available in cath/glove kits 

made us the number one supplier of and tracheal suction trays, and as 

plastic and rubber catheters. our innovative Cath 'N Sleeve 

Riif if '« not tViP nnlv difference. No doubt about it Davol makes a 



plastic and rubber catheters. our mnovative Uatn in bie 

But it's not the only difference. No doubt about it. DavoJ 

Our latex catheters are easy to lot of difference. And that's 

insert. And they're the softest our story really begins. 

catheters made. Davol Canada Ltd., 103S 

Our plastic catheters have a View Rd., Port Credit, Ont 

special slip finish that slides easily L5E-1H2 (416) 274-5252 

through endotracheal tubes. 

All have raised control vents to / 



BUILDING ON A CENTURY OF QUALITY 
HEALTH CARE PRODUCTS 



1874-1974 



OPINION 



A diploma is not 
an oil painting! 



The author compares the nurse who believes her education is complete 
and the job is now to be done, to a housewife who finds the oil painting 
of her choice and hangs it on the wall, desiring no change. Nurses who want 
job satisfaction will demand opportunities for learning as an integral part 
of the work day. 



Can you see an analogy between the 
suburban housewife, who has been 
saving for an original oil painting to 
hang above her fireplace, and the nurse, 
who studies and works diligently until 
graduation day when she receives her 
diploma or degree'.' 

The housewife tmds the painting 
she wants at a price she can afford, 
she completes the transaction, and 
hangs her treasure to be admired for- 
ever more. The nurse proffers the 
parchment evidence of her accomplish- 
ments to her initial employer and then 
places it among her possessions to be 
admired forever more. 

Ten years later, the suburban house- 
wife is still satisfied with her initial 
purchase and has no desire to acquire 
another, and 10 years later the nurse is 
still satisfied with her initial acquisi- 
tion and feels no need to add to her 
educational accomplishments. 

The analogy is not flattering to 
professional nurses but it is none- 
theless deserved. Although less preva- 
lent than formerly, the belief still exists 
among many of my practicing col- 
leagues that education has already 
been accomplished and that there 
remains the job to be done — the 
patients to be cared for, the time sheets 
to be arranged, the union regulations 
to be considered when assigning duties 
for today and planning for tomorrow. 

For many of us, this routine remains 

FEBRUARY 1974 



Moira MacDougall, B.N. 

unchanged, broken only occasionally 
when one or two of the more senior 
nurses is offered the opportunity to 
attend a conference or workshop. Of 
course, stipulations will be made that 
those who attend must later report to 
their colleagues remaining on the ward, 
but pressures, tensions, and the general 
amount of work all too often make 
reporting impossible. 

Why does this lackad;iisical attitude 
toward continuing education exist on 
a continent where nurses call themselves 
professionals? In part, it exists because 
of the well-internalized image of the 
nurse as a doer of tasks, as a giver of 
time, attention, and technical skills. In 
part, because of the nurse's acceptance 
of the handmaiden role, which makes 
it easier to act under the physician's 



Ms. MacDougall. a graduate of St. 
Martha's Hospital school of nursing. 
Antigonish. Nova .Scotia, and the post- 
graduate clinical course in psychiatric 
nursing at the Allan Memorial Institute. 
Montreal, received a B.N. from McGill 
University. She says, "The article is the 
result of three years' experience in inscr- 
vice education and of numerous discus- 
sions with colleagues — nursing staff and 
nursing administrators." Ms. MacDougall 
has rccentb accepted a position with the 
department of national health and welfare 
to work in public health in Inuvik. NWT. 



direction and to learn from him than 
to exercise control over her own pro- 
fessional life and identify her own 
needs for continuing education. And, 
also, partly because many nurses see 
nursing as a respectable, middle-class 
profession to be practiced full time 
until wedding bells beckon, and there- 
after between babies or to supplement 
the husband's income. 

When you add these reasons to the 
fact that there are still directors of nurs- 
ing who, because of existing staffing 
shortages, prefer to place additional 
staff in direct service areas rather than 
in the more nebulous area of continuing 
education, you understand why estab- 
lished inservice programs exist only in 
some hospitals. 

Are inservice or continuing educa- 
tion programs nebulous entities to be 
considered secondary to staffing? Defi- 
nitely they are, when nursing produc- 
tivity is measured by number of nurs- 
ing hours per patient per day. And 
these programs will continue to be 
nebulous as long as statistics do not 
differentiate between number of nurs- 
itig hours and number of intelligently 
spent nursing hours. Educational pro- 
grams are luxury items to be encour- 
aged only when time allows some en- 
richment of our job satisfaction. 

If you doubt this, try to tell busy, 
run-off-their-feet nurses that their lives 
will be enhanced by the hour they take. 
THE CANADIAN NURSE 19 



to attend a lecture or participate in a 
workshop. The hour away from their 
duties probably means an hour overtime 
to finish the reports and charting they 
won't have time to do if they attend 
the program, designed to help them 
function more adequately and to enrich 
their working lives. 

In our North American, work-orient- 
ed culture, enrichment is what you do 
with your free time; it is definitely not 
what you do in working hours. But, why 
not? Many of us spend almost one-third 
of our lives, between the ages of 20 and 
60, working. Wouldn't patients benefit 
if nurses were more proficient in their 
work and enjoyed it no less? If we 
believe that we ourselves and our pa- 
tients would benefit from inservicc 
programs, there are several things we 
can do to make these programs a gen- 
eral reality. Responsibility for initiat- 
ing these programs lies in two areas; 
the director of nursing and her asso- 
ciates, and the inscrvice educator. 

Responsibilities of the director 

First and foremost among the re- 
sponsibilities of the director of nurses 
and her associates is active involve- 
ment with the inscrvice educator in 
setting up the programs. The resultant 
programs will better reflect the priori- 
ties and interests of both teaching and 
administration. An inscrvice program 
designed wholly by administration, or 
wholly by teaching, will be incomplete 
and biased toward one set of priorities 
or the other. The most direct ways in 
which the director can show her support 
are by advertising the existence of such 
programs to potential employees and 
by reminding newly hired employees 
that attendance will be encouraged and 
supported. She can also give evidence 
of support by attending herself. If she is 
too busy to participate, can junior staff 
members be criticized for not attending 
for the same reason? 

The policy of the director, which is 
conducive to the successful function- 
ing of an inscrvice program, could be 
derived from the following values; 
• Recognition that stimulation of 
curiosity is a human need as basic as 
are the needs for food and shelter. Few 
persons are able to work productively 

20 THE CANADIAN NURSE 



for years in a situation where no pro- 
vision has been made for meeting the 
need for stimulation, without symp- 
toms that accrue from prolonged bore- 
dom. Some of these symptoms are; 
an entrenched belief in the validity of 
nonchangc, an inability (more potent 
than a refusal) to consider anything 
new, a higher rate of absenteeism and 
illness, and irritability and anxiety 
when the prospect of change threatens 
established ritual. 

• Belief in the ability of all to learn 
and to grow, to reexamine, and to 
change. It does nothing but disservice 
to the person involved to assume that 
behavior is too well entrenched to allow 
for new learnings. ' 

• Realization that inservicc educa- 
tion programs cannot be successful 
unless "a policy of reimbursement for 
individual effort is adopted. This 
compensation can be made by providing 
participating members of a program 
with replacement for time away from 
the wards. Staff cannot always be 
expected to work overtime to "pay 
back" educational opportunities provid- 
ed for them. This replacement can be 
provided by having head nurse and 
supervisory personnel take their turn 
replacing junior staff on the wards at 
conference or workshop time. Another 
relatively painless method of compen- 
sation is for staff who participate to 
be permitted to leave work early when 
the situation allows. These compensa- 
tory measures are important because cif 
their implicit message to staff: We arc 
encouraging and supporting your efforts 
to learn, to grow, to change. 

Responsibilities of the educator 

In these days, when we have a num- 
ber of varied programs for the basic 
education of nurses and an ongoing 
evaluation of formerly used methods, 
a considerable amount of anxiety is 
elicited from all members of this 
profession. Anxiety in the graduates 
from the newer programs takes the 
form of wondering if they will be ac- 
cepted by graduates of the more tra- 
ditional and work-oriented schools. 
Graduates of the latter schools wondfer 
if their knowledge will be sufficient to 
cope with these younger and often 



more inquiring minds. 

The educator must acknowledge and 
understand these feelings of suspicion 
and seek ways to lessen them by bring- 
ing groups together. She can best do 
this by stressing the fact that wisdom 
is derived from both formal study and 
life experience, and that neither is 
complete without the other. By func- 
tioning as a catalyst who is skilled in 
identifying problems and at eliciting 
solutions from this combined group, 
she will avoid the pitfall of treating 
graduates like basic students. 

She must realize that, although staff 
members who have not recently had 
opportunity to look at their own 
preparation and experience to find the 
solution of a problem will be reluctant 
to come forward and volunteer their 
knowledge, the reason is not because 
they lack the ability. There are nurses 
who have not taken time at work to sit 
and reexamine their beliefs and ideas 
since student days. These people will 
initially expect the educator to do all 
the work while they sit, perhaps reluc- 
tantly, and listen. But, if the educator 
is skillful enough to elicit their partici- 
pation initially, the satisfaction they 
derive from finding a solution to their 
problems will encourage further and 
more extensive participation. 

An educator who is able to deal 
with these initial reluctances is well 
on the way to meeting her first respon- 
sibility — setting up an environment 
that is conducive to further and joint 
learning. Her other responsibilities 
are. 

• Problem solving. Individuals are 
most willing to learn what they need to 
know at a particular time. An inscrvice 
educator must realize she has an obliga- 
tion to identify the areas that pose 
problems to her staff and to zero in on 
these to search for a solution. She can 
do this by her presence. She will never 
be able to identify areas of conflict if she 
remains closeted behind a desk in her 
office. 

Her availability to staff on the wards 
will sharpen her perceptions about 
what is actually happening and will 
make her a figure to be included and 
consulted. She can also elicit sugges- 
tions from the staff on the content 

FEBRUARY 1974 




A DIPLOMA J S NOT AN OIL PAINTING! 



they desire; then, she can choose the 
problem that is relevant at a particular 
time and arrange a session to discuss 
the problem and to attempt to elicit the 
most acceptable solution. 

Problems solved in this way, with 
the identification of the problem, the 
discussion, and the solution coming 
from a group of the nurses involved, 
with the added resources of the inserv'ice 
educator, will provide more learning 
than a situation in which the educator 
gathers people together to say "this is 
your problem, and this is my solution." 
• Planniiii> for procedures. All of us 
experience some anxiety at the pros- 
pect of breaking with established policy 
and embarking on a new course. How- 
ever, the earlier people are consulted 
and the more time available for accept- 
ing and working out these feelings, the 
greater is the chance of success for the 
new program. The inservice educator 
must, therefore, be prepared to inform 
staff of changes in procedure or the 
introduction of a new operating policy. 
To do this successfully, she must hcr- 

FEBRUARY 1974 



self be a part of the institution's deci- 
sion-making structure. It is also her 
responsibility to keep senior adminis- 
trative personnel aware that early 
involvement of nonmanagement nurs- 
ing staff could elicit comments from 
this group about the effect of the 
proposed change. 

• Reinforcement of old material. 
Knowledge and techniques previously 
learned and not used frequently are 
likely to be ignored or forgotten. There 
are several areas of learning in this 
category that must not be forgotten, 
and the educator must be prepared to 
reinforce these. Here is an example: 
nurses in a psychiatric hospital become 
less adept at dealing with physical 
emergencies than do their colleagues 
in a general hospital. A general review 
for all nurses in this category, conduct- 
ed at regular intervals, must be part 
of an inservice education program. 
% General stimulation. This last area 
is fourth in order but not in importance. 
We would be dull individuals indeed 
if we learned only what is immediately 



relevant. Material that has no direct 
daily use still has an application for 
nurses, as it has for all intelligent 
beings. It is often this category of 
knowledge that makes us interesting, 
informed, and interested human beings 
who approach others with an active 
curiosity and genuine desire to know 
and understand. And, is it not this 
nurse we would choose to work beside 
or to work with us if we were ill? An 
example of this area of education 
would be an examination of the cultural 
background of patients whose culture 
is different from ours. 

Conclusion 

I believe that within a few years 
inservice education for nurses will no 
longer be considered a luxury for the 
well -staffed, generously supported hos- 
pital. I further anticipate that the tra- 
ditional resistance to learning as a life- 
long occupation will lessen. Why am I 
so optimistic? Because hospitals are 
hiring staff from a variety of academic 
and experiential backgrounds. The 
days when a particular hospital is 
largely staffed by its own graduates 
are limited. Putting together people 
from various schools leads to sharing 
and sharing leads to mutual problem 
solving. 

In addition, nurses are becoming 
more realistic business people who 
know that annual increments and the 
prospect of job security, barring some 
accident, are not enough. They are now 
beginning to demand less tangible 
benefits, like Job satisfaction. This sat- 
isfaction comes mainly from challenge 
and from creative involvement with 
their work. In an effort to achieve this 
challenge and involvement, nurses are 
demanding continuously provided op- 
portunities to learn, to question, and 
not to be relegated to a niche defined 
only by their initial qualifications and 
years of service. For these nurses, an 
inservice program, based on ccxipera- 
tion between education and adminis- 
tration and ft)unded on the principles 
outlined, will become as integral a 
part of their working day as the coffee 
break. ^ 



THE CANADIAN NURSE 21 



^AD 



I 



Ethics of nursing practice 



The CNA special committee on nursing research asked nurses to describe 
ethical problems they had encountered in their nursing practice. A member 
of the nursing research committee analyzes the problems reported by 
Canadian nurses. 



Moyra Allen, R.N., Ph.D. 



One of the first activities undertaicen 
by the Canadian Nurses' Association 
special committee on nursing research 
was to prepare a statement on the 
ethics of nursing research. Early in 
this endeavor, the committee members 
became increasingly aware of the 
changing nature of nursing practice 
and of the potential ethical and moral 
problems confronting practitioners. 
The committee decided to carry out 
a preliminary inquiry into the ethical 
problems nurses are facing and, with 
this as a basis, to plan a more formal 
study of the ethical problems in 
modern nursing practice. 

Statements appeared in The Cana- 
dian Nurse requesting nurses who had 
faced a particular ethical problem to 
describe the situation in detail and to 
forward the description to the Cana- 
dian Nurses" Association. This method 
was employed to obtain some basic 
information in as simple a fashion as 
possible. Although the request appear- 
ed in several issues of the journal, only 

Moyra Allen is professor of nursing, in 
charge of the research unit in nursing and 
health. School of Nursing, McGill Uni- 
versity. She is a graduate of the Montreal 
General Hospital school of nursing. Dr. 
Allen received a B.N.. McGill University: 
M.A.. University of Chicago; and Ph.D.. 
Stanford University. 



22 THE CANADIAN NURSE 



22 responses were received from the 
more than 100,000 nurses across 
Canada. Certainly 22 cannot be con- 
sidered a representative sample of the 
nurses of Canada or of the ethical 
problems they experience. 

However, owing to the nature of 
the problems and the detailed descrip- 
tions that some responders included, 
the committee believes it is reasonable 
to provide the nursing public with some 
notion of the problems indicated in 
these few responses. The committee 
hopes that when nurses read this article, 
they will be concerned and feel obliged 
to describe any ethical problems they 
are experiencing and to forward their 
descriptions to the Canadian Nurses' 
Association. 

If these problems have any relevance 
for you or if they bring to mind other 
types of problems you face, the CNA 
would be pleased to receive informa- 
tion about them. (All material will be 
treated confidentially.) Ultimately, an 
analysis of these materials will be 
carried out and be made available to 
assist all nurses in their practice. 

Three kinds of problem 

The 3 types of problem discovered 
in the 22 responses received from 
nurses across Canada are presented 
here. 

\Z\To whom am I responsible? This will 

determine what should he done and, 

FEBRUARY 1974 



therefore, my course of action. 

Ethical problems are seen as situa- 
tions in which the nurse perceives a 
difficulty in determining where her 
responsibility lies, that is, to whom she 
is responsible. She feels a conflict with- 
in herself because she is being pulled or 
pushed into action on two sides and 
from opposing forces. Somewhere in 
this contlict the nurse feels she ought to 
do something, but she is being pressed 
ttiward different courses of action. If 
she could determine to whom she is 
responsible, her problem would be 
solved. 

Most of the responses were of this 
nature. Some examples follow. Am I 
respt)nsible to the hospital and ward 
doctor with reference to the patient or 
to the patient's own doctor who is an 
outsider not on the staff of the hospi- 
tal? The outside doctor is concerned for 
his patient's welfare and requires 
information on the plan of treatment 
and the patient's progress. 

What is my responsibility to a co- 
worker, a nurse who is taking drugs? I 
wish to protect her and prevent anyone 
from knowing but I have a responsibility 
to the institution, too. 

As a schixil nurse, what is my res- 
ponsibility to a teenager who is found 
to be taking drugs or is in need of an 
abortion? 

Am 1 responsible to baptize a sickly 
newborn, as indicated by hospital 
policy, or not to baptize him, owing to 
the critical nature of his condition? 

Am 1 to call the clergy for a dying 
patient, according to hospital policy, 
or to assess the needs of the patient 
and to follow them'.' 

What is my responsibility to the 
patient who is having an abortion 
(consent signed by the dcKtor) and to 
the husband who should legally know 
and agree to the abortion, although the 
husband is not the father of the child'.' 

What is my responsibility to the idea 
of one dcK'tor-one patient versus the 
real situation, three doctors caring for 
one patient, preoperativcly, during the 
operation, and postoperatively? 
FEBRUARY 1974 



Q/ know what should he done, hut 
what course of action should I take? 

A small number of responses con- 
cerned themselves with a problem with- 
in the self, the individual knew she 
should act in a certain way and she 
cither did act in that way or did not, or, 
in some cases, she withdrew from the 
situation. In no case was there contlict 
within the person as to what should be 
done. Nurses described the following 
situations as raising ethical problems. 

A sterilization procedure is frequent- 
ly carried out for women who are said 
to be intolerant of the pill. However, 
the nurse discovered that they were not 
intolerant of the pill; this reason was 
given so that the prcx:edure could be 
charged to hospital insurance. 

Reporting of medication errors is 
not possible because many of the errors 
are made by black nurses. Black nurses 
cannot be reported because the nurse 
reporting will be said to be discriminat- 
ing and will be called up by the Human 
Rights Commission. 

Nurses are asked to add the drug to 
iVs to initiate an abortion. (The nurse 
decided she would nurse these patients 
but she would not initiate the abcirtion.) 

Nurses are asked to teach birth con- 
trol. 

Of all the responses that were for- 
warded, only three nurses experienced 
ethical problems related to the negation 
o\' the human person or to inhumanity 
in dealing with patients. These examples 
centered around the harassment of the 
aged and chronically ill in an institu- 
tion, the battering of babies in an infant 
ward, and the destruction of the fetus 
in surgical abortions. 
D/" i^eneral. the quality of care is 
unsaiisfactoiy. What can I do'.' 

Other problems related to difficult 
situations in which a whole group of 
people and, in some instances, the 
institution as a whole was described by 
the nurse as sanctioning and condoning 
factors that produce exceedingly poor 
care for patients; for example, dirt, 
filth, cockroaches, inadequate linen 
supply, poor food, numerous medication 



errors, inadequate care on all sides, 
and so on. The individual nurse in this 
situation was not apparently experienc- 
ing an ethical problem within herself. 
Her problem lay in how to deal with 
the situation and what she could do to 
change it. In fact, many of these situa- 
tions dealt with the problem of perceiv- 
ed unethical behavior in other people. 

in analyzing these examples, it would 
appear, in many instances, that the 
problem of responding to the individual 
patient and of meeting his needs was 
perceived to be in conflict with direc- 
tives arising from other sources — 
medicine, hospital policy, the law, or 
religion. Other ethical considerations 
dealt with how to cope or how to re- 
spond in highly complex, multiproblem 
situations. 

No problem was cited that dealt with 
the ethic of the individual versus the 
ethic of the group, with the problem of 
life and death, such as maintaining life 
for long periods in nonresponding 
individuals, euthanasia, or with the 
ethical considerations experienced in 
nursing patients with organ transplants. 

in reality, it would appear that 
nurses seldom experience ethical prob- 
lems, in the first instance, the nurse, 
if she knew how to determine to whom 
she wiLS responsible, would then know 
whose directive should be followed. In 
the second instance, the nurse believes 
that she knows what the ethical 
behavior should be; the problem lies in 
how to get other people to behave in 
this ethical fashion. "^ 

I he author analyzed the material received 
from respondents and assumes, lor this 
reason, full responsibilily for Ihe coiilenl 
of this article. 



THE CANADIAN NURSE 23 



When you visit a sick friend 





"Do Stay Off The Bed When You Visit... 



Vanvouver cartoonist J. F. Dunnet 
illustrates some suggestions from the 
Catholic Hospital Association's pamphlet, 
Visiting Patients: Some Hints on 
What to Do and Say. 




"Do Remember That Even Minor Surgery 
Is Of Major Concern To The Fellow Who 
Has It " 



24 THE CANADIAN NURSE 



FEBRUARY 1974 



Clinical Laboratory Procedures 



This is a 1973 revision of the summary first published in 1949 and subse- 
quently brought up-to-date in 1956, 1960, and 1969. 



E.M. Watson, M.D., F.R.C.P.(C) 



Revisedby A.H. Neiifclcl. M.D.. Ph.D.. F.C.I.C. 



FEBRUARY 1974 



In laboratory medicine, approaches and 
techniques are changing more rapidU 
than in any other branch of medicine. 
At present, automation and the increas- 
ing use of various t_\pes of' data prt)ces- 
sing unfortunately tend to automate the 
patient as well. In addition, highly 
specialized units and services, which 
are coming into being at an increasing 
tempts, are also heavily dependent on 
laboratory data. These include inten- 
sive care, cardiac units, hennxiialysis. 
open heart surgery, organ transplants, 
and so on. 

It is. therefore, pertinent that the 
medical team, especiallv the nurses, 
have a better understanding of the sig- 
nificance of specific laboratory data to 
the welfare of the patient. Therefore, 
the following condensed information is 
presented. 

A number of changes, additions, and 
deletions have again been necessary. 
Sequence is based on the usual adminis- 
trative arrangements in the laborator\. 
The order, however, is not necessarily 
the order of importance. 

Hematology 

BUxxi Bank 

Biixjhemistry — serum and plasma 

— urine 

— cerebrospinal 
lluid 

Function tests and investigations 
Microbiology 

Tests Identified by proper names 

The use of a man's name for labor- 
atory tests fortunately is on the way 
out. along with outmixled tests. How- 
ever, scmie still persist and those most 
commonly used follow. 
Bencc-J(ines protein — the abnormal 



protein found in the urine of about 
50 percent of patients with myeloma 

tioilaiisky unit — the amount of phos- 
phatase required to liberate I mg. 
of phosphorus; test result for alkaline 
or acid phosphatases (see also Sigma) 

Coonihs — a test used in pregnant 
women and newborn infants relative 
to Rh sensitization; also used in 
hemolytic anemias, and so on. 

Diil^i' — a method tor determining the 
bleeding time of a patient 

Kcilui — a test for syphilis 

Kini>-Arnistr<>iii> unit — an amount of 
phosphatase required to liberate I 
mg. of phenol; test result for alkaline 
or acid phosphatases 

Liiniic's Colloidal Gold — a test on 
C.S.F. as an aid in diagnosis 

Mosentluil — a tv\o-hour specific gra- 
vity volume test for evaluating kidney 
function 

f'apcinicoliioii — a technique for ident- 
ifying cancer cells 

I'iiiil-Biinncll — a serological test for 
infectious moimnucleosis 

Rtiniplc-Leedf — not a laboratory test, 
but a method to determine capillary 
fragility by inllating a blood pressure 
cuff and counting the petechiae in 
a circumscribed area o\ skin 

Svhillinii — a radioisotope test for 
pernicious anemia 

Or. Walson. formerly Professor and Head 
of l';ilhological t hemistry and .Senior As- 
sociate in Medicine, faculty of Medicine. 
L nivcrsity of VVeslern Ontario, and Cli- 
nical I'aihologisi al Victoria Hospital, 
died June ,^(). ^I97.V Dr. Neufcld. Profes- 
sor Knieriliis. I aeultv of Medicine. Uni- 
versiiv of Western Ontario, succeeded Dr. 
Walson as PrDl'csMn in hXiO 

THE CANADIAN NURSE 25 



Si(;ina — the amount ot phosphatase 
required to liberate 1 mg. of phos- 
phorus; test result tor alkaline or 
acid phosphatases (see also Bcxian- 
sky) 

Wassenuanii — the original test for 
syphylis 

Wcstergien — a technique lor perform- 
ing the R.B.C. sedimentation rate 

Widal — a serological test tor typhoid 
and paratyphoid fevers 

Wimiohe — a special tube for deter- 
mining red cell volume and sedimen- 
tation rate 

Zii'hl-Nc'clsL'ii — a stain for acid-fast 
bacteriti, usually for tubercle bacilli 



Abbreviations and symbols 

ABO — the main blood group system 

Ac. — acid 

A.C.D. — anticoagulant used in pre- 
serving blood (acid-cltrate-dextrose) 

ACTH — adrenocorlicotrophic hor- 
mone 

A.F.B. — acid-fast baccilus; a char- 
acteristic staining quality of the tu- 
bercle bacillus 

Alk. — alkaline 

B.S. — blood sugar 

BSP — bromsulphalein; a liver func- 
tion test 

B,T. — bleeding time 

BUN — blood urea nitrogen 

C. — centigrade 

Ca — calcium 

cc. — cubic centimeter (not used now) 

CI — chlorine 

C.P.K. — the enzyme creatine phos- 
phokinase 

Cr — chromium 

C.S.F. — cerebrospinal tluid 

Cu — copper 

C.V.I. — cell volume index 

Diff. — differential; used with reference 
to a smear of blood or C.S.F. to de- 
termine the types and percentages 
of white blood cells present 

ECG or EKG — electrocardiogram 

EDTA — an anticoagulant, frequently 
used in blood samples for hematology 

EEC — electroencephalogram 

Eos. — eosinophil; a variety of white 
blood cell 

E.S.R. — er>'thr(x;yte sedimentation 
rate 

F. — Fahrenheit 

F.B.S. — fasting blood sugar 

Fe — iron 

FSH — follicle stimulating hormone 
of the pituitary gland 

g. — gram 

G.A. — gastric analysis 

GC — gonococcus. causative organism 
of gonorrhea 

Gl — gastrointestinal 

H & E — hematoxylin and eosin stain; 
used in the preparation t)f patholo- 
gical material for examination 

17HC — I 7-hydroxyc()rticoids 

HCG — human chorionic gonadotro- 

26 THE CANADIAN NURSE 



phic hormone, present in pregnancy 
(pregnancy test) and malignant tu- 
mors of the testes 

Hg — mercury 

Hgb. — hemoglobin 

5HIAA — 5-hydroxyindoleacetic acid 

HI. — hematocrit 

ICDH — isocitric dehydrogenase, a 
tissue enzyme 

Ig — the blood immunoglobulins, such 
as IgA. IgG, IgM. etc. 

lU — international unit 

I.V. — intravenous 

K — potassium 

17KS — I 7-ketostcroids; urinary hor- 
mones from the adrenal cortex and 
testes 

L. or I. — liter 

EDH — lactic dehydrogenase, a tis- 
sue enzyme 

L.E. — lupus erythematosus 

Lymph. — lymphocyte, a type of white 
blood cell 

MCH — mean corpuscular hemoglobin 

1V1CHC — mean corpuscular hemoglo- 
bin concentration 

IVICV — mean corpuscular volume 

mEq./l. — milliequivalent per liter 

mg. — milligram; see Weights 

ml. — millilVter. 1/1 ()()() part of a liter; 
appK)ximately the same as cc. but a 
more exact expression of measure- 
ment 

mOsm — milliosmole. 1/I()()0 part of 
an osmotically active unit per liter 

IVIycIo — myelocyte, the forerunner of 
the granular leukocyte 

IN — nitrogen 

Na — sodium 

Neut. — neutrophile. a variety of white 
blood cell 

NPN — nonprotein nitrogen 

O 2 — oxygen 

Osm — one osmotically active unit 
(molecule or ion) per liter 

P.A. — pernicious anemia 

Pap stain — Papanicolaou stain for 
cancer cells 

PBI — protein-bound iodine, and esti- 
mation used in connection with thy- 
roid function 

PCO2 — partial pressure of carbon 
dioxide 

pH — a symbol used to express acid- 
ity and alkalinity 

PI. Ct. — blood platelet count 

pOa — partial pressure of oxygen 

P.S.P. — phenolsulphonaphthalein 
test, a method for assessing kidney 
function 

R.A. — rheumatoid arthritis 

R.B.C. — red blood cell count 

Retic — reticulocyte, a young R.B.C. 

RF — rheumatoid factor, present in 
blood in rheumatoid arthritis and 
occasionally in lupus erythematosis, 
etc. 

Rh — Rhesus, the Rh factor of blood 

risa — radio-iodinated serum albumin, 
a material for measuring plasma 
volume 



SGOT — serum glutamic -oxalacetic 
transaminase 

SGPT — serum glutamic-pyruvic 
transaminase 

S.G. — specific gravity 

T 3 — an //) vhm test for thyroid func- 
tion 

T4 — a test for thyroxine, the thyroid 
hormone 

T.P.I. — Treponema pallidum immo- 
bilization, a specific test of serum 
for syphilis 

TSH — thyroid stimulating hormone of 
the pituitary gland 

U. — unit, a comparative weight mea- 
sure 

U.A. — urine analysis 

Ur.Ac. — uric acid 

VDRL — tlocculation test for syphilis 

VMA — vanilmandelic acid, a test for 
adrenal medulla function 

W.B.C. — white blood cell count 

Weights 



g- 



W.R. 



1 kg. 


kilog. 


103 


Ig- 

1 mg. 


gram 
millig. 


10-3 


1 meg. 
1 ng. 


microg. 
nanog. 


ic-6 

10-9 


' Pg- 


picog. 


10-1 



Wassermann reaction 



FEBRUARY 1974 



Hematological Values 

Most hematological analyses are carried out on blood collected either in a potassium - 
amnonium oxalate or in EDTA. Exceptions to this are the prothrombin atul partial 
thromplastin time, collected in fluid anticoagulant, atul the LE preparation on clotted 
blood. Usually from 3-7 ml. is adequate for analysis. 



Determination 



Autohemolysis 



Bleeding time 
(Duke) 



Blood volume 



Carbon monoxide 
hemoglobin 



Clot retraction 



Coagulation 
(clottmg time) 



Coagulation 
factors 



Differential 
White cell count 



FEBRUARY 1974 



Normal Values 



0.5-3.6% without glucose 
0.1-0.8% with glucose 



1-3 min. 



60-90 ml./kg. 



none 



complete and perfect 
in 24 hours 



8-18 min. (test tube 
method); 1-5 min. (capil- 
lary tube method) 



Factor VIII deficiency 
Factor IX deficiency 
other Factors 



Mature neutrophils 

52-70% ; 3.000-6.000/cu.mm. 

Young neutrophils 

3-5%; 150-400 

Eosinophils 

1-4%; 50-400 

Basophils 

0-1.5% ; 15-150 

Lymphocites 

20-35% (up to 50% in 

children) 1.500-3.000 

monocytes 

2-6%.; 100-600 



Clinical Significance 



differential test for 
certain anemias 
(spherocytoxic) 



prolonged when platelets 
reduced (as in thrombo- 
cytopenia purpura) 



increased in polycythemia 
vera; decreased in dehy- 
dration, shock, hemorrhage, 
postoperatively, etc. 



in carbon monoxide poison- 
ing or intoxication (car 
exhaust, etc.) 



delayed and imperfect in 
thrombocytopenia purpura 
(platelet deficiency) 



prolonged in hemophilia, 
also after heparin ad- 
ministration 



classical hemophilia 

Christmas disease 

other coagulopathies, usu- 
ally chronic 



increased in many infections; 
decreased in agranulocytosis 



increased in many allergic 
conditions 



increased in lymphocytic 
leukemia, infectious mono- 
nucleosis, and whooping cough 



THE CAN/^IAN NURSE 27 



Determination 


Normal Values 
and Notes 


Clinical Significance 


Fibrinogen 


200-500 mg./lOO mi. 
Fibrindex — less than 
60 sec. 


decreased or prolonged in 
severe liver disease and 
in a complication of 
pregnancy 


Folate 


>^ ng./ml. 


folate deficiency anemia 


Folate in R.B.C. 


>175 ng./ml. 


as above 


G-6-PD (glucose- 

6-phosphate 

dehydrogenase) 


120-240 mU./ 109 R.B.C. 


familial hemolytic anemia 
(primarily in Negroes) 


Hematocrit 


Male; 40-54% 
Female; 37-47%o 


decreased in the anemias; in- 
creased in polycythemia 
and hemoconcentration 


Hemoglobin 


Adult male; 
I4-17.5g./100ml. 
Adult female; 
12-15.5 g./lOO ml. 
Children; 
1 l-13g./100ml. 
Infants (I day to 2 
weeks); 15-22 g./lOO ml. 


decreased in the anemias; 
increased in polycythemia 
and hemoconcentration 
(shock, burns, myocardial 
infarction) 

decreased in hemolytic 
disease of the newborn 
(erythroblastosis) 


Hemoglobin electro- 
phoresis 


HgA —about 95% 
HgA2— <3% 

HgF — < 2% (50-90% in the 
newborn) 


hemoglobinopathies 
(sickle cell anemia, 
thalassemias, etc.) 


Iron 


60-150 meg./ 100 ml. 


increased in hemolytic 
anemias, hemochromatosis, 
high intake; decreased 
in iron deficiency 
anemia 


iron binding 
capacity 


220-400 mcg./l 00 ml. 


increased in iron defi- 
ciency anemia and late 
pregnancy; decreased in 
hemolytic anemia, P. A., 
hemochromatosis 


L.E. preparation 


none 


positive in lupus 
erythematosis 



28 THE CANADIAN NURSE 



FEBRUARY 1974 



Determination 



Mean corpusclar 
hemoglobin 



Mean corpuscular 

hemoglobin 

concentration 



Mean corpuscular 
volume 



Partial thromboplas- 
tin time (PTT) 



Paul-Bunnel 

(hcterophile 

antibodies) 



Plasma hemoglobin 



Plasma iron incorpor- 
ation (^^Fe) 



Plasma iron turn- 
over (sspe) 



Plasma volume 



Platelets 



Prothrombin time 



FEBRUARY 1974 



Normal Values 
and Notes 



27-32 ng./10()ml 



33-38' 



80-94 cubic micra 



0.347o 
60-70 sec. 



negative 



0-4.0 mg./lOO ml. 



75% and over in 7-10 
days 



0.061 mg./day/g.Hg. 



34-60 ml./kg. 



150,000-450,000/cu. mm. 



12-16 sec, reported 
with control 



Clinical Significance 



increased in macrocytic 
anemia (e.g., pernicious 
anemia); low in hypo- 
chromic anemia 



same as above 



same as above 



a test for hemophilia- 
like states 



a test for infectious 
monocucleosis 



increased in hemolytic 
anemia and other hemor- 
rhagic processes (mis- 
matched blood, etc.) 



decreased in hemolytic 
anemia; a measure of the 
rate of formation of red 
blood cells 



important in study of 
iron metabolism 



decreased in hemoconcen- 
tration; increased in 
some with hypertension, 
Paget's disease, and some 
other clinical conditions 



decreased in thrombocyto- 
penia purpura and other 
clinical conditions 



mainly used in control of 
anticoagulant therapy 



THE CANADIAN NURSE 29 



Determination 



Radioiron clearance 



Red blood eel 
count 



Red blood eel 1 
volume ("U) 



Red cell fragility 
(osmotic fragility 
test) 



Red cell survival 
test (withsi Cr) 



Reticulocytes 



Schilling test 
(radio cobalt 
Vitamin B12) 



Sedimentation rate 
(Westergren) 



Total body water 
(tritium space) 



Normal Values 
and Notes 



T i — 120 min. 



Adult male: 

4-5 million/eu.mm. 

Adult female: 

4-5 million/eu.mm. 

Infants. 

5-7 million/eu.mm. 

at birth, gradually 

decreasing to adult 

at 1 5 years 



29-33 ml. /kg. in males 
20-26 ml./kg. in 
females 



hemolysis begins at 
0.43 9r NaCl 
hemolysis complete at 
0.34-0.3% NaCl 



Half-life: 25-35 days 



0.5-1.5'. of all red 
blood cells 



10% and over 
(urinary excretion) 



Male: 0-9 mm./hr. 
Female. 0-20 mm./hr. 



50-70% of body weight 



Clinical Significance 



decreased in iron defi- 
ciency: increased in 
hemosiderosis and aplas- 
tic anemia 



decreased in the anemias; 
increased in polycythemia 
and hemoconcentration 
(shock, burns, myocardial 
infarction) 



decreased in blood loss; 
increased in polycythem- 
ia vera and hemoconcen- 
tration 



fragility increased in 
hemolytic Jaundice; de- 
creased in obstructuve 
jaundice 



decreased in hemolytic 
anemias; a test for life 
span of the red blood 
cell 



increased in pernicious 
anemia following Vita- 
min B12 therapy and in 
hemolytic anemias; de- 
creased in aplastic and 
pernicious anemia 



this is a specific test 
for pernicious anemia 



increased in infectious 
and intlammatory dis- 
eases 



increased in edema; de- 
creased in hcmiK-oncen- 
tration (burns, shock, 
etc.) 



30 THE CANADIAN NURSE 



FEBRUARY 1974 



Determination 


Values 


Clinical Significance 


Vitamin B12 


>150pg./ml. 


increased in acute and 
chronic leukemia, infec- 
tious hepatitis, liver 
cirrhosis: decreased in 
the anemias, malabsorp- 
tion, malnutrition) 




Blood Bank Values 




Determination 


Values 


Clinical Significance 


ABO groups 


0-45 9f of population 
A-40% of population 
8-10% of piipulation 
AB-5% of population 


essential to determine 
before blood transfusion 


Rh groups 


D — Rh pos. .S5 ''y of pop. 
d — Rh neg. 15^^^ of pop. 


important in pregnancy. 
The Rh ncg. mother with 
a possible Rh pos. fetus 
might lead to erythroblas- 
tosis fetalis: also in 
persons receiving re- 
peated transfusions 


Rh phenotypes 


D causes most diffi- 
culties in transfu- 
sion; others (C, E) 
may cause difficul- 
ty in crossmatch 


difficulties are picked 
up in a crossmatch: in 
rare instances no cross- 
match possible and then 
blood must be given very 
slowly with close obser- 
vation 


Crossmatch 


match ABO group: in 
the Rh group. D:d 


essential in order to 
eliminate transfusion 
reaction 


Antibody screen 


screening procedure for 
other Rh phenotypes and 
other blood groups — 
M. Kell.etc. 


same as Rh phenotypes: 
also in forensic path- 
ology 


Coomhs test 


a test for Rh anti- 
bodies 


Rh neg. mother with Rh 
pos. fetus may lead to 
increased antibody to D. 
Fortunately this can now 
be eliminated by treat- 
ing mother at parturition 
with high liter anti-D 
scrum 



FEBRUARY 1974 



THE CANADIAN NURSE 



31 



Determination 


Normal Values 
and Notes 


Clinical Significance 


Cold agglutinins 


when present, these ag- 
glutinate patient's 
red cells 


essential to identity; 
this can be either re- 
versed or weakened by 
warming the blood to 

37°C 


Amniotic fluid 
analysis 


test tor several chemi- 
cals (bilirubin, etc.) 


in the Rh mother, tests 
will show whether fetus 
is Rh neg. or Rh pos.; 
also tor genetic dis- 
orders 



Biochemistry, Blood Plasma or Serum Values 

/// the majority ofhos/iiials. all hiochcinistry analyses are carried out on serum. However, 
some liospiials still ii.se o.xalated hlood for ammonia. BUN. glucose, and NPN. Amounts of 
blood required for the analyses range from 5-10 ml. 



Determination 


Normal Value 


Note 


Clinical Significance 


Aldolase 


3-SU./ml. 




increased in viral 
hepatitis, progres- 
sive muscular dystro- 
phy, myocardial in- 
farction 


Ammonia 


48-115 meg./ 100 ml. 


test must be 


increased in severe 


nitrogen 




done immedi- 


liver disease and 






ately 


bleeding into gastro- 
intestinal tract, es- 
pecially from esopha- 
geal varices 


Amylase 


60-160 Somogyi 


do not draw 


increased in acute pan- 




U./IOOml. 


during or 


creatitis; also in 






just follow- 


parotitis, perforated 






ing l.V. 


peptic ulcer, abdom- 






glucose or 


inal trauma, after 






after admin- 


morphine, etc. 






istration of 








morphine 




Ascorbic acid 


0.6-1.2 mg./lOO ml. 


blood must be 


low in scurvy 


(Vitamin C) 




placed in a 
tube surround- 
ed by ice and 
sent immedi- 
ately to the 
laboratory 





32 THE CANADIAN NURSE 



FEBRUARY 1974 



Determination 


Normal Value 


Note 


Clinical Significance 


Bicarbonate 


see pulmonary func- 
tion 






Bilirubin (Van 
den Bergh 
test), total 


0.1-0.8 mg./l 00 4nl. 




increased in jaundice; 
latent jaundice 0.5- 
2.0; clinical jaundice 
above 2.0 


Bilirubin, 
Direct 


0-0.2 mg./lOO ml. 




increased in obstruc- 
tive jaundice 


Calcium 


9-11 mg./lOOml. 
or 4.5-5.7 mEq./l. 




low in hypoparathy- 
roidism, sprue, and 
steatorrhea; increased 
in hyperparathyroidism 
and some bone diseases 


Ceruloplasmin 


35-65 lU/ml. 




decreased in Wilson's 
disease 


Chlorides 


96-105 mEq./l. 




decreased in vomiting, 
starvation, and after 
gastrointestinal 
surgery 


Cholesterol 


Adults; 150- 
275 mg./lOOml. 
Children; 100- 
225mg./100ml. 
Infants; 70- 
125 mg./lOOml. 




increased in hypothy- 
roidism, diabetes, and 
nephrosis; also in 
hyperlipidemia, in 
hypercholesterolemia 


Cholinesterase 


0.62-1.26 
U./ml. 




decreased in hepato- 
cellular jaundice, ad- 
vanced cirrhosis, after 
hepatotoxic agents; 
familial 


Copper 


80-120 
mcg./lOO ml. 




decreased in Wilson's 
disease (hepatolentic- 
ular degeneration) 


Creatinine 


0.7-1.4 mg./lOO ml. 




impairment of urine 
formation or excre- 
tion (renal and/or 
pre-renal) 



FEBRUARY 1974 



THE CANADIAN NURSE 



33 



Determination 


Normal Value 


Note 


Clinical Significance 


Creatine phospho- 
kinase (CPK) 


0-20 lU/ml. 




increased in muscle- 
wasting disease, mus- 
cle trauma, C.V. ac- 
cident, severe mus- 
cular exercise 


Glucose (fasting) 


70-100 mg./ 100 ml. 


up to 140-160 
after meals 


increased in diabetes 
mcllitus. Cushing's 
disease; decreased in 
hyperinsulinism, 
fasting 


Growth hormone 


male: 0-8 ng./ml. 
female; 0-30 ng./ml. 
Child; 0-10 ng./ml. 

child; 0-10 ng./ml. 


used with 
challenge 
dose of in- 
sulin or 
arginine 


increased in acromeg- 
aly, pituitary giant- 
ism, and related con- 
ditions; decreased in 
hypopituitary states 


1 7-Hydroxycorti- 

costeroids 

(Cortisol) 


5-25 mcg./lOOml. 


heparinized 
blood 


increased in Cushing's 
disease, moderate in 
infections, burns, 
surgery; decreased in 
Addison's, etc. 


Insulin 


4-24 mc. U./ml. 


usually with 
glucose tol- 
erance 


insulin resistant 
diabetes; presence 
of an insulinoma 


Isocitric dehy- 
drogenase (ICDH) 


50-260 U./l 00 ml. 




increased in diseases 
of the liver 


Lactic dehydro- 
genase (LDH) 


200-450 u./ml. 


test for the 
five isoen- 
zymes will 
give more 
specific in- 
formation 


increased in myocar- 
dial infarction, li- 
ver diseases, pulmon- 
ary infarct, etc. 


Lipase 


0.2-1.5 U./ml. 




increased in acute pan- 
creatitis, etc. 


Lipoproteins 


300-800 mg./lOO ml. 


consists of 
four frac- 
tions; chylo- 
microns, beta, pre-beta, 
alpha 


differential diagnosis 
of hyperlipoprotein- 
emias (five types) 



34 THE CANADIAN NURSE 



FEBRUARY 1974 



Determination 



Magnesium 



PH 



Phosphatase, 
acid 



Phosphatase, 
alkaline 



Phosphorus, 
inorganic 



Phospholipids 



Potassium 



Protein bound 
iodine (PBl) 



FEBRUARY 1974 



Normal Value 



1.3-2.5 niEq./l. 



Note 



draw in poly- 
ethylene tube 



see pulmonary func- 
tion 



0.1 3-0.63 Sigma 

U/lOOml. 
0.2-0.8 Bodansky 

U/lOOml. 
1-4 King-Armstrong 

U/lOOml. 



0.8-2.3 Sigma 

U/lOOml. 
1-4 Bodansky 

U/lOOml. 
3-1 3 King-Armstrong 

U/ 100 ml. 
Child; 2.8-6.7 

Sigma U/100 ml. 



adult: 

2-4.5 mg./lOOml. 
child: 

4-6.5 mg./lOOml. 



test tor the 
isoenzymes 
may be more 

specific 



50-300 mg./ 100 ml 



3.5-5 mEq./l. 



4-8 meg./ 100 ml 



serum must be 
separated from 
the cells with- 
in one hour 



Clinical Significance 



decreased in unexplained 
tetany and in marked renal 
insufficiency 



increased in cancer of 
the prostate with meta- 
stases of bone; also in 
hemolized serum 



increased in hyperpara- 
thyroidism, bil- 
iary obstruction, rick- 
ets, active bone depos- 
ition (excess osteo- 
blastic activity) 



increased in severe 
nephritis, sometimes in 
rickets; decreased in 
conditions in which 
serum calcium is 
elevated 



important in relation 
to disorders involving 
fat metabolism 



increased in renal 
failure and severe 
Addison's disease; de- 
creased in diabetic 
coma; especially im- 
portant for patients 
on hemodialysis 



decreased in debilita- 
ting and febrile ill- 
nesses; increased in 
hyperthyroidism, preg- 
nancy, oral contracep- 
tives, and iodine-con- 
taining drugs 



THE CANADIAN NURSE 



35 



Determination 


Normal Value 


Note 


Clinical Significance 


Proteins, adult; 






decreased as a result 


by electrophor- 






of marked and prolong- 


esis 






ed albuminuria, neph- 


Total 


6-8 g./ 100 ml. 




ritis, liver disease. 


Albumin 


3.2-5.6 g./ 100 ml. 




starvation causing 


Globulin 


1.2-3.2 g./i 00 ml. 




edema; increased in in- 


Alpha 1 


0.1-0.4g./100mi. 




fections, pneumonia. 


Alpha 2 


0.4-1.2 g./l 00 ml. 




multiple myeloma, etc. 


Beta 


0.4-1.0 g./lOO ml. 






Gamma 


0.4-1.5 g./lOO ml. 






Fibrinogen 


0.2-0.5 g./lOO ml. 






Newborn: 








Albumin 


3.3-5.1 g./l 00 ml 






Globulin 








alpha 1 


0.12-0.32 g./l 00 ml. 






alpha 2 


0.25-0.47 g./l 00 ml. 






beta 


0.17-0.61 g./i 00 mi. 






gamma 


0.4-1.41 g./i00ml. 






1 year; 








Albumin 


4.0-5.0 g./lOO ml. 






Globulin 








alpha 1 


0.15-0.35 g./l 00 ml. 






alpha 2 


0.5-1.1 i g./l 00 ml. 






beta 


0.52-0. ,S3 g./ 100 ml. 






gamma 


0.45-0.66 g./lOO ml. 






over 4 years; 








Albumin 


3.7-5.5 g./ 1 00 ml. 






Globulin 








alpha 1 


0.12-0.3 g./lOO mi. 






alpha 2 


0.35-0.95 g./lOO ml. 






beta 


0.47-0.92 g./i 00 ml. 






gamma 


0.53-1.2 g./lOO ml. 






Rheumatoid 


negative 




increased in rheumatic 


factor (RF) 






fever, rheumatoid 
arthritis, lupus; and con- 
ditions with immuno- 
logic stimulation 


Sodium (Na) 


133-148 mEq./l. 




increased after ex- 
cess intake of NaCI 
by patient with im- 
paired kidney func- 
tion; decreased in 
vomiting, Gl dis- 
orders, tube drain- 
age (postop), diabetic 
coma, Addison"s dis- 
ease 


T3 


25-35% uptal<c 




decreased in hypothy- 
roidism, pregnancy, 
after oral contraceptives; 
increased in hyper- 
thyroidism, nephrosis, 
liver disease, after 
coumarin drugs, sali- 
cylates 



36 THE CANADIAN NURSE 



FEBRUARY 1974 



Determination 


Normal Value 


Note 


Clinical Significance 


Ta 


5.8-12.3 mcg./lOO ml. 




more specific measure 
than above 


Thyroid binding 
globulin (TBG) 


10-26 meg./ 100 ml. 




as above; also cret- 
inism, etc. 


SCOT 

Transaminase 


10-50 Karmen U/ml. 
(3-20 lU) 




increased in myocar- 
dial infarction, in- 
fectious hepatitis, 
muscle-wasting 
diseases 


SGPT 

Transaminase 


5-35 KU/ml. 
(3-18 lU) 




increased in acute 
hepatitis, cirrhosis 
in relapse, less in 
myocardial infarction 


Triglycerides 


50-150 mg./ 100 ml. 




increased in hyperlip- 
idemia (diabetes, xan- 
thomatosis, biliary 
cirrhosis, etc.) 


BUN (Urea 
nitrogen) 


9-20mg./l00ml. 




decreased in malnutri- 
tion, pregnancy; in- 
creased in nephritis, 
urinary tract obstruc- 
tion, congestive heart 
failure, shock 


Uric acid 


2.5-7.5 mg./lOO ml. 




increased in acute 
gout, nephritis, leu- 
kemia, frequently in 
myelomatosis 


Urine Values 




Determination 


Normal Value 


Specimen 
Required 


Note 


Clinical Significance 


Aldosterone 


2-20 mcg./24 hr. 


24 hr. 


patient 
must be 
on spe- 
cial diet; 
keep 
urine 
bottle 
cold 


hyperaldosteronism in 
hypertension 



FEBRUARY 1974 



THE CANADIAN NURSE 

% 



37 



Determination 


Normal Value 


Specimen 
Required 


Note 


Clinical Significance 


Amylase 


60-225 SomogyiU./ 
100 ml. 


random 




increased in acute 
pancreatitis, paro- 
titis, peptic ulcer, 
abdominal trauma 


Calcium 


50-300 mg./24 hr. 


24 hr. 


patient 
on spe- 
cial 
diet 


increased in hyperpara- 
thyroidism, myeloma- 
tosis with bone metastases 


Catecholamines 


up to 100 meg./ 
24 hr. 


24 hr. 


patient must 
be off cer- 
tain medica- 
tion; hyper- 
tensive drugs, 
tetracycline, 
epinephrine- 
like, etc. 


increased in adrenal 
medulla tumors and 
those of neural or- 
igin 


Chlorides 


1 70-250 mEq./l. 


random 




important in control- 
ling saline adminis- 
tration 


Copper 


up to 70 meg./ 
24 hr. 


24 hr. 


preserve in 
polyethy- 
lene bottle 


increased in Wilson's 
disease 


Copropor- 
phyrins 


50-160 meg./ 
24 hr. 
Child; 

0-80 meg. 


24 hr. 


preserve in 
polyethy- 
lene bottle 


increased in the 
porphyrias 


Creatine 


50-100 mg./ 
24 hr. 


24 hr. 


preserve in 
toluene 


used in the study of 
muscle diseases 


Creatinine 


0.8-1.5 g./ 
24 hr. 


24 hr. 


preserve in 
toluene 


normally excretion 
constant; altered in 
certain muscle dis- 
eases 



38 THE CANADIAN NURSE 



FEBRUARY 1974 



Determination 


Normal Value 


Specimen 
Required 


Note 


Clinical Significance 


Estrogens 


ovulatory 
cycle; 

4-64 mcg./24 hr. 
normal male: 
4-25 mcg./24 hr. 
prepubertal 
male and female; 
4-25 mcg./24 hr. 
postmenopaus- 
al; 

0.5 mcg./24 hr. 
pregnancy (3rd 
trimester); 
26-60 mg./24 hr. 


24 hr. 


preserve in 
polyethy- 
ene bottle; 
keep cool 


increased in tumors 
of the ovaries; de- 
creased in ovarian 
and pituitary mal- 
function 


Follicle 
Stimulating 
Hormone (FSH) 


before puberty; 
less than 6.5 
Mouse U./24 hr. 
after puberty ; 
6.5-52; 
after meno- 
pause; 
96-600 


24 hr. 




important in 
the investigation 
of endocrine dis- 
turbances 


1 7-hydroxy- 
corticoids 


female; 5-18 
mg./24 hr. 
male; 8-25 
mg./24 hr. 


24 hr. 


preserve in 
polyethy- 
lene bottle; 
keep cool 


important in the in- 
vestigation of adre- 
nal and testicular 
malfunctions 


5-hydroxy- 
indole- 
acetic acid 
(Serotonin) 


60-160 meg./ 
24 hr. 


24 hr. 


patient must 
avoid eating 
bananas dur- 
ing collec- 
tion 


increased in carcin- 
oid tumors 


17-keto- 
steroids 


under 10 yr.; 
0-4mg./24 hr.: 
10-15 yr.; 
3-10mg./24hr.; 
Adult female: 
2-l7mg./24hr.: 
Adult male; 
3-23 mg./24 hr. 


24 hr. 


preserve in 
polyethy- 
lene bottle; 
keep cool 


important in the in- 
vestigation of endo- 
crine disturbances 
(adrenal, testes) 


Lead 


0-0. 1 2 mg./24 
hr. 


24 hr. 


preserve in 
Jolyethy- 
ene bottle 


increased in lead 
intoxication 


Osmolality 

(Osm) 


500-850 mOsm/ 
kg. water 


random 
or 24 
hr. 




concentrating and di- 
luting ability of the 
kidneys 



FEBRUARY 1974 



THE CANADIAN NURSE 

• 



39 



Determination 


1 
Normal Value 


Specimen 
Required 


Note 


Clinical Significance 


Potassium 


25-100 mEq./l. 


24 hr. 


varies with 
dietary in- 
take 


useful in the study of 
renal and adrenal dis- 
turbance, water and 
acid-base balance 


Pregnanediol 


female; 

3-10mg./24hr. 

male; 

0-1.5 mg./24hr. 


24 hr. 


preserve in 
polyethy- 
ene bottle; 
keep cool 


increased in corpus 
luteum cysts and some 
adrenal cortical 
tumors; decreased in 
threatened abortions 


Sodium 


130-260 mEq./l. 


24 hr. 


varies with 
salt intake 


same as potassium 


Urea 
nitrogen 


8-15g./24hr. 


24 hr. 


preserve in 
tol uene 


important in the 
investigation of 
metabolic disturb- 
ances 


Uric acid 


0.4-1.0 g./ 
24 hr. 


24 hr. 


preserve in 
toluene 


useful in the inves- 
tigation of metabolic 
disturbances 


Urobilinogen 


Qualit.; 

Pos. in 1 ;20 

Quant.; 

0.2-3.3 mg./24hr. 


Random 
or 24 
hr. 


preserve 
with sod. 
carb. un- 
der pe- 
troleum 
ether 


increased in liver 
diseases and hemoly- 
tic jaundice 



Cerebrospinal Fluid Values 



Test 


Normal Value 


Clinical Significance 


Color and appearance 


clear and colorless; may 
be slightly blood tinged 
from needle trauma; no 
clot 


cloudy, turbulent, or gros- 
sly purulent in meningitis; 
bloody or yellow when hem- 
orrhage involves CNS 


Pressure 


7-15 mm. Hg. (100-200 mm. 
of water), patient lying down; 
15-22 mm. Hg. (200-300 
mm. of water), patient sit- 
ting up; 

Child; 3.5-7 mm. Hg. (50- 
100 mm. of water), patient 
lying down 


increased in meningitis, 
edema of the brain, hemor- 
rhage, neurosyphilis; de- 
creased in shock, dehydra- 
tion, and spinal canal 
block 



40 THE CANADIAN NURSE 



FEBRUARY 1974 



Test 



Normal Value 



Clinical Significance 



Cell count 



Glucose 



Proteins 
albumin 
alpha 1 
alpha 2 
beta 
gamma 



Chlorides 



0-5/cu.mm.; all lymphocytes 



45-80 mg./lOO ml. 



15-40 mg./ 100 ml. 

52% 
5% 
14% 
10% 
19% 



Colloidal Gold 
test 



Bacteriologic 
examination 



Serologic tests 
for syphilis 



120-1 30 mEq./l. 



0000000000 



neg. 



neg. 



FEBRUARY 1974 



increased in the various 
types of meningitis, polio- 
myelitis, neurosyphilis, 
and encephalitis; pus cells 
predominate in the acute 
bacterial processes. In- 
creased lymphocytes in 
tuberculous meningitis, po- 
liomyelitis, and neuro- 
syphilis 



increased in diabetes, en- 
cephalitis, uremia, and 
sometimes in brain tumor. 
Decreased in acute menin- 
gitis, tuberculous meningitis 
and insulin shock. 
Normal values usually 
found in neurosyphilis. 



increased in those condi- 
tions with an increased cell 
count (see above); increased 
in spinal cord tumor and 
infectious polyneuritis 



increased in uremia; de- 
creased in tuberculous 
meningitis 



abnormal forms in meningi- 
tis, and svphilis. Examples; 
55555432 1 000, paretic-type 
curve; 02443 10000, luetic- or 
tabetic-type curve; 
0000245520, meningitis- 
type curve 



important in differentiat- 
ing between bacterial, 
viral, and other causes 
of meningitis 



for syphilis 



THE CANADIAN NURSE 

% 



41 



Function Tests and Investigations 



Tests 


Principle 


Normal Value 


Clinical Significance 


a.c. — p.c. 


person's ability 


a.c; 70-100 mg./ 


a screening test for 


blood 


to handle diet- 


100 ml. 


diabetes mellitus. 


glu(X)se 


ary carbohydrate 


p.c; less than 


Cushing's syndrome. 






150mg./100ml. 


etc. 


Glucose 


a test of ability 


blood glucose not 


for diagnosis of 


tolerance 


to store and util- 


to exceed 1 50 mg. 


diabetes mellitus. 




ize dietary carbo- 


and return to 


Cushing's syndrome. 




hydrate. The 


normal in 2 hr. 


dumping syndrome. 




standard test, one 




etc. 




dose glucose (50 








or 100 g.). blood 








samples i.hr.. 








1 hr., 2 hr.; oc- 








casionally 4, 5, 








or 6 hr. test 








required 






Intravenous 


eliminate possi- 


blood glucose 


same as for glucose 


glucose 


bility of impair- 


returns to nor- 


tolerance 


tolerance 


ed absorption 


mal fasting 






from the intes- 


within \-i 






tines 


hr. 




Insulin 


test of patient's 


blood glucose 


test for hypopitu- 


sensitivity 


sensitivity to 


decreased about 


itarism, also use- 


test 


insulin, to pro- 


45 mg./lOO ml. 


ful in Addison's 




mote withdrawal 


one hr. after 


disease 




of glucose from 


ingestion of 






blood stream. 


glucose with 






Dose; 0.25 V.I 


insulin, then 






kg. body wt. 


with glucose alone 




Bromsulphalein 


Bromsulphalein, 


0-7% in 45 min. 


a liver function 




after I.V. in- 




test in patients 




jection, is ex- 




without Jaundice 




creted almost en- 








tirely by liver 






Renin activity 


renin-angioten- 


40-275 ng./lOO ml. 


in hypertension; mar- 


(angiotensin 


sin control of 




kedly influenced by 


II) 


aldosterone se- 




physical activity 




cretion 




and salt intake 


Kidney function. 


based on abili- 


morning specimen 


valuable in renal dis- 


diurnal varia- 


ty of kidneys 


S.G. 1.023 or 


ease, especially slow- 


tion 


to concentrate 


higher 


ly developing chronic 




urine 




diseases 


Mosenthal test 


ability of kid- 


night specimen 


same as above 




neys to concen- 


not to exceed 






trate urine af- 


575 ml., S.G. 






ter a test meal 


>1.018; day spe- 
cimens S.G. 
varies by 9 points 
or more, reaching 
1 .020 in one or 
two specimens 





42 THE CANADIAN NURSE 



FEBRUARY 1974 



Tests 



P.S.P. excretion 



Creatinine 
clearance 



Gl absorption 
test 1251 
triolein 



GI absorption 
test '25 1 
oleic acid 



Xylose tolerance 



ACTH stimulation 



Congo red 



Gastric function 



Maximal gastric 
secretion 



Gastric function 
(recent trend) 



FEBRUARY 1974 



Principle 



normal kidneys 
rapidly and 
efficiently 
excrete the dye 



rate of elimi- 
nation of cre- 
atinine by the 
kidneys 



triolein is di- 
gested by pan- 
creatic lipase 
and absorption is 
facilitated by bile 



absorption re- 
quires presence 
of bile 



xylose is ab- 
sorbed by dif- 
fusion and not 
metabolized when 
given by mouth 



ACTH stimulates 
the adrenal cor- 
tex to secrete 
corticosteroids 



amyloid tissue pre- 
ferentially ab- 
sorbs the dye. 
Given l.V. and mea- 
sured serially in 
blood 



acidity of fast- 
ing content: ser- 
ial samples after 
test meal (with 
or without his- 
tamine) 



modification of 
above to create 
a maximum res- 
ponse; with large 
dose of antihis- 
tamine followed 
by large dose of 
histamine 



pH of gastric sam- 
ples under contin- 
uous aspiration; 
intubation under 
radiological con- 
trol; can be com- 
bined with secre- 
tin stimulation 



Normal Value 



30-50"^^ excreted 
in 15 min. 



80-160ml./min. 



>89f in the 4th. 
5th. and 6th hr. 



same as above 



1 hr.r 29-49 
mg./IOOml. 

2 hr.: 20-60 

3 hr.: 8-16 
5 hr. urine 

4-8 g. 



>8-16mg./24 hr.; 
also blood I7HC 



<35^,c retention 



fasting: 5-100 ml. 
1st hr.: 30-300 ml. 
titratable HCl 
female: 0-25 
mEq./l./hr. 
male: ()-48 mEq 



female basal: 
0.5-2 mEq./l.; 
post-hist. 10- 

24 mEq 
male basal: 1 -3 
mEq./l.; post- 
hist. 10-30 mEq 



Clinical Significance 



test for renal tubu- 
lar function 



test for glomerular 
function of the 
kidneys 



malfunction of bile 
and pancreas; dis- 
eases of liver and 
pancreas 



diseases of the liver; 
with triolein test 
eliminates diseases of 
the pancreas 



useful test for GI ab- 
sorption in absence 
of renal disease 



diseases of the pitu- 
itary and adrenal 
cortex 



amyloid disease, prim- 
ary and secondary 



diseases of the 
stomach 



diseases of the 
stomach 



as above, but more 
precise data 



THE CANAC^AN NURSE 43 



Tests 


Principle 


Normal Value 


Clinical Significance 


Pulmonary function 


blood must be drawn 


18-25 mEq./l. 


complete investiga- 


HCO3 


without stasis from 




tion of acid-base 


(bicarbonate) 


tournique 




balance; will estab- 
lish the relative 


PH 


drawn in a special 


7.35-7.45 


contributions of 




syringe without 




respiratory and non- 




stasis 




respiratory factors, 
thereby indicating 


po. 


as above 


90-1 10 mm. Hg. 


necessary therapy to 


I 






restore balance 


pCO^ 


as above 


35-45 mm. Hg. 




B.E. (base 


calculated from 


/O (±2) 




excess) 


above data 






L.E. test 


abnormal granulo- 


neg. 


positive results in 




cytes in blood with 




lupus, liver dis- 




large amount of 




ease, myelomatosis; 




nuclear material 




occasionally in rheu- 
matoid arthritis 


Sweat test 


in certain dis- 


sodium 10-80 


increased sodium 




eases of the pan- 


mEq./l. 


and chloride in the 




creas there is 


chloride 4-60 


sweat in fibrocystic 




excess secretion 


mEq./l. 


diseases of the pan- 




of sodium chlor- 




creas (mucoviscidosis) 




ide in the sweat 






Fecal tat 


most d ietary fat 


1-7 g./24hr. 


increased amount in 




is digested and ab- 


7-25 7c (dry 


sprue, steatorrhea, 




sorbed; increase 


weight) 


etc. 




in fecal fat is. 








therefore, signif- 








icant 






Fecal 


to establish pres- 


reported as 


differential diagno- 


bacteriology 


ence of abnormal 


"normal flora" 


sis in diseases as- 




bacteria in G! 


and any abnor- 


sociated with diar- 




tract; specimen 


mal organisms 


rhea. 




must be fresh 






Fecal mycology 


to verify presence 


presence of ova 


same as above 




of ameba, etc., in 


or spores re- 






Gl tract; speci- 


ported 






men must be fresh 







Clinical microbiology is a specialty 
that includes bacteriology, mycology, 
parasitology, and virology. It is most 
essential that sterile techniques be fol- 
lowed for all specimen collection, con- 
tainers used, and transport to the labor- 
atory; the slightest contaminent may 
well mvalidate the result. 

Bacteriology: In the laboratory most 
specimens are cultured on various 
media, depending on the presence of 
suspected organisms. They iire sub- 
sequently identified and subjected 
to various tests, such as antibiotic 
sensitivity, etc. 

It is important that, whenever 
44 THE CANADIAN NURSE 



Clinical Microbiology 

possible, specimens be procured prior 
to use of antiseptics or antibiotics. 

Mycology: These organisms (fungi) 
can frequently be identified by micro- 
scopic examination. When it is necessa- 
ry to culture them, they require up to 
several weeks for growth and identi- 
fication. 

Parcisilology: With increasing travel 
and temporary residence abroad, just 
about all human parasitic infections 
are being seen in Canada. In general, 
specmiens, especially stools, must be 
delivered to the laboratory in as fresh 
a state as possible. 

Examples of medically important 



parasites are as follows: 

• Protozoa — amoebic dysentery, 
malaria 

• Platylhelminths — tapeworm, schis- 
tosomiasis 

• Nemathelminths — round worms, 
pinworms 

• Arthropods — scabies, body lice 

Virology: The presence of virus is 
established either serologically or by 
isolation. Virus laboratories are highly 
specialized centers. Therefore, in most 
instances, specimens are referred to 
them for isolation and identification. 
Usually, special specimen containers 
are supplied. 'i? 

FEBRUARY 1974 



in a capsule 



The vertical wrinkle 

This letter to the editor appeared in the 
Journal of the American Medical 
Association last November 12; 

"As a plastic surgeon. 1 have a 
problem with the vertical wrinkles 
often seen on the upper lip [between 
lip and nose], almost invariably in 
women. Fortunately, we can treat these 
effectively today with a chemical peel 
procedure. 

The question is. though, are these 
vertical wrinkles from cigarette smok- 
ing, or pipe smoking, or whistling, or 
kissing, or drinking from a straw, or 
applying lipstick, or not shaving, or 
pouting, or having more female hor- 
mones, or holding diaper pins between 
the lips, or what? — Edward N. Ludin. 
M.D., Cherry Hill. NJ.' 

Perhaps from holding tongue in 
cheek? 



Staff passion aroused 

The following notice appeared on the 
letters-to-the-editor page of the Decem- 
ber 1973 issue of What's New. pub- 
lished by The Hospital for Sick Children 
in Toronto. 

"No recent issue has roused staff 
passion and fury as the great tobacco 
vendetta. When a box of exploding 
cigars was left in the doctors" lounge, 
administration decided the time had 
come for action. 

"Consequently, effective January 30. 
1974, segregated dining will be intro- 
duced to the cafeteria. The Non-Smok- 
ers" Preserve will seat 2S0 in the center 
and north sections. Black-lunged 
lunchers will be confined to 124 seats 
in the south (bring your compass). Signs 
will be posted, and the administration 
hopes all will cooperate. Suspected 
infiltrators will be a.sked to submit to a 
nicotine-stain finger inspection."" 



Comment on "consumer" 

Those who object to the expression 
"delivery of health care," believing the 
word delivery is best used when refer- 
ring to milk, are no doubt beating 
their brows about the use of the word 
consumer when talking about those 
who require or will require health care. 
FEBRUARY 1974 



These persons will welcome the words 
of Dr. E. Gray Dimond. provost for the 
health sciences at the University of 
Missouri. 

Writing in the October 9. 1973 issue 
o\' Saturday Review! World. Dr. Dimond 
says. "As always, there will be those, 
btith on the medical faculty and among 
the public (now referred to. digestively. 
as health consumers) ...."" 



Warning to farmers 

An article in the November 1973 issue 
of the American Lung Association 
Bulletin tells of a disease called ""farm- 
ers lung."" which is traceable to expo- 
sure to moldy hay. 

This is one of the hypersensitivity 
diseases, which are ""due to a pulmonary 
reaction to an organic (usually vege- 
table) dust inhaled by persons sensitized 



... to the dust by previous exposure to 
it."" 

The article also notes that the disease 
"occurs four to eight hours after expo- 
sure to hay that has become moldy 
during storage in poorly ventilated 
barns or bins. The first symptoms are 
chills and fever, cough, and shortness 
of breath. As a rule, the acute stage 
subsides in a week or 10 days, some- 
times to recur."" 

According to this article, there is 
no specific treatment, although steroids 
are prescribed in some cases to reduce 
inflammation. The best treatment is 
prevention, the article notes. 

Because of heavy rains in 1973, 
farmers are warned to take the utmost 
precaution to make sure that hay and 
other farm products arc prtnccted from 
dampness when they arc stored in barns 
and bins. ' {^ 




"I don't know — she claims to be someone's ant.' 



THE CANADIAN NURSE 45 



March 2, 1974 

One-day clinical nursing session on 
"Shock: Pathophysiology, Therapy 
and Nursing Care, " Cody Hall, Univer- 
sity of Toronto. Fee; S12.00. For further 
information, contact: Faculty of Nurs- 
ing, Continuing Education Program, 
U. of Toronto, 50 St. George St., To- 
ronto, Ontario M5S 1A1. 

March 23, 1974 

One-day clinical nursing session on 
"Crisis Intervention in Health and Ill- 
ness for Individuals and Families," 
Cody Hall, University of Toronto. Fee: 
$12.00. For further information, con- 
tact: Faculty of Nursing, Continuing 
Education Program, U. of Toronto, 50 
St. George St., Toronto, Ontario M5S 
1A1. 

March 30,1974 

One-day clinical nursing session on 
"The Role of the Nurse in Sexual Coun- 
selling and Family Planning." Cody 
Hall, University of Toronto. Fee: $12.00. 
For further information, contact: Fa- 
culty of Nursing, Continuing Education 
Program, U. of Toronto, 50 St. George 
St., Toronto, Ontario M5S 1 A1 . 

Spring 1974 

Workshops on staffing for hospitals, 
entitled "Cost Effective Staffing Direct- 
ly Related to Patient Needs. ' Locations 
for workshops: Toronto — March 11- 
13; London — March 14-16; Thunder 
Bay — May 23-25; Ottawa — May 27- 
29; Sudbury — June 6-8, 1974. Confer- 
ence fee: $80.00. For further informa- 
tion, write to: Professional Develop- 
ment Dept., Registered Nurses' Asso- 
ciation of Ontario, 33 Price St., Toron- 
to, Ontario M4W1Z2. 

April 1-3,1974 

Three-day course on audiometry and 
hearing conservation in industry for 
nurses, doctors and technicians, Rens- 
selaer Polytechnic Institute, Troy, New 
York. For further information, write 
to: Rensselaer Polytechnic Institute, 
Communications Center 209, Troy, 
N.Y. 12181, U.S.A. 
46 THE CANADIAN NURSE 



April 8-9, 1974 

Two-day conference on "State of the 
Art of Psychiatric Nursing," Rutgers 
Continuing Education Center, Rutgers 
University, New Brunswick, New Jer- 
sey. Dr. Hildegarde Peplau will be 
director of the conference. 



May 2-4, 1974 

Registered Nurses' Association of 
Ontario, annual meeting. Royal York 
Hotel, Toronto, Ontario. 



May 4, 1974 

All-day public conference on "Human 
Rights and Health Care," University 
Commons, Rutgers University, College 
of Nursing, New Brunswick, New Jer- 
sey. 

May 8-10, 1974 

Registered Nurses' Association of 
British Columbia, 62nd annual meeting, 
Bayshore Inn, Vancouver, B.C. 

May 9-11,1974 

Atlantic Conference on Adolescent 
Health Care, Sir Charles Tupper Build- 
ing, Dalhousie University, Halifax, 
Nova Scotia. 

May 12-15,1974 

Workshop on evaluation of student 
nurse clinical performance, co-spon- 
sored by the faculty of nursing and the 
summer school and extension depart- 
ment. University of Western Ontario, 
London, Ontario. The instructor will 
be Vivian Wood. Tuition fee of $130.00 
includes course fees, accommodation, 
and meals. For further information, 
write to: Summer School and Exten- 
sion Dept., U. of Western Ontario, 
London, Ontario N6A 3K7. 

May 23, 1974 

Conference on "Rehabilitation of the 
Geriatric Patient," Maimonides Hospi- 
tal and Home for the Aged, Montreal, 
Quebec. For further information, write 
to: Gilbert M. Rosenberg, M.D., 5795 
Caldwell Ave., Montreal, P.O. H4W 1 W3. 



June 16-21, 1974 

Canadian Nurses' As- 
soc iation annual 
meeting and conven- 
tion, to be held in the 
Manitoba Centennial 
Centre Concert Hall, 
Winnipeg, Manitoba. 



^ 

^IP 



June 17-19, 1974 

Emergency Nurses' Association of 
Ontario, third annual conference. Royal 
Connaught Hotel, Hamilton, Ontario. 
For further information, write to: Ms. 
Jean Grote, 137 Duke St., Apt. 4, Ham- 
ilton, Ontario L8P 1X8. 

June 17-21, 1974 

One-week conference, immediately 
following the American Nurses' Asso- 
ciation convention in San Francisco, 
on "An Adventure in Transcultural 
Communication, " Honolulu, Hawaii. 
Tours, special airfare and post-con- 
ference trips will be available. For 
further information, write to: Continu- 
ing Education Coordinator, University 
of Hawaii, School of Nursing, Webster 
301, 2528 The Mall, Honolulu, Hawaii, 
96822, U.S.A. 

June 18-21, 1974 

Canadian Public Health Association, 
65th annual meeting, St. John's, Nfld. 
Theme: "Patterns of Health Delivery — 
Rural and Urban. " CPHA members and 
non-members wishing to participate in 
the scientific sessions should submit 
abstracts of proposed papers to: Lowell 
W. Gerson, Ph.D., Chairman, Scientific 
Program Planning Committee, Faculty 
of Medicine, Memorial University of 
Newfoundland, St. John's. Deadline for 
submission of abstracts is February 15, 
1974. 



June 22, 1974 

"Jubilee" and "Adieu" celebration, 
St. Joseph's School of Nursing, To- 
ronto, Ontario. For further information, 
write to: Ms. Nancy Litwak, 1048 Lake- 
shore Road West, Mississauga, On- 
tario, w 
FEBRUARY 1974 



names 





h.llziihclh Iii)iiii;i)iiin 



I'll II I Bourdon in 



Elizabeth Johnson Bourgouin and her 

husband. Dr. Paul Bourgouin, have ar- 
rived in Indonesia to serve for two years 
with MEDICO, a service of CARE. They 
are stationed at a hospital complex in 
Surakarta (Solo), Central Java, as part 
of a 15-membcr CARE-MEDICO team. 
The program, which is presently ex- 
panding into obstetrics and pediatrics, 
includes an inservice education pro- 
gram for nurses. 

Ms. Bourgouin {R.N., Montreal Gen- 
eral Hospital school of nursing) has 
been on staff at The Montreal General 
Hospital, has nursed in Trinidad, West 
Indies, and has been an air stewardess 
with Air Canada. 

Dr. Bourgouin graduated in medicine 
at Laval University, Quebec City, and 
completed his postgraduate training at 
The Montreal General Hospital, Prior 
to Joining MEDICO, he worked in Maria 
in the Gaspe. 

Dorothy Wyatt (B.A., B.Ed., B.N.) 

was elected mayor of St. John's New- 
foundland in November. She is the first 
woman to hold that post. 

Ms. Wyatt will no longer be nurse- 
secretary for her husband. Dr. Donald 
Wyatt, as she will devote her full time 
to her duties as mayor. 

Carolyn J. Isley is the nev.' director of 
nursing at the North Okanagan Region- 
al Hospitals, a tri-hospital complex 
comprising Vernon Jubilee Hospital, 
Armstrong-Spall umchcen Hospital, 
and Enderby and District Memorial 
Hospital. 

Before coming to Vernon, B.C., in 
1972. Ms. Isley (R.N., Moose Jaw 
Union Hospital school of nursing: Dipl. 
teaching in schools of nursing, U. of 
Saskatchewan, Saskatoon, Sask.) work- 
ed in various capacities at the Moose 
Jaw Union Hospital in Moose Jaw, 
Saskatchewan. 

FEBRUARY 1974 



Mary Mills (Reg.N., Belleville Gen. 
Hosp. school of nursing; B.A„ Carle- 
ton University, Ottawa) was appointed 
executive director of Planned Parent- 
hood Ottawa. Her responsibilities 
include promoting and developing 
family planning programs, working 
with volunteers, fund raising, and ad- 
ministrative duties. 

Ms. Mills is a member of the Nurs- 
ing Advisory Committee for Children's 
Hospital of Eastern Ontario, and was 
formerly a child-care supervisor in 
the children's inpatient unit at Royal 
Ottawa Hospital. 



E.A. Pattinson is director of the extended 
care department of the Burnaby Gen- 
eral Hospital, Burnaby, B.C. She was 
apptiinted a year before the depart- 
ment opened, and was actively involved 
in its planning. 

Ms. Pattinson (R.N.. Royal Inland 
Hospital school of nursing. Kamloops. 
B.C.: Dipl. Nurs. Serv. Admin., U. of 
Saskatchewan) has been on staff of the 
Burnaby General Hospital for several 
years, having been assistant director of 
nursing prior to her current appoint- 
ment. 



The nursing department of Grant Mac 
Ewan Community College in Edmon- 
ton, Alberta, has appointed the follow- 
ing instructors: 





.liiliiiiiii LiKiinik 



Hiiirv OImii 



Juliana Lazaruk (R.N., St. Boniface 
General Hosp., Winnipeg: Dipl. Teach- 
ing and Superv., U. of Manitoba: B.A., 
U. of Winnipeg) has had experience in 
clinical nursing and has taught medical- 
surgical nursing. 

Barry Olsen (R.N., Red Deer College 
Red Deer: R.P.N.. Alberta Hosp., 
Ponoka: B.Sc.N., U. of Alberta. Ed- 
monton) has had experience in general 
duty and psychiatric nursing. 





hil RoiUt 

Billie Purcell (R.N., Edmonton Gen- 
eral Hosp., Edmonton: B.N., McGill 
U.. Montreal) has had experience in 
clinical nursing and has taught medical- 
surgical nursing. 

Pat Roddick (R.N.. Edmonton Gen- 
eral Hosp., Edmonton: B.Sc.N.. U. of 
Alberta, Edmonton) has had experience 
in clinical nursing, has taught medical- 
surgical nursing, pediatrics, and has 
also taught in the nursing orderly pro- 
gram in Edmonton. 

A former instructor in the nursing de- 
partment. Jenniece Larsen (R.N.. Mis- 
ericordia Hosp., Edmonton: R.P.N., 
Alberta Hosp. . 
Edmonton: B.Sc.N., 
U. of Alberta, Ed- 
monton) has been 
appointed Chair- 
man of the Allied 
Health Department. 
This department in- 
cludes several pro- 
grams related to 
health services and includes all types 
and levels of health care workers. It is 
significant to note that a nurse has been 
chosen for this coordinating position. 



Lucille Carber is the public health/hos- 
pital liaison nurse in the Prince Edward 
Island Department of Health. A grad- 
uate of Dalhousie University schotil of 
nursing, Ms. Carber was formerly em- 
ployed at the Isaac Walton Killam Hos- 
pital in Halifax. N.S. 

Fernande Harrison, health services 
administrator — nursing. Alberta Hos- 
pital Services Commission, was present- 
ed with the Robert Wixid Johnson 
Award. This award of SI, 000 and cer- 
tificate of merit is made available 
annually by Johnson & Johnson Limited 
to the graduating student in the health 
services administration course at the 
University of Alberta who is considered 

THE CANADIAN NURSE 47 




names 



by the faculty as most likely to make 
a substantial contribution to the field 
of health services administration. 

Ms. Harrison (R.N., Misericordia 
Hospital school of nursing, Montreal; 
B.Sc.N., and M.H.S.A., U. of Alberta) 
is a former director of nursing adminis- 
tration at the Misericordia Hospital, 
Edmonton. 



Vivian B. Kirkpatrick was recently ap- 
pointed director of nursing service at 
Doctors Hospital, Toronto. 

During her nursing career. Dr. Kirk- 
patrick (Reg.N., Women's College Hos- 
pital school of nursing, Toronto; B.N., 
McGill U., Montreal; M.A. and Ed.D., 
Columbia U., New York) has worked 
with WHO in Formosa and India, has 
taught public health nursing at the 
University of Western Ontario and the 
University of Hawaii, has been a nurs- 
ing consultant for the Ontario depart- 
ment of health, and has been director 
of education and service at Galesburg 




Hollister's comDiete 

U-BAG 

system 



regular 

and 24-hour 

collectors 

in newborn 

and 

pediatric 

sizes 



a 



get any inlant 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 24-hour 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. 

48 THE CANADIAN NURSE 



State Research Hospital in Illinois. 

More recently, Dr. Kirkpatrick 
organized the school of nursing and 
later taught psychiatric nursing at 
Laurentian University in Sudbury. 



f Margaret Wootton 
(B.S.N., U. of Brit- 
ish Columbia) has 
been appointed sen- 
ior public health 
nurse of the North 
Okanagan health 
unit, Salmon Arm, 
B.C. She is respon- 
sible for the nurses 
in the Enderby, Salmon Arm, and Re- 
vclstoke areas. 

Ms. Wootton has been public health 
nurse at the South Okanagan health 
unit in Rutland and at the South Cen- 
tral health unit in Kamploops, B.C. 



Jean Lowery has been elected president 
of the Ontario Nurses' Association 
(collective bargaining). Ms. Lowery is 
public health liaison and coordinator 
of home care services at Queensway 
General Hospital, Toronto. 



Marlyn Andrews, (R.N., St. Michael's 
school of nursing, Dipl. PHN, Univer- 
sity of Alberta), has been appointed to 
the new position, public health nursing 
consultant in mental health, established 
by the public health nursing division 
of the Edmonton local board of health. 
In preparation for her role, Ms. An- 
drews interned for a year with the com- 
munity psychiatric services of Edmon- 
ton's board of health. She has had 
experience in hospital nursing and 
public health nursing in southern Sas- 
katchewan and with the city of Eidmon- 
ton. 



Honors in the Order of St. John were 
granted two Nova Scotia nurses at the 
annual investiture of the order: 

Margaret Mary Matheson of Stellar- 
ton was promoted to the rank of Offi- 
cer Sister. Also active in the Registered 
Nurses' Association of Nova Scotia, 
she was president in 1959-61 and was 
the recipient of a life membership in 
the association in 196cS. 

Jean Nelson, director of nursing at 
Camp Hill Hospital, was admitted to 
the Order of St. John in the rank of 
Serving Sister. She was with the Royal 
Canadian Army Medical Corps as 
nursing sister during World War 11, 
and prior to her present appointment 
was assistant director of nursing at St. 
Anne de Bellevue, Quebec, Department 
of Veterans Affairs. ■£? 

FEBRUARY 1974 



new products { 



Descriptions are based on information 
supplied by the manufacturer. No 
endorsement is intended. 



New lightweight cast 

It might have been a dull summer tor 
t'our-ycar-i)ld Pierre Martin, if he had 
been burdened with a heavy plaster 
cast. With the new Lightcast II. avail- 
able throughout Canada from Charles 
E. Frosst & Co.. restrictions to his 
normal activities were cut to the 
minimum. In addition to being thin 
and light, this cast is strong and dur- 
able, is water immersible, and dries 
quickly. 

For further information, write to 
Charles E. Frosst & Co., P.O. Box 
2 1 7, Pointc Claire. Dorval 700, P.O. 

New rescue system 

The new Bradford Casualty Carrier is 
a multipurpose rescue and evacuation 
system. It may be used as an ambulance 
stretcher or as a rescue stretcher to suit 
all conditions. The carrier makes it 
possible to move a patient from an 
accident location to the ambulance, 
hospital emergency, hospital trolley, 
or x-ray bed without creating additional 
trauma or discomfort. 

The Bradford Casualty Carrier can 
serve as a rigid ambulance stretcher 
with backrest, in place of a "basket - 
type litter," or as an enveloping stretch- 
er for difficult extrication problems. It 
may be lifted in a horizontal position to 
be hoisted by a helicopter or crane or 
in a vertical position for extremely 
difficult rescues. A patient can be 
carried through holes 25 inches wide. 



%.w 


J 


mk\'' 


J-^) 


yh 


^Ji 




|gj^ 


fe^^ 


yi 


r-V^ 


Child's Mitt 




Lightweight Cast 



FEBRUARY 1974 



This product is available from Safety 
Supply Company. 214 King Street 
East. Toronto. Ontario. 



Child's mitt 

The Posey Company recently introduced 
a child's mitt that is designed to keep a 
youngster from putting his hand down 
his throat or using his fingers. 

The back of the mitt is made of 
Posey Breezeline dacron mesh, which 
gives full vision of the back of the hand. 
The palm is filled with resiliant polyes- 
ter. For more information, w rite to Fnns 
& Cjilniore I id., lO.V^ Rangeview Rd., 
Port Credit, Ontario. 

New tricyclic antidepressant 

Anatranil (clomipramine) is a new 
tricyclic antidepressant that is potent 
and rapid acting. Anatranil has shown 
excellent results in the treatment t>f 
depressive illness, according to Geigy 
Pharmaceuticals. It provides a distinct 
three-fold action, relieving the total 
symptom complex of depression 



through elevation of mood, remission 
of somatic symptoms, and alleviation 
ot anxiety. 

Anatranil is available as a sugar- 
coated, 25 mg. pale yellow lenticular 
tablet. It conies in bottles of 50 and 
500. More information is available 
from Geigy Pharmaceuticals, Dorval, 
Ouebec. 

Literature available 

A new 40-page guide describing nearly 
300 silicone products and their appli- 
cations is available from Dow Corning 
Silicones Inter-America l,td,. I I'ippet 
Road, Downsview. Ontario M3H 5T2. 
This brochure, entitled "A Ciuide to 
Dow Corning Products." is organized 
for selection of silicone products by 
industry classification. There are 28 
product groups, ranging from rubber 
compounds to powder treatments, dc- 
foamcrs and lubricants. Ihese product 
groups arc cross-indexed to 19 industry 
classifications, which include appli- 
ances, chemical processing, rubber, and 
equipment. 

THE CAN/^IAN NURSE 49 



POSEY LAP ROBE 



The Posey Lap Robe is one 
of the many products included 
in the complete Posey Line. Since 
the introduction of the original 
Posey Safely Bell in 1937, the Posey 
Company has specialized in hos- 
pital and nursing products which 
provide maximum patient protec- 
tion and ease of 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, $27.00. 




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. 
#5763-6470, $75.00 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. #5763- 
7737 (with tie er^ds), $9.90. 




new products 



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), $5.70. 




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. #5763- 
3472, $75.00. 



Send for the free all new POSEY catalog - supersedes all previous editions. 
Please insist on Posey Quality- specify the Posey Brand name. 



Send your order today! 

POSEY PRODUCTS 
Stocked in Canada 

ENNS & 6ILM0RE LIMITED 

1033 Rangeview Road 
Port Credit, Ontario, Canada 




50 THE CANADIAN NURSE 



The following sections of the bro- 
chure give data on the applications and 
characteristics of each product group. 
At the end is a list of applications 
indexed to the appropriate product 
inforiTiation. 

Treatment for menopausal symptoms 

Ortho Pharmaceutical (Canada) Ltd. 
has developed a programmed method 
of oral treatment for the menopause, 
which can be obtained by prescription. 
The treatment combines two synthetic 
hormones, estrogen and progestin, with 
a sequential tablet package. Each tablet 
is numbered to correspond with days 
of the month, from the first to the 
twenty-fourth. After the twenty-fourth 
day, the tablets are discontinued until 
the first day of the next month. 

Program tablets are available in 
three different color-coded packages, 
according to required strengths for 
the individual patient. The first 17 
tablets contain only estrogen, and the 
next 7 tablets contain estrogen plus pro- 
gestin. These ingredients replace the 
natural ovarian hormones of estrogen 
and progesterone, the levels of which 
are significantly reduced at the onset of 
menopause. 

Estrogen-related symptoms include 
depression, adverse skin effects, hot 
flushes, and hypertension. Progester- 
one-related symptoms include im- 
balance of the nervous system, mam- 
mary changes, and irregular bleeding. 

More information is available from 
Ortho Pharmaceutical (Canada) Ltd., 
19 Green Belt Drive, Don Mills, 
Ontario. 

Disposable isolation tray 

A new disposable isolation tray service 
is available through American Hospital 
Supply. 1076 Lakeshorc Road East, 
Mississauga. Ontario L5E .^B6. Includ- 
ed in this tray service arc dishes, bowls 
and lids, flatware, napkin, nonwovcn 
fabric tray cover, and individual poly 
bags for disposing of each service. 

Iso-Pak components, which are 
F.D.A. approved, insulate foam to 
hold food at a maximum eating temp- 
erature. The foam withstands tem- 
peratures from minus 40 degrees 
fahrenheit to IX.S degrees fahrenheit 
without distortion, and can be used in 
microwave ovens. The Iso-Pak bowls 
and dishes do not absorb liquids, are 
firmly rigid for easy handling, and give 
no odor or taste to fcxxl. 

All the items necessary for the tray 

service are in one box and the trays in 

a second box. V 

FEBRUARY 1974 



research abstracts 



Mooney, Sr. Mary Margaret. A compar- 
alivc study of nurses' recording of 
analgesic therapy. Cleveland. Ohio. 
1972. Thesis (M.S.N.) Case Western 
Reserve U. 

A review of the literature revealed s 
consistency of expectation as to the 
content of nursing notes. Included in re- 
corded nursing observations are nota- 
tions as to the kind and amount of anal- 
gesic, the time of administration of 
p.r.n. analgesics, descriptions of the 
patient's pain, and notations of patient 
response to analgesic therapy. It is 
proposed that certain approaches to 
recording nursing observations promote 
the inclusion of more expected content 
than other approaches to recording 
nursing observations. 

This study considered whether the 
use of a problem list as a guide for 
recording nursing observations con- 
tributed to the inclusion of more ex- 
pected and recommended content than 
was included in nursing notes when 
such a problem list was not used. Pa- 
tient age. patient sex. length of hospi- 
talization, length of postoperative 
period, type of service, and the cx;cupa- 
tional status of the recorder of nursing 
notes were other variables considered." 

The nursing notes from the patient 
record of 100 medical-surgical adult 
patients in three Cleveland hospitals 
were analyzed for expected content con- 
cerning the administration of p.r.n. 
analgesics. The following hypotheses 
were tested and confumed", 

1. The administration of p.r.n. anal- 
gesics is recorded with significantly 
greater frequency in problem-oriented 
nursing notes than in nursing notes 
that are not problem-oriented. 

2. Descriptions of pain experienced 
by the patient immediately prior to or at 
the time of administration of p.r.n. 
analgesics are recorded with significant- 
ly greater frequency in problem-oriented 
nursitng notes than in those that are not 
problem-oriented. 

3. Patient response to p.r.n. anal- 
gesics is recorded with significantly 
greater frequency in problem-oriented 
nursing notes than in those that are not 
problem-oriented. 

The conclusions as assessed in this 
study were that: 

• problem-oriented nursing notes are 
more likely to contain expected content 
FEBRUARY 1974 



than non problem-oriented nursing notes 

• expected content in problem-oriented 
nursing notes of surgical patients is 
more likely to be recorded concerning 
the administration of parenterally ad- 
ministered analgesics than concerning 
the administration of orally administer"^ 
ed analgesics 

• the response of male patients to anal- 
gesic therapy is more likely to be re- 
corded in the nursing notes than the 
response of female patients, irrespec- 
tive of whether or not the nursing notes 
are problem -oriented 

• expected content concerning the ad- 
ministration of p.r.n. analgesics is 
more likely to be recorded inlhe nurs- 
ing notes of patients who have been 
hospitalized six days or less than for 
those hospitalized seven days or more. 

Robinson, Leola Anne. Information 
utilized by eleven cardiac patients 
and the relationship of this in- 
formation to progress after discharge. 
Montreal. Que.. 1V7.\' Studv (M.Sc. 
(Appl.)) McGill U. 

This study used qualitative research 
techniques to examine the information 
used by 1 1 cardiac patients in assessing 
their illness situations. Each patient 
was visited throughout a period of hos- 
pitalization, and at least twice after 
discharge. Follow-up medical -record 
data were also obtained for all patients. 

The data revealed six sources of 
information used by patients. Three 
of these were external to the patient's 
personal experience: the health team, 
the public media, and others with heart 
disease. The other three sources were 
internal to the patient's personal exper- 
ience: past illnesses, physiological feed- 
back, and factors in one's life situation. 

The summation of all the informa- 
tion accumulated by each patient in- 
dicated the information base for that 
patient. This information base resulted 
in the patient's viewing the illness in a 
particular way. Three "view of illness" 
categories were identified: optimistic, 
uncertain, and pessimistic. 

The view of illness a patient po.ssess- 
ed was positively associated with his 
progress two to four months after dis- 
charge. That is. patients with an opti- 
mistic view of their illness did well, and 
patients with a pessimistic or uncertain 
view of their illness did poorly. 



The findings of this study suggest 
that it would be helpful for the health 
team to be aware of the information 
base a patient possesses. In this way, 
health team intervention can be directed 
more readily toward the specific needs 
of each patient. Patients with an opti- 
mistic view of their illness may only 
need straightforward guidelines and 
instructions. Patients wiUi uncertain or 
pessimistic views of their illness require 
more than this. 

Clements, Dianne B. Loss: a major con- 
versational theme of the elderly. 
Montreal. Que.. 1973. Studv (M.Sc. 
(Appl.)) McGill U. 

The purpose of this research was to 
study systematically the theme of loss 
dominant in the conversation of the 
elderly. This was done to determine 
patterns of conversation about loss and 
predict what groups of people would 
talk about particular losses. 

Unstructured interviews were car- 
ried out with 24 people between the 
ages of 65 and SS years. The analysis of 
the conversations revealed five major 
themes of loss: loss of self, loss "of 
others, loss of home, loss of activities, 
and loss of health. These major loss 
themes were related to selected demo- 
graphic variables and conversational 
characteristics. The researcher dis- 
covered that people who talked about 
a particular kind of loss had certain 
characteristics in common. 

Those who talked most about their 
own death, loss of self, were in the older 
age group of the sample (eighties and 
late seventies), and talked about a large 
number of losses. The conversations 
were either very short or very long. 
Widows, who were also in the older 
group and talked about multiple losses, 
tended to talk most about the loss of 
others. 

Those who had either lived on one 
farm all of their lives or !iad been born 
in Europe talked about the loss of their 
homes or the loss of their native land. 

Those in the younger age group 
(sixties and early seventies) talked 
about fewer k)sses and focused on loss 
of activity. The younger people v\ho 
mentioned few losses, but who also 
talked for relatively short periods, 
focused on loss of health. 

These findings may lead nurses to 
THE CANADIAN NURSE 51 



research abstracts 



question some otthc basic assumptions 
that guide their nursing care of the 
elderly. Further qualitative research 
is needed to obtain a more complete 
and detailed picture of the importance 
of loss to the elderly and the role of 
the nurse in helping these people 
cope with the aging process. 

Reighley, Ronald S. The concerns ex- 
pressed hy palients with cardiac 
conditions during the first 13 days of 
hospitalization and the responses of 
health workers and other patients 
to these concerns. Montreal, P.O., 
1971. Study (M.Sc. (Appl.)) Mc- 
Gill U. 

Ihis study, usnig qualitative research 
methods, was designed to investigate 
the concerns expressed by .''^(S patients 
with cardiac conditions during the 
first 1.'^ days in hospital, and the res- 
ponses made b\ hospital personnel 
and other patients to these concerns. 

Seven categories of concerns and 
five categories o\' responses were 
identified from the 1 14 incidents ex- 
trapolated from the data. The responses 
to the concerns expressed by patients 
were analyzed in terms of the effect 
they had on the expressed concern. 

Responses that alkiwed ibr a resolu- 
tion or lessening of a concein were 
termed facilitative, and responses 
considered not to assist o/ to lessen 
a cxmcern were termed nonfacilitative. 

I'his study found that nonfacilitative 
responses predominated for 9 of the 
I .^ clays. The greater proportion of non- 
facilitative responses were demonstrat- 
ed during the first four days o\' htispita- 
li/ation. and only on the twelfth day 
did facilitative responses exceed the 
nonfacilitative responses. 

The findings indicated that the 
type t)f ct)ncern expressed by a patient 
with a cardiac condition, during the 
first I 3 days of hospitalization, is close- 
ly related to the number of days spent 
in hospital. 

It was found that a strong relation- 
ship existed between the category of 
personnel making the response and 
the type of response given in response 
to a patient's expressed concern. 

The tlnding that the concerns of 
patients with cardiac conditions tend 
to be "day specific" suggests that pa- 
tient education could be geared to the 
changing concern pattern. Such a pro- 
ject could form the basis of further 
research. 

52 THE CANADIAN NURSE 



The great variation of responses by 
hospital personnel suggests an area 
for further research to ascertain the 
different frames of reference being 
used by the health workers giving care. 



McMahon, Sister Mary. A study to 
identify the concerns of mothers, 
the strategies used to express them, 
and the nursing iiUeiyention elicited 
hy them as revealed during the bath- 
ing of the baby. Montreal. Que.. 
1972. Study (M.Sc. (Appl.)) Mc- 
Gill U. 

This study was designed \o identify 
the concerns of mothers in relation to 
the care of their babies during the post- 
partum hospitalization period. 

In this study, concern refers to any 
interest, worry, or desire to know exhi- 
bited by the mother during the bathing 
of the baby. 

By means of the participant-observer 
role, data were collected at the time the 
mothers were bathing their infants. This 
was a return bath, since most mothers 
in the sample had been given a bath 
demonstration the previous day. The 
sample included 36 mothers — 26 
primipara and 10 multipara. 

Mothers" concerns fall into six cate- 
gories and they use four strategies to 
express them. Five categories of nursing 
intervention are employed to respond 
to the mothers" concerns. 

Analysis of the data in relation to 
the three variables, mothers" concerns, 
strategies used to express them, and 
nursing intervention, reveals that two 
interaction patterns emerged from the 
data. 

Patter)! I: When mothers are con- 
cerned about the procedure and the care 
and condition of the baby, they use the 
strategy of inquiry, and the nurses 
respond by giving directions, informing, 
or approving. 

Pattern II: When mothers" concerns 
are in the area of the baby's behavior, 
their own performance, socializing, and 
comparison with siblings they use the 
strategies of commenting to the nurse 
or commenting to the baby. The nurses 
primarily do not respond but. on occa- 
sion, give approval. 

Findings reveal that; 

1. Mothers" greatest concerns are 
with the procedure (3X percent), care 
and condition of the baby (2S percent), 
and baby"s behavior ( 19 percent). 

2. Mothers use the strategies of in- 
quiry (37 percent), commenting to 
the nurse (29 percent), and commenting 
to the baby (29 percent) most frequent- 
ly- 

3. Nursing intervention is primarily 

in relation to the procedure (66 per- 
cent). 



4. Mothers comply with the nursing 
intervention in 50 percent of the cases, 
while in I 8 percent of the cases they do 
not respiond at all. and in 17 percent of 
the cases they inform. 

.5. Nurses do not respond to mothers" 
concerns 36 percent of the time, and 
give information in 31 percent of the 
cases. 

These findings suggest that when 
mothers inquire about their concerns, 
they are more likely to obtain a response 
than when they comment to the nurse 
or to the baby. 

The tlnding that the mothers great- 
est concern is the procedure suggests 
that for mothers to be able to perform 
the procedure properly is a sign to 
them of their confidence in being able 
to care for the baby. It could also sug- 
gest that the mothers are responding to 
the manner in which the bath demons- 
tration was given. 

The high proportion of compliance 
(50 percent) to the nursing intervention 
suggests the amount of influence the 
nurse has in this situation. 



Tremblay, Charlotte. Nurse aide sim- 
ilarity to patient and feelings of 
helplessness. Cleveland. Ohio. 1971. 
rhesis (M.S.N.) Case Western Re- 
serve U. 

The present study was to investigate 
the relationship between the perception 
of similarity of the nurse aide between 
herself and the terminally ill patient, 
and the nurse aide"s feelings of help- 
lessness in caring for the terminally ill 
patient in nursing homes. 

Subjects for the present study were 
30 female nurse aides working in three 
nursing homes. I'he criteria for inclu- 
sion of nurse aides were that they had 
given care to one of the women patients 
for at least 15 days and that they knew 
how to read and to write. 

The hypothesis stated that there is 
a relationship between the perceived 
similarity o\' the nurse aide between 
herself and the terminally ill patient, 
and the nurse aide's feelings of help- 
lessness. 

A Pearson product moment correla- 
tion coefficient was computed to de- 
termine the extent of relationship 
between these variables. The obtained 
correlation of +.38 was significant at 
the .05 level on a two-tailed test. 

The hypothesis was supported. I'his 
meant that when nurse aides perceived 
themselves as being more similar to 
the patients, nurse aides reported feel- 
ings of helpfulness, and when nurse 
aides perceived themselves as being 
less similar to the patients, nurse aides 
reported feelings of helplessness. 

The investigator concluded that 
inservice education in regard to the 

FEBRUARY 1974 



variables in this study may be helpful 
to nurse aides who are working with 
terminally ill patients in nursing homes. 
Research is needed to explore more 
fully the relationship between the per- 
ceived similarity of the nurse aides 
between themselves and the terminally 
ill patients, and the nurse aides" feel- 
ings of helplessness. Such research 
ct)uld enable nurses to formulate plans 
to help nurse aides feel more helpful 
in caring for terminally ill patients. 



Kravitz, Mona B. Joking bcluiviour on 
orthopedics — a descriptive stitdx. 
Montreal. Que.. I97,\ Study (M.Sc. 
(Appl.)) McGill U. 

This descriptive study was to generate 
useful knowledge about joking in the 
substantive context of orthopedic pa- 
tient care. 

Joking behavior was defined as any 
statement or action that evokes laugh- 
ter in the subject or listener. 

Participant observation permitted 
exploration of some of the subtle nu- 
ances of interaction among patients and 
between patients and nurses. Written 
records allowed the researcher to learn 
something about what patients were 
like prior to hospitalization, their prog- 
ress in hospital, and the behaviors on 
which nurses focused in w ritten rejDorts. 

The sample consisted of 24 ortho- 
pedic patients on bed rest. Patients in 
the immediate postoperative phase 
were excluded. Patients were observed 
on at least two separate occasions. The 
average hours of observation per patient 
were 1.75. All but one patient were in 
four-bedded rooms. 

As some patients joked during the 
observation periods while others did 
not, a category set was thus identified. 
Jokers and Nonjokers were among the 
patients observed, and a number of 
differences were observed between 
them. 

1. Jokers demonstrated considerable 
verbal and social skill in interactions 
with others. This was not evident in 
the nonjoker group. Interactions ob- 
served between nurses and jokers were 
suggestive of a sharing of what it was 
like to nurse and what it was like to he 
nursed. Little interaction was observed 
between nonjokers and nurses and non- 
jokers and other patients. 

2. Jokers tended to be in rooms 
where other occupants joked. Non- 
jokers tended to be in rooms where 
other occupants did not joke. In their 
spare moments, nurses tended to gravi- 
tate to rooms characterized by a joking 
climate. 

3. Jokers did not tend to complain 
of pain and minimized other physical 
and psychological discomforts. Non- 

FEBRUARY 1974 



jokers appeared to be preoccupied w ith 
such discomforts. 

4. More nonjokers than jokers re- 
ceived tranquillizers during hospitali- 
zation. 

5. More jokers were gainfully cm- 
ployed prior to hospitalization than 
nonjokers. Many nonjokers were social- 
ly deviant with respect to problems of 
alcoholism, retardation, mental illness, 
and criminal activity. 

6. Jokers focused on life outside 
hospital — their work and recreational 
activities. Nonjokers did not. 

Variables that did not discriminate 
between jokers and nonjokers were, 
fever, diagnosis, surgery, traction, anal- 
gesic and sedative medication, length 
of stay, previous hospital experience, 
language, age, sex, religion, and ethnic 
origin. 

A perception was conceptualized as 
a judgment by a person of another's 
characteristics or attributes. A total of 
I I I statements were collected and cate- 
gorized along the dimension of nurses' 
perception. Ninety-four (85 percent) of 
them were obtained from written re- 
cords, and 17 (15 percent) from verbal 
remarks made by nurses about patients 
in casual conversation. Items were 



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assigned to two categories: the social 
nature of the patient and the progress 
he was making in hospital. Nurses tend- 
ed to perceive jokers as sociable and 
progressing welj, and nonjokers as un- 
sociable and not progressing well. 

A total of 42 statements made by 
patients about nurses and/or nursing 
care were considered as indices of pat- 
terns of patients' perception. Jokers 
tended to perceive nurses as sociable, 
efficient, but busy. Nonjokers tended to 
perceive nurses as unstxiable, ineffi- 
cient, and busy. 



Bhusari, Marjorie. A study of luirsing 
strategies and subsequent patient 
outcomes in a psychiatric setting. 
Montreal. Quebec, 1971. Study 
(M.Sc. (Appl.)) McGill U. 

In nursing we have little descriptive 
cv idence on which to base both practice 
and teaching, of how nurses practice, 
or of how patients behave in response 
to their nursing. This is a descriptive 
study ot the relationships among nurs- 
ing strategies and subsequent patient 
outcomes. 

A nursing strategy was defined as 
a verbal or nonverbal nurse behavior 
performed while nursing a patient, and 
a patient outcome as a behav ior cx;cur- 
ring in response to a nurse strategy. 
The study was conducted by the method 
of grounded theory. Data were collected 
by participant observation of inter- 
actions between 29 patients and I .> 
nursing staff, in a short-term psychiatric 
setting. 

Analysis revealed that nurse strat- 
egies were not qualitatively different 
from patient outcomes. Six such strat- 
egy and outcome types were identitied. 
avoidance, power-protest, bargaining, 
iiiiorming, inquiry, and acquiescence. 
Both nurses and patients used inform- 
ing, inquiry, and power-protest strat- 
egies more frequently than they did the 
remaining three. Characteristic patterns 
of relationships were identified among 
strategy types and outciime types. The 
\ arious strategies ot nurses and patients 
were conceptualized as falling along a 
single contriil-compliance continuum 
extending from avuidance to acquies- 
cence. 

The findings suggest several areas 
for subsajuent (.iescriptive research. 

1. how strategies and outcomes are 
affected by setting, type of illness, 
stage of illness, or the expected course 
of illness. 

2. the discover) of concepts and 
hypotheses relevant to the area of 
control. 

.V the effects in practice o\ teaching 
nursing as inquiry, that is, as a ci>ntinu- 
ing inquiry into what (Krcurs subsequent 
to particular nursing acts. ;J2? 

THE CANADIAN NURSE 53 



The Crisis Team: A Handbook for the 
Mental Health Professional by Ju- 
lian Lieb. Ian I. Lipsitch, and An- 
drew E. Slaby. 186 pages. Hagcrs- 
town. Maryland. Harper and Row. 
1973. 

Reviewed hy Philip E.T. Gower. 
former Assistant Director of Nursing 
Service. Queen Street Meittal Health 
Centre. Toronto. Ontario. 

In this expensive paperback, the organ- 
izational structures required to support 
a muitidisciplinary team's work in crisis 
intervention are plainly stated and 
described. Because it is aimed at prac- 
tically anyone interested in this work, 
psychiatrists or clinicians familiar with 
this aspect of psychiatric care will find 
The Crisis Team somewhat repetitious. 
Newcomers and trainees, on the other 
hand, will find the boiik a helpful walk- 
through of how to set up and run a suc- 
cessful crisis intervention center. 

The varied readership at which this 
handbook is aimed somewhat blunts 
the two major elements. The review 
of crisis intervention as a technique 
is too briefly outlined to provide a 
complete grasp of the real nature of the 
work; and the clinical case histories, 
while numerous, are too sketchy to be 
proper models for emulation. 

In addition, the descriptions o'i the 
structure and functioning of. a unit as 
an organization would need further 
amplification to be really helpful. How- 
ever, ample references on crisis inter- 
vention methodology are provided, and 
careful reading will sort out the form 
of organization the authors recommend. 

Ihe appendix is useful to those 
who are unfamiliar with the Spitzer 
and Endicott computerized Psychiatric 
Anamnestic Record and Mental Status 
Examination Forms, as an exact copy 
of each form is provided. I was disap- 
pointed that the authors did not give an 
address where more copies of the forms 
could be obtained, as they are com- 
prehensive, self-explanatory, and adapt- 
able to a variety ot settings. 

Crisis intervention is an essential 
part of modern, community-oriented 
psychiatric nursing practice, and this 
handbook gives full recognition and 
support to the validity of professionals 
other than psychiatrists taking on this 
helping role. As it assumes that the 
qualities needed for successful perform - 
54 THE CANADIAN NURSE 



ance are not restricted to doctors, this 
book encourages nurses or other profes- 
sionals to accept an active role in the 
organization and provision of a com- 
plete crisis intervention service. 



Midwifery by Jean I.. Hallum. 152 
pages. London, English Universities 
Press, 1972. Canadian Agent. Mus- 
son, Don Mills. Ontario. 
Reviewed by M.T. Mildred Morris. 
Assistant Prtfessor. School of Nurs- 
ing. University of Ottawa. Ottawa, 
Ontario. 

This text is part of a modern nursing 
series designed for student midwives 
in the United Kingdom. The author 
stresses that childbirth is a natural phe- 
nomenon, and states: "Unnecessary 
interference with nature can cause much 
harm."' 

Further, the author deplores undue 
haste in the management of labor. She 
gives as examples the use of an episio- 
toniy except in an emergency, oxytocics 
to hasten placental separation, and the 
Brandt Andrews method to deliver the 
placenta. However, in North America 
there is general acceptance by nurse- 
midwives of the use of midline episio- 
tomy where indicated: these indications 
are broad compared to those listed by 
Hallum, such as prevention of a severe 
perineal tear. 

Careful proofreading would have 
eliminated distracting typographical 
errors, for instance on page I 1, 510 gm 
is given as the weight of the non- 
pregnant uterus, and on page 29, chro- 
nic villi. Generally, this work seems 
oversimplifled; the physiologic basis 
for treatment is not generally stated, 
but rather information is presented 
without explanation. However, the good 
line-drawings add to the reader's under- 
standing. The use of rhetorical ques- 
tiims breaks the continuity of the 
material and, at times, the author seems 
to be sermonizing. 

One wonders why a treatment re- 
garded by North American and Euro- 
pean authorities as being of historical 
interest, the use of Willet's forceps to 
apply traction to the fetal scalp in the 
management of marginal placenta pre- 
via, is included in a basic text. 

An excellent summary of the train- 
ing programs for midwives in the UK 



is included, which should interest 
nurses and nurse-midwives in other 
countries. The use of this work as a 
reference for Canadian nurses and 
nurse-midwives is limited, since mater- 
nity CLue here, particularly management 
of labor, is different from that described 
by the author. 



The Interpersonal Basis of Psychiatric 
Nursing b\ A.H. Chapman and El/a 
M. Almeida. 59S pages. New York. 
Putnam's. 1972. Canadian Agent. 
Maemillan, Toronto. 
Reviewed hy Margaret R. IVehb. 
Instructor. School of Nursing. Uni- 
versity oj' Calgary. Calgary. Alta. 

This text meets the objective set forth 
by the authors, it is a ■'clear, compre- 
hensive textbook of psychiatric nurs- 
ing." The bcxik covers all aspects of 
psychiatric nursing, ranging from its 
beginnings in the nineteenth century 
to the present. As well, sections are 
included that are not typically found 
in psychiatric nursing texts, such as 
discussion of cttnimon emotional prob- 
lems found in medical and pediatric 
nursing, and the nurse's role in psychiat- 
ric research. 

This is a valuable text lor under- 
graduate students, and one they would 
use in all areas of nursing. Each chapter 
is summarized by a list of the important 
concepts presented in that chapter; a 
fairly extensive glossary of psychiatric 
terms is included at the end iif the book. 

Unlike many of the current psychiat- 
tric nursing texts, this book still refers 
to patients as diagnostic entities rather 
than in behavioral terms. However, 
included within each patient classifi- 
cation is an extensive description of the 
nursing care required by these patients. 
Ol' particular interest is a chapter deal- 
ing with the assessment of the psychiat- 
lic patient. An assessment framewcirk 
is outlined, indicating the various ways 
in which each member of the health 
team, such as the nurse, the psychol- 
ogist, and the psychiatrist, contribute 
to the formulation of the psychiatric 
diagnosis. 

As well as being useful for the im- 
dergraduale student, this book would 
undoubtedly be a valuable reference 
source for nursing libraries. 

(Continued on page 36) 

FEBRUARY 1974 



New 6th Edition! Carini-Owens 

NEUROLOGICAL AND 
NEUROSURGICAL NURSING 

Highlighted by extensive revisions, this new 6th edition appears as the 
nnost comprehensive neurological and neurosurgical nursing text available. 
Students will find a new section on acupuncture, a totally revised section 
on multiple sclerosis, an all-encompassing presentation of drugs; plus 
in-depth treatment of broad topics in the field, including cerebrovascular 
disease, and related procedures and nursing care. 

By ESTA CARINI, R.N., Ph.D.; and GUY OWENS, M.D. April, 1974. Approx. 424 
pages, 7" x 10", 155 illustrations, 2 in color. About S11.85. 



A New Book! Conover 

CARDIAC ARRHYTHMIAS: 
Exercises in Pattern Interpretation 

This practical volume can reinforce and broaden your student's expertise 
in the interpretation of arrhythmias. Common and rare patterns — more 
than 200 — are included for their personal diagnosis. An analysis by the 
author follows each. 

By MARY H. CONOVER, R.N., B.S.N. Ed. January, 1974. Approx. 240 pages, 8" x 
10", 266 illustrations in 234 ECG tracings. About S7.10. 



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FEBRUARY 1974 



WORKBOOK AND STUDY GUIDE 
FOR MEDICAL-SURGICAL NURSING, 
A Patient-Centered Approach 

This carefully revised patient-centered workbook encourages the use of 
problem-solving techniques. Each case study first examines the patient as 
an individual and family member and notes the etiology and early 
symptoms of the disease. Students are given the opportunity to apply 
basic science principles to patient care and patient care planning. 

By ALMA JOEL LABUNSKI, R.N., B.S.N.; MARJORIE BEYERS, R.N., B.S., M.S.; 
LOIS S. CARTER, R.N., B.S.N., BARBARA PURAS STELMAN. R.N., B.S.N. ; 
MARY ANN PUGH RANDOLPH. R.N., B.S.N,; and DOROTHY SAVICH, R.N., B.S. 
October, 1973. 331 pages plus FM l-VIII, 7'/." x 10'//'. Price, S6.25. 

THE CANADIAN NURSE 



55 



IC iiiiliniicil fiiiiii /'(/,!,'(' 5-1) 

Childhood Learning, Behavior and the 
Family by Louise C. Taichcrt. 112 
pages. New York. Behavioral Pub- 
lications, 1973. 

Reviewed by Ccithryn Glanville. As- 
sociate Professor, McMaster Uni- 
versity School of Nursing, Hamilton, 
Ontario. 

This book presents a ncurodevelop- 
mental-t'amily approach to understand- 
ing and managing childhood learning 
and behavioral problems. 

The neurodevclopmenlal approach is 
based on the assumption that, although 
the child and his family are separate 
systems, they must be viewed together 
as a functional unit. Such an approach 
provides for a process-oriented, non- 
catagorical assessment of the child's 
developmental level and how this is 
intluenced by many variables within 
the family system. These variables could 
be: communication patterns, norms, 
values, and roles. This approach is 
quite different from the traditional 
medical models, which tend to empha- 
size diagnostic labels and management 
of the child in isolation from the total 
family. 

The first two chapters present a 
historical review of critical issues of 
childhood learning and behavior, which 
extends beyond the nature-nurture con- 
flict. Critical phases of learning as des- 
cribed by F.rikson. Piaget, and Freud 
arc compared. The author not only 
identities specific learning problems, 
but also describes the learning process 
involved in achieving academic tasks. 

Chapters three and four focus on 
behavioral events occurring as the child 
with specific learning disorders and his 
family interact with each other. Pat- 
terns of communication within a closed 
family system and a dysfunctional 
family system are examined and cases 
cited as examples. 

As the treatment and management of 
childhood learning and behavioral prob- 
lems are described in chapter five. 
continuous emphasis is placed on the 
significance of early detection i>f high- 
risk children. 

Chapter six describes how the ncuro- 
devclopmental approach to learning and 
behavioral problems is made operation- 
al through the use of gestalt-orienied. 
conjoint, family therapy. Cases are 
presented to illustrate the therapists" 
task in helping the child and his family. 

Ihis book is excellent tor anyone 
working with children and their fami- 
lies. 
56 THE CANADIAN NURSE 




Perspectives in Human Development; 
Nursing Throughout the Life Cycle 

by Doris Cook Sutterley and Gloria 
f-erraro Donnely. .^31 pages. New 
York. Springer. 1973. Canadian 
Agent, l.ippincott, Toronto. 
Reviewed hy Raymond M. Thomp- 
son. Assistant Professor. University 
of British Columbia Scluwl of Nurs- 
ing. Vancouver. B.C. 

The authors of this publication have 
used systems theory for presenting a 
multidisciplinary view of man. The 
book is intended to meet the learning 
needs of freshman nursing students. 

Eight life processes form the frame- 
work for the presentation of content. 
An attempt is made to demonstrate 
the relationship among the processes, 
thereby creating a multidimensional 
view of man. Other content areas of 
particular note are related to systems 
theory, environmental factors intlucn- 
cing man, and the profession of nursing 
viewed as an open system. The treat- 
ment of the content is of sufficient 
breadth and depth to be stimulating 
for the beginning nursing student. 

Cases are used tt) illustrate the con- 
tent and to show generally how the 
nurse functions in a variety of settings 
with a variety of health-team members. 
A select few of the cases pose problems 
and could be used as a basis for further 
discussion; otherwise the use of the 
cases for this purpose is extremely 
limited. 

An extensive number of tlgurcs and 
tables provide the reader with vast 
amounts of data in an organized, use- 
able format. Of particular note are the 
Whipple Age-Portrait Summaries that 
permit the reader to take a theory, such 
as Erickson's. and identify behaviors 
characterized in that theory. A few 
of these tables and figures arc complex 
and appear superfluous to the purposes 
of the book. 

Each chapter division is provided 



with a large number of references that 
should provide the reader with addi- 
tional scope in a given content area. 

A small number of the references 
are for periodicals, which is interesting 
because these publications are the 
source of much of the up-to-date infor- 
mation. Also of note is a dearth of 
nursing references, particularly when 
excellent ones relevant to some areas, 
such as systems theory, do exist. 

Although the publication is for 
nursing and is relevant to nursing, there 
is a limited attempt to demonstrate for 
the intended audience just how the data 
may be used in an application setting. 
The content needs to be supplemented 
by the provision of some tools, such as 
a nursing history tool and physical and 
developmental appraisal tools. Ba- 
sically, the book may well serve as one 
item in the data base needed for the 
effective use of the nursing process. 

The chief value o\ this book is as 
a reference in obtaining a broad, inte- 
grated view of man throughout the life 
cycle. Because of its particular frame- 
work for the presentation of content, 
it may be difficult to use this success- 
fully as a text in a curriculum that uses 
a different system model. 



Industrial Mental Health and Employee 
Counseling, edited by Robert L. 
Noland. 432 pages. New York, 
Behavioral Publications, 1973. 
Reviewed by Rachel Ann Gaw, 
Industrial Nurse. Air Canada, To- 
ronto International Airport. 

"A problem employee is one who does 
not conform to the social-vocational 
role expected of him at his place of 
employment." This book is concerned 
with the problem employee. Its purpose 
is to provide the reader with a compre- 
hensive view of what various companies 
and individuals have done to understand 

(Coiiliiuicd tin pave .f/i) 
FEBRUARY 1974 



A New Book! Mclnnes 

CONTROLLING THE SPREAD 
OF INFECTION: A Programmed 
Presentation 

As a handy reference, this new programmed presentation offers the 
scientific principles of asepsis for immediate and realistic application in the 
everyday care of patients. Emphasis throughout is on these principles as 
they apply to both patients and health care personnel, and on the 
infection control procedures necessary to establish and maintain an aseptic 
environment. 

By BETTY MclNNES, R.N., B.Sc.N., M.Sc.(Ed.). July, 1973. 112 pages plus FM 
1X11,7" X 10". Price, $4.75. 



A New Book! Dubay-Grubb 

INFECTION: Prevention and Control 

This new reference guides you in establishing a program for prevention and 
control of infection in all health care facilities. Pertinent chapters discuss 
meeting the needs of the isolation patient, legal aspects of hospital- 
associated infections, and much more! 

By ELAINE C. DUBAY, R.N., 8.S.; and REBA D. GRUBB, Medical Writer. August, 
1973. 160 pages plus FM l-XVI, 6" x 9", 40 illustrations. Price, $5.15. 



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INTRAVENOUS MEDICATIONS- 

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In this unique new volume, the author presents the complete, specific, stat 
information designed to aid you in the administration of all I.V. 
medications. 

By BETTY L. GAHART, R.N. May, 1973. 176 pages plus FM I XII, 6" x 9". Price 
$5.00. 

A New Book! 

READINGS IN GERONTOLOGY 

As a current sourcebook for selected readings, this new volume considers 
gerontology, psychology, physiology, medical science, sociology, and 
more! 

Edited by VIRGINIA M. BRANTL, Ph.D., and SISTER MARIE RAYMOND 
BROWN, R.S.M., M.N.Ed. July, 1973. 1 18 pages plus FM l-X, 6" x 9". Price, $4.15. 

THE CANAI^AN NURSE 57 




<C(iiiliiii(ccl from /)((,!,'(• 5f>) 

and deal effectively with problem 
employees. 

The book is divided into five parts; 
each part is a collection of papers by 
academic, medical, and industrial 
experts. 

Part I concerns mental illness, how 
it effects productivity and efficiency, 
and the economic consequences of job 
disruption. An interesting chapter 
deals with identifying emotional dis- 
turbance in persons seen in industrial 
clinics. 

A recent study found 1 .S percent 
fewer industrial clinic patients than 
patients in a general group medical 
practice were considered by nonpsy- 
chiatric physicians to have an emotional 
problem, the author feels this could 
be attributable to the fact that employ- 
ees in these companies were initially 
screened through job interviews and 
physical examinations. 

Where companies encourage health 
care by partial subsidy of good insur- 
ance coverage and where a company is 
supportive of employees with emotional 
problems by eliminating stressful 
on-tne-|ot) situations, even it this means 
changing jobs, the incidence of employ- 
ee emotional problems seems to be 
lessened. 

•'It can be correctly stated that a 
worker can be a bit fearful, a bit 
forgetful, a bit suspicious, a bit ciimpul- 
sive, irritable, and angry, and still be 
very much a normal person." These 
and other traits are discussed in Part 
n. The reader is given sufficient 
historical background in the problems 
of employee mental health to enable 
her to understand both problems and 
trends in current industrial mental 
health and employee counseling. 

Part 111 deals with the multiple 
approaches to employee counseling, 
from the role of the psychiatrist in 
industry, through the value of clinical 
counseling, to the role of the pastor 
in employee counseling. 

Part IV has four chapters dealing 
with the mental health of supervisory 
and managerial personnel, the impact 
of their problems on the organization, 
and the care that must be taken in 
dealing with the problems of people 
at this level. 

Part V is composed of eight chapters 
that deal with the latest trends for 
cooperation of labor management and 
community resources. It relates the ex- 
periences of unions in bargaining for 
and setting up mental health services. 
58 THE CANADIAN NURSE 



This book is well written, well 
documented, and interesting to read. 
It could be a valuable reference for 
any occupational health clinic, for 
college students in personnel or indus- 
trial management, or management 
personnel and industrial training in- 
structors. 

Although the book deals exclusively 
with American companies, it is quite 
easy to equate the same mental health 
problems with Canadian industry. 



Effective Approaches to Patients' Beha- 
vior by Gladys B. Lipkin and Rober- 
ta G. Cohen. 198 pages. New York, 
Springer, 1973. 

Reviewed by Christina I. Mikoski, 
Teacher, Nursing Program. Confed- 
eration College. Thunder Bay. Ont. 

This bcxik deals with behaviors found 
in persons with various health problems, 
which makes it more versatile and 
worthwhile than a basic text related 
specifically to psychiatric problems. 

The authors recognize the need for 
all health workers to develop mean- 
ingful and assertive intervention to meet 
a client's emotional needs. It is pointed 
out that many- health workers avoid 
patients with emotional needs as the 
worker is not sure of what to say or 
do. With these two premises in mind, 
the authors have prepared a short man- 
ual that describes problem behavior, 
discusses the dynamics involved, and 
suggests approaches suitable for use 
in any hospital or community setting. 

The book is divided into two sections. 
The short, first one deals with some of 
the key concepts of interpersonal rela- 
tionships and preventive psychiatry. 
There is a noteworthy focus on the 
attitudes and approaches of the health 
worker. This is as important as studying 
and understanding the patient, since 
the health worker is 50 percent of a 
one-to-one relationship. 

It also establishes that the health 
worker cannot begin to understand 
and help the patient until she has 
understood and dealt with her own 
feelings appropriately. Many examples 
illustrate that, too often, the nurse"s 
conclusions about a patient are colored 
by her own perspectives and do not 
accurately reflect the patient's needs. 

The chapter dealing with crisis 
intervention provides a broad over- 
view of crisis points in life, as seen 
from a maturational outlook (the stress 
times of growth and development). It 
might have been advisable to delineate 
between the normal developmental 
crisis, such as weaning or puberty, and 
the accidental type of crisis, such as 
loss of a job, illness, or being a victim 
of a disaster. 



In the longer, second section of the 
book, each chapter deals with a specific 
behavioral problem — "The Hostile 
Patient," "The Helpless Patient" — 
or an illness entity in which the com- 
plexity of behavior poses a challenge. 
"The Patient Undergoing Renal Dial- 
ysis or Transplant." 

Each patient behavior is simply 
and clearly described. There is some 
interpretation of possible causes and 
significance. This is frequently followed 
by a discussion of common, negative, 
nurse reactions. 

The second portion of each chapter 
identifies specific approaches to the 
behavioral problem. This is done in 
steps that include practical dos and 
don'ts. 

Concrete directions are given, with 
actual examples of what to do and what 
to say. These suggested approaches 
are one of the strongest points in the 
book. Too often, textbooks provide 
only wonderful ideas, concepts, theories, 
and generalizations. Many health work- 
ers, including diploma student nurses, 
need assistance in transferring such 
knowledge into a form suitable for 
practical application. This book does 
just that. 

The authors are to be commended 
for preparing a practical resource man- 
ual that could be an asset to any health 
worker in any setting. It meets the 
authors" intentions of helping the reader 
to understand the whys and to acquire 
the knowledge of what and how to do 
it, as related to specific behaviors, 
regardless of the diagnosis. 



Monitoring Central Venous Pressure; 
a Programmed Sequence by Jean M. 
Krueger, illus. by Jane Sullivan. 95 
pages. New York. Springer, 1973. 
Reviewed by Kay DeJong. Inservice 
Education Instructor, St. Boniface 
General Hospital. Winnipeg. Man- 
itoba. 

As happens so often in this rapidly 
changing world of health care, the 
specialty world for which a book was 
originally intended is part of the non- 
specialty world of general nursing by 
the time the book is published. This is 
evident in the section entitled "Assump- 
tions about Learners," in which the 
author assumes that the nurse to whom 
her book is directed is "ideally" a nurse 
who works in an ICU or CCU. This 
nonvalid assumption, however, in no 
way detracts from the value of the text 
on an "In" procedure in today's hos- 
pital. 

The introduction and objectives 
state clearly, in language understood 
by undergraduate or graduate, what 
the book is all about. 

iCoiitiitiii'd oil p(ii;i' M)i 

FEBRUARY 1974 



New 2nd Edition! Aguilera-Messick 

CRISIS INTERVENTION: 
Theory and Methodology 

Thoroughly revised and updated, this new edition presents the problem- 
solving approach which offers clear-cut rationale to follow in stressful 
situations. Directed toward all levels of health care, it discusses all aspects 
of crisis intervention. 

By DONNA C. AGUILERA, M.S.; and JANICE M. MESSICK, M.S. April. 1974, 
Approx. 146 pages, SVi" x gVi", 13 illustrations. About S6.30. 

ANewBool<! Berni-Fordyce 

BEHAVIOR MODIFICATION 
AND THE NURSING PROCESS 

Designed to acquaint you with the rudiments of behavioral analysis, this 
new volume outlines procedures and principles to follow in applying 
behavioral analysis to the wide range of problems you encounter in your 
daily work. 

By ROSEMARIAN BERNI, R.N., B.S., and WILBERT E. FORDYCE, B.S., M.S. 
Ph.D. June, 1973. 136 pages plus FM I XII, SVi" X 8'/2". Price, S4.15. 



BASICS & 
BEYOND.. 



new Mosby nursing books 
enhance interpersonal 
perception 



MOSBV 

TIMES MIRROR 

THE C V MOSBY COMPANY, LTD 

86 NORTHLINE ROAD 

TORONTO. ONTARIO 

M4B 3E5 

New 2nd Edition! Douglass-Bevis 

NURSING LEADERSHIP IN ACTION: 

Principles and Application To Staff Situations 

In seven highly informative discussions, the authors show how to 
formulate principles from reference readings and resource material. They 
provide a theoretical framework and practical methods for administrative 
nursing activities. 

By LAURA MAE DOUGLASS, R.N., B.A., M.S.; and EM OLIVIA BEVIS, R.N., 
B.S., M.A. April. 1974. Approx. 192 pages, 7" x 10", 17 illustrations. About $6.05. 

A New Book! Popiel 

NURSING AND THE PROCESS 
OF CONTINUING EDUCATION 

This book works as a handy reference to successful continuing education 
programs. 

Edited by ELDA S. POPIEL. R.N.. B.S., M.S.; with 32 contributors. July. 1973. 
248 pages plus FM l-XX, 6/2" x 9V4". Price, $7.30. 

FEBRUARY 1974 THE CANADft^N NURSE 



59 




(Contiiiiu'il from piit^i' 5H) 

The division of the book into three 
parts lends itself to either study or 
review. The brief end-of-sequence re- 
views would be excellent refreshers 
for nurses who have had previous in- 
struction or experience. 

Beginners at cvp's will find the 
entire program necessary and benefi- 
cial. The author has repeated many 
questions several different ways; this 
may stimulate learning in the young 
student, but may not do the same for 
the RN who wishes to review cvp. 

The objectives, generally speaking, 
have been met. 

The author's style of writing makes 
what could be a boring procedure an 
interesting and absorbing exercise. 
The light weight of the text makes it 
easy to handle and carry in a pocket 
or purse. This lightness could be a 
drawback if the text were going to be 
used by a large number of people. Its 
spine may not stand the stram: 

There are areas that we found to be 
inadequately dealt with or completely 
lacking. It should be stressed that final 
assessment of the position of the CVP 
catheter tip can be done only with an 
anterior/posterior x-ray of the chest. 

The second area of weakness is in 
determining the CVP zero point. The 
method the author outlines can lead 
to variations in implementing the CVP 
procedure. We prefer to use the 4th 
intercostal space and mark our patient's 
chest wall halfway between the spine 
and the top of the chest; in this way all 
personnel use the same criteria for 
finding the zero point. The positioning 
of the manometer is rarely •' . . . initial- 
ly determined by the physician." but 
is done by the nurse. 

More detail on technique of dressing 
the puncture site should have been in- 
cluded, as the consequences of infec- 
tion are grave. 

"Flushing the catheter" is a proced- 
ure that is fraught with danger. The 
author has not clarified whether Hush- 
ing is accomplished by gravity flow of 
IV solution or by forcing fluid under 
pressure through the tubing. Gravity 
flow would probably not dislodge a 
well -formed clot in the CVP catheter, 
but flushing with a pressure device 
could, resulting in the death of a pa- 
tient, due to an emb<ilus. 

The procedure for removing the 
CVP catheter has not been included by 
the author. 

Although the author has recommend- 
ed the book for both graduates and 
undergraduates, I would recommend it 
60 THE CANADIAN NURSE 



primarily as a teaching tool for student 
nurses who wish to understand the 
purpose and functioning of the CVP 
procedure. But the book could be used 
by RNs to be assured of the same 
"standard" of knowledge and perform- 
ance of CVP measurement. 



Behavior Modification and the Nursing 
Process by Rosemarian Berni and 
Wilbert E. Fordyce. 135 pages. St. 
Louis, Mosby, 1973. 
Reviewed by Beverlee Cox, Lectur- 
er, University of British Columbia 
School of Nursing, Vancouver, 
British Columbia. 

For those professional nurses who wish 
to acquire the basic knowledge relating 
to learning theory and its specific appli- 
cation in the treatment modality known 
as behavior modification, this book will 
prove to be a useful guide. The authors 
state; "This book seeks to acquaint 
nursing personnel and others working 
in the health care field with the rudi- 
ments of behavioral analysis and with 
procedures and principles to follow in 
applying behavioral analysis to a range 
of problems in their daily work." 

They have managed to do just that, 
through a careful and logical develop- 
ment for the unitiated reader of the 
various concepts underlying the prac- 
tice of behavior modification. Of par- 
ticular value is their frequent use of 
examples of patient situations, describ- 
ing observable and measurable behavior 
that is amenable to conditioning tech- 
niques through the use of appropriate 
reinforcement. 

The major portion of the book is 
devoted to a detailed, systematic expo- 
sition of the "behavioral analysis pro- 
cess," as the authors have termed it. 
In each chapter, fundamental concepts 
and principles from learning theory 
are presented. Definitions of terms 
are provided, and generally the con- 
cepts are well explained. 

What is not fully explained, how- 
ever, is the rationale for the use of this 
methodology in nursing situations. A 
brief historical overview of the develop- 
ment of learning theory, citing the work 
of such major theorists as Skinner, 
Eysenck. and Wolpe, is lacking in this 
book. This background information, 
had it been included, would have 
provided the reader with some inkling 
of the giant leap that learning theory 
has taken from the experimental work 
done in animal laboratories to the 
more recent application in clinical 
settings. 

Probably of greatest interest to 
nurses is the material contained in 
the last few chapters of the book, in 
which thoughtful consideration is 
given to the planning and implementa- 



tion of behavior modification in the 
nursing situation. There is also a chap- 
ter devoted to evaluation and problem- 
oriented charting, one to ethical issues, 
and another to a discussion of future 
trends for the use of behavior modifi- 
cation. These are all timely subjects, 
and treated in sufficient depth to give 
the reader an increased understanding 
of them. 

In the chapter on ethical issues, the 
authors have made the point quite 
unequivocally that patients must be 
involved in setting the terms of a 
contract that employs a behavior modi- 
fication scheme. This should allay the 
fears of those who view behavior mo- 
dification as a covert manipulation of 
patient behavior. 

The book itself takes the form of 
a manual, designed to promote self- 
learning by the inclusion of practice 
problems at the end of each chapter. 
The authors have also provided cogent 
summaries of the major topics covered 
at appropriate points in the text. 

This book should serve as a useful, 
practical guide for those students and 
practitioners who are interested in 
applying a well-defined methodology 
for nursing intervention. ^> 



AV aids 



DATA BANK SERVICE 

D The University of Southern Cali- 
fornia is offering the NICEM Update 
Subscription Service to update and 
supplement all previous NICEM in- 
dexes. NICEM has published 14 com- 
prehensive volumes dealing with non- 
book media. The subscription service 
provides 10 yearly volumes, each 
containing a subject section outline, 
subject guide, alphabetical guide, and 
producer/distributor directory. This 
allows the user of the 14-volunie set 
to find new titles in all the media and 
all subject areas, and also helps those 
who only need access to one media 
volume, such as the Index to 16mm 
Educational Films. 

For more information, write to the 
University of Southern California, 
National Information Center for Edu- 
cational Media, University Park, Los 
Angeles, California 90007, U.S.A. 



AUDIO CASSETTES 

D Educational Testing Service has an- 
nounced the availability of Proceed- 
ings and audio cassettes of presenta- 
tions made at its 1973 Invitational 
Conference on Testing problems. The 
FEBRUARY 1974 



theme of the conference was measure- 
ment for self-understanding and per- 
sonal development. 

A separate audio cassette is avail- 
able for each of the five presentations; 
the uses and abuses of moral stages; 
the uses of psychology in conflict reso- 
lution in a university setting; exploring 
values for career decision making: a 
computer-based system of interactive 
guidance and information (SIGI); a 
significant change in direction; its im- 
plications for psychological measure- 
ment; and four talks on the contribu- 
tion of measurement to self-under- 
standing. 

The Proceedings contain all presen- 
tations. Orders should be directed to 
Invitational Conference on Testing 
Problems. Educational Testing Ser- 
vice. Princeton, New Jersey 08540. 
U.S.A. 



FILMS 

D Films on a variety of health sub- 
jects are available from International 
Tele-Film Enterprises, Toronto, Ont 
Among these films. The Heart Attack 
(25 min., color) explores the nine risk 
factors of heart disease; high blood 
pressure, cholesterol level, excess 
weight, ovcrnutrition, sedentary living, 
stress, age, diabetes, and heredity; 
The Heart: Counterattack (25 min., 
color) gives advice on how heart disease 
can be prevented and demonstrates 
modifications of the dangerous pat- 
terns of life many lead; Muscle (30 
min., color) combines animation tech- 
niques with commentary to show the' 
dynamics of muscle tissue and the 
processes involved in muscle contrac- 
tion; The Cell: A Functioning Struc- 
ture. Part I (30 min., color) covers 
aspects of the living cell as part of the 
process of life and death at the molecul- 
ar level; The Cell. Part II (30 min., 
color) concentrates on the chemical 
events taking place within the cell; 
and Infancy (2() min., color) examines 
the infant's early development. 

Films on abortion and acupuncture 
anesthesia are available from Cinema 
Images, a division of International 
Tele-Film Enterprises, 221 Victoria 
St.. Toronto, Ontario M5B 1 V5. ■£? 



accession list 



Publications on this list have been 
received recently in the CNA library 
and are listed in language of source. 

Materials on this list, except refer- 
FEBKUARY 1974 



ence items, may be borrowed by CNA 
members, schools of nursing and other 
institutions. Reference (R) items (ar- 
chive books and directories, almanacs 
and similar basic books) do not go out 
on loan. Theses, also r are on Reserve 
and may go out on Interlibrary loan 
only. 

Request for loans should be made on 
the "Request Form for Accession List"" 
and should be addressed to: The Libra- 
ry, Canadian Nurses" Association. 50 
The Driveway, Ottawa, Ont. K2P IE2. 
No more than three titles should be 
requested at any one time. 

BOOKS AND DOCUMENTS 

1. AicdHule pliinning for iiulcpendenl living 
for older people. Conference on Gerontolofiy. 
22nd. University of Florida. Feb. 6-8. edited 
by Carter C. Osterbind. Gainesville. Fla.. 
University of Florida Press. 1973. 142p. 
2. Borllclt's iinfantiliiir qnouilions. by Leo- 
nard Louis Levinson. Chicago. Cowles Book 
Co.. 1971. 341p. R 

.3. Basil facts of body water and ions, by 
Stewart Marshall Brooks. 3ed. New York. 
Springer. 1973. 1 17p. 

4. Basic luinuin anatomy and pliysiolof;y, 
by Charlotte M. Dienhart. 2ed. Toronto. 
Saunders. 1973. 280p. 

5. Ba'iic library ntana^enient for health 
sciences libraries, by Ann L. Schaap. 2ed. 



Madison. Wise.. University of Wisconsin 
Extension. Dept. of Communication Arts. 
1973. 304p. 

6. Bitter itd^'c.s; Ralph Nader's sliidy };roap 
reporl on disease and injiay on ihe job. by 
Joseph A. Page and Mary-Win O'Brien. 
New York. Grossman. 1973. 314p. 

7. Canadian fiovernmeni prof;ramnies and 
services: government organization. Sept. 
1973. Don Mills. Ont.. CCH Canadian 
Limited. 1973. I vol. R 

8. Critical incidents in nursing. Edited by 
Loretta Sue Bermosk and Raymond J. Cor- 
sini. Toronto. Saunders. 1973. 369p. 

9. Decision niakin!> in the coronary care unit; 
a manual and workbook for nurses, by Wil- 
liam P. Hamilton and Mary Ann Lavin. 
St, Louis. Mosby. 1972. 150p. 

10. Dictionnaire pratique de therapentiqiie 
inedicale. par Leon Perlemuter et al. Paris, 
Masson. 1972. 1200p. R 

1 1 . Directory of interlibrary loan policies 
and photocopying services in Canadian li- 
braries. Compiled by the Committee on the 
Directory .... Information Services Section. 
Ottawa. Canadian Library Association. 1973. 
88p. 

12. Evaluation in tlie conliniinni of medical 
education. Philadelphia. National Board 
of Medical Examiners. Committee on Goals 
and Priorities. 1973. 94p, 

13. Form and function of written agreements 
in the clinical education of health profes- 



Some nurses are just nurses. 
Our nurses are also 
Commissioned Officers. 



Nurses are very special people in the Canadian Forces- 

They earn an Officers salary, enjoy an Officer's privileges 
and live in Officers' Ouarters (or in civilian accommodation if they 
prefer) on Canadian Forces bases all over Canada and in many 
other parts of the world. 

If they decide to specialize, they can apply for postgraduate 
training with no loss of pay or privileges. Promotion is based on 
ability as well as length of service And they become eligible for 
retirement benefits (including a lifetime pension) at a much earlier 
age than in civilian life. 

If you were a nurse in the Canadian Forces, you would be 
a special person doing an esoecially responsible, rewarding and 
worthwhile job 

For full information, write the Director at Recuiling and Selec- 
tion. National Defence Headquarters. Ottawa. Ontario K1A 0K2 




"^^ 



Get involved with tlie 
Canadian Armed Forces. 



THE CANADIAN NURSE 



61 



accession list 



sioiiiil.s. by Margaret L. Moore et ul. Thoro- 
fare. N.J.. Charles B. Slack. 1972. 81 p. 

14. Lti foniuitioii dcs c/wiclu'iir.s en .sciences 
inediciiles: coinple reiulii ti'iaic Uihle roiule 
oijwnisee pur Ic CIOMS avec I'ds.si.stiiiice 
ile rOMS et de f UNESCO. Geneve. 10-11 
seplcnihre 1970. Geneve. Organisation Mon- 
diale de Same. 197.V 206p. 

15. Great ailventiires in nnr.sini:. edited by 
Helen Wright and Samuel Rapport. New 
York. Harper and Brothers. 1960. 2S8p. 

16. Membership directory. 1973. American 
Library Association. 197.^. 218p. R 

1 7. Industrial mental Itealtli and employee 
counseling, compiled by Robert L. Noland. 
New York, Behavioral. 1973. 4.32p. 

I 8. An introduction to working' with the a};in!J 
person who is visually handicapped. New 
York. American Foundation for the Blind. 

1972. .Mp. 

19. Micro-Robert: dictioiinaire du jram^ciis 
primordial, apr Paul Robert. Paris. S.N.L. 
Le Robert. 1971. I207p. R 

20. Noise; an occupational ha:xud luid 
public nuisance, by Alan Bell. Geneva. 
World Health Organization. 1966. l.^lp. 
(World Health Organization. Public health 
papers no. 30) 

21 . Nurses' aliimiuie journal. 1973. Winnipeg. 
The Alumnae Association of Winnipeg 
General Hospital. School of Nursing. 1973. 
93p. R 

22. Tlic nursin.i; clinics of North America, 
vol. 8. no. 3. Sept. 1973. Toronto. Saunders. 

1973. p. 375-570. (Contents. -Emergency 
nursing. -Maternal and infant care in high- 
risk families) 

23. Pocket pal. A t^raphic arts dif^esl for 
printers and advertisini; production man- 
a.K'crs. 9ed. New York. lnlernation;d Paper 
Co.. 1966. I90p. 

24. The principles and practice of surf^ery 
for nurses and allied professions, by Denis 
Frederic Ellison Nash. 5ed. London. Ed- 
ward Arnold. 1973. 987p, 

25. Psychological tests: tlieir use and vididily 
in selecting candidates for .schools of nursing 
in Israel, by Rebecca Bergman et al. Tel- 
Aviv. Tel-Aviv Univ.. Faculty of Continuing 
Medical Education. Dept. of Nursing. 1973. 
46p. 

26. Reader in medical librariiuiship. Edited 
by Winifred Sewell. Washington. CD.. NCR 
Microcard Editions, 1973. 382p. 

27. Quest for the optimum. Proeeedings of 
the annual meetinf> of Association of Univer- 
sities and Colleges of Canada. Toronto. Oct. 
30-Nov. 2. 1972. Ottawa, The Association. 
1972. I23p. 

28. Reference books in paperback: an annot- 
ated guide, edited by Bohdan S. Wynar. 
Littleton. Colo.. Libraries Unlimited. 1972. 
199p. 

29. Report 1973. London. Royal College of 

62 THE CANADIAN NURSE 



Nursing and National Council of Nurses of 
the United Kingdom. 1973. 66p. 

30. Report of the Canadian University Nurs- 
ing Studetits Association Conference. Hali- 
fa.x. Feb. 9-11, 1973. Halifax. Dalhousie 
University. School of Nursing. 1973. 161p. 

31. Respiratoiy intensive care nursing, from 
Beth Israel Hospital, Bo.ston. by Sharon 
Spaeth Bushnell with 3 contributing authors. 
Boston. Little. Brown. 1973. 354p. 

32. Saunders tests for .self-evaluation of nurs- 
ing conipeience. by Dee Ann Gillies and Ire- 
ne Barrett Alyn. 2ed. Toronto. Saunders. 
1973. 392p. 

33. A textbook for nursing assistants, by 
Gertrude D. Cherescavich, 3ed. St. Louis. 
Mosby. 1973. 44 Ip. 

34. The University of Ottawa School of 
Nursing 1933-1973. Ottawa, University of 
Ottawa. School of Nursing. 1973. I45p. R 

35. Women in the work force: proceedings of 
a conference sponsored by the Division of 
Personnel Psychology of the New York Stale 
Psychological Association. November, 1970. 
New York. Edited by Mildred E. Katzell 
and William C. Byham. New York. Behav- 
ioral. 1972. 86p. 

PAMPHLETS 

36. Address list. 1973-74. Ottawa. Canadian 
Medical Association, 1973. 39p. R 

37. Ambulatory care: an annotated biblio- 
graphy of recent planning literature, by 
Gerald M. Richmond and W. David Helms. 
Monticello. 111.. Council of Planning Libra- 
rians. 1973. 37p. (Council of Planning Libra- 
rians. Exchange bibliography no. 404) 

38. Can we conquer cancer? by Clifton R. 
Read. New York. Public Affairs Committee. 
1973. 28p. (Public affairs pamphlet no. 496) 

39. The Canadian scene. First Elsie Stephen- 
son Memorial Lecture delivered by Profes.sor 
Helen M. Carpenter of Faculty of Niasing. 
University of Toronto on Wednesday. Nth 
March, 1973. Edinburgh. University of 
Edinburgh. 1973. 15p. 




NOW HAPPY ! I 

had ugly superfluous hair . . . was 
unloved . . . discouraged. Tried many 
things . . . even razors. Nothing was 
satisfactory. Then I developed a sim- 
ple, painless, inexpensive, nonelectric 
method. It has helped thousands win 
beauty, love, happiness. My F~REE 
book, "What 1 Did About .Super- 
fluous Hair" explains method. Mailed 
in plain envelope. Also Trial Offer. 
Write Mme Annette Lanzette, P.O. 
Box 610. Dept. C-376. Adelaide .St. 
P.O.. loronto 210. Ont. 



40. Comprehensive health planning biblio- 
graphy, by Robert G. Dyck. Monticello. 111., 
Council of Planning Librarians, 1973. 28p. 
(Exchange bibliography no. 392) 

41. Housing: a nationwide crisis, by Maxwell 
S. Stewart. New York, Public Affairs Com- 
mittee. 1973. 28p. (Public affairs pamphlet 
no. 495) 

42. The N LN pre-nursing and guidance e.xa- 
mination. 4ed. New York. National League 
for Nursing. Division of Nursing Education. 
1965. 37p. 

43. Nursing papers, vol. 5. iu>. 2. September 
1973. Montreal, McGill University, School 
for Graduate Nurses. 1973. 35p. (Contents 
-Teaching as guidance of learning. -Group 
methotls and personal growth. -Identifica- 
tion of learning needs by means of critical 
events. -Concept teaching in nursing) 

44. Registration examination policies. Fre- 
dericton. New Brunswick Association of 
Registered Nurses, 1973. 

45. Report. 1973. Ottawa. Canadian Council 
on Social Development. 1973. 24p. 

46. Some statistics on baccalaureate and 
higher degree programs in nursing 1972-73. 
New York. National League for Nursing, 
Division of Research. 1973. 17p. 

47. Symposium on Child Abuse. New York 
University Medical Centre. New York, June 
15, 1971 . Edited by Aaron R. Rausen. Evan- 
ston, III.. American Academy of Pediatrics, 
1973. p.771-812. (Pediatrics. v.5l. no.4. pt.2. 
April 1973) 

48. A systematic analysis of Job descriptions 
for nursing management; how to produce 
them, how to u.se them, by Bernard W. Steel. 
Edgware. Eng.. B.W. Steel. 1971. 31p. 

GOVERNMENT DOCUMENTS 
Canadti 

49. Commission de la Fonction publique. 
Bureau des Langues. Redaction administra- 
tive. Le.xique. fran(,ai.s-angl(us, anglais-fran- 
^ais. 3ed. Ottawa. 1971. 172p. 

50. — . Bureau des Langues. Redaction ad- 
ministrative. Ottawa, 1971. 7 vols. 

51. Conseil des Sciences du Canada. Etudes 
sur certain aspects de la politique des riches- 
.ses nalurelles. par W.D. Bennett et al. Ot- 
tawa, Information Canada. 1973. 126p. 
(Its Etude speciale no. 27) 

52. Economic Council of Canada, for the 
Interdepartmental Committee on Candide. 
CANDIDE model 1 .0: saving and consump- 
tion, by Thomas T. Schweitzer and Tom 
Diedule. Ottawa, 1973. 73p. (CANDIDE, 
Project paper no. 2) 

53. Health and Welfare Canada, Handbook 
on development of community emergency 
welfare services. Ottawa. 1973. 47p. 

54. Labour Canada. Developments in the 
enactment and administration of labour laws 
in Canada. iu>. I. June 1973. Ottawa, 1973. 
1 15p, 

55. Manpower and Immigration. Offices 
abroad. Ottawa, 1973. 9p. R 

56. Parliament. Senate. Special Committee 
on Science Policy, Report, vol.3. A govern- 
ment organization for the seventies. Ottawa, 

FEBRUARY 1974 



Information Canada, 1973. 1 vol. 

57. Public Service Canada. Iinplenu'iitarion 
report oil stains of women report recoin- 
mencUilions hy the Public Service Coinniis- 
sion. Ottawa, information Canada. 1973. 

58. Science Council of Canada. Strntegies of 
development for the Canadian computer 
industry. Ottawa. Information Canada. 1973. 
80p. ( Its Report no. 2 1 ) 

59. Statistics Canada. Annual salaries of 
public health nurses, 1971. Ottawa. Infor- 
mation Canada. 1973. 50p. 

60. — .Continuing education; pt.l . elemen- 
tary-secondary level. 1970-71. Ottawa. In- 
formation Canada. 1973. 79p. 
61. — .Family expenditure in Canada. 1969. 
Ottawa. Information Canada. 1973. 2 vols. 

62. — . Hospital statistics, vol.2 Hospital 
services. 1971 . Ottawa. Information Canada. 
1973. 207p. 

63. — . Hospital statistics, vol.3 Hospital 
personnel, 1971. Ottawa. Information 
Canada. 1973. 228p. 

64. — .Hospital smtislics. vol. 4 hidance 
sheets. 1971. Ottawa. Information Canada 
1973. lOOp. 

65. — . Hospital statistics, vol. 5 Hospital 
eveniies. 1971 . Ottawa. Information Canada. 

1973, 78p. 

66. — .Hospital .statistics, vol. 6 Hospital 
expenditures. 1971. Ottawa, Information 
Canada, 1973. 249p. 

67. — . Instructional media in the universities 



of the Atlantic provinces, 1972. Ottawa. 
Information Canada, 1973. 35p. 

68. — . Instructions and definitions for the 
animal return of psychiatric units. Ottawa. 

1972. I vol. 
Miuiitoha 

69. Committee on Health. Education and 
Social Policy. White paper on health policy. 
Winnipeg. 1972. 3 vols. 

Ontario 

70. Ministry of Labour. Industry-sponsored 
trainiiif! prograntmcs in Ontario. August 
1968 — July 1969. Toronto. 1973. 78p. 

71. — . Labour market experience of persons 
who received advance notice of employment 
termination, by Ian B. McKenna. Toronto. 

1973. lip, (Employment mformal ion series 
no. 4) 

72. Ministry of Social Development. Equcd 
opportunity for women in Ontario: a plan 
for action. Toronto. 1973. 73p. 

73. Workmen's Compensation Board. Annual 
report, /972. Toronto. 1973. 36p. 

United States 

74. Library of Congress. Subject Cataloging 
Division. Subject headings used in the dic- 
tionary catalogs of the Library of Congress. 
7ed, Edited by Marguerite V, Quattlebaum. 
Washington. 1966. I432p. 

75. National Institutes of Health. Soviet 
medicine: a bibliography of bibliographies. 
Washington. U.S. Govt. Print. Off. 197? 
46p. (DHEW Publication no. (NIH) 74-575) 



76. Public Health Service. The health con- 
sequences of smoking: a report of the Surgeon 
General: 1971. Bethesda. Md.. 1971. 458p. 
77. — .Division of Nursing. Research on 
nurse staffing in hospitals: report of a con- 
ference. May 1972. Bethesda, Md.. 1973. 
I 87p. (DHEW Publication no. (NIH) 73-434) 

STUDIES DEPOSITED IN CNA REPOSITORY 
COLLECTION 

78. A discussion paper on nursing assistants 
in Canada. A report of a survey. Prepared 
for the Canadian Nurses' Association, by 
Sister Madeleine Bachand, Ottawa. Canadian 
Nurses' Association. 1973. 1 Ip. 

79. ,•) multidimensional analysis of role 
perception in a mental health system, by 
Beverley J. Riddell, Calgary. Alberta. 1971. 
70p, (Thesis (M.Sc.) — Calgary)R 

80. Resources for the preparation of nnrse- 
learhers — examination of a situation, by 
Shirley Yvonne Alcoe. New York, 1973. 
238p. (Thesis — Teachers College. Colum- 
bia) R 

81. The role of the nurse (professional) in 
the administration and implementation of 
patient care, by Katherine MacLaggan. New 
York. 1966. 54p. R 

82. Some concepts of drug-related patient 
care as viewed by the major health care 
professions in Ontario, by James Lyon Mann. 
Toronto. 1972, 246p. (Thesis (M.Sc.Phm.) 
— Toronto) R ^ 



Request Form 
for "Accession List" 

CANADIAN NURSES' 
ASSOCIATION LIBRARY 

Sen(j this coupon or facsmile to 
LIBRARIAN, Canadian Nurses' Association, 
50 The Driveway, Ottawa K2P 1E2, Ontario. 

Please lend me the following publications, listed in the 

issue ot The Canadian Nurse, 

or add my name to the waiting list to receive them when 
available. 

Item Author Short title (for identification) 

No. 

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 

Date of request 



Tropical 
Diseases 
and 
Parasitology 




Take our special course in tropical diseases 
and related subjects. This equips you to function 
intettiaenlly as a nurse In an environment where 
such diseases pose a health problem. 

Open to graduate nurses currently registered in 
their own province or state Comprehensive 16 
week course commences in September and 
February. Train In modern, equipped centre with 
attractive accommodation for living in located 
in Metropolitan Toronto 

For information write to: 

Co-ordinalor 

international 
health institute 

4000 Le«Ue Street, VMUowdale. 
Ontaflo, Canada. 



FEBRUARY 1974 



THE CANADIAN NURSE 

% 



63 



classified advertisements 



ALBERTA 



BRITISH COLUMBIA 



BRITISH COLUMBIA 



DIRECTOR OF NURSING required for modern 25-bed 
Hospital on Highway 12. East Central Alberta. Please 
apply to Administrator, CORONATION MUNICIPAL 
HOSPITAL, CORONATION, ALBERTA, TOC ICO Tele- 
phone: 578-3691. 



HEAD NURSE required for Obstetrical-Gynecological 

Nursing Unit (including nursery) in 230-bed active 
treatment hospital m Okanagan Valley of British 
Columbia. RNABC contract m eftect. Apply to: Direct- 
or of Nursing, Penticton Regional Hospital. Penticton, 
British Columbia. 



EXPERIENCED GENERAL DUTy NURSES for modern 
lO-bed hospital with doctors offices in hospital 
Situated: beautiful west coast of Vancouver Island; 
Accommodation: S50.00 a month. Apply: Administra- 
tor. Tahsis Hospital, Box 399, Tahsis. British 
Columbia. 



REGISTERED NURSES required for 70 bed accredited 
active treatment Hospital Full time and summer 
relief. All AARN personnel policies. Apply in writing 
to the Director of Nursing. Drumhetler General Hos- 
pital. Drumheller. Alberta 



REGISTERED NURSES required immediately for 72 
bed accredited, active treatment hospital. Also 1 R.N 
for 50-bed Nursing Home AARN -AHA contract in 
force. Refund of fare after one year of service. Apply 
Director of Nursing. Providence Hospital, High Prai- 
ne. Alberta TOG 1E0 



BRITISH COLUMBIA 



HEAD NURSE required for an acute modern 35-bed 
hospital, located in southern B C s Boundary area 
With excellent recreation facilities. Position to be 
filled by April. 1 974. Salary and personnel policies 
in accordance with the RNABC Apply by fvlarch 31, 
1974, to Director of Nursmg, Boundary Hospital, 
Grand Forks. Bntish Columbia 



ADVERTISING 
RATES 

FOR ALL 
CLASSIFIED ADVERTISING 

$15.00 for 6 lines or less 
12.50 for eoch odditionol line 

Rotes for display 
advertisements on request 

Closing dole for copy and cancellation is 
6 weeks prior to 1st day of publication 
month. 

The Conadion Nurses' Associotion does 
not review the personnel policies of 
the hospitals and agencies odvertising 
ir* 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 
OTTAWA, ONTARIO 
K2P 1E2 




OPERATING ROOM NURSE wanted for active mo- 
dern acute tiospital. Four Certified Surgeons on 
attending staff. Experience of training desirable. 
Must be eligible for B.C Registration. Nurses 
residence available. Salary according to RNABC 
Contract Apply to Director pf Nursing Mills Merit- 
orial Hospital. 2711 Tetrault St.. Terrace. Bntish 
Columbia. 



EXPERIENCED NURSES required in 409-bed acute 

Hospital with School of Nursing Vacancies in 
medical, surgical, obstetric, operating room, pediat- 
ric and Intensive Care areas. Basic salary $672. — 
$842. BC Registration required. Apply: Director 
of Nursing. Royal Columbian Hospital. New West- 
minster, British Columbia. 



EXPERIENCED GENERAL DUTY NURSES AND 
LICENSED PRACTICAL NURSES required for small 
upcoast hospital Salary and personnel policies as 
per RNABC contract Salaries start at S672.00 for 
Registered Nurses: S577 75 for Licensed Practical 
Nurses Residence accommodation S25 00 per month. 
Transportation paid from Vancouver. Apply to 
Director of Nursing, St George s Hospital, Alert Bay. 
British Columbia, 



GENERAL DUTY NURSES AND LICENSED PRACTI- 
CAL NURSES for modern 130 bed accredited hospital 
on Vancouver Island Resort area — home ol the Tyee 
Salmon Four hours travelling time to city of Vancou. 
ver. Collective agreements with Provincial Nursing 
Association and Hospital Employees Union. Resi- 
dence accommodation available Please direct in- 
quiries to Director of Nursing Services. Campbell 
River & District General Hospital, 375 — 2nd Avenue, 
Campbell River, British Columbia, V9W 3V1 



GENERAL DUTY NURSES lor modern 41-bed 
hospital, located on the Alaska Highway, Salary and 
personnel policies in accordance with RNABC 
Accommodation available in residence. Apply: 
Director of Nursing, Fort Nelson General Hospital, 
Fort Nelson, British Columbia, 



GENERAL DUTY NURSES, lor modern 35-bed hospi 
tal located in southern BC s Boundary Area with 
excellent recreation faciliiies. Salary and personnel 
policies in accordance with RNABC Comfortable 
Nurses s home. Apply: Director of Nursing, Boundary 
Hospital, Grand Forks. British Columbia, 



GENERAL DUTY NURSES REQUIRED FOR 21-BED 
HOSPITAL 120 MILES NORTH OF PRINCE GEORGE, 
B C, RNABC POLICIES IN EFFECT APPLY TO: 
DIRECTOR OF NURSING, MacKENZIE HOSPITAL, 
BOX 249, MacKENZIE, BRITISH COLUMBIA 



EXPERIENCED GENERAL DUTY NURSES required for 
151 -bed Hospital, Basic Salary $672 — $842 per 
month Policies in accordance with RNABC Contract, 
Residence accommodation available. Apply to: 
Director of Nursing, Powell River General Hospital 
5871 Arbutus Avenue, Powell River, British Columbia, 



NURSES REQUIRED FOR GENERAL DUTY AND 
INTENSIVE CARE UNIT, IN EIGHTY-FOUR BED 
MODERN ACUTE GENERAL ACCREDITED HOSPITAL 
IN CENTRAL BRITISH COLUMBIA. RNABC CON- 
TRACT WAGES RESIDENCE ACCOMMODATION 
AVAILABLE. PLEASE APPLY IN WRITING TO: DI- 
RECTOR OF NURSING. CARIBOO MEMORIAL HOS- 
PITAL. 517 NORTH SIXTH AVENUE, WILLIAMS 
LAKE. BRITISH COLUMBIA, 



MANITOBA 



REGISTERED NURSES required for an 1 1 bed hos- 
pital at Notre Dame de Lourdes, Manitoba, Excellent 
salary and will credit for acceptable past experience. 
Please apply to: Administrator Notre Dame Hospital, 
Notre Dame de Lourdes, Manitoba, 



TWO REGISTERED NURSES are required by Baldui 
District Hospital for general duty. Duties to commence 
in early 1974, Attractive residence in 16-bed hospital. 
Salary based on Government scale with consideration 
for experience. For further information contact: Mrs 
K Gordon. Director of Nursing, telephone 535-2373, 
Batdur District Hospital, Baldur, Manitoba, 



Required immediately — 3 REGISTERED NURSES and 
3 LICENSED PRACTICAL NURSES for a new 60-bed 
Personal Care Home, Salary in accordance with the 
recommendations of the MARN, Apply: Director of 
Nursing Swan River Valley Personal Care Home 
inc, SWAN RIVER, Manitoba ROL 1Z0. 



NEW BRUNSWICK 



REGISTERED NURSES required immediately for 
general duty in 300 active treatment hospital. Salary 
$567 - $658 per month, dependant on experience 
Excellent fringe benefits. Apply: Personnel Director, 
West Saint John Community Hospital, B3610, Postal 
Station B, Saint John, New Brunswick E2M 4X3, 



Additional faculty member needed by July 1, 1974, to 
coordinate and teach an introductory course in in- 
tegrated baccalaureate program. Recent master s 
degree in medical and surgical nursing required, 
and some experience team teaching m integrated 
programs preferred. The extras we have to offer are 
an exciting new curriculum approach, a new, well- 
equipped self-instruclional laboratory, and the ad- 
vantages of living in a beautiful, small city. Address 
Dean, Faculty of Nursing, The University ol New 
Brunswick, Fredericton, New Brunswick, 



ONTARIO 



64 THE CANADIAN NURSE 



REGISTERED NURSES required for a new 79-bed 
General Hospital in bilingual community of North- 
ern Ontario, French language an asset, but not 
compulsory Salary is $645, to $758. monthly with 
allowance lor past experience, 4 weeks vacation 
alter 1 year and 18 sick leave days per year, Unused 
sick leave days paid at 100% every year. Master 
rotation in effect. Rooming accommodations available 
in town. Excellent personnel policies. Apply to: Per- 
sonnel Director. Notre-Dame Hospital, P O Box 850. 
Hearst, Ont, 

FEBRUARY 1974 



ONTARIO 



UNITED STATES 



REGISTERED NURSES for 34-bed General Hospital. 
Salary $646 per month to $756. plus experience al- 
lowance. Excellent personnel policies. Apply to 
Director of Nursing Englehart & District Hospital 
Inc.. Englehart, Ontario. 



HEGISTERED NURSES AND REGISTERED NURSING 
ASSISTANTS tor 45- bed Hospital. Salary ranges 
include generous experience allowances R N s 
salary S680 to S780 and R N A s salary S490 to S&65 
Nurses residence — private rooms with bath — $40, 
per month. Apply to: The Director of Nursing. Gerald- 
ton District Hospital. Geraldton Ontario POT IMO 



REGISTERED NURSES FOR GENERAL DUTY. I.C.U.. 
ecu. UNIT and OPERATING ROOM required for 
fully accredited hospital. Starting salary S697.00 with 
regular increments and with allowance for experi- 
ence Excellent personnel policies and temporary 
residence accommodation available. Apply to The 
Director of Nursing Kirkland & District Hospital 
Kirkland Lake. Ontario P2N 1 R2 



OPERATING ROOM TECHNICIAN required for full> 
accredited 75-bed Hospital. You will be in the 
Vacationland of the North, midway between Thunder 
Bay. Ontario and Winnipeg. Manitoba. Basic wage is 
$471.50 with consideration lor experience. Write or 
phone the Director of Nursing. Dryden District 
General Hospital, Dryden. Ontario, 



QUEBEC 



RESIDENT CHILDRENS CAMPS IN THE LAUREN- 
TIANS REQUIRE: GRADUATE NURSES for the sum 
mer Apply Jewish Community Camps. 5151 Cote St. 
Catherine Road. Room 203, Montreal Quebec H3W 
1 M6, Phone 735-3669 



UNITED STATES 



NURSING DIRECTOR: Laredo Junior College at 
Laredo Texas, ts seeking a nursing director lOr a 
forward-moving, open-curnculum nursing program 
which includes three levels health assistant licens- 
ed vocational nurse and registered nurse. Program 
is well established. Person sought must have a 
Masters Degree with some experience, preferably 
in educational administration A very challenging 
program Salary open Please contact Betty Schmidt 
Director, Nursing Education, Laredo Junior College 
P O, Box 738, Laredo Texas 78040, 512-722-0521 Ex 
46 (collect) 



NURSING INSTRUCTOR: Laredo Junior College at 
Laredo Texas, iS seeking nursing instructors for a 
forward-moving, open-curnculum nursing program 
which includes three levels health assistant, licens- 
ed vocational nurse and registered nurse Program is 
well established Masters Degree preferable A 
very challenging program. Salary open. Please con- 
tact Betty Schmidt. Director, Nursing Education. La- 
redo Junior College. PC Box 738, Laredo, Texas 
78040 



Monte Vista, Colorado requires REGISTERED 
NURSES for 50-bed hospital. Working visa readily 
available after January Ist 1974 Transportation one 
way can be obtained Please write directly to the 
Administrator Monte Vista General Hospital Monte 
Visia Colorado 81144 or call Calgary 271-2502 after 
5pm 



TEXAS wants you! if you are an RN. experienced or 
a recent graduate come lo Corpus Chnsti, Sparkling 
City by the Sea a cily building for a belter 

future where your opporlunilies for recreation and 
studies are limitless Memorial Medical Center. 500 
bed general teaching hospital encourages career 
advancement and provides m-service orientation 
Salary from S682.00 to $940 00 per month, com 
mensurate with education and experience Differential 
for evening shifts, available Benefits include holi- 
days sick leave, vacations, paid hospitalization 
health life insurance pension program. Become a 
Vital part of a modern, up-to-date hospital write or 
call collect John W Cover. Jr,. Director of Per 
sonnel. Memorial Medical Center, PO Box 5280, 
Corpus Chnsti. Texas 78405, 



R.N. s — SOUTHERN CALIFORNIA — Immediate need 
exists for medical*surgical units. Orientation and m- 
service program Excellent salary, full paid benefits. 
We Will assist you with your h-1 visa for immigration. 
An interim permit may be obtained from the Califor- 
nia Board of Nursmg Education and Registration to 
practice nursing m California prior to licensing. Con- 
tact: Personnel Director, The Hospital of the Good 
Samaritan, 1212 Shatto Street, Los Angeles. Califor- 
nia 90017, (213) 482-8111 ex 287. 



PUBLIC RELATIONS OFFICER 

Responsible for providing information services to 
members of a professional association and tfie public 
In support of the public relations objectives of the Asso- 
ciation. 

General duties Include writing, editing and layout of a 
monthly news bulletin, press releases, media contacts 
and the coordination of the annual convention. 

Applicants should have the type of qualifications and 
experience which would allow them to perform the 
above duties competently. Experience in communica- 
tions and public relations with an association would be 
desirable. 

Salary will be commensurate with experience and 
preparation. 

Send your resume to: 

Executive Secretary 

Alberta Association of Registered 

Nurses 
10256 — 112 Street 
Edmonton, Alberta 
T5K 1M6 



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. Paediatrics, Obste- 
trics and Gynaecology, General Surgerv and 
Medicine. 

Basic 2 week Orientation Program and con- 
tinuing Active Inservlce Program for all levels 
of Staff. 

Salary is commensurate with preparation and 
experience. 

Benefits include Canada Pension Plan, Hospital 
Pension Plan, Unemployment Insurance. — 
Group Life Insurance and O.H.I. P. (66-2/3% 
Basic Rate paid by Hospital). — Extended 
Health Care Plan — Supplementary Blue Cross. 
After 3 months, cumulative sick time. 
Rotating periods of duty — 40 hour week — 
10 Statutory holidays — 3 weeks annual vaca- 
tion after completion of one years service. 

APPLY: 

ASSOCIATE DIRECTOR 
OF NURSING SERVICE 

ST. JOSEPHS HOSPITAL 

30 The Queensway 
TORONTO 3. ONTARIO. 



HUMBER MEMORIAL 
HOSPITAL 

Telephone 249-8111 (Toronto) 

200 Church Street, 

Weston, M9N-1 MB, Ont. 



Registered Nurses and Registered Nursing Assistants seeking 
employment in an active treatment hospital in NORTH WEST 
METROPOLITAN TORONTO, are requested to write to the Di- 
rector of Nursing concerning employment opportunities. 

Orientation and Staff Development Programmes are provided. 

Competitive salaries offered to qualified personnel. Registered 
Nurses are urgently required for temporary employment July, 
August and September. 



FEBRUARY 1974 



THE CANADIAN NURSE 



65 



THE 

PEDIATRIC PAVILION 

NURSING DIVISION 

OF THE 

LOS ANGELES COUNTY - 

UNIVERSITY OF SOUTHERN CALIFORNIA 

MEDICAL CENTER 

invites Canadian Nurses interested in 
comprehensive Pediatric Nursing to write 
for more details about our hospital. 

Starting Salary: $842 month 
Promotional Opportunities 
In-Sen/ice Programs 
Excellent fringe benefits 

Write: 

Mrs. Dorothy Easley, R.N. 

Box 2071, 

1200 North State Street, 

Los Angeles, California 90033 



RED DEER COLLEGE 

requires 

NURSING 
INSTRUCTOR(S) 

Position(s) open July 1st, 1974. Masters 
Degree in a Clinical Specialty preferred, but 
Baccalaureate Degree considered. Exper- 
ience in Nursing Practice essential. Instruc- 
tors involved in several practice settings. 
Program is integrated by teaching of basic 
concepts of Nursing. Post-basic nursing 
courses also in the planning stages. 

Apply with — 

(1) Curriculum Vitae 

(2) References 

to: Dr. G.O. KELLY 
Director of Programs 
Red Deer College 
Red Deer, Alberta. 



GRANDE PRAIRIE HEALTH UNIT 

requires a 

NURSE 



For general public health nursing to work out of 
Valleyview Sub-Office. Minimum qualification 
R.N. (P.H.N, or B.Sc. preferred). Annual salary 
range $7056 - $1 0,51 2. Starting salary dependent 
on qualifications and experience. Generous 
fringe benefits. Application forms and further 
details from : 



Grande Prairie Health Unit 
9640 - 105 Avenue 
GRANDE PRAIRIE, Alberta 
T8V 3B5 
532-4441 



Applications are invited from: 



PUBLIC HEALTH NURSES 
NURSING INSTRUCTORS 

for 

OVERSEAS APPOINTMENTS 

(Minimum three-year term) 



Further information and application 
forms from: 



The Division of Ministry Personnel and 

Education 

The United Church of Canada 

85 St. Clair Ave. East 
Toronto, Ontario. M4T 1M8 
Attention: Mrs. Jean Parker 



McMASTER 

UNIVERSITY 

School 

of Nursing 

Nurse faculty members, including an Asso- 
ciate Director, required for July, 1974 by a 
progressive Scfiool of Nursing. Ttie School is 
an integral part of a newly developed Health 
Sciences Centre where collaborative relation- 
ships are fostered among the various health 
professions. 

Requirements: masters or doctoral degree 
preferred, with clinical specialist preparation 
or experience and/or preparation in teaching. 

Salaries: commensurate with education and 
experience. 

Application, with copy of 

curriculum vitae and two 

references to 

Dr. D.J. Kergin, Director, 
School of Nursing, 

McMaster University, 

Health Sciences Centre, 

1200 Main Street West, 

HAMILTON, Ontario, 

L8S 4J9. 



MEMORIAL UNIVERSITY OF 

NEWFOUNDLAND 

SCHOOL OF NURSING 

IS 

Analyzing and revising its curricula and is expanding programs to better prepare 
graduates in leadership for the future health care system. 

Additional personnel required August 1974. 

There are positions open for faculty with creative ability and advanced preparation 
in: 

NURSING OF ADULTS 
NURSING OF CHILDREN 
PARENT-CHILD NURSING 
MENTAL HEALTH NURSING 
CURRICULUM DESIGN 
MANAGEMENT OF NURSING CARE 
RESEARCH IN NURSING 
COMMUNITY NURSING 

Preparation at the Master's level Is preferred but persons with a baccalaureate and 
appropriate experience will be considered. 

Please direct inquiries or applications to: 

Miss MARGARET D. McLEAN 
Director, School of Nursing 
Memorial University of Newfoundland 
St. John's, Newfoundland 



66 THE CANADIAN NURSE 



FEBRUARY 1974 



EXCITEMENT IIM NURSING 
THE MAGIC OF ARIZONA 

For professionalism in a perfect setting, join 
our team in a new, modern, fully accredited 
hospital with services focused on care of adult 
patients. Openings all shifts for RNs and LPNs, 
Great opportunities also for interested or 
experienced ICU-CCU Nurses. 

All of our nursing units are in-the-round 
facilitating our giving individualized patient 
care. Located in a delightful retirement 
community near Phoenix, Arizona, This is the 
sunniest, safest, resort area in the U.S. You 
will enioy the advantages of a large metro- 
politan area with none of its problems. 

Wed like the opportunity to give you all the 
details' 

Write to: 
Mary Welch 

Assistant Director of Nursing 
WALTER 0. BOSWELL HOSPITAL 
P.O. Box 10 
Sun City, Arizona. 

An Equal Opportunity Employer. 



CLINICAL NURSE 
SPECIALIST 

FOR 

MED-SURG 
NURSING 

REQUIRED IN 254-BED 

ACTIVE CARE 

GENERAL HOSPITAL 

APPLY TO: 
Director of Nursing 
Moose Jaw Union Hospital 
Moose Jaw, Sask. 
692-1841 



THE LADY MINTO HOSPITAL 
AT COCHRANE 

invite applications from 

REGISTERED NURSES 

54-bed accredited general hospi- 
tal. Northeastern Ontario. Compe- 
titive salaries and generous bene- 
fits. Send inquires and applications 

to: 

MISS E.LOCKE 

Director of Nursing 

The Lady Minto Hospital at 

Cochrane 

P.O. Box 1660 

Cochrane, Ontario 

POL ICO 



Public Service Fonction publique 
Canada Canada 



THIS COMPETITION IS OPEN TO BOTH MEN AND WOMEN 



REGISTERED 
NURSES 



Department of 
Veterans Affairs, 
Camp Hill Hospital 



Salary: 
$6938 - $8308 



Eff. December 31 /73 
$7701-89216 



Halifax, 
Nova Scotia. 



General duty nurses are required for full-time staff positions, 
with rotating shifts. There are immediate vacancies. Know- 
ledge of the English language is essential. 



Further information on duties and qualifications may be obtain- 
ed from and applications should be directed immediately to: 



PERSONNEL MANAGEMENT ADVISOR, 
DEPARTMENT OF VETERANS AFFAIRS, 
CAMP HILL HOSPITAL, 
HALIFAX, NOVA SCOTIA. 



Please quote reference number 73-H980. 

Appointments as a result of this competition are subject to the 
provisions of the Public Service Employment Act. 



ADMINISTRATIVE 
NURSING SUPERVISOR 



Required for the late night tour of duty. To assume administrative nursing 
responsibility for a chronic care hospital of 500 beds. 

The successful candidate must be a registered nurse in possession of a 
certificate of Hospital Departmental Management of the Canadian Hospital 
Association, or its equivalent and have at least 5 years of administrative 
experience at the Head Nurse and Supervisory level. 



For applications and further information, please contact: 

PERSONNEL DEPARTMENT, 

QUEEN ELIZABETH HOSPITAL, 

130 DUNN AVENUE, 

TORONTO, ONTARIO. 

M6K 2R7 



FEBRUARY 1974 



THE CANADIAN NURSE 

% 



67 



REGISTERED NURSES 

AND 

REGISTERED NURSING ASSISTANTS 

required for a 104-bed active treatment plus 
72-bed chronic care unit located at Haileybury. 
The Tri-Town area consisting of New Liskeard, 
Haileybury, Cobalt all within 5 miles of each 
other is located 90 miles from North Bay 
with daily plane, tram and bus service to and 
from Toronto etc. Beautiful recreational facil 
ities including curling, skating, skiing, swim 
ming, boating, hunting, fishing. 

Salary fully appropriate to the responsibility of 
the position: personnel policies in line with 
industry and hospital practice. Orientation 
and In-Service Educational programmes are 
provided. 

Apply in writing tO: 

PERSONNEL DIRECTOR, 
Temiskaming Hospitals, 
Hailewburv. Ontario, 



GENERAL DUTY NURSES 

Required Immediately 

« for 270-bed acute care general hospital 
expanding to 370 beds 

• clinical areas include: Medicine Surgery 
Obstetrics Paediatrics Psychiatry Rehabilita- 
tion Extended Care and Intensive and 
Coronary Care 

• Must be eligible for B,C. registration 

• Personnel policies in accordance with 
RNABC Contract 

• 1973 Salary $672 -$842.00 per month 

Please contact: 



Director of Nursing 

Prince George Regional Hospital 

Prince George, B.C. 



RIVERVIEW UNIT 

WINDSOR WESTERN HOSPITAL 

CENTRE 

Invites applications from 

REGISTERED NURSES 

starting Salary $655 
Increments for Contemporary Experience 
REGISTERED NURSING ASSISTANTS 
Starting Salary December 1st $493 
TOP FRINGE BENEFITS 
All Shifts 
Permanent positions available 
Afternoons and Nights 
Orientation and Staff Development Program 
W/indsor offers cultural and educational oppor- 
tunities including University and Community 
College. 

W/E ARE PEOPLE HELPING PEOPLE 
in tile rapidly progressing specialty of chronic 
care and rehabilitation. We offer 

— a challenge 

— job satisfaction 

— a happy environment 
Apply tO: 

Director of Nursing 
3177 Riverside Drive E., 
Windsor, Ontario 
N8Y 4S2 



THE MONTREAL 
CHILDREN'S HOSPITAL 

REGISTERED NURSES 
NURSING ASSISTANTS 

Our patient population consists of 
the baby of less than an hour old 
to the adolescent who has just 
turned seventeen. We see them in 
Intensive Care, in one of the Med- 
ical or Surgical General Wards, or 
in some of the Pediatric Specialty 
areas. 

They abound in our clinics and 
their numbers increase daily in our 
Emergency. 

If you do not like working with 
children and with their families, 
you would not like it here. 

If you do like children and their 
families, we would like you on our 
staff. 

Interested qualified applicants 
should apply to the: 

DIRECTOR OF NURSING 
Montreal Children's Hospital 
2300 Tupper Street 
Montreal 108, Quebec 



DURHAM COLLEGE 
OF APPLIED ARTS AND TECHNOLOGY 

invites applicants for 

FACULTY POSITIONS 

in the Nursing Department 



Qualifications: 

— Registration in Ontario 

— University preparation in Nursing education, bac- 
calaureate degree preferred 

— Minimum of two years bedside nursing experience. 

Responsibilities: 

— Classroom teaching and clinical supervision. 

Salary: 

— Commensurate with preparation and experience 
within the CSAO range. 

Starting Date: 

— August 1. 1974 



Direct applications witti 
complete resume to: 

DEAN OF ACADEMIC AFFAIRS, 
DURHAM COLLEGE OF APPLIED 
ARTS AND TECHNOLOGY, 
BOX 385, 

OSHAWA, ONTARIO. 
L1H7L7 



NORTH NEWFOUNDLAND & LABRADOR 

requires 

REGISTERED NURSES 
PUBLIC HEALTH NURSES 

International Grenfe!! Association provides 
medical services for Northern Newfoundland 
and Labrador, We staff four hospitals, eleven 
nursing stations, eleven Public Health units. 
Our main 180-bed accredited hospital is 
situated at St, Anthony, Newfoundland, Active 
treatment is carried on in Surgery. Medicine. 
Paediatrics. Obstetrics, Psychiatry. Also. 
Intensive Care Unit, Orientation and In-Service 
programs. 40-hour week, rotating shifts. Living 
accomodations supplied at low cost. PUBLIC 
HEALTH has challenge of large remote areas. 
Excellent personnel benefits include liberal 
vacation and sick leave. Salary based on 
Government scales. 
Apply to: 

INTERNATIONAL GRENFELL ASSOCIATION 
Assistant Administrator of 

Nursing Services, 
St. Anthony, Newfoundland. 



GENERAL DUTY and 
INTENSIVE CARE UNIT NURSES 

for 139 Acute, 30 Extended Care 
Bed Modern Accredited Hospital 
on Vancouver Island. Excellent 
recreational facilities and within 
easy reach of Victoria and Vancou- 
ver. 

Personnel Policies as per RNABC 
Contract. 

Apply: 

Director of Nursing, 
West Coast General Hospital, 
814 - 8th Avenue, North, 
Port Alberni. B.C. 



GENERAL DUTY 
NURSES 



for 360-bed acute general hospital 

-clinical areas include: — Medicine, Surgery. 
Obstetrics. Paediatrics, Psychiatry, Rehabili- 
tation, Extended Care and Coronary Care 

■ B.C Registration preferred but not manditory 
during initial employment 

Personnel policies in accordance with 
RNABC Contract, 



Please contact the: 

Director of Nursing 

Nanaimo Regional General 

Hospital 

Nanaimo, British Columbia 



68 THE CANADIAN NURSE 



FEBRUARY 1974 



uiorth 
looking 
into... 




occupotionol 

liealtii 

nursing 

with Canada's 

federal public 

servants. 



■* 



Health and Welfare Same et Bien-etre socai 
Canada Canada 



Medical Services Branch 

Department of National Health and Welfare 

Ottawa, Ontario K1A0K9 



Please send me information on career 
opportunities in this service. 



Name: 
Address: 

City: 



Prov: 



Public Service Fonction publique 
Canada Canada 



THIS COMPETITION IS OPEN TO BOTH MEN AND WOMEN 



NURSING ADVISORS 

$13,542 to $16,642 (Under negotiation) 
Ottawa 

with 



Canadian Penitentiary 
Services Solicitor General 



Under the direction of the Director, 
Medical Services, will assist in the re- 
organization of the total nursing program 
of the Canadian Penitentiary Service to 
provide nursing care to approximately 
7000 inmates in some 35 institutions; 
advises the Director on the continuing 
efficiency of the nursing services as relat- 
ed to medical, psychiatric, dental and 
surgical care and nursing administration: 
assists in the development of training 
programs ot nursing staff and nursing 
service policies which will attract qualifi- 
ed staff and promiote maximum utiliza- 
tion of all nursing personnel; participates 
in establishing a budget for the nursing 
service and in the planning of the physical 
facilities. In consultation, initiates studies 
and research and prepares recommenda- 
tions in related areas; maintains pertinent 
records; will represent the Canadian 
Penitentiary Service in interdepartmental 
committees and liaise with national and 
provincial nursing associations, federal 
and provincial departments of Health. 
hospitals and universities; other related 
duties- 



Heallh Programs 
National Health and Welfare 



Under the general direction of the Senior 
Advisor. Health Systems, plans, organ- 
izes and directs the work of teams 
composed of Federal /Provincial and 
non-government professionals in analy- 
sis of present and proposed health care 
sub systems related to nursing commu- 
nity health care needs, resources and 
programs: coordinates and directs a 
Federal /Provincial multidisciplinary 

team in the conduct of ma)or studies 
related to the total health care system 
or ma)or portions of rt; coordinates and 
directs the development, evaluation and 
use of methodologies related to utiliza- 
tion of health care facilities and assess- 
ment of present and future resource 
requirements; provides professional 
advice to the Assistant Deputy Minister. 
the Senior Advisor. Health Systems and 
other Branch and Department officers 
to assist in formulating departmental 
attitudes and policies; participates in 
departmental assistance ot education of 
health personnel on a national basis and 
performs related duties. 



FEBRUARY 1974 



QUALIFICATIONS: 

— Eligibility for registration as a nurse in a province ot Canada 

— Baclielor's degree in Nursing 

— Considerable experience in all fields ot nursing administration 



LANGUAGE REQUIREMENTS: 

For the position wilti Health Progtam. iinowledge ot the English language is essential. For the position 
with Canadian Penitentiary Services, knowledge of both the English and French languages is essential 
For this latter position unilingual persons may also apply in this competition They must however, 
indicate in writing, their willingness to undertake continuous language training al public expense tor 
a period ot up to twelve months Such training shall be undertaken immediately at the time ot conditio nal 
appointment, in or through the Public Service Commission s Language Bureau and at locations 
specified by the Public Service Commission 

The Public Service Commission will seek evidence of the likely capacity of unilingual candidates from 
outside the Public Service to become bilingual. 

Please apply on Application tor EmploymenI , Form PSC 367-401 , available at Post Offices, Canada 
Manpower Centers and offices ot the Public Service Commission of Canada, and send to 



SCIENCES AND TECHNOLOGY PROGRAM 
PUBLIC SERVICE COMMISSION OF CANADA 
TOWER "A", PLACE DE VILLE 
OTTAWA, ONTARIO K1A 0M7 

Please quote competition number 73-166-02 on all correspondence. 

Appointments as a result ot this competition are subject to the provisions ot the Public 
Service Employment Act. 



THE CANADIAN NURSE 



69 




FACULTY 
POSITIONS 

Open (or clinical experts 
to teacti in the 
undergraduate programs. 



COMMUNITY HEALTH NURSING 

MENTAL HEALTH NURSING 

MEDICAL-SURGICAL NURSING 

OBSTETRICAL NURSING 

and 
CONTINUING EDUCATION 

Personnel policies and salaries in accord with University 
schedule based on qualifications and experience. 

Apply in writing to: 

RUTH E. McCLURE. M.P.H. 
Director, School of Nursing 
University of Alberta 
Edmonton, Alberta 
T6G 2G3 



2 L.P.N.'S 

REQUIRED IMMEDIATELY 



For a 68-becl Personal Care Home, a mo- 
dern facility, 80 miles south west of Winni- 
peg. Tfiriving community of 1500 people. 
Living quarters provided. Will credit for past 
experience. Excellent salary and fringe 
benefits. 



For further information contact: 

Mr. Ren6 Comte 

Foyer Notre Dame Inc. 

Notre Dame de Lourdes, 

Manitoba 

ROG 1M0 

248-2092 



REGISTERED NURSES 

for 

GENERAL DUTY 

for 

General or Specialized wards includ- 
ing O.R. for 550-bed hospital on Uni- 
versity Campus. 

Team or Unit Nursing 

Liberal fringe benefits 

for further information please 
contact: 

Employment Officer, Nursing, 
University Hospital, 
Saskatoon, Bask. 



Wanted for a 56-bed hospital in the Lakes 
District of Central B.C.: 

(1)A DIRECTOR OF NURSING 

— Degree in nursing preferable, exper- 
ience in Nursing Administration in a small 
acute Hospital essential. 

(2)geNERAL DUTY NURSES 

Salary and benefits according to 
R.N.A.B.C. contract. 



Please apply to: 

The Administrator, 

Burns Lake and District Hospital. 

Box 479, 

Burns Lake, British Columbia, 

VOJ 1E0. 



DOUGLAS HOSPITAL 

IN METROPOLITAIN MONTREAL 

A multi-disciplinary psychiatric hospital with 
1.100 adult and 100 children's beds; 

requires 

NURSING STAFF ON ALL LEVELS 

We invite enquiries from registered nurses with 
experience in psychiatric nursing or new 
graduates for our medical, geriatric or 
children's services. 

Nursing assistants with experience or newly 
graduated. Psychiatric nursing background is 
preferable but not essential. 

Language requirement for licensing in Quebec 
not applicable to Canadian citizens. 

Applications and enquiries should be sent tO; 

DIRECTOR OF NURSING 
6875LaSalle boulevard 
Verdun 204, Quebec. 



THE UNIVERSITY OF BRITISH COLUMBIA 
SCHOOL OF NURSING 

FACULTY POSITIONS — 

Rapidly developing new curriculum re- 
quires ten senior faculty members witfi ex- 
perience in all clinical areas as well as 
in education, evaluation, curriculum dev- 
elopment and research. Positions available 
now. 



Apply to: 

Muriel Uprichard, Ph.D. 

Director 

School of Nursing, IRC BIdg. No. 341 

University of British Columbia 

Vancouver, B.C. 

V6T 1W5 



INTENSIVE CARE UNIT NURSES 

With preparation and/or experience in intensive and Coronary 
Care Nursing, or Interest in training for this Nursing Speciality. 

QUALIFICATIONS: Successful completion of an approved basic 

course in Nursing. Active registration in New Brunswick, or 
eligible tor same. Must be able to work rotating shift. 
SALARY RANGE: S567 - S658 per month. Salary commensurate 
with qualifications and experience 

REHABILITATION NURSES 

With preparation and/or experience in Rehabilitation Nursing 

QUALIFICATIONS: Successful completion of an approved basic 
course m Nursing Active registration in New Brunswici<, or 
eligible for same Must be able to work rotating stiift. 

SALARY RANGE: S567-S658 per montti. Salary commensurate 
With qualifications and expenence. 

Excellent fnnge benefits Ttiree weeks vacation arter one year 
service. Insurance and pension programs. 37'^ fiour week. 

Apply to: 

Personnel Director 
WEST SAINT JOHN COMMUNITY HOSPITAL 
B 3610. Postal Station B 
Saint Jolin. N.B. E2M 4X3 



DIRECTOR OF NURSING 

REQUIRED IMMEDIATELY 



For a 68-bed Personal Care Home, a mo- 
dern facility, 80 miles south west of Winni- 
peg. Thriving community of 1500 people. 
Living quarters provided. Excellent salary 
and fringe benefits. Will credit for past ex- 
perience. Must be bilingual and have ex- 
perience in geriatrics. 

For further information contact: 

Mr. RENE COMTE 

Foyer Notre Dame Inc. 

Notre Dame de Lourdes 

Manitoba 

ROG 1M0 

248-2092 



OPERATING ROOM 
NURSES 

— required for 270 bed acute care 
hospital 

— expanding to 370 beds 

— must be eligible for B.C. registration 
Personnel policies in accordance 
w/ith RNABC contract 

— 1973 salary $672.00 - $842.00 per 
month plus credit for postgraduate 
certificates and experience 

Please contact: 

Director of Nursing 

Prince George Regional Hospital 

Prince George, B.C. 



70 THE CANADIAN NURSE 



FEBRUARY 1974 



career opportunity 



DIRECTOR OF 

PUBLIC HEALTH 

NURSING 

Local Board of Health 
City of Calgary Health District 

To direct and deploy a staff of approximately 95 Public 
Health Nurses in generalized functions, including programs 
of Child Health, Communicable Disease Control, Tubercu- 
losis Control and Family Planning. 
SALARY: $13,500.00 to $17,500.00 per annum. 

Requires a minimum of a Bachelor's Degree in Public 
Health Nursing with broad related experience in supervision 
and administration. 
Competition No. 73-315 

Qualified applicants are invited to submit application forms 
or resumes in confidence to 

Mr. C. Lukenbill, I ^^^[^"N I Box 2100, 

Supervisor of I ff^^^^ > I Calgary, Alberta 

Employment I li<n'^%i'? _ I T2P2M5 
Manpower Dept 



MP-739 



THE CITY OF CALGARY 



INSTRUCTOR, TECHNICAL INSTITUTE 
(DIPLOMA NURSING PROGRAM) 

required by 

Department of Continuing Education 

KESLEY INSTITUTE of Applied Arts and Sciences 

Saskatoon 



SALARY: 

Under negotiation and commensurate with education and 

experience. 

Range IV - S8.268 - $13,440 per annum 

Range V - $9,120 - $14,820 per annum 

Range Vl - $10,056 - $15,552 per annum 

DUTIES: Teaching and clinical guidance of students in the first 
and second year of the program. 

QUALIFICATIONS: Registered Nurse with Bachelor of Science in 
Nursing degree, teaching preparation and experience in nursing 
education and nursing practice. 

NOTE: Suitable applicants will form an eligible list for positions in 
Saskatoon, North Battleford and Prince Albert, Saskatchewan. 

Please quote competition number: cc6203 

Closing date for receipt of applications: As soon as possible 



For application forms, please contact: Public Service 
Commission, 1820 Albert Street, Regina, Sask. 



VANCOUVER 
GENERAL HOSPITAL 

Invites applications for 

REGULAR and RELIEF 
GENERAL DUTY 

Nursing positions in all clinical areas of an active 

teaching hospital, closely affiliated with the University of B.C. 

and the development of the B.C. Medical Centre. 

For further information, please write to: 

PERSONNEL SERVICES 

VANCOUVER GENERAL HOSPITAL 

855 WEST 12TH AVE. 

VANCOUVER, B.C. 




FEBRUARY 1974 



THE CANADIAN NURSE 71 




-"^^ 



HOSPITAL: 

Accredited modern general - 260 beds. Expansion 
to 420 beds in progress. 

LOCATION: 

immediately north of Toronto. 
APARTMENTS: 

Furnished - shared. 

Swimming Pool. Tennis Court, Recreation Room. 

Free Parking. 

BENEFITS: 

Competitive salaries and excellent fringe benefits. 
Planned staff development programs. 

Please address all enquiries to: 
Assistant Administrator (Nursing) 
York County Hospital. 
NEWMARKET, Ontario. 
L3Y 2R1 



BORED? 
RESTLESS? 



R 



Stimulating General Duty activities in 
a 675 bed liospital — on a unit of your 
choice 

Leisure time activitiesthat are interest- 
ing and exciting 



Apply to: 

Director of Nursing 
Regina General Hospital 
Regina, Saskatchewan 




NURSING 
ADMINISTRATOR 



AVAILABLE 

A challenge in the Community Nursing Education 
Programme 

WHERE WHEN 

Evening Division Begins July 1. 1974 

Loyola of Montreal 
Health Education 
HOW 

As Assistant to the Coordinator of Community 
Health Nursing 

WHO 

Holds a Master's Degree in Nursing and has the 
ability to work with people in a challenging multi- 
discipline programme, preferably bilingual 

SALARY 

According to University scale 

INFORMATION FROM 
G. Lennox 

Programme Coordinator for Health Education 
Loyola of Montreal 
Evening Division 
7270 Sherbrooke Street West 
Montreal. Quebec 
H4B 1R6 
Tel. 514-482-0320 (loc. 427) 



TORONTO 
GENERAL HOSPITAL 

Invites applications from 

REGISTERED NURSES 
REGISTERED NURSING 

ASSISTANTS 
FOR GENERAL DUTY 

— Superior opportunities for Professional Growth 
and Development. 

— Progressive Personnel Policies. 

— Excellent opportunities for advancement m 
atmosphere of medical excellence. 

Please apply to: — 

Personnel Office 

TORONTO GENERAL HOSPITAL 

101, College St.. 

Toronto, Ontario, 

M5G 1L7. 



72 THE CANADIAN NURSE 



FEBRUARY 1974 



ADVISER IN NURSING 

ONTARIO MINISTRY OF CORRECTIONAL SERVICES 

This new position provides for the development of nursing 
services within a multi-disciplinary concept of health care at 
the (Vlinistry's juvenile and adult institutions. 
The successful candidate will be a person of proven ability 
in the areas of programme administration, and one who can 
apply new models of nursing care and plan corresponding 
training programmes. 

The Adviser in Nursing will be based in Toronto, but the posi- 
tion will require frequent trips. This is a full-time contract 
position, salary negotiable, and intended to attract persons 
who have held senior nursing appointments. 

Enquiries should be directed to the: 

DIRECTOR OF PERSONNEL 

MINISTRY OF CORRECTIONAL SERVICES 

434 UNIVERSITY AVENUE 

TORONTO, ONTARIO 




Ontario 



Ontario 
Ministry of 
Correctional 
Services 



Montreal is a fascinating, 
bicultural city, but don't 
take our word — Enjoy it 
from the vantage point of 
"THE ROYAL VIC" situated 
in the heart of the city. 

Those of you who are 

ready to meet the challenge 

of new experience, 

we will prepare you 

for nursing roles in 

a research — teaching 

hospital 

where 

NURSES ARE IMPORTANT 

No special language requirement 
for Canadian Citizens but the 
opportunity to improve your 
French is open to you. 

Write to: 
Anne Bruce R.N. 
Nursing Recruitment Officer 
Royal Victoria Hospital 
687, Pine Avenue West 
Montreal, Quebec, Canada 
H3A1A1 



FEBRUARY 1974 




THE CANADIAN NURSE 

% 



UNIVERSITY OF 
ALBERTA HOSPITAL 

EDMONTON, ALBERTA 
invites applications from general duty nurses 



Opportunities for Professional development in 
general and specialty areas of Medical and Sur- 
gical Nursing, Paediatrics, Obstetrics, Psychiatry, 
Operating Room, Renal Dialysis Unit, and Extend- 
ed Care. 

Planned Orientation Program, 
In-service Education Program. 

Salary commensurate with education and expe- 
rience. 

For further information write to: 

EMPLOYMENT SUPERVISOR — NURSING 
UNIVERSITY OF ALBERTA HOSPITAL 
84 Avenue & 112 Street 
Edmonton, Alberta 




DALHOUSIE UNIVERSITY 

SCHOOL OF NURSING 

FACULTY POSITIONS AVAILABLE 

July, 1973 

1) Medical Surgical Nursing 

2) Psychiatric Nursing 

3) Community Health Nursing 

4) Maternal-Child Nursing 

Masters degree required. 
Apply to: 

Dr. Floris E. King 

Director 

SCHOOL OF NURSING 

DALHOUSIE UNIVERSITY 

Halifax, Nova Scotia 



LAKEHEAD UNIVERSITY 

REQUIRES A 

CHAIRMAN, SCHOOL OF NURSING 



An experienced academic administrator who can assume 
responsibility tor a well established Baccalaureate Degree 
Program. The successful applicant will hold academic rank 
in the faculty. 

Administrative ability, teaching experience in a speciality 
area and skill in interpersonal and public relations are prime 
qualities sought. 

Interested individuals, qualified at a Master's level or 
higher, are invited to submit curriculum vitae and other rele- 
vant information, together with names of three referees, to: 



Mr. D. AYRE 

Secretary of the University 

Lakehead University 

Thunder Bay, Ontario 

P7B 5E1 

Attention: School of Nursing Search Committee 



ACCEPT THE CHALLENGE 

ST. BONIFACE GENERAL HOSPITAL 



Due to the expansion of our present program and 
facilities, invites applications from 



REGISTERED NURSES 
FOR GENERAL DUTY 

FOR A NEW 
200 BED EXTENDED CARE WING 



The wing comprises five nursing units designed to 
provide care for patients requiring active rehabilita- 
tion and a planned team approach. 

To be a member of this team please fon.vard all 
applications and enquiries to: 



ASSISTANT DIRECTOR 

NURSING SERVICE (STAFFING) 

ST. BONIFACE GENERAL HOSPITAL 

409TACHE AVENUE, WINNIPEG, MANITOBA 

R2H 2A6 



74 THE CANADIAN NURSE 



FEBRUARY 1974 



NATIONAL HEALTH CARE 
EVALUATION SEMINAR 

Faculty of Medicine, Dalhousie University 

Halifax, Nova Scotia 
June 10-14, 1974 

OBJECTIVES: 

To assist people involved in health care delivery and re- 
search to develop an understanding of methods and tech- 
niques required for demonstrating and evaluating health- 
care projects. 

PARTICIPANTS: 

health professionals, administrators, and others, from all 
health fields, concerned with evaluating health care. 

EXPENSES: 

Tuition is $1 00. Lodgings will be arranged at the University 
for $5.00/day. Limited financial support is available. 

For information and application forms, write to: 

Mrs. Marilyn Janlgan (Program Co-ordinator), 
Department of Preventive Medicine, Faculty of 

Medicine, 
Dalhousie University, Halifax, Nova Scotia. 

Deadline for application: May 1, 1974. 

This seminar is supported by a grant from the Department of National 
Health and Welfare. 




THE RELIGIOUS 
HOSPITALLERS 
OF SAINT JOSEPH 



INVITE YOU to share their 300 year heritage of service to the 
Church in health, education and welfare services in 
the United States, Canada and France 

to share their availability to reach out to those in 
need in Africa, Peru and the Dominican Republic 
proclaiming Christ's love by care and prevention, 
teaching and development programs 

to share their common life of prayer and work in a 
spirit of openness to God and the needs of others 



R.S.V.P. FORMATION CENTER 
438V2 College St. 
Burlington, Vermont 
05401 

FORMATION CENTER 
4 Toronto Street, 
Ottawa, Ontario. 
K1S0N2 




Jewish General Hospital 

Montreal, Quebec ■ 

A modern 700 bed non-sectarian hospital which has general and special services. 
Active In-Service Education Programme, including Planned Orientation Programme. 
Excellent personnel policies. Bursaries for post-basic University courses in Nursing 
Supervision and Administration. 
Applications invited from Registered Nurses and Nursing Assistants. 

For further Information, please write: 

Director, Nursing Service JEWISH GENERAL HOSPITAL 
3755 Cote St. Catherine Road Montreal 249, Quebec 



FEBRUARY 1974 



THE CANADIAN NURSE 



REGISTERED NURSES 



This 500-bed chronic and convalescent hospital has imme- 
diate full-time and part-time vacancies for Registered 
Nurses or Graduate Nurses with pending Ontario registra- 
tion. 

Positions offer starting salaries commensurate with exper- 
ience, liberal fringe benefits and scope for advancement 



For an interview please contact: 



PERSONNEL DEPARTMENT 
QUEEN ELIZABETH HOSPITAL 
130 DUNN AVENUE 
TORONTO, ONTARIO 
M6K 2R7 
Tel.: 537-2411 



THE COLLEGE OF NURSES OF ONTARIO 

invites applications for the position of 

ASSISTANT DIRECTOR — 
PROFESSIONAL STANDARDS 

Position available - June 1, 1974 



Position — 

The position provides opportunity to assist the Director in conduct- 
ing the affairs of the College, with prime responsibility for the dev- 
elop "nt and maintenance of standards for registration of nurses 
ana ,,jrsing assistants and for the discipline of registrants. 
The Assistant Director is responsible for coordinating the activities 
of the staff of the Professional Standards Department. 

Qualifications — 

A registered nurse with master's degree and progressive experi- 
ence in nursing practice or education. Must have demonstrat- 
ed competence in administration in a senior position. 

Salary —dependent upon qualifications. 



Apply to: 



The Director 

The College of Nurses of Ontario 

600 Egllnton Avenue East 

Toronto, Ontario 

M4P 1P4 




ORTHOPAEDIC U ARTHRITIC 
HOSRITAI— 



X=/|\^ 



43 WELLESLEY STREET, EAST, 

TORONTO, ONTARIO 

M4Y1H1 



Enlarging Specialty Hospital offers a unique op- 
portunity to nurses and nursing assistants interested 
in the care of patients with bone and joint disorders 

Must be registered in the Province of Ontario. 

Preparation by post-graduate education or exper- 
ience required for Senior positions. 




THE SCARBOROUGH 
GENERAL HOSPITAL 

invites applications from: 
Registered Nurses and Registered Nursing Assist- 
ants to work in our 650-bed progressive, accredit- 
ed, community-centered, active treatment hospital. 

We offer opportunities in Medical, Surgical, Paediatric, and Obstetrical 

nursing. 

Our specialties include a Burns and Plastic Unit, Coronary Care, Intensive 

Care and Neurosurgery Units and an active Emergency Departmsnt. 

• Obstetrical Department — participation In "Family centered" teach- 
ing program. 

• Paediatric Department — participation in Play Therapy Program. 

• Orientation and on-going staff education. 

• Progressive personnel policies. 

The hospital is located in Eastern Metropolitan Toronto. 
For further information, write to: 

The Director of Nursing, 

SCARBOROUGH GENERAL HOSPITAL, 
3050 Lawrence Avenue, East, Scarborough, Ontario. 



76 THE CANADIAN NURSE 



FEBRUARY 1974 



EXTENSION COURSE IN 
NURSING UNIT ADMINISTRATION 



REGISTERED NURSES employed full time in management posi- 
tions may apply for enrolment in tfie extension course in Nursing 
Unit Administration. A limited number of registered psychiatric 
nurses may also enrol. The program is designed for nurses who 
wish to improve their administrative skills and is available in French 
and in English. 

The course begins with a five day Intramural session In September, 
followed by a seven month period of home study. The program 
concludes with a final five day workshop session In April or in May. 
The Intramural sessions are arranged on a regional basis. 

The extension course In Nursing Unit Administration is sponsored 
jointly by the Canadian Nurses' Association and the Canadian Hos- 
pital Association. 

Registered Nurses interested in enrolling in the 1974-75 class 
should submit applications before May 15th. Early application is 
advised. The tuition fee of $175.00 is payable on or before July 1st. 



For additional Information and application forms direct 
enquiries to: 

Director, 

Extension Course in Nursing Unit Administration, 

25 Imperial Street, 

Toronto, Ontario MSP 1C1 



REGISTERED NURSES 

Immediate Openings in all Services 

Come work and play in Nev^ffoundland's second largest city! 

Corner Brook has a population of approximately 35.000 with a 
temperate climate in comparison with most of Canada. Outdoor life 
is among the finest to be found in North America. The airports serv- 
ing Corner Brook are at Deer Lake. 32 miles away, and Stephenville, 
50 miles away. 

Connections with these airports make readily available air travel 
anywhere In the world. 

— Present Salary Scale: S6.900.00 -8,810 00 per annum. 

— Effective April 1. 1974: $7,452.00 -9,515.00 per annum. 

— Effective September 1, 1974: $7,652.00 - 9,715.00 per annum. 

— Service Credits - One step for two years experience, maximum 
two steps. April 1st. 1974 ■ maximum, tfiree steps. 

— Educational differential for B. N. and master's degree in Nursing. 

— .804 psr s/7/ft for rotating evenings and nigfits. 

— $2.00 per sfiift for Ctiarge Nurse. 

— $50.00 uniform allowance annually. 

— 20 woricing days annual vacation. 

— 8 statutory fiolidays. 

— Sick Leave - 1 'i days per montfi. 

— Accommodation available. 

— Two week orientation on commencement. 

— Continuing Staff Education program. 

At the present time, a major expansion project Is in progress to 
provide regional hospital facilities for the West Coast of the Prov- 
ince. The Hospital will have a 350 bed capacity by December. 1 974. 
Services include Medicine, Surgery, Paediatrics, Obstetrics, Psy- 
chiatry, ecu, and ICU. 

Letters of application should be submitted to: 

DIRECTOR OF PERSONNEL, 
WESTERN MEMORIAL HOSPITAL. 
CORNER BROOK, NFLD. 



Sunnybrook Hospital 

• a 1,200 bed University owned 
teaching hospital with 
opportunities for development 
in modern specialty 

nursing units. 

• comprehensive range of 
fringe benefits. 





• competitive salaries. 

• staff residence 
accommodation with parkland 
setting and excellent 
transportation to 
downtown Toronto. 

• recreation facilities. 



SUNNYBROOK 

HOSPITAL 

is 

PEOPLE 

JOIN US 

Write to: 

Selection Officer 

Personnel Department 

SUNNYBROOK HOSPITAL 

2075 Bayview Avenue 
Toronto 315, Ontario 




FEBRUARY 1974 



THE CANADIAN NURSE 



77 




CARIBOO COLLEGE 

KAMLOOPS 
BRITISH COLUMBIA 

Situated north of the Okanagan Valley in a city of 
55,000. 

Applications are invited for teaching positions in an 

established, approved two-year diploma nursing 
program. Positions will be available from the spring 
of 1974. 

Applicants with a Master's degree are preferred. 
Minimum requirements are a baccalaureate degree 
with experience in nursing and teaching and eligibili- 
ty for registration in B.C. 

Attractive salaries commensurate with preparation 
and experience. 

Apply in writing stating experience, qualifications 
and references to: 

Chairman of Nursing 

Cariboo College 

Box 860 

Kamloops, B.C. V2C 5N3 



REGISTERED NURSES 

and 

LICENSED PRACTICAL NURSES 

required for 

fully modern 433-bed accredited hospital 

comprising 232 acute treatment beds and a new 201 

bed rehabilitation and extended care facility to open 

in January 1974. 

Brandon is an attractive, growing, university city in western 
Manitoba with population of 35,000 and offers a full range of 
year around recreational facilities. 

Staff nurse positions are available in — 

CLINICAL AREAS — 
MEDICINE 
SURGERY 
OBSTETRICS 
INTENSIVE CARE 
REHABILITATION 
EXTENDED CARE 

An active staff development program is in existence 

Apply in writing to: 

Mr. A. LESKO, 
PERSONNEL OFFICE, 
BRANDON GENERAL HOSPITAL, 
BRANDON, MANITOBA 
R7A 1L7 



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 bdow: 

MEMBERSHIP (payable annually) 



Nurse Member — 


Regular 

Sustaining 

Patron 

Sustaining 
Patron 

RESEA 

in me 


$ 500 




$ 50.00 




$500.00 


Public Member — 


$ 50.00 


BURSARIES $ 


$500.00 

RCH $ 


MEMORIAL $ 


mory of 


Name and address of person 
this gift 


to be notified of 




REMIHER 


Address 


(Print name 


in full) 


Position 


Em ployer 



N.B.: CONTRIBUTIONS TO CNF 
ARE DEDUCTIBLE FOR INCOME TAX PURPOSES 



78 THE CANADIAN NURSE 



FEBRUARY 1974 



Index 

to 

Advertisers 

February 1974 



Astra Pharmaceuticals Canada I.td f, 

Canadian Armed Forces 51 

Clinic Siioemakcrs 2 

Davol Canada Ltd I ^ 

Hollistcr Limited _i^ 

ICN Canada Ltd I | 

International Health Institute 53 

Lan/ette Products 52 

J.B. Lippincott Co, ot Canada Ltd I 

Mont Sutton Inc I 5 

C.V. Mosby Company, l-td SS, 57. S9 

J.T. Posey Company ^^0 

Procter & Gamble 1 :; 

Reeves Company I 4 | <; 

William H. Rorer (Canada) Ltd 17 

Sando/ (Canada) Ltd 1 1 

Schcring Corporation limited 7y. Cover IV 

White Sister Uniform. Inc 5. 9. Cover II. Cover III 



A dvcnisini' Manager 
Cicorgina Clarke 
The Canadian Nurse 
50 The Driveway 
Ottawa K2P 1 E-:2 (Ontario) 

A (Ivcrlising Rcprcsentati ves 
Richard P. Wilson 
219 East Lancaster Avenue 
Ardmore, Penna. 19003 

Telephone, (21.5) |V1id\va_\ 9-1497 

Gordon TitTin 

2 Tremont Crescent 

Don Mills, Ontario 

Telephone, (416) 444-47.'^ I 

Member of Canadian 
Circulations Audit Board Inc. 



[mo 



FEBRUARY 1974 



Copicidin'D' 



DESCRIPTION: 
Coricidin 'D': Each white, coated 

tablet contains: 

2 mg chlorpheniramine maleate U.S. P., 

390 mg acetvlsalicyhc acid, 

30 mg caffeine and 

10 mg phenylephrine. 

Available in blisters of 12 

and 24, and bottles of 100 tablets. 

Coriciciin 'D' Medilets: Each orange- 
pineapple-flavored multicolored tablet contain 
0,5 mg chlorpheniramine maleate U.S. P., 
80 mg acetylsalicylic acid and 
2 , 5 mg phenylephrine HC 1 . 
Available in boxes of 24 Medilets in a 
child s protective package. 
INDICATIONS: 

Symptomatic reliefofnasal congestion and 
other discomforts associated with sinusitis, 
colds and allergic or vasomotor rhinitis. 
CONTRAINDICATIONS : 

Sensitivity to any of the components, 
patients receiving MAO inhibitors. 

PRECAUTIONS: 

Administer with care topatients with hyper- 
tension, cardiac disorders, hyperthyroidism, 
diabetes mellitus and patients hypersensitive 
to sympathomimetic compounds 

Patients should be cautioned not to oper- 
ate vehicles or hazardous machinery until 
their response to the drug has been deter- 
mined Since the depressant effects of anti- 
histamines are additive to those of other 
drugs affecting the central nervous system, 
patients should be cautioned against drink- 
ing alcoholic beverages or taking hypnotics, 
sedatives, psychotherapeutic agents or other 
drugs with CNS depressant effects during 
antihistaminic therapy. 

Rarely, prolonged therapy with antihista- 
mine-containing preparations can produce 
blood dvscrasias. 

ADVERSE EFFECTS: 

Drciwsiness, dizziness, nau.sea, mcreased 
irritability or excitement may be 
encountered. 
DOSAGE: 

Coricidin 'D': Adults: 1 tablet every 4 
hours, not to exceed 4 tablets in 24 hours. 
Children 10 to 14 years: 1/2 adult dose: 
under 10 years: at discretion of physician. 
Coricidin 'D' Medilets: 2 to 6 years: 
1/4 to 1 .Medilets: 7 to 1 2 years: 1 to 2 
Medilets. Each dose may be repeated every 
3 to 4 hours, but not more than 4 Medilets 
should be given in one day to children 2 to 
6 years, and 6 Medilets to children 7 to 1 2 
years. Liipit treattrient to 3 days. The recom- 
mended dosage should not be exceeded 
except on a physician's advise. 



Detailed information is available on 
request 

SCHERING CORPORATION LIMITED 
Pointe Claire, Quebec H9R 1B4 

I PMAC I 



PROVINCIAL ASSOCIATIONS OF REGISTERED NURSES 



Alberta 

Alberta Associalion of Registered Nurses. 
10256—11: Street. Edmonton. T.sK 1M6. 
/'/(■A.. A.J. Prowse; I'irs.-Elcci: D.F.. Huff- 
man: l'icc-Prc\.: A. Thompson. 1. Walker. 
Comniitlccs — Staff Nurses: C. .Asp; Nsi;. 
Fuliic: W. Mills: N.v.v. Piaclicc: A. Clark: 
Siipcrv. Nurses: i. Smith: Project Dine. /V.vt,'. 
Eiliie.: M. Moncrieff. I'rov. Office Staff — 
Fiih. Rel. Officer: A. Shaw: Employ. Rel.: 
Y. Chapman: .-Issl. Eiitploy. Rel. Officer: 
R.R. Donahue: Ns^. Serv. Consult.: B. Sel- 
lers: Coniiti. Advisor: H. Cotter: R^f;istrar: 
A.R. McKinnon: t.xec. Sec.: H.M. Sabin: 
Office Miiiuif'cr: M. Garrick. 

British Columbia 

Registered Nurses' Association of British 
Columbia. 21.^0 West 12th Avenue. Van- 
couver. Fres.: G. l.aPointe: I'ice-I'res.: T. 
Duck. R. Macfadyen. Coiiiitiittees — N.\^. 
tuliic: J.K. Griffith: A'.vi,'. Practice: E.H. 
Dancer: Soc. & Ecoit. Welf.: B. Archer. Staff 
— Exec. Direc: F.A. Kennedy: Rei;istrar: 
H. Grice: Asst. Re^i.urar: J, Small: Direc 
huliic. Serv.: C kermacks: Assi. Direc. Ecluc. 
Serv.: J. McCullagh: Direc. Ns^. Serv.: T. 
Schnurr: Direc. Personnel Serv.: N. Paton: 
Asst. Direc. Personnel Serv.: iPlacenieni 
Serv.): F. MacDonald. I Ijihor Rel.): G. 
Smale: Direc. Coiniii. Serv.: C. Marcus: 
Librarian: J. Molson: .Ailinin. Asst.: D. St. 
Germain. 

Manitoba 

Manitoba Association of Registered Nurses. 
647 Broadway Avenue. Winnipeg. R.1C 0X2. 
Pres.: F. McNaught: Past Pres.: E.M. Nu- 
gent: Vice-Pres.: R.G. Black. I.. McClure. 
Conunitiees — Ns}<.: A. Croteau. M. Swe- 
dish: Soc. & Econ. Welf.: \. Daniels: Lciiisl.: 
O. McDermott: Bid. of E.xain.: O. McDer- 
mott; Finance: K. DeJong: Profess. Staff — 
Employ. Rel. Ad vis.: J. Gleason: Piih. Rel. 
Officer: M. Paynter: Rei;i.strar: M. Caldwell: 
Contin. Ediic. Advis.: H. Simdstrom, 

New Brunswick 

New Brunswick Association of Registered 
Nurses. 2'S\ Saunders Street. Fredericton. 
Pres.: B. LeBlanc: Past Pres.: A. Robichaud: 
Vice-Pres.: S. Cormier. R. Dennison: lloit. 
Sec: S. Robichaud. Cinniuiltces — Nst;.: 
Z. Hawkes. S. MacLeod; Nsf>. Asst. Comni.: 
J. Sherwood; Lef;isl.: K. Wright; Exec. .Set .; 
MJ. Anderson: Liaison Officer: N. Rideout: 
Consult. Soc. & Econ. Welf.: G. Rowsell: 
Registrar: E. O'Connor: As.\l. E.xec. Sec. <S 
Registrar: M, Russell: EdiK. Consult: A. 
Christie. 

Newfoundland 

Association of Registered Nurses of New 
foundland. 67 Le Marchand Road. St. John's. 
Pres.: E. Wilton: Pa.yt Pres.: P. Barrett: Pres. 
Elect: F. Bouzan: Vice-Pres.: E. Summers 
J. Nevitl. Conunitiees — Nsg. Ediic: E. 

80 THE CANADIAN NURSE 



Gardner: A'sf. Serv.:}. Pawlett; .Soc. tt /•;(()//. 
lie//:.- W. Williams: E.xec. Sec.: P. Barrett. 

Nova Scotia 

Registered Nurses' Association of Nova 
Scotia. isO.V'i Coburg Road. Halifax. 
Pres.: M. Bradley; Past Pres.: J. Fox; Vice- 
Pres.: Sr. M. Barbara. G. Smith. C. Butler; 
Record. Sec: .Sr. M. Gillis; Exec. Sec: F. 
Moss. Committees-— Nsii. luluc.:T. Blaikie: 
Nsg. .Serv.: S. MacDouakl; .S<i<-, A Econ. 
Welf: G. Murphy: Advis. A/vf. Ediic: Sr. C. 
Marie: Advis. Nsg. Serv.: J. Macl.ean: Em- 
ploy. Rel. Officer: M. Benlley; Piih. Rel. Offi- 
cer: D. Miller; Admin. Asst.: E. MacDonald. 

Ontario 

Registered Nurses' Association of Ontario. 
■!.^ Price .Street. Toronto. M4W 1Z2. 
Pres.: W.J. Gerhard: Pres. Elect: N.M. Ma- 
rossi. Committees — Socio-Econ. Welf: C.J. 
Seppala: Nsg.: G.L. Schmidt; Eliacitor: C.J. 
Faulkner; Admin.: M.L. Peart: E.xec. Direc: 
I.. Barr; A.\st. E.xec Direc: D. Gibney; 
Direc Employ. Rel.: A.S. Gribben; Direc. 
Profess. Devel.: CM. Adams; Reg. E.xec. 
Sec: M.I.Thomas. F.Winchester. 

Prince Edward Island 

Association of Nurses of Prince Fxiward 
Island. I8S Prince St.. Charlottetown. 
Pres.: E. MacLeod: Peru Pres.: C. Carruthers; 
Pres. Elect: B. Robinson: Vice Pres.: S. 
Mulligan: Exec Sec. -Reg.: L. Eraser. Com- 
mittees — N.\g. Ediic: D. Sawler; N.\g. 
San-.: J. Peters; Piih. Rel.: H. Wood: Finan- 
ce: C. Carruthers: Legisl. & By-Ltiws: Sr. 
M. Cahill: Soc. & Econ. Welf.: M. Babineau. 

Quebec 

Association of Nurses of the Province of 
Quebec. 4200 Dorchester Blvd.. W.. Mont- 
real. H.'A IV2. 

Pres.: R. Buieau: Vice-Pres.: S. O'Neill. 
J, Pinkham. iFng.). P. Proulx. Y. LePage. 
(Fr.): //()/(. Treas.: C. Royer; Hon. Sec: P. 
Boucher. Committees — Nsg. Ediic: G. Al- 
len. D. Lalancette. N.sg. Serv.: J. Hackwell. 
R. Dionne; Profess. .Vc/v..- S. O'Neill. P. Mur- 
phy; .School of Nsg.: R. Atto. C. de Villiers 
Sauve: Legisl.: M. Masters. C. Belanger; 
Sec Reg.: N. Du Mouchel; Piih. Rel. Officer: 
.\LJean. 



Saskatchewan 

Saskatchewan Registered Nurses' Associa- 
tion. 2066 Retallack St.. Regina. S4T 2K2. 
Pres.: DJ. Pipher: Past Pres.: E. Linnell; 
Pres. Elect: J. MacKay; Vice-Pres.: Sr. B. 
Bezaire. S. Rhoden. Committees — Nsg.: 
I. Watson: Chapters & Pub. Rel.: R. Leding- 
harrt, .V<K-. & Econ. Welf: G. Hutchinson: 
E.xec. Sec: A. Mills: Registrar: E. Dumas: 
Pub. Inform. Officer: B. Schill; Nsg. Consult.: 
R. Mireau: A.s.\l. Registrar }. Passmore. 



.^ 



<^ i Canadian 

Q_/t\_t Nurses' 

v^ ^ Association 



Directors 



President 



Marguerite E. Schumacher 



Presidenl-Elect Huguette Labellc 



1st Vice-President .. Beverly Du Gas 



Member-at-Large Glenna Rowsell 



Member-at-Large .. K. Marion Smith 



Member-at-Large 



Denise Lalancette 



Member-at-Large Roberta Coutts 



A.J. Prowse AARN 



G. LaPomte KNABC 



F. McNaught MARN 



B. LeBlanc NBARN 



E. Wilton ARNN 



M. Bradley RNANS 



W. Gerhard RNAO 



E. MacLeod ANPEI 



R. Bureau ANPQ 



DJ. Pipher SRNA 



Executive Director 



Helen K. Mussallem 



_ 



FEBRUARY 1974 



ruiN MiNu PMoniwiN vvuKiv lUvjtintK 




IFORM SPECIALTY 

1254 BAY ST. 



SHOP IN PERSON AT OUR 
NEW BAY STREET 



CT/~»Dir 



MAIL ORDER DIVISION 
372 QUEEN ST. W. 
TORONTO M5V2A3 

Please send III mail orHers tn 



Howto''catch"a cold 



M':!^ 




^ 



Surprise a cold rij^'ht at its onset with 
Coricidin 'D' for adults and Coricidin 'D' 
Medilets" for children. You can recom- 
mend these products knowing they will 
provide relief from aches, pains and 
fever plus decongestant action. 
Coricidin 'D" and Coricidin 'D" 
Medilets contain Chlor-Tripolonf 
one of the world's most widely used 
antihistamines; phenylephrine, a 
highly effective decongestant and acetyl- 
salicylic acid for aches, pains and fever. 
The adult form contains caffeine as a mild 
stimulant to keep your patients on the go. 



CoricidinD' 



^Ua 




For complete product information see paye 79. 



•RcK.T.M. 




March 1974 



Nurse 




WHITE SISTER WRAPS YOU IN CONFIDENCE 
TO COMPLIMENT YOUR ABILITY... 




Style No. 42360 

"Royale Rib" Tricot Knit 

Sizes 3-15 

White only 

About S29.00 



^ 




$tyle No. 2342 

"Royale Rib" Tricot Knit 

Sizes 8-18 - Missy length 

White only 

About S24.00 



Style No. 2364 

"Royale Rib" Tricot Knit 

Sizes 8-18 

White only 

About 



$30.00 



CAREER APPAREL 



CAREER APPAREL AT FINE STORES ACROSS CANADA 




Recent releases 

for clinical 
competence 



© 



WINTERS' PROTECTIVE BODY 
MECHANICS: A Manual for Nurses 

Bilger and Greene 

. . . Concentrates on the physical and physiological 

principles underlying the body movements that need 

to be initiated to achieve therapeutic objectives in 

patient care. 

Springer May 1973 $6.25 



^ . THE BODY'S RESPONSE TO TRAUMA: 
^ ) Fractures 

Clissold 

... In this programmed text, fracture is used to 

demonstrate the responses of the cells of the body 

to trauma. 

Springer June 1973 $6.75 



® 



p. > MONITORING CENTRAL VENOUS 

tl ] PRESSURE: A Programmed Sequence 

Krueger 



® 



© 



A programmed text on the aspects of central 
venous pressure of concern in nursing. 
Springer June 1973 $4.25 



MATERNAL-CHILD NURSING 

Broadribb and Corliss 

A family centered text for students being prepared 
to give direct care to mothers and children. 
Lippincott September 1973 about $11.00 






® 



RESPIRATORY INTENSIVE CARE 
NURSING 

Beth Israel Hospital. Boston 

. . . A comprehensive presentation of current inter- 
disciplinary practices in respiratory and nursing 
care. 
Little. Brown April 1973 $10.95 



. X COMMUNICATION IN NURSING 
^ J PRACTICE 

He in 

. . . Presents a simple, formal model of the com- 
munication process between nurse and patient, but 
emphasizes the need to use variety in meeting 
variety. 
Little. Brown July 1973 $6.25 



® 



® 




PERSPECTIVES IN HUMAN 
DEVELOPMENT: Nursing Throughout 
the Life Cycle 

Sutterley and Donnelly 

. . . Emphasizes a multi-disciplinary, holistic view of 

man. the promotion and maintenance of health as 

well as intervention in times of physical, emotional 

and social stress. 

Lippincott fylay 1973 $8.75 



THE PRACTICE OF MENTAL HEALTH 
NURSING: A Community Approach 

Morgan and Moreno 

. . . Reflects the dynamic quality of psychiatric care 
in a community setting and desirable colleague re- 
lationships required for successful treatment of the 
emotionally disturbed. 
Lippincott f^ay 1973 flexible cover $5.95 




Serving the health professions in 

Canada since 1897 

J. B. Lippincott Co. of Canada Ltd. 

75 Horner Ave. 

Toronto, Ontario MBZ 4X7 

Representing in Canada: 

Little, Brown and Company 

Blackwell Scientific Publications Ltd. 

Springer Publishing Company, Inc. 



Please send me the book(s) whose number(s) I have circled 

1 5 

2 6 

3 7 

4 8 

Name 

Address Position 

City Province Postal Code 

□ Payment enclosed (send postpaid) □ Use my Chargex number 

Books may be returned within 15 days □ Charge and bill me CN-3 74 



MARCH 1974 



THE CANADIAN NURSE 1 




SOME STYLES ALSO AVAILABLE IN COLORS . . . SOME STYLES VhA2 t\kkK-^. about 23,95 to 29.95. 

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-3, 7912 Bonhomme Ave. • St. Louis, Mo. 63105 

2 THE CANADIAN NURSE MARCH 1974 



The 

Canadian 
Nurse 




^^p 



A monthly journal for the nurses of Canada published 

in English and French editions by the Canadian Nurses' Association 



Volume 70, Number 3 



March 1974 



17 A Death At Home D. McNeil 

21 Poor Baby: The Nurse and Feminism D.S. Starr 

25 Cholera Epidemiology and Control J.W. Davies 

28 Surviving in the Bush j. O'Brien 

31 A Volunteer Nurse in Israel C. Dworkin 

33 The Hair Dryer Treatment for Decubiti D.H. Denholm 

I he vicus cxpicsscil in llic aliumal ;irKl \;ii ions iiilJLlcs aic Ihcisc o\ Ihc aiillmis anil 
ill) nol ncccssarils rcpicscnl ilic piilicicsui \ icus ol the ( anailian Nurses' Associalinn. 



4 Letters 

7 News 

35 In A Capsule 

36 Dates 

38 Research Abstracts 



41 Names 

42 New Products 
46 Books 

52 Accession List 

72 Index to Advertisers 



txcirutivc DircLUir: Hclin K. Mussallt'm • 
IditDr Virginia A. lindaburx • VsmsI.iiii 
I dilors l.iv-Klk-n l.(H.'ki-hiTt>. Doriilh) S. 
Slarr • I diiorial Assjsiiinl C'ari>l A. Dwor- 
l(in • Prculuclion Assistani Kli/^bi-th A. 
Slanton • ( irculalion M.inagi.i Bi-nl Dar- 
ling • AilMTlismg Man.igcr (A-iirRina Clarke 

• Subscription Ratv>: ( .iikkI,! oik \i.,ir. 
S6.(K); iwci vcars. 5,1 I. (HI. I urcign imc >i;ar, 
$6.50; iwo years. $12.00. Single copies 
$1.00 each. Make cheques or money orders 
pa\ablc 1(1 Ihc Canadian \urscs AsvK;iation, 

• Change of Address: Si\ \vccks' nolicc: tlu 
iild address as \\cll ,is the new .irc ncccssiirv . 
logclhcr «iih registration number in a pro- 
vincial nurses" association. «here applicable 
Nol responsible lor journals lost in mail due 
to errors in address. 



Manuscript Inrormalion: I Ik ( anadian 
Nurse" \\cleniiK's unsolicited articles. -\ll 
inaiiusenpls should Iv l>pvd. double-spaced, 
on one side ol unruled paper leaMiig Hide 
margins. Manuscripts arc accepted lor rcMew 
lor exclusive publication. I he editor reserves 
the right to make the usual editorial changes 
I'hotographs (glosss prints) and graphs and 
diagrams idra«n in india ink on white p.iper) 
.ire welcomed with such arlicles. I he editor 
Is nol commuted to publish .ill articles sent, 
nor lo indicate det'inile dales ol publication. 

Postage paid m cash at third class rale 
MON7RI.AI. I>0 I'ermil No. IO.(K)l. 
.SO The Driveway. Ollavva. Onuirio. K2P 112 

O 'anadian Nurses" \ssiici.iiioii l'n4. 



MARCH 1974 



In 1907. Ethel Johns wrote that 
nurses must choose between the 
profession of nursing and matri- 
mony. According to her biography. 
Watch-fires on the Mountains, Ms. 
Johns warned: ■'Do not hope to con- 
ciliate both (marriage and nursing]. 
They are quite incompatible. Like 
iron and whiskey they are both 
valuable — but you cannot take 
them in the same glass. ' 

Social circumstances have 
changed somewhat m the past 64 
years: the extended family has 
shrunk and day-care centers prolif- 
erate, the nursing workweek is 
about half as long as in 1907. and 
technology may be used to prevent 
conception. But nurses still must 
take difficult decisions about per- 
sonal priorities. 

The article Poor Baby points out 
that women today, including nurses, 
base important decisions on soci- 
ety's expectations: Every girl wants 
to get married. Every married wom- 
an will have at least one child to 
prove her femininity and her mate's 
virility. A husbands needs are more 
important than a careers require- 
ments. 

Why? More important to whom? 
Women are asking questions and 
considering alternatives rational- 
ly, as they seek ways to achieve 
satisfying personal relationships 
and creative professional lives. 
Some men have achieved this: 
many men have failed. But men do 
not believe they have to choose 
between marriage and a career. 

Although women today should 
not have to choose, many still be- 
lieve there is a basic incompatibility 
between marriage and a woman's 
professional commitment — like 
iron and whiskey. 

The nursing profession should not 
shrug off feminists as kinky bra- 
burners, formerly marrieds. and 
sexual deviants. Nursing needs 
feminist answer-seekers. 

Rather than adapting to society s 
notions, for example, that mothers 
are more responsible than fathers 
for the joint product of conception, 
nursing should support women's 
efforts to obtain equal rights and 
responsibilities in activities of daily 
life. 

Nursing could support part-time 
work for both mothers and fathers, 
so both can share child-care and 
careers. Nursing could reconsider 
the attitude, "fecund is beautiful.' 
and award equal status to mother- 
hood and voluntary childlessness. 

— D S.S 
THE CANADIAN NURSE 3 



letters { 



Letters to the editor are welcome. 

Only signed letters, which include the writer's complete address, 

will be considered for publication. 

Name will be withheld at the writer's request. 



Article arouses interest 

I wiHild to share with The Canadian 
Nurse stal'tand readers the interest that 
has been shown in my article "Control- 
hng the tight/tlight patient" (October 
1973). 

• An excellent letter from a practicing 
nurse was forwarded to me. Both the 
letter and my attempt to clarity some 
points were published in the January 
1974 issue. 

• I agreed to a request to reprint the 
complete article in The Atistrala.sicin 
Nurses Journal in 1974. 

• In November 1973. I was invited to 
participate in an inscrvice program with 
the supervisory nursing statT at the 
Royal Ottawa Hospital. My article, 
plus a videotape produced by the psy- 
chology department at the University 
ol Western Ontario in l-ondon, were 
part of an interesting program. The 
videotape, which depicted visual meth- 
ods and commentary used by statT in 
coping with heightened anxiety in 
patients, elicited both positive and 
negative reactions by those present. The 
nursing department of the Allan Me- 
morial Institute in Montreal has begun 
taping some useful material in this 
field, using equipment from McGill 
University. 

Personal letters and messages have 
surprised and tlattered me. The need 
to communicate what we see as daily 
routine activity in crisis situations is 
topical. Jean A. Reicl. Ottawa. 



Article draws support 

It was with real relief that 1 read Sandra 
Kcssler's article, entitled "Protecting 
nonsmokers in public places" (January 
1974). As a nonsmoker, 1 get tired of 
all the stress laid on smokers" health, 
while nothing is said about our health 
in their polluted world. 

I am a nurse presently on leave 
from a large Canadian hospital (whose 
cafeteria and coffee shop are notorious- 
ly smoke-tilled). I have been working 
for a few months as an office assistant 
in a new and modern YM-YWCA com- 
plex, and have been appalled at the 
amount of smoking around me. In all 
fairness, I understand that smoking is 
not allowed in the health and physical 
education department, but there seems 
to be no restriction elsewhere. I work 
in a small suite of offices, housing from 
five to eight staff members at a time. 

4 THE CANADIAN NURSE 



most of whom smoke in varying 
amounts. By 5.00 P.M. each day I feel 
overpowered by thick, smelly air. The 
walk home on city sidewalks is fresh by 
comparison. 

For three months, I have made count- 
less remarks — humorous, concerned, 
or frustrated. Every comment is either 
ignored or treated as a joke. The sole 
result of three months of campaigning 
is my refusal to allow an ashtray on 
my desk while I am seated at it. 

In summary, and in reaction to your 
editorial, (January 1974), no campaign 
is better named than GASP! — RN . 
Ontario (name withheld on request). 



Surgery "in the second person" 

Reading Margaret Guthrie's frank and 
perceptive article, "Cardiac surgery 
in the first person" (September 1973), 
was a truly moving experience for me, 
as one who had undergone the exasper- 
ating procedure "in the second person" 
with a husband who was a heart patient. 

Unlike Ms. Guthrie, who was a pa- 
tient in intensive care and found it "a 
safe retreat" after surgery. I was in the 
unfortunate position of being the wife 
of the patient and a registered nurse. As 
an RN, I thought I could expect some 
response from the nursing staff regard- 
ing my husbands condition. 

My experience, however, was similar 
to the impersonality Ms. Guthrie felt 
when she was first examined. This may 
have been because I was regarded as 
a potential interference by the nursing 
staff. The kind of interaction that should 
have taken place in the intensive care 
unit did take place with the staff of the 
coronary care unit, where my husband 
and 1 were treated as individuals. I 
will always be particularly grateful to 
one Philippine nurse who was able lo 



Rcgislcred nurses, 
your community needs 
[the benefit of youi 
skills and experience. 
Volunteer now to 
leach .St. John Ambulance home 
niirsinp and child care courses. 

C'onlacf your Provincial Headquarters, 
.St. John Ambulance. 



consider the situation from my perspec- 
tive and helped restore my confidence 
in myself as a nurse. 

Ms. Guthrie's description of the 
traumatic move from ICU to the ward 
and the problems she enci>untered there 
elicited my sympathetic response. This 
transition takes place at a crucial time 
in the patient's recovery, when a proper 
understanding of his condition and 
encouragement are required. I found 
there was inadequate briefing as to what 
the patient should expect and insuffi- 
cient consideration by the nursing staff. 

I iigree entirely with the suggestions 
Ms. Guthrie makes in her conclusions, 
and would add the following, the medic- 
al and surgical teams should come to 
some agreement on the best course the 
patient should follow with respect to 
such subjects as activity and alcohol 
consumption; those closest to the pa- 
tient should be given some medically 
informed advice as to what one may 
expect to see in a patient's behavior 
following cardiac surgery, i.e., severe 
depression and personality change; 
and there should also be follow-up 
treatment for patients who have had 
major surgery, even if a relative of the 
patient is an RN. 

I am thankful to Ms. Guthrie for 
describing the patient's position so well 
and for reflecting my own experience 
in an honest and enlightening way. — 
Barbara A . Chandler, London, Ontario. 



June reunion in Winnipeg 

In conjunction with Winnipeg's centen- 
nial celebrations, we are planning a 
large reunion of all Grace General 
Hospital graduates, including those of 
the 3-year program from the last 40 
years and from the I S-nionth obstetrical 
program pricM' to 1934. 

Events trom June 27 to 30. 1974. 
will include an alumnae banquet for 
the 1974 graduating class, graduatiim 
exercises, a garden party and lours of 
Grace General Hospital, and church 
services at the Citadel. 

As bookings might be heavy this 
\ear. we vvoukl like to hear from our 
alumnae by April I . Write to Brigadier 
Frances Wagner. Grace General Hos- 
pital. 300 Booth Drive. Winnipeg, 
Manitoba R3J 3M7. - /•,. Des-en. 
secretary. Grace Cieneral Hospital 
Nurses' Alumnae. V 

MARCH 1974 






CAREER GIRLS! CHOOSE FASHIONS THAT WORK FOR YOU - AT EATON'S 



Here's your chance to have uniforms that combine 
everyday comfort with up-to-date looks. Made by 
White Sister, these polyester and nylon corded tricot 
knit styles wash just as easily as they wear. And just 
look at the great fabric textures and seam details. 
Thanks to White Sister, you can be just as fashion 
conscious on the job as off. Come to Eaton's soon and 
take a look at our great selection of career apparel. 
Visit or phone your nearest Eaton's Store. Merchandise 
available at or through Eaton's Stores and Catalogue 
Offices across Canada. 



1. The fresh and alluring styling of this dress features 
attractive front yoke with decorative stitching, front 
patch pockets, short sleeves with turn-back cuffs, ac- 
tion sleeves, pointed collar and back zip. White only. 
Sizes 6 to 16. 20.00. Model 2459. 

2. Pert and youthful, this style features attractive 
front smocking, button trim, short sleeves with turn- 
back cuffs, front patch pockets, rounded collar, back 
zip and action sleeves. In white, 22.00; in pink, blue 
or yellow. 24.00. Sizes 3 to 1 5. Model 42420. 



EATON'S 



^ 




CAREER APPAREL 



Davol dialled suction instruments 
just enough to make a big difference. 



There's only one difference 
between Davol instruments and . 
metal ones. 

Davol made them disposable. 

So now nursing staffs save time 
because there's no recleaning. 

And most important, there's no 
risk of contamination. 

Everything else is the same. Your 
surgeons get the look, feel and action 
they're used to in metal Yankauers, 
Pooles, Fraziers and sigmoidoscopic 
instruments. 



Price? 

Davol suction instruments are 
priced to make disposability practical 

Davol introduced disposable 
suction instruments. Since then 
over two thousand hospitals have 
already converted. 

Apparently, we made a big 
difference. 

Davol Canada Ltd., 1033 Range 
View Rd., Port Credit, Ont, 
L5E-1H2 (416)274-5252 



BUILDING ON A CENTURY OF QUALITY 
HEALTH CARE PRODUCTS 




1874-1974 



news 



CNA Gives Over 100 Gift Copies 
Of Biography Of Ethel Johns 

Oitiiwa. Out. — The Canadian Nurses' 
Assdciation has sent iiver 100 copies 
ol Walch-fircs on the nioiintaiiis: the 
life and writin/JS of Ethel Johns, as gifts 
to national and international nursing 
leaders. The biography oi' Ms, Johns, 
editor o\' The Canadian Nurse from 
ly.'^.^ to 1944, was written by Margaret 
M. Street. Vancouver. 

In September 1972. CNA directors 
agreed to support publication of the 
book by purchasing copies to the value 
of SI. 000. Gift copies of much-fires 
on the mountains have been sent to 
English-speaking. national nursing 
associations that are members of the 
international Council of Nurses and 
to honorary members, past presidents, 
and directors of CNA. as well as to 
other leaders of the nursing profession 
in Canada and abroad. 

A review of Watch-jires on the 
nioiiniains appears on page 44. 

Quebec Association Name Change 
Became Effective February 1st 

Montreal. Que. — The Professional 
Code of the province of Quebec was 
proclaimed on February 1. 1974. so 
the title for the Quebec nursing asso- 
ciation is now; Order of Nurses of Que- 
bec (ONQ). 

At the annual meeting of the Asso- 
ciation of Nurses of the Province of 
Quebec, held in November 1973, dele- 
gates adopted a resolution to change 
the name to Order of Nurses of Que- 
bec when the Professional Code was 
proclaimed law. (News, January 1974 
pp. 9-10.) 



SRNA Rejects Setting Up Of Board 
To Regulate Health Disciplines 

Ref^ina. .Sask. Ihe Saskatchewan 
Registered Nurses" Association has 
rejected the establishment of a health 
disciplines regulation board, as recom- 
mended in the Mcleod Report, which 
was commissioned by the provincial 
health minister and released for public 
discussion in August 1973. 

I he Mel. cod Report advocates con- 
sumer participatiiin on the governing 
biKlies of professional associations, 
consumer and practitioner representa- 
lioii on health advisory and planning 
bodies, public regulation of the profes- 
MARCH1974 




I he Royal Winnipeg Ballet, the Winnipeg .Syniphonv Orchestra, and other 
renowned cultural groups have played to capacity audiences in the concert hall 
ol the Manitoba Centennial Centre in Winnipet;. The featured attraction in 
the hall from June 16 to 2 1, 1974, will be the annual meeting and convention 
ot the Canadian Nurses' Association. 



sions through a health disciplines regu- 
lation board composed of lay persons, 
decentralization o\' health services, and 
the development of community health 
and social centers. 

The health disciplines regulation 
board would have the power to review 
and revoke regulations made by indi- 
vidual professions, lis rulings would 
be binding on the professions; there 
is no provision for appeal. The board 
wouki be composetl of three tt) live lay 
members appointed by the Crown. 

In its initial response to the report, 
sent to Health Minister W.E. Smishek 
on December 21, 1973, the association 
said it strongly rejects the establish- 
ment of such a health disciplines regula- 
tion boind. SKNA notes that the pre- 
sent mechanism for review of profes- 
sional acts, regulalii>ns, and bylaws 
by the Legislative Assembly has been 
satisfactory. 

SKNA states its belief that this me- 
chanism is in the best interest of the 
people of Saskatchewan and that the 
responsibility for review should be 



retanied by the elected representatives 
of the province. 

ihe nurses' associatiim stipports 
the necil to review professional acts, 
but sees this review as the responsibility 
of the Legislative Assembly. Although 
it endorses the \m:c<.\ for priM'essioii;il 
acts to "retlect existing s(K'ial needs," 
it emphasizes that consultation with 
the governing body of each professional 
association is imperative betore any 
revisions are made. 

SRNA supports in principle consum- 
er participation on the governing bodies 
of professional assiK'iations, biu rejects 
consumer participation on professional 
associations' (.liscipluiars committees, 
■■"riiis is the responsibility of the prii- 
fession and members should be entitled 
to a peer review," the association 
says. It also notes in its response that 
there must he a general understanding 
and acceptance of Ihe term "consumer." 

The .SKNA response supports the 
concept t)f consumer and practitii>ner 
participation in determining the pri- 

iCiiiiiininil nil /></•,•'' I >> 

THE CANADIAN NURSE 7 



news 



Saskatchewan Nurses Look To SUN 
For Bright Bargaining Future 

SasKuiiM'i:. Susf.. — Nurses in Sas- 
katchewan have established a province- 
wide unk)n. called the Saskatchev^ an 
Union of Nurses (SLN). for the purpose 
of collective bargaining for nurses, by 
nurses. 

At a meeting last Janu;ir>. X9 nurses 
representing 43 staff nurse associations 
and nurse groups in the province voted 
in favor of setting up the union and 
elected a 1 2-niember board of directors. 
The organizations constitution divide*- 
the province into 7 geographical hospi 
tal regions and one nursing home 
region. 

A staff nurse association pro\ incial 
steering committee was established in 
November 1 973. after the Saskatchewan 
Registered Nurses" Association decided 
against any involvement in collective 
bargaining because of the Supreme 
Court of Canada ruling (News. Decem- 
ber 1973. page 12». 

SLN was set up to represent nurses 
in any health care institution in the 
province. Membership in the union will 
be by affiliation as a chartered, local 
staff association or through direct 
membership. 

The new nurses" union w ill appl) as 
soon as possible to the provincial 
Labor Relations Board for certification 
as the bargaining representative for 
various groups of nurses in Saskatche- 
wan. This represents a change in 
bargaining approach by the nurses. 
Previously, independent bargaining 
groups applied to the Labor Relations 
Board for certification; SLN members 
believe that a central bargaining organi- 
zation, which can be certified as the 
bargaining agent for all groups of 
nurses, will exert more impact at the 
bargaining table. 

SLNs board of directors accepted the 
previous nurses" provincial negotiating 
committee as a committee of the new 
union. This committee has been 
negotiating with the Saskatchewan 
Hospital Association since late No- 
vember 1973 for a new contract for 
hospital nurses. The previous contract 
expired at the end of 1973. 

A! Shalansky. formerly employment 
relations officer for SRNA. is a consul- 
tant to SLN. Mary Parchewsky. Sas- 
katoon. IS the SLN president; Jeari 
Hodgson. Regina. is first vice-presi- 
dent (hospital group); and Geraldine 
Mang. Melville, is second vice-presi- 
dent (nursing home group). 
8 THE CANADIAN NURSE 





CNA Membership 


Continues 


To Grow 




Figures for CN.A 


members 


in 19 


73. 


compared to iy"] and 1972. show an | 


increase of nearl\ 


5,000 in 


the 


past 


vear. CS.\ 


membership, by provincial | 


association, is. 








1971 


1972 


19"3 


.Alberta 








9,754 


10.261 


10.060 


British Columbia 








11,905 


12.530 


13.389 


Manitoba 








5.466 


5,719 


6.007 


.New Brunswick 








3,856 


4.145 


4,339 


Newfoundland 








2,243 


2.204 


2.442 


Nova Scotia 








5,072 


5.273 


5.263 


Ontario 








1 1,579 


11.829 


13.183 


Prince Edward Island 






725 


755 


803 


Quebec 








32.198 


33,391 


35.196 


Saskatchewan 








6,075 


6,253 


6,470 


Total 








^.873 


92.315 


97.152 









Labor Relations Board Approves 
Central Union For Ontario Nurses 

Jcr._,ni,. Oiv. — Trii province-wide 
coUeaive bargaining unit for nurses in 
Ontario was approved b> the Ontario 
Labor Relations Board at a hearing on 
Januarv 14. 1974. 

The Nurses" Association Halton 
County Heahh Unit applied to the 
Labor Relations Board for approval 
to merge with the Ontario Nurses" As- 
sociation (ON A) and became Local 1 
of the new association. The hearing 
before the Labor Relations Board was 
held to prove the status of ONA as an 
appropriate trade union. 

When the ONA was formed in Octob- 
er 1973. representatives of 85 of On- 
tario"s 100 individual collective bar- 
gaining units for nurses indicated a 
desire to merge with a central union. 
(News. Januarv 1974. p. 11). 

The board of the Halton Countv 
Health Unit, employers of the nurses in 
ONA Local 1. introduced no evidence 
opptosing the application when it was 
heard by the Labor Relations Board, 
according to the Registered Nurses" 
Association of Ontario (RN.\0). But 
counsel did cross-examine the associa- 
tion witnesses to make sure that all the 
prof)er procedures for forming a new 
union and for transfer of bargaining 
rights had been observed. 

An RN.AO repon says: "Apparently 
the I Labor Relations] Board w as well 
satisfied with the evidence given. The 
certificate . . . was dated January 
15thl"", one day after the hearing. 



Preparation For Disaster Nursing 
Discussed By Nurses In N.S. 
Halifax. S.S. — Nurses working in 
emergency health services at the fed- 
eral and provincial government levels 
met with faculty representatives of 
schools of nursing in Nova Scotia on 



January 24, 1974, to discuss the prep- 
aration of nurses for a responsible role 
in disaster nursing. The meeting was 
held at the headquaners of the Register- 
ed Nurses" Association of Nova Scotia. 

.\ 1972 Disaster Sursing Study, is- 
sued by Health and Welfare Canada, 
showed that 41.8 percent of teaching 
staff in Nova Scotia schools of nursing 
had received specific preparation in 
disaster nursing; this percentage was 
higher than in any other province. 
Following Nova Scotia was Manitoba, 
with 20.8 percent of nursing faculty 
prepared. In 5 provinces, fewer than 
10 percent of the teaching staff in 
schools of nursing had received such 
preparation. 

F. Lorraine Davies. nursing consul- 
tant to the emergency health services 
division of Health and \\ elfare Canada, 
was invited bv Nova Scotia to partici- 
pate in the one -day seminar. .Ms. Dav ies 
initiated the federal government studv 
on disaster nursing and prepared the 
report on it. 

The Disaster Sursing Study pointed 
to the continuing "need to provide a 
federal course at the Canadian Emer- 
gency Measures College in Amprior. 
[Ontario] . where nurse educators can 
be exposed to the total, broad concept 
of disaster planning in Canada."" 

But this study noted that "the main 
responsibility for emergency health 
planning lies at the provincial level." 
The federal emergency health services 
organization's primarv task "is to ad- 
vise and assist the provinces in meetir^ 
their planning objectives."" 

Christine Steele, nursing officer with 
the Nova Scotia government's emer- 
geiKV health services division and 
one of the participants in the Januarv 
seminar, says she is encouraged by the 
response she is getting from nurses in 
the province, who are recognizing more 
and more that one of their prime res- 
(Conlimied on pufc lOi 
MARCH 1974 



■LEASE REGISTER ME FOR: 

NNUAL MEETING. CANADIAN NURSES ASSOCIATION 

';oa Certennial Centre- \*finrypeg. Mar. June iS-^i lyi 



--.a:;- :■- i:- --i-:;- ;-; 


{-—^■■i-r--.z 


MAMF 


ADDRESS 


>j-«-«Pc» 




'RFSFNT POSITION 


=?EGISTRATION No 


PROV OF RFfi 





CNA 
Sludene 



REGISTRATION FEE 

$i3J» s e -.'-. 

S4500 Si: -yy. 



Spec^ Day IS; 



^er:-" tis CaMaCf YOvdieque or money :r3er:;a/ac«r 

ASSOOATIOH - SO aw Dnvnray ■ Oltnn - Canadi K2f> 1 E2 




.a's Friendl; Peopk Pnmoce 



Welcomes Ton to Winnip^ 
"Heart of tlie CoDtinent" 



I 



news 



Saskatchewan Nurses Look To SUN 
For Bright Bargaining Future 

Saskatoon. Sask. — Nurses in Sas- 
katchewan have established a province- 
wide union, called the Saskatchewan 
Union of Nurses (SUN), for the purpose 
of collective bargaining for nurses, by 
nurses. 

At a meeting last January, 89 nurses 
representing 43 staff nurse associations 
and nurse groups in the province voted 
in favor of setting up the union and 
elected a I 2-member board of directors. 
The organization's constitution divides 
the province into 7 geographical hospi- 
tal regions and one nursing home 
region. 

A staff nurse association provincial 
steering committee was established in 
November 1973, after the Saskatchewan 
Registered Nurses' Association decided 
against any involvement in collective 
bargaining because of the Supreme 
Court of Canada ruling (News, Decem- 
ber 1973, page 12). 

SUN was set up to represent nurses 
in any health care institution in the 
province. Membership in the union will 
be by affiliation as a chartered, local 
staff association or through direct 
membership. 

The new nurses' union will apply as 
soon as possible to the provincial 
Labor Relations Board for certification 
as the bargaining representative for 
various groups of nurses in Saskatche- 
wan. This represents a change in 
bargaining approach by the nurses. 
Previously, independent bargaining 
groups applied to the Labor Relations 
Board for certification; SUN members 
believe that a central bargaining organi- 
zation, which can be certified as the 
bargaining agent for all groups of 
nurses, will exert more impact at the 
bargaining table. 

SUN 's board of directors accepted the 
previous nurses" provincial negotiating 
committee as a committee of the new 
union. This committee has been 
negotiating with the Saskatchewan 
Hospital Association since late No- 
vember 1973 tor a new contract for 
hospital nurses. The previous contract 
expired at the end of 1973. 

Al Shalansky, formerly employment 
relations officer for SRNA, is a consul- 
tant to SUN. Mary Parchewsky, Sas- 
katoon, is the SUN president; Jeari 
Hodgson, Regina, is first vice-presi- 
dent (hospital group); and Geraldine 
Mang, Melville, is second vice-presi- 
dent (nursing home group). 

8 THE CANADIAN NURSE 



Figur 






\ 










1 


incre; 








1 


associ 




- 






Alber 








1 


Britis 








J 


Man it 








New I 








1 

V 


Newfc 








Nova 








Ontar 










Princf 








Quebe 








^ 


Saskat 
















,1 
1 










i 


Labor 










Centra 








f 


Toront 


' 






'l 


COlicCl 

Ontari( 








'j 



Labor Relations Board at a hearing on 
January 14, 1974. 

The Nurses' Association Halton 
County Health Unit applied to the 
Labor Relations Board for approval 
to merge with the Ontario Nurses' As- 
sociation (ONA) and became Local 1 
of the new association. The hearing 
before the Labor Relations Board was 
held to prove the status of ONA as an 
appropriate trade union. 

When the ONA was formed in Octob- 
er 1973, representatives of 85 of On- 
tario's 100 individual collective bar- 
gaining units for nurses indicated a 
desire to merge with a central union. 
(News, January 1974, p. 11). 

The board of the Halton County 
Health Unit, employers of the nurses in 
ONA Local 1, introduced no evidence 
opposing the application when it was 
heard by the Labor Relations Board, 
according to the Registered Nurses' 
Association of Ontario (RNAO). But 
counsel did cross-examine the associa- 
tion witnesses to make sure that all the 
proper procedures for forming a new 
union and for transfer of bargaining 
rights had been observed. 

An RNAO report says: "Apparently 
the [Labor Relations] Board was well 
satisfied with the evidence given. The 
certificate . . . was dated January 
1 5th!", one day after the hearing. 



Preparation For Disaster Nursing 
Discussed By Nurses In N.S. 
Halifax, N.S. — Nurses working in 
emergency health services at the fed- 
eral and provincial government levels 
met with faculty representatives of 
schools of nursing in Nova Scotia on 



A 1972 Disaster Nursing Study, is- 
sued by Health and Welfare Canada, 
showed that 41.8 percent of teaching 
staff in Nova Scotia schools of nursing 
had received specific preparation in 
disaster nursing; this percentage was 
higher than in any other province. 
Following Nova Scotia was Manitoba, 
with 20.8 percent of nursing faculty 
prepared. In 5 provinces, fewer than 
10 percent of the teaching staff in 
schools of nursing had received such 
preparation. 

F. Lorraine Davies, nursing consul- 
tant to the emergency health services 
division of Health and Welfare Canada, 
was invited by Nova Scotia to partici- 
pate in the one-day seminar. Ms. Davies 
initiated the federal government study 
on disaster nursing and prepared the 
report on it. 

The Disaster Nursing Study pointed 
to the continuing "need to provide a 
federal course at the Canadian Emer- 
gency Measures College in Arnprior, 
[Ontario] , where nurse educators can 
be exposed to the total, broad concept 
of disaster planning in Canada." 

But this study noted that "the main 
responsibility for emergency health 
planning lies at the provincial level." 
The federal emergency health services 
organization's primary task "is to ad- 
vise and assist the provinces in meeting 
their planning objectives." 

Christine Steele, nursing officer with 
the Nova Scotia government's emer- 
gency health services division and 
one of the participants in the January 
seminar, says she is encouraged by the 
response she is getting from nurses in 
the province, who are recognizing more 
and more that one of their prime res- 

(Contiiuu'd on ptijic 10) 
MARCH 1974 



Annual Meeting and Convention 
Canadian Nurses' Association 
Manitoba Centennial Centre 
Winnipeg, June 16-21, 1974 




Canada's Friendly People Province 
Welcomes You to Winnipeg 
"Heart of the Continent" 





news 



MONT SUTTON commands the highest peak 
within a radius of 100. miles of Montreal. 
20 miles of trails and slopes, 6 modern 
lifts, ski school, ski shop and full range 
of facilities, great snow and superior 
grooming! 

Mid-Week Special 

SUTTON 5 

Lift tickets and Ski Lessons $43.00 

a) 5 consecutive days (Monday to Friday) 
with 4 hours of ski lessons per day. 

b) 5 days to be enjoyed at will over a 
period of your choice, with 2 hours of ski 
lessons per day. 

Lift tickets only $24.00 

a) 5 consecutive days (Monday to Friday). 

b) 5 days of skiing to be enjoyed at will 
over a period of your choice. 

Also ... a special BONUS. 

Buy your regular mid-week day ticket any- 
time after 12:00 noon and you automa- 
tically receive another full-day mid-week 
ticket . . . FREE, usable anytime, except on 
holidays and week-ends. 

We invite you to ski with us this season. 
MONT SUnON INC. Sutton, Quebec 
Tel.: (snow reports) . . . (514)866-7639 

(514)866-7718 

Accommodation (514) 538-2646 

Office (514)866-5156 

(514)538-2545 



(Continued from pane H) 

ponsibilities is to accept a leadership 

role in emergencies. 

"Nurses are telling me that they 
want to do their part, not only as profes- 
sionals but as good citizens, in prepar- 
ing themselves for emergencies [and ] 
in participating in the campaigns to 
cut down accident rates and upgrade 
ambulance services. They feel that 
special first-aid courses should be 
included in the curricula of all schools 
of nursing," says Ms. Steele. 



Nursing Home Strike Averted, 
Nurses Gain Wage Increases 

Winnipeg, Man. — "A threatened with- 
drawal of service has served its intend- 
ed purpose," announced the Manitoba 
provincial staff nurses" council when a 
collective agreement was reached be- 
tween the Convalescent Home register- 
ed nurses" association and the Convales- 
cent Home of Winnipeg. If the 6 nurses 
employed at the 84-bed nursing home 
had gone on strike, it would have been 
Manitoba"s first strike by registered 
nurses. 

The collective agreement, which 
covers a 19-month period from Decem- 
ber 1, 1973 to June 30, 1975, provides 
for 3 salary increases. The increases 
raise the starting salary by $80 a month 
and the top of the salary scale by $220 
a month during the life of the agree- 
ment. This provides a starting salary 
$15 below the rates for hospital head 
nurses. 

The number of increments is increas- 
ed by the new agreement from 1 to 4 
on December 1. 1973, and a fifth in- 
crement is added on January 1, 1975. 
In addition, each nurse will receive a 
lump sum payment of up to $250 to 
compensate for the period in 1973 that 
was not covered by the agreement. 

The collective bargaining unit at 
the Convalescent Home was formed in 
March 1973 and certified by the Man- 
itoba Labor Board on May 10, 1973. 
Although negotiations began in May, 
the employer did not make a salary 
offer until early October. A concilia- 
tion officer was appointed in Novem- 
ber. 

The 6 nurses, 2 of whom work full- 
time and 4 part-time, earned $620 to 
$629 a month on the previous wage 
scale. Residents of the nursing home 
include 56 persons classified as ex- 
tended care patients and only 28 who 
are personal care patients. A nurse 
works alone on each shift, as the only 



registered nurse on duty in the Con- 
valescent Home, except for the matron 
of the home. 

The Convalescent Home of Winni- 
peg is a nonprofit organization control- 
led by a board of 20 women. It is the 
oldest personal care home in Manitoba, 
established in 1883, according to a 
Winnipeg newspaper. 



Six Nurses' Associations )oin 
Commonwealth Nurses Federation 

Ottawa — Six national nursing asso- 
ciations were admitted to membership 
in the Commonwealth Nurses Federa- 
tion at a meeting of the federation"s 
interim board, held in Lagon, Ghana, 
in January 1974. The new members re- 
present nurses in Bangladesh, Com- 
monwealth of the Bahamas, India, 
Lesotho, St. Kitts-Nevis-Anguilla, and 
Tanzania. 

Two other groups of nurses, from 
the Grand Cayman Islands and from 
the Turks and Caicos Islands, were 
admitted to affiliate membership in 
the federation. Meetings of the interim 
board of directors coincided with the 
first African regional seminar sponsor- 
ed by the Commonwealth Nurses Fede- 
ration, which was held at the Univer- 
sity of Ghana, January 2 to 8, 1974. 

Helen K. Mussallem, executive di- 
rector of the Canadian Nurses" Asso- 
ciation, was the only representative of a 
non-African country invited to partici- 
pate in the seminar. Dr. Mussallem 
spoke to seminar delegates about the 
Canadian health field concept and its 
implications for nursing education. 

The seminar was on the general topic 
of "Educating Nurses for Community 
Health Services."' It was planned by the 
host association, the Ghana Registered 
Nurses" Association, and the Nigerian 
Nurses" Association, with the help of a 
temporary adviser from the World 
Health Organization. More than 40 
senior nurses, who are employed in 
nursing education and service, attended 
the seminar; they came from 1 6 African 
countries. 

A federation of nursing associations 
in Commonwealth countries was first 
considered in June 1969, when repre- 
sentatives of 33 Commonwealth coun- 
tries met in Montreal during the con- 
gress of the International Council of 
Nurses (ICN). The group appointed an 
ad hoc committee, with members trom 
six regions of the Commonwealth, to 
look into the possibility of forming a 
Commonwealth organization of nurses. 
CNA executive director Dr. Mussallem 
was a member of the ad hoc committee, 
representing the Atlantic region, which 
includes the Caribbean countries and 
Canada. 

The ad hoc committee reported at 

(Continneil on inii;e 12) 

44 A Dr-U 1 QT/1 



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LOOK FOR t H IS NEW LINE AT 
BETTER STOR|S ACROSS CANADA 



Next Month 
in 



The 

Canadian 
Nurse 



news 



• CNA Annual Meeting 
and Convention Highlights 



• Nurses "Break the Ice" 
on the Sir John A. Macdonakl 



Parents Make the Decisions 




^^^ 



Photo Credits 
for March 1974 



Manitoba Centennial Centre, 
Winnipeg, p. 7 

Miller Services Ltd., 
Toronto, pp. 19,21,23 

Jan O'Brien, photographer, and 
Whitchorsc Star. Whitehorsc. 
Yukon, pp. 28-29 

Israel Intormation Service, 
Jerusalem, p. .^2 

Margaret M. Street and 

Vancouver General Hospital, 
p. 44 



■ '% -Y-LJi: /-AKIArklAI^I Ikll IDCC 



{Conliniic'd from pa^c 10) 
a meeting of Commonwealth nurses" as- 
sociations, held in July 1971 in Lon- 
don, England, that 23 national associa- 
tions, including the CNA, had voted 
in favor of establishing the federation. 
A constitution was accepted and the 
federation formed, subject to financial 
grants. 

The Commonwealth Foundation gave 
an unusually large grant, the equivalent 
of $36,000 per year for three years, 
to help nurses form the Commonwealth 
Nurses Federation. 

Members of the ad hoc committee, 
formed in 1969, have served until the 
present as the interim board of the 
federation. Election of the first regular 
board of directors has been carried out 
in recent months; ballots were mailed 
to nonnurse scrutineers in England by 
February 15, 1974. A board member 
is to be elected from each of six geo- 
graphic regions; East and Central 
Africa; West Africa; Atlantic; Austra- 
lasia, the Far East, and Pacific; South 
Asia; and Europe. 

The CNA board nominated Dr. Mus- 
sallem to represent the Atlantic region 
on the new federation board. The re- 
presentative of each region is to be 
elected by the associations in the region. 

Commenting on the relationship be- 
tween the International Council of 
Nurses and the Commonwealth Federa- 



Happy Birthday, Dear Winnipeg 



.^1874^ 



w 



The 1974 annual meeting and con- 
vention of the Canadian Nurses" 
Association will be held in Winnipeg 
during the city"s centennial year 
Nurses from across the country wil 
gather to deliberate, debate, and 
participate on June 16 to 21. Will 
you blow in to help blow out the 
candles on Winnipeg"s birthday 



tion of Nurses, Dr. Mussallem told The 
Canadian Nurse: "There is no formal 
relationship but there is continuing 
liaison. ICN is kept informed of action 
taken by the federation and plans are 
being made to have ICN representation 
at future meetings of the federation 
board. The two international groups do 
not compete; the Commonwealth Fede- 
ration is able to do things for developing 
countries, such as assisting with the 
recent seminar for the two federation 
regions in Africa. 

"We are now planning not only 
collaboration with other nursing bodies 
but to invite other Commonwealth 
professional federations to participate 
in regional meetings."" 



Ontario CAAT Regents Set 
Nursing Program Standards 

Toronto. Ont. — Standards for nurs- 
ing education programs in Ontario 
are now set by the council of regents, 
govern! ng body of all colleges of appl ied 
arts and technology (CAAT), because 
diploma nursing education has been 
transferred from hospital, regional, and 
independent schools of nursing to com- 
munity college programs. 

Joan Macdonald, executive director 
of the College of Nurses of Ontario 
(C NO), told the directors of the Regis- 
tered Nurses" Association of Ontario 
(RNAO) that the community college 
regents are "committed to ensuring 
that the nursing programs maintain a 
standard which is at least as good as 
in the past or even better."" The College 
of Nurses was responsible for determin- 
ing standards for diploma and degree 
nursing education programs before 
Septeniber 1973 when the diploma 
programs shifted from the ministry of 
heakh to the ministry of education. 
(News, March 1973. page 14.) 

The council of regents agreed, Ms. 
Macdonald said, to accept the standards 
proposed by the College of Nurses, as 
a basis for program approval. The 
council of regents asked the CNO in- 
spectors to continue assessing nursing 
programs for a 3-year period, to ensure 
the maintenance of program quality. 
This arrangement will be reassessed in 
2 years. 

A provincial advisory committee on 
nursing, to make recommendations to 
the council of regents regarding initial 
and continuing approval o\' diploma 
nursing and nursing assistant programs 
in CAAT, has been established. Repre- 
sentation on the advisory committee 
includes 5 CNO members nominated 
by the council of the CNO; 1 member 
each nominated by RNAO, the Ontario 
Association of Registered Nursing As- 
sistants, the ministry of health, ministry 
(Contiiiin'd on pii^c 15) 
MARCH 1974 



Pampas 




ives 



you both 
abieak 



^eepvS 
lim drier 

Instead of holding 
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allows it to pass 
through and get _— 

"trapped" in the 
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sheet stays drier, and 
baby's bottom stays 
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cloth diapers. 




SaVCvS 

you time 

Pampers construction 
helps prevent moisture 
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result of this superior 
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conventional cloth 
diapers. And when less 
time is spent changing 
linens, those who take 
care of babies have 
more time to spend on 
other tasks. 



PROCTER k GAM8d 



IVc^P^n^V^r 



Reeves Name Pins . . . finest 
quality, smartest styling. 
with safety clasps. New 
optional Duotone finish with 
contrasting satin background 
and polished edges for a 
distinctive flair. 



/Utm 7^ 1^ flcHo^...^ 



VMl 



Mrs. R. F. JOHNSON 

SUPERVISOR 



)^ 



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 2Vz"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. . . . 37.95 ea, 



CAP ACCESSORIES 




uty 
free 




CAP TOTE keeps your caps crisp and clean . ^ ^ . 

while stored or carried. Flexible clear plastic, white "■* , 

trim, zipper, carrying strap, hang loop. Stores fiat. Also , --"^ * 
for wiglets, curlers, etc. 8V2" 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 2.25, 
6for65( ea., 12foreo«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 C"f~-- 

(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 Pair of dainty 

jewelry-quality Tacs with grippers, holds cap 

n tf-^rs^ B bands securely. Sculptured metal, gold finish, 

niSlJ] ^approx. ^" wide. Choose RN, LPN, LVN, RN 

*— *^«W -iiS^^ Caducetis or Plain Caduceus. Gift boxed. 

■K^ No. CT-1 {Specify Initials). No. CT-2 (Plain 
**^Cad.) or No. CT-3 (RN Cad.) . . . 2.95 pr. 

SEL-FIX CAP BAND Slackvelvet 
band material. Self-adhesive, presses on, 
pulls off; no sewing, or pinning. Reusable 
several times. Each band 20" long, pre-cut to 
popular widths: Vi" (12 per plastic box) Vz" 
(8 per box) W (6 per box) 1" (6 per bbx). 
Specify width under ITEM column on coupon. 
No. 6343 Band. . .1.75 per box 3 or more 



.T 





CROSS PEN ^ „ JlrtAl^X^^ 

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 12kt. G.F. 



TO: REEVES COMPANY, Box C . Attieboro. Mass 02703 




Use extra sheet for additional items ororders- 
INITIALS as desired: 



TO ORDER NAME PINS, fill out all information in box, top 
right, clip out and attach to this coupon. 



1 No COD'S or billing to individuals. 

I enclose $ I Mass- residents add 3% S. T. 

Billing terms available to institutions only: $1, service charge 
added on all orders billed at $10, or less. 



Send to . 
Street .. 



IT'S EASY TO ORDER REEVES NAME PINS FOR YOURSELF OR FRIENDS ! 

Choose style you want, shown left. Print name (and 2nd 
line if desired) on dotted lines below. Check other info in 
boxes on chart, clip this section and attach to coupon 



bottom left. Attach extra sheet (or additional pins, 
NOTE SAVINGS ON 2 IDENTICAL PINS . , . more convenient, 
spare in case of loss. 



LETTERING: 2nd LINE: 

BACKGROUND 



Plastic I 
Uminate | 169 
No. 559 ■ 



ALL METAL.,, rich, trim and 
tailored. Lightweight, smooth 
edges, rounded corners. 



PLASTIC LAMINATE . . slimmer, 
i broader: engraved thru surface to 
I contrasting core color. Beveled 
' border matches fettering. 



■ METAL FRAMED. -Classic 
f design; snow-white plastic with 
' smooth, polished beveled frame 



L MOLDED PLASTIC . .Simple, smart, 
§ economical. Will never discolor, 

ooth founded rcrnprs snd edges. 



METAL 
i:OLOII 



□ Gold 
D Silver 



D Gold 
a Silver 



METAL 
FINISH 



Q Duotone 
□ Polished 
O Satin 



Polished 
frame 
only 



COLOd 
tPUstic) 



Does 
not 
apply 



DWhite 

□ Med- Green] 

□ Med. Blue 

□ Cocoa 



'J*l 



White 
only 



White 
only 



UnERING 
COLOi) 



□ Black 

□ Dk, Blue 

□ White 



□ Black 

□ Dk. Blue 
^White 

Letters only 



□ Black 

□ Dk. Blue 



D Black 
□ Dk. Blue 



PRICES* 
bipviti t Lim EniMvtd 2 lines 



G I Pin 2.25 
C 2 Pins 3.75 



D 1 P'n -95 
D 2 Pins 1.65 



C, 1 Pin 2.25 

D 2 Pins 3.75 

(wme name) 



n 1 Pin .95 
Q 2 Pins 1.65 



: 1 Pin 3.00 

: 2 Pins 4.95 

(same name] 



D 1 Pin 1.55 
D 2 Pins 2.60 



C 1 Pin 3.00 
C 2 Pins 4.95 



D 1 Pin 1.55 
n 2 Pins 2.60 



'Please add 25t per order for 3 pins or less. 



QUANTITY DISCOUNTS: 10-24 pins, deduct 10%; 
25-99 pins, 15%; 100 or more pins, 20%. 



3=£: 



I I I 



■ ■ ■ ■ ' ^ 



MEDI-CARD SET Handiest reference 
ever! 6 smooth plastic cards OVs" x 5W) cram- (^YyA^ 
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. 
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 handy for 
every nurse! 5Vi" stainless steel, fully 
guaranteed. Ideal for clamping off tubing. Your 
own initials help prevent loss. 
No. 2&-72 Forceps . . . 2.75 ea. 6 or more 2.50 ea. 
Your Initials enpaved, add 50* per forceps. 




Free Initials and Scope Sack 
with your own 

Littmann Nurmcope! 

Famous Littmann nurses' 
diaphragm stethoscope , . , 
a fine precision instrument, 
with high sensitivity for 
blood pressures, apical pulse 
rate. Only 2 ozs., fits in 
pocket, with gray vinyl anti- 
collapse tubing, non-chilling 
epoxy diaphragm. 28" over- 
all. Non-rotating angled ear 
tubes and chest piece beau- 
tifully styled in choice of'5 
jewel-like colors: Goldtone, 
Silvertone, Blue, Green, Pink.* 

FREE INITIALS AND SACK! 

Your initials engraved FREE 
on chest piece; lend individ- 
ual distinction and help pre- 
vent loss. Also FREE SCOPE 
SACK included, worth $1. 
(Free sacks not personal- 
ized; add 5li( if initials de- 
sired.) Note big savings on 

quantity orders. 

No. 216 Nursescope . . . 13.80 ea. ppd. 
6-11 ... 12.80 ea. 12 or more ... 11.80 ea. ^ 

Group Discounts include free Initials and SacK!.^ 
"IMPORTANT: New "Medallion" styling includes tubing in> 
colors to match metal parts. If desired, add $1. ea. to^ 
prices above; add "M" to Order (No. 216M) on coupon. Q 
No. 223 Scope Sack only . . . 1.00 ea. ppd. 
ft or mnrp 7^if RA. Rnid ^tamoed initials, add 50£ 




. . ■ ■ . 1 ■ ■ 1 ■ ■ 1 1 I 1 ■ ■ i-i- 



KFJin^Tipl*! Precision-made imported forged steel. 
KiSiLSLJiSM Professional quality. Guaranteed 2 years. 

3V2" LISTER MINI-SCISSORS 

Tmy, handy, slip into uniform pocket or 
purse Choose jewelers Gold or gleaming 
Chrome ptate hnish on coupon 
No. 3500 Mini-Scissors . . . 2.75 ea. 
4V2" or 5V2" LISTER SCISSORS 

As above, but larger (or bigger jobs. Chrome finish only 
No. 4500 i4Vi") or Ho. 5500 (SVj") Scissors , . . 2.75 

5V2" OPERATING SCISSORS 

Stainless steel, with sharp/blunt 
points. Beautifully polished finish. 
No. 705 OR Scissors . , . 2.75 ea. 
All scissors above: I do;, or more (any style) . . . 2.00 ea. 
Your initials engraved, add 50c per scissors 





CLAYTON DUAL STETHOSCOPE ughi 

weight imported dual scope; highest sensitivity for apica]_„. 

pulse rate. Chromed head tubes and chest piece with j 

P's" bell and H/s" diaphragm, grey anti-collapse 

tubing. 4 oz„ 29" long. Extra ear plugs and f (^DT 

diaphragm included. Two initials engraved free, I V^-> Q^ty I 

No. 413 Dual Steth 17.95 ea. ^^^— .•^ree 



mrnr 




t\ 



NURSES CHARMS ^, ^^ 

Finest sculptured Fisher charms, ''^Sp^ "^W^b* 
Sterling or Gold Filled (specify under COLOR on coupon), '-s ^1 

For bracelet or pendant ctiain. Add to your collection! '/, ^% 

No. 263 Caduceus; No. 164 Cap; No. 68 A^ 

Grad. Hat; No. 8. Band. Scissors . . 3.49 ea. ^^ 

UK PIERCED EARRINGS^ 

* Dainty, detailed 14K Gold caduceus. for on or off duty 
^ wear. Shown actual size. Gift boxed for friends, too. 
f 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 Pin Guard .... 2.95 ea 




® 



ENAMELED PINS Beautifully sculptured status 
insignia, 2-color keyed, tiard-fired enamel on gold plate 
Dime-sized, pin-back Specify m. LF*. PN. LVN, NA, or 
RPh, on coupon. 
No. 205 Enam. Pin 1.95 ea., 12 or more l.SO ea. 



POCKET SAVERS 




EndUra NURSE'S WATCH Fine Swiss made 
waterproof timepiece. Raised easy-to-read white numerals 
and hands on blach dial, luminous markings. Red sweep- 
second hand. Chrome finish, stainless back. Includes 
black velvet strap. Gift-boxed, with 1 year guarantee. 
Very dependable. Includes 3 initials engraved FREE! 
,No. 1093 Nurses Watcfi 19.95 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 tor 1.50, 25 or more 20< ea. 

No. 791 (left) Deluxe Saver. 3 compt, , / ( 

change pocket & key chain . . . w_i._^^ j 
6 lor 2.98. 25 or more 35# ea. 

Nurses' POCKET PAL KIT 

Handiest for busy nurses. Includes white Deluxe 
Pocket Saver, with 5" Bandage Shear (both shown 
opposite page). Tri-Color ball-point pen, plus 
handsome little pen light ... all silver finished. 
Change compartment, key chain- 
No. 291 Pal Kit 4.95 ea. 

3 Initials engraved on sfiears, add 50< per kit. 



BZZZ MEMO-TIMER Time hot packs, heal ,,, 

lamps, park meters. Remember to check vital si^ns Sk- 
give medication, etc. Lightweight, compact l\W dia,), 
sets to buzz 5 to 60 min. Key ling. Swiss made- 
No. M-22 Timer 4.95 ea. 

3 or more 3.95 ea.; 6 or more 3.50 ea. 




EXAMINING PENLIGHT 

White barrel with caduceus imprint, aluminum 
band and clip, 5 " long, U.S. made, batteries included (re- 
"placemenl batteries available any store). Your own light, gift boxed 
No. 007 Penlight . . . 3.98 ea. Your Initials engraved, add 50* per tight. 




Whittenton -. . 

Unilpm MMonl 




REEVA 

Young ffesh multi-tuck bib. 2- 
Dutton cuft Gusset ^4 sleeves 
100% Dacfon Double-Knit 
STYLE No. 4697 
6-20.4-16 Petite... 22. 95 
14'/,-26'/2 . . . 24.95 

75% Dacron, 25% Cotton 
STYLE No. 4797 
6-20, 4-16 Petite . . 16.95 
14'/;-26V2 . . . 17.95 



MISS FIVE^ 

Unique smock style with a \\\\\f 
girl look Generous patch pock 
ets, inner surgical pockpt 
Short sleeves, 100% Dacmn 
Double Knit 
STYLE No. 4632 

3/4-15/16... 21.95 






IGIBSON GIRL 

Youthful tiigti-fise waist, mini 

soft sfiirred skirt, pleated 

blouse Inner surgical pocket 

100% Polyester Warp Knit V4 

sleeves, 

STYLE No. 4624 

3/4-15/16... 18.95 
60% Dacron. 40% Nylon cord 
lersey, short sleeves 
STYLE No. 4*24 

3/4-15/16... 15.95 



Famous 

NXJR-SE 
]VIATES' 

New "Saucy" Bump Toe Moc 

Little fashion notches run around sole and 

heel; latest bumper-toe look with 

big bold eyelets; sturdy extra-light 

cushion crepe sole and heel; finest 

long-wearing white glove leather 

the ideal shoe to feel pretty 

in uniform Fit guaranteed 

or return (unmarred) 

for Size exchange 

No. 854 Saucy Shoe 

. . . 16.95 pr. 

New TCorknJtes Featherweight Style 

Extremely lightweight . . with the new 
"bottom" look. Smart comlortable lace- 
up heel oJtfofd. Thick sim cork sole 
with 1 i/e" cork heel (very slip-resistant 
outwears crepe). White washable 
soft glove upper leattier, tricot 
lined, arch vents Fit guaran 
teed or return (unmarred) 
for sire exchange 

No. 638 Kork-Lite Shoe 
■ ■ ■ 16.95 pr. 

Alt-Weather NURSES' CAPE 

Stay snug in cool weather, dry m the ram 
Traditional Navy with Bright Red lining 
Finest tailoring of 65% Dacron polyester 
35% combed cotton, Zepel treated 100% 
Nylon Ouralyn lining Snap fasteners arm 
openings. Matching head scarf. SMALL lup to 
34 bust), MEDIUM (35-38.) or LARGE (39-42) i 
specify size on coupon. 

No, 658 Cape 14.95 e 

3 Gold Initials on collar, add l.QQ per cape. 

(QA^ NURSES BAG A lifetime of service I 
for visiting nurses! Finest black W thick I 
genuine cowhide, beautifully crafted with I 
rugged stitched and rivet construction. I 
Water repellant. Roomy interior, with snap- 1 
in washable liner and compartments to I 
organize contents Snap strap holds top I 
open during use Name card holder on ena I 
Two fugged carrying straps 6" x 8" x 12". I 
Youf initials gold embossed FREE on top. An I 
outstanding value of superb quality. 

No. 1544-1 Bag (with liner). . 37.95 ea. 

Extra liner No. 4415 6.95 ea. 





news 



iCitnliniiCil friiiw piiu'c 12) 

(it education. Ontarui Hospital Asso- 
ciation. Ontario Medical Association. 
at the ( ,'\,A I council t)l presidents. 

The Ontario Nurses' Act regulating 
schools ot nursing was considered by 
the government to be inapplicable 
since, in its interpretation, there are 
no diploma schools oi' nursing now but 
rather nursing programs in colleges ol' 
applied arts and technology. 

The College of Nurses of Ontario 
continues to have responsibility tor 
setting standards for admission to the 
profession. The CAA T council of regents 
requires assurance in writing froni the 
College of Nurses that graduates of 
CAAr nursing programs will be eligible 
for recognition by the CNO as the regis- 
tering bod\. before programs are ap- 
proved. 

I, aura Biirr. executive director of 
RNAO, told The Caiuuliiiii Nurse: "The 
RN.AO must reassess its role in nursing 
education. We have established a task 
force to look at the RNAO role and to 
have a statement ready for the annual 
meeting in May. 

""The RNAO needs to reassert itself."" 
Ms. Barr said. "A stronger professional 
association is absolutely essential. We 
must establish principles on which 
nurse-teachers can stand. The RNAO 
will be the watchdog tor its members." 



.SW,V,-l rcit( l\ . . . Ii ii/iliiiiitil JiDin ptii:c 7) 

oriiies in health services and in the 
health system at all levels. It also 
strongly supports the Mel. cod report 
regarding the need to represent the 
disadvantaged as well as the aftluent 
and middle-class consumer on health 
advisory and planning bodies. 

.SKNA docs not agree with the propos- 
ed ratio (one-third physicians, one- 
third allied health personnel, one-third 
laymen) for a health council to advise 
the minister of health. Instead, the asso- 
ciation recommends that the health 
practitioner component be distributed 
in relation to the population within the 
health professions. As the largest 
group of health practitioners in "the 
province. .SKNA believes it must have 
signiticani representation. 

SKNA supports in principle the re- 
port's recomntendation that community 
liealth and stK'ial centers, as recom- 
mended by the Hastings Report, be es- 
tablished, providing the centers in- 
corporate a significant com[Xincnt ol 
preventive health services. It says it 
must be involved in developing the 



nurse's role in such centers. (News, 
February 1974, page 7). 

The ass(x:iation endorses the recom- 
mendatitin that a regional health sys- 
tem be developed in the province as 
long as it emphasizes the administra- 
tion and provision of coordinated health 
services. F-Apanding such a system to 
include other services, such as social 
services, education, and agriculture, 
should be decided through a vote by 
the population in each region, says 

SRNA 

Pill's Potential Not Achieved 
Says Developer Of Contraceptive 

Clildii'o, III. — The pill has not achiev- 
ed its potential in the 22 years it has 
been used, says Carl DJerassi, Ph.D., 
the man who synthesized the first oral 
contraceptive. 

Dr. DJerassi says that "hypercau- 
tion" on the part of federal authorities 
has slammed the dixir shut on the in- 
troduction of new birth control methods, 
according to the January 1974 issue of 
Prism, published by the American 
Medical Association' "To me," Dr. 
DJerassi said, "the pill was only a 
beginning — a very imperfect begin- 
ning."" He expected it would lead to 
other, better methtxis. 

He finds that U.S. federal authorities, 
responding to pressure from legislators 
and "sensational press cover;ige" of the 
pill, have imposed '"unwarranted hy- 
percautiim" on consideration of any 
new birth control method. He said, 
"the amount of practical clinical re- 
search in reproductive biologv now 
being done by the industry or in the 
universities has gone down, and spec- 
tacular advances are no longer in the 
cards." 

According to Dr. Djerassi. aecept- 
ance ot the pill by almost every religious 
and ethnic griiup means that ■"women 
have come into control of their fertility 
and have been able to make a decision 
that previously had been left to men 
or chance. Nothing has had a bigger 
impact on the emancipation of women 
and on the fostering and stimulation of 
women's rights." 

In his view, the pill is not the ulti- 
mate answer to the world's rapid popu- 
lation growth. The development of a 
once-a-month, menses-inducing abor- 
tifacient pill is foreseen by Dr. DJerassi. 
A pill of this kind would be ""the most 
useful contraceptive and something that 
would, by no means, take as long to 
develop as an immunological contra- 
ceptive." 

The ultimate concept would be the 
ability to switch on and olf a woman's 
tertility. safely and conveniently, rather 
than negating nature during the mens- 
trual cycle. But Dr. Djerassi doesn't 
think such .1 technii|ue will be develop- 
ed in less than 2.'i vears. 

THE CANADIAN NURSE 15 




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16 THE CANADIAN NURSE MARCH 1974 



A death at home 



The diagnosis of amyotrophic lateral sclerosis could have been a death 
sentence; but the three years of decline became a family affair, even to the 
final hour of life. 



Dawn McNeil 



MARCH 1974 



Amyotrophic lateral sclerosis was a 
disease I had never heard about before, 
yet I knew that very quickly it would 
be affecting our lives as the doctor told 
my father. "There is no known cause; 
there is no cure." My father was a strong 
man who enjoyed life to its fullest, but 
this disease was something in life wc 
were finding hard to comprehend. 

Tears filled father's eyes as he sat 
across from me in our car one cold 
October day almo.st four years ago. It 
was difficult to tell me he was ill. but it 
was even more difficult to tell me he 
was dying. I had had no idea previously 
of anything seriously wrong, as I was 
beginning a new life for myself away 
from home at university. This was go- 
ing to be my first encounter with death. 
I was shocked and frightened. 

For several years my father had 
noticed a weakness in his left arm and 
that he was beginning to drop things. 
He did not pay much attention to these 
early symptoms until he suffered a fall 
off a ladder early in 1^)6^. which in- 
creased the difficulty with his left arm. 
The doctors thought there could be an 
impacted vertebra in the neck causing 
pressure on the arm. but they were also 
concerned that there might be some 
other influencing condition. 

A scries of x-rays and tests were 
conducted in the fall of 19()9 to tiy 
to establish the diagnosis. Electrical 
analysis of the muscles of the left arm 



showed a marked deviation from the 
normal wavy line, which caused the 
doctors a considerable amount of ex- 
citement and concern. 

It was two weeks of anxious waiting 
before my parents were told. The dtxrtor 
was 90 percent sure of the diagnosis, 
but wished to do some further tests to 
eliminate the possibility of a brain 
tumor or a spinal lesion. 

After further consultation, father 
was told that he had a form of progres- 
sive muscular atrophy. 

The doctor was most gracious and 
kind. He explained that the condition 
was quite rare — a disease that is com- 
mon in one or two islands in the mid- 
Pacific, but rather uncommon in North 
America. It usually occurs in males 
over the age of 40, with normal life 
expectancy after diagnosis of two to 
three years. 

AKIHK IHK 01 IHI ()( the initial 
shock, my parents spent some time 
together discussing what they might 
kH)k forward to and searching for in- 
formation in the Merck Medical Man- 
ual about the prognosis of the disease 
and the different things we would have 
to cimtend with. 



(he author, currcnily in Europe, obtained 
her B.-Sc.N. degree from the University of 
.S;iskiilchcwiiii in M;iv. l')7V 



THE CANADIAN NURSE 1 7 



Looking ahead was terrifying, but 
we ail soon learned tliat any problem 
loses much of its magnitude when it 
is faced one day at a time. Throughout 
the course of the illness. I marvelled 
at my father's continued determination 
and joy of living as his physical strength 
deteriorated with each week and mtinth 
that passed. 

The normal process in amyotrophic 
lateral sclerosis is that nerves in the 
central spinal system that control the 
skeletal muscles are damaged. These 
nerves die. and all impulses to the 
muscles are cut off. As a result, the 
muscles gradually waste away, begin- 
ning with the small, finer muscles. 

The wasting began in my father's 
left hand and arm and quickly spread 
to his right hand and arm. The wasting 
ol" the muscles is accompanied or pre- 
ceded by a fasciculation of the muscle. 
Soon my father could no longer hold on 
to objects, button or unbutton his 
clothes, or turn knobs on the radio or 
television. 

Wasting continued thriuigh his arms 
and shoulders, and then proceeded 
downward to the muscles of his legs, 
again with the finer muscles wasting 
away first. He was having difficulty in 
maintaining balance when walking and 
soon began tripping and falling, as his 
feet tended to drag with each step. 
When we first got a wheelchair, it was 
difficult to accept, but father had al- 
ready suffered .^0 to 40 I'alls. some 
more severe than others. 

AS A FAMILY. WE REAI.IZHD we had 
. two choices: we could squander 
the time we had left together feeling 
sorry for ourselves, or we could cherish 
it. We decided we weren't going to 
waste any time. Although it was most 
difficult at times, something wonder- 
ful happened to the relationship within 
OUT family. We laughed more and had 
a rich and deep fellowship together — 
more sharing and doing things together. 
My father helped us realize that 
much of the fun of life is lost when 
people are driven by desire for material 
things. The material values that used 
18 THE CANADIAN NURSE 



to mean so much became less important 
to us. as people became more and more 
so. With this came increasingly open 
free communication within our family 
and with friends. We realized that so 
much around us is beautiful and won- 
derful — even a drive around the park 
became something special. My father 
wanted to take in as much as possible 
before he had to leave it all. 

Wc spent a great deal of time to- 
gether as a family discussing the future. 
We did not play games or pretend 
that things would be different from 
what they really were. Father believed 
it is every man's responsibility to pre- 
pare his wife for widowhood. One ad- 
vantage of a terminal disease over 
sudden death is the time it gave us h) 
discuss, plan, and prepare for the 
future. We talked about life, and we 
talked about serious illness and the 
eventuality ol' death. 

We tried to help one another face 
the situation realistically without fear. 
My father had no fear of death through- 
out his illness, as he felt that things 
were in good control and that God 
would prepare him to meet whatever 
was ahead. 

We were continual!) amazed by 
father's sense of humor. He seemed to 
reach states of euphoria where things 
would strike him as highly amusing. 
This is an interesting aspect of the 
disease, as he became supersensitive 
to certain emotions, particularly to 
certain sensory reactions. He did not 
have any particular periods of depres- 
sion, but would quickly become dis- 
couraged if something was bothering 
any one of the family. 

AS IHK DISEASE PROGRESSED, the 
muscles in father's neck gradually 
became quite seriously affected. This 
meant verbal communication was 
soon to be eliminated. It was difficult 
when he finally reached this point. As 
long as we could talk together, things 
didn't seem too bad. 

We were able to work out a form 
of communication by spelling out words 
while father was able to blink his eyes 



and move his eyebrows to indicate the 
letters he wanted. This got to be frus- 
trating at times when father was trying 
to tell us something and we couldn't 
understand: but we had to communi- 
cate. 

Sitting in a wheelchair presented 
additional problems as father was not 
able to support his own head due to the 
weakened neck muscles. My brothers 
and an occupational therapist from a 
local hospital worked together to de- 
sign a head support with a system of 
pulleys. This allowed father a good 
range of motion of his head and neck. 
yet gave the support he needed for sit- 
ting up. He was then able to be up for 
long periotis and to read with the help 
of an electric paper turner. 

Eating and drinking became more 
difficult with each meal, and we lived 
daily with the fear of having father 
choke to death. By January 1972 he 
was very thin and hungry, weighing 
only 90 of his original 155 pounds. We 
decided, with the doctors, to have a 
gastrostomy done. The operation was 
performed under a local anesthetic, as 
the risk otherwise was too great with his 
decreased respiratory function. Follow- 
ing the operation, my father no longer 
had anything to cat by mouth, which 
eliminated all the strain and stress of 
choking. 

We talked about a tracheotomy and 
the possibility of an artificial respirator, 
but we felt we should do only what 
would make life easier without unduly 
prolonging it. This was father's deci- 
sion as well as that of the rest of the 
family. 

WE WERE FORTUNATE as a fam- 
ily to be able to keep our father 
at home throughout the course of his 
illness. He was put on a paraplegic 
program, through one of the hospitals 
in the city, which provided us with any 
equipment we needed — electric page- 
turner, hospital bed, wheelchair. Hover 
hydraulic lift and swing, raised toilet 
seat, and portable oxygen equipment. 
A doctor loaned us an electric suction 
from his office. 

MARCH 1974 



W'c coiivcrtod our livingroom \ulo 
lather's bedrcHMii. This allowed him to 
bo a part ot tlio activities ot the house- 
hold. 

They were three dit'ficult years, but 
also very rewarding. There were times 
of discouragement, even times of 
resentment; there was pain: and there 
were long nights of sitting by father's 
side as he struggled with the last few 
days and httius of his life. 

He died peacefully in August. 1972. 
There was no struggle but, rather, a 
peaceful surrender to a long battle. 
My mother and I sat by his side hold- 
ing his hand, and I sensed that he felt 
our presence. We gathered as a family 

there was nobody to hustle us avva). 
Father seemed to have a smile of con- 
tentment on his face as we sat in the 
livingroom with him. 

it was hard to let the ambulance 
take him away. His illness and death 
had been a family affair. I wish we 
could have buried him in our own 
garden, which he had loved so much 
during his life. 

He is missed. Our remembrance is 
o\' a strong, active man who faced life 
courageously and surrendered this 
life as we know it with a great deal of 
dignity. His ashes lie beneath the first 
tree he planted — a very tall, majestic 
tree. « 






-■ ^-l>■/f^/■ 





MARCH1974 



.i. 



THt CANADIAN NURSE 19 



OPINION 



Poor baby: the nurse 
and feminism 



Most nurses are ill-suited to the debate and demands of a push for women's 
rights and ill-equipped to organize on behalf of women's interests. They are 
hooked on self-deprivation and subordinate their interests to family, com- 
munity, doctors, and nurses above them in the nursing hierarchy. The author 
suggests five remedies for the "poor baby" syndrome. 



Dorothy S. Starr, M.N. 



A current TV ad depicts a man who 
has a cold. A woman addresses him 
as "poor baby." and brings him a head- 
ache-t'ever-stutly nose remedy; soon he 
feels well enough to lake out the gar- 
bage. A contrasting TV ad shows a 
young woman surrounded by noisy 
children at a birthday party; she, too. 
feels unwell. No one "poor babys" her; 
she goes to the medicine cupboard, 
doses herself with a headache remedy, 
and carries on her hostessing. The other 
women at the party do not assist her. 
according to the ad. 

Nurses suffer from the "poor baby"" 
syndrome. A predisposition to it is 
indicated in the reason given by women 
for entering a nursing program. "I want 
to help people and take care o\' them 
when they" re sick."" A nurse expects to 
subordinate her interests to those of her 
patients. Nurses carry the attitude into 
their private lives as adult women, and 
subordinate their interests to those of 
husband, children, neighbors, or com- 
munity activities and, in the work 
world, to those of doctors and of nurses 
above them in the nursing hierarchy. 

Imperceptibly, nurses come to de- 
pend on the maternal stance for their 
self-respect and self-image. They get 
hooked on self-deprivation. Women are 
20 THE CANADIAN NURSE 



the ones who make the coffee, take the 
minutes, do the errands, and put them- 
selves — their growth and development, 
their satisfactions — last. Nurses, along 
with others, have abrogated their rights 
and denied their interests as women. 

A feminist is committed to creating 
the equality, not the sameness, of the 
sexes in all the rights and responsibili- 
ties of life. It is not surprising that 
nurses are not noticeably active in the 
feminist movement. Most nurses are ill- 
suited to the debate and demands of a 
push for women"s rights, and ill-equip- 
ped to organize on behalf of women's 
interests. 

Many nurses have difficulty seeing 
a place for themselves in the feminist 
world. Their reasoning goes. Since i 
am part of a profession of women, there 
is no question of women"s rights, no 
competition with men. But there's a 
world of men and women around us. If 
nurses lift their sights from the kitchen 
sink, the neatly made bed. and the prob- 



Ms. Starr is an assistant editor of ihc 
CaiHuliaii Niirsf. Phis article is based on 
a speech she gave to the Alumni Associa- 
tion of the University of Ottawa School of 

Nursing in November 1973. 



Icm-oriented patient records, the need 
for the feminist movement in nurses" 
personal and professional lives will 
become apparent. 

Restraints 

The most important restraints on 
women in a male-oriented, male-domi- 
nated society are social, embedded in 
attitudes. Every individual experiences 
restraints on his behavior, imposed by 
living with others. Few women have 
questioned why they do not feel free to 
do what is best for them as individuals, 
within the group restrictions. For most 
couples, the male's educational or job 
opportunities rank ahead of the fe- 
male's. A woman's income is regarded 
as a supplement to the family income; 
"family" equals male, in this context. 
These attitudes were, perhaps, under- 
standable when most women devoted 
their working lives to the home, and the 
male wage-earner provided the family 
income. Today, over 46.000 married 
nurses are employed full-time in nursing 
and nearly 20.000 married nurses work 
part-time, i 

Nurses consider a man unusually 
understanding when he assists his wife 
to attend university, but a nurse is only 
doing what is expected when she helps 

MARCH 1974 



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MARCH 1974 



THE CANADIAN NURSE 21 



her husband to go to school. Examples 
arc numerous ol' the automatic prece- 
dence given males over tcmalcs. Some 
men hold doors and chairs for women, 
but this cannot be equated with the 
cducatit)nal and career opportunities 
atTorded to men as their right. 

Some Canadian laws restricting 
women's activities have been rescinded 
and others are in the process of change. 
When His Majesty's Privy Council in 
London overruled the Supreme Court of 
Canada in 1929, and ruled that the 
word "persons" includes members of 
the male and female sex and that 
women are eligible to be summonsed 
and become members of the Senate of 
Canada, the legal way was cleared for 
women to participate in Canadian polit- 
ical life. 

The Royal Commission on the Status 
of Women in Canada, whose report 
was published in 1970, made 167 re- 
commendations to ensure for women 
equal opportunities with men. National 
and provincial committees on the status 
of women are prodding for implementa- 
tion of these recommendations. 

But what about restraints that are 
self-imposed'.' Appropriate behavior for 
men and women toward each other and 
towiud their own sex is learned from 
early childhood. IJttle girls are made 
of sugar and spice and all things nice, 
according to the nursery rhyme, while 
little boys are constructed of nails and 
snails and puppy dogs' tails. Even the 
ingredients of little boys are active, 
while sugar and spice just sit there! 

Books for children emphasize an 
active, problem-solving role for males 
and a passive, dependent role for fe- 
males. "Oh, oh! Lcxik, look! Sec Dick 
run! Oh, oh! Look, look! See Jane sit!" 

If the male is the active and dominant 
one, he is important. Females compete 
for his attention and spend time with 
other females as second-best. The man- 
woman games wc play are partially the 
result of ideas implanted in minds too 
young to query the rationality of the 
grown-ups, and partly the result of 
conflicts aroused by the burgeoning 
sexuality of adolescence. 

Alix Kates Shulman wrote about 
relationships between adolescent boys 
22 THE CANADIAN NURSE 



and girls from a woman's point of view, 
in an article entitled "The War in the 
Back Seat. "^ She says the object of the 
real-life dating game in the 1 940s and 
'50s was. for the boy. sexual intercourse 
and, for the girl, avoidance of vaginal 
penetration without complete alienation 
of the boy. it was psychological war- 
fare in the back seats of cars and in 
other uncomfortable, unprivatc places; 
no one emerged unscarrcd or victorious. 

A current philosophy of sexual be- 
havior is that women should be as free 
as men to select their partners and 
to enjoy relationships, freed by the Pill 
from the deterrent fear of pregnancy. 
But today's young adults are the off- 
spring of parents whose attitudes were 
shaped by the war in the back seat. A 
double standard continues to be applied 
to the behavior of men and women be- 
cause many can't shake free of their 
guilty hang-ups. 

As a result, women react to men by 
a teasing, tlirting, advance-and-retreat 
behavior that mitigates against honest 
friendships and inhibits a woman's 
ability to do her best work and make 
her maximum contribution in business 
and professional life. 

We live in a male-oriented, male- 
dominated society, as our mothers did. 
and we adapt to it with covert behavior 
and sly maneuvering. By such behavior, 
we support the present status of women, 
including ourselves, and fail to ques- 
tion or challenge our accorded status. 

PhyllisChesler makes the frightening 
point in her book, IVonwn and Mad- 
ness? that male psychiatrists may diag- 
nose a woman as mentally ill if she 
rebels against male domination. 

A married woman in present-day 
Western society suffers a terrible eco- 
nomic and social vulnerability. She 
can come to middle-age without know- 
ing the particulars of the family's 
business and financial affairs, without 
making major, long-range decisions. 
If she is left on her own by death, deser- 
tion, or divorce, she lacks necessary 
information and experience. 

Housewives, nurses, and secretaries 
are all victims of a fatal availability. 
The willingness to accept resptinsibility 
for the housekeeping, nurturing tasks 



and a denial of self — an unselfishness 
— lead to nonpermanent achievements. 
Daily meals must be cooked, patients 
bathed, and letters typed; no one doubts 
these tasks need to be done or that they 
can be done with skill and devotion. 
But a job consisting of tasks in which 
one worker can replace another, almost 
without pause, does not give the worker 
power. 

Nurses are without open power. As 
Virginia Cleland asked, "Just who 
makes the really important decisions 
for nurses and nursing'.'"'' A variation 
of the man-woman game, the nurse- 
doctor game, has been described many 
times. The nurse who insinuates sug- 
gestions into a conversation with a doc- 
tor, in such a way that the doctor thinks 
the ideas for better patient care origi- 
nate with him, is playing the nurse- 
doctor game. 

As women and nurses, wc support a 
role for the male as master and enemy, 
loved and despised, whom women cajole 
and trick, cosset and cheat but, when 
the crunch comes, to whom they defer. 
Although we say "poor baby," we are 
the poor babies. 

Remedies 

Here are five remedies for the poor 
baby syndrome, become aware, make J 
personal choices, change child-rearing " 
practices, support other women, and 
work for a two-gender nursing. 

To become aware, read, listen, and 
look. As the level of consciousness 
rises, so will the blood pressure. The 
number of put-downs women take is 
incredible! If a woman remarks on an 
ad or a movie diminishing women, a 
man will say. "Oh, come now. You 
don't take that seriously' Where's your 
sense of humor '" 

Refusal to laugh off humor that 
treats women as sex objects can have 
positive results. The Metric Commis- 
sion tried to make Canadians aware of 
metric measurements by picturing a 
scantily clad female with bust, waist, 
and hip circumference printed in cen- 
timeters; the outcry of women got the 
poster removed from circulation. 

To become aware is to become irri- 
tated and frustrated, to be forced to 

MARCH 1974 



reconsider personal relationships, and 
to discover that some treasured child- 
hood legacies are sexist. It is sad to 
realize that The Little Prince was a male 
chauvinist toward his Rose. 

Awareness of tacts, trends, and 
social nuances is the first step in moving 
women closer to equality. 

After becoming aware, women need 
to make personal choices based on 
themselves as individuals and not on 
society's view of women. We can prom- 
ise that we will never again refer to 
ourselves as "just" anything, just a 
housewife, just a mother, just a nurse. 
We put women down when we use 
belittling phrases about ourselves. 

Each woman has to decide for her- 
self what she wants to be free from, 
what she wants to be freed to be and 
do. and what price she is willing to 
pay for her particular freedoms. As a 
suburban housewife, who became a 
feminist organizer, said. "I"m a woman 
just as much as a welfare mother, inas- 
much as we're assigned certain roles 
by society. Just because I'm middle 
class doesn't mean I'm not oppressed."^ 

Women who have children or work 
with children will find their growing 
awareness reflected in child-rearing 
practices. 1 hey will try to make sure 
that little children are treated as per- 
•Mns first, and persons of a certain sex. 
second. In nonsexist nursery schools, 
little girls will play with trucks and 
little boys pour water at make-believe 
tea parties. Someday our scx;icty will 
no longer assume that K>ys are born 
with a mechanical aptitude that auto- 
matically disqualifies girls from a range 
of hobbies and careers. 

Another remedy is to have confidence 
in women and support them in their 
endeavors. Many women establish only 
superficial relationships with other 
women, and never discuss important 
matters with another woman. Ideally, a 
lawyer, dentist, or doctor is chosen for 
her or his competence. If one has no 
criterion or information, why not trust 
a woman lawyer or dentist'.' A women's 
center in your community can suggest 
names ot women pa)tessionals. 

Become aware ot and support wom- 
en who have accepted high office and 
MARCH 1974 



high responsibility in public life. There 
are seven women in the federal govern- 
ment's 700 senior executives. Seven 
isn't many among 700, but if we sup- 
port the women at the top and help 
them with comments, suggestions, and 
encouragement, there will be more 
women willing and able to accept the 
pressure of high-level decision-making. 
If women don't support women in pub- 
lic life, who will' Many men will not. 
because they don't think women can do 
a good job in public life. 

A final remedy suggested is that 
nurses work for a two-gender nursing 
profession. Any profession that is ex- 
clusively one sex is not whole and 
balanced. It is good to have women 
engineers, economists, and veterinari- 
ans; it is good to have men as nurses. 

We don't need men so they can take 
all the top nursing jobs and replicate 
the present, male-dominated society. 
And not. as some have suggested, so 
society will perceive the male's need 
for an adequate salary and so raise the 
pay of all nurses. One rcastin for having 
nimibers of men in nursing is to help 
break down the old doctor/nurse, male/ 
female stereotype and let doctois and 
nurses relate to one another as persons, 
for the betterment of patient care. 

Rewards 

At present, the rewards of a success- 
ful feminist movement in which the 
rights and interests ot women are 
brought into balance with those of men 
are speculative. In society generally, 
the interests of wtimen and children 
will be protected only as women accced 
to positions of inlluence and decision- 
making. 

Nurses' rewards tor participating in 
the feminist movement will be a more 
nearly autonomous profession with 
more open power. This means nurses' 
ability to help patients will be magni- 
tied. through their ability to get deci- 
sions and plans implemented. Another 
reward will be attracting into the pro- 
lession creative, thinking, compassion- 
ate people of both sexes. 

On a personal basis, growth in be- 
lieving in her own rights and interests 
produces a woman wh<i strives to rea- 



lize her iiwn potential, whatever it may 
be. Simone de Beauvoir said it. "What 
wciman essentially lacks today for doing 
great things is forgetful ness of herself; 
but to forget oneself it is first necessary 
that now and for the future, one has 
found oneself. "6 

Summary 

The liberation of women will result 
in freeing feminine qualities — the real 
feminine qualities, such as compassion, 
tenderness, empathy — in persons of 
both sexes. The feminist movement's 
message to the nurse is; Don't poor 
baby another person and don't be a 
poor baby yourself. 

References 

I.Canadian Nurses' Association. Coiint- 

ilowii 1972. Ottawa. Canadian Nurses' 

Association. I')73. p. 12. 
2. .Shulman. Alix Kates. 1 he War in the 

Back Seal. I he AihiiirU. 2M):\:50-5. 

July 1972. 
.V C'hesler. Phyllis. Women and Mtulncss. 

Garden City, N.Y.. Doublcday. 1972. 
4. C'leland. Virginia. Sex discrimination: 

Nursing's Most Pervasive Problem. 

Aiucr'uan Jonrnal of Niirsini;. 7I:,S: 

1542-7. August 1971. 
.'^. Johnson. Valerie Miner. Ihe Suburban 

Housewife as Feminist Organizer. Sn- 

liiidiiy Niiilii, July 1973, pp.l5-S. 
6. de Beauvoir. Simone. The Second Sex. 

Trans. H.M. Parshley. New York, 

Knopf. 1971. ^ 




THE CANADIAN NURSE 23 



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Canadian 
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24 THE CANADIAN NURSE 



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graphed must be secured. Your own organization's form 
may be used or CNA forms are available on request. 

Line drawings can be submitted in rough. If suitable, they 
will be redrawn by the journal's artist. 

Tables and charts should be referred to in the text, but 
should be self-explanatory. Figures on charts and tables 
should be typed within pencil-ruled columns. 

The Canadian Nurse 

OFHCIAL JOtJRNAL OF THE CANADIAN NURSES' ASSOCIATION 

MARCH 1974 



Cholera epidemiology 
and control 



Cholera can be introduced into any country despite the use of mmuniza- 
tion. The most effective way of keeping this dreaded disease under control 
is by improving the environmental sanitation and the personal hygiene 
habits of the inhabitants. 



John W. Davies, M.B., B.S., D.P.H., M.Sc. 



Cholera has been endemic in the delta 
of the Ganges River in eastern India 
since the beginning of recorded history, 
and has periodically ranged over the 
entire globe. Between the years 1X17 
and 1 923, six cholera pandemics spread 
beyond this area along the trade routes 
to involve most of the globe. Except 
for one isolated epidemic in Egypt in 
1947, cholera was confined to the 
endemic regions of South East Asia 
from 1923 to 1959. 

The seventh pandemic, which start- 
ed in I960, spread from a focus in the 
Celebes Islands in what is now Indo- 
nesia 'Figure I). It was a long time 
before scientists realized that the of- 
fending organism was El Tor vibrio, 
not the classical Vibrio cholerae. Bv 
1963, the disease had extended north- 
ward as far as Korea, China, and the 
Philippines; by 1965, classical K 
cholerae in India had been almost 
completely replaced by El Tor vibrio. 
In East Pakistan, however, the classical 
y. cholerae, serotype Inaba, remain- 
ed predominant. 

Since 1965, cholera has spread west 
via West Pakistan, Afghanistan, Iran, 
and Iraq. In 1970 it struck Odessa and 
Kerch on the Black Sea, the Middle 
East, and North Africa. In August 
1970, El Tor cholera Ogawa serotype 
was introduced into Guinea, West 
Africa, where it had not been recogniz- 
MARCH1974 



ed since 1 894. Since then, the disease 
has been reported by more than a dozen 
West African countries. 

Spread of cholera in Africa follow- 
ed one of two routes; the coast border- 
ing the Gulf of Guinea, and the Niger 
River. In both areas water serves as the 
major transportation and communica- 
tion link within and between countries. 
Cholera is introduced by fishermen and 
traders to a given region; then, multiple 
factors, such as availability of safe water 
supply, eating and cooking practices, 
level of personal hygiene, and com- 
munity sanitation, influence the effect 
of the importation. 

Official reports from these West 
African countries indicated approxi- 
mately 24.()()() clinical cases, with over 
3,000 deaths. It has been estimated, 
however, that in reality more than 
three-quarters of a million cholera 
infections have occurred in West 
Africa since August 1970. 

The summer of 197! was notable in 
three ways. 

1 . There was further extcnsit)n ol the 
disease in Africa, affecting Ethiopia, 
Somalia, and East Africa, to involve 



Or. Davies is Ditvclor. Bureau ot Epidem- 
iology. I.iiboratory C cnlrc for Disease 
Control. Health Protection Branch. Health 
\ VVell'aie C anaJa. Ottawa. 



altogether a total of about 20 countries. 

2. Massive epidemics of cholera oc- 
curred in refugee camps in West Bengal 
and along the frontier of East Pakistan. 
Well over 20,000 cases and 3,000 
deaths occurred in this area. 

3. Cholera was imported into a num- 
ber of European countries, including 
France, Spain. Portugal. Sweden, and 
the United Kingdom, usually by return- 
ing tourists. 

In August 1973. Italian officials 
notified the World Health Organiza- 
tion of an outbreak of cholera in two 
localities south of Naples. Several 
hundred cases occurred before this 
epidemic was brought under control. 
Epidemiological investigation tended 
to confirm that infected shellfish were 
the sources of the epidemic. 

Another notable event in August 
1973 was the report of a single con- 
firmed case of cholera in Port Lavaca, 
1 exas. The source was never found 
and there was no spread of the disease. 
This is the first recognized case in 
North America in over 50 vears. 

The ever-widening geographic dis- 
persion of the disease raises the threat 
of further importatiitn int.o the Ameri- 
can continent. 

Organisms 

In many respects, cholera resembles 
other enteric infections, hut is cha- 

THE CANADIAN NURSE 25 



racterized by its greater potentiality to 
spread rapidly in receptive areas and its 
ability in severe cases to kill within 
hours. 

The two recognized biotypes are 
the classic and El Tc variants, which 
are antigenically separated into two 
mains serotypes, Ogawa and Inaba. 
V. cholerae. biotype El Tor, is the 
predominant etiological agent in ail 
the countries affected except East 
Pakistan, where classical cholera is 
prevalent. More recently, the classical 
type is again being isolated in neighbor- 
ing West Bengal, India. 

El Tor is somewhat more resistant 
than classical cholera and survives 
longer in the environment. It is more 
easily detectable in bacteriological 
surveys of water and night-soil samples. 

Seasonal pattern 

Cholera has a characteristic sea- 
sonal pattern, although this pattern 
varies from place to place. For example, 
in Dacca, Bangladesh, the cholera 
season follows the monsoon rains, peaks 
in November, December, and January, 
and usually disappears during the dry 
months. 

In Calcutta, by contrast, the cholera 
season characteristically rises to its 
peak during the hot, dry season and 
hence declines with the onset of the 
mons(xin. In some parts of the Philip- 
pines, cholera tends to reach its peak 
during the rainy season. The cause of 
these seasonal patterns is unknown. 

Pattern of spread 

Bad environmental sanitation, par- 
ticularly a lack of adequate fresh water 
for personal use. seems to be the 
fundamental factor in the spread of 
cholera. Provision of abundant amounts 
of safe water for all personal use can 
break this cycle, leading to its control. 
There are two main types of spread. 

I. The explosive epidemic where a 
common source or common vehicle, 
such as water, is implicated and an 
explosive outbreak appears over a 
short time. An example of this is the 
Broad Street Pump epidemic in 1834, 
identified by Snow.* 



* John Snow. Snow on iholcni. Reprint- 
ed 1936 cd.. Now York. H;ifncr. 1965. 
26 THE CANADIAN NURSE 



2. By contrast, protracted epidemics 
may occur with the appearance of only 
sporadic clinical cases over a period of 
time. In these outbreaks the means of 
transmission is not always well defin- 
ed. Contact spread has been suggested, 
but this has not been conclusively 
documented. As a rule, cholera is not 
easily spread by person-to-person con- 
tact. Numerous inapparent infections 
and occasional small explosive out- 
breaks may be demonstrated in family 
groups that have a common food and 
water supply. 

Susceptibility 

Cholera usually affects individuals 
of the lowest socioeconomic groups 
because of their poorer sanitation. 
When an epidemic strikes a new area, 
the earliest cases are often predominant- 
ly adult males, due to their mobility 
and higher exposure to potential 
sources. When a disease is established 
in a community, the sexes are equally 
affected. 

In the endemic cholera areas, the 
attack rate is much higher for children 
than for adults, because adults in these 
areas acquire antibodies as a result of 
previous repeated exposures. 

Reservoir of infection 

The only known natural reservoir 
is man. Cholera is maintained by a 
cycle of transmission from man to man 
through the environment. As a rule, 
infected individuals excrete vibrios for 
several days, but a few chronic carriers 
have been described. Maintenance of 
infection in communities is facilitated 
by the presence of subclinical cases 
and by the relatively brief immunity 
following infection so that reinfections 
from year to year are common. 

Clinical picture 

The spectrum of diarrheal disease 
for which V. cholerae is responsible 
ranges from a completely asymptomatic 
state to severe diarrhea and vomiting 
that require hospitalization. In the 
case of classical cholera, the ratio of 
severe to mild or inapparent cases is 
about I to 10. and for El Tor cholera, 
perhaps as low as I to 50 or 1 to 100. 

In the classical textbook description, 
patients usually have an abrupt onset of 
effortless vomiting and watery diarrhea 
that quickly assumes the characteristic 



rice-water appearance (colorless with 
fiecks of floating mucus), although it 
may occasionally be cream colored or 
even bloody. Soon after the onset of 
diarrhea, the patient ceases to urinate 
and exhibits moderate thirst, followed 
by cramps in the muscles. 

The massive gastrointestinal loss of 
isotonic fluid of very low protein but 
high bicarbonate and potassium content 
leads to profound dehydration with 
hemoconcentration, shock, hypokale- 
mia, and metabolic acidosis. In the 
extreme case the patient will be cold 
and pulseless on admission, with 
cyanosis of finger tips, tongue, and 
lips. 

If untreated, these patients have a 
mortality rate of 60 percent or greater. 
Many countries report mortality rates 
of 20-30 percent for cholera; however, 
with adequate treatment, including 
correction of saline depletion and 
acidosis, mortality should be almost nil 
in all age groups. 

Treatment 

Treatment should be given immedi- 
ately. It consists chiefly of intravenous 
fluids and electrolytes to restore the 
circulation and to correct the dehydra- 
tion, acidosis, and potassium loss. 
Tetracyclines are valuable in shortening 
the period of diarrhea and eradicat- 
ing the organism. 

Chemoprophylaxis of contacts with 
tetracyclines has a limited place in 
controlling the disease because of the 
risk of developing drug-resistant 
vibrios. 

Cholera surveillance and control 

Cholera can be introduced into any 
country despite immunization with 
presently available vaccines and the 
use of other preventive measures list- 
ed under the International Health 
Regulations. It should be recognized, 
however, that cholera can spread only 
in areas with poor environmental 
sanitation and personal hygiene and 
with inadequate basic health services. 

The risk of further invasions is much 
greater at present as cholera has be- 
come endemic over a wide area of the 
world. Also, the El Tor biotype. with 
its high proportion of mild cases and 
carriers, spreads nn>re easily than the 
classical biotype. 

The wide geographic dispersion of 
MARCH 1974 



FIGURE I 
Extension of Cholera, 1961-70 




Sonne: IIVcA/v lipidcniitiloi^iml Record. 46 (32). Aiit;. 6, 1971 , World Health Association. 



cholera in recent years and the 
magnitude of tourist traffic make this 
continent more vunlerable to the im- 
portation of cholera. The risi< of spread 
of the disease is minimal, however, with 
the exception of certain Latin American 
countries and the Caribbean — coun- 
tries that have poor environmental 
sanitation. 

The risk will be minimized further 
in such areas by ensuring the availability 
of health personnel trained in epide- 
miology, bacteriology, and treatment of 
cholera; the existence of well-organiz- 
ed laboratory services 'equipped with 
standard diagnostic reagents and media 
for diagnosis of cholera; facilities for 
treatment, chemoprophylaxis. and 
health education; and the existence of 
personnel and equipment to improve 
sanitation and water supplies. The 
stockpiling of rehydration fluids, 
laboratory supplies, vaccines for select- 
ive vaccination, supplies for disinfec- 
tion of water, and antibiotics has been 
recommended by the World Health 
Organization in areas threatened by 
cholera. 

The most effective and long-lasting 
way of making countries unreceptive 
to cholera is by improving environment- 
al sanitation and personal hygiene for 
the inhabitants. Particular emphasis 

MARCH 1974 



should be put on vulnerable commu- 
nities or situations that are conducive 
to implantation. 

Although introduction of cholera 
into a country cannot be prevented, its 
spread can be checked by early detec- 
tion of outbreaks and immediate ac- 
tion to control the disease. Fortunately, 
in a country such as Canada, cholera, 
even if imported, has little prospect of 
establishing itself. 

During the past decade, only six 
reported cases of cholera and no deaths 
have occurred among the millions of 
North Americans who have traveled in 
cholera-infected areas of the world. It 
wt)uld be a wise precaution, however, 
for physicians to take measures to ex- 
clude this disease by performing bacter- 
iological tests on tourists with diar- 
rheal disease who are returning to Can- 
ada from countries where cholera has 
been a problem. 

Summary 

Seven cholera pandemics have in- 
volved the globe since 1817. The cur- 
rent pandemic started in Indonesia in 
1960 and in ever-increasing waves 
extended northwest to involve progres- 
sively China, India, the Middle East, 
Africa, and, a decade later, Europe. 
Simultaneously, the classical Vibrio 



cholerae was almost completely replac- 
ed by the El Tor vibrio. 

The wide geographic dispersion of 
cholera and the magnitude of tourist 
traffic make parts of this continent 
more vulnerable to importation. It 
can be introduced into any country 
despite immunization with presently 
available vaccines and the use of 
other measures listed under the inter- 
national Health Regulations, its spread 
can be checked by early detection and 
immediate action to control the disease. 
Vaccines have limited usefulness. 

Cholera is maintained in nature by a 
cycle of transmission from man to man 
through the environment. The funda- 
mental factor in spread of the disease 
is inadequate sanitation, particularly 
lack of adequate water supplies for 
personal use. 

The most effective and long-lasting 
way of making countries unreceptive 
to cholera is by improving environ- 
mental sanitation and personal hygiene 
for the inhabitants. ^^ 



THE CANADIAN NURSE 27 



Surviving in the bush 



Jan O'Brien 



Setting snares, building tires, and 
making lean-tos are not tasks usually 
associated with nursing. But this is 
what northern health service (NH.S) 
nurses have been doing recently. 

The Canadian Forces and NH.S have 
been jointly conducting a "survival in 
the north" seminar. Yukon public health 
nurses learned the survival theory one 
day and put it into practice the next. 

"It's a very essential part of a north- 
ern nurse's training. I hope the program 
will be held every year." Yukon field 
supervisor Helen Williams saitl. 

Ms. Williams said the two-day 
course was a first for the nurses and 
is something nurses have been asking 
for. 

NH.S nurses are frequently called 
upon to accompain seriously ill patients 
on air evacuation tlights. usually under 
adverse conditions impt)sed by an emer- 
gency situation and the harsh Arctic 
environment. Therefore, instruction 
was oriented toward air emergencies. 

A year ago. a nurse working in the 
Northwest Territories died when a 
plane went off course and crashed. 
Ms. Williams said the accident had a 
lot to do with setting up the seminars. 

"I think survival in the north is 
something that is on our minds a kn. 
especialK for the nurses who lly." she 
said. 

Herta Richter. a nurse in the Yukon's 
most remote ciimminiity. Old Crow, 
said the course had reinforced the 
things she had known a person should 
do in an emergency situation. 

"Most of us have it at the back of 
our mind. The possibility of having to 
survive in the outdoors always exists 
when were traveling." 

The 1 1 nurses from each of the 
Yukon's nursing stations received ins- 



Ms. OBi icn IS ii reporter ;ind photograph- 
er uilh Ihe \\ liilcluiiM- Si(ir. Whilchorsc. 
\ uktrn. I his article is adapted from her 
arliele that appeared in I he \\ liilvhorsc 
Star. No\ciiibcr 2.v I >■>"■>. 
28 THE CANADIAN NURSE 



truction in building shelters, living off 
the land, search and rescue procedures, 
air signals, and the psychology of sur- 
vival. They built lean-tos. started fires, 
and learned to set snares in the woods 
outside Whitehorse, in -25° F. weather. 
■■We hope to make the muses aware 
that there is a problem and get them to 
develop a little interest so they will 
read and practice survival techniques 
ou their own." said Warrant Officer 



Bob Cooper of the survival training 
school in Edmonton. 

He said the group was much more 
enthusiastic than military groups he 
usually teaches ■"probably because 
they want to be here. " He added that it 
is not possible to teach all there is to 
know about survival in two days. 

For nurses unable to attend the 
course, videotaped recordings of the 
teaching sessions will be distributed. s2? 



Wielding an axe is 
Watson Lake nurse Liz 
Barclay. She was one of 
11 Yukon nurses who 
participated in a "sur- 
vival in the north" 
course last November. 




1 







Gathered around the fire, which can 
be used for warmth and as a distress 
signal, are some Yukon nurses and 
their Canadian Armed Forces instruc- 
tors. 



Carmacks nurse Barbara 
Ludwig starts a fire from 
spruce twigs. Fire making 
was one of the many survi- 
val techniques that northern 
federal nurses practiced. 



.»^'- '^ 



" ■>>.._»«, 



m^ I 



;>%i « I! 



Yukon field supervisor, Helen Williams, 
helps construct a lean-to. 



_^" t 



MARCH 1974 



THE CAtN^DIAN NURSE 29 



A volunteer nurse 
in Israel 



When war exploded in the Middle East last October, at least one Canadian 
nurse knew where she was needed. Leaving three young children at home 
was not easy for Rivqa Resnick, but she felt she had to volunteer her help. 
For over three weeks, she gave bedside care and comfort to many, while 
absorbing the somber mood of this small country. 



Carol Dworkin 



When war took Israelis by surprise in 
October 1973, normal life came to a 
standstill. As so many civilians had to 
report for military duty — men to the 
front lines and women to noncombat 
assignments — essential seivices had 
to be maintained by the rest of the 
population. For this reason, volunteers 
from other countries were badly need- 
ed. 

Israeli-born Rivqa Resnick of Ot- 
tawa knew this, in addition to working 
as a nurse in Tel Aviv from 196.^ to 
1964,''' she had lived in Israel during 
her husband's two sabbatical years. 
Thus the nurse's husband and three 
youngsters understood her decision to 
offer whatever help she sould during 
the Israeli crisis. 

On the flight to Israel, Ms. Resnick 
met an organized health care team, con- 
sisting of operating room nurses, phy- 
siotherapists, and orthopedic surgeons 
from various parts of Canada and the 
United States. The Ottawa nurse 



Ms. Dworkin is a graduate of the C'arlcion 
University .School of Journalism. .She is 
editorial assistant. I lie Cunucliun Nmsc. 




30 THE CANADIAN NURSE 



■ Rivqa Resnick is a graduate of the Jew- 
ish General Hospital in Montreal, where 
she worked in the emergency department 
Ironi ('.fdO to I'Xi.v and again after her 
return from Israel. She has also worked 
part time in several Ottawa hospitals. 

MARCH 1974 



thought she would join this team, which 
had been requested by Israel. But the 
nurse from the Israeli Health Ministry 
who met the volunteers at Lod Airport 
in Tel Aviv decided otherwise. 

Ms. Resnick was sent to the 600-bed 
Ichilov Hospital, the largest in Tel 
Aviv. It had been converted from a 
general hospital to a military hospital; 
the civilian patients who could not be 
discharged had been transferred to a 
local hospital. 

During the three and one-half weeks 
when she did bedside nursing and visited 
grieving relatives in the country, Ms. 
Resnick learned about the organization 
of Israel's medical services for wartime, 
the mood of the people, and the psy- 
chological effects of the war. Last 
December, in the comfort of her mo- 
dern Ottawa home, she discussed her 
brief but intense experience. 

Treatment begins on the field 

For many soldiers wounded in the 
Sinai or on the Golan Heights, under- 
ground field hospitals — built in the 
form of air raid shelters — provided 
immediate emergency treatment. Teams 
of soldiers, who had been taught to 
administer medical care, and doctors 
cleansed and bandaged wounds, gave 
morphine when necessary, and started 
ivs. Doctors in the field also used 
hypnosis to treat shell shock. 

Following these emergency proced- 
ures, the soliders were transferred by 
air or ground to regular hospitals. At- 
tached to each of the wounded was a 
chart that related pertinent information, 
such as vital signs and the initial treat- 
ment given. 

At Ichilov Hospital, a team of doc- 
tors and nurses met the wounded as 
they arrived. In the hospital lobby, 
which had bect)me an adjunct to the 
emergency department, they reexamined 
the soldiers, cleansed their wounds, 
and gave further treatment and medi- 
cation. 

Friim the lobby, the men were ad- 
mitted to one of tlve departments, gen- 
eral surgery, orthopedics, ophthal- 
mology, neurological, and burn. On the 
general surgical ward where Ms. 
MARCH 1974 



Resnick was working 12-hour days, 
six days a week, most of the men suf- 
fered from a combination of shrap- 
nel wounds, fractures, amputations, 
and burns. 

More burns than are usually seen 
in war victims resulted from the 
antitank missiles, explained Ms. 
Resnick. She mentioned her sur- 
prise at hearing that young men who 
had no history of ulcers developed 
bleeding ulcers within two weeks 
because of the immense tension they 
experienced. 

As soon as active treatment was 
no longer necessary, the soldiers 
were transferred to convalescent 
hospitals. The aim of this was to pro- 
vide a more cheerful setting, where 
the men could partake in other ac- 
tivities. At the same time, the transfer 
made beds available for others. 

Nursing care is more emotional 

Ms. Resnick described how the emo- 
tional care provided by the nurses dif- 
fered in wartime. "There was a remark- 
able difference in the staffs attitude 
toward the patients. Under normal 
circumstances, nursing care is objective, 
kind, and efficient. Now the care was of 
a more subjective and maternal nature. 
This continued in spite of the very 
long working hours [12 to 16 hours a 
day]."' 

She said everyone was emotionnally 
involved with the patients, "if it wasn't 
your brother who was wounded or kil- 
led, it was your husband." In such a 
small country, where the civilians com- 
prise the army, everyone is in the same 
predicament. 

It was not surprising that every 
nurse found this experience emotion- 
ally draining. At one time. Ms. Resnick 
noticed that al' the nurses in the group 
she was with were in tears because of 
what they were seeing. 

The staff- relative relationship was 
also unique. Ms. Resnick p^iinted out 
that the staff had a tremendous feeling 
of empathy toward the patients" rela- 
tives. Since all regulations governing 
visiting hours were ignored, many 
relatives stayed with patients around- 



the-clock. Yet they did not interfere 
with nursing or medical procedures. 

Relatives' reaction to the wunded 
was different than normal. Whereas 
they are usually upset and may be 
difficult to deal with, at this time they 
were happy to see the men alive and 
particularly grateful to the staff, ex- 
plained the nurse. There was a mixture 
of relief and grief. 

A year of experience in psychiatry 
that Ms. Resnick had at the Jewish 
General Hospital in Montreal helped 
her a great deal in communicating with 
her patients. By speaking with them 
as much as possible and listening to 
them, she found she was able to allay 
their anxiety. 

Didn't know what hit them 

Each day Ms. Resnick cared for 
three patients, who ranged in age from 
19 to 21 years. For these young men, 
the tlrst encounter with war was es- 
pecially cruel. 

"Raziel was one of the young men 
on the Bar-l.ev line [overrun by the 
Egyptians] when the war broke out. 
These men just didn't know what hit 
them. This l^-year-old. who was about 
to be married, had one lung pierced, 
one testicle severed, and had to have 
one leg amputated below the knee. 
Because of severe shrapnel wounds, 
one kidney was also removed. There 
were periods when he burst into tears 
and when he had feelings of hopeless- 
ness." 

Another of her patients was 2 I -year- 
old Ariel, an Israeli officer who was 
vacationing in Europe when the war 
began. He returned home immediately 
and was sent to Sinai. There he sustain- 
ed multiple injuries, including second - 
and third-degree burns on his shoulder 
anti back. Gangrene developed in one 
leg. 

Ariel kept dozing off, and while he 
was asleep he wt)uld relive the battle, 
hollering out orders, Ms. Resnick also 
recalled that because he was so proud 
and his burns were so painful, he would 
ask her if he could yell every time she 
changed his dressings. This patient's 
elderly mother never left the hospital. 
THE CANADIAN NURSE 31 




When Ms. Resnick arrived on the 
surgical ward, she found that the Kar- 
dex system was not being used, which 
made it dit'tlcuit for those who were 
unfamiliar with the patients" condi- 
tions. She was the first one to introduce 
the Kardex. The staff welcomed the 
idea. "I believe they will use it now."" 
she said. 

Nurses come from other countries 

About .^0 nurse volunteers went to 
Israel during the war. Ms. Resnick met 
three non-Jewish nurses — trom Hol- 
land. Sweden, and the United States 
— who were also working at Ichilov 
Hospital. Another two volunteers, 
both operating room nurses from the 
U.S., insisted on being sent to a field 
hospital. 
32 THE CANADIAN NURSE 



During the time Ms. Resnick spent 
at the Tel Aviv hospital, the director of 
nursing invited all the nurse volunteers 
for tea. This gave them an opportunity 
to talk about their work. 

Ms. Resnick, who had left Israel 
in 1 952 with her parents, found that 
speaking Hebrew was a great help, 
though not essential. Most of the sol- 
diers speak English and many nursing 
duties can be done without knowing 
Hebrew, she said. "Without the lan- 
guage though, it was more difficult 
for the volunteer nurses to adjust, but 
they were all strong willed."" 

The nursing staff at the hospital 
was divided into two shifts, with ap- 
proximately 60 nurses per shift. That 
meant one nurse for 10 patients. Ms. 
Resnick said nurses in Israel are over- 



worked in comparison with Canadian 
nurses, although nurses" aides do just 
about everything an RN does, even 
administering medication and changing 
IVs. As the schools were closed then, 
nursing and medical students also work- 
ed with the nurses. 

By the time Ms. Resnick left the 
hospital, no new casualties were being 
brought in. 

Aftermath of war 

Ms. Resnick described the mood in 
Israel while she was there; "There was 
an ominous aura of sadness and fatigue, 
but on the surface there was a thin 
layer of hope. The entire population's 
main thought and activities revolved 
around the bereaved and the wounded. 

"Women who would ordinarily be 
sitting in coffee houses knitting and 
sipping expresso coffee, were now 
serving food trays to the wounded, 
feeding where necessary, or washing 
dishes. High school students also vo- 
lunteered to act as messengers around 
the hospitals or work in kitchens and 
laundry rooms. 

■'Many persons volunteered to drive 
staff and relatives to and from hospi- 
tals. School children were busy writing 
soldiers "get well" notes, and enter- 
tainers offered their services in the 
form of nightly shows for the injured. 
Unfortunately, the audience could not 
resptmd to anything light-hearted.'" 

Another sad aspect of this war was 
also explained by Ms. Resnick. "An 
Israeli could never allow himself the 
luxury of planning ahead, since he 
did not know what the next month would 
bring. In the last six years, however, 
people had begun relaxing and were 
more optimistic about the future. This 
war destroyed every hope they had." 

Despite their shattered economy, 
deepening fear for their prisoners 
of war in Syria, and sense of person- 
al loss, the Israelis continue to hope 
for a peaceful future. 'w' 

MARCH 1974 



The hair dryer treatment 
for decubiti 



The author, who has worked in an extended care hospital for the past 10 
years, describes the treatment of decubitus ulcers of varying severity. 



The article "Decubitis ulcer manage- 
ment — a team approach" (October 
1973, pp. 41-43) was valuable and in- 
teresting. To motivate further discussion 
ot the subject and to support the benefit 
of continuity of daily care given by the 
same persons, the following classifica- 
tion of ulcers and their treatment is 
given. 

Four general types of decubitus 
ulcer, progressing in sevcritv. arc. 
superficial, subcutaneous, anoxic, and 
pregun^renoiis. 

A superficial ulcer is a break in the 
skin that occurs if moisture is neglected 
or if adjacent skin surfaces are not 
kept separated. These ulcers are easily 
healed, often in less than a week, by 
changing the individual's position fre- 
quently and having him lie prone if 
possible. The ulcer is cleansed with 
hydrogen peroxide and exposed to 
rapidly circulating, warm air. A hair 
dryer is placed on an overbed tabic with 
the air stream directed at the ulcer for 
20 minutes daily. A mild ointment or 
powder is applied, and a light dressing 
fastened with nonallergic tape. 

If a superficial ulcer is not treated 
and becomes infected, it soon goes 
deeper into the skin. Subcutaneous 
ulcers may be caused by pressure for as 
short a time as 2 to 3 hours in a sick, 
immobile individual, such as a patient 
with a severe CVA or a fractured hip. 
Subcutaneous ulcers usually occur in 
MARCH 1974 



Dorothy H. Denholm 

the coccygeal area or over bony pro- 
tuberances, such as the hip or ankle. 

The treatment is irrigation — I 
prefer a bulb syringe with which a 
gentle force may be exercised, using 
Eusol* 1/4 strength solution: prone, 
or at least semiprone position, while 
under the hair dryer; gentle packing 
in the open area, usually Sofra-Tulle 
or iodoform dressing; and absorption of 
a nutrient. 

An ulcer of this type does not take 
more than a week or two to be free of 
infection, but healing is slow unless a 
local application of a nutrient is intro- 
duced with the packing. My favorite 
kinds are vitamin A and D ointment. 
Gel foam flakes, granulated sugar crys- 
tals, or cod-liver oil packing. In patients 
with dark complexions, cod-liver oil is 
immediately beneficial, while in Cau- 
casians the vitamin ointment or Gel- 
foam is absorbed more quickly. 

I often prevail upon our medical 
staff to order ascorbic acid 100 mgs. 
three times daily for one week, as this 
is a reducing agent and may be neces- 
sary for healing. Elderly and sick pa- 
tients are often deficient in ascorbic 
acid. General nutrition — calories, 
proteins — are importiint. In many 



■ Eusol solution is made with sodium 
hypochlorite; full-sircnglh solution is 
0. 1 2.'i percent available chlorine. 



long-term patients, metabolism is slower 
than normal, thus cpithclialization takes 
place faster if aided by these nutrients. 
Subcutaneous ulcers gradually close in 
from the edges to the center, finally 
being covered with new epithelium. 

Anoxic ulcers 

Ulcers form soon after spinal cord 
injuries, caused by damage done during 
or immediately after the injury. They 
occur on any weight-bearing protubcr- 
ence, or occasionally on a metatarsal 
joint. The response by the system is 
called reactive hyperemia: a flare, or 
vascular dilatation, is the response to 
pressure and is indicative of marked 
slowing of the circulation and preexist- 
ing vasoconstriction. 

Pressure causes hypoxia (interference 
in the use of oxygen in the tissues), 
which results in anoxia — literally, no 
oxygen in the tissues. Unless immediate 
attention is given to relieving the area 
of weight, necrosis sets in below the 
skin surface and spreads radially, un- 
dermining the surrounding skin. A dry. 



Ms. Denholm is a graduate ol Winnipeg 
General Hi>spital school of nursing. .She 
has worked at .St. Vital Extended I real- 
nienl Hospital in Winni|X~g. Manitoba, 
lor the past 10 years. Ihe author expres- 
ses her thanks to Dr. M. Newman, neuro- 
logist, lor his assistance with the arlielo 

THE CANADIAN NURSE 33 



blacK scab ensues, frequently with in- 
fection under it; if the infection is not 
checked, it m;iy enter the tendons, and 
even the bones. 

In most cases of persons with spinal 
cord injury, so much attention is given 
to other aspects of treatment that it is 
not realized that permanent damage 
is occurring, which may be prevented 
by easing the weight from any weight- 
bearing area. The ideal treatment is 
prevention; some advise hyperbaric 
oxygen. 

Anoxic ulcers can be treated with 
compresses of half-strength Eusol 
solution, kept on for one hour, three 
times daily and a dressing with an oint- 
ment containing enzymes — Elase or 
Varidase — generously applied be- 
tween compress treatments. The com- 
presses cause the scab to shrink from 
the edges. As soon as it is possible to 
lift even a corner of the scab, the depth 
of the ulcer can be irrigated and packed, 
or Cicatrin powder blown under it. The 
scab gradually dries and can be clipped 
back each day. thus performing a grad- 
ual debridement. At this point, the use 
of the hair dryer is beneficial as a dry- 
ing agent and to stimulate circulation. 

Generous applications of nutritive 
substances should now be applied; 
granulated sugar acts as a gentle abra- 
sive and, used with Gelfoam tlakes. 
brings noticeable results. These should 
be used for a period of about a week, 
then vitamin A and D ointment in- 
creases granulation. 

This treatment is long and not al- 
ways successful, though many ulcers 
heal completely. The general condi- 
tion of these patients frequently pro- 
hibits surgical treatment, especially if 
the vitality of any proposed donor area 
is lacking, due to the individual's age 
or disturbance of his central nervous 
system. 

Pregangrenous ulcers 

Threat of gangrene is involved in 

peripheral vascular disease, with the 

occurrence of a thickened dark scab, 

usually on a heel, metatarsal joint, or 

34 THE CANADIAN NURSE 



even toes. Diabetic patients are prone 
to this type of ulcer, and many individ- 
uals do not seek medical advice until 
the ulcer is advanced to the stage of 
necrotic tissue under the scab. 

In treatment, the prone position is a 
must! There is no substitute for this 
position, which allows free circulation 
to the heels. A Stryker frame may be 
necessary but these persons must turn. 
One member of our medical staff expli- 
citly ordered prone lying except while 
up in a chair, so the patient sat up in a 
chair for meals and visitors and lay 
prone the rest of the time. A huge ulcer 
on the patient's heel completely healed. 

In addition to the prone position, 
a Eusol soak h.;lps the ulcer. I hold 
the heel in a small amount of half- 
strength Eusol solution for about K) 
minutes, then dress the ulcer with 
Elase ointment and Sofra-Tulle. Again, 
loosen an edge of the scab as soon as 
possible. Paint the scab, and as far 
under it as possible, with tincture of 
benzoin compound; this soon gives 
the necrosis a "honeycomb" appearance 
and the Cicatrin powder can penetrate 
deeper. The same sequence of debri- 
dement, hair dryer treatment, and 
nourishment is used as described above 
for the anoxic ulcer. 

These are the various types of ulcers, 
or bed sores, that plague every hospital. 

Purchased aids 

Several aids, which may be pur- 
chased, are helpful in caring for per- 
sons with decubitus ulcers. 

An air mattress with electric pump 
allows pressure to alternate on weight- 
bearing areas. A fine, foam material, 
adhesive on one side, may be placed in 
a horseshoe shape around a pressure 
area to prevent skin breakdown. Mois- 
ture cannot penetrate this and it can be 
left on, even during a bath. It adheres 
better if the area is first painted with 
tincture of benzoin compound. Such 
material should be removed at least 
once a week and left olf for a day or 
two, as it inhibits washing and rubbing 
of the area. 



A portable hair dryer is an essential 
piece of equipment. 

Bt>ots of a synthetic material resem- 
bling sheepskin are made into a heel 
covering, strapped over the instep. 
These offer good protection for heels, 
but patients often complain that the 
boots are too warm. Sheepskin placed 
over the drawsheet. large enough for a 
patient's torso, is an excellent preventive 
measure. The natural oil in the sheep- 
skin is of value. Sheepskin is expensive, 
however, and a washable synthetic 
material is sometimes substituted. 

Continuity of care 

Continuity ot care — one nurse 
doing the treating of bed sores day 
after day — is the most important and 
most beneficial suggestion I can offer. 
Only this nurse can recognize when it 
is prudent to move on to a more ad- 
vanced treatment and can quickly assess 
the type of ulcer. Although ulcer treat- 
ment is discouraging at times, it is very 
rewarding to the nurse on the whole. 
The main thing is never to give up! 



Bibliography 

Munro. Donald. "Bed Sores." In Modern 
Neiir<>l(>s;y. edited by Simeon l.oekc. 
pp. 6()7-12, Boston. Little. Brown and 
Company. I ')6y. ■§ 



MARCH 1974 



in a capsule 



"Up Canada" 

The House of Commons debates, as re- 
corded in Hansard, can scarcely com- 
pete with a Bob Hope script. There are 
exceptions, however, as this excerpt 
troni Hansard reveals. (The speaker is 
F. Oberle, MP for Prince George- 
Peace River.): 

■"Mr. Speaker, on January S, 1974, 
the night before last, the government- 
subsidized national television network 
aired a program called "Up Canada," a 
portion of which was dedicated to a 
soap opera called. 'One Honorable 
Member." It may be coincidental that 
this program was followed immediately 
by a program called, 'Some Honorable 
Members." 1, and I am sure most hon. 
members, appreciate the mcdia"s re- 
cognition of our presence here in Ot- 
tawa, but we must object to the use of 
the national network in creating a false 
impression about our activities here. 

"The scene in the opera showed one 
hon. member from the west coast, whose 
name and address were almost identical 
with those of one of my colleagues, 
in bed with another member"s secre- 
tary. The male actor was clad only in a 
blanket with which he protected his 
vitals, and the female was devoid of 
any clothing apart from false eyelashes 
and fingernails. 

"An argument ensued in bed over 
the arrival of the member's wife from 
the west coast. The girl decided to 'split 
the sheets" and she called a taxi which 
was to arrive in five minutes. As it 
happened, the taxi was on the spot al- 
most immediately. 

"I would expect, Mr. Speaker, that 
the minister responsible for financing 
the corporation would make every ef- 
fort to stop the ct)ntinuation of this 
exhilarating cultural experience so that 
we do not create the impression in 
Canada that any member or his secre- 
tary can call a taxi in Ottawa and ex- 
pect to have it arrive in less than half an 
hour. 

SiH)H' lion. Members: Hear, hear! 

Cancer of esophagus 

Two main risk factors predi>minate in 
the cause of cancer of the esophagus, 
smoking and high alcohol consumption. 
In an article in last December's issue of 
the Journal of the American Medical 
Asso( iation. two doctors, E. Wynder 
and K. Mabuchi. report that the risk o\ 

MARCH 1974 



developing cancer of the esophagus is 
significantly higher among smokers, 
whether cigarettes, cigars, or pipes are 
involved. Serveral studies have shown 
that heavy alcohol consumption in- 
creases the risk of smokers to develop 
esophageal cancer. 

In their article. Drs. Wynder and 
Mabuchi say that long-term nutrition- 
al deficiency, particularly chronic 
deficiencies of iron or any of the vita- 
min B complex, can lead to esophageal 
cancer without the added influence 
of either tobacco or alcohol. 

The rate of esophageal cancer is 
higher in certain countries than in 
others, according to the MDs. France, 
for example, has a high rate, paral- 
leled by a high level of alcohol con- 
sumption; India and Ceylon also have 
high rates, probably as a result of the 
"chewing of betel and the general nutri- 
tional deficiencies endemic in Asia." 



Traditionalh. there is less drinking 
among Jewish people than non-Jews; 
perhaps not surprisingly, Jewish peo- 
ple have a lower rate of esophageal 
cancer. Seventh Day Adventists, who 
are forbidden to smoke and drink, have 
accordingly lower incidence rates of 
cancer of the esophagus. 

The nonfat, fat cookbook 

A cookbook published by the American 
Heart Association contains more than 
500 recipes, chosen by the association's 
nutritionists, which are aimed at de- 
creasing excess fat intake and replacing 
saturated fats with polyunsaturated fats. 

The 412-page hardbound book, 
which gives traditional dishes from all 
regions of the United States, is publish- 
ed by David McKay Company Inc. 

This information appeared in the 
September 1973 issue of the American 
Journal of Nursint; '^ 




THE CAISI^DIAN NURSE 35 



March 18- June 28, 1974 

Four-month program in neonatal inten- 
sive care nursing, to be repeated in 
October 1974, will be conducted by 
ttie nursing education department, 
The Hospital tor Sick Children. In- 
cluded will be a study of the high risk 
mother and implications for the baby's 
health; detailed study and practice 
with the premature and sick newborn. 
Fee: S200. Maximum enrolment of 10 
for each program. For further infor- 
mation and application forms, write to: 
Ms. Hilda Rolstin, Acting Director, 
Nursing Education, The Hospital for 
Sick Children, 555 University Ave., 
Toronto, Ont. M5G 1X8. 

April 17-19,1974 

Symposium entitled "Today's Psychia- 
tric Unit in the General Hospital," 
sponsored by the department of psy- 
chiatry, Foothills Hospital, and faculty 
of medicine, U. of Calgary. Guest 
speaker: Dr. Peter Sainsbury, Director 
of Clinical Psychiatry Research Unit, 
Medical Research Council of Britain. 
For further information, write to: 
Psychiatry 74, Foothills Hospital, Cal- 
gary, Alberta. 

April 18-19,1974 

Operating Room Nurses of Greater 
Toronto, educational seminar. Royal 
York Hotel, Toronto. Ontario. Enquiries 
may be directed to: Ms. J.G. Mansell. 
Operating Room. The Hospital for Sick 
Children, Toronto, Ont. M5G 1X8. 

April 20, 1974 

One-day workshop on "Nursing and the 
Law," Scarborough Regional Campus 
of Centennial College of Applied Arts 
and Technology. Fee: $5.00. Speaker: 
Mr. L.E. Rosovsky, barrister and solici- 
tor. For further information, write to: 
R. Hopper, Scarborough Regional 
Campus (Nursing), 651 Warden Ave- 
nue, Scarborough, Ontario. 

April 25-28, 1974 

National Student Nurses' Association, 
22nd national convention, Salt Lake 
City, Utah. For further information, 
36 THE CANADIAN NURSE 



write to: National Student Nurses' 
Association, Inc., 10 Columbus Circle, 
New York, N.Y. 10019, U.S.A. 

April 29-May 10,1974 

Calgary General Hospital, departments 
of physical medicine and rehabilita- 
tion, nursing service and nursing 
education, offer a course in "Organiza- 
tion and Techniques of Rehabilitation 
Medicine" for directors of nursing, 
head nurses, general duty nurses, ad- 
ministrators, and board members. This 
course satisfies the prerequisites for 
the setting up of physiotherapy and 
rehabilitation services in small rural 
hospitals as outlined in Alberta Hos- 
pital Services Commission Bulletin 
no. 4. October 30. 1972. For further 
information, write to: Ms. E.A. Halver- 
son. Course Coordinator. Calgary 
General Hospital, 841 Centre Ave., E., 
Calgary, Alberta. T2E 0A1. 

May 1,1974 

Workshop on tuberculosis and respi- 
ratory disease. Nurses' Residence, 
The Moncton Hospital, Moncton, N.B. 
Sponsored by the New Brunswick 
Tuberculosis & Respiratory Disease 
Association, in cooperation with the 
Moncton Hospital. Workshop to be 
conducted in English. No registration 
fee. For further information, contact: 
A.H. Gardner, Executive Director, 
NBTRDA, P.O. Box 1345, Fredericton, 
N.B., E3B 1N6. 



May 2-4, 1974 

Registered Nurses' Association of 
Ontario, annual meeting. Royal York 
Hotel, Toronto, Ontario. 



May 7-10,1974 

Alberta Association of Registered 
Nurses, annual convention. Chateau 
Lacombe, Edmonton, Alberta. Conven- 
tion theme: "Continuing Education." 

May 8-10,1974 

Registered Nurses' Association of 
British Columbia, 62nd annual meeting, 
Bayshore Inn, Vancouver, B.C. 



May 19-22,1974 

Conference on Man and His Environ- 
ment, " Banff, Alberta. Topics to be 
discussed include limits to growth, 
natural resources, population, produc- 
tion and pollution, and man in the tech- 
nological world. More information is 
available from Dr. M.F. Mohtadi. Con- 
ference Chairman, Chemical Engineer- 
ing Dept., University of Calgary, Cal- 
gary, Alberta. 



May 22-24, 1974 

Registered Nurses' Association of Nova 
Scotia, annual meeting. Amherst, Nova 
Scotia. 



May 26-28, 1974 

Manitoba Association of Registered 
Nurses, annual meeting. Winnipeg, 
Manitoba. 



May 28-30,1974 

New Brunswick Association of Regis- 
tered Nurses, annual meeting, Bathurst 
Trade School, Bathurst, N.B. 



June 5-7, 1974 

Canadian Hospital Association, an- 
nual meeting, Vancouver Hotel. Van- 
couver. B.C. 



June 10-12, 1974 

Canadian Tuberculosis and Respira- 
tory Disease Association. 74th annual 
meeting: Canadian Thoracic Society. 
16th annual meeting: and 11th annual 
nurses' institute. Chateau Laurier 
Hotel. Ottawa, Ontario. For further in- 
formation, write to: Mr. H.E. Drouin. 
Executive Secretary, CTRDA. 345 
O'Connor St., Ottawa. Ont. K2P 1V9. 



June 16-21, 1974 

Canadian Nurses' As- 
soc iation annual 
meeting and conven- 
tion, to be held in the 
Manitoba Centennial 
Centre Concert Hall, 
Winnipeg, Manitoba. 




^^P 



MARCH 1974 



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ctirm imrtij^ion 



research abstracts 



The following are abstracts of studies 
selected from the Canadian Nurses" 
Association Repositor\ Collection ot 
Nursing Studies. Abstract manuscripts 
are prepared b\ the authors. 



Finch, Elizabeth. A siiuly of fhe concerns 
of ainhulatory patients in the hospital 
en)eri;eney room and ilie professional 
response to those concerns. Mont- 
real. Ouebec. 1973. Study (M.Sc. 
(Appl.)) McGill U. 

This stud), using qualitative research 
methixls. identified and classified the 
health concerns o\ ambulator) patients 
who use the hospital emergency rmim 
as a primary care center, and the res- 
ponse strategies of professionals inter- 
acting with them. 

Data were collected by observing 
patient-nurse, patient-doctor inter- 
actions, and b) the use of unstructured 
interviews. The sample consisted of 
-M) patients. {'■) males and 1 I females. 

In this study, concern refers to any 
behavior exhibited by the patient during 
his stay in the emergency room that 
wduld indicate an interest or uneasiness 
related to his state of health or the con- 
ditions surrounding it. Professional 
response is del'ined as an) statement or 
action on the part of a nurse or doctor 
related to the expression or rest)lution 
of patients' concerns. 

[■*atients expressed a total of 1 v^ 
concerns — 70 to nurses and doctors, 
the remainder to the researcher. Con- 
cerns cif symptomatic discimifort were 
expressed most frequently (.^X.64 per- 
cent) and professionals concentralei.1 
their efforts on eliciting and resolving 
these concerns (.^S of the 70). 

Approximatel) M) percent of con- 
cerns were related to emergency health 
service and social and economic situa- 
tion, and the majority of these were 
elicited by the researcher. 

AnaKsis of professit)nal responses 
showed a total ot 27S responses made 
to 70 concerns, with a mean of .^.97 
responses per concern. 

More respcMises were made to facil- 
itate expression of concern (l.^(S) than 
were made to facilitate resolution of 
concern (119). Few responses were 
inhibitory (21). Doctors made more than 
twice the number of responses than 
nurses (|M"^ lo S5). Responding stra- 

38 THE CANADIAN NURSE 



tegies of nurses mainly were to facilitate 
expression of concern. Inquiring was the 
strategy most frequenth used by both 
respondents. 

Because of its ready accessibility to 
the community, the emergency room 
staff has a unique opportunity tt) study 
community health needs and to exper- 
iment with health care practices de- 
signed to meet those needs. Findings 
from this study provide a basis tor 
experimentation of this nature. 



Funke, Jeanette and Irby, Margaret 
Imle. A sincly of predictive criteria 
in relation to motherim^ behavior. 
Denver. Colo.. 1973. Study (M.S. 
(Nurs.)) LJ. of Colorado. 

Predictive criteria for assessing poten- 
tial mother-child relations have been 
studied but have not been sufficiently 
researched to be reliable for all popu- 
lations. Therefore, the two-fold purpose 
of this study was; I. to assess the rela- 
tionship between the answers from the 
predictive questionnaire and the sub- 
sequent performance of mothering 
behavior, and 2. to develop a useful, 
reliable tool that can be used success- 
fully to predict inadequate mothers. 

The target population was the pre- 
natal clinic patients at a county general 
hospital in a large metropolitan area. 
The research design was a nonexperi- 
mental retrospective study of one group. 
The research consisted of a content 
analysis of the prenatal predictive ques- 
tionnaire and interview, which was rated 
and scored as predictive of future 
mother-child relationships. These pre- 
dictive scores were then compared with 
a behavioral assessment tool that assess- 
ed the performance t)f mothering be- 
havior four to six weeks postpartum. 

The results of this study indicate that 
the following questions are predictive 
of maladaptive mothering behaviors; 
1. When yt)u were a child; (a) How did 
your parents discipline you? (b) Did 
you think the way your parents disci- 
plined you was the best way? 2. When 
st)mething you try to do doesn't work 
out the way you want it to. what do you 
do? 3. When you tlrst felt movement, 
how did it make you feel? 4. How do 
you plan to tliscipline your baby? 

Study results of the behavioral assess- 
ment tool indicated a higher frequency 



of maladaptive mothering behavior in 
the following behavioral categories; 
feeding, moving and holding, verbal 
and nonverbal communication, and 
tiHiching. 

The researchers hope that, with 
turther development of these tools, 
inadequate mothering behavior can be 
successfully predicted and evaluated. 
Having accomplished this, the basic 
ft)undation will be laid for providing 
nursing intervention for those mothers 
predicted to have poor mother-child 
relations. 



Christensen, Patricia Anne. The hostile 
behavior of a priniii;ravida. Pitts- 
burgh. Pa. Thesis (M.N.) U. of Pitts- 
burgh. 

This study was undertaken to identify 
the feelings about self as relleeted in the 
hostile behavior of a selected primi- 
grav ida. I he behavior was examined 
for indication of a reaction to preg- 
nancy, evidence of variation in in- 
tensity, and evidence of change. 

A hostile primigravida was chosen 
for the study, the basis of the selection 
being "inappropriate attire." The study 
extended over two months. Initial 
contact w ith the subject occurred during 
her thirty-first week of pregnane). 

I he clinical setting tor the study was 
the antepartal clinic of a large, uni- 
versity-affiliated, women's hospital 
in a mid-eastern city in the L'niled 
States. 

During tlata collection, the writer 
functioned as a participant-observer, 
gathering data in free association inter- 
views that were terminated by the sub- 
ject. Following each interview, the 
data were recorded, interpreted, and 
analyzed. The focus of the study emerg- 
ed on completion of data collection. 
The data were then reinterpreted. 

Pregnancy was a time for this 
primigravida to experience leelings 
of doubt and hate about herself as a 
person, a woman, and a mother-to-be. 
Self-hate was expressed in projected 
hostility and self-depreciation. 

The hostile behavior of this primi- 
gravida could not be identified as a 
specific reaction to pregnancy. How- 
ever, it was identified as a reaction to 
one component of pregnane), that of 

MARCH 1974 



childbcaring. This primigravida had 
fantasies that her worthless self would 
be retlected in the ehikl she bore. The 
hostility expressed as a reaction to the 
tear of childbirth decreased as clarifi- 
cation of the fear occurred. 

The intensity of this primigravida's 
hostility varied. As aspects of herself 
were unveiled, she experienced acute, 
overwhelming hostility that was project- 
ed outward. A less intense hostility was 
apparent folknving the episodes of 
acute hostility. While the intensity of 
her hostility was decreasing, this pri- 
migravida clarified her feelings of self- 
doubt. 

This primigravida"s hostile behavior 
and self-doubt changed over time. The 
episodes of acute hostility decreased 
and the components of her self-hate 
changed. There was movement from 
expressing self-hate as a woman, a 
person, and a mother-to-be to express- 
ing an increased self-esteem for herself 
as a woman and nnnher-to-be. 

Concomitantly, there was a move- 
ment from rejecting her identity as a 
woman toward identifying herself as 
a woman, and expressing herself as a 
woman. Simultaneously, there was a 
decrease in expressiiMis of self-doubt. 
The change in her feelings about her- 
sell seemed to be related to the verbal- 
ization of her hi>stility. which appear- 
ed to serve as a catharsis and as a 
means of gaining perspective about who 
she. as a wiiman. was and who she. as 
a woman, w ished to become. 

F'eelings o\' shame were experienced 
concomitantly with feelings of doubt 
and hale. The feelings of shame and 
self-hate may have motivated this 
primigravida to become someone other 
than who she perceived herself to be. 



Robertson, Caroline. A stiiclv conccrn- 
///,!,' children wirh a rcrniiiuil illness 
and their reUnionsliip to others while 
in hospital. Montreal. Que.. 1^72. 
Thesis (M.Sc. (Appl.)) McGill U. 

This descriptive study, airried out in a 
pediatric setting, examined the behav- 
iors of 12 children with a terminal ill- 
ness, and those of the mothers, nurses, 
student nurses, and others with whom 
they interacted. 

The purpose of the study was to 
identify the nature of these childrens 
relationships with others in the hospital 
situation. 

The data consisted of the interaction 
sequences where the child or adult ini- 
tiated the conversation and had a result- 
ing response. 1 he content o\' the inter- 
action anil the outcome ot each se- 
quence were also considered. 

It was found that the children bcg;ui 
the interaction with the adults about 
MARCH 1974 



half as frequently as the adults began 
it with them. The most frequent eliciting 
behaviors of the children were demand- 
ing (42 percent) and protesting (24 
percent), while the adults commenced 
interaction by inquiring (.i7 percent) 
and informing (2N percent). 

When children began the interaction, 
the common pattern was a demand by 
the child, with a cooperating response 
by the adult. This accomplished the 
child's objective. The most frequent 
pattern for adults began by inquiring 
and the rest of the sequence developed 
in the same way. 

The child-mother relationship was 
typically a cooperating-cherishing 
dyad. Children gained their objectives 
with their mothers in S4 percent of the 
sequences. 

The child-nurse relationship was 
characterized by the nurse using "in- 
forming" somewhat more w ith the chil- 
dren than the rest of the group. She 
was also the most frequent confidante 
of the child on the topic of loss of his 
mother. The children talked about loss 
as much as they did about play. 

There were two distinctive charac- 
teristics of the child student nurse rela- 



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MAIL TO: 

The Canadian Nurse 

50 The Driveway 

OTTAWA, Canada K2P 1E2 



tionship. The student used ""inquiring" 
as eliciting behavior more than anyone 
else. She also cooperated with the child 
almost as much as did the mother. 

The child's relationship with others 
appeared least close of all. Although 
others used the "enjoying"" response 
most with the child, he did not do so 
with them. The pattern of behavior that 
led to the outcome of withdrawal, al- 
though infrequent, occured most often 
with others. 

There is a hint of regression in the 
frequent use of demanding and protest- 
ing by these children. However, it can- 
not be stated that the group under study 
showed a demonstrable difference to 
other groups of hospitalized children. 
Therefore, it is suggested that further 
study of such a group be done, through 
observation of the behaviors while at 
hospital and at home, to discover if the 
frequency of demanding and protesting 
differs in the two situations. 



Oloflnboba, |ola. Concerns of diabetic 
children and parents of diabetic 
children. Montreal. Que.. 197.^. 
Ihcsis (M.Sc. (Appl.)) McGill U. 

This study employed qualitative re- 
search methixis to investigate the con- 
cerns that diabetic children and parents 
t>f diabetic children have in relation to 
diabetes mellitus. The aim v\ as to gener- 
ate know ledge that might shed addition- 
al light on the needs of young diabetics. 

The sample consisted oi' 16 diabetic 
children who were interviewed and 16 
parents who were observed with their 
children during their visit with the 
doctor. The data consisted of verbal 
expressions, and these were analyzed 
according to their contents and focus 
of concern. 

Findings were as follows. 

1. All children indicated that having 
diabetes did not bother them. They 
focused on the "normal" aspect of their 
life situation more than their disease 
process. The conclusion was that they 
tound diabetes relativelv unprohlem- 
atic. 

2. Children gave various reasons for 
not feeling bothered by their disease. 
Among these were, they did not hmk 
different; they were as active as their 
friends: they devised means of coping 
w ith their problems. 

.\ All parents were concerned about 
management of the diabetic regime. 
I hey tended to emphasize the disease 
process over the child's "normal" life 
situation. 

4. .Most parents stressed the degree 
of cooperation received from their 
children in following the prescribed 
regime. No relationship was indicated 
between number of problems and the 
THE CANADIAN NURSE 39 



research abstracts 



child's cooperation or lack of cooper- 
ation. 

Two hypotheses were generated: 

• Knowledge derived from direct exper- 
ience with diabetes and its inherent 
problems and solutions results in a 
focus of concern on the "normal" life 
situation and a response characterized 
by tlexibility regarding the therapeutic 
regime (i.e.. diabetic children), 

• Knowledge derived from indirect ex- 
perience with diabetes results in a focus 
of concern on the disease process and a 
response characterized by inflexibility 
regarding the therapeutic regime (i.e., 
parents). 

Implicciiions are. 1 . There is a need 
to encourage the diabetic child to take 
a more active role in his care. 2. Parents 
need help with developing criteria for 
assessing cooperation and crises so that 
minor departures from the diabetic 
regime are not perceived iis critical. 
3. There is a need to explore ways of 
helping children to share their "testing- 
out"" experiences with their parents and 
health personnel. This exchange of in- 
formation would lead to a greater tlex- 
ibility on the part of parents and health 
professionals. 



DeMarsh, Kathleen C; Anderson, A.J.; 
Pooie, Pamela E. A study of the ef- 
fects of a specific iiiservice ecltica- 
lion program for registered nurses 
on patient welfare and hospital 
operation. Winnipeg, Man. Research 
Project (National Health Grant No. 
607-21-1). Health Sciences Centre. 

This project was concerned with the 
effects of a specific inservice education 
program for registered nurses on pa- 
tient welfare and hospital operation. 
Two surgical wards of comparable size 
on the same floor of a large teaching 
hospital were involved, one as the 
experimental and the other as the con- 
trol ward. 1 he project used a "before 
and after" design that provided for the 
same five-month data collection periods 
in each of three years and two seven- 
month intervals when nurses on the 
experimental ward participated in a 
planned inservice education program. 

Each ward was compared to itself 
over the three time periods on all 
measures except mobility of auxiliary 
staff and incidence of absenteeism. 
In these instances the two wards were 
compared with each other. 

The findings indicate that the spe- 
40 THE CANADIAN NURSE 



cific inservice education program for 
registered nurses did not influence drug 
use. However, there were significant 
decreases in the number of days patients 
remained on intravenous fluids post- 
operatively and in the amount of intra- 
venous fluids consumed by patients on 
the experimental ward. These decreases 
were reflected in per diem costs and 
in the use of goods from the central 
supply room, where a steady decrease 
in costs occurred over the three time 
periods. 

Levine tubes were removed earlier 
each year on the experimental ward, 
and one surgeon was influenced to 
change his routine orders for chole- 
cystectomy patients. 

Awareness of the individuality of 
patients was significantly increased in 
more than half the 1 8 nurses exposed 
to the inservice education program. A 
change in nurse behavior because t)f 
this was evidenced by the positive 
change in the patients' assessment of 
their care over the three time periods. 

Differences in staff mobility and in 
patterns of absenteeism suggest that 
the milieu of the experimental ward 
was more conducive to job satisfaction, 
but the findings on the latter are in- 
conclusive. 

Some differences in patient and nurse 
perception of what is important, and 
of the care that is provided, are reveal- 
ed on comparing responses to matched 
items on their respective inventories. 
Also, some interesting questions are 
raised concerning the potential ability 
of nurses to individualize care, and the 
possibility of measuring this potential 
in applicants prit)r to their admissicMi to 
schools of nursing. 

Copies of this study may be obtain- 
ed by writing to Kathleen G. DeMarsh, 
Vice-President, Nursing, Health Sci- 
ences Centre, 700 William Ave., Winni- 
peg, Man., R3E 0Z3. Each copy costs 
$3.50. 



Christensen, Judith C. Saline abortion: 
a study of female behavior in a crisis 
situation. Montreal, Que., 1972. 
Thesis (M.Sc. (Appl.)) McGill U. 

This study, set in the maternity unit 
of a large general hospital, used quali- 
tative methods to examine the behavior 
and certain attitudes of a group of 
women during their hospitalization to 
terminate a mid-trimester pregnancy by 
means of 20 percent hypertonic saline. 

A series of four visits made to most 
of the 21 women included in this study 
were timed to coincide with what seem- 
ed to be the most critical periods of the 
process: admission, injection, labor and 
delivery, and the postabortion period. 

As data collection progressed, a set 
of questions was formulated, which 



determined the nature of the sub- 
sequent analysis. The analysis is a gen- 
eral summation of the data designed to 
answer these questions: 

• What are the social characteristics of 
women who use the facilities of a public 
hospital for an abortion? 

• What reasons are given for termina- 
tion of the pregnancy? 

• What kinds of behaviors emerge 
during the stages of the abortion pro- 
cess? 

• Who does the woman inform about 
the pregnancy and her desire for abor- 
tion? 

• What is the woman"s attitude toward 
the product of conception? 

• What is the woman's attitude to future 
use of a contraceptive device? 

It soon became evident that obstet- 
rical history was an important distin- 
guishing feature. This was chosen as a 
simple dichotomous classification 
scheme for organization of the findings 
in answer to the research questions. 
Multigravidas tended to be older, were 
more likely married, had young chil- 
dren at home, were usually receiving 
financial assistance from the state, 
knew less about the details of the abor- 
tion sequence, experienced a shorter 
labor or no labor at all. and required 
less sedation. 

Most other generalizations derived 
from the data refer to the group as a 
whole. For example: 

• Women undergoing abortion by 
means of saline injection tend to be 
generally subdued and submissive 
during the process. 

• Women undergoing abortion do not 
seek information from persons involved 
in the performance of a task, or who 
seem to be in a hurry, even when a 
problem is obviously developing. 

• Women often weep during the injec- 
tion procedure, but become increasingly 
comptised after the needle is inserted. 

• Behavioral cues that labor has com- 
menced are an important indication of 
the kind of analgesic required to re- 
lieve discomfort. 

• Delivery of the fetus is not a painful 
or extremely distressing experience. 

• Only selected persons in the woman's 
family and group of friends are inform- 
ed of the pregnancy and wish for 
abortion. 

• Depersonalization of the fetus, evi- 
denced by the frequent use of "it" as a 
term of reference, is common. 

• Women may, or may not, ask to see 
and/or know the sex of the fetus. The 
most common time for this request is 
at the time of abortion. 

• Most women undergoing elective 
abortion have not used any form of con- 
traception previously. 

• Most women will agree to use an oral 
form of contraception after the abor^ 
tion. w 

MARCH 1974 



names 




Margaret M. Street, author of Walch- 
Fires on the Mountains, has been 
awarded the Dr. Walter Stewart Baird 
Memorial Medal. This honor was eon- 
t'erred on Ms. Street by the president of 
the University of British Columbia for 
her outstanding work in the history of 
health sciences. 

K. Marion Smith, assistant director oi 
nursing at Surrey Memorial Hospital, 
has been appointed to the new position 
of associate executive director of the 
Registered Nurses" Association o[ 
British Columbia, effective February 
I.S. 1974. 

A former honorary 
secretary of the 
RNABC, Ms. Smith 
has been active on 
numerous associa- 
tion committees. She 
IS a member of the 
task committee to 
develop criteria for 
staffing the operat- 
ing room and was chairman of the com- 
mittee on mandatory registration, which 
reaimmended lay participation on the 
association's board of directors and 
standing committees. 

Ms. Smith is serving a two-year 
term as one of four members-at-large 
on the Canadian Nurses" Association 
board of directors, representing the area 
of nursing administration. 

Ms. Smith (B.Sc.N., U. of British 
Columbia. M.S., McGill U.) was a nurs- 
ing sister in the Royal Canadian Air 
Force from 195.S until 1%!, serving 
as flying officer in Ontario. Labrador, 
and Alberta. 

Irene MacMillan is inservice director 
at the New Waterford Consolidated 
Hospital. New Waterford. N.S. 

Ms. MacMillan 
earned her R.N. at 
the New Waterford 
General Hospital 
school of nursing, 
return i ng a few yea rs 
later to become 
night supervisor 
there. After the hos- 
pital was renamed 
the Consolidated Hospital, Ms. Mac- 
Millan was. tor several years, its even- 
ing and night supervisor of nurses. 
MARCH 1974 





Dorothy McClure 

(Reg.N.. Victoria 
Hospital School of 
Nursing. London. 
Ont.; B.Sc.N., U. of 
Western Ontario. 
London; M.Se.N., 
Boston U.. Boston) 
has been appointed 
director of the 
school of nursing at Lambton College 
of Applied Arts and Technology. Sar- 
nia. Ontario. 

Ms. McClure's nursing experience 
includes several years on the nursing 
staff of Victoria Hospital and West- 
minster Hospital. London, and Sunny- 
brook Hospital. Toronto, and two years 
with the North Atlantic Treaty Organ- 
ization/Royal Canadian Air Force in 
France. She was a public health nurse 
at Norfolk County Health Unit and 
Brant County Health Unit in Ontario. 

Ms. MeCiurc taught at Hamilton 
Civic Hospitals school of nursing, where 
she was activelv involved in dc\ eloping 
and implementmg the curriculum for the 
two-year program. More recently. Ms. 
McClure was an assistant professor at 
McMaster University where she was 
responsible for ciH)rdinating the Year 
1 nursing ct)urse in the baccalaureate 
program. 



The current slate i>f officers of the 
Ontario Occupational Health Nurses" 
Association is as follows. 

President. Jean Laing (Nursing Ser- 
vice Supervisor. Bell Canada. Toronto): 
past president. Patricia Ewen, (Abitibi 
Pnwincial Paper Ittl.. Ihi'rold); I si 
vice-president, Dorothy Schwab (Fos- 
ter-Wheeler Co.. St. Catharines): 2nd 
vice president. Joan Subasic (University 
Hospital. I,ondon): secretary. Gale 
Pearson (St. Joseph's Hospital. Guelph): 
and treasurer. Barbara Bollis (Wolverine 
Tube Ltd.. London). 



Kerry Marshall, currently director of 
nursing at the Belleville General Hos- 
pital. Belleville. Ontario, has been 
medical-surgical supervisor at the 
Toronto General Hospital and staff 
nurse and supervisor at the Royal Vic- 
toria Hospital in Montreal. 

Ms. Marshall (Reg.N., Toronto Gen- 
eral Hospital school of nursing: B.N.. 



Mc-Gill U.) was. in 197.^. granted a 
diploma in health administration from 
the University of Toronto, for which 
she conducted a survey on "Professional 
nurses' attitudes to physicians and the 
personnel in hospital departments." 



Carol Koester of Regina has been named 
the consumer representative on the 
Saskatchewan Registered Nurses' As- 
sociation standing committee on nurs- 
ing. 

Ms. Koester has been active with the 
Regina and provincial branches of the 
Canadian Association of Consumers for 
more than 10 years, and is a past pres- 
ident of the provincial branch. 

A graduate of the University of 
Saskatchewan. Saskatoon Campus, 
holding a bachelor of arts degree and a 
bachelor's degree in education. Ms. 
Koester is currently operating a private 
nursery school tour days a week. 



Sister Joan Carr, (R.N., B.Sc. (Elem. 
Educ). B.Sc.N.. M.Sc.N.), is the new 
director of nursing education at the Ha- 
lifax Infirmary. 

Active in the Registered Nurses' 
Ass(x;iation of Nova Scotia. Sister Carr 
has been chairman of the nursing edu- 
cation committee of its Cape Breton- 
Victoria branch, chairman of the prov- 
incial nursing education committee, 
and a member of curriculum council. 



Louise Beaton was appointed regional 
nursing supervisor for the Prince Al- 
bert Health Region in Prince Albert. 
Saskaskatehewan. 

Ms. Beaton (R.N., 
St. Paul's Hospital 
school of nursing. 
Saskatoon: Dipl. 
P.H., B.Sc.N., U.of 
Saskatchewan. 
Saskatoon ) has been 
a clinical instructor 
' with the Saskatoon 

^ - City Hospital, and 

public health nurse with the Saskatoon 
City Health Department and with the 
Victorian Order of Nurses. Prior to her 
current appointment. Ms. Beaton was a 
public health nurse in the Saskatoon 
Rural Health Region. i? 

THE CAr>|ADi AN NURSE 41 




new products { 



Descriptions are based on information 
supplied by the manufacturer. No 
endorsement is intended. 




Ciic II incision I niy 



•iVf^K 



eoG 



II 
f I 






lilooil ('((//('(7//H,' /V('('<//CA 



Circumcision tray 

The Hollister circumcision tray puts 
everything at the obstetrician's finger- 
tips tor quici< circumcision in the deli- 
very room, nursery, or physician's 
oftlce. Contents, which are guaranteed 
sterile, include prep sponges and 
fenestrated drape (in sequence of use), 
Plastibell circumcision device with 
ligature, and all instruments. The tray 
eliminates costly preparation time and 
the chance of finding an instrument 
dulled by previous use. Single-use 
instruments are designed specifically 
for the three-minute circumcision 
procedure. 

This tray is supplied by Hoi lister 
Limited. 332 Consumers Road, Wil- 
lowdale. Ontario. 

Blood collecting needles 

The new Jelco Disposable Blood Col- 
leaing Needles, Safe 1 and Safe 11, have 
been designed for patient safety and 
for the safety of technicians. Bleeding 
thumbs are eliminated with the safe 
puncture-resistant package. 

42 THE CANADIAN NURSE 



According to the company, the triple- 
beveled needle point and exclusive 
micro-bonded siliconized needle 
reduces patient pain to a minimum. 
Needle "spinout" is prevented because 
the threaded metal hub locks firmly 
onto the needle holder. On the multiple- 
sample needle, the resiliency of the 
valve permits repeated draws without 
leakage. 

Three needle sizes are available. 
For further information, write to 
Arbrook Ltd.. Peterborough, Ont. 
Kyj 7B9. 



Ventilator control system 

The Life Systems Division of Bourns, 
Inc. has introduced the Model LSI2.'^ 
Ventilator Control System. This unit 
provides volumetric limit control and 
continuously variable sigh function 
control for any pressure limited ventil- 
ator (I PPV). 

It controls the volume of gas deliver- 
ed to the patient from the ventilator 
within the pressure and tlow capabilities 
of the ventilator used, without impair- 



ing any of the control functions of the 
ventilator, including ;issist, assist- 
control, and control modes of ventila- 
tion. The system provides alarms for 
high and low pressure, plus an alarm 
for apnea, all of which deliver both an 
audible and visual signal. 

The Model LSI 25 is placed in the 
pneumatic line between the ventilator 
and the patient with no functional 
mechanical interconnection with the 
ventilator, hence its interchangeability 
with any I PPV. Mechanical support is 
provided by accessory mounting brack- 
ets, and interconnecting tubing lor 
various respirators is available. 

There are two Canadian distributors 
of this system. E-I-L Inc.. 1565 Lou- 
vain St. W.. Montreal 1 I, Quebec; and 
Mid-Canada Medical. 1244 Albert 
Street, Regina, Saskatchewan. 

New approach to ileostomy 

The Swedish International Press 
Bureau rept^rted last January that a 
new approach to ileostomy has done 
much to remove patients' objections to 

MARCH 1974 



the operation, which previously caused 
distressing side effects. 

Dr. Nils Kock of Sahlgrenska Hos- 
pital, Gothenburg, has used his new 
method on some 100 patients so far. 
This method provides for a bag to be 
placed inside the abdomen. Its outflow 
is fitted with a special valve, which 
prevents involuntary emptying of the 
intestine and eliminates odor. Dr. Kock 
has used the modified surgery on 10 
patients who had undergone the con- 
ventional operation, which calls for 
the removal of the colon and creation 
of an artificial opening into the ileum. 

The newspaper Svenska Dagbladet 
first reported this new method. 



Literature available 

A bulletin (no. 51-215) on Dow Com- 
ing's new Silastic contour design 
mammary prosthesis is available from 
Dow Corning Silicones Inter-America 
Ltd.. 1 Tippet Road, Downsview, On- 
tario M3H 5T2. This bulletin describes 
the prosthesis, gives the instructions for 
using it, and explains the surgical 
procedure (Cronin technique) for an 
augmentation. 

The shape of this prosthesis is not 
new when it is compared to prior seam- 



less contour design, but its envelope is 
thinner. The soft, seamless envelope, 
which characterizes the prosthesis, 
contains a low viscosity, translucent 
silicone gel that closely approximates 
the softness, mobility, and weight of 
the normal breast. 



l.umcx. Inc. has issued a new brochure, 
which outlines the company's line of 
bed rails and safety sides available in 
a variety of models to fit all types of 
beds. The brochure is available in 
Canada from Bercotec, Inc., 11422 
Albert Hudon Blvd., Montreal 462, 
Quebec. 



Ileostomy patients can get advice about 
specific techniques of care, use of ap- 
pliances, and other areas of concern 
from Living Comfortably with Your 
Ileostomy, a booklet published by Sister 
Kenny Institute, Minneapolis, Minne- 
sota. This revised edition contains 
photographs of step-by-step proced- 
ures, as well as current equipment 
information. Techniques that enable 
the patient to care for his ileostomy 
with maximum ease are described. 



A discussion of necessary adjust- 
ments is included. There are sections 
on topics, such as skin care, general 
care and bathing, physical activities, 
clothing, daily living, and travel. A diet 
guideline for the patient to follow dur- 
ing the first six weeks following surgery 
is provided. An information form for 
ordering supplies — to be completed 
by physician and patient — simplifies 
this task. 

This manual, which was written by 
a nurse, may be obtained from the 
Publication Department, Sister Kenny 
Institute, 1800 Chicago Avenue. Min- 
neapolis, Minnesota 55404, U.S.A. 
Prepayment of SI. 25 per copy is re- 
quested on orders under S5. 

Heel Protector 

Posey Company has introduced a new 
heel protector, designed not to ride up 
the patient's leg nor be kicked off by a 
restless patient. This protector is avail- 
able in synthetic fur or polyurethane 
foam. Plenty of air circulation is insur- 
ed because the protector is vented on 
both sides of the ankle and at the heel. 

This product is available from Enns 
and Gilmore Limited, 1033 Range- 
view Road, Port Credit, Ontario. ■^ 




Introducing an 
extremely useful new 
medical instrument. 



Although the 'BIG 4' colour pen nnay not rank with the greatest medical inven- 
tions of the century, it's certainly one of the handiest. With this one neat 
little device you can mark down temperatures, blood pressures, allergies 
and do all the strange things doctors and nurses do, all in different 
colours. You also pay less for it than you would for even the simplest 
medical instrument. The 'BIG 4' colour pen is only $1.29. And our almost 
as useful 'BIG 2' colour pen is 79C. Both come in Fine or Medium points 
and are available everywhere. 



(^^ 



MedluyyyiOt 




couleurs 
colour pen 




MARCH 1974 



THE CAN/telAN NURSE 43 



Wafch-fires on the Mountains: The 
Life and Writings of Ethel Johns, 

by Margaret M. Street. 336 pages. 
Toronto, University of Toronto 
Press, 1973. 

Reviewed by Jean E. MacGregor, 
Librarian. National Science Library. 
Ottawa, and former Associate Editor. 
The Canadian Nurse. 

Every profession numbers in its ranics 
those, who through excellence of mind 
and spirit, not only make history but 
themselves become an enduring part of 
it. Ethel Johns is of this company. We 
are indebted to her biographer — her- 
self a distinguished Canadian nurse 
— for affording us the opportunity 
of seeing this courageous and dynamic 
woman within the perspective of both 
national and international nursing. 
The author undertook the project to 
mark another milestone in Canadian 
nursing history — the Golden Jubilee 
of the^UBC School of Nursing. Ms. 
Johns was its first director. 

Painstakingly researched and record- 
ed with warmth and understanding, the 
story of this eventful life gradually un- 
folds in a series of chapters correspond- 
ing to significant periods of personal 
and professional development. Proba- 
bly best known in her various profes- 
sional capacities, the glimpses of an- 
other, more intimate side of Ms. Johns' 
nature are doubly appreciated. 

The little girl who sailed from Eng- 
land in 1N92 to join her parents in 
Canada had already learned much self- 
reliance. The subsequent nine years on 
the Wabigoon Indian reserve were to 
test those inner resources even more 
deeply. The sudden death of her father 
committed her to an indefinite period 
in an isolated area, and dashed hopes 
for additional formal education. She 
was 20 years of age when the way was 
finally clear for her to enter the Winni- 
peg General Hospital Training School 
for Nurses. The year was 1 H99, and 
Ethel Johns was launched on her varied, 
sometimes controversial, career. 

In the years that opened before 
her, she was to become known as nurse 
educator, lecturer, administrator, edi- 
tor, and author. She was to be held in 
high esteem for her foresightedness. 
sound judgment, and integrity. Her 
opinions and advice were to be sought 
both wrthin and outside her own pro- 
fession. She was a visionary who saw 

AA TLJC /^ A 1^1 A rtl A K.I VII rDCC 




EthelJohns. circa 79/ 9. 

nursing not only as it was, but as it 
could be. Consequently, the causes that 
she championed were often far in ad- 
vance of the time. 

As a young graduate, troubled over 
the deficiencies in current nursing edu- 
cation programs, she looked ahead to a 
better day when schools of nursing 
would be under university direction. 
Concern for the protection of the public 
and her profession prompted her sup- 
port of nurse registration. Her convic- 
tion that those slated for nursing leader- 
ship required advanced learning won 
her enthusiastic efforts on behalf of 
university programs. She foresaw a role 
for an auxiliary group of nursing atten- 
dants who could free the professional 
nurse for more difficult and highly 
skilled duties. Her faith in the effective- 
ness of organized groups led to her 
involvement in nursing and hospital 
organizations. 

Coming from a family where culture 
and learning had been paramount, Ethel 
Johns inherited considerable literary 
talent. Her lack of more formal educa- 
tion had been offset by the reading pro- 
gram set for her by her father, and her 
own continuing thirst for knowledge. 
Her appointment as editor of The 
Canadian Nurse came at a critical per- 
iod in the journal's history. Depres- 
sion years were at their height: sub- 
scriptions were declining. The Weir 
Report on nursing education in Canada 
had just been released; it was hoped that 
ihc journal would contribute substan- 
tially to its effectiveness. 



From the day she started work as 
editor in 1933, until her retirement in 
1944, Ms. Johns devoted herself to the 
growth and improvement of the publi- 
cation. She enlisted support through her 
ability as a speaker and her encour- 
agement of nurse authors. Her own 
writing talent was given an outlet as 
well. They were not easy years, but they 
were good years as both the journal and 
the Canadian Nurses' Association ex- 
perienced growing pains. 

Ethel Johns' biography belongs in 
any collection of nursmg or medical 
history, for she was truly an interna- 
tional figure. Her life touched or was 
touched by many of the outstanding 
leaders of her profession on this conti- 
nent. Students of Canadian nursing his- 
tory will appreciate both the additional 
information and the immensely read- 
able tbrmal in which it is presented. 

There is a need for more contribu- 
tions of a similar nature. Canadians 
tend to be somewhat dilatory in their 
recognition of the great ones in their 
midst. Readers outside the profession 
can enjoy and appreciate this chapter 
in the history of a nation; the causes 
championed were to affect the lives of 
everyone. Above all, nurses can be 
grateful that Ethel Johns, and others like 
her, "climbed the hill" and lit the 
watch-fires. 



A Programmed Introduction to Micro- 
Biology, 2ed. by Stewart M. Brooks, 
1 24 pages. Saint Louis. Mosby. 
1973. 

Reviewed by Richard J. Bozynski, 
Master, Nursing Program . Confeder- 
ation College. Thunder Bay. Onl. 

This thin, wire-bound ""self-learner"" is 
intended to be used with any standard 
textbook of introductory microbiology. 
The use of this paperback is threefold, 
to provide the instructor with a skeleton 
for his notes; to provide the student 
with a simple format for review: and 
ti> help the student who is learning the 
subject for the first time. 

In this second edition, all the infor- 
mation has been updated and stream- 
lined. The interest of teachers and 
students has been kept in mind: many 
of the changes were prompted by sug- 
ijestions and constructive criticisms. 

This '"sell-learner" is contemporary 
(CoiiliiiiiccI on pane 46) 
MARCH 1974 



A New Book! CHILD HEALTH MAINTENANCE: Concepts in 
Family-Centered Care. This book provides a comprehensive resource for 
the study of concepts needed to maintain or restore health for the child 
within the context of his family and environment. In addition, the 
book provides the only summary of developmental physiology avail- 
able. Behavioral theories and a philosophy of comprehensive health care 
by a multi-professional team are presented in the same detail. By 
PEGGY L. CHINN, R.N., Ph.D. March, 1974. Approx. 608 pages, 8" x 
10", 214 illustrations. About $14.20. 

A New Book! CHILD HEALTH MAINTENANCE: A Guide to Clinical 
Assessment. In easy-to-use table form, this complete guide integrates 
principles of behavior, nutrition, family and environmental sciences. 
Topics include: developmental differences; immunizations; vital signs; 
lab procedures; environmental standards; assessment of growth and 
development; common illnesses; and nutrition. By PEGGY L. CHINN, 
R.N., Ph.D.; and CYNTHIA J. LEITCH, R.N., M.S. March, 1974. 
Approx. 148 pages, 8" x 10", 20 illustrations in 20 figures. About 
$5.20. 

New 7th Edition! SCIENTIFIC PRINCIPLES IN NURSING. Providing 
a concise, clear-cut foundation for effective application of scientific 
principles in the daily ministration of patient care, this book supplies a 
rational approach to planning nursing care that meets the needs of the 
patient as he responds to his environment. Concepts of stress and 
homeostasis are presented throughout as components in planning 
holistic care. By SHIRLEY HAWKE GRAGG, R.N., B.S.N.; and OLIVE 
M. REES, R.N., M.A. April, 1974. Approx. 480 pages, 7" x 10", 259 
illustrations. About $10.25. 

A New Book! ESSENTIALS OF NUTRITION AND DIET THERAPY. 

Designed to contain current material pertinent to the needs of health 
workers at all levels, this text includes material on nutritional 
counseling, food needs and costs, electrolytes and metabolism, and in 
depth material on ethnic groups, their nutritional needs, and family 
customs. Of special significance is a complete chapter on the food 
environment including ecology of human nutrition, economic and 
political environment, hunger, poverty and government programs. By 
SUE RODWELL WILLIAMS, M.R.Ed., M.P.H. April, 1974. Approx. 
352 pages, 7" x 10", 33 illustrations. About $7.30. 

New 7th Edition! HISTORY AND TRENDS OF PROFESSIONAL 
NURSING. Stressing the evolutionary role of women in today's society 
and interweaving it with the equally monumental change in nursing and 
the delivery of health services, the authors report on such current topics 
as: female liberation; abortion laws; legal aspects of nursing; continuing 
education in nursing; research; the ladder concept; and the "nurse 
practitioner". By GERALD JOSEPH GRIFFIN, B.S., M.A., Ed.D., R.N.; 
and JOANNE KING GRIFFIN, B.S., M..A., R.N.; with a special unit on 
Legal Aspects by ROBERT G. BOWERS, B.A., J.D. July, 1973. 312 
pages plus FM I -XI I, 7" x 10", 62 illustrations. Price. $9.45. 



MOSBY 

TIMES MIRROR 

THE C V MOSBY COMPANY. LTD 

86 NORTHLINE ROAD 

TORONTO. ONTARIO 

M4B 3E5 



VITAL SIGNS 
OF NURSING 
PROGRESS... 
NEW BOOKS 
FROM MOSBY 





1 


CLINICIAN 


INTERVENTION 


1 






1 


ASSESSMENT 


PRACTITIONER 


1 






1 


ICU 


ecu 


1 






1 


PRIMARY 


PSYCHOSOCIAL 


1 






1 


COMMUNITY 


MOBILITY 


1 






1 


REVIEW 


RESEARCH 


1 






1 


CHALLENGE 


O.R. 


1 






1 


EDUCATION 



MARCH 1974 



THE CANADIAN NURSE 

% 



45 




tCitiUiniicd from piii;c' 44) 

with the needs of nurses who are requir- 
ed to upgrade their education. A well- 
organized text, it gradually develops 
the learners knowledge of the subject 
with a simple to complex approach, 
to give the student a general under- 
standing of microbiology. 

Understanding of new content is 
reinforced by a repetative and progres- 
sive use of terminology and facts in 
structuring the questions. Answers 
are given in the margin opposite the 
question; a mask is provided with the 
test to cover the answer(s). 

This "'self-learner" is divided into 
three major parts. Part 1 deals with the 
general principles of microbiology, such 
as the various microorganisms and 
their characteristics. Part 11 familiarizes 
the student with medical microbiology, 
dealing with such topics as infection, 
immunity, diagnosis, and diseases 
caused by the various classifications of 
microorganisms. Part 111 provides the 
student with an understanding of 
sanitary, industrial, and soil micro- 
biology. 

The apparent intent of this program- 
med text is to provide a general know- 
ledge oi microbiology. An adequate 
reference list for both teachers and 
students is included in the text. 

The general impression of those 
who have shared with me A Program- 
DU'il Introduction to Microbiology is 
that it ranks among the better program- 
med texts. 



Dr. Turtle's Babies by William John 
Turtle. 318 pages. Toronto, W.B. 
Saunders Company, 1973. 
Reviewed by Barbara G. Brown. 
Assistant Professor, Faculty of Nurs- 
ing, The University of Western On- 
tario. London, Ontario. 

Dr. Turtle, a retired pediatrician, found 
that most of his time in practice had 
been spent trying to assist parents deal 
with handling and behavioral prob- 
lems. This book, an outgrowth of a 
discussion group series for expectant 
parents, is Dr. Turtle's attempt to give 
parents a clear, beforehand picture of 
how babies grow, develop, and behave, 
and to help them understand what is 
involved in rearing a child. 

In the first part of the book, the 
author discusses the fundamentals in- 
volved in the job of being parents. These 
fundamentals are divided into four as- 
pects; six major areas of responsibility 
46 THE CANADIAN NURSE 



in care and handling of a baby; tech- 
nique of feeding; specific problems in 
care and handling; and nursery set-up 
and equipment. 

On Nature rests the prime respon- 
sibility for the first two areas, treatment 
of infections and feeding, with the 
parents playing a supportive role. The 
four remaining areas of respt^nsibility; 
prevention of accidents, training, dis- 
cipline, and education, rest on the 
shoulders of the parents. The section on 
technique of feeding is comprehensive 
and. what is most important, equal 
treatment is given to breast and bottle 
feeding. Practical suggestions related 
to both techniques are offered. 

As Dr. Turtle stated in the intro- 
duction, he discusses a few specific 
problems in care and handling. Al- 
though most of these are problems that 
will inevitably arise, they are too few 
and too specific. This section would be 
more useful had the author included 
some principles applicable to dealing 
with problems in general. 

In the second part of the book the 
author has taken the fundamentals 
dealt with in the first part and applied 
them chronologically to the care and 
rearing of an infant from birth to one 
year. The format and presentation of 
the material with repetition of points 
— not only from part one to part two 
but within each part — combined with 
the frequent use of italics and the enu- 
meration of steps or requirements, puts 
across the author's message in a pedan- 
tic manner. This same style, however, 
makes it easy for the reader to locate 
a specific topic or point, and thus in- 
creases the book's value as a reference. 

The practical approach to the care 
and handling of an infant, with an 
emphasis on prevention, makes this 
book useful, not only as a guide for its 
intended audience — expectant pa- 
rents — but also as an additional refer- 
ence for nurses, particularly neophytes, 
working with parents expecting and 
rearing young children. 



Family Health Care by Debra P. Hymo- 
vich and Martha Underwood Bar- 
nard. 462 pages. Toronto, McGraw- 
Hill, 1973. 

Reviewed by Janet C. Kerr. Assis- 
tant Professor, School of Nursing, 
University of Calgary. Calgary. 
.4 Iberta. 

This volume of original contributions 
by some 34 authors represents an im- 
portant contribution to the literature 
relating to health care and families. It 
cuts across much of the current theory 
arising from various disciplines con- 
cerning the family and applies this to 
health care. In so doing, it is unique 
because it provides a comprehensive 



reference on the subject, not previously 
available for nurses in practice and 
nursing students. 

Part one of the three-part book pre- 
sents concepts, which relate to the fa- 
mily, from a number of disciplines, 
including nursing, medicine, law, socio- 
logy, economics, and anthropology. 
Significant aspects of this section of the 
book include the account of the histori- 
cal development of family nursing and 
family medicine. 

In Part two the focus of discussion 
is the expanding and contracting fa- 
mily. Consideration is given to family 
planning; the adopting family; and 
families with infants, young children, 
school-age children, adolescents, and 
elderly members. The family in crisis is 
the topic for Part three and a number 
of possible family crises are used as 
illustrative material in this section. 
Some of the specific content areas cov- 
ered include the family with a child with 
a birth defect, child abuse, abortion, 
suicide, myocardial infarction, and ter- 
minal illness. 

This book will undoubtedly prove 
to be a useful and exciting tool for 
nurses interested in providing improved 
health care for families. However, the 
authors have intended that their book 
be used more widely and it is certain 
that this volume will provide a valuable 
reference for the health professions 
generally. 



Principles of Microbiology, 7ed., and 
Laboratory Manual and Workbook, 

by Alice Lorraine Smith. 681 pages. 
St. Louis, Mosby, 1973. 
Reviewed by Jean Jenny, Instructor, 
University of Ottawa, School of 
Nursing, Ottawa, Ontario. 

Those familiar with Smith's textbook, 
Principles of Microbiology, will wel- 
come this updated and greatly expand- 
ed seventh edition. It has been rework- 
ed "to give contemporary coverage in 
microbiology and ordered to progress 
in a design readily assimilated by stu- 
dents in health science training pro- 
grams." 

The material comprises six separate 
units. The first two introduce the nature 
of microbiology and its basic principles 
and procedures, including emphasis on 
the use of the microscope. A separate 
chapter on specimen collection would 
be useful to the student in her clinical 
practice. 

Units three and four discuss or- 
ganisms in relation to infection and 
disease, particularly stressing immu- 
nology and the immunologic reactions. 
A variety of tables, such as a listing of 
distribution of organisms resident on 
the body, the transmission of disease, 
iCoiitiiuicil 1)11 pciiii' 4S) 

MARCH 1974 



A New Book! READINGS IN CHILD AND ADOLESCENT PSYCHI- 
ATRIC NURSING. Here is the only volume specifically directed to the 
nurse's therapeutic role with the emotionally disturbed child and 
adolescent. The book is divided into three parts: the first part providing 
an overview of nursing in child psychiatry; the second part dealing with 
therapeutic intervention with latency age children; and the third part 
focusing on therapeutic intervention with emotionally disturbed adoles- 
cents. Edited by CLAIRE M. FAGIN, Ph.D., R.N./ with 34 contributors. 
January, 1974. 190 pages plus FM l-XIV, 6" x 9", 10 illustrations in 10 
figures. Price, $6.05. 

New 2nd Edition/ CR\S\S INTERVENTION: Theory and Methodology. 

Presenting a comprehensive overview as well as an introduction and 
guide to crisis intervention from its historical development to its 
present utilization, this book shows different techniques used in 
short-term therapy as opposed to those for extensive analysis. Factual 
discussions in nontechnical language describe events which may 
precipitate a crisis and introduce practical methods for intervention. By 
DONNA C. AGUILERA, M.S.; and JANICE M. MESSICK, M.S. June, 
1974. Approx. 148 pages, 6V2" x 9V2", 13 illustrations in 13 figures. 
About $6.30. 

A New Book! FAMILY-CENTERED COMMUNITY NURSING: A 
Sociocultural Framework. Emphasizing the varied facets of family and 
community living essential to planning and delivering health care, this 
new book illustrates the nature of new roles the nurse is expected to 
assume. The readings examine the cultural and psychosocial factors 
which determine whether families are likely to use available health care 
services. By ADINA M. REINHARDT, Ph.D.; and MILDRED D. 
QUINN, R.N., M.S.; with 40 contributors. October, 1973. 304 pages 
plus FM l-XVI, 6%" x9%". Price, $6.60. 

A New Book! SCHOOL NURSING IN TRANSITION. Specific guide- 
lines are presented for developing and administering programs, and the 
core nursing procedures involved in health service delivery are detailed. 
The need for new techniques is emphasized to increase the effectiveness 
of school health services. The book outlines principles of interrelation 
between the school nurse and children, parents, and community and 
school personnel. Problems discussed include health appraisal and 
communicable disease care. By DORIS S. BRYAN, R.N., M.P.H., Ph.D. 
October, 1973. 204 pages plus FM l-XIV, 7" x 10", 57 illustrations. 
Price, $8.40. 

A New Book! CLINICAL ASSESSMENT FOR THE NURSE PRACTI- 
TIONER. The authors of this new book provide a helpful overview of 
the clinical diagnostic process. The book explores the essentials of 
patient history-taking, performing a physical examination, keeping 
meaningful patient records, and ordering and interpreting appropriate 
laboratory studies. Anatomical and pathological processes are briefly 
outlined, and a final chapter applies diagnostic methods to specific 
patient situations. By WILLIAM C. FOWKES. Jr., M.D.; and 
VIRGINIA K. HUNN, R.N., B.S.N. August, 1973. 190 pages plus FM 
l-X, 7" X 10", 36 illustrations. Price, $6.30. 



MPS BY 

TIMES MIRROR 

THE C V MOSBY COMPANY. LTD 

86 NORTHLINE ROAD 

TORONTO. ONTARIO 

M4B 3E5 



VITAL SIGNS 
OF NURSING 
PROGRESS... 
NEW BOOKS 
FROM MOSBY 



CLINICIAN 



INTERVENTION 



ASSESSMENT 



PRACTITIONER 









ecu 






« 




PRIMARY 


PSYCHOSOCIAL 











COMMUNITY 


MOBILITY 










*. 






REVIEW 


RESEARCH 










CHALLENGE 


O.R. 






t 










EDUCATION 



MARCH 1974 



THE CANADIAN NURSE 47 



'JAD 



iCoiitiiiiicil fioiii />».!,'(' -46) 

and household pets as sources of in- 
fections, enlarge on the topic of infec- 
tiousness. One would, perhaps, have 
expected more than a half page on 
autoimmune diseases. 

Unit four covers the principles of 
sterilization, providing a useful refer- 
ence in central supply and isolation 
techniques for practicing nurses. 

Unit tlve, the largest, presents a 
roster of significant pathogens ami 
parasites. Material on the venereal dis- 
eases has been augmented, presumably 
to reflect current epidemiological 
trends. The major infectious diseases 
are dealt with comprehensively, making 
this text an excellent reference source 
for graduate nurses. 

Unit six relates to the microbial 
presence in everyday life. A survey. 
It includes the latest information on 
immunization and environmental san- 
itation. 

Also available is a Microbiology 
Laboratory Manual and Workbook by 
the same author. It is designed to be 
used with the textbook, as indicated in 
the reference sources. Each exercise 
is directed toward specific, stated ob- 
jectives and lists the equipment needed 
and techniques to employ. Twenty- 
nine exercises are described, covering 
such subjects as cultivation of bacteria, 
sources of infection, phagocytosis, 
anaphylaxis, and testing the efficiency 
of sterilization procedures. It is a 
good basic laboratory manual with 
clear and easy-to-follow instructions. 

Both volumes would be excellent for 
use in presenting a comprehensive 
course in microbiology for nurses. 



A Practical Manual on Reproduction 

by Jacques E. Rioux and John Col- 
lins, Eds. 330 pages, Laval. Presses 
de rUniversite Laval, 1973. 
Reviewed by May Tolh, Lecturer. 
Maternal-Child Nursing. School of 
Nursing. McMaster University .Ham- 
ilton. Ontario. 

This book is bilingual. The editors 
were directed to produce it by the 
Canadian Fertility Society. They sug- 
gest that the book will be of practical 
value to medical students and family 
physicians. Fourteen authors were 
involved in the presentation of the 
material. 

The material presented covers the 
general areas of anatomy and physiology 
of the male and female genitalia, con- 

48 THE CANADIAN NURSE 



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ception, infertility, contraception, abor- 
tion, sexual behavior, and sex education. 
There is a liberal supply of diagrams 
and charts throughout the text. 

The amount of bibliographic mater- 
ial offered varies from author to author. 
For example, there were only two re- 
ferences given in regard to the hormon- 
al methods of birth control. 

The section covering the anatomy 
and physiology of the genitalia and 
conception is easy to understand and 
well supplied with diagrams. Material 
related to development of the organs in 
utero is helpful. However, it is disap- 
pointing to note that though two para- 
graphs are devoted to the male sexual 
response, no space is devoted to the 
female sexual response. 

The section on reproductive failure 
is helptul. Many possible problems, 
and tests to aid in the diagnosis of 
problems, are cited. The technical as- 
pects of investigative procedures are 
discussed in several instances. There 
is a periodic attempt to consider the 
psychosocial aspects of care. 

The section on reproductive control 
is generally adequate. The authors of 
the chapters on IUt)s and sterilization 
are, perhaps, rather conservative in 
their approach to the use of these meth- 
ods. Long-term effects of sterilization 
are inadequately covered. 

The section on sexual behavior is 
useful but too brief. It is not free from 
value judgments. The one on sex edu- 
cation in schools is extremely valuable. 
The authors combined medical and 
educational theory. The result is a 
usable study of the subject. 

The text could be a useful reference 
for health-care practitioners and student 
practitioners, if it is kept in mind that 
the need for brevity has necessitated 
skimming many subject areas. It is cer- 
tainly useful to have material on infer- 
tility and contraception in the same 
text. Practitioners and learners would 



be wise to use additional reference 
material in most areas. 

The fact that the text is bilingual 
is both an advantage and a disadvan- 
tage. Had the book been published 
simultaneously in French and English, 
a smaller and less costly book could 
have been produced. The bilingual 
text is useful for libraries serving bi- 
lingual populations. Individual pur- 
chasers might prefer to purchase it in 
one or the other language. 



The Cardiac Rhythms: A Systematic 
Approach to Interpretation by Ray- 
mond E, Phillips and Mary K. Feen- 
ey. 3?4 pages. Toronto, Saunders, 
1973. 

Reviewed by Joan Royle. McMaster 
University School of Nursing, Ham- 
ilton. Ontario. 

As the title implies, this book is intend- 
ed to help the student recognize and 
describe the common disorders of the 
cardiac rhythm. 

The authors begin with a brief re- 
view of the embiyological development 
and clectrophysiology of the human 
heart. The section on the standard elec- 
trocardiogram and lead system pro- 
vides the basis for interpretation of 
arrhythmias. 

The major portion of the book deals 
with the common cardiac rhythms, 
which are discussed according to the 
anatomical source of the deviation. The 
content is made more meaningful to the 
reader by the use of actual patient 
histories and tracings and by the many 
practical points the authors share from 
their experiences. Many test tracings 
throughout the text provide the reader 
with feedback on his comprehension of 
the text. 

Sections on electronic pacemakers 
and cardiac drugs provide a basis for 

(Conliniicil oil piiiic 50) 
MARCH 1974 



New 2nd Edition! INTENSIVE NURSING CARE. This new book 
presents essential information needed by personnel who care for 
critically ill patients and briefly explains the physiological mechanisms 
involved. Discussions include problems and skills involved in care of 
patients with respiratory, neurological, gastrointestinal, renal and 
endocrine disorders; management of obstetric complications, shock, 
and poisoning; as well as care of the critical cardiac patient. By 
LENETTE OWENS BURRELL. R.N., B.S., l\/i.S.N.; and ZEB L. 
BURR ELL. Jr., A.B.. M.D., F.A.C.P. June, 1973. 360 pages plus FM 
l-XVI, 7" X 10", 84 illustrations, with drawings by WEONA WRIGHT. 
Price, $10.25. 

A New Book! UROLOGIC ENDOSCOPIC PROCEDURES. Designed to 
serve as an informative guide for understanding the patient in the 
urologic endoscopic room, this book informs you of the indications and 
equipment requirements for urologic endoscopic procedures. Basic 
equipment and instrument requirements for specified procedures, and 
techniques for instrument sterilization and maintenance are described 
in detail. Included also are chapters devoted to patient care before and 
after the urologic procedures. By ALICE MOREL, R.N. ; and GILBERT 
J. WISE. M.D., F.A.C.S. May, 1974. Approx. 144 pages, 6%" x 9%", 
172 illustrations. About $10.00. 

New 2nd Edition! MATERNITY NURSING. Presenting the entire 
maternity cycle as a normal physiologic process, this new edition 
emphasizes nursing responsibility throughout. Material is included on 
the preparatory phase, pregnancy, labor and parturition, the post- 
partum period, and the neonate. A new unit of review questions, 
following case histories of two expectant mothers completely through 
the maternity cycle, has been added. By CONSTANCE LERCH, R.N., 
B.S.fEd.). April, 1974. Approx. 352 pages, 7" x 10", 189 illustrations. 
About $11.50. 

New 3rd Edition! WORKBOOK FOR MATERNITY NURSING. This 
workbook covers all aspects of the subject — anatomy, conception, 
fetology, labor and delivery, and the newborn infant. It reviews 
techniques and procedures pertaining to successful maternal care; 
discussing diagnosis of pregnancy, resultant physiological changes, and 
complications. Up-to-the-minute topics include: the nurse and the 
unwed mother; the prenatal clinic; high-risk labor and delivery; and the 
high-risk neonate. By CONSTANCE LERCH, R.N., B.S.fEd.). October, 
1973. 194 pages plus FM l-VIII, 7%" x 10%", 37 illustrations. Price. 
$555. 

A New Book! REVIEW OF PHARMACOLOGY IN NURSING. This 
concise addition to the Mosby Comprehensive Review Series fosters an 
understanding of basic pharmacologic action and its clinical application. 
In a question-and-answer format, this book looks at pharmacologic 
principles, administration of drugs, specific drugs which act on the 
various body systems and toxicology. Also discussed in a pertinent, 
up-to-the-minute chapter is recognition, control and treatment of drug 
abuse. By BETTY S. BERGERSEN, R.N., M.S., Ed.D.; and JURA TE A. 
SAKALYS, M.S. May, 1974. Approx. 176 pages, 5%" x 8%". About 
$4.75. 



MOSBY 

TIMES MIRROR 

THE C V MOSBY COMPANY. LTD 

86 NOBTHLINE ROAD 

TORONTO. ONTARIO 

M4B 3E5 



VITAL SIGNS 
OF NURSING 
PROGRESS... 
NEW BOOKS 
FROM MOSBY 



CLINICIAN 



INTERVENTION 



ASSESSMENT 



PRACTITIONER 



ecu 










PRIMARY 


PSYCHOSOCIAL 










COMMUNITY 









MOBILITY 










REVIEW 


RESEARCH 










CHALLENGE 


O.R. 










EDUCATION 



MARCH 1974 



THE CANADIAN NURSE 49 



gAfil 




(Ci>iiliniii'd from pai;c' 4Sj 

understanding the treatment o\ various 
arrhythmias. 

The authors have collected and or- 
ganized a vast number of electrcxrar- 
diographic tracings into a text designed 
as a primer for self-study. The student 
or graduate nurse preparing to function 
in a coronary care unit or wishing to 
increase her skill in recognizing and 
describing cardiac arrhythmias will 
find this a valuable reference book. 

The authors do a good job in deliver- 
ing what they promise, a plan for ac- 
quiring skill in the electrocardiogra- 
phic interpretation of the heartbeat. A 
major criticism of scope lies in the 
authors' failure to discuss vector ana- 
lysis and to provide sufficient depth 
in cardiac physiology and electrophy- 
siology to enable the reader to under- 
stand the pathophysiological processes 
underlying the arrhythmias. 



Leadership Technique in Expectant 
Parent Education, 2cd.. by Anne L. 
Clark. 1 1 8 pages. New York, Spring- 
er, 1973. Canadian Agent; Lippin- 
cott, Toronto. 

Reviewed by Catherine McCaffrey, 
Lecturer, School of Nursing, The 
University of Manitoba, Winnipeg, 
Manitoba. 

The main purpose of the book is to 
provide a guide for the beginning 
instructor and to help her develop 
skill in using the group leadership 
method to conduct parent education 
courses. 

Further objectives identified are. 
to encourage the nurse instructor to 
develop her own teaching style, and 
to keep abreast of current research 
and practices in parent education. 

One particularly interesting piece 
of research is in the area of "reaction 
to the state of pregnancy." Some reports 
indicated that up to 85 percent of 
women were unhappy upon first dis- 
covering that they were pregnant, it 
was found that many women do not 
like to be pregnant and may resent it. 
This response seems to be especially 
relevant when one considers how society 
views pregnancy. Society makes the 
assumption that every pregnant mother 
(married) wants her baby. 

One item, which was difficult to 
grasp in terms of feasibility, was that 
of "employment"' of the expectant 
mother. The b(X)k states. "Generally 
speaking, if she is happy in her position. 

50 THE CANADIAN NURSE 



the work not overly tiring and her 
pregnancy progressing normally, she 
may be permitted to do so." 1 wondered 
how many expectant mothers have this 
choice, especially in the present time 
of inflation and world tensions. 

1 strongly recommend this book to 
those concerned with parent education. 
The value of such a book lies in its 
variety of applications. Not only is it 
an excellent guide for the beginning 
instructor, but it has great potential lor 
teaching at all levels. For example, the 
benefit of such a book, incorporated 
into the teaching of baccalaureate stu- 
dents, can be readily seen and was also 
demonstrated by the author. 

Another major asset of this book 
is its current and relevant bibliography. 
One can appreciate the human aspect 
of the extent of the research, as demon- 
strated by the participation of pregnant 
mothers in the Olympic games; one 
can easily see how such information 
would incite the interest of the univer- 
sity student. Another benefit of this 
book is the concise form of its presenta- 
tion, which provides accessible material 
to all readers. 



Controlling the Spread of Infection: 
A Programmed Presentation by Betty 
Mclnnes. 1 1 1 pasjes. St. Louis, Mos- 

by. 1973. 

Reviewed by Jean Shea, I eaclier. 
Department of Nursing, Huniber 
College of Applied Arts and Tecli- 
nology, Rexdale, Ontario. 

The author states, "the purpose of this 
book is to present, primarily to nursing 
students but also to other hospital per- 
sonnel, basic fundamentals that can 
be applied to the nursing management 
and control of the spread of infection 
without a prior knowledge of microbi- 
ology." The author has fulfilled her 
purpose. 

"This programmed learning book has 
a traditional set-up. The answer(s) for 
each frame appears in the answer co- 
lumn beside the frame. The frames 
are clearly and concisely written so 
that students should not have difficulty 
comprehending them. 

The book is divided into three parts. 
Part I — The Microscopic Enemy — 
presents good basic information regard- 
ing microorganisms and the spread of 
infection. One error was noted in this 
section. The author states that "sterile" 
masks and caps must be worn in the 
operating room; this is incorrect. 

Part 1 1 — Asepsis — covers asepsis 
in general; medical asepsis, with con- 
siderable stress on handwashing; and 
surgical asepsis, including methods of 
sterilization. Part III — Practical Ways 
of Controlling the Spread of Infection 
— covers basic protective measures for 



the nurse and the patient, and princi- 
ples of asepsis as applied to nursing 
skills and to isolation. 

The information presented in this 
book provides a good basic understand- 
ing of the fundamentals of microbiology 
and control of infection. There is some 
repetition from Part 1 in Part II, and 
from Part II in Part III. It is outlined 
as being review and would be most 
helpful if the sections were being used 
at different times. In each section, 
principles, rather than specific pro- 
cedures, are stressed. 

Case study frames are used through- 
out the three parts, necessitating appli- 
cation of the principles to practice. This 
book is appropriate for beginning nurs- 
ing students and other allied health 
workers who are concerned with the 
spread of infection but who do not re- 
quire knowledge in depth. The section 
on surgical asepsis could be omitted 
for workers not requiring this infor- 
mation. 



Rehabilitation Nursing: Perspectives 
and Applications by Victor A. Chris- 
topherson. Pearl P. Coulter and Mary 
O. Wolanin. 586 pages. New York. 
McGraw-Hill, 1974. 
Reviewed by Olga Greenwell. Head 
Nurse. Shaiighnessy Hospital, Van- 
couver. B.C. 

It has been rewarding to read a book 
that has so clearly done what the editors 
set out to do. Their objective was ti) 
provide a single volume to use as a 
reference work for personnel practicing 
in isolated areas with limited library 
resources, or for those with limited 
reading time. The book is concise, 
easily read, and highly instructive. 

There are 74 articles, called readings 
in this volume, culled from various 
journals published over the past 10 
years. The authors are mostly nurses, 
physicians, physical therapists, or social 
science personnel. Although emphasis 
has been placed on rehabilitation, the 
discussion of nursing care planning and 
assessment will be enlightening to 
nurses working in any field. 

The information runs the gamut 
from pediatrics to geriatrics, amputa- 
tions to drug abuse, alcoholism to C'VAs. 
and many more. One area that is fre- 
quently neglected but is well covered 
here is sexuality. The book provides a 
series of readings on sexuality that not 
only confirm that it is a real and dis- 
tressing problem for both staff and 
patient, but also give some dowii-to- 
earth advice on how to deal with the 
problem in general and how to go about 
getting help for the patient. 

A unique facet of this book is that 
many of the contributors were patients 

(Conliniicil on pat;c 52) 
MARCH 1974 



New 8th Edition! Mosby's COMPREHENSIVE REVIEW OF NURS- 
ING. Extensively revised to incorporate current ideas and develop- 
ments, this respected new edition correlates nursing arts and basic 
science knowledge with clinical nursing. Including a close exannination 
of the entire spectrum of nursing subjects, this book features expanded 
coverage of medical-surgical nursing and a completely updated section 
on fundamentals of nursing. A convenient outline format adds to the 
book's utility. By an editorial panel of 12. September, 1973. 645 pages 
plus FM l-XII, 7%"x IOV2". Price, $1 1.05. 

A New Book! CURRICULUM BUILDING IN NURSING: A Process. 

This "how to" book is designed to facilitate the task of the curriculum 
builder or planner by providing essential theory and its application to 
nursing curricula. An outstanding feature is the heuristics — examples 
of devices for involving people — placed at the end of each chapter. 
Among the many topics considered are future nursing functions; 
student and faculty characteristics; evaluation methods; learning strate- 
gies; educational and health environments; and content development. 
By EM OLIVIA BEVIS, R.N., B.S.. M.A. August, 1973. 172 pages plus 
FM l-XII. 7" X 10". 28 illustrations. Price. $7. 10. 

A New Book! A PROBLEM-SOLVING APPROACH TO NURSING 
CARE PLANS: A Program. In this new book, case studies are used to 
reinforce and demonstrate principles in the problem solving approach 
relating to implementation of relevant nursing care plans. The book 
details problem-solving process, purposes of nursing care plans, and data 
collection and methods. By BARBARA ANN VITALE. R.N.. M.A.; 
NANCY V. SCHULTZ, R.N., M. A.; and PATRICIA MARY NUGENT, 
R.N.. M.S. April. 1974. Approx. 128 pages. 7" x 10", 28 illustrations. 
About $5.20. 

A New Book! THE PROCESS OF STAFF DEVELOPMENT: Com- 
ponents for Change. This book presents the development process and 
concepts of staff development education and its relationship to the 
overall continuing education effort. Areas discussed include: the history 
of staff development; adult learning; motivation; organization and 
administration; philosophy; and learning needs. By HELEN M. TOBIN. 
R.N., M.S.N. ; PATS. YODER. R.N.. M.S.N. ; PEGGY K. HULL. R.N.. 
M.A.; and BARBARA J. CLARK. R.N.. M.A.; with 2 contributing 
authors. April. 1974. Approx. 224 pages, 7" x 10", 21 illustrations. 
About $9.40. 

A New Book! THE GROUP APPROACH IN NURSING PRACTICE. 

Describing the scope of group work in nursing and illustrating the 
theoretical frameworks that guide study and practice in this area, this 
book provides a clear understanding of group process, leadership and 
methods as well as the therapeutic potential. Group psychotherapy and 
therapeutic, reference, self-actualization, self-help and reference groups 
are discussed. Other topics include co-leadership and co-therapy and 
basic leadership function. By GWEN D. MARRAM. R.N.. B.S., M.S.. 
Ph.D. May. 1973. 220 pages plus FM l-XII. 6" x 9". Price. $5.80. 



MOSBY 

TIMES MIRROR 

THE C M MOSBY COMPANY. LTD 

86 NORTHLINE ROAD 

TORONTO. ONTARIO 

M4B 3E5 



VITAL SIGNS 
OF NURSING 
PROGRESS... 
NEW BOOKS 
FROM MOSBY 



CLINICIAN 



INTERVENTION 



PRACTITIONER 



ASSESSMENT 













ICU 


ecu 










PRIMARY 


PSYCHOSOCIAL 










COMMUNITY 


MOBILITY 






» 










REVIEW 


RESEARCH 










CHALLENGE 


O.R. 










EDUCATION 



MARCH 1974 



THE CANAOIAN NURSE 51 



themselves in the settings they describe. 
These particular articles offer an insight 
and immediacy that brings home their 
message with clarity. They will stimu- 
late staff in even the most efficient 
rehabilitation setting to look over their 
programs for improvements. For exam- 
ple, the author of Reading 25 describes 
how he. a CVA with visual-auditory 
disturbances, could have been spared 
much anxiety and trauma if a little 
thought had been given to his bed pla- 
cement in the ward. 

"I was one of those unfortunates." 
he writes, ""whose unimpaired left side 
visual-auditory fields were focused on 
a blank wall. . . . Even the patient in 
the bed to my right was unseen. It was 
frightening to feel isolated in a room 
full of patients who. due to blatant cir- 
cumstances, also ignored my attempts 
to socialize. Even the most casual lan- 
guage stimulation was absent while I 
was in that "dead" corner except during 
the visitations made by my wife." 

This btxik. easily read and highly 
instructive, will provide techniques 
and stimulation for nurses in any area. 
It should be forgiven the few lapses 
into jargon that require a second reading 
here and there. <^ 



accession list 



Publications on this list have been re- 
ceived recently in the CNA library and 
are listed in language of source. 

Materials on this list except reference 
items may be borrowed by CNA mem- 
bers, schools of nursing and other ins- 
titutions. Reference (R) items (archive 
books and directories, almanacs and 
similar basic books) to not go out on 
loan. Theses, also R. arc on Reserve 
and may go out on Intcrlilirary loan 
only. 

Request for loans should be made on 
the ""Request Form for Accession List" 
and should be addressed to; The Li- 
brary, Canadian N urses" Association, 50 
The Driveway. Ottawa, Ont. K2P IE2. 

No more than three titles should be 
requested at any one time. 

BOOKS AND DOCUMENTS 

1. Tlic ANA ill Wiisliiiifititii. by Julia Thomp- 
son. Kansas Cily. Missouri. American 
Nurses' Association. 1972. I47p. 

2. ANA clinical sessions nj A iiwiHiiii Nurses' 



Association. 1972. New York. Appleton- 
Century-Crofts. 197.\ 237p. 
.^. Tlic American Heart Association cook- 
liool^. by the American Heart Association. 
New York. David McKay. 197.1. 412p. 

4. Ailiiiinisieriii.1; iiiirsiiif; service, by Marie 
DiVincenti. Boston. Little, Brown. 1972. 
?40p. 

^. Admission of patients lo hospital, by 
Howard Baderman et al. London. King 
Edward's Hospital Fund for I^indon. 197.'!. 
,slp. 

h. Allied medical education directory. \97i. 
4ed. C hicago. American Medical Associa- 
tion. Council on Malical Education. 1971. 
421p. 

7. Architectural barriers to the physically 
disabled, by .Sue- Anne Kirkland. Toronto. 
Canadian Rehabilitation Council for the 
Disabled. 1973. .s4p. 

5. l^'art lie yarder tes enfants. par Therese 
Grenier-Forest. Montreal. Editions du Jour. 
197.1. 179p. 

9. Before addiction: how to lielp youth, by 
Florence Lieberman et al. New York, Behav- 
ioral, 197.1. 1.11 p. 

10. Tlie hiolos;ic af(es of man from concep- 
tion throitfih old af-e. Edited by David W. 
.Smith and Edwin L. Bierman. Toronto. 
Saunders. 1973. 21 Ip. 

(Continued on pat>e 54) 



a residential conference on: 

AUTHORITY, LEADERSHIP 
AND ORGANIZATION 

June 19th-23rd, 1974, in Toronto 
sponsored jointly by 

ROSEHILL INSTITUTE OF 
HUMAN RELATIONS 

and 

TAVISTOCK INSTITUTE OF 
HUMAN RELATIONS 

Centre for Applied Social Research 
London, England 

To study the dynamics of organizational functioning through 
group and intergroup events. 

Tuition: 
$250.00, plus $100.00 accommodation. 
Total fee $350.00 

Enquiries: 

Dr. Sheldon Heath, 

Rosehill Institute of Human Relations, 

1365 Yonge Street, 

Toronto, Ontario. 

M4T 2P7 

(416)922-3203 



r 

r" 



Thi.$ 
Pul^cation 
is A\ailaUe in 

MIGROF(H(M 




Xerox University Microfilms 

300 North Zeeb Road 
Ann Arbor, Michigan 48106 

Xerox University Microfilms 

35 Mobile Drive 
Toronto, Ontario, 
Canada M4A 1H6 

University Microfilms Limited 

St, John's Road, 

Tyler's Green, Penn, 

Buckinghamshire, England 

PLEASE WRITE FOR COMPLETE INFORMATION 



52 THE CANADIAN NURSE 



MARCH 1974 



New...readytouse... 
"bolus" prefilled syringe. 

Xylocaine'100 mg 

(lidocaine hydrochloride injection, USP) 

For 'Stat' I.V. treatment of life 
threatening arrhythmias. 



D Functions like a standard syringe. 




® 



D Calibrated and contains 5 ml Xylocaine 

D Pacl<age designed for safe and easy 
storage in critical care area 



n The only lidocaine preparation 
with specific labelling 
information concerning its 
use in the treatment of cardiac 
arrhythmias. 




an original from 

AS Tit A 




MARCH 1974 



Xylocaine® 100 mg 

(lidocaine hydrochloride injection U S P ) 

INDICATIONS-Xylocaine administered intra- 
venously is specifically indicated in the acute 
management of ( I ) ventricular arrhythmias occur- 
ring during cardiac manipulation, such as cardiac 
surgery; and (2) life-threatening arrhythmias, par- 
ticularly those which are ventricular in origin, such 
as occur during acute myocardial infarction. 

CONTRAINDICATIONS-Xylocame is contra- 
indicated (1) in paiienLs with a known history of 
hypersensitivity to local anesthetics of the amide 
type: and (2) in patients with Adams-Stokes syn- 
drome or with severe degrees of sinoatrial, atrio- 
ventricular or intraventricular block. 

WARNINGS— Constant monitoring with an elec- 
trocardiograph is essential in the proper adminis- 
tration of Xylocaine intravenously. Signs of exces- 
sive depression of cardiac conductivity, such as 
prolongation of PR interval and QRS complex 
and the appearance or aggravation of arrhythmias, 
should be followed by prompt cessation of the 
intravenous infusion of this agent. It is mandatory 
to have emergency resuscitative equipment and 
drugs immediately available to manage possible 
adverse reactions involving the cardiovascular, 
respiratory or central nervous systems. 

Evidence for proper usage in children is limited, 

PRECAUTIONS-Caution should be employed 
in the repeated use of Xylocaine in patients with 
severe liver or renal disease because accumulation 
may occur and may lead to toxic phenomena, since 
Xylocaine is metabolized mainlv in the liver and 
excreted by the kidney The drug should also be 
used with caution in patients with hypovolemia 
and shock, and all forms of heart block (see CON- 
TRAINDICATIONS AND WARNINGS). 

In patients with sinus bradycardia the adminis- 
tration of Xylocaine intravenously for the elimina- 
tion of ventricular ectopic beats without prior 
acceleration in heart rale (e.g. by isoproterenol 
or by electric pacing) may provoke more frequent 
and serious ventricular arrhythmias. 

ADVERSE REACriONS-Systemic reactions of 
the following types have been reported, 

(1) Central Nervous System: lightheadedness, 
drowsiness; dizziness: apprehension; euphoria; 
tinnitus; blurred or double vision; vomiting; sen- 
sations of heat, cold or numbness; twitching; 
tremors: convulsions; unconsciousness; and respi- 
ratory depression and arrest. 

(2) Cardiovascular System: hypotension; car- 
diovascular collapse: and bradycardia which may 
lead to cardiac arrest. 

There have been no reports of cross sensitivity 
between Xylocaine and procainamide or between 
Xylocaine and quinidine, 

DOSAGE AND ADMINISTRATIGN-Single 
Injection: The usual dose is 50 mg to 100 mg 
administered intravenously under ECG monitor- 
ing. This dose may be administered at the rate 
of approximately 25 mg to 50 mg per minute. 
Sufficient time should be allowed to enable a slow 
circulation to carry the drug to the site of action. 
If the initial injection of 50 mg to 100 mg does 
not produce a desired response, a second dose may 
be repeated after 10-20 minutes, 

NO MORE THAN 200 MG TO 300 MG OF 
XYLOCAINE SHOULD BE ADMINISTERED 
DURING A ONE HOUR PERIOD 

In children experience with the drug is limited. 

Continuous! Infusion: Following a single injection 
in those patients in whom the arrhythmia tends 
to recur and who are incapable of receiving oral 
antiarrhythmic therapy, intravenous infusions of 
Xvlocaine mav be admini.siered at the rate of ! 
mg to 2 mgper minute (20 to 25 ug/kgper minute 
in the average 70 kg man). Intravenous infusions 
of Xylocaine must be administered under constant 
ECG monitoring to avoid potential overdosage 
and toxicity Intravenous infusion should be ter- 
minated as soon as the patient's basic rhythm 
appears to be stable or at the earliest signs of 
toxicity It should rarely be necessary to continue 
intravenous infusions beyond 24 hours As M>on 
as possible, and when indicated, patients should 
be changed to an oral antiarrhythmic agent for 
maintenance therapy. 

Solutions for intravenous infusion should be 
prepared by the addition of one 50 ml single dose 
vial of Xylocaine 2*f or one 5 ml Xvlocame One 
Gram Disposable Transfer Syringe to I liter of 
appropriate solution. This will provide a 0,lSf 
solution: that is. each ml will contain I mg of 
Xylocaine HCl, Thus I ml to 2 ml per minute 
will provide 1 mg to 2 mg of Xylocaine HCl per 
minute. 



THE CANADIAN NURSE 53 



accession list 



iCdiiliiiiu'il from /xiuc 52) 

11. Tlic icircliiic iirrliyihiiiid.s. by Brendan 
Phibbs. 2e<J. St. Louis. Mosby. 1973. 20.>p. 

12. C<iic of the oMoniy piiliciil. by Virginia 
Vukovich and Reha D. Giubb. .St. Louis. 
Mosby. 1973. 138p. 

1 3. Catcilogiiv ilc films it cl'midio-visiicls. 
/97.?. Ottawa. Conseil canadien pour la 
cooperation inlernationale. 1973. 62p. 

14. CataloiiKC of films on work! dcvclopmciU 
1973. Ottawa. Canadian Council for Inter- 
national Development. 1973. 62p. 

I 5. Cliiiidil ti.ssc.ssincnt for the mirsc prac- 
tilioiicr. by William C. Fowkes and Virginia 
K. Hunn. St. Louis. Mosby. 1973. I9()p. 
\6. Coiitcmportiry issues in Ctintiilidii linv 
for mirscs. by Shirley R. Good and Janet 
C. Kerr. Montreal. Holt. Rinehart and Win- 
ston. 1973. I93p. 

\7. Cin-riciiliiDi htdliliiii; in mirsinii: u pro- 
cess, by Em Olivia Bevis. .St. Louis. Mosby. 
1973. I72p. 

1 !<. D<iy cure: ,!,'/i)n /;;,!,'. leiirnini;. iiirini;: 
tiatiotuil !^nicU'lines for the ilevelopment of 
lUiy cure sei \ices for children. Ottawa. Cana- 
dian Council on Social Development. 1973. 
.s-sp. 

19. Distrihiition of health miinpower: un an- 
notated hihlioi;ritphy prepared by Hllen Sax. 
Manpower Distribution Project. New York. 
National Health ( ouncil. 1973. 26p. R 

20. Family plannini; in the education of 
nurses and midlives. Edited by Lily M. 
TurnbuU and Helena Pizurki. Geneva. World 
Health Organization. 1973. .'^Op. (World 
Health Organization. Public health papers 
no. .''3) 

2\. Guide to the health care field. 1973. 
Chicago. American Hospital Association. 
1973. 584p. R 

22. Health sciences education. Price schedule. 
Toronto. Mediascience Ltd.. 1973. 1 vol. 

23. Introductory concepts in communication 
processes, by Robert O. Reid. Toronlo. Ber- 
keley .Studio, 1973. 6.sp. 

24. La jeiines.se et la drogue: rapport il'iiii 
Groiipe d'etiide de fOMS. Geneve. Organi- 
sation Mondiale de la Sante. 1973. 4Sp. (Its 
Seriede rapports techniques no. .'il6) 

2.'^. Medical cure and mediccd care: prospects 
for the organization and financing of per- 
sonal health care services. Spyros Andreo- 
poulos. editor. New York. 1972. 25lp. (Mil- 
bank Memorial Lund. Ouartcrly. v..S(). no. 4. 
pt.2) 

26. Moshy's (ompreliensive review oj nurs- 
ing. 8ed. St. Louis. Mosby. 1973. 64.Sp. 
7. Nursing and the process of continuing 
education, by Elda S. Popiel. St. Louis. Mos- 
by. 1973. 248p. 

28, La planification des soins par Dolores 
E. Little et Doris L. Carnevali. Traduction 
revue par Cecile Boisvert. Montreal. Re- 
nouveau Pedagogique. 1973. 246p. 

54 THE CANADIAN NURSE 



29, Psychiatric nursing, by Marguerite Lucy 
Manfreda, 9ed. Philadelphia. Davis. 1973. 
.s.'^7p. 

30. I'sychology as applied to nursing, by .An- 
drew McGhie. 6ed. Edinburgh. Churchill 
Livingstone. 1973. 292p. 

3 1 . Report of the annual meeting of the .-isso- 
ciation of Registered Nurses of NewftHdul- 
land. St. John's. 1973. .S4p. 
32. Resnltais finals de I'eliide siir facte 
infirmier dans Ics differenis centres de .sante 
de la proviiHe tie Qiichec 1972-73. Mont- 
real. Association des Infirmieres et Int'ir- 
miers de la Province de Quebec. 1973. 82p. 
3 3. Review of team nursing, by Laura Mae 
Douglass. .St. Louis. Mosby. 1973. I31p. 
( Mosby's comprehensive review series) 
34. .Serial puhliciuions: their phue ami 
treatment in lihraries. by Andrew Delbridge 
Osborn. 2ed. rev. Chicago. American l.i- 
brary Association. 1973. 434p. 
3.'i. A study of economies of group practice 
in Saskatchewan, by Donald O. Anderson 
and Anne O.J. Crichton. Vancouver. B.C.. 
University of British Columbia, 1973. 2 vols. 

36. Training of the nurse practitioner: a cli- 
nical and statistical analysis, by Doris M. 
Storms. North Haven, Conn,, Connecticut 
Health .Services Research Series, 1973. lOSp. 
(Connecticut Health Services Research 
series no, 4) 

37, /,(/ transparence ile soi. par Sidney M. 
Jourard. Traduit de lamericain par .Serge 
Baron et al., qui ont ajoute un addendum sur 
la psychologic humanistique. Quebec. Edi- 
tions Ste-Koy. 1972. 291 p. 

3 8. Walch-jires on tlie mountains: the life 
and writings of Ethel Johns, by Margaret M. 
Street. Toronto. University of Toronto. 1973. 
336p. 

PAMPHLETS 

39. Basic list of guides aiul injormation sour- 
ces for priifessional tind patients' lihriuies 
in hospitals, compiled by Council of National 
Library Associations. Joint Committee on 
Library Service in Hospitals, 8ed, Chicago. 
American Hospital Association. 1973. 27p, 

40. Beyond conflict or compromise: liumiui 
progress. en\iromuentid protection and the 
United Nations Developmetit Programme. 
New York. United Nations. 1973. 39p. 

4\. Bylaws as amended May 1973. New 
York, National League for Nursing. 1973. 
29p. 

42. College education: key to a professional 
career in nursing 1972-73. New York. Na- 
tional League for Nursing, Depl. of Bacai- 
laureate and Higher Degree Programs. 1973, 
23p, 

43. Constitution ami hylaws as amended 
1973. Geneva. International Council of 
Nurses. 1973. 2 1 p. 

44. A guide to metric conversion (SI) Mont- 
real. Association of Hospitals of the Province 
of Quebec, 1973. 33p. 

4.S. A joint statement of the American 
Nurses' Association aiul the Ameriaut School 
Health Association. Recommendati<ms on 
educational preparation and definition of 
the expanded role and functions of the school 



nurse practitioner. Kansas City, No,, Amer- 
ican Nurses' Association. 1973, 6p, 

46. A niiilti-national study of the interna- 
tiontd migration of physicians ami mirses. 
Geneva. World Health Organization. 1973. 
I7p. 

47. Nmsing units, wtirds. imd patient bed- 
rooms: literature review and annotated bib- 
liography, by Shevra L. Martin. Washfng- 
ton, D.C.. Gordon A. Friesen International. 
1973. 33p. 

48. Programs tiicredited for public beidth 
nursing preparation. 1972-73. New York. 
National League for Nursing. Dept. of Bac- 
calaureate and Higher Degree Programs. 
1973. 8p. R 

49. Stiutdiads of priutice. Kansas City. Mo., 
American Nurses' Association. 1973. f' 
parts. -Nursing practice. -Community health 
nursing practice. -Geriatric nursing practice. - 
Maternal child health nursing practice.- 
Psychiatric-mental health nursing practice. 
."iO. Three challenges to the nursing profes- 
sion. Selected papers from the 1972 ANA 
convention. Kansas City. Mo., American 
Nurses' Association, 1973. 32p, 

GOVERNIVIENT DOCUMENTS 

Ciuiada 

.si. Dept. of National Health and Welfare. 
Trends in cigarette consumption. Cimaila 
1920 to 1970. Ottawa, n.d. pam. 
.s2. Economic Council of Canada. Aiuuiid 
review. 1973. Ottawa. Information Canada. 
1973. 21 1 p. 

.s3. Health and Welfare Canada. Disaster 
nursing study: a report to Linergency Health 
Services, prepared by K. Lorraine Davies. 
Ottawa. 1972. 37p. 

.'^4. Health and Welfare Canada. Nittrilion: 
a national priority. A report by Nutrition 
Caiuula to the Depl. <)f National Health and 
Welfare. Ottawa Information Canada. 1973. 
I.s2p. 

."i.s. Ministry of .State for Science and Lech- 
nology. The mirrored spectrum: a cidlection 
of reports for the non-scientist ami non-en- 
gineer about achievements in Canadi(Ui 
science (uid technology. Ottawa. Information 
Canada. 1973. 80p. 

.^6. National Library of Canada. Report 
1972173. Ottawa. 1973. 67p. 
.'^7. Statistics Canada. Hospital indicators. 
January-Jitiie. 1973. Ottawa. Information 
( anada, 1973. 192p. 

."58. — . Hospital statistics, v. I Hospitid beds. 
1971. Ottawa Information Canada. 1973. 
19."; p. 

Great Britain 

.s9. Joint Board of Clinical Nursing Studies. 
London. 1973. Outline curriculum in acci- 
dent and emergency nursing for state regis- 
tered nurses. I 9p. (Course no. 198) 
60. — . Outline ciorienlnm in advancetl 
psychiatric nursing for nurses on the regis- 
ter for mental luirses or the regi.sler for nurses 
of the mentally subnormal. I Op. (Course 
no. 820) 

61. — .Outliiw enrricnium in behaviour 
modification in menttil handicap for regis- 
tered nurses. I2p. (Course no. 700) 

MARCH 1974 



62. — . Oiiilinc ciirrUiiliim in cliihl and tulo- 
IcMciit psyihidlric nursing for rcgislcrcil 
nurses. 1 I p. (Course no. 600) 

63. — . Outline curriculum in gcucnil inten- 
sive cure nnrsiiif; for stale enrolled nurses. 
I2p. (Course no. I l.'^l 

64. — . Outline curriculum in operulini' 
ile/icirtinenl nursiiif- for state rciiistered 
nurses. 14p. (Course no. 176) 

6.'^. . Outline ciirriculuin in s/iecial and 
intensive nursiiif; care of tlie newborn. I 2p. 
(Course no. 401 ) 

66. — . Outline curriculum in special and 
intensive nursing care of the newhorn tor 
slate certified inidwives, state registered 
nurses or registered .sick children's nurses. 
I4p. (Course no. 400) 

Ontario 

67. Dept. of Health. Directory of nursing 
personnel in clnirge of official ptihlic lieallli 
nursing services in Ontario. Toronto. 197.3. 
4p. R 

68. Ministry of Labour. Research Branch. 
Collective bargaining provisions in Ontario 
municipal agreements. ToTonXo, 1973. WSp. 
United Stales 

69. Departement de la Sante. <Je I'bducation 
el tlu Bien-etre. Cancer et soins inftrmiers; 
inanuel de I'infirniiere \isiieiise. Revu en 
\955. Traduction par M. Jean-Rodolphe 
Borduas. New York. Departement de la 
Sante, 1955. 88p. 



70. National Institutes of Health. Foreign 
Iraineil pliysicians aiul American medicine, 
by Rosemary Stevens and Joan Vermeulen. 
For sale by U.S. Govt. Print. Off.. Washing- 
ton. D.C.. 1972. 170p. (DHEW Publication 
no. (NIH) 7V325) 

STUDIES DEPOSITED IN CNA REPOSITORY 
COLLECTION 

71. The circunislances in which postoperulive 
patients and their nurses determine need for 
an analgesic, by Myrtle I. Macdonald. Mont- 
real. 1971. 117p. (Thesis ( M.Sc.l Appl.)) - 
McGilDR 

72. The comfort of patients in traction: a 
descriptive study, by Wilton S. Kezala. Mont- 
real. 1972. 67p. (Thesis (M.Sc.( Appl.)) - 
McGill) R 

73. The concerns expressed by palienis wiili 
cardiac conditions during the first ihirlcen 
days of hospitalization and the responses of 
health workers and other patients to these 
concerns, by Ronald S. Reighley. Montreal. 
1971. (Thesis (M.Sc.( Appl.)) - McGill) R 

74. lnformati<m utilized by eleven cardiac 
patients and the relationship of this informa- 
tion to progress after discharge, by Leola 
Anne Robinson. Montreal. 1973. 53p. (The- 
sis (M.Sc.( Appl.)) - McGilDR 

75. Les readmissions dans les ecoles d'infir- 
inieres canadiennes-frant^aises. par Soeur 
Rita Gagne. Montreal. 1957. 40p. R 



76. Relationships between unmarried niolli- 
ers and iheir newborn infants in hospital 
by E. Gail Carleton. Montreal. 1971. 6Kp. 
(Thesis (M.Sc. (Appl.)) - McGill) R 

77. Saline abortion: a sliidy of female behav- 
iour in a crisis siiiialion, by Judith C. Chris- 
tensen. Montreal, 1972. lOOp. (Thesis (M.Sc. 
(Appl.))- McGilDR 

^H. A study to determine if a need exists for 
a refresher course for in-active nurses wish- 
ing lo return to active nursing, by Mona E. 
Callin. Montreal. Association of Nurses of 
the Province of Quebec. 1967. 16p. R 

79. A study to find out why registered nurses 
in Newfoundland are inactive in nursing. 
by Dawn Hanson et aL St. Johns. Memorial 
University of Newfoundland. 1973. 26p. R 

AUDIOVISUAL AIDS 

80. Association des Medecins de l.angue 
frangaise du Canada. Montreal. 1973. 
Sonoined. serie I. no. 7. - Cote A. 1. Masse 
au sein. 2. Coliques du jeune bebe. 3. Phle- 
bites. - Cote B. 1. Endometriose. 
Soiiomed. serie I. no. H. -Cote A. 1. Hypo- 
glycemiants oraux. 2. Alcoolisme. - Cote B. 
1. Ocytociques. 2. Rhinjte iillergique. 3. Im- 
puissance sexuelle organique. 

Sonoined. serie I, no. 9. - Cote A. 1. Syphi- 
lis. 2. Hypothyroidie. - Cote B. 1. Strabisme 
chez Tenfant. 2. Voix rauque. 3. Hemor- 
roides. ■£? 



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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 Author Short title (for identification) 

No. 

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 

Date of request 



In decubitus 
ulcers 




Nursing Care is 
what it's all about. 



A comprehensive film on the role of the nurse 
in the treatment and prevention of decubitus ulcers 
plus a unique concept in skin care, is available 
upon request from the Education Department. 
Westwood Pharmaceuticals, 1 20 North Queen Street, 
Toronto, Ontario M8Z 2E3. 

Suppliers of Alpha-Keri*, therapeutic bath 
oil, and Keri* Lotion, all over body lotion. 

•T.M. Auth. User 




□ YES, please contact me to schedule a viewing of 
Westwood's in-service film on decubitus ulcers. 



Westwood Pharmaceuticals Toronto, Ontario M8Z 2E3 



Name- 



TiUe. 



. Area code_ 



.Telephone No.. 



Institution _ 
Address 



City. 



, l*rovince . 



Postal Code _ 



MARCH 1974 



THE CANADIAN NURSE 55 



classified advertisements 



BRITISH COLUMBIA 



MANITOBA 



REGISTERED NURSES required for 70 bed accredited 
active treatment Hospital, Full time and summer 
relief All AARN personnel policies. Apply in writing 
to the Director of Nursing. Drumfieller General Hos 
pilal Drumheller Alberta 

REGISTERED NURSES. We need you for our summer 
relief program Come and join us for a three or four 
month period You can gain a great deal of clinical 
experience during this time, as well as get to know 
our part of the country For more information on 
Central Alberta and the Red Deer General Hospital 
write to Personnel Department, Red Deer General 
Hospital. Red Deer. Alberta. 

immediate openings for TWO GENERAL DUTY 
NURSES. Salary in accordance with AARN S625 
S750. 30 bed active, accredited hospital 80 miles 
from Edmonton Accommodation available Apply 
Director of Nursing, Daysland General Hospital 
Daysland Alberta. TOB 1A0, 



BRITISH COLUMBIA 



HEAD NURSE required for an acute modern 35-bed 
hospital, located in southern BCs Boundary area 
With excellent recreation facilities. Position to be 
filled by April 197J, Salary and personnel policies 
in accordance with the RNABC Apply by March 31. 
1974. to Director of Nursing, Boundary Hospital 
Grand Forks, British Columbia 



ADVERTISING 
RATES 

FOR ALL 

CLASSIFIED ADVERTISING 

$15.00 for 6 lines or less 
$2.50 for each odditiorKil lir>e 

Rotes for display 
advertisements on request 

Closing dote for copy ond cancellation is 
6 weeks prior to 1st day of publication 
month. 

The Conodion Nurses' Associotion does 
not review the personnel policies of 
the hospitols and agencies advertising 
in the Journal, For authentic information, 
prospective oppliconts 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 
OTTAWA, ONTARIO 
K2P 1E2 




HEAD NURSE required April 1. 1974 for a very active 
35-bed Acute Care Unit -comprising Paediatnc 

Medical, I C U , Surgical and OBS services. Previous 
Head Nurses experience essential. Suite available in 
Nurses Residence Apply to Director of Nursing, St 
Marys Hospital, Sectielt, British Columbia 



OPERATING ROOM NURSE wanted for active mo- 
dern acute hospital. Four Certified Surgeons on 
attending staff. Experience of training desirable. 
Must be eligible for B,C Registration, Nurses 
residence available. Salary according lo RNABC 
Contract, Apply to Director pf Nursing. Mills Mem- 
orial Hospital, 2711 Tetrault St,, Terrace, British 
Columbia. 



EXPERIENCED GENERAL DUTY NURSES AND 
LICENSED PRACTICAL NURSES required for small 
upcoast hospital. Salary and personnel policies as 
per RNABC contract. Satanes start at S672,00 for 
Registered Nurses; S577 75 for Licensed Practical 
Nurses. Residence accommodation $25 00 per month. 
Transportation paid from Vancouver Apply to 
Director of Nursing, St George s Hospital, Alert Bay 
British Columbia 



GENERAL DUTY NURSES for modern 30-bed accre 
dited hospital Salary and personnel policies in ac 
cordance with RNABC Apply Director of Nursing 
Chetwynd General Hospital. PO Box 507 Chetwynd 

British Columbia. 



GENERAL DUTY NURSES tor modern 41-bea 
hospital, located on the Alaska Highway. Salary and 
personnel policies in accordance with RNABC 
Accommodation available in residence. Apply: 
Director of Nursing. Fort Nelson General Hospital, 
Fort Nelson. British Columbia. 



EXPERIENCED NURSES required m 409-bed acute 
Hospital with School of Nursing, Vacancies m 
medical, surgical, obstetric, operating room, pediat- 
ric and Intensive Care areas, Basic salary $672, - 
$842. B,C Registration required. Apply Director 
of Nursing, Royal Columbian Hospital. New West- 
minster. British Columbia. 



EXPERIENCED GENERAL DUTY NURSES required for 
151-bed Hospital, Basic Salary S672 — S842 per 
month Policies m accordance with RNABC Contract, 
Residence accommodation available. Apply to. 
Director of Nursing. Powell River General Hospital 
5871 Arbutus Avenue, Powell River, British Columbia. 



EXPERIENCED GENERAL DUTY NURSES for modern 

lO-bed hospital with doctors offices in hospital. 
Situated beautiful west coast of Vancouver I si and 
Accommodation $50 00 a month. Apply Administra 
tor, Tahsis Hospital. Box 399, Tahsis. British 
Columbia, 



GENERAL DUTY NURSES required for an 87-bed 
acute care hospital m Northern BC Residence 
accommodations available RNABC policies in effect 
Apply to Director of Nursing Mills Memorial Hos 
pital. Terrace. British Columbia V8G 2W7 



NURSES REQUIRED FOR GENERAL DUTY AND 
INTENSIVE CARE UNIT, IN EIGHTY-FOUR BED 
MODERN ACUTE GENERAL ACCREDITED HOSPITAL 
IN CENTRAL BRITISH COLUMBIA RNABC CON- 
TRACT WAGES RESIDENCE ACCOMMODATION 
AVAILABLE, PLEASE APPLY IN WRITING TO DI- 
RECTOR OF NURSING. CARIBOO MEMORIAL HOS- 
PITAL, 517 NORTH SIXTH AVENUE WILLIAMS 
LAKE. BRITISH COLUMBIA 



DIRECTOR OF NURSING required immediately for an 
11-bed Hospital a modern facility 80 miles south 
west of Winnipeg Thriving community of 1500 
people. Living quarters provided. Salary scale S9.120 
10,680 per annum. Will credit for past experience. 
For further information contact Administrator, Notre 
Dame Hospital Notre Dame de Lourdes Manitoba 
ROG 1M0. Telephone 2-18-2092 



1 REGISTERED NURSE — 1 LICENSED PRACTICAL 
NURSE required for small active treatment hos^pital. 
General duty Live out Apply giving experience and 
references, to Director of Nurses Hartney Medical 

Nursing Unit. Hartney. Manitoba ROM 0X0. 

REGISTERED NURSES required immediately for a 
Community Health Centre in Leaf Rapids, Manitoba: 
salary range S720 $835 monthly For further infor- 
mation and to apply please contact Michael Hoare 
Leaf Rapids Health and Social Development Centre, 
Leaf Rapids, Manitoba ROB 1W0. 

REGISTERED NURSES required for the following 
positions in a 68 -bed acute care general hospital 
Nighl Supervisor, Operating Room Supervisor Ex- 
perience essential: General duty nurses m Pediatric 
Department Remuneration for past experience, Shifl 
differential Salary m accordance with M H S C ap- 
proved rate Apply to Administrator Ste Rose Gen 
eral Hospital Ste-Rose-du Lac Manitoba ROL ISO, 

Required immediately -— 3 REGISTERED NURSES and 
3 LICENSED PRACTICAL NURSES for a new 60-bed 
Personal Care Home, Salary in accordance with the 
recommendations of the MARN, Apply Director of 
Nursing Swan River Valley Personal Care Home 
inc,, SWAN RIVER, Manitoba ROL IZO, 



NEW BRUNSWICK 



WANTED: TWO REGISTERED NURSES, GENERAL 
DUTY required for 17-bed active hospital, modernly 
equipped Also ONE REGISTERED NURSING ASSIS- 
TANT. GENERAL DUTY. For furthef information con- 
tact The Administrator Albert County Hospital. 
Albert, New Brunswick EOA 1 AO 



NOVA SCOTIA 



SENIOR FACULTY position open, basic requirement. 
Bachelor of Nursing Responsible tor pediatric as- 
pecl of an mt erg rated program. The pediatric pro- 
gram IS interfaced with maternity and also with med- 
ical and surgical nursing Apply to Director of Edu- 
cation, Yarmouth Regional Hospital, Yarmouth. 
Nova Scotia 



ONTARIO 



REGISTERED NURSES' for 34-bed General Hospital, 
Salary $646, per month to $756, plus experience al- 
lowance. Excellent personnel policies. Apply lo: 
Director of Nursing Englehart & District Hospital 
Inc.. Englehart, Ontario. 



SUPERVISOR OF PUBLIC HEALTH NURSING for 

progressive generalized public health program Salary 
adjustment lor experience Salary range S12 000 - 
$14,000. Car allowance S60 00 + 12 a mile Apply 
Dr, H H Washburn, M D , D P H Medical Officer of 
Health Haldimand-Norfolk Health Unit Box 247, 
Simcoe. Ontario N3Y 4L1 



REGISTERED NURSES required for a new 79-bed 
General Hospital in bilingual community of North- 
ern Ontario. French language an asset, but not 
compulsory. Salary is $645, to $758. monthly with 
allowance for past experience, 4 weeks vacation 
after 1 year and 18 sick leave days per year. Unused 
sick leave days paid at 100% every year. Master 
rotation in effect. Rooming accommodations available 
in town. Excellent personnel policies Apply to: Per- 
sonnel Director. Notre-Dame Hospital. P O Box 850. 
Hearst. Ont. 



56 THE CANADIAN NURSE 



MARCH 1974 



ONTARIO 



SASKATCHEWAN 



REGISTERED NURSES FOR GENERAL DUTY. I.C.U.. 
ecu. UNIT and OPERATING ROOM required for 

fully accredited hospital Starting salary S697,00 with 
regular mere men is and with allowance for experi- 
ence Excellent personnel policies and temporary 
residence accommodation available. Apply to The 
Director of Nursing, Kirkland & District Hospital 
Kirktand Lake Ontario P2N 1R2 



REGISTERED NURSES: Experienced general duty 
nurses required for 28-bed General Hospital in North- 
west Ontario, Monthly salary schedule under review, 
experience recognized Nurses Residence provides 
individual self contained furnished apartments at 
minimal rental rate Apply to the Director of Nursing, 
General Hospital. Mamtouwadge Ontario Telephone 
826-3251 (area code 807). 



REGISTERED NURSES AND REGISTERED NURSING 
ASSISTANTS for 45-bed Hospita!. Salary ranges 
include generous experience allowances R.N.'s 
salary 5680 to S780. and R N A 5 salary S490 to S565. 
Nurses residence — private rooms with bath — $40. 
per month, AdoIv to: The Director of Nursing. Gerald- 
'on District Hospital. Geraldton. Ontario POT IfvlO 



REGISTERED NURSES tor GENERAL DUTY and for 
INTENSIVE CARE NURSING. Salary and benefits 
comparative with other areas includes 20 days va- 
cation, shift rotation required Residential accommo 
dation available Apply to Director of Nursing, Hunts- 
ville District Memorial Hospital, Huntsville Muskoka, 
Ontario. 

LAURENTIAN UNIVERSITY mvttes applicants for 

the 1974-75 session to teach m all chmcal nursing 
fields tn a School of Nursing offering preparation 
toward a B Sc N Degree Opportunity to participate 
in designing a new nursing curriculum in a young 
and growing university which serves North Eastern 
Ontario. Master s qualifications in clinical specialty 
preferably Salary and rank commensurate with 
qualifications and experience. Bilingual (EnQhsh^ 
French) preferred Apply to Miss Alma E. Reid. 
Acting Director. School of Nursing. Laurentian Uni- 
versity Sudbury. Ontario 



OPERATING ROOM TECHNICIAN required for fully 
accredited 75-bed Hospital, You will be in the 
Vacationland of the North, midway between Thunder 
Bay, Ontario and Winnipeg, Manitoba. Basic wage is 
$471.50 With consideration tor experience. Write or 
phone the: Director of Nursing. Dryden District 
General Hospital. Dryden, Ontario. 



Overnight camp in Ontario (near Ottawa) requires 
FULL-TIME NURSE from June 26— August 14. 1974, 

For information contact D Em-Dar, 272 Codsell 
Avenue. Downsview. Ontario M3H 3X2. Telephone 
office area code (416) 633-2511 Evenings -- (416| 
221-2422 



SUMMER COED CAMP small family-type situation 
Northern Ontario approx, 80 campers ages 14 to 16. 
requires UNMARRIED RN-7 wks June 24 to Aug 12, 

Health Centre accommodation Write or phone CAMP 
SOLELIM 588 Melrose Avenue TORONTO Ontario 
M5M2A6 or (4l6l 781-5156 



QUEBEC 



REGISTERED NURSE required for co ed children s 
summer camp in the Laurentians (seventy miles north 
o( Montreal) from June 21 1974 until August 20 1974 
Call 514 688-1753 or write Camp Maromac 4548 
8th Street Chomedey Laval, Quebec H7W 2A4 

REGISTERED NURSES with experience required im- 
mediately for Nursing Stations in English speaking 

villages on iho North Coast of Ouebec Transporta- 
tion of patients to hospital of Blanc Sablon by ambu 
lance helicopter Applicants must be registered or 
eligible for registration in Quebec Salary as approved 
by H I S Recognition tor experience Additional 
isolation allowance S25. weekly Residence accom- 
modation m Nursing Stations S25 monthly Please 
forward application and curriculum vitae to Louise 
Gobeil Director of Nursing, Notre-Dame Hospital 
Lourdes du Blanc Sablon Cte Ouplessis Quebec 



IF YOU WANT TO FEEL LIKE A PERSON CONTRIB- 
UTING TO THE COMMUNITY AND NOT JUST A 
MEMBER OF IT we need GENERAL DUTY NURSES. 

for a modern progressive, 255-bed General Hospital 
in the West end of Montreal Applications will be 
welcomed at Queen Elizabeth Hospital of Montreal, 
Nursing Personnel, 2100 Marlowe Avenue. Montreal 
260, Quebec, 



COLLEGE OF NURSING. UNIVERSITY OF SAS- 
KATCHEWAN. LECTURER or ASSISTANT PROFES- 
SOR Faculty members required to teach m several 

clinical nursing fields - maternal -child nursing 
intensive care nursing and community nursing 
Master s degree in clinical specialty preferred 
Teaching responsibility in basic B SN program and 
the B SN program for registered nurses Apply to: 
Dean. College of Nursing, University of Saskatch- 
ewan. Saskatoon Saskatchewan S7N OWO by May 
1,1974. 



UNITED STATES 



R.N.'s — SOUTHERN CALIFORNIA — Immediate need 
exists for medical-surgical units Orientation and in- 

service program. Excellent salary, full paid benefits. 
We will assist you with your H-1 visa for immigration. 
An interim permit may be obtained from the Califor- 
nia Board of Nursing Education and Registration to 
practice nursing in California prior fo licensmg. Con- 
tact: Personnel Director, The Hospital of the Good 
Samaritan, 1212 Shatto Street, Los Angeles, Califor- 
nia 90017. (213) 482-8111 ex 287. 



Monte Vista Colorado requires REGISTERED 
NURSES for 50-bed hospital. Working visa readily 
available after January Isl 1974, Transportation one 
way can be obtained. Please write directly to the 
Administrator. Monte Vista General Hospital. Monte 
Vista, Colorado 81144 or call Calgary 271-2502 after 
5 p m. 



RN's and LPN's — University Hospital North, a 
teaching Hospital of the University of Oregon Medical 
School, has openings m a variety of Hospital ser- 
vices We offer competitive salaries and excellent 
fringe benefits. Inquires should be directed to. Gale 
Rankin, Director of Nursing, 3171 8 W, Sam Jackson 
Park Road, Portland, Oregon 97201. 



TEXAS wants you! If you are an RN. experienced or 
a recent graduate, come to Corpus Christi, Sparkling 
City by the Sea , , a city building for a better 
future, where your opportunities for recreation and 
studies are limitless Memorial Medical Center 500- 
bed general, teaching hospital encourages career 
advancement and provides in-service orientation. 
Salary from $682,00 to 5940.00 per month, com- 
mensurate with education and experience Differential 
for evening shifts, available Benefits include holi- 
days, sick leave, vacations, paid hospitalization, 
health, life insurance, pension program Become a 
vital part of a modern, up-to-date hospital, write or 
call collect John W Gover, jr , Director of Per- 
sonnel, Memorial Medical Center PO Box 5280, 
Corpus Christi. Texas 78405. 



AUSTRALIA 



WESTERN AUSTRALIAN SCHOOL OF NURSING — 
PRINCIPAL - Applications are invited for the posi- 
tion of PRINCIPAL of a new independent school of 

nursing The new school will be the first o* its kind 
in Western Australia and will be associated with a 
major teaching hospital of over 1,000 beds Additional 
clinical experience is also obtainable at other 
metropolitan and regional hospitals The School is 
designed to cater for 1.100 students and will be an 
independent organization controlled by a Committee 
of Management The Principal will be chief executive 
officer A new building will be completed by April 
1975. Nurse education programmes to be conducted 
by the school will comprise the hospital based di 
ploma course in general nursing nursing aide training 
and post graduate and post-registration courses. 
Candidates are required to possess a sound knowl 
edge of nursing principles and practices a higher 
qualification m education or an allied subject to 
gether with administrative experience Salary: Si 3, 160 
per annum Memorandun of information is available 
on request Applications stating age, qualifications 
experience and the names and addresses of two 
professional referees, together with a recent photo 
graph should be forwarded to the Chairman, Interim 
Committee of Management, Western Australian 
School of Nursing c/o Royal Perth Hospital Perth 
WESTERN AUSTRALIA, 6000 The closing date is 
22nd March. 1974. 




FACULTY 
POSITIONS 

Open for clinical experts 
to teach in the 
undergraduate programs. 



COMMUNITY HEALTH NURSING 

MENTAL HEALTH NURSING 

MEDICAL-SURGICAL NURSING 

OBSTETRICAL NURSING 

and 
CONTINUING EDUCATION 

Personnel policies and salaries in accord with University 
schedule based on qualifications and experience. 

Apply in writing to: 

RUTH E. McCLURE. M.P.H. 
Director, School of Nursing 
University of Alberta 
Edmonton, Alberta 
T6G 2G3 



UNITED STATES 



REGISTERED NURSES — A ma|or hospital m Central 
Washington has openings for registered nurses in 

medical surgical and critical care departments. Pro- 
gressive mservice department with continuing edu- 
cahon program with community college Excellent 
opportunity to work in acute care hospital that offers 
challenging experience in all areas of nursing Hos- 
pital located in rural type community located n 
miles from Mission Ridge Ski Area Contact Per- 
sonnel Department. Central Washington Deaconess 
Hospital Wenatchee, Washington, 98801, 



REGISTERED 
NURSES 



positions available immediately in a 500 
bed active Hospital tor the following 
departments: - 



Medical/Surgical 

Obstetrics/Gynecology 

Psychiatry 

Excellent fringe benefits. 



Apply to: 

Director of Nursing Services, 

The IVIetropolitan General 

Hospital, 

1995 Lens Avenue, 

WINDSOR, 

Ontario NSW 1L9 



MARCH 1974 



THE CANAIJIAN NURSE 57 



REGISTERED NURSES 

AND 

REGISTERED NURSING ASSISTANTS 

required for a 104-bed active treatment plus 
72-bed chronic care unit located at Haileybury. 
The Tri-Town area consisting of New LiskearO. 
Haileybury, Cobalt all within 5 miles of each 
other is located 90 miles from North Bay 
with daily plane, tram and bus service to and 
from Toronto etc. Beautiful recreational facil- 
ities including curling, skating, skiing, swim- 
ming, boating, hunting, fishing. 

Salary fully appropriate to the responsibility of 
the position; personnel policies in line with 
industry and hospital practice. Orientation 
and In-Service Educational programmes are 
provided. 

Apply in writing to: 

PERSONNEL DIRECTOR, 
Temiskaming Hospitals, 
Haileybury, Ontario. 



Wanted for a 56-bed hospital In tlie Lakes 
District of Central B.C.: 

(1)A DIRECTOR OF NURSING 

— Degree in nursing preferable, exper- 
ience in Nursing Adnninlstration In a small 
acute Hospital essential. 

(2) GENERAL DUTY NURSES 

Salary and benefits according to 
R.N.A.B.C. contract. 



Please apply to: 

The Administrator, 

Burns Lake and District Hospital, 

Box 479, 

Burns Lake, British Columbia, 

V0J1E0. 



GENERAL DUTY NURSES 
Required Immediately 

a for 270-bed acute care general hospital 
expanding to 370 beds 

• clinical areas include: Medicine Surgery 
Obstetrics Paediatrics Psychiatry Rehabilita- 
tion Extended Care and Intensive and 
Coronary Care 

• Must be eligible for B.C. registration 

• Personnel policies in accordance with 
RNABC Contract 

• 1973 Salary $672 - $842.00 per month 
Please contact: 



Director of Nursing 

Prince George Regional Hospital 

Prince George, B.C. 



NURSES 



Take this opportunity to work in Calgary 
the "Stampede City" near Banff and moun- 
tains. 

Full time general duty nurses required at 
Rockyview and Holy Cross Hospitals. 

Advise all details and what starting dates 
available from May 1, 1974 until October 
1, 1974. 



Personnel Officer 
Hospital District No. 93 
100 - 6712 Fisher Street S.E. 
Calgary, Alberta T2H 2A7 



NURSING TEACHERS 
REQUIRED 



For our 2 year Diploma Program. 
Nurses tiolding a degree preferred. 
Duties to commence late August. Va- 
cancies in Medical - Surgical Nursing 
and Psychiatric Nursing. 



Please apply to: 

MISSC.H.A.M.STOKVIS 

DIRECTOR SCHOOL OF NURSING 

ST. BONIFACE GENERAL HOSPITAL 

431 TACHE AVENUE 
WINNIPEG, MANITOBA R2H 2A7 



REGISTERED NURSES 



with training in Midwitery and pre- 
terably with O.R. experience re- 
quired for 20-bed tiospital in Labra- 
dor. 



Apply to: 

Director of Nursing 

International Grenfell 

Association 

Happy Valley. Labrador 



QUEEN'S UNIVERSITY 

invites applications for the following 
positions for 1974-1975: 

1. Assistant or Associate Professors in 
Maternity Nursing, Nursing of Children 
and Medical-Surgical Nursing. 

2. Assistant Professor or Lecturer in Com- 
munity Health Nursing. 

3. Lecturers in Maternity Nursing, Medical- 
Surgical Nursing and Community Health. 

Requirements: 

Ivlasters degree in clinical field and 
experience for appointment as Assistant 
or Associate Professor; 

Baccalaureate degree and experience 
for appointment as lecturer. 

Academic appointment and salary com- 
mensurate with preparation. 
Apply: 

Dean, School of Nursing 

Queen's University 

Kingston, Ontario 

K7L 3N6 



GENERAL DUTY 
NURSES 



- for 360-bed acute general tiospital 

-clinical areas include: — Medicine, Surgery, 
Obstetrics. Paediatrics. Psyctiiatry. Refiabili- 
tation. Extended Care and Coronary Care 

B.C. Registration preferred but not manditory 
during initial employment 

-Personnel policies in accordance with 
RNABC Contract. 



Please contact the: 

Director of Nursing 

Nanaimo Regional General 

Hospital 

Nanaimo, British Columbia 



WANTED 

DIRECTOR OF 
NURSING 

The James Paton Memorial Hospital Board is 
accepting applications from qualified nurses to 
fill ifie position of Director o! Nursing. 

This is a challenging position in a modern. 
150-bed regional hospital which caters to a 
population of approximately 50.000 people. 

All general hospital facilities are provided, 
i.e., Psychiatry. Pathology. Radiology. Urology 
Ophthamology, Paediatrics ^nd Surgery. The 
hospital has a nursing staff of 120 as well as 
a fully-qualified team of 16 physicians. 

The salary for this positio'". is negotiable, on 
the scale $11,109. - $14,171. 

Applications in writing stating age. educa- 
tion, training, experience and references should 
be forwarded to: 

The Administrator 

James Paton Memorial Hospital 

Gander, Newfoundland 

A1V1P7 



58 THE CANADIAN NURSE 



MARCH 1974 



DURHAM COLLEGE 
OF APPLIED ARTS AND TECHNOLOGY 

invites applicants for 

FACULTY POSITIONS 

in the Nursing Department 



Qualifications: 

— Registration in Ontario 

— University preparation in Nursing education, bac- 
calaureate degree preferred 

— Minimum of two years bedside nursing experience. 

Responsibilities: 

— Classroom teaching and dinical supervision. 

Salary: 

— Commensurate with preparation and experience 
within the CSAO range. 

Starting Date: 

— August 1 , 1 974 



Direct applications witti 
complete resume to: 

DEAN OF ACADEMIC AFFAIRS, 
DURHAM COLLEGE OF APPLIED 
ARTS AND TECHNOLOGY, 
BOX 385, 

OSHAWA, ONTARIO. 
L1H 7L7 



Some nurses are just nurses. 
Our nurses are also 
Commissioned Officers. 



Nurses are very special people in the Canadian Forces 

They earn an Officers salary, enjoy an Officers privileges 
and live in Officers' Ouarters (or In civilian accommodatidn if they 
prefer) on Canadian Forces bases all over Canada and in many 
other parts of the world. 

If they decide to specialize, they can apply for postgraduate 
training with no loss of pay or privileges Promotion is based on 
ability as well as length of service And they become eligible for 
retirement benefits (including a lifetime pension) at a much earlier 
age than in civilian life. 

If you were a nurse in the Canadian Forces, you would be 
a special person doing an especially responsible, rewarding and 
worthwhile job. 

For full information, write the Director of Recuiting and Selec- 
tion. National Defence Headquarters. Ottawa. Ontario K1A 0K2 



^^ Get involved With the 
W' Canadian Armed Forces. 



HEAD NURSE 

WANTED 
IMIVIEDIATELY 



to supervise and administer a modern 24- 
bed acute Psychiatric Unit attached to a 
214-bed Regional Referral Hospital. This 
is an active treatment unit. 



Applicants must possess a Baccalaureate 
degree in Nursing; Post-graduate certifi- 
cate in Psychiatric Nursing or extensive 
background in this tield is essential. 



Apply in writing to: 

Director of Nursing 
Trail Regional Hospital 
TRAIL, British Columbia 



CLINICAL NURSE SPECIALISTS 

- Cardiothoracic and Neurological Sciences — 



An excellent opportunity for self-directing individuals wtio are interested in the 
responsibilities of working with nursing staff as consultants, teachers and 
researchers in their specialty area. 

Successful applicants must possess a Master's Degree in Nursing and clinical 
or teaching experience. 



Apply in confidence by sending curriculum vitae to: 

Associate Executive-Director — Patient Services 

UNIVERSITY HOSPITAL 

339 Windermere Rd., London, Ontario 



MARCH 1974 



THE CANAWAN NURSE 59 



REGISTERED NURSES 



A progressive General Hospital with 
focus on the patient as a person, mem- 
ber of a family and the community re- 
quires general duty nurses, all areas, 
commensurate salary, excellent fringe 
benefits. Must be eligible for Ontario 
Registration. 



Apply with full resume to: 

The Director of Nursing 
The Doctors Hospital 
45 Brunswick Avenue 
Toronto. Ontario 
Phone:923-5411 



MONTREAL 

NEUROLOGICAL 

HOSPITAL 

A Teaching Hospital 
of McGill University 

requires 

Registered Nurses 

for 
General Duty 

Previous experience in neurological nursing not 
required. Active inservice education programme. 

Apply to: 

The Director of Nursing, 

Montreal Neurological Hospital 

3801 University Street, 

Montreal 112, P.O. 



THE LADY MINTO HOSPITAL 
AT COCHRANE 

invite applications from 

REGISTERED NURSES 

54-bed accredited general hospi- 
tal. Northeastern Ontario. Compe- 
titive salaries and generous bene- 
fits. Send inquires and applications 
to: 

MISS E.LOCKE 

Director of Nursing 

The Lady Minto Hospital at 

Cochrane 

P.O. Box 1660 

Cochrane, Ontario 

POL ICO 



REGISTERED NURSES 
GRADUATE NURSES 

and 

REGISTERED NURSING ASSISTANTS 

required for 

FIVE SUMMER CAMPS 

Suategically located throughout Ontario 

and near 

OTTAWA. LONDON. COLLINGWOOD, PORT 

COLBORNE. KIRKUAND LAKE 

'accredited members - Ontario Camping 
Association) 
Applications invited from Nurses interested in 
supervisory. assistant and general cabin 
responsibilities in the field of rehabilitation of 
physically handicapped children 
Apply in writing to: 

Supervisor of Camping and Recreation, 

Ontario Society for Crippled Children, 

350 Rumsey Road, 

Toronto, Ontario, 

M4G 1R8. 



O.R. SUPERVISOR 

required for a 268-bed, fully accre- 
ditated hospital. The O.R. Super- 
visor is responsible for the O.R.. 
P.A.R. and Emergency Depart- 
ments. 

We require someone with manage- 
ment experience and advanced 
preparation in operating room 
technique and administration. 

R.N. A. B.C. policies in effect. 



Apply to: 

Director of Nursing 
Chiliiwacl< General Hospital 
Chilliwack, British Columbia 



NORTH NEWFOUNDLAND & LABRADOR 

requires 

REGISTERED NURSES 
PUBLIC HEALTH NURSES 

International Grenfell Association provides 
medical services for Northern Newfoundland 
and Labrador. We staff four hospitals, eleven 
nursing stations, eleven Public Health units. 
Our mam 180-bed accredited hospital is 
situated at St. Anthony. Newfoundland. Active 
treatment is carried on in Surgery. Medicine, 
Paediatrics, Obstetrics. Psychiatry. Also. 
Intensive Care Unit. Orientation and In-Service 
programs. 40-hour week, rotating shifts. Living 
accomodations supplied at low cost. PUBLIC 
HEALTH has challenge of large remote areas. 
Excellent personnel benefits include liberal 
vacation and sick leave. Salary based on 
Government scales. 
Apply to: 

INTERNATIONAL GRENFELL ASSOCIATION 
Assistant Administrator of 

Nursing Services, 
St. Anthony, Newfoundland. 



THE SALVATION ARMY GRACE 
GENERAL HOSPITAL 

invites application for 

REGISTERED NURSES 

in tfie 

MEDICAL, SURGICAL. OBSTETRICAL, AND 

PSYCHIATRIC DEPARTMENTS, AND ALL 

SPECIAL UNITS. 

Salary is according to the A.R,N,N, agree- 
ment beginning at $6,900 per annum. 

Please apply in writing to: 

The Personnel Director, 
Grace General Hospital, 
LeMarchant Road, 
St. John's, 
Newfoundland. 



DIRECTOR OF 
NURSING SERVICES 



Applications are invited lor the position ot 
Director of Nursing Services for an active 
222-bed general hospital in the Okanagan 
Valley The position will be available in the 
summer ot 1974. 

The hospital has undergone a recent ma)or 
expansion and complete renovation and ope 
rates extended activation, psychiatric inten- 
sive and coronary care programs 

Applications should be m writing providing 
details of education, experience references. 

age and mteresls. and be addressed to 



Administrator, 

Penticton Regional Hospital, 

Penticton, B.C. 



DIRECTOR OF NURSING 



Applications are invited for this posi- 
tion in a 167-becl fully accredited tios- 
pital. 

Individuals possessing a BSc in Nurs- 
ing and experienced in Nursing Ad- 
ministration wtio are interested are 
requested to supply a sfiort resume contain- 
ing details of education, training and expe- 
rience, and date of availability for em- 
ployment. 

Resumes should be directed to: 

The Personnel Director 
Temiskaming Hospitals 
Haileybury. Ontario 
POJ 1K0 



60 THE CANADIAN NURSE 



MARCH 1974 




VICTORIA GENERAL HOSPITAL 

HALIFAX, NOVA SCOTIA 

The Maritimes" largest teaching hospital, has immediate 
openings for Registered Nurses. Certified Nursing Assistants 
and Orderlies. Positions are available in Special Units and 
for general nursing duties. It is the principal adult teaching 
hospital of Dalhousie University and also operates a large 
school of nursing. 
SALARY: 

Commensurate with qualifications and experience. 
SPECIAL UNIT NURSES S8l70-$95«2 

REGISTERED NURSES $7816-S9229 

CERT. NURSING ASSISTANTS $5626-57 180 

NURSING ORDERLIES $4991-56333 

BENEFITS; 

Full Civil Service Benefits, including three weeks vaca- 
tion, four weeks after 5 years of service and shift diffe- 
rential. 
For further information and/or application forms, please 
contact: 

Personnel Office. 
Victoria General Hospital. 
Halifax. Nova Scotia. 



McMASTER UNIVERSITY 

MEDICAL CENTRE 

is 
expanding 



Applications are invited from Ontario Registered Nurses, or those 
eligible for registration, who are interested in working at a new. 
innovative teaching hospital located on the campus of McMaster 
University. Hamilton, Ontario. 

Positions will be coming available througtiout the year in a variety 
of areas. If you are contemplating a change, write us indicating 
your areas of interest and expertise. 



Mr. R.E. Capstick 

Manager. Employment & Staff Relations 

McMaster University Medical Centre 

1200 Main Street West 

HAMILTON, Ontario 

L8S 4J9 



GOOD NURSING 
POSITIONS 
OPEN IN 
SUNNY TEXAS 



MARCH 1974 



COME TO PRESBYTERIAN HOSPITAL 
OF DALLAS 



Presbyterian Hospital of Dallas in Dallas, 
Texas, tias openings for botfi new and 
experienced professional graduate nurses. 



Excellent working conditions and good 
fringe benefits. 



Luxury apartments provided without cost to 
new arrivals for up to 30 days. 

We will help finance your transportation to 
Dallas by forwarding your fare. (Can be paid 
back over the length of your contract.) 



One-year contract required. 

Personal interviews with those interested 
will be conducted by our staff in Ontario. 



Presbyterian Hospital is a 485-bed acute 
care general hospital providing all major 
services. Beautiful new physical plant 
located on 70-acre campus in one of the 
city's finest and fastest-growing residential 
neighborhoods. 



For more information write: 
Barbara Woodard. R.N.. Ed. D. 
Director of Nursing 

PRESBYTERIAN HOSPITAL OF DALLAS 
8200 WALNUT HILL LANE 
DALLAS, TEXAS 75231 

THE CANA^AN NURSE 51 



SUPERVISOR OF NURSING REQUIRED FOR A 

COMMUNITY SPONSORED HEALTH & SOCIAL 

DEVELOPMENT CENTRE IN 

LEAF RAPIDS ■ A MODERN ATTRACTIVE 

NEW COMMUNITY IN THE MID-NORTH OF 

MANITOBA POPULATION OF 

APPROXIMATELY 2.000 RISING 

TO 3,000 PEOPLE 



We are looking for a person with organi- 
zational and administrative ability, in- 
terested in playing an active role in the 
early development stages of our Health 
Centre. 

SALARY: Approximately $12,000 depend- 
ing upon qualifications and ex- 
perience. 



Please apply to: 

Mr. Michael Hoare, 

Leaf Rapids Health and Social 

Development Centre, 

Leaf Rapids, Manitoba, 

ROB 1W0. 



THE MONTREAL 
CHILDREN'S HOSPITAL 

REGISTERED NURSES 
NURSING ASSISTANTS 

Our patient population consists of 
the baby of less than an hour old 
to the adolescent who has just 
turned seventeen. We see them in 
Intensive Care, in one of the Med- 
ical or Surgical General Wards, or 
in some of the Pediatric Specialty 
areas. 

They abound in our clinics and 
their numbers increase daily in our 
Emergency. 

If you do not like working with 
children and with their families, 
you would not like it here. 

If you do like children and their 
families, we would like you on our 
staff. 

Interested qualified applicants 
should apply to the: 

DIRECTOR OF NURSING 
Montreal Children's Hospital 
2300 Tupper Street 
Montreal 108, Quebec 



nurses 

who want to 

nurse 



At York Central you can Join 
an active, interested group of 
nurses who want the chance to 
nurse in its broadest sense. Our 
126-bed, fully accredited hospi- 
tal is young, and already expand- 
ing. Nursing is a profession we 
respect and we were the first to 
plan and develop a unique nurs- 
ing audit system, there are 
opportunities for gaining wide 
experience, for getting to know 
patients as well as staff. 



Situated in Richmond Hill, all 
the cultural and entertainment fa- 
cilities of Metropolitan Toronto 
are available a few miles to the 
South . . . and the winter and 
summer holiday and week-end 
pleasures of Ontario are easily 
accessible to the North. If you 
are really interested in nursing, 
you are needed and will be made 
welcome. 



Apply in person or by mail to the 
Director of Nursing. 



YORK 
CENTRAL 
HOSPITAL 



RICHMOND HILL, 
ONTARIO 



ST. JOSEPH'S HOSPITAL 
TORONTO, ONTARIO. 

REGISTERED NURSES 

530-bed fully accredited Hospital provides 
experience in Emergency, Operating Room. 
Post Anaesthesia Room. Intensive Care Unit. 
Orttiopaedics. Psychiatry, Paediatrics, Obste- 
trics and Gynaecology, General Surgery and 
Medicine. 

Basic 2 week Orientation Program and con- 
tinuing Active Inservice Program for all levels 
of Staff. 

Salary is commensurate viith preparation and 
experience. 

Benefits include Canada Pension Plan. Hospital 
Pension Plan, Unemployment Insurance. — 
Group Life Insurance and O.H.I. P. (66-2/3°o 
Basic Rate paid by Hospital). — Extended 
Health Care Plan — Supplementary Blue Cross. 
After 3 months, cumulative sick time. 
Rotating periods of duty — 40 hour week — 
10 Statutory holidays — 3 weeks annual vaca- 
tion after completion of one years service. 

APPLY: 

ASSOCIATE DIRECTOR 
OF NURSING SERVICE 

ST. JOSEPH'S HOSPITAL 

30 The Queensway 
TORONTO 3, ONTARIO. 



NURSING EDUCATION 
CO-ORDINATOR 



For communily orientated General Hospital 
with expanding programmes. Approximately 
300 nursing personnel. 

Duties Will include planning, directing, im 
plementing and evaluating educational pro- 
grammes for all levels of nursing personnel 
focusing on the patient as a person, a mem 
ber of the family and the community. 

Salary and Fringe Benefits commensurate. 

Must have 

Masters Degree in Nursing 
Experience in continuing education 

Eligibility for Ontario Registration 



Write. 



The Director of Nursing 

The Doctors Hospital 

45 Brunswick Avenue. Toronto, Ontario 

OR PHONE: 416-923-5411 



62 THE CANADIAN NURSE 



MARCH 1974 




VICTORIA GENERAL HOSPITAL 

HALIFAX, NOVA SCOTIA 

The Maritimcs' largest hospital, has immediate openings tor 
Clinieal Nursing Supervisors. It is the principal adult teach- 
ing hospital ot Dalhousie University and also operates a 
large school of Nursing. 

.SALARY: ' $11,560-513.537 

CLINICAL NURSING SUPERVISORS 

A .Masters Degree is preferable but candidates with a 
Bachelors' Degree would be given consideration. 3 years 
e.xperience. 1 of which was at the supervisory level is 
required. Courses in Clinical Speciality Nursing, especially 
in Medical or Surgical Nursing would be considered. 
BENEFITS: 

Lull Civil Service Benefits, including three weeks vaca- 
tion and four weeks after five years of service. 
Competition is open to both men and women. 
Lor further information and/or application forms, please 
contact; 

Personnel Office, 
Victoria General Hospital. 
Halifax. Nova Scotia. 




REGISTERED 
NURSES 



Applications are invited for vacancies that we expect to develop 
in all areas of this 1,000 bed fully accredited hospital. We are 
especially interested in applicants with post graduate training 
in any of the specialties. Salaries frotn $665 to $855 with start- 
ing rate dependant on experience and qualifications. 

Calgary is a city of 425,000 nestled in the foothills of the Rock- 
ies. In addition to all of the usual cultural and sports activities 
available in any major city, 80 miles distant is a mountain play- 
ground of ski slopes, nature trails and hot springs. 

Why not sample western hospitality by joining the staff of a 
progressive hospital in a growing young city? 
Apply to: 

Mrs. Joyce Nazar 
Department of Personnel 
Calgary General Hospital 
841 Centre Avenue East 
Calgary, Alberta 
T2E 0A1 




Arctic- 
warmth 




— Avhen 

somebody 

9 cares. 







if you care, 

send Ihis 

coupon today. 



/■ r. 



i y-, ;-' Medical Services Branch 

r. - A ^ Department of National 

k' I'i^.' Health and Welfare 

■■^- ■ . Ottawa, Ontario K1A0K9 



Please send me more information on nursing 
opportunities in Canada's Northern Health Service 



Name: 
Address: 

City: 



Prov: 



1^ 



MARCH 1974 



Health and WeUare Sante et Bien-fetre social 
Canada Canada 



THE CANABIAN NURSE 63 



Certificate In Tropical 
Community Medicine & Health 

This three-months course, held twice a year, is specifically designed 
for nonphysician members of the Health Team. It is open to Nurses, 
Health Inspectors. Health Educators. Administrators and Economists, 
and others concerned with Community Health, particularly in the 
Developing Area. An objective of the course is to acquaint students 
with the nature of Health Care practices and problems in these areas. 

Participants are integrated with physicians attending the Diploma 
in Tropical Medicine and Hygiene course, for core subject material in 
Tropical Medicine, Tropical Community Health, Tropical Paediatrics, 
Parasitology and Entomology, So far as practicable, appropriate electives 
will be geared to the needs of individual stadents, 

A Certificate in Tropical Community Medicine and Health is awarded, 
by the Incorporated Liverpool School of Tropical Medicine, on satisfac- 
tory completion of the course and examination. 

The course fee is normally £ 56.50 which covers tuition and 
examination. Accommodation is an additional expense and is the res- 
ponsibility of the student. The School may be able to advise on ob- 
taining accommodation. 

A prospectus and application form may be obtained from the Admin- 
istrative Secretary, The School of Tropical Medicine, Pembroke Place, 
Liverpool L3 5QA, England, 

Early application for places is advised. Expected dates of future 
courses are: 



September 16 - December 18, 1974 
January 6 -April 9, 1975 
September 15 - December 17, 1975 
and similar dates each year. 



DIRECTOR 

OF 
NURSING 



Applications are invited for this position in a 240- 
bed convalescent - rehabilitation fully accredited 
hospital. 

Applicants should have a B.Sc. in nursing and 
experience in nursing administration. A l<nowledge of 
French would be an asset. 



Direct applications to: 



GENERAL MANAGER 

MONTREAL CONVALESCENT HOSPITAL 

3001 KENT AVENUE 

MONTREAL, QUEBEC 

H3S 1M9 




•*»«.ii^^^ M» ^ 



THE SCARBOROUGH 
GENERAL HOSPITAL 

invites applications from: 
Registered Nurses and Registered Nursing Assist- 
ants to work in our 650-bed progressive, accredit- 
ed, community-centered, active treatment hospital. 

We offer opportunities in Medical, Surgical. Paediatric, and Obstetrical 

nursing. 

Our specialties include a Burns and Plastic Unit. Coronary Care, Intensive 

Care and Neurosurgery Units and an active Emergency Department. 

• Obstetrical Department — participation in "Family centered" teach- 
ing program. 

• Paediatric Department — participation in Play Therapy Program. 

• Orientation and on-going staff education. 

• Progressive personnel policies. 

The hospital is located in Eastern Metropolitan Toronto. 

For further information, write to: 

The Director of Nursing, 

SCARBOROUGH GENERAL HOSPITAL, 
3050 Lawrence Avenue, East, Scarborough, Ontario. 




THE RELIGIOUS 
HOSPITALLERS 
OF SAINT JOSEPH 



INVITE YOU to share their 300 year heritage of service to the 
Church in health, education and welfare services in 
the United States, Canada and France 

to share their availability to reach out to those in 
need in Africa, Peru and the Dominican Republic 
proclaiming Christ's love by care and prevention, 
teaching and development programs 

to share their common life of prayer and work in a 
spirit of openness to God and the needs of others 



R.S.V.P. FORMATION CENTER 
438V2 College St. 
Burlington, Vermont 
05401 

FORMATION CENTER 
4 Toronto Street, 
Ottawa, Ontario. 
K1S0N2 



64 THE CANADIAN NURSE 



MARCH 1974 



.cV-NV CEVfip^^ 



ACCOMMODATION FOR 1974 ANNUAL MEETING CNA WINNIPEG. MANITOBA, JUNE 16-21 



HOTEL RATES 



gORTHSTAR INN 
'88 Portage Ave., 
Vinnipeg, Manitoba 
«C 0B8 



SR 



$24.00 -$28.00 



DB or TB 



$30.00 -$34.00 




t/^CH\^^ 



-lOTEL FORT GARRY 
Vinnipeg, Manitoba 
«C 0R3 



$24.00 



$30.00 



VINNIPEG INN 
: Lombard Place 
Vinnipeg, Manitoba 
12B 0Y3 



$23.00 



$29.00 



}R— Single Room DB— Double Bed TB— Twin Beds 

leaislrants will make their own resen/ations by writing directly to ttie above addresses, 
3ook early to avoid disappointment! 



REQUIRED 
IMMEDIATELY 

For a 68-bed Personal Care Home, 
a modern facility, 80 miles south 
west of Winnipeg. Thriving com- 
munity of 1500 people. Living 
quarters provided. Will credit for 
past experience. Excellent salary 
and fringe benefits. 

For further information contact: 

Administrator 
Foyer Notre Dame Inc. 
Notre Dame de Lourdes, 
Manitoba ROG 1M0 
Telephone: 248-2092 



REGISTERED NURSES 

for 

GENERAL DUTY 

for 

General or Specialized wards includ- 
ing O.R. for 550-bed hospital on Uni- 
versity Campus. 

Team or Unit Nursing 

Liberal fringe benefits 

for furtfier information please 
contact: 

Employment Officer, Nursing, 
University Hospital, 
Saskatoon, Sask. 



MARCH 1974 



rvices are progressive! 

■m 

So is nursing 



at 



The Montreal General Hospital 

a teaching hospital of McGill University 



Come and nurse in exciting Montreal 



r 






\' 



''^,^- 



^ 



The Montreal General Hospital 

1650 Cedar Avenue, Montreal, Quebec H3G 1A4 



Pleose tell me oboul hospital nursing under Quebec's new concept of Social ond 
Preventive Medicine. 



Name_ 



Addreis_ 



Quebec languoge requirements do not apply to Canadian opplicants. 
I 1 

THE CANADIAN NURSE 65 



Certificate In Trop 
Community IVIedicine i 

This three-months course, held twice a year, is 
for non-physician members of the Health Team. It 
Health Inspectors. Health Educators. Administrat( 
and others concerned with Community Health, 
Developing Area. An objective of the course is t 
with the nature of Health Care practices and problem 

Participants are integrated with physicians att 
in Tropical Medicine and Hygiene course, for core 
Tropical Medicine. Tropical Community Health. 
Parasitology and Entomology. So far as practicable. 
will be geared to the needs of individual stSients. 

A Certificate in Tropical Community Medicine an 
by the Incorporated Liverpool School of Tropical U 
tory completion of the course and examination. 

The course fee is normally £56.50 which 
examination. Accommodation is an additional expi 
ponsibility of the student. The School may be at 
taming accommodation. 

A prospectus and application form may be obtai 
istrative Secretary. The School of Tropical Medici 
Liverpool L3 5QA, England. 

Early application for places is advised. Expec] 
courses are: 

September 16 - December 18, 1974 
January 6 -April 9, 1975 
September 15 - December 17, 1975 
and similar dates each year. 



• Orientation and on-going staff education. 

• Progressive personnel policies. 

The hospital is located in Eastern Metropolitan Toronto. 

For further information, write to: 

The Director of Nursing, 

SCARBOROUGH GENERAL HOSPITAL, 
3050 Lawrence Avenue, East, Scarborough, Ontario. 



DIRECTOR 

OF 
NURSING 



Applications are invited for this position in a 240- 
bed convalescent - rehabilitation fully accredited 
hospital. 

Applicants should have a B.Sc. in nursing and 
experience in nursing administration. A know/ledge of 
French would be an asset. 



Direct applications to: 



GENERAL MANAGER 

MONTREAL CONVALESCENT HOSPITAL 

3001 KENT AVENUE 

MONTREAL, QUEBEC 

H3S 1M9 




THE RELIGIOUS 
HOSPITALLERS 
OF SAINT JOSEPH 



INVITE YOU to share their 300 year heritage of service to the 
Church in health, education and welfare services in 
the United States, Canada and France 

to share their availability to reach out to those in 
need in Africa, Peru and the Dominican Republic 
proclaiming Christ's love by care and prevention, 
teaching and development programs 

to share their common life of prayer and work m a 
spirit of openness to God and the needs of others 



R.S.V.P. FORMATION CENTER 
438 V2 College St. 
Burlington, Vermont 
05401 

FORMATION CENTER 
4 Toronto Street, 
Ottawa, Ontario. 
K1S0N2 



f.A THPrAMArtiAN niir<;f 



MARCH 1974 



RED DEER COLLEGE 

requires 

NURSING 
INSTRUCTOR(S) 

Position(s) open July 1st, 1974. Masters 
Degree in a Clinical Specialty preferred, but 
Baccalaureate Degree considered. Exper- 
ience in Nursing Practice essential. Instruc- 
tors involved in several practice settings. 
Program is integrated by teaching of basic 
concepts of Nursing. Post-basic nursing 
courses also in the planning stages. 

Apply with — 

(1) Curriculum Vitae 

(2) References 

to: Dr. G.O. KELLY 

Director of Programs 
Red Deer College 
Red Deer, Alberta. 



R.N.'S&L.P.N.'S 

REQUIRED 
IMMEDIATELY 

For a 68-bed Personal Care Home, 
a modern facility, 80 miles south 
west of Winnipeg. Thriving com- 
munity of 1500 people. Living 
quarters provided. Will credit for 
past experience. Excellent salary 
and fringe benefits. 

For further information contact: 

Administrator 
Foyer Notre Dame Inc. 
Notre Dame de Lourdes, 
Manitoba ROG 1M0 
Telephone: 248-2092 



REGISTERED NURSES 

for 

GENERAL DUTY 

for 

General or Specialized wards includ- 
ing O.R. for 550-bed hospital on Uni- 
versity Campus. 

Team or Unit Nursing 

Liberal fringe benefits 

for further information please 
contact: 

Employment Officer, Nursing, 
University Hospital, 
Saskatoon, Sask. 




'^TtAon^^' 



Quebec's Health Services are progressive! 



So is nursing 



at 



The Montreal General Hospital 

a teaching hospital of McGill University 



Come and nurse in exciting Montreal 






\' 



■v 



^ 



The Montreal General Hospital 

I'TM*-''' 1650 Cedar Avenue, Monlreol, Quebec H3G 1A4 

Please tell me about hospital nursing under Quebec's new concept of Social and 
Preventive Medicine. 



Name_ 



Address 



Quebec language requirements do not apply to Conodion applicants. 



MARCH 1974 



THE CANADIAN NURSE 65 



EXTENSION COURSE IN 
NURSING UNIT ADMINISTRATION 



REGISTERED NURSES employed full time in management posi- 
tions may apply for enrolment in the extension course in Nursing 
Unit Administration. A limited number of registered psychiatric 
nurses may also enrol. The program is designed for nurses who 
wish to improve their administrative skills and is available in French 
and in English. 

The course begins with a five day intramural session in September, 
followed by a seven month period of home study. The program 
concludes with a final five day workshop session in April or in May. 
The intramural sessions are arranged on a regional basis. 
The extension course in Nursing Unit Administration is sponsored 
jointly by the Canadian Nurses' Association and the Canadian Hos- 
pital Association. 

Registered Nurses interested in enrolling in the 1974-75 class 
should submit applications before May 15th. Early application is 
advised. The tuition fee of $175.00 is payable on or before July 1 st. 

For additional information and application forms direct 
enquiries to: 

Director, 

Extension Course in Nursing Unit Administration, 

25 Imperial Street, 

Toronto, Ontario MSP 1C1 




HOSPITAL: 

Accredited modern general - 260 beds. Expansion 
to 420 beds in progress. 

LOCATION: 

Immediately north of Toronto. 

APARTMENTS: 

Furnished - shared. 

Swimming Pool, Tennis Court, Recreation Room. 

Free Parking, 

BENEFITS: 

Competitive salaries and excellent fringe benefits. 
Planned staff development programs. 

Please address all enquiries to: 
Assistant Administrator (Nursing) 
York County Hospital, 
NEWMARKET, Ontario. 
L3Y 2R1 



See what your dollais can do. 

Support teter Seals. 



UNIVERSITY OF 
ALBERTA HOSPITAL 

EDMONTON, ALBERTA 
invites applications from general duty nurses 



Opportunities for Professional development in 
general and specialty areas of Medical and Sur- 
gical Nursing, Paediatrics, Obstetrics, Psychiatry, 
Operating Room, Renal Dialysis Unit, and Extend- 
ed Care. 

Planned Orientation Program, 
In-service Education Program. 

Salary commensurate with education and expe- 
rience. 

For further information write to: 

EMPLOYIVIENT SUPERVISOR — NURSING 
UNIVERSITY OF ALBERTA HOSPITAL 
84 Avenue & 11 2 Street 
Edmonton, Alberta 



66 THE CANADIAN NURSE 



MARCH 1974 



SHERBROOKE HOSPITAL 

SHERBROOKE, QUEBEC, 
invites applications from 

REGISTERED NURSES 
GENERAL DUTY 



138-becl active General Hospital; fully accredited with 
Coronary, Medical and Surgical Intensive Care. 
Situated in the picturesque eastern Townships, 
approximately 80 miles from Montreal via autoroute. 
Friendly community, close to U.S. border. Good 
recreational facilities. Excellent personnel policies, 
salary comparable with Montreal hospitals. 



Apply to: 
Director of Nursing 

SHERBROOKE HOSPITAL 

Sherbrooke, Quebec. 




ORTHOPAEDIC i<: ARTHR|-riC 
HOSPITAL, 



^^/|\^ 



43 WELLESLEY STREET, EAST, 

TORONTO, ONTARIO 

M4Y 1H1 



Enlarging Specialty Hospital offers a unique op- 
portunity to nurses and nursing assistants interested 
in the care of patients with bone and joint disorders 

Must be registered in the Province of Ontario. 

Preparation by post-graduate education or exper- 
ience required for Senior positions. 



Join our team at 
Sunnybrook 
Medical Cent re - 
and grow! 




• University Teaching Hospital 

• In-Service Opportunities 

• Active Care 

• Extended Care 

• Good Public Transportation 

• Residence Available 



Write today. 
Selection Officer 
Personnel Department 
Sunnybrook Medical Centre 
2075 Bayview Avenue 
Toronto, Ontario M4N 3M5 




MARCH 1974 



THE CANAD^N NURSE 67 



OPERATING ROOM 
NURSES 

— required for 270 bed acute care 
hospital 

— expanding to 370 beds 

— must be eligible for B.C. registration 
Personnel policies in accordance 
with RNABC contract 

— 1973 salary $672.00 - $842.00 per 
month plus credit for postgraduate 
certificates and experience 

Please contact: 

Director of Nursing 

Prince George Regional Hospital 

Prince George, B.C. 



NEWFOUNDLAND 
DEPARTMENT OF HEALTH 

PUBLIC HEALTH NURSES 



PUBLIC HEALTH NURSES are required lo 
carry out a generalized programme in rural 
areas of the province. 

Applicants should have a baccalaureate de 
gree with a major or a diploma m public health 
nursing. 

Salary and Innge benefits m accordance with 
the collective agreement of the Association of 
Registered Nurses of Newfoundland and appli- 
cants should be eligible for registration m the 
association. 

For application forms and/or further informa- 
tion apply in writing to 

Director 

Public Health Nursing Division 

Department of Health 

Confederation Building 

St. John's, Newfoundland 



PATIENT CARE STAFF 



The following permanent positions are 
available for qualifietd experienced per- 
sonnel. Salaries will be in accordance 
with current collective agreements. 



HEAD NURSE PEDIATRICS 

REGISTERED NURSES — General Duty 

ORDERLIES 

Reply in confidence to: 

Director of Nurses 
Vernon Jubilee Hospital 
Vernon, British Columbia 
V1T5L2 



JOHN ABBOTT COLLEGE (CEGEP) 

Ste Anne de Bellevue 

(Suburban Montreal) 

THREE-YEAR NURSING PROGRAMME 

requires 

ADDITIONAL TEACHING STAFF 
for September, 1974. 

Applicants should possess a R.N. Bachelor's Degree in nursing and a minimum of 
two years general nursing experience. 

John Abbott College is a community college serving the West Island of Montreal. 
It offers a park-like setting, close to the city, on campus sports, recreation, and the 
possibility of residence on or close to the campus. 

Teaching salaries according to Quebec teacher's scale, excellent fringe benefits, 
group insurance, pension plan, health benefits, and two months paid vacation. 

Address application and completed curriculum vitae to: 

DIRECTOR OF PERSONNEL 

JOHN ABBOTT COLLEGE 

P.O. BOX 2000 

STE ANNE DE BELLEVUE, QUEBEC 

H9X 3L9 



< 



MEMORIAL UNIVERSITY OF 

NEWFOUNDLAND 

SCHOOL OF NURSING 

IS 

Analyzing and revising its curricula and is expanding programs to better prepare 
graduates in leadership for the future health care system. 

Additional personnel required August 1974. 

There are positions open for faculty with creative ability and advanced preparation 

in: 

NURSING OF ADULTS 
NURSING OF CHILDREN 
PARENT-CHILD NURSING 
MENTAL HEALTH NURSING 
CURRICULUM DESIGN 
MANAGEMENT OF NURSING CARE 
RESEARCH IN NURSING 
COMMUNITY NURSING 

Preparation at the Master's level is preferred but persons with a baccalaureate and 
appropriate experience will be considered. 

Please direct inquiries or applications to: 

Miss MARGARET D. McLEAN 
Director, School of Nursing 
Memorial University of Newfoundland 
St. John's, Newfoundland 



68 THE CANADIAN NURSE 



MARCH 1974 



The George Brown College of Applied Arts 
and Technology 

Requires 

DEAN, NURSING DIVISION 

Reporting to the Vice-President, Academic, the 
Dean will be responsible for the direction, coordination 
and development of the Nursing Division of the College. 
(Student enrolment: 1,200; staff: 170). The Dean's imme- 
diate concern will be in the integration of the Nursing 
Schools of St. Joseph's and St. Michael's Hospitals, the 
Toronto General Hospital, the Toronto Western Hospital 
and Nightingale into a division of the College. The division 
will offer diploma nursing, affiliate and graduate programs. 

The appointment will be made no later than Septem- 
ber 1,1974. 



Interested applicants should forward resumes by 
April 15, 1974 to: 

Director of Personnel, 
P.O.Box 1015, 
Station B, 
Toronto, Ontario, 
M5T 2T9. 



REGISTERED NURSES 



This 500-bed chronic and convalescent hospital has imme- 
diate full-time and part-time vacancies for Registered 
Nurses or Graduate Nurses with pending Ontario registra- 
tion. 

Positions offer starting salaries commensurate with exper- 
ience, liberal fringe benefits and scope for advancement. 



For an interview please contact: 



PERSONNEL DEPARTMENT 
QUEEN ELIZABETH HOSPITAL 
130 DUNN AVENUE 
TORONTO, ONTARIO 
M6K 2R7 
Tel.: 537-2411 



VANCOUVER 
GENERAL HOSPITAL 

Invites applications for 

REGULAR and RELIEF 
GENERAL DUTY 

Nursing positions in all clinical areas of an active 

teaching hospital, closely affiliated with the University of B.C. 

and the development of the B.C. Medical Centre. 

For further information, please write to: 

PERSONNEL SERVICES 

VANCOUVER GENERAL HOSPITAL 

855 WEST 12TH AVE. 

VANCOUVER, B.C. 




MARCH 1974 



THE CANADIAN NURSE 69 



DIRECTOR OF NURSING 



A challenging position in a modern (1971) 192 bed psychiatric 
hospital with Day Centre and Out Patient Clinic. The hos- 
pital IS about to become part of a new Community Mental Health 
Centre for the City of Halifax and surrounding area (pop. 150,000) 
and the expansion is planned to include affiliation with Dalhousie 
University. 

Qualifications 

Eligible for Nursing Registration in Nova Scotia; 
A degree in nursing, preferably at Masters level, with consider- 
able psychiatric experience; 
Administrative experience in a psychiatric setting; 
Recent experience in Community Mental Health Programmes 
would be desirable. 

Salary; According to qualifications and experience. 

Please apply in writing with a resume stating full 
details of education and experience to: 

The Administrator 

Abble J. Lane Memorial Hospital 

5909 Jubilee Road 

Halifax, Nova Scotia 

B3H 2E2 



TORONTO 
GENERAL HOSPITAL 

Invites applications from 

REGISTERED NURSES 
REGISTERED NURSING 

ASSISTANTS 
FOR GENERAL DUTY 

— Superior opportunities for Professional Growth 
and Development. 

— Progressive Personnel Policies. 

— Excellent opportunities for advancement in 
atmosphere of medical excellence. 

Please apply to: — 

Personnel Office 

TORONTO GENERAL HOSPITAL 

101, College St., 

Toronto. Ontario, 

M5G 1L7. 




Jewish General Hospital 

Montreal, Quebec * 

A modern 700 bed non-sectarian hospital which has general and special services. 
Active In-Service Education Programme, including Planned Orientation Programme. 
Excellent personnel policies. Bursaries for post-basic University courses in Nursing 
Supervision and Administration. 
Applications invited from Registered Nurses and Nursing Assistants. 

For further information, please write: 

Director, Nursing Service JEWISH GENERAL HOSPITAL 
3755 Cote St. Catherine Road Montreal 249, Quebec 



70 THE CANADIAN NURSE 



MARCH 1974 



SASKATCHEWAN REGISTERED 
NURSES' ASSOCIATION 

invites applications for the position of 

EXECUTIVE DIRECTOR 



Ttiis position entails managing the business affairs of the 
6.500-member association. Duties include participating in the 
development and implementation of policy, budgeting and 
financial management, communication with groups and individu- 
als. The successful applicant vi/ill have over-all responsibility for a 
staff of ten, and w\\\ answer directly to the association's 
seven-member governing council. 

Salary range: $15,000 - $17,000 per annum. 

QuaKfications: Applicants must be eligible for registration with 
the Saskatchewan Registered Nurses' Association, have a 
masters/baccalaureate degree with a major in administration, 
several years experience in an administrative position or related 
experience 

Applications, giving full details of education, qualifications 
and experience, should be sent to: 

Miss ELEANOR LINNELL, Chairman 

Selection Committee 

607 - 1 1 00 Broadway Avenue 

Regina, Saskatchewan 

S4P1E3 



RN and RNA 



Permanent or summer staff positions available 

Active 250-bed General Hospital 

Year-round recreational area of scenic Georgian 
Bay 

Good salary and benefits 

Residence accommodation 



For information write 



Executive Director of Nursing 
General & Marine Hospital 
1201-6th Avenue West 
Owen Sound, Ontario 
N4K 5H3 



HEALTH 

SCIENCES 

CENTER 

WINNIPEG, 
MANITOBA 




THIS 1345 BED COIVIPLEX WITH ITS SEVERAL AMBULATORY CARE 
CLINICS, AFFILIATED WITH THE UNIVERSITY OF MANITOBA, 
CENTRALLY LOCATED IN A LARGE, CULTURALLY ALIVE 
COSMOPOLITAN CITY. 

INVITES APPLICATIONS FROM 

REGISTERED NURSES SEEKING PROFESSIONAL 

GROWTH, OPPORTUNITY FOR INNOVATION, AND JOB 

SATISFACTION. 

ORIENTATION - Extensive two week program at full salary 

ON-GOING EOUCATION Provided ttirough 

— active m-service programmes in all patient care areas 

— opportunity to attend conferences, institutes, meetings of professional 
association 

— post basic courses in selected clinical specialties 
PROGRESSIVE PERSONNEL POLICIES 

— salary based on experience and preparation 

— paid vacation based on years of service 

— shift differential for rotating services 

— 10 statutory fiolidays per year 

— insurance, retirement and pension plans 

SPECIALIZED SERVICE AREAS include orthopedics, psychiatry, post 
anaesthetic, casualty, intensive care, coronary care, respiratory care, dialysis, 
medicine and surgery, obstetrics, gynaecology and rehabilitation. 

ENQUIRIES WELCOME 

FOR FURTHER INFORMATION PLEASE WRITE TO: 

PERSONNEL DEPARTMENT. NURSING SECTION 
HEALTH SCIENCES CENTRE, 

700 WILLIAM AVENUE, WINNIPEG. MANITOBA R3E0Z3 



MARCH 1974 



THE CANAQIAN NURSE 71 



Index 

to 

Advertisers 

March 1974 



Astra Pharmaceuticals Canada'Ltd 53 

Bic Pen (Canada) Ltd 43 

Clinic Shoemakers 2 

Davol Canada Ltd 6 

Department of National Defence 59 

Hollister Limited 37 

J.B. Lippincott Company of Canada. Ltd 1 

Mont Sutton Inc '0 

C.V, Mosby Company, Ltd 45, 47, 49, 51 

Procter & Gamble '3 

Reeves Company '4- 15 

William H. Rorer. (Canada) Ltd 16 

Rosehill Institute of Human Relations 52 

Schering Corporation Limited 72, Cover IV 

Westwood Pharmaceuticals 55 

White Sister Uniform, Inc 5, 1 1, Cover II, Cover III 



A dvcrtising Manager 
Georgina Clarke 
The Canadian Nurse 
50 The Driveway 
Ottawa K2P 1E2 (Ontario) 

A clverlisin^ Representatives 
Richard P. Wilson 
219 East Lancaster Avenue 
Ardmore, Penna. 19003 

Iclcphoiic. (215) Midway 9-1497 

Gordon Tiffin 

2 Tremont Crescent 

Don Mills, Ontario 

Telephone. (416)444-4731 

Member of Canadian 
Circulations Audit Board Inc. 



rssB 



Coricidin'D' 



DESCRIPTION: 

Coricidin 'D': Each white, coated 
tablet contains: 

2 mg chlorpheniramine maleate U.S-P-, 
390 mg acetylsalicylic acid. 
30 mg caffeine and 
10 mg phenylephrine . 
Available in blisters of 12 
and 24, and bottles of 100 tablets, 

Coricidin 'D' Medilets: Each orange- 
pineapple-flavored multicolored tablet contains; 
0,5 mg chlorpheniramine maleate U.S. P., 
80 mg acetylsalicylic acid and 
2,5 mg phenylephrine HCl, 
Available m boxes of 24 Medilets in a 
child's protective package. 
INDICATIONS: 

Symptomaticrelief of nasal congestion and 
other discomforts associated with sinusitis, 
colds and allergic or vasomotor rhinitis. 
CONTRAINDICATIONS: 

Sensitivity to any of the components, 
patients receiving MAO mhibitors. 

PRECAUTIONS: 

Admmister with caretopatients with hyper- 
tension, cardiac disorders, hyperthyroidism, 
diabetes mellitus and patients hypersensitive 
to sympathomimetic compounds. 

Patients should be cautioned not to oper- 
ate vehicles or hazardous machinery until 
their response to the drug has been deter- 
mined. Since the depressant effects of anti- 
histamines are additive to those of other 
drugs affecting the central nervous system, 
patients should be cautioned against drink- 
ing alcoholic beverages or taking hypnotics, 
sedatives, psychotherapeutic agents or other 
drugs with CNS depressant effects during 
antihistamine therapy. 

Rarely, prolonged therapy with antihista- 
mine-containing preparations can produce 
blood dyscrasias 

ADVERSE EFFECTS: 

Drowsiness, dizziness, nausea, increased 
irritability or excitement may be 
encountered 
DOSAGE: 

Coricidin 'D': Adults: 1 tablet every 4 
hours, not to exceed 4 tablets in 24 hours. 
Children 10 to 14 years: 1/2 adult dose: 
under 10 years: at discretion of physician. 
Coricidin 'D' Medilets: 2 to 6 years: 
1/4 to 1 Medilets: 7 to 1 2 years: 1 to 2 
Medilets. Each dose may be repeated every 
3 to 4 hours, but not more than 4 Medilets 
should be given in one day tci children 2 to 
6 years, and 6 Medilets to children 7 to 12 
years. Limit treatrnent to 3 days. The recom- 
mended dosage should not be exceeded 
except on a physician's advise. 



Detailed information is available on 

request 

SCHERING CORPORATION LIMITED 

Pointe Claire. Quebec H9R 1B4 



I t>MAC I 



72 THE CANADIAN NURSE 



MARCH 1974 



UNIFORM SPECIALTY 

nAKES IT EASY 
O LOOK GREAT 



e 42346 

yale Rib" Tricot Knit 

or Length 

:s 3-15 

te only 

00 

e 42841 

yale Oxford" Tricot Knit 

■s 5-15 

te S25.00 

yale Corded" Knit 

and Yellow 
00 

e 2465 

yale Corded" Tricot Knit 

s 10-20 

te S26.00 

ow S27.00 




HOP IN PERSON AT OUR 
BAY STREET STORE 

'R WRITE TO OUR MAIL 
DER DIVISION FOR A NEW 
CATALOGUE 



UNIFORM SPECIALTY 

1254 BAY ST. 
(Just above Bloor) TORONTO 



MAIL ORDER DIVISION 

372 Queen St. W. 

Toronto, Ont. M5V 2A3 

Please send all mail orders to 
above address (jr phone 366-1414 



Howto''catch''a cold 



Surprise a cold ri^ht at its onset with 
Coricidin 'D" tor adults and Coricidin 'D" 
Medilets" tor children. You can recom- 
mend these products knowing they will 
proxide reliet from aches, pains and 
fever plus decongestant action. 
Coricidin 'D' and Coricidin 'D" 
Medilets contain Chlor-Tripolonf 
one of the world s most widely used 
antihistamines; phenylephrine, a 
highly effective decongestant and acetyl- 
salicvlic acid for aches, pains and tever. 
The adult torm contains caffeine as a mild 
stimulant to keep your patients on the go. 



Coricidin'D' 



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^ /Mgjllj^: 

^ 9 



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Nurse 




MISS MRA LOYER 



158 GUIGUES ST 

OTTA W A KIN 5tj 9 00056886 



v,T^ 




nurses break the ice in the Arctic 




WHITE 
SISTER 

HAS THE 

SIMPLE 

DIFFERENCE 



A) Style #42871 

"Royale Oxford" 
Junior Length 
Sizes 5-15 

White only 

About S20.Q 

B) Style #2358 

"Royale Rib" 
Missy Length 
Sizes 8-18 

White only 

About $24.C 

C) Style #2456 

"Royale Corded" 
Sizes 8-18 

White about $27X1 

Navy about $29.« 



^^^1 



CAREER APPAREL AT FINE STORES ACROSS CANADA 




© 



y.. 






AXD 

IXSTRrCTIOX 

L\ 

xrKSixc. 



VIRC.IXIACCON'l.EV 



new Book/ 
now InfoimcilioA 



New — 7/7;Vd Edition 

BASIC PSYCHIATRIC CONCEPTS IN NURSING 

This thoroughly revised edition provides sharper focus on the dynamics of 
the nurse's role and function, and is designed to facilitate the student's 
progress from the theoretical to the operational level. Proceeding from basic 
psychiatric concepts, the authors use case studies to explain and demon- 
strate how the nurse can intervene. Many case studies and examples of 
nursing practice are interspersed throughout. Content extensively revised 
includes drug abuse; sexual deviation; understanding of behavior; sensi- 
tivity to the human condition; nursing management of neurotic and psychotic 
patients; understanding self in realtion to interaction with peers, super- 
visors, subordinates and patients; recognition of emotional problems faced 
by all hospitalized patients. 
600 pages/April, 1974/about $10.00 

Joan J. Kyes, R.N., M.S.N., Altoona (Pa.) Hospital Community Healtti Center; 
Charles K. Hofling, M.D., St. Louis University. 

New — Second Edition 

NURSES' HANDBOOK OF FLUID BALANCE 

The increasing responsibilities of the nurse for physical diagnosis, treat- 
ment and evaluation of laboratory findings are reflected in this thoroughly 
revised edition. All chapters include the latest findings in types of im- 
balances, treatments, and medication; each element, deficit and excess is 
discussed in greater depth and clarity An important new chapter. Fluid 
Balance in Pregnancy, incorporates new knowledge on sodium restriction 
and effects of pregnancy on body fluid disturbances. Other new chapters 
deal with routes of transport, organs of homeostasis, and disturbances in 
water and electrolytes. With many new illustrations and an attractive new 
format. 

325 pages/illustrated/April, 1974/paperbound, about $8.50 
Norma M. Metheny, R.N., M.S., Meramec Community College, St. Louis; 
William D. Snively, Jr., M.D., F.A.C.P., University of Evansville School of 
Nursing and Indiana University School of Medicine. 

CURRICULUM AND INSTRUCTION IN NURSING 

Nursing educators are l<eenly aware of the impact of twentieth-century 
scientific and technological events upon the health care of the members of 
society. This text carefully examines nursing education and the process of 
change in relation to the nature and objectives of curriculum and instruc- 
tion. Part I deals with the dynamics of curriculum development and basic 
issues and participants in that development. In Part II sources of curriculum 
decisions are dealt with in relation to cultural values, social and scientific 
forces, nursing education, the student, and psychological and learning 
theories. The design, structure, and evaluation of curriculum are covered in 
the next part, and Part IV treats the nature of instruction, variables in the 
instructional process, and instructional modes and media. The final part 
deals with strategies for curriculum change, and with roles and processes 
in that change. 

Virginia C. Conley, R.N., Ed.D., Dean of the School of Nursing, The 
Catholic University of America. 673 pages, illustrated. $16.50 
November 1973 




Serving the health professions in 

Canada since 1897 

J. B. Lippincott Co. of Canada Ltd. 

75 Horner Ave. 

Toronto, Ontario M8Z 4X7 

Representing in Canada: 

Little Brown and Company 

Blackwell Scientific Publications Ltd. 

Springer Publishing Company, Inc. 



Please send me the book(s) whose number(s) I have circled 

1 2 3 

Name 

Address Position 



City 



Province Postal Code 



□ Payment enclosed (send postpaid) 
Books may be returned within 15 days 



□ Use my Chargex number 

□ Charge and bill me 



CN.4-74 



'Now you can squeeze 
a little more out of DavoL 



You said bulb syringes get slippery. 
So we molded rings onto them. Now 
they won't slip even when your hands 
are wet. 

You told us you wanted a piston 
syringe you could operate with one 
' land. So we added a thumb ring and 
finger rim. 

We made some other changes, too. 
We enlarged our calibrations for easy 
reading. And gave our bulb-type 
syringes an exclusive Plivof bulb 



and finger grip for easy thumb- 
squeeze action. 

Most important, we gave our 
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Take a close look at syringes. 
You'll see that Davol makes the 
difference. 

Davol Canada Ltd., 1033 Range 
View Rd., Port Credit, Ont, 
L5E-1H2 (416)274-5252 



BUILDING ON A CENTURY OF QUALITY 
HEALTH CARE PRODUCTS 



1874-1974 



The 

Canadian 
Nurse 




^^17 



A monthly journal for the nurses of Canada published 

in English and French editions bv the Canadian Nurses' Association 



Volume 70, Number 4 



April 1974 



2 1 CN A Ticket of Nominations 

3 1 CNA Financial Report and Auditor" s Statement 

36 CNA Convention Program 

38 Nurses Break the Ice H.L. Brigstocke 

42 Maternity Patients Make Decisions M.B. Ratsoy 

45 Idea Exchange 



I ho views expressed in ihe etliioiiiil :ind various articles are ihusc dI' Ihe authors anil 
do not necessarily repiesent the policies or view sot' the ( anadian Nurses' Association. 



4 Letters 
47 Dates 
50 Accession List 



9 News 
48 Names 
72 Index to Advertisers 



Excculi\e Director: Hvkrn K. Muvsallvm • 
I (Jili)r Virginia \. I.indabur> • Assim.imi 
I diliirs l.i«-Klk'n I .i>cki-hvrg, l>or<>lh\ S. 
Starr • I dilnrial \^sl^t.lnt Carol A. I)»<ir- 
kin • I'rcxluclion Assisiani Kliubi-th A. 
Stanton • ( irculatinn Vl.iniiger Bt.-r>l Dar- 
ling • AilM-Tlising M.in.iger Gi'orgina Clarke 

• Subscription Ralv>: ( anada one >car. 
S^-IK), two \ears. Sll.(K). Iiircigii oik- >ear. 
$6.50; two years. $12.00 Single copies 
$1.00 each. Make cheques or money orders 
pavabk- to the Canadian Nurses .AssiHTialion. 

• Change of .\ddrfss: Six weeks' nonce; the 
old address ;is well as the new are necessarv. 
together with registration nunilxr in a pro- 
vincial nurses' ass(x;iation. where applicable 
Not responsible tor journals K>st in mail ilue 
to errors in address. 



Manuscript Inforination: Ihe ( .inadian 
Nurse" v^elcoTnes unsoiieiled articles. All 
manuscripts should N.- t\(vd. double-spaced, 
on one side ol unruled pa|xr le;iv ing wide 
margins. Manuscripts are .iccepted tor review 
tor exclusive publication. Ihe editor reserves 
the right to make the usual editorial changes 
I'hoiographs iglossy printsi and gr;iphs and 
diagrams Idrawn in india ink on white paper) 
.ire welcomed with such .irticles. Ihe editor 
IS not committed to publish all articles sent, 
nor to indicate definite d;ites of publication. 

Postage p;iid in cash at third class rale 
MONTRIAI. I'O Permit No. KUKtl. 
^U Ihe Driveway. Ottawa. Ontario. K2P 112 

C) ( .in.tili.m Nurses' \ss4ii.-i.ilion l*)74. 



In his guest editorial in January 1974, 
Health Minister Lalonde referred to the 
need to "increase the Individual's 
responsibility for his own health. " The 
Canadian Nurses' Association hopes 
to sensitize nurses to ways in which 
individuals can modify their life-styles 
to improve their health. 

However, some Individuals have 
existing health problems that will not 
be dissipated by a healthier mode of 
living. For such a person, responsibil- 
ity for his own health may include 
providing a means of communicating 
vital information to health care per- 
sonnel, in the event that he is uncon- 
scious or othen\ise unable to speak 
up. 

The Canadian Medic-Alert Founda- 
tion offers individuals an opportunity to 
register their medical history and re- 
levant resource persons, such as 
physician and next-of-kin, with a tele- 
phone center that is open 
24-hours-a-day. (News, page 11.) 
Bnef information about the individual's 
health problems is inscribed on the 
back of a stainless steel disk, worn on 
a bracelet of steel links. The front of 
the disk has an insignia in red: a 
serpent-wreathed rod and the words 
Medic Alert. It looks like this: 




APRIL 1974 



Nurses should look for the bracelet 
and use the information in patient 
care. The disk may contain such clues 
as: contact lenses, allergic to tetanus 
antitoxin, allergic to penicillin, multiple 
sclerosis, diabetes, or glaucoma. 
Blood type may also be inscribed. 

The bracelet is functional rather 
than decorative; on festive occasions, 
a woman may fasten it in a less 
conspicuous place, such as on her bra 
strap. So watch for the bracelet when 
an emergency patient is undressed for 
medical examination and treatment. 

If you want to ensure that a continu- 
ing health problem will be recognized 
in an emergency, wear a Medic-Alert 
bracelet. When you nurse patients, 
watch for the Medic-Alert insignia and 
use its information for the wearer's 
care. 

Individuals have a responsibility for 
their own health, and health profes- 
sionals must cooperate with persons' 
efforts to be responsible. — D.S.S. 

THE CANADIAN NURSE 3 



letters { 



Letters to the editor are welcome. 

Only signed letters, which include the writer's complete address, 

will be considered for publication. 

Name will be withheld at the writer's request. 



Nurse wants to share experience 

As I have had ""a wolf by the ears" for 
three years now, I read Bonnie Hartley's 
article (January 1974) with much interest. 

Having recovered from an acute ill- 
ness, I also have much to thank God for. I 
am enjoying a normal, healthy life, 
maintained on medication and working 
full-time. 

Since little is known of systemic lupus 
erythematosus, perhaps we could form a 
club or other group and communicate. I 
would like to share my experience, what I 
have learned, and am still learning. — 
Margaret Duffy, Reg.N., Dorion. 
Quebec. 



Educator responds to article 

In response to the article by Barbara 
Geach, "The Problem-Solving Techni- 
que: Is It Relevant to Practice?" (January 
1974), I would like to make the following 
comments. 

The words "problem-solving" can be 
used in different ways and can mean 
different things. A child learning to tie a 
shoe is solving a problem. Research is 
undertaken to solve a problem. In discus- 
sing its relevance to any particular situa- 
tion, we must define what we mean by the 
term. How is it interpreted in nursing? Is 
it used as in mathematics when it refers to 
a kind of drill? Are we using it to refer to 
a method of intellectual evaluation? 

Some authors seem to use the term 
"problem-solving" in somewhat the 
same way as B.F. Skinner uses the term 
"conditioning," in making reference to 
the conditions within the learner, that is, 
the previous learning and recall, and 
also the conditions in the learning situa- 
tion. Some authors talk about problem- 
solving and discovery; of problem-solv- 
ing and creativity; or discuss learning 
strategy in problem-solving, and self- 
instruction in study skills. 

Ausubel (1968) discusses problem- 
solving and insight. He defines two 
principal kinds of problem-solving that 
can occur at all age levels: one is trial and 
error, and the second is insight — the 
discovery of meaningful means-end rela- 
tionships. Translating this to classroom 
activity, problem-solving can constitute a 
form of directed or arranged discovery. 
Ausubel says that problem-solving is 
impossible without the relevant back- 
ground knowledge, that is, the concepts, 
the principles, and the transactional 
terms, in relation to the problem. 

4 THE CANADIAN NURSE 



Problem-solving is relevant to practice 
in the clinical area; indeed, it is relevant 
to all aspects of living. I see a different 
type of problem-solving in the classroom 
than one would expect to find in real life 
situations. In a clinical area, the nurse 
must have the knowledge, the confi- 
dence, and the competence to be able to 
problem solve instantaneously when an 
emergency situation arises. 

The content we teach in schools of 
nursing may not be relevant to practice. I 
agree there is an urgent need for educators 
and clinicians to work together to identify 
the real problem, and to use the problem- 
solving technique to find the 
answer. — Jane C. Haliburton, Director 
of Education, Yarmouth Regional Hospi- 
tal, Yarmouth, Nova Scotia. 



Comments on problem-solving 

Bravo to a teacher who publicly re- 
quests the help of clinicians in devel- 
oping relevant educational content 
("The Problem-Solving Technique: Is 
It Relevant to Practice?" January 
1974). Educators such as Barbara 
Geach help bridge the practice-theory 
gap by stressing the interdependence 
between the two worlds. 

I feel, however, that the request for 
documentation of the usefulness of 
problem-solving per se may be un- 
realistic. Problem-solving is an ongoing 
process and is thus difficult to describe 
in writing. Nursing care plans and the 
prt)blcm-oricnted medical record show 
the results of clinical problem-solving, 
and clinicians such as Marlene Mayers 
do write abt)ut the effectiveness ol 
these tools. I wonder if Ms. Geach is 
looking in the wrong place for valida- 
tion. 

Changing students" attitudes toward 
this "cerebral activity" will be more 
difficult than simply reassuring one- 
self that it is a meaningful process. 
Nurse educators may use the terminol- 
ogy of problem-solving, but it is my 
concern that this complex process may 
not be well understood by them — a 
complication that would profoundly 
affect their teaching of that priKCss. I 
suggest that the writer's appeal tor help 
should not only be directed toward 
clinicians, but also toward researchers 
who are studying the process of prob- 
lem-solving. — Jessie Mantle. Asso- 
ciate Professor. The University of West- 
ern Ontario. London, Ontario. 



Author replies 

It was pleasing to get such a rapid 
response to my article, although sadden- 
ing that an educator, rather than a 
clinician, should be the first to write. It 
may be true, as Professor Jessie Mantle 
suggests, that care plans and problem- 
oriented records are evidence of the 
results of clinical problem-solving. There 
is some evidence, however, to suggest 
that in at least some institutions, care 
plans have fallen into disuse. 

Problem-oriented records are a newer 
arrival on the scene, but they may fall into 
similar disuse in time. One could say that 
such an institution was probably a bad 
one, and that we cannot base our teaching 
or our practice on what bad institutions 
do. But the nagging question remains: 
Could the use of these tools be dropped 
becau.se they are unwieldy encrustations 
on the work of clinicians, rather than 
something that enhances this work and 
makes it more efficient? 

Further, when one thinks carefully 
about these "evidences of problem- 
solving," one must conclude that they are 
only written portions of the process, 
having their purpose chiefly in data 
collection and evaluation; that is, they 
are, at best, representative of only parts of 
the process — important parts, no doubt, 
but not the whole. 

I cannot agree that it is unrealistic to 
ask clinicians: "How do you use this 
process when you are confronted with 
situations involving one or more pa- 
tients?" The problem-solving technique 
is a label that could describe the way 
anybody thinks and acts any time he has 
to do a task. This has been of interest to 
the human race for some time, and there 
is no reason why clinicians should be 
immune from curiosity about how and 
why we think and act, or should be 
exempt from the responsibility to know 
themselves. 

Until we hear from clinicians, we shall 
remain at our present level: using a rather 
sterile, artificial language to expound and 
laboriously categorize the components of 
a fundamental process. Language shapes 
experience, as Whorf (Language, 
Thought, and Reality, 1956) has shown 
us. We must care that the language we 
choose is not one that is alien to the 
experience — or else neither language nor 
experience can mature and flourish in 
interaction with each other. Yes, let's 
have research! But let it be on the process 

(Ciinliiiiietl on i>iif;e 6) 
APRIL 1974 




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) Eaton s soon and take a look at our great selection 
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tore. Merchandise available at or through Eaton's 
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EATON'S 



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(Conlinuedfrum page 4) 

in action, in many contexts, and 
"operationalized" in terms of the experi- 
ence of clinicians. — Barbara Geach, 
Assistant Professor, University of Con- 
necticut, Wallingford. 



Nursing journal is now quarterly 

In 1973. Nursing Papers, the publica- 
tion initiated by the School of Nursing, 
McGill University, and supported in 
part by the Canadian Association of 
University Schools of Nursing, celebrat- 
ed its fifth year as a nursing journal in 
Canada. It is devoted to research ap- 
proaches to problems in the practice 
of nursing, in teaching, and in the 
management and provision of services. 
As of this year, the journal will ap- 
pear quarterly. Nursing Papers is 
designed for clinicians and practitioners 
of nursing, for teachers, researchers, 
supervisors, and others. Subscription 
is $4 annually. Further information 
regarding subscriptions, advertising, 
and publication of articles may be 
obtained from me. — Vivian Geeza, 
Managing Editor, School of Nursing, 
McGill Universitv. 3506 University 
Street. Montreal, P.Q. H3A 2A7. 

Reasons for nurse shortage 

These days, when a shortage of nurses is 
clearly evident, the widening division 
between baccalaureate and diploma 
nurses is increasing the shortage by 
driving the well-qualified, experienced 
diploma nurses out of the profession for 
lack of reasonable opportunities for ad- 
vancement. Many positions are adver- 
tised, with the qualification requirement 
being a BN degree or more for anything 
other than patient care. 
So we are left with: 

• The experienced, older woman who 
may have nursed for 15 years or more, 
and now wishes to pass on her experience 
and expertise to younger nurses; as she 
has no degree, she is denied this oppor- 
tunity. 

• The "northern" nurse who, after a 
period of isolation, wishes to return south 
for a time. But after all the responsibility 
in the north, few of these nurses are 
anxious to return to ward work. In the 
north, they functioned at or above the 
nursing action level expected of a bac- 
calaureate nurse. Many of these nurses do 
not have degrees because no such prog- 
ram existed in the country where they 
were trained, although many may have 
spent four or five years training in various 
hospital settings. 

6 THE CANADIAN NURSE 



• A large group of diploma nurses who 
have worked and supported their hus- 
bands while they obtained their degrees. 
These women often ended up studying 
with their husbands so they could help 
them with tests, papers, and so on, 
through the liberal arts part of the course, 
if not the specialty. All this past training 
and self-education, however, count for 
approximately 20 credits, at most, toward 
a university degree. 

Having worked with both excellent and 
poor nurses from both programs, and 
knowing some diploma nurses who far 
outshine the baccalaureate ones, we 
would like to see each person evaluated 
by the universities on her experience, 
training, and savoir-faire. Possibly this 
could be achieved through university 
entrance examinations, which determine 
the number of credits allowed toward a 
degree. 

The nursing hierarchy should wake up 
to the fact that a vast source of needed 
woman- and manpower will be lost 
forever if the university nursing schools 
continue to make it so difficult for a 
diploma nurse to get a degree. — Lynda 
Dean. RN, SRN, BN; Margaret Nixon, RN, 
SRN. PHN; and Alberta Piatt. RN. Win- 
nipeg, Manitoba. 



Comments on gonorrhea 

I read with interest the comments con- 
cerning the international symposium 
on gonorrhea (December 1973. pages 
15-16). Two statements concern me. 
First, the Women's Self-Help Clinic 
does not encourage women to treat 
themselves, but rather educates women 
about their bodies and about health. 
The objective is to provide women with 
knowledge so that they know when to 
seek medical attention and are able 
to participate in the resolution o^ an 
illness stage. In this clinic, women help 
women, and a female physician is 
always present. 

Second. I stressed that the provincial 
VD Clinic in Vancouver is one of the 
few. if not the only, VD clinics run by 
nurses. We rely a lot on public health 
nurses to carry out the VD program for 
the rest of the province. — Trudi Rui- 
tcrnuin. Division of VD Control, De- 
partment of Health Services. Vancou- 
ver, Britisli Columbia. 



Fund will help northern nurses 

In memory of the two northern nurses 
who lost their lives in airplane crashes 
while on mercy flights, nurses in the 
Northwest Territories have established 
The Northern Nurses Memorial Address 
Fund. The two nurses who died were 
Julia May King, in April 1968, and Judith 
Hill, in November 1972. 

This fund will be used to bring a 
keynote speaker to each annual general 



meeting of the Northwest Territories 
Registered Nurses' Association. The ad- 
dress will be videotaped and distributed to 
all nurses in the NWT who are unable to 
attend the session. Thus the fund will 
benefit all the nurses in the north. 

The Northwest Territories Registered 
Nurses' Association, at present a fledg- 
ling association, is planning to hold its 
first annual general meeting in the spring 
of 1974. It is attempting to improve 
communications and to give good rep- 
resentation to nurses working across this 
vast land, from Fort Smith in the south to 
Grise Fiord, the northernmost nursing 
station, and from Frobisher Bay in the 
east to Inuvik in the West. 

Anyone wishing to assist the nurses in 
the NWT with this memorial address may 
send contributions to: The Northern 
Nurses Memorial Fund, c/o The Imperial 
Bank of Commerce, Yellowknife, nwt. 
Every donation will be appreciated. — 
Lois Torrance, President, Yellowknife 
Nurses' Association. 



Plans for native women 

Having spent most of my nursing career 
working with Indian people, and having 
since taken on different types of work in 
government, I am concerned about health 
services in general for the native popula- 
tion in Canada. 

Because I have the responsibility for 
the development of programs for native 
women under the grants program in the 
native citizen's group of the department 
of the secretary of state, I believe it is 
possible to bring these nurses together to 
develop plans and programs prior to 1975 

— International Year for Women. 

Edith Green, rn (who is currently 
working in the Public Service Commis- 
sion in Ottawa) and I have contacted 
some of our friends; thus far, all of them 
are enthusiastic about the idea of getting 
Canadian Indian nurses together in the 
early spring, perhaps in Ottawa. I know 
there are a number of registered nurses of 
Canadian Indian ancestry who may or 
may not be practicing their profession. It 
would be interesting to know how many 
there are and their geographical location. 

— Jean Goodwill, Coordinator, Native 
Women & Native Youth Programs, Citi- 
zen Branch, Secretary of State Depart- 
ment, Ottawa. v^ 



Registered nurses, 
your community needs 
the benefit of youi 
skills and experience. 
Volunteer now to 
leach Si. John Ambulance home 
nursinp and child care courses. 

Contact your Provincial Headquarters, 
St. John Ambulance. 



APRIL 1974 





DESIGNER'S 
CHOICE 



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When it's time to move fron 
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offer a new line with touchej 
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Two styles in our delightfu 
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polyester blended with nylot 
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Style #42744 

Sizes 5-15 
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About SI 9.98 

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Sizes 8-18 
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About S30.00 



AT BETTER STORES 
ACROSS CANADA 



designer's 
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A 

LIMITED 

EDITION 



New...readytouse... 
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Xylocaine'100 mg 

(lidocaine hydrochloride injection, USP) 

For 'Stat' I.V. treatment of life 
threatening arrhythmias. 



D Functions like a standard syringe. 



® 



n Calibrated and contains 5 ml Xylocaine. 

D Package designed for safe and easy 
storage in critical care area 



\ 
^ 



D The only lidocaine preparation 
with specific labelling 
information concerning its 
use in the treatment of cardiac 
arrhythmias. 



an original from 
8 THE CANADIAN NURSE 




Xylocaine® 100 mg 

{iidocaJne hydrochloride injection USP) 

INDICATIONS-Xylocaine administered intra- 
venously is specifically indicated in the acute 
management oU I) ventricular arrhythmias occur- 
ring during cardiac manipulation, such as cardiac 
surgery; and (2) life-threatening arrhythmias, par- 
ticularly those which are ventricular in origin, such 
as occur during acute myocardial infarction. 

CONTRAINDICATIONS- Xylocaine is contra- 
indicated (I) in patients with a known history of 
hypersensitivity to local anesthetics of the amide 
type: and (2) in patients with Adams-Stokes syn- 
drome or with severe degrees of sinoatrial, atrio- 
ventricular or intraventricular block. 

WARNINGS-Constant monitoring with an elec- 
trocardiograph is essentia! in the proper adminis- 
tration of Xylocaine intravenously. Signs of exces- 
sive depression of cardiac conductivity, such as 
prolongation of PR interval and QRS complex 
and the appearance or aggravationof arrhythmias, 
should be followed by prompt cessation of the 
intravenous infusion of this agent- It is mandatory 
to have emergency resuscitative equipment and 
drugs immediately available to manage possible 
adverse reactions involving the cardiovascular, 
respiratory or central nervous systems. 

Evidence for proper usage in children is limited. 

PRECAUTIONS-Caution should be employed 
in the repeated use of Xylocaine in patients with 
severe liver or renal disease because accumulation 
may occur and may lead to toxic phenomena, since 
Xylocaine is metabolized mainlv in the liver and 
excreted by the kidney. The drug should also be 
used with caution in patients with hypovolemia 
and shock, and all formsof heart block (see CON- 
TRAINDICATIONS AND WARNINGS). 

In patients with sinus bradycardia the adminis- 
tration of Xylocaine intravenously for the elimina- 
tion of ventricular ectopic beats without prior 
acceleration in heart rate (e.g. by isoproterenol 
or by electric pacing) may provoke more frequent 
and serious ventricular arrhythmias. 

ADVERSE REACTIONS-Systemic reactions of 
the following types have been reported. 

(1) Central Nervous System: lightheadedness, 
drowsiness; dizziness; apprehension; euphoria; 
tinnitus; blurred or double vision; vomiting; sen- 
sations of heat, cold or numbness; twitching: 
tremors; convulsions; unconsciousness: and respi- 
ratory depression and arrest, 

(2) Cardiovascular System: hypotension; car- 
diovascular collapse: and bradycardia which may 
lead to cardiac arrest. 

There have been no reports of cross sensitivity 
between Xylocaine and procainamide or between 
Xylocaine and quinidine. 

DOSAGE AND ADMINISTRATION-Singte 
injection: The usual dose is 50 mg to 100 mg 
administered intravenously under ECG monitor- 
ing. This dose may be administered at the rate 
of approximately 25 mg to 50 mg per minute. 
Sufficient time should be allowed to enable a slow 
circulation tt) carrv the drug to the site of action. 
if the initial injection of 50 mg to 100 mg does 
not produce a desired response, a second dose may 
be repealed after 10-20 minutes, 

NO MORE THAN 200 MG TO 300 MG OF 
XYLOCAINE SHOULD BE ADMINISTERED 
DURING A ONE HOUR PERIOD. 

In children experience with the drug is limited. 

Continuous Infusion: Following a single injection 
in those patients in whom the arrhythmia tends 
to recur and who are incapable of receiving oral 
antiarrhythmic therapy, intravenous infusions of 
Xylocaine may be administered at the rate of I 
mg to2 mgper minute (20 to 25 ug/kgper minute 
in the average 70 kg man). Intravenous infusions 
of Xylocaine must be administered under constant 
ECG monitoring to avoid potential overdosage 
and toxicity. Intravenous infusion should be ter- 
minated as soon as the patient's basic rhythm 
appears to be stable or at the earliest signs of 
toxicity. It should rarely be necessary to continue 
intravenous infusions beyond 24 hours. As soon 
as possible, and when indicated, patients should 
be changed to an oral antiarrhythmic agent for 
maintenance therapy. 

Solutions for intravenous infusion should be 
prepared by the addition of one 50 ml single dose 
vial of Xylocaine 2% or one 5 ml Xylocaine One 
Gram Disposable Transfer Syringe to I liter of 
appropriate solution. This will provide a 01% 
solution; that is. each ml will contain 1 mg of 
Xylocaine HCl. Thus I ml to 2 ml per minute 
will provide 1 mg to 2 mg of Xylocaine HCl per 
minute. 



APRIL 1974 



news 



CNA Directors Opt For Balanced Budget In '74 
Decide To Cut CNF Support, Countdown, Services 



Ottawa — Canadian Nurses' Association 
(CNA) directors voted in favor of a 
balanced budget for 1974, during a 
meeting hield on February 6, 7, and 8. 
They decided not to expand services and 
activities to help attain a break-even 
financial statement. Further adjustments 
were left to the discretion of the cna 
executive director, Helen K. Mussallem. 

The directors decided that Count- 
^own would no longer be printed in its 
present form by cna, effective with the 
1974 issue. CNA will continue to compile 
nursmg statistics until another agency 
takes over publication of the data. There 
will be no gap in annual statistics on 
nurses . 

Directors voted to inform the Canadian 
Nurses" Foundation (CNF) that CNA is no 
longer able to provide financial support 
for the foundation. For over 10 years, 
CNA has assisted CNF by providing an 
office, support services, and secretarial 
and professional staff. CNA directors said 
other demands on cna take priority now. 

At the June 1973 meeting of the CNF 
directors, it was decided that the founda- 
tion would pay the major portion of the 
secretary's salary. A CNF committee was 
appointed in October 1973, to study the 



problem of the foundation's finances. 
(News, December 1973, page 8.) 

Proposed cuts in library service to CNA 
members include: fewer special bibliog- 
raphies prepared by library staff, discon- 
tinuing the addendum to the Index of 
Canadian Nursing Studies, and reduction 
in the number of new books added to the 
CNA Library. 

It was also suggested that telephone 
conferences are less expensive than meet- 
ings, in some instances. 

CNA directors considered the 1974 
budget at the October 1973 board meeting 
and postponed decision on it until Feb- 
ruary 1974. In October 1973, CNA staff 
members were asked to prepare a com- 
prehensive document about CNA pro- 
grams, activities, events, and budgetary 
allocations to help the directors make 
their decision. 

The 115-page document, plus appen- 
dixes, represents a 4-month study that 
involved every member of the CNA staff. 
It took over 2,000 hours of staff time to 
prepare. The directors devoted February 6 
to the study and the discussion of the 
document, before deciding on February 7 
to hold the line on activities and services, 
and balance the budget. 



CNA Directors Rename IS Board, 
Set Up CNATS Review Task Force 

Ottawa — Directors of the Canadian 
Nurses' Association changed the name of 
the test service board to testing service 
committee, during the CNA directors' 
meeting on February 7, 1974. Commit- 
tees presently relating to the test service 
board will become subcommittees of the 
testing service committee. 

CNA directors also established an ad 
hoc committee, to be known as a task 
force, to review the initial action taken to 
establish and organize the CNA Testing 
Service (CNATS) . 

CNA directors named to the task force 
are Wendy Gerhard, London. Ont., and 
Geraidine LaPointe, Kamloops, B.C. The 
testing service committee was asked to 
make nominations from which the CNA 
President, Marguerite Schumacher, will 
select two members for the task force. 

APRIL 1974 



The task force will have the assistance of 
a French-speaking adviser. 

The original motion to establish the 
testing service, passed by CNA directors in 
January 1970, specified a review within a 
period of 5 years. 

Early appointment of the review com- 
mittee was one of 13 recommendations 
contained in the report of a 3-member ad 
hoc committee on the testing service. 
This group was created on 13 April 1973 
as a committee of persons not implicated 
in the problems of the testing service 
operation "to study this complex subject 
and to report and bring forth recommen- 
dations in one year." The committee was 
asked to review all decisions made by the 
CNA directors regarding the testing ser- 
vice. The ad hoc committee was chaired 
by Dr. Alice Girard, Montreal; members 
were Alice Baumgart, Vancouver, and 
Kathleen DeMarsh, Winnipeg. 



CNA directors referred several recom- 
mendations of the ad hoc committee to 
the newly established task force. Re- 
commendations referred included: 

• That the assets of the testing service, 
including an inventory of examination 
items, be evaluated and that an inventory 
of its holdings be conducted annually. 

• That steps be taken to establish a central 
financial control mechanism for the CNA 
corporate fund with provision for a 
central payroll, single investment of 
corporate funds, and a quarterly advance 
of operating capital to the testing service. 

• That the CNATS exercise control in 
formulation of policies on content of 
tests, the process of test construction, 
security, delivery, processing, and the 
evaluation of test results. 

• That the CNA board exercise control in 
formulation of policies pertaining to 
development of the testing service, in- 
cluding major changes that may affect the 
extent and nature of the test services 
provided. 

Recommendations of the ad hoc com- 
mittee that were accepted by cna direc- 
tors included maintenance of the present 
practice of having a separate audited 
statement to identify the cash flow of the 
testing service; presenting priorities of the 
testing service committee to CNA directors 
annually before they consider the testing 
service budget: and inviting senior testing 
service staff members to attend CNA board 
meetings as observers. 

Directors also approved a recommen- 
dation reiterating that appointments to the 
testing service committee are made by the 
CNA directors. Jurisdictions (licensing/ 
registering bodies in the provinces) are 
asked to nominate members for appoint- 
ment to the committee. 

Directors rejected three recommenda- 
tions of the ad hoc committee. These 
recommendations were: 

• That provision be made for the College 
of Nurses of Ontario, the major non-CNA 
user of tests, to appoint a representative to 
the CNA board, as an exofficio member 
without voting privileges. 

• That the nature of representation of user 
jurisdictions on the testing service com- 
mittee be changed to provide for one RN 
representative from each provincial 
registering/licensing authoritv , plus a rep- 
resentative from a nursing assistant au- 
thority. 

• That the feasibility of engaging in a 
building program to expand facilities of 

THE CANADIAN NURSE 9 



news 



CNA House be explored, with a view to 
providing space for the testing service. 

At the board meeting, cna directors 
approved a cnats recommendation that 
the fee charged to nursing assistants be 
raised to $10 per paper, beginning in July 
1974. 



Affiliation With CNA Offered 
To National Nursing Groups 

Ottawa — The Canadian Nurses' As- 
sociation will consider offering affiliate 
status to national nursing organizations. 
This recommendation by an ad hoc 
committee- working party on liaison with 
CNA was accepted by CNA directors at 
their meeting on February 6 to 8. There 
are no organizations in affiliation with 
CNA now. 

National nursing groups invited to 
affiliate with cna would not be charged a 
membership fee. Officers of an affiliate 
organization will be eligible to attend 
CNA's annual meeting without vote, and 
may be invited to attend CNA board 
meetings as observers. Affiliate member- 
ship status will provide for mutual sharing 
of information on issues of concern to 
CNA and the affiliate group. 

Members of the ad hoc committee- 
working party were: Margaret Neylan. 
Vancouver, chairman; Doris Gibney, To- 
ronto; and Glenna Rowsell, Fredericton. 

Directors accepted 1 1 out of 15 ad hoc 
committee-working party recommenda- 
tions. They voted to accept the following 
guidelines on liaison: 

• CNA should seek or maintain relation- 
ships with other groups when they assist 
CNA to achieve its objects. 

• These groups should include only the 
federal government and organizations that 
are national in scope, and in which 
residents of all provinces and territories 
are eligible for membership. 

• CNa's external relationships should be 
ordered into six categories of diminishing 
importance: federal government, nurses" 
organizations, organizations of other 
health professions, of health institutions 
and agencies, organizations with a health 
orientation, and unclassified national or- 
ganizations. 

• CNA should have relationships only with 
organizations that have stated objectives; 
have an identified structure; share a 
common concern; are self-supporting; are 
autonomous; and, if an occupational 
group, have members who are or will be 
eligible to be licensed, registered, or 
certified to practice. 

Directors also accepted a recommenda- 
tion that CNA adopt the principle of nurse 

10 THE CANADIAN NURSE 



Resolutions for Consideration 

at the CNA Annual Meeting and Convention 

in June 1974 



Whereas the present system of determining fees paid to the Canadian Nurses' 
Association by provinces is based on the number of nurses who are members of the 
provincial associations and decreased as numbers increase; and 
Whereas this method forces higher dues on the smaller provinces; 
Be it resolved that 

— this method of levying fees on the provincial associations be changed; 

— the fee be made uniform for each nurse and neither increased nor decreased 
according to the number of nurses in a province; 

— the amount of the fee be reviewed periodically and increased or decreased 
according to the cost of living to meet increases in CNA programs as 
determined by the cna board of directors. 

Whereas different curricula now prevail across Canada for the nurse practitioner 

course; and 

Whereas differences in roles and responsibilities exist; and 

Whereas remuneration policies for this category of worker vary within the 

profession; 

Be it resolved that CNA take leadership in establishing standards for preparation, 

practice, responsibilities, roles, and remuneration for the nurse practitioner group. 

Whereas some registered nurses are performing medical functions, particularly in 

physicians" offices, without benefit of the appropriate formal education for safe 

practice and protection of the public; and 

Whereas there is no control regarding entry into the nurse practitioner role; and 

Whereas there is no mechanism to ensure competency of those presently practicing; 

and 

Whereas there is no protection for the nurse practicing in this expanded role; 

Be it resolved that CNA take whatever action it deems necessary to protect the public 

and the nurse and discuss these concerns with other appropriate organizations, such 

as the Canadian Medical Association. 



representation at the federal level of 
government, to monitor and influence 
legislation at the federal level that has 
impact on health care and on the health 
professions . 



Nurses At CNA Convention 
Will Try New Fitness Tests 

Ottawa — Canadian nurses will be 
among the first to have the opportunity of 
testing their fitness rating with a new kit 
developed by Health and Welfare 
Canada. The kits will be available to 
delegates to the 1974 annual meeting and 
convention of cna in Winnipeg, June 16 
to 21. 

The fitness tests are part of a conven- 
tion program focused on the theme of 
"Nursing and Health." The kits offer 
nurses an opportunity to become more 
involved in health education programs in 
the community. The tests included give 
objective measures of physical features, 
such as height, weight, skinfold thickness, 
handgrip strength and flexibility. 

At the CNA convention, a learning-by- 
doing approach will be used to demon- 
strate the way the fitness tests work. 



Groups of about 8 nurses will receive 
instruction in how to complete the tests. 
After taking the tests, which require about 
15 minutes, these nurses will be prepared 
to assist others. Test results will be 
available during the convention. 

In addition to the tests for physical 
fitness, nurses will be given the opportun- 
ity to complete a health hazard appraisal 
questionnaire developed as part of the 
antismoking program of Health and Wel- 
fare Canada. A series of information 
sheets on related subjects, such as nutri- 
tion, will be included in the kits. 



Convention's Social Events 
Say "Welcome To Manitoba" 

Ottawa — From June 16 to 21 the 
Manitoba Association of Registered 
Nurses plays host to delegates of the 
Canadian Nurses" Association, its mem- 
bers, and visitors. The program begins 
Sunday afternoon with an interfaith ser- 
vice, followed by a reception, and food 
(wine and cheese). 

Monday's dinner for participants will 
be a colorful occasion as period costumes 

APRIL 1974 



may be worn. So. get your own costume 
ready, but make sure it's easy to pack. 

Then, Tuesday, we need good weather. 
as a sunset cruise is planned. Three river 
boats are already booked, the chefs are 
preparing the menus for the on-board 
meal, and entertainers are rehearsing their 
roles. 

For the free afternoon, Wednesday, 
June 19, you have the choice of a golf 
game, or a relaxing swim in the Pan- 
American Games pool, or a half-day tour 
of Winnipeg and environs. A Folklorama 
is planned for the evening. This will bring 
together a potpourri of food, dancing, and 
music, representing the cultures of many 
nationalities; among them, Canadian In- 
dians, Germans, Ukranians, Irish, and 
Jamaicans. If you have a national cos- 
tume, this will be an occasion to wear it. 

Thursday's social events include a 
night club tour that will give you a chance 
to paint the town red. 

Friday, June 21, the convention closes 
with the president's reception at the 
Centennial Centre. 

To make sure of your place on Wed- 
nesday's city tours and Thursday's night 
club tour, write at once to the Manitoba 
Association of Registered Nurses, 647 
Broadway Avenue, Winnipeg. Manitoba. 
R3COX2. 

Deadline for reservations is April 30. 



One In Five Canadians Needs 
Medic-Alert Identification 

Toronto, Out. — "If you are among the 
one in five Canadians with a medical 
problem, admit it, learn to live with it, 
and identify with the protection of a 
Medic-Alert bracelet and confidential 
emergency-available medical file. This 
speaks when you are unable to speak for 
yourself," advises the Canadian Medic- 
Alert Foundation. 

The 12-year-old. nonprofit organiza- 



Official Notice 

of 

Annual General Meeting 

of 

Canadian Nurses' Foundation 

The 1974 annual general meeting of 
the Canadian Nurses' Foundation will 
be held on Wednesday, 19 June, 1974, 
commencing at 0900 hours in the 
Concert Hall of the Manitoba Centen- 
nial Centre, Winnipeg, Manitoba. The 
election of the CNF board of directors 
for the 1974-76 term of office will be 
conducted during the meeting. — 
Helen K. M us so Hem, Secretary- 
Treasurer, Canadian Nurses' Founda- 
tion. 



tion has 1 10,000 Canadian members, but 
the foundation estimates that 4,000,000 
Canadians have continuing or potential 
medical problems that should be iden- 
tified in an emergency . 

The 15 most common medical prob- 
lems listed on Medic-Alert bracelets 
include: allergic to tetanus antitoxin, 
tetanus toxoid, penicillin, bee stings, or 
sulpha drugs; diagnoses such as multiple 
sclerosis, myasthenia gravis, diabetes, 
epilepsy, hemophilia, or glaucoma; neck 
breather; contact lenses; scuba diver; and 
deep sea diver. 

Persons with plastic (prosthetic) heart 



valves, kidney transplants, or pacemaker 
implants should be identified with 
Medic- Alert bracelets. The pacemaker 
serial number and manufacturer should be 
registered on the individual's confidential 
medical history, the Foundation says. 

The Foundation files members' medi- 
cal records and makes them available on 
24-hour emergency demand by prepaid 
telephone calls, worldwide, from doctors 
and hospitals. 

For information and application forms, 
write to Canadian Medic-Alert Founda- 
tion at 174 St. George St.. Toronto. Ont., 
M5R2NI. 



in geriatric atonic constipation. . . 

Glysennid* tonight- 
action tomorrow! 



Glysennid ... for predictable action. Taken at bedtime, it 
acts in the morning! Ideal for geriatric atonic constipation. 
Glysennid . . . supplied in easy-to-take tablets. 
Glysennid . . . clinically proven, constant potency. 
Glysennid . . . acts systemically to help re-establish nor- 
mal bowel evacuation patterns . . . ideal for nursing 
homes, institutions. 



Composition: Each tablet contains 1 2 mg sennosides A and B. 
Average dosage: 2 tablets at bedtime until normal routme is estab- 
lished. Then 1 tablet at bedtime. Dosage may be increased to a maximum 
of 5 daily if required. 
Contraindications: Appendicitis, intestinal hemorrhage, ulcerative 

COlitiS- 

Supply: Bottles of 1 00 and 500 tablets 

Full product information available upon request (g 

SANDOZ 

DORVAL. QUEBEC 



%■ 



Sandoz Phatmaceuicais. Division of Sandoz (Canada) Ltd Dorvai Quebec 




APRIL 1974 



THE CANADIAN 

% 



NURSE 11 



news 



Internal, External Groups 
Will Study CNA Journals 

Ottawa — Canadian Nurses' Association 
(CNA) directors asked an internal and an 
external group to study the two CNA jour- 
nals. The Canadian Nurse and L'infinnie- 
re canadienne. The journals were discus- 
sed by CNA directors during consideration 
of the budget on February 6. 

Directors said the journals should pro- 
mote national unity, should be used to 
communicate CNA objectives and biennial 
goal focus, and should ensure that nurses 
get similar messages in the French- and 
English-language magazines. 

The staff of the journals and senior CNA 
administrative staff were asked to under- 
take the internal study of the journals. 
Directors named Alice Baumgart, Van- 
couver and Toronto, Florita Vialle- 
Soubranne, Montreal, and Judith Prowse, 
Edmonton, to study the policies and 
philosophy of the two journals and to 
make recommendations to the directors. 
Ms. Prowse is the only CNA director on 
the external study committee. 



Program In Psychiatric Nursing 
Is Offered Again At Ryerson 

Toronto, Ont. — Beginning in September 
1974, the postdiploma program in 
psychiatric nursing will again be offered 
at Ryerson Polytechnical Institute. For 
the past two years, the Institute has been 
unable to offer this program. 

In addition to the psychiatric program 
for registered nurses, postdiploma pro- 
grams in pediatric nursing and in adult 
intensive care nursing are ottered at 
Ryerson. All three programs began in 
September 1971, when the nursing de- 
partment expanded its postdiploma pro- 
grams for Ontario RNs. 

More information about these programs 
is available from the Chairman, Nursing 
Department, Ryerson Polytechnical Insti- 
tute, 50 Gould Street, Toronto, Ontario 
MSB 1E8. 



Master's Program In Nursing 
Recommended For Atlantic Region 

Fredericton, N.B. — Dalhousie Univer- 
sity in Halifax, Nova Scotia, is the 
location recommended for an English- 
language master's program in nursing for 
the Atlantic region. This is one of seven 
recommendations contained in a study by 
Dorothy Kergin, director of the McMas- 
ter University School of Nursing in 
Hamilton, Ontario. 

According to a news item in the 
February 1974 issue of NBARN News, 

12 THE CANADIAN NURSE 



CNA Statement 

on 

the Nurse-Midwife 

Position 

At present, the provision of health services to Canadian women during the span of 
their reproductive life is fragmented, uncoordinated, and sometimes inadequate. In 
addition, there exists a growing demand for more extensive counseling and 
educational programs in this area. 

CNA recommends recognition of the nurse-midwife as the health professional best 
equipped to meet the growing need for counseling services and for greater 
continuity of care within this area of the health system. 

Function 

The nurse-midwife provides a family-oriented service that offers comprehensive 
care to the mother and child during the entire maternity cycle. 

The nurse- midwife is prepared, through her education and experience, to give the 
supervision, care, and advice that women require during pregnancy, labor, 
delivery, and following birth. 

This care includes: supervision of uncomplicated pregnancies, conduct of normal 
deliveries, institution of preventive measures, detection of abnormal conditions in 
mother and child, procurement of medical assistance when necessary, execution of 
emergency measures in the absence of medical help, and care of the healthy 
newborn. 

The nurse-midwife provides counseling, not only for the individual woman, but 
also for the family and members of the community. This assistance includes advice 
on common gynecological problems, family planning, and child care, as well as 
prenatal education and preparation for parenthood. 

Preparation 

National standards regulating educational programs and practice should be 
developed jointly by nurses, physicians, and nurse-midwives and implemented by 
nursing regulatory bodies. 

Nurse-midwifery programs should be provided in institutions of nursing 
education. These programs should be offered at two levels: postbasic (diploma or 
baccalaureate) and master's degree. 

Qualification 

A nurse-midwife is a person who is eligible for registration as a nurse in a province 
of Canada, has successfully completed a prescribed course of study in 
nurse-midwifery in a recognized educational program, and has acquired the 
requisite qualification to be certified to practice nurse-midwifery. 

Practice and Remuneration 

The nurse-midwife functions as a member of the health care team. The amount of 
physician participation and supervision depends on the degree of deviation of the 
maternity cycle from the normal. The scope of activities and responsibilities varies 
according to the setting. 

Remuneration should be on the basis of a salary that is adequate, competitive, 
and reflects responsibility, experience, educational qualifications, and seniority. 

CNA supports the establishment of a national organization for nurse-midwives and 
agrees with the principle of formal liaison between this organization and CNA. 

(Accepted by the CNA board of directors on February 6-8, 1974) 



this study calls for the proposed program 
to be one to two years long and to 
concentrate on public health or commun- 
ity nursing and medical-surgical nursing. 
Master's preparation for French-language 
nurses in New Brunswick should be 
arranged by that province and the Univer- 
sity of Montreal , the study also says . 

Dr. Kergin's study emphasizes that the 
six university schools of nursing in the 



Atlantic region should collaborate in 
planning the master's program and in 
sharing resources. With such coopera- 
tion, students could study and practice in 
their own provinces during part of the 
program . 

The Association of Atlantic Univer- 
sities sponsored the study at the request of 
the Canadian Conference of University 
Schools of Nursing, Atlantic Region. 

APRIL 1974 



Your patients 
will amaze 
you . . . 




# 



\ 



,^' 



? 



1 



:^»^' 




h\ % 





so will retelast 

Your patients will be back to normal in no 
time and ready to start their activities as if 
nothing happened. 

NOT SURPRISING . . . 

RETELAST is so comfortable and gives 
such fast relief. Moreover, RETELAST 
costs up to 40% less than any other 
dressing or traditional bandage. 




^P» OCTO LABORATORY LTD . 
^^^ Laval. Quebec 

|-|p CANADA PHARMACAL CO LTD. 
^■^ Toronto. Ontario 



APRIL 1974 



DEf^ONSTRATION 
AND FOLDERS 
UPON REQUEST 

THE CANADIAN NURSE 13 



fiLI^-^fsr 



Reeves Name Pins . . . finest 
quality, smartest styling, 
with safety clasps. New 
optional Ouotone finish with 
contrasting satin background 
and polished edges for a 
distinctive flair. 



/warn 7^ 'fc /lct^...^m ^ee4^ 



Mrs. R. F. JOHNSON 

SUPERVISOf? 



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 IVi" t 4" X 1" . 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 Sphyg. . . . 37.95 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 ^ ^— - t ' 

for wiglets, curlers, etc. %y%" dia,, 6" high, ' ' ; 

No. 333 Tote . . 2.65 ea., 6 or more . . 2.35 ea. Ji 

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 eigtit 
3" clips included in plastic snap box. 
No. 529 Clips ... 3 boxes for 2.25, 
6 for 65< ea., 12 for 60« 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 Pair of dainty 
jewelry-quality Tacs with grippers, holds cap 
bands securely. Sculptured metal, gold finish, 
approx. H" wide. Choose RN. LPN, LVN. RN 
Caduceus or Plain Caduceus. Gift boxed. 
^ No. CT-1 (Specify Initials). No. CT-2 (Plain 
- Cad.) or No. CT-3 (RN Cad.) . . . 2.95 pr. 

SEL-FIX CAP BAND aiackveivet 

band material. Self-adhesive, presses on, 
pulls off, no sewing, or pinning. Reusable 
several times. Each band 20" long, pre<ut to 
popular widths: Vi" (12 per plastic box) W 
(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 . . 1.50 ea. 




Use extra sheet for additional items or orders. 
INITIALS as desired: 



TO ORDER NAME PINS, fill out all information in box. top 
right, clip out and attach to this coupon. 



I enclose $_ 



( No COD'S or billing to individuals 
„/ Mass- residents add 3% S. T. 



Billing terms available to institutions only; $1. service cfiarge 
added on all orders billed at $10. or less. 



Street 
City 



.Zip 



IT'S EASY TO ORDER REEVES NAME PINS FOR YOURSELF OR FRIENDS ! 



Choose style you want, shown left. Print name (and 2nd 
line if desiied) on dotted lines below. Check other info in 
boxes on chart, clip this section and attach to coupon 



bottom left, Attach extra sheet for additional pins 
NOTE SAVINGS ON 2 IDENTICAL PINS . . . more convenient, 
spare in case of loss. 



LETTERING: 2nd LINE: 

DESCRIPTIOII 



ISTYU 

HB. 



Plastic I 
Uminate I 169 
No.559 I 



ALL METAL rich, trim and 
tailored Lightweight, smooth 
edges, rounded corners. 



PLASTIC LAMINATE . . slimmer, 

\ broader; engraved thru surface to 
r contrasting core color. Beveled 
' border matches lettering. 



, METAL FRAMED Classic 
^|J|1 design; snow-whiie plastic witi 
smooth, polished beveled frarr 



CROSS PEN ""^ -- - ^' ^o^o/i^'^'ff"^ 

World-famous ballpoint, with 
sculptured caduceus emblem. Full name 
FREE engraved on barrel (include name with coupon) 
Refills avail, everywhere. Lifetime guarantee. 
No. 3502 Cfirome 8.00 ea. No. 6602 12kt. G.F. 11.50 ea. 



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



COLOR SIZE QUANT. PRICE 



^ MOLDED PLASTIC Simple. smart, 

nomical. Will never discolor. 
' Smooth rounded corners and edges. 



WTAL 
COLM 



n Gold 
□ Silver 



D Gold 
Q Silver 



METAL 
FINISH 



Q DuDtone 
□ Polished 
n Satin 



Does 
not 

apply 



Polished 
frame 
only 



BACKGROUND 

COLOR 
{Piacfo) 



apply 



D White 
D Med. Green] 
a Med. Blue 
□ Cocoa 



While 
only 



White 
only 



LETTERING 

COUR 



□ Black 
Q Dk. Blue 
n VVhite 






D Black 
D Dk Blue 
.White 
Letters only 



D Black 
D Dk Blue 



D Black 
DOk Blu 



PHICtS* 
C«tnn4 1 LiM ERffawd 2 Lines 



D 1 Pin 2.25 
□ 2 Pins 3.75 



n 1 Pin .95 
n 2 Pins 1.65 



G 1 Pin 2.25 

D 2 Pins 3.75 

(same namel 



n 1 Pin .95 
n 2 Pins 1.65 



; 1 Pin 3.00 
,2 Pins 4.95 

(iame name) 



C 1 Pin 1.55 
D 2 Pins 2.60 



■G 1 Pin 3.00 
n 2 Pins 4.95 



D 1 Pin 1.55 
n 2 Pins 2.60 



'Please add 25( per order for 3 pins or less. 



' ■ ■ ' ■ 



QUANTITY DISCOUNTS: 10-24 pins, deduct 10%; 
25-99 pins, ]5%i 100 or more pins, 20%. 



MEDI-CARD SET Handiest reference 

ever! 6 smootti plastic cards (3^^" x 51^") cram- rfrr\~T 

med with information, including Equivalencies of ^, "^ 

Apothecary to Metric to Household Meas., Temp, 

°C to °F. Prescrip. Aljbr., Urinalysis, Body Chem., 

Blood Chem.. Liver Tests, Bone Marrow, Disease 

Incub. Periods, Adult Wgts. 

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 handy for 

every nurse! 5V^" 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 engravBd, add 50« per forceps. 




Free Initials and Scope Sack 
with your own 

Littmann Nurmcope! 

Famous Littmann nurses' 
diaphragm stethoscope . . . 
a fine precision instrument, 
with high sensitivity for 
blood pressures, apical pulse 
rate. Only 2 07S., fits in 
pocket, with gray vinyl anti- 
collapse tubing, non-chilling 
epoxy diaphragm. 28" over- 
all. Non-rotating angled ear 
tubes and chest piece beau- 
tifully styled in choice of'5 
jewel-like colors: Goldtone, 
Silvertone, Blue, Green, Pink.* 

FREE INITIALS AND SACK! 

Your initials engraved FREE 
on chest piece; lend indiviii- 
ual distinction and help pre- 
vent loss. Also FREE SCOPE 
SACK included, worth $1. 
{Free sacks not personal- 
ized; add 50(1 if initials de- 
sired.) Note big savings on 
quantity orders. 
No. 216 Nursescope . . . 13.80 ea. ppd. 
6-11. .. 12.80 ea. 12 or more ... 11.80 ea. % 

Group Discounts include free Initials and Sack!,^ 
■IMPORTANT: New "l^cdallion" styling includes tubing in >, 
colors to match metal parts. If desired, add $1. ea. to^ 
prices above; add "M" to Order (No. 216M) on coupon, D 
No. 223 Scope Sack only . . . 1.00 ea. ppd. 
6 or more 75< ea. Gold stamped initials, add 50«: 




1 ■ ■ ■ ■ 1 ■ ■ 1 I 1 1 i i i i 1 r-i-i- 



^n^^lftn Precision-made imported forged steel. 
miOSS^MXm Professional quality. Guaranteed 2 yeai 



years. 
3V2" LISTER MINI-SCISSORS 

tifly. handy. sliD into unitorm pochet Of 
purse Choose jewelers Gold or gleaming 
Chrome plate fmish on coupon 
No. 3S00 Mini-Scissors . . . 2.75 ea. 
4V2" or bVr" LISTER SCISSORS 

As above, but larger for bigger jobs Chrome finish only 
Ho, 4500 (4Vj") or No 5500 (5Vi") Scissors . . . 2.75 

5V2" OPERATING SCISSORS r^pp^^ 

Stainless steel, with sharp/ blunt '•m^^^j^-^-r^^J^J 

points. Beautifully polished finish. ~'- - -^S^^^amS^^ 

00 ea ^^ 




No. 705 OR Scissors . . 2.75 ea. 
All scissors above: 1 doi. or more (any style) . . 2. 
Your initials engraved, add 50c per scissors 



CLAYTON DUAL STETHOSCOPE ligui ,_ . 

weight imported dual scope; highest sensitivity lor apicaL--'^'^ ^--'' 
pulse rate. Chromed head tubes and chest piece with /V^.^" 
IVg" bell and \Vt" diaphragm, grey anti-collapse ^^^^ jSw* 
tubing. 4 oz., 29" long. Extra ear plugs and f (p~r^^<;i 

diaphragm included. Two initials engraved free. I v^iri^ Q^ty I 
No. 413 Dual Steth 17.95 ea. ^^_^^^ee 



UVi^iryj NURSES CHARMS ^ 

Finest sculptured Fisher charms, -^S^ 
Sterling or Goid Fi'ied (specify under COLOR on coupon). % 



^^ 



P 'f 



For bracelet or pendant chain. Add to your collection 
No. 263 Caduceus; No. 164 Cap; No. 68 
Grad. Hat; No. 8. Band. Scissors . . 3.49 ea. 

14K PIERCED EARRINGS 

' Dainty, detailed UK Gold caduceus. for on or off 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 
or LVN No. 3420 Pin Guard .... 2.95 ea. 





ENAMELED PINS Beautifully sculptured status 

insignia, 2-colof ktyed. hard-fired enamel on gold plate. 

Dime-sized, pin-back. Specify RN. LPN, PN, LVN, NA, or 
'IjR% RPh. on coupon. 
kLinf No. 205 Enam. Pin 1.95 ea., 12 or more 1.50 ea. 



POCKET SAVERS 




Endura NURSE'S WATCH nne swissmade 

waterproof timepiece. Raised easyto-read white numerals 
and hands on black dial, luminous markings. Red sweep 
second hand. Chrome finish, stainless back. Includes 
black velvet strap. Gift-boxed, with 1 year guarantee 
Very dependable Includes 3 initials engraved FREE! 

Nurses Watch 19.95 ea. 




Prevent stains and wear! 

Smooth, pliable pure white vinyl. Idea! 
low-cost group gifts or favors. 
No. 210-E (rjglit), two compartments 
with flap, gold stamped caduceus . . . 
6 tor 1.50, 25 or more 20* ea. 

Ho. 791 (left) Deluxe Saver, 3 compt. 
change pocket & key chain . . . 
6 for 2.98, 25 or more 35* «a. 

Nurses' POCKET PAL KIT 

Handiest tor busy nurses. Includes white Deluxe 
Pocket Saver, with 5" Bandage Shear (both shoiwn 
opposite page), Tri-Color ballpoint pen, plus 
handsome little pen light ... all silver finished. 

Change compartment, key chain. 

No. 291 Pal Kit 4.95 ea. 

3 Initials engraved on shears, add 50* per hit. 



BZZZ MEMO-TIMER lime hot packs, heat ^.,, 
lamps, park meters. Remember to check vital si^ns. ^.- 
give medication, etc. Lightweight, compact d^" dia.), 
sets to buzz 5 to 50 min. Key /ing. Swiss made. 

No. M-22 Timer 4.95 ea. 

3 or more 3.95 ea.; 6 or more 3.50 ea. 





'■DW ^.-^ EXAMINING PENLI6HT 

White barrel with caduceus imprint, aluminum 
band and clip 5" long, US. made, batteries included (re- 
placement batteries available any store). Your own light, gift boxed 
No. 007 Penlrglit . . . 3.98 ea. Your Injttafs engraved, add S0< per light. 



Whittenton 



UniiprmFoAfft 



/mm 



J 



V 



|REEVA 

Young fresh multi-tuck bib. 2- 
buttot! cutt Gusset 3/j sleeves 
100% Dacron Double-Knit 
STYLE No. 4697 
6-20. 4-16 Petite. .22.95 
14V,.26'/j . . . 24.95 

75% Dacron/25% Cotton 
STYLE No. 4797 
6-20. 4 16 Petite... 16 95 
14V,-26V;. . . 17.95 



MISS FIVE| 



Unique smock style with a little 
gifi look Generous patch pock 
ets. inner surgical pocket 
Short sleeves, 100% Oacr. • 
Double Knit 
STYLE No. 4632 

3/4-15/16. -.21.95 



4^i 
\ 




J{ 



■ GIBSON GIRL 

Youthful high-rise waist, mini 

soft shirred skirt, pleated 

blouse Inner surgical pocket 

100% Polyester Warp Knit V, 

sleeves, 

STYLE No. 4624 

3;4-15; 16... 18.95 
60% Dacron. 40% Nylon cord 
lersey. short sleeves 
STYLE No. 4824 

3/4-15/ 16... 15.95 




#f 



Famous 

NXJFISE 

IVIATES' 

New "Saucy" Bump Toe Moc 

Little fashion notches run around sole and 

heel; latest bumper-toe look with 

big bold eyelets: sturdy extra-ligt>t 

cushion crepe sole and heel; finest 

long-wearing white glove leather 

. the ideal shoe to feel pretty 

in uniform. Fit guaranteed 

or return (unmarred) 

for size eichange 

No. 854 Saucy Shoe 
. . . 16.95 pr. 

New TCork-T-hes Featherweight Style 

Eitremely lightweight . with the new 
"bottom" look. Smart comfortable lace- 
up tieel oxford Thick Sim cork sole 
with 1 i/g" cork heel (very slip-resistant 
outwears crepe) White washable 
soft glove upper leather, tricot 
lined, arch vents Fit guaran- 
teed or return (unmarred) 
for sue exchange 

No. 638 Kork-Lite Sttoe 
. . 16.95 pr. 

All-Weather NURSES' CAPE 

Stay snug in cool weather, dry m the ram 
Traditional Navy with Bright Red linmg. 
Finest tailoring o) 55% Dacron polyester. 
35% combed cotton Zepel treated 100% 
Nylon Ouralyn lining Snap fasteners, arm | 
openings Matching head scarf. SMALL (up to I 
34 bust), MEDIUM 135-38.) or LARGE (39-42) | 
. , specify size on coupon. 

No. 658 Cape 14.95 ea. 

3 Colli Initials on collar, a dd 1,00 per cape 

— CQa!^ nurses bag a tifelime of service 1 
for visiting nurses! finest black W thick I 
genuine cowhide, beautifully crafted with I 
rugged stitched and rivet construction. I 
Water repellant Roomy interior, with snap- 1 
in washable liner and compartments to I 
organize contents Snap strap holds topi 
open during use Name card holder on end. \ 
Two rugged carrying straps 6" x 8" x 12". I 
Vour initials gold embossed FREE on top. An I 
outstanding value of superb quality. 

No. 1544-1 Bag (with liner). . 37.95 ea. 

Extra liner No. 4415 6.95 ea. 






irp« 



tContinued from pa^e 12 1 

Govt., Profession Urge MDs 
To Provide Better VD Care 

Oiiana — The Department cit' National 
Health and VVeltare, the Canadian 
Medical Association (CMA), and the 
Canadian association of French-hm- 
giiage physicians have sent a Joint letter 
to all doctors in Canada, urging each 
to "review your participation and your 
performance as a physician in the con- 
trol of venereal disease." 

The letter, which is termed "unpre- 
cedented" by the CMA, asks doctors to 
consult their peers in VD practice and 
also recent issues of The Canadian 
Medical Association Journal (CMAJ) 
or other publications. 

Enclosed in the letter to the doctors 
is a recommended guide to the treat- 
ment of venereal disease. The letter 
says that, if an alternative to the sug- 
gested treatment guide is used, the 
doctor has "a professional — a moral 
responsibility to ensure that it is as 
effective, or an improvement on, that 
recommended" by his peers. 



A recent survey of venereal disease 
treated by Manitoba physicians in 
1972, published in the January 19, 
1974 issue of CM.^J states. "Notifica- 
tion of disease to the public health 
authorities is extremely limited and 
therefore epidemiological measures 
necessary for proper control are rarely 
activated." This report also says that, 
although a recommended and frequent- 
ly re\ ised schedule of treatment is mail- 
ed to all dcKtc^rs. "noncompliance with 
the schedule is the rule rather than the 
exception." 

At the 1972 meeting of the general 
council of the Canadian Medical Asso- 
ciation, a resolution was passed call- 
ing for a review of VD therapy and 
control programs, more effective pro- 
fessional education, and the report- 
ing of all cases. 



Sask. Labor Relations Board 
Hears From Many Nurses' Groups 

Rei^ina, Sask. — Last No\ ember, the 
Saskatchewan Registered Nurses' 
Association wrote a letter to the Sas- 
katchewan labor Relations Board, 
pointing out that because nurses do not 
share the same interest with other 
groups of employees in health care 
agencies, they constitute an appropriate 



CNA directors at work . . . 



Some issues discussed by the CNA board of directors during their meeting on 6-8 
February, 1974, were: 

• Accreditation of nursing education programs: Directors accepted a resolution that 
CNA develop optimum standards for nursing education programs. The executive 
committee will appoint an expert committee of not more than five persons to monitor 
staff activities in the development of these optimum standards. 

• Hospital accreditation surveyors' pay: On learning that a nurse surveyor of the 
Canadian Council on Hospital Accreditation does not receive pay equal to that of a 
medical practitioner who performs similar surveying duties, the directors of CNA 
passed a motion to convey to CCHA a belief in the principle that all members of a 
surveyor team be given equal pay. 

• Evaluation of nursing practice: The CNA special committee on nursing research 
offered to identify the means through which a position paper on the what, why, and 
how of the evaluation of nursing practice may be developed, and to nmnitor the 
process. Directors accepted the offer. 

• Three nurses to he honored: Three nurses will be honored at the CNA convention and 
annual meeting to be held in Winnipeg in June. They will be presented with a gold pin 
depicting the leaf and the lamp, with a mby as the flame. 

• Unemployment insurance: A study of the Unemployment Insurance Act (1971 ) as it 
affects nurses was made in response to concerns expressed by provincial nurses' 
associations. CNA directors will submit a brief to the Minister of Manpower and 
Immigration to inform him of the difficulties encountered by nurses and to recommend 
pertinent changes in Sections 25 and 40 of the Act. 

THE CANADIAN NURSE 15 



Next Month 
in 



The 

Canadian 
Nurse 



• Self-Help Clinic 
for Women 



• Wanted: A Definition 
of Nursing 



1 Basic Physical Assessment 



& 

^^P 



Photo Credits 
for April 1974 



Information Directorate. Health and 
Welfare Canada, Ottawa, 
pp. 38-41 

St. Paul's Hospital, Vancouver, 
B.C., pp. 42-44 

Telephone Pioneers of America, 
Manitoba Chapter No. 50, 
Winnipeg, p. 46 



news 



bargaining unit; and that past practice 
in Saskatchewan and other provinces 
has been for nurses to negotiate on their 
own behalf through a separate bargain- 
ing unit. 

SKNA's letter also noted that too 
many units in an agency could weaken 
the bargaining power of the various 
groups of employees, and that employ- 
ers cannot be expected to negotiate with 
a large number of bargaining units. It 
added that its main concern was to 
ensure employees" rights, as guaranteed 
by the Saskatchewan Trade Union Act. 

Another brief to the board was 



presented by registered and graduate 
nurses representing 41 staff nurses' 
associations and nurse groups employ- 
ed at .^7 hospitals and four nursing 
homes. This brief supported the prin- 
ciple of minimizing the number of 
bargaining units in hospitals, nursing 
homes, and health care institutions to 
a manageable level and preserving the 
right of employees to bargain collec- 
tively through a trade union of their 
own choosing. 

Briefs were also sent to the board by 
the Biggar Staff Nurses' Association, the 
Swift Current Chapter of SRNA, a 
committee of the Lloydminster Hos- 
pital Staff Nurses' Association, Indian 
Head Staff Nurses' Association, Mel- 
fort Union Hospital Staff Nurses' As- 
sociation, the nursing staff at Preece- 
ville Union Hospital, and the Battleford 
chapter of SRNA. 



Is there a subject you would like explored in The Canadian 
Nurse? We are counting on you to provide Canadian nurses 
with original material. 

Let your article be considered for publication. Think about it 
. . . write it . . . and send it to the Editor, The Canadian Nurse , 
50 The Driveway, Ottawa, Ont., K2P 1E2, 

Why not share your experience and thoughts with nurses 
across the country? ■^ 




16 THE CANADIAN NURSE 



APRIL 1974 





■ where 
ore you 

orow' 



,»^-*;^-^v% 







A New Book! 

CHILD HEALTH MAINTENANCE: 
Concepts in Family Centered Care 



Chinn 



r 



Unique in approach, this new text focuses on normal growth \j 
and development, both biological and behavioral, from 
conception through adolescence. Special attention is 
afforded environmental and familial aspects of child health 
maintenance as well as developmental physiology. Dr.Chinn 
sets forth the conceptual framework and tools for applied 
nursing assessment, nursing diagnosis, nursing management 
and much more! 

By PEGGY L. CHINN, R.N., Ph.D. March. 1974. Approx. 608 pages. 
8" X 10", 214 illustrations. About S14. IS. 



A New Book! Chinn-Leitch 

CHILD HEALTH MAINTENANCE: 
A Guide to Clinical Assessment 

This outstanding new guide provides basic information on 
developmental differences observed throughout childhood, 
indicates deviations that may occur and explains their 
implications for health care. Many clinical resources 
needed in actually implementing the health assessment, 
such as growth graphs, nutritional data, etc., are included — 
all in easy-to-use table form. 

By PEGGY L. CHINN, R.N., Ph.D.: and CYNTHIA JO LEITCH, 
R.N., Ph.D. March, 1974. Approx. 148 pages, 8" x 10", 20 
illustrations. About $5.20. 




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APRIL 1974 



MOSBV 

TIMES fVIIRROn 

THE C. V. MOSBY COMPANY. LTD. • 86 NORTHLINE ROAD. TORONTO, ONTARIO M4B 3E5 

THE CANADIAN NURSE 17 



New 7th Edition! PRINCIPLES OF 
MICROBIOLOGY. Praised for its 
excellent organization, illustrations, and 
readability, this revised and updated edition 
concentrates on the events that take place 
when microbes and their products contact 
living human cells. After presenting basic 
microbiologic principles, it identifies 
harmful microorganisms, explains how 
they cause disease, and emphasizes 
restraints. The text includes: new chapters 
on immunologic reactions and metazoa; 
expanded material on nosocomial 
infections, venereal disease, viral oncogenesis, 
viral teratogenesis; and more. By ALICE 
LORRAINE SMITH, A.B., M.D., F.C.A.P., 
F.A.C.P. June, 1973. 681 pages plus FM 
l-X, 7" X 10", 305 illustrations. Price, 
$12.35. 

New 3rd Edition! MICROBIOLOGY 
LABORATORY MANUAL AND 
WORKBOOK. This workbook is the ideal 
companion to the new 7th edition of 
Principles of Microbiology — yet is readily 
adaptable for use with any current text on 
the subject. It effectively relates classroom 
theory to practical laboratory applications. 
Carefully revised and updated, this new 
edition spotlights the fine points of 
bacteriologic technic with new illustrations 
and clearly demonstrates the care and use of 
compound and phase microscopes. By 
ALICE LORRAINE SMITH, A.B., M.D., 
F.C.A.P., F.A.C.P. June, 1973. 172 pages 
plus FM /- VIII, 7% " X 10%". Price, $5.55. 

A New Book! PHARMACODYNAMICS 
AND PATIENT CARE. This meaningful new 
approach views medications in relation to 
the biochemical or physiologic effects they 
produce to control patient problems. It 
demonstrates nursing actions that contribute 
to the effectiveness of drug therapy and 
provides guidelines to use in overall plans for 
health maintenance. Students can analyze 
and compare the effects of drugs used to 
control hemodynamics; activity and pain; 
anabolic-catabolic balance; reproduction and 
fertility; and more. By MARJORIE P. 
JOHNS, R.N., B.S., M.S. January, 1974. 337 
pages plus FM I -XI I, 7" x 10", 62 illustrations. 
Price, $8.95. 




New 3rd Edition! THE ARITHMETIC OF 
DOSAGES AND SOLUTIONS: A 
Programmed Presentation. Totally reworked 
and reworded for greater clarity and 
accuracy, this concise, programmed approach 
actively involves students in the learning 
process. Information is arranged in logical 
order; each step builds on the one before; 
answers to each problem appear at the end of 
the exercise. A refresher on fractions, 
decimals, percentages and ratios is included 
as well as information on pediatric dosages, 
abbreviations used in medication orders, and 
an expanded discussion of insulin and IV 
fluid flow. By LAURA K. HART, R.N.. 
B.S.N. , M.Ed., M.A., Ph.D. 1973, 76 pages 
plus FM I- VIII, 7" X 10". Price, $4. 15. 

New 3rd Edition! WORKBOOK AND 
STUDY GUIDE FOR MEDICAL- 
SURGICAL NURSING, A Patient-Centered 
Approach. This patient-centered workbook 
encourages the use of problem-solving 
techniques. Students are given opportunities 
to apply basic science principles to patient 
care, to make nursing diagnoses and plans 
for immediate and long-term care. By ALMA 
JOEL LABUNSKI, R.N., B.S.N.; MARJORIE 
BEYERS, R.N., B.S, M.S.; LOIS S. 
CARTER, R.N., B.SN.; BARBARA PURAS 
STELMAN, R.N., B.S.N.; MARY ANN 
PUGH RANDOLPH, R.N., B. S.N. : and 
DOROTHY SA VICH, R.N., B.S. October, 

1973. 331 pages plus FM I -VIII, 7%" x 
10V/'. Price, $6.25. 

A New Book! REALITY SHOCK: Why 
Nurses Leave Nursing. This new book, 
written by a leading researcher in nursing, 
comes to grips with the problems of the 
nurse's role on the health care team, and the 
disparities between nurses' "ideal" views of 
their field and the "realities" often 
encountered. It offers a blueprint for 
reconciling these differences and influencing 
changes in the nursing picture. By 
MARLENE KRAMER, R.N., Ph.D. May, 

1974. Approx. 288 pages, 7" x 10", 47 
illustrations. About $7.85. 




18 THE CANADIAN NURSE 



APRIL 1974 



New 8th Edition! ORTHOPEDIC 
NURSING. This new edition has been 
completely revised to include current 
information on body mechanics, 
behavioral aspects of rehabilitation, 
metabolic disorders of bone, and lOtal 
hip and knee joint replacement. Other 
areas discussed include: care of patients 
in casts, traction, and braces; surgical 
patients; congenital deformities; legal 
liability; and more. By CARROLL B. 
LARSON, M.D., F.A.C.S.; and 
IVIARJORIE GOULD, R.N., B.S., M.S. 
April, 1974. Approx. 576 pages, 7" x 
10", 572 illustrations. About $12. 10. 
New 6th Edition! NEUROLOGICAL 
AND NEUROSURGICAL NURSING. 
Highlighted by extensive revisions, 
this new edition is the most 
comprehensive neurological and 
neurosurgical nursing text available. 
Students will find a new section on 
acupuncture; a totally revised section 
on multiple sclerosis; an 
all-encompassing presentation of drugs; 
and in-depth treatment of broad topics 
in the field. By ESTA CAR IN I, R.N., 
Ph.D.; and GUY OWENS, M.D. April, 
1974. Approx. 424 pages, 7" x 10", 
155 illustrations, 2 in color. About 
$1 1.80. 

New 3rd Edition! NURSING CARE IN 
EYE, EAR, NOSE, AND THROAT 
DISORDERS. This revision emphasizes 
the nurse's expanding role on the 
health care team. It aids the nurse in 
assessment, and in developing a care 
plan based upon better understanding 
of the pathophysiology, treatment 
and related problems of the patient. 
By WILLIAM H. HA VENER, B.A., 
M.S.fOphth.), M.D.; WILLIAM H. 
SAUNDERS, B.A., M.D.; CAROL 
FAIR KEITH, R.N., B.S.N. . M.S.; and 
ARDRA W. PRESCOTT, R.N. 
February, 1974. 460 pages plus 
FM l-VI 11,6%" x9y2", 357 
illustrations. Price, $12.35. 



Because professional growth and development is such 
an Integral part of your life, we'd like to offer you an 
opportunity to win a terrarium kit. Just fill out the 
coupon below and return it to Terrarium Contest in 
care of our address. At the CNA Convention in June, 
we'll have a drawing . . . with one winner selected 
from each province. 




A New Book! CARE OF THE OSTOMY PATIENT. 

This new book provides guidelines for understanding 

the specific needs of ostomy patients and the 

behavioral and physical problems encountered in their 

return to a productive life. Beginning with the normal 

digestive tract, it shows progressively how the body 

develops problems leading to ostomy surgery. 

Diagnosis, tests and surgeries are discussed as well as 

diet, medications, appliances, and counseling and 

care of the dying patient. By VIRGINIA C. 

VUKOVICH, RNET;and REBA D. GRUBB, Medical 

Writer. August, 1973. 138 pages plus FM l-XIV, 6" x 

9", 23 illustrations by TRA VIS L. MA YHALL. 

Price, $5. 55. 

New 6th Edition! PSYCHIATRIC NURSING. 

Emphasizing the development of interpersonal skills, 

this new edition considers all aspects of the nurse's 

role with the psychiatric patient. Up-to-date 

nformation is included on drug addiction, community 

mental health, psychopathology, chemotherapy, 

crisis intervention and emotional problems of 

children. New material has been added on the 

evolution of personality, crisis intervention, the 

characteristics of organic behavior disorders, and 

suicide. By RUTH V. MATHENEY, R.N., Ed.D.; 

and MARY TOP A L IS, R. N. , Ed. D.; with guest 

contributor, JEANETTE A. WEISS, R.N.,M.A. 

August, 1974. Approx. 400 pages, 7" x 10", 50 

illustrations. About $9.70. 

A New Book! PRIMARY NURSING: A Model for 

Individualized Care. This versatile new text explores 

the potentials of primary nursing. It is directed toward 

organization of nursing care for maximum patient 

benefit and at the same time, maximum utilization 

and development of nurses. Many current topics of 

interest are examined: professional developmental 

stages and nursing care delivery; bureaucracy 

and nursing care delivery; male-dominated society; to 

name a few. Emphasis is placed on "giving" rather 

than delegating care. By GWEN D. MARRAM, R.N., 

Ph.D.; MARGARET W. SCHLEGEL, R.N. ; and 

EM 0. BE VIS, R.N., M.A. May, 1974. Approx. 184 

pages, 6" x 9", 23 illustrations. About $6.25. 



A 



NAME 



ADDRESS 



\ 



MOSBV 

TIIVIES MIRROR 



CITY PROVINCE 

HOSPITAL AFFILIATION 



THE C. V MOSBY COMPANY LTD ■ 86 NORTHLINE ROAD. TORONTO. ONTARIO M4B SES 



I 

I 
I 
I 

I 

I 



CN 4'74 



APRIL 1974 



THE CANADIAN NURSE 



t9 




<^0 
^0 





New Uo/ume /I// CURRENT CONCEPTS IN 
CLINICAL NURSING. This compilation of 
articles deals with the most vital and current 
topics in clinical nursing. Combining the 
expertise of forty-three noted contributors, 
it presents a composite picture of pertinent 
techniques and knowledge in psychiatric, 
pediatric, maternity, and medical-surgical 
nursing. Edited by EDITH H. ANDERSON, 
R.N., Ph.D.: BETTY S. BERGERSEN, R.N., 
Ed.D.; MARGERY DUFFEY, R.N., Ph.D.; 
MARY LOHR, R.N., Ed.D.; and MARION 
H. ROSE, R.N., Ph.D.; with 43 contributors. 
December, 1973. 361 pages plus FM l-XIV, 
7" X 10", 37 illustrations. Price, $16.30. 

New 2nd Edition! WORKBOOK FOR PEDI- 
ATRIC NURSES. This unique workbook 
provides students with an effective study 
guide during their clinical experience in 
pediatric nursing. Through a series of simu- 
lated case studies, students are allowed to 
apply basic principles to care situations and 
are given the opportunity to evaluate their 
personal experience of actual nursing care. 
All discussions are patient-centered, princi- 
ples oriented and stress growth and develop- 
ment — from conception through adoles- 
cence. By NORMA J. ANDERSON, R.N. 
June. 1974. Approx. 172 pages, 7%" x 
lO'A", 21 illustrations. About $6.05. 

A New Book! A REVIEW OF PEDIATRIC 

NURSING. This concise question-and- 
answer review of the entire spectrum of 
pediatric nursing places emphasis on family 
centered care. With content structured 
around the wellness-illness continuum, it 
considers all aspects of a particular situation; 
psychosocial, economic, pathogenic, diag- 
nostic, nursing management, etc. A special 
section on pediatric pharmacology is in- 
cluded. By FLORENCE BRIGHT 
ROBERTS, R.N.. M.N. February. 1974. 178 
pages plus FM l-XIV. 5V2" x 8%". Price. 
$6.55. 

A New Book! REVIEW OF TEAM NURS- 
ING (Mosby's Comprehensive Review 
Series). Help students gain the knowledge 
they need to be nurse leaders with this new 
text. It carefully reviews team nursing and 
nursing's historical background, emphasizing 
the emergence of nurse leaders. Some of the 
current topics considered are: processes in- 
volved in delegation of authority; group 
dynamics and communication; nurse charac- 
teristics; and much more. By LAURA MAE 
DOUGLASS, R.N., B.A., M.S. August, 1973. 
132 pages plus FM l-X, S'A" x SYi". Price, 
$5.20. 



A New Book! COMMUNICATIONS 
AND RELATIONSHIPS IN NURSING. 

This new text studies commonalities of 
human nature relevant to communica- 
tion; proceeds to basic facets of com- 
munication skills; and closes with 
specific communication problem situa- 
tions. Topics include self-awareness, use 
of appropriate language, and reality 
perception. Ten "communications inter- 
actions" demonstrate principles dis- 
cussed. By MAUREEN J. O'BRIEN. 
R.N., M.S May, 1974. Approx. 216 
pages, 5V2" x 8V1", 11 illustrations. 
About $5.25. 

New 2nd Edition! VOCATIONAL AND 
PERSONAL ADJUSTMENTS IN 
PRACTICAL NURSING. This new edi- 
tion prepares students for adjustment to 
professional life. The role of the LPN in 
both hospital and community is de- 
fined, and standards for professional 
conduct are set forth. Legal, religious, 
and racial aspects of practical nursing; 
types of nursing care — these topics and 
many more are treated in depth. By 
BETTY GLORE BECKER, R.N.; and 
SISTER RUTH ANN HASSLER, 
S.S.M., R.N., B.S., M.S. December, 
1973. 177 pages plus FM l-XII, 6" x 9". 
illustrated. Price, $4.50. 

New 3rd Edition! A TEXTBOOK FOR 
NURSING ASSISTANTS. This volume 
focuses on the nursing assistant as a 
team member in the health care delivery 
system, providing practical advice on 
patient needs and how the assistant can 
best meet these needs. Emphasis is 
placed on the use of disposable equip- 
ment, with material on reusable types 
deleted. By GERTRUDE D. 
CHERESCAVICH, R.N., B.S., M.S. 
June, 1973. 442 pages plus FM l-XII, 7" 
X 10", 179 illustrations. Price, $10.00. 



INSTRUCTOR'S NOTE: To receives compli- 
mentary copy for firsthand evaluation, write 
to the Textbook Department mentioning 
your position, course and enrollment. 



THE 



M05BV 

TIMES MIRROR 

C V MOSBY COMPANY. LTD 
86 NORTHLINE ROAD 
TORONTO, ONTARIO 
M4B 3E5 



20 THE CANADIAN NURSE 



APRIL 1974 



Canadian Nurses' Association 

TICKET OF NOMINATIONS 

Biennium 1972-1974 



President-Elect: (1 to be elected) 
Beverly W. Du Gas, Joan M. Gilchrist 

Vice-Presidents: (2 to be elected) 
Margaret D. McLean, Helen D. Taylor 

Member-at-Large, Nursing Administration: (1 to be elected) 

Marguerite Bicknell, Olivette Gareau, 
Fernande P. Harrison, Margaret L. Peart, Marilyn S. Riley 

Member-at-Large, Nursing Education: (1 to be elected) 

Sister Joan Carr, Myrtle E. Crawford, Denise Lalancette, 

Joyce Nevitt, Shirley M. Stinson, Anne D. Thome 

Member-at-Large, Nursing Practice: (1 to be elected) 
Lorine Besel, Roberta Coutts, Doris Hynes 

Member-at-Large, Social and Economic Welfare: (1 to be elected) 
E. Margaret Bentley, Yvonne Chapman, Jean E.C. Lewis, Glenna Rowsell 

(Note: Following the filing of the "Ticket of Nominations, " 
Yvonne Chapman and Roberta Coutts withdrew. ) 



President: Huguette Labelle 




Huguette Labelle. Reg.N., B.Sc.N.Ed.. 
B.Ed., M.Ed., University of Ottawa. 

Present Position: Principal Nursing Of- 
ficer. Health and Welfare Canada. Ot- 
tawa. 

APRIL 1974 



Association Activities: President-elect, 
Canadian Nurses' Association, 1972-74; 
member. Priory Council. Order of St. 
John; member. Advisory Nursing Com- 
mittee. Victorian Order of Nurses for 
Canada; member, Board of Governors. 
Canadian Nurses' Association Testing 
Service; member. ETV Nursing Educa- 
tion Committee, Ontario Educational 
Communications Authority. Ontario; 
member. Board of Governors, United 
Appeal Ottawa-Carleton. 

In recent years, the Canadian Nurses' 
Association has stated its position clearly 
on several health, education, and social 
issues that relate to nursing, to the health 
of the population, and to the organization 
of health care services. I see a strong 
mandate for the next biennium to con- 
tinue this key function of the national 
association, to identify necessary action 
inherent in statements made, and to 
implement such action where appropriate. 
In striving to meet the goals of the 
association. I hope that together we will 
pay special attention to: 
• the development of new mechanisms 
for reaching out to membership. 



• the development of standards of excel- 
lence for nursing practice and nursing 
education. 

• the interpretation of the dynamic state 
of the nurse's role. 

• a review of the existing framework for 
basic and continuing nursing education in 
the light of current developments. 

• the development of additional bridges 
with other groups for cooperative action. 

• the promotion of nursing research; 
thereby assisting nurses to become better 
architects of the essential service that they 
provide and of their own future. 



THE CANADIAN NURSE 21 



CANDIDATES FOR PRESrOENT-ELECT 




Beverly Witter Du Gas. The Vancouver 
General Hospital; B.A., U. of British 
Cohiinhia: M.S.. U. of Washington. 
Seattle: Ecl.D. , U. of British Columbia. 

Present Position: Director. Health Man- 
power Planning Division, Health Man- 
power Directorate, Department of Na- 
tional Health and Welfare, Ottawa. 

Association Activities: 1st vice-president 
CNA, 1972-74 



Probably never before in Canadian nurs- 
ing has there been greater opportunity for 
our national association to play a signif- 
icant role in shaping the future of health 
services in Canada. Often in the past, we, 
as nurses, have felt that others were 
controlling our destiny — that important 
decisions were being made that affected 
nursing, but in which nurses had had little 
say. We seemed to be frequently left in 
the unhappy position of protesting after 
the fact, of trying to alter policy rather 
than helping to shape it. 

This situation is rapidly changing, as 
evidenced by the increased autonomy and 
responsibility being accorded individual 
nurses in clinical practice, by the rapidly 
growing number of nurses in senior 
management positions in our health ser- 
vices, and by the constantly widening 
scope of activities of our provincial and 
national associations. In short, nurses are 
now "where the action is.'" They are 
participating in policy and decision mak- 
ing on major issues in health care, both as 
individuals and as representatives of a 
major health discipline. 

The Canadian Nurses' Association 
must be prepared to play its part as an 
equal member of the health team. We 



must be alert to what is happening in the 
country and be able to identify trends and 
issues before they assume crisis propor- 
tions. We must also be willing, and able, 
to take a stand on the important issues of 
the day. We now have the opportunity — 
let us use it! 

These are exciting times for the nursing 
profession in Canada. If the members of 
the association decide they would like me 
to represent them as president-elect of the 
Canadian Nurses' Association, I would 
commit myself wholeheartedly to carry- 
ing out the responsibilities of the position 
to the best of my ability. 



I 




Joan M. Gilchrist. The Wellesley Hospital, 
Toronto: B.N.. M. Sc. (AppUed). McGill 
University, Montreal: completing Ph. D.. 
McGill University. 

Present Position: Director, School of 
Nursing, McGill University. Montreal. 

.Association Activities: member, special 
committee on research, Canadian 
Nurses' As.sociation: chairman, commit- 
tee on research and development. Order 
of Nurses of Quebec : member (represent- 

22 THE CANADIAN NURSE 



ing Quebec Region), committee on 
studies, Canadian Association of Univer- 
sity Schools of Nursing. 

The role of an organized profession in 
health care today is multifaceted. It 
makes decisions and takes action relevant 
to many spheres of responsibility. In 
general, however, its concern is to pro- 
vide the framework within which desira- 
ble changes are identified, innovative 
structures for their attainment are 
evolved, and individuals are prepared and 
motivated to carry out responsive and 
goal-orienled actions. 

Crucial in shaping this role in nursing 
as a collectivity is the articulation of one 
central principle upon which national 
policies are predicated. This principle is 
simply that nursing is accountable to the 
people of Canada and is. therefore, 
responsive to the human need of all 
Canadians for health care. 

To achieve health services that are 
comprehensive in nature and universal in 
reach, and to exploit educational struc- 
tures for the preparation of new members, 
an ability and a willingness are needed on 
the part of nursing leaders to acquire 
visit)n and accept risk. 

In accepting the nomination for elec- 
tion to the office of president-elect of the 
Canadian Nurses' Association, 1 am 



prepared to make a personal and profe,s- 
sional commitment to work with my 
colleagues and others in moving toward 
these goals. 



APRIL 1974 



CANdfOAtES FOR VICE- PRtSfDENT 




Margaret D. McLean. Royal Victoria Hos- 
pital. Montreal: B.Sc.N.. U. of Western 
Ontario. London: M.A.. Columbia U.. 
N.Y.: post-masters study in administra- 
tion of schools of nursing and of nursing 
service. 

Present Position: Director and Professor. 
Memorial University of Newfoundland 
School of Nursing. St. John's. 



Association Activities: formerly on e.xecu- 
tive of .AARN; Board of E.xaminers, AARS: 
chairman. C.\A nursing service committee 
1966-68. and 1968-70: 2nd vice- 
president CNA. 1968-70: has served on 
many other c.\'A ad hoc and special 
committees: member, joint advisory 
council. Nursing Unit Administration Ex- 
tension Course: member, planning com- 
mittee for first conference on hospital- 
medical stuff relationships . 

After much thought 1 have accepted 
nominatii)n for vice-president of the 
Canadian Nurses" Association. 

I believe the profession of nursing has a 
great opponunity to make its optimum 
contribution to the well-being of indi- 
viduals, families, and communities. 
Nurses have said they are responsive to 
the health needs of people. We must 
really be so now if nursing is to achieve 
its potential in the health care system. 
This will necessitate great changes, but 
the time is ripe for the organized profes- 
sion to respond to the health needs of the 
people in helpful ways, to demonstrate 
what excellence in expanded nursing 
practice can do. and to work in cof- 
league.ship with t)ther health professionals 



and consumers in the promotion, reten- 
tion, attainment, and restoration of health 
and well-being. 

I am trying to give leadership in this in 
a university school of nursing by working 
with community nursing agencies and by 
planning a continuing education program 
for nurses in a province, with the provin- 
cial association. 

I would be happy to be part of the 
leadership team at the CNA. 




Helen D. Taylor. The Montreal General 
Hospital: B.N.. McGill U. Studying for 
M.Sc. IApp.).McGill. 

Present Position: Director of Nursing. 
Jewish General Hospital, Montreal. 

Association Activities: 1st vice-president 
ANPQ. 1967-69: president anpq. 
1969-71 :CNA hoard of directors 1967-71: 
2nd vice-president ASPQ. 1971-72: presi- 
dent, district 11. English chapter, anpq. 

APRIL 1974 



1971-72: vice-president CNF. 1971- 
73: ANPQ hoard of advisers, council 
on discipline, legislation committee: 
board of directors. Association of Hospi- 
tal Administrators. Province of Quebec: 
surveyor. Canadian Council on Hospital 
Accreditation. 

The important changes that are taking 
place in the distribution of health services 
in Canada offer nurses an unparalleled 
opportunity to pailicipate at all levels in 
the health care system. Many exciting 
challenges are before us as a group. 

As individuals, we each adopt our own 
commitment, but also learn to realize we 
need each other to test and share certain 
ideas. The immediate future will demand 
that we resolve long-standing problems 
within our own profession; at the same 
time we must press toward new avenues 
of development. Critical areas must con- 
stantly be identified and researched. Each 
nurse has a professional respi)nsibility. 
and one nurse's responsibilit\ is not more 
or less important than the other's — it is 
just different. 

We have recognized that our ap- 
proaches must continually be adapted to 
societal needs and that we must share 
with other professionals, with a host of 
agencies, with government, and with one 
another if we believe we can determine 



and live up to our own professional roles. 
I believe, very simply, that all this can 
better be achieved by working together 
through the Canadian Nurses' Associa- 
tion. 



THE CANADIAN NURSE 23 



CANDIDATES FOR MEMBER-AT-LARGE, NURSING ADMINISTRATION ^ 




Marguerite M. Bicknell. Misericordia 
Hospital Winnipeg; B.N.. McGill; 
M.H.S.A.. U. of Alberta. 

Present Position: Assistant Executive Di- 
rector — Nursing, Brandon General 
Hospital, Brandon. Manitoba. 



Association Activities: member of district 
and provincial committees. MARN: presi- 
dent, district 2. MARS; member of board 
of directors, MARN. 

The emerging, comprehensive health- 
care systems are producing a spiraiing 
demand for more and more complex 
nursing services in a wide variety of 
service modalities. In response to this 
demand, present and future roles for 
nurses and nursing practice are being 
defined within the broad context of the 
envisaged systems and educational prep- 
arations outlined referrent to the per- 
ceived roles and practices. I believe it is 
equally essential that attention be directed 
toward the development of organizational 
frameworks wherein the nurses of today 
and tomorrow can function effectively. 
Organized nursing services, in all practice 
settings, must provide an administrative 
structure whereby the distinctive con- 
tributions, because of level of preparation 
and competence, are readily identifiable 
and acknowledged in pracitioners of 
nursing. 



I also believe in and support the 
visionary prediction that the nurse of the 
future will be self-directed, able to make 
autonomous decisions, and be accounta- 
ble for his or her actions. To this end, 
curriculum and nursing service organiza- 
tional structures must be diligently di- 
rected . 

Finally, I believe that a strong and 
viable professional association is abso- 
lutely essential to guide the course of 
nursing toward these ultimate goals. Only 
through unified action within our national 
professional body can we translate 
today's opportunities into tomorrow's 
realities. 

It is for these reasons that I am pleased 
to accept the nomination. 




Olivette Careau. Ste-Justine Hospital, 
Montreal, BN, M.Sc.A., McGill U. 

Present Position: Nursing Consultant, 
Community Health Directorate, National 
Health and Welfare. Ottawa. 

Association Activities: member of board 
of administration, anpq. 1962-70; 
chairman of district XI, ANPQ, 
1966-67; member of executive council, 
Canadian Public Health Association, 
1967-72; metnber of editorial board, 
CPHA. 1968-71; chairman of public health 
nursing section, CPHA. 1964-65; vice- 
president of American Public Health 
Association (for Canada). 

24 THE CANADIAN NURSE 



I believe the Canadian Nurses" Associa- 
tion has a responsibility to promote the 
development of the qualifications of its 
members in meeting the health-care needs 
of the population. During the past few 
years, cna has increased its efforts in 
nursing education, perhaps at the expense 
of the administration of nursing services 
and nursing care. Now we are witnessing 
the divorce of two partners essential to the 
survival of the profession, and it is up to 
CNA to reunite them. Of what use are 
highly qualified nurses if they do not have 
an opportunity to use their knowledge 
because the administrative staff feel 
threatened by new ideas or projects? 

I believe cna is aware of this problem 
and is developing a means to face this 
situation at the administrative level of 
nursing care and at the intermediate level 
where conflicts seem more prevalent. 

I further believe cna is a powerful 
political force that must be put to the 
fullest use. It must attempt to influence 
decision making at government level, 
whether obtaining grants for members or 
defining policies on health services. 

I am also convinced that nurses should 
participate in planning and coordinating 
health services at community, provincial, 
and national levels. However, the increas- 
ing complexity of modern living seems to 
have decreased the power and influence 
of the individual to a point where the 
director of nursing must depend on other 
individuals or groups to be able to play 
her role as she sees it. I envisage an 



important role that the CNA will have to 
develop to promote use of skills in 
administration of nursing care beyond the 
limits of the profession, that is, at the 
upper levels of decision making. 

I believe that by resorting to carefully 
planned and organized political pressure 
at every level of government, the CNA 
will become a vital force in decision 
making. 

Such political action is essential if we 
want to secure for nurses in the area of 
administration a voice in the development 
of future national policies on health 
matters. 

I believe that my experience in Quebec 
and currently at the national level allows 
me to make a contribution lo the work 
CNA must assume in the field of nursing 
care administration. 



APRIL 1974 




Fernande P. Harrison. Misericordia Hos- 
pital Montreal, Quebec: B.Sc.N., 
M.H.S.A.. U. of Alberta. 



Present Position: Health Services Ad- 
ministrator — Nursing. Alberta Hospital 
Services Commission, Edmonton, Al- 
berta. 

Association Activities: member of 1969 
A.ARN planning convention committee; 
member of registration committee 
1969-70: member of aarn nursing re- 
search committee 1971-72 

The provision of health services in 
Canada is undergoing rapid change. Nurs- 
ing, as one of the health professional 
groups, has a critical role to play in the 
planning, evaluation, and provision of 
health services. 

Stemming from my belief that nurses 
must be involved at all decision-making 
levels in matters relating to health ser- 
vices. I would consider it a privilege to be 



associated with the Canadian Nurses' 
.Association when the future of nursing in 
particular, and health care system in 
general, has reached this crucial point. 




Margaret L. Peart. 5/. Joseph' s Hospital. 
Hamilton: cert, in nursing education, 
U. of Toronto; cert., hospital organiza- 
tion and management. Canadian Hospital 

Association. 

Present Position: Director of Nursing. St. 
Joseph's Hospital. Hamilton, Ontario. 

Association Activities: RNAO board of 
directors: standing committees at provin- 
cial and national levels: chairman, ad- 
ministrator committee, RNAO; e.xecutive 
committee, rnao; member ofRN.AO advis- 
ory on finance committee: member, board 
of directors. VON. Hamilton; nursing 
advisory sub-committee, health science 
division, Humber College; member of 
council. College of Nurses of Ontario: 
member of nursing committee, Catholic 
Hospital Conference. 

APRIL 1974 



My acceptance of the nomination as a 
member-at-large representing nursing 
administration is based upon my sincere 
interest and activity in the affairs of 
nursing. 

As the major part of my nursing career 
has been in nursing administration, 
change has been a key word, and I well 
recognize that the profession has yet 
many changes ahead to meet with experi- 
ence and wise decisions. It would be a 
challenge to participate. 

The influence of nursing administration 
can give great strength to the continued 
progress of nursing in our society. I 
believe this can only be done positively 
by tho.se willing to develop and imple- 
ment change. 

I believe in the health team approach to 
patient care which, in my opinion, is only 
in the early stages of really being experi- 
enced. This identifies the present and 
future need to participate actively with the 
other health disciplines in providing the 
best possible care for our patients and 
community. Today, no group can work in 
isolation. 

I believe that this is a critical time 
for nurses. It is vital that the voice and 
identity of nursing be recognized in the 
design for the provision of health care. 
With the introduction of technology and 
neu health workers, the effect upon 
nursing is already being felt. It is impor- 
tant that the profession continue to have 
dialogue with the appropriate groups. 

My present position, as the director of 
a department of nursing, includes such 
activities as the development of staff 
education programs; planning for team 
nursing; all aspects of budgeting; the 



fostering of the health team approach to 
patient care; the introduction of the 
nursing audit; and enjoying a healthy 
relationship with our nurses" association. 
These have influenced my reason for 
accepting this nomination. 

It is a privilege to tell of some of my 
beliefs and activities. Your support is 
sought. 



THE CANADIAN NURSE 



25 




Marilyn Smith Riley. Paxzant Memorial 
Hospital. Windsor, ' N.S.: B.N.. 
Dalhousie U.. Halifax. N.S.; M.Sc.N.. 
U. of Western Ontario. London. 



Present Position: Academic Coordinator, 
basic decree program, Dalhousie Uni- 
versity school of nursing: 
Supervisor, medical unit. Victoria Gen- 
eral Hospital, Halijdx, N.S.: and Consul- 
tant, Nursing, Nova Scotia Health Ser- 
vices and Insurance Commission. 

Association Activities: recording secret- 
ary, e.xecutive, R\'.4.\'S 1966-68; member, 
.special cotnmittee on nursing research, 
RSASS: chairman, committee safe prac- 
tice of nursing, R\a.m.S; member, curricu- 
lum council, RSANS: coordinator, annual 
nursing seminar. RyA.\'S (1971-72, 1972- 
73): member, CNF hoard. 

I believe nursing semce administration 
has the responsibility to create conditions 
so that practicing nurses can work toward 
self-fulfillment by directing their efforts 
toward patient care. 



There is an urgent need for a change in 
philosophy of administration in nursing. 
We must recognize the tremendous poten- 
tial we have in staff nurses. We cannot 
use this potential by controlling it. but 
rather by listening to the practicing nurses 
and supporting them in making the 
changes they see necessary to give them 
the freedom they need to practice. 

I accept this nomination for member- 
at-large. nursing service administration, 
because the Canadian Nurses" Associa- 
tion is the organization through which all 
nurses in Canada can be heard. J 




Xndidatesforme 



/^BISWWaBBI^ 



URSING EDUCA 



Sister Joan Carr. B.Sc.(El.Ed. ). Mount 
Saint Vincent U.. Halifa.x, N.S.; 
B.Sc. Nursing, Mount Saint Vincent Uni- 



versity and Halifax Infirmary: M.S., 
Boston University. 

Present Position: Director, Halifax In- 
firmary school of nursing, Halifax, Nova 
Scotia. 

Association Activities: chairman, nursing 
education committee, Cape Breton- 
Victoria branch, RNANS; provincial 
chairman of nursing education commit- 
tee, RNANS, 1970-72: member of nursing 
education committee at national level. 

To express my rationale in accepting 
nomination for the office of member-at- 
large. nursing education, is to reveal my 
philosophy of nursing and. more pre- 
cisely, my philosophy of nursing educa- 
tion. 



I firmly believe that the nurse, irrespec- 
tive of her immediate position, has a vital 
role — that of service to others. Educa- 
tion is the area of nursing I am engaged in 
at present. It is my conviction that quality 
of nursing care is a goal set early in the 
"learning of nursing." and a goal to be 
aimed at during the practice of nursing. 

I believe that education is an ongoing 
process and that nursing education in the 
70s is a challenge for the student, the 
educator, and the graduate nurse. It is 
evident that nursing needs to be an 
exchange of ideas, aspirations, and tal- 
ents of thinking people. We need to hold 
strong convictions of our beliefs in what 
our role is in the health care system and to 
have the courage of our convictions. My 
concern for nursing has prompted me to 
allow my name to stand for nomination. 




Myrtle E. Crawford. Regina Grey Nuns' 
Hospital: B.S.N., U. of Saskatchewan: 
M.A., Teachers College, Columbia U. 

Present Position: Associate Professor of 
Nursing, University of Saskatchewan, 
Saskatoon, Sask. 

26 THE CANADIAN NURSE 



Association Activities: member of Sas- 
katchewan Registered Nurses' Associa- 
tion council 1960-63, 1965-67: president 
.SRNA 1963-65: board of directors, Cana- 
dian Nurses' Association, 1963-65: 
member of various CNA committees: con- 
sultant to SRNA committee on legislation 
arul bylaws; U. of Saskatchewan Senate, 
1962-68; chairman, advisory committee 
to the nurse-pratitioner program (new 
program to be given by the College of 
Nursing). 

1 am pleased, but also a bit apprehensive, 
to accept the nomination for member-at- 
large for nursing education. This is an 
important and exciting time in the de- 
velopment of nursing as a profession, and 
if one feels strongly about the way in 
which nursing should develop, then one 
should be willing to commit oneself to 
intluence the course of events. However, 
it is also somewhat frightening to take the 



responsibility for recommending future 
courses of action in the field of nursing 
and health care, because there are so 
many conflicting opinions and viewpoints 
regarding the direction we should take. 

The Canadian Nurses" Association, 
representing a large body of health 
workers, should be influential in promot- 
ing improved health care. I feel that I do 
have something to offer at this level and 
at this time, in terms of experience and 
knowledge. 

1 believe that nursing should break new 
ground and should accept additional 
responsibility in the provision of health 
care. Nurses should not wait for events to 
happen or be led by others, but rather 
should be leaders who cause things to 
happen. There is enough diversity within 
nursing that it should be possible to do 
this while continuing to provide the 
nurturing and caring aspects of nursing. 

APRIL 1974 




Denise Lalancette. Hotel Dieu de Gaspe, 
Gaspe. Quebec: B.Sc.N., Marguerite 



d'Youville Institute. Montreal; M.S. 
Nursing, Boston U. 



m 



Present Position: Clinical nurse — mat- 
ernal and child care. U. of Sherbrooke 
Clinic. Sherbrooke. Quebec. 

Association Activities: French-speaking 
co-president, committee on nursing edu- 
cation, .^NPQ; member of CNA committee 
on nursing education; memher-at-large, 
nursing education, Canadian Nurses' 
Association. 

\ believe in the importance of both basic 
and continuing education for nurses, 
especially at a time when we hear so 
much about expanding the role of the 
nurse. 

My purpose in accepting nomination 
for a position 1 have held for the past two 
years is to ensure a continuity (which to 



me seems important) at the level of 
administration of the Canadian Nurses' 
Association. 




Shirley M. Stinson.B.5c. in Nursing, U. of 
.Alberta; M.N. A.. U. of Minnesota; 
Ed.D.. Columbia U.. N.Y. 

Present Position: Joint Appointment: 
Professor. School of Nursing, and Divi- 
sion of Health Services .Administration. 
U. of Alberta; and Graduate Program 
Coordinator. School of Nursing, U . of Al- 
berta. Edmonton. 

Association Activities: chairman. Cana- 
dian Nurse.s' Foundation scholarship 
selections committee. 1971; chairman, 
resolutions session, first national confer- 
ence on nursing research. 1971; chair- 
man. Alberta Association of Registered 
Nurses ad hoc committee on the Alberta 
legislative committee on occupations; 
member, special conference of past pres- 
idents and Canadian Nurses' Association 
committee chairmen to discuss the struc- 
ture and functions of CNA. 1971 ; member. 
CNA special committee on nursing re- 
APRIL 1974 



search; member, health committee for the 
Economic Council of Canada's national 
ecomomic outlook conference. 

I see the main role of the nursing 
education member-at-large as being 
twofold: actively ensuring that the Cana- 
dian Nurses' Association assumes re- 
sponsive and responsible professionnal 
leadership in relation to nursing educa- 
tion matters, and actively ensuring that 
the CNA identifies central nursing educa- 
tion implications of trends within nursing 
and health care delivery in particular, and 
within society in general. 

Some of the central beliefs I would 
bring to the above job are as follows: 
•To me, there are no pat answers to the 
question of what nursing education 
should be. My professional experience 
lies in public health nursing, nursing 
education, hospital nursing service, and 
health care delivery education and re- 
search, and so far as I can see, we have 
needed and will continue to need many 
different kinds of nurses and nursing 
programs. In this light, it is not only 
nonsense but undesirable to think that the 
tenn " "nurse" should mean and be the 
same things to all people. I am less 
concerned with our developing identical 
nursing education and service standards 
across Canada than I am with identifying 
and communicating the similarities and 
differences. 

•The more we are able to envision 
■"nursing education" as being a never- 
ending process rather than an initial 
program, the more realistic and workable 
our approaches to nursing care needs are 
likely to be. We should view the initial 
RN (or BScN) as a life-long p^rwi; to learn. 
rather than as proof that one ""already 
knows enough". 



•To me, the core of nursing is the 
tailor-making of care to people with 
health and/or illness concerns. As 
such, nurses must possess sound scienti- 
fic knowledge; but we must al.so value, 
develop, and uscintuitive knowledge. To 
overemphasize science and under- 
emphasize intuition in nursing is to miss 
the boat: we can't truly "tailor" nursing 
care if we use only the former: yet it is 
equally unsound to use only intuition as, 
used exclusively, it can be misleading and 
dangerous. Nursing education, both 
basic and continuing, should concern 
both intuitive knowledge and hard-nosed 
facts. 

I do not feel that I, or any other one 
member of CNA. have instant answers to 
the complex and varied nursing education 
problems of today: but I feel I can ask 
some of the main questions, questions 
which would, I hope, help the CNA 
formulate sensible policies and take prac- 
tical actions in relation to nursing educa- 
tion in Canada. 



THE CANADIAN NURSE 27 




I 



Joyce Nevitt. B.Sc.N., McMaster U., 
Hamilton, Ont.; M.A., Teachers College, 
Columbia U ., New York. 

Present Position: On sabbatical leave 
from Memorial U. of Newfoundland 
(Assoc. Professor). 



Association Activities: second vice- 
president. Association of Registered 
Nurses of Newfoundland: past president, 
Newfoundland-Labrador branch of the 
Canadian Public Health Association: 
member of several committees and of 
council of ARNN: member, Canadian 
Association on Gerontology. 

I believe the time has come when the 
nursing profession must concentrate on 
patterns of education that will not only 
prepare nurses for immediate service to 
patients, but will also prepare nurses who 
will recognize and accept continuing 
education as a personal responsibility. 

Teac